bluuebunny/crossref_metadata_2025 huggingface dataset:
Histopathological, Ultrastructural, and Immunohistochemical Findings in MYH11-Variant Visceral Myopathy
Authors: Kapur Raj P.
Published: December 2022

Background:

Pathogenic mutations in the smooth muscle myosin heavy chain gene, MYH11, cause megacystis megacolon intestinal hypoperistalsis syndrome and other forms of chronic intestinal pseudo-obstruction. Evaluation of intestinal tissues from affected patients is often performed before mutational analysis, but the pathological findings of MYH11-variant visceral myopathy have not been well defined.

Methods:

Light microscopic, immunohistochemical, and ultrastructural findings from multiple intestinal samples from 2 patients with MYH11-variant visceral myopathy were reviewed, including MYH11-specific immunohistochemistry. The findings were compared with intestinal samples from patients with gamma-smooth muscle actin ( ACTG2)-variant visceral myopathy and non-pseudo-obstruction controls.

Results:

Apart from non-specific changes (e.g., muscle hypertrophy and distension-related muscularis propria necrosis), no alterations were identified by routine histopathological evaluation or electron microscopy. Immunohistochemistry with antibodies against a battery of smooth muscle proteins, including MYH11, revealed indistinguishable patterns of immunoreactivity in the muscularis propria of both patients and controls.

Conclusions:

Myopathic morphological or immunohistochemical changes may not be present in intestinal specimens from patients with MYH11-variant visceral myopathy. Molecular genetic studies should be considered for patients with chronic intestinal pseudo-obstruction and normal or non-specific pathology findings.
Telehealth-guided provider-to-provider communication to improve rural health: A systematic review
Authors: Totten Annette M , Womack Dana M , Griffin Jessica C , McDonagh Marian S , Davis-O’Reilly Cynthia , Blazina Ian , Grusing Sara , Elder Nancy
Published: December 2022

Introduction

Telehealth may address healthcare disparities for rural populations. This systematic review assesses the use, effectiveness, and implementation of telehealth-supported provider-to-provider collaboration to improve rural healthcare.

Methods

We searched Ovid MEDLINE®, CINAHL®, EMBASE, and Cochrane CENTRAL from 1 January 2010 to 12 October 2021 for trials and observational studies of rural provider-to-provider telehealth. Abstracts and full text were dual-reviewed. We assessed the risk of bias for individual studies and strength of evidence for studies with similar outcomes.

Results

Seven studies of rural uptake of provider-to-provider telehealth documented increases over time but variability across geographic regions. In 97 effectiveness studies, outcomes were similar with rural provider-to-provider telehealth versus without for inpatient consultations, neonatal care, outpatient depression and diabetes, and emergency care. Better or similar results were reported for changes in rural clinician behavior, knowledge, confidence, and self-efficacy. Evidence was insufficient for other clinical uses and outcomes. Sixty-seven (67) evaluation and qualitative studies identified barriers and facilitators to implementing rural provider-to-provider telehealth. Success was linked to well-functioning technology, sufficient resources, and adequate payment. Barriers included lack of understanding of rural context and resources. Methodologic weaknesses of studies included less rigorous study designs and small samples.

Discussion

Rural provider-to-provider telehealth produces similar or better results versus care without telehealth. Barriers to rural provider-to-provider telehealth implementation are common to practice change but include some specific to rural adaptation and adoption. Evidence gaps are partially due to studies that do not address differences in the groups compared or do not include sufficient sample sizes.
Do you have to have sex to have sex? Defining sex in British law and medicine from the 1950s
Authors: Griffiths David A , Hubbard Katherine A
Published: December 2022

Sex has at least two different but related meanings: a biological property that bodies can seemingly ‘have’, and a set of bodily practices that one or more people can ‘have’. In the 1950s, the endocrinologist CN Armstrong stated that biomedical evidence of sex variance and the lack of a clear legal definition of sex highlighted a problem with the criminalisation of homosexual activity. It was not until the 1970s that a clear category of legal sex was enacted in law. In this paper, we consider the Wolfenden Committee (1954–57) and the legal cases of Georgina Somerset and April Ashley (1969–70). As we demonstrate, despite the complexity revealed by biomedicine, the law has not struggled to enact binary categories, due to the normative force of binary and heteronormative social understandings of sex (in all its meanings). We conclude by reflecting upon the many queer ways that people have and do sex outside of the purview of legal or medical definitions.
Grindr? it’s a “Blackmailer’s goldmine”! The weaponization of queer data publics Amid the US–China trade conflict
Authors: Myles David
Published: December 2022

