bluuebunny/crossref_metadata_2025 huggingface dataset:
Friend–Enemy Divided Thinking from the Perspective of Intergroup Conflict: Relationship with International Attitudes and Conspiracy Beliefs
Authors: Nawata Kengo , Fujimura Makoto , Oga Toru
Published: May 2024

The cognitive process of social categorization and perceived outgroup threat leads to the perception of the world as divided into intergroup conflict relations between enemy and friend groups—termed “friend–enemy divided thinking.” This study proposes the concept of friend–enemy divided thinking from the perspective of intergroup conflict and examines how this concept affects (1) political attitudes toward international relations and (2) conspiracy beliefs, which are closely related to intergroup conflict. A survey was conducted in Japan ( N = 735). The results showed that the stronger the friend–enemy divided thinking is, the stronger the conspiracy beliefs are. People with stronger friend–enemy divided thinking felt threatened by national defense and immigration and supported negative policies against international relations. Both conspiracy beliefs and negative political attitudes toward national defense and immigration in international relations were interpreted to be associated with the perception of a hostile intergroup conflict that is heightened by friend–enemy divided thinking.
Understanding the Adoption of Artificial Intelligence in Journalism: An Empirical Study in Vietnam
Authors: Trang Ta Thi Nguyet , Chien Thang Pham , Hai Le Dinh , Phuong Vi Thi , Quy Tran Quang
Published: May 2024

This study examines the factors influencing Vietnamese journalists’ adoption of Artificial Intelligence in journalism. Drawing on the Unified Theory of Acceptance and Use of Technology (UTAUT) framework, it hypothesizes that performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, trust, regulatory support, and technology affinity and incorporating additional trust, regulatory support, and technology affinity have significant impacts on journalists’ adoption of technology. Questionnaires were administered to 238 journalists in the context of the Vietnamese press. The findings showed the significant impact of performance expectancy, effort expectancy, social influence, facilitating conditions, behavioral intention, trust, regulatory support, and technology affinity on journalists’ adoption of AI in journalism. These results expand the UTAUT framework and offer a more comprehensive understanding of technology adoption in journalism. Practically, the study provides valuable insights for practitioners and policymakers in the journalism industry. Understanding the determinants of journalists’ adoption can inform the development of targeted interventions, training programs, and regulatory frameworks to facilitate the integration of AI technologies into journalistic practices. However, the study has limitations, and future research should replicate the findings in diverse cultural and organizational contexts while considering additional moderating factors.
The Use of Physically Active Academic Lessons During the Transition to Face-to-Face Classes
Authors: Beserra Vagner , Nussbaum Miguel , Navarrete Mónica , Garrido Norman , Alvares Danilo
Published: May 2024

Schools are pivotal stakeholders in increasing the amount of student physical activity, an attribution especially relevant while the COVID-19 pandemic is not overcome. This article evaluates how the use of physically active academic lessons impacted mathematics learning and the amount of physical activity during the transition to face-to-face classes. The objective was also to analyze students, parents, and teachers’ perceptions of this experience. Therefore, for at least 6 weeks in mid-2021, 290 Chilean elementary school students from different schools, together with their 11 teachers, learned and practiced a choreography on geometry during the school routine. Both quantitative and qualitative instruments were used to evaluate this experience. The results from the pre- and post-test showed that students increased their geometry scores significantly ( Z = 13.116, p < .001) by an average of 24.28 percentage points with an increase of 7.33 percentage points if the student attended face-to-face classes. Moreover, the results of the focus groups revealed a positive perception of the experience and increased physical activity. Overall, the study suggests that incorporating physically active academic lessons positively affect both academic performance and students’ physical activity levels during the transition to face-to-face classes.
Sacral dysmorphism and its influence on hardware choice in sacral fractures: A scoping review
Authors: Alshaalan Fawaz N , Al-Mohrej Omar A , Hakeem Naif N , Al-Asiri Jamal , Johal Herman
Published: May 2024

Purpose

In the setting of sacral fractures, percutaneous screw fixation is a reliable, safe, and minimally invasive method for managing most stable and unstable fractures. However, significant variations in sacral anatomy due to sacral dysmorphism (SDM) could prevent safe implementation. This scoping review aimed to highlight such a detrimental yet under-reported variable in managing sacral fractures.

Methods

A scoping review was conducted following the Arksey and O’Malley framework for scoping studies. A comprehensive literature search of four electronic databases was conducted to identify relevant peer-reviewed studies. Data were extracted from eligible articles to summarize, collate, and create a narrative account of the findings.

Results

Twenty-one articles were included in our review (18 level III, two level II, and one level I). Studies were categorized into three main groups based on the investigated outcomes: prevalence and determinants of SDM, effect of SDM on the surgical corridor, and efficacy of different intra-operative imaging modalities. The prevalence of SDM ranged from 10 to 85%. The presence of SDM decreased the available surgical corridor at S1, with a compensated increase at S2 and S3. Mixed results regarding accuracy and revision rate were identified between different intra-operative imaging techniques.

