bluuebunny/crossref_metadata_2025 huggingface dataset:
Decomposing socioeconomic inequality in blood pressure and blood glucose testing: evidence from four districts in Kerala, India
Authors: Sharma Santosh Kumar , Nambiar Devaki , Sankar Hari , Joseph Jaison , Surendran Surya , Benny Gloria
Published: September 2022

Background

Non-Communicable Diseases (NCDs) constitute a significant danger to the nation’s public health system, both in terms of morbidity and mortality, as well as the financial burden they inflict. Kerala is undergoing an epidemiologic transition, which has significantly impacted the state’s morbidity and mortality figures. For decades, the state has been putting in place myriad programs to reduce the burden of NCDs across population groups. Socioeconomic inequalities in NCD testing have been documented in India, although they are understudied in Kerala. The study aimed to estimate and characterize districtwise socioeconomic inequality in Blood Pressure (BP) and Blood Glucose (BG) testing.

Methods

A cross-sectional household survey was conducted between July–October 2019 in Kasaragod, Alappuzha, Kollam and Thiruvananthapuram districts of Kerala, India. A total of 6383 participants aged 30 years and above were interviewed using multistage random sampling. Descriptive statistics were derived district-wise. We computed ratios, differences, equiplots, and Erreygers concentration indices for each district to measure socioeconomic inequality in BP and BG testing. Erreygers decomposition techniques were used to estimate the relative contribution of covariates to socioeconomic inequality.

Results

There was a significant concentration of BP and BG testing favouring wealthier quintiles in Alappuzha, Kollam, and Thiruvananthapuram districts. The inequality in BP and BG testing was highest in Thiruvananthapuram (0.087 and 0.110), followed by Kollam (0.077 and 0.090), Alappuzha (0.083 and 0.073) and Kasaragod (0.026 and 0.056). Decomposition analysis revealed that wealth quintile and education contributed substantially to socioeconomic inequality in BP and BG testing in all four districts. It was also found that family history of NCDs significantly contributed to observed socioeconomic inequality in BP testing (29, 11, 16, and 27% in Kasaragod, Alappuzha, Kollam, and Thiruvananthapuram, respectively). Similarly, in BG testing, family history of NCDs substantially contributed to observed socioeconomic inequality, explaining 16–17% in Kasaragod, Alappuzha, Kollam, and Thiruvananthapuram respectively of the total inequality.

Conclusion

While the magnitude of socioeconomic inequality in NCD risk factor testing did not appear to be very high in four Kerala districts, although levels were statistically significant in three of them. Greater exploration is needed on how education and caste contribute to these inequalities and their relationship to NCD risk factors such as family history. From such analyses, we may be able to identify entry points to mitigate inequalities in testing access, as well as burden.
EQ-5D-5L measurement properties are superior to EQ-5D-3L across the continuum of health using US value sets
Authors: Jiang Ruixuan , Rand Kim , Kuharic Maja , Pickard A. Simon
Published: September 2022

Objective

The objective of this study was to compare the measurement properties of the US EQ-5D-3L, EQ-5D-5L, and -5L to -3L crosswalk value sets (3L; 5L; 5L > 3L) across the spectrum of health.

Methods

The three scoring approaches were compared in terms of range of scale, percent of worse-than-dead health states, and mean single-level transitions. Discriminative ability was compared by leveraging two cross-sectional datasets. A novel method was used to visualize and compare the responsiveness of 3L and 5L scoring approaches across EQ VAS values.

Results

The US 5L value set had the broadest range of scale at 1.573 (vs. 1.109 for 3L and crosswalk). The crosswalk had the smallest mean single-level transition of 0.061 (vs. 0.078 for 5L and 0.111 for 3L). The 5L value set tended to be more discriminative/greater statistical efficiency than the crosswalk (F-statistic ratio: 1.111, 95% CI 0.989–1.240) and 3L (F-statistic ratio: 1.102 95% CI 0.861–1.383) across levels of general health. The 5L was the most responsive value set between EQ VAS values of 25 and 75.

Conclusion

These results imply greater sensitivity of the 5L to health changes and potentially lower incremental cost-utility ratios compared to the 3L.
Impact of N6-methyladenosine (m6A) modification on immunity
Authors: Elsabbagh Raghda A. , Rady Mona , Watzl Carsten , Abou-Aisha Khaled , Gad Mohamed Z.
Published: September 2022

N6-methyl-adenosine (m6A) is the most prevalent modification on mRNAs and long noncoding RNAs (lnRNAs) in higher eukaryotes. Modulation of m6A relies on m6A writers, erasers and readers. m6A modification contributes to diverse fundamental biological functions at the molecular, cellular, and physiological levels. The dysregulation of m6A modification has been implicated in various human diseases. Thus, m6A modification has now become a research hotspot for its potential therapeutic applications in the treatment of various cancers and diseases. The immune system is essential to provide defense against infections and cancers. This review summarizes the current knowledge about the roles of m6A in regulating immune cell functions and immune responses.
The role of exome sequencing in childhood interstitial or diffuse lung disease
Authors: Temple Suzanna E. L. , Ho Gladys , Bennetts Bruce , Boggs Kirsten , Vidic Nada , Mowat David , Christodoulou John , Schultz André , Gayagay Thet , Roscioli Tony , Zhu Ying , Lunke Sebastian , Armstrong David , Harrison Joanne , Kapur Nitin , McDonald Tim , Selvadurai Hiran , Tai Andrew , Stark Zornitza , Jaffe Adam
Published: September 2022

