bluuebunny/crossref_metadata_2025 huggingface dataset:
Birthweight, gestational age, and early school trajectory
Authors: Gansaonré Rabi Joël , Moore Lynne , Kobiané Jean-François , Sié Ali , Haddad Slim
Published: May 2023

Background

Birthweight and gestational age are important factors of not only newborn health by also child development and can contribute to delayed cognitive abilities. However, no study has analyzed the association of birthweight and gestational age with school trajectory measured simultaneously by school entry, grade repetition, and school dropout. This study aims, first, to analyze the association of birthweight or gestational age with school entry, and second, to explore the relationship between birthweight or gestational age and grade repetition and school dropout among children in Ouagadougou, Burkina Faso.

Methods

This study used longitudinal data from the Ouagadougou Health and Demographic Surveillance System. Our samples consisted of children born between 2008 and 2014 who were at least three years old at the beginning of the 2017–18 school year. Samples included 13,676, 3152, and 3498 children for the analysis of the school entry, grade repetition, and dropout, respectively. A discrete-time survival model was used to examine the relationship between birthweight or gestational age and school entry, grade repetition, and dropout. The association between birthweight or gestational age and age at school entry were assessed using a Poisson regression.

Results

The incidence rate of school entry was 18.1 per 100 people-years. The incidence of first repetition and dropout were 12.6 and 5.9, respectively. The probability of school entry decreased by 31% (HR:0.69, 95%CI: 0.56–0.85) and 8% (HR:0.92, 95%CI: 0.85–0.99) for children weighing less than 2000 g and those weighing between 2000 and 2499 g, respectively, compared to those born with a normal weight (weight ≥ 2500 g). The age at school entry of children with a birthweight less than 2000 g and between 2000 and 2499 g was 7% (IRR: 1.07, 95%CI: 1.06–1.08) and 3% (IRR: 1.03, 95%CI: 1.00-1.06) higher than children born at a normal birthweight, respectively. Gestational age was not associated with school entry or age at school entry. Similarly, birthweight and gestational age were not associated with grade repetition or dropout.

Conclusion

This study shows that low birthweight is negatively associated with school entry and age at school entry in Ouagadougou. Efforts to avoid low birthweights should be part of maternal and prenatal health care because the associated difficulties may be difficult to overcome later in the child’s life. Further longitudinal studies are needed to better understand the relationship between development at birth and school trajectory.
Relationship among symptoms, quality of life, and complementary and alternative medicines use among patients undergoing hemodialysis in French-speaking Switzerland
Authors: Kemnitz Marie , Antonini Matteo , Delmas Philippe
Published: May 2023

Background

Chronic renal disease is considered a main public health problem due to its high prevalence in the population. The solution of choice currently available is kidney transplantation but when this option is not available, blood purification treatments, notably haemodialysis (HD), are necessary. The presence of chronic renal disease combined with this demanding medical procedure leads to a hard symptomatology. To face this situation, HD patients often resort to complementary and alternative medicines (CAM) as they perceive that the healthcare professionals aren’t paying enough attention to their quality of life.

Given this background, we aim to describe the prevalence and the type of the CAM used among HD patients and their possible relations with patients’ symptomatology and quality of life.

Methods

We interviewed 88 patients, undergoing hemodialysis in three hemodialysis centers in French-speaking Switzerland, about the presence of symptoms, their quality of life, and the possible use of CAM. Cluster analysis was used to create patients’ profiles about CAM use and regression analysis to explore the links between symptoms’ presence, patients’ quality of life, and CAM use.

Results

Our results show a large use of CAM: almost two HD patients out of three uses at least one CAM. Using cluster analysis, we were able to identify five patients’ profiles: non-users (37.5% of our sample), users of herbal medicine (20.5%), users of prayer-based practices (18.2%), people mainly using massages (9.1%), and a residual group including the users of other CAMs, with a predominance of meditation (14.8%). As expected, we observe a negative relation between the number of declared symptoms and patients' quality of life. Contrarily, we observe no relation between the use of CAM and the presence of symptoms. Our results show a positive relationship between the use of CAM and patients’ overall perception of health as well as the psychological dimension of their quality of life. No relationship is observed with other dimensions of quality of life, notably the physical dimension.

Conclusions

Our results suggests that CAMs aren’t used as a substitute of official medicine but as a parallel support to HD patients’ quality of life.
Social prescribing practices and learning across the North West Coast region: essential elements and key challenges to implementing effective and sustainable social prescribing services
Authors: Hassan Shaima M. , Ring Adele , Goodall Mark , Abba Katharine , Gabbay Mark , van Ginneken Nadja
Published: May 2023

Introduction

Social prescribing has become an important feature of the UK primary care offer. However, there remains limited evidence on how best to implement and deliver social prescribing programmes to maximise effectiveness and long-term sustainability.

Aim

To explore social prescribing practices and experience of implementing social prescribing programmes across National Institute for Health and Social Care Research (NIHR) Collaborative Leadership for Applied Health and Care Research (CLAHRC) North West Coast (NWC) and NIHR Applied Research Collaboration (ARC) NWC region to identify key learning points that can be applied to other settings.

