bluuebunny/crossref_metadata_2025 huggingface dataset:
Methodological development through critical reflections on a study focusing on daily valuable encounters in early childhood settings
Authors: Manni Annika , Löfgren Håkan
Published: October 2022

This article focuses on the methodological experiences that emerged from a study investigating how teachers valued their daily encounters with children in early childhood education. Early childhood teachers often balance the demands of documentation with time spent with children, so have little time to reflect on their practice. Furthermore, participation in research projects tends to be both time-consuming and distracting from the practitioners’ perspective, without providing immediate opportunities for professional development. The purpose of this article is to elaborate on the use of a mixed-methods approach that combines a quantitative digital tool (an application) for collecting data with the use of short qualitative interviews in order to explore methodological aspects in educational research. The pros of this mixed-methods approach include flexibility, the instant overview of data, and the reflective potential offered to the participants, as well as the researchers. The teachers had the opportunity to ‘set the agenda’ when giving their own definitions of valuable encounters and then reflect on their experiences in their own words. This gave them a strong voice. The main risks of this method concern the dependence on technical devices and software. The authors argue that there is potential in the reflective methodology used in this study to bring research and practice closer in comprehensive knowledge creation. This methodology offers a respectful way to gather information from practice and simultaneously provide opportunities to change.
Murray Bookchin and the value of democratic municipalism
Authors: Shelley Cain
Published: October 2022

Recent debates about the most appropriate political agents for realising social justice have largely focused on the potential value of national political parties on the one hand, and trade unions on the other. Drawing on the thought of Murray Bookchin, this article suggests that democratic municipalist agents – democratic associations of local residents that build and empower neighbourhood assemblies and improve the municipal provision of basic goods and services – can often also make valuable contributions to projects of just social change. I identify a long-term and a more short-term argument for the value of democratic municipalist agency in Bookchin's thought and claim that the latter provides a compelling case for the valuable contributions this form of action can make to the achievement of a wide variety of visions of social justice. This provides a useful partial corrective to recent political theorising about the nature of the partisanship and trade unionism necessary to secure social justice.
More care, less pathway. . .More plans?
Authors: Haughey Conn
Published: October 2022

Treatment Escalation Plans (TEPs) risk becoming the next ‘tick box exercise’, if not supported by open and compassionate conversations by healthcare teams brave enough to adequately address the culturally taboo subject of death. This requires a wider system of ongoing support, education and clinical leadership to create a culture of open communication. While excellent to read the emphasis that palliative treatments should not be reserved for the terminally ill, further advancements would see ‘Supportive Care’ move from the lowest levels of escalation to becoming embedded as standard practice for all deteriorating patients. This supportive element of care, underpinned by clear communication, could accompany patients regardless of their level of escalation. Through adopting the Palliative and Supportive Care ethos, addressing not only physical symptom needs, but also exploring social, psychological and spiritual concerns, be it in the ICU or on a general ward, we may move closer towards offering the truly individualised plans of care that TEPs promise.
Overcoming Barriers to Improve Treatments in Epilepsy
Authors: Wong Jennifer C.
Published: October 2022

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The Power of Voice: Storytelling as Peacebuilding in Post-Troubles Northern Ireland
Authors: Schmidt Elizabeth , Lada Jenna , Donahoe Amanda E. , Hancock Landon E.
Published: October 2022

The Northern Ireland peace process has been long and tumultuous, yet 20 years after the Good Friday Agreement, peace has not become a reality for many Northern Irish citizens. For those who have been excluded from the state and the institution-led peace process, grassroots methods of peacebuilding are needed to create an everyday peace that is owned by and includes all Northern Irish citizens. A narrative approach to peacebuilding is one that addresses many of the challenges to everyday peace following the “Troubles.” By exploring the use and impact of storytelling and narrative on everyday experiences, the narrative approach proves to be a viable tool for elevating and giving ownership of the peace process to marginalized members of Northern Irish society.
Upper-Limb Motor Intervention Elements That Drive Improvement in Biomarkers and Clinical Measures Post-Stroke: A Systematic Review in a Systems Paradigm
Authors: Wingfield Matthew , Fini Natalie A. , Brodtmann Amy , Williams Gavin , Churilov Leonid , Hayward Kathryn S.
Published: October 2022

Objective

To use a systems paradigm to examine upper limb (UL) motor intervention elements driving biomarker and clinical measure improvement after stroke.

Methods

Databases were searched up to March 2022. Eligibility screening was completed by 2 authors. Studies using biomarkers and clinical measures pre- and post-upper limb intervention were included. Studies of adjunct interventions (eg, brain stimulation) were excluded. Cochrane Risk-of-Bias tools and Template for Intervention Description and Replication were used to rate studies. Studies were synthesized using a systems paradigm: intervention outcome was considered an emergent property of the systemic interactions of 4 intervention elements (demographics, type, quality, and dose) characterized by individual dimensions.

