bluuebunny/crossref_metadata_2025 huggingface dataset:
Social-ecological semiotics and the complex organization of psyche, language, and culture
Authors: Rutherford Glen , Tuntivivat Sudarat
Published: February 2024

In each given situation, our words and deeds carry signs and meanings that are contingent on, and reflect, the social-ecological semiotic settings. The purpose of this work is to better understand the complex organization of psyche, language, and culture. The process of hyper-generalization brings affective and cognitive opposites into the whole sign field and guides the whole relating with the world. As well, the process of semiotic mediation entails signs constraining and enhancing both interpersonal and intrapersonal psychological processes and experiences, including through nested systems (the levels of the individual-the relationship-the community-the societal). We present data for Australia and Thailand on Hofstede’s six culture dimensions, that is, power distance, uncertainty avoidance, masculinity/femininity, individualism/collectivism, short-term/long-term orientation & restraint/indulgence. An idealized and dynamic model of relations of Hofstede’s six culture dimensions and four indeterminate pronouns (e.g., ‘every’-one, ‘some’-one, ‘any’-one, ‘no’ one) is proposed. As a framework for construing the complex semiotic organization of (western, English-speaking) culture and psyche, four “cyclical” regulatory statements are outlined, regarding personal constraint, personal enhancement, cultural constraint, and cultural enhancement in language and culture, that is, in semiotic cultural psychology. Examples on the values of caring for people and planet are given to illustrate the social-ecological semiotic framework.
Virtual Motivational Interviewing (VIMINT) to support physical activity: Experiences of older adults and counsellors
Authors: Akinrolie Olayinka , Ripat Jacquie , Strachan Shaelyn , Webber Sandra C , Barclay Ruth
Published: February 2024

The aim of this study was to explore the experiences of older adults and counsellors involved in virtual motivational interviewing (MI). This study was part of the Virtual Motivational INTerviewing (VIMINT) feasibility trial of virtual MI for physical activity in older adults. A descriptive qualitative design utilized content analysis. Seven older adults and three counsellors were interviewed. Four categories were developed: (i) Benefits and limitations of using technology (ii) Relationships between older adults and counsellors (iii) MI skills and spirit and (iv) Effects of virtual MI. Older adults and counsellors reported that receiving/delivering MI virtually was convenient and flexible. They described reduced non-verbal communication in virtual MI. Virtual MI facilitates interpersonal relationships, and counsellors reported that MI skills and spirit can be applied virtually. This study showed that virtual MI offers potential benefits with some limitations. The findings could inform future research involving virtual delivery of MI.
The development of a prototype footbridge composed of biological self-healing and ultra-high-performance concretes
Authors: Jakubovskis Ronaldas , Sokolov Aleksandr
Published: February 2024

Developments in concrete technologies have allowed engineers to design lightweight, slender, and aesthetically attractive structures. The application of new concrete types in real projects, however, is uncommon. The lack of regulation, uncertainty in material performance, and the absence of successfully implemented projects hinders the use of modern concretes in everyday design projects. The present paper examines the application of two specific concrete types in a prototype footbridge: ultra-high-performance concrete (UHPC), and biological self-healing concrete (BSHC). The material properties of UHPC were selected and tailored specifically for the prototype structure, applying the principles of performance-based design. To evaluate the efficiency of self-healing under real environmental conditions, BSHC beams were designed as a structural part of the bridge. The step-by step presentation of the bridge development demonstrates the specifics in material design and a structural analysis of the prototype structure. The prototype structure serves as demonstrative example of the use of BSH and UHP concretes, encouraging engineers towards the wider application of advanced materials in construction projects.
Intergenerational Mobility in South Asia
Authors: Khan Zanbaz Ahmed , Patra Biswajit
Published: February 2024

This article analyses the movement of intergenerational mobility (IGM) in South Asia from birth cohorts comprising 1950–1980 using the World Bank’s data on IGM. The article compares the IGM movements across countries to account for the causal factors of the IGM. Exploratory data analysis and Bayesian regression have been used in this study for empirical analysis. We note that in the past three decades, the share of primary parental education in South Asia constitutes 79% of the total, while the children who achieved the highest level of education constitute only 10%. Children in Sri Lanka have been enrolled in school for the greatest number of years, but the absolute IGM in India is greater than Sri Lanka. Bhutan lags in average years of educational attainment, yet their relative mobility surpasses every country in South Asia. The likelihood that Pakistani children’s status shall be independent of their parental status is as low as 20%. Despite variation in parental education, absolute IGM in India is highest in South Asia. Variation in parental education reduces the degree of independence in the next generation. Relative measure of mobility is a better indicator of social mobility than the absolute measure.

JEL Codes: I21, I24, I28, J24, J62, N35
A retrospective cohort study on renal morbidity related to stoma type in inflammatory bowel disease patients following colectomy and ileal pouch-anal anastomosis surgery
Authors: Lundström Simon , Buchwald Pamela , Agger Erik
Published: February 2024

Background and objective:

Defunctioning loop ileostomy (DLI) is frequently used to decrease the consequences of anastomotic leak after ileal pouch-anal anastomosis (IPAA) surgery but is controversial because of stoma-associated morbidity. The aim of this study was to describe stoma-associated morbidity in IPAA–DLI patients compared with terminal ileostomy patients.