In March 2019, the Committee on Foreign Investment in the United States (CFIUS) identified Grindr, a hookup app that predominantly caters to men who have sex with men, as a “national security threat” and compelled the Chinese conglomerate Kunlun Tech to divest from it entirely. The CFIUS-Grindr ruling is indicative of larger regulatory debates over increasing datafication trends in the dating app industry. Through a political economy approach to communication, this paper examines how this ruling was predominantly constructed by various stakeholders as a public controversy in light of the ongoing US–China trade conflict. This interpretation of the controversy relies on a prejudicial trope that construes queer dating app users as vulnerable targets of potential blackmail schemes operated by Chinese intelligence agencies. Through the Lavender Scare, a historical period referring to state-led investigations into the presence of LGBTQ+ employees in Western federal workforces, this paper historicizes this blackmail trope to highlight how the politicization of queer vulnerabilities amid global hegemonic conflicts is a tactic that predates the US-China trade conflict. It argues that the CFIUS-Grindr ruling weaponizes Grindr’s queer data publics as threats against which the US government should protect itself, while failing to fully recognize the urgency for the state to protect the data privacy rights of the LGBTQ+ communities in the digital economy. In light of the CFIUS-Grindr ruling, this paper examines the implications that datafication raises for the LGBTQ+ communities whose sexual lives and identities are increasingly being datafied and exploited by digital media platforms.
Shades of green: Change, continuity and conservation among Tasmanian forestry workers
Authors: Langridge Megan , White Rob
Published: December 2022

The Tasmanian forestry industry has undergone major transition due to industry readjustments and critique from environmental movements. This article focuses on how Tasmanian forestry workers think and feel about an industry in transition. Through the sociological lens of habitus, it investigates how these workers seek to behave in ways that they see as reflecting moral, ethical, and sustainable behaviour. Thematic analysis of semi-structured interviews is used to explore how forestry workers continue or alter their everyday practices and how their dispositions, formed in the crucible of the forest, shape these social processes. The article demonstrates that as structural changes transform the lives of workers, the people who live and work in the forest are nonetheless trying to understand, articulate, and respond to the changes in ways that they see as reflecting ethical and sustainable behaviour.
Embodied, embedded and educated: How everyday heroes strive to save lives during a pandemic
Authors: Kleppe Ingeborg Astrid , Caldwell Marylouise , Stensaker Inger G
Published: December 2022

Drawing on an ethnographic study of the HIV/AIDS pandemic, we explore how ordinary people make extraordinary efforts to convince others to comply with health authorities’ advice to change their behaviour. Theories of heroism and embodied health movements inform our typology consisting of four distinct types of everyday heroes. Everyday heroes adopt a variety of actions, uniquely drawing on their embodiment of the illness and embeddedness in the local context. The ‘national role model’ builds a personal brand promoting beauty with a purpose, while the ‘national entrepreneur’ assembles resources and builds support networks and institutions. The ‘local caregiver’ offers face-to-face support to the diseased and afflicted, while the ‘local entrepreneur’ creates non-risky health practices to replace risky ones. A significant finding is the heroes’ courage and creative self-educational work, through which they find their own ways to translate medical knowledge into the local vernacular and practice.
Dementia knowledge among physiotherapists in Nigeria
Authors: Onyekwuluje Chisom I , Willis Rosalind , Ogbueche Chukwudi M
Published: December 2022

Background

With the growing population of older adults in Nigeria comes a simultaneous rise in the incidence of dementia in the country. Adequate knowledge of dementia is needed to effectively administer interventions for persons living with dementia. Physiotherapy is one of the professions providing care for people with dementia. The aim of this study was to evaluate the knowledge of dementia among physiotherapists in Nigeria.

Methods

An online survey method was used to collect data from the sample population of practicing physiotherapists in Nigeria. Data was collected using the 21-item Dementia Knowledge Assessment Tool Version Two (DKAT2) and the respondents also provided some demographic information. Mann Whitney test, Kruskal Wallis test and Spearman’s rho correlation were used to test for association between the DKAT2 scores and the demographic variables and this association was further explored with multiple linear regression analysis.

Results

A total number of 223 physiotherapists participated in this study. The findings of the study show that there is limited knowledge of dementia among the physiotherapists. Number of years of professional experience and specialty groups predicted significantly higher knowledge scores.

Conclusion

The knowledge deficits found among physiotherapists in Nigeria indicate that older adults living with dementia might not be receiving the best evidence-based physiotherapy treatments for their condition. This research therefore advocates for an educational intervention to be carried out within the physiotherapy profession in order to improve the quality of services rendered to their patients.
Orally Administered Probiotics in the Prevention of Chemotherapy (± Radiotherapy)-Induced Gastrointestinal Toxicity: A Systematic Review With Meta-Analysis of Randomized Trials
Authors: Danis Radoslav , Mego Michal , Antonova Mariya , Stepanova Radka , Svobodnik Adam , Hejnova Renata , Wawruch Martin
Published: December 2022

Background:

Chemoradiotherapy-induced gastrointestinal toxicity may lead to a significant impairment of the oncological patient’s quality of life, as well as to reduced adherence to the treatment, which may have a negative impact on survival and mortality rates.

Objective:

The aim of this review was to investigate whether oral probiotic administration prevents chemotherapy (± radiotherapy)-induced gastrointestinal toxicity, particularly diarrhea.

Methods:

We searched the MEDLINE, Web of Science, and SCOPUS databases for randomized controlled trials in English published between 1990 and 2020. We conducted statistical data analyses expressing the treatment effect size as a risk ratio (RR) together with a 95% confidence interval (CI). Implications are based on trials rated as having a low risk of bias (RoB).

