bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between body mass index and varicocele among 211 989 Chinese reproductive‐age males
Authors: Hu Xuhuai , Yang Xueying , Zhao Jun , Guan Ting , Dai Qiaoyun , Yang Juan , Zhang Hongguang , Zhang Dongmei , Zhang Yue , Shang Li , Ma Xu
Published: April 2022

Objectives

To explore the relationship between body mass index and varicocele, the range of body mass index that leads to increased odds of varicocele, and the association between body mass index with the position and grade of varicocele.

Methods

We conducted a cross‐sectional study of 211 989 Chinese males aged 18–65 years participated in the National Free Pre‐conception Check‐up Projects from January 2013 to December 2018. Univariate and multivariate logistic regression models were constructed to assess the association between body mass index and varicocele.

Results

Overweight and obese males had 13.1% (odds ratio 0.869, 95% confidence interval 0.838–0.902) and 32.3% (odds ratio 0.677, 95% confidence interval 0.632–0.725) lower odds of varicocele than those with normal body mass index, respectively. The association between them was non‐linear, and males with body mass index of 17.74 to 23.09 kg/m2 had an increased odds of varicocele. The overweight and obese males had lower odds of left and bilateral varicocele, but the right varicocele odds was increased by 63.3% in obese males.

Conclusion

Body mass index was associated with the odds of varicocele among reproductive‐age males, but the odds varied by position. The effects of weight management and varicocele on fertility should be taken into account in fertility guidance.
Control of innate immunity by the cGAS‐STING pathway
Authors: Mosallanejad Kenta , Kagan Jonathan C
Published: April 2022

Within the cytoplasm of mammalian cells is a protein called cyclic GMP‐AMP synthase (cGAS), which acts to defend against infection and other threats to the host. cGAS operates in this manner through its ability to detect a molecular occurrence that should not exist in healthy cells – the existence of DNA in the cytosol. Upon DNA binding, cGAS synthesizes cyclic GMP‐AMP (cGAMP), a cyclic dinucleotide that activates the endoplasmic reticulum‐localized protein stimulator of interferon genes (STING). STING‐mediated signaling culminates in host defensive responses typified by inflammatory cytokine and interferon expression, and the induction of autophagy. Studies over the past several years have established a consensus in the field of the enzymatic activities of cGAS in vitro, as it relates to DNA‐induced production of cGAMP. However, much additional work is needed to understand the regulation of cGAS functions within cells, where multiple sources of DNA can create a problem of self and non‐self discrimination. In this review, we provide an overview of how the cGAS‐STING pathway mediates innate immune responses during infection and other cellular stresses. We then highlight recent progress in the understanding of the increasingly diverse ways in which this DNA‐sensing machinery is regulated inside cells, including how cGAS remains inactive to host‐derived DNA under conditions of homeostasis.
Assessment of occlusion and temporomandibular joint after placing preformed metal crowns on all primary molars in children
Authors: Shih Yi‐Chun , Yang Ran , Zou Jing
Published: April 2022

Background

Placing preformed metal crowns (PMCs) on all eight primary molars at one single clinical visit may disrupt a child's occlusion; the literature regarding the effects on occlusion and temporomandibular joint (TMJ) is scarce.

Aim

This study aimed to quantify the changes in occlusion using T‐Scan III and to investigate whether there was TMJ dysfunction after placing eight PMCs at the same time.

Design

In this study, we enrolled children with severe early childhood caries (S‐ECC) and dental phobia, who needed eight PMCs to be placed under general anesthesia. The participants underwent occlusal examinations with a computed occlusal analysis system. The vertical dimension of occlusion (VDO) was measured using a dental vertical dimension gauge, TMJ dysfunction signs were recorded by the clinical dysfunction index (Di), and TMJ dysfunction symptoms were recorded using a questionnaire. The data were collected before treatment (T0), 1 week after treatment (T1), and 1 month (T2) and 3 months (T3) after treatment during follow‐up visits. Repeated‐measures analysis of variance and Friedman's test were used for occlusal data analysis. In addition, the Di and symptoms were compared over time using McNemar's test.

Results

Forty patients (mean age = 4.25 ± 0.63 years, age range = 3–5 years, 21 boys and 19 girls) were followed up for 3 months. The occlusal contact area 3 months after treatment did not return to the pretreatment status (p = .03). The total of force at the 3‐month follow‐up visit increased significantly (p = .009) compared with that at the pretreatment. The asymmetric ratio of occlusal force at the 1‐month follow‐up visit was restored to pretreatment. Concerning the occlusion time, no significant changes were observed for any time intervals (p = .069). The VDO was recovered at the 1‐month follow‐up visit. The statistical analysis of TMJ dysfunction showed no significant differences in the Di and TMJ dysfunction symptoms before and after treatment (p > .05).

Conclusion

After undergoing eight PMC restorations under general anesthesia, occlusal re‐equilibration was attained approximately after 1 month. There were no significant signs and symptoms of TMJ dysfunction after treatment.
Comparing the care experiences of Medicare Advantage beneficiaries with and without Alzheimer's disease and related dementias
Authors: Meyers David J. , Rivera‐Hernandez Maricruz , Kim Daeho , Keohane Laura M. , Mor Vincent , Trivedi Amal N.
Published: April 2022

Background

The Medicare Advantage (MA) program is rapidly growing. Limited evidence exists about the care experiences of MA beneficiaries with Alzheimer's Disease and Related Dementia (ADRD). Our objective was to compare care experiences for MA beneficiaries with and without ADRD.

