bluuebunny/crossref_metadata_2025 huggingface dataset:
Buprenorphine-naloxone versus Buprenorphine for Treatment of Opioid Use Disorder in Pregnancy
Authors: Perry Briana N. , Vais Simone , Boateng Jeffery O. , Jain Mayuri , Wachman Elisha M. , Saia Kelley A.
Published: August 2022

Objectives

Data regarding treatment outcomes with the use of buprenorphine-naloxone (BUP-NX) in pregnancy are scarce. The objective of this study is to examine the outcomes in a cohort of pregnancies treated with BUP-NX versus buprenorphine (BUP).

Methods

This single-center, retrospective cohort study examined birthing person-infant dyads treated with BUP-NX versus BUP. The primary birthing person outcome was return to opioid use in pregnancy. The primary neonatal outcome was the need for pharmacologic treatment for neonatal opioid withdrawal syndrome (NOWS).

Results

The BUP-NX and the BUP treatment groups included 33 and 73 dyads, respectively. Except for psychiatric medication use, all demographics were similar between groups. In the final regression models, neither the birthing person nor the neonatal outcomes differed. The adjusted odds ratio for return to use during pregnancy for the BUP-NX versus BUP groups was 1.93 (95% confidence interval, 0.78–4.76). The adjusted odds ratio for pharmacologic treatment of NOWS for the BUP-NX versus BUP groups was 0.65 (95% confidence interval, 0.27–1.54). Among a subgroup of persons who transitioned from BUP to BUP-NX mid-pregnancy, there was no proximate return to use or need for dose increase.

Conclusions

Compared with BUP, the use of BUP-NX in pregnancy is not associated with a higher risk of return to opioid use or a higher need for pharmacological treatment for NOWS.
Circumstances Around Cigarette Use After Enforced Abstinence From Smoking in an American Prison
Authors: Martin Rosemarie A. , Stein L. A. R. , Kang Augustine , Rohsenow Damaris J. , Bock Beth , Martin Stephen A. , Clarke Jennifer G.
Published: August 2022

Objectives

Most adults return to smoking after enforced tobacco abstinence when incarcerated in US prisons. Little is known about the specific relapse triggers on reentry. This study examines situational, affective, and motivational antecedents of return to smoking immediately after release from a tobacco-free prison.

Methods

Assessments were administered before release and 1 and 7 days after release to 190 incarcerated adults who were smokers before incarceration. Those reporting smoking within 7 days after release were asked about circumstances surrounding their first cigarette.

Results

Two-thirds reported smoking in the 7 days after release (76% of those in the first day) with the first cigarette smoked 21 hours after release on average. Smoking occurred more quickly for women than men and for those who planned to smoke after release (P values from 0.05 to 0.001). Forty-one percent of participants smoked while waiting for a ride or on the way home, 68% were given their first cigarette, 28% reported first smoking when reuniting with others, 42% first smoked with smokers, and 26% first smoked as celebration. The moods most reported before smoking were happy (60%) or excited (41.5%). Factors reported that could have prevented smoking were avoiding other smokers (27%), avoiding stress (16%), not drinking/using drugs (12%), and not having access to cigarettes (11%).

Conclusions

High rates of return to smoking occurred rapidly when around other smokers, using other substances, and in a positive mood. Interventions that focus specifically on these factors and can be immediately accessed upon release are required to help sustain people's desired abstinence.
Successful Buprenorphine/Naloxone Low-dose Induction in Pregnancy: A Case Report
Authors: Coish Rebecca , Hardial Janine
Published: August 2022

Background

Medication for opioid use disorder (OUD) with methadone or buprenorphine/naloxone is recommended for pregnant women with OUD. Traditional buprenorphine/naloxone induction requires patients to be in moderate withdrawal before the first dose of medication to minimize the chances of precipitated withdrawal. The low-dose buprenorphine “microinduction” (Bernese) method was described in 2016 and involves giving small doses of buprenorphine to patients for whom opioid withdrawal was not desirable. This method is being used widely in Vancouver in the context of high rates of overdose due to fentanyl poisoning.

Case Presentation

A 24-year-old woman, in her first pregnancy, with severe opioid and stimulant use disorder successfully started on buprenorphine/naloxone through a low-dose-induction protocol. The dose was started at 0.5 mg sublingual daily and slowly increased to 18 mg over 17 days. She continued to use fentanyl/heroin during the induction. She did not experience precipitated withdrawal and was able to stop using nonprescribed opioids once at a therapeutic dose of buprenorphine/naloxone.

Discussion

This represents the first documented case of successful buprenorphine/naloxone low-dose induction in pregnancy. First-line recommendations still remain to use traditional buprenorphine/naloxone induction when patients present in withdrawal. Obtaining informed consent regarding the lack of research on low-dose induction in pregnancy as well as discussion of risks and benefits is essential.

