bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of coordination mechanisms based on information and communication technologies on cross-level clinical coordination: A scoping review
Authors: Campaz-Landazábal Daniela , Vargas Ingrid , Vázquez María-Luisa
Published: August 2024

Background

Coordination mechanisms based on information and communication technologies (ICTs) are gaining attention, especially since the pandemic, due to their potential to improve communication between health professionals. However, their impact on cross-level clinical coordination remains unclear. The aim is to synthesize the evidence on the impact of ICT-based coordination mechanisms on clinical coordination between primary care and secondary care (SC) doctors and to identify knowledge gaps.

Methods

A scoping review was conducted by searching for original articles in six electronic databases and a manual search, with no restrictions regarding time, area, or methodology. Titles and abstracts were screened. Full texts of the selected articles were reviewed and analysed to assess the impact of each mechanism, according to the cross-level clinical coordination conceptual framework.

Results

Of the 6555 articles identified, 30 met the inclusion criteria. All had been conducted in high-income countries, most ( n = 26) evaluated the impact of a single mechanism – asynchronous electronic consultations via electronic health records (EHR) – and were limited in terms of design and types and dimensions of cross-level clinical coordination analysed. The evaluation of electronic consultations showed positive impacts on the appropriateness of referrals and accessibility to SC, yet the qualitative studies also highlighted potential risks. Studies on other mechanisms were scarce (shared EHR, email consultations) or non-existent (videoconferencing, mobile applications).

Conclusions

Evidence of the impact of ICT-based mechanisms on clinical coordination between levels is limited. Rigorous evaluations are needed to inform policies and strategies for improving coordination between healthcare levels, thus contributing to high-quality, efficient healthcare.
Evaluating ChatGPT responses to frequently asked patient questions regarding periprosthetic joint infection after total hip and knee arthroplasty
Authors: Hu Xiaojun , Niemann Marcel , Kienzle Arne , Braun Karl , Back David Alexander , Gwinner Clemens , Renz Nora , Stoeckle Ulrich , Trampuz Andrej , Meller Sebastian
Published: August 2024

Background

Patients access relevant information concerning their orthopaedic surgery resources through multiple information channels before presenting for clinical treatment. Recently, artificial intelligence (AI)-powered chatbots have become another source of information for patients. The currently developed AI chat technology ChatGPT (OpenAI LP) is an application for such purposes and it has been rapidly gaining popularity, including for patient education. This study sought to evaluate whether ChatGPT can correctly answer frequently asked questions (FAQ) regarding periprosthetic joint infection (PJI).

Methods

Twelve FAQs about PJI after hip and knee arthroplasty were identified from the websites of fifteen international clinical expert centres. ChatGPT was confronted with these questions and its responses were analysed for their accuracy using an evidence-based approach by a multidisciplinary team. Responses were categorised in four groups: (1) Excellent response that did not require additional improvement; (2) Satisfactory responses that required a small amount of improvement; (3) Satisfactory responses that required moderate improvement; and (4) Unsatisfactory responses that required a large amount of improvement.

Results

From the analysis of the responses given by the chatbot, no reply received an ‘unsatisfactory’ rating; one did not require any correction; and the majority of the responses required low (7 out of 12) or moderate (4 out of 12) clarification. Although a few responses required minimal clarification, the chatbot responses were generally unbiased and evidence-based, even when asked controversial questions.

Conclusions

The AI-chatbot ChatGPT was able to effectively answer the FAQs of patients seeking information around PJI diagnosis and treatment. The given information was also written in a manner that can be assumed to be understandable by patients. The chatbot could be a valuable clinical tool for patient education and understanding around PJI treatment in the future. Further studies should evaluate its use and acceptance by patients with PJI.
Schlager vs. Techno: Style-Specific Rationales for Musical Taste
Authors: Gernandt Emily , Merrill Julia
Published: August 2024

Musical taste is a complex phenomenon that has been researched primarily in breadth, revealing commonalities of musical preferences. Such research has led to the specifics of musical taste for different music being lost. To expand the research on musical taste in more depth, semi-structured interviews were conducted with listeners of two very different musical styles, namely 10 who have a strong preference for techno 10 ten who strongly like German Schlager. The participants reported on the development and functions, the values associated with their musical taste (i.e., the musical, personal, and social values they ascribe to their music), and social acceptance of their taste. The analysis revealed both style-specific similarities and differences between the two groups of listeners. For instance, Schlager listeners often develop their taste within the family, enjoy singing along, and favor German lyrics, whereas techno listeners develop their taste through peer influence, enjoy dancing to the music, and prefer its rhythm. Interestingly, the qualities that the participants themselves value most about their style are also the qualities they suspect might make it unappealing to others. These findings illustrate the variability in the interaction between judgments concerning musical value and the functions associated with music listening, dependent on the specific style or substyle. Hence, recognizing the distinctiveness of different musical styles allows for a deeper exploration of the intricacies of musical preference to gain a more nuanced understanding of the complexity of musical taste.
Factors Associated with Hospital Length of Stay among VTE Cases: Insights from the i-RegVed Registry
Authors: Aggarwal Sumit , Rulu Peteneinuo ,   i-RegVed Team, Tabassum Heena
Published: August 2024

Introduction:

Venous thromboembolism (VTE) is a multifactorial condition and one of the leading causes of mortality and disability. The present study explores the factors associated with hospitalization duration among different types of venous thromboembolism diagnoses, such as deep vein thrombosis (DVT), pulmonary embolism (PE), and other forms of thrombosis.