Results

Sixty-four studies (n = 1814 participants) containing 106 intervention groups (66 experimental; 40 control) were included. Combined biomarker and clinical outcomes defined 3 scenarios: restitution, mixed, and unchanged. The restitution scenario included more moderate-to-severely impaired participants in earlier recovery phases (<6 months). Interventions with graded difficulty were more frequently used in the restitution scenario compared with the unchanged scenario. No difference in quality or amount of therapy was identified when examining scenarios that demonstrated restitution compared to those that did not (mixed and unchanged).

Conclusions

A systems paradigm may be one of many approaches to understand UL motor restitution. This review found no single element consistently delivered improvements in biomarkers and clinical measures in the examined intervention groups. Complex patterns formed by multiple interacting intervention elements were observed in participants with and without restitution.
Boundary work in collaborative inquiry: Framing the contributions
Authors: May Tim
Published: October 2022

This article situates the contributions to this special issue. It does so by examining the process of methodological justification and the relations between the content of knowledge and the context of production. Boundary work concerning these dynamics, along with issues applicability and credibility, along with the university as a core site of social research practice, are discussed. Once engagement with communities comes into the process of co-production, there is an ambivalence both among academics and universities concerning the place of such work. This leads to a set of devilish dichotomies in research practice that requires intensive boundary work in a process characterized as active intermediation between varying expectations. Framing the contributions in this way enables an enlargement of the scope of research with different communities in terms of boundaries of practice, whilst also questioning the selectivity that informs the impact and engagement agendas in universities.
Exploring Korean College of Education Pre-service Teacher Persistence Toward a Teaching Career: Quantitative Analysis of Reasons and Factors for Persisting
Authors: Murdoch Yvette Denise , Lim Hyejung
Published: October 2022

Teacher attrition is a global concern. Because motivation drives a teacher to persist in their teaching career and affects their effectiveness, persistence among pre-service teachers is important. This exploratory study ( N = 55) of college of education students at a university in metropolitan Seoul, South Korea, using survey data, used (a) independent samples t-test to determine reasons for persisting and (b) correlation analysis among demographics and five persistence factors: Academic Integration, Social Integration, Supportive Service Satisfaction, Degree Commitment, and Academic Conscientiousness to understand persistence to a teaching career. The main motivation, job security, moderately correlated with two persistence factors while general interest in the subject and English proficiency positively associated with all persistence factors. The higher students assessed their English proficiency, the more they did not wish to become a teacher because of “salary.” More frequent and earlier teaching practicums and capitalizing on the Halo Effect are discussed for positive results.
Quantifying the Spinal Lordosis Ratio Unique to the Type of Spinal Sagittal Alignment in a Normal Population
Authors: Chevillotte Thomas , Chan Sook-Kwan , Grobost Pierre , Laouissat Fethi , Darnis Alice , Silvestre Clément , Roussouly Pierre
Published: October 2022

Study Design

Data collection of radiological parameters in non-pathological adult spines.

Objectives

Establishing a baseline database for measurements of the spinal lordosis ratio between upper and lower arcs of the lumbar spine unique to each type of spine described by Roussouly’s classification. Illustrating the importance of correct rationing of the upper and lower arcs.

Methods

Standardised standing true lateral plain radiographs of the spine (including base of skull and proximal femurs) from 373 adult volunteers were obtained. Exclusion criteria : any history of disease involving the spine, pelvis, hips or lower limbs. Incidental detection of any spinal deformity on radiography also excluded further participation in this study. Sacro-pelvic parameters data collected : Pelvic Incidence (PI), Pelvic Tilt (PT), Sacral Slope (SS), location of Inflection Point, number of vertebras in the spinal lordosis and type of Roussouly’s spine. Values of upper arc, lower arc and spinal lordosis ratio (SLR) was determined.

Results

Bivariate analysis revealed statistically significant ( P < .0001) correlation between the types of sagittal spinal alignments based on Roussouly’s classification and the SLR. Type 1: SLR .76 ± .17, Type 2: SLR .60 ± .18, Type 3 with anteverted pelvis: SLR .53 ± .11, Type 3: SLR .49 ± .12, Type4: SLR .41 ± .11.

Conclusion

With this data we are able to quantify the ratio of lumbar lordosis unique to each type of Roussouly’s spine. It functions as a guide when planning lumbar spine surgeries in order to restore the SLR correctly and thus prevent post-op complications such as proximal junction kyphosis.
Very Early Diagnosis of Systemic Sclerosis: Deciphering the heterogeneity of systemic sclerosis in the very early stages of the disease
Authors: Lescoat Alain
Published: October 2022

The early diagnosis of systemic sclerosis has been a major challenge for the scleroderma community in the past 50 years. The recent publication of the predictive value of the VEDOSS (Very Early Diagnosis of Systemic Sclerosis) criteria in the Lancet Rheumatology in December 2021 has provided an unprecedented insight in the early stages of the disease. This editorial discusses the main findings from this 2021 VEDOSS publication and highlights key unanswered questions to be proposed on the research agenda in very early systemic sclerosis.
Neurobiology of Sex and Pornography Addictions: A Primer
Authors: Jha Aishwariya , Banerjee Debanjan
Published: October 2022

