bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing process-based models with the inventory approach to predict CH4 emission of livestock enteric fermentation
Authors: Zhang Jianan , Chen Lan , Chen Yizhao , Groisman Pavel
Published: January 2023

Livestock production is the largest anthropogenic methane (CH4) source globally over the decades. Enteric fermentation of ruminants is responsible for the majority of global livestock CH4 emissions. Both inventory-based models (IvtMs) and process-based models (PcMs) are extensively used to assess the livestock CH4 emission dynamics. However, the model performance and the associated uncertainty have not been well quantified and understood, which greatly hamper our credibility of the regional and global CH4 emission predictions. In this study, we compared the CH4 emissions of livestock enteric fermentation (CH4,ef) predicted by multiple IvtMs and PcMs across Inner Mongolia, a region dominated by typical temperate grasslands that are widely used for animal husbandry. Twenty predictions from five IvtMs, and ten predations from five PcMs were explicitly calculated and compared for the reference year of 2006. The CH4,ef predicted from PcMs is lower than IvtMs and the variation between PcMs is substantially higher, i.e. 0.34 ± 0.36 g CH4/m2yr and 0.78 ± 0.14 g CH4/m2yr for PcMs and IvtMs, respectively. Different model strategies undertaken, i.e. the demand-oriented strategy for IvtMs and the resource-demand co-determined one for PcMs, cause the different predictions of CH4,ef between the two model groups. Using the results from IvtMs as the baseline scalar, we identified and benchmarked the performance of individual PcMs in the study region. The quantitative information provided can facilitate the understanding of key principles and processes of CH4,ef estimations, which will contribute to the future model development of global CH4 emission.
Thermalization and disentanglement with a nonlinear Schrödinger equation
Authors: Buks Eyal
Published: January 2023

We study a recently proposed modified Schrödinger equation having an added nonlinear term. For the case where a stochastic term is added to the Hamiltonian, the fluctuating response is found to resemble the process of thermalization. Disentanglement induced by the added nonlinear term is explored for a system made of two coupled spins. A butterfly-like effect is found near fully entangled states of the spin–spin system. A limit cycle solution is found when one of the spins is externally driven.
Quantum formalism of interference as confinement in spatially structured Lorentzian wells
Authors: Castañeda Román , Bedoya-Ríos Pablo , Hurtado Camilo
Published: January 2023

Non-paraxial interference has recently been explained as light energy confinement in spatially structured Lorentzian wells. This theory describes, in the same way, single particle interference in ordinary space too. Such an alternative thought is discussed here in the framework of a quantum formalism, which introduces confinement operators and density matrices of space states for the first time. Therefore, Lorentzian wells are characterized as the base states of space, which are excited by the geometric potential to produce interference. Geometrical uncertainty and space entanglement are discussed as novel features that approach the proposed theory in the quantum context. This formalism provides insight into the role of space in interference.
Double scaling limit of multi-matrix models at large D
Authors: Bonzom V , Nador V , Tanasa A
Published: January 2023

In this paper, we study a double scaling limit of two multi-matrix models: the

U
(
N

)
2

×
O
(
D
)

-invariant model with all quartic interactions and the bipartite

U
(
N
)
×
O
(
D
)

-invariant model with tetrahedral interaction (D being here the number of matrices and N being the size of each matrix). Those models admit a double, large N and large D expansion. While N tracks the genus of the Feynman graphs, D tracks another quantity called the grade. In both models, we rewrite the sum over Feynman graphs at fixed genus and grade as a finite sum over combinatorial objects called schemes. This is a result of combinatorial nature which remains true in the quantum mechanical setting and in quantum field theory. Then we proceed to the double scaling limit at large D, i.e. for vanishing grade. In particular, we find that the most singular schemes, in both models, are the same as those found in Benedetti et al for the

U
(
N

)
2

×
O
(
D
)

-invariant model restricted to its tetrahedral interaction. This is a different universality class than in the 1-matrix model whose double scaling is not summable.
Measuring the pitch control of professional football players using spatiotemporal tracking data
Authors: Higgins Lewis , Galla Tobias , Prestidge Brian , Wyatt Terry
Published: January 2023

We study pitch control in football, using data from six complete seasons of the English Premier League. Our objective is to investigate features of pitch control in the data. We process the data to ensure consistency of the tracking and event datasets. This represents the largest coherent dataset analysed in the literature and allows the observation of consistent patterns across several seasons’ data. We demonstrate that teams playing in front of a crowd at home control on average

2.9
±
0.2

%

more of the pitch than teams playing away, which reduces to

1.5
±
0.6

%

in matches played behind closed doors. We observe that match by match the difference in pitch control between the teams has a weak, positive correlation with the difference in expected goals (Pearson correlation R = 0.38). As a further manifestation of home advantage we find that in games which the two teams have equal pitch control, on average the home team accumulates greater expected goals (

0.16
±
0.03

). The concept of weighted pitch control is introduced, by assigning a weight to regions of the pitch. We demonstrate that pitch control of the penalty box of the out-of-possession team is negatively correlated with expected goals in each of the six seasons, and interpret this apparently counter-intuitive result.
Clinical Utility of WAIS-IV Matrix Reasoning Among Adult Low Educated Recent Immigrants; A Note of Caution
Authors: Nielsen T Rune , Staios Mathew
Published: January 2023

Objective

To examine the clinical utility of Wechsler Adult Intelligence Scale-IV (WAIS-IV) Matrix Reasoning in limited educated recently arrived immigrants in Denmark.

