bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessment of Nasal Aesthetic Parameters in Patients with Unilateral Cleft Lip and Palate – A Retrospective Study
Authors: Anishya Daphane , Nagesh Shweta
Published: June 2024

Objectives

To assess and compare the deviating nasal cephalometric parameters of patients with unilateral cleft lip and palate (UCLP) with a control group. The study also aims to correlate the deviating cephalometric parameters with two aesthetic scoring systems.

Design

A retrospective study.

Setting

Dental college and hospital.

Participants

Pre-treatment lateral cephalograms and extra oral photographs of 20 adult patients with repaired UCLP presenting for orthodontic treatment. 20 patients with age and type of malocclusion matched control were selected.

Main Outcome

The nasal cephalometric parameters of patients with UCLP and a control group were compared. The nasolabial region of patients with cleft lip and palate (CLP) was scored using Asher McDade Aesthetic Index (AMAI) and Cleft Aesthetic Rating Scale (CARS). The scoring was done by six different groups assessors to study their perception of the nasolabial region. Correlation between cephalometric parameters and the aesthetic scores was done.

Results

The study found significant differences in nasal length ( P = .003) and depth ( P < .001) between UCLP and the non-cleft control group. In the aesthetic assessment, orthodontist gave the least scores, while layman group scored the highest. The CARS nose aesthetic scores showed statistically significant high, negative correlation with the nasal length ( P = .01).

Conclusion

The cephalometric parameters and the aesthetic indices can be aid the orthodontists in the assessment of nasolabial aesthetics and additionally refer for further definitive rhinoplasty to improve the patient's overall facial aesthetics.
Optical coherence tomography angiography reveals macular microvascular changes in myopic adolescents following orthokeratology lens wear
Authors: Zhou Yali , Yang Wenlei , Dai Yikang
Published: June 2024

Background

This study aimed to investigate the 6-month effects of wearing orthokeratology (OK) lenses on the retina vessel density (VD), vessel diameter index (VDI), and foveal avascular zone (FAZ) of myopia children using optical coherence tomography angiography, and to further investigate the underlying mechanisms of Orthokeratology in myopia control.

Methods

Sixty-two eyes form 62 subjects were included in the study. Baseline and 6-month measurements of axial length (AL), anterior chamber depth (ACD), FAZ area, FAZ perimeter, FAZ circularity, vessel density (VD) and VDI from both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) were obtained.

Results

The mean age of the participants was 11.02 years (range: 8 years to 15 years), with 41.9% males and 58.1% females. Six months after orthokeratology, ACD decreased significantly, and AL remain unchanged. SCP-VD and DCP-VD significantly increased after treatment without obvious change of VDI, and FAZ parameters remained unchanged. During follow-up period, SCP-VD increased in all subgroups especially in mild myopia group, and DCP-VD increased significantly in all subgroups except for the group 8–10 years.

Conclusion

After the 6-month treatment of orthokeratology in myopia children, the macular microvasculature changed significantly. We observed a significant increase of vessel densities in both SCP and DCP without obvious effect on vascular morphology. The changes of DCP-VD tended to be more sensitive in the elder subgroup, and the efficacy of orthokeratology might be greater in mild myopia group. OCT-A may provide additional information on myopia progression and the mechanisms of controlling myopia with OK lens treatment.
Outcomes of iStent versus endocyclophotocoagulation (ECP) as adjunct to cataract surgery by phacoemulsification for glaucoma patients
Authors: Algorinees Rakan , Almohizea Asma , Aldalgan Hind , Alobaida Ibrahim , Schargel Konrad , Aljohar Seham
Published: June 2024

Purpose

To compare the efficacy and safety of iStent versus Endocyclophotocoagulation (ECP) as an adjunct to cataract surgery by Phacoemulsification for treating glaucoma patients in a tertiary eye center.

Methods

Retrospective study of 67 eyes of 61 patients with glaucoma and cataract who underwent either phaco-ECP or phaco-iStent. Primary efficacy endpoint is the Intraocular pressure (IOP) reduction, while reduction of glaucoma medications is the secondary outcome. In addition to IOP and number of glaucoma medications; visual acuity, degree of disc cupping, safety profiles were all assessed at different intervals up to 12 months.

Results

A total of 40 eyes underwent phaco-ECP, and 27 eyes underwent phaco-iStent. Both groups were associated with a significant reduction in the number of glaucoma medications; however phaco-iStent group achieved slightly lower IOP levels than the phaco-ECP group. Furthermore, iStent inject had better control of IOP at the last follow-up compared to first-generation stents. Moreover; 2 or more stents significantly reduced IOP than single stent ( p = 0.009 vs. p = 0.618, respectively). Phaco-iStent achieved a better reduction in the number of glaucoma medications for primary open-angle glaucoma ( p = 0.007) compared to pseudoexfoliation glaucoma patients ( p = 0.084). Complications were seen in 12 eyes (18%), of which five eyes in phaco-ECP (7.4%) and 7 eyes in phaco-iStent (10.4%), majority were mild and treated conservatively.

