bluuebunny/crossref_metadata_2025 huggingface dataset:
Heart rate variability behavior in athletes after a sports concussion: A systematic review
Authors: Flores Gonçalo , Monteiro Diogo , Silva Fernanda , Duarte‐Mendes Pedro
Published: May 2023

Objective

This systematic review aims to investigate the adaptations of the autonomic nervous system (ANS) after a concussion by measuring HRV in athletes over the age of 16 after injury.

Methods

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA). Web of Science, Pubmed, SCOPUS, and Sport Discus were searched using predefined search terms to identify relevant original cross‐sectional, longitudinal, and cohort epidemiological studies published before December 2021.

Results

After screening 1737 potential articles, four studies met the inclusion criteria. Studies included participants with concussion (n = 63) and healthy control athletes (n = 140) who practised different sports. Two studies describe a decrease in HRV following a sports concussion, and one proposed that the resolution of symptoms does not necessarily reflect ANS recovery. Lastly, one study concluded that submaximal exercise induces alteration in ANS, not seen in rest after an injury.

Conclusions

In the frequency domain, a decrease in high frequency power and an increase of low frequency/high frequency ratio is expected, as the activity of the sympathetic nervous system increases, and the parasympathetic nervous system decreases after injury. In the frequency domain, heart rate variability (HRV) may help monitor the activity of ANS evaluating signals of somatic tissue distress and early identification of other types of musculoskeletal injuries. Further research should investigate the relationship between HRV and other musculoskeletal injuries.
Comparison of anaerobic speed reserve and maximal aerobic speed methods to prescribe short format high‐intensity interval training
Authors: Bok Daniel , Gulin Jere , Škegro Dario , Šalaj Sanja , Foster Carl
Published: May 2023

The purpose of the study was to compare the degree of intersubject variability in the cardiorespiratory, metabolic, and perceptual responses to high‐intensity interval training (HIIT) prescribed based on the relative anaerobic speed reserve (ASR) or maximal aerobic speed (MAS) and to identify the optimal % ASR for execution of such HIIT. Seventeen male physical education students (age: 23.6 ± 1.1 years, height: 180.2 ± 5.9, body mass: 78.3 ± 8.1 kg; % body fat: 14.3 ± 2.7%) volunteered to execute three randomly scheduled 10‐min HIIT exercises at 110% vVO2max, Δ15% ASR, or Δ25% ASR. Analysis of variance for repeated measures and the least significant difference post‐hoc test were used to compare the physiological responses and the mean of individual residuals between the training sessions. The coefficients of variation (CV) of time spent ≥90% of maximal oxygen uptake (VO2max) and maximal heart rate (HRmax), peak VO2, mean VO2, peak HR, mean HR, blood lactate [La], and rating of perceived exertion (RPE) were 48.7%, 35.9%, 9.3%, 7%, 3.5%, 4.8%, 32%, and 16.9% during 110% vVO2max, 47.2%, 31%, 7.5%, 6.7%, 3.9%, 4.6%, 24.2%, and 14.6% during Δ15% ASR, and 48.1%, 31.5%, 7.6%, 8.4%, 3.6%, 4.1%, 20.2%, and 3.4% during Δ25% ASR session, respectively. Only the residuals in RPE were significantly (p < 0.001) higher in 110% vVO2max and Δ15% ASR in comparison to Δ25% ASR. Time spent ≥90% HRmax/VO2max was maximized during Δ15% ASR session, albeit this was not significantly different from other sessions. The ASR‐based method leads to reduced CVs of physiological and perceptual responses during 10‐min HIIT; however, only reductions in [La] and RPE may be considered practically meaningful. Practitioners can use vVO2max for prescription of 10‐min HIIT session comprised of 15‐s work and passive recovery intervals.
Robust Liu‐type estimator based on GM estimator
Authors: Işılar Melike , Bulut Y. Murat
Published: May 2023

Ordinary Least Squares Estimator (OLSE) is widely used to estimate parameters in regression analysis. In practice, the assumptions of regression analysis are often not met. The most common problems that break these assumptions are outliers and multicollinearity problems. As a result of these problems, OLSE loses efficiency. Therefore, alternative estimators to OLSE have been proposed to solve these problems. Robust estimators are often used to solve the outlier problem, and biased estimators are often used to solve the multicollinearity problem. These problems do not always occur individually in the real‐world dataset. Therefore, robust biased estimators are proposed for simultaneous solutions to these problems. The aim of this study is to propose Liu‐type Generalized M Estimator as an alternative to the robust biased estimators available in the literature to obtain more efficient results. This estimator gives effective results in the case of outlier and multicollinearity in both dependent and independent variables. The proposed estimator is theoretically compared with other estimators available in the literature. In addition, Monte Carlo simulation and real dataset example are performed to compare the performance of the estimator with existing estimators.
Donor‐derived fulminant herpes simplex virus hepatitis after liver transplantation: Two cases and review of literature
Authors: Reinhold Ilana , Teasca Laurent , Rodriguez Elena Requejo , Berney Thierry , Mueller Nicolas J , Hilty Matthias , Andermatt Rea , Saro Francesca , Dutkowski Philipp , Müllhaupt Beat , van Delden Christian ,   Swiss Transplant Cohort Study (STCS)
Published: May 2023

Background

Fulminant herpetic hepatitis due to herpes simplex virus (HSV), serotype 1 or 2, is a rare but often fatal complication after solid organ transplantation (SOT). HSV hepatitis in SOT recipients can occur either due to primary infection acquired post transplantation, viral reactivation in a seropositive patient, or as donor‐derived infection. Cases of fatal hepatitis have been reported in the liver as well as in other SOT recipients. The fatal outcome is mostly due to delayed diagnosis and treatment, which is explained by the lack of clinical specificity of HSV hepatitis.