Methods

We examined MA beneficiaries who completed the Medicare Advantage Consumer Assessment of Healthcare Providers and Systems (CAHPS) and used inpatient, nursing home, or home health services in the past 3 years. We classified beneficiaries with ADRD using the presence of diagnosis codes in hospitals, nursing homes, and home health records. Our key measures included overall ratings of care and health plan, and indices of receiving timely care, care coordination, receiving needed care, and customer service. We compared differences between beneficiaries with and without ADRD using regression analysis adjusting for demographic, health, and plan characteristics, and stratifying by proxy response status.

Results

Among beneficiaries sampled by CAHPS, 22.2% with ADRD completed the survey compared to 38.5% without ADRD. Among proxy responses, beneficiaries with ADRD were 4.2 (95% CI: 0.1–8.4) percentage points less likely to report a high score for receiving needed care, and 3.5 percentage points (95% CI: 0.2–6.9) less likely to report a high score for customer service. Among non‐proxy responses, those with ADRD were 9.0 (95% CI: 5.5–12.5) percentage points less likely to report a high score for needed care, and 8.5 (95% CI: 5.4–11.5) percentage points less likely to report a high score for customer service.

Conclusions

ADRD respondents to the CAHPS were more likely to be excluded from CAHPS performance measures because they did not meet eligibility requirements and rates of non‐response were higher. Among responders with or without a proxy, MA enrollees with an ADRD diagnosis reported worse care experiences in receiving needed care and in customer service than those without an ADRD diagnosis.
Nurses' attitudes towards the use of physical restraint in psychiatric care: A systematic review of qualitative and quantitative studies
Authors: Wong Wai Kit , Bressington Daniel Thomas
Published: April 2022

Accessible Summary

What is known on the subject?

Application of physical restraint is a common practice to protect service users and staff in psychiatric care.

Nurses' attitudes towards physical restraint and its influencing factors in psychiatric settings in different countries are variable.

Previous reviews include studies on different coercive methods, making it difficult to differentiate attitudes specific to physical restraint.

What this paper adds to existing knowledge?

Nurses' attitudes were marked by negative feelings and moral conflict towards the use of physical restraint and consider it a necessary nursing intervention and a last resort.

The barriers for restraint‐free environment practice included contextual demand, lack of knowledge on restraint and lack of alternatives to restraint.

What are the implications for practice?

Nurse educators should develop and evaluate related educational training programmes to promote the development of alternative effective skills in handling violence instead of physical restraint.

Policy makers should develop strategies to remove the barriers to a restraint‐free environments.

Introduction

Physical restraint is common in psychiatric care; nurses' attitudes are crucial as nurses often implement the procedure. Previous reviews include studies exploring coercive methods but do not specifically focus on physical restraint.

Aims

This integrated mixed‐method systematic review aimed to examine nurses' attitudes towards the use of physical restraint in psychiatric care and the factors influencing these attitudes.

Methods

Six databases were searched from 2000 to 2021. Thematic integrative analysis was used to synthesize the data.

Results

Ten studies were included. Five themes encapsulate nurses' attitudes towards physical restraint: “emotional responses,” “moral conflicts,” “ensuring safety for all,” “a necessary nursing intervention” and “a last resort.” Three themes were identified for factors influencing attitudes: “contextual demands,” “level of knowledge” and “alternatives to restraint.”

Discussion

Nurses' attitudes were marked by negative feelings and moral conflict towards the use of physical restraint. However, nurses applied physical restraint as an ordinary nursing intervention. Educational interventions and the leadership role may facilitate the change of current practice to a restraint‐free environment.

Implications for Practice

Mental health nurses should work to remove the barriers to restraint‐free environment and develop effective skills that can be used as alternatives to physical restraint.
Sleep quality in persons with mental disorders: Changes during inpatient treatment across 10 diagnostic groups
Authors: Meule Adrian , Riemann Dieter , Voderholzer Ulrich
Published: April 2022

Sleep disturbances have been documented across a range of mental disorders, particularly depression. However, studies that have examined sleep quality in large samples of different diagnostic groups and that report how sleep quality changes during inpatient treatment have been scarce. This retrospective, observational study examined changes in sleep quality during inpatient treatment at a psychosomatic hospital in Germany from admission to discharge as a function of 10 diagnostic groups. Data of 11,226 inpatients were analysed who completed the Pittsburgh Sleep Quality Index as part of the routine diagnostic assessment at admission and discharge. All diagnostic groups showed impaired sleep quality (Pittsburgh Sleep Quality Index score > 5). Patients with trauma‐related disorders had the lowest sleep quality and patients with obsessive–compulsive disorder had the highest sleep quality. While sleep quality significantly improved in each diagnostic group, changes differed in size, with patients with trauma‐related disorders showing the smallest improvement and patients with eating disorders showing the largest improvement. The current study documents impaired sleep quality in inpatients with mental disorders and shows that sleep problems are a transdiagnostic feature in this population. Results also resonate with earlier suggestions that sleep disturbances represent a key feature of trauma‐related disorders in particular and the need for trauma‐specific sleep interventions. Although sleep quality significantly improved during disorder‐specific inpatient treatment in all diagnostic groups, average scores were still clinically elevated at discharge. Thus, a future avenue would be to examine whether adding sleep‐specific treatment elements fosters both short‐ and long‐term success in the treatment of mental disorders.
Factors associated with successful passage of the American College of Veterinary Internal Medicine general examination
Authors: Boudreaux Bonnie , Hill Tracy
Published: April 2022

Background

Board certification relies on passing the American College of Veterinary Internal Medicine (ACVIM) general examination. Pass rates might depend on properties of residency training programs (RTP).

