bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigating the local foodscape: qualitative investigation of food retail and dietary preferences in Kisumu and Homa Bay Counties, western Kenya
Authors: Musuva Rosemary M. , Foley Louise , Wadende Pamela , Francis Oliver , Lwanga Charles , Turner-Moss Eleanor , Were Vincent , Obonyo Charles
Published: June 2022

Introduction

Non-communicable diseases have risen markedly over the last decade. A phenomenon that was mainly endemic in high-income countries has now visibly encroached on low and middle-income settings. A major contributor to this is a shift towards unhealthy dietary behavior. This study aimed to examine the complex interplay between people’s characteristics and the environment to understand how these influenced food choices and practices in Western Kenya.

Methods

This study used semi-structured guides to conduct in-depth interviews and focus group discussions with both male and female members of the community, across various socioeconomic groups, from Kisumu and Homa Bay Counties to further understand their perspectives on the influences of dietary behavior. Voice data was captured using digital voice recorders, transcribed verbatim, and translated to English. Data analysis adopted an exploratory and inductive analysis approach. Coded responses were analyzed using NVIVO 12 PRO software.

Results

Intrapersonal levels of influence included: Age, the nutritional value of food, occupation, perceived satiety of some foods as opposed to others, religion, and medical reasons. The majority of the participants mentioned location as the main source of influence at the community level reflected by the regional staple foodscape. Others include seasonality of produce, social pressure, and availability of food in the market. Pricing of food and distance to food markets was mentioned as the major macro-level influence. This was followed by an increase in population and road infrastructure.

Conclusion

This study demonstrated that understanding dietary preferences are complex. Future interventions should not only consider intrapersonal and interpersonal influences when aiming to promote healthy eating among communities but also need to target the community and macro environments. This means that nutrition promotion strategies should focus on multiple levels of influence that broaden options for interventions. However, government interventions in addressing food access, affordability, and marketing remain essential to any significant change.
Thrombin antithrombin complex concentration as an early predictor of deep vein thrombosis after total hip arthroplasty and total knee arthroplasty
Authors: Lin Zhencan , Sun Hao , Li Deng , Cai Zhiqing , Chen Meiyi , Zhang Wenhui , Liu Fangzhou , Huang Zhencheng , Wang Yimin , Xu Jie , Ma Ruofan
Published: June 2022

Aim

Early predictive markers of venous thromboembolism (VTE) after total hip arthroplasty (THA)/total knee arthroplasty (TKA) remain unclear. Our study identified early predictive markers for VTE after THA/TKA.

Methods

A single-institution retrospective review study was conducted between May 2020 and April 2022 (n = 256). All patients underwent Doppler ultrasounds exam in preoperation and seventh day after surgery. Deep vein thrombosis (DVT) was defined by Doppler ultrasound of the lower extremities, which revealed thrombosis. Thrombin-antithrombin complex (TAT), thrombomodulin (TM), and plasmin-antiplasmin complex (PIC) concentration were tested from each patient’s preoperative and postoperative days 1, 4, 7, 14. These values were then accessed via receiver operating characteristic (ROC) curve analysis and further quantified the level of this risk by concentration.

Results

On postoperative day 1 (pod-1), all patients’ TAT and PIC concentrations were significantly higher than those preoperatively (p < 0.05). The levels of TAT and PIC in patients in the DVT group on pod-1 were significantly higher than those in the non-DVT group (p < 0.05). At pod-1, the TAT concentration for DVT patients was 49.47 ng/mL compared to 20.70 ng/mL for non-DVT patients, PIC was 3.72μg/mL compared to 1.65μg/mL. ROC curve analysis demonstrated that a TAT concentration of 24.3 ng/mL had a sensitivity of 87.9% and a specificity of 69.1%.

Conclusion

TAT levels on pod-1 may predict DVT early after THA/TKA, which makes it possible for early intervention to decrease the incidence of DVT.
Managing community engagement in research in Uganda: insights from practices in HIV/AIDS research
Authors: Barugahare John , Kass Nancy E.
Published: June 2022

Background

Community engagement (CE) in research is valuable for instrumental and intrinsic reasons. Despite existing guidance on how to ensure meaningful CE, much of what it takes to achieve this goal differs across settings. Considering the emerging trend towards mandating CE in many research studies, this study aimed at documenting how CE is conceptualized and implemented, and then providing context-specific guidance on how researchers and research regulators in Uganda could think about and manage CE in research.

Methods

We conducted qualitative interviews and focus group discussions involving forty-one respondents who were experienced in HIV/AIDS biomedical research involving CE. Thirty-eight of these were directly or indirectly associated with Uganda’s leading research institution in the field of HIV/AIDS. They included Principal Investigators, Community Liaisons Officers, Research Ethics Committee members and Community Advisory Board Members. Three respondents were from Uganda National Council for Science and Technology. Data were collected between August 2019 and August 2020, using audio-taped focus group discussions and key informant interviews, transcribed and analyzed manually to generate themes and subthemes.

