bluuebunny/crossref_metadata_2025 huggingface dataset:
Consensus Statement on the Management of Nonthrombotic Iliac Vein Lesions From the VIVA Foundation, the American Venous Forum, and the American Vein and Lymphatic Society
Authors: Desai Kush R. , Sabri Saher S. , Elias Steve , Gagne Paul J. , Garcia Mark J. , Gibson Kathleen , Kiguchi Misaki M. , Mathews Santhosh J. , Murphy Erin H. , Secemsky Eric A. , Ting Windsor , Kolluri Raghu
Published: July 2024

A nonthrombotic iliac vein lesion is defined as the extrinsic compression of the iliac vein. Symptoms of lower extremity chronic venous insufficiency or pelvic venous disease can develop secondary to nonthrombotic iliac vein lesion. Anatomic compression has been observed in both symptomatic and asymptomatic patients. Causative factors that lead to symptomatic manifestations remain unclear. To provide guidance for providers treating patients with nonthrombotic iliac vein lesion, the VIVA Foundation convened a multidisciplinary group of leaders in venous disease management with representatives from the American Venous Forum and the American Vein and Lymphatic Society. Consensus statements regarding nonthrombotic iliac vein lesions were drafted by the participants to address patient selection, imaging for diagnosis, technical considerations for stent placement, postprocedure management, and future research/educational needs.
Demystifying the Contemporary Role of 12-Month Dual Antiplatelet Therapy After Acute Coronary Syndrome
Authors: Valgimigli Marco , Landi Antonio , Angiolillo Dominick J. , Baber Usman , Bhatt Deepak L. , Bonaca Marc P. , Capodanno Davide , Cohen David J. , Gibson C. Michael , James Stefan , Kimura Takeshi , Lopes Renato D. , Mehta Shamir R. , Montalescot Gilles , Sibbing Dirk , Steg P. Gabriel , Stone Gregg W. , Storey Robert F. , Vranckx Pascal , Windecker Stephan , Mehran Roxana
Published: July 2024

For almost two decades, 12-month dual antiplatelet therapy (DAPT) in acute coronary syndrome (ACS) has been the only class I recommendation on DAPT in American and European guidelines, which has resulted in 12-month durations of DAPT therapy being the most frequently implemented in ACS patients undergoing percutaneous coronary intervention (PCI) across the globe. Twelve-month DAPT was initially grounded in the results of the CURE (Clopidogrel in Unstable Angina to Prevent Recurrent Events) trial, which, by design, studied DAPT versus no DAPT rather than the optimal DAPT duration. The average DAPT duration in this study was 9 months, not 12 months. Subsequent ACS studies, which were not designed to assess DAPT duration, rather its composition (aspirin with prasugrel or ticagrelor compared with clopidogrel) were further interpreted as supportive evidence for 12-month DAPT duration. In these studies, the median DAPT duration was 9 or 15 months for ticagrelor and prasugrel, respectively. Several subsequent studies questioned the 12-month regimen and suggested that DAPT duration should either be fewer than 12 months in patients at high bleeding risk or more than 12 months in patients at high ischemic risk who can safely tolerate the treatment. Bleeding, rather than ischemic risk assessment, has emerged as a treatment modifier for maximizing the net clinical benefit of DAPT, due to excessive bleeding and no clear benefit of prolonged treatment regimens in high bleeding risk patients. Multiple DAPT de-escalation treatment strategies, including switching from prasugrel or ticagrelor to clopidogrel, reducing the dose of prasugrel or ticagrelor, and shortening DAPT duration while maintaining monotherapy with ticagrelor, have been consistently shown to reduce bleeding without increasing fatal or nonfatal cardiovascular or cerebral ischemic risks compared with 12-month DAPT. However, 12-month DAPT remains the only class-I DAPT recommendation for patients with ACS despite the lack of prospectively established evidence, leading to unnecessary and potentially harmful overtreatment in many patients. It is time for clinical practice and guideline recommendations to be updated to reflect the totality of the evidence regarding the optimal DAPT duration in ACS.
Training and retraining civil servants in Vietnam
Authors: Trung Ngo Sy
Published: July 2024

Each nation employs a variety of specialized policy measures to grow and expand its contingent of civil servants through its political system and civil service features. Among them, training and retraining are deemed to be the most important measures. Although the approaches and contents used for training and retraining civil servants vary, they all strive to create a workforce of employees who are well-equipped to meet the demands of serving the government and the people. The author of this paper examines training and retraining and how they affect the competence of civil servants. Based on the theoretical framework developed, the author conducts a direct survey of 250 local civil servants at the commune level in five provinces, including Dien Bien Province, Lai Chau Province (Northern Region), Quang Ngai Province (Central region), and Tay Ninh Province, Binh Duong Province (Southern region). According to research findings, civil servants underappreciate the training, additional knowledge, and professional training that local authorities deliver. The author offers some recommendations from the study’s findings for local leaders to adjust training and retraining strategies appropriately to improve the quality of civil servants toward better serving the people, including: Developing and implementing a training and retraining program for government civil servants under the competency framework for each job title and position.
Maya Traditional Knowledge of Cnidoscolus spp. in the Yucatán Peninsula
Authors: Méndez-Aguilar María de Jesús , Montañez-Escalante Patricia Irene , Maya-Lastra Carlos Alonso
Published: July 2024