Methods:

Patients treated with colectomy for inflammatory bowel disease at Skåne University Hospital, Sweden, between 2005 and 2021 were eligible for inclusion. Terminal stoma-related morbidity was measured until 12 months after colectomy, IPAA surgery, or conversion to ileorectal anastomosis, whichever occurred first. DLI-related morbidity was measured until 12 months after IPAA surgery or stoma closure, whichever occurred first. Laboratory data were reviewed up to 18 months after surgery since patients without complications were rarely subjected to blood sampling. Data on patient characteristics, renal function, surgical complications, and readmissions were collected retrospectively. Primary outcomes were DLI- and terminal ileostomy-related renal morbidity, whereas secondary outcomes focused on stoma-related complications.

Results:

The study cohort consisted of 165 patients with terminal ileostomy after colectomy (median (interquartile range (IQR)): stoma time 30 (15–74) months) and 42 patients with IPAA–DLI (median (IQR): stoma time 4 (3–5) months). One case of anastomotic IPAA leakage was observed. IPAA–DLI patients more often required hospital care due to high-volume stoma output immediately after surgery (0–30 days, 29%) compared with terminal ileostomy patients (4%, p < 0.001). There were no significant differences in acute renal injury ( p = 0.073) or chronic renal failure ( p = 0.936) incidences between the groups. DLI closure was achieved in 95% of IPAA–DLI patients, with 5% suffering Clavien–Dindo complications > 2.

Conclusions:

IPAA–DLI patients exhibited higher incidence of short-term high-volume stoma output without higher rates of acute renal injury or chronic renal failure compared with terminal ileostomy patients in this small single-center retrospective study suggesting that the risk of renal morbidity in IPAA–DLI patients may have been overestimated.
Research on the hydrodynamic performance of propellers under oblique flow conditions
Authors: Wei Xinxin , Yan Tianhong , Sun Tao , Liu Shulin , Du Hongyi
Published: February 2024

The phenomenon of oblique water inflow is widespread in the operation of thrusters, which will cause adverse effects on the hydrodynamic performance of thrusters. In order to investigate the hydrodynamic performance and stress variation of the propeller in oblique flow, based on computational fluid dynamics theory, this paper takes the DTMB4119 propeller as the research object and conducts numerical simulation research on the propeller in oblique flow by solving the RANS equation. By calculating the open water performance curve and surface pressure distribution of the propeller, the rationality of the numerical method and the meshing are verified. Considering the flow field information such as velocity, oblique flow angles, flow line distribution, and pressure distribution, the changes in hydrodynamic characteristics of the propeller are simulated and analyzed. The results show that the uneven distribution of pressure on the propeller blade surface increases with a decrease in the advance coefficient. The force pulsation amplitude of a single blade increases with an increase in oblique flow angles. With the increase in oblique flow angles, the thrust, torque, and efficiency of the propeller show different increasing trends. With the increase in propeller advance coefficient, propeller thrust and torque decrease gradually, and propeller efficiency increases gradually. By using mature propellers, this paper has more reference value for studying the flow field around the ship hull and the hydrodynamic performance of propellers in the process of ship maneuvering.
Vibration-based structural damage localization through a discriminant analysis strategy with cepstral coefficients
Authors: Li Lechen , Brügger Adrian , Betti Raimondo , Shen Zhenzhong , Gan Lei
Published: February 2024

Over the past decades, Vibration-Based Methods (VBMs) have consistently exhibited exceptional effectiveness in the field of Structural Health Monitoring when it comes to assessing structural damage in both civil and mechanical structures. Recently, the progress made in data-driven strategies for localizing structural damage through the VBMs has resulted in substantial benefits. These advanced strategies not only enable an efficient decision-making process but also provide precise identification of repair locations for monitored structures. Importantly, they achieve this without the inherent complexity and computational burden typically associated with traditional model-based methods. In this study, an innovative data-driven method for localizing and quantifying structural damage is proposed. The method is developed on the basis of the principles of Linear Discriminant Analysis (LDA) and a newly devised modeling strategy that utilizes the power cepstral coefficients extracted from the structural acceleration response. The developed LDA model is able to highlight the local structural characteristics (i.e., mode shape-related information) embedded in the cepstral coefficients in the LDA latent space. Based on the highlighted local characteristics of the cepstral coefficients, a statistical pattern recognition strategy is proposed to effectively conduct the quantification and localization of structural damage. The proposed damage localization method is designed to function in a completely unsupervised-learning manner, which eliminates the requirement for the model to have access to any prior knowledge or information regarding structural damage during the training phase. The proposed method has been validated by both numerical simulations and experimental data.
Turnover Rates and Factors Associated With Turnover: A Longitudinal Analysis of the Retention Period of Clinical Nurses in Korea Using National Data
Authors: Kim Yunmi , Kim Hyun-Young
Published: February 2024

