bluuebunny/crossref_metadata_2025 huggingface dataset:
Emtricitabine/tenofovir alafenamide usage in a Scottish sexual health service providing HIV pre-exposure prophylaxis: A service evaluation
Authors: Burley Nathan , MacDonald Rona , Khan Aafreen
Published: December 2023

Background: In this service evaluation we evaluate the usage of emtricitabine and tenofovir alafenamide (FTC-TAF) in a large Scottish sexual health service providing Human Immunodeficiency Virus (HIV) Pre-Exposure Prophylaxis (PrEP) over a one-year period (May 2022-May 2023).

Purpose: We evaluated the use of FTC-TAF as it is 30 times more expensive per 30 tablet supply than emtricitabine/tenofovir disoproxil (FTC-TDF). We sought to establish: - Number of patients initiated on FTC-TAF - Reasons for FTC-TAF initiation - Adherence to FTC-TAF.

Results: Out of a total cohort of 1744 patients on HIV PrEP as of May 2023, seven patients (0.4%) had been initiated on FTC-TAF. The remainder (99.6%) were taking FTC-TDF. The majority of patients ( n = 6) were initiated on FTC-TAF due to renal reasons, one patient was initiated FTC-TAF for bone mineral density concerns.

Conclusions: All of the patients met eligibility criteria. In terms of adherence, three patients were regular attenders, two patients used FTC-TAF sporadically, and two had initiated and subsequently discontinued FTC-TAF altogether at the time of data analysis. FTC-TAF utilisation was lower than anticipated, initiated apropriately, and followed similar adherence patterns to FTC-TDF users. This will be helpful for financial forecasting and in the development of services where FTC-TAF is newly commissioned.
The Development and Re-Forming of Quality Assurance in German Higher Education – An Organizational Reform Perspective
Authors: Röbken Heinke , Schütz Marcel
Published: December 2023

In this article, we analyze the historical development of quality-related reforms in German higher education using an organizational reform perspective. The purpose is to shed light on the processes behind recurring attempts to reform teaching quality since the beginnings of the modern research university to the present day. The development, variation, and also facilitation of quality approaches can be considered as a reaction to major changes in the context of universities, especially with regard to organizational growth. We argue that recurring reform initiatives can be interpreted as continuous, externally motivated self-improvement programs, which simultaneously contribute to communicating externally about quality. Overall, as the discourse on quality in universities intensifies and becomes more differentiated, the topic has increasing taken on a life of its own. Universities are internalizing quality management ideas and using them to distinguish themselves.
Successful Recovery of COVID-19 Associated With Cardiomyopathy in Advanced Breast Cancer Patient With Pulmonary Lymphangitis Carcinomatosis
Authors: Alquaydheb Hisham , Alharbi Abrar , Badran Ahmed , Alshamsan Bader , Algwaiz Ghada , Elshenawy Mahmoud A , Ajarim Dahish
Published: December 2023

SARS-CoV-2 infection induces myocardiopathy in 19% of severe cases, with a mortality rate of up to 51%. The mainstay of treatment is supportive care, steroids, and tocilizumab (anti-IL-6). This is a case of a 43-year-old woman diagnosed with hormone-positive breast cancer with lung metastasis and pulmonary lymphangitis carcinomatosis (PLC). Her baseline cardiac function was within normal limits. She presented to the emergency department with respiratory distress. Chest CT showed multiple bilateral ground-glass opacities consistent with COVID-19 pneumonia and confirmed by COVID-19-PCR nasal swab. Her condition deteriorated, and she was urgently admitted to the intensive care unit with evidence of a cytokine storm. She was started on tocilizumab, dexamethasone, and meropenem. Echocardiogram (echo) showed a severely reduced ejection fraction with severe global hypokinesis. A second dose of tocilizumab was given, and the dexamethasone dose was increased. Fortunately, the patient had significant clinical and biochemical improvement and regained her normal cardiac function. In conclusion, dexamethasone and tocilizumab could be promising aids in treating cardiomyopathy secondary to SARS-CoV-2 infection.
Organizing our situated solidarity against misrecognition: The de facto stateless Rohingyas and the political economy of slow and ongoing genocide
Authors: Habiburahman  , Alamgir Fahreen
Published: December 2023

This paper discusses the political economy of organizing slow and ongoing genocide against the de facto stateless community of Rohingyas. We draw on the method of organizing situated solidarity offered by Richa Nagar and the concept of political society. Basing on that, we explore the ways, methods, and contents of organizing situated solidarity during Myanmar’s political transition as a democratic state against Rohingyas’ misrecognition and their experience of slow and ongoing genocide. We argue that such organizing urges us to recognize the structural reasons for misrecognizing Rohingyas as internally displaced people (IDP) or stateless people. Thus, our analysis shows that structuring misrecognizing by the militarized state and its interventions was deeply linked to the political economy of slow and ongoing genocide. We argue that the method of organizing situated solidarity has enabled us to constitute our situated understandings and has the capacity to extend the debate by asking what role we should undertake as researchers and business academics in an increasingly militarized racial capitalism.
Neoliberalism versus the market? Liz Truss, neoliberal resilience, and Lacan’s theory of the four discourses
Authors: Maher Henry
Published: December 2023