Contrary to the earlier notion that addiction is predominantly a substance dependency, research now suggests that any source or experience capable of stimulating an individual has addictive potential. This has led to a paradigm shift in the psychiatric understanding of behavioural addictions. These can refer to a range of behaviors such as gambling, video gaming, and sexual practices. Hypersexual behavior and pornography addiction come to the fore when the behavior becomes intensive, out of the individual’s control, and persists in that pattern despite harmful consequences and risk of harm to one’s emotional and/or physical health. The ongoing Coronavirus disease 2019 pandemic with its’ social distancing norms has further turned sexual practices to digital platforms with increase in pornography use, and hence addictions and unhealthy use of technology. There are several overlapping lines between these dimensions, and there are both components of compulsivity and impulsivity involved. Substantial evidence of neurobiological and psychological models has been used to conceptualize sex and pornography addictions. However, there is no academic consensus or operational criteria that can aid in diagnosing these conditions or estimating their impact. Moreover, the body of evidence on effective treatments is limited. With this background, this descriptive review looks at the various neurophysiological, genetic, and imaging markers of sex and pornography addictions including their possible evidence-based neuroplastic effects on the brain functioning and sexual behavior, and the neurobiological intersections with substance-abuse disorders, and finally outlines the future directions of related research.
Clonal hematopoiesis in patients with stem cell mobilization failure: a nested case-control study
Authors: Hazenberg Carin L. E. , de Graaf Aniek O. , Mulder René , Bungener Laura B. , van Bergen Maaike G. J. M. , Mulder André B. , Choi Goda , Schuringa Jan Jacob , de Groot Marco R. , Vellenga Edo , Jansen Joop H. , Huls Gerwin , van Zeventer Isabelle A.
Published: October 2022

Inadequate mobilization of peripheral blood progenitor cells (PBPCs) is a limiting factor to proceeding with autologous hematopoietic cell transplantation (auto-HCT). To assess the impact of clonal hematopoiesis (CH) on mobilization failure of PBPC for auto-HCT, we investigated the characteristics of poor mobilizers (with a total PBPC collection <2 × 106 CD34+ cells per kg) in a consecutive single-center cohort of 776 patients. Targeted error-corrected next-generation sequencing of 28 genes was performed in a nested case-control cohort of 90 poor mobilizers and 89 matched controls. CH was detected in 48 out of 179 patients (27%), with most patients carrying a single mutation. The presence of CH (detected at variant allele frequency [VAF] ≥ 1%) did not associate with poor mobilization potential (31% vs 22% in controls, odds ratio, 1.55; 95% confidence interval, 0.76-3.23; P = .238). PPM1D mutations were detected more often in poor mobilizers (P = .005). In addition, TP53 mutations in this cohort were detected exclusively in patients with poor mobilization potential (P = .06). The incidence of therapy-related myeloid neoplasms (t-MN) was higher among patients with mobilization failure (P = .014). Although poor mobilizers experienced worse overall survival (P = .019), this was not affected by the presence of CH. We conclude that CH at low VAF (1%-10%) is common at the time of stem cell mobilization. TP53 mutations and PPM1D mutations are associated with poor mobilization potential and their role in subsequent development of t-MN in these individuals should be established.
Anti-aging effect of β-carotene through regulating the KAT7-P15 signaling axis, inflammation and oxidative stress process
Authors: Zheng Wei V. , Xu Wang , Li Yaqin , Qin Jie , Zhou Tao , Li Dezhi , Xu Yanwei , Cheng Xianyi , Xiong Yu , Chen Zaizhong
Published: October 2022

Background

Research on aging is growing as the elderly make up a greater share of the population, focusing on reversing and inhibiting the aging process. The exhaustion and senescence of stem cells are the fundamental drivers behind aging. β-Carotene has been depicted to have many biological functions, and we speculate that it may have an anti-aging effect.

Methods

Firstly, the anti-aging property of β-carotene was investigated in vitro using mesenchymal stem cells (MSCs) induced by H2O2. The anti-aging effect was characterized using Western-bloting, confocal laser scanning microscopy, indirect immunofluorescence, and immunohistochemistry. The anti-aging property was also tested in vivo using aged mice.

Results

The in vitro experiment revealed that β-carotene could relieve the aging of MSCs, as evidenced by a series of aging marker molecules such as p16 and p21. β-Carotene appeared to inhibit aging by regulating the KAT7-P15 signaling axis. The in vivo experiment revealed that β-carotene treatment has significantly down-regulated the aging level of tissues and organs.

