bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of a Defusion Exercise Including a Hierarchical Procedure on Depressive Rumination
Authors: Shigemoto Yuki , Stewart Ian , Muto Takashi
Published: June 2024

This study examined the effect of a defusion exercise with a hierarchical procedure in the context of depression, depressive rumination, and behavioral inflexibility. A total of 38 undergraduates were randomly assigned to either a defusion or control group. All participants answered questionnaires and engaged in a behavioral flexibility task before and after intervention. For the intervention, the defusion group engaged in a hierarchical defusion procedure. They sorted their depressive private events into either thoughts, feelings, or sensations, and all of them were integrated to “depression.” Subsequently, they engaged in word‐repetition exercises for “depression.” The control group read an emotionally neutral article on Japanese culture for 5 min. Results showed that the defusion exercise decreased cognitive fusion regarding depression. However, it did not decrease depressive rumination or promote behavioral flexibility. These results suggest that adjustments in the implementation of defusion exercises and other interventions may be necessary to reduce depressive rumination and promote behavioral flexibility.
Patriarchy, development, and the divergence of women's empowerment
Authors: Davis Lewis
Published: June 2024

How do culture and development interact to determine women's empowerment? I develop a simple model of women's labor supply in which economic development simultaneously reduces the stigma against women working and relaxes the consumption constraint that often forces poor women to work. The model predicts that women's labor supply will follow a U‐shaped relationship, falling and then rising as development proceeds. In addition, in countries with more patriarchal values, women's labor supply will be lower, fall over a greater income range, and then rise more slowly on the upward sloping portion of the curve. I investigate and confirm these predictions in a broad sample of countries employing six different measures of historical patriarchy as well as a composite measure of patriarchal history. These findings indicate that as economic development proceeds, women's labor supply will diverge across countries as differences in the intensity of patriarchal values play an ever larger role in the allocation of women's labor.
A case of SBMA presenting with myasthenic syndrome limited to a dropped head
Authors: Sumikura Hiroyuki , Hatayama Naoki , Fujioka Tomohiro , Nagashima Nozomi , Shimada Yuki , Fukasaka Isao , Sakaguchi Manabu
Published: June 2024

A 76‐year‐old man with spinal and bulbar muscular atrophy (SBMA) developed an acute course of the dropped head with diurnal fluctuations that worsened in the evening. He was diagnosed with myasthenic syndrome based on a decreased response to repeated stimulation, as well as increased jitter and blocking on single‐fiber electromyography, indicating disturbed neuromuscular transmission. Dropped head symptom was successfully alleviated and maintained by immunotherapy. Although limited reports are available on SBMA cases accompanied by myasthenic syndrome and on the clinical impact of impaired neuromuscular transmission on SBMA, myasthenic syndrome may be a common condition and even a part of the phenotypic spectrum of SBMA. To our knowledge, this is the first case of SBMA comorbid with myasthenic syndrome limited to the dropped head.
A good therapeutic response to evocalcet for dropped head due to primary hyperparathyroidism: A case report
Authors: Sumikura Hiroyuki , Miyakawa Hiromitsu , Tomoda Takahiro , Sato Takuma , Ito Mai , Shimada Yuki , Ueda Yoshiyasu , Sakaguchi Manabu
Published: June 2024

An 83‐year‐old woman presented with an acute course of dropped head syndrome (DHS) with muscle weakness localized to the neck. Serum calcium and intact parathyroid hormone (iPTH) levels were elevated to 12.2 mg/dL and 173 pg/mL, respectively, and 99mTc‐MIBI scintigraphy showed a hyperfunctioning parathyroid gland. Electromyography revealed myopathic features in the posterior neck extensor muscles. Primary hyperparathyroidism (PHPT)‐associated myopathy was diagnosed as the cause of the DHS. Oral administration of evocalcet ameliorated DHS and normalized the elevated serum calcium levels, whereas iPTH levels remained elevated. Subsequently, parathyroidectomy reduced the iPTH level to normal, and DHS did not flare‐up. Cases of PHPT with DHS as the initial symptom are extremely rare, and to our knowledge, this is the first report of remission of DHS with evocalcet. Therefore, serum iPTH levels may not necessarily correlate with muscle weakness.
Maternal experiences of pregnant women affected by natural disasters: A modified grounded theory approach
Authors: Suzuki Satoko , Sato Naho , Miyazaki Misako
Published: June 2024

Pregnant women experience medical and psychological difficulties in their daily lives during disasters. Since the care provided to them in disaster situations is unclear, it is necessary to better understand their experiences. This study aims to identify the maternal experiences of pregnant women during natural disasters. This research employed a modified grounded theory approach. Twenty‐three pregnant women, living in disaster‐affected areas, were interviewed. The research methods were utilized and interpretive analysis was conducted, resulting in a diagram and storyline to describe the process. The characteristics of the maternal experiences fluctuated between “being unable to face pregnancy because of the disaster response” and “facing the fact of being pregnant.” To maintain a fluctuation between their affected life and their pregnant life, it was necessary to control the weighting between “securing a safe and secure place,” “encountering support based on pregnancy,” and “signs from the fetus.” Clarifying the maternal experiences of pregnant women living in disaster areas revealed a multilayered structure of categories and relationships. This study suggests that understanding the structure of fluctuations and control is critical for the nursing practice.
Depth of emotional experiencing and outcome in therapy with young people
Authors: Geyer Darcy , Lam Virginia , Gilbert Hannah , Cooper Mick
Published: June 2024

Objectives

To analyse the relationship between depth of emotional experiencing and outcomes in young people. We also wanted to understand whether ‘early’ or ‘working’ depth of emotional experiencing was most predictive of outcomes, and how these compared against alliance effects.