This article uses concepts from Lacanian discourse analysis to examine the rise and fall of Liz Truss, and to draw conclusions about the nature and resilience of neoliberalism. I begin by outlining Lacan’s theory of the four discourses in relation to neoliberalism, distinguishing a ‘neoliberal master discourse’ comprising soaring rhetoric about freedom and prosperity, from a ‘neoliberal university discourse’ grounded in economic science. I argue Liz Truss represented an unusually pure form of the neoliberal master discourse, prioritising notions of freedom and prosperity over the more pragmatic focus on austerity and market discipline. However, when Truss’ discourse failed it led not to the repudiation of neoliberalism, but rather to the return of a neoliberal university discourse of austerity developed by Rishi Sunak and Jeremy Hunt. I conclude that the relationship between the neoliberal master and university discourses is crucial to understanding the ongoing discursive resilience of neoliberalism.
California’s push for universal pre-K: Uneven school capacity and racial disparities in access
Authors: Slovick Abigail , Fuller Bruce , Banks Ja’Nya , Huang Chunhan , Bryant Carla
Published: December 2023

Policy makers in California intend to provide free preschool to all 4-year-olds solely within public schools by 2026, becoming the nation’s second largest single pre-K program in the United States after Head Start. This initiative builds on the state’s existing Transitional Kindergarten (TK) option that has served a modest share of 4-year-olds since 2010. Tracing the historical growth in TK enrollments, we find that just 30, mostly urban school districts, enrolled two-fifths of all children served by 2020, responding to funding incentives and displaying stronger organizational capacity. Meanwhile, one-third of California’s nearly one thousand districts enrolled fewer than 12 TK children. Black, white, and Asian children remained disproportionally under-enrolled as a share of their respective populations, as enrollments climbed past 90,000 children prior to the COVID-19 pandemic. Identifying factors that may explain widely differing gains in TK enrollment, merging education and local census data, we find the suburbs began to catch-up with cities in serving additional 4-year-olds, as well as districts offering school choice (e.g., charter schools). We discuss implications for other nations attempting to rapidly expand preschool, including the inequities that may inadvertently arise.
Utility of Routine Blood Cultures for Upper Extremity Abscesses
Authors: Kurucan Etka , Echeverria Nicolas J. , Jacquez Evan , Ramsey Frederick V. , Solarz Mark
Published: December 2023

Background:

Patients with skin and soft tissue infections (SSTIs) are often admitted by the emergency department for intravenous antibiotic therapy and surgical drainage of abscesses if necessary. As part of the initial diagnostic workup, blood cultures are routinely drawn at our institution in patients with SSTIs. This study seeks to identify the utility of performing blood cultures in patients with upper extremity abscesses as it relates to the number of incision and drainage (I&D) procedures performed, patient readmission rates, and length of hospital stay.

Methods:

A retrospective chart review of 314 patients aged 18 to 89 years who underwent 1 or more I&D procedures of upper extremity abscesses were included in the study. Patient demographic data, comorbidities, laboratory values, wound and blood culture results, number of I&D procedures performed, length of stay, and readmission rates were evaluated.

Results:

Increasing age and white blood count were associated with an increased number of I&Ds performed. Obtaining blood cultures, whether positive or negative, was associated with increased length of stay. There was no association between obtaining blood cultures and number of procedures performed on multivariable analysis. Positive blood cultures were associated with increased readmission rates.

Conclusions:

Routinely obtaining blood cultures in patients with upper extremity abscesses may not be beneficial. Obtaining blood cultures is not associated with an increased number of I&D procedures or readmission rates. Furthermore, obtaining blood cultures, regardless of positivity, is associated with increased lengths of hospital stay.
Fine Companions: Critical Realism and Framework Analysis
Authors: Mercier Jayne , Sanders Jackie , Munford Robyn
Published: December 2023

This article discusses the alignment of framework analysis with a critical realist philosophy in qualitative analysis. Whilst both are used in social sciences and prioritise meaning making of complex phenomena, the two approaches have not been combined prior to the study outlined in this article. The article describes critical realist ontology and epistemology, the implications of this philosophy for data analysis and the structured processes of framework analysis. Using an example from a study of youth programmes in Aotearoa/New Zealand, the article demonstrates the value of framework analysis for critical realist studies. Emphasis is placed on the capacity of framework analysis to support varied foci on data, theory, and different modes of inferencing which are used in critical realist studies to provide an explanatory account of data.
Effects of orthodontic treatment on porphyromonas gingivalis, gingipains and gingival inflammation
Authors: Wang Lin , Wang Zhigang , Zhang Mei , Xiao Shuiqing , Gao Qiushuang
Published: December 2023

