bluuebunny/crossref_metadata_2025 huggingface dataset:
Injustice and indignity in the threshold of materiality
Authors: Zhou Catherine
Published: May 2023

This article considers the role of dignity in the context of procedural fairness and the threshold of materiality. The author argues that dignity and indignation operate as social contingencies with expressive and constitutive consequences. The author particularly analyses the use of dignity as a justification for procedural fairness, and the ways in which a socio-political concept of dignity facilitates contestation of the law. Finally, the author explains how the threshold of materiality has conversely diminished such contestation by diminishing indignation.
Fight, Flight, or Freeze?: Equine-Assisted Learning as a Means to Explore Anxiety, Self-Efficacy, and Agency in Rural Youth During COVID-19
Authors: Davis Lauren , Stanton Christine Rogers
Published: May 2023

Background: Given the emerging information about the COVID-19 pandemic's detrimental impacts on youth well-being, it is paramount to consider interventions that may mitigate these consequences, especially those available in socially distanced, outdoor settings. Further, adolescents in rural settings are at a significant disadvantage for accessing critical mental health services; therefore, novel, community-based approaches are necessary to support youth wellness efforts. Purpose: This study sought to address youth mental health challenges exacerbated by the COVID-19 pandemic in rural Montana by combining mindfulness techniques with Equine Assisted Learning. Methodology: The study applied a mixed methods phenomenological case study. Surveys and participatory observations/ interviews provided a foundation for multi-phase data analysis. Descriptive statistics and paired samples t-tests were used to analyze quantitative data; multi-phase qualitative coding (open, focused, and values coding) was utilized to analyze interview and observational data. Findings: Participants’ anxiety levels were greatly reduced following the intervention; mixed outcomes resulted from self-efficacy measures. Qualitatively, the findings demonstrate alignment between course topics, goals, and outcomes. Implications: Results suggest the potential for EAL to reduce anxiety levels in youth and increase self-awareness and agency in application of strategies to manage anxiety. Questions surrounding Bandura's self-efficacy scales arose as a result of this research.
Study on excitation threshold of strong modulation response and vibration suppression performance of bistable nonlinear energy sink
Authors: Wang Yujiang , Yang Haiyan , Song Weizhi , Lu Chihua , Liu Zhien , Zhou Hui
Published: May 2023

The dynamics and vibration reduction performance of bistable nonlinear energy sink (BNES) are studied in this paper. First, the negative stiffness of BNES is realized by geometric nonlinearity, and the dynamics model of the system is established. The slow flow equation of the system under 1:1 main resonance is analyzed based on the complexification-averaging (CX-A) method, and the boundary conditions of saddle node bifurcation and Hopf bifurcation are analyzed. Second, the slow invariant manifold (SIM) of the BNES is studied based on multiscale analysis, and the excitation threshold of strongly modulated response (SMR) is analyzed; the analysis results are verified by the numerical method. The results show that the analytical solution is highly consistent with the numerical solution, and the error is less than 1%. Finally, the influence of structural parameters on the vibration reduction performance is analyzed and optimized. The vibration reduction performance of BNES and CNES is compared, and the results show that the BNES has better vibration reduction performance in the full frequency band.
Research on signal separation method of micro-speed difference dual-rotor based on ZFFT and FT algorithm
Authors: Meng Zhang , Jiaqiao Lu , Xin Pan
Published: May 2023

Aiming at the problem that the traditional analysis methods such as Zoom-FFT (ZFFT) heavily depend on the data length in the frequency separation accuracy when separating the unbalanced signals of the inner and outer rotors of the dual-rotor system with micro-speed difference, an improved method based on ZFFT + FT was proposed to refine the signal spectrum and accurately identify the unbalanced response of the inner and outer rotors. On the basis of sampling and filtering the micro-speed difference signal by ZFFT, DFT was used to refine the frequency segment, so as to extract the corresponding amplitude of the operating frequency components of the inner and outer rotors. The basic principles of Chirp-Z transform (CZT), ZFFT, and ZFFT + FT algorithms were introduced, and the corresponding programs of each algorithm were written based on LabVIEW software for simulation, then the signal generator was used to carry out the micro-speed difference signal extraction test and finally the dynamic balance test was carried out on the dual-rotor test bench. Data simulation and field test show that compared with the CZT and ZFFT methods, the method has better frequency resolution ability and can separate the micro-speed difference signal with higher accuracy, and has high feasibility and practicability in the dynamic balance of the micro-speed difference dual-rotor system.
Access to post-secondary Education in Canada for students with disabilities
Authors: Jacobs Laverne
Published: May 2023

