bluuebunny/crossref_metadata_2025 huggingface dataset:
Stable carbon isotopic compositions of individual light hydrocarbons in the C5–C7 range in natural gas from the Qaidam Basin, China
Authors: Zhang Chen , Zhang Daoyong , Ma Wenli , Chen Kefei , Li Jing , Zhou Shixin
Published: March 2023

C5–C7 light hydrocarbons are important components in petroleum and are extensively employed as an auxiliary approach in petroleum research. Consensus on the mechanism of light hydrocarbon generation has not yet been achieved. In this study, 20 gas samples were collected from the western part and northern margin of the Qaidam Basin. The molecular and carbon isotopic compositions of C1–C3 gaseous hydrocarbons and C5–C7 light hydrocarbons, as well as the carbon isotopes of oils were analyzed. Based on the relationships between carbon isotopes (13C) of individual light hydrocarbons and calculated vitrinite reflectance, it suggests that organic matters play a fundamental role in the carbon isotopes of light hydrocarbons, and maturity mainly affects the carbon isotopes of n-alkanes in light hydrocarbons. In addition, carbon isotopic differences between n-, iso- and cyclo-alkanes indicate that light hydrocarbons with different structures are produced from various biological precursors. Besides, carbon isotopes of individual light hydrocarbons can be used to estimate the δ13Ckerogen and distinguish cracked gas. On the one hand, small isotope fractionation between iso-alkanes and kerogen is observed. Average carbon isotopic compositions of iso-pentane ( i-C5), 2-methylpentane (2-MC5) and 3-methylpentane (3-MC5) can provide a similar δ13Ckerogen with actual values. On the other hand, the carbon isotopic difference between 2-MC5 and n-C6 generally decreases with increasing maturity. Combined with the parameter (2-MC6 + 3-MC6)/ n-C6, kerogen-cracked gases are characterized by high δ13C2MC5–δ13CnC6 and low (2-MC6 + 3-MC6)/ n-C6 values, whereas oil-cracked gases exhibit the opposite features.
The Nexus Between German Pietism and the Mission, Theology, and Spirituality of the Evangelical Presbyterian Church, Ghana
Authors: Adufuli Denis Mawunyo
Published: March 2023

While the Pentecostal Christianity on the continent of Africa in general and Ghana, in particular, continues to attract growth in terms of membership, the same cannot be said of the historic mission churches in the same breath. This development is partly because the Christianity introduced by the nineteenth-century European missionaries was enveloped in European culture making it almost impossible to resonate with its religio-cultural milieu. As a result, converts have great difficulty in identifying with their newly found faith as it also struggled to address their existential challenges. This development had translated into a situation where the Christian faith as introduced at the time failed to attract new converts while some of the existing ones made their way back into their former religion (syncretism). Other developments besides syncretism experienced by the historic mission churches were schism(s) as well as the emergence of Pentecostal Christianity in Ghana.
The educational experiences of children in care across five decades: A new perspective on the education of looked after children in the UK
Authors: Kenny Karen
Published: March 2023

Children in care have consistently lower educational attainment than peers who live with their birth families. However, metrics often define ‘education’ narrowly, focusing on traditional in-school achievements with which this population typically struggles. In this study, interviews with current and former children in care ( n = 7, ages: 11–59) revealed that they perceive education in a much broader way, occurring across their life experiences and encompassing both life and social skills. Regardless of their performance in school, participants storied themselves as achievers in the context of this broader concept of ‘education’ and described positive outcomes such as independence, agency, development of authentic identities and capacity to strive for and achieve goals. These reflections have implications for the provision of social support services and the evaluation of outcomes for children who are taken into the care of the state. For example, it may be valuable to redefine ‘education’ to include a wider range of activities and to therefore encompass a variety of potential interventions to support development and success. Additionally, there seems to be scope for working more closely with children in care when making decisions, centring their lived experiences and drawing on their insights so as to achieve a better balance of support for both formal and informal educational opportunities.
Reading silences/silent readings: Disrupting the hegemony of voice in research with disabled children
Authors: Karmiris Maria
Published: March 2023

By referring to an example from my doctoral research with children labeled and diagnosed with intellectual disabilities, I make a case for the ways that reading silences and silent readings within research are not only necessary but integral to refusing the claims of western colonial logics while also attending to the circulation of power imbalances within research processes. One of the key aims is to consider how embodied knowledges might increase access and inclusion of disabled children in knowledge production.
Scrutinizing the role of renewable energy and patents in pollution abatement and economic growth in South Korea
Authors: Ghorbal Sana , Ben Youssef Slim
Published: March 2023