Conclusion

SDM represents consistent yet atypical “safe zone,” sizes, and angles that require careful analysis and technique alterations when placing upper and second sacral segment screws. Considering their limited availability, high cost, and mixed results, navigated imaging systems represent a promising technique that requires more rigorous examination of its efficacy before widespread adoption.
Efficacy of Monetary Policy Transmission During the Flexible Inflation Targeting Regime in India
Authors: Phul Samahita
Published: May 2024

This article builds a Structural Vector Autoregressive model and employs non-recursive identification restrictions to examine the effectiveness of the Monetary policy transmission mechanism in India during the Flexible Inflation Targeting regime (2016–2023). The results indicate that policy rate shocks have a significant negative impact on domestic output and prices during this regime. The findings further, reveal evidence of an exchange rate puzzle during the Flexible Inflation Targeting regime. Our results give credence to the RBI’s move towards a Flexible indicator targeting approach as all the macroeconomic variables of interest, that is, Domestic output and inflation produce plausible estimates in response to a monetary policy shock.

JEL Classification: C32, E52, E5, E52, F41
Complete Pathologic Response With Pembrolizumab and Enfortumab Vedotin in Urothelial Carcinoma of the Upper Urinary Tract
Authors: Chan Kok Hoe , Shu Tung , Al Shaarani Majd , Cen Putao
Published: May 2024

Urothelial carcinoma of the upper urinary tract (UTUC) presents a significant clinical challenge, often requiring aggressive surgical intervention for optimal management. We present a case of an 84-year-old woman with recurrent high-grade papillary UTUC of the left renal pelvis, refractory to prior endourologic interventions, who underwent neoadjuvant treatment with pembrolizumab and enfortumab vedotin (Pembro/EV) due to contraindications to cisplatin therapy. Following a favorable response to neoadjuvant therapy, the patient underwent laparoscopic left radical nephroureterectomy, achieving a pathologic complete response. We discuss the utility of Pembro/EV in the perioperative management of patients with UTUC, particularly in those ineligible for cisplatin-based therapy. In addition, we highlight the potential role of somatic mutation testing and the integration of novel therapeutic agents such as olaparib in personalized treatment strategies for UTUC. This case underscores the importance of exploring innovative treatment approaches and optimizing patient selection for kidney preservation strategies in the management of UTUC. Further research and clinical trials are warranted to elucidate the full therapeutic potential of Pembro/EV and other emerging therapies in this setting.
Perspectives of Healthcare Professionals on Clinician–Patient Communication of Cardiovascular Disease Risk
Authors: Campbell Mark , McEvoy John William , Calpin Gavin , Concannon Fiona , Redfern Sam
Published: May 2024

When the consultation is predominantly verbal, existing research in clinician–patient communication indicates that many patients struggle to understand and recall medical consultations or may not understand the extent of their illness or the purpose of their treatment plan. When the clinician–patient discussion centers around the risk of a repeated cardiovascular disease (CVD) related event, qualitatively assessing what factors affect the communication of this risk may guide the creation of effective communication solutions. Semi-structured interviews were conducted with 17 clinicians treating patients at stages along the cardiac rehabilitation patients’ journey. Thematic analysis identified factors that prevent patients from understanding the risk they face of experiencing a repeated cardiac event. Results indicate a clearer understanding of the cardiac rehabilitation patient journey by means of a patient journey map; an overview of how CVD risk is currently communicated; and the factors that affect communication of these risks in the form of themes and sub-themes. Findings shape the proposal of an evidence informed model of opportunities for enhanced digital media supported communication in cardiac rehabilitation.
Heat and mass transfer analysis of Casson-based hybrid nanofluid flow in the presence of an aligned magnetic field: An application toward mechanical engineering
Authors: Tanuja TN , Kavitha L , Varma SVK , Raju VCC , Ganteda Charan Kumar , Obulesu Mopuri , Jamshed Wasim , Eid Mohamed R , Hussain Syed M
Published: May 2024

This examination explores the flow of a hybridized nanofluid (HyNf) containing silica and tin oxide nanoparticles mixed with engine oil (EO/SnO2-SiO2). The flowing occurs via a permeable material constrained by a semi-infinite flat plate. The study takes into account various factors such as convective heat and mass transference, chemical reactions, the Dufour effect, the Lorentz force, thermal radiative fluxing, and radiative absorbing. The research involves converting the managing formulas of the flowing model into a dimensionless form and applying the regular perturbation procedure to find solutions for the rate of fluid flow, temperature, and species diffusion. The surface frictional factor, Nusselt quantity, and Sherwood quantity reflect the shearing stress, rates of heat transference, and rates of mass transport at the plate, respectively. An analysis is conducted on the impact of several factors, including the suction variable, magnetic variable, radiation-absorbing factor, Casson parameter, and Dufour number, on the flow and related quantities. This analysis is based on an examination of graphs and tables. The findings suggest that the heat transference rate in the Casson hybridized nanofluid is better than that in the mono nanofluid. It is exposed that the temperature reduces at the plate having improved frequency of oscillation and also fluid velocity declines for improving values of aligned magnetized field [Formula: see text], but it shows the reverse phenomenon with Gr1 and Gc1.
Agribusiness Supply Chain Collaboration: Role of Innovation Capacity and Business Process Agility as Antecedents of Supply Chain Performance
Authors: Dza Mawuko
Published: May 2024

This article examines the role of innovation capacity and business process agility (BPA) in the relationship between supply chain collaboration (SCC) and supply chain performance (SCP) of smallholder agro-based enterprises (SAEs). Based on the relational view and dynamic capability theories and the survey research design, the author used questionnaires to gather data from 226 SAEs who were sampled from agribusiness associations in four regions of Ghana via the quota sampling technique. Smart PLS-SEM 4.0 was used as the statistical method to analyze the data.

