bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility Analysis of the 3-Day Urination Diary for Children With Enuresis
Authors: Zhang Li , Gao Dianyong , Wang Yingjie
Published: October 2023

This study aimed to evaluate the feasibility of the 3-day micturition diary for children with enuresis. We included 53 such children (March 2020-December 2021), who kept a urination diary and filled out a questionnaire. The data were retrospectively analyzed; the differences in completion rate, sensitivity, and specificity between the urination diaries recorded for 3 and 7 days were compared; and factors affecting the completion of the urination diary were assessed. Compared with the 7-day micturition diary, the 3-day micturition diary is easier to complete; the data tend to be more credible; and its application in children with enuresis is feasible.
Terahertz pulsed imaging of low velocity impact damage in woven fiber composite laminates
Authors: Pomarède Pascal , Miqoi Nada , Christophe David , Citrin David S. , Meraghni Fodil , Locquet Alexandre
Published: October 2023

Recently, terahertz pulse imaging has been used extensively to characterize internal defects in various electrically insulating materials. In this work, terahertz pulse imaging is used to identify the damage induced by low-velocity impact on woven glass-fiber reinforced polyamide laminates. Several impact energies are considered to study the damage initiation and propagation. The permanent indentation, known to be a relevant damage indicator, is extracted from the terahertz results and validated through comparison with profilometry. Further, the criticality of the damage, in terms of the number of composite plies in which the cracks propagate, can be clearly determined from terahertz imaging. These observations are validated through X-ray tomographic observations and analysis. Finally, a strong connection is established between the evolution of the permanent indentation and the appearance, and criticality, of the low-velocity impact-induced damage. These observations suggest that terahertz imaging is a reliable technique for the nondestructive assessment of impact damage in glass fiber composites.
Perceived Risk of Weekly Marijuana Use Among Students Participating in the National Survey on Drug Use and Health
Authors: Dunn Michael S. , Klump Madison A.
Published: October 2023

This study sought to assess the relationship of risk perception of weekly marijuana use and the influence of parental, peer, and school factors as predictors among U.S. adolescents. Data for this study was derived from the 2020 National Survey on Drug Use and Health. Students who reported strong parental involvement/support, peer disapproval of marijuana use, low perception of peer use, and enjoyed school were more likely to report that using marijuana weekly was a risk behavior. Students who reported no lifetime alcohol or illicit drug use were more likely to view weekly marijuana use as a risk behavior. Differences were also observed for sex of respondent. This study further adds evidence of the influence of parental, peer, and school factors as effective strategies to control adolescent marijuana use. There is a need for multidimensional programs that target adolescents’ perceptions of risk of marijuana use, as well as targeting significant others.
Photodynamic therapy for treatment of recurrent hemoptysis secondary to pulmonary endometriosis: a case report
Authors: Wang Tao , Long Fa , Liu Shengming , Wang Qiongping , Long Liang , Huang Wenting , Fu Peng , Dong Hongbo
Published: October 2023

Pulmonary endometriosis (PEM) is rare, and drug therapy remains the primary treatment. However, patients with PEM frequently experience recurrent hemoptysis that is refractory to pharmacological intervention. We herein describe a patient with PEM who developed recurrent hemoptysis and was successfully treated with photodynamic therapy (PDT) after drug withdrawal. The patient was admitted to our hospital because of recurrent hemoptysis despite repeated drug treatments for more than 1 year. Given that PDT targets specific tissues and destroys vascular endothelial cells through the cytotoxic effect produced by the photodynamic reaction of the photosensitizer, we considered that it may effectively control hemoptysis secondary to vascular morphological changes in PEM. Therefore, we performed PDT in this case, and the patient’s recurrent hemoptysis regressed. Approximately 2 years following PDT, the patient had recovered well and reported no discomfort. We recommend consideration of PDT as a treatment option for patients with PEM who develop recurrent hemoptysis after drug withdrawal. Notably, the patient’s lung lesions should be superficial and limited, and no contraindications should be present.
Downregulation of circETS1 disrupts Th17/Treg homeostasis by inhibiting FOXP3 transcription: A new potential biomarker in systemic lupus erythematosus
Authors: Ma Sha , Feng Guofu , Li Li , Li Zi , Zhou Xiaoyu , Zhou Yan , Zhang Ruixian
Published: October 2023