The genus Cnidoscolus (Euphorbiaceae) contains some species with socioeconomic and cultural relevance in the Yucatán Peninsula, Mexico. There is little published information on the traditional knowledge of this genus, and the recent movements of younger people to more populated cities and towns risks this knowledge being forgotten. To preserve this knowledge, we wanted to answer the questions: what are the species or varieties of the plant with the generic name chaya that the contemporary Maya population uses in the Yucatan Peninsula, and in which agroecosystems are these species or varieties found? Nine local communities were selected for interviews in which the general population and healers shared their knowledge about the uses and management of Cnidoscolus spp. Through these interviews, we identified eight species or cultivars used by these communities: six cultivars of C. aconitifolius ( chay, makat chay, chay sin espinas, ch’inch’in chay, tsaj, and tsaj/ hoja de papaya), C. multilobus ( tsaj), and C. souzae ( tsaj). Within homegardens chay, makat chay and chay sin espinas are utilized for their feeding, medicinal and fodder value; while ch'inch'in chay and tsaj are utilized for their feeding, medicinal, and living-fence potential. In paddocks, ch’inch’in chay and tsaj are utilized as livestock feed. Tsaj is used for handcrafts, and tsaj/ hoja de papaya possesses spiritual-religious attributes. The feeding, medicinal, fodder, living-fence, spiritual-religious, and handcraft potential of species and cultivars of Cnidoscolus reflect their biocultural importance for Maya inhabiting the peninsula of Yucatan.
Assessing the impact of information literacy on farmers’ decision-making processes: A mixed-methods approach
Authors: Wann Tiplut , Khongtim Jiarlimon , Chyne Rudolf Carey
Published: July 2024

This article investigates the link between information literacy and farmers’ decision-making processes, highlighting the potential for improving information literacy to promote sustainable agricultural practices. This study employed a mixed-methods approach – that is, qualitative and quantitative data collection techniques. It was found that gender did not significantly influence the reported skills and behaviours. However, the use of digital technologies showed a significant positive correlation with seeking information on new agricultural practices ( r = .254, p < .01). This shows that proficient users of digital tools are more likely to seek new agricultural information actively. This research emphasizes the importance of collaboration and knowledge-sharing among farmers and stakeholders to effectively use agricultural information in decision-making, with implications for academic research and practical agricultural interventions.
Influence of varying matrix/fiber concentration on mechanical properties of bi-directional carbon fiber reinforced polymer composite
Authors: Jagadeesh H , Banakar Prashanth , Sampathkumaran P , Sailaja RRN , Katiyar Jitendra Kumar
Published: July 2024

The polymer composites comprising bi-directional carbon fabric incorporated in the epoxy matrix have been developed for various advanced applications in the field of automobile and aerospace sectors. The distinct advantages of using epoxy material with hardener are good adhesion, high tensile, compression and bending strengths, good corrosion, and heat resistance properties. Using carbon fiber enhances the stiffness, reduces the weight, and improves the chemical resistance apart from possessing high thermal conductivity and low coefficient of thermal expansion. Considering all the above aspects, the present work proposes to investigate the mechanical properties of carbon-reinforced epoxy composites with fiber matrix ratios of 40:60, 50:50, and 60:40 by wt% as these particular combinations have been limitedly addressed so far. The well-known hand lay-up technique has produced the laminates and the test samples prepared from the laminate are subjected to tensile, flexural, hardness, and impact strength properties. Based on the experimental work of the composites made in the laboratory, the fiber matrix ratio of 60:40 has revealed the best attributes in terms of higher mechanical strengths compared to the composites with fiber matrix ratio of 40:60 and 50:50 and the data obtained have been substantiated using scanning electron microscope analysis.
Impact of safety regulation on rare event occurrence: The case of nuclear power plants in Korea
Authors: Choi Bongseok , Cho Hong Chong
Published: July 2024

Climate change mitigation and energy supply security are the most important issues worldwide. To attain carbon neutrality and restrict global warming to 1.5°C, expediting investments in energy sectors and facilitating the expansion of clean energy is imperative. Nuclear power generation, as a base load, contributes to the energy transition because it is low-carbon and can be deployed on a large scale; however, particular challenges arise due to the risk of accidents, radioactive waste management problems, and public acceptance. Considering the similarity between macroeconomic data and nuclear power generation data from a time-series perspective, this study estimates the frequency of rare event (RE) occurrence in nuclear reactors using macro time-series methodology. We employ the Bayesian Markov Chain Monte Carlo method, developed by Barro and Jin (2021), to estimate the likelihood of RE occurrences for the reactors using the panel data of electricity production (MWh) obtained from the International Atomic Energy Agency's Power Reactor Information System. The findings indicate that the frequency of RE occurrences significantly decreases as nuclear safety regulations strengthen and the regulatory workforce increases. Despite the limitations of being directly utilized as practical indicators for safety performance, observing its similar pattern with the World Association of Nuclear Operators performance indicators provides insights for policy implications in intermediate safety management aimed at preventing major disaster incidents.
Adaptive event-triggered finite-time prescribed performance control of PMSM stochastic system considering time-varying delays
Authors: Tuo Yaoyao , Song Yankui
Published: July 2024

