bluuebunny/crossref_metadata_2025 huggingface dataset:
Becoming morally equipped: A study of children’s public expressions
Authors: Haugseth Jan Frode , Smeplass Eli
Published: May 2024

This article discusses the notion of a ‘morally equipped’ childhood and adolescence, and how such a notion can help us get a fresh perspective on the relation between young people’s participation and empowerment, and the formation of personal and the collective moral repertoires of modern society. Utilising a mixed-methods approach inspired by the sociology of conventions (SC) and the sociology of regimes of engagement (SRE), we analyse letters to the editor of the Norwegian children’s newspaper Aftenposten Junior, to investigate the formats of children’s generalised moral arguments. We demonstrate that our informants exhibit a broad moral sensibility in the letters we have analysed, particularly showing keen engagement with issues related to civic rights. We discuss the young participants’ expressions in the light of convention theory. We make a case for how becoming ‘morally equipped’ could be understood as being able to engage, challenge, and articulate the tensions and negotiations between personal formats of daily experiences and interactions, and collective formats, such as public expressions, throughout childhood and adolescence.
A Free-Floating Aortic Thrombus: An Uncommon Approach to Handle a Rare Clinical Entity
Authors: Grassl Kristina , Hangler Herbert , Gratl Alexandra , Enzmann Florian , Grimm Michael , Klocker Josef , Wipper Sabine
Published: May 2024

Background:

Thrombotic material in the non-aneurysmatic and non-atherosclerotic aorta is a rare entity without any recommended standard treatment so far. We present a successful treatment strategy for patients who do not fit into any of the common approaches.

Case report:

A free-floating thrombus in the descending aorta was found as source of embolism in an 82-year-old female patient with lower limb ischemia. After initial heparinization of the patient without relevant reduction of the thrombotic mass, the thrombus was removed using an interdisciplinary approach. Under echocardiographic guidance to locate the thrombus, the AngioVac device, usually licensed to remove floating thrombi from the venous system, was used off-label to remove the thrombus by a transfemoral approach. To avoid rebuilding of a new thrombus, the attachment point with an exulcerated plaque in the descending aorta was covered by a stent graft via the same femoral access. The patient did not experience any further embolic events, and the postoperative course was uncomplicated.

Conclusion:

Patients with uncommon aortic diseases, such as the reported free-floating thrombus, should be treated by an individualized, interdisciplinary approach. Besides the recommended treatment options, there are other uncommon approaches that might offer an alternative in complex cases.

Clinical Impact

Evidence is rare for the treatment of a free-floating thrombus in the descending aorta and the treatment strategy remains discussed controversially. We present a rather uncommon approach of successful off-label treatment for patients who do not fit into any of the common approaches (operative, endovascular, or conservative treatment based on patient’s comorbidities). The AngioVac System has already been successfully used off-label in the arterial system but not in the above presented way of treating a free-floating thrombus in a patient with high embolization risk and treatment-limiting comorbidities.
An Intersectionality-Based Research Framework and Methodology That Emphasizes Systemic Inequities in Public Schooling, Including Racism, Sexism, and Classism
Authors: Scheurich James Joseph , Mason Madeline
Published: May 2024

While there is broad support among education scholars for the assertion that inequities of race, gender, and class within education are systemic and intersectional, many education researchers continue to publish research, especially in highly influential journals, like those of the American Educational Research Association (AERA), that either ignore systemic intersectional inequities or treat the inequities as mere variables. In contrast, we provide a proposed intersectionality-based research framework and a methodology that emphasizes systemic inequities in public schooling, including racism, sexism/patriarchy, and classism. We discuss this framework, describe our methodology (drawn mainly from Matias), and illustrate how it could be applied to research on three White teachers. For each of these teachers, we discuss some possibly new insights or “suppositions” that were yielded by the application of our framework and methodology. We then call on other researchers to strongly center systemic intersectional inequities in research and in research methodologies.
Radiomics and Clinical Characters Based Gaussian Naive Bayes (GNB) Model for Preoperative Differentiation of Pulmonary Pure Invasive Mucinous Adenocarcinoma From Mixed Mucinous Adenocarcinoma
Authors: Zhang Junjie , Hao Ligang , Xu Qian , Gao Fengxiao
Published: May 2024

Objective: To develop and validate predictive models based on clinical parameters, and radiomic features to distinguish pulmonary pure invasive mucinous adenocarcinoma (pIMA) from mixed mucinous adenocarcinoma (mIMA) before surgery. Method: From January 2017 to December 2022, 193 pIMA and 111 mIMA were retrospectively analyzed at our hospital in this retrospective study. From contrast-enhanced computed tomography, 1037 radiomic features were extracted. The patients were randomly divided into a training group and a test group (n = 213 and 91, respectively) in a 7:3 ratio. The least absolute shrinkage and selection operator algorithm was used to select radiomic features. In this study, 9 machine learning radiomics prediction models were applied. The radiomics score was then calculated based on the best-performing machine learning model adopted. The clinical model was developed using the same machine learning model of radiomics. In the end, a combined model based on clinical factors and radiomics features was developed. The area under the receiver operating characteristic curve (AUC) value and decision curve analysis (DCA) were used to evaluate the clinical usefulness of the prediction model. Results: The combined model established by the Gaussian Naive Bayes machine learning method exhibited the best performance. The AUC of the combined model, clinical model, and radiomics model were 0.81, 0.80, and 0.68 in the training group and 0.91, 0.80, and 0.81 in the test group, respectively. The Brier scores of the combined model were 0.171 and 0.112. The DCA curve also showed that the combined model was beneficial to clinical settings. Conclusion: The combined model integration of radiomics features and clinical parameters may have potential value for the preoperative differentiation of pIMA from mIMA.
The improvement of body signal measurement using adhesive intermediate electrode between skin and textile
Authors: Song Ji Eun , Kim Hyelim , Lim Daeyoung , Lee Sohee
Published: May 2024

