bluuebunny/crossref_metadata_2025 huggingface dataset:
Atypical pattern separation memory and its association with restricted interests and repetitive behaviors in autistic children
Authors: Chen Lang , Liu Jin , Kang Julia Boram , Rosenberg-Lee Miriam , Abrams Daniel A , Menon Vinod
Published: January 2024

Emerging research suggests that episodic memory challenges are commonly encountered by autistic individuals; however, the specific nature of these memory challenges remains elusive. Here, we address critical gaps in the literature by examining pattern separation memory, the ability to store distinct memories of similar stimuli, and its links to the core autistic trait of repetitive, restricted interests and behaviors. Utilizing a large sample of over 120 autistic children and well-matched non-autistic peers, we found that autistic children showed significantly reduced performance on pattern separation memory. A clustering analysis identified three distinct pattern separation memory profiles in autism, each characterized by reduced or increased generalization abilities. Importantly, pattern separation memory was negatively correlated with the severity of repetitive, restricted interest and behavior symptoms in autism. These findings offer new evidence for challenges in pattern separation memory in autism and emphasize the need to consider these challenges when assessing and supporting autistic individuals in educational and clinical settings.

Lay abstract

Memory challenges remain understudied in childhood autism. Our study investigates one specific aspect of memory function, known as pattern separation memory, in autistic children. Pattern separation memory refers to the critical ability to store unique memories of similar stimuli; however, its role in childhood autism remains largely uncharted. Our study first uncovered that the pattern separation memory was significantly reduced in autistic children, and then showed that reduced memory performance was linked to their symptoms of repetitive, restricted interest and behavior. We also identified distinct subgroups with profiles of reduced and increased generalization for pattern separation memory. More than 72% of autistic children showed a tendency to reduce memory generalization, focusing heavily on unique details of objects for memorization. This focus made it challenging for them to identify commonalities across similar entities. Interestingly, a smaller proportion of autistic children displayed an opposite pattern of increased generalization, marked by challenges in differentiating between similar yet distinct objects. Our findings advance the understanding of memory function in autism and have practical implications for devising personalized learning strategies that align with the unique memory patterns exhibited by autistic children. This study will be of broad interest to researchers in psychology, psychiatry, and brain development as well as teachers, parents, clinicians, and the wider public.
The politicization of PISA in evidence-based policy discourses
Authors: Volante Louis , Mattei Paola
Published: January 2024

Education reform efforts stemming from the Programme in International Student Achievement have strengthened in recent years, particularly in response to the growth of global references societies – high achieving educational jurisdictions such as Finland, Hong Kong-China, and more recently Estonia and Singapore. Despite political rhetoric, evidence-based policy development associated with this international benchmark measure is rarely, if ever, a neutral enterprise that is guided by the best available evidence. Indeed, political discourse and policy framing surrounding PISA often results in the selective use of results to justify contested policy reforms. Brief cases from Japan, Sweden, and Canada illustrate how national policies have been adopted that are not grounded, and may even run counter, to research findings. The discussion examines the politicization of PISA and its symbolic role in adding legitimacy to education reform agendas. Collectively, the analysis offers an alternative perspective to the popular notion that PISA guides evidence-based decision-making.
Practicalities and dichotomies of education policy and practice of higher education in the Golden Triangle Area (Southeast Asia): Implications for international development
Authors: Aung Shine Wanna , Aye Than Than
Published: January 2024

Following the paradigm of globalization and development as a means of achieving a better life from the domestic sphere to the international landscape, different stakeholders including scholars, researchers, practitioners, policy makers, and institutions have been focusing on better informed policy and practice with an embedded mission of international development. Educational policymaking and implementation processes of a nation-state are constrained by global economic and political environments. The ongoing status of educational efforts in each country and disputing factors to the implementation of the education policies were examined. In this study, systematic literature review was conducted on the research of higher education policy in line with globalization and internationalization to depict the practicalities and dichotomies in implementing the sectors at the Golden Triangle Area (Laos, Myanmar, and Thailand). The internationalization of higher education in Golden Triangle Area needs promoting its strategic advantage in offering business opportunities through government policies to further promoting as an affordable study destination and attracting international students from ASEAN countries. The factors affecting the higher education quality and capacity of Laos, Myanmar, and Thailand include the need for better quality, barriers to research capacity development, the policy process of quality assurance, and the initiatives for internationalization in all three countries.
Intimate Partner Violence Against Women Before, During, and After Pregnancy: A Meta-Analysis
Authors: Chen Xiao-Yan , Lo Camilla Kin Ming , Chen Qiqi , Gao Shuling , Ho Frederick K. , Brownridge Douglas Austin , Leung Wing Cheong , Ip Patrick , Ling Chan Ko
Published: January 2024

