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The impact of anticoagulant-related bleeding on quality of life: Development of a novel measure based on perspectives from older adults
Background Venous thromboembolism (VTE) and atrial fibrillation (AF) disproportionately affect older adults, who are at increased risk of bleeding from treatment with anticoagulant therapy. The impact of bleeding on older adults’ quality of life (QoL) is poorly understood due to the lack of a validated measure of their experience. This study’s purpose is to describe the first evidence-based steps in developing a new condition-specific patient-reported outcome measure (PROM) for the effect of anticoagulant-related bleeding on older adults’ QoL. Methods Adults aged 65 years and older with VTE or AF at the University of Utah who were eligible for anticoagulation were recruited. We purposely sampled by age, sex, race/ethnicity, diagnosis, bleeding history and anticoagulant. In accordance with evidence-based guidelines for PROM development, focus groups were conducted to refine a hypothesized conceptual model of bleeding-related QoL and analyzed according to hybrid inductive and deductive thematic analysis methods. Focus group results were used to write a draft PROM. Semi-structured qualitative interviews were conducted to revise items on the draft PROM and were analyzed using thematic analysis to generate a final bleeding-related QoL PROM. Results Twenty individuals participated in interviews, and nine in two focus groups. Median age was 81 (range 69–95), 52% were women and 69% were White (10% Asian, 10% Hispanic, 7% Black, 3% Native Hawaiian/Pacific Islander). Through inductive and deductive thematic analysis of focus groups, we identified 19 themes (e.g., specific bleeding symptoms, adaptations in relationships, fatigue) that fell into 5 domains: 1) bleeding symptoms, 2) healthcare experiences, 3) social function, 4) emotional function, 5) physical function. These 19 themes and 5 domains formed the basis of the draft PROM. We conducted semi-structured cognitive interviews, and we performed thematic analysis to revise the drafted measure for clarity and relevance. The data resulted in a new PROM for bleeding-related QoL in older adults. Conclusion Employing evidence-based methods for PROM development, we found that bleeding can have a marked impact on everyday activities, emotional wellbeing and interpersonal relations for older adults. We incorporated these distinct aspects of wellbeing and function into a novel PROM for bleeding-related QoL that can inform clinical care and research after subsequent psychometric validation.
Light-driven dancing of nematic colloids in fractional skyrmions and bimerons
Venous leg ulcer healing as a determinant of quality of life in patients treated with unna boot: A quasi-experimental study
Our objective was to assess the effect of Venous Leg Ulcer (VLU) healing on Quality of Life (QoL) in patients undergoing compression therapy. This non-randomized, quasi-experimental, and observational study involved patients with VLU. A convenience sample of individuals receiving services was followed for at least one year while undergoing compression therapy. The Medical Outcomes Short-Form Health Survey (SF-36) and the Charing Cross Venous Ulcer Questionnaire (CCVUQ) were employed to measure the variables of interest. Study participants were categorized into the Healed Group (HG) and the Unhealed Group (UG). The final sample comprised 103 individuals. The HG demonstrated improvements in SF-36 scores in the domains of Social Role Functioning (n = 34, p<0.001), Physical Role Functioning (n = 33, p<0.001), and the Physical Health Dimension (n = 38, p<0.001). Additionally, the CCVUQ assessment revealed score enhancements in the domains of Domestic Activities (n = 30, p = 0.001) and Social Interaction (n = 30, p = 0.009). QoL showed significant improvements in functionality, physical performance, and social interaction in the HG after one year of compression therapy treatment. In contrast, the UG was the only group to experience significant deteriorations in QoL.
Want to get a species protected? Publish in a small, niche journal
Reply to: Oligoclonality of TRBC1 and TRBC2 in T cell lymphomas as mechanism of primary resistance to TRBC-directed CAR T cell therapies
Mouthguard use, hygiene, and maintenance practices among combat and team sports athletes: A comparative study
This study aimed to investigate the attitudes of combat and team sports athletes towards the use, storage, and hygiene conditions of mouthguards, with the goal of understanding disparities in usage and maintenance practices and their implications for oral health. A cross-sectional study was conducted involving 394 athletes (316 combat athletes and 78 team athletes). Participants completed a 28-question survey assessing their knowledge, attitudes, and practices regarding mouthguard use, hygiene, and maintenance. The survey included questions on demographic data, mouthguard usage habits, cleaning methods, and storage practices. Combat sports athletes exhibited significantly higher rates of mouthguard use (100%) compared to team sports athletes (29.5%) (chi square [χ2] = 258.971, p<0.001). Significant differences were also found in cleaning (χ2 = 252.195, p<0.001) and storage practices (χ2 = 14.195, p = 0.002), with combat athletes demonstrating better adherence to recommended guidelines. Common complaints about mouthguards included difficulties with speaking (χ2 = 7.792, p = 0.005) and breathing (χ2 = 11.431, p = 0.001), with combat athletes reporting fewer issues. The study highlights the need for increased awareness and education on mouthguard use among team sports athletes. Dentists and coaches play a crucial role in promoting proper mouthguard use, hygiene, and maintenance to prevent sports-related dental injuries. Emphasis should be placed on the benefits of custom-made mouthguards for improved comfort and protection.
