bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Obstructive Sleep Apnea Among Veterans and Nonveterans
Authors: Goldstein Lizabeth A. , Bernhard Paul A. , Hoffmire Claire A. , Schneiderman Aaron , Maguen Shira
Published: August 2024

Purpose

Understanding disease prevalence can inform treatment and resource needs across populations. This study aimed to identify the prevalence of sleep apnea (OSA) among veterans and nonveterans.

Design

The national Comparative Health Assessment Interview Study, cross-sectional survey using probability-based sampling frames.

Setting

Surveys completed by Internet or phone.

Subjects

15,166 veterans (40% response rate) and 4,654 nonveterans (57% response rate).

Measures

Self-report of healthcare provider-based diagnosis of OSA.

Analysis

Calculation of prevalence of OSA using statistical weighting to allow for direct comparison between veterans and nonveterans. Secondary analyses evaluated OSA by deployment status among veterans and compared average age of OSA diagnosis and differences in OSA prevalence among veterans and nonveterans stratified by gender, marital status, race/ethnicity, and posttraumatic stress disorder diagnosis.

Results

OSA diagnosis was more than twice as prevalent among veterans (21%, 95% CI 20%-22%) than nonveterans (9%, 95% CI 8%-10%; aOR: 2.56, 95% CI 2.22-2.95, P < .001). Deployment was associated with higher odds of OSA among veterans (aOR: 1.64, 95% CI 1.43-18.7, P < 001.) Veterans were diagnosed with OSA on average 5 years earlier than nonveterans.

Conclusion

Veterans have a high prevalence rate of OSA, highlighting the importance of veterans’ access to treatment. OSA is likely underdiagnosed in nonveterans, particularly among racial/ethnic minoritized groups. Future research should investigate disparities in access to diagnostic testing for racial/ethnic minority nonveterans and/or risk factors for OSA among racial/ethnic minority veterans. The increased odds of OSA among those with PTSD highlights in the importance of early referral for OSA testing by providers as well as development of trauma-informed strategies to promote OSA treatment adherence. Limitations include a bias toward underestimation of true disease prevalence due to self-report of diagnosis.
The Mediating Role of Lifestyle Activities in the Association Between Social Deprivation and Cognition in Older Adulthood: Results From the Health and Retirement (HRS) Study
Authors: Hofbauer Lena M. , Rodriguez PD Francisca S.
Published: August 2024

Objectives: We aimed to investigate the mediating role of lifestyle activities in the association between social deprivation and cognition. Methods: To investigate, we analysed data of 3867 respondents (Mean Age: 73.37, SD: 5.57) in the U.S. Health and Retirement Study (HRS) using growth curve and path analysis, adjusted for demographic and health covariates. Results: Being in the high (vs. moderate) Social Deprivation Index group was associated with lower cognition scores (β = −2.63, [95 % CI: −2.90, −2.36]). Conversely, higher (vs. lower) Lifestyle Index scores were associated with higher cognition scores (β = 1.17, [95 % CI: 0.72, 1.63]). In mediation analysis, the Lifestyle Index score explained 27 % of the association of So Dep Index group on cognition at the final follow-up. Discussion: While lifestyle activities did mediate the association between social deprivation and cognition, factors not investigated accounted for the majority of the variation. These may include systemic disadvantages.
The influence of dimensional parameters on the kinetic range of four systems of deployable structures with hinged nodes and rigid rods
Authors: Pérez-Egea Adolfo , García Martínez Pedro , Ródenas-López Manuel Alejandro
Published: August 2024

In several previous studies regarding foldable structures comprised of rods and knots, it has been usual to simplify their geometry to lines and points respectively. However, this study assumes that the dimensions that these elements necessarily acquire (due to their material condition) constitute an important issue in the folding and unfolding process. To test this hypothesis, the research first defines the concept of kinetic range and its various variants and studies how variations in the radius of the rods, the eccentricity of the knots and the opening angle influence this parameter. Furthermore, this study will demonstrate that this parameter is extensible to bar bundle systems and scissors systems and finally will verify that the results obtained by using algorithm-driven models are also verifiable by mathematical methods and experimentation using physical models. As a result, the methodology followed in this article allows the inclusion of a comparative table that classifies the performance of the structural systems studied in order to establish which is the optimum in relation to their kinetic range.
Politics of Infrastructural Developmentalism: A Spatial Reading of the Colombo Port City Project
Authors: Mishra Mayank
Published: August 2024