Method

Participants were 64 limited educated (0–9 years’ education) independently living adult immigrants primarily from Middle Eastern and Sub-Saharan African countries who completed WAIS-IV Matrix Reasoning as well as demographic, and medical questionnaires.

Results

Thirty-eight participants (59%) scored more than two standard deviations below the Scandinavian mean (scaled score < 4). Performances were significantly associated with years of education but not with occupational status, years of residence in Denmark, or Danish language skills. The most common error types were repetition errors (15.84%) and incomplete correlate errors (10.47%), with a strong trend for a higher proportion of repetition errors in participants with <5 years of education.

Conclusions

The findings indicate that WAIS-IV Matrix Reasoning underestimates cognitive functioning in limited educated recently arrived immigrants, thus calling its clinical utility into question.
New synthesis of (±)-karanone, an important aroma compound in agarwood
Authors: Inori Yuta , Takikawa Hirosato , Ogura Yusuke
Published: January 2023

A concise synthesis of (±)-karanone, an important aroma compound of agarwood, was achieved from a commercially available 3-methylcyclohex-2-enol in 3.5% yield in 11 steps. The two contiguous stereocenters at C4 and C5 were constructed via Ireland–Claisen rearrangement. The allylic oxidation at C8 was successfully performed with the mixture of tert-butyl hydroperoxide (TBHP) and CuI. A precursor of ring-closing metathesis to construct a bicyclic dienone was efficiently synthesized from iodoenone by 1,4-addition and nucleophilic substitution of the vinyl group in one pot.
The significance of plus-development through sport: the practices and neoliberal politics of attracting participants to corporate sport-for-development
Authors: Eisenkraft Klein Daniel , Darnell Simon
Published: January 2023

Despite significant growth in the sport-for-development (SFD) sector, there has been little research to date examining the ways that SFD organizations attract communities, and/or the reasons that SFD organizations are able to attract and retain community members in their programmes. The purpose of this study was to explore how and why Maple Leafs Sports and Entertainment (MLSE) Launchpad, an SFD facility in downtown Toronto, attracted participants into its programmes, and to understand how and why community members took up the offer to engage in its programmes. Using ethnographic observations and semi-structured interviews with Launchpad staff, we found that ‘development’ activities, with little or no sport component to them at all, were, in many instances, the main attraction to participants at MLSE Launchpad, a phenomenon that we term ‘plus-development.’ In these cases, what attracted participants to MLSE Launchpad were programmes that, in practice, filled gaps in basic social and community service provisions. We use these findings to advance some critical insights about the broader neoliberal structures under which programmes like MLSE Launchpad operate, and the significance of SFD for and within urban communities.
Solid-organ malignancy in patients with hidradenitis suppurativa treated with tumour necrosis factor-alpha inhibitors: a case series
Authors: Lynch Fiona , Walsh Mary-Catherine , Sadlier Muriel
Published: January 2023

This article details three cases of solid-organ malignancy associated with TNF-alpha inhibitor therapy for hidradenitis suppurativa. It highlights the unknown effect of biologic agents on cancer risk in these patients, who have a baseline elevated cancer risk.
Absolute pitch: neurophysiological evidence for early brain activity in prefrontal cortex
Authors: Sharma Vivek V , Thaut Michael , Russo Frank A , Alain Claude
Published: January 2023

Absolute pitch (AP) is the ability to rapidly label pitch without an external reference. The speed of AP labeling may be related to faster sensory processing. We compared time needed for auditory processing in AP musicians, non-AP musicians, and nonmusicians (NM) using high-density electroencephalographic recording. Participants responded to pure tones and sung voice. Stimuli evoked a negative deflection peaking at ~100 ms (N1) post-stimulus onset, followed by a positive deflection peaking at ~200 ms (P2). N1 latency was shortest in AP, intermediate in non-AP musicians, and longest in NM. Source analyses showed decreased auditory cortex and increased frontal cortex contributions to N1 for complex tones compared with pure tones. Compared with NM, AP musicians had weaker source currents in left auditory cortex but stronger currents in left inferior frontal gyrus (IFG) during N1, and stronger currents in left IFG during P2. Compared with non-AP musicians, AP musicians exhibited stronger source currents in right insula and left IFG during N1, and stronger currents in left IFG during P2. Non-AP musicians had stronger N1 currents in right auditory cortex than nonmusicians. Currents in left IFG and left auditory cortex were correlated to response times exclusively in AP. Findings suggest a left frontotemporal network supports rapid pitch labeling in AP.
Flexible quasi-2D inversion of time-domain AEM data, using a wavelet-based complexity measure
Authors: Deleersnyder Wouter , Maveau Benjamin , Hermans Thomas , Dudal David
Published: January 2023