In Canada, access to post-secondary education is guaranteed by a number of domestic instruments. These instruments are: statutory human rights legislation, constitutional law, and accessibility legislation. These guarantees are further bolstered by Article 24 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD). Statutory human rights legislation (or anti-discrimination law) plays the most extensive role in controlling the discretionary power that colleges and universities exercise with respect to the admission of prospective students and the reasonable accommodation of matriculated students with disabilities. This article presents the findings of a review of decisions by human rights tribunals in Canada over the 7-year period of 2014–2021. With respect to both admissions cases and in-program reasonable accommodations cases, it identifies the main types of barriers experienced by persons with disabilities. It also examines the ways in which accessibility legislation, a proactive standard-setting form of legislation in Canada, has sought to improve access to post-secondary students with disabilities, focusing on Ontario’s post-secondary education accessibility standards as an example. Finally, it argues that changes to policies and practices on the ground that draw more inspiration from Article 24 of the CRPD will help to ensure that the equality right to post-secondary education for students with disabilities is fulfilled in letter and spirit.
Positively Original: Effects of Mindfulness on Social Media Tweets and Sentiment
Authors: Errmann Amy , Kishore Shohil , Lee Sanghyub John
Published: May 2023

Mindfulness challenges allow consumers to track meditation frequency through posting social media updates documenting their regular meditations. However, little is known about the effects of mindfulness on consumers in these representative online settings. In one study (1a and 1b) the research utilises two types of data to explore how a contemplative practice such as mindfulness influences online behaviour. Specifically, consumers who have completed a 60-day online meditation challenge showed an increase (vs. decrease) in original tweets (vs. retweets) (study 1a), and further, consumers who completed the challenge (vs. did not complete) showed higher (vs. lower) positive sentiment of original tweets. Despite some research showing engagement in social media as maladaptive, we provide a positive and unexpected contribution to show that mindfulness has a positive effect on how consumers may engage with social media. Further, we contribute a novel research method based on Twitter that advances immediate and unique marketing methods. Finally, we expand the practical application of mindfulness by exploring how consumers are organically, and consequentially, practicing mindfulness in field settings.
Mechanical, water absorption and tribological properties of epoxy composites filled with waste eggshell and fish scale particles
Authors: Behera Sudhakar , Gautam Rakesh Kumar , Mohan Sunil , Tiwari Anupam
Published: May 2023

Egg shells and fish scales are two abundantly available by-products from food industries which can be used as filler materials to reinforce polymer composites. The bulk of discarded chicken eggshells and fish scales are disposed of in landfills, which cause environmental issues. The present research work focuses on the water absorption, mechanical and tribological properties of epoxy composites reinforced with chicken eggshells and catla fish scale particles. Hybrid composites incorporating both fillers were also made and evaluated. Results from the water absorption tests showed that the addition of fillers decreased the water absorption of the composites than neat epoxy. Tensile and impact tests revealed that the inclusion of fillers reduced the tensile and impact strength of the composites compared to neat epoxy, but improved the tensile modulus. The hybrid composite (EFREC) showed improvement in both flexural strength and modulus in comparison to neat epoxy. Also, the results from the wear tests revealed that the addition of fillers improved the wear resistance of the composites. Among all the mechanical and wear tested composite specimens, the hybrid composite (EFREC) showed the best performance. This was also validated from the SEM images of the fracture and wear surfaces of the composites.
Giving Voice to People With Dementia and Their Carers: The Impact of Communication Difficulties on Everyday Conversations
Authors: Volkmer Anna , Bruns Claudia , Zimmerer Vitor , Varley Rosemary , Beeke Suzanne
Published: May 2023

People living with dementia are an under-served group, whose voices are often excluded from research studies due to their speech, language and communication difficulties. As part of a larger study into language processing in dementia, we invited five people with dementia and their carers to tell us about how dementia impacts on their everyday conversations. We also wanted to gain insights into their views on communication strategies to circumvent these difficulties. Aware of the limitations of a standard focus group methodology for this population, we adapted this approach to provide people with dementia the opportunity to be active research participants. To amplify their voices and to enable carers to be as open as possible we ran the groups separately. Each was facilitated by a speech and language therapist. Both groups used communication accessible materials, to create an inclusive environment that valued contributions from all participants. The topic guide remained the same for all participants, ensuring equity in posing the same core questions. Focus groups were video recorded and transcribed. Reflexive thematic analysis was selected as the most appropriate method to ensure overarching themes identified were based in the data. In our analysis the main theme was sense-making; participants experienced and tried to make sense of dementia through the lens of interaction. Four subthemes were also identified, 1. It’s a journey, 2. You have to make the most of things, 3. Ask the right questions and it just flows-strategies in conversation, and 4. Dealing with people. Multimodal adaptations to a focus group methodology have given voice to people with dementia as well as their carers. They characterise dementia and identify useful strategies based on observations of what changes for them in everyday conversations.
CD64 as a diagnostic marker for bacterial infection in acute bronchiolitis
Authors: Shalaby Amira M , Ismail Asmaa M , Farook Yasser , Abdel-Aziz Safwat M , Thabet Marwa M , Mokhtar Abeer A , Fadle Azza A , Nigm Dalia A
Published: May 2023

Objectives: The aim of this study was to determine the association between neutrophils and monocytes CD 64 molecules and cases of bronchiolitis with an associated bacterial infection.

