bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceived benefits of digital health and social services among older adults: A population-based cross-sectional survey
Authors: Kainiemi Emma , Saukkonen Petra , Virtanen Lotta , Vehko Tuulikki , Kyytsönen Maiju , Aaltonen Mari , Heponiemi Tarja
Published: June 2023

Objective

The aim of this study was to describe the benefits of digital health and social services perceived by older adults and to examine factors associated with perceiving these benefits. Several factors related to (a) sociodemographic characteristics, (b) area of residence, (c) physical, cognitive, psychological, and social functioning, and (d) Internet use, were examined.

Methods

The present sample included 8019 respondents aged between 75 and 99 years. The inverse probability weighting method was used to correct for bias. Linear regression analyses were used to examine the associations.

Results

The ease of use of the services regardless of the time and location was perceived as the most beneficial. Convenient distance to local health or social services (parameter estimate  =  0.15 [0.08–0.23]), good functional ability (PE  =  0.08 [0.01–0.14]), good vision (PE  =  0.15 [0.04–0.25]), ability to learn (PE  =  0.05 [0.01–0.10]) and living with someone (PE  =  0.08 [95% CI 0.04–0.13]) were associated with perceiving more benefits. In addition, access to the Internet (PE  =  0.12 [0.06–0.19]) and independent use of the Internet (PE  =  0.23 [0.17–0.29]) were associated with perceiving more benefits.

Conclusions

Older adults who are healthier, have a social relationship in their everyday life or have easier access to traditional services seem to perceive more benefits from digital health and social services. Digital services should be developed to correspond with special needs caused by disadvantages in health and the social environment. To facilitate the use of digital health and social services, more efforts should be made to enhance older adults’ perceptions of their benefits.
Evaluation of response to incentive recruitment strategies in a social media-based survey
Authors: Ichimiya Megumi , Muller-Tabanera Hope , Cantrell Jennifer , Bingenheimer Jeffrey B , Gerard Raquel , Hair Elizabeth C , Donati Dante , Rao Nandan , Evans W Douglas
Published: June 2023

Objective

This study aimed to examine varying incentives on acceptance to participate in an online survey on social media and to identify related demographic factors.

Methods

The study used Facebook and targeted its users aged 18 to 24 years in the United States. During recruitment, participants were randomized to one of the three types of incentives for survey completion, (1) a $5 gift card, (2) a lottery for a $200 gift card, and (3) a $5 gift card plus a lottery for a $200 gift card. Acceptance rates for survey participation were compared across three incentives using percentages, 95% logit-transformed confidence intervals, and Pearson’s chi-squared tests. The survey asked about cognition and behaviors around smoking and vaping.

Results

The ads had 1,782,931 impressions, 1,104,139 reaches, and 11,878 clicks. The average ad frequency was 1.615, and the click-through rate was 0.67%. Males clicked less than females when seeing the ads. The acceptance rates for the three incentives were 63.7%, 37.2%, and 64.6%, respectively. A Chi-square test confirmed that the lottery-only group had a lower acceptance rate compared to those guaranteed an incentive, including the gift card group and the gift card and lottery group. Further analyses indicated that males did not opt into the survey as often as females when given the lottery-only incentive option, and those who did not meet their financial expenses opted into the survey more often than those who had more money than their expenses when given the lottery-only incentive option.

Conclusions

This study suggests that incentives guaranteed to all participants, even if the incentive's value is small, may lead to higher acceptance rates compared to a lottery for a greater incentive in social media-based surveys.
MonDiaL-CAD: Monkeypox diagnosis via selected hybrid CNNs unified with feature selection and ensemble learning
Authors: Attallah Omneya
Published: June 2023

Objective

Recently, monkeypox virus is slowly evolving and there are fears it will spread as COVID-19. Computer-aided diagnosis (CAD) based on deep learning approaches especially convolutional neural network (CNN) can assist in the rapid determination of reported incidents. The current CADs were mostly based on an individual CNN. Few CADs employed multiple CNNs but did not investigate which combination of CNNs has a greater impact on the performance. Furthermore, they relied on only spatial information of deep features to train their models. This study aims to construct a CAD tool named “Monkey-CAD” that can address the previous limitations and automatically diagnose monkeypox rapidly and accurately.

Methods

Monkey-CAD extracts features from eight CNNs and then examines the best possible combination of deep features that influence classification. It employs discrete wavelet transform (DWT) to merge features which diminishes fused features' size and provides a time-frequency demonstration. These deep features’ sizes are then further reduced via an entropy-based feature selection approach. These reduced fused features are finally used to deliver a better representation of the input features and feed three ensemble classifiers.

Results

Two freely accessible datasets called Monkeypox skin image (MSID) and Monkeypox skin lesion (MSLD) are employed in this study. Monkey-CAD could discriminate among cases with and without Monkeypox achieving an accuracy of 97.1% for MSID and 98.7% for MSLD datasets respectively.