Hypothesis

We hypothesized that <4 weeks of dedicated study time, lack of board preparation lectures, status as a re‐taker, and private practice RTP would result in lower pass rates of the ACVIM general examination.

Subjects

Two hundred forty‐eight ACVIM general examinees.

Methods

Cross‐sectional study. Examinees were surveyed using a Qualtrics survey over a 3‐year period. Factors included: study weeks, on‐call duty, board preparation lectures, academic or private practice program, and status as a re‐taker.

Results

First‐attempt examinees were more likely to pass (P < .0001, OR 5.12, 95% CI [2.53, 10.52]). For first‐attempt examinees, on‐call duty during study weeks resulted in a lower pass rate (P = .002, OR 0.31, 95% CI [0.16, 0.67]). General didactic and specific board‐preparation lectures resulted in higher pass rates (P = .003, OR 3.08, 95% CI [1.44, 6.61]; P = .02, OR 3.04, 95% CI [1.20, 7.68]). Diplomate‐led board‐preparation lectures resulted in higher pass rates than resident‐led (P = .007, OR 10.67, 95% CI [1.75, 64.91]). Using a mixed effect logistic model, predicted pass rates were highest with both lack of on‐call duty and presence of didactic lectures (predicted pass rate 95%, 95% CI [0.87, 0.98]).

Conclusions and Clinical Importance

To optimize pass rates, RTP should provide study time without on‐call duty. Provision of didactic lectures and specific board‐preparation lectures by diplomates assist in candidate preparation.
Carryover effects of pesticide exposure and pond drying on performance, behavior, and sex ratios in a pool breeding amphibian
Authors: Thompson C. M. , Sweeney M. R. , Popescu V. D.
Published: April 2022

Neonicotinoid pesticides are widely used to combat agricultural and forest pests, yet the extent of their biological effects and synergies with other stressors is not well understood, particularly for species with complex life cycles such as amphibians. While there is extensive research on the impacts of agricultural chemicals on amphibians (particularly larval stage), research on the effects of the new class of widely used neonicotinoid pesticides across life stages is lacking. In this study, we used aquatic mesocosm manipulations and terrestrial locomotor and behavior trials to evaluate demographic, behavioral, and fitness carryover effects of sublethal neonicotinoid pesticide (imidacloprid) exposure and hydroperiod length on the wood frog (Rana sylvatica), a model organism. We found that the interaction of imidacloprid exposure and shorter hydroperiod led to decreased larval survival to metamorphosis (0.54 ± 0.14, compared to control 0.75 ± 0.04). When exposed to their thermal optimum (18°C), individuals exposed to imidacloprid as larvae had higher terrestrial locomotor performance (284.08 ± 28.62 body lengths traveled) but also experienced the largest decreases in performance (147.88 ± 19.27 fewer body lengths traveled) after terrestrial imidacloprid exposure. In a 48‐h substrate choice experiment, post‐metamorphic frogs did not show behavioral avoidance of imidacloprid‐treated substrates. Finally, we observed a skewed juvenile sex ratio from imidacloprid treatments (~10% fewer males compared to control), and we were not able to assign 15.7% of individuals from imidacloprid treatments to either sex due to ambiguous reproductive organ morphology. Our empirical assessment of carryover effects of chemical exposure and pond drying provides insights into the physiological capacity of taxa with complex lifecycles to respond to contaminants experienced at multiple life stages and informs best practices for neonicotinoid pesticide use in forest settings and conservation strategies for pond‐breeding amphibians.
miR‐2392 functions as tumour suppressor and inhibits malignant progression of hepatocellular carcinoma via directly targeting JAG2
Authors: Sun Bin , Ji Weidan , Liu Chunying , Lin Xuejing , Chen Lei , Qian Haihua , Su Changqing
Published: April 2022

Background & Aims

Dysregulation of microRNA (miRNA) expression in various cancers and their vital roles in malignant progression of cancers are well investigated. Our previous studies have analysed miRNAs that promote malignant progression in hepatocellular carcinoma (HCC); this study aims to systematically elucidate the mechanism of metastasis suppressor miRNAs in HCC.

Methods

High‐throughput RNA sequencing was used to identify anti‐metastatic miRNAs. The relative expression levels of miRNAs were confirmed by qRT‐PCR. The biological functions of miRNAs were detected in vitro and in vivo. Circulating tumour cells (CTCs) were enriched from blood samples of HCC patients and cultured by three‐dimensional (3D) system. Kaplan–Meier and Cox regression were used to analyse the value of potential target mRNAs on overall survival.

Results

miR‐2392 was significantly down‐regulated in HCC. Overexpression of miR‐2392 suppressed proliferation, clonogenicity, mobility, spheroid formation and maintenance of cancer stem cells (CSC)‐like characteristics in HCC cells. CTCs from HCC patients with lower serum miR‐2392 level had stronger cell spheroid formation ability. A negative correlation between the content of miR‐2392 in serum and the number of CTC spheroids had been found. We identified Jagged2 (JAG2) as a direct target of miR‐2392. miR‐2392 inhibited the expression of JAG2 by targeting 3’‐UTR of JAG2. Down‐regulation of JAG2 inhibited the overexpression effects of miR‐2392 in vitro and in vivo. JAG2 is highly expressed in HCC and is closely related to poor prognosis and survival of patients.

