bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of BASE eConsult Manitoba: patient perspectives on the use of electronic consultation to improve access to specialty advice in Manitoba
Authors: Singer Alexander , Ireland Laurie , Sepehri Zahra , Brown Kelly , Turner Kevin , Liddy Clare , Keely Erin , Oppenheimer Luis
Published: February 2023

Background

The burden of waiting to access specialist expertise may contribute to poorer health outcomes and causes distress for patients and providers. One solution to improve access to specialist care is to use innovative tools such as remote asynchronous electronic consultation (eConsult). Modeled after the Champlain BASE™ (Building Access to Specialist Advice) eConsult service, BASE™ eConsult Manitoba was launched in 2017 to help address long waits for patients to access specialist advice.

Objective

We aimed to evaluate patients’ experiences after obtaining a BASE™ eConsult Manitoba service in their primary care setting.

Methods

Patients whose Primary Care Providers (PCPs) used BASE™ eConsult as part of their care were asked to participate and complete a telephone-based or online 29-question survey between January 2021 and October 2021. The survey questions were created in consultation with patient partners and based on questions asked in studies done in other jurisdictions.

Results

Of the 36 patients who chose to participate, 29 completed the entire survey (80%). Two-thirds (n = 22) agreed that eConsult has been helpful in their situation, and over 80% (n = 24) of participants agreed that eConsult was an acceptable way to access specialist care. During the visit when their PCP sent the eConsult, 7 patients were expecting to be referred to a specialist for a face-to-face consultation. Over half of all respondents (n = 15) reported that before the eConsult occurred, their PCP asked them what questions they wanted to be answered by the specialist. Almost all of these respondents’ questions were fully answered by the eConsult. All of the respondents were satisfied with the experience of receiving an eConsult.

Conclusion

Using eConsult is an acceptable way to improve access to specialist advice from patients’ perspectives. Consideration should be given to expanding the use of eConsult services to improve access to specialist expertise for PCPs and their patients.
Developing tailored intervention strategies for implementation of stratified care to low back pain with physiotherapists in Nigeria: a Delphi study
Authors: Adje Mishael , Steinhäuser Jost , Stevenson Kay , Mbada Chidozie , Alonge Victor , Karstens Sven
Published: February 2023

Background

Stratified care approach involving use of the STarT-Back tool to optimise care for patients with low back pain is gaining widespread attention in western countries. However, adoption and implementation of this approach in low-and-middle-income countries will be restricted by context-specific factors that need to be addressed. This study aimed to develop with physiotherapists, tailored intervention strategies for the implementation of stratified care for patients with low back pain.

Methods

A two-round web-based Delphi survey was conducted among purposively sampled physiotherapists with a minimum of three years of clinical experience, with post-graduation certification or specialists. Thirty statements on barriers and enablers for implementation were extracted from the qualitative phase. Statements were rated by a Delphi panel with additional open-ended feedback. After each Delphi round, participants received feedback which informed their subsequent responses. Additional qualitative feedback were analysed using qualitative content analysis. The criteria for consensus and stability were pre-determined using percentage agreement (≥ 75%), median value (≥ 4), Inter-quartile range (≤ 1), and Wilcoxon matched-pairs test respectively.

Results

Participants in the first round were 139 and 125 of them completed the study, yielding a response rate of 90%. Participants were aged 35.2 (SD6.6) years, and 55 (39.6%) were female. Consensus was achieved in 25/30 statements. Wilcoxon’s test showed stability in responses after the 5 statements failed to reach consensus: ‘translate the STarT-Back Tool topidginlanguage’ 71% (p = 0.76), ‘begin implementation with government hospitals’ 63% (p = 0.11), ‘share knowledge with traditional bone setters’ 35% (p = 0.67), ‘get second opinion on clinician’s advice’ 63% (p = 0.24) and ‘carry out online consultations’ 65% (p = 0.41). Four statements strengthened by additional qualitative data achieved the highest consensus: ‘patient education’ (96%), ‘quality improvement appraisals’ (96%), ‘undergraduate training on psychosocial care’ (96%) and ‘patient-clinician communication’ (95%).

Conclusion

There was concordance of opinion that patients should be educated to correct misplaced expectations and proper time for communication is vital to implementation. This communication should be learned at undergraduate level, and for already qualified clinicians, quality improvement appraisals are key to sustained and effective care. These recommendations provide a framework for future research on monitored implementation of stratified care in middle-income countries.
Views on patient portal use for adolescents in mental health care - a qualitative study
Authors: Nielsen Martine Stecher , Steinsbekk Aslak , Nøst Torunn Hatlen
Published: February 2023

Background

Digitalization of health care has opened up for new ways to involve and engage patients. With this, increased attention has been put on digital patient portals. There exists some research on patient portals for adolescent patients in general and for adults in mental health care. However, no studies on patient portals for adolescents in mental health care have been identified in a recent review. The aim was therefore to explore the views on using patient portals for adolescents in mental health care among persons involved in and/or being affected by the introduction of a patient portal.

Methods

A qualitative study was conducted using individual semi-structured interviews with 14 persons who were healthcare providers in child and adolescent mental health care, young representatives from the user panel, or persons affiliated with an EHR-project introducing a patient portal. The main questions addressed their views on introducing patient portals for adolescents in mental health care and how patient portals and access to clinical notes can affect them and their treatment.

Results

The findings were categorised into four main themes; “Does access to a patient portal help or harm adolescents?”, “Who decides access?”, “Mostly a political goal” and “Need for support and competency”. Informants mentioned situations in which both adolescents’ and parents’ access to a patient portal could help adolescents in mental health care, but also where it could potentially harm their treatment and threaten confidentiality. Most informants thought that healthcare providers should have the autonomy to determine which information should be shared with whom, but also requested guidelines to ensure equal practice and support in difficult situations. Some perceived patient portals as the result of a political decision, rather than healthcare providers´ wishes, while others described it as a necessary development towards democratization.