Systemic lupus erythematosus (SLE) is an autoimmune disease associated with an imbalance of T helper 17 (Th17) to regulatory T cells (Tregs). However, the underlying mechanism remains unclear. Increasing evidence suggests that circular RNAs play a crucial role in SLE. Although circETS1 was discovered 30 years ago, detailed exploration of its functions remains limited. In this study, we measured the expression levels of circETS1 in peripheral blood mononuclear cells (PBMCs) and CD4+ T cells of patients with SLE by quantitative polymerase chain reaction. The impact of circETS1 expression on the Th17/Treg balance and underlying mechanism were evaluated using double-luciferase reporter, gain-/loss-of-function, and rescue assays. Receiver operating characteristic (ROC) curve analysis was conducted to assess the diagnostic value of circETS1. Both circETS1 and FOXP3 expression were downregulated in the PBMCs and CD4+ T cells of patients with SLE ( n = 28) compared with those in the cells of healthy controls ( n = 20). Mechanistically, we found that circETS1 can bind directly to the microRNA miR-1205, acting as a sponge to upregulate the transcription of FOXP3, thereby maintaining the Th17/Treg balance. Notably, ROC analysis showed that the expression level of circETS1 in PBMCs had an area under the curve of 0.873 (95% confidence interval: 0.771–0.976; p < .001) for diagnosing SLE, with a sensitivity of 80.00% and a specificity of 89.29%. Finally, we found negative correlations between the level of circETS1 in PBMCs and disease severity (according to the Systemic Lupus Erythematosus Disease Activity Index) in patients with SLE (r = –0.7712, 95% CI: –0.8910 to –0.5509; p < .001). The imbalance in Th17/Treg cells in SLE may be attributed, in part, to the circETS1/miR-1205/ FOXP3 pathway. CircETS1 has potential to serve as a valuable biomarker for the diagnosis and evaluation of SLE.
A novel meso-damage constitutive model of rock under true triaxial stress with three-dimensional cracking strength, threshold and closure effect
Authors: Zheng Zhi , Zhou Jiaju , Li Junhong , Tao Honghui , Han Xiaofeng , Xu Hongyu , Zhang Qiang
Published: October 2023

Deep underground engineering is in a true three-dimensional stress state, and the adjustment of the three-dimensional stress state caused by engineering excavation will induce the fracture or even instability of the surrounding rock. However, three-dimensional mechanical model research suitable for the stability analysis of deep surrounding rock is very scarce. Therefore, a series of tests under different true triaxial stresses on two rocks (rhyodacite and marble) were conducted, and the characteristic strength (crack stable propagation initiation stress, crack unstable propagation initiation stress and peak strength) and deformation characteristics were further analyzed. After that, using the Lemaitre strain equivalence hypothesis and rock statistical damage theory, a new statistical damage constitutive model at true triaxial stress states was proposed, which introduced the three-dimensional strength criterion Modified Wiebols Cook to characterize the three-dimensional strength of the rock microelement. Therefore, the intermediate principal stress can be reasonably considered. The damage threshold, initial compaction effect and residual strength of the rock microelement at different true triaxial stress conditions were also considered. Then the relationships between the proposed model parameters and σ2 and σ3 were analyzed. Furthermore, sensitivity analysis of the influence of parameters m and F0 in proposed model on the shape of rock stress–strain curve and peak strength was also investigated. The comparison between the results predicted by proposed model and the experimental data shows that the new model established in this study can well simulate the prepeak and postpeak deformation characteristics of rock and the intermediate principal stress effect under true triaxial stress conditions.
Global buckling behavior of a sandwich beam with graded lattice cores
Authors: Zhang He , Liu Yu-kun , Wang Xiao-hong , Zeng Tao , Lu Zhi-xin , Xu Guo-dong
Published: October 2023

The present study investigates the global buckling behavior of sandwich beams with graded lattice cores. The continuous equivalent theory is utilized to construct a discrete graded lattice core sandwich beam for a continuously varying gradient beam, whose material properties vary with position. A theoretical model of sandwich beams with graded lattice cores is established using the energy method. Finite element models are developed in ABAQUS to validate the theoretical results. Furthermore, four sets of specimens were manufactured and tested to validate the theoretical analysis methods used. The effects of the graded parameters and geometric parameters on the critical buckling load of sandwich beams with graded lattice cores are discussed. The graded lattice sandwich beams exhibit global buckling when the graded parameter is small, with the influence on buckling performance being minor. However, as the graded parameter increases, the graded lattice sandwich beams experience local buckling, and their buckling resistance weakens. Therefore, graded parameters that are too large and cause local buckling should be avoided in gradient design.
Odour discrimination and identification as a biomarker of long-term disability worsening in multiple sclerosis
Authors: Berek Klaus , Hegen Harald , Auer Michael , Barket Robert , Di Pauli Franziska , Hocher Jakob , Krajnc Nik , Zinganell Anne , Deisenhammer Florian , Berger Thomas , Bsteh Gabriel
Published: October 2023

Background:

Odour discrimination and identification (DI) are markers associated with disability worsening and neuroaxonal damage in multiple sclerosis (MS).

Objective:

The main objective of this research is to investigate whether longitudinal change of DI predicts long-term MS disease course.

Methods:

This is a 6-year prospective longitudinal study on MS patients at the MS Clinic Innsbruck. Clinical, bi-annual visits assessed patients’ history and Expanded Disability Status Scale (EDSS) score. DI and cognitive function were assessed at baseline (BL), Year 1 (Y1), Year 2 (Y2) and Year 6 (Y6) by the ‘Sniffin’ Sticks’/Symbol Digit Modalities Test.

