bluuebunny/crossref_metadata_2025 huggingface dataset:
A worldwide bibliometric analysis of the research trends and hotspots of bruxism in adults during 1991–2021
Authors: Zhong Jiawei , Gao Xinlin , Hu Shoushan , Yue Yuan , Liu Yang , Xiong Xin
Published: August 2023

Background and Objectives

With the increasing attention to bruxism, the research on bruxism is increasing rapidly. However, there is still a lack of systematic bibliometric analysis in the field of bruxism in adults. This study aimed to comprehensively explore and visualize the global trends and research hotspots in the field of bruxism in adults during 1991–2021.

Methods

The study searched the literature published during 1991–2021 in the Web of Science Core Collection database without language restrictions. VOSviewer, CiteSpace and Microsoft Excel were applied to analyse the authors, institutions, journals, countries, cited references, keywords and other information of the included publications, and construct visualized cooperation networks.

Results

A total of 878 articles were finally included. The top two most productive authors in the past 30 years were Lobbezoo F and Manfredini D. ACTA‐Amsterdam, Univ Sao Paulo, Univ Helsinki, Univ Padua, Univ Montreal, et al. were prominent institutions in this field. Journal of Oral Rehabilitation made outstanding contributions in this field. The United States produced the most documents in this field, followed by Brazil. Both countries and authors cooperated closely around the world. The two most cited articles focused on the definition, assessment and classification of bruxism. In recent years, diagnostic criteria and stress have begun to receive a lot of attention.

Conclusion

From 1991 to 2021, the attention to bruxism in adults continued to increase. Diagnostic criteria and stress may be potential research hotspots in this field. This study references relevant scholars on development trends and research hotspots.
Gene‐rich plastid genomes of two parasitic red algal species, Laurencia australis and L. verruciformis (Rhodomelaceae, Ceramiales), and a taxonomic revision of Janczewskia
Authors: Preuss Maren , Díaz‐Tapia Pilar , Verbruggen Heroen , Zuccarello Giuseppe C.
Published: August 2023

Parasitic red algae are an interesting system for investigating the genetic changes that occur in parasites. These parasites have evolved independently multiple times within the red algae. The functional loss of plastid genomes can be investigated in these multiple independent examples, and fine‐scale patterns may be discerned. The only plastid genomes from red algal parasites known so far are highly reduced and missing almost all photosynthetic genes. Our study assembled and annotated plastid genomes from the parasites Janczewskia tasmanica and its two Laurencia host species (Laurencia elata and one unidentified Laurencia sp. A25) from Australia and Janczewskia verruciformis, its host species (Laurencia catarinensis), and the closest known free‐living relative (Laurencia obtusa) from the Canary Islands (Spain). For the first time we show parasitic red algal plastid genomes that are similar in size and gene content to free‐living host species without any gene loss or genome reduction. The only exception was two pseudogenes (moeB and ycf46) found in the plastid genome of both isolates of J. tasmanica, indicating potential for future loss of these genes. Further comparative analyses with the three highly reduced plastid genomes showed possible gene loss patterns, in which photosynthetic gene categories were lost followed by other gene categories. Phylogenetic analyses did not confirm monophyly of Janczewskia, and the genus was subsumed into Laurencia. Further investigations will determine if any convergent small‐scale patterns of gene loss exist in parasitic red algae and how these are applicable to other parasitic systems.
Novel insights into symbiont population structure: Globe‐trotting avian feather mites contradict the specialist–generalist variation hypothesis
Authors: Matthews Alix E. , Boves Than J. , Sweet Andrew D. , Ames Elizabeth M. , Bulluck Lesley P. , Johnson Erik I. , Johnson Matthew , Lipshutz Sara E. , Percy Katie L. , Raybuck Douglas W. , Schelsky Wendy M. , Tonra Christopher M. , Viverette Catherine B. , Wijeratne Asela J.
Published: August 2023

Researchers often examine symbiont host specificity as a species‐level pattern, but it can also be key to understanding processes occurring at the population level, which are not as well understood. The specialist–generalist variation hypothesis (SGVH) attempts to explain how host specificity influences population‐level processes, stating that single‐host symbionts (specialists) exhibit stronger population genetic structure than multi‐host symbionts (generalists) because of fewer opportunities for dispersal and more restricted gene flow between populations. However, this hypothesis has not been tested in systems with highly mobile hosts, in which population connectivity may vary temporally and spatially. To address this gap, we tested the SGVH on proctophyllodid feather mites found on migratory warblers (family Parulidae) with contrasting host specificities, Amerodectes protonotaria (a host specialist of Protonotaria citrea) and A. ischyros (a host generalist of 17 parulid species). We used a pooled‐sequencing approach and a novel workflow to analyse genetic variants obtained from whole genome data. Both mite species exhibited fairly weak population structure overall, and contrary to predictions of the SGVH, the generalist was more strongly structured than the specialist. These results may suggest that specialists disperse more freely among conspecifics, whereas generalists sort according to geography. Furthermore, our results may reflect an unexpected period for mite transmission – during the nonbreeding season of migratory hosts – as mite population structure more closely reflects the distributions of hosts during the nonbreeding season. Our findings alter our current understanding of feather mite biology and highlight the potential for studies to explore factors driving symbiont diversification at multiple evolutionary scales.
Meal‐eating characteristics among patients with symptoms of gastroparesis: Relationships to delays in gastric emptying
Authors: Barrett Alexandra C. , Johnson Kathleen P. , Halabi Maan El , Parkman Henry P.
Published: August 2023

Background

Patients with symptoms of gastroparesis (Gp) often modify their diets and consume small meals. However, the relationship between patients' eating behavior and their gastric emptying is not well understood. This study describes meal‐eating characteristics of patients with Gp symptoms and relates them to severity of emptying delay.