Conclusions

Such promising results demonstrate that the Monkey-CAD can be employed to assist health practitioners. They also verify that fusing deep features from selected CNNs can boost performance.
Remote vision testing of central retinal acuity and comparison with clinic-based Snellen acuity testing in patients followed for retinal conditions
Authors: Chen Earnest P , Mills Michael , Gallagher Tara , Polis Andrew , Blasberg Sophie , Pham Peter , Gentile Ronald C , Ianchulev Tsontcho ,   (The Accustat Study Group)
Published: June 2023

Introduction

The unmet need for remote monitoring of visual function with home-based, patient-centric technologies became increasingly palpable during the COVID-19 pandemic. Many patients with chronic eye conditions lack access to office-based examinations. Here, we evaluate the efficacy of the Accustat® test, a virtual application for measuring near visual acuity on any portable electronic device via telehealth.

Materials and methods

Thirty-three adult subjects from the telehealth remote monitoring service of a retina practice performed the Accustat® acuity testing at home. All patients underwent in-office general eye examination with additional fundoscopic examination and optical coherence tomography retina imaging. Best corrected visual acuity assessment using a Snellen chart was compared with remote visual acuity assessment with the Accustat® test. Visual acuity was analyzed and compared between the best-corrected near visual acuity potential achieved on the Accustat® and in-office distance best-corrected Snellen visual acuity.

Results

The mean logarithm of the minimum angle of resolution (logMAR) visual acuities of all eyes tested using the Accustat test was 0.19 ± 024 and for the office Snellen test 0.21 ±  0.21. A linear regression model with 95% confidence intervals reveals that there is a strong linear relationship between Accustat logMAR and office Snellen logMAR. Bland–Altman analysis demonstrated 95.2% significant agreement between Accustat and Office Snellen’s best corrected visual acuity. Intraclass correlation coefficient (ICC = 0.94) demonstrated a strong positive correlation between at home versus office visual acuity.

Conclusion

There was a high correlation between the visual acuity measured with the Accustat near vision digital self-test and the office Snellen acuity test, suggesting the potential utility of scalable remote monitoring of central retinal function via telehealth.
Exploring the mass adoption potential of wearable fitness devices in Malaysia
Authors: Hayat Naeem , Salameh Anas A , Mamun Abdullah Al , Alam Syed Shah , Zainol Noor Raihani
Published: June 2023

Objective

The current study explores the formation of an intention to use wearable fitness devices (WFDs) with wearable fitness attributes and health consciousness (HCS). Moreover, the research examines the use of WFDs with the health motivation (HMT) and intention to use WFDs. The study also exposes the moderating effect of HMT between the intention to use WFDs and the use of WFDs.

Methods

Five hundred and twenty-five adults participated in the current study, and data were collected from January 2021 to March 2021 through the online survey of Malaysian respondents. The cross-sectional data was analyzed using the second-generation statistical method of partial least square structural equation modeling.

Results

HCS is insignificantly associated with the intention to use WFDs. Perceived compatibility, perceived product value, perceived usefulness, and perceived technology accuracy significantly influence the intention to use WFDs. HMT significantly impacts the adoption of WFDs; however, the intention to use WFDs negatively but significantly influences the use of WFDs. Lastly, the association between the intention to use WFDs and the adoption of WFDs is significantly moderated by HMT.

Conclusions

Our study findings illuminate the significant impact of technology-level attributes of WFDs on the intention to use WFDs. However, an insignificant impact of HCS on the intention to use WFDs was reported. Our result confirms that HMT plays a significant role in the use of WFDs. Such as the moderating role of HMT is vital to transform the intention to use WFDs into the adoption of WFDs.
Activated Prothrombin Complex Concentrate in Pediatric Cardiac Patients, Our Early Experience
Authors: Ashikhmina Swan Elena , Brinkman Nathan J. , Lahr Brian D. , Nemergut Michael E. , Dearani Joseph A. , Stephens Elizabeth H.
Published: June 2023

Background

Pediatric cardiac surgery is associated with abnormal coagulation, bleeding, and nearly ubiquitous transfusions. With the popularization of patient blood management, attempts are being made to decrease liberal transfusions by administering prothrombin complex concentrates (PCCs). The safety and efficacy of PCCs in adult cardiac surgery has been studied extensively, but only few reports address this in children. We performed an observational study focused on transfusion requirements after off-label use of activated PCC Factor Eight Inhibitor Bypassing Activity (FEIBA) as an adjunct to post-cardiopulmonary bypass (CPB) hemostatic protocol.

Methods

We reviewed the medical records of children ≤15 kg undergoing cardiac operations with CPB between May 2018 and March 2022. A propensity score (PS) analysis was performed to identify matched pairs of patients who did and did not receive FEIBA.

Results

Out of 210 patients who met the inclusion criteria, 44 patients received FEIBA. Propensity score-based analysis identified 40 matched pairs of patients with similar baseline characteristics. There was no statistically significant difference in the primary outcome—the volume of transfusion after CPB, which included all allogeneic blood products and salvaged washed red cells administered after protamine. Specifically, FEIBA patients were transfused 28 (22-34) mL/kg and controls were transfused 22 (11-49) mL/kg, P = .989. Upon arrival to ICU, the FEIBA group averaged an 8% lower international normalized ratio, compared with the controls ( P = .009) and a 1.08 g/dL higher hemoglobin ( P = .050). Neither difference remained significant on POD 1.