Results:

Around 92 of 139 patients were available for Y6 follow-up. Mean DI scores significantly decreased over time (BL = 27.8, Y1 = 27.5, Y2 = 26.3 and Y6 = 26.3; p < 0.001) and negatively correlated with patients’ age ( rs = −0.120, p = 0.032) and disease duration ( rs = −0.103, p = 0.041). Multivariable regression analyses revealed that lower absolute DI scores and larger DI score loss over time were associated with higher probability of EDSS worsening (per −1 point: hazard ratio (HR) = 1.40 (1.16–1.68) and 2.34 (1.27–4.21)), progression independent of relapse activity (PIRA) (HR = 1.49 (1.20–1.85) and 2.22 (1.33–3.31)) and cognitive deterioration (HR = 1.75 (1.35–2.27) and 4.29 (1.26–2.84)) at Y6, but not with time to first relapse.

Conclusion:

Odour DI is an irreversible marker of neuroaxonal damage, associated with PIRA, cognitive deterioration and EDSS worsening.
Synthesis, characterization, and mechanical properties of Al–Zn–Mg alloy-based hybrid metal matrix composites reinforced with Si3N4/TiB2 particles processed through stir casting technique
Authors: Agrawal Anant Prakash , Srivastava Sunil Kumar
Published: October 2023

In this study, the microstructural and mechanical properties of Al-Si3N4/TiB2 hybrid reinforced composites are examined. The aim is to investigate the impact of a novel combination of reinforcements (Si3N4/TiB2) on the mechanical behavior of hybrid metal matrix composites (HMMCs). The composites are produced by adding a fixed amount of Si3N4 (4 wt.%) and 2, 4, and 6 wt.% of TiB2, respectively, into molten AA7075 aluminum alloy using a liquid state stir casting process. The physical and mechanical properties of fabricated HMMCs are determined through the measurement of density, porosity, tensile strength, Brinell hardness, flexural, and impact strength. The microstructural study of HMMCs reveals a consistent distribution of microparticles within the matrix. Evidence of reinforcement particles in the HMMCs is confirmed through field emission scanning electron microscopy with energy-dispersive spectroscopy and X-ray diffraction analysis. The fabricated HMMCs with 4 wt.% Si3N4 and 6 wt.% TiB2 particulates demonstrated the greatest strength among others. The ultimate tensile strength, Brinell hardness, and flexural strength are improved by 59.36%, 95.59%, and 49.33%, respectively, compared to the base Al-Zn-Mg alloy. However, the increment in strength of HMMCs comes with the tradeoff of reduced ductility and impact resistance measured through the percentage elongation and energy absorbed by the samples.
Development of correlation model for cavitating spray using Eulerian simulations
Authors: Liu Xinlei , Guo Junjun , Im Hong G.
Published: October 2023

Modern high-pressure injection systems for heavy-duty applications are prone to cavitation, which may have a detrimental effect on the system integrity. The present study aims to develop reliable correlations for Lagrangian engineering simulations to predict the onset of cavitation. Using the extensive data generated from the high-fidelity Eulerian volume-of-fluid (VOF) simulations of a single-hole injector for a wide range of operating conditions, a proper set of discharge ( Cd) and contraction ( Ca) coefficients are determined. In particular, four significant factors characterizing nozzle geometry are considered: the K factor, inlet curvature radius, nozzle exit radius, and channel length, as well as ambient and injection pressures. The results showed that a larger K factor and inlet curvature radius yielded higher Cd and Ca values, while the exit radius and channel length had a less significant impact on the cavitation dynamics. The smaller pressure difference between the nozzle inlet and exit mitigated the cavitation formation. These trends were well described using the mathematical regression model. Furthermore, two other correlation models based on the regression learner and artificial neural network methods were also developed. Of these three models, the mathematical regression model yielded the best agreement with an external validation dataset.
Virtual reality technology for workplace training: The case for developing cultural intelligence
Authors: Philip Jestine , Jiang Yeling , Akdere Mesut
Published: October 2023

Cultural intelligence (CQ) is becoming increasingly important in today’s globally interconnected business world, where employees from various national cultures work collaboratively. This research uses immersive virtual reality (VR) technology as a training device to help narrow the existing knowledge gaps in CQ scholarly literature and corporate diversity training. A VR head-mounted device was used to capture qualitative and quantitative data from participants to conduct a mixed methods study. After participants engaged in the virtual simulation, a method triangulation approach - using deductive thematic analysis, word frequency analysis, sentiment analysis, and correlational analysis - was used to draw conclusions from their reflections on CQ development. Results revealed a convergence of participant statements, sentiments, and CQ scores. In addition, the emerging themes aligned with the behavioral, cognitive, and motivational dimensions of the CQ construct. A fourth theme - VR experience - also emerged from participant reflections. Sentiments concerning their immersive experience in VR were largely positive. Lastly, the quantitative scores obtained by administering the CQ measurement scale showed a high motivational CQ score indicating participant eagerness to continue engaging in the VR environment. The topical themes that emerged from this study offer theoretical contributions and practical guidelines for CQ scholars, management researchers interested in exploring VR, and corporate training managers.
Poverty metaphors: An autoethnography in three parts
Authors: Hardy Mark A
Published: October 2023

