bluuebunny/crossref_metadata_2025 huggingface dataset:
Relational Mobility and Problematic Internet Use: A Person–Environment Interactionist Perspective
Authors: Dong Zhiwen , Hou Yubo , Cao Yi , Wu Zhongda
Published: February 2023

Problematic internet use (PIU) is a concerning issue worldwide, and a considerable body of knowledge has accrued from research on the predictors of PIU; however, few studies have investigated the dynamic process by which the social environment impacts individuals’ PIU. Integrating a person–environment interactionist perspective with self-determination theory, we investigate how relational mobility impacts PIU by proposing a “permeating” mechanism of social interactions (i.e., interpersonal sensitivity) and basic psychological needs (i.e., relatedness satisfaction). In Study 1, using a large data set from the Chinese General Social Survey ( N = 2,192), we found that relational mobility was negatively related to PIU. In Study 2, using a new sample ( N = 392), we found that relational mobility alleviated PIU through interpersonal sensitivity. In Study 3, using a cross-lagged design and two-wave data ( N = 298), we confirmed the chain-mediating roles of interpersonal sensitivity and relatedness satisfaction in the relationship between relational mobility and PIU.
Desocializing Social Media: The Visual and Media Ideologies of Stock Photography
Authors: Aiello Giorgia , Thurlow Crispin , Portmann Lara
Published: February 2023

Commercial image banks powerfully shape the cultural meanings of social media, especially when circulated as “fact” in the news media. To this end, we report a social semiotic analysis that documents the representational, compositional, and interpersonal framing of social media in a corpus of 600 stock photographs top-sliced from three global image banks. This core analysis is complemented with reference to (a) keywords used to categorize photos in image banks, and (b) two indicative samples of photos reproduced in international English-language news reports. We find that a visual “regime of truth” is produced in stock photography (and then circulated by the news media) that is gendered, affectively flattened, and “corporatized.” Social media are also depicted in ways that are disembedded and largely asocial or desocialized. We interpret these findings in terms of visual and media ideologies, and vis-à-vis scholarly perspectives on “connectivity” and “sociality” in digital communication/culture.
Online Harassment: Assessing Harms and Remedies
Authors: Schoenebeck Sarita , Lampe Cliff , Triệu Penny
Published: February 2023

Online harassment refers to a wide range of harmful behaviors, including hate speech, insults, doxxing, and non-consensual image sharing. Social media platforms have developed complex processes to try to detect and manage content that may violate community guidelines; however, less work has examined the types of harms associated with online harassment or preferred remedies to that harassment. We conducted three online surveys with US adult Internet users measuring perceived harms and preferred remedies associated with online harassment. Study 1 found greater perceived harm associated with non-consensual photo sharing, doxxing, and reputational damage compared to other types of harassment. Study 2 found greater perceived harm with repeated harassment compared to one-time harassment, but no difference between individual and group harassment. Study 3 found variance in remedy preferences by harassment type; for example, banning users is rated highly in general, but is rated lower for non-consensual photo sharing and doxxing compared to harassing family and friends and damaging reputation. Our findings highlight that remedies should be responsive to harassment type and potential for harm. Remedies are also not necessarily correlated with harassment severity—expanding remedies may allow for more contextually appropriate and effective responses to harassment.
The “Fox Eye” Challenge Trend: Anti-Racism Work, Platform Affordances, and the Vernacular of Gesticular Activism on TikTok
Authors: Zhao Xinyu , Abidin Crystal
Published: February 2023

This article takes the “Fox Eye” challenge that trended on social media in 2020 as a case study in anti-racism activism by (East) Asian users on TikTok. The “Fox Eye” challenge was a trend in which both celebrities and ordinary users—often predominantly White women—posted photos and short videos on how to wear specific styles of make-up to achieve almond-shaped eyes or “fox eyes.” This was often accompanied with a “migraine pose” where a user pushes their index and middle fingers up against the temples on both sides of their head to “lift” the corners of their upper eyelids, and was colloquially referred to as a “Chinese” or “oriental” look. In response, (East) Asian users on TikTok called out the historically racist undertones of this seemingly superficial trend, using the features and affordances of the platform to produce everyday, nonheroic forms of digital activism, as an act of civic engagement and activist campaigning. Building on the scholarship on digital activism, we consider how TikTok has emerged as an alternative activist space for young people, specifically as it services users as a video production and sharing app. We specifically focus on the audiovisual aesthetics of the TikTok narratives in the counter-Fox Eye trend campaign, wherein the strategic and templatable deployments of vernacular TikTok aesthetics—curated image selections, creative uses of sound and audio memes, specific renders of visual filters and effects—play a central role in giving meaning to the online activist narratives created. This has given rise to platformed activism in the TikTok vernacular that we term “gesticular activism,” which focuses on the generation of visibility and virality as awareness-building and consciousness-raising tactics.
TikTok as a Key Platform for Youth Political Expression: Reflecting on the Opportunities and Stakes Involved
Authors: Literat Ioana , Kligler-Vilenchik Neta
Published: February 2023

