bluuebunny/crossref_metadata_2025 huggingface dataset:
Nitrous Oxide-Oxygen Analgesia: The Performance of the MC Mask Delivery System
Authors: Ooi R , Joshi P , Soni N
Published: August 2022

Nitrous oxide administration via an oxygen facemask such as the Mary Catterall (MC) is an accepted technique for supplementing regional anaesthesia. This study assessed the range of nitrous oxide and oxygen concentrations delivered to the trachea using a mechanical lung model. The inspired concentrations of these two gases were determined by the total fresh gas inflow rates, their concentrations in the fresh gas mixture and the peak inspiratory flow rate of the analogue lung. A 1: 1 nitrous oxide-oxygen mixture in the fresh gas with an inflow rate of 4–6 1/min is recommended to ensure adequate oxygen delivery into the trachea as well as achieving the therapeutic concentrations of nitrous oxide (20–30%).
Hypnoanalgesia for Chronic Pain: The Response to Multiple Inductions at One Session and to Separate Single Inductions
Authors: Lewis D O
Published: August 2022

Serial hypnotic inductions conveying the same analgesic message produce a progressively longer response in an increasing number of patients. The resulting analgesia appears to be independent of the spacing of inductions — Whether given at a single session or on separate occasions — And to depend upon their number. However, multiple inductions at a single session save time.

Elimination of pain can be achieved, by either approach, for a year or more in up to 70% of patients.
Diagnosis and Management of Renal Angioma
Authors: Abercrombie J F , Holmes S A V , Ball A J
Published: August 2022

Five patients with symptomatic renal angiomata are described. All presented with heavy haematuria and unilateral ureteric obstruction without evidence of a mass distorting the renal architecture. Renal angiomata are most easily diagnosed by selective renal angiography. They may be treated by intra-arterial embolization, avoiding the need for major ablative surgery.
A Survey of Industries and Colorectal Cancer Screening of Employees in the East Midlands of England
Authors: Hart A R , Wicks A C B , Mayberry J F
Published: August 2022

The number of industries in the East Midlands of England who were prepared to enrol their employees in a scheme to detect colorectal cancer by faecal occult blood testing was investigated. Company directors were asked if they would supply a list of their employees over the age of 40 years and allow a research team to give a 15 min talk at the workplace. Forty-nine per cent of firms responded to the questionnaire and 27% of businesses were prepared to enrol. There was no difference in mean total employees between firms willing and unwilling to participate (unpaired t-test, P>0.05). The commonest reason given by managers rejecting the scheme was that they did not believe the workforce would be interested.
Breast Reconstruction at a District General Hospital
Authors: Evans Abigail A , Straker Virginia F , Rainsbury Richard M
Published: August 2022

Breast reconstruction is normally carried out by plastic surgeons, but the advent of permanent tissue expanders places post-mastectomy reconstruction within easy reach of the general surgeon. Nineteen patients underwent breast reconstruction between 1989 and 1991 using a subpectoral silicone-based, double lumen tissue expander. Assessment of results was by: ( a) patient completed questionnaire; and ( b) third party evaluation of standardized photographs.

The mean operating time was 58 min (40–80 min) and mean hospital stay 3 days (2–7 days). Complications included one flap necrosis and one leaking injection port. Outpatient tissue expansion required an average of seven visits (4–11) and was completed in an average of 12 months (7–19). The injection port was subsequently removed under local anaesthetic as a day case. The fully dressed appearance following reconstruction was graded good or excellent by 100% of patients and in over 80% of third-party assessments. Equivalent figures for the appearance when wearing a bra were 93% and 60% and undressed 57% and 47%, respectively. All patients recommended the procedure but 25% found inflation uncomfortable.

Subpectoral tissue expansion is a safe, cosmetically acceptable method of breast reconstruction which is associated with a high level of patient satisfaction.
Health Promotion at Work
Authors: Brodie David , Dugdill Lyndsay
Published: August 2022

This study examined health promotion intervention amongst council employees and determined the extent that any changes were subsequently maintained. The results showed that even with modest intervention, beneficial changes were observed in alcohol consumption, diastolic blood pressure, body mass, waist/hips ratio, body fat, aerobic capacity and arm strength. Behavioural measures tended not to change, but this could be a consequence of unfocused questioning or insufficient intensity of the health promotion activities. The sickness and absenteeism rates improved during the intervention and maintenance phases, making a strong case for health promotion from the employer's perspective. A critique of the experimental procedure suggested that the testing venue, the methods of obtaining consent, the continuity of subjects, initial attitudes, the intensity of the intervention and the project delivery were all features that would contribute to a successful outcome.
Wartime Colon Injuries: Primary Repair or Colostomy?
Authors: Moreels R , Pont M , Ean Sae , Vitharit M , Vuthy C , Roy S , Boelaert M
Published: August 2022

A retrospective non-randomized study, comparing primary repair with colostomy, was made on a series of 102 patients with penetrating intraperitoneal colon injuries, in a war surgery programme in Cambodia. The overall case fatality rate (CFR) was 25.5%, whereas in the primary repair group CFR was 20%, compared to 30.8% in the colostomy group. The difference was not statistically significant ( P=0.30). Adjustment for possible confounding factors in the two groups did not alter the results. Considering the numerous advantages to the patient of a primary closure in the precarious situations where war surgery is often performed, this technique merits consideration.
Glucose Tolerance and Ageing
Authors: Stout Robert W
Published: August 2022