Conclusions

In this work, we explored the anti-aging effect of β-carotene in vivo and in vitro. The experimental results indicate that β-carotene may be an important potential anti-aging molecule, which can be used as a drug or in functional food to treat aging in the future.
Mainstreaming adult ADHD into primary care in the UK: guidance, practice, and best practice recommendations
Authors: Asherson Philip , Leaver Laurence , Adamou Marios , Arif Muhammad , Askey Gemma , Butler Margi , Cubbin Sally , Newlove-Delgado Tamsin , Kustow James , Lanham-Cook Jonathan , Findlay James , Maxwell Judith , Mason Peter , Read Helen , van Rensburg Kobus , Müller-Sedgwick Ulrich , Sedgwick-Müller Jane , Skirrow Caroline
Published: October 2022

Background

ADHD in adults is a common and debilitating neurodevelopmental mental health condition. Yet, diagnosis, clinical management and monitoring are frequently constrained by scarce resources, low capacity in specialist services and limited awareness or training in both primary and secondary care. As a result, many people with ADHD experience serious barriers in accessing the care they need.

Methods

Professionals across primary, secondary, and tertiary care met to discuss adult ADHD clinical care in the United Kingdom. Discussions identified constraints in service provision, and service delivery models with potential to improve healthcare access and delivery. The group aimed to provide a roadmap for improving access to ADHD treatment, identifying avenues for improving provision under current constraints, and innovating provision in the longer-term. National Institute for Health and Care Excellence (NICE) guidelines were used as a benchmark in discussions.

Results

The group identified three interrelated constraints. First, inconsistent interpretation of what constitutes a ‘specialist’ in the context of delivering ADHD care. Second, restriction of service delivery to limited capacity secondary or tertiary care services. Third, financial limitations or conflicts which reduce capacity and render transfer of care between healthcare sectors difficult. The group recommended the development of ADHD specialism within primary care, along with the transfer of routine and straightforward treatment monitoring to primary care services. Longer term, ADHD care pathways should be brought into line with those for other common mental health disorders, including treatment initiation by appropriately qualified clinicians in primary care, and referral to secondary mental health or tertiary services for more complex cases. Long-term plans in the NHS for more joined up and flexible provision, using a primary care network approach, could invest in developing shared ADHD specialist resources.

Conclusions

The relegation of adult ADHD diagnosis, treatment and monitoring to specialist tertiary and secondary services is at odds with its high prevalence and chronic course. To enable the cost-effective and at-scale access to ADHD treatment that is needed, general adult mental health and primary care must be empowered to play a key role in the delivery of quality services for adults with ADHD.
The impact of volunteering with a student-run free clinic on medical student specialty selection
Authors: Thomson Kyle B. , Mirpuri Pranav , Chen Melissa
Published: October 2022

Background

The shortage of primary care physicians in the United States is expected to grow to 17,800–48,000 physicians by 2034. Student Run Free Clinics are an increasingly popular component of medical schools and may provide an avenue for increasing medical student interest in primary care specialties. However, there is limited research on the impact of Student Run Free Clinics on medical student specialty choice. This investigation sought to determine whether volunteering with the Interprofessional Community Clinic (ICC), the Student Run Free Clinic associated with Chicago Medical School, was associated with an increased likelihood of matching into primary care specialties. Secondarily, the authors investigated associations between volunteering and matching into family practice. Finally, the authors explored associations between volunteering and the competitiveness of specialty choice.

Methods

This retrospective review utilized data on medical school graduates from 2015 – 2021 including their matched specialties, the number of ICC shifts they volunteered for, and whether they held an ICC leadership position (executive officers). Primary care specialties were defined as internal medicine, family practice, pediatrics, or combined internal medicine/pediatrics. Residency fill rate was used as a proxy for competitiveness.

Results

This analysis included 506 medical students (254 ICC volunteers and 252 non-volunteers). Among ICC volunteers, 47.2% matched into a primary care specialty compared to 36.5% of non-volunteers (RR 1.29, 95% CI 1.05–1.59). Each additional shift worked at the ICC was correlated with increased odds of matching into family practice by a factor of 1.042 (95% CI 1.005–1.079).

Conclusions

Medical students who volunteered with the ICC were more likely to match into primary care residencies. Students who volunteered more frequently were more likely to match into family practice. Further investigation is warranted to determine whether these associations are causative and could thus be leveraged to encourage medical students to pursue primary care careers.
Mental health task-sharing in South Africa – a role for clinical associates?
Authors: Moodley Saiendhra Vasudevan , Wolvaardt Jacqueline , Grobler Christoffel
Published: October 2022

Background

South Africa (SA) lacks the specialised workforce needed to provide mental health services particularly in the public sector and in rural areas. Mid-level medical workers offer a potential option for mental health task-sharing in countries where they exist, including SA. The objectives of the study were to explore the roles that SA’s mid-level medical worker cadre (clinical associates) could play in mental health service delivery, and to explore views on advanced training in mental health for this cadre.

Methods

This was an explorative, qualitative study involving key informants linked to the three clinical associate training programmes in SA. A total of 19 in-depth interviews were conducted with university-based academic staff, facility-based trainers, and student representatives. The interviews were audio-recorded and professionally transcribed. Thematic analysis was conducted with the aid of Atlas.ti software. Themes and subthemes were identified.