Reflecting on 6 years of our research—which began on musical.ly and transitioned into TikTok—we argue that TikTok is a vital space to study social movements due to its centrality in youth lives and its ability to give voice to youth political expression in richly creative ways. We see the political expression happening on TikTok as a harbinger of the changing nature of this phenomenon, and a necessary impetus to broaden our understandings of activism and political expression today. At the same time, we must also consider the implications of TikTok becoming such a valuable space for youth politics and activism, in terms of the kinds of expression it affords or constrains, and the power it gives the platform. In closing, we encourage scholars to maintain a balanced and constructive approach in researching the platform, and embrace the messiness and complexity inherent in this endeavor—which mirrors the messiness and complexity of the platform itself.
#StopAsianHate on TikTok: Asian/American Women’s Space-Making for Spearheading Counter-Narratives and Forming an Ad Hoc Asian Community
Authors: Lee Jeehyun Jenny , Lee Jin
Published: February 2023

TikTok, one of the fastest growing entertainment platforms, is also a burgeoning space for hosting political expressions and movements. In this study, we examine how Asian/American women creatively occupy the #StopAsianHate hashtag on TikTok to counter anti-Asian racism and form pan-Asian solidarity. We analyze their participation in the #StopAsianHate hashtag as anti-racist space-making practices, which we define as the act of carving out discursive spaces to spread counter-narratives to anti-Asian racism and claiming space through their agentive, visual presence. Drawing upon Critical Technocultural Discourse Analysis (CTDA) as our method, we analyze 130 #StopAsianHate TikTok videos by Asian/American women and examine how their anti-racist space-making practices draw upon the features and cultures of TikTok. We illustrate how Asian/American women extend the discussion on anti-Asian racism to include their gendered and raced experiences, and challenge racism in affective and evocative ways. We conclude by discussing how their space-making practices foster an ad hoc community for Asian/Americans across differences amid rising anti-Asian hate crimes.
Association Between Venous Homografts and Allosensitization After Norwood Procedure
Authors: Tan Christian H , Cleveland David C , Dabal Robert J , Padilla Luz A , Maxwell Kathryn S , Law Mark A , Carlo Waldemar F , Borasino Santiago , Sorabella Robert A
Published: February 2023

Background

Right ventricle (RV) to pulmonary artery (PA) shunts have become the shunt of choice at many centers for use during the Norwood procedure for single ventricle palliation. Some centers have begun to use cryopreserved femoral or saphenous venous homografts as an alternative to polytetrafluoroethylene (PTFE) for shunt construction. The immunogenicity of these homografts is unknown, and potential allosensitization could have significant implications on transplant candidacy.

Methods

All patients undergoing Glenn procedure at our center between 2013 and 2020 were screened. Patients who initially underwent Norwood procedure with either PTFE or venous homograft RV-PA shunt and had available pre-Glenn serum were included in the study. The primary outcome of interest was panel reactive antibody (PRA) level at the time of Glenn surgery.

Results

Thirty-six patients met inclusion criteria (N = 28 PTFE, N = 8 homograft). Patients in the homograft group had significantly higher median PRA levels at the time of Glenn surgery (0% [IQR 0-18] PTFE vs 94% [IQR 74-100] homograft, P = .003). There were no other differences between the two groups.

Conclusions

Despite potential improvements in PA architecture, the use of venous homografts for RV-PA shunt construction at the time of Norwood procedure is associated with significantly elevated PRA level at the time of Glenn surgery. Centers should carefully consider the use of currently available venous homografts given the high percentage of these patients who may require future transplantation.
Isolated Vascular Rings Are Common Cardiovascular Malformations
Authors: Evans William N. , Acherman Ruben J. , Ciccolo Michael L. , Lehoux Juan , Berthoty Dean , Montes Arthur , Mayman Gary A. , Restrepo Humberto
Published: February 2023

Objective

We investigated the prevalence of isolated vascular rings in the general population of Southern Nevada.

Methods

We identified those prenatally and postnatally diagnosed with an isolated vascular ring between January 2014 and December 2021. We included only those with vascular or ligamentous structures completely encircling the trachea and esophagus. To investigate the prevalence of isolated vascular rings, we included only those with situs solitus, levocardia, and no significant intracardiac malformations.

Results

We identified 112 patients. Of the 112, 66 (59%) were female. There were approximately 211,000 total live births in Southern Nevada for the study period, for an overall prevalence of 5.3 isolated vascular rings per 10 000 live births. However, for the years 2014 to 2017, the average prevalence figure was 3.5 per 10 000 live births, and for the years 2018 to 2021, the average prevalence figure was 7.1 (range 6.5-8.0) per 10 000 live births. Simultaneously, the prenatal detection rate rose from 66% to 86%.

Conclusions

Isolated vascular rings are common cardiovascular malformations. As prenatal detection rates in the Southern Nevada general population approach 90%, the prevalence figures for isolated vascular rings appear to asymptote at about 7 per 10 000 live births.
Influence of Body Mass Index in Donor–Recipient Size Mismatch in Pediatric Heart Transplantation
Authors: Lowrey Laura K , Trivedi Jaimin , Ramakrishnan Karthik , Sinha Pranava , Deshpande Shriprasad R
Published: February 2023

Background

Body weight is the traditional metric for matching donor and recipient size for pediatric heart transplantation (pHT). We hypothesized that mismatch in body mass index (BMI) or body surface area (BSA) rather than weight is better associated with outcomes of transplantation and therefore should be used for donor–recipient size matching.