This paper investigates the finite-time prescribed performance tracking control problem of permanent magnet synchronous motor (PMSM) considering stochastic disturbances and time-varying delays under event-triggered mechanism. A quintuple polynomial finite-time prescribed performance function (FPPF) is introduced to ensure the transient and steady-state performance of the system output, and a nonlinear transformation function is employed to convert the constrained error into an unconstrained one. The Lyapunov-Krasovskii function is constructed to address time delays. And the system uncertainties are approximated by the radial basis function neural networks (RBFNN). For the “explosion of complexity” caused by backstepping method, a tracking differentiator (TD) is employed. By combining finite time control, command filtering backstepping control, and event-triggered mechanism, the effect of the filter errors is decreased, and the update frequency of the control signals are reduced. It is shown that the proposed controller can guarantee finite time convergence bounded of all signals in the closed-loop system, and the tracking error can converge in finite time. Finally, simulation results are presented to illustrate the effectiveness of the proposed controller.
Intracardiac Echocardiography—Applications in the Electrophysiology and the Cardiac Catheterization Labs
Authors: Myadam Rahul , Kolominsky Jeffrey , Mankad Pranav , Koneru Jayanthi
Published: July 2024

Background. Intracardiac echocardiography (ICE) is routinely used in cardiac electrophysiology and catheterization labs. It plays a vital role in understanding cardiac anatomy, procedural planning, and early identification of complications. In this review, we describe the utility of ICE for procedures in the electrophysiology lab, including atrial fibrillation ablation, left atrial appendage occlusion device implantation, and cardiac implantable electronic device (CIED) extraction. Intracardiac echocardiography also helps in the identification of complications such as pericardial effusion, pulmonary vein stenosis, and left atrial appendage thrombus. Compared with traditional echocardiographic modalities such as transesophageal echocardiogram (TEE), ICE has equivalent image quality, requires less sedation, and possesses no risk of esophageal injury. The disadvantages of ICE include a learning curve and necessity for central vascular access.
Re-imagining performance spaces and locations in ecological dynamics: Implications for pedagogical practices in physical education
Authors: Rothwell Martyn , Bjerke Øyvind , Strafford Ben William , Robinson Tim , Haslingden Craig , Navarro Martina , Davids Keith
Published: July 2024

Many places and locations for physical education, and the associated pedagogies, limit the enrichment of the individual–environment system. Strengthening this relationship can provide children and youth with greater functionality to navigate a diverse range of environments more effectively, leading to a positive relationship with sport and physical activity across the lifespan. The purpose of this position paper is to draw attention to the role that environmental constraints play in shaping the relationship between places, locations, and pedagogical practice in physical education. More specifically, we demonstrate how the design of spaces for physical education, and movement competencies more generally, emerges under political, historical, cultural, and socioeconomic factors. Ecological dynamics is presented as an explanatory framework to position the concept of open spaces as a means of enriching individual–environment interactions via guided discovery and exploratory behaviour. In unpacking these key concepts, we highlight innovative approaches to the design of open spaces for physical activity and sport, exemplified by the Skills Garden and PLAYCE initiatives. To move beyond the theoretical arguments presented in this article, we encourage practitioners and applied scientists to collaborate and integrate sub-disciplines, applied ideas, and research methods to re-imagine the design of spaces for learning. To take full advantage of redesigned spaces in strengthening the individual–environment system, practitioners need to adopt a model of physical education that complements these contemporary learning spaces.
Legal status of the self-employed person in the field of social protection in Ukraine
Authors: Yaroshenko Oleg M , Ivchuk Yuliia Yu , Maliuha Lesya Ju , Nesterovych Oleksii S , Lutsenko Olena Ye
Published: July 2024

Due to the existence of many scientific studies and various statements regarding the legal status of the self-employed person and their legal status in the field of social protection. It is necessary to conduct a thorough analysis of important aspects of this issue. Especially in times of war, when the unemployment rate is steadily increasing and self-employed persons are increasing their value to the state. This is the reason for the relevance of the study. The purpose of this research is: to determine the legal status of the self-employed person in the field of social protection in Ukraine; to analyze the characteristics of legal regulation applicable to the self-employed; to process data on the basic principles of social security for the self-employed. Important steps are also to analyse the most significant problems faced by self-employed persons in the field of social protection and to discuss possible solutions.
Theorising power and resistance under contemporary capitalism: An interview with Nancy Fraser
Authors: Fraser Nancy , Maiguashca Bice , Masquelier Charles
Published: July 2024

In this interview, Fraser reflects on the meaning of the so-called ‘culture wars’ for theorising power and domination, the nature of contemporary struggles for liberation, the role the concept of labour could play in bringing those movements together in political action, and the wider theoretical and political work needed to achieve it. She also offers her assessment of some of the theoretical literature that has addressed those issues. In doing so, she both situates her own work within the wider tradition of Frankfurt School critical theory and clarifies her views on intersectionality theory.
Vibration control and transmission mechanism of super high-rise building located on subway based on spring vibration isolation system
Authors: Mei Can , Wang Dayang , Zhang Yongshan
Published: July 2024