Intimate partner violence (IPV) against pregnant women negatively impacts women’s and infants’ health. Yet inconsistent results have been found regarding whether pregnancy increases or decreases the risk of IPV. To answer this question, we systematically searched for studies that provided data on IPV against women before pregnancy, during pregnancy, and after childbirth. Nineteen studies met our selection criteria. We meta-analyzed the nineteen studies for the pooled prevalence of IPV across the three periods and examined study characteristics that moderate the prevalence. Results showed the pooled prevalence estimates of IPV were 21.2% before pregnancy, 12.8% during pregnancy and 14.7% after childbirth. Although these findings suggest a reduction in IPV during pregnancy, our closer evaluation of the prevalence of IPV after childbirth revealed that the reduction does not appear to persist. The prevalence of IPV increased from 12.8% within the first year after childbirth to 24.0% beyond the first year. Taken together, we should not assume pregnancy protects women from IPV, as IPV tends to persist across a longer-term period. Future studies are needed to investigate if IPV transits into other less obvious types of violence during pregnancy. Moderator analyses showed the prevalence estimates significantly varied across countries by income levels and regions.
Community and Organizational Readiness to Adopt a Physical Activity Intervention in Micropolitan Settings
Authors: Gauthreaux Nicole , Bucklin Rebecca , Correa Anna , Steere Eliza , Pham Hanh , Afifi Rima A. , Askelson Natoshia M.
Published: January 2024

Background

Assessing community and organizational readiness is key to successfully implementing programs. The purpose of this study was to assess the baseline readiness of micropolitan communities to adopt an evidence-based physical activity (PA) intervention by exploring three dimensions: (1) attitudes and current efforts toward prevention, (2) community and organizational climate that facilitates (or impedes) change, and (3) capacity to implement change.

Method

Data were collected from community leaders in 14 communities through an online survey in June 2021 (n = 149). Data were analyzed in aggregate using descriptive statistics for multiple-choice responses and content analysis for open ended responses. One-way repeated analyses of variance were used to compare mean score differences.

Results

In reference to their attitudes prior to the pandemic, respondents said that addressing PA was “somewhat a priority” in their professional positions ( M = 2.01, SD = 0.94), their organizations ( M = 2.08, SD = 0.91), and their communities ( M = 2.28, SD = 0.88). Current PA efforts included statewide initiatives, community sponsored events/clubs, and youth sports leagues. The community climate included both PA facilitators (mainly outdoor PA resources) and barriers (cost, lack of social services, and an unsupportive PA environment). Individual-level capacity ( M = 2.94; SD = 1.21) to adopt a PA program was regarded lower than the community’s capacity ( M = 3.95; SD = 0.82), and perceptions of capacity at the community level improved even more if technical assistance ( M = 3.96; SD = 0.84) or financial support ( M = 4.12; SD = 0.80) were provided.

Conclusion

Readiness varied by dimension, suggesting the need for tailored implementation supports including technical assistance and financial support.
Decoding the perception of prescribers towards generic medicine: A bibliometric study
Authors: Prasad T Aditya , Panesar Ashwani
Published: January 2024

2008 can be considered a watershed year for generic medicine in India, as it saw the launch of the Jan Aushadi scheme, to provide cost-effective quality medicines to its populace, through special stores called Jan Aushadi stores. With more than 8800 stores, the scheme is touted as one of the world’s largest pharmaceutical retail chains. Since then, many generic medicine start-ups have also launched operations in the country- Zeno Health, One India Pharmacy, Generic Aadhaar and StayHappi Generics. These supply side developments will however have to be complemented with commensurate demand side responses for it make a sustainable impact towards the push for affordable and accessible healthcare for all (Sustainable Development Goal 3). Many studies have established that, on the demand side, owing to the lack of requisite medical knowledge on part of the patients, there exists a strong agency relationship, where patients rely heavily on their physicians (prescribers) to make decisions on choice of treatments. Though promotion of generic medicines requires a coordinated effort from many stakeholders, analysis reveals that the prescribers, and hence their perception of generics, plays a pivotal role in their adoption. This study undertakes a bibliometric analysis of the top 100 most-cited research papers published between 2012 and 2022 on the perception of prescribers towards generic medicine from SCOPUS database. Suitable keywords have been incorporated to reach the relevant publications and VOSviewer (version 1.6.10) has been used for analysis. The findings of the study recommend further research on interventions aimed at improving prescriber’s perception towards generic medicines to enhance their adoption and promote cost effective healthcare delivery.
Future-readiness and its educational implications: A Daoist interpretation
Authors: Tan Charlene
Published: January 2024

This paper explores the extent to which our past and present knowledge can help us to be future-ready, and suggests a theoretical basis for future-readiness. Drawing on the thought of the Daoist philosopher Zhuangzi, it is argued that future-readiness is primarily about having an open and flexible mindset where one responds appropriately to emerging realities and challenges. Two salient key Daoist principles that underpin the notion of future-readiness are ‘walking two roads’ ( liang xing) and ‘rightness of the present this’ ( yin shi). The former is about going beyond shi/fei distinctions – ‘this/right’ versus ‘not-this/wrong’ – to consider and harmonise alternatives to achieve the best possible outcome. The principle of ‘rightness of the present this’ refers to making the most appropriate response based on situational constraints. The major educational implications are a rejection of limiting teaching and learning to skills-centred education; an emphasis on unlearning; and the promotion of self-transformative education.
Rhodium-catalyzed C–H selective amination of 2,4-diarylquinazolines with N-fluorobenzenesulfonimide
Authors: Gao Wei , Hu Lifang , Gao Fang , Hu Guozhu , Zhou Xueying
Published: January 2024

