bluuebunny/crossref_metadata_2025 huggingface dataset:
Thirty-minute motor imagery exercise aided by EEG sensorimotor rhythm neurofeedback enhances morphing of sensorimotor cortices: a double-blind sham-controlled study
Authors: Kodama Midori , Iwama Seitaro , Morishige Masumi , Ushiba Junichi
Published: January 2023

Neurofeedback training using electroencephalogram (EEG)-based brain–computer interfaces (BCIs) combined with mental rehearsals of motor behavior has demonstrated successful self-regulation of motor cortical excitability. However, it remains unclear whether the acquisition of skills to voluntarily control neural excitability is accompanied by structural plasticity boosted by neurofeedback. Here, we sought short-term changes in cortical structures induced by 30 min of BCI-based neurofeedback training, which aimed at the regulation of sensorimotor rhythm (SMR) in scalp EEG. When participants performed kinesthetic motor imagery of right finger movement with online feedback of either event-related desynchronisation (ERD) of SMR magnitude from the contralateral sensorimotor cortex (SM1) or those from other participants (i.e. placebo), the learning rate of SMR-ERD control was significantly different. Although overlapped structural changes in gray matter volumes were found in both groups, significant differences revealed by group-by-group comparison were spatially different; whereas the veritable neurofeedback group exhibited sensorimotor area-specific changes, the placebo exhibited spatially distributed changes. The white matter change indicated a significant decrease in the corpus callosum in the verum group. Furthermore, the learning rate of SMR regulation was correlated with the volume changes in the ipsilateral SM1, suggesting the involvement of interhemispheric motor control circuitries in BCI control tasks.
An Introduction to Political Philosophy
Authors: Wolff Jonathan
Published: January 2023

An Introduction to Political Philosophy provides an introduction to the subject, combining clarity and a conversational style with a thought-provoking account of the central questions of the discipline. It explores the subject through a series of enduring and timeless questions, crossing centuries and millennia to consider the most influential answers and demonstrate the relevance of political philosophy for an understanding of contemporary issues. This new edition has been updated to include on-going developments in multiculturalism and global justice, as well as in human rights and deliberative democracy.
2. Justifying The State
Authors: Wolff Jonathan
Published: January 2023

This chapter examines consent theory and utilitarian theory, along with some other approaches to the moral defence of the state. Before deciding how best to justify the state, the chapter explains what a state is. It considers different types of state, from liberal democracies to dictatorships, benign or tyrannical, based on military rule, a monarchical family line, or party membership. Some states promote the free market, while others attempt collective forms of production and distribution. The chapter proceeds by discussing the goal of justifying the state: to show that there are universal political obligations. It then explores a number of defences of political obligation based on social contract, utilitarianism, and the principle of fairness.
Introduction
Authors: Wolff Jonathan
Published: January 2023

This text explores the main questions of political philosophy and looks at some of the most influential answers, from the ancient Greeks to the present day. Each chapter takes on a particular question or controversy. The natural starting point is political power, the right to command. The first chapter considers the question of what would happen in a ‘state of nature’ without government, while the second tackles the problem of political obligation. The third chapter is concerned with democracy, asking whether a state should be democratic, for example, or whether there is any rationale for preferring rule by the people to rule by an expert. The next two chapters deal with liberty and property. The text concludes by focusing on questions that have drawn greater attention in more recent decades, such as issues of gender, race, disability, sexual orientation, immigration, global justice, and justice to future generations.
1. Introduction: from international politics to world politics
Authors: Baylis John , Smith Steve , Owens Patricia
Published: January 2023

This chapter introduces the text which offers a comprehensive analysis of world politics in a global era. The text examines the main theories of world politics— realism, liberalism, Marxism, social constructivism, poststructuralism, post-colonialism, and feminism. It reviews the main structures and processes that shape contemporary world politics, such as global political economy, international security, war, gender, and race. Furthermore, it addresses some of the main policy issues in the globalized world, including poverty, human rights, health (with particular emphasis on the recent global pandemic), and the environment. This introduction offers some arguments both for and against seeing globalization as an important new development in world politics. It also explains the various terms used to describe world politics and the academic field, particularly the use of ‘world politics’ rather than ‘international politics’ or ‘international relations’. Finally, it summarizes the main assumptions underlying realism, liberalism, Marxism, social constructivism, post-structuralism, post-colonialism, and feminism.
6. Rising powers and the emerging global order
Authors: Hurrell Andrew
Published: January 2023

