bluuebunny/crossref_metadata_2025 huggingface dataset:
Resolution of Sleep Disturbance and Improved Functional Outcomes After Rotator Cuff Repair
Authors: Zheng Evan T. , Lowenstein Natalie A. , Collins Jamie E. , Matzkin Elizabeth G.
Published: May 2023

Background:

Most patients experience sleep disturbances before rotator cuff repair, with these symptoms largely improving postoperatively. However, the relationship between the resolution or persistence of sleep disturbance and patient-reported outcomes after rotator cuff repair remains unknown.

Purpose:

To compare outcomes after rotator cuff repair between patients who reported a preoperative sleep disturbance and those who did not. Outcomes at various time points after surgery were also assessed in relation to the persistence or resolution of sleep disturbance.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

Patients undergoing primary arthroscopic rotator cuff repair at a tertiary academic center were prospectively enrolled in a registry database. Patient characteristics were obtained preoperatively and validated patient-reported outcome measures (PROMs) were obtained pre- and postoperatively, including the visual analog scale for pain, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Simple Shoulder Test, and Veterans RAND 12-Item Health Survey Physical and Mental components. Sleep disturbance was evaluated via responses to Simple Shoulder Test question 2. Patients with and without sleep disturbance were compared before and after surgery.

Results:

In total, 293 patients were prospectively enrolled. A total of 262 (89.8%) patients reported a sleep disturbance preoperatively. Of these, 221 (84.4%) reported a resolution of sleep disturbance by 2 years postoperatively. After adjustment for age, workers’ compensation status, and Cofield tear size, patients with a preoperative sleep disturbance reported significantly worse baseline PROMs, apart from the Veterans RAND 12-Item Health Survey Mental component, before surgery. However, postoperatively, these patients had greater improvement in PROMs, and no significant remaining differences were seen at follow-up between patients with and without preoperative sleep disturbance. Among patients who reported a preoperative sleep disturbance, those whose symptoms resolved postoperatively had superior PROM scores as well as significantly greater improvements from preoperative baseline values compared with patients with persistent sleep disturbances after surgery.

Conclusion:

Patients with preoperative sleep disturbances reported worse baseline functional scores before rotator cuff repair compared with patients without sleep disturbance. These disturbances largely resolved after surgery, with postoperative outcomes comparable with those of patients who reported no preoperative sleep concerns. Patients whose sleep disturbances resolved postoperatively also reported superior PROM scores compared with patients whose sleep disturbances persisted postoperatively.
The discourse of the non-method
Authors: Roy Olivier
Published: May 2023

The article proposes a reflection on the methodological dimensions of a research path initially devoted to the relationship between Islam and politics in Afghanistan, then in various regional contexts, and finally extended to the relationship between religion, politics and culture in the contemporary world. The author returns to his concrete, empirical and intuitive relationship with fieldwork, nourished by a culture of human and social sciences impregnated with anthropology and philosophy. The article first examines the modalities and limits of the interview and/or questionnaire survey based on the author’s seminal investigations in Afghanistan, arguing for a prolonged coexistence with the actors. It then examines the comparative and interpretive challenge that any change of case study represents for this immersive posture. The article then examines the methodological and ethical effects of surveys conducted in contexts of political violence. Finally, the relative value of quantitative and qualitative methods and the implications of this debate for the teaching of methods are discussed in light of research on religion.
Increased frequency of hospital admissions with active systemic lupus erythematosus disease activity defined by two different disease activity indices: A cohort study
Authors: Wang Chun-Lung , Koo Malcolm , Hsu Chia-Wen , Lu Ming-Chi
Published: May 2023

The objective of this cohort study was to evaluate the association between the frequency of hospital admissions and disease activity, as defined by two different disease activity measurements: the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) and the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K), in adult patients with systemic lupus erythematosus (SLEs). Patients with SLE were recruited from the rheumatology outpatient department of a regional hospital in southern Taiwan. SLE-DAS and SLEDAI-2K were used to define SLE disease activity and the cause of hospital admissions was identified by a rheumatologist based on medical records. A generalized linear model (GLM) with gamma distribution and log-linked function was used to analyze variables associated with the frequency of admission. The mean frequency of hospitalization was 0.34 times per year for all-cause and 0.21 times per year for SLE-related admission. Multivariate GLM analysis showed that moderate/severe SLE disease activity defined by SLE-DAS was associated with an increased frequency of all-cause and SLE-related hospital admissions while adjusting for other covariates. Moderate/severe SLE disease activity defined by SLEDAI-2K was only significantly associated with an increased frequency of all-cause hospitalization. When steroid dosage was included in the model, moderate/severe SLE disease activity defined by the SLE-DAS remained significantly associated with SLE-related hospital admissions ( p = 0.032). In conclusion, disease activity defined by the SLE-DAS, but not SLEDAI-2K was associated with an increased frequency of SLE-related hospitalization. Steroid dosage, a lower educational level, and smoking were associated with an increased frequency of hospital admissions, whereas underweight and alcohol use were associated with a decreased frequency of hospital admissions. Rheumatologists should promptly control SLE disease activity of their patients, provide them with adequate health education, and maintain steroid doses to as low as possible to reduce the risk of hospital admissions.
Does the Coronavirus Anxiety Scale Measure Coronaphobia the Same Way for Mourners With and Without Dysfunctional Grief?
Authors: Lobos-Rivera Marlon Elías , Marroquín-Carpio Wendy Carolina , Caycho-Rodríguez Tomás , Lee Sherman A. , Tejada Rodríguez Jennyfer Carolina , Flores-Monterrosa Angélica Nohemy , Valencia Pablo D. , Carbajal-León Carlos , Vilca Lindsey W. , Torales Julio , Reyes-Bossio Mario
Published: May 2023