Results:

We included 8 trials (n = 697 participants), from which 3 studies rated as low RoB contained primary endpoint data; the risk of developing grade 3/4 diarrhea in patients receiving probiotics was reduced by 78% compared to the control group (RR = 0.22 [95% CI 0.05-1.08]; P = .06; n = 114 participants). Probiotics showed preventive effects in patients treated with chemotherapy alone (RR = 0.34 [0.12-0.94]; P = .04, n = 121 participants) and in patients with colorectal cancer (RR = 0.56 [0.34-0.92]; P = .02; n = 208 participants). The reduction in the incidence of overall diarrhea was not significant.

Conclusions:

Probiotics failed to prove a preventive effect of statistical significance against the development of severe and overall diarrhea in cancer patients treated with chemotherapy (± radiotherapy). However, we cannot rule out that the effects of probiotics are clinically relevant, especially in certain subgroups of patients. This needs to be clarified in further well-performed studies.
Laparoscopic Electromyography and Electrostimulation of the Gastrointestinal Tract Before Placement of Theranostic Devices
Authors: Schiemer Jonas F. , Stumm Karen , Somerlik-Fuchs Karin H. , Hoffmann Klaus-Peter , Ruff Roman , Lang Hauke , Farkas Stefan , Baumgart Jan , Kneist Werner
Published: December 2022

Need

Electrical stimulation (ES) is a promising therapy for multisegmental gastrointestinal (GI) motility disorders such as gastroparesis with slow-transit constipation or chronic intestinal pseudo-obstruction. Wireless communicating GI devices for smart sensing and ES-based motility modulation will soon be available. Before placement, a potential benefit for each GI segment must be intraoperatively assessed.

Technical Solution

A minimally invasive multisegmental electromyography (EMG) analysis with ES of the GI tract is required.

Proof of Concept

Two porcine experiments were performed with a laparoscopic setup. Multiple hook-needle electrodes were subserosally applied in the stomach, duodenum, jejunum, ileum, and colon. EMG signals were acquired for computer-assisted motility analysis. Gastric ES, duodenal ES, jejunal ES, ileal ES, and colonic ES were applied.

Next Steps

Further technological and rapid regulatory solutions are desired to initialize a clinical trial of the next generation devices in the near future.

Conclusion

We demonstrate a laparoscopic strategy with EMG analysis and ES of multiple GI segments. Thus, GI function may be evaluated before theranostic devices are placed. Extended GI resection or organ transplantation may be delayed or even avoided in affected patients.
Innovative technique in sheet forming of feminine personal protective armor by combined cyclic stretching and deep drawing method
Authors: Messiry Magdi El , Mohamed Abeer
Published: December 2022

The developed technologies for creating the three-dimensional shape for the formation of feminine personal protective armor proved to be applicable in the case of high-performance protective triaxial fabric, made of polyester, Vectran, and Kevlar. The suggested method combines cyclic loading and deep forming under heat. Cup shape geometry was analyzed to get the relations between the cup volume and the cup diameter for different cup bra sizing systems. This work analyzed the factors of molding triaxial fabric in creating a three-dimensional shape to get a bra fitting essential for the comfort of the protective armor and to provide useful information about the treatment of different fabrics molding. A smoothly formed cup surface has a natural configuration of the breast shape and also provides unlimited designs. The suggested technology of fabric forming will architect fabric from 2D to construct the required 3D shapes. In this work, a setup was designed for heating the fabric accomplished with the application of variable cyclic loading. The procedure of forming bra cup shapes with the deep drawing that permits 3D fabric architects for the bra shapes of varied sizes was given.
Abductor Pollicis Longus Tendon Abnormalities and Release in Children With Congenital Clasped Thumb
Authors: Israel Jacqueline S. , Jeardeau Teresa A. , Tomhave Wendy A. , Moran Steven L.
Published: December 2022

Background:

Congenital clasped thumb is associated with deficient thumb extensor tendons. Reconstruction includes tendon transfer. Here, we describe a variant of the abductor pollicis longus (APL) tendon, not previously reported, contributing to the flexion deformity. The purpose of this study is to report examples of and offer surgical repair techniques for APL variants identified in patients with clasped thumb.

Methods:

We reviewed records of 11 consecutive patients undergoing reconstruction for clasped thumb. Surgical anatomy of the APL tendon was evaluated in all patients, followed by release of aberrant APL attachments. Participants were invited to return for an in-person assessment with a certified hand therapist. Data were collected regarding intraoperative findings, surgical techniques for reconstruction, postoperative thumb motion, and patient and caregiver satisfaction.

Results:

Eleven children (12 thumbs) underwent aberrant APL release and rerouting between 2019 and 2021. Preoperatively, all thumbs were passively correctible to 0° of extension. In all patients, the APL was found to terminate palmar to the metacarpophalangeal (MCP) joint, creating an MCP flexion moment when tensioned. The average age at surgery was 7 years (range: 1-15 years), and the average follow-up was 14.2 months (range: 1-21 months). The mean postoperative thumb radial abduction was 55° (range: 20°-75°).