Design

Hierarchical linear regression analysis of data from a study of school‐based humanistic counselling (SBHC).

Methods

Data from 60 young people were used for the study across 15 schools: mean age 13.7 years old (range: 13–16); 67% female; 52% from Black, mixed or non‐white ethnicities. Depth of emotional experiencing was rated using the Client Experiencing Scale at session 1 (early EXP) and session 6 (working EXP). The dependent variable was changes in psychological distress from baseline to 12‐week follow‐up, as assessed by the Young Person's CORE.

Results

In our final model, working EXP accounted for 11.6% of the variance in YP‐CORE change scores after baseline YP‐CORE scores were taken into account. Early EXP and working alliance were not predictive of benefit. Sensitivity analyses indicated that working EXP was associated with benefits across a range of indicators.

Conclusions

Our findings show, for the first time, that depth of emotional experiencing has a significant and sizeable association with outcomes in therapy for young people. This is consistent with emerging evidence from the adult field. It suggests that practitioners working with young people should monitor the depth of emotional experiencing and foster methods for supporting its development.
The extended evolutionary synthesis: An integrated historical and philosophical examination
Authors: Shan Yafeng
Published: June 2024

Among biologists and philosophers, there is an ongoing debate over the Modern Synthesis and the Extended Evolutionary Synthesis. Some argue that our current evolutionary biology is in need of (at least) some substantial revision or nontrivial extension, while others maintain that the Modern Synthesis remains the foundational framework for evolutionary biology. It has been widely debated whether the Extended Evolutionary Synthesis provides a more promising framework than the Modern Synthesis. The nature and methodological implications of the Extended Evolutionary Synthesis were also examined. This paper offers an integrated historical and philosophical examination of the debate over the Extended Evolutionary Synthesis. It reviews the development of evolutionary biology of the twentieth century. It argues that there are substantial conceptual and theoretical differences between the Modern Synthesis and the Extended Evolutionary Synthesis, but they are not incommensurable paradigms in the Kuhnian sense. It also argues for a functional approach to the debate over these two frameworks of evolutionary theory.
Infinite inference and mathematical conventionalism
Authors: Blue Douglas
Published: June 2024

We argue that (1) a purported example of an infinite inference we humans can actually perform admits a faithful, finitary description, and (2) infinite inference contravenes any view which does not grant our minds uncomputable powers. These arguments block the strategy, dating back to Carnap's Logical Syntax of Language, of using infinitary inference rules to secure the determinacy of arithmetical truth on conventionalist grounds.
Repugnance at the limit
Authors: Cato Susumu , Harada Ko , Oshitani Ken
Published: June 2024

The implications of the repugnant conclusion for consequentialist theories, such as total utilitarianism, have been extensively discussed since the work of Derek Parfit. These discussions make the paradoxes of population ethics depend on welfarist conditions, like the dominance condition (or the Pareto Principle). Thus, one might think that the repugnant conclusion is not a practical problem for deontologists, who deny that we always ought to do what produces the most aggregate welfare. In this study, we offer two impossibility results using what we call the limit aggregation property. This states that when welfaristic and non‐welfaristic considerations conflict, there is a threshold number of persons such that the former can override the latter as long as more people than the threshold number can enjoy increases in well‐being levels. We argue that this property should be accepted even by deontologists, insofar as they do not commit themselves to the implausible absolutist position that fails to assign any moral weight to aggregate welfare. Our results therefore state that any normative population theory that is not absolutist entails (a variant of) the repugnant conclusion or some other implausible conclusion. Therefore, the repugnant conclusion must be taken seriously even by non‐absolutist deontologists, not just consequentialists.
Outpatient and inpatient dental care for patients with disabilities in Brazil's public healthcare system: A population‐based approach from 2014 to 2023
Authors: Gomes e Moura Ana Paula , Lima Ricardo Barbosa , de Queiroz Alexandra Mussolino , da Silva Léa Assed Bezerra , Segato Raquel Assed Bezerra
Published: June 2024

Aim

The aim of this study was to evaluate outpatient and inpatient dental care for patients with disabilities from 2014 to 2023.

Material and methods

A time series analysis was carried out with data from Brazil's public healthcare system, considering the outpatient productivity of Special Needs Dentistry specialists and hospitalizations (inpatient admissions) of patients with disabilities for dental procedures, both normalized to every 100,000 inhabitants (incidence). The significance level was set at 5%.

Results

In the last 10 years, 22,420,859 procedures were carried out and 89,380 hospitalizations were approved. Trend analysis showed no significant temporal variation in the incidence of both variables. Regarding the procedures, the majority were low‐complexity (82.1%, p < .001) and clinical (71.2%, p < .001). Periodontal (19.9%) and restorative (19.5%) procedures were the most frequent. Considering the hospitalizations, almost (R$) 40 million was allocated, and the majority were classified as elective (71.9%, p = .002) and of short duration (less than a day).