Conclusions

Both groups had equal efficacy in reducing the IOP. However, phaco-iStent seems superior in reducing the number of glaucoma medications after 1 year of follow-up compared to phaco-ECP, particularly when 2 or more stents are used. Both groups showed an overall good safety profile.
Treatment strategy and clinical outcomes of surgically managed hip periprosthetic fractures: analysis from a high-volume centre
Authors: Mancino Fabio , Wall Ben , Bucher Thomas A , Prosser Gareth H , Yates Piers J , Jones Christopher W
Published: June 2024

Background:

Hip periprosthetic fractures (PPF) after total hip arthroplasty (THA) are becoming increasingly prevalent. Their management is secondary to the fracture type and the stability of the implant. This study aimed to provide the outcomes of operatively managed PPF from a high-volume centre to help guide future decision making.

Methods:

This was a retrospective study of prospectively collected data from January 2008 to January 2021. Patient demographics, implant specific details, and fixation strategy were collected. Complications including infection, reoperation, re-fracture, re-revision, were collected. Short-term mortality was evaluated at 3 months and 1 year. P-values <0.05 were considered significant.

Results:

282 surgically managed PPF were identified. Vancouver B2 were predominant in 52% of the cases. Revision alone and revision with additional fixation were the most frequent strategies in 168 cases (60%). Complications requiring reoperation occurred in 20% of the cases, with infection as the most frequent (8.5%). Mortality rate was 7.8% at 3 months and 15.7% at 1 year, with significantly lower rates in B2 type. B2 fractures treated with cemented stems had a significantly lower 1-year mortality than distal fit revisions.

Conclusions:

PPF is associated with a high complication rate. Revision alone and revision with additional fixation remain the preferred method in B2/B3 type fractures, however, cemented revision can yield similar outcomes with lower short-term mortality. Considering the high-risk elderly and frail category of patients, a multidisciplinary team is necessary to improve outcomes and reduce mortality.
Numerical Analysis of Indoor Air Characteristics and Window Screen Influence on Particulate Matter Dispersion in a Childcare Center Using Computational Fluid Dynamics
Authors: Simatupang Cathleen Ariella , Strezov Vladimir , Boontanon Suwanna Kitpati , Pongkiatkul Prapat , Boontanon Narin , Jindal Ranjna
Published: June 2024

Indoor exposure to outdoor pollutants adversely affects health, varying with building dimensions and particularly ventilation that have critical role on their indoor dispersion. This study assesses the impact of outdoor air on indoor air quality in a child care center. Computational fluid dynamics was utilized to analyze the dispersion of particulate matter, with a specific focus on window screens featuring 6 distinct pore sizes ranging from 0.8 mm to 2 mm and 2 different thicknesses of 0.5 mm and 0.1 mm. Results indicate that the presence of a window screen offers significant advantages in controlling particle infiltration compared to scenarios without a screen, as larger particles tend to pass directly through the window within the breathing zone. The scenario without window screens minimizes pressure drop but lacks enhanced particle capture capabilities. However, for effective particle reduction, the window screen with a pore size of 0.8 mm (R0.8T2) and a thickness of 0.5 mm proves to be the most beneficial, achieving the particle filtering efficiency of approximately 54.16%, while the larger window screen with a pore size of 2 mm and a thickness of 1 mm exhibits the lowest efficiency at about 23.85%. Nonetheless, screens with very small sizes are associated with a high-pressure drop, impacting energy efficiency, and overall window performance. Larger pores with smaller thicknesses (0.5 mm) reduced particle count by approximately 45.97%. Therefore, the significance of window screen thickness beyond pore size for particle reduction efficiency is highlighted, emphasizing screens’ role in indoor air quality and health protection.
PCSK9 expression in fibrous cap possesses a marker for rupture in advanced plaque
Authors: Zhang Yingying , Dai Dongwei , Geng Shuang , Rong Chenbin , Zou Rong , Leng Xiaochang , Xiang Jianping , Liu Jianmin , Ding Jing
Published: June 2024

Background:

To date, PCSK9 inhibitors are well known for eliminating cardiac and cerebral artery ischemia events by lowering the serum lipid level. However, the pathophysiological value of in-plaque PCSK9 expression is still unclear.

Methods:

Advanced plaques removed by carotid endarterectomy were sectioned and stained to identify the PCSK9 expression pattern and its co-expression with rupture-relevant markers. To investigate the correlation of PCSK9 expression with regional blood shear flow, hemodynamic characteristics were analyzed using computational fluid dynamics, and representative parameters were compared between PCSK9 positive and negative staining plaques. To explore this phenomenon in vitro, human aortic vascular smooth muscle cells were used to overexpress and knock down PCSK9. The impacts of PCSK9 modulations on mechanical sensor activity were testified by western blot and immunofluorescence. Real-time polymerase chain reaction was used to evaluate the transcription levels of downstream rupture-prone effectors.

Results:

PCSK9 distribution in plaque preferred cap and shoulder regions, residing predominantly in smooth muscle actin-positive cells. Cap PCSK9 expression correlated with fibrous cap thickness negatively and co-expressed with MMP-9, both pointing to the direction of plaque rupture. A hemodynamic profile indicated a rupture-prone feature of cap PCSK9 expression. In vitro, overexpression and knockdown of PCSK9 in human aortic vascular smooth muscle cells has positive modulation on mechanical sensor Yes-associated protein 1 (YAP) activity and transcription levels of its downstream rupture-prone effectors. Serial section staining verified in situ colocalization among PCSK9, YAP, and downstream effectors.