Conclusions:

When reconstructing clasped thumbs, surgeons should explore the presence of APL abnormalities. Release and centralization of the APL can improve thumb position and function. This technique may avoid the need for extra-anatomical tendon transfer in patients with clasped thumb.
The Evolution of Popular Politics in 19th-Century Sweden and the Road from Oligarchy to Democracy
Authors: Bengtsson Erik
Published: December 2022

In the 20th century, Sweden distinguished itself as one of the most organized and participatory democracies in the world. But in the late 19th century the situation was much the opposite – Sweden had for Western Europe a low degree of suffrage, and low political participation. To explain the turnaround, this paper explores the evolution of a democratic political culture in the final third of the 19th century, in opposition to the oligarchic system. The empirical material consists of digitalized newspapers from the south of Sweden in the period 1866 to 1900, studying about 2700 articles that mention ‘popular meetings’, folkmöten, which was the contemporary description of political meetings. In the 1860s and 1870s a farmer-centred democratic critique dominated, combining proposals for widened suffrage with criticisms of banks and the bureaucracy. In the 1880s and 1890s, the social base was widened as urban workers – socialist and antisocialist – took a greater part and the ideological composition became more heterogeneous. The paper suggests that the folkmöten constituted an important arena for democratic socialization in a country with an oligarchical political system, creating a road forward for democratic reforms and a democratic society.
Incidence, predictors, and impact on outcome of underlying intracranial atherosclerotic disease in acute vertebrobasilar artery occlusion undergoing endovascular therapy: Data from ANGEL-ACT registry
Authors: Li Kangyue , Sun Dapeng , Tong Xu , Wang Anxin , Zhang Yijun , Ma Gaoting , Huo Xiaochuan , Ma Ning , Gao Feng , Mo Dapeng , Sun Xuan , Peng Guangge , Zhang Xuelei , Jia Baixue , Miao Zhongrong
Published: December 2022

Background and Purpose:

Intracranial atherosclerotic disease (ICAD) is a common etiology of acute vertebrobasilar artery occlusion (VBAO) in Asia, which complicated endovascular treatment (EVT). We aimed to investigate the incidence, impacts, and predictors of ICAD in VBAO.

Methods:

Subjects were selected from the Endovascular Treatment Key Technique and Emergency Work Flow Improvement of Acute Ischemic Stroke registry and divided into two groups based on whether underlying ICAD existed. Underlying ICAD was determined when the following situations arise in the occlusion site during EVT: (1) fixed stenosis degree >70% or (2) stenosis >50% with distal blood flow impairment or evidence of repeated reocclusion. Multivariable regression models were used to investigate the effect of underlying ICAD on outcomes measured by modified Rankin Scale (mRS) score at 90 days and to identify baseline characteristics associated with underlying ICAD.

Results:

Among the 315 patients enrolled, 171 (54.3%) had underlying ICAD. Favorable functional outcomes (mRS 0–3) occurred in 79 of 163 patients (48.5%) with ICAD and 69 of 137 patients (50.4%) without ICAD ( p = 0.743). Outcomes were similar between the two groups and remained similar after adjusting for the confounders. History of hypertension and elevated admission neutrophil to lymphocyte ratio were strong predictors of underlying ICAD, whereas history of atrial fibrillation and distal basilar artery occlusion were negative predictors.

Conclusions:

In our study, underlying ICAD was recognized in approximately half of the VBAO patients, leading to comparable outcomes after more complex EVT strategies. Some baseline characteristics were identified to be predictors for underlying ICAD, which were helpful to guide the EVT strategies before the procedure.
Prognostic impact of sarcopenia in patients with hepatocellular carcinoma treated with PD-1 inhibitor
Authors: Guo Yusheng , Ren Yanqiao , Wu Feihong , Dong Xiangjun , Zheng Chuansheng
Published: December 2022

Background:

Sarcopenia is a progressive generalized loss of skeletal muscle mass commonly observed in advanced stages of cancer.

Objective:

To assess the relationship between sarcopenia and the prognosis of patients with hepatocellular carcinoma (HCC) treated with a programmed cell death 1 (PD-1) inhibitor.

Design:

This is a retrospective study.

Methods:

This study included patients with HCC treated with camrelizumab between 1 March 2020 and 1 December 2021. The skeletal muscle area at the L3 vertebra middle level was used to calculate the skeletal muscle index. Propensity score matching (PSM) analysis was used to balance the variables between the two groups.

Results:

In all, 97 patients with HCC were included in the study, with 46 and 51 patients in the sarcopenia group and the non-sarcopenia group, respectively. The baseline characteristics of albumin, Child-Pugh class, albumin–bilirubin score, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio were significantly different between the two groups. In total, 26 patients from each group ( n = 52) were selected after the PSM analysis. The progression-free survival (PFS) in the non-sarcopenia group was significantly longer than that in the sarcopenia group before and after PSM analysis (6.5 versus 4.8 months, p = 0.038). In addition, the disease control rate was similar before and after PSM analysis (57.7% versus 69.2%, p = 0.388). The objective response rate in the non-sarcopenia group tended to be higher than that in the sarcopenia group (11.5% versus 30.8%, p = 0.090, after PSM), but no statistically significant difference was found. The median overall survival (OS) in the non-sarcopenia group tended to longer than it in the sarcopenia group before PSM without significant differences (16.3 versus 11.3 months, p = 0.090) and the median OS was similar between the two groups after PSM (16.3 versus 16.8 months, p = 0.735).

