bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining the Empathy Profiles and Work Outcomes of Trauma Workers
Authors: Anderson Gregory G. , Gilin Debra A.
Published: November 2024

Trauma work involves intervening with others enduring acute pain and suffering, often with heavy psychological and physical health impacts. An important question is whether dispositional empathy helps or hurts trauma workers in their occupational functioning. The current study addresses this gap in the research literature by using a person-centered approach to examine the empathy profiles and professional outcomes of a broad sample of trauma workers ( n = 315). We measured their trait empathy and organizational outcomes (occupational burnout, person-job fit, turnover intentions, job performance), and found three distinct empathy profiles which differed significantly in their occupational functioning. A ‘self-focused’ empathy profile (dominated by high personal distress responding) reported the worst functioning; an ‘other-oriented’ profile (high on perspective taking and empathic concern) had more positive functioning, and an unexpected ‘low reactivity’ profile (a full SD below the general population on empathy facets) showed the lowest exhaustion. Exploratory analyses revealed that first responders (e.g., police, firefighters, EMTs, paramedics) were overrepresented in the ‘low reactivity’ profile, while psychology-related professions (e.g., psychologists, counsellors, social workers) were underrepresented in that profile. The significance of these results, as well as their implications for empathy research and vocational counselling in the field of trauma work, are discussed.
Effects of Mecobalamin on the Functional Outcomes of Complex Regional Pain Syndrome Type 1 of the Foot and Ankle
Authors: Arunakul Marut , Kohkaeng Watcharin , Samornpitakul Pheemaphol , Arunakul Preeyaphan , Kulalert Prapasri , Rachayont Krit
Published: November 2024

Background:

Because of the unclear pathophysiology and the lack of consensus on the gold standard treatment of complex regional pain syndrome (CRPS), management requires a multidisciplinary approach, with the use of various treatment modalities. Nonetheless, no studies have ever been conducted to uncover the potential of mecobalamin as a treatment for CRPS type 1. Hence, the aim of this clinical trial was to evaluate the effects of mecobalamin on the functional outcomes of patients with CRPS type 1 of the foot and ankle, the total amount of pregabalin ingested, and the duration of pregabalin use in each patient.

Methods:

Forty-seven patients diagnosed with acute CRPS type 1 of the foot and ankle were recruited. Patients were randomly allocated into a control group (23 patients) and a mecobalamin group (24 patients), both receiving similar pain control medications and rehabilitation programs. Three divided doses of mecobalamin 1.5 mg/d were provided to the mecobalamin group for the first 3 months, whereas a placebo was administered to the control group. Data were collected from the pretreatment period, and from 1, 3, 6, and 12 months following the treatment.

Results:

Both groups had similar demographics. The mean Foot and Ankle Ability Measure (FAAM) activities of daily living (ADL) and FAAM-sport scores in the mecobalamin group at 3 months were 74.5 ± 17.9 and 56.3 ± 22.9, whereas the mean FAAM-ADL and FAAM-sport scores in the placebo group at 3 months were 62.2.5 ± 15.2 and 43.4 ± 14.9, respectively ( P < .05). The 36-Item Short Form Health Survey (SF-36) mental health subscale after 3 months were 83.3 ± 9.5 points and 75.8 ± 12.6 points in the mecobalamin and placebo group, respectively ( P < .05). However, at other time points of assessment (1, 6, and 12 months), the improvement in symptoms was not distinguishable between the 2 groups. Both the amount and duration of total pregabalin required to achieve similar improvements in pain scores were significantly lower in the mecobalamin group than the control group.

Conclusion:

This small study revealed an improvement of the functional outcomes in patients with CRPS type 1 of the foot and ankle who received mecobalamin instead of a placebo at 3 months that was not sustained at 6 and 12 months. We identified an average 39% total reduction in the amount of total pregabalin used in the mecobalamin group in the first 12 months.
Carboplatin dosing in obese patients
Authors: Ramírez-Roig Cristina , Espuny-Miró Alberto , Olmos-Jiménez Raquel , Díaz-Carrasco María Sacramento
Published: November 2024

Objectives

The study aimed to: 1) Describe the carboplatin dosing criteria in obese patients in routine clinical practicein a general university hospital. 2) Evaluate toxicity based on the dosing criterion used. 3) Assess effectiveness in major diagnoses according to the dosing criterion employed.

Methodology

An observational, retrospective, descriptive study, including all obese patients (BMI ≥ 30 kg/m2) who started carboplatin treatment between 1st January 2012 and 31st January 2015. Data on patient characteristics, disease and treatment were collected. As a result variables were collected: carboplatin dosing methods, dosage criteria, alternative dosing approaches, treatment delays, dose reductions, relative dose intensity, adverse reactions and severity (CTCAE v. 4.0) as well as overall survival and progressive free survival for major diagnoses.

