bluuebunny/crossref_metadata_2025 huggingface dataset:
Proximal Interphalangeal Joint Arthroplasty Using the Wide-Awake Local Anesthesia No Tourniquet Technique
Authors: Sharma Sidharth , Ong Jason , Putti Amit
Published: December 2021

Background:

Proximal interphalangeal joint (PIPJ) osteoarthritis is a common condition that results in pain, stiffness, and loss of function in the affected hand. Proximal interphalangeal joint arthroplasty is an effective treatment option when conservative methods have failed. The wide-awake local anesthesia no tourniquet (WALANT) technique to perform surgery carries advantages such as lack of tourniquet discomfort, reduces the staffing and costs associated with anesthesia and sedation, and allows faster recovery. We aimed to determine whether the WALANT technique was safe and effective in the context of PIPJ arthroplasty.

Methods:

Patients were enrolled retrospectively from January 2015 to October 2020 by examining operating theater records and surgeon logbooks. Electronic patient records were examined to obtain patient data. Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaires and Visual Analog Scale (VAS) for pain were sent by post to patients—with a separate DASH and VAS for each digit operated on.

Results:

Twenty-nine PIPJ arthroplasties were carried out using WALANT technique by 3 different surgeons all using the dorsal approach. All cases were successfully carried out as day-case procedures. There was a significant correlation with increasing VAS and increasing DASH score. Proximal interphalangeal joint arthroplasty improved range of motion from 28.9 ± 5.5° to 79.4 ± 13.3° ( P < .0001). Two cases developed complications related to surgery.

Conclusions:

Our study is the first to report the use of WALANT to perform PIPJ arthroplasty, and shows comparable results with traditional methods. Larger, multicenter prospective trials are required to determine the efficacy of this technique and to quantify its economical benefit.
Association Between Occupational Sitting With High Sensitivity C-Reactive Protein: The Jackson Heart Study
Authors: Jones Raymond , Norris Keith C. , McCoy Stephanie M. , Thorpe Roland J. , Bruce Marino A. , Heitman Elizabeth , Beech Bettina M.
Published: December 2021

Modifiable, behavioral risk factors like occupational sitting may contribute to inflammation, an important cardiovascular risk factor. This study evaluated the association of self-reported occupational sitting with changes in c-reactive protein (CRP) and the role of sex. We examined occupational sitting and baseline CRP levels for 2889 African American participants in the Jackson Heart Study. Four multivariable linear regression models were estimated to determine the association of occupational sitting and CRP. Analyses were conducted in 2020. The mean age was 50.8 years and 61% were female. Participants who reported occupational sitting as “often/always” had CRP levels of 4.9±6.8 mg/L, “sometimes” had levels of 4.8±8.1 mg/L, and “never/seldom” had levels of 4.3±6.8 mg/L. In the unadjusted model, “often/always” engaging in occupational sitting was significantly associated with higher levels of CRP when compared to “never/seldom” ( P < .05). This differed by sex with female participants who reported “often/always” occupational sitting had CRP levels of 6.0±7.6 mg/L compared to only 5.1±6.9 mg/L for “never/seldom.” Neither the overall association nor the female-specific association remained statistically significant in the adjusted models. We found an association between occupational sitting and inflammation, measured by CRP. This association varied by sex but did not remain significant after fully adjusting for covariates.
Intraarterial urokinase for thrombus migration after mechanical thrombectomy for large vessel ischemic stroke
Authors: Neki Hiroaki , Katano Takehiro , Maeda Takuma , Shibata Aoto , Komine Hiroyuki , Kikkawa Yuichiro
Published: December 2021

Background

Achieving rapid and complete reperfusion is the ultimate purpose for ischemic stroke with large vessel occlusion (LVO). Although mechanical thrombectomy (MT) had been a proverbially important procedure, medium vessel occlusion (MeVO) with thrombus migration can sporadically occur after MT. Moreover, the safe and effective approach for such had been unknown. We reported thrombolysis with intraarterial urokinase for MeVO with thrombus migration after MT.

Methods

We included 122 patients who were treated by MT with LVO stroke at our institution between April 2019 and March 2021. Of 26 patients (21.3%) who developed MeVO with thrombus migration after MT, 11 (9.0%) underwent additional MT (MT group) and 15 (12.3%) received intraarterial urokinase (UK group). The procedure time; angiographically modified Treatment in Cerebral Ischemia Scale (mTICI); functional independence, which was defined as modified Rankin Scale 0–2, on day 30 or upon discharge; and symptomatic and asymptomatic intracerebral hemorrhage (ICH) were compared between the UK and MT groups.

Results

The procedure time, mTICI, and asymptomatic ICH did not significantly differ between the groups. In the UK group, 8 of 15 (53.3%) patients obtained functional independence, and the functional independence rate was significantly higher in the UK group than in the MT group ( p < 0.05). Symptomatic ICH did not occur in the UK group, and its incidence was significantly smaller than that in the MT group ( p < 0.05).

