bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender-Based Violence Interventions in Low- and Middle-Income Countries: A Systematic Review of Interventions at Structural, Community, Interpersonal, Individual, and Multiple Levels
Authors: Sabri Bushra , Sellke Robert , Smudde Michelle , Bourey Christina , Murray Sarah McIvor
Published: October 2022

Gender-based violence (GBV) disproportionately impacts women and girls in low- and middle-income countries (LMIC). This review described the characteristics of structural, community, interpersonal, individual, and multilevel GBV interventions in LMIC and examined components of interventions implemented at different socio-ecological levels. We conducted a systematic search of peer-reviewed literature on GBV intervention evaluation studies in LMIC using the following databases: PubMed, CINAHL, Embase, Cochrane, Academic Search Ultimate, PsycInfo, and Web of Science. The search resulted in 3,256 articles, with 60 articles meeting the eligibility criteria. Thirty-eight articles reported positive GBV outcomes with significant differences between intervention and control arms on at least one GBV outcome. Very few interventions were found to be stand-alone GBV interventions. The key components of interventions effective in addressing victimization and perpetration across levels were education or psychoeducation, psychotherapy, skills development, gender transformative activities, community engagement, focus on men and/or partners, and health promotion activities such as HIV or STI prevention. Most interventions were multilevel, with positive outcomes for victimization. Fewer evidence-based interventions existed for addressing perpetration. There is need for additional research using rigorous methods to establish an evidence base for effective interventions in under-researched regions in LMIC as well as for interventions that address perpetration of GBV.
Family Function and Post-Traumatic Stress Disorder in Children and Adolescents: A Meta-Analysis
Authors: Ye Yingying , Li Yifan , Jin Shuxian , Huang Jiali , Ma Rong , Wang Xuan , Zhou Xiao
Published: October 2022

Family function reflects the operating status of the family system, which plays a vital role in children’s mental health. The current meta-analysis examined the association between family function and post-traumatic stress disorder (PTSD) in children and adolescents for the first time. Studies published from 1980 to 2021 were identified via searching and screening. We identified 31 studies (91 unique effects) with 8,684 children. A three-level meta-analysis revealed that overall family function was negatively associated with PTSD ( r = −0.205). Among elements of family function, family affect ( r = −0.251), communication ( r = −0.221), and cohesion ( r = −0.184) were associated with less PTSD, whereas family conflict ( r = 0.228) was associated with more PTSD in children. Family flexibility ( r = −0.103) was not associated with PTSD. Moderator analyses revealed differences between various types of trauma events and family function scales. The findings highlight the differences in the roles of the elements of family function and suggest that interventions should be focused on targeting specific elements of family function.
Sex-based differences in concussion incidence and its underlying injury mechanism in team bat/stick sports: A systematic review and meta-analysis
Authors: Sundaram Vasanth , Ramachandran Akhilesh Kumar , Singh Utkarsh , Pearce Alan J
Published: October 2022

This study aimed to synthesize and quantify the sex-based differences in concussion incidences rate and associated mechanism of injuries in team bat/stick sports. Following a systematic search across five electronic databases, 46 studies were included in the review; 24 were included in the incidence rate (IR) meta-analysis and 13 of the 24 studies met the eligibility criteria for the meta-analysis involving injury mechanism. DerSimonian and Laird random effects models were used for pooling the Rate Ratio (RR) data. Ice-hockey had the highest overall risk of concussion, followed by lacrosse and baseball/softball. Female players had higher concussion IRs compared to males (RR 0.74 [95% CI 0.58–0.95], p = .02) across all sports included in this study. Sex-based differences in concussion IRs for ice-hockey and lacrosse were not statistically significant. Male athletes were more statistically likely to sustain concussion because of player-contact in ice-hockey (RR 1.55 [95% CI 1.29–1.86], p < .001) and lacrosse (RR 3.20 [95% CI 1.54–6.64], p = .002). Conversely, female athletes showed a higher risk of concussion due to equipment contact in lacrosse (RR 0.29 [95% CI 0.20–0.43], p < .001). Injury mechanism varies between male and female athletes across these bat/stick sports. Female athletes have a higher risk of getting concussed due to the impact of players with equipment (ball/puck) and surface contact for lacrosse and ice-hockey. Findings from this study can help coaches, sports administrators, and health care providers with further data on the current information regarding concussion-related factors in these respective sports.
Human Rights During Transition: Accountability Mechanisms in Mexican States 1997–2008
Authors: Brennan Bernard , Johnson Kristin , Rundlett Ashlea
Published: October 2022

This paper assesses the impact of political and fiscal accountability mechanisms on the severity and scope of human rights violations in Mexico's states during its democratic transition. First, we argue that elites in states with lower levels of electoral accountability are free of constraints that would normally result in their removal from office should they engage in human rights violations. Similarly, we argue that local elites maintain power while evading accountability when supported by transfers from the central government, and are thereby freer to use force. We find statistical support for our claims that lower levels of procedural democracy and higher levels of central transfers are associated with higher levels of human rights and physical integrity rights violations. These results are robust to subsample and numerous economic and other factors. Our findings suggest that particularly during democratic transitions, subnational institutions are salient in explaining the frequency of human rights violations.
Rabies prevention and control practices and associated factors among dog owners in Chiro, West Hararghe, Ethiopia
Authors: Ahmed Mohammed Jemal , Dirirsa Gebisa , Mengistu Dechasa Adare , Demena Melake , Geremew Abraham
Published: October 2022

Background:

Rabies is among the most deadly and fatal diseases of all human diseases, once clinical symptoms appear. In developing countries, including Ethiopia, rabies prevention and control practices is not adequate. The study aimed to assess knowledge, attitude, and practices toward rabies prevention and control and identified factors associated with prevention and control practices.

