bluuebunny/crossref_metadata_2025 huggingface dataset:
Dupilumab in a patient with severe asthma and glucocorticoid hypersensitivity: a case report
Authors: Handa Hiroshi , Tsuruoka Hajime , Kinoshita Kohei , Mineshita Masamichi
Published: August 2023

Recently, several biologics have been approved for the treatment of severe asthma. Dupilumab, a biologic used to treat severe asthma, is a monoclonal antibody targeting interleukin-4 and interleukin-13. In the present case, inhaled corticosteroid-induced glucocorticoid hypersensitivity was suspected, and the administration of omalizumab and mepolizumab had no beneficial effects. Subsequently, we switched to dupilumab therapy, which produced better effectiveness. Therefore, when a biologic agent proves ineffective, changing to another suitable biologic agent should be considered.
The politics of non-membership: How exclusion from international institutions shapes international relations
Authors: Castle Matthew A
Published: August 2023

Preferential trade agreements (PTAs) are generally understood to promote political cooperation between members. I argue that institutional exclusion can damage political cooperation between members and non-members. Preferential trade agreements reflect strategic considerations, enabling countries to promote new trade norms, strengthen diplomatic networks, and redirect commercial flows to allies. Excluded countries are denied these benefits and may possibly be targeted by members. Thus, excluding PTAs may be perceived as threats. The record of the Trans-Pacific Partnership illustrates the theory. Statistical analysis of the near-universe of PTAs and countries’ voting affinities in the United Nations General Assembly supports the argument.
Democratic Governance, Kinship Networks, and Entrepreneurial Development: Evidence from Rural China
Authors: Zhou Wubiao , Xu Tuoqian
Published: August 2023

Existing entrepreneurship literature has focused on formal regulatory institutions but has rarely examined effects on entrepreneurship of formal political institutions, particularly that of democracy. This study explores the role of democracy in entrepreneurial development, as well as how democracy moderates the role of kinship networks, in a developing or emerging economy setting. Integrating new institutional economic theory with social network theory, this study examines the rate of rural entrepreneurship in China by arguing that stronger local democratic governance facilitates entrepreneurial development and negatively moderates the role of kinship networks in entrepreneurial development. In particular, while kinship networks have a positive effect on entrepreneurial development when democratic governance is weak, their effect turns negative when it is strong. We use a national sample of villages from China for our empirical test. Results from both Ordinary Least Squares and an instrumental variable approach provide strong support for our hypotheses. The research contributions and implications are discussed.
Assessing Arabic youtube videos on herbal cancer treatment: Absence of health information quality
Authors: Kharbat Faten F. , Abu Daabes Ajayeb
Published: August 2023

This study assesses the quality of the health information in Arabic YouTube videos regarding herbal cancer treatment. It also provides an overview of how the quality of video content shapes user awareness by assessing the users’ engagement indicators. A simple Python tool was developed using YouTube API V3 to automate the YouTube search based on the recommendation of Google Trends. After applying inclusion and exclusion criteria, 110 YouTube videos were selected, of which 95% were uploaded by non-experts and had a total of 8,633,569 views. The analyzed videos presented more than 40 different herbals as sources of cancer treatment; for example, Ephedra, garden cress, Green tea, Ginseng, Rosemary, and Thyme. 32.7% of the videos provided information about a single herb, 41% about mixing herbals, and 26.3% provided testimonials and success stories without pointing to specific herbs. The videos were assessed by two experts using two reliable tools, DISCERN and PEMAT, which were produced mainly for assessing health information quality. DISCERN has evaluated the reliability and quality of health information. PEMAT has assessed the understandability and actionability. The qualitative and quantitative analyses of the videos represent bias and poor health information quality, with a total score of 27 out of 80 for DISCERN and 31 out of 100 for the PEMAT. The results also showed weak users’ awareness regarding the content of videos with no association between user engagement indicators (likes, dislikes, VPI, views, comments) and the dimensions of the two tools. The study concludes that it is evident that YouTube, in its current form, is an inadequate Arabic source for herbal cancer treatment information. To overcome this, this study proposed the GAP framework for social media that integrated Governance, Awareness, and Proficiency.
A black box approach to fitting smooth models of mortality
Authors: Currie Iain D
Published: August 2023

Actuaries have long been interested in the forecasting of mortality for the purpose of the pricing and reserving of pensions and annuities. Most models of mortality in age and year of death, and often year of birth, are not identifiable so actuaries worried about what constraints should be used to give sensible estimates of the age and year of death parameters, and, if required, the year of birth parameters. These parameters were then forecast with an ARIMA model to give the required forecasts of mortality. A recent article showed that, while the fitted parameters were not identifiable, both the fitted and forecast mortalities were. This result holds if the age term is smoothed with P-splines. The present article deals with generalized linear models with a rank deficient regression matrix. We have two aims. First, we investigate the effect that different constraints have on the estimated regression coefficients. We show that it is possible to fit the model under different constraints in R without imposing any explicit constraints. R does all the necessary booking-keeping ‘under the bonnet’. The estimated regression coefficients under a particular set of constraints can then be recovered from the invariant fitted values. We have a black box approach to fitting the model subject to any set of constraints.
Exploring the construction and analysis method of landscape spatial structure based on complex networks
Authors: Wang Yijing , Cheng Shi , Cheng Ziqian , Cheng Yuning
Published: August 2023

