bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding conflict penality: Dominant themes and the case of the Israeli–Palestinian conflict
Authors: Noah Hefetz Rachel
Published: June 2023

Confinement is a common result of conflict, and states use various mechanisms to imprison enemy fighters. This article examines practices of incarceration in times of conflict as punishment. It analyses dominant themes in how states punish those they conceive as ‘enemies’ and proposes the term ‘conflict penality’ to encapsulate commonalities in state punishment during conflict. The article then discusses conflict penality further by examining Israel's punishment of Palestinians for ‘security offences’. The article contributes to the geographical and topical expansion of punishment studies, beyond the traditional borders of national criminal justice systems of Anglo-European countries. It concludes by showing how, under the extreme political climate of conflict, states use penal power to delegitimise their opponents, yet do so through extensive normative compromises that undermine their moral authority to punish.
I talk normal: A comparative case study of raciolinguistic socialization in preschool
Authors: Quast Erin
Published: June 2023

This study analyzes how raciolinguistic ideologies shape children’s identity construction within two American preschool classrooms. Specifically, I attend to the ways three-, four-, and five- year-old Dominant American English-speaking children adopted white listening subject positions and shaped peer interactions in the classroom. Ethnographic data for this comparative case study included children and teacher interviews, classroom observations, and classroom artifact collection. Within- and cross-case analyses revealed three salient raciolinguistic socialization processes: marking of language, racialization of differences, and enacted raciolinguistic hierarchies. Children’s participation within these raciolinguistic processes reflected the local particulars of the classroom, including curriculum, educators’ pedagogies, and classroom demographics. Implication for research and practices that attend to young children's raciolinguistic socialization are discussed
Serious Leisure as Human Resource Development Intervention
Authors: Sritanyarat Dawisa , Tehmarn Asma , Thongteera Wanida , Marin Thawanporn , McLean Gary N.
Published: June 2023

Leisure and work are often thought of as independent parts of life. While leisure has the potential of contributing to HRD and vice versa, it has received limited attention in HRD. Therefore, in this study, we used an integrative literature review to explore how leisure can contribute to HRD and become an HRD intervention. To search the literature, we used keywords relating to leisure, work, and HRD. One among several leisure types found was serious leisure. Serious leisure requires engagement in the activity with a sense of self-development. The results from serious leisure could include knowledge and skill development, which might not be related directly to short-term work performance improvement. Despite this, it allows for intrinsically sustainable self-development. Such self-development can yield positive results in every element of life, including work. To facilitate serious leisure as an HRD intervention, practitioners and policymakers need to eliminate leisure constraints.
The Prevalence and Risk Factors of Electrical Status Epilepticus During Slow-Wave Sleep in Self-Limited Epilepsy With Centrotemporal Spikes
Authors: Lu Guangshuang , Cheng Yun , Wang Yun , Hu Jie , Zhang Fan , Li Wenbo , Xia Minnong , Lu Xiaoyan , Yang Wu
Published: June 2023

Objective . To investigate the prevalence and risk factors for electrical status epilepticus during slow-wave sleep (ESES) in patients with self-limited epilepsy with centrotemporal spikes (SeLECTS). Methods. The clinical and follow-up data of children with SeLECTS were collected between 2017 and 2021. Patients were divided into typical ESES, atypical ESES, and non-ESES groups according to spike-wave indices (SWI). Clinical and electroencephalography characteristics were retrospectively analyzed. Logistic regression was used to identify risk factors for ESES. Results. A total of 95 patients with SeLECTS were enrolled. Seven patients (7.4%) developed typical ESES, 30 (31.6%) developed atypical ESES, 25 (26.3%) developed ESES at the first visit, and 12 (12.6%) developed ESES during treatment and follow-up. Multivariate logistic regression analysis showed that the risk factors for SeLECTS combined with ESES were Rolandic double or multiple spikes (OR = 8.626, 95% CI: 2.644-28.147, P < .001) and Rolandic slow waves (OR = 53.550, 95% CI: 6.339-452.368, P < .001). There were no significant differences in seizure characteristics, electroencephalogram (EEG) findings, or cognitive impairment between the atypical and typical ESES groups. Conclusion. More than one-third of the SeLECTS patients combined with ESES. Both atypical and typical ESES scores can affect cognitive function. On electroencephalography, interictal Rolandic double/multiple spikes and slow-wave abnormalities may indicate SeLECTS with ESES.
Counseling With Male Clients: The Case for Relational Resilience Approach
Authors: Cotter Carol A. , O’Neill Melissa K. , Stevens Madeleine N. , Sanders Penny G. , Henninger Janessa
Published: June 2023

Although there is no lack of research on masculinity and help-seeking behavior, men continue to seek counseling less often than women. It is crucial we find effective therapeutic approaches to connect and meet men where they are, acknowledging the positive aspects of their masculinity while addressing their needs in the counseling setting. In this conceptual research article, we propose a new approach for counselors to utilize with men seeking counseling, the Relational Resilience Approach, which applies tenets of Relational-Cultural Theory, Positive Psychology, and Shame Resilience Theory.
Resilience in the face of adversity: How people with intellectual disabilities deal with challenging times
Authors: Scheffers Femke , van Vugt Eveline , Moonen Xavier
Published: June 2023