Conclusion

Dental care for patients with disabilities presented patterns related to the types of procedures, complexity and circumstance, in addition to not showing significant temporal variation over the last 10 years.
Periocular fibrosarcoma with lipogranulomatous conjunctivitis in a cat
Authors: Foster T. M. , Newbold G. M. , Miller E. J. , Jeong Y. J. , Premanandan C. , Husbands B. D.
Published: June 2024

A 9‐year‐old, female spayed domestic short‐haired cat was presented with a 4‐year history of bilateral lipogranulomatous conjunctivitis (LGC), which was confirmed via histopathology. Thirteen months following the initial biopsy, the cat was presented with a rapidly progressive mass lesion of the palpebral conjunctiva of the right eye. A surgical debulking, followed 1 month later by exenteration after marked regrowth of the mass confirmed fibrosarcoma. This case report is the first to describe a cat with chronic bilateral LGC that later developed a unilateral fibrosarcoma within the eyelid tissue of the right eye. Fibrosarcoma should be considered a differential in any cat with chronic LGC that develops a rapidly progressive mass in the eyelid.
Effect of Heat Exchanger and Capillary Geometry on the Performance of Joule–Thomson Refrigerators Operating With Different Mixtures
Authors: Dasari Venkatesh , Venkatarathnam G.
Published: June 2024

Joule–Thomson (J–T) refrigerators or J–T cryocoolers are extensively used in many low-temperature applications. J–T refrigerators operating with nitrogen–hydrocarbon (N2-HC) refrigerant mixtures offer several advantages, such as low operating pressures (<20 bar), high exergy efficiency, no moving parts in the cold section, and low cost. The cooling power or cooling capacity of the J–T refrigerator depends on the hardware used as well as the refrigerant composition. The proposed work focuses on estimating the cooling capacity of a mixed refrigerant J–T (MRJ–T) refrigerator of the given hardware and specified refrigerant. An iterative steady-state full-cycle simulation procedure has been presented in this work to simulate the complete system and estimate the cooling capacity, taking into account the possibility of choking of the expansion capillary. Some of the results have been validated against experimental results of an MRJ–T refrigerator available in the open literature. Details of the simulation model and the results of our studies on the prediction of stable operating range, maximum cooling capacity, the effect of heat exchanger geometry, expansion capillary geometry, mixture composition, and choking of the refrigerant mixture on the performance of an MRJ–T refrigerator are presented in this article.
A Mathematical Modeling of Computer Numerical Control Skiving Process for Manufacturing Helical Face Gears Using Sensitivity Matrix Combined With Levenberg–Marquardt Algorithm
Authors: Le Khoe-Qui , Wu Yu-Ren , Luu Trong-Thuan
Published: June 2024

Currently, numerous studies have applied gear skiving processes to produce face gear. However, there remains a significant challenge in achieving a flexible computing model for manufacturing a precise tooth surface for face gear. This study proposes a novel mathematical model that combines the cutter modification method and computer numerical control (CNC)-axis motion modification methods within a unified “closed-loop optimization.” This approach aims to enhance the tooth surface accuracy of skived helical face gears by determining optimal coefficients. Applying the Levenberg–Marquardt algorithm and sensitivity matrix enables the calculation of new polynomial coefficients, ensuring the attainment of gear surfaces with an accuracy grade of B6 (according to the ANSI/AGMA 2009-B01 standard) for each target surface. The proposed methodology involves the generation of a helical skiving cutter using a corrected rack. Subsequently, the cutting path on the CNC machine is optimized by incorporating additional motions expressed in polynomials. A comprehensive skiving simulation is conducted to achieve the desired face-gear surface, which is corrected by specified polynomial coefficients. The proposed model is validated through numerical and machining simulations using vericut software. The results affirm the practicality and efficacy of our approach in achieving the desired accuracy in producing helical face gears through power skiving processes.
Comparison of GeSn alloy films prepared by ion implantation and remote plasma-enhanced chemical vapor deposition methods
Authors: Huang X. , Lim S. Q. , Ratcliff T. , Smillie L. A. , Grzybowski G. J. , Claflin B. B. , Warrender J. M. , Williams J. S.
Published: June 2024

Thin films of germanium-tin (GeSn) alloy with Sn content well above its equilibrium solubility limit in Ge are produced using both remote plasma-enhanced chemical vapor deposition (RPECVD) directly on silicon substrates and ion implantation of Sn into Ge. For RPECVD, the growth temperature of 302 °C resulted in fully relaxed GeSn alloys with high defect density, principally threading dislocations related to the large lattice mismatch between Si and GeSn. For the implantation case, pulsed laser melting was used to melt and crystallize the GeSn layer on a time scale of a few tens of nanoseconds. The resulting GeSn layers were also relaxed and defective, presumably again as a result of lattice mismatch with the underlying Ge lattice. However, the nature of the defects was quite different to the RPECVD method, whereby the line defects were not threading dislocations but stackinglike defects, which developed into arrays of these defects in the high Sn content region close to the surface. For the purpose of comparing RPECVD and ion-implantation methods, alloy films of similar thickness (400–450 nm) and Sn content (4.5–6.5 at. %) were examined. Film parameters (thickness, Sn content, Sn solubility, and segregation), as well as film quality and defect structures, were examined for both fabrication methods using several analytical techniques. This comparison provided us with a better physical understanding of our GeSn films and will help inform future growth/fabrication strategies targeted at minimizing defects formed in the GeSn films for the realization of optoelectronic devices.
Characterizing Longitudinal Alterations in Postural Control Following Lower Limb Injury in Professional Rugby Union Players
Authors: McCarthy-Ryan Molly F. , Mellalieu Stephen D. , Jones Holly , Bruton Adam , Moore Isabel S.
Published: June 2024