This study suggests solutions to improve the adhesive of textile electrodes and the body signal occasion such as surface electromyography (sEMG). For this, a textile electrode embedded in the forearm band was produced using a knitting technique with two designs. The effects of skintight conditions on the forearm band during sEMG measurement were evaluated according to the pattern reduction rate (PRR) of the forearm band, ranging from 0% to 30%. Finally, an adhesive intermediate electrode, conductive gel, between the skin and the textile electrode was introduced to improve the unstable skin contact. The sEMG measurements confirmed that the sEMG signal was detected stably without excessive skintight conditions, such as a more than 20% PRR by applying the adhesive intermediate electrode. Skin-electrode impedance evaluation results also showed a similar tendency. Therefore, the knitted electrode developed in this study uses an adhesive intermediate electrode to improve the electrode performance and provide comfortable wearing conditions. This electrode is a practical electrode substrate for bio signal monitoring that allows the detection of muscle activity in a comfortable wearing condition for a long time.
Step-by-step venous navigation in treatment of tentorial dural arteriovenous fistula supplied by artery of Bernasconi and Cassinari
Authors: Prenc Matea , Žižek Helena , Radić Petra , Škoro Marija , Novak Ana-Marija , Čulo Branimir , Kalousek Vladimir
Published: May 2024

The artery of Bernasconi and Cassinari is a small infraclinoid branch of the internal carotid artery that originates from its cavernous segment and then runs along the tentorium. Because of its gracile appearance, it is often visible only when related to neoplasms and vascular lesions in the tentorial regions. 1 Dural arteriovenous fistulas (dAVFs) are arteriovenous shunts contained within the dural leaflets, supplied largely by the regional meningeal arteries and classified based on the type of venous drainage. Tentorial dAVFs are mostly supplied by branches of the meningohypophyseal trunk, including the artery of Bernasconi and Cassinari. 2 Unlike fistulas of other locations, tentorial fistulas are linked with a higher risk for venous hypertension and hemorrhage and thus demand immediate and appropriate treatment. 3 Digital subtraction angiography is necessary to understand its arterial and venous components. Treatment aims to achieve complete embolization of the fistulous connection and venous portions by either a transarterial or transvenous approach, without causing serious changes in the flow dynamics. 4 , 5
Multi-perspective ultrasound evaluation of Carotid Intima-Media thickness in hemodialysis access patients and its possible use to predict clinical outcomes
Authors: Torres-Machorro Adriana , Anaya-Ayala Javier E. , Lopez-Mendez Alejandra , Martinez-Quesada Jose I. , García-Alva Jose R. , Cuen-Ojeda Cesar , Lozano-Corona Rodrigo , Luna Lizeth , Hinojosa Carlos A.
Published: May 2024

Background

Hemodialysis (HD) patients present an increased carotid intima-media thickness (CIMT) and calcified plaques, and studies have demonstrated that CIMT is predictor for cardiovascular death in this patient population; hence, the importance of identifying early non-invasive markers of atherosclerosis. We aim to propose a new three-perspective CIMT measuring method in HD population, and to further investigate the possible use and value of this method to predict outcomes.

Methods

A cross-sectional study was conducted, the CIMT was measured with duplex ultrasound during the perioperative access planning. Software provided maximum CIMT in a 10 mm (mm) width of the common carotid artery. CIMT was measured in Right (R) and Left (L) carotid arteries, both in anterior (a), lateral (l), and posterior (p) view. The sum of these values (Ra+Rl+Rp+La+Ll+Lp) was completed and termed as Sixth Carotid Intimal (SCI) score. We stratified either in low (summation <4) or high (>=4) SCI score groups. Demographics, patency rates, complications, and mortality were collected; chi-square test was used for our analysis.

Results

A total of 30 patients (mean age 49 years and 56% females) that underwent access creation in the upper arm from 2010 to 2016 were selected and studied. A low SCI score was found 19 patients and 11 had high SCI, no significant difference was observed in demographics, history cardiovascular disease, and clinical outcomes as early thrombosis, and primary, primary-assisted patency at 12 months. Interestingly, during the follow up period of 36 months a significant higher difference in late thrombosis rates occurred (63.6% vs 26.3%, p = .044) and a higher all-cause mortality (54.4% vs 15.7%, p = .025) in patients with SCI score group above 4.

