bluuebunny/crossref_metadata_2025 huggingface dataset:
Multivocal Critical Qualitative Inquiry as an Avenue for Public Policy
Authors: Cisneros-Puebla César A.
Published: March 2023

Nowadays, multivocality has been discussed as if it were a criterion for evaluating the quality of qualitative research, as well as if it were the practice, style, or format of narrative research itself. Grounded in Bakhtin’s legacy, the need to incorporate multivocality as a key element of critical qualitative inquiry as a whole is raised. Thus, multivocal critical qualitative inquiry (MCQI) is proposed as an opportunity to build democratic possibilities for a practice that operates on the threshold of new realities that emerge through the conjunction of alternative interpretive methodologies and emerging social movements of protest. MCQI is then outlined as an avenue for the gestation of public policies despite the fact that the real links between citizen actions of protest and government responsiveness have hardly been rigorously explored. Sympoiesis and pluriversal politics are the theoretical and epistemological perspectives of such conjunction nourished by inquiry practices such as creative subversion, creative activism, and militant research. To exemplify the ways in which MCQI practices can be thought, seven projects were selected from a worldwide production: two projects on ecological issues and environmental care, three in the area of urban planning and democratization, and two around the sensitive problems of refugees, exiles, and migrants. MCQI may constitute a crossroad for the best and most committed inquiry practices nurtured by the interpretive traditions of the social sciences in its ties to struggles for the destruction of all kinds of epistemic, social, political, racial, economic, ecological, cognitive, and legal injustice.
Lifting the Veil: Utilizing Critical Qualitative Inquiry to Demystify the Public Policymaking Process
Authors: Jones Sosanya M.
Published: March 2023

Public policymaking processes in the United States have often been characterized as veiled and lacking transparency. This article explores how critical qualitative inquiry can be used to examine the public policymaking process in ways that help demystify the process and open it up for interrogation and critique for greater democratic engagement. Critical questions are raised about which parts of the public policymaking process are hidden and underexplored and how researchers interested in advancing knowledge, justice, and empowerment for communities of color can use critical qualitative inquiry to “unveil” components of the process for greater advocacy and civic engagement.
Multiple cardiotoxicities during osimertinib therapy
Authors: Kobat Hasan , Davidson Michael , Elkonaissi Islam , Foreman Emma , Nabhani-Gebara Shereen
Published: March 2023

Introduction

The tyrosine-kinase inhibitor osimertinib is an oral anti-cancer agent that is used for the treatment of patients with metastatic non-small cell lung cancer harbouring sensitising EGFR mutations. Patients receiving osimertinib are at higher risk of developing cardiac toxicity, and here we present the case of a 72-year-old male who developed multiple cardiotoxicities during therapy (i.e. QTc prolongation, atrial fibrillation, heart failure).

Case Report

A 72-year-old white British, ex-smoker male patient was admitted to our cancer centre with adenocarcinoma of the lung. Afatinib, gefitinib, osimertinib, and carboplatin plus pemetrexed chemotherapy were the treatments he received. At the 15th month of osimertinib therapy, the patient developed QTc prolongation. Two weeks after the first incidence of QTc prolongation, electrocardiography showed rate-controlled atrial fibrillation. In addition to his atrial fibrillation, echocardiography revealed severely impaired left ventricular systolic function (left ventricular ejection fraction: 30%).

Management and Outcomes

Baseline to osimertinib, an electrocardiography investigation was carried out as per the protocol. Baseline drug history was reviewed and rosuvastatin was discontinued before initiating osimertinib as both drugs contribute to QTc prolongation. Dabigatran, bisoprolol, and digoxin were started for the treatment of atrial fibrillation. Ramipril and spironolactone were prescribed for the treatment of heart failure but osimertinib continued uneventfully. The patient died of non-small cell lung cancer.

Discussion

Recommendations for practical and clinically relevant baseline and on-treatment assessments are considered which may reduce the risk of cardiac toxicity during osimertinib therapy. These include baseline cardiac risk stratification, consideration of concomitant medications that may result in additive cardiac risk, and use of electrocardiography and echocardiography surveillance.
Schools as a Source of Mental Health Literacy: Adjusting and Validating a Mental Health Literacy Scale
Authors: Bjørnsen Hanne Nissen , Bjørnebekk Gunnar , Brandmo Christian
Published: March 2023

Over the last decade, there has been a growing interest in mental health literacy (MHL) in health promotion, largely motivated by increased awareness of MHL as a modifiable determinant of mental health. Accordingly, MHL has been associated with the health-promoting school approach emerging over the last 20 years. To succeed in promoting MHL, it is of vast importance to evaluate working strategies and interventions to address MHL using validated instruments. The current study describes the revision and psychometric testing of a modified version of the 10-item adolescents’ positive MHL measure, the MHPK-10, the only identified instrument measuring adolescents’ positive MHL. The MHPK-10 was adjusted to address the previously documented ceiling effects and was further optimized for use in schools by reworking it to measure learning rather than self-reported knowledge, becoming the new nine-item Mental Health Learning Scale (MHLS-9). The MHLS-9 was tested on a national sample of N = 2,012 Norwegian ninth graders. Data were analyzed by confirmatory factor analysis (CFA) and tests of reliability and validity. The revised CFA model for the MHLS-9 showed an improved fit over the original CFA model for the MHPK-10. The MHLS-9s’ CFA model revealed excellent factor determinacy (.95) and scale reliability (ω = .91). Thus, the MHLS-9 is an improved measure for the positive component of MHL for use in school settings, enabling researchers and practitioners to evaluate and focus positive MHL interventions in schools using a short, reliable, and valid measure for adolescents’ learning about the factors promoting good mental health.
Apixaban for Treatment of Atrial Fibrillation and Venous Thromboembolism After Lung Transplantation
Authors: Nikodem Anne , Arjuna Ashwini , Hu Chengcheng , Nasar Aasya , Lam Jade C. , Cherrier Lauren
Published: March 2023

Introduction

Guidelines recommend the use of direct oral anticoagulation therapy over warfarin for the treatment of venous thromboembolism and atrial fibrillation. However, there is uncertainty and a lack of data supporting the safety and efficacy of anticoagulation therapy in lung transplant recipients. Additionally, there are unique considerations for this population, such as labile renal function and drug interactions.