Complex network theory proposes a structural network model that abstracts the elements in a complex system into nodes and the relationship between elements into ties, which proved to be a scientific method to study the structural system of complexities. This article aims to apply the complex network theory to interpret the organization of landscape spatial structure and propose a spatial structure network construction and quantitative analysis method suitable for landscape space. The following two questions are addressed in this research: (1) How to extract the structural elements from the landscape space and realize the construction of the structural network model based on the 3D spatial information? (2) How to quantitatively analyze the organization characteristics of a spatial structure according to the particularity of landscape space? The research content of this article includes the following five aspects, which are 3D spatial information acquisition, structural element extraction, structural element description, structural network model diagramming, and quantitative index selection. Taking Nanjing Lovers Park as an example, the feasibility of this method is verified. The results show that the method proposed can guarantee the accuracy of the landscape spatial structure model, visualize the attributes of structural elements, and achieve a refined analysis of the structure organization.
Crippling of Klebsiella pneumoniae virulence by metformin, N-acetylcysteine and secnidazole
Authors: M. Shafik Shokri , Abbas Hisham A. , Yousef Nehal , Saleh Moustafa M.
Published: August 2023

Introduction

The emergence of multidrug-resistant Klebsiella pneumoniae in hospitals represents a serious threat to public health. Infections caused by Klebsiella pneumoniae are widespread in healthcare institutions, mainly pneumonia, bloodstream infections, and infections affecting neonates in intensive care units; so, it is necessary to combat this pathogen with new strategies. Targeting virulence factors necessary to induce host damage and disease is a new paradigm for antimicrobial therapy with several potential benefits that could lead to decreased resistance.

Background

The influence of metformin, N-acetylcysteine, and secnidazole on Klebsiella pneumoniae virulence factors production was tested. The production of Klebsiella pneumoniae virulence factors such as biofilm formation, urease, proteases, hemolysins, and tolerance to oxidative stress was evaluated phenotypically using sub-inhibitory concentration (1/8 MIC) of metformin, N-acetylcysteine, and secnidazole. For more confirmation, qRT-PCR was used to assess the relative expression level of rmpA, wcaG, fimH-1, mrkD, ureA, and khe genes regulating virulence factors production.

Results

Metformin, N-acetylcysteine, and secnidazole were all found to have a powerful inhibitory effect on the production of virulence factors phenotypically. Our results showed a significant reduction in the expression level of rmpA, wcaG, fimH-1, mrkD, ureA, and khe genes. Furthermore, the tested drugs were investigated in vivo to inform their ability to protect mice against Klebsiella pneumoniae pathogenesis.

Conclusions

Metformin, N-acetylcysteine, and secnidazole inhibited the virulence of Klebsiella pneumoniae. Besides combating resistant Klebsiella pneumoniae, the tested drugs could also serve as an adjuvant to traditional antibiotics.
Experiences of family caregivers of people with intellectual disabilities from rural areas in southeastern Iran: a qualitative study
Authors: Bahador Raziyeh Sadat , Farokhzadian Jamileh , Rafiee Sarbijan Nasab Farshid , Abbasi Mohsen
Published: August 2023

Background

Caring for people with intellectual disabilities can be a challenging task, but it can also bring about positive experiences for family caregivers. The present study aimed to explore these positive experiences and shed light on the ways in which family caregivers of people with intellectual disabilities can find meaning and fulfillment in their roles.

Methods

This qualitative study used conventional content analysis to explore the positive experiences of family caregivers of people with intellectual disabilities. Sixteen family caregivers from rural areas in southeastern Iran were purposively selected to participate in the study. Semi-structured in-depth interviews were conducted to collect data. The interviews were audio-recorded and transcribed verbatim. The data were analyzed using the method proposed by Graneheim and Lundman.

Results

The data analysis resulted in the emergence of a single theme, which was achievements of providing care for people with intellectual disabilities. This theme was comprised of four main categories: a new outlook on life, family caregivers’ peace of mind, strengthening of family ties, and improvement of social status. The provision of care for people with intellectual disabilities created positive changes, affecting family functioning and care provision for people with intellectual disabilities.

Conclusion

It is recommended that families of people with intellectual disabilities focus on these positive experiences and share them with other families who may be struggling with a recent diagnosis of intellectual disability in their child.
Comparison of pharmacy student performance in a self-care therapeutics course conducted as a flipped classroom on-campus and remotely
Authors: Cornelison Bernadette , Zerr Beth
Published: August 2023

Background

The COVID-19 pandemic required the University of Arizona R. Ken Coit College of Pharmacy’s Self-Care Therapeutics course to be taught as a synchronous, live online course. The course has traditionally utilized a flipped-classroom to increase student engagement and improve learning performance. The goal of this study is to compare student performance in a flipped-classroom self-care therapeutics course taught to students attending class on-campus versus online via web-conferencing.