Methods

Analysis of the United Network for Organ Sharing database limited to pHT recipients was performed. Donor and recipient mismatch groups were created for weight, BMI, and BSA ratios. Differences in recipient characteristics between each cohort and the impact of mismatch on outcomes were statistically analyzed.

Results

A total of 4,465 patients were included in the analysis of which 43% had congenital heart disease (CHD). There were significant differences in patient characteristics by matching, independent of the matching parameter. Multivariable regression analysis showed that a low donor–recipient BMI ratio (compared to normal) (CHD OR 1.70; non-CHD 2.78) was a predictor of one-year mortality (all P < .001) in both CHD and non-CHD cohorts. Low BMI ratio was also associated with worse long-term survival in non-CHD groups, but not in the CHD cohort. Weight and BSA ratio did not predict one year or long-term survival.

Conclusion

The use of low BMI donors compared to recipient may predict poor early and long-term survival and therefore should be avoided in pHT. The use of BMI matching may improve donor–recipient matching in pHT.
Factors Influencing the Initial Constraint Level of the Knee Joint and Its Effect on Clinical Outcomes After ACL Reconstruction With Hamstring Graft
Authors: Chung Kwangho , Choi Chong Hyuk , Jung Min , Choi Jeehoon , Kim Sung-Jae , Kim Sung-Hwan
Published: February 2023

Background:

A force-based tension protocol that uses a certain amount of tension at graft fixation could still give rise to variations in initial constraint levels of the knee joint in terms of side-to-side difference (SSD) in anterior translation.

Purpose:

To investigate the factors influencing the initial constraint level in anterior cruciate ligament (ACL)–reconstructed knees and compare outcomes according to the level of constraint in terms of anterior translation SSD.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Included were 113 patients who underwent ipsilateral ACL reconstruction using an autologous hamstring graft and had minimum 2-year follow-up outcomes. All grafts were tensioned and fixed at 80 N using a tensioner at the time of graft fixation. The patients were classified into the following 2 groups according to the initial anterior translation SSD, measured using the KT-2000 arthrometer: a physiologic constraint group with restored anterior laxity ≤2 mm (group P; n = 66) and a high-constraint group with restored anterior laxity >2 mm (group H; n = 47). Clinical outcomes were compared between the groups, and preoperative and intraoperative variables were evaluated to identify factors affecting the initial constraint level.

Results:

Between group P and group H, generalized joint laxity ( P = .005), posterior tibial slope ( P = .022), and anterior translation measured in the contralateral knee ( P < .001) were found to differ significantly. Measured anterior translation in the contralateral knee was the only significant predictor of high initial graft tension ( P = .001). No significant differences were found between the groups regarding clinical outcomes and subsequent surgery.

Conclusion:

Greater anterior translation measured in the contralateral knee was an independent predictor of a more constrained knee after ACL reconstruction. The short-term clinical outcomes after ACL reconstruction were comparable, regardless of the initial constraint level in terms of anterior translation SSD.
Comparison of Primary Care Patients’ and Unannounced Standardized Patients’ Perceptions of Care
Authors: Altshuler Lisa , Fisher Harriet , Wilhite Jeffrey , Phillips Zoe , Holmes Isaac , Greene Richard E , Wallach Andrew B , Smith Reina , Hanley Kathleen , Schwartz Mark D , Zabar Sondra
Published: February 2023

The objective of this study was to compare unannounced standardized patient (USP) and patient reports of care. Patient satisfaction surveys and USP checklist results collected at an urban, public hospital were compared to identify items included in both surveys. Qualitative commentary was reviewed to better understand USP and patient satisfaction survey data. Analyses included χ2 and Mann-Whitney U test. Patients provided significantly higher ratings on 10 of the 11 items when compared to USPs. USPs may provide a more objective perspective on a clinical encounter than a real patient, reinforcing the notion that real patients skew overly positive or negative.
Knowledge, Attitudes, Practices, and Associated Factors Towards Care of Elderly Patients among Nurses
Authors: Mitike Hailye , Yimam Wondwossen , Goshiye Debrnesh , Kumar Kumar Prem
Published: February 2023

Background

Ethiopia's elderly care service is relatively young and little is known about the practices or readiness of nurses to provide care. Nurses need to have good knowledge, a positive attitude, and experience when it comes to caring for the elderly or patients who are chronically providing quality care. This study aimed to assess the knowledge, attitudes, and practices towards care for elderly patients and associated factors among nurses working in adult care units of public hospitals in Harar, 2021.

Methods

An institutional-based descriptive cross-sectional study was conducted from February 12 to July 10, 2021. A simple random sampling technique was used to select 478 study participants. Data were collected by trained data collectors using a pretested self-administered questionnaire. From the pretest, Cronbach's alpha for all items was above 0.7 for all items. Data were entered into Epi Data v.4.6 and exported to the Statistical Package for Social Science Version 26 for binary logistic regression analysis. A P-value of 0.05 was used to declare a significant association between variables.