Conclusions:

Cap PCSK9 possesses a biomarker for rupture risk, and its modulation may lead to a novel biomechanical angle for plaque interventions.
Fatigue analysis and strengthening measure for longitudinal steel truss diaphragms in a cable-stayed bridge
Authors: Fan Ziyuan , Ren Yuan , Li Yi , Song Yuyu , Deng Chao , Xu Xiang , Huang Qiao
Published: June 2024

For some long span cable supported bridges, the longitudinal diaphragms in main girder are designed as steel truss to reduce structural self-weight. However, unanticipated fatigue cracking in critical details of longitudinal steel truss diaphragm may occur after only a few years of service, resulting in stiffness weakening and stress redistribution. Based on an actual cable-stayed bridge, this paper presents a fatigue analysis of longitudinal steel truss diaphragms and provide an effective strengthening measure to elongate the fatigue life. Using traffic information from bridge toll station, the fatigue vehicle models were established. Then, a multi-scale finite element (FE) model was developed to help determining critical details of potential cracking and calculating the vehicle induced stress. After obtaining the required parameters, fatigue life of the specific critical detail was estimated base on damage accumulation law. The result agrees well with field observation. To ensure the performance of steel girder, the strengthening measure that replace diagonal tubes in longitudinal steel truss diaphragm with bolted channel steels was proposed and then applied. The assessment result indicated that the provided strengthening measure achieves satisfactory effects. It can also provide experience and partial reference for maintenance of similar structures.
Tensions between the professional and academic worlds of journalism: Paradoxes of the Brazilian reality
Authors: Daros Otávio
Published: June 2024

For 40 years, Brazil was one of the few places in the world in which the regulation of journalistic activity was based on the requirement of a university degree, which associated being a journalist with having an academic qualification and not necessarily a professional one, unlike other countries that established or not licensing/accreditation  systems. In the light of historical sociology, this article aims to scrutinize this intricacy of relationships between the professional and academic worlds of journalism, based on the case of the largest media market and scholarship in Latin America. It is shown how, between 1969 and 2013, there was tension and resistance on the part of international press associations, national news media companies and renowned journalists in relation to the mandatory diploma defended by the unions; as well as there were disputes and demands, within the community of professors and researchers, for the emancipation of journalism education in relation to communication studies.
Identification of Immune Infiltrating Cell-Related Biomarkers in Early Gastric Cancer Progression
Authors: Ji Chenguang , Cai Hongmei , Jin Xiaoxu , Yin Kaige , Zhao Dongqiang , Feng Zhijie , Liu Li
Published: June 2024

Objectives

Gastric cancer (GC) is one of the most prevalent malignancies worldwide, and early detection is crucial for improving patient survival rates. We aimed to identify immune infiltrating cell-related biomarkers in early gastric cancer (EGC) progression.

Methods

The GSE55696 and GSE130823 datasets with low-grade intraepithelial neoplasia (LGIN), high-grade intraepithelial neoplasia (HGIN), and EGC samples were downloaded from the Gene Expression Omnibus database to perform an observational study. Immune infiltration analysis was performed by single sample gene set enrichment analysis and Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data. Weighted gene co-expression network analysis was used to explore the co-expression modules and genes, and further enrichment analysis was performed on these genes. A protein-protein interaction (PPI) network of these genes was constructed to identify biomarkers associated with EGC progression. Screened hub genes were validated by the rank sum test and reverse transcription quantitative polymerase chain reaction.

Results

Immune scores were significantly elevated in EGC samples compared to LGIN and HGIN samples. The green-yellow module exhibited the strongest correlation with both immune score and disease progression. The 87 genes within this module were associated with the chemokine signaling pathways, the PI3K-Akt signaling pathways, leukocyte transendothelial migration, and Ras signaling pathways. Through PPI network analysis, the hub genes identified were protein tyrosine phosphatase receptor-type C (PTPRC), pleckstrin, CD53, CD48, lymphocyte cytosolic protein 1 (LCP1), hematopoietic cell-specific Lyn substrate 1, IKAROS Family Zinc Finger 1, Bruton tyrosine kinase, and Vav guanine nucleotide exchange factor 1. Notably, CD48, LCP1, and PTPRC showed high expression levels in EGC samples, with the remaining hub genes demonstrating a similar expression trend.

Conclusion

This study identified 9 immune cell-related biomarkers that may be actively involved in the progression of EGC and serve as potential targets for GC diagnosis and treatment.
The Activist Character: Power and Empowerment in Bestselling Activist Memoirs in the United States
Authors: Gøtzsche-Astrup Johan
Published: June 2024

This article introduces the activist as a widely disseminated character within the culture of social movement societies. Drawing on studies of activist identities, Alasdair MacIntyre on characters, and the sociology of critique, it argues that the activist provides one way of imagining unjust structures of power and the possibilities of critical empowerment. The article unpacks this character in 20 bestselling activist memoirs in the United States. Across the memoirs, the structures of power are understood as total, decentred, and internalised by the individual. Empowerment involves a work on the self that taps into a disruptive source of power outside these structures. While this construction of the activist is shared, it is also inflected through two distinct repertoires in which the activist is empowered through their authenticity or a transformative love that transcends the individual.
Evaluation of the Rennes Universal Measurement Method (RUMM), an artificial intelligence application for hand joint angle assessment
Authors: Dutrey Thomas , Maximen Julien , Mevel Gwenaël , Ropars Mickael , Dreano Thierry
Published: June 2024