Methods

We report two cases of fatal donor‐derived HSV hepatitis in liver‐transplanted recipients. We reviewed all published cases of donor‐derived HSV infections after SOT with an evaluation of the presence of prophylaxis and outcome.

Results

In both liver recipients, the retrospective determination of HSV serostatus was negative, and both cases occurred in the absence of cytomegalovirus or HSV prophylaxis. A review of the literature showed a significant series of cases of severe hepatitis, mostly fatal, as well as the absence of specific preventive therapy guidelines in cases of HSV serology mismatch.

Conclusions

The occurrence of two fatal donor‐derived hepatitis made the Swiss Transplant Infectious Diseases working group modify its national recommendations regarding pretransplant serostatus determination and HSV prophylaxis after liver transplantation. Further studies are needed to assess this approach.

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Extra‐EU immigrants and labour productivity: New evidence from Italian firms
Authors: Vittori Claudia , Ricci Andrea , Ferri Valentina
Published: May 2023

This paper investigates the impact of extra‐EU workers on labour productivity in Italy. To this aim, we take advantage of firm‐level data derived from the Rilevazione Imprese e Lavoro (RIL‐AIDA) surveys merged with the AIDA‐Bureau Van Dijk archive over the period 2007–2015. Using an econometric strategy that accounts for firms' observed heterogeneity and endogeneity issues, we obtain the following results. First, an increase in the share of extra‐EU workers leads to a decline in labour productivity. Second, the relationship between extra‐EU workers and productivity appears to be different between firms located in centre‐north and those in southern regions. Third, the share of extra‐EU workers is also associated with a decline in average wages and sales per employee, even though this effect is less than that observed for productivity. Our findings support the hypothesis that the demand of immigrants arises as a labour cost reduction strategy and hence tends to weaken firms' competitiveness.
Measurement of the Cross Section for the Neutron-Induced Fission of 238U Nuclei in the Energy Range of 0.3–500 MeV
Authors: Vorobyev A. S. , Gagarski A. M. , Shcherbakov O. A. , Vaishnene L. A. , Barabanov A. L.
Published: May 2023

The cross section for the neutron-induced fission of 238U nuclei has been measured using the time-of-flight spectrometer of the GNEIS neutron complex at the Petersburg Nuclear Physics Institute, National Research Center Kurchatov Institute, in the neutron energy range of 0.3–500 MeV. Fission fragments have been detected by low-pressure position-sensitive multiwire proportional counters. The cross section for 238U(n, f) fission has been measured with respect to the cross section for 235U(n,  f) fission, which is an accepted international standard. Data on the energy dependence of the anisotropy of the angular distribution of fragments of neutron-induced 238U nuclei are also presented. The data obtained have been compared to previous experiments carried out using both similar and significantly different methods.
Towards $$\mathcal{P}\mathcal{T}$$-Symmetric Optical Dimer Fabrication without a Light-Absorbing Material
Authors: Dmitriev A. A. , Baryshnikova K. V. , Rybin M. V.
Published: May 2023

We consider an approach to engineer an optical dimer of particles operating in the spectral region near the dipolar resonance that exhibits parity–time symmetry-like features. Both particles are assumed to be made of a gain medium with the same refractive index and extinction coefficient. We suggest introducing a gain–loss contrast by altering the radiative loss of the particles through changing their shape. To demonstrate our approach, we consider a dimer of infinite filled and hollow cylinders. We demonstrate that a larger hollow diameter leads to a stronger radiative decay. Then we find the parameters of a dimer that has an exceptional point at a real frequency and exhibits two real eigenfrequencies when the gain–loss contrast is decreased.
Repeated ultrasound tests could be used to identify an isolated gastric duplication cyst before surgery
Authors: Arayama Akane , Tomari Kouki , Takayama Tomotada , Matsuoka Takashi
Published: May 2023

A toddler girl was diagnosed with intra-abdominal simple cyst in the splenic flexure at the gestational period. Due to a severe fever that persisted for 6 days, she was admitted to the emergency room. The diagnosis of intraperitoneal cyst infection was made after contrast-enhanced CT revealed an enlarged cyst and a heterogeneous contrast effect on the cyst wall. A double-wall sign was observed on the cyst wall during continuous ultrasound follow-up, which led to the preoperative diagnosis of the cyst as a duplication cyst. The double-wall sign and cyst peristalsis were identified via successive ultrasound examinations to support the cyst diagnosis. Identifying a duplication cyst based solely on symptoms alone is difficult because the condition may present in different ways.
Primary gastric amyloidosis associated with linitis plastica and delayed progression to systemic amyloidosis and multiple myeloma
Authors: Khalil Georges , Fiani Dimitri , Antaki Fares , Diab Ernest
Published: May 2023

