Browse Articles

Debating Race and the Diagnosis of Anemia — How Medicine Moved Away from Race-Based Standards

Retraction: Receptor-Recognized α2-Macroglobulin Binds to Cell Surface-Associated GRP78 and Activates mTORC1 and mTORC2 Signaling in Prostate Cancer Cells

Aspiration Thrombectomy for Coronary Stent Thrombosis

Clinical and economic burden of surgical site infections following selected surgeries in France

In France, surgical site infections (SSIs) are the second most frequent hospital-acquired infection. The study aimed to estimate the in-hospital clinical and economic burden of SSIs following 4 groups of surgeries. This retrospective observational study was based on the exhaustive national hospital database (PMSI. Adults with ≥1 digestive (colorectal or appendectomy), gynaecologic/obstetric (caesarean section, hysterectomy, or breast), cardiac (artery bypass or aortic valve replacement), or orthopaedic (hip or knee) surgery between 01-01-2019 and 30-11-2020 were included in the study. Patients with SSI were matched with patients without SSI. Patients were followed-up for 30 days except orthopaedic patients (90 days), according to clinical practice. A total of 240675, 331364, 52535, and 407823, patients with digestive, gynaecologic/obstetric, cardiac, and orthopaedic surgery were included. Respectively, 5.8%, 0.1%, 2.0%, and 1.0% of patients experienced an SSI, corresponding to 197.2, 3.4, 68.6, and 11.6 SSIs per 100000 patient-years. SSI patients stayed 13, 7, 15, and 20 extra days at the hospital, costing an extra EUR5246, EUR5363, EUR5725, and EUR11097 (National Health Insurance’s perspective). The in-hospital mortality hazard ratios were 2.13, 7.24, 2.90, and 12.01 in SSI patients compared to patients without SSI. SSI greatly increases the risk of death, the length of stay and the hospital cost. Efforts to curtail SSI burden must be renewed.

Health Care in an Evolving Immigration Landscape — Providing Care while Upholding the Law

Examining the inaccurate reproductive health messaging of crisis pregnancy centers: A comparative qualitative study

Objectives Given the prevalence of inaccurate or misleading health messaging linked to crisis pregnancy centers (CPCs) in the literature, we sought to understand what role, if any, standardized training materials might play in perpetuating common themes in reproductive health misinformation. Study design We identified inaccurate health messages present in qualitative interviews with 10 staff members from 8 CPCs in Ohio. Separately, we conducted a content analysis of training manuals from two parent organizations, Care Net and Heartbeat International, to understand the form and substance of inaccurate health information messages in official CPC training materials. We compared the content of the two data sources to identify themes common to both, representing both individual and institutional level dissemination of false health messages. Results We found that parent organizations provide false and misleading information in their training materials, often presenting such information as factually true or accurate. In interviews with a self-identified researcher, CPC staff relayed similar inaccurate health messages about the dangers of abortion and contraception, efficacy of condoms, and causes of infertility, strongly endorsing this false information. As an incidental finding, we documented enthusiasm for dissemination of inaccurate health information by CPC staff members who engage in public outreach and education. Conclusions We found clear similarities in the inaccurate health messages provided by staff to researchers and the official training documents published by the CPC parent organizations. Parent organizations, therefore, may represent a potent source of reproductive health misinformation.

TAVR for Asymptomatic Severe Aortic Stenosis

The balance stabilising benefit of social touch: Influence of an individual’s age and the partner’s relative body characteristics

Interpersonal touch (IPT) is a successful strategy to support balance during a wide range of activities in daily life, including physical education and therapy. Despite common practice, however, the influence of individual characteristics – such as age, balancing skills, motor experience, sex and anthropometry – and differences between interaction partners on the balance stabilising benefit of social touch is unknown. In an opportunity sample of 72 pairs (age range 4–63 years), we assessed an individual’s postural sway and change due to IPT during single-legged stance under four sensory conditions: with or without vision in combination with IPT or without. Following hierarchical cluster analysis (Ward’s method) based on individual relative responses to IPT, individual and relative partner’s characteristics two participant subgroups were identified: one of less stable, more vulnerable individuals, and another of more stable, mature participants. We developed multiple linear regression models, including moderating variables, to identify predictors of IPT benefit under each condition. Without visual input, an individual’s benefit of IPT was determined by their balancing skill and the partner-related difference in balancing skill but not by any other factor or partner-related difference. Especially vulnerable individuals improved considerably with IPT when visual feedback was unavailable. When vision accompanied IPT, an individual’s age-related motor developmental potential also played a significant moderating role. These findings indicate that the extent to which IPT is benefitting mutual balance stabilisation does not depend on biomechanical factors. Instead, the IPT benefit emerges as a product of both partners’ sensorimotor capabilities and when visual feedback is available is also moderated by a person’s motor developmental potential. We discuss a theoretical framework that accounts for the observed dependencies of the effect of haptic social support on balance control.