South Korea is considered one of the leading countries in innovation and research and development (R&D), in particular in renewable energy R&D efforts, but it is also one of the more polluting countries. So, understanding the interplay between these variables is of great interest. The main objective of this article is to examine the relationship between carbon dioxide (CO2) emissions, economic growth (GDP), renewable energy consumption (RE), foreign direct investment (FDI), home patents (HP), and foreign patents (FP) in South Korea using data ranging from 1980 to 2018. For this purpose, the autoregressive distributed lag (ARDL) approach and Granger causality tests were employed. Estimates of long-run elasticity point to a positive relationship between GDP and CO2 emissions. FP and RE have a negative influence on CO2 emissions but they have a favorable effect on GDP. FDI and HP have positive impacts on CO2 emissions. Granger causality outcomes demonstrate that CO2 emissions, GDP, RE, and FP have long-term bidirectional causal relationships. In the short-run, there are unidirectional causalities running from FP and FDI to RE and from FDI and HP to GDP. Besides, there is a bidirectional causality between GDP and RE. South Korea should continue to promote renewable energies and facilitate the use of foreign patents, particularly those relating to renewable energies. This will lead to a reduction in its carbon emissions while benefiting its economic growth.
Derivation of Sendai-Virus-Reprogrammed Human iPSCs-Neuronal Precursors: In Vitro and In Vivo Post-grafting Safety Characterization
Authors: Shigyo Michiko , Kobayashi Yoshiomi , Platoshyn Oleksandr , Marsala Silvia , Kato Jr Tomohisa , Takamura Naoki , Yoshida Kenji , Kishino Akiyoshi , Bravo-Hernandez Mariana , Juhas Stefan , Juhasova Jana , Studenovska Hana , Proks Vladimir , Ciacci Joseph D. , Marsala Martin
Published: March 2023

The critical requirements in developing clinical-grade human-induced pluripotent stem cells–derived neural precursors (hiPSCs-NPCs) are defined by expandability, genetic stability, predictable in vivo post-grafting differentiation, and acceptable safety profile. Here, we report on the use of manual-selection protocol for generating expandable and stable human NPCs from induced pluripotent stem cells. The hiPSCs were generated by the reprogramming of peripheral blood mononuclear cells with Sendai-virus (SeV) vector encoding Yamanaka factors. After induction of neural rosettes, morphologically defined NPC colonies were manually harvested, re-plated, and expanded for up to 20 passages. Established NPCs showed normal karyotype, expression of typical NPCs markers at the proliferative stage, and ability to generate functional, calcium oscillating GABAergic or glutamatergic neurons after in vitro differentiation. Grafted NPCs into the striatum or spinal cord of immunodeficient rats showed progressive maturation and expression of early and late human-specific neuronal and glial markers at 2 or 6 months post-grafting. No tumor formation was seen in NPCs-grafted brain or spinal cord samples. These data demonstrate the effective use of in vitro manual-selection protocol to generate safe and expandable NPCs from hiPSCs cells. This protocol has the potential to be used to generate GMP (Good Manufacturing Practice)-grade NPCs from hiPSCs for future clinical use.
Universalising Healthcare in India: Managing the Provider–Purchaser Split
Authors: Nagarajan Shyama , Tripathy Shruti , Sodani P. R. , Sharma Rachna
Published: March 2023

Several countries with diverse health systems have achieved universalization (UHC). The trajectory towards universal coverage almost always has three typical features: (i) a political process driven by a range of regulatory changes to simplify access; (ii) an increase in health spending; (iii) an increase in the share of pooled spending rather than paid out-of-pocket. Therefore, a study was undertaken to understand the extent of the provider-purchaser relationship of governments to achieve UHC while reforming healthcare.

The present paper focuses on extensive secondary research across countries and evaluates the experiences of select developed and developing economies with India’s experiments on- Financing mechanisms, management arrangements, governance and health outcomes; to offer a comparison of practices and their impact. While Italy, the UK, Germany, Australia, Japan, Canada and most recently China are countries that have achieved UHC; countries like USA and Brazil are on the verge of achieving UHC. These nine countries represent the entire spectrum of pure purchasing models, mixed and pure provisioning models to help us leverage from their experience.

All countries that have attained UHC have a well-defined package of services that the government commits to fund and provide for (both public and private). Additionalities around wellness and cosmetic care is managed through supplementary insurance. Overall funding is through an autonomous body, at arm’s length of government; primarily to govern and manage the state’s health priorities. And the government purely behaves as a regulator setting policy and giving directions to the providers.

However, ensuring the sustenance of such a mixed model requires; (i) a well-regulated ecosystem that thrives on evidence, (ii) the governments must clearly define the role/s of each stakeholder and hold them accountable for their deliverables in attaining UHC.
Factors Associated With Nonunion in Arthrodesis of the First Metatarsophalangeal Joint: A Multicenter Retrospective Cohort Study
Authors: Füssenich Wout , Seeber Gesine H. , van Raaij Tom M. , van Lingen Christiaan P. , Zuurmond Rutger G. , Stevens Martin , Somford Matthijs P.
Published: March 2023

Background:

Arthrodesis of the first metatarsophalangeal joint is the current treatment of choice for symptomatic advanced hallux rigidus and moderate-to-severe hallux valgus. There are different methods to perform arthrodesis, yet no consensus on the best approach. Therefore, this study aimed to determine the effects of preoperative and postoperative hallux valgus angle (HVA), joint preparation and fixation technique, and postoperative immobilization on the incidence of nonunion.

Methods:

A retrospective multicenter cohort study was performed that included 794 patients. Univariate and multiple logistic regression was conducted to determine associations between joint preparation, fixation techniques, postoperative immobilization, weightbearing, and pre- and postoperative HVA with nonunion.

Results:

Nonunion incidence was 15.2%, with 11.1% symptomatic and revised. Joint preparation using hand instruments (OR 3.75, CI 1.90-7.42) and convex/concave reamers (OR 2.80, CI 1.52-5.16) were associated with greater odds of a nonunion compared to planar cuts. Joint fixation with crossed screws was associated with greater odds of nonunion (OR 2.00, CI 1.11-3.42), as was greater preoperative HVA (OR 1.02, CI 1.00-1.03). However, the latter effect disappeared after inclusion of postoperative HVA in the model, with a small association identified between residual postoperative HVA and nonunion (OR 1.04, CI 1.01-1.08). Similarly, we found an association between odds of nonunion and higher body weight (OR 1.02, CI 1.01-1.04) but not of body mass index.

