bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of COVID-19 information, education and communication materials in India: A content analysis
Authors: Biswas Soniya , Hense Sibasis , Kodali Prakash Babu , Thankappan Kavumpurathu Raman 
Published: March 2023

Objective: This study examined the characteristics and quality of publicly available COVID-19 information education and communication (IEC) materials in India between March and December 2020. Design: An explanatory sequential mixed-method design was employed to examine the characteristics and quality of 265 purposefully selected IEC materials. Setting: The IEC materials analysed were those published between March and December 2020 on the Ministry of Health and Family Welfare website, Government of India. Methods: A checklist was utilised to examine the quality and characteristics of the materials. Thereafter, qualitative analysis provided insights into the contents of the materials with specific focus on the ‘COVID-19 continuum of care’. Results: The majority (73.96%, n = 196) of the selected materials were directed towards the general public and had a focus on prevention (67.55 %, n = 179). Despite COVID-19-associated stigma, only 56 (21.13%) of the materials addressed this issue. However, most (95.47%, n = 253) of the materials adhered to quality standards for contents, readability and aesthetics. This qualitative analysis focused on the contents of selected IEC materials using the concept of ‘continuum of care’. The analysis identified three important themes: prevention to early diagnosis and treatment; mitigation of stigma and discrimination surrounding COVID-19; and addressing the infodemic caused by COVID-19. Conclusion: The quality of materials was mostly satisfactory and appropriate to the emergent requirements. Strengthening audience engagement and attractiveness of the materials might enhance readability and actionability. A bottom–up approach to the development of future IEC materials, involving the community might widen the coverage of vulnerable populations in future crisis events.
De-storying Community Narratives: Unimagined Community in Queer Educators’ Small Stories
Authors: Coleman (Josh) James Joshua 
Published: March 2023

Background/Context: Within critical research broadly, scholars increasingly turn to stories and storytelling to pursue equity in educational contexts. Such scholarship does, however, primarily focus on the composition or creation of stories. Expanding the scope of storytelling research, this article turns to queer and trans knowledges to highlight a parallel set of storytelling practices—de-composing practices—and demonstrates their impact on historically marginalized community narratives and the pursuit of equity and justice in the field of education. Purpose/Objective/Research Question or Focus of Study: As critical calls for storying, counter-storytelling, and restorying increase within critical research in education, this article theorizes a parallel literacy practice, de-storying, as part of a set of de-composing practices. Defined as the habitual and often subconscious unimagining of community narratives in alignment with dominant narratives, de-storying shows how certain stories of marginalized communities come to be consistently unimagined. This article focuses particularly on queer community narratives and de-storying’s impact in the form of unimagined ancestors, elders, guardians, and peers. Research Design: A narrative inquiry project, this research study shares data from an inquiry community of nine queer educators. Gathering together 13 times over the course of an academic year, these educators engaged in a structured restorying process and through speculative storytelling reimagined and rewrote narrativized experiences of queerphobia. In particular, small stories demonstrated how de-storying affected these educators’ storytelling practices and, furthermore, revealed that three dominant community narratives (i.e., heteronormativity, queer fatalism, and homonormativity) compressed the potential small stories these educators told. Conclusions/Recommendations: Findings from this project illustrate how de-storying practices resulted in four unimagined community narratives across participants: missing queer ancestors, elders, guardians, and peers. De-storying occurred across various intersections of participants’ identities. Findings from this study advance critical approaches to storytelling by revealing de-storying as one of many potential de-composing practices. This article concludes by inviting the theorization of additional de-composing practices in order to center the most marginalized stories within education—namely, those that are actively unimagined.
Overexpression of complement C5a indicates poor survival and therapeutic response in metastatic renal cell carcinoma
Authors: Yang Changjun , Yang Faying , Chen Xiang , Li Yunpeng , Hu Xiaoyi , Guo Jianming , Yao Jiaxi 
Published: March 2023