Conclusions

The SCI score method, might offer a screening tool for traditional cardiovascular risk factors in HD patients. In this study, we demonstrate an increased rate in late thrombosis and mortality in those with high SCI. Further research is necessary to better define the role of CIMT in vascular surgical procedures.
Taking the Law with a Pinch of Salt: A Brief Collection of Emblems for Bonus Dives Imaginosus
Authors: Hayaert (with images by David Bond) Valérie
Published: May 2024

This essay introduces the reader to the poetics (or, at least, the enargeia) of Peter Goodrich by offering an assembly of images seasoned with text, and vice versa. What follows is a short collection of emblems and their commentary. The Latinized name adopted for Professor Peter Goodrich, replacing the academic title (Pr.) with a new agnomen or nickname, is Bonus Dives Imaginosus. Bonus, meaning “good”, and dives, meaning “rich”, with imaginosus as a neologism advertising his connection with imagination and wit. Such additions to one’s name were well established in Antiquity and revived by humanists as a flyting game. In the case of Peter Goodrich, both adjectives “good” and “rich” already hint at distinguishing nicknames. The invention of an emblematic alter ego goes hand in hand with a tribute to Peter Goodrich’s baroque and pataphysical language, an outward contempt for the aseptic tongues of positivistic jurists, often sterilized by the academic chisel. The collection below, of emblems and accompanying discussion, is dedicated to Bonus Dives Imaginosus, the enfant terrible of Benjamin Cardozo School of Law at Yeshiva University, a published cook whose character is also a metaphor of a sleeping god, devoted to rêverie.
Exploring the lived experiences and care challenges of formal paid caregivers for people with intellectual disability and dementia
Authors: Acton Daniel James , Jaydeokar Sujeet , Taylor Ruth , Jones Steven
Published: May 2024

A greater number of people with intellectual disability are living into older age and are at increased risk of developing conditions such as dementia. Caring for a person with dementia presents several challenges for formal caregivers due to the progressive nature of the disease. An interpretive phenomenological analysis was used to understand the lived experiences of a purposive sample of formal caregivers in caring for people with intellectual disability and dementia. Discussions from 14 individual interviews generated data were analysed. Four key super-ordinate themes emerged which were: (1) recognising early indicators and diagnosis, (2) post diagnostic support, (3) coping with change and (4) need for future development. Themes reflected the experiences, barriers to dementia diagnosis and provide a valuable insight into the challenges faced by formal caregivers in providing aged care services.
Assessment of orofacial nociceptive behaviors of mice with the sheltering tube method: Oxaliplatin-induced mechanical and cold allodynia in orofacial regions
Authors: Gupta Saurav , Ling Jennifer , Gu Jianguo G
Published: May 2024

Preclinical studies on pathological pain rely on the von Frey test to examine changes in mechanical thresholds and the acetone spray test to determine alterations in cold sensitivity in rodents. These tests are typically conducted on rodent hindpaws, where animals with pathological pain show reliable nocifensive responses to von Frey filaments and acetone drops applied to the hindpaws. Pathological pain in orofacial regions is also an important clinical problem and has been investigated with rodents. However, performing the von Frey and acetone spray tests in the orofacial region has been challenging, largely due to the high mobility of the head of testing animals. To solve this problem, we implemented a sheltering tube method to assess orofacial nociception in mice. In experiments, mice were sheltered in elevated tubes, where they were well accommodated because the tubes provided safe shelters for mice. Examiners could reliably apply mechanical stimuli with von Frey filament, cold stimuli with acetone spray, and light stimuli with a laser beam to the orofacial regions. We validated this method in Nav1.8-ChR2 mice treated with oxaliplatin that induced peripheral neuropathy. Using the von Frey test, orofacial response frequencies and nociceptive response scores were significantly increased in Nav1.8-ChR2 mice treated with oxaliplatin. In the acetone spray test, the duration of orofacial responses was significantly prolonged in oxaliplatin-treated mice. The response frequencies to laser light stimulation were significantly increased in Nav1.8-ChR2 mice treated with oxaliplatin. Our sheltering tube method allows us to reliably perform the von Frey, acetone spray, and optogenetic tests in orofacial regions to investigate orofacial pain.
A pilot survey of students’ menstrual attitudes, experiences, and needs on an urban university campus
Authors: Suleman Abigail , Krishna Shruthi , Krishnakumar Divya , Nemoto Kai , Nguyễn My Lê Thảo , Mehta Supriya D
Published: May 2024

Background:

In the United States, many menstruators face barriers to period management, such as period poverty, or the lack of access to relevant knowledge and affordable menstrual products. Our current understanding of the social, emotional, and physical impacts of period poverty on students in post-secondary institutions is largely limited.

Objectives:

The purpose of this pilot study is to assess period poverty, period-related class disruption, and avoidance of menstrual hygiene management on campus among students and to identify recommendations for action at the University of Illinois Chicago and other urban universities.

Design:

An online cross-sectional study from February to May 2023.

Methods:

Enrolled students who were at least 18 years old completed an anonymous, self-administered online survey. Through descriptive statistics and chi-square tests in SAS version 9.4, we analyzed the sociodemographic, academic, and menstrual characteristics of those who had a period in the past 12 months. We also performed a thematic analysis of students’ open-ended responses regarding their menstrual experiences on campus.