Methods:

A community-based cross-sectional study was conducted from July 30 to August 30, 2021. A total of 326 dog-owner households were selected from the total number of 6500 dog-owner households using a simple random sampling method. Pretested and structured questionnaire were used to collect the data. The sections of the questionnaire includes socio-demographic, knowledge, attitude, and practice toward rabies prevention practices, and health and personal-related characteristics of the participants. The data was analyzed using SPSS version 24. Bivariate and multivariable logistic regression were used to determine the association variables. Finally, a p-value of less than 0.05 was considered as a cut-off point for statistical significance.

Results:

Of 326 households involved in the study, 52.8% of the participants were found to have poor rabies prevention and control practices. More than half (52.1%) of the respondents had good knowledge of rabies prevention and control practices, and 49.1% had a positive attitude. Only 28.2% of the respondents reported a history of dog bites. Factors associated with good rabies prevention and control practices were; having good knowledge of human rabies virus [(Adjusted Odd Ratio (AOR) = 2.41 (95% CI: 2.25−4.83)], having good attitude on prevention and control [AOR = 2.06 (95% CI: 1.95–3.82)], having only one dog per household [AOR = 2.46 (95% CI: 1.25–4.83)], availability of vet clinic within 30 min distance from residents [AOR = 9.32 (95% CI: 4.19–20.70)], and getting health information from Mass media [AOR = 3.68(95% CI: 1.74–7.77)] or Health workers [AOR = 3.16 (95% CI: 1.60–6.23)].

Conclusions:

More than half (52.1%) of the participants had poor rabies prevention and control practices. Improving rabies prevention and control practices through improving the knowledge and attitude of the community is important to protect public health.
Neuromuscular Control During Stair Descent and Artificial Tibial Translation After Acute ACL Rupture
Authors: Blasimann Angela , Busch Aglaja , Henle Philipp , Bruhn Sven , Vissers Dirk , Baur Heiner
Published: October 2022

Background:

Anterior cruciate ligament (ACL) rupture has direct effect on passive and active knee stability and, specifically, stretch-reflex excitability.

Purpose/Hypothesis:

The purpose of this study was to investigate neuromuscular activity in patients with an acute ACL deficit (ACL-D group) compared with a matched control group with an intact ACL (ACL-I group) during stair descent and artificially induced anterior tibial translation. It was hypothesized that neuromuscular control would be impaired in the ACL-D group.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

Surface electromyographic (EMG) activity of the vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF), and semitendinosus (ST) muscles was recorded bilaterally in 15 patients with ACL-D (mean, 13.8 days [range, 7-21 days] since injury) and 15 controls with ACL-I during stair descent and artificially induced anterior tibial translation. The movements of stair descent were divided into preactivity, weight acceptance, and push-off phases. Reflex activity during anterior tibial translation was split into preactivity and short, medium, and late latency responses. Walking on a treadmill was used for submaximal EMG normalization. Kruskal-Wallis test and post hoc analyses with Dunn-Bonferroni correction were used to compare normalized root mean square values for each muscle, limb, movement, and reflex phase between the ACL-D and ACL-I groups.

Results:

During the preactivity phase of stair descent, the hamstrings of the involved leg of the ACL-D group showed 33% to 51% less activity compared with the matched leg and contralateral leg of the ACL-I group ( P < .05). During the weight acceptance and push-off phases, the VL revealed a significant reduction (approximately 40%) in the involved leg of the ACL-D group compared with the ACL-I group. At short latency, the BF and ST of the involved leg of the ACL-D group showed a significant increase in EMG activity compared with the uninvolved leg of the ACL-I group, by a factor of 2.2 to 4.6.

Conclusion:

In the acute phase after an ACL rupture, neuromuscular alterations were found mainly in the hamstrings of both limbs during stair descent and reflex activity. The potential role of prehabilitation needs to be further studied.
Book review: Bill Hughes, A Historical Sociology of Disability: Human Validity and Invalidity from Antiquity to Early Modernity
Authors: Bozkurt Ozancan
Published: October 2022

Bill Hughes, A Historical Sociology of Disability: Human Validity and Invalidity from Antiquity to Early Modernity (New York: Routledge Taylor & Francis Group), 2020, xiv + 355 pp., $35.31 (pb).
Representations of the Mughals in Present-Day India: From K. Asif’s Akbar to the Babur of Nikkhil Advani
Authors: Rezavi Syed Ali Nadeem
Published: October 2022

The Hindi film industry (Bollywood) has been fascinated since practically its beginnings with revisiting history and rewriting it. Over the years, we have had several historical period films, and of them a number have been on Mughal emperors and princesses. This article tries to review the content of some of the celebrated movies based on the Great Mughals, produced after independence: starting with Mughal-e-Azam of K. Asif to Jodhaa Akbar of Ashutosh Gowariker and a recently shot historical serial. The basic argument of the article is that compared to Western endeavours, or even other Asian film-makers, the products of the Hindi film industry, or even the OTT platforms, have somehow failed in conforming to established historical facts while constructing their romances. The article examines how the films often depart from reality to reconstruct a mythical past. The recent tendency towards communalisation, however, is not here studied.
Journal N-Pact Factors From 2011 to 2019: Evaluating the Quality of Social/Personality Journals With Respect to Sample Size and Statistical Power
Authors: Fraley R. Chris , Chong Jia Y. , Baacke Kyle A. , Greco Anthony J. , Guan Hanxiong , Vazire Simine
Published: October 2022