Results

The first theme identified was ‘there is a place for them at the table’. Participants felt that there was a definite role for clinical associates in mental health service provision. The levels of care thought most appropriate were primary health care facilities and district hospitals. The most frequently identified role for clinical associates was in providing immediate care and stabilising mental health patients presenting in emergency settings. Other potential settings included inpatient wards, outpatients’ departments, and in communities (e.g. home visits). The second theme identified was ‘earning a seat at the table’. There was virtually unanimous support for additional training and in particular a postgraduate clinical specialisation in mental health. Participants felt a clinical specialisation in mental health would strengthen the health system by addressing workforce shortages as well as access and equity issues. They also held the view it would strengthen the profession by creating a career path and providing more employment opportunities for clinical associates.

Conclusions

There was broad support for a role for clinical associates in mental health service delivery in SA as well as for the establishing a clinical specialisation in mental health for clinical associates. Clinical associates with advanced training in mental health could potentially play an important role in rural settings to alleviate the shortage of specialist mental health practitioners.
Different phenotypes of microglia in animal models of Alzheimer disease
Authors: Wei Yun , Li Xianxiao
Published: October 2022

Microglia are immune-competent cells that are critically involved in maintaining normal brain function. A prominent characteristic of Alzheimer disease (AD) is microglial proliferation and activation concentrated around amyloid plaques in the brain. Recent research has revealed numerous microglial phenotypes related to aging and AD, apart from the traditional M1 and M2 types. Redox signalling modulates the acquisition of the classical or alternative microglia activation phenotypes. The numerous microglial functions can be achieved through these multiple phenotypes, which are associated with distinct molecular signatures.
Moving towards a continuum of safer supply options for people who use drugs: A qualitative study exploring national perspectives on safer supply among professional stakeholders in Canada
Authors: Foreman-Mackey Annie , Pauly Bernie , Ivsins Andrew , Urbanoski Karen , Mansoor Manal , Bardwell Geoff
Published: October 2022

Background

Novel public health interventions are needed to address the toxic drug supply and meet the needs of people who use drugs amidst the overdose crisis. Safer supply – low-barrier distribution of pharmaceutical grade substances – has been implemented in some jurisdictions to provide safer alternatives to the unregulated drug supply, yet no studies to date have explored professional stakeholder perspectives on this approach.

Methods

We used purposive sampling to recruit professional stakeholders (n = 17) from four locations in British Columbia, Ontario, and Nova Scotia, including program managers, executive directors, political and health authority representatives, and healthcare providers involved in the design, implementation, and/or operation of safer supply programs in their communities. Semi-structured, one-to-one interviews were conducted, and interview data were coded and analyzed using thematic analyses.

Results

Participants defined safer supply as low-barrier access to substances of known quality and quantity, offered on a continuum from prescribed to a legal, regulated supply, and focused on upholding autonomy and liberation of people who use drugs. Stakeholders expressed support for safer supply but explained that current iterations do not meet the needs of all people who use drugs and that implementation is limited by a lack of willing prescribers, stigma towards people who use drugs, and precarity of harm reduction programs to political ideology. Stakeholders expressed strong support for wider-reaching approaches such as decriminalization, legalization, and regulation of substances as a way to fully realize a continuum of safer supply, directly address the overdose crisis and toxic drug supply, and ensure equity of access nationally.

Conclusion

The results of this study highlight the need for innovative strategies to address the overdose crisis and that safer supply has the potential to benefit certain people who use drugs. A one-size-fits-all approach is not sufficient and the perspectives of professional stakeholders should be considered alongside those of people who use drugs when designing and implementing future safer supply.
Anatomical observation, classification, fracture and finite element analysis of the posterior process of the Asian adult talus
Authors: Yang Han , Liao Liqing , Xue Fan , Li Yikai , Hu Guanyu
Published: October 2022

Background

Fractures of the posterior process of the talus are rarely seen and frequently overlooked. In our study, anatomical observation and classification of the posterior process of the talus were carried out, and related imaging and finite element methods were combined. The study aimed to observe and provide anatomical data related to posterior process of talus in Asian adults and explore the potential relationships between the different types with fracture of posterior process of talus.

Methods

Combined with the anatomical morphology and imaging data, the posterior process of talus was divided into four types, and the incidence and fracture situation were statistically analyzed. The finite element models of four different types of talus processes were established and verified, and the stress and strain were simulated and analyzed.

Results

The total incidence of the posterior process of the talus was 97.47%. The proportions of the four types were neck-like 10.13%, flat 36.29%, pointy 12.66% and round blunt 38.39%. The overall incidence of bone cracks of the posterior process of the talus was 4.98%; the most common type was neck-like type. Compared with the value on the other types, the maximum von Mises stress increased by 67.66%, 83.90% and 111.18% on the neck-like posterior process of talus respectively.