Background

Children’s interstitial and diffuse lung disease (chILD) is a complex heterogeneous group of lung disorders. Gene panel approaches have a reported diagnostic yield of ~ 12%. No data currently exist using trio exome sequencing as the standard diagnostic modality. We assessed the diagnostic utility of using trio exome sequencing in chILD. We prospectively enrolled children meeting specified clinical criteria between 2016 and 2020 from 16 Australian hospitals. Exome sequencing was performed with analysis of an initial gene panel followed by trio exome analysis. A subset of critically ill infants underwent ultra-rapid trio exome sequencing as first-line test.

Results

36 patients [median (range) age 0.34 years (0.02–11.46); 11F] were recruited from multiple States and Territories. Five patients had clinically significant likely pathogenic/pathogenic variants (RARB, RPL15, CTCF, RFXANK, TBX4) and one patient had a variant of uncertain significance (VIP) suspected to contribute to their clinical phenotype, with VIP being a novel gene candidate.

Conclusions

Trio exomes (6/36; 16.7%) had a better diagnostic rate than gene panel (1/36; 2.8%), due to the ability to consider a broader range of underlying conditions. However, the aetiology of chILD in most cases remained undetermined, likely reflecting the interplay between low penetrant genetic and environmental factors.
Predictors of transfer from a remote trauma facility to an urban level I trauma center for blunt splenic injuries: a retrospective observational multicenter study
Authors: McGraw Constance , Mains Charles W. , Taylor Jodie , D’Huyvetter Cecile , Salottolo Kristin , Bar-Or David
Published: September 2022

Background

The decision-making for admission versus emergent transfer of patients with blunt splenic injuries presenting to remote trauma centers with limited resources remains a challenge. Although splenectomy is standard for hemodynamically unstable patients, the specific criterion for non-operative management continues to be debated. Often, lower-level trauma centers do not have interventional radiology capabilities for splenic artery embolization, leading to transfer to a higher level of a care. Thus, the aim of this study was to identify specific characteristics of patients with blunt splenic injuries used for admittance or transfer at a remote trauma center.

Methods

A retrospective observational study was performed to examine the management of splenic injuries at a mountainous and remote Level III trauma center. Trauma patients ≥ 18 years who had a blunt splenic injury and initially received care at a Level III trauma center prior to admittance or transfer were included. Data were collected over 4.5 years (January 1, 2016 – June 1, 2020). Patients who were transferred out in > 24 h were excluded. Patient demographics, injury severity, spleen radiology findings, and clinical characteristics were compared by decision to admit or transfer to a higher level of care ≤ 24 h of injury. Results were analyzed using chi-square, Fisher’s exact, or Wilcoxon tests. Multivariable logistic models were used to identify predictors of transfer.

Results

Of the 73 patients included with a blunt splenic injury, 48% were admitted and 52% were transferred to a Level I facility. Most patients were male (n = 58), were a median age of 26 (21–42) years old, most (n = 62) had no comorbidities, and 47 had been injured from a ski/snowboarding accident. Compared to admitted patients, transferred patients were significantly more likely to be female (13/38 vs. 3/36, p = 0.007), to have an abbreviated injury scale score ≥ 3 of the chest (31/38 vs. 7/35, p = 0.002), have a higher injury severity score (16 (16–22) vs. 13 (9–16), p = 0.008), and a splenic injury grade ≥ 3 (32/38 vs. 12/35, p < 0.001). After adjustment, splenic injury grade ≥ 3 was the only predictor of transfer (OR: 12.1, 95% CI: 3.9–37.3, p < 0.001). Of the 32 transfers with grades 3–5, 16 were observed, and 16 had an intervention. Compared to patients who were observed after transfer, significantly more who received an intervention had a blush on CT (1/16 vs. 7/16, p = 0.02) and a higher median spleen grade of 4 (3–5) vs. 3 (3–3.5), p = 0.01).

Conclusions

Our data suggest that most patients transferred from a remote facility had a splenic injury grade ≥ 3, with concomitant injuries but were hemodynamically stable and were successfully managed non-operatively. Stratifying by spleen grade may assist remote trauma centers with refining transfer criteria for solid organ injuries.
The effect of the Progressive Goal Attainment Program on cognitions, perceptions, and work participation of workers with chronic health problems: study protocol for a randomized controlled trial
Authors: de Wit Mariska , Zijlstra Hendrika P. , Hulshof Carel T. J. , van der Burg-Vermeulen Sylvia J. , de Boer Angela G. E. M.
Published: September 2022

Background

Cognitions and perceptions of workers with chronic health problems, such as catastrophizing thoughts and fear-avoidance beliefs, can negatively influence work participation. The Progressive Goal Attainment Program (PGAP) is an intervention developed in Canada with the aim of decreasing limiting cognitions and perceptions and increasing work participation. The objective of this protocol article is to describe the design of a randomized controlled superiority trial to study whether PGAP is effective in decreasing limiting cognitions and perceptions and increasing workability and work participation of workers with chronic health problems in the Netherlands.