Conclusion

The results of this study suggest that intraarterial urokinase for MeVO with thrombus migration after MT may safely improve angiographic reperfusion.
Finite element modeling of sub-surface damage while machining aluminum based metal matrix composites
Authors: Umer Usama , Alkhalefah Hisham , Abidi Mustufa Haider , Mohammed Muneer Khan , Kishawy Hossam
Published: December 2021

Sub-surface damage during machining of aluminum-based metal matrix composites (MMCs) has been modeled using finite element models. These models are based on reinforcement particles size and volume fractions and particles are distributed uniformly in the metal matrix. In order to simulate particle debonding cohesive zone elements (CZE) have been incorporated along the parting line. In addition, failure criteria based on brittle fracture have been added for ceramic particles to simulate particle fracture. To reduce computational time and simplify the model both CZE and particle fracture is limited to the reinforced particles along the parting lines facing the tip of the cutting tool. The damage depth beneath the machined surface is measured by using the non-zero plastic strain values in the equivalent plastic strain contours obtained from the FE models. The results were compared against published experimental data and found to be in good agreement.
Movement generalization of variable initial task state based on Euclidean transformation dynamical movement primitives
Authors: Ti Boyang , Gao Yongsheng , Shi Ming , Fu Le , Zhao Jie
Published: December 2021

Robots need the ability to tackle problems of movement generalization in variable task state and complex environment. Dynamical movement primitives can effectively endow robots with humanoid characteristics. However, when the initial state of tasks changes, the generalized trajectories by dynamical movement primitives cannot retain shape features of demonstration, resulting in the loss of imitation quality. In this article, a modified dynamical movement primitives based on Euclidean transformation is proposed to solve this problem. It transforms the initial task state to a virtual situation similar to the demonstration and then utilizes the dynamical movement primitive method to realize movement generalization. Finally, it reverses the movement back to the real situation. Besides, the information of obstacles is added to Euclidean transformation based dynamical movement primitives framework to endow robots with the ability of obstacle avoidance. The normalized root-mean-square error is proposed as the criterion to evaluate the imitation similarity. The feasibility of this method is verified through writing letters, wiping whiteboard in two-dimensional task, and stirring mixture in three-dimensional task. The results show that the similarity of movement imitation in the proposed method is higher than dynamical movement primitives when the initial state changes. Meanwhile, Euclidean transformation based dynamical movement primitives can still greatly retain shape feature of demonstration while avoiding obstacles in an unstructured environment.
Supporting teacher professional learning in Oman: The effects of principal leadership, teacher trust, and teacher agency
Authors: Hendawy Al-Mahdy Yasser F. , Hallinger Philip , Emam Mahmoud , Hammad Waheed , Alabri Khalaf Marhoun , Al-Harthi Khalsa
Published: December 2021

Lagging student performance in the Sultanate of Oman has, in recent years, led the Ministry of Education to target teachers’ professional learning as a key strategic pillar in its efforts to reform the education system. While international evidence finds principal leadership can make a meaningful difference in teacher engagement in professional learning, this has yet to be studied in Arab societies. The current study collected data from 887 teachers in 78 Omani middle schools with the aim of understanding if and how their principals’ learning-centered leadership influences teacher agency, teacher trust and teacher professional learning. Factor analysis, structural equation modelling, and bootstrapping were used to explore both partial and full mediation models of these relationships. Results validated a partial mediation model in which learning-centered leadership had moderate direct and indirect effects on teacher professional learning. The validated model also highlights the important role that principals can play in creating a climate of trust where teachers believe that investing their time and effort in professional learning will be beneficial for themselves and their schools. The results from Oman are compared with findings from other Asian societies and implications discussed.
Clinical letters to patients with intellectual disabilities after psychiatric review: A quality improvement project
Authors: Sawhney Indermeet , Zia Asif , Gates Bob , Sharma Anu , Adeniji Adetayo
Published: December 2021

Aim:

This Quality Improvement Project sought to improve communication between patients with intellectual disabilities and their psychiatrists by sharing medical information using an easy read letter format following psychiatric review.

Background:

Writing directly to patients is in keeping with good medical practice. Previous studies have shown patients with intellectual disabilities prefer letters tailored to meet their needs.

Method:

An easy read letter was used by nine psychiatrists who handed them to 100 consecutive patients after review. Feedback of acceptability to patients was obtained using a three-item facial rating scale and the use of free text. Feedback of acceptability was obtained from participating psychiatrists.

Results:

Patients found the easy read letter helpful and felt it should be used routinely. Psychiatrists felt this approach was beneficial as well as aiding patient understanding of review.

Conclusions:

The easy read letter was reported to improve communication following psychiatric review. Limitations are acknowledged but it is concluded that an easy read letter should be adopted as routine practice following psychiatric review, for people with intellectual disabilities.
Pregnancy danger signs: Knowledge and health-seeking behavior among reproductive age women in southwest Ethiopia
Authors: Yosef Tewodros , Tesfaye Melkamsew
Published: December 2021

Background:

Warning signs of pregnancy are not reliably predictable. But, knowing these early warning signs is very important for pregnant women to eliminate serious complications and start treatment immediately. The higher level of maternal mortality can be reduced by providing quality maternity service and empowering women with good knowledge of the danger signs of pregnancy and promoting appropriate health-seeking behavior. Therefore, this study aimed to assess the knowledge of pregnancy danger signs and health-seeking behavior among reproductive age women in southwest Ethiopia.