In people with intellectual disabilities research and policy are often still focused on risks or the prevention of risks. Research on the process of resilience is in its infancy in the care for people with intellectual disabilities. In the current study, applying a guided photovoice procedure, people with intellectual disabilities were asked what helped them to deal with adverse events. Additionally, informants from their social network were asked to reflect on this question. The following sources of resilience were identified: acceptance, autonomy, beautiful memories, perseverance, physical wellbeing, positive emotions, social skills, spirituality, activities, a home and the social network. Our findings provide practical guidelines for clinicians to talk about resilience with people with intellectual disabilities. Suggestions for future research are made that will contribute to the process of resilience and inclusion of people with intellectual disabilities.
A differential detailed diffusion-weighted imaging-ASPECTS for cerebral infarct volume measurement and outcome prediction
Authors: Suzuki Kentaro , Liebeskind David S , Nishi Yuji , Kutsuna Akihito , Katano Takehiro , Sakamoto Yuki , Saito Tomonari , Aoki Junya , Matsumoto Noriko , Nishiyama Yasuhiro , Kimura Kazumi
Published: June 2023

Background:

Diffusion-weighted imaging-Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) has been used to estimate infarct core volume in acute stroke. However, the same and indiscriminate score deduction for punctate or confluent DWI high-intensity lesion might lead to variation in performance.

Aims:

To develop and evaluate a differential detailed DWI-ASPECTS method in comparison with the conventional DWI-ASPECTS in core infarct volume measurement and clinical outcome prediction.

Methods:

We retrospectively recruited patients with acute ischemic stroke (AIS) treated with endovascular treatment between April 2013 and October 2019. In differential detailed DWI-ASPECTS, restricted diffusion lesion that was punctate or less than half of a cortical region (M1–M6) would not lead to subtraction of point. A favorable outcome was modified Rankin Scale score ⩽2 at 90 days after stroke onset.

Results:

Among 298 AIS patients, mean age was 75 years (interquartile range (IQR) 67–82), and 194 patients (65%) were males. Mean infarct core volume was 11 mL (IQR 3–37). Overall, the score by detailed DWI-ASPECTS was significantly higher than conventional DWI-ASPECTS (8 (7–9) vs. 7 (5–9); P < 0.01). The detailed DWI-ASPECTS resulted in a higher correlation coefficient (r) for core infarct volume estimation than the conventional DWI-ASPECTS (r = 0.832 vs. 0.773; P < 0.01). Upon re-classification of those scored ⩽6 in conventional DWI-ASPECTS (n = 134) by detailed DWI-ASPECTS, the rate of favorable outcome in patients with detailed DWI-ASPECTS >6 was significantly higher than those with ⩽6 (29 (48%) vs. 14 (19%); P < 0.01).

Conclusions:

Detailed DWI-ASPECTS appeared to provide a more accurate infarct core volume measurement and clinical outcome correlation than conventional DWI-ASPECTS among AIS patients treated with endovascular therapy.
Diabetic ketoacidosis in a patient known with Gitelman syndrome
Authors: Nielsen Ida Ringsing , Skat-Rørdam Patricia Almine , Jensen Ivan Werner
Published: June 2023

Summary

Gitelman syndrome is a rare hereditary nephropathy, which causes chronic metabolic alkalosis with low potassium and magnesium levels. There is no known coherence between Gitelman syndrome and Type-1 diabetes but patients with both diseases that develop diabetic ketoacidosis might present with normal acid status and receive incorrect treatment. In our case report the patient was known with both diseases and quickly diagnosed and treated but the condition is rare and previously only described in two other case reports.
Vincristine-Induced Acrocyanosis and Erythema Pernio
Authors: Middleton Hayden T. , Boswell Christopher L. , Houwink Elisa J. , Allen-Rhoades Wendy A. , Kuhn Alexis K. , Wright Jessica A.
Published: June 2023

Introduction:

Acrocyanosis and erythema pernio are 2 dermatologic manifestations of vasospastic changes. Primary care providers should consider that these conditions can occur as primary or idiopathic conditions and as secondary conditions related to another disease or medication. Herein we describe a case of acrocyanosis and erythema pernio attributed to vincristine therapy.

Case Description:

A 22-year-old man was evaluated for discomfort and red lesions involving the toes of both feet for several weeks. He had completed chemotherapy 1 month earlier for Ewing sarcoma in the right femur. Local control for the primary tumor included wide local excision and reconstruction with a vascularized fibular allograft from the right fibula. On examination, his right foot was dark blue and cool. Toes on both feet had nonpainful erythematous papules. After the case was discussed with the patient’s oncology team, the diagnosis was medication-induced acrocyanosis of the right foot and bilateral erythema pernio. Treatment consisted of supportive care to keep the feet warm and promote circulation to the feet. At 2-week follow-up, the patient’s symptoms and the appearance of his feet had markedly improved.