This autoethnography seeks to open up for re-interpretation and debate three topics that feature within social work practice, research, and education: firstly the value and use of metaphor in understanding practice, secondly approaches to social work reflective writing, and thirdly the issue of poverty and its significance and impact in child and family social work. Metaphors can be valuable in framing understanding of issues within social work practice and advocating for change. Three metaphors have been particularly used in understanding the relationship between social work practice and poverty: The Invisibility of Poverty, The Elephant in the Room, and The Wallpaper of Practice. The three Parts of this autoethnography each adopt a different approach to autoethnographic writing and addresses and unsettles one of these metaphors. The first part adopts a narrative-reflective-analytical approach conventional to reflective writing in social work. The second and third parts adopt poetic and post-humanist approaches, respectively. It is proposed that adopting autoethnography as a methodology challenges the uncritical application of metaphor to situated practice and thereby prevents interpretive foreclosure. ‘Writing against’ objectified social work knowledge may assist in opening up practice to more challenging critical reflection and re-interpretation. Juxtaposing these three parts demonstrates the potential of non-conventional autoethnographic approaches to provide opportunities for deeper reflection on the experiences of doing social work within the context of poverty than conventional approaches to reflective writing. Furthermore, they indicate a need to reconsider how well these metaphors reflect social work practice experience with poverty.
Community-based advocacy in “cold case” sexual assault prosecutions: A qualitative exploration of survivors’ and advocates’ experiences
Authors: Campbell Rebecca , Gregory Katie , Goodman-Williams Rachael , Engleton Jasmine , Javorka McKenzie
Published: October 2023

Sexual assault survivors who report to the criminal legal system often need the assistance of victim advocates to navigate this complex and often retraumatizing system. In recent years, victim advocates have been called upon to assist more survivors in “cold case” sexual assault prosecutions. The term “cold case” refers to a criminal incident that is reopened years after it was initially reported, often because new evidence has become available. In this study, we interviewed sexual assault survivors and community-based victim advocates about their experiences working together in cold cases. These cases were reopened because victims’ sexual assault kits (SAKs; also known as “rape kits”) had not been submitted by the police for forensic DNA testing in a timely way. When these SAKs were finally tested, the biological evidence produced new investigatory leads, and prosecutors wanted to move forward with criminal charges against the offenders. Re-opening these legal cases caused significant emotional distress for survivors, but most did not want mental health counseling during their legal re-engagement. Instead, survivors wanted their advocates to provide emotional support while focusing on their tangible needs so that they had sufficient life stability to re-engage in the prosecution process. Survivors also needed extensive legal advocacy from their advocates throughout their hearings and trials. These results underscore the need for cold case protocols that train practitioners about the long-term impacts of trauma and the importance of centering survivors’ individual needs.
New weft knitting process: Morphological, physical and mechanical characterisation of the innovative knitted fabrics
Authors: Holderied Prisca , Weber Marcus O. , Bueno Marie-Ange
Published: October 2023

A new knitting process is presented based on a novel yarn feeding technique. It allows the knitting of new structures: single jersey on one or both needle beds and rib structure on both needle beds in the same knitting cycle, that is the same needles. The innovative knitted fabrics were compared to standard 1 × 1 rib and plain woven fabrics made from the same material. All samples were tested for physical (grammage, air permeability), morphological (number of stitches per centimetre in wale and course directions and number of stitches per square centimetre, cover factor) and mechanical (uniaxial and multidirectional tensile behaviour) properties. Grammage was used as a reference parameter to render the results comparable. The results show that the innovative fabrics are less stretchable than the standard knitted fabrics, especially in the course direction, therefore more rigid in this direction. Furthermore, they can be mechanically balanced in course and wale directions, which is unexpected for knitted fabrics. The innovative knitted fabrics are thicker than the standard knitted fabrics for the same grammage and have a lower number of stitches per square centimetre, enabling higher production rates. Due to their lower cover factor, the innovative fabrics are expected to be easier to impregnate by resin for composite applications than the standard knitted fabrics. Based on these results and the ability to increase knitting productivity, we conclude that that this novel process can transform future processes and open the door to new markets and applications.
Nurses’ Perceptions of Climate Change and its Effects on Health: A Qualitative Research Protocol
Authors: Caraballo-Betancort Antonio Miguel , Marcilla-Toribio Irene , Notario-Pacheco Blanca , Moratalla-Cebrian Maria Leopolda , Lucas-de la Cruz Lidia , Martinez-Andres Maria
Published: October 2023

Background: Climate change represents a serious threat to the health of the population. Nurses are the ideal group to act on the health risks posed by climate change. However, their perception of this phenomenon is unknown, as existing studies are very scarce. An in-depth study of nurses’ perceptions of climate change is needed. For this purpose, qualitative research is the best alternative. Objective: To understand nurses’ perceptions of their role as health assets in relation to climate change. Methods: A qualitative study will be carried out. The sample will be selected by means of purposive sampling with a maximum variation approach and will be defined by the data saturation criterion and will include nurses from different health units and regions of Spain. Semistructured interviews will be conducted using a videoconferencing platform. The interviews will be transcribed and analysed by several researchers using the logic of a three-step thematic analysis. Discussion: The results of this study will provide for the first time a clear, in-depth, and representative picture of Spanish nurses’ perceptions of climate change. This is essential for the development of concrete measures through which nurses become real health assets in the face of climate change.
A WeChat mini-program-based approach to smoking cessation behavioral interventions: Development and preliminary evaluation in a single-arm trial
Authors: Chu Shuilian , Feng Lin , Jing Hang , Zhang Di , Tong Zhaohui , Liang Lirong
Published: October 2023

Objective

This study sought to develop a WeChat mini-program for smoking cessation behavioral interventions (named the WQ mini-program) and evaluate its usability, acceptability, and preliminary efficacy among Chinese smokers.