Purpose: To assess the effects of orthodontic treatment on the changes of Porphyromonas gingivalis ( P.g) and gingipains as well as gingival inflammation. Materials and methods: A total of 105 patients who had healthy gingivae and were treated as research subjects, the gingival crevicular fluid of whom was all collected before treatment and in the 1st, 2nd, 3rd, and 6th months after wearing an appliance. Then, the 16S ribosomal deoxyribonucleic acid (rDNA) polymerase chain reaction (PCR) technique was employed to detect the levels of P.g, Lys-gingipain (Kgp) and Arg-gingipain (Rgp) in the specimens. It was followed by a statistical analysis of the data via the SPSS 23.0 software package. Results: In P.g detection, the 16S rDNA PCR technique presented specific advantages and high sensitivity. The positive detection rate of P.g in the 1st, 2nd and 3rd month of treatment ( p < .05), that of Kgp in P.g-positive patients in the 2nd and 3rd months of treatment ( p < .05), and that of Rgp in P.g-positive patients in the 2nd and 3rd months of treatment ( p < .05) were higher than the pre-treatment results. Compared with gingival index (GI)-0 patients, GI-1 patients exhibited higher positive detection rates of P.g and Kgp and Rgp, which were further found to be positively correlated with the treatment duration and GI ( p < .05). Conclusion: In the early stage of orthodontic treatment, the levels of P.g, Kgp and Rgp rise after wearing the appliance, inducing gingival inflammation.
Does perceptual disfluency affect the illusion of causality?
Authors: Bona Stefano Dalla , Vicovaro Michele
Published: December 2023

When a subjective experience of difficulty is associated with a mental task, people tend to engage in systematic and deliberative reasoning, which can reduce the usage of intuitive and effortless thinking that gives rise to cognitive biases. One such bias is the illusion of causality, where people perceive a causal link between two unrelated events. In 2019, Díaz-Lago and Matute found that a superficial perceptual feature of the task could modulate the magnitude of the illusion (i.e., a hard-to-read font led to a decrease in the magnitude of the illusion). The present study explored the generalisability of the idea that perceptual disfluency can lead to a decrease in the magnitude of the illusion. In the first experiment, we tested whether a physical-perceptual manipulation of the stimuli, specifically the contrast between the written text and the background, could modulate the illusion in a contingency learning task. The results of the online experiment ( N = 200) showed no effect of contrast on the magnitude of the illusion, despite our manipulation having successfully induced task fluency or disfluency. Building upon this null result, our second experiment ( N = 100) focused on manipulating the font type, in an attempt to replicate the results obtained by Díaz-Lago and Matute. In contrast to their findings, we found no discernible effect of font type on the magnitude of the illusion, even though this manipulation also effectively induced variations in task fluency or disfluency. These results underscore the notion that not all categories of (dis)fluency in cognitive processing wield a modulatory influence on cognitive biases, and they call for a re-evaluation and a more precise delineation of the (dis)fluency construct.
The Center-Center Image Closely Approximates Other Methods for Syndesmosis Reduction Clamp Placement
Authors: Jackson Nicholas J. , Flores Koen , Blake Andrew , Harley Joel B. , Reb Christopher W. , Nichols Jennifer A.
Published: December 2023

Background

The optimal placement for a syndesmosis reduction clamp remains an open question. This study compared the center-center axis, which localizes clamp placement using only an internally rotated lateral ankle X-ray, with other common approaches, whose accuracy can only be confirmed using computed tomography (CT).

Methods

Bone models of anatomically aligned (n = 6) and malreduced (n = 48) limbs were generated from CT scans of cadaveric specimens. Four axes for guiding clamp placement (center-center, centroid, B2, and trans-syndesmotic) were then analyzed, using digitally reconstructed radiographs derived from the bone models. Each axis’ location was defined using angle-height pairs that describe axis orientation along the full anatomical region where syndesmosis fixation occurs.

Results

In anatomically aligned limbs, the center-center axis was located on average (±95% CI [confidence interval]), 0.64° (±0.50°) internal rotation, 1.03° (±0.73°) internal rotation, and 2.09° (±7.29°) external rotation from the centroid, B2, and trans-syndesmotic axes, respectively. Fibular displacement altered the magnitude of limb rotation needed to identify the center-center axis.

Conclusion

The center-center technique is a valid method that closely approximates previously described methods for syndesmosis clamp placement without using CT, and the magnitude of C-arm rotation needed to transition from a talar dome lateral to a center-center view may be a potential method for assessing syndesmosis reduction.

Levels of Evidence:

Level III: Retrospective comparative study
How Have Predictors of Engagement in Tourism Crisis Planning and Preparedness Changed in More Than a Decade?
Authors: Pennington-Gray Lori , Kim Mina
Published: December 2023

In this study, the research team reexamined the relationship between resource allocation and crisis experience, on both crisis planning and crisis communications, 12 years after the original study completed by Pennington-Gray et al. The goal was to determine how time mediated the relationship between the two independent variables and the outcome variables. The passage of time seemed to have a tangible impact on both dependent variables. With time, there was an evident change in variables, suggesting that organizations learn, adapt, and modify their strategies based on prior experiences and changing circumstances. Prior experiences with crises play a crucial role in crisis planning and crisis communications. Having faced crises in the past furnishes organizations with insights and knowledge that aid in more detailed planning and communication strategies.
The Impact of Restaurant Menu Calorie Labels on Restaurant Revenue and Profit: Evidence From a Randomized Controlled Trial
Authors: Susskind Alex , Willage Barton , Cawley John
Published: December 2023