We report the case of a woman in her 50s who underwent, 5 years prior, a total gastrectomy after neoadjuvant chemotherapy for diffuse-type gastric cancer diagnosed during a workup for isolated gastric primary light chain (AL) amyloidosis. At the time of diagnosis, immunoglobulins light chain measurements and bone marrow biopsy were performed to rule out multiple myeloma and came back normal. Three years later, the patient developed systemic amyloidosis involving the heart and the lungs, after which she developed multiple myeloma. Isolated amyloid deposits in the stomach are a rare finding. While AL amyloidosis is frequently found in concomitance with multiple myeloma, late progression of primary AL amyloidosis to systemic amyloidosis and multiple myeloma is uncommon.
Resolution of atypical posterior semicircular canal BPPV: evidence for putative short-arm location
Authors: Ludwig Daniel , Schubert Michael C
Published: May 2023

This case demonstrates the successful identification and treatment of atypical posterior semicircular canal benign paroxysmal positional vertigo (BPPV) based on a unique presentation of positional nystagmus, the resultant nystagmus from repositioning manoeuvers, and restored function of the affected semicircular canal. This case illustrates the importance of completing a comprehensive clinical examination and the value for incorporating the video head impulse test as well as adjusting treatment based on testing and patient response when managing variant cases of BPPV.
Investing in a global pooled-funding mechanism for late-stage clinical trials of poverty-related and neglected diseases: an economic evaluation
Authors: Zimmerman Armand , Diab Mohamed Mustafa , Schäferhoff Marco , McDade Kaci Kennedy , Yamey Gavin , Ogbuoji Osondu
Published: May 2023

Introduction

Poverty-related and neglected diseases (PRNDs) cause over three million deaths annually. Despite this burden, there is a large gap between actual funding for PRND research and development (R&D) and the funding needed to launch PRND products from the R&D pipeline. This study provides an economic evaluation of a theoretical global pooled-funding mechanism to finance late-stage clinical trials of PRND products.

Methods

We modelled three pooled-funding design options, each based on a different level of coverage of candidate products for WHO’s list of PRNDs: (1) vaccines covering 4 PRNDs, (2) vaccines and therapeutics covering 9 PRNDs and (3) vaccines, therapeutics and diagnostics covering 30 PRNDs. For each option, we constructed a discrete event simulation of the 2019 PRND R&D pipeline to estimate required funding for phase III trials and expected product launches through 2035. For each launch, we estimated global PRND treatment costs averted, deaths averted and disability-adjusted life-years (DALYs) averted. For each design option, we calculated the cost per death averted, cost per DALY averted, the benefit–cost ratio (BCR) and the incremental cost-effectiveness ratio (ICER).

Results

Option 1 averts 18.4 million deaths and 516 million DALYs, has a cost per DALY averted of US$84 and yields a BCR of 5.53. Option 2 averts 22.9 million deaths and 674 million DALYs, has a cost per DALY averted of US$75, an ICER over option 1 of US$49 and yields a BCR of 3.88. Option 3 averts 26.9 million deaths and 1 billion DALYs, has a cost per DALY averted of US$114, an ICER over option 2 of US$186 and yields a BCR of 2.52.

Conclusions

All 3 options for a pooled-funding mechanism—vaccines for 4 PRNDs, vaccines and therapeutics for 9 PRNDs, and vaccines, therapeutics and diagnostics for 30 PRNDs—would generate a large return on investment, avert a substantial proportion of the global burden of morbidity and mortality for diseases of poverty and be cost-effective.
Social venues and HIV vulnerability of young venue workers: a cluster analysis of data from a national-level cross-sectional survey of social venues in Uganda
Authors: Babirye Susan , Ssengooba Freddie , Weir Sharon Stucker , Michielsen Kristien
Published: May 2023

Objective

Venues where people socialize, such as bars, play a significant role in HIV transmission risk. However, little research has been done that identifies characteristics of high-risk venues, to inform HIV prevention efforts. This study identified clusters of social venues in Uganda and their relationship with HIV vulnerability of young venue workers (15–24 years). We also assessed availability of HIV prevention services at the venues.

Design and setting

This was a secondary analysis of data from a larger cross-sectional survey of social venues in 25 districts of Uganda.

Participants

A total of 480 venues that employed young workers were included in this study.

Analysis

Hierarchical cluster and mixed-effects regression analyses were conducted.

Results

Four clusters were adopted: cluster 1 represented 127 venues (mainly alcohol-serving sex work venues with a provision of on-site sex); cluster 2 represented 80 venues (mainly alcohol-serving sex work venues without a provision of on-site sex); cluster 3 represented 113 venues (mainly alcohol-serving venues without sex work or on-site sex); and cluster 4 represented 160 venues (non-alcohol-serving venues). We found a positive correlation between venue clusters and HIV vulnerability. Workers who belonged to cluster 1 (alcohol-serving sex work venues with a provision of on-site sex) had a 0.15 increase in HIV vulnerability compared with those in alcohol-serving venues without sex work or a provision of on-site sex (cluster 3) (coefficient: 0.15, 95% CI: 0.030 to 0.287) after adjusting for age, sex and marital status. Thirty-seven per cent of cluster 1 venues reported any HIV prevention services in the past 12 months.