Although goniometric measurement is considered the gold standard for the measurement of digital range of motion, visual estimation is often employed due to its simplicity despite being inconsistent with recommended guidelines. We evaluated the Rennes Universal Measurement Method, an innovative tool employing artificial intelligence to concurrently analyse hand joint angles based on a single photograph. We found a strong correlation between the goniometric method and the photograph-based approach (Spearman correlation coefficient 0.7). The mean standard error of measurement was −1° (SD 17°). Regarding reproducibility with different photographic angles, an excellent intraclass correlation coefficient of 0.9 was noted. The tool had a processing time of less than 0.1 s per hand, while traditional goniometric methods took 20–30 s per finger. Combining simplicity, high reproducibility and good inter-rater reliability, this is a potentially useful tool that can be used to monitor patient progress in place of traditional goniometry.
Evidence-based decision-making in a climate of political expediency: insights from local government
Authors: Woodall J , Homer C , Freeman C , South J , Cooke J , Holliday J , Hartley A , Mullen S , Stafford B
Published: June 2024

Aims:

Local authorities in England are responsible for public health and health promotion. This article sought to explore how research and decision-making co-exist in a local authority in England.

Methods:

An Embedded Researcher was based within the local authority and used qualitative methodology to address the research aim. Interviews and focus groups were employed to ascertain a range of stakeholder views in the local authority. All transcripts were coded on NVivo 12 by the Embedded Researcher and two members of the research team cross-checked a sample for coding accuracy. Data were analysed using framework analysis.

Results:

The data suggest several barriers to using research to inform decision-making in health promotion and public health. The study shows that research is valued in local authorities, but not always privileged – this is due to cultural factors and practical political reasons which often means that decisions need to be made expediently. Participants outlined a juxtaposition between academic credibility; timeliness to complete the research and the financial cost associated with it; against the independence and credibility that independent academics could bring.

Conclusion:

Policy formulation and delivery is an integral aspect of health promotion and critical to achieving improved population health and reductions in health inequalities. However, there exists tensions between gathering research evidence and making research-informed decisions. The article concludes by advocating the use of Embedded Researchers to fully understand how research is gathered and used to support public health and health promotion policymaking.
Saving time and staying rigorous: The RADaR technique for qualitative research
Authors: Berthelsen Connie
Published: June 2024

Saving time within a research process is a joy to all qualitative researchers. However, combing a time-saving qualitative approach with a rigorous process and ending up with valid findings is an even bigger pleasure. In this Contemporary Issue, I present the Rigorous and Accelerated Data Reduction (RADaR) technique as described by Watkins, to disseminate an example of how to master this venture. The RADaR technique is a five-step approach combining data collection, data analysis and reporting of findings in a structured tabular format. Even though the RADaR technique is performed without a philosophical paradigm of basic theoretical beliefs of the researchers and how it influences the steps of their research approach, the advantages of using this technique are considerable. They include eluding extensive periods of abduction and the time-consuming process of transcribing data materials as well as providing an opportunity to include more participants than usual.
Lumbar Total Disc Replacement Leads to Increased Subsequent Facet Injections Compared to Anterolateral Lumbar Interbody Fusions
Authors: Narendran Nakul , Mikhail Christopher M. , Nilssen Paal K. , Tuchman Alexander , Skaggs David L.
Published: June 2024

Study Design

Retrospective Matched Cohort.

Objective

Despite known consequences to the facet joints following lumbar total disc replacement (TDR), there is limited data on facet injection usage for persistent postoperative pain. This study uses real-world data to compare the usage of therapeutic lumbar facet injections as a measure of symptomatic facet arthrosis following single-level, stand-alone TDR vs anterolateral lumbar interbody fusion (ALIF/LLIF).

Methods

The PearlDiver database was queried for patients (2010-2021) with lumbar degenerative disc disease who received either a single-level, stand-alone TDR or ALIF/LLIF. All patients were followed for ≥2 years and excluded if they had a history of facet injections or spinal trauma, fracture, infection, or neoplasm. The two cohorts were matched 1:1 based on age, sex, insurance, year of operation, and medical comorbidities. The primary outcome was the use of therapeutic lumbar facet injections at 1-, 2-, and 5-year follow-up. Secondary outcomes included subsequent lumbar surgeries and surgical complications.

Results

After 1:1 matching, each cohort had 1203 patients. Lumbar facet injections occurred significantly more frequently in the TDR group at 1-year (6.07% vs 1.66%, P < .0001), 2-year (8.40% vs 3.74%%, P < .0001), and 5-year (11.47% vs 6.40%, P < .0001) follow-up. 5-year injection-free probability curves demonstrated an 87.1% injection-free rate for TDR vs 92.9% for ALIF/LLIF. There was no clinical difference in the incidence of subsequent lumbar surgeries or complications.