Deaths from COVID-19 have exceeded 6.5 million people globally. Although many people are mourning the loss of loved ones to this deadly disease, little is known about the validity of measuring coronavirus-related anxiety with this particular group of people. Therefore, the objective of this study is to determine if the coronavirus anxiety scale (CAS) measures the coronaphobia construct the same way for mourners with and without dysfunctional levels of grief. The results indicated that the four-item version of the CAS has acceptable fit indices and is partially invariant between people with dysfunctional and non-dysfunctional grief. Moreover, the CAS demonstrated adequate criterion validity and reliability with this group of bereaved adults. In conclusion, the CAS can be used to measure anxiety due to COVID-19 in people who are going through dysfunctional and non-dysfunctional grieving processes.
Effect of cutting parameters on the microstructure evolution and damage mechanism of 7075-T6 aluminum alloy in micro cutting
Authors: Zhang Ping , Lin Zhenyong , Liu Zehua , Liu Junling , Mai Qingqun , Yue Xiujie
Published: May 2023

This work aims to explore how cutting parameters affect the microstructure evolution and damage mechanism of 7075-T6 aluminum alloy in micro cutting. The effect of cutting parameters on micro cutting force and surface morphology is examined through single-factor test. By building a 3D micro finite element model for micro cutting based on crystal plasticity theory, the effect of cutting parameters on residual stress, microstructure evolution and damage behavior is analyzed to establish a mapping relation between residual stress and damage. The results show that as cutting speed increases, main cutting force first reduces then increases in all cases, but the cutting speed at the inflection point corresponding to main cutting force is different. The micro cutting surface morphology of 7075-T6 aluminum alloy displays obvious signs of plowing; detectable oxidation adhesion wear appears when the cutting depth is greater than 150 μm. Crack initiation and propagation on the machined surface of 7075-T6 aluminum alloy vary considerably under different cutting parameters. Residual stress distribution displays a ladle profile. The deeper the maximum residual compressive stress is from the surface, the harder it is for micro cracks to initiate and propagate. SEM and EDS analysis indicates that at smaller cutting depths, micro cutting tool wear is dominated by oxidation wear; at larger cutting depths, surface morphology is mostly better than at smaller cutting depths.
Lateral buckling of drill strings revisited: localised “snaking”
Authors: Coman Ciprian D
Published: May 2023

The classical lateral buckling of a straight drill string confined within an inclined cylindrical borehole is formulated as a singularly perturbed boundary-value problem which is subsequently explored using asymptotic techniques. In particular, the localised nature of the critical eigenmodes is discussed with the help of a special multiple-scale technique that yields simple and accurate approximations for the corresponding critical loads. The asymptotic formulae obtained capture the dependence of these loads on the magnitude of the frictional forces as well as the inclination angle of the confining borehole.
Multiple hierarchies within the ‘civilized’ world: country ranking and regional power in the International Labour Organization (1919–1922)
Authors: Barros Leal Farias Deborah
Published: May 2023

There is significant and growing interest in better understanding hierarchy in the international system, especially in relation to intergovernmental organizations (IGOs). Acknowledging the existence of hierarchy in a system implies that there are different social positions (higher/lower), but not why or how a specific differentiation came to be used, nor how it is structured, contested or resolved. This article is interested in contributing to these questions, particularly in the context of heterarchical settings (where more than one hierarchy is present), which is also not fully understood. It uses the first years of the International Labour Organization (ILO) as a springboard to reflect upon hierarchy within the so-called ‘civilized’ group of countries in the immediate aftermath of World War I. This IGO was the first to (1) introduce statistical data to rank countries, with criteria designed to ‘objectively’ gauge industrial power and (2) establish a geographic allocation of countries in its main decision-making body’s structure. Non-European countries and non-great powers had critical roles in establishing these novel ways of dealing with hierarchies and their institutional design in IGOs. One hundred years later, these discussions still resonate with several ongoing cases of contestation in IGOs over ‘fair’ hierarchical structures.
Historical institutionalism and institutional design: divergent pathways to regime complexes in Asia and Europe
Authors: Hofmann Stephanie C. , Yeo Andrew
Published: May 2023