Methods:

The data included participants with VTE admitted to 13 hospitals within pan-India from June 2022 to December 2023 to the i-RegVed registry, where socio-demographic data, clinical history, and various factors associated with hospital length of stay (LOS) were included for analyses. Multilinear regression was performed to explore the factors associated with hospital LOS among VTE conditions such as DVT, PE, forms of thrombosis other than PE and DVT, and all VTE diagnoses.

Results:

A total of 633 participants were included in the study, with 55% being males, and 28.9% being homemakers. Longer hospital LOS was significantly associated with age (β = −.09, P < .05), sex (β = 3.21, P < .05), and non-communicable diseases (β = 3.51, P < .05) among participants with DVT and among participants with at least one of the VTE diagnoses, age (β = −.12, P < .001) and anticoagulant use (β = −2.49, P < .05) was significantly associated.

Conclusion:

The findings provide insights into the factors influencing hospital outcomes among participants with different types of VTE, highlighting the importance of age and comorbidities in predicting the hospital LOS.
The Utility and Necessity for Radiographic Follow-Up After Arthroplasty for Geriatric Neck of Femur Fractures
Authors: Koh Don Jun Rui , Yeo Kuei Siong Andy , Kon Kam King Charles , Moo Ing How
Published: August 2024

Background

Hip fractures are a common and debilitating condition posing not only a huge health care but also socioeconomic burden. Surgical management for a neck of femur fracture is typically with arthroplasty in the form of total hip arthroplasty or hip hemiarthroplasty. Serial radiographs are typically performed routinely as part of follow-up to look for complications, although their clinical utility in asymptomatic patients is yet to be validated. Our paper therefore aims to review the utility and necessity of radiographic follow-up following arthroplasty for NOF fractures.

Materials and Methods

Patients who underwent operative management for acute fragility neck of femur fractures in the year from 1st January 2018 to 31st December 2018 at the author’s institution were identified. All patients who underwent surgery, and had at least one pre and one post-operative plain film radiograph of the affected hip were included in this study. Exclusion criteria included patients who had undergone surgery for chronic fractures, avascular necrosis of the femoral head, mortality within 1 year, peri-prosthetic fractures, pathological fractures from metastases, had concomitant injuries, or had inaccessible or incomplete records. Clinical records were assessed for the number of visits, an abnormal presenting history or clinical examination, as well as changes in management of the patient. The number and type of radiographs were also assessed, and each radiograph analyzed for abnormal findings.

Results

A total of 157 patients were included in our study with a mean age of 79.5 at the time of surgery, and a mean follow up of 17.3 months. Data was collected from 626 clinical visits and a total of 973 radiographs. The 3 abnormal radiographic series identified with a corresponding normal consult did not result in a change of management for the patient. A negative change in management was only observed in 1 patient with an abnormal consult and a corresponding normal radiograph.

Conclusion

Post-operative complications following arthroplasty for NOF fractures are likely to result in a symptomatic presentation of the patient. Routine radiographic follow-up provides limited utility in asymptomatic patients and should only be performed if clinically indicated.
Diasporic Practices and Cultural Identifications of Shanghainese Seamen in Liverpool
Authors: Zeng Shu , Wang Lin
Published: August 2024

This article draws on the understudied oral testimonies collected by Guanbao Shen and Ling Li in 1997 and 1998 to discuss the diasporic practices and cultural identifications of Shanghainese seamen in Liverpool, a community that has received less scholarly attention than other overseas Chinese communities. The Shanghainese seafarers are marked by three important characteristics—provenance, profession, and intermarriage, adding to the diversity and uniqueness of their diasporic practices. The discussions revolve around the wider social meanings and purposes of Chinese food-centered practices, return to the home country and negotiation of multiple boundaries among the Shanghainese seafarers. It is argued that the prosaic and festive eating and cooking of Chinese food is employed to (re)create ethnicity, resume the state of relatedness and strengthen the intergenerational bond, and that the return to the origin of birth could potentially disrupt an idealized and imagined conception of the homeland. Shanghainese seamen’s individual and collective negotiation of ethnic boundaries features complicated entanglement and thus permeability and fluidity, which echoes Ien Ang’s call for moving beyond diaspora into hybridity.
The Quest for a “Soft Life” and the Transition into Adulthood: Views from South African Emerging Adult Students
Authors: Naudé Luzelle , Esau Merlene
Published: August 2024

Gaining financial independence is a prominent marker of adulthood. This study explored the experiences of a group of South African students (MAge = 22.24), with a specific focus on how the psychological tasks of emerging adulthood are embedded in the socio-economic context. Through the thematic analysis of 26 interviews, participants’ hopes, fears, and well-being (while managing student life shaped by an economically contentious situation) were unpacked. Considering the academic, personal, and social threats in their quests for independence, participants appreciated the support from parents, the university, and funders. Despite financial obstacles, they portrayed a strong personal commitment and resilience to excel academically, be financially liberated, and break the cycle of poverty. Hardship inspired dreams to secure a better future, a ‘soft life’, for themselves and others. Findings are discussed in juxtaposition with the responsibility of institutions to ensure a just society where emerging adults can flourish into financially stable adulthoods and futures.
Outcomes of ACL Reconstruction Utilizing Supercritical CO2-Sterilized Allografts
Authors: Farey John E. , Salmon Lucy J. , Roe Justin P. , Russell Vivianne , Sundaraj Keran , Pinczewski Leo A.
Published: August 2024

