bluuebunny/crossref_metadata_2025 huggingface dataset:
Wide-awake surgery using local anaesthesia with adrenaline for ulnar nerve decompression and medial epicondylectomy
Authors: Mak Rex Wang-Fung , Mak Michael Chu-Kay , Ho Pak-Cheong
Published: May 2024

Ulnar nerve decompression with medial epicondylectomy was performed under Wide-Awake Local Anaesthesia No Tourniquet (WALANT) for cubital tunnel syndrome. Prospective investigation showed that WALANT is a safe and effective method of anaesthesia with good patient satisfaction.
Congenital hand difference associated with 12q13.13 microdeletion
Authors: Chu Howard , Parsons Daisy , Metcalfe James , Armstrong Alexander
Published: May 2024

We report the case of a 15-year-old boy with a de novo chromosomal deletion in the 12q13.13 region, presenting with congenital hand difference. This case emphasizes the clinical significance of recognizing such genetic anomalies and their implications.
Differential risk factor profile and neuroimaging markers of small vessel disease between lacunar ischemic stroke and deep intracerebral hemorrhage
Authors: Cheng Yajun , Valdés Hernández Maria del C. , Xu Mangmang , Zhang Shuting , Pan Xiaohua , An Baoqiang , Wardlaw Joanna M. , Liu Ming , Wu Bo
Published: May 2024

Background:

Lacunar ischemic stroke (LIS) and deep intracerebral hemorrhage (dICH) are two stroke phenotypes of deep perforator arteriopathy. It is unclear what factors predispose individuals with deep perforator arteriopathy to either ischemic or hemorrhagic events.

Objectives:

We aimed to investigate risk factors and neuroimaging features of small vessel disease (SVD) associated with LIS versus dICH in a cross-sectional study.

Methods:

We included patients with clinically presenting, magnetic resonance imaging-confirmed LIS or dICH from two tertiary hospitals between 2010 and 2021. We recorded vascular risk factors and SVD markers, including lacunes, white matter hyperintensities (WMH), perivascular spaces (PVS), and cerebral microbleeds (CMB). Logistic regression modeling was used to determine the association between vascular risk factors, SVD markers, and stroke phenotype. We further created WMH probability maps to compare WMH distribution between LIS and dICH.

Results:

A total of 834 patients with LIS (mean age 61.7 ± 12.1 years) and 405 with dICH (57.7 ± 13.2 years) were included. Hypertension was equally frequent between LIS and dICH (72.3% versus 74.8%, p = 0.349). Diabetes mellitus, hyperlipidemia, smoking, and prior ischemic stroke were more associated with LIS [odds ratio (OR) (95% confidence interval (CI)), 0.35 (0.25–0.48), 0.32 (0.22–0.44), 0.31 (0.22–0.44), and 0.38 (0.18–0.75)]. Alcohol intake and prior ICH were more associated with dICH [OR (95% CI), 2.34 (1.68–3.28), 2.53 (1.31–4.92)]. Lacunes were more prevalent in LIS [OR (95% CI) 0.23 (0.11–0.43)], while moderate-to-severe basal-ganglia PVS and CMB were more prevalent in dICH [OR (95% CI) 2.63 (1.35–5.27), 4.95 (2.71–9.42)]. WMH burden and spatial distribution did not differ between groups.

Conclusion:

The microangiopathy underlying LIS and dICH reflects distinct risk profiles and SVD features, hence possibly SVD subtype susceptibility. Prospective studies with careful phenotyping and genetics are needed to clarify the mechanisms underlying this difference.
Why Are Constitutional Amendments in Mexico so Frequent?
Authors: Tsebelis George , Atilano-Robles Edwin
Published: May 2024

This research investigates the reasons for the overwhelming frequency of constitutional amendments in Mexico despite the widely held academic views of its constitution's rigidity. The article introduces a novel model highlighting the core of the Mexican Constitution. This model serves as a foundational lens to understand the interplay between political institutions, preferences of political actors, and amendment provisions. The application of this model attributes the frequency of amendments to three different reasons: first, the length and inconsistency of the Mexican Constitution; second, the institutional requirements for amendments; third, the political consensus prevailing in the Mexican political scene (crucial instances, such as the onset of multipartyism with concertacesión and pivotal reforms to Articles 27 and 73, offer deeper context) makes amendments feasible. A comprehensive analysis of the 68 constitutional amendments from 2000 to 2013 corroborates these expectations concerning institutional thresholds, coalition dynamics, and amendment significance.
Preservation of Residual Hearing: Long-Term Results With a Mid-Scala Electrode
Authors: Gerbert Martin , Ernst Arne , Seidl Rainer , Decker Lars , Scholz Sandra , Lauer Gina , Mittmann Philipp
Published: May 2024

Objective

The long-term preservation of residual hearing after cochlear implantation has become a major goal over the past few years. The aim of the present study was to evaluate residual hearing in the long-term follow-up using mid-scala electrodes.

Methods

In this retrospective, single-center study, we collected data from 27 patients who were implanted between 2014 and 2015 with residual hearing in the low-frequency range using a mid-scala electrode. Measurements of the hearing thresholds were carried out directly postoperatively (day 1 after surgery) and in the long-term follow-up 43.7 ± 6.9 months. The calculation of the extent of audiological hearing preservation was determined using the HEARRING group formula by Skarsynski.

