bluuebunny/crossref_metadata_2025 huggingface dataset:
Review of Indo-West Pacific jawfishes (Opistognathus: Opistognathidae), with descriptions of 18 new species
Authors: SMITH-VANIZ WILLIAM F.
Published: March 2023

Sixty species of jawfishes (Opistognathus) from the Indo-West Pacific are reported in an updated review, including descriptions of 18 new species: Opistognathus albomaculatus n.sp., O. asper n.sp., O. aurolineatus n.sp., O. bathyphilus n.sp., O. biporus n.sp., O. challenger n.sp., O. erdmanni n.sp., O. flavidus n.sp., O. helvolus n.sp., O. hyalinus n.sp., O. megalops n.sp., O. microspilus n.sp., O. nigripinnis n.sp., O. parvus n.sp., O. pholeter n.sp., O. triops n.sp., O. vigilax n.sp., and O. wassi n.sp.. Species accounts are provided for each species, including illustrations or color photographs, complete synonymies, specimens examined (or appropriate citation if previously published in detail), diagnosis, comparisons, etymology, and distribution maps. Geographic range extensions are reported for a number of species. An identification key is given for all species and frequency tables of important characters are also provided. The taxonomic status of Opistognathus inornatus and O. rosenbergii annulatus are discussed in detail but not completely resolved pending unavailable molecular data. Geographic variation is also described for Opistognathus adelus, O. albomaculatus n.sp., O. castelnaui, O. margaretae, O. variabilis, and O. vigilax n.sp. Many species are known only from holotypes and others from single localities, indicating how much more remains to be known about these jawfishes.
The Poetic Edda
Authors: Pettit Edward
Published: March 2023

This book is an edition and translation of one of the most important and celebrated sources of Old Norse-Icelandic mythology and heroic legend, namely the medieval poems now known collectively as the Poetic Edda or Elder Edda.

Included are thirty-six texts, which are mostly preserved in medieval manuscripts, especially the thirteenth-century Icelandic codex traditionally known as the Codex Regius of the Poetic Edda. The poems cover diverse subjects, including the creation, destruction and rebirth of the world, the dealings of gods such as Óðinn, Þórr and Loki with giants and each other, and the more intimate, personal tragedies of the hero Sigurðr, his wife Guðrún and the valkyrie Brynhildr.

Each poem is provided with an introduction, synopsis and suggestions for further reading. The Old Norse texts are furnished with a textual apparatus recording the manuscript readings behind this edition’s emendations, as well as select variant readings. The accompanying translations, informed by the latest scholarship, are concisely annotated to make them as accessible as possible.

As the first open-access, single-volume parallel Old Norse edition and English translation of the Poetic Edda, this book will prove a valuable resource for students and scholars of Old Norse literature. It will also interest those researching other fields of medieval literature (especially Old English and Middle High German), and appeal to a wider general audience drawn to the myths and legends of the Viking Age and subsequent centuries.
Toward Probabilistic Post-Fire Debris-Flow Hazard Decision Support
Authors: Oakley Nina S. , Liu Tao , McGuire Luke A. , Simpson Matthew , Hatchett Benjamin J. , Tardy Alex , Kean Jason W. , Castellano Chris , Laber Jayme L. , Steinhoff Daniel
Published: March 2023

Post-wildfire debris flows (PFDF) threaten life and property in western North America. They are triggered by short-duration, high-intensity rainfall. Following a wildfire, rainfall thresholds are developed that, if exceeded, indicate high likelihood of a PFDF. Existing weather forecast products allow forecasters to identify favorable atmospheric conditions for rainfall intensities that may exceed established thresholds at lead times needed for decision-making (e.g., ≥24 h). However, at these lead times, considerable uncertainty exists regarding rainfall intensity and whether the high-intensity rainfall will intersect the burn area. The approach of messaging on potential hazards given favorable conditions is generally effective in avoiding unanticipated PFDF impacts, but may lead to “messaging fatigue” if favorable triggering conditions are forecast numerous times, yet no PFDF occurs (i.e., false alarm). Forecasters and emergency managers need additional tools that increase their confidence regarding occurrence of short-duration, high-intensity rainfall as well as tools that tie rainfall forecasts to potential PFDF outcomes. We present a concept for probabilistic tools that evaluate PFDF hazards by coupling a high-resolution (1-km), large (100-member) ensemble 24-h precipitation forecast at 5-min resolution with PFDF likelihood and volume models. The observed 15-min maximum rainfall intensities are captured within the ensemble spread, though in highest ∼10% of members. We visualize the model output in several ways to demonstrate most likely and most extreme outcomes and to characterize uncertainty. Our experiment highlights the benefits and limitations of this approach, and provides an initial step toward further developing situational awareness and impact-based decision-support tools for forecasting PFDF hazards.
Interaction of a Hysteresis Western Boundary Current with a Large-Scale Marginal Sea Circulation in a Gap-Leaping System
Authors: Mei Huan , Li Kunshan , Liu Qian , Wang Bin , Wu Xiangbai
Published: March 2023