A rhodium-catalyzed C–H selective amination of 2,4-diarylquinazolines has been developed with the commercially available N-fluorobenzenesulfonimide as the amino source. This approach offers a unique route for direct C–H amidation and demonstrates remarkable functional group tolerance and regioselectivity.
Exploring the Biomedical Potential of Endophytic Fungi Isolated from Panamanian Mangroves
Authors: Cherigo Lilia , López Dioxelis , Spadafora Carmenza , Mejia Luis C. , Martínez-Luis Sergio
Published: January 2024

Objective: The objective of this study was to assess the biomedical potential of endophytic fungi isolated from Panamanian mangrove plants. This was achieved through the biological evaluation of organic extracts to determine their antiparasitic, anticancer, toxicity activity, and inhibition of the enzyme α-glucosidase. Methods: Leaves from various mangrove plant species in five different zones along the Pacific coast of Panama were collected using standard procedures. Endophytic fungi present on the leaves of each plant mangrove species collected were isolated using standard microbiological protocols. Organic extracts of each fungal isolate were prepared through maceration. The antiparasitic activity against Plasmodium falciparum, Trypanosoma cruzi, and Leishmania donovani, toxicity against Artemia salina, and anticancer activity in the MCF-7 cell line were investigated following protocols established by our institution. Finally, the ability to inhibit the enzymatic activity of α-glucosidase was evaluated by monitoring the hydrolysis of PNP-G. Results: Forty-three fungal isolates were isolated from the mangrove leaves analyzed. Organic extracts were prepared from each isolate for subsequent biological evaluation. It was found that twenty-one of the organic extracts showed activity in at least one of the performed bioassays. In the brine shrimp test, most samples were nontoxic or exhibited weak toxicity. Two fungal extracts showed anticancer activity, three showed antileishmanial activity, and one exhibited weak activity against P. falciparum. The most significant biological activity shown by the evaluated extracts was the inhibition of the α-glucosidase enzyme, where 44% of the fungal extracts were active. Conclusion: The most promising biomedical activity detected in the fungal isolates associated with mangrove plants is the inhibition of the α-glucosidase enzyme. Among the active samples, a high percentage belonged to fungi identified within the class Dothidiomycetes, revealing that this class is a potential new source of compounds with hypoglycemic activity.
Adapting to Change: A Systematic Literature Review of Environmental Flexibility in Emergency Departments
Authors: Jamshidi Saman , Hashemi Seyedehnastaran , Valipoor Shabboo
Published: January 2024

Purpose:

This study aimed to offer a comprehensive analysis of distinct design strategies identified, evaluated, or discussed in the existing literature that promote environmental flexibility in the context of emergency departments (EDs).

Background:

EDs are subject to constant changes caused by several factors, including seasonal disease trends, the emergence of new technologies, and surges resulting from local or global disasters, such as mass casualty incidents or pandemics. Thus, integrating flexibility into ED design becomes crucial to effectively addressing these evolving needs.

Methods:

A systematic search was conducted in four databases: CINAHL, MEDLINE, PubMed, and ScienceDirect, in addition to a hand search. A two-stage review process was employed to determine the final list of included articles based on the inclusion criteria. Included studies were evaluated for quality, and findings were categorized using a hybrid deductive and inductive coding approach.

Results:

From the initial yield of 900 records, 22 studies met the inclusion criteria and were included in the final full-text review. The identified design strategies were organized into five categories: modifiability ( n = 13 articles), versatility ( n = 8 articles), tolerance ( n = 6 articles), convertibility ( n = 4 articles), and scalability ( n = 7 articles). Specific design strategies under each category are reported in detail.

Conclusions:

Our findings suggest that most flexibility design solutions are based on anecdotal evidence or descriptive studies, which carry less weight in terms of reliable support for conclusions. Therefore, more studies employing quantitative, relational, or causal designs are recommended.
Swimming Anatomy and Lower Back Injuries in Competitive Swimmers: A Narrative Review
Authors: Hsu Connie , Krabak Brian , Cunningham Brian , Borg-Stein Joanne
Published: January 2024

Context:

Competitive swimmers are at high risk of overuse musculoskeletal injuries due to their high training volumes. Spine injuries are the second most common musculoskeletal injury in swimmers and are often a result of the combination of improper technique, high loads on the spine in strokes that require hyperextension, and repetitive overuse leading to fatigue of the supporting trunk muscles. The purpose of this review is to summarize the current evidence regarding swimming biomechanics, stroke techniques, and common injuries in the lumbar spine to promote a discussion on the prevention and rehabilitation of lower back injuries in competitive swimmers.

Evidence Acquisition:

From a PUBMED/MEDLINE search, 16 articles were identified for inclusion using the search terms “swimming,” “low back” or “lumbar,” and “injury” or “injuries.”