Assessment of player’s postural control following a lower limb injury is of interest to sports medicine practitioners due to its fundamental role in daily tasks and sporting activities. The aim was to longitudinally monitor professional rugby union players’ postural control during each phase of the rehabilitation program (acute, middle, and late) following a lower limb injury. Seven male rugby union players (height 1.80 [0.02] m; mass 100.3 [11.4] kg; age 24 [4] y) sustained a time loss, noncontact lower limb injury. Static postural control was assessed via sway path (in meters), and dynamic postural control was assessed via vertical postural stability index. Group differences (P < .05) were reported across the acute, middle, and late phase. Smaller magnitudes of sway path were observed for eyes-open sway path, and for the middle and late phase smaller magnitudes of vertical postural stability index (P < .05) at the end session compared with first session. Whereas larger magnitudes of vertical postural stability index were found between baseline and the last session (P < .05). Large interindividual and intraindividual variation was apparent across the 3 phases of rehabilitation. Postural control improvements were identified during rehabilitation. However, postural control did not return to baseline, with altered kinetics throughout each rehabilitation phase.
MAIT cell activation and recruitment in inflammation and tissue damage in acute appendicitis
Authors: Zheng Yichao , Han Fei , Wu Zhengyu , Wang Bingjie , Chen Xingchi , Boulouis Caroline , Jiang Yuebin , Ho Amanda , He Dan , Sia Wan Rong , Mak Jeffrey Y. W. , Fairlie David P. , Wang Lin-Fa , Sandberg Johan K. , Lobie Peter E. , Ma Shaohua , Leeansyah Edwin
Published: June 2024

Mucosal-associated invariant T (MAIT) cells are antimicrobial T cells abundant in the gut, but mechanisms for their migration into tissues during inflammation are poorly understood. Here, we used acute pediatric appendicitis (APA), a model of acute intestinal inflammation, to examine these migration mechanisms. MAIT cells were lower in numbers in circulation of patients with APA but were enriched in the inflamed appendix with increased production of proinflammatory cytokines. Using the patient-derived appendix organoid (PDAO) model, we found that circulating MAIT cells treated with inflammatory cytokines elevated in APA up-regulated chemokine receptors, including CCR1, CCR3, and CCR4. They exhibited enhanced infiltration of
Escherichia coli
–pulsed PDAO in a CCR1-, CCR2-, and CCR4-dependent manner. Close interactions of MAIT cells with infected organoids led to the PDAO structural destruction and death. These findings reveal a previously unidentified mechanism of MAIT cell tissue homing, their participation in tissue damage in APA, and their intricate relationship with mucosal tissues during acute intestinal inflammation in humans.
Information-hiding cameras: Optical concealment of object information into ordinary images
Authors: Bai Bijie , Lee Ryan , Li Yuhang , Gan Tianyi , Wang Yuntian , Jarrahi Mona , Ozcan Aydogan
Published: June 2024

We introduce an information-hiding camera integrated with an electronic decoder that is jointly optimized through deep learning. This system uses a diffractive optical processor, which transforms and hides input images into ordinary-looking patterns that deceive/mislead observers. This information-hiding transformation is valid for infinitely many combinations of secret messages, transformed into ordinary-looking output images through passive light-matter interactions within the diffractive processor. By processing these output patterns, an electronic decoder network accurately reconstructs the original information hidden within the deceptive output. We demonstrated our approach by designing information-hiding diffractive cameras operating under various lighting conditions and noise levels, showing their robustness. We further extended this framework to multispectral operation, allowing the concealment and decoding of multiple images at different wavelengths, performed simultaneously. The feasibility of our framework was also validated experimentally using terahertz radiation. This optical encoder–electronic decoder-based codesign provides a high speed and energy efficient information-hiding camera, offering a powerful solution for visual information security.
Microglia promote maladaptive plasticity in autonomic circuitry after spinal cord injury in mice
Authors: Brennan Faith H. , Swarts Emily A. , Kigerl Kristina A. , Mifflin Katherine A. , Guan Zhen , Noble Benjamin T. , Wang Yan , Witcher Kristina G. , Godbout Jonathan P. , Popovich Phillip G.
Published: June 2024

Robust structural remodeling and synaptic plasticity occurs within spinal autonomic circuitry after severe high-level spinal cord injury (SCI). As a result, normally innocuous visceral or somatic stimuli elicit uncontrolled activation of spinal sympathetic reflexes that contribute to systemic disease and organ-specific pathology. How hyperexcitable sympathetic circuitry forms is unknown, but local cues from neighboring glia likely help mold these maladaptive neuronal networks. Here, we used a mouse model of SCI to show that microglia surrounded active glutamatergic interneurons and subsequently coordinated multi-segmental excitatory synaptogenesis and expansion of sympathetic networks that control immune, neuroendocrine, and cardiovascular functions. Depleting microglia during critical periods of circuit remodeling after SCI prevented maladaptive synaptic and structural plasticity in autonomic networks, decreased the frequency and severity of autonomic dysreflexia, and prevented SCI-induced immunosuppression. Forced turnover of microglia in microglia-depleted mice restored structural and functional indices of pathological dysautonomia, providing further evidence that microglia are key effectors of autonomic plasticity. Additional data show that microglia-dependent autonomic plasticity required expression of triggering receptor expressed on myeloid cells 2 (Trem2) and α2δ-1–dependent synaptogenesis. These data suggest that microglia are primary effectors of autonomic neuroplasticity and dysautonomia after SCI in mice. Manipulating microglia may be a strategy to limit autonomic complications after SCI or other forms of neurologic disease.
Spatio-temporal organization of the
E. coli
chromosome from base to cellular length scales
Authors: Royzenblat Sonya K. , Freddolino Lydia
Published: June 2024