Methods

Adult patients with Gp symptoms underwent 4‐h gastric emptying scintigraphy and completed questionnaires including the Patient Assessment of GI Symptoms, a nutrition and diet questionnaire, and the Meal Patterns Questionnaire.

Key Results

Of 119 patients with Gp symptoms, 35 had normal gastric emptying (≤10% gastric retention at 4 h), 26 mildly delayed (>10%–20%), 28 moderately delayed (>20%–35%), and 30 severely delayed (>35%). Most patients (85%) reported eating small meals with an average of 2.4 meals per day. The most common reasons for stopping eating a meal were feeling full (83%), nausea (46%), and abdominal pain (31%). As gastric emptying worsened, patients increasingly made diet modifications such as low‐fat, low‐fiber, Gp diet, oral supplements, and blenderized meals (r = 0.309, p = 0.0007). Postprandial fullness lasted for 351 ± 451 min for patients with severely delayed emptying versus 207 ± 173 min for patients with normal emptying (p = 0.19).

Conclusions & Inferences

Meal‐eating characteristics were found to vary with severity of gastric retention. Patients with severely delayed gastric emptying reported the longest duration of postprandial fullness. Dietary modification increased significantly with gastric retention. These meal‐eating characteristics are important to understand as they impact on dietary education given to Gp patients for symptom management.
Voice hearers' explanations of trauma‐related voices and processes of change throughout imagery rescripting: A qualitative exploration
Authors: Strachan Laura P. , Paulik Georgie , Roberts Lynne , McEvoy Peter M.
Published: August 2023

Objectives

Post‐traumatic stress is common among people who hear voices (auditory verbal hallucinations), many of whom hear trauma‐related voices, whereby voice content is related to past trauma. Preliminary evidence suggests that imagery rescripting (ImRs) may more effectively reduce post‐traumatic stress and voices compared to treatments that are based on existing models of PTSD or positive symptoms. No known studies have explored the potential maintaining factors of trauma‐related voices in relation to ImRs. We aimed to uncover insights into the factors that maintain trauma‐related voices and how ImRs may influence such factors by exploring voice hearers' explanations of voices and experiences of change throughout ImRs.

Design

Thematic analytical methodology was used due to the study's critical epistemological framework.

Methods

Semi‐structured interviews explored relationships between trauma and voices, and experiences of change and stability throughout ImRs in a transdiagnostic sample (N = 10) who underwent 10–18 weekly ImRs sessions. Thematic analysis was used to develop themes.

Results

Two themes captured explanations of voices, which suggested voices may have counterproductive protective functions. Three themes captured psychological experiences during ImRs, which reflected concepts such as freedom to experience emotions, and experiences of justice, closure and grieving. Three themes described the outcomes of ImRs, reflecting concepts such as increased confidence, coping, perceived safety and voices becoming less powerful.

Conclusions

Trauma‐related voices may have underlying protective functions and ImRs may support emotional expression, adaptive trauma re‐appraisals and improve self‐worth and coping self‐efficacy. These change processes may have clinical implications in ImRs and other treatments for trauma‐affected voice hearers.
Freedom, moral responsibility, and the failure of universal defeat
Authors: Latham Andrew J. , Tierney Hannah , Varga Somogy
Published: August 2023

Proponents of manipulation arguments against compatibilism hold that manipulation scope (how many agents are manipulated) and manipulation type (whether the manipulator intends that an agent perform a particular action) donotimpact judgments about free will and moral responsibility. Many opponents of manipulation arguments agree that manipulation scope has no impact but hold that manipulation type does. Recent work by Latham and Tierney (2022, 2023) found that people's judgments were sensitive to manipulation scope: people judged that an agent waslessfree and responsible when a manipulation was existential (impacting at least one but not all agents) than when the manipulation was universal (impacting every agent). This study examines people's judgements about existential and universal manipulation cases that involve both intentional and non‐intentional outcomes. We found that manipulation scope also affects people's free will and responsibility judgments in manipulation cases involving both intentional and non‐intentional outcomes. Interestingly, we also found that manipulation type influences the effect that manipulation scope has on people's free will judgments but not their moral responsibility judgments, which indicates that people's free will and responsibility judgments can come apart. This puts pressure on the prevalent assumption that judgments about free will and moral responsibility are conceptually bound together.
Ameliorative effect of chitosan nanoparticles in capacitation media on post‐thawing in vitro fertilizing ability of bovine spermatozoa
Authors: Mahmoud Mona , Abd‐Allah Saber M. , Abdel‐Halim Bakar R. , Khalil Abdeltawab A.Y.
Published: August 2023