Project Aims

The objective of this program evaluation was to evaluate the safety and efficacy of apixaban therapy for atrial fibrillation and venous thromboembolism in lung transplant recipients.

Design

Medical records of all adult lung transplant recipients who received apixaban for atrial fibrillation or venous thromboembolism treatment between January 1, 2018, and August 31, 2020 were retrospectively reviewed. Safety was evaluated by the incidence of bleeding. Efficacy was evaluated by the recurrence of blood clots or the incidence of stroke.

Results

A total of 134 recipients were included in the review. Thromboembolisms occurred in 14 recipients (10%), and none experienced a stroke. Bleeding occurred in 12 recipients (9%).

Conclusions

The results of this evaluation were similar to those seen in smaller studies of the safety and efficacy of direct oral anticoagulation therapy for the treatment of atrial fibrillation or venous thromboembolism in lung transplant recipients, especially in recipients taking interacting azole antifungals. Prospective, comparative studies are needed to confirm these findings.
Stattic alleviates pulmonary fibrosis in a mouse model of rheumatoid arthritis–relevant interstitial lung disease
Authors: Xie Lihu , Li Youyou , Tang Wenting , Zhang Qingxiu , Luo Cong , Long Xiaoping
Published: March 2023

Approximately 20% of rheumatoid arthritis (RA) patients have RA-related interstitial lung disease (RA-ILD). Stattic, an STAT3 inhibitor, has been confirmed to be relevant to both RA and ILD. Therefore, this study explored the effect of Stattic on the progression of joint disease and pulmonary fibrosis in zymosan-treated female SKG mice, an established model for autoimmune arthritis. The experimental mice developed pulmonary interstitial pneumonia, which is similar to human cellular and fibrotic nonspecific interstitial pneumonia. Oral gavage of Stattic (60 mg/kg/d) was initiated 10 weeks after zymosan injection. Arthritis and lung fibrosis outcome scores decreased significantly following Stattic treatment. An obvious decrease in lung collagen levels, measured using hydroxyproline level determination and collagen staining, was detected after 6 weeks in Stattic-exposed mice with established disease. Stattic also dramatically restricted arthritis progression, based on joint evaluation. Transforming growth factor beta 1 (TGF-β1) is a pivotal fibrosis-causing cytokine, used here to treat myofibroblasts, thereby establishing a lung fibrosis cell model. Stattic treatment can mitigate the TGF-β1-triggered inflammatory response, myofibroblast activation, oxidative stress, and hyperproliferation by modulating the JAK1/STAT3 pathway. Our observations support a direct role of Stattic-inhibited STAT3 activation in lung fibrosis, which may be particularly relevant in the RA-ILD context.
Heterogeneity of humoral response patterns in mildly symptomatic, non-hospitalized COVID-19 patients: A one-year longitudinal study
Authors: Andrade Luis AF , Bagno Flávia F , Sérgio Sarah AR , Parise Pierina L , Toledo-Teixeira Daniel A , Fernandes Ana PSM , Teixeira Santuza MR , Granja Fabiana , Proenca-Modena José Luiz , da Fonseca Flavio G
Published: March 2023

The duration and protectiveness of antibodies against SARS-CoV-2 in infected subjects are still uncertain; nonetheless, anti-S-specific antibodies can contribute to protective immunity against new infections. It has been described that the level of antibodies produced in COVID-19 is related to the severity of symptoms, and the majority of the humoral response studies have been conducted in hospitalized patients who have been, then, followed over time. However, about 80% of SARS-CoV-2 infections in unvaccinated people are mild to asymptomatic, and this percentage reaches more than 95% in vaccinated individuals. Therefore, understanding the long-term dynamics of the antibody responses in this predominant part of the COVID-19-affected population is essential. In this study, we followed a cohort of individuals with mild COVID-19 who did not require hospitalization. We collected blood samples at sequential times after the SARS-CoV-2-positive qRT-PCR result. From 65 recruited patients, 50 had detectable antibodies at screening. Anti-SARS-CoV-2 IgM levels peaked around two weeks post-COVID-19 diagnostics, becoming undetectable after 65 days. IgG levels reached a peak in approximately one month and remained detectable for more than one year. In contrast to the levels of anti-SARS-CoV-2, antibody neutralization potency indexes persisted over time. In this study, humoral responses in mild COVID-19 patients persisted for more than one year. This is an important long-term follow-up study that includes responses from COVID-19 patients before and after vaccination, a scenery that has become increasingly difficult to evaluate due to the growing vaccination of the world human population.
Study on axial compression property of thin walled tube filled with negative Poisson’s ratio lattice
Authors: Sun Xiaodong , Huang Zhaoming , Wang Tao , Hu Yan , Wang Li , Zhao Niu
Published: March 2023

In this paper, a new type of thin-walled energy absorbing structure filled with auxetic lattice structure has been proposed. The deformation mode and mechanical responses of the new filled tube under compression load have been studied through quasi-static compression experiment and numerical simulation. A theoretical model for predicting the average compression force has been established and verified with simulation analysis. The influences of the geometrical parameters in the compression performance of the filled tube have been studied. The results show that the failure mode of the filled tube under compression load is local buckling failure. Compared with the single thin-walled tube and the lattice structure, the filled tube has better compression resistance. Through parameter analysis, it is clear that the anti-compression property of the filled tube can be significantly improved by increasing the wall thickness of the cell rod and the angle of the lower support rod, which will provide an important reference for the anti-impact optimization design of the negative Poisson’s ratio lattice filled structure.
Peripheral artery disease and extracorporeal membrane oxygenation: Examining a high-risk cohort over time
Authors: Alnahhal Khaled I , Majumdar Monica , Irshad Ali , Kapur Navin , Kumar Shivani , Salehi Payam
Published: March 2023

Objective

Venoarterial extracorporeal membrane oxygenation (VA-ECMO) is a resource-intensive approach for the management of refractory cardiogenic shock. Within this population exists a substantial cohort of patients with peripheral artery disease (PAD), which independently increases the risk of complications and all-cause mortality. We studied 10-year national trends of the impact of PAD among VA-ECMO recipients to better understand the prevalence of PAD and implications on outcomes in this vulnerable population.