Method:

A cross-sectional study was carried out with 526 randomly selected women from 1 to 30 January 2019. The data were collected through face-to-face interviews and analyzed using Statistical Package for the Social Sciences version 21. Both bivariate and multivariable logistic regression analyses were conducted to determine factors associated with the outcome variable. The level of significance was declared at a p-value < 0.05.

Results:

The proportion of mothers who had good knowledge of pregnancy danger signs were 43.2%. The majority (65%) of those surveyed mentioned vaginal bleeding as a pregnancy danger sign. The factors associated with good knowledge of pregnancy danger signs were husbands with secondary education and above (adjusted odds ratio = 2.52, 95% confidence interval (1.08–5.91) monthly income ⩾ 1000 Ethiopian Birr (adjusted odds ratio = 2.64, 95% confidence interval (1.48–4.71) being multigravida (adjusted odds ratio = 2.14, 95% confidence interval (1.17–3.94) and last delivery at the health facility (adjusted odds ratio = 6.84, 95% confidence interval (4.02–11.63) The proportion of mothers who experienced pregnancy danger signs and had good health-seeking behavior was 72.7%.

Conclusion:

The knowledge of pregnancy danger signs among reproductive age women was low in the study area. This indicates the large proportions of women who do not know the danger signs are likely to delay in deciding to seek care when they face the problem. Therefore, empowering women, improving the quality of health information about danger signs during antenatal care follow-up, and promoting institutional delivery are the recommended interventions.
Impact of cervical cancer on the sexual and physical health of women diagnosed with cervical cancer in Ghana: A qualitative phenomenological study
Authors: Osei Appiah Evans , Amertil Ninon P , Oti-Boadi Ezekiel Ezekiel , Lavoe Honest , Siedu Dimah John
Published: December 2021

Introduction:

Although cervical cancer is preventable, it is a major gynecological disorder among women currently. More than 500,000 new cases of cervical cancer are being diagnosed across the globe, with one woman dying of cervical cancer every 2 minutes. In addition, about half of cervical cancer survivors have challenges with their sexual function. Despite these findings, literature regarding the sexual function of women with cervical cancer is scanty. The study aims to assess cervical cancer’s impact on the sexual and physical health of women diagnosed with cervical cancer in Ghana.

Methods:

The researchers of this study employed a qualitative approach with phenomenological design. A purposive sampling technique was used to select 30 participants engaged in face-to-face in-depth interviews that were audio-recorded. The content of the transcripts was analyzed using content analysis.

Results:

This study revealed that cervical cancer patients experienced low libido due to the cervical cancer symptoms and the side effects of chemotherapy. This low libido made them divert their sexual gratification from the vagina to other centers of the body. Findings further revealed that some participants showed apathy toward their partners’ sexual feelings. Some physical problems experienced by the participants were also unraveled.

Conclusion:

Cervical cancer affects all aspects of a woman’s health, including sexual function and physical well-being. Therefore, there is the need for further studies to help address challenges faced by cervical cancer women about their sexual and physical health.
Fecal microbiota transplantation for recurrent Clostridioides difficile, safety, and pitfalls
Authors: Sandhu Avnish , Chopra Teena
Published: December 2021

Clostridioides difficile infection (CDI) is one of the leading causes of hospital-acquired infection attributing to substantial morbidity, mortality, and healthcare cost. Recurrent CDI (rCDI) is common and occurs after effective treatment of first episode. Treatment of rCDI is based on accurate diagnoses, due to difficulty in distinguishing between colonization of C. difficile spores or CDI; coronavirus disease 2019 (COVID-19) added to the complexity of diagnoses as both entities can co-occur. It is difficult to eradicate rCDI, and there remains a critical gap regarding treatment of rCDI. The treatment goal of rCDI is to reestablish normal microbiota. Fecal microbiota transplantation (FMT) is suggested as a treatment for second episode of rCDI. Based on the collective evidence of all randomized controlled trials, FMT was reported more efficacious compared with vancomycin or fidaxomicin; however, these trials had limited number of patients and all patients were pre-treated with vancomycin prior to FMT. Furthermore, when comparing various routes of instillation and types of preparation of fecal microbiota, no difference was observed in cure rate. Despite the success rate of FMT, there remains a concern for transmission of infectious agents, such as Gram negative bacteremia or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), adverse events (diarrhea and abdominal pain), and reports of new diagnoses (inflammatory bowel disease, weight gain and irritable bowel syndrome). To lessen the risk of transmissible infections, donor screening should be performed, which includes screening for medical comorbidities and infectious pathogens in blood and feces. Scheduling complexities and reimbursement places an additional roadblock for using FMT. Microbiome-based therapies are being developed to eliminate the logistical challenges related to FMT. Large prospective and placebo-controlled studies are needed to evaluate the efficacy and long-term safety of FMT, so its use can be justified in clinical practice.
Optimizing biologic therapy in inflammatory bowel disease: a Delphi consensus in the United Arab Emirates
Authors: Annese Vito , Nathwani Rahul , Alkhatry Maryam , Al-Rifai Ahmad , Al Awadhi Sameer , Georgopoulos Filippos , Jazzar Ahmad N. , Khassouan Ahmed M. , Koutoubi Zaher , Taha Mazen S. , Limdi Jimmy K.
Published: December 2021

Background:

Inflammatory bowel diseases (IBD) are chronic, relapsing-remitting inflammatory conditions with a substantial negative impact on health-related quality of life and work productivity. Treatment of IBD has been revolutionized by the advent of biologic therapies, initially with anti-TNF agents and more recently with multiple alternatives targets, and yet more under development.