Conclusion:

Based on our results, first metatarsophalangeal joint arthrodesis with planar cuts and fixation with a plate and interfragmentary screw is associated with the lowest odds of resulting in a nonunion. Higher body weight and greater preoperative HVA were associated with slight increase in rates of nonunion. It is crucial to properly correct the hallux valgus deformity during surgery.

Level of Evidence:

Level III, retrospective case control study.
Stability of Treatment Effects and Caregiver-Reported Outcomes: A Meta-Analysis of Trauma-Focused Cognitive Behavioral Therapy for Children and Adolescents
Authors: Thielemann Jonathan Felix Benjamin , Kasparik Barbara , König Julia , Unterhitzenberger Johanna , Rosner Rita
Published: March 2023

The efficacy of trauma-focused treatments for children and adolescents is well researched. However, less is known about the long-term and caregiver-reported effects. Searched databases were PsychInfo, MEDLINE, Cochrane Library, PTSDPubs, PubMed, Web of Science, and OpenGrey. Treatment effects of trauma-focused cognitive behavioral therapy (TF-CBT) were computed at 12-month follow-up with posttraumatic stress symptoms (PTSS) as primary outcome and symptoms of depression, anxiety, and grief as secondary outcomes. Concordance between participant and caregiver ratings were investigated. TF-CBT showed large improvements across all outcomes from pre-treatment to 12-month follow-up (PTSS: g = 1.71, CI 1.27–2.15) and favorable results compared to active treatments and treatment as usual at 12-month follow-up (PTSS: g = .35, CI .13–.56). More pronounced effects were found in group settings. No significant differences were detected between participant and caregiver ratings with high reliability across almost all outcomes and assessment points. TF-CBT is a reliable treatment for pediatric PTSS and secondary symptoms with stable results at 12-month follow-up.
Anatomic Utility of Single Branched Thoracic Endograft During Thoracic Endovascular Aortic Repair
Authors: Kumins Norman H. , Ambani Ravi N. , Bose Saideep , King Alexander H. , Cho Jae S. , Colvard Benjamin , Kashyap Vikram S.
Published: March 2023

Introduction

Single branched thoracic endografts (SBTEs) have been designed for pathology requiring zone 2 seal during thoracic endovascular aortic repair (TEVAR). Numerous criteria must be met to allow for their implantation. Our aim was to analyze anatomic suitability for a next generation SBTE.

Methods

We reviewed 150 TEVAR procedures between 2015 and 2019. Proximal seal was: zone 0 in 21 (16%), zone 1 in 4 (3%), zone 2 in 52 (40%), zone 3 in 45 (35%), and zone 4 or distal in 7 (5%). We analyzed the Zone 2 patient’s angiograms and CT angiograms using centerline software to measure arterial diameters and length in relation to the left common carotid artery (LCCA), left subclavian artery (LSA) and proximal extent of aortic disease to determine if patients met anatomic criteria of a novel SBTE.

Results

Zone 2 average age was 64.4 ± 16.3 years; 34 patients were male (65%). Indications for repair were aneurysm (N = 9, 17%), acute dissection (N = 14, 27%), chronic dissection with aneurysmal degeneration (N = 7, 13%), intramural hematoma (N = 9, 17%), penetrating aortic ulcer (N = 5, 10%), and blunt traumatic aortic injury (BTAI, N = 8, 15%). LSA revascularization occurred in 27 patients (52%). Overall, 20 (38.5%) of the zone 2 patients met anatomic criteria. Patients with dissection met anatomic criteria less frequently than aneurysm (33% [10 of 30] vs 64% [9 of 14]). Patients treated for BTAI rarely met the anatomic criteria (1 of 8, 13%). The main anatomic constraints were an inadequate distance from the LCCA to the LSA takeoff and from the LCCA to the start of the aortic disease process.

Conclusion

Less than half of patients who require seal in zone 2 met criteria for this SBTE. Patients with aneurysms met anatomic criteria more often than those with dissection. The device would have little applicability in treating patients with BTAI.
Opioid Consumption After Upper Extremity Surgery: A Systematic Review
Authors: Huynh Minh N. Q. , Yuan Morgan , Gallo Lucas , Olaiya Oluwatobi R. , Barkho Jouseph , McRae Matthew
Published: March 2023

There is currently an overprescription of opioids, which may result in abuse and diversion of narcotics. The aim of this systematic review was to investigate opioid prescription practices and consumption by patients after upper extremity surgery. This review was registered a priori on Open Science Framework (osf.io/6u5ny) and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A search strategy was performed using MEDLINE, Embase, PubMed, and Cochrane Central Register of Controlled Trials databases (from their inception to October 17, 2021). Prospective studies investigating opioid consumption of patients aged 18 years or older undergoing upper extremity surgeries were included. The Risk of Bias in Nonrandomized Studies of Interventions and Risk of Bias 2.0 tools were used for quality assessment. In total, 21 articles met the inclusion criteria, including 7 randomized controlled trials and 14 prospective cohort studies. This represented 4195 patients who underwent upper extremity surgery. Most patients took less than half of the prescribed opioids. The percentage of opioids consumed ranged from 11% to 77%. There was moderate to severe risk of bias among the included studies. This review demonstrated that there is routinely excessive opioid prescription relative to consumption after upper limb surgery. Additional randomized trials are warranted, particularly with standardized reporting of opioid consumption and assessment of patient-reported outcomes.
Multimodality imaging review of ulnar nerve pathologies
Authors: Chaudhary Ranjit Kumar , Karkala Nikitha , Nepal Pankaj , Gupta Elina , Kaur Neeraj , Batchala Prem , Sapire Joshua , Alam Syed Intkhab
Published: March 2023

