bluuebunny/crossref_metadata_2025 huggingface dataset:
C71. Perimyocarditis related Corona Virus Disease: A Case Report
Authors: Budi D S , Anggrahini D W , Hartopo A B
Published: April 2022

Background

One of the ongoing outbreaks is the SARS-COV2 with clinical manifestations are dominated by pulmonary symptoms. However, some patients have reported mild to severe cardiovascular damage1.

Case Summary

We report a 26-year-old male with confirmed Corona Virus Disease (COVID-19), who has manifestation of perimyocarditis. Diagnosis was built through clinical symptoms of fever, dyspnea, with ST elevation and PR depression on ECG, and an increase of hs-Troponin I and NT-Pro-BNP. There appeared to be a pericardial effusion on echocardiography, and an increase number of cardiothoracic ratio (CTR) during the infection. All of the perimyocarditis parameters improved when symptoms are decrease meanwhile laboratory showing improvement of inflammatory parameters (CRP, D-Dimer).

Discussion

Acute perimyocarditis is a reported cardiac complication of COVID-191. COVID-19 perimyocarditis associated with pericardial effusion and cardiac tamponade2. Electrocardiogram (ECG) abnormalities commonly seen with pericarditis, such as ST elevation and PR depression, may be observed in myocarditis3. Many COVID-19 patients were reported to have a detectable level of cardiac-Troponin-I as a result of oxygen supply–demand mismatch, which could precipitate ischemia that results in type 2 myocardial infarction. NT-pro-BNP level also could increase secondary to myocardial stress, a possible knock-on effect from severe respiratory illness4.
C73. Phlegmasia Cerulea Dolens "A Case of the Blue Leg": Act Properly, Avoid Morbidity and Mortality
Authors: Dewi I P , Wardhani L F K , Budiarto R M
Published: April 2022

Background

Deep vein thrombosis (DVT) may compromise venous outflow from a limb, causing significant swelling. Phlegmasia cerulea dolens (PCD) is a severe presentation of massive DVT. PCD is a medical emergency that can lead to venous gangrene of the lower extremity. Early diagnosis and prompt treatment are crucial for limb salvage.

Case Presentation

We report 65-year-old woman presented with acute onset edema and pain in left leg. Left lower limb examination found edema from the left groin to the distal left extremity, marmorata, and bullae with cold palpation. Sensoric and motoric function of left leg were decrease. Duplex ultrasonography showed thrombus and non compressible in left common femoral vein (CFV). We have done systemic thrombolytic using streptokinase 250.000 IU. However, the condition of the patient didn’t improve. The patient then underwent surgical thrombectomy procedure with a forgaty catheter. There was a ± 20 cm of thrombus. Her left lower limb became warm after thrombectomy and her symptoms improved. Finally, after 12 days hospitalization the patient was discharged and give anticoagulant therapy.

Conclusion

Although uncommon, it is important to identify patients with PCD because they should be considered for more aggressive management. Intravenous anticoagulant is one of therapeutic strategy while a decision to pursue more aggressive therapy is being considered. Patients with extensive DVT but without signs of PCD do not routinely receive thrombolysis but should be anticoagulated and monitored closely for the development of PCD.
C88. Sick sinus syndrome in acute anterior myocardial infarction: when culprit strategy ended up jeopardy
Authors: Nadia  , Fitra M
Published: April 2022

Background

Atrial arrhythmias occur in 10% of acute myocardial infarctions and increases incidence of death. Altered heart rhythm with brady-tachy episodes indicates sinus node dysfunction ordinarily cause by inferior myocardial infarction.

Case Description

A 66-year-old-man, diagnosed with 2 days onset Acute Anterior Myocardial Infarction with history of syncope after chest pain, referred with sinus arrest and junctional rhythm that changed into atrial fibrillation. During hospitalization the heart rhythm changing periodically from bradycardia to tachycardia repeatedly with witnessed new ST elevation in inferior lead before an episode of cardiac arrest. After primary PCI to the RCA as the new culprit lesion, chest pain was relieved but hemodynamic condition was not stable and the rhythm remained continuously altered.

Discussion

Sick sinus syndrome is a cardiac conduction disorder characterized by symptomatic dysfunction of the sinoatrial node generally manifests as sinus bradycardia, sinus arrest, or sinoatrial block, and accompanied by supraventricular tachyarrhythmias (tachy-brady syndrome). This case of acute myocardial infarction with 3 vessel diseased lesion and total occlusion in RCA affected sinoatrial node causing sick sinus syndrome. Recently multi-vessels PCI strategy increasingly recommended at the time of primary PCI for patient with arrhythmia.

Conclusion

A man 66 years old with acute anterior MI compelling with sick sinus syndrome on presentation because apparently the culprit lesion was RCA. Unfortunately, at that time non-IRA lesion were not opened and TPM was not available, bradycardia continues and the patient ended up being jeopardy.
C89. Simultaneous Aortic Stenosis (AS) and Pulmonary Stenosis (PS) in A Middle-Aged Man: A Rare Case Report
Authors: Eliza B Suhuyanly , Sumantra I G
Published: April 2022

Background

Combined valvular lesions is very rare. Only 16 cases of combined valvular stenosis of the aortic and pulmonary valves have been reported. Failure to recognize and adequately correct both lesions may be catastrophic for the patient.

