bluuebunny/crossref_metadata_2025 huggingface dataset:
Book review: Bahana, D., Singh, S. and Msibi, T. (ed.), South Africa: Gender, Sexuality, and Violence in South African Educational Spaces
Authors: Tanomand Mitra
Published: November 2023

Bahana, D., Singh, S. and Msibi, T. (ed.), South Africa: Gender, Sexuality, and Violence in South African Educational Spaces (Switzerland: Palgrave Macmillan, 2021), 315 pp., £109.99 (cloth), £109.99 (paper), ISBN: 9783030699871 paper.
Comparative evaluation of different operating parameters on performance, combustion, and emission characteristics in gasoline compression ignition (GCI) engine by using carbon neutrally biofuels
Authors: Zhao Wenbin , Mi Shijie , Wu Haoqing , Zhang Yaoyuan , Qian Yong , Lu Xingcai
Published: November 2023

The stringent emission regulations and energy shortage put forward strict requirements for highly efficient and clean combustion for internal combustion engines. The gasoline compression ignition (GCI), which is a new advanced combustion concept, can obtain high efficiency and low emissions simultaneously without many modifications of standard diesel engines. However, little research has been carried out to synergistically optimize the operation parameters in a wide load range, especially fueled with the carbon neutrally biofuels. Therefore, in this paper, the effects of various operating parameters on engine performance, combustion, and emission characteristics of the gasoline compression ignition (GCI) strategy fueled with a blend of butanol and biodiesel were investigated. Specifically, the impact of butanol energy ratio, fuel direct injection timing, and exhaust gas recirculation (EGR) at the indicated mean effective pressure (IMEP) of 4, 8, and 14 bar and the butanol energy ratio of 60%, 70%, and 80% were examined. Result shown that the increase in butanol energy ratio decreased the fuel reactivity and worsen the combustion process, while the lower butanol energy was also disadvantage to the engine performance. The indicated thermal efficiency could achieve 48.5% when the butanol energy ratio was 70% at medium engine load. The earlier fuel injection timing was needed at low engine load, the EGR was necessary to inhibit the in-cylinder pressure rise at high engine load, in which the EGR rates of 20% at the IMEP of 8 bar and 30% at the IMEP of 14 bar could achieve the optimum engine performance, respectively. Meanwhile, the nitrogen oxides emissions shown a greatly decrease with the EGR rates increase, and it was less than 200 ppm at the IMEP of 14 bar when the EGR rates were 50%.
Development of turbocharged engine bench test adapted to multiple driving cycles for lubricants fuel economy
Authors: Ye Hong , Yimin Mo , Xiangkui Kong
Published: November 2023

Aimed to more truly and stably measure the fuel economy of a vehicle under different driving cycles, simultaneously reduce prime cost and short experimental period. An engine fuel economy test method and bench which could adapt to multiple cycle conditions was developed. The fuel economy test of a certain SUV under NEDC/WLTC was carried out, and the transient operating parameters of the engine were collected. The engine fuel economy test bench was established and accurately controlled according to transient parameters. The FEI of five different formulations of engine oils was tested. The results indicate that the actual bench parameters are in good agreement with the target transient parameters. Multiple FC measurements of baseline oil and multiple FEI measurements of high reference oil show that the engine bench has good repeatability. The data fluctuation degree of bench test is obviously smaller than that of vehicle test. The correlation coefficients of comprehensive FEI between bench test and vehicle test are 95.25% (NEDC) and 96.39% (WLTC). It means that the bench test can completely replace the vehicle test for fuel economy analysis. The FEI of No.3 oil which has the best fuel improvement are 1.888% (NEDC) and 1.248% (WLTC) respectively. Compared with the vehicle test, the engine bench testing can save 75% of the time. The fuel economy bench and test methods are also suitable for the verification of fuel economy improvement of other engine optimization measures under different driving cycles. The development period of engine technologies can be shortened, and the test cost can be reduced.
Epitope characterization of proteins and aptamers with mass spectrometry
Authors: Lupu Loredana , Kleinekofort Wolfgang , Morgner Nina
Published: November 2023

The way in which professor Michael Przybylski has combined the spirit of research with entrepreneurship has set an example for any and all scientists. He has made significant achievements in the fields of mass spectrometry, biochemistry and medicine, and has initiated important technological developments in the area of protein analysis. Between 2016 and 2023 professor Przybylski's scientific focus shifted on protein interactions with emphasis on aptamer-protein and antibody-protein analysis. This review focuses on professor Przybylski's achievements in the last few years highlighting his impact on the scientific community, on his students and colleagues.
Structure, positions and mechanisms: A case study of two Dutch Salafi-Jihadi networks
Authors: van Nassau Casper S. , Diviák Tomáš , de Poot Christianne J.
Published: November 2023

