bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biomarkers predicting central serous chorioretinopathy episode persistence
Authors: Kiraly Peter , Smrekar Jaka , Jaki Mekjavić Polona 
Published: November 2022

Purpose The purpose of this study was to identify biomarkers at presentation that are associated with a persistent central serous chorioretinopathy (CSC) episode. Methods The prospective study included 35 patients with an acute CSC episode. Potential clinical and imaging biomarkers were evaluated at baseline and 3 months from the episode onset. As biomarkers age, sex, steroid use, episode recurrence, central retinal thickness (CRT), macular volume (MV), choroidal thickness (CT), pigment epithelial detachment (PED) height, and width, number of retinal hyperreflective foci (HF), leakage pattern, and area of retinal pigment epithelial (RPE) alterations were investigated. Results At 3 months from the CSC episode onset, spontaneous resolution occurred in 19 patients, while 16 patients had a persistent CSC episode. The group of patients with a persistent episode was statistically significantly associated with female sex (p = 0.032), older age (p = 0.015), wider PED (p = 0.005), and higher number of HF (p = 0.02). Moreover, this group of patients had a significant association with thinner choroid and diffuse RPE alterations as a pair (p = 0.008). Conclusions Older and female CSC patients with wider PED, increased number of HF, thinner choroid, and diffuse RPE alterations at presentation are inclined to episode persistence and could benefit from earlier treatment.
Imaging vitreous cortex hyalocyte response to paracentral acute middle maculopathy (PAMM) using En Face OCT
Authors: Otero-Marquez Oscar , Ahsanuddin Sofia , Spellman Lily , Pinhas Alexander , Chui Toco YP , Rosen Richard B 
Published: November 2022

Introduction Vitreous cortex hyalocytes (VCH) are resident macrophage cells that provide immunosurveillance, respond to tissue injury and inflammation, and help maintain the transparency of the media. In this case report we demonstrate the use of en face optical coherence tomography (OCT) to image VCH in vivo in a patient presenting with PAMM secondary to antiphospholipid syndrome. Case description A 38-year-old female with no known medical history presented with complaints of visual disturbances in the right eye. OCT revealed hyperreflective bands in the IPL and INL nasal to the fovea. A diagnosis of PAMM was made. Work-up revealed elevated titers of antiphospholipid antibodies. En face OCT revealed a decline in the inflammatory activation over a seven-month period as evidenced by changes in VCH distribution and morphology. Conclusions Our findings suggest that monitoring changes in the distribution and morphology of VCH could have a potential clinical utility for assessing disease severity, predicting recovery, and early recognition of treatment response in various inflammatory ocular pathologies such as PAMM.
CT is unreliable in locoregional staging of early colon cancer: A nationwide registry-based study
Authors: Wetterholm Erik , Rosén Roberto , Rahman Milladur , Rönnow Carl-Fredrik 
Published: November 2022

Background and objective: The option to treat early colon cancer (CC) with local resection, as well as trials investigating neoadjuvant treatment, has increased the importance of identifying early-stage disease in the workup. Most CC patients are T- and N-staged preoperatively with CT, although its reliability in staging early CC remains elusive. The aim of this study was to investigate CT-staging accuracy in early CC by evaluating pT and pN stages in patients staged as cT1-2, and cT and cN stages in patients with pT1 tumors. Methods: Retrospective population-based cohort study on data from the nationwide Swedish colorectal cancer registry on all CC patients staged as cT1-2 and all patients with pT1 undergoing surgical resection 2009–2018. CT-acquired T- and N-stages were compared with final histopathology. Factors potentially influencing accuracy were analyzed with uni- and multivariate logistic regression. Results: Computed tomography (CT) staged 4849 patients as cT1-2, whereas 2445 (50%) were pT3 and 453 (9%) pT4. Positive predictive value of the cT1-2 stage was 40%. Of 1401 pT1 patients, 624 (45%) were staged as cT1-2, 139 (10%) as cT3, 15 (1%) as cT4 and 623 (44%) as cTx. In all, 1474 (30%) of the cT1-2 patients were pN+, whereas CT staged 1062 (72%) as cN0. A total of 771 patients were staged as cN+, whereas 403 (52%) were pN0. Overall accuracy in determining N+ was 67%, with 26% sensitivity and 88% specificity. Positive and negative predictive values in determining N+ were 48% and 73%, respectively. Conclusions: This nationwide population-based study shows that CT-staging carries a substantial risk of understaging locally advanced tumors as cT1-2 and pT1 tumors as cTx, in addition to poor N-staging. Thus, CT obtained T- and N-staging should not be used for deciding treatment strategies in early CC.
Developing Leaders Using On-Line Action Learning: An Activity Theory Analysis
Authors: Willocks Katie 
Published: November 2022