Conclusions:

HCC patients with sarcopenia tended to have higher levels of inflammation and lower levels of albumin than patients without sarcopenia. Sarcopenia is associated with a shorter PFS in HCC patients treated with PD-1 inhibitor.
High-dose dual therapy versus culture-based susceptibility-guided therapy as a rescue regimen for Helicobacter pylori infection: a randomized controlled trial
Authors: Zhao Zhe , Zou Pei-Ying , Su Na-Yun , Guo Yan , Wang Xing-Wei , Zhao Jing-Tao , Mei Hao , Shi Qing , Wang Bin , Chen Dong-Feng , Lan Chun-Hui
Published: December 2022

Background:

Although the Maastricht VI/Florence consensus report recommended high-dose proton pump inhibitor–amoxicillin dual therapy as possible rescue therapy for Helicobacter pylori infection, clinical evidence of its efficacy was lacking.

Objectives:

To compare the efficacy, safety, patient compliance, and cost between high-dose dual therapy (HDDT) and culture-based susceptibility-guided therapy (CB-SGT) as a rescue regimen for H. pylori infection.

Design:

A single-center, open-label, randomized controlled clinical trial.

Methods:

In all, 146 patients with a history of eradication failure were enrolled and randomly assigned to receive HDDT or CB-SGT. HDDT consisted of esomeprazole 20 mg and amoxicillin 750 mg, both given four times per day (qid). CB-SGT consisted of esomeprazole 20 mg twice daily (bid), amoxicillin 1000 mg bid plus clarithromycin 500 mg bid, metronidazole 400 mg bid, or levofloxacin 500 mg daily (qd) for sensitive patients, in that order. For patients with triple resistance, a bismuth-containing regimen with a high dose of metronidazole was chosen, including esomeprazole 20 mg bid, bismuth 220 mg bid, amoxicillin 1000 mg bid, and metronidazole 400 mg qid. All regimens were given for 14 days.

Results:

The eradication H. pylori rates achieved with HDDT in the intention-to-treat (ITT), per-protocol, and modified ITT analyses were all 84.9% [62/73, 95% confidence interval (CI): 76.5–93.9%], compared with 83.6% (61/73, 95% CI: 74.9–92.3%), 84.7% (61/72, 95% CI: 76.2–93.2%), and 84.7% (61/72, 95% CI: 76.2–93.2%) with CB-SGT, respectively. For patients with CYP2C19 polymorphisms of intermediate/poor metabolizers, the eradication rates of HDDT and CB-SGT were 90.70% (39/43, 95% CI: 77.86–97.41%) and 84.21% (32/38, 95% CI: 68.75–93.98%), respectively. The difference between groups was 6.49% (95% CI: −8.00% to 20.97%), and the non-inferiority p value was 0.0128. For patients with a treatment interval of more than 3 months, the eradication rates of the two regimens reached 88.71% (95% CI: 78.11–95.34%) and 71.97% (95% CI: 70.02–90.64%). The difference between groups was 6.74% (95% CI: −5.71% to 19.20%), with a non-inferiority p value of 0.0042. Patient adherence was high in both groups. The HDDT had a lower cost and rate of side effects ( p < 0.001) compared with CB-SGT.

Conclusions:

HDDT can reach an eradication rate of 85% in treatment-experienced patients of H. pylori infection and 91% in patients with CYP2C19 polymorphisms of intermediate/poor metabolizers, with good compliance, lower side effects and costs, and less use of antibiotics. In conclusion, HDDT offers an effective rescue regimen for H. pylori infection.

Registration:

This clinical trial was registered at the Chinese Clinical Trail Registry (trail registration number: ChiCTR1900025044)
Association of periprocedural perfusion non-improvement with recurrent stroke after endovascular treatment for Intracranial Atherosclerotic Stenosis
Authors: Yan Long , Hou Zhikai , Fu Weilun , Yu Ying , Cui Rongrong , Miao Zhongrong , Lou Xin , Ma Ning
Published: December 2022

Background:

Predictors of recurrent stroke after endovascular treatment for symptomatic intracranial atherosclerotic stenosis (ICAS) remain uncertain.

Objectives:

Among baseline characteristics, lesion features, and cerebral perfusion changes, we try to explore which factors are associated with the risk of recurrent stroke in symptomatic ICAS after endovascular treatment.

Design:

Consecutive patients with symptomatic ICAS of 70–99% receiving endovascular treatment were enrolled. All patients underwent whole-brain computer tomography perfusion (CTP) within 3 days before and 3 days after the endovascular treatment. Baseline characteristics, lesion features, and cerebral perfusion changes were collected.

Methods:

Cerebral perfusion changes were evaluated with RAPID software and calculated as preprocedural cerebral blood flow (CBF) < 30%, time to maximum of the residue function (Tmax) > 6 s, and Tmax > 4 s volumes minus postprocedural. Cerebral perfusion changes were divided into periprocedural perfusion improvement (>0 ml) and non-improvement (⩽ 0 ml). Recurrent stroke within 180 days was collected. The Cox proportional hazards analysis analyses were performed to evaluate factors associated with recurrent stroke.