Methods

This study assessed examination performance of 118 students that took the class on-campus in 2019 and 125 students that took the class online in 2020. Course design was similar between the two cohorts, with each completing assigned pre-reading, an associated short multiple-choice quiz, in-class small group discussions and in-class large group faculty-led debrief. Both cohorts took pre-class quizzes and three examinations to assess their knowledge. Exam, quiz, overall class performance, and student experience was compared for the 2019 on-campus attending cohort and the 2020 online attending cohort.

Results

No statistical differences were seen in the overall exam performance, the final course score, and the student experience between cohorts. Statistical differences (p = 0.02) were found between cohorts for the overall quiz performance, with the on-campus attending cohort performing slightly better than the online attending cohort (mean score of 88% compared to 84.4%).

Conclusion

Examination performance was similar for students taking a flipped-classroom course online and on-campus. Further research using data from multiple courses or from the same cohort, randomized, is needed to improve the internal and external validity of these findings.
“Hooking method” for hepatic inflow control: a new approach for laparoscopic Pringle maneuver
Authors: Zhou Yi , Wang Yifan , Ma Jinliang , Zhang Chuanhai
Published: August 2023

Background

The laparoscopic Pringle maneuver is crucial for controlling bleeding during laparoscopic hepatectomy. In this study, we introduce a new laparoscopic Pringle maneuver and preliminarily investigate its application in laparoscopic hepatectomy.

Methods

We collected and analyzed the clinical data of 17 consecutive patients who underwent laparoscopic hepatectomy at the Department of Hepatic Surgery, the First Affiliated Hospital of the University of Science and Technology of China, from January 2022 to January 2023. All patients underwent the hooking method for intermittent occlusion of hepatic inflow. Intraoperative and postoperative clinical indices were observed and recorded.

Results

All 17 patients underwent laparoscopic hepatectomy with hepatic inflow control using the hooking method. Four patients with adhesions under the hepatoduodenal ligament successfully had occlusion loops placed using the hooking method combined with Zhang’s modified method during surgery. The median occlusion time for the 17 patients was 34 (12–60) min, and the mean operation time was 210 ± 70 min. The mean intraoperative blood loss was 145 ± 86 ml, and no patients required intraoperative blood transfusion. The patients’ postoperative peak AST was 336 ± 183 U/L, and the postoperative peak ALT was 289 ± 159 U/L. Postoperative complications occurred in 2 patients (11.8%), including 1 Clavien-Dindo grade I and 1 Clavien-Dindo grade II complication. No Clavien-Dindo grade IIIa or higher complications or deaths occurred in any patient. None of the patients developed portal vein thrombosis or hepatic artery aneurysm formation. The median postoperative hospital stay was 6 (4–14) days.

Conclusion

The hooking method combines the advantages of both intracorporeal Pringle maneuver and extracorporeal Pringle maneuver. It is a simple, safe, and effective method for controlling hepatic inflow and represents a promising approach for performing totally intracorporeal laparoscopic Pringle maneuver.
A compendium of mitochondrial molecular characteristics provides novel perspectives on the treatment of rheumatoid arthritis patients
Authors: Wang Qi , Gao Qi-Chao , Wang Qi-Chuan , Wu Li , Yu Qi , He Pei-Feng
Published: August 2023

Rheumatoid arthritis (RA) is an autoimmune disease that exhibits a high degree of heterogeneity, marked by unpredictable disease flares and significant variations in the response to available treatments. The lack of optimal stratification for RA patients may be a contributing factor to the poor efficacy of current treatment options. The objective of this study is to elucidate the molecular characteristics of RA through the utilization of mitochondrial genes and subsequently construct and authenticate a diagnostic framework for RA. Mitochondrial proteins were obtained from the MitoCarta database, and the R package limma was employed to filter for differentially expressed mitochondrial genes (MDEGs). Metascape was utilized to perform enrichment analysis, followed by an unsupervised clustering algorithm using the ConsensuClusterPlus package to identify distinct subtypes based on MDEGs. The immune microenvironment, biological pathways, and drug response were further explored in these subtypes. Finally, a multi-biomarker-based diagnostic model was constructed using machine learning algorithms. Utilizing 88 MDEGs present in transcript profiles, it was possible to classify RA patients into three distinct subtypes, each characterized by unique molecular and cellular signatures. Subtype A exhibited a marked activation of inflammatory cells and pathways, while subtype C was characterized by the presence of specific innate lymphocytes. Inflammatory and immune cells in subtype B displayed a more modest level of activation (Wilcoxon test P < 0.05). Notably, subtype C demonstrated a stronger correlation with a superior response to biologics such as infliximab, anti-TNF, rituximab, and methotrexate/abatacept (P = 0.001) using the fisher test. Furthermore, the mitochondrial diagnosis SVM model demonstrated a high degree of discriminatory ability in distinguishing RA in both training (AUC = 100%) and validation sets (AUC = 80.1%). This study presents a pioneering analysis of mitochondrial modifications in RA, offering a novel framework for patient stratification and potentially enhancing therapeutic decision-making.
One-stage rotator cuff repair in stiff shoulders shows comparable range of motion, clinical outcome and retear rates to non-stiff shoulders: a systematic review
Authors: Yao Lei , Li Yinghao , Li Tao , Pang Long , Li Jian , Tang Xin
Published: August 2023