Case Illustration

A 38-year-old male came to the outpatient department with shortness of breath, fatigue, and swollen ankles. He had a short posture, broad forehead, bitemporal narrowing, broad nasal tip, long philtrum, wide mouth, and large earlobes. Cardiac examination revealed systolic murmurs over the pulmonary valve and at the aortic valve radiating to the apex (galliverdin phenomenon), rales in both lungs, and bilateral ankle edema. Electrocardiogram revealed sinus rhythm, extreme axis, RA enlargement, RBBB, and bifascicular block. Chest radiograph showed cardiomegaly, pulmonary edema, and left pleural effusion. Echocardiography demonstrated a dilated LA and concentric LVH with good LV function, HF/HG severe AS, a bicuspid aortic valve causing moderate aortic regurgitation, mild mitral regurgitation, mild tricuspid regurgitation, and severe valvular or supravalvular PS with RV hypertrophy. The patient was administered diuretics, a beta blocker, and an anti-platelet.

Discussion

Most patients with combined aortic and pulmonary obstruction at sub-valvular level have hypertrophic cardiomyopathy. Cases with both aortic and pulmonary valve stenoses are exceedingly rare. The age of presentation ranges from neonate to 55 years. It is more common in males. Most patients present with murmur since birth, dyspnea, and fatigue. Our patient is suspected to have Williams syndrome based on the physical appearance and cardiac examination findings.
C90. Successful Procedure of Ductus Arteriosus Stenting: Promising Choice for Pulmonary Atresia Survival
Authors: Andini R , Permitasari D A , Priyatno A
Published: April 2022

Background

Duct-dependant circulation in a baby presents as a life threatening emergency. Maintain the duct patency is crucial for patient survival before they have an cardiac surgery. We describe a case of a baby with pulmonary atresia who underwent succesful procedure of patent ductus arteriosus (PDA) stenting.

Case Summary

a female baby was born in peripheral hospital with birth weight of 3 kg by normal delivery, noticed to have cyanosis sixteen hours after birth. At our centre, the baby look cyanosed. Saturation by pulse oximetry was 84%. In physical examination appears, a continuous murmur was heard below clavicle at linea parasternal. Echocardiography confirmed the diagnosis of pulmonary atresia. Faint flow of PDA observed with duct size less than 1 mm. Prostaglandin E1 Infusion was start immediately at the rate of 1 µg/Kg/min. Within 6 hours of infusion the baby had an episode of apnoea. The baby then taken up for ductal stenting to keep the duct patent for few months before staged cardiac surgery.

Discussion

Pulmonary atresia is an critical case of congenital heart disease. The systemic or pulmonary circulation are mantained through flow in patent ductus arteriosus. Before cardiac surgical repair these patient can survive only if duct patency is reliably maintained. PDA stenting has been shown to be as an acceptable and less invasive approach to maintain ductal patency.
C95. The electrocardiographic changes in a hypertensive COVID-19 patient who received beta-blocker and favipiravir: a case report
Authors: Fatimah V A N , Istiqomah N S , Fadjri M
Published: April 2022

Background

Various electrocardiographic manifestations have been reported in COVID-19 which either result from myocarditis or insult-induced re-emerging of pre-existing condition. Some antiviruses used off-labelly for COVID-19, including favipiravir, are considered to be proarrhythmic. Meanwhile, anti-hypertensive drugs such as beta-blocker may induce bradyarrhythmia.

Case Summary

A 69-year-old male with confirmed COVID-19 and a history of uncontrolled hypertension presented with blood pressure of 216/111mmHg at admission. No sign and symptom of acute target organ damage had been reported. His electrocardiography showed normal sinus rhythm (heart rate [HR] 60bpm). The echocardiographic finding revealed normal heart function. He received favipiravir for 5 days, intravenous nicardipine (0.5mcg/kgBW/hour), and peroral amlodipine (1x10mg), candesartan (1x16mg), and bisoprolol (1x2.5mg). During hospitalization, the HR fluctuated between 52-109. On the sixth day, a total atrioventricular (AV) block with junctional escape rhythm (HR 66bpm) was present. Both favipiravir and bisoprolol were ceased simultaneously. The AV block persisted for 4 days then transformed into a junctional rhythm for the next 3 days and sinus bradycardia (HR 48bpm) thereafter. No pacing was performed.

Discussion

The possible differential diagnoses in this case include sick sinus syndrome (SSS), COVID-19-induced myocarditis, and drug-induced. The SSS might explain the wide variability of the HR. There were some reports presenting the sinus node dysfunction as a manifestation of SARS-CoV-2 infection. Further evaluation using Holter and/or electrophysiological study is warranted. Drug-induced cause may be excluded because the bradyarrhythmia remained after the cessation of both beta-blocker and favipiravir.
C102. Transjugular venous access for permanent pacemaker as an approach when there was no other choice : A Case Report
Authors: Fathoni E , Rizal A
Published: April 2022

Background

When conventional veins are inaccessible, the transjugular Seldinger technique for permanent pacemaker (PPM) implantation could be used as the last resort.