Hyperglycaemia, impaired glucose tolerance and non-insulin dependent diabetes become progressively more common with advancing age. The mechanism is insensitivity to the actions of insulin at the postreceptor level. Inadequate secretion of insulin and decreased hepatic sensitivity to insulin's action in suppressing glucose output also occur. The age-related changes may be made worse by obesity, renal failure or the ingestion of certain drugs, or may be lessened by increased physical activity.
Increased quantity and diversity of patient referrals following the introduction of a novel vision rehabilitation model
Authors: Pucchio Aidan , Eden Karen , Foster Julia , Hopman Wilma , Bona Mark
Published: August 2022

Despite effective vision rehabilitation (VR) interventions, no gold standard model of care delivery has been established. The institution of the South East Ontario Vision Rehabilitation Service (SOVRS) introduced a centralized intake, an occupational therapist as a systems navigator, and improved communication pathways between low vision services in order to optimize regional VR care. The aim of this study is to compare the SOVRS model of VR to a traditional, hospital-based pre-SOVRS-implementation model using referral data.

A single-site (Vision Rehabilitation Clinic at Kingston Health Sciences Center), retrospective medical chart review was performed. Data were gathered from the electronic medical records of patients who received a low vision assessment at the pre-SOVRS-implementation clinic (2017) and the SOVRS clinics (2019).

A total of 245 charts were reviewed over the two study periods. There were no significant differences in the age, gender, or diagnoses causing vision loss between 2017 and 2019. One hundred nine incoming referrals were received in 2017, with 136 in 2019, representing a 25% increase in incoming referrals ( p < .001). The proportion of incoming referrals from non-ophthalmologists rose from 3.7% in 2017 to 31.9% in 2019 ( p < .001). The number of outgoing referrals also increased significantly, from 113 outgoing referrals in 2017 to 259 in 2019 ( p < .001), equivalent to a mean of 1.04 ± 0.68 (± standard deviation) outgoing referrals per incoming referral in 2017 and 1.90 ± 0.97 outgoing referrals per incoming referral in 2019. Outgoing service referrals also diversified significantly in 2019 ( p < .001), with more referrals to services such as VR health service organizations and community services.

The SOVRS model was able to increase both the quantity and diversity of incoming and outgoing referrals by adopting several key strategies during its development. By expanding referrals, SOVRS increased the services available to patients and enabled a larger population to receive VR care.
Rewarming from unwitnessed hypothermic cardiac arrest with good neurological recovery using extracorporeal membrane oxygenation
Authors: Gordon Les , Ferris John , Pauli Henning
Published: August 2022

A 26-year-old man, who was training in bad weather for a mountain ultramarathon, became hypothermic after running for 4 h. He deteriorated and was unable to continue. His running partner went for help. The man suffered an unwitnessed hypothermic cardiac arrest. The on-site management and evacuation are described and included the use of intermittent cardiopulmonary resuscitation and a mechanical device during transport. The patient was successfully resuscitated and rewarmed by Extracorporeal Membrane Oxygenation (ECMO) after more than 2 h of cardiopulmonary resuscitation. After 14 h of ECMO support and five days of ventilation, the patient subsequently made a good neurological recovery. At hospital discharge, he had normal cerebral function, and an improving peripheral polyneuropathy affecting distal limbs, with paraesthesia in both feet and reduced coordination and fine motor skills in both hands.
Deep learning reconstruction allows for usage of contrast agent of lower concentration for coronary CTA than filtered back projection and hybrid iterative reconstruction
Authors: Otgonbaatar Chuluunbaatar , Ryu Jae-Kyun , Shin Jaemin , Kim Han Myun , Seo Jung Wook , Shim Hackjoon , Hwang Dae Hyun
Published: August 2022

Background

The demand for homogeneous and higher vascular contrast enhancement is critical to provide an appropriate interpretation of abnormal vascular findings in coronary computed tomography angiography (CTA).

Purpose

To evaluate the effect of various contrast media concentrations (Iohexol-370, Iohexol-300, Iohexol-240) and image reconstructions (filtered back projection [FBP], hybrid iterative reconstruction [IR], and deep learning reconstruction [DLR]) on coronary CTA.

Material and Methods

A total of 63 patients referred for coronary CTA between July and October 2021 were enrolled in this prospective study, and they randomly received one of three contrast media. CTA images were reconstructed with FBP, hybrid IR, and DLR. The CT attenuation, image noise, signal-to-noise ratio (SNR), and contrast-to-noise ratio (CNR) were calculated for all three images. The images were subjectively evaluated by two radiologists in terms of overall image quality, artifacts, image noise, and vessel wall delineation on a 5-point Likert scale.

Results

The application of DLR resulted in significantly lower image noise; higher CT attenuation, SNR, and CNR; and better subjective analysis among the three different concentrations of contrast media groups ( P < 0.001). There was no significant difference in the CT attenuation of the left ventricle ( P = 0.089) and coronary arteries ( P = 0.072) between hybrid IR at Iohexol-300 and DLR at Iohexol-240. Furthermore, application of DLR to the Iohexol-240 significantly improved SNR and CNR; it achieved higher subjective scores compared with hybrid IR at Iohexol-300 ( P < 0.001).