Methods: Blood samples were obtained from patients younger than 2 years old diagnosed with bronchiolitis. Complete blood count (CBC), blood culture, procalcitonin, and CD64 surface expression in neutrophils and monocytes were examined using flow cytometry. We also assessed CBC, procalcitonin, and CD64 levels in neutrophils and monocytes in 31 healthy control subjects.

Results: Sixty-two patients with lower respiratory tract infections were included in the first group. The patients were divided into 34 with non-bacterial infections and 28 with possible bacterial infections. We found a significant increase in the number of positive cells in the Mean Fluorescence Intensity (MFI) of both nCD64 and mCD64 in the Possible Bacterial Infection (PBI) group. Procalcitonin levels correlated with nCD64 and nCD64%, but not with mCD64. The AUC of nCD64 was 0.873 (at a cut-off point of 4489.4; the MFI had a specificity of 73% and a sensitivity of 94%).

Conclusion: Neutrophil CD64 may be a marker for bacterial infection in children with bronchiolitis.
Latest insights in disease-modifying osteoarthritis drugs development
Authors: Li Shengfa , Cao Peihua , Chen Tianyu , Ding Changhai
Published: May 2023

Osteoarthritis (OA) is a prevalent and severely debilitating disease with an unmet medical need. In order to alleviate OA symptoms or prevent structural progression of OA, new drugs, particularly disease-modifying osteoarthritis drugs (DMOADs), are required. Several drugs have been reported to attenuate cartilage loss or reduce subchondral bone lesions in OA and thus potentially be DMOADs. Most biologics (including interleukin-1 (IL-1) and tumor necrosis factor (TNF) inhibitors), sprifermin, and bisphosphonates failed to yield satisfactory results when treating OA. OA clinical heterogeneity is one of the primary reasons for the failure of these clinical trials, which can require different therapeutic approaches based on different phenotypes. This review describes the latest insights into the development of DMOADs. We summarize in this review the efficacy and safety profiles of various DMOADs targeting cartilage, synovitis, and subchondral bone endotypes in phase 2 and 3 clinical trials. To conclude, we summarize the reasons for clinical trial failures in OA and suggest possible solutions.
Carotid canal fracture with internal carotid artery transection: A deadly trauma
Authors: Naggar Amine , Benmoussa Meryem , Diallo Ibrahima Dokal , El Aoufir Omar , Laamrani Fatima Zahra , Jroundi Laila
Published: May 2023

Carotid artery injuries are rare with an incidence of 1%–2.6% in trauma patients. They are associated with high morbi-mortality rates, with mortality ranging from 19% to 43%. The diagnosis relies mainly on computed tomography angiography in the emergency setting; however, it is fundamental to be able to suspect carotid artery injuries on non-contrast computed tomography, as the latter is the routine imaging tool for trauma patients. We report the case of a young male, victim of a blunt high velocity motor-vehicle trauma. He was unconscious, with abundant epistaxis and hypovolemic shock. A fracture of the left carotid canal on non-contrast computed tomography was seen, raising concern for an arterial injury. A computed tomography angiography was performed subsequently revealing a transection of the internal carotid artery. This type of injury is highly lethal, and its management relies on urgent surgical intervention, and endovascular treatment, with the purpose of controlling the hemorrhage.
Review of the Area Health Education Center Scholars Didactic Curricula: A Federal Program for Students Interested in Rural Health
Authors: Vyas Kartavya J
Published: May 2023

The objective of this review is to critically evaluate the Area Health Education Center Scholars' didactic curricula and determine whether the goal of developing a sustainable rural healthcare workforce is achievable under the program. The didactic curricula from the Alabama, Florida, and South Carolina programs were evaluated using a context-input-process-product model and a mixed-methods approach. Modules were assessed for their content and mode of delivery, and whether the eight competency domains from the Council on Education for Public Health were incorporated. Student evaluations from the 2019–2020 cohort were also examined to identify themes from each module. On average, across modules, nearly all students strongly agreed or agreed that the facilitator had been responsive (97%); that the modules had been clearly outlined (95%), easy to understand (96%), not overly time-consumptive (96%), and relatable to their career (96%); and felt that their understanding had improved (97%) and felt satisfied overall (96%). Some argued, however, that parts of the content may have been lengthy and dense, and that there were insufficient materials tailored toward healthcare professionals, including the cultural barriers of populations they are expected to attend to and actionable ways to advocate for patients. Public health policy, leadership, and communication competencies were noticeably absent in several modules. It is recommended that modules be amended to include components that students felt were instructive. It is also suggested that a committee standardize the core curricula; local programs may then tailor them as needed.
Nanobiotechnology in crop stress management: an overview of novel applications
Authors: Nawaz Ahmad , Rehman Hafeez ur , Usman Muhammad , Wakeel Abdul , Shahid Muhammad Shafiq , Alam Sardar , Sanaullah Muhammad , Atiq Muhammad , Farooq Muhammad
Published: May 2023