Results

Three major themes emerged: goals or value of CE; the means of CE, and, the evaluation of CE. Goals or value of CE generated four subthemes representing the overarching goals of CE: (1) Promote communities’ agency; (2) Generate and sustain trust; (3) Protect and promote communities’ rights and interests; and, (4) Help studies optimize participation in the form of enrolment and retention of participants. What usually comes under the nomenclatures of methods, strategies, and approaches of CE, such as town-hall meetings, sports events, drama, and the like, should simply be understood as the means of CE, and it is not desirable to hold pre-conceived and fixed ideas about the best means to conduct CE in research since a lot depend on the context. Finally, the study found that despite CE’s critical importance, which suggests the need to track and evaluate it, CE is currently intermittently evaluated, and for inadequate motivations.

Conclusions

Existing guidance on how to conduct robust CE in research is no substitute for creativity, flexibility, and reflexivity on the part of both researchers and research regulators.
Plasma concentration, cardiorespiratory and analgesic effects of ketamine-fentanyl infusion in dogs submitted to mastectomy
Authors: de Moura Rauane Sousa , Bittar Isabela Plazza , Gomes Janainne Hilbig , de Oliveira Yan Victor Rodrigues , de Sousa Filho Gladsthon Divino , de Faria Soares Glauco Cézar Fragola , Lima Eliana Martins , Franco Leandro Guimarães
Published: June 2022

Background

The analgesic and cardiorespiratory effects of ketamine, fentanyl, or ketamine-fentanyl constant rate infusion (CRI) in dogs undergoing mastectomy were evaluated. Seventeen female dogs received CRI of ketamine (GK [n = 6]: bolus 0.5 mg/kg; CRI 20 µg/kg/min in intra- and postoperative periods], fentanyl (GF [n = 5]: bolus 20 µg/kg; intraoperative CRI 5 20 µg/kg/hour and postoperative CRI 2 20 µg/kg/hour), or combination of ketamine-fentanyl (GKF [n = 6]: aforementioned doses) for 8 h. Cardiorespiratory, blood gas analyses, plasma drug concentrations, sedation score (SS), Pain Scores were evaluated.

Results

The heart rate decreased in the GF and GKF (p < 0.04); the mean arterial pressure was lower in the GKF than in the GK at 35 min (p < 0.001). Maximum plasma concentrations were observed 5 min after bolus in the GK (2847.06 ± 2903.03 ng/mL) and GKF (2811.20 ± 1931.76 ng/mL). Plasma concentration in intraoperative period of ketamine was of > 100 ng/mL in 5/5 and 2/5 animals in the GKF and GK, respectively; and > 1.1 ng/mL of fentanyl in 4/5 and 3/5 in GKF and GF, respectively.

Conclusion

Ketamine with/without fentanyl provided analgesia without significant cardiorespiratory and guaranteed the minimal plasma levels with analgesic potential during the 8 h.
Thrombospondin-2 acts as a bridge between tumor extracellular matrix and immune infiltration in pancreatic and stomach adenocarcinomas: an integrative pan-cancer analysis
Authors: Liao Xingchen , Wang Wei , Yu Baoping , Tan Shiyun
Published: June 2022

Background

Thrombospondin-2 (THBS2) is a versatile glycoprotein that regulates numerous biological functions, including the apoptosis-proliferation balance in endothelial cells, and it has been linked to tumor angiogenesis. However, the exact role of THBS2 in human cancer remains unknown. This study aimed to determine THBS2 expression in a pan-cancer analysis and its association with pan-cancer prognosis and to further identify its possible roles in tumor immunity and the extracellular matrix (ECM).

Methods

Data on THBS2 expression in cancers and normal tissues were downloaded from the Genotype-Tissue Expression portal and UCSC Xena visual exploration tool and analyzed using the ONCOMINE database, Perl programming language, and Gene Expression Profiling and Interactive Analyses vision 2 webserver. In addition, survival prognosis was analyzed using the survival, survminer, limma, and forestplot packages in R v. 4.0.3.Immune and matrix components were also analyzed using R v. 4.0.3. Most importantly, we partially validated the role and mechanism of THBS2 in pancreatic and gastric cancers in vitro using PANC1 and BGC-823 cell lines.

Results

THBS2 was significantly overexpressed in 17 of the 33 investigated cancers and linked to a poor prognosis in pan-cancer survival analysis. High THBS2 expression was an independent unfavorable prognostic factor in kidney renal papillary cell, mesothelioma, and stomach and pancreatic adenocarcinomas. Immune infiltration and THBS2 expression were also related. THBS2 expression has been linked to immune and stromal scores and immune checkpoint markers in various cancers. The protein–protein interaction network revealed that THBS2 is associated with multiple ECM and immune proteins. THBS2 knockdown decreased the expression of CD47 and matrix metallopeptidase 2 (MMP-2) as well as the proliferation, migration, and invasion of PANC1 and BGC-823 cells in vitro.