Case Description

An 80-years-old woman had wound skin extrusion and infection at the site of left deltopectoral pocket of permanent pacemaker. After removing the PPM lead generator and debriding the wound, a single chamber PPM was implanted in right hemithorax after temporary pacemaker backup. There was no access in the left area and proximal vein stenosis was found following an early attempt to reach the right subclavian vein and cut-down surgical procedure. Other stenosis were also found at the upper right veins by venography. A single chamber PPM was implanted utilizing the Seldinger technique to puncture the internal jugular vein without surgical cut-down and dissection for tunneling the lead from right jugular area to deltopectoral pocket. Lead test came out acceptable: R wave of 12 mV, Slew >4 V/s current >25 mA, impedance 688 Ω and threshold of 0.87V. There were no pneumothorax and other complications followed.

Discussion

Venous occlusion could be found in patients undergoing pacemaker insertion. For some cases, the internal jugular vein works as an alternative access for PPM insertion without surgical cut down. Percutaneous access to the internal jugular vein is safer, and the risk of lead fractures is reduced.
Thoracic mediastinal-occupying ratio predicts recovery and prognosis after lung transplantation
Authors: Yoshiyasu Nobuyuki , Sato Masaaki , Yasui Takeshi , Takami Maki , Kawahara Takuya , Konoeda Chihiro , Nakajima Jun
Published: April 2022

OBJECTIVES

Even after transplantation of favourable donor lungs, some recipients require prolonged weaning from mechanical ventilation, indicating a poor prognosis. We investigated the effects of prolonged mechanical ventilation (PMV) for >14 days on the recovery and survival of patients who underwent cadaveric lung transplantation in relation to their physical traits.

METHODS

We retrospectively reviewed patients who underwent cadaveric lung transplantation (age ≥15 years) at a single centre between April 2015 and December 2020 and classified them into PMV and non-PMV groups (>14 and ≤14 days of mechanical ventilation postoperatively, respectively). The factors predicting PMV comprised clinical factors (e.g. marginal donor) and physical features, namely flat chest, narrow fourth intercostal space (length, <5 mm), mediastinal shift, thoracic mediastinal-occupying ratio (TMOR) >40% and sarcopenia, according to the logistic regression analysis. The log-rank test was used to examine the association between TMOR >40% and 3-year prognosis.

RESULTS

The PMV group comprised 17 (33%) of 51 recipients. Multivariable logistic analysis showed that the TMOR >40% (odds ratio, 7.3; 95% confidence interval, 1.3–40.1; P = 0.023) was an independent preoperative predictive factor for PMV postoperatively. Stepwise analysis revealed intraoperative extracorporeal membrane oxygenation and reoperation as postoperative predictive factors in addition to TMOR >40%. Recipients with TMOR >40% had significantly worse 3-year survival than other recipients (71.2% vs 100.0%, respectively; P = 0.008).

CONCLUSIONS

Recipients with a TMOR >40% may be long-term ventilator dependent and have a poor prognosis.
An exploration of hospital pharmacists’ engagement with sustainability policy in the NHS England
Authors: Singleton Judith A , Lau Esther T , Nissen Lisa M
Published: April 2022

Objectives

NHS England has set itself a target of net zero emissions by 2050. Therefore, to address this gap in the literature, this study aimed to explore engagement with NHS policy on carbon reduction (including awareness of the Sustainable Development Unit [SDU] and the Coalition for Sustainable Pharmaceuticals and Medical Devices [CSPM]) in NHS hospital pharmacists in England.

Methods

Semi-structured interviews were conducted with 23 pharmacists working in six NHS England hospitals across all hierarchical levels. Four interview questions elicited Yes/No responses and one generated qualitative data which were analysed by two methods – Leximancer and manual coding.

Key Findings

Only five (5/23; 21.74%) had heard of the SDU and none knew its purpose. Those who did not wish to learn more about the SDU could not see its relevance to their clinical practice. Barriers identified to the inclusion of sustainability considerations in clinical decision-making were lack of knowledge of the environmental risk profiles for treatment options, lack of quality environmental evidence incorporated into clinical guidelines and lack of time to research for themselves. Many participants did not believe that environmental considerations were part of their job.

Conclusions

For NHS England to successfully deliver on its target of net zero emissions by 2050, immediate action is required from all hospital staff, clinicians included. The challenge for the NHS will be engaging pharmacists and other clinicians with sustainable clinical practice and working with clinicians to reduce identified barriers. As these data were collected in 2016, further research is warranted to determine if pharmacists’ attitudes towards sustainable practice are changing.
Temporal instability of curved viscous fibers with a radial electric field
Authors: Alsharif Abdullah M , Părău Emilian I
Published: April 2022

One-dimensional equations are derived for a rotating viscous slender liquid jet in a radial electric field using asymptotic methods. The trajectory of the curved Newtonian liquid jets is found by solving the nonlinear one-dimensional equations. The temporal instability of the steady solutions is analysed. It was found that the electric force enhances the growth rate and increases its corresponding maximum wavenumber.
Deciphering the Molecular Mechanisms of Insecticide Resistance From the Transcriptome Data of Field Evolved Spinosad Resistant and Susceptible Populations of Plutella xylostella (Lepidoptera: Plutellidae)
Authors: Agrawal Aditi , Ramasamy Gandhi Gracy , Pathak Jyoti , Nayyar Nishtha , Muthugounder Mohan , Maria Pratheepa , Rai Anil , Thiruvengadam Venkatesan
Published: April 2022