Method

We held a learning exchange workshop attended by practitioners and Public Advisors who had been involved in implementing and evaluating eight different social prescribing programmes with the support of NIHR CLAHRC NWC. We followed this with an online survey of social prescribing practice and priorities within the NIHR ARC NWC area. We used the findings from the workshop and survey to develop an initial model of the elements needed to successfully implement and sustain a working social prescribing programme.

Findings

We identified three core essential elements for a successful social prescribing programme: a personalised approach; meaningful service-user and community involvement; and whole systems working. These core elements need to be supported with adequate resources in the form of continuity of funding and adequate community resources to refer people to, capacity building and appropriate evaluation.

Conclusion

We were able to use a learning exchange workshop to both facilitate learning between practitioners and begin the process of identifying the ingredients needed for a successful social prescribing programme, which may be built on with further research.
An ICD-Associated DAMP Gene signature predicts survival and immunotherapy response of patients with lung adenocarcinoma
Authors: Wu Yuxin , Li Kexin , Liang Shuang , Lou Xiaoying , Li Yiling , Xu Danfei , Wu Yue , Wang Yuan , Cui Wei
Published: May 2023

Background

While some lung adenocarcinoma (LUAD) patients benefit long-term from treatment with immune checkpoint inhibitors, the sad reality is that a considerable proportion of patients do not. The classification of the LUAD tumor microenvironment (TME) can be used to conceptually comprehend primary resistance mechanisms. In addition, the most recent research demonstrates that the release of damage-associated molecular pattern (DAMP) in TME by immunogenic cell death (ICD) may contribute to the adaptive immune response. Currently, however, there is no such comprehensive research on this topic in LUAD patients. Therefore, we set out to investigate how to reverse the poor infiltration characteristics of immune cells and boost antitumor immunity by identifying DAMP model.

Methods

In this study, ICD-related DAMP genes were selected to investigate their effects on the prognosis of LUAD. To create a risk signature using the TCGA-LUAD cohort, the univariate COX regression and the least absolute shrinkage and selection operator regression were carried out, and the results were verified in a GEO dataset. Subsequently, the multivariate COX regression was applied to establish a prognostic nomogram. And the ESTIMATE and ssGSEA algorithms were utilized to analyze immune activity and the TIDE algorithm was for responsiveness to immunotherapy. Moreover, clinical tissue samples were used to verify the differential expression of 9 DAMP genes in the signature.

Results

We identified two distinct DAMP molecular subtypes, and there are remarkable differences in survival probability between the two subtypes, and patients with higher levels of DAMP-related genes are “hot tumors” with increased immune activity. In addition, 9 DAMP genes were selected as prognostic signature genes, and clinical outcomes and immunotherapy response were better for participants in the low-risk group. Importantly, according to the area under the curve (AUC) value in evaluating the efficacy of immunotherapy, this signature is superior to existing predictors, such as PD-L1 and TIDE.

Conclusions

Our study suggests ICD plays an important part in modeling the TME of LUAD patients. And this signature could be utilized as a reliable predictor to estimate clinical outcomes and predict immunotherapy efficacy among LUAD patients.
A cost-effectiveness analysis of ruxolitinib versus best alternative therapy for patients with steroid-refractory chronic graft-versus-host disease aged > 12 years in Singapore
Authors: Ong Jian Chun Matthew , Than Hein , Tripathi Sandeep , Gkitzia Christina , Wang Xiaojun
Published: May 2023

Background

Approximately 30–70% of patients who have undergone allogeneic (allo) hematopoietic stem cell transplantation (HSCT) eventually experience chronic graft-versus-host disease (cGVHD). Patients who develop steroid-refractory (SR)-cGVHD are the most severely impacted due to significant disease and financial burden. There remains an unmet need for safe, efficacious, and accessible treatments for these patients. The objective of this study was to determine the cost effectiveness of ruxolitinib for treatment of SR-cGvHD from the Singapore healthcare system perspective.

Methods

Based on data from the REACH3 randomized open-label trial, a semi-Markov model was developed to evaluate cost-effectiveness of ruxolitinib compared with investigators' choice of best alternative therapy (BAT) for treatment of patients > 12 years of age with SR-cGVHD in Singapore over a 40-year time horizon. The model only considered direct medical-care costs related to the treatment of SR-cGVHD and reported them in Singapore Dollars (SGD). Half-cycle correction was applied to all costs and outcomes, which were discounted at 3%. Probabilistic sensitivity analysis (PSA), one-way sensitivity analysis (OWSA), and scenario analysis were conducted to explore the drivers of uncertainty in the model.

Results

In the deterministic base case, more life years (LY; 10.28 vs. 9.42) and quality-adjusted life years (QALYs; 7.31 vs. 6.51) were gained with ruxolitinib than BAT at higher costs (SGD 303,214 vs. SGD 302,673) leading to an incremental cost-effectiveness ratio (ICER) of SGD 677/QALY. At a willingness-to-pay threshold of SGD 75,000/QALY gained, PSA found that ruxolitinib had a 78.52% probability of being cost-effective. Findings were sensitive to variations in non-responder utilities in the BAT arm and duration of BAT treatment in the OWSA, or comparison to either methotrexate (MTX) or mycophenolic acid as a single comparator in the scenario analysis. ICERs remained lower than SGD 75,000/QALY in all other tested variations and scenarios.