Discussion:

Primary care clinicians should be able to recognize dermatologic manifestations of vasospastic changes, including acrocyanosis and erythema pernio, and rule out possible secondary causes, such as pharmacologic agents. This patient’s history of therapy for Ewing sarcoma prompted consideration of medication-induced vasospastic changes most likely related to the adverse vasospastic effects of vincristine. Symptoms should improve with cessation of the offending medication.
Evaluation of Internet-Based Training in Trauma Care for Nurses in Mental Health Welfare Centers: A Cluster Randomized Controlled Trial
Authors: Kim Sunah , Kim Go-Un , Park Jinyoung
Published: June 2023

Objective:

This study evaluates the efficacy of Internet-Based Training in Trauma Care for Nurses (IBTTCN) to improve nurses’ trauma intervention self-efficacy, professional quality of life, and attitudes and knowledge about post-traumatic stress disorder.

Methods:

Forty-one nurses participated from May to July 2021. The assessment points were at baseline (T1), immediately after program completion (4 weeks; T2), and 1 month after T2 (T3). Data were analyzed using repeated-measures analysis and generalized estimating equations.

Results:

In the intervention group, trauma intervention self-efficacy increased significantly after the IBTTCN, and the effect of such self-efficacy over time was significant.

Conclusions:

The IBTTCN improved nurses’ trauma intervention self-efficacy.
Mid-Term Follow-Up Results After Hemiarthroplasty Using Long Femoral Stem Prosthesis (Peerless-160) for Intertrochanteric Fractures in Octogenarians
Authors: Mao Qiang , Zhang Yi , Hua Jiang , He Bangjian
Published: June 2023

Purpose

To analyze the clinical effect and imaging data of cementless bipolar hemiarthroplasty employing a long femoral stem (peerless-160) and 2 reconstructed femoral titanium wires to repair intertrochanteric fractures among the octogenarians.

Methods

Between June 2014 and August 2016, 58 octogenarians with femoral intertrochanteric fractures underwent the long femoral stem (peerless-160) cementless bipolar hemiarthroplasty by the same surgeon. We assessed clinical and radiological outcomes such as operative time, bleeding volume, blood transfusion volume, length of hospital stay, full weight-bearing walking time, walking ability calculated by Koval classification and Harris Hip Score (HHS), including fracture healing and greater trochanter fragments subsidence.

Result

The surgery was successfully performed in all patients. The average operation time was 72.8 ± 13.2 min, the average blood loss during surgery was 225.0 ± 91.4 mL, 200 mL of blood was transfused, the mean duration of hospitalization was 11.9 ± 4.0 days, the mean time of full weight bearing was 12.5 ± 3.8 days. Patients were followed up for 24-68 months, averagely 49.4 ± 10.3 months. During follow-up, 4 (6.9%) patients died, and 1 (1.7%) was completely lost to ask about the recent situation. The average Harris Hip Score at the last follow-up was 87.8 ± 6.1, most of the patients recovered walking ability, under radiological examination, the prosthesis showed no signs of loosening. All trochanteric fractures gradually healed, the clinical and radiographic signs of healing occurred at average of 4.0 ± 1.1 months postoperatively.

Conclusion

For osteoporotic unstable intertrochanteric fractures in octogenarians, this study confirmed that the Cementless Bipolar Hemiarthroplasty Using a Long Femoral stem (peerless-160) with double cross binding technique is a satisfactory and safe choice for the octogenarians.
Assessing the Effects of Customer-perceived Values Toward Organic Food: The Moderating Role of Media Exposure to Food Safety Issues
Authors: Kamboj Kavita , Kishor Nawal
Published: June 2023

Despite a plentiful supply of organic food in emerging economies, consumers are slow to adopt sustainable organic food behaviors. India is one of the top five nations in the world in terms of the total amount of agricultural land that is certified as organic, but the domestic organic consumption in the country itself is really sparse. Using the framework of the theory of reasoned action, this investigation explores how customers’ perceived values (health and hedonic values) influence their attitude toward purchasing organic food. Also, it elaborates on the moderating effect of media exposure to food safety issues to know its strength in the attitude–intention relationship. This research utilized PLS-SEM to analyze the structural relationships among the constructs, with 202 responses from consumers in India. The study found the strongest influence of hedonic value over health value and subjective norms on the green purchase attitude of consumers. To the best of our knowledge, this is the first study that investigated the moderating effect of media exposure on food safety issues on consumers’ attitude–intention relationship in a developing nation context. The study highlighted that people who have regularly been exposed to food safety related issues around them are more willing to buy organic food. Thus, it contributes to a more robust attitude–intention relationship among customers toward the purchase of organic food.
Evaluation of the All-Inside Technique for the Repair of Lateral Meniscus Root Tears at 1 Year After ACL Reconstruction
Authors: Cuvillier Marianne , Marot Vincent , Bukvić Frane , Lucena Thibaut , Martinel Vincent , Bérard Emilie , Cavaignac Etienne
Published: June 2023

Background:

The presence of a lateral meniscus root tear (LMRT) in patients with an anterior cruciate ligament (ACL) tear makes the knee more unstable and increases the risk of osteoarthritis and osteonecrosis. An all-inside suture repair technique without bone tunnels has been proposed to treat LMRT.

Purpose:

To compare the 1-year postoperative findings between patients who underwent ACL reconstruction combined with LMRT repair (LMRT group) and patients who underwent isolated ACL reconstruction (control group).