Conclusion

We suggest that using DLR with Iohexol-240 contrast media is preferable to hybrid IR with Iohexol-300 contrast media in coronary CTA.
Testing the effect of display organization in the collinear search impairment
Authors: Jingling Li , Shioiri Satoshi
Published: August 2022

Previous studies established that a salient collinear structure impairs local visual search. A display organization hypothesis states that the vertical grouping of elemental bars in the search display may selectively increase the salience of the local target in the background than that in the collinear distractor, leading to the collinear search impairment. Three displays were designed to test this hypothesis. A classical search display was adopted as a baseline. A diagonal search display was created with tilted bars, making perceptual organization diagonal and should reduce collinear search impairment. An illusory search display was designed by using abutting line illusion to emphasize the vertical grouping direction, which should increase collinear search impairment. A manipulation check was conducted with an online survey to understand the perceptual organization of the three displays. Results showed that the probability to perceive the stimuli grouping in the vertical direction was strongest in the illusory display and the least in the diagonal display. Nevertheless, the collinear search impairment did not vary with these manipulations, argue against the display organization hypothesis. We speculate that the search impairment might associate with the perceptual organization of the collinear distractor per se, rather than the perceptual organization of the background.
Parenting in the Context of Intimate Partner Violence: Understanding Mothers’ Perceptions
Authors: Reiter Johanna E. , Grossman Susan F. , Perkins Nathan H. , Pryce Julia , Flaherty-Gupta Anne
Published: August 2022

Despite existing research, which has focused on the impacts of intimate partner violence (IPV) on mothers and their children, there is a paucity of research specifically examining mothers’ perceptions of parenting in the context of IPV. This qualitative study explored parenting capacity and meaning making among a purposive sample of 16 female survivors of IPV who experienced IPV during both childhood and adulthood and had at least one school-aged child. Participants completed semi-structured in-person interviews during which they were asked a series of questions about their experiences with IPV and their parenting practices. Analysis revealed that parenting capacity could be categorized by two capacities: relational and operational. Based on these descriptive accounts of the experiences of parenting in contexts of IPV, a preliminary model suggesting a Dual-Part Model of Parenting (relational and operational capacity) is presented to aid in understanding the complexity and nuance of how parenting capacity may be impacted by IPV exposure throughout the lifespan. Strengths-based approaches to supporting survivors in parenting are explored, and future implications for strengths-based approaches to clinical practice with IPV survivors as well as improved research practices and social policies that emphasize an intersectionality approach are discussed.
Maoism and mental illness: psychiatric institutionalization during the Chinese Cultural Revolution
Authors: Baum Emily , Lin Zhuyun
Published: August 2022

This article offers a preliminary analysis of psychiatric treatment during the Chinese Cultural Revolution on the basis of interviews and rare case records obtained from ‘F Hospital’ in southern China. In contrast to the prevailing view of psychiatry during this time, which highlights either rampant patient abuse or revolutionary ideology, we show that psychiatric treatment at this facility was not radically altered by the politics of the Maoist period. Instead, treatments were informed by a predominantly biomedical understanding of mental illness, one that derived from the prior training of the facility’s lead physicians. Although political education was nominally incorporated into patient rehabilitation and outpatient care, it was not a constitutive element of inpatient treatment during the acute phase of illness.
Making meaning of women's persistence and protagonism in the wake of genocidal violence: Maya Ixil and K’iche’ women of Chajul, Guatemala
Authors: Lykes M. Brinton , Távara Gabriela , Rey-Guerra Catalina
Published: August 2022

Fifteen Maya Ixil and K’iche’ women of Chajul, Guatemala, were interviewed 17 years after publishing their feminist participatory action photovoice research. Their book documents gross violations of human rights during nearly 36 years of armed conflict and their memories of survivance and persistence. A constructivist grounded theory analysis of in-depth interviews with these Maya Ixil and K’iche’ women contributed to the authors’ “bottom up” meaning making of the women's narratives – stories that reflect memories of participatory, community-based workshops and community actions in the wake of genocidal violence. The latter included performances of: presence despite absences; profound losses amidst ongoing suffering; renewed and transformative engagement with traditional beliefs and practices; women's protagonism evidenced through enhanced skills; new capacities performed in multiple contexts within and beyond their community's borders. We analyze these narratives of protagonism and persistence to elucidate some of the multiple contributions of long-term feminist community-based accompaniment and participatory processes as resources for rethreading life and wellbeing in the wake of war.
Psychometric Properties of the Hospital Survey of Patient Safety Culture in Type A Hospitals in Kingston and St. Andrew, Jamaica
Authors: Thompson Camelia , James Kenneth , Chin-Bailey Cameal , Nevins Desmalee Holder , Thompson Elon , Thame Minerva
Published: August 2022