Agricultural crops are subject to a variety of biotic and abiotic stresses that adversely affect growth and reduce the yield of crop plantss. Traditional crop stress management approaches are not capable of fulfilling the food demand of the human population which is projected to reach 10 billion by 2050. Nanobiotechnology is the application of nanotechnology in biological fields and has emerged as a sustainable approach to enhancing agricultural productivity by alleviating various plant stresses. This article reviews innovations in nanobiotechnology and its role in promoting plant growth and enhancing plant resistance/tolerance against biotic and abiotic stresses and the underlying mechanisms. Nanoparticles, synthesized through various approaches (physical, chemical and biological), induce plant resistance against these stresses by strengthening the physical barriers, improving plant photosynthesis and activating plant defense mechanisms. The nanoparticles can also upregulate the expression of stress-related genes by increasing anti-stress compounds and activating the expression of defense-related genes. The unique physico-chemical characteristics of nanoparticles enhance biochemical activity and effectiveness to cause diverse impacts on plants. Molecular mechanisms of nanobiotechnology-induced tolerance to abiotic and biotic stresses have also been highlighted. Further research is needed on efficient synthesis methods, optimization of nanoparticle dosages, application techniques and integration with other technologies, and a better understanding of their fate in agricultural systems.
Cheilitis in an atopic dermatitis patient associated with co-infection of Staphylococcus pseudintermedius and Staphylococcus aureus
Authors: Wang Shucui , Nurxat Nadira , Wei Muyun , Wu Yao , Wang Qichen , Li Ming , Liu Qian
Published: May 2023

Background

Atopic dermatitis (AD) is an inflammatory skin condition distinguished by an activated Th2 immune response. The local skin microbial dysbiosis is a contributing factor to the development of AD. The pathogenic coagulase-positive Staphylococcus aureus is the primary species responsible for the progression of AD. Even though Staphylococcus pseudintermedius is an animal-origin pathogen, it is increasingly becoming a source of concern in human diseases. As another coagulase-positive Staphylococci, it is crucial to pay more attention to S. pseudintermedius isolated from the lesion site.

Results

In our investigation, we presented a case of cheilitis in a patient with atopic dermatitis (AD). We utilized culture and next-generation genomic sequencing (NGS) to identify the bacteria present on the skin swabs taken from the lip sites both prior to and following treatment. Our findings indicated that the predominant bacteria colonizing the lesion site of AD were S. pseudintermedius and S. aureus, both of which were eradicated after treatment. The Multi-locus sequence typing (MLST) of S. pseudintermedius and S. aureus demonstrated coordinated antibiotic susceptibility, with ST2384 and ST22 being the respective types. Although the skin abscess area resulting from S. pseudintermedius infection was significantly smaller than that caused by S. aureus in mice, the expression of cytokines interleukin-4 (IL-4) and interleukin-5 (IL-5) were significantly higher in the S. pseudintermedius-infected mice.

Conclusions

The S. pseudintermedius strain isolated from the lesion site of the AD patient exhibited a higher expression of IL-4 and IL-5 when colonized on mouse skin, as compared to S. aureus. This observation confirms that S. pseudintermedius can effectively induce the Th2 response in vivo. Our findings suggest that animal-origin S. pseudintermedius may play a role in the development of AD when colonized on the skin, emphasizing the importance of taking preventive measures when in contact with animals.
Reply to the letter “Understanding lactate and its clearance during extracorporeal membrane oxygenation for supporting refractory cardiogenic shock patients”
Authors: Scolari Fernando Luís , Schneider Daniel , Fogazzi Débora Vacaro , Gus Miguel , Rover Marciane Maria , Bonatto Marcely Gimenes , de Araújo Gustavo Neves , Zimerman André , Sganzerla Daniel , Goldraich Lívia Adams , Teixeira Cassiano , Friedman Gilberto , Polanczyk Carisi Anne , Rohde Luis Eduardo , Rosa Regis Goulart , Wainstein Rodrigo Vugman
Published: May 2023

This is a reply to the letter titled “Understanding lactate and its clearance during extracorporeal membrane oxygenation for supporting refractory cardiogenic shock patients” by Eva Rully Kurniawati et al. In response to the concerns raised about our paper published in BMC Cardiovascular Disorders, titled “Association between serum lactate levels and mortality in patients with cardiogenic shock receiving mechanical circulatory support: a multicenter retrospective cohort study,“ we have addressed the confounding bias on the population included and the use of VA-ECMO and Impella CP. Furthermore, we have provided new data on the correlation of oxygen supply and lactate levels at admission of cardiogenic shock.
TRIPLE C reporting principles for case study evaluations of the role of context in complex interventions
Authors: Shaw Sara E. , Paparini Sara , Murdoch Jamie , Green Judith , Greenhalgh Trisha , Hanckel Benjamin , James Hannah M. , Petticrew Mark , Wood Gary W. , Papoutsi Chrysanthi
Published: May 2023

Background

Guidance and reporting principles such as CONSORT (for randomised trials) and PRISMA (for systematic reviews) have greatly improved the reporting, discoverability, transparency and consistency of published research. We sought to develop similar guidance for case study evaluations undertaken to explore the influence of context on the processes and outcomes of complex interventions.