Why and how do pathways to regime complexes diverge? Building on insights from the literatures on institutional design and historical institutionalism, we argue that early institutional design choices produce long-term variation in the pace, density, and composition of institutional layers within a regime complex. In a first step, we argue that if an institution becomes focal, this increases the exit costs for member-states to leave. Additional institutional layers become a more likely outcome. In a second step, we argue that depending on the focal organization’s formal or informal design, variegated sovereignty costs inform the additional layering pathways. If a focal organization is formal, sovereignty costs are high for member-states. Consequently, creating additional institutional layers becomes cumbersome, leading to a slow pace of “negotiated layering” and a regime complex characterized by low density and composed of formal and informal institutions. In contrast, low sovereignty costs associated with informal focal organizations enable a rapid process of “breakout layering” resulting in a high density of mostly informal institutions. We develop our argument by examining the evolution of security institutions in Europe and Asia through diplomatic cables, treaty texts, personal memoirs, and policy memos.
Challenges and strategies for implementers and evaluators working in conflict settings
Authors: Bond Laura , Klein Elizabeth K. , Gates Emily F.
Published: May 2023

Practitioners implementing and evaluating humanitarian programs in conflict zones face unique challenges requiring context-sensitive guidance. Conflict zones—geographical areas with militarized and non-militarized violence, widespread political instability, and state-sanctioned intimidation and genocidal violence—are rife with logistical, methodological, and ethical challenges that impact implementation and evaluation. Although challenges have been well-documented, few solutions or evaluation frameworks exist to help evaluators in conflict zones confront these challenges. This article examines how the application of implementation science frameworks, specifically, Reach, Effectiveness, Adoption, Implementation, and Maintenance and the Consolidated Framework for Implementation Research, offers useful strategies to mitigate some challenges in conducting evaluations in conflict zones. Areas for future research include collaborative team approaches to using these frameworks, ethical guidance, and reporting and dissemination.
Effects of short-form video application users’ guanxi on intention to visit rural tourism destinations: The moderating role of tourism fatigue
Authors: Liao Shan-Shan , Lin Ching-Yuan , Xie Xing-Zheng
Published: May 2023

Short-form video applications (SFV apps) provide an ideal channel for promoting rural tourism. Based on the elaboration likelihood model, this study integrated guanxi, telepresence, destination image, and tourism fatigue to investigate the factors affecting user intentions to travel to rural tourism destinations in the context of SFV apps. Through the use of structural equation modeling (SEM) and fuzzy-set qualitative comparative analysis (fsQCA), the theoretical framework was examined using data collected from 445 SFV app users. The SEM findings revealed that guanxi could directly affect argument quality and source credibility, which further strengthened destination image and telepresence; the travel intention could be affected by destination image and telepresence without guanxi. Also, tourism fatigue played three roles in the formation of travel intention. Additionally, the results of fsQCA illustrated three configurations leading to high and low intention to visit rural tourism destinations.
Come together? The unusual combination of precariat materialist and educated post-materialist support for an Australian Universal Basic Income
Authors: Patulny Roger , Spies-Butcher Ben
Published: May 2023

International studies using the European Social Survey (ESS) reveal higher support for Universal Basic Income (UBI) in poorer countries with less generous welfare systems, and among individuals with lower income and education, and leftist political leanings. We present data from the 2019−20 Australian Survey of Social Attitudes mirroring the ESS question. Australia falls in the middle of European opinion, with 51% supporting a UBI, increasing slightly during the onset of Covid-19. We also find higher support among two different groups: (1) those facing greater ‘material’ precarity, including younger, low-income, unemployed, suburban renters, and (2) those who have more post-materialist concerns, including Green-left voters and those favouring redistributive values. Unlike in other countries, higher education predicts more support, while homeownership predicts less. The article concludes with challenges to introducing UBI to Australia, including potentially contradictory strategies for different support bases (material vs post-material), ongoing commitments to means-testing, and negative framing in the media.
Addressing Gendered Racism Against Black Girls Using a Strengths-Based Empowerment-Intersectional Framework for Sexual Health and Substance Use Prevention Programming
Authors: Opara Ijeoma , Martin Raquel , Hill Ashley V. , Calhoun Amanda
Published: May 2023

Although Black girls use substances at lower rates than boys and girls from various other racial groups, they tend to have worse health outcomes associated with substance use that can also impact their sexual health. The association between substance use and sexual risk behaviors is usually attributed to lack of access to quality health care and lack of culturally specific prevention programming and treatment options tailored to this group. Accordingly, the theoretical frameworks for health promotion for Black girls often focus on addressing deficits, ignoring the powerful and intersecting social forces that can impact identity, agency, and behavioral options. Key among these forces is gendered racism. We propose a strengths-based conceptual framework to address and challenge gendered racism as a critical foundation for promoting health and wellbeing for Black girls. Our approach integrates Intersectionality Theory and Empowerment Theory, with psychological and intrapersonal empowerment identified as critical mediators of behavior and health outcomes, supported by protective factors of positive racial identity and gendered racial socialization. This framework has been developed with and for Black girls but can be adapted for health promotion efforts with other minoritized groups.
Elastic Deformation Measurement Using Duplex Ultrasound for the Detection of High Aneurysm Sac Pressure Following EVAR
Authors: van Genderen Olton S. , van Wissen Rob C. , Hamming Jaap F. , van Schaik Jan , van der Vorst Joost R.
Published: May 2023

Purpose:

To describe the concept of aortic elastic deformation (ED) measurement using duplex ultrasonography (DUS) as a tool for detection of high aneurysm sac pressure following endovascular aortic repair (EVAR).

