bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracellular vesicles through the blood–brain barrier: a review
Authors: Ramos-Zaldívar Héctor M. , Polakovicova Iva , Salas-Huenuleo Edison , Corvalán Alejandro H. , Kogan Marcelo J. , Yefi Claudia P. , Andia Marcelo E.
Published: July 2022

Extracellular vesicles (EVs) are particles naturally released from cells that are delimited by a lipid bilayer and are unable to replicate. How the EVs cross the Blood–Brain barrier (BBB) in a bidirectional manner between the bloodstream and brain parenchyma remains poorly understood. Most in vitro models that have evaluated this event have relied on monolayer transwell or microfluidic organ-on-a-chip techniques that do not account for the combined effect of all cellular layers that constitute the BBB at different sites of the Central Nervous System. There has not been direct transcytosis visualization through the BBB in mammals in vivo, and evidence comes from in vivo experiments in zebrafish. Literature is scarce on this topic, and techniques describing the mechanisms of EVs motion through the BBB are inconsistent. This review will focus on in vitro and in vivo methodologies used to evaluate EVs transcytosis, how EVs overcome this fundamental structure, and discuss potential methodological approaches for future analyses to clarify these issues. Understanding how EVs cross the BBB will be essential for their future use as vehicles in pharmacology and therapeutics.
Who are the chiropractic students favouring a limitless scope of practice? Exploring the relationship with personality, magical thinking, and academic achievement
Authors: Innes Stanley , Goncalves Guillaume , Leboeuf-Yde Charlotte
Published: July 2022

Introduction

Some chiropractors seem to have an inflated belief in the powers of spinal manipulation (SMT), for example aiming at preventing future spinal degeneration and health problems, activities that are without supporting evidence. Non-evidenced health beliefs have been shown to be associated with a tendency toward magical thinking. Holding such beliefs about SMT is associated with a limitless scope of practice (LLSoP). Recent studies have shown that “chiropractic conservatism” (ChiroCon) is also associated with such approaches. We wanted to understand ChiroCon and these attitudes toward SMT by exploring three different factors: intolerance to uncertainty, academic achievement, and tendency toward magical thinking and how they relate to ChiroCon and LLSoP.

Method

A cross-sectional survey of 243 chiropractic students from an Australian chiropractic program was conducted in May 2020. Students answered a questionnaire involving a patient case-scenario for LLSoP, levels of ChiroCon, validated questionnaires on (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. LLSoP was defined as wanting to treat with SMT a 5-year-old asymptomatic child for future (i) Musculoskeletal (MSK) problems and/or (ii) Non-musculoskeletal diseases. Logistic regression models were used to confirm if there was an association between ChiroCon and LLSoP and to explore associations between LLSoP and (i) Intolerance of uncertainty, (ii) Academic achievement, and (iii) Magical thinking. We repeated the same analyses using ChiroCon as the outcome variable.

Results

We confirmed that chiropractic students in the more extreme ChiroCon group were more likely to want to prevent future spinal disorders in an asymptomatic 5-year-old child as compared to those with lower levels (OR = 3.9, (95%CI 1.97–7.72). This was also the case for the prevention of future diseases in the same child (OR = 6.9, (95%CI 3.11–15.06). Of the three predictor variables, magical belief was positively associated with both ChiroCon and LLSoP.

Conclusion

Not surprisingly, ChiroCon is closely related to LLSoP and both were linked to magical thinking. Therefore, the questionnaire ‘Magical Health Beliefs’ could be a useful instrument to screen future chiropractic students to prevent a mismatch between student and institution. Depending on the outlook of the school, some schools would welcome these students, whereas other institutions would want to avoid them in their education program.
Seroprevalence of vector-borne pathogens in outdoor workers from southern Italy and associated occupational risk factors
Authors: Stufano Angela , Iatta Roberta , Sgroi Giovanni , Jahantigh Hamid Reza , Cagnazzo Francesco , Flöel Agnes , Lucchese Guglielmo , Loconsole Daniela , Centrone Francesca , Mendoza-Roldan Jairo Alfonso , Chironna Maria , Otranto Domenico , Lovreglio Piero
Published: July 2022

Background

Vector-borne diseases (VBDs) represent an emerging global threat to public health due to the geographical expansion of arthropod vectors. The study aims to assess the seroprevalence of selected vector-borne pathogens (VBPs) in different groups of outdoor workers and the occupational risk factors for exposure to arthropod bites.

Methods

A cross-sectional study was conducted on 170 workers recruited in two different regions of southern Italy, including farmers, forestry workers, veterinarians, geologists/agronomists and administrative employees, and tested for IgG antibodies against Bartonella henselae, Borrelia spp. Coxiella burnetii and Rickettsia conorii, using a chemiluminescent immunoassay (CLIA). The relationship among job characteristics, tick exposure and the prevalence of seropositive subjects for each pathogen was investigated by applying categorical principal component analysis (CATPCA).

Results

A high seroprevalence for C. burnetii (30.0%) and R. conorii (15.3%) was reported, mainly in farmers (67.7% and 54.8%, respectively) and forestry workers (29.0% and 16.1%, respectively), while a low prevalence was observed for B. henselae and Borrelia spp. (8.8% and 4.1%, respectively). The regression equation by CATPCA was significant for C. burnetii and R. conorii (P < 0.001), showing a positive association with job, tick bite exposure, working area and contact with animals.