Scholars and institutions commonly use impact factors to evaluate the quality of empirical research. However, a number of findings published in journals with high impact factors have failed to replicate, suggesting that impact alone may not be an accurate indicator of quality. Fraley and Vazire proposed an alternative index, the N-pact factor, which indexes the median sample size of published studies, providing a narrow but relevant indicator of research quality. In the present research, we expand on the original report by examining the N-pact factor of social/personality-psychology journals between 2011 and 2019, incorporating additional journals and accounting for study design (i.e., between persons, repeated measures, and mixed). There was substantial variation in the sample sizes used in studies published in different journals. Journals that emphasized personality processes and individual differences had larger N-pact factors than journals that emphasized social-psychological processes. Moreover, N-pact factors were largely independent of traditional markers of impact. Although the majority of journals in 2011 published studies that were not well powered to detect an effect of ρ = .20, this situation had improved considerably by 2019. In 2019, eight of the nine journals we sampled published studies that were, on average, powered at 80% or higher to detect such an effect. After decades of unheeded warnings from methodologists about the dangers of small-sample designs, the field of social/personality psychology has begun to use larger samples. We hope the N-pact factor will be supplemented by other indices that can be used as alternatives to improve further the evaluation of research.
Combined Margin Convergence Repair and Subacromial Balloon Spacer for the Treatment of Massive Rotator Cuff Tears
Authors: Sivasundaram Lakshmanan , Hevesi Mario , Berlinberg Elyse J. , Patel Harsh H. , Verma Nikhil N. , Forsythe Brian
Published: October 2022

Background:

Current joint-sparing treatment options for massive, irreparable rotator cuff tears aim to prevent superior migration of the humeral head and maintain the subacromial space. Although options such as superior capsular reconstruction and posterosuperior tendon transfer may appropriately restore function and reduce pain, these procedures harbor significant comorbidity and intense postoperative rehabilitation. Recently, studies have demonstrated excellent results from a subacromial balloon spacer composed of a biocompatible copolymer that degrades over the 12 months following implantation. This spacer enables a more anatomic position of the humeral head to restore normal shoulder biomechanics.

Indications:

The subacromial balloon spacer is primarily indicated in patients with massive, irreparable rotator cuff tears who demonstrate proximal humeral migration. Contraindications include subscapularis or teres minor tendon tears, deltoid dysfunction, and pseudoparalysis.

Technique Description:

Standard arthroscopic portals are established, and a diagnostic arthroscopy is performed to assess the glenohumeral joint space and subscapularis tendon. A subacromial bursectomy is performed without proceeding medial to the superior glenoid rim. The subacromial space is measured utilizing an arthroscopic measurement probe to ensure that the selected spacer will lie slightly medial to the glenoid. The rotator cuff is then reapproximated from the lateral to medial aspect of the tear and repaired via a side-to-side manner with high strength, nonabsorbable tape, and a self-capturing suture device. Following repair, the deployment device is inserted through the lateral portal, placed slightly medial to the glenoid, and inflated with saline.

Results:

Utilization of the described subacromial balloon augmentation provides significant pain relief by restoring glenohumeral biomechanics, improvements in range of motion, and an enhancement in quality of life.

Discussion:

This case report and video review of a technique for utilizing a subacromial balloon spacer demonstrates an effective, simple, and safe treatment for massive, irreparable rotator cuff tears. Positive results rely on appropriate inflation and secure fixation. Recent clinical trial data suggest that functional outcomes for the subacromial balloon spacer are noninferior to that of partial rotator cuff repair. These promising results suggest that the subacromial balloon spacer may prove an essential tool for joint-preserving surgery following massive, irreparable rotator cuff tears.
Effect of adaptive servo-ventilation for central sleep apnoea in systolic heart failure on muscle sympathetic nerve activity: a SERVE-HF randomised ancillary study
Authors: Tamisier Renaud , Pépin Jean-Louis , Woehrle Holger , Salvat Muriel , Barone-Rochette Gilles , Rocca Cécile , Vettorazzi Eik , Teschler Helmut , Cowie Martin , Lévy Patrick
Published: October 2022

Background

Adaptive servo-ventilation (ASV) effectively suppresses central sleep apnoea (CSA) but has been associated with increased all-cause and cardiovascular mortality in chronic heart failure patients with reduced ventricular ejection fraction (HFrEF). All-cause and, especially, cardiovascular mortality in chronic heart failure is highly correlated with sympathetic tone. This analysis of SERVE-HF data investigated the effect of ASV on sympathetic tone in patients with HFrEF and CSA.

Methods

HFrEF patients in the SERVE-HF trial (left ventricular ejection fraction (LVEF) ≤45%, apnoea–hypopnoea index (AHI) ≥15 events·h−1with predominant CSA) were randomly assigned to receive guideline-based heart failure treatment alone (controls) or plus ASV. For this analysis, the primary outcome was change in muscle sympathetic nerve activity (MSNA) at 3-month follow-up. The effects of baseline MSNA and change in MSNA over time on mortality in the main study were also assessed.