This study aimed to investigate the effect of supplementation of chitosan nanoparticles (CSNPs) on the capacitation of bovine spermatozoa during the in vitro fertilization process. Hyperactivated motility (HAM) and acrosome reaction (AR) of sperm cells as well as in vitro fertilization and cleavage rates are the main parameters used to estimate the effect of CSNPs on bovine spermatozoa's fertilizing ability. In this study, three different concentrations of CSNPs (10, 20 and 100 μg/mL) were prepared and characterized. Motile spermatozoa were separated from frozen–thawed semen by a swim‐up technique and capacitated in Sperm‐TALP medium supplemented with heparin only without CSNPs treatment (positive control), heparin + 10 μg/mL CSNPs, heparin + 20 μg/mL CSNPs, heparin + 100 μg/mL CSNPs and the last one served as a negative control tube which supplemented with 10 μg/mL CSNPs without adding heparin. Sperm cells were incubated for 90 min at 39°C in a 5% CO2 incubator and evaluated every 30 min at intervals. Cumulus oophorus complex (COCs) were matured in a 5% CO2 incubator at 39°C and inseminated in vitro with frozen–thawed bull sperm of the above concentrations. The inseminated oocytes were incubated at 39°C in a 5% CO2 incubator for 24 h and then examined for evidence of fertilization. The results of this investigation showed that HAM and AR were best affected by CSNPs at a concentration of 20 μg/mL during an incubation time of 60 min. As time went on, the overall proportion of spermatozoa with progressive motility (PM) decreased across all groups, and a substantially lower value was found at the dose mentioned above. Additionally, the impact of sperm treated with CSNPs on fertilization rate was assessed. The outcomes demonstrated that in comparison to the other concentrations (10 and 100 μg/mL), the positive control and the negative control, the proportion of fertilized oocytes was significantly higher in the CSNPs concentration (20 μg/mL). In conclusion, it could be inferred from this investigation that CSNPs support sperm functions during IVF and can be used for biomedical interventions in bovine spermatozoa. Additionally, a high IVF rate was achieved by using sperm treated with CSNPs as CSNPs enhance sperm capacitation and acrosome reaction.
Rogue waves arising on the standing periodic waves in the Ablowitz–Ladik equation
Authors: Chen Jinbing , Pelinovsky Dmitry E.
Published: August 2023

We study the standing periodic waves in the semidiscrete integrable system modeled by the Ablowitz–Ladik (AL) equation. We have related the stability spectrum to the Lax spectrum by separating the variables and by finding the characteristic polynomial for the standing periodic waves. We have also obtained rogue waves on the background of the modulationally unstable standing periodic waves by using the end points of spectral bands and the corresponding eigenfunctions. The magnification factors for the rogue waves have been computed analytically and compared with their continuous counterparts. The main novelty of this work is that we explore a nonstandard linear Lax system, which is different from the standard Lax representation of the AL equation.
Test–retest reliability of ski‐specific aerobic, sprint, and neuromuscular performance tests in highly trained cross‐country skiers
Authors: Bucher Elias , Millet Grégoire P. , Wehrlin Jon P. , Steiner Thomas
Published: August 2023

Purpose

Laboratory tests are commonly performed by cross‐country (XC) skiers due to the challenges of obtaining reliable performance indicators on snow. However, only a few studies have reported reliability data for ski‐specific test protocols. Therefore, this study examined the test–retest reliability of ski‐specific aerobic, sprint, and neuromuscular performance tests.

Methods

Thirty‐nine highly trained XC skiers (26 men and 13 women, age: 22 ± 4 years, V̇O2max: 70.1 ± 4.5 and 58.8 ± 4.4 mL·kg−1·min−1, respectively) performed two test trials within 6 days of a diagonal V̇O2max test, n = 27; skating graded exercise test to assess the second lactate threshold (LT2), n = 27; 24‐min double poling time trial (24‐min DP, n = 25), double poling sprint test (SprintDP1, n = 27), and 1‐min self‐paced skating sprint test (Sprint1‐min, n = 26) using roller skis on a treadmill, and an upper‐body strength test (UB‐ST, n = 27) to assess peak power (Ppeak) with light, medium, and heavy loads. For each test, the coefficient of variation (CV), intraclass correlation coefficient (ICC), and minimal detectable change (MDC) were calculated.

Results

V̇O2max demonstrated good‐to‐excellent reliability (CV = 1.4%; ICC = 0.99; MDC = 112 mL·min−1), whereas moderate‐to‐excellent reliability was found for LT2 (CV = 3.1%; ICC = 0.95). Performance during 24‐min DP, SprintDP1, and Sprint1‐min showed good‐to‐excellent reliability (CV = 1.0%–2.3%; ICC = 0.96–0.99). Absolute reliability for UB‐ST Ppeak was poor (CV = 4.9%–7.8%), while relative reliability was excellent (ICC = 0.93–0.97) across the loads.