Social network analysis can be a powerful tool to better understand the social context of terrorist activities, and it may also offer potential leads for agencies to intervene. Our access to Dutch police information allows us to analyse the relational features of two networks that include actors who planned acts of terrorism and were active in the dissemination of a Salafi-Jihadi interpretation of Islam ( n = 57; n = 26). Based on a mixed-method approach that combines qualitative and more formal statistical analysis (exponential random graph models), we analyse the structural characteristics of these networks, individual positions and the extent to which radical leaders, pre-existing family and friendship ties and radicalizing settings affect actors to form ties. We find that both networks resemble a core–periphery structure, with cores formed by a densely interconnected group of actors who frequently meet in radicalizing settings. Based on our findings, we discuss the potential effects of preventive and repressive measures developed within the Dutch counterterrorism framework.
Integrated Predictors by Propensity Scoring With Tumor Markers and Plasma Levels of microRNA-21-5p, IL-17, and IL-10 Complement Early Detection of Hepatocellular Carcinoma in Patients With Liver Cirrhosis
Authors: Machida Maiko , Ambo Mayuko , Mishina Runa , Hada Nanaka , Tachibana Fuhito , Yamashita Miki , Konda Ainari , Tsuji Kunihiko
Published: November 2023

Objectives: The clinical usefulness of tumor markers alpha-fetoprotein (AFP) and des-gamma carboxyprothrombin (DCP) in the early detection of hepatocellular carcinoma (HCC) in patients with liver cirrhosis (LC), including those with marker decline after antiviral therapy, is limited. MicroRNAs (miRNAs) are expected to complement detection; however, their details remain unknown. Our prospective pilot study aimed to improve the surveillance of HCC high-risk LC patients by propensity scoring with tumor markers and additional predictors. Methods: Tumor markers and plasma levels of cytokines and miRNAs were observationally measured and statistically evaluated with propensity scoring in 85 eligible patients: 43 with current HCC (cHCC) including 8 with early-HCC, 22 with previous HCC cured (pHCC), and 20 with intact LC (iLC). Results: The analysis of the area under the receiver operating characteristic curve (AUC) showed that the best single predictor was AFP (0.794 for cHCC-discrimination and 0.771 for pHCC-discrimination). AFP−DCP integrated with miR-21-5p for cHCC-discrimination was 0.896; with IL-10 for pHCC-discrimination was 0.872, these were significantly better than those of AFP alone, independently ( P < .01). The best single predictor for iLC-discrimination was IL-17 level (0.756). IL-17 integrated with AFP−DCP was 0.882, which was significantly better than that of IL-17 alone ( P < .01). The positive likelihood ratio (pLR) for cHCC-discrimination by integration of AFP−DCP and miR-21-5p was 32.2. Preliminary validation analysis of early-HCCs compared to conventional AFP and DCP showed the combinations of AFP–DCP and 3 integrated predictors, miR-21-5p for cHCC-discrimination, IL-10 for pHCC-discrimination, and IL-17 for iLC-discrimination, sensitivity, specificity, and pLR, improved from 37.5% to 62.5%, 55.8% to 83.1%, and 0.85 to 3.70, respectively. Conclusion: The predictors of AFP-DCP combined with iR-21-5p, IL-10, and IL-17 by propensity scoring achieved higher discrimination of cHCCs, pHCCs, and iLCs, may be beneficial for the surveillance of early-HCCs, improving prediction of early-HCCs over conventional methods. However, further validation is required.
Psychological Effects of a Structured Exercise Intervention During Umbilical Cord Blood Transplantation in Children and Adolescents
Authors: Huang Lu , Wu Yun , Xu Ming , Wang Yingying , Jia Chengzhen , Song Guiqi , Song Kaidi , Wu Yaohua , Zhang Yongliang
Published: November 2023

Background:

Children and adolescents undergoing umbilical cord blood transplantation (UCBT) are faced with severe fatigue and a decline in quality of life (QoL) during the inpatient period.

Objective:

To investigate the effect of a structured exercise intervention on fatigue, QoL and clinical outcomes among children and adolescents during UCBT.

Methods:

In this randomized controlled trial, participants (n = 48) were randomized to a control group (CG: usual care) or an intervention group (IG: a structured exercise intervention). Fatigue and QoL were assessed at hospital admission, 14 days after UCBT, and at discharge using linear mixed model analysis. In addition, engraftment kinetics, supportive treatment, transplant-related complications, and hospital length of stay were derived from medical records.

Results:

4 patients completed the study, the IG participated in an average of 2.12 (1.36-2.8) sessions with a duration of 24 (16-34) min weekly, and the total rate of adherence to the training program was 70.59%. For fatigue and QoL, there was a significant effect of time in the control group, with the total score of fatigue decreased from T1 to T2 (73.9vs 60.9, P = .001) and T1 to T3 (73.9vs 65.6, P = .049), and the QoL scores decreased from T1 to T2 (73.9vs 66.1, P = .043). The hospital length of stay was less in the intervention group ( P = .034).

Conclusion:

Our randomized study indicated that structured exercise interventions might exert a protective effect by attenuating the decline in fatigue and QoL, and shortening duration of hospitalization.
Factors Associated With Higher Utilization of Outpatient Physical Therapy for Patients Who Have Undergone Primary Total Joint Arthroplasty: A Retrospective Cohort Study
Authors: Wu Curtis , McAdam Ashleigh , Siverling Scott , Nguyen Joseph , Edwards Danielle
Published: November 2023

Background:

Research has identified predictive factors for inpatient complications and short-term recovery following total knee arthroplasty (TKA) and total hip arthroplasty (THA). Predictors that may influence length of care in outpatient physical therapy (PT) have yet to be examined. Doing so may improve the quality and efficiency of PT care following TKA and THA.