In 2018, the United States implemented a nationwide law requiring chain restaurants with more than 20 units to post calorie counts next to each of their menu items. Previously, individual cities, counties, and states had passed such laws, and certain chains had voluntarily posted calorie counts. Despite the widespread nature of this practice, the effect of calorie counts on restaurant outcomes is still not well understood. This paper estimates the impact of restaurant menu calorie labels on four important outcomes: 1) restaurant revenue; 2) restaurant profit; 3) the labor time of kitchen staff; and 4) patrons’ support for calorie labels. We estimate these impacts by conducting a randomized controlled experiment in two full-service restaurants. The results indicate that posting calorie counts on menus has no detectable negative impact on restaurants – the impacts on revenue, profit, and labor time are indistinguishable from zero. Moreover, exposure to the labels increases patrons’ support of restaurant menu calorie labels by 14.3% and reduces their opposition to them by 27.1%. Altogether, these results suggest that posting calorie counts does not harm restaurants, and are appealing to consumers.
Validation of Minimal Clinically Important Difference (MCID) for University of Pennsylvania Smell Identification Test (UPSIT)
Authors: Mahadev Ashna , Kallogjeri Dorina , Piccirillo Jay F.
Published: December 2023

Background

The University of Pennsylvania Smell Identification Test is widely used to measure change in olfactory function, but a minimal clinically important difference (MCID) has not been well-established. A study published in 1997 regarding patients with head trauma reported an MCID of 4 but did not detail the methods used in the calculation.

Objective

To validate the MCID for UPSIT in patients with postviral, sinusitis, and procedure-associated olfactory loss.

Methods

This was a secondary analysis of prospectively collected data from 5 clinical research studies related to olfactory function. Three studies included subjects with COVID-19-related olfactory dysfunction, one with chronic sinusitis subjects, and one with subjects undergoing transsphenoidal surgery. All subjects had completed a baseline and follow-up UPSIT, baseline and follow-up Clinical Global Impression-Severity (CGI-Severity), and a follow-up CGI-Improvement. Both distribution- and anchor-based methods were used to determine the MCID of UPSIT. Distribution-based method calculated MCID using half standard deviation of baseline UPSIT and delta UPSIT scores. Clinical-anchor method determined MCID by comparing delta UPSIT scores between consecutive CGI-I clinical categories ranging from very much better to very much worse.

Results

The study population comprised 295 subjects. Subjects had a mean (SD) baseline UPSIT score of 27 (7.5), and follow-up score of 28 (7.9), and a mean UPSIT change of 0.6 (5.8). Half the baseline UPSIT SD was 3.75 and half the delta UPSIT SD was 2.9. With the anchor-based approach, an MCID of 4 was defined as clinically meaningful by exploring the relationship between delta UPSIT and CGI-Improvement. Using a more conservative approach based on the MCID values identified from both methods, we determined that a change of 4 or greater is the appropriate MCID for UPSIT.

Conclusion

Investigators in the future should use 4 as MCID for UPSIT and report the percentage of study subjects who achieve a clinically meaningful difference.

Level of Evidence

III.
Modified Dixon sequential method to determine the effective dose of alfentanil compounded with propofol for day-case hysteroscopy
Authors: Xu Chenyang , Peng Rui , Qian Xiali , Feng Shanwu , Yuan Hongmei
Published: December 2023

Background:

Propofol combined with alfentanil is suitable for intravenous anesthesia for day-case hysteroscopy.

Objective:

To investigate the median effective dose (ED50) and 95% effective dose (ED95) of alfentanil compounded with propofol for day-case hysteroscopy.

Design:

In all, 29 patients who volunteered for painless hysteroscopy in 2022 were recruited. 1.5 mg/kg propofol was given as a sedative to all patients. The trial was conducted using the modified Dixon sequential method, with an initial dose of 10 μg/kg of alfentanil, and the subject’s alfentanil dose depended on whether the prior hysteroscopy had failed, which was defined as inadequate cervical dilatation and hysteroscope placement with the patient exhibiting body movement, frowning, or a MOAA/S score >1. If the hysteroscopy failed (i.e. a positive response), the subsequent subject’s alfentanil dosage was raised, and conversely (i.e. a negative response), the dose was decreased, with the adjacent dose ratio always being 1:1.2. The formal test begins with the first crossover wave and lasts until seven crossover waves materialize.

Methods:

The probit method was used to calculate the ED50, ED95, and corresponding 95% confidence intervals (CIs) of alfentanil compounded with propofol for hysteroscopy.

Results:

The ED50 and ED95 of alfentanil combined with propofol for day-case hysteroscopy were 5.701 (95% CI: 3.841–7.069) μg/kg and 8.817 (95% CI: 7.307–20.868) μg/kg, respectively.

Conclusion:

Alfentanil at 8.817 μg/kg in conjunction with propofol is a successful and safe approach for day-case painless hysteroscopy.