Study Design:

Narrative review.

Level of Evidence:

Levels 4 and 5.

Results:

The trunk muscles are integral to swimming stroke biomechanics. In freestyle and backstroke, the body roll generated by the paraspinal and abdominal muscles is integral to efficient stroke mechanics by allowing synergistic movements of the upper and lower extremities. In butterfly and breaststroke, the undulating wave like motion of the dolphin kick requires dynamic engagement of the core to generate repetitive flexion and extension of the spine and is a common mechanism for hyperextension injuries. The most common lower back injuries in swimming were determined to be lumbar strain, spondylolysis and spondylolisthesis, facet joint pain, and disc disease. Most overuse swimming injuries can be treated conservatively with physical therapy and training adjustments.

Conclusion:

Managing swimmers with low back pain requires a basic knowledge of swimming technique and a focus on prevention-based care. Since most swimming injuries are secondary to overuse, it is important for providers to understand the mechanisms underlying the swimming injury, including an understanding of the biomechanics involved in swimming and the role of spine involvement in the 4 strokes that assist in stabilization and force generation in the water. Knowledge of the biomechanics involved in swimming and the significant demands placed on the spinal musculoskeletal system will aid the clinician in the diagnosis and management of injuries and assist in the development of a proper rehabilitation program aimed at correction of any abnormal swimming mechanics, treatment of pain, and future injury prevention.

Strength of Recommendations:

B. Recommendation based on limited quality or inconsistent patient-oriented evidence.
The Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities
Authors: Del Brutto Oscar H. , Mera Robertino M. , Rumbea Denisse A. , Sedler Mark J.
Published: January 2024

Background:

Information on factors that increase mortality in remote settings is limited. This study aims to estimate the independent and joint role of several factors on mortality risk among older adults living in rural Ecuador.

Methods:

Participants were selected from community-dwelling older adults who were included in previous studies targeting mortality risk factors in the study population. Generalized structural equation modeling (GSEM) was utilized to evaluate prior causal assumptions, to redraw causal links, and to introduce latent variables that may help to explain how the independently significant variables are associated with mortality.

Results:

The study included 590 individuals (mean age: 67.9 ± 7.3 years; 57% women), followed for a median of 8.2 years. Mortality rate was 3.4 per 100 person-years. Prior work on separate multivariate Poisson and Cox models was used to build a tentative causal construct. A GSEM containing all variables showed that age, symptoms of depression, high social risk, high fasting glucose, a history of overt stroke, and neck circumference were directly associated with mortality. Two latent variables were introduced, 1 representing the impact of biological factors and another, the impact of social factors on mortality. The social variable significantly influenced the biological variable which carried most of the direct effect on mortality.

Conclusions:

Several factors contributed to mortality risk in the study population, the most significant being biological factors which are highly influenced by social factors. High social risk interact with biological variables and play an important role in mortality risk.
Surgical Management of Ebstein Anomaly: The Australia and New Zealand Experience
Authors: Doig F. , Finucane K. , Skillington P. , Jones S. , Sharma V. , Daley M. , Wall D. , Suna J. , Alphonso N. , Bandara D. , Chard R. , Calderoni F. , Brizard C.
Published: January 2024

Background

Ebstein anomaly is a rare congenital anomaly of the tricuspid valve which presents challenges to cardiac surgeons due to the spectrum of the disease and the technical difficulty of valve repair. The natural history of the anomaly differs between patients presenting in the neonatal period to those presenting in adulthood.

Methods

A retrospective review of all patients >15 years of age with Ebstein anomaly, undergoing surgery on the tricuspid valve at 6 centers across Australia and New Zealand was performed. Patients from 1985 to 2019 were included in the study.

Results

A total of 125 patients were included in the study, 76 patients (60%) undergoing tricuspid valve repair, of which 23 patients underwent a Cone repair and 49 (40%) had a tricuspid valve replacement. The mean follow-up was 7.9 ± 7.3 years. Postoperatively, early mortality was 3 patients (2%) and 10-year survival was 91.5%. A postoperative pacemaker was required in 24 patients (19%). Reoperation was required in 21 patients (17%). There was no statistically significant difference in survival or reoperation between patients who underwent repair or replacement of the tricuspid valve; however, with a small number of patients in long-term follow-up.