This chapter examines the global order, led by the United States, that emerged at the end of the cold war and asks whether it has been effectively challenged by rising powers. It begins with a discussion of the challenges to the idea of a U.S.-dominated global order, focusing in particular on the role of large, emerging developing countries as well as the idea of the BRICS (Brazil, Russia, India, China, and South Africa) in the context of the future of the global economy. The chapter then considers the more recent economic slowdown in the emerging world, along with the political and social challenges facing many emerging societies. It also analyses some of the major theoretical arguments about the impact of rising powers on international relations and whether they are powerful enough to affect international order. The chapter also asks, what is the role of emerging powers in a post-Western order characterized both by US/China rivalry and by pressing global challenges such as climate change and the Covid-19 pandemic?
11. Postcolonial and decolonial approaches
Authors: Sabaratnam Meera
Published: January 2023

This chapter looks at postcolonial and decolonial approaches to studying world politics, arguing that these are multi-layered and diverse. These do not constitute a single ‘theory’ of the international but rather a set of orientations think about it. The chapter starts by separating a number of different elements involved in theorizing the world, and how postcolonial and decolonial approaches look at them. These include questions of epistemology, ontology, and norms or ethics. It then examines the historical context in which postcolonial and decolonial approaches arose, showing that there was a dynamic relationship between political struggles for decolonization and the development of different intellectual arguments. It considers where postcolonial and decolonial approaches have emerged and where they depart from each other in terms of analysis and focus. Having traced these traditions through the twentieth century, the chapter describes the key concepts used in postcolonial and decolonial thought across different disciplines, before looking at their impact on the field of international relations (IR). The chapter also explores the similarities and differences between different approaches and other theories in the field of IR. Finally, it contemplates the on-going popularity of postcolonial and decolonial approaches in the present day.
16. Global political economy
Authors: Phillips Nicola
Published: January 2023

This chapter introduces the field of international political economy (IPE), the themes and insights of which are reflected in the global political economy (GPE), and what it offers in the study of contemporary globalization. It begins with three framing questions: How should we think about power in the contemporary global political economy? How does IPE help us to understand what drives globalization? What does IPE tell us about who wins and who loses from globalization? The chapter proceeds by discussing various approaches to IPE and the consequences of globalization, focusing on IPE debates about inequality, labour exploitation, and global migration. Two case studies are presented, the first looking at global value chains (GVCs) and global development and the second dealing with globalization and child labour.
21. The United Nations
Authors: Curtis Devon E. A. , Taylor Paul
Published: January 2023

This chapter examines the development of the United Nations and the changes and challenges that it has faced since it was founded in 1945. It opens with three framing questions: Does the UN succeed in reconciling traditions of great power politics and traditions of universalism? Why has the UN become more involved in matters within states and what are the limits to this involvement? What are the UN's biggest successes and challenges in its efforts to prevent and resolve conflict and to promote sustainable development? The chapter proceeds by providing a brief history of the UN and its principal organs. It also considers the UN's role in the maintenance of international peace and security, and how the UN addresses issues relating to economic and social development. Two case studies are presented: the first is about the role of the UN in dealing with conflict in Syria and the second is about UN peacekeeping in the Congo.
22. NGOs in world politics
Authors: Joachim Jutta
Published: January 2023

This chapter examines the role of non-governmental organizations (NGOs) in world politics. It considers what distinguishes NGOs from other actors in international politics, what types of influence NGOs exert in international relations, and whether NGOs contribute to more democratic policy-making at the international level. The chapter also discusses the growing importance of NGOs and presents two case studies that illustrate how they have contributed to the emergence of new norms through their engagement with international governmental organizations (IGOs). The first case study pitches Friends of the Earth against Royal Dutch Shell to show how NGOs have impacted on climate change law. The second case study focuses on the #BlackLivesMatter movement.
26. Refugees and forced migration
Authors: Estévez Ariadna
Published: January 2023

This chapter is concerned with the international politics of refugees and forced migration. It shows how they are produced and managed in the context of contemporary globalization. Forced migration, the chapter defines, is the compulsory mobility of people due to existing and potential threats, mostly in the Global South and East. The chapter explains that these threats are related to a variety of international issues, and highlights the fact that there is debate concerning the underlying causes, including on-going colonial legacies and existing power relations. In order to discuss forced migration, with an emphasis on the international politics of refugee legislation and law, the chapter locates the subject within the field of international relations (IR). It goes on to provide an overview of the conceptual debate, presenting a critical discussion of new ways of characterizing forced migration, along with their analytical and policy implications. It then considers how policy-makers classify various types of forced migration. Case studies look at Covid-19 and the effect the pandemic has had on asylum processing and forced migration, criminal and state violence, and corporations in Venezuela.
29. Terrorism and globalization
Authors: Kiras James D.
Published: January 2023

This chapter examines how globalization has contributed to the growth of terrorism as a global phenomenon. It considers whether global terrorism is the price states pay for entry into and continued access to a globalized system, why violent Islamic extremism continues to be the primary motivator for global terrorist violence, and whether freedoms should be restricted to ensure greater security against the threat of global terrorism. The chapter first looks at the definitions of terrorism before tracing the transformation of terrorism from a transnational to a global phenomenon. It then explores the role of technology in terrorism and ways of combating terrorism. The two case studies in this chapter deal with activities of the so-called Islamic State in the Philippines and Mozambique since 2017 and the US ‘insurrection’ on 6 January 2021.
30. Proliferation of weapons of mass destruction
Authors: Greitens Sheena Chestnut
Published: January 2023