Conclusions

1) Carboplatin dosing at the centre used Calvert's formula for calculating AUC and Cockcroft-Gault's formula for estimating glomerular filtration rate. 2) Cockcroft-Gault's formula employed actual body weight and ideal adjusted body weight in similar proportions. 3) The ideal adjusted body weight was more commonly used in patients with higher obesity and diabetes. 4) In the general population, the developmental trend of toxicity during treatment was greater in the group dosed by actual body weight, reaching significant differences in thrombopenia, neutropenia, GOT elevation, hyporexia and myalgias. 5) Major diagnoses in the present study were ovarian cancer and non-small cell lung cancer. The effectiveness in terms of overall survival and progression-free survival, comparing the groups dosed by actual body weight and ideal adjusted body weight within each pathology did not show statistically significant differences.
Exploring the Relationship of Dietary Intake With Inattention, Hyperactivity, and Impulsivity, Beyond ADHD
Authors: Dalnoki Laura , Hurks Petra P. M. , Gubbels Jessica S. , Eussen Simone J. P. M , Mommers Monique , Thijs Carel
Published: November 2024

Objectives:

This study investigates the association between dietary intake and ADHD diagnosis and its dimensions in adolescents.

Methods:

In the KOALA Birth Cohort Study, 810 adolescents aged 16 to 20 years provided information on ADHD diagnosis and completed a food frequency questionnaire. Dietary patterns were extracted using Principal Component Analysis. Parents reported on ADHD symptoms using the Conners’ Parent Rating Scale—Revised Short form, and the Impulsivity subscale from the Temperament in Middle Childhood Questionnaire.

Results:

The 80 adolescents with ADHD scored higher on the Snacking dietary pattern compared to those without ADHD, while they did not differ on Healthy, Animal-based, Sweet, or Beverage dietary patterns. All ADHD symptom scores (Hyperactivity, Inattention and Impulsivity, and ADHD-index) correlated with increased Snacking. Impulsivity was inversely related to Sweet dietary patterns and positively to Beverage dietary patterns.

Conclusion:

The results highlight the importance of considering ADHD dimensions beyond diagnosis in understanding adolescents’ dietary intake.
Decreased Serum Insulin Receptor Messenger RNA Level in H. pylori IgG Seropositive Type 2 Diabetic Patients
Authors: Tagoe Emmanuel Ayitey , Appiah Jael Acquah , Boateng Pius Agyenim , Quaye Osbourne , Bosomprah Samuel
Published: November 2024

Background:

Helicobacter pylori (H. pylori) is a known gastro-intestinal pathogen but implicated in extra-gastric diseases. The relationship between H. pylori infection and type 2 diabetes (T2DM) remains insufficiently elucidated, particularly in terms of molecular mediators such as microRNAs (miRNAs) and messenger RNAs (mRNAs).

Objective:

We aimed to characterize expression pattern of insulin signalling mRNAs and targeted miRNAs in T2DM patients exposed to H. pylori infection.

Methods:

We conducted a cross-sectional study among patients diagnosed with type 2 diabetes mellitus and were aged 18 to 60 years. Overnight fasting blood samples were collected and processed for plasma and serum. The plasma samples were used for glucose estimation and the serum used for H. pylori IgG screening. Total RNA was extracted from the serum with commercial kit, and mRNAs and miRNAs quantified by RT-qPCR with specific primers and under predetermined amplification conditions. Clinical data were obtained from medical records of patients.

Results:

Among 351 patients enrolled, 267 (76.1%) were females, 224 (63.8%) were married, and 79 (22.5%) had tertiary education. Expression level of insulin receptor mRNA was significantly lower in H. pylori positive T2DM patients compared to H. pylori negative ( P < .05). There was no evidence of a difference in insulin receptor substrate 1 mRNA level ( P > .05). Although not statistically significant, the expression levels of miRNA-222 and miRNA-155 in the patients exposed to H. pylori were higher than that of the unexposed group ( P > .05).

Conclusions:

We found a significantly reduced serum insulin receptor messenger RNA level and higher levels of miRNA-222 and miRNA-155 in H. pylori exposed T2DM patients. The findings suggest a possible role of the infection in insulin signalling alteration in the patients.
Systematic Analysis and Insights Into the Mutation Spectrum and Ethnic Differences in ATP7B Mutations Associated With Wilson Disease
Authors: Lao Thuan Duc , Le Thuy Ai Huyen
Published: November 2024

Background:

ATP7B (ATPase copper transporting beta gene) is constituted of 21 exons, and codes for a 1465 amino acid. The protein of ATP7B plays an key role of copper metabolism. Many previous reports indicated that mutations in ATP7B are well known to cause defective copper transporting copper-transporting ATPase 2 protein leading to the accumulation of copper, resulting the Wilson disease.

Objectives:

The meta-analysis was performed to comprehensive gain a thorough grasp of the spectrum of genetic variations.

Design:

A meta-analysis was conducted according to the guiding of PRISMA. aiming to assess the diversity and frequency of mutations in the ATP7B gene, with an emphasis on mutations located within specific exons.

Data sources and methods:

The dataset of detected mutations within their positions, types as well as nomenclature, were recorded from previous studies (spanning the year from 2013 to 2023). The analysis focused on exon-specific variations and their prevalence across different populations.

