bluuebunny/crossref_metadata_2025 huggingface dataset:
Hemodynamic responses in the rat hippocampus are simultaneously controlled by at least two independently acting neurovascular coupling mechanisms
Authors: Arboit Alberto , Krautwald Karla , Angenstein Frank
Published: December 2023

We combined electrical perforant pathway stimulation with electrophysiological and fMRI recordings in the hippocampus to investigate the effects of neuronal afterdischarges (nAD) on subsequent fMRI BOLD signals in the presence of isoflurane and medetomidine. These two drugs already alter basal hemodynamics in the hippocampus, with isoflurane being mildly vasodilatory and medetomidine being mildly vasoconstrictive. The perforant pathway was stimulated once for 8 seconds with either continuous 20 Hz pulses ( continuous stimulation) or 8 bursts of 20 high-frequency pulses ( burst stimulation). Burst stimulation in the presence of medetomidine elicited long-lasting nAD that coincided with a brief positive BOLD response and a subsequent long-lasting decrease in BOLD signals. Under isoflurane, this stimulation elicited only short-lasting nAD and only a short-lasting decline in BOLD signals. In contrast, continuous stimulation under isoflurane and medetomidine caused a similar duration of nAD. Under isoflurane, this caused only a sharp and prolonged decline in BOLD signals, whereas under medetomidine, again, only a brief positive BOLD response was elicited, followed by a shorter and moderate decline in BOLD signals. Our results suggest that nAD simultaneously activate different neurovascular coupling mechanisms that then independently alter local hemodynamics in the hippocampus, resulting in an even more complex neurovascular coupling mechanism.
Three novel SLC37A4 variants in glycogen storage disease type 1b and a literature review
Authors: Wang Zhuolin , Zhao Ruiqin , Jia Xiaoyun , Li Xiaolei , Ma Li , Fu Haiyan
Published: December 2023

Glycogen storage disease type 1b (GSD1b) is a rare genetic disorder, resulting from mutations in the SLC37A4 gene located on chromosome 11q23.3. Although the SLC37A4 gene has been identified as the pathogenic gene for GSD1b, the complete variant spectrum of this gene remains to be fully elucidated. In this study, we present three patients diagnosed with GSD1b through genetic testing. We detected five variants of the SLC37A4 gene in these three patients, with three of these mutations (p. L382Pfs*15, p. G117fs*28, and p. T312Sfs*13) being novel variants not previously reported in the literature. We also present a literature review and general overview of the currently reported SLC37A4 gene variants. Our study expands the mutation spectrum of SLC37A4, which may help enable genetic testing to facilitate prompt diagnosis, appropriate intervention, and genetic counseling for affected families.
Do Airports Affect Regional Economic Growth? Evidence From China
Authors: Song Ge , Tan Jing
Published: December 2023

This paper investigates the impacts of airports on regional economic growth using county-level data in China from 2000 to 2019. Firstly, this paper constructs the air accessibility index, which measures airport activities and improves the previous measurements by adding flight frequency as the weight. Secondly, to address the endogeneity problem in determining airport location, this paper uses the instrument variable and adopts the two-stage least squares method. This paper uses historical air accessibility estimated based on the airport network in 1957 as the instrumental variable. The paper finds the following. (1) Air accessibility positively affects economic growth in China, and the impacts are differentiated by regional heterogeneity and industrial heterogeneity. (2) The construction of new airports shortens the travel time by road transport to the airport, thus reducing the total travel time from origin to destination. The effects of airport construction are significant for local economic growth. (3) This paper takes a closer look at the spatial pattern of airport economic effects. In addition, the results show that local economic effects are differentiated by their distance from airports. This study shows clear and consistent evidence that airport construction positively affects regional economies, and it is beneficial for policy-makers in formulating policies to promote local economic growth.
Comparison of Fixed Dosing vs Train of Four Titration of Cisatracurium in COVID-19 ARDS Patients
Authors: Banerjee Oyshik , Elefritz Jessica L. , Doepker Bruce A. , Atyia Sara A. , Brummel Nathan E. , Smith Rachel M. , Handley Demond , Cape Kari M.
Published: December 2023

Background: Early neuromuscular blockade with cisatracurium has been associated with improved outcomes in moderate-severe acute respiratory distress syndrome (ARDS). Previous studies have demonstrated increased drug utilization without benefits in oxygenation using fixed dose cisatracurium compared to train-of-four (TOF) titration. Objective: We sought to compare a novel, lower fixed dose cisatracurium protocol to TOF titration evaluating the impact on PaO2:FiO2 ratio (P/F). Methods: We conducted a single-center retrospective cohort study comparing fixed dose cisatracurium to TOF titration. We included patients aged 18-89 treated for COVID-19 ARDS with a baseline P/F≤200 who received a cisatracurium infusion for ≥12 h. The primary outcome was change in P/F at 48 h from baseline. Secondary outcomes included change in P/F at 24 h and 7 days, need for mechanical ventilation at day 28, and cisatracurium utilization. Results: Analyses included 125 patients (fixed dose = 65, TOF = 60). Severe ARDS was common with a baseline median P/F of 73.7 vs 79.5, P = .133. The change in P/F at 48 h was larger in the TOF cohort in the adjusted analysis (24.9 vs 70.8, P < .005). The rate and total cumulative dose of cisatracurium were higher in the fixed dose cohort (5 vs 3 mcg/kg/min, P < .001; 1034 vs 612 mg, P < .001) despite similar infusion durations (44.1 h vs 48.5 h, P = .642). Conclusions: Patients in the TOF cisatracurium cohort had improved P/F at 48 h compared to the fixed dose cohort, while also using only 60% of the cumulative dose. Future directions should include analysis of the implications of increased cisatracurium exposure on patient outcomes.
Metallurgical, mechanical and corrosion behavior of Interpulse and pulsed current TIG dissimilar welds of Monel 400 and AISI 316L
Authors: Yelamasetti Balram , N Santhi Sree , Saxena Kuldeep K , Gupta Nakul , P Naveen Kumar , Shelare Sagar Dnyaneshwar
Published: December 2023