Conclusions

In this exploratory study, we found no change in transfusion requirements after CPB despite FEIBA administration.
Osteoporosis in the Setting of Shoulder Arthroplasty: A Narrative Review
Authors: Daher Mohammad , Fares Mohamad Y. , Boufadel Peter , Khanna Akshay , Zalaquett Ziad , Abboud Joseph A.
Published: June 2023

Patients who undergo shoulder surgery are frequently affected by osteoporosis and osteopenia, and the prevalence of this association is expected to increase due to the growing number of elderly individuals undergoing these procedures. It may be advisable to conduct a preoperative DXA scan for orthopedic surgical candidates at high risk, to detect those who could benefit from early intervention and avoid any related adverse events. Some of these complications include periprosthetic fractures, infection, subsequent fragility fractures, and have an all-cause revision arthroplasty at 2 years post-op. Some studies analyzed the beneficence of antiresorptive medications pre-operatively but the latter did not show favorable outcomes. Surgical management may include cementing components of the prosthesis as well as modifying the diameter of the shoulder stem. Nevertheless, more studies are needed to evaluate the efficacy of any intervention, whether medical or surgical, to avoid any shoulder arthroplasty related-complication that may be precipitated by the reduced bone mineral density.
A Novel Approach to the Treatment of Comminuted Mandibular Condyle Fractures
Authors: Knight Paige , Bjornson Lindsay , Courtemanche Rebecca , Courtemanche Douglas J
Published: June 2023

Introduction: A suture enlocation (SE) approach is proposed to manage comminuted intra-articular mandibular condyle fractures not amenable to open reduction internal fixation approaches. The SE approach is an effective operative option for the treatment of condylar fractures with the combination of fracture dislocation, malocclusion, comminution, and inadequate surface area for open fixation techniques. This study describes the SE approach, outcomes, and complications. Methods: The SE technique is described, and the health records of patients treated with the SE approach are reviewed. Outcome data were collected for diet, interincisal opening, occlusion, pain, and complications. Results: Technique: The SE approach involves reducing the fractured condylar fragment using a hole drilled through the fragment to secure it to the periosteum with a polydioxanone suture. This allows the reduced fragment to be managed as a nondisplaced fracture with mandibulomaxillary fixation and class 2 elastics. Outcomes: A chart review involving 8 patients (11 condyles) illustrates the outcomes of the SE approach from 2006 to 2021. Age at the time of injury ranged from 12 to 51 years and the follow up ranged from 2 to 68 months. At final follow up, 7 patients were eating a regular diet, 7 had normal interincisal opening, 4 had normal occlusion, and 4 reported ongoing mandibular discomfort. Failure of fixation occurred in 1 case, which required further operative management. Conclusions: The SE technique shows promise as an effective way to reduce fracture components, manage occlusion, and facilitate secondary bone healing in comminuted and displaced mandibular condyle fractures.
Exercise Therapy for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis
Authors: Mo Ling , Jiang Banghua , Mei Tao , Zhou Daihua
Published: June 2023

Background:

Exercise is an effective nonpharmaceutical therapy for knee osteoarthritis (KOA).

Purpose:

To identify the most effective type of exercise therapy for KOA with regard to pain, stiffness, joint function, and quality of life.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

The PubMed, Web of Science, Embase, and Cochrane Library databases were searched, from inception to April 4, 2022. Included were randomized controlled trials that assessed the efficacy on KOA among 5 different exercise therapy groups (aquatic exercise [AE], stationary cycling [CY], resistance training [RT], traditional exercise [TC], and yoga [YG]) and compared with the control group. Outcomes among the groups were assessed with the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), 6-minute walk test (6-MWT), visual analog scale (VAS) for pain, and Knee injury and Osteoarthritis Outcome Score (KOOS); weighted mean differences (WMDs) and 95% confidence intervals were calculated. Network meta-analyses comparing outcomes between all groups and with controls were performed, and group rankings were calculated using the surface under the cumulative ranking curve (SUCRA).

Results:

A total of 39 studies (N = 2646 participants) were included. Most of the studies failed to blind participants and researchers, resulting in a high risk of performance bias. Significantly worse WOMAC-Pain scores were seen in controls compared with all exercise interventions except AE (WMD [95% CI]: CY, –4.45 [–5.69 to –3.20]; RT, –4.28 [–5.48 to –3.07]; TC, –4.20 [–5.37 to –3.04]; and YG, –0.57 [–1.04 to –1.04]), and worse scores were seen in controls compared with YG regarding WOMAC-Stiffness (WMD, –1.40 [95% CI, –2.45 to –0.34]) and WOMAC-Function (WMD, –0.49 [95% CI, –0.95 to –0.02]). According to the SUCRA, CY was the most effective for improving WOMAC-Pain (80.8%) and 6-MWT (76.1%); YG was most effective for improving WOMAC-Stiffness (90.6%), WOMAC-Function (77.4%), KOOS–Activities of Daily Living (72.0%), and KOOS–Quality of Life (79.1%); AE was the most effective regarding VAS pain (77.2%) and KOOS-Pain (64.0%); and RT was the most effective regarding KOOS-Symptoms (84.5%).