Background

One-stage treatment involving rotator cuff repair and shoulder capsule release is mainly used to treat patients with rotator cuff tears (RCTs) and concomitant shoulder stiffness. Despite the increasing attention to the efficacy and safety of one-stage treatment, controversy still remains. Therefore, this systematic review aims to summarize the indications, operation procedure and rehabilitation protocol, and compare the range of motions (ROMs), functional outcomes and retear rates of one-stage treatment for RCTs in stiff shoulders and non-stiff shoulders.

Methods

Multiple databases (PubMed, the Cochrane Library, Embase and MEDLINE) were searched for studies that investigated outcomes after one-stage treatment for RCTs concomitant with shoulder stiffness compared with rotator cuff repair for RCTs alone, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. Descriptive statistics, including range of motion, patient-reported outcome and retear rate, are presented without meta-analysis due to the heterogeneity and low levels of evidence.

Results

A total of 9 cohort studies were included, with 305 patients treated with one-stage treatment involving rotator cuff repair and simultaneous shoulder capsular release and 1059 patients treated with rotator cuff repair alone. Patients in both groups had significant symptom improvement and functional recovery after the one-stage treatment for the stiffness group and standard repair for the non-stiffness group, and most patients could return to normal life and work within 6 months after the operation. The retear rate in the one-stage treatment group was not higher than that in the rotator cuff repair group. No statistically significant differences between the two groups were observed in terms of range of motion and patient-reported outcomes in the vast majority of studies at the final follow-up, including the visual analog scale for pain, the Constant score, the American Shoulder and Elbow Surgeons score, the University of California Los Angeles Shoulder Score, the Oxford shoulder score and the Simple Shoulder Test.

Conclusion

One-stage treatment for RCTs in stiff shoulders provides comparable ROM and patient-reported clinical outcomes as rotator cuff repair for non-stiff RCTs. In addition, the rate of postoperative retear in stiff shoulder treated with one-stage treatment was not higher than in non-stiff shoulders.
Duplex loop-mediated isothermal amplification assay for simultaneous detection of human and human male DNA
Authors: Kubo Seiji , Niimi Hideki , Kitajima Isao
Published: August 2023

Objective

Screening of human and human male DNA is necessary for forensic DNA analyses. Although quantitative real-time PCR (qPCR) is commonly used for detecting and quantifying these DNA targets, its use as a screening tool is time-consuming and labor-intensive. To streamline and simplify the screening process, we aimed to develop a duplex loop-mediated isothermal amplification (LAMP) assay capable of simultaneously detecting human and human male DNA in a single tube. We assessed the duplex LAMP assay for forensic application.

Results

For our duplex LAMP assay, we have utilized two fluorescent probes with HEX and FAM fluorophores to specifically detect human and human male DNA, respectively. The HEX (human target) signal was detected from both the male and female DNA samples, and the FAM (male target) signal was detected from only the male DNA sample. This assay has a sensitivity of 10–1 pg of DNA for both targets. Additionally, we successfully detected the two targets in the DNA samples extracted from forensically relevant body fluids, including blood, saliva, semen, and vaginal secretions.
Pentaene macrolides AB023a and takanawaene C produced by Streptomyces xanthocidicus strain S3 for controlling pepper anthracnose
Authors: Jeon Byeong Jun , Kang Ji Eun , Do Kim Jeong , Kim Beom Seok
Published: August 2023

A natural product library consisting of the culture extracts of 814 actinomycete strains was screened for antifungal compounds that disrupt the cell integrity of plant pathogenic fungi using an adenylate kinase (AK) assay system. The culture extract of Streptomyces xanthocidicus strain S3 exhibited high AK activity against various plant pathogens. The active ingredients, AT-1 and AT-2, were isolated from the culture extract using a series of chromatographic procedures. Based on MS, UV, and NMR spectrometric analyses, the structures of AT-1 and AT-2 were determined as the pentaene macrolides, AB023a and takanawaene C. AB023a and takanawaene C displayed broad-spectrum antifungal activity against Aspergillus oryzae, Botrytis cinerea, Colletotrichum coccodes, C. gloeosporioides, C. orbiculare, Cylindrocarpon destructans, and Fusarium oxysporum f. sp. lycopersici, showing minimum inhibitory concentrations of 1–32 μg/mL. Treatment of AB023a and takanawaene C successfully inhibited anthracnose development on pepper plants in a concentration-dependent manner without phytotoxicity. The disease control efficacy of both compounds was comparable to that of the commercial fungicide chlorothalonil. Collectively, these results suggest that the polyene macrolides produced by S. xanthocidicus strain S3 can be used as natural fungicides for plant disease control.
Assessing the sustainability of two independent voucher-based family planning programs in Pakistan: a 24-months post-intervention evaluation
Authors: Azmat Syed Khurram , Ali Moazzam , Rahman Md. Mizanur
Published: August 2023

Introduction

Family planning vouchers have emerged as a promising approach to improve coverage of underserved groups or underutilized services. The current study was designed to measure the residual/longer-term impact of two-independent FP voucher programs on women’s practices beyond the program’s life program.