The influence of a large-scale circulation (LSC) in a marginal sea on a hysteresis western boundary current (WBC) flowing across a gap is studied using a nonlinear 1.5-layer ocean model. Results show that both single-gyre LSC and double-gyre LSC are able to induce the critical-state WBC transition from the eddy-shedding regime to the leaping regime, while only double-gyre LSC is able to induce the critical-state WBC transition from the leaping regime to the eddy-shedding regime. The dynamics of WBC transition suggests that the meridional advection enhanced by the perturbation of the LSC is responsible for the regime shift from penetration to leap and that the meridional advection reduced by the perturbation of the LSC is responsible for the regime shift from leap to penetration. We also present the parameter space of the critical LSC that can induce the regime shift of WBC far away from the critical state. When the WBC is in the eddy-shedding regime, the critical strength of the single-gyre LSC increases as the WBC transport decreases regardless of the island’s presence in the gap. The critical strength of the double-gyre LSC increases as the WBC transport decreases in the no-island case, while the critical parameter increases as the WBC transport at first decreases and then increases in the island case. When the WBC is in the leaping regime, the critical strength of the double-gyre LSC increases as the WBC transport increases. These results help to explain the observed fact that the Kuroshio flows across the Luzon Strait in the leaping regime or the penetrating regime.
Predicting Early Versus Late In-Hospital Mortality in the Trauma Population
Authors: Dunitz Jackson , Rhodes Heather X. , Pepe Antonio P.
Published: March 2023

This study aimed to evaluate non-survivors who were admitted to a level I trauma center but later died, in terms of predicting who would expire early vs late. This is a single-center study of Trauma Registry data, from July 3, 2016, to February 24, 2022. The inclusion criteria were based upon age (≥18 years) and in-hospital mortality. 546 patients (mean age 58) were included in the analysis. Trauma patients who may experience an earlier death were those with increasing injury severity scores, activation of massive transfusion protocol, comorbid advanced directive limiting care, COPD, personality disorder, and ED death location. Patients were more likely to experience later in-hospital mortality, including those with increasing ICU stays, and comorbid dementia.
In/dividuality and charisma among Pentecostal Gypsies
Authors: Jiménez-Royo Javier
Published: March 2023

This text reflects on the constitution of the Gypsy Pentecostal person, thus inserting itself in the debates on the continuity or rupture that motivate conversions to Christianity. The moral obligations generated by kinship relations among the Gypsies and the links with the Holy Spirit make it difficult to find gaps for the deployment of individuality by evangelical Gypsies. However, the materialization of God’s desire is embedded in the dynamics of leadership, which in the context of the religious organization causes the charisma to avoid its routinization.
Comparative analysis of the whole life carbon of three construction methods of a UK-based supermarket
Authors: Mohebbi Golnaz , Hasan Agha , Blay-Armah Augustine , Bahadori-Jahromi Ali , Mylona Anastasia , Barthorpe Mark
Published: March 2023

The built environment has been a significant contributor to global carbon emissions. It, therefore, has a vital role to play in the reduction efforts of future climate change. While the design of buildings may determine future energy use for cooling, heating, and lighting during the operational stage of the building, this study aims to observe the effect of the building design on the operational as well as the whole-life carbon emissions. Past studies have focused on either the operational carbon or the embodied carbon of a building. Using a cradle-to-grave assessment of a typical UK supermarket, this study explores the relationship between embodied carbon and operational carbon. Additionally, it examines the effects of the variables between three approved construction methods of the same design on the whole life of carbon. These methods are a steel structural frame and cladding panel external wall, steel frame and poroton walls, precast concrete and glulam frame and precast concrete walls. The findings of this research will contribute to mitigation strategies for the environmental impacts of supermarket building construction whilst providing a framework for future assessment of the whole-life carbon of supermarket buildings.

Employing the life cycle assessment methodology, this paper examines the potential of minimising both embodied and operational carbon by observing the whole life carbon. Highlighting the influence of the GHG emission contributing factors in each stage on each other. Additionally, the recommended methodology for the supermarket building types of this case study, could be adapted for other types of buildings. The findings could also augment carbon emission research and guide the development of supermarket buildings to low carbon intensive. Furthermore, collaboration with the industry in carrying out this research aids in adopting the findings as practical and theoretical guides for engineers and designers in reducing the building sector’s harmful environmental impact.
Clinical course and features of soft tissue sarcomas in geriatric patients: a single-center experience
Authors: Pehlivan Metin , İribaş Ayça , Bilgiç Bilge , Başaran Mert , Ekenel Meltem
Published: March 2023

Objective

This study was performed to examine the disease course in geriatric patients with soft tissue sarcoma and determine the risk factors for mortality.

Methods

We retrospectively analyzed patients who were treated at Istanbul University Oncology Institute from January 2000 to August 2021.

Results

Eighty patients were included in the study. The patients’ median age was 69 years (range, 65–88 years). The median overall survival of patients diagnosed between the ages of 65 and 74 years was 70 months, and that of patients diagnosed at the age of ≤75 years was significantly lower at 46 months. The median survival of patients who did and did not undergo surgical resection was 66 and 11 months, respectively, with a significant difference. The median overall survival of patients with positive and negative surgical margins was 58 and 96 months, respectively, also with a significant difference. Age at diagnosis and recurrence/metastasis significantly affected mortality. A 1-year increase in the age at diagnosis increased mortality by 1.147 times.