Conclusions

These findings highlight the need of activating an appropriate occupational health response for minimizing the risk of arthropod vector exposure in workplaces, considering specific preventive measures in particular in high-risk job categories.

Graphical Abstract
Oral dextran sulfate sodium administration induces peripheral spondyloarthritis features in SKG mice accompanied by intestinal bacterial translocation and systemic Th1 and Th17 cell activation
Authors: Tabuchi Yuya , Katsushima Masao , Nishida Yuri , Shirakashi Mirei , Tsuji Hideaki , Onizawa Hideo , Kitagori Koji , Akizuki Shuji , Nakashima Ran , Murakami Kosaku , Murata Koichi , Yoshifuji Hajime , Tanaka Masao , Morinobu Akio , Hashimoto Motomu
Published: July 2022

Background

Spondyloarthritis (SpA) is an autoimmune and autoinflammatory musculoskeletal disease characterised by systemic enthesitis. Recent research has focused on subclinical inflammatory bowel disease (IBD) in SpA pathogenesis. SKG mice, harbouring the Zap70 W163C mutation, increase autoreactive Th17 cells intrinsically, and in a conventional environment, they exhibit spontaneous arthritis with fungal factors. Under SPF conditions, they show SpA features, including enteritis, after peritoneal injection of β-1,3-glucan. This study aimed to clarify whether oral dextran sulfate sodium (DSS) administration, utilised in IBD model mice, can provoke SpA features in SKG mice under SPF conditions, focusing on the relationship between gut microorganisms and SpA pathogenesis.

Methods

BALB/c and SKG mice were administered oral DSS, and their body weights, arthritis, and enthesitis scores were recorded. In another cohort, antibiotics (meropenem and vancomycin) or an anti-fungal agent (amphotericin B) was administered orally before DSS administration. The splenic Th1 and Th17 cell populations were examined before and after DSS administration using flow cytometry. Furthermore, the amount of circulating bacterial DNA in whole blood was measured by absolute quantitative polymerase chain reaction (qPCR), and the number and characteristics of bacterial species corresponding to these circulating DNA were analysed by next-generation sequencing (NGS).

Results

Ankle enthesitis as a peripheral SpA feature was elicited in half of DSS-administered SKG mice, and none of the BALB/c mice. Pre-administration of antibiotics suppressed enthesitis, whilst an anti-fungal agent could not. Th1 and Th17 cell levels in the spleen increased after DSS administration, and this was suppressed by pre-administration of antibiotics. SKG mice have a larger amount of bacterial DNA in whole blood than BALB/c mice before and 1 day after the initiation of DSS administration. The number of bacterial species in whole blood increased after DSS administration in BALB/c and SKG mice. Some genera and species significantly specific to the DSS-treated SKG mouse group were also detected.

Conclusion

Oral DSS administration alone elicited peripheral enthesitis in SKG mice with bacterial translocation accompanied by increased splenic Th1 and Th17 cell levels. Pre-administration of antibiotics ameliorated these DSS-induced SpA features. These findings suggest that intestinal bacterial leakage plays a pivotal role in SpA pathogenesis.
Xanthine oxidase inhibitor urate-lowering therapy titration to target decreases serum free fatty acids in gout and suppresses lipolysis by adipocytes
Authors: Guma Monica , Dadpey Benyamin , Coras Roxana , Mikuls Ted R. , Hamilton Bartlett , Quehenberger Oswald , Thorisdottir Hilda , Bittleman David , Lauro Kimberly , Reilly Shannon M. , Liu-Bryan Ru , Terkeltaub Robert
Published: July 2022

Objective

Linked metabolic and cardiovascular comorbidities are prevalent in hyperuricemia and gout. For mechanistic insight into impact on inflammatory processes and cardiometabolic risk factors of xanthine oxidase inhibitor urate-lowering therapy (ULT) titration to target, we performed a prospective study of gout serum metabolomes from a ULT trial.

Methods

Sera of gout patients meeting the 2015 ACR/EULAR gout classification criteria (n = 20) and with hyperuricemia were studied at time zero and weeks 12 and 24 of febuxostat or allopurinol dose titration ULT. Ultrahigh performance liquid chromatography-tandem mass spectroscopy acquired the serum spectra. Data were assessed using the Metabolon and Metaboloanalyst software. Lipolysis validation assays were done in febuxostat and/or colchicine-treated 3T3-L1 differentiated adipocytes.

Results

Serum urate decreased from time zero (8.21 ±1.139 SD) at weeks 12 (5.965 ± 1.734 SD) and 24 (5.655 ±1.763 SD). Top metabolites generated by changes in nucleotide and certain amino acid metabolism and polyamine pathways were enriched at 12 and 24 weeks ULT, respectively. Decreases in multiple fatty acid metabolites were observed at 24 weeks, linked with obesity. In cultured adipocytes, febuxostat significantly decreased while colchicine increased the lipolytic response to β-adrenergic-agonism or TNF.