This chapter focuses on the proliferation of weapons of mass destruction (WMD). It examines the patterns that can be observed in the spread and use/non-use of nuclear, chemical, and biological weapons since 1945, how nuclear weapons have changed world politics, and whether non-proliferation efforts have been successful. The chapter first provides an overview of WMD technology and its spread before discussing biological and chemical weapons. It then considers theoretical debates about nuclear proliferation and the evolution of non-proliferation efforts. Two case studies are presented, one dealing with the nuclear programme of North Korea and the other looking at the nuclear programme in Iran.
32. Human rights
Authors: Kapur Ratna
Published: January 2023

This chapter looks at human rights, analysing the structure and politics of human rights in the twenty-first century. In particular, the chapter examines the influence of liberal internationalism on human rights and how this is shaped by the legacies of colonialism, slavery, apartheid, and engagements with sexual, religious, and racial differences. The chapter encourages questions about whether rights are universal instruments of emancipation, or whether the rights are more complex, contradictory, and contingent in their functioning. The chapter also sets out the dominant understandings of human rights as progressive, universal, and based on a common human subject. Human rights advocates sometimes differ on the strategies to be adopted to address violations; these can have material, normative, and structural consequences that are not always empowering. These competing positions are illustrated through two case studies: one on the Islamic veil bans in Europe and the second on same-sex, queer relationships, LGBTQ rights, and colonial laws.
Dysregulation of the chromatin environment leads to differential alternative splicing as a mechanism of disease in a human model of autism spectrum disorder
Authors: Leung Calvin S , Rosenzweig Shoshana J , Yoon Brian , Marinelli Nicholas A , Hollingsworth Ethan W , Maguire Abbie M , Cowen Mara H , Schmidt Michael , Imitola Jaime , Gamsiz Uzun Ece D , Lizarraga Sofia B
Published: January 2023

Autism spectrum disorder (ASD) affects 1 in 44 children. Chromatin regulatory proteins are overrepresented among genes that contain high risk variants in ASD. Disruption of the chromatin environment leads to widespread dysregulation of gene expression, which is traditionally thought of as a mechanism of disease pathogenesis associated with ASD. Alternatively, alterations in chromatin dynamics could also lead to dysregulation of alternative splicing, which is understudied as a mechanism of ASD pathogenesis. The anticonvulsant valproic acid (VPA) is a well-known environmental risk factor for ASD that acts as a class I histone deacetylase inhibitor. However, the precise molecular mechanisms underlying defects in human neuronal development associated with exposure to VPA are understudied. To dissect how VPA exposure and subsequent chromatin hyperacetylation influence molecular signatures involved in ASD pathogenesis, we conducted RNA sequencing (RNA-seq) in human cortical neurons that were treated with VPA. We observed that differentially expressed genes (DEGs) were enriched for mRNA splicing, mRNA processing, histone modification and metabolism related gene sets. Furthermore, we observed widespread increases in the number and the type of alternative splicing events. Analysis of differential transcript usage (DTU) showed that exposure to VPA induces extensive alterations in transcript isoform usage across neurodevelopmentally important genes. Finally, we find that DEGs and genes that display DTU overlap with known ASD-risk genes. Altogether, these findings suggest that, in addition to differential gene expression, changes in alternative splicing correlated with alterations in the chromatin environment could act as an additional mechanism of disease in ASD.
How bright can old magnetars be? Assessing the impact of magnetized envelopes and field topology on neutron star cooling
Authors: Dehman Clara , Pons José A , Viganò Daniele , Rea Nanda
Published: January 2023

Neutron stars cool down during their lifetime through the combination of neutrino emission from the interior and photon cooling from the surface. Strongly magnetized neutron stars, called magnetars, are no exception, but the effect of their strong fields adds further complexities to the cooling theory. Besides other factors, modelling the outermost hundred meters (the envelope) plays a crucial role in predicting their surface temperatures. In this letter, we revisit the influence of envelopes on the cooling properties of neutron stars, with special focus on the critical effects of the magnetic field. We explore how our understanding of the relation between the internal and surface temperatures has evolved over the past two decades, and how different assumptions about the neutron star envelope and field topology lead to radically different conclusions on the surface temperature and its cooling with age. In particular, we find that relatively old magnetars with core-threading magnetic fields are actually much cooler than a rotation-powered pulsar of the same age. This is at variance with what is typically observed in crustal-confined models. Our results have important implications for the estimates of the X-ray luminosities of aged magnetars, and the subsequent population study of the different neutron star classes.
Dissecting the Biology ofRafflesiaSpecies: Current Progress and Future Directions Made Possible with High-Throughput Sequencing Data
Authors: Mursyidah Anwarali-Khan , Hafizzudin-Fedeli Mohamad , Nor Muhammad Nor Azlan , Latiff A , Firdaus-Raih Mohd , Wan Kiew-Lian
Published: January 2023