Conclusion

Age of >75 years, inability to undergo surgery, positive surgical margins, and head and neck location may be associated with a poor prognosis in geriatric patients with soft tissue sarcoma.
Investigation of the Pier Response during the Lateral Slide of Multi-Span Bridges
Authors: Dahlberg Justin , Phares Brent M. , Liu Zhengyu , Freeseman Katelyn S.
Published: March 2023

Lateral slide-in bridge construction—also referred to as slide-in bridge construction (SIBC)—has gained increasing attention as a viable accelerated bridge construction (ABC) approach. Although SIBC has been successfully employed on multiple single-span bridge projects, the use of SIBC on multi-span bridges is rare. Adding more spans creates a more complex system that requires connections (and other details) that were previously not needed in a single-span slide. Also, it is a concern that the multi-span bridge would need to slide on piers, which creates possible uplift and overturning scenarios. As such, it was vitally important to understand the structural response of the substructure during the bridge sliding. Although much general information on lateral slides as an ABC method was available, very little literature had been published related explicitly to such construction for multi-span bridges. The objective of this research was to develop durable design details to be used with the lateral slide concept with a focus on pier connection details and evaluate the performance of the bridge pier during the sliding. To achieve the goal, relevant information was collected and evaluated by conducting a literature review on various details and construction approaches for previously completed lateral slide projects. Further, a three-span, 300 ft long steel girder bridge on IA 1 southwest of Iowa City, Iowa, U.S., was monitored using gauges during the slide-in. The results indicated that the current slide-in practice works well with the multi-span steel girder superstructure and the wall pier. No significant response from the substructure was visually observed during the slide-in, and no cracking occurred on the concrete deck or piers. This indicated that the superstructure with steel girders and concrete diaphragms could be built with the lateral slide-in method. The significant strain was measured from the pile strain gauges. However, the piles were functionally adequate to carry the vertical load, and the moment carried by each pile was minimal. An uplifting action was captured on Pier 1. However, this effect was minimal on Pier 2.
Donor Hematopoietic Stem Cell/Lymphocyte Maintenance Treatment After CAR T-Cell Therapy in Patients With B-Cell Acute Lymphoblastic Leukemia Relapse Following Stem Cell Transplant
Authors: Li Qing , Lyu Cuicui , Liu Meijing , Wang Jia , Mou Nan , Jiang Erlie , Zhang Rongli , Deng Qi
Published: March 2023

Maintaining the efficacy of anti-CD19 chimeric antigen receptor modified (CAR) T-cell therapy in patients with B-cell acute lymphoblastic leukemia (B-ALL) relapse after allogeneic hematopoietic stem cell transplant (allo-HSCT) is an urgent problem. In this study, we aimed to compare the efficacy of donor hematopoietic stem cell infusion (DSI) therapy and donor lymphocyte infusion (DLI) therapy as a maintenance therapy after R/R B-ALL patients achieved CR in anti-CD19-CAR T-cell therapy but relapsed after allo-HSCT. In total, 22 B-ALL patients who relapsed after allo-HSCT received anti-CD19-CAR T-cell therapy. Patients who responded to CAR T-cell therapy received DSI or DLI as maintenance therapy. We compared the clinical responses, acute graft versus host disease (aGVHD), expansion of CAR-T-cells, and adverse events between the two groups. In our study, 19 patients received DSI/DLI as maintenance therapy. After DSI/DLI therapy, progression-free survival and overall survival were higher in the DSI group than in the DLI group at 365 days. The grades I and II of aGVHD was observed in four patients (36.4%) in the DSI group. Only one patient developed grade II aGVHD in the DLI group. The peaks of CAR T-cells in the DSI group were higher than those in the DLI group. IL-6 and TNF-α levels increased again in nine of 11 patients after DSI but not in the DLI group. Our findings indicate that for B-ALL patients who relapse after allo-HSCT, DSI is a feasible maintenance therapy if CR is obtained with CAR-T-cell therapy.
Direct and indirect costs for families of children with autism spectrum disorder in China
Authors: Zhao Yanan , Luo Yanan , Zhang Rong , Zheng Xiaoying
Published: March 2023

Autism spectrum disorder has gained international attention due to its prevalence and the extent to which it can affect families. As a disorder without quantifiable treatment effects, it is easily overlooked in the battle for resources. Estimating family economic burdens and the specific factors that may be associated with them could help in the identification of resources and the promotion of social justice. We examined the family costs from a national family survey with Children with autism spectrum disorder aged 2–6 years ( N = 3236). A three-tiered model to quantify the costs was used. The families’ average annual direct cost per child was $24,869.0, including direct medical cost (inpatient, outpatient,drugs, etc.) of $6009.2 and direct nonmedical cost (rehabilitation or educational, rental, transportation, care, and others) of $18,859.8. The annual indirect costs (productivity loss from resignation and job adjustment) for families were $13,990.7. The total costs were $34,206.5. The results of the regression revealed that the mothers’ educational level was significantly associated with costs. Families with an interprovincial immigration background, a higher-than-average income, or children with more severe autism spectrum disorder had a greater possibility of higher direct, indirect, and overall costs. Autism spectrum disorder imposed a significant financial burden on the families of children with autism spectrum disorder.