Conclusion

Ruxolitinib is likely to be cost-effective from Singapore healthcare system’s perspective for patients with SR-cGVHD, which is promising in the management of patients with unmet clinical needs.
Spatial analysis of stromal signatures identifies invasive front carcinoma-associated fibroblasts as suppressors of anti-tumor immune response in esophageal cancer
Authors: He Jian-Zhong , Chen Yang , Zeng Fa-Min , Huang Qing-Feng , Zhang Hai-Feng , Wang Shao-Hong , Yu Shuai-Xia , Pang Xiao-Xiao , Liu Ye , Xu Xiu-E , Wu Jian-Yi , Shen Wen-Jun , Li Zhan-Yu , Li En-Min , Xu Li-Yan
Published: May 2023

Background

Increasing evidence indicates that the tumor microenvironment (TME) is a crucial determinant of cancer progression. However, the clinical and pathobiological significance of stromal signatures in the TME, as a complex dynamic entity, is still unclear in esophageal squamous cell carcinoma (ESCC).

Methods

Herein, we used single-cell transcriptome sequencing data, imaging mass cytometry (IMC) and multiplex immunofluorescence staining to characterize the stromal signatures in ESCC and evaluate their prognostic values in this aggressive disease. An automated quantitative pathology imaging system determined the locations of the lamina propria, stroma, and invasive front. Subsequently, IMC spatial analyses further uncovered spatial interaction and distribution. Additionally, bioinformatics analysis was performed to explore the TME remodeling mechanism in ESCC. To define a new molecular prognostic model, we calculated the risk score of each patient based on their TME signatures and pTNM stages.

Results

We demonstrate that the presence of fibroblasts at the tumor invasive front was associated with the invasive depth and poor prognosis. Furthermore, the amount of α-smooth muscle actin (α-SMA)+ fibroblasts at the tumor invasive front positively correlated with the number of macrophages (MØs), but negatively correlated with that of tumor-infiltrating granzyme B+ immune cells, and CD4+ and CD8+ T cells. Spatial analyses uncovered a significant spatial interaction between α-SMA+ fibroblasts and CD163+ MØs in the TME, which resulted in spatially exclusive interactions to anti-tumor immune cells. We further validated the laminin and collagen signaling network contributions to TME remodeling. Moreover, compared with pTNM staging, a molecular prognostic model, based on expression of α-SMA+ fibroblasts at the invasive front, and CD163+ MØs, showed higher accuracy in predicting survival or recurrence in ESCC patients. Regression analysis confirmed this model is an independent predictor for survival, which also identifies a high-risk group of ESCC patients that can benefit from adjuvant therapy.

Conclusions

Our newly defined biomarker signature may serve as a complement for current clinical risk stratification approaches and provide potential therapeutic targets for reversing the fibroblast-mediated immunosuppressive microenvironment.
Efficacy of CytoSorb®: a systematic review and meta-analysis
Authors: Becker Sören , Lang Hannah , Vollmer Barbosa Clara , Tian Zhejia , Melk Anette , Schmidt Bernhard M. W.
Published: May 2023

Introduction

Cytokine adsorption using the CytoSorb® adsorber has been proposed in various clinical settings including sepsis, ARDS, hyperinflammatory syndromes, cardiac surgery or recovery after cardiac arrest. The aim of this analysis is to provide evidence for the efficacy of the CytoSorb® adsorber with regard to mortality in various settings.

Methods

We searched PubMed, Cochrane Library database and the database provided by Cytosorbents™ (01.1.2010–29.5.2022). We considered randomized controlled trials and observational studies with control groups. The longest reported mortality was defined as the primary endpoint. We computed risk ratios and 95%-confidence intervals and used DerSimonian and Lairds random effects model. We analysed all studies combined and divided them into the subgroups: sepsis, cardiopulmonary bypass surgery (CPB), other severe illness, SARS-CoV-2 infection and recovery from cardiac arrest. The meta-analysis was registered in advance (PROSPERO: CRD42022290334).

Results

Of an initial 1295 publications, 34 studies were found eligible, including 1297 patients treated with CytoSorb® and 1314 controls. Cytosorb® intervention did not lower mortality (RR [95%-CI]: all studies 1.07 [0.88; 1.31], sepsis 0.98 [0.74; 1.31], CPB surgery 0.91 [0.64; 1.29], severe illness 0.95 [0.59; 1.55], SARS-CoV-2 1.58 [0.50; 4.94]). In patients with cardiac arrest, we found a significant survival advantage of the untreated controls (1.22 [1.02; 1.46]). We did not find significant differences in ICU length of stay, lactate levels, or IL-6 levels after treatment. Of the eligible 34 studies only 12 were randomized controlled trials. All observational studies showed moderate to serious risk of bias.

Interpretation

To date, there is no evidence for a positive effect of the CytoSorb® adsorber on mortality across a variety of diagnoses that justifies its widespread use in intensive care medicine.
A peripheral signature of Alzheimer’s disease featuring microbiota-gut-brain axis markers
Authors: Marizzoni Moira , Mirabelli Peppino , Mombelli Elisa , Coppola Luigi , Festari Cristina , Lopizzo Nicola , Luongo Delia , Mazzelli Monica , Naviglio Daniele , Blouin Jean-Louis , Abramowicz Marc , Salvatore Marco , Pievani Michela , Cattaneo Annamaria , Frisoni Giovanni B.
Published: May 2023

Background

Increasing evidence links the gut microbiota (GM) to Alzheimer’s disease (AD) but the mechanisms through which gut bacteria influence the brain are still unclear. This study tests the hypothesis that GM and mediators of the microbiota-gut-brain axis (MGBA) are associated with the amyloid cascade in sporadic AD.