A state produces political space and uses this space as a privileged instrument to impose its rationality. A high-modernist state commences ‘prescribing’ and ‘imposing’ to establish a ‘new society’, thus adhering to a tabula rasa (blank slate) approach in policies and planning. It denounces the past as a model to ameliorate the present, disregarding local conditions and knowledge, and perpetuating visual images that promise an alchemised future. In a typical spatial understanding of the state, the standard marker of growth is perceivably developing infrastructure. The article intends to do a spatial and temporal reading of the Colombo Port City (CPC) project, deemed to perceivably transform the Sri Lankan urban economic landscape, as a case study. The article conducted an ethnographic study of the project, locating it in Harvey’s ‘spatial fix’, Scott’s High Modernism and Guy Debord’s concept of spectacle to comprehend the larger spatial politics that an infrastructure project exhibits. Considering Colombo as a case study, the article shall also examine infrastructure’s political affect and how spatial reconfigurations rearrange government institutions as the infrastructure impacts and alters the nature of power. It will critically examine the modality of the investments in infrastructure, its internal politics and its much fetishized economic feasibility.
Assessment of Online Arabic Patient-Centered Knowledge About Orthognathic Surgery: An Infodemiologic Study
Authors: Alassaf Muath Saad , Sharbib Shadan H. , Alhammad Reem H. , Alabdali Faisal Hussain , Habib Osama A. , Abdelfattah Ashraf , Aboalkhair Ayoub , Albeshir Hasan , Samman Mahmood
Published: August 2024

Background

Orthognathic surgery, addressing skeletal and dental irregularities, is pivotal for patients suffering from malocclusion, facial asymmetry, and related disorders. With the internet becoming a primary source of health information, the accuracy, quality, and reliability of online Arabic-language patient-centered information on orthognathic surgery necessitate thorough evaluation. This study aimed to assess the quality, reliability, and readability of Arabic online resources about orthognathic surgery to ascertain their potential as reliable patient education tools.

Methods

An infodemiological approach was employed, analyzing the top 100 websites from Google, Yahoo, and Bing based on specific Arabic search terms related to orthognathic surgery. Websites were evaluated for affiliation, content specialization, and presentation and excluded based on predetermined criteria to ensure relevance and focus. Quality assessment was conducted using the DISCERN instrument, Journal of the American Medical Association (JAMA) benchmarks, and Health On the Net code evaluation. Readability was assessed using the Flesch-Kincaid Grade Level, Simplified Measure of Gobbledygook, and Flesch Reading Ease scales.

Results

Of 600 initial websites, 96 met the inclusion criteria. Most were affiliated with universities or medical centers (53.1%), followed by commercial (28.1%), and non-profit organizations (16.7%). The majority of websites (96.9%) were only partially related to orthognathic surgery. Content analysis revealed a moderate quality of information, with a median overall DISCERN quality rating of 3 out of 5. The JAMA benchmarks showed a lack of comprehensive adherence, with currency being the most achieved criterion. Readability assessments indicated the content was generally accessible yet highlighted the need for Arabic-specific readability evaluation tools.

Conclusion

The study reveals a critical need for enhancing Arabic online resources on orthognathic surgery. Despite the available content's moderate quality and acceptable readability, there is a substantial gap in providing comprehensive, patient-centered, and easily understandable information. Future efforts should focus on developing high-quality, reliable, and readable online resources to aid Arabic-speaking patients in making informed decisions about orthognathic surgery.
Artificial Intelligence on the Digital Flight Deck: A Continuum with Parallel Trajectories
Authors: Holley Sam , Miller Mark , Halawi Leila
Published: August 2024

Reports of artificial intelligence (AI) in industries have drawn attention to digital flight decks of airliners. This encompasses single pilot operations, distributed crewing, and forms of reduced crew operations. Pilots, understandably, have concerns about reliability of AI and intrusion in crew operational procedures. To better comprehend the extent of automation malfunctions, and advanced roles for AI, data from NTSB and ASRS databases were examined. Results were assessed for applications of AI to resolve known human or system limitations. To evaluate trust and confidence related to AI, a survey of 42 company pilots provided baseline findings. Results revealed a substantial level of distrust in AI to make important decisions and that pilots believe they are necessary to prevent critical mistakes. To better understand the potential role of AI on the flight deck, parallel tracks for development are presented that illustrate domain-specific applications from more complex human-automation teaming and shared cognition operations.
An Analysis of Online Peer Support Groups for Informal Caregivers of Patients with Parkinson’s Disease
Authors: Nair Nandana , Vemuri Anirudh , Clayton Caroline , Anoop Avantika , Sharma Agastya , Sawant Sarvesh , Chalil Madathil Kapil
Published: August 2024

Parkinson’s Disease (PD) affects over 500,000 Americans, causing symptoms like tremors and stiffness. Informal caregivers, often family or friends, play a critical role in providing support, which includes emotional support, assistance with daily activities, and medication management. However, this caregiving is emotionally and physically taxing, leading to stress, burnout, and adverse effects on mental health. Online peer support groups, especially on platforms like Reddit, have become essential for caregivers, allowing them to connect virtually and share experiences, overcoming geographical and time constraints and reluctance to engage in person. This study aims to explore the specific needs and challenges faced by PD caregivers in these online communities. It examines the types of information they seek, the responses they receive, and the range of emotions they experience. By understanding these aspects, the research seeks to enhance the support dynamics and emotional wellbeing within these virtual support networks.
Risk-Based Visualization of Hurricane Forecasts
Authors: Outwater John C. , Woodruff Mariah J. , Hill Aaron R. , Schober Michael F.
Published: August 2024