Results

Postoperative preservation of residual hearing was achieved in 69.2% of the cases in the low-frequency range between 250 Hz and 1 kHz, of which 89.5% of the patients had frequencies that suggested using electroacoustic stimulation (EAS). In the long-term follow-up, 30.8% of the patients showed residual hearing; however, 57.1% had apparently benefited from EAS.

Conclusion

Preservation of residual hearing is feasible in the long term using mid-scala electrodes. Postoperatively, there is over the half of patients who benefit from an EAS strategy. The long-term follow-up shows a certain decrease in residual hearing. However, these results are comparable to studies relating to other types of electrodes. Further research should be conducted in future to better evaluate hearing loss in long-term follow-up, compared to direct postoperative audiological results.
Media Use, Feelings of Being Devalued, and Democratically Corrosive Sentiment in the US
Authors: Bimber Bruce , Labarre Julien , Gomez Daniel , Nikiforov Ilia , Koc-Michalska Karolina
Published: May 2024

We take two approaches to understanding democratically corrosive sentiment (DCS) in the US, which we operationalize in terms of populist attitudes, conspiracy beliefs, and expectation of fraud in the next election. Our first approach is media use, which is not well understood as a correlate of DCS beyond generalities about the harms of social media and partisan news. We distinguish between mainstream news and right-wing media, and between three categories of social media: those facilitating stronger ties among users, those facilitating weaker ties, and extremist Alt-Tech brands. Our second approach to explaining DCS is attitudinal. For this, we introduce a concept called Feelings of Being Devalued (FBD), which we offer as a complement to status threat and sense of material deprivation. Using a survey of our design ( N = 2,000) fielded in the US in 2022, we show that: (1) mainstream news use and attention to right-wing media have opposite relationships with DCS; (2) not only Alt-Tech social media but also stronger-tie media such as Facebook are correlated with DCS, while use of weaker-tie social media such as X are uncorrelated in a model with a rich set of controls; and (3) FBD is strongly associated with DCS—more so than right-wing authoritarianism, social dominance orientation, and ideology.
The case for tattoos as religious practices. From footnote to survey indicator
Authors: Morello SJ Gustavo
Published: May 2024

Most studies in the sociology of religion in the West ignored religious tattoos or understood them as marginal practices. However, people have been getting religious tattoos since the beginning of the common era. I investigate the lack of sociological studies on religious tattoos and explain the marginal location of tattoos for the discipline. I propose a lived religion approach to understand tattoos as a legitimate religious practice and explore the historical and contemporary record of religious tattooing in the West. Finally, I make the case for studying tattoos as religious practices in Western, Christian contexts, and as a way to assess contemporary religiousness.
Cervical spine fracture in diffuse idiopathic skeletal hyperostosis: A bibliometric analysis
Authors: Liawrungrueang Wongthawat , Sarasombath Peem
Published: May 2024

Objective:

The study aimed to assess and investigate cervical spine fracture in diffuse idiopathic skeletal hyperostosis and to identify research trends in cervical spine fracture in diffuse idiopathic skeletal hyperostosis in countries around the world using bibliometric analysis.

Method:

We examined bibliometric data obtained from the Scopus database collection for the periods 1 January 2000 and 1 January 2022. Authors, institutions, nations, publications, keywords, and references were noted and analyzed. The total number of research articles published on the subject of diffuse idiopathic skeletal hyperostosis was used to calculate the amount of research on that subject undertaken in the study period. A sample of the publication data collected from the Scopus database was then analyzed using the Bibliometric program and used to develop a relationship chart using the Bibliometrix and VOSviewer programs.

Results:

The number of citations was assumed to be a qualitative measure of the publication. We estimated the impact of the research using several metrics, including the H-index, in the bibliometric analysis of authors, geographic areas, institutes, and references. A total of 52 studies related to cervical spine fractures in diffuse idiopathic skeletal hyperostosis were identified. Only 5.12% of those studies were cited in other publications, for a total of 1410 citations in publications by 342 authors, of whom only two authors had published a single study. Co-authorships occurred at 7.273%. Diseases common in elderly males were often studied retrospectively, and “Diffuse Idiopathic Skeletal Hyperostosis” was a frequently mentioned keyword.

Conclusion:

The findings of this study provide insights into authors, institutions, key publications, and research trends related to diffuse idiopathic skeletal hyperostosis and can potentially serve as a guide for further studies in the field. The bibliometric analysis of cervical spine fractures in patients with diffuse idiopathic skeletal hyperostosis highlights important contributors, influential papers, geographical trends, and study characteristics in this area of research.
Factors associated with frailty among older individuals with chronic diseases: A multicenter study
Authors: Quintero-Cruz María Victoria , Mantilla-Morrón Mirary , Urina-Jassir Manuel , Pinillos-Patiño Yisel , Quijano-Del Gordo Carmen Inés , Buelvas Walberto , De Ávila-Quintana Luzdaris , Cotes Karin , Urina-Triana Miguel
Published: May 2024

Objective:

Frailty is a syndrome that predisposes older individuals to adverse health outcomes, such as disability, dependence, falls, hospitalization, post-operative complications, and poor health in general. This study aimed to identify factors associated with frailty in older people with chronic diseases in Colombia.