A guidance to intelligent metamaterials and metamaterials intelligence
Abstract The bidirectional interactions between metamaterials and artificial intelligence have recently attracted immense interest to motivate scientists to revisit respective communities, giving rise to the proliferation of intelligent metamaterials and metamaterials intelligence. Owning to the strong nonlinear fitting and generalization ability, artificial intelligence is poised to serve as a materials-savvy surrogate electromagnetic simulator and a high-speed computing nucleus that drives numerous self-driving metamaterial applications, such as invisibility cloak, imaging, detection, and wireless communication. In turn, metamaterials create a versatile electromagnetic manipulator for wave-based analogue computing to be complementary with conventional electronic computing. In this Review, we stand from a unified perspective to review the recent advancements in these two nascent fields. For intelligent metamaterials, we discuss how artificial intelligence, exemplified by deep learning, streamline the photonic design, foster independent working manner, and unearth latent physics. For metamaterials intelligence, we particularly unfold three canonical categories, i.e., wave-based neural network, mathematical operation, and logic operation, all of which directly execute computation, detection, and inference task in physical space. Finally, future challenges and perspectives are pinpointed, including data curation, knowledge migration, and imminent practice-oriented issues, with a great vision of ushering in the free management of entire electromagnetic space.
The efficacy of novel biomarkers for the early detection and management of acute kidney injury: A systematic review
Acute kidney injury (AKI) is a frequent clinical complication lacking early diagnostic tests and effective treatments. Novel biomarkers have shown promise for enabling earlier detection, risk stratification, and guiding management of AKI. We conducted a systematic review to synthesize evidence on the efficacy of novel biomarkers for AKI detection and management. Database searches yielded 17 relevant studies which were critically appraised. Key themes were biomarker efficacy in predicting AKI risk and severity before functional changes; potential to improve clinical management through earlier diagnosis, prognostic enrichment, and guiding interventions; emerging roles as therapeutic targets and prognostic tools; and ongoing challenges requiring further validation. Overall, novel biomarkers like neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and cell cycle arrest markers ([TIMP-2] •[IGFBP7]) demonstrate capability for very early AKI prediction and accurate risk stratification. Their incorporation has potential to facilitate timely targeted interventions and personalized management. However, factors influencing biomarker performance, optimal cutoffs, cost-effectiveness, and impact on patient outcomes require robust validation across diverse settings before widespread implementation. Addressing these limitations through ongoing research can help translate novel biomarkers into improved detection, prognosis, and management of AKI in clinical practice.
Three-dimensional diffractive acoustic tomography
“I sometimes feel like I can’t win!”: An exploratory mixed-methods study of women’s body image and experiences of exercising in gym settings
Despite an increase in gym memberships, women are less active than men and little is known about the barriers women face when navigating gym spaces. This study explored women’s body image and experiences exercising in gyms. Two-hundred and seventy-nine women (84% current gym-goers; 68.1% White) completed an online mixed-methods survey. Thematic analysis of qualitative data produced four themes and nine subthemes: (1) “Never enough” ([perceived] judgement about appearance, [perceived] judgement about performance); (2) “Often too much” (self-criticism, clothing challenges); (3) “Always on display” (harassment and safety, fighting for space, the appearance contingency); and (4) “Sometimes empowered” (empowering places, empowering self). Qualitative and quantitative data showed that women often feel judged for their appearance and performance, leading to a persistent sense of inadequacy, as well as having to fight for space in the gym and to be taken seriously, while navigating harassment and unsolicited comments from men. Despite this, women showed signs of resistance towards gendered and appearance ideals permeating gym environments and some experienced empowerment through skill acquisition, breaking gender norms, and exercising in supportive environments. Based on our findings, we suggest a multi-level approach to tackling these barriers and creating more inclusive gym spaces for women.
Molecular and pharmacological heterogeneity of ETV6::RUNX1 acute lymphoblastic leukemia
Taming the transplant troll: Exploring racial and ethnic disparities in cytomegalovirus infection among kidney transplant patients
Background Cytomegalovirus (CMV) infection poses a significant risk to kidney transplant recipients. This study investigated CMV disease incidence, outcomes, and management challenges in racial and ethnic minority populations following kidney transplantation. Methods This single-center, mixed-methods study included a retrospective cohort analysis of kidney transplant recipients (n = 58) and qualitative surveys of healthcare providers. Patients were categorized as minorities (n = 49) or non-Hispanic whites (n = 9). The primary outcome was CMV disease incidence. Secondary outcomes included graft failure, mortality, and identification of management barriers. Results The cumulative incidence of CMV disease was higher in minorities than in non-Hispanic whites (12.3% vs. 0%, p = 0.58), although the difference was not statistically significant. All graft failures (8.6%, n = 5) occurred in the minority group. Although not statistically significant, all-cause mortality was higher in the minority group (24.5% vs. 11.1%, p = 0.54), with 46.2% of the deaths occurring within 90 days of CMV diagnosis. Qualitative analysis revealed challenges in diagnosis, treatment-related side effects, medication costs, and insurance barriers. The providers emphasized the importance of interdisciplinary collaboration and standardized protocols. Conclusion While limited by the small sample size, this study highlights potential disparities in the incidence and outcomes of CMV disease among minority kidney transplant recipients, suggesting that barriers in care and access may contribute to these differences. These hypothesis-generating findings underscore the need for larger multicenter studies to validate these patterns and to inform targeted strategies that may reduce inequities in post-transplant outcomes.