Lay abstract

This is the first comprehensive national study to explore the direct and indirect costs for families of children with autism spectrum disorder in China. The increasing prevalence of autism spectrum disorder highlights a growing need for resources to provide care for families of children with autism spectrum disorder. The medical and nonmedical costs and parents’ productivity loss have caused a serious burden on their families. Our objective is to estimate the direct and indirect costs for the families of children with autism spectrum disorder in China. The target population was parents of children with autism spectrum disorder. We analyzed the costs using cross-sectional data from a Chinese national family survey with children aged 2–6 years ( N = 3236) who were clinically diagnosed with autism spectrum disorder. Family data from 30 provinces in China were obtained. Cost items included direct medical costs, direct nonmedical costs, and indirect costs. In this study, we found that the largest part of family costs for autism spectrum disorder are nonmedical costs and productivity loss. Autism spectrum disorder has imposed a huge economic burden on parents having children with autism spectrum disorder in China, who need more support than the current health care system provides.
A step not beyond education’s autonomy
Authors: Tervo Juuso
Published: March 2023

Many arguments for education’s autonomy put forward a repeated yet undefined claim that there is an identifiable, dividing line between education and its outside, and that it is within the distinct contours of “the educational” where the nomos of its autonomy lies. Approaching this claim from a literary perspective, I conduct a critical reading of the language of education’s autonomy that runs on the interplay between internal and external laws, and thus frames education’s distinctiveness (or its indistinctiveness) as a question of governance. I claim that such emphasis on governance ties the discussion of education’s autonomy to narratives of progress associated with occidental modernity and forms a self-generating feedback loop where self-governing education and self-governing human life serve as each other’s arche and telos. As an alternative, antinomic figuration of education’s autonomy, I offer a reading of a scene from Johan Amos Comenius’s utopic novel The Labyrinth of the World and the Paradise of the Heart and pair it with Maurice Blanchot’s writings on the neuter. While acknowledging that an ungovernable approach to education’s autonomy poses challenges for educational thought, practice, and policy, I see that it nevertheless allows to question education’s intelligibility and progress that governance assumedly guarantees.
Contrast-Associated Acute Kidney Injury in High-Risk Patients Undergoing Peripheral Vascular Interventions
Authors: Locham Satinderjit , Rodriguez Alejandra , Balceniuk Mark D , Mix Doran , Newhall Karina , Doyle Adam , Glocker Roan , Ellis Jennifer , Stoner Michael
Published: March 2023

Objective: This study aims to evaluate the use of prophylactic intravenous hydration (IV prophylaxis) and carbon dioxide (CO2) angiography in reducing contrast associated-acute kidney injury (CA-AKI) and determine the overall incidence and risk factors of CA-AKI in high-risk patients undergoing peripheral vascular interventions (PVI). Method: Only patients undergoing elective PVI from 2017 to 2021 with chronic kidney disease (CKD) stage 3-5 in the Vascular Quality Initiative (VQI) database were included. Patients were grouped into IV prophylaxis vs no prophylaxis. The study’s primary outcome was CA-AKI, defined as a rise in creatinine (>.5 mg/dL) or new dialysis within 48 hours following contrast administration. Standard univariate and multivariable (logistic regression) analyses were conducted. Results: A total of 4497 patients were identified. Of these, 65% received IV prophylaxis. The overall incidence of CA-AKI was .93%. No significant difference was seen in overall contrast volume (mean (SD): 66.89(49.54) vs 65.94(51.97) milliliters, P > .05) between the 2 groups. After adjusting for significant covariates, the use of IV prophylaxis (OR (95% CI): 1.54(.77-3.18), P = .25) and CO2 angiography (OR (95%CI): .95(.44-2.08), P = .90) was not associated with a significant reduction in CA-AKI compared to the patients with no prophylaxis. The severity of CKD and diabetes were the only predictor of CA-AKI. Compared to patients with no CA-AKI, patients with CA-AKI were at risk of higher 30-day mortality (OR (95% CI): 11.09 (4.25-28.93)) and cardiopulmonary complications (OR (95% CI): 19.03 (8.74-41.39) following PVI (Both P < .001). Conclusion: Using a large national vascular database, our study demonstrates that prophylactic use of IV hydration and CO2 angiography in high-risk CKD patients is not associated with a reduction in renal injury following PVI. Reduced kidney function and history of diabetes is an independent predictor of CA-AKI and patients that develop post-procedural AKI are at an increased risk of morbidity and mortality.
The correlation between proprioceptive drift and subjective embodiment during the rubber hand illusion: A meta-analytic approach
Authors: Tosi Giorgia , Mentesana Benedetta , Romano Daniele
Published: March 2023