Purpose:

The aim of this study was to determine factors associated with a higher utilization of outpatient PT visits for patients who have had primary THA or TKA.

Methods:

A retrospective cohort study was performed using a population of 5147 patients who underwent THA and TKA between January 2017 and October 2022. Demographic and clinical factors were analyzed to determine which factors influenced PT utilization.

Results:

Our multivariable linear regression model revealed that female sex, need for inpatient PT visits, and TKA as opposed to THA were significantly associated with an increase in outpatient PT visits. Older age, number of telerehabilitation visits, and history of depression were associated with fewer outpatient PT visits while accounting for all other variables.

Conclusions:

The results of this retrospective analysis may help to identify some potential factors including TKA vs THA, patient age, and a history of depression that can be evaluated prospectively in future studies to determine whether they predict subsequent outpatient PT utilization.
Narrative Resilience Among Formerly Incarcerated Mothers
Authors: Richards-Karamarkovich Arden , Umamaheswar Janani
Published: November 2023

Whereas much of the research on mothers in reentry has focused on the resistance strategies these mothers develop to combat the stigma they face, we explore how formerly incarcerated women’s narratives of motherhood reflect their resilience. Using in-depth interviews with 15 formerly incarcerated women, we describe participants’ “narrative resilience”—their focus on their strength and perseverance as they told stories of adversity. Narrative resilience facilitates a novel understanding of formerly incarcerated women’s construction of mothering—one that reveals how women incorporated experiences of structural disadvantage into their mothering identities by framing these experiences as evidence of their tenacity.
PROMIS Global Physical Health Subscale Strongly Correlates and Performs Similarly to the QuickDASH in Hand and Upper Extremity Patients
Authors: Bernstein David N. , Bakshi Chinmay V. , Lans Jonathan , Garg Rohit , Bhashyam Abhiram R. , Tobert Daniel G.
Published: November 2023

Background:

The Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) is a validated, static hand and upper extremity patient-reported outcome measure (PROM) commonly used. However, with the growth of PROM implementation across orthopedic and plastic surgery clinics, it is beneficial to determine whether a more general PROM can be used to capture the same insights. This would ease implementation broadly. There is a paucity of literature assessing whether the QuickDASH and Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 are correlated and perform similarly.

Methods:

Between June 2016 and December 2020, hand and upper extremity patients seeking care at clinics associated with a single quaternary academic medical center were identified. Those who completed the PROMIS Global-10 and QuickDASH as part of routine care were identified. The PROMIS Global-10 is divided into the PROMIS Global Physical Health and PROMIS Global Mental Health subscores. Spearman rho (ρ) correlations were calculated across PROMs, and ceiling and floor effects were determined.

Results:

Across the 18 744 included patients, there was a strong correlation and strong-moderate correlation found between the QuickDASH and PROMIS Global Physical Health (ρ = 0.70, P < .001) and PROMIS Global Mental Health (ρ = 0.69, P < .001), respectively. Although small, QuickDASH demonstrates the worst floor effect (2.6%, [n = 478]), whereas PROMIS Global Mental Health demonstrated a much more notable ceiling effect (11%, [n = 2034]).

Conclusions:

The PROMIS Global-10 can be used to assess the functional status of patients presenting for hand and upper extremity concerns, while also capturing aspects of mental health. The PROMIS Global-10 may ease PROM implementation broadly.
Wear mechanisms of aluminum 5083/6061/7075 with and without T6 treatment
Authors: Chang Yuh-Ping , Liu Chien-Te , Chu Li-Ming , Chou Huann-Ming
Published: November 2023

The application of hardened aluminum alloys on the drive elements must be safe and reliable, T6 treatment is often used to improve their mechanical properties and dimensional stability. However, the impact of T6 treatment on operating life is not easy to evaluate. Hence, the effects of T6 treatment on the wear of aluminum 5083/6061/7075 were studied by a steel ball on disk tester. The results showed that T6 treatment tended to reduce the values of the friction coefficient about 9%. Moreover, T6 treatment had no significant effect on the frequency of the change of the friction coefficient of 5083 and 6061, but significantly affected that of 7075. T6 treatment can also reduce the size of wear particles about 16%. Based on the results, the wear mechanisms of aluminum 5083/6061/7075 with and without T6 treatment are described in this paper.
STAT1 negatively regulates human glioma U251 cell proliferation Huang et al: Role of STAT1 in glioma
Authors: Huang Ping , Huang Qiang , Wang Hongwei , Dou Changwu , Ju Haitao , Xiao Rui , Zhang Lixia , Li Hailong
Published: November 2023

Background

Glioma is one of the most malignant tumors, which leads to high mortality in cancer patients. At present, there is no effective therapy for glioma. Therefore, it is urgent and necessary to find new molecular targets for anti-glioma therapy.

Objective

The present study aimed to investigate the role of signal transducer and activator of transcription 1 (STAT1) in the development and progression of human glioma and related mechanisms.

Methods

According to the instructions of Lipofectamine TM2000 transfection reagent, we transiently transfected the plasmid pcDNA3.1-STAT1 into glioma U251 cells. Then STAT1 expression in glioma U251 and LN382 cells was detected by Western blot. MTT was performed to assay the proliferative activity of U251 cells after STAT1 transduction, flow cytometry was used to detect cell cycle and apoptosis indicators, cell migration indicator was determined by Wound healing, and Western blot was used for detecting the expression level and change trend of p53, p21, bcl-2, Caspase-8, Cyclin A and Cyclin E in transfected cells.