Results

40 patients with HFrEF were included in this analysis (age 71.3±11.7 years, LVEF 34.2±7.7%, 57.5% in New York Heart Association (NYHA) Functional Class II, 42.5% in NYHA Functional Class III, AHI 35.2±11 events·h−1). Sympathetic tone evolution during follow-up did not differ between groups (controls: 47.6±8.3 bursts·min−1at baseline to 44.6±11.2 bursts·min−1; ASV group: 43.0±9.0 bursts·min−1at baseline to 42.74±9.45 bursts·min−1). The reduction in sympathetic tone was associated with significantly increased cardiovascular mortality in the ASV group, whereas in the control group reduced sympathetic tone appeared to be protective.

Conclusions

Suppression of CSA with ASV did not seem to have a significant effect on chronic heart failure-related sympathetic activation. Simultaneous suppression of CSA and reduction in MSNA was associated with increased cardiovascular mortality.
ERS/ESTS statement on the management of pleural infection in adults
Authors: Bedawi Eihab O. , Ricciardi Sara , Hassan Maged , Gooseman Michael R. , Asciak Rachelle , Castro-Añón Olalla , Armbruster Karin , Bonifazi Martina , Poole Sarah , Harris Elinor K. , Elia Stefano , Krenke Rafal , Mariani Alessandro , Maskell Nick A. , Polverino Eva , Porcel Jose M. , Yarmus Lonny , Belcher Elizabeth P. , Opitz Isabelle , Rahman Najib M.
Published: October 2022

Pleural infection is a common condition encountered by respiratory physicians and thoracic surgeons alike. The European Respiratory Society (ERS) and European Society of Thoracic Surgeons (ESTS) established a multidisciplinary collaboration of clinicians with expertise in managing pleural infection with the aim of producing a comprehensive review of the scientific literature. Six areas of interest were identified: 1) epidemiology of pleural infection, 2) optimal antibiotic strategy, 3) diagnostic parameters for chest tube drainage, 4) status of intrapleural therapies, 5) role of surgery and 6) current place of outcome prediction in management. The literature revealed that recently updated epidemiological data continue to show an overall upwards trend in incidence, but there is an urgent need for a more comprehensive characterisation of the burden of pleural infection in specific populations such as immunocompromised hosts. There is a sparsity of regular analyses and documentation of microbiological patterns at a local level to inform geographical variation, and ongoing research efforts are needed to improve antibiotic stewardship. The evidence remains in favour of a small-bore chest tube optimally placed under image guidance as an appropriate initial intervention for most cases of pleural infection. With a growing body of data suggesting delays to treatment are key contributors to poor outcomes, this suggests that earlier consideration of combination intrapleural enzyme therapy (IET) with concurrent surgical consultation should remain a priority. Since publication of the MIST-2 study, there has been considerable data supporting safety and efficacy of IET, but further studies are needed to optimise dosing using individualised biomarkers of treatment failure. Pending further prospective evaluation, the MIST-2 regimen remains the most evidence based. Several studies have externally validated the RAPID score, but it requires incorporating into prospective intervention studies prior to adopting into clinical practice.
Apnoea–hypopnoea index of 5 events·h−1as a metabolomic threshold in patients with sleep complaints
Authors: Kiens Ott , Taalberg Egon , Ivanova Viktoria , Veeväli Ketlin , Laurits Triin , Tamm Ragne , Ottas Aigar , Kilk Kalle , Soomets Ursel , Altraja Alan
Published: October 2022

Background

The apnoea–hypopnoea index (AHI) forms the basis for severity of obstructive sleep apnoea (OSA), a condition expected to reprogramme metabolic pathways in humans. We aimed to identify the AHI breakpoint from which the majority of significant changes in the systemic metabolome of patients with sleep complaints occur.

Methods

In a prospective observational study on symptomatic individuals, who underwent polysomnography for the diagnosis of OSA, profiles of 187 metabolites including amino acids, biogenic amines, acylcarnitines, lysophosphatidylcholines, phosphatidylcholines and sphingomyelins were analysed with liquid chromatography mass spectrometry in peripheral blood drawn at three different time points overnight. Comparisons of rank-transformed data using a general linear model for repeated measures after dichotomising the study group at different AHI levels were applied to define the best cut-off based on Cohen's f.

Results

65 subjects were recruited with a median AHI of 15.6 events·h−1. The mean Cohen's f over the metabolites was highest (0.161) at an AHI level of 5 events·h−1representing the metabolomic threshold. Of the particular between-group differences, eight phosphatidylcholines, nine acylcarnitines and one amino acid (threonine) had significantly lower concentrations in the individuals with an AHI level equal to or above the metabolomic threshold. The metabolomic changes at AHI levels defining moderate and severe OSA were smaller than at an AHI of 5 events·h−1.

Conclusions

The metabolomic threshold for patients with sleep complaints described in this report for the first time coincides with the AHI threshold required to confirm the diagnosis of OSA.
Prime-boost, double-dose influenza vaccine immunity in COPD: a pilot observational study
Authors: Anderson Gary P. , Irving Louis B. , Jarnicki Andrew , Kedzierska Katherine , Koutsakos Marios , Kent Stephen , Hurt Aeron C. , Wheatley Adam K. , Nguyen Thi H.O. , Snape Natale , Upham John W.
Published: October 2022

Background

COPD patients are more susceptible to viral respiratory infections and their sequelae, and have intrinsically weaker immune responses to vaccinations against influenza and other pathogens. Prime-boost, double-dose immunisation has been suggested as a general strategy to overcome weak humoral response to vaccines, such as seasonal influenza vaccination, in susceptible populations with weak immunity. However, this strategy, which may also provide fundamental insights into the nature of weakened immunity, has not been formally studied in COPD.