Conclusion

Low-dose induction with buprenorphine/naloxone was successfully done in an outpatient setting. This represents a novel way of initiation of medication for OUD, which may enhance choice and collaboration between health care providers and women impacted by substance use in pregnancy.
Value-based Care and Quality Improvement in Perioperative Neuroscience
Authors: Luoma Astri M.V. , Flexman Alana M.
Published: August 2022

Value-based care and quality improvement are related concepts used to measure and improve clinical care. Value-based care represents the relationship between the incremental gain in outcome for patients and cost efficiency. It is achieved by identifying outcomes that are important to patients, codesigning solutions using multidisciplinary teams, measuring both outcomes and costs to drive further improvements, and developing partnerships across the health system. Quality improvement is focused on process improvement and compliance with best practice, and often uses “Plan-Do-Study-Act” cycles to identify, test, and implement change. Validated, standardized core outcome sets for perioperative neuroscience are currently lacking, but neuroanesthesiologists can consider using traditional clinical indicators, patient-reported outcomes measures, and perioperative core outcome measures. Several examples of bundled care solutions have been successfully implemented in perioperative neuroscience to increase value; for example, enhanced recovery for spine surgery, delirium reduction pathways, and same-day discharge craniotomy. This review proposes potential individual- and system-based solutions to address barriers to value-based care and quality improvement in perioperative neuroscience.
Anterograde Intramedullary Headless Compression Screw for Managing Extra-articular Thumb Metacarpal Base Fracture: Technique and Report
Authors: Rosifini Alves Rezende Luis G.
Published: August 2022

Extra-articular base fractures of the thumb are typical in hand surgeon practice. Nonoperative methods (spica) and operative methods are available for its management. There are operative methods described, such as plate and screws, Kirschner wires, and intramedullary screws. However, there is only a retrograde technique described. This study aims to present a new technique of an anterograde intramedullary headless compression screw to manage the extra-articular thumb metacarpal base fracture. This minimally invasive method allows an early range of motion and does not cross the articular surface of the thumb. This alternative fixation method has the advantage of low damage to soft tissues and good functional outcomes.
Investigation of pharmacologic interactions between omeprazole and tacrolimus in a membranous nephropathy patient with CYP3A5 nonexpresser: a case report
Authors: Li Yanli , Liu Yi , Sun Zengxian
Published: August 2022

Tacrolimus has been widely used in membranous nephropathy in recent years. The drug interactions of the coadministration of tacrolimus with omeprazole in CYP3A5 nonexpresser membranous nephropathy patients have not been demonstrated. Here, we report an idiopathic membranous nephropathy patient who was with CYP2C19*2/*2, CYP3A5*3/*3 (nonexpresser) and ABCB1 (3435 TT, 1236 computed tomography, 2677 TT) genotype requiring treatment with tacrolimus and omeprazole and found to have fluctuating metabolism of tacrolimus. This study shows that tacrolimus and omeprazole have pharmacologic drug interactions in CYP3A5 nonexpressers, implying that the CYP3A and ABCB1 gene mutations linked to tacrolimus metabolism may alter tacrolimus levels in the blood. The observed concentrations of tacrolimus were decreased after the discontinuation of omeprazole therapy. It demonstrates that, in addition to genotype, clinical covariates, such as omeprazole are important when it comes to better understanding and prediction of tacrolimus dosage. It is deemed necessary to monitor tacrolimus blood concentrations and make dose adjustments when patients were coadministered with omeprazole.
Salivary metabolome indicates a shift in tyrosine metabolism in patients with burning mouth syndrome: a prospective case–control study
Authors: Moreau Charlotte , El Habnouni Chakib , Lecron Jean-Claude , Morel Franck , Delwail Adriana , Le Gall-Ianotto Christelle , Le Garrec Raphaele , Misery Laurent , Piver Eric , Vaillant Loïc , Lefevre Antoine , Emond Patrick , Blasco Hélène , Samimi Mahtab
Published: August 2022

The pathophysiology of primary burning mouth syndrome (BMS) remains controversial. Targeted analyses or “omics” approach of saliva provide diagnostic or pathophysiological biomarkers. This pilot study's primary objective was to explore the pathophysiology of BMS through a comparative analysis of the salivary metabolome among 26 BMS female cases and 25 age- and sex-matched control subjects. Secondary objectives included comparative analyses of inflammatory cytokines, neuroinflammatory markers, and steroid hormones among cases and control subjects, and among BMS patients according to their clinical characteristics. Salivary metabolome, neuroinflammatory markers, cytokines, and steroids were, respectively, analysed by liquid chromatography coupled with mass spectrometry, ELISA and protease activity assay, and multiparametric Luminex method. Among the 166 detected metabolites, univariate analysis did not find any discriminant metabolite between groups. Supervised multivariate analysis divided patients into 2 groups with an accuracy of 60% but did not allow significant discrimination (permutation test, P = 0.35). Among the metabolites contributing to the model, 3 belonging to the tyrosine pathway (l-dopa, l-tyrosine, and tyramine) were involved in the discrimination between cases and control subjects, and among BMS patients according to their levels of pain. Among the detectable molecules, levels of cytokines, steroid hormones, and neuroinflammatory markers did not differ between cases and control subjects and were not associated with characteristics of BMS patients. These results do not support the involvement of steroid hormones, inflammatory cytokines, or inflammatory neurogenic mediators in the pathophysiology of pain in BMS, whereas the observed shift in tyrosine metabolism may indicate an adaptative response to chronic pain or an impaired dopaminergic transmission.
ARMS/Kidins220 regulates nociception by controlling brain-derived neurotrophic factor secretion
Authors: Sánchez-Sánchez Julia , Vicente-García Cristina , Cañada-García Daniel , Martín-Zanca Dionisio , Arévalo Juan C.
Published: August 2022