In the rubber hand illusion (RHI), participants see a fake hand touched synchronously with their real hand, which is hidden from view. The three-way interaction between vision, touch, and proprioception induces the sensation that the dummy hand belongs to oneself (i.e., subjective embodiment) and the illusory displacement of the real hand towards the fake one (i.e., proprioceptive drift). In the literature, there are mixed results (some positive and some null) regarding the existence of a relationship between subjective embodiment and proprioceptive drift. We conducted a Bayesian meta-analysis to tackle this issue quantitatively. Evidence strongly favours the presence of a correlation between subjective embodiment and proprioceptive drift, supporting the model proposed by Botvinick and Cohen in 1998. However, the correlation is around .35, a value suggesting that the two indices capture different facets of the RHI. This result clarifies the association between the illusory effects produced by the RHI and may be helpful for designing studies having appropriate statistical power.
A God-Tier LARP? QAnon as Conspiracy Fictioning
Authors: Zeeuw Daniël de , Gekker Alex
Published: March 2023

The QAnon movement, which gained a lot of traction in recent years, defies categorization: is it a conspiracy theory, a new mythology, a social movement, a religious cult, or an alternate reality game? How did the posts of a (supposedly) anonymous government insider named Q on an obscure online imageboard in October 2017 instigate a serious conspiracy movement taking part in the storming of the US Capitol in early 2021? Returning to the origins of QAnon on 4chan’s Politically Incorrect board and its initial reception as a potential LARP, we analyze it as an instance of participatory online play that fosters deep engagement above all. Drawing on concepts from play and performance studies, we theorize the dynamics by which QAnon developed into an influential conspiracy narrative as instances of “conspiracy fictioning.” In particular, we revive the notion of hyperstition to make sense of how such conspiracy fictionings work to recursively “bootstrap” their own alternate realities into existence. By thus exploring the participatory and playful engagement mechanisms that drive today’s conspiracy movements, we aim to elucidate the epistemological and socio-political dynamics that mark the growing entanglement of play and politics, fact and fiction in society.
Frontonasal Dysplasia: A Diagnostic Challenge with Fetal MRI in Twin Pregnancy
Authors: Virupakshaiah Akash , Teixeira Sara Reis , Sotardi Susan , Liu Grant , Agarwal Sonika
Published: March 2023

Callosal agenesis is a complex condition with disruption in the steps such as cellular proliferation, migration, axonal growth, guidance, or glial patterning at the midline. Agenesis of the corpus callosum (AgCC) is associated with diverse midline craniofacial malformations affecting the frontal-cranial and midface skeleton. Diagnosing midline abnormalities prenatally can be challenging, especially in twin pregnancies, due to poor resolution of skull base structures on fetal MRI, basal cephalocele could be mistaken for fluid in the nasopharynx, motion limitation, and fetal positioning. Our case highlights the importance of evaluation for other associated midline anomalies when there is callosal agenesis.
Lessons Learned about Developing Faith and Public Health Partnerships to Address Health Disparities
Authors: Williams Malcolm V , Flórez Karen R , Branch Cheryl A , Hawes-Dawson Jennifer , Mata Michael A , Oden Clyde W , Derose Kathryn P
Published: March 2023

Partnerships between public health and faith-based organizations draw on the strengths of both sectors to achieve a shared interest in promoting health and reducing disparities. However, information about implementation of faith and public health partnerships-particularly those involving diverse racial-ethnic groups-is limited. This paper reports on findings from qualitative interviews conducted with 16 public health and congregational leaders around the country as part of the early phase of the development of a faith and public health partnership to address health disparities in Los Angeles, CA. We identified eight themes regarding the barriers and facilitators to building faith and public health partnerships and distilled these into 10 lessons for developing such approaches. These interviews identified that engaging religious organizations often requires building congregational capacity of the congregation to participate in health programs; and that trust is a critically important element of these relationships. Further, trust is closely related to how well each organization involved in the partnership understands their partners’ belief structures, approaches to addressing health and well-being and capacities to contribute to the partnership. Tailoring congregational health programs to match the interests, needs and capacity of partners was identified as an important approach to ensuring that the partnership is successful. But, this is complicated by working across multiple faith traditions and the racial-ethnic backgrounds, thus requiring increased and diverse communication strategies on the part of the partnership leadership. These lessons provide important information for faith and public health leaders interested in developing partnered approaches to address health in diverse urban communities.
Glyphosate affects persistence and tolerance but not antibiotic resistance
Authors: Ospino Katia , Spira Beny
Published: March 2023

Glyphosate is a herbicide widely used in food production that blocks the synthesis of aromatic amino acids in plants and in microorganisms and also induces the accumulation of the alarmone (p)ppGpp. The purpose of this study was to investigate whether glyphosate affects the resistance, tolerance or persistence of bacteria towards three different classes of antibiotics and the possible role of (p)ppGpp in this activity. Glyphosate did not affect the minimum inhibitory concentration of the tested antibiotics, but enhanced bacterial tolerance and/or persistence towards them. The upshift in ciprofloxacin and kanamycin tolerance was partially dependent on the presence of relA that promotes (p)ppGpp accumulation in response to glyphosate. Conversely, the strong increase in ampicillin tolerance caused by glyphosate was independent of relA. We conclude that by inducing aromatic amino acid starvation glyphosate contributes to the temporary increase in E. coli tolerance or persistence, but does not affect antibiotic resistance.
Cooling spray or lidocaine spray and needle insertion pain in hemodialysis patients: an open-label cross-over randomized clinical trial
Authors: Khosravi Pour Armin , Hejazi Sima , Kameli Ahmad , Hoseini Azizi Tooba , Armat Mohammad Reza , Eshghi Maesoomeh
Published: March 2023

Background

The needle insertion pain to perform hemodialysis is the main challenge and a common problem that requires pain management techniques for patients’ comfort.