Methods

This 10-year retrospective, propensity score-matched study identified all adult patients (≥18) who underwent VA-ECMO between 2009 and 2018, from a large US database (National Inpatient Sample). Patients with an ICD diagnosis of PAD were identified. The primary endpoints of in-hospital mortality, bleeding complications and major limb loss (above- or below-knee amputation) were compared between patients with PAD to those without.

Results

A total of 6768 patients were identified, of which 342 (5.3%) had PAD. The median age at admission was significantly higher in PAD patients [64 years vs. 55 years; p < .01], as was male gender [71% vs. 64%; p < .01]. Patients with PAD had higher rates of smoking (38.9% vs. 23.3%), hypertension (71.1% vs. 50%), diabetes (37.4% vs. 27.0%), chronic kidney disease (30.1% vs. 18.0%), coronary artery disease (76.0% vs. 35.0%) and dyslipidemia (76.0% vs. 35.0); all p < .01. After propensity-matching 2:1 for comorbidities, PAD patients were found to have significantly greater overall complications, including in-hospital mortality, bleeding, surgical wound infections, pseudoaneurysms, and major adverse limb events [71.9% vs. 63.9%; p < .01]. Subgroup analysis revealed greater in-hospital mortality [62.2% vs. 55.3%; p < .05], major amputations [4.1% vs. 0.3%; p < .01] and blood transfusions [32.2% vs. 26.2%; p < .05] in PAD patients. Over 2014–2018, the non-PAD group demonstrated statistically discernable trends in a 51.1% decrease in overall complications and a 28.1% increase in survival to discharge (all p < .01). Over the same time period the PAD cohort experienced a modest, nonsignificant, decrease in complications [7.0%, p = .40] and a decrease in those surviving to discharge [47.1% vs. 40.5%, p = .91].

Conclusion

Patients with PAD on VA-ECMO are sicker at baseline and experience significantly greater major amputations and higher in-hospital mortality. They have not benefitted from the considerable decrease in complication rates and increase in survival to discharge over time as compared to their non-PAD counterparts. These findings demonstrate the substantial frailty of the PAD population within an already high-risk cohort, and highlight the need for better procedural approaches and innovative technologies.
Culturally-Motivated Bullying and Bystander Intervention: The Role of Witness Situational Awareness, Intervention History, and Victim Race
Authors: Vera Elizabeth M. , Galvin Sarah , Millon Fioralba , Drapcho Rachael , Payne Hannah
Published: March 2023

Research indicates that individuals who are not part of mainstream cultures may be disproportionately vulnerable to bully victimization. In response to culturally-motivated bullying vignettes, we explored bystander intervention/upstanding behavioral intentions in an experimental design involving 294 college student participants. Participants were randomly assigned to conditions that presented vignettes involving race-, gender-, and sexual orientation-based bullying. Race of victim was significantly related to upstanding behaviors. Perceived emergency of the situation and previous experience with upstanding interventions were also predictive of upstanding behavior. Empathy for the victims and intentions to comfort them were the primary rationales cited for preferring specific upstanding behaviors. Findings have implications for designing culturally-motivated bullying prevention programs in school and campus settings.
Supervisor beware: Contemptuous feedback harms low performers and taxes working memory of rejection sensitive persons
Authors: Hamdani Maria , Turner Jennifer R. , Stanley Jennifer Tehan
Published: March 2023

In this independent constructive replication and generalizability study, we revisit Melwani and Barsade’s laboratory study on receiving contempt in a work context. They found that recipients of contempt had better task performance than the recipients of neutral, angry, or no failure feedback. They also found social status moderates this link, such that the low-status recipients of contempt performed significantly better than high-status recipients. The present study revisits the emotional feedback and performance link by focusing on objective task performance in a supervisor–subordinate setting. Participants ( N = 124) were randomly assigned to one of three scripted negative feedback conditions (neutral, anger, and contempt) and interacted with the team using an online messenger platform. Participants completed three copyediting tasks and received three rounds of negative written feedback. Results indicated that contempt led to a distinct pattern: subjects with low baseline performance on copyediting tasks consistently performed worse in the contempt condition than those in other conditions. We also extend the replication by showing how working memory is taxed differentially across feedback conditions. We found that rejection-sensitive participants incurred greater working memory deficits when receiving contempt. Our results inform research on Golem and Underdog effects and can also have implications for inclusive management practices in online work.
The relationship between eHealth literacy and palliative care knowledge, attitudes, and practice among nurses: a cross-sectional study
Authors: Yuan Niu , Lv Zhang-Hong , Wen Yuan-Yuan , Sun Chun-Rong , Tao Ting-Yu , Qian Dan
Published: March 2023

Background

The crucial role that nurses play in offering palliative care to patients with life-threatening diseases is widely acknowledged, but the correlation between their eHealth literacy and their knowledge, attitudes, and practice in this domain has yet to be investigated. This study is conducted to investigate the status of eHealth literacy and knowledge, attitudes, and practice regarding palliative care among nurses, and to examine their relationship.

Methods

A cross-sectional study design was conducted among 546 nurses selected from the first-class tertiary hospitals located both inside and outside of Zhejiang Province between May 12 and May 20, 2022. The online survey of eHealth literacy scale (eHEALS) and scale of knowledge, attitudes, and practice (KAP) regarding palliative care was performed using snowball sampling through the WeChat mini program “Questionnaire Star”. The Spearman rank correlation and binary logistic regression model were used to analyze the independent association between eHealth literacy and KAP toward palliative care.

Results

The median scores of eHEALS and KAP regarding palliative care were 32 (interquartile range[IQR] 29 to 38) and 82 (IQR 54 to 106) points. The results of correlation analysis showed that the KAP regarding palliative care was significantly correlated with eHEALS (rho = 0.189, P < 0.001). In addition, the results of binary logistic regression analysis demonstrated that the eHEALS score was independently associated with the KAP score regarding palliative care when controlling for sociodemographic factors (OR = 2.109; P < 0.001).