The ulnar nerve is the second most commonly entrapped nerve after the median nerve. Although clinical evaluation and electrodiagnostic studies remain widely used for the evaluation of ulnar neuropathy, advancements in imaging have led to increased utilization of these newer / better imaging techniques in the overall management of ulnar neuropathy. Specifically, high-resolution ultrasonography of peripheral nerves as well as MRI has become quite useful in evaluating the ulnar nerve in order to better guide treatment. The caliber and fascicular pattern identified in the normal ulnar nerves are important distinguishing features from ulnar nerve pathology. The cubital tunnel within the elbow and Guyon’s canal within the wrist are important sites to evaluate with respect to ulnar nerve compression. Both acute and chronic conditions resulting in deformity, trauma as well as inflammatory conditions may predispose certain patients to ulnar neuropathy. Granulomatous diseases as well as both neurogenic and non-neurogenic tumors can also potentially result in ulnar neuropathy. Tumors around the ulnar nerve can also lead to mass effect on the nerve, particularly in tight spaces like the aforementioned canals. Although high-resolution ultrasonography is a useful modality initially, particularly as it can be helpful for dynamic evaluation, MRI remains most reliable due to its higher resolution. Newer imaging techniques like sonoelastography and microneurography, as well as nerve-specific contrast agents, are currently being investigated for their usefulness and are not routinely being used currently.
Glycoprotein IIb/IIIa inhibitors in the treatment of thromboembolic events related to endovascular treatment of cerebral aneurysms-systematic review and meta-analysis
Authors: Hasanpour Mohammad , Maleki Samane , Rezaee Hamid , Aminzadeh Behzad , Abbasi Shaye Zahra , Keykhosravi Ehsan
Published: March 2023

Background and Aims

Thromboembolism complication is considered the most common complication associated with the treatment of endovascular. This systematic review and meta-analysis aimed to assess the studies investigating the effect of glycoprotein IIb/IIIa inhibitor agents on thromboembolic complications during endovascular aneurysm coiling.

Materials and Methods

This systematic review investigated the outcome of the use of three glycoprotein IIb/IIIa inhibitor agents (ie abciximab, tirofiban, and eptifibatide) on the thromboembolic complications during endovascular aneurysm coiling. The electronic databases of PubMed, Web of Science, Scopus, and Medline were searched up to 25 June 2021, using the keywords “Abciximab,” “Tirofiban,” and “Eptifibatide” incombination with “Thromboembolism Complication,” “Aneurysms,” and “Endovascular Aneurysm Coiling.”

Results

A total of 21 articles were found to be eligible and included in this review. The rates of complete and partial recanalization were estimated to be 56% and 92% in patients who underwent abciximab and tirofiban therapy, respectively. Rupture aneurysms were found in the majority of patients. In general, the mortality rate of the patients treated for thromboembolic complications during endovascular treatment of cerebral aneurysms with glycoprotein IIb/IIIa inhibitors was found to be 4.8% (CI 95%:0.027–0.067; p < .005). The average remission rate in studies investigating thromboembolism was 91% (CI 95%:0.88–0.95, I2 : 65.65/ p < .001).

Conclusion

Based on the obtained results, a higher mean rate of complete recanalization by eptifibatide was found in studies in which abciximab or tirofiban were used, compared to other mentioned agents. Moreover, the amount of hemorrhage was reported to be less after using tirofiban rather than abciximab.
Prediction of delayed reperfusion in patients with incomplete reperfusion following thrombectomy
Authors: Mujanovic Adnan , Brigger Robin , Kurmann Christoph C , Ng Felix , Branca Mattia , Dobrocky Tomas , Meinel Thomas R , Windecker Daniel , Almiri William , Grunder Lorenz , Beyeler Morin , Seiffge David J , Pilgram-Pastor Sara , Arnold Marcel , Piechowiak Eike I , Campbell Bruce , Gralla Jan , Fischer Urs , Kaesmacher Johannes
Published: March 2023

Background:

The clinical course of patients with incomplete reperfusion after thrombectomy, defined as an expanded Thrombolysis in Cerebral Infarction (eTICI) score of 2a–2c, is heterogeneous. Patients showing delayed reperfusion (DR) have good clinical outcomes, almost comparable to patients with ad-hoc TICI3 reperfusion. We aimed to develop and internally validate a model that predicts DR occurrence in order to inform physicians about the likelihood of a benign natural disease progression.

Patients and methods:

Single-center registry analysis including all consecutive, study-eligible patients admitted between 02/2015 and 12/2021. Preliminary variable selection for the prediction of DR was performed using bootstrapped stepwise backward logistic regression. Interval validation was performed with bootstrapping and the final model was developed using a random forests classification algorithm. Model performance metrics are reported with discrimination, calibration, and clinical decision curves. Primary outcome was concordance statistics as a measure of goodness of fit for the occurrence of DR.

