bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of international food tourists’ food experiences on place attachment and behavioral intentions: The moderating role of food variety seeking tendency
Authors: Akoğul Emre , Selçuk Gökalp N.
Published: February 2024

This study aims to develop a framework for determining the underpinning factors behind international food tourists’ intentions for food-based visit behavior. Specifically, by engaging food tourists in a systematic study, this study investigates the direct and indirect predictive effects of food tourist local food experiences (LFEs), perceptions of experiential value (EV), and satisfaction with food experiences on place attachment (PA) and behavioral intentions (BIs). Data were collected using a questionnaire from 451 food tourists who participated in a food tour for a day or longer in Istanbul. Structural equation modeling was used to test the proposed model. The findings demonstrate that LFE significantly influences EV, PA and satisfaction (SAS). Second, EV, PA and SAS were found to be significant predictors of BI. Third, food variety seeking (VARSEEK) was found to have a moderating effect between LFE and PA while weakening tourist PA. The study provides new insights into tourist dining experiences and offers a number of recommendations for destination managers and stakeholders to enrich tourist experiences.
The Danish Health Survey among Marginalized People: Study design and respondent characteristics
Authors: Nilou Freja E. , Christoffersen Nanna B. , Pedersen Pia V. , Ekholm Ola , Ahlmark Nanna G.
Published: February 2024

Aim:

The Danish Health Survey among Marginalized People is a nationwide health survey targeting people in marginalized life situations in Denmark. The aim of this paper is to present the study design, data collection methods and respondent characteristics of the survey, which was conducted in 2007, 2012, 2017 and 2022.

Methods:

The survey applies an outreach data collection approach which entails reaching out to social services (public and private) asking for their help with distributing self-administered paper questionnaires among their users. Themes include self-rated health, mental health, morbidity, pain, oral health, health behaviours, gambling problems, social relations, violence, sexual harassment and assault, suicide, and source of income.

Results:

The overall number of respondents has decreased slightly from 2007 (1290) to 2022 (1134). In all survey waves, men were overrepresented among the respondents. In 2007, women represented only 28%, which increased to 37% in 2022. There have been remarkable changes in the age distribution among respondents between 2007 and 2022. For example, the oldest age group (55–80 years) accounted for 15% of the respondents in 2007 and 40% in 2022.

Conclusions:

Conducting surveys among marginalized people entails methodological challenges and ethical considerations. However, continually attempting to reach marginalized people in surveys by tailoring data collection strategies to their specific life situation is essential to gain insight into their health and well-being.
Policing social media: Are procedural justice principles guiding Canadian police interactions online?
Authors: Zaidi Huda , O’Connor Christopher D
Published: February 2024

Police presence on social media has become increasingly common in recent years and has arguably altered policing in many ways. Although research in this area is increasing, the growing presence of police on a range of social media platforms requires further examination of the various nuances that continue to emerge regarding this symbiosis. To that end, only a small number of studies have examined this topic from the perspective of police personnel in the Canadian context. Accordingly, drawing on in-depth interviews with police personnel overseeing police social media sites, this article examines how Canadian police services manage negativity and conflict online. The findings suggest that police services address negativity and conflict on their social media sites by drawing on the principles of procedural justice to guide their interactions. We discuss the implications of these findings and how police–public social media interactions might be improved.
A timely efficient and emissions-aware multiobjective truck-sharing integrated scheduling model in container terminals
Authors: Fereidoonian Farnaz , Sadjadi Seyed Jafar , Heydari Mahdi , Mirzapour Al-e-Hashem Seyed Mohammad Javad
Published: February 2024

In line with the development of green port terminals and the necessity of environmentally friendly efficient use of handling and transportation equipment, criteria such as emission reduction, energy minimization, and efficiency in a container terminal are prominent issues, which in recent years, have been the main concern of container terminal managers in developing terminal operating systems. Therefore, in this study, a bi-objective mixed integer mathematical programing model of integrated scheduling for ships’ loading and unloading operation sequencing in container terminals is proposed, which considers the minimization of containers’ flow time, trucks’ emission, and energy consumption as well as sharing trucks among quay cranes and decreasing their empty trips. In this model trucks’ technical specifications and polluting levels are input parameters for estimating emission and energy consumption of operation, which consequently leads to two uniform parallel machine scheduling models. To derive the exact solution of the model, the epsilon-constraint method is applied. Nevertheless, due to the problem’s NP-hardness attribute, two variants of non-dominated sorting genetic algorithm and multiobjective particle swarm optimization metaheuristic algorithms are proposed to identify the approximate Pareto front of solutions. In large-size problems, these algorithms outperform the epsilon-constraint method by finding acceptable results in a reasonable time. This model, which could be embedded in terminal operating software, not only yields a practical optimum operational sequence but also measures the amount of energy and emission from trucks during loading and unloading operations. The results, which utilized the data collected from Shahid Rajaee port in southern Iran, indicate that this practical model as compared to the current procedure in the terminal, results in a significant improvement in energy and emission reduction and terminal flow time.
How to Omit the Potential Pitfalls in Distal Radial Access: Lessons From Cadaveric and CTA Analysis
Authors: Wang Ping , Shan Yuezhan , Xiao Benshan , Zhang Xiang , Hou Jianfei , Cui Ni , Cao Xianglong , Cheng Kailiang
Published: February 2024

Objectives:

To verify the anatomical basis, ideal puncture sites, and potential pitfalls of the distal radial artery (dRA) in the anatomical snuffbox region for distal radial access (dTRA).