Conclusion

Older children and adult patients undergoing surgery for Ebstein anomaly in Australia and New Zealand experience good medium-term postoperative survival. Repair of the valve is achieved in a significant proportion of patients with increasing use and success with the Cone repair technique.
Public–Private Partnership for Treatment of Congenital Heart Diseases: Experiences From an Indian State
Authors: Das Debasis , Dutta Nilanjan , Das Shubhadeep , Sharma Manish Kumar , Chattopadhyay Amitabha , Ghosh Sanjiban , Das Jayita Nandy
Published: January 2024

Background: Treatment of congenital heart disease (CHD), being the most common congenital anomaly, puts immense financial burden in low- and middle-income countries (LMICs) and contributes significantly to infant mortality. We report experiences of treatment of CHD in the Indian state of West Bengal by a public–private partnership (PPP) model. Methods: Under the Rashtriya Bal Swasthya Karyakram, the government of the state of West Bengal in India launched a program called the “Sishu Sathi Scheme” to provide free treatment to children who need heart surgeries, irrespective of economic status. Treatment was provided in selected private hospitals and some public hospitals in a reimbursement model where government compensated the hospitals. Data were collected on such procedures from 2013 to 2022 and analyzed. Results: A total of 27,844 patients with CHD received treatment under the Sishu Sathi Scheme from August 2013 to December 2022. The average number of patients per year was 3,093. Detailed data of procedures from January 2016 to December 2022 showed a total of 22,572 procedures (6,249 device interventions, 4,840 cardiac catheterizations, and 11,483 surgical interventions). The in-hospital mortality of surgical procedures and catheterization lab procedures were 5.2% and 0.9%, respectively. Conclusions: A large number of patients with CHD were successfully treated under a PPP in the state of West Bengal in India. In spite of its inherent challenges, this model is of special relevance in LMICs where access and affordability for treatment of CHD always remain a challenge.
The Utility of the Validated Intraoperative Bleeding Scale in Thoracolumbar Spine Surgery: A Single-Center Prospective Study
Authors: Smith Ryan A. , Pease Tyler J. , Chiu Anthony K. , Shear Brian M. , Sahlani Mario N. , Ratanpal Amit S. , Ye Ivan B. , Thomson Alexandra E. , Bivona Louis J. , Jauregui Julio J. , Crandall Kenneth M. , Sansur Charles A. , Cavanaugh Daniel L. , Koh Eugene Y. , Ludwig Steven C.
Published: January 2024

Study Design

Prospective, single-center study.

Objective

To evaluate the clinical relevance of the validated intraoperative bleeding severity scale (VIBe) in thoracolumbar spine surgery.

Methods

Adult patients aged 18 through 88 undergoing elective decompression, instrumentation, and fusion of the thoracolumbar spine were prospectively enrolled after informed consent was provided and written consent was obtained. Validated intraoperative bleeding severity scores were recorded intraoperatively. Univariate analysis consisted of Student T-tests, Pearson’s χ2 Tests, Fisher’s Exact Tests, linear regression, and binary logistic regression. Multivariable regression was conducted to adjust for baseline characteristics and potential confounding variables.

Results

A total of N = 121 patients were enrolled and included in the analysis. After adjusting for confounders, VIBe scores were correlated with an increased likelihood of intraoperative blood transfusion (β = 2.46, P = .012), postoperative blood transfusion (β = 2.36, P = .015), any transfusion (β = 2.49, P < .001), total transfusion volume (β = 180.8, P = .020), and estimated blood loss (EBL) (β = 409, P < .001). Validated intraoperative bleeding severity scores had no significant association with length of hospital stay, 30-day readmission, 30-day reoperation, 30-day emergency department visit, change in pre- to post-op hemoglobin and hematocrit, total drain output, or length of surgery.

Conclusion

The VIBe scale is associated with perioperative transfusion rates and EBL in patients undergoing thoracolumbar spine surgery. Overall, the VIBe scale has clinically relevant meaning in spine surgery, and shows potential utility in clinical research.

Level of evidence

Level II.
What Do Patients Encounter When Searching Online About Meniscal Surgery? An Analysis of Internet Trends
Authors: Gaudiani Michael A. , Castle Joshua P. , Gasparro Matthew A. , Halkias Eleftherios L. , Adjemian Andranig , McGee Anna , Fife Jonathan , Moutzouros Vasilios , Lynch T. Sean
Published: January 2024

Background:

Many patients use the internet to learn about their orthopaedic conditions and find answers to their common questions. However, the sources and quality of information available to patients regarding meniscal surgery have not been fully evaluated.

Purpose:

To determine the most frequently searched questions associated with meniscal surgery based on question type and topic, as well as to assess the website source type and quality.

Study Design:

Cross-sectional study.

Methods:

The following search terms were entered into a web search ( www.google.com ) using a clean-install browser: “meniscal tear,”“meniscus repair,”“meniscectomy,”“knee scope,”“meniscus surgery,” and “knee arthroscopy.” The Rothwell classification system was used to categorize questions and sort them into 1 of 13 topics relevant to meniscal surgery. Websites were also categorized by source into groups. The Journal of the American Medical Association ( JAMA) benchmark criteria (medians and interquartile ranges [IQRs]) were used to measure website quality.

Results:

A total of 337 unique questions associated with 234 websites were extracted and categorized. The most popular questions were “What is the fastest way to recover from meniscus surgery?” and “What happens if a meniscus tear is left untreated?” Academic websites were associated more commonly with diagnosis questions (41.9%, P < .01). Commercial websites were associated more commonly with cost (71.4%, P = .03) and management (47.6%, P = .02). Government websites addressed a higher proportion of questions regarding timeline of recovery (22.2%, P < .01). Websites associated with medical practices were associated more commonly with risks/complications (43.8%, P = .01) while websites associated with single surgeons were associated more commonly with pain (19.4%, P = .03). Commercial and academic websites had the highest median JAMA benchmark scores (4 [IQR, 3-4] and 3 [IQR, 2-4], respectively) while websites associated with a single surgeon or categorized as “other” had the lowest scores (1 [IQR 1-2] and 1 [IQR 1-1.5], respectively).