The angiosperm Rafflesia exhibits a unique biology, including a growth strategy that involves endophytic parasitism of a specific host, with only the gigantic flower externally visible. The Rafflesia possesses many unique evolutionary, developmental and morphological features that are rooted in yet-to-be-explained physiological processes. Although studies on the molecular biology of Rafflesia are limited by sampling difficulties due to its rarity in the wild and the short life span of its flower, current advances in high-throughput sequencing technology have allowed for the genome- and transcriptome-level dissection of the molecular mechanisms behind the unique characteristics of this parasitic plant. In this review, we summarize major findings on the cryptic biology of Rafflesia and provide insights into future research directions. The wealth of data obtained can improve our understanding of Rafflesia species and contribute toward the conservation strategy of this endangered plant.
Competing for Deal Flow in Local Mortgage Markets
Authors: Aiello Darren J , Garmaise Mark J , Natividad Gabriel
Published: January 2023

The U.S. mortgage market exhibits competitive instability in which some lenders rapidly emerge from the fringe to substantial market shares. Using inferred discontinuities in application acceptance models to generate local lending shocks, we analyze the impact on a lender of a surge in originations by its competitors. We show that the quickest-growing (but not the largest) competitors divert applications and originations from other lenders. Facing a quickly growing competitor, lenders charge higher interest rates, partially because of the increased risk of their loans. Loan performance suffers for other lenders as the quickest-growing competitor’s originations increase. (JEL G21, D40)

Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Humoral responses against HDL are linked to lipoprotein traits, atherosclerosis, inflammation and pathogenic pathways during early arthritis stages
Authors: Rodríguez-Carrio Javier , Alperi-López Mercedes , López Patricia , Pérez-Álvarez Ángel I , Robinson George A , Alonso-Castro Sara , Amigo-Grau Núria , Atzeni Fabiola , Suárez Ana
Published: January 2023

Objective

Chronic inflammation and immune dysregulation are crucial mechanisms for atherosclerosis in RA. Recent evidence suggests a link via humoral responses against high-density lipoproteins (HDL). This study aimed to characterize the specificity, clinical relevance and emergence of humoral responses against HDL along disease course, especially during the earliest phases of arthritis.

Methods

IgG and IgM serum levels of antibodies against HDL (anti-HDL) and apolipoprotein A1 (anti-ApoA1) were measured in 82 early RA patients, 14 arthralgia individuals and 96 controls. Established RA patients (n = 42) were included for validation. Atherosclerosis and vascular stiffness were measured by Doppler ultrasound. Lipoprotein content, particle numbers and size were measured by H-NMR. Cytokines were measured by immunoassays. A cardiometabolic-related protein panel was evaluated using high-throughput targeted proteomics.

Results

Anti-HDL and anti-ApoA1 responses were increased in early RA compared with controls (both P < 0.001) and were comparable to established disease. Only anti-ApoA1 antibodies were increased in arthralgia. IgG anti-HDL and anti-ApoA1 were associated with unfavourable lipoprotein traits in RA and arthralgia, respectively. A similar picture was observed for inflammatory mediators. No associations with clinical features or risk factors were found. IgG anti-HDL were independently associated with atherosclerosis occurrence in early RA, and outperformed patient stratification over conventional algorithms (mSCORE) and their anti-ApoA1 counterparts. Anti-HDL antibodies correlated with proteins involved in immune activation, remodelling and lipid metabolism pathways in early RA.

Conclusion

Humoral responses against HDL particles are an early event along the arthritis course, although quantitative and qualitative differences can be noticed among stages. These differences informed distinct capacities as biomarkers and underlying pathogenic circuits.
Efficacy of Biocontrol Agents Coniothyrium minitans and Bacillus amyloliquefaciens for Managing Sclerotinia sclerotiorum in Indiana Soybean
Authors: Conrad Audrey M. , Telenko Darcy E. P.
Published: January 2023