Methods

We included 34 patients with cognitive impairment due to AD (CI-AD), 37 patients with cognitive impairment not due to AD (CI-NAD), and 13 cognitively unimpaired persons (CU). We studied the following systems: (1) fecal GM, with 16S rRNA sequencing; (2) a panel of putative MGBA mediators in the blood including immune and endothelial markers as bacterial products (i.e., lipopolysaccharide, LPS), cell adhesion molecules (CAMs) indicative of endothelial dysfunction (VCAM-1, PECAM-1), vascular changes (P-, E-Selectin), and upregulated after infections (NCAM, ICAM-1), as well as pro- (IL1β, IL6, TNFα, IL18) and anti- (IL10) inflammatory cytokines; (3) the amyloid cascade with amyloid PET, plasma phosphorylated tau (pTau-181, for tau pathology), neurofilament light chain (NfL, for neurodegeneration), and global cognition measured using MMSE and ADAScog. We performed 3-group comparisons of markers in the 3 systems and calculated correlation matrices for the pooled group of CI-AD and CU as well as CI-NAD and CU. Patterns of associations based on Spearman’s rho were used to validate the study hypothesis.

Results

CI-AD were characterized by (1) higher abundance of Clostridia_UCG-014 and decreased abundance of Moryella and Blautia (p < .04); (2) elevated levels of LPS (p < .03), upregulation of CAMs, Il1β, IL6, and TNFα, and downregulation of IL10 (p < .05); (3) increased brain amyloid, plasma pTau-181, and NfL (p < 0.004) compared with the other groups. CI-NAD showed (1) higher abundance of [Eubacterium] coprostanoligenes group and Collinsella and decreased abundance of Lachnospiraceae_ND3007_group, [Ruminococcus]_gnavus_group and Oscillibacter (p < .03); (2) upregulation of PECAM-1 and TNFα (p < .03); (4) increased plasma levels of NfL (p < .02) compared with CU. Different GM genera were associated with immune and endothelial markers in both CI-NAD and CI-AD but these mediators were widely related to amyloid cascade markers only in CI-AD.

Conclusions

Specific bacterial genera are associated with immune and endothelial MGBA mediators, and these are associated with amyloid cascade markers in sporadic AD. The physiological mechanisms linking the GM to the amyloid cascade should be further investigated to elucidate their potential therapeutic implications.
Infinitely many homoclinic solutions for fractional discrete Kirchhoff–Schrödinger equations
Authors: Ju Chunming , Molica Bisci Giovanni , Zhang Binlin
Published: May 2023

In the present paper, we consider a fractional discrete Schrödinger equation with Kirchhoff term. Through the fountain theorem and the dual fountain theorem, we obtain two different conclusions about infinitely many homoclinic solutions to this equation.
Many Pieces to the Puzzle: A New Holistic Workload Approach to Designing Practice in Sports
Authors: Champion Luke , Middleton Kane , MacMahon Clare
Published: May 2023

Representative learning design (RLD) in sport is a well-established concept in both theory and practice. The goal of RLD is to faithfully replicate competition environments in training settings to benefit improvement in athletic performance. There is currently little research that considers how representative an activity needs to be to facilitate learning transfer, and how that level of representativeness might fluctuate between activities or sessions, and across competitive cycles. Similarly, there is no existing research that specifically considers the elevated workload (in cognitive and physical load) of highly representative training, and the potential impacts of chronic overuse of these highly demanding activities. This paper addresses these limitations, making a case for the application of RLD that considers the level of representativeness (fidelity) and the demands placed on athletes (load) from both a cognitive and physical perspective. This paper also suggests several categorisations of training activities that are based on their relative representativeness, level of imposed demands, and the intended outcomes of the activity with reference to the perception–action cycle. The two core concepts of fidelity and load are combined for a new approach to representative training that allows practitioners to balance the benefits of representative training with the risks of imposing excessive load on athletes.
A proposal to embed patient and public involvement within qualitative data collection and analysis phases of a primary care based implementation study
Authors: Moult Alice , McGrath Carmel , Lippiett Kate , Coope Caroline , Chilcott Simon , Mann Cindy , Evans Nicola , Turner Andrew , Dziedzic Krysia , Portillo M. C. , Johnson Rachel
Published: May 2023

Background

Patient and public involvement (PPI) is increasingly seen as essential to health service research. There are strong moral and ethical arguments for good quality PPI. Despite the development of guidance aimed at addressing the inconsistent reporting of PPI activities within research, little progress has been made in documenting the steps taken to undertake PPI and how it influences the direction of a study. Without this information, there are minimal opportunities to share learnings across projects and strengthen future PPI practices. The aim of this paper is to present details on the processes and activities planned to integrate PPI into the qualitative research component of a mixed-methods, multi-site study evaluating the implementation of a smart template to promote personalised primary care for patients with multiple long-term conditions.