Navigational Bronchoscopy or Transthoracic Needle Biopsy for Lung Nodules

Engaging social media users with corporate social responsibility messages: An integrated theoretical approach in the automotive industry during social media era

Corporate Social Responsibility (CSR) messaging on social media has become a key strategy for companies to engage the public. However, limited research has investigated how specific CSR communication strategies influence public online engagement, particularly in the Chinese context. This study analyzed the effects of three dependent variables: (1) CSR message themes (aligned with ISO 26000 standards), (2) relationship cultivation strategies (Openness, Information Dissemination, Interactivity and Involvement, and Sharing Tasks), and (3) multimodal message types (text with emoticons, picutures, and videos) on social media users’ engagement behaviors (likes, shares, and comments). A quantitative content analysis was conducted on 421 CSR-related posts from the Weibo accounts of the top ten automotive brands in China, using Negative Binomial Regression (NB2) to examine the associations between CSR factors and user engagement. The findings revealed that consumer-related CSR themes significantly increased likes, shares, and comments. Relationship cultivation strategies, particularly Interactivity and Involvement, positively impacted engagement, especially in posts that encouraged commenting or sharing. Additionally, posts incorporating text with emoticons were found to significantly boost comments. Theoretically, this study integrates Stimuli-Response Theory’s focus on external stimuli with Uses and Gratifications Theory’s emphasis on users’ active motivations, offering a more comprehensive framework for understanding user engagement. Practically, it provides clear, actionable recommendations for automotive companies: prioritize consumer-focused CSR topics, adopt interactive strategies, simplify technical content, and utilize.

From Where It Stems

Validation and pilot feasibility study of a novel screener to assess diet, lifestyle and mental health in people living with and beyond cancer: Study protocols

Background and aim Current clinical care may not address behavioural and psychosocial elements which can influence quality of life (QoL) and recurrence risk of people living with and beyond cancer (PLWBC). There is a lack of validated tools to assess diet, lifestyle and mental health in PLWBC. We have developed a screener to identify individuals who may need further support beyond cancer recurrence. The aim is two-fold: 1) validate the screener in PLWBC; and 2) carry out a pilot feasibility study (PFS) to explore the impact of a lifestyle complex intervention (diet, physical activity and mental health components) on the QoL of PLWBC. Methods The study will be carried out at the University Hospital Son Espases (Spain) in PLWBC. A face validity study (n = 15) will assess construct interpretation, completion time, and acquiescence of the screener. For construct validity and reproducibility analysis (n = 100), participants will answer the screener together with validated diet, lifestyle, and mental health questionnaires for comparison. Body composition, physical activity, strength and cortisol levels will be assessed using validated instruments. All participants will answer the screener 7–10 days later for reproducibility analysis. Participants will then be randomized (1:1) to the Low Intervention (LI) or the High Intervention (HI) for the PFS study. LI will receive general advice regarding diet, lifestyle and mental health, and HI will receive individual and group sessions with specialised health professionals. Participants will be followed for three months. Primary outcomes include: 1) validity and reproducibility of the screener; and 2) feasibility of a complex intervention to improve QoL of PLWBC. Secondary outcomes include changes in screener answers and body composition. Discussion A validated screener which detects PLWBC’s needs could be used in follow-up care plans. The PFS will inform on the recruitment of participants and identify potential shortfalls of the design and efficacy. Trial registration ClinicalTrials.gov NCT06582498.