This study focuses on the vibration control effect of the spring vibration isolation system (SVIS) on a super high-rise building located on the subway (BLS) and the transmission mechanism of vibration in super high-rise BLS. Firstly, the 1:35 scale shaking table test model of super high-rise BLS is designed, the rationality of the shaking table test model is verified, and the shaking table test is implemented. Secondly, the finite element model (FEM) is established and verified based on the results of the shaking table test. Finally, based on verified FEM, the vibration control effect of SVIS on super high-rise BLS and the vibration transmission mechanism of super high-rise BLS is analyzed. The results show that the vibration response of the BLS show amplification trend along the height direction. The amplification of vibration response of BLS is effectively controlled by SVIS. The higher the floor, the greater the reduction coefficient, and the better the control effect. The reduction coefficient above 10F is mainly distributed above 0.80 due to the SVIS. The BLS equipped with the SVIS maintains the degree of Z-direction vibration and 1/3 octave vibration acceleration level that is within the limits stipulated by the specifications. The first-order vertical frequency of BLS equipped with the SVIS is adjusted from 65 Hz to 8 Hz, far from the favorable frequency range of the subway wave.
Algorithm optimization of architectural form through sequential landscape evaluation
Authors: Matsuoka Masaaki , Fujiwara Kunihiko
Published: July 2024

Designing architectural and urban spaces based on continuous human spatial experience throughout a sequence may lead to architectural and urban forms not bound to conventional concepts. These forms would be made possible through the combination of a quantitative sequential landscape evaluation and morphological optimization utilizing algorithmic processes. In this study, we introduce a method for evaluating sequential landscapes, in which the configuration of buildings, trees, etc., in view changes as pedestrians move along a particular path, using a genetic algorithm optimization of architectural forms to bring them closer to the designer’s ideals. The method’s validity was tested using two case studies, assuming the design of a sequential landscape in an actual city and park. The results present a more efficient, objective, and reproducible method for designing sequences in buildings, cities, and landscapes, compared to traditional methods.
Protocolized Foot Exercises Help in Improvement of Diabetic Foot Ulcers and Quality of Life When Added to Standard Therapy–A Randomized Clinical Trial
Authors: Nayak Deepak , Ray Rubik , Anand Chetan , Baruah Tridip Dutta , Goyal Ashok
Published: July 2024

Context

Diabetic foot disease is the major cause of nontraumatic limb amputations worldwide causing a high socioeconomic and psychological toll and a huge burden to the healthcare system. Currently, standard treatment of diabetic foot ulcer is through multidisciplinary therapy. Foot exercises have been shown to improve healing in diabetic ulcers although evidence is limited and applicability is non-uniform. Our study aimed to generate more evidence regarding the benefit of addition of protocolized foot exercises so that it can be instituted as a standard of care.

Methods and Material

It was an open label Randomized controlled trial with seventy-two patients and study duration of one and half years Patients with diabetic foot ulcers were randomized into two groups. Both groups received standard therapy for diabetic foot ulcer. The intervention group in addition received three months of protocolized foot exercises. At the end of three months ulcer healing and quality of life were m compared among both the groups.

Results

Regular exercises for three months caused significant reduction in ulcer area compared to the non-intervention group [100% versus 45.22%, 95% CI =36.30(16.04—56.56), P-value = 0.001]. Quality of life analyzed by SF-36 score showed significant improvement in components like physical function [69.4 ± 8.9 versus 63.7 ± 11.0, 95% CI = 5.73 (0.97-10.48), P-value = 0.01], emotional well-being [65.2 ± 7.6 versus 60.8 ± 7.9, 95% CI = 4.44 (0.79-8.10), P-value = 0.01], and pain components [55.4 ± 18.5 versus 47.5 ± 14.5, 95% CI = 7.99 (0.16-15.81), P-value = 0.04) at 3 months although change in social functioning, physical health limitation, health change, energy and general health improvement were not significant.

Conclusions

Addition of protocolized foot exercises are beneficial for patients of diabetic foot ulcers in terms of ulcer healing as well as improvement of quality of life provided compliance to exercises can be ensured.
Reliability assessment of distal occlusion eTICI scoring
Authors: Dolia Jaydevsinh N , Grossberg Jonathan A , Martins Pedro N , Tarek Mohamed A , Pabaney Aqueel , Al-Bayati Alhamza R , Nogueira Raul G , Haussen Diogo C
Published: July 2024

Background

The eThrombolysis in Cerebral Infarction (eTICI) score has been validated in proximal large artery occlusion (pLAOs). Despite the growing number of distal medium vessel occlusions (DMVOs) mechanical thrombectomies (MT) and the widespread utilization of the eTICI scoring system, its reliability and standardization for more distal occlusions have not been validated. We aim to evaluate the interrater reliability of eTICI scores in primary DMVOs.

Methods

This was a retrospective analysis of a prospectively maintained database for consecutive patients with pLAO and DMVO MT at a single comprehensive stroke center from 2015 to 2022. Two fellowship-trained neurointerventionalists blindly/independently assessed digital subtraction angiograms for final eTICI, followed by consensus reads for discrepancies.