Methods

This proposal describes the processes and activities planned to integrate PPI into the development and piloting of qualitative data collection tools (topic guides for both practice staff and patients) and a tailored data analysis package developed for PPI members incorporating broad concepts and specific methods of qualitative data analysis.

Discussion

Outputs relating to PPI activity may include clear, concise and suitably worded topic guides for qualitative interviews. Piloting of the topic guides via mock interviews will further develop researchers’ skills including sensitisation to the experiences of participants being interviewed. Working with PPI members when analysing the qualitative data aims to provide reciprocal learning opportunities and may contribute to improving the overall rigour of the data analysis. The intent of publishing proposed PPI activities within this project is to inform the future delivery of high quality PPI.
Maternal transmission gives way to social transmission during gut microbiota assembly in wild mice
Authors: Wanelik Klara M. , Raulo Aura , Troitsky Tanya , Husby Arild , Knowles Sarah C. L.
Published: May 2023

Background

The mammalian gut microbiota influences a wide array of phenotypes which are relevant to fitness, yet knowledge about the transmission routes by which gut microbes colonise hosts in natural populations remains limited. Here, we use an intensively studied wild population of wood mice (Apodemus sylvaticus) to examine how vertical (maternal) and horizontal (social) transmission routes influence gut microbiota composition throughout life.

Results

We identify independent signals of maternal transmission (sharing of taxa between a mother and her offspring) and social transmission (sharing of taxa predicted by the social network), whose relative magnitudes shift as hosts age. In early life, gut microbiota composition is predicted by both maternal and social relationships, but by adulthood the impact of maternal transmission becomes undetectable, leaving only a signal of social transmission. By exploring which taxa drive the maternal transmission signal, we identify a candidate maternally-transmitted bacterial family in wood mice, the Muribaculaceae.

Conclusion

Overall, our findings point to an ontogenetically shifting transmission landscape in wild mice, with a mother’s influence on microbiota composition waning as offspring age, while the relative impact of social contacts grows.
Dynamic responses of a train-track-bridge coupled system under earthquakes
Authors: Zhang Xuebing , Wu Han , Zhao Han , Xiang Ping
Published: May 2023

The probability of a train running over a bridge when an earthquake occurs is increasing with the total mileage of China’s high-speed railway network expanding. To study this issue, a three-dimensional train-track-bridge dynamic interaction system subjected to seismic excitations is established based on commercial mathematical software. Besides, a set of motion equations of the system are derived according to the multibody dynamics, the finite element method theory and the bridge seismic theory. Moreover, in order to study the dynamic response of high-speed railway bridges under earthquake, a series of experiments are conducted on a scaled high-speed railway simple supported bridge model with a ballastless track slab excited by shaking table tests. Meanwhile, the strain of rails, track slabs, base plates and girder in various working conditions are measured by quasi-distributed optical fiber sensing stuck in bridge members. At last, the dynamic response of each structure member is demonstrated in the time and frequency domains. Furthermore, the seismic isolation performance of bridge members, such as fasteners, cement asphalt (CA) mortar layer and so on, is explained in details.
Communication Barriers in Oncology Care for Elderly Deaf Patients: A Daughter's Narrative and Call for Tailored Medical Services
Authors: Tannenbaum-Baruchi Carolina
Published: May 2023

My father is deaf. A year ago, he was diagnosed with Hodgkin lymphoma. Most patients with hearing disabilities suffer from a lack of access to health care in a form that ensures they receive a rapid diagnosis, correct and effective treatment, and medical treatment options they understand. The minimal evidence that exists is associated with the timeliness of a cancer diagnosis, therapy, and consequences for these patients. We must give them the appropriate treatment for their disease and include them in clinical trials if they will benefit from them and provide health care workers training and tools on how to communicate better with these patients.
Operative Management of Thyroid Disease in Older Adults
Authors: Kim Jina , Seib Carolyn D
Published: May 2023

As the population ages, both domestically and globally, clinicians will increasingly find themselves navigating treatment decisions for thyroid disease in older adults. When considering surgical treatment, individualizing risk assessment is particularly important, as older patients can present with very different health profiles. While fit, independent individuals may benefit from thyroidectomy with minimal risk, those with multiple comorbidities and poor functional status are at higher risk of perioperative complications, which can have adverse health effects and detract from long-term quality of life. In order to optimize surgical outcomes for older adults, strategies for accurate risk assessment and mitigation are being explored. Surgical decision-making also should consider the characteristics of the thyroid disease being treated, given many benign thyroid disorders and some well-differentiated thyroid cancers can be appropriately managed nonoperatively without compromising longevity. Shared decision-making becomes increasingly important to respect the health priorities and optimize outcomes for older adults with thyroid disease. This review summarizes the current knowledge of thyroid surgery in older adults to help inform decision-making among patients and their physicians.
Antiracist Protest Pedagogy
Authors: Lotier Kristopher M. , Perez Xiomara Trinidad , Pierre Aidan , Shah Prameet V.
Published: May 2023

This article describes an antiracist first-year writing curriculum, formulated in the wake of Black Lives Matter protests in 2020. Classroom participants examined the racialized and class-based nature of “Standard English,” then each student informed their instructor of how they wished to be graded. Student coauthors reflect on their educational experience.
The Twain Shall Meet
Authors: Ponce Timothy
Published: May 2023