Technique:

High aneurysm sac pressure, with or without proven endoleak, will result in a less compressible aneurysm. Using the dual image function in B-mode of the DUS device and a standardized amount of applied probe pressure, ED can be measured. It is defined as the percentage of deformation of the aneurysm sac on probe pressure application. We hypothesize that less ED of the aneurysm sac can be related with high aneurysm sac pressure and possibly the presence of clinically relevant endoleak. In this note, we describe the technical details of the procedure and report on the applicability and results of ED measurements in the framework of aortic aneurysm and EVAR follow-up in a cohort of 109 patients.

Conclusion:

ED measurement is the first noninvasive pressure-based method in the quest to find a practical and reliable diagnostic tool to exclude high aneurysm sac pressure. In our patient cohort, patients with proven endoleak showed a smaller ED (less compressible), implying the presence of high aneurysm sac pressure. Further research should confirm whether ED measurement using DUS could reliably exclude endoleak after EVAR and further explore its potential for clinical application in EVAR follow-up.

Clinical Impact

For the first time, a simple, fast, and inexpensive diagnostic tool is presented in this study for detecting high sac pressure following EVAR. High sac pressure is typically caused by clinically significant endoleaks, which can have significant consequences. Currently, computed tomography scanning is the most common method used to identify and characterize endoleaks. However, measuring elastic deformation may potentially replace more invasive and expensive modalities, such as the computed tomography in the future.
Strain-gauge venous occlusion plethysmography: An objective and non-invasive approach to the evaluation of venous hemodynamics in patients with acute deep-vein thrombosis undergoing post-pharmacomechanical thrombolysis
Authors: Guven Hakan
Published: May 2023

Objectives

Strain-gauge venous occlusion plethysmography (SGVOP) is a means of acquiring hemodynamic data non-invasively, unlike other methods used routinely for the diagnosis and follow-up of venous diseases. The present study compares the plethysmographic data with early- and mid-term routine data of patients with acute deep-vein thrombosis (DVT) who underwent pharmacomechanical thrombolysis.

Patients and method

Included in this retrospective study were 118 patients with acute DVT, who underwent pharmacomechanical thrombolysis between February 2018 and July 2019. Pre- and post-procedure follow-up data including CIVIQ-20 (quality of life), VCSS (Venous Clinical Severity Score), D-Dimer, Doppler USG results, venous capacity (VC), and venous outflow (VO) obtained by SGVOP were recorded and compared.

Results

In all 118 (100%) patients who underwent the procedure, early- and mid-term patency was seen to have been provided on Doppler USG follow-up, and various degrees of venous insufficiency were identified. A statistically significant improvement was observed in VCSS, CIVIQ-20, D-Dimer, VO, and VC measurements, although when the discrepancies between CIVIQ-20 and plethysmographic measurements were examined individually during the 6-month follow-up, nine (13.1%) patients were identified with comorbidities.

Conclusions

Pharmacomechanical thrombolysis is an effective treatment approach for patients with acute DVT. Providing non-invasive objective data supporting the diagnosis and follow-up of venous diseases, the SGVOP approach offers significant benefits and should be considered more frequently as a viable therapy.
National Independence Versus Traditional Culture: Framing the Same-Sex Marriage Movement and Countermovement in Taiwan
Authors: Sun Xiaomei , Wang Yidong Steven , McLeod Douglas M.
Published: May 2023

Taiwan’s legalization of same-sex marriage in 2019 made it the first nation in Asia to grant marital rights to gay and lesbian couples. In the years leading up to legalization, the Marriage Equality Coalition Taiwan (pro-same-sex marriage) and the Coalition for the Happiness of Our Next Generation (anti-same-sex marriage) mobilized large-scale social movements on social media between 2016 and 2017 to influence the legislative process. The network structure and affordances of digital platforms have facilitated communication and mobilization for social movements. However, new technology alone does not guarantee participation, and cultural aspects of mobilization on digital platforms are an important area of study. This paper examines the framing strategies these two organizations used on Facebook pages and the political and cultural contexts that facilitated or constrained frame alignment. A mixed-method framing analysis combining quantitative and qualitative methods of their Facebook posts revealed that the supporting group framed same-sex marriage as an issue of human rights and as a democratic development linked to Taiwan’s goal of national independence, whereas the opposing group framed it as a destruction of traditional culture concerning family values and social order. Our analysis identified the distinct features of framing strategy in Taiwan’s marriage equality movement and countermovement, including the appeal to nationalism and the downplaying of religion, that were affected by Taiwan’s specific political and cultural contexts.
Job Involvement as a Mediating Factor Between Empowerment and Organizational Citizenship Behavior Among Clinical Instructors at Nursing Technical Institutes
Authors: El-Sayed Ghonem Nadia Mohamed
Published: May 2023

Introduction

Empowerment is an important motivator for clinical instructors to develop organizational citizenship behaviors. Job engagement may serve as a moderator, amplifying the impact of empowerment on organizational citizenship behavior.

Objective

This study examines the effect of job participation as a mediator between empowerment and organizational citizenship behavior among clinical teachers at nursing technical institutes.