Many countries, including Korea, are struggling with a nursing workforce shortage. This study aimed to identify the actual turnover rate of Korean clinical nurses and the factors affecting the turnover rate, considering the time required for nurses to gain experience at their current medical institution. This longitudinal study followed up on a cohort consisting of all 107,682 nurses from January 1, 2017 to July 30, 2020. Differences in the distribution of retention and turnover according to the medical institutions’ and nurses’ characteristics were analyzed using the chi-square test. The hazard ratios (HRs) for turnover in each analysis interval were analyzed using multilevel Cox proportional-hazards analysis. The mean turnover rate was 10.0% within 1 year and 33.4% within 3.5 years. Several organizational characteristics (the type and ownership of the hospital, its location, and the bed-to-nurse ratio) and individual characteristics (gender, age, and clinical experience) were found to be associated with turnover risk. Among these factors, compared to hospitals with a bed-to-nurse ratio in general wards of 6.0 or more, those with a ratio of 3.5–3.9 had an HR for 1-year turnover of 0.81 (95% confidence interval [CI]  =  0.67–0.98), and those with a ratio of 2.5–2.9 had an HR for 3.5-year turnover of 0.77 (95% CI  =  0.66–0.90). The bed-to-nurse ratio is a condition that can be modified through collaboration between government policy-makers and medical institutions. To reduce nurse turnover and retain experienced nurses, appropriate staffing should be implemented.
The Relationship Between Health Literacy and Diabetes Self-Efficacy and Foot Self-Care in Type II Diabetics
Authors: Kaplan Burcu , Koçak Hatice Serap , Kaplan Serin Emine
Published: February 2024

This study was conducted to determine the effect of health literacy on diabetes self-efficacy and foot self-care in type II diabetics. This descriptive correlational study was conducted with 187 people. The research was conducted between 01 June 2021 and 31 December 2021 in a province located in the southeastern region of Turkey. Non-probability purposive sampling was used as the sampling method. An introductory information form, and the Turkish Health Literacy Scale-32 (THLS-32), Diabetes Self-Efficacy Scale and Diabetes Foot Self-Care Behavior Scale (DFSBS) were used in the study. Data were evaluated with frequency, percentage, mean, and correlation analyses using SPSS 25 software. It was determined that the participants had a low education level and were of advanced age, and that the feet of most of the patients were not examined and there were no wounds on their feet. The health literacy level of 57.8% of the participants was found to be insufficient. The mean THLS-32 score was 22.50 ± 10.65, the Diabetes Self-Efficacy Scale mean score was 72.83 ± 11.84, and the Diabetes Foot Self-Care Behavior Scale mean score was 22.60 ± 5.44. It was determined that there was a relationship between the THLS-32 and Diabetes Self-Efficacy score of those with type II diabetes, and that as health literacy increased, diabetes self-efficacy increased ( p < 0.05). It was determined that the health literacy level was insufficient, whereas diabetes self-efficacy and foot self-care were at a good level. It was found that as health literacy increased, self-efficacy increased. Information on health literacy is effective in coping with the disease. For this reason, information on health literacy should be given from an early age.
A Comparison of Outcomes in Acute Perilunate Injuries: Systematic Review and Meta-Analysis of Treatment Approaches
Authors: Abola Matthew V. , Gerber Brett A. , Rocks Madeline C. , Chen Jeffrey S. , Hacquebord Jacques H. , Azad Ali
Published: February 2024

Background:

Perilunate dislocations (PLD) and fracture-dislocations (PLFD) comprise a spectrum of high-energy wrist injuries. The purpose of this review was to review operative strategies for perilunate injuries based on approach and compare outcomes.

Methods:

A systematic review of literature on PLD and fracture-dislocations was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). PubMed and EMBASE databases were queried for literature. Inclusion criteria included English studies reporting clinical or functional outcomes of acute PLD and PLFD.

Results:

Twenty-nine full-text articles (604 PLD and PLFD injuries) were included. The most common method of PLD and PLFD fixation is through an open approach with combined volar and dorsal exposure. There were no differences between approaches with regard to total arc range of motion, grip strength, Mayo Wrist Score, or mean scapholunate angle. Similarly, there was no difference between approaches and postoperative radiographic arthritis or complications. Most patients were able to return to their prior level of function and work. The incidence of postoperative complications ranged from 0% to 22.5%.

Conclusion:

Current evidence shows no difference in postoperative total wrist arc range of motion, grip strength (as compared to contralateral), or Mayo Wrist Score with regard to surgical approach. The most common method of PLD and PLFD fixation in the literature is through an open approach with combined volar and dorsal exposure. There is a large difference in reported rates of radiographic arthritis, although this finding does not appear to correlate with postoperative pain or disability.

Level of Evidence:

I, Systematic Review.
Transvenous embolization of noncavernous dural arteriovenous fistulas (dAVFs): A systematic review and meta-analysis
Authors: Lim Jaims , Donnelly Brianna M. , Jaikumar Vinay , Kruk Marissa D. , Kuo Cathleen C. , Monteiro Andre , Siddiqi Manhal , Baig Ammad A. , Patel Devan , Raygor Kunal P. , Snyder Kenneth V. , Davies Jason M. , Levy Elad I. , Siddiqui Adnan H.
Published: February 2024

Background

Intracranial dural arteriovenous fistulas (dAVFs) are abnormal connections between arteries and veins within the dura mater. Various treatment modalities, such as surgical ligation, endovascular intervention, and radiosurgery, aim to close the fistulous connection. Although transvenous embolization (TVE) is the preferred method for carotid-cavernous fistulas, its description and outcomes for noncavernous dAVFs vary. This has prompted a systematic review and meta-analysis to comprehensively assess the effectiveness of TVE in treating noncavernous dAVFs, addressing variations in outcomes and techniques.

Methods

We searched PubMed and Embase, spanning from the earliest records to December 2022, to identify pertinent English-language articles detailing the utilization of TVE. We focused on specific procedural details, outcomes, and complications in patients older than 18 years. The data collected and analyzed comprised the sample size, number of fistulas, publication specifics, presenting symptoms, fistula grades, and pooled rates of embolizations, outcomes, follow-up information, and complications.