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The LMRT group consisted of 19 patients, and the control group consisted of 56 patients. In this study, the authors compared the postoperative magnetic resonance imaging (MRI) findings (meniscal extrusion, ghost sign, and hyperintensity in the tibial plateau beneath the LMRT), functional outcomes (International Knee Documentation Committee [IKDC], Lysholm, and Tegner scores), and reoperation rate between groups. The primary endpoint was analyzed by comparing, in the LMRT group, the 1-sided 97.5% confidence interval (CI) of the mean lateral meniscal extrusion at 1 year to the limit of noninferiority (fixed at 0.51). To take into account imbalanced baseline characteristics between groups, adjusted mean meniscal extrusion (with 1-sided 97.5% CI) was assessed using a linear regression model.

Results:

The mean follow-up was 12.2 months (range, 7.7-14.7 months) in the control group and 11.5 months (range, 7.1-13.0 months) in the LMRT group ( P = .06). For meniscal extrusion, the LMRT group was noninferior to the control group. The mean meniscal extrusion was 2.19 mm (97.5% CI, —infinity to 2.68 mm) in the LMRT group and 2.03 mm (97.5% CI,—infinity to 2.27 mm) in the control group, indicating that the upper boundary of the 1-sided 97.5% CI in the LMRT group was less than the noninferiority threshold of 2.78 (ie, 2.27 mm + 0.51 mm = 2.78 mm). There was a statistically significant difference in the IKDC score between the LMRT and control groups (77.2 ± 8.1 vs 80.3 ± 7.3, respectively; P = .04). There was no between-group difference in the other MRI parameters, the Lysholm and Tegner scores, or the reoperation rate.

Conclusion:

There was no significant difference in extrusion on MRI or clinical outcomes at 1-year follow-up in patients who underwent ACL reconstruction with all-inside LMRT repair compared with patients who did not have an LMRT.
Stillbirth and Preterm Birth During Lockdown Periods in 5 Waves of COVID-19 Pandemic in Northern Iran: A Region-Wide Cohort Study in Mazandaran Province
Authors: Farhadi Roya , Noori Hanieh , GhaffariSaravi Vajiheh , Moosazadeh Mahmood
Published: June 2023

Introduction

Conflicting reports for preterm birth and stillbirth during the lockdown imposed during the COVID-19 pandemic have emerged. Most of the studies are related to the initial waves of the pandemic.

Objectives

This study aims to evaluate changes in preterm birth and stillbirth rates during various waves of COVID-19 in northern Iran.

Methods

This is a retrospective cohort study to evaluate preterm birth and stillbirth rate based on weight distribution per 1000 live births during lockdown periods in 5 peaks of the COVID-19 pandemic using the regional data registration system at Mazandaran University of Medical Sciences in northern Iran. We compared these rates with the corresponding months 4 years before the pandemic. The odds ratio for the primary outcome was estimated by logistic regression.

Results

We observed an overall increased rate of preterm birth during the pandemic compared to the pre-pandemic period (4.7% vs 2.8%, P < .001). The overall stillbirth rate increased during the COVID-19 pandemic compared to the pre-pandemic period (7.48/1000 vs 5.41/1000, odds ratio: 1.38 [1.21-1.57]). This increase in the rate of stillbirth was significantly observed in the fifth wave of the COVID-19 pandemic ( P < .001).

Conclusion

Our study showed that adverse pregnancy outcomes increased during lockdown periods of a global pandemic. Further studies from geographically diverse regions to evaluate different behavior changes during pregnancy and access to prenatal services, and its impact on pregnancy outcomes is recommended.
Diagnostic value of carotid intima-media thickness and clinical risk scores in determining etiology of ischemic stroke
Authors: Sievering Esther MW , Grosshennig Anika , Kottas Martina , Ernst Johanna , Ringlstetter Rieke , Koch Armin , Weissenborn Karin , Grosse Gerrit M
Published: June 2023

Background:

In the general population, carotid intima-media thickness (CIMT) is associated with atherosclerosis as well as atrial fibrillation (AF). However, the extent to which CIMT might be of diagnostic value in clarifying stroke etiology is currently unclear.

Methods:

In this retrospective cohort study, we included 800 consecutive patients with acute ischemic stroke. We compared CIMT-values between stroke etiologies. The association between CIMT and cardioembolic stroke was investigated via logistic regression analysis adjusting for vascular risk factors. Receiver operating characteristic analyses were conducted to investigate the diagnostic value of CIMT in comparison to vascular risk factors and clinical AF risk scores (CHA2DS2VASc, HAVOC, and AS5F).

Results:

CIMT-values were highest in patients with cardioembolic or atherosclerotic stroke origin. CIMT was associated with newly diagnosed AF compared against cryptogenic strokes (crude odds ratio (OR) per 0.1 mm-increase of CIMT: 1.26 (95% confidence interval (CI): 1.13–1.41)). After adjustment for vascular risk factors, the effect of CIMT on AF-diagnosis, however, was weakened (adjusted OR: 1.10 (95% CI: 0.97–1.25)). The diagnostic value of CIMT for detection of AF (AUC: 0.60, 95% CI: 0.54–0.65) was outperformed by AF risk scores. Among the scores investigated, the AS5F-score yielded best accuracy and calibration to predict newly diagnosed AF (AUC: 0.71, 95% CI: 0.65–0.78).