Methods

We conducted an open-label study of seasonal influenza vaccination in 33 vaccine-experienced COPD patients recruited from established cohorts (mean age 70 (95% CI 66.9–73.2) years; mean forced expiratory volume in 1 s/forced vital capacity ratio 53.4% (95% CI 48.0–58.8%)). Patients received two sequential standard doses of the 2018 quadrivalent influenza vaccine (15 μg haemagglutinin per strain) in a prime-boost schedule 28 days apart. We measured strain-specific antibody titres, an accepted surrogate of likely efficacy, and induction of strain-specific B-cell responses following the prime and boost immunisations.

Results

Whereas priming immunisation induced the expected increase in strain-specific antibody titres, a second booster dose was strikingly ineffective at further increasing antibody titres. Similarly, priming immunisation induced strain-specific B-cells, but a second booster dose did not further enhance the B-cell response. Poor antibody responses were associated with male gender and cumulative cigarette exposure.

Conclusions

Prime-boost, double-dose immunisation does not further improve influenza vaccine immunogenicity in previously vaccinated COPD patients. These findings underscore the need to design more effective vaccine strategies for COPD patients for influenza.
Health worker perspectives of Smart Triage, a digital triaging platform for quality improvement at a referral hospital in Uganda: a qualitative analysis
Authors: Novakowski Stefanie K , Kabajaasi Olive , Kinshella Mai-Lei Woo , Pillay Yashodani , Johnson Teresa , Dunsmuir Dustin , Pallot Katija , Rigg Jessica , Kenya-Mugisha Nathan , Opar Bernard Toliva , Ansermino J Mark , Tagoola Abner , Kissoon Niranjan
Published: October 2022

Background

Effective triage at hospitals can improve outcomes for children globally by helping identify and prioritize care for those most at-risk of death. Paper-based pediatric triage guidelines have been developed to support frontline health workers in low-resource settings, but these guidelines can be challenging to implement. Smart Triage is a digital triaging platform for quality improvement (QI) that aims to address this challenge. Smart Triage represents a major cultural and behavioural shift in terms of managing patients at health facilities in low-and middle-income countries. The purpose of this study is to understand user perspectives on the usability, feasibility, and acceptability of Smart Triage to inform ongoing and future implementation.

Methods

This was a descriptive qualitative study comprising of face-to-face interviews with health workers (n = 15) at a regional referral hospital in Eastern Uganda, conducted as a sub-study of a larger clinical trial to evaluate Smart Triage (NCT04304235). Thematic analysis was used to assess the usability, feasibility, and acceptability of the platform, focusing on its use in stratifying and prioritizing patients according to their risk and informing QI initiatives implemented by health workers.

Results

With appropriate training and experience, health workers found most features of Smart Triage usable and feasible to implement, and reported the platform was acceptable due to its positive impact on reducing the time to treatment for emergency pediatric cases and its use in informing QI initiatives within the pediatric ward. Several factors that reduced the feasibility and acceptability were identified, including high staff turnover, a lack of medical supplies at the hospital, and challenges with staff attitudes.

Conclusion

Health workers can use the Smart Triage digital triaging platform to identify and prioritize care for severely ill children and improve quality of care at health facilities in low-resource settings. Future innovation is needed to address identified feasibility and acceptability challenges; however, this platform could potentially address some of the challenges to implementing current paper-based systems.
The effect of salience of rewards on effort-based decision making in psychotic disorders
Authors: Renz Katharina E. , Lincoln Tania M.
Published: October 2022

Background

Although motivational negative symptoms account for reduced functioning and quality of life in individuals with psychotic disorders, the underlying mechanisms are yet not fully understood. Neuroimaging studies suggest that an impaired perception of reward cues could result in a lack of incentive value that then leads to a decrease in goal-directed behavior. Therefore, the aim of this study was to test the effect of increasing the salience of reward cues on goal-directed behavior.

Methods

We recruited a sample of n = 30 participants with a psychotic disorder and at least mild negative symptoms and n = 30 healthy controls. We used the Balloon Effort Task, an effort-based decision-making paradigm, to assess amotivation on a behavioral level. We manipulated the salience of rewards in the paradigm by highlighting the monetary rewards in half of the trials.

Results

Total effort expenditure did not differ between participants with and without psychotic disorders, but participants with psychotic disorders showed a significantly reduced effort allocation to the level of rewards. The salience of rewards manipulation significantly increased effort expenditure both in participants with psychotic disorders and in the healthy controls, but had no impact on effort allocation.

Conclusions

Increasing the salience of reward cues promotes goal-directed behavior. This opens up new possibilities for interventions addressing amotivation in individuals with negative symptoms by facilitating the perception of reward cues.
Implementation of a standardized surgical technique in robot-assisted restorative rectal cancer resection: a single center cohort study
Authors: Eriksen Jacob Damgaard , Thaysen Henriette Vind , Emmertsen Katrine Jøssing , Madsen Anders Husted , Tøttrup Anders , Nørager Charlotte Buchard , Ljungmann Ken , Thomassen Niels , Delaney Conor Patrick , Iversen Lene Hjerrild
Published: October 2022

Background

Despite increasing focus on the technical performance of total mesorectal excision over recent decades, anastomotic leakage (AL) continues to be a serious complication for many patients, even in the hands of experienced surgical teams. This study describes implementation of standardized surgical technique in an effort to reduce variability, decrease the risk of anastomotic leakage, and improve associated short-term outcomes for rectal cancer patients undergoing robot-assisted restorative rectal resection (RRR).