Conclusion

Compared with ALIF/LLIF, patients who underwent TDR received significantly more facet injections, suggesting a greater progression of symptomatic facet arthrosis. TDR was not protective against reoperations compared to ALIF/LLIF.
The Islamic Republic of Iran’s Multipronged Approach to the Repression of Kurds
Authors: Hassaniyan Allan
Published: June 2024

Since the establishment of the modern Iranian nation-state in 1923, successive regimes and governments of Iran have pursued an intricate policy of suppressing and persecuting its Kurdish people, presenting a significant threat to the Kurdish national identity, culture, and society. The successive Iranian regimes have, along with military means, employed the state’s cultural, educational, religious, and economic institutions to accomplish their goals of assimilating and conquering the Kurds. An examination of Kurdish history and politics in Iran reveals that while the international community has some knowledge of the Iranian state’s extensive deployment of military force and explicit militarization of Iranian Kurdistan (Rojhelat/East Kurdistan), the broader psychological and nonmilitary (soft power) practices employed to suppress the Kurdish movement, identity, and culture are lesser known to the outside world. By focusing on mass media and policies of “divide-and-rule” as measures and mechanisms used by the Iranian state to subdue its Kurdish citizens, this article aims to provide an analysis of the post-1979 state-Kurdish relationships in Iran.
‘I Don’t Play Games’: Migrant Workers and Digital Media in Bengaluru
Authors: Rajappa Amoolya , Sawhney Rashmi Devi
Published: June 2024

The great impact of media technologies in reordering almost every facet of modern life has been noted by theorists for over a century now, particularly since the idea of the ‘global village’ imagined by media theorists, and enabled by globalisation and digital technology has become an inescapable reality. The new experience of time and space bears upon various dimensions of life, including the nature of work, the organisation of time and the place of leisure within these rhythms. This article attempts to engage with this very weighty body of scholarship in a modest way, through ethnographic research, to understand how mobile phones and internet technologies structure the experience of ‘everyday life’ for low-income migrant workers in Bengaluru. The sites include a construction site and a hookah bar, and the study focuses on mobile gaming and the structuring of migrant social networks.
Newer Challenges in Sexual Health
Authors: Sidhu Gulbahar Singh
Published: June 2024

More and more professionals in the field of Sexual Health are encountering problems that do not find a mention in conventional diagnostic manuals. Sexless marriages are one such problem. Its reported incidence varies from 2% to 45% in the age group 18–60 years, depending on the definition used. The figures are higher for the ages of 60 or more. The reasons for the same range from economic development and its ramifications, the monotony of sexual experience, the emergence of the smartphone, and social networking sites, to a possible role of substance use. Artificial intelligence could offer a solution to this vexed problem, although the benefits of anonymous access and a non-judgmental format could actually contribute to increasing the problem.
Sexual Knowledge, Attitude, Behaviours and Sources of Influences in Undergraduate Medical Students in a Peripheral Medical College: A Cross-sectional Study
Authors: Mahadik Humaid , Shaikh Mujahid , Muthe Mayur
Published: June 2024

Background:

The word ‘sex’ in India is taboo and is not discussed openly. Sex attitude refers to one’s attitude towards sexuality or different sexual behaviours. Poor sex knowledge causes many problems. A liberal attitude without adequate knowledge is harmful.

Aim:

To explore and study sexual knowledge, attitudes, behaviours and the sources of influence and to examine the relationship between sexual knowledge, attitude and behaviours in undergraduate medical students.

Material and Methods:

A cross-sectional study was carried out to assess sex knowledge and attitude among 506 medical undergraduate students. A Google document in the form of a structured questionnaire containing three important parts was used for the assessment: (a) demographic details of students; (b) sex knowledge and attitude questionnaire II (SKAQ II); and (c) Sexual Behaviour and Sources of Influence (SBSI) scale. Data was interpreted using mean, unpaired ‘t’ test and chi-square test.

Results:

Overall, participants showed a conservative attitude towards sex. As the academic year of participants progressed, sex knowledge increased. A statistically significant positive correlation was observed between sex knowledge and attitude scores. Sexual behaviours through media and with self or others were found to be low. The Internet was found to be the major source for gathering information and was considered the most reliable source.

Conclusion:

Participants were deficient in sex knowledge and had a conservative attitude in certain areas. Females, higher education levels and urban area participants had higher sex knowledge and liberal attitudes. There are areas of sex knowledge and attitude that need improvement by proper sex education.
Unprotected Risky Sex Among Men with Opioid Dependence: Is More Needed to Be Done?
Authors: Chattopadhyay Ankita , Chawla Nishtha , Sen Mahadev Singh , Verma Suraj , Ganesh Ragul , Sarkar Siddharth , Ambekar Atul
Published: June 2024

Background and Objectives:

Risky behaviors are common among patients with substance use disorders. Knowing the determinants of risky sexual behaviors can identify individuals who may benefit from targeted interventions. The primary aim of the study was to assess unprotected risky sexual behavior and its sociodemographic and clinical correlates in treatment-seeking opioid-dependent patients.

Methods:

A cross-sectional exploratory study was done on 112 married treatment-seeking opioid-dependent male patients. A semi-structured proforma consisting of sociodemographic and clinical details was used to assess sexual behavior, other risky behaviors like injecting drug use (IDU), and knowledge of and attitude toward risky sexual behavior.