On Wednesday, March 11, 2020, the author received an email that would change the course of his teaching for the following twenty-four months. The university-wide communication indicated that, due to the emerging COVID-19 crisis, all classes, activities, and university business was suspended, with the email further instructing faculty to wait at home for more details. As the author mulled over the educational shifts ahead of him, his training as a technical communicator—and more specifically his knowledge of user-experience (UX) and design thinking—kicked in, offering him a set of tools he could pull from as he sought to create courses that reflected the quickly shifting needs of his students. In this article, the author discusses how the use of design thinking expands the limited conversations about course co-creation, a practice that leads to more effective and equitable course designs. The author additionally uses his experience employing design thinking in the creation of his Shakespeare seminar course as a case study, demonstrating the value that the collaborative nature of design thinking has for pedagogy.
Corequisite English and Community College
Authors: Porter Elizabeth
Published: May 2023

This article proposes that the methods and philosophies informing corequisite teaching could be generalized throughout English studies to support students at all levels who are undergoing and recovering from pandemic-related traumas. Corequisite courses, which promote equity among first-year students, are designed with attention to trauma-informed approaches and a focus on process-driven writing. Instructors address noncognitive skills with students, such as time management and note-taking, and consider the cultural relevance of their reading and writing assignments. By describing specific activities and methods used at Hostos Community College, the article considers how strategies that are central to corequisite pedagogy might be widely adopted or adapted in this moment of reorientation for English studies. Additionally, the article suggests that mission-driven practices of community colleges serve as a model for higher education more broadly.
Intraoperative Biceps/Brachialis Stimulation for Snapping Triceps With Ulnar Neuritis
Authors: Maldonado Andres A. , Oishi Tatsuya , Lee Robert A. , Spinner Robert J.
Published: May 2023

BACKGROUND AND IMPORTANCE:

Snapping of the triceps muscle occurs when a portion of the medial head dislocates over the medial epicondyle with elbow flexion. Resection or redirection of a portion of the triceps muscle is the main surgical treatment. The extent of triceps resection/redirection is difficult to evaluate. A novel intraoperative technique, stimulating the musculocutaneous nerve, to simulate active elbow flexion is proposed to help ensure that the snapping triceps has been adequately treated.

CLINICAL PRESENTATION:

A patient presented with a several year history of bilateral elbow pain, snapping, and ulnar nerve (UN) paresthesias. Previous staged bilateral subcutaneous UN transpositions were performed at another institution for documented UN dislocation and neuritis. Postoperatively symptoms of painful snapping persisted. Bilateral snapping triceps was diagnosed. The left elbow was reoperated. Intraoperative electrical stimulation of the musculocutaneous nerve was performed to reproduce the snapping triceps. Activation of the biceps/brachialis muscles produced powerful elbow flexion, allowed direct visualization of the forceful snapping triceps, and helped assess the adequacy of muscle resection/redirection.

CONCLUSION:

Intraoperative biceps/brachialis stimulation can potentially help determine how much triceps muscle should be resected/redirected to treat patients with snapping triceps.
When Losses Turn into Loans: The Cost of Weak Banks
Authors: Blattner Laura , Farinha Luisa , Rebelo Francisca
Published: May 2023

We provide evidence that banks distort the composition of credit supply in order to comply with ratio-based capital requirements in times of economic distress. An unexpected intervention by the European Banking Authority provides a natural experiment to study how banks respond to falling below minimum required capital ratios during an economic downturn. We show that affected banks respond by cutting lending but also by reallocating credit to distressed firms with underreported loan losses. We develop a method to detect underreported losses using loan-level data. The credit reallocation leads to a reallocation of inputs across firms. We calculate that the resulting increase in input misallocation accounts for about 22 percent of the decline in productivity in Portugal in 2012. (JEL E23, E32, G21, G28, G32, G38)
Occupational Exposure to Capital-Embodied Technical Change
Authors: Caunedo Julieta , Jaume David , Keller Elisa
Published: May 2023

We study differences in exposure to factor-biased technical change among occupations by providing the first measures of capital-embodied technical change (CETC) and of the elasticity of substitution between capital and labor at the occupational level. We document sizable occupational heterogeneity in both measures, but quantitatively, it is the heterogeneity in factor substitutability that fuels workers’ exposure to CETC. In a general equilibrium model of worker sorting across occupations, CETC accounts for almost all of the observed labor reallocation in the US between 1984 and 2015. Absent occupational heterogeneity in factor substitutability, CETC accounts for only 17 percent of it (JEL I26, J16, J24, J31, O33)
Evaluation of quantitative-qualitative levels of blood pressure by Tensioregulom
Authors: Kozyavkina Nataliya , Popovych Igor , Vovchyna Yuliya , Voronych-Semchenko Nataliya , Zukow Walery , Popovych Dariya
Published: May 2023