The results showed that SCC has a significant and positive relationship with SCP, innovation capacity, and BPA. Innovation capacity significantly mediates the relationship between SCC and SCP. Furthermore, BPA fully mediates the relationship between SCC and innovation capacity, with innovation capacity also influencing SCP. This study integrates relational and capability-based views to propose a comprehensive theoretical model showing the inter-relational effect of SCC, BPA, and innovation capacity on SCP. The empirical findings widen the context of SCC literature to include SAEs from emerging economies in sub-Saharan Africa. The empirical findings enrich the understanding of how SAEs can manage their SCCs to develop and use specific capabilities that positively impact SCP. The uniqueness of this article rests in the proposed model and new empirical knowledge, which extends the scope of the relational and capability-based views and SCC literature to include innovation capacity, BPA, and SCP of SAEs in emerging markets.
Diabetes and Hearing Impairment: Knowledge, Attitudes, and Practices Among Providers and Patients
Authors: Sewell Hayley E. , Planas Lourdes G. , Brown Michael R. , Orcutt Natasha , Johnson Carole E. , Lim Jonea , Skaggs Joanne C. , O’Neal Katherine S.
Published: May 2024

Purpose

The purpose of this study was to assess the knowledge, attitudes, and practices among providers and patients regarding hearing impairment and screening referrals in people with diabetes.

Methods

A cross-sectional survey design among health care providers and patients at an academic medical center in Oklahoma was used to gather knowledge, attitudes, and practices data.

Results

Only 25.6% of providers selected hearing impairment as a complication of diabetes, whereas 96.7% selected retinopathy, kidney dysfunction, and foot infection. Reported barriers to referring patients for hearing impairment screenings were being unfamiliar with recommended screening frequency (57.3%) and existence of higher priorities (35.4%). When asked to select parts of the body affected by diabetes, 21.0% of patients surveyed selected ears, 88.0% selected feet, and 85.0% selected eyes and kidneys. Fewer patients reported being told hearing impairment is a complication of diabetes compared to retinopathy (8.1% vs 85.9%). Additionally, 24.2% of patients reported having a hearing impairment screening, and 96.0% reported having a dilated eye exam.

Conclusions

Most providers and patients at an academic medical center are unaware of the relationship between diabetes and hearing impairment. Providers reported there are several barriers that need to be overcome to refer patients to audiologists.
CD20-bispecific antibodies improve response to CD19-CAR T cells in lymphoma in vitro and CLL in vivo models
Authors: Brinkmann Berit J. , Floerchinger Alessia , Schniederjohann Christina , Roider Tobias , Coelho Mariana , Mack Norman , Bruch Peter-Martin , Liebers Nora , Dötsch Sarah , Busch Dirk H. , Schmitt Michael , Neumann Frank , Roessner Philipp M. , Seiffert Martina , Dietrich Sascha
Published: May 2024

Relapse after anti-CD19 chimeric antigen receptor (CD19-CAR) occurs in a substantial proportion of patients with lymphoid malignancies. We assessed the potential benefits of co-administering CD20-targeting bispecific antibodies (CD20-BsAbs) with CD19-CAR T cells with the aim of enhancing immunotherapeutic efficacy. Addition of CD20-BsAbs to cocultures of CD19-CARs and primary samples of B-cell malignancies, comprising malignant B cells and endogenous T cells, significantly improved killing of malignant cells and enhanced the expansion of both endogenous T cells and CD19-CAR T cells. In an immunocompetent mouse model of chronic lymphocytic leukemia, relapse after initial treatment response frequently occurred after CD19-CAR T-cell monotherapy. Additional treatment with CD20-BsAbs significantly enhanced the treatment response and led to improved eradication of malignant cells. Higher efficacy was accompanied by improved T-cell expansion with CD20-BsAb administration and led to longer survival with 80% of the mice being cured with no detectable malignant cell population within 8 weeks of therapy initiation. Collectively, our in vitro and in vivo data demonstrate enhanced therapeutic efficacy of CD19-CAR T cells when combined with CD20-BsAbs in B-cell malignancies. Activation and proliferation of both infused CAR T cells and endogenous T cells may contribute to improved disease control.
Advancing LED technology: the FDCSP element’s breakthrough in mini and micro-LED packaging and backlight module enhancement
Authors: Chen Jo-Hsiang , Huang Che-Hsuan , Lee Tzu-Yi , Chen Fang-Chung , Kao Tsung-Sheng , Kuo Hao-Chung
Published: May 2024