Introduction Complement C5a is an important component of the innate immune system. An increasing number of reports have revealed the relevance of C5a in tumor progression; however, its exact role in metastatic renal cell carcinoma (mRCC) remains unknown. Methods We evaluated C5a expression in tumor tissue microarrays of 231 mRCC patients and analyzed the relationship between C5a levels and clinical outcomes, and the expression of epithelial-mesenchymal transition (EMT)-related proteins, programmed cell death protein 1 (PD-1), and programmed cell death-ligand 1 (PD-L1). In-vitro functional experiments using exogenous C5a stimulation and C5a silencing in renal cell carcinoma cells were used to validate the tissue findings. Results High C5a expression was associated with poor therapeutic responses, poor overall and progression-free survival, and high expression of EMT-related proteins and PD-1/PD-L1 in mRCC patients. Exogenous C5a promoted proliferation, migration, and invasion of renal cell carcinoma cells, and induced the expression of EMT-related proteins and PD-1/PD-L1. Conversely, C5a silencing inhibited migration and invasion of renal cell carcinoma cells and decreased the expression of EMT-related proteins and PD-1/PD-L1. Conclusions Our findings indicate that elevated C5a expression is associated with poor outcomes in patients with mRCC, and this effect may be partly attributed to the ability of C5a to promote EMT and PD-1/PD-L1 expression. C5a may be a potential novel target for the treatment of mRCC.
Patient-Centred Outcomes Following Tracheostomy in Critical Care
Authors: Mc Mahon A. , Griffin S. , Gorman Emma , Lennon Aoife , Kielthy Stephen , Flannery Andrea , Cherian Bindu Sam , Josy Minu , Marsh B. 
Published: March 2023

Introduction Around 20% of intensive care unit (ICU) patients undergo tracheostomy insertion and expect high-quality care concentrating on patient-centered outcomes including communication, oral intake, and mobilization. The majority of data has focused on timing, mortality, and resource utilization, with a paucity of information on quality of life following tracheostomy. Methods Single center retrospective study including all patients requiring tracheostomy from 2017 to 2019. Information collected on demographics, severity of illness, ICU and hospital length of stay (LOS), ICU and hospital mortality, discharge disposition, sedation, time to vocalization, swallow and mobilization. Outcomes were compared for early versus late tracheostomy (early = <day 10) and age category (≤ 65 vs ≥ 66 years). Results In total, 304 patients were included and 71% male, median age 59, APACHE II score 17. Median ICU and hospital LOS 16 and 56 days, respectively. ICU and hospital mortality 9.9% and 22.4%. Median time to tracheostomy 8 days, 8.55% open. Following tracheostomy, median days of sedation was 0, time to noninvasive ventilation (NIV) 1 day (94% of patients achieving this), ventilator-free breathing (VFB) 5 days (72%), speaking valve 7 days (60%), dynamic sitting 5 days (64%), and swallow assessment 16 days (73%). Early tracheostomy was associated with shorter ICU LOS (13 vs 26 days, P < .0001), reduced sedation (6 vs 12 days, P < .0001), faster transition to level 2 care (6 vs 10 days, P < .003), NIV (1 vs 2 days, P < .003), and VFB (4 vs 7 days, P < .005). Older patients received less sedation, had higher APACHE II scores and mortality (36.1%) and 18.5% were discharged home. Median time to VFB was 6 days (63.9%), speaking valve 7 days (64.7%), swallow assessment 20.5 days (66.7%), and dynamic sitting 5 days (62.2%). Conclusion Patient-centered outcomes are a worthy goal to consider when selecting patients for tracheostomy in addition to mortality or timing alone, including in older patients.
Characteristics of Extranodal NK/T-Cell Lymphoma, Nasal Type, Compared with Nasal Diffuse Large B-cell Lymphoma
Authors: Tanaka Hirotaka , Mori Eri , Akutsu Taisuke , Saito Shota , Tei Masayoshi , Otori Nobuyoshi 
Published: March 2023