Escherichia coli
has been a vital model organism for studying chromosomal structure, thanks, in part, to its small and circular genome (4.6 million base pairs) and well-characterized biochemical pathways. Over the last several decades, we have made considerable progress in understanding the intricacies of the structure and subsequent function of the
E. coli
nucleoid. At the smallest scale, DNA, with no physical constraints, takes on a shape reminiscent of a randomly twisted cable, forming mostly random coils but partly affected by its stiffness. This ball-of-spaghetti-like shape forms a structure several times too large to fit into the cell. Once the physiological constraints of the cell are added, the DNA takes on overtwisted (negatively supercoiled) structures, which are shaped by an intricate interplay of many proteins carrying out essential biological processes. At shorter length scales (up to about 1 kb), nucleoid-associated proteins organize and condense the chromosome by inducing loops, bends, and forming bridges. Zooming out further and including cellular processes, topological domains are formed, which are flanked by supercoiling barriers. At the megabase-scale both large, highly self-interacting regions (macrodomains) and strong contacts between distant but co-regulated genes have been observed. At the largest scale, the nucleoid forms a helical ellipsoid. In this review, we will explore the history and recent advances that pave the way for a better understanding of
E. coli
chromosome organization and structure, discussing the cellular processes that drive changes in DNA shape, and what contributes to compaction and formation of dynamic structures, and in turn how bacterial chromatin affects key processes such as transcription and replication.
Headache, dizziness, and leg weakness with multiple cerebral nodules
Authors: Liang Ni , Li Liang-Ming , Fan Yi-Ming
Published: June 2024

Read the full article for the answer.
Supplemental Material: Joint flexural-density modeling of the Taltal, Copiapó, and Iquique hotspot ridges and the surrounding oceanic plate, offshore Chile
Authors: Maksymowicz Andrei , al. et
Published: June 2024

Details of the analytic definition of elastic thickness, joint flexural-density models of all individual profiles, and maps of the magnetic anomalies and modeled elastic thickness.
Challenges of managing anomalous mitral arcade with severe mitral regurgitation and hydrops fetalis in infants
Authors: Trisauvapak Tienake , Bongkotwilawan Nitiroj , Ekawaravong Suparat
Published: June 2024

Anomalous mitral arcade (MA) is a rare congenital anomaly. We report a case of MA in a newborn who presented with hydrops fetalis due to severe mitral regurgitation. After birth, he developed severe respiratory failure, congestive heart failure and airway obstruction because an enlarged left atrium from severe mitral regurgitation compressed the distal left main bronchus. There is limited experience in surgical management of this condition in Thailand, and the patient’s mitral valve was too small for replacement. Therefore, he was treated with medication to control heart failure and supported with positive pressure ventilation to promote growth. We have followed the patient until the current time of writing this report at the age of 2 years, and his outcome is favourable regarding heart failure symptoms, airway obstruction, growth and development. This case describes a challenging experience in the non-surgical management of MA with severe regurgitation, which presented at birth.
‘Grasshopper sign’: the novel imaging of post-COVID-19 myelopathy with delayed longitudinal white matter abnormalities
Authors: Okumura Motohiro , Sekiguchi Kazumasa , Okamoto Tomoko , Saika Reiko , Maki Hiroyuki , Sato Wakiro , Sato Noriko , Yamamura Takashi , Takahashi Yuji
Published: June 2024

Introduction

Recently, there have been a few reports of atypical post-coronavirus disease 2019 (COVID-19) myelopathy manifesting tract-specific lesions similar to those due to vitamin B12deficiency. However, the precise characteristics of imaging or clinical course remain not well understood.

Methods

A retrospective analysis of the clinical and imaging characteristics of four patients who were referred to our hospital with a unique post-COVID-19 myelopathy was performed.

Results

Four-to-six weeks following COVID-19 infection in the summer of 2023, four middle-aged men developed paraparesis, hypo/dysesthesia and bladder/bowel disturbance, suggesting myelopathy. Although spinal MRI showed no abnormalities in the early stages, tract-specific longitudinal lesions along the dorsal and lateral columns became apparent as the symptoms progressed. Owing to the lack of MRI findings at the early stage, all cases were challenging to diagnose. However, the patients remained partially responsive to aggressive immunosuppressive therapies, even in the advanced stage.