Trial registration:

The trial registry name: Modified sequential method to determine the half-effective dose of alfentanil compounded with propofol for ambulatory hysteroscopy. The URL of registration is https://www.chictr.org.cn/showproj.html?proj=171786 , where the full trial protocol can be accessed. Registration number: ChiCTR2200061619.
Telerehabilitation for Lee Silverman Voice Treatment (Tele-LSVT)-Loud on voice intensity and voice use in daily living in people with multiple sclerosis: A protocol for a feasibility and pilot randomized controlled study
Authors: Vitali Chiara , Fusari Giulia , Baldanzi Cinzia , Cacciatore Diego Michael , Crispiatico Valeria , Carullo Alessio , Rovaris Marco , Cattaneo Davide , Baglio Francesca , Isernia Sara
Published: December 2023

Objective

Alterations in voice intensity and quality may constitute a social life limitation in people with multiple sclerosis (MS), but only 2% of cases receive speech therapy. Especially the Lee Silverman Voice Treatment (LSVT)-Loud is a highly effective intensive method for voice intensity, requiring subjects’ repeated attendance at the clinic. Telerehabilitation may represent a feasible solution to bypass potential barriers related to speech therapy attendance, scaling up the beneficial effects of the treatment to a broader population. The proposed protocol aims to test the feasibility and the pilot efficacy of the LSVT-Loud delivered in telerehabilitation (Tele-LSVT-Loud), compared to the same treatment delivered in the clinic (LSVT-Loud).

Methods

A single-blinded, parallel, two-arm, pilot randomized (1:1 ratio) controlled trial will be performed involving 20 people with MS. Patients will be allocated to 4 weeks of Tele-LSVT-Loud by accessing a telerehabilitation platform at home or LSVT-Loud conventionally delivered in the clinic. Feasibility and pilot effectiveness will be evaluated three times: before (T0), after the treatment (T1), and 3-month follow-up (T2). Feasibility measures will include adherence, adverse events, user experience, motivation, engagement, and acceptability. Vocal intensity during a 1-minute monologue will be the primary outcome measure. Secondary outcome measures will be the vocal quality during a 1-minute monologue, sustained /a/ voice intensity, quality and stability, voice use in daily life, voice subjective perception in daily life, and quality of life.

Results

Expected results will be (1) high feasibility of Tele-LSVT-Loud and (2) a non-inferiority effect of Tele-LSVT-Loud compared with face-to-face treatment delivery on voice intensity and quality outcomes.

Conclusions

Tele-LSVT-Loud may be a feasible intervention for MS alteration in voice intensity and quality with a non-inferior effect compared to LSVT-Loud.
The Shifting Trajectories of Hindutva: Bharat Sevashram Sangha and the Making of a Saffron Wave in Contemporary West Bengal
Authors: Dasgupta Koushiki
Published: December 2023

This article strives to explore the ways in which the politics of Hindutva, as represented by the Sangh Parivar, permeated new organizational and ideological spaces in Bengal following the Lok Sabha election of 2014. The article specifically delves into the case of the Bharat Sevashram Sangha, a significant Hindu spiritual and philanthropic entity in Bengal. The Bharat Sevashram Sangha and the Sangh-Parivar represent distinct but interconnected manifestations of the broader Hindutva ideology. With a focus on the Bharat Sevashram Sangha’s position on the configuration of Hindutva, this article revolves around deciphering the intricate interplay between religion and politics within the context of the Bharat Sevashram Sangha’s engagement with the Hindu right-wing organizations. Moreover, the article seeks to unveil how the Bharat Sevashram Sangha’s spiritual and cultural visions converged with a strategic political consciousness and potentially paved the way for the emergence of new opportunities for right-wing political forces within the state.
Electoral Participation and Political Choice Among Muslims
Authors: Alam Mohd. Sanjeer
Published: December 2023

Muslims are the largest minority group in India. As a minority group, their electoral participation and expression has drawn wide religious attention of scholars. However, much of the discussion around Muslims’ electoral participation and political preference is either based on speculations or on sketchy field studies. This article, drawing upon large scale representative surveys, analyses Muslims’ electoral participation and choices since 1990s. It argues that inferences about the community’s electoral behaviour at the national level are misleading. Its electoral behaviour can better be understood by locating them in politically differentiated contexts.
Neoliberal Multiculturalism and Changing Colonial Racial Hierarchies in International Development
Authors: Niles Skye , Roudbari Shawhin , Contreras Santina
Published: December 2023

This research examines a shift in international development discourse away from more overtly colonial and abject depictions of people from the Global South toward foregrounding positive portrayals of people from the Global South who are self-reliant and empowered through entrepreneurship and market labor. Through interviews, observations, and content analysis of university-based development programs and development organizations, we examine the racial meaning and consequences of this shift. We argue that this discourse reformulates colonial racial hierarchies in development by suturing racial value to adherence to free market ideals, such as freedom and fulfillment through markets, while legitimizing these changes through affirmations of multiculturalism. This shift in development aligns with a broader context of neoliberal multiculturalism, which has reconfigured racial hierarchies based on adherence to multicultural global citizenship and free market principles. This research illustrates the changing intersections of race, colonialism, neoliberalism, and development and speaks to the importance of universities and development organizations in shaping racial meaning and inequalities in a global context.
Hepatic Arteriovenous Malformation in a Preterm Infant With High-Output Cardiac Failure
Authors: Jakubowicz Jessica , Lynch Ashley , Wong Kevin , Aucoin Maggie
Published: December 2023