Results

Overexpressed STAT1 significantly inhibited U251 cell proliferation and promoted U251 cell apoptosis. Meanwhile, high expression of STAT1 can increase the expression of p53, p21, and Caspase-8 while inhibiting the expression of bcl-2, Cyclin A, and Cyclin E.

Conclusion

Highly expressed STAT1 inhibits the proliferative activity of human glioma U251 cells and can promote tumor cell apoptosis and block cell cycle progression while regulating the expression of various signal transduction molecules. Thus, STAT1 has a critical function in the development and progression of glioma and is a novel target for glioma therapy.
Insights into the epidemiology and clinical aspects of post-COVID-19 conditions in adult
Authors: Huynh Dieu Hien T , Nguyen Dat T , Nguyen Thu Suong T , Nguyen Bao An H , Huynh Anh T T , Nguyen Vy N N , Tran Dat Q , Hoang Thi N N , Tran Huy Dung , Liem Dao Thanh , Vo Giau V , Nguyen Minh Nam
Published: November 2023

Objectives

While most individuals infected with COVID-19 recover completely within a few weeks, some continue to experience lingering symptoms. This study was conducted to identify and describe the clinical and subclinical manifestations of adult patients from the long-term effects of COVID-19.

Methods

The study analyzed 205 medical records of inpatients (age ≥ 16 years, ≥ 4 weeks post-COVID-19 recovery, and a negative SARS-CoV-2 status at enrollment) at Thong Nhat Hospital, Vietnam, from 6 September 2021 to 26 August 2022, using R language software.

Results

The majority of patients hospitalized with long COVID-19 symptoms (92.68%) had normal consciousness. The most common symptoms on admission were fatigue (59.02%), dyspnea (52.68%), and cough (42.93%). In total, 80% of patients observed respiratory symptoms, primarily dyspnea, while 42.44% reported neurological symptoms, with sleep disturbance being the most common. Noticeably, 42.93% of patients experienced respiratory failure in the post-COVID-19 period, resembling acute respiratory distress syndrome.

Discussion

These findings provide crucial insights into the epidemiology, clinical, and subclinical aspects of post-COVID-19 conditions, shedding light on the prevalence of common symptoms and the demographic distribution of affected patients. Understanding these manifestations is vital for patient well-being, improved clinical practice, and targeted healthcare planning, potentially leading to better patient care, management, and future interventions.
Postpartum cardiogenic shock with rapid recovery in a Titin gene variant: The role of genetic predisposition in peripartum cardiomyopathy
Authors: Karner Eva , Keller Hans , Schäffl-Doweik Lilian , Laccone Franco , Stöllberger Claudia
Published: November 2023

Peripartum cardiomyopathy is defined as heart failure secondary to left ventricular (LV) dysfunction with a left ventricular ejection fraction <45% occurring towards the end of pregnancy or in the months following delivery without other identifiable cause. Pathogenesis of peripartum cardiomyopathy and the role of genetic variants are unknown. We present a previously healthy 33-year-old woman in her first pregnancy with acute onset of heart failure postpartum. She developed cardiogenic shock four days after caesarean section and was treated with levosimendan, cabergoline, ramipril and bisoprolol. She used a wearable cardioverter/defibrillator for 3 months. After 8 months, she was free of symptoms with normal left ventricular function and brain-natriuretic-peptide-levels. Genetic analysis was carried out due to a positive family history and disclosed a heterozygous variant c7627dupA in the TTN gene. Genetic analysis in patients with a positive family history should be carried out since that may provide insights in the pathogenesis of heart failure due to systolic dysfunction including peripartum cardiomyopathy.
Citizens’ Stability of Electoral Preferences in Chile Since the Social Upheaval
Authors: Altman David , Díaz Juan , Engel Eduardo , Peña Benjamín
Published: November 2023

A strong oscillation of electoral preferences took place in Chile between the election of the members of the Constitutional Convention in May 2021 and the election of the members of the Constitutional Council in May 2023. This is surprising because, until the national-scale social uprising in 2019, there was a broad consensus that Chile was a highly institutionalised party system where political preferences tended to be stable. In this research note, we study how the electoral choices made by citizens shifted between both elections, using the ecological inference approach based on a Bayesian hierarchical model developed elsewhere. We find that a vast majority of the new voters that resulted from the compulsory voting policy implemented between both elections opted for centre-right to right-wing candidates. However, this evidence is insufficient to determine whether these new voters predominantly align with right-leaning ideologies or hold anti-systemic viewpoints.
Privacy Concerns Related to Data Sharing for European Diabetes Devices
Authors: Randine Pietro , Pocs Matthias , Cooper John Graham , Tsolovos Dimitrios , Muzny Miroslav , Besters Rouven , Årsand Eirik
Published: November 2023

Background:

Individuals with diabetes rely on medical equipment (eg, continuous glucose monitoring (CGM), hybrid closed-loop systems) and mobile applications to manage their condition, providing valuable data to health care providers. Data sharing from this equipment is regulated via Terms of Service (ToS) and Privacy Policy documents. The introduction of the Medical Devices Regulation (MDR) and In Vitro Diagnostic Medical Devices Regulation (IVDR) in the European Union has established updated rules for medical devices, including software.