This research work explores the weldability, structural integrity, mechanical properties, and corrosion behavior of dissimilar welds of Monel 400 and AISI 316L developed by using Interpulse and pulse arc current modes in TIG welding process. ERNiCrMo-3 filler of 1.6 mm was used to fill the V-groove configuration of 5 mm thick plates in multiple passes. Metallurgical changes were observed in both Interpulse and pulsed current dissimilar weldments using optical and scanning electron microscope techniques. Mechanical properties of the joined structures were evaluated by performing tensile tests on UTM and hardness measurements on weld surfaces using Vickers hardness tester. The resistance against the corrosion especially at the weld area of both welded structures was measured using a cyclic sweep test. From the XRT and visual inspection analyses, the joined structures were free from defects and also seen the uniformity of the filler distribution toward the base metals. The grain structure with well-defined grain structures were identified in PC-TIG weldments whereas fine grains with clear distribution of filler alloying elements were seen in Interpulse-TIG weldments. Interpulse-TIG weldments exhibited with better mechanical and corrosion resistance properties than the PC-TIG weldments vowing to constricted arc mode during the welding process.
Transmission mechanism of public concern in waste-sorting policy: Evidence from text mining
Authors: Shi Binfeng
Published: December 2023

An escalating amount of urban waste poses a significant threat to the sustainable growth of cities. Therefore, a waste-sorting policy is crucial for the advancement of humankind. The implementation of a waste-sorting policy relies heavily on public participation to ensure effective governance. This study examines public participation in urban waste-sorting by mining more than 580,000 microblog texts related to waste-sorting from 2012 to 2022, using data from Sina Weibo, China's leading social media platform. My findings indicate that (1) residents’ attention to and support for mandatory waste-sorting policies varies by region; (2) widespread public interest stimulates publicity, education, and commercial entertainment related to waste-sorting policies and investment in thematically related sectors; (3) residents in regions with high education and income levels are more likely to generate waste and pay greater attention to waste-sorting policies; and (4) the promotion of waste-sorting policies affects knowledge dissemination. This study combines textual analysis and econometric techniques to offer a fresh perspective on the significance of public participation in promoting waste-sorting policies. It serves as an invaluable resource for governments to implement waste-sorting policies.
Anti-rheumatic and Memory-enhancing Effect of Memantine on Complete Freund’s Adjuvant-induced Rheumatoid Arthritis Compared to Methotrexate in Wistar Rats
Authors: Jalgaonkar Sharmila V. , Ourasang Sumith , Tripathi Raakhi K. , Vaideeswar Pradeep , Badhe Padma
Published: December 2023

Objectives

To evaluate the anti-inflammatory and memory-enhancing effects of memantine (MEM) in complete Freund’s adjuvant (CFA)-induced rheumatoid arthritis (RA) in Wistar rats. The effect of MEM on cognition in CFA-induced RA was also evaluated.

Materials and Methods

The rats were randomly assigned to one of five groups: sham control (SC), disease control (DC)—CFA 0.1 mg, positive control (PC)—methotrexate (MTX) 1 mg/kg, low dose MEM—20 mg/kg, and high dose MEM (HD-M)—50 mg/kg. All groups received a subcutaneous injection of CFA in the left paw on day 0, except for the SC group, which received a distilled water (DW) injection. The study drugs, MEM and MTX, were administered orally from days 15 to 28. The SC group received DW orally from days 15 to 28. Variables for physical (paw volume, paw surface temperature, and ankle joint diameter) and behavior (open field test, grip strength test, and water corn test) were performed on days 1, 0, 7, 14, 21, and 28. On day 28, blood was collected for serum inflammatory markers, tumor necrosis factor-alpha (TNF-α) and interleukin (IL)-6. Ex vivo radiological changes in the ankle joint were recorded using a digitalized X-ray machine. Histopathology of the ankle joint was performed.

Results

When compared to the DC group, the HD-M group showed a significant improvement in all physical and behavioral characteristics ( p < 0.001). When compared to the DC group, TNF-α, IL-6 levels, and histopathological scores were significantly lower in the HD-M group ( p < 0.01).

Conclusion

MEM reduces inflammation and improves memory in Wistar rats with CFA-induced RA. MEM can be used as an anti-inflammatory drug in elderly patients at risk of dementia.
Primary Uterine Alveolar Soft Part Sarcoma in a Postmenopausal Woman: Histopathologic and Immunohistochemical Characteristics of a Rare Case
Authors: Gupta Anjali , Gupta Parikshaa , Kaur Amarjot , Kumari Snigdha , Nalini Gupta , Gainder Shalini
Published: December 2023

Background

Primary uterine alveolar soft part sarcoma (ASPS) is a rare, indolent mesenchymal malignancy with less than 40 patients documented in the literature.

