bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Rosuvastatin on Facial Nerve Regeneration After Facial Nerve Injury: An Experimental Animal Study
Authors: Dincer Uğur , Verim Ayşegül , Becerik Çağrı , Gürsan Nilüfer , Tepe Karaca Çiğdem , Toros Sema Zer
Published: November 2024

Objectives:

Rosuvastatin is an antihyperlipidemic statin group pharmacological agent with antioxidant, neuroprotective, and anti-inflammatory effects. In this study, we aimed to examine the functional, electrophysiological, and histopathological effects of rosuvastatin or in combination with corticosteroids on facial nerve regeneration in rats with traumatic peripheral facial paralysis (PFP).

Methods:

PFP was induced in 28 female Sprague Dawley rats that we divided into 4 groups: group 1, control group; group 2, methylprednisolone group; group 3, rosuvastatin group; group 4, rosuvastatin and methylprednisolone group. Electrophysiological, functional, and histopathological examinations were performed before and after the medications.

Results:

Electrophysiological threshold values of group 3 and group 4 were found to be significantly lower than the control group on day 21 after treatment ( P = .002, P = .001; P < .01).In the histopathological evaluation, axonal degeneration, macrovacuolization, and vascular congestion levels were compared between the groups, and a statistically significant difference was observed in group 4 compared to the control group. The recovery time of the eye corneal reflex was found to be significantly higher in the control group than in groups 3 and 4 when comparing postoperative day 1 to day 7 and postoperative day 1 to day 14.

Conclusion:

Rosuvastatin, especially when combined with methylprednisolone was found to significantly increase the facial nerve electrophysiological, functional, and histopathological recovery in injury-induced traumatic PFP.
Reliability and Validity of the L Test in Persons With Multiple Sclerosis
Authors: Bilek Furkan , Demir Caner F
Published: November 2024

The L Test has been developed to assess balance and gait disorders. Our aim in this study was to estimate the test-retest reliability and validity of the L Test when used with 82 persons with multiple sclerosis (PwMS). For these participants, we examined the degree of agreement between the results of a first and second administration of the L Test (separated by one day), using Bland-Altman analysis and intra-class correlation coefficients (ICCs). We computed minimal detectable change (MDC) and standard error of measurement (SEM) values for the L Test and evaluated concurrent validity by correlating L Test results with the Timed Up and Go test (TUG) and the 10-minute Walk Test (10MWT). Prior to administering these measurements, we randomized the sequence of the test administrations to our participants. The Bland–Altman analysis showed that L Test was reproducible, with upper and lower limits of agreement of 0.99 and −1.45 seconds, respectively. The L Test demonstrated excellent test–retest reliability, with an ICC value of 0.996 (95% CI: 0.994–0.998). Cronbach’s alpha coefficient was 0.996. The performance of the L Test is measured by seconds required to complete the task, and we found the L Test SEM value to be 0.35 seconds, and its MDC value to be 0.97 seconds. The L Test showed a strong correlation with both the TUG test (rho = 0.936; p < .001) and the 10MWT (rho = 0.925; p < .001). We concluded that the L Test is a reliable and valid \ tool for assessing functional mobility and balance in PwMS.
Three decades of psychology in South Africa: legacies of hope and fault lines of the future
Authors: Bowman Brett , Malherbe Nick , Suffla Shahnaaz
Published: November 2024

Three decades have passed since South Africa’s formal transition from apartheid to liberal democracy. This milestone signified a triumph of hope over despair for a country that had struggled under a suffocating system of racist, dehumanising oppression since its colonisation in the seventeenth century. Reflecting this zeitgeist, divisions, and complicities that had characterised the study, practice, and organisation of psychology within South Africa’s racist structures were disassembled. The discipline committed to social justice, inclusive science, liberatory praxis, and global well-being. From a 30-year vantage point that many imagined would represent a clearer picture of a maturing and free rather than an emerging and new South African democracy, this article assesses the discipline’s progress in achieving the socio-political, economic, health and psychological imperatives it set for itself in 1994. Through grounding this analysis in the 10 contributions that constitute this Special Issue, the article pits the promises of struggle and hope against the yields of democracy and its imagined freedoms. It argues that despite the unmistakable continuities of despair that define South African life and the discipline’s response thereto, there are several discernible legacies of hope that psychology has recuperated in its journey thus far, and that these may offer fault lines for a hopeful future. These moments of hope are most powerful when the discipline seeks solidarity rather than solipsism, transcends rather than polices its epistemic and political boundaries, and embraces ordinariness through disavowing the exceptionalism that forecloses its connectedness to several overriding movements that prioritise planetary justice for all.
Inoculating Against Moral Disengagement Creates Ethical Adherence for Narcissism
Authors: Jones Daniel N. , Beekun Rafik , Schermer Julie Aitken , MacDonald Kristi Baerg , Compton Josh
Published: November 2024