Regularization methods improve the stability of ill-posed inverse problems by introducing some a priori characteristics for the solution such as smoothness or sharpness. In this contribution, we propose a multidimensional scale-dependent wavelet-based ℓ1-regularization term to cure the ill-posedness of the airborne (time-domain) electromagnetic induction inverse problem. The regularization term is flexible, as it can recover blocky, smooth and tunable in-between inversion models, based on a suitable wavelet basis function. For each orientation, a different wavelet basis function can be used, introducing an additional relative regularization parameter. We propose a calibration method to determine (an educated initial guess for) this relative regularization parameter, which reduces the need to optimize for this parameter and, consequently, the overall computation time is under control. We apply our novel scheme to a time-domain airborne electromagnetic data set in Belgian saltwater intrusion context, but the scheme could equally apply to any other 2D or 3D geophysical inverse problem.
MUCOSAL EXPRESSION OF GENES PI3, ANXA1, AND VDR DESCRIMINATES CROHNS DISEASE FROM ULCERATIVE COLITIS IN INFLAMMATORY BOWEL DISEASE PATIENTS
Authors: James Jaslin , Nielsen Boye S , Christensen Ib , Langholz Ebbe , Malham Mikkel , Riis Lene , Høgdall Estrid
Published: January 2023

INTRODUCTION

Differential diagnosis of Inflammatory Bowel Disease Unclassified (IBDU) patients to Crohn’s Disease (CD) or Ulcerative Colitis (UC) at diagnosis is challenging. Personalized disease-specific strategies are becoming state of art and therefore it is of importance for outcome of the patients and treatment decision to be taken by the clinicians to have a precise diagnosis.

METHODS

Whole transcriptome RNA sequencing was performed using AmpliSeq human gene expression panel on formalin-fixed paraffin-embedded (FFPE) colonic mucosal biopsies of IBD patients (CD, n=16, UC, n=17) and non-IBD controls (n=10) to study differential gene expression between CD and UC samples. Top 100 of the most significant differentially expressed genes were then tested in two independent external GEO datasets. Functional enrichment analysis of 10 successful candidates were performed and 7 genes were selected for further validation. RT-qPCR analyses were performed on an independent patient cohort of 45 CDs and 53 UCs along with 12 non-IBD controls. The cDNA samples were submitted to quality restriction during the statistical analysis resulting in a cut-off of Ct values below 29 for the endogenous control allowing 46 patient samples to enter the analysis. In situ hybridization (ISH) was performed using RNAscope on 11 selected cases for describing tissue localisation and expression.

RESULTS

Sequencing results showed 308 genes differentially expressed between CD and UC from a total of 14190 genes. The genes MTCL1, SH3PXD2A-AS1, CLCF1, and CD180 were under the limit of detection with RT-qPCR and were excluded from further analysis. Relative expression levels from RT-qPCR for the genes PI3, ANXA1, and VDR, together with the age and sex, resulted in an area under the receiver-operating characteristic curve (AUC) of 0.84 (P = 0.02) in discriminating CD from UC. Significantly higher expression of VDR alone was observed in CD samples with AUCs of 0.77 (P = 0.01). ISH analyses showed expression of PI3, ANXA1, and VDR mRNAs localized to mucosal epithelial cells.

CONCLUSION

Using whole transcriptome analysis of FFPE sample-derived RNA, we have identified genes that are differentially expressed in CD and UC, and we have developed an RT-qPCR assay including a panel of 3 genes (PI3, ANXA1, VDR) for the differential diagnosis among IBD unclassified (IBDU) patients. We propose that the RT-qPCR assay could be used in a clinical routine setup for distinguishing UC from CD.
REAL WORLD IMPLEMENTATION OF TREAT-TO-TARGET IN PATIENTS WITH IBD IN A LEARNING HEALTH SYSTEM: AN IBD QORUS COLLABORATIVE STUDY
Authors: Singh Siddharth , Oliver Brant , Hou Jason , Lum Donald , van Deen Welmoed , Weaver Alandra , Siegel Corey , Melmed Gil
Published: January 2023

BACKGROUND AND AIMS

A treat-to-target (TTT) strategy of aiming for symptomatic and endoscopic remission is recommended for the management of inflammatory bowel diseases (IBD). Yet, real-world uptake of TTT strategies has been modest. We sought to assess the feasibility of implementing TTT and improve its uptake in the Crohn’s and Colitis Foundation’s IBD Qorus learning health system (LHS).

METHODS

We examined an ‘intention to TTT’ for each eligible clinic visit (patients not in endoscopic remission on most recent evaluation) across a multi-center LHS over a 12-month period (November 2020-November 2021). ‘Intention to TTT’ (or TTT score) was defined as an affirmative response to all three of the following: (1) Was treat-to target discussed with patient?, (2) Was objective assessment for inflammation (endoscopy, radiology and/or fecal calprotectin) performed within the preceding 12m?, (3) Is there an intention to change treatment since target has not been reached? Over a 12-month breakthrough series (BTS) collaborative, we sought to improve implementation of TTT with monthly report cards, webinars, an active listserv and two all-Qorus learning sessions. Changes in rates of ‘intention to TTT’ were examined over 12 months, overall and at each site, with an earliest clinically meaningful signal of improvement defined a priori as 2% increase per month. In secondary analyses, we compared overall rates of achieving endoscopic remission and corticosteroid-free clinical remission in sites with improvement in rates of ‘intention to TTT’ relative to sites without improvement (only sites with valid data for 8/12 months).