Omitting Regional Nodal Irradiation after Response to Neoadjuvant Chemotherapy

Modelling of ankle joint range of motion and landing quality scores in female soccer players with quantile regression approach

Purpose Ankle dorsiflexion range of motion (DF-ROM) has been shown to be associated with poor landing posture. This study aimed to model the relationship between DF-ROM and landing quality during the Soccer-Specific Jump-Landing task (SSJL) on the non-dominant extremity in elite and amateur female soccer players using a quantile regression approach. Methods 55 amateur and 47 professional female soccer players participated in the study. The relationship between DF-ROM and SSJL quality was evaluated using Pearson’s product-moment correlation analysis and Quantile regression modelling. Results There was a statistically significant negative correlation between DF-ROM and SSJL landing quality among female soccer players (r = − 0.33, p = 0.001). Moreover, there was a statistically significant negative correlation between DF-ROM and SSJL landing quality in amateur female soccer players (r = − 0.63, p = 0.001), no significant correlation was found in elite female soccer players (r = 0.22, p = 0.13). Quantile regression results for amateur female soccer players indicate that the association between ankle DF-ROM and landing quality is stronger in athletes with higher SSJL landing quality scores (e.g., Q75 and Q90) compared to those with lower scores (e.g., Q10 and Q25). This suggests that ankle DF-ROM plays a more critical role in achieving higher-quality landing techniques than in poorer techniques. Conclusions Higher quality landing techniques in female soccer players are associated with larger ranges of ankle DF-ROM. Therefore, ankle DF-ROM level may be a functional clinical measurement for amateur female athletes in determining landing-related injury risk factors during SSJL.

Semaglutide for Metabolic Dysfunction–Associated Steatohepatitis

Scientific conferences are leaving the US amid border fears

Alliance-based modeling of interbank lending networks: insights into risk contagion dynamics

The financial market, a highly intricate and dynamic system, relies heavily on banks as its central pillars. The interactions among these banks are pivotal in shaping the stability and efficiency of the overall financial system. A comprehensive understanding of the interbank relationships and network structures is essential to uncover the underlying mechanisms that drive financial markets. This paper presents a novel approach to modeling interbank lending as a dynamic network, aiming to explore the influence of banking alliances on risk contagion dynamics. While extensive research has been dedicated to interbank lending strategies, the role of long-term cooperative alliances and their structural effects on lending behavior has remained largely underexplored. In this study, we propose an innovative interbank lending strategy that integrates alliance relationships, facilitating the construction of networks that more accurately represent the characteristics of real-world banking alliances. Through a series of simulation experiments, we investigate the risk contagion dynamics within these alliance-based networks under different external shock scenarios. Our findings provide valuable insights into the resilience and contagion mechanisms of banking alliance networks, offering practical recommendations for both financial institutions and regulators in designing more effective risk mitigation strategies.

Case 2-2025: A Man with Loss of Consciousness and a Fall

Health worker acceptability of an HIV testing mobile health application within a rural Zambian HIV treatment programme

Background As more people living with HIV are identified and prescribed antiretroviral treatment in Zambia, detecting new HIV infections to complete the last mile of epidemic control is challenging. To address this, innovative targeted testing strategies are essential. Therefore, Right to Care Zambia developed and implemented a novel digital health surveillance application, Lynx, in three Zambian provinces—Northern, Luapula, and Muchinga in 2018. Lynx offers real-time HIV testing data with geo-spatial analysis for targeted testing, and has proven effective in enhancing HIV testing yield. This cross-sectional mixed methods study assessed the acceptability of Lynx among HIV testing healthcare workers in Zambia. Methods A quantitative Likert scale (1–5) survey was administered to 176 healthcare workers to gauge Lynx’s acceptability. Additionally, six qualitative key person interviews and five focus group discussions were conducted to gain an in-depth understanding of acceptability, and identify relevant barriers and facilitators. Quantitative data were analysed by averaging survey responses and running descriptive statistics. Qualitative data were transcribed and analysed in thematic coding. Data triangulation was utilised between the data sources to verify findings. Results Overall, the average survey score of perceived ease of use was 3.926 (agree), perceived usefulness was 4.179 (strongly agree) and perceived compatibility was 3.574 (agree). Survey questions related to network requirements, resource availability, and IT support had the most “strongly disagree” responses. The qualitative data collection revealed that Lynx was perceived as useful, and easy to use. Training for staff and regular updates were identified as facilitators, while conflicting work priorities and inconsistent IT support were identified barriers. Conclusion Lynx was identified as acceptable by health workers due to its perceived usefulness, staff trainings, and regular updates. For a mobile health intervention to be embraced in rural Zambian settings, key facilitators include robust IT support, comprehensive training, user feedback-based updates, and consideration of facility staff priorities.

Oral Hairy Leukoplakia