Congenital hepatic arteriovenous malformations (HAVM) are rare and serious with a known high mortality rate. They are mostly described in the term population and, if symptomatic, present with early-onset congestive heart failure. To our knowledge, there have been no published cases of an affected very preterm infant. Prenatal diagnosis and preprocedural planning are paramount in these critically ill infants. Strategies for management of HAVM differ depending on the size of both the infant and HAVM as well as severity of symptoms. Management may include supportive pharmacologic therapy, transcatheter embolization, and surgical resection or ligation. In this report, we present the case of a 28-week gestation infant with high-output cardiac failure secondary to prenatally diagnosed hepatic arteriovenous malformation. On day of life 3, the infant underwent successful transcatheter occlusion. However, despite maximal medical management and partial embolization of his HAVM, he did not survive.
Efficacy of oral mefenamic acid versus paracetamol as a prophylactic analgesic for needle pain in children receiving vaccination: a three-arm, parallel, triple-blind, placebo-controlled MAP VaC randomized controlled trial
Authors: Pasi Rachna , Babu Thirunavukkarasu Arun , Kallidoss Vinoth Kumar
Published: December 2023

Background:

Needle pain due to routine vaccination is an important factor contributing to low vaccine adherence and immunization coverage. Prophylactic oral analgesics can address this important issue of needle pain related to vaccination. Paracetamol and mefenamic acid are commonly used nonsteroidal anti-inflammatory drugs for pain relief, but there is little published literature on whether the same can be used for needle pain related to vaccination.

Objectives:

This study was planned to compare the efficacy of oral mefenamic acid and paracetamol over placebo as a prophylactic analgesic during vaccination and prophylactic antipyretic during the post-vaccination period.

Designs:

Three-arm, triple-blind, randomized controlled trial.

Methods:

This study was conducted at the outpatient department of a tertiary-level medical college in South India from January 2021 to June 2022. In this three-arm interventional trial, each arm had either a single dose of placebo or mefenamic acid (4 mg/kg/dose) or paracetamol (10 mg/kg/dose). These medicines were administered orally 30 min before vaccination to reduce needle pain.

Main outcome and measures:

Outcome was measured with the change of FLACC (Face, Leg, Activity, Cry, Consolability) scoring at the time of vaccination, subsequently at 15 and 30 min of vaccination in all three groups. Appearance of fever, grade of fever, and need for antipyretics 24 h after vaccination were also noted.

Results:

There was a significant difference in FLACC scores at the time of administration ( p = 0.010) and at 15 min ( p = 0.014) with mefenamic acid compared to placebo. Although the paracetamol group showed a difference when compared to the placebo, it was not significant at the time of administration ( p = 0.401), at 15 min ( p = 0.451), or 30 min ( p = 0.892) post-vaccination. The appearance of fever, grade of fever, and use of antipyretic up to 24 h post-vaccination had no significant difference among any of the three groups.

Conclusion:

Mefenamic acid was more potent than placebo for pre-vaccination pain prophylaxis in children. There was no difference in the appearance of fever and its grade among the three groups. The promising results from this trial warrant further large-scale studies to recommend a single oral dose of mefenamic acid to tackle needle pain related to vaccination in children to improve vaccine adherence and coverage.

Trial registration:

CTRI (Clinical trials registry-India) (CTRI/2021/01/030239). [Date of Commencement: 13 Jan 2021, Date of last recruitment: 30 June 2022 (now closed for new participants)]
Anteromedial Tibial Tubercle Osteotomy for Recurrent Patella Subluxation
Authors: Franciozi Carlos E. , Barcelos Victor A. , Mameri Enzo S. , Schumacher Felipe C. , Credidio Marcos V. , Kubota Marcelo S. , Luzo Marcus V.
Published: December 2023

Background:

Patellofemoral pathology resulting from improper biomechanics is difficult to treat, and lateral patellar instability requires individualized treatment, which may include tibial tubercle osteotomy (TTO) with anteromedial repositioning.

Indications:

Symptomatic patellofemoral instability with maltracking, particularly in cases with a tibial tuberosity-trochlear groove distance >16 mm.

Technique Description:

We describe an oblique osteotomy from medial to lateral. A careful completion of the osteotomy is made with an osteotome, and the resulting fragment is mobilized to achieve anteromedial repositioning—as well as distalization in cases of patella alta. Two bicortical screws with a washer are used for fixation of the tibial tubercle following anteromedialization.

Results:

Systematic reviews demonstrated that the treatment of the lateral patellar instability requires an individual treatment and the anteromedial TTO is a very important procedure alone or in association with medial patellofemoral ligament.

Discussion/Conclusion:

Recurrent lateral patellar instability is a challenging condition with complex causes and various treatment options, but anteromedial TTO provides an effective way to improve clinical outcomes and correct patellar maltracking, with relatively low complication rates.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Patterns of physical activity among nursing home residents before and during the Covid 19 pandemic—a systematic observation
Authors: Hahn Lea-Sofie , Thiel Ansgar , Trüb Dorothée , Eschweiler Gerhard W. , Nieß Andreas M. , Sudeck Gorden , Frahsa Annika
Published: December 2023

Background

The Covid-19 outbreak in spring of 2020 posed an array of challenges for nursing homes, including promoting resident physical activity (PA). Given the diversity of factors affecting resident PA, we explored how activity patterns outside weekly-scheduled structured activities changed during the pandemic and what factors promoted or inhibited PA during the pandemic.