RESULTS

Over 12 months, there were 7934 patient visits across 38 sites in the collaborative; patients in 37% visits (n=2913) were not in endoscopic remission at time of visit. Overall, rates of ‘intention to TTT’ increased from 23% at the beginning of the BTS, to 49% at the end of the BTS, corresponding to a clinically significant 2.4% per month increase in rates of implementing TTT (Figure 1). While rates of discussion of TTT (88% of eligible visits) and intending to adjust therapy (70% of eligible visits) were consistently high, there was a significant increase in objective evaluation for inflammation during the course of the BTS. There was considerable variability across sites in rates of ‘intention to TTT’. Comparing 9/14 sites with improvement in rates of implementing TTT vs. 5/14 sites without improvement, there were trends towards increasing rates of site-level endoscopic remission and steroid-free clinical remission (Figure 2).

CONCLUSIONS

Through a quality improvement initiative in a LHS, rates of ‘intention to TTT’ increased significantly over 12-months. This improvement in implementation of TTT was accompanied by increase in rates of achieving endoscopic remission and steroid-free clinical remission.
Pairs of Diagonal Quartic Forms: The Asymptotic Formulae
Authors: Brüdern Jörg , Wooley Trevor D
Published: January 2023

We establish an asymptotic formula for the number of integral solutions of bounded height for pairs of diagonal quartic equations in $26$ or more variables. In certain cases, pairs in $25$ variables can be handled.
Age-related alterations in protein phosphatase 2A methylation levels in brains of cynomolgus monkeys: a pilot study
Authors: Ando Sana , Sakurai Masashi , Shibutani Shusaku , Kimura Nobuyuki , Shimozawa Nobuhiro , Yasutomi Yasuhiro , Yabe Ryotaro , Ohama Takashi , Sato Koichi
Published: January 2023

The abnormal activity of PP2A, a dominant member of type 2A serine/threonine protein phosphatase, has been implicated in the development of Alzheimer’s disease (AD) and dementia with Lewy bodies (DLB). PP2A is a holoenzyme, and protein methylation of the catalytic subunit, PP2Ac, alters the complex composition. A decrease in PP2Ac methylation levels has been reported in AD and DLB. Aging is the most common risk factor for AD and DLB, but the relationship between aging and PP2A has not been studied in detail. Cynomolgus monkey show increased phosphorylation levels of tau and α-synuclein with aging. In this study, we investigated the alterations in the PP2A activity regulation with aging in monkey brains from 2 to 43 years of age using fractionated proteins. We found that type 2A protein phosphatase activity decreased with aging in cytoplasmic and nuclear-soluble fractions. PP2Ac methylation level was decreased in cytoplasmic and sarkosyl-insoluble fractions. A principal component analysis using PP2Ac, demethylated PP2Ac and PP2A methylesterase PME-1 levels in cytoplasmic and nuclear-soluble fractions as attributes showed that aged monkeys were in the same cluster. Our results show that brain aging in cynomolgus monkeys is closely related to changes in PP2A methylation.
Elevated levels of circulatory follicular T helper cells in chronic lymphocytic leukemia contribute to B cell expansion
Authors: Le Saos-Patrinos Corentin , Loizon Séverine , Zouine Atika , Turpin Delphine , Dilhuydy Marie-Sarah , Blanco Patrick , Sisirak Vanja , Forcade Edouard , Duluc Dorothée
Published: January 2023

Chronic lymphocytic leukemia (CLL) is characterized by an expansion of mature B cells in the bone marrow, peripheral lymphoid organs, and blood. CD4 T helper (Th) lymphocytes significantly contribute to the physiopathology of CLL, but the subset(s) of Th cell involved in CLL pathogenesis is (are) still under debate. In this study, we performed flow cytometry analysis of the circulatory T cells of untreated CLL patients and observed an increase in follicular helper T cells (Tfh), which is a subset of T cells specialized in B cell help. Elevated numbers of Tfh cells correlated with disease severity as measured by the Binet staging system. Tfh from CLL patients were activated and skewed toward a Th1 profile as evidenced by their PD-1+IL-21+IFNγ+ phenotype and their CXCR3+CCR6− chemokine receptor profile. Tfh efficiently enhanced B-CLL survival and proliferation through IL-21 but independently of IFNγ. Finally, we observed an inverse correlation between the Tfh1 and IgA and IgG serum levels in patients, suggesting a role for this Tfh subset in the immune dysfunction associated with CLL. Altogether, our data highlight an impairment in circulatory Tfh subsets in CLL patients and their critical role in CLL physiopathology.
Children and adolescents in the Amsterdam Cohort of Gender Dysphoria: trends in diagnostic- and treatment trajectories during the first 20 years of the Dutch Protocol
Authors: van der Loos Maria A T C , Klink Daniel T , Hannema Sabine E , Bruinsma Sjoerdje , Steensma Thomas D , Kreukels Baudewijntje P C , Cohen-Kettenis Peggy T , de Vries Annelou L C , den Heijer Martin , Wiepjes Chantal M
Published: January 2023

Background

Twenty years ago, the Dutch Protocol—consisting of a gonadotropin-releasing hormone agonist (GnRHa) to halt puberty and subsequent gender-affirming hormones (GAHs)—was implemented to treat adolescents with gender dysphoria.

