bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Illustrated Postoperative Instructions on Knowledge and Retention During a Cleft Lip and Palate Surgical Mission
Authors: Card Elizabeth B. , Morales Carrie E. , Ramirez Juan M. , Billingslea Marce , Marroquín Ariel , Trueblood Eo , Javia Luv R. , McCormack Susan M. , Friedland Leonard R. , Low David W. , Schwartz Alan Jay , Scott Michelle , Jackson Oksana A.
Published: June 2022

Objective

To determine the impact of illustrated postoperative instructions on patient-caregiver knowledge and retention.

Design

Prospective study with all participants receiving an educational intervention.

Setting

Pediatric plastic surgical missions in Guatemala City, Guatemala, between 2019 and 2020.

Participants

A total of 63 majority-indigenous Guatemalan caregivers of patients receiving cleft lip and/or palate surgery.

Intervention

Illustrated culturally appropriate postoperative care instructions were iteratively developed and given to caregivers who were surveyed on illustration-based and text-based information at preoperative, postoperative, and four-week follow-up time points.

Main Outcome Measure

Postoperative care knowledge of illustration-based versus text-based information as determined by the ability to answer 11 illustration- and 8 text-based all-or-nothing questions, as well as retention of knowledge as determined by the same survey given at four weeks follow-up.

Results

Scores for illustration-based and text-based information both significantly increased after caregivers received the postoperative instructions (+13.30 ± 3.78 % SE, + 11.26 ± 4.81 % SE; P < .05). At follow-up, scores were unchanged for illustration-based (−3.42 ± 4.49 % SE, P > .05), but significantly lower for text-based information (−28.46 ± 6.09 % SE, P < .01). Retention of text-based information at follow-up correlated positively with education level and Spanish literacy, but not for illustration-based.

Conclusions

In the setting of language and cultural barriers on a surgical mission, understanding of illustration-based and text-based information both increased after verbal explanation of illustrated postoperative instructions. Illustration-based information was more likely to be retained by patient caregivers after four weeks than text-based information, the latter of which correlated with increased education and literacy.
Global Trends in Knowledge, Attitude, and Awareness of Orthodontists Regarding the Management of Patients with Cleft lip and/or Palate: A Systematic Review
Authors: Srivastav Sukeshana , Tewari Nitesh , Goel Shubhi , Duggal Ritu , Antonarakis Gregory S. , Haldar Partha
Published: June 2022

The aim of the present systematic review was to assess the trends in knowledge, attitude, awareness, and practice among orthodontists regarding the management of patients with cleft lip and/or palate.

An a priori protocol was developed as per the best practices of evidence-based medicine and registered in Prospero (CRD42022306107). The literature search was conducted electronically, using MeSH-terms, keywords, and Boolean-operators “AND” and “OR” in different combinations in multiple databases and screening of titles and abstracts followed by full-text evaluation was performed. The risk of bias (ROB) was assessed using Joanna Briggs Institute critical appraisal checklist.

Five studies were included in the qualitative synthesis and three of them showed a high ROB. When participants were questioned about which other specialists worked in the cleft team in addition to the orthodontists, 84% of them in one study reported it to be general dentists. Furthermore, the absence of an interdisciplinary team was reported in two studies from Africa. When asked about the percentage of their practice devoted to the care of patients with cleft lip and palate (CLP) one study reported that 52% of orthodontists had treated <10 such patients in their entire career.

The present systematic review highlights the lack of knowledge and experience among orthodontists and orthodontic residents regarding the management of patients with CLP. Efforts must be made to design validated questionnaires and conduct methodologically sound studies in different geographical locations to develop adequate modules for improving the knowledge of orthodontists in this domain.
Correlation Between and Nursing Satisfaction With CIWA-Ar, mMINDS, and SEWS Scoring Tools for the Assessment of Severe Alcohol Withdrawal Syndrome in ICU Patients
Authors: Bradley Mary , Kiser Tyree H. , Mueller Scott W. , Reynolds Paul M. , MacLaren Robert
Published: June 2022

Background

Management of alcohol withdrawal syndrome (AWS) requires bedside assessments of symptom severity to guide therapies. Commonly used assessment tools are the Clinical Institute Withdrawal Assessment for Alcohol (CIWA-Ar), the modified Minnesota Detoxification Scale (mMINDS) and the Severity of Ethanol Withdrawal Scale (SEWS).

Objective

To determine strength of correlation between the CIWA-Ar, mMINDS, and SEWS for bedside assessment of severe AWS and to survey nurses regarding ease of use of each tool.

Methods

A single-center prospective correlation study of the three assessment tools performed by bedside nurses on patients with AWS followed by a questionnaire assessing ease of use of each tool (1 being the easiest and 9 being the hardest).