Case

We report an example of ASPS in a 61-year-old postmenopausal woman. Macroscopically, the uterus showed multiple nodular masses. Microscopic examination revealed tumor arranged in nests and alveolar pattern. The tumor cells were moderately to markedly pleomorphic, epithelioid to polygonal, with eccentrically placed nuclei, vesicular chromatin, prominent macro-nucleoli, and moderate to abundant eosinophilic cytoplasm. PAS-positive and diastase-resistant intracytoplasmic crystals were also seen in some tumor cells. On immunohistochemistry, the tumor cells showed diffuse positivity for vimentin and nuclear positivity for TFE3, a surrogate marker for ASPS. These were negative for SMA, desmin, CD10, h-caldesmon, cyclin D1, EMA, Melan A, and CD34. SMARCB1 expression was retained. Based on the histopathology and IHC, a final diagnosis of uterine ASPS was rendered.

Conclusions

Knowledge of the characteristic histopathologic and immunohistochemical features can help accurately diagnose such rare tumors. Knowledge of the characteristic histopathologic and immunohistochemical features can help accurately diagnose such rare sarcoma in an uncommon site with an unusual age.
Shifting Standards in Consumer Evaluations of Global and Local Brands After Product-Harm Crises
Authors: Sayin Eda , Aydınoğlu Nilüfer Z. , Özsomer Ayşegül , Gürhan-Canlı Zeynep
Published: December 2023

Building on shifting standards theory from social psychology, the authors suggest global versus local branding as an important categorization that affects consumers’ reactions to product-harm crises in emerging markets. Specifically, the distinct associations attached to global and local brands create shifting standards and lead to differential consumer expectations and evaluations. In four main and two supplementary experiments, the authors demonstrate that consumers from emerging markets react more negatively toward a product-harm crisis by global (vs. local) brands. Higher initial expectations for global brands are the underlying cause of this more pronounced consumer response to failures. The authors demonstrate which specific expectations are driven by the shifting standards around global and local brands and identify product category as a relevant boundary condition. Finally, consumers with high ethnocentrism appreciate it directionally more when a local brand provides compensation after a product-harm crisis than when a global brand provides compensation. The results have important implications for brand management and crisis management strategies.
Foodborne pathogen inactivation in fruit juices utilizing commercial scale high-pressure processing: Effects of acidulants and pH
Authors: Cheng Rebecca M. , Usaga Jessie , Worobo Randy W.
Published: December 2023

The effects of juice pH, type of acidulant, and post-treatment refrigeration on the high-pressure processing (HPP) inactivation of Escherichia coli O157:H7, Salmonella enterica, and Listeria monocytogenes in acid beverages were evaluated. Inoculated apple, orange, and grape juices (at their original pH and adjusted to pH 4.00, 4.50, and 5.00) were treated at 550 MPa for 1 min at 5 °C. In addition, inoculated model solutions acidified to a pH of 5.00 with acetic, citric, malic, and tartaric acids were treated at 400 MPa for 1 min at 5 °C. The effect of refrigerated storage for 24 h after treatment on pathogen inactivation in both experiments was also assessed. A greater than 5-log reduction of the three pathogens inoculated was achieved in all juices immediately after HPP at the juices’ original pH, and of L. monocytogenes under all experimental conditions. Refrigerated storage for 24 h after HPP treatment improved the inactivation of E. coli O157:H7, to >5-log reduction, at pH 4.00 in apple juice and of Salmonella in the three juices at pH 4.00. The type of acidulant did not significantly ( p > 0.01) affect E. coli or Salmonella inactivation in acidified model solutions but a greater than 5-log reduction after HPP was only achieved for L. monocytogenes when acetic acid was used. The effectiveness of HPP for pathogen inactivation depended largely on product pH and the target pathogen of concern.
Ink blot leakage in central retinal artery occlusion
Authors: Venkatesh Ramesh , Joshi Aishwarya , Thadani Atul , Rubble Mangla , Handa Ashit , Chhablani Jay
Published: December 2023

Purpose

To describe a typical case of acute central retinal artery occlusion (CRAO) with an ink-blot pattern of hyperfluorescent leak on fundus fluorescein angiography (FFA).

Case description

A 21-year-old woman came to the clinic with one day of painless right eye vision loss. Her right eye had finger counting at ½ meter. Her right eye had a relative afferent pupillary defect, but her anterior segment and intraocular pressure of both eyes were normal.

Results

The right eye fundus showed signs of acute CRAO with severe grade on optical coherence tomography (OCT). FFA imaging showed a mid-phase hyperfluorescent leak that persisted until the late stage. OCT scan through the hyperfluorescent spot showed absence of neurosensory detachment with normal retinal pigment epithelium, ruling out a central serous chorioretinopathy (CSCR). Ocular massage and anterior chamber paracentesis were performed. At the 10-day follow-up, the patient's visual acuity was counting fingers at ½ meter, and the OCT scan showed findings of CRAO chronicity. The hyperfluorescent spot disappeared on the subsequent FFA.

Conclusion

We report a case of ink-blot leakage on FFA, similar to that observed in CSCR in an eye with acute CRAO. We propose that the hyperfluorescent spot in our acute CRAO was likely caused by red blood cell aggregation or rouleaux formation.
Development of an educational program for ultrasound-based tip location during placement of PICC-port to improve the competence of specialized nurse
Authors: Shen Yan , Zhou Xingmei , Yu Jiaqi , Chang Jian , Li Xin , Li Xianrui , Zhang Huiyan
Published: December 2023

Objectives:

To create an educational program and provide a valid, evidence-based course for ultrasound-based tip location during placement of PICC-port for specialized nurses.