Background:

Allograft tendons are perceived to have a high ACL graft failure rate in primary anterior cruciate ligament (ACL) reconstruction (ACLR). Historical series may be biased by graft processing methods that degrade the biomechanical properties of donor tendons such as irradiation. Supercritical carbon dioxide (SCCO2) is a validated method of terminally sterilizing biomaterials at physiological temperatures without irradiation, but in vivo use of SCCO2-processed tendon allografts for primary ACLR has not been reported to date.

Hypothesis:

ACLR with SCCO2 allografts would result in acceptable failure rates, subjective knee scores, and clinical evaluation at 2 years postoperatively.

Study Design:

Case series; Level of evidence, 4.

Methods:

Patients underwent primary ACLR with terminally sterilized SCCO2-processed human gracilis, peroneus longus, semitendinosus, tibialis anterior, and tibialis posterior tendon allografts. Patient demographics were collected, along with tendon donor age and sex. At 1 year postoperatively, subjective International Knee Documentation Committee (IKDC) and ACL–Return to Sport After Injury (ACL-RSI) scores were collected, as well as clinical evaluation. At 2 years postoperatively, the IKDC and ACL-RSI scores were repeated, and return to sports and further knee injuries were recorded.

Results:

A total of 144 patients with a medianage of 26 (IQR 14) years formed the study group. Patients were predominately male (58%). The loss to follow-up rate was 8% (n = 12). The mean age of allograft tendon donors was 37 (range 17-58) years, and the majority were male (83%). The mean allograft diameter was 8.9 ± 1.0 mm. At 2 years, ACL graft failureoccurred in 5% (n = 7). All graft failureswere in patients aged ≤25 years ( P = .007). Neither donor age (≤40 or >40 years) nor donor sex was associated with graft failure ( P > .05). The median IKDC subjective score was 95 and ACL-RSI score was 75. There were no revisions for sepsis within the first 2 years postoperatively.

Conclusion:

SCCO2 processing of allograft tendons demonstrated satisfactory clinical and patient-reported outcomes at 24 months postoperatively in a consecutive series of patients with primary ACLR, with similar ACL graft failure rates and subjective knee scores compared with those reported in published series of hamstring tendon autograft and fresh frozen nonirradiated allograft.
A Continuum of Expressions of Hope and the Influence on Leadership Through Times of Crisis
Authors: Virella Patricia
Published: August 2024

Given today’s crisis-laden context filled with educational challenges, it is critical to understand how principals express hope through their leadership to navigate these challenges. Through an extensive qualitative research study conducted in 2019–2022, I examined how 50 principals expressed and used hope in varying degrees to hinder or facilitate increased outcomes, inclusivity, and stable recovery post-crisis to design a better future for their school communities. In so doing, I describe (a) how the context in which principals lead lends itself to expressing high- or low-hope leadership attributes; (b) principals’ expressions of high-hope leadership during and post-crisis; and (c) principals’ expressions of low-hope leadership during and post-crisis. Identifying expressions of hope leadership practices with the potential to cultivate inclusive, equitable school climates proves vital, given the complexity of leadership today and the myriad crises leaders face.
Randomized Controlled Trials Assessing Exposure Frequency Effects of Stannous Fluoride on Gingivitis
Authors: He T. , Zou Y. , Grender J. , Amini P. , Kaminski M. , Biesbrock A.R.
Published: August 2024

Objective:

To evaluate the exposure frequency effect of 0.454% stannous fluoride (SnF2) toothpaste in controlling gingivitis.

Methods:

Two randomized controlled trials enrolled generally healthy adults with gingivitis. The study duration was 1 mo (study 1) and 3 mo (study 2). Gingivitis was assessed using the Löe-Silness Gingival Index (LSGI) at baseline, 1 mo (both studies), and 3 mo (study 2); bleeding scores were derived from the LSGI. Study groups consisted of positive control (twice-daily use of 0.454% SnF2 toothpaste), experimental group (brushing in the morning with SnF2 toothpaste and in the evening with 0.76% sodium monofluorophosphate [SMFP] toothpaste), and negative control (twice-daily use of SMFP toothpaste). The primary endpoint was number of bleeding sites.

Results:

Study 1 and study 2 each enrolled and randomized 90 participants; 86 and 89 participants, respectively, completed the trials. At baseline, the mean (SD) number of bleeding sites was 47.6 (18.54) in study 1 and 41.5 (17.84) in study 2. At 3 mo (study 2), the positive control produced 51.3% fewer bleeding sites, and the experimental group produced 32.5% fewer bleeding sites versus the negative control ( P < 0.001 for both). At 1 mo, the positive control produced 45.1% (study 1) and 45.8% (study 2) fewer bleeding sites versus the negative control ( P < 0.001 for both), and the experimental group produced 33.0% (study 1) and 24.8% (study 2) fewer bleeding sites, respectively, versus the negative control ( P ≤ 0.002 for both). The benefit was observed as early as 1 mo and was consistent with 3-mo results.