Results

A total of 66 correlation assessments were performed by 49 nurses in 21 patients with AWS. Bedside CIWA-Ar, mMINDS, and SEWS were 14 ± 8.3, 13.9 ± 6.5, and 10.1 ± 4.5, respectively. The Pearson correlation coefficients were 0.814 (95% CI, 0.714-0.881) between CIWA-Ar and mMINDS; 0.722 (95% CI, 0.585-0.820) between CIWA-Ar and SEWS; and 0.658 (95% CI, 0.498-0.775) between SEWS and mMINDS. Nurse ratings for ease of use were 4 ± 2.3 for CIWA-Ar, 2.9 ± 2 for mMINDS (p=0.0044 vs. CIWA-Ar), and 4.8 ± 2.1 for SEWS (p=0.036 vs. CIWA-Ar, p<0.0001 vs. mMINDS). Forty-six (69.7%) respondents preferred mMINDS versus 14 (21.2%) and 6 (9.1%) respondents favored CIWA-Ar and SEWS, respectively.

Conclusion

Correlations between the three scoring tools in severe AWS are robust. Only mMINDS was considered easy to use by nurses. It was the preferred tool.
A Rare Case of a Solitary Fibrous Tumor in a Child, Presenting as a Congenital Mass, Displaying NAB2ex4::STAT6ex2 Gene Fusion with an Incidental Ganglioneuroblastoma
Authors: Rao Vidya , Rekhi Bharat , Abraham Latha K , Bapat Prachi
Published: June 2022

A solitary fibrous tumor (SFT) is a ubiquitous tumor that occurs across all ages. It is rarely reported in pediatric patients, especially as a congenital mass. A 1 year 7-month old male child presented with a slow-growing gluteal mass since birth along with a recent episode of bleeding. Magnetic resonance imaging (MRI) showed a well-defined, T1-hypointense and T2-hyperintense mass in the skin and the subcutaneous plane. Subsequently, he underwent a surgical resection that revealed a 5.7 cm-sized fleshy mass. On histopathologic examination, there was a fairly well-circumscribed, cellular spindle cell tumor, with cells arranged in intersecting fascicles and hemangiopericytomatous pattern with areas of hemorrhage and fibrinoid necrosis. Cells revealed mild nuclear atypia. Mitotic figures were up to 8/10 hpf. Immunohistochemically, the tumor cells were diffusely positive for CD34 and STAT6. Furthermore, the tumor revealed NAB2 exon 4:: STAT6 exon 2 fusion by RT-PCR and Sanger sequencing. Post-excision, during follow-up, the patient developed an adrenal mass that was histopathologically proven as a neuroblastic tumor, not further specified on biopsy and finally as ganglioneuroblastoma, intermixed type on excision. This constitutes one of the rare cases of SFT in a pediatric patient, presenting as a congenital mass, confirmed by STAT6 immunostaining and further, molecular testing. A review of literature of similar cases, including treatment-related implications, is presented.
Screening for Pregnancy-Related Anxiety: Evaluation of the Pregnancy-Related Anxiety Scale–Screener Using Rasch Methodology
Authors: Dryer Rachel , Brunton Robyn , Krägeloh Chris , Medvedev Oleg
Published: June 2022

Pregnancy-related anxiety has been linked to many maternal and child-related negative outcomes. However, there is an absence of free, well-validated screeners for this condition. The Pregnancy-related Anxiety Scale–Screener (PrAS-Screener) was evaluated using robust Rasch methodology. This study also aimed to develop a shorter version to meet the need of settings governed by professional guidelines stipulating the use of brief instruments. Data from 400 pregnant women ( Mage = 27.82, SD = 5.38) were subjected to Rasch analyses and the resulting Rasch models confirmed in a second sample ( N = 400, Mage = 26.29, SD = 4.95). After minor modifications, the original 15-item PrAS-Screener demonstrated good fit, unidimensionality, excellent targeting, invariance, and internal consistency. After removal of items with content overlap, an 11-item version was developed, with this version showing good fit, unidimensionality, reasonable targeting, and sound internal consistency. The PrAS-Screeners show promise as psychometrically sound clinical scales for screening pregnancy-related anxiety.
Practical finite-time consensus of multi-agent systems with unknown nonlinear dynamics and the asymmetric input dead zone
Authors: Zamanian Mehdi , Abdollahi Farzaneh , Yadavar Nikravesh Seyyed Kamaleddin
Published: June 2022

This paper investigates the practical finite-time consensus problem for heterogeneous multi-agent systems with unknown nonlinear dynamics, the asymmetric input dead zone, and external disturbances under directed topology. The model of heterogeneous multi-agent systems is composed of first-order and second-order dynamics. First, we show that under the proposed protocol, the sliding mode surface converges to a compact set in finite time. Then, we prove that the position errors and the velocity errors (for second-order agents) between any two agents reach a small desired neighborhood of the origin in finite time. In this approach, adaptive neural networks are employed to compensate for the nonlinear dynamics of agents. By applying sliding mode control, the external disturbances and the imperfect approximation of neural networks are rejected. The approach of the adaptive compensator plus dead zone is applied to overcome the asymmetric input dead zone. Besides, our proposed protocol is fully distributed, which means that the global graph information is not required beforehand by adaptive control gains. The effectiveness of our proposed protocol is finally validated through numerical simulations.
The Insider Looking Out: Discovering the Real Me
Authors: Forber-Pratt Anjali J.
Published: June 2022

This article is an autoethnographic performative account based on my story as a transnational adopted academic disabled scholar of color finding my own sense of personal and professional “home.” The format was constructed based on my previous work of specific movie scenes and corresponding dialogue appearing throughout the text. The resulting piece showcases the journey and the struggles to find and to intentionally build my home in the academy using my complex identities as the foundation.
Are Luxury Travelers Alike? A Qualitative Means–End Segmentation Approach
Authors: Zhang Elaine Yulan , McKercher Bob , Tse Tony S. M.
Published: June 2022