Conclusion

The informants’ views varied from thinking that a patient portal could support adolescents in mental health care, to worrying that it could be detrimental to the treatment. Informants emphasized that the management should facilitate training and support for healthcare providers in using patient portals and telehealth.
Physicochemical properties of otic products for Canine Otitis Externa: comparative analysis of marketed products
Authors: Song Yunmei , Abdella Sadikalmahdi , Afinjuomo Franklin , Weir Emily Josephine , Tan Jin Quan Eugene , Hill Peter , Page Stephen W. , Garg Sanjay
Published: February 2023

Background

Otitis externa is a commonly diagnosed dermatological disorder in canines. The pathogens primarily involved in canine otitis externa (COE) include Staphylococcus pseudintermedius, Pseudomonas aeruginosa, Proteus mirabilis, and Malassezia pachydermatis. As COE tends to be superficial, medications delivered topically are often effective and practical in managing the condition. As such, there is a wide variety of approved topical products currently available in the market. The efficacy of topical dosage forms can be dependent on various factors such as the pharmacology of active constituents and the physicochemical properties of the formulation, including pH, viscosity, spreadability, and bio-adhesion. Currently, there is a lack of published literature available on the optimal properties of topical COE products. In this study, we compared the physicochemical properties of nine commercially available otic veterinarian products in Australia used clinically to manage COE.

Results

Based on our comparative analysis, the pH (6.26 ± 0.04) of an aqueous-based product was similar to a healthy dog’s external auditory canal. Products containing polymers exhibited higher viscosity and bio-adhesion. Spreadability was inversely related to viscosity and Osurnia ® a product with high viscosity demonstrated the lowest spreadability. Aqueous-based otic products showed better syringebility whereas oil-based systems required higher force to expel the products. Variability in droplet size was noted. Derm Otic, Baytril Otic, and Aurizon Ear Drops had the lower standard deviation which indicates they would give a more consistent dose.

Conclusions

Findings from this work provide considerations for industry researchers or formulation scientists working in the area of otic dosage formulations.
Clinical characterization of Lamb-Shaffer syndrome: a case report and literature review
Authors: Zhu Guo-qing , Dong Ping , Li Dong-yun , Hu Chun-chun , Li Hui-ping , Lu Ping , Pan Xue-xia , He Lin-lin , Xu Xiu , Xu Qiong
Published: February 2023

Background

Lamb-Shaffer syndrome (LAMSHF, MIM 616,803) is a rare neurodevelopmental disorder due to haploinsufficiency of SOX5. Furthermore, studies about the clinical features of LAMSHF patients with same allele of c.1477C > T (p. R493*) are very limited.

Case presentation

We analyzed the phenotypes of one of our cases and two previously reported cases with c.1477C > T (p. R493*), and reviewed the correlating literature. A de novo heterozygous variation c.1477C > T (p. R493*) in SOX5 was identified in a 4 years and 2 months old boy with global development delay by trio-based whole exome sequencing. We compared our case and previously 2 cases reported with recurrent variation, the overlapping clinical features are global developmental delay or intellectual disability, language delay and scoliosis, but their other clinical characteristics are different.

Conclusions

This study suggests that the clinical features of LAMSHF patients with recurrent variations in the SOX5 gene are different. It is suggested that the LAMSHF-related SOX5 gene should be screened and included as one of the candidate genes for neurodevelopmental disorders of unknown etiology.
Laboratory-based efficacy evaluation of Bacillus thuringiensis var. israelensis and temephos larvicides against larvae of Anopheles stephensi in ethiopia
Authors: Teshome Abebe , Erko Berhanu , Golassa Lemu , Yohannes Gedeon , Irish Seth R. , Zohdy Sarah , Dugassa Sisay
Published: February 2023

Background

Malaria, transmitted by the bite of infective female Anopheles mosquitoes, remains a global public health problem. The presence of an invasive Anopheles stephensi, capable of transmitting Plasmodium vivax and Plasmodium falciparum parasites was first reported in Ethiopia in 2016. The ecology of An. stephensi is different from that of Anopheles arabiensis, the primary Ethiopian malaria vector, and this suggests that alternative control strategies may be necessary. Larviciding may be an effective alternative strategy, but there is limited information on the susceptibility of Ethiopian An. stephensi to common larvicides. This study aimed to evaluate the efficacy of temephos and Bacillus thuringiensis var. israelensis (Bti) larvicides against larvae of invasive An. stephensi.

Methods

The diagnostic doses of two larvicides, temephos (0.25 ml/l) and Bti (0.05 mg/l) were tested in the laboratory against the immature stages (late third to early fourth stages larvae) of An. stephensi collected from the field and reared in a bio-secure insectary. Larvae were collected from two sites (Haro Adi and Awash Subuh Kilo). For each site, three hundred larvae were tested against each insecticide (as well as an untreated control), in batches of 25. The data from all replicates were pooled and descriptive statistics prepared.

Results

The mortality of larvae exposed to temephos was 100% for both sites. Mortality to Bti was 99.7% at Awash and 100% at Haro Adi site.