Pain is an alarm mechanism to prevent body damage in response to noxious stimuli. The nerve growth factor (NGF)/TrkA axis plays an essential role as pain mediator, and several clinical trials using antibodies against NGF have yielded promising results, but side effects have precluded their clinical approval. A better understanding of the mechanism of NGF/TrkA–mediated nociception is needed. Here, we find that ARMS/Kidins220, a scaffold protein for Trk receptors, is a modulator of nociception. Male mice, with ARMS/Kidins220 reduction exclusively in TrkA-expressing cells, displayed hyperalgesia to heat, inflammatory, and capsaicin stimuli, but not to cold or mechanical stimuli. Simultaneous deletion of brain-derived neurotrophic factor (BDNF) reversed the effects of ARMS/Kidins220 knock down alone. Mechanistically, ARMS/Kidins220 levels are reduced in vitro and in vivo in response to capsaicin through calpains, and this reduction leads to enhanced regulated BDNF secretion from dorsal root ganglion. Altogether, these data indicate that ARMS/Kidins220 protein levels have a role as a pain modulator in the NGF/TrkA axis regulating BDNF secretion.
Physician Assistant Students’ Perspective on Ultrasound as an Educational Technology
Authors: Breunig Michael , Plooster Corbin , Huckabee Michael
Published: August 2022

Introduction

The use of ultrasound as an educational technology in medical education to teach basic sciences, including anatomy and physical examination techniques, has become common. Multiple studies have demonstrated the benefits of using ultrasound to teach anatomy and physical examination skills; however, this has not been studied in physician assistant (PA) students.

Methods

This qualitative phenomenological research used 5 semi-structured interviews of first semester PA students to obtain a deeper understanding of students’ perspectives. Dominant coding categories were identified through open coding, and thematic analysis was completed to identify emerging themes of participants’ perspectives.

Results

Overall, the students positively perceived this use of ultrasound. Four themes emerged regarding PA students’ perspectives of ultrasound as an educational technology within their Clinical Anatomy and History and Physical Examination classes: solidifying the curriculum, desiring more, looking ahead, and burden of curriculum.

Discussion

This study supports the use of ultrasound as an educational technology to solidify prior learning; however, steps to ensure student commitment to the technology should be taken. Careful consideration for curricular sequencing and allocation of time should be utilized by programs attempting to integrate ultrasound in this manner. Hands-on experiences, rather than faculty demonstrations, and clinical correlation should be utilized whenever possible.
Conservative Treatment for Cervical Adenocarcinoma In Situ: Long Term Results
Authors: Monti Ermelinda , Somigliana Edgardo , Alberico Daniela , Boero Veronica , Iorio Maria , Di Loreto Eugenia , Dell'acqua Andrea , Liverani Carlo Antonio
Published: August 2022

Objective

This study aimed to evaluate the effectiveness of conservative treatment for cervical adenocarcinoma in situ (AIS).

Materials and Methods

This is a retrospective study on women with histologically confirmed AIS on cervical loop electrosurgical excision procedure specimen, treated conservatively between 2008 and 2020 in our center, Ospedale Maggiore Policlinico, Milan. The main outcome investigated was the risk of recurrence defined as a subsequent finding of recurrent AIS or invasive adenocarcinoma in a long-term follow-up. The disease-free survival curve was computed using the Kaplan-Meyer method. All patients underwent colposcopy with endocervical curettage and cytology every 6 months for the first 2 years after initial surgery and then annual cytology.

Results

Thirty women, aged 26 to 51 years, with histologically proven AIS on excisional specimen with negative margins, negative apex, and negative endocervical curettage were included. The median follow-up was 5.4 years. One woman had a recurrence of AIS after 8 years of follow-up and underwent total hysterectomy. No invasive cervical disease was detected during surveillance.

Conclusions

Women with cervical AIS can be managed conservatively by an excisional procedure, provided that the margins are free and a close and long-term follow-up is guaranteed.
Hyperviscosity syndromes; hemorheology for physicians and the use of microfluidic devices
Authors: Musick Jamie O. , Fibben Kirby S. , Lam Wilbur A.
Published: August 2022

Purpose of review

Hyperviscosity syndromes can lead to significant morbidity and mortality. Existing methods to measure microcirculatory rheology are not readily available and limited in relevance and accuracy at this level. In this review, we review selected hyperviscosity syndromes and the advancement of their knowledge using microfluidic platforms.

Recent findings

Viscosity changes drastically at the microvascular level as the physical properties of the cells themselves become the major determinants of resistance to blood flow. Current, outdated viscosity measurements only quantify whole blood or serum. Changes in blood composition, cell number, or the physical properties themselves lead to increased blood viscosity. Given the significant morbidity and mortality from hyperviscosity syndromes, new biophysical tools are needed and being developed to study microvascular biophysical and hemodynamic conditions at this microvascular level to help predict those at risk and guide therapeutic treatment.