Results

The study revealed that 311 (69%) had inadequate knowledge. Having a first degree and an unfavorable attitude towards nurses showed a statistically significant association with nurses’ inadequate knowledge. A total of 275 (61.0%) nurses were found to have an unfavorable attitude and were significantly associated with having a diploma and first degree, learning in a private organization, 6 to 10 years of experience, lack of training, and inadequate knowledge of nurses. A total of 297 (65.9%) study units had inadequate practice towards the care of elderly patients. Nurses’ practices showed a significant association with the type of hospital, work experience, and adherence to guidelines with a response rate of 94.4%.

Conclusion

The majority of nurses had inadequate knowledge, an unfavorable attitude, and inadequate practice towards the care of elderly patients. Having a first-degree and an unfavorable attitude with inadequate knowledge, lack of training and inadequate knowledge, unfavorable attitudes and less than 11 years of experience, working in non-academic hospitals, and unavailability of guidelines with inadequate practices were significantly associated.
Inequality in Healthcare Access at the Intersection of Caste and Gender
Authors: Ahmed Shakeel , Mahapatro Sandhya
Published: February 2023

Health equity is of particular concern in the Indian context in the light of widening economic inequality and healthcare reforms which have wider ramifications on healthcare access. Despite various programs and interventions, a wide gap in health condition is observed in society among different castes, groups and income-classes. In this article, the inequality in healthcare access is studied at the cross-section of gender (man and women) and social groups—Schedule Caste and Schedule Tribe (SC-ST), Other backward classes (OBC) and Others—and an attempt has been made to explore how much the women from SC-ST community are deprived of healthcare access in comparison to other gender-group intersections. To proceed with analysis, data on ‘National Sample Survey (NSS), 75th Round (2017–2018) on Health Consumptions’ are taken. Analyses are carried on in SPSS Ver.18 and Stata-16. Regression Analysis shows that women from SC-ST are 1.37 times more likely to non-access to healthcare services than men from the general category. Further, to measure the intensity of inequality in healthcare access, Wagstaff’s Concentration Index (CI) is calculated at –0.195 that shows income-related inequality highly persists among the poor. At last, the decomposition analysis of CI reveals that gender, income and social groups are some of the major contributory factors to CI, that is, health inequality. The results indicate despite the mandate of universal healthcare access, India is lagging in achieving equity in healthcare as the poor and marginalized are deprived of it.
Pediatric Central Retinal Vein Occlusion Secondary to Concurrent Mechanisms of Optic Neuritis and Antiphospholipid Syndrome
Authors: Rana Viren , Kim Eric , Rana Shivani , Janigian Robert H. , Bakaeva Tatiana , Saade Celine
Published: February 2023

Purpose: To report a pediatric case of optic neuritis with subsequent development of central retinal vein occlusion (CRVO). Methods: A case and its findings were analyzed. Results: A 16-year-old boy presented with painful vision loss in the left eye, an afferent pupillary defect, and optic disc edema. Magnetic resonance imaging showed optic nerve enhancement and contrast-enhancing cerebral white-matter lesions, consistent with optic neuritis and demyelinating disease. He received intravenous methylprednisolone followed by a prednisone taper. At the 3-week follow-up, the visual acuity (VA) in the left eye had worsened and fundoscopic examination showed a new CRVO. A hypercoagulable workup showed antiphospholipid syndrome, which was treated with warfarin. He received intravitreal antivascular endothelial growth factor treatment with subsequent improvement in VA and resolution of the macular edema. Conclusions: This case describes an unusual mechanism for CRVO via a combination of optic disc edema from optic neuritis and hypercoagulability from antiphospholipid syndrome. It is important to recognize this complication of optic disc edema and the necessary workup for a pediatric CRVO.
Mutational Bias and Natural Selection Driving the Synonymous Codon Usage of Single-Exon Genes in Rice (Oryza sativa L.)
Authors: Hu Huan , Dong Boran , Fan Xiaoji , Wang Meixia , Wang Tingzhang , Liu Qingpo
Published: February 2023

The relative abundance of single-exon genes (SEGs) in higher plants is perplexing. Uncovering the synonymous codon usage pattern of SEGs will benefit for further understanding their underlying evolutionary mechanism in plants. Using internal correspondence analysis (ICA), we reveal a significant difference in synonymous codon usage between SEGs and multiple-exon genes (MEGs) in rice. But the effect is weak, accounting for only 2.61% of the total codon usage variability. SEGs and MEGs contain remarkably different base compositions, and are under clearly differential selective constraints, with the former having higher GC content, and evolving relatively faster during evolution. In the group of SEGs, the variability in synonymous codon usage among genes is partially due to the variations in GC content, gene function, and gene expression level, which accounts for 22.03%, 5.99%, and 3.32% of the total codon usage variability, respectively. Therefore, mutational bias and natural selection should work on affecting the synonymous codon usage of SEGs in rice. These findings may deepen our knowledge for the mechanisms of origination, differentiation and regulation of SEGs in plants.
Total exudative retinal detachment in a child with pars planitis- a challenging case with optimistic results
Authors: Navarrete Ana , Jaouni Tareq , Amer Radgonde
Published: February 2023