Conclusions

Larvae of An. stephensi are susceptible to temephos and Bti larvicides suggesting that larviciding with these insecticides through vector control programmes may be effective against An. stephensi in these localities.
Protective effect of spore oil-functionalized nano-selenium system on cisplatin-induced nephrotoxicity by regulating oxidative stress-mediated pathways and activating immune response
Authors: Liu Chaofan , Zhou Sajin , Lai Haoqiang , Shi Lei , Bai Weibin , Li Xiaoling
Published: February 2023

In clinical practice, cisplatin is the most commonly used chemotherapy drug to treat a range of malignancies. Severe ROS-regulated nephrotoxicity, however, restricts its applicability. Currently, the main mechanisms leading to cisplatin-induced nephrotoxicity in clinical settings involve hydration or diuresis. However, not all patients can be treated with massive hydration or diuretics. Therefore, it is crucial to develop a treatment modality that can effectively reduce nephrotoxicity through a foodborne route. Selenium has been reported to have strong antioxidant as well as anticancer effects when administered as spore oil. Herein, we established cellular and animal models of cisplatin-induced nephrotoxicity and synthesized spore oil-functionalized nano-selenium (GLSO@SeNPs). We found that GLSO@SeNPs inhibit the mitochondrial apoptotic pathway by maintaining oxidative homeostasis and regulating related signaling pathways (the MAPK, caspase, and AKT signaling pathways). In vivo, GLSO@SeNPs could effectively improve cisplatin-induced renal impairment, effectively maintaining oxidative homeostasis in renal tissues and thus inhibiting the process of renal injury. In addition, GLSO@SeNPs were converted into selenocysteine (SeCys2), which may exert protective effects. Furthermore, GLSO@SeNPs could effectively modulate the ratio of immune cells in kidneys and spleen, reducing the proportions of CD3+CD4+ T cells, CD3+CD8+ T cells, and M1 phenotype macrophages and increasing the proportion of anti-inflammatory regulatory T cells. In summary, in this study, we synthesized food-derived spore oil-functionalized nanomaterials, and we explored the mechanisms by which GLSO@SeNPs inhibit cisplatin-induced nephrotoxicity. Our study provides a basis and rationale for the inhibition of cisplatin-induced nephrotoxicity by food-derived nutrients.
Contralateral lymph node metastasis in recurrent ipsilateral breast cancer with Lynch syndrome: a locoregional event
Authors: Zwimpfer Tibor A. , Schwab Fabienne D. , Steffens Daniel , Kaul Felix , Schmidt Noemi , Geiger James , Geissler Franziska , Heinzelmann-Schwarz Viola , Weber Walter P. , Kurzeder Christian
Published: February 2023

Introduction

Contralateral axillary lymph node metastasis (CALNM) in breast cancer (BC) is considered a distant metastasis, marking stage 4cancer. Therefore, it is generally treated as an incurable disease. However, in clinical practice, staging and treatment remain controversial due to a paucity of data, and the St. Gallen 2021 consensus panel recommended a curative approach in patients with oligometastatic disease. Aberrant lymph node (LN) drainage following previous surgery or radiotherapy is common. Therefore, CALNM may be considered a regional event rather than systemic disease, and a re-sentinel procedure aided by lymphoscintigraphy permits adequate regional staging.

Case report

Here, we report a 37-year-old patient with Lynch syndrome who presented with CALNM in an ipsilateral relapse of a moderately differentiated invasive ductal BC (ER 90%, PR 30%, HER2 negative, Ki-67 25%, microsatellite stable), 3 years after the initial diagnosis. Lymphoscintigraphy detected a positive sentinel LN in the contralateral axilla despite no sign of LN involvement or distant metastases on FDG PET/CT or MRI. The patient underwent bilateral mastectomy with sentinel node dissection, surgical reconstruction with histological confirmation of the CALNM, left axillary dissection, adjuvant chemotherapy, and anti-hormone therapy. In addition to her regular BC follow-up visits, the patient will undergo annual colonoscopy, gastroscopy, abdominal, and vaginal ultrasound screening. In January 2023, the patient was free of progression for 23 months after initiation of treatment for recurrent BC and CALNM.

Conclusion

This case highlights the value of delayed lymphoscintigraphy and the contribution of sentinel procedure for local control in the setting of recurrent BC. Aberrant lymph node drainage following previous surgery may be the underlying cause of CALNM. We propose that CALNM without evidence of systemic metastasis should be considered a regional event in recurrent BC, and thus, a curative approach can be pursued. The next AJCC BC staging should clarify the role of CALNM in recurrent BC to allow for the development of specific treatment guidelines.
New insights on partial trisomy 3q syndrome: de novo 3q27.1-q29 duplication in a newborn with pre and postnatal overgrowth and assisted reproductive conception
Authors: Serra Gregorio , Antona Vincenzo , Cimador Marcello , Collodoro Giorgia , Guida Marco , Piro Ettore , Schierz Ingrid Anne Mandy , Verde Vincenzo , Giuffrè Mario , Corsello Giovanni
Published: February 2023

Background

Duplications of the long arm of chromosome 3 are rare, and associated to a well-defined contiguous gene syndrome known as partial trisomy 3q syndrome. It has been first described in 1966 by Falek et al., and since then around 100 patients have been reported. Clinical manifestations include characteristic facial dysmorphic features, microcephaly, hirsutism, congenital heart disease, genitourinary anomalies, hand and feet abnormalities, growth disturbances and intellectual disability. Most of cases are due to unbalanced translocations, inherited from a parent carrying a balanced aberration (reciprocal translocation or inversion), and rarely the genomic anomaly arises de novo. Very few studies report on the prenatal identification of such rearrangements.

Case presentation

Hereby, we report on a newborn with a rare pure duplication of the long arm of chromosome 3. Noninvasive prenatal test (cell free fetal DNA analysis on maternal blood), performed for advanced parental age and use of assisted reproductive technique, evidenced a partial 3q trisomy. Then, invasive cytogenetic (standard and molecular) investigations, carried out through amniocentesis, confirmed and defined a 3q27.1-q29 duplication spanning 10.9 Mb, and including about 80 genes. Our patient showed clinical findings (typical facial dysmorphic features, esotropia, short neck, atrial septal defect, hepatomegaly, mild motor delay) compatible with partial trisomy 3q syndrome diagnosis, in addition to pre- and postnatal overgrowth.