The Problem. There is an urgent need for leadership development in today’s turbulent, organizational context. Methods that support leadership development in collaborative and peer settings as well as spaces and environments where leaders can develop, learn and grow through their collaborative interactions are critical. The Solution. This article explores how an online action learning set established as part of a large-scale management and leadership development intervention provides a space where leadership learning can flourish. The article draws on a theory of practice known as Cultural Historical Activity Theory to identify the micro level details of what occurs when leaders work with others in an online action learning set. The Stakeholders. Human resource development (HRD) researchers, scholars, organizational leaders, practitioners and others interested in contributing to HRD theory.
UV protection properties of workwear fabric coated with metal-organic frameworks
Authors: Rabiei Hadiseh , Montazer Majid , Khaloo Shokooh Sadat , Helmi Kohanehshari Mehrdad , Farhang Dehghan Somayeh 
Published: November 2022

The main purpose of this study was to evaluate the ultraviolet protective factor (UPF) of fabrics coated with titanium-based metal-organic framework (MOFs) (NH2-MIL-125(Ti)) made using an In-situ synthesis method and more accurately assess the intrinsic properties of the fabric. The cotton-polyester twill fabric (70-30%) (246.67 g/m2) was coated. In-situ coating conducted in 4 steps washing the fabrics, preparation of MOFs, injecting the MOFs to fabrics, and drying the fabric after coating. The scanning electron microscope (SEM), FTIR spectrometer, dynamic light scattering (DLS) and UV-Vis spectrophotometer were used to analyses the data of coating and UPF results. Also, four standards such as ASTM D737, ISIRI 8332, ISIRI 4199, and ISIRI 567 were used for analyzing the intrinsic properties of the fabric. The results of SEM and DLS altogether confirmed the in-situ formation of MOFs onto the fabric fibers. Moreover, the UPF value of the uncoated and coated fabrics was 3.67 and 315.73, respectively. It was showed that the in-situ deposition of NH2-MIL-125(Ti) on fabric can provide adequate protection against UVR. Also, the results of analyzing the intrinsic properties of the fabric showed that there was no significant difference in the intrinsic properties between the coated and uncoated fabrics. Based on the results, it can be concluded that the UV protective property of workwear fabrics can be improved by coating NH2-MIL-125(Ti) on them without any effect on the cooling effect of perspiration evaporation.
The Willingness to Help People With Dementia Symptoms Among Four Occupation Practitioners in Macao
Authors: Che Sok Leng , Wu Jianwei , Chuang Yao-Chen , Van Iat Kio , Leong Sok Man 
Published: November 2022

Background Dementia-friendly community has been promoted in Macao since 2016. There is no study investigating the understanding of nor attitudes towards dementia among public contact staff in Macao. This study aimed to (i) understand the level of knowledge of dementia, (ii) examine the attitudes towards people living with dementia, and (iii) explore the associated factors of the willingness to help people with dementia symptoms among police officers, bank officers, bus drivers, and building superintendents. Methods A cross-sectional survey was conducted between January and May 2019 using a structured questionnaire. Results A total of 351 valid questionnaires were received. Building superintendents had more knowledge while police officers and bank officers had more positive attitudes. All practitioners were more willing to help people with dementia symptoms when they were on official duty. Participants who had more knowledge about dementia were associated with a higher willingness to help people with dementia symptoms.
Autistic women’s diagnostic experiences: Interactions with identity and impacts on well-being
Authors: Harmens Miriam , Sedgewick Felicity , Hobson Hannah 
Published: November 2022