Discussion

We termed these tract-specific longitudinal lesions in the presented case series ‘Grasshopper sign’ because brain coronal and spine axial MRI findings looked like a grasshopper’s antennae and face. Early identification of the characteristic MRI abnormality could allow for early intervention using intensive immunosuppressive therapy, which could improve patient outcomes.
Efficacy and safety of transcutaneous electrical acupoint stimulation for the management of primary dysmenorrhoea: protocol for a randomised controlled trial in China
Authors: Liu Weiting , Ding Yanting , Xie Honggang , Liu Hansheng , Liang Changhao
Published: June 2024

Introduction

Primary dysmenorrhoea (PD) is a common menstrual concern with significant physical and psychosocial impacts. The effectiveness and safety of transcutaneous electrical acupoint stimulation (TEAS) in alleviating PD symptoms remain uncertain due to insufficient evidence. This single-centre, parallel, randomised controlled study intends to evaluate the efficacy and safety of TEAS for PD management.

Methods and analysis

60 participants aged 18–40 years diagnosed with moderate to severe PD will be recruited from Tai’an Hospital of Traditional Chinese Medicine (TCM) and randomly assigned to either a TEAS group or a TEAS-sham group (1:1). The TEAS group will undergo 12 sessions of TEAS treatment over two menstrual cycles, with 30 min per session, three sessions weekly. Participants in the TEAS-sham group will receive TEAS stimulation using identical devices and protocols but without current output. The primary outcome is the Visual Analogue Scale (VAS) for pain assessment. Secondary outcomes are Short-Form McGill Pain Questionnaire, total effective rate, uterine artery haemodynamics, prostaglandin and β-endorphin level, mental well-being and quality of life. Adverse events and their potential reasons and the use of analgesics will also be recorded.

Ethics and dissemination

This study was approved by the Medical Ethics Committee of Tai’an Hospital of TCM. Written informed consent will be obtained from each participant. The results will be submitted for publication in a peer-reviewed journal.

Trial registration number

ChiCTR2300071686.
Graves-PCD: protocol for a randomised, dose-finding, adaptive trial of the plasma cell-depleting agent daratumumab in severe Graves’ disease
Authors: Wolstenhulme Faye , Bibby Irena , Cole Michael , Grixti Lydia , McGregor Naomi , Bradley Penny , Maier Rebecca H , Walker Jenn , Pearce Simon H , Wason James
Published: June 2024

Introduction

Severe Graves’ disease is a life-changing condition with poor outcomes from currently available treatments. It is caused by directly pathogenic thyroid-stimulating hormone receptor-stimulating antibodies (TRAb), which are secreted from plasma cells. The human anti-CD38 monoclonal antibody daratumumab was developed to target plasma cells which express high levels of CD38, and is currently licensed for treatment of the plasma cell malignancy, myeloma. However, it can also deplete benign plasma cells with the potential to reduce TRAb and alter the natural history of severe Graves’ disease. This study aims to establish proof of concept that daratumumab has efficacy in patients with severe Graves’ disease and will provide important data to inform a choice of dosing regimen for subsequent trials.

Methods and analysis

The Graves-PCD trial aims to determine if daratumumab modulates the humoral immune response in patients with severe Graves’ disease, and if so, over what time period, and to find an optimal dose. It is a single-blinded, randomised, dose-finding, adaptive trial using four different doses of daratumumab or placebo in 30 adult patients. Part 1 of the trial is dose-finding and, following an interim analysis, in part 2, the remaining patients will be randomised between the chosen dose(s) from the interim analysis or placebo. The primary outcome is the percentage change in serum TRAb from baseline to 12 weeks.

Ethics and dissemination

The trial received a favourable ethical opinion from London-Hampstead Research Ethics Committee (reference 21/LO/0449). The results of this trial will be disseminated at international meetings, in the peer-reviewed literature and through partner patient group newsletters and presentations at patient education events.

Trial registration number

ISRCTN81162400.
Association of perioperative glucose profiles assessed by continuous glucose monitoring (CGM) with prognosis in Chinese patients with non-ST-elevation acute coronary syndrome: a cohort study protocol
Authors: Shi Jie , Zhang Hongqiang , Wang Xulin , Weng Jiahao , Ding Yu , Wu Jiawei , Zheng Xueying , Luo Sihui , Hu Hao
Published: June 2024

Introduction

Non-ST-elevation acute coronary syndrome (NSTE-ACS) remains a significant clinical concern, accounting for over 70% of acute coronary syndrome cases. One well-established risk factor for NSTE-ACS is abnormal glucose metabolism, which is associated with a poor prognosis postpercutaneous coronary intervention. Effective monitoring of blood glucose is crucial in diabetes care, as it helps identify glucose metabolic imbalances, thereby guiding therapeutic strategies and assessing treatment efficacy. Continuous glucose monitoring (CGM) provides comprehensive glucose profiles. Therefore, the study aims to use CGM to track perioperative glucose variations in NSTE-ACS patients and to determine its prognostic implications.

Methods and analysis

This is a multicentre, prospective observational study in a sample of patients (aged >18 years) with NSTE-ACS. A total of 1200 eligible patients will be recruited within 1 year at 6 sites in China. The primary composite endpoint will be determined as major adverse cardiovascular events (MACE) at 3 years. MACE includes all-cause mortality, non-fatal myocardial infarction, non-fatal stroke and target vessel revascularisation. Employing the CGM system, glucose levels will be continuously monitored throughout the perioperative phase. Prespecified cardiovascular analyses included analyses of the components of this composite and outcomes according to CGM-derived glucometrics at baseline.