Methods

A cross-sectional survey conducted, as part of the two-independent larger mixed-method studies, approximately 24 months after the close-down of Marie Stopes Society and Greenstar Social Marketing family planning voucher intervention programs in Punjab, Pakistan. Following necessary ethics approvals, 338 voucher MSS clients & 324 voucher GSM clients were interviewed using a structured questionnaire at the household level.

Results

Compared with end-line data, a significant decrease in the modern contraceptive uptake in both MSS (90% at endline to current (or post-endline) 52%) and GSM (from 84% to current 56%) intervention sites among the voucher clients was noted. Among MSS voucher clients, the highest decline in use was observed in IUCD (54% at endline versus to current 13%); however no change between the surveys was noted among GSM clients. In both projects, following closure of voucher intervention 34% of the discontinued users in MSS and 29% in GSM sites adopted/switched to a new modern contraceptive again. In the post-intervention survey, wealth-based inequality in GSM data depicts more pro-rich utility for modern methods, indicating pro-rich inequality, in contrast, the post-intervention survey in MSS found mixed results such as pro-poor inequality for any method and modern method use.

Conclusions

The prevalence for contraception in two-independent study sites, following closure of voucher intervention remained high than national average. This study provides evidence that family planning vouchers can bring about an enduring positive change in clients’ behaviours in using modern contraceptive methods among poor populations among both intervention models. These results are useful to design family planning programs that will sustain when the donor funding terminates.
Effect of workplace violence on health workers injuries and workplace absenteeism in Bangladesh
Authors: Shahjalal Md. , Parvez Mosharaf Md. , Mahumud Rashidul Alam
Published: August 2023

Background

Workplace violence (WPV) is an emerging problem for health workers (HWs) and a global concern in health systems. Scientific literatures infer that WPV against HWs is often attributed to workplace injuries and absenteeism, leading to a series of adverse consequences. Therefore, this study aimed to investigate the prevalence of workplace injuries and absenteeism due to WPV among Bangladeshi HWs and its association with factors related to health facilities, work environments, and rotating shift work.

Methods

This study used participants who had experienced WPV, including medical doctors, nurses, or any form of medical staff. A total of 468 victim HWs were added in the analytical exploration. Participants were generated from our previous cross-sectional study of 1081 Bangladeshi HWs. A logistic regression model was used to find the association between workplace injuries and absenteeism due to WPV among HWs and associated factors.

Results

The prevalence of workplace injuries and absenteeism due to WPV among HWs were 14.10% (95% CI 11.23–7.57) and 22.44% (95% CI 18.87–26.45), respectively. Injury incidence was higher among males (17.67%) and young HWs (20.83%). Workplace absenteeism was more common among male HWs (25%) and those working in public hospitals (23.46%). The magnitude of injuries and absenteeism varied significantly by hospital departments. Workplace injury was significantly higher among HWs who worked in the emergency (AOR = 21.53, 95% CI 2.55–181.71), intensive care (AOR = 22.94, 95% CI 2.24–234.88), surgery (AOR = 17.22, 95% CI 1.96–151.39), and gynecology & obstetrics departments (AOR = 22.42, 95% CI 2.25–223.07) compared with other departments. The burden of work-related absenteeism was significantly associated with HWs who worked in the emergency (AOR = 4.44, 95% CI 1.56–12.61), surgery (AOR = 4.11, 95% CI 1.42–11.90), and gynecology and obstetrics departments (AOR = 5.08, 95% CI 1.47–17.50).

Conclusions

This study observed a high prevalence of workplace injuries and absenteeism among HWs due to WPV across hospital departments, including emergency, surgery, intensive care and gynecology & obstetrics units. Policymakers should incorporate suitable strategies into Bangladesh’s national health policy to combat violence in healthcare settings.
Synaptic microenvironment and altered state of consciousness in schizophrenia: a possible link between synapse geometry and orchestrated objective reduction theory
Authors: Ahmadpour Shahriar
Published: August 2023

In recent decades, studies have provided convincing evidence indicating abnormalities in some aspects of consciousness in schizophrenia patients. One of the pioneering theory, orchestrated objective reduction (OR) on the mechanism of consciousness has been proposed by Hameroff and Penrose. According to OR, consciousness roots in microtubules (MTs) which act as quantum computation apparatus. OR theory attribute the consciousness generation to MTs, while the “inception” of the events begins at synaptic level where other players regulate the signal transduction and neurotransmitters bioavailability at synaptic microenvironment. Homeostasis and geometry of synaptic microenvironment are actively regulated by glial cell particularly astrocytes. Experimental and post mortem studies have documented evidence indicating the involvement of main participants of synapse such as astrocytes and extracellular matrix (ECM) in schizophrenia. This literature aims to review the role(s) of active participants of synaptic microenvironment and disturbed state of consciousness based on OR theory in schizophrenia.
Current methods of left atrial appendage closure: the non-pharmacological approach for stroke prevention in atrial fibrillation patients
Authors: Jeong Dong Seop
Published: August 2023