Methods

This study is a randomized controlled superiority trial with two (parallel) groups, in which workers on sick leave are randomly assigned to an intervention group (PGAP intervention) or to a waiting-list control group (care as usual). The PGAP intervention consists of a maximum of 10 weekly individual sessions provided by a trained PGAP professional in which the worker learns about staying active, planning activities, and setting goals. Participants in this risk-targeted behavioral activation intervention also learn to be more aware of their cognitions and perceptions and learn about solution-focused problem-solving skills in challenging situations. The primary outcome is the degree of catastrophizing. Secondary outcomes are other personal cognitions and perceptions (e.g., expectations regarding return to work, self-efficacy), health symptoms (e.g., fatigue, depression), work participation (e.g., sick leave status, work hours), and other work-related outcomes (e.g., workability, quality of working life).

Discussion

Although PGAP shows positive effects in Canada, we do not know whether this intervention is effective in the Netherlands. This study is the first randomized controlled trial to test the effect of PGAP on limiting cognitions and perceptions and on work participation of workers with chronic health problems in the Netherlands. If PGAP is effective it could be implemented in the Netherlands in order to stimulate workability and work participation of workers.

Trial registration

The protocol of this study is registered in the Netherlands Trial Register (NL9832) in October 2021.
Reshaping the path of mild cognitive impairment by refining exercise prescription: a study protocol of a randomized controlled trial to understand the “what,” “for whom,” and “how” of exercise to promote cognitive function
Authors: Barha Cindy K. , Falck Ryan S. , Best John R. , Nagamatsu Lindsay S. , Hsiung Ging-Yuek Robin , Sheel A. William , Hsu Chun Liang , Kramer Arthur F. , Voss Michelle W. , Erickson Kirk I. , Davis Jennifer C. , Shoemaker J. Kevin , Boyd Lara , Crockett Rachel A. , ten Brinke Lisanne , Bherer Louis , Singer Joel , Galea Liisa A. M. , Jacova Claudia , Bullock Alexis , Grant Sofia , Liu-Ambrose Teresa
Published: September 2022

Background

Targeted exercise training is a promising strategy for promoting cognitive function and preventing dementia in older age. Despite the utility of exercise as an intervention, variation still exists in exercise-induced cognitive gains and questions remain regarding the type of training (i.e., what), as well as moderators (i.e., for whom) and mechanisms (i.e., how) of benefit. Both aerobic training (AT) and resistance training (RT) enhance cognitive function in older adults without cognitive impairment; however, the vast majority of trials have focused exclusively on AT. Thus, more research is needed on RT, as well as on the combination of AT and RT, in older adults with mild cognitive impairment (MCI), a prodromal stage of dementia. Therefore, we aim to conduct a 6-month, 2 × 2 factorial randomized controlled trial in older adults with MCI to assess the individual effects of AT and RT, and the combined effect of AT and RT on cognitive function and to determine the possible underlying biological mechanisms.

Methods

Two hundred and sixteen community-dwelling adults, aged 65 to 85 years, with MCI from metropolitan Vancouver will be recruited to participate in this study. Randomization will be stratified by biological sex and participants will be randomly allocated to one of the four experimental groups: (1) 4×/week balance and tone (BAT; i.e., active control); (2) combined 2×/week AT + 2×/week RT; (3) 2×/week AT + 2×/week BAT; or (4) 2×/week RT + 2×/week BAT. The primary outcome is cognitive function as measured by the Alzheimer’s Disease Assessment Scale-Cognitive-Plus. Secondary outcomes include cognitive function, health-related quality of life, physical function, actigraphy measures, questionnaires, and falls. Outcomes will be measured at baseline, 6 months (i.e., trial completion), and 18 months (i.e., 12-month follow-up).

Discussion

Establishing the efficacy of different types and combinations of exercise training to minimize cognitive decline will advance our ability to prescribe exercise as “medicine” to treat MCI and delay the onset and progression of dementia. This trial is extremely timely as cognitive impairment and dementia pose a growing threat to global public health.

Trial registration

ClinicalTrials.gov NCT02737878. Registered on April 14, 2016.
The unique diagnostic and management challenge of a patient with concomitant anti-interferon-gamma autoantibody associated immunodeficiency syndrome, IgG4-related disease, and treatment refractory, disseminated mycobacterium avium complex infection
Authors: Boyle Spencer , Hagiya Ashley , Nguyen Minh-Vu H. , Liebman Howard , Lee Jin Sol G.
Published: September 2022

Background

Anti-interferon-gamma autoantibody-associated immunodeficiency syndrome is a rare and underrecognized adult onset immunodeficiency syndrome associated with severe opportunistic infections such as disseminated nontuberculous mycobacterium. Few cases have documented a relationship with IgG4-related disease. Concomitant diagnoses of these diseases present a diagnostic and management challenge.