Results:

From March 2021 to December 2021, 107 patients with symptomatic ICAS were enrolled. Of the 107 enrolled patients, 30 (28.0%) patients underwent balloon angioplasty alone and 77 patients (72.0%) underwent stenting. The perioperative complications occurred in three patients. Among CBF < 30%, Tmax > 6 s, and Tmax > 4 s volumes, Tmax > 4 s volume was available to evaluate cerebral perfusion changes. Periprocedural perfusion improvement was found in 77 patients (72.0%) and non-improvement in 30 patients (28.0%). Nine patients (8.4%) suffered from recurrent stroke in 180-day follow-up. In Cox proportional hazards analysis adjusted for age and sex, perfusion non-improvement was associated with recurrent stroke [hazards ratio (HR): 4.472; 95% CI: 1.069–18.718; p = 0.040].

Conclusion:

In patients with symptomatic ICAS treated with endovascular treatment, recurrent stroke may be related to periprocedural cerebral perfusion non-improvement.

Registration:

http://www.chictr.org.cn . Unique identifier: ChiCTR2100052925.
Environmental Transformations Enhancing Dignity in an Acute Psychiatric Ward: Outcome of a User-Driven Service Design Project
Authors: Faerden Ann , Rosenqvist Christine , Håkansson Mats , Strøm-Gundersen Eline , Stav Åshild , Svartsund Jan , Røssæg Trude , Davik Nils , Kvarstein Elfrida , Pedersen Geir , Dieset Ingrid , Nyrud Anders Q. , Weedon-Fekjær Harald , Kistorp Kaja Misvær
Published: December 2022

Objectives:

The goal of the current project was to enhance the feeling of dignity for patients in the seclusion unit in an acute psychiatric ward through environmental design changes and to evaluate the effect of the refurbishment.

Background:

Treating people with dignity is essential in all health-related work and important for our mental health. Hospital architecture and design signal values that can promote dignity. Patients who must spend time in seclusion are at their most vulnerable mental state and the often worn-down like environment can challenge the feeling of dignity. How environmental design can promote dignity in seclusion units have not been studied.

Methods:

To reach suggestions for design changes enhancing dignity, we used service design that included a broad user group. The effect of design changes was evaluated by a questionnaire answered by the nursing staff during a 4-week period pre- and post refurbishment and included a control group.

Results:

The design concepts agreed upon were a welcoming atmosphere, contact with nature, room for privacy, close contact with staff, and a designated smoking area inside the unit. The evaluation found that the environmental design changes significantly supported the patients in their situation and the staff in their work.

Conclusion:

We conclude that dignity design concepts are highly applicable also in an acute psychiatric setting and improve the situation of secluded mental health patients, which is much needed. Findings align with other environmental changes in psychiatric wards that improve the patients’ well-being and reduce aggression.
Engineering transplantable human lymphatic and blood capillary networks in a porous scaffold
Authors: Kong Anne M , Lim Shiang Y , Palmer Jason A , Rixon Amanda , Gerrand Yi-Wen , Yap Kiryu K , Morrison Wayne A , Mitchell Geraldine M
Published: December 2022

Due to a relative paucity of studies on human lymphatic assembly in vitro and subsequent in vivo transplantation, capillary formation and survival of primary human lymphatic (hLEC) and blood endothelial cells (hBEC) ± primary human vascular smooth muscle cells (hvSMC) were evaluated and compared in vitro and in vivo. hLEC ± hvSMC or hBEC ± hvSMC were seeded in a 3D porous scaffold in vitro, and capillary percent vascular volume (PVV) and vascular density (VD)/mm2 assessed. Scaffolds were also transplanted into a sub-cutaneous rat wound with morphology/morphometry assessment. Initially hBEC formed a larger vessel network in vitro than hLEC, with interconnected capillaries evident at 2 days. Interconnected lymphatic capillaries were slower (3 days) to assemble. hLEC capillaries demonstrated a significant overall increase in PVV ( p = 0.0083) and VD ( p = 0.0039) in vitro when co-cultured with hvSMC. A similar increase did not occur for hBEC + hvSMC in vitro, but hBEC + hvSMC in vivo significantly increased PVV ( p = 0.0035) and VD ( p = 0.0087). Morphology/morphometry established that hLEC vessels maintained distinct cell markers, and demonstrated significantly increased individual vessel and network size, and longer survival than hBEC capillaries in vivo, and established inosculation with rat lymphatics, with evidence of lymphatic function. The porous polyurethane scaffold provided advantages to capillary network formation due to its large (300–600 μm diameter) interconnected pores, and sufficient stability to ensure successful surgical transplantation in vivo. Given their successful survival and function in vivo within the porous scaffold, in vitro assembled hLEC networks using this method are potentially applicable to clinical scenarios requiring replacement of dysfunctional or absent lymphatic networks.
Current perspectives on the epidemiology and burden of tardive dyskinesia: a focused review of the clinical situation in Japan
Authors: Mori Yasuhiro , Takeuchi Hiroyoshi , Tsutsumi Yuichiro
Published: December 2022

Tardive dyskinesia (TD) is a movement disorder that can develop with the use of dopamine receptor-blocking agents and is most commonly caused by antipsychotics. The use of antipsychotics is expanding, which may lead to an increased number of patients experiencing TD. To summarise the current knowledge of the epidemiology and risk factors for TD in Japan, we reviewed articles related to the current state of knowledge around TD identified through a PubMed search, and held a roundtable discussion of experts in Japan on 9 September 2021 to form the basis of the opinion presented within this review. The true prevalence of TD among patients treated with antipsychotics is not well characterised; it is reported to be between 15% and 50% globally and between 6.5% and 7.7% in Japan. Potential barriers to timely treatment of TD include the stigma surrounding mental health issues and the lack of data regarding TD in Asian patients. This review summarises the current knowledge of the epidemiology, challenges to TD diagnosis and risk factors for TD in Japan. Recent strategies for symptom monitoring and early diagnosis, as well as consensus recommendations are included. Achieving a high level of awareness of TD among physicians who treat patients with psychiatric disorders is of great importance and physicians should ensure that patients with psychiatric disorders receiving antipsychotics are proactively monitored for signs of TD.