Materials and Methods:

Overall, 26 formalin-fixed upper limbs and computed tomography angiography (CTA) of the upper limbs of 168 consecutive patients were studied. Cadaveric dissection and dRA 3D reconstruction were used to evaluate the dRA route for dTRA. The puncture sites, dRA diameter, and angle of the dRA and tendons of the extensor pollicis brevis were also measured in the patients and cadavers.

Results:

The cadaver dissection provided more insights than did the dRA 3D reconstruction. However, preoperative evaluation had better diagnostic accuracy (p=0.024). Puncture sites 1 and 3 had a high success rate (63.2% possible success rate, 191/302). The DISFAVOR theory was put forward, in which 8 types of potential pitfalls that may interrupt puncture procedure or lead to a surgical failure were observed, including occlusion, stenosis, tortuosity, arteriovenous fistula, angioma, different radial artery (RA) ramifications, radial veins, and cephalic veins. The mean diameter of dRA based on cadaver dissection and CTA was 2.53 (SD=0.73) and 2.63 (SD=0.69) mm, respectively. Furthermore, the minimum distance from the outer layer of dRA to the skin was 5.71 (SD=2.0) mm based on CTA. The angle between the dRA and tendons of extensor pollicis brevis (TEPB) based on cadaver dissection and CTA was 58.0° (SD=21.5°) and 51.8° (SD=16.6°), respectively.

Conclusions:

Puncture sites 1 and 3 were more suitable for the dTRA, and we put forward the DISFAVOR theory to summarize the 8 types of potential pitfalls during the use of dTRA.
Extracellular Vesicles Obtained From Lung Adenocarcinoma Cells Cultured Under Intermittent Hypoxia Induce M2 Macrophage Polarization via miR-20a-5p Delivery
Authors: Liu Yuanling , Lu Minzhen , Liu Feng , Xu Gang , Feng Congrui , Chen Yuluo , Cai Danyan , Sun Huake , Zeng Yanjun , Xie Jian , Ma Wei , Gao Xinglin
Published: February 2024

Introduction: Intermittent hypoxia (IH), an important feature of obstructive sleep apnea, enhances the function of lung cancer cell-derived extracellular vesicles (EVs) to exacerbate the immunosuppressive properties of macrophages. Herein, we investigated the effects of EVs obtained from lung adenocarcinoma cells cultured under IH on macrophage polarization. Methods: The M1-type and M2-type tumor-associated macrophages (TAMs) in tissues from lung adenocarcinoma cases with (n = 10) or without (n = 12) OSA were assessed by immunohistochemical studies. EVs obtained from A549 cells grown under normoxia (EV-NA) or IH (EV-IH) were isolated and cocultured with macrophages. MicroRNA sequencing was used to determine discrepant miRNAs in EVs, selecting miR-20a-5p for subsequent experiments. Next, reverse transcription-quantitative polymerase chain reaction, flow cytometry, luciferase reporter assay, western blotting assay, and gain- and loss-of-function assays were used to explore the mechanism by which miR-20a-5p promotes M2 macrophage polarization by targeting phosphatase and Tensin homolog gene (PTEN). Results: Stromal M2 TAMs were highly abundant in patients with lung adenocarcinoma and obstructive sleep apnea. Macrophages treated with EV-IH that highly expressed miR-20a-5p showed the M2 phenotype. Luciferase reporter assay confirmed PTEN as a target of miR-20a-5p. Transfection of miR-20a-5p mimics decreased PTEN expression, upregulated M2 polarization markers, and promoted Akt phosphorylation in macrophages, while transfection with a miR-20a-5p inhibitor had the opposite effects. Furthermore, miR-20a-5p inhibition in macrophages eliminated the PTEN downregulation, Akt phosphorylation, and upregulation of M2 polarization markers induced by EV-IH transfection.

Conclusion: These findings indicate that EVs obtained from lung adenocarcinoma cells cultured under IH deliver miR-20a-5p to promote M2 macrophage polarization by targeting PTEN.
Dexterity in the Acute Phase of Stroke: Impairments and Neural Substrates
Authors: Gerardin Eloïse , Regnier Maxime , Dricot Laurence , Lambert Julien , van Ravestyn Coralie , De Coene Béatrice , Bihin Benoît , Lindberg Påvel , Vandermeeren Yves
Published: February 2024

Background

Stroke can impair manual dexterity, leading to loss of independence following incomplete recovery. Enhancing our understanding of dexterity impairment may improve neurorehabilitation.

Objectives

The study aimed to measure dexterity components in acute stroke patients with and without hand motor deficits, compare them to those of healthy controls (HC), and to explore the neural substrates involved in specific components of dexterity.