Objective:

This study examines how data sharing is regulated by the ToS and Privacy Policy documents of approved diabetes medical equipment and associated software. It focuses on the equipment approved by the Norwegian Regional Health Authorities.

Methods:

A document analysis was conducted on the ToS and Privacy Policy documents of diabetes medical equipment and software applications approved in Norway.

Results:

The analysis identified 11 medical equipment and 12 software applications used for diabetes data transfer and analysis in Norway. Only 3 medical equipment (OmniPod Dash, Accu-Chek Insight, and Accu-Chek Solo) were registered in the European Database on Medical Devices (EUDAMED) database, whereas none of their respective software applications were registered. Compliance with General Data Protection Regulation (GDPR) security requirements varied, with some software relying on adequacy decisions (8/12), whereas others did not (4/12).

Conclusions:

The study highlights the dominance of non-European Economic Area (EEA) companies in medical device technology development. It also identifies the lack of registration for medical equipment and software in the EUDAMED database, which is currently not mandatory. These findings underscore the need for further attention to ensure regulatory compliance and improve data-sharing practices in the context of diabetes management.
Detecting macromolecular differences of the CSF in low disability multiple sclerosis using quantitative MT MRI at 3T
Authors: Lawless Richard D , McKnight Colin D , O’Grady Kristin P , Combes Anna JE , Rogers Baxter P , Witt Atlee A , Visagie Mereze , Houston Delaney C , Prock Logan E , Bagnato Francesca R , Smith Seth A
Published: November 2023

Background

Imaging investigation of cerebrospinal fluid (CSF) in multiple sclerosis (MS) is understudied. Development of noninvasive methods to detect pathological CSF changes would have a profound effect on MS diagnosis and would offer insight into MS pathophysiology and mechanisms of neurological impairment.

Objective

We propose magnetization transfer (MT) MRI as a tool to detect macromolecular changes in spinal CSF.

Methods

MT and quantitative MT (qMT) data were acquired in the cervical region in 27 people with relapsing-remitting multiple sclerosis (pwRRMS) and 38 age and sex-matched healthy controls (HCs). MT ratio (MTR), the B1, B0, and R1 corrected qMT-derived pool size ratio (PSR) were quantified in the spinal cord and CSF of each group.

Results

Both CSF MTR and CSF qMT-derived PSR were significantly increased in pwRRMS compared to HC ( p = 0.027 and p = 0.020, respectively). CSF PSR of pwRRMS was correlated to Expanded Disability Status Scale Scores ( p = 0.045, R = 0.352).

Conclusion

Our findings demonstrate increased CSF macromolecular content in pwRRMS and link CSF macromolecular content with clinical impairment. This highlights the potential role of CSF in processing products of demyelination.
Climate Risk, Stock Crash Risk, and Greenhouse Gas Emission Trading Scheme: Evidence From Korea
Authors: Kim Su-In , Kim Yujin
Published: November 2023

This study examines the relationship between climate risk and stock crash risk and the moderating effect of greenhouse gas emission trading scheme (ETS). Numerous studies have tested stock price crash risk measured by the negative skewness of return distributions in the areas of internal governance mechanism. While interest in environmental performance for sustainable growth of firms has increased, there are no studies on the effect of climate risk on stock crash risk. Thus, we find that climate risk (a firm’s greenhouse gas emissions and energy consumption) increases stock crash risk, and the positive effect of climate risk on stock crash risk is weakened after introduction of the emission trading scheme. This study theoretically extends the literature on the empirical determinants of stock crash risk, and practically provides investors with proven information about whether climate risk is worth considering during investment decisions. Furthermore, at the level of government policy, we can suggest that a monitoring system is needed to mitigate potential information asymmetry problems in firm with high climate risk.
Ethical Considerations in Pediatric External Ear Surgery
Authors: Al-Halabi Becher , Alabdulkarim Abdulaziz , Cugno Sabrina
Published: November 2023

The distinction between reconstructive and aesthetic surgery becomes less apparent when body image and self-esteem secondary to congenital deformities affect psychosocial well-being. Parents and plastic surgeons debate the appropriate age to correct non-life-threatening congenital defects to avoid a psychologically distressing event to the child. Furthermore, an ethical debate emerges when parents make decisions on behalf of children below the age of consent and lack the necessary cognitive development. This challenging responsibility then rests upon the operating practitioner to prioritize the child's best interests. This paper examines three hypothetical cases to explore the psychosocial and ethical aspects of conducting external ear surgery in the pediatric population and determining the ideal timing.
Strategic supplier performance in a competitive landscape: Enhancing organizational performance through lean supply chain management
Authors: Garcia-Buendia Noelia , Moyano-Fuentes José , Maqueira-Marín Juan Manuel , Romano Pietro , Molinaro Margherita
Published: November 2023

In a context characterized by increasing competitive pressure, supply chain collaboration has gained greater relevance and lean principles have been integrated into supply chain management to address the challenge of achieving better organizational performance. The purpose of this study is to understand the roles of strategic supplier performance and competitive intensity in Lean Supply Chain Management (LSCM) implementation and its performance. We use a variance-based Structural Equation Model analysis with empirical data from a sample of 273 Spanish companies to analyze the relationships among strategic suppliers, competitive intensity, LSCM implementation, and performance. Our findings indicate that strategic supplier performance is positively associated with LSCM implementation and that this relationship is heightened in highly competitive industries. Our results also reveal the indirect association of LSCM implementation in the strategic supplier performance-organizational performance relationship.