This study sought to examine the internal consistency reliability and underlying factor structure of the Agency of Health Research on Quality Hospital Survey on Patient Safety Culture (AHRQ HSOPSC) in two large acute care hospitals in a developing country setting (Jamaica). A cross-sectional study was done among 328 doctors and nurses. Reliability (internal consistency) analysis was done for each of the 12 composites and the Cronbach’s Alpha coefficients were reported. Principal axis factor analysis (PA) using Varimax rotation was done to identify the underlying factor structure. The Cronbach’s Alpha coefficient was ≥ 0.60 in ten composites. ‘Overall perception of patient safety’ and ‘staffing’ had Cronbach’s Alpha values of 0.585 and 0.553 respectively. A ten-factor solution (34 items) with factor loading of ≥ 0.40 is the best model fit, and composites are now named ‘handoff and transitions/information exchange,’ ‘communication/feedback,’ ‘frequency of events reported,’ ‘management support for patient safety,’ ‘teamwork in unit,’ ‘non-punitive response to errors,’ ‘overall perception of patient safety,’ ‘supervision/management expectations and actions promoting patient safety,’ ‘organizational learning - continuous improvement’ and ‘staffing’. The AHRQ HSOPSC is generally reliable in this developing country setting and the ten-factor structure is consistent with suggested modifications for the emergent AHRQ HSOPSC Version 2 tool.
Hard LRE Choices in the Era of Inclusion: Rights and Their Implications
Authors: Kauffman James M. , Burke Mack D. , Anastasiou Dimitris
Published: August 2022

Rights of students are often misunderstood. Civil rights of minorities granted by the U.S. Supreme Court are confused with human rights of individuals with disabilities granted by the U.S. Congress. Federal law applying to the education of individuals with disabilities requires that difficult decisions be made by families and schools regarding how to address four different and interrelated provisions of Public Law 94-142 of 1975 (now the Individuals with Disabilities Education Improvement Act of 2004 or IDEA): (a) a free, appropriate public education (FAPE), (b) an Individualized Education Program (IEP), (c) placement in the least restrictive environment (LRE), and (d) a full continuum of alternative placements (CAP). Special attention is given to LRE because the full inclusion movement and other influences related to a portion of disability studies have made it the central issue in special education. Under the law, three hard-to-answer questions must be asked in all cases involving special education: (a) What is an appropriate special education for a particular student with a disability? (b) What is the LRE in which that most appropriate education can occur for that individual student? (c) What is the CAP related to that individualized appropriate education?
Association Between Statins and the Risk of Kidney Cancer Incidence and Mortality Using the Korean National Health Insurance Claims Database
Authors: Kim Dong-Sook , Kim Hyun Jung , Ahn Hyeong Sik
Published: August 2022

Background

Conflicting results have been reported regarding the potential preventive effects of statins on the risk of cancer. This study investigated the associations of statin use with the incidence and mortality of kidney cancer in South Korea.

Methods

In this retrospective population-based cohort study using the National Health Insurance claims database, we compared patients aged 45-70 years who had used statins for at least 6 months to non-statin users matched by age and sex from 2005 to June 2013. The main outcomes were kidney cancer incidence and mortality according to statin use. Cox proportional hazard regression was used to calculate the adjusted hazard ratios (aHRs) and 95% confidence intervals (95% CIs).

Results

In the cohort of 1 008 101 people, the aHRs for the association between statin use and the outcomes were .84 (95% CI: 0.71-.99) for kidney cancer incidence and .65 (95% CI: 0.41-.98) for kidney cancer mortality. In the matched cohort of 337 578, the risk per 1000 people of cancer incidence and mortality was 1.63, 1.07, and .24, .17 in statin users and non-users, respectively. In matched cohort, the risk of kidney cancer incidence and mortality decreased, but it is not statistically significant. Also, there was no linear relationship with increased doses.

Conclusion

Statin use might be associated with a decreased risk of kidney cancer incidence and mortality, but it showed no statistical significance. This study was a large-scale analysis, however, further studies that are larger and multinational in scope are needed to confirm the beneficial effects of statins on survival.
Molecular Epidemiology and Hematologic Characterization of Thalassemia in Guangdong Province, Southern China
Authors: Xian Jiajia , Wang Yanchao , He Jianchun , Li Shaoying , He Wenzhi , Ma Xiaoyan , Li Qing
Published: August 2022

Introduction: About 2% of the population in the world are carriers of the thalassemia gene. Thalassemia is highly prevalent in Southern China, and traditional clinical testing methods would cause missed diagnosis of partial static thalassemia. Here, we reviewed and summarized a set of simple and clinically feasible thalassemia detection protocols adopted by the Prenatal Diagnosis and Reproductive Center of our hospital. Methods: From January 1, 2015, to December 31, 2020, 31 512 peripheral blood samples and 3828 prenatal samples were collected in our study. All the peripheral blood samples were performed through thalassemia screening by routine blood tests and hemoglobin electrophoresis and gene detection. The prenatal diagnosis would be implemented for the fetus if the parents were carriers of the same type of thalassemia. Results: A total of 6137 (19.48%) cases were diagnosed as thalassemia, in which 4749 (15.07%) were α-thalassemia, 1196 (3.80%) were β-thalassemia and 192 (0.61%) were co-inheritance of α- and β-thalassemia. For prenatal samples, 3160 (82.55%) cases were diagnosed as thalassemia, in which 2021 (52.80%) were α-thalassemia, 997 (26.05%) were β-thalassemia and 142 (3.71%) were co-inheritance of α- and β-thalassemia. In addition, we also found five novel mutations, including NC_000016.9:g.223681-227492del3812; HBA1: c.301-31_301-24delCTCGGCCCinsG; HBA2: c.95+7C>T for α-thalassemia and HBB: c.263_276delCACTGAGTGAGCTG; HBB: c.315+143G>A for β-thalassemia. Conclusion: The present study updates the epidemiological characteristics and mutation spectrum of thalassemia in Southern China and demonstrated five novel mutations. Our research provides a reference for clinical diagnosis and treatment, prenatal diagnosis, or reproductive genetic counseling for patients with thalassemia in Guangdong.
Association of Prolonged Disease Duration and TG/HDL-C Ratio in Accelerating Atherosclerosis in Patients with Takayasu's Arteritis
Authors: Du Juan , Ren Yanlong , Liu Jiayi , Li Taotao , Zhang Yaxin , Yang Shiyu , Kang Tieduo , Ning Shangqiu , Chen Liying , Guo Xi , Liu Wenxian , Pan Lili
Published: August 2022