Methods

A range of experts were recruited to an online Delphi panel, sampling for maximum diversity in disciplines (e.g. public health, health services research, organisational studies), settings (e.g. country), and sectors (e.g. academic, policy, third sector). To inform panel deliberations, we prepared background materials based on: [a] a systematic meta-narrative review of empirical and methodological literatures on case study, context and complex interventions; [b] the collective experience of a network of health systems and public health researchers; and [c] the established RAMESES II standards (which cover one kind of case study). We developed a list of topics and issues based on these sources and encouraged panel members to provide free text comments. Their feedback informed development of a set of items in the form of questions for potential inclusion in the reporting principles. We circulated these by email, asking panel members to rank each potential item twice (for relevance and validity) on a 7-point Likert scale. This sequence was repeated twice.

Results

We recruited 51 panel members from 50 organisations across 12 countries, who brought experience of a range of case study research methods and applications. 26 completed all three Delphi rounds, reaching over 80% consensus on 16 items covering title, abstract, definitions of terms, philosophical assumptions, research question(s), rationale, how context and complexity relates to the intervention, ethical approval, empirical methods, findings, use of theory, generalisability and transferability, researcher perspective and influence, conclusions and recommendations, and funding and conflicts of interest.

Conclusion

The ‘Triple C’ (Case study, Context, Complex interventions) reporting principles recognise that case studies are undertaken in different ways for different purposes and based on different philosophical assumptions. They are designed to be enabling rather than prescriptive, and to make case study evaluation reporting on context and complex health interventions more comprehensive, accessible and useable.
Trends in intentional and unintentional poisonings among older adults - A national register-based study in Sweden
Authors: Möller J. , Lindholm E. , Fredlund P. , Vaez M. , Liang Y. , Laflamme L.
Published: May 2023

Background

Among older people intentional poisoning outnumber unintentional ones. While there are indications that time trends differ by poisoning intent, studies are scarce. We assessed how the annual prevalence of intentional and unintentional poisoning changed over time, overall and by demographic groups.

Methods

We conducted a national open cohort study of individuals aged 50–100 years, resident in Sweden during 2005–2016. Individuals were followed up in population-based registers for their demographic and health attributes from 2006–2016. Annual prevalence of hospitalization and death by poisoning intent (unintentional vs. intentional or undetermined; ICD-10 definitions) were compiled for the categories of four demographic attributes (age, sex, marital status, and birth cohort “baby boomers”). The time trends were assessed by multinomial logistic regression with year as an independent variable.

Results

The annual overall prevalence of hospitalization and death by intentional poisonings consistently exceeded that of unintentional poisonings. There was a significant downward trend in intentional poisonings but not in unintentional ones. This difference in trends also applied when considering men and women separately, married and unmarried people, the young-old individuals (but not the older- or oldest-old ones), and the baby boomers and non-baby boomers. The largest demographic differences within intent were found between married and unmarried people, and the smallest one between men and women.

Conclusion

As expected, the annual prevalence of intentional poisonings considerably exceed that of unintentional ones among Swedish older people. The recent trends reveal a significant reduction of intentional poisonings, consistent across a range of demographic attributes. The scope for action regarding this preventable cause of mortality and morbidity remains considerable.
Effect of pharmacogenomics testing guiding on clinical outcomes in major depressive disorder: a systematic review and meta-analysis of RCT
Authors: Wang Xinrui , Wang Chenfei , Zhang Yi , An Zhuoling
Published: May 2023

Background

Pharmacogenomic testing guided treatment have been developed to guide drug selection or conversion in major depressive disorder patients. Whether patients benefit from pharmacogenetic testing remains unclear. We aim to evaluates the effect of pharmacogenomic testing guiding on clinical outcomes of major depressive disorder.

Methods

Pubmed, Embase, and Cochrane Library of Clinical Trials were searched from inception until August 2022. Key terms included pharmacogenomic and antidepressive. Odds ratios (RR) with 95% confidence intervals (95%CIs) were calculated using fixed-effects model for low or moderate heterogeneity or random-effects model for high heterogeneity.

Results

Eleven studies (5347 patients) were included. Compared with usual group, pharmacogenomic testing guided group was associated with an increased response rate at week 8 (OR 1.32, 95%CI 1.15–1.53, 8 studies, 4328 participants) and week 12 (OR 1.36, 95%CI 1.15–1.62, 4 studies, 2814 participants). Similarly, guided group was associated with an increased rate of remission at week 8 (OR 1.58, 95%CI 1.31–1.92, 8 studies, 3971 participants) and week 12 (OR 2.23, 95%CI 1.23–4.04, 5 studies, 2664 participants). However, no significant differences were found between the two groups in response rate at week 4 (OR 1.12, 95%CI 0.89–1.41, 2 studies, 2261 participants) and week 24 (OR 1.16, 95%CI 0.96–1.41, 2 studies, 2252 participants), and remission rate at week 4 (OR 1.26, 95%CI 0.93–1.72, 2 studies, 2261 participants) and week 24 (OR 1.06, 95%CI 0.83–1.34, 2 studies, 2252 participants). Medication congruence in 30 days was significantly reduced in the pharmacogenomic guided group compared with the usual care group (OR 2.07, 95%CI 1.69–2.54, 3 studies, 2862 participants). We found significant differences between subgroups of target population in response and remission rate.

