bluuebunny/crossref_metadata_2025 huggingface dataset:
The damselfly genus Megaloprepus (Odonata: Pseudostigmatidae): Revalidation and delimitation of species-level taxa including the description of one new species
Authors: FEINDT WIEBKE , HADRYS HEIKE
Published: March 2022

As the longest-winged odonate species of the extant world, Megaloprepus caerulatus (Drury, 1782) has received attention by many entomologists. While the behavior and ecology of this species has been subject of intense studies, biogeography and species status throughout its distributional range in old-growth Neotropical forests are less well known. For tropical forests, this information is a sine qua non when estimating the impact of degradation and climate change. Recent population genetic analyses, quantitative morphometric, and traditional taxonomic studies rediscovered a complex composed of cryptic species within the genus Megaloprepus Rambur, 1842—up until now still regarded as a monotypic genus. Here we introduce one new species Megaloprepus diaboli sp. nov. from the southern Pacific coast of Costa Rica and from the central Caribbean coast of Honduras and Guatemala. The holotype is from the Corcovado National Park, Costa Rica (N 8°28’55.62” W 83°35’13.92”), and was deposited at the National Museum of Costa Rica. Aside from M. caerulatus, two formerly described and later refused species within the genus were reevaluated and consequently raised to species status: Megaloprepus latipennis Selys, 1860 is found in the northeastern regions of Mesoamerica and Megaloprepus brevistigma Selys, 1860 in South America east of the Andes. Morphological descriptions of selected specimens (holotype of M. diaboli, lectotype of M. latipennis, and the mature males of M. brevistigma and M. caerulatus) are provided. Diagnostic features of the four species are illustrated, discussed, and summarized in a key to adult males.
A contribution to understanding the morphology of the genus Anthroherpon (= Parantrophilon syn. nov.) and new combination for a species from the Balkan Peninsula (Insecta, Coleoptera, Leiodidae, Cholevinae, Leptodirini)
Authors: ČEPLÍK DÁVID , HLAVÁČ PETER
Published: March 2022

The subterranean beetle genus Anthroherpon Reitter, 1889 stands for an iconic cave-adapted organism due to wide range of the morphological variability and the diversification of its species in the Central and Southern Dinarides. The monotypical genus Parantrophilon Noesske, 1914 is nested within the distribution area of Anthroherpon and it is also narrowly distributed. After a morphological study and comparison with the related material of the genus Anthroherpon Reitter, 1889, the synonymy of Parantrophilon to Anthroherpon is established. A redescription of the genus Anthroherpon Reitter, 1889 is given.
Two new genera of phorid flies, Macgrathphora and Aurisetiphora, from Costa Rica (Diptera: Phoridae), with recommendations for naming new genera in the family
Authors: BROWN BRIAN V.
Published: March 2022

Two new genera and four new species of metopinine phorid fly are described from Costa Rica. Macgrathphora new genus is described with the following new species: M. caribbea, M. longifurca, and M. pacifica. In particular, M. caribbea is one of the most abundant phorids collected in a recent inventory project in Northwestern Costa Rica. Aurisetiphora new genus is described for a single species, A. maggiesnowae new species, from a site in the Central Valley, near San José. Guidelines for describing new genera within the Phoridae, especially the Metopininae, are given, and genus Synaptophora Brown is synonymized with Dohrniphora Dahl (new synonymy).
Possible Relationship between January “Warm Arctic–Cold Eurasia” and February Haze in North China
Authors: Zhang Yijia , Yin Zhicong , Zhou Botao , Wang Huijun
Published: March 2022

Haze pollution frequently occurs in North China almost every winter month. However, many previous studies pointed out that the interannual–decadal variations of haze in February were inconsistent with that in early winter, which demonstrated an evident subseasonal change in haze pollution. In this study, we found a close relationship between the “warm Arctic–cold Eurasia” (WACE) pattern in January and the weakened February haze pollution in North China according to monthly composites from 1980 to 2019. Associated with the warming signal in sea ice and the cooling signal in Eurasian soil temperatures, the WACE pattern sustained from January to February. The combined signal of sea ice and soil temperature anomalies and its associated anomalous cyclonic circulations over North China provided an environment conducive to the dispersion of pollutants. The relationship between the WACE pattern and the cyclonic circulation anomaly could also be detected from the large-ensemble CMIP6 simulations. Furthermore, the relationship between the January WACE pattern and the reduction of February haze pollution has been prominently enhanced since the late 1990s, which accurately corresponds to the deep Arctic warming that has emerged since the late 1990s.