Conclusions:

CIMT may help in the diagnosis of stroke etiology. However, compared with vascular risk factors or clinical AF risk scores, CIMT does not provide substantial additional information on the risk of newly detected AF. Thus, stratification of AF risk based on scores, such as the AS5F, is advisable.
Inferring and comparing trip purposes of shared micromobility services: A case study of Ningbo, China
Authors: Wang Chaofan , Zhang Yongping
Published: June 2023

Over the past decades, shared micromobility services (SMSs) have experienced ever-fast growth around the world. Such increment has raised issues such as how to improve the efficiency of the service operation and regulation. To address these issues, it is essential to understand how and why these SMSs are used. This research aims to infer trip purposes of two types of dockless SMSs, i.e., dockless shared bikes and e-bikes, and make a comparison between them, mainly using a Latent Dirichlet Allocation (LDA)-based analytical framework. The proposed framework was applied in Ningbo, China by combining a large-scale bike-sharing trip dataset and a Points of Interest (POIs) dataset. In our case study, we successfully revealed seven typical trip purposes, i.e., transport, work, lodging, eating, shopping, education, and others. The results showed that eating is the most prevalent trip purpose for both bike and e-bike users. Surprisingly, the proportions of transport-related trips were insignificant compared to previous observations, for both shared bikes and e-bikes. Moreover, the shared bike played a more significant role than the shared e-bike in daily trips related to lodging and education, indicating that the role of the shared e-bike in these trips might have been overestimated previously. This study provides insight into the trip purposes of SMSs and gives targeted planning and operation suggestions, which can promote sustainable development of the urban micromobility systems.
Meta-analysis of the effects of proton pump inhibitors on the human gut microbiota
Authors: Zhang Jiayi , Zhang Chengcheng , Zhang Qingsong , Yu Leilei , Chen Wei , Xue Yuzheng , Zhai Qixiao
Published: June 2023

Mounting evidence has linked changes in human gut microbiota to proton pump inhibitor (PPI) use. Accordingly, multiple studies have analyzed the gut microbiomes of PPI users, but PPI–microbe interactions are still understudied. Here, we performed a meta-analysis of four studies with available 16S rRNA gene amplicon sequencing data to uncover the potential changes in human gut microbes among PPI users. Despite some differences, we found common features of the PPI-specific microbiota, including a decrease in the Shannon diversity index and the depletion of bacteria from the Ruminococcaceae and Lachnospiraceae families, which are crucial short-chain fatty acid-producers. Through training based on multiple studies, using a random forest classification model, we further verified the representativeness of the six screened gut microbial genera and 20 functional genes as PPI-related biomarkers, with AUC values of 0.748 and 0.879, respectively. Functional analysis of the PPI-associated 16S rRNA microbiome revealed enriched carbohydrate- and energy-associated genes, mostly encoding fructose-1,6-bisphosphatase and pyruvate dehydrogenase, among others. In this study, we have demonstrated alterations in bacterial abundance and functional metabolic potential related to PPI use, as a basis for future studies on PPI-induced adverse effects.
Use and misuse of random forest variable importance metrics in medicine: demonstrations through incident stroke prediction
Authors: Wallace Meredith L. , Mentch Lucas , Wheeler Bradley J. , Tapia Amanda L. , Richards Marc , Zhou Siyu , Yi Lixia , Redline Susan , Buysse Daniel J.
Published: June 2023

Background

Machine learning tools such as random forests provide important opportunities for modeling large, complex modern data generated in medicine. Unfortunately, when it comes to understandingwhymachine learning models are predictive, applied research continues to rely on ‘out of bag’ (OOB) variable importance metrics (VIMPs) that are known to have considerable shortcomings within the statistics community. After explaining the limitations of OOB VIMPs – including bias towards correlated features and limited interpretability – we describe a modern approach called ‘knockoff VIMPs’ and explain its advantages.

Methods

We first evaluate current VIMP practices through an in-depth literature review of 50 recent random forest manuscripts. Next, we recommend organized and interpretable strategies for analysis with knockoff VIMPs, including computing them for groups of features and considering multiple model performance metrics. To demonstrate methods, we develop a random forest to predict 5-year incident stroke in the Sleep Heart Health Study and compare results based on OOB and knockoff VIMPs.

Results

Nearly all papers in the literature review contained substantial limitations in their use of VIMPs. In our demonstration, using OOB VIMPs for individual variables suggested two highly correlated lung function variables (forced expiratory volume, forced vital capacity) as the best predictors of incident stroke, followed by age and height. Using an organized analytic approach that considered knockoff VIMPs of both groups of features and individual features, the largest contributions to model sensitivity were medications (especially cardiovascular) and measured medical risk factors, while the largest contributions to model specificity were age, diastolic blood pressure, self-reported medical risk factors, polysomnography features, and pack-years of smoking. Thus, we reach very different conclusions about stroke risk factors using OOB VIMPs versus knockoff VIMPs.