Results:

A total of 40 studies were enrolled into current data analysis. Our comprehensive study revealed a variety of mutations, most notably over 50% of single nucleotide changes described, distributed over the 21 exons of the gene. Focusing on the exon 8, itisplayed the most diversity of mutations, with 18 studies identifying 53 unique variants, the majority of which were missense mutations (81.13%). Additionally, the variations c.2333G>A/T (p.R778Q/L), c.2305A>G (p.M769V), c.2336G>A (p.W779*), and c.2304dupC (p.M769HfsX26) are reported in many populations. The weighted mean of variants’ proportion was used to calculate the pooled estimate of these percentages, which were 14.19% for c.2333G>A/T (p.R778Q/L), 2.70% for c.2305A>G (p.M769V), 1.42% for c.2336G>A (p.W779*), and 2.33% for c.2304dupC (p.M769HfsX26).

Conclusion:

This design demonstrate to identify the spectrum of ATP7B gene’s mutations, especially exon 8, offering important insights into the prevalence and significance of exon 8 mutations. Understanding the mutation in the ATP7B gene offers insights into the mechanisms behind WD and guides strategies for diagnosis and treatment.
A Physical Framework to Study the Effect of Magnetic Fields on the Spike-Time Coding
Authors: Rivas Manuel , Martinez-Garcia Marina
Published: November 2024

A temporal neural code reliant on the pattern of spike times rather than spike rates offers a feasible mechanism for encoding information from weak periodic external stimuli, such as static or extremely low-frequency electromagnetic fields. Our model focuses on the influence of magnetic fields on neurotransmitter dynamics near the neuron membrane. Neurotransmitter binding to specific receptor sites on membrane proteins can regulate biochemical reactions. The duration a neurotransmitter spends in the bonded state serves as a metric for the magnetic field’s capacity as a chemical regulator. By initiating a physical analysis of ligand-receptor binding, utilizing the alpha function for synaptic conductance, and employing a modified version of Bell’s law, we quantified the impact of magnetic fields on the bond half-life time and, consequently, on postsynaptic spike timing.
Active micro-vibration isolation system for adaptive vibration suppression tests using piezoelectric stack actuator
Authors: Gao Zhiyuan , Zhang Lei , Xu Tongxin , Zhu Xiaojin
Published: November 2024

An active micro-vibration isolation system for adaptive vibration suppression using piezoelectric stack actuators is presented, along with the discrete time modelling method, real-time adaptive controller design, and hardware implementation. The system comprises piezoelectric stack actuators, capacitive displacement sensors, power amplifiers, signal conditioners, and a real-time computer. A discrete asymmetric Bouc-Wen model is developed to characterize the nonlinear behavior of the piezoelectric stack actuators. System identification is conducted using an improved particle swarm optimization method, specifically the Hybrid PSO-Jaya algorithm, which sequentially integrates the PSO algorithm with the Jaya algorithm. Additionally, an improved adaptive filtering algorithm employing affine projection, referred to as the FXAPA algorithm, is introduced to facilitate real-time control. The efficacy of the proposed active micro-vibration isolation technology is validated through micro-vibration suppression tests.
Making a difference with matter in researchers’ positionality dynamics in qualitative inquiry
Authors: Adjei Moses , Nung Chan Annie Hau
Published: November 2024

Scholars have increasingly highlighted the usefulness of new materialist theories and methodologies in attempts to address the perceived shortcomings of conventional theories inspired by social constructionism and post-structuralism. Contributing to these discussions, we utilize a new materialist theory which rests on a monistic ontology drawn from Spinozian and Deleuzian assemblage theory to examine the constitutive role of material elements (e.g. audio recorders, video cameras, and dress/shirts worn during interviews), spatial, and discursive forces in co-creating fluid nonstatic researcher positionalities in qualitative research process. This article is part of a larger ethnographic study conducted by the first author among fisherfolk in Ghana's coastal fishing communities. Our results show that the researcher's fluid positionalities during interview encounters were brought to bear and sustained in space and time through the joint effort of material, discursive, and spatial forces. As qualitative researchers seek ways to ensure better understanding of their study communities through intimate interactions, an attention to the assemblage of material-discursive forces in interview encounters may highlight some of the opportunities and obstacles in qualitative inquiry beyond human agency and negotiations.
Restoring Nsukka Music School, 1970–1985
Authors: Ogisi Arugha A.
Published: November 2024

During the Nigerian Civil War (1967–1970), the University of Nigeria, Nsukka (UNN) was plundered and was restored thereafter. This paper is about how the Department of Music in the UNN Nsukka Music School (NMS) was restored following the war. Data for the study were obtained from alumni who were eye witnesses; data-bearing documents in NMS’s office; embedded experience as a student in the NMS between 1977 and 1982; and, relevant publications. The data were subjected to deductive analysis and sequenced to answer the research questions. Findings indicate that between 1970 and 1975, the Sowande Building (SB) was renovated; the pioneer staff re-enlisted, as other faculty were appointed and sponsored abroad for graduate studies; a modicum of teaching-learning facilities was provided; a new curriculum was produced; and another building was erected and extended to cope with growing student registration. By 1979, most NMS faculty on graduate studies had returned, the extant teaching-learning facilities were decrepit, and some were replaced. With the new facilities, more ensembles were formed and public performances increased. By 1985, NMS was the flagship in Nigeria’s higher music education.
Compensatory training sessions, do they really compensate?
Authors: Casamichana David , Barba Eider , Aguirre Gorka , Agirrezabalaga Oier , Castellano Julen
Published: November 2024