Results

From a total of 565 screened articles, 15 retrospective articles encompassing 166 patients spanning across seven countries met the inclusion criteria. Their Newcastle–Ottawa scores ranged from 6 to 8. Intraprocedural complication rate was 10% (95% confidence interval [CI] = 5.9–17.1) and in-hospital postprocedural complication rate was 5.4% (95% CI = 2.8–10.6). Prevalence of in-hospital mortality was 5.5% (95% CI = 2.9–10.6). Complication rate during follow-up was 8.6% (95% CI = 4.7–15.7) with fistula rupture occurring in 5.5% (95% CI = 2.6–11.6) of patients. Complete obliteration rate at final angiographic follow-up was 94.9% (95% CI = 90.3–99.9). Symptoms improved in 95% (95% CI = 89.8–100) of patients at final follow-up.

Conclusion

To our knowledge, we present the first meta-analysis assessing obliteration rates, outcomes, and complications of TVE for dAVFs. Our analysis highlights the higher (>90%) complete obliteration rates. Large prospective multicenter studies are needed to better define the utility of TVE for noncavernous dAVFs.
Addressing Race in Fieldnotes in Qualitative Health Research: A Methodological Critique
Authors: Johnson Alisha H. , Taylor Janiece L. , Caudillo Lucia , Hwang Hyenam , Gill Eliana , Harrison Tracie C.
Published: February 2024

Attention has recently been given to the role of race in many aspects of the research process; however, minimal has been written to critique the role of race in qualitative fieldnotes. This gap creates potential conflicts about representation that can exclude marginalized communities and call into question findings when race is ignored in the research process. To successfully address potential investigator biases with a lens towards social justice and equity in healthcare, a critique of foundational methods is required. Here we posit that a qualitative health researchers’ primary tool is their fieldnotes because they contextualize findings and serve as a method to learn through systematic interpretation of local meanings revealed by participants. Here, we provide researchers guidance for teaching and writing fieldnotes that speak to current nuances of observations and interactions with participants. Definitions related to race and ethnicity, the importance of applying appropriate sensitizing frameworks, followed by a discussion of how to use fieldnotes in findings are covered. We include (1) a call for more preparation of novice researchers and a challenge for established researchers to update expertise for collecting and using fieldnotes in the research process, (2) guidance on negotiating difficult situations, and (3) the significance of language in creating credibility in findings when addressing race in qualitative research.
Long-pulsed 1064nm Nd:YAG laser in the treatment of leg veins: Systematic review
Authors: Baldaia Leonor , Dias-Neto Marina , Almeida Pinto João
Published: February 2024

Objective

Long-pulsed 1064 nm Nd:YAG laser can damage vessels with higher diameters and penetrate to a deeper level than other laser therapies. We aim to analyze outcomes of the treatment of leg veins with long-pulsed 1064 nm Nd:YAG laser regarding intervention protocol, technical success, clinical success, and side effects.

Methods

A research of the published literature was conducted, using PubMed and Embase databases, in April 2022. The key words used were telangiectasia, reticular veins, neodymium YAG laser, clearance, satisfaction, and treatment. PRISMA guidelines were followed.

Results

We included twenty-six articles, twenty-three prospective and three retrospective studies, with a total of 1991 patients. The articles were organized in different sections according to the control group. The four outcomes were analyzed in each section. These studies showed that the long-pulsed 1064 nm Nd:YAG laser is a safe and very good option for the treatment of leg veins measuring up to 3 mm in diameter. Studies comparing long-pulsed 1064 nm Nd:YAG laser therapy and sclerotherapy showed similar clearance rates with no significant differences. However, sclerotherapy seemed to be less painful and to have faster clinical improvements. In two articles, Nd:YAG laser had better outcomes in the treatment of smaller vessels with less than 1 mm in diameter, than sclerotherapy alone. Treatment with polidocanol microfoam and Nd:YAG laser had better clearance rates than Nd:YAG laser alone in three studies. In the comparison of 1064 nm Nd:YAG laser therapy with other lasers and light sources, the studies had contradictory results.

Conclusion

Long-pulsed 1064 nm Nd:YAG laser is a valid therapeutic option for leg telangiectasia and reticular veins with great aesthetic outcomes and minor side effects. Nd:YAG laser therapy could be combined with sclerotherapy or other laser therapies or IPL in order to achieve better results. Serious side effects are rare, but the procedure is almost always accompanied by moderate tolerable pain.
Endovenous glue ablation for chronic venous insufficiency: A comprehensive 5-year assessment of clinical and hemodynamic outcomes
Authors: Guven Hakan
Published: February 2024

Objectives

Chronic venous insufficiency is mainly caused by reflux, obstruction, or both. Endovenous glue ablation has become one of the widely used methods for treating reflux in recent years. Duplex ultrasonography is the most commonly used method for diagnosing and evaluating treatment. However, there is important information that plethysmographic venous hemodynamics provides, which Duplex USG cannot provide. This retrospective study aimed to evaluate the 5-year clinical, anatomical, and hemodynamic results of endovenous glue ablation in the treatment of chronic venous insufficience, accompanied by the data from the plethysmographic study.

Patients and Method

Between January 2018 and August 2018, 133 patients with symptomatic CEAP 2-6 varicose veins with reflux of the great saphenous vein lasting longer than 0.5 seconds and a diameter of 5.5 mm in the standing great saphenous vein underwent EVGA. CEAP, VCSS, CIVIQ 20, Doppler USG, GSV diameters and insufficiency times, and hemodynamically Venous Refilling Time and Venous Half-Value Time measurements were performed before the procedure. In the same way, measurements were made at the 1st, 3rd, 6th, 12th, 24th, and 60th months of the patients who were called and came to the postoperative follow-up.

