Global hand surgery collaborations: national survey of UK surgical trainees.

This cross-sectional national survey used qualitative methodology to explore the views of surgical trainees about hand surgery in low-resource settings. Key concerns have been identified and recommendations are made for responsible organizations to promote equal access for the engagement of trainees in global surgery partnerships.

From Home to Heaven: The Spatial Imaginaries of Nonprofit Organizations.

We investigate how nonprofit organizations (NPOs) construct imaginaries of their premises, their local environment, and beyond. Based on a qualitative analysis of the websites of 209 randomly sampled NPOs in a metropolitan region in Central Europe, we find four distinct spatial imaginaries: (1) The world polity imaginary constructs NPOs as a part of a spatial environment that is neatly divided into nation states, supranational structures, and subnational units. (2) In the world society imaginary, NPOs are active in blurred, fluid, and overlapping spaces such as networks, commercialized spaces, or natural habitats. (3) In a religious imaginary, the material world is complemented by a transcendental realm and categorized into spaces of the sacred and the evil. (4) Finally, in a lococentric imaginary, NPOs construct a dichotomy between "home" and the alien rest of the world. Each of these spatial imaginaries conveys distinctive ways of situating the organization in their spatial environment and implies specific organizational practices and emotional enchantments of space. Supplementary Information: The online version contains supplementary material available at 10.1007/s11266-023-00603-w.

Civil Society Involvement in Managing the COVID-19 Pandemic: A Case Study of a Large and Congested Urban Community in Bangkok, Thailand.

Introduction: The COVID-19 pandemic has significantly impacted Thailand, including urban centers like Bangkok and surrounding areas, highlighting a critical need for effective management within densely populated communities to mitigate its effects. Methods: This qualitative study sought to explore community management strategies developed in Khlong Toei, a large, congested urban community in Bangkok, Thailand. Seven in-depth interviews (n=7), six focus groups (n=23), and two brainstorming sessions (n=12) were conducted for this study. Data were collected using Zoom, an online communication platform, and through on-site interviews between August 2021 and March 2022 in the congested urban community of Bangkok, Thailand. The data were analyzed using content analysis. Results: All informants (age range: 20-66 years, female respondents: 73.33%) were recruited by a community leader and the abbot of Saphan Temple, the community waiting area in Khlong Toei. The findings revealed two main themes: (1) Caring people, including two subthemes, and (2) Caring community, including two subthemes. Discussion: The study's findings provide guiding inputs for management of public fear to prevent emerging or re-emerging infectious pandemics within congested urban communities.

Assessment of the appropriateness of stress ulcer prophylaxis use and its determinants among admitted surgical patients at Debre Berhan University Hakim Gizaw Hospital, Ethiopia. A hospital-based cross-sectional study.

Introduction: Pharmacological stress ulcer prophylaxis (SUP) has been recommended for many years to reduce the risk of clinically significant upper gastrointestinal (GI) bleeding caused by stress ulcers (SUs). Stress-related ulcer bleeding in surgical patients significantly increases morbidity and mortality. Therefore, preventing stress-induced hemorrhage is the most appropriate measure for patients who are at increased risk. However, the inappropriate use of SUP has increased in recent years, and its use in Ethiopian surgical patients has not been well studied. Objective: The aim of this study was to assess the appropriateness of SUP use and its determinants among admitted surgical patients at Debre Berhan University Hakim Gizaw Hospital (DBUHGH), Ethiopia. Methods: We randomly selected 230 patients from the whole cross-sectional group of all surgical patients at DBUHGH from 1 February to 30 June 2023. The risk of stress ulcer (SU) development was assessed using the modified American Society of Health-System Pharmacists (ASHP) guidelines. For data analysis, we used SPSS version 25. Results: The mean age of study participants was 47.2 years (SD ± 20.4), and out of the total of 230, 130 (56.5%) were women. Approximately 66% of study participants took inappropriate SUP based on ASHP guidelines criteria. The most commonly used drug class for SUP was histamine-2 receptor blockers 115 (50%). Study participants who have a Charlson Comorbidity Index Score of moderate and GI bleeding have been significantly associated with the inappropriate use of SUP. Conclusion: In our study, inappropriate SUP use was common in the surgical ward of DBUHGH. This may be an area that requires further and more focused working together among clinical pharmacists and medical professionals in an institution-specific SUP protocol that aids clinicians in identifying appropriate candidates for SUP medication.