Identification method of wheel-rail two-point contact state in switch area
Time-resolved Brownian tomography of single nanocrystals in liquid during oxidative etching
Beyond the spotlight: Unveiling the gender bias curtain in movie reviews
Historically, the film industry has been male-dominated both in front of and behind the camera, resulting in a longstanding gender imbalance in storytelling and representation. This legacy of male-centric narratives may unconsciously influence critics’ expectations and judgments. Existing literature suggests that negative critiques in movie reviews can significantly impact actors’ earnings by diminishing a film’s commercial prospects. This influence extends to potential reductions in back-end compensation and marketability for future projects, and it can directly affect actors’ well-being, leading to increased stress levels and elevated cardiovascular reactivity. Previously, gender biases in movie reviews were computed using disparities in male-led versus female-led movie ratings or box-office earnings; however, no work has been done to quantify the linguistic biases within movie review transcripts. This work aims to leverage our language-model-powered gender bias detection system to measure benevolent sexism, hostile sexism, explicit marking of sex, dehumanization, and generic pronouns in reviews published by professional critics. Therefore, we analyzed 17,165 professionally written reviews, comprising a total of 735,000 sentences. Our analysis uncovers pronounced representation bias in key movie roles, with 72% of first actors, 91% of first directors, and 86% of first writers being male. More importantly, the findings indicate that movies with female-dominated casts evoke, on average, 149% higher magnitude of hostile sexism and 44% higher magnitude of benevolent sexism in their reviews compared to movies with male-dominated casts. We also find that benevolent sexism is most common in Family and Music genres, reflecting the romanticization of gender roles, whereas hostile sexism peaks in Romance. A non-parametric statistical analysis revealed significant gender differences in benevolent and hostile sexism scores for movie reviews, with female first actors, directors, and writers receiving higher levels of both benevolent and hostile sexist criticism compared to their male counterparts.
Cost-effectiveness analysis of extended endoscopic lumbar foraminotomy (EELF) and transforaminal lumbar interbody fusion (TLIF): a prospective observational study
Sucrose-preferring gut microbes prevent host obesity by producing exopolysaccharides
Exploring the relationship between established HIV risk factors and depressive symptoms amongst young women without HIV in two sites in South Africa
Purpose Adolescent girls are at high risk for depression and human immunodeficiency virus (HIV) acquisition. Poor mental health can increase vulnerability to risky sexual behaviours. Therefore, this study aims to determine the prevalence of depressive symptomology and explore the convergence of HIV risk factors with depressive symptoms amongst cis-gender adolescent girls and young women (AGYW) in rural KwaZulu-Natal (KZN) and peri-urban Western Cape (WC) communities in South Africa. Methods Cross-sectional survey data from two sites in South Africa was used - the rural Vulindlela community in KZN and the peri-urban Philippi East community in the WC. Study inclusion criteria included being sexually active with at least one male partner, and not planning to relocate in the next 12 months. The PHQ-9 scale was used to determine depressive symptomology, a socio-behavioural questionnaire was used to determine sexual behaviours, odds ratios and confidence intervals derived from logistic regression models were used to explore the associations between depressive symptomology and socio-behavioural factors associated with HIV acquisition. Results The cohort consisted of 274 adolescent girls, 38.6% from the WC site and 61.4% from the KZN site. Overall, 15.7% (43/274) of AGYW reported depressive symptoms. Participants from the peri-urban WC site were more likely to experience depressive symptoms (OR 8.34; 95% CI 3.80–18.30) compared to those living in the rural KZN site. Depressive symptoms were less likely to occur in adolescent girls between the ages of 14 to 17 as compared to those between the ages of 18 and 19 (OR 0.44; 95% CI 0.22–0.90). Socio-behavioural HIV risk factors associated with depressive symptoms include: age disparate relationships (OR 2.98; 95% CI 1.52–5.84), high (four or more) numbers of lifetime partners (OR 8.15; 95% CI 3.60–18.45) and engaging in sex under the influence of alcohol (OR 2.58; 95% CI 1.32–5.04). Multivariate analysis showed that participants from the WC site (AOR 5.25; 95% CI 1.95–14.17) had higher odds of experiencing depressive symptoms while participants with four or more lifetime partners (AOR 3.46; 95% CI 1.24–9.60) were at higher odds of experiencing depressive symptoms. Conclusion In this cross-sectional study, depressive symptomology is associated with certain HIV risk behaviours. Longitudinal studies are required to test the causal relationship between depression and HIV acquisition and to better understand the geospatial differences observed.