Results:

A total of 477 patients (48.8% female, mean age 74 years) were included, of whom 279 (58.5%) showed DR on 24 follow-up. The model’s discriminative ability for predicting DR was adequate (C-statistics 0.79 [95% CI: 0.72–0.85]). Variables with strongest association with DR were: atrial fibrillation (aOR 2.06 [95% CI: 1.23–3.49]), Intervention-To-Follow-Up time (aOR 1.06 [95% CI: 1.03–1.10]), eTICI score (aOR 3.49 [95% CI: 2.64–4.73]), and collateral status (aOR 1.33 [95% CI: 1.06–1.68]). At a risk threshold of R = 30%, use of the prediction model could potentially reduce the number of additional attempts in one out of four patients who will have spontaneous DR, without missing any patients who do not show spontaneous DR on follow-up.

Conclusions:

The model presented here shows fair predictive accuracy for estimating chances of DR after incomplete thrombectomy. This may inform treating physicians on the chances of a favorable natural disease progression if no further reperfusion attempts are made.
Complete sequence verification of plasmid DNA using the Oxford Nanopore Technologies’ MinION device
Authors: Brown Scott D. , Dreolini Lisa , Wilson Jessica F. , Balasundaram Miruna , Holt Robert A.
Published: March 2023

Background

Sequence verification is essential for plasmids used as critical reagents or therapeutic products. Typically, high-quality plasmid sequence is achieved through capillary-based Sanger sequencing, requiring customized sets of primers for each plasmid. This process can become expensive, particularly for applications where the validated sequence needs to be produced within a regulated and quality-controlled environment for downstream clinical research applications.

Results

Here, we describe a cost-effective and accurate plasmid sequencing and consensus generation procedure using the Oxford Nanopore Technologies’ MinION device as an alternative to capillary-based plasmid sequencing options. This procedure can verify the identity of a pure population of plasmid, either confirming it matches the known and expected sequence, or identifying mutations present in the plasmid if any exist. We use a full MinION flow cell per plasmid, maximizing available data and allowing for stringent quality filters. Pseudopairing reads for consensus base calling reduces read error rates from 5.3 to 0.53%, and our pileup consensus approach provides per-base counts and confidence scores, allowing for interpretation of the certainty of the resulting consensus sequences. For pure plasmid samples, we demonstrate 100% accuracy in the resulting consensus sequence, and the sensitivity to detect small mutations such as insertions, deletions, and single nucleotide variants. In test cases where the sequenced pool of plasmids contains subclonal templates, detection sensitivity is similar to that of traditional capillary sequencing.

Conclusions

Our pipeline can provide significant cost savings compared to outsourcing clinical-grade sequencing of plasmids, making generation of high-quality plasmid sequence for clinical sequence verification more accessible. While other long-read-based methods offer higher-throughput and less cost, our pipeline produces complete and accurate sequence verification for cases where absolute sequence accuracy is required.
A deep generative adversarial network capturing complex spiral waves in disinhibited circuits of the cerebral cortex
Authors: Boucher-Routhier Megan , Thivierge Jean-Philippe
Published: March 2023

Background

In the cerebral cortex, disinhibited activity is characterized by propagating waves that spread across neural tissue. In this pathological state, a widely reported form of activity are spiral waves that travel in a circular pattern around a fixed spatial locus termed the center of mass. Spiral waves exhibit stereotypical activity and involve broad patterns of co-fluctuations, suggesting that they may be of lower complexity than healthy activity.

Results

To evaluate this hypothesis, we performed dense multi-electrode recordings of cortical networks where disinhibition was induced by perfusing a pro-epileptiform solution containing 4-Aminopyridine as well as increased potassium and decreased magnesium. Spiral waves were identified based on a spatially delimited center of mass and a broad distribution of instantaneous phases across electrodes. Individual waves were decomposed into “snapshots” that captured instantaneous neural activation across the entire network. The complexity of these snapshots was examined using a measure termed the participation ratio. Contrary to our expectations, an eigenspectrum analysis of these snapshots revealed a broad distribution of eigenvalues and an increase in complexity compared to baseline networks. A deep generative adversarial network was trained to generate novel exemplars of snapshots that closely captured cortical spiral waves. These synthetic waves replicated key features of experimental data including a tight center of mass, a broad eigenvalue distribution, spatially-dependent correlations, and a high complexity. By adjusting the input to the model, new samples were generated that deviated in systematic ways from the experimental data, thus allowing the exploration of a broad range of states from healthy to pathologically disinhibited neural networks.

Conclusions

Together, results show that the complexity of population activity serves as a marker along a continuum from healthy to disinhibited brain states. The proposed generative adversarial network opens avenues for replicating the dynamics of cortical seizures and accelerating the design of optimal neurostimulation aimed at suppressing pathological brain activity.
Adenosine 2 receptor regulates autophagy and apoptosis to alleviate ischemia reperfusion injury in type 2 diabetes via IRE-1 signaling
Authors: Yacouba Moukeila Mohamed Bassirou , Thokerunga Erick , He Feng , Bongolo Christian Cedric , Xia Yun , Wang Fuyu , Gado Adamou Foumakoye , Mamoudou Hama , Khan Shahzad , Ousseina Bonkano , Ousmane Hadjara Abdoulkarim , Diarra Drissa , Ke Jianjuan , Zhang Zongze , Wang Yanlin
Published: March 2023

Purpose

This study aimed to determine the effect and mechanism of action of adenosine 2 receptor (A2R) activation on myocardial ischemia reperfusion injury (MIRI) under diabetic conditions.