Results:

Of our sample (N = 106), 17.1% of students have faced period poverty, 55.8% experienced period-related class disruption, and 47.5% avoided changing their menstrual products on campus. The relationships between the three menstrual experiences were statistically significant. In the open responses, students reported that their personal experiences with menstruation were largely painful and disruptive. We identified the following themes: (1) inadequate water, sanitation, and hygiene facilities; (2) understocked, empty, or non-existent menstrual product dispensers; (3) a desire for additional resources for menstruation; and (4) the unpredictability of menstruation.

Conclusion:

Our findings indicate that students continue to face obstacles to menstruation management due to inadequate support related to menstrual infrastructure, products, and pain. We outline several recommendations for university/college institutions to prioritize a more inclusive and supportive educational environment for all students.
Leveraging web search data in Germany to identify unmet needs of contraceptives on a population-based level: A longitudinal retrospective study
Authors: Steiner Charlotte , Wecker Hannah , Tizek Linda , Ziehfreund Stefanie , Preis Sarah , Pfister Kerstin , Oberländer Viktoria , Biedermann Tilo , Zink Alexander
Published: May 2024

Background:

There are a variety of possible contraceptives available. While medical advice is an important resource for selecting the individual contraceptive, previous research has shown that the Internet has become an increasingly important source of health care information.

Objectives:

This study aims to identify key trends in contraception-related web searches in Germany and thus allows conclusions about preferences and unmet needs with regard to pregnancy prevention.

Design:

Longitudinal retrospective study.

Methods:

Google Ads Keyword Planner was used to identify contraception-related keywords and their search volume in Germany and all federal states between 2018 and 2021. The keywords were categorized based on gender, hormonal/non-hormonal, and different contraceptive methods. Search volume and categories were analyzed for temporal trends, regional differences, and underlying socioeconomic variables.

Results:

The 1481 contraception-related keywords corresponded to 15,081,760 searches. In total, a 56% increase in searches/100,000 inhabitants was observed. Highest mean search volume was observed in categories “woman,” “woman/non-hormonal” and “woman/non-hormonal/barrier,” respectively, and in the federal state Hamburg, while the lowest was seen in North Rhine-Westphalia.

Conclusion:

The increase in search volume reflects a high interest in contraception, particularly in non-hormonal female methods. This stands in contrast to the limited number of effective non-hormonal contraceptives available and points to an unmet need. In addition, the low search volume for male contraceptives demonstrates gender-specific responsibilities regarding family planning in German society.
Prevalence of right-to-left shunt in stroke patients with cancer
Authors: Steinauer Fabienne , Bücke Philipp , Buffle Eric , Branca Mattia , Göcmen Jayan , Navi Babak B , Liberman Ava L , Boronylo Anna , Clenin Leander , Goeldlin Martina , Lippert Julian , Volbers Bastian , Meinel Thomas R , Seiffge David , Mujanovic Adnan , Kaesmacher Johannes , Fischer Urs , Arnold Marcel , Pabst Thomas , Berger Martin D , Jung Simon , Beyeler Morin
Published: May 2024

Background and Objectives:

Cancer is associated with an increased risk of acute ischemic stroke (AIS) and venous thromboembolism. The role of a cardiac right-to-left shunt (RLS) as a surrogate parameter for paradoxical embolism in cancer-related strokes is uncertain. We sought to investigate the relationship between the presence of an RLS and cancer in AIS patients.

Methods:

We included consecutive AIS patients hospitalized at our tertiary stroke center between January 2015 and December 2020 with available RLS status as detected on transesophageal echocardiography (TEE). Active cancers were retrospectively identified and the association with RLS was assessed with multivariable logistic regression and inverse probability of treatment weighting to minimize the ascertainment bias of having a TEE obtained.

Results:

Of the 2236 AIS patients included, 103 (4.6%) had active cancer, of whom 24 (23%) were diagnosed with RLS. An RLS was present in 774 out of the 2133 AIS patients without active cancer (36%). After adjustment and weighting, the absence of RLS was associated with active cancer (adjusted odds ratio (aOR) 2.29; 95% confidence interval (CI), 1.14–4.58). When analysis was restricted to patients younger than 60 years of age or those with a high-risk RLS (Risk of Paradoxical Embolism Score ⩾ 6), there was no association between RLS and cancer (aOR, 3.07; 95% CI, 0.79–11.88 and aOR, 0.56; 95% CI, 0.10–3.10, respectively).

Conclusion:

RLS was diagnosed less frequently in AIS patients with cancer than in cancer-free patients, suggesting that arterial sources may play a larger role in cancer-related strokes than paradoxical venous embolization. Future studies are needed to validate these findings and evaluate potential therapeutic implications, such as the general indication, or lack thereof, for patent foramen ovale (PFO) closure in this patient population.
The shift in focus from victims to the most serious perpetrators of domestic abuse
Authors: Godfrey Barry S , Richardson Jane C
Published: May 2024