Conclusions

miR‐2392 may play a role as a tumour suppressor to guide the individualized precise treatment of HCC.
Mental health self‐disclosure: From stigma to empowerment
Authors: Hauer Karen E. , Hung Erick
Published: April 2022

Hauer and Hung argue that it is time to confront and disrupt structures within medicine that perpetuate mental health stigma and cause harm.
How to use imaginary cases in normative theory
Authors: Dowding Keith
Published: April 2022

This paper defends the use of imaginary cases in normative theorizing. Imaginary cases are used as a part of an argument and should be assessed in terms of the role they play within arguments. The paper identifies five ways in which they are used and then uses some of the best examples to bring out how they contribute to debates. While not directly akin to empirical experiments, criticisms of imaginary cases can be represented in terms of the well‐known distinction between internal and external validity in social science experiments. While imaginary cases can suffer from internal and external validity problems, these do not constitute a decisive critique of their use as a method of analysis. Criticisms of imaginary cases should detail the precise form in which they are used, and why any particular use is invalid, internally or externally, in the context of the argument for which the case is presented.
Might Zika virus‐associated microcephaly's severity impact deciduous tooth eruption and orofacial structures?
Authors: Vaz Fernando Flávio Souza , da Silva Sobrinho Adriano Referino , Athayde Fernanda Regina Ribeiro Santos , de Vasconcelos Carvalho Marianne , Sette‐de‐Souza Pedro Henrique , Ferreira Stefânia Jeronimo
Published: April 2022

Objective

to investigate the impact of the severity of microcephaly caused by the Zika virus (MCZ) on tooth eruption and orofacial structures of children.

Design

This case series study developed the research at the Mens Sana Rehabilitation Center, Arcoverde, Brazil. The study included 27 children diagnosed with MCZ. We performed the data collection in June 2018 through a questionnaire answered by the legal guardians, followed by a clinical examination of the children. The data were analyzed by the Mann–Whitney and Fisher's exact tests (p = 0.05).

Results

The final sample was composed of 20 children. Of these, 13 (35.0%) had severe microcephaly, 5 (30.0%) had altered sequence of tooth eruption, 10 (50.0%) had delayed eruption, and the mean number of decayed teeth was 2.3. The most identified orofacial changes were teeth grinding habit (65.0%), difficult chewing (50.0%), and non‐nutritive sucking (50.0%). The Mann–Whitney test showed that the severity of microcephaly did not affect tooth eruption (p = 0.581). The Fisher's exact test showed that the severity of microcephaly was not associated with orofacial changes (p > 0.05).

Conclusions

The severity of MCZ does not seem to influence changes in deciduous tooth eruption and the presence of orofacial anomalies.
Addition of epidermal growth factor receptor inhibitors to standard chemotherapy increases survival of advanced head and neck squamous cell carcinoma patients: A systematic review and meta‐analysis
Authors: Kiss Fruzsina , Pohóczky Krisztina , Görbe Anikó , Dembrovszky Fanni , Kiss Szabolcs , Hegyi Péter , Szakó Lajos , Tóth Lilla , Ezer Éva Somogyiné , Szalai Eszter , Helyes Zsuzsanna
Published: April 2022

Head and neck squamous cell carcinoma (HNSCC) is among the common tumors associated with high mortality. The aim of our meta‐analysis was to determine how additional anti‐epidermal growth factor receptor (EGFR) therapy to standard chemotherapy affects the progression‐free (PFS) and overall survival (OS) of the patients, besides the most common side effects. We used CENTRAL, MEDLINE, and Embase databases until October 26, 2020, and included 13 eligible randomized controlled trials in our systematic research. The pooled hazard ratios (HR) for the main outcomes from the original data were estimated and for the other dichotomous outcomes, odds ratios (ORs) with their 95% confidence intervals (CI) were calculated. Addition of EGFR inhibitors to conventional chemotherapy significantly decreased the death and disease progression (for PFS HR: 0.68, 95% CI: 0.55–0.81, I2 = 65.5%, p = 0.005) and mortality (for OS HR: 0.83, 95% CI: 0.72–0.94, I2 = 42.3%, p = 0.076). In the EGFR inhibitor group, we revealed an increased chance of the over Grade 3 skin rashes (OR: 4.86; 95% CI: 1.52–15.49, I2 = 2.3%, p = 0.407), and all Grade skin rashes (OR: 18.32, 95% CI: 8.07–41.60, I2 = 56.6%, p = 0.032). Despite their unwanted dermatological side effects, the addition of EGFR inhibitors is recommended to be included in advanced HNSCC therapy.
Fear and Greed: Mapping the Australian Debate on China's Economic Sanctions
Authors: Xue Ye
Published: April 2022

Since Canberra's embrace of a more confrontational China policy in the last four years, Australian scholars and analysts have begun to debate China's economic retaliation against Australia. This group of people, also known as “issue publics,” have special functions in the Australian foreign policymaking process. This article covers four years of debate within Australian issue publics since early 2017. It aims to document the major arguments that have emerged during this heated public debate on China's sanctions policy, Australia's vulnerability and resilience, and Australia's response to China's economic coercion. The review shows that the arguments expressed in this debate have been polarized. The black‐and‐white assessment of Chinese and Australian national interests reshaped the social atmosphere for policymaking. This somewhat contributed to the current stuckedness and ambiguity of Australia's China policy.
Plasma exchange and infliximab as a third‐line therapy for refractory infantile Kawasaki disease
Authors: Ansai Hideto , Masuda Hiroshi , Nakao Hiro , Nishimura Nao , Kubota Mitsuru
Published: April 2022

Background

The treatment for Kawasaki disease (KD) patients refractory to intravenous immunoglobulin (IVIG) therapy is still controversial, and the efficacy of plasma exchange (PE) and infliximab (IFX) therapy for infantile KD is unknown.