Increasing honesty is critical in modern society. Moral Disengagement Tactics (MDTs) enable individuals to engage in unethical behavior while avoiding self-criticism, making MDTs a form of self-persuasion. One way to prevent persuasion is inoculation. Across three experiments ( N = 972), two preregistered, we randomly assigned individuals to a code of ethics versus inoculation to MDTs condition. Study 1 ( n = 443) found that those high in narcissism reported increased ethical intentions in the inoculation condition. Study 2 ( n = 224) replicated and extended this effect, finding that individuals high in narcissism were more likely to behave honestly in the inoculation condition. Study 3 ( n = 305) was a longitudinal study finding that inoculating those high in narcissism led to fewer lies over the past week’s inoculation. None of these interaction patterns emerged for Machiavellianism or psychopathy. Thus, inoculation to MDTs appears effective in reducing dishonesty among those high in narcissism.
Unpacking news consumption and trust decisions through a folk theory approach: A study of Austrian young adults
Authors: Garusi Diego , Juarez Miro Clara
Published: November 2024

This article introduces and applies a situational, interactional, and processual theoretical framework to explore how folk theories of journalism shape people’s news use and trust decisions in specific, real-life circumstances. Following the “episode method”, 48 semi-structured interviews conducted with Austrian young adults revealed that objectivity and impartiality are regarded as the two cornerstones of journalism, aligning with Austria’s traditional journalistic culture. Thus, for Austrian young adults, informing oneself is a search for the ultimate truth. Whether objectivity and impartiality are thought to be actually found in journalism shapes (dis)engagement with it. Different news consumption and trust decisions emerged from interviewees who believe that journalists manage to be impartial and objective versus ones believing that journalists cannot or do not want to. Whereas the former recalled using and trusting information sources that they regarded as reputable, the situation is more nuanced for the latter. They showcased trust decisions ranging from reliance on external information sources to reliance on oneself to discern the truth. Those findings suggest that despite the emergence of new forms of journalistic actors and work, traditional journalistic values and norms remain central in audiences’ news use and trust decisions.
Intergenerational Value Discordances and Affectual and Associational Solidarity Between Older Parents and Adult Children
Authors: Hwang Woosang , Kim Jeung Hyun , Zhang Wencheng , Brown Maria T. , Silverstein Merril
Published: November 2024

Using data from the Longitudinal Study of Generations 2016, we tested three hypotheses: (1) discordances in three intergenerational values (religion, gender role attitudes, and political attitudes) between parents and adult children would be negatively related to their affectual and associational solidarity with each other, (2) discordances in three values would be more deleterious for children’s perceived solidarity with parents than vice versa, and (3) mother–daughter relations would be less affected by discordances in three values than other parent–child gender combinations. The overlapping sample was 157 mother–son, 180 mother–daughter, 124 father–son, and 113 father–daughter dyads. Results of structural equation modeling and multigroup analysis showed that religion discordance between fathers and daughters was associated with lower levels of daughters’ perceived affectual and associational solidarity with fathers. Furthermore, political attitudes differences between fathers and sons were associated with lower levels of sons’ perceived affectual and associational solidarity with fathers.
Online Public Sphere and Threats of Disinformation, Extremism and Hate Speech: Reflections on Threat-Mitigation
Authors: Kumar Anoop , Maurya Mohit Kumar
Published: November 2024

Social media platforms have become gateways to information and news. These platforms potentially offer discursive arenas where individuals can participate in rational-critical discourses, resembling with the public sphere. Nonetheless, the threats linked with social media platforms stymie the public sphere potential of the latter. This article attempts to provide an overview of threats namely disinformation, ideological polarization and concomitant extremism and hate speech propagated through social media platforms. Drawing from multidisciplinary literature, we reflect upon solutions which include (1) strengthening of mainstream and professional journalism; (2) fact-checking; (3) platform-driven and technology-based solutions; (4) law enforcement and social media regulations; and (5) media literacy and care for truth. This article contributes to the literature on strengthening the public sphere potential of social media platforms.
The Association Between Victimization and Perpetration of Physical Intimate Partner Violence and Unmet Healthcare Needs Among Married Women in South Korea
Authors: Kim Ranyeong , Puno Abigail , Choo Sungsub , Kim Seung-Sup , Kim Rockli
Published: November 2024

This study assessed physical intimate partner violence (IPV) experiences and examined their association with unmet healthcare needs among married women in South Korea. We analyzed data from a nationally representative longitudinal survey of 6,533 women at baseline. Participants were asked yes/no questions about their experiences of physical IPV victimization and perpetration over the past year. The responses were classified into four categories of IPV experience: “none,” “victimization only,” “perpetration only,” and “both victimization and perpetration.” At baseline, 0.9% reported being victimized only, and 25.9% reported both victimization and perpetration. The prevalence of unmet healthcare needs over the past year at baseline was 0.8%. Compared to women without any IPV experience, women in the IPV “victimization only” category had greater unmet healthcare needs (OR: 5.49, 95% CI [2.30, 13.12]) after adjusting for sociodemographic variables. Experiencing IPV perpetration only and both IPV victimization and perpetration were not statistically significantly associated with unmet healthcare needs. These results imply that physical IPV victims face difficulties accessing healthcare services which could exacerbate health inequalities over time. Moreover, this study suggests that it is necessary to distinguish IPV victims from those who experience IPV victimization only and those who experience both IPV victimization and perpetration.
Numerical study on flow field uniformity of a pneumatic dryer
Authors: Yang Guanglu , Ding Meizhou , Wei Xinfeng , Yang Jinchu , Liu Yong , Wu Xuehong
Published: November 2024