Conclusions

Advanced parental age increases the probability of chromosomal and/or genomic anomalies, while ART that of epigenomic defects. Both conditions, thus, deserve more careful prenatal monitoring and screening/diagnostic investigations. Among the latter, cell free fetal DNA testing can detect large segmental aneuploidies, along with chromosomal abnormalities. It identified in our patient a wide 3q rearrangement, then confirmed and defined through invasive molecular cytogenetic analysis. Neonatologists and pediatricians must be aware of the potential risks associated to duplication syndromes. Therefore, they should offer to affected subjects an adequate management and early and careful follow-up. These may be able to guarantee to patients satisfactory growth and development profiles, prevent and/or limit neurodevelopmental disorders, and timely recognition of complications.
Pervasiveness of HLA allele-specific expression loss across tumor types
Authors: Filip Ioan , Wang Anqi , Kravets Oleksandr , Orenbuch Rose , Zhao Junfei , Perea-Chamblee Tomin E. , Manji Gulam A. , López de Maturana Evangelina , Malats Núria , Olive Kenneth P. , Rabadan Raul
Published: February 2023

Background

Efficient presentation of mutant peptide fragments by the human leukocyte antigen class I (HLA-I) genes is necessary for immune-mediated killing of cancer cells. According to recent reports, patient HLA-I genotypes can impact the efficacy of cancer immunotherapy, and the somatic loss of HLA-I heterozygosity has been established as a factor in immune evasion. While global deregulated expression of HLA-I has also been reported in different tumor types, the role of HLA-I allele-specific expression loss — that is, the preferential RNA expression loss of specific HLA-I alleles — has not been fully characterized in cancer.

Methods

Here, we use RNA and whole-exome sequencing data to quantify HLA-I allele-specific expression (ASE) in cancer using our novel method arcasHLA-quant.

Results

We show that HLA-I ASE loss in at least one of the three HLA-I genes is a pervasive phenomenon across TCGA tumor types. In pancreatic adenocarcinoma, tumor-specific HLA-I ASE loss is associated with decreased overall survival specifically in the basal-like subtype, a finding that we validated in an independent cohort through laser-capture microdissection. Additionally, we show that HLA-I ASE loss is associated with poor immunotherapy outcomes in metastatic melanoma through retrospective analyses.

Conclusions

Together, our results highlight the prevalence of HLA-I ASE loss and provide initial evidence of its clinical significance in cancer prognosis and immunotherapy treatment.
Hashimoto’s thyroiditis increases the risk of new-onset systemic lupus erythematosus: a nationwide population-based cohort study
Authors: Lin Hong-Ci , Chang Hsu-Min , Hung Yao-Min , Chang Renin , Chen Hsin-Hua , Wei James Cheng-Chung
Published: February 2023

Background

Previous studies have shown systemic lupus erythematosus (SLE) patients had a significantly higher prevalence of thyroid diseases and hypothyroidism than matched controls, and some case reports showed SLE may occur after Hashimoto’s thyroiditis (HT).

Objective

This study aimed to investigate the subsequent risk of SLE in patients with HT.

Methods

In this retrospective cohort study done by the Taiwan National Health Insurance Research Database, the HT group (exposure group) and the non-HT group (comparator group) were propensity score matched at a ratio of 1:2 by demographic data, comorbidities, medications, and the index date. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Several sensitivity analyses were done for cross-validation of our findings.

Results

We identified 15,512 HT patients and matched 31,024 individuals. The incidence rate ratio of SLE was 3.58 (95% CI, 2.43–5.28; p < 0.01). Several sensitivity analyses show adjusted hazard ratio (aHR) (CIs) of 4.35 (3.28–5.76), 4.39 (3.31–5.82), 5.11 (3.75–6.98), and 4.70 (3.46–6.38), consistent with the results of the main model.

Conclusion

Our study showed an increased risk of SLE in the HT group after adjustment for baseline characteristics, comorbidities, and medical confounders compared with the reference group.
Cardiac tamponade during venoarterial extracorporeal membrane oxygenation: a case report
Authors: Adriaansen E. J. M. , Hermens J. A. J. , Broome M. , Pladet L. , Dubois E. , Donker D. W. , Meuwese C. L.
Published: February 2023

Background

Cardiac tamponade may present with very different signs and clinical consequences in patients who are supported with venoarterial extracorporeal membrane oxygenation. Failure to recognize cardiac tamponade in this setting can cause failure to wean from venoarterial extracorporeal membrane oxygenation, and even lead to death.

Case presentation

We present a 44-year-old Caucasian female in whom cardiac tamponade manifested as venoarterial extracorporeal membrane oxygenation weaning failure. After discovering the contribution of cardiac tamponade, it was possible to wean the patient from venoarterial extracorporeal membrane oxygenation support. No clear signs of cardiac tamponade had existed beforehand.

Conclusions

The diagnosis of cardiac tamponade can be very challenging in venoarterial extracorporeal membrane oxygenation supported patients due to (patho)physiological particularities related to the parallel blood flow.
Triple-tyrosine kinase inhibition by BIBF1000 attenuates airway and pulmonary arterial remodeling following chronic allergen challenges in mice
Authors: Gurusamy Malarvizhi , Nasseri Saeed , Rampa Dileep Reddy , Feng Huiying , Lee Dongwon , Pekcec Anton , Doods Henri , Wu Dongmei
Published: February 2023

Background

Airway remodeling is an important pathological feature of chronic airway diseases, which leads to a progressive decline in lung function. The present study examined the anti-remodeling and anti- inflammatory effect of BIBF1000, a triple-tyrosine kinase inhibitor that targets VEGF, PDGF, and FGF receptor signaling in a mouse model of repeated ovalbumin (OVA) challenges.