Background and aim: Takayasu's arteritis (TA) is a chronic inflammation that frequently involves the aorta and its major branches. It has been known that atherosclerosis can occur in some TA patients. Objectives: This study aimed to identify the risk factors associated with the development of atherosclerosis in TA. Methods: This retrospective study enrolled a total of 101 TA patients. All patients were divided into two groups according to the absence or presence of atherosclerosis. Baseline demographic features and clinical characteristics were compared between two groups. A logistic model was applied to determine the risk factors associated with the development of atherosclerosis. Results: Our data suggested that the disease duration of patients in the atherosclerosis group was significantly longer than that of patients in the non-atherosclerosis group [96(18.00, 180.00) versus 48.00(12.00, 111.00) months] ( P = .015). In addition, the average age of patients with atherosclerosis was significantly older compared to patients without atherosclerosis [44.00(38.00, 48.00)versus 28.50(24.00，37.00)years] ( P  < .001). Logistic regression analysis showed that the risk of developing atherosclerosis increased by 9.2% per 1 year increase in the disease duration ( P = .005, OR 1.092, 95%CI: 1.027-1.162). Patients with TG/HDL-C ratio more than 0.8875 were associated with a 5.861fold increase of risk developing atherosclerosis ( P  < .001, OR 5.861, 95%CI: 2.299-14.939). Conclusion: Our study indicated that prolonged disease duration and elevated TG/HDL-C ratio are associated with the development of atherosclerosis in TA patients.
Patient Advocates’ Perspectives on the Care of Sexual Assault Survivors in Chicago-Area Emergency Departments
Authors: Chalmers Kristen D. , Parameswaran Ramya , Dussault Nicole E. , Farnan Jeanne M. , Oyola Sonia , Carter Keme
Published: August 2022

Emergency departments (EDs) providing care and forensic examinations for sexual assault (SA) survivors are often supported by SA patient advocates. This study explored advocates’ perspectives regarding problems and potential solutions in SA patient care through a focus group with 12 advocates. Thematic analysis identified two major themes: provider–patient interactions and ED–hospital systems. Challenging aspects of provider–patient interactions included (a) provider attitudes and (b) disempowering behaviors. Within ED–hospital systems, themes included time constraints, efficiencies, and hospital preparation. Advocates surveyed were optimistic about an increased presence of SA nurse examiners and enhanced protocols and provider training to improve survivors’ experiences.
Prophylactic and Therapeutic Effect of Kynurenine for Experimental Autoimmune Encephalomyelitis (EAE) Disease
Authors: Sundaram Gayathri , Bessede Alban , Gilot David , Staats Pires Ananda , Sherman Larry S , Brew Bruce J , Guillemin Gilles J
Published: August 2022

Background:

The essential amino acid, tryptophan, is predominantly metabolised through the kynurenine pathway (KP) to generate kynurenine, an aryl-hydrocarbon receptor (AhR) pro-ligand that exerts its effects in a ligand-dependent manner. Interaction between kynurenine and the AhR is an effector mechanism of immunosuppression. We previously found that the KP is involved in multiple sclerosis (MS) disease progression. We postulated that AhR activation by kynurenine might be neuroprotective by encouraging differentiation of Tregs. In this study, we assess both the prophylactic and therapeutic efficiency of kynurenine on disease severity and progression in mice with experimental autoimmune encephalomyelitis (EAE), an MS model.

Methods:

Myelin oligodendrocyte glycoprotein induced EAE mice (n = 6 per group) were treated with 200 mg/kg L-kynurenine once daily for 10 days beginning on either day 1 of EAE induction (prophylactic) or once they demonstrated motor weakness (therapeutic). Clinical disease severity measured by disease score, time on rotarod, and body weight.

Results:

The prophylactic kynurenine treatment significantly ( P < .0001) prevented the development of a more severe disease course with mice demonstrating diminished relapse rate and improved clinical and behavioural outcomes. However, therapeutic kynurenine did not significantly ( P = .4463) decrease the clinical signs until 36 days following induction of disease; after 36 days, it also significantly ( P = .0479) reduced disease relapse. Mean body weight measurements only correlated with time on rotarod ( r = −.6410; P = .0007) but not clinical scores ( r = .1925; P = .3674).