Methods:

A cross-sectional study was conducted with a nonprobabilistic sample of 230 older people (aged ⩾ 60 years) from four Colombian cities. Frailty was based on Fried’s phenotype (frail defined as having ⩾3 criteria). Comorbidities were classified based on Charlson’s Comorbidity Index and key questionnaires for activities of daily living (ADLs) were evaluated.

Results:

Most were female (57.8%) with a mean ± SD age of 71.9 ± 8 years. Among them, 27.4% were frail and 58.7% were prefrail. Female gender, age ⩾ 75 years, low educational and socioeconomic level, dependence on ADLs, and cognitive impairment were associated with higher odds of prefrailty/frailty.

Conclusions:

Prefrailty and frailty are common among older people with chronic diseases in Colombia. This syndrome is associated with social and health-related conditions, which should be addressed when providing care for these patients.
Hemophagocytic Lymphohistiocytosis in a Remote Kidney Transplant Recipient Triggered by HSV Infection With Complete Recovery: An Educational Case Report
Authors: Gopal Anjana , Kim S. Joseph
Published: May 2024

Rationale:

Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease characterized by excessive immune activation. It is more commonly seen in children but increasingly recognized in adults. Primary HLH relies on a genetic predisposition, whereas secondary HLH develops in the context of infections, malignancies, or autoimmune diseases. Hemophagocytic lymphohistiocytosis has been rarely described in patients on immunosuppressive therapy after kidney transplant. Here, we describe a case of HLH in a patient with a remote history of kidney transplant, triggered by a viral infection.

Presenting Concerns:

A 45-year-old female, with a kidney transplant in 2009 for IgA nephropathy, presented with fever, vomiting, and back pain of 1-week duration. She was on triple immunosuppression consisting of daily doses of prednisone 5 mg, azathioprine 100 mg, and tacrolimus extended release 1 mg, and a baseline creatinine of 130 µmol/L.

Diagnosis:

Initial investigations showed anemia, leukopenia, elevated serum creatinine, transaminitis, and markedly increased ferritin of 67 600 µg/L which prompted a bone marrow biopsy to rule out HLH. The bone marrow showed an increased proportion of CD68+ cells (macrophages) with more than 5 in 1000 hemophagocytic macrophages. Her soluble IL-2 receptor (CD25) level was 3406 pg/mL (606-2299 pg/mL) which was mildly elevated. She fulfilled 4 of the 8 criteria for HLH and with an H score was 223 which suggested a diagnosis of HLH with 96.9% probability. An extensive secondary workup for possible triggers for HLH led to a swab from genital ulcers that was positive for herpes simplex virus (HSV) type 2. The polymerase chain reaction (PCR) in the blood for HSV type 2 was also positive.

Interventions:

Given the diagnosis of HSV type 2 as the putative trigger for HLH, she was started on parenteral acyclovir for 2 weeks followed by oral valacyclovir for 2 more weeks. In the context of infection, the azathioprine was stopped while low-dose steroid and tacrolimus were continued.

Outcomes:

With the initiation of treatment for HSV infection, leukopenia, creatinine, and transaminases improved along with ferritin levels. At her 6-month follow-up, her blood counts and liver enzymes had normalized, and ferritin was 566 µg/L.

Teaching points:

Hemophagocytic lymphohistiocytosis is a rare disease in kidney transplant recipients with a high mortality rate. It can occur even in remote kidney transplant recipients so a high degree of suspicion is necessary to lead to a prompt diagnosis. Infections are common triggers for secondary HLH. Early identification and treatment of the triggering infection may improve outcomes.
Multiclassification of the symptom severity of social anxiety disorder using digital phenotypes and feature representation learning
Authors: Choi Hyoungshin , Cho Yesol , Min Choongki , Kim Kyungnam , Kim Eunji , Lee Seungmin , Kim Jae-Jin
Published: May 2024

Objective

Social anxiety disorder (SAD) is characterized by heightened sensitivity to social interactions or settings, which disrupts daily activities and social relationships. This study aimed to explore the feasibility of utilizing digital phenotypes for predicting the severity of these symptoms and to elucidate how the main predictive digital phenotypes differed depending on the symptom severity.

Method

We collected 511 behavioral and physiological data over 7 to 13 weeks from 27 SAD and 31 healthy individuals using smartphones and smartbands, from which we extracted 76 digital phenotype features. To reduce data dimensionality, we employed an autoencoder, an unsupervised machine learning model that transformed these features into low-dimensional latent representations. Symptom severity was assessed with three social anxiety-specific and nine additional psychological scales. For each symptom, we developed individual classifiers to predict the severity and applied integrated gradients to identify critical predictive features.

Results

Classifiers targeting social anxiety symptoms outperformed baseline accuracy, achieving mean accuracy and F1 scores of 87% (with both metrics in the range 84–90%). For secondary psychological symptoms, classifiers demonstrated mean accuracy and F1 scores of 85%. Application of integrated gradients revealed key digital phenotypes with substantial influence on the predictive models, differentiated by symptom types and levels of severity.