Conclusion

Nurses who worked in first-class tertiary hospitals have good levels of eHealth literacy, while the overall level of KAP regarding palliative care is moderate. Our findings highlight that the eHEALS score is independently associated with the KAP score regarding palliative care. Therefore, nursing managers should adopt multiple measures to comprehensively improve eHealth literacy among nurses, further enrich their knowledge of palliative care, promote a positive transformation of attitudes towards palliative care, and efficiently implement palliative care practice, in order to promote high-quality development of palliative care.
Large-scale morphometry of the subarachnoid space of the optic nerve
Authors: Rossinelli Diego , Killer Hanspeter Esriel , Meyer Peter , Knott Graham , Fourestey Gilles , Kurtcuoglu Vartan , Kohler Corina , Gruber Philipp , Remonda Luca , Neutzner Albert , Berberat Jatta
Published: March 2023

Background

The meninges, formed by dura, arachnoid and pia mater, cover the central nervous system and provide important barrier functions. Located between arachnoid and pia mater, the cerebrospinal fluid (CSF)-filled subarachnoid space (SAS) features a variety of trabeculae, septae and pillars. Like the arachnoid and the pia mater, these structures are covered with leptomeningeal or meningothelial cells (MECs) that form a barrier between CSF and the parenchyma of the optic nerve (ON). MECs contribute to the CSF proteome through extensive protein secretion. In vitro, they were shown to phagocytose potentially toxic proteins, such as α-synuclein and amyloid beta, as well as apoptotic cell bodies. They therefore may contribute to CSF homeostasis in the SAS as a functional exchange surface. Determining the total area of the SAS covered by these cells that are in direct contact with CSF is thus important for estimating their potential contribution to CSF homeostasis.

Methods

Using synchrotron radiation-based micro-computed tomography (SRµCT), two 0.75 mm-thick sections of a human optic nerve were acquired at a resolution of 0.325 µm/pixel, producing images of multiple terabytes capturing the geometrical details of the CSF space. Special-purpose supercomputing techniques were employed to obtain a pixel-accurate morphometric description of the trabeculae and estimate internal volume and surface area of the ON SAS.

Results

In the bulbar segment, the ON SAS microstructure is shown to amplify the MECs surface area up to 4.85-fold compared to an “empty” ON SAS, while just occupying 35% of the volume. In the intraorbital segment, the microstructure occupies 35% of the volume and amplifies the ON SAS area 3.24-fold.

Conclusions

We provided for the first time an estimation of the interface area between CSF and MECs. This area is of importance for estimating a potential contribution of MECs on CSF homeostasis.
Reversible skin microvascular hyporeactivity in patients with immune-mediated thrombocytopenic thrombotic purpura
Authors: Joffre Jérémie , Raia Lisa , Urbina Tomas , Bonny Vincent , Gabarre Paul , Missri Louai , Baudel Jean-Luc , Coppo Paul , Guidet Bertrand , Maury Eric , Ait-Oufella Hafid
Published: March 2023

Background

Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare disease characterized by arteriolar and capillary microthrombosis precipitating organ failure. However, the contribution of endothelial dysfunction on impaired microvascular blood flow in iTTP patients has been poorly explored. This pilot observational study aimed to explore endothelial-mediated vasoreactivity in iTTP patients at admission and its changes after plasma exchange therapy (PE).

Methods

We conducted a prospective observational study in patients (> 18-year old) admitted in ICU for iTTP. Using laser Doppler flowmetry and acetylcholine (Ach) iontophoresis in the forearm, we recorded the skin microvascular blood flow and the endothelium-mediated vasoreactivity at admission and after PE. Demographics, biological, clinical courses, and outcomes were also collected. As a control group, we used a previously published cohort of young diabetic patients after correction of ketoacidosis.

Results

Eighteen confirmed iTTP patients and 34 controls were included in the study, mainly female (72%) aged 43 ± 16-year-old. At admission, 55% had neurological abnormalities, 50% cardiac issues and 27.8% an acute kidney injury. Median platelet count was 19 G/mL [10–37]. Baseline microvascular blood flow was decreased in iTTP patients when compared to controls (5.97 ± 4.5 vs. 10.1 ± 6.3 PU, P = 0.03), associated with markedly impaired endothelial-mediated skin microvascular reactivity (AUC: 9627 ± 8122 vs. 16,475 ± 11,738, P = 0.03). Microvascular reactivity improved after the first PE session (AUC: 9627 ± 8122 vs 16,558 ± 10,699, P = 0.007, respectively, baseline and post-PE1) and much more after the second session (26,431 ± 23,181, P = 0.04 post-PE1 vs post-PE2). Hemolysis biomarkers (LDH and bilirubin) negatively correlated with skin microvascular flow and vasoreactivity.

Conclusion

We highlighted a marked yet reversible skin endothelium-mediated microvascular hyporeactivity in iTTP patients that could participate in organ injury pathophysiology.
Modulation of duodenal and jejunal microbiota by rifaximin in mice with CCl4-induced liver fibrosis
Authors: Ikeuchi Kazuhiko , Tsutsumi Takeya , Ishizaka Aya , Mizutani Taketoshi , Sedohara Ayako , Koga Michiko , Tamaoki Satoru , Yotsuyanagi Hiroshi
Published: March 2023

Background

Rifaximin is a poorly absorbed broad-spectrum antibiotic used for hepatic encephalopathy. Although increased Lactobacillaceae and decreased Bacteroidetes abundance are characteristic of hepatic encephalopathy, rifaximin does not dramatically alter the stool microbiota. As the antimicrobial effect of rifaximin increases by micellization with bile acids, we hypothesized that rifaximin alters the microbiota in the duodenum and jejunum, where the levels of bile acids are abundant.