The use of ‘lab-on-a-chip’ technology continues to rise to relevance with point of care, personalized testing and medicine as customizable microfluidic platforms enable independent control of many in vivo factors and are a powerful tool to study microcirculatory hemorheology.
The New 2021 CKD-EPI Equation Without Race in a European Cohort of Renal Transplanted Patients
Authors: Delanaye Pierre , Masson Ingrid , Maillard Nicolas , Pottel Hans , Mariat Christophe
Published: August 2022

Background.

Whether the new chronic kidney disease-epidemiology (CKD-EPI) equation without the race variable remains accurate enough for glomerular filtration rate (GFR) estimation in non-US kidney transplant recipients (KTRs) is unclear. We sought to compare the predictive performance between this equation and the classical CKD-EPI equation in a French cohort of KTRs. We also evaluated the performance of the European Kidney Function Consortium (EKFC) equation, an estimate that has proved very accurate in nontransplant patients and that does not include race variable.

Methods.

We retrospectively selected 489 KTRs for whom GFR was measured by inulin clearance. Performances of GFR equations were compared according to median bias, imprecision, and accuracy within 30% (P30) and 20% (P20). Differences in P20/P30 were tested using the exact McNemar test.

Results.

Although the 4 equations exhibited a similar level of imprecision, the bias of the new CKD-EPI equation was +5.5 (4.0; 6.6) mL/min/1.73 m², much higher than the bias of the classical CKD-EPI, EKFC, and Modified Diet in Renal Diseases (MDRD) equation (2.4 [1.7;3.5], 2.2 [1.1;3.1], and −0.5 [−1.5; 1.0] mL/min/1.73 m², respectively). The new CKD-EPI equation was significantly less accurate with a P30 of 68.3% as compared with 74.2%, 75.3%, and 77.1% for the classical CKD-EPI, EKFC, and MDRD equation, respectively. The EKFC equation outperformed both versions of the CKD-EPI equation in terms of P20.

Conclusions.

The new CKD-EPI equation is suboptimal for the care and follow-up of European transplanted patients. The EKFC equation shows at least a similar performance to the MDRD and the classical CKD-EPI equation. Further validation of the EKFC equation in KTRs from a diverse ethnic background is needed.
Preliminary Clinical Experience of Molnupiravir to Prevent Progression of COVID-19 in Kidney Transplant Recipients
Authors: Villamarín Miguel , Márquez-Algaba Ester , Esperalba Juliana , Perelló Manuel , Los Arcos Ibai , Campany David , Moreso Francisco , Len Oscar
Published: August 2022

Background.

Recently, different therapeutic lines have been tried in the initial stage of the disease of COVID-19, including remdesivir and molnupiravir. There is scarce evidence on the efficacy and safety of molnupiravir in kidney transplant recipients (KTRs).

Methods.

ingle-center prospective cohort study‚ all adult KTRs diagnosed with COVID-19 and treated with molnupiravir or remdesivir from January to April 2022 were included.

Results.

Nine KTRs with SARS-CoV-2 (Omicron variant) infection and mild symptoms received molnupiravir in an outpatient basis and were compared with a cohort of similar patients treated with remdesivir (n = 7). Three patients in the molnupiravir cohort were in the early posttransplant period and received a basiliximab (n = 2) or antithymocite globulin–based induction (n = 1). One of the patients had been treated with methylprednisolone bolus and antithymocite globulin for an episode of acute rejection in the previous months. They were all vaccinated with mRNA vaccines‚ and all but 1 had serological response. Only one of the patients experienced clinical worsening despite molnupiravir treatment and developed pneumonia requiring hospital admission. None of the patients suffered adverse effects attributed to molnupiravir‚ and no adjustment of tacrolimus dose was needed. None of the patients treated with remdesivir progressed in COVID-19 severity.

Conclusions.

Our study suggests that KTRs with SARS-CoV-2 infection under treatment with molnupiravir have a good clinical evolution with a probable lower risk for hospitalization and no adverse effects. At the renal level, molnupiravir was well tolerated, with no evidence of nephrotoxicity secondary to the drug nor interactions with the immunosuppressive therapy.
Risk of conversion to bipolar disorder in patients with late-onset major depression
Authors: Elefante Camilla , Brancati Giulio Emilio , Petrucci Alessandra , Gemmellaro Teresa , Toni Cristina , Lattanzi Lorenzo , Perugi Giulio
Published: August 2022

To evaluate the impact of age at onset on late-life depression course and on risk of conversion to bipolar disorder (BD). A retrospective chart review of 100 elderly patients (age ≥ 65 years) diagnosed with a moderate-to-severe depressive episode and followed up for at least 18 months was conducted. Among patients affected by major depressive disorder (N = 57), follow-up morbidity differences between those with typical onset depression (TOD) (<60 years) and those with late-onset depression (LOD) (≥60 years) were investigated using Wilcoxon rank-sum test and Cox proportional hazard model. Patients belonging to the LOD group had a significantly lower percentage of follow-up time spent with depressive symptoms compared with patients with TOD (r = 0.36; P = 0.006), but significantly more time spent with (hypo)manic episodes (r = −0.31; P = 0.021). Moreover, LOD was significantly associated with a faster conversion to BD (hazard ratio = 3.05; P = 0.037). Depression first emerging in late life may represent an unstable condition with a high risk to convert to BD. Given the potential clinical implications, further studies on the course of LOD are required.
Inflammatory responses is induced in pulmonary embolic lung: evaluation by a reproducible pulmonary embolism model in mice
Authors: Okabe Honoka , Kato Haruka , Yoshida Momoka , Kotake Mayu , Tanabe Ruriko , Matano Yasuki , Yoshida Masaki , Nomura Shintaro , Yamashita Atsushi , Nagai Nobuo
Published: August 2022