In this research, we introduce an advanced methodology for the calculation of bulk light sources tailored for free-form surface design, focusing on the principle of energy conservation. This method is especially relevant for the evolving needs of micro-LED packaging, highlighting its potential in this burgeoning field. Our work includes the development of an algorithm for creating freeform-designed chip-scale package (FDCSP) components. These components seamlessly integrate LEDs and lenses, underscoring our commitment to advancing free-form surface design in chip-level packaging. By adhering to the principle of energy conservation, our approach facilitates a meticulous comparison of simulation outcomes with predefined target functions. This enables the iterative correction of discrepancies, employing layering techniques to refine the design until the simulated results closely align with our goals, as demonstrated by an appropriate difference curve. The practical application of these simulations leads to the innovative design of FDCSP devices. Notably, these devices are not just suitable for traditional applications in backlight modules but are explicitly optimized for the emerging sector of micro-LED packaging. Our successful demonstration of these FDCSP devices within backlight modules represents a significant achievement. It underscores the effectiveness of our design strategy and its expansive potential to transform micro-LED packaging solutions. This research not only contributes to the theoretical understanding of energy conservation in lighting design but also paves the way for groundbreaking applications in micro-LED and backlight module technologies.
Natures instead of nature—plural perceptions and representations of nature and its challenges for ecological transition: a systematic review of the scientific production
Authors: Vidal Diogo Guedes , Alves Fátima , Valentim Cristina Sá , Freitas Helena
Published: May 2024

Background

Recognizing nature and the environment as sociocultural constructions is critical to enhancing a transformational ecological change. This involves understanding their diverse sociocultural meanings and societal approaches and how these understandings affect equitable ecological transitions. We reviewed empirical studies and essays, categorizing 161 studies into three main categories: opposition, domination, and interdependencies, reflecting varying knowledge, power dynamics, cultures, and contexts. These studies aim to uncover how societies conceptualize, explain, and engage with nature and the environment, shaping society–nature relationships and influencing ecological transitions.

Results

This study underscores the diverse perceptions and representations of nature, from a controllable resource to an integrated web of life. Three main categories emerged: (i) nature against society, in a logic of opposition; (ii) nature subordinated to society, in a logic of domination, although integrated into society; and (iii) nature united with society, in a logic of interdependence. Thus, this study advocates discussing “natures” as sociocultural constructs, highlighting the plurality of social perceptions and representations, which can inform policies and challenge socio-political and socio-economic systems.

Conclusions

This review may pave the way to, first, give visibility and value that diversity and plurality as an instrument that can enrich policies and defy socio-political and socio-economic systems to change and, second, identify the main drivers and resistances that the implementation of an ecological transformation change may face in different sociocultural contexts.
A multisite validation of a two hours antibiotic susceptibility flow cytometry assay directly from positive blood cultures
Authors: Pina-Vaz C. , Silva-Dias A. , Martins-Oliveira I. , Gomes R. , Perez-Viso B. , Cruz S. , Rodrigues A. G. , Sarmento A. , Cantón R.
Published: May 2024

Background

Rapid antimicrobial susceptibility testing (AST) is urgently needed to provide safer treatment to counteract antimicrobial resistance. This is critical in septic patients, because resistance increases empiric therapy uncertainty and the risk of a poor outcome. We validate a novel 2h flow cytometry AST assay directly from positive blood cultures (PBC) by using a room temperature stable FASTgramneg and FASTgrampos kits (FASTinov® Porto, Portugal) in three sites: FASTinov (site-1), Hospital Ramon y Cajal, Madrid, Spain (site-2) and Centro Hospitalar S. João, Porto, Portugal (site-3). A total of 670 PBC were included: 333 spiked (site-1) and 337 clinical PBC (151 site-2 and 186 site-3): 367 gram-negative and 303 gram-positive. Manufacturer instructions were followed for sample preparation, panel inoculation, incubation (1h/37ºC) and flow cytometry analysis using CytoFlex (Site-1 and -2) or DxFlex (site-3) both instruments from Beckman-Coulter, USA.

Results

A proprietary software (bioFAST) was used to immediately generate a susceptibility report in less than 2 h. In parallel, samples were processed according to reference AST methods (disk diffusion and/or microdilution) and interpreted with EUCAST and CLSI criteria. Additionally, ten samples were spiked in all sites for inter-laboratory reproducibility. Sensitivity and specificity were >95% for all antimicrobials. Reproducibility was 96.8%/95.0% for FASTgramneg and 95.1%/95.1% for FASTgrampos regarding EUCAST/CLSI criteria, respectively.

Conclusion

FASTinov® kits consistently provide ultra-rapid AST in 2h with high accuracy and reproducibility on both Gram-negative and Gram-positive bacteria. This technology creates a new paradigm in bacterial infection management and holds the potential to significantly impact septic patient outcomes and antimicrobial stewardship.
Predictive value of the neutrophil percentage-to-albumin ratio for coronary atherosclerosis severity in patients with CKD
Authors: Zhao Mengqi , Huang Xin , Zhang Yang , Wang Zuoyan , Zhang Songli , Peng Jianjun
Published: May 2024

Background

The neutrophil percentage-to-albumin ratio (NPAR), which is defined as the percentage of neutrophils divided by the concentration of albumin, is a cost-effective and readily available biomarker of inflammation. This study aimed to evaluate the association between the NPAR and the severity of coronary atherosclerosis in patients with chronic kidney disease (CKD).