Aim

To study trends in trajectories in children and adolescents who were referred for evaluation of gender dysphoria and/or treated following the Dutch Protocol.

Methods

The current study is based on a retrospective cohort of 1766 children and adolescents in the Amsterdam Cohort of Gender Dysphoria.

Outcomes

Outcomes included trends in number of intakes, ratio of assigned sex at birth, age at intake, age at start of GnRHa and GAH, puberty stage at start of GnRHa, proportions of adolescents starting and stopping GnRHa, reasons for refraining from GnRHa, and proportions of people undergoing gender-affirming surgery.

Results

A steep increase in referrals was observed over the years. A change in the AMAB:AFAB ratio (assigned male at birth to assigned female at birth) was seen over time, tipping the balance toward AFAB. Age at intake and at start of GnRHa has increased over time. Of possibly eligible adolescents who had their first visit before age 10 years, nearly half started GnRHa vs around two-thirds who had their first visit at or after age 10 years. The proportion starting GnRHa rose only for those first visiting before age 10. Puberty stage at start of GnRHa fluctuated over time. Absence of gender dysphoria diagnosis was the main reason for not starting GnRHa. Very few stopped GnRHa (1.4%), mostly because of remission of gender dysphoria. Age at start of GAH has increased mainly in the most recent years. When a change in law was made in July 2014 no longer requiring gonadectomy to change legal sex, percentages of people undergoing gonadectomy decreased in AMAB and AFAB.

Clinical Implications

A substantial number of adolescents did not start medical treatment. In the ones who did, risk for retransitioning was very low, providing ongoing support for medical interventions in comprehensively assessed gender diverse adolescents.

Strengths and Limitations

Important topics on transgender health care for children and adolescents were studied in a large cohort over an unprecedented time span, limited by the retrospective design.

Conclusion

Trajectories in diagnostic evaluation and medical treatment in children and adolescents referred for gender dysphoria are diverse. Initiating medical treatment and need for surgical procedures depends on not only personal characteristics but societal and legal factors as well.
Antimicrobial, antiadhesive, and antibiofilm actions of rhamnolipids on ESKAPE pathogens
Authors: Firdose Ayesha , Chong Nur Hazlin Hazrin , Ramli Ramliza , Aqma Wan Syaidatul
Published: January 2023

The aim of this study was to test the antimicrobial, antiadhesive, and antibiofilm activities of a rhamnolipid extracted from Pseudomonas aeruginosa UKMP14T previously isolated from oil-contaminated soil in Malaysia against ESKAPE (i.e. multidrug resistant) pathogens. Zones of inhibition in an agar well diffusion assay were observed at 50 µg mL−1 concentrations of rhamnolipid for all the ESKAPE bacteria. The MIC and MBC values ranged between 7.81–62.5 µg mL−1 and 31.25–1000 µg mL−1, respectively. Percent killing was recorded to be >90% except for Klebsiella pneumoniae (86.84%). Furthermore, antiadhesion studies showed that there was 76% hindrance in attachment of Enterococcus faecium and 91% in Acinetobacter baumannii at 4 × MIC. The highest inhibition in adhesion was found at 4 × MIC, which was 46% for Ac. baumannii and 62% for Enterococcus faecium. Finally, the antibiofilm capability of the rhamnolipid was determined, which ranged between 25%–76% in Ac. baumannii and 35%–88% in Enterococcus faecium. To the best of our knowledge, this is the first study to include research on antimicrobial, antiadhesive and antibiofilm activities of rhamnolipid from the local isolate Ps. aeruginosa UKMP14T against ESKAPE bacteria. Obtained results suggest that this rhamnolipid can be exploited commercially for the production of novel antibiotics.
Culturally Responsive Approaches to Traditional Assessment
Authors: Goforth Anisa N. , Pham Andy V.
Published: January 2023

This chapter describes strategies for conducting culturally responsive assessments that foster collaboration with families to develop goals and school-based supports for students. The Culturally Responsive Strengths-Based Assessment to Inform Intervention includes five steps: (1) relationship building and goal orientation, (2) assessment of sociocultural and ecological factors that foster resilience, (3) collaborative development of an intervention aligned toward a goal, (4) implementing an intervention, and (5) evaluating strengths within an intervention and areas to improve. The most comprehensive approach to assessing sociocultural and ecological factors is through a multi-method and multi-source approach. Specifically, practitioners can gather information from (1) reviewing psychological, educational, and medical records, (2) school and home observations, (3) interviews, and (4) tests and measures. Finally, this chapter briefly provides suggestions for summarizing and synthesizing this information in a written report and sharing the results with the student and their caregivers.
Literacy, Language, and Acculturation of Diverse Students
Authors: Goforth Anisa N. , Pham Andy V.
Published: January 2023