Objectives:

Approximatively one third of patients do not respond to biologic therapy and more importantly a significant proportion experiences partial response or loss of response during treatment. The latter are common clinical situations and paradoxically are not addressed in the commercial drug labels and available guidelines. There is therefore a clinical need for physicians to understand when and how eventually to optimize the biologic therapy.

Design:

This consensus using a Delphi methodology was promoted and supported by the Emirates Society of Gastroenterology and Hepatology to close this gap.

Data Sources and Methods:

Following an extensive systematic review of over 60,000 studies, 81 studies with dose escalation and five addressing drug monitoring were selected and in addition five systematic reviews and three guidelines.

Results and Conclusion:

after three rounds of voting 18 statements were selected with agreement ranging from of 80% to 100%
Final results regarding the addition of dendritic cell vaccines to neoadjuvant chemotherapy in early HER2-negative breast cancer patients: clinical and translational analysis
Authors: Santisteban Marta , Solans Belén Pérez , Hato Laura , Urrizola Amaia , Mejías Luis Daniel , Salgado Esteban , Sánchez-Bayona Rodrigo , Toledo Estefanía , Rodríguez-Spiteri Natalia , Olartecoechea Begoña , Idoate Miguel Angel , López-Díaz de Cerio Ascensión , Inogés Susana
Published: December 2021

Background:

Primary breast cancer (BC) has shown a higher immune infiltration than the metastatic disease, justifying the optimal scenario for immunotherapy. Recently, neoadjuvant chemotherapy (NAC) combined with immune checkpoint inhibitors has demonstrated a gain in pathological complete responses (tpCR) in patients with BC. The aim of our study is to evaluate the safety, feasibility, and efficacy of the addition of dendritic cell vaccines (DCV) to NAC in HER2-negative BC patients.

Methods:

Thirty-nine patients with early BC received DCV together with NAC conforming the vaccinated group (VG) and compared with 44 patients as the control group (CG). All patients received anthracyclines and taxanes-based NAC (ddECx4→Dx4) followed by surgery ± radiotherapy ± hormonotherapy.

Results:

The tpCR rate was 28.9% in the VG and 9.09% in the CG ( p = 0.03). Pathological CR in the triple negative (TN) BC were 50.0% versus 30.7% ( p = 0.25), 16.6% versus 0% in luminal B ( p = 0.15), and none among luminal A patients in VG versus CG, respectively. Impact of DCV was significantly higher in the programmed cell death ligand 1 (PD-L1) negative population ( p < 0.001). PD-L1 expression was increased in patients with residual disease in the VG as compared with the CG ( p < 0.01). No grade ⩾3 vaccine-related adverse events occurred. With a median follow-up of 8 years, no changes were seen in event-free survival or overall survival. Phenotypic changes post DCV in peripheral blood were observed in myeloid-derived suppressor cells (MDSC), NK, and T cells. Increase in blood cell proliferation and interferon (IFN)-γ production was detected in 69% and 74% in the VG, respectively. Humoral response was also found. Clonality changes in TCR-β repertoire were detected in 67% of the patients with a drop in diversity index after treatment.

Conclusion:

The combination of DCV plus NAC is safe and increases tpCR, with a significant benefit among PD-L1-negative tumors. DCV modify tumor milieu and perform cellular and humoral responses in peripheral blood with no impact in outcome.

Trial registration:

ClinicalTrials.gov number: NCT01431196. EudraCT 2009-017402-36.
Validity, reliability and viability of pre-school educators’ use of early years toolbox early numeracy
Authors: Howard Steven J , Neilsen-Hewett Cathrine , de Rosnay Marc , Melhuish Edward C , Buckley-Walker Kellie
Published: December 2021

There is need and opportunity for assessments that support quick and playful – yet also accurate, rigorous and developmentally sensitive – appraisals of early numeracy. Ideally, these should be accessible to those who have opportunity to support children’s learning development and ultimately shift children’s trajectories. The iPad-based Early Years Toolbox (EYT) Early Numeracy assessment was developed and evaluated to determine its validity and reliability, and appropriateness of use by researchers and preschool educators. Results from two studies with 246 children aged 3–5 years indicated the following: construct validity and internal consistency, concurrent validity with established measures, developmental sensitivity, test–retest reliability and highly comparable results whether used by a researcher or an educator. This yields a brief and playful assessment of early numeracy and a potential approach to develop broad-use early years assessments.
Energy, climate change and security: The Russian strategic conundrum
Authors: Godzimirski Jakub Maciej
Published: December 2021

Global and regional energy markets are increasingly influenced by policies aimed at climate change mitigation, with possible grave implications for major producers and exporters of fossil fuels – including Russia, which is planning further increases. This article examines the evolution of Russian official thinking on the role of climate change as a strategic factor in policymaking as expressed in key documents on security and in strategic statements made by Presidents Putin and Medvedev (2000–2020). The set of strategic statements examined in this article show surprisingly little attention to this important matter.
Decentralization, legitimacy, and democracy in post-Soviet Central Asia
Authors: Siegel David
Published: December 2021