Conclusions:

Kynurenine ameliorates EAE disease progression prophylactically and reduces relapses therapeutically. Further investigations are needed to elucidate the molecular mechanism explaining the therapeutic role of kynurenine for MS.
Sexual consent as an interactional achievement: Overcoming ambiguities and social vulnerabilities in the initiations of sexual activities
Authors: Magnusson Simon , Stevanovic Melisa
Published: August 2022

Sexual consent is advocated around the world to reduce sexual assault. The widespread affirmative consent model emphasizes a need for unambiguous consent. In this paper, we contribute to a deeper understanding of how ambiguities in the initiations of sexual activities are routinely solved to achieve consent. Drawing on conversation analytic research on joint decision-making, and a dataset of 80 cases of sexual initiation in contemporary TV-series and movies, we investigate the interactional practices by which sexual activities are presented as consensual and how consent is achieved across sequences of interaction. We found there to be social advantages of synchronous initiation, compared to sequential verbal initiations, which were associated with various social vulnerabilities. These vulnerabilities could however be circumvented by two practices, each of which made use of a distinct combination of verbal and embodied resources. While ambiguities exist, our results oppose the idea of sexual consent as a practically hopeless and awkward endeavor. Instead, consent consists of joint action that is achieved through recognizable and systematic ways.
On knocking combustion development of oxygenated gasoline fuels in a cooperative fuel research engine
Authors: Han Dong , Lyu Delin , Sun Zijian , Liang Xin , Huang Zhen
Published: August 2022

Fuel octane number has long been used as an indicator for anti-knock capability of gasolines. However, whether octane number could capture the real knocking combustion process in practical engines remains unknown. In this work, the knocking combustion characteristics of methanol/PRF (Primary Reference Fuels), ethanol/PRF, and iso-propanol/PRF fuel blends with either the same research octane number (RON) or the motor octane number (MON) were studied using a three-dimensional numerical model of a Cooperative Fuel Research (CFR) engine. It is observed that the three fuel blends with the same octane rating present different knocking combustion characteristics. The methanol/PRF blend shows an advanced knock onset and higher knock intensity compared to the ethanol/PRF and iso-propanol/PRF blends at the RON test condition, while the iso-propanol/PRF blend is observed to have the earliest knock onset at the MON test condition. It is discovered that even with the same octane number, deviations in the end-gas auto-ignition and flame characteristics of the three fuel blends lead to different knock onsets, which in turn influences their knock intensity.
Trajectories towards a voluntary simplicity lifestyle and inner growth
Authors: Devenin Veronica , Bianchi Constanza
Published: August 2022

Although there is an increase in research on different aspects of voluntary simplicity (VS), there is less understanding of the trajectories that individuals follow when adopting a voluntary simplicity lifestyle, and how transitioning to this lifestyle relates to inner growth. The aim of the paper is to examine the role of inner growth on differentiating voluntary simplicity from other lifestyles. We draw on the framework of resonance by Rosa (2019) Resonance. A sociology of our relationship to the world. Cambridge, UK: Polity Press, who claims the need to move from a state of permanent search for material resources, to develop a resonant relationship with the world. Resonance is a way of relating to the world, where individuals and the world mutually affect each other in an interactive way. Seventeen in-depth interviews were held with voluntary simplifiers living in Chile. The findings propose a model that identifies three different trajectories that people follow to achieve a voluntary simplicity lifestyle and the implication for inner growth as a result of more resonant relationships with the world.
Using cognitive models to design dynamic task allocation systems
Authors: Fisher Christopher R , Frame Mary E , Stevens Christopher
Published: August 2022

Many operations in Intelligence, Surveillance, and Reconnaissance (ISR) involve balancing multiple simultaneous interdependent tasks and coordinating between multiple teammates. Recently, autonomous managers (AMs) were proposed as a method for optimizing performance in team-based workflows using dynamic reallocation in response to changes in workload and performance. We demonstrate how cognitive models can be used in the design and evaluation of AMs. Specifically, cognitive models can be used to inform an AM’s decision policy, and to stress test an AM under a wide variety of conditions. Simulation 1 tested the robustness of numerous AMs across a wide range of cognitive agents. We found that a simpler cognitive model in the AM’s decision system was more robust than more complex models. In the second simulation study, we compared dynamic task reallocation and corrective feedback to improve performance of cognitive agents based on the ACT-R cognitive architecture. Our results indicate that both interventions have the potential to improve performance, and that the most robust AM from simulation 1 can improve the performance of a model with realistic learning dynamics. Our simulations demonstrate that cognitive models are useful for designing and evaluating AMs for multiple military applications, including ISR.
Receive + Heart = Love. Bidirectional Nourishment in the Practice of Medicine
Authors: Carne Ross
Published: August 2022

Attitudinal considerations are so important in the practice of meeting the patient as whole person, and in our literature, these are underexamined. Where does love sit in the transactionality of medical practice? Is this an uncomfortable question? In times which challenge intention and resolve, could the reflection be in some way nourishing?
Deprescribing practices in Canada: A scoping review
Authors: Desai Mansi , Park Tanya
Published: August 2022

Background:

Excessive and inappropriate use of medications, defined as polypharmacy, can increase the risk of adverse drug reactions while affecting patient adherence and quality of life. Therefore, optimizing pharmacotherapies through deprescribing practices plays a crucial role in managing chronic conditions, avoiding adverse effects and improving patient outcomes. The purpose of this study was to explore research initiatives surrounding deprescribing in Canada.

Methods:

A scoping review was conducted that involved a search of 6 databases. Studies that highlighted deprescribing interventions, experiences and other effects on Canadian populations were included.

Results:

Searches yielded 2327 citations, of which 31 were included in this review. Five major themes and ideas were identified: deprescribing targeted medications, financial effects of deprescribing, deprescribing in special populations, insight from health care providers and deprescribing frameworks.