Conclusion

Metabolomic profiles linked xanthine oxidase inhibitor-based ULT titration to target with reduced serum free fatty acids. In vitro validation studies revealed that febuxostat, but not colchicine, reduced lipolysis in cultured adipocytes. Since soluble urate, xanthine oxidase inhibitor treatment, and free fatty acids modulate inflammation, our findings suggest that by suppressing lipolysis, ULT could regulate inflammation in gout and comorbid metabolic and cardiovascular disease.
Preadmission assessment of extended length of hospital stay with RFECV-ETC and hospital-specific data
Authors: Ossai Chinedu I. , Rankin David , Wickramasinghe Nilmini
Published: July 2022

Background

Patients who exceed their expected length of stay in the hospital come at a cost to stakeholders in the healthcare sector as bed spaces are limited for new patients, nosocomial infections increase and the outcome for many patients is hampered due to multimorbidity after hospitalization.

Objectives

This paper develops a technique for predicting Extended Length of Hospital Stay (ELOHS) at preadmission and their risk factors using hospital data.

Methods

A total of 91,468 records of patient’s hospital information from a private acute teaching hospital were used for developing a machine learning algorithm relaying on Recursive Feature Elimination with Cross-Validation and Extra Tree Classifier (RFECV-ETC). The study implemented Synthetic Minority Oversampling Technique (SMOTE) and tenfold cross-validation to determine the optimal features for predicting ELOHS while relying on multivariate Logistic Regression (LR) for computing the risk factors and the Relative Risk (RR) of ELOHS at a 95% confidence level.

Results

An estimated 11.54% of the patients have ELOHS, which increases with patient age as patients < 18 years, 18–40 years, 40–65 years and ≥ 65 years, respectively, have 2.57%, 4.33%, 8.1%, and 15.18% ELOHS rates. The RFECV-ETC algorithm predicted preadmission ELOHS to an accuracy of 89.3%. Age is a predominant risk factors of ELOHS with patients who are > 90 years—PAG (> 90) {RR: 1.85 (1.34–2.56), P:  < 0.001} having 6.23% and 23.3%, respectively, higher likelihood of ELOHS than patient 80–90 years old—PAG (80–90) {RR: 1.74 (1.34–2.38), P:  < 0.001} and those 70–80 years old—PAG (70–80) {RR: 1.5 (1.1–2.05), P: 0.011}. Those from admission category—ADC (US1) {RR: 3.64 (3.09–4.28, P:  < 0.001} are 14.8% and 70.5%, respectively, more prone to ELOHS compared to ADC (UC1) {RR: 3.17 (2.82–3.55), P:  < 0.001} and ADC (EMG) {RR: 2.11 (1.93–2.31), P:  < 0.001}. Patients from SES (low) {RR: 1.45 (1.24–1.71), P:  < 0.001)} are 13.3% and 45% more susceptible to those from SES (middle) and SES (high). Admission type (ADT) such as AS2, M2, NEWS, S2 and others {RR: 1.37–2.77 (1.25–6.19), P:  < 0.001} also have a high likelihood of contributing to ELOHS while the distance to hospital (DTH) {RR: 0.64–0.75 (0.56–0.82), P:  < 0.001}, Charlson Score (CCI) {RR: 0.31–0.68 (0.22–0.99), P:  < 0.001–0.043} and some VMO specialties {RR: 0.08–0.69 (0.03–0.98), P:  < 0.001–0.035} have limited influence on ELOHS.

Conclusions

Relying on the preadmission assessment of ELOHS helps identify those patients who are susceptible to exceeding their expected length of stay on admission, thus, making it possible to improve patients’ management and outcomes.
Which patients are prone to suffer liver metastasis? A review of risk factors of metachronous liver metastasis of colorectal cancer
Authors: Hao Mengdi , Wang Kun , Ding Yuhan , Li Huimin , Liu Yin , Ding Lei
Published: July 2022

Background

In recent years, with the increasing incidence of colorectal cancer (CRC) and its high fatality rate, CRC has seized the attention of the world. And liver metastasis, as the main cause of death of CRC, has become the leading cause of treatment failure in CRC, especially metachronous liver metastasis, have caused patients who underwent bowel resection to experience multiple tortures.

Main body

Metachronous liver metastasis has severely affected the quality of life and prognosis of patients. Therefore, in this review, we discuss risk factors for metachronous liver metastasis of CRC, which is the premise for effective intervention for CRC patients who suffer metachronous liver metastasis after undergoing surgery, as well as the signaling pathways associated with CRC.

Conclusion

The occurrence of metachronous liver metastasis is closely related to histology-based prognostic biomarkers, serum-based biomarkers, tumor microenvironment, pre-metastatic niche, liquid biopsy and tissue-based biomarkers. Further research is required to explore the risk factors associated with liver metastasis of CRC.
A review of deep learning applications in human genomics using next-generation sequencing data
Authors: Alharbi Wardah S. , Rashid Mamoon
Published: July 2022

Genomics is advancing towards data-driven science. Through the advent of high-throughput data generating technologies in human genomics, we are overwhelmed with the heap of genomic data. To extract knowledge and pattern out of this genomic data, artificial intelligence especially deep learning methods has been instrumental. In the current review, we address development and application of deep learning methods/models in different subarea of human genomics. We assessed over- and under-charted area of genomics by deep learning techniques. Deep learning algorithms underlying the genomic tools have been discussed briefly in later part of this review. Finally, we discussed briefly about the late application of deep learning tools in genomic. Conclusively, this review is timely for biotechnology or genomic scientists in order to guide them why, when and how to use deep learning methods to analyse human genomic data.
Association between muscle dysmorphia psychopathology and binge eating in a large at-risk cohort of men and women
Authors: Halioua Robin , Wyssen Andrea , Iff Samuel , Karrer Yannis , Seifritz Erich , Quednow Boris B. , Claussen Malte Christian
Published: July 2022

Background

Current research on muscle dysmorphia (MD) has focused on restrained eating behaviors and has adopted a primarily male perspective. Despite initial evidence, the role of possible binge eating associated with MD has only been scarcely investigated. To extend the transdiagnostic and cross-gender approaches and address the dearth in research related to MD, this study investigated the association between MD psychopathology and binge eating in men and women.