Methods

A total of 280 CKD patients who underwent coronary angiography were retrospectively enrolled in this study. The severity of coronary atherosclerosis was evaluated using the Gensini score (GS). Patients were divided into low-, medium- and high-NPAR groups according to the tertiles of the NPAR values. Logistic regression analysis was conducted to analyze the relationship between the NPAR and the GS. The cutoff points for the sensitivity and specificity of the NPAR in predicting the GS were estimated via receiver operating characteristic (ROC) analysis.

Results

There was a higher prevalence of coronary artery disease (CAD) among CKD patients with higher NPARs (P =0.041). More patients in the high-NPAR group had complex CAD (triple-vessel disease and/or left main coronary artery stenosis) and chronic total occlusion lesions, and more of these patients required revascularization therapy (P<0.05). Multivariate logistic regression analysis revealed a significant positive correlation between the NPAR and the severity of coronary stenosis (adjusted OR 2.68, 95% CI 1.25-5.76, p=0.012), particularly among female and older (age ≥65) patients. The ROC analysis indicated that the optimal cutoff value for the NPAR in predicting severe coronary artery stenosis (GS>60) in CKD patients was 1.91 (sensitivity 0.495, specificity 0.749), with an area under the curve (AUC) of 0.650 (95% CI 0.581-0.719, P<0.001). A subgroup analysis according to sex revealed that the NPAR exhibited stronger predictive value in female patients (AUC 0.730, 95% CI 0.643-0.817) than in male patients (AUC 0.565, 95% CI 0.460-0.670) (P<0.001), and the optimal cutoff value for the NPAR in female patients was 1.80 (sensitivity 0.667, specificity 0.705).

Conclusions

Our study demonstrated that the NPAR is independently associated with the severity of coronary atherosclerosis in CKD patients, especially in female and elderly patients (≥65 years old). Moreover, the NPAR can effectively predict the severity of coronary atherosclerosis, exhibiting greater predictive value in females than in males.
Factors associated with intention to implement SBI and SUD treatment: a survey of primary care clinicians in Texas enrolled in an online course
Authors: Kowalchuk Alicia , Ostovar-Kermani Tiffany G. , Schaper Kylie , Grigoryan Larissa , Hirth Jacqueline M. , Mejia Maria Carmenza , Spooner Kiara K. , Zoorob Roger J.
Published: May 2024

Background

Substance use disorder (SUD) presents a range of public health challenges and consequences. Despite the prevention potential of screening and brief intervention (SBI) in the primary care setting, implementation is low. The purpose of this study was to assess associations of primary care clinicians’ knowledge of SBI and SUD treatment, subjective norms, and perceived behavioral control with intention to incorporate SBI and SUD treatment into regular clinical practice.

Methods

This online survey was administered to primary care clinicians who practice in Texas between March 1, 2021, and February 5, 2023. Survey questions were mapped to factors in the Theory of Planned Behavior and included measures of knowledge, subjective norms, and perceived behavioral controls related to SBI and SUD treatment. Intention to engage in SBI and SUD treatment was assessed as the outcome.

Results

Of 645 participants included in this study, 59.5% were physicians. Knowledge was low, with less than half correctly reporting what was considered a standard drink (39.6%) and only 20% knew the correct number of alcoholic beverages considered risky drinking in 21-year-old non-pregnant women. Subjective norms, such as having colleagues within their practice support addressing SUDs, and perceived behavioral control such as having SUD screening routinized within clinic workflows, were positively associated with intention to implement SBI and SUD treatment in primary care settings.

Conclusions

Modifying knowledge gaps, subjective norms, and perceived behavioral control requires a multipronged interventional approach that blends accessible clinician training with systemic workplace enhancements and a collective shift in professional norms.
Clinical and endoscopic characteristics of patients undergoing gastrointestinal endoscopic procedures in Egypt: a nationwide multicenter study
Authors: Elbadry Mohamed , El-Raey Fathiya , Alboraie Mohamed , Abdel-Samiee Mohamed , Abdeltawab Doaa , Ahmed Mohammed Hussien , Sherief Ahmed F , Eliwa Ahmed , Tharwat Mina , Abdelmawgod Amira , Ahmed Ossama Ashraf , Abdelsameea Eman , Mahros Aya , Moussa Abdelmajeed M , Eid Alshaimaa , Raafat Khaled , Yousef Ahmed , Rafea Saad A. S. , Alazzaq Youssef , Mare’y Mohamed , Abdelaziz Ahmed , Ibrahim El Sayed Abouzid , El Dayem Waleed A Abd , Abdelmoati Ahmed A , Tawheed Ahmed , Amer Mohammad , Zaky Samy , El-Kassas Mohamed
Published: May 2024

Background

Egypt faces a significant public health burden due to chronic liver diseases (CLD) and peptic ulcer disease. CLD, primarily caused by Hepatitis C virus (HCV) infection, affects over 2.9% of the population nationwide, with regional variations. Steatotic liver disease is rapidly emerging as a significant contributor to CLD, especially in urban areas. Acid-related disorders are another widespread condition that can significantly impact the quality of life. These factors and others significantly influence the indications and findings of gastrointestinal endoscopic procedures performed in Egypt.

Aim

We aimed to evaluate the clinico-demographic data, indications, and endoscopic findings in Egyptian patients undergoing gastrointestinal endoscopic procedures in various regions of Egypt.