Results:

The mean age of the sample was 34.1 years, and that at first sexual intercourse was 18.6 years. History of unprotected risky sex (unprotected sex with a casual partner or female sex worker or person having a sexually transmitted disease or with males or having sex for rewards) was present in 30 patients (26.8% of the sample). Unprotected risky sex was found to be significantly associated with younger age at first sexual encounter ( p = .010), more sexual partners ( p < .001), greater frequency of masturbation ( p = .031), and watching pornography ( p = .028). However, it was not found to be related to other risky behaviors such as IDU ( p = .210) and sex under intoxication ( p = .149) and also did not vary between treatment-naïve and under-treatment populations ( p = .434). No significant relationship was found between knowledge and attitude about risky sexual behavior and unprotected risky sex in the present sample.

Conclusion:

Risky sexual behavior in opioid-dependent patients is a concern, as this may be an additional mode of transmission of blood-borne viruses apart from IDU. Safe sex practices need to be emphasized in this population, and efforts at behavioral changes are desirable.
Study of Sexual Dysfunctions in Male Patients with Alcohol Dependence Syndrome
Authors: Soni Parth A. , Jadhav Bindoo S. , Verma Rishab
Published: June 2024

Background:

Virtually all aspects of the human sexual response are affected by alcohol. Chronic and persistent alcohol use has been seen to impair erectile, orgasmic and ejaculatory capacities, which leads to marked distress and interpersonal difficulty.

Aims and Objectives:

To study the prevalence and types of sexual dysfunction and to study the impact of the severity of alcohol dependence on sexual dysfunctions in male patients with alcohol dependence syndrome.

Methodology:

A cross-sectional study was done at the outpatient Department of Psychiatry of a tertiary teaching hospital. Socio-demographic details of the patient and alcohol-related clinical variables were collected using the study proforma. The severity of alcohol dependence was assessed using the Alcohol Dependence Scale (ADS). To assess the presence of sexual dysfunction, the Arizona Sexual Experience Scale (ASEX) was used and the type of sexual dysfunction was decided by the Sexual Dysfunction Checklist (SDC) based on ICD 10, and the data was analysed.

Results:

170 male patients with alcohol dependence, with a mean age of 35.84 years, participated in the study. The prevalence of sexual dysfunction was 67.06%. Loss or lack of sexual desire was the most common sexual dysfunction, followed by failure of genital response (erectile dysfunction), frequency dissatisfaction and premature ejaculation. The majority of the sample studied had one or more sexual dysfunctions. The ADS score positively correlated with the ASEX score, and this correlation was statistically significant.

Conclusion:

Alcohol use was found to be associated with sexual dysfunctions, and lack of sexual desire was the most common sexual dysfunction.
Uncovering the Knowledge Gap: Sexual and Reproductive Health Education and Knowledge Among Unmarried Sri Lankan Youth
Authors: De Silva Indralal W. , Suranga M. Suchira S. , Kumarasinghe Malith , De Silva Ranjith
Published: June 2024

Introduction:

Sexual and reproductive health (SRH) education is crucial to prevent unwanted pregnancies and sexually transmitted infections (STIs) among young people. However, in Sri Lanka, little is known about the level of access to SRH education and knowledge among unmarried youth. This study aimed to assess perceptions of SRH education at school and the level of knowledge on selected aspects of SRH among unmarried youth aged 15–24 years in Sri Lanka.

Methods:

A cross-sectional study was conducted among 1057 unmarried male and female youth aged 15–24 years in three selected districts of Sri Lanka. A semi-structured, self-administered questionnaire was operationalized after receiving informed consent. Twelve focus group discussions were also conducted with the youth.

Results:

A sizable proportion of youth demonstrated low access to SRH education and a low level of knowledge on pregnancy, contraception, and STIs. Although it is limited, respondents felt that the SRH education received in school is useful for their life. Friends and the Internet were identified as the primary sources of information among boys, whereas the mother was the primary source for the majority of girls. Boys demonstrated better SRH knowledge compared to girls for most of the aspects. SRH knowledge was increased among both boys and girls significantly with maturity.

Conclusion:

Results conclude that there is a significant knowledge gap on SRH among unmarried youth. Introduction of age-specific and gender-sensitive SRH education is important to address the current gap in SRH knowledge.
Harnessing barley grains for green synthesis of gold and silver nanoparticles with antibacterial potential
Authors: Singh Priyanka , Mijakovic Ivan
Published: June 2024