Background: Extranodal NK/T-cell lymphoma, nasal type (ENKL), is an aggressive tumour with poor prognosis. Its early diagnosis may improve the prognosis of patients; however, it is often overlooked in many cases and misdiagnosed as an inflammatory sinus disease during its initial stage. Identifying the clinical characteristics of ENKL may aid otorhinolaryngologists in indicating cases early for a pathologic examination. In this study, we aimed to investigate the clinical characteristics of ENKL compared with that of diffuse large B-cell lymphoma (DLBCL), which is the most common nasal malignant lymphoma. Methods: The backgrounds, clinical symptoms, blood test results, and computed tomography images of patients with nasal/paranasal malignant lymphoma in our hospital between 2012 and 2017 were investigated. The characteristics of ENKL and nasal DLBCL were compared to differentiate them. Results: A total of 27 patients with nasal cavity and/or paranasal sinus lymphoma were included. Extranodal NK/T-cell lymphoma, nasal type, was diagnosed in 10 patients, while DLBCL was diagnosed in 17 patients. The median age of patients with ENKL was significantly lower than that of patients with DLBCL. All patients with ENKL had a unilateral lesion in the nasal cavity, with most located at the inferior turbinate. They also experienced nasal symptoms with significantly higher incidence of nasal obstruction and tendency of bleeding. Conclusion: ENKL was often unilateral and caused nasal obstruction, unlike DLBCL. Those who are younger in age and have sinonasal tumour with unilateral nasal obstruction and bleeding should be considered for early and repeated biopsies at multiple sites, with ENKL taken into consideration.
Government interventions and control policies to contain the first COVID-19 outbreak: An analysis of evidence
Authors: Fernández Daniel , Giné-Vázquez Iago , Morena Marianthi , Koyanagi AI , Janko Mark M. , Haro Josep Maria , Panagiotakos Demosthenes , Molassiotis Alex , Pan William K. , Tyrovolas Stefanos 
Published: March 2023

Background: The overarching aim of this study was to evaluate the effectiveness over time of government interventions and policy restrictions and the impact of determinants on spread and mortality during the first-wave of the COVID-19 pandemic, globally, regionally and by country-income level, up to 18 May 2020. Methods: We created a global database merging World Health Organization daily case reports (from 218 countries/territories) with other socio-demographic and population health measures from 21 January to 18 May 2020. A four-level government policy interventions score (low to very high) was created based on the Oxford Stringency Index. Results: Our results support the use of very high government interventions to suppress both COVID-19 spread and mortality effectively during wave one globally compared to other policy levels of control. Similar trends in virus propagation and mortality were observed in all country-income levels and specific regions. Conclusions: Rapid implementation of government interventions was needed to contain the first wave of the COVID-19 outbreak and to reduce COVID-19-related mortality.
Inhalation and deposition of gas–droplet contaminant in the human microenvironment in an industrial building
Authors: Yang Yang , Zhu Ningbin , Wang Yi , Wei Yingrong 
Published: March 2023

Gas–droplet contaminants such as HCl gas and hydrochloric droplets are typical pollutants in industrial indoor environments. They are harmful to workers. As the transportation modes of the gas and droplet phases are different, they cause different exposure characteristics for human beings. This study numerically investigated the transport of HCl gas and hydrochloric droplets emitted from a pickling tank to a human microenvironment. Meanwhile, inhalation and deposition of hydrochloric acid gas and hydrochloric acid droplets by humans were also studied, which were influenced by the droplet initial diameter (10–100 μm), air draught (0.1–0.5 m/s) and the distance between the source and the manikin (0.5–1.5 m). The results showed that the cases considering an initial droplet diameter of 50 μm could cause the largest droplet deposition on the manikin, which was influenced by the combination of droplet gravity and plume. The velocity of the air draught could significantly enhance the inhalation of HCl gas and droplet deposition on the manikin when the velocity was ≥ 0.3 m/s. Furthermore, when the distance was increased from 1.0 to 1.5 m, the thermal plume enhanced the inhalation of HCl gas.
Customizing foam sclerotherapy of the great saphenous vein: A proposed algorithm to enhance technical efficacy
Authors: Georgakarakos Efstratios , Dimitriadis Konstantinos , Tasopoulou Kalliopi-Maria , Doukas Damianos , Argyriou Christos , Georgiadis George S 
Published: March 2023