Conclusion:

This research is to our knowledge the first to demonstrate a gingivitis-reduction response effect for the frequency of bioavailable SnF2 toothpaste use, with maximum benefit from twice-daily use, followed by a single-daily exposure versus the negative control. Clinical trial registration numbers: NCT05916508 and NCT05916521.

Knowledge Transfer Statement:

The results of this study can be used by dental professionals to guide their recommendations for therapeutic toothpaste for gingival health. Emphasis on the importance of twice-daily brushing with bioavailable stannous fluoride dentifrice will help patients optimize gingival health benefits achieved via self-care.
Land-use efficiency and local government revenue: Evidence from 272 Chinese cities using a novel structural equation modelling approach
Authors: Wang Tianyuan , Wan Li , Bao Helen XH
Published: August 2024

The unprecedented urbanisation observed in leading developing countries has placed immense pressure on effective and efficient land management. The significance of land-use efficiency in the Chinese context has been addressed in the literature, particularly on the measurements of land-use efficiency and key influencing factors. However, quantifying the interdependence between land-use efficiency, local government revenue, employment and infrastructure development whilst controlling for significant cross-city differences remains a gap in the literature. Based on data for 272 prefecture-level Chinese cities between 2012 and 2017, this study employs a novel modelling approach, combining latent class analysis (LCA) in a generalised structural equation model. The incorporation of LCA helps to control for the significant, non-linear heterogeneity across city samples. The empirical model identifies both the direct (one-off land conveyance fee and transaction-related tax revenue from land transactions) and indirect (corporate and personal taxes generated from employment and business growth) channels, through which land development contributes to local government revenue. It also provides one of the first quantified evidence, confirming that employment growth provides higher long-term return than a one-off, land conveyance fee to government revenue in China, controlling for significant cross-city heterogeneity in land-use efficiency and wage.
NT-proBNP in Heart Failure with Preserved Ejection Fraction: A Comprehensive Review
Authors: Dsouza Glory , Sharma Manjari
Published: August 2024

The diagnosis and therapy of heart failure with preserved ejection fraction (HFpEF) are complicated by the disease’s varied etiology. In the field of heart failure (HF), N-terminal pro-B-type natriuretic peptide (NT-proBNP) has become an important biomarker, providing information on diagnosis, prognosis, and treatment monitoring. This in-depth investigation looks at the connection involving NT-proBNP levels and HFpEF, offering information on possible diagnostic applications as well as consequences for patient care. The study reviews the literature on the connection concerning NT-proBNP and HFpEF and emphasizes how NT-proBNP aids in the distinction of HFpEF from various cardiac and non-cardiac conditions. HF is known to be associated with elevated NT-proBNP levels, but the complex link with HFpEF necessitates careful examination. The abstract explores the difficulties in using NT-proBNP as a diagnostic tool for HFpEF, taking into account the potential influence of renal function, age, and comorbidities on NT-proBNP levels. Additionally, the predictive importance of NT-proBNP in HFpEF is explored, emphasizing its capacity to forecast death and severe cardiovascular events. The abstract emphasizes that diagnosing HFpEF requires a multimodal approach that includes clinical assessment, imaging modalities, and NT-proBNP measurement. In order to accurately manage patients with HF, particularly HFpEF, the abstract highlights the significance of integrating clinical judgment and other diagnostic measures, even though NT-proBNP is still a useful marker in this regard. Lastly, the study offers suggestions for future research trajectories that should further our knowledge of NT-proBNP’s function in HFpEF and improve its clinical applicability in this intricate and varied illness.
Exuberant and fantastical: How flythroughs are changing the way museums construct their identities and build relationships with their publics
Authors: Hellwig Anne F. J.
Published: August 2024

Digital ‘flythroughs’ are increasingly being used by museums to promote themselves to their publics and to extend their spatial and experiential boundaries. These complex, multimodal artefacts use 3D animation, AI imagery, drone footage, sound, music and other modes to construct a parallel museum experience. Such an experience is markedly dissimilar from an ‘ordinary’ embodied relationship to architectural space, and instead constructs an experience of elevated velocity, height and glissade. These movement style choices construct a ‘non-naturalistic’ experience of moving through space that differs considerably from the embodied experience constructed by digital walkthroughs, augmented and virtual reality and ordinary corporeal movement through a museum. Instead, they offer a potential imaginary, a supernatural or ’extracorporeal’ embodiment of a kind typically associated with fantasy films, video games, amusement rides and dreams. This paper analyses 10 flythroughs from a variety of museums and locations through the lens of multimodal social semiotics. The systems of movement styles and visual validity are used to explore how meanings are made in the flythroughs and how they may be understood in terms of the ‘fantasy’ coding orientation. The implications for how museums construct their respective identities and relate to their publics are also unpacked.
Dark intelligence: When the possibility of 1984 becomes reality
Authors: Sternberg Robert J.
Published: August 2024