Diamondback moth, Plutella xylostella is a serious pest of cruciferous vegetables and causes substantial economic loss all over the world. This study was undertaken to decipher the molecular mechanisms involved in the field evolved insecticide resistance in P. xylostella upon exposure to spinosad. To do so, spinosad-resistant and susceptible larval populations were subjected to transcriptome analysis using Illumina paired-end sequencing. De novo assembly was generated from raw reads of both the samples which resulted in the identification of 41,205 unigenes. Functional annotation and digital gene expression analysis were carried out to determine the differentially expressed genes. 1,348 unigenes were found to have a significant differential expression in the resistant population. Several genes involved in insecticide resistance like CYP P450, GSTs, small heat shock protein, and UDP glycosyltransferase were found to be up-regulated while genes related to mitochondrial energy metabolism and cuticular processes were down-regulated. Further, gene mining and phylogenetic analysis of two important gene families namely, CYP and GSTs were performed and the results revealed that these genes could play a major role in the development of field evolved spinosad resistance in P. xylostella by gene duplication and differential gene expression.
A pilot study examining the efficacy of hochuekkito for improving quality of life in patients with myeloproliferative neoplasms
Authors: Edahiro Yoko , Koike Michiaki , Nojiri Shuko , Harada Yoshinao , Gotoh Akihiko , Fujibayashi Kazutoshi , Nishizaki Yuji , Yanagisawa Naotake , Takaku Tomoiku , Nitta Hideaki , Tsukune Yutaka , Misawa Kyohei , Kobayashi Hiroyuki , Komatsu Norio
Published: April 2022

Background

The prognosis of Philadelphia chromosome-negative myeloproliferative neoplasms is relatively favorable, but the quality of life can be severely affected by myeloproliferative neoplasm-related symptoms such as fatigue, pruritus, night sweats, bone pain, fever and weight loss. In this study, we administered hochuekkito, a traditional herbal medicine, to patients with myeloproliferative neoplasms and investigated whether there was a reduction in myeloproliferative neoplasm-related symptoms.

Methods

We conducted a randomized parallel-group pilot study. Patients were assigned to a hochuekkito administration or non-hochuekkito administration group. Myeloproliferative neoplasm-related symptoms based on Myeloproliferative Neoplasm Symptom Assessment Form total symptom score and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 were examined before hochuekkito administration and 4 and 8 weeks after administration.

Results

Among the 42 patients included in the analysis, 21 were assigned to the hochuekkito group and 21 were assigned to the control group. After administering hochuekkito, the median values of Myeloproliferative Neoplasms Symptom Assessment Form total symptom score at 4 and 8 weeks in the hochuekkito group demonstrated a decreasing trend; however, the difference between the two groups was not significant.

Conclusions

In this study, we were unable to demonstrate significant differences between the hochuekkito and control groups in terms of the efficacy of hochuekkito in treating myeloproliferative neoplasm-related symptoms. However, there were cases that presented prominent improvement in symptoms in the hochuekkito group. The only reported adverse event was grade 1 impaired hepatic function. Therefore, hochuekkito might be a therapeutic option for patients with severely affected quality of life due to myeloproliferative neoplasm-related symptoms.
Rotator cuff tear with scapular dyskinesis treated with a pectoralis major transfer and rotator cuff repair: a case report
Authors: Figueras Jorge H , Sabbagh Ramsey S , Thomson Cameron G , Shah Nihar S , Kuechly Henry A , Mennenga Ashley , Grawe Brian
Published: April 2022

We report a 45-year-old man who presented with a rotator cuff tear and scapular dyskinesis of his left shoulder and underwent a pectoralis major split transfer with an allograft to the inferior border of his scapula. The patient reported significant improvement in shoulder function and decreased severity of his scapular dyskinesis. Combined arthroscopic rotator cuff repair and allograft scapula stabilization is a novel technique for the unusual clinical presentation reported in this case report. To the best of our knowledge, this is the first reported surgical management of a patient with rotator cuff repair and non-palsy-related scapular dyskinesis.
Effectiveness of combination tocilizumab and glucocorticoids as an induction therapy in patients with Takayasu arteritis: An observational study
Authors: Yoshida Shuhei , Suzuki Eiji , Matsumoto Haruki , Yokose Kohei , Fujita Yuya , Temmoku Jumpei , Matsuoka Naoki , Yashiro-Furuya Makiko , Asano Tomoyuki , Sato Shuzo , Watanabe Hiroshi , Migita Kiyoshi
Published: April 2022

Background

The efficacy of tocilizumab (TCZ) in the treatment of Takayasu arteritis (TA) was demonstrated in randomized controlled trials. The objective of this study was to analyse the effectiveness of combining TCZ with glucocorticoids (GC) as induction therapy in patients with TA.

Method

This was a retrospective observational study including 32 patients with newly diagnosed TA. Clinical effectiveness of TCZ in maintaining relapse-free remission and GC-tapering were compared between patients who were treated with TCZ plus GC and those who were treated with GC with or without immunosuppressants.

Results

The study comprised 32 patients (27 women/5 men) with a median age of 25.5 years (range, 13–72). In the TCZ group (n = 14), patients received TCZ in combination with GC as an induction therapy. In the non-TCZ group (n = 18), patients were treated with single-agent GC or GC plus immunosuppressant. In the matched analysis, relapse-free survival rate was significantly higher in the TCZ group as compared to the non-TCZ group during GC taper.