Methods

This study investigated the association between MD psychopathology and binge eating in both men and women. Participants were a sample of 5905 men (n = 422) and women (n = 5483) social media users aged 18–72 years. They completed an online survey that included self-report measures assessing demographics, binge eating, MD psychopathology, and drive for thinness and leanness. Binge eating was assessed using the diagnostic questions of the validated German version of the Eating Disorder Examination-Questionnaire. The Muscle Dysmorphic Disorder Inventory (MDDI) was used to assess MD psychopathology. A total score of > 39 was set as a cutoff to define an “MD at-risk” state for both men and women. Hierarchical logistic regression analysis was used to analyze the association between MD psychopathology and binge eating.

Results

MD psychopathology was significantly positively associated with binge eating in both men and women. Among the three MDDI subscales, only appearance intolerance was significantly associated with MD, and drive for size and functional impairment were not associated. MD at-risk status yielded a predicted probability of binge eating of 25% for men and 66.9% for women. The increased probability of binge eating associated with MD at-risk status was mainly accounted for by appearance intolerance in men and drive for thinness in women.

Conclusion

MD psychopathology is positively associated with binge eating in both men and women. Binge eating episodes should therefore form part of the clinical assessment of MD.
Dynamic change of soluble interleukin-2 receptor distinguished molecular heterogeneity and microenvironment alterations in diffuse large B-cell lymphoma
Authors: Huo Yu-Jia , Xu Peng-Peng , Wang Li , Zhong Hui-Juan , Fu Di , Shi Qing , Cheng Shu , Wang Shuo , Zhang Mu-Chen , Zhao Wei-Li
Published: July 2022

Diffuse large B-cell lymphoma (DLBCL) is an aggressive lymphoma with variable clinical outcomes and prediction of prognosis remains important for long-term remission. We performed serial serum soluble interleukin-2 receptor (sIL-2R) measurement pretreatment and before each cycle of the treatment in 599 patients with de novo DLBCL. Genomic and transcriptomic features were analyzed by 223 DNA- and 227 RNA-sequencing, respectively. Applying the cut-off value to sIL-2R pretreatment and cycle 2 (C2) level, patients were classified into FINE subtype (pretreatment low level) with good prognosis, RES subtype (pretreatment high level and C2 low level) with intermediate prognosis, and RET subtype (pretreatment high level and C2 high level) with poor prognosis, independent of International Prognostic Index. In “others” genetic subtype, dynamic change of sIL-2R showed prognostic significance and genetic features. Compared with FINE subtype, RES subtype had increased ARID1A and MYD88 mutations, and RET subtype had increased KMT2D, LYN and SOCS1 mutations. RES and RET subtypes showed significant enrichment in oncogenic pathways, such as ERK, NF-κB, JAK-STAT, and immune-associated pathways. As for tumor microenvironment, RES subtype exhibited increased recruiting activity of CD8 + T, T helper 1, and natural killer cells, and RET subtype with increased recruiting activity of CD4 + T and regulatory T cells in silico. There was a positive correlation between transcripts of IL-2R and immune checkpoint expressions including PD-1 and CTLA-4. Our findings identified that dynamic change of sIL-2R, with this simple and easy detection method in peripheral blood, had long-term prognostic effect and specific relation to microenvironment alterations in DLBCL.
Identification and a culture method for a Helicotylenchus microlobus from tomato in China
Authors: Xia Yan-Hui , Li Jin , Xu Fei-Fei , Lei Bin , Li Hong-Lian , Wang Ke , Li Yu
Published: July 2022

Background

The nematodes of the genus Helicotylenchus are root parasites of a wide variety of plants, and certain species can cause serious damage to their hosts. During a survey of the plant-parasitic nematode associated with tomato, a population of Helicotylenchus was collected from tomato roots and soil samples. Thus, one of the objectives of the study was to confirm the specie of Helicotylenchus obtained from the tomato samples based on morphological and molecular characteristics. In addition, a mass pure culture of plant-parasitic nematodes is key to pathogenicity studies and many other biological studies. However, a successful mass rearing method for Helicotylenchus has not been reported. Thus, the other objective of the study was to establish a method of culturing Helicotylenchus.

Results

Based on both the morphological characteristics and molecular analysis of the internal transcribed spacer (ITS) and D2-D3 expansion region of 28S ribosomal RNA (rRNA) sequences the specimens were identified as Helicotylenchus microlobus. Phylogenetic analysis with the rRNA sequences of the ITS and 28S D2-D3 regions was consistent with molecular identification, suggesting this population formed a highly supported clade with other H. microlobus populations. Additionally, a method for culture of H. microlobus on carrot disks was established, and the effect of temperature on the reproduction rate (Rr) of H. microlobus was investigated. The optimum temperature for culturing H. microlobus on carrot disks was 27.5 °C and, after inoculation with 30 females of H. microlobus at 27.5 °C for 90 days, Rr reached 406.