Objectives The catheter-directed foam sclerotherapy (FS) and the suggested perivenous tumescent application for great saphenous vein (GSV) diameter reduction are suggested to improve technical and clinical results; yet, their use is reported rather indiscriminately. Our aim is to introduce an algorithm categorising the use of technical modalities accompanying ultrasound-guided FS of the GSV and present the technical efficacy of FS through a 5 F × 11 cm sheath placed at the knee level. Methods Representative cases of GSV insufficiency were chosen to describe our methodology. Results Sole sheath-directed FS can achieve complete GSV occlusion proximally at a level comparable to the catheter-directed technique. We apply perivenous 4°C cold tumescent to GSV >6 mm even in the standing position to ensure diameter reduction of the proximal GSV as close to the saphenofemoral junction. We use long catheters only to overcome large varicosities above the knee level that could otherwise compromise the adequate foam infusion from the sheath tip. When GSV insufficiency extends along the entire limb and severe skin lesions preclude the antegrade distal catheterisation, the sheath-directed FS in the thigh can be concomitantly combined with retrograde FS from catheterisation just below the knee. Conclusions A topology-oriented methodology with sheath-directed FS is technically feasible and avoids indiscriminate use of more complex modalities.
Amputation and advance care plans: An observational study exploring decision making and long-term outcomes in a vascular centre
Authors: Grange Robert , Carter Ben , Chamberlain Charlotte , Brooks Marcus , Nitharsan Ramya , Twine Christopher , Braude Philip 
Published: March 2023

Background Half of those undergoing major lower limb amputation for peripheral arterial disease die within 1 year. Advance care planning reduces days in hospital and increases the chance of dying in a preferred place. Aim To investigate the prevalence and content of advance care planning for people having a lower limb amputation due to acute or chronic limb-threatening ischaemia or diabetes. Secondary aims were to explore its association with mortality, and length of hospital stay. Design A retrospective observational cohort study. The intervention was advance care planning. Setting/participants Patients admitted to the South West England Major Arterial Centre between 1 January 2019 and 1 January 2021 who received unilateral or bilateral below, above, or through knee amputation due to acute or chronic limb-threatening ischaemia or diabetes. Results 116 patients were included in the study. 20.7% ( n = 24) died within 1 year. 40.5% ( n = 47) had an advance care planning discussion of which all included cardiopulmonary resuscitation decisions with few exploring other options. Patients who were more likely to have advance care planning discussions were ≥75 years (aOR = 5.58, 95%CI 1.56–20.0), female (aOR = 3.24, 95%CI 1.21–8.69), and had multimorbidity (Charlson Comorbidity Index ≥5, aOR = 2.97, 95%CI 1.11–7.92). Discussions occurred more often in the emergency pathway and were predominantly initiated by physicians. Advance care planning was associated with increased mortality (aHR = 2.63, 95%CI 1.01, 5.02) and longer hospital stay (aHR = 0.52, 95%CI 0.32–0.83). Conclusions Despite a high risk of death for all patients in the months following amputation, advance care planning occurred in fewer than half of people and mostly focused on resuscitation.
Generic drugs use during the COVID-19 pandemic among Lebanese patients using psychotropics: An opportunity for generic drug promotion
Authors: Hatem Georges , Ankouni Ali , Salhab Sethrida , Kteich Walaa , Awada Sanaa 
Published: March 2023