Significance Statement

Haze pollution frequently occurs in North China almost every winter month, but with an apparent subseasonal change. Climate anomalies in the mid- to high latitudes could regulate the variations in haze through atmospheric teleconnection. Our study found a relationship between the “warm Arctic–cold Eurasia” (WACE) pattern in January and the weakened February haze pollution in North China. The lingering signal of the WACE was associated to the anomalous cyclonic circulations over North China in February, which was conducive to the dispersion of pollutants. Furthermore, the relationship between the WACE pattern and February haze pollution has been prominently enhancing since the late 1990s, which accurately corresponds to the emergence of the deep Arctic warming accompanied by the strengthened Eurasian cooling. This investigation is of great significance for subseasonal haze prediction.
Land–Snow Data Assimilation Including a Moderately Coupled Initialization Method Applied to NWP
Authors: Benjamin Stanley G. , Smirnova Tatiana G. , James Eric P. , Lin Liao-Fan , Hu Ming , Turner David D. , He Siwei
Published: March 2022

Initialization methods are needed for geophysical components of Earth system prediction models. These methods are needed from medium-range to decadal predictions and also for short-range Earth system forecasts in support of safety (e.g., severe weather), economic (e.g., energy), and other applications. Strongly coupled land–atmosphere data assimilation (SCDA), producing balanced initial conditions across the land–atmosphere components, has not yet been introduced to operational numerical weather prediction (NWP) systems. Most NWP systems have evolved separate data assimilation (DA) procedures for the atmosphere versus land/snow system components. This separated method has been classified as a weakly coupled DA system (WCDA). In the NOAA operational short-range weather models, a moderately coupled land–snow–atmosphere assimilation method (MCLDA) has been implemented, a step forward from WCDA toward SCDA. The atmosphere and land (including snow) variables are both updated within the DA using the same set of observations (aircraft, radiosonde, satellite radiances, surface, etc.). Using this assimilation method, land surface state variables have cycled continuously for 6 years since 2015 for the 3-km NOAA HRRR model and with CONUS cycling since 1997. Month-long experiments were conducted with and without MCLDA for both winter and summer seasons using the 13-km Rapid Refresh model with atmosphere (50 levels), soil (9 levels), and snow (up to 2 layers if present) on the same horizontal grid. Improvements were evident for 2-m temperature for all times of day out to 6–12 h for both seasons but stronger in winter. Better temperature forecasts were also shown in the 1000–900-hPa layer corresponding roughly to the boundary layer.

Significance Statement

Accuracy of weather models depends on accurate initial conditions for soil temperature and moisture as well as for the atmosphere itself. This paper describes a moderately coupled data assimilation method that modifies soil conditions based on forecast error corrections indicated by atmospheric observations. This method has been tested for a month-long period in summer and winter and shown to consistently improve short-range forecasts of 2-m temperature and moisture. This coupled data assimilation method is used already in NOAA operational short-range models to improve its prediction skill for clouds, convective storms, and general weather conditions.
Robotic Resection of Retroperitoneal Perinephric Tumor. Application of Intraurethral Indocyanine Green Injection As an Adjunct to Avoid Ureteral Injury
Authors: Sucandy Iswanto , Ross Sharona , Touadi Melissa , Crespo Kaitlyn , Syblis Cameron , Rosemurgy Alexander
Published: March 2022

The majority of retroperitoneal mass excision is performed via conventional “open” laparotomy due to concerns of technical difficulty and adequate oncological margins in cases of a malignant sarcoma. A very few cases of minimally invasive resection by laparoscopy had been reported in the literature. Despite the rapid adoption of robotic technology in general surgery and surgical oncology, the robotic technique has not been applied for this pathology. We discussed a complete resection of a large perinephric tumor using a robotic platform. To our knowledge, this is the first study to report the robotic technique of retroperitoneal tumor excision, highlighting the application and usefulness of intraurethral indocyanine green (ICG) injection.
Enhanced Recovery After Surgery Protocols for Head and Neck Cancer: Systematic Review and Meta‐analysis
Authors: Kattar Nrusheel , Wang Steven X. , Trojan Jeffrey D. , Ballard Craig R. , McCoul Edward D. , Moore Brian A.
Published: March 2022

Objective

Enhanced recovery after surgery (ERAS) protocols aim to optimize the pre‐, intra‐, and postoperative care of patients to improve surgery outcomes, reduce complications, decrease length of stay, and more. We aim to perform a systematic review and meta‐analysis of ERAS protocols for head and neck cancer surgery with or without microvascular reconstruction.

Data Sources

PubMed, Embase, and Web of Science databases were queried, and abstracts were screened independently by 2 investigators.

Review Methods

This review was conducted in accordance with the PRISMA guidelines. We included comparative observational studies but excluded animal studies, case reports, and case series.

Results

Of 557 articles initially reviewed by title and/or abstract, we identified 30 for full‐text screening, and 9 met the criteria for qualitative synthesis. Meta‐analysis of length of stay revealed a mean decrease of 1.37 days (95% CI, 0.77‐1.96; I2 = 0%; P < .00001) with the ERAS group as compared with non‐ERAS controls. The standardized mean difference of the morphine milligram equivalent was 0.72 lower (95% CI, 0.26‐1.18; I2 = 82%; P = .002) in the ERAS group vs controls. The quality of studies was moderate with a median MINORS score of 18.5 (range, 13.5‐21.5).

Conclusion

Implementation of ERAS protocols can lead to decreases in length of stay and opioid drug utilization. However, further high‐quality prospective studies of ERAS protocols are needed, especially with stratified analysis of outcomes based on the type of head and neck cancer surgery.
Dysphagia Outcomes Following Surgical Management of Unilateral Vocal Fold Immobility in Children: A Systematic Review
Authors: Marvin Kastley , Coulter Michael , Johnson Christopher , Friesen Tzyynong , Morris Kimberly , Brigger Matthew T.
Published: March 2022

Objective

To assess dysphagia outcomes following surgical management of unilateral vocal fold immobility in children.