Results

Procedural success was 100%, and complete occlusion was observed %93 after treatment, at the 60 month. The improvement in VCSS (from 4.4 ± 1.3 to 1.7 ± 0.9), CIVIQ20 (from 8.5 ± 3.1 to 4.7 ± 2.0), VRT (from 20.3 ± 5.0 to 131.1 ± 4.0), and TH (from 2.8 ± 0.3 to 2.4 ± 0.2) was significant ( p < .001 was for all).

Conclusion

Endovenous glue ablation is a preferred method for the treatment of great saphenous vein insufficiency due to its ease of use and the comfort it provides to patients, as well as its effectiveness and safety. In particular, it can be considered an effective method for improving venous hemodynamics and relieving associated symptoms.
Ortho-iodination of aromatic carboxylic acids in aqueous media
Authors: Havasel Hengameh , Soltani Roghaye , Eshghi Hossein , Ghaderi Arash
Published: February 2024

A straightforward method has been developed for Pd(II) catalyzed ortho-iodination of benzoic acids in aqueous media. In this paper, mono-iodination of benzoic acids is reported in the presence of KI as the iodine source.
Association between dietary calcium intake and severe abdominal aorta calcification among American adults: a cross-sectional analysis of the National Health and Nutrition Examination Survey
Authors: Zhang Kai , Gu Fangming , Han Yu , Cai Tianyi , Gu Zhaoxuan , Chen Jianguo , Chen Bowen , Gao Min , Hou Zhengyan , Yu Xiaoqi , Zhao JiaYu , Gao Yafang , Xie Jinyu , Hu Rui , Liu Tianzhou , Li Bo
Published: February 2024

Background:

Evidence regarding the relationship between dietary calcium intake and severe abdominal aortic calcification (AAC) is limited. Therefore, this study aimed to investigate the association between dietary calcium intake and severe AAC in American adults based on data from the National Health and Nutrition Examination Survey (NHANES).

Methods:

The present cross-sectional study utilized data from the NHANES 2013–2014, a population-based dataset. Dietary calcium intake was assessed using two 24-h dietary recall interviews. Quantification of the AAC scores was accomplished utilizing the Kauppila score system, whereby severe AAC was defined as having an AAC score greater than 6. We used multivariable logistic regression models, a restricted cubic spline analysis, and a two-piecewise linear regression model to show the effect of calcium intake on severe AAC.

Results:

Out of the 2640 individuals examined, 10.9% had severe AAC. Following the adjustment for confounding variables, an independent association was discovered between an augmented intake of dietary calcium and the incidence of severe AAC. When comparing individuals in the second quartile (Q2) of dietary calcium intake with those in the lowest quartile (Q1), a decrease in the occurrence of severe AAC was observed (odds ratio: 0.66; 95% confidence interval: 0.44–0.99). Furthermore, the relationship between dietary calcium intake and severe AAC demonstrated an L-shaped pattern, with an inflection point observed at 907.259 mg/day. Subgroup analyses revealed no significant interaction effects.

Conclusion:

The study revealed that the relationship between dietary calcium intake and severe AAC in American adults is L-shaped, with an inflection point of 907.259 mg/day. Further research is required to confirm this association.
Stricture dilation via balloon-assisted endoscopy in Crohn’s disease: approach and intraprocedural outcomes with the single-balloon and double-balloon systems
Authors: Halloran Brendan P. , Reeson Matthew , Teshima Christopher , Kroeker Karen , Huang Vivian , Dieleman Levinus , Holmes Peter , Baumgart Daniel C. , Wong Karen , Hoentjen Frank , Peerani Farhad , Zepeda-Gomez Sergio
Published: February 2024

Background:

Despite recent emerging literature involving the utility of endoscopic balloon dilation (EBD) of strictures via balloon-assisted endoscopy (BAE), specifically regarding the management of Crohn’s disease (CD), the optimal clinical approach with balloon systems has been largely neglected in academic literature.

Objectives:

This study assesses the intra-procedural success and safety of EBD via BAE for small bowel CD strictures while detailing our clinical approach and technique. Secondarily, we compare the single-balloon endoscope (SBE) and double-balloon endoscope (DBE) systems for EBD-related outcomes.

Design:

Retrospective consecutive patient cohort analysis.

Methods:

We retrospectively assessed a consecutive small bowel CD patient cohort undergoing BAE at the University of Alberta Hospital endoscopy unit from 2013 to 2020. The primary endpoint discerned the safety and immediate success rate of EBD during endoscopy, and comparisons of the dilation parameters and efficacy of SBE versus DBE were assessed as secondary outcomes.

Results:

During the study period, 87 patients (44 male) with a mean age of 56 ± 14.7 years underwent 179 endoscopic procedures (92 DBE and 87 SBE). Of 358 strictures encountered, 320 (89.4%) were successfully dilated and traversed. The mean maximum dilation diameter was 15.76 ± 2.10 mm. There were no perforations or major adverse events.