Conclusions

Our findings suggested that THBS2 might promote cancer progression by remodeling the tumor microenvironment, affecting CD47-mediated signaling pathways, activating the pro-tumor functions of a disintegrin and metalloproteinase with thrombospondin motifs, and enhancing MMP-2 expression. Furthermore, it functions as a bridge between the ECM and immune infiltration in cancer and serves as a potential prognostic biomarker for several cancers, especially pancreatic and gastric adenocarcinomas.
Recent advances in mRNA-LNP therapeutics: immunological and pharmacological aspects
Authors: Kiaie Seyed Hossein , Majidi Zolbanin Naime , Ahmadi Armin , Bagherifar Rafieh , Valizadeh Hadi , Kashanchi Fatah , Jafari Reza
Published: June 2022

In the last decade, the development of messenger RNA (mRNA) therapeutics by lipid nanoparticles (LNP) leads to facilitate clinical trial recruitment, which improves the efficacy of treatment modality to a large extent. Although mRNA-LNP vaccine platforms for the COVID-19 pandemic demonstrated high efficiency, safety and adverse effects challenges due to the uncontrolled immune responses and inappropriate pharmacological interventions could limit this tremendous efficacy. The current study reveals the interplay of immune responses with LNP compositions and characterization and clarifies the interaction of mRNA-LNP therapeutics with dendritic, macrophages, neutrophile cells, and complement. Then, pharmacological profiles for mRNA-LNP delivery, including pharmacokinetics and cellular trafficking, were discussed in detail in cancer types and infectious diseases. This review study opens a new and vital landscape to improve multidisciplinary therapeutics on mRNA-LNP through modulation of immunopharmacological responses in clinical trials.

Graphical Abstract
Study on the morphological characteristics and rotational alignment axis of placement plane of the tibial component in total knee arthroplasty for hemophilia-related knee arthritis
Authors: Feng Ru , Zhong Qigang , Zheng Liujie , Ye Houlong , Luo Dasheng , Ding Mingyang , Pang Nanyu , Li Jiale , Yao Yunfeng
Published: June 2022

Background

Abnormal epiphyseal growth plate development of the proximal tibia in hemophilia patients leads to notable morphological changes in the mature knee joint. This study aimed to compare the morphological characteristics of tibial component placement cut surface in patients with hemophilic arthritis (HA) and osteoarthritis (OA) and to determine the tibial component rotational alignment axis’ best position for HA patients.

Methods

Preoperative computed tomography scans of 40 OA and 40 HA patients who underwent total knee arthroplasty were evaluated using a three-dimensional (3D) software. The tibial component’s placement morphological parameters were measured. The tibial component’s rotational mismatch angles were evaluated, and the most appropriate 0°AP axis position for HA patients was investigated.

Results

In the two groups, the morphology was significantly different in some of the parameters (p < 0.05). The tibial component rotational mismatch angles were significantly different between both groups (p < 0.05). The medial 9.26° of the medial 1/3 of the patellar tendon was the point through which 0°AP axis passed for the HA patients. Similarly, the medial 13.02° of the medial 1/3 of the tibial tubercle was also the point through which the 0°AP axis passed.

Conclusions

The ratio of the anteroposterior length to the geometric transverse length of the placement section of the tibial component in HA patients was smaller than that in OA patients. The medial 9.26° of the medial 1/3 of the patellar tendon or the medial 13.02° of the medial 1/3 of the tibial tubercle seem to be an ideal reference position of the rotational alignment axis of the tibial component for HA patients.
Downregulation of CDK5 signaling in the dorsal striatum alters striatal microcircuits implicating the association of pathologies with circadian behavior in mice
Authors: Zhou Hu , Zhang Jingxin , Shi Huaxiang , Li Pengfei , Sui Xin , Wang Yongan , Wang Liyun
Published: June 2022

Dysfunction of striatal dopaminergic circuits has been implicated in motor impairment and Parkinson’s disease (PD)-related circadian perturbations that may represent an early prodromal marker of PD. Cyclin-dependent kinase 5 (CDK5) negatively regulates dopamine signaling in the striatum, suggesting a critical role of CDK5 in circadian and sleep disorders. Here, we used clustered regularly interspaced short palindromic repeats (CRISPR)/Cas9 gene editing to produce mice with a dorsal striatum (DS)-specific knockdown (KD) of theCdk5gene (referred to as DS-CDK5-KD mice) and investigate its role in vivo. DS-CDK5-KD mice exhibited deficits in locomotor activity and disturbances in activity/rest behavior. Additionally, Golgi staining of neurons in the DS revealed that CDK5 deletion reduced dendrite length and the number of functional synapses, which was confirmed by significant downregulation of MAP2, PSD-95, and synapsin I. Correlated with this, DS-CDK5-KD mice displayed reduced phosphorylation of Tau at Thr181. Furthermore, whole-cell patch-clamp recordings of green fluorescent protein-tagged neurons in the striatum of DS-CDK5-KD mice revealed a decreased frequency of spontaneous inhibitory postsynaptic currents and altered excitatory/inhibitory synaptic balance. Notably, anterograde labeling showed that CDK5 KD in the DS disrupted long-range projections to the secondary motor cortex, dorsal and ventral thalamic nuclei, and basolateral amygdala, which are involved in the regulation of motor and circadian rhythms in the brain. These findings support a critical role of CDK5 in the DS in maintaining the striatal neural circuitry underlying motor functions and activity/rest associated with circadian rhythms that are perturbed in neurodegenerative disorders.
Specific Learning Disorders and Eating Disorders: an Italian retrospective study
Authors: Aruta Salvatore Ferdinando , Pruccoli Jacopo , Bandini Nicole , Rucci Paola , Parmeggiani Antonia
Published: June 2022

Background

Although Anorexia Nervosa (AN) patients show dysfunctional behaviour in information processing, visual and verbal memory performance, and different cognitive fields, regardless of their BMI, the literature on the correlations between Eating Disorders (ED) and Neurodevelopmental Disorders (NDD) does not provide conclusive data. Rather than a consequence of the mental disorder, cognitive dysfunctions may be a risk factor for AN.