The aim of this study was to compare the external load accumulated by players belonging to three teams of the same professional club in the compensatory training session, training the day after the match, expressing this both in absolute values and in values relative to the match demands. Fifty-one soccer players from three different categories (professional team [PRO] n= 16 players; reserve team [RES]= 15 players; and second reserve team [RES2]= 20 players) were monitored by micro-electromechanical systems devices in compensatory training sessions. Large and very large differences between teams were shown in the variables most related to volume (duration, player load, total distance, acceleration load and distance at >14 km h−1), while the variables most related to intensity show trivial and small differences between teams (distance at >21 and >24 km h−1, and number of accelerations and decelerations). Our main finding agreed with our hypothesis, showing that most of the external load variables range between 30–90% of the official match load, most of the external load variables being in ranges close to 50–60% of the match demands, reaching a higher percentage in the variables related to the accelerations and decelerations actions.
In vivo assessment of a modification of a domiciliary ventilator which reduces oxygen consumption in mechanically ventilated patients
Authors: Jenkins Timothy O , Sutton Thomas M , Griffen Peter , Mebrate Yoseph , Polkey Michael I
Published: November 2024

There are instances where hospitals may experience a relative shortage of oxygen, for example, future pandemics, natural disasters or wartime. We developed a modification to a domiciliary ventilator that captures oxygen normally vented during expiration into the atmosphere, delivering it to the patient. The modification significantly increases PaO2 in mechanically ventilated patients at their baseline FiO2 and baseline FiO2 +1, +2 and +3 L/min compared to no modification. The modification reduces walled oxygen consumption by median (IQR) −1.0 (−1.25 to −1.00) L/min whilst maintaining PaO2. This modification may be a valuable in circumstances where there is a relative shortage of oxygen.
Partial object doubling in the periphery induced by negative afterimages
Authors: Thornton Ian M. , Riga Anna
Published: November 2024

We describe a new phenomenon—partial object doubling—in which the perceived contours of peripherally viewed moving targets become distorted and duplicated. The effect appears to arise due to interactions between physically drawn contours and the strong negative afterimages that are dynamically released during stable viewing of the displays. An online demo is provided where the effect can be experienced and relevant parameters manipulated.
Engaging citizens in experiments with computational analysis of patient stories: From unwarranted reductions to meaningful insights
Authors: Akrouh Nada , Wehrens Rik , van de Bovenkamp Hester
Published: November 2024

In recent years, citizen engagement in policy and research has gained considerable momentum. In the healthcare domain, patient narratives, through various mediums, have emerged as a valuable source of insight into the experiences of patients and the healthcare system. Recognizing the value of such textual data, diverse analytical methods have been developed, spanning from text mining to narrative analysis. This article presents experiments that combine computational methods, qualitative methods and citizen science for analyzing patients’ stories. In this article, we reflect on two experiments in which we combined these approaches, which we analyze through a generative lens. We distinguish three main effects of the experiments: they provide a platform for discussions as a 'site of controversy'; they act as 'mediator', fostering new connections and mutual understanding among participants; and they serve as 'tin opener', stimulating substantive discussions about methodological development and substantive healthcare matters. Narrative reduction, which occurs when rich narrative data is simplified into structured quantifiable forms, is not inherently problematic; instead, it can be meaningful when combined with qualitative methods and citizen science, emphasizing the importance of utilizing diverse methods to balance authenticity and gaining broader insights. The study highlights the significance of collaborative sense-making and meaning-making in interdisciplinary research. Engaging patients, their relatives, and professionals in the analytical process, facilitated by tools like word clouds, promotes engaged discussions that yield actionable insights. Further development of such interdisciplinary approaches holds promise for a more nuanced understanding of patient experiences, fostering epistemological pluralism, and refining healthcare practices.
Role of SGLT-2 Inhibitors in Ultrafiltration Failure in Peritoneal Dialysis: A Narrative Review
Authors: Riedl Khursigara Magdalena , Liu Ping , Kaur Reetinder , Mavrakanas Thomas A.
Published: November 2024

Purpose of review:

Sodium-glucose co-transporter-2 (SGLT-2) inhibitors are glucose lowering agents with protective effects on cardiovascular health and the ability to slow chronic kidney disease (CKD) progression. The benefits of SGLT-2 inhibitors have not been studied in patients with advanced CKD or on maintenance dialysis. Ultrafiltration failure is a common reason for failure of peritoneal dialysis (PD). Glucose transporters, such as SGLT-2, are involved in the progression to ultrafiltration failure, and hence, SGLT-2 inhibitors might be beneficial in patients on PD to prevent ultrafiltration failure.

Source of information:

Here, we review data from animal models and ongoing clinical trials of SGLT-2 inhibitors in advanced CKD, as well as considerations for a phase III trial in patients on PD.

Methods:

A literature search was conducted and information on clinical trials was obtained from clinicaltrials.gov.