Objective: There has been suggestion that current diagnostic instruments are not sufficient for detecting and diagnosing autism in women, and research suggests that a lack of diagnosis could negatively impact autistic women’s well-being and identity. This study aimed to explore the well-being and identity of autistic women at three points of their diagnostic journey: self-identifying or awaiting assessment, currently undergoing assessment or recently diagnosed, and more than a year post-diagnosis. Methods: Mixed-methods were used to explore this with 96 women who identified as autistic and within one of these three groups. Participants completed an online questionnaire, and a sub-sample of 24 of these women participated in a semi-structured interview. Results: Well-being was found to differ significantly across groups in three domains: satisfaction with health, psychological health, and environmental health. Validation was found to be a central issue for all autistic women, which impacted their diagnosis, identity, and well-being. The subthemes of don’t forget I’m autistic; what now?; having to be the professional; and no one saw me were also identified. Conclusion: These results suggest that autistic women’s well-being and identity differ in relation to their position on the diagnostic journey in a non-linear manner. We suggest that training on the presentation of autism in women for primary and secondary healthcare professionals, along with improved diagnostic and support pathways for autistic adult women could go some way to support well-being.
Design and Usability of an Avatar-Based Learning Program to Support Diabetes Education: Quality Improvement Study in Colombia
Authors: Bishop Emma , Allington Daisy , Ringrose Tim , Martin Clare , Aldea Arantza , García-Jaramillo Maira , León-Vargas Fabian , Leal Yenny , Henao Diana , Gómez Ana Maria 
Published: November 2022

Background: This quality improvement study, entitled Avatar-Based LEarning for Diabetes Optimal Control (ABLEDOC), explored the feasibility of delivering an educational program to people with diabetes in Colombia. The aim was to discover how this approach could be used to improve awareness and understanding of the condition, the effects of treatment, and strategies for effective management of blood-glucose control. Methods: Individuals with diabetes were recruited by Colombian endocrinologists to a human-centered study to codesign the educational program, using the Double Diamond model. Participants contributed to two phases. The first phase focused on gathering unmet educational needs and choice of curriculum. Three prototypes were developed as a result. During phase 2, a different group of participants engaged with the program for several weeks, before reporting back. Results: Thirty-six participants completed a Web survey during phase 1, and five were also interviewed by telephone. The majority (33 of 36; 91%) were receptive to the prospect of educational interventions and ranked the chosen topic of hypoglycemia highly. In phase 2, the three prototypes were tested by 17 participants, 10 of whom also gave feedback in focus groups. The response was overwhelmingly positive, with 16 of 17 (94%) stating they would use a program like this again. The 3D version was the most highly rated. Conclusions: Immersive, avatar-based programs, delivered through smartphone, have the potential to deliver educational information that is trusted, engaging, and useful. Future work includes expansion of the curriculum, evaluation with a larger group, and exploration of the prospective role of artificial intelligence in personalizing this form of educational intervention.
The Effect of Different Frequencies of Pulsed Electromagnetic Fields on Cartilage Repair of Adipose Mesenchymal Stem Cell–Derived Exosomes in Osteoarthritis
Authors: Xu Yang , Wang Qian , Wang Xiang-Xiu , Xiang Xiao-Na , Peng Jia-Lei , He Cheng-Qi , He Hong-Chen 
Published: November 2022