Conclusions

To our knowledge, this is the first detailed description of H. microlobus from tomato in China. This study also demonstrated that the carrot disk method is suitable for the culture of H. microlobus. This study lays a foundation for other related research on H. microlobus, and has significance for the study of Helicotylenchus.
Impact of hemodialysis solutions containing different levels of molecular hydrogen (H2) on the patient-reported outcome of fatigue
Authors: Uemura Susumu , Kegasa Yoshitaka , Tada Keigo , Tsukahara Taichi , Kabayama Shigeru , Yamamoto Tae , Miyazaki Mariko , Takada Joji , Nakayama Masaaki
Published: July 2022

Background

Reportedly, dialysis solutions containing molecular hydrogen (H2) might ameliorate patient-reported fatigue in hemodialysis (HD) patients. However, it is unknown whether its impact might differ with different H2 levels.

Method

This single-arm, prospective observational study examined 105 patients on chronic HD (62 males; mean age, 66 years; mean HD duration, 117 months). All patients were originally treated with an HD solution with 47 ppb (mean) H2 for more than 12 months, followed by an HD solution with 154 ppb (mean) H2 for 8 weeks. Baseline and changes in subjective fatigue status rated on a numerical rating scale (NRS) were assessed before the start of the study (baseline) and 8th week of the study.

Results

Patients were classified into three groups according to the presence of subjective fatigue at baseline: Group A (15.2%), presence of fatigue on both HD and HD-free days; Group B (28.6%), fatigue only on HD days; and Group C (56.2%), freedom from fatigue. In Group A, NRS scores during the 8-week period were significantly decreased as compared with 0 week, at the 4th and 8th week on HD days, and at the 8th week on HD-free day, respectively. While no consistent changes were found in other groups. At the 8th week, 64 patients (61%) presented absence of or decrease in the NRS score of fatigue, while the rest of patients did not present the decrease in NRS (the non-improved: 39%). Regarding the factors related to the non-improved, prescription of antihypertensive agents was a significant independent risk factor by multivariate analysis, indicating the possible involvement of excess fall in blood pressure (BP) in those patients.

Conclusion

Amelioration of the patient-reported outcome of fatigue might be influenced by H2 levels in the HD solution, and the optimal H2 level in the dialysate needs to be elucidated in consideration of clinical type of fatigue and BP control status.
Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) values of optic nerve head in Papilledema
Authors: Maaly Mohamed Abdel-Aziz , Hafez Kamal Y. M. K. , Habib Rehab Mohammed
Published: July 2022

Background

Papilledema is optic disc pathology characterized by swelling of the optic disc occurring secondary to elevated intracranial pressure (ICP), and it was proposed that elevated ICP is transferred along the subarachnoid space to the optic nerve (ON) leading to metabolic process interruptions and MRI changes within ON head. This study aimed to rule out if DWI and ADC map can be used as a diagnostic tool for detection of papilledema and if ADC values can be helpful in papilledema grading.

Result

ADC value was significantly lower in papilledema cases group (A) in comparison with control group (B).

Conclusion

Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) map can be utilized as a diagnostic tool for diagnosis of papilledema, and ADC values can be helpful in diagnosis of papilledema grade.
Biatrial and interatrial septal calcification in the setting of rheumatic heart disease and mitral and tricuspid valves replacement
Authors: Dadkhah Adeleh , Borjian Mohammad Amin , Akbarzadeh Pasha Saeed
Published: July 2022

Background

Although cardiac calcifications are described in the literature, calcification of atria is less frequently reported. There have been few case studies about atrial wall calcification in the literature, most of which were in middle-age females and were attributable to chronic heart diseases including rheumatic heart disease and valve replacement. In majority of the reported cases, interatrial septum has been spared. Only one case of bilateral atrial wall calcification has been reported prior to the current report, which has been in a patient with renal failure, calciphylaxis and long-term haemodialysis and calcium supplement intake.

Case presentation

The patient was a 57-year-old female with history of rheumatic valvular heart disease and two prior valve replacement surgeries. She didn’t have any history of renal function impairment and haemodialysis or calcium supplements intake. Her laboratory data showed anaemia, increased cardiac biomarkers and active urinalysis. Performed echocardiography showed moderate right ventricular dilation with relatively poor contraction, normal left ventricular size and contraction, dilated right and left atria and good prosthetic valve function. On computed tomography (CT) scan, calcification of left atrial posterior and free walls, interatrial septum and right atrial free wall were noted. Evidence of hepatic congestion and cirrhosis was seen in abdominal CT scan and ultrasonography.

Conclusion

Atrial wall calcification is a rare finding but is important to report since it can complicate cardiac surgeries. It's also probable that this kind of dystrophic calcification could not be detected during routine echocardiography and CT scan should be performed in suspected cases.
Practitioners’ experience of the working alliance in a blended cognitive–behavioural therapy intervention for depression: qualitative study of barriers and facilitators
Authors: Doukani Asmae , Free Caroline , Araya Ricardo , Michelson Daniel , Cerga-Pashoja Arlinda , Kakuma Ritsuko
Published: July 2022

Background

Digital technologies have been widely acknowledged as a potentially useful resource for increasing mental healthcare access. The working alliance is a key influence on outcomes in conventional psychotherapy, but little is known about therapists’ experiences of forming an effective working alliance in blended interventions that involve in-person psychotherapy and a digital programme.