Aim

This study aimed to compare the effects of cooling and lidocaine sprays on needle insertion pain in hemodialysis patients.

Methods

In this randomized cross-over clinical trial study, the hemodialysis patients were selected through convenience sampling according to inclusion criteria and randomly assigned to three intervention groups using the block randomization method. Each patient received three interventions in a cross-over design: Cooling spray or 10% lidocaine spray or placebo spray. There was a 2-week wash-out time between each intervention. The pain score was measured four times for each patient by the Numerical Rating Scale.

Results

Forty-one hemodialysis patients were included. The results showed a significant interaction between time and group (p < 0.05), so only observations of time 1 with adjustment for baseline values were used to evaluate the effect of the intervention. Patients receiving cooling spray reported 2.29 less pain score on average compared to placebo (B=-2.29, 95% CI: -4.17 to -0.43; p < 0.05); Also, patients receiving cooling spray reported a 1.61 lower pain score than those receiving lidocaine spray, but this difference was not statistically significant (95% CI: -0.26 to 3.48; p > 0.05).

Conclusion

The cooling spray was effective in reducing the needle insertion pain. Although it was impossible to compare the pain scores at different times and following different interventions, the present study results can help supplement the existing knowledge regarding cooling and lidocaine sprays.
Safer cycling in older age (SiFAr): effects of a multi-component cycle training. a randomized controlled trial
Authors: Keppner Veronika , Krumpoch Sebastian , Kob Robert , Rappl Anja , Sieber Cornel C. , Freiberger Ellen , Siebentritt Hanna Maria
Published: March 2023

Background

The risk of older adults being injured or killed in a bicycle accident increases significantly due to the age-related decline of physical function. Therefore, targeted interventions for older adults to improve safe cycling competence (CC) are urgently needed.

Methods

The “Safer Cycling in Older Age” (SiFAr) randomized controlled trial investigated if a progressive multi-component training program related to cycling improves CC of older adults. Between June 2020 and May 2022, 127 community-dwelling persons living in the area Nürnberg-Fürth-Erlangen, Germany aged 65 years and older were recruited, who are either (1) beginners with the e-bike or (2) feeling self-reported unsteadiness when cycling or (3) uptaking cycling after a longer break. Participants were either randomized 1:1 to an intervention group (IG; cycling exercise program, 8 sessions within 3 months) or an active control group (aCG; health recommendations). The CC as primary outcome was tested not blinded in a standardized cycle course prior and after the intervention period and after 6–9 months, which consists of variant tasks requiring skills related to daily traffic situations. Regression analyses with difference of errors in the cycling course as dependent variable and group as independent variable adjusted for covariates (gender, number of errors at baseline, bicycle type, age and cycled distance) were performed.

Results

96 participants (73.4 ± 5.1 years; 59.4% female) were analyzed for primary outcome. Compared to the aCG (n = 49), the IG (n = 47) made an average of 2.37 fewer errors in the cycle course after the 3 months intervention period (p = 0.004). People with more errors at baseline had higher potential for improvement (B=-0.38; p < 0.001). Women on average made 2.31 (p = 0.016) more errors than men, even after intervention. All other confounders had no significant effect on the difference in errors. The intervention effect was very stable until 6–9 months after the intervention (B=-3.07, p = 0.003), but decreased with a higher age at baseline in the adjusted model (B = 0.21, p = 0.0499).

Conclusion

The SiFAr program increases cycling skills among older adults with self-perceived needs for improvement in CC and could easily be made available to a broad public due to its standardized structure and a train-the-trainer approach.

Trial Registration

This study was registered with clinicaltrials.gov: NCT04362514 (27/04/2020), https://clinicaltrials.gov/ct2/show/NCT04362514.
Clinical characteristics and outcomes of children with single or co-detected rhinovirus-associated acute respiratory infection in Middle Tennessee
Authors: Amarin Justin Z. , Potter Molly , Thota Jyotsna , Rankin Danielle A. , Probst Varvara , Haddadin Zaid , Stewart Laura S. , Yanis Ahmad , Talj Rana , Rahman Herdi , Markus Tiffanie M. , Chappell James , Lindegren Mary Lou , Schaffner William , Spieker Andrew J. , Halasa Natasha B.
Published: March 2023

Background

Rhinovirus (RV) is one of the most common etiologic agents of acute respiratory infection (ARI), which is a leading cause of morbidity and mortality in young children. The clinical significance of RV co-detection with other respiratory viruses, including respiratory syncytial virus (RSV), remains unclear. We aimed to compare the clinical characteristics and outcomes of children with ARI-associated RV-only detection and those with RV co-detection—with an emphasis on RV/RSV co-detection.