This study proposes a qualitative means–end approach that considers both product preferences and personal values in segmenting the emerging luxury travel market. Many studies have treated this market as homogeneous, emphasizing luxury travelers’ common characteristics. However, distinct segments of luxury travelers can be identified using this new approach. Soft laddering interviews with 30 Chinese luxury travelers revealed diverse levels of luxuriousness in travel modes (means) and various personal values associated with luxury travel (ends), such as status and family security. These differences segment the luxury travel market. Despite its limited sample size, this study empirically demonstrated the effectiveness of means–end segmentation. The results of this study provide a solid basis for future larger-scale studies and have practical implications for practitioners in the luxury travel market.
Comparing adipose-derived mesenchymal stem cells with prednisolone for the treatment of feline inflammatory bowel disease
Authors: Webb Tracy L , Webb Craig B
Published: June 2022

Objectives

The objective of this study was to compare the efficacy of feline mesenchymal stem cells (fMSC) with prednisolone as a treatment for inflammatory bowel disease (IBD) in cats.

Methods

Cats with chronic enteropathy that failed a 2-week diet trial and were not found to have significant concurrent disease were eligible for the study. If endoscopic biopsies confirmed a histopathologic diagnosis of IBD, the cat was randomly assigned to either the fMSC or prednisolone groups. Owners were blinded to the grouping. Stem cell treatment consisted of two intravenous injections of 2 × 106 cells/kg of freshly cultured allogeneic stem cells separated by 2 weeks. Prednisolone treatment was 1–2 mg/kg PO q24h, tapered according to clinical response. Owners were asked to make no changes (eg, diet and other medications) for the first 2 months, at which time they either continued to the 6-month recheck with no changes, or ‘failed’ treatment and owners were unblinded and changes made as necessary.

Results

Six prednisolone and six fMSC treatment cats completed the study. All six prednisolone group cats were spayed females with a mean age of 8.3 years (range 2–14), a mean body weight of 3.6 kg (range 2.5–4.8) and a mean pretreatment Feline Chronic Enteropathy Activity Index (FCEAI) score of 3.6 (range 2–6). The six stem cell cats included three spayed females and three castrated males, and had a mean age of 8.0 years (range 4.5–13), a mean body weight of 4.9 kg (range 4.0–5.9) and a mean pretreatment FCEAI score of 3.7 (range 2–5). One cat in each group failed at the 2-month recheck. At the 6-month recheck, the mean FCEAI score for the prednisolone group was 3.7 (range 0.5–9) and 0.75 (range 0–1.5) for the fMSC group.

Conclusions and relevance

These results suggest that this specific fMSC protocol appears to be as effective in the treatment of feline IBD as a standard course of prednisolone therapy.
Application of metagenomic next-generation sequencing in suspected intraocular infections
Authors: Qian Zhuyun , Zhang Yankun , Wang Lu , Li Ziqiang , Wang Hui , Kang Hao , Feng Jing , Hu Xiaofeng , Tao Yong
Published: June 2022

Purpose

To evaluate the efficacy of metagenomic next-generation sequencing (mNGS) and to explore its value in the diagnosis of intraocular infection.

Methods

A retrospective case-series study of patients with suspected intraocular infection was performed. Intraocular fluid samples were collected from all the patients and sent for mNGS. Detailed clinical data, the results of mNGS and other laboratory examinations, the sequencing data of mNGS, and the final diagnosis were recorded.

Results

Fifteen eyes of 15 patients were included in the study. Eight samples were identified as positive for different kinds of pathogens by mNGS, which were all confirmed by other laboratory examinations or effective diagnostic treatment. The mNGS results were negative in seven samples. The final diagnosis was still intraocular infection in four of the seven negative results. Of these, one patient was diagnosed with fungal endophthalmitis according to the clinical characteristics and good treatment response to the anti-fungal therapy, one patient underwent vitrectomy and the bacterial culture of the vitreous sample was positive for Brucella melitensis, and two patients were diagnosed with ocular tuberculosis according to the positive T-SPOT test and effective anti-tuberculous treatments.

Conclusions

mNGS could be helpful in determining pathogens in cases of suspected intraocular infection. The mNGS protocols should be optimized for the detection of intracellular bacterial and fungal pathogens.
Evaluating the beads of life groups: hearing from our participants
Authors: Valentino Charlotte , Daniilidi Xeni , Portnoy Sara
Published: June 2022

Introduction and Aims

The Beads of Life (BOL) approach uses a narratively informed methodology ‘to enable children and young people to make sense of their cancer journey in ways that make them stronger'. We will share feedback from BOL groups and reflect on changes made over time.

Method

Between 2014 and 2019, we have run 14 groups. Participants were aged 13–25, had received a diagnosis of cancer and were either on or had completed treatment. Quantitative and qualitative feedback was gathered at each workshop and 1 month later, with qualitative data then being analysed using thematic analysis.