Conclusions

It is speculated that different types of the posterior process of the talus may be related to the probability of fracture, and it may be better to consider different treatment strategies for different types of fractures.
Effects of C/N ratio on the growth and protein accumulation of heterotrophic Chlorella in broken rice hydrolysate
Authors: Cai Yihui , Zhai Ligong , Fang Xiaoman , Wu Kangping , Liu Yuhuan , Cui Xian , Wang Yunpu , Yu Zhigang , Ruan Roger , Liu Tongying , Zhang Qi
Published: October 2022

Background

Microalgae protein is considered as a sustainable alternative to animal protein in the future. Using waste for microalgal culture can upgrade low-value raw materials into high-value products, helping to offset the cost of microalgal protein production. In this study we explored the feasibility of using microalgae heterotrophic fermentation to convert broken rice hydrolysate (BRH) into protein.

Results

The results showed that the increase of BRH supplemental ratio was beneficial to the increase of biomass production but not beneficial to the increase of intracellular protein content. To further improve protein production, the effect of C/N ratio on intracellular protein accumulation was studied. It was found that low C/N ratio was beneficial to the synthesis of glutamate in microalgae cells, which in turn promoted the anabolism of other amino acids and further the protein. When the C/N ratio was 12:1, the biomass productivity and protein content could reach a higher level, which were 0.90 g/L/day and 61.56%, respectively. The obtained Chlorella vulgaris biomass was rich in essential amino acids (41.80%), the essential amino acid index was as high as 89.07, and the lysine content could reach up to 4.05 g/100 g.

Conclusions

This study provides a theoretical basis and guidance for using Chlorella vulgaris as an industrial fermentation platform to convert broken rice into products with high nutritional value.
Preoperative prediction of lymph node metastasis in nonfunctioning pancreatic neuroendocrine tumors from clinical and MRI features: a multicenter study
Authors: Zhu Hai-bin , Nie Pei , Jiang Liu , Hu Juan , Zhang Xiao-Yan , Li Xiao-Ting , Lu Ming , Sun Ying-Shi
Published: October 2022

Background

The extent of surgery in nonfunctioning pancreatic neuroendocrine tumors (NF-PNETs) has not well established, partly owing to the dilemma of precise prediction of lymph node metastasis (LNM) preoperatively. This study proposed to develop and validate the value of MRI features for predicting LNM in NF-PNETs.

Methods

A total of 187 patients with NF-PNETs who underwent MR scan and subsequent lymphadenectomy from 4 hospitals were included and divided into training group (n = 66, 1 center) and validation group (n = 121, 3 centers). The clinical characteristics and qualitative MRI features were collected. Multivariate logistic regression model for predicting LNM in NF-PNETs was constructed using the training group and further tested using validation group.

Results

Nodal metastases were reported in 41 patients (21.9%). Multivariate analysis showed that regular shape of primary tumor (odds ratio [OR], 4.722; p = .038) and the short axis of the largest lymph node in the regional area (OR, 1.488; p = .002) were independent predictors for LNM in the training group. The area under the receiver operating characteristic curve in the training group and validation group were 0.890 and 0.849, respectively. Disease-free survival was significantly different between model-defined LNM and non-LNM group.

Conclusions

The novel MRI-based model considering regular shape of primary tumor and short axis of largest lymph node in the regional area can accurately predict lymph node metastases preoperatively in NF-PNETs patients, which might facilitate the surgeons’ decision on risk stratification.
De Winter presentations and considerations: a case series
Authors: Shahri Bahram , Vojdanparast Mohammad , Keihanian Faeze , Eshraghi Ali
Published: October 2022

Background

The electrocardiogram has a critical role in the diagnosis and risk assessment of patients presenting with chest pain in the emergency ward.

Case presentation

We present 11 Iranian patients with diagnosis of de Winter referred to our center. Right coronary artery involvement was seen in four cases, left circumflex artery in three cases, proximal left anterior descending artery in two cases, and middle left anterior descending artery in seven cases. We present the case of a 52-year old Iranian male patient in detail.

Conclusion

Recognizing the electrocardiogram of de Winter as an ST-elevation myocardial infarction equivalent in cases with suspected acute infarction is very important.
No matter how much space and light are available, radial growth distribution in Fagus sylvatica L. trees is under strong biomechanical control
Authors: Dongmo Keumo Jiazet Joel Hans , Dlouha Jana , Fournier Meriem , Moulia Bruno , Ningre François , Constant Thiery
Published: October 2022

Key message

This study presents the first attempt to quantify how the thigmomorphogenetic syndrome is involved inFagus sylvaticaL. tree growth responses to thinning. An experimental design preventing mechanosensing in half of the trees demonstrated that radial growth distribution in roots and along the tree stem is under strong biomechanical control.

Context

Studies on the mechanosensitive control of growth under real forest conditions are rare and those existing to date all deal with conifer species. In the current context of global changes, it is important to disentangle how different biotic and abiotic factors affect tree growth.

Aims

Whereas growth changes after thinning are usually interpreted as responses to decreased competition for resources, this study investigates the importance of how mechanosensing controls growth distribution inside the tree.