Conclusion

Patients with major depressive disorder may benefit from pharmacogenomic testing guided treatment by achieving target response and remission rates more quickly.
Using the COM-B model and Behaviour Change Wheel to develop a theory and evidence-based intervention for women with gestational diabetes (IINDIAGO)
Authors: Murphy Katherine , Berk Jamie , Muhwava-Mbabala Lorrein , Booley Sharmilah , Harbron Janetta , Ware Lisa , Norris Shane , Zarowsky Christina , Lambert Estelle V. , Levitt Naomi S.
Published: May 2023

Background

In South Africa, the prevalence of gestational diabetes (GDM) is growing, concomitant with the dramatically increasing prevalence of overweight/obesity among women. There is an urgent need to develop tailored interventions to support women with GDM to mitigate pregnancy risks and to prevent progression to type 2 diabetes post-partum. The IINDIAGO study aims to develop and evaluate an intervention for disadvantaged GDM women attending three large, public-sector hospitals for antenatal care in Cape Town and Soweto, SA. This paper offers a detailed description of the development of a theory-based behaviour change intervention, prior to its preliminary testing for feasibility and efficacy in the health system.

Methods

The Behaviour Change Wheel (BCW) and the COM-B model of behaviour change were used to guide the development of the IINDIAGO intervention. This framework provides a systematic, step-by-step process, starting with a behavioural analysis of the problem and making a diagnosis of what needs to change, and then linking this to intervention functions and behaviour change techniques to bring about the desired result. Findings from primary formative research with women with GDM and healthcare providers were a key source of information for this process.

Results

Key objectives of our planned intervention were 1) to address women’s evident need for information and psychosocial support by positioning peer counsellors and a diabetes nurse in the GDM antenatal clinic, and 2) to offer accessible and convenient post-partum screening and counselling for sustained behaviour change among women with GDM by integrating follow-up into the routine immunisation programme at the Well Baby clinic. The peer counsellors and the diabetes nurse were trained in patient-centred, motivational counselling methods.

Conclusions

This paper offers a rich description and analysis of designing a complex intervention tailored to the challenging contexts of urban South Africa. The BCW was a valuable tool to use in designing our intervention and tailoring its content and format to our target population and local setting. It provided a robust and transparent theoretical foundation on which to develop our intervention, assisted us in making the hypothesised pathways for behaviour change explicit and enabled us to describe the intervention in standardised, precisely defined terms. Using such tools can contribute to improving rigour in the design of behavioural change interventions.

Trial registration

First registered on 20/04/2018, Pan African Clinical Trials Registry (PACTR): PACTR201805003336174.
Effects of a randomized controlled hiking intervention on daily activities, sleep, and stress among adults during the COVID-19 pandemic
Authors: Anzman-Frasca Stephanie , Drozdowsky Julia , Zayatz Callista , Holmbeck Katherine
Published: May 2023

Background

Physical activity promotes health, and physical activity done outdoors in nature may be particularly beneficial. We conducted two randomized studies to examine the implementation of a winter hiking intervention and whether this intervention affected activity choices and aspects of well-being during the COVID-19 pandemic.

Methods

Convenience samples of adults (n = 53; n = 51) were recruited into two different randomized studies in 2021 and 2022 respectively. Participants completed online surveys at baseline and 6 and 11–12 weeks later. Participants were randomized to a study group (intervention or control) shortly after the baseline assessments. In both studies, the intervention group received free access to a regional winter hiking challenge. In the second study, we also provided winter traction cleats to this group to facilitate engagement in the hiking challenge. Descriptive statistics were used to summarize intervention implementation, including participants’ engagement in challenge hikes. Repeated measures ANOVA models were used to test intervention effects on key outcome variables, including hiking frequency via the Pleasant Activities List, stress via the Perceived Stress Scale, and sleep duration via the Pittsburgh Sleep Quality Index.

Results

In the first study, the intervention group’s engagement in challenge hikes was low (38.5%); reported barriers included access to winter hiking equipment. In the second study, when winter traction cleats were provided, engagement in the intervention was higher, and the intervention increased hiking frequency and improved sleep. There were no significant intervention effects on stress, but the direction of effects was in the expected direction.

Conclusions

Results highlight some potential positive impacts of this intervention designed to facilitate access to winter hiking. Future research could examine whether effects are stronger in a larger sample, in which additional barriers to engagement are addressed.