This article contends that there has been a recent shift in focus towards the most serious perpetrators of domestic abuse in England. Police forces employ different ways of both identifying and managing high-harm high-frequency domestic abuse perpetrators. However, there is little evidence as to which management strategies are most effective. We use research findings from a recently conducted academic/police research partnership project to understand how the new focus on perpetrators is configured within current and proposed police practices and strategies in England.
Time to grow up: readiness associated with improved clinical outcomes in pediatric inflammatory bowel disease patients undergoing transition
Authors: Nardone Olga Maria , Martinelli Massimo , de Sire Roberto , Calabrese Giulio , Caiazzo Anna , Testa Anna , Rispo Antonio , Miele Erasmo , La Mantia Alessia , D’Alessandro Ermelinda , Fioretti Maria Teresa , Limansky Lara , Ferrante Mario , Di Luna Imma , Staiano Annamaria , Castiglione Fabiana
Published: May 2024

Background:

The transition from pediatric to adult healthcare in individuals with inflammatory bowel disease (IBD) poses significant challenges mainly due to the high burden of IBD during adolescence, a critical period of psychosocial development. So far, there are few longitudinal data linking transition readiness to long-term disease outcomes.

Objective:

We aimed to assess patients’ readiness to transition and its impact on clinical outcomes, quality of life, and adherence to therapy.

Design:

An observational, prospective study was conducted in a tertiary adult and pediatric center, including adolescents aged ⩾17 years with a diagnosis of IBD, who underwent a ‘structured transition’ program including two joint adult–pediatric visits.

Methods:

Transition readiness skills were assessed with the Transition Readiness Assessment Questionnaire (TRAQ). All patients completed the TRAQ at the time of recruitment, which occurred during the initial joint adult–pediatric visit, to determine those deemed ready for transition versus those not ready. The Morisky Medication Adherence Scale and the 36-Item Short Form Health Survey Questionnaire (SF-36) were also completed at baseline and after 12 months. Clinical outcomes were collected at the 12-month follow-up.

Results:

In all, 80 patients were enrolled who had transitioned through a structured transition clinic and completed 12 months of follow-up. In total, 54 patients were ready for the transition, with a mean TRAQ = 3.2 ± 0.5. The number of clinical relapses and hospitalizations at 12 months was lower in ready compared to not-ready patients ( p = 0.004 and p = 0.04, respectively). SF-36 did not differ between ready and not-ready patients and pre- and post-transition clinics ( p > 0.05). Based on the receiver operating characteristic curve, a TRAQ cutoff ⩾3.16 could predict medication adherence with a sensibility of 77%, a specificity of 82%, and an AUC of 0.81 (0.71–0.91; p < 0.001).

Conclusion:

Patients ready for transition had better outcomes at 12 months compared to those who were not ready. Therefore, readiness assessment tools should be integrated into transition management to ensure that interventions are targeted, patient-centered, and responsive to individuals’ changing needs.
Prostatic stents: a narrative review of current evidence
Authors: Cerrato Clara , Antoniou Vaki , Napolean Fernandes Shriya , Madaan Sanjeev , Somani Bhaskar Kumar
Published: May 2024

Benign prostatic hyperplasia (BPH) is a common chronic urologic condition affecting approximately 50% of men above the age of 60. As per European Association of Urology Guidelines, BPH can be treated according to a stepwise approach starting from a conservative management, a pharmacologic approach, and finally surgery. Both medical and surgical therapies have side effects, impacting on ejaculation and sexual function and patients with multiple comorbidities might not be considered surgically suitable candidates. Prostatic stents offer a minimally invasive procedures in an out-patient setting, possibly under local anaesthesia. Utilized since the 1980s, the past stents encompassed permanent (epithelializing) or temporary (non-epithelializing) devices, like the Uro-Lume (American Medical Systems, Minnetonka, MN, USA) and the Memokath, or Memotherm (Engineers & Doctors A/S, Denmark), and the biodegradable stents made of self-reinforced poly-L-lactide or braided poly lactic-co-glycolic acid. Previous stents however showed a quite high rate of complications among which pain, incontinence, infections, stent migration or blockage, and incomplete degradation that might lead to premature removal of stent. The stents currently available on the market instead are the temporary device Allium Triangular Prostatic Urethral Stent (Allium Urological Solutions, Caesarea, Israel) and the temporary stent SPANNER (AbbeyMoor Medical, Inc., Parkers Prairie, MN, USA), which might be used in case of bladder outflow obstruction, post-operatively, or for acute urinary retention. Studies showed encouraging results, in terms of effectiveness and safety improving patients’ quality of life and International Prostate Symptom Score, but longer-term studies are needed to identify the most suitable patients who might benefit from their use. Newer stents and nitinol devices are currently investigated, and we are waiting for the results of the ongoing clinical trials.
The protocol of a clinical effectiveness trial comparing standard step-up care, early combination DMARD therapy and early use of TNF inhibitors for the treatment of moderate to severe psoriatic arthritis: the 3-arm parallel group SPEED randomized controlled trial
Authors: Watson Marion , Tillett William , Jadon Deepak , Massa M. Sofia , Francis Anne , Gullick Nicola , Rombach Ines , Sinomati Yvonne , Tucker Laura , Coates Laura C.
Published: May 2024

Objectives:

The aim of the Severe Psoriatic arthritis – Early intervEntion to control Disease trial is to compare outcomes in psoriatic arthritis (PsA) patients with poor prognostic factors treated with standard step-up conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), combination csDMARDs or a course of early biologics.