Conclusion:

Our study found that the most common questions regarding meniscal surgery were associated with diagnosis of meniscal injury, followed by activities and restrictions after meniscal surgery. Academic websites were associated significantly with diagnosis questions. The highest quality websites were commercial and academic websites.
Prevalence and Site of Concomitant Osteochondral Injuries in Patients With Acute Lateral Patellar Dislocation: A Systematic Review and Meta-analysis
Authors: Yi Zhi , Jiang Jin , Liu Jinmin , Ma Ming , Chen Yi , Teng Fei , Yang Ao , Liu Zhongcheng , Geng Bin , Xia Yayi , Wu Meng
Published: January 2024

Background:

Osteochondral injuries (OCIs) are common in patients with acute lateral patellar dislocation, which can produce both short- and long-;term adverse effects. However, the pattern of these injuries warrants further analysis, especially in relation to patient age.

Purpose:

To determine the overall prevalence of concomitant OCIs as well as the prevalence differences based on location and age after acute lateral patellar dislocations.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

A comprehensive search of PubMed, Embase, Web of Science, and Cochrane Library was completed from inception to July 20, 2022. All articles reporting the prevalence of OCI were included. The sample characteristics such as age, study design, magnetic resonance imaging diagnostic data, and the number of patients with OCI were extracted. The Methodological Index for Non-Randomized Studies (MINORS) was used for quality assessment. The overall and per-;site injury rates were calculated, and the prevalence was stratified by age-;group (≤16 and >16 years) and compared.

Results:

The systematic review included 39 studies involving 3354 patients. MINORS scores were 11.94 ± 1.98 and 16 ± 3.46 in the noncomparative and comparative studies, respectively. The overall prevalence of bone bruises and OCI was 89.6% (95% CI, 77.4%-97.7%) and 48.8% (95% CI, 39.0%-58.7%), respectively. In both overall and >16-year-old patients, the lateral femoral condyle (LFC) was the most common site of bone bruise (90.5% [95% CI, 84.0%-95.6%] and 91.5% [95% CI, 84.3%-96.9%], respectively); however, the medial patellar bruise was more common in patients ≤16 years (89.2% [95% CI, 82.9%-94.4%]). Among the pooled sites of OCI, the medial patella accounted for the largest proportion (36.9% [95% CI, 28.0%-46.3%]). OCIs were more common in patients >16 years (52.6% [95% CI, 39.4%-65.6%]) than in patients ≤16 years (46.6% [95% CI, 33.2%-60.3%]).

Conclusion:

Bone bruises on the LFC were most prevalent overall and in patients >16 years, whereas bone bruises on the medial patella were more prevalent in patients ≤16 years. OCIs were frequently seen in patients >16 years, with the most common site being the medial patella.
Ruled by the Demons? Exploring the Relationship Between Belief in Demons and Public Attitudes Toward Donald Trump and Joe Biden
Authors: Nie Fanhao
Published: January 2024

Beliefs in supernatural evils are prevalent among many religions. Prior research has shown that beliefs in supernatural evils were tied to various social and health outcomes. However, much less is known about the political implications of beliefs in supernatural evils. To fill this research void, a national survey of 1,092 adults with oversamples of respondents of Asian or Hispanic heritage was conducted in March 2023. The findings suggest that a stronger belief in demons or evil spirits was associated with more negative views toward President Joe Biden. This demonic effect was robust even after controlling for a variety of religious and sociodemographic variables. Besides being robust, the demonic effect was the strongest among all religiosity measures. In contrast, a main relationship between a stronger belief in demons and greater support for Donald Trump was found. However, this demonic effect was explained by Christian nationalism. Finally, these demonic effects vary based on one’s political party identity.
Effect of Serial Clinical Observation Complemented by Point-of-Care Blood Culture Volume Verification on Antibiotic Exposure in Newborns
Authors: Wawrzoniak Tomasz , Romańska Justyna
Published: January 2024

Objective. This study evaluated the effects of serial clinical observation strategy complemented by point-of-care verification of blood culture volume in managing term and near-term newborns at risk for early-onset sepsis. Methods. We used a “before-and-after” approach. Infants born at ≥35 0/7 weeks’ gestation were eligible. Our strategy was based on serial clinical observation complemented with point-of-care verification of blood culture volume. Two separate 12-month periods were analyzed. The number of infants exposed to antibiotics started during the first 3 days of life was compared before and after introducing the strategy. Results. During the post-intervention period, 0.6% of infants received antibiotic therapy, compared to 4.1% during the pre-intervention period ( P < .001; relative risk [RR]: 0.15; 95% CI: 0.08-0.28). Conclusion. Serial clinical observation complemented with verification of blood culture volume might reduce antibiotic utilization in newborns in the early postnatal period.
Defining Key Elements of a Clinical Experience in Hospice and Palliative Medicine for Medical Residents in the United States
Authors: Kezar Carolyn E , Lawton Andrew J
Published: January 2024