This essay reviews a concept that is too rarely dealt with, if at all, in the literature on human intelligence, namely, dark intelligence. I argue that dark intelligence is the possession and, as relevant, deployment of creative, analytical, and practical abilities and attitudes that, in particular tasks confronted in particular situations, can be, and are used for negative, harmful, and, sometimes, malign purposes. Dark intelligence is extremely common, and the world is the worse for it. Yet intelligence research continues to focus largely on solving test-like problems that do not speak to how intelligence is deployed on particular tasks in particular situations, either for good or for evil purposes. The world is facing severe crises, such as climate change, weapons of mass destruction, violence, and enormous income disparities. Creativity researchers, recognizing these problems, have developed a thriving field of “dark creativity.” Intelligence researchers have been largely absent, however, largely ignoring the dark side of intelligence. Yet dark intelligence can be and is being used to cause harm. The world is at increasing peril from its intended and unintended consequences; understanding dark intelligence may help to mitigate some of that peril.
A qualitative investigation into autistic adults’ perspectives on intervention goals for autistic children
Authors: Schuck Rachel K. , Geng Alicia , Doss Yvette , Lin Florence , Crousore Hannah , Baiden Kaitlynn M. P. , Dwyer Patrick , Williams Zachary J. , Wang Mian
Published: August 2024

Behavioral intervention programs for autistic children target a variety of goals including communication, social, academic, and daily living skills. A key component of ethical interventions is social validity, the extent to which interested parties find the program goals, procedures, and outcomes acceptable. However, past research indicates that social validity is rarely assessed from the autistic point of view. Thus, while intervention goals may be acceptable from parent or clinician perspectives, little is known regarding autistic individuals’ views of these goals. In this study, autistic adults were presented with common intervention goals and asked to provide written feedback on them. Though these open-ended questions were presented as an optional survey question, each goal received open-ended feedback from 120 to 189 participants (out of a possible 214 who completed the relevant survey portions). Responses were analyzed using reflexive thematic analysis by a team of nonautistic and autistic researchers. Four themes were identified: “Autistic Way of Being & The Double Empathy Problem”; “Supporting Autonomy, Self-Advocacy, and Interdependence”; “Implementation Matters,", and “Moving Beyond Behavior.” Findings will hopefully aid providers in developing intervention goals that are aligned with the perspectives of the autistic community.

Lay abstract

Intervention programs for autistic children aim to help children with communication, social skills, academic tasks, and everyday behaviors and activities. A major factor in ensuring these programs are ethical is “social validity,” which means ensuring that the program goals, procedures, and outcomes are deemed acceptable by those involved. Historically, the views of autistic individuals on these interventions have been overlooked; instead, researchers have focused on the perspectives of clinicians and parents. This study used a survey with open-ended questions to explore autistic adults’ perspectives on the acceptability of common intervention goals. Our research team, which included both autistic and nonautistic members, analyzed and categorized the survey answers into four themes: “Autistic Way of Being & The Double Empathy Problem”; “Supporting Autonomy, Self-Advocacy, and Interdependence”; “Implementation Matters”; and “Moving Beyond Behavior.” Findings aim to encourage providers to develop intervention goals that align with the perspectives of the autistic community.
Austerity Measures and the Resilience of Zimbabwe's Healthcare System: Challenges and Solutions
Authors: Chiwaridzo Option Takunda
Published: August 2024

Austerity measures have become a contentious topic, shaping the landscape of health care systems around the world. As governments grapple with economic challenges, the impact of austerity on health care has emerged as a critical concern. This study focuses on the consequences of austerity actions adopted by the Zimbabwean government under the Transitional Stabilization Program (TSP) from August 2018 to December 2025. This research examines the impact of austerity measures on Zimbabwe's health care sector, exploring its connections with health infrastructure and resources, accessibility and affordability of health care, health funding, health care inequalities, and the health care workforce. Using a quantitative approach and data from 970 participants, including the general populace, health care providers, and government officials, significant positive correlations between austerity measures and these health care variables were identified. The findings indicated a noteworthy positive correlation between the independent variable “austerity measures” and five dependent variables: health care accessibility and affordability, health care inequalities, infrastructure and resources, health care funding, and health care workforce. The t-statistics values exceeded the threshold of 1.96, with values of 5.085, 3.120, 6.459, 8.517, and 3.830, respectively. These findings highlight the importance of considering the effects of austerity on health care access, health funding, health care inequalities, health workforce, health infrastructure and resources development. Policymakers should prioritize equitable resource allocation and targeted investments to strengthen the resilience of the health care system during economic challenges. Understanding these associations is crucial for evidence-based policy decisions and fostering a more equitable and resilient health care system in Zimbabwe.
Improvisation in Turbulent Environments: An Exploratory Case Study of a Rescue Projects Organization
Authors: Sumbal Muhammad Saleem , Ahmed Awais , Tariq Adeel , Raziq Muhammad Mustafa , Tariq Beenish
Published: August 2024