Conclusion

TCZ, in combination with GC, would be an effective alternative induction regimen for patients with TA.
Giant Cell Tumor of Bone: Effect of Longer Dosing Intervals of Denosumab on Tumor Control and Bone-related Complications
Authors: Jiang Cindy Y , Zhao Lili , Schuetze Scott M , Chugh Rashmi
Published: April 2022

Background

Denosumab is an effective treatment for giant cell tumor of the bone (GCTB) but can cause clinically significant adverse effects. Current approved dosing is every 4 weeks after 3 weekly loading doses. We assessed whether alternative, longer dosing intervals are associated with differences in efficacy or bone toxicity.

Methods

Single institution retrospective chart review was conducted on patients with GCTB over 18 years old who received at least 1 year of standard denosumab dosing. Patients identified using a free-text search engine with keywords “giant cell tumor” and “denosumab” from January 1998 to August 2020.

Results

Approximately 37 patients with GCTB (19F, 18M) were identified with median age of 37 years (range 22-73). Dosing interval was increased in 38% (n = 14), with the most common final dosing interval 12 weeks (n = 8). Six patients (16%) had bone complications: osteonecrosis of the jaw (n =5), atypical fracture (n = 1), and nonhealing dental wounds (n = 2). All patients with bone complications were on the monthly dosing schedule, but there was no statistically significant difference compared to longer dosing intervals (P = .22). No statistically significant difference in median PFS was noted (P = .97). However, 5-year PFS was superior in patients treated with less frequent versus standard dosing of denosumab (P = .036).

Conclusions

Increasing the interval of denosumab dosing for GCTB provided similar tumor control compared to standard dosing and lower absolute number of bone toxicity events. Larger studies are needed to better define the optimal interval of denosumab administration and the effect on efficacy, toxicity, and associated healthcare expense.
Hippocampal Subfield Volumes Predict Disengagement from Maintenance Treatment in First Episode Schizophrenia
Authors: Qi Wei , Marx Julia , Zingman Michael , Li Yi , Petkova Eva , Blessing Esther , Ardekani Babak , Sakalli Kani Ayse , Cather Corinne , Freudenreich Oliver , Holt Daphne , Zhao Jingping , Wang Jijun , Goff Donald C
Published: April 2022

Objectives

Disengagement from treatment is common in first episode schizophrenia (FES) and is associated with poor outcomes. Our aim was to determine whether hippocampal subfield volumes predict disengagement during maintenance treatment of FES.

Methods

FES patients were recruited from sites in Boston, New York, Shanghai, and Changsha. After stabilization on antipsychotic medication, participants were randomized to add-on citalopram or placebo and followed for 12 months. Demographic, clinical and cognitive factors at baseline were compared between completers and disengagers in addition to volumes of hippocampal subfields.

Results

Baseline data were available for 95 randomized participants. Disengagers (n = 38, 40%) differed from completers (n = 57, 60%) by race (more likely Black; less likely Asian) and in more alcohol use, parkinsonism, negative symptoms and more impairment in visual learning and working memory. Bilateral dentate gyrus (DG), CA1, CA2/3 and whole hippocampal volumes were significantly smaller in disengagers compared to completers. When all the eight volumes were entered into the model simultaneously, only left DG volume significantly predicted disengagement status and remained significant after adjusting for age, sex, race, intracranial volume, antipsychotic dose, duration of untreated psychosis, citalopram status, alcohol status, and smoking status (P < .01). Left DG volume predicted disengagement with 57% sensitivity and 83% specificity.

Conclusions

Smaller left DG was significantly associated with disengagement status over 12 months of maintenance treatment in patients with FES participating in a randomized clinical trial. If replicated, these findings may provide a biomarker to identify patients at risk for disengagement and a potential target for interventions.
Ritualizing Nonreligion: Cultivating Rational Rituals in Secular Spaces
Authors: Frost Jacqui
Published: April 2022

As the religious landscape in the United States continues to change, and as more Americans leave organized religion, scholars have raised important questions about the role of ritual in secular spaces and whether or not religious decline will result in a decline in meaningful ritual practices. As ritual is often conflated with religion, it is often also assumed that nonreligious people are uninterested in rituals because they are committed to science, rationality, and materialism. And many believe this means that the nonreligious live “disenchanted” lives with no means for experiencing greater meaning, transcendence, or spirituality. Drawing on an ethnographic case study of ritual creation at a secular congregation called the Sunday Assembly, I disrupt these presumed dichotomies between rationality/ritual and science/spirituality. I show how atheists and agnostics at the Sunday Assembly are secularizing religious rituals, as well as creating new secular rituals, by relying on the scientific method and a trial-and-error approach to ritual creation. In doing so, they are producing experiences of transcendence, collective effervescence, and “secular spirituality.” And I show how these “rational rituals” are often seen by nonreligious people as being more meaningful than religious rituals because of the work that goes into their creation. I argue that the Sunday Assembly is an illustrative case for shedding new light on the ritual creation process, and my findings contribute to discussions about how nonreligious people negotiate what many assume are conflicting discourses of science and religion as they create meaningful secular rituals.
Impairments in glycemic control during Eastbound transatlantic travel in healthy adults
Authors: Blankenship Jennifer M , Vetter Céline , Broussard Josiane L
Published: April 2022

Study Objectives

Repeated bouts of circadian misalignment impair glucose tolerance. However, whether circadian misalignment associated with travel and jet lag impair glucose homeostasis in a free-living population is not known. The goal of the present study was to examine glycemic control during one week of Eastbound transatlantic travel in healthy men and women.