Methods

We evaluated all rectal cancer patients undergoing robot-assisted RRR at Aarhus University Hospital between 2017 and 2020. Six standardized surgical steps directed to improve anastomotic healing were mandatory for all RRR. Additional changes were made during the period with prohibition of systemic dexamethasone and limiting the use of endoscopic stapling devices.

Results

The use of the full standardization, including all six surgical steps, increased from 40.3% (95% CI, 0.28–0.54) to 86.2% (95% CI, 0.68–0.95). The incidence of AL decreased from 21.0% (95% CI, 0.12–0.33) to 6.9% (95% CI, 0.01–0.23). Length of hospital stay (LOS) decreased from 6 days (range 2–50) to 5 days (range 2–26). The rate of patients readmitted within 90 days decreased from 21.0% (95% CI, 0.12–0.33), to 6.9% (95% CI, 0.01–0.23).

Conclusion

The full standardization was effectively implemented for rectal cancer patients undergoing robot-assisted RRR. The risk of AL, LOS and readmission decreased during the study period. A team focus on high-reliability and peri-operative complications can improve patient outcomes.
The protective effect of L-carnitine on testosterone synthesis pathway, and spermatogenesis in monosodium glutamate-induced rats
Authors: Koohpeyma Farhad , Gholizadeh Fatemeh , Hafezi Hannaneh , Hajiaghayi Mehri , Siri Morvarid , Allahyari Shaghayegh , Maleki Mohammad Hasan , Asmarian Naeimehossadat , Bayat Elahe , Dastghaib Sanaz
Published: October 2022

Background

Monosodium glutamate (MSG) is a food ingredient that is increasingly used commercially. MSG leads to oxidative stress, consequently suppressing steroid hormone production that causes defects in male reproductive system. This study aimed to evaluate the effect of L-carnitine as an antioxidant on testicular damage in MSG-induced male rats.

Methods

Sixty adult male Spargue-Dawley rats were randomly divided into six groups of ten as follows: control (water), sham (normal saline), L-carnitine (200 mg/kg b.w), MSG (3 g/kg b.w), MSG + L-carnitine 100 (3 g/kg b.w of MSG and 100 mg/kg b.w of L-carnitine), and MSG + L-carnitine 200 (3 g/kg b.w of MSG and 200 mg/kg b.w of L-carnitine). The treatment was administered by oral gavage for six months. Serum levels of Malondialdehyde (MDA), Total Anti-oxidant Capacity (TAC), LH, FSH, testosterone, and mRNA expressions of Star, Cyp11a1, and Hsd17b3 genes, and histological and stereological changes were assessed.

Results

L-carnitine led to a significant decrease in the level of MDA and a significant rise in the serum levels of TAC, LH, FSH, and mRNA expression of Star and Cyp11a1 compared to the MSG group (p < 0.05). Furthermore, stereological results indicated a significant increment in the number of sexual lineage cells, the total volume of the testis, length, diameter, and volume of seminiferous tubules, the height of the germinal epithelium, sperm count, and sperm motility (p < 0.05) in MSG + L-carnitine 200 compare to MSG group.

Conclusion

The study’s findings demonstrated that L-carnitine due to its anti-oxidant properties, ameliorated the reproductive abnormalities in the male rats exposed to MSG.
Sleep postures monitoring based on capacitively coupled electrodes and deep recurrent neural networks
Authors: Peng Shun , Li Yang , Cui Rui , Xu Ke , Wu Yonglin , Huang Ming , Dai Chenyun , Tamur Toshiyo , Mukhopadhyay Subhas , Chen Chen , Chen Wei
Published: October 2022

Background

Capacitively coupled electrode (CC electrode), as a non-contact and unobtrusive technology for measuring physiological signals, has been widely applied in sleep monitoring scenarios. The most common implementation is capacitive electrocardiogram (cECG) that could provide useful clinical information for assessing cardiac function and detecting cardiovascular diseases. In the current study, we sought to explore another potential application of cECG in sleep monitoring, i.e., sleep postures recognition.

Methods

Two sets of experiments, the short-term experiment, and the overnight experiment, were conducted. The cECG signals were measured by a smart mattress based on flexible CC electrodes and sleep postures were recorded simultaneously. Then, a classifier model based on a deep recurrent neural network (RNN) was proposed to distinguish sleep postures (supine, left lateral and right lateral). To verify the reliability of the proposed model, leave-one-subject-out cross-validation was introduced.

Results

In the short-term experiment, the overall accuracy of 96.2% was achieved based on 30-s segment, while the overall accuracy was 88.8% using one heart beat segment. For the unconstrained overnight experiment, the accuracy of 91.0% was achieved based on 30-s segment, while the accuracy was 81.4% using one heart beat segment.