Key findings:

Animal models of PD have shown upregulation of glucose transporters in the peritoneal membrane and a potential effect of SGLT-2 inhibitors on glucose absorption and ultrafiltration. Several clinical trials are currently ongoing with SGLT-2 inhibitors in patients on PD. We discuss their study designs and propose a mixed-methods, patient-centered approach to studying SGLT-2 inhibitors in PD patients. We also discuss the potential implications of SGLT-2 inhibitors on people living with kidney failure, especially in remote communities.
Use of intranasal povidone-iodine packing in the management of infectious rhinosinusitis in three cats
Authors: Sorrentino Paul J , MacArthur Sandra L
Published: November 2024

Case series summary

Described are three cats diagnosed with rhinosinusitis secondary to Mycobacterium bouchedurhonense, Aspergillus species and Alternaria species, respectively. Medical records were retrospectively reviewed to identify cats with decreased nasal airflow and mucopurulent discharge that failed to improve on antibiotic therapy of 3 months or longer duration. Surgical debridement was followed by nasal packing using 5% povidone-iodine saturated umbilical tape, which was replaced at 24 h postoperatively. At 48 h postoperatively, the rhinotomy site was closed. Systemic therapy continued in the postoperative period. All cases were minimally responsive to previous medical management. History, signalment, clinical signs, diagnostic findings, treatment, and short- and long-term outcomes were retrieved. All cats were middle-aged with outdoor access and had clinical signs that commenced during the summer months. CT revealed turbinate destruction and soft tissue densities within the nasal passages. The otic apparatuses and calvaria were intact in all cats before surgery. A repeat CT examination revealed an improvement of the proliferative tissue identified in preoperative imaging in all cases. All cats achieved successful interruption of nasal discharge and restoration of nasal airflow with follow-up times of up to 16 months postoperatively.

Relevance and novel information

To the authors’ knowledge, this is the first report of the use of intranasal povidone-iodine packing in cats for the management of infectious rhinosinusitis. Surgical debridement and intranasal packing in addition to systemic therapy were successful in restoring nasal airflow and resolving nasal discharge in all cats with long-term follow-up.
Assessing the accuracy and clinical utility of GPT-4O in abnormal blood cell morphology recognition
Authors: Cai Xinjian , Zhan Lili , Lin Yiteng
Published: November 2024

Objectives

To evaluate the accuracy and clinical utility of GPT-4O in recognizing abnormal blood cell morphology, a critical component of hematologic diagnostics.

Methods

GPT-4O's blood cell morphology recognition capabilities were assessed by comparing its performance with hematologists. A total of 70 images from the Chinese National Center for Clinical Laboratories, External Quality Assessment (EQA) from 2022 to 2024 were analyzed. Two experienced hematology experts evaluated GPT-4O's recognition accuracy using a Likert scale.

Results

GPT-4O achieved an overall accuracy of 70% in blood cell morphology recognition, significantly lower than the 95.42% accuracy of hematologists (p < 0.05). For peripheral blood smears and bone marrow smears, GPT-4O's accuracy was 77.14% and 62.86% respectively. Likert scale evaluations revealed further discrepancies, with GPT-4O scoring 288.50 out of 350, compared to higher manual scores. GPT-4O accurately recognized certain intracellular inclusions such as Howell-Jolly bodies and Auer rods, while it misidentified fragmented red blood cells as neutrophilic metamyelocytes and oval-shaped red blood cells as sickle cells. Additionally, GPT-4O had difficulty accurately identifying intracellular granules and distinguishing cell nuclei and cytoplasm.

Conclusion

GPT-4O's performance in recognizing abnormal blood cell morphology is currently inadequate compared to hematologists. Despite its potential as a supplementary tool, significant improvements in its recognition algorithms and an expanded dataset are necessary for it to be reliable for clinical use. Future research should focus on enhancing GPT-4O's diagnostic accuracy and addressing its current limitations.
Impact of a Pediatric Produce Prescription Intervention on Food Security and Perceived Nutrition-Related Behaviors: A Mixed-Methods Study
Authors: Muleta Hemen , Fischer Laura , Ali Qadira , Menezes Shannon , Kim Noah , Minkah-Premo Emily , Essel Kofi
Published: November 2024

Objectives:

Poor Food security (FS) is associated with risk of diet-related diseases and rising healthcare costs. Produce Prescription Interventions (PRx) are emerging clinical tools to improve FS and diet quality, but their impact in families with children is not well established. This study evaluates the impact of a pediatric PRx on FS and nutrition-related behaviors.

Methods:

Adult caregivers of children (0-18) were enrolled within a 6-month produce delivery and nutrition education intervention. A validated food security survey was administered pre/post intervention to determine FS scores and “Food Secure” status. Statistical analyses tested pre-post differences in FS scores and proportion of scores within the “Food Secure” range. Semi-structured interviews were performed post-intervention to explore families’ experiences with low FS and healthy behaviors and were thematically analyzed.

Results:

Between October 2021 and December 2022, 82 families were enrolled, 65 completed FS survey at baseline and 54 completed it at post-intervention. FS scores improved post-intervention ( P < .05) and a greater proportion of household- and child-level scores fell within the “Food Secure” range post-intervention ( P < .05). Twenty-eight interviews were analyzed. Three salient themes were identified: (1) value of healthcare-based screening and intervention, (2) food and education motivate behavior change, and (3) perceptions of post-intervention lifestyle sustainability.