Background The intra-articular injection of mesenchymal stem cell (MSC)-derived exosomes has already been proved to reverse osteoarthritic cartilage degeneration. Pulsed electromagnetic field (PEMF) has been found to regulate the biogenic function of MSCs. However, the effect of PEMF on MSC-derived exosomes has not yet been characterized. The aim of this study was to elucidate the regulatory role of different frequencies of PEMF in promoting the osteoarthritic cartilage regeneration of MSC-derived exosomes. Methods The adipose tissue–derived MSCs (AMSCs) were extracted from the epididymal fat of healthy rats and further exposed to the PEMF at 1 mT amplitude and a frequency of 15, 45, and 75 Hz, respectively, in an incubator. The chondrocytes were treated with interlukin-1β (IL-1β) and the regenerative effect of co-culturing with PEMF-exposed AMSC-derived exosomes was assessed via Western blot, quantitative polymerase chain reaction, and ELISA assays. A rat model of osteoarthritis was established by anterior cruciate ligament transection (ACLT) surgery and received 4 times intra-articular injection of PEMF-exposed AMSC-derived exosomes once a week. After 8 weeks, the knee joint specimens of rats were collected for micro–computed tomography and histologic analyses. Results PEMF-exposed AMSC-derived exosomes could be endocytosed with IL-1β-induced chondrocytes. Compared with the AMSC-derived exosomes alone, the PEMF-exposed AMSC-derived exosomes substantially suppressed the inflammation and extracellular matrix degeneration of IL-1β-induced chondrocytes as shown by higher expression of transcripts and proteins of COL2A1, SOX9, and ACAN and lower expression of MMP13 and caspase-1. Of these, the 75-Hz PEMF presented a more significant inhibitive effect than the 15-Hz and 45-Hz PEMFs. Furthermore, the intra-articular injection of 75-Hz PEMF-exposed exosomes could obviously increase the number of tibial epiphyseal trabeculae, lead to a remarkable decrease in Osteoarthritis Research Society International score, and upregulate the COL2A1 and ACAN protein level of the degenerated cartilage. Conclusion The present study demonstrated that PEMF stimulation could effectively promote the regeneration effects of AMSC-derived exosomes on osteoarthritic cartilage. Compared with other frequency parameters, the PEMF at a frequency of 75 Hz showed a superior positive effect on AMSC-derived exosomes in suppressing the IL-1β-induced chondrocyte inflammation and extracellular matrix catabolism, as well as the osteoarthritic cartilage degeneration.
Shall we start? Ready, set, go! Toward early intervention in infants with unilateral cerebral palsy. A randomized clinical trial protocol
Authors: Palomo-Carrión Rocío , Pinero-Pinto Elena , Romay-Barrero Helena , Escobio-Prieto Isabel , Lillo-Navarro Carmen , Romero-Galisteo Rita-Pilar 
Published: November 2022

Background: It is crucial to start an early intervention in unilateral cerebral palsy. Intensive therapies are focused on training based on activities. Objective: The objective of the study was to study the changes in the bimanual functional performance (BFP) after early intensive therapies at home compared with standard care in children with unilateral cerebral palsy from 9 to 18 months of age. Design: A single-blind comparative effectiveness study will be conducted. Methods and Analysis: Children will be randomized into four groups: infant-mCIMT, infant-BIT, infant-hybrid, and infant standard therapy (control group, CG). Each early intensive protocol will last 50 h and will be applied throughout a 10-week period with the family involvement at home. The main outcomes are BFP measure with mini-Assisting Hand Assessment (mini-AHA) scale, functional goals measure with Goal Attainment Scale (GAS), and satisfaction and expectations on intensive therapy from parents measure through specific questionnaire. Baseline characteristics between groups will be compared using independent t test and Fisher’s exact test. Pre- and post-treatment outcomes of standard assessments will be compared using analysis of variance (ANOVA) for parametric and Kruskal–Wallis test for non-parametric variables. The Bonferroni correction is applied for multiple comparisons. An alpha level of p ⩽ 0.05 is considered significant. Discussion: In relation to other studies that have analyzed intensive therapies, although with fewer intervention groups, it seems that the application of any of the intensive interventions is effective with the applied dose to obtain changes in BFP and increase the spontaneous use of the affected upper limb. Registration: ClinicalTrials.gov Identifier: NCT04642872
Community-Based HIV and Viral Hepatitis Fellowship Evaluation: Results from a Qualitative Study
Authors: Bolduc Philip , Day Philip G. , Behl-Chadha Bittie , Karapanos Melissa , Carson-Sasso Vanessa , Simpson E. Hatheway , Hebert Scott 
Published: November 2022