The research presented here tests user comprehension of a new kind of risk-based visualization of hurricane forecasts versus other common representations: a cone of uncertainty (with and without a centerline) and an ensemble representation. Our landfall heat maps use intensity hues and a ﬁlled black circle with size representing hurricane category at the time of forecast, rather than representing the hurricane path. In two online studies we compare how different representations of the same scenarios affect viewers’ (a) judgments of the risk that a location is likely to be hit by a hurricane, (b) their likelihood of issuing an evacuation order for that location (if they were to be in a role of issuing evacuation orders), and (c) their conﬁdence in their judgment. Findings contribute to developing a toolkit of visual materials that designers of hurricane visualizations can select from based on empirical evidence of user responses to their elements.
Assessing Student Performance Through Pupil Dilation and Problem-Solving Time in Augmented Reality
Authors: Kim Jung Hyup , Monhanty Siddarth , Pulipati Varun , Wang Fang , Mostowfi Sara , Oprean Danielle , Wang Yi , Seo Kangwon
Published: August 2024

This research aims to explore the prediction of student learning outcomes in Augmented Reality (AR) educational settings, focusing on engineering education, by analyzing pupil dilation and problem-solving time as key indicators. In this research, we have created an innovative AR learning platform through the incorporation of eye-tracking technology into the Microsoft HoloLens 2. This enhanced learning platform enables the collection of data on pupil dilation and problem-solving duration as students engage in AR-based learning activities. In this study, we hypothesize that pupil dilation and problem-solving time could be significant predictors of student performance in the AR learning environment. The results of our study suggest that problem-solving time may be a critical factor in predicting student learning success for materials involving procedural knowledge at low difficulty levels. Additionally, both pupil dilation and problem-solving time are predictive indicators of student learning outcomes when dealing with predominantly procedural knowledge at high difficulty levels.
Empirical Impacts of Independent and Collaborative Training on Task Performance and Improvement in Human-AI Teams
Authors: Flathmann Christopher , Schelble Beau G. , Galeano Anna
Published: August 2024

With improving AI technology, human-AI teams are becoming increasingly common in research. Within these teams, humans and AI can work collaboratively to complete shared tasks. However, continuing research efforts highlight that humans are ill-prepared to work in human-AI teams. As such, recent efforts have called for training to become a greater focus in the. This paper reports on an empirical in-person experiment that explored the impact of individual and collaborative task-focused training in human-AI teams. Participants were tasked with either training together or separately prior to collaborative working in a human-AI team. Results show that having humans train together prior to joining a human-AI team can negatively impact their performance and ability to improve at a task when they begin working in a human-AI team. As such, results suggest that human-AI teams need to identify ideal ways to collaboratively train humans on task-related skills in human-AI teams.
Analysis of a parabolic bilateral obstacle problem with non-monotone relations in the domain
Authors: Wang Xilu , Cheng Xiaoliang , Xuan Hailing
Published: August 2024

In this paper, we consider a new parabolic bilateral obstacle model. Both upper and lower obstacles are elastic-rigid and assign a non-monotone reactive normal pressure with respect to the interpenetration. The weak form of the model is a parabolic variational–hemivariational inequality with non-monotone multivalued relations in the domain. We show the existence and uniqueness of the solution. Then, a fully discrete numerical method is introduced, with the approximations can be internal or external. We bound the error estimates and obtain the Céa type inequality. Using the linear finite elements, the optimal-order error estimates are derived. Finally, we report the numerical simulation results.
Different diversities: Policies and practices at three European public service VoD services
Authors: Bengesser Cathrin , Sørensen Jannick Kirk
Published: August 2024

While globally operating SVoDs have discovered identity-based diversity as a branding strategy, diversity has a longer history and broader meaning in public service media (PSM) tied to the foundational ideals of universality and pluralism that oblige PSM to speak to all members of a society and to offer diverse programmes and viewpoints. We investigate: How are these two understandings of ‘diversity’ expressed 1) in legal and policy requirements to the PSM, 2) in strategy papers and audits issued by PSM, 3) in the presentation and exposure of content in VoD interfaces? And 4) How can PSMs' practice around diversity on VoD be tracked methodologically? The article examines these questions by comparing: BBC iPlayer (UK), DRTV (Denmark) and ARD Mediathek (Germany). A document analysis examines how legal remits and strategies governing these institutions talk about diversity. We analyse the presentation and exposure of ‘diversity’ in VoD content via longitudinal datasets that document the three VoD landing pages daily between early 2022 and late 2023, recording the position of every programme title at the VoDs’ front pages, as well as deck titles. We test four approaches to this dataset: Spotting diversity in deck titles, looking for content tagged as diverse on IMDb and by Chat GPT, calculating diversity of exposed content with the Gini-Simpson-Index and assessing diversity through a manual coding of deck titles and sampling content displayed in selected decks. The article shows how differently diversity can be conceptualised and operationalised in VoD practice and concludes that multi-dimensional methodological approaches are needed. This article is a report on different publishing strategies for ‘diversity content’ in PSM VoD interfaces; a discussion of the conflicting relation between public service ideals and the notion of identity-based ‘branded diversity' of globally operating VoDs; and a contribution to developing methods for monitoring diversity on VoD.
Relationship of the modified Glasgow Prognostic Score with peripheral artery disease severity and procedure success in patients who had undergone endovascular treatment
Authors: Karaduman Ahmet , Balaban İsmail , Biyiklı Kadir , Keten Mustafa Ferhat , Kalkan Semih , Kahyaoglu Muzaffer , Celik Mehmet , Gecmen Çetin
Published: August 2024