Methods

We conducted systematic direct observations over 823.5 h in eight nursing homes in Southern Germany in 2020 and 2021. Results: In 2020, 84.7% of person observation units were classified as sedentary (average activity level: 1.14 MET). In 2021, the percentage increased to 91.6% of observed person units (average activity level: 1.08 MET) (t = 6.947; p = .000). According to tree classification, influencing factors of PA included mealtime and daytime in 2020 and 2021, as well as presence of men residents only in 2020 and guided low threshold activities in 2021.

Conclusions

Nursing homes constitute highly sedentary places—an issue exacerbated by access restrictions for external activity experts and significant others as well as behavioural restrictions for residents during the Covid-19 pandemic. Staff could not compensate due to existing time restraints and lack of training in PA promotion. Based on our findings, we recommend future studies to develop feasible and resource-low activities to be integrated into the daily routines of nursing homes.
Phosphate Transporter OsPT4, Ubiquitinated by E3 Ligase OsAIRP2, Plays a Crucial Role in Phosphorus and Nitrogen Translocation and Consumption in Germinating Seed
Authors: Sun Yafei , Zhang Fang , Wei Jia , Song Ke , Sun Lijuan , Yang Yang , Qin Qin , Yang Shiyan , Li Zhouwen , Xu Guohua , Sun Shubin , Xue Yong
Published: December 2023

Phosphorus (P) and nitrogen (N) are essential macronutrients necessary for plant growth and development. OsPT4 is a high-affinity phosphate (Pi) transporter that has a positive impact on nutrient uptake and seed development. In this study, the expression patterns of different Pi transporter genes in germinating seeds were determined, and the relative expression of OsPT4 was induced in Pi-deficient seeds and gradually increased with the passage of germination time. The analysis of P, N, Pi, and amino acid concentrations in germinating seeds of OsPT4 mutants showed that the OsPT4 mutation caused P and N retention and a continuous reduction in multiple amino acid concentrations in germinating seeds. Transcriptome analysis and qRT-PCR results also indicated that the OsPT4 mutation inhibits the expression of genes related to P and N transportation and amino acid synthesis in germinating seeds. In addition, the paraffin section and TUNEL assay of OsPT4 mutant germinating seeds suggests that OsPT4 mutation causes programmed cell death (PCD) delayed in the aleurone layer and inhibition of leaf outgrowth. Moreover, we also found that OsPT4 was ubiquitinated by OsAIRP2, which is a C3HC4-type RING E3 Ub ligase. Our studies illustrate that OsPT4 plays a crucial role in P and N collaborative translocation and consumption in germinating seeds. It also provides a theoretical basis for the molecules and physiological mechanisms of P and N cross-talk under suppressed Pi uptake conditions.
Molecular and functional characterization of chemosensory genes from the root-knot nematode Meloidogyne graminicola
Authors: Dutta Tushar K. , Akhil Voodikala S. , Dash Manoranjan , Kundu Artha , Phani Victor , Sirohi Anil
Published: December 2023

Background

Root-knot nematode Meloidogyne graminicola has emerged as a major threat in rice agroecosystems owing to climate change-induced changes in cultivation practices. Synthetic nematicides are continually being withdrawn from the nematode management toolbox because of their ill effects on the environment. A sustainable strategy would be to develop novel nematicides or resistant plants that would target nematode sensory perception, which is a key step in the host finding biology of plant-parasitic nematodes (PPNs). However, compared to the extensive literature on the free-living nematode Caenorhabditis elegans, negligible research has been performed on PPN chemosensory biology.

Results

The present study characterizes the five chemosensory genes (Mg-odr-7, Mg-tax-4, Mg-tax-4.1, Mg-osm-9, and Mg-ocr-2) from M. graminicola that are putatively associated with nematode host-finding biology. All the genes were highly transcribed in the early life stages, and RNA interference (RNAi)-induced downregulation of each candidate gene perturbed the normal behavioural phenotypes of M. graminicola, as determined by examining the tracking pattern of juveniles on Pluronic gel medium, attraction to and penetration in rice root tip, and developmental progression in rice root. In addition, a detrimental effect on nematode chemotaxis towards different volatile and nonvolatile organic compounds and host root exudates was documented.

Conclusion

Our findings enrich the existing literature on PPN chemosensory biology and can supplement future research aimed at identifying a comprehensive chemosensory signal transduction pathway in PPNs.
Genomic and phenotypic analysis of a novel clinical isolate of Corynebacterium pyruviciproducens
Authors: Wang Jiaqi , Feng Jiajia , Jia Wei , Yuan Tingxun , He Xinyu , Wu Qianqian , Peng Fujun , Gao Wei , Yang Zhongfa , Tao Yuanyong , Li Qian
Published: December 2023

Background

Corynebacterium pyruviciproducens is a recently described species of Corynebacterium. There are few reports on the microbiological characteristics of the new species, and there is a lack of reports on the genomic analysis of the species.