Methods

This study employed a retrospective multicenter cross-sectional design. Data was collected from patients referred for gastrointestinal endoscopy across 15 tertiary gastrointestinal endoscopy units in various governorates throughout Egypt.

Results

5910 patients aged 38–63 were enrolled in the study; 75% underwent esophagogastroduodenoscopy (EGD), while 25% underwent a colonoscopy. In all studied patients, the most frequent indications for EGD were dyspepsia (19.5%), followed by hematemesis (19.06%), and melena (17.07%). The final EGD diagnoses for the recruited patients were portal hypertension-related sequelae (60.3%), followed by acid-related diseases (55%), while 10.44% of patients had a normally apparent endoscopy. Male gender, old age, and the presence of chronic liver diseases were more common in patients from upper than lower Egypt governorates. Hematochezia (38.11%) was the most reported indication for colonoscopy, followed by anemia of unknown origin (25.11%). IBD and hemorrhoids (22.34% and 21.86%, respectively) were the most prevalent diagnoses among studied patients, while normal colonoscopy findings were encountered in 18.21% of them.

Conclusion

This is the largest study describing the situation of endoscopic procedures in Egypt. our study highlights the significant impact of regional variations in disease burden on the utilization and outcomes of GI endoscopy in Egypt. The high prevalence of chronic liver disease is reflected in the EGD findings, while the colonoscopy results suggest a potential need for increased awareness of colorectal diseases.
Progression of macular retinoschisis following intravitreal aflibercept injection for myopic macular neovascularization—a case report and review of literature
Authors: Gopalakrishnan Nikhil , Joshi Aishwarya , Kumar Yadav Naresh , Prabhu Vishma , Bavaskar Snehal , Chhablani Jay , Venkatesh Ramesh
Published: May 2024

Background

Macular retinoschisis (MRS) and myopic macular neovascularization (mMNV) are both potentially blinding complications of high myopia. In this case report, we highlight the progression of MRS after intravitreal anti-vascular endothelial growth factor (anti-VEGF) treatment for mMNV, as well as an extensive review of the literature on this topic.

Case description

A 49-year-old woman presented with two weeks of recent onset blurring and metamorphopsia in her right eye. She had high myopia in both eyes (right eye − 20/60 with − 16D, left eye − 20/20 with − 13D). Slit-lamp ophthalmoscopy found a normal anterior segment in both eyes. On fundus examination, features of pathological myopia with posterior staphyloma and peripapillary atrophy were observed in both eyes. An active mMNV, as well as intraretinal fluid, minimal perifoveal inner and outer MRS, and focal posterior vitreous traction along the inferotemporal retinal arcade, were detected on optical coherence tomography (OCT) of the right eye. The patient received an intravitreal injection of Aflibercept (2 mg/0.05 ml).

Results

OCT scans at two- and four-month follow-up visits revealed regressed mMNV with a taut epiretinal membrane, progressive worsening of outer MRS, and the development of multiple perifoveal retinal detachment inferior to the fovea. Pars plana vitrectomy surgery was performed for the progressive MRS with good anatomical (resolved MRS) and functional outcome (maintained visual acuity at 20/60) at the last one-month post-surgery visit.

Conclusion

Intravitreal anti-VEGF injections for mMNV can cause vitreoretinal interface changes, exacerbating MRS and causing visual deterioration. Vitrectomy for MRS could be one of several treatment options.
Sleep quality mediates the effect of medical social support on depression symptoms in patients with HIV/AIDS
Authors: Chen Ziqi , He Kailian , Chen Yulu , Zhang Xiashuang , Ye Zeyan , Xie Chaofan , Luo Tingyu , Fu Xiaofeng , Shi Wuxiang , Zhang Zhiyong , Cao Liang , Li You
Published: May 2024

Objectives

The purpose of our study is to further understanding of the depression symptoms of HIV/AIDS patients in Guilin, Guangxi via exploring whether there is a mediating effect of sleep quality on medical-social support and depression symptoms and therefore provide a theoretical basis for application of medical-social support to alleviate depression symptoms of HIV/AIDS patients.

Methods

A convenience sampling method was used to select 200 HIV/AIDS patients for the study. Depression symptoms, sleep quality, and medical-social support of the study participants were investigated using The Center for Epidemiological Studies Depression Scale (CES-D), The Pittsburg Sleep Quality Index (PSQI), and The Medical Outcomes Study Social Support Survey (MOS-SSS), respectively. Predictors of depression symptoms were explored by multiple linear regression, and Pearson correlation was used to analyze the relationship between sleep quality, medical-social support, and depression symptoms. Mediating effect analysis was performed by nonparametric Bootstrap test.

Results

In this study, the incidence of depression symptoms was 54.4%. Multiple linear regression analysis showed that leanness (β = 0.161, P = 0.008), obesity (β = 0.186, P = 0.002), sleep quality score > 7 (β = 0.331, P < 0.001), and medical-social support score > 56 (β = -0.247, P < 0.001) could influence depression symptoms of HIV and Pearson’s correlation analysis demonstrated that there was a two-way correlation between sleep quality, medical social support and depression symptoms (P < 0.05). In addition, Bootstrap tests showed that medical-social support might affect depression symptoms not only directly but also indirectly through the mediating effect of sleep quality with the direct and mediating effects accounting for 77.25% and 22.75% of the total effect, respectively.