Methods

MIRI type 2 diabetic rats and H9C2 cardiomyocytes were treated with A2R agonist and then subjected to hypoxia for 6 h and reoxygenation for 18 h. Myocardial damage, and infarct size were determined by cardiac ultrasound. Indicators of cardiomyocyte injury, creatine kinase-MB and cardiac troponin I were detected by Enzyme Linked Immunosorbent Assay. Endoplasmic reticulum stress (ERS) was determined through measuring the expression levels of ERS related genes GRP78, p-IRE1/IRE1, and p-JNKJNK. The mechanism of A2R cardio protection in MIRI through regulating ERS induced autophagy was determined by investigating the ER resident protein IRE-1. The ER-stress inducer Tunicamycin, and the IRE-1 inhibitor STF in combination with the A2R agonist NECA were used, and the cellular responses were assessed through autophagy proteins expression Beclin-1, p62, LC3 and apoptosis.

Results

NECA improved left ventricular function post MIRI, limited myocardial infarct size, reduced myocardial damage, decreased cardiomyocytes apoptosis, and attenuated ERS induced autophagy through regulating the IRE-XBP1s-CHOP pathway. These actions resulted into overall protection of the myocardium against MIRI.

Conclusion

In summary, A2R activation by NECA prior to ischemia attenuates apoptosis, reduces ERS induced autophagy and restores left ventricular function. This protective effect occurs through regulating the IRE1-XBPs-CHOP related mechanisms. NECA is thus a potential target for the treatment of MIRI in patient with type 2 diabetes.
Magnitude of troponin elevation in patients with biomarker evidence of myocardial injury: relative frequency and outcomes in a cohort study across a large healthcare system
Authors: McIlvennan Colleen K. , Urra Manuel , Helmkamp Laura , Messenger John C. , Raymer David , Ream Karen S. , Oldemeyer J. Bradley , Ambardekar Amrut V. , Barnes Kathleen , Allen Larry A.
Published: March 2023

Background

Serum troponin levels correlate with the extent of myocyte necrosis in acute myocardial infarction (AMI) and predict adverse outcomes. However, thresholds of cardiac troponin elevation that could portend to poor outcomes have not been established.

Methods

In this cohort study, we characterized all cardiac troponin elevations > 0.04 ng/mL (upper limit of normal [ULN]) from patients hospitalized with an ICD-9/10 diagnosis of AMI across our health system from 2012–2019. We grouped events into exponential categories of peak cardiac troponin and evaluated the association of these troponin categories with all-cause mortality, heart transplants, or durable left ventricular assist devices (LVAD). Patients with cardiac troponin > 10,000 × ULN were manually chart reviewed and described.

Results

There were 18,194 AMI hospitalizations with elevated cardiac troponin. Peak troponin was 1–10 × ULN in 21.1%, 10–100 × ULN in 34.8%, 100–1,000 × ULN in 30.1%, 1,000–10,000 × ULN in 13.1%, and > 10,000 × ULN in 0.9% of patients. One-year mortality was 17–21% across groups, except in > 10,000 × ULN group where it was 33% (adjusted hazard ratio (99%CI) for > 10,000 × ULN group compared to all others: 1.86 (1.21, 2.86)). Hazards of one-year transplant and MCS were also significantly elevated in the > 10,000 × ULN group.

Conclusions

Elevation in cardiac troponin levels post AMI that are > 10,000 × ULN was rare but identified patients at particularly high risk of adverse events. These patients may benefit from clarification of goals of care and early referral for advanced heart failure therapies. These data have implications for conversion to newer high-sensitivity cardiac troponin assays whose maximum assay limit is often lower than traditional assays.
Seeking lifestyle counselling at primary health care centres: a cross-sectional study in the Swedish population
Authors: Lundin Gurné Frida , Svensson Per-Arne , Björkman Ida , Lidén Eva , Jakobsson Sofie
Published: March 2023

Background

Millions of people follow an unhealthy lifestyle in terms of tobacco consumption, hazardous use of alcohol, poor eating habits, and insufficient physical activity. Healthy lifestyles can to a large extent prevent and/or delay progression of non-communicable diseases. Factors influencing persons health-seeking behaviour regarding unhealthy lifestyles are of importance for sustainable health-promotive and disease-preventive work in primary health care. Generally, lifestyle interventions within primary health care are seen as feasible, but rarely reach all members of the general population. Few studies have been conducted about the likelihood among the general population to voluntarily contact a primary health care centre for support regarding lifestyle changes. The present study therefore aimed to investigate the general population’s likelihood of contacting a primary health care centre regarding their lifestyles, and factors associated with a lower such likelihood.

Methods

A probability sample of adults living in Sweden (n = 3 750) were invited to participate in a cross-sectional survey regarding how societal developments affect attitudes and behaviours of the adult Swedish population. Data were collected between September and December 2020. Participants completed a questionnaire about lifestyle changes, and the data were analysed using descriptive statistics, Chi-square test and logistic regression analysis.

Results

The response rate was 52.0% (n = 1 896). Few persons responded that they would be likely to contact a primary health care centre for support regarding their lifestyles. Factors predicting a lower likelihood of contacting primary health care included few yearly visits to a primary health care centre, male sex, and living in a rural area.