Case presentation

A 61 year old man of Southeast Asian descent with pulmonary mycobacterium avium complex infection presented to our hospital system with a new skin rash and worsening lymphadenopathy. He was eventually diagnosed with IgG4-related disease through excisional nodal biopsy. He was managed with immunosuppressive treatment with prednisone, rituximab and cyclophosphamide. He later re-presented with disseminated mycobacterium avium complex infiltration of his joints, bones and prostate. Original titers of anti-interferon-gamma autoantibodies were falsely negative due to being on immunosuppressive therapy for his IgG4-related disease. However, anti-interferon-gamma autoantibody titers were re-sent after immunosuppression was held and returned strongly positive.

Conclusions

This case reviews diagnostic criteria and discusses management strategies with existing challenges in treating a patient with concomitant adult onset immunodeficiency syndrome, IgG4-related disease and a disseminated mycobacterial avium complex infection.
Item performance across native language groups on the Iranian National University Entrance English Exam: a nationwide study
Authors: Bormanaki Hamidreza Babaee , Ajideh Parviz
Published: September 2022

This paper reports on an investigation of differential item functioning (DIF) in the Iranian Undergraduate University Entrance Special English Exam (IUUESEE) across four native language groups including the Azeri, the Persian, the Kurdish, and the Luri test takers via Rasch analysis. A total sample of 14,172 participants was selected for the study. After establishing the unidimensionality and local independence of the data, the authors employed two methods to test for the DIF: (a) a t-test uniform DIF analysis, which showed that the Luri test-takers were more favored than other native language groups, and (b) nonuniform DIF analysis, which revealed that majority of nonuniform DIF instances functioned in favor of the low-ability Azeri, the low-ability Persian, the high-ability Kurdish, and the high-ability Luri test-takers. A possible explanation for native language-ability DIF was that the Luri and low-ability test-takers were more likely to venture lucky guesses. We also referred to socioeconomic status (e.g., test-wiseness), guessing, overconfidence, thoughtless errors, stem length, time, L1, and unappealing distractors as possible sources of DIF in IUUESEE.
Difference between 5A score and the HOPE score
Authors: Okada Yohei , Matsuyama Tasuku , Hayashida Kei , Takauji Shuhei , Kanda Jun , Yokobori Shoji
Published: September 2022

Recently, a letter to the editor was published to comment on the 5A score which is the prediction model for accidental hypothermia patients comparing the HOPE score. In this letter, we responded to the comments to clarify the difference between the 5A score and the HOPE score.
An online survey of dietary quality during complementary feeding; associations with maternal feeding self-efficacy and adherence to dietary recommendations
Authors: Spyreli Eleni , McKinley Michelle C. , Dean Moira
Published: September 2022

Background

Parents are the gatekeepers of nutrition in early life and their feeding practices form children’s dietary behaviours. Although maternal characteristics have been associated with certain feeding practices, their relationship with overall quality of complementary feeding diets has not been explored. This study aimed to: assess dietary quality in complementary feeding age; explore its association with maternal and child characteristics; and evaluate the association between complementary feeding practices and child weight.

Methods

An online cross-sectional survey captured data from a self-selected sample of mothers living in the UK with a healthy full-term child in complementary feeding age. A total of 466 mothers completed a questionnaire on their complementary feeding practices, demographics, anthropometrics, rates of maternal food neophobia, feeding self-efficacy, social support, postnatal depression and infant temperament. Dietary quality was assessed using the Complementary Feeding Utility Index (CFUI). Children were classified into underweight, normal weight, overweight and obese.

Results

Majority of participants reported high levels of dietary quality as determined by a mean CFUI score of 80%. High dietary quality was associated with reliance on the NHS recommendation on timing of complementary feeding and maternal self-efficacy in promoting a healthy diet and limiting non-recommended foods. Responsive feeding, longer breastfeeding duration, frequent exposure to fruits and to a high variety of protein-rich animal foods were significantly associated with lighter child weight status. Consumption of sweetened drinks and delayed introduction of lumpy foods were associated with heavier child weight status.

Conclusions

This study provided an evaluation of dietary quality in complementary feeding in a UK sample of children and explored its relationship with maternal and child attributes. Increasing understanding of the current complementary feeding recommendations and strengthening maternal feeding self-efficacy may be key for healthcare professionals and researchers to improving complementary feeding practices.
Adapting an intervention of brief problem-solving therapy to improve the health of women with antenatal depressive symptoms in primary healthcare in rural Ethiopia
Authors: Bitew Tesera , Keynejad Roxanne , Myers Bronwyn , Honikman Simone , Sorsdahl Katherine , Hanlon Charlotte
Published: September 2022

Background

Evidence-based brief psychological interventions are safe and effective for the treatment of antenatal depressive symptoms. However, the adaptation of such interventions for low- and middle-income countries has not been prioritised. This study aimed to select and adapt a brief psychological intervention for women with antenatal depressive symptoms attending primary healthcare (PHC) in rural Ethiopia.