Data Sources

Ovid Medline, Embase, Web of Science, and CENTRAL databases.

Review Methods

A systematic review of the medical literature was performed following the PRISMA guidelines. An a priori protocol was defined to identify all articles that presented quantifiable outcome data in children aged <18 years who underwent surgical treatment to improve glottal competence for dysphagia. Two authors independently determined references meeting the inclusion criteria, extracted data, and assigned levels of evidence. Data were pooled via a random effects model where possible. The quality of studies was graded with the MINORS criteria.

Results

An overall 398 publications were screened, with 9 meeting inclusion criteria. A total of 115 patients were included. Of these, 75% had preoperative swallowing symptoms. Surgical intervention for dysphagia included 61 injection laryngoplasties, 11 medialization laryngoplasties, and 10 reinnervations (ansa cervicalis to recurrent laryngeal nerve). The articles consistently reported success in improving dysphagia symptoms, and limited meta‐analysis demonstrated a mean improvement after surgical intervention in 79% (95% CI, 67%‐91%) of children. The reported rate of minor and major complications was 15% (95% CI, 1%‐29%). The MINORS scores ranged from 5 to 12.

Conclusion

Surgical management of unilateral vocal fold immobility in properly selected children can be an effective treatment for dysphagia when symptoms are present. Selection of surgical modalities relies on patient‐ and surgeon‐related factors, and the rate of success is high across different interventions in treating these complex children.
On variational principles in coupled strain-gradient elasticity
Authors: Nazarenko Lidiia , Glüge Rainer , Altenbach Holm
Published: March 2022

Strain-gradient elasticity is a special case of high-gradient theories in which the potential energy density depends on the first and second gradient of the displacement field. The presence of a coupling term in the material law leads to a non-diagonal quadratic form of the stored energy, which makes it difficult for the derivation of fundamental theorems. In this article, two variational principles of the minimum of potential and complementary energies are argued in the context of the coupled strain-gradient elasticity theory. The basis of the proofs of both variational principles is the equivalent transformation of the stain and strain-gradient energy density that allows to avoid the complication related to the presence of the fifth-rank coupling tensor [Formula: see text] in the equation for the potential energy density and leads to diagonalization of the quadratic form of the stored energy. This transformation enables to inverse Hook’s law, to determine compliance tensors, and to obtain closed-form relation for the complementary energy. After that the proofs of both principles of a minimum of potential and complementary energies are provided in the usual manner adopted in the classical theory of elasticity.
Religious affiliation and philosophical and moral beliefs about vaccines: A longitudinal study
Authors: Kuru Ozan , Chan Man-pui Sally , Lu Hang , Stecula Dominik Andrzej , Jamieson Kathleen Hall , Albarracín Dolores
Published: March 2022

How do religious affiliation and beliefs shape vaccine attitudes and behaviors? This study examined the associations of attitudes and behaviors relevant to the flu, measles-mumps-rubella (MMR), and human-papillomavirus (HPV) vaccines with religious affiliations, as well as philosophical, spiritual, and moral beliefs. Respondents were 3005 adults from a probability-based, four-wave panel survey in the United States. Longitudinal structural equation modeling examined how religious affiliations and philosophical/moral beliefs shaped attitudes toward vaccines and actual vaccination. Stronger philosophical beliefs predicted more negative attitudes toward each vaccine and stronger moral beliefs more negative attitudes toward the HPV vaccine. Negative vaccine attitudes then predicted weaker intentions to encourage others to vaccinate and lower probability of receiving a vaccine. Theoretical and public health messaging implications are discussed.
Longitudinal intronic RNA-Seq analysis of Parkinson’s disease patients reveals disease-specific nascent transcription
Authors: Koks Sulev , Pfaff Abigail L , Bubb Vivien J , Quinn John P
Published: March 2022

Transcriptomic studies usually focus on either gene or exon-based annotations, and only limited experiments have reported changes in reads mapping to introns. The analysis of intronic reads allows the detection of nascent transcription that is not influenced by steady-state RNA levels and provides information on actively transcribed genes. Here, we describe substantial intronic transcriptional changes in Parkinson’s disease (PD) patients compared to healthy controls (CO) at two different timepoints; at the time of diagnosis (BL) and three years later (V08). We used blood RNA-Seq data from the Parkinson’s Progression Markers Initiative (PPMI) cohort and identified significantly changed transcription of intronic reads only in PD patients during this follow-up period. In CO subjects, only nine transcripts demonstrated differentially expressed introns between visits. However, in PD patients, 4873 transcripts had differentially expressed introns at visit V08 compared to BL, many of them in genes previously associated with neurodegenerative diseases, such as LRRK2, C9orf72, LGALS3, KANSL1AS1, and ALS2. In addition, at the time of diagnosis (BL visit), we identified 836 transcripts (e.g. SNCA, DNAJC19, PRRG4) and at visit V08, 2184 transcripts (e.g. PINK1, GBA, ALS2, PLEKHM1) with differential intronic expression specific to PD patients. In contrast, reads mapping to exonic regions demonstrated little variation indicating highly specific changes only in intronic transcription. Our study demonstrated that PD is characterized by substantial changes in the nascent transcription, and description of these changes could help to understand the molecular pathology underpinning this disease.
A qualitative study exploring tactical performance determinants from the perspective of three Rugby World Cup coaches
Authors: Colomer Carmen M. E. , Pyne David B. , Mooney Mitch , McKune Andrew , Serpell Benjamin G.
Published: March 2022