Sclerotinia sclerotiorum is a soilborne pathogen of soybean that causes Sclerotinia stem rot, also called white mold. Sclerotinia stem rot can cause significant yield losses under cool and wet environmental conditions. Two biofungicides, Coniothyrium minitans and Bacillus amyloliquefaciens, are currently available and labeled to limit or suppress S. sclerotiorum in soybean. These biofungicides can be applied in place of synthetic foliar fungicides to provide an alternative mode of action for the control of Sclerotinia stem rot. However, limited information is available regarding the efficacy of C. minitans and B. amyloliquefaciens as biocontrol agents of S. sclerotiorum in soybean. To assess the effectiveness of C. minitans and B. amyloliquefaciens as biocontrol agents of S. sclerotiorum, dual culture and soil plate assays were conducted, along with experiments in the growth chamber and field. Degradation of sclerotia following treatment with C. minitans in the soil plate assay confirmed that the primary mode of action is mycoparasitism. In the growth chamber, B. amyloliquefaciens at 14.03 liters/ha applied using the dip method significantly reduced Sclerotinia stem rot lesion length over the nontreated control and resulted in the lowest lesion area under the disease progress curve. When B. amyloliquefaciens and C. minitans were applied in the field, no differences were observed between treatments for soybean moisture, test weight, or yield in Indiana.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Immunonutrition of perioperative therapy for colorectal cancer
Authors: Wu Jin-Ming , Chang Kai-Hsing , Hsu Francis Li-Tien
Published: January 2023

Immunonutrition, a modified nutritional formula that involves the addition of glutamine, arginine, omega-3 fatty acids, nucleotides, and other potential compounds to the diet, has proven its potential for use in immunomodulation and protein metabolism improvement. Its clinical benefits include shortening hospital stays and lowering surgical infectious complications in upper gastrointestinal surgery. However, the use of perioperative immunonutrition is rare among colorectal cancer patients undergoing surgical intervention. Colorectal cancer is one of the most common cancers around the world, but its malnutrition rate is not high in comparison with other cancers (eg, gastric cancer or esophageal cancer). Furthermore, the surgical modality for the majority of colorectal cancer patients involves minimal invasive surgery (MIS), which enhances recovery speed. It is an interesting clinical question whether or not perioperative immunonutrition supplementation for colorectal cancer patients undergoing MIS causes extraclinical impacts. The immunomodulation effect of CD4+ T cells has been proven in colorectal patients undergoing elective surgery. In recent years, there have been several prospective randomized studies elucidating the clinical effects of immunonutrition on colorectal cancer patients undergoing surgery in Western countries. These studies have generally found that perioperative immunonutrition was associated with a lower rate of surgical infectious complications even in normo-nourished patients undergoing MIS. The use of perioperative immunonutrition provides clinical benefits according to high-quality studies. However, most results come from Western countries, and its effect needs to be validated in Asian countries.
Postoperative posterior reversible encephalopathy syndrome in a hereditary spherocytosis child undergoing splenectomy
Authors: Srivastava Saurav , Chaubey Digamber , Kumar Sujit , Thakur Vinit Kumar , Rahul Sandip Kumar
Published: January 2023

Postoperative posterior reversible encephalopathy syndrome has seldom been reported in the pediatric age group. We describe this syndrome in a child of hereditary spherocytosis who underwent splenectomy for hypersplenism.
Late perforation of a gastric ulcer secondary to intragastric balloon: Report of a combined endoscopic and laparoscopic approach
Authors: Fonseca Mariana Kumaira , Iaroseski Julia , Grossi João Vicente Machado , Nacul Miguel P.
Published: January 2023

Intragastric balloons (IGBs) are minimally invasive devices used for managing obesity. Despite their relative safety and patient tolerance, there have been reports of adverse events associated with IGBs. Gastric perforation is a rare but feared complication that mostly occurs as an early event after transitional interventions, such as insertion or removal procedures. This case report describes a combined endoscopic and laparoscopic approach to a rare case of late gastric perforation secondary to an IGB whose removal was long overdue.
Mild Traumatic Brain Injury and Functional Outcome in Older Adults: Pain Interference But Not Cognition Mediates the Relationship Between Traumatic Injury and Functional Difficulties
Authors: Hume Camilla H. , Mitra Biswadev , Wright Bradley J. , Kinsella Glynda J.
Published: January 2023

Objective:

To examine functional status of older people 3 months after mild traumatic brain injury (mTBI) and identify whether pain interference or cognition mediates any relationship found between injury status and functional outcomes.

Setting:

Patients admitted to a Melbourne-based emergency department.

Participants:

Older adults 65 years and older: 40 with mTBI, 66 with orthopedic injury without mTBI (TC), and 47 healthy controls (CC) without injury.

Design:

Observational cohort study.

Main Measures:

Functional outcome was measured using the World Health Organization Disability Assessment Schedule (WHODAS 2.0) and single- and dual-task conditions of the Timed-Up-and-Go task. Pain interference and cognitive performance at 3 months post-injury were examined as mediators of the relationship between injury status (injured vs noninjured) and functional outcome.