Conclusion:

All 5 types of exercise were able to ameliorate KOA. AE (for pain relief) and YG (for joint stiffness, limited knee function, and quality of life) were the most effective approaches, followed by RT, CY, and TC.
Arabic Translation of the Knee Outcome Survey–Sports Activities Scale With Cross-cultural Adaptation and Validation
Authors: Alrabai Hamza M. , Algarni Abdulrahman D. , Alshehri Abdulrahman Ahmed , Alshihri Adel Faiz , Almansour Ammar Saleh , Alrawaf Rawaf Khalid , Al-Ahaideb Abdulaziz S.
Published: June 2023

Background:

There are few sports-specific knee functional scales in the Arabic language. The Knee Outcome Survey–Sports Activities Scale (KOS-SAS) is a validated sports-specific patient-reported outcome measure that assesses knee function in an athletic population.

Purpose:

To provide a validated Arabic version of the KOS-SAS (KOS-SAS-Ar) while achieving cross-cultural adaptation for use in an Arabic-speaking population with sports-related knee disorders.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

There were 2 independent translators who conducted a forward translation of the KOS-SAS, followed by a backward translation by different translators. Subsequently, researchers and expert invitees judged the conceptual content and cultural adaptations of the final translation. A total of 276 patients completed the KOS-SAS-Ar as well as the International Knee Documentation Committee (IKDC) subjective assessment of knee function and a visual analog scale (VAS) for pain. Statistical analysis was performed for test-retest reliability, convergent validity, construct validity, and factor analysis.

Results:

The test-retest reliability of the KOS-SAS-Ar was high ( r = 0.9). The items of the KOS-SAS-Ar had statistically significant internal consistency, with a Cronbach alpha of .924 ( P < .0001). The KOS-SAS-Ar Symptoms subscore correlated with the VAS pain score ( P < .0001), and the KOS-SAS-Ar Functional Limitations subscore correlated with the IKDC subjective score ( P < .0001). The construct validity of the KOS-SAS-Ar was satisfactory (Kaiser-Meyer-Olkin value = 0.868; Bartlett test: P < .0001). Factor analysis showed a statistical correlation among the 11 items of the KOS-SAS-Ar.

Conclusion:

The KOS-SAS-Ar demonstrated favorable reliability and validity, and it appears to be a suitable tool for Arabic-speaking patients with sports-related knee conditions.
Translation and Validation of a Simplified Chinese Version of the Anterior Cruciate Ligament–Quality of Life Questionnaire
Authors: Kou Jun , Deng Bing , Liu Jinbiao , Wen Jun , Yin Li , Xie Qingyun , Wei Wang
Published: June 2023

Background:

The Anterior Cruciate Ligament–Quality of Life (ACL-QOL) questionnaire is a widely used and effective scale for quality of life in patients with chronic anterior cruciate ligament (ACL) injury.

Purpose:

To translate and adapt the ACL-QOL questionnaire for Chinese patients and evaluate its reliability, validity, and responsiveness in this population.

Study Design:

Cohort study (diagnosis); Level of evidence, 2.

Methods:

Translation and adaptation were conducted in accordance with the guidelines of the A merican Academy of Orthopaedic Surgeons Outcome Committee. Included were 121 patients who were diagnosed with a chronic ACL injury and underwent ACL reconstruction between January 2020 and June 2021. Preoperatively, patients completed the simplified Chinese version of the ACL-QOL (ACL-QOL-C), the Knee injury and Osteoarthritis Outcome Score, and the 12-Item Short Form Health Survey. The ACL-QOL-C was also completed at 12- and 24-week follow-ups. Psychometric evaluations were then performed and included score distribution, internal consistency, test-retest reliability, construct validity, and responsiveness.

Results:

The Cronbach alpha ranged from .905 to .975, indicating excellent internal consistency, and the intraclass correlation coefficient ranged from 0.864 to 0.985, indicating excellent test-retest reliability. The consistency between the above results and our a priori hypotheses was more than 70% (35/42), indicating good construct validity. The standard error of measurement and effect size of the total score and each item of the ACL-QOL-C were >0.8 at the final follow-up, indicating good responsiveness.

Conclusion:

The English version of the ACL-QOL has been successfully translated into Chinese, and it has been shown to be applicable for the assessment of the quality of life in Chinese patients with chronic ACL injury.
Listening Effort in Quiet and Noisy Environments in the Daily Life of Adults With Hearing Aids: An Extended Version of the Effort Assessment Scale (EEAS)
Authors: Ferschneider Mathieu , Moulin Annie
Published: June 2023

This study was aimed at assessing listening effort (LE) in quiet and in noisy daily life situations, in 481 adults with hearing aids (HAs) and 62 adults with normal hearing, using an Extended version of the Effort Assessment Scale (EEAS). Participants were invited to self-assess their LE in daily life, on a visual analog scale graded from 0 (no effort) to 10. The EEAS's internal structure identified two separate constructs pertaining to LE in quiet and LE in noise, each with good consistency (Cronbach's α > 0.83). A three-factor model explained 12% of the variance of the EEAS scores, with HA experience the most important one, and better ear hearing threshold (averaged across 0.5–4 kHz) and ear asymmetry as the other two factors. The EEAS subscales differed in behavior, with the LE in noise being the most dependent on HA experience, whereas LE in quiet depended more on better ear hearing threshold. In a subgroup of people with 6 months to less than 24 months HA experience, a significant decrease in LE in noise was observed with increasing HA experience (0.26 points decrease per year of HA experience), whereas in a group of people with at least 24 months of HA experience, a small increase in LE in noise was observed. This effect was not mediated by age, nor hearing threshold. The extended Effort Assessment Scale is therefore offering an assessment of both LE in quiet and LE in noise, with different dependence on HA experience and hearing thresholds.
Intervention for Prevention of Type 2 Diabetes Mellitus Among Prediabetes: A Review of the Literature
Authors: Thipsawat Sopida
Published: June 2023