Results

This study involved a clinical isolate from the pus of a hospital patient with sebaceous gland abscesses. The clinically isolated strain was identified as C. pyruviciproducens strain WYJY-01. In this study, referring to Koch’s postulates, we observed the pathological changes of animal models infected by intraperitoneal injection and subcutaneous injection of pure culture of the strain WYJY-01. Furthermore, the strain WYJY-01 was isolated and cultured again from animal models' subcutaneous abscess drainage fluid. Subsequently, the genomics of the strain WYJY-01 was analyzed. By comparing various gene databases, this study predicted the core secondary metabolite gene cluster of the strain WYJY-01, virulence factor genes carried by prophage, pathogenicity islands, and resistance islands. In addition, the genomes of C. pyruviciproducens strain WYJY-01, ATCC BAA-1742 T, and UMB0763 were analyzed by comparative genomics, and the differential genes of strain WYJY-01 were compared, and their functions were analyzed.

Conclusion

The findings showed that the strain WYJY-01 had pathogenicity, supplementing the phenotype characteristics of C. pyruviciproducens. Meanwhile, this research revealed the possible molecular mechanism of the pathogenicity of the strain WYJY-01 at the gene level through whole genome sequence analysis, providing a molecular basis for further research.
Effects of electroacupuncture on imaging and behavior in rats with ischemic stroke through miR-212-5p
Authors: Li Sisi , Xing Xiangxin , Hua Xuyun , Zhang Yuwen , Wu Jiajia , Shan Chunlei , Zheng Mouxiong , Wang He , Xu Jianguang
Published: December 2023

Background

Ischemic stroke is a serious disease leading to significant disability in humans worldwide. Increasing evidence suggests that some microRNAs (miRNAs) participate in the pathophysiology of ischemic stroke. A key role for MiR-212 has been found in neuronal function and synaptic plasticity. Ischemic stroke can be effectively treated with electroacupuncture (EA); however, there is a lack of understanding of the relevant mechanisms. In this study, we employed behavioral test and resting-state functional magnetic resonance imaging (rs-fMRI) to detect behavioral and brain function alterations in rats suffering from ischemic stroke. The efficacy of EA therapy and miR-212-5p’s role in this process were also evaluated.

Methods and results

Forty rats were randomly divided into the following groups: Sham, middle cerebral artery occlusion/reperfusion (MCAO/R), MCAO/R + EA, MCAO/R + EA + antagomir-negative control and MCAO/R + EA + antagomir-212-5p groups. Behavioral changes were assessed by Catwalk gait analysis prior to and after modeling. Rs-fMRI was performed at one week after EA treatment, amplitude of low-frequency fluctuations (ALFF) and regional homogeneity (ReHo) were calculated to reveal neural activity. Furthermore, neuronal apoptosis in the ischemic penumbra was analyzed using a TUNEL assay. Treatment with EA significantly improved the performance of rats in the behavioral test. The motor and cognition-related brain regions showed decreased ALFF and ReHo following focal cerebral ischemia-reperfusion, and EA treatment could reactivate these brain regions. Moreover, EA treatment significantly decreased MCAO/R-induced cell death. However, the transfection of antagomir-212-5p attenuated the therapeutic effect of EA.

Conclusions

In conclusion, the results suggested that EA improved the behavioral and imaging outcomes of ischemic stroke through miR-212-5p.
One-lung ventilation with a bronchial blocker in thoracic patients
Authors: Cano Paulo Andrés , Mora Luis Carlos , Enríquez Irene , Reis Matías Santiago , Martínez Eva , Barturen Fernando
Published: December 2023

Background

Lung isolation is a technique used in a multitude of surgeries to ensure single-lung ventilation with collapse of the contralateral lung, as to achieve improved access and visualization of relevant anatomical structures. Despite being accepted and having favorable outcomes, bronchial blockers (BBs) are not to this day the main device of choice among anaesthesiologists.

Methods

In this retrospective and descriptive study, we analyzed the safety and efficacy of a BB in all types of thoracic surgeries in our centre between 2015 and 2022, excluding patients with massive hemoptysis or empyema, or who had undergone a prior pneumonectomy.

Results

One hundred and thirty-four patients were intervened due to lung cancer (67.9%), respiratory disease (23.9%), and non-respiratory disease (8.2%) undergoing lung surgeries (65.7%), pleural and mediastinal surgeries (29.9%), chest wall surgeries (3.0%) and other surgeries (1.5%). In most cases, lung collapse was considered excellent (63.9%) or good (33.1%) with only 4 cases (3.0%) of poor lung collapse. More than 90% of patients did not present intraoperative or immediate postoperative complications. No statistically significant differences were found between lung collapse and the demographic, clinical or BB-related variables (p > 0.05). However, we found a significatively higher proportion of excellent lung collapses in VATS surgeries and lateral decubitus positioning, as well as a significatively less proportion of poor lung collapses (p < 0.05). Moreover, there was a significantly higher proportion of excellent lung collapses when the BB was placed in the left bronchus (p < 0.05).

Conclusions

With these results, in our experience BBs constitute an effective alternative, capable of achieving pulmonary collapse in all kinds of thoracic procedures with satisfactory safety rates due to their minimal complications.