Results:

Patients with mTBI and/or orthopedic injury reported greater difficulties in overall functioning, including community participation, compared with noninjured older people (CC group). Both trauma groups walked slower than the CC group on the mobility task, but all groups were similar on the dual-task condition. Pain interference mediated the relationship between injury status and overall functioning [b = 0.284; 95% CI = 0.057, 0.536), community participation (b = 0.259; 95% CI = 0.051, 0.485), and mobility (b = 0.116; 95% CI = 0.019, 0.247). However, cognition did not mediate the relationship between injury status and functional outcomes.

Conclusions:

Three months after mild traumatic injury (with and without mTBI), patients 65 years and older had greater functional difficulties compared with noninjured peers. Pain interference, but not cognition, partially explained the impact of traumatic injury on functional outcomes. This highlights the importance of reducing pain interference for older patients after injury (including mTBI) to support better functional recovery.
Discriminating Mild Traumatic Brain Injury and Posttraumatic Stress Disorder Using Latent Neuroimaging and Neuropsychological Profiles in Active-Duty Military Service Members
Authors: de Souza Nicola L. , Esopenko Carrie , Jia Yuane , Parrott J. Scott , Merkley Tricia L. , Dennis Emily L. , Hillary Frank G. , Velez Carmen , Cooper Douglas B. , Kennedy Jan E. , Lewis Jeffrey D. , York Gerald E. , Menefee Deleene S. , McCauley Stephen R. , Bowles Amy O. , Wilde Elisabeth A. , Tate David F.
Published: January 2023

Objective:

Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) commonly occur among military Service Members and Veterans and have heterogenous, but also overlapping symptom presentations, which often complicate the diagnoses of underlying impairments and development of effective treatment plans. Thus, we sought to examine whether the combination of whole brain gray matter (GM) and white matter (WM) structural measures with neuropsychological performance can aid in the classification of military personnel with mTBI and PTSD.

Methods:

Active-Duty US Service Members (n = 156; 87.8% male) with a history of mTBI, PTSD, combined mTBI+PTSD, or orthopedic injury completed a neuropsychological battery and T1- and diffusion-weighted structural neuroimaging. Cortical, subcortical, ventricular, and WM volumes and whole brain fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated. Latent profile analyses were performed to determine how the GM and WM indicators, together with neuropsychological indicators, classified individuals.

Results:

For both GM and WM, respectively, a 4-profile model was the best fit. The GM model identified greater ventricular volumes in Service Members with cognitive symptoms, including those with a diagnosis of mTBI, either alone or with PTSD. The WM model identified reduced FA and elevated RD in those with psychological symptoms, including those with PTSD or mTBI and comorbid PTSD. However, contrary to expectation, a global neural signature unique to those with comorbid mTBI and PTSD was not identified.

Conclusions:

The findings demonstrate that neuropsychological performance alone is more robust in differentiating Active-Duty Service Members with mTBI and PTSD, whereas global neuroimaging measures do not reliably differentiate between these groups.
Neurobehavioral Symptom Inventory Item-Level Change Complements the Reliable Change Method
Authors: Scarlett Emily , Lu Lisa H. , Cummings Latiba D. , Bowles Amy O.
Published: January 2023

Objective:

To determine correspondence between the statistically derived 8-point reliable change index for the Neurobehavioral Symptom Inventory (NSI) against clinically significant item-level change in symptom severity from intake to discharge for mild traumatic brain injury (mTBI).

Setting:

Brain Injury Rehabilitation Service at Brooke Army Medical Center, Fort Sam Houston, San Antonio, Texas.

Patients:

In total, 655 active-duty service members with a diagnosis of mTBI who received treatment and completed self-report measures between 2007 and 2020.

Design:

Observational retrospective analysis of outpatient clinical outcomes data.

Main Measures:

NSI total score change was used to divide patients into responder and nonresponders based on whether they met an 8-point decrease between intake and discharge. In addition, patients who had at least one NSI item that changed from a rating of 3 (severe) or 4 (very severe) at intake to a rating of 0 (none) or 1 (mild) at discharge were coded as an individual with significant item-level change.

Results:

Forty-five percent of the sample had significant item-level change and were classified as responders according to the reliable change method. Eight percent of the sample had significant item-level change but did not meet the 8-point reliable change threshold. Fifteen percent of the sample did not experience significant item-level change but were classified as responders according to reliable change. Thirty-one percent did not meet either method's criterion for change. Classification agreement between the reliable change and item-level change methods was 76%, which was statistically significant (

= 181.32, P < .001).

Conclusion:

There is good correspondence between reliable change and item-level change on the NSI in this population. Reliable change is easily calculated and thus much more accessible than the item-level change method. There may be some situations where calculating item-level change may be helpful.
Future regenerative therapies for corneal disease
Authors: Lee John Y. , Knight Robert J. , Deng Sophie X.
Published: January 2023

Purpose of review

To highlight the progress and future direction of stem-cell based regenerative therapies for the treatment of corneal disease

Recent findings

Corneal stem cell-based therapies, such as limbal stem cell transplantation, corneal stromal stem cell transplantation, endothelial stem cell transplantation, and stem cell-derived extracellular vesicles have demonstrated promising results in the laboratory. Although most are still in preclinical development or early phase clinical trials, these stem cell-based therapies hold potential to facilitate tissue regeneration, restore native function, and inhibit pathologic disease processes such as fibrosis, inflammation, and neovascularization.