Methods

Our retrospective study investigates the prevalence of Specific Learning Disorder (SLD) among patients with ED. We considered 262 patients being treated at the Emilia Romagna Feeding and Eating Disorders Outpatient Service in Bologna, Italy. We compared the results with the Italian reference values, according to the most recent data provided by the Italian Ministry of Education.

Results

We found that 25 patients out of 262 (9.54%) presented a comorbid diagnosis of SLD. This SLD prevalence is higher than the Italian reference values (4.9% in the school year 2018/19, p < 0.001). Comorbidity with SLD was significantly more frequent in males. A diagnosis of SLD was not associated with a higher frequency of any specific ED diagnosis or with psychiatric comorbidity in general. Positive family history for SLD was not significantly associated with either a positive family history for ED or a diagnosis of SLD.

Conclusions

This is the first Italian study to investigate the prevalence of SLD in ED patients during childhood and adolescence. Our data support previous research documenting that neuropsychological deficit could lead to the development of ED.
NSAIDs in sciatica (NIS): study protocol for an investigator-initiated multicentre, randomized placebo-controlled trial of naproxen in patients with sciatica
Authors: Grøvle Lars , Hasvik Eivind , Holst Rene , Haugen Anne Julsrud
Published: June 2022

Background

Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used to treat sciatica, despite insufficient evidence from placebo-controlled trials. NSAIDs may cause serious side effects; hence, there is a strong need to clarify their potential beneficial effects in patients with sciatica.

Methods

This is a multicentre, randomized, placebo-controlled, parallel-group superiority trial. Participants will be recruited among sciatica patients referred to outpatient clinics at hospitals in Norway who have radiating pain below the knee with a severity score of ≥ 4 on a 0–10 numeric rating scale and clinical signs of nerve root or spinal nerve involvement. The intervention consists of oral naproxen 500 mg or placebo twice daily for 10 days. Participants will report the outcomes and adverse events daily using an electronic case report form. The primary endpoint is change in leg pain intensity from baseline to day 10 based on daily observations. The secondary outcomes are back pain intensity, disability, sciatica symptom severity, rescue medication (paracetamol) consumption, opioid use, ability to work or study, 30% and 50% improvement in leg pain, and global perceived change of sciatica/back problem. The outcomes will be analysed using mixed effects models for repeated measurements. The total duration of follow-up is 12 (± 2) days.

Discussion

This trial aims to evaluate the benefits of naproxen, a non-selective NSAID, in patients with sciatica. No important differences in efficacy have been demonstrated between different NSAIDs in the management of musculoskeletal disorders; hence, the results of this trial will likely be applicable to other NSAIDs.

Trial registration

ClinicalTrials.gov NCT03347929. Registered on November 20, 2017.
Navigation programs relevant for African American men with prostate cancer: a scoping review protocol
Authors: Palmer Nynikka R. , Smith Ashley Nicole , Campbell Brittany A. , Andemeskel Ghilamichael , Tahir Peggy , Felder Tisha M. , Cicerelli Barbara
Published: June 2022

Background

The excess incidence and mortality due to prostate cancer that impacts African American men constitutes the largest of all cancer disparities. Patient navigation is a patient-centered healthcare system intervention to eliminate barriers to timely, high-quality care across the cancer continuum and improves health outcomes among vulnerable patients. However, little is known regarding the extent to which navigation programs include cultural humility to address prostate cancer disparities among African American men. We present a scoping review protocol of an in-depth examination of navigation programs in prostate cancer care—including navigation activities/procedures, training, and management—with a special focus on cultural context and humility for African American men to achieve health equity.

Methods

We will conduct comprehensive searches of the literature in PubMed, Embase, Web of Science, and CINAHL Complete, using keywords and index terms (Mesh and Emtree) within the three main themes: prostate cancer, patient navigation, and African American men. We will also conduct a search of the gray literature, hand-searching, and reviewing references of included papers and conference abstracts. In a two-phase approach, two authors will independently screen titles and abstracts, and full-text based on inclusion/exclusion criteria. All study designs will be included that present detailed data about the elements of navigation programs, including intervention content, navigator training, and/or management. Data will be extracted from included studies, and review findings will be synthesized and summarized.

Discussion

A scoping review focused on cultural humility in patient navigation within the context of eliminating disparities in PCa care among African American men does not yet exist. This review will synthesize existing evidence of patient navigation programs for African American prostate cancer patients and the inclusion of cultural humility. Results will inform the development and implementation of future programs to meet the unique needs of vulnerable prostate cancer patients in safety net settings.