Methods

Seven healthy participants (5 women; age: 35.6 ± 2.5 years, BMI: 23.9 ± 2.4 m/kg2) traveled from Colorado, USA (GMT-7) to Europe (GMT and GMT+1) and wore a continuous glucose monitor (Freestyle Libre Pro) for 8–14 days before, during, and after travel. Indices of glycemic control were summarized over 24-hour periods and by day and night.

Results

Mean glucose, peak glucose, and time spent in hyperglycemia increased linearly throughout the travel period relative to baseline levels. Mean glucose concentrations rose 1.03 mg/dL (95% CI: 0.34, 1.74) and duration of hyperglycemia increased by 17 min (95% CI: 5.5, 28.6) each 24-hour period. Increases in 24-hour glucose were primarily driven by increases in daytime parameters with rising mean glucose (0.72 mg/dL per day, [95% CI: −0.1, 1.5]) and duration of hyperglycemia (13.2 min per day [95% CI: 4.3, 22.1]). Mean glucose, but not peak glucose or time spent in hyperglycemia, increased each night (0.7 mg/dL per night [95% CI: 0.2, 1.2]).

Conclusions

Eastbound transatlantic travel induced a progressive worsening of glucose metrics during 24-hour, day, and night periods. Future research on managing glycemic control during jet lag in people with metabolic disorders is warranted.

Clinical Trial Registration

None
Wnt Signaling in the Adult Hippocampal Neurogenic Niche
Authors: Arredondo Sebastian B , Valenzuela-Bezanilla Daniela , Santibanez Sebastian H , Varela-Nallar Lorena
Published: April 2022

The subgranular zone (SGZ) of the hippocampal dentate gyrus (DG) is a neurogenic niche of the adult brain that contains neural stem cells (NSCs) able to generate excitatory glutamatergic granule neurons, which integrate into the DG circuit and contribute to hippocampal plasticity, learning, and memory. Thus, endogenous NSCs could be harnessed for therapeutic purposes. In this context, it is critical to characterize the molecular mechanisms controlling the generation and functional integration of adult-born neurons. Adult hippocampal neurogenesis is tightly controlled by both cell-autonomous mechanisms and the interaction with the complex niche microenvironment, which harbors the NSCs and provides the signals to support their maintenance, activation, and differentiation. Among niche-derived factors, Wnt ligands play diverse roles. Wnts are secreted glycoproteins that bind to Frizzled receptors and co-receptors to trigger the Wnt signaling pathway. Here, we summarize the current knowledge about the roles of Wnts in the regulation of adult hippocampal neurogenesis. We discuss the possible contribution of the different niche cells to the regulation of local Wnt signaling activity, and how Wnts derived from different cell types could induce differential effects. Finally, we discuss how the effects of Wnt signaling on hippocampal network activity might contribute to neurogenesis regulation. Although the evidence supports relevant roles for Wnt signaling in adult hippocampal neurogenesis, defining the cellular source and the mechanisms controlling secretion and diffusion of Wnts will be crucial to further understand Wnt signaling regulation of adult NSCs, and eventually, to propose this pathway as a therapeutic target to promote neurogenesis.
RNA Viral Communities Are Structured by Host Plant Phylogeny in Oak and Conifer Leaves
Authors: ter Horst Anneliek M. , Fudyma Jane D. , Bak Aurélie , Hwang Min Sook , Santos-Medellín Christian , Stevens Kristian A. , Rizzo David M. , Al Rwahnih Maher , Emerson Joanne B.
Published: April 2022

Wild plants can suffer devastating diseases, experience asymptomatic persistent infections, and serve as reservoirs for viruses of agricultural crops; however, we have a limited understanding of the natural plant virosphere. To access representatives of locally and globally distinct wild plants and investigate their viral diversity, we extracted and sequenced double-stranded RNA from leaves from 16 healthy oak and conifer trees in the University of California–Davis Arboretum (Davis, CA, U.S.A.). From de novo assemblies, we recovered 389 RNA-dependent RNA polymerase gene sequences from 384 putative viral species, and identified 580 putative viral contigs via virus prediction software followed by manual confirmation of virus annotation. Based on similarity to known viruses, most recovered viruses were predicted to infect plants or fungi, with the highest diversity and abundance observed in the Totiviridae and Mitoviridae families. Phyllosphere viral community composition differed significantly by host plant phylogeny, suggesting the potential for host-specific viromes. The phyllosphere viral community of one oak tree differed substantially from other oak viral communities and contained a greater proportion of putative mycoviral sequences, potentially due to the tree's more advanced senescence at the time of sampling. These results suggest that oak and conifer trees harbor a vast diversity of viruses with as-yet-unknown roles in plant health and phyllosphere microbial ecology.