Stem cell-based therapy offers a promising therapeutic option that can circumvent several of the challenges and limitations of traditional surgical treatment. This concise review summarizes the progress in stem-cell based therapies for corneal diseases along with their history, underlying mechanisms, limitations, and future areas for development.
Healthcare Workers' Perceptions of On-Site Childcare
Authors: Braddock Amy , Malm-Buatsi Elizabeth , Hicks Sarah , Harris Grant , Alafaireet Patricia
Published: January 2023

Goal:

Measures taken by healthcare organizations to address COVID-19 highlighted the long-standing lack of childcare infrastructure required to support healthcare workers. This study, designed to provide evidence to support operations at an academic medical center, looked at the influence that in-house and emergency childcare could have on the retention, recruitment, and productivity of healthcare workers. This study also outlined the implications that childcare, or its lack, has for healthcare organizations during and after the COVID-19 pandemic.

Methods:

We conducted a 35-question electronic employee survey (under institutional review board approval) during pandemic-induced public school closures, which included both quantitative and qualitative (write-in) questions.

Principal Findings:

The survey results showed that weekday on-site childcare was very or extremely important to more than half of survey respondents, the majority of whom were staff members (28%) or physicians (25%), followed by administrators (15%), researchers (12%), others (10%), nurses (5%), educators (2%), and residents (1%). Sixty percent of respondents reported that emergency on-site childcare was extremely important (34%) or very important (26%). Almost half (49%) reported that emergency childcare needs have disrupted their work in the past year, including canceling of clinics or surgical cases. Analysis of qualitative comments via a strategy based on coding and categorization showed that, when asked how childcare influences their work choices, employees responded that childcare availability has limited the hours or times they could work, that lack of childcare has prevented career growth, that they left a previous job or will leave their current job because of childcare needs, or that they stayed at a previous job or have remained in their current job longer because of the availability of childcare.

Practical Applications:

Although data from this mixed-methods study support findings in the literature that there is a need for in-house and emergency childcare, the data suggest that current employees at this academic medical center do not currently expect it, likely because such childcare is not generally available at most academic institutions. With increased rates of burnout and healthcare workers leaving the field since COVID-19, offering in-house and emergency childcare provides hospital systems with new opportunities to retain and recruit physicians, nurses, and staff, as well as to improve their well-being and productivity.
Primary care nurse practitioner practices to lower type 2 diabetes risks in women with a history of gestational diabetes mellitus
Authors: Quelly Susan B. , LaManna Jacqueline B. , Hyer Suzanne , Davis Jean W. , Giurgescu Carmen , Martinez Valerie
Published: January 2023

Background:

Women with a gestational diabetes mellitus (GDM) history have increased lifetime type 2 diabetes (T2D) risk, with 16 times greater risk 3 to 6 years after the pregnancy, compared with women without GDM. Offspring from diabetes-complicated pregnancies also face increased health risks.

Purpose:

The study purpose was to describe the primary care practices of nurse practitioners (NPs) aimed at reducing T2D-related health risks in women with a history of GDM.

Methodology:

Florida-licensed primary care NPs (n = 47) completed a 57-item online survey that included an 8-item scale about recommended practices to reduce T2D risks for women with GDM history. Descriptive statistics, Chi Square test, and Fisher exact test were conducted.

Results:

Most (67%) participants “often/always” screened for T2D every 1–3 years per guidelines, but only 31.8% “often/always” advised about pregnancy planning/preconception T2D assessment. Compared with “none” or ≤2 hours of GDM care education, participants with >2 hours were more likely (p < .05) to “often/always” perform five recommended practices: 1) counsel about increased T2D risks; 2) educate about self-advocacy for T2D screening; 3) T2D screening every 1–3 years; 4) counsel about breastfeeding to reduce T2D risk; and 5) discuss postpartum weight loss and increased physical activity to lower T2D risk.

Conclusion:

Findings indicate inconsistent care practices and suggest that >2 hours of education about care of women with GDM history may increase primary care NPs performing recommended practices to reduce T2D risks and prevent health problems for women and future offspring.