Conclusion

In highly trained XC skiers, sport‐specific aerobic and sprint performance tests demonstrated high test–retest reliability, while neuromuscular performance for the upper body was less reliable. Using the presented protocols, practitioners can assess within‐ and between‐season changes in relevant performance indicators.
Heterogeneous trade agreements and adverse implications of restrictive rules of origin: Evidence from apparel trade
Authors: Abreha Kaleb , Robertson Raymond
Published: August 2023

We revisit the heterogeneous effects of regional trade agreements (RTAs) using a PPML gravity model and comparing apparel and total trade. Apparel, as a politically sensitive sector, has specialised, unusually restrictive rules of origin (RoOs) clauses that vary considerably across RTAs. Our RTA estimates have a significantly higher variance for apparel trade than total trade. We also find that the sizes of the RTA estimates for apparel trade are significantly and negatively correlated with the restrictiveness of RoOs. Additionally, assessing temporary exceptions to the apparel RoOs in US trade agreements, we find that ending the temporary exceptions is associated with less apparel trade. We further illustrate how RTAs can be effective development policy instruments to promote economic development in developing countries. For example, updating the RoOs in the Dominican Republic‐Central America Free Trade Agreement can create jobs and significantly reduce Central American emigration.
Descriptive analysis of haemangiosarcoma occurrence in dogs enrolled in the Golden Retriever lifetime study
Authors: Hillman Alison , Swafford Brenna , Delavenne Camille , Fieten Hille , Boerkamp Kim , Tietje Kathy
Published: August 2023

Haemangiosarcoma is a relatively common malignant tumour in dogs, and one of the primary outcomes of interest for the Golden Retriever Lifetime Study. This study collects longitudinal data and samples from a cohort of golden retrievers, with the aim of identification of nutritional, genetic, environmental, lifestyle and reproductive risk factors for cancers and other important diseases in dogs. This analysis describes the accumulating data and samples, which are available for use by researchers to fulfil the study's objectives. As of September 2022, 233/3044 dogs enrolled in the study had been diagnosed with haemangiosarcoma (7.65%), with an incidence rate of 1.10 cases per 100 dog‐years. Visceral haemangiosarcoma was the most common, affecting 211/3044 study dogs (6.9%). One hundred and twenty eight visceral haemangiosarcoma diagnoses specified the presence of splenic tumours (60.7%) and 119 specified the presence of cardiac tumours (56.4%). The probability of remaining without a haemangiosarcoma diagnosis declined from 100% from approximately 4 years of age, to a 12 year probability of 91.1% in intact females (95% CI 84.4%–98.3%), 60.7% in neutered females (95% CI 41.6%–88.6%), 72.9% in intact males (95% CI 62.9%–84.6%) and 70.0% in neutered males (95% CI 53.4%–92.0%). The 1 year survival probability for visceral haemangiosarcoma was 1.42% (95% CI 0.37%–5.47%); for cutaneous haemangiosarcoma, it was 84.6% (95% CI 67.1%–99.99%). The accumulated data and samples are a considerable resource for further investigation of canine haemangiosarcoma and have a potential role in translational medicine.
The fallacy of functional nomenclature in the kingdom of biological multifunctionality: physiological and evolutionary considerations on ion channels
Authors: Munaron Luca , Chinigò Giorgia , Scarpellino Giorgia , Ruffinatti Federico Alessandro
Published: August 2023

Living organisms are multiscale complex systems that have evolved high degrees of multifunctionality and redundancy in the structure–function relationship. A number of factors, only in part determined genetically, affect the jobs of proteins. The overall structural organization confers unique molecular properties that provide the potential to perform a pattern of activities, some of which are co‐opted by specific environments. The variety of multifunctional proteins is expanding, but most cases are handled individually and according to the still dominant ‘one structure–one function’ approach, which relies on the attribution of canonical names typically referring to the first task identified for a given protein. The present topical review focuses on the multifunctionality of ion channels as a paradigmatic example. Mounting evidence reports the ability of many ion channels (including members of voltage‐dependent, ligand‐gated and transient receptor potential families) to exert biological effects independently of their ion conductivity. ‘Functionally based’ nomenclature (the practice of naming a protein or family of proteins based on a single purpose) is a conceptual bias for three main reasons: (i) it increases the amount of ambiguity, deceiving our understanding of the multiple contributions of biomolecules that is the heart of the complexity; (ii) it is in stark contrast to protein evolution dynamics, largely based on multidomain arrangement; and (iii) it overlooks the crucial role played by the microenvironment in adjusting the actions of cell structures and in tuning protein isoform diversity to accomplish adaptational requirements. Biological information in protein physiology is distributed among different entwined layers working as the primary ‘locus’ of natural selection and of evolutionary constraints.

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Compression Characteristics of Liquid Ring Compressors With Fixed and Freely Rotating Casings
Authors: Acarer Sercan , Gürbüz M. Tayyip , Cukurel Beni
Published: August 2023

Liquid ring compressors (LRC) are used for a wide range of compression and vacuum applications, including corrosive or flammable gases for which other compression technologies may not be feasible. The presence of a surrounding liquid ring may offer the possibility of polytropic compression due to incremental heat loss to the liquid. This aspect may play a critical role in compression (and expansion) processes of heat engine cycles toward approaching the targeted Carnot efficiencies. To date, published research addressing the physical phenomena behind LRC is highly limited. Experimentally studying these machines will result in a demonstration of aggregate performance. In order to improve our understanding of LRC with and without freely rotating casings and to be able to analyze the complex inner workings, a numerical approach using computational fluid dynamics (CFD) tools, supported by available experimental data for validation purposes, has been established. Physical parameters such as water–air interface, temperature, pressure, entropy production, vorticity, and shear strain rate are presented for a baseline geometry taken from the open literature. Finally, temperature-entropy paths and isothermal and isentropic efficiencies are presented. The significant performance gain from the freely rotating casing is highlighted. Detailed results present insights into work addition processes of such machines.
Thermoelastohydrodynamic Mixed Lubrication of Combined Rod Seals Operating at High Pressures and Speeds: Mathematical Modeling and Numerical Analysis
Authors: Wang Bingqing , Li Xiaoxuan , Peng Xudong , Li Yuntang , Chen Yuan , Jin Jie
Published: August 2023