Conclusion:

Deprescribing practices in Canada have shown a wide range of beneficial results across various health care settings, populations and medication classes and have the potential to reduce medication-related harm in all Canadian health care settings.
Online architectural education: Reflections on COVID-19 emergency remote learning in East Africa
Authors: Olweny Mark RO , Ndibwami Alex , Ahimbisibwe Achilles
Published: August 2022

This paper investigates how students in two schools of architecture in East Africa, engaged with educational activities during the early phase of the COVID-19 lockdown. The COVID-19 lockdown and shift to emergency remote teaching and learning raised a number of questions for architectural education. These relate to access, equity and pedagogical approaches, which emerged through this study. The paper presents the findings of the study carried out in the University of Rwanda, and Uganda Martyrs University, along with the implications of the findings for architectural education. Making use of an online questionnaire distributed via QualtricsXM, the study attracted 70 student participants. The paper concludes with some suggestions for architectural educators as they rethink the embedded pedagogical traditions of architectural education, and how these must adapt for the future in order to cope with future shocks and disruptions.
The Impact of Digital Technology and Business Regulations on Financial Inclusion and Socio-Economic Development in Low-Income Countries
Authors: Yakubi Yusef Ali Yusef , Basuki Basuki , Purwono Rudi , Usman Indrianawati
Published: August 2022

This study aims to test the impact of digital technology and business regulations on financial inclusion and socioeconomic development in low-income countries. Digital technology and business regulations are perceived to be powerful factors to spur financial inclusive economies and ease several social and economic ills and thus enhance the welfare of low-income nations which represent most world regions. Secondary data were collected for 77 low-income countries from different sources including World Bank, IMF, and UNDP while Smart PLS 3. software was employed for data analysis. This study is distinguished by casting a new angle of linking digital technology and business regulations as drivers of financial inclusion and socioeconomic development. It also presents financial inclusion as a means to an end. Furthermore, it contributes to the literature by providing an empirical evidence on the significant positive impact of digital technology and business regulations on both financial inclusion and socioeconomic development using PLS-SEM method. Thus, stakeholders, governments, and supporters ought to sustainably endorse adoption of digital finance and business environment to assist the poor low-income citizens get pulled into a better-quality life and more improved living standards.
Targeting FLT3 with a new-generation antibody-drug conjugate in combination with kinase inhibitors for treatment of AML
Authors: Roas Maike , Vick Binje , Kasper Marc-André , Able Marina , Polzer Harald , Gerlach Marcus , Kremmer Elisabeth , Hecker Judith S. , Schmitt Saskia , Stengl Andreas , Waller Verena , Hohmann Natascha , Festini Moreno , Ludwig Alexander , Rohrbacher Lisa , Herold Tobias , Subklewe Marion , Götze Katharina S. , Hackenberger Christian P. R. , Schumacher Dominik , Helma-Smets Jonas , Jeremias Irmela , Leonhardt Heinrich , Spiekermann Karsten
Published: August 2022

Fms-like tyrosine kinase 3 (FLT3) is often overexpressed or constitutively activated by internal tandem duplication (ITD) and tyrosine kinase domain (TKD) mutations in acute myeloid leukemia (AML). Despite the use of receptor tyrosine kinase inhibitors (TKI) in FLT3-ITD–positive AML, the prognosis of patients is still poor, and further improvement of therapy is required. Targeting FLT3 independent of mutations by antibody-drug conjugates (ADCs) is a promising strategy for AML therapy. Here, we report the development and preclinical characterization of a novel FLT3-targeting ADC, 20D9-ADC, which was generated by applying the innovative P5 conjugation technology. In vitro, 20D9-ADC mediated potent cytotoxicity to Ba/F3 cells expressing transgenic FLT3 or FLT3-ITD, to AML cell lines, and to FLT3-ITD–positive patient-derived xenograft AML cells. In vivo, 20D9-ADC treatment led to a significant tumor reduction and even durable complete remission in AML xenograft models. Furthermore, 20D9-ADC demonstrated no severe hematotoxicity in in vitro colony formation assays using concentrations that were cytotoxic in AML cell line treatment. The combination of 20D9-ADC with the TKI midostaurin showed strong synergy in vitro and in vivo, leading to reduction of aggressive AML cells below the detection limit. Our data indicate that targeting FLT3 with an advanced new-generation ADC is a promising and potent antileukemic strategy, especially when combined with FLT3-TKI in FLT3-ITD–positive AML.
Endothelial cell–leukemia interactions remodel drug responses, uncovering T-ALL vulnerabilities
Authors: Cappelli Luca Vincenzo , Fiore Danilo , Phillip Jude M. , Yoffe Liron , Di Giacomo Filomena , Chiu William , Hu Yang , Kayembe Clarisse , Ginsberg Michael , Consolino Lorena , Barcia Duran Jose Gabriel , Zamponi Nahuel , Melnick Ari M. , Boccalatte Francesco , Tam Wayne , Elemento Olivier , Chiaretti Sabina , Guarini Anna , Foà Robin , Cerchietti Leandro , Rafii Shahin , Inghirami Giorgio
Published: August 2022