Systematic review registration

PROSPERO 2021CRD42021221412
Economic burden of antibiotic-not-susceptible isolates in uncomplicated urinary tract infection: Analysis of a US integrated delivery network database
Authors: Shafrin Jason , Marijam Alen , Joshi Ashish V. , Mitrani-Gold Fanny S. , Everson Katie , Tuly Rifat , Rosenquist Peter , Gillam Michael , Ruiz Maria Elena
Published: June 2022

Background

Uncomplicated urinary tract infections (uUTIs) are one of the most common bacterial infections in the United States (US). Contemporary data are important for understanding the health economic impact of antimicrobial-resistant uUTIs. We compared the economic burden among patients with uUTI isolates susceptible or not-susceptible to the initial antibiotic prescription.

Methods

This retrospective cohort study utilized electronic health record data (1 July 2016–31 March 2020) from a large Mid-Atlantic US integrated delivery network database. Patients were females aged ≥ 12 years with a uUTI, who received oral antibiotic treatment and had ≥ 1 urine culture within ± 5 days of diagnosis. The primary outcome was the difference in healthcare resource use and costs (all-cause, urinary tract infection [UTI]-related) among patients with susceptible versus not-susceptible isolates during the 6 months after the index uUTI diagnosis. Secondary outcomes included: pharmacy costs, hospital admissions and emergency department visits, as well as the probability of uUTI progressing to complicated UTI (cUTI) between patients with susceptible and not-susceptible isolates. Patient outcomes were compared using 1:1 propensity score matching. Winsorized costs were adjusted to 2020 quarter 1 US dollars ($).

Results

A total of 2565 patients were eligible for analysis. The propensity score-matched sample comprised 2018 patients, with an average age of 44.0 and 41.0 years for the susceptible and not-susceptible populations, respectively. In the 6 months post-index uUTI event, patients with not-susceptible isolates had significantly more all-cause prescriptions orders (+ 1.41 [P = 0.001]), UTI-related prescriptions orders (+ 0.26 [P < 0.001]) and a higher probability of all-cause inpatient (+ 1.4% [P = 0.009]), outpatient (+ 6.1% [P = 0.006]), or UTI-related outpatient (+ 3.7% [P = 0.039]) encounters. Patients with a uUTI and an antibiotic-not-susceptible isolate were significantly more likely to progress to cUTI than those with susceptible isolates (odds ratio: 2.35 [confidence interval: 1.66–3.33; P < 0.001]). Over 6 months, patients with not-susceptible versus susceptible isolates had significantly higher all-cause costs (+ $426 [P = 0.031]) and UTI-related costs (+ $157 [P = 0.034]).

Conclusions

Patients with a uUTI caused by antibiotic-not-susceptible isolates had higher healthcare resource usage, costs, and increased likelihood of progressing to cUTI than those with antibiotic-susceptible isolates.
Prevalence of potential drug − drug interactions in the cardiothoracic intensive care unit patients in a Chinese tertiary care teaching hospital
Authors: Wang Haitao , Shi Haitao , Wang Na , Wang Yan , Zhang Li , Zhao Yujie , Xie Jiao
Published: June 2022

Background

With an increasing number of reviews describing clinically significant drug–drug interactions (DDIs), the scope and severity of interactions involving commonly used drugs in cardiothoracic intensive care units (CCUs) remain unclear. This study aims to identify risk factors and determine the incidence of potential DDIs in intensive care units.

Methods

DDIs were identified based on the profile of the prescribed drug and classified according to the Micromedex drug interaction database. Potential risk factors associated with DDIs have been identified.

Results

A total of 3193 medication episodes were evaluated, and 680 DDIs (21.3%) were found. A total of 203 patients were recruited into the study, with an average of 3.4 DDIs per patient [95% confidence interval (3.2 − 3.6)]. A total of 84.2% of the patients experienced at least one DDI. Anticoagulant and antiplatelet agents were involved in 33.5% (228/680) of the potential drug − drug interactions in the CCU. Univariate analysis and multiple logistic regression analysis showed that the age of the patient and the number of medications prescribed were significantly correlated with the occurrence of DDIs. In multiple linear regression analysis, the number of DDIs had a significant correlation only with the number of prescription drugs.

Conclusions

A high prevalence of DDIs was observed, especially in intensive care units without pharmacist intervention and computerized drug monitoring systems, highlighting the need for active surveillance to prevent potential adverse events.
Study on space diversity and influencing factors of Tunpu settlement in central Guizhou Province of China
Authors: Ge Hongyi , Wang Zhitai , Bao Yu , Huang Zongsheng , Chen Xintong , Wu Bin , Qiao Yunwei
Published: June 2022