During the 1990s, a conventional wisdom emerged, based on literature going back decades, that political decentralization might be among the most effective forces for democratization. If ordinary people could participate in autonomous local governments, democracy would be built from the ground up, ultimately shaping the entire political system. Once decentralization reforms were implemented across the world, however, the results were disappointing. Authoritarianism not only thrived at the local level, it could also undermine democratization at the national level. Thus, local-national transference still held, but sometimes as a poison. In this context, the case of post-Soviet Kyrgyzstan is an anomaly. Here, the relative success of political decentralization—rather than its failure—nevertheless failed to spur democratization at the national level. I argue that this is because decentralization allowed national authorities to appease international donors while they consolidated their own power. Moreover, while decentralization empowered local communities, it did so in ways that personalized local authority and pitted local and national authorities against one another, resulting in intense localism and antagonistic center-local relations that undermined any democratic transference. The case study findings are based on ten months of field research, which includes interviews with local and national officials, ordinary villagers, and representatives of NGOs and international organizations.
Molecular Mechanism of Chrysin in Hepatocellular Carcinoma Treatment Based on Network Pharmacology and in Vitro Experiments
Authors: Wei Jialin , Sun Zhiyuan , Shi Li , Hu Shaodan , Liu Da , Wei Hong
Published: December 2021

This study elucidated the potential molecular mechanism of chrysin in hepatocellular carcinoma (HCC) treatment using network pharmacology and in vitro experiments. Chrysin and candidate targets of HCC were obtained from the TCMSP and DrugBank databases, followed by mapping and screening of chrysin and HCC targets to identify the core targets of chrysin in HCC treatment. The interaction of chrysin and its targets, including CDK1, CDK5, as well as MMP9, were evaluated by molecular docking. The STRING database and Cytoscape (version 3.8.2) software were used to construct protein interactions and component-target networks of the core targets. Gene Ontology (GO) annotation and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analysis of the core target genes were performed using the DAVID database. Network pharmacology results showed that chrysin treatment of HCC was mainly related to cell proliferation and cell cycle. Accordingly, the cell counting kit-8 method and flow cytometry were used to detect the cell viability and cell cycle of hepatocarcinoma cells HCCLM3 and BEL-7402 in vitro. A total of 142 compound targets of chrysin, 12,179 HCC-related targets, and 116 intersecting targets were screened. The first 20 GO biological annotations of 17 core targets and the first 20 KEGG pathways mainly involved cell proliferation and cell cycle. In vitro experiments showed that chrysin inhibits the proliferation of human hepatocarcinoma cells (HCCLM3 and BEL-7402) in a dose-dependent manner. Moreover, chrysin induced cell cycle arrest in HCCLM3 and BEL-7402 cells in the G2 phase, and the expression was downregulated of cyclin-dependent kinases (CDKs), CDK2 and CDK4. Chrysin can offset HCC mainly by regulating the cell cycle and inhibiting cell proliferation. The network pharmacology results were verified, providing the basis for further study on the mechanism of chrysin intervention in HCC.
Protection Against Oxidative Stress-Induced Retinal Cell Death by Compounds Isolated From Ehretia asperula
Authors: Le Tam Thi , Kang Tae Kyeom , Do Ha Thi , Nghiem Trong Duc , Lee Wook-Bin , Jung Sang Hoon
Published: December 2021

Ehretia asperula ( E asperula) is a well-known traditional medicinal plant in Vietnam with potent activity against a wide range of diseases, including hepatitis B and various cancers. Although E asperula has been used in traditional medicine, the efficacy of E asperula and its bioactive components on retinal degenerative diseases has not been fully evaluated. In present this study, we found that ethanolic extracts of E asperula increased cell viability in retinal precursor cells exposed to glutamate/BSO-induced excitotoxicity/oxidative stress. The major responsible bioactive compounds were rosmarinic acid and methylrosmarinic acid. First, 10 known compounds were isolated from E asperula leaves. Their chemical structures were determined using 1D and 2D nuclear magnetic resonance, and compared with published data. Using high-performance liquid chromatography, we determined the content of 4 compounds in E asperula extract: rosmarinic acid, lithospermic acid B, astragalin, and kaempferol 3-rutinoside. The most abundant of these compounds was lithospermic acid B. The protective effects of the pure compounds and ethanolic extracts against excitotoxicity and oxidative stress-induced retinal cell death were tested in R28 cells. Both 70% and 95% ethanolic extracts of E asperula increased cell viability in these conditions. Rosmarinic acid and methyl rosmarinic acid were more effective at protecting against retinal cell death and elevated reactive oxygen species in cells subjected to glutamate/BSO-induced excitotoxicity/oxidative stress. These findings suggested that E asperula could potentially be used to treat retinal degeneration.
A recent development of new therapeutic agents and novel drug targets for cancer treatment
Authors: Kifle Zemene Demelash , Tadele Meklit , Alemu Eyerusalem , Gedamu Tadele , Ayele Akeberegn Gorems
Published: December 2021