This study explores the antecedents of knowledge utilization, specifically tacit knowledge, leading to improvisation in rescue projects confronted with turbulent situations. We used semistructured interviews and observations to collect data in a large public-sector rescue organization. Findings reveal that improvisation is an essential part of projects in turbulent situations bounded by time limitations; resource constraint factors, such as lack of technology, information, resources, and rugged terrains; and collectivistic societal and cultural issues. Rescue workers improvise through sensemaking, problem identification, and tacit knowledge utilization to handle emergencies.
Altered enhancer-promoter interaction leads to MNX1 expression in pediatric acute myeloid leukemia with t(7;12)(q36;p13)
Authors: Weichenhan Dieter , Riedel Anna , Sollier Etienne , Toprak Umut H. , Hey Joschka , Breuer Kersten , Wierzbinska Justyna A. , Touzart Aurore , Lutsik Pavlo , Bähr Marion , Östlund Anders , Nilsson Tina , Jacobsson Susanna , Edler Marcel , Waraky Ahmed , Behrens Yvonne Lisa , Göhring Gudrun , Schlegelberger Brigitte , Steinek Clemens , Harz Hartmann , Leonhardt Heinrich , Dolnik Anna , Reinhardt Dirk , Bullinger Lars , Palmqvist Lars , Lipka Daniel B. , Plass Christoph
Published: August 2024

Acute myeloid leukemia (AML) with the t(7;12)(q36;p13) translocation occurs only in very young children and has a poor clinical outcome. The expected oncofusion between break point partners (motor neuron and pancreas homeobox 1 [MNX1] and ETS variant transcription factor 6 [ETV6]) has only been reported in a subset of cases. However, a universal feature is the strong transcript and protein expression of MNX1, a homeobox transcription factor that is normally not expressed in hematopoietic cells. Here, we map the translocation break points on chromosomes 7 and 12 in affected patients to a region proximal to MNX1 and either introns 1 or 2 of ETV6. The frequency of MNX1 overexpression in pediatric AML is 2.4% and occurs predominantly in t(7;12)(q36;p13) AML. Chromatin interaction assays in a t(7;12)(q36;p13) induced pluripotent stem cell line model unravel an enhancer-hijacking event that explains MNX1 overexpression in hematopoietic cells. Our data suggest that enhancer hijacking may be a more widespread consequence of translocations in which no oncofusion product was identified, including t(1;3) or t(4;12) AML.
Real-world incidence and prevention of tumor lysis syndrome in chronic lymphocytic leukemia treated with venetoclax
Authors: Valtis Yannis K. , Nemirovsky David , Derkach Andriy , Sharan Saumya , Kabel Charlene , Ortiz Ricardo , Thompson Meghan C. , Roeker Lindsey E. , Geyer Mark B.
Published: August 2024

Venetoclax is a B-cell lymphoma 2 inhibitor used in chronic lymphocytic leukemia (CLL), which can cause tumor lysis syndrome (TLS). We aimed to determine the incidence of, and risk factors for, TLS among patients with CLL/small lymphocytic lymphoma who received treatment with venetoclax at our institution from 1 January 2016 to 31 December 2020. We included 616 venetoclax escalations among 136 patients with CLL. Overall, 74 patients (54%) underwent escalation exclusively outpatient, 35 (26%) had at least 1 planned hospitalization, and 27 (20%) were escalated exclusively inpatient. During venetoclax initiation, 86% of patients received allopurinol, 71% intravenous hydration, 18% phosphate binders, and 10% prophylactic rasburicase. Among the entire cohort, 7 patients (5.1%) developed laboratory TLS by modified Cairo Bishop criteria and none developed clinical TLS. Incidence of laboratory TLS was 15% for those escalated exclusively inpatient, 2.9% for those with any prophylactic hospitalization, and 2.7% for those escalated exclusively outpatient. Those who developed TLS were more likely to have higher TLS risk, and no additional risk factors were identified. In this single institution retrospective cohort study, laboratory TLS was observed, although clinical TLS was not. Prophylactic measures, including use of IV hydration, may have contributed to low rates of observed TLS in the outpatient setting.
Electrophysiological effects of Japanese cedarwood on sleep quality in humans
Authors: Okamoto Tsuyoshi , Nakashima Taisuke , Permana Kurniawan Eka , Fadilla Zennifa , Watanabe Yuichiro , Yasunari Shinji , Nagano Jun , Fujimoto Noboru , Shimizu Kuniyoshi
Published: August 2024

Sleep plays an important role in human health. Changes in the sleeping environment can affect sleep quality. The present study investigated the effects of natural wood on sleep quality. The interior material was a fully used Cryptomeria japonica wood board (Japanese cedar room), while the particleboard and medium-density fiberboard (MDF) were covered by a vinyl cloth with a woodgrain (resin room). In order to assess sleep quality, the sleep–depth index (SDI) is calculated based on the lengths of sleep stage 3 and the rapid eye movement (REM) stage using electroencephalography (EEG). Before the sleep experiments, the Pittsburgh Sleep Quality Inventory (PSQI) and Morningness–Eveningness Questionnaire (MEQ) were administered to confirm the participants’ usual sleep habits. Thirteen participants were invited to sleep in two different environments. The MEQ before sleep experiments confirmed that eight participants were of the intermediate type and five participants were of the moderate evening type. According to the PSQI, three participants were poor sleepers and ten were good sleepers. The sleep EEG demonstrated that 12 of 13 participants had higher SDI in the Japanese cedarwood room than in the resin room. A Wilcoxon signed-rank test revealed that SDI was significantly prolonged in the Japanese cedarwood room than in the resin room, regardless of the small sample size (n = 13, z = 2.48, p = 0.014, effect size = 0.78). The present study demonstrated that the indoor environment with C. japonica induced a significantly higher SDI compared to that with wood-grain vinyl cloth. This indicates that the interior materials of C. Japonica wood can positively influence the sleep environment.
Supporting the right workplace experience: a dynamic evaluation of three activation programmes for young job seekers in Slovakia
Authors: Štefánik Miroslav , Lafférs Lukáš
Published: August 2024