The non-uniformity of the airflow inside the dryer in pneumatic dryer directly affects the humidity non-uniformity at the exit of the cut tobacco, which is of significant importance to the quality of the tobacco manufacturing process. By establishing models of pneumatic dryer with two types of deflector, the unevenness of the airflow inside the dryer under different flow rate distributions of the hot air inlet and tobacco inlet is numerically analysed. The study found that the unevenness of the airflow inside the dryer is influenced by the flow rate distribution of the hot air inlet and tobacco inlet, the arrangement of the deflector and the structure of the equalizing roller. The variation of the coefficient of non-uniformity in the dryers with equidistant and non-equidistant deflector decreases with an increase in the flow rate of the hot air inlet. Under high flow rate conditions of the hot air inlet, the dryer with equidistant distribution plates exhibits higher non-uniformity in the flow field and temperature field. At the hot air inlet air volume of 30,000 m3/h-tobacco inlet air volume of 28,000 m3/h, the average value of non-uniformity coefficient decreased by more than 10%.
COVID-19 Infection and the Risk of CMV Reactivation: A Systematic Review of Case Reports and Case Series
Authors: Chorya Harshal Prakash , Naik Aastha Ketan
Published: November 2024

Background and Aims:

Several opportunistic infections have increased, including cytomegalovirus (CMV) in coronavirus disease 2019 (COVID-19) patients. The literature has reported few cases, and the authors are not aware of any systematic review of CMV infection reactivation associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This review aims to assess the incidence of CMV reactivation and its outcomes among patients diagnosed with SARS-CoV-2 infection.

Methods:

We searched several electronic literature databases for studies published between 1 November 2019 and 7 February 2022. We then selected all available English-language articles (a total of 15 case reports and case studies) that reported underlying conditions, hospitalisation courses, treatment specifics and clinical outcomes of hospitalised patients coinfected with SARS-CoV-2 and CMV viruses. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed.

Results:

Out of 1304 screened articles, this review included 15 articles, representing 34 patients. Among those, five were case series and 10 were case reports with patients’ ages ranging from 42 to 92 years. Other parameters evaluated included gender, comorbid conditions, intensive care unit (ICU) length of stay (ranging from 15 to 40.5 days), use of immunosuppressants, other treatments administered and clinical outcome (death for 19 of the 34 patients).

Conclusion:

Our findings showed that besides immune system dysregulation due to severe COVID-19 infection itself, underlying conditions and the use of immunosuppressants substantially contributed to the reactivation of CMV in hospitalised COVID-19 patients. Additionally, CMV reactivation was linked with poor clinical outcomes, including increased mortality.
Are Descriptive Representatives More Successful Passing Group-Relevant Legislation? The Case of Native American State Legislators
Authors: Blasingame Elise , Hansen Eric R. , Witmer Richard C.
Published: November 2024

Descriptive representatives often sponsor legislation that advances their groups’ policy interests, but it remains unclear how successful they are passing such legislation. Colleagues might defer and support group-relevant measures from descriptive representatives, perceiving them to have greater expertise and legitimate claims to address the issues than outgroup members. However, colleagues might also oppose those measures in an act of backlash against those groups (especially historically marginalized groups) making new claims on the political system. To answer the question of descriptive representative success, we review 3,401 pieces of legislation related to Native American issues introduced at the state level between 2010 and 2020. We find that measures related to Native affairs are no more likely to pass if sponsored by a Native lawmaker than if sponsored by a non-Native lawmaker. However, symbolic measures of Native concern are more likely to pass than substantive measures regardless of the identity of the sponsor. With more Native Americans running for office than ever before, our findings have important implications for considering the effects of increased descriptive representation in state legislatures.
The Challenge of Data Integration—Digital Twin Certification to Support Remote Operations
Authors: Jurski Dylan , Ulrich Thomas
Published: November 2024

Microreactors for generating electricity in remote areas, such as mining sites, offer the potential for autonomous nuclear reactors, enabling self-sufficient mitigation measures. Remote operation allows experienced teams to oversee and manage operations from a command center, which may be located in a geographically distinct location. Using digital twins, real-time simulations of the reactor alongside its actual instrumentation and control system parameters, as certifiers has been proposed to ensure data accuracy. By comparing signals from the actual reactor with predictions from the digital twin models, data certification can be achieved. The details of this system are beyond the scope of this paper and can be found elsewhere. This research addresses the fundamental hypothesis of whether an operator can interpret three distinct data sources of the same system to successfully identify discrepancies and its root cause.
Demographic, clinical and laboratory characteristics of extrapulmonary tuberculosis: Eight-year results of a multicenter retrospective study in Turkey
Authors: Celik Mehmet , Gurbuz Esra , Cicek Yeliz , Buyuktuna Seyit Ali , Gundag Omur , Gulderen Kuscu Evrim , Mermutluoglu Cigdem , Alkan Sevil , Yuruk Atasoy Pınar , Yuksekkaya Esra , Sahinoglu Mustafa Serhat , Sahin Ahmet , Parlak Emine , Akgul Fethiye , Dindar Demiray Emine Kubra , Oz Murtaza , Ciftci Elif Zelal , Kirik Yasemin , Arslan Yusuf , Ceylan Mehmet Resat , Mert Ali
Published: November 2024