We describe a case report of pediatric pars planitis complicated with massive exudative retinal detachment (ERD). A 7-year-old presented with visual acuity (VA) in the right eye (RE) of 6/9 and in the left eye (LE) 6/15. Fundoscopy revealed BE inferior retinoschisis, vitritis and snowballs. He was treated with systemic immunosuppressants. RE retinoschisis resolved within 2 months. Three years later presented with LE VA 6/60 and total ERD. Systemic and intravitreal steroids were administered. Due to refractoriness, he underwent 360° scleral buckle and drainage of subretinal fluid. No retinal breaks or traction were detected. Five months postoperatively LE VA was 6/7.5. Long-term stable outcome was maintained. We report a challenging total ERD as a complication of pars planitis. Although extensive and non-responsive to medical therapy, complete resolution and improvement in vision was achieved with surgical intervention and systemic immunosuppression. We speculate that uncontrolled chronic vasculitic process culminated in diffuse ERD.
Radiolabeled nanomaterial for cancer diagnostics and therapeutics: principles and concepts
Authors: Goel Muskan , Mackeyev Yuri , Krishnan Sunil
Published: February 2023

In the last three decades, radiopharmaceuticals have proven their effectiveness for cancer diagnosis and therapy. In parallel, the advances in nanotechnology have fueled a plethora of applications in biology and medicine. A convergence of these disciplines has emerged more recently with the advent of nanotechnology-aided radiopharmaceuticals. Capitalizing on the unique physical and functional properties of nanoparticles, radiolabeled nanomaterials or nano-radiopharmaceuticals have the potential to enhance imaging and therapy of human diseases. This article provides an overview of various radionuclides used in diagnostic, therapeutic, and theranostic applications, radionuclide production through different techniques, conventional radionuclide delivery systems, and advancements in the delivery systems for nanomaterials. The review also provides insights into fundamental concepts necessary to improve currently available radionuclide agents and formulate new nano-radiopharmaceuticals.
Insights into the enumeration of mixtures of probiotic bacteria by flow cytometry
Authors: Tracey Harry , Coates Niall , Hulme Eleri , John Daniel , Michael Daryn Robert , Plummer Susan Frances
Published: February 2023

The use of flow cytometry to enumerate microorganisms is gaining traction over the traditional plate count technique on the basis of superior accuracy, precision and time-to-result. Here, we assessed the suitability of live/dead flow cytometry for the enumeration of mixed populations of probiotic bacteria (L. acidophilus, L. paracasei, L. plantarum, L. salivarius, B. lactis and B. bifidum) whilst comparing outcomes with plate counting. Using a novel gating strategy designed specifically for the enumeration of mixed populations, the application of flow cytometry resulted in the detection of higher numbers of viable bacteria with a greater level of repeatability than plate counting (RSD of 6.82 and 13.14% respectively). Across all multi-species blends tested, viable cell input was more accurately recovered by flow cytometry (101.8 ± 6.95%) than plate counts (81.37 ± 16.03%). However, when certain probiotic mixtures contained preparations with high numbers of non-viable cells in their total population, flow cytometry had the potential for overestimation of the viable population. Nevertheless, the comparative plate counts of these mixtures were low and variable, thus supporting the use of flow cytometry for the enumeration of viable bacteria in mixed populations.
Whole-genome sequence analysis of clinically isolated carbapenem resistant Escherichia coli from Iran
Authors: Haeili Mehri , Barmudeh Samaneh , Omrani Maryam , Zeinalzadeh Narges , Kafil Hossein Samadi , Batignani Virginia , Ghodousi Arash , Cirillo Daniela Maria
Published: February 2023

Background

The emergence of carbapenem-resistant Enterobacterales (CRE) continues to threaten public health due to limited therapeutic options. In the current study the incidence of carbapenem resistance among the 104 clinical isolates of Escherichia coli and the genomic features of carbapenem resistant isolates were investigated.

Methods

The susceptibility to imipenem, tigecycline and colistin was tested by broth dilution method. Susceptibility to other classes of antimicrobials was examined by disk diffusion test. The presence of blaOXA-48, blaKPC, blaNDM, and blaVIM carbapenemase genes was examined by PCR. Molecular characteristics of carbapenem resistant isolates were further investigated by whole-genome sequencing (WGS) using Illumina and Nanopore platforms.

Results

Four isolates (3.8%) revealed imipenem MIC of ≥32 mg/L and positive results for modified carbapenem inactivation method and categorized as carbapenem resistant E. coli (CREC). Colistin, nitrofurantoin, fosfomycin, and tigecycline were the most active agents against all isolates (total susceptibility rate of 99, 99, 96 and 95.2% respectively) with the last three compounds being found as the most active antimicrobials for carbapenem resistant isolates (susceptibility rate of 100%). According to Multilocus Sequence Type (MLST) analysis the 4 CREC isolates belonged to ST167 (n = 2), ST361 (n = 1) and ST648 (n = 1). NDM was detected in all CREC isolates (NDM-1 (n = 1) and NMD-5 (n = 3)) among which one isolate co-harbored NDM-5 and OXA-181 carbapenemases. WGS further detected blaCTX-M-15, blaCMY-145, blaCMY-42 and blaTEM-1 (with different frequencies) among CREC isolates. Co-occurrence of NDM-type carbapenemase and 16S rRNA methyltransferase RmtB and RmtC was found in two isolates belonging to ST167 and ST648. A colistin-carbapenem resistant isolate which was mcr-negative, revealed various amino acid substitutions in PmrB, PmrD and PhoPQ proteins.