Conclusions:

Participation in the PRx was associated with improvements in FS and nutrition-related attitudes and behaviors. PRx can be implemented by health systems to improve FS and health behaviors associated with risk for diet-related diseases. Longer-term support may be needed to maintain healthy behavior changes associated with PRx participation.
Analyzing diversity trends in dermatology: A comprehensive overview
Authors: Mayo Michael , Ratnayake Isuru , Pepper Sam , Rahman Mohammod Mahmudur , Talukder Md. Robiul Islam , McGuirk Matthew , Martinez Joshua , Cardones Adela Rambi , Wick Jo , Mudaranthakam Dinesh Pal
Published: November 2024

Background:

Dermatology lags behind other medical specialties in workforce diversity, particularly regarding gender, race, and ethnicity. This study aims to analyze the current demographics of dermatology physicians in the United States, comparing them with other medical specialties, the overall population of practicing U.S. physicians, and the U.S. population as a whole.

Design and Method:

Data from the Association of American Medical Colleges and the U.S. Census Bureau (2007–2022) were used to evaluate gender, racial, and ethnic diversity within dermatology. Demographic factors analyzed included gender, race, and ethnicity, with racial categories grouped as White, Asian, and underrepresented minorities in medicine (URiM). Chi-square tests assessed the fit of gender and age distributions with population proportions, while linear regression models examined trends over time.

Results:

From 2007 to 2021, the number of dermatologists grew by 22.9%, with a corresponding decrease in population per dermatologist, indicating growth relative to the general population. The proportion of female dermatologists rose by 68.1% during this period, while the male proportion declined by 5.1%. From 2019 to 2022, a significant linear increase (p < 0.001) in URiM representation among dermatology residents was observed, with a model-predicted annual increase of 1.6%.

Conclusions:

The increasing diversity in dermatology may be attributed to initiatives such as scholarships and mentorship programs implemented by dermatology organizations and residency programs. By fostering a more diverse workforce, dermatology can better address the healthcare needs of a diverse population and promote health equity across all demographics.
Using Comfort Theory for Addressing the Psychosocial Needs of an Afghan Refugee Child with Thalassemia: A Case Report
Authors: Ebrahimpour Fatemeh , Mirlashari Jila
Published: November 2024

Psychological and social support is one of the factors that promote resilience in refugee children. Immigrant children with thalassemia have special psychosocial needs in the host country. The comfort model can help identify psychosocial needs. We applied Kolcaba’s comfort theory to an 8-year-old Afghan boy with a history of thalassemia in Iran. According to Kolcaba’s model, the taxonomy of psychological and social comfort needs were separation from mother, anxiety due to unfamiliarity with the hospital, fear of interaction and preference for silence, different culture and place of living, language barrier. To address his psychospiritual and sociocultural comfort care, we used coaching and comfort food interventions recommended by Kolcaba. The use of Kolcaba’s Comfort Theory was helpful in promoting the child’s emotional and social comfort in the case of an Afghan refugee child with thalassemia in Iran.
Development of a Framework of Leadership in Academic Medicine (FLAM)
Authors: Dash Nihar Ranjan , Koutaich Rim , Al Khalaf Heba Awad , Hani Mohammad Jasem , Koutaich Rayan , Guraya Salman Yousuf
Published: November 2024

OBJECTIVES

Leadership within medical academic institutions often adheres to hierarchical structures, relying on factors like seniority and context, with limited focus on leadership development. This study aims to develop a structured framework by examining the traits, aspirations, and pre-requisites of academic leaders within medical school faculties.

METHODS

A cross-sectional study collected input from regular medical faculty and those in leadership roles through an online questionnaire, followed by quantitative and qualitative analyses. Data was curated, analyzed, and triangulated to establish subdomains, domains, and themes for the framework.

RESULTS

Among 229 respondents, 121 held formal academic leadership roles, the remaining 108 were regular medical faculty. And 92% of regular faculty cited lack of experience and training as significant barriers to effective leadership. Both groups agreed on the need for intensive leadership training, as 85% of leaders and 66% of regular faculty lacked formal academic leadership training. The concept of affiliative leadership was favored by 45% of leaders. Qualitative analysis and subtheme triangulation led to the development of the 6 Es Framework for Leadership in Academic Medicine (FLAM). This framework encompasses: ethics (accountability and role modeling), education (structured curriculum and training), envision (clear path and talent identification), engagement (structural foundation and attainable goals), empowerment (fostering passion), and encouragement (financial incentives).

CONCLUSION

This research reinforces the necessity of structured leadership development in academic medicine. The unique attributes of the 6Es FLAM have the potential to enhance leadership in this field.
Long COVID and recovery from Long COVID: quality of life impairments and subjective cognitive decline at a median of 2 years after initial infection
Authors: Szewczyk Warren , Fitzpatrick Annette L. , Fossou Herve , Gentile Nicole L. , Sotoodehnia Nona , Vora Surabhi B. , West T. Eoin , Bertolli Jeanne , Cope Jennifer R. , Lin Jin-Mann S. , Unger Elizabeth R. , Vu Quan M.
Published: November 2024

Background

Recovery from SARS CoV-2 infection is expected within 3 months. Long COVID occurs after SARS-CoV-2 when symptoms are present for more than 3 months that are continuous, relapsing and remitting, or progressive. Better understanding of Long COVID illness trajectories could strengthen patient care and support.