[Formula: see text] Copyright © 2022 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
A Survey for Viruses and Viroids of Peach in Tennessee Orchards by RNA Sequencing
Authors: Dias Naymã P. , Hu Rongbin , Hensley Darrell D. , Hansen Zachariah R. , Domier Leslie L. , Hajimorad M. R.
Published: April 2022

The prevalent viruses and viroids in a population of 100 peach trees grown in Tennessee (TN) orchards were investigated by RNA sequencing and analysis of a pool of ribosomal-depleted total RNA derived from these plants. The sequences of nine viruses (cherry green ring mottle virus; cherry necrotic rusty mottle virus; grapevine-associated ilarvirus, GaIV; nectarine virus M, NeVM; Prunus necrotic ringspot virus, PNRSV; tomato mosaic virus, ToMV; tomato ringspot virus, ToRSV; turnip vein-clearing virus, TVCV; and white clover mosaic virus, WClMV) and one viroid (peach latent mosaic viroid, PLMVd) were detected. The presence of ToMV, PNRSV, NeVM, ToRSV and PLMVd sequences were confirmed in the original samples by RT-PCR followed by Sanger sequencing. This study represents the first survey of viruses and viroids of peach trees in TN orchards. To the best of our knowledge, ToMV, NeVM, GaIV, TVCV, and WClMV have not been reported previously associated with peach trees elsewhere in the world.
Clinical implementation of long-acting antiretroviral treatment in high-income countries: challenges and advantages
Authors: Waters Laura , Sparrowhawk Alex
Published: April 2022

Purpose of review

Long-acting antiretroviral therapy (LA-ART) brings a paradigm shift to HIV care with injectable cabotegravir/rilpivirine (IM-CAB/RPV) in current or imminent use in several countries. This brings the usual opportunities and challenges of a new therapy, plus requirements to adapt services to reliably deliver injections and ensure patients understand advantages and limitations. We summarise key considerations for implementation in high-income countries.

Recent findings

Monthly IM-CAB/RPV is noninferior to oral ART and monthly IM-CAB/RPV to 1-monthly in carefully selected virally suppressed people. The numerically higher virological failure rate on two-monthly IM-CAB/RPV warrants close attention and careful monitoring. Implementation projects report positive experiences for patients and staff, but also barriers. Data is needed in younger people, pregnancy/breastfeeding, and in those with detectable viraemia secondary to suboptimal adherence.

We highlight a paucity of real-world data and key unanswered questions. Existing data on injection techniques may have implications for training; monitoring of outcomes is crucial to ensure clinical trial results are replicated in real-life. Better understanding of treatment failure, and individualised therapy, is crucial, and it is important to repeat patient preference surveys as new data emerges to ensure decisions are based on the most recent evidence of benefit vs risk.
An exploration of how broadly neutralizing antibodies might induce HIV remission: the ‘vaccinal’ effect
Authors: Tipoe Timothy , Fidler Sarah , Frater John
Published: April 2022

Purpose of review

Broadly neutralizing antibodies (bNAbs) are a potential new therapeutic strategy to treat HIV infection. This review explores possible mechanisms of action of bNAbs and summarizes the current evidence supporting their immunomodulatory properties, which might lead to sustained virological remission – the ‘vaccinal effect’.

Recent findings

Antiretroviral therapy (ART) is required to confer lasting HIV suppression; stopping ART almost invariably leads to HIV recrudescence from a persistent pool of virally infected cells – the HIV reservoir. HIV-specific broadly neutralizing antibodies (bNAbs) may confer viral control after ART cessation predominantly through blockade of viral entry into uninfected target cells. In some human and animal studies, HIV bNAbs also conferred lasting viral suppression after therapeutic bNAb plasma levels had declined. Immune-modulatory mechanisms have been postulated to underlie this observation – the ‘vaccinal effect’. Hypothesized mechanisms include the formation of immune complexes between bNAbs and HIV envelope protein, thereby enhancing antigen presentation and uptake by immune cells, with boosted adaptive immune responses subsequently controlling the HIV reservoir.

There is emerging evidence for potent antiviral efficacy of bNAb therapy. Whether bNAbs can induce sustained viral suppression after dropping below therapeutic levels remains controversial. Mechanistic data from on-going and future clinical trials will help answer these questions.
Implementation of long-acting antiretroviral therapy in low-income and middle-income countries
Authors: Cresswell Fiona V. , Lamorde Mohammed
Published: April 2022

Purpose of review

With oral antiretroviral therapy, HIV has become a manageable chronic illness. However, UNAIDS targets for virologic suppression have not yet been attained in many low-income and middle-income countries (LMICs). Long-acting drug formulations hold promise to improve treatment outcomes. In this rapidly evolving area of research, we aim to review recent literature on the treatment of HIV with long-acting agents and identify implementation considerations for LMICs.

Recent findings

Randomized controlled trials have shown that monthly long-acting injectable cabotegravir (CAB) and rilpivirine (RPV) is noninferior to oral ART, and 2-monthly CAB/RPV is noninferior to monthly injections. However, few people from LMICs were included. A modelling study predicts that in sub-Saharan Africa, injectable CAB/RPV is best targeted to those with poor adherence (HIV viral load >1000 copies/ml) in whom cost-effectiveness is greatest and risk of contributing to further resistance is no greater than continuation of oral ART. Other promising agents, such as lenacapavir are under investigation and may prove particularly useful in heavily treatment-experienced adults.