This paper investigates three alternative active labour market policy programmes available to young job seekers in Slovakia who were registered in 2011. All of the programmes facilitate gaining work experience and share a comparable design; however, they differ mainly in the collected workplace experience and the composition of participants. Using administrative data, we first explore the selection into each programme; second, we estimate the treatment effects on job seekers’ postparticipation absence from the registry of the unemployed. For this we argue that we have sufficiently rich data to control for selection into programs. We use a dynamic estimator and report the average treatment effects of participation in different periods between the sixth and fifteenth month after starting unemployment. For participation in earlier stages of unemployment, we confirm differences in the programmes impacts, with patterns described by previous literature; workplace experience collected in either the private sector or in a regular workplace appears to improve the chances of absence from registered unemployment of young job seekers relatively more than does participation in a public works type of programme. When compared later in the unemployment spell, the between-programme differences level out. Despite its ambivalent average impact, the public works type of programme positively impacts specific subgroups of participants.
Effects of exposure length, cortical and trabecular bone contact areas on primary stability of infrazygomatic crest mini-screws at different insertion angles
Authors: Du Bingran , Lin Yuan , Ji Mohan , Yang Qiaohua , Jiang Jiang , Wang Fei , Wang Xiaoyi , Tan Jinchuan , Jia Rui , Li Jianyi
Published: August 2024

Background

The infrazygomatic crest mini-screw has been widely used, but the biomechanical performance of mini-screws at different insertion angles is still uncertain. The aim of this study was to analyse the primary stability of infrazygomatic crest mini-screws at different angles and to explore the effects of the exposure length (EL), screw-cortical bone contact area (SCA), and screw-trabecular bone contact area (STA) on this primary stability.

Methods

Ninety synthetic bones were assigned to nine groups to insert mini-screws at the cross-combined angles in the occlusogingival and mesiodistal directions. SCA, STA, EL, and lateral pull-out strength (LPS) were measured, and their relationships were analysed. Twelve mini-screws were then inserted at the optimal and poor angulations into the maxillae from six fresh cadaver heads, and the same biomechanical metrics were measured for validation.

Results

In the synthetic-bone test, the LPS, SCA, STA, and EL had significant correlations with the angle in the occlusogingival direction (rLPS = 0.886, rSCA = -0.946, rSTA = 0.911, and rEL= -0.731; all P < 0.001). In the cadaver-validation test, significant differences were noted in the LPS (P = 0.011), SCA (P = 0.020), STA (P = 0.004), and EL (P = 0.001) between the poor and optimal angulations in the occlusogingival direction. The STA had positive correlations with LPS (rs = 0.245 [synthetic-bone test] and r = 0.720 [cadaver-validation test]; both P < 0.05).

Conclusions

The primary stability of the infrazygomatic crest mini-screw was correlated with occlusogingival angulations. The STA significantly affected the primary stability of the infrazygomatic crest mini-screw, but the SCA and EL did not.
The effect of rs2910686 on ERAP2 expression in IBD and epithelial inflammatory response
Authors: Sæterstad Siri , Østvik Ann Elisabeth , Hansen Marianne Doré , Bruland Torunn , van Beelen Granlund Atle
Published: August 2024

Background

ERAP2 is an aminopeptidase involved in antigen processing and presentation, and harbor genetic variants linked to several inflammatory diseases such as Inflammatory Bowel Disease (IBD). The lack of an ERAP2 gene homologue in mice has hampered functional studies, and most human studies have focused on cells of hematopoietic origin. Using an IBD biobank as vantage point, this study explores how genetic variation in ERAP2 affects gene expression in human-derived epithelial organoids upon proinflammatory stimulation.

Methods

An IBD patient cohort was genotyped with regards to two single nucleotide polymorphisms (SNP) (rs2910686/rs2248374) associated with ERAP2 expression levels, and we examined the correlation between colon gene expression and genotype, specifically aiming to establish a relationship with ERAP2 expression proficiency. Human-derived colon organoids (colonoids) with known ERAP2 genotype were established and used to explore differences in whole genome gene expression between ERAP2-deficient (n = 4) and -proficient (n = 4) donors upon pro-inflammatory encounter.

Results

When taking rs2910686 genotype into account, ERAP2 gene expression is upregulated in the inflamed colon of IBD patients. Colonoids upregulate ERAP2 upon IFNɣ stimulation, and ERAP2 expression proficiency is dependent on rs2910686 genotype. Colonoid genotyping confirms that mechanisms independent of the frequently studied SNP rs2248374 can cause ERAP2-deficiency. A total of 586 genes involved in various molecular mechanisms are differentially expressed between ERAP2 proficient- and deficient colonoids upon proinflammatory stimulation, including genes encoding proteins with the following molecular function: catalytic activity (AOC1, CPE, ANPEP and MEP1A), regulator activity (TNFSF9, MDK, GDF15, ILR6A, LGALS3 and FLNA), transmembrane transporter activity (SLC40A1 and SLC5A1), and extracellular matrix structural constituents (FGL2, HMCN2, and MUC17).