Methods

We characterized functional impairments, quality of life (QoL), and cognition among patients who recovered from SARS-CoV-2 infection within 3 months (without Long COVID), after 3 months (Recovered Long COVID), or remained symptomatic (Long COVID). Among 7305 patients identified with previous SARS-CoV-2 infection between March 2020 and December 2021, confirmed in the medical record with laboratory test or physician diagnosis, 435 (6%) completed a single self-administered survey between March 2022 and September 2022. Multi-domain QoL and cognitive concerns were evaluated using PROMIS-29 and the Cognitive Change Index-12.

Results

Nearly half the participants (47.7%) were surveyed more than 2 years from initial infection (median = 23.3 months; IQR = 18.6, 26.7) and 86.7% were surveyed more than 1 year from infection. A significantly greater proportion of the Long COVID (n = 215) group, (Current and Recovered combined), had moderate-to-severe impairment in all health domains assessed compared to those Without Long COVID (n = 220; all p < 0.05). The Recovered Long COVID group (n = 34) had significantly lower prevalence of fatigue, pain, depression, and physical and social function impairment compared to those with Current Long COVID (n = 181; all p < 0.05). However, compared to patients Without Long COVID, the Recovered Long COVID group had greater prevalences of fatigue, pain (p ≤ 0.06) and subjective cognitive decline (61.8% vs 29.1%; p < 0.01). Multivariate relative risk (RR) regression indicated Long COVID risk was greater for older age groups (RR range 1.46–1.52; all p ≤ 0.05), those without a bachelor’s degree (RR = 1.33; 95% CI = 1.03–1.71; p = 0.03), and those with 3 or more comorbidities prior to SARS-CoV-2 infection (RR = 1.45; 95% CI = 1.11–1.90; p < 0.01).

Conclusions

Long COVID is associated with long-term subjective cognitive decline and diminished quality of life. Clinically significant cognitive complaints, fatigue, and pain were present even in those who reported they had recovered from Long COVID. These findings have implications for the sustainability of participation in work, education, and social activities.
HTLV infection in urban population from Mato Grosso do Sul, Central Brazil
Authors: Amianti Carolina , Bandeira Larissa Melo , Cardoso Wesley Marcio , da Silva Andréia Souza Pinto , de Jesus Milena da Silva , Ibañez Rodrigo , Freitas Felipe Bonfim , Uehara Silvia Naomi de Oliveira , Vallinoto Izaura Maria Vieira Cayres , Vallinoto Antonio Carlos Rosário , Motta-Castro Ana Rita Coimbra
Published: November 2024

Background

Brazil has the highest number of HTLV-1 infection in Latin America, with around one million cases spread unevenly across regions. However, there is a limited number of studies on this infection in the general population. This cross-sectional study aimed to estimate the prevalence of HTLV as well as identify types, and subtypes of HTLV among the urban population of Campo Grande, capital of Mato Grosso do Sul state (MS).

Results

Between July 2023 and March 2024, all information was obtained from self-reported interviews, and blood samples were collected and screened for anti-HTLV-1/2 by immunoassay and confirmed using the immunoblot method. The proviral DNA of HTLV-1/2 in positive samples was quantified by real-time PCR (qPCR) and genotyped by nucleotide sequencing (Sanger’s method). The study enrolled 611 participants, with the majority being women (90.54%), mixed race (46.32%), heterosexual (87.64%), and with a median age of 39 years. The prevalence rate of anti-HTLV-1 infection was 0.82% (CI 95% 0.34–1.96). All positive samples (n = 5) were identified as belonging to the Cosmopolitan subtype, one belonging to Japanese and four to Transcontinental subgroups. Among the five positive individuals, two presented symptoms associated with HTLV-1 infection.

Conclusion

This study highlights an intermediate prevalence of HTLV-1 in the urban population of Campo Grande, Mato Grosso do Sul, and provides epidemiological information that could help bridge the gaps in the distribution of HTLV in the general population. Also, medical care was provided for individuals presenting clinical manifestations who were previously unaware of their serological status.
Construction of multilayered gene circuits using de-novo-designed synthetic transcriptional regulators in cell-free systems
Authors: Zhao Mingming , Kim Jeongwon , Jiao Jiayan , Lim Yelin , Shi Xianai , Guo Shaobin , Kim Jongmin
Published: November 2024

Background

De-novo-designed synthetic transcriptional regulators have great potential as the genetic parts for constructing complex multilayered gene circuits. The design flexibility afforded by advanced nucleic acid sequence design tools vastly expands the repertoire of regulatory elements for circuit design. In principle, the design space of synthetic regulators should allow for the construction of regulatory circuits of arbitrary complexity; still, the orthogonality and robustness of such components have not been fully elucidated, thereby limiting the depth and width of synthetic circuits.