Objectives

The modified Glasgow Prognostic Score (mGPS) is one type of inflammation-based index; it includes data on elevated C-reactive protein and reduced albumin content. The predictive value of mGPS for outcomes is investigated in various diseases such as cancer, heart failure, myocardial infarction, acute pulmonary embolism, and inflammatory bowel diseases. This study aimed to evaluate the link between mGPS and the severity and complexity of peripheral arterial disease (PAD) as determined by the Transatlantic Intercommunal Consensus Document (TASC-II) classification and the prediction value of mGPS for procedural success in patients undergoing endovascular treatment (EVT).

Methods

Our study included 203 consecutive patients receiving EVT for atherosclerotic obstruction of aortoiliac, femoro-popliteal, and below-knee arteries between January 2019 and February 2020. The lesion characteristics were determined according to categories in the TASC-II. Operational failure is the inability to position the guidewire through the occluded lesion following percutaneous intervention or achieve distal perfusion following EVT.

Results

In our study, we observed 136 patients (%6) with TASC A–B lesions and 67 patients (%33) with TASC C–D lesions. EVT was performed on the femoro-popliteal artery in 59.4% of the patients, on the aortoiliac artery in 30.7%, and on the below-the-knee artery in 9.9%. mGPS was an independent predictor of severe PAD (OR: 17.943, 95% CI: 5.120–62.882; p < .001) and procedural success (odds ratio: 0.004; 95% CI: 0.001–0.099; p < .001). Additionally, we identified age and the presence of a TASC D lesion as independent predictors of interventional success (OR: 0.938, 95% CI: 0.819–0.979; p: .034; OR: 0.104, 95% CI: 0.107–0.643; p: .015, respectively).

Conclusion

We determined that mGPS independently predicts PAD complexity and severity based on TASC-II classification; the EVT success rate is lower in patients with high mGPS.
‘I Need the White Pill!’ – A Creative Exploration of How Minority Flemish Youth Employ Ethnic Humour for Identity Construction
Authors: Lion Anke
Published: August 2024

This article explores how young people with minoritized ethnic (mostly Moroccan or Turkish backgrounds) and religious (Muslim) identities in Flanders employ humour for identity construction. The participants created comedy sketches that featured ‘ethnic humour’, which focuses on the characteristics and stereotypes of different ethnic, racial, and national groups. Thematic analysis revealed how humour serves as a powerful tool for minority youth to navigate self-identity and contest the sociopolitical contexts that shape their identities. By making fun of the social contexts that force them to enact ridiculous stereotypes, as well as mocking the taken-for-granted assumption that white culture is the norm, the participants challenged dominant systems of oppression that interpellate them as ethnic and religious subjects. Furthermore, humour played a crucial role in mediating the different lived experiences of the participants and the white atheist researcher throughout the study; as a result, their interactions provided a rich source for jokes and identity mapping as well. Through an analysis of the comedy sketches and researcher–participant interactions, this article examines the role of minority youth as humour producers and performers, hitherto a neglected area of scholarship. As such, it furthers an understanding of the dynamic interplay between humour, identity, and power.
Conjuring the ‘ship of dreams’: Spatial narratives and making the absent present around and within Titanic Belfast
Authors: Grek-Martin Jason
Published: August 2024

Powerful prosthetic memories of the Titanic story have circulated in popular culture for more than a century and have become the focus of several experiential museums and Titanic-focused heritage sites on both sides of the Atlantic, most notably in Belfast, Northern Ireland, where the doomed liner was built. Drawing on recent field work, this article analyses the ways in which a series of engaging, multisensory and three-dimensional spatial narratives have been deployed within the new Titanic Belfast signature attraction and the surrounding memoryscape to make the absent ship present for visitors once more. These spatial narratives inform an affective heritage approach that focuses, not on the tragedy of Titanic’s sinking, but on feelings of awe and wonder at the scale and grandeur of the great ship, allowing memory managers to tell a celebratory, Belfast-focused origin story for this internationally renowned ‘ship of dreams’.
Adolescents’ unhealthy snacking behaviour during the school journey and the association with transport modes and food outlets along the school route
Authors: Situmorang ML , Mandic S , Smith M , Keall M , Donnellan N , Coppell KJ
Published: August 2024

Aims:

Active transport to and from school provides an opportunity for adolescents to engage in physical activity, but travelling through an obesogenic environment may have unintended consequences on their snacking behaviour. This study aimed to: (1) identify whether adolescents’ unhealthy snacking behaviour was associated with school transport modes and food outlets on their estimated school route and (2) explore whether food outlet density on the school route differed between school transport modes.