Plain Language Summary

[Figure: see text] Plain Language Summary ( In Japanese )

Visual Summary

[Figure: see text] Visual Summary ( In Japanese )
Gender dysphoria in adolescents with Ehlers–Danlos syndrome
Authors: Jones Jordan T. , Black William R. , Moser Christine N. , Rush Eric T. , Malloy Walton Lindsey
Published: December 2022

Objectives:

Ehlers–Danlos Syndrome represents a family of heritable connective tissue disorders that include joint hypermobility, tissue fragility, and skin hyperextensibility. Ehlers–Danlos Syndrome presents with clinical sequela across multiple body systems that require multidisciplinary care. Little is known about adolescents with Ehlers–Danlos Syndrome who are transgender and gender diverse. To date, there have been no reports of transgender and gender diverse youth in pediatric patients with Ehlers–Danlos Syndrome. The objective of this study was to characterize transgender and gender diverse adolescents with Ehlers–Danlos Syndrome seen in a pediatric multidisciplinary specialty clinic.

Methods:

A retrospective chart review was performed and it was found that 28 patients were seen in the Ehlers–Danlos Syndrome multidisciplinary clinic were reported being transgender and gender diverse. Chart review included analysis of all documents in the electronic medical record, including demographic data, gender identity, chosen pronouns, specialty care previously received for Ehlers–Danlos Syndrome, symptoms and conditions related to it, and medications.

Results:

Of the 166 total adolescents seen in the pediatric multidisciplinary Ehlers–Danlos Syndrome clinic during the study period, 17% reported gender dysphoria. The average age at Ehlers–Danlos Syndrome diagnosis was 13.5 years (range 8–17 years). Most (61%) reported their gender identity as transgender, followed by nonbinary (14%). Most had preferred male (he/him) pronouns (47%), followed by nonbinary (they/them) pronouns (39%). The vast majority reported fatigue (75%), musculoskeletal issues (96%), psychiatric issues (86%), cardiac issues (71%), gastrointestinal issues (68%), and neurologic issues (79%).

Conclusions:

Here we report the first cohort of transgender and gender diverse adolescents in the Ehlers–Danlos syndrome population and show an association between the two. This report increases awareness for providers who care for patients with Ehlers–Danlos Syndrome. As care for those with Ehlers–Danlos Syndrome is often complex and multidisciplinary, providers should adopt practices of gender-affirming medical care that contribute to improved care and outcomes.
Adolescents and parents’ perception of Young Person's Face IT: An online intervention for adolescents struggling with conditions affecting their appearance
Authors: Millgård Moa , Feragen Kristin B , Ullmann Miller Jeanette , Arfa Shahrzad , Williamson Heidi , Kling Johanna
Published: December 2022

Objective

A visible difference in appearance caused by a congenital or acquired condition can negatively affect adolescents’ psychosocial well-being. Young Person's Face IT (YPF) is an online intervention based on cognitive behavioural therapy and social skills training, developed to help adolescents who struggle with adjusting to a visible difference. The objective of the present study was to explore adolescents’ and parents’ perceptions of the intervention's relevance and usefulness in supporting young people with appearance-related psychosocial concerns.

Methods

Participants were adolescents ( N = 76, aged 11–18) and parents ( N = 15), recruited in a larger randomised controlled trial aiming at evaluating YPF. This qualitative study with descriptive data includes adolescents’ ratings on YPF's usefulness, and interview data from adolescents and parents on their experiences with YPF. The interviews were analysed using a thematic approach.

Results

Results indicated that YPF was experienced as useful and relevant. Interviews showed that adolescents felt validated through the programme's content, discovered that other young people had similar experiences and felt that YPF could contribute to changing self-perceptions for the better. However, results could not confirm whether perceived usefulness led to the development and use of new social skills in real-life situations.

Conclusion

This study offers new perspectives on the relevance and usefulness of YPF in supporting adolescents with appearance-related psychosocial concerns. Findings suggest that updates and modifications are required so that YPF stays relevant and useful for adolescents in need of support.