Conclusion:

EBD via BAE is a safe procedure in small bowel CD with a high intraprocedural success rate. Overall, SBE had a higher success rate in traversing strictures before and after dilation using our technique. This analysis is limited by the retrospective nature of our study and must be balanced against the inherent benefits of the DBE system.
Carboplatin in metastatic castration-resistant prostate cancer patients with molecular alterations of the DNA damage repair pathway: the PRO-CARBO phase II trial
Authors: Coquan Elodie , Penel Nicolas , Lequesne Justine , Leman Raphaël , Lavaud Pernelle , Neviere Zoé , Brachet Pierre-Emmanuel , Meriaux Emeline , Carnot Aurélien , Boutrois Jérémy , Castera Marie , Goardon Nicolas , Muller Etienne , Leconte Alexandra , Thiery-Vuillemin Antoine , Clarisse Bénédicte , Joly Florence
Published: February 2024

Introduction:

DNA damage repair genes are altered in 20–35% of metastatic castration-resistant prostate cancer (mCRPC). Poly-ADP (Adénosine Diphosphate)-ribose polymerase inhibitors (PARPi) showed significant activity for these selected tumors, especially with homologous recombination repair (HRR) deficiency. These alterations could also predict platinum sensitivity. Although carboplatin was inconclusive in unselected mCRPC, the literature suggests an anti-tumoral activity in mCRPC with HHR gene alterations. We aimed to assess the efficacy of carboplatin monotherapy in mCRPC patients with HRR deficiency.

Methods:

This prospective multicenter single-arm two-stage phase II addressed mCRPC men with HRR somatic and/or germline alterations, pretreated with ⩾2 taxane chemotherapy regimens and one androgen receptor pathway inhibitor. Prior PARPi treatment was allowed. Enrolled patients received intravenous carboplatin (AUC5) every 21 days for 6–9 cycles. The primary endpoint was the best response rate according to adapted PCWG3 guidelines: radiological response (RECIST 1.1 criteria) and/or biological response [⩾50% prostate-specific antigen (PSA) decline].

Results:

A total of 15 out of 16 enrolled patients started carboplatin treatment. Genomic alterations were identified for BRCA2 ( n = 5), CDK12 ( n = 3), ATM ( n = 3) CHEK2 ( n = 2), CHEK1 ( n = 1), and BRCA1 ( n = 1) genes. Objective response (partial biological response + stable radiological response) was achieved in one patient (6.7%), carrying a BRCA2 mutation and not pre-treated with PARPi; stable disease was observed for five patients (33.5%). Among seven patients (46.7%) with previous PARPi treatment, four patients (57.1%) had a stable disease. The median progression-free and overall survivals were 1.9 [95% confidence interval (95% CI), 1.8–9.5] and 8.6 months (95% CI, 4.3–19.5), respectively. The most common severe (grade 3–4) treatment-related toxicities were thrombocytopenia (66.7%), anemia (66.7%), and nausea (60%). Overall, 8 (53.3%) patients experienced a severe hematological event.

Conclusion:

The study was prematurely stopped as pre-planned considering the limited activity of carboplatin monotherapy in heavily pre-treated, HHR-deficient mCRPC patients. Larger experience is needed in mCRPC with BRCA alterations.

Trial registration:

NCT03652493, EudraCT ID number 2017-004764-35.
A remnant never forgotten: the utility of circulating tumor DNA in treatment guidance of urachal cancer
Authors: Grant Christopher Ryan , Benjamin David J. , Cramer Scott , Rezazadeh Kalebasty Arash
Published: February 2024

Urachal cancer is a rare malignancy of the urachus that is treated with surgical resection if localized and systemic chemotherapy for metastatic disease. Circulating tumor DNA (ctDNA) is a single-stranded or double-stranded DNA released by tumor cells into the blood and harbored the mutations of the original tumor, shedding new light on molecular diagnosis and monitoring of cancer. We report a case of resected localized urachal cancer with clear surgical margins and negative lymph node dissection but elevated ctDNA that progressed to metastatic disease. We also highlight the possibility of using ctDNA levels to assist in adjuvant therapy.
Methylated ctDNA predicts early recurrence risk in patients undergoing resection of initially unresectable colorectal cancer liver metastases
Authors: Chen Zhi-Gang , Ji Xiao-Meng , Xu Yu-Xia , Fong William Pat , Liu Xiao-Yun , Liang Jie-Ying , Tan Qiong , Wen Lei , Cai Yan-Yu , Wang De-Shen , Li Yu-Hong
Published: February 2024

Background:

Patients with initially unresectable colorectal cancer liver metastases (IU-CRLM) might benefit from using an effective systemic treatment followed by resection of liver metastases but the curative success rate is quite low. Indeed, nearly one-third of patients exhibit early recurrence within the first 6 months after surgery, and these individuals often have poor overall survival.

Objectives:

This study aims to clarify the application value of serial circulating tumor DNA (ctDNA) analysis in predicting the clinical outcome of IU-CRLM patients following liver metastasectomy.

Design:

A retrospective study was conducted on a cohort of patients with IU-CRLM between February 2018 and April 2021.

Methods:

Plasma samples at different time points during CRLM treatment [baseline (BL), preoperation (PRE), postoperation (POST), end-of-treatment (EOT), and progressive disease (PD)] were retrospectively collected from patients with initially unresectable CRLM enrolled at the Sun Yat-sen University Cancer Center. Dynamic changes of SEPTIN 9 (SEPT9) and Neuropeptide Y (NPY) methylated circulating tumor DNA (MetctDNA) levels in serial plasma samples were detected using droplet-digital PCR (ddPCR).