Background

Atrial fibrillation (AF) is a significant contributor to cardioembolic stroke, with the left atrial appendage (LAA) often being the principal source of thrombus. Given the substantial impact of stroke on patient quality of life, and its potential life-threatening nature, stroke prevention is paramount in the management of AF. Nonvitamin K oral anticoagulants (NOACs) or vitamin K antagonists are typically the first line of treatment to prevent strokes caused by AF. However, for patients unable to tolerate oral anticoagulants, alternatives such as percutaneous LAA closure (LAAC) or surgical LAAC might be considered.

Main body

The most widely used percutaneous LAAC methods are the AMPLATZER Amulet and WATCHMAN devices. Registry studies have shown promising results for both devices, with low ischemic stroke rates in patients undergoing LAAC (Reddy in J Am Coll Cardiol 70(24):2964–75, 2017, Holmes in J Am Coll Cardiol 64(1):1–12, 2014). However, catheter-based LAAC has some limitations, such as a risk of device-related thrombus and the need for antithrombotic medication to facilitate device endothelialization Mesnier (Circ Cardiovasc Interv 16(5):e012812, 2023.). Surgical LAAC is being considered as a method that can complement the shortcomings of percutaneous LAAC. In the past, surgical LAAC was performed either by LAA resection or internal obliteration during open-heart surgery, but it was not widely used as a standalone treatment due to its high invasiveness. More recently, the development of a new clip device allows for LAAC via thoracoscopy, eliminating the need for cardiopulmonary bypass. Moreover, its safety and efficacy profiles surpass those of previous LAAC.

Conclusion

The recent surgical LAAC devices have not only demonstrated high success rates but also shown low invasiveness. It becomes a feasible treatment alternative for non-valvular AF patients who experience NOAC failure or have a high bleeding risk with oral anticoagulants.
Association between Asia–Pacific body mass index classification and serum liver enzymes: alanine aminotransferase, aspartate aminotransferase and gamma-glutamyl transferase in healthy individuals
Authors: Dilhara Epitagama Liyana Arachchige Navoda , Pushpakumara Kosgahagoda Durage Chandika , Dias Pathiranage , Priyadarshani Athapaththu Mudiyanselage Buddhika
Published: August 2023

Background

Elevated levels of serum liver transaminases are good indicators of liver cell damage, and elevated serum gamma-glutamyl transferase (GGT) level is a good indicator of both bile duct and hepatocellular damage. At early stages, elevated serum levels of these liver enzymes can be mostly prevailed as an asymptomatic condition and therefore in an undiagnosed state. This may be resulted in a number of complications and may lead to chronic hepatic damage that will be more severe and difficult to care. Serum liver enzyme levels are affected by age, gender, body mass index (BMI), ethnicity, drugs and viruses. Obesity has been an epidemic in nearly every country in the world. BMI is the best parameter to assess the magnitude of obesity. Having this background, the present study was designed to investigate the correlation between the levels of serum liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase (AST) and GGT and Asia–Pacific cut-off points of BMI in healthy individuals.

Methods

A descriptive cross-sectional study was conducted using 120 Sinhala, Buddhist subjects which belonged to 18–32 years. BMI was calculated according to the standard protocol. The serum ALT and AST concentrations were measured by UV assay according to the IFCC method without pyridoxal phosphate activation, and the serum GGT concentration was measured by UV assay according to Szasz method, using the Mindray BS-240 Full Automatic Biochemistry Analyser.

Results

Serum levels of liver enzymes were significantly higher in males than females. In females, serum levels of ALT (r = 0.312, p < 0.001), AST (r = 0.138, p = 0.071) and GGT (r = 0.212, p = 0.047) positively correlated with BMI. In males too, serum levels of ALT (r = 0.431, p < 0.001), AST (r = 0.324, p = 0.013) and GGT (r = 0.314, p = 0.031) were positively correlated with BMI. The minimum values of serum ALT, AST and GGT levels were observed in underweight group, while the maximum values were observed in obese group in both genders.

Conclusions

ALT had the strongest correlation with BMI in both females and males. Therefore, ALT can be suggested as the best liver enzyme that can be used in screening purposes by concerning BMI.
Different tonsillectomy techniques in Egypt: advantages and disadvantages — experience and review of literature
Authors: Abdel-Aziz Mosaad , Atef Ahmed , Sabry Omar Aly , Yousef Ahmed Ibrahim , Ahmed Ahmed Salah , Hussien Ahmed Abo , Abdel-Haleem Mohamed , Samir Amr
Published: August 2023

The debate about which surgical technique for tonsillectomy could be superior over another is continuous. Tonsillectomy techniques are classified into cold and hot procedures. In cold techniques, no heat is used; they include dissection, guillotine, microdebrider, harmonic scalpel, and cryosurgery. Hot techniques include electrocautery, coblation, radio frequency, and laser. In Egypt, the used methods are cold dissection, electrocautery, cold dissection with electrocautery hemostasis, coblation, and less commonly laser. In this study, we described the advantages and disadvantages of each technique.