Introduction The Coronavirus disease of 2019 (COVID-19) pandemic has imposed several challenges leading to the shortage of medications due to the disruption of their supply chains. Among others, patients using psychotropics encountered difficulties finding their medication despite the efforts of investing in local production. Encouraging patients to use generic drugs can be an effective strategy to ensure sustainable access to medication. Objectives This study aimed to describe the consumption of psychotropic medications during the COVID-19 pandemic and the willingness together with the reasons for using generic drugs. It also assessed the association between generic drugs and the general characteristics of the patients. Design A cross-sectional study was performed over a period of 4 months (July–October 2021) targeting 128 patients using psychotropic drugs. Results The sample included more women than men with a mean age of 38 years. Antidepressants were the psychotropic medications mostly consumed followed by anti-anxiety medications. Almost 13% of the patients started using psychotropics either through self-prescription or a friend’s advice and 73.4% used generic drugs. Fear of dependence, unavailability of the brand drug, and pharmacist’s recommendation were the main reported reasons for using generic drugs. Conclusion During the COVID-19 pandemic, the consumption of psychotropics increased due to new prescriptions and self-medication. No differences were noted between using generics and the characteristics of the patients in contrast to previous studies which support the implementation of generic prescription and substitution policies.
Collision metastasis from prostate adenocarcinoma and pancreatic ductal adenocarcinoma to a lung nodule
Authors: Mohamed Ahmed , Yao Mark , Saw Sonia , Clark Amanda , Madaan Sanjeev 
Published: March 2023

Introduction Prostate cancer and pancreatic cancer are often complex pathologies that affect millions of patients worldwide. However, the incidence of a distant collision metastasis of both malignancies remains a rare and often poorly documented incidence. Case presentation A 75-year-old male patient with past history of prostate cancer on maximal androgen blockade was recently diagnosed with pancreatic cancer for which he underwent radical surgical resection of pancreas with curative intent. A metastatic lung nodule was noted on surveillance CT imaging and, subsequently, biopsied. A diagnosis of collision metastasis from two distinct primary malignancies was histopathologically confirmed following immunohistochemical evaluation. Conclusion We report the first case of collision metastasis of prostate and pancreatic adenocarcinomata to a lung nodule to the best of our knowledge.
Do Preoperative Supine Radiographs Predict Postoperative Residual Lumbar Curvatures in Adolescent Idiopathic Scoliosis? A Retrospective Cohort Study
Authors: Rajan Prashant V. , Steiner Richard , Ritzman Todd F. , Moberly Trey , Floccari Lorena V. 
Published: March 2023

Study Design Retrospective comparative study. Objectives This study compares supine vs bending flexibility radiographs and evaluates their ability to predict residual postoperative lumbar curvature after selective thoracic fusion for Lenke 1 and 2 curves across different lumbar modifiers (A, B, and C) in adolescent idiopathic scoliosis (AIS). Methods This was a retrospective review of AIS Lenke 1 and 2 patients who underwent posterior fusion. All patients had preoperative flexibility radiographs including side-bending and supine posteroanterior (PA) films, in addition to pre- and post-operative standing PA and lateral radiographs. We used SurgiMap 2.0 software for all radiographic measurements. Pearson correlations and linear regression models were developed in SAS. Results A total of 86 patients were included mean age 14.9 years and follow-up 72.3 months. Preoperative supine lumbar Cobb angle and preoperative side-bending Cobb angles had similar, positive correlations with postoperative lumbar Cobb angle, r = .55 ( P < .001) and r = .54 ( P < .001), respectively. Three regression models were built to predict postoperative lumbar Cobb angles from preoperative information: Model S (R2 = .39) uses preoperative supine lumbar curve; Model B (R2 = .44) uses preoperative side-bending lumbar curve; Model SB (R2 = .49) uses both preoperative supine and side-bending lumbar curves. Model S and B performed just as well as Model SB. Conclusion Either supine or side-bending radiographs alone may be used to estimate mean residual postoperative lumbar curvature after selective posterior thoracic fusion, but little is to be gained by taking both supine and side-bending radiographs.