Conclusion

Alcohol-serving sex work venues with a provision of on-site sex (cluster 1) appeared to reinforce vulnerability to HIV in this study and should be targeted with HIV prevention interventions. Such venues can amplify HIV transmission by facilitating sexual partner coupling and on-site sex.
Feasibility and acceptability pilot of video-based direct observed treatment (vDOT) for supporting antitubercular treatment in South India: a cohort study
Authors: Rodrigues Rashmi , Varghese Suman Sarah , Mahrous Mohammed , Ananthaneni Kumar Anil , Ahmed Mohammed Naseer , D'Souza George
Published: May 2023

Objectives

The objective of this study was to assess the feasibility and acceptability of video-based anti-tuberculosis (TB) treatment adherence support in patients with TB (PwTB) in South India.

Design

An exploratory cohort.

Setting

Participants were recruited at the TB treatment centre (direct observed treatment short centre) of a tertiary-level teaching facility in Bangalore, Karnataka, South India.

Participants

The study enrolled 25 PwTB, with replacement. Adult PwTB who were on drug-sensitive treatment regimens were included, while those who had drug resistant TB were excluded from the study.

Intervention

Participants received scheduled adherence reminders and were trained to videorecord themselves swallowing their medication via a mobile application. The application was automated to submit these videos for evaluation. Participants were followed up monthly till treatment completion or withdrawal.

Outcome measures

Adherence rate and acceptability of video-based directly observed treatment (vDOT).

Results

The mean±SD age of the participants was 33±14 years, majority were females (16, 64%), residing in urban areas (24,96%), married (17, 68%) and had access to smart phones (23,92%). A total of 3193 person days of follow-up was completed; of the videos submitted within the first 6 months of enrollment (2501), 94% (2354/2501) were considered ‘acceptable’ and 16 (64%) participants were optimally adherent (ie, ≥80%). Participant videos improved in quality and a higher proportion met acceptability criteria over time. Twenty-one (84%) participants stated that they found the application easy to learn; 13 (52%) preferred vDOT over DOT. Mixed model logistic regression showed that those who are married are more likely have daily adherence to anti-TB treatment.

Conclusion

Video-based mobile phone interventions are acceptable to PwTB and the ease of using the application increases with time. To provide patient-centred care, vDOT is a promising option that can be offered to patients for treatment support and adherence monitoring.
Effects of music therapy on anxiety in patients with cancer: study protocol of a randomised controlled trial
Authors: Sun Chenbing , Sang Shuliu , Tang Yunzhe , Niu Xiaodie , Yoo Hwa-Seung , Zhou Ping , Liu Hao , Gong Yabin , Xu Ling
Published: May 2023

Introduction

Although music therapy (MT) has been found to reduce anxiety in patients with cancer and delay tumour progression to some extent, its mechanism of action has not been determined. MT may reduce anxiety by reducing the concentrations of proinflammatory cytokines. The present study was designed to evaluate the effects of MT on anxiety and cytokine levels in patients with cancer.

Methods and analysis

This randomised, open, single-centre parallel-controlled trial will randomise 60 patients with malignant tumours who meet the inclusion criteria in a 1:1 ratio to either an MT group or a non-MT (NMT) group. Patients in the MT group will receive emotional nursing care and individualised receptive MT for 1 week, whereas patients in the NMT group will receive emotional nursing care alone. Primary outcomes will include scores on the State-Trait Anxiety Inventory, Distress Thermometer and Hamilton Anxiety Scale. Secondary outcomes will include scores on the Quality of Life Questionnaire C30, serum concentrations of the cytokines interleukin (IL)-1β, tumour necrosis factor-α, IL-2R, IL-4, IL-6, IL-8 and IL-10, serum concentrations of the neurotransmitters 5-hydroxytryptamine, dopamine, norepinephrine, adrenocorticotropic hormone and γ-aminobutyric acid, and determination of gut microbiota populations.

Ethics and dissemination

On 5 August 2020, the study protocol was approved by the Research Ethics Committee of the Yueyang Hospital of Integrated Traditional Chinese and Western Medicine of the Shanghai University of Traditional Chinese Medicine. The findings of this study will be published in peer-reviewed publications and presented at appropriate conferences.

Trial registration number

CTR2000035244.
Advance care planning for frail elderly: are we missing a golden opportunity? A mixed-method systematic review and meta-analysis
Authors: Wang Xinying , Huang Xin-Lin , Wang Wei-Jia , Liao Li
Published: May 2023

Objective

The aim is to integrate quantitative and qualitative evidence to understand the effectiveness and experience of advance care planning (ACP) for frail elderly.

Design

A mixed-methods systematic review and meta-analysis was conducted. Quality evaluation was conducted using critical appraisal tools from the Joanna Briggs Institute. Data were synthesised and pooled for meta-analysis or meta-aggregation as needed.

Data sources

An electronic search of MEDLINE, CINAHL, Embase, PubMed, PsycINFO, and Cochrane Library databases from January 2003 to April 2022.

Eligibility criteria for selecting studies

We included experimental and mixed-methods studies. The quantitative component attempts to incorporate a broader study design. The qualitative component aids in comprehending the participant’s experience with ACP and its efficacy.

Data extraction and synthesis

Two independent reviewers undertook screening, data extraction and quality assessment. The quantitative and qualitative data were synthesised and integrated using a convergent segregated approach.