Results:

SEPT9 and NPY genes were hypermethylated in colon cancer cell lines and tissues while no difference was observed between primary and metastatic tumors. Patients with MetctDNA positive at POST or EOT had significantly lower recurrence-free survival (RFS) compared to patients with MetctDNA negative at these time points [POST: Hazard ratio (HR) 9.44, 95% confidence interval (CI) 5.15–17.30, p < 0.001; EOT: HR 11.48, 95% CI 3.27–40.31, p < 0.001]. Multivariate analysis demonstrated that POST (OR 33.96, 95% CI 4.03–286.10, p = 0.001) and EOT (OR 18.36, 95% CI 1.14–295.71, p = 0.04) MetctDNA was an independent risk factor for early recurrence. Time-dependent receiver operating characteristic curve (T-ROC) analysis revealed that area under the curve (AUC) value was greatest at the relapse time point of 6 months post-intervention, with POST-AUC and EOT-AUC values of 0.74 (95% CI 0.66–0.81) and 0.73 (95% CI 0.53–0.94), respectively. Serial MetctDNA analysis showed that RFS was significantly lower in patients with no MetctDNA clearance compared with those with MetctDNA clearance (HR 26.05, 95% CI 4.92–137.81, p < 0.001).

Conclusion:

Our study confirmed that serial ctDNA analysis of NPY and SEPT9 gene methylation could effectively predict early recurrence in IU-CRLM patients, especially at POST and EOT.
To flare or not to flare: patients’ and rheumatologists’ perceptions on the on-flare retreatment strategy of rituximab in rheumatoid arthritis
Authors: Bertrand Delphine , Deprez Anke , Doumen Michaël , De Cock Diederik , Pazmino Sofia , Marchal Anja , Thelissen Marc , Joly Johan , De Meyst Elias , Neerinckx Barbara , Westhovens René , Verschueren Patrick
Published: February 2024

Background:

Several retreatment strategies exist for rituximab in rheumatoid arthritis (RA). In some countries, reimbursement criteria require a loss of disease control for rituximab retreatment. Understanding the patients’ and rheumatologists’ perceptions regarding this retreatment strategy would be informative in identifying the optimal treatment administration schedule.

Objectives:

This study aimed to uncover patients’ and rheumatologists’ perceptions regarding retreatment strategies of rituximab.

Design:

Qualitative study – semi-structured interviews

Methods:

Patients with RA, treated with rituximab, and rheumatologists were invited to participate in a qualitative study consisting of individual, in-depth, semi-structured interviews. Interviews were analysed according to the Qualitative Analysis Guide of Leuven.

Results:

A total of 16 patients and 13 rheumatologists were interviewed. Benefits (e.g. decreased risk of overtreatment, cost savings and long-lasting effectiveness of rituximab) and barriers (e.g. fluctuating disease activity, slow mode of action and increased glucocorticoid use) of on-flare retreatment were identified. To effectively treat on-flare, flares must first be identified timely. Both stakeholder groups acknowledged that patients are capable of recognizing flares. However, the patient’s ability to discriminate between inflammatory and other types of pain was perceived as difficult. Furthermore, patients and rheumatologists stressed that patients must timely seek professional help in case of a flare, followed by a swift response from the rheumatologists. Remarkably, retreatment was approached in various ways among rheumatologists, and not always adhering strictly to the on-flare reimbursement criteria.

Conclusion:

This study revealed that both stakeholder groups perceived the heterogeneity in recognition of and reaction to a flare as important in influencing the effectiveness of the on-flare retreatment strategy. Moreover, this study identified the benefits and barriers of treating on-flare, which could be informative for daily practice decisions.
Mechanism of Action of Yikun Yitong Ping-Containing Serum on Mast Cells and its Possible Involvement in Endometriosis-Related Dysmenorrhea
Authors: Yang Fang , Yu Yonghui , Liu Hong
Published: February 2024

Background

Previously, we showed that Yikun Yitong Ping (YKYTP) can effectively and safely relieve endometriosis-related dysmenorrhea; however, the underlying mechanism remained unclear. This study aimed to assess the effects of YKYTP-containing serum on rat basophilic leukemia cell line, as mast cells (MCs) analog, and investigate the mechanisms by which YKYTP alleviates endometriosis-related dysmenorrhea.

Method

In this study, YKYTP drug-containing serum was used to treat rat basophilic leukemia cell line (RBL2H3). The effect of YKYTP-containing serum on the expression of ER-α, ER-β, NGF, and NGFRp75 in RBL2H3 cells was evaluated using enzyme-linked immunosorbent assay, quantitative real-time polymerase reaction, and Western blotting.

Results

Different concentrations (5%-40%) of YKYTP-containing serum reduced ER expression in RBL2H3 cells, and the optimum concentration was 40%. Compared to the blank group, the expression of ER and NGF significantly increased in the E2 group ( P < .01). After co-administration with YKYTP-containing serum, the expression of ER-α, ER-β, NGF, and P75 significantly decreased ( P < .01).