Experiential knowledge of elite international coaches was investigated to reveal insights on successful rugby union strategies and tactics required to prevail in international competition. Three elite coaches who coached at a Rugby World Cup were interviewed using an in-depth, semi-structured approach. They were asked about specific strategies and tactics which they believed were required to be successful in an upcoming international tournament and a thematic analysis of qualitative data followed. Particular interest was paid to the influence of potential constraints and how these factors impact performance behaviours over time. The importance of an effective tactical kicking game in attacking strategies was highlighted, along with an adaptable defensive structure following a turnover. Unsuccessful performance behaviours in international rugby were reported to be connected with an irrational kicking game, a weak defensive line and losing possession off set-piece plays. These results support the need for a multidisciplinary approach, where exploring coaches’ knowledge presents an opportunity to enhance understanding across the performance analysis field. Further research is needed to complement experiential knowledge with quantitative research in rugby performance analysis.
Attitude and practice toward traditional medicine among hypertensive patients on follow-up at Mizan–Tepi University Teaching Hospital, Southwest Ethiopia
Authors: Aferu Temesgen , Mamenie Yalew , Mulugeta Meseret , Feyisa Diriba , Shafi Miftah , Regassa Tolcha , Ejeta Fikadu , Hammeso Workineh Woldeselassie
Published: March 2022

Introduction:

Traditional medicine has been used for the management of common mild conditions such as headache, diarrhea, and common cold as well as in the treatment of chronic diseases including hypertension. The usage of this medicine is regarded as acceptably safe with most Ethiopian people. Attitude and practices toward traditional medicine are crucial elements of hypertension control and its favorable outcome expectation. This study aimed at assessing the attitude and practice toward traditional medicine among hypertensive patients on follow-up at Mizan–Tepi University Teaching Hospital, Southwest Ethiopia.

Method:

Facility-based cross-sectional study was conducted from 1st December 2020 to 30th December 2020 among 173 hypertensive patients. A consecutive sampling technique was used to select study participants. Data were collected through interviewer-administered structured questionnaire and analyzed using Statistical Package for the Social Sciences software version 23. Multivariable logistic regression analysis was done to identify the independent predictors of patients’ attitude toward traditional medicine and their traditional medicine use at a p value ⩽0.05.

Results:

Eighty-seven (50.29%) of the total 173 approached patients were found to have good attitude toward traditional medicine. Ninety-seven (56.07%) participants had used traditional medicine at least once in their lifetime and 45 (46.39%) patients used traditional medicine and modern medicine concomitantly. Participants’ residence (adjusted odds ratio = 2.79, confidence interval = 1.01–7.74, p-value = 0.049) and educational status (adjusted odds ratio = 1.76, confidence interval = 1.61–5.09, p-value = 0.032) had significant association with attitude toward traditional medicine, while patients’ age (adjusted odds ratio = 1.43, confidence interval = 1.32–4.96, p-value = 0.039), residence (adjusted odds ratio = 2.18, confidence interval = 1.10–4.32, p-value = 0.025), and occupation (adjusted odds ratio = 3.38, confidence interval = 1.55–7.38, p-value = 0.002) had significant association with their traditional medicine use.

Conclusion:

Half of the study participants had good attitude toward traditional medicine, and nearly, one-fourth of the participants had practiced traditional medicine along with modern medicine. Health service providers should be aware of traditional medicine use and advise patients on the dosing of traditional medicine.
Interpretation of convolutional neural networks reveals crucial sequence features involving in transcription during fiber development
Authors: Liu Shang , Cheng Hailiang , Ashraf Javaria , Zhang Youping , Wang Qiaolian , Lv Limin , He Man , Song Guoli , Zuo Dongyun
Published: March 2022

Background

Upland cotton provides the most natural fiber in the world. During fiber development, the quality and yield of fiber were influenced by gene transcription. Revealing sequence features related to transcription has a profound impact on cotton molecular breeding. We applied convolutional neural networks to predict gene expression status based on the sequences of gene transcription start regions. After that, a gradient-based interpretation and an N-adjusted kernel transformation were implemented to extract sequence features contributing to transcription.

Results

Our models had approximate 80% accuracies, and the area under the receiver operating characteristic curve reached over 0.85. Gradient-based interpretation revealed 5' untranslated region contributed to gene transcription. Furthermore, 6 DOF binding motifs and 4 transcription activator binding motifs were obtained by N-adjusted kernel-motif transformation from models in three developmental stages. Apart from 10 general motifs, 3 DOF5.1 genes were also detected. In silico analysis about these motifs’ binding proteins implied their potential functions in fiber formation. Besides, we also found some novel motifs in plants as important sequence features for transcription.