Results

106 young people attended the groups. Young people reported that sharing experiences of cancer was useful, that they enjoyed the group and that they were highly likely to recommend it to others. Feedback remained consistent a month post-intervention. Qualitative feedback showed the value young people placed on meeting others, sharing their stories and on things they learnt about themselves from the group.

Discussion

Themes support the intention of the intervention to provide a safe space for young people to share and reflect on their cancer journey, to connect with others and to enable peer support and mutual learning.
Nonlinear dynamics and static bifurcations control of the 12-pole magnetic bearings system utilizing the integral resonant control strategy
Authors: Saeed Nasser A , El-Shourbagy Sabry M , Kamel Magdi , Raslan Kamal R , Aboudaif Mohamed K
Published: June 2022

In this study, the Integral Resonant Controller (IRC) is presented along with the Proportional-Derivative (PD) controller as a novel control technique to control the dynamical behaviors of the 12-pole rotor active magnetic bearing system. According to the proposed control strategy, the system model has been derived as a two-degree-of-freedom nonlinear dynamical system coupled with two first-order filters. The obtained mathematical model has been analyzed utilizing the asymptotic analysis. The nonlinear algebraic system that governs the steady-state vibration amplitudes and corresponding phase angles of the considered system has been extracted. The influence of the IRC control parameters on the rotor dynamics has been explored by plotting the different bifurcation diagrams. The analytical investigations demonstrated that the vibration suppression efficiency of the combined controller (i.e., PD and IRC) is proportional to the product of control and feedback gains of the IRC as well as the derivative gain of the PD-controller. In addition, it is found that the controller efficiency is inversely proportional to both the square of the internal loop feedback gain of the IRC and the position gain of the PD-controller. Accordingly, an objective function has been derived to design the best control gains of the proposed controller strategy. The analytical and numerical simulations confirmed that the suggested control method can suppress the system vibration and eliminate the catastrophic bifurcation behaviors if the control gains are selected according to the proposed objective function. Finally, the effect of failing one of the coupled integral resonant controllers on the rotor dynamics has been explored as a precautionary procedure. It is found that the failure of one of the coupled integral resonant controllers may breakdown the bifurcation symmetry of the rotor system, but the system does not lose its stability.
An autonomous method for diagnosing raceway defects and misalignment in a self-aligning rolling-element bearing
Authors: Parmar Vivek , Saran V Huzur , Harsha Suraj P
Published: June 2022

This paper presents an autonomous method to diagnose a double-row self-aligning ball bearing for any dynamic misalignment or localized defects, using vibration signals. The frequency spectra from the experimental investigation revealed that irrespective of the health condition of the bearing i.e. either healthy or defective, the frequency spectrum had a clear cage frequency peak whenever the system was under dynamic-misalignment. An improved version of Harmonic Product Spectrum (HPS) called sideband product spectrum (SPS) was used to identify the cage frequency peaks which was preprocessed using kurtosis-based band-pass filter and parameter-optimized variational mode decomposition (VMD) algorithm. A mathematical model is also presented to analyze the dynamic behavior of double-row self-aligning ball bearing under such conditions. From the model, it was realized that during misalignment, the contact load shared by the rolling elements, generates some moment which has a tendency to rotate the bearing’s inner-race about the radial axis and thus resulting in a wobbly rotary motion. This wobbly motion of the inner race in fact characterizes the bearing for dynamic misalignment. The simulated results were in accordance with the experimentally obtained results.
Responding to the deteriorating patient: The rationale for treatment escalation plans
Authors: Taylor D Robin , Lightbody Calvin J , Venn Richard , Ireland Alastair J
Published: June 2022

A Treatment Escalation Plan (TEP) is a communication tool designed to improve quality of care in hospital, particularly if patients deteriorate. The aims are to reduce variation caused by discontinuity of care; avoid harms caused by inappropriate treatment and promote patients’ priorities and preferences. The TEP is based on the goals of treatment – ‘What are we trying to achieve?’ The goals take account of the context of acute illness, the consequences of interventions and discussion with the patient. They should reflect a shift away from ‘fix-it’ medicine to what is realistic and pragmatic. A TEP has three escalation categories: full escalation, selected appropriate treatments and palliative/supportive care. Other appropriate/inappropriate treatments are also recorded. Treatment Escalation Plans are associated with significant reductions in intensive care unit (ICU) admissions, non-beneficial interventions, harms and complaints. Treatment Escalation Plans contribute to staff well-being by reducing uncertainty. Successful implementation requires training and education in medical decision-making and communication skills.
Tenofovir-induced distal renal tubular acidosis: A rare cause of recurrent hypokalaemic paralysis
Authors: Dave Mahesh , Sareen Manasvin , Goyal Anuj , Gonchikar Nagaraj T , Shah Yash
Published: June 2022