Aims

To investigate psychological well-being practitioners’ (PWPs’) experiences of the working alliance in a trial of blended cognitive–behavioural therapy (b-CBT) for depression. Trial registration ISRCTN12388725.

Method

Semi-structured qualitative interviews were conducted with 13 PWPs who delivered b-CBT in a two-arm, non-inferiority randomised controlled trial investigating the effectiveness of b-CBT compared with face-to-face CBT. Thematic analysis was used to analyse the data.

Results

Participants reported four facilitating factors when building and maintaining a working alliance in b-CBT: having more time to deliver treatment, access to a wider toolkit, capacity to tailor components of b-CBT and receiving appropriate training and support. Participants also identified four barriers to building and maintaining a working alliance: time and resource constraints, usability challenges, limited flexibility to tailor the digital programme to patients’ needs and lack of confidence in delivering b-CBT.

Conclusions

Our study is the first specifically to investigate practitioners’ perceived facilitators and barriers to forming a working alliance in b-CBT for depression. Findings suggest that PWPs’ experiences of the working alliance can be improved by: accounting for the time required to deliver b-CBT in service workflows to reduce time pressures; increasing opportunities to tailor the digital programme through offering transdiagnostic tools and adaptable features; and providing appropriate b-CBT training and technical support.
Design and Evaluation of Novel Bite Block for Invasive Imaging Procedures
Authors: Jelacic Srdjan , Bowdle Andrew , Madhavaram Sai Krishna , Garana Belinda B.
Published: July 2022

Commercially available bite blocks used for invasive imaging procedures have design limitations, including bulky profile, being made of hard plastic that may damage surrounding tissue, and tendency to dislodge. We designed a novel bite block to address these limitations and evaluated this bite block in 50 patients undergoing diagnostic or intraprocedural transesophageal echocardiography examinations. Nine of 11 (82%) imagers who used the redesigned bite block preferred it over the standard bite block used at our institution. The novel bite block is an alternative device to standard bite blocks that was redesigned to protect both the patient and probe.
Fire Hazard in an Anesthesia Machine: A Case Report
Authors: Sokhal Suman , Sokhal Navdeep , Sharma Pradeep , Chouhan Rajendra Singh
Published: July 2022

An operating room (OR) fire is a rare event but may cause critical harm to patients and health care personnel. We present 2 fire incidents in the rear cabinet of an anesthesia machine, not previously reported in the literature. An anesthesia machine in standby mode is considered safer than in use, but in the first case, the fire occurred while the machine was on standby mode. In another case, the fire erupted while surgery was in progress. Here, we discuss the management of an anesthesia machine fire and emphasize the need for improved fire safety in advanced anesthesia machines.
The Bayh-Dole Act at 40: Accomplishments, Challenges, and Possible Reforms
Authors: Sarpatwari Ameet , Kesselheim Aaron S. , Cook-Deegan Robert
Published: July 2022

More than 40 years have passed since the enactment of the Patent and Trademark Amendment (Bayh-Dole) Act, which authorized institutions to patent inventions arising from federally funded research. Although some experts have heralded the Bayh-Dole Act as ushering in a new era of technological advances, others have been less sanguine about its impact. In recent years, the high price of prescription drugs and the patenting of COVID-19 therapeutics and vaccines developed with substantial federal government support have rekindled the debate over whether companies should receive more restricted rights to products originating with government funding. This article traces the history leading to the enactment of the Bayh-Dole Act and critically assesses its strengths and weaknesses as well as unresolved questions concerning its scope. Based on this analysis, the authors propose reforms to better align the Bayh-Dole Act with public values and health outcomes, including clarifying government-use rights, making it easier to invoke march-in rights for failure to meet health and safety needs, increasing transparency in how patents are licensed, and testing different approaches to foster the development and application of inventions.
A hypomorphic mutation in Pold1 disrupts the coordination of embryo size expansion and morphogenesis during gastrulation
Authors: Chen Tingxu , Alcorn Heather , Devbhandari Sujan , Remus Dirk , Lacy Elizabeth , Huangfu Danwei , Anderson Kathryn V.
Published: July 2022

Formation of a properly sized and patterned embryo during gastrulation requires a well-coordinated interplay between cell proliferation, lineage specification and tissue morphogenesis. Following transient physical or pharmacological manipulations of embryo size, pre-gastrulation mouse embryos show remarkable plasticity to recover and resume normal development. However, it remains unclear how mechanisms driving lineage specification and morphogenesis respond to defects in cell proliferation during and after gastrulation. Null mutations in DNA replication or cell-cycle-related genes frequently lead to cell-cycle arrest and reduced cell proliferation, resulting in developmental arrest before the onset of gastrulation; such early lethality precludes studies aiming to determine the impact of cell proliferation on lineage specification and morphogenesis during gastrulation. From an unbiased ENU mutagenesis screen, we discovered a mouse mutant, tiny siren (tyrn), that carries a hypomorphic mutation producing an aspartate to tyrosine (D939Y) substitution in Pold1, the catalytic subunit of DNA polymerase δ. Impaired cell proliferation in the tyrn mutant leaves anterior–posterior patterning unperturbed during gastrulation but results in reduced embryo size and severe morphogenetic defects. Our analyses show that the successful execution of morphogenetic events during gastrulation requires that lineage specification and the ordered production of differentiated cell types occur in concordance with embryonic growth.
A Year at the Forefront of Engineering Photosynthesis
Authors: Johnson Sophie L.
Published: July 2022