Conclusions

Primary health care centres are not the first choice for lifestyle counselling for the majority of adults living in Sweden. We have identified factors predicting low likelihood of using the support available at these centres. In order to work with sustainable and visible health-promotive and disease-preventive strategies at primary health care centres, these settings need to find valid methods to involve and collaborate with the members of the general community, to meet the needs of a population struggling with unhealthy lifestyles.
Efficacy of surgical treatment on polypharmacy of elderly patients with lumbar spinal canal stenosis: retrospective exploratory research
Authors: Nagai Sota , Inagaki Risa , Michikawa Takehiro , Kawabata Soya , Ito Kaori , Hachiya Kurenai , Takeda Hiroki , Ikeda Daiki , Kaneko Shinjiro , Yamada Shigeki , Fujita Nobuyuki
Published: March 2023

Background

Polypharmacy is a growing public health problem occurring in all healthcare settings worldwide. Elderly patients with lumbar spinal canal stenosis (LSS) who manifest low back and neuropathic pain and have a high frequency of comorbidity are predicted to take many drugs. However, no studies have reported polypharmacy in elderly patients with LSS. Thus, we aimed to review the polypharmacy among elderly LSS patients with elective surgeries and examine how the surgical treatment reduces the polypharmacy.

Methods

We retrospectively enrolled all the patients aged ≥ 65 years who underwent spinal surgery for LSS between April 2020 and March 2021. The prescribed drugs of participants were directly checked by pharmacists in the outpatient department preoperatively and 6-month and 1-year postoperatively. The baseline characteristics were collected beside the patient-based outcomes including Roland–Morris Disability Questionnaire, Zurich Claudication Questionnaire, and Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ). The cutoff number of drugs for polypharmacy was defined as 6. The prescription drugs were divided into 9 categories: drugs for neuropsychiatric, cardiovascular, respiratory, digestive, endocrine metabolic, and urinary renal diseases; blood products; pain relief medication; and others.

Results

A total of 102 cases were finally analyzed, with a follow-up rate of 78.0%. Of the participants, the preoperative polypharmacy prevalence was 66.7%. The number of drugs 6-month and 1-year postoperatively was significantly less than the preoperative one. The proportions of polypharmacy at 6 months and 1 year after surgery significantly decreased to 57.8% and 55.9%, respectively. When the prescribed drugs were divided into 9 categories, the number of drugs for pain relief and digestive diseases was significantly reduced after surgery. The multi-variable analysis revealed that a higher score in the psychological disorder of JOABPEQ was associated with 3 or more drugs decreased 1-year postoperatively (OR, 2.5; 95% CI: 1.0–6.1).

Conclusion

Polypharmacy prevalence was high among elderly LSS patients indicated for lumbar spinal surgery. Additionally, our data showed that lumbar spinal surgery was effective in reducing polypharmacy among elderly LSS patients. Finally, the multi-variable analysis indicated that better psychological condition was associated with the reduction of prescribed drugs after lumbar spinal surgery.
Steroid-induced hypokalemic periodic paralysis: a case report and literature review
Authors: Tai Haw-Ting , Lee Po-Tsang , Ou Shih-Hsiang
Published: March 2023

Background

Hypokalemic periodic paralysis (HPP) is a rare channelopathy characterized by episodic attacks of acute muscle weakness concomitant with hypokalemia. The etiology of hypokalemia is the shift of potassium into the cells, and the clinical symptoms resolve when potassium starts to leak back to the serum. Most of the time, the underlying ion channel defects are well compensated, and an additional trigger is often required to initiate an attack. Well-known trigger factors include carbohydrate-rich meals, exercise followed by rest, stress, cold weather, and alcohol consumption.

Case presentation

Here, we present the case of a 26-year-old Asian man who suffered from an acute onset of bilateral lower limb weakness with hypokalemia following dexamethasone injection. He was diagnosed with HPP.

Conclusions

We would like to remind physicians to think of steroids as an unusual precipitating factor while managing patients with HPP, per results of this case study.
Associations between severe and notifiable respiratory infections during the first trimester of pregnancy and congenital anomalies at birth: a register-based cohort study
Authors: Chughtai Abrar A. , He Wen-Qiang , Liu Bette
Published: March 2023

Background

Evidence regarding the association between acute respiratory infections during pregnancy and congenital anomalies in babies, is limited and conflicting. The aim of this study was to examine the association between acute respiratory infections during the first trimester of pregnancy and congenital anomalies in babies using record linkage.

Methods

We linked a perinatal register to hospitalisation and disease notifications in the Australian state of New South Wales (NSW) between 2001 to 2016. We quantified the risk of congenital anomalies, identified from the babies’ linked hospital record in relation to notifiable respiratory and other infections during pregnancy using generalized Estimating Equations (GEE) adjusted for maternal sociodemographic and other characteristics.