Thermoelastohydrodynamic (TEHD) mixed lubrication characteristics of a step-combined rod seal under high-pressure and high-speed conditions are analyzed in this article. A novel TEHD mixed lubrication model for combined rod seals is innovatively established from the perspective of “seal-film-rod” system for the first time. Parameterized studies are conducted to evaluate the thermal effect on seal behavior with the comparison of isothermal elastohydrodynamic (EHD) lubrication analysis. Numerical results show that the interface friction heat is quite remarkable and mainly concentrated on the sealing lip, especially in high pressure and speed cases. With the increasing sealed pressure or rod speed, the temperature rise becomes more obvious and has a more significant impact on the sealing performance. The excessively rising temperature will even exceed the melting point of the sealing material, causing thermal damage.
High-quality genomes of
Paenibacillus
spp. RC334 and RC343, isolated from a long-term forest soil warming experiment
Authors: Kitzmiller Claire E. , Tran Wyatt C. , Sullivan Brendan , Cortez Florencia , Choudoir Mallory , Simoes Rachel , Dayarathne Nipuni , DeAngelis Kristen M.
Published: August 2023

Paenibacillus
spp. RC334 and RC343 were isolated from heated soil in a long-term soil warming experiment. Both genomes were 5.98 Mb and assembled as a single contig. We describe the assembly and annotation of the two high-quality draft genomes for these isolates here.
Mycobacteriophage Rita: a cluster F1 phage discovered in North Easton, Massachusetts
Authors: Fakhri Anna M. , Warner Marcie H. , DeGiorgis Joseph A. , Cornely Kathleen
Published: August 2023

Mycobacteriophage Rita infects
Mycobacterium smegmatis
mc
2
155 and was isolated from a soil sample collected in North Easton, Massachusetts. Assigned to cluster F1 based on sequence similarity to other phages in the same cluster, Rita has a 58,771 bp genome and encodes 104 genes. Rita is 98% similar to phage Bipolar.
Supplemental Material: Revised chronology of the Middle–Upper Cenozoic succession in the Tuotuohe Basin, central-northern Tibetan Plateau, and its paleoelevation implications
Authors: Li  , Chang Hong , et al.
Published: August 2023

Petrographic analyses and reconstructed annual mean air temperature based on regional empirical formula；Reconstructed temperatures based on different br-GDGTs calibrations, and Paleoclimate model uncertainties.
Supplemental Material: Origin of composite Ni-Cu sulfide- and Fe-Ti oxide-bearing mafic-ultramafic intrusions in the Central Asian Orogenic Belt, China: Role of externally derived crustal organic carbon in controlling mineralization of post-collisional mafic magmatism
Authors: Cao Yonghua , Yan Wang Christina , et al.
Published: August 2023

Detailed description of modeling the relationship of olivine Fo versus Ni for rocks of the Kebu intrusion, complete lithogeochemical and mineral chemical data sets, as well as geochemical modeling results.
Supramolecular Strategy for the Design of Nanocarriers for Drugs and Natural Bioactives: Current State of the Art (A Review)
Authors: Zakharova L. Ya. , Maganova F. I. , Sinyashin K. O. , Gaynanova G. A. , Mirgorodskaya A. B. , Vasilieva E. A. , Sinyashin O. G.
Published: August 2023

The review focuses on the lipid based nanocarriers, with special attention paid to natural bioactive payloads. First, micelles and microemulsions are considered as very attractive colloidal nanocontainers that allow for marked improving the solubility of hydrophobic bioactives. Further, liposomal vehicles are reviewed, with both advantages and limitations discussed. Literature assay covers up-to-date information of about last three to five years, although brief background is given on the pioneer works addressing the liposomes and their evolution from bench to bedside. Final part of the review is devoted to the modern modifications of vesicular nanocarriers which can be adapted to specific administration way due to improved targeting properties, permeability, mucoadhesiveness and possibility to cross biological barriers. Therein, such kinds of nanocarriers as transfersomes, niosomes, ethosomes, chitosomes are evaluated; and separate sections focus on the natural based formulations, i.e., phytosomes and invasomes.
Diffuse large B cell lymphoma presenting as multiple cavitary lung lesions
Authors: Uppal Manisha , Hassan Ahmad , Ahari Jalil
Published: August 2023