Conclusion

The prevalence of depression symptoms is high among HIV/AIDS patients in Guilin City. The depressive symptoms of PLWHs(people living with HIV) are related to their sleep quality and medical-social support, and sleep quality partially mediates the relationship between medical-social support and depression symptoms. Therefore, interventions to improve sleep quality and medical-social support have the potential to allay the depression symptoms of HIV/AIDS patients.
Combined anatomical reduction plate for quadrilateral acetabular fractures via a posterior approach: an anatomical–morphological study
Authors: Chongshuai Bao , Xuhang Yan , Li He , Qingshuang Yao , Lin Chen , Jun Ao
Published: May 2024

Objective

To digitally measure the fixation trajectory of anatomical plates used in the combined reduction of quadrilateral acetabular fractures via the posterior approach, and to develop anatomical plates that align with the characteristics of the pelvis in the Chinese population.

Methods

Pelvic computed tomography (CT) data from 102 adult patients were collected at the Affiliated Hospital of Zunyi Medical University. This group included 51 males and 51 females, aged between 20 and 60 years. Using Mimics software (version 21.0), a three-dimensional model of each pelvic data point was reconstructed. The fixation path for the combined reset anatomical steel plate was drawn, where the curves on the fixation path were approximated as arcs. The radius of curvature and length of these curves were measured, and an anatomical steel plate was designed to best fit the pelvic structure.

Results

The combined anatomical reduction plate fixation system for quadrilateral acetabular fractures using a posterior approach consisted of two parts: a locking plate and a reduction plate. The posterior wall region (r2), ischial region (r3), quadrilateral region (r4), and bending region (r5), and the total length of the reduction plate were significantly smaller in females (P < 0.05). Similarly, the posterior wall region (R3), distal posterior wall region (R4), and the total length of the locking plate were significantly smaller in females (P < 0.05). Additionally, the anterior superior iliac spine side (r1) and the total length of the T-shaped auxiliary plate were significantly smaller in females (P < 0.05). The bending angle (< A) was also significantly smaller in females (P < 0.05).

Conclusions

The pelvic surface structure is irregular and varies greatly among individuals.Compared to the traditional steel plate, The combined reduction anatomical plate designed in this study demonstrated high precision and improved conformity to the anatomical structure of the pelvis.
Investigating oral microbiome profiles in patients with cleft lip and palate compared with the healthy control
Authors: Jiang Wenxiu , Yan Zixin , Chen Zhenwei , Gu Lanxin , Bao Han , Cao Ye , Liu Luwei , Yan Bin
Published: May 2024

Background

Patients with cleft lip and palate (CLP) have an oronasal communication differed from the closed state in healthy individuals, leading to a unique oral microbiome. This study aimed to determine if variances in the oral microbiota persist among CLP patients who have received treatments for the closure of these fistulas compared to the microbiota of healthy individuals.

Methods

Saliva samples were collected from a cohort comprising 28 CLP patients (CLP group) and 30 healthy controls (HC group). Utilizing 16S rRNA sequencing on the Illumina NovaSeq platform, we conducted a comprehensive analysis of the diversity and composition of the oral microbiota.

Results

The analysis of the microbiota in the saliva samples revealed a total of 23 microbial phyla, 38 classes, 111 orders, 184 families, 327 genera and 612 species. The alpha diversity with microbial abundance and evenness indicated the significant difference between the CLP and HC groups. Principal coordinate analysis (PCoA) and the ADONIS test further supported the presence of distinct microorganisms between the two groups. The CLP group displayed elevated abundances of Neisseria, Haemophilus, Porphyromonas, and Granulicatella, as indicated by LefSe analysis. Conversely, Rothia, Veillonella, and Pauljensenia exhibited significant reductions in abundance in the CLP group. The results of the PICRUSt analysis indicated significant differences in the relative abundance of 25 KEGG pathways within the CLP group. Through Spearman correlation analysis, strong associations between Rothia, Veillonella, and Pauljensenia and 25 functional pathways linked to CLP were identified.

Conclusion

Findings of this study offer a thorough comprehension of the microbiome profiles of CLP patients after the restoration of oronasal structure and are anticipated to present innovative concepts for the treatment of CLP.
FOXD2-AS1 promotes malignant cell behavior in oral squamous cell carcinoma via the miR-378 g/CRABP2 axis
Authors: Guo Shaoyong , Huang Bixia , You Zhisong , Luo Zhenzhi , Xu Da , Zhang Jieru , Lin Jialin
Published: May 2024

Background

Oral squamous cell cancer (OSCC) is a prevalent malignancy in oral cavity, accounting for nearly 90% of oral malignancies. It ranks sixth among the most common types of cancer worldwide and is responsible for approximately 145,000 deaths each year. It is widely accepted that noncoding RNAs participate cancer development in competitive regulatory interaction, knowing as competing endogenous RNA (ceRNA) network, whereby long non-coding RNA (lncRNA) function as decoys of microRNAs to regulate gene expression. LncRNA FOXD2-AS1 was reported to exert an oncogenic role in OSCC. Nevertheless, the ceRNA network mediated by FOXD2-AS1 was not investigated yet. This study aimed to explore the effect of FOXD2-AS1 on OSCC cell process and the underlying ceRNA mechanism.