Conclusion

About 1.9% of E. coli isolates studied here were resistant to imipenem, colistin and/or amikacin which raises the concern about the outbreaks of difficult-to-treat infection by these emerging superbugs in the future.
Patient and nurse preference for Sensoready autoinjector pen versus other autoinjectors in multiple sclerosis: results from a pilot multicenter survey
Authors: Ross Amy Perrin , Besser Christian , Naval Shubhanvita , Stoneman Dee , Gaunt Harriet , Barker Noreen
Published: February 2023

Background

Sensoready® autoinjector pen facilitates self-administration of subcutaneous ofatumumab injections at home. We aim to investigate patient and nurse preference for using Sensoready® versus comparator autoinjectors in multiple sclerosis (MS).

Methods

A pilot survey was conducted in Germany followed by in-field interviews across United States, Germany, France, and Italy. The survey recruited 80 MS patients and 50 MS nurses. Respondents were interviewed for 45-min on qualitative open-ended and quantitative close-ended survey consisting of 31 questions for patients and 41 for nurses. Ratings were measured on Likert scale from 1 (not at all important) to 10 (extremely important).

Results

“Easy to perform self-injection with the pen” and “Patient able to use independently” (both, mean overall score 9.4) were the most important attributes for both patients and nurses. Sensoready® scored high across most important attributes for both patients and nurses (p < 0.05). Sensoready® was preferred over comparator devices across majority of the important attributes (84%; p < 0.05), especially ease of use of the pen (mean overall score 9.4). Sensoready® was preferred over their current device by 9/10 nurses and 8/10 patients if they had to choose a treatment based on the device alone.

Conclusion

Both MS patients and nurses preferred the Sensoready® (ofatumumab) over comparator autoinjectors for their treatment, mostly driven by ease of administration.
A randomised clinical trial comparing outcomes of a single digit volar plate injury — Buddy loops versus dorsal thermoplastic orthosis in a neutral position: study protocol
Authors: Walsh Sarah , Fahey Paul , Liu Karen
Published: February 2023

Background

Volar plate injuries are a common hand injury and complications associated with this injury such as a fixed flexion deformity, persistent pain and oedema can have a significant impact on a person’s function. The literature reports these injuries are treated using various splinting materials such as thermoplastic, in varying degrees of proximal interphalangeal joint flexion or buddy loops. Despite volar plate injuries being reported as common, optimal non-surgical treatment of these injuries remains unclear.

This study aims to investigate whether a dorsal blocking orthosis in a neutral position (00) is more effective than buddy loops for a volar plate injury to the proximal interphalangeal joint in preventing a fixed flexion deformity, reducing pain, managing oedema, and promoting function.

Methods

This study is a single-centre, prospective parallel-group, single blinded (assessor), randomised clinical trial. Patients between 18–65 years, who have sustained a volar plate injury to a single digit, have adequate cognitive functioning and give written informed consent will be invited to participate in this study. Patients will be randomised to either the control group where they will be fitted with buddy loops and commence early active motion exercises or the experimental group where they will receive a dorsal thermoplastic orthosis in a neutral position and commence early active motion exercises. The primary outcome measure is passive proximal interphalangeal joint extension and secondary outcome measures include passive range of motion, total passive motion, active range of motion, total active motion, grip strength, oedema, pain, function and adherence to treatment. Assessments will be completed until 8 weeks following commencement of treatment. The sample size calculation indicates that 23 patients is required in each group. With an expected dropout rate of 25% a total of 32 patients will be enrolled in each group.

Discussion

This study will assist in trying to improve treatment of volar plate injuries and assist in reducing complications associated with volar plate injuries, potentially reducing the need for prolonged hand therapy.

Trial registration

This trial has been registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622001425785p). Ethical approval has been granted by the South Eastern Sydney Local Health District ethical committee (2022/ETH01697).
Hot fomentation of newborn fontanelles as an indigenous practice in Ghana: implications for policy and integrated community-based health care in Covid-19 pandemic and beyond
Authors: Ani-Amponsah Mary , Richter Solina , Adam Mariam Al-Hassan , Osei Evans Appiah , Mustapha Mahama , Oti-Boadi Ezekiel
Published: February 2023

Objective

African newborns undergo numerous traditional and religious practices ranging from fontanelle fomentation to total head shaving, scalp molding, skin scarification and ano-genital irrigation which can negatively impact the health of neonates. Hot fomentation of fontanelles has been a predominant indigenous home-based postnatal practice in Ghana and among Africans in the diaspora. Mobility restrictions during the Covid-19 pandemic has impacted direct access to facility-based care as well as home care. The flourishing of newborn traditional practices among African populations during this Covid-19 pandemic offers opportunities to rethink the provision of family healthcare support for newborns during the ongoing pandemic and beyond. Hence, the aim of this critical review was to examine and describe a common indigenous practice—hot fontanelle fomentation to inform home birth support, discharge planning, and the delivery of optimal home-based care support.

Study design

This study is a review of literature on hot fomentation of newborn fontanelles.