Methods

Female Balb-c mice were immunized intraperitoneally on days 0 and 12 with 50 µg ovalbumin plus 1 mg of Al(OH)3 in 200 μl saline. Intranasal OVA challenges (20 µg/50 µl in PBS) were administered on days 26, 29, and 31, and were repeated twice a week for 3 months. Animals received vehicle or BIBF1000 (25 mg/kg, b.i.d.) through gavage from day 26 to the end of fourth month. On day 120, bronchoalveolar lavage (BAL) and lung tissue were collected for biochemical and immunohistological analysis.

Results

Compared to vehicle controls, treatment with BIBF1000 reduced the numbers of BAL eosinophils, macrophages, neutrophils, and lymphocytes by 70.0%, 57.9%, 47.5%, and 63.0%, respectively, and reduced IL-5 and IL-13 in BAL. Treatment with BIBF1000 reduced airway mucus secretion, peribronchial fibrosis, small airway, and pulmonary arterial wall thickness, compared to vehicle controls. Furthermore, treatment with BIBF1000 also reduced the expression of inflammatory mediators (TNF-α, IL-1β, IL-5, IL-13, MMP-2, MMP-9, COX-2, and iNOS) and inhibited ERK and AKT phosphorylation.

Conclusions

The protective effect afforded by triple-tyrosine kinase inhibition with BIBF1000 in reducing allergen-induced airway and arterial remodeling was associated with down-regulation of inflammatory mediators, as well as inhibition of ERK and AKT signaling pathways.
Not all engaged students are alike: patterns of engagement and burnout among elementary students using a person-centered approach
Authors: Yang Dong , Cai Zhenyu , Wang Chaoyi , Zhang Chen , Chen Peng , Huang Ronghuai
Published: February 2023

Due to its potential to address low achievement, high dropout rates, and misbehavior among students, school engagement has become an important topic in contemporary developmental psychology and educational research. Although there is a wealth of literature on the causes and effects of student engagement, the current understanding of how student engagement varies in response to different teaching styles is limited. This study examined the engagement and burnout profiles of elementary school pupils (N = 798; 51% females; Mage = 11.54, SDage = 0.72) and the interactions between those profiles, students’ characteristics and their perceptions of instructional behaviors (e.g., supporting criticism, suppressing criticism & independent viewpoints, intruding). Latent profile analysis revealed five types of profiles: moderately burned out, slightly burned out, moderately engaged, highly engaged, and highly burned out. Follow-up logistic regression analysis found that students clustered into engagement groups were likely to report higher autonomy support from teachers, especially when teachers permit criticism and independent thinking from students. In contrast, students clustered into burned out profiles were more likely to rate teacher strategies as autonomy suppressive. This became more obvious when instructors imposed meaningless and uninteresting activities. Taken together, this study indicated that autonomy-supportive teaching behaviors are pivotal in understanding student engagement and school burnout. The significance of the findings was addressed, along with implications and limitations.
Including the child’s voice in research from a longitudinal birth cohort: insights from the ROLO young person’s advisory group
Authors: Delahunt Anna , Callanan Sophie , Killeen Sarah Louise , McDonnell Ciara M. , McAuliffe Fionnuala M.
Published: February 2023

Background

Public and patient involvement (PPI) through Young Person’s Advisory Groups (YPAG) enables children to provide guidance and insight into research activities. PPI is an important characteristic of research, however, to date, most collaboration has been with adults. Also, few YPAGs have been established within the Irish setting. The ROLO (Randomised cOntrol trial of a LOw glycaemic index diet in pregnancy to prevent macrosomia) YPAG was established in July 2020 to identify the research priorities of a group of healthy Irish children who are part of a longitudinal birth cohort. We aimed to describe this process and the key insights to date.

Methods

The ROLO study is a longitudinal birth cohort which has followed-up mother–child dyads at multiple timepoints over 10 years. Mothers actively involved in the study were contacted by the research team to invite their ROLO child and older sibling to participate in the YPAG. Meetings were conducted virtually between July 2020 and February 2022. Researchers encouraged free expression of views amongst the children regarding their research interests. Meetings were recorded, transcribed verbatim and analysed for themes based on the topics most frequently discussed and considered important to participants.

Results

In all, seven ROLO children and six older siblings attended four ROLO YPAG meetings. Participants were aged between nine to fifteen years old. Four key themes were identified; study children viewed their identity as part of a longitudinal birth cohort as positive and unique; study children considered the fitness test and body measurements as fun aspects related to their participation; all children considered the impact and use of social media as an important form of communication; and all participants expressed interest in attaining new health-related information and learning opportunities. Children suggested topics such as mental health, future viruses, organ transplants, cancer, and the effect of technology and chemicals on the body were important for future research.

Conclusion

The ROLO YPAG offers promising scope for continued collaboration. The themes identified from the meetings contribute to a gap in the literature which will guide future research activities, particularly with children, in view of study design, relevance, and by communication strategies.

Trial Details: ISRCTN54392969 registered at www.isrctn.com.
Drowsiness following ondansetron given the day after general anesthesia for postoperative nausea: a pediatric case report
Authors: Furuta Machiko , Miyasaka Kiyoyuki , Suzuki Yasuyuki
Published: February 2023

Background

Ondansetron is an antiemetic drug that is useful not only for prevention but also for the treatment of postoperative nausea and vomiting (PONV). We report a rare case of drowsiness in a child after using ondansetron for nausea on the day after general anesthesia.

Case presentation

A 5-year-old boy underwent circumcision under general anesthesia and suffered from postoperative nausea and vomiting. He was administered 0.1mg/kg of ondansetron in the PACU and 23 h later on the day after surgery. After the second dose, he acutely exhibited drowsiness which resolved in 3 h. He was discharged to home later on the same day. He was not given any other drugs at the time, and the drowsiness was thought to be directly attributable to ondansetron, though the exact mechanism was unknown.