Hot techniques have shorter operative time and less intraoperative bleeding, while cold dissection technique has less postoperative pain and less postoperative complications especially secondary hemorrhage, with more rapid wound healing. However, coblation technique may have less pain in the first few hours postoperatively relative to cold technique. Electrocautery technique is the most painful method with delayed wound healing. Laser technique is nearly equivalent to electrocautery with slightly less pain. Cold dissection technique is less costly when compared to other techniques. Family satisfaction after tonsillectomy is dependent mainly on less postoperative pain and rapid recovery.

Cold dissection is still considered the gold standard technique. Caution should be taken on using hot techniques especially when used for dissection, and the trainee surgeons should become familiar with cold dissection before shifting to other tonsillectomy techniques. From this study, we can say that hot techniques should not be used except after mastering the cold dissection tonsillectomy; also, the new advanced techniques can be reserved for high-risk patients such as having bleeding disorders.
Risk of autism spectrum disorder and association of its symptoms with psychiatric and substance use disorders in non-clinical student sample in Kenya: cross-sectional study
Authors: Mutiso Victoria N. , Ndetei David M. , Muia Esther N. , Masake Monicah , Alietsi Rita K. , Onsinyo Lydia , Musyimi Christine , Mamah Daniel
Published: August 2023

Background

The prevalence and patterns of autism spectrum disorder (ASD) symptoms/traits and the associations of ASD with psychiatric and substance use disorders has not been documented in non-clinical students in Sub-Saharan Africa, and Kenya in particular.

Aims

To document the risk level of ASD and its traits in a Kenyan student population (high school, college and university) using the Autism-Spectrum Quotient (AQ); and to determine the associations between ASD and other psychiatric and substance use disorders.

Method

This was a cross-sectional study among students (n = 9626). We used instruments with sufficient psychometric properties and good discriminative validity to collect data. A cut-off score of ≥32 on the AQ was used to identify those at high risk of ASD. We conducted the following statistical tests: (a) basic descriptive statistics; (b) chi-squared tests and Fisher's exact tests to analyse associations between categorical variables and ASD; (c) independent t-tests to examine two-group comparisons with ASD; (d) one-way analysis of variance to make comparisons between categorical variables with three or more groups and ASD; (e) statistically significant (P < 0.05) variables fitted into an ordinal logistic regression model to identify determinants of ASD; (f) Pearson's correlation and reliability analysis.

Results

Of the total sample, 54 (0.56%) were at high risk of ASD. Sociodemographic differences were found in the mean scores for the various traits, and statistically significant (P < 0.05) associations we found between ASD and various psychiatric and substance use disorders.

Conclusions

Risk of ASD, gender characteristics and associations with psychiatric and substance use disorders are similar in this Kenyan sample to those found in Western settings in non-clinical populations.
Ambiguous Affect
Authors: Paasonen Susanna
Published: August 2023

Ambiguity refers to the instability or multiplicity of meaning and is therefore something of a fact of life, whereas affect is not an issue of meaning as such. The turn to affect in cultural inquiry from the 1990s has partly been a reaction to the perceived dominance of questions connected to meaning, representation, and signification within the humanities and social sciences. This chapter focuses on how affective intensities are registered in different bodies and, consequently, how they impact ways of making sense of the world, opening up spaces for thinking mutually conflicting meanings together without doing away with irreconcilable tensions between them. The issue is one of ambivalence and mixed feelings but, even more centrally, that involving epistemological work on the possibilities and impossibilities of knowing. Ambiguity means that things can be both and. This chapter explores what this means for how we address approach in cultural analysis and in media research in particular.
Affect and Affirmation
Authors: Palmer Tyrone S.
Published: August 2023

This chapter considers the stakes of the affirmative drive of affect theory. It argues that the insistent affirmationist drive of affect and its foreclosure of the negative is mirrored by and intertwined with the structuring absence of blackness within its precincts. Affect theory's investment in terms of affirmation (potential, becoming, capacity) is, fundamentally, a move against and foreclosure of blackness's essential negativity and all that it portends for the question of affect. Against the affirmationist logic of worlding, a reckoning with blackness and/as negativity presents a mode of thinking/feeling affect in antagonism with worldly creation and its corollary terms—relation, becoming, and so forth. In identifying blackness as the figure that affirmationist theory constructs itself against, this chapter considers what might be gleaned from a fidelity to the negativity that blackness brings to bear on the world of possibility and the possibility of world(s).
Unfuckology
Authors: Schuller Kyla
Published: August 2023