Introduction

In recent decades, the prevalence and incidence of type 2 diabetes mellitus (T2DM) have increased rapidly and represent a significant public health problem worldwide. Long-term T2DM is associated with microvascular complications such as retinopathy, nephropathy, and neuropathy. Prediabetes is a state of hyperglycemia with blood glucose levels higher than normal but lower than the diabetes threshold. Several studies have demonstrated the effectiveness of lifestyle interventions that resulted in a 40% to 70% reduction in diabetes mellitus in adults with prediabetes. These interventions focused on increased physical activity and dietary changes that were able to prevent or delay the onset of T2DM in prediabetes. However, most review studies focused on interventions to prevent T2DM in high-risk groups such as obesity. There was a limitation of reports related to prediabetes. Nevertheless, it remains a high-risk condition for the development of T2DM with a conversion rate of 5% to 10% per year. Therefore, the aim of this study was to review the current evidence on intervention studies aimed at reducing the incidence of type 2 diabetes in prediabetes.

Method

The researcher conducted a literature search of common online databases such as Medline, Google Scholar, and Cochrane Library between January 2011 and December 2021.

Result

The intervention for the prevention of T2DM in prediabetes consisted of a lifestyle intervention, a nutritional supplementation intervention, and a pharmacological intervention

Conclusion

Several studies suggest that T2DM in prediabetes can be prevented by lifestyle modification and pharmacological interventions, or a combined intervention. However, further interventions may be needed to confirm this.
Ambedkar’s Idea of Minority Rights in a Democracy: Status of Muslim as a Test
Authors: Ali Manjur
Published: June 2023

Dr B. R. Ambedkar dreamt of a society based on modern liberal ideals of ‘Liberty, Equality and Fraternity’, throughout his life. To translate his dream into a reality, Dr Ambedkar strove harder to put ‘Depressed Classes’ under the ‘Minority’ category. While arguing in favour of his argument, he put forth the socio-economic status of Dalit before the Southborough Committee in 1919. After a long struggle, he was able to achieve constitutional safeguards for dalits. Dr Ambedkar had roped in all the principles into India’s Constitution in the post-independence period to peaceful social revolution. However, after independence protection of Dalit came under the Scheduled Castes category. Nonetheless, his epistemological origin and engagement with the minority as an ‘idea’ and creating favourable space within the democratic political structure has been still relevant. This article has engaged with Dr Ambedkar’s idea of minorities and their political and economic welfare in a communal majoritarian polity. To operationalise the ideas, this article has discussed the implementation of the constitutional promise of ‘rights’ in the case of Muslims. The article also looks at successive governments’ approaches vis-a-vis Muslims’ development to ascertain the trajectory of policies.
‘Musahar’, in Uttar Pradesh: A Caste Searching for its Identity in Contemporary India
Authors: Singh Rakshita , Singh Pankaj
Published: June 2023

Caste-class nexus, a discourse which never gets old in a highly stratified country like India. Within every level of stratification, a dominant caste had formed its class and a mechanism for discrimination within caste and social groups. From the 1950s onwards in India, voting and identity politics played a crucial role in the strong caste-class phenomenon. This discourse had forced some caste groups to remain at the bottom of the hierarchy, and one such caste is Musahar. They are one of the most discriminated social groups, a marginalised dalit caste, (dalit among dalits), officially ex-untouchables, sufferers of extreme poverty, hunger and malnutrition and commonly known by the name ‘Musa-har’, which means rat-eaters, they are primarily found in Bihar and Uttar Pradesh. Among the dalit fold, they are at the lowest rung of the caste hierarchy mostly agricultural labourers. This article is an ethnographic study conducted in four villages in Jaunpur district. This article will be focused on the sociopolitical and cultural aspects of the Musahar in their day-to-day lives. A section of this article is dedicated to the identity crisis among Musahar castes occurring as a result of their lower sociopolitical position in the caste hierarchy. After the pandemic, the socioeconomic status of Musahar is more deteriorated due to the unavailability of essential services in their locality, and a section of this article assessed the implementation of government policies before and after the pandemic.
Activating Life Course Theory through a Whole System Prevention Framework to Address the Wicked Problem of Maternal and Infant Morbidity and Mortality
Authors: LaFave Lea Ayers , Clemmons Naomi , Kotelchuck Milton , Morales Cozier Naima , Geltman Ana , Browne Dianne R. , Kenyon Katie
Published: June 2023

Background

Racial/ethnic disparities in maternal and infant morbidity and mortality (MIM&M) is a wicked problem that is reinforced and perpetuated by our system[s] of care. Life Course Theory (LCT) helps to explain drivers of health disparities, but its application is challenged. An upstream approach that promotes systemic change requires the implementation of an expanded prevention framework that includes primordial and quaternary prevention.