Methods

The WQ mini-program was designed based on behavioral change theories and clinical practice guidelines, and clinical smoking cessation experts participated in the development process. Fifty Chinese smokers and five software experts were involved in a single-arm trial. Smokers were asked to use the WQ mini-program at least once a day for 4 weeks and to complete a weekly online follow-up questionnaire. Software experts were asked to complete an online follow-up questionnaire after using all functions of the WQ mini-program. Primary outcomes were usability and acceptability of and satisfaction with the mini-program tested by the System Usability Scale (SUS) and the Mobile App Rating Scale (MARS). Self-reported 7-day point prevalence abstinence (PPA) was used to evaluate its preliminary efficacy for smoking cessation. Optimization suggestions for the mini-program were collected from all participants through an open-ended question at the last follow-up and were analyzed by thematic analysis.

Results

The mean SUS and MARS total scores for the WQ mini-program as evaluated by smokers were 82.1 ± 13.8 and 84.5 ± 3.3 and by software experts were 4.21 ± 0.32 and 4.27 ± 0.15, respectively. Most smokers reported being willing to recommend this mini-program to other smokers (85.4%) and would continue to use it (95.8%). The mean satisfaction score for the mini-program was 4.23 ± 0.69 (out of 5 points) among smokers. Self-reported 7-day PPA among smokers at the 4-week follow-up was 50% (25/50).

Conclusions

This study demonstrated that the WQ mini-program would be a feasible and potentially effective method to encourage Chinese smokers to quit smoking. However, future research is needed to confirm its efficacy through a randomized controlled trial.
Return to Skiing After Tibial Plateau Fracture
Authors: O’Neill Dillon C. , Sato Eleanor H. , Myhre Luke A. , Kantor Adam H. , Rothberg David L. , Higgins Thomas F. , Marchand Lucas S. , Haller Justin M.
Published: October 2023

Background:

Tibial plateau fractures in skiers are devastating injuries with increasing incidence. Few studies have evaluated patient-reported outcomes and return to skiing after operative fixation of a tibial plateau fracture.

Purpose:

To (1) identify demographic factors, fracture characteristics, and patient-reported outcome measures that are associated with return to skiing and (2) characterize changes in skiing performance after operative fixation of a tibial plateau fracture.

Study Design:

Case series; Level of evidence, 4.

Methods:

We reviewed all operative tibial plateau fractures performed between 2016 and 2021 at a single level-1 trauma center. Patients with a minimum of 10-month follow-up data were included. Patients who self-identified as skiers or were injured skiing were divided into those who returned to skiing and those who did not postoperatively. Patients were contacted to complete the Patient-Reported Outcomes Measurement Information System–Physical Function domain (PROMIS-PF), the Knee injury and Osteoarthritis Outcome Score–Activities of Living (KOOS-ADL), and a custom return-to-skiing questionnaire. Multivariate logistic regression was performed with sex, injury while skiing, PROMIS-PF, and KOOS-ADL as covariates to evaluate factors predictive of return to skiing.

Results:

A total of 90 skiers with a mean follow-up of 3.4 ± 1.5 years were included in the analysis. The rate of return to skiing was 45.6% (n = 41). The return cohort was significantly more likely to be men (66% vs 41%; P = .018) and injured while skiing (63% vs 39%; P = .020). In the return cohort, 51.2% returned to skiing 12 months postoperatively. The percentage of patients who self-reported skiing on expert terrain dropped by half from pre- to postinjury (61% vs 29.3%, respectively). Only 78% of return skiers had regained comfort with skiing at the final follow-up. Most patients (65%) felt the hardest aspect of returning to skiing was psychological. In the multivariate regression, the male sex and KOOS-ADL independently predicted return to skiing ( P = .006 and P = .028, respectively).

Conclusion:

Fewer than half of skiers who underwent operative fixation of a tibial plateau fracture could return to skiing at a mean 3-year follow-up. The knee-specific KOOS-ADL outperformed the global PROMIS-PF in predicting a return to skiing.
“He’s shouting so loud but nobody’s hearing him”: A multi-informant study of autistic pupils’ experiences of school non-attendance and exclusion
Authors: Gray Laura , Hill Vivian , Pellicano Elizabeth
Published: October 2023

Background and aims

Children and young people on the autism spectrum frequently report a range of negative educational experiences and face disproportionally high rates of school non-attendance, including school avoidance and permanent exclusion, which can have a significant impact on their well-being as well as educational and broader life outcomes. To date, few studies have examined the full range of proximal (child, parent/family, school levels) and distal (community and society levels) barriers to ensuring the school attendance and the inclusion of autistic pupils. The current study sought to do just that by examining autistic young peoples’ school non-attendance and exclusion experiences from the perspectives of multiple informants.