Methods

This cross-sectional analytical study was performed on a convenience sample of 161 clinical instructors from six technical nursing institutes connected with five Egyptian Universities. For data collection, a self-administered questionnaire, including measures for assessing job engagement, empowerment, and citizenship behavior, was employed. This ran till November 2019, starting in June.

Results

Most clinical instructors had a high level of job involvement (82%), 72.0% had high empowerment score, and 55.3% had high citizenship behavior. Empowerment, job involvement, and citizenship scores were positively correlated. The female gender predicted empowerment positively. The workplace was also a powerful predictor of job engagement and empowerment ratings. Importantly mediated the link between empowerment and citizenship behavior was occupational engagement.

Conclusions

Employment participation was a crucial moderator of the link between autonomy and citizenship behavior. The nursing institutes’ administration needs to empower clinical instructors with more autonomy and participation in decision making through psychological support and fair salaries. It is proposed that an additional study be conducted to assess the efficacy of empowerment initiatives as a pathway to job engagement, resulting in higher civic behavior among clinical instructors.
Practitioner Application of Ethics in Ethical Decision-Making Within Projects: A Process Theory View
Authors: Baker Elizabeth White , Niederman Fred
Published: May 2023

This study examines the approach and range of thinking project management practitioners apply when dealing with issues that have ethical considerations. This article presents a nuanced view of processual engagement with ethics rather than a narrower decision model-based approach based on responses to various ethically challenging scenarios that may confront project managers. Based on qualitative data from a more extensive study we find that practitioner considerations regarding specific ethical decisions range from precursors to the development of a situation as a problem through particular actions and decisions, to potential ways that adverse outcomes can be remediated, and positive ones enhanced. We find that these concerns arise in addition to ethical decision-making considering all three core ethical views collectively, though not necessarily by each individual. The findings suggest broadening the investigation of ethical behavior from making better judgments to structuring the environment where such choices are made, laying solid foundations for ensuring positive choices, and working with even poor choices when they are still the best available to mitigate and control consequences.
Prevalence, treatment and determinants of obstructive sleep apnoea and its symptoms in a population-based French cohort
Authors: Balagny Pauline , Vidal-Petiot Emmanuelle , Renuy Adeline , Matta Joane , Frija-Masson Justine , Steg Philippe Gabriel , Goldberg Marcel , Zins Marie , d'Ortho Marie-Pia , Wiernik Emmanuel
Published: May 2023

Background

Obstructive sleep apnoea (OSA) is associated with increased morbidity and mortality. Although the disorder has been well studied in selected high-risk populations, few data exist on its prevalence in the general population. We aimed to assess the prevalence and determinants of OSA in France.

Methods

Data from participants of the French population-based CONSTANCES cohort aged 18–69 years at inclusion and being treated for sleep apnoea or screened for OSA in 2017 using the Berlin Questionnaire were analysed. Weighted analyses were performed to provide recent and representative results in the general population.

Results

Among 20 151 participants, the prevalence of treated sleep apnoea was 3.5% (95% CI 3.0–3.9%). The prevalence of untreated subjects with a positive Berlin Questionnaire was 18.1% (95% CI 17.3–19.2%) for a total weighted prevalence of treated sleep apnoea or high risk of OSA of 20.9% (95% CI 20.0–21.9%). Regarding prevalence of OSA symptoms, it was 37.2% (95% CI 36.1–38.3%) for severe snoring and 14.6% (95% CI 13.8–15.5%) for hypersomnolence. In multivariable logistic regression analysis, male sex, age, previous cardiovascular events, smoking, low educational level, low physical activity and depressive symptoms were associated with having either treated sleep apnoea or a positive Berlin Questionnaire.

Conclusion

In this large French population-based cohort, one in five participants had a high likelihood of OSA, whereas only 3.5% were treated for the disorder, suggesting major underdiagnosis in the general population. OSA diagnosis should be considered more often in people with risk factors such as depressive symptoms as well as unhealthy behaviours and socioeconomic conditions.
Radiosurgery for classical trigeminal neuralgia: impact of the shot size on clinical outcome
Authors: Ortholan Cécile , Colin Philippe , Serrano Benjamin , Bouet Thibault , Garnier Nicolas , le Guyader Maud , Amblard Regis , Villeneuve Rémy , Chanalet Stéphane , Alchaar Haiel , Bozzolo Eric , Lanteri-Minet Michel , Fontaine Denys
Published: May 2023

Background

This study compares the outcome of patients suffering from medically refractory classical trigeminal neuralgia (TN) after treatment with radiosurgery using two different shot sizes (5- and 6-mm).

Methods

All patients included in this open, prospective, non-controlled study were treated in a single institution for TN (95 cases in 93 patients) with LINear ACcelerators (LINAC) single-dose radiosurgery using a 5-mm shot (43 cases) or 6-mm shot (52 cases). The target was positioned on the intracisternal part of the trigeminal nerve.