Implications:

Nurse practitioner education is needed involving care of women with GDM history to mitigate risks for T2D.
Postoperative Handheld Gastric Point-of-Care Ultrasound and Delayed Bowel Function
Authors: Lamm Ryan , Collins Micaela , Bloom Jamie , Joel Marisa , Iosif Leah , Park Doo , Reny Jacky , Schultz Samuel , Yeo Charles J , Beausang David , Schwenk Eric S , Costanzo Caitlyn , Phillips Benjamin R
Published: January 2023

Background:

Delayed bowel function (DBF) following intra-abdominal surgery is a common problem that contributes to postoperative complications and prolonged length of stay. Utilization of a handheld Gastric Point of Care Ultrasound (GPOCUS) can identify a full versus empty stomach in the postoperative period. We hypothesized that the findings of a full stomach identified on a postoperative day 1 (POD1) GPOCUS exam would predict an increased risk of delayed bowel function.

Study Design:

A blinded, prospective cohort study was performed. Postoperative colorectal surgery patients were identified as having either a full or empty stomach based on previously published definitions. GPOCUS examinations were performed on POD1 using a handheld ultrasound device and clinicians were blinded to the results. Demographic and perioperative data were collected. The primary outcome variable was Gastrointestinal-3 (GI-3) recovery, defined as time to tolerance of diet and either flatus or bowel movement.

Results:

Fifty-six patients agreed to participate in the study; fifty were eligible and included. Eighteen patients’ stomachs were identified as full on POD1 GPOCUS examination and thirty-two were identified as empty. No significant demographic or perioperative differences existed between groups. Full stomach patients had significantly delayed GI-3 recovery (4 v 1 days, p<0.0001) and longer length of stay (5 v 3 days, p<0.0001). Full stomach patients also had significantly more emesis and NGT placement (both p<0.05).

Conclusion:

GPOCUS performed on POD1 can predict delayed bowel function, length of stay, likelihood of emesis, and NGT placement. Utilization of handheld devices for GPOCUS showed promise for the identification of patients at high risk for DBF and could provide an opportunity for preemptive intervention.
Post-COVID-19 Pneumocystis pneumonia cases from Pakistan: an observational study
Authors: Niamatullah Hammad , Nasir Nosheen , Jabeen Kauser , Rattani Salima , Farooqi Joveria , Ghanchi Najia , Irfan Muhammad
Published: January 2023

Background. Concurrent coronavirus disease 2019 (COVID-19) and Pneumocystis jirovecii pneumonia (PJP) has been described in various reports, with a recent study describing a 9.3 % P. jirovecii detection rate in critically ill COVID-19 patients.

Methods. Patients with PCR-confirmed PJP following COVID-19 infection who were admitted to Aga Khan University Hospital, Karachi, Pakistan from March 2020–June 2021 were identified through a laboratory database. Detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus was performed by RT-PCR Cobas SARS-CoV-2 qualitative assay. P. jirovecii PCR was performed using the RealStar Pneumocystis jirovecii PCR kit. Clinical, radiological and laboratory data for PJP patients were recorded.

Results. During the study period, 3707 patients were admitted with COVID-19 at our hospital. P. jirovecii PCR was requested for 90 patients and was positive in 10 (11 %). Five out of 10 patients were discharged from the hospital and later developed cough and dyspnoea. Five patients remained hospitalized with severe COVID-19 and developed PJP. Eight patients in our study received systemic steroids. The trends of lymphocyte counts of all patients showed a lymphocyte count of <1000 mm−3 (<1.0×106 cells µl−1) in the week of PJP diagnosis. Four patients did not survive; one of these patients did not receive co-trimoxazole due to late diagnosis, one patient had concomitant nosocomial pneumonia and bacteraemia with multidrug-resistant

Acinetobacter

species, and two patients had concomitant aspergillosis.

Conclusion. In summary, invasive fungal infections such as PJP should be considered as a complication in COVID-19 patients, with prompt evaluation and management.
Description of Jidongwangia harbinensis gen. nov. sp. nov
Authors: Han Chuang , Liu Ting , Guo Lifeng , Wang Xiangjing , Zhao Junwei , Xiang Wensheng
Published: January 2023

During our previous study, strain NEAU-J3T was classified as representing a novel genus ‘

Wangella

’ within the family

Micromonosporaceae

. Nevertheless, it is a great pity the name cannot be validated as the proposed genus name is illegitimate (Principle 2 of the ICNP). In this study, we describe Jidongwangia as a novel genus within the family

Micromonosporaceae

and a polyphasic approach was used to provide evidence to support the classification. The G+C content of the genomic DNA of the type strain is 71.6 %. Digital DNA–DNA hybridization and average nucleotide identity (ANI) values could be used to differentiate NEAU-J3T from its related type strains. The phenotypic, genetic and chemotaxonomic data also indicated that NEAU-J3T occupies a branch separated from those of known genera in the family

Micromonosporaceae

. Therefore, NEAU-J3T represents a novel species of a novel genus in the family

Micromonosporaceae

, for which the name Jidongwangia harbinensis gen. nov., sp. nov. is proposed. The type strain of Jidongwangia harbinensis is NEAU-J3T (= CGMCC 4.7039T = DSM 45747T).