JEL CLASSIFICATION: M11
A Novel Case-Based Learning Activity With a Focus on Food Insecurity
Authors: Brown Brandon D , Haley Sean P , Berini Carole R , Ramsetty Anita N
Published: November 2023

OBJECTIVE

Food insecurity is a social determinant of health (SDOH) affecting 1 in 10 households per year in the United States and has major impacts on the course of chronic health conditions. It is beneficial to introduce screening and appropriate treatment plans to medical students. This study utilized a novel case-based learning exercise (CBLE) to assess confidence, attitudes and improvements in knowledge on recognizing and addressing food insecurity.

METHODS

A CBLE focused on food insecurity was developed to be implemented in a 2-h session as part of the curriculum for all first-year medical students at the Medical University of South Carolina. The CBLE included a case for discussion, followed by an interview with a standardized patient. Students received invitations to complete pre- and post-CBLE assessment surveys.

RESULTS

Completion of both pre- and post-surveys was achieved by 29% of students (48 out of 166). Knowledge around the formal definition of “food insecurity,” how to recognize food insecurity versus hunger, and how to screen for food insecurity all increased significantly ( P < .05). Responses relating to the association between certain chronic diseases and food insecurity did not change pre and post-CBLE.

CONCLUSION

This novel CBLE was successfully implemented within a 2-h teaching session and improved knowledge on recognizing food insecurity in practice. However, additional learning exercises are likely needed to improve knowledge of the relationship between food insecurity and chronic disease states. Nonetheless, the CBLE structure provided students with multiple formats of learning and integration of skills, which shows promise and may be applicable to improve knowledge of other SDOHs.
Medical Humanities in Undergraduate Psychiatry Teaching: Learner Assessment and Mediators of Better Learning Outcomes
Authors: Rajagopalan Arvind , Chew Qian Hui , Sim Kang
Published: November 2023

OBJECTIVES

Previous studies have found that the inclusion of medical humanities in medical education was associated with improvements in learner reflectivity and empathy. There is less data, however, on the impact of medical humanities on perceived patient care and mediators of learner outcomes. Our study aimed to determine the impact of medical humanities on perceived learner well-being and patient care, and the mediators of these outcomes in medical undergraduates undergoing psychiatric training.

METHODS

This cross-sectional study was conducted from August 2021 to December 2022 within undergraduate medical students undergoing psychiatry rotations and who attended sessions entitled “Humanities in Psychiatry.” Both quantitative and qualitative data were obtained through anonymized online feedback forms. Path analysis was performed to examine the relationship between learners’ perception of the medical humanities writing activity and its potential to improve their well-being, patient care, as well as mediators of these outcomes.

RESULTS

Overall, 97 medical undergraduates (response rate 67.4%) participated in the study and more than four-fifths reported improvements in listening, reflection, empathy, personal well-being, and perceived patient care. Males showed more interest in additional medical humanities sessions (mean rank 57.9 vs 42.5, P = .005) and greater improvements in personal well-being (mean rank 55.1 vs 44.5, P = .044). Path analysis showed that reflective capacity of learners mediated the relationship between reflective writing and perceived improvements in learner well-being (β = 0.596, 95% CI = 0.409-0.737) and patient care (β = 0.557, 95% CI = 0.379-0.702).

CONCLUSIONS

Our study found that the majority of learners responded positively to the medical humanities sessions, which suggests that its use could be beneficial in fostering empathy, reflection, learner well-being, and improved patient care. Using the PRISM model, we present practical implications for educators to consider when using medical humanities in relation to psychiatry training.
Image Enhanced Endoscopy in Esophageal Squamous Cell Carcinoma
Authors: Vasavada Shaleen , Anandasabapathy Sharmila
Published: November 2023

Esophageal Squamous Cell Carcinoma (ESCC) accounts for a significant portion of esophageal cancer cases worldwide, particularly in high-risk regions like China, Iran, and eastern Africa. It is often diagnosed at advanced stages, leading to poor prognosis and limited treatment options. Image-enhanced endoscopy enables precise visualization of abnormal mucosa, aiding in targeted biopsies for early detection of ESCC and reducing unnecessary sampling. Various techniques have emerged including lugol’s chromoendoscopy, narrow-band imaging, confocal laser endomicroscopy, and high-resolution microendoscopy. This article also discusses advancements in post-processing imaging technology and the novel role of Artificial Intelligence (AI) in improving diagnostic accuracy. While image enhanced endoscopy is promising, challenges such as training, standardization, and long-term validation remain. Implementing image enhanced endoscopy, combined with advancements in AI, has the potential to transform ESCC diagnosis and significantly improve patient outcomes, especially in high-risk populations.
Physical exercise for a healthy pregnancy: the role of placentokines and exerkines
Authors: Pahlavani Hamed Alizadeh , Laher Ismail , Weiss Katja , Knechtle Beat , Zouhal Hassane
Published: November 2023