Methods

We recruited 12 autistic pupils, who had previously experienced school avoidance and/or exclusion, from one local authority in England, United Kingdom. We conducted semi-structured interviews with the young people themselves, ten of their parents, eight of their current teachers and nine local authority professionals, including six educational psychologists and three specialist autism teachers. We analyzed interviewees’ responses using reflexive thematic analysis.

Results

Interviewees gave overwhelmingly negative accounts of autistic pupils’ school non-attendance and exclusion experiences. Our analysis identified a range of school-related factors they felt led to, or exacerbated, negative experiences in their former mainstream schools, and which ultimately led to their or their children's school non-attendance. It also went further to identify distal factors, including fragmented educational experiences, parents “fighting” against a complex bureaucratic system to secure appropriate education for their children, and limited professional involvement.

Conclusions

Our findings emphasize the importance of examining the broader context in which autistic pupils are embedded and demonstrate that such pupils are able to successfully attend—and even enjoy—school when they receive the appropriate care and support.

Implications

Schools and local authority professionals should seek to work in partnership with parents and autistic pupils to secure the necessary support for their inclusion in mainstream education. Government policy should support the provision of sufficient local authority professionals to adopt a more proactive approach to mitigate autistic pupils’ avoidance of and exclusion from school.
Systematic review of ceftaroline fosamil in the management of patients with methicillin-resistantStaphylococcus aureuspneumonia
Authors: Torres Antoní , Kuraieva Alona , Stone Gregory G. , Cillóniz Catia
Published: October 2023

Methicillin-resistantStaphylococcus aureus(MRSA) is responsible for an array of problematic community- and healthcare-acquired infections, including pneumonia, and is frequently associated with severe disease and high mortality rates. Standard recommended treatments for empiric and targeted coverage of suspected MRSA in patients with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP), including ventilator-associated pneumonia (VAP), are vancomycin and linezolid. However, adverse events such as acute kidney injury andClostridium difficileinfection have been associated with these antibiotics. Ceftaroline fosamil is a β-lactam/extended-spectrum cephalosporin approved for the treatment of adults and children with CAP and complicated skin and soft tissue infections. Ceftaroline hasin vitroactivity against a range of common Gram-positive bacteria and is distinct among the β-lactams in retaining activity against MRSA. Due to the design of the pivotal randomised controlled trials of ceftaroline fosamil, outcomes in patients with MRSA CAP were not evaluated. However, various reports of real-world outcomes with ceftaroline fosamil for pneumonia caused by MRSA, including CAP and HAP/VAP, been published since its approval. A systematic literature review and qualitative analysis of relevant publications was undertaken to collate and summarise relevant published data on the efficacy and safety of ceftaroline fosamil in patients with MRSA pneumonia. While relatively few real-world outcomes studies are available, the available data suggest that ceftaroline fosamil is a possible alternative to linezolid and vancomycin for MRSA pneumonia. Specific scenarios in which ceftaroline fosamil might be considered include bacteraemia and complicating factors such as empyema.
Exploring the association of lifestyle behaviors and healthy ageing among the older adults in India: evidence from LASI survey
Authors: Mandi Raghunath , Bansod Dhananjay W , Goyal Amit Kumar
Published: October 2023

Background

Understanding health and developing trends among the older population is essential for countries to tackle the challenges of an ageing population and formulate relevant policies. Facilitating healthy ageing is an essential strategy to address the issues arising among the aged. The concept of healthy ageing is defined as “the process of developing and maintaining the functional ability that enables wellbeing in old age (WHO),“ where “functional ability comprises the health-related attributes that enable people to be and to do what they have reason to value.“ People have different ageing pathways depending on their genetic profile and different life course health risk exposures. Therefore, ageing, more specifically healthy ageing, largely depends on individual lifestyle choices. This study examines the association between lifestyle behaviours and healthy ageing among older adults in India.

Methods

Based on the first round of LASI in 2017-18, we conceptualized healthy ageing within the WHO functional ability framework. We developed a Healthy Ageing Index (HAI), which incorporates physiological health, functional health, cognitive functions, psychological well-being, and social engagement. We used principal component analysis to generate a composite score for HAI. We then used multiple linear regression to demonstrate the association between lifestyle behaviours and HAI.

Result

The mean HAI was 82.8%, indicating that the study population is healthier. The study findings show that smoking and drinking are more prevalent among males, rural residents, illiterate individuals, those currently employed, and those belonging to the poorest wealth quintile. Engaging in physical activity is associated with better health outcomes (β = 2.36; 95% CI: 2.16–2.56).

Conclusion

This study emphasizes the importance of adopting a healthier lifestyle to achieve healthy ageing. Health behaviours are modifiable, so our results highlight the need for policy interventions to promote a healthier lifestyle from an early age.
In-hospital adverse outcomes and risk factors among chronic kidney disease patients infected with the omicron variant of SARS-CoV-2: a single-center retrospective study
Authors: Guo Yue , Guo Yifei , Ying Huajian , Yu Weien , Chen Shiqi , Zhang Yao , Zhang Shenyan , Lin Yanxue , Sun Feng , Zhang Yongmei , Yu Jie , Ma Ke , Qin Lunxiu , Long Feng , Zhu Haoxiang , Mao Richeng , Xue Jun , Zhang Jiming
Published: October 2023

Introduction

The SARS-CoV-2 Omicron variant has decreased virulence and pathogenicity, yet the number of Omicron infections worldwide is unprecedentedly high, with rather high mortality and severe disease rate. Chronic kidney disease (CKD) patients are particularly vulnerable to the SARS-CoV-2 Omicron variant and have unique clinical outcomes.