Culturally and linguistically diverse (CLD) students often enter a new classroom bringing their own educational and family history, language background, and life experiences. The purpose of this chapter is to discuss best practices in conducting ecological assessment of academic learning and language of CLD students. In particular, the chapter discusses how enculturation, assimilation, and acculturation contribute to student’s learning and language development. These processes can also affect how students approach classwork and assessment tasks. Achievement and opportunity gaps are often the outcomes when curricula, instruction, and assessment do not capture the cultural strengths of students. Recommendations are provided for educators and practitioners to assess and address literacy and language skills of CLD students better, including English language learners.
Assessing Intelligence of Diverse Students
Authors: Goforth Anisa N. , Pham Andy V.
Published: January 2023

Psychological testing and assessment of intelligence have been fraught with controversy, particularly when it comes to evaluation of culturally and linguistically diverse students. Cultural bias in intelligence tests is thought to be the reason for disproportionate placement in special education or gifted education programs. The chapter discusses the issues and complexities regarding the construct of intelligence, measurement of intelligence, and their use in educational decision-making. Although intelligence tests will likely continue to be widespread in school systems, norm-referenced interpretations do not necessarily provide contextual information on individual learning strengths and weaknesses. The chapter provides recommendations for more contextualized assessment of intelligence, which can help mitigate the challenges for using standardized tests of intelligence in schools.
Discussing Sex as Both a Goal and Context
Authors: Dellucci Trey V. , Starks Tyrel J.
Published: January 2023

For a range of reasons, the integration of attention to sex and sexuality may enhance Motivational Interviewing practice. Goals related to sexual satisfaction or improving sexual health may motivate some clients to pursue counseling. For some clients, substance use and sex are highly interrelated behaviors, making sex essential to any understanding of factors motivating substance use. This chapter provides an overview of information about normative sexuality development and functioning that is essential for counselors who wish to integrate attention to sex in their practice. We review the historical separation of sex therapy from counseling more generally and provide examples of how Motivational Interviewing counselors might draw upon models from couples’ HIV testing and counseling (CHTC), sensate focus therapy, and sexual script research to integrate attention to couples’ sexual satisfaction and sexual risk reduction in Motivational Interviewing practice.
Session 3: Increasing Motivation for Treatment Through Values
Authors: Woods Douglas W. , Twohig Michael P.
Published: January 2023

This chapter discusses how to increase the patient’s motivation for treatment by uncovering their values. Therapy aims to help the patient lead a better life instead of just reducing hair-pulling habits. Values refer to the kind of person the patient wants to be. Values differ from goals, which are short-term and can be achieved. Therapy and following one’s values lie in the process instead of the outcome. Values serve as a guiding light that can be constantly and continually worked toward. Worksheets help the patient determine the life they want to live. These are used to explore the patient’s values and motivate them to work on reducing hair-pulling habits.
Session 4: Can Pulling-Related Inner Experiences Be Controlled?
Authors: Woods Douglas W. , Twohig Michael P.
Published: January 2023

This chapter explores the strategies patients can use to control pulling urges while also regulating their internal experiences. It highlights the importance of values, which help provide motivation for the work the patient is putting into improving their life. The therapist encourages the patient to talk about the strategies they use to try to control urges to pull or other unpleasant internal experiences such as thoughts, emotions, or cravings for sensory experiences. The goal is for the patient to learn whether these controlling procedures truly work in the long run to regulate those internal experiences. The patient is asked to make a behavioral commitment to reducing hair pulling using Acceptance and Commitment Therapy, which involves reducing the habit while experiencing the urges to pull. The chapter compares urges to pull to a playground bully, who is better off ignored despite the difficulty of doing so.
Session 5: Acceptance of Pulling-Related Inner Experiences
Authors: Woods Douglas W. , Twohig Michael P.
Published: January 2023

This chapter explores the acceptance of pulling-related inner experiences. It explains that accepting the urges will result in the possible management of pulling and the chance to live life in accordance with one’s values. Learning to accept unpleasant private events allows people to experience feelings without letting them interfere with their life values. Acceptance is not about understanding hair pulling itself but rather about embracing unwanted inner experiences and taking an active stand against urges. Habit reversal training and trigger reduction strategies help the patient to control the actual activity of pulling hair and to stop engaging in behaviors that do not allow them to follow their values.
Session 8: Practicing Acceptance and Commitment Therapy (ACT)
Authors: Woods Douglas W. , Twohig Michael P.
Published: January 2023

This chapter introduces Acceptance and Commitment Therapy (ACT). It presents exercises that allow the patient to experience urges to pull without actually pulling hair. Learning to accept the presence of these urges is more useful than trying to control them. Practicing the skills of acceptance and defusion lets patients move away from their previous habits of controlling urges and other inner experiences and shift to a new approach that allows these feelings to be present. The chapter presents general guidelines and things to consider when practicing to function with urges. It highlights the importance of making room in the mind and allowing oneself to experience feelings when urge-provoking activities happen.
Session 3: Increasing Motivation for Treatment Through Values
Authors: Woods Douglas W. , Twohig Michael P.
Published: January 2023