Conclusions

In conclusion, the N-adjusted kernel transformation method could interpret convolutional neural networks and reveal important sequence features related to transcription during fiber development. Potential functions of motifs interpreted from convolutional neural networks could be validated by further wet-lab experiments and applied in cotton molecular breeding.
The efficacy of human epidermal growth factor receptor 2 (HER2) blockade switching mode in refractory patients with HER2-positive metastatic breast cancer: a phase II, multicenter, single-arm study (SYSUCC-005)
Authors: Duan Fangfang , Zhong Muyi , Ma Yuyu , Song Chenge , Zhang Lehong , Lin Ying , Wu Zhiyong , Zhang Yuanqi , Huang Jiajia , Xu Fei , Shi Yanxia , Wang Shusen , Yuan Zhongyu , Xia Wen , Bi Xiwen
Published: March 2022

Background

Despite significant survival improvement in human epidermal growth factor receptor 2 (HER2) blockade for HER2-positive breast cancer, resistance to anti-HER2 remains inevitable. Subsequent anti-HER2 with continuing trastuzumab beyond progression is acceptable with limited efficacy when other anti-HER2 treatment is unavailable. This single-arm, phase II study (SYSUCC-005) aimed to explore the efficacy of switching mode for HER2-positive refractory metastatic breast cancer.

Methods

Patients with HER2-positive metastatic breast cancer rapidly progressing during pre-trastuzumab from six hospitals in China were designed to switch to lapatinib 1,250 mg orally once per day continuously plus capecitabine (1,000 mg/m2 orally twice per day on days 1–14) or vinorelbine (25 mg/m2 intravenously once per day on days 1 and 8) of each 21-day cycle. The primary endpoint was progression-free survival (PFS).

Results

Between January 5, 2015 and May 31, 2020, 159 patients were eligible in this study. The median follow-up was 33.1 months, a median PFS of 8.5 months was achieved. Brain metastases (hazard ratio [HR] = 1.582, 95% confidence interval [CI] 1.019- 2.453, P = 0.041) and ≥ 2 metastatic sites (HR = 1.679, 95% CI 1.151–2.450, P = 0.007) were independent prognostic factors for PFS. The most common grade ≥ 3 adverse events were diarrhea (3.8%) and hand-foot syndrome (9.4%).

Conclusion

The switching mode showed predominant efficacy, which might be a prior therapeutic option over continuing mode in subsequent anti-HER2 therapy for patients with HER2-positive refractory metastatic breast cancer.

Trial registration

This trial was registered on ClinicalTrials.gov (NCT02362958) on 13/02/2015.
Changes of retinal structure and function in patients with internal carotid artery stenosis
Authors: Wu Dong-hui , Wu Lan-ting , Wang Yan-ling , Wang Jia-lin
Published: March 2022

Background

To investigate the structural and functional changes of the retina in patients with different degrees of internal carotid artery (ICA) stenosis.

Methods

This cross-sectional study included patients with varying degrees ICA stenosis. Clinical characteristics of 41 patients were collected after being divided into four groups according to the ICA stenosis indicated by computed tomographic angiography (Group 0: without ICA stenosis, Group 1: ipsilateral slight ICA stenosis, Group 2: ipsilateral moderate ICA stenosis, Group 3: ipsilateral severe ICA stenosis). Retinal vessel caliber (RVC) was measured quantitatively with the Integrative Vessel Analysis software. The retinal sensitivity was examined with the MP-3 microperimeter. The relationships among central retinal artery equivalent (CRAE), central retinal vein equivalent, arteriole to venule ratio (AVR), mean retinal sensitivity (MS) and ICA stenosis degree were analysed.

Results

The CRAE in Group 3 were significantly smaller compared with Group 0, Group 1 and Group 2 (P < 0.001, P < 0.001, P = 0.002). Significant decrease was found between Group 3 with other groups in MS at fovea (P < 0.001, P < 0.001, P = 0.002). Moreover, there was a positive correlation found between MS and CRAE (Beta = 0.60, P < 0.001 at fovea; Beta = 0.64, P < 0.001 at 2 degree; Beta = 0.60, P < 0.001 at 4 degree; Beta = 0.55, P < 0.001 at 8 degree; Beta = 0.53, P < 0.001 at 12 degree).

Conclusions

The present study revealed smaller CRAE and AVR in ipsilateral severe ICA stenosis patients. And the MS decreased in patients with severe ICA stenosis. In addition, MS had a positive correlation with CRAE.
An analysis of views about supported reduction or discontinuation of antipsychotic treatment among people with schizophrenia and other psychotic disorders
Authors: Crellin Nadia E. , Priebe Stefan , Morant Nicola , Lewis Glyn , Freemantle Nick , Johnson Sonia , Horne Rob , Pinfold Vanessa , Kent Lyn , Smith Ruth , Darton Katherine , Cooper Ruth E. , Long Maria , Thompson Jemima , Gruenwald Lisa , Freudenthal Robert , Stansfeld Jacki L. , Moncrieff Joanna
Published: March 2022

Background

Antipsychotic medication can reduce psychotic symptoms and risk of relapse in people with schizophrenia and related disorders, but it is not always effective and adverse effects can be significant. We know little of patients’ views about continuing or discontinuing antipsychotic treatment.

Aims

To explore the views of people with schizophrenia and other psychotic disorders about continuing their antipsychotic medication or attempting to reduce or discontinue this medication with clinical support.

Methods

We collected quantitative and qualitative data by conducting semi-structured interviews in London, UK. Factors predicting a desire to discontinue medication were explored. Content analysis of qualitative data was undertaken.