Despite recent advances in cancer diagnosis, prevention, detection, as well as management, the disease is expected to be the top cause of death globally. The chemotherapy approach for cancer has become more advanced in its design, yet no medication can cure enough against all types of cancer and its stage. Thus, this review aimed to summarize a recent development of new therapeutic agents and novel drug targets for the treatment of cancer. Several obstacles stand in the way of effective cancer treatment and drug development, including inaccessibility of tumor site by appropriate drug concentration, debilitating untoward effects caused by non-selective tissue distribution of chemotherapeutic agents, and occurrence of drug resistance, which leads to cross-resistance to a variety of drugs. Resistance to treatment with anticancer drugs results from multiple factors and the most common reason for acquiring drug resistance is marking and expelling drugs that prevent cancer cells to be targeted by chemotherapeutic agents. Moreover, insensitivity to drug-induced apoptosis, alteration, and mutation of drug target and interference/change of DNA replication are other main causes of treatment failure.
Quadruple-negative RT-PCR assay for COVID-19, but clinically and radiologically COVID pneumonia with POTS: Case report and case-based review
Authors: Rajendran Nithya , Rameli Puteri Maisarah , Collins Grace
Published: December 2021

A 25-year-old woman with a background history of bronchial asthma and intellectual disability presented to hospital with progressively worsening dyspnoea. Despite testing negative four times for coronavirus disease infection by nasopharyngeal swab reverse-transcriptase polymerase chain reaction, her clinical symptoms of hypoxaemic respiratory failure and radiological findings on computed tomography pulmonary angiogram were consistent with coronavirus disease pneumonia. Although she made a quick recovery in the intensive care unit with a combination of empirical antibiotics, corticosteroids, high flow nasal oxygen, therapeutic anticoagulation and awake semi proning, her protracted hospital course due to persistent sinus tachycardia remained challenging. A diagnosis of potential postural orthostatic tachycardia syndrome was explored during the acute phase of illness following an active stand test and exclusion of other causes. She was treated with beta blockers as she failed to improve with non-pharmacological measures. We searched for similar cases by analysing the literature databases. Our case aims to stress the importance of recognising and treating patients with negative nasal reverse-transcriptase polymerase chain reaction swabs as coronavirus disease infection, especially if there is strong evidence of clinical and radiological findings where diagnosis is often under recognised in asthmatics with intellectual disability.
Uterine torsion in non-gravid women: A case report and review of cases reported in the last 20 years
Authors: Matsumoto Harunobu , Aoyagi Yoko , Morita Taisuke , Nasu Kaei
Published: December 2021

Uterine torsion is defined as a rotation of >45° around the long axis of the uterus. Uterine torsion is an uncommon event but is even rarer in non-gravid women, with only 25 cases reported in the last 20 years. Here, we report a case of uterine torsion associated with multiple pedunculated subserosal uterine leiomyomas in an 83-year-old woman. She presented at the hospital with lower abdominal pain, and a computed tomography scan revealed multiple uterine leiomyomas with calcifications. Subsequent magnetic resonance imaging raised suspicion for torsion of pedunculated subserosal uterine leiomyomas. Emergency laparotomy was performed, and the patient was diagnosed with uterine torsion with multiple pedunculated subserosal uterine leiomyomas. Total abdominal hysterectomy and bilateral salpingo-oophorectomy were performed. The patient’s postoperative course was uneventful. Although difficult to diagnose due to its rarity, uterine torsion can be life-threatening and may cause infertility. Therefore, early diagnosis with imaging and surgical intervention are crucial to avoid serious complications.
Neurenteric cyst of the temporal bone: A case report
Authors: Fan Timothy , Benaim Ezer , Lee Diaz Jorge , MacDonald Charles
Published: December 2021

Neurenteric cysts are rare, developmental malformations mainly found in the spinal canal. The authors report on a 29-year-old woman who presented with congenital left-sided hearing loss and a 9 days history of left ear pain and facial weakness (House–Brackmann IV). Radiological examination revealed a complex 7 mm cystic structure involving the petrous and mastoid portions of the left temporal bone. Intraoperatively, a red-brown multicystic mass was discovered and excised completely. Histologic findings showed simple columnar epithelium with goblet cells and bilayers of submucosal musculature, resembling normal intestinal linings. Post resection, the patient regained nearly full facial nerve capabilities (House–Brackmann II) with complete resolution of pain, but no changes to her hearing. The objectives of this case report are to describe the clinical, radiologic, intraoperative, and pathologic characteristics of an extradural temporal neurenteric cyst with sensorineural deficits to contribute to the growing knowledge regarding this rare entity.
A Model of Psychological Mechanisms of Inclusive Music-Making: Empowerment of Marginalized Young People
Authors: Levstek Maruša , Banerjee Robin
Published: December 2021