Evaluating the Clinical Relevance of Routine Sonication for Periprosthetic Hip or Knee Joint Infection Diagnosis.

Periprosthetic joint infection (PJI) is a serious complication after joint arthroplasty. PJI screening and conventional cultures may be inconclusive. Sonication fluid culturing stands out as a valuable adjunct technique for PJI diagnosis. This study aims to determine the clinical relevance of routine sonication for all (a)septic revisions. All patients who underwent (partial) hip or knee revision arthroplasty between 2012 and 2021 were retrospectively reviewed. We formed three groups based on the European Bone and Joint Society PJI criteria: infection confirmed, likely, and unlikely. We analyzed clinical, laboratory, and radiological screening. Sensitivity and specificity were calculated for synovial fluid (preoperative), tissue, and sonication fluid cultures. We determined the clinical relevance of sonication as the percentage of patients for whom sonication confirmed PJI; 429 patients who underwent (partial) revision of hip or knee arthroplasty were included. Sensitivity and specificity were 69% and 99% for synovial fluid cultures, 76% and 92% for tissue cultures, and 80% and 89% for sonication fluid cultures, respectively. Sonication fluid cultures improved tissue culture sensitivity and specificity to 83% and 99%, respectively. In 11% of PJIs, sonication fluid cultures were decisive for diagnosis. This is applicable to acute and chronic infections. Sonication fluid cultures enhanced the sensitivity and specificity of PJI diagnostics. In 11% of PJI cases, causative pathogens were confirmed by sonication fluid culture results. Sonication fluid culture should be performed in all revision arthroplasties.

A Multidisciplinary Assessment of ChatGPT's Knowledge of Amyloidosis: Observational Study.

BACKGROUND: Amyloidosis, a rare multisystem condition, often requires complex, multidisciplinary care. Its low prevalence underscores the importance of efforts to ensure the availability of high-quality patient education materials for better outcomes. ChatGPT (OpenAI) is a large language model powered by artificial intelligence that offers a potential avenue for disseminating accurate, reliable, and accessible educational resources for both patients and providers. Its user-friendly interface, engaging conversational responses, and the capability for users to ask follow-up questions make it a promising future tool in delivering accurate and tailored information to patients. OBJECTIVE: We performed a multidisciplinary assessment of the accuracy, reproducibility, and readability of ChatGPT in answering questions related to amyloidosis. METHODS: In total, 98 amyloidosis questions related to cardiology, gastroenterology, and neurology were curated from medical societies, institutions, and amyloidosis Facebook support groups and inputted into ChatGPT-3.5 and ChatGPT-4. Cardiology- and gastroenterology-related responses were independently graded by a board-certified cardiologist and gastroenterologist, respectively, who specialize in amyloidosis. These 2 reviewers (RG and DCK) also graded general questions for which disagreements were resolved with discussion. Neurology-related responses were graded by a board-certified neurologist (AAH) who specializes in amyloidosis. Reviewers used the following grading scale: (1) comprehensive, (2) correct but inadequate, (3) some correct and some incorrect, and (4) completely incorrect. Questions were stratified by categories for further analysis. Reproducibility was assessed by inputting each question twice into each model. The readability of ChatGPT-4 responses was also evaluated using the Textstat library in Python (Python Software Foundation) and the Textstat readability package in R software (R Foundation for Statistical Computing). RESULTS: ChatGPT-4 (n=98) provided 93 (95%) responses with accurate information, and 82 (84%) were comprehensive. ChatGPT-3.5 (n=83) provided 74 (89%) responses with accurate information, and 66 (79%) were comprehensive. When examined by question category, ChatGTP-4 and ChatGPT-3.5 provided 53 (95%) and 48 (86%) comprehensive responses, respectively, to "general questions" (n=56). When examined by subject, ChatGPT-4 and ChatGPT-3.5 performed best in response to cardiology questions (n=12) with both models producing 10 (83%) comprehensive responses. For gastroenterology (n=15), ChatGPT-4 received comprehensive grades for 9 (60%) responses, and ChatGPT-3.5 provided 8 (53%) responses. Overall, 96 of 98 (98%) responses for ChatGPT-4 and 73 of 83 (88%) for ChatGPT-3.5 were reproducible. The readability of ChatGPT-4's responses ranged from 10th to beyond graduate US grade levels with an average of 15.5 (SD 1.9). CONCLUSIONS: Large language models are a promising tool for accurate and reliable health information for patients living with amyloidosis. However, ChatGPT's responses exceeded the American Medical Association's recommended fifth- to sixth-grade reading level. Future studies focusing on improving response accuracy and readability are warranted. Prior to widespread implementation, the technology's limitations and ethical implications must be further explored to ensure patient safety and equitable implementation.