Training in hospice and palliative medicine (HPM) is essential for practicing internists, who routinely care for patients and families facing serious illness. Program directors and medical residents acknowledge the importance of palliative medicine skills, and trainees themselves desire more such training. The ACGME has also recognized the importance of HPM training for medical residents, establishing in its 2022 Common Program Requirements for Internal Medicine a new expectation that all residents have a clinical experience in HPM. However, internal medicine residencies vary significantly in their approach to teaching HPM skills, and what constitutes a useful clinical experience in HPM has not been well-described. In this perspective, we draw from the available literature and our experience as educators to propose 5 core elements for creating an optimal HPM experience for medical residents. These include practice with symptom management and communication in serious illness, exposure to interdisciplinary care, appreciation of the continuum of care settings for HPM delivery, and an understanding of the key principles of hospice care. We then describe the relevance of each element and offer educational strategies regarding how each can be achieved.
A call for reform: Education’s role in strengthening democracy
Authors: McGravey Michael J
Published: January 2024

This essay maintains that the ideal American democracy necessitates a fair, equitable, and just education system. This fair system would subsequently create an educated electorate to then select their representatives, vote on policy amendments or changes, and remain informed on issues that affect all aspects of life in this representative democracy. It pays special attention to the racial inequities that continue to exist due to an unjust taxation and funding system, corrupt political bodies, and the urban-suburban divide. Relying on the Founding Fathers, Dr. Martin Luther King, Jr, and contemporary sociologists and economists, this essay identifies key factors which continue to divide the American educational system. The essay contends that such inequities, political actions aimed at the elimination of content or curriculum, and the continued underfunding of American school systems puts the long-term viability of our democracy in peril.
Green and solvent-free fabrication of conductive halloysite–polythiophene nanocomposites for the removal of organic pollutants from aqueous media
Authors: Samee Golshan , Arsalani Nasser , Same Saeideh , Navidi Golnaz , Kalantar Esfangare Hasan
Published: January 2024

Toxic pharmaceutical pollutants, such as nicotine, represent a significant threat to natural water sources due to their continuous discharge. To address this issue, clay minerals and their composites have demonstrated exceptional adsorptive and remedial capabilities for wastewater purification. This research focused on developing green clay-polymeric adsorbents for the efficient removal of pharmaceutical pollutants from industrial wastewater. The synthesis involves creating halloysite nanotube–polythiophene nanocomposites through a green and cost-effective method using vapour polymerization and a solvent-free, ball-milled technique for the adsorptive removal of nicotine from wastewater. The investigation evaluates the impacts of preparation, modification and environmental conditions on the adsorptive performance of these clay-based nanocomposites compared to pure polythiophene. The polymerization process was evaluated by varying the vapour polymerization holding time for a fixed amount of oxidant (FeCl3) and halloysite nanotube (HNT) to investigate the impacts of monomer vapour exposure time on the polymerization of nanocomposites. Following the characterization of the synthesized adsorbents using various methods, the study investigated the impacts of various parameters (e.g. adsorbent dosage, pH and contact time) on the adsorption capabilities of the materials on a laboratory scale. The results revealed that the incorporation of HNT improved the adsorbing performance of nanocomposites. The pH, absorbent concentration and contact time directly affect nicotine adsorption. Significantly, halloysite–polythiophene 3 with a 2 h polymerization duration demonstrated the maximum adsorption efficacy of 78.94% at pH 10 after a 24 h contact time. The environmentally friendly halloysite-based nanocomposite shows promising potential as an effective adsorbent for pharmaceutical pollutant (nicotine) removal from aquatic environments.
A post hoc analysis of previously untreated patients with severe hemophilia A who developed inhibitors in the PUPs A-LONG trial
Authors: Carcao Manuel , Schiavulli Michele , Kulkarni Roshni , Rendo Pablo , Foster Meredith , Santagostino Elena , Casiano Sandra , Königs Christoph
Published: January 2024