Extrapulmonary tuberculosis (EPTB) is an important public health problem due to its diverse clinical presentations, diagnostic complexities, and significant impact on patient outcomes and public health. Our study aimed to understand the sociodemographic, clinical, and laboratory characteristics as well as diagnostic and treatment modalities of adult patients with EPTB. This is a multicentric retrospective study that covers patients with EPTB cases followed up from January 2015 to December 2022 among tuberculosis (TB) dispensaries and Infectious Diseases and Clinical Microbiology clinics of 15 hospitals located in various regions of Turkey. The study included 64.6% women with a mean age of 44 years and a mortality rate of 3.5% within 1 year of diagnosis. Initial constitutional symptoms were predominantly fatigue (57%) and anorexia (53.7%). The most commonly affected sites were the lymph nodes (49.1%) and pleura (9.7%). The lumbar region was particularly involved in cases with spinal TB. Diagnostic findings included acid-fast bacilli positivity in 27.5% of cases, tuberculosis polymerase chain reaction positivity in 41%, elevated adenosine deaminase levels in 91.2% (especially in pleural and peritoneal fluids), and mycobacterial culture positivity in 40.9%. Pathology slides showed granulomatous inflammation in 97.7%. Increased C-reactive protein (CRP) levels correlated with the number of organs affected. Anti-TB treatment-related hepatotoxicity was detected in 8.9% of patients. In this study, it is important to note that the lumbar region is predominantly affected with involvement in spinal region. CRP level was consistent with the number of organ involvements and was one of the most critical results of this study.
The Impacts of Supervisor Support on Employee Service Performance: A Change Perspective
Authors: Liu Xin , Mao Jih-Yu , Ni Dan , Quan Jing , Zheng Xiaoming
Published: November 2024

Predominantly based on a static perspective, existing studies have documented that supervisor support is a key facilitator of front-line employees’ service behaviors. Incorporating a change perspective, our study examines the effects of daily shift and variability in supervisor support on employees’ service performance at both the within- and between-person levels. We draw on affective events theory to propose positive affect as the underlying mediating mechanism and examine the moderating role of employee self-control capability. We test the hypotheses using data from 56 front-line service employees across 10 consecutive workdays ( N = 547) and from their supervisors in the follow-up survey. The results indicate that, at the within-person level, an upshift (downshift) in daily supervisor support is positively (negatively) related to daily positive affect, leading to higher (lower) levels of daily service performance. At the between-person level, variability in supervisor support is negatively related to employees’ positive affect, which in turn, reduces their service performance. A lower (versus higher) level of employee self-control capability at the between-person level enhances the within-person relationship between daily supervisor support change and daily positive affect and the between-person relationship between variability in supervisor support and employees’ positive affect. Theoretical and practical implications are discussed.
Polarization insensitive eye-shape enclosed split ring resonator-based multi-band metamaterial absorber/sensor for S, C, X, Ku, and K-band microwave applications
Authors: Uddin Md Kutub , Hakim Mohammad Lutful , Alam Touhidul , Islam Mohammad Tariqul , Alsaif Haitham , Islam Md Shabiul
Published: November 2024

This article proposes an eye-shape enclosed split ring resonator (ESE-SRR) based metamaterial absorber for multi-band microwave applications with high absorption levels. Four-fold rotational symmetric eye-shaped electrical resonators form the structure of the proposed metamaterial absorber (MMA) to achieve polarisation-insensitive characteristics. Eight near-unity absorption peaks between S, C, X, Ku, and K-band are achieved, where peak absorptions are attained at 3.349 GHz, 5.06 GHz, 6.829 GHz, 9.178 GHz, 14.54 GHz, 17.96 GHz, 18.89 GHz, and 20.4 GHz with absorption levels of 99.8%, 99.7%, 92.9%, 99.1%, 96.4%, 93.3%, 91.3%, and 99.35%, respectively. The electrical dimension of the unit cell is 0.112λmin × 0.112λmin × 0.018λmin, making it a subwavelength compact structure for oblique incident angle stable absorption behaviour. The absorption characteristics are also investigated with metamaterial properties, surface current, and electromagnetic field distributions. The designed MMA is validated by prototype fabrication and measurement, which shows good agreement with simulation results. Finally, the proposed MMA shows an electrically compact structure with eight near-unity absorption peaks and polarisation insensitivity, which makes it an attractive candidate for absorption, sensing, radar cross-section reduction, etc.
Preliminary investigation of the large-scale sandwich decks with graded 3D printed auxetic core
Authors: Stepinac Lucija , Galić Josip
Published: November 2024