Methods

We employed the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. Alongside this, we used the ADAPT-ITT model of process adaptation and the ecological validity model (EVM) to guide content adaptation. We conducted formative work, comprising a qualitative study, a series of three participatory theories of change workshops and an expert adaptation workshop to assess the needs of the target population and to select an intervention for adaptation. The adaptation process followed a series of steps: (1) training Ethiopian mental health experts in the original South African problem-solving therapy (PST version 0.0) and an initial adaptation workshop leading to PST Version 1.0. (2) Version 1.0 was presented to perinatal women and healthcare professionals in the form of a ‘theatre test’, leading to further adaptations (version 2.0). (3) Local and international stakeholders reviewed version 2.0, leading to version 3.0, which was used to train 12 PHC staff using clinical cases. (4) Finally, feedback about PST version 3.0 and its delivery was obtained from PHC staff.

Results

In the first step, we modified case examples and terminology from the South African model, introduced an in-session pictorial flipchart for this low literacy setting, and added strategies to facilitate women’s engagement before translating into Amharic. In the second step, adaptations included renaming of the types of problems and inclusion of more exercises to demonstrate proposed coping strategies. In the third step, the components of motivational interviewing were dropped due to cultural incongruence. In the final step, refresher training was delivered as well as additional training on supporting control of women’s emotions to address PHC staff training needs, leading to the final version (version 4.0).

Conclusion

Using a series of steps, we have adapted the content and delivery of brief PST to fit the cultural context of this setting. The next step will be to assess the feasibility and acceptability of the intervention and its delivery in antenatal care settings.
Inhospital cardiac arrest — the crucial first 5 min: a simulation study
Authors: Stærk Mathilde , Lauridsen Kasper G. , Støtt Camilla Thomsen , Riis Dung Nguyen , Løfgren Bo , Krogh Kristian
Published: September 2022

Background

Early recognition and call for help, fast initiation of chest compressions, and early defibrillation are key elements to improve survival after cardiac arrest but are often not achieved. We aimed to investigate what occurs during the initial treatment of unannounced in situ simulated inhospital cardiac arrests and reasons for successful or inadequate initial resuscitation efforts.

Methods

We conducted unannounced full-scale in situ simulated inhospital cardiac arrest followed by a debriefing. Simulations and debriefings were video recorded for subsequent analysis. We analyzed quantitative data on actions performed and time measurements to key actions from simulations and qualitative data from transcribed debriefings.

Results

We conducted 36 simulations. Time to diagnosis of cardiac arrest was 37 (27; 55) s. Time to first chest compression from diagnosis of cardiac arrest was 37 (18; 74) s, time to calling the cardiac arrest team was 144 (71; 180) s, and time to first shock was 221 (181; 301) s. We observed participants perform several actions after diagnosing the cardiac arrest and before initiating chest compressions. Domains emerging from the debriefings were teaming and resources. Teaming included the themes communication, role allocation, leadership, and shared knowledge, which all included facilitators and barriers. Resources included the themes knowledge, technical issues, and organizational resources, of which all included barriers, and knowledge also included facilitators.

Conclusion

Using unannounced in situ simulated cardiac arrests, we found that key elements such as chest compressions, calling the cardiac arrest team, and defibrillation were delayed. Perceived barriers to resuscitation performance were leadership and teaming, whereas experience, clear leadership, and recent training were perceived as important facilitators for treatment progress.
The association between cannabis and codeine use: a nationally representative cross-sectional study in Canada
Authors: Garg Ria , Shojania Kam , De Vera Mary A.
Published: September 2022

Background

Due to the growing use of cannabis for the purposes of pain relief, evidence is needed on the impact of cannabis use on concurrent analgesic use. Therefore, our objective was to evaluate the association between the use of cannabis and codeine.

Methods

We conducted a cross-sectional study using data from the nationally representative Canadian Tobacco, Alcohol and Drugs Survey (2017). The primary explanatory variable was self-reported use of cannabis within the past year. The outcome was the use of codeine-containing product(s) within the past year. We used multivariable binomial logistic regression models.

Results

Our study sample comprised 15,459 respondents including 3338 individuals who reported cannabis use within the past year of whom 955 (36.2%) used it for medical purposes. Among individuals who reported cannabis use, the majority were male (N = 1833, 62.2%). Self-reported use of cannabis was associated with codeine use (adjusted odds ratio [aOR] 1.89, 95% CI 1.36 to 2.62). Additionally, when limited to cannabis users only, we found people who used cannabis for medical purposes to be three times more likely to also report codeine use (adjusted odds ratio [aOR] 2.96, 95% CI 1.72 to 5.09).