Methods

In an even-aged beech stand, 40 pole-sized trees (size class at first thinning) were selected, half of the plot was thinned and, within each sub-plot (thinned and unthinned), half of the tree were guy-wired in order to remove mechanical stimulations to the lower part of the stem. Four years later, all trees were felled and volume increment, ring width distribution along the tree height, and the largest ring width of the structural roots were measured. The effect of mechanical stimulation in the two treatments (thinned and unthinned) was assessed.

Results

Removal of mechanical stimulation decreased the volume increment in the lower part of the stem as well as radial root growth but did not affect axial growth. When mechanical strain was removed, the ring width distribution along the stem height changed drastically to an ice-cream cone-like distribution, indicating a strong mechanosensitive control of tree shape.

Conclusion

In a forest stand, the growth allocation inside the tree is under strong mechanical control. Mechanical stimulations explain more than 50% of the increment stimulated by thinning, whatever the growth indicator. A further challenge is to better understand how cambial cells perceive strains during growth in order to integrate mechanosensing into process-based tree-growth modeling.
Multi-encoder attention-based architectures for sound recognition with partial visual assistance
Authors: Boes Wim , Van hamme Hugo
Published: October 2022

Large-scale sound recognition data sets typically consist of acoustic recordings obtained from multimedia libraries. As a consequence, modalities other than audio can often be exploited to improve the outputs of models designed for associated tasks. Frequently, however, not all contents are available for all samples of such a collection: For example, the original material may have been removed from the source platform at some point, and therefore, non-auditory features can no longer be acquired. We demonstrate that a multi-encoder framework can be employed to deal with this issue by applying this method to attention-based deep learning systems, which are currently part of the state of the art in the domain of sound recognition. More specifically, we show that the proposed model extension can successfully be utilized to incorporate partially available visual information into the operational procedures of such networks, which normally only use auditory features during training and inference. Experimentally, we verify that the considered approach leads to improved predictions in a number of evaluation scenarios pertaining to audio tagging and sound event detection. Additionally, we scrutinize some properties and limitations of the presented technique.
On the noncooperative Schrödinger–Kirchhoff system involving the critical nonlinearities on the Heisenberg group
Authors: Sun Xueqi , Bai Shujie , Song Yueqiang
Published: October 2022

This paper deals with the existence of solutions for the noncooperative Schrödinger–Kirchhoff system involving the p-Laplacian operator and critical nonlinearities on the Heisenberg group. Under some suitable conditions, together with the limit index theory and the concentration–compactness principle, we obtain the existence and multiplicity of solutions for this system. To our best knowledge, the existence results for the noncooperative system with p-Laplacian and critical nonlinearities are new on the Heisenberg group.
Discharge locations after hospitalizations involving opioid use disorder among medicare beneficiaries
Authors: Moyo Patience , Eliot Melissa , Shah Asghar , Goodyear Kimberly , Jutkowitz Eric , Thomas Kali , Zullo Andrew R.
Published: October 2022

Background

Hospitalizations involving opioid use disorder (OUD) have been increasing among Medicare beneficiaries of all ages. With rising OUD-related acute care use comes the need to understand where post-acute care is provided and the capacities for OUD treatment in those settings. Our objective was to describe hospitalized Medicare beneficiaries with OUD, their post-acute care locations, and all-cause mortality and readmissions stratified by post-acute care location.

Methods

We conducted a retrospective cohort study of acute hospitalizations using 2016–2018 Medicare Provider Analysis and Review (MedPAR) files linked to Medicare enrollment data and the Residential History File (RHF) for 100% of Medicare fee-for-service beneficiaries. The RHF which provides a person-level chronological history of health service utilization and locations of care was used to identify hospital discharge locations. We used ICD-10 codes for opioid dependence or “abuse” to identify OUD diagnoses from the MedPAR file. We conducted logistic regression to identify factors associated with discharge to an institutional setting versus home adjusting for demographics, comorbidities, and hospital stay characteristics.

Results

Our analysis included 459,763 hospitalized patients with OUD. Of these, patients aged < 65 years and those dually enrolled in Medicaid comprised the majority (59.1%). OUD and opioid overdose were primary diagnoses in 14.3% and 6.2% of analyzed hospitalizations, respectively. We found that 70.3% of hospitalized patients with OUD were discharged home, 15.8% to a skilled nursing facility (SNF), 9.6% to a non-SNF institutional facility, 2.5% home with home health services, and 1.8% died in-hospital. Within 30 days of hospital discharge, rates of readmissions and mortality were 29.7% and 3.9%; respectively, with wide variation across post-acute locations. Factors associated with greater odds of discharge to institutional settings were older age, female sex, non-Hispanic White race and ethnicity, dual enrollment, longer hospital stay, more comorbidities, intensive care use, surgery, and primary diagnoses including opioid or other drug overdoses, fractures, and septicemia.