Conclusions

When drowsiness or other cognitive symptoms are observed after administration of ondansetron, it must be considered and managed as a possible side effect.
Right ventricle speckle tracking in bronchopulmonary dysplasia: one-year follow-up
Authors: Clavero-Adell Marcos , Palanca-Arias Daniel , López-Ramón Marta , Jimenez-Montañés Lorenzo , Serrano-Viñuales Itziar , Rite-Gracia Segundo , Ayerza-Casas Ariadna
Published: February 2023

Background

Bronchopulmonary dysplasia (BPD) is still a major concern in preterm infants and adequate screening methods for secondary right ventricle (RV) failure are needed. Early detection could be aided by taking measurements of RV deformation using speckle tracking echocardiography. A prospective longitudinal study was carried out over 28 months at a tertiary care pediatric cardiology center. Preterm infants < 32 weeks gestational age (GA) were eligible for the study. Enrolled patients were separated in two groups: NO-BPD or BPD. At three timepoints over the first year of life, echocardiogram measurements were performed. Right ventricle strain was studied using speckle tracking analysis and compared to conventional function parameters.

Results

Fifty patients were enrolled in the study, 22 in the NO-BPD group and 28 in the BPD group. RV strain showed no statistical differences between groups. However, the BPD group showed worse RV function than the NO-BPD group, using speckle tracking analysis and other conventional parameters. During the study follow-up, an improvement trend is shown in RV strain.

Conclusions

RV longitudinal strain and strain rate derived by speckle tracking is feasible in preterm infants. Although there seems to be a good correlation between RV strain and BPD severity, the results of this study were not conclusive. More studies should be carried out to investigate the optimum echocardiographic screening model of RV dysfunction in BPD patients.
An alternative anatomical classification for carotid bifurcation and impact on outcome of carotid endarterectomy: a multicenter study
Authors: Kazantsev Anton N. , Korotkikh Alexander V. , Lider Roman Yu. , Lebedev Oleg V. , Sirotkin Alexey A. , Palagin Petr D. , Mukhtorov Otabek Sh. , Shmatov Dmitriy V. , Sergey Artyukhov , Kazantseva Elizaveta G. , Bagdavadze Goderzi Sh. , Wang Shuowen , Roshkovskaya Ludmila V. , Khetagurov Mikhail A. , Unguryan Vladimir M. , Chernyavin Maxim P. , Nonye Okenu Gloria , Belov Yuri V.
Published: February 2023

Background

The present multicenter retrospective study included 7148 patients who underwent carotid endarterectomy (CEA) between 2010 and 2021. Based on the results of angiography (AG)/multislice computed tomography (MSCT) angiography, 3 types of carotid bifurcation were identified depending on the projection of the carotid sinus to the cervical vertebrae: type I (high)—from the upper edge of the body of the II cervical vertebra to the lower edge of intervertebral disc located between III and IV cervical vertebrae; type II (medium)—from the upper edge of the body of the IV cervical vertebra to the lower edge of the body of the V cervical vertebra; and type III (low)—from the upper edge of the intervertebral disc located between the V and VI cervical vertebrae to the lower edge of the body of the VII cervical vertebra.

Purpose of the study

To develop a new classification of the types (high, medium, low) of carotid bifurcations (based on the level of cervical vertebrae) with analysis of the results of CEA depending on the type.

Results

The largest number of ischemic strokes (n = 15; 1.1%; p = 0.0001) was found in type I (high) bifurcation of the carotid artery. The majority of bleedings of type 3b and higher according to the BARC scale with the formation of acute hematomas in the intervention area (n = 14; 1.2%; p = 0.0029) were recorded in type III carotid bifurcation (low).

Conclusions

Type II (medium) carotid bifurcation may be the most preferred for CEA.
Reverse End-to-Side Transfer to Ulnar Motor Nerve: Evidence From Preclinical and Clinical Studies
Authors: Pathiyil Rajesh Krishna , Alzahrani Saud , Midha Rajiv
Published: February 2023

The disappointing outcomes of conventional nerve repair or grafting procedures for proximal ulnar nerve injuries have led the scientific community to search for better alternatives. The pronator quadratus branch of the anterior interosseous nerve has been transferred to the distal ulnar motor branch in a reverse end-to-side fashion with encouraging results. This transfer is now becoming commonly used as an adjunct to cubital tunnel decompression in patients with compressive ulnar neuropathy, underscoring the need for this knowledge transfer to the neurosurgical community. However, the mechanism of recovery after these transfers is not understood completely. We have reviewed the existing preclinical and clinical literature relevant to this transfer to summarize the current level of understanding of the underlying mechanisms, define the indications for performing this transfer in the clinic, and identify the complications and best practices with respect to the operative technique. We have also attempted to identify the major deficiencies in our current level of understanding of the recovery process to propose directions for future research.
Stent-Assisted Coil Embolization Versus Flow-Diverting Stent in Unruptured Vertebral Artery Dissecting Aneurysms: Efficacy and Safety Comparison
Authors: Oh Han San , Bae Jin Woo , Hong Chang-eui , Kim Kang Min , Yoo Dong Hyun , Kang Hyun-Seung , Cho Young Dae
Published: February 2023

BACKGROUND:

Reconstructive strategies for unruptured vertebral artery dissecting aneurysms (VADAs) have increasingly relied on newly developed endovascular devices. However, their clinical performance metrics are seldom reported.

OBJECTIVE:

To compare stent-assisted coil embolization (SACE) and flow-diverting stent (FDS) deployment as treatments for unruptured VADAs, focusing on efficacy and safety.

METHODS:

A total of 72 VADAs were submitted to SACE (n = 48) or FDS (n = 24) between April 2009 and September 2021. We reviewed medical records and radiological data to assess efficacy and safety outcomes by method, building an inverse probability of treatment-weighted (IPTW) logistic regression model and conducting survival analyses.