Materials and methods:

We designed three phases for program development. Phase 1: summarizing the evidences as a knowledge foundation; Phase 2: developing an educational program for ultrasound-based tip location during placement of PICC-port; Phase 3: expert panel to validate the developed program.

Results:

The educational program was composed of five parts and 12 lessons, with three lessons each devoted to basic knowledge, practice, and testing, respectively. First, the criteria for defining an expert trainer is determined. Second, some basic conditions are confirmed. Third, the image acquisition windows of transthoracic echocardiographic are recommended. Fourth, the knowledge about ultrasound-based tip location is categorized. Fifth, the procedures for ultrasound-based tip location combined with “bubble test” were listed. The program’s content was verified by experts and found to have a validity coefficient of 0.95.

Conclusion:

The program, encompassing theoretical and practical components, as well as assessment items, can be applied in specialized nursing education and skills training, and it enhances nurses’ competence in accurately identifying the tip location during the placement of PICC-ports and other central venous access implants.
Hey, You! The Importance of Pragmatics in Localizations of Mass Effect in French and Spanish
Authors: Stainton Alexander , Roberts Seán G. , Rennick Stephanie
Published: December 2023

The localization of video game dialog for diverse audiences is challenging because of differences in linguistic features between languages and pragmatic norms between cultures. For example, localizers must decide how to translate the English second-person singular pronoun “you” into languages that have a pragmatic distinction between formal and informal pronouns (e.g., “vous” and “tu” in French). These distinctions are used in social interaction to signal politeness, respect, and social distance, which are important elements that shape player experience in role-playing games. We analyze the dialog from French and Spanish localizations of Mass Effect and show they have strikingly different strategies for translating pronouns. French mostly uses formal pronouns while Spanish mostly uses informal pronouns. We explain how these differences affect player experience and argue that effective localization requires a clear strategy for dealing with pragmatics. We conclude by making practical suggestions for how game creators can better support localization.
Upper Hemisternotomy Versus Full Sternotomy for Replacement of the Supracoronary Ascending Aorta and Aortic Valve
Authors: Shah Vishal N. , Binongo Jose , Wei Jane , Till Brian M. , King Colin , McGee Jacqueline , Plestis Konstadinos A.
Published: December 2023

Objective:

Upper hemisternotomy (UHS) for supracoronary ascending aorta replacement (scAAR) with concomitant aortic valve replacement (AVR) results in less trauma and potentially faster convalescence compared with full sternotomy (FS). Direct head-to-head studies are lacking. We compared a group of UHS patients with a matched group of FS patients undergoing scAAR and AVR.

Methods:

There were 198 patients who underwent scAAR and AVR procedures by a single surgeon between 1999 and 2020. After matching 6 preoperative characteristics, there were 50 UHS and 50 FS patients. Patients who required acute type A aortic dissection repair, reoperations, concomitant procedures, or hypothermic circulatory arrest were excluded.

Results:

In the matched sample, the hospital mortality rate was 1% (1 of 100). The median cardiopulmonary bypass time was 150 (interquartile range [IQR], 131 to 172) min and 164.5 (IQR, 138 to 190) min, respectively, for the UHS and FS groups ( P = 0.08). The median aortic cross-clamp time was 121 (IQR, 107 to 139) min during UHS and 131 (IQR, 115 to 159) min during FS ( P = 0.05). The median ventilation time was 7 (IQR, 3 to 14) h versus 17 (IQR, 10 to 24) h, respectively, after UHS and FS ( P = 0.005). The median hospital length of stay was 7 (IQR, 6 to 9) days after UHS and 8 (IQR, 7 to 11) days after FS ( P = 0.05).

Conclusions:

The low morbidity and mortality support the wider use of UHS for scAAR and AVR in appropriately selected patients. Larger studies are needed to confirm these initial findings.
Experience in early diagnosis of pyoderma gangrenosum: A case report
Authors: Shen Cong mo , Li Feng
Published: December 2023

The early clinical manifestations of pyoderma gangrenosum are not characteristic, it resembles other infectious skin lesions and is difficult to identify in the early stages. The exploratory surgery for direct observation of the superficial fascia of the suspected infection site for signs of infection, together with the collection of tissue samples for bacterial culture, combined with histopathological biopsy and clinical manifestations, was of significant value in the differential diagnosis of this disease and infectious skin lesions with similar manifestations. We introduce a patient who was admitted to hospital with redness and swelling of the left calf and foot for 7 days. The local appearance of the lesion resembled a carbuncle or early-stage necrotizing fasciitis. We performed surgical exploration for a definitive diagnosis but found no signs of infection, therefore, infection could be preliminarily ruled out. The disease was finally diagnosed as pyoderma gangrenosum, which was treated with hormone therapy and recovered after dressing change.
Note-taking for the win: Doodling does not reduce boredom or mind-wandering, nor enhance attention or retention of lecture material
Authors: Spencer-Mueller Emily Krysten , Fenske Mark J
Published: December 2023