The Tunpu settlements are the historical product of the co-evolution development of the unique geographical and cultural environment of Guizhou and the military defense policies of Ming Dynasty (1368–1644 AD), which created products such as the station troops and station farms. In this study, taking 10 Tunpu settlements in central Guizhou as the research objects, the space diversity of the Tunpu settlement and its influencing factors were analyzed based on the theory and calculation method of plant community species diversity. The results showed that: (1) On the whole, the space α-diversities of the military Tunpu settlements and the commercial Tunpu settlements were relatively high, with strong spatial similarity, while the residential Tunpu settlements had a lower degree of space α-diversity and significant difference. The space α-diversity of different types of the Tunpu settlement presents a variety of changes from the core protected areas to coordinated control areas. (2) There was a significant correlation between the spatial network and spatial morphological indicators and space β-diversity among the Tunpu settlement, and the stepwise regression showed that spatial morphological indicators had a strong explanatory power for the space β-diversity among the Tunpu settlements. (3) The space diversities of the Tunpu settlements were affected by the multiple synergies of natural environment, policy support, social-economic factors and cultural customs. Among them, policy factors and cultural factors were the dominant factors in the space diversity characteristics of the Tunpu settlements. By analyzing the space diversity law and its driving factors of the Tunpu settlements, this study could provide an important scientific basis for the protection planning and management of traditional settlements.
The forgotten appearance of metastatic melanoma in the small bowel
Authors: Mendes Serrao Eva , Joslin Emily , McMorran Victoria , Hough Caroline , Palmer Cheryl , McDonald Sarah , Cargill Emma , Shaw Ashley S. , O’Carrigan Brent , Parkinson Christine A. , Corrie Pippa G. , Sadler Timothy J.
Published: June 2022

Background

Melanoma is the most aggressive form of skin cancer, with a tendency to metastasise to any organ of the human body. While the most common body organs affected include liver, lungs, brain and soft tissues, spread to the gastrointestinal tract is not uncommon. In the bowel, it can present with a multitude of imaging appearances, more rarely as an aneurysmal dilatation. This appearance is classically associated with lymphoma, but it has more rarely been associated with other forms of malignancy.

Case presentation

We report a case series of three patients with aneurysmal dilatation in the small bowel (SB) confirmed to be due to metastatic melanoma (MM). All patients had non-specific symptoms; most times being attributed initially to causes other than melanoma. On CT the identified aneurysmal SB dilatations were diagnosed as presumed lymphoma in all cases. In two cases, the aneurysmal dilatation was the first presentation of metastatic disease and in two of the cases more than one site of the gastrointestinal tract was concomitantly involved. All patients underwent surgical resection with histological confirmation of MM.

Conclusions

Recognition of unusual SB presentation of MM, such as aneurysmal SB dilatation, is important to expedite diagnosis, provide appropriate treatment, and consequently improve quality of life and likely survival of these patients. As the most common cancer to metastasise to the SB and as a known imaging mimicker, MM should remain in any radiologist’s differential diagnosis for SB lesions with aneurysmal dilatation.
Plural violence(s) and migrants’ transnational engagement with democratic politics: the case of Colombians in Europe
Authors: Bermudez Anastasia
Published: June 2022

This article explores how multiple, interrelated violence(s) shape the ways in which migrants relate to democratic politics transnationally. It takes as a departing point the literature on violent democracies and violent pluralism in the Latin American context, and more specifically the situation in Colombia, where democratic institutions coexist with plural violence(s). Following on from studies of migrant transnational politics, the analysis focuses on the Colombian diaspora and how migrants coming from violent democracies engage politically with the home country. Based on extensive research with Colombian migrants in Europe since the mid-90s, the article shows how despite different motivations for migrating, origin-country violence plays a significant role in the lives of many Colombians abroad. It then explores how violence influences migrants’ transnational politics. Migrating from a context of pervasive violence(s) can affect migrants’ sense of transnational belonging as well as increase mistrust and indifference towards formal democratic processes. However, the situation in the home country, together with being exposed to different conditions in the host society, can also motivate migrants to participate transnationally in initiatives to end the violence, thus increasing cooperation and trust.
The effect of anesthesia without opioid on perioperative opioid demand in children with severe obstructive sleep apnea (OSA) for adenotonsillectomies — single-center retrospective observational study
Authors: Mun-Price Connie , Than Kathleen , Klein Margaret J. , Ross Patrick , Kim Eugene , Hochstim Christian , Nagoshi Makoto
Published: June 2022

Background

Children with severe obstructive sleep apnea (OSA) carry a higher risk of respiratory complications after adenotonsillectomy. Their altered sensitivity to opioids may be a significant contributor to respiratory morbidity. The purpose of this study was to identify how anesthesia without opioids affects perioperative opioid demand and postoperative course.

Methods

A chart review of children with severe OSA (apnea hypoxia index; AHI ≥ 10) undergoing adenotonsillectomies was performed. Comorbidities and perioperative medications were documented. Perioperative opioid doses within 48 h of procedure were calculated as morphine equivalents (mcg/kg). Pain scores, rescue medications, and postoperative complications in PICU and non-PICU settings were also documented. Anesthesia without opioid and with opioid groups were compared.

Results

The analysis included 225 children. A significantly higher percentage of children received no postoperative opioids in the anesthesia without opioid group compared to those with opioid (46 of 88 children vs. 43 of 137; P < 0.05). The incidence of severe postoperative pain between the two groups was not different in PICU (P = 0.88) or non-PICU setting (P = 0.84). Perioperative opioid administration was significantly lower in anesthesia without opioid (median, Q1, Q3: 0.0, 0.0, 83.0) compared to with opioid (144.4, 72.5, 222.2; P < 0.01). Anesthesia without opioid was one of the independent factors to achieve perioperative opioid avoidance (<50mcg/kg).