Long-acting regimens are a promising advance in HIV treatment. By extending the dosing interval, increasing convenience and being discreet these regimens may reduce HIV treatment challenges. However, there are multiple implementation considerations in LMICs including the need for exclusion of hepatitis B, cold chain, oral bridging in case of missed dosing and switching during tuberculosis therapy. Efficacy and safety data are also awaited for settings without routine access to baseline resistance testing or regular viral load monitoring and for special populations, such as pregnancy, children and the elderly.
Immigrant-Related Policies and the Health Outcomes of Latinx Adults in the United States: A Systematic Review
Authors: Crookes Danielle M. , Stanhope Kaitlyn K. , Suglia Shakira F.
Published: April 2022

Background:

US federal and subfederal immigrant-related policy activity has increased in recent years. We hypothesize that these policies are structural determinants of health for Latinx communities, operating through access to resources, discriminatory enforcement, and stress.

Methods:

We searched seven databases for quantitative studies, published as of September 2021, examining the association between the presence of federal, state, or local immigrant-related policy(ies), over time or cross-sectionally, and mental or physical health outcomes among immigrant or US-born Latinx adults. We rated studies on methodologic quality.

Results:

Eleven studies were included. Policies included federal and state policies. Health outcomes included mental health (seven studies), self-rated health (n = 6), and physical disability (n = 1). Among immigrant, noncitizen, or Spanish-preferring Latinx adults, exclusionary policies were associated with poor self-rated health, physical disability, and poor mental health. Inclusive policies were associated with better health, although null findings were more common than among studies of exclusionary policies. Only three studies separately examined policy effects on US-born or citizen Latinx adults and these findings were often null. All studies received a weak overall study quality rating; among quality domains, studies were strongest in confounding control and weakest in outcome information bias and reporting missing data approaches.

Conclusions:

These results support the hypothesis that immigrant-related policies, especially exclusionary policies, are structural drivers of health for immigrant or noncitizen Latinx adults. However, evidence is scant among US-born or citizen Latinx adults. Studies of policies and physical health outcomes besides disability are lacking, as are results disaggregated by nativity and/or citizenship status.
Buspirone, a 5-HT1A agonist attenuates social isolation-induced behavior deficits in rats: a comparative study with fluoxetine
Authors: Aswar Urmila , Shende Hrudaya , Aswar Manoj
Published: April 2022

Social isolation is a potent stressor in both humans and animals that results in increased anger-like emotion, (anger in humans), aggression and suicidal ideation in humans [suicidal trait-related behavior in rats (STRB)]. The study’s purpose was to compare the effects of buspirone (BUS) and fluoxetine (Flx) on social isolation-induced behavior deficits in rats. The male Wistar rats were randomized into six groups and caged individually for 14 days except for the non stress control (nSC) group. They were then divided into the following groups, stress control (SC), Flx (30), BUS (10), BUS (20) and BUS (40) and treated from day 14 to day 28. On the last day of treatment behavior parameters were recorded. Serum cortisol, blood pressure (BP) measurement, magnetic resonance imaging (MRI) of the rat’s brain and brain-derived neurotrophic factor (BDNF) expression were performed. SC group showed a significant increase in anger-like emotion, aggression, irritability score, learned helplessness, increased cortisol level and reduced BDNF. These behavioral deficits were attenuated by BUS and Flx, Both were found to be equally beneficial in preventing anger-like emotions and aggression. Flx, which has been found to promote suicidal thoughts in people, did not reduce irritability in rats, showing that it did not affect it. BUS significantly improved all behavioral traits also reduced cortisol levels, significantly increased BDNF and normalized BP. Neuroimaging studies in SC brains showed a reduction in amygdala size compared to nSC, BUS treatment mitigated this reduction. Buspirone is effective in preventing social isolation induced behavioural-deficits.
Interprofessional Collaboration to Optimize Trauma-Informed Care in Pediatric Forensics
Authors: Morris Kristen A. , Glover Stephanie , Neff Samantha
Published: April 2022

There are many challenges in providing trauma-informed healthcare to pediatric victims of sexual abuse and their families. We address this through collaborative interprofessional efforts within our hospital facility, located in a Midwestern adult Level 1 and pediatric trauma center. Our sexual assault nurse examiner team is composed of eight nurses and provides 24/7 coverage. The child abuse team located in our hospital includes one board-certified child abuse pediatrician, one certified pediatric nurse practitioner, and a licensed clinical social worker. The application of trauma-informed care using case scenarios involving both teams is described in this article.
Utilization of Improvement Methodologies by Healthcare Quality Professionals During the COVID-19 Pandemic
Authors: Pesch Lucie , Stafford Terry , Hunter Jaclyn , Stewart Glenda , Miltner Rebecca
Published: April 2022

Introduction:

This study describes the work of healthcare quality professionals during the COVID-19 pandemic, highlighting the successes and challenges they faced when applying their expertise in performance and process improvement (PPI) to help manage the crisis.

Methods:

The researchers performed a descriptive analysis of anonymous survey data collected from members of the National Association for Healthcare Quality professional community who were asked about their improvement work during the pandemic response.

Results:

Most survey respondents used improvement methods to a great or moderate extent to measure what was happening (83%), rapidly review processes and practice (81%), and decide where to focus effort (81%). Fewer respondents used PPI methods to engage with patients and families (58% to a great or moderate extent). Looking to the future, respondents indicated that embedding systematic approaches to improvement within healthcare organizations (59%) and working in a more integrated way across teams (48%) should be prioritized in the post-pandemic recovery.

Conclusions:

The results from this study demonstrate why healthcare leaders should recognize the value that performance improvement approaches provide to everyday operations. They must empower PPI experts to lead this critical work and continue building workforce capacity in PPI methods to strengthen staff engagement and achieve better outcomes.