Methods

We used the Dextrain Manipulandum to quantify fine finger force control, finger selection accuracy, coactivation, and reaction time (RT). Dexterity was evaluated twice (2 days apart) in 74 patients and 14 HC. Voxel-Lesion-Symptom-Mapping (VLSM) was used to analyze the relationship between tissue damage and dexterity. Results. Due to severe paresis or fatigue, 24 patients could not perform these tasks. In 50 patients (included 4.6 ± 3.3 days post-stroke), finger force control improved ( P < .001), as it did in HC ( P = .03) who performed better than patients on both evaluations. Accuracy of finger selection did not improve significantly in any group, but the HC performed better on both evaluations. Unexpectedly, coactivation was better in patients than in HC at D3 ( P = .03). There were no between-group differences in RT. VLSM showed that damage to the superior temporal gyrus (STG) impaired finger force control while damage to the posterior limb of the internal capsule (PLIC) impaired finger selectivity.

Conclusions

Acute stroke affecting the STG or PLIC impaired selective components of dexterity. Patients with mild to moderate impairment showed better finger force control and accuracy selection within 48 hours, suggesting the feasibility of detecting early dexterity improvements.
Unveiling the Cumulative Impact: Major Sports Events as Catalysts for the Construction of Sport City in China
Authors: Zhang Yongtao , Wang Mingtao , Zhao Xi , Wang Mengkai , Wang Hong
Published: February 2024

Employing a grounded theory approach, this study conducts interviews with 30 scholars and government officials actively involved in extensive study and practical endeavors within the domains of Sport City and sports events. The inquiry aims to elucidate the factors driving the promotion of the construction of Sport City facilitated by hosting major sports events. The results indicate that major sports events demonstrate a “cumulative effect” in fostering the construction of Sport City. Influential factors encompass the function of Sport City, the economy of Sport City, the resident well-being of Sport City, and the soft power of Sport City. Furthermore, the promotional influence of hosting major sports events on one facet of Sport City positively impacts the development of other facets.
Transformations towards an integrated leadership development system—A longitudinal study in a high-performing public organization
Authors: Fabisch Anna , Kjellström Sofia , Ockander Marlene , Avby Gunilla
Published: February 2024

Leadership development (LD) plays a significant role in achieving high-quality performance and business results, but there is little research on how leadership development itself evolves as the organization develops. This study explores how a leadership development system evolved over 30 years, during a time when the organization became increasingly high performing. Through reflexive thematic analysis of organizational documents and interviews with top managers and practitioners, the study provides a rich longitudinal description of the evolvement. The results revealed three pervasive changes of the leadership development system: 1) from a system for business-specific learning to one for system-wide learning; 2) from a system for personal development to one for customer-oriented quality development; and 3) from a leadership development system consisting of leadership development programs to one that is integrated into regular meetings and uses simple rules. These changes supported the gradual transformation of the leadership development from being independent to becoming integrated in the wider system, supporting the business system. The findings offer a unique insight into how an organization transitioned from individual leader development towards promoting collective aspects of leadership development. The study provides two main theoretical contributions that support the perspective of viewing leadership development as integrated within organizational development. Firstly, we present a more multifaceted way of understanding leadership development, wherein managers and employees, customer outcomes, and business advancement are seen as mutually developing. Secondly, we introduce two new critical points that complement previous descriptions of an advanced leadership development system: It is system wide (not only business specific) and customer oriented (not only leader/participant oriented).
The use of procedural kits may reduce unscheduled central line dressing changes: A matched pre–post intervention study
Authors: Bahl Amit , Mielke Nicholas , Gibson Steven Matthew , George Julie
Published: February 2024

Background

Unscheduled dressing changes for central venous lines (CVLs) have been shown to increase the risk of bloodstream infections.

Objective

The objective of this study is to determine if the use of an innovative dressing change kit reduces the rate of unscheduled dressing changes.

Methods

This pre–post interventional study took place at a large, academic, tertiary care center in metro Detroit, Michigan, the United States. We assessed the impact of the interventional dressing change procedure kit on the rate of unscheduled dressing changes for adult patients who underwent placement of a CVL inclusive of a central catheter, peripherally inserted central catheter, or hemodialysis catheter. Data was collected for the pre-intervention cohort through electronic health records (EHRs), while data for the post-intervention cohort were collected by direct observation by trained research staff in combination with EHR data. The primary outcome was the rate of unscheduled dressing changes. Secondary outcomes included rate of unscheduled dressing changes based on admission floor type, etiology of unscheduled dressing changes, and central line-associated bloodstream infections (CLABSIs).

Results

The study included a convenience sample of 1548 CVLs placed between May 2018 and June 2022 with a matched analysis including 488 catheters in each of the pre- and post-intervention groups. The results showed that the unadjusted rate of unscheduled dressing evaluations was significantly reduced from the pre-intervention group (0.21 per day) to the post-intervention group (0.13 per day) ( p < .001). The adjusted rate ratio demonstrated the same trend at 1.00 pre- and 0.60 post-intervention ( p < .001). Stratifying the analysis based on the highest level of care showed that the intervention was effective in reducing the unadjusted rate of unscheduled dressing evaluations for both the advanced and regular medical floor subgroups pre- to post-intervention; the advanced subgroup had an reduction from 0.22 to 0.15 per day ( p = .001), while the regular medical floor subgroup had a reduction from 0.21 to 0.09 per day ( p < .001). CLABSIs were similar in both groups (0.6% vs 0.8%; p = 1.00) in pre- and post-intervention groups, respectively.