A female patient in her 50s presented to the hospital with a 2 months history of shortness of breath and productive cough. She also had ongoing fatigue and unintentional weight loss. Investigations demonstrated a normal white cell count and elevated lactate dehydrogenase). A CT scan of the chest revealed multiple bilateral cavitary lung masses and pulmonary nodules. Bronchoscopy with transbronchial biopsy and fine needle aspiration of mediastinal lymph node was performed. The histopathology was consistent with the non-germinal centre B cell subtype of diffuse large B cell lymphoma (DLBCL). A regimen of rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone was started, which improved her symptoms. Although a rare presentation, this case highlights the need to consider DLBCL among the differential diagnoses for cavitary lung lesions when the workup fails to elicit an alternate cause. Given its aggressive nature, prompt diagnosis and treatment are critical.
Pulmonary haemorrhage and extensive arterial thrombosis with anabolic steroid abuse
Authors: Singh Angad , Kaur Anahat , Stephens Corbin , Fekete Ian , Nelson John , Kodwani Naresh
Published: August 2023

Anabolic-androgenic steroids (AASs) are commonly implicated in thromboembolic events but rarely cause diffuse alveolar haemorrhage. We report the case of a Caucasian man in his late 40s who was consuming supratherapeutic doses of AAS and presented with shortness of breath and haemoptysis. Chest imaging showed bilateral patchy infiltrates in the lungs with diffuse blood throughout the airways on bronchoscopy. Extensive infectious and autoimmune workup were unremarkable. The patient then developed right foot ischaemia and was found to have extensive aortic and bilateral lower extremity arterial thrombosis. Anticoagulation was attempted despite haemoptysis. Thrombectomy procedures were unsuccessful and the patient eventually developed worsening rhabdomyolysis requiring intubation and bilateral amputation. His clinical condition continued to worsen and he passed away 10 days after admission. This case highlights the rare synchronous occurrence of two life-threatening complications secondary to anabolic steroid abuse which can pose a significant diagnostic and therapeutic challenge for clinicians.
Predictors of harsh parenting practices and inter-partner conflict during the COVID-19 pandemic in Ontario, Canada: a cross-sectional analysis from the Ontario Parent Survey
Authors: Joshi Divya , Aschner Amir , Atkinson Leslie , Halili-Sychangco Daniella , Duku Eric , Puffer Eve S , Rieder Amber , Tonmyr Lil , Gonzalez Andrea
Published: August 2023

Objectives

Guided by the bioecological model, the purpose of this study was to examine the associations of (1) individual level factors (sociodemographic, health behaviour and mental health), (2) family (micro) level COVID-19 experiences (difficulty with household management, managing child mood and behaviour, and pandemic-related positive experiences) and (3) community (macro) level factors (residential instability, ethnic concentration, material deprivation and dependency, an indicator of age and labour force) with harsh parenting practices and inter-partner conflict during the early lockdown of the COVID-19 pandemic in Ontario, Canada.

Design

A cross-sectional analysis of data from the Ontario Parent Survey.

Setting

A convenience sample of 7451 caregivers living in Ontario, Canada, at the time of baseline data collection (May–June 2020).

Participants

Caregivers aged 18 years and older with children 17 years or younger.

Outcome measures

Parenting practices over the past 2 months was assessed using a published modification of the Parenting Scale. The frequency of inter-partner conflict over the past month was assessed using the Marital Conflict scale.

Results

Individual (sociodemographic factors, alcohol use, and higher depressive and anxiety symptoms) and family (difficulties with managing the household and child mood and behaviour) level factors were positively associated with inter-partner conflict and harsh parenting practices. Having fewer positive experiences (eg, performing activities with children), and economic adversity at the family level were positively associated with inter-partner conflict but inversely associated with harsh parenting. At the community level, residential instability was negatively associated with harsh parenting practices.

Conclusions

Individual and family level factors were associated with harsh parenting and inter-partner conflict. The associations of fewer positive experiences and economic hardship with harsh parenting practices may be more complex than initially thought. Efforts that raise awareness and address caregiver mental health concerns are needed as part of the pandemic response to promote positive inter-partner and parent-child interactions.
Efficacy of a medical grade honey formulation (L-Mesitran) in comparison with fluconazole in the treatment of women with recurrent vulvovaginal candidiasis: protocol for a randomised controlled trial (HONEY STUDY)
Authors: van Riel Senna J J M , Lardenoije Céline M J G , Wassen Martine M L H , van Kuijk Sander M J , Cremers Niels A J
Published: August 2023

Introduction

Recurrent vulvovaginal candidiasis (RVVC) affects up to 9% of women worldwide. This amount is expected to increase due to lifestyle changes, increased fungal resistance and biofilm formation. Treatment options are limited and in 57% of the cases, relapses occur within 12 months after starting fluconazole therapy (golden standard). The pathogenesis of RVVC is multifactorial and includes fungal biology, the vaginal microenvironment and the immune system. Fluconazole is antimicrobial and effective in inducing short-term remission but a long-term cure is hard to achieve. Medical grade honey (MGH) has antimicrobial, protective, antioxidative and immunomodulatory activity and may therefore be a good alternative treatment. This study aims to investigate the clinical cure rate and long-term efficacy of MGH compared with fluconazole in patients with RVVC.

Methods and analysis

This study is a multicentre, randomised controlled trial (Maastricht University Medical Centre+ and Zuyderland Medical Centre). A total of 252 eligible women will be randomly assigned to the fluconazole group (control) or the MGH group (L-Mesitran, treatment). The primary objective is to investigate the mycological cure rate after 1 month assessed through a vaginal culture. Secondary objectives are the clinical cure rate regarding symptoms, the prophylactic activity after 6 months of maintenance therapy and the number of relapses within 12 months. Moreover, information about side effects, discomfort and quality of life will be collected with the use of questionnaires.