Conclusions

Anesthesia without opioid for children with severe OSA for tonsillectomy significantly reduced perioperative demand for opioid and did not affect the occurrence of severe pain. Anesthesia without opioid is an effective strategy to minimalize opioid demand perioperatively for children with severe OSA for tonsillectomy.
Cancer-related emergency and urgent care: expanding the research agenda
Authors: Shelburne Nonniekaye , Simonds Naoko Ishibe , Jensen Roxanne E. , Brown Jeremy
Published: June 2022

Purpose of review

Cancer-related emergency department (ED) visits often result in higher hospital admission rates than non-cancer visits. It has been estimated many of these costly hospital admissions can be prevented, yet urgent care clinics and EDs lack cancer-specific care resources to support the needs of this complex population. Implementing effective approaches across different care settings and populations to minimize ED and urgent care visits improves oncologic complication management, and coordinating follow-up care will be particularly important as the population of cancer patients and survivors continues to increase. The National Cancer Institute (NCI) and the Office of Emergency Care (OECR) convened a workshop in December 2021, “Cancer-related Emergency and Urgent Care: Prevention, Management, and Care Coordination” to highlight progress, knowledge gaps, and research opportunities. This report describes the current landscape of cancer-related urgent and emergency care and includes research recommendations from workshop participants to decrease the risk of oncologic complications, improve their management, and enhance coordination of care.

Recent findings

Since 2014, NCI and OECR have collaborated to support research in cancer-related emergency care. Workshop participants recommended a number of promising research opportunities, as well as key considerations for designing and conducting research in this area. Opportunities included better characterizing unscheduled care services, identifying those at higher risk for such care, developing care delivery models to minimize unplanned events and enhance their care, recognizing cancer prevention and screening opportunities in the ED, improving management of specific cancer-related presentations, and conducting goals of care conversations.

Significant progress has been made over the past 7 years with the creation of the Comprehensive Oncologic Emergency Research Network, broad involvement of the emergency medicine and oncology communities, establishing a proof-of-concept observational study, and NCI and OECR’s efforts to support this area of research. However, critical gaps remain.
A selective review of smoking cessation interventions in the emergency department
Authors: Pettit Nicholas , Pope Ian , Neuner Bruno , Lash Rebecca , Bernstein Steven L.
Published: June 2022

Background

Emergency department (ED) patients disproportionally smoke compared to the general population and frequently utilize the ED for routine, urgent, and emergent care. Thus, the ED is a target-rich environment for interventions aimed at increasing smoking cessation, especially among vulnerable populations. Promotion of smoking cessation in the ED has the potential to address health inequalities and reach patients that experience significant barriers to accessing preventive care and lifestyle modifications.

Topics of review

This narrative review presents a concise summary of the major smoking cessation strategies studied in the ED setting for adults, children, and pregnant ED patients. Additionally, this review presents the strategies to increase the uptake of smoking cessation in the ED, as well as an international perspective of smoking cessation efforts in the ED. Past and ongoing efforts to improve smoking cessation among ED patients are discussed, and critical knowledge gaps and research opportunities are highlighted.

Conclusion

Smoking cessation is both efficacious and feasible during an ED visit, with multiple options available to both adults, children, parents, and pregnant patients. Little standardization among cessation strategies among EDs has been demonstrated, despite the ED being uniquely positioned to address disparities in smoking cessation and contribute towards national smoking cessation goals. During most ED visits, any health care team member can address ongoing tobacco use, and smoking cessation can easily be related to the context of the patient’s presenting complaint. To be effective, health care systems and teams must recognize the ED as a suitable location to engage with patients regarding their knowledge and awareness of ongoing smoking use, and are well suited to provide and initiate effective smoking cessation treatments.
Playing with Photographs
Authors: Viswanathan Rashmi
Published: June 2022

Two recent exhibitions in New York City invite thoughts about the meanings and possibilities of photography in art. Featuring the works of the artists Gauri Gill and Farideh Sakhaeifar, the exhibitions explore unconventional methods of photo-taking and making. Long known for her collaborative practice, Gill's work features multiple authors and subjects who play with photographic conventions and subject-object relations. Her subjects devise their presentation and mask their faces. Pointedly rejecting the ethnographic perspective, Gill's subjects exercise a level of freedom from the fixity of the camera. Sakhaeifar, from a markedly critical vantage point, draws attention to the ways that photography can obscure its subjects. Deeply sensitive to the histories of photography, both artists visualize the things that photography cannot contour—horror, pain, joy, and the unreal.
Molecular Arrangement Control of [1]Benzothieno[3,2-b][1]benzothiophene (BTBT) via Charge-Assisted Hydrogen Bond
Authors: Akai Ryota , Oka Kouki , Dekura Shun , Mori Hatsumi , Tohnai Norimitsu
Published: June 2022