Trial registration

This study was registered at clinicaltrials.gov on 28/12/2020 prior to participant enrollment (NCT04685681), https://clinicaltrials.gov/ct2/show/NCT04685681.
Tongue necrosis secondary to giant cell arteritis, successfully treated with tocilizumab: a case report
Authors: Cho Young Min , El Khoury Lara , Paramo Jonathan , Horowitz Diane Michelle , Li Jian Yi , Kello Nina
Published: May 2023

Abstracts

Background

Giant Cell Arteritis (GCA) is a large vessel vasculitis that most commonly presents with headache, scalp tenderness, jaw claudication, and vision changes. Various other, less common, manifestations have been reported in the literature such as scalp and tongue necrosis. Though most patients respond to corticosteroids, some cases of GCA are refractory to the high doses of corticosteroids.

Case presentation

We present a 73-year-old female with GCA refractory to corticosteroids presenting with tongue necrosis. This patient significantly improved with a dose of tocilizumab, an IL-6 inhibitor.

Conclusion

To the best of our knowledge, this is the first case report of a patient with refractory GCA presenting with tongue necrosis that had rapid improvement with tocilizumab. Prompt diagnosis and treatment can prevent severe outcomes such as tongue amputation in GCA patients with tongue necrosis, and tocilizumab may be effective for corticosteroid-refractory cases.
Percutaneous versus open posterior stabilization and decompression in AOSpine-type A3 thoracolumbar fractures with neurological deficit
Authors: Song Xin , Ren Donglin , Zhang Feng , Han Shuai , Wu Desheng , Wang Jian
Published: May 2023

Background

This retrospective cohort study aimed to compare the clinical and radiological outcomes between two treatment strategies focusing on non-osteoporotic AOSpine-type A3 fractures of the thoracolumbar spine with neurological deficits at levels T11 to L2.

Methods

In total, 67 patients between 18 and 60 years of age who were treated operatively with either of the two treatment strategies were included. One treatment strategy included open posterior stabilization and decompression, whereas the other was based on percutaneous posterior stabilization and decompression via a tubular retraction system. Demographic data, surgical variables, and further parameters were assessed. Patient-reported outcomes (PROs), including the Visual Analog Scale (VAS), the Oswestry Disability Index (ODI), and the American Spinal Injury Association (ASIA) impairment score, were measured to assess functional outcomes. The regional Cobb angle (CA), the anterior height ratio of the fractured vertebrae (AHRV), and the degree of canal encroachment (DCE) were assessed. The ASIA score was used to assess neurological function recovery. The follow-up period was at least 12 months.

Results

Surgical time and postoperative hospital stay were significantly shorter in the minimally invasive surgery (MIS) group. Intraoperative blood loss was significantly less in the MIS group. Regarding radiological outcome, CA and AHRV at the time of follow-up did not show a significant difference. DCE at the time of follow-up was significantly improved in the MIS group. Lower VAS scores and better ODIs were observed in the MIS group at the 6-month follow-up, but similar outcomes were observed at the 12-month follow-up. The ASIA score was similar between both groups at the 12-month follow-up.

Conclusions

Both treatment strategies are safe and effective; however, MIS could provide earlier pain relief and better functional outcomes compared with OS.
Varying degrees of spontaneous osteogenesis of Masquelet’s induced membrane: experimental and clinical observations
Authors: Yin Qudong , Chen Xueming , Dai Beichen , Liu Jun , Yang Ying , Song Sheng , Ding Yanping
Published: May 2023

Background

Masquelet’s induced membrane (IM) has osteogenesis activity, but IM spontaneous osteogenesis (SO) has not been described previously.

Objectives

To report on varying degrees of IMSO and analyze its possible causes.

Methods

Twelve eight-week-old male Sprague-Dawley rats with 10 mm right femoral bone defects who received the first stage of IM technique (IMT) were used to observe the SO. In addition, clinical data from patients with bone defects who received the first stage of IMT with an interval of > 2 months post-operatively and exhibited SO between January 2012 and June 2020 were retrospectively analyzed. The SO was divided into four grades according to the amount and characteristics of the new bone formation.

Results

At twelve weeks, grade II SO was observed in all rats, and more new bone was formed in the IM near the bone end forming an uneven margin. Histology revealed bone and cartilage foci in the new bone. Four of the 98 patients treated with the first stage of IMT exhibited IMSO, including one female and three males with a median age of 40.5 years (range 29–52 years). The bone defects were caused by severe fractures and infection in two cases and by infection or tumor in one case each. Partial or segmental defects occurred in two cases. The time interval between inserting a cement spacer and diagnosis of SO ranged from six months to nine years. Two cases were grade I, and one case each of grades III and IV.