Discussion

Procedural kits for central line dressing changes are effective in reducing unscheduled dressing changes and may have a role in reducing CLABSI. Further studies assessing the impact of dressing change kits on cost, procedural compliance, and the precise impact on CLABSI are needed.
Management and subsequent outcomes of patellar sleeve injuries: A retrospective case series of 90 pediatric and adolescent patients
Authors: Yellin Joseph L , Feroe Aliya G , Watkins Ian T , Franco Helena , Guevel Borna , Haber Daniel B , Kocher Mininder S
Published: February 2024

Purpose:

This study aims to report the epidemiology of patellar sleeve injuries, describe diagnostic findings and treatment, and assess functional outcomes following different treatments.

Methods:

A medical database was queried from 1990 to 2016 to identify patients ≤18 years presenting to a single pediatric institution with a patellar sleeve injury. Patients with significant comorbidities or previously operatively treated for ipsilateral knee injuries were excluded. Standard demographic data, mechanism of injury, skeletal maturity, injury-related radiographic parameters, along with treatment paradigms, post-treatment clinical and radiographic findings, and patient-reported outcomes were collected.

Results:

A total of 90 patients, mean age of 10.7 years (range: 7–17) was included, of which 69 (77%) were male. Seventy-three percent of all injuries occurred while playing sports (particularly football/basketball/soccer), with “direct blow” or “landing” being the most prevalent mechanisms of injury. Twenty-six (29%) underwent operative treatment, with transosseous suture fixation being the most popular surgical technique (73%). Of the 64 (71%) non-operatively treated patients, 18 (39%) were placed in a hinged knee brace locked in extension with the remainder split between casting and standard knee immobilizer. Compared to the non-operative cohort, a higher percentage of the operative group had a pre-treatment extensor lag (p < 0.001) and greater fragment displacement (p < 0.001) with patella alta (p < 0.001) on imaging. There was no difference in outcome scores (Pedi-IKDC/Lysholm) or patella alta on radiographs between groups. Post-treatment surveys indicated no difference in residual pain or ability to return to sport.

Conclusion:

This large case series provides valuable epidemiologic, clinical, and radiographic data describing patellar sleeve fractures, along with outcomes following non-operative and operative treatments.

Level of evidence:

IV.
Comparability Evaluation of Three Benchtop Glucose Analyzers With the Recently Withdrawn YSI 2300 Stat Plus
Authors: Dunseath Gareth J. , Vatavu Iulius-Dumitru , Luzio Stephen D.
Published: February 2024

Background:

We compared the performance of three currently available laboratory benchtop glucose analyzers with the outgoing YSI 2300 Stat Plus.

Methods:

Plasma samples (100), across a wide glucose concentration range were analysed on the YSI 2500, Randox daytona+ (glucose oxidase) and EKF Biosen in a single laboratory and compared to the YSI 2300 Stat Plus.

Results:

All three analyzers showed good agreement with the YSI 2300 Stat Plus, and only a small bias (≤1% YSI 2500 and Randox daytona+, 4.6% EKF Biosen) was observed for each analyzer. None of the three comparator analyzers were affected by either proportional or constant bias, thus no significant differences between the YSI 2300 Stat Plus and the comparator methods were identified.

Conclusions:

The results from this study suggest all could be considered as suitable reference laboratory glucose analyzers and replacements for the recently withdrawn YSI 2300 Stat Plus.
A case report: Management of carbamazepine intoxication using hemodialysis followed by continuous venovenous hemodialysis
Authors: Abdullah-Koolmees Heshu , Mekel Vivian CC , I Veldkamp Agnes , Caris Martine G , Swart Eleonora L
Published: February 2024

An 18-year-old woman presented to the emergency department. She had ingested 43 extended-release tablets of carbamazepine 400 mg. Although the patient had high carbamazepine plasma levels and classified as severe intoxication, her clinical symptoms were less severe than expected. With the combination of hemodialysis and continuous venovenous hemodialysis in addition to usual care, including multiple-dose activated charcoal, a fast decrease (within 3 days) in carbamazepine plasma levels to levels in the therapeutic range was achieved. Only one session of hemodialysis was performed because the clinical status of the patient stabilized. In retrospect, the patient did not suffer severe toxicological symptoms from carbamazepine. Therefore, continuous venovenous hemodialysis could have been discontinued earlier. On the other hand, the fast decrease in carbamazepine plasma levels during extracorporeal treatment may have prevented the development of severe or rebound toxicological symptoms. This case report adds evidence to the successful management of carbamazepine intoxication using hemodialysis followed by continuous venovenous hemodialysis.
Bone metastasis manifested 52 years after resection of an apparently benign paraganglioma: A case report
Authors: Yu Run , Auerbach Martin S , Honda Nathan S
Published: February 2024