This research presents an innovative sandwich bridge deck system inspired by triply periodic minimal surface (TPMS) structures for load-bearing applications. The deck features a parametrically designed graded gyroid core, optimized through structural optimization to achieve a 10% relative density. The core was manufactured using Fused Deposition Modelling (FDM) and bonded with tempered glass flanges. Numerical analysis was performed using Abaqus software with an elastic-plastic material model based on tension tests, offering a simplified yet effective approach compared to the more complex analysis possible with custom VUMAT subroutines. A single scaled prototype was produced and subjected to a three-point bending test. The results demonstrated successful bonding between the sheets and core but revealed challenges such as premature shear failure of the polymeric core, crack propagation between print beads, and compression-induced failure of the glass flanges. A size effect was identified, as tension tests were performed at a much finer resolution than the core printing, leading to a drop in the material’s mechanical properties. These failure modes were correlated with numerical predictions, underscoring the need for further investigation into thermo-mechanical effects on 3D printed materials.
Making Marketing Discipline More Scientific–Contesting Christian Grönroos’s “Toward a Marketing Renaissance”
Authors: Möller Kristian
Published: November 2024

This article examines Christian Grönroos’s “Toward a Marketing Renaissance: Challenging Underlying Assumptions,” offering support for the advancement of marketing as a discipline while raising several critical issues with Grönroos’s approach. First, Grönroos’s analysis and proposals lack clarity regarding their focus on either marketing practice or the theoretical discipline of marketing. His analysis of foundational assumptions appears grounded in a predominantly managerial view of marketing, potentially limiting its scope. Second, the suggested foundational shifts overlook significant developments within academic marketing research. Finally, Grönroos’s vision of marketing as “meaningfulness” is based on an idealistic, marketer- and consumer-centric perspective that does not offer a solid foundation for marketing as an academic discipline. This article advocates positioning marketing firmly within the social sciences and proposes distinguishing between three perspectives in marketing scholarship: (1) marketing practice, (2) research into marketing practice (both empirical and theoretical), and (3) meta-theoretical research into the discipline itself. By identifying key research directions within these domains, the paper outlines an agenda for future scholarship that embraces marketing’s complexity, promotes rigorous and critical theory-building, and enhances marketing’s role within the broader social sciences.
Wishing for a more sober society: A scoping review on addiction problems and treatment in Greenland preceding the 2016 national treatment strategy
Authors: Flyger Holflod Julie , Lytken Larsen Christina Viskum , Niclasen Birgit , Søgaard Nielsen Anette
Published: November 2024

Introduction: The per capita intake of alcohol in Greenland has risen rapidly since it became commercially available, leading to a corresponding increase in addiction problems and demands for treatment services. Despite efforts to establish addiction treatment services, none were deemed adequate. In response, the Greenlandic parliament initiated a new treatment service strategy in 2015. The aim of this study was to explore the pre-implementation process of this national service by examining literature on addiction problems and treatment services. Methods: Using a scoping review and document analysis methodology, we focused on documents related to alcohol, cannabis, gambling, addiction and treatment within the context of Greenland. Data were sourced from parliamentary records, governmental publications and academic literature in the period 2010–2016, leading up to the decision on the new treatment service. A total of 54 documents were identified and organised into three main themes: the national discourse on addiction problems; strategies and action plans addressing addiction; and demographic mapping of addiction issues within the population. Notably, addiction problems emerged as a significant public concern across all themes. Results: Three key documents emerged as pivotal in the implementation of the new treatment service: a government report from 2012; a parliamentary inquiry in spring 2013; and an agenda item in fall 2013. These documents played a crucial role in shaping discussions and decisions. Conclusion: The findings underscore the widespread recognition of addiction problems as a pressing issue in Greenland, as evidenced by the prominence of relevant documents in shaping policy discussions and the implementation of new treatment initiatives.
The Promise of edu-business: Storytelling and affective subjectivation of edu-preneurs in Finland
Authors: Brunila Kristiina , Mertanen Katariina , Green Crystal
Published: November 2024

Edu-business is changing understandings, aims, content and methods of education on both a European and global scale. This is also the case in Finland, where various private educational enterprises are gaining a stronger role in defining what education is and should be. In this article, informed by our previous conceptual work related to changes in education governance and marketisation and privatisation of education, we are analysing interviews of edu-preneurs as powerful new actors in education. We ask what kind of storytelling is involved when edu-preneurs in Finland describe their services and products, and how they make sense of their industry, their work and themselves as edu-preneurs and how affective dimensions are involved.
Incidence and Risk Factors for Amputations in Persons with Diabetes Mellitus: A Retrospective Cohort Study
Authors: Bandeira Mariana Alves , Macedo Rosana Nascimento , Lázaro-Martinez José Luis , Alvarez Yolanda Garcia , Rocha Michele Neves Brajão , Santos Vera Lucia Conceição de Gouveia
Published: November 2024