Complications such as diabetes and preeclampsia can occur during pregnancy. Moderate-intensity exercise can prevent such complications by releasing placentokines and exerkines, such as apelin, adiponectin, leptin, irisin, and chemerin. Exercise and apelin increase thermogenesis and glucose uptake in pregnancy by activating AMPK, PI3K, PGC-1α, AKT1, UCP3, and sarcolipin. Exercise increases apelin levels to reduce preeclampsia symptoms by increasing eNOS, NO, placental growth factor (PlGF), and VEGF and decreasing levels of fms-like tyrosine kinase 1 (sFlt-1), soluble endoglin (sEng), and oxidative stress. A negative relationship has been reported between plasma leptin and VO2peak/kg and VO2peak in women with gestational diabetes. In active women, decreases in leptin levels reduce the risk of preeclampsia by ~ 40%. Higher adiponectin levels are associated with greater physical activity and lead to increased insulin sensitivity. Increased adiponectin levels in preeclampsia and exercise counteract inflammatory and atherogenic activities while also having vascular protective effects. Exercise increases irisin levels that correlate negatively with fasting glucose, insulin concentration, and glycosylated hemoglobin levels. Irisin augments mRNA expression levels of UCP1 and cell death-inducing DNA fragmentation factor-like effector A (cidea) to cause browning of adipose tissue, increased thermogenesis, and increased energy consumption. Irisin concentrations in mothers with preeclampsia in the third trimester negatively correlate with systolic and diastolic blood pressure. Expression levels of chemerin, IL-6, and TNF-α are increased in gestational diabetes, and the increases in chemerin in late pregnancy positively correlate with the ratio of sFlt-1 to PlGF as a marker of preeclampsia. The effects of physical exercise on placentokines and exerkines in women at various stages of pregnancy remain poorly understood.
Predictive value of type D personality for cardiac events in Chinese patients with acute myocardial infarction
Authors: Li Jiahui , Wu Wenjing , Li Nan , Wang Jian , Zu Liyuan , Ye Xiaojun
Published: November 2023

Background

Our study aimed to investigate the association between type D personality and adverse cardiac events in chinese patients after acute myocardial infarction (AMI).

Methods

Patients with AMI admitted to cardiac care unit (CCU) of China-Japan Friendship Hospital, Beijing, China between January 2016 and December 2017 were enrolled. 257 patients completed psychological questionnaires at enrollment. Type D personality was assessed with 14-item Type D Scale-14 (DS14). Anxiety and depression were quantified using Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regression analysis was used to determine the independent predictors of in-hospital major adverse cardiac events (MACEs), while cox regression analysis was used to evaluate post-discharge endpoints.

Results

54 patients (21%) were classified as Type D personality defined by the combination of a negative affectivity (NA) score ≥ 10 and a social inhibition (SI) score ≥ 10 on the DS14. Patients with Type D personality displayed significantly higher scores of anxiety (7.4 ± 3.1 vs. 4.2 ± 3.1, p < .001) and depression (7.2 ± 3.8 vs. 4.0 ± 3.4, p < .001). AMI patients with Type D personality had higher prevalence rates of anxiety (χ2 = 30.095, P < .001) and depression (χ2 = 27.082, P < .001). Type D group also displayed a significantly higher level of blood lipoprotein(a) (177.2 ± 200.7 vs. 118.1 ± 255.7 mg/L, P = .048). The incidence of in-hospital MACEs was higher in type D than in non-Type D patients (24.1% vs. 11.3%, χ2 = 5.751, P = .026). Multivariable logistic regression showed three significant independent predictors of in-hospital MACEs: age [odds ratio(OR) = 1.055; 95%CI 1.016–1.095, p = .004], type-D personality(OR 3.332; 95% CI 1.149–9.661, p = .014) and killip classification(OR 2.275, 95% CI 1.506–3.437, p < .001). The average follow-up time was 31 (23-37.5) months. Type D patients had higher incidences of post-discharge events(23.1% vs. 11.5%, p = .032). In the analysis of post-discharge events by Cox regression, χ2 of the Cox regression equation was 16.795 (P = .032). Smoking (HR 2.602; 95% CI1.266–5.347, p = .009) and type-D personality (HR 2.265; 95%CI 1.028–4.988, p = .042) were independent predictors of long-term cardiac events. Kaplan–Meier curves showed significant difference in event-free survival between type D and non-type D group (p = .043).

Conclusions

Type D personality is an independent predictor of in-hospital and post-discharge cardiac events after AMI in Chinese patients.
Real-world evidence of fremanezumab for treating migraine in Japan: a retrospective study
Authors: Ohtani Seiya , Watanabe Narumi , Ihara Keiko , Takahashi Nobuyuki , Miyazaki Naoki , Ishizuchi Kei , Takemura Ryo , Hori Satoko , Nakahara Jin , Takizawa Tsubasa
Published: November 2023

Background

There have been very few real-world studies reported in the literature solely focusing on fremanezumab in Asia. This study aimed to evaluate the efficacy and safety of fremanezumab in a real-world setting in Japan.

Method

This single-centered, observational, retrospective study examined patients with migraines who received four doses of fremanezumab between December 2021 and August 2022 at Keio University Hospital. We assessed the changes in monthly migraine days, responder rates, and migraine-associated symptoms, as well as injection site reactions and adverse events.