Methods

A total of 22 infantile KD patients refractory to initial and additional IVIG, who received either PE or IFX as third‐line therapy from October 2008 to February 2020 were examined retrospectively. The patients’ sex, age, days of first IVIG, days of PE or IFX therapy, laboratory data preceding PE or IFX therapy, coronary artery lesions (CALs), and adverse effects were investigated.

Results

Thirteen patients received PE and nine patients received IFX as the third‐line therapy. For the median age at onset, the median days of first IVIG and PE or IFX, and pre‐PE or IFX therapy blood test results, there were no significant between‐group differences. At admission, and before and after the third‐line therapy, there were also no significant differences in occurrence of CALs. The frequency of serious adverse events was significantly higher in the PE group than in the IFX group.

Conclusions

Although there were no significant differences in patient background, blood test results, or frequency of CALs, the frequency of adverse events was significantly higher in the PE group. With the trend of expansion of IFX therapy for KD patients refractory to IVIG, the role of PE as the additional therapy may become more limited.
The utility of core‐needle tumor biopsy for pediatric patients
Authors: Kawakubo Naonori , Takemoto Junkichi , Koga Yuhki , Hino Yuko , Tamaki Akihiko , Kohashi Kenichi , Ono Hiroaki , Oda Yoshinao , Ohga Shouichi , Tajiri Tatsuro
Published: April 2022

Background

Core‐needle biopsy (CNB) is used less frequently for the diagnosis of tumors in pediatric patients. In this report, the utility and safety of CNB for pediatric patients are described.

Methods

The medical records of patients who underwent CNB at the Department of Pediatric Surgery, Kyushu University Hospital from April 2020 to November 2021 were retrospectively reviewed. A 14 G or 16 G BARDMISSION Disposable Needle Instrument was used. For the diagnosis of neuroblastoma, a 14 G needle was selected; for the diagnosis of other tumors a 16 G needle was selected.

Results

During the above period 17 CNBs were performed in 17 patients, and the median patient age was 8 years (range, 15 days–19 years). The pathological diagnoses of the tumors were as follows: neuroblastoma, n = 6; lymphoma, n = 3; hepatoblastoma, n = 2; and others, n = 6. The quantity and quality of all tumor samples obtained by CNB was sufficient to make a diagnosis. The postoperative course after CNB was uneventful in most cases, with the exception of one case of hepatoblastoma (pseudoaneurysm).

Conclusions

Core‐needle biopsy is useful for pediatric patients. Sufficient tumor specimens were able to be obtained in all cases, irrespective of the type of tumor, and an accurate diagnosis could be made.
Influence of endometritis on the follicular dynamics, recovery, quality, gene expression, nuclear maturation and in‐vitro developmental competence of oocytes in Sahiwal cattle
Authors: Saleem Muhammad , Yousuf Muhammad Rizwan , Ghafoor Aamir , Riaz Amjad
Published: April 2022

Uterine infections often lead to culling of valuable animals from a herd, resulting in genetic drain. The genetic potential of problematic females could be harvested by in‐vitro embryo production. The objective of this study was to evaluate the effect of clinical endometritis on follicular dynamics, recovery, quality, gene expression, nuclear maturation and in‐vitro developmental competence of oocytes in Sahiwal cattle. The B‐mode ultrasonography was performed to examine the uterus for the presence of pus. Based on the history and reproductive examination of cows, a total of twelve (n = 12) Sahiwal cattle were selected for the experiment: (1) healthy group (n = 6) and (2) clinical endometritis group (n = 6). The 1st ovum pick‐up (OPU) was conducted on day 165 postpartum. The collected cumulus oocytes complexes (COCs) were graded into A, B, C and D grades depending on the number of layers of cumulus cells and homogeneous nature of cytoplasm. Nuclear maturation was assessed by staining the oocytes with Hoechst 33,342. The results revealed that the number of medium‐sized follicle (1.3 ± 0.1 versus 0.6 ± 0.1) and total number of follicles (9.1 ± 0.7 versus 6.6 ± 0.7) were higher (p < .05) in the healthy group as compared to clinical endometritis group, respectively. Similarly, the number of oocytes recovered (5.0 ± 0.4 versus 2.8 ± 0.4), oocytes with grade A, B and C (2.9 ± 0.3 versus 1.5 ± 0.3), proportion of oocytes with grade A or B (33 ± 0.0 versus 20 ± 0.1) and nuclear maturation (68 ± 0.1 versus 55 ± 0.1) were also higher (p < .05) in the healthy group as compared to clinical endometritis group, respectively. Perhaps, cleavage rate (55.1 ± 0.1 versus 46.2 ± 0.1) and blastocyst rate (29.7 ± 0.0 versus 26.3 ± 0.1) did not differ (p > .05) between the groups. Likewise, the expression level of growth differentiation factor 9 (GDF9) and bone morphogenetic protein 15 (BMP15) in immature oocytes did not differ (p > .05) between both the groups. In conclusion, clinical endometritis has a negative effect on follicular dynamics, oocyte recovery, oocyte quality and nuclear maturation; furthermore, the developmental competence of COCs is not compromised by it.
Effects of isometric loading intensity on patellar tendon microvascular response
Authors: Earp Jacob E. , Gesick Haley , Angelino Domenic , Adami Alessandra
Published: April 2022