The aim of this study was to identify and analyze the incidence rate of amputations and their risk factors in people with Diabetes Mellitus (DM) in two specialized outpatient clinics in Brazil. This is an epidemiological, retrospective cohort study using data collected from electronic health records of 281 adult diabetic patient types 1 or 2; attended in specialized outpatient service between 2015 and 2020. Statistical analyses were performed using the 2 sample t-test or Wilcoxon–Mann–Whitney test, for quantitative variables, and the Pearson's χ2 test or Fisher's exact test for categorical variables. The investigation of the risk factors for amputation was carried out through logistic regression. The study was approved by ethical committee. The sample mean age was 65.6 years (SD 13.05), predominating male gender n = 211 (75%), type 2 DM n = 223 (86.7%), with cardiovascular disease n = 143 (63.2%), and about 68.7% (n = 156) with peripheral arterial disease (PAD). Seventy-seven had lower limb amputation (LLA), with a rate incidence of 31.9% during five years. Logistic regression analysis showed the following associations with amputation: Diabetic peripheral neuropathy increased the rate of amputation by 3.6 times (OR = 3.631, 95% CI = 1.214-11.353; P = .022), and peripheral arterial disease increased by 10 times (OR = 10.631; 95% CI = 2.969-57.029; P = .001). The LLA in individuals with DM in two specialized outpatient services was higher compared to international literature; DPN and PAD were confirmed as risk factors for amputation, according to literature. This finding suggests that the study population faces an increased risk of amputation, highlighting the urgent need for targeted interventions and implementing robust preventive strategies to transform the current scenario and mitigate these severe outcomes. A comprehensive approach is essential to proactively address the underlying issues and reduce the prevalence and impact of amputations in Brazil.
Crohn’s disease management: translating STRIDE-II for UK clinical practice
Authors: Kemp Karen , Samaan Mark A. , Verma Ajay M. , Lobo Alan J.
Published: November 2024

Crohn’s disease (CD) is a chronic inflammatory bowel disease (IBD) characterised by endoscopic inflammation, progressive bowel damage and gastrointestinal lesions. Although treatment strategies for CD have traditionally focused on a stepwise pharmacological approach to achieve clinical remission or symptom resolution, these treatment goals correlate poorly with disease activity. Thus, achieving full clinical remission and full endoscopic healing alone may be insufficient, as patients may remain at risk of inflammatory complications. Individualised ‘treat-to-target’ (T2T) pharmacological and treatment approaches represent a promising strategy for improving endoscopic remission and symptom resolution among patients with CD. The Selecting Therapeutic Targets in Inflammatory Bowel Disease (STRIDE) and STRIDE-II guidelines, launched in 2013 and later renewed, identified individualised targets for a T2T therapeutic approach for patients with IBD. These guidelines facilitate the individualisation of target treatment goals through evidence-based, long-term (health-related quality of life, absence of disability, endoscopic healing) and intermediate/short-term (abdominal pain, stool frequency, normalisation of biomarker levels) treatment targets, allowing patients and clinicians to consider the risk-to-benefit balance of goals and selected therapeutic strategies. This article aims to summarise the STRIDE-II guidelines and provide intellectual guidance for healthcare professionals to apply the STRIDE-II principles to current clinical practice in the United Kingdom (UK). Management recommendations for primary and secondary first-line non-responders are provided, along with suggestions for utilising the endoscopic outcomes scoring system in UK clinical practice.

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Évaluation de la mise en œuvre des missions de service sanitaire en santé sexuelle en Île-de-France
Authors: Robin Marion , Dariane Charles , de Sousa Ambre , Le Tourneux Marie , Quiley Marie , Frain Elise , Pinot Juliette , Frachon Adèle
Published: November 2024

Contexte:

Le service sanitaire français, réalisé par des étudiants en santé (3ème année), est un programme de promotion de la santé (PS) récent qui est encore peu évalué.

Objectif:

Cette étude s’est intéressée au service mis en place dans la filière médecine à l’université Paris Cité, sur la thématique santé sexuelle. L’objectif de l’étude est d’évaluer des interventions réalisées par les étudiants en termes pédagogiques et en termes de bonnes pratiques en PS, sur les plans suivants : éthique, qualité du contenu et communication.

Méthode:

Les actions menées par les groupes d’étudiants dans les établissements scolaires ont été observées, et cotées à l’aide d’une grille standardisée.

Résultats:

Au total, 28 groupes d’intervention représentant 77 étudiants ont été observés. L’implication des étudiants a été jugée conséquente et leurs objectifs pédagogiques correctement remplis, mais la qualité de la démarche de PS présente un certain nombre d’insuffisances en termes de critères éthiques et techniques.