Ethics and dissemination

This study has received approval from the Medical Research Ethics Committee of The First Affiliated Hospital of the University of Science and Technology of China (No. 2022KY357) and will adhere to the moral, ethical and scientific principles outlined in the Declaration of Helsinki. All participants will provide written informed consent prior to any study-related procedures. Findings from the study will be shared at conferences and published in peer-reviewed scientific journals.

Trial registration number

ChiCT2300069663.
Is household food insecurity associated with social attitudes accepting of physical intimate partner violence against women in Nigeria? A population-level cross-sectional study
Authors: Ujah Otobo I , Ocheke Amaka N , Olagbuji Biodun N
Published: June 2024

Objectives

Although prior research suggests that household food insecurity (HFI) is associated with intimate partner violence against women (IPVAW), there is a paucity of research regarding its impact on attitudes accepting of IPVAW. We examined whether individuals experiencing HFI are more likely to accept physical IPVAW, whether the association varies by gender and whether it persists when models are adjusted for other confounders.

Design

Population-level cross-sectional analysis.

Setting

This study used the round 6 of the UNICEF-supported Multiple Indicator Cluster Survey (MICS) conducted in Nigeria.

Participants

The sample included 23 200 women and 7087 men, aged 15–49 years, who were currently married or in union and responded to the attitudes towards domestic violence and HFI modules in the MICS.

Outcome measures and statistical analysis

Attitudinal acceptance of physical IPVAW (specific forms and overall). We conducted weighted multivariable logistic regression to estimate the OR and their corresponding 95% CIs of the associations of food insecurity (FI) with attitudinal acceptance of physical IPVAW, adjusting for potential confounders.

Results

Multivariable results indicate that severe HFI was positively associated with attitudinal acceptance physical IPVAW in at least one of the scenarios presented (aOR=1.11; 95% CI: 1.01 to 1.22). Individuals experiencing severe HFI had higher odds of physical IPVAW acceptance when wife neglects the children (aOR=1.15; 95% CI: 1.02 to 1.31). The likelihood of physical IPVAW acceptance if wife burns the food was lower for women experiencing moderate HFI (aOR=0.86; 95% CI: 0.74 to 0.99). Stratified analyses indicated heterogeneity in the association between HFI and attitudinal acceptance of physical IPVAW by gender.

Conclusion

Our findings indicate that, depending on the severity, FI status may be associated with attitudinal acceptance of physical IPVAW, with potential variations based on gender. The public health implications are discussed.
Burden of recreational water illness due to exposure to cyanobacteria and their toxins in freshwater beaches in Canada: protocol of a prospective cohort study
Authors: Young Ian , Sanchez J Johanna , Sekerciouglu Fatih , Desta Binyam N , Holeton Claire , Lyng Dylan , Peczulis Victoria , Renwick Shane , Brooks Teresa , Tustin Jordan
Published: June 2024

Introduction

Cyanobacterial blooms are increasingly common in freshwater sources used for swimming and other recreational water contact activities in Canada. Many species of cyanobacteria can produce toxins that affect human and animal health, but there are limited data on the risk of illness associated with water contact at impacted beaches.

Methods and analysis

This study will investigate the incidence of recreational water illness due to exposure to cyanobacterial blooms and their toxins in four targeted and popular freshwater beaches in Ontario, Manitoba and Nova Scotia, Canada. A prospective cohort design and One Health approach will be used. On-site recruitment of recreational water users will be conducted at two beaches per year during the summers of 2024 and 2025. The population of interest includes recreational water users of any age and their pet dogs. After enrolment, an in-person survey will determine beach exposures and confounding factors, and a 3-day follow-up survey will ascertain any acute illness outcomes experienced by participants or their dogs. The target sample size is 2500 recreational water users. Water samples will be taken each recruitment day and analysed for cyanobacterial indicators (pigments), cell counts and toxin levels. Bayesian regression analysis will be conducted to estimate the association with water contact, cyanobacterial levels and risks of different acute illness outcomes.

Ethics and dissemination

This study has been approved by the Toronto Metropolitan University Research Ethics Board (REB 2023-461). Study results will be published in a peer-reviewed journal and as infographics on a project website.
Exploring the effect of the menstrual cycle or oral contraception on elite athletes’ training responses when workload is not objectively quantifiable: the MILS approach and findings from female Olympians
Authors: De Larochelambert Quentin , Hamri Imad , Chassard Tom , Meignié Alice , Storme Florent , Dupuit Marine , Diry Allison , Toussaint Jean-François , Louis Pierre Yves , Coulmy Nicolas , Antero Juliana da Silva
Published: June 2024

Objectives

Develop the Markov Index Load State (MILS) model, based on hidden Markov chains, to assess athletes’ workload responses and investigate the effects of menstrual cycle (MC)/oral contraception (OC), sex steroids hormones and wellness on elite athletes’ training.

Methods

On a 7-month longitudinal follow-up, daily training (volume and perceived effort, n=2200) and wellness (reported sleep quality and quantity, fitness, mood, menstrual symptoms, n=2509) data were collected from 24 female rowers and skiers preparing for the Olympics. 51 MC and 54 OC full cycles relying on 214 salivary hormone samples were analysed. MC/OC cycles were normalised, converted in % from 0% (first bleeding/pill withdrawal day) to 100% (end).