Purpose: The UMass Chan Medical School/New England AIDS Education and Training Center Community-Based HIV and Viral Hepatitis Fellowship was launched in 2014 to train physicians and nurse practitioners to become experts in outpatient management of HIV, hepatitis B and C, and latent tuberculosis. The purpose of this study was to identify areas of strength and improvement and understand fellows’ perceptions of the program and its impact on their current positions and career trajectories. Methods: Qualitative study utilizing a semi-structured interview guide with (11) fellowship graduates (8 MDs; 3 NPs). 45 to 60 min interviews were conducted in April and May 2021, recorded and transcribed. Transcripts were analyzed for representative themes and general patterns in the data. Results: Results indicate high satisfaction with the fellowship, which left a positive and indelible impact on their careers and patient care. Fellows highlighted the program’s commitment to health equity, its role in transforming them into leaders and advocates for HIV in primary care, and their ability to balance their work and training demands with their personal lives and needs. The fellowship motivated them to become more involved in public health initiatives, serve marginalized communities and reduce their health disparities. They expressed confidence in their ability to independently manage outpatient HIV, viral hepatitis B and C, and latent tuberculosis, and found areas of overlap with their work in primary care. Conclusion: As the care of people with HIV becomes more commonplace in primary care clinics, it is imperative that primary care providers receive the necessary training and education to meet this need. Our study of 11 former fellows shows that the Community-Based HIV and Viral Hepatitis Fellowship offers such training, spreads it to other institutions, and can be a model for other programs nationwide.
Surgical Options for Chronic Lateral Ankle Instability: How Has the Incidence of the Broström-Gould Procedure Evolved in the Past Decade?
Authors: Karzon Anthony L. , Bariteau Jason T. , Coleman Michelle M. , Kadakia Rishin J. , Jacobson Joseph E. , Labib Sameh (Sam) A. 
Published: November 2022

Category: Ankle; Trauma Introduction/Purpose: The past 50 years has seen significant development of surgical techniques aimed at treating chronic lateral ankle instability. Surgical procedures currently being performed can be classified as anatomic ligament reconstruction as well as nonanatomic, and more recently, anatomic repair by tenodesis. Anatomic reconstruction is successful at circumventing important shortcomings associated with nonanatomic repair such as impaired ankle kinematics and biomechanics. One variation of the anatomic repairs described in orthopedic literature demonstrating excellent long-term functional outcomes includes the Broström-Gould (BG) modification. However, there is no detailed depiction of the procedural incidence in recent years. We hypothesize that the incidence of this surgical technique has risen in the past decade. Methods: The Truven MarketScan database was queried to identify patients who underwent a BG procedure from January 2009 to December 2019 based on CPT coding. Population estimates from the US Census Bureau were used to calculate the annual incidence of the BG procedure. Volume and incidence were estimated for annual sums, gender, age subgroups, and four statistical geographical regions of the U.S. Results: In total, 160,457 BG procedures were identified in the database from 2009 to 2019. Annual volumes have increased by 89.9%, from 10,441 to 19,829 total procedures nationwide. Procedural incidence reported per 1,000,000 people increased by 76.6%, at 61.1 in 2019. Increased incidence was demonstrated in males and females ≤65 years, with the highest annual incidence found <55 years of age. Incidence stratified by region rose in the South, West, and Midwest regions of the United States by 81.7%, 75.4%, and 69.2%, respectively. Conclusion: The epidemiology of operative treatment for chronic lateral ankle instability has yet to be clarified in recent years. Our findings demonstrate that the annual volumes and incidence of the BG procedure has increased in the past 11 years. Growth in incidence was found in both sexes below the age of 65 years whereby the greatest annual incidence was found in ages below 55 years. Incidence significantly rose in all regions of the United States except for the Northeast. The insight provided by epidemiologic studies allows orthopedic surgeons to better adapt their practice to the current trends in the field.