Discussion:

Cette étude permet d’envisager des pistes d’évolution des modalités du dispositif et de les comparer au niveau international.
Rare co-occurrence of probable pernicious anemia and autoimmune hepatitis in a 55-year-old male patient: A case report
Authors: Ibrahim Siddiqui Ahmed , Luqman Muhammad , Mustafa Siddiqui Ahmed , Bin Aijaz Arqam , Zuberi Muhammad Abdul Wasay , Abdul Rauf Sameer , Shah Hussain Haider
Published: November 2024

This is a case of probable pernicious anemia in the setting of autoimmune hepatitis. A 55-year-old male patient presented to the Emergency Room at Dr. Ruth K.M. Pfau Civil Hospital, Karachi with complaints of diarrhea and fever and was subsequently transferred to the medicine ward. The patient also had signs of unexplained anemia. We performed laboratory tests and were able to rule out the common causes of liver pathology, including viral hepatitis. For blood, the values showed decreased hemoglobin levels and an elevated Mean corpuscular hemoglobin (MCH) and mean corpuscular volume (MCV) (114 fL), indicating macrocytosis. Finally, we were able to conclude autoimmune pathology after the results of antibody testing demonstrated positive lab values for anti-smooth muscle antibodies, antinuclear antibodies, and anti-gastric parietal cell antibodies. The patient had developed pernicious anemia in the setting of autoimmune hepatitis, which is an extremely rare case and documented instances are scarce in the available literature regarding such cases.
Normative In-Game Data for Collegiate Baseball Pitchers Using Markerless Tracking Technology
Authors: Giordano Kevin A. , Schmitt Abigail , Nebel Adam , Yanagita Yuki , Oliver Gretchen D.
Published: November 2024

Background:

The current standard for motion capture data collection in baseball biomechanics is marker-based optical motion capture. Recent advancement in markerless motion capture capabilities has greatly improved accessibility to in-game, high-precision motion capture data, but specific values may differ from markered systems, necessitating separate normative values. For future data comparison, reference data are needed.

Purpose:

To describe common kinematic variables in baseball pitching using an in-game markerless motion capture system.

Study Design:

Descriptive laboratory study.

Methods:

Kinematic data were collected in 2 collegiate stadiums in the National Collegiate Athletic Association Division I Southeastern Conference using 8 synchronized 300-Hz KinaTrax cameras placed around the playing field. The in-game biomechanics data of 51 pitchers from 5 different teams during the 2023 season were collected; only pitchers with >3 outings during the season were included. After averaging all available fastballs thrown in the first inning of a game, we analyzed triaxial trunk (rotation, flexion, and lean) and pelvic rotation angles in the global reference frame, as well as shoulder rotation, shoulder horizontal abduction, shoulder abduction, elbow flexion, stride knee flexion, and hip-shoulder separation.

Results:

A total of 509 fastballs were analyzed. Mean fastball velocity was 40.98 m/s (91.5 mph), with a vertical break of 42.0 ± 10.6 cm (16.5 ± 4.2 inches) and a horizontal break of 28.0 ± 11.1 cm (11.0 ± 4.4 inches). Mean stride length was 1.41 ± 0.08 m. The mean arm slot was 59.4°± 9.3°, and the mean upper arm slot was 72.9°± 9.3° at ball release. Additional normative time-series data are presented for commonly analyzed variables, and discrete metrics are provided at distinct time points in the pitching cycle.

Conclusion:

These data fill a need for separate norms for in-game, markerless motion capture performance metrics, and biomechanics for collegiate baseball pitchers to be used as reference values for researchers, coaches, and clinicians.

Clinical Relevance:

Clinicians should use these results as reference values to contextualize injury mechanisms and the injury-performance trade-off. These data will also educate clinicians on what athletes’ bodies must do to perform when constructing plans of care and return-to-play timelines.
Bridging the Gap: A Framework for Experiential Learning in Higher Education
Authors: Phan Nhan
Published: November 2024

This article presents a conceptual framework for integrating experiential learning into higher education, focusing on guest speaker engagements, company field trips, and project-based learning. Grounded in Kolb’s experiential learning theory and Bandura’s social learning theory, the framework aims to bridge the gap between academic theory and professional practice by fostering critical thinking, teamwork, and communication skills. The article also explores the potential of technologies like virtual reality and AI in enhancing experiential learning, while emphasizing future research on long-term impacts, cultural adaptation, and faculty development.
Improving Quality of Life in Underserved Communities: A Case from Humanity Initiative's Student-Led Clinics
Authors: Abidi Syed Muhammad Aqeel , Nazeer Ali Hyder , Rizvi Muhammad Mushahid Hussain , Abidi Syeda Tayyaba Fatima
Published: November 2024

Using the case study of a 12-year-old girl diagnosed with complex congenital heart disease at a student-led clinic (SLC) organized by Humanity Initiative (HI) in Karachi, the paper highlights the effectiveness of SLCs in providing accessible and comprehensive healthcare services. The article contributes to existing literature by demonstrating the practical benefits of SLCs in a real-world setting, particularly in resource-limited environments. It underscores the potential of SLCs not only to improve community health but also to enhance medical education by providing students with hands-on experience and fostering a sense of social responsibility. Collaborative efforts between medical students, professionals, and the community are essential to ensure the continuity and effectiveness of healthcare interventions. For the success of such initiatives, there is a need for sustainable funding, effective follow-up protocols, and reliable communication channels with patients, offering solutions like peer mentoring and technology integration to overcome these barriers.
CHASM: A configurational measure of socio-spatial residential segregation
Authors: Saboya Renato Tibiriçá de , Peres Otavio Martins
Published: November 2024