Background. Earlier we showed that the qualitative-quantitative clusters of blood pressure (BP) are very clearly different from each other by age, sex and the constellation of neuro-endocrine, immune and metabolic variables, which we called the Tensioregulome by analogy with the metabolome and the microbiome. The purpose of this study is detailing this concept. Materials and methods. Under an observations were 44 patients with chronic pyelonephritis and cholecystitis in the phase of remission. Testing was performed twice - on admission and after 7-10 days of standard balneotherapy. The main object of the study was BP. We determined parameters of EEG and HRV, plasma levels of adaptation hormones, electrolytes, lipids, and nitrogenous metabolites, components of humoral, cellular, and phagocytic links of immunity and microbiota as well as markers of pyelonephritis. Results. The forward stepwise program identified 42 Tensioregulome parameters as characteristic of quantitative-qualitative blood pressure clusters: 25 EEGs, sympathetic tone, cortisol, calcitonin, Bifidobacteria faeces, 5 metabolic and 5 immune parameters as well as sex and age. The accuracy of patient classification is 97,7%. Another 15 parameters were found to be characteristic, but were outside the discriminant model. Non-linear correlations between the BP and Tensioregulome parameters were revealed. Conclusion. The Tensioregulome allows us to reliably evaluate quantitative-qualitative levels of blood pressure without measuring it with a tonometer.
Evaluation of the effectiveness and safety of anti-obesity drugs - an update on the current state of knowledge on available and investigational drugs
Authors: Cichoń Katarzyna , Chyćko Małgorzata , Czarnota Julia , Kromer Agata , Zapała Magdalena Alicja , Środoń Agnieszka , Wilk Joanna , Cholewa Małgorzata Maria , Gawryś Agnieszka , Łapaj Monika
Published: May 2023

Introduction and purpose of the work: Disturbing epidemiological data indicate that obesity has become a global problem and has reached the size of a worldwide epidemic. The search for effective methods of combating obesity seems to be an important step in preventing cardiovascular diseases and numerous metabolic complications. The aim of the study is to assess the effectiveness and safety of available drugs used in the treatment of obesity in accordance with the current state of knowledge and to present new pharmacological options.

State of knowledge: Pharmacotherapy provides overweight and obese adults with the opportunity to support weight reduction in the event of failure of lifestyle modifications. Currently registered drugs for the treatment of obesity are orlistat, lorcaserin, liraglutide and combination preparations: phentermine/topiramate and naltrexone SR/bupropion SR.  

Summary: Among the currently available drugs for obesity, the most effective are phentermine/topiramate and liraglutide. Research is also underway on the use of new substances that promote weight loss. The latest data on semaglutide and tirzepatide have better efficacy results compared to currently available drugs with a similar safety profile. The latest data on semaglutide and tirzepatide improve the efficacy results of current drugs while maintaining a similar safety profile. It seems that the best way to lose excessive body weight should be an individualized approach to the treatment of obesity among patients, taking into account i.a. degree of obesity, comorbidities, contraindications, patient preferences, cost and availability of treatment. In clinical practice, when choosing a drug, we should pay attention to side effects and find a balance between effectiveness and safety. In addition to weight loss, the use of anti-obesity drugs has many additional benefits, including improvement of the cardiometabolic profile, reduction of glucose, insulin and lipids in the blood.
El envejecimiento de la población. Oportunidades y retos
Authors: Latorre Santos Catalina
Published: May 2023

En los últimos años se ha hecho visible la transición demográfica y la epidemiológica. Es evidente que el envejecimiento de la población llegó para quedarse. El escenario nos enfrenta a un crecimiento de la población mayor de 60 años con una tendencia marcada a aumentar. Este incremento puede ser el desenlace de múltiples avances que durante los últimos años se han producido en el marco de las intervenciones sanitarias, las vacunas, el acceso a servicios de salud, la urbanización, entre otras, y por la disminución de los nacimientos.La pirámide poblacional mundial ha cambiado significativamente en los últimos 60 años, dada una reducción en el porcentaje de personas menores de 14 años y un aumento constante en el de personas mayores. En 1950, el porcentaje de personas mayores de 65 años en la población mundial era de aproximadamente el 5,1 %, mientras que para 2017 fue del 8,7 %, y se espera que para 2050 sea del 15,8 %. En general, las áreas metropolitanas y urbanas presentan un envejecimiento más acelerado.
La determinación social de la salud: la comprensión de la complejidad de la vida
Authors: Soliz Torres Fernanda
Published: May 2023

Quiero agradecer a la Revista Ciencias de la Salud de la Universidad del Rosario por permitirme leer los artículos de esta revista y presentarla. Hacer un monográfico sobre la determinación social de la salud es un aporte importante para ampliar las discusiones en salud colectiva, y es fundamental reconocer que en el sistema mundial actual se requiere de ejercicios sistemáticos que interpelen la hegemonía en salud que en los últimos 50 años ha profundizado las desigualdades en los modos de vida.
Rumination about the death of a spouse versus the severity of somatic
symptom disorder and sleep disturbances in widowed individuals in late
adulthood
Authors: Ludwikowska-Świeboda Karolina
Published: May 2023

Introduction: The aim of the study was to gain a better understanding of the role of emotion regulation (understood in terms of the intensity of intrusive and deliberate rumination about the death of a spouse) in the etiology of sleep disturbances and somatic symptom disorder in widowed people in late adulthood.
Material and methods: The study involved 82 older people (66 women and 16 men) whose spouses had died at least six months before the study. The following measures were used: the Event Related Rumination Inventory (ERRI) to assess the intensity of intrusive and deliberate rumination; the General Health Questionnaire (GHQ-28) (somatic symptoms scale) to assess the intensity of somatic symptom disorder; two items of the arousal subscale from the Event Impact Scale – Revised (IES-R) for evaluating the severity of sleep disorder symptoms; as well as a self-designed demographic data questionnaire.
Results: The study showed that the intensity of somatic symptom disorder and sleep disturbances can be explained by intrusive rumination. No relationship was found between deliberate rumination and the severity of these disorders. Additionally, there is a positive relationship between the severity of somatic symptom disorder and the age of the study participants.
Conclusions: The present findings can potentially be applied in therapeutic programs for widowed individuals who experience sleep disturbances and somatic symptom disorder as a result of unresolved grief.