Methods:

Adolescents ( n = 406; aged 15.1 ± 1.4 years; 50.7% boys; 63.5% New Zealand European) from all 12 secondary schools in Dunedin city, Aotearoa New Zealand, completed an online survey. School transport modes (active, motorised or mixed) and unhealthy snacking data were collected. Food outlet data were collected using Google Places Application Programming Interface (API). Home-to-school route and distance were estimated using geographical information system (GIS) analysis based on a walkable road network. Data were analysed using the chi-square test and logistic regression.

Results:

Overall, 26.4% of adolescents reported purchasing and consuming unhealthy snacks or soft drinks on the way to school and 41.4% from school. The odds of unhealthy snacking during the school journey was higher among mixed transport users than active transport users on the way to (odds ratio (OR) = 2.73, 95% confidence interval (CI) = 1.39–5.36) and from school (OR = 2.68, 95% CI = 1.40–5.13). No differences were observed by food outlet type. There were no food outlets on the estimated school route for 44.8% of adolescents. The presence of more than one food outlet per kilometre of the estimated school route differed between active (38.7%), motorised (42.6%) and mixed transport users (46.4%; p = 0.006).

Conclusion:

School transport modes were significantly associated with adolescents’ unhealthy snacking behaviour and food outlets on their school journey. Policy measures which minimise exposure to unhealthy food outlets may reduce unhealthy snacking among adolescents.
Dynamic three-dimensional coculture model: The future of tissue engineering applied to the peripheral nervous system
Authors: Choinière William , Petit Ève , Monfette Vincent , Pelletier Samuel , Godbout-Lavoie Catherine , Lauzon Marc-Antoine
Published: August 2024

Traumatic injuries to the peripheral nervous system (PNI) can lead to severe consequences such as paralysis. Unfortunately, current treatments rarely allow for satisfactory functional recovery. The high healthcare costs associated with PNS injuries, worker disability, and low patient satisfaction press for alternative solutions that surpass current standards. For the treatment of injuries with a deficit of less than 30 mm to bridge, the use of synthetic nerve conduits (NGC) is favored. However, to develop such promising therapeutic strategies, in vitro models that more faithfully mimic nerve physiology are needed. The absence of a clinically scaled model with essential elements such as a three-dimension environment and dynamic coculture has hindered progress in this field. The presented research focuses on the development of an in vitro coculture model of the peripheral nervous system (PNS) involving the use of functional biomaterial which microstructure replicates nerve topography. Initially, the behavior of neuron-derived cell lines (N) and Schwann cells (SC) in contact with a short section of biomaterial (5 mm) was studied. Subsequent investigations, using fluorescent markers and survival assays, demonstrated the synergistic effects of coculture. These optimized parameters were then applied to longer biomaterials (30 mm), equivalent to clinically used NGC. The results obtained demonstrated the possibility of maintaining an extended coculture of SC and N over a 7-day period on a clinically scaled biomaterial, observing some functionality. In the long term, the knowledge gained from this work will contribute to a better understanding of the PNS regeneration process and promote the development of future therapeutic approaches while reducing reliance on animal experimentation. This model can be used for drug screening and adapted for personalized medicine trials. Ultimately, this work fills a critical gap in current research, providing a transformative approach to study and advance treatments for PNS injuries.
Orality and Memory in Bible Translation
Authors: Liriano Fausto
Published: August 2024

In the last three years, the field of Bible translation has seen a growing interest in oral Bible translation. While this has been seen as an advantage in bringing the Bible to cultures where orality is the norm, surprisingly, the oral nature of the biblical text in the Hebrew Bible has received less attention. Usually, indigenous translators have worked from Bible translations that have been produced for written language, making the text more difficult to translate into their languages in an oral way. In this article I advocate for a closer exploration of the Hebrew text, its characteristics, and its oral forms, as a means of facilitating the work of translators in oral Bible translations.
The Case for Nurturing AI Literacy in Law Schools
Authors: Migliorini Sara , Moreira João Ilhão
Published: August 2024

The debate surrounding the permissibility of generative artificial intelligence (AI) tools in legal education has garnered widespread attention. However, this discourse has largely oscillated between the advantages and disadvantages of generative AI usage whilst failing to fully consider how the uptake of these tools relates to the fundamental objectives of legal education. This article contributes to the current debate by positing that since the primary aim of legal education is the preparation of legal professionals and the development of legal research, generative AI must be holistically integrated into the dominant approaches to legal teaching. This stems from the fact that the legal profession will increasingly rely on generative AI in its daily work. Therefore, AI literacy will emerge as a critical professional skill in the legal realm. Against this background, this article further argues that the integration of AI into the legal curriculum should be addressed by diversifying assessment strategies, emphasizing the importance of academic integrity and making resources on the ethical use of AI available to both students and academic staff in law schools.
Bridge-Enhanced Anterior Cruciate Ligament Restoration: 6-Year Results From the First-in-Human Cohort Study
Authors: Fleming Braden C. , Baranker Ben , Badger Gary J. , Kiapour Ata M. , Ecklund Kirsten , Micheli Lyle J. , Murray Martha M.
Published: August 2024

Background:

Bridge-enhanced anterior cruciate ligament restoration (BEAR) combines suture repair of the anterior cruciate ligament (ACL) with an extracellular matrix implant plus autologous blood to facilitate native ACL healing.