Results

The mean Dmax (D0.035) to the brainstem was higher in the 6-mm group: 12.6 vs 21.3 Gy (p < 0.001). Pain relief was significantly better in the 6-mm group: at 12 and 24 months in the 6-mm group the rate of pain-free patients was 90.2 and 87.8%, respectively vs. 73.6 and 73.6% in the 5-mm group (p = 0.045). At 12 and 24 months post-radiosurgical hypoesthesia was more frequent in the 6-mm group: 47.0 and 58% vs.11.3 and 30.8% in the 5-mm group (p = 0.002). To investigate the effect of cone diameter and the dose to the brainstem on outcomes, patients were stratified into three groups: group 1 = 5-mm shot, (all Dmax < 25 Gy, 43 cases), group 2 = 6-mm shot, Dmax < 25 Gy (32 cases), group 3 = 6-mm shot Dmax > 25 Gy (20 cases). At 12 months the rates of hypoesthesia were 11.3, 33.5 and 76.0%, respectively in groups 1, 2 and 3 (p < 0.001) and the rates of recurrence of pain were 26.4, 16.5 and 5%, respectively, (p = 0.11).

Conclusion

LINAC treatment with a 6-mm shot provided excellent control of pain, but increased the rate of trigeminal nerve dysfunction, especially when the maximum dose to the brainstem was higher than 25 Gy.
Optogenetic control of YAP can enhance the rate of wound healing
Authors: Toh Pearlyn Jia Ying , Sudol Marius , Saunders Timothy Edward
Published: May 2023

Background

Tissues need to regenerate to restore function after injury. Yet, this regenerative capacity varies significantly between organs and between species. For example, in the heart, some species retain full regenerative capacity throughout their lifespan but human cardiac cells display a limited ability to repair the injury. After a myocardial infarction, the function of cardiomyocytes is impaired and reduces the ability of the heart to pump, causing heart failure. Therefore, there is a need to restore the function of an injured heart post myocardial infarction. We investigate in cell culture the role of the Yes-associated protein (YAP), a transcriptional co-regulator with a pivotal role in growth, in driving repair after injury.

Methods

We express optogenetic YAP (optoYAP) in three different cell lines. We characterised the behaviour and function of optoYAP using fluorescence imaging and quantitative real-time PCR of downstream YAP target genes. Mutant constructs were generated using site-directed mutagenesis. Nuclear localised optoYAP was functionally tested using wound healing assay.

Results

Utilising optoYAP, which enables precise control of pathway activation, we show that YAP induces the expression of downstream genes involved in proliferation and migration. optoYAP can increase the speed of wound healing in H9c2 cardiomyoblasts. Interestingly, this is not driven by an increase in proliferation, but by collective cell migration. We subsequently dissect specific phosphorylation sites in YAP to identify the molecular driver of accelerated healing.

Conclusions

This study shows that optogenetic YAP is functional in H9c2 cardiomyoblasts and its controlled activation can potentially enhance wound healing in a range of conditions.
Multiomics strategies for decoding seed dormancy breakdown in Paris polyphylla
Authors: Zheng Guowei , Li Wenchun , Zhang Shunzhen , Mi Qi , Luo Wenxiu , Zhao Yanli , Qin Xiangshi , Li Weijiao , Pu Shibiao , Xu Furong
Published: May 2023

Background

The disruption of seed dormancy is a complicated process and is controlled by various factors. Among these factors, membrane lipids and plant hormones are two of the most important ones. Paris polyphylla is an important Chinese herbaceous species, and the dormancy trait of its seed limits the cultivation of this herb.

Results

In this study, we investigate the global metabolic and transcriptomic profiles of Paris polyphylla during seed dormancy breaking. Widely targeted metabolomics revealed that lysophospholipids (lysoPLs) increased during P. polyphylla seed dormancy breaking. The expression of phospholipase A2 (PLA2), genes correlated to the production of lysoPLs, up-regulated significantly during this process. Abscisic acid (ABA) decreased dramatically during seed dormancy breaking of P. polyphylla. Changes of different GAs varied during P. polyphylla seeds dormancy breaking, 13-OH GAs, such as GA53 were not detected, and GA3 decreased significantly, whereas 13-H GAs, such as GA15, GA24 and GA4 increased. The expression of CYP707As was not synchronous with the change of ABA content, and the expression of most UGTs, GA20ox and GA3ox up-regulated during seed dormancy breaking.

Conclusions

These results suggest that PLA2 mediated production of lysoPLs may correlate to the seed dormancy breaking of P. polyphylla. The conversion of ABA to ABA-GE catalysed by UGTs may be the main cause of ABA degradation. Through inhibition the expression of genes related to the synthesis of 13-OH GAs and up-regulation genes related to the synthesis of 13-H GAs, P. polyphylla synthesized more bioactive 13-H GA (GA4) to break its seed dormancy.
High-dose polyethylene glycol-3350 and gatorade solutions for patients with previous inadequate bowel preparations for colonoscopy are safe and effective
Authors: Gerard David P. , Gerard Sophia F. , Raiser Manfred W.
Published: May 2023

Background

Inadequate bowel preparation for colonoscopy remains an issue resulting in lower adenoma detection rates and increased cost. We assessed the efficacy, safety and tolerability of high-dose bowel preparations in subjects who previously had an inadequate colonoscopy preparation.