Conclusions

The results suggest that cECG could render valuable information about sleep postures detection and potentially be helpful for sleep disorder diagnosis.
Bioconversion of vitamin D3 to bioactive calcifediol and calcitriol as high-value compounds
Authors: Wang Zheyi , Zeng Yan , Jia Hongmin , Yang Niping , Liu Mengshuang , Jiang Mingyue , Zheng Yanning
Published: October 2022

Biological catalysis is an important approach for the production of high-value-added compounds, especially for products with complex structures. Limited by the complex steps of chemical synthesis and low yields, the bioconversion of vitamin D3 (VD3) to calcifediol and calcitriol, which are natural steroid products with high added value and significantly higher biological activity compared to VD3, is probably the most promising strategy for calcifediol and calcitriol production, and can be used as an alternative method for chemical synthesis. The conversion efficiency of VD3 to calcifediol and calcitriol has continued to rise in the past few decades with the help of several different VD3 hydroxylases, mostly cytochrome P450s (CYPs), and newly isolated strains. The production of calcifediol and calcitriol can be systematically increased in different ways. Specific CYPs and steroid C25 dehydrogenase (S25DH), as VD3 hydroxylases, are capable of converting VD3 to calcifediol and calcitriol. Some isolated actinomycetes have also been exploited for fermentative production of calcifediol and calcitriol, although the VD3 hydroxylases of these strains have not been elucidated. With the rapid development of synthetic biology and enzyme engineering, quite a lot of advances in bioproduction of calcifediol and calcitriol has been achieved in recent years. Therefore, here we review the successful strategies of promoting VD3 hydroxylation and provide some perspective on how to further improve the bioconversion of VD3 to calcifediol and calcitriol.
Targeting hepatic sulfane sulfur/hydrogen sulfide signaling pathway with α-lipoic acid to prevent diabetes-induced liver injury via upregulating hepatic CSE/3-MST expression
Authors: Dugbartey George J. , Alornyo Karl K. , Adams Ismaila , Atule Stephen , Obeng-Kyeremeh Richard , Amoah Daniel , Adjei Samuel
Published: October 2022

Background

Diabetes-induced liver injury is a complication of diabetes mellitus of which there are no approved drugs for effective treatment or prevention. This study investigates possible hepatoprotective effect of alpha-lipoic acid (ALA), and sulfane sulfur/hydrogen sulfide pathway as a novel protective mechanism in a rat model of type 2 diabetes-induced liver injury.

Methods

Thirty Sprague–Dawley rats underwent fasting for 12 h after which fasting blood glucose was measured and rats were randomly assigned to diabetic and non-diabetic groups. Type 2 diabetes mellitus (T2DM) was induced in diabetic group by administration of nicotinamide (110 mg/kg) and streptozotocin (55 mg/kg). Diabetic rats were treated daily with ALA (60 mg/kg/day p.o.) or 40 mg/kg/day DL-propargylglycine (PPG, an inhibitor of endogenous hydrogen sulfide production) for 6 weeks and then sacrificed. Liver, pancreas and blood samples were collected for analysis. Untreated T2DM rats received distilled water.

Results

Hypoinsulinemia, hyperglycemia, hepatomegaly and reduced hepatic glycogen content were observed in untreated T2DM rats compared to healthy control group (p < 0.001). Also, the pancreas of untreated T2DM rats showed severely damaged pancreatic islets while liver damage was characterized by markedly increased hepatocellular vacuolation, sinusoidal enlargement, abnormal intrahepatic lipid accumulation, severe transaminitis, hyperbilirubinemia, and impaired hepatic antioxidant status and inflammation compared to healthy control rats (p < 0.01). While pharmacological inhibition of hepatic sulfane sulfur/hydrogen sulfide with PPG administration aggravated these pathological changes (p < 0.05), ALA strongly prevented these changes. ALA also significantly increased hepatic expression of hydrogen sulfide-producing enzymes (cystathionine γ-lyase and 3-mecaptopyruvate sulfurtransferase) as well as hepatic sulfane sulfur and hydrogen sulfide levels compared to all groups (p < 0.01).

Conclusions

To the best of our knowledge, this is the first experimental evidence showing that ALA prevents diabetes-induced liver injury by activating hepatic sulfane sulfur/hydrogen sulfide pathway via upregulation of hepatic cystathionine γ-lyase and 3-mecaptopyruvate sulfurtransferase expressions. Therefore, ALA could serve as a novel pharmacological agent for the treatment and prevention of diabetes-induced liver injury, with hepatic sulfane sulfur/hydrogen sulfide as a novel therapeutic target.
Classification accuracy of blood-based and neurophysiological markers in the differential diagnosis of Alzheimer’s disease and frontotemporal lobar degeneration
Authors: Benussi Alberto , Cantoni Valentina , Rivolta Jasmine , Archetti Silvana , Micheli Anna , Ashton Nicholas , Zetterberg Henrik , Blennow Kaj , Borroni Barbara
Published: October 2022

Background

In the last decade, non-invasive blood-based and neurophysiological biomarkers have shown great potential for the discrimination of several neurodegenerative disorders. However, in the clinical workup of patients with cognitive impairment, it will be highly unlikely that any biomarker will achieve the highest potential predictive accuracy on its own, owing to the multifactorial nature of Alzheimer’s disease (AD) and frontotemporal lobar degeneration (FTLD).