Research Design

We developed an innovative expanded Whole System Prevention Framework (WSPF) that incorporates LCT, prevention (including primordial and quaternary prevention) and systems thinking.

Study Sample

We implemented this new conceptual Framework with two Healthy Start community partnerships through training, service mapping, and strategic planning to address upstream drivers of MIM&M.

Data Collection and Analysis

Service mapping revealed few Healthy Start upstream activities/services with the predominance being delivered downstream at the program (microsystem) level.

Results

Service mapping provided a snapshot of the current service distribution of services across the systems. The preponderance were primary, secondary and tertiary prevention activities (75.5% and 65.6%) delivered at the program level (58.2% and 68%), revealing opportunities for upstream strategies to promote equity. The implementation process provided a new way to frame strategic planning and develop upstream strategies to promote health equity and reduce MIM&M.

Conclusion

The Whole System Prevention Framework and its implementation methodology could be applied to address other wicked problems.
Spooky concepts and urban studies: Conceptual metaphor, narrative tension and explanatory power
Authors: Rogers Dallas
Published: June 2023

From the metaphor-soaked concepts of Dracula urbanism, the Vampire index, Frankenstein urbanism and zombie neoliberalism to the idea of a vampire property-holding class, conceptual metaphors are a repeating theme in urban studies. Once you are alert to their presence, conceptual metaphors seem to be everywhere, operating as key literary devices, productive interpretive tactics and critical discursive manoeuvres in the field. And if it is true that metaphor is an important conceptual device in urban studies, then the field's use of conceptual metaphor deserves our critical attention. Taking Wilson and Wyly's Dracula urbanism as a prompt, this commentary offers some speculative reflections on conceptual metaphor in urban studies, before commenting on Dracula urbanism as a concept directly. The discussion is organised around the narrative tension, explanatory power and discursive playfulness that conceptual metaphor affords in urban studies. I argue the power of conceptual metaphor comes into play at the level of analytical acuity. A good conceptual metaphor has an explanatory power that moves our understanding of an urban process, issue, etc. forward. It opens new conceptual vistas, or it brings into focus new conceptual stakes, or it paths the way for new types of empirical investigation in the field. Put simply, a good conceptual metaphor allows for a good theoretical intervention. It has productive explanatory power; it takes urban scholars somewhere beyond their initial excitement about a fancy new name for a concept. A spooky conceptual metaphor must be analytically powerful, otherwise it's just Halloween; an empty signifier dressed up as Frankenstein for a night, trick or treating for citations and attention.
Student Perceptions of Glover/Curwen Hand Signs in the Elementary Music Classroom
Authors: Mayo Whitney
Published: June 2023

Elementary music educators use a variety of strategies in classroom instruction. The purpose of this case study was to explore student perceptions of Curwen hand signs, a common instructional strategy in elementary music classrooms. Second- and third-grade students reported various challenges, benefits, and influential factors surrounding hand sign use. Results indicated that students enjoyed movement activities and benefited from visual and physical reminders of singing tasks during instruction. They described several challenges, including multitasking, required background knowledge, and distraction. Influential factors included a learning curve, accuracy, placement, pattern length and complexity, and enjoyment. The results of this study suggest that hand signs should be considered one instructional strategy in a toolbox of multiple approaches.
Collegiate Instrumentalists’ Applications of Practice Strategies and Practice Motivation
Authors: Liu Yue
Published: June 2023

The purpose of this descriptive research study was to examine collegiate instrumentalists’ applications of practice strategies and their motivation orientations to practice. Respondents ( N = 128) were music majors who enrolled in concert band or orchestra. Results indicated that pianists spent more time in practice followed by percussionists, brass, other instrumentalists (e.g., organ), woodwind, and string players. Collegiate instrumentalists used systematic practice strategies most frequently, followed by error correction techniques, using a metronome and listening to recordings, concentration control, analytic strategies, and the organization of practice sessions. In addition, collegiate instrumentalists were more motivated by intrinsic factors than extrinsic factors. Weekly practice hours were negatively correlated with Extrinsic Motivation: Avoid Failure, but positively correlated with Intrinsic Motivation: Growth. Implications for instrumental teaching and learning are discussed.
Guadecitabine vs treatment choice in newly diagnosed acute myeloid leukemia: a global phase 3 randomized study
Authors: Fenaux Pierre , Gobbi Marco , Kropf Patricia L. , Issa Jean-Pierre J. , Roboz Gail J. , Mayer Jiri , Krauter Jürgen , Robak Tadeusz , Kantarjian Hagop , Novak Jan , Jedrzejczak Wieslaw. W. , Thomas Xavier , Ojeda-Uribe Mario , Miyazaki Yasushi , Min Yoo Hong , Yeh Su-Peng , Brandwein Joseph , Gercheva-Kyuchukova Liana , Demeter Judit , Griffiths Elizabeth , Yee Karen , Döhner Konstanze , Hao Yong , Keer Harold , Azab Mohammad , Döhner Hartmut
Published: June 2023