Methods and results

Eight-week-old BALB/c mice were injected with carbon tetrachloride (CCl4) intraperitoneally for 12 weeks to induce liver fibrosis. The mice were grouped into the control (n = 9), CCl4 (n = 13), and rifaximin group in which mice were treated with rifaximin for two weeks after CCl4 administration (n = 13). We analyzed the microbiota of the duodenum, jejunum, ileum, cecum, and stool using 16S ribosomal RNA gene analysis. The content of Lactobacillaceae, the most abundant bacterial family in the duodenum and small intestine, increased in the CCl4 group, especially in the jejunum (median 67.0% vs 87.8%, p = 0.03). Rifaximin significantly decreased Lactobacillaceae content in the duodenum (median 79.4% vs 19.0%, p = 0.006) and jejunum (median 87.8% vs 61.3%, p = 0.03), but not in the ileum, cecum, and stool. Bacteroidetes abundance tended to decrease on CCl4 administration and increased following rifaximin treatment in the duodenum and jejunum. S24_7, the most abundant family in Bacteroidetes, demonstrated a significant inverse correlation with Lactobacillaceae (duodenum, r = − 0.61, p < 0.001; jejunum, r = − 0.72, p < 0.001). In the ileum, cecum, and stool, the effect of rifaximin on the microbiota was minimal, with changes within the same phylum. The percentage of bacterial families, such as Lactobacillaceae and S24_7 in the duodenum and small intestine, did not correlate with that in the stool.

Conclusions

The abundance of Lactobacillaceae increased in the jejunum of mice with CCl4-induced liver fibrosis, while rifaximin significantly reduced it in the duodenum and jejunum. Thus, rifaximin possibly exerts its effect by altering the duodenal and jejunal microbiota. Furthermore, changes in the duodenal and small intestinal microbiota were not associated with that of stool, suggesting that the analysis of stool microbiota is insufficient to evaluate upper intestinal microbiota.
Identification reproducible microbiota biomarkers for the diagnosis of cirrhosis and hepatocellular carcinoma
Authors: Zhang Huarong , Wu Junling , Liu Yijuan , Zeng Yongbin , Jiang Zhiyu , Yan Haidan , Lin Jie , Zhou Weixin , Ou Qishui , Ao Lu
Published: March 2023

Hepatocellular carcinoma (HCC) is a malignant tumor with high incidence in China, which is mainly related to chronic hepatitis B (CHB) and liver cirrhosis (LC) caused by hepatitis B virus (HBV) infection. This study aimed to identify reproducible gut microbial biomarkers across Chinese population for LC and HCC diagnosis. In this study, a group of 21 CHB, 25 LC, 21 HCC and 15 healthy control (HC) were examined, and used as the training data. Four published faecal datasets from different regions of China were collected, totally including 121 CHB, 33 LC, 70 HCC and 96 HC. Beta diversity showed that the distribution of community structure in CHB, LC, HCC was significantly different from HC. Correspondingly, 14 and 10 reproducible differential genera across datasets were identified in LC and HCC, respectively, defined as LC-associated and HCC-associated genera. Two random forest (RF) models based on these reproducible genera distinguished LC or HCC from HC with an area under the curve (AUC) of 0.824 and 0.902 in the training dataset, respectively, and achieved cross-region validations. Moreover, AUCs were greatly improved when clinical factors were added. A reconstructed random forest model on eight genera with significant changes between HCC and non-HCC can accurately distinguished HCC from LC. Conclusively, two RF models based on 14 reproducible LC-associated and 10 reproducible HCC-associated genera were constructed for LC and HCC diagnosis, which is of great significance to assist clinical early diagnosis.
Single-cell transcriptomic analysis of normal and pathological tissues from the same patient uncovers colon cancer progression
Authors: Sun Ruifang , Yang Yang , Lü Weidong , Yang Yanqi , Li Yulong , Liu Zhigang , Diao Dongmei , Wang Yang , Chang Su’e , Lu Mengnan , Jiang Qiuyu , Dai Bingling , Ma Xiaobin , Zhao Chang’an , Lü Moqi , Zhang Juan , Ding Caixia , Li Na , Zhang Jian , Xiao Zhengtao , Zhou Dangxia , Huang Chen
Published: March 2023

The aim of the present study was to elucidate the evolutionary trajectory of colon cells from normal colon mucosa, to adenoma, then to carcinoma in the same microenvironment. Normal colon, adenoma and carcinoma tissues from the same patient were analyzed by single-cell sequencing, which perfectly simulated the process of time-dependent colon cancer due to the same microenvironment. A total of 22 cell types were identified. Results suggest the presence of dominant clones of same cells including C2 goblet cell, epithelial cell subtype 1 (Epi1), enterocyte cell subset 0 (Entero0), and Entero5 in carcinoma. Epi1 and Entero0 were Co-enriched in antibacterial and IL-17 signaling, Entero5 was enriched in immune response and mucin-type O-glycan biosynthesis. We discovered new colon cancer related genes including AC007952.4, NEK8, CHRM3, ANO7, B3GNT6, NEURL1, ODC1 and KCNMA1. The function of TBC1D4, LTB, C2CD4A, AND GBP4/5 in T cells needs to be clarified. We used colon samples from the same person, which provide new information for colon cancer therapy.
Efficacy and safety of duloxetine in painful diabetic peripheral neuropathy: a systematic review and meta-analysis of randomized controlled trials
Authors: Wu Chung-Sheng , Huang Yu-Jui , Ko Yuan-Chun , Lee Che-Hsiung
Published: March 2023

Background

Painful diabetic peripheral neuropathy (PDPN) is a key concern in clinical practice. In this systematic review and meta-analysis, we compared duloxetine and placebo treatments in terms of their efficacy and safety in patients with PDPN.

Methods

Following the PRISMA guidelines, we searched the Cochrane Library, PubMed, and Embase databases for relevant English articles published before January 11, 2021. Treatment efficacy and safety were assessed in terms of pain improvement, patient-reported health-related performance, and patients’ quality of life.

Results

We reviewed a total of 7 randomized controlled trials. Regarding pain improvement, duloxetine was more efficacious than placebo (mean difference [MD] − 0.89; 95% confidence interval [CI] − 1.09 to − 0.69; P < .00001). Furthermore, duloxetine significantly improved the patients’ quality of life, which was assessed using the Clinical Global Impression severity subscale (MD − 0.48; 95% CI − 0.61 to − 0.36; P < .00001), Patient Global Impression of Improvement scale (MD − 0.50; 95% CI − 0.64 to − 0.37; P < .00001), and European Quality of Life Instrument 5D version (MD 0.04; 95% CI 0.02 to 0.07; P = .0002). Severe adverse events were rare, whereas nausea, somnolence, dizziness, fatigue, constipation, and decreased appetite were common; approximately, 12.6% of all patients dropped out because of the common symptoms.