Background

Since previously established models of pulmonary embolism showed a large variability in the degree of ischemia, it is difficult to assess the pathophysiological response in the lung after embolization. Here, we established a model of pulmonary embolism by certain amount of relatively small thrombi, in which the degree of ischemia was reproducible.

Methods

Thrombi with a maximum diameter of 100 μm or 500 μm were administered intravenously under anesthesia, and the survival ratio at 4 hours was evaluated. The location of thrombi in the lung was visualized by administration of fluorescent-labeled thrombus, and the hemodynamics of the lung after administration of thrombi was evaluated. CT angiography was also performed to evaluate the ratio of the embolized vessels. In addition, cytokine mRNAs was quantified 4 hours in embolized lung. Immunohistochemical analysis for interleukin (IL)-6 and CD68 as a marker of macrophages were also performed.

Results

It was found that mice with 100 μm clots, but not with 500 μm clots, showed a dose-dependence of survival between 2.3 μL/g and 3.0 μL/g at 4 hours from embolization induction. In mice treated with 2.5 μL/g of 100 μm thrombus, thrombi were located in the peripheral region of the lung, which was consistent with the disruption of blood circulation the peripheral region. In addition, about 60% of the vessels with a diameter of less than 100 μm were occluded in these mice. In the lungs after 4 hours of embolization, IL-6 mRNA and tumor necrosis factor (TNF)-α mRNA were significantly higher and lower than control lungs. IL-6 was expressed in CD68-positive macrophages in both embolized and control lungs after 4 hours of embolization, and the number of each positive cells were comparable in both embolized and control lungs.

Conclusions

These results show that the pulmonary embolization model induced by a certain amount of small thrombus is useful for evaluating the pathological responses in the embolized lung. Furthermore, it was found that IL-6 expression was increased in macrophages in the embolized lung, indicating that inflammatory responses may contribute to the pathogenesis of pulmonary embolism.
Local production of reactive oxygen species drives vincristine-induced axon degeneration
Authors: Gómez-Deza Jorge , Slavutsky Anastasia L. , Nebiyou Matthew , Le Pichon Claire E.
Published: August 2022

Neurological side effects arising from chemotherapy, such as severe pain and cognitive impairment, are a major concern for cancer patients. These major side effects can lead to reduction or termination of chemotherapy medication in patients, negatively impacting their prognoses. With cancer survival rates improving dramatically, addressing side effects of cancer treatment has become pressing. Here, we use iPSC-derived human neurons to investigate the molecular mechanisms that lead to neurotoxicity induced by vincristine, a common chemotherapeutic used to treat solid tumors. Our results uncover a novel mechanism by which vincristine causes a local increase in mitochondrial proteins that produce reactive oxygen species (ROS) in the axon. Vincristine triggers a cascade of axon pathology, causing mitochondrial dysfunction that leads to elevated axonal ROS levels and SARM1-dependent axon degeneration. Importantly, we show that the neurotoxic effect of increased axonal ROS can be mitigated by the small molecule mdivi-1 and antioxidants glutathione and mitoquinone, identifying a novel therapeutic avenue to treat the neurological effects of chemotherapy.
Sucrose-stimulated Salivary pH as an Adjunct to Caries Risk Assessment
Authors: Okuji David , Odusanwo Olutayo , Wu Yinxiang , Yeh Susanna , Dhar Sohini
Published: August 2022

Background

Child and maternal sucrose-stimulated salivary pH (SSS pH) levels have the potential to be associated with childhood caries.

Aim

This study investigated the relationships among child and maternal SSS pH and child caries diagnosis, severity, and risk.

Design

SSS pH levels were measured from 202 pediatric subjects and 175 mothers. Early childhood caries (ECC) and severe ECC (SECC) diagnoses, caries risk assessment (CRA) results, and caries severity scores were recorded. The associations between child and maternal SSS pH and children’s caries risk, diagnosis, and severity were respectively assessed using regression models.

Results

Children with SSS pH ≤5.6 had higher odds to be diagnosed with ECC or SECC (aOR=7.27), and higher odds to present with moderate to extensive caries severity (aOR=5.63). Child SSS pH was associated with multiple risk factors on a CRA. When child SSS pH was adjusted for age, gender, and race/ethnicity as a predictor for SECC and ECC, the sensitivity and specificity estimates increased. Maternal and child SSS pH were positively associated.