Inhibitor development is a major therapeutic complication for people with hemophilia. The phase 3 PUPs A-LONG study evaluated the safety and efficacy of efmoroctocog alfa (a recombinant factor VIII Fc fusion protein, herein referred to as rFVIIIFc) in previously untreated patients (PUPs) with severe hemophilia A. Male PUPs <6 years old were enrolled and received rFVIIIFc; inhibitor development was the primary end point. Post hoc analyses, including patient treatment regimen patterns and timing of inhibitor development, descriptive and Kaplan-Meier analyses of time to first inhibitor-positive test by treatment regimen and by titer, and consumption, were performed to describe patients who developed inhibitors during PUPs A-LONG. We investigated patient characteristics (eg, demographics and genotype) and nongenetic risk factors (eg, intense factor exposure and central venous access device [CVAD] placement) that may predict inhibitor development and characteristics of inhibitor development (low-titer vs high-titer inhibitor). Baseline characteristics were similarly distributed for age, race, and ethnicity across both patients who were inhibitor-positive and those who were inhibitor-negative (all P > .05). High-risk F8 variants were associated with development of high-titer inhibitors (P = .028). High-titer inhibitor development was often preceded by the presence of a low-titer inhibitor. Patients whose low-titer inhibitor progressed to a high-titer inhibitor received a higher mean dose per infusion (98.4 IU/kg, n = 5) compared with those whose low-titer inhibitor resolved spontaneously (59.2 IU/kg, n = 7; P = .033) or persisted (45.0 IU/kg, n = 5; P = .047). There was no association between CVAD placement surgery and inhibitor development. Post hoc analyses suggest that F8 genotype and dose of factor are as important as inhibitor risk factors and require further investigation. This study was registered at ClinicalTrials.gov as #NCT02234323.
Dual-targeting CD33/CD123 NANOBODY T-cell engager with potent anti-AML activity and good safety profile
Authors: Zeng Zhihong , Roobrouck Annelies , Deschamps Geert , Bonnevaux Helene , Guerif Stephane , De Brabandere Veronique , Amara Céline , Dejonckheere Eline , Virone-Oddos Angela , Chiron Marielle , Konopleva Marina , Dullaers Melissa
Published: January 2024

Novel therapies are needed for effective treatment of acute myeloid leukemia (AML). Relapse is common and salvage treatment with cytotoxic chemotherapy is rarely curative. CD123 and CD33, 2 clinically validated targets in AML, are jointly expressed on blasts and leukemic stem cells in >95% of patients with AML. However, their expression is heterogenous between subclones and between patients, which may affect the efficacy of single-targeting agents in certain patient populations. We present here a dual-targeting CD33/CD123 NANOBODY T-cell engager (CD33/CD123-TCE) that was designed to decrease the risk of relapse from possible single antigen-negative clones and to increase coverage within and across patients. CD33/CD123-TCE killed AML tumor cells expressing 1 or both antigens in vitro. Compared with single-targeting control compounds, CD33/CD123-TCE conferred equal or better ex vivo killing of AML blasts in most primary AML samples tested, suggesting a broader effectiveness across patients. In a disseminated cell-line–derived xenograft mouse model of AML, CD33/CD123-TCE cleared cancer cells in long bones and in soft tissues. As cytokine release syndrome is a well-documented adverse effect of TCE, the compound was tested in a cytokine release assay and shown to induce less cytokines compared to a CD123 single-targeting control. In an exploratory single-dose nonhuman primate study, CD33/CD123-TCE revealed a favorable PK profile. Depletion of CD123 and CD33 expressing cells was observed, but there were neither signs of cytokine release syndrome nor clinical signs of toxicity. Taken together, the CD33/CD123 dual-targeting NANOBODY TCE exhibits potent and safe anti-AML activity and promises a broad patient coverage.
Symptom effects and central mechanism of acupuncture in patients with functional gastrointestinal disorders: a systematic review based on fMRI studies
Authors: Wang Lin , Luo Xiaoying , Qing Xiangli , Fang Shuangshuang , Jiang Tianyuan , Wang Qianying , Zhong Zhuotai , Yang Yang , Yang Jianqin , Song Gengqing , Su Xiaolan , Wei Wei
Published: January 2024

Background

Functional gastrointestinal disorders (FGIDs) are closely related to disorders of brain-gut interaction. FGIDs are the dominant disease of acupuncture treatment, which can improve the symptoms and emotional state.

Aim

To evaluate the results and quality of the available clinical evidence and to summarize the central mechanism and effect of acupuncture on FGIDs.

Methods

PubMed, EMBASE, Web of science, Cochrane Library, China National Knowledge Infrastructure (CNKI) were searched by computer to collect the randomized controlled trials (RCTs), which contained central mechanisms via fMRI research of acupuncture in the treatment of FGIDs patients. The search time limit was from the establishment of the database to June 22, 2022. Two researchers independently screened the literature, extracted data, and evaluated the quality.

Results

Ten RCTs involving fMRI data were included in this study, including 4 Functional dyspepsia (FD) studies, 3 irritable bowel syndrome (IBS) studies, and 3 functional constipation (FC) studies. The score of improvements in both gastrointestinal symptoms and psychological symptoms showed that acupuncture could significantly improve the clinical symptoms of FGIDs patients, including abdominal pain, abdominal distension, frequency of defecation, and stool characteristics, and could relieve anxiety and depression symptoms of patients. Acupuncture could regulate brain functional connections and functional activity in FGIDs patients, mainly including insula, anterior cingulate cortex, prefrontal cortex, thalamus, hippocampus, amygdala and other brain regions.

Conclusion

Acupuncture can improve gastrointestinal symptoms and psychological status in FGIDs patients, and regulate functional connectivity and activity of brain regions such as insula, ACC, PFC, thalamus, HIPP, amygdala, etc. These changes in brain activity may related to visceral sensation, pain regulation, emotion, but further studies of high quality are still necessary.