Conclusions

Leveraging digital phenotypes through feature representation learning could effectively classify symptom severities in SAD. It identifies distinct digital phenotypes associated with the cognitive, emotional, and behavioral dimensions of SAD, thereby advancing the understanding of SAD. These findings underscore the potential utility of digital phenotypes in informing clinical management.
Exploring the influence of transformer-based multimodal modeling on clinicians’ diagnosis of skin diseases: A quantitative analysis
Authors: Zhang Yujiao , Hu Yunfeng , Li Ke , Pan Xiangjun , Mo Xiaoling , Zhang Hong
Published: May 2024

Objectives

The study aimed to propose a multimodal model that incorporates both macroscopic and microscopic images and analyze its influence on clinicians’ decision-making with different levels of experience.

Methods

First, we constructed a multimodal dataset for five skin disorders. Next, we trained unimodal models on three different types of images and selected the best-performing models as the base learners. Then, we used a soft voting strategy to create the multimodal model. Finally, 12 clinicians were divided into three groups, with each group including one director dermatologist, one dermatologist-in-charge, one resident dermatologist, and one general practitioner. They were asked to diagnose the skin disorders in four unaided situations (macroscopic images only, dermatopathological images only, macroscopic and dermatopathological images, all images and metadata), and three aided situations (macroscopic images with model 1 aid, dermatopathological images with model 2&3 aid, all images with multimodal model 4 aid). The clinicians’ diagnosis accuracy and time for each diagnosis were recorded.

Results

Among the trained models, the vision transformer (ViT) achieved the best performance, with accuracies of 0.8636, 0.9545, 0.9673, and AUCs of 0.9823, 0.9952, 0.9989 on the training set, respectively. However, on the external validation set, they only achieved accuracies of 0.70, 0.90, and 0.94, respectively. The multimodal model performed well compared to the unimodal models, achieving an accuracy of 0.98 on the external validation set. The results of logit regression analysis indicate that all models are helpful to clinicians in making diagnostic decisions [Odds Ratios (OR) > 1], while metadata does not provide assistance to clinicians (OR < 1). Linear analysis results indicate that metadata significantly increases clinicians’ diagnosis time ( P < 0.05), while model assistance does not ( P > 0.05).

Conclusions

The results of this study suggest that the multimodal model effectively improves clinicians’ diagnostic performance without significantly increasing the diagnostic time. However, further large-scale prospective studies are necessary.
Factors Associated With Malnutrition in Children Under 2 Years Old in Terengganu, Malaysia
Authors: Te Ku Nor Tengku Fatin Nadhirah , Wee Bee Suan , Aung Myat Moe Thwe , Mohamad Marhazlina , Ahmad Aryati , Che Taha Che Suhaili , Ismail Karimah Fakhriah , Shahril Mohd Razif
Published: May 2024

The importance of the first 1000 days of life for children has been acknowledged as a crucial phase for malnutrition prevention, where understanding the underlying causes of the problem should be done accordingly. Thus, the study’s objective was to find the factors associated with malnutrition in children under 2 years old. A crosssectional study was conducted involving mothers and children under 2 years old dyads ( n = 244). A structured and validated socio-demographic and nutrition KAP questionnaire was used whilst weight and height were measured. In this study, 19.3%, 11.8%, and 10.2% of children were stunted, underweight, and wasted, respectively, according to the WHO Growth Reference cut-off. By using multiple logistic regression, this study found that children who have low birth weight and whose mothers have poor nutrition knowledge have higher odds of malnutrition. In conclusion, proper prevention planning considering these associated factors should be done to ensure the effectiveness of the malnutrition prevention program.
Reimagining Pathways Into Culture and Creative Industries in the City of Seattle
Authors: Macklin Scott , van den Berg Amanda , Pretorius Deon
Published: May 2024

In view that Culture and Creative Industries (CCI) are multi-sector, emergent, and complex, this paper couples the theoretical perspective of Margaret Archer’s Morphogenetic Approach with Adam Kahane’s Tansformative Scenario Planning (TSP) as its strategic framework to discover, articulate, and connect cross-sector (community-based organizations, industry, government, and education) CCI efforts. This study has sought to understand how and in what ways the actions found in the creative sector can be leveraged to enhance participation and ameliorate the outputs of socio-economic efforts across the full spectrum of the greater Seattle region. Thus, though this example it contributes to the creation of vital places of public welfare, where public frameworks and policies nurture accessibility and participate in connected culture and creative ecology.
Does the Tourist Appreciate Your Employees? Prioritizing Service Employee Improvements Based on User-Generated Content Mining
Authors: Hu Feng , Jin Yijie , Niu Yaqian , Chen Keyi
Published: May 2024