Doodling and fidgeting—traditionally viewed in educational contexts as markers of inattention and poor classroom behaviour—have more recently been considered as possible routes to improve performance by reducing boredom and its negative impact on memory. However, there is a surprising lack of well-controlled studies examining this possibility, despite the widespread adoption of fidget toys and doodling exercises within classroom settings. Here we report two experiments (total N = 222) that assess the impact of doodling on boredom, attention, mind-wandering, and subsequent recall of auditory information. In Experiment 1, participants first listened to a 15-min section of a lecture known to induce boredom. Immediately thereafter they were asked to jot down important information from a short voicemail that they listened to while either doodling (adding shading to shapes) or doing nothing in between note-taking. In Experiment 2, participants listened to a 45-min section of the same lecture under one of four conditions: structured doodling (i.e., shade in shapes), unstructured doodling, note-taking, or listen-only. Thought probes assessed self-perceived levels of state boredom, mind-wandering, and attention throughout the lecture. Across studies, doodling neither reduced boredom or mind-wandering nor increased attention or retention of information compared with other conditions. In contrast, attention and test performance were highest (and boredom and mind-wandering lowest) for those focused solely on note-taking.
A computational linguistic analysis of the anatomy of production, consumption, and diffusion of misinformation and authentic information in social media: The case of the COVID-19 pandemic
Authors: Han Yuzhang , Modaresnezhad Minoo , Dissanayake Indika , Mehta Nikhil , Nemati Hamid
Published: December 2023

Social media has become a powerful conduit for misinformation during major public events. As a result, an extant body of research has emerged on misinformation and its diffusion. However, the research is fragmented and has mainly focused on understanding the content of misinformation messages. Little attention is paid to the production and consumption of misinformation. This study presents the results of a detailed comparative analysis of the production, consumption, and diffusion of misinformation with authentic information. Our findings, based on extensive use of computational linguistic analyses of COVID-19 pandemic-related messages on the Twitter platform, revealed that misinformation and authentic information exhibit very different characteristics in terms of their contents, production, diffusion, and their ultimate consumption. To support our study, we carefully selected a sample of 500 widely propagated messages confirmed by fact-checking websites as misinformation or authentic information about pandemic-related topics from the Twitter platform. Detailed computational linguistic analyses were performed on these messages and their replies ( N = 198,750). Additionally, we analyzed approximately 1.2 million Twitter user accounts responsible for producing, forwarding, or replying to these messages. Our extensive and detailed findings were used to develop and propose a theoretical framework for understanding the diffusion of misinformation on social media. Our study offers insights for social media platforms, researchers, policymakers, and online information consumers about how misinformation spreads over social media platforms.
Changes in Quality of Life Among Collegiate Athletes During COVID-19
Authors: Harris Thomas , Sanfilippo Jennifer , Haraldsdottir Kristin , Anderson Scott , Watson Andrew
Published: December 2023

Background:

The COVID-19 pandemic has had a significant effect on the mental health of athletes. How this has affected quality of life (QoL), specifically in the college population, is poorly defined.

Hypothesis:

During the COVID-19 pandemic, the mental and physical QoL will have decreased in collegiate athletes as compared with before the pandemic.

Study Design:

Cross-sectional study.

Level of Evidence:

Level 3.

Methods:

Division I athletes from a total of 23 varsity teams at a single institution completed surveys between 2018 and 2022. QoL was assessed using the Veterans RAND 12-Item Health Survey (VR-12). VR-12 scores were separated into mental component scores (MCS) and physical component scores (PCS). Separate linear mixed effects models evaluated changes in MCS and PCS from pre-COVID to during COVID overall, as well as differences in changes by sex and sport type (individual, team).

Results:

For all athletes, the PCS increased (54.6 [95% CI 54.4-54.7] vs 55.1 [54.9-55.3]; P < 0.01) and the MCS decreased (55.2 [54.9-55.5] vs 53.5 [53.1-53.8]; P < 0.01) from pre-COVID to during COVID. When evaluating for sex, women demonstrated a greater increase in PCS (0.57 ± 0.22; P = 0.01) and greater decrease in MCS (1.06 ± 0.38; P < 0.01). With respect to sport type, individual sports demonstrated a greater decrease in MCS (1.46 ± 0.39; P < 0.01), but no interaction was identified for PCS (0.42 ± 0.23; P = 0.07).

Conclusion:

Collegiate athletes demonstrated a decrease in their self-reported mental QoL during the COVID-19 pandemic, as compared with before the pandemic. This effect was most evident in women and in individual sports. Athletes also reported an increase in physical QoL during COVID that was also larger in women, but not related to sport.

Clinical Relevance:

This study demonstrates the impact of the COVID-19 pandemic on collegiate athletes’ QoL, including negative effects on mental health. It also identifies cohorts of athletes (women, individual) who may be more significantly affected.
The Role of the School Nurse in Addressing Climate-Associated Illnesses: Air Quality
Authors: Oerther Sarah , Manspeaker Sarah
Published: December 2023

Climate change is having an unprecedented influence on human health. Children’s allergies and respiratory problems are increasing because of rising pollen levels and air pollution. School nurses are well positioned to prevent and treat allergies, asthma, and other respiratory conditions. Due to their consistent presence with the school setting, nurses can promote health, wellness, and academic productivity by addressing poor indoor and outdoor air quality. The purpose of this article is to increase understanding of how air quality affects the health of school-age children and to provide school nurses with primary, secondary, and tertiary prevention strategies for ensuring clean and healthy learning environments. This is the second in a series of articles aimed at raising awareness among school nurses about climate-associated illnesses and equipping them with the resources they need to protect students’ health.
The efficacy, acceptability and safety of acceptance and commitment therapy for fibromyalgia – a systematic review and meta-analysis
Authors: Eastwood Florence , Godfrey Emma
Published: December 2023

Background

Fibromyalgia (FM) is a chronic pain disorder characterised by widespread pain, fatigue and cognitive symptoms. Acceptance and commitment therapy (ACT) aims to improve psychological flexibility and has been found to be beneficial in treating chronic pain; however, there are few studies evaluating its efficacy in treating FM.