Methods

Literature search in CINAHL, PubMed, African Index Medicus and Scopus, was conducted and evidence synthesised from articles ranging from 1983–2022. Sixty articles were reviewed; however, 10 manuscripts were excluded prior to screening. The other 19 were exempted because they were either below 1983 or were not the best fit for the study purpose. In all, 31 studies were included in the study. The study was guided by Madeleine Leininger’s Culture Care Diversity and Universality care theory.

Results

The current study identifies hot fomentation of newborn fontanelles practices in Ghana, the description of hot fomentation practices and the dangers associated with it. The findings and suggested ways to help overcome this challenge.

Conclusion

There are several neonatal indigenous practices including fontanelle fomentation which pose threat to the health of the neonate as discussed in this study. Future research needs to investigate innovative ways of fontanelle fomentation where necessary instead of the use of hot water by mothers, especially in this Covid-19 pandemic where health and mobility restrictions impact physical access to timely health care. This research will help educate mothers about the dangers of fontanel fomentation and reduce the practice, especially in rural areas of developing countries. This could help reduce neonatal mortality and unnecessary healthcare costs.
Prenatal and childhood chlordecone exposure, cognitive abilities and problem behaviors in 7-year-old children: the TIMOUN mother–child cohort in Guadeloupe
Authors: Oulhote Youssef , Rouget Florence , Michineau Léah , Monfort Christine , Desrochers-Couture Mireille , Thomé Jean-Pierre , Kadhel Philippe , Multigner Luc , Cordier Sylvaine , Muckle Gina
Published: February 2023

Background

Chlordecone is a highly persistent organochlorine insecticide that was intensively used in banana fields in the French West Indies, resulting in a widespread contamination. Neurotoxicity of acute exposures in adults is well recognized, and empirical data suggests that prenatal exposure affects visual and fine motor developments during infancy and childhood, with greater susceptibility in boys.

Objective

To assess the associations between pre- and postnatal exposures to chlordecone and cognitive and behavioral functions in school-aged children from Guadeloupe.

Methods

We examined 576 children from the TIMOUN mother–child cohort in Guadeloupe at 7 years of age. Concentrations of chlordecone and other environmental contaminants were measured in cord- and children’s blood at age 7 years. Cognitive abilities of children were assessed with the Wechsler Intelligence Scale for Children-IV (WISC-IV), and externalizing and internalizing problem behaviors documented with the Strengths and Difficulties Questionnaire (SDQ) completed by the child’s mother. We estimated covariate-adjusted associations between cord- and 7-years chlordecone concentrations and child outcomes using structural equations modeling, and tested effect modification by sex.

Results

Geometric means of blood chlordecone concentrations were 0.13 µg/L in cord blood and 0.06 µg/L in children’s blood at age 7 years. A twofold increase in cord blood concentrations was associated with 0.05 standard deviation (SD) (95% Confidence Interval [CI]: 0.0, 0.10) higher internalizing problem scores, whereas 7-years chlordecone concentrations were associated with lower Full-Scale IQ scores (FSIQ) and greater externalized behavioral problem scores. A twofold increase in 7-year chlordecone concentrations was associated with a decrease of 0.67 point (95% CI: -1.13, -0.22) on FSIQ and an increase of 0.04 SD (95% CI: 0.0, 0.07) on externalizing problems. These associations with Cognitive abilities were driven by decreases in perceptive reasoning, working memory and verbal comprehension. Associations between 7-year exposure and perceptive reasoning, working memory, and the FSIQ were stronger in boys, whereas cord blood and child blood associations with internalizing problems were stronger in girls.

Conclusions

These results suggests that cognitive abilities and externalizing behavior problems at school age are impaired by childhood, but not in utero, exposure to chlordecone, and that prenatal exposure is related to greater internalizing behavioral problems.
The impact of depression at preconception on pregnancy planning and unmet need for contraception in the first postpartum year: a cohort study from rural Malawi
Authors: Catalao Raquel , Chapota Hilda , Chorwe-Sungani Genesis , Hall Jennifer
Published: February 2023

Background

The impact of depression on women’s use of contraception and degree of pregnancy planning in low-income settings has been poorly researched. Our study aims to explore if symptoms of depression at preconception are associated with unplanned pregnancy and nonuse of contraception at the point of conception and in the postpartum period.

Methods

Population-based cohort of 4244 pregnant women in rural Malawi were recruited in 2013 and were followed up at 28 days, 6 months and 12 months postpartum. Women were asked about symptoms of depression in the year before pregnancy and assessed for depression symptoms at antenatal interview using the Self‐Reporting Questionnaire‐20, degree of pregnancy planning using the London Measure of Unplanned Pregnancy and use of contraception at conception and the three time points postpartum.

Results

Of the 3986 women who completed the antenatal interview, 553 (13.9%) reported depressive symptoms in the year before pregnancy and 907 (22.8%) showed current high depression symptoms. History of depression in the year before pregnancy was associated with inconsistent use of contraception at the time of conception [adjusted relative risk (adjRR) 1.52; 95% confidence interval (1.24–1.86)] and higher risk of unplanned [adjRR 2.18 (1.73–2.76)] or ambivalent [adj RR 1.75 (1.36–2.26)] pregnancy. At 28 days post-partum it was also associated with no use of contraception despite no desire for a further pregnancy [adjRR 1.49 (1.13–1.97)] as well as reduced use of modern contraceptives [adj RR 0.74 (0.58–0.96)]. These results remained significant after adjusting for socio-demographic factors known to impact on women’s access and use of family planning services, high depression symptoms at antenatal interview as well as disclosure of interpersonal violence. Although directions and magnitudes of effect were similar at six and 12 months, these relationships were not statistically significant.