Multiple proof-of-principle experiments and successful field trials have demonstrated that engineering photosynthesis is a viable strategy for improving crop yields. Advances to engineering technologies have accelerated efforts to improve photosynthesis, generating a large volume of published literature: this Review therefore aims to highlight the most promising results from the period February 2021 to January 2022. Recent research has demonstrated the importance of understanding the impact of changing climates on photosynthesis to ensure that proposed engineering strategies are resilient to climate change. Encouragingly, there have been several reports of strategies that have benefits at temperatures higher than current ambient conditions. There has also been success in engineering synthetic bypass pathways, providing support for the feasibility of a synthetic biology approach. Continued developments in all areas of engineering photosynthesis will be necessary for sustainably securing sufficient crop yields for the future.

This article has an associated First Person interview with the first author of the paper.
Chromatin dynamics through mouse preimplantation development revealed by single molecule localisation microscopy
Authors: Portela Marta , Jimenez-Carretero Daniel , Labrador Veronica , Andreu Maria Jose , Arza Elvira , Caiolfa Valeria R. , Manzanares Miguel
Published: July 2022

Most studies addressing chromatin behaviour during preimplantation development are based on biochemical assays that lack spatial and cell-specific information, crucial during early development. Here, we describe the changes in chromatin taking place at the transition from totipotency to lineage specification, by using direct stochastical optical reconstruction microscopy (dSTORM) in whole-mount embryos during the first stages of mouse development. Through the study of two post-translational modifications of Histone 3 related to active and repressed chromatin, H3K4me3 and H3K9me3 respectively, we obtained a time-course of chromatin states, showing spatial differences between cell types, related to their differentiation state. This analysis adds a new layer of information to previous biochemical studies and provides novel insight to current models of chromatin organisation during the first stages of development.
Multifunctional role of GPCR signaling in epithelial tube formation
Authors: Vishwakarma Vishakha , Le Thao Phuong , Chung SeYeon
Published: July 2022

Epithelial tube formation requires Rho1-dependent actomyosin contractility to generate the cellular forces that drive cell shape changes and rearrangement. Rho1 signaling is activated by G-protein-coupled receptor (GPCR) signaling at the cell surface. During Drosophila embryonic salivary gland (SG) invagination, the GPCR ligand Folded gastrulation (Fog) activates Rho1 signaling to drive apical constriction. The SG receptor that transduces the Fog signal into Rho1-dependent myosin activation has not been identified. Here, we reveal that the Smog GPCR transduces Fog signal to regulate Rho kinase accumulation and myosin activation in the medioapical region of cells to control apical constriction during SG invagination. We also report on unexpected Fog-independent roles for Smog in maintaining epithelial integrity and organizing cortical actin. Our data support a model wherein Smog regulates distinct myosin pools and actin cytoskeleton in a ligand-dependent manner during epithelial tube formation.
Development of Precisely Controlled Structures Containing Main Group Elements for Preparing Superatoms
Authors: Kambe Tetsuya , Yamamoto Kimihisa
Published: July 2022

This review summarizes our recent studies of main group elements of boron, aluminum, gallium and bismuth units with dendrimer templates. Stepwise assembly of bismuth salts realized tunable photoluminescent materials according to the introduced amounts. Solid-state emission and switching of optical properties were demonstrated by using a shell-effect of the dendrimer. BH3 species placed in the dendrimer acted as a reductant in the nanosized space to form size-controlled metal particles. Atomicity control for AlCl3 or GaCl3 enabled a solution-phase synthesis of superatoms, which have been expected to be new building blocks for materials.
Accumulation of the gaseous hormone ethylene helps roots sense compact soil
Authors: Kramer Eric M , Masle Josette , Robinson Sarah , Topp Christopher N
Published: July 2022

Soil compaction, in which soil grains are pressed together leaving less pore space for air and water, is a persistent problem in mechanized agriculture. Most plant roots fail to penetrate soil if it is too dense. One might assume that they are physically unable to penetrate the compact soil. However, new research demonstrates a more complex mechanism that requires the build-up of the volatile plant hormone ethylene in the rhizosphere1. Ethylene itself can arrest growth and, in compact soil, it is present in higher concentrations near roots due to its reduced ability to diffuse. Roots that lack the ethylene response pathway grow better through compact soil, demonstrating that it is physically possible to do so. The work suggests new levers for crop improvement in increasingly degraded soils.
Doświadczenie (syn)estetyczne: Performatywne aspekty przedstawień site-specific
Authors: Chaberski Mateusz
Published: July 2022