Discussion

The use of cannabis was associated with increased odds of codeine use, especially among individuals who used it for medical purposes. Our findings suggest a potential role for healthcare providers to be aware of or monitor patients’ use of cannabis, as the long-term adverse events associated with concurrent cannabis and opioid use remain unknown.
Exosomes in schizophrenia: Pathophysiological mechanisms, biomarkers, and therapeutic targets
Authors: Wang Yu , Amdanee Nousayhah , Zhang Xiangrong
Published: September 2022

While schizophrenia (SCZ) is a devastating psychiatric disorder that detrimentally affects a significant portion of the worldwide population, its diagnosis is traditionally based on a relatively subjective assessment of current symptoms and medical history, devoid of an objective diagnostic modality. Antipsychotic medications are commonly used in the treatment of SCZ; however, some patients have low remission rates or forsake treatment due to the associated multiple side effects, resulting in recurrent episodes of the disease and poor prognosis. These situations imply that the diagnosis, treatment, and prognosis of SCZ need to be improved to increase the odds of a better outcome. Mounting studies have found that extracellular vesicles (EVs) play essential roles in the central nervous system. They are implicated in several mechanisms closely associated with SCZ such as cellular communication and synaptic plasticity. They can additionally exhibit neuroprotective and therapeutic effects. Since they possess distinct constituents, are readily available, easily detectable, and dependent on the internal environment, they can potentially serve as reliable biomarkers for disease diagnosis. Moreover, their biological configuration along with their ability to increase the bioavailability of their constituents and modulate intricate intracellular reactions in target cells, propel EVs as new targets for treatment. This review paper summarizes relevant research pertaining to the roles of EVs in SCZ, with the aim of improving insights into SCZ pathogenesis and evaluating EVs as potential biomarkers in the diagnosis and treatment of SCZ.
The Mughal Self and the Jain Other in Siddhicandra's Bhanucandraganicarita
Authors: Truschke Audrey
Published: September 2022

Siddhicandra's Bhanucandraganicarita (Biography of Bhanucandra, ca. 1620s) enacts a stunning development in Sanskrit historiography. The text's title bills it as a biography of a Jain mendicant, a standard genre of Jain-authored works. But, in fact, the text treats cross-cultural relations between Jain ascetics and Mughal elites as its main subject. It is arguably the first Sanskrit text to focus specifically and exclusively on Mughal contexts. This literary and historiographical choice is all the more noteworthy because of the text's carefully delineated approach to negotiating between Sanskrit, Jain, and Mughal cultural norms. Throughout the work Siddhicandra depicts the Mughals as steeped in Sanskrit literary culture while showing himself to be fluent in a Persianate cultural zone. In the tradition of Sanskrit writing on Indo-Persian political figures, which was several hundred years old by the early seventeenth century, the Bhanucandraganicarita marks a moment when the Mughals ceased to be other in any identifiable way, except as offering a new cultural context for Jain self-expression.
The Use of Brajbhasha in Sikh Contexts
Authors: Vig Julie
Published: September 2022

This article connects the Sikh tradition to wider cultural and literary worlds by examining how gurbilās literature—written from the end of the seventeenth century into the nineteenth—is tied to the wider Braj literary world and more specifically to Braj martial poetry. Gurbilās literature—or “the play or pastimes of the Guru”—refers to a collection of biographies of the Sikh Gurus emphasizing the narration of life stories of Guru Gobind Singh and his heroic deeds. This essay focuses on the portrayal of an important battle widely narrated in Sikh history, the battle of Bhangani (dated to 1688), in three gurbilās texts. Its goal is to examine two main issues: first, how these three narratives, and gurbilās literature more broadly, interact along multiple poles with the wider world of Braj literary traditions, specifically with Braj martial poetry; and second, how these texts provide us with material to think about the context of performance of these texts. It concludes with a broad reflection on how these three narratives represent a textual microcosm that reveals the many connections gurbilās literature—and more broadly the Sikh cultural world—has with other genres and traditions.
Demystifying the Image
Authors: Alemu Amsale
Published: September 2022

While opposition to the Ethiopian monarchy was an immediate imperative of the Ethiopian revolutionary movement, self-professed “anti-feudalism” was but one part of the political-economic object of revolutionary critique. Originating from a country famous for its legacy of African independence, and against a monarch who was a global pan-African icon, Ethiopian revolutionary opposition to Haile Selassie would require not only a politics of dissent, but also an anti-colonial framing. This article centers anti-imperialism—specifically challenges to US neo-imperialism in Ethiopia—among Ethiopian student revolutionaries in the United States during the late 1960s and early 1970s. Examining organizational writing and direct action, as well as editorials in Muhammad Speaks and The Black Panther, this article argues that US-based Ethiopian students employed demystification as a signature revolutionary tactic. They attempted to reframe Ethiopian exceptionalist narratives as currency of US neo-imperialism, drawing on arguments strengthened by engaging Black Power concepts and thinkers. Demystification, while rooted in narrative modes and historical tropes specific to Ethiopian students' location in the United States, offers a concept to think through other oppositional movements as generative of global theoretical critique. Ethiopian students not only demanded the overthrow of the monarchy, but also joined anti-colonial appeals for the structural transformation of the world.
Decolonizing History
Authors: Harrison Olivia C.
Published: September 2022