International Society of Paediatric Oncology (SIOP) Global Mapping Programme: Latin American Society of Pediatric Oncology (SLAOP) country-level report.

BACKGROUND: Latin American countries are improving childhood cancer care, showing strong commitment to implement the Global Initiative for Childhood Cancer, but there are scant publications of the situation at a continental level. METHODS: As part of the International Society of Paediatric Oncology Global Mapping project, delegates of each country participating in the Latin American Society of Pediatric Oncology (SLAOP) and chairs of national pediatric oncology societies and cooperative groups were invited to provide information regarding availability of national pediatric cancer control programs (NPCCP), pediatric oncology laws, pediatric oncology tumor registries, and training programs and support to diagnosis and treatment. RESULTS: Nineteen of the 20 countries participating in SLAOP responded. National delegates reported nine countries with NPCCP and four of them were launched in the past 5 years. National pediatric tumor registries are available in eight countries, and three provided published survival results. Fellowship programs for training pediatric oncologists are available in 12 countries. National delegates reported that eight countries provide support to most essential diagnosis and treatments and 11 provide partial or minimal support that is supplemented by civil society organizations. Seven countries have a pediatric oncology law. There are three international cooperative groups and four national societies for pediatric oncology. CONCLUSION: Despite many challenges, there were dramatic advances in survivorship, access to treatment, and availability of NPCCP in Latin America. Countries with highest social development scores in general provide more complete support and are more likely to have NPCCP, training programs, and reported survival results.

Prostitution in the shadow of life-long sexual abuse: Arab women's retrospective experiences.

The present study uses the life-course and intersectionality perspectives to explore the meaning that aging Arab women attribute to their lived experiences of life-long sexual abuse in the shadow of engaging in prostitution. Interpretive phenomenological analysis was used to analyze the narratives of 10 older Arab women in Israel who were engaged in prostitution. Four themes emerged: experiencing childhood in the shadow of sexual abuse, becoming a prostitute, being entrapped in prostitution, and settling accounts with the native culture. Women aging in prostitution experience a harsh reality of abuse and loss. The present study points to multiple channels of abuse throughout the life course, from childhood until old age.

Contribution and influence of "Ningbo oriental acupuncture-moxibustion society". / 宁波东方针灸学社的贡献及影响.

"Ningbo oriental acupuncture-moxibustion society" was founded in 1930 by ZHANG Junyi. At that era, the enrollment conditions were flexible, the disciplines of warm moxibustion and acupuncture-moxibustion were set and taught by means of face-to-face class and correspondence one. The teaching content included the knowledge of western learning and traditional theory of acupuncture-moxibustion. The Society issued two periodicals, MedicalNewspaper of Warm Moxibustion and Oriental Acupuncture and Moxibustion, the staffs of the Society compiled teaching materials such as Warm Moxibustion and Advanced Acupuncture-Moxibustion, translated relevant books and improved the device and herbal medicine of warm moxibustion. The students trained in the Society worked all of the country and engaged in various professional fields. "Ningbo oriental acupuncture-moxibustion society" has cultivated a large number of excellent talents, adhering the teaching concept of integration of Chinese and western medicine, and has made the contribution to the preservation of precious literature, and promoting the innovation of acupuncture-moxibustion technology and the dissemination of warm moxibustion.