Paraganglioma is derived from the paraganglia tissue in the neck, along the sympathetic trunk, and in the pelvis. Paraganglioma has malignant potential and can metastasize to remote organs such as the liver, lungs, and bones. Most metachronous metastases occur within several years after the initial diagnosis of paraganglioma. Here, we report the case of a 71-year-old male patient who developed bony metastasis 52 years after the resection of a large paraganglioma at the aortic bifurcation. The biopsy-proven paraganglioma metastasis to the lesser trochanter of left femur presented as an avulsion fracture. His normetanephrine level was elevated. DOTATATE PET (positron emission tomography) did not find any other metastatic lesions. The bony metastasis was treated with radiation therapy. We believe that the patient had one of the longest gaps ever reported, 52 years, between the initial diagnosis and metastasis of paraganglioma. This case highlights the importance of long-term surveillance of patients with paraganglioma for metastasis.
Qur’ānic Intertextuality in Early Christian Arabic Bible Translations
Authors: Hjälm Miriam L.
Published: February 2024

This paper provides a number of cases where early Christian Arabic Bible translators resorted to qur’ānic-sounding language and (later) also a qur’ānic aesthetic in their production of biblical codices. The main purpose of the paper is to discuss various reasons as to why they went so far into the “realm of the other” when producing these translations. The answer to that question is most likely connected to the little-known function of these Bible translations, a topic also addressed in the paper. The adoption of qur’ānic language results in a comparatively high level of intertextuality and the use of codicological features associated with Mamluk Qur’āns also tend to blur religious borders. Thus, the paper also explores the possibility to view a portion of the Christian Arabic Bible endeavour as part of the broader process of “religious co-production.”
Bible Translations for Turkish-Speaking Muslims: Contemporary Considerations
Authors: Akkuş Hasan H. , Richardson Bill T.
Published: February 2024

This article first evaluates the social structure of Turkish-speaking communities, the traumatic experiences they have faced, and the latest trends as of 2023. Societal changes in Turkey and their effects on vocabulary are outlined. The reactions of people to these changes are evaluated in light of the historical background in Turkey. The article goes on to give a brief summary of Bible translations into Turkish from 1665 to 2023. After that, the opinions of Muslim scholars about current Bible translations are evaluated. In addition, fifteen Turkish-speaking Muslims were surveyed to understand their preferences and criticisms about current translations. Based on input from emerging groups of Muslims who accept the Bible as a sacred text in addition to the Qur’ān, the article presents a series of suggestions about how to improve Bible translations for Turkish-speaking Muslim readers.
Differences in risk of generalized anxiety disorder according to physical activity type in Korea adolescents: The Korea youth risk behavior web-based survey, 2020–2021
Authors: Shin Jhinyi , Lee Kihyuk
Published: February 2024

Objective

This study aimed to analyze the association between the types of physical activity (PA) and the level of generalized anxiety disorder (GAD) in Korean adolescents.

Methods

This study analyzed data from the Korea Youth Risk Behavior Web-based Survey (KYRBS) for, 2020–2021. The dependent variable was the level of generalized anxiety disorder-7 (GAD-7). The GAD-7 scores were divided into four levels: normal, mild, moderate, and severe. The independent variables were moderate PA, vigorous PA, and strength exercises. Sex, school grade, body mass index, stress, depression, suicidal thoughts, violent victimization, drinking, smoking, substance abuse, sleep satisfaction, and sedentary time were selected as confounding variables.

Results

The independent variable and all confounding variables showed significant differences with the level of GAD-7 (all p < .001). After adjusting for all confounding variables, we observed a 1.062 elevation in mild anxiety disorders, a 1.147 increase in moderate anxiety disorders, and a 1.218 increased incidence of severe anxiety disorders in the absence of vigorous PA. In the absence of strength exercises, there was a 1.057 elevation in mild anxiety disorders, a 1.110 increase in moderate anxiety disorders, and a 1.351 increased incidence of severe anxiety disorders. However, in the case of moderate PA, after adjusting for confounding variables, there was no significant association with GAD-7 levels.

Conclusion

To prevent anxiety disorders among Korean adolescents, the type of PA should be considered. Vigorous PA or strength exercises may help prevent GAD in Korean adolescents.
Literary Associations and Language Activism: Reading the Past and Present Motivations of Asam Sahitya Sabha
Authors: Dhar Ivy
Published: February 2024

In the early decades of the twentieth century in colonial Assam, the standardisation of language, the expansion of regional literature and literary circles, and the challenges arising for linguistic communities led to the formation of Asam Sahitya Sabha (ASS) that intended to work for the advancement of Assamese language in the interest of the public. Implicit in its model of association was the notion of collective identity that gradually set the pace for assertions. The ASS’s motivations cannot be discussed in isolation. The historical junctures of colonial India must be taken into account that had set the stage for revolutionising the literary spaces. This article has two key aims, first to discuss the events of ASS’s activism during the colonial and post-independence periods and observe the relevant transitions. Second, to look at the mobilisation agendas pursued by the ASS in contemporary times and whether there are alternative inspirations. To place the key issues of the present, the insights from ASS members, who were interviewed, are included. Overall, this article looks at the associational form of the language assertion in Assam, years earlier and the roles adopted with the changing times.
Association Between Social Media Activity and Ratings on Physician Review Websites Among Orthopaedic Surgeons With an Active Online Media Presence
Authors: Kerzner Benjamin , Dasari Suhas P. , Swindell Hasani W. , Obioha Obianuju A. , Khan Zeeshan A. , Rea Parker M. , Fortier Luc M. , Haynes Monique S. , Chahla Jorge
Published: February 2024

Background:

Social media has the potential to play a substantial role in the decision-making of patients when choosing a physician for care.