Results

59 DMVO of 2248 thrombectomies [M3:29(50%)/M4:1(2%)/A1:3(5%)/A2:12(22%)/A3: 5(9%)/P1:7(12%)/P2:1(2%)] and 124 pLAOs of 308 thrombectomies [i-ICA:13(11%)/MCA-M1: 111(90%)] were included. The distribution of final eTICI scores was comparable between pLAO vs DMVOs (p = 0.82). The pLAO final eTICI score assessment between two readers demonstrated moderate reliability with a kappa0.77 (95%CI: 0.67–0.88), while the DMVO eTICI score assessment exhibited almost-perfect agreement with kappa 0.94 (95%CI: 0.90–0.99). The agreement between the consensus read and the original report in DMVOs was 0.86 (95% CI: 0.71–1.00) while for pLAO it was 0.83(95% CI: 0.76–0.90). The performance of eTICI was comparable amongst different DMVO territories as well as for distal vs. very distal occlusions.

Conclusion

eTICI score exhibited comparable performance for DMVO as compared to pLAO strokes. Further studies investigating DMVO eTICI grading and clinical outcomes are warranted.
Rescue extracranial vertebral stenting in tandem occlusions: A preliminary Vietnamese study
Authors: Minh Thang Le , Chi Cuong Tran , Hoai Nam Nguyen , Hoang Dinh Nguyen , Luu Giang Nguyen , Nhat Huy Nguyen Dao , Hoang Linh Duong , Tran Tran Nguyen , Bao Luan Tran Minh
Published: July 2024

Background and Purpose

The acute vertebrobasilar occlusion associated with the poor prognosis, particularly tandem occlusion. However, few data on the efficacy of the endovascular therapy was indicated in this occlusion. We investigated whether the additional rescue extracranial vertebral stenting improved clinical outcome by modified Rankin scale (mRS) score within 3 months after the procedure.

Methods

This was a retrospective analysis of patients with acute posterior tandem occlusion who were treated with rescue extracranial vertebral stenting between December 2020 and January 2024 at our hospital. Clinical, neuroimaging, procedural, and complication data were collected. Primary outcomes included the rate of good outcomes (mRS ≤ 2) at 3-month follow-up.

Results

Nine patients who underwent rescue extracranial vertebral stenting in posterior circulation tandem occlusions were enrolled in the study. All patients were achieved the successful recanalization (mTICI ≥ 2b). Of Dotter technique in the “distal-to-proximal” approach, Diagnostic-Dotter made up 66.7%. Five patients (55.6%) with good outcome (mRS ≤ 2) at 3 months, and 1 patient (11.1%) underwent suboccipital decompressive craniectomy due to the malignant cerebellar infarction.

Conclusion

Our study suggests that despite the small series with posterior tandem occlusions, the rescue extracranial vertebral stenting could be an important alternative treatment followed by mechanical thrombectomy.
Extra-Limbic Seronegative Encephalitis Preceding Recurrent Hodgkin’s Lymphoma and Gastric Diffuse Large B-Cell Lymphoma: A Case Report
Authors: Li Carrie , Fisher David , Bhattacharyya Shamik
Published: July 2024

We describe a patient with extra-limbic seronegative encephalitis with relapsing progressive course as the harbinger of sequential Hodgkin’s lymphoma and Diffuse Large B-Cell lymphoma. Diagnosis of probable paraneoplastic neurologic syndrome (PNS) was arrived at by exhaustive elimination of alternative causes and supportive tissue diagnosis. This case highlights the phenotypic variety of paraneoplastic neurologic syndromes associated with hematologic malignancies and the challenges in their recognition, diagnosis, and treatment. We discuss and apply the updated consensus diagnostic criteria for paraneoplastic syndromes to our case as a means of bolstering probability in cases of diagnostic uncertainty.
How much ICT literacy is required? The epistemic perceptual framework of Iranian university faculty members during the COVID-19 pandemic
Authors: Azad Mahnaz
Published: July 2024

Nowadays, information and communications technology literacy (ICT) means more than achieving isolated digital and technological skills. ICT literacy means the skills young people need in the digital world in which information and interaction are accessed through such digital technologies as social networks, virtual environments, and smartphones. To enhance the ICT literacy of these “digital natives”, university faculty are encouraged to implement digital technology in their classes and this will be fulfilled if they are highly competent in the area. This situation gained more prominence during the COVID-19 pandemic as the educational systems all around the world were reshaped requiring educators to embrace new educational technologies in instruction. This study is based on the premise that faculties play a key role in successful incorporation of digital technology in higher education. To explore the issue, the epistemic perceptual framework of 285 male and female university faculty members teaching different fields of study in both public and private universities in Iran was investigated considering their knowledge and perception of ICT literacy, its integration at academic levels, and how coronavirus pandemic has affected the incorporation of digital technology in teaching. Exploring the results showed that there was a significant difference between the lecturers’ actual and perceived ICT literacy in Iran. It was revealed that some faculty had never used technological tools in their classes before the pandemic and the situation has forced them to adopt digital teaching. However, most faculty favored digital integration claiming the pandemic had caused them to improve their ICT literacy and teaching methods. The findings called for an urgent need for faculty’s continuous and effective ICT education upgrading which in turn results in training a more efficient young generation for the digital world.
Engaging with the public on their views on the collection, use and sharing of personal health information: Development of a scenario-based survey instrument
Authors: Tuohy Ella , Murphy-Dooley Alana , Flaherty Sarah Jane , Duggan Catherine , Foley Barbara , Flynn Rachel
Published: July 2024

Background

Members of the public differ regarding their views on the use and sharing of personal health information.