RESULTS:

Ultimately, 24 aneurysms (33.3%) showed signs of recanalization (major, 14; minor, 10) at 6-month follow-up. Initially determined 6-month rates of overall (SACE, 31.2%; FDS, 41.7%) and major (SACE, 20.8%; FDS, 16.7%) recanalization did not differ significantly by modality; but in the IPTW logistic regression model, adjusted for aneurysm morphology, major recanalization at 6 months was lower for the FDS (vs SACE) subset (odds ratio = 0.196; P = .027). Likewise, the cumulative rate of major recanalization was more favorable for the FDS (vs SACE) subset (hazard ratio = 0.291; P = .048) in IPTW Cox proportional hazards model adjusted for aneurysm morphology. Modality-based assessments of procedural and delayed complications were similar.

CONCLUSION:

Both reconstructive VADA interventions are safe and effective by adjusting treatment modality depending on the angioanatomic configuration. However, follow-up data after treatment proved more favorable for FDS deployment than for SACE in limiting major recanalization. Case-controlled studies of more sizeable cohorts are needed for corroboration.
Size-Dependent Oscillation in Optical Spectra from Fly Ash Cenospheres: Particle Sizing Using Darkfield Hyperspectral Interferometry
Authors: Beach James M , Kryuchkova Marina , Fakhrullin Ramil , Mazurova Kristina , Stavitskaya Anna , Cheatham Byron J , Fakhrullin Rawil
Published: February 2023

Fly ash by-products are emerging biocompatible fillers for a number of construction materials. The value of fly ash as a filler is higher if the content of hollow cenospheres is increased. Here we describe a new method for detection and sizing of fly ash spheres based on darkfield microscopy with hyperspectral image capture to perform white light interferometry. Our method is cost-effective and can provide rapid means for evaluating cenosphere content during the enrichment process. We show that fly ash cenospheres produce a strong oscillation over wavelength in optical recordings. The phenomenon is easiest to observe using microscope imaging techniques that preserve both spatial and spectral information. Frequency is observed to increase in direct proportion to the sphere diameter. The oscillation appears in light recorded from any focal plane on the sphere which indicates that the entire sphere is involved in sustaining the signal, making the detection of cenospheres of different size and displacement within a recording volume productive. There is no oscillation from nonspherical particles of fly ash or other material, so this detection method is highly selective for the cenospheres.
Μια ειδική περίπτωση ορθογράφησης: Το ρ στα όρια των μορφημάτων
Authors: Σέργης Γιώργος Γρηγόριος
Published: February 2023

Στην παρούσα εργασία πραγματευόμαστε μια ειδική περίπτωση ορθογράφησης που αποτελεί ένα αμφιλεγόμενο σημείο της νεοελληνικής ορθογραφίας, αφού η σχολική Γραμματική δεν έχει συμπεριλάβει στις ρυθμίσεις της όλες εκείνες τις περιπτώσεις των νεότερων σύνθετων λέξεων που πρέπει να γραφούν με διπλό ή μονό ρ στα όρια των μορφημάτων τους, π.χ. ηχορύπανση ή ηχορρύπανση, ταχύρυθμος ή ταχύρρυθμος. Θέλοντας να εξετάσουμε τις πρακτικές που ακολουθούνται σήμερα για αυτή την κατηγορία συνθέτων, ανατρέξαμε σε σύγχρονα νεοελληνικά λεξικά, ώστε να διαπιστώσουμε τις ορθογραφικές τους επιλογές αλλά και τις προτάσεις τους, που απορρέουν μέσα από αυτές. Ταυτόχρονα, πραγματοποιήσαμε μικρή έρευνα στο Διαδίκτυο, ώστε να ελέγξουμε τα κριτήρια ορθογράφησης των χρηστών της ελληνικής για τα σύνθετα που εξετάζουμε. Τέλος, γίνεται προσπάθεια εξαγωγής ασφαλών συμπερασμάτων σχετικά με τη λύση που θα μπορούσε να υιοθετηθεί ώστε να λυθεί το συγκεκριμένο ορθογραφικό πρόβλημα.
Παρεμβατικό Εκπαιδευτικό Πλαίσιο Διαχείρισης Ειδικών Μαθησιακών Δυσκολιών
Authors: Καλιότσου Ισιδώρα , Κουγιουμτζής Γιώργος Α. , Φελλά Αργυρώ , Σοφολόγη Μαρία , Μπόντη Ελένη , Παπαντωνίου Γεωργία
Published: February 2023

Κατά τη διάρκεια των τριών τελευταίων δεκαετιών, το ενδιαφέρον των εκπαιδευτικών και γονιών έχει εστιαστεί στις δυσκολίες μάθησης που αντιμετωπίζουν τα παιδιά στο σχολείο. Ένας σημαντικός αριθμός μαθητών και μαθητριών αποτυγχάνει συστηματικά, καθώς στερείται έγκαιρης ανίχνευσης των μαθησιακών δυσκολιών ή αποτελεσματικής παρέμβασης. Στο παρόν κείμενο εξετάζεται ένας μαθητής μέσα σε ένα γενικότερο πλαίσιο, με παράθεση πληροφοριών που αφορούν στην πρώτη παιδική ηλικία, λαμβάνοντας υπόψη παραμέτρους, όπως το οικογενειακό, σχολικό και κοινωνικό περιβάλλον. Ακολούθως, αναφέρονται αναλυτικά οι δυσκολίες του σε πρακτικό επίπεδο, καθώς και οι τρόποι αντιμετώπισής τους, μέσα από την εφαρμογή ενός εξατομικευμένου προγράμματος παρέμβασης, που ανταποκρίνεται εστιασμένα στις ανάγκες του συγκεκριμένου μαθητή. Τέλος, παρατίθενται στοιχεία για την ανάπτυξη συνεργασίας με τους γονείς, καθώς και με φορείς-δομές που ενισχύουν τη δυνατότητα παρέμβασης.
Η εκπαίδευση στην περιοχή του Νομού Έβρου: το παράδειγμα της Ορεστιάδας την περίοδο 1920-1940
Authors: Καλιούνη Ελένη
Published: February 2023