Acute increases in tendon blood flow and oxygenation after stress (i.e., hyperemic response) can enhance tendon recovery. While loading intensity is a fundamental part of resistance training programs, its effects on tendon's hyperemic response are unknown. This study aimed to compare acute changes in total (total hemoglobin [THb]) and oxygenated hemoglobin (HbO2) concentrations in the patellar tendon after isometric exercise at different intensities. Thirteen participants performed 8 (5 s) isometric knee extensions at 25%, 50%, and 75% maximal load (maximal voluntarily isometric contraction [MVIC]), separated by 20 min recovery, prescribed in randomized and counterbalanced order. Changes in patellar tendon THb, HbO2 and deoxygenated hemoglobin (HHb) in response to exercise at each intensity were measured using near‐infrared spectroscopy. Post‐exercise, HbO2 increased with 50% ( = 0.305, f = 5.26, p < 0.01) and 75% ( = 0.245, f = 4.56, p < 0.01) but not 25% ( = 0.088, f = 1.16, p = 0.339) MVIC, while THb increased in 50% ( = 0.305, f = 5.26, p = 0.01) but not 25% ( = 0.067, f = 0.865, p = 0.51) or 75% ( = 0.126, f = 1.729, p = 0.14) MVIC. Additionally, increasing load from 25% to 50% MVIC resulted in greater THb (f = 2.459, p = 0.43), HbO2 (f = 3.389, p = 0.13) and HHb (f = 0.320, p = 0.01) post‐exercise responses, but no differences were observed between 50% and 75% MVIC (THb: f = 0.748, p = 0.59; HbO2: f = 0.825, p = 0.54; HHb: f = 0.713, p = 0.62). Our results suggest there is a loading threshold at ~50% MVIC at which the tendon hyperemic response is fully achieved. Training above this intensity is not expected to provide any additional change to the tendon microvascular response. Therefore, moderate loading seems to be sufficient to fully elicit the patellar tendon hyperemic response that's believed to stimulate tendon healing.
Active video game on children and adolescents' physical activity and weight management: A network meta‐analysis
Authors: Ho Robin Sze‐Tak , Chan Eddie Ka‐Yui , Liu Kenneth Kang‐Yue , Wong Stephen Heung‐Sang
Published: April 2022

We synthesized evidence on the effectiveness of active video games (AVGs) versus no AVG‐applied comparators on various physical activity (PA) levels and weight management outcomes in children and adolescents. We analyzed the comparative evidence on different sub‐categories of AVGs and ranking the best option. An overview of systematic reviews (SRs) and network meta‐analysis (NMA) (PROSPERO: CRD42021248499) was employed. A search for relevant literature published in English was conducted in six electronic databases from their inception until April 2021. SRs consisting of randomized control trials (RCTs) and satisfying our PICOS inclusion criteria were included. RCTs included were a comparison of groups among children and adolescents between 6 and 21, where groups with AVG interventions were compared with groups without them. Direct head‐to‐head pairwise meta‐analyses were conducted using weighted mean difference between the two groups, and the comparative effectiveness of different sub‐categories of AVGs was analyzed indirectly using NMA. Overall, 17 SRs were identified from the 6036 screened citations. Of these, 350 citations were retrieved, and 12 RCTs were finally included. Compared with no AVG group, AVG groups were shown to be more effective in achieving vigorous, moderate‐to‐vigorous, and moderate PA levels, and decreased BMI and body fat. NMA showed that rhythmic dance games had the highest probability of being the most effective sub‐category for reducing BMI. AVGs are effective in attaining vigorous, moderate to vigorous, and moderate PA levels, and reducing BMI and body fat among children and adolescents. Dance appears to be the best option for reducing BMI among AVG subcategories.
Recognition of the HLA‐A*11:398 allele in a Chinese patient and his sister
Authors: Shi Xiu‐Min , Li Pei‐Tong , Hu Rui‐Ping , Han Wei , Gao Su‐Jun
Published: April 2022

HLA‐A*11:398 has one nonsynonymous nucleotide change from HLA‐A*11:01:01:01 at nucleotide 709, changing Isoleucine 213 to Valine.
Exploring Adult Educators’ Views About Mentoring as a Tool for Their Teaching Work-A Greek Empirical Study
Authors: Koutsoukos Marios
Published: April 2022

Since the Lisbon European Council in 2000, there has been a growing interest in the European in Europe concerning mentoring in adult education, which, however, has focused primarily on adult learners as beneficiaries, and is linked to their participation in educational programs, as well as their inclusion in the labour market. The aim of this paper is to present a research study aimed at exploring Greek adult educators’ views on mentoring. The findings indicated that adult educators are favourably disposed to mentorship and they describe a framework which incorporates the concepts of teamwork and reflection.
La relación járis-phýsis en Evagrio Póntico a la luz de la tradición clásica: un camino epistemológicamente válido para dilucidar las proyecciones psicoterapéuticas de su obra
Authors: Vázquez Santiago Hernán , Gargiulo María Teresa
Published: April 2022