Objective

This paper describes the methodology employed to develop a telephone-based survey tool to capture views of the public on the collection, use and sharing of personal health information.

Method

A rigorous methodology comprising multiple stages was undertaken to develop a vignette/scenario-based survey instrument. These steps included a review of instruments used in other jurisdictions, focus groups, engagement meetings with healthcare professionals, cognitive testing and piloting the final instrument. Informed by the findings of each survey development phase, draft scenarios and accompanying questions were developed.

Results

The following scenarios were developed: ‘Circle of care,’ ‘Use of information beyond your direct care’ and ‘Digital records.’

Conclusion

The findings from this survey will inform national policy in relation to health information and will inform the development and implementation of eHealth initiatives. In turn, this should support the delivery of high-quality, effective health and social care. The learnings from the development of this survey will contribute to future health information policy and governance in countries or jurisdictions considering the development of a national electronic health record system. Moreover, this research will support public and population health management by encouraging public engagement to support successful implementation of new health information systems.
Morpho-anatomical studies of family lamiaceae species of district Lahore, Punjab: a revision to flora of Pakistan
Authors: Majeed Javaria , Shaheen Shabnum , Waheed Muhammad , Abbas Moneeza , Ghani Nadia , Ashfaq Muhammad , Hashem Abeer , Kumar Ajay , Abd-Allah Elsayed Fathi
Published: July 2024

Background

This study was aimed to determine the taxonomic position and delimitation of fifteen Lamiaceae taxa using leaf epidermal morpho-anatomical features in Lahore. A main objective of the study was also the revision and upgradation of Lamiaceae taxa in the flora of Pakistan, as no details of studied species are found in the flora of Pakistan.

Methods

The examination of significant anatomical parameters, such as epidermal cell shape and size, stomatal types, guard and subsidiary cells shape and size, stomatal cavity size, trichome size and shape, oil droplets, crystals, and secretory cavity characteristics were studied using light microscopic (LM) and scanning electron microscopic (SEM) techniques. Among all the studied Lamiaceae species, these anatomical features varied significantly. Principal component analysis and correlation were done to distinguish the species’ similarities.

Results

Most species had pentagonal and hexagonal epidermal cells with straight anticlinal wall thickness. On the adaxial surface, paracytic stomata were found in Ocimum basilicum L. and Rosmarinus officinalis L. Diacytic stomata was observed in Ajuga reptans L. and anisocytic stomata in Galeopsis tetrahit L. In the abaxial surface, trichomes were present in five species, i.e., Mentha suaveolens Ehrh. A. reptans, Thymus vulgaris L., M. haplocalyx, and Salvia splendens Ewat. In S. splendens, peltate and glandular trichomes were seen whereas, in other species, trichomes were long, unbranched glandular and had tapering ends. In adaxial side trichomes were present only in M. suaveolens, A. reptans, S. bazyntina, O. basciculum, S. splendens, S. officinalis, S. rosemarinus. In other species, trichomes were absent on the adaxial surface. In abaxial view, M. suaveolens had the largest length of trichomes, and O. basciculum had the smallest. S. splendens L. had the largest trichome width, while T. vulgaris had the smallest.

Conclusion

Hence, according to these findings, morpho-anatomical traits are useful for identifying Lamiaceae taxa. Also, there is a need of upgradation and addition of studied taxa in flora of Pakistan comprehensively.
Genetic characteristic of mumps virus from 2012 to 2016 and its serum antibody level among general healthy population during 2018–2020 in Jiangsu Province, China
Authors: Deng Xiuying , Hu Ying , Lu Peishan , Wang Zhiguo , Guo Hongxiong
Published: July 2024

Mumps is a vaccine-preventable disease with high contagious capability. Its incidence declined rapidly since one dose of mumps vaccine was introduced into Expanded Program of Immunization (EPI) in 2008 in China. Nonetheless, the outbreaks of mumps remain frequent in China. Here we aim to assess herd immunity level followed by one-dose mumps ingredient vaccine and to elucidate the genetic characteristics of mumps viruses circulating in the post vaccine era in Jiangsu province of China. The complete sequences of mumps virus small hydrophobic(SH) gene were amplified and sequenced; coalescent-based Bayesian method was used to perform phylogenetic analysis with BEAST 1.84 software. Commercially available indirect enzyme-linked immune-sorbent IgG assay was used for the quantitative detection of IgG antibody against mumps virus. Our results show that genotype F was the predominant mumps viruses and belonged to indigenous spread, and most of Jiangsu sequences clustered together and formed a monophyly. The prevalence of mumps reached a peak in 2012 and subsequently declined, which presented an obvious different trajectory with virus circulating in other regions of China. The gene diversity of viruses circulating in Jiangsu province was far less than those in China. The antibody prevalence reached 70.42% in the general population during 2018 to 2020. The rising trend of antibody level was also observed. Although mumps antibody prevalence does not reach expected level, mumps virus faces higher pressure in Jiangsu province than the whole of China. To reduce further the prevalence of mumps viruses, two doses of mumps vaccine should be involved into EPI.
Transition to end-of-life care in patients with neurological diseases in an acute hospital ward
Authors: Jonsdottir Gudrun , Haraldsdottir Erna , Vilhjalmsson Runar , Sigurdardottir Valgerdur , Hjaltason Haukur , Klinke Marianne Elisabeth , Tryggvadottir Gudny Bergthora , Jonsdottir Helga
Published: July 2024

Background

Transitioning to end-of-life care and thereby changing the focus of treatment directives from life-sustaining treatment to comfort care is important for neurological patients in advanced stages. Late transition to end-of-life care for neurological patients has been described previously.