T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive and often incurable disease. To uncover therapeutic vulnerabilities, we first developed T-ALL patient–derived tumor xenografts (PDXs) and exposed PDX cells to a library of 433 clinical-stage compounds in vitro. We identified 39 broadly active drugs with antileukemia activity. Because endothelial cells (ECs) can alter drug responses in T-ALL, we developed an EC/T-ALL coculture system. We found that ECs provide protumorigenic signals and mitigate drug responses in T-ALL PDXs. Whereas ECs broadly rescued several compounds in most models, for some drugs the rescue was restricted to individual PDXs, suggesting unique crosstalk interactions and/or intrinsic tumor features. Mechanistically, cocultured T-ALL cells and ECs underwent bidirectional transcriptomic changes at the single-cell level, highlighting distinct “education signatures.” These changes were linked to bidirectional regulation of multiple pathways in T-ALL cells as well as in ECs. Remarkably, in vitro EC-educated T-ALL cells transcriptionally mirrored ex vivo splenic T-ALL at single-cell resolution. Last, 5 effective drugs from the 2 drug screenings were tested in vivo and shown to effectively delay tumor growth and dissemination thus prolonging overall survival. In sum, we developed a T-ALL/EC platform that elucidated leukemia-microenvironment interactions and identified effective compounds and therapeutic vulnerabilities.
Leukemia inhibitory factor protects against graft-versus-host disease while preserving graft-versus-leukemia activity
Authors: Wang Jianming , Chang Chun-Yuan , Yang Xue , Zhou Fan , Liu Juan , Zhu Sining , Yu Xue-Zhong , Liu Chen , O’Sullivan Timothy E. , Xie Ping , Feng Zhaohui , Hu Wenwei
Published: August 2022

Graft-versus-host disease (GVHD) remains a major complication after allogeneic hematopoietic stem cell transplantation, a widely used therapy for hematologic malignancies and blood disorders. Here, we report an unexpected role of cytokine leukemia inhibitory factor (LIF) in protecting against GVHD development. Administrating recombinant LIF protein (rLIF) protects mice from GVHD-induced tissue damage and lethality without compromising the graft-versus-leukemia activity, which is crucial to prevent tumor relapse. We found that rLIF decreases the infiltration and activation of donor immune cells and protects intestinal stem cells to ameliorate GVHD. Mechanistically, rLIF downregulates IL-12–p40 expression in recipient dendritic cells after irradiation through activating STAT1 signaling, which results in decreased major histocompatibility complex II levels on intestinal epithelial cells and decreased donor T-cell activation and infiltration. This study reveals a previously unidentified protective role of LIF for GVHD-induced tissue pathology and provides a potential effective therapeutic strategy to limit tissue pathology without compromising antileukemic efficacy.
RNA secondary structure factorization in prime tangles
Authors: Marchei Daniele , Merelli Emanuela
Published: August 2022

Background

Due to its key role in various biological processes, RNA secondary structures have always been the focus of in-depth analyses, with great efforts from mathematicians and biologists, to find a suitable abstract representation for modelling its functional and structural properties. One contribution is due to Kauffman and Magarshak, who modelled RNA secondary structures as mathematical objectsconstructedin link theory:tangles of the Brauer Monoid. In this paper, we extend the tangle-based model with its minimal prime factorization, useful to analyze patterns that characterize the RNA secondary structure.

Results

By leveraging the mapping between RNA and tangles, we prove that the prime factorizations of tangle-based models share some patterns with RNA folding’s features. We analyze theE. colitRNA and provide some visual examples of interesting patterns.

Conclusions

We formulate an open question on the nature of the class of equivalent factorizations and discuss some research directions in this regard. We also propose some practical applications of the tangle-based method to RNA classification and folding prediction as a useful tool for learning algorithms, even though the full factorization is not known.
Modeled microgravity alters apoptotic gene expression and caspase activity in the squid-vibrio symbiosis
Authors: Vroom Madeline M. , Troncoso-Garcia Angel , Duscher Alexandrea A. , Foster Jamie S.
Published: August 2022

Background

Spaceflight is a novel and profoundly stressful environment for life. One aspect of spaceflight, microgravity, has been shown to perturb animal physiology thereby posing numerous health risks, including dysregulation of normal developmental pathways. Microgravity can also negatively impact the interactions between animals and their microbiomes. However, the effects of microgravity on developmental processes influenced by beneficial microbes, such as apoptosis, remains poorly understood. Here, the binary mutualism between the bobtail squid, Euprymna scolopes, and the gram-negative bacterium, Vibrio fischeri, was studied under modeled microgravity conditions to elucidate how this unique stressor alters apoptotic cell death induced by beneficial microbes.

Results

Analysis of the host genome and transcriptome revealed a complex network of apoptosis genes affiliated with extrinsic/receptor-mediated and intrinsic/stress-induced apoptosis. Expression of apoptosis genes under modeled microgravity conditions occurred earlier and at high levels compared to gravity controls, in particular the expression of genes encoding initiator and executioner caspases. Functional assays of these apoptotic proteases revealed heightened activity under modeled microgravity; however, these increases could be mitigated using caspase inhibitors.

Conclusions

The outcomes of this study indicated that modeled microgravity alters the expression of both extrinsic and intrinsic apoptosis gene expression and that this process is mediated in part by caspases. Modeled microgravity-associated increases of caspase activity can be pharmacologically inhibited suggesting that perturbations to the normal apoptosis signaling cascade can be mitigated, which may have broader implications for maintaining animal-microbial homeostasis in spaceflight.