Conclusion

YKYTP-containing serum can efficiently inhibit the expression of ER-α, ER-β, NGF, and P75 in RBL2H3 cells. YKYTP may alleviate endometriosis-related dysmenorrhea by downregulating ER expression in MCs.
Pancreatitis associated with Mycoplasma felis infection in a cat
Authors: Eiermann Jennifer S , Peters Laureen M , Bagatella Stefano , Milenkovic Jana , Jähne Stéphanie OA , Burg-Personnaz Juliette B , Schuller Simone , Valencia Alejandra Carranza
Published: February 2024

Case summary

A 7-year-old domestic shorthair cat was presented for periuria, apathy, fever, inappetence, diarrhoea and vomiting. A complete blood count and biochemistry analysis revealed severe thrombocytopenia, severe azotaemia, moderate panhypoproteinemia, mildly elevated DGGR lipase activity and mildly elevated liver enzyme activity. Abdominal ultrasound showed a hypoechoic pancreas with surrounding hyperechoic fat demonstrating dirty shadowing and ascites (protein-poor transudate). The cat was treated medically for pancreatitis with fluid therapy, antiemetics and pain medication. During the hospitalisation period, the cat developed severe anaemia and received multiple whole blood transfusions yet showed no signs of clinical improvement. A repeat ultrasound examination performed after 8 days showed progressive pancreatic lesions and ongoing ascites. Analysis of the free abdominal fluid revealed neutrophilic inflammation despite low protein and cell concentration, with the presence of numerous very small, coccoid, basophilic inclusions within neutrophils, raising the concern for a septic peritonitis due to Mycoplasma species. Quantitative PCR (qPCR) confirmed the presence of Mycoplasma felis. After 10 days of hospitalisation, the cat developed refractory septic shock and was euthanased. Necropsy revealed severe necrotising pancreatitis with systemic changes consistent with sepsis and microthrombi. qPCR testing for M felis in pancreatic tissue also yielded a positive result.

Relevance and novel information

Although pancreatitis is a common disease in cats, this case report presents the first documented occurrence of M felis as the suspected primary pathogen causing pancreatitis in a cat.
Perceptions Matter: Do Divergent Views of Management and Colleagues on Social Climate Drive Employee Engagement Through Organizational Identification and Growth Satisfaction?
Authors: Binyamin Galy
Published: February 2024

A growing body of research has explored the conditions that motivate employees to engage at work. While employees’ attitudes and behaviors are socially influenced by their significant others’ perceptions, the divergent perceptions of organizational climate are underexplored. This study examines the socio-psychological mechanisms by which employees’ and managers’ perceptions of social climate enhance employee engagement at work. Based on the postulate that “ psychological state engagement” are the primary catalyst for “ behavioral engagement,” this study presents a serial mediation model that examines the role of divergent perceptions of social climate (as characterized by cooperation, shared codes and language, benevolence, and integrity) in fostering individual engagement through the mechanisms of organizational identification and growth satisfaction. Data were collected from both managers and employees, using a time-lagged design at two-time points. The findings revealed that managers’ collective perceptions of social climate were associated with organizational identification and growth satisfaction, which in turn fostered employee engagement at work. Contrary to expectations, there was no statistically significant relationship between employees’ collective perceptions of social climate and their engagement. However, individuals who had more favorable perceptions of the social climate (compare to colleagues’ collective perception) reported higher levels of organizational identification. These results point to ways in which social climate can impact employee engagement, and underscore the importance of taking divergent perceptions of organizations into account. They advance theories on the inherent tension between individuals’ desire for inclusion and the need to maintain a sense of individuality and distinctiveness.
Hip Arthroscopy in Recreational Athletes: Risk Factors For Failure to Return to Sport and Factors That Influence Psychological Readiness to Return to Sport
Authors: Kingston Kiera , Day Molly , Olsen Reena , Wimberly Audrey , Ranawat Anil , Kelly Bryan , Nawabi Danyal , Hippensteel KJ
Published: February 2024

Objective:

High level athletes achieve high rates of return to play and improved patient reported outcomes (PROMs) after hip arthroscopy for femoroacetabular impingement (FAI). However, few studies have evaluated return to sport rates in recreational athletes, risk factors for failure to return to sport, and the effect of psychological readiness to return to sport (RTS) within this population. We hypothesize that recreational athletes undergoing hip arthroscopy for FAI achieve high PROMs and rates of RTS and that psychological readiness is a risk factor for failure to RTS. Additionally, we hypothesize that male athletes and younger age are positively associated with psychological readiness to RTS.

Methods:

Retrospective review of prospectively collected data in our institution's Center for Hip Pain and Preservation Outcomes Registry identified recreational athletes with a minimum of 12 months follow-up, who underwent hip arthroscopy for FAI between 2008-2018. The primary outcome was RTS. The secondary outcomes were ---Hip-RSI (SF) score, modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living (HOS-ADL), Hip Outcome Score Sport (HOS-Sport), and International Hip Outcome Tool (iHOT33).

Results:

84.8% of recreational athletes returned to sport with 70.52% returning to the same level of play. Athletes who failed to RTS were younger (p-value=0.0427), last participated 9-12 months prior to surgery (32.26%) or had stopped participating in sports altogether (70.97%) (p-value=0.0002 and p-value=0.0013). Hip-RSI Score was a statistically significant predictor of failure to RTS at one and two years respectively (OR 0.915 (95%CI 0.87, 0.962) and OR 0.904 (95%CI 0.818, 0.999)). Increasing age had a positive effect on psychological readiness to RTS (0.5004-point increase in RSI score (p-value=0.0002)) while sex, BMI, additional ipsilateral surgery, and last participation in sport were not predictive of psychological readiness (p-values>0.05).

Conclusions:

Recreational athletes undergoing hip arthroscopy achieve high rates of RTS, return to the same level of play, and demonstrate significant improvements in PROMs. The Hip-RSI-score was a statistically significant predictor of failure to RTS at 1 and 2 years post operatively. Lastly, higher psychological readiness for return to sport was seen in older recreational athletes undergoing hip arthroscopy for FAI.