Conclusions

Dentists should consider the use of children’s SSS pH as an inexpensive adjunct to the CRA and know that maternal and child SSS pH are significantly associated.
CRISPR/Cas9 screens implicate RARA and SPNS1 in doxorubicin cardiotoxicity
Authors: Lv Wenjian , Shao Yeng , Hoshino Atsushi , Arany Zoltan , Musunuru Kiran , McDermott-Roe Chris
Published: August 2022

Doxorubicin (DOX) is an efficacious chemotherapy compound used to treat various cancers which elicits severe side effects, including heart failure. Uptake of DOX by cardiomyocytes causes metabolic dysfunction and cell death but causal mechanisms remain largely undefined. We applied genome-wide CRISPR/Cas9 knockout screens to discover genetic modifiers of DOX-induced cardiomyocyte cell death, and independently, DOX uptake and clearance. Both screens discovered known and novel factors. In cell death screens and validation studies, loss of retinoic acid receptor-α (RARA) predisposed cardiomyocytes to DOX-mediated cell death. Conversely, RARA activation reduced DOX cytotoxicity in wild type cardiomyocytes. RNA-Seq analysis revealed that whilst DOX caused large-scale suppression of metabolic and mitochondrial gene expression, RARA activation mitigated this effect. In DOX accumulation screens, an essential role for lysosomes in DOX clearance was observed. Loss of Sphingolipid Transporter 1 (SPNS1) led to DOX hyperaccumulation, suppression of autophagy, increased DNA damage, and increased cell death. Hence, SPNS1 plays a key role in buffering against DOX accumulation and toxicity. Collectively, our study nominated hundreds of drug-gene interactions, providing a springboard for exploration of causal mechanisms, and a technical framework for future screening campaigns.
Impact of OEI requirement on parallel hybrid electric turboprop regional aircraft optimization
Authors: Quillet Dominik , Boulanger Vincent , Rancourt David , Freer Richard , Bertrand Pierre
Published: August 2022

Purpose

Parallel hybrid electric (HE) propulsion retrofit is a promising alternative to reduce fuel burn of aircraft operating on short regional flights. However, if the batteries are depleted at the end of the mission, the hybrid powertrain designs with downsized gas turbines (GTs) and additional electric motors might not meet the one-engine inoperative (OEI) missed approach climb performance required by the certification. Alternatively, hybrid designs using the original full-size GT can perform one engine climb without electric assistance. This paper aims to evaluate the impact of overshoot climb requirements on powertrain design and performance comparing the two design approaches.

Design/methodology/approach

An aircraft-level parametric mission analysis model is used to evaluate aircraft performance combined with an optimization framework including multiple constraints. An indirect approach using metamodels is used to optimize powertrain sizing and operation strategy.

Findings

Considering OEI climb requirements, no benefits were found using a design with downsized GTs. Equivalent fuel burns were found for hybrid designs that keep the original size GTs, but do not require electric energy for the OEI overshoot at the end of the mission. Then, it is recommended to size the GT to maintain the emergency climb capabilities with no electric assistance to ensure power availability regardless of remaining battery energy.

Originality/value

This work introduces a new perspective on parallel HE sizing with consideration for the dependency of power capability at aircraft level on the electric energy availability in case of critical mission scenarios such as overshoot climb at the end of the mission.
A trip down memory lane to travellers’ food experiences
Authors: Afaq Anam , Gaur Loveleen , Singh Gurmeet
Published: August 2022

Purpose

Research on food tourism has a significant impact on destination attractiveness. However, components interfacing food experiences and memory are under-researched topics in food tourism literature. Therefore, this study aims to present a framework based on the components of rememberable food experiences while travelling through the lens of the diffusion of sensory stimulation.

Design/methodology/approach

This study adopted a qualitative application of “Memory-Work”, a social constructionist archetype suggested for food tourism-related research. A survey was conducted, and the respondents were asked an open-ended question.

Findings

The analysis found the components instigating these food experiences: Peculiar food and drink experience, setting/geographical location, companions and social interactions, celebrating occasions and touristic components (e.g. serendipitous travel experience and food nostalgic memory). Predominantly, rememberable food tourism experiences are more explicit than memorable tourism experiences.

Research limitations/implications

The components mentioned in this framework illustrate that various food-related experiences should be involved in destination marketing. Service providers could use these components to create unique destination stories.

Originality/value

This study is the first to present a newly developed framework for food tourism service providers that incorporates sensory impressions with food memories to explore the connection between food memories associated with a destination.
Finding one's own way: how newcomers who differ stay well
Authors: Chen Jenny , Cooper-Thomas Helena D.
Published: August 2022

Purpose

Being different from others can be stressful, and this may be especially salient for newcomers during organizational socialization when they may be expected to fit in. Thus, drawing on conservation of resources theory, the authors examine the effects of newcomers' individual differentiation on their subsequent emotional exhaustion.

Design/methodology/approach

The authors test a multiple mediation model with data from 161 UK graduates collected at three times using structural equation modeling.

Findings

The results largely support the hypotheses, identifying individual differentiation as a motivational resource associated with the proactive behavior of changing work procedures. In turn, changing work procedures links with the personal resource of positive affect, which facilitates the relational resource of social acceptance and predicts lower emotional exhaustion. Individual differentiation predicts lower social acceptance also, but not via monitoring as anticipated.