Conclusions

Duloxetine is more efficacious than placebo treatments in patients with PDPN. The rarity of severe adverse events indicates that duloxetine is safe. When a 60-mg dose is insufficient, 120 mg of duloxetine may improve PDPN symptoms. Our findings may help devise optimal treatment strategies for PDPN.

Systematic review registration

PROSPERO CRD42021225451
Identifying Subsets of Patients With Adult Spinal Deformity Who Maintained a Positive Response to Nonoperative Management
Authors: Passias Peter G. , Ahmad Waleed , Tretiakov Peter , Krol Oscar , Segreto Frank , Lafage Renaud , Lafage Virginie , Soroceanu Alex , Daniels Alan , Gum Jeffrey , Line Breton , Schoenfeld Andrew J. , Vira Shaleen , Hart Robert , Burton Douglas , Smith Justin S. , Ames Christopher P. , Shaffrey Christopher , Schwab Frank , Bess Shay
Published: March 2023

BACKGROUND:

Adult spinal deformity (ASD) represents a major cause of disability in the elderly population in the United States. Surgical intervention has been shown to reduce disability and pain in properly indicated patients. However, there is a small subset of patients in whom nonoperative treatment is also able to durably maintain or improve symptoms.

OBJECTIVE:

To examine the factors associated with successful nonoperative management in patients with ASD.

METHODS:

We retrospectively evaluated a cohort of 207 patients with nonoperative ASD, stratified into 3 groups: (1) success, (2) no change, and (3) failure. Success was defined as a gain in minimal clinically importance difference in both Oswestry Disability Index and Scoliosis Research Society-Pain. Logistic regression model and conditional inference decision trees established cutoffs for success according to baseline (BL) frailty and sagittal vertical axis.

RESULTS:

In our cohort, 44.9% of patients experienced successful nonoperative treatment, 22.7% exhibited no change, and 32.4% failed. Successful nonoperative patients at BL were significantly younger, had a lower body mass index, decreased Charlson Comorbidity Index, lower frailty scores, lower rates of hypertension, obesity, depression, and neurological dysfunction (all P < .05) and significantly higher rates of grade 0 deformity for all Schwab modifiers (all P < .05). Conditional inference decision tree analysis determined that patients with a BL ASD-frailty index ≤ 1.579 (odds ratio: 8.3 [4.0-17.5], P < .001) were significantly more likely to achieve nonoperative success.

CONCLUSION:

Success of nonoperative treatment was more frequent among younger patients and those with less severe deformity and frailty at BL, with BL frailty the most important determinant factor. The factors presented here may be useful in informing preoperative discussion and clinical decision-making regarding treatment strategies.
Robustness of Randomized Control Trials Supporting Current Neurosurgery Guidelines
Authors: Hameed N. U. Farrukh , Zhang Xiaoran , Sajjad Omar , Sathyamurthi Sam , Zaidi Maadeha H. , Jovanovich Nicolina , Habib Ahmed , Priyadharshini Mamindla , Zinn Pascal O.
Published: March 2023

BACKGROUND:

Treatment guidelines in neurosurgery are often based on evidence obtained from randomized controlled trials (RCTs).

OBJECTIVE:

To evaluate the robustness of RCTs supporting current central nervous tumor and cerebrovascular disease guidelines by calculating their fragility index (FI)—the minimum number of patients needed to switch from an event to nonevent outcome to change significant trial primary outcome.

METHODS:

We analyzed RCTs referenced in the Congress of Neurological Surgeons and American Association of Neurological Surgeons guidelines on central nervous tumor and cerebrovascular disease management. Trial characteristics, finding of a statistically significant difference in the primary endpoint favoring the experimental intervention, the FI, and FI minus number lost to follow-up were assessed.

RESULTS:

Of 312 RCTs identified, 158 (50.6%) were published from 2000 to 2010 and 106 (34%) after 2010. Sixty-three trials (19.2%) were categorized as surgical trials, and the rest studied medical treatment (82.0%) or percutaneous intervention (8.33%). The trials had a median power of 80.0% (IQR 80.0-90.0). Of these, 120 trials were eligible for FI calculation. The median FI was 7.0 (IQR 2.0-16.25). Forty-four (36.6%) trials had FI ≤ 3 indicating very low robustness. After adjusting for covariates, recently published trials and trials studying percutaneous interventions were associated with significantly higher FI compared with older trials and trials comparing surgical approaches, respectively. Trials limited to single centers were associated with significantly lower FI.

CONCLUSION:

Trials supporting current guidelines on neuro-oncological and neurovascular surgical interventions have low robustness. While the robustness of trials has improved over time, future guidelines must take into consideration this metric in their recommendations.
Σύνθεση τελειών άνθρακα και αξιοποίηση στην ανάπτυξη μίκρο- και νανοσυσκευών και διατάξεων
Authors: Σέγκος Απόστολος
Published: March 2023