The continuous evolution and significance of green resources-based nanomaterials have spurred the exploration of sustainable sources for nanoparticle production. Green synthesis routes offer eco-friendly methodologies, ensuring nanoparticle stability and monodispersity, enhancing their efficiency for various applications. Notably, the thick biological corona layer surrounding nanoparticles (NPs) synthesized through green routes contributes to their unique properties. Consequently, there has been a surge in the development of NPs synthesis methods utilizing medicinal plants and diverse agricultural and waste resources. This study highlights the sustainable potential of barley grains for the synthesis of gold nanoparticles (Barley-AuNPs) and silver nanoparticles (Barley-AgNPs) as an environmentally friendly alternative, followed by NPs characterizations and their application against pathogenic bacteria: Escherichia coli UTI 89 and Pseudomonas aeruginosa PAO1. The rapid synthesis of Barley-AuNPs within 20 min and Barley-AgNPs within 30 min at 90 °C underscores the efficiency of barley as a green precursor. Characterization through advanced techniques, including SEM, TEM, EDS, AFM, DLS, FT-IR, MALDI-TOF, and sp-ICPMS, reveals the 20–25 nm size for Barley-AuNPs, while Barley-AgNPs demonstrate 2–10 nm size with spherical monodispersity. A notable contribution lies in the stability of these NPs over extended periods, attributed to a thick biological corona layer. This corona layer, which enhances stability, also influences the antimicrobial activity of Barley-AgNPs, presenting an intriguing trade-off. The antimicrobial investigations highlight the significant potential of Barley-AgNPs, with distinct minimum bactericidal concentrations (MBC) against P. aeruginosa and E. coli at 8 µg/mL. Overall, this research pioneers the use of barley grains for nanoparticle synthesis and unveils these nanoparticles' unique characteristics and potential antibacterial applications, contributing to the evolving landscape of sustainable nanotechnology.

Graphic Abstract
Clinical application of targeted tumour sequencing tests for detecting ERBB2 amplification and optimizing anti-HER2 therapy in gastric cancer
Authors: Ichikawa Hiroshi , Usui Kenji , Aizawa Masaki , Shimada Yoshifumi , Muneoka Yusuke , Kano Yosuke , Sugai Mika , Moro Kazuki , Hirose Yuki , Miura Kohei , Sakata Jun , Yabusaki Hiroshi , Nakagawa Satoru , Kawasaki Takashi , Umezu Hajime , Okuda Shujiro , Wakai Toshifumi
Published: June 2024

Background

Evaluation of human epidermal growth factor receptor 2 (HER2) overexpression caused by erb-b2 receptor tyrosine kinase 2 (ERBB2) amplification (AMP) by immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) is essential for treating unresectable metastatic gastric cancer (GC). A targeted tumour sequencing test enables comprehensive assessment of alterations in cancer-related genes, includingERBB2. This study aimed to evaluate the concordance between the targeted tumour sequencing test and IHC/FISH for detecting HER2-positive GC and to clarify the significance ofERBB2AMP and concomitant genetic alterations in HER2 downstream pathways (DPs) in anti-HER2 therapy for unresectable metastatic GC patients.

Methods

ERBB2copy number alteration (CNA) was examined via a targeted tumour sequencing test in 152 formalin-fixed paraffin-embedded (FFPE) GC tissues.ERBB2CNA was compared to HER2 status evaluated by IHC/FISH in FFPE block sections, which were identical to those subjected to the targeted tumour sequencing test. Treatment outcomes of anti-HER2 therapy in 11 patients with unresectable metastatic GC was evaluated.

Results

ERBB2AMP (≥ 2.5-fold change) was detected by the targeted tumour sequencing test in 15 patients (9.9%), and HER2 positivity (IHC 3 + or IHC 2+/FISH positive) was detected in 21 patients (13.8%). The overall percent agreement, positive percent agreement, negative percent agreement and Cohen’s kappa betweenERBB2CNA and HER2 status were 94.7%, 66.7%, 99.2% and 0.75, respectively. Progression-free survival for trastuzumab therapy in patients withERBB2AMP was significantly longer than that in patients with noERBB2AMP detected by the targeted tumour sequencing test (median 14 months vs. 4 months,P = 0.007). Treatment response to trastuzumab therapy was reduced in patients withERBB2AMP and concomitant CNAs of genes in HER2 DPs. One patient withERBB2AMP and concomitant CNAs of genes in HER2 DPs achieved a durable response to trastuzumab deruxtecan as fourth-line therapy.

Conclusions

A targeted tumour sequencing test is a reliable modality for identifying HER2-positive GC.ERBB2AMP and concomitant genetic alterations detected through the targeted tumour sequencing test are potential indicators of treatment response to trastuzumab therapy. The targeted tumour sequencing test has emerged as a plausible candidate for companion diagnostics to determine indications for anti-HER2 therapy in the era of precision medicine for GC.
Randomized trial comparing the effects of a 3D head-up system and microscope eyepiece-assisted simulated vitrectomy with intraocular illumination on the ocular surface of an operator
Authors: Ge Xing , Liu Dandan , Fan Fangfang , Xu Tengyu , Zhang Zhengpei , Liu Haiyang , Li Suyan
Published: June 2024

Background

To compare the effects of a 3D head-up system and microscope eyepiece-assisted simulated vitrectomy intraocular illumination on the ocular surface of an operator.

Methods

This was a prospective randomized controlled study. According to the application system, thirty ophthalmic operators (60 eyes) were randomly divided into 3D and eyepiece groups. Under different intensities of intraocular illumination, operators in both groups viewed the fundus model through a 3D display screen or microscopic eyepiece for 2 h. Objective examinations and a subjective symptom questionnaire were used immediately after the test to evaluate the ocular surface of the operators. Objective examinations included nonintrusion tear meniscus height (NIKTMH), nonintrusion break-up time (NIKBUT), and bulbar redness and strip meniscometry tube (SMTube) measurements. Statistical analyses were performed by using SPSS 26.0 software.