Methods

In this retrospective study, performed on 202 participants, we analysed plasma neurofilament light (NfL), glial fibrillary acidic protein (GFAP), and tau phosphorylated at amino acid 181 (p-Tau181) concentrations, as well as amyloid β42 to 40 ratio (Aβ1–42/1–40) ratio, using the ultrasensitive single-molecule array (Simoa) technique, and neurophysiological measures obtained by transcranial magnetic stimulation (TMS), including short-interval intracortical inhibition (SICI), intracortical facilitation (ICF), long-interval intracortical inhibition (LICI), and short-latency afferent inhibition (SAI). We assessed the diagnostic accuracy of combinations of both plasma and neurophysiological biomarkers in the differential diagnosis between healthy ageing, AD, and FTLD.

Results

We observed significant differences in plasma NfL, GFAP, and p-Tau181 levels between the groups, but not for the Aβ1–42/Aβ1–40 ratio. For the evaluation of diagnostic accuracy, we adopted a two-step process which reflects the clinical judgement on clinical grounds. In the first step, the best single biomarker to classify “cases” vs “controls” was NfL (AUC 0.94, p < 0.001), whilst in the second step, the best single biomarker to classify AD vs FTLD was SAI (AUC 0.96, p < 0.001). The combination of multiple biomarkers significantly increased diagnostic accuracy. The best model for classifying “cases” vs “controls” included the predictors p-Tau181, GFAP, NfL, SICI, ICF, and SAI, resulting in an AUC of 0.99 (p < 0.001). For the second step, classifying AD from FTD, the best model included the combination of Aβ1–42/Aβ1–40 ratio, p-Tau181, SICI, ICF, and SAI, resulting in an AUC of 0.98 (p < 0.001).

Conclusions

The combined assessment of plasma and neurophysiological measures may greatly improve the differential diagnosis of AD and FTLD.
Computational phenotyping of obstructive airway diseases: protocol for a systematic review
Authors: Bashir Muwada Bashir Awad , Basna Rani , Zhang Guo-Qiang , Backman Helena , Lindberg Anne , Ekerljung Linda , Axelsson Malin , Hedman Linnea , Vanfleteren Lowie , Lundbäck Bo , Rönmark Eva , Nwaru Bright I.
Published: October 2022

Background

Over the last decade, computational sciences have contributed immensely to characterization of phenotypes of airway diseases, but it is difficult to compare derived phenotypes across studies, perhaps as a result of the different decisions that fed into these phenotyping exercises. We aim to perform a systematic review of studies using computational approaches to phenotype obstructive airway diseases in children and adults.

Methods and analysis

We will search PubMed, Embase, Scopus, Web of Science, and Google Scholar for papers published between 2010 and 2020. Conferences proceedings, reference list of included papers, and experts will form additional sources of literature. We will include observational epidemiological studies that used a computational approach to derive phenotypes of chronic airway diseases, whether in a general population or in a clinical setting. Two reviewers will independently screen the retrieved studies for eligibility, extract relevant data, and perform quality appraisal of included studies. A third reviewer will arbitrate any disagreements in these processes. Quality appraisal of the studies will be undertaken using the Effective Public Health Practice Project quality assessment tool. We will use summary tables to describe the included studies. We will narratively synthesize the generated evidence, providing critical assessment of the populations, variables, and computational approaches used in deriving the phenotypes across studies

Conclusion

As progress continues to be made in the area of computational phenotyping of chronic obstructive airway diseases, this systematic review, the first on this topic, will provide the state of the art on the field and highlight important perspectives for future works.

Ethics and dissemination

No ethical approval is needed for this work is based only on the published literature and does not involve collection of any primary or human data.

Registration and reporting

Systematic review registration

PROSPERO CRD42020164898
Deep brain stimulation for neurological disorders: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis of randomised clinical trials
Authors: Petersen Johanne Juul , Juul Sophie , Jørgensen Caroline Kamp , Gluud Christian , Jakobsen Janus Christian
Published: October 2022

Background

Deep brain stimulation has been used since the 1980s for neurological disorders and the USA and Europe have now approved it for Parkinson’s disease, essential tremor, dystonia, and epilepsy. Previous reviews have assessed the effects of deep brain stimulation on different neurological disorders. These reviews all had methodological limitations.

Methods

This is a protocol for a systematic review based on searches of major medical databases (e.g. MEDLINE, EMBASE, CENTRAL) and clinical trial registries. Two review authors will independently extract data and conduct risk of bias assessment. We will include published and unpublished randomised clinical trial comparing deep brain stimulation versus no intervention, usual care, sham stimulation, medical treatment, or resective surgery for Parkinson’s disease, essential tremor, dystonia, or epilepsy. The effects of deep brain stimulation will be analysed separately for each of the different diagnoses. Primary outcomes will be all-cause mortality, disease-specific symptoms, and serious adverse events. Secondary outcomes will be quality of life, depressive symptoms, executive functioning, level of functioning, and non-serious adverse events. Data will be analysed using fixed-effect and random-effects meta-analyses and Trial Sequential Analysis. Risk of bias will be assessed with the Cochrane Risk of Bias tool—version 2, an eight-step procedure to assess if the thresholds for clinical significance are crossed, and the certainty of the evidence will be assessed by Grading of Recommendations, Assessment, Development and Evaluations (GRADE).

Discussion

Deep brain stimulation is increasingly being used for different neurological diseases, and the effects are unclear based on previous evidence. There is a need for a comprehensive systematic review of the current evidence. This review will provide the necessary background for weighing the benefits against the harms when assessing deep brain stimulation as intervention for individual neurological disorders.

Systematic review registration

PROSPERO 306,556.