Ο σκοπός της παρούσας εργασίας είναι να εξετάσει τα στοιχεία τα οποία μπορούν να αποτυπώσουν με σαφήνεια την εκπαιδευτική κατάσταση η οποία επικρατούσε στην Ορεστιάδα την περίοδο 1920-1940. Πιο συγκεκριμένα, αυτή η εργασία, μελετά δεδομένα τα οποία προκύπτουν από τα μαθητολόγια των σχολείων την περίοδο εκείνη. Μέσα από την έρευνα παρατηρήθηκε ότι το σύνολο των εγγραφέντων και των φοιτησάντων αγοριών και κοριτσιών ήταν σχεδόν ίδιο. Ένα άλλο σημείο άξιο αναφοράς ήταν η έντονη στασιμότητα που παρατηρήθηκε στην πρώτη τάξη. Ένα εξίσου σημαντικό τμήμα αυτού του άρθρου αποτελεί και η αναφορά στα επαγγέλματα με τα οποία ασχολούνταν οι γηγενείς. Καταληκτικά θα αναφερθούμε στα στοιχεία που συλλέξαμε μέσα από τα Γενικά Αρχεία του Κράτους του Νομού Έβρου, τα οποία μας βοήθησαν να δημιουργήσουμε μια πιο ολοκληρωμένη εικόνα για την εκπαίδευση της περιόδου. Για παράδειγμα υπήρχαν αναφορές για ίδρυση ομάδας προσκόπων, επίσης το έτος 1938 λειτουργούσε συσσίτιο, το οποίο εκτός από τους άπορους μαθητές ήταν και για τους φτωχούς και άνεργους κατοίκους της Ορεστιάδας.
El traslado del cuerpo de Santiago el Mayor
Authors: Leyra Faraldo Ángel María , Leyra Curiá Montse
Published: February 2023

Sobre la predicación del Evangelio por Santiago el Mayor en España existe bastante documentación extra-hispánica. Existen también documentos de origen hispano sobre dicha evangelización. En cambio, la tradición sobre el traslado del cuerpo del apóstol desde Tierra Santa a Galicia cuenta con escasa documentación.
Los escritos más antiguos sobre la venida del apóstol a España son dos martirologios redactados en Lyon: el de Floro, escrito entre 808 y 838, y el de Adón, escrito entre 850 y 860. El primero en España que precisa algo sobre este traslado es el rey Alfonso III en un escrito del año 906. Uno de los relatos medievales más importantes sobre este traslado figura en La historia compostelana o hechos de Gelmírez, escrito entre 1100 y 1139 en vida del arzobispo Diego Gelmírez: La historia compostelana o los Hechos de Gelmirez. Algunos historiadores de la Iglesia consideran más verosímil que haya habido dos o tres traslados diferentes.
En una conferencia sobre la tumba apostólica de Santiago a la luz de las excavaciones recientes, el profesor de arqueología cristiana P. E. Kirschbaum, S. J., afirmó que la traslación de un cuerpo en época romana desde Palestina hasta el último ángulo de la tierra conocida entonces no contradice lo que se conoce de las tradiciones sobre traslados de cuerpos de otros personajes célebres en la Antigüedad como el de Moisés, Alejandro Magno o S. Esteban.
Facta est Maria fenestra coeli
Authors: Salvador-Gonzalez José María
Published: February 2023

This article aims to iconographically interpret the doctrinal meanings of the divine ray of light passing through a window in images of the Annunciation from the 14th and 15th centuries. To achieve this purpose, I analyze firstly a large corpus of texts by which numerous Church Fathers, theologians, and medieval hymnographers decipher several metaphors alluding to “light,” “Sun,” “star,” “window,” “door,” “crystal,” and other similar expressions referring to luminous phenomena. The next stage is the analysis of twelve images of the Annunciation that include this ray of light passing through a window. I complement this last analysis with some criticism of several unjustified “interpretations” made by some art historians and iconographers. The comparative analysis and the essential interrelation of these texts and these images help to justify the validity of my iconographic interpretations of the deep doctrinal meanings that this specific feature contains in the analyzed Annunciations.
Hermeneutyka biblijna w ujęciu biskupa Jana Bernarda Szlagi
Authors: Pikor Wojciech
Published: February 2023

Celem artykułu jest ukazanie specyfiki hermeneutyki stosowanej przez biskupa Szlagę w interpretacji Biblii. Pierwszym etapem badań było uporządkowanie jego dorobku naukowego liczącego blisko 1700 pozycji, które pozwoliło wskazać zasadnicze obszary jego zainteresowania Biblią: teologia biblijna, symbolika biblijna, List do Hebrajczyków oraz hermeneutyka biblijna. W drugiej części artykułu są przedstawione zasadnicze filary hermeneutyki biblijnej stosowanej przez Szlagę w jego studiach biblijnych, przede wszystkim w obszarze krytyki literackiej Biblii, w której kładł nacisk na badania etymologii, kompozycji i kontekstu. Trzecia część artykułu omawia trzy filary myślenia biblijnego Szlagi, które uwzględniały historiozbawczy, symboliczny i narracyjny charakter słowa Bożego. Ostatecznie myślenie biblijne Szlagi bazuje na hermeneutyce wiary, łączącej hermeneutykę historyczno-krytyczną z hermeneutyka teologiczną.