Originality/value

The results provide novel insights into the effects of individual differentiation on emotional exhaustion in the context of organizational socialization. The study highlights that, while newcomers high in individual differentiation face depletion of the relational resource of social acceptance, they can still adjust well and avoid emotional exhaustion through changing work procedures to foster positive affect.
Conducting research by mixed methods: an autoethnography account of a PhD research in facilities management from a developing country
Authors: Amos Daniel
Published: August 2022

Purpose

Despite the increasing discourse on mixed methods (MM) in academic literature, less attention has been focused on its methodological development in the built environment in developing countries. This paper aims to examine the basis and challenges of the application of MM for health-care facilities management (FM) research in Ghana.

Design/methodology/approach

This paper adopts autoethnography as its research method, coupled with a scholarly review of methodological literature to position a technical view on the application of mixed methods for health-care FM research in a developing country.

Findings

This paper contributes and lends support to the methodological strength of MM as epistemologically coherent and useful for understanding the intricacies of health-care FM. This paper advances the proposition that the nascent stage of FM development in Ghana, paucity of literature, epistemological and axiological considerations underscore the choice of a sequential MM. The attitude of research participants, ethical challenges and time-lapse for data analysis were observed as practical challenges.

Research limitations/implications

Discussion of data integration is excluded.

Practical implications

This paper provides a nuanced understanding of the concept of MM in health-care FM and set forth practical recommendations worthy to enhance the application of MM research.

Originality/value

This paper is among the few focusing on methodological discussion of health-care FM. This paper proposes a framework to guide researchers in the application of mixed methods.
Shariah compliance and stock price synchronicity: evidence from India
Authors: Farooq Omar , Ahmed Neveen
Published: August 2022

Purpose

This paper aims to document the effect of shariah compliance on stock price synchronicity.

Design/methodology/approach

This paper uses the data of non-financial firms from India and various estimation procedures (pooled OLS and instrument variable regression) to test the arguments presented in this paper. The time period of the study ranges between 2000 and 2019.

Findings

The results show that shariah-compliant firms have significantly higher levels of synchronicity than non-compliant firms. The findings hold after comprehensive inclusion of relevant controls and to a number of sensitivity tests. The authors attribute this result to the unique financial characteristics (lower levels of leverage, liquidity and cash) of shariah-compliant firms. The paper argues that these characteristics are related to better information environment which is responsible for higher levels of synchronicity. The paper also shows that the difference in the synchronicity levels of the two groups is less pronounced for those shariah-compliant firms that have relatively high levels of leverage and cash ratios.

Originality/value

The authors believe that this is an initial attempt to document the impact of shariah compliance on stock price synchronicity.
Sjögren syndrome is a hidden contributor of macrovascular and microvascular complications in patients with type 2 diabetes
Authors: Su Yu‐Jih , Leong Pui‐Ying , Wang Yu‐Hsun , Wei James Cheng‐Chung
Published: August 2022

Objective

To investigate cardiovascular risk among diabetic patients with Sjögren syndrome.

Methods

This study was a nationwide population‐based case‐control study from 1997 to 2013, in which the association between autoimmune diseases and diabetes was investigated. The study population consisted of individuals with newly diagnosed type 2 diabetes with macrovascular or microvascular complications with at least two outpatient visits or one hospitalization as the outcome variables, and the exposure variables included traditional risk factors, medications, and autoimmune diseases. The odds ratio of cardiovascular events among each prevalent autoimmune disease and hydroxychloroquine's effect on cardiovascular risk were analyzed.

Results

The study included a total of 7026 individuals with diabetes with microvascular and macrovascular complications and the same number of patients in the control group. Sjögren syndrome was significantly higher in the diabetes complication group than in the non‐complication group (0.8% vs 0.5%,P = 0.036). By using multivariate analysis, we found hypertension, hyperlipidemia, and Sjögren syndrome to be three independent risk factors for diabetes vascular complications (odds ratio [OR] 1.96, 95% confidence interval [CI] 1.82‐2.10; OR 1.53, 95% CI 1.42‐1.64; and OR 1.67, 95% CI 1.06‐2.65; respectively, allP < 0.05). Treatment with traditional statins and aspirin might be able to overcome the increased risk of developing cardiovascular events while comparing between diabetes patients with and without Sjögren syndrome.

Conclusion

Sjögren syndrome is an unrecognized independent risk factor for cardiovascular events among diabetes patients, which indicates that patients with diabetes combined with Sjögren syndrome require closer follow up regarding cardiovascular complications in clinical settings. Treatment with hydroxychloroquine might not be enough to lower the cardiovascular risk significantly in diabetes patients with Sjögren syndrome.
Consensus statements for pharmacological management, monitoring of therapies, and comorbidity management of psoriatic arthritis in the United Arab Emirates
Authors: Alnaqbi Khalid A. , Hannawi Suad , Namas Rajaie , Alshehhi Waleed , Badsha Humeira , Al‐Saleh Jamal
Published: August 2022

Objective

Psoriatic arthritis (PsA), a chronic inflammatory disease characterized by heterogeneous clinical manifestations, substantially impacts the quality of life of affected individuals. This article aims at developing consensus recommendations for the management of PsA and associated comorbidities and screening and monitoring requirements of PsA therapies in the United Arab Emirates (UAE) population.