Design:

This multicentre UK trial was embedded within the MONITOR-PsA cohort, which uses a trial within cohort design.

Methods and analysis:

Patients with newly diagnosed PsA and at least one poor prognostic factor (polyarthritis, C-reactive protein >5 mg/dL, health assessment questionnaire >1, radiographic erosions) were randomized equally and open-label to either standard care with ‘step-up’ csDMARD therapy, initial therapy with combination csDMARDs (methotrexate with either sulfasalazine or leflunomide) or to early biologics induction therapy (adalimumab plus methotrexate). The primary outcome is the PsA disease activity score at week 24.

Ethics:

Ethical approval for the study was granted by the South Central Research Ethics Committee (ref 18/SC/0107).

Discussion:

Treatment recommendations for PsA suggest more intensive therapy for those with poor prognostic factors but there are no studies that have previously used prognostic factors to guide therapy. Applying initial intensive therapy has shown improved outcomes in other inflammatory arthritides but has never been tried in PsA. Combination csDMARDs have shown some superiority over single therapies but there are limited data and concerns about side effects. Early use of biologics has also been shown to be superior to methotrexate but these drugs are costly and not usually funded first line. However, if a short course of biologics can rapidly suppress inflammation allowing treatment to be withdrawn and response maintained on methotrexate, this may be a cost-effective model for early use.

Trial registration:

ClinicalTrials.gov (NCT03739853) and EudraCT (2017-004542-24).
The interplay between environmental crime and corporate sustainability due diligence
Authors: Albuquerque Beatriz
Published: May 2024

Environmental crimes are a growing concern of today’s society, as are human rights violations committed by corporations. The European Union has defined both topics as legislative priorities and put forward two legislative instruments to better regulate these issues. On a first glance, there is no connection between these topics. However, this paper suggests that there is such a connection, and that the excellent timing of the proposals, which are being discussed at the same time, should be seized. This paper thus argues that the proposal for an Environmental Crime Directive should encompass a human rights approach by criminalizing the violation of serious due diligence obligations of the Corporate Sustainability Due Diligence Directive. Through a detailed analysis of the legislative drafting procedure leading to the proposal for an Environmental Crime Directive, this paper will assess whether such human rights approach is possible and whether it should be followed.
Intensive chemotherapy with dual induction and ALL-like consolidation for childhood acute myeloid leukemia: a respective report from multiple centers in China
Authors: Li Jia-Nan , Chen Yi-Jun , Fan Zhong , Li Qiao-Ru , Liao Liu-Hua , Ke Zhi-Yong , Li Yu , Wang Li-Na , Yang Cui-Yun , Luo Xue-Qun , Tang Yan-Lai , Zhang Xiao-Li , Huang Li-Bin
Published: May 2024

Background:

Pediatric acute myeloid leukemia (AML) has poor prognosis and high rate of relapse and mortality, and exploration of new treatment options is still critically needed.

Objectives:

To summarize the outcome of our new treatment strategies for pediatric AML, which is characterized by dual induction and acute lymphoblastic leukemia (ALL) elements consolidation.

Design:

Retrospective, single-arm study.

Methods:

From July 2012 to December 2019, an intensive chemotherapy protocol was used for newly diagnosed children with AML, which contains dual induction, three courses of consolidations based on high-dose cytarabine, and two courses of consolidations composed of high-dose methotrexate, vincristine, asparaginase, and mercaptopurine (ALL-like elements). Blasts were monitored by bone marrow smears at intervals, and two lumbar punctures were performed during chemotherapy. We retrospectively analyzed the efficacy and safety of this study. The last follow-up was on 26 May 2023.

Results:

A total of 70 pediatric AMLs were included. The median age at diagnosis was 6.7 (0.5–16.0) years. The median initial WBC count was 23.74 × 109/L, 11 of whom ⩾100 × 109/L. After dual induction, there were 62 cases of complete remission (CR), 5 cases of partial remission, and 3 cases of nonremission. The CR rate was 88.57%. The median follow-up time was 5.8 (0.2–9.4) years, the 5-year overall survival was 78.2% ± 5%, the event-free survival (EFS) was 71.2% ± 5.6%, and the cumulative recurrence rate was 27.75%. The 5-year EFS of patients with initial WBC < 100 × 109/L ( n = 59) and ⩾100 × 109/L ( n = 11) were 76.4% ± 5.7% and 45.5% ± 15% ( p = 0.013), respectively. A total of 650 hospital infections occurred. The main causes of infection were respiratory tract infection (26.92%), septicemia (18.46%), stomatitis (11.85%), and skin and soft-tissue infection (10.46%).

Conclusion:

This intensive treatment protocol with dual induction and ALL-like elements is effective and safe for childhood AML. Initial WBC ⩾ 100 × 109/L was the only independent risk factor in this cohort.

Trial registration:

It is a retrospective study, and no registration on ClinicalTrials.gov.
Prevalence of visual impairment and associated factors among primary school children in Ambo Town, Ethiopia, 2021
Authors: Legesse Nigist , Abdissa Bayisa , Begna Zenabu , Lemma Dereje
Published: May 2024

Background:

Visual impairment is a functional limitation of the eye(s) or the visual system manifested as reduced visual acuity. At least 2.2 billion people have visual impairment worldwide, and 90% of people with visual impairment have either preventable or treatable causes with cost-effective interventions.