Trial registration number

NCT03165331
Could Bio-Inspired Nacre-Like Ceramics be Suitable to Fabricate Musical Instruments?
Authors: Ferrand Hortense Le
Published: December 2022

In the past, natural ceramic biomaterials like bones and seashells were used to make music. Today, ceramics are largely absent from the musical scene. Yet, recent development of bio-inspired ceramics could be used to create musical instruments that emulate sound from ancient times, that do not make use of endangered animal species or that enable exploration of new types of music. In this paper, the question of whether bio-inspired ceramics would be suitable for usage in musical instrument is posed. The study focusses on nacre-like alumina ceramics of various compositions and their suitability to be used, fabricated, and to produce sound are discussed based on materials’ properties. It is found that flat pieces could be produced with high throughput for making idiophones or parts of musical instruments to increase the sound radiance, for example, and that complex shapes could be produced by a craftsperson to reproduce other musical instruments’ designs or create new ones using 3D printing technologies. The potential application of such ceramics for music could also open ideas in architecture where tiles are used, for example. Future work to enable these applications should be on more thorough characterisation of dynamic properties according to standards, scaled-up and reliable fabrication processes, and evaluation of the sound produced.
The Impact of Armed Conflicts on Forced Migration Crises in Nigeria and Mali
Authors: Targba Aondowase
Published: December 2022

Forced migration crises caused by non-state actors such as the Islamic State West Africa Province (ISWAP), Boko Haram insurgency, Tuareg Armed Group, herders-farmers’ armed groups, bandits, separatists, and other local tribal militias have forced many in West Africa to flee to other countries or to become internally displaced persons (IDPs). This paper focuses on the effects of armed conflict on forced migrants in Nigeria and Mali. It finds the major causes of armed conflicts in Nigeria and Mali to be social injustice, the proliferation of small arms and light weapons, poverty, illiteracy, bad governance, and religious extremism. It also finds that climate change and political instability contribute to forced migration in these two countries. IDPs in Nigeria and Mali have little to no access to basic necessities. The article finds that policymakers and local authorities are not fully committed to either returning or resettling refugees and IDPs and that most of the refugees are unwilling to return to their homes because of safety concerns. The study finds that refugees and IDPs are not integrated into the local communities due to stigmatization, which further affects their social and psychological well-being. It recommends that the governments of Nigeria and Mali tackle the root causes of armed conflicts, including poverty, religious extremism, and social injustice. These governments and other stakeholders should also ensure that the human rights of forced migrants are protected in terms of their identity and access to social services. Finally, they should ensure the safety of forced migrants who are willing to return to their ancestral homes.
Do Patients’ and Physicians’ Perspectives Differ on Preferences for Irritable Bowel Syndrome Treatment?
Authors: Sturkenboom Rosel , Essers Brigitte A B , Masclee Ad A M , Keszthelyi Daniel
Published: December 2022

Irritable bowel syndrome (IBS) is a highly prevalent disorder of gut–brain interaction and poses a significant burden to patients. Pharmacotherapy, diet, and psychotherapy all have largely comparable clinical efficacy. Therefore, factors outside efficacy can have an important impact in determining preferences for a specific therapeutic entity. The aim of this study was to compare the patient and physician perspectives and identify important treatment characteristics regarding the management of IBS. Semistructured interviews were performed among IBS patients (n = 8), fulfilling the Rome IV criteria, and surveys were sent to physicians involved in IBS care (n = 15). Nine important treatment characteristics were revealed: effectiveness, time until response, cessation of response, side effects, location, waiting period, treatment burden, frequency of healthcare appointments, and willingness to pay. Time to response, location, and waiting time were less important for patients compared to physicians. This study assessed important IBS treatment characteristics and provided context to preferences from a patient and physician perspective. These data could be relevant during shared decision-making in clinical practice.
Indian Intellectual Tradition and Politics of Knowledge: A Quest for a Dialogical Thinking
Authors: Wighmal Varun
Published: December 2022

Manindra Nath Thakur, Gyan Ki Rajneeti: Samaj Adhyyan aur Bhartiya Chitan. Noida: Setuprakashan, 2022, 360 pp., ₹350. ISBN: 9789393758415.
Palmoplantar Pustulosis has a Greater Disease Burden than Plaque Psoriasis: Real-World Evidence From the CorEvitas Psoriasis Registry
Authors: Lebwohl Mark G. , Medeiros Rose Anne , Mackey Rachel H. , Valdecantos Wendell C. , Brodovicz Kimberly G. , Lertratanakul Apinya , Strober Bruce
Published: December 2022

Background

Palmoplantar pustulosis (PPP) is a rare skin disease characterized by episodes of neutrophilic pustules on the palms of the hands and soles of the feet. Current treatments for PPP have limited efficacy, and there is little real-world evidence characterizing the disease burden of PPP in patients.

Objective

To describe and compare the clinical characteristics and patient-reported outcomes (PROs) of patients with PPP with those of patients with plaque psoriasis.

Methods

This real-world study used data from patients with PPP or plaque psoriasis enrolled in the CorEvitas Psoriasis Registry. Disease characteristics, historical medical data, PROs, and quality-of-life measures were compared between patients with PPP and those with plaque psoriasis. These measures were also compared following patient stratification by body surface area involvement or Psoriasis Area and Severity Index. This study is purely descriptive; no hypothesis testing was performed.

Results

In this data set, patients with PPP (n = 64) reported higher mean overall pain, using the visual analog scale, relative to those with plaque psoriasis (n = 4894). Patients with PPP also reported a greater proportion of work hours missed or affected; greater impairment of work; and greater impairment of daily activity than patients with plaque psoriasis. Similar effects were observed irrespective of patient stratification.

Conclusion

Generally, PPP was associated with worse PROs and a greater impact on quality of life compared with plaque psoriasis. These findings highlight a need to develop effective therapies for PPP to improve disease management.