Results

In this work, we systematically explored the design strategy of synthetic transcriptional regulators, termed switchable transcription terminators. Specifically, by redesigning key sequence domains, we created a high-performance switchable transcription terminator with a maximum fold change of 283.11 upon activation by its cognate input RNA. Further, an automated design algorithm was developed for these elements to improve orthogonality for a complex multi-layered circuit construction. The resulting orthogonal switchable transcription terminators could be used to construct a three-layer cascade circuit and a two-input three-layer OR gate.

Conclusions

We demonstrated a practical strategy for designing standardized regulatory elements and assembling modular gene circuits, ultimately laying the foundation for the streamlined construction of complex synthetic gene circuits.
Sustainable and efficient monitoring of tryptophan and tyrosine serum levels: a green HPTLC method as a biomarker for type 2 diabetes
Authors: Kamel Rania M. , Abdel-aal Fatma A. M. , Mohamed Fardous A. , Mohamed Abdel-Maaboud I.
Published: November 2024

In recent years, there has been considerable interest in using amino acids like tryptophan (Trp) and tyrosine (Tyr) as biomarkers for various diseases, including type 2 diabetes mellitus (T2D). In diseases like T2D, the metabolism of Trp and Tyr is altered. The activity of enzymes involved in Trp metabolism increases, leading to a decrease in its serum level. On the other hand, the serum level of Tyr increases due to the suppressed activity of its metabolizing enzymes. These observations suggest that Trp and Tyr metabolism may play a crucial role in the pathophysiology of type 2 diabetes. Our study highlights the potential utility of Trp and Tyr as biomarkers for the early detection, prognosis, and monitoring of this metabolic disorder. Given these observations, we aimed to develop a high-performance thin-layer chromatographic (HPTLC) method that is sensitive, selective, rapid, and environmentally friendly for estimating the concentrations of Trp and Tyr in biological fluids, particularly serum samples. To evaluate the method, we performed analysis using serum samples from controlled and streptozotocin-induced diabetic rats. Our main objective was to develop a method that is sensitive and selective for precisely determining Trp and Tyr serum levels, which could serve as potential biomarkers for T2D. Fluorescence and absorption modes were employed for densitometry scanning. We assessed the precision and high separation efficiency of the chromatographic system by calculating parameters such as separation and resolution factors, number of theoretical plates, and height equivalent to theoretical plates. To evaluate the environmental impact of our proposed method, we employed the AGREE (Analytical GREEnness metric) and GAPI (Green Analytical Procedure Index) greenness assessment tools. The results confirmed that our method is environmentally friendly and exhibits superior eco-friendliness and greenness compared to other reported methods.

Graphical Abstract
Spatial pattern and its influencing factors of national-level cultural heritage in China
Authors: Shen Wei , Chen Yanli , Cao Weiwei , Yu Ruyi , Rong Peijun , Cheng Jinlong
Published: November 2024

Exploring the spatial pattern and its influencing mechanism of cultural heritage is of great significance for the systematic protection, inheritance and utilization of cultural heritage. In this study, the national-level cultural heritage of China as the research object, and the spatial patterns of the cultural heritage (CH), tangible cultural heritage (TCH) and intangible cultural heritage (ICH) are analyzed are summarized using the multiple geospatial analysis method, and their spatial distribution differences. Then, the optimal parameter geodetector model was further used to analyze the influencing and interaction effect of natural environment (NE) factors, socioeconomic and cultural environment (SCE) factors on the spatial distribution of CH, TCH and ICH, and the interaction mechanism was deeply discussed. The results show that high-density region of CH are mainly located in the southeastern Heihe-Tengchong Line of China, while low-density region are mostly located in the northwestern Heihe-Tengchong Line. In terms of local spatial differences, the spatial distribution of material cultural heritage is different in different river basins, different terrains and different climates. The spatial distribution of ICH mainly shows significant differences in terrain and climate, and does not show significant differences in river basins. In terms of influencing factors, sociocultural environment, education level, historical settlement environment, road traffic, climate, economy, population and terrain factors all have a significant impact on the spatial distribution of CH and TCH. Sociocultural environment, education level, historical settlement environment, road traffic, climate, economy and population have a significant impact on the spatial distribution of ICH, while topographic factors and water system factors have no significant impact on the spatial distribution of ICH. Compared with ICH, TCH is more likely to be directly affected by topographic conditions (altitude, relief of terrain) and hydrological conditions (production and living water sources and flood risk) during its formation stage. At the same time, topographic and hydrological conditions can also indirectly affect the spatial distribution of TCH by directly affecting human agricultural activities, economic activities and cultural activities.
Technological leadership of kindergarten teachers along their careers and during the COVID-19 period
Authors: Aizenberg Merav , Zilka Gila Cohen
Published: November 2024

The study examines the use of technology by kindergarten teachers during the COVID-19 pandemic and in the course of their professional careers, and their attitudes toward the integration of technology in kindergartens with the resolution of the crisis. The article presents findings derived from interviews with kindergarten teachers in Israel. The study revealed three patterns of technology use by kindergarten teachers, with no differences between career stages. The avoidance pattern (37%), the structured activism pattern (22%), and the entrepreneurial pattern (40%). The findings of the study contradict the approach that explains the use of technology based on career stages.