Results

There were 12 158 articles found, and 17 matched the inclusion criteria. The quality of the quantitative component of most included studies (6/10) was rated as low, and the qualitative component of half included studies (4/8) was rated as moderate. The meta-analysis showed that the intervention of ACP for frail elderly effectively increases readiness, knowledge and process of ACP behaviours. The meta-aggregation showed that the participants hold a positive attitude towards ACP and think it facilitates expressing their preferences for the medical decision.

Conclusion

ACP is an effective and feasible strategy to facilitate frail elderly to express their healthcare wishes timely and improve their outcomes. This study could provide proof for a better understanding of the subject and help direct future clinical practice. More well-designed randomised controlled trials evaluating the most effective ACP interventions and tools are needed for the frail elderly population.

PROSPERO registration number

CRD42022329615.
Benefits, challenges and sustainability of digital healthcare for NHS Wales: a qualitative study
Authors: Johns Gemma , Whistance Bethan , Burhouse Anna , Khalil Sara , Whistance Megan , Ahuja Saiba , Ogonovsky Mike , Ahuja Alka
Published: May 2023

Introduction

Digital healthcare in the UK was adopted out of necessity rather than choice during the COVID-19 pandemic. However, as we move forward, UK governments and healthcare services have acknowledged its evident benefits for patients, staff and the National Health Service (NHS), and are keen to sustain its improvements in the long term.

Objective

To understand the benefits, challenges and sustainability of a future-proof digital healthcare.

Design

A semi-structured interview study was conducted.

Setting

In NHS services in Wales, UK.

Participants

With clinical and non-clinical staff across a mix of clinical specialties.

Outcome measures

Semi-structured interviews were conducted to address benefits, challenges and sustainability of a national video consulting (VC) service, and thematically coded using a quantification method of qualitative work.

Results

A total of 203 interviews were conducted and 3 dominant domains emerged, with 7 themes and 26 categories.

Limitations

It is important to acknowledge that these findings were captured during a pandemic.

Conclusions

NHS Wales has demonstrated that currently there are an equal measure of benefits and challenges to a national digital healthcare. However, with ongoing government and service support, improvement and evaluation, it has potential for a sustainable digital future, in which the benefits can outweigh the challenges.
Impact of COVID-19 pandemic on health service utilisation and household economy of pregnant and postpartum women: a cross-sectional study from rural Sri Lanka
Authors: Gunarathna Sajan Praveena , Wickramasinghe Nuwan Darshana , Agampodi Thilini Chanchala , Prasanna Indika Ruwan , Agampodi Suneth Buddhika
Published: May 2023

Objectives

This study aims to describe how household economies and health service utilisation of pregnant and postpartum women were affected during the pandemic.

Design

A cross-sectional study.

Setting

This study was conducted in the Anuradhapura district, Sri Lanka.

Participants

The study participants were 1460 pregnant and postpartum women recruited for the Rajarata Pregnancy Cohort during the initial stage of the COVID-19 pandemic.

Primary and secondary outcome measures

Household economic (income, poverty, nutritional and health expenditures) and health service utilisation details during the COVID-19 pandemic were gathered through telephone interviews. Sociodemographic and economic data were obtained from the cohort baseline and analysed with descriptive and non-parametric analysis.

Results

Out of the 1460 women in the sample, 55.3% (n=807) were pregnant and 44.7% (n=653) were postpartum women. Of the total sample, 1172 (80.3%) women participated in the economic component. The monthly household income (median (IQR)=212.39 (159.29–265.49)) reduced (median (IQR)=159.29 (106.20–212.39)) in 50.5% (n=592) families during the pandemic (Z=−8.555, p<0.001). Only 10.3% (n=61) of affected families had received financial assistance from the government, which was only 46.4% of the affected income. The nutritional expenditure of pregnant women was reduced (Z=−2.023, p=0.043) by 6.7%. During the pandemic, 103 (8.8%) families with pregnant or postpartum women were pushed into poverty, and families who were pushed into poverty did not receive any financial assistance. The majority of women (n=1096, 83.3%) were satisfied with the free public health services provided by the public health midwife during the pandemic.

Conclusion

During the early stages of the pandemic, healthcare utilisation of pregnant women was minimally affected. Even before the country’s current economic crisis, the household economies of pregnant women in rural Sri Lanka were severely affected, pushing families into poverty due to the pandemic. The impact of COVID-19 and the aftermath on pregnant women will have many consequences if the policies and strategies are not revised to address this issue.
Tackling childbirth-related intrusive memories with a single-session behavioural intervention involving a visuospatial task: protocol for a single-blind, waitlist-controlled randomised trial
Authors: Fort Déborah , Deforges Camille , Messerli-Bürgy Nadine , Michael Tanja , Baud David , Lalor Joan , Rimmele Ulrike , Horsch Antje
Published: May 2023

Introduction

Approximately 12.3% of mothers experience childbirth-related post-traumatic stress symptoms (CB-PTSS). However, evidence-based interventions to treat CB-PTSS are lacking. Intrusive memories (IM), a key CB-PTSS, are distressing and can trigger other PTSS by reliving the traumatic event. Emerging evidence shows that a behavioural intervention involving a visuospatial task (BI-VT) can reduce the number of IM and PTSS, supposedly by interfering with the reconsolidation of the trauma memory. This study aims to test the efficacy of a single-session BI-VT targeting IM to reduce the number of childbirth-related (CB-)IM and PTSS, in comparison to a waitlist control group (WCG).