Aim

This systematic review and meta-analysis evaluated the efficacy of acceptance and commitment therapy in patients with fibromyalgia.

Methods

PubMed, Embase and PsychInfo databases were searched. Randomised Controlled Trials (RCTs) were eligible for inclusion if participants had FM, and the intervention was based on the ACT framework/model, and not combined with any other active therapy; any non-ACT control was accepted. A meta-analysis was performed, with the primary outcomes pain acceptance (chronic pain acceptance questionnaire, CPAQ), health-related quality of life (fibromyalgia impact questionnaire, FIQ), attrition rate and frequency of adverse events, and the secondary outcomes pain intensity, disability, depression, anxiety, and fatigue.

Results

Six RCTs, with a total of 384, mostly-female, participants were included, with ACT being delivered online, in a group setting, or one-to-one. ACT was superior to controls in improving FIQ score at post-intervention (SMD −1.05, 95% CI −2.02, −0.09) and follow-up (SMD −1.43, 95% CI −2.17, −0.69) and CPAQ post-intervention (SMD 1.05, 95% CI 0.61, 1.49) and at follow-up (SMD 0.95, 95% CI 0.40, 1.49). Attrition was below 20% in 4/6 studies and no adverse events were reported as attributable to ACT. All secondary outcomes showed large-to-moderate pooled effect estimates post-intervention, indicating improvement in anxiety, depression, pain and disability. Fatigue also improved, with a large negative effect.

Conclusions

The results suggest ACT improved outcomes in patients with FM: there was an overall improvement in all outcomes post-intervention, with most maintained at follow-up. This review was, however, limited by the small body of evidence and differing methodologies of included studies.
Recursive Bayesian Estimation Search with Environmental Constraints and Psychological Beliefs and Biases
Authors: Hechinger Misty R. , Howell Steven C. , Le Triet M. , Thomas Rickey P.
Published: December 2023

In the paper, we consider a modification of the Recursive Bayesian Estimation technique and incorporate the Fast Sweeping Method to extend recent work in search applications with an algorithm capable of calculating optimal trajectories in the context of multiple targets and searchers. In addition to providing a computational overview of the algorithm, we demonstrate how incorporating knowledge, deception, and belief biases into the algorithm alters the optimal trajectories of the searchers. Finally, we present Monte-Carlo simulations of how these psychological factors influence the mean probability that the searchers detect the target. We will discuss the implications of the findings, current limitations and future extensions of the model, and potential applications to decision support.
Does Tibial Tuberosity Osteotomy Improve Outcomes When Combined With Medial Patellofemoral Ligament Reconstruction in the Presence of Increased Tibial Tuberosity–Trochlear Groove Distance? A Systematic Review and Meta-analysis
Authors: Guevel Borna , Njai Abdoulie , Raboff Aly , Hillman Andrew , Barton Michael , Kocher Mininder S.
Published: December 2023

Background:

There has been recent debate regarding the optimal surgical management strategy for recurrent patellofemoral instability in the presence of an increased tibial tuberosity–trochlear groove (TT-TG) distance. In particular, performing a combined tibial tuberosity osteotomy (TTO) and medial patellofemoral ligament reconstruction (MPFLR) for patients with a TT-TG >20 mm has been questioned, with the hypothesis that an isolated MPFLR (iMPFLR) would be just as effective.

Purpose:

To pool and compare outcomes after MPFLR+TTO versus iMPFLR in patients with a TT-TG >20 mm.

Study Design:

Systematic review; Level of evidence, 4.

Methods:

PubMed-MEDLINE, Embase, Web of Science, and Cochrane Central were searched, and a systematic review was performed. Included were studies that reported postoperative redislocation rates and/or functional outcome scores for patients with recurrent patellar instability and a TT-TG >20 mm who underwent either MPFLR+TTO or iMPFLR and had minimum 2-year follow-up data. Methodologic quality was assessed using the modified Coleman Methodology Score (mCMS). A proportional meta-analysis comparing redislocation, subjective instability, and total complication rates was performed, and mean postoperative functional outcome scores were pooled using a random-effects model with a restricted maximum likelihood estimator.

Results:

In total, 1548 studies were screened, from which 13 were included for analysis. Of the 386 included patients (406 knees), 276 underwent MPFLR+TTO and 110 underwent iMPFLR. The mean mCMS was 61.3 ± 10.5 (range, 48-77). The pooled postoperative redislocation rate was 1.22% (95% CI, 0.22%-7%), with no significant difference between the study groups ( P = .9995). The pooled complication rate was 10.17% (95% CI, 6.2%-16.3%) with no difference between groups ( P = .9275), although the MPFLR+TTO group had higher heterogeneity in complication rates ( I2 = 79.4%) compared with iMPFLR ( I2 = 0%). There was no group difference in the pooled postoperative Lysholm scores ( P = .5177), but patients who underwent iMPFLR had significantly higher postoperative Kujala scores compared with those who underwent MPFLR+TTO ( P = .0283).