Conclusions

The near-ubiquitous reliance on OOB VIMPs may provide misleading results for researchers who use such methods to guide their research. Given the rapid pace of scientific inquiry using machine learning, it is essential to bring modern knockoff VIMPs that are interpretable and unbiased into widespread applied practice to steer researchers using random forest machine learning toward more meaningful results.
Atrophic gastritis rather than Helicobacter pylori infection can be an independent risk factor of colorectal polyps: a retrospective study in China
Authors: Shao-hua Zhang , Lin-lin Ren , Shen Su , Yun-he Tang , Zi-bin Tian , Yi Liu , Tao Mao
Published: June 2023

Background

Colonoscopy is considered the most effective screening method for colorectal polyps. However, the longevity and complexity of the procedure makes it less desirable to screen for colorectal polyps in the general population. Therefore, it is essential to identify other independent risk factors. In this study, we explored the link between Hp infection, atrophic gastritis, and colorectal polyps to identify a new potential risk factors of colorectal polyps.

Methods

In this study, atrophic gastritis and intestinal polyps were diagnosed by endoscopy and pathology. All the 792 patients in this retrospective study were divided into sub-groups based on the presence of colorectal polyps. The correlation between polyps and atrophic gastritis was analyzed using the chi-square test and Kruskal-Wallis test. The receiver operating characteristic (ROC) curve was used to compare the predictive value for colorectal polyps between Hp infection and atrophic gastritis. Binary logistic regression was utilized to identify independent risk factors for colorectal polyps.

Results

Patients with colorectal polyps were primarily male with advanced age, and the number of patients with colorectal polyps had a higher association with smoking, alcohol drinking, and Hp infection than the control group. A positive correlation between the number of colorectal polyps and the severity of atrophic gastritis was observed. ROC analysis showed that atrophic gastritis was a better risk factors for colorectal polyps. Multivariate analysis identified atrophic gastritis as an independent risk factor for colorectal polyps (OR 2.294; 95% CI 1.597–3.296).

Conclusions

Atrophic gastritis confirmed could be an independent risk factors for colorectal polyps.
Association of medication use with falls and mortality among long-term care residents: a longitudinal cohort study
Authors: Roitto Hanna-Maria , Aalto Ulla L. , Öhman Hanna , Saarela Riitta K. T. , Kautiainen Hannu , Salminen Karoliina , Pitkälä Kaisu H.
Published: June 2023

Background

Falls in long-term care are common. The aim of our study was to explore how medication use is associated with incidence of falls, related consequences, and all-cause mortality among long-term care residents.

Methods

Five hundred thirty two long-term care residents aged 65 years or older participated in this longitudinal cohort study in 2018–2021. Data on medication use were retrieved from medical records. Polypharmacy was defined as use of 5–10 medications and excessive polypharmacy as use of > 10 medications. The numbers of falls, injuries, fractures, and hospitalizations were collected from medical records over 12 months following baseline assessment. Participants were followed for three years for mortality. All analysis were adjusted for age, sex, Charlson Comorbidity Index, Clinical dementia rating, and mobility.

Results

A total of 606 falls occurred during the follow-up. Falls increased significantly with the number of medications used. Fall rate was 0.84/person-years (pyrs) (95% CI 0.56 to 1.13) for the non-polypharmacy group, 1.13/pyrs (95% CI 1.01 to 1.26) for the polypharmacy group, and 1.84/pyrs (95% CI 1.60 to 2.09) for the excessive polypharmacy group. Incidence rate ratio for falls was 1.73 (95% CI 1.44 to 2.10) for opioids, 1.48 (95% CI 1.23 to 1.78) for anticholinergic medication, 0.93 (95% CI 0.70 to 1.25) for psychotropics, and 0.91 (95% CI 0.77 to 1.08) for Alzheimer medication. The three-year follow-up showed significant differences in mortality between the groups, the lowest survival rate (25%) being in the excessive polypharmacy group.

Conclusion

Polypharmacy, opioid and anticholinergic medication use predicted incidence of falls in long-term care. The use of more than 10 medications predicted all-cause mortality. Special attention should be paid to both number and type of medications when prescribing in long-term care.
Pain assessment tools for use in infants: a meta-review
Authors: Arabiat Diana , Mörelius Evalotte , Hoti Kreshnik , Hughes Jeffery
Published: June 2023

Background

Identifying pain in infants is challenging due to their inability to self-report pain, therefore the availability of valid and reliable means of assessing pain is critical.

Objective

This meta-review sought to identify evidence that could guide the selection of appropriate tools in this vulnerable population.

Methods

We searched Scopus, Medline, Embase, CINAHL, MIDRIS, EMCare and Google Scholar for eligible systematic reviews. Eligible reviews documented psychometric properties of available observational tools used to assess pain in infants.

Results

A total of 516 reviews were identified of which 11 met our inclusion criteria. We identified 36 pain assessment tools (evaluated in 11 reviews) of which seven were reported in at least three reviews. The level of evidence reported on the psychometric properties of pain assessment tools varied widely ranging from low to good reliability and validity, whilst there are limited data on usability and clinical utility.