Conclusion

Varying degrees of SO confirm the existence of the IMSO phenomenon. Bioactive bone tissue or local inflammation and a long time interval are the primary reasons underlying enhancement of the osteogenic activity of IM and leading to SO, which tends to take place as endochondral osteogenesis.
Oral pathology and overweight among pupils in government primary schools in Cameroon: a cross-sectional study
Authors: Boukeng Lionel Berthold Keubou , Minkandi Claude Axel , Dapi Leonie Nzefa
Published: May 2023

Background

Tooth decay and periodontal diseases are the main oral pathologies in the world. The prevalence of overweight in children has increased worldwide. Overweight children have alterations in the composition of saliva and excessive consumption of saturated fatty acids tend to slow the metabolism of carbohydrates in the oral cavity leading to tooth decay, periodontal disease and others oral disorders. The aim of this study was to assess the relationship between oral pathologies and overweight in pupils of primary schools of Cameroon.

Methods

A cross-sectional study was carried out from June to August 2020 in four government primary schools selected through cluster sampling in Yaounde. 650 pupils aged between 6 and 11 years were enrolled. Data collected included anthropometric, oral pathologies, quality of oral hygiene and feeding habits. Data were analysed with the SPSS 26.0 statistical software and binary logistic regression was used to determine the risks of oral pathologies in overweight pupils. P-value of 0.05 was considered statistically significant.

Results

The prevalence of overweight was 27% (95% CI: 23.5—30.5). The main oral pathologies was tooth decay (60.3%). Binary logistic regression revealed that overweight pupils were significantly 1.5 times more likely to develop tooth decay than non-overweight pupils (95% CI: 1.1—2.4).

Conclusion

Overweight, tooth decay are prevalent among pupils. Overweight pupils have a higher risk of developing tooth decay compared to non-obese pupils. An integrated package of oral and nutritional health promotion activities is necessary in primary schools in Cameroon.
Effects of metaverse-based career mentoring for nursing students: a mixed methods study
Authors: Kim Yujeong , Kim Mi Young
Published: May 2023

Background

There is a lack of studies on metaverse-based career mentoring for college students in both quantitative and qualitative research. This study aimed to examine the effect of metaverse-based career mentoring among nursing students and explore the experiences of mentors and mentees.

Methods

This study used a mixed methods design using both a survey for collecting quantitative data and focus group interviews for a qualitative one. A total of 8 mentors and 43 mentees participated in the metaverse-based career mentoring program. The program covered eight career fields and was delivered across eight sessions of 60 min each, over six days. Career decision-making self-efficacy among mentees and platform and program satisfaction were measured before and after the program. Afterwards, 7 mentors and 12 mentees participated in the focus group interviews to investigate their experience of participating in the metaverse-based career mentoring program. Quantitative data were analyzed using descriptive statistics, paired t-test, Wilcoxon signed-rank test, and Mann-Whitney U test. The qualitative data underwent thematic analysis.

Results

After the metaverse-based career mentoring program, mentees’ career decision-making self-efficacy increased significantly compared to the baseline level. From the mentor–mentee focus group interviews, three key themes were derived: (i) communicating frankly and openly, (ii) being satisfied with realistic communication and program functions, and (iii) expecting an even more optimized program.

Conclusions

A metaverse-based career mentoring program for nursing students can have a positive effect on their career decision-making self-efficacy. In addition, in terms of education, it is helpful as a non-face-to-face medium and feeling a sense of reality, so it is expected that it will be beneficial in education by applying various contents in the future.
Symptoms and risk factors for long COVID in Tunisian population
Authors: Chelly Souhir , Rouis Sourour , Ezzi Olfa , Ammar Asma , Fitouri Sami , Soua Asma , Fathallah Ines , Njah Mansour , Mahjoub Mohamed
Published: May 2023

Background

The COVID-19 pandemic has presented various challenges, one of which is the discovery that after the acute episode, around 30% of patients experience persistent symptoms or develop new ones, now known as long COVID. This new disease has significant social and financial impacts. The objective is to determine the prevalence of long COVID in the Tunisian population and identify its predictive factors.

Methods

This was a cross-sectional study conducted among Tunisians who were infected with COVID-19 between March 2020 and February 2022. An online self-administered questionnaire was distributed through social media, radio, and television channels over the course of one month (February 2022). Long COVID was defined as the persistence of existing symptoms or the development of new symptoms within three months after onset, lasting for at least two months, and with no differential diagnosis. We performed univariate and multivariate analyses using binary stepwise logistic regression with a significance level set at 5%.

Results

A total of 1911 patients participated in our study, and the prevalence of long COVID was 46.5%. The two most frequent categories were general and neurological post-COVID syndrome, with a prevalence of 36.7% each. The most commonly observed symptoms were fatigue (63.7%) and memory problems (49.1%). In the multivariate analysis, the predictive factors for long COVID were female gender and age of 60 years or older, while complete anti-COVID vaccination was found to be a protective factor.

Conclusions

Our study found that complete vaccination was a protective factor against long COVID, while female gender and age of 60 years or older were identified as the main risk factors. These findings are consistent with studies conducted on other ethnic groups. However, many aspects of long COVID remain unclear, including its underlying mechanisms, the identification of which could guide the development of potential effective treatments.