Despite recent advances in the quantification of residential segregation, several important limitations persist. Zone-based measures have low resolution and treat all locations inside a zone as identical; oversimplify the possibility of interaction between zones; and underestimate the role of the street layout and how it can shape potential movement and exposure. Here, we propose a new measure of socio-spatial residential segregation called CHASM that estimates potential exposure between different social groups based on their positions in the street grid and comparing them to a hypothetical scenario in which all groups are evenly distributed (i.e., a situation of non-segregation). Depending on the type of centrality chosen for the analysis, its scores represent the degree to which the distances of a street segment to the different social groups are unevenly distributed or, alternatively, the degree to which different social groups tend to avoid sharing the same street segments in their trips. We tested CHASM’s validity through a random permutation test in a hypothetical scenario and a comparison with more traditional measures in a medium-sized Brazilian city. The results suggest that CHASM is indeed able to quantify residential segregation and: (a) better estimates distances, connections, and continuities between different areas of the city, including the implications of barriers that are overlooked in zone-based measures; (b) minimizes distortions introduced by zones’ arbitrary shapes; and (c) opens up new possibilities for testing alternative designs for the street system.
Pulmonary hypertension in patients carrying FLNA loss-of-function variants
Authors: Stourm Laura , Grynblat Julien , Savale Laurent , Lacoste-Palasset Thomas , Jaïs Xavier , Coulet Florence , Levy Marilyne , Meyrignac Olivier , Ghigna Maria-Rosa , Cottin Vincent , Sitbon Olivier , Bonnet Damien , Goupil Francois , Humbert Marc , Gagnadoux Frederic , Montani David
Published: November 2024

Background

Pulmonary hypertension (PH) is an unusual complication of X-linked disease caused by loss-of-function (LOF) variants in thefilamin A(FLNA) gene. Patients withFLNALOF may also present dysmorphic facial features, aortic dilation, thrombopenia, and periventricular nodular heterotopia (PVNH).

Methods

We reported clinical, functional, radiologic, and hemodynamic characteristics of patients withFLNALOF variants and PH from the French PH Network.

Results

Nine patients were identified with a female to male ratio of 8:1. PH was diagnosed at a median age of 36 [0–69] years. Associated conditions included epilepsy (n=5), PVNH (n=7), valvular heart disease (n=8), congenital heart diseases (n=4), thrombocytopenia (n=4), and hyperlaxity (n=4). Right heart catheterisation confirmed moderate-to-severe precapillary PH with a median mPAP of 33 [22–49] mmHg and PVR of 4.7 [2.4–8.0] WU. The DLCO was markedly decreased (48 [22–64] %pred) and five patients had obstructive ventilatory disorder. High-resolution CT showed heterogeneous parenchyma (n=8), emphysema (n=3), presence of a peripheral hyperclear band (n=3) and aortic ectasia (n=4). Pathologic assessment available in one patient revealed significant remodelling of small pulmonary arteries, interstitial edema, and irregular alveoli shapes. During follow-up, three patients died, including two from right heart failure. No patient died from aortic rupture.

Conclusions

Precapillary PH, likely due to multiple mechanisms, may complicate the course of patients with LOFFLNAvariants and may be the presenting symptom leading to diagnosis. The combination of PH with parenchymal involvement and extrapulmonary symptoms (epilepsy, congenital heart diseases, valvular and aortic involvement, thrombocytopenia) should prompt genetic screening forFLNA.
Vascular involvement in idiopathic pulmonary fibrosis
Authors: Mondoni Michele , Rinaldo Rocco , Ryerson Christopher J. , Albrici Cristina , Baccelli Andrea , Tirelli Claudio , Marchetti Francesca , Cefalo Jacopo , Nalesso Giulia , Ferranti Giulia , Alfano Fausta , Sotgiu Giovanni , Guazzi Marco , Centanni Stefano
Published: November 2024

Background

Idiopathic pulmonary fibrosis (IPF) is a chronic, fibrosing and progressive interstitial lung disease of unknown aetiology with a pathogenesis still partly unknown. Several microvascular and macrovascular abnormalities have been demonstrated in the pathogenesis of IPF and related pulmonary hypertension (PH), a complication of the disease.

Methods

We carried out a non-systematic, narrative literature review aimed at describing the role of the vasculature in the natural history of IPF.

Results

The main molecular pathogenetic mechanisms involving vasculature (i.e.endothelial-to-mesenchymal transition, vascular remodelling, endothelial permeability, occult alveolar haemorrhage, vasoconstriction and hypoxia) and the genetic basis of vascular remodelling are described. The prevalence and clinical relevance of associated PH are highlighted with focus on the vasculature as a prognostic marker. The vascular effects of current antifibrotic therapies, the role of pulmonary vasodilators in the treatment of disease, and new pharmacological options with vascular-targeted activity are described.

Conclusions

The vasculature plays a key role in the natural history of IPF from the early phases of disease until development of PH in a subgroup of patients, a complication related to a worse prognosis. Pulmonary vascular volume has emerged as a novel computed tomography finding and a predictor of mortality, independent of PH. New pharmacological options with concomitant vascular-directed activity might be promising in the treatment of IPF.