Objective

To investigate whether previous treatment directives, primary medical diagnoses, and demographic factors predict the transition to end-of-life care and time to eventual death in patients with neurological diseases in an acute hospital setting.

Method

All consecutive health records of patients diagnosed with stroke, amyotrophic lateral sclerosis (ALS), and Parkinson’s disease or other extrapyramidal diseases (PDoed), who died in an acute neurological ward between January 2011 and August 2020 were retrieved retrospectively. Descriptive statistics and multivariate Cox regression were used to examine the timing of treatment directives and death in relation to medical diagnosis, age, gender, and marital status.

Results

A total of 271 records were involved in the analysis. Patients in all diagnostic categories had a treatment directive for end-of-life care, with patients with haemorrhagic stroke having the highest (92%) and patients with PDoed the lowest (73%) proportion. Cox regression identified that the likelihood of end-of-life care decision-making was related to advancing age (HR = 1.02, 95% CI: 1.007–1.039, P = 0.005), ischaemic stroke (HR = 1.64, 95% CI: 1.034–2.618, P = 0.036) and haemorrhagic stroke (HR = 2.04, 95% CI: 1.219–3.423, P = 0.007) diagnoses. End-of-life care decision occurred from four to twenty-two days after hospital admission. The time from end-of-life care decision to death was a median of two days. Treatment directives, demographic factors, and diagnostic categories did not increase the likelihood of death following an end-of-life care decision.

Conclusions

Results show not only that neurological patients transit late to end-of-life care but that the timeframe of the decision differs between patients with acute neurological diseases and those with progressive neurological diseases, highlighting the particular significance of the short timeframe of patients with the progressive neurological diseases ALS and PDoed. Different trajectories of patients with neurological diseases at end-of-life should be further explored and clinical guidelines expanded to embrace the high diversity in neurological patients.
Association between CYP1A2 gene variants −163 C/A (rs762551) and −3860 G/A (rs2069514) and bladder cancer susceptibility
Authors: Iqbal Muhammad Sarfaraz , Sardar Nimra , Peng Kaoqing , Almutairi Layla A. , Duan Xialo , Tanvir Fouzia , Attia Kotb A. , Zeng Gouhua , Gu Di
Published: July 2024

Background

Bladder cancer (BLCA) poses a significant global health challenge due to its high incidence, poor prognosis, and limited treatment options.

Aims and objectives

This study aims to investigate the association between two specific polymorphisms, CYP1A2-163 C/A and CYP1A2-3860G/A, within the Cytochrome P450 1A2 (CYP1A2) gene and susceptibility to BLCA.

Methods

The study employed a case-control design, genotyping 340 individuals using Polymerase Chain Reaction-High-Resolution Melting Curve (PCR-HRM). Various genetic models were applied to evaluate allele and genotype frequencies. Genetic linkage analysis was facilitated using R packages.

Results

The study reveals a significant association with the − 163 C/A allele, particularly in the additive model. Odds ratio (OR) analysis links CYP1A2-163 C/A (rs762551) and CYP1A2-3860G/A(rs2069514) polymorphisms to BLCA susceptibility. The rs762551 C/A genotype is prevalent in 55% of BLCA cases and exhibits an OR of 2.21. The A/A genotype has an OR of 1.54. Regarding CYP1A2-3860G/A, the G/A genotype has an OR of 1.54, and the A/A genotype has an OR of 2.08. Haplotype analysis shows a predominant C-C haplotype at 38.2%, followed by a C-A haplotype at 54.7%, and a less frequent A-A haplotype at 7.1%. This study underscores associations between CYP1A2 gene variants, particularly rs762551 (CYP1A2-163 C/A), and an increased susceptibility to BLCA. Haplotype analysis of 340 individuals reveals a predominant C-C haplotype at 38.2%, followed by a C-A haplotype at 54.7%, and a less frequent A-A haplotype at 7.1%.

Conclusion

In conclusion, the − 163 C/A allele, C/A genotype of rs762551, and G/A genotype of rs2069514 emerge as potential genetic markers associated with elevated BLCA risk.
Differentiation of granulomatous nodules with lobulation and spiculation signs from solid lung adenocarcinomas using a CT deep learning model
Authors: Wen Yanhua , Wu Wensheng , Liufu Yuling , Pan Xiaohuan , Zhang Yingying , Qi Shouliang , Guan Yubao
Published: July 2024

Background

The diagnosis of solitary pulmonary nodules has always been a difficult and important point in clinical research, especially granulomatous nodules (GNs) with lobulation and spiculation signs, which are easily misdiagnosed as malignant tumors. Therefore, in this study, we utilised a CT deep learning (DL) model to distinguish GNs with lobulation and spiculation signs from solid lung adenocarcinomas (LADCs), to improve the diagnostic accuracy of preoperative diagnosis.