Organic semiconductors have π-conjugation in the constituent molecules and exhibit optical and electrical properties. Since these properties are significantly affected by the overlap of π-orbitals between adjacent molecules, not only their molecular structures but also their molecular arrangement has been well known as critical; however, control of the molecular arrangement without modifying the electronic character of the constituent molecule has been difficult. In the current work, we report organic salts composed of disulfonic acid with a moiety of a representative organic semiconductor molecule, [1]benzothieno[3,2-b][1]benzothiophene (BTBT), as a functional component, and different types of alkylamines as an arrangement-controlling component via charge-assisted hydrogen bonds. We successfully controlled the molecular arrangement of BTBT moiety by changing alkylamines, without changing the structure of disulfonic acid with the BTBT functional moiety. Depending on the bulkiness of alkylamines, the molecular arrangement of these organic salts changed from an edge-to-face herringbone-type arrangement, where CH/π interactions were dominant similar to the common crystal structure of BTBT, to a novel one-dimensional (1D) slipped parallel-type arrangement for BTBT, without changing the molecular structure of disulfonic acid. In addition, we revealed that the dimensionality of the electronic state and properties of the organic salts also changed according to the molecular arrangement of BTBT moiety.
Epigenome-Wide Association Study Identified VTI1A DNA Methylation Associated With Accelerometer-Assessed Physical Activity
Authors: NISHIDA YUICHIRO , HARA MEGUMI , OHMOMO HIDEKI , ONO KANAKO , SHIMIZU ATSUSHI , HORITA MIKAKO , SHIMANOE CHISATO , TAGUCHI NAOTO , HIGAKI YASUKI , TANAKA KEITARO
Published: June 2022

Introduction

Health benefits of physical activity (PA) may be mediated by DNA methylation alterations. The purpose of the current study was to comprehensively identify CpG sites whose methylation levels were associated with accelerometer-assessed total PA in a general Japanese population.

Methods

The study participants were from the baseline survey of Saga Japan Multi-institutional Collaborative Cohort. PA was objectively measured by a single-axis accelerometer for 7 d. We used a two-stage strategy. In the discovery stage, we performed a meta-analysis of two epigenome-wide association studies of total PA in 898 individuals (a combination of random sample (n = 507) and case–control study sample (n = 391)). Peripheral blood DNA methylation levels were measured using Infinium EPIC or HM450 arrays. In the replication stage, we subsequently examined whether CpG sites significantly associated (P < 1 × 10−5) with total PA were replicated in another sample (n = 1711), in which methylation levels were measured by pyrosequencing. A multiple linear regression was performed to determine the cross-sectional association between total PA and methylation levels with adjustment for potential confounders, including body mass index. A fixed-effects model was used in the meta-analysis. Correlations between total PA–associated DNA methylation and several inflammatory markers, such as high-sensitivity C-reactive protein, were also conducted.

Results

In the meta-analysis, nine CpG sites were significantly associated with total PA (P < 1 × 10−5). Among the nine sites, one site cg07030336 (annotated to VTI1A/ZDHHC6 gene) was successfully replicated (P = 0.009).

Conclusions

The current study showed that greater accelerometer-assessed total PA was associated with higher DNA methylation levels at cg07030336 (VTI1A/ZDHHC6) in the general population. In addition, we found a divergent relationship between the methylation levels at cg07030336 and several inflammatory biomarkers.
Perceived Severity and Management of Low Back Pain in Adult Dancers in the United States
Authors: Henn Erica D. , Smith Tina , Ambegaonkar Jatin P. , Wyon Matthew A.
Published: June 2022

Introduction: Low back pain (LBP) lifetime prevalence in dancers reportedly ranges from 17% to 88%. Low back pain can have negative secondary consequences on dancers' lives and careers. Still, how LBP impacts dancer function and medical care-seeking behaviors and whether these issues differ across dance genres, is understudied.
 Materials and Methods: Two hundred and eight-nine ballet, modern, and hip-hop dancers and teachers (median age: 20.3 years; range: 18 to 69 years) in the United States completed an online 24-question survey assessing LBP related self-reported injury history, impact on their lives, and management strategies. We defined LBP as occurrence of acute or chronic pain in the lumbar or sacral regions of the back.
 Results: Two hundred and fifty-seven participants (88.9% of 289 total) reported at least one instance of LBP during their lifetime and 220 participants reported LBP in the prior 4 weeks. Of these 220, 72 (32.7%) had LBP severe enough to limit their activities of daily living. Of the 213 who had LBP and danced during that time, 89 (41.8%) reported that LBP limited their dancing. Pain intensity (median: 4 on a 0 to 10 scale, IQR: 3.0) and LBP prevalence were similar across dance genres. Dancers sought multiple medical professionals, most often chiropractors (n = 94, 33.8%), medical doctors (n = 77, 27.7%), and physiotherapists (n = 60, 21.6%). Ninety dancers (35.0% of those with LBP) never sought medical care. Dancers who did seek care reported higher pain intensities (median: 4, IQR: 3.8) than those who did not (median: 3, IQR: 3.0).
 Conclusion: Overall, most participants did suffer from LBP. Low back pain negatively impacts dancers' everyday activities and dancing. Pain intensity and loss of function may impact care-seeking. Our findings highlight the need for all dance stakeholders to educate dancers about their health, provide resources for dancer health care, and proactively create an environment that supports injury reporting behaviors in dancers.