Tenofovir disoproxil fumarate was the first nucleotide analogue reverse transcriptase inhibitor to be approved for treatment of human immunodeficiency virus infection. It is a relatively safe drug but can present with nephrotoxicity. We report a case of 36-year-old male who presented with acute onset flaccid paraparesis. He was a diagnosed case of acquired immunodeficiency syndrome for 9 years ago and was on tenofovir-based antiretroviral therapy for last 6 months. As the patient had normal anion gap metabolic acidosis, hypokalaemia and urine pH > 5.5, distal renal tubular acidosis (RTA) was suspected. He improved dramatically within 24 h of hospitalisation after potassium correction to regain normal power. Tenofovir-induced distal RTA presenting as hypokalaemic paralysis is a very rare complication of tenofovir; hence, we are reporting this case. In addition, we suggest regular follow-up of patients taking tenofovir with urine analysis and serum potassium to detect this complication earlier as it is reversible.
The Relationship Between Financial Stress and College Retention Rates
Authors: Smathers Kelsie , Chapman Erin , Deringer Nancy , Grieb Terrance
Published: June 2022

This study examined the relationship between financial stress and student retention for post-secondary students. Data from 2014 collected at a Pacific Northwest University using The Ohio State's National Student Financial Wellness Study were used to examine the students’ reported levels of stress related to finances. Students reported the most financial stress came from their student loan debt. Data analyses showed significance between participants who reported “large” and “extreme” amounts of stress from debt and their decisions to reduce course work, drop out, and/or take a break. Although future research is needed to determine the exact relationship between financial stress and retention rates, it is important to acknowledge that financial stress influences students’ educational decisions.
Assessing Inferencing Skills in Children Through the Lens of Dynamic Visual Narratives
Authors: Rooha Aysha , Anil Malavika Anakkathil , Bhat Jayashree S. , Bajaj Gagan , Deshpande Apramita
Published: June 2022

The lack of research exploring the influence of dynamic visual narratives on inference skills prompted the present study with an aim to profile the inference skills in school children between the ages of 6 years and 9 years 11 months using dynamic visual narratives. A total of 80 participants were considered for the study. An animated story was designed as the dynamic visual narrative stimuli based on which an “inference task” was formulated, which included forced-choice questions and free-response questions. The responses of the forced-choice questions were analyzed quantitatively using one-way analysis of variance (ANOVA), while the responses from the free-response questions were analyzed qualitatively. The results revealed an increase in inference skills with age, with children using less seductive details, beginning to display inductive inference, and providing multiple inferences. The inference profiles obtained from the study can serve as evidence for the development of bridging inference skills from dynamic visual narratives in children.
The influence of wind load on the stress characteristics of dropper for a high-speed railway
Authors: Chen Liming , Guo Dandan , Pan Like , He Fan
Published: June 2022

In this paper, the influence of wind load on the stress characteristics of dropper for a high-speed railway is studied. The section method is used to obtain the vibration equation of the dropper, and the finite difference method is used to convert the partial differential equation of the dropper vibration into a finite difference equation. Through the force analysis of the contact line section upwind, the vibration equation of the contact line with air damping is obtained. Thus, the partial differential equation of the motion can determine the initial and boundary conditions of each dropper. The MATLAB program is written to obtain the stress change diagram of each dropper, and the influence of wind load on the stress characteristics of the dropper is analyzed. The results show that the maximum tensile and compressive stresses of each dropper are different due to the difference of wind load and dropper location, and the dropper in the middle location is most sensitive to the change of wind load. At a low wind speed, there are immediate rebound and obvious attenuation vibration stages during the stress change of dropper. In addition, with the increasing speed of wind load, the stress amplitude and the maximum tensile stress of dropper do not almost change or decrease except the middle dropper.
Numerical thermal featuring in γAl2O3-C2H6O2 nanofluid under the influence of thermal radiation and convective heat condition by inducing novel effects of effective Prandtl number model (EPNM)
Authors: Adnan  , Ashraf Waqas
Published: June 2022

The investigation of thermal transport in the nanofluid attained much interest of the researchers due to their extensive applications in automobile, mechanical engineering, radiators, aerodynamics, and many other industries. Therefore, a nanofluid model is developed for γAl2O3-C2H6O2 by incorporating the novel effects of Effective Prandtl Number Model (EPNM), thermal radiations, and convective heat condition. The model discussed numerically and furnished the results against the governing flow quantities. It is examined that the nanofluid velocity alters significantly due to combined convection and stretching parameter. Induction of thermal radiation in the model significantly contributed in the temperature of nanofluids and high temperature is observed by strengthen thermal radiation (Rd) parameter. Further, convection from the surface (convective heat condition) provided extra energy to the fluid particles which boosts the temperature of γAl2O3-C2H6O2. The comparison of nanofluid (γAl2O3-C2H6O2) temperature with base fluid (C2H6O2) revealed that γAl2O3-C2H6O2 has high temperature and would be fruitful for future industrial applications. Moreover, the study is validated with previously reported literature and found reliability of the study.
Regulatory T-cells and IL-5 mediate pain outcomes in a preclinical model of chronic muscle pain
Authors: Lenert Melissa E , Szabo-Pardi Thomas A , Burton Michael D
Published: June 2022