This phase 3 study evaluated the efficacy and safety of the new hypomethylating agent guadecitabine (n = 408) vs a preselected treatment choice (TC; n = 407) of azacitidine, decitabine, or low-dose cytarabine in patients with acute myeloid leukemia unfit to receive intensive induction chemotherapy. Half of the patients (50%) had poor Eastern Cooperative Oncology Group Performance Status (2-3). The coprimary end points were complete remission (19% and 17% of patients for guadecitabine and TC, respectively [stratified P = .48]) and overall survival (median survival 7.1 and 8.5 months for guadecitabine and TC, respectively [hazard ratio, 0.97; 95% confidence interval, 0.83-1.14; stratified log-rank P = .73]). One- and 2-year survival estimates were 37% and 18% for guadecitabine and 36% and 14% for TC, respectively. A large proportion of patients (42%) received <4 cycles of treatment in both the arms. In a post hoc analysis of patients who received ≥4 treatment cycles, guadecitabine was associated with longer median survival vs TC (15.6 vs 13.0 months [hazard ratio, 0.78; 95% confidence interval, 0.64-0.96; log-rank P = .02]). There was no significant difference in the proportion of patients with grade ≥3 adverse events (AEs) between guadecitabine (92%) and TC (88%); however, grade ≥3 AEs of febrile neutropenia, neutropenia, and pneumonia were higher with guadecitabine. In conclusion, no significant difference was observed in the efficacy of guadecitabine and TC in the overall population. This trial was registered at www.clinicaltrials.gov as #NCT02348489.
Cell-free DNA measurable residual disease as a predictor of postallogeneic hematopoietic cell transplant outcomes
Authors: Pasca Sergiu , Guo Matthew Z. , Wang Shiyu , Stokvis Kristin , Shedeck Audra , Pallavajjala Aparna , Shams Cynthia , Pallavajjala Roshni , DeZern Amy E. , Varadhan Ravi , Gocke Christopher D. , Jones Richard J. , Gondek Lukasz P.
Published: June 2023

The measurable residual disease (MRD) assessment provides an attractive predictor of allogeneic hematopoietic cell transplnat (alloHCT) outcomes. Cell-free DNA (cfDNA) has been applied to diagnosis, early detection, and disease burden monitoring in various tumors, but its utility as an MRD test in myeloid malignancies has not been systematically evaluated. We sought to determine the differential sensitivity between bone marrow (BM) and cfDNA MRD and to assess the effect of cfDNA MRD on alloHCT outcomes. The technical and clinical validation cohorts, including 82 patients participating in clinical trials (Bone Marrow Transplant Clinical Trials Network-0201 and 0402), were used. Ultradeep error-corrected targeted sequencing was performed on plasma and BM-derived DNA. We demonstrated that 94.6% (range, 93.9-95.3) of cfDNA was derived from hematopoietic tissue. The mutant allele fraction was congruent between BM and cfDNA (rho = 0.8; P < .0001); however, cfDNA seemed to be more sensitive in detecting clones with a variant allele frequency (VAF) of <0.26%. cfDNA-MRD clearance by day 90 after alloHCT (D90) was associated with improved relapse-free survival (RFS, median survival not reached vs 5.5 months; P < .0001) and overall survival (OS, median survival not reached vs 7.3 months; P < .0001) when compared with patients with persistent MRD. Irrespective of pre-alloHCT MRD, D90 cfDNA MRD was associated with inferior 2-year OS (16.7% vs 84.8%; P < .0001) and RFS (16.7% vs 80.7%; P < .0001). cfDNA seems to be an accurate, minimally invasive alternative to BM aspirates in MRD assessment and confers important prognostic implications in patients with myeloid malignancies undergoing alloHCT.
PACAP6-38 improves nitroglycerin-induced central sensitization by modulating synaptic plasticity at the trigeminal nucleus caudalis in a male rat model of chronic migraine
Authors: Zhang Lily , Zhou Yanjie , Yang Liu , Wang Yue , Xiao Zheman
Published: June 2023

Aims

Chronic migraine (CM) is a common neurological disorder with complex pathogenesis. Evidence suggests that pituitary adenylate cyclase-activating peptide (PACAP) induces migraine-like attacks and may be potential a new target for migraine treatment, but the therapeutic results of targeting PACAP and its receptors are not uniform. Therefore, the aim of this study was to investigate the regulatory effect of PACAP type I receptor (PAC1R) antagonist, PACAP6-38, on nitroglycerin (NTG)-induced central sensitization in a CM model.

Methods

Sprague–Dawley (SD) rats received repeated injections of NTG to construct a CM model. Mechanical and thermal thresholds were measured using Von Frey filaments and hot plate tests. C-Fos expression was measured by western blotting and immunofluorescence staining to assess the central sensitization. PACAP6-38 was intracerebrally injected into the trigeminal nucleus caudalis (TNC), and then the changes in c-Fos, the synaptic-associated proteins, phospho-ERK1/2 (p-ERK1/2), phosphorylation of cyclic adenosine monophosphate response element-binding protein (p-CREB) and brain-derived neurotrophic factor (BDNF) were detected. Transmission electron microscopy (TEM) and Golgi-Cox staining were used to observe the ultrastructure of synapses and dendritic structures of TNC neurons.