Purpose/Hypothesis:

The purpose of this study was to compare the 6-year follow-up outcomes of patients who underwent the BEAR procedure with those of a nonrandomized concurrent control group receiving autograft ACL reconstruction (ACLR) in the first-in-human safety study of the BEAR implant (BEAR I trial). Based on the 2-year results, it was hypothesized that isometric hamstring strength after the BEAR procedure would be greater than that after ACLR and that there would be no other differences in outcomes at 6 years.

Study Design:

Cohort study, Level of evidence, 2.

Methods:

Ten patients underwent BEAR and 10 received ACLR with a 4-stranded hamstring autograft. Outcomes assessed included the record of subsequent surgeries, the International Knee Documentation Committee (IKDC) Subjective Knee Score, IKDC physical examination grade, the Knee injury and Osteoarthritis Outcome Score, instrumented knee laxity, functional outcomes (ie, muscle strength assessments and hop testing), and qualitative magnetic resonance imaging assessment. Comparisons between treatments were based on computations of the mean differences and the associated 95% CIs.

Results:

One patient in the BEAR group and 3 patients in the ACLR group were lost to follow-up. In the period between 2 and 6 years, 1 patient in each group underwent revision surgery. There were no differences between groups at the 6-year follow-up in any of the outcome measures except for isometric hamstring strength, which was approximately equal to that of the contralateral knee in the BEAR group and <44% of that in the contralateral knee in the ACLR group ( P < .01).

Conclusion:

This preliminary study suggests that the outcomes of BEAR and ACLR with a hamstring tendon graft may be similar at the 6-year follow-up and warrants investigation of the BEAR procedure in a larger cohort of patients.
Mitigating Climate Change via the Demand Side and Behavioral Insights: Policy Recommendation and Current Challenges
Authors: Berger Sebastian , Cologna Viktoria , Bauer Jan M.
Published: August 2024

Applying behavioral insights for climate-change mitigation has both potential and pitfalls. Drawing upon IPCC insights on the potential of demand-side mitigation of various sectors, actors, and regions, three arguments address the role of the behavioral sciences. First, behavioral insights have heterogeneous effects, rendering the question of their average contribution meaningless. Second, many effects from behavioral science are found outside of the academic literature, so these relevant indicators of effectiveness do not inform the debate. Third, mitigation impact depends on scaling, which provides unique challenges for behavioral science because the research and application settings are often markedly different. Due to these challenges, policymakers should proceed with caution and apply behavioral insights with a careful case-by-case analysis.
Book review: Radhika Iyengar, Fire on the Ganges: Life Among the Dead in Banaras
Authors: Bhattacharjee Anindita
Published: August 2024

Radhika Iyengar, Fire on the Ganges: Life Among the Dead in Banaras. Fourth Estate, 2023, 352 pp., ₹599 (Hardcover). ISBN: 9789356994676.
Recent Advances on Synaptotagmin-Like Mitochondrial-Lipid Binding Protein Domain Containing Lipid Transfer Proteins
Authors: Hu Xuewen , Cai Yirui , Ji Wei-Ke
Published: August 2024

The Synaptotagmin-like mitochondrial-lipid binding protein (SMP) domain is found in a group of ER-resident lipid transfer proteins that are recruited to membrane contact sites (MCSs) by adaptors. Deciphering the molecular basis underlying the recruitment of SMP proteins to specific MCS sheds light not only on their cellular localization but also on their biological functions at these sites. Here we summarize recent advances in SMP domain-containing lipid transfer proteins, focusing on a recent study showing the localization, regulation and cellular function of a specific SMP protein named testis expressed protein 2 (Tex2). TMEM55, a potential PIP phosphatase on late endosome/lysosomal (LE/lys) membranes, was identified as an adaptor that enables the recruitment of Tex2 to ER- LE/lys MCS. In addition, we have summarized several important questions about the regulation and physiological functions of Tex2 that remained unanswered.
Impact of cerebral protection on observed versus predicted in-hospital stroke in a high stroke risk TAVR cohort
Authors: Marcusohn Erez , Manoragavan Ragavie , Fremes Stephen , Tarola Christopher , Sathananthan Janarthanan , Barabash Israel M. , Orbach Ady , Sachedina Ayaaz K. , Radhakrishnan Sam , Wijeysundera Harindra C.
Published: August 2024

Background

Despite impressive improvements in the safety profile of Transcatheter aortic valve replacement (TAVR), the risk for peri-procedural stroke after TAVR has not declined substantially. In an effort to reduce periprocedural stroke, cerebral embolic protection (CEP) devices have been utilized but have yet to demonstrate benefit in all-comers. There is a paucity of data supporting the utilization of CEP in TAVR patients with an anticipated high risk for peri-procedural stroke.

Methods

The Transcatheter Aortic Valve Replacement In-Hospital Stroke (TASK) score is a clinical risk tool for predicting the in-hospital stroke risk of patients undergoing transfemoral TAVR. This score was used to identify high-risk patients and calculate the expected in-hospital stroke risk. This was a single-centre cohort study in all consecutive TAVR patients who had placement of CEP. The observed versus expected ratio for peri-procedural stroke was calculated. To obtain 95% credible intervals, we used 1000 bootstrapped samples of the original cohort sample size without replacement and recalculated the TASK predicted scores.