The borders between North and South quickly erode when we study the history of anti-colonial revolutions. This is perhaps especially true of France, where the Palestinian revolution has been a rallying cry in the struggle for migrant rights for the past half century. This article investigates the reactivation of anti-colonialism in the postcolonial era, tracing the decades-long “postcolonial anti-colonial” movements born in migrant circles in France, from the 1970s to the present. What happens to the notion of anti-colonial revolution when it is brought back to the metropole? How does it change when it is brought to bear on the migrant question? First posed by the Palestine committees forged by migrant workers, foreign students, and Maoist militants in the wake of the September 1970 massacre of Palestinians in Jordan, these questions have shaped discourses around migrant rights in France for the past fifty years. In conclusion, this article revisits the archive of the migrant theater collective Al Assifa as it is remediated in Bouchra Khalili's 2017 film The Tempest Society, and speculates on the current place of migration in world historical discourses of decolonization.
Worldly Marxism
Authors: Ali Noaman G. , Raza Shozab
Published: September 2022

How can Marxism, a theory and practice that emerged from the European experience, speak to contexts outside that experience? Recent scholarship has returned to the moment of the 1960s and 1970s to examine how political movements in the global South that embraced Marxism grappled with this question, aiming to reformulate Marxist theories and categories of analysis for postcolonial realities. Whereas this scholarship focuses on the writings of intellectuals, in this article, the authors supplement prose with oral history and ethnography to also identify the theory immanent in practice. They show how the translation of Marxist theory for political practice in the peripheries instantiated what the authors call a worldly Marxism: that is, a Marxism that is constantly renewed as it exceeds its origins in Europe and attends to the specificities of settler-colonies, (post-)colonies and metropoles. Worldly Marxism thus entails theorizing in the conjuncture, that is, from a particular historical moment, and involves arranging multiple conceptual elements to clarify and understand the political task at hand. The authors illustrate how such worldly Marxism was produced in Pakistan by examining the Mazdoor Kisan Party (MKP), the country's historically largest communist party, as it engaged with agrarian transitions, religion, and gender.
Alternative Histories of Global Sovereignty
Authors: Shipley Jesse Weaver
Published: September 2022

Between 1979 and 1983 soldiers, workers, and students in Ghana launched a revolution to destroy the neo-imperial order. In the Ghanaian historical imagination that era is not remembered for its radical populism but as a time of violent chaos before the nation-state followed the road to purported neoliberal stability. The sudden rise and fall of revolutionary Ghana reveals both the possibility of alternative modes of political power in Africa and how these forms have been contained through both violence and the control of representational practices. In the contemporary moment, it is hard to theorize alternate ideas of freedom and political difference. If we start a study of twentieth-century revolution with a coup d’état in 1979 Accra, Ghana—rather than student upheavals in 1968 Paris, for example—it reorients our understanding of power by showing how young radicals sought an African-grounded sovereignty, an alternate future now forgotten.
Highest Achievable Outcomes for Patients Undergoing Cervical Deformity Corrective Surgery by Frailty
Authors: Passias Peter G. , Kummer Nicholas , Williamson Tyler K. , Moattari Kevin , Lafage Virginie , Lafage Renaud , Kim Han Jo , Daniels Alan H. , Gum Jeffrey L. , Diebo Bassel G. , Protopsaltis Themistocles S. , Mundis Gregory M. , Eastlack Robert K. , Soroceanu Alexandra , Scheer Justin K. , Hamilton D. Kojo , Klineberg Eric O. , Line Breton , Hart Robert A. , Burton Douglas C. , Mummaneni Praveen , Chou Dean , Park Paul , Schwab Frank J. , Shaffrey Christopher I. , Bess Shay , Ames Christopher P. , Smith Justin S.
Published: September 2022

BACKGROUND:

Frailty is influential in determining operative outcomes, including complications, in patients with cervical deformity (CD).

OBJECTIVE:

To assess whether frailty status limits the highest achievable outcomes of patients with CD.

METHODS:

Adult patients with CD with 2-year (2Y) data included. Frailty stratification: not frail (NF) <0.2, frail (F) 0.2 to 0.4, and severely frail (SF) >0.4. Analysis of covariance established estimated marginal means based on age, invasiveness, and baseline deformity, for improvement, deterioration, or maintenance in Neck Disability Index (NDI), Modified Japanese Orthopaedic Association (mJOA), and Numerical Rating Scale Neck Pain.

RESULTS:

One hundred twenty-six patients with CD included 29 NF, 83 F, and 14 SF. The NF group had the highest rates of deterioration and lowest rates of improvement in cervical Sagittal Vertical Axis and horizontal gaze modifiers. Two-year improvements in NDI by frailty: NF: −11.2, F: −16.9, and SF: −14.6 (P = .524). The top quartile of NF patients also had the lowest 1-year (1Y) NDI (7.0) compared with F (11.0) and SF (40.5). Between 1Y and 2Y, 7.9% of patients deteriorated in NDI, 71.1% maintained, and 21.1% improved. Between 1Y and 2Y, SF had the highest rate of improvement (42%), while NF had the highest rate of deterioration (18.5%).