Intersections in the digital society: cancel culture, fake news, and contemporary public discourse.

This article critically examines the intricate relationship between cancel culture and fake news, shedding light on their collective impact on current societies. The changing social landscape, marked by the transition from the "network society" to the "platform society," has given rise to unprecedented phenomena such as cancel culture. Rooted in social media complaints, cancel culture intersects with the dissemination of intentionally created false information, forming a complex web of dynamics. The study explores the multifaceted nature of cancel culture, its unintended consequences and the nuanced definitions surrounding it. The synthesis of erasure culture and fake news prompts critical reflections on the democratization of information, the protection of fundamental rights, and the potential risks to democracies of an unbridled online narrative. As digital networks continue to play a central role in everyday life, understanding and addressing these challenges is essential to maintaining a balanced discourse that upholds democratic values.

Unveiling the relationships between eco-anxiety, psychological symptoms and anthropocentric narcissism: The psychometric properties of the Turkish version of the Hogg eco-anxiety scale.

The increasing number of losses and damages caused by the climate crisis has rendered the psychometric assessment of the climate crisis more important than ever, specifically in developing countries, such as Turkey. The aim of this study was to examine the psychometric properties of the Turkish version of the Hogg Eco-Anxiety Scale (HEAS-13), using exploratory structural equation modeling (ESEM) on the cross-sectional data collected from 445 adults (286 females and 159 males; Mage = 29.76, range 18-65). The results supported the four-factor solution of the original version in the Turkish sample. Further analysis confirmed the invariance of the HEAS-13 across genders. The results demonstrated significant correlations of the HEAS-13 subscales with the Brief Symptom Inventory (BSI) and the Anthropocentric Narcissism Scale (ANS), except for that between the behavioral symptoms subscale of the HEAS-13 and the ANS. Both the total and the subscale scores of the HEAS-13 were also found to be reliable, given the internal consistency and test-retest reliability values. The Turkish version of the HEAS-13 can expand the scientific understanding of eco-anxiety, which can help develop mental health services to mitigate the negative mental health impacts of the environmental crisis.

Trends in functional outcome measures in orthopedic oncology.

The purpose of this study was to identify trends in the use of functional outcome measures within orthopedic oncology. The search engine, PubMed, was reviewed for all articles over an 11-year period from 2011 to 2021 from five major journals that publish in the field of orthopedic oncology. The functional outcome measures used in the articles were recorded along with study date, study design, clinical topic/pathology, and level of evidence. Out of 5968 musculoskeletal tumor-focused articles reviewed, 293 (4.9%) included at least one outcome measure. A total of 28 different outcome tools were identified. The most popular were Musculoskeletal Tumor Society (MSTS) score (61.1%) and Toronto Extremity Salvage (TESS) score (14.0%), followed by 36-Item Short Form Survey (SF-36) (4.1%) and Patient-Reported Outcomes Measurement Information System (PROMIS) (3.8%). The use of MSTS scores decreased by 0.7% each year, whereas PROMIS increased by 1.2% each year. Seventy-four articles used more than one outcome measure. Of these 74 articles, 61 had the MSTS as one of the outcome measures. Orthopedic oncology utilizes functional outcome measures less commonly in comparison to other orthopedic subspecialties. However, this may be due in large part to orthopedic oncologists putting more emphasis on outcomes such as local recurrence, implant failure, and mortality. MSTS score is the most widely used functional outcome measure, but the utilization of PROMIS has increased recently, and could be the next step in evaluating outcomes in orthopedic oncology as it is patient-derived rather than physician-derived.