Conclusions

Depression in the year before pregnancy impacts on women’s use of contraception at conception and in the early postpartum period. This places these women at risk of unplanned pregnancies in this high fertility, high unmet need for contraception cohort of women in rural Malawi. Our results call for higher integration of mental health care into family planning services and for a focus on early postnatal contraception.
Bimanual movements in children with cerebral palsy: a systematic review of instrumented assessments
Authors: Cacioppo Marine , Loos Anthéa , Lempereur Mathieu , Brochard Sylvain
Published: February 2023

Background

Assessment of bimanual movements, which are frequently impaired in children with cerebral palsy, is highly challenging in clinical practice. Instrumented measures have been developed to evaluate and help to understand impaired upper limb movement during bimanual tasks in these children. The aim of this review was to report instrumented measurement tools (3D motion analysis, sensors, etc.) used for bimanual task movement analysis, and the metrological properties of the measures in children with cerebral palsy.

Methods

A systematic review was conducted (Prospero CRD42022308517). PubMed, Web of Science, Cochrane and Scopus databases were searched with relevant keywords and inclusion/exclusion criteria. Article quality and biomechanical methods were evaluated with a customized scale and metrological properties with the COSMIN checklist.

Results

In total, 452 children, mostly with unilateral cerebral palsy, mean age 10.9 (SD 3.2) years, underwent quantitative bimanual assessments in the 31 included studies (mean quality score 22/32 points [SD 4.7]). The tools used were 3D motion analysis (n = 26), accelerometers (n = 2), and other instruments (cube, digitizer, etc.) (n = 3). Children performed 1–5 bimanual tasks in laboratory settings, mostly activities of daily living or game scenarios. Analyses focused mostly on spatiotemporal variables, 6 of which were specifically developed for bilateral measures (task completion time, goal synchronization, movement overlap time, interlimb coupling, continuous relative phase and asynchrony). These instrumented measurements had moderate to good discriminant and convergent validity, but reliability and responsiveness assessments were lacking.

Conclusions

A large number of quantitative bimanual assessments involving different tools, bimanual tasks and specific variables developed to evaluate bimanual function were found. Development of other relevant variables and validation of these tools are needed to further determine their usefulness, both as research outcomes and to guide therapies in clinical practice. Future research, involving younger children and real-life assessments, will improve our understanding of bimanual function in children with cerebral palsy.
Integrative analysis of bulk and single-cell gene expression profiles to identify tumor-associated macrophage-derived CCL18 as a therapeutic target of esophageal squamous cell carcinoma
Authors: Sui Xinghua , Chen Chunxia , Zhou Xiuman , Wen Xueyan , Shi Chao , Chen Guanyu , Liu Juan , He Zhuoying , Yao Yongjie , Li Yin , Gao Yanfeng
Published: February 2023

Background

Esophageal squamous cell carcinoma (ESCC) is a common gastrointestinal malignancy with poor patient prognosis. Current treatment for ESCC, including immunotherapy, is only beneficial for a small subset of patients. Better characterization of the tumor microenvironment (TME) and the development of novel therapeutic targets are urgently needed.

Methods

In the present study, we hypothesized that integration of single-cell transcriptomic sequencing and large microarray sequencing of ESCC biopsies would reveal the key cell subtypes and therapeutic targets that determine the prognostic and tumorigenesis of ESCC. We characterized the gene expression profiles, gene sets enrichment, and the TME landscape of a microarray cohort including 84 ESCC tumors and their paired peritumor samples. We integrated single-cell transcriptomic sequencing and bulk microarray sequencing of ESCC to reveal key cell subtypes and druggable targets that determine the prognostic and tumorigenesis of ESCC. We then designed and screened a blocking peptide targeting Chemokine C–C motif ligand 18 (CCL18) derived from tumor associated macrophages and validated its potency by MTT assay. The antitumor activity of CCL18 blocking peptide was validated in vivo by using 4-nitroquinoline-1-oxide (4-NQO) induced spontaneous ESCC mouse model.

Results

Comparative gene expression and cell–cell interaction analyses revealed dysregulated chemokine and cytokine pathways during ESCC carcinogenesis. TME deconvolution and cell interaction analyses allow us to identify the chemokine CCL18 secreted by tumor associated macrophages could promote tumor cell proliferation via JAK2/STAT3 signaling pathway and lead to poor prognosis of ESCC. The peptide Pep3 could inhibit the proliferation of EC-109 cells promoted by CCL18 and significantly restrain the tumor progression in 4-NQO-induced spontaneous ESCC mouse model.

Conclusions

For the first time, we discovered and validated that CCL18 blockade could significantly prevent ESCC progression. Our study revealed the comprehensive cell–cell interaction network in the TME of ESCC and provided novel therapeutic targets and strategies to ESCC treatment.