Methods

We performed a multi-step prospective trial of high-dose bowel preparations with subjects assigned to the dose higher than their previous inadequate preparation. Step 1: 1.5 times the standard-dose of polyethylene glycol 3350 (PEG, 459 g) and Gatorade; and Step 2: 2.0 times the standard-dose of PEG (612 g) and Gatorade, both were given as extended split-dose preparations. 69 outpatients consumed their preparation before a morning colonoscopy. The primary endpoint was colon cleanliness assessed by the Chicago bowel preparation scale (BPS). Safety was assessed by comparing a baseline basic metabolic panel (BMP) to a post-cleansing BMP. Patients with no history of inadequate colon cleansing who consumed standard doses of PEG (306 g to 357 g) and Gatorade were used as a comparison group. Tolerability of the bowel preparation was assessed using a subject-questionnaire.

Results

When compared to controls consuming standard-dose bowel preparations, subjects consuming high-dose preparations had no statistically significant difference in colon cleanliness as measured by the modified or total Chicago BPS scores or differences in tolerability. Baseline and post-cleaning BMPs were not significantly different other than the BUN falling (p < 0.0001) after the preparation.

Conclusions

The multi-step high-dose bowel cleansing protocol proved highly efficacious, safe and well tolerated in subjects who previously had an inadequate colonoscopy preparation.

Trial registration: ClinicalTrials.gov NCT02661750.
Characteristics of falls among older hip fracture patients from six Chinese hospitals: a post-hoc descriptive analysis
Authors: Peng Junyi , Ye Pengpeng , Zhang Jing , Zhang Xinyi , Peng Ke , He Jiusheng , Wen Liangyuan , Wang Xianhai , Shi Zongxin , Hu Sanbao , Sun Fengpo , Gong Zishun , Sun Mingyao , Liu Tingzhuo , Liu Xinyan , Ma Ruofei , Zhu Shiwen , Wu Xinbao , Ivers Rebecca , Yang Minghui , Tian Maoyi
Published: May 2023

Background

There is well-established evidence to understand the characteristics of falls among the older patients with hip fracture in many countries, but very little knowledge existed in China. This study described the characteristics of falls in older patients with hip fractures from six Chinese hospitals.

Methods

This cross-sectional study is a post-hoc descriptive analysis of a recently completed trial. Eligible patients were aged 65 years and older, with confirmed hip fractures due to falls, and were admitted to the hospital within 21 days of the fracture. All patients were consecutively enrolled and screened within one year (November 15, 2018, to November 14, 2019). The collected data included patient demographics and fall-related information.

Results

A total of 1,892 patients’ fall-related information were described. Most patients with hip fractures caused by falls were in the oldest old age group (60.4% in age group ≥ 80), with an overall average age of 80.7 (7.6) years. There were more females (n = 1,325, 70.0%) than males (n = 567, 30.0%). The majority lived in urban (n = 1,409, 74.5%). Most falls (n = 1,237, 67.3%) occurred during the daytime (6:01–18:00). There were 1,451 patients had their falls occurring at home (76.7%). Lost balance (n = 1,031, 54.5%) was reported as the primary reason to cause falls. The most common activity during a fall was walking (n = 1,079, 57.0%).

Conclusions

Although the incidence of fall-related hip fractures in China is unclear, preventing falls and fall-related hip fractures in older people remains an urgent health concern as the ageing society increases. Studies with larger sample size and diverse population are needed to robustly understand this growing epidemic.
Relationship between person, environmental factors, and activities of daily living performance among physically disabled older adults living at home: a structural equation model
Authors: Fang Shuai , Liang Hong , Liang Yan
Published: May 2023

Background

Older adults with physical disability need long-term services and support, which incur enormous costs. However, supportive environments may reduce disability and promote aging in place. It is unclear how the physical and social environment affect different types of functional impairments and influence the performance of activities of daily living (ADL) in physically disabled older adults.

Objective

The purpose of this study was to examine the relationship between person, environmental factors, and ADL performance among physically disabled older adults living at home.

Methods

This was a cross-sectional study. Using long-term care insurance claims data from a pilot city in China, we used a structural equation model to assess the potential paths among person, environmental factors, and ADL performance.

Results

Education and income had different influences on the social environment and physical environment. The functional impairments had significant effects on ADL performance, either directly or through physical environment (with handrails) and social environment (family support).

Conclusions

The present findings offer crucial evidence for understanding the interactions between a person and the environment, as well as their influence on physical ADLs, suggesting the importance of a supportive environment and a subpopulation-targeting strategy for disabled older adults.
Successful pregnancy and delivery after ovulation induction therapy in a woman with congenital hypogonadotropic hypogonadism: a case report
Authors: Liang Yu , Yang Xiaokui , Li Ying , Lei Lingling , Lan Yonglian , Wang Shuyu
Published: May 2023

Background

Congenital hypogonadotropic hypogonadism (CHH) is a rare disorder resulting from a deficient secretion of the episodic gonadotropin-releasing hormone, leading to delayed or absent puberty and infertility. In female patients with CHH, the most commonly used treatment is gonadotropin (Gn) therapy. Due to the rarity of the disease in females, there are limited case reports available. This article offers a management approach for this unusual disease that can be helpful for clinicians.