Methods

We retrospectively collected data from 2140 hospitalized patients with SARS-CoV-2 Omicron variant infection from March 29, 2022, to May 17, 2022. Demographic characteristics, ancillary examination results, and clinical treatments were described. Occurrence of critical COVID-19 or death and time of positive-to-negative conversion was defined as primary outcomes. The presence of COVID-19 pneumonia and the usage of respiratory or circulatory support was defined as secondary outcomes. Univariate or multivariate logistic regression analyses were performed to identify risk factors for primary outcomes.

Results

15.74% of CKD patients infected with the SARS-CoV-2 Omicron variant ended up with critical COVID-19 or death. Pre-existing CKD was a risk factor for critical COVID-19 or death and prolonged time of positive-to-negative conversion of SARS-CoV-2. Nirmatrelvir-ritonavir facilitated viral clearance among COVID-19 patients with non-severe CKD.

Conclusion

We found patients with CKD and COVID-19 due to Omicron experienced worse clinical outcomes and prolonged time of positive-to-negative conversion of SARS-CoV-2 compared to patients without CKD, which helps rationalize limited medical resources and offers guidance for appropriate clinical treatments.
The geographical distribution and socioeconomic risk factors of COVID-19, tuberculosis and leprosy in Fortaleza, Brazil
Authors: Taal A. T. , Barreto J. G. , Santos de Sousa G. dos , da Rocha A. Medeiros , Lima Ferreira N. N. , Menezes da Silva J. A. , Hinders D. C. , van Brakel W. H. , Richardus J. H. , Blok D. J.
Published: October 2023

Background

Fortaleza (Brazil) is high endemic for coronavirus disease 2019 (COVID-19), tuberculosis (TB) and leprosy. These three diseases share respiratory droplets through coughing or sneezing as the main mode of transmission but differ in incubation time, with COVID-19 having a short and leprosy a long incubation time. Consequently, contacts of a patient are at higher risk of infection and developing these diseases. There might be scope for combined preventive measures, but a better understanding of the geographical distribution and relevant socioeconomic risk factors of the three diseases is needed first. This study aims to describe the geographic distribution of COVID-19, TB and leprosy incidence and to identify common socioeconomic risk factors.

Methods

The total number of new cases of COVID-19, TB and leprosy, as well as socioeconomic and demographic variables, were retrieved from official registers. The geographical distribution of COVID-19, TB and leprosy rates per neighbourhood was visualised in Quantum GIS, and spatial autocorrelation was measured with Moran’s I in GeoDa. A spatial regression model was applied to understand the association between COVID-19, TB, leprosy rates, and socioeconomic factors.

Results

COVID-19 and TB showed a more homogenous distribution, whereas leprosy is located more in the south and west of Fortaleza. One neighbourhood (Pedras) in the southeast was identified as high endemic for all three diseases. Literacy was a socioeconomic risk factor for all three diseases: a high literacy rate increases the risk of COVID-19, and a low literacy rate (i.e., illiteracy) increases the risk of TB and leprosy. In addition, high income was associated with COVID-19, while low income with TB.

Conclusions

Despite the similar mode of transmission, COVID-19, TB and leprosy show a different distribution of cases in Fortaleza. In addition, associated risk factors are related to wealth in COVID-19 and to poverty in TB and leprosy. These findings may support policymakers in developing (partially combined) primary and secondary prevention considering the efficient use of resources.
Evaluation of different diagnostic methods for spinal tuberculosis infection
Authors: Li Zhaoxin , Wang Jin , Xiu Xin , Shi Zhenpeng , Zhang Qiang , Chen Deqiang
Published: October 2023

Background and purpose

Tuberculosis (TB) is the most fatal infectious disease worldwide. Approximately 24.6% of tuberculosis cases are extrapulmonary and predominantly affect the spine. It is difficult to diagnose spinal TB (STB). We aimed to evaluate the diagnostic performance of the Mycobacteria Growth Indicator Tube (MGIT)-960 culture, T-SPOT.TB, Xpert Mycobacterium tuberculosis complex (MTB)/resistance to rifampin (RIF), and Metagenomic Next-Generation Sequencing (mNGS) to detect STB.

Methods

We assessed 126 patients presumed to have STB using these four methods. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using clinical diagnosis as a reference.