Conclusion:

Even in the presence of previously indicative anatomic factors (TT-TG >20 mm), TTO combined with MPFLR does not seem to confer additional benefit compared with iMPFLR. This finding could be advantageous in minimizing the burden of additional surgery with its associated risks. The study findings should, however, be interpreted with caution given the heterogeneity of the studies.
Single-center randomized trial of T-reg graft alone vs T-reg graft plus tacrolimus for the prevention of acute GVHD
Authors: Bader Cameron S. , Pavlova Anna , Lowsky Robert , Muffly Lori S. , Shiraz Parveen , Arai Sally , Johnston Laura J. , Rezvani Andrew R. , Weng Wen-Kai , Miklos David B. , Frank Matthew J. , Tamaresis John S. , Agrawal Vaibhav , Bharadwaj Sushma , Sidana Surbhi , Shizuru Judith A. , Fernhoff Nathaniel B. , Putnam Amy , Killian Scott , Xie Bryan J. , Negrin Robert S. , Meyer Everett H.
Published: December 2023

Allogeneic hematopoietic cell transplantation (HCT) is a curative therapy for hematological malignancies for which graft-versus-host disease (GVHD) remains a major complication. The use of donor T-regulatory cells (Tregs) to prevent GVHD appears promising, including in our previous evaluation of an engineered graft product (T-reg graft) consisting of the timed, sequential infusion of CD34+ hematopoietic stem cells and high-purity Tregs followed by conventional T cells. However, whether immunosuppressive prophylaxis can be removed from this protocol remains unclear. We report the results of the first stage of an open-label single-center phase 2 study (NCT01660607) investigating T-reg graft in myeloablative HCT of HLA-matched and 9/10-matched recipients. Twenty-four patients were randomized to receive T-reg graft alone (n = 12) or T-reg graft plus single-agent GVHD prophylaxis (n = 12) to determine whether T-reg graft alone was noninferior in preventing acute GVHD. All patients developed full-donor myeloid chimerism. Patients with T-reg graft alone vs with prophylaxis had incidences of grade 3 to 4 acute GVHD of 58% vs 8% (P = .005) and grade 3 to 4 of 17% vs 0% (P = .149), respectively. The incidence of moderate-to-severe chronic GVHD was 28% in the T-reg graft alone arm vs 0% with prophylaxis (P = .056). Among patients with T-reg graft and prophylaxis, CD4+ T-cell–to–Treg ratios were reduced after transplantation, gene expression profiles showed reduced CD4+ proliferation, and the achievement of full-donor T-cell chimerism was delayed. This study indicates that T-reg graft with single-agent tacrolimus is preferred over T-reg graft alone for the prevention of acute GVHD. This trial was registered at www.clinicaltrials.gov as #NCT01660607.
The impact of patients as trainers on registered nurses’ patient engagement in primary care clinics: a qualitative study
Authors: Morin A. , Couturier Y. , Poirier M-D. , T. Vaillancourt V. , Massé S. , D. Tardif A. , Poitras M-E.
Published: December 2023

Background

In Canada, primary care is usually the front door to health care for people with health issues. Among these primary care services are primary care clinics (PCC), where the competencies of registered nurses (RNs) are needed. However, nursing practice in PCCs is variable and sometimes suboptimal from one PCC to another. In 2019, the Quebec Ministry of Health and Social Services deployed a practical guide for RNs practicing in PCCs. This guide was intended to support best professional and interprofessional practices and enhance the quality of services offered according to a physical-social vision of care, interprofessional collaboration and partnership with the patient. TheFormation de formateurs en première ligne (F2PL) project team developed a train-the-trainer educational intervention to support RNs in assimilating the content of this guide. This educational intervention is uncommon because it includes patients as trainers (PTs). PTs developed and provided andragogic content about patient’s experience to enhance patient engagement.

Objective

To describe the impacts of the educational intervention provided by the PTs in nurses’ patient engagement practices in PCCs.

Methods

A descriptive qualitative approach was used to describe in-depth changes in RNs’ practices. Individual interviews were conducted with 10 RNs and 3 PTs to explore the changes in RNs’ practice and the barriers and facilitators to adopting this new practice. An inductive and deductive thematic analysis was carried out according to a conceptual model of patient engagement (the Montreal Model), and emerging themes were condensed into propositions. To ensure credibility, a peer review was conducted with the F2PL team, which includes a patient co-leader.

Results

The educational intervention provided by PTs has impacted RNs’ practice in 3 ways: awareness or reminding of general principles, updating commitment to already known principles and enhancing the development of new professional skills.

Conclusions

PTs could effectively support the RNs’ motivation to use patient engagement practices in primary care.
Real-world clinical outcomes and treatment patterns in patients with MDD treated with vortioxetine: a retrospective study
Authors: McDaniel Brandon T. , Cornet Victor , Carroll Jeanne , Chrones Lambros , Chudzik Joseph , Cochran Jeanette , Guha Shion , Lawrence Debra F. , McCue Maggie , Sarkey Sara , Lorenz Betty , Fawver Jay
Published: December 2023

Background

This study included evaluation of the effectiveness of vortioxetine, a treatment for adults with major depressive disorder (MDD), using patient-reported outcome measures (PROMs) in a real-world setting.