Results

MILS identified three chronic workload response states: ‘easy’, ‘moderate’ and ‘hard’. A cyclic training response linked to MC or OC (95% CI) was observed, primarily related to progesterone level (p=8.23e-03 and 5.72e-03 for the easy and hard state, respectively). MC athletes predominantly exhibited the ‘easy’ state during the cycle’s first half (8%–53%), transitioning to the ‘hard’ state post-estimated ovulation (63%–96%). OC users had an increased ‘hard’ state (4%–32%) during pill withdrawal, transitioning to ‘easy’ (50%–60%) when on the pill. Wellness metrics influenced the training load response: better sleep quality (p=5.20e-04), mood (p=8.94e-06) and fitness (p=6.29e-03) increased the likelihood of the ‘easy’ state. Menstrual symptoms increased the ‘hard’ state probability (p=5.92e-02).

Conclusion

The MILS model, leveraging hidden Markov chains, effectively analyses cumulative training load responses. The model identified cyclic training responses linked to MC/OC in elite female athletes.
Enhanced simulated sunlight photocatalytic performance in K2Ti6O13/g-C3N4 heterojunction
Authors: Li Zhi , Jing Yuhan , Ye Qianxu , Wang Jie , Sun Nan , Zhou Liexing , Cai Jinming
Published: June 2024

In this study, K2Ti6O[Formula: see text] (KTO) nanowires were doped with carbon (CKTO) via a novel solid-phase approach at 800∘C for the first time using ethanol, KF, and TiO2. In addition to the lower sintering temperature, a shorter insulation period was achieved compared to the conventional solid-phase method. Furthermore, by combining and calcining CKTO and g-C3N4, a CKTO/g-C3N4 heterojunction composite was produced. The rate at which CKTO/g-C3N4 photocatalytically degraded methylene blue was higher than those of pure CKTO and g-C3N4. Our study indicates that adding g-C3N4 enhances photocatalytic performance by reducing the recombination rate of photogenerated electron–hole pairs and narrowing the bandgap of the CKTO/g-C3N4 heterostructure. This paper presents a novel method for creating KTO composites in an eco-friendly and productive manner for the photocatalytic degradation of organic colors.
Hemoglobin’s β-subunit is primed to synergize oxygen delivery with nitric oxide-mediated increased blood flow
Authors: Shadrina Maria S. , Laterreur Julie , Peslherbe Gilles H. , English Ann M.
Published: June 2024

Hemoglobin (Hb) undergoes a well-documented R[Formula: see text]T quaternary transition from a high [Formula: see text] affinity R state to a low [Formula: see text] affinity T state to optimize [Formula: see text] delivery to tissues. Also, red blood cells (RBCs) release a nitrovasodilator that increases blood flow to boost [Formula: see text] delivery. Hb’s R[Formula: see text]T transition coordinates its [Formula: see text] desaturation and RBC nitrovasodilator release by much-debated mechanisms. Here we investigate the allosterically controlled [Formula: see text]-nitrosation of Hb at its conserved βCys93 (i.e., SNO-Hb formation) for nitrovasodilator release. First, we examined NO[Formula: see text]/deoxyHb (HbFeII) incubations following aeration to mimic RBC NO production by the nitrite reductase activity of HbFeII and trapping of the nascent NO by βCys93 to give SNO-Hb on HbFeII conversion to oxyHb (HbFeO2). We confirmed SNO-Hb formation in the incubations with yields modulated by RBC antioxidant enzymes and [Formula: see text] but not CO. Since FeO2 hemes scavenge free NO, we hypothesized NO channeling within Hb and found by molecular dynamics simulations that most unligated NO molecules placed in the β-distal heme pocket (βDP) rapidly diffuse into a wide β-tunnel connecting the βDP to Hb’s central cavity and βCys93. Contraction of the central cavity brings NO closer to βCys93 in R-state plus βPhe71 and βTyr145 adopt conformations favorable to thiol access and SNO-Hb formation. In T-state, the SNO group is surface-exposed and destabilized to extrude NO. Thus, its structure, dynamics and conserved reactive thiol (βCys93) suggest that the β-subunit evolved to synergize [Formula: see text] and nitrovasoactivity delivery to tissues as a function of Hb [Formula: see text] saturation.
CREATIVE AND PURE IMITATION UNDER ENVIRONMENTAL TURBULENCE: EVIDENCE FROM AN EMERGING ECONOMY
Authors: NGUYEN NINH GIA , NGUYEN TRIEU KHOA
Published: June 2024

Due to the significance of imitation in business success and economic growth, there is an increasing interest of scholars in exploring different dimensions of imitation, illuminating the ‘black box’ of imitation. Given the increasingly turbulent nature of business environments, this study aims to investigate creative and pure imitation-based competitive strategies and their performance under different levels of environmental turbulence. A theoretical framework was tested using a sample of manufacturing firms in Vietnam. The results revealed that creative imitation is positively associated with sustained competitive advantage, while the impact of pure imitation on sustained competitive advantage is negligible. Furthermore, environmental turbulence affects both creative and pure imitation, with only creative imitation mediating the effects of environmental turbulence on sustained competitive advantage. Lastly, environmental turbulence amplifies the effect of pure imitation on sustained competitive advantage, while it has minimal moderating effects on the relationship between creative imitation and sustained competitive advantage. This study contributes to the literature by being the first to examine the effect of environmental turbulence on the performance of both creative and pure imitation strategies.