Conclusions

More than one-quarter (25.8%) of hospitalized Medicare beneficiaries with OUD received post-acute care in a setting other than home. High rates and wide variation in all-cause readmissions and mortality within 30 days post-discharge emphasize the need for improved post-acute care for people with OUD.
The development of a glaucoma-specific health-related quality of life item bank supporting a novel computerized adaptive testing system in Asia
Authors: Fenwick Eva K. , Lim Belicia , Man Ryan E. K. , Baskaran Mani , Nongpiur Monisha E. , Sng Chelvin C. A. , Iyer Jayant V. , Husain Rahat , Perera Shamira A. , Wong Tina T. , Low Jin Rong , Shimin Olivia Huang , Lun Katherine , Aung Tin , Lamoureux Ecosse L.
Published: October 2022

Background

A glaucoma-specific health-related quality of life (HRQoL) item bank (IB) and computerized adaptive testing (CAT) system relevant to Asian populations is not currently available. We aimed to develop content for an IB focusing on HRQoL domains important to Asian people with glaucoma; and to compare the content coverage of our new instrument with established glaucoma-specific instruments.

Methods

In this qualitative study of glaucoma patients recruited from the Singapore National Eye Centre (November 2018-November 2019), items/domains were generated from: (1) glaucoma-specific questionnaires; (2) published articles; (3) focus groups/semi-structured interviews with glaucoma patients (n = 27); and (4) feedback from glaucoma experts. Data were analyzed using the constant comparative method. Items were systematically refined to a concise set, and pre-tested using cognitive interviews with 27 additional glaucoma patients.

Results

Of the 54 patients (mean ± standard deviation [SD] age 66.9 ± 9.8; 53.7% male), 67 (62.0%), 30 (27.8%), and 11 (10.2%) eyes had primary open angle glaucoma, angle closure glaucoma, and no glaucoma respectively. Eighteen (33.3%), 11 (20.4%), 8 (14.8%), 12 (22.2%), and 5 (9.3%) patients had no, mild, moderate, severe, or advanced/end-stage glaucoma (better eye), respectively. Initially, 311 items within nine HRQoL domains were identified: Visual Symptoms, Ocular Comfort Symptoms, Activity Limitation, Driving, Lighting, Mobility, Psychosocial, Glaucoma management, and Work; however, Driving and Visual Symptoms were subsequently removed during the refinement process. During cognitive interviews, 12, 23 and 10 items were added, dropped and modified, respectively.

Conclusion

Following a rigorous process, we developed a 221-item, 7-domain Asian glaucoma-specific IB. Once operationalised using CAT, this new instrument will enable precise, rapid, and comprehensive assessment of the HRQoL impact of glaucoma and associated treatment efficacy.
Fine-needle aspiration cytology versus core needle lymph node biopsy in axillary staging of breast cancer
Authors: Mahmoud Omar M. , Khedrawy Mai El-MoatazBellah , Megally Hasan Ibrahim , Mohamed Mahmoud Farouk , Allam Momtaz Thabet
Published: October 2022

Background

Axillary lymph node status is an extremely important prognostic factor in evaluating and managing recently diagnosed breast cancer patients. So, preoperative evaluation of the lymph nodes in breast cancer patients with minimally invasive methods is of significant concern. Ultrasonography is the main modality used for this purpose, with advantages including the ability to help to guide the biopsy. This study aimed to compare ultrasound-guided fine-needle aspiration cytology (FNAC) and core needle biopsy (CNB) in their ability to detect metastatic disease in the axillary lymph nodes, as well as to estimate the accuracy of preoperative ultrasound-guided axillary lymph node biopsy for staging in patients with breast cancer.

Results

In total, 108 cases were included in the study, and 55.6% (60 cases) had metastases. The sensitivity for FNAC was 83.3%, and the specificity was 100%. The sensitivity for CNB was 100% and the specificity was 100%. The negative predictive value for FNAC was 81.5%, and that for CNB was 100%. The positive predictive value was 100% for both methods.

Conclusions

CNB biopsy shows higher sensitivity and accuracy than FNAC in the characterization of benign and malignant lymph nodes. FNAC is a suitable substitute when a smaller node is encountered, a node in an inaccessible site, or even an uncorrectable bleeding diathesis of the patient.
Are CD45RO+ and CD45RA- genuine markers for bovine memory T cells?
Authors: Anmol Kandel , Akanksha Hada , Zhengguo Xiao
Published: October 2022

Effective vaccination induces memory T cells, which protect the host against pathogen re-infections. Therefore, detection of memory T cells is essential for evaluating vaccine efficacy, which was originally dependent on cytokine induction assays. Currently, two isoforms of CD45 tyrosine phosphatase, CD45RO expression and CD45RA exclusion (CD45RO+/ CD45RA-) are used extensively for detecting memory T cells in cattle. The CD45RO+/CD45RA-markers were first established in humans around three decades ago, and were adopted in cattle soon after. However, in the last two decades, some published data in humans have challenged the initial paradigm, and required multiple markers for identifying memory T cells. On the contrary, memory T cell detection in cattle still mostly relies on CD45RO+/CD45RA-despite some controversial evidence. In this review, we summarized the current literature to examine if CD45RO+/CD45RA-are valid markers for detecting memory T cells in cattle. It seems CD45RA and CD45RO (CD45RA/RO) as markers for identifying bovine memory T cells are questionable.