Methods

This retrospective chart review analyzed the care experiences of adult patients with a diagnosis of MDD from Parkview Physicians Group – Mind-Body Medicine, Midwestern United States. Patients with a prescription for vortioxetine, an initial baseline visit, and ≥ 2 follow-up visits within 16 weeks from September 2014 to December 2018 were included. The primary outcome measure was effectiveness of vortioxetine on depression severity as assessed by change in Patient Health Questionnaire-9 (PHQ-9) scores ~ 12 weeks after initiation of vortioxetine. Secondary outcomes included changes in depression-related symptoms (i.e., sexual dysfunction, sleep disturbance, cognitive function, work/social function), clinical characteristics, response, remission, and medication persistence. Clinical narrative notes were also analyzed to examine sleep disturbance, sexual dysfunction, appetite, absenteeism, and presenteeism. All outcomes were examined at index (start of vortioxetine) and at ~ 12 weeks, and mean differences were analyzed using pairwise t tests.

Results

A total of 1242 patients with MDD met inclusion criteria, and 63.9% of these patients had ≥ 3 psychiatric diagnoses and 65.9% were taking ≥ 3 medications. PHQ-9 mean scores decreased significantly from baseline to week 12 (14.15 ± 5.8 to 9.62 ± 6.03, respectively; p < 0.001). At week 12, the response and remission rates in all patients were 31.0% and 23.1%, respectively, and 67% continued vortioxetine treatment. Overall, results also showed significant improvements by week 12 in anxiety (p < 0.001), sexual dysfunction (p < 0.01), sleep disturbance (p < 0.01), cognitive function (p < 0.001), work/social functioning (p = 0.021), and appetite (p < 0.001). A significant decrease in presenteeism was observed at week 12 (p < 0.001); however, no significant change was observed in absenteeism (p = 0.466).

Conclusions

Using PROMs, our study results suggest that adults with MDD prescribed vortioxetine showed improvement in depressive symptoms in the context of a real-world clinical practice setting. These patients had multiple comorbid psychiatric and physical diagnoses and multiple previous antidepressant treatments had failed.
Trajectories of spherical equivalent refraction from grades 1 to 4 in Chinese children
Authors: Li Yanzhi , Guo Lan , Zhang Jiayu , Tang Xianghua , Zhao Feng , Hu Yin , Guo Yangfeng , Du Xueying , Yang Xiao , Lu Ciyong
Published: December 2023

Background

The development trajectories of children’s SER remain unknown. This study aimed to characterize spherical equivalent refraction (SER) trajectories during grades 1–4 in Chinese children.

Methods

This prospective cohort study included 1226 first-grade non-myopic children from 12 public primary schools, randomly selected in two districts in Guangzhou, China. From November 2018 to March 2022, four-wave ocular examinations and questionnaire surveys have been completed. The group-based trajectory modeling was used to explore SER trajectories in grades 1–4.

Results

All five trajectories showed an upward trend and rose faster after grade 2. Children in the sharp-developing (n = 44), high-developing (n = 136), and rapid-developing (n = 237) myopia groups developed myopia before grades 2, 3, and 4, respectively. Their SER development speed remained at a relatively high level after myopia, almost consistent with that before myopia. Children in the moderate-developing (n = 418) and low-developing (n = 391) non-myopia groups did not develop myopia before grade 4. Some characteristics in grade 1 were independently associated with SER trajectories, including sex, axial length, number of parents with myopia, residence, academic achievement, and the duration of outdoor activity. Based on the baseline characteristics, we established the model predicting the probability of children belonging to each group.

Conclusions

Myopia interventions are best started in grade 1 or preschool age. If interventions are not taken in time, the latest intervention window might be in grades 1, 2, and 3 for children with a high probability of belonging to the sharp-developing, high-developing, and rapid-developing myopia groups, respectively. The above probabilities might be predicted using the model we established. Moreover, the interventions for myopic children shouldn’t be ignored.
What are important areas where better technology would support women’s health? Findings from a priority setting partnership
Authors: Dixon Sharon , Keating Sabrina , McNiven Abigail , Edwards George , Turner Philip , Knox-Peebles Camilla , Taghinejadi Neda , Vincent Katy , James Olivia , Hayward Gail
Published: December 2023

Background

Women’s health has historically lacked investment in research and development. Technologies that enhance women’s health (‘FemTech’) could contribute to improving this. However, there has been little work to understand which priority unmet needs should be a focus for women’s health technology development. The voices of clinicians and those who experience and utilise these technologies (including those used at home or encountered in clinical settings) are needed to ensure that device development aligns with need, without risking exacerbating or creating health inequities.

Method

We undertook a priority setting partnership project exploring unmet needs in women’s health and well-being where physical technologies or innovations could help. This comprised gathering feedback from: patients and clinicians using both qualitative surveys and discussions; collating and publishing these responses and asking for feedback; evidence checking unmet needs identified, and holding a partnership priority setting event to agree a top 10 and top 20 list of priorities.

Results

We generated a ‘longlist’ of 54 suggestions for areas where better kit, devices or equipment could support women’s health. For three, we found evidence of existing technologies which mitigated against that need. We took the remaining 51 suggestions to a partnership priority setting meeting which brought together clinicians and service users. Through discussion as this group, we generated a list of the top 10 areas identified as priorities for technological development and improvement. These included better devices to manage examination, diagnosis and treatment of pelvic pain (including endometriosis), prolapse care, continence (treatment and prevention, related to pregnancy and beyond), menstruation, vaginal pain and vaginismus, point of care tests for common infections, and nipple care when breastfeeding.

Conclusion

The top priorities suggest far-reaching areas of unmet need across women’s life course and across multiple domains of health and well-being, and opportunities where innovation in the devices that people use themselves or encounter in health settings could potentially enhance health and healthcare experiences.