CONCLUSION:

Although frail patients improved more often by 1Y, SF patients achieve most of their clinical improvement between 1 and 2Y. Frailty is associated with factors such as osteoporosis, poor alignment, neurological status, sarcopenia, and other medical comorbidities. Similarly, clinical outcomes can be affected by many factors (fusion status, number of pain generators within treated levels, integrity of soft tissues and bone, and deformity correction). Although accounting for such factors will ultimately determine whether frailty alone is an independent risk factor, these preliminary findings may suggest that frailty status affects the clinical outcomes and improvement after CD surgery.
Targeted Temperature Management for Severe Subarachnoid Hemorrhage Using Endovascular and Surface Cooling Systems: A Nonrandomized Interventional Study Using Historical Control
Authors: Kobata Hitoshi , Tucker Adam , Sarapuddin Gemmalynn , Sugie Akira , Negoro Takayoshi , Kawakami Makiko , Tada Kenji
Published: September 2022

BACKGROUND:

Although targeted temperature management (TTM) may mitigate brain injury for severe subarachnoid hemorrhage (SAH), rebound fever correlates with poor outcomes.

OBJECTIVE:

To study the effect of endovascular TTM after rewarming from initial surface cooling during a high-risk period for delayed cerebral ischemia.

METHODS:

We studied patients with World Federation of Neurological Surgeons grade V SAH before and after the introduction of endovascular TTM. Both groups (36 patients each) were treated with TTM at 34 °C with conventional surface cooling immediately after SAH diagnosis, together with emergency aneurysm repair. When rewarmed to 36 °C, around 7 days later, the study group underwent TTM at 36 to 38 °C for 7 days with an endovascular cooling system. The control group was treated with antipyretics.

RESULTS:

Sex, age, Glasgow Coma Scale score, modified Fisher computed tomography classification, aneurysm location, and treatment methods were not different between the study and control groups. Differences were detected in the incidence of fever >38 °C (13 vs 26 patients, P = .0021), duration of fever >38 °C (4.1 vs 18.8 hours, P = .0021), incidence of vasospasm-related cerebral infarction (17% vs 42%, P = .037), and the likelihood of excellent outcomes (0 and 1 on a modified Rankin Scale) at 6 months (42% vs 17%, P = .037). In endovascular TTM, shivering occurred more frequently in patients with better outcomes, requiring aggressive treatment to avoid fever.

CONCLUSION:

Endovascular TTM at 36 to 38 °C after surface cooling was feasible and safely performed in patients with severe SAH. Combined TTM for 2 weeks was associated with a lower incidence of vasospasm-related infarction and may improve outcomes.
Designing of Praseodymium Oxide Nanoparticle-Based Photoluminescent Composite Films Using Polyurethane Matrix
Authors: Miyazaki Hidetoshi , Yamada Katsumi
Published: September 2022

Praseodymium oxide nanoparticle-embedded composite films were prepared using praseodymium nitrate and transparent urethane resin. The prepared films were further irradiated with ultraviolet (UV) light, and subsequently, their microstructure and optical properties were investigated. The color of the composite films turned from pale green (close to the precursor color) to reddish brown owing to UV irradiation. Pr6O11 particles were found to be present in the obtained films, and the particle size in the films increased upon increasing the UV irradiation time. The films obtained after UV irradiation showed absorption peaks at 444, 468, 483, 592, and 1020 nm, which were attributed to 3H4→3P2, 3P1, 3P0, 1D2, and 1G4, respectively, corresponding to the 4f-4f transition of Pr3+. The composite films exhibited photoluminescence with a peak at 605 nm corresponding to the 1D2→3H4 transition of Pr3+ up on excitation with 444 nm light.
Portal vein aneurysm, a pathological entity or an innocent bystander? A review of six cases
Authors: Majeed Nada , Bannan Badr , Ahmad Niaz , Zia Zergham , Ashour Majed
Published: September 2022

Portal venous aneurysms (PVAs) are a rare venous aneurysms. The mean diameter of a healthy portal vein varies considerably, with maximum diameter of 15 mm in healthy subjects and 19 mm in cirrhotic patients.

The presentation varies; they could come with abdominal pain or more often as an incident imaging finding. Although risk factors like portal hypertension and liver cirrhosis have been highlighted, the aetiology remains to be clarified. PVA may be associated with various complications: thrombosis, aneurysmal rupture, inferior vena cava obstruction or duodenal compression. A conservative treatment showed satisfying clinical and radiological response, however, surgical and endovascular options can be considered.

The aetiology and the mechanism of formation of PVA remain ill-defined. We aimed to use the small cohort of cases to define the distribution and radiological features of PVA and not for determining its prevalence or details of management.

We retrospectively reviewed six cases from our institution (King Faisal Specialist Hospital and Research Centre, Jeddah) with variable presentations, complications and outcomes.

Our review revealed that portal venous system aneurysms were mostly incidental, single, not gender- or age-specific and were frequently (66%) intrahepatic. Main portal vein was involved in three cases and splenic vein in only one case. Most of the portal venous system aneurysms were fusiform in configuration.

Although PVAs are rare, more cases are detected through imaging. Hepatobiliary surgeons, gastroenterologists and radiologists should be aware of this entity, as it can have a wide variety of clinical spectrum.

Our review and the limited evidence in published literature suggest that an individualised multidisciplinary team approach should be adopted to decide the best management and outcomes for each patient.