While a multitude of opinion mining studies have examined the impact of attribute performance on customer satisfaction, they have offered limited insights into the role performance of service employees by investigating tourists’ experiences. Focusing on the hotel industry, this study investigated tourists’ evaluations of service personnel by scrutinizing 68,439 hotel reviews and explored the asymmetric effects of employee performance on customer satisfaction according to service employee functions and traveler types. The results indicate that different travelers have distinct expectations of different kinds of services, thereby moderating the asymmetric impact of role performance on tourist satisfaction. Manager employee, in particular, constitutes an excitement factor for family, solo, and couple travelers. The findings have implications for the formulation of operation strategies to promote tourists’ satisfaction rather than frustration. This study contributes to the literature by offering a novel understanding of the asymmetric effect of customer–personnel interactions on tourist satisfaction.
Analysis of Noise pollution level in Enugu campus, of the University of Nigeria
Authors: Egbenta Idu Robert , Elugwaraonu Ngozi Faith , Ndukwu Raphael I. , Okosun Andrew Egara
Published: May 2024

Noise is sound of any kind that is undesirable and unwanted as part of the environment under consideration. It is one of the types of pollution that have great impact on our health and wellbeing. The occurrence of noise in our environment is increasing daily because of growing population and industrialization. Noise pollution have great consequences on our social and economic lives especially in teaching and learning environment, which is presumed to be in silent zone. It is worth investigating whether environment in which teaching and learning take place is in quiet condition? The aim of the study was to analyze the level of noise pollution at different locations in the University of Nigeria, Enugu Campus. The Nigeria Standard noise level for higher education institutions and hospitals should be 60 dB for day and 50 dBA for night. The Noise levels dBA was measured with the help of noise meter at 14 points and at a height of 1 m above the ground level within the campus at three different times (6–8 am, 12–2 pm and 4–6 pm). The total Leq noise level in the University of Nigeria, Enugu Campus is 70.94 dBA which is above the level recommended for educational institutions. The period of intensity of noise was recorded during afternoon, morning and evening respectively. This rate of noise level during the day is high and unsuitable for teaching-learning process. Therefore, university management should take proactive measures to regulate noise pollution within the campus and indeed, other university campuses in Nigeria.
So Similar, Yet So Different: How Motivations to Use Facebook, Instagram, Twitter, and TikTok Predict Problematic Use and Use Continuance Intentions
Authors: Alhabash Saleem , Smischney Tegan Marie , Suneja Anvita , Nimmagadda Anish , White Linda R.
Published: May 2024

While much of the studies within the Uses and Gratifications (U&G) tradition were set to predict facets of media use, the current study examines how use motivations, nature of platform use, and privacy-related perceptions predict users’ use continuance intentions for Facebook, Instagram, Twitter, and TikTok and their problematic use (i.e., addiction), simultaneously. The study uses a cross-sectional survey of undergraduate students at a large Midwestern University ( N = 685), where participants expressed their motivations to use each of the four platforms (depending on their active use of the platform), platform affinity and other usage factors, their intentions to continue using the platform, and their problematic use of the platform. Findings showed superiority of Instagram in terms of U&G. Regression models highlighted differences in the four platforms’ problematic use and continuance intentions. Findings are discussed within the framework of reconceptualizing U&G outcomes within the evolving social media environment.
Immersive Empathy in Digital Music Listening: Ideas and Sustainable Paths for Developing Auditory Experiences in Museums
Authors: Yi Kui , Wu Yingqi , Liu Yiying , Xu Ziqi
Published: May 2024

With the development of modern technologies, museums have been engaged in the competition for novel sensory resources. Taking into consideration the main body of visitors, their experiential representation has gradually become the focal point of the museums. However, at present, the museum display is limited to visual effect. The scientific and technological methods proposed by existing research have not really formed a deep cultural memory of historical stories, and the sustainable development paths of museums need to be further optimized. Thus, the purpose of this study is to explore the conception and path of museum auditory experience development, and to verify the existing patterns of empathy in museum auditory experience development. We set up digital music vocalization tools in the museum to temporarily create the immersion experience for digital music. In this scenario, we could meticulously observe the tourists’ experience, with the joint effect of active cognitive environment and environment-driven emotion. We also conducted a timely survey on the cognition, emotion, and experience of the observation subjects after the experiment. Last, empirical methods has been used to analyze the role of immersive empathy in enhancing visitors’ experience, in order to gain insights into visitors’ perception and cognition of the museum, integrating with the digital music. After analyzing the collected data, this study found that cognitive empathy has a significant positive impact on visitors’ experience. It indicated that for the historical stories presentation, the properly integration of museum and digital can help tourists deeply understand the historical events, which could restore the cultural connotation conveyed by the designer. Emotional empathy also has a significant positive impact on visitors’ experience. It showed that that the rendering of digital music will motivate visitors’ emotional fluctuation, during their visit to the museum. And through the combination of audio-visual effects, the constructed spatial perception, allowing visitors to enjoy immersive experience. This study proposed a vision for the development of auditory experiences in museums, based on both cognitively active immersion and emotionally passive immersion of visitors. We also suggested that in the new era, museums need to reform with voice, to timely adjust and innovate their way to exhibit cultural relics, with the hierarchical design of audiovisual integration to construct a more appealing scene and atmosphere.
Impact of Migration on Time Use Pattern of Left-Behind Male and Female in Rural Bangladesh
Authors: Uddin Md. Nadim
Published: May 2024