Results

We interviewed 269 participants. 33% (95% CI, 27 to 39%) were content with taking long-term antipsychotic medication. Others reported they took it reluctantly (19%), accepted it on a temporary basis (24%) or actively disliked it (18%). 31% (95% CI, 25 to 37%) said they would like to try to stop medication with professional support, and 45% (95% CI, 39 to 51%) wanted the opportunity to reduce medication. People who wanted to discontinue had more negative attitudes towards the medication but were otherwise similar to other participants. Wanting to stop or reduce medication was motivated mainly by adverse effects and health concerns. Professional support was identified as potentially helpful to achieve reduction.

Conclusions

This large study reveals that patients are commonly unhappy about the idea of taking antipsychotics on a continuing or life-long basis. Professional support for people who want to try to reduce or stop medication is valued.
BDNF-TrkB signaling-mediated upregulation of Narp is involved in the antidepressant-like effects of (2R,6R)-hydroxynorketamine in a chronic restraint stress mouse model
Authors: Ju Lingsha , Yang Jiaojiao , Zhu Tingting , Liu Panmiao , Yang Jianjun
Published: March 2022

Background

Preclinical studies have indicated that the ketamine metabolite (2R,6R)-hydroxynorketamine (HNK) is a rapid-acting antidepressant drug with limited dissociation properties and low abuse potential. However, its effects and molecular mechanisms remain unclear. In this work, we examined the involvement of brain-derived neurotrophic factor (BDNF), tropomyosin receptor kinase B (TrkB) and Narp in the antidepressant-like actions of (2R,6R)-HNK in a chronic restraint stress (CRS) mouse model.

Methods

C57BL/6 male mice were subjected to CRS for 8 h per day for 14 consecutive days. Open field, forced swimming, novelty suppressed feeding, and tail suspension tests were performed after administering (2R,6R)-HNK (10 mg/kg), a combination of (2R,6R)-HNK and NBQX (an alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptor antagonist; 10 mg/kg), or a combination of (2R,6R)-HNK and ANA-12 (a TrkB receptor antagonist; 0.5 mg/kg). The mRNA levels of Bdnf and Narp in the hippocampus were determined by quantitative reverse transcription-PCR (qRT–PCR). Western blotting was used to determine the hippocampal protein levels of GluA1, GluA2, BDNF, Narp, PSD95, and synaptophysin, as well as the p-TrkB/TrkB protein ratio.

Results

(2R,6R)-HNK had rapid antidepressant-like effects in CRS mice. Furthermore, (2R,6R)-HNK significantly ameliorated CRS-induced downregulation of GluA1, GluA2, BDNF, Narp, PSD95, and the p-TrkB/TrkB protein ratio in the hippocampus. The effects of (2R,6R)-HNK were blocked by combinations with NBQX or ANA-12.

Conclusion

BDNF-TrkB signaling-mediated upregulation of Narp in the hippocampus may play a key role in the antidepressant-like effect of (2R,6R)-HNK in the CRS model of depression.
A comparative study on mental health and adaptability between older and younger adults during the COVID-19 circuit breaker in Singapore
Authors: Yu Chou Chuen , Tou Nien Xiang , Low James Alvin
Published: March 2022

Background

While older age is associated with better emotional well-being, it is unclear whether such age advantages remain during a pandemic. This study examined differences in mental health, adaptive behaviours, social support, perceived stress, digital media usage, and perceived change in circumstances between younger and older adults during the circuit breaker period (partial lockdown) in Singapore.

Methods

A door-to-door survey was administered to a nationally representative sample of 602 younger (n = 302) and older (n = 300) adults aged 21–89 years from Singapore from 17 October to 27 November 2020. All participants self-reported their depression, anxiety, stress, adaptive behaviours, social support, perceived stress, change in circumstances, and digital media usage during the partial lockdown period.

Results

Older adults were found to report significantly lower levels of depression, anxiety, and stress as compared to younger adults. Although older adults were less able to perform essential activities during the lockdown, they were more adaptable psycho-socially. Logistic regression analyses revealed that for older age group, adaptability and health status significantly predicted better mental health. Older adults had higher odds of low depression scores [odds ratio (OR) 1.81, 95% confidence intervals (CI) 1.07–3.08], anxiety scores (OR 1.80, 95% CI 1.05–3.08), and stress scores (OR 3.05, 95% CI 1.72–5.41). In addition, adaptability was found to moderate the relationship between age and mental health with detrimental effects of low adaptability stronger for younger adults than older adults.

Conclusions

During the lockdown period, older adults in Singapore had better mental health, perceived less stress-related concerns and were more adaptable psycho-socially as compared to younger adults. This study’s findings extend current evidence that age-related advantages in emotional well-being persisted in the wake of the COVID-19 pandemic.
The impact of COVID-19 on access to harm reduction, substance use treatment and recovery services in Scotland: a qualitative study
Authors: Schofield Joe , Dumbrell Joshua , Matheson Catriona , Parkes Tessa , Bancroft Angus
Published: March 2022

Introduction

People who use drugs (PWUD) are considered vulnerable to COVID-19 exposure and the sequelae of infection due to their social circumstances, health conditions, drug purchasing, and substance use. They can depend on access to services that provide harm reduction, substance use treatment, recovery and support, and general healthcare. Social distancing measures and service restrictions posed significant challenges to the health and wellbeing of PWUD.

Methods

Ethical approvals were secured. PWUD were recruited from voluntary sector homeless and housing, harm reduction, and recovery organisations across central Scotland. Data was collected via semi-structured interviews and analysed using the Framework Method.