Το αντικείμενο της παρούσας διδακτορικής διατριβής είναι η σύνθεση και ο χαρακτηρισμός Τελειών Άνθρακα με στόχο την αξιοποίησή τους σε μίκρο- και νανοσυσκευές και διατάξεις. Οι Τελείες Άνθρακα, οι οποίες ανακαλύφθηκαν το 2004 και αποτελούν τη νεότερη προσθήκη στην οικογένεια των νανοϋλικών με βάση τον άνθρακα, έχουν προσελκύσει το ερευνητικό ενδιαφέρον λόγω των εύκολων και χαμηλού κόστους μεθόδων σύνθεσής τους, της χαμηλής τοξικότητας που παρουσιάζουν αλλά κυριότερα λόγω του φθορισμού που επιδεικνύουν κατά τη διέγερσή τους στο εγγύς υπεριώδες και ορατό φάσμα. Παρόλο που μέχρι σήμερα το μεγαλύτερο μέρος των ιδιοτήτων τους και των μηχανισμών που τις διέπουν δεν έχουν αποσαφηνιστεί πλήρως, τα υλικά αυτά θα μπορούσαν να χρησιμοποιηθούν για μια σειρά από δυνητικές εφαρμογές.Η μεθοδολογία που ακολουθήθηκε σε ερευνητικό επίπεδο χωρίζεται σε τρεις διακριτούς άξονες. Αρχικά αναπτύσσονται Τελείες Άνθρακα μέσω υδροθερμικής σύνθεσης με τη βοήθεια μικροκυματικής ακτινοβολίας, οι οποίες έπειτα χαρακτηρίζονται ως προς τις χημικές και δομικές τους ιδιότητες στην υγρή και στερεά κατάσταση. Στη συνέχεια γίνεται ανάλυση της ιδιότητας φθορισμού τους και ερευνώνται οι μηχανισμοί που διέπουν τη φωτοφωταύγεια των νανοϋλικών, ενώ επίσης γίνεται σύνδεση αυτών με τα δομικά χαρακτηριστικά τους. Τέλος, ερευνώνται τεχνικές για την αξιοποίηση των Τελειών Άνθρακα στο σχεδιασμό και την ανάπτυξη μίκρο- και νανοσυσκευών, οι οποίες στη συνέχεια μελετώνται ως προς τα χαρακτηριστικά λειτουργίας τους.Η μελέτη των Τελειών Άνθρακα βρίσκεται ακόμα σε πρώιμο στάδιο με τη δομή και τις οπτικές τους ιδιότητες να αποτελούν πεδίο συζήτησης. Μέχρι στιγμής, η έρευνα των νέων αυτών υλικών έχει επικεντρωθεί κυρίως στις ιδιότητές τους στην υγρή φάση, ενώ αντίστοιχα οι περισσότερες εφαρμογές που έχουν διερευνηθεί αφορούν διαλύματά τους.Τα συμπεράσματα της παρούσας διδακτορικής διατριβής συμβάλουν στην περαιτέρω κατανόηση των χημικών χαρακτηριστικών και της δομής των Τελειών Άνθρακα και επιτυγχάνουν τη σύνδεσή τους με τους μηχανισμούς φθορισμού. Παράλληλα τα αποτελέσματα διευρύνονται και στις ιδιότητες των υλικών στη στερεά κατάσταση, που αποτελεί σημαντικό προαπαιτούμενο για την αξιοποίησή τους σε εφαρμογές σχεδιασμού και ανάπτυξης διατάξεων.Τέλος, οι μεθοδολογίες που αναπτύχθηκαν για πρώτη φορά στο πλαίσιο της παρούσας διατριβής επιτρέπουν την εναπόθεση, επεξεργασία και μορφοποίηση των Τελειών Άνθρακα υπό την μορφή λεπτών υμενίων με κλασικά εργαλεία της μικροηλεκτρονικής, όπως για παράδειγμα η οπτική λιθογραφία, προσφέροντας τη δυνατότητα για αξιοποίηση τους ως δομικά ενεργά στοιχεία στην κατασκευή μίκρο- και νανοσυσκευών και διατάξεων.
Το θέατρο στις χώρες της πρώην Γιουγκοσλαβίας και η σχέση του με το ελληνικό (1990-2016)
Authors: Ζαμπετάκη Ελπίδα
Published: March 2023

Η παρούσα διατριβή συγκαταλέγεται στο ευρύ πεδίο του βαλκανικού θεάτρου, εστιάζοντας στη μελέτη των χωρών της πρώην Γιουγκοσλαβίας και στη σχέση που εκείνες έχουν αναπτύξει με το ελληνικό θέατρο (1990-2016). Η έρευνα ξεκινά από την επίμαχη δεκαετία του ’80 και ’90, επιδιώκοντας να αναδείξει τους τρόπους με τους οποίους η αφύπνιση του εθνικισμού στη γιουγκοσλαβική κοινωνία αποτυπώθηκε στο θέατρο των σοσιαλιστικών ομοσπονδιών. Στη συνέχεια περιγράφει τις αλλαγές που σημειώθηκαν στον χώρο του θεάτρου την περίοδο της διεξαγωγής των γιουγκοσλαβικών πολέμων, αλλά και την περίοδο της δημιουργίας και λειτουργίας των νέων εθνικών κρατών. Τέλος, αναδεικνύει την άγνωστη -μέχρι πρότινος- σχέση του γιουγκοσλαβικού και μετσαγιουγκοσλαβικού θεάτρου με το ελληνικό.
Διερεύνηση της συμπεριφοράς και του επιπέδου συνειδητοποίησης των ατόμων στην πρόληψη δημιουργίας στερεών αστικών αποβλήτων, με έμφαση στο ρεύμα των αποβλήτων τροφίμων
Authors: Κρητικού Θεοδώρα
Published: March 2023