Ethics and dissemination

Ethical approval from the Medical Ethics Review Committee of the academic hospital Maastricht/University Maastricht has been obtained (NL 73974.068.21, V.7 on 8 February 2022). Additional approval was obtained from the Ethics Committee of the Zuyderland Medical Centre Heerlen (Z2021141 on 4 March 2022). The first patient was randomised on 22 August 2022. Results will be made available to researchers and healthcare professionals via conferences, meetings and peer-reviewed international publications.

Trial registration number

NCT05367089.
Deep versus moderate neuromuscular blockade during total hip arthroplasty to improve postoperative quality of recovery and immune function: protocol for a randomised controlled study
Authors: Bijkerk Veerle , Visser Jetze , Jacobs Lotte M C , Keijzer Christiaan , Warlé Michiel C
Published: August 2023

Introduction

There is accumulating evidence that deep neuromuscular blockade (NMB) improves intraoperative surgical conditions during laparoscopic surgery. Studies investigating the effects of deep NMB in open surgery are scarce. In theory, by limiting surgical damage through deeper muscle relaxation, postoperative inflammation and concomitant immune suppression can be reduced. Therefore, this study will investigate the effects of deep NMB during total hip arthroplasty, which demands a relatively large exposure of the hip joint through and in between muscles.

Methods and analysis

This study is a monocentre blinded randomised controlled trial in 100 patients undergoing total hip arthroplasty under general anaesthesia. Patients will be randomised in a 1:1 fashion to an intervention group of intraoperative deep NMB (a post-tetanic count of 1–2) or a control group receiving moderate NMB (a train-of-four count of 1–2). NMB will be achieved by continuous or bolus administration of rocuronium, respectively. The primary endpoint is the quality of recovery at postoperative day 1 measured by the Quality of Recovery-40 Questionnaire, analysed by Analysis of Variance. The secondary endpoint is postoperative innate immune function, measured byex vivoproduction capacity of tumour necrosis factor and interleukin-1β on endotoxin stimulation of whole blood.

Ethics and dissemination

Ethical approval for this study was granted by the Medical Ethics Committee ‘METC Oost-Nederland’ (reference number 2022-15754). Informed consent will be obtained prior to study participation. Study results will be published in an international peer-reviewed journal.

Trial registration numbers

ClinicalTrials.gov Registry (NCT05562999) and EudraCT Registry (2022-002451-19).
SocialBit: protocol for a prospective observational study to validate a wearable social sensor for stroke survivors with diverse neurological abilities
Authors: White Kelly , Tate Samuel , Zafonte Ross , Narayanan Shrikanth , Mehl Matthias R , Shin Min , Dhand Amar
Published: August 2023

Introduction

Social isolation has been found to be a significant risk factor for health outcomes, on par with traditional risk factors. This isolation is characterised by reduced social interactions, which can be detected acoustically. To accomplish this, we created a machine learning algorithm called SocialBit. SocialBit runs on a smartwatch and detects minutes of social interaction based on vocal features from ambient audio samples without natural language processing.

Methods and analysis

In this study, we aim to validate the accuracy of SocialBit in stroke survivors with varying speech, cognitive and physical deficits. Training and testing on persons with diverse neurological abilities allows SocialBit to be a universally accessible social sensor. We are recruiting 200 patients and following them for up to 8 days during hospitalisation and rehabilitation, while they wear a SocialBit-equipped smartwatch and engage in naturalistic daily interactions. Human observers tally the interactions via a video livestream (ground truth) to analyse the performance of SocialBit against it. We also examine the association of social interaction time with stroke characteristics and outcomes. If successful, SocialBit would be the first social sensor available on commercial devices for persons with diverse abilities.

Ethics and dissemination

This study has received ethical approval from the Institutional Review Board of Mass General Brigham (Protocol #2020P003739). The results of this study will be published in a peer-reviewed journal.
Texting is caring: a content analysis of clinical text messages by hospitalists
Authors: Donnelly Claire Elyse , Flores Perla L , Weiner Michael , Kara Areeba Y , Lee Joy L
Published: August 2023

Background

Clinical texting systems (CTS) are widely used in hospitals for team communication about patients. With more institutions adopting such systems, there is a need to understand how texting is being used in clinical practice.

Methods

We conducted content analysis of 809 randomly selected message threads sent to and from hospitalists in a 9-month window. The process, purpose and content of messages were analysed. We also examined messages for personal content (to identify whether CTS was being used for professional matters) and discussion of near miss errors. The risk levels of these near misses were also assessed.

Results

Most messages focused on clinical management of patient needs (62%; n=498) and functioned to provide a notification or update regarding clinical care (64%; n=518) or make a request of the recipient (63%; n=510). Personal content was infrequent in message threads (10%; n=80). Five per cent (n=38) of message threads included discussion of a near miss, and most near misses posed low clinical risk overall (66%; n=25).