Purpose:

The purpose of this study was to determine whether an association exists between physician social media activity and patient satisfaction ratings on physician review websites (PRWs) as well as number of reviews. It was hypothesized that there would be a significant association between physician social media utilization and patient satisfaction ratings.

Study Design:

Cross-sectional study.

Methods:

The American Orthopaedic Society for Sports Medicine database was queried for the complete membership list. The online media profile and level of activity of the members were evaluated, and an online media presence score was calculated. The surgeons with the approximately top 10% of online media presence scores were compiled to assess the relationship between social media usage (Twitter, Instagram, YouTube, and Facebook) and patient satisfaction ratings on the Google Reviews, Healthgrades, and Vitals PRWs. Bivariate analysis was performed to compare demographic variables and level of online presence.

Results:

A total of 325 surgeons were included in the analysis. The most common platform used was Facebook (88.3%). There was no significant relationship between active social media use and overall ratings on any of the PRWs. Active Twitter use was associated with a greater number of ratings on all review websites, a greater number of comments on Google Reviews and Healthgrades, and shorter patient-reported clinic wait times on Healthgrades. Active Instagram use was associated with a greater number of comments on Vitals. No relationships were observed for YouTube or Facebook.

Conclusion:

For the included sports medicine surgeons who were most active on social media, no significant relationships were found between social media use and overall ratings on PRWs. Of all the platforms assessed, active use of Twitter was the only significant predictor of more reviews on PRWs. Thus, when deciding which form of social media engagement to prioritize in building one's practice, Twitter may serve as a relatively low-demand, high-reward option.
An equivalent point-source stochastic model of the NGA-East ground-motion models
Authors: Pezeshk Shahram , Assadollahi Christie , Zandieh Arash
Published: February 2024

The main objective of this study is to estimate seismological parameters in Central and Eastern North America (CENA), including the geometrical spreading, anelastic attenuation, stress parameter, and site attenuation parameters. In this study, we use particle swarm optimization (PSO) to invert a weighted average of the median 5%-damped pseudo-spectral acceleration (PSA) predicted from the Next Generation Attenuation-East (NGA-East) ground-motion models (GMMs) to develop a point-source stochastic GMM with a well-constrained set of ground-motion parameters. Magnitude-specific inversions are performed for moment magnitude ranges M = 4.0–8.0, rupture distances Rrup = 1–1000 km, and periods T = 0.01–10 s, and National Earthquake Hazard Reduction Program site class A conditions. The result of this study yields a single stochastic GMM that yields PSA values similar to the median NGA-East GMMs. The parameters derived from this study can be used for the hybrid empirical method (HEM) applications. This study is the first to perform a formal inversion using the GMMs developed for the NGA-East project. The approach has been validated using simulated small-to-moderate magnitude and large-magnitude data derived from the NGA-West2 GMMs.
Cluster analysis to identify long COVID phenotypes using129Xe magnetic resonance imaging: a multicentre evaluation
Authors: Eddy Rachel L. , Mummy David , Zhang Shuo , Dai Haoran , Bechtel Aryil , Schmidt Alexandra , Frizzell Bradie , Gerayeli Firoozeh V. , Leipsic Jonathon A. , Leung Janice M. , Driehuys Bastiaan , Que Loretta G. , Castro Mario , Sin Don D. , Niedbalski Peter J.
Published: February 2024

Background

Long COVID impacts ∼10% of people diagnosed with coronavirus disease 2019 (COVID-19), yet the pathophysiology driving ongoing symptoms is poorly understood. We hypothesised that129Xe magnetic resonance imaging (MRI) could identify unique pulmonary phenotypic subgroups of long COVID. Therefore, we evaluated ventilation and gas exchange measurements with cluster analysis to generate imaging-based phenotypes.

Methods

COVID-negative controls and participants who previously tested positive for COVID-19 underwent129Xe MRI ∼14 months post-acute infection across three centres. Long COVID was defined as persistent dyspnoea, chest tightness, cough, fatigue, nausea and/or loss of taste/smell at MRI; participants reporting no symptoms were considered fully recovered.129Xe MRI ventilation defect percent (VDP) and membrane-to-gas (Mem/Gas), red blood cell-to-membrane (RBC/Mem) and red blood cell-to-gas (RBC/Gas) ratios were used in k-means clustering for long COVID, and measurements were compared using ANOVA with post-hoc Bonferroni correction.

Results

We evaluated 135 participants across three centres: 28 COVID-negative (mean±sdage 40±16 years), 34 fully recovered (42±14 years) and 73 long COVID (49±13 years). RBC/Mem (p=0.03) and forced expiratory volume in 1 s (FEV1) (p=0.04) were different between long COVID and COVID-negative; FEV1and all other pulmonary function tests (PFTs) were within normal ranges. Four unique long COVID clusters were identified compared with recovered and COVID-negative. Cluster 1 was the youngest with normal MRI and mild gas trapping; Cluster 2 was the oldest, characterised by reduced RBC/Mem but normal PFTs; Cluster 3 had mildly increased Mem/Gas with normal PFTs; and Cluster 4 had markedly increased Mem/Gas with concomitant reduction in RBC/Mem and restrictive PFT pattern.