Methods and analysis

In this multicentre, single-blind, randomised controlled trial being undertaken at one regional and one university hospital in Switzerland, 60 participants will be allocated to the Immediate Intervention Group (IIG), receiving the immediate intervention on day 15, and 60 participants to the WCG receiving the delayed intervention on day 30. All participants will report their CB-IM during the 2 weeks preimmediate and postimmediate intervention in diaries. The IIG will additionally report their CB-IM over weeks 5 and 6 postimmediate intervention. Self-report questionnaires will assess CB-PTSS at 2 weeks preimmediate and postimmediate intervention in both groups, and at 6 weeks postimmediate intervention in the IIG. A feedback questionnaire will evaluate the intervention acceptability. The primary outcome will be group differences in the number of CB-IM between the 2 weeks preimmediate and postimmediate intervention. Secondary outcomes will be CB-PTSS at 2 and 6 weeks postimmediate intervention, the number of CB-IM at weeks 5 and 6 postimmediate intervention, and intervention acceptability.

Ethics and dissemination

Ethical approval was granted by the Human Research Ethics Committee of the Canton of Vaud (study number 202200652). Participants will provide an informed consent before study participation. Results will be presented in peer-reviewed journals and at conferences.

Trial registration number

NCT05381155.
Clearing the path to vision restoration: an analysis of attitudes and associated factors towards cornea donation in Syria
Authors: Soqia Jameel , Alhomsi Rawan , Ataya Jamal , Al-Mashhour Obaida , Hamzeh Farah , Hamwy Romeo , Sulayman Siba , Alhomsi Nadimah , Hamzeh Ammar
Published: May 2023

Objective

This study aims to assess attitudes and associated factors towards cornea donation among visitors of a main public hospital in Damascus. Findings of this study can contribute to the development of effective donation campaigns and applying cornea donation in Syria.

Methods

This cross-sectional study included individuals who were above 18 years old and were visitors of Al-Mouwasat University Hospital in Damascus, Syria. Data were gathered using a questionnaire administered through face-to-face interviews with the participants. A validated questionnaire was used and consisted of three sections: demographic information, awareness assessment and evaluation of participants’ attitudes towards corneal donation. Associations between participants’ demographics and variables were tested using χ2test, and a p value of <0.05 was considered significant.

Results

637 participants were randomly interviewed. 70.8% of the sample were female and 45.7% have heard about cornea donation. 68.3% of the participants accepted donation of their cornea after death, but this decreased to 56.2% when it comes to donation from relatives after their death. The main reasons for refusing and accepting cornea donation were religious beliefs (10.8%) and intention to help others (65.8%), respectively. Women were more likely to accept donation after death than men (71.4% vs 60.8%, p=0.009). Finally, acceptance of cornea donation would increase if participants lived in a more developed country (71.7% vs 68.3%).

Conclusion

Despite the high willingness, corneal donation in Syria is still not enough. Corneal donation requires an ensured donation system that supports and organises the processes, a simplified education about the importance of donation, and clarifying the right instructions of religion.
Can running-related injuries be prevented through an online behavioural intervention in adult novice runners? Results of a randomised controlled trial
Authors: van der Does Henrike , Kemler Ellen , Gouttebarge Vincent
Published: May 2023

Objective

To evaluate the effectiveness of the Runfitcheck on time until the onset of a new running-related injury (RRI) among adult novice runners.

Methods

A three-arm randomised controlled trial was conducted over 7 months. Adult novice runners completed a baseline online questionnaire on their characteristics, running activity, RRIs and injury preventive behaviour. Runners were randomly allocated to one of two intervention groups or the control group (n=238). One intervention group obtained access to the Runfitcheck (n=252), an online intervention to encourage injury preventive behaviour, and was fortnightly promoted to use Runfitcheck; the other intervention group (n=251) was directed towards the Runfitcheck once. Runners were followed for 4 months, not all starting at the same time over 7 months. The main outcome measure was time to a new RRI using the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire, and was analysed with survival analysis Cox regression. Generalised estimating equations (GEE) were used to gain insight into the effectiveness of the Runfitcheck.

Results

The time to the occurrence of the first RRI did not differ between the study groups (Wald χ2=0.893). GEE analysis showed no difference in the risk of a new RRI in the group that was referred to the Runfitcheck once (OR 1.22, 95% CI 0.86 to 1.74) nor in the active approach group (OR 1.01, 95% CI 0.71 to 1.45) compared with the control group. Furthermore, the onset of the new RRIs did not change over time (OR 0.96, 95% CI 0.91 to 1.01).

Conclusions

The online intervention Runfitcheck was ineffective in reducing the instantaneous risk of new RRIs in adult novice runners. More research is needed to determine how injuries in novice runners can be prevented.

Trial registration number

Dutch Trial Registry (ID: NL7823).
What evidence is needed to inform postoperative opioid consumption guidelines? A cohort study of the Michigan Surgical Quality Collaborative
Authors: Song Jiyeon , Li Yi , Waljee Jennifer F , Gunaseelan Vidhya , Brummett Chad M , Englesbe Michael J , Bicket Mark C
Published: May 2023

Introduction

To balance adequate pain management while minimizing opioid-related harms after surgery, opioid prescribing guidelines rely on patient-reported use after surgery. However, it is unclear how many patients are required to develop precise guidelines. We aimed to compare patterns of use, required sample size, and the precision for patient-reported opioid consumption after common surgical procedures.