This study uses neoclassical labour theory to examine the association between migration and the time-spending behaviour of left behind family members by gender and the female relationship with migrated members. Using two-year panel data, this study controls the individual-level time-invariant factors to correct potential self-selection. The study finds that migration of a family member is associated with decreasing off-farm labour of both working-age females and males. Additionally, it is observed that the leisure time of working-age females increases while their work burden on domestic labour decreases. Migration also increases off-farm labour of left-behind wives when only the husbands migrate and decreases off-farm and domestic labour, and increases the leisure of left-behind mothers when only sons/daughters migrate. Thus, migration reshapes the left behind family members’ time allocation between labour and leisure with a heterogeneous impact on the wives and mothers.
Reduced Subsidence With PEEK-Titanium Composite Versus 3D Titanium Cages in a Retrospective, Self-Controlled Study in Transforaminal Lumbar Interbody Fusion
Authors: Chahlavi Ali
Published: May 2024

Study Design

Retrospective Study.

Objectives

To compare subsidence and radiographic fusion rates of titanium-surface polyetheretherketone (PEEK-Ti) and 3D-Titanium (3D-Ti) cages, implanted within the same patient concurrently, during multi-level transforaminal lumbar interbody fusions (TLIF).

Methods

Forty-eight patients were treated with both PEEK-Ti and 3D-Ti cages during 2- or 3-level TLIF and instrumented posterolateral fusion (108 spinal levels in all). Equivalent bone graft material was implanted within each patient. Radiographic analysis of CT and/or X-ray imaging was performed retrospectively for each spinal level throughout 12-month follow-up period. Fusion was defined as bridging trabecular bone and subsidence was incursion into one/both vertebral bodies >20% cage height. Outcomes were analyzed with Fisher’s exact test.

Results

At 6-months post-operative follow-up, incidence of subsidence was significantly lower for PEEK-Ti cages, with 4.8% subsidence, compared to a 27.9% subsidence rate for 3D-Ti cages ( P = .007). Fusion rates were comparable at 100% for PEEK-Ti and 95.5% for 3D-Ti. Results at 12-months showed similar but not statistically significant trends of less subsidence with PEEK-Ti than 3D-Ti cages (14.3% PEEK-Ti, 37.5% 3D-Ti), and similar fusion rates of 100% for PEEK-Ti and 91.7% for 3D-Ti. Thirty-nine out of 48 total patients were available for follow-up at 6 months and 20 patients at 12 months. CT availability at 6 and 12-months was 100% and 90%, respectively.

Conclusions

A significantly lower subsidence rate was associated with a PEEK-Ti cage, compared to 3D-Ti, 6 months after TLIF. Results may not be generalized across technologies due to differences in cage designs; additional research studies are warranted.
Head Start Children’s Dual Enrollment in State Pre-K: Prevalence and Child Outcomes
Authors: Choi Ji-Young , Betancur Laura C. , Rouse Heather L.
Published: May 2024

The current study investigated the prevalence and outcomes related to Head Start (HS) children’s dual enrollment in state-funded prekindergarten (state Pre-K) using a secondary analysis of a statewide integrated administrative dataset (N = 2,986). It also explored whether a program partnership between HS and the local school district (within the same geographic service area) was associated with HS children’s higher enrollment in Pre-K. Findings showed that over half of the children attending HS additionally participated in Pre-K. Such dual enrollment, which reflects more daily hours of center-based early care and education, predicted higher teacher-reported school readiness skills, including cognitive, language, literacy, math, physical, and social-emotional skills. The rate of HS children’s dual enrollment was higher when their HS grantee had a stronger partnership with the local school district. Our findings highlight the importance of systematic efforts to maximize the utilization of ECE-allocated resources for low-income children.
Psychometric Validation and Setting Cutoff Point for the Persian Version of Mindful Self-Care Scale (MSCS) Among Older Adults
Authors: Motamed-Jahromi Mohadeseh , Kaveh Mohammad Hossein , Nazari Far Ebrahim , Asadollahi Abdolrahim , Vitale Elsa , Parvaresh-Masoud Mohammad
Published: May 2024

Mindful self-care is a valuable activity that contributes to old people’s independence and self-control and its development is in line with the duties of social workers. This study aimed to validate the mindful self-care scale (MSCS) for Iranian old people and was performed on old people living in the community of Shiraz, Iran. This cross-sectional study was conducted on old people living in the community who met the inclusion criteria in Shiraz, Iran. After linguistic validation of the Persian version of MSCS with 36 items, face, and content validity were determined. Then the first part of construct validity was conducted using a kurtosis test, and exploratory factor analysis with the first sample ( n = 250). After selecting the appropriate items, confirmatory factor analysis was assessed with the second sample ( n = 250). Scale reliability was also evaluated. The optimal cut-off points were obtained by calculating the area under the curve (AUC). SPSS version 23 was used for further data analysis, while confirmatory factor analysis was conducted using AMOS version 24. Exploratory factor analysis loaded only 24 items with four factors. The modified second-order confirmatory factor analysis model displayed a good fit (RMSEA = 0.04; CFI = 0.90; GFI = 0.90). Cronbach’s alpha coefficient of MSCS with 24 items was .94. The cut-off points were 38, 11, 23, and 17 for factors of resilience, goal achievement, supportive relationship, and self-care respectively, and 90 for the whole instrument. The study found that the MSCS short form with 24 items is valid and reliable in the Iranian elderly population, making it an effective tool for mental self-care screening and a practical tool for social workers. However, the study recommends repeating the study in other cities of Iran to generalize the findings.
Assisted Reproduction for a Same-Sex Couple: Interdisciplinary Preclinical Active Learning Module Combining Case-Based Small Group Discussion and Patient Panel
Authors: Green Xochitl A. , Flores Tindall Kayla J. , Flores Tindall Ana L. , Anderson Hana , Hou Melody Y.
Published: May 2024