Fibromyalgia (FM) is a chronic musculoskeletal pain disorder primarily diagnosed in women. Historically, clinical literature focusing on cytokines and immune cells has been inconsistent. However, recent key studies show several layers of immune system dysfunction in FM. Preclinically, studies of the immune system have focused on monocytes with little focus on other immune cells. Importantly, T-cells are implicated in the development and resolution of chronic pain states, particularly in females. Our previous work showed that monocytes from women with FM produced more interleukin 5 (IL-5) and systemic treatment of IL-5 reversed mechanical hypersensitivity in a preclinical model of FM. Typically, IL-5 is produced by TH2-cells, so in this study we assessed T-cell populations and cytokine production in female mice using the acid-induced chronic muscle pain model of FM before and after treatment with IL-5. Two unilateral injections of pH4.0 saline, five days apart, into the gastrocnemius muscle induce long-lasting widespread pain. We found that peripheral (blood) regulatory Thelper-cells (CD4+ FOXP3+) are downregulated in pH4.0-injected mice, with no differences in tissue (lymph nodes) or CD8+ T-cell populations. We tested the analgesic properties of IL-5 using a battery of spontaneous and evoked pain measures. Interestingly, IL-5 treatment induced place preference in mice previously injected with pH4.0 saline. Mice treated with IL-5 show limited changes in T-cell populations compared to controls, with a rescue in regulatory T-cells which positively correlates with improved mechanical hypersensitivity. The experiments in this study provide novel evidence that downregulation of regulatory T-cells play a role in chronic muscle pain pathology in the acidic saline model of FM and that IL-5 signaling is a promising target for future development of therapeutics.
Enhancement of behavioral nociceptive responses but not itching responses by viewing mirror images in adult mice
Authors: Zhou Si-Bo , Xue Man , Shi Wantong , Fan Kexin , Chen Yu-Xin , Chen Qi-Yu , Wang Jinjun , Lu Jing-Shan , Li Xu-Hui , Zhuo Min
Published: June 2022

Can mice recognize themselves in a mirror? The answer is unclear. Previous studies have reported that adult mice – when shown itch-like videos - demonstrated itch empathy. However, this was proven to be unreproducible in other studies. In the present study, we wanted to examine whether adult mice were able to recognize their mirror image. In our testing, we found that mice spent more time in the central area in an open field with mirrors surrounding the chamber than those in a normal open field. In a similar open field test with four mice placed in four directions, mice showed similar behavioral responses to those with mirrors. These results indicate that mice are able to recognize images in the mirror, however, they cannot distinguish their own mirror images from the mirror images of other mice. To repeat the experiments of itch empathy, we compared the itch responses of mice in the mirrored environment, to those without. No significant difference in itching responses was detected. Differently, in the case of chemical pain (formalin injection), animals’ nociceptive responses to formalin during Phase II were significantly enhanced in the mirrored open field. A new format of heat map was developed to help the analysis of the trace of mice in the open field. Our results suggest that mice do recognize the presence of mice in the mirror, and their nociceptive - but not itch - responses are enhanced.
A density functional theory study on the mechanism of simultaneous trifluoromethylation and oximation of aryl-substituted ethylenes
Authors: Wang Sen , Song Wenlu , Lan Xiaowei , Meng Xuan , Li Nan , Wei Xianfu , Jing Wenjie , Lu Kui , Dai Yujie
Published: June 2022

The effects of different substituents, located at the para position of the aromatic ring and at the β-carbon atom of styrenes, on difunctionalizations involving trifluoromethylation and oxime formation are investigated, showing that the difunctionalization reaction has a good adaptability to such reactants containing a range of substituents. This is important in the actual production process. It was found that proton transfer in the final tautomerism step involving transformation of a nitroso intermediate into an oxime is the rate-limiting step. The solvent effect did not influence the rate-limiting step significantly. Compared with direct proton transfer in a vacuum, the energy barrier of the final tautomerism step decreased from 57.80 kcal mol−1 in vacuum to 12.98 kcal mol−1 in water occurring via mediated proton transfer, which declines by 77.5%. When water participates in the rate-limiting steps in organic solvents, the energy barrier also decreases significantly, which indicates that a small amount of water in the organic solvent is conducive to the reaction.
Association between systolic blood pressure parameters and unexplained early neurological deterioration (UnND) in acute ischemic stroke patients treated with mechanical thrombectomy
Authors: Vilionskis Aleksandras , Gaigalaite Virginija , Salasevicius Lukas , Jatuzis Dalius
Published: June 2022

Background:

Neurological deterioration (ND) after mechanical thrombectomy (MT) of acute ischemic stroke (AIS) in anterior circulation is an important complication associated with a poor outcome. Moreover, evident causes of ND may remain unexplained (UnND).

Objective:

We sought to evaluate the association of the systolic blood pressure (SBP) parameters before MT, during MT, and during a 24-h period after MT with UnND.

Methods:

We analyzed 382 MT-treated AIS patients in two stroke centers from 2017 to 2019. The patients with unsuccessful recanalization and/or with symptomatic intracerebral hemorrhage after MT were excluded. Multivariate logistic regression analysis was used to identify the SBP parameters that predict UnND.

Results:

There were 5.9% patients with UnND within 24 h after MT among patients with successful recanalization what comprises 4.9% of all patients who had undergone MT. SBP > 180 mmHg on admission (odds ratio (OR): 4, 95% confidence interval (CI): 1.6–10, p = 0.004) and a drop of SBP below100 mmHg during MT (OR: 4.7, 95% CI: 1.3–17, p = 0.019) were associated with UnND occurrence within 7 days without a significant association with UnND within 24 h. UnND within 7 days was predicted by the episodes of SBP exceeding the level of SBP observed before the groin puncture and occurring over the first 2 h following recanalization (OR: 5, 95% CI: 1.3–19, p = 0.021), an increase of SBP of more than 20% within 2–24 h after MT (OR: 3.4, 95% CI: 1.1–10, p = 0.035), and a drop of SBP below 100 mmHg after MT (OR: 3.2, 95% CI: 1.1–9, p = 0.039).