Keywords: somatic symptom disorder, insomnia, grief, death of a spouse, rumination
Risk factors of Secondary Traumatic Stress in psychotherapists studied during the COVID-19
Authors: Kulik Agnieszka , Kajka Natalia , Banakiewicz Agata , Frańczyk Ewelina
Published: May 2023

Introduction: The aim of the study was: to assess the severity of Secondary Traumatic Stress (STS), to identify ST's predictors, and to assess the model of relationships between predictors of Secondary Traumatic Stress in psychotherapists working during the pandemic in Poland.
Materials and methods: The research group consisted of 153 psychotherapists (130 women, 85%) aged 25-66 (M = 39.39; SD = 9.65). The following tools were used to measure the variables: Coping Inventory for Stressful Situations (CISS), Perceived Stress Scale (PSS-10), Fatigue Severity Scale (FSS), FCV-19S Fear of COVID-19 Scale (FCV-19S), Secondary Traumatic Stress Scale (STSS), Personal Inquiry, Assessment of working conditions during a pandemic.
Discussion: It has been shown that 9.8% of psychotherapists working during the pandemic experienced high or very high-intensity of symptoms of Secondary Traumatic Stress. The predictors of STS turned out to be: task-induced stress during the pandemic, emotion-focused stress-coping style, and fear of COVID-19. The proposed model of moderated moderation, which assumes that COVID-19 anxiety that intensifies the emotional style of coping with stress in specialists, has an influence on the relationship between occupational tasks stress during a pandemic and the severity of symptoms of Secondary Traumatic Stress, has not been confirmed. Therefore, there is a need for further exploration of the issue.
Conclusions: Research shows an increase in STSD among Polish psychotherapists during covid as well as risk factors intensifying this diagnosis.

Keywords: secondary traumatic stress, psychotherapist, anxiety, coping, risk factors
Adolescent women's perspective of pregnancy in Iran: a qualitative study
Authors: Moridi Maryam , Shokravi Farkhondeh Amin , Pazandeh Farzaneh
Published: May 2023

Background/Aims

Adolescent pregnancy is a significant health problem that can lead to adverse effects for the health of both adolescent mothers and their babies. Little is known about adolescent pregnancy from the perspective of adolescents, especially in developing countries, including Iran. The present study's aim was to explore Iranian adolescent women's perspectives of pregnancy.

Methods

This study was a thematic analysis conducted from November 2018 to October 2019 in north Iran. Data were collected through 24 unstructured, face-to-face in depth interviews which were transcribed and analysed using coding, constant comparison and memo writing.

Results

The experiences were categorised into five themes: ‘skeptical confronting pregnancy’, ‘intelligent self-care’, ‘embracing the pregnancy’, ‘effective support from others’ and ‘mixed perceptions of pregnancy’.

Conclusions

This study could improve healthcare professionals' adaptation of care for pregnant adolescent women and inspire them to tailor their care specifically to adolescents' needs.
Local elections and local health systems
Authors: Holloway Victoria
Published: May 2023

Our Political Editor discusses why it is important to consider voting in your local elections in order to make larger changes and bring in the right initiatives.
The Welsh Surgical Society/Cymdeithas Lawfeddygol Cymru: Happy 70th Birthday
Authors: Gomez KF
Published: May 2023

We take a look at the last 70 years of the Welsh Surgical Society, and what its future looks like.
Guidelines: not applicable to all?
Authors: Wheeler Robert
Published: May 2023

Our Legal editor looks at what happens when guidelines do not cover all scenarios, and how to best review and apply guideline recommendations.
Computational visualization of semi-transparent metallic thin films with roughness
Authors: Loi Wei Sen , Chau Kenneth J.
Published: May 2023

We model the visual appearance of thin, semi-transparent metallic films coated on arbitrary three-dimensional substrates, incorporating effects including nanoscale film roughness, microscale substrate roughness, and source of light. Film reflectance is modeled by combining electrodynamic simulations with the Schlick approximation, which is adapted and validated to describe the color appearance of thin semi-transparent metallic films with nanoscale, subwavelength roughness. Diffuse scattering originating from microscale roughness of the substrate and partial reflectance is described by a microfacet model. Photorealistic rendered images generated by our approach are qualitatively compared to photographs of fabricated thin-film samples under similar lighting conditions. We render images of semi-transparent metallic films as a function of film thickness, multilayer composition, substrate type, nanoscale film roughness, microscale substrate roughness, and environmental lighting, yielding physically plausible results consistent with previously reported observations.