Conclusions

We identified four129Xe MRI long COVID phenotypes with distinct characteristics.129Xe MRI can dissect pathophysiological heterogeneity of long COVID to enable personalised patient care.
Changes in the physical and affective dimensions of dyspnoea after a home-based pulmonary rehabilitation in fibrotic idiopathic interstitial pneumonias
Authors: Chenivesse C�cile , Gephine Sarah , Dornbierer Martin , Valentin Victor , Le Rouzic Olivier , W�meau Lidwine , Grosbois Jean-Marie
Published: February 2024

Background

Our objective was to evaluate the short-, medium- and long-term benefits of home-based pulmonary rehabilitation (PR) on the physical and affective components of dyspnoea in people with fibrotic idiopathic interstitial pneumonias (f-IIPs). Anxiety and depressive symptoms, fatigue, health-related quality of life and exercise tolerance were also assessed.

Methods

Data on 166 individuals with f-IIPs who enrolled in an 8-week home-based PR programme (weekly supervised 90-min session) were retrospectively analysed. Assessments included the Dyspnoea-12 (D-12) questionnaire, Hospital Anxiety and Depression Scale, Fatigue Assessment Scale, Visual Simplified Respiratory Questionnaire and 6-min stepper test, and were performed at home at short, medium (6 months) and long (12 months) term.

Results

Among the 166 individuals with f-IIPs who enrolled in PR, 75 (45%) and 91 (55%) participants had a diagnosis of idiopathic pulmonary fibrosis and fibrosing non-specific interstitial pneumonia, respectively, and 87 (52%) participants concluded a full year of follow-up. In the total group, both physical and affective components of dyspnoea were improved, at short, medium and long term, after PR. Overall, half of the participants reached the minimally important difference of 3 points of the D-12 questionnaire at the end of PR, and at the 6- and 12-month follow-ups. Anxiety and depressive symptoms, fatigue and health-related quality of life were also improved, while the short-term benefits in exercise tolerance were not maintained 1 year after PR.

Conclusion

An individualised home-based PR programme resulted in short-, medium- and long-term improvements in both physical and affective components of dyspnoea assessed by the D-12 questionnaire.
Multimodal Biomedical Image Segmentation using Multi-Dimensional U-Convolutional Neural Network
Authors: Srinivasan Saravanan , Durairaju Kirubha , Deeba K. , Mathivanan Sandeep Kumar , Karthikeyan P. , Shah Mohd Asif
Published: February 2024

Deep learning recently achieved advancement in the segmentation of medical images. In this regard, U-Net is the most predominant deep neural network, and its architecture is the most prevalent in the medical imaging society. Experiments conducted on difficult datasets directed us to the conclusion that the traditional U-Net framework appears to be deficient in certain respects, despite its overall excellence in segmenting multimodal medical images. Therefore, we propose several modifications to the existing cutting-edge U-Net model. The technical approach involves applying a Multi-Dimensional U-Convolutional Neural Network to achieve accurate segmentation of multimodal biomedical images, enhancing precision and comprehensiveness in identifying and analyzing structures across diverse imaging modalities. As a result of the enhancements, we propose a novel framework called Multi-Dimensional U-Convolutional Neural Network (MDU-CNN) as a potential successor to the U-Net framework. On a large set of multimodal medical images, we compared our proposed framework, MDU-CNN, to the classical U-Net. There have been small changes in the case of perfect images, and a huge improvement is obtained in the case of difficult images. We tested our model on five distinct datasets, each of which presented unique challenges, and found that it has obtained a better performance of 1.32%, 5.19%, 4.50%, 10.23% and 0.87%, respectively.
Are 6 more accurate than 4? The influence of different modes of delivery on postpartum depression and PTSD
Authors: Beck-Hiestermann Franziska Marie Lea , Hartung Lisa Kathrin , Richert Nadine , Miethe Sandra , Wiegand-Grefe Silke
Published: February 2024

Background

Empirical evidence shows that 4.6–6.3% of all women develop a post-traumatic stress disorder (PTSD) and approximately 10–15% postpartum depression (PPD) following childbirth. This study explores the relationship between delivery mode and the occurrence of PTSD and PPD, specifically examining four distinct caesarean section (CS) modes: primary on maternal request (Grade 4), medically indicated primary (Grade 3), secondary CS from relative indication (Grade 2) and emergency secondary CS (Grade 1), compared to vaginal and assisted vaginal delivery (AVD). The research aims to understand how these six subcategories of delivery modes impact PPD and PTSD levels. Common predictors, including the need for psychological treatment before childbirth, fear of childbirth, planning of pregnancy, induction of labor, birth debriefing, and lack of social support after childbirth, will be analyzed to determine their association with postpartum mental health outcomes.

Methods

The study was planned and carried out by a research team of the psychology department at the Medical School Hamburg, Germany. Within an online-study (cross-sectional design) N = 1223 German speaking women with a baby who did not die before, during or after birth were surveyed once between four weeks and twelve months postpartum via an anonymous online questionnaire on demographic and gynecological data, delivery mode, PTSD (PCL-5) and PPD (EPDS).