Niezwykła różnorodność interesujących mnie zjawisk artystycznych, obejmu­jących działania z pogranicza teatru, sztuk wizualnych i instalacji artystycznych, prowokuje ( ... ) do sformułowania zupełnie nowej metody ich badania. Bez wątpienia metoda ta powinna wyjść poza tradycyjny model analiz teatrologicznych, zakładają­cych ścisły podział na scenę i widownię. Po­staram się zatem przedstawić nowy sposób badań przedstawień site-specifc czy - sze­rzej rzecz ujmując - nowy język opisu tego typu działań. Powinien on objąć wzajem­ne oddziaływania, jakie zachodzą między wszystkimi ich uczestnikami - przestrze­nią, obiektami i strategiami artystyczny­mi, wprowadzanymi do niej przez twórców, a także tymi, którzy w niej przebywają. Fragment Wstępu
Optimization Helps Scheduling Nursing Staff at the Long-Term Care Homes of the City of Toronto
Authors: Anderson Manion , Bodur Merve , Rathwell Scott , Sarhangian Vahid
Published: July 2022

The City of Toronto Long-Term Care Homes and Services (LTCH&S) division is one of the largest providers of long-term care in the Canadian province of Ontario, providing care to 2,640 residents at 10 homes across Toronto. Our collaboration with LTCH&S was initiated to facilitate the increasingly challenging task of scheduling nursing staff and reduce the high absenteeism rate observed among the part-time nurses. We developed a spreadsheet-based scheduling tool to automate the generation of schedules and incorporate nurses’ preferences for different shifts into the schedules. At the core of the scheduling tool is a hierarchical optimization model that generates a feasible schedule with the highest total preference score while satisfying the maximum possible demand. Feasible schedules had to abide by a set of complex seniority requirements, which prioritized more-senior nurses when allocating the available shifts. Our scheduling tool was implemented in a 391-bed home in Toronto. The tool allowed nursing managers to generate feasible schedules within a fraction of an hour, in contrast to the status quo manual approach, which could take up to tens of hours. In addition, the schedules successfully accounted for preferences with, on average, above 94% of the allocated shifts ranked as most preferred.

History: This paper was refereed.
Pseudoshock: A Challenging Presentation of Bilateral Subclavian Artery Stenosis
Authors: Nasrullah Adeel , Singh Romil , Hamza Amina , DiSilvio Briana
Published: July 2022

Introduction: Subclavian artery stenosis (SAS) is a manifestation of peripheral artery disease (PAD). Presentation varies, ranging from arm claudication and muscle fatigue to symptoms which reflect vertebrobasilar hypoperfusion, among which are syncope, ataxia and dysphagia. Although rare, severe bilateral SAS can exist and present as refractory hypotension. We describe a case of bilateral SAS masquerading as circulatory shock, or rather ‘pseudoshock’. Case Description: A 59-year-old female patient presented to the emergency department with complaints of dark stools. She was anaemic and hypotensive and therefore suspected to have an acute gastrointestinal bleed (GIB) with resultant haemorrhagic shock. Her hypotension was unresponsive to fluid resuscitation and blood transfusions. Bilateral upper extremity radial artery catheters confirmed low blood pressures. After her blood pressure failed to improve despite the addition of several vasopressors, a femoral artery catheter (FAC) was placed, which revealed significant hypertension discordant with the hypotension measured by the radial artery catheters. Review of CT angiography of the upper extremities revealed the presence of bilateral SAS which was deemed to be the aetiology of the falsely low blood pressure. Discussion: SAS should be suspected in patients with lower extremity PAD or a blood pressure (BP) differential of 15 mmHg or more between arms. When bilateral subclavian arteries are stenosed, this difference in BP may be concealed, making lower extremity BP measurements, as seen in non-invasive tests such as ankle brachial index (ABI) tests or through more invasive procedures such as FAC placement, critically important. Conclusion: Bilateral SAS may present as pseudo-hypotension. In cases of refractory shock of unclear aetiology, especially in patients with known PAD, a high index of suspicion is warranted for ‘pseudoshock’ secondary to severe vascular stenosis. Comparison of upper and lower extremity BP via invasive arterial catheters or non-invasive ABI tests can aid in the diagnosis of bilateral SAS.
The Gender Dimension of Covid 19 Pandemic in India
Authors: Pande Rekha
Published: July 2022

The present paper analyses the gender dimension of Covid 19 in India, focusing on three major areas, womens work, domestic violence and education. This paper concludes with certain policy suggestions arising out of this and recommends that civil society needs to join together and collectively look for solutions. The paper argues that finding a solution will take time; nevertheless, it may be able to develop alternative ideas and tactics that will not only help treat the problem but also help to prevent it. In any pandemic there is a strong correlation between factors such as income, race, and place of residence. Gender-based effects are also a part of this epidemic. Despite the fact that the crisis affects men and women differently and not always in the same direction, it has a greater impact on women. Our societys social constructs are to blame for this. Hence, it becomes necessary to examine the gender dimension of Covid 19. Some of the aspects that are discussed include, the impact in the job market, increase in care work, the rise of domestic work load, declining output of professional women, impact on elderly and mental health and domestic violence. It also examines how the scenario of education changed after Covid 19 and what are the challenges and opportunities in it. During the lockdowns, inequities overwhelmingly impact the wellbeing and economic resilience. Due to the current social structure, women bear the brunt of unpaid caregiving in today's stressed-out households. The rise in domestic violence is causing increasing concern. Older people with already other symptoms of disease and those with underlying health conditions are likely to experience serious illness. This coronavirus epidemic is not just a medical issue but a social and economic one and its impact is global and prolonged and has left a mark on our society.