Results

Of 1,453,037 birth records identified from the perinatal register between 2001 and 2016, 11,710 (0.81%) mothers were hospitalised for acute respiratory infection, 2850 (0.20%) had influenza and 1011 (0.07%) had high risk infections (a record of cytomegalovirus, rubella, herpes simplex, herpes zoster, toxoplasmosis, syphilis, chickenpox (varicella) and zika) during the pregnancy. During the first trimester, acute respiratory infection, influenza and high-risk infections were reported by 1547 (0.11%), 399 (0.03%) and 129 (0.01%) mothers. There were 15,644 (1.08%) babies reported with major congenital anomalies, 2242 (0.15%) with cleft lip/ plate, 7770 (0.53%) with all major cardiovascular anomalies and 1746 (0.12%) with selected major cardiovascular anomalies. The rate of selected major cardiovascular anomalies was significantly higher if the mother had an acute respiratory infection during the first trimester of pregnancy (AOR 3.64, 95% CI 1.73 to 7.66). The rates of all major congenital anomalies and all major cardiovascular anomalies were also higher if the mother had an acute respiratory infection during the first trimester of pregnancy, however the difference was no statistically significant. Influenza during the first trimester was not associated with major congenital anomalies, selected major cardiovascular anomalies or all major cardiovascular anomalies in this study.

Conclusion

This large population-based study found severe acute respiratory infection in first trimester of pregnancy was associated with a higher risk of selected major cardiovascular anomalies in babies. These findings support measures to prevent acute respiratory infections in pregnant women including through vaccination.
Prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia
Authors: Ayele Tafere Birlie , Moyehodie Yikeber Abebaw
Published: March 2023

Backgrounds

Preterm birth is defined as babies born alive before 37 weeks of pregnancy or fewer than 259 days since the first day of a woman’s last menstrual period. Globally, 14.84 million babies were preterm births. Preterm infants are at risk for specific diseases related to the immaturity of various organ systems. This study aimed to assess the prevalence of preterm birth and associated factors among mothers who gave birth in public hospitals of east Gojjam zone, Ethiopia.

Methods

An institutional-based cross-sectional study was conducted from April 1 up to June 30, 2021, in public hospitals in the east Gojjam zone. Systematic random sampling was used. Data were collected through structured questionnaires, patient interviews and patient card reviews. We used binary logistic regression analysis with 95% CI and P-value < 0.05 to identify the significant factors with preterm birth.

Results

Out of 615 mothers, 13.2% gave a preterm birth. Antenatal care (AOR = 2.87; 95% CI = (1.67, 5.09)), educational status of mother (AOR = 2.79; 95% CI = (1.27, 6.67)), husband educational status(AOR = 2.11; 95% CI = (1.10, 4.18)), Average monthly family income(AOR = 1.95; 95% CI = (1.05, 3.75)),family size(AOR = 0.15; 95% CI = (0.03, 0.67)), multifetal gestation (AOR = 3.30; 95% CI = (1.29, 8.69), having Premature Rupture Of Membrane (AOR = 6.46; 95% CI= (2.52, 18.24)), history of chronic illness (AOR = 3.94; 95% CI = (1.67, 9.45)), being HIV positive(AOR = 6.99; 95% CI= (1.13, 44.65)), Ante-Partum Hemorrhage (AOR = 3.62; 95% CI= (1.12, 12.59)), pregnancy Induced Hypertension (AOR = 3.61; 95% CI= (1.19, 11.84)), mode of delivery (AOR = 7.16; 95% CI = (2.09, 29.29)), and onset of labor (AOR = 0.10; 95% CI = (0.03, 0.29)) were found to be significantly associated with preterm birth.

Conclusions

antenatal care, educational status of the mother, husband’s educational status, family income, family size, multifetal gestation, Premature Rupture of the membrane, history of chronic illness, being HIV positive, Ante-Partum Hemorrhage, pregnancy Induced Hypertension, mode of delivery, and the onset of labor were found to be significantly associated with preterm birth. To minimize the proportion of preterm birth focusing on this important variables, timely identification of obstetric complications, strengthening early screening of HIV and high-risk pregnancies like multiple gestations, PIH and APH were important.
The effectiveness of peer support from a person with lived experience of mental health challenges for young people with anxiety and depression: a systematic review
Authors: Simmons Magenta B. , Cartner Sharla , MacDonald Roxxanne , Whitson Sarah , Bailey Alan , Brown Ellie
Published: March 2023

Background

Peer workers support individuals experiencing mental health challenges by drawing on their shared lived experience. Peer support has become increasingly popular for young people with anxiety and depression, but the evidence base is unclear. This systematic review aimed to understand the effectiveness of peer support for youth depression and anxiety (either primary or comorbid), and to understand in which contexts, for whom, and why peer support works.

Methods

A systematic search was conducted with the Orygen Evidence Finder, Embase, MEDLINE, and PsycInfo from January 1980 to July 2022. Controlled trials of interventions to improve mental health in young people (mean age 14–24), delivered by a peer worker with lived experienced of mental health challenges were included. Outcomes related to depression or anxiety were extracted and descriptive synthesis was undertaken due to the heterogeneity of studies. Study quality was rated using the Critical Appraisal Skills Programme; reporting adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.

Results

Nine randomised controlled trials with 2,003 participants were included, with seven undertaken in high income countries. One targeted depression and anxiety, two stigma-distress (any mental disorder), one first episode psychosis, four studies preventing eating disorders and one drug misuse. One study successfully reduced anxiety and depression, another reduced depression only, four reported reductions in negative affect, with the final three measuring, but not having a significant impact on depression. Study quality was rated as ‘good’ overall.

Discussion

Despite the uptake of youth peer support globally, there is limited evidence from controlled trials of the effect of peer support-related interventions on anxiety and depression. There is some effect on negative affect, especially for university students. Further rigorously designed trials of peer delivered interventions for young people need to be conducted with a focus on understanding the mechanisms of action underpinning peer support.