Adopting a mixed-methods research design, this study explored the psychological experiences of marginalized young people participating in inclusive music projects, with attention to inter- and intra-personal outcomes and underlying mechanisms. We worked with four different music projects, aimed at young people from lower socio-economic backgrounds or those with special educational needs and/or disabilities. With a total sample of 134 young people, parents, and creative practitioners, we used quantitative analyses of retrospective surveys to assess staff members’ perceptions of changes evident in individual young people (n1(total) = 99, n1(female) = 39, n1(male) = 59, n1(non-binary) = 1, mean age = 15.59). We performed thematic analysis on eleven semi-structured focus group discussions conducted with the young people (n2  =  26), their parents (n3  =  14), and staff members (n3  =  21), and 82 session reports completed by the staff members after each session. Growth over time in both intra-personal and inter-personal dimensions of functioning was observed, with qualitative data illuminating possible environmental and psychological mechanisms via two overarching themes of “ Self-Development” and “ Social Acknowledgement”. These results are collated in the model of youth empowerment, and its relevance to marginalized groups of young people is highlighted through promotion of active agency and empowerment. The model is interpreted in the light of several psychological theories of well-being, particularly self-determination theory and access-awareness-agency model, and implications for future work are discussed.
Post-Covid-19 Syndrome: Improvements in Health-Related Quality of Life Following Psychology-Led Interdisciplinary Virtual Rehabilitation
Authors: Harenwall Sari , Heywood-Everett Suzanne , Henderson Rebecca , Godsell Sherri , Jordan Sarah , Moore Angela , Philpot Ursula , Shepherd Kirsty , Smith Joanne , Bland Amy Rachel
Published: December 2021

Coronavirus disease 2019 (COVID-19) is increasingly recognized as having significant long-term impact on physical and mental health. The Primary Care Wellbeing Service (PCWBS) in Bradford District Care NHS Foundation Trust (BDCFT) is a psychology-led specialist interdisciplinary team of health professionals specializing in persistent physical symptoms (PPS) and Chronic Fatigue Syndrome (CFS)/Myalgic Encephalomyelitis (ME) with an emphasis on holistic integrated care. The PCWBS quickly recognized the risk of the long-term effects of COVID-19, particularly for social, health and care staff, and developed a 7-week virtual rehabilitation course which was piloted in October 2020. The “ Recovering from COVID” course takes a whole system, biopsychosocial approach to understanding COVID-19 and post-viral fatigue (PVF) and is delivered by an interdisciplinary team consisting of a clinical psychologist, physiotherapist, occupational therapist, dietitian, speech and language therapist, assistant psychologist, and a personal support navigator with support from a team administrator. The course focuses on understanding PVF, sleep optimization, nutrition, swallowing, activity management, energy conservation, stress management, breathing optimization, managing setbacks, and signposting to appropriate resources and services. Since the pilot, PCWBS has delivered 7 courses to support over 200 people suffering from post-COVID-19 syndrome. One hundred and forty-nine individuals that enrolled on the “ Recovering from COVID” course completed the EQ-5D-5L to assess Health-related quality of life (HRQoL) across 5 dimensions, including problems with mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Subsequently, 76 individuals completed these measures at the end of the rehabilitation course showing that patient ratings were significantly improved. In response to the NIHR recommendation for rapid evaluation of different service models for supporting people with post-COVID-19 syndrome, this data offers hope that rehabilitation is effective in reversing some of the problems faced by people living with the long-term effects of COVID-19.
Functional Hand-Based Splint in the Treatment of Metacarpal Fractures
Authors: Oxley Paul J. , Fin Hodge W.
Published: December 2021

Background: Post-treatment stiffness remains a significant hurdle following treatment for displaced or minimally displaced metacarpal fractures. Treatment goals should focus on a stable and acceptable reduction, minimal patient morbidity, and optimal mobility. Methods: A retrospective review of all non-operative metacarpal fractures over a five-month period at a tertiary center hand clinic treated with a hand-based splint were reviewed for radiologic and clinical stability. The splint allowed metacarpophalngeal joint, interphalangeal joint, and radiocarpal joint motion. Data collected included age, handedness, type and location of fracture, occupation, and ability to continue working. Radiologic images were reviewed by a radiologist not otherwise involved in patient care. Results: Thirty-three patients were reviewed with a total of 39 fractures of the second, third, fourth, and fifth metacarpals. Nine patients had nondominant hand fractures while 24 were dominant hand injuries. Twenty out of 24 patients employed pre-injury were able to continue working without missing any days. Three patients were lost to the final follow-up. The average splint duration was 24 days. Twenty-seven of 30 patients showed no change in alignment from start of splinting to end, while three showed some change but remained within non-operative criteria. Conclusion: A hand-based functional splint for metacarpal fractures allows for excellent maintenance of fracture reduction, early or immediate return to pre-injury activities, low patient morbidity, and maintains functional motion throughout treatment. It can be applied to any non-operative fracture of the second through the fifth metacarpal.
Heart of the Matter: Syncope as a Rare Presentation of Lung Cancer Invading the Heart
Authors: Al-Juburi Saleh , Rafizadeh Sassan , Zeki Amir A.
Published: December 2021