Conclusions

Currently, no observer administered pain assessment tool can be recommended as the gold standard due to limited availability and quality of the evidence that supports their validity, reliability and clinical utility. This meta-review attempts to collate the available evidence to assist clinicians to decide on what is the most appropriate tool to use in their clinical practice setting. It is important that researchers adopt a standard approach to evaluating the psychometric properties of pain assessment tools and evaluations of the clinical utility in order that the highest level of evidence can be used to guide tool selection.
Comprehensive rehabilitation and job reintegration of people with severe mental illness in a Latin American country: REINTEGRA study protocol
Authors: Carmona-Huerta Jaime , Durand-Arias Sol , Cárdenas-García Elsy , Arámbula-Román J. Carlos , Guzmán-Ramírez Marianne , Estrada-Ramírez Isabel , Amezcua-Ramírez María Trinidad , Lastra-González Verónica , Obeso Santiago Castiello-de , Aldana-López Alejandro
Published: June 2023

Background

Despite the increasing use of comprehensive rehabilitation models for people with severe mental illness (SMI), there are still limitations to their implementation and replicability in a consensual way, particularly in Latin American countries. The REINTEGRA program aims to be a standardized model of comprehensive rehabilitation focused on psychosocial and cognitive improvement through a set of interventions on different areas of people’s functionality, with the goal of reintegrating people with SMI into the labour market. In this paper we summarize the protocol for its subsequent implementation in a mental health institution in Mexico.

Method

The protocol is based on a quasi-experimental, prospective longitudinal study, with a pragmatic or naturalistic control group. It will be carried out in three phases. Phase 1 consists of a series of interventions focused on psychosocial improvement; Phase 2 focuses on cognitive and behavioral improvement treatments; and Phase 3 targets psychosocial recovery through rehabilitation and reintegration into the labour market. The overall procedure will be monitored with standarized evaluations at different stages of the program.

Discussion

This study presents a model of integral rehabilitation of people with SMI. At the moment, one of the obstacles to overcome is the organization and procedural control of the different actors needed for its implementation (nurses, psychologists, doctors, companies, institutions, etc.). REINTEGRA will be the first comprehensive rehabilitation model that includes systematized procedures for job reinsertion for people with SMI in Mexico, which aims to be a standardized tool of easy adaptation and the replicability for other mental health centers and institutions.
Longitudinal changes in depressive symptoms associated with social isolation after the Great East Japan Earthquake in Iwate Prefecture: findings from the TMM CommCohort study
Authors: Kotozaki Yuka , Tanno Kozo , Otsuka Kotaro , Sasaki Ryohei , Sasaki Makoto
Published: June 2023

Background

Whether past disaster experiences affect the association between changes in social isolation and depressive symptoms is largely unknown. This study examined the association between changes in social isolation and depressive symptoms among survivors who experienced earthquake damage in the aftermath of the Great East Japan Earthquake (GEJE).

Methods

We analyzed longitudinal data from 10,314 participants who responded to self-report questionnaires on the Lubben Social Network Scale-6 (LSNS-6) and the Center for Epidemiological Studies-Depressive Scale (CES-D) in both the baseline survey (FY2013 to FY2015) and follow-up survey (FY2017 to FY2019) after the GEJE. According to changes in the presence of social isolation (< 12 of LSNS-6) at two time points, participants were categorized into four groups: “not socially isolated,” “improved socially isolated,” “newly socially isolated,” and “continuously socially isolated.” At the follow-up survey, a CES-D score of ≥ 16 indicates the presence of depressive symptoms. The adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were estimated using the logistic regression analysis to examine the influence of the change in social isolation over four years on depressive symptoms.

Results

Participants who were newly socially isolated had a significantly higher prevalence of depressive symptoms than those who were not socially isolated (AOR = 1.89, 95% CI = 1.61 − 2.23). In addition, AORs were highest for those who were continuously socially isolated and had experienced house damage (AOR = 2.17, 95% CI = 1.73 − 2.72) and those who were newly socially isolated and had not experienced the death of family members due to the GEJE (AOR = 1.88, 95%CI = 1.60 − 2.22).

Conclusion

Our longitudinal findings suggest that being newly or continuously socially isolated is associated with a risk of depressive symptoms, not only among those who had experienced house damage or the death of a family member, but also those who had not, in the disaster-affected area. Our study underlines the clinical importance of social isolation after a large-scale natural disaster and draws attention to the need for appropriate prevention measures.
Thoracic empyema due to nontuberculous mycobacteria in an immunocompetent patient without pulmonary disease: a case report
Authors: Yu Fengjiao , Li Yongxia , Luo Jing , Chen Xingru , Jiang Yu
Published: June 2023

Background

Pleural involvement by non-tuberculous mycobacteria (NTM), especially NTM empyema in the immunocompetent patient without pulmonary diseases is a rare disease. It is difficult to diagnose with only a few cases of immunodeficient patients in the literature.

Case presentation

We describe a 63-year-old male with empyema due to NTM and highlight the challenges of diagnosis.