Στόχος της παρούσας διατριβής είναι η διερεύνηση της συμπεριφοράς τωνΕλλήνων, όσον αφορά στα παραγόμενα απόβλητα από τα νοικοκυριά τους, καθώςκαι η αναζήτηση των παραγόντων που επιδρούν στην πρόληψη της δημιουργίαςτους.Η πρόληψη δημιουργίας αποβλήτων είναι μία συγχωνευμένη συμπεριφορά, ηοποία προκύπτει ως σύνθετος συνδυασμός αποφάσεων, επιλογών και πρακτικώνπου μπορεί να εκδηλώνονται ως απόρροια του ατομικού αξιακού συστήματος, ή ωςαπλή μη ενσυνείδητη συνήθεια. Με την αξιοποίηση κατάλληλων εννοιολογικώνμοντέλων της περιβαλλοντικής ψυχολογίας, όπως η Θεωρία της ΠροσχεδιασμένηςΣυμπεριφοράς, δύναται να βελτιωθούν οι ιδέες μας για τον τρόπο που μπορεί ναεπιτευχθεί αυτή η συμπεριφορά, δημιουργώντας μια απλή διανοητική εικόνα τωνσχέσεων μεταξύ των παραγόντων που την επηρεάζουν, ακόμη και αν τα βαθύτερααίτια δεν είναι πλήρως κατανοητά.Τα δεδομένα της έρευνας συλλέχθηκαν μέσω δομημένου ερωτηματολογίου πουσυμπληρώθηκε από 921 άτομα, κατά το χρονικό διάστημα Απριλίου-Ιουλίου 2017 καιη στατιστική τους ανάλυση έγινε με τη χρήση του λογισμικού STATA 12.Πραγματοποιήθηκε Διερευνητική Ανάλυση Παραγόντων για τη συνοπτική περιγραφήτου μεγάλου πλήθους των παρατηρήσιμων μεταβλητών, μέσα από την ομαδοποίησήτους και την αναγωγή τους σε λανθάνουσες δομές. Ακολούθησε η ΕπιβεβαιωτικήΑνάλυση Παραγόντων, για τον έλεγχο της θεωρίας στην οποία βασίστηκαν οιδιατυπωμένες υποθέσεις και η στατιστική τεχνική των Μοντέλων ΔομικώνΕξισώσεων για την περιγραφή των αλληλοσυνδέσεων μεταξύ των μεταβλητών.Οι Υποκειμενικοί Κανόνες αναδείχθηκαν ως ο σημαντικότερος παράγοντας για τηνπρόβλεψη της Συμπεριφοράς πρόληψης δημιουργίας αποβλήτων συσκευασίας καιάλλων προϊόντων, ενώ η περιβαλλοντική στάση βρέθηκε να επιδρά μόνο στηνΠρόθεση και όχι στην ίδια τη Συμπεριφορά. Αντίθετα, διαπιστώθηκε έλλειψησυσχέτισης ανάμεσα στους Υποκειμενικούς Κανόνες και στη Συμπεριφοράπρόληψης δημιουργίας αποβλήτων τροφίμων, κάτι που αποδίδεται στο γεγονός ότιαυτή είναι μία συμπεριφορά μη ορατή στους άλλους και η υιοθέτησή της βασίζεταιπερισσότερο στο ατομικό ηθικό σύστημα και όχι στην κοινωνική πίεση. Με τηνανάδειξη της συμπεριφοράς αυτής σε κοινωνικό κανόνα θα αυξηθεί η πιθανότητανα την εκδηλώσουν περισσότεροι άνθρωποι ακόμα και αν δεν έχουν ισχυρή θετικήΣτάση ως προς αυτή. Οι αυτό-αναφερόμενες ποσότητες αποβλήτων τροφίμωνσχετίζονται με την Πρόθεση πρόληψης δημιουργίας αποβλήτων τροφίμων και με τιςσυνήθειες προγραμματισμού των αγορών. Καθοριστικότερος παράγοντας για τηνΠρόθεση εμφανίζεται η Γενική Περιβαλλοντική Στάση. Τα στοιχεία δείχνουν ότι οιΈλληνες έχουν πολύ καλή Γενική Περιβαλλοντική Στάση, ιδιαίτερα οι γυναίκεςηλικίας 45-54 ετών. Επιπλέον, τα Ελληνικά νοικοκυριά έχουν συστηματικήοργάνωση και προγραμματισμό των αγορών τους, όπως επίσης και συγκρατημένεςκαταναλωτικές συνήθειες. Πρόκειται για ένα νέο καταναλωτικό πρότυπο πουπροέκυψε στην Ελλάδα, περισσότερο ως αποτέλεσμα της μακροχρόνιαςοικονομικής λιτότητας και λιγότερο ως μια συνειδητή περιβαλλοντική επιλογή.
La "femme modèle" from the first communicant to the affectionate mother
Authors: Ανέστη Μαρία
Published: March 2023

Η διατριβή επικεντρώνεται στην διαμόρφωση και εξέλιξη της ηθικής ταυτότητας και της κοινωνικής θέσης των γυναικών στη Γαλλία, μέσα από έργα ζωγραφικής που δημιουργήθηκαν στα πρώτα τριάντα χρόνια της Τρίτης Δημοκρατίας (1870-1900). Το κείμενο μελετά την καλλιτεχνική πρόσληψη και εικαστική απόδοση «παραδοσιακών» γυναικείων ρόλων, αναλύοντας τους ιστορικο-κοινωνικούς παράγοντες που συνέβαλαν στην κατασκευή του γυναικείου ιδεώδους εκείνης της εποχής. Οι έννοιες της αγνότητας, της ευσέβειας, της συζυγικής αφοσίωσης και του μητρικού καθήκοντος που αναδύονται από έργα τέχνης αναλύονται στο φως συγγραμμάτων τα οποία επεξεργάζονται ζητήματα ηθικής φύσης. Ο πατριωτισμός και οι εθνικιστικές τάσεις της περιόδου που ακολούθησε τον Γαλλοπρωσικό πόλεμο είναι θέματα που επανέρχονται στα κεφάλαια της παρούσας μελέτης. Παράλληλα, εξετάζονται η προώθηση ορισμένων κοινωνικά χρήσιμων αντιλήψεων και ο τρόπος που η φιλοπατρία των Γάλλων επηρέασε την εκπαίδευση και τη μορφή του οικογενειακού θεσμού. Η διατριβή παρακολουθεί την ταραχώδη σχέση του ρεπουμπλικανικού καθεστώτος με την Ρωμαιοκαθολική Εκκλησία, από την εχθρότητα της δεκαετίας του 1880 μέχρί τις προσπάθειες για συμβιβασμό που έγιναν μετά το 1890. Τα κείμενα σημαντικών πνευματικών και ηθικών ταγών της εποχής παρείχαν το ιστορικό και θεωρητικό υπόβαθρο που επέτρεψε την κατανόηση μεγάλων κοινωνικών ανησυχιών συνδεδεμένων με την πληθυσμιακή μείωση και την ηθική παρακμή της Γαλλίας. Οι Γάλλοι καλλιτέχνες και εικονογράφοι συμμετείχαν μέσα από το έργο τους στις κορυφαίες ιδεολογικές αντιπαραθέσεις του καιρού τους. Η σχέση των γυναικών με τη θρησκεία αποτελεί ένα θέμα-κλειδί που διερευνάται εκτενώς. Οι ισχυροί δεσμοί του γυναικών με την Καθολική Εκκλησία σφυρηλατήθηκαν στη διάρκεια πολλών αιώνων, μέσα από την εκπαίδευση που έπαιρναν τα κορίτσια στο σπίτι ή στο σχολείο διαμορφώνοντας την ηθική τους ταύτοτητα. Η εικόνα της Γαλλίδας αστής ή χωρικής ως πιστής χριστιανής αναδεικνύεται μέσα από πολλά παραδείγματα.