Results

The study included 103 patients. The median age was 83 (IQR 78,89). 63 were male (61.1%) and 45 (43.69%) had a history of previous Stroke or TIA. Two patients had an in-hospital stroke after TAVR (1.94%). The expected risk of in-hospital stroke based on the TASK score was 3.39% (95% CI 3.07–3.73). The observed versus expected ratio was 0.57 (95% CI 0.52–0.64).

Conclusion

In this single-center study, we found that in patients undergoing TAVR with high stroke risk, CEP reduced the in-hospital stroke risk by 43% when compared with the risk-score predicted rate.

Clinical trial number

N/A.
Predictors of dementia among the oldest old: longitudinal findings from the representative “survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)”
Authors: Hajek André , Kretzler Benedikt , Riedel-Heller Steffi G. , Gyasi Razak M. , König Hans-Helmut
Published: August 2024

Background/Aims

Our current study aimed to investigate the determinants of dementia among the oldest old using longitudinal data from a representative sample covering both community-dwelling and institutionalized individuals.

Methods/Design

Longitudinal representative data were taken from the “Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)” that surveyed community-dwelling and institutionalized individuals aged 80 years and above (n = 1,296 observations in the analytic sample), living in North Rhine-Westphalia (most populous state of Germany). The established DemTect was used to measure cognitive impairment (i.e., probable dementia). A logistic random effects model was used to examine the determinants of probable dementia.

Results

The mean age was 86.3 years (SD: 4.2 years). Multiple logistic regressions revealed that a higher likelihood of probable dementia was positively associated with lower education (e.g., low education compared to medium education: OR: 3.31 [95% CI: 1.10–9.98]), a smaller network size (OR: 0.87 [95% CI: 0.79–0.96]), lower health literacy (OR: 0.29 [95% CI: 0.14–0.60]), and higher functional impairment (OR: 13.45 [3.86–46.92]), whereas it was not significantly associated with sex, age, marital status, loneliness, and depressive symptoms in the total sample. Regressions stratified by sex were also reported.

Discussion

Our study identified factors associated with dementia among the oldest old. This study extends current knowledge by using data from the oldest old; and by presenting findings based on longitudinal, representative data (also including individuals residing in institutionalized settings).

Conclusions

Efforts to increase, among other things, formal education, network size, and health literacy may be fruitful in postponing dementia, particularly among older women. Developing health literacy programs, for example, may be beneficial to reduce the burden associated with dementia.
Antibiotic prescribing practices and antibiotic use quality indicators in Luang Prabang, Lao PDR: a point prevalence survey in a tertiary care hospital
Authors: Elias Christelle , Ha Nay Thi , Sengvilaipaserth Onanong , Phaychith Athip , Chansamouth Vilada , Phongsavath Valy , Keohavong Bounxou , Detleuxay Khamsay , Maniphonh Phaylinh , Soukhaseum Thongphout , Vanhems Philippe , Babin François-Xavier
Published: August 2024

Context

The increase and global dissemination of antibiotic resistance limit the use of antibiotics to prevent and treat infections. Implementing antibiotic stewardship programs guided by local data on prescription profiles is a useful strategy to reduce the burden of antibiotic resistance. The aim was to determine the prevalence of antibiotic use and guideline compliance at Luang Prabang provincial hospital, Lao PDR.

Methods

A point prevalence survey of antibiotics was conducted among hospitalized patients admitted to Luang Prabang hospital (204 beds) in Lao PDR on May 25, 2023. All patients presenting at 8:00 AM were eligible. Sociodemographic data, indications for antibiotic use, and antibiotic prescriptions were collected from medical records using a paper-based questionnaire and entered into an electronic platform following WHO methodology. The prevalence of antibiotic use was determined.

Results

Out of the 102 patients included, 60(58.8%) were undergoing antibiotic treatment, of which 33(55.0%) received combination therapy, and 7(10.5%) had two indications for antibiotic use. The highest prevalence was in the surgical ward (14/15, 93%) followed by general paediatrics (18/27, 67%). Out of the 100 antibiotic prescriptions, 47(47%) were for community-acquired infections, 26(26%) for surgical prophylaxis, 13(13%) for hospital-acquired infections and 5(5%) for medical prophylaxis. Twenty(20%) antibiotics were prescribed for obstetrics and gynaecology prophylaxis, 17(17%) for intra-abdominal infections, and 10(10.0%) for pneumonia treatment as well as bone, and joint infections. The main antibiotics prescribed were ceftriaxone 36(34.6%), metronidazole 18(17.3%), ampicillin 8(7.7%), and gentamicin 8(7.7%). Only 2(3%) samples were sent to the laboratory, one of which showed a positive culture for Escherichia coli Extended Spectrum β-Lactamase. According to the WHO Access Watch and Reserve classification, 55(52.9%) molecules belonged to the Access category, 47(49.1%) to the Watch category, and none to the Reserve category. Only 14.9% of antibiotic prescriptions were fully compliant with current guidelines.