Conclusions

Non-tuberculous mycobacterial infection should be considered as a cause of pleuritis or empyema without pulmonary disease, however it is a real diagnostic dilemma.
The adherence to and utility of the Global Initiative for Chronic Obstructive Lung Disease guidelines for treating COPD among pulmonary specialists: a retrospective analysis
Authors: Alabi Fortune O. , Alkhateeb Hadaya A. , Zibanayi Mukudzeishe T. , Garces Jica , DeBarros Kayla M. , Barletti Pierina S. Benel , Garcia Kayla , James Randall K.
Published: June 2023

Background

Despite the evidence-based guidelines promoted by the Global Initiative for Chronic Obstructive Lung Disease (GOLD), the overuse of prescription drugs to manage COPD, particularly inhaled corticosteroids (ICS), remains a persistent challenge. In this real-world study, we evaluated how patients with COPD were divided into ABCD groups based on the 2017 GOLD guidelines, determined the rate of adherence to the GOLD treatment recommendations, described the rate of ICS usage, and determined the rate of triple therapy (TT) prescription.

Methods

The charts of 2291 patients diagnosed with COPD were retrospectively analyzed, of which 1438 matched the eligibility criteria.

Results

The average patient age was 69.6 ± 10.9 years; 52% of patients were female. The average COPD assessment test (CAT) score was 18.3 ± 9.1. The ABCD breakdown was as follows: group A 19.5%, group B 64.1%, group C 1.8%, and group D 14.6%. All groups, except group D, showed discordance in COPD treatment relative to the proposed GOLD guidelines. Only 18.9% of group A and 26% of group B were treated in concordance with the guidelines. TT was primarily used in group D (63.3%) and overused in groups A (30.6%) and B (47.8%). ICS was overused in all groups, particularly in groups A (56.2%) and B (67.3%).

Conclusion

Studies from the last decade have consistently revealed a lack of conformity between what physicians prescribe and what GOLD guidelines recommend. The excessive usage of ICS, which continues despite all the associated adverse effects and the attributable costs, is concerning. The awareness of GOLD guidelines among primary care physicians (PCPs) and respiratory specialists needs to be improved.
Prevalence of musculoskeletal disorders and associated risk factors in canadian university students
Authors: Parto Dorsa Nouri , Wong Arnold YL , Macedo Luciana
Published: June 2023

Background

Musculoskeletal disorders (MSKDs) present a significant burden to health care systems worldwide. Evidence suggests that university students may have unique risk factors for developing MSKDs; however, research on the corresponding prevalence and risk factors of MSKDs in Canadian students is limited.

Methods

Using a multi-year cross-sectional survey, we aimed to understand the prevalence and risk factors of MSKDs in students at McMaster University. A survey on the prevalence of MSKD as well as potential risk factors was conducted online in the years 2018–2022. Our outcomes were the prevalence of MSKDs over the last 7 days and the last 12 months, as well as presence of lower body, upper body, and spine MSKDs. We investigated risk factors using negative binomial regression analysis, including a sex-stratified analysis.

Results

There were a total of 289 respondents in 2018 with a decrease in the number of participants in the subsequent years (n2019 = 173, n2020 = 131, n2021 = 76). Participants reported a median of 2–3 pain sites in the last year and 1–2 pain sites in the last week in all four years. The most prevalent sources of self-reported pain were the lower back and neck. Depending on the year and outcome studied, 59–67% of participants reported neck/lower back pain in the last year, and 43–49% reported it in the last week. Although risk factors were different depending on the year and sex, overall, poorer mental health, being in health care studies, regular sports participation (males only), older age, and less hours of sleep were significantly associated with higher prevalence of MSKDs.

Conclusions

This study identified that MSKDs are a prevalent source of pain in university students. While some risk factors, such as mental health, are known to play a role in developing MSKDs, sports activity and academic pressure are risk factors that are unique to students. Our study also suggests that there may be differences in risk factors between sexes.
Assessment of the canal anatomy of the premolar teeth in a selected Turkish population: a cone-beam computed tomography study
Authors: Erkan Erhan , Olcay Keziban , Eyüboğlu Tan Fırat , Şener Elif , Gündoğar Mustafa
Published: June 2023

Background

Teeth may have additional roots and a different number of root canals. Overlooked root canals may cause endodontic failure. The aim of this study was to investigate the prevalence of root canals and the number of roots of premolars in a selected Turkish population.

Materials and methods

A total of 2,570 teeth from 1,438 patients were evaluated. The cone-beam computed tomography scans of 1,055 maxillary and 1,515 mandibular premolars were examined.

Results

Type IV root canal morphology was observed most frequently in maxillary first premolars (77%), and the rates of single and double channel formations were very similar (51% and 49%, respectively). Of the second maxillary premolars, 57.4% had Type I morphology, and 89.9% of the teeth were single-rooted, while 68.6% had a single root canal. The most common formation was Type I (85%) among mandibular first premolars, and a single root was observed in 95.6% of these teeth. In addition, 87% of the mandibular first premolars had a single root canal. The second mandibular premolars mostly had Type I (95.4%) formation, and 99.3% of the teeth were single-rooted, while 96.9% had a single root canal.

Conclusion

According to our findings, 51% of maxillary first premolars had a single root, 79.4% had two root canals, and 77% had Type IV (77%) formation. Maxillary second premolars mostly had Type I formation. In addition, a single root and single root canal formation were most common. Mandibular first premolars generally had a single root and single root canal formation, but 13% had two root canals, and 6.4% had Type V formation. More than 95% of mandibular second premolars had Type I formation.