En los últimos años, un número creciente de estudios ha presentado, de una u otra manera, diversas proyecciones psicoterapéuticas de determinadas prácticas espirituales del primer monacato cristiano. Ahora bien, creemos que en tales estudios puede existir el peligro de extrapolar términos, preguntas y discusiones anacrónicas y ajenas al contexto original de los padres. En orden a salvar esta dificultad trataremos de dilucidar el modelo de integración psicoespiritual de Evagrio Póntico mediante su particular compresión de las relaciones efectivas entre gracia y naturaleza. Esta comprensión será alcanzada a partir del análisis de las nociones de magia y phýsis en las dos tradiciones clásicas que más impactaron en su obra: la platónica y la hipocrática.Enfocar de este modo el modelo evagriano nos permitirá traducir y comprender el actual interés por su modelo psicoespiritual, en los mismos términos en los que es formulado por nuestro autor monástico. La obra evagriana renueva y repite el rechazo hipocrático y platónico hacia la magia. El monje del Ponto comparte, con aquella tradición profana, su comprensión de la magia en cuanto acto de impiedad hacia el orden divino inscrito en la phýsis. Este rechazo hacia la hechicería y la magia es integrado por nuestro autor en una nueva síntesis cristiana, que se esfuerza por evitar toda adjudicación mágica o milagrosa a la gracia. Ahora bien, en la medida en que Evagrio se aleja de una concepcion mágica de la gracia, se puede encontrar en sus escritos un bagaje de conocimientos teórico-prácticos referidos a la salud psíquico-espiritual. Nuestro autor está particularmente interesado en especificar cómo ella opera en las dinámicas cognitivo-emocionales que intervienen en los procesos de la cura del alma, sin contradecir o suspender mágicamente las leyes inmanentes de la phýsis.
DynaRing: A Patient-Specific Mitral Annuloplasty Ring With Selective Stiffness Segments
Authors: Frishman Samuel , Kight Ali , Pirozzi Ileana , Maddineni Sainiteesh , Imbrie-Moore Annabel M. , Karachiwalla Zulekha , Paulsen Michael J. , Kaiser Alexander D. , Woo Y. Joseph , Cutkosky Mark R.
Published: April 2022

Annuloplasty ring choice and design are critical to the long-term efficacy of mitral valve (MV) repair. DynaRing is a selectively compliant annuloplasty ring composed of varying stiffness elastomer segments, a shape-set nitinol core, and a cross diameter filament. The ring provides sufficient stiffness to stabilize a diseased annulus while allowing physiological annular dynamics. Moreover, adjusting elastomer properties provides a mechanism for effectively tuning key MV metrics to specific patients. We evaluate the ring embedded in porcine valves with an ex-vivo left heart simulator and perform a 150 million cycle fatigue test via a custom oscillatory system. We present a patient-specific design approach for determining ring parameters using a finite element model optimization and patient MRI data. Ex-vivo experiment results demonstrate that motion of DynaRing closely matches literature values for healthy annuli. Findings from the patient-specific optimization establish DynaRing's ability to adjust the anterior–posterior and intercommissural diameters and saddle height by up to 8.8%, 5.6%, 19.8%, respectively, and match a wide range of patient data.
Lower-Limb Muscle Activity During Aquatic Treadmill Running in Individuals With Anterior Cruciate Ligament Reconstruction
Authors: So Billy Chun-Lung , Kwok Man-Ying , Chan Yin-Leuk , Lam Hing-Fung Kevin , Chang Hei-Tung Hilda , Chan Tsz-Kit , Leung Chi-Yin Ken , Tse Hon-Ting
Published: April 2022

Introduction: While anterior cruciate ligament (ACL) tears are commonly managed with ACL reconstruction (ACL-R), 35% of ACL-R individuals fail to return to the preinjury elite sport level. Persistent neuromuscular deficits in the hamstrings and quadriceps have been observed. It has been proposed that aquatic therapy can be used to optimize neuromuscular control after ACL-R. Objectives: (1) To compare muscle activity in ACL-R individuals during aquatic treadmill (ATM) running at different water depths and (2) to compare muscle activity during ATM running between ACL-R and healthy individuals. Methods: A total of 38 participants, including 18 ACL-R individuals (mean postoperative time [SD] = 25.8 [25.0] mo) and 20 healthy individuals were recruited. Muscle activity of biceps femoris (BF), rectus femoris (RF), tibialis anterior, and medial gastrocnemius during land treadmill and ATM running at mid-shin, mid-thigh, and waist levels were recorded using surface electromyography (sEMG).  The sEMG signals of the selected muscles were normalized and expressed in % Maximal Voluntary Contraction (%MVC). Muscle activity of the ACL-R, ACL-contralateral, and healthy control limbs at different water depths was compared. Results: Among the 3 groups, the ACL-R group demonstrated the most prominent percentage increase of 101.97% (P = .001) at mid-shin level, 139.66% (P = .001) at mid-thigh level, and 141.97% (P < .001) at waist level, respectively, in %MVC when compared to land. In the ACL-R group, muscle activity of BF in the stance phase (BFSt) was significantly higher than the control group on land at all water depths. Muscle activity of RF in the swing phase (RFSw) in the ACL-R group significantly increased in all water depths immersion when compared to land, respectively. Conclusion: This study showed an increasing trend in muscle activity of BFSt and RFSw in ACL-R individuals during ATM running at increased water depths. ATM running could be implemented as neuromuscular training in rehabilitation after ACL-R.
All-weather thermochromic windows for synchronous solar and thermal radiation regulation
Authors: Lin Chongjia , Hur Jun , Chao Christopher Y. H. , Liu Gongze , Yao Shuhuai , Li Weihong , Huang Baoling
Published: April 2022