Methods

An extensive review of present international and regional guidelines and publications on the pharmacological management, monitoring of therapies in the context of PsA was performed. Key findings from guidelines and literature were reviewed by a panel of experts from the UAE at several meetings to align with current clinical practices. Consensus statements were formulated based on collective agreement of the experts and members of Emirates Society for Rheumatology.

Results

The consensus recommendations were developed to aid practitioners in clinical decision‐making with respect to dosage recommendations for pharmacological therapies for PsA, including conventional drugs, non‐biologic, and biologic therapies. Consensus recommendations for therapeutic options for the treatment of PsA domains, including peripheral arthritis, axial disease, enthesitis, dactylitis, psoriasis, and nail disease, were developed. The panel emphasized the importance of monitoring PsA therapies and arrived at a consensus on monitoring requirements for PsA therapies. The expert panel proposed recommendations for the management of common comorbidities associated with PsA.

Conclusion

These consensus recommendations can guide physicians and healthcare professionals in the UAE in making proper treatment decisions, as well as efficiently managing comorbidities and monitoring therapies in patients with PsA.
The Eternal Debate Over Conservatism and Prudence: A Historical Perspective on the Conceptualization of Asymmetry in Financial Accounting Theory*
Authors: Orthaus Selina , Pelger Christoph , Kuhner Christoph
Published: August 2022

The recent revisions of conceptual frameworks (CFs) by the IASB and the FASB included changes to the status of prudence/conservatism, accompanied by a broader debate about the meaning and role of asymmetry in financial accounting theory (FinAT). This paper adopts a historical perspective to identify possible sources of the current controversies by examining how the discourse on asymmetry has developed over time. For this purpose, we trace the conceptualization of asymmetry in FinAT building from the 19th century until 2018, covering contributions to the US FinAT literature and the conceptual reasoning of standard setters (and their constituents) in the United States and at the international level. We identify four distinct constructs of asymmetry (ultra‐, specified, discretionary, and neutral asymmetry) developed in FinAT under the headings of “conservatism” and/or “prudence.” Our analysis reveals that the respective historical circumstances strongly influenced which notion and role of asymmetry were commonly accepted in FinAT, while the arguments underlying the debates were going in circles and were characterized by an increasing level of abstraction over time. We conclude that the controversy about asymmetry is partially due to conceptual ambiguity but also due to different assumptions about the objective of financial reporting and attributes of the preparer, which are indicative of two conflicting paradigms shaping the FinAT discourse on asymmetry. Our findings point to gaps and limitations in the deductive CFs currently employed by the IASB and FASB. Our study highlights future research potential regarding the construction of the preparer in standard setting and analyses of the ways in which deductive CFs (fail to) translate into consistent standards.
The ethanol inhibition of basolateral amygdala neuron spiking is mediated by a γ‐aminobutyric acid type A‐mediated tonic current
Authors: Nimitvilai‐Roberts Sudarat , Woodward John J.
Published: August 2022

Background

The basolateral nucleus of the amygdala (BLA) plays an important role in the development of fear and anxiety‐related behaviors. The BLA receives inputs from all sensory stimuli. After processing those stimuli, BLA neurons signal neurons within the central amygdala and other brain regions, including the ventral and dorsal striatum and frontal cortex. Studies suggest that the BLA is involved in drug dependence and in the reinforcing actions of ethanol. For example, acute exposure to ethanol reduces anxiety, while withdrawal from chronic ethanol exposure alters BLA synaptic transmission, which increases anxiety, a common underlying cause of relapse. Exposure to and withdrawal from chronic alcohol also disrupts many brain areas that connect with the BLA. Despite these important findings, the acute actions of alcohol on the intrinsic excitability of BLA neurons have not been fully characterized.

Methods

Brain slices containing the BLA were prepared from adult C57BL/6J male mice. Whole‐cell and sharp electrode electrophysiological recordings were performed to characterize the effects of acute ethanol on BLA neuronal and astrocyte function, respectively.

Results

Ethanol inhibited action potential (AP) firing of BLA neurons but had no effect on BLA astrocyte resting membrane potential. The ethanol‐induced inhibition of firing was concentration‐dependent (11 to 66 mM) and accompanied by a reduction in the input resistance and an increase in the rheobase of BLA neurons. The inhibitory effect of ethanol was suppressed by picrotoxin, which blocks both γ‐aminobutyric acid type A (GABAA) and glycine receptors, but not by the selective glycine receptor antagonist strychnine, which suggests an involvement of GABAA receptors. Ethanol did not affect spontaneous inhibitory postsynaptic currents suggesting that the inhibition of BLA neuronal excitability by ethanol was not due to an increase in GABAA‐mediated synaptic transmission. However, acute ethanol enhanced the amplitude of the holding current of BLA neurons, an effect that was prevented by picrotoxin, which by itself reduced the holding current.

Conclusions

These results suggest that BLA neurons express a GABA‐mediated tonic current that is enhanced by acute ethanol, which leads to reduced excitability of BLA neurons.