Methods

We analyzed procedure-specific 30-day opioid consumption data reported after discharge from 15 common surgical procedures between January 2018 and May 2019 across 65 hospitals in the Michigan Surgical Quality Collaborative. We calculated proportions of patients using no pills and the estimated number of pills meeting most patients’ needs, defined as the 75th percentile of consumption. We compared several methods to model consumption patterns. Using the best method (Tweedie), we calculated sample sizes required to identify opioid consumption within a 5-pill interval and estimates of pills to meet most patients’ needs by calculating the width of 95% CIs.

Results

In a cohort of 10,688 patients, many patients did not consume any opioids after all types of procedures (range 20%–40%). Most patients’ needs were met with 4 pills (thyroidectomy) to 13 pills (abdominal hysterectomy). Sample sizes required to estimate opioid consumption within a 5-pill wide 95% CI ranged from 48 for laparoscopic appendectomy to 188 for open colectomy. The 95% CI width for estimates ranged from 0.7 pills for laparoscopic cholecystectomy to 7.0 pills for ileostomy/colostomy.

Conclusions

This study demonstrates that profiles of opioid consumption share more similarities than differences for certain surgical procedures. Future investigations on patient-reported consumption are required for procedures not currently included in prescribing guidelines to ensure surgeons and perioperative providers can appropriately tailor recommendations to the postoperative needs of patients.
No microplastics detected in the first assessment of Atlantic walrus stomachs from Nunavut, Canada
Authors: Jardine Alexander M. , Matthews Cory J.D. , Provencher Jennifer F. , Hornby Claire , Gamberg Mary , Bourdages Madelaine P.T. , Alexander David , Naullaq Manasie , Vermaire Jesse C.
Published: May 2023

As plastic pollution continues to persist at a global level, the Arctic has drawn increased research interest as a possible sink for marine pollutants. Plastic and microplastics are highly durable and can be transported across vast distances. To date, only a handful of studies have directly assessed microplastics in Arctic mammals. In Canada, it is still unclear whether they show a concrete propensity for microplastic retention and ingestion. Atlantic walruses ( Odobenus rosmarus rosmarus (Linnaeus, 1758)) are economically and culturally important for Inuit and are key predators in Arctic marine ecosystems. Here, we present the first assessment of microplastic pollution in Canadian walruses and the first gastrointestinal assessment of microplastic in walruses globally. Since microplastics accumulate in benthic sediment and animals, we expected that walruses may ingest and retain microplastic contaminants when sifting in search of prey or when eating contaminated bivalves and invertebrates. We detected no microplastics ≥80 µm in our evaluation of 36 walruses from five communities in NU, Canada. Our results suggest that walruses in this region do not retain microplastic particles ≥80 µm in their stomachs, which is consistent with findings in other pinnipeds that have been evaluated in Arctic Canada.
A tale of two mistletoes: phenology and fauna associated with two sympatric species
Authors: Pincheira Javiera , Villarroel Javiera , Orellana José I. , Fontúrbel Francisco E.
Published: May 2023

Mistletoes are parasitic plants that largely rely on animals for pollination and seed dispersal but establish complex interactions with their host plants. Mistletoes are considered keystone species in forest ecosystems as they facilitate several interactions. We studied the fauna associated with two sympatric mistletoe species ( Tristerix corymbosus (L.) Kuijt and Desmaria mutabilis (Poepp. & Endl.) Tiegh.) from the temperate rainforests of southern Chile. We set 40 camera traps from November 2021 to May 2022 to monitor the main pollinator (the hummingbird Sephanoides sephaniodes (R. Lesson & Garnot, 1827)), the main seed disperser (the arboreal marsupial Dromiciops bozinovici D’Elía, Hurtado & D’Anatro, 2016), and other animals (birds, mammals, reptiles, and insects). We compared fauna associated with Tristerix corymbosus between spring and summer–fall periods and between Tristerix corymbosus and Desmaria mutabilis during summer–fall. Species composition associated with Tristerix corymbosus showed a significant temporal variation, mainly explained by Sephanoides sephaniodes and Dromiciops bozinovici, which are more abundant in the summer–fall period. We found that animal species composition differences between mistletoe species were mainly explained by S. sephaniodes, Dromiciops bozinovici, and insects. While Tristerix corymbosus was mainly pollinated by hummingbirds, insects frequently visited Desmaria mutabilis flowers. Although both mistletoes have many similarities, they also have some phenology differences that affect their associations with animals, potentially influencing ecological processes.
Linking ecosystem processes to consumer growth rates: gross primary productivity as a driver of freshwater fish somatic growth in a resource-limited river
Authors: Hansen Lindsay E. , Yackulic Charles B. , Dickson Brett G. , Deemer Bridget R. , Best Rebecca J.
Published: May 2023