Results

Twenty nine PWUD participated and reported mixed experiences of the impacts of COVID-19 lockdown. Several benefitted from policy and practice developments designed to sustain or increase access to harm reduction services. Some PWUD reported improved access to substitute prescribing and/or appreciated being trusted to manage multiple take-home doses. Others noted the loss of regular in-person contact with treatment providers and dispensers. Access to recovery support was challenging for many, especially those unable to access or uncomfortable with online provision who experienced greater isolation. Lack of access to general healthcare services was common, and especially problematic for PWUD with chronic physical and mental health conditions.

Conclusions

This qualitative research describes the impacts of COVID-19 social and service restrictions on PWUD in Scotland. These impacts were anticipated by policy makers and service providers. Effective and acceptable developments were shown to maintain and even increase service provision for PWUD. Developments were geographically dependent and significant challenges remained for many people. The learning generated can inform responses to increase service access and uptake in post-pandemic times.
Factors associated with increased physical activity among patients prescribed physical activity in Swedish routine health care including an offer of counselor support: a 1-year follow-up
Authors: Andersen Pia , Holmberg Sara , Årestedt Kristofer , Lendahls Lena , Nilsen Per
Published: March 2022

Background

The study addresses knowledge gaps in research regarding influences of routine health care delivery of physical activity on prescription (PAP). The aim was to investigate if patient and health care characteristics are associated with increased physical activity 1 year after prescription among patients offered counselor support in addition to health care professionals’ prescription. The study was conducted in primary and secondary care in a Swedish health care region.

Methods

All PAP recipients during 1 year were invited (N = 1503) to participate in this observational prospective study. Data were collected from medical records and questionnaires (baseline and follow-up). Descriptive statistics and multiple logistic regression analysis were used. The outcome variable was increased physical activity after 1 year. Study variables were patient and health care characteristics.

Results

Three hundred and fifty-five patients with complete follow-up data were included. The mean age was 62 years (SD = 14; range, 18–90) and 68% were females. Almost half (47%) had increased physical activity 1 year after PAP. Multiple logistic regression analysis showed that increased physical activity at follow-up was positively associated with lower baseline activity, counselor use, and positive perception of support. Counselor users with low baseline activity had higher odds ratio for increased physical activity at follow-up than non-users (OR = 7.2, 95% CI = 2.2–23.5 vs. OR = 3.2, 95% CI = 1.4–7.5). Positive perception of support was associated with increased physical activity among counselor users but not among non-users.

Conclusions

An increase in physical activity after PAP was related to low baseline activity, positive perception of support, and use of counselor support after PAP. Qualified counseling support linked to PAP seems to be important for achieving increased physical activity among patients with lower baseline activity.
Increase in tibial internal rotation due to weight-bearing is a key feature to diagnose early-stage knee osteoarthritis: a study with upright computed tomography
Authors: Kaneda Kazuya , Harato Kengo , Oki Satoshi , Yamada Yoshitake , Nakamura Masaya , Nagura Takeo , Jinzaki Masahiro
Published: March 2022

Background

The classification of knee osteoarthritis is an essential clinical issue, particularly in terms of diagnosing early knee osteoarthritis. However, the evaluation of three-dimensional limb alignment on two-dimensional radiographs is limited. This study evaluated the three-dimensional changes induced by weight-bearing in the alignments of lower limbs at various stages of knee osteoarthritis.

Methods

Forty five knees of 25 patients (69.9 ± 8.9 years) with knee OA were examined in the study. CT images of the entire leg were obtained in the supine and standing positions using conventional CT and 320-row detector upright CT, respectively. Next, the differences in the three-dimensional alignment of the entire leg in the supine and standing positions were obtained using 3D-3D surface registration technique, and those were compared for each Kellgren–Lawrence grade.

Results

Greater flexion, adduction, and tibial internal rotation were observed in the standing position, as opposed to the supine position. Kellgren–Lawrence grades 1 and 4 showed significant differences in flexion, adduction, and tibial internal rotation between two postures. Grades 2 and 4 showed significant differences in adduction, while grades 1 and 2, and 1 and 3 showed significant differences in tibial internal rotation between standing and supine positions.

Conclusions

Weight-bearing makes greater the three-dimensional deformities in knees with osteoarthritis. Particularly, greater tibial internal rotation was observed in patients with grades 2 and 3 compared to those with grade 1. The greater tibial internal rotation due to weight-bearing is a key pathologic feature to detect early osteoarthritic change in knees undergoing osteoarthritis.
Impact of a new combined preoperative cleft assessment on dental implant success in patients with cleft and palate: a retrospective study
Authors: Savoldelli Charles , Bailleux Sonanda , Chamorey Emmanuel , Vandersteen Clair , Lerhe Barbara , Afota Franck
Published: March 2022

Background

Bone height assessment alone is frequently used to guide rehabilitation choice, without consideration for soft tissues or adjacent teeth. This study aimed to evaluate the impact of different preoperative cleft assessments on implant success and patient satisfaction.