OBJECTIVE

Physicians often feel they are not equipped to serve the lesbian, gay, bisexual, and queer (LGBTQ) community, but integrating education that incorporates LGBTQ content and perspective into an already-condensed medical school curriculum is challenging. We developed a preclinical active learning module on assisted reproductive technologies (ART) in LGBTQ care, integrating clinical and basic science content with patient perspective.

METHODS

We created a module that combined a case-based small group discussion with a patient panel. We developed a case for discussion in collaboration with a female cis-gender same-sex couple who conceived through ART. A patient panel with the same couple followed the discussion. All first-year medical students attended both parts of the module. Prior to participation, students learned reproductive endocrinology and genetics concepts through lectures. After the module, students voluntarily completed an anonymous survey to evaluate self-perceived changes in familiarity and confidence with LGBTQ patients and satisfaction with the module.

RESULTS

Of the 126 students who attended, 72 (57%) completed the survey. Of these, 69 (95.8%) felt the module gave them better perspectives on LGBTQ patient experiences, and 66 to 69 (92-96%) agreed the small group discussion achieved its learning objectives on LGBTQ health barriers and the application of ART. Students valued the patient panel (84.7%) and cited a better understanding of reproductive barriers for LGBTQ patients as its most valuable point.

CONCLUSION

A preclerkship module combining a case-based small group discussion and patient panel on ART delivered in the context of a real-life LGBTQ patient experience provided an opportunity for the students to integrate basic science and clinical science knowledge to reflect on the healthcare needs of this patient population. Creating the case in collaboration with the same-sex couple and having them present their own experience provided an authentic perspective to students on reproductive healthcare issues and how they impact members of the LGBTQ community.
Fountainhead School: The Training Dilemma
Authors: Jhala Pratha , Mistry Janki
Published: May 2024

The teaching case ‘Fountainhead School: The Training Dilemma’ is a primary data case about a reputed school called Fountainhead based out of Surat offering the International Baccalaureate programme for all students from kindergarten to grade 12. The case is based on the problem of teacher turnover and goes on to touch upon various issues pertaining to human resource management. The case has a strategic focus on outcome-based human resource models. It will be useful for teaching undergraduate and graduate students of management, human resource and other social science disciplines.
Targeting Reactive Astrocytes in Vascular Dementia: Investigation of Neuronal-Astrocyte-Vascular Interactions
Authors: Sompol Pradoldej
Published: May 2024

Historically known as neuronal support cells, astrocytes are now widely studied for their close structural and functional interactions with multiple neural cell types and cerebral vessels where they maintain an ideal environment for optimized brain function. Under pathological conditions, astrocytes become reactive and lose key protective functions. In this commentary, we discuss our recent work in The Journal of Neuroscience (Sompol et al., 2023) that showed Ca2+ dysregulation in reactive astrocytes, as well as hyperactivation of the Ca2+-dependent protein phosphatase calcineurin (CN) and the Nuclear Factor of Activated T Cells (NFATs), in a diet-induced hyperhomocystienemia (HHcy) mouse model of Vascular Contributions to Cognitive Impairment and Dementia (VCID). Intravital multiphoton imaging coupled with whisker stimulation was used to explore astrocyte Ca2+ signaling and neurovascular function under active phase, fully awake conditions. Interestingly, evoked Ca2+ transients in individual astrocytes were greater, even though intercorrelated Ca2+ signaling across networks of astrocytes was impaired in HHcy mice. Blockade of astrocytic CN/NFAT reduced signs of astrocyte reactivity, normalized cerebrovascular function, and improved hippocampal synaptic strength and hippocampal dependent cognition in HHcy mice, revealing a previously unrecognized deficit regarding neuron-astrocyte-vascular interactions. These findings strongly support the use of astrocyte targeting strategies to mitigate pathophysiological changes associated with VCID and other Alzheimer’s-related dementias.
The response of the Irish pharmaceutical manufacturing sector to the COVID-19 pandemic with a focus on Lean and JIT
Authors: Howlett Michael , Niarchou Eleni , Naughton Bernard D.
Published: May 2024

Background:

Just in Time (JIT) and Lean manufacturing are concepts that originated in the automotive industry and were then adopted by pharmaceutical and biopharmaceutical companies during the 1990s. However, the Covid-19 pandemic and the urgent demand for pharmaceutical treatment challenged JIT and Lean manufacturing processes. Production of Covid-19-related medicines increased, putting pressure on global supply chains and operations. This also hindered the production of medicines using the same or similar materials. Thus, questions are raised concerning JIT and Lean supply chains in the pharmaceutical industry.