This chapter details the third session of the Acceptance and Commitment Therapy (ACT) Enhanced Behavior Therapy for Trichotillomania (AEBT-T) treatment package. The therapist explains how clients often value things, such as being a good caregiver, spouse, or friend; being a great employee; being there for others; or being a good listener. However, the immediate rewards produced by pulling often outweigh the delayed rewards that come from behaving in a way that is more consistent with the aspects of life the client most values. The therapist helps the client see why time is spent talking about defining and following values, noting how this differs from following emotions. Thinking about values as things people do, rather than things people think and feel, can help the client conceptualize their own values.
Case 2
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 26-year-old woman presented to the Emergency Department with a 10-day history of vomiting. Over the preceding 24 hours she had vomited approximately 10 times. She reported being unable to sustain any oral intake but had not had diarrhoea or abdominal pain. She had lost 5 kg of weight in the last few weeks (from a baseline of 52 kg). She had been diagnosed with asthma previously for which she used a regular steroid inhaler and salbutamol as required. She was on no other regular medications. A urinary pregnancy test was positive, and she thought her last menstrual period was 10 weeks previously.
Case 5
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 36-year-old woman presented in spontaneous labour at 40 weeks of gestation. This was her first pregnancy and it had been uneventful to this point. She had no past medical history and was on no regular medications except multivitamins. She worked as a lawyer, did not smoke, drink alcohol, or take recreational drugs. She was a keen cyclist and had exercised throughout pregnancy. On presentation her blood pressure was 108/64 mmHg, and her urine showed 2+ ketones. During the following 12 hours she was given 2L of intravenous 5% glucose. She appeared to be a bit vague during labour, and was not always following the instructions of her midwife. Her husband was present and encouraged her throughout, including ensuring she drank 1L of water every 3 hours.
Case 9
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 32-year-old woman presented to the Emergency Department with shortness of breath 3 weeks after the birth of her first child. The pregnancy had been uneventful, and she had an uncomplicated vaginal birth after spontaneous labour at 40 weeks of gestation. She was discharged the day following birth. She described worsening short of breath over the preceding week. This was worse on exertion, and she was unable to walk up the stairs. She also felt occasionally short of breath at rest. She did not wake up at night feeling breathless but was sleeping on four pillows as she felt short of breath lying flatter than this. She also suffered from palpitations for the last 3 days but did not have any chest pain. She had no other significant past medical history or family history. She was on no regular medications and did not smoke.
Case 10
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 25-year-old woman had a history of end-stage renal failure (ESRF) secondary to focal segmental glomerulosclerosis and was having regular haemodialysis via tunnelled catheter. She had been on the transplant list for a year, but no match had been identified. She attended the Emergency Department with abdominal pain, fever, vomiting, and concern about sepsis. She still passed small volumes of urine and did not have any symptoms of urine infection. She had no other past medical history. She was taking alfacalcidol three times a week, erythropoietin injections twice a week, ramipril daily, and intermittently received intravenous iron whilst on haemodialysis. She had no family history of any illnesses and had never smoked.
Case 12
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 20-year-old woman presented at 28 weeks of gestation in her first pregnancy with a 2-week history of palpitations. They were occurring daily, lasting for 10–15 minutes, and usually occurred at rest. There was no associated chest pain, shortness of breath, or syncope. She had had no previous episodes and was otherwise fit and well, with no significant past medical history. She was not on any regular medication, and she had never smoked. Her booking BP was 100/70 mmHg and BMI was 24 kg/m2. On examination observations were normal apart from a heart rate of 110 bpm.
Case 20
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 37-year-old woman was pregnant for the first time with DCDA twins. She had an uncomplicated pregnancy and elective caesarean delivery was undertaken at 37 weeks of gestation. The twins were born in good condition with normal birthweight. Birth was complicated by postpartum haemorrhage; the mother lost approximately 400 ml of blood. She had no significant past medical history and her only regular medication in pregnancy was vitamin D and aspirin 150 mg daily (pre-eclampsia prophylaxis).