Methods

420 patients with pathologically confirmed GNs and LADCs from three medical institutions were retrospectively enrolled. The regions of interest in non-enhanced CT (NECT) and venous contrast-enhanced CT (VECT) were identified and labeled, and self-supervised labels were constructed. Cases from institution 1 were randomly divided into a training set (TS) and an internal validation set (IVS), and cases from institutions 2 and 3 were treated as an external validation set (EVS). Training and validation were performed using self-supervised transfer learning, and the results were compared with the radiologists’ diagnoses.

Results

The DL model achieved good performance in distinguishing GNs and LADCs, with area under curve (AUC) values of 0.917, 0.876, and 0.896 in the IVS and 0.889, 0.879, and 0.881 in the EVS for NECT, VECT, and non-enhanced with venous contrast-enhanced CT (NEVECT) images, respectively. The AUCs of radiologists 1, 2, 3, and 4 were, respectively, 0.739, 0.783, 0.883, and 0.901 in the (IVS) and 0.760, 0.760, 0.841, and 0.844 in the EVS.

Conclusions

A CT DL model showed great value for preoperative differentiation of GNs with lobulation and spiculation signs from solid LADCs, and its predictive performance was higher than that of radiologists.
Symptom impact and health-related quality of life (HRQoL) assessment by cancer stage: a narrative literature review
Authors: Chung Karen C. , Muthutantri Anushini , Goldsmith Grace G. , Watts Megan R. , Brown Audrey E. , Patrick Donald L.
Published: July 2024

Background

Cancer stage at diagnosis is an important prognostic indicator for patient outcomes, with detection at later stages associated with increased mortality and morbidity. The impact of cancer stage on patient-reported outcomes is poorly understood. This research aimed to understand symptom burden and health related quality of life (HRQoL) impact by cancer stage for ten cancer types: 1) ovarian, 2) lung, 3) pancreatic, 4) esophageal, 5) stomach, 6) head and neck, 7) colorectal, 8) anal, 9) cervical, and 10) liver and bile duct.

Methods

Ten narrative literature reviews were performed to identify and collate published literature on patient burden at different stages of disease progression. Literature searches were conducted using an AI-assisted platform to identify relevant articles published in the last five (2017–2022) or ten years (2012–2022) where articles were limited. Conference abstracts were searched for the last two years (2020–2022). The geographic scope was limited to the United States, Canada, Europe, and global studies, and only journal articles written in English were included.

Results

A total of 26 studies with results stratified by cancer stage at diagnosis (and before treatment) were selected for the cancer types of lung, pancreatic, esophageal, stomach, head and neck, colorectal, anal, and cervical cancers. Two cancer types, ovarian cancer, and liver and bile duct cancer did not return any search results with outcomes stratified by disease stage. A general trend was observed for worse patient-reported outcomes in patients with cancer diagnosed at an advanced stage of disease compared with diagnosis at an earlier stage. Advanced disease stage was associated with greater symptom impact including general physical impairments such as pain, fatigue, and interference with functioning, as well as disease/region-specific symptom burden. Poorer HRQoL was also associated with advanced disease with commonly reported symptoms including anxiety and depression.

Conclusions

Overall, the general trend for greater symptom burden and poorer HRQoL seen in late stage versus early-stage disease across the included cancer types supports the importance for early diagnosis and treatment to improve patient survival and decrease negative impacts on disease burden and HRQoL.
Increasing serum miR-223-3p indicates the onset, severe development, and adverse prognosis of bronchiectasis: a retrospective study
Authors: Fang Jia , Xu Yao , Lin Chenghui , Yang Jiewen , Zhai Dongxu , Zhuang Qingyuan , Qiu Wangli , Wang Yun , Zhang Longjuan
Published: July 2024

Background

miR-223-3p has been demonstrated as a Pseudomonas aeruginosa colonization-related miRNA in bronchiectasis (BE), but its clinical value in BE has not been revealed, which is of great significance for the clinical diagnosis and monitoring of BE. This study aimed to identify a reliable biomarker for screening BE and predicting patients’ outcomes.

Methods

The serum expression of miR-223-3p was compared between healthy individuals (n = 101) and BE patients (n = 133) and evaluated its potential in distinguishing BE patients. The severity of BE patients was estimated by BSI and FACED score, and the correlation of miR-223-3p with inflammation and severity of BE patients was evaluated by Pearson correlation analysis. BE patients were followed up for 3 years, and the predictive value of miR-223-3p in prognosis was assessed by logistic regression analysis.

Results

Significant upregulation of miR-223-3p was observed in BE patients, which significantly distinguished BE patients and showed positive correlations with C-reactive protein (CRP), procalcitonin (PCT), interleukin 6 (IL-6), and neutrophil-to-lymphocyte ratio (NLR) of BE patients. Additionally, miR-223-3p was also positively correlated with BSI and FACED scores, indicating its correlation with inflammation and severity of BE. BE patients with adverse prognoses showed a higher serum miR-223-3p level, which was identified as an adverse prognostic factor and discriminated patients with different prognoses.

Conclusion

Increasing serum miR-223-3p can be considered a biomarker for the onset, severity, and prognosis of BE.