Results

For both psychiatric disorders, ANOVA revealed significant differences between delivery mode and PPD and PTSD. With weak effects for PPD and medium to strong effects for PTSD. Post-hoc tests showed increased levels of PPD for two CS types (Grade 1, Grade 3) compared to vaginal delivery. For PTSD, secondary CS from relative indication (Grade 2), emergency secondary CS (Grade 1) and assisted vaginal delivery (AVD) were associated with elevated levels of PTSD. Regression analysis revealed delivery mode as a significant predictor of EPDS- (medium effect size) and PCL-5-Score (medium to high effect size).

Limitation

Delivery was considered as the potential traumatic event, and any previous traumas were not documented. Additionally, the categorization of delivery modes relied on subjective reports rather than medical confirmation.

Conclusion

The study highlights the influence of delivery mode on the mental health of postpartum mothers: different modes influence postpartum disorders in various ways. However, the definition of delivery mode was only stated subjectively and not medically confirmed. Further research should investigate which aspects of the different delivery modes affect maternal mental health and explore how the perception of childbirth may be influenced by specific delivery experiences.
Triage practices for emergency care delivery: a qualitative study among febrile patients and healthcare workers in a tertiary care hospital in Nepal
Authors: Adhikari Bipin , Shrestha Lava , Bajracharya Manjita , Aryal Nishika , Rajbhandari Anuja , Maharjan Ramesh K. , Das Santa K. , Sapkota Jyotshna , Tetteh Kevin K. A. , Das Debashish
Published: February 2024

Background

Improving screening and triage practices is essential for early severity assessments at the first point of contact and ensuring timely attention by healthcare workers (HCWs). The main objective of this study was to explore the triage process among febrile patients and HCWs in the emergency department (ED) of a tertiary care hospital in a resource-constrained setting.

Methods

This qualitative study was conducted from March to May 2023 at the ED of Tribhuvan University Teaching Hospital (TUTH), Nepal. The study included in-depth interviews with febrile patients (n = 15) and HCWs (n = 15). Additionally, direct observation notes (n = 20) were collected to document the triage process and patients’ experiences in the ED. Data underwent thematic analysis using the Interpretative Phenomenological Analysis (IPA) approach.

Results

The ED of TUTH offered comprehensive triage services with clear delineation for the severity of febrile patients in line with the World Health Organization (WHO) guidelines. Nonetheless, challenges and constraints were identified. In the ED, evenings were generally the busiest period, and the triage process was not thorough during night shifts. Perception of triage was limited among patients and variable among HCWs. Digitalizing recordings of patient information including payment was deemed necessary for effective management of patients’ waiting times at the triage station. High patient throughput added pressure on HCWs and had a potential influence on the delivery of services. Availability of medical equipment and space were also identified as challenges, with patients sometimes compelled to share beds. There were constraints related to waste disposal, hygiene, cleanliness, and the availability and maintenance of washrooms. Febrile patients experienced delays in receiving timely consultations and laboratory investigation reports, which affected their rapid diagnosis and discharge; nonetheless, patients were satisfied with the overall healthcare services received in the ED.

Conclusions

Improving current triage management requires resource organization, including optimizing the waiting time of patients through a digitalized system. Urgent priorities involve upgrading visitor facilities, patient consultations, laboratory investigations, hygiene, and sanitation. HCWs’ recommendations to resource the ED with more equipment, space, and beds and a dedicated triage officer to ensure 24-hour service, together with training and incentives, warrant further attention.
Convergent genomic signatures associated with vertebrate viviparity
Authors: Eastment Rhiannon V. , Wong Bob B. M. , McGee Matthew D.
Published: February 2024

Background

Viviparity—live birth—is a complex and innovative mode of reproduction that has evolved repeatedly across the vertebrate Tree of Life. Viviparous species exhibit remarkable levels of reproductive diversity, both in the amount of care provided by the parent during gestation, and the ways in which that care is delivered. The genetic basis of viviparity has garnered increasing interest over recent years; however, such studies are often undertaken on small evolutionary timelines, and thus are not able to address changes occurring on a broader scale. Using whole genome data, we investigated the molecular basis of this innovation across the diversity of vertebrates to answer a long held question in evolutionary biology: is the evolution of convergent traits driven by convergent genomic changes?

Results

We reveal convergent changes in protein family sizes, protein-coding regions, introns, and untranslated regions (UTRs) in a number of distantly related viviparous lineages. Specifically, we identify 15 protein families showing evidence of contraction or expansion associated with viviparity. We additionally identify elevated substitution rates in both coding and noncoding sequences in several viviparous lineages. However, we did not find any convergent changes—be it at the nucleotide or protein level—common to all viviparous lineages.

Conclusions

Our results highlight the value of macroevolutionary comparative genomics in determining the genomic basis of complex evolutionary transitions. While we identify a number of convergent genomic changes that may be associated with the evolution of viviparity in vertebrates, there does not appear to be a convergent molecular signature shared by all viviparous vertebrates. Ultimately, our findings indicate that a complex trait such as viviparity likely evolves with changes occurring in multiple different pathways.