Objectives:

To assess magnitude of visual impairment and associated factors among primary school children in Ambo Town, Ethiopia, in 2021.

Methods:

A cross-sectional study was conducted in selected primary schools of Ambo Town. A simple random sampling technique was used to select schools and study participants. Data were collected using an interviewer-administered structured questionnaire and entered into Epidata version 3.1 for analysis by using SPSS version 23. Binary logistic regression was adopted to identify statistically significant factors which were associated with visual impairment. The Hosmer-Lemeshow test was used to evaluate how well the logistic regression model fits to the data.

Results:

About 780 out of 838 primary school children were enrolled in the study, yielding a response rate of 93.07%. The estimated prevalence of visual impairment was 8.8% with 95% CI: 6.81–10.79. The main risk factor for visual impairment among primary school children were Students’ grade level, exposure to mobile screen, family history of visual problems, and family awareness about the status of their child’s eye problems were significantly associated with visual impairments (AOR = 2.375, 95% CI: 1.079–5.226; AOR = 2.44, 95% CI: 1.401–5.01; AOR = 2.41, 95% CI: 1.071–5.42; and AOR = 4.503, 95% CI: 2.12–9.55, respectively).

Conclusion:

A high prevalence of visual impairment was observed among primary school children. Attending higher grades, being exposed to mobile screen, and having a family history of visual problems were significantly associated with visual impairment.
“Keep trying”: a qualitative investigation into what patients with chronic pain gain from Project ECHO
Authors: Carlin Leslie , Zhao Q Jane , Bhatia Dominika , Taenzer Paul , Flannery John , Furlan Andrea D
Published: May 2024

Objective:

The study aims to investigate the patient perspective on the pathway from healthcare practitioners’ presentations of their cases at a Project ECHO (Extension for Community Healthcare Outcomes) tele-clinic to the management of those patients’ chronic pain.

Introduction:

Managing patients with chronic and complex pain constitutes a prevalent, stressful challenge in the primary care setting. Primary care physicians typically have received little training in treating such patients and, until recently, have relied heavily on opioid and other pharmaceutical therapies as part of their regimen. Project ECHO Ontario Chronic Pain and Opioid Stewardship is an interprofessional telementoring program connecting pain specialists to primary care practitioners with the aim of supporting them in managing their patients with chronic pain, although the patients concerned do not generally participate in the telementoring sessions. While a number of papers have described the benefits accruing to healthcare professionals through participating in Project ECHO, there has been little exploration concerning patients’ perceptions of their care subsequent to case presentation.

Methods:

Using data from in-depth interviews with 20 patients along with their associated case presentation forms and the recommendations following the presentation, we look at the alignment of patient and practitioner views and inquire about the patient’s perceptions of how Project ECHO affects them.

Results:

Results suggest that the impact on patients is indirect but positive: most respondents express pleasure in contributing to research around chronic pain management, though only two of them identified a direct impact on their own treatment. They also appreciated their practitioner’s efforts to bring expert attention to the patient’s situation.

Conclusions:

Patients whose cases are presented to Project ECHO sessions experience positive emotions at being part of the process of research and quality improvement, regardless of changes in their own conditions. This study highlights the importance to patients of their practitioners’ commitment to managing their chronic pain.
A retrospective cohort study of implantable venous access port-related and peripherally inserted central catheter-related complications in patients with hematological malignancies in China
Authors: Lu Aiwen , Hu Min , Qi Xin , Zhao Yujing , Huang Yijun
Published: May 2024

Objective:

We explored the differences in deep venous catheterization-associated complications between patients with hematological malignancies after peripherally inserted central catheter placement and such patients after implantable venous access port catheterization.

Introduction:

peripherally inserted central catheters and implantable venous access ports are the most popular devices used for chemotherapy. However, no study has revealed differences between peripherally inserted central catheters and implantable venous access ports in Chinese patients with hematological malignancies.

Methods:

The clinical data of 322 patients with hematological malignancies who were treated from January 1, 2020 to December 30, 2021 were included in a retrospective cohort study. Postoperative color Doppler ultrasonography and follow-up results were used to compare the incidence rates of deep venous catheterization -associated complications after peripherally inserted central catheters and implantable venous access ports catheterization.

Results:

The relative risk of catheter-related complications considering the type of device was 8.3 (95% CI = 3.0–22.8). In addition, chi-square segmentation analysis revealed a significant difference in the complication rate between the internal jugular vein and the basilic vein (χ2 = 22.002, p < 0.0001) and between the subclavian vein and the basilic vein (χ2 = 28.940, p < 0.0001).

Conclusion:

Implantable venous access ports are safer than peripherally inserted central catheters for Chinese patients with hematological malignancies. The implantation of implantable venous access ports could be firstly considered for systematic anti-cancer treatment.
Opportunities for Improving the Transplant Assessment and Education Process in British Columbia: Patient and Health Care Provider Perspective
Authors: Aiyegbusi Oshorenua , Gradin Sharon , Rajmohan Yanchini , Zhu Bingyue , Romann Alexandra , Chiu Helen , Gill Jagbir , Johnston Olwyn , Bevilacqua Micheli
Published: May 2024

Background:

There are several steps patients and their health care providers must navigate to access kidney transplantation in British Columbia (BC).