Immediately postpartum she had a single episode of hypertension (150/95 mmHg) that was normal when repeated. The day after birth it was noted that her urine output reduced significantly. The day after this, she complained of feeling generally unwell, with blurred vision and dizziness. She did not have a headache and had no altered level of consciousness.
Case 22
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 37-year-old woman attended the Maternity Assessment Unit at 26 weeks of gestation, reporting a 4-day history of itchy feet and arms which was so severe that she could sleep. There was no associated rash. She initially thought she had been bitten by an insect but there was no evidence of any bites. She reported dark urine but was uncertain about whether her stool was paler in colour than normal. She was in her first pregnancy, and at booking her BP, BMI, and routine bloods were normal. She had no significant past medical history. She was taking vitamin D supplements and had not taken any new medications or supplements in the weeks preceding this presentation. She described allergies to penicillin and peanuts. She did try some chlorphenamine which helped her sleep but did not improve the itch. She worked as a teacher and had never smoked.
Case 29
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 35-year-old woman was pregnant for the first time. She had no significant past medical history. When she booked with her midwife, she had a normal blood pressure (105/70 mmHg), and a urine sample was sent for culture. No dipstick results were documented. Her BMI was 42 kg/m2. At her 16-week antenatal visit she was noted to have 2+ proteinuria on dipstick, which was confirmed by a urinary protein:creatinine ratio of 100 mg/mmol. Her blood pressure remained normal, she had no symptoms of urinary tract infection, and she was entirely well in herself. There were no abnormal findings on examination.
Case 38
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 37-year-old woman was re-admitted 5 days after birth having developed shortness of breath and wheeze. Her pregnancy had been uncomplicated, and she had required an emergency caesarean section for a failed induction of labour (post-dates). She was discharged 2 days after birth with non-steroidal analgesia and the remainder of a 10-day course of prophylactic LMWH. Daily midwifery review after discharge had not identified any abnormalities except peripheral oedema. She had no other past medical history and no allergies. She was exclusively breastfeeding her infant. On examination, she was unwell, oxygen saturations were 70%, blood pressure was 170/100 mmHg and respiratory rate 28 breaths/min.
Case 46
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 26-year-old woman in her second pregnancy attended the Maternity Assessment Unit at 30 weeks of gestation. She had felt unwell for 1 week, with nausea, malaise, vomiting, transient diarrhoea, mild fever, and non-specific abdominal pain. She also complained of itch on her arms. She had been well in her pregnancy up to that point. She had no other significant past medical history and was on no regular medication except pregnancy multivitamins. She had been taking paracetamol for the last week to help with her symptoms. She did not drink alcohol and had never smoked. She had not had any unwell contacts. She had spent 1 month in India from 21 weeks of gestation visiting family in both the city and countryside.
Case 53
Authors: Frise Charlotte , Bhalsod Krupa , Scott Rebecca , Gibson Harry
Published: January 2023

A 45-year-old woman in her first pregnancy presented to the maternity day assessment unit at 22 weeks of gestation with 2 transient episodes of abnormal vision and difficulty speaking normally, associated with a headache. Each episode lasted for about 2 hours, had an acute onset and offset, and had fully resolved by the time she was assessed. She had no past medical history, however had been experiencing unilateral headaches throughout pregnancy. She was not taking any regular medications and had no known drug allergies. Her father had had a stroke aged 60 years. She had never smoked.
Integrating Psychiatry and Palliative Medicine
Authors: Kissane David W.
Published: January 2023

The biopsychosocial model is integral to the understanding of human suffering and well-espoused by consultation-liaison psychiatry, which has made a vital contribution to the development of palliative care. The research methodologies from psycho-oncology have contributed greatly through several interventions designed to preserve dignity and sustain meaning in the face of dying. Psychiatry has grappled with the existential challenges so prevalent at the end of life; helped in the recognition of maladaptive pathways that end in depression, anxiety, and demoralization; and aided with effective treatments that sustain well-being and quality of life. The psychiatrist has accumulated evidence for best practice treatment of depression, anxiety, delirium, and suicidal ideation while being recognized as the expert to assess decision-making capacity when this is needed in palliative care. Much of the art of the physician as a compassionate healer is derived from the integration of psychiatric practice into palliative medicine.
Palliative Care for People Who Experience Severe Persistent Mental Illness
Authors: Bates Alan , Nunez John-Jose , Farag Alexandra , Fudge David , O’Shea Timothy , Baba Willison Kathleen , Woods Anne
Published: January 2023

There are many complexities in psychiatric care of people with severe and persistent mental illness (SPMI) and care of people at end-of-life. The combination of the two can be particularly challenging with major issues including access to care, care planning, care setting, patient decision-making capacity and autonomy, medication interactions, and patient vulnerability. The significant diversity in SPMI requires a tailored approach to each syndrome and individual. With schizophrenia, there is likely to be greater focus on decision-making capacity. Patients with substance use disorders often require a trauma-informed approach to care, as do patients with personality disorders who also underline need for thoughtful communication between team members. With the highest mortality rate among psychiatric illnesses, anorexia nervosa often demonstrates the similarities between life-limiting psychiatric illness and life-limiting non-psychiatric illness. This chapter also addresses other areas of overlap between psychiatry and palliative care. SPMI can be mimicked by phenomena such as delirium and steroid-induced psychosis or mood lability in acute medical settings. As well, interactions between psychiatric and non-psychiatric medications can be a concern. The authors expect clinical training and provision of care models that combine mental health and palliative care expertise will continue to evolve, with future changes likely having as much to do with ethics and models of care as with more direct management of physical symptoms and mental status.
Cancer Caregivers
Authors: Applebaum Allison J. , Mitchell Hannah-Rose
Published: January 2023

This chapter provides an overview of who cancer caregivers are in the United States; the developmental, social, and cultural context which shapes the caregiving experience; and the burden of caregiving. The authors describe the psychological, physical, existential, and financial impact of caregiving and underscore this role as one that has the potential to impact multiple health outcomes. The chapter also describes several empirically supported interventions designed to address the unique needs of cancer caregivers and implications for clinical practice and policy to improve caregiver and patient health outcomes. The authors emphasize how the COVID-19 pandemic has highlighted the already existing caregiving crisis in the United States and the urgent need for the development and dissemination of policies that will support caregivers as they shoulder growing responsibilities for patients at home.