Conclusion

This study indicated a significant prevalence of antibiotic use and a very low compliance with guidelines at Luang Prabang provincial hospital, Lao PDR. This highlights an urgent need for comprehensive strategies at all levels to optimize antibiotic use in hospitals, emphasizing diagnostic improvements, and continued research to address the factors driving this excessive antibiotic usage and improve adherence to guidelines.
Bacterial pathogens and antimicrobial susceptibility in ocular infections: A study at Boru-Meda General Hospital, Dessie, Ethiopia
Authors: Asfaw Tegegne , Metaferia Yeshi , Weldehanna Endalkachew Gebretsadik , Weldehanna Daniel Gebretsadik
Published: August 2024

Introduction

The eye consists of both internal and external compartments. Several variables, including microbes, dust, and high temperatures can cause eye illnesses that can result in blindness. Bacterial eye infections continue to be a major cause of ocular morbidity and blindness, and their prevalence is periodically rising. The objective of the study was to detect bacterial pathogens and assess their susceptibility profiles to antibiotics in the ophthalmology unit of Boru-meda Hospital in Dessie, Ethiopia.

Methods

A hospital-based cross-sectional study was conducted from February 1 to April 30, 2021, among 319 study participants with symptomatic ocular or peri-ocular infections who were enrolled using a consecutive sampling technique. After proper specimen collection, the specimen was immediately inoculated with chocolate, blood, and MacConkey agar. After pure colonies were obtained, they were identified using standard microbiological methods. The Kirby Bauer disk diffusion method was used to test antimicrobial susceptibility patterns, based on the guidelines of the Clinical and Laboratory Standards Institute.

Results

The majority of participants developed conjunctivitis 126 (39.5%), followed by blepharitis 47 (14.73%), and dacryocystitis 45 (14.1%). Overall, 164 (51.4%) participants were culture positive, six (1.9%) participants had mixed bacterial isolates, giving a total of 170 bacterial isolates with an isolation rate of 53.3%. The predominant species was CoNS 47 (27.6%), followed by S. aureus 38 (22.4%) and Moraxella species 32 (18.8%). The overall Multi-Drug Resistance (MDR) rate was 62.9%, with 33 (44.6%) being gram-negative and 74 (77.1%) being gram-positive isolates.

Conclusion

Conjunctivitis was the dominant clinical case and CoNS, was the predominant isolate. A higher rate of MDR isolates, particularly gram-positive ones, was observed. Efficient peri-ocular or ocular bacterial infection surveillance, including microbiological laboratory data, is necessary for monitoring disease trends.
The genetic differences between types 1 and 2 in von Hippel-Lindau syndrome: comprehensive meta-analysis
Authors: Azimi Fatemeh , Naseripour Masood , Aghajani Ali , Kasraei Hengameh , Chaibakhsh Samira
Published: August 2024

Background

Patients with von Hippel-Lindau (VHL) disease are at risk of developing tumors in the eye, brain, kidney, adrenal gland, and other organs based on their gene mutations. The VHL tumor suppressor gene contains pathogenic variants responsible for these events. This meta-analysis aims to investigate the genetic differences among the various types of VHL syndrome and their correlation with the location of mutations (exons and domains) in the VHL gene.

Method

Papers eligible for publication until September 2023 were identified using the electronic databases of PubMed, Google Scholar, Scopus, and EMBASE. The Random Effect model was utilized to evaluate the genetic differences between type 1 and type 2 VHL syndromes.

Results

The prevalence of missense mutations (MSs) was found to be 58.9% in type 1, while it was 88.1% in type 2. Interestingly, the probability of observing MSs in type 1 was 0.42 times lower compared to type 2. The mutation hotspots of the VHL gene were R167Q/W, Y98H, R238W, and S65L, respectively. Although type 2 had a high presentation of Y98H and R238W, it did not have a higher S65L than type 1. The analysis demonstrated a statistically significant higher prevalence of truncated mutations (PTMs) in type 1. Among type 1, large/complete deletions (L/C DELs) were found in 16.9% of cases, whereas in type 2 only 3.7%. This difference was statistically significant with a p-value < 0.001. Overall, the probability of identifying mutations in domain 2 compared to domain 1 was found to be 2.13 times higher in type 1 (p-value < 0.001). Furthermore, the probability of detecting exon 1 in comparison with observing exon 2 in type 1 was 2.11 times higher than type 2 and revealed a statistically significant result (p-value < 0.001). The detection of exon 2 was 2.18 times higher in type 1 (p-value < 0.001). In addition, the likelihood of discovering exon 2 compared with others was significantly lower in type 1 compared with type 2 VHL (OR = 0.63, p-value = 0.015).

Conclusions

We have revealed a comprehensive genetic difference between types 1 and 2 of VHL syndrome. The significant differences in MS, PTMs, L/C DELs, and the location of the mutations between type 1 and type 2 VHL patients in the Asian, European, and American populations emphasize the genetic heterogeneity of the syndrome. These findings may pave the way for the diagnosis, treatment, and further investigation of the mechanisms behind this complex genetic disorder.