Objective:

We explored perceptions and experiences with the pretransplant process across BC to determine where process improvements can be made to enhance access to transplantation.

Design:

Anonymous surveys were sent online and via post to health care providers (including nephrologists, registered nurses, and coordinators) and patients across BC.

Setting:

Kidney care clinics, transplant regional clinics, and provincial transplant centers in BC.

Measurements:

Surveys included Likert scale questions on the current pretransplant process and transplant education available in BC. The health provider survey focused on understanding the pretransplant process, knowledge, roles, and communication while the patient survey focused on patient education and experience of the pretransplant processes.

Results:

A total of 100 health care providers and 146 patients responded. Seventy-six percent of health care providers understood their role and responsibility in the pretransplant process, while only 47% understood others’ roles in the process. Fifty-nine percent of health care respondents felt adequately supported by the provincial donor and transplant teams. Seventy-one percent of registered nurses and 92% of nephrologists understood transplant eligibility. About 68% and 77% of nurses and nephrologists, respectively, reported having enough knowledge to discuss living donation with patients. Fifty percent of patients had received transplant education, of which 60% had a good grasp of the pretransplant clinical processes. Sixty-three percent felt their respective kidney teams had provided enough advice and tools to support them in finding a living donor. Fifty percent of patients reported feeling up to date with their status in the evaluation process.

Limitations:

This analysis was conducted between December 2021 and June 2022 and may need to account for practice changes that occurred during the COVID-19 pandemic. Responses are from a selection of health care providers, thus acknowledging a risk of selection bias. Furthermore, we are not able to verify patients who reported receiving formal transplant education from their health care providers.

Conclusions:

Exploring these themes suggests communication with regional clinics and transplant centers can be improved. In addition, patient and staff education can benefit from education on kidney transplantation and the pretransplant clinical processes. Our findings provide opportunities to develop strategies to actively address modifiable barriers in a patient’s kidney transplantation journey.
Dialect on Trial: An Experimental Examination of Raciolinguistic Ideologies and Character Judgments
Authors: Dunbar Adam , King Sharese , Vaughn Charlotte
Published: May 2024

The current study examines the effect of dialect for a Black speaker, paying particular attention to the implications for criminal justice processing. Participants in this study heard an audio clip of a Black man describing his weekend and were randomly assigned to hear the account spoken in African American Vernacular English (AAVE) or Mainstream American English (MAE). For half of each sample, the audio clip was described as an alibi. Participants then evaluated the speaker across dimensions related to character and criminality, as well as his race, education, and socio-economic status. Results indicate that the speaker was viewed as having worse character and a greater criminal propensity if he spoke using the AAVE guise rather than the MAE guise. Additionally, participants perceived the AAVE speaker to be more stereotypically Black, less educated, and lower socio-economic status. These findings raise questions about contemporary forms of bias in criminal justice processing.
Supporting Students’ Re-Entry and Reintegration After Crises: A Framework for School Counselors to Promote Mental Health and Safety
Authors: Cunningham Patrick D. , Haag Granello Darcy
Published: May 2024

In recent years, the rates of children and adolescents hospitalized for suicidal thoughts and behaviors have increased, necessitating that schools be prepared to support students as they return to school after hospitalization. Yet, recent research shows that most schools do not have formalized policies and procedures to support students during their re-entry and reintegration. Further, although school counselors are often the members of the school community charged with organizing and implementing accommodations and interventions in support of these students, the field of school counseling has not adequately addressed the need for formalized re-entry and reintegration plans or the role that school counselors have in leading this process. To meet the needs of students returning after hospitalization for suicidal thoughts and behaviors, schools benefit from formalized and individualized re-entry and reintegration plans that are grounded in a larger framework of support. Further, school counselors are well positioned to take a leadership role in this process, and specific and practical strategies are available to guide them. We organize these recommendations using the evidence-based school counseling model.
Limit to Arbitrage and Distress Risk Puzzle in Vietnam: Does Corporate Bankruptcy Regulation Matter?
Authors: Duong Khoa Dang , Nguyen Ngoc Thi Thanh , Do Nga Thu Thi , Le Hoa Thanh Phan
Published: May 2024

This study is the first to examine how limit-to-arbitrage factors impact the distress risk puzzle in Vietnam before and after implementing bankruptcy regulations. Our research utilizes asset pricing models, portfolio sorting methodologies, and the Fama and French four-factor model to analyze an unbalanced panel with 35,255 firm-month observations from non-financial firms in the Vietnam stock market from 2008 to 2021. We find a persistent negative correlation between distress risk and corporate profitability, even after accounting for limit-to-arbitrage factors. Notably, this trend is more pronounced among larger firms. Intriguingly, the distress risk puzzle disappears after the introduction of bankruptcy regulations. Additionally, we observe that limit-to-arbitrage factors suppress stock returns due to mispricing issues, supporting liquidity risk theory. Our study provides valuable insights into the distress risk puzzle, especially in emerging markets.

JEL Classification: G11, G12, G14.