Case presentation

We report the case of a 29-year-old woman who successfully achieved pregnancy and delivered healthy twin girls after ovulation induction therapy. The patient was diagnosed with CHH at 18 years of age due to primary amenorrhea and the absence of secondary sexual characteristics. After experiencing infertility for three years, the patient sought medical assistance for conceiving. The patient was treated with gonadotropin therapy due to anovulation. In her first treatment cycle, the initial dose of HMG used for treatment was 75IU, which was increased to 150IU after six days. However, the cycle was canceled due to follicular dysplasia. In the second cycle, the treatment began with an initial dose of 150IU, and the follicles grew normally, but the estrogen level was low. Consequently, the treatment was interrupted. In a third ovulation stimulation cycle, HMG was adjusted to 150IU, and recombinant LH was added. After 12 days of ovulation, three mature follicles grew, the estrogen level was normal,and the treatment resulted in successful ovulation and subsequent pregnancy. At 35 weeks of gestation, the patient underwent a cesarean section and delivered two healthy female infants weighing 2,405 g and 2,755 g with an Apgar score of 10/10.

Conclusions

Early diagnosis and timely and appropriate hormone replacement therapy are important for future pregnancy. Ovulation induction therapy is necessary to stimulate fertility. Gn therapy is a feasible and effective treatment for reproduction in CHH females, but the selection of Gn type and dosage must be personalized to maximize fertility outcomes. Effective treatment is available not only for inducing estrogenization and promoting fertility, but also for addressing concerns about psychological and emotional well-being.
Behavioral activation for depression in patients with advanced cancer: study protocol for a multicenter randomized controlled trial
Authors: Hirayama Takatoshi , Ogawa Yuko , Ogawa Asao , Igarashi Emi , Soejima Saaya , Hata Kotone , Utsumi Yusuke , Mashiko Yuki , Ogata Kyoka , Kayano Ayako , Yanai Yuko , Suzuki Shin-ichi
Published: May 2023

Background

Though behavioral activation (BA) has been shown to be effective for depression, evidence in patients with advanced cancer has not been established. This study aimed to examine the effectiveness of a BA program on depression in this population.

Methods

A randomized controlled trial with a wait-list control group (waiting group) of 38 patients with advanced cancer and depression will be conducted at three sites in Japan. The BA program consists of seven sessions. Outcome measures will be evaluated at three times in the intervention group; at the entry, at the end of the intervention and 4 months after the end of the intervention and four times in the waiting group: at the entry, before the intervention, at the end of the intervention, and 4 months after the end of the intervention. Primary outcome is Beck Depression Inventory-II (BDI-II) score. To examine the main effect of the intervention, two-way repeated measures analysis of variance (ANOVA) will be conducted, with timing and intervention status as the independent variables and BDI-II score as the dependent variable. One-way repeated measures ANOVA will be conducted to combine data from the intervention and control groups and examine changes in BDI-II scores by timing in both groups. Secondary endpoints (anxiety, quality of life, spirituality, degree of behavioral activation, value, and pain) will be evaluated with rating scales. Two-way repeated measures ANOVA will be conducted to examine whether there are differences between the groups before and after the intervention, with timing and intervention status as the independent variables and scores on each rating scale as the dependent variables.

Discussion

This multicenter randomized controlled trial is the first study to assess the effectiveness of BA on depression in patients with advanced cancer. Our findings will provide evidence about the effectiveness of BA on depression and provide an intervention option that is acceptable and feasible for the treatment of depression in this population. The results of this study will lead to improved mood and rebuilding to regain life purpose and value in this vulnerable population.

Trial Registration Number

jRCT, jRCT1030210687, Registered 22 March 2022, https://jrct.niph.go.jp/en-latest-detail/jRCT1030210687.
Factors influencing and changes in childhood vaccination coverage over time in Bangladesh: a multilevel mixed-effects analysis
Authors: Kundu Satyajit , Kundu Subarna , Seidu Abdul-Aziz , Okyere Joshua , Ghosh Susmita , Hossain Ahmed , Alshahrani Najim Z. , Banna Md. Hasan Al , Rahman Md. Ashfikur , Ahinkorah Bright Opoku
Published: May 2023

Introduction

This study aimed to investigate the associated factors and changes in childhood vaccination coverage over time in Bangladesh.

Methods

Bangladesh’s Demographic and Health Surveys from 2011, 2014, and 2017-18 provided data for this study on vaccination coverage among children aged 12 to 35 months. For three survey periods, multilevel binary logistic regression models were employed.

Results

The overall prevalence (weighted) of full vaccination among children aged 12–35 months were 86.17% in 2011, 85.13% in 2014, and 89.23% in 2017-18. Children from families with high wealth index, mothers with higher education, and over the age of 24 and who sought at least four ANC visits, as well as children from urban areas were more likely to receive full vaccination. Rangpur division had the highest change rate of vaccination coverage from 2011 to 2014 (2.26%), whereas Sylhet division had the highest change rate from 2014 to 2017-18 (34.34%).

Conclusion

To improve immunization coverage for Bangladeshi children, policymakers must integrate vaccine programs, paying special attention to mothers without at least a high school education and families with low wealth index. Increased antenatal care visits may also aid in increasing the immunization coverage of their children.