Result

Twenty-nine patients were enrolled, wherein 79.3% were women. Compared with those at baseline, the monthly migraine days decreased by 5.9 days at 4 months. The 50% responder rate was 55.2% at 4 months. A total of 57.9%, 47.8%, and 65.0% of patients showed improvement in the severity of photophobia, phonophobia, and nausea/vomiting, respectively. Moreover, injection site reactions were the most common adverse events (55.2%).

Conclusion

Fremanezumab is effective and safe for migraine prevention in Japan. Fremanezumab also improved migraine-associated symptoms in half of the patients.
Tongue Mucoceles: a retrospective clinic-pathological evaluation of 240 cases
Authors: Patini Romeo , Giuliani Michele , Gioco Gioele , Tranfa Mariateresa , Caponio Vito Carlo Alberto , Fantasia John , Lajolo Carlo
Published: November 2023

Background

Minor salivary glands can be found in the ventral and anterior part of the tongue; these glands can rarely develop mucoceles that, due to their rarity and their unusual clinical appearance, may present an interesting differential diagnosis. Mucoceles appear as an exophytic, sometimes pedunculated, lesion, which is a feature that is due to the absence of a capsule; thus, the glands are right beneath the mucosa and over the muscle tissue. The aim of this article is to retrospectively present and discuss the anatomy, pathology, clinical features and therapy of several cases of Blandin-Nunh mucoceles collected from two different institutions.

Methods

A retrospective case review was carried out in two university institutions, retrieving all cases of tongue mucoceles from 1999 to today. Two oral pathologists reviewed all the slides, confirming the diagnosis. Demographic data of the patient, anatomic location and clinical appearance were retrieved from clinical charts, together with the type of surgical procedure and possible relapses.

Results

A total of 240 cases of tongue mucoceles were gathered from the archives: the mean age was 22 years (DS = 14,7; Range 2–83), 126 were females (52,5%, mean age 22,7 years, DS = 16,5; Range 2–83), and 114 were males (47,5%, mean age 20,9 years, DS = 12,4; Range 3–73); in all cases, a history of trauma was reported. The ventral surface was the most frequent location (224 cases – 93,3%), and in the great majority (235 cases – 97,9%), pathology revealed mucous spillage with a wall formed by fibrous connective and granulation tissue with no epithelium lining the cavity. Superficial mucocele and sclerosing sialoadenitis were the more frequent pathological variants (21 cases – 8,8%). All lesions were treated with excision and enucleation of the servicing gland. The healing was uneventful in all cases, but there were four recurrences and two cases of sensory paraesthesia of the border of the tongue, all in males, except one case of paraesthesia in a female.

Conclusions

Tongue mucoceles must be differentiated from many benign and malignant lesions. For this reason, surgical removal of the lesion and of the associated gland with a pathological exam is mandatory. In fact, the anatomical location of the glands and the possible pathological variants must be considered to reach a correct diagnosis and diminish possible relapses.

Trial registration

CE-Muc_Ton_3/2023.
Explore the active ingredients and potential mechanisms of JianPi QingRe HuaYu Methods in the treatment of gastric inflammation-cancer transformation by network pharmacology and experimental validation
Authors: Nie Kechao , Zheng Zhihua , Li Xiushen , Chang Yonglong , Liu FengBin , Wang Xiaoyu
Published: November 2023

Background

JianPi QingRe HuaYu Methods (JQH) have been long used to treat chronic atrophic gastritis (CAG) and precancerous lesions of gastric cancer (PLGC). However, whether JQH can inhibit the transformation of gastritis to gastric cancer (GC) remains unclear.

Methods

Herein, we first retrieved the active ingredients and targets of JQH from the TCMSP database and the targets related to the gastric inflammation-cancer transformation from public databases. Differentially expressed genes (DEGs) related to gastric inflammation-cancer transformation were identified from the Gene Expression Omnibus (GEO) database. Then, we obtained the potential therapeutic targets of JQH in treating gastric inflammation-cancer transformation by intersecting drugs and disease targets. The Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG), and protein–protein interaction (PPI) analyses of the potential therapeutic targets were conducted using R software. Next, we conducted molecular docking and in vitro experiments to validate our results.

Results

We obtained 214 potential therapeutic targets of JQH by intersecting drugs and disease targets. We found that the potential mechanisms of JQH in treating gastric inflammation-cancer transformation might be related to JAK-STAT, Wnt, p53 and VEGF signaling pathways. The molecular docking indicated that quercetin, as the main active ingredient of JQH, might inhibit gastric inflammation-cancer transformation by binding with specific receptors. Our experimental results showed that quercetin inhibited cells proliferation (P < 0.001), promoted cell apoptosis (P < 0.001), reduced the secretion of pro-inflammatory cytokines (P < 0.001) and promoted the secretion of anti-inflammatory cytokines (P < 0.001) in MNNG-induced GES-1 cells. Furthermore, quercetin inhibited cells proliferation (P < 0.001) and reduced mRNA and protein level of markers of PLGC (P < 0.001) in CDCA-induced GES-1 cells.

Conclusion

These results provide the material basis and regulatory mechanisms of JQH in treating gastric inflammation-cancer transformation.