Conclusion:

The association between the SBP parameters and UnND depends on the treatment period and the time of UnND occurrence. The J/U resembling relationship between SBP and UnEND was established during a 24-h period after MT.
Cancer-cell-derived cell-free DNA can predict distant metastasis earlier in pancreatic cancer: a prospective cohort study
Authors: Huang Chien-Jui , Huang Wen-Yen , Chen Chien-Yu , Chao Ying-Jui , Chiang Nai-Jung , Shan Yan-Shen
Published: June 2022

Background:

Carbohydrate antigen 19-9 (CA19-9) is the only biomarker for monitoring responses during treatments of pancreatic cancer, but its accuracy for disease outcome is controversial. Fluid biopsy is a new method for diagnosis and monitoring treatment response. In this study, we investigate the usefulness of cell-free DNA (cfDNA) in predicting disease progression during the treatment of pancreatic cancer.

Methods:

Biopsy-proved advanced pancreatic cancer patients who received systemic chemotherapy were enrolled after signed informed consent. CA19-9 and cfDNA in blood were measured before and after every two cycles of treatments, and the disease progression was monitored by computed tomography (CT) with 3-month interval.

Results:

In total, 74 patients and 148 blood samples were enrolled in this study. Patients whose average blood cfDNA concentration of >9.71 ng/mL before and after first two courses of chemotherapy would subsequently show new distant metastasis (NDM) on CT scans 3 months later. The accuracy was 94.37% (AUC 0.9705, p < 0.0001) and the progression-free survival (PFS) and overall survival (OS) of patients with cfDNA concentration of >9.71 ng/mL were worse than those patients with cfDNA concentration of <9.71 ng/mL (median PFS: 95 days versus 322 days, p < 0.0001; median OS: 150 days versus 431 days, p < 0.0001). The cfDNA concentration of >9.71 ng/mL is a predictor for PFS, OS, and distant metastasis-free survival by multivariate analysis. Comparison of KRAS G12 variants detected by next-generation sequencing from tumor tissue issue and remnant DNA of cfDNA showed that increased cfDNA was primarily derived from cancer cells.

Conclusion:

The cancer-cell-derived cfDNA levels could be served as a powerful biomarker for prediction of NDM in patients with advanced/metastatic pancreatic cancer.
Does Virtual Reality Trigger Visits and Booking Holiday Travel Packages?
Authors: Bigne Enrique , Maturana Patricio
Published: June 2022

Although virtual reality technology is increasingly being used in tourism, its potential as a shopping tool and as an avenue for marketing and selling tourism products and services has not yet been examined. Likewise, very little is known about how exploring holiday packages through virtual reality affects behavioral intention to visit tourist destinations. This study aims to compare the visit intentions evoked and the process of booking holiday travel packages between an immersive virtual reality environment (displayed through Oculus head-mounted glasses) and a traditional web-based 2D platform. A causal model is proposed and tested for both designs. Using a between-subjects experimental design with a sample of 202 individuals, the experiences of two randomly selected groups were observed as they bought holiday tour packages to Rio de Janeiro, Brazil. The first group made a simulated purchase in an immersive virtual reality environment using a head-mounted device, and the second group made the purchase on a traditional e-commerce website. The findings revealed that the scores given to sense of presence, attitude change, and perceived ease of use were greater among those who made the purchase in the more immersive virtual reality environment. However, the relationships between the variables in the causal model were stronger for the classic website than for the virtual reality setting. Attitude change positively affected intention to visit a destination more in the virtual reality environment.
Optimizing Handwritten Font Style to Connect With Customers
Authors: Hwang YooHee , Gao Yixing (Lisa) , Mattila Anna S. , Wang Peihao
Published: June 2022

Considerable research has demonstrated the positive effects of handwritten font styles on product attachment and word-of-mouth behavior. However, few studies examined whether these positive effects can be mitigated or even reversed. The purpose of this study is to fill this knowledge gap by identifying several boundary conditions (communal orientation, message type, and hotel type) for the positive effects of handwritten font styles. We conducted two quasi-experimental studies. In Study 1 ( n = 125), the positive effect of handwritten font styles on attitude toward a hotel was not observed among individuals with a low communal orientation. In Study 2 ( n = 245), the handwritten (vs. machine-written) font styles in the sustainability messages of a luxury hotel reduce warmth of the hotel. Hospitality managers should use handwritten font styles carefully depending on hotel type, message type, and customer characteristics.
Defamiliarizing a Walk
Authors: Powell Kimberly , Altuntas Ilayda , Bricker Michael
Published: June 2022