Methods

The study involved a retrospective assessment of records from 40 patients with cleft lip and palate (CLP). The alveolar cleft score (ACS; clinical criteria), interdental alveolar bone height (IABH) score (radiological criteria), patient compliance score (dental hygiene, medical visit observance, and smoking), and a novel combined score (IABH-ACS-Compliance) were assessed from patient records. Patients who required prosthetic tooth rehabilitation in the cleft dental arch space were included. Twenty-six patients (Group 1) were treated with dental implants, and 14 patients (Group 2) selected another prosthetic option (fixed prosthodontics, removal prosthesis), orthodontic space closure, or no rehabilitation. The main outcomes measured were relative implant success (no implant loss involving marginal bone loss ≤ 1.9 mm) for patients treated with dental implant therapy (Group 1) and patient satisfaction for all patients (Groups 1 and 2).

Results

Forty dental implants were placed in the patients in Group 1. Four implants in four patients (Group 1 relative failure, RF) were lost (implant survival rate of 90%) after 36 (± 12.4) months of follow-up. Twenty-two patients who received implants belonged to the relative implant success group (Group 1 RS). The average “IABH-ACS-Compliance” scores were significantly different (p < 0.05): 16.90 ± 2.35 and 12.75 ± 0.43 for the Group 1 RS and RF groups, respectively.

Conclusions

Preoperative cleft parameters have an impact on relative implant success and patient satisfaction. The new cleft assessment combined-score (“IABH-ACS-Compliance”) allows an accurate selection of cleft cases eligible for dental implants, thereby improving postoperative outcomes.
Students’ perception of educational environment based on Dundee Ready Education Environment Measure and the role of peer mentoring: a cross-sectional study
Authors: Behkam Shadab , Tavallaei Amirhossein , Maghbouli Nastaran , Mafinejad Mahboobeh Khabaz , Ali Jemal Haidar
Published: March 2022

Objective

The curricular reform at Tehran University of Medical Sciences (TUMS), Iran, has been implemented since 2011 when peer mentoring program started. The program is believed to have a crucial role in students’ perception of the educational environment (EE). We aimed to determine how students perceive the educational environment and compared the mentees and non-mentees’ perception of EE.

Methods

A cross-sectional descriptive study was conducted among 190 first-year medical students enrolling at Tehran University of Medical Sciences from March to September 2019. A questionnaire was used to collect information on students’ age, gender, marital status, dormitory status, and their mentoring status including satisfaction of mentor-mentee relationship. The study also employed Dundee Ready Education Environment Measure (DREEM). The collected data were then entered and analysed using SPSS version 20. To compare the perception of EE between mentees and non-mentees, we used independent t-test.

Results

The mean (SD) for total DREEM score for EE was 144.1 (19.3), which signifies a more positive than negative educational environment perception. Nonetheless, the mean scores of total DREEM was not significantly different between students with or without mentors (P =0.390). The overall mean score for student perceptions of learning for mentees was 32.47 (4.5) while for those without a mentor, the score was 31.70 (4.9) (P =0.491). The items concerned with “emphasizing factual learning” and “teacher-based teaching” were rated the least. The item “having an appropriate support system” was scored significantly different between students with or without mentors (P =0.009).

Conclusions

Since having an appropriate support system was significantly different between groups, we suggest curriculum designers focus on the above-mentioned issue under caption for improvement during the reform programs.
Assessing the utility of virtual OSCE sessions as an educational tool: a national pilot study
Authors: Grover Sarika , Pandya Maharsh , Ranasinghe Chavini , Ramji Saajan P. , Bola Harroop , Raj Siddarth
Published: March 2022

Background

Objective Structured Clinical Examinations (OSCEs) are a common form of assessment used across medical schools in the UK to assess clinical competence and practical skills and are traditionally held in an in-person format. In the past, medical students have often prepared for such exams through in-person peer-assisted learning (PAL), however, due to the recent Covid-19 pandemic, many in-person teaching sessions transitioned to online-based formats. There is currently a paucity of research on the utility of virtual PAL OSCE sessions and thus, we carried out a national pilot study to determine the feasibility of virtual OSCE teaching via feedback from participants and examiners.

Methods

A total of 85 students from 19 UK-based medical schools with eight students based internationally attended the series of online OSCE workshops delivered via Zoom®. All students and examiners completed a feedback questionnaire at the end of each session regarding parameters, which included questions on pre-and post-workshop confidence in three OSCE domains: history-taking, communication and data interpretation. A Likert scale using 5 Likert items was used to self-report confidence, and the results were analysed using the Mann-Whitney U test after assessing for normality using the Shapiro-Wilk test.

Results

Results from student feedback showed an increase in confidence for all three OSCE domains after each event (p < 0.001) with 69.4% agreeing or strongly agreeing that online OSCE sessions could sufficiently prepare them for in-person exams. Questionnaire feedback revealed that 97.6% of students and 86.7% of examiners agreed that virtual OSCE teaching would be useful for preparing for in-person OSCE examinations after the pandemic.

Conclusion

Most participants in the virtual OSCE sessions reported an improvement in their confidence in history-taking, communication and data interpretation skills. Of the participants and examiners that had also experienced in-person OSCE examinations, the majority also reported that they found virtual OSCE sessions to be as engaging and as interactive as in-person teaching. This study has demonstrated that virtual OSCE workshops are a feasible option with the potential to be beneficial beyond the pandemic. However, more studies are required to assess the overall impact on student learning and to determine the value of virtual OSCE workshops on exam performance.