Conclusions

ERAP2 is upregulated in the inflamed IBD colon mucosa, and expression proficiency is highly correlated with genotype of rs2910686. While the SNP rs2248374 is commonly used to determine ERAP2 expressional proficiency, our data confirms that mechanisms independent of this SNP can lead to ERAP2 deficiency. Our data demonstrates that epithelial ERAP2 presence affects the inflammatory response in colonoids, suggesting a pleiotropic role of ERAP2 beyond MHC class I antigen processing.
Inferring clonal somatic mutations directed by X chromosome inactivation status in single cells
Authors: Demirci Ilke , Larsson Anton J. M. , Chen Xinsong , Hartman Johan , Sandberg Rickard , Frisén Jonas
Published: August 2024

Analysis of clonal dynamics in human tissues is enabled by somatic genetic variation. Here, we show that analysis of mitochondrial mutations in single cells is dramatically improved in females when using X chromosome inactivation to select informative clonal mutations. Applying this strategy to human peripheral mononuclear blood cells reveals clonal structures within T cells that otherwise are blurred by non-informative mutations, including the separation of gamma-delta T cells, suggesting this approach can be used to decipher clonal dynamics of cells in human tissues.
Antibiotic prophylaxis in emergency cholecystectomy for mild to moderate acute cholecystitis: a systematic review and meta-analysis of randomized controlled trials
Authors: Elkasaby Mohamed Hamouda , Elsayed Hesham , Charo Dilawer Chofan , Rashed Mohamed Abdalla , Elkoumi Omar , Elhaddad Islam Mohsen , Gadallah Ahmed , Ramadan Alaa
Published: August 2024

Background

Emergency cholecystectomy is the mainstay in treating acute cholecystitis (AC). In actual practice, perioperative prophylactic antibiotics are used to prevent postoperative infectious complications (PIC), but their effectiveness lacks evidence. We aim to investigate the efficacy of prophylactic antibiotics in emergency cholecystectomy.

Methods

We searched PubMed, Embase, Cochrane CENTRAL, Web of Science (WOS), and Scopus up to June 14, 2023. We included randomized controlled trials (RCTs) that involved patients diagnosed with mild to moderate AC according to Tokyo guidelines who were undergoing emergency cholecystectomy and were administered preoperative and/or postoperative antibiotics as an intervention group and compared to a placebo group. For dichotomous data, we applied the risk ratio (RR) and the 95% confidence interval (CI), while for continuous data, we used the mean difference (MD) and 95% CI.

Results

We included seven RCTs encompassing a collective sample size of 1747 patients. Our analysis showed no significant differences regarding total PIC (RR = 0.84 with 95% CI (0.63, 1.12), P = 0.23), surgical site infection (RR = 0.79 with 95% CI (0.56, 1.12), P = 0.19), distant infections (RR = 1.01 with 95% CI (0.55, 1.88), P = 0.97), non-infectious complications (RR = 0.84 with 95% CI (0.64, 1.11), P = 0.22), mortality (RR = 0.34 with 95% CI (0.04, 3.23), P = 0.35), and readmission (RR = 0.69 with 95% CI (0.43, 1.11), P = 0.13).

Conclusion

Perioperative antibiotics in patients with mild to moderate acute cholecystitis did not show a significant reduction of postoperative infectious complications after emergency cholecystectomy. (PROSPERO registration number: CRD42023438755).
Barriers and facilitators to ethical co-production with Autistic people with an eating disorder
Authors: Nimbley Emy , Maloney Ellen , Buchan Kyle , Sader Michelle , Gillespie-Smith Karri , Duffy Fiona
Published: August 2024

Background

Co-production is the collaboration between researchers and the lived experience community in designing, conducting and sharing research. The importance of co-production is increasingly advocated in both the autism and eating disorder fields. Despite this, there remains a lack of clarity at how to define, apply and conduct ethical co-production. Understanding common challenges and what we can do to overcome these challenges are integral to ensuring ethical and meaningful research with Autistic people with an eating disorder. The current study therefore explored: What are the barriers and facilitators to ethical co-production with Autistic people with an ED?

Methods

Five workshops were conducted with 30 collaborators exploring barriers and facilitators to ethical co-production. Synchronous (online workshops) and asynchronous (offline discussion forum) data was analysed using thematic analysis. Themes were co-produced by a neurotypical and Autistic researcher with lived/living experience of an eating disorder.

Results

Four themes were identified that explored barriers to ethical co-production: unequal partnerships, the inaccessibility of research, excluded by diagnoses and communication differences. Three themes were identified with regards to facilitators of ethical co-production: shared power (with sub-themes relationships, not roles and creative compensation), clarity and transparency and autism-affirming approaches.

Discussion

Conducting ethical co-production with Autistic people with eating disorders has the potential to generate meaningful research that can be translated into improving the lives of the Autistic and eating disorder community. To achieve this, co-production teams should strive towards shared power and long-term relationships, adapting for communication differences and preferences and operating firmly within an autism-affirming framework. It is hoped that study findings will inspire collaboration, discussion and novel, translatable research.