This article chronicles the development of walking workshops through a technique of defamiliarization in order to dislodge the taken-for-granted and open up walking to experimentation and novelty. We work with these concerns to consider walking as a research-creation methodology that composes inventive connections of a relational ethics that enacts a shared ecology of living and lived practices. Walking is not just about directional movement, traveling to or from a place. Walking’s movement is also affective: emergent; sometimes imperceptible; and a performative practice of knowledge in the making that is coproduced by more than human matter. Walking is thus open to novelty. Two of the authors in this article share their participation in these workshops, experimenting with ethico-aesthetic architectures of borders, spaces, and transitions that choreograph movements in places.
The potential of pirtobrutinib in multiple B-cell malignancies
Authors: Jensen Jeffrey L. , Mato Anthony R. , Pena Camila , Roeker Lindsey E. , Coombs Catherine C.
Published: June 2022

Bruton’s tyrosine kinase (BTK) is a critical downstream signaling element from the B-cell receptor (BCR) that has been effectively inhibited in B-cell cancers by irreversible, covalent inhibitors including ibrutinib and acalabrutinib. All FDA-approved covalent BTK inhibitors rely on binding to the cysteine 481 (C481) amino acid within the active site of BTK, thus rendering it inert. While covalent BTK inhibitors have been very successful in multiple B-cell malignancies, improving both overall survival and progression-free survival relative to chemoimmunotherapy in phase 3 trials, they can be limited by intolerance and disease progression. Pirtobrutinib is a novel, highly selective, and non-covalent BTK inhibitor that binds independently of C481, and in a recent, first-in-human phase 1/2 clinical trial was shown to be extremely well tolerated and lead to remissions in relapsed/refractory patients with multiple B-cell malignancies. Here, we review the pharmacologic rationale for pursuing non-covalent BTK inhibitors, the clinical need for such inhibitors, existing safety, and resistance mechanism data for pirtobrutinib, and the forthcoming clinical trials that seek to define the clinical utility of pirtobrutinib, which has the potential to fulfill multiple areas of unmet clinical need for patients with B-cell malignancies.
Elementary math class in face-to-face, fully online, and flipped mode: A comparative study on students’ achievement and satisfaction
Authors: Kundu Arnab , Bej Tripti , Mondal Gourish C
Published: June 2022

Excellent certificates are not enough to make excellent teachers rather, teaching demands constant insight, reflection, and suitable pedagogy. Determining the best pedagogical method of course delivery plagues faculty members and schools across the globe. This paper reports on an investigation and outcomes of a comparative study of three different methods of course delivery offered for the same course in an Indian elementary school before the COVID-19 pandemic. The study followed a Design-Based Research (DBR) approach. Comparisons have been made to the collected quantitative data from each teaching method-face-to-face, blended flipped, and fully online-in respect of students’ learning achievement and satisfaction. Findings revealed that participants in the face-to-face group achieved better than the rest two groups. However, students in the flipped group reported better satisfaction with the course than in the other two modes, and it happened within 8 weeks. These results offer implications for selecting the best method of course delivery for elementary mathematics even in unequipped schools, echoing an insight for practice to add effectiveness to the delivery mode.
Estimation of cardiac QTc intervals in people prescribed antipsychotics: a comparison of correction factors
Authors: Andric Teodora , Winckel Karl , Tanzer Timothy David , Hollingworth Samantha , Smith Lesley , Isoardi Katherine , Tan Olivier , Siskind Dan
Published: June 2022

Background:

A prolonged electrocardiogram (ECG) QT interval is associated with cardiac events and increased mortality. Antipsychotics can prolong the QT interval. The QT interval requires correction (QTc) for heart rate using a formula or QT-nomogram. The QT and QTc can be calculated automatically by the ECG machine or manually; however, machine-measured QT(c) intervals may be inaccurate.

Objective:

We aimed to investigate the mean QTc and proportion of prolonged QTc intervals in people taking antipsychotic medicines.

Methods:

We conducted an observational retrospective chart review and data analysis of all consecutive patients taking antipsychotics, with an ECG record, admitted to the psychiatric unit of a large tertiary hospital in Brisbane, Australia, between 1 January 2017 and 30 January 2019. We investigated the mean QTc of people taking antipsychotics to determine differences using (a) machine versus manual QT interval measurement and (b) QTc correction formulae (Bazett, Fridericia, Framingham, Hodges and Rautaharju) and the QT-nomogram. We also determined the number of people with a prolonged QTc using different methods and compared rates of prolonged QTc with antipsychotic monotherapy and polypharmacy.

Results:

Of 920 included people, the mean (±SD) machine-measured, Bazett-corrected QT interval (recorded from the ECG) was 435 ms (±27), significantly longer ( p < 0.001) than the mean manually measured corrected QT intervals with Fridericia 394 ms (±24), Framingham 395 ms (±22), Hodges 398 ms (±22) and Rautaharju 400 ms (±24) formulae. There were significantly more people with a prolonged QTc using machine-measured QT and the Bazett formula (12.0%, 110/920) when compared with manually measured QT and the Fridericia formula (2.2%, 20/920) or QT-nomogram (0.7%, 6/920). Rates of QTc prolongation did not differ between people taking antipsychotic polypharmacy compared with monotherapy.

Conclusion:

Machine-measured QTc using the Bazett formula overestimates the QTc interval length and number of people with a prolonged QTc, compared with other formulae and the QT-nomogram. We recommend manually measuring the QT and correcting with the Fridericia formula or QT-nomogram prior to modifying antipsychotic therapies.