Objectives:

The present study aimed to explore (1) if material and supply constraints occurred due to the Covid-19 pandemic, (2) how companies were impacted and managed and (3) if changes are required to future proof the JIT supply chain approach for future global events.

Design:

A mixed-method cross-sectional survey design was used and focused on material supply, qualification and validation in Irish pharmaceutical manufacturing sites.

Methods:

Employees working in the Irish pharmaceutical manufacturing industry were recruited using convenience sampling through online advertisement using the social media platform ‘LinkedIn’. Quantitative data was analysed using percentages and qualitative data from free-text responses were used to add context to the quantitative survey questions.

Results:

A total of 41 participants were recruited. The results suggested that the pandemic had a negative effect on material availability according to 81% of participants. This translated to delays or stoppage of production activity and was mainly handled by sourcing new materials (70%). To cope with future global crises, 60% of participants recommended more flexibility in future validation processes while 78% of participants acknowledged the importance of validating additional suppliers. A hybrid model of manufacturing and supply chain management was also a preferred approach to exclusive Lean and JIT (42%).

Conclusions:

The production of non-Covid-19 medicines was adversely affected by the Covid-19 pandemic, but the pharmaceutical industry in Ireland demonstrated resilience and collaboration in response to these challenges. This study suggests that the JIT and Lean manufacturing model should be adjusted to ensure medicine supply chains are not disrupted during future global events.
Physiologically based trimester-specific serum ferritin thresholds for iron deficiency in US pregnant women
Authors: Mei Zuguo , Addo O. Yaw , Jefferds Maria Elena D. , Flores-Ayala Rafael C. , Brittenham Gary M.
Published: May 2024

Serum ferritin (SF) concentration is the most widely used indicator for iron deficiency (ID). During pregnancy, the World Health Organization recently recommended SF thresholds for ID of <15 μg/L for the first trimester of pregnancy, based on expert opinion, and made no recommendations for the second and third trimesters. We examined the relationship of SF with 2 independent indicators of the onset of iron-deficient erythropoiesis, hemoglobin and soluble transferrin receptor 1, in cross-sectional data from US National Health and Nutrition Examination Survey for 1999 to 2010 and 2015 to 2018. We included 1288 pregnant women aged 15 to 49 years and excluded women with inflammation or potential liver disease. We used restricted cubic spline (RCS) regression analysis to determine SF thresholds for iron-deficient erythropoiesis. SF decreased during pregnancy; geometric mean SF was higher during the first and lower during the second and third trimesters. Using RCS analysis, the SF thresholds identified during pregnancy were <25.8 μg/L (18.1-28.5) during first trimester, <18.3 μg/L (16.3-22.9) during second trimester, and <19.0 μg/L (14.4- 26.1) during third trimester. These SF threshold levels track concentrations of hepcidin, the iron-regulatory hormone controlling the mobilization of iron stores. An SF concentration of <15 μg/L as the criterion for ID may underestimate the true prevalence of ID throughout pregnancy. In our study, an additional 1 of every 10 pregnant women would be recognized as iron deficient by using the physiologically based thresholds at SF of ∼25 μg/L during the first and ∼20 μg/L during the second and third trimesters.
MERTK in the rat trigeminal system: a potential novel target for cluster headache?
Authors: Edvinsson Jacob C. A. , Ran Caroline , Olofsgård Felicia Jennysdotter , Steinberg Anna , Edvinsson Lars , Belin Andrea Carmine
Published: May 2024

The trigeminal system is key to the pathophysiology of migraine and cluster headache, two primary headache disorders that share many features. Recently, MER proto-oncogene tyrosine kinase (MERTK), a cell surface receptor, was strongly associated with cluster headache through genetic studies. Further, the MERTK ligand galectin-3 has been found to be elevated in serum of migraine patients. In this study, MERTK and MERTK ligands were investigated in key tissue to better understand their potential implication in the pathophysiology of primary headache disorders. Immunohistochemistry was used to map MERTK and galectin-3 expression in rat trigeminal ganglia. RT-qPCR was used to assess MERTK gene expression in blood, and ELISA immunoassays were used for MERTK ligand quantification in serum from study participants with and without cluster headache. MERTK gene expression was elevated in blood samples from study participants with cluster headache compared to controls. In addition, MERTK ligand galectin-3 was found at increased concentration in the serum of study participants with cluster headache, whereas the levels of MERTK ligands growth arrest specific 6 and protein S unaffected. MERTK and galectin-3 were both expressed in rat trigeminal ganglia. Galectin-3 was primarily localized in smaller neurons and to a lesser extent in C-fibres, while MERTK was found in satellite glia cells and in the outer membrane of Schwann cells. Interestingly, a strong MERTK signal was found specifically in the region proximal to the nodes of Ranvier. The overexpression of MERTK and galectin-3 in tissue from study participants with cluster headache, as well as the presence of MERTK in rat peripheral satellite glia cells and Schwann cells in the trigeminal ganglia, further highlights MERTK signalling as an interesting potential future therapeutic target in primary headache.

Graphical Abstract