This chapter argues that affect underpins the possibility of the development of the self-possessed, liberal individual known as Man, and for this reason, scientists, writers, and reformers have scripted affect into the mechanisms of race and gender difference. This essay first turns to the overlooked role of affect in constructing the nineteenth-century discourse of biological race and sex difference by elaborating on the concept of impressibility. The chapter uncovers how the capacity to absorb impressions underwrote the modern notions of biological race and sex difference. It then turns to the twentieth-century notion of gender as developed by sexologists. Tracing commonalities across these distinct periods, the chapter exposes affect to lie at the core of humanism's sensory-energetic regime. To understand the intersecting dynamic of the notions of race and sex difference requires interrogating political and scientific uses of affect to delimit the basic capacities of life and universal energy.
Minor Feelings and the Affective Life of Race
Authors: Cvetkovich Ann
Published: August 2023

This chapter explores the intersections of critical race studies and affect studies in order to place the ordinary life of racialized experience at the center of the affective turn. Additionally, the chapter focuses on the migration of critical race theory and queer feminist affect theory into creative nonfiction and other experimental genres of public writing. The ongoingness of Black death and Black mourning continues to warrant attention, and one aim of the chapter is to account for the histories of the present that inform contemporary approaches to the affective life of racism. The centrality of Black and African diaspora studies to racialized understandings of affect has expanded to produce an “intimacies of four continents” across racialized histories of sensory and felt experience. This chapter also explores how new genres draw from earlier models to put affective experience at the forefront of discussions of anti-racism and racism as ordinary.
Migration
Authors: Kasmani Omar
Published: August 2023

European mistrust of migrant and Muslim interiorities is contrasted with the insight that the affective work of (be)longing happens sub rosa: beneath, beyond, behind scenes or that turning inward or less visible is not the same as disinvesting from the sphere of the political. Public opacities constitute a mode of resistance in that these work against European norms of transparency, interrupt the gaze of Western thought and governance, and count as a refusal to be accepted solely on the terms of the colonizer. Theorizing by way of the intimate, this chapter seeks to explore what thinness yields in political and analytical terms against enduring colonial and imperial separations/ideations of space, time, and bodies in the European contemporary. The provocation—affect is migrant—articulates foremost the will to traverse less habituated geographies and mobilizations of theory. It also gathers archives, journeys, and genealogies that are foreclosed by a Western Europe and North America centering grain of affect studies.
The Feeling of Knowing Music
Authors: Robinson Dylan , Nickleson Patrick
Published: August 2023

What is the feeling of knowing music? Answering this question requires awareness of the values that subtend different epistemological orientations and their connection to feelings of mastery, the provisional, and collectivity. This chapter examines how settler colonialism and Indigenous epistemology inaugurate particular feelings of knowing music. Music scholarship exists in relation to an intractable problem: most people feel that they already know music very well. Against such feelings of intimacy, what do disciplinary practices of structural listening and positivist analysis have to offer? The chapter also examines the disciplinary affect through which music studies substitutes categorization for wonder, certainty for curiosity, and expertise for ambivalence by substituting disciplinary knowledge of music for a range of affective relations. This chapter addresses how listening positionalities orient Indigenous and settler structures of feeling musical knowledge and how listening otherwise might begin from sensory-formalist analysis that affirms nongeneralizable and idiomatic moments of feeling listening.
Algorithmic Governance and Racializing Affect
Authors: Dixon-Román Ezekiel
Published: August 2023

Algorithms have become ubiquitous in social life. From macro governmental decision making to our everyday quotidian acts, we interact with algorithms as they learn from and shape our becoming, seeking to compress patterns and rhythms into their existing logics. Algorithms attempt to enfold the variability of knowing into the political-juridical, transparent, or self-determining subject. The performative force of algorithms lies not in predicting behavior but rather in violently shaping behaviors while simultaneously becoming futures. How, then, to account for the enfolding of Man in technosocial systems? This chapter argues that Sylvia Wynter's sociogenic principle can be helpful to rethink how algorithmic rhythms and patterns of sociopolitical relations become ontogenic via the flesh/body, shaping the always already mattering flesh, and as such producing racializing affect. Racializing affect, the chapter argues, is inseparable from the patterns and rhythms of technosocial systems and the historicity of colonialism.
Dividual Economies, of Data, of Flesh
Authors: Puar Jasbir K.
Published: August 2023

Slow life is a reckoning with the capitalist captures of uncertainty and modulations of time: historical/civilizational time, the stealing of time through the expansion of labor time, the refusal or withholding of temporal simultaneity but most significantly, the cordoning off space through time. As seen in Palestine, the stretching of time is not a by-product of surveillance; it is the point of surveillance. Uncertainty becomes a primary affective orientation, a folded-into-the-flesh condition of possibility. Unlike affective labor, time itself refers to the laboring of affect, a laboring that contributes to the capitalist profitability and expansion of the occupation writ large. It is less a stripping away of individual properties than an endless interfacing of dividual data and metrics This chapter is interested in how dividualization is both digital and of the flesh, involving series of recursive relationalities as well as a way of unseeing and reseeing corporeality.