Individual growth can exert strong control on population dynamics but is constrained by resource acquisition rates. Difficulty in accurately quantifying resource availability over large spatial extents and at high temporal frequencies often limits attempts to understand the extent to which resources limit individual growth. Daily estimates of stream metabolism, including gross primary productivity (GPP), are increasingly available but have not, to our knowledge, been linked to fish growth. Here we examine how environmental variables such as GPP, water temperature, turbidity, and high-flow releases from a dam are linked to spatiotemporal variation in the growth of flannelmouth sucker ( Catostomus latipinnis) in the Colorado River within the Grand Canyon. We fit state-space growth models to 6 years of mark–recapture data collected in four river reaches spanning 300 river kilometers. Consistent with past research in this system, we find that all four environmental variables influence growth in length of a native primary consumer fish. GPP and temperature have a positive influence on growth, while turbidity and high-flow events have a negative influence. Water temperature is the dominant driver of spatiotemporal variation in growth, while the link between high-frequency GPP and fish growth is relatively novel. Fish growth is likely to be linked to stream metabolism in other systems where overall productivity, not the quality of primary producers, limits the food webs that support fish growth.
THRESHOLD DYNAMICS AND BIFURCATION ANALYSIS OF THE EPIDEMIC MODEL OF MERS-CoV
Authors: ALQAHTANI HESSAH , BADSHAH QAISAR , RAHMAN GHAUS UR , BALEANU DUMITRU , SAKHI SHAZIA
Published: May 2023

A viral respiratory disease, MERS spread by a novel coronavirus, was first detected in Saudi Arabia in 2012. It is a big threat for the Arab community and is a horrible prediction that the disease may rapidly propagate to other parts of the world. In this research endeavor, a mathematical model of MERS-Corona virus (MERS-CoV) is presented. Initially, we formulate a model, governing the dynamics of MERS-CoV disease and then determine basic reproductive number [Formula: see text]. Local stability analysis results are formulated at the equilibrium points. It has been found that one of the eigenvalues is zero, therefore bifurcation exists. Afterward, in formulating proper Lyapunov functional [J. P. LaSalle, The Stability of Dynamical Systems, Vol. 25 (Society for Industrial and Applied Mathematics, 1976)], we successfully established results about global stability of the proposed model at both equilibrium points. Sensitivity analysis of the parameters as well as of threshold value for the underlying model has been exhibited. The numerical illustration of theoretical findings is explained via examples.
Pyrrole-contained fused-ring compounds
Authors: Li Zhi-Ao , Peng Li-Jun , Wang Xin-Yue , Gong Han-Yuan
Published: May 2023

Three series of pyrrole-contained fused ring compounds are summarized. In recent years, these compounds attracted wide attention with their special and elegant structures. Furthermore, they have played important roles in new optoelectronic materials and guest receptors due to their excellent photoelectric effects and unique properties with nitrogen atom doping.
Protective role of VEGF/VEGFR2 against mitochondrial dysfunction that underpins high fatality associated with hepatic encephalopathy
Authors: Tsai Ching-Yi
Published: May 2023

Hepatic encephalopathy (HE) is a neurological complication arising from acute liver failure and is associated with high mortality. Clinical reports showed that the degree of baroreflex dysregulation is related to the severity of HE. Furthermore, mitochondrial dysfunction in the rostral ventrolateral medulla (RVLM), a key neural substrate that maintains blood pressure and sympathetic vasomotor tone, is known to underpin impairment of baroreflex. In addition to angiogenic and vasculogenic effects, vascular endothelial growth factor (VEGF) and its receptor (VEGFR2) elicits neuroprotection by maintaining mitochondrial function, and the guiding hypothesis of this study is that the VEGF/VEGFR2 signaling plays a protective role against mitochondrial dysfunction in the RVLM to ameliorate baroreflex dysregulation that underpins the high fatality associated with HE. In this study, we were carried out in proof-of-concept experiments using an in vitro model of HE that involved incubation of cultured mouse neurons with ammonium chloride. Corroboratory experiments were subsequently performed using an azoxymethane-induced acute liver failure model of HE in adult male C57BL/6 mice and VEGFR2 wild-type and heterozygous mice. We demonstrated that VEGFR2 is present in cultured neurons, and observed that whereas recombinant VEGF maintained cell viability, gene-knockdown of vegfr2 enhanced the reduction of cell viability. In mouse model of HE, we found that VEGFR2 heterozygous mice exhibited shorter survival rate and time when compared to wild-type mice. In C57BL/6 mice, results from 31P magnetic resonance spectroscopy chemical shift imaging obtained from mouse brainstem showed reduced ratio between phosphocreatine and γATP, indicating mitochondrial dysfunction during HE. Furthermore, there was a progressive reduction in VEGFR2 mRNA and protein expression, mitochondrial membrane potential and ATP levels, alongside augmentation of apoptotic cell death in the RVLM, accompanied by a decrease in baroreflex-mediated sympathetic vasomotor tone and hypotension. Loss-of-function of VEGF by immunoneutralization exacerbated mitochondrial membrane potential reduction or apoptotic cell death during HE. We therefore suggest that, acting via VEGFR2, the endogenous VEGF plays a protective role against high fatality associated with HE by amelioration of baroreflex dysregulation through sustaining mitochondrial bioenergetics functions and eliciting anti-apoptotic action in the RVLM.

This study was supported by research grants from the National Science and Technology Council, Taiwan (NSTC-106-2320-B-182A-014-MY3 and NSTC-109-2320-B-182A-007-MY3) and the Chang Gung Medical Foundation, Taiwan (CLRPG8J0031-3).

This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.