Results

After the test, the NIKTMH, NIKBUT and SMTube measurements decreased; however, the degree of change varied among the groups of different systems. The differences between the 3D group and the eyepiece group in NIKTMH measurements, SMTube measurements, subjective symptom scores (eye dryness, difficulty focusing, and cervical pain), and light intensity reaching the ocular surface of the operators were statistically significant (P < 0.05). All of the objective and subjective tests showed that the 3D group had fewer effects on the NIKTMH and SMTube measurements, and the subjective comfort of the 3D group was greater.

Conclusion

For both 3D screens and eyepieces, simulated vitrectomy with intraocular illumination for two hours can lead to discomfort and abnormalities in the operator’s ocular surface; however, these abnormalities are less severe in the 3D group.

Trial registration

This trial was registered on December 22, 2022, at the Chinese Clinical Trials Registry with NO. ChiCTR2200066989.
The role of gender in health insurance enrollment among geriatric caregivers: results from the 2022 informal caregiving, health, and healthcare survey in Ghana
Authors: Agyemang-Duah Williams , Oduro Michael Safo , Peprah Prince , Adei Dina , Nkansah Jacob Oppong
Published: June 2024

Background

Female informal caregivers of older adults experience a higher burden of physical and mental health problems compared to their male counterparts due to the greater intensity of care they provide. This is likely to result in an imbalance in health needs, including health insurance enrollment, between male and female informal caregivers of older adults. However, to date, no study is available on the role of gender in health insurance enrollment among informal caregivers of older adults in Ghana. This study examines the association between gender and health insurance enrollment among informal caregivers of older adults in Ghana.

Methods

Cross-sectional data from the Informal Caregiving, Health, and Healthcare Survey among caregivers of older adults aged 50 years or above (N = 1,853 and mean ages =   39.15 years and  75.08 years of informal caregivers and their care recipients, respectively) in Ghana were analyzed. A binary logit regression model was used to estimate the association between gender and health insurance enrollment. All statistical inferences were made at the 5% significance level.

Results

The final Model (3) showed that female informal caregivers were 2.70 times significantly more likely to enrol in a health insurance scheme than their male counterparts (AOR: 2.70, 95% CI: 2.09–3.48, p-value = 0.001). Apart from gender, the results revealed that participants aged 55–64 years (AOR = 2.38, 95%CI: 1.29–4.41, p-value = 0.006), with tertiary education (AOR: 3.62, 95% CI: 2.32–5.66, p-value = 0.001) and living with the care recipients (AOR: 1.50, 95% CI: 1.14–1.98, p-value = 0.003) were significantly more likely to enrol in a health insurance scheme than their counterparts. The findings further showed that those who earned between GH¢1000 and 1999 (US$99.50-198.50) monthly (AOR: 0.70, 95% CI: 0.52–0.95, p-value = 0.022) and were affiliated with African traditional religion (AOR: 0.30, 95%CI: 0.09–0.99, p-value = 0.048) were significantly less likely to enrol in a health insurance scheme than their counterparts.

Conclusion

Gender was a significant predictor of health insurance enrollment among informal caregivers of older adults. This finding contributes to the empirical debates on the role of gender in health insurance enrollment among informal caregivers of older adults. Policymakers need to develop gender-specific measures to address gender gaps in health insurance enrollment among informal caregivers of older adults in Ghana. Such health policies and programs should consider other significant demographic and socioeconomic factors associated with health insurance enrolment among informal caregivers of older adults in Ghana.
“It’s another gay disease”: an intersectional qualitative approach contextualizing the lived experiences of young gay, bisexual, and other sexual minoritized men in the United States during the mpox outbreak
Authors: Takenaka Bryce Puesta , Kirklewski Sally J. , Griffith Frances J. , Gibbs Jeremy J. , Lauckner Carolyn K. , Nicholson Erin , Tengatenga Cecil , Hansen Nathan B. , Kershaw Trace
Published: June 2024

Background

The U.S. mpox outbreak in 2022 introduced new and exacerbated existing challenges that disproportionately stigmatize gay, bisexual, and other sexual minoritized men (GBSMM). This study contextualizes the perceptions, susceptibility, and lived experiences of the mpox outbreak among GBSMM in the U.S. using an intersectional framework.

Methods

Between September 2022 to February 2023, we conducted 33 semi-structured qualitative interviews with purposively sampled GBSMM in the Northeast and the South region of the United States on various aspects related to their experience during the mpox outbreak.

Results

We identified four themes: (1) understanding and conceptualizations of mpox, (2) mpox vaccine availability and accessibility, (3) mpox vaccine hesitancy and mistrust, and (4) call to action and recommendations. GBSMM collectively discussed the elevated mpox stigmatization and homophobic discourse from mainstream social media and news outlets. GBSMM also discussed the lack of availability of mpox vaccines, unclear procedures to receive the vaccine, and continued mistrust in government, non-government, and other institutions of health that were complicit in anti-LGBTQ + narratives related to mpox. However, they expressed that these challenges may be addressed through more LGTBQ + representation and leveraging ways to empower these communities.

Conclusion

GBSMM have mpox experiences that are distinct and multifaceted. Effectively addressing mpox and mitigating public health emergencies for GBSMM requires prioritizing destigmatizing communication channels and vaccine distribution strategies by centering their stories and lived experiences to advance health equity.