Methods

FOXD2-AS1 expression in OSCC cells were determined via reverse transcription and quantitative polymerase chain reaction. Short hairpin RNA targeting FOXD2-AS1 was transfected into OSCC cells to silence FOXD2-AS1 expression. Then, loss-of-function experiments (n = 3 each assay) were performed to measure cell proliferation, apoptosis, migration, and invasion using colony formation, TdT-mediated dUTP Nick-End Labeling, wound healing and Transwell assays, respectively. RNA binding relation was verified by RNA immunoprecipitation and luciferase reporter assays. Rescue experiments were designed to validate whether FOXD2-AS1 affects cell behavior via the gene cellular retinoic acid binding protein 2 (CRABP2). Statistics were processed by GraphPad Prism 6.0 Software and SPSS software.

Results

FOXD2-AS1 was significantly upregulated in Cal27 and SCC9 cells (6.8 and 6.4 folds). In response to FOXD2-AS1 knockout, OSCC cell proliferation, migration and invasion were suppressed (approximately 50% decrease) while OSCC cell apoptosis was enhanced (more than two-fold increase). FOXD2-AS1 interacted with miR-378 g to alter CRABP2 expression. CRABP2 upregulation partly rescued (*p < 0.05, **p < 0.01, ***p < 0.001) the inhibitory impact of FOXD2-AS1 depletion on malignant characteristics of OSCC cells.

Conclusion

FOXD2-AS1 enhances OSCC malignant cell behaviors by interacting with miR-378 g to regulate CRABP2 expression.
What makes an article a must read in medical education?
Authors: Nakhostin-Ansari Amin , Mirabal Susan C. , Mendes Thiago Bosco , Ma Yuxing Emily , Saldanha Neves Horta Lima Carolina , Chapla Kavita , Reynolds Stasia , Oswalt Hannah , Wright Scott M. , Tackett Sean
Published: May 2024

Background

The dissemination of published scholarship is intended to bring new evidence and ideas to a wide audience. However, the increasing number of articles makes it challenging to determine where to focus one’s attention. This study describes factors that may influence decisions to read and recommend a medical education article.

Methods

Authors analyzed data collected from March 2021 through September 2022 during a monthly process to identify “Must Read” articles in medical education. An international team of health sciences educators, learners, and researchers voted on titles and abstracts to advance articles to full text review. Full texts were rated using five criteria: relevance, methodology, readability, originality, and whether it addressed a critical issue in medical education. At an end-of-month meeting, 3–4 articles were chosen by consensus as “Must Read” articles. Analyses were used to explore the associations of article characteristics and ratings with Must Read selection.

Results

Over a period of 19 months, 7487 articles from 856 journals were screened, 207 (2.8%) full texts were evaluated, and 62 (0.8%) were chosen as Must Reads. During screening, 3976 articles (53.1%) received no votes. BMC Medical Education had the largest number of articles at screening (n = 1181, 15.8%). Academic Medicine had the largest number as Must Reads (n = 22, 35.5%). In logistic regressions adjusting for the effect of individual reviewers, all rating criteria were independently associated with selection as a Must Read (p < 0.05), with methodology (OR 1.44 (95%CI = 1.23–1.69) and relevance (OR 1.43 (95%CI = 1.20–1.70)) having the highest odds ratios.

Conclusions

Over half of the published medical education articles did not appeal to a diverse group of potential readers; this represents a missed opportunity to make an impact and potentially wasted effort. Our findings suggest opportunities to enhance value in the production and dissemination of medical education scholarship.
Capability to identify and manage critical conditions: effects of an interprofessional training intervention
Authors: Santesson Ia , Schell Carl Otto , Bjurling-Sjöberg Petronella
Published: May 2024

Background

The burden of critical illness is a global issue. Healthcare systems often fail to provide essential emergency and critical care for deteriorating patients, and the optimal strategy for ensuring safe care is not fully known. This study aimed to explore the capability to identify and manage critical conditions and to evaluate how an interprofessional training intervention that included theory as well as high-fidelity simulation (proACT) in the short and long term affected the capability.

Methods

A questionnaire study was performed. A cross-sectional survey of all in-hospital nurses and physicians in a Swedish region (n538) and a longitudinal cohort of participants entering the proACT course during a six-month period (n99) were included. Descriptive and comparative statistics were generated. Additionally, qualitative content analysis was performed for free text answers.

Results

The findings demonstrated that the intervention improved the individual healthcare professionals’ competence with a sustained effect over time. The coverage of proACT trained staff increased from 13.2% to 26.5%, but no correlation was observed with workplace conditions that support safe care. Collaboration and workplace climate were perceived to be mainly positive, but for safer care, an overall need for improved competence and staffing was emphasized.

Conclusions

The present study confirms previously identified issues and the need for improvements in the care of critically ill patients in general hospital wards. It supports the notion that a training intervention, such as proACT, can increase the capability to identify and manage patients with critical conditions. All healthcare professions increased the competence. Hence, more effort is needed to enable staff of all professions to participate in such training. Studies of interventions cover higher number of trained staff in the setting are warranted to clarify whether the training can also improve workplace conditions that support safe care of deteriorating and critically ill patients.