Methods

We conducted a prospective viral surveillance study (11/2015–7/2016) in Nashville, Tennessee. Children < 18 years old who presented to the emergency department (ED) or were hospitalized with fever and/or respiratory symptoms of < 14 days duration were eligible if they resided in one of nine counties in Middle Tennessee. Demographics and clinical characteristics were collected by parental interviews and medical chart abstractions. Nasal and/or throat specimens were collected and tested for RV, RSV, metapneumovirus, adenovirus, parainfluenza 1–4, and influenza A–C using reverse transcription quantitative polymerase chain reaction assays. We compared the clinical characteristics and outcomes of children with RV-only detection and those with RV co-detection using Pearson’s χ2 test for categorical variables and the two-sample t-test with unequal variances for continuous variables.

Results

Of 1250 children, 904 (72.3%) were virus-positive. RV was the most common virus (n = 406; 44.9%), followed by RSV (n = 207; 19.3%). Of 406 children with RV, 289 (71.2%) had RV-only detection, and 117 (28.8%) had RV co-detection. The most common virus co-detected with RV was RSV (n = 43; 36.8%). Children with RV co-detection were less likely than those with RV-only detection to be diagnosed with asthma or reactive airway disease both in the ED and in-hospital. We did not identify differences in hospitalization, intensive care unit admission, supplemental oxygen use, or length of stay between children with RV-only detection and those with RV co-detection.

Conclusion

We found no evidence that RV co-detection was associated with poorer outcomes. However, the clinical significance of RV co-detection is heterogeneous and varies by virus pair and age group. Future studies of RV co-detection should incorporate analyses of RV/non-RV pairs and include age as a key covariate of RV contribution to clinical manifestations and infection outcomes.
Fluoroquinolone resistance among fecal extended spectrum βeta lactamases positive Enterobacterales isolates from children in Dar es Salaam, Tanzania
Authors: Kibwana Upendo O. , Manyahi Joel , Sandnes Helene Heitmann , Blomberg Bjørn , Mshana Stephen E. , Langeland Nina , Roberts Adam P. , Moyo Sabrina J.
Published: March 2023

Background

Fluoroquinolones have been, and continue to be, routinely used for treatment of many bacterial infections. In recent years, most parts of the world have reported an increasing trend of fluoroquinolone resistant (FQR) Gram-negative bacteria.

Methods

A cross-sectional study was conducted between March 2017 and July 2018 among children admitted due to fever to referral hospitals in Dar es Salaam, Tanzania. Rectal swabs were used to screen for carriage of extended-spectrum β-lactamase-producing Enterobacterales (ESBL-PE). ESBL-PE isolates were tested for quinolone resistance by disk diffusion method. Randomly selected fluroquinolone resistant isolates were characterized by using whole genome sequencing.

Results

A total of 142 ESBL-PE archived isolates were tested for fluoroquinolone resistance. Overall phenotypic resistance to ciprofloxacin, levofloxacin and moxifloxacin was found in 68% (97/142). The highest resistance rate was seen among Citrobacterspp. (100%, 5/5), followed by Klebsiella.pneumoniae (76.1%; 35/46), Escherichiacoli (65.6%; 42/64) and Enterobacter spp. (31.9%; 15/47). Whole genome sequencing (WGS) was performed on 42 fluoroquinolone resistant-ESBL producing isolates and revealed that 38/42; or 90.5%, of the isolates carried one or more plasmid mediated quinolone resistance (PMQR) genes. The most frequent PMQR genes were aac(6’)-lb-cr (74%; 31/42), followed by qnrB1 (40%; 17/42), oqx,qnrB6 and qnS1. Chromosomal mutations in gyrA, parC and parE were detected among 19/42 isolates, and all were in E.coli. Most of the E. coli isolates (17/20) had high MIC values of > 32 µg/ml for fluoroquinolones. In these strains, multiple chromosomal mutations were detected, and all except three strains had additional PMQR genes. Sequence types, ST131 and ST617 predominated among E.coli isolates, while ST607 was more common out of 12 sequence types detected among the K.pneumoniae. Fluoroquinolone resistance genes were mostly associated with the IncF plasmids.

Conclusion

The ESBL-PE isolates showed high rates of phenotypic resistance towards fluoroquinolones likely mediated by both chromosomal mutations and PMQR genes. Chromosomal mutations with or without the presence of PMQR were associated with high MIC values in these bacteria strains. We also found a diversity of PMQR genes, sequence types, virulence genes, and plasmid located antimicrobial resistance (AMR) genes towards other antimicrobial agents.
Development and validation of a survival nomogram and calculator for male patients with metastatic castration-resistant prostate cancer treated with abiraterone acetate and/or enzalutamide
Authors: Kawahara Takashi , Saigusa Yusuke , Yoneyama Shuko , Kato Masashi , Kojima Ippei , Yamada Hiroshi , Kamihira Osamu , Tabata Kenichi , Tsumura Hideyasu , Iwamura Masatsugu , Makiyama Kazuhide , Uemura Hiroji , Miyoshi Yasuhide
Published: March 2023

Background

Despite the widespread availability of medication choices for metastatic castration-resistant prostate cancer (mCRPC), biomarkers to predict the efficacy of each mCRPC treatment have not yet been established. This study developed a prognostic nomogram and a calculator to predict the prognosis of patients with mCRPC who received abiraterone acetate (ABI) and/or enzalutamide (ENZ).