Results

Of the patients, 41 were diagnosed with STB and 85 with non-STB. In the STB group, the sensitivity, specificity, PPV, and NPV of the MGIT-960 culture were 29.3% (12/41), 100% (85/85), 100% (12/12), and 74.6% (85/114), respectively. The sensitivity, specificity, PPV, and NPV of T-SPOT.TB were 92.7% (38/41), 82.4% (70/85), 58.5% (31/53), and 95.9% (70/73), respectively. The sensitivity, specificity, PPV, and NPV of the Xpert MTB/RIF assay were 53.7% (22/41), 100% (85/85), 100% (22/22), and 81.7% (85/104), respectively. The sensitivity, specificity, PPV, and NPV of mNGS were 39.0% (16/41), 98.8% (84/85), 94.1% (16/17), and 77.1% (84/109), respectively. The sensitivity, specificity, PPV, and NPV of mNGS + Xpert MTB/RIF were 73.2% (30/41), 100% (85/85), 96.8% (30/31), and 72.0% (85/118), respectively. The sensitivity, specificity, PPV, and NPV of the mNGS + T-spot assay were 97.6% (40/41), 100% (85/85), 67.9% (38/56), and 75.9% (85/113), respectively. Moreover, the sensitivity, specificity, PPV, and NPV of T-spot + Xpert MTB/RIF were 95.1% (39/41), 100% (85/85), 72.2% (39/54), and 81.0% (85/105), respectively.

Conclusions

T-SPOT.TB is the most effective method for diagnosing STB; however, Xpert MTB/RIF is more reliable and can detect RIF resistance. Clinicians can use mNGS to identify pathogens in patients with spinal infections; these pathogens appeared to be more meaningful in guiding the clinical management of patients in the non-STB group. The combination of Xpert MTB/RIF and mNGS can improve the early diagnosis rate and drug resistance detection, reduce the diagnostic cycle, and provide early targeted anti-TB treatment for patients with STB.
The effect of radiofrequency ablation on pain score and non-steroidal painkiller use in osteoid osteoma patients
Authors: Mahmutoğlu Abdullah Soydan , Arslan Fatma Zeynep , Karagülle Mehmet , Çakır Mehmet Semih , Mahmutoğlu Özdeş
Published: October 2023

Aim

CT-guided radiofrequency ablation (RFA) is among the thermal ablative procedures and provides great benefits with a minimally invasive procedure. In this prospective study, we aimed to reveal the significance of a multidisciplinary method in reducing the recurrence and complications in osteoid osteoma patients with CT-guided RFA performed by a team of experts in the field.

Materials and methods

A total of consecutive 40 patients with osteoid osteoma were prospectively evaluated and treated with CT-guided RFA. Before and the post ablation the visual analog scale (VAS) and use of nonsteroidal anti-inflammatory drugs (NSAIDS) were compared.

Results

Post-ablation VAS of the patients at the 1st week and 3rd month after the procedure decreased significantly (p < 0.01) compared to the pre-ablation. The frequency of NSAID use after the ablation decreased significantly (p < 0.01) compared to the pre-ablation time. The pre-procedure NSAID use of our patients included in the study was average 6.93 per week, the NSAID use in the 3rd month post-procedure controls was average 0.53 per week. Recurrence was detected in 4 of our patients, 36 patients had complete recovery.

Conclusion

Radiofrequency ablation is an effective treatment method in the management of osteoid osteomas. Radiofrequency ablation has low recurrence rates and provides rapid regression in patients’ pain after treatment.
Sexual dysfunction and its associated factors among reproductive-age women at Gurage Zone, Southern Ethiopia, 2023
Authors: Zeleke Fentahun Tamene , Ezedin Semer , Aleminew Fentahun , Alem Kassa Genetu , Tefera Daniel Tsega , Demissie Mebratu , Beriso Jima Gudeta , Endeshaw Fikremariam , Belay Aynalem , Ayele Alemitu , Andebet Demeke , Zegeye Ambaye Minayehu
Published: October 2023

Introduction

Female sexual dysfunction is commonly neglected, under-investigated, and under-treated in Ethiopia. Therefore, this study aimed to determine the prevalence and its associated factors of female sexual dysfunction among reproductive-aged women at Gurage zone hospitals, in southern Ethiopia.

Methods

An institutional-based cross-sectional study was conducted among 424 reproductive-age group women. A systematic random sampling method was employed and structured questionnaires were used to collect the data through a face-to-face interview. Data were entered into EpiData version 4.6 and analyzed by SPSS version 25.0. Descriptive statistics, and bivariable, and multivariable logistic regression were conducted. Statistical significance was declared at a p-value of < 0.05.

Result

Four hundred two participants completed the interview with a response rate of 94.8%. Arousal dysfunction 91.0% and pain during sexual intercourse 39.3% were the most and the least prevalent domains of female sexual dysfunction respectively. Overall 32.1% of the respondents had female sexual dysfunction. Body mass index (AOR = 3.6; 95% CI: 1.2, 10.8), history of pelvic surgery (AOR = 3.5; 95% CI: 1.3, 9.2), marriage satisfaction (AOR = 3.9; 95% CI: 1.4, 1o.6), a satisfaction of spouses’ sex ability (AOR = 3.1; 95% CI: 1.2, 8.5), breastfeeding (AOR = 3.3; 95% CI: 1.6, 7.0), and mode of delivery [vaginal delivery with tear and episiotomy (AOR = 3.7; 95% CI: 1.6, 8.8), instrument assisted vaginal delivery (AOR = 7.0; 95% CI: 1.2, 39.8)], were statistically associated with female sexual dysfunction. All-encompassing professional counseling addressing psychological and interpersonal acts and weight management interventions are needed for couples to maintain sexual functioning.