Adaptive control of solar and thermal radiation through windows is of pivotal importance for building energy saving. However, such synchronous passive regulations are challenging to be integrated into one thermochromic window. Here, we develop a solar and thermal regulatory (STR) window by integrating poly(
N
-isopropylacrylamide) (pNIPAm) and silver nanowires (AgNWs) into pNIPAm/AgNW composites. A hitherto unexplored mechanism, originating from the temperature-triggered water capture and release due to pNIPAm phase transition, is exploited to achieve simultaneous regulations of solar transmission and thermal emission. The STR window shows excellent solar modulation (58.4%) and thermal modulation (57.1%) and demonstrates effective regulation of indoor temperatures during both daytime and nighttime. Compared to other thermochromic technologies, the STR window reduces heat loss in cold environment while promotes heat dissipation in hot conditions, achieving efficient energy saving in all weathers. This dual solar and thermal regulation mechanism may provide unidentified insights into the advancement of smart window technology.
[68Ga]Ga-DOTA-TATE uptake in subacute stroke following craniotomy for meningioma: a diagnostic tool for stroke?
Authors: Cappuzzo Justin , Popoola Daniel , Prasad Dheerendra , Lipinski Lindsay
Published: April 2022

Gallium 68 (68Ga) 1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid labelled octreotate ([68Ga]Ga-DOTA-TATE) positron emission tomography (PET) is an established imaging technique for identifying tumours of neuroendocrine origin and meningiomas; the radiotracer binds to somatostatin receptor type 2 (SSTR2), which is richly expressed by these malignancies. Here, we present a rare case hinting at novel ischaemic stroke detection by [68Ga]Ga-DOTA-TATE PET scan. The scan was performed 14 days post resection of an atypical meningioma with the intention to assess the extent of residual tumour for radiosurgical treatment of the operative cavity. Surprisingly, the [68Ga]Ga-DOTA-TATE PET-avid region corresponded to an area of perioperative subacute ischaemic stroke detected by MRI. This case corroborates the two previously reported cases of incidental detection of ischaemic stroke during routine [68Ga]Ga-DOTA-TATE PET imaging, collectively suggesting the need for caution when interpreting the imaging findings. A possible underlying mechanism for [68Ga]Ga-DOTA-TATE uptake in stroke is increased SSTR2 expression by macrophages recruited into infarcted tissue.
Mycoplasma pneumoniae-associated diffuse alveolar haemorrhage: an atypical presentation of a prevalent pathogen
Authors: Slauer Ryan D , Mourad Ahmad , Krishnan Govind , Feeney Colby
Published: April 2022

A transgender man in his late teens presented with signs of multisystem disease, including hepatitis, mucositis and bone marrow suppression. He later developed dyspnoea, leucocytosis and bilateral pulmonary infiltrates on chest radiograph. He was treated for community-acquired pneumonia. After several days of treatment, he developed hypoxaemic respiratory failure due to bronchoscopy-confirmed diffuse alveolar haemorrhage (DAH). The differential diagnosis and workup were extensive, and he was ultimately treated with intravenous steroids and five sessions of plasmapheresis for a presumed autoimmune aetiology. Investigations were remarkable only for elevated IgM and IgG toMycoplasma pneumoniae(MP). This case represents a rare presentation of multisystem disease secondary to MP in adults. Clinicians should considerMycoplasmainfection in cases of multisystem disease and observe for DAH even after initiation of appropriate therapy.
Response of focal refractory status epilepticus to lacosamide in an infant
Authors: Akbar Asra , Harthan Aaron A , Creeden Sean , Deshpande Girish G
Published: April 2022

Status epilepticus (SE) is a life-threatening medical emergency which is frequently encountered in the critical care setting and can be refractory to treatment. Refractory status epilepticus (RSE) is defined as SE that has failed to respond to adequately used first-line and second-line antiepileptic medications. Super refractory status epilepticus is defined as SE that persists for 24 hours or more after the use of an anaesthetic agent or recurs after its withdrawal.

If SE persists beyond a period of 7 days it is referred to as prolonged, refractory status epilepticus (PRSE). There are limited data guiding treatment of RSE in the paediatric population.

Lacosamide (LCM) is licensed as an adjunctive treatment for partial-onset seizures. Evidence for the efficacy of LCM in paediatric SE is scarce. This case report may suggest a synergistic effect of LCM on slow-activation sodium channels in conjunction with medications such as phenytoin that causes fast inactivation of sodium channels. The dual fast and slow inactivation of sodium channels may enhance the effectiveness in treatment of RSE. This is the first case report of PRSE in an infant, successfully treated with LCM. A brief review of literature is also a part of this report.
Key takeaways from China’s success in eliminating malaria: leveraging existing evidence for a malaria-free world
Authors: Feng Xinyu , Huang Fang , Yin Jianhai , Wang Rubo , Xia Zhigui
Published: April 2022

Although the total number of malaria cases and fatalities have declined globally since 2010, there were still 241 million malaria cases identified across 85 countries and territories in 2020. As the global malaria eradication process accelerates, more countries have launched their own initiatives of elimination. Notably, China achieved this goal by 2021, ending thousands of years of endemic. Undoubtedly, tremendous experience and vital lessons have been accrued en route to the malaria-free goal in malaria-eliminated countries including China. To enhance prospects of a malaria-free world by bridging the key evidence from a malaria-eliminated country to the contexts of affected, this personal view highlights concerted commitments and universal investment in healthcare, improved surveillance and response system, constant capacity building, demand-oriented scientific research, and multiway cooperation, which have helped China to eliminate this ancient scourge. We discuss how these key takeaways could be leveraged to different contexts. We also argue the long-term challenges and barriers on the pathway to malaria elimination and underline the needs for consistent efforts to maintain zero indigenous cases and prevent re-introduction of malaria. Through concerted efforts from global collaboration, a malaria-free world can become a reality.