Methods

In total, 568 patients with mCRPC who underwent ABI and/or ENZ between 2012 and 2017 were enrolled. A prognostic nomogram based on the risk factors was developed using the Cox proportional hazards regression model and clinically important factors. The discriminatory ability of the nomogram was assessed according to the concordance index (C-index). A 5-fold cross-validation was repeated 2000 times to estimate the C-index, and the means of the estimated C-index for the training and validation sets were determined. A calculator based on this nomogram was then developed.

Results

The median overall survival (OS) was 24.7 months. Multivariate analysis showed that the time to CRPC, pre-chemotherapy, baseline prostate-specific antigen, baseline alkaline phosphatase, and baseline lactate dehydrogenase levels were independent risk factors for OS (hazard ratio [HR]: 0.521, 1.681, 1.439, 1.827, and 12.123, p = 0.001, 0.001,  < 0.001, 0.019, and  < 0.001, respectively). The C-index was 0.72 in the training cohort and 0.71 in the validation cohort.

Conclusions

We developed a nomogram and calculator to predict OS in Japanese patients with mCRPC who received ABI and/or ENZ. Reproducible prognostic prediction calculators for mCRPC will facilitate greater accessibility for clinical use.
Attitudes towards persons with mental health conditions and psychosocial disabilities as rights holders in Ghana: a World Health Organization study
Authors: Harden Briony , Gyimah Leveana , Funk Michelle , Drew-Bold Natalie , Orrell Martin , Moro Maria Francesca , Cole Celline , Ohene Sally-Ann , Baingana Florence , Amissah Caroline , Ansong Joana , Tawiah Priscilla Elikplim , Brobbey Kwaku , Carta Mauro Giovanni , Osei Akwasi
Published: March 2023

Background

There are currently major efforts underway in Ghana to address stigma and discrimination, and promote the human rights of those with mental health conditions, within mental health services and the community, working with the World Health Organization’s QualityRights initiative. The present study aims to investigate attitudes towards people with lived experience of mental health conditions and psychosocial disabilities as rights holders.

Methods

Stakeholders within the Ghanaian mental health system and community, including health professionals, policy makers, and persons with lived experience, completed the QualityRights pre-training questionnaire. The items examined attitudes towards coercion, legal capacity, service environment, and community inclusion. Additional analyses explored how far participant factors may link to attitudes.

Results

Overall, attitudes towards the rights of persons with lived experience were not well aligned with a human rights approach to mental health. Most people supported the use of coercive practices and often thought that health practitioners and family members were in the best position to make treatment decisions. Health/mental health professionals were less likely to endorse coercive measures compared to other groups.

Conclusion

This was the first in-depth study assessing attitudes towards persons with lived experience as rights holders in Ghana, and frequently attitudes did not comply with human rights standards, demonstrating a need for training initiatives to combat stigma and discrimination and promote human rights.
Socioeconomic inequalities in self-assessed health and food consumption: the mediating roles of daily hassles and the perceived importance of health
Authors: Verra Sanne E. , Poelman Maartje P. , Mudd Andrea L. , de Vet Emely , de Wit John , Kamphuis Carlijn B. M.
Published: March 2023

Background

Urgent daily hassles, which are more common among people with a lower socioeconomic position (SEP), might limit one’s ability to address less pressing goals, such as goals related to health promotion. Consequently, health goals may be viewed as less focal, which could jeopardize one’s health. This study examined an understudied pathway: whether a higher severity of daily hassles resulted in a lower perceived importance of health and whether these two factors sequentially mediate socioeconomic inequalities in self-assessed health (SAH) and food consumption.

Methods

A cross-sectional survey among 1,330 Dutch adults was conducted in 2019. Participants self-reported SEP (household income, educational level), the severity of eleven daily hassles (e.g., financial hassles, legal hassles), the perceived importance of health (not being ill, living a long life), SAH, and food consumption. Structural equation modeling was used to examine whether daily hassles and the perceived importance of health sequentially mediated income and educational inequalities in SAH, fruit and vegetable consumption (FVC) and snack consumption.

Results

No evidence of sequential mediation through daily hassles and the perceived importance of health was found. Daily hassles individually mediated income inequalities in SAH (indirect effect: 0.04, total effect: 0.06) and in FVC (indirect effect: 0.02, total effect: 0.09). The perceived importance of not being ill and living a long life both individually mediated educational inequalities in SAH (indirect effects: 0.01 and -0.01, respectively, total effect: 0.07).

Conclusions

Income inequalities in SAH and FVC were explained by daily hassles, and educational inequalities in SAH were explained by the perceived importance of health. Socioeconomic inequalities may not be sequentially explained by a more severe experience of daily hassles and a lower perceived importance of health. Interventions and policies addressing challenging circumstances associated with a low income may improve SAH and healthy food consumption among lower-income groups.