Syncope is common, affecting approximately 1 million Americans every year. Although multiple pathophysiological mechanisms regarding its etiology have been documented, neurocardiogenic or vasovagal syncope is the most common cause of these episodes. Other less appreciated etiologies include various cardiac abnormalities in which a structural, electrical, or obstructive disturbance leads to a temporary reduction in blood flow to the brain, resulting in transient loss of consciousness. Cardiac malignancies, while rare, can present with syncope by either disrupting the cardiac conduction apparatus or simply obstructing blood flow through the cardiac chambers. Electrocardiograms and echocardiography are often very helpful in identifying these abnormalities. Here, we report a rare case of late-stage invasive squamous cell carcinoma of the lung presenting with recurrent syncopal events. The cancer invaded the cardiac right atrium causing various dysrhythmias, leading to a very rare cause of cardiogenic syncope. We also discuss how lung cancer can present in a subclinical manner and at times without obvious respiratory symptoms, dramatic physical examination abnormalities, and/or thoracic imaging abnormalities on chest radiograph.
The Uniqueness of the Chinese Mission Movement—Past, Present, and Future
Authors: Ho Mary , Mak Rudolf
Published: December 2021

Using the World Christian Encyclopedia, 3rd edition ( WCE-3) as the springboard, this article explores the uniqueness of the Chinese missions movement from China, not including the overseas Chinese diaspora or Taiwan, Hong Kong, and Singapore. First, we provide an overview, context, and backdrop of the Chinese missions movement. Second, we compare and contrast China’s missions sending with that of (1) the United States/United Kingdom and (2) Brazil. We then highlight the unique characteristics of the Chinese missions movement and conclude with a future outlook.
What the World Christian Encyclopedia Tells Us about Freedom of Religion or Belief
Authors: Ochab Ewelina U.
Published: December 2021

The third edition of the World Christian Encyclopedia presents important findings regarding the current situation of Christians in the world, how it has been changing, and how it is expected to change. Some of the changes consider the limitations of the right to freedom of religion or belief in various parts of the world. This article discusses troubling trends in this area in the Middle East. The projections of the WCE-3 for 2050 should be seen as a warning for anyone working on the issue of the right to freedom of religion or belief, especially in the Middle East.

[Formula: see text]
Women Worldwide: Interplay between Church and Society and the Gender Paradox
Authors: Wong Wai-Yin Christina
Published: December 2021

This article analyzes the findings of women and gender issues presented in the recently published World Christian Encyclopedia, 3rd edition (2019). In addition to a brief illustration and discussion, I address two complex issues regarding women inspired by WCE-3, namely, the interplay between church and society and the gender paradox in World Christianity.
Psoriatic Onycho-Pachydermo-Periostitis
Authors: Hesni Susan , Khodatars Davoud , Rees Richard , Khanna Monica , Walker Miny
Published: December 2021

Psoriatic onycho-pachydermo-periostitis (POPP) is an unfamiliar and poorly recognised condition first described in 1989 by Fournie et al. It is a variant of psoriatic arthritis comprising the triad of onycholysis, soft tissue thickening and radiographically apparent periostitis. Whilst typically affecting the great toe, any of the digits of the hands and feet may be affected.

A ‘drumstick’ appearance to the digits of the foot is the most common clinical presentation and can be extremely painful. Nail changes are another hallmark of POPP and can be mistakenly diagnosed as fungal infection leading to lengthy periods of incorrect treatment.

In this article, we will outline the clinical presentation, imaging features, pathogenesis and treatment options for POPP. Currently, the existence of POPP is not widely known. Awareness of this unusual condition will allow early appropriate treatment and can aid in the diagnosis of indeterminate seronegative disease.
Artemisia lactiflora Extracts Prevent Inflammatory Responses of Human Macrophages Stimulated with Charcoal Pyrolysis Smoke
Authors: Kooltheat Nateelak , Chujit Kamonrat , Nuangnong Kanjana , Nokkaew Nuttikarn , Bunluepuech Kingkan , Yamasaki Kenshi , Chatatikun Moragot
Published: December 2021

Artemisia lactiflora, a Chinese-origin plant, has been reported to have unique phytochemicals responsible for its medicinal properties. The growth of the agricultural industry emits air pollution, which has adverse effects on health. There are limited scientific reports on the biological activities of A. lactiflora. Studies on its activities and mechanisms may provide insight into its use in medicinal purposes to treat those health problems and conditions. In this study, leaves of A. lactiflora were extracted and fractioned with solvents of different polarities. Total phenolics, total flavonoids DPPH• scavenging, ABTS•+ scavenging, and cytotoxicity of A. lactiflora were assessed. Anti-inflammatory activities were evaluated by pre-treating macrophages with extract or fractions then induced inflammatory response by coconut shell pyrolysis smoke. Inflammatory responses were assessed by measuring pro-inflammatory genes expression and pro-inflammatory cytokines secretion. Among all extract and fractions of A. lactiflora, butanol fraction has the highest phenolic, flavonoid, and DPPH• scavenging activity. All extract and fractions significantly down-regulated pro-inflammatory genes expression ( RelA, TNF, IL6) and decreased pro-inflammatory cytokines secretion (TNF-α, IL-6), p < 0.0001, compared with pyrolysis smoke-induced macrophages. The ethyl acetate fraction showed the highest anti-inflammatory activity in decreasing pro-inflammatory cytokines secretion. These results may prove the anti-inflammatory activities of A. lactiflora through the inhibition of the NF-κB-dependent pathway. Taken together, this study first reported the anti-inflammatory activities of A. lactiflora. Thus, the plant can be used to prevent and treat inflammatory responses caused by highly oxidative pyrolysis smoke released from the re-utilization of agro-industrial leftovers.