Results

The results showed that PACAP and PAC1R expression were significantly raised in the TNC after repeated NTG injections. Additionally, PACAP6-38 treatment alleviated nociceptive sensitization, inhibited NTG-induced overexpression of c-Fos and synaptic-associated proteins in the TNC of CM rat, restored aberrant synaptic structures. Furthermore, the expression of ERK/CREB/BDNF pathway was depressed by PACAP6-38.

Conclusions

Our results demonstrated that abnormal synaptic structure in the TNC of CM, which could be reversed by inhibition of PAC1R via down-regulating the ERK/CREB/BDNF signaling pathway. PACAP6-38 improves NTG-induced central sensitization by regulating synaptic plasticity in the TNC of CM rat, which may provide new insights into the treatments targeting PACAP/PAC1R in migraine.
The predictive value of CD4, CD8, and C—reactive protein in the prognosis of schistosomal and non-schistosomal colorectal cancer
Authors: Cheng Meihong , Jing Hongyan , Bu Dacheng , Liu Jing , Lu Kui , Liu Jican , Xu Yanchao , Zhu Ting , Hou Yingyong , Yao Junxia , Zhai Qilin , Wang Weixia
Published: June 2023

Background

Although schistosomiasis has been basically eliminated, it has not been completely extinction in China and occasional outbreaks occur in Europe in recent years. The relationship between inflammation caused by Schistosoma japonicum and colorectal cancer (CRC) is still obscure, and the inflammation based prognostic systems of schistosomal colorectal (SCRC) has rarely been reported.

Aim

To explore the different roles of tumor infiltrating lymphocytes (TILs) and C-reactive protein (CRP) in SCRC and in Non-schistosomal CRC (NSCRC), providing a possible predictive system to evaluate outcomes and to improve the risk stratification for CRC patients, especially for CRC patients with schistosomiasis.

Methods

Three hundred fifty-one CRC tumors were evaluated for density of CD4 + , CD8 + T cells and CRP in intratumoral and stromal compartments by immunohistochemical using tissue microarray.

Results

There were no association between TILs and CRP and schistosomiasis. Multivariate analysis identified stromal CD4 (sCD4) (p = 0.038), intratumoral CD8 (iCD8) (p = 0.003), schistosomiasis (p = 0.045) as independent prognostic factors for overall survival (OS) in the whole cohort; and sCD4 (p = 0.006) and iCD8 (p = 0.020) were independent prognostic factors for OS in the NSCRC and SCRC set, respectively. Besides, we found that there were no differences of TILs and CRP, which were distributed in different areas of tumor tissue, between CRC patients with and without schistosomiasis.

Conclusion

The results remind us that different subtypes of TILs have distinguished biological behavior and prognosis value in the immune microenvironment of NSCRC and SCRC patients. Meanwhile, the findings require us to stratify patients with schistosomiasis and this might facilitate patient counseling and management.
Determinants of physical, psychological, and social well-being in older adults: a cross-sectional study in senior care facilities of Pakistan (2019/20)
Authors: Tariq Jawad , Zakar Rubeena , Ali Mohammad Vaqas , Zakar Muhammad Zakria , Sajjad Amal , Fischer Florian
Published: June 2023

Background

Published research on senior care facilities in Pakistan is scarce and no large-scale study has been conducted to assess factors affecting well-being of older adults in these facilities. This study, therefore, investigated the effects of relocation autonomy, loneliness, and satisfaction with services along with socio-demographic characteristics on physical, psychological, and social well-being of older residents living in senior care facilities of Punjab, Pakistan.

Methods

This cross-sectional study collected data from 270 older residents living in 18 senior care facilities across 11 districts of Punjab, Pakistan from November 2019 to February 2020 using multistage random sampling. Existing reliable and valid scales were used to collect information from older adults related to relocation autonomy (Perceived Control Measure Scale), loneliness (de Jong-Gierveld Loneliness Scale), satisfaction with service quality (Service Quality Scale), physical and psychological well-being (General Well-Being Scale), and social well-being (Duke Social Support Index). A psychometric analysis of these scales was carried out followed by three separate multiple regression analyses to predict physical, psychological, and social well-being from socio-demographic variables and key independent variables (relocation autonomy, loneliness, and satisfaction with service quality).

Results

The results of multiple regression analyses showed that the models predicting physical (R2 = 0.579), psychological (R2 = 0.654), and social well-being (R2 = 0.615) were statistically significant (p < 0.001). Number of visitors was a significant predictor of physical (b = 0.82, p = 0.01), psychological (b = 0.80, p < 0.001), and social (b = 2.40, p < 0.001) well-being. Loneliness significantly predicted physical (b = -0.14, p = 0.005), psychological (b = -0.19, p < 0.001), and social (b = -0.36, p < 0.001) well-being. Control over relocation process significantly predicted physical (b = 0.56, p < 0.001) and psychological (b = 0.36, p < 0.001) well-being. Satisfaction with services significantly predicted physical (b = 0.07, p < 0.001) and social (b = 0.08, p < 0.001) well-being.

Conclusion

Pragmatic, equitable and cost-effective interventions are needed to improve the wellbeing of older residents living in senior care facilities. Friendly behavior of mobilizing staff and adjusted residents to facilitate new residents, therapeutic interventions such as relocation support programs, reminiscence therapy and intergenerational support, and increasing their exposure and connection to the outside world, can raise their physical, psychological, and social well-being.