Conclusion

Most CTS communication centred around direct clinical management. Fewer messages were focused on non-clinical areas such as administrative tasks or personal communication. Further examination of care delivery, error communication and the consequences of the care discussed in messages would help clinical leaders understand the impact of clinical texting on teamwork and quality of care.
Adding liposomal doxorubicin enhances the abscopal effect induced by radiation/αPD1 therapy depending on tumor cell mitochondrial DNA and cGAS/STING
Authors: Wang Liqun , Luo Ren , Onyshchenko Kateryna , Rao Xi , Wang Meidan , Menz Beatrice , Gaedicke Simone , Grosu Anca-Ligia , Firat Elke , Niedermann Gabriele
Published: August 2023

Background

Localized radiotherapy (RT) can cause a T cell-mediated abscopal effect on non-irradiated tumor lesions, especially in combination with immune checkpoint blockade. However, this effect is still clinically rare and improvements are highly desirable. We investigated whether triple combination with a low dose of clinically approved liposomal doxorubicin (Doxil) could augment abscopal responses compared with RT/αPD-1 and Doxil/αPD-1. We also investigated whether the enhanced abscopal responses depended on the mitochondrial DNA (mtDNA)/cyclic GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING)/IFN-I pathway.

Materials/methods

We used Doxil in combination with RT and αPD-1 in two tumor models (B16-CD133 melanoma and MC38 colon carcinoma) with mice bearing two tumors, only one of which was irradiated. Mechanistic studies on the role of the mtDNA/cGAS/STING/IFN-I axis were performed using inhibitors and knockout cells in vitro as well as in mice.

Results

Addition of a single low dose of Doxil to RT and αPD-1 strongly enhanced the RT/αPD-1-induced abscopal effect in both models. Complete cures of non-irradiated tumors were mainly observed in triple-treated mice. Triple therapy induced more cross-presenting dendritic cells (DCs) and more tumor-specific CD8+T cells than RT/αPD-1 and Doxil/αPD-1, particularly in non-irradiated tumors. Coincubation of Doxil-treated and/or RT-treated tumor cells with DCs enhanced DC antigen cross-presentation which is crucial for inducing CD8+T cells. CD8+T cell depletion or implantation of cGAS-deficient or STING-deficient tumor cells abolished the abscopal effect. Doxorubicin-induced/Doxil-induced IFNβ1 markedly depended on the cGAS/STING pathway. Doxorubicin-treated/Doxil-treated tumor cells depleted of mtDNA secreted less IFNβ1, of the related T cell-recruiting chemokine CXCL10, and ATP; coincubation with mtDNA-depleted tumor cells strongly reduced IFNβ1 secretion by DCs. Implantation of mtDNA-depleted tumor cells, particularly at the non-irradiated/abscopal site, substantially diminished the Doxil-enhanced abscopal effect and tumor infiltration by tumor-specific CD8+T cells.

Conclusions

These data show that single low-dose Doxil can substantially enhance the RT/αPD-1-induced abscopal effect, with a strong increase in cross-presenting DCs and CD8+tumor-specific T cells particularly in abscopal tumors compared with RT/αPD-1 and Doxil/αPD-1. Moreover, they indicate that the mtDNA/cGAS/STING/IFN-I axis is important for the immunogenic/immunomodulatory doxorubicin effects. Our ﬁndings may be helpful for the planning of clinical radiochemoimmunotherapy trials in (oligo)metastatic patients.
Intramuscular lesions in musculoskeletal MRI as a favourable prognostic sign in patients with anti-MDA5 antibody-positive dermatomyositis
Authors: Oto Yohsuke , Yoshida Ken , Fukuda Takeshi , Fukuda Taiki , Ukichi Taro , Noda Kentaro , Ito Haruyasu , Kurosaka Daitaro
Published: August 2023

Objectives

Anti-differentiation-associated gene 5 (MDA5) antibody-positive dermatomyositis, which has been described as clinically amyopathic dermatomyositis, complicates rapidly progressive interstitial lung disease (ILD). Owing to the absence of significant muscle symptoms, musculoskeletal MRI is often not performed. In this study, we aimed to devise a simple evaluation method using musculoskeletal MRI findings to elucidate the relationship between MRI findings and ILD prognosis and development.

Methods

The medical records and MRI scans of the proximal muscles at the time of diagnosis were retrospectively reviewed for 28 patients with anti-MDA5 antibody-positive dermatomyositis who were admitted to The Jikei University Hospital and The Jikei University Kashiwa Hospital between January 2008 and March 2022. Three observers evaluated nine proximal muscles for high signals on either short-tau inversion recovery images and/or fat-saturated gadolinium-enhanced T1-weighted images in the fascia and/or in the margins of the muscles in contact with the fascia (fascial pattern), and/or high signals in the muscles away from the fascia (intramuscular pattern), and a consensus was reached.

Results

Of the 28 patients, 15 presented with ‘radiological myositis’, where an intramuscular pattern was observed at any site. Patients with radiological myositis had significantly higher survival rates than those without radiological myositis, despite the lower rate of triple therapy with prednisolone, calcineurin inhibitors and cyclophosphamide. The spread of ILD on chest CT negatively and significantly correlated with the proportion of intramuscular lesions.

Conclusion

The detection of intramuscular lesions on musculoskeletal MRI using our novel evaluation method could be clinically useful as a favourable prognostic marker.