bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel graphical assessment approach for compressed curved structures under vertical loading
Authors: Olivieri Carlo , Adriaenssens Sigrid , Cennamo Claudia
Published: April 2023

Geometry forms the basis for the study of equilibrium of masonry structures. The dependence of the stability of masonry structures on geometry rather than on material strength was well known to the ancient builders who, over time, empirically worked out rules of proportion for good structural building design. We propose a new graphical approach to assess, the equilibrium in compression for planar and non-planer arches and curves according to the Safe Theorem of Limit Analysis. The approach extends an existing two-dimensional funicular polygon strategy into three dimensions for the first time. The method finds robust applications in the study of masonry flying staircases made of monolithic blocks, giving an alternative for equilibrium to the pure torsional solution. The advantage of the presented approach is that it can be solved solely graphically. The approach is demonstrated by assessing the equilibrium of the main flying or open-well staircase in the Palazzo delle Poste (Trapani, 1924, designed and constructed by Francesco La Grassa), an expressive yet poorly understood structure.
Comparative evaluation of combustion, performance, exergy and emission characteristics in hydrogen-biodiesel dual fuel engine under RCCI mode
Authors: Kumar Mukund , Paul Abhishek
Published: April 2023

The present work focuses on the impact of combustion phase shifting from CDC (conventional diesel combustion) to RCCI (reactivity controlled compression ignition) mode of operation under various premixed ratios of hydrogen on the combustion, performance and exhaust emissions of a partially modified CI (compression ignition) engine. The hydrogen premix ratios are varied from 10% to 60% with 10% increment and the engine is tested at 0.9 kW, 1.8 kW, and 2.7 kW. The experimental results have shown that the hydrogen participation up to 40% premixed ratio improves the homogeneousness and stability of the combustion, resulting in 8.19% increase in cylinder pressure and 27.81% increase in heat release rate (HRR) at 2.7 kW brake power. It is also observed that the premix phase of combustion is faster with up to 40% hydrogen participation as the 50% mass burn is found to shift towards TDC. At the same operating point, the combustion is also found to be more stable with 72% reduction in COVIMEP. The brake thermal efficiency (BTE) increases by 10.07% when operating at 2.7 kW brake power with a 40% premix ratio, compared to diesel CDC operation. The unburned hydrocarbon (UHC), carbon monoxide (CO), and PM emissions are reduced by 9.17%, 21.68%, and 9.51%, respectively, for the hydrogen premixed ratio of 40%, with a marginal increase in the oxide of nitrogen (NOX) emissions.
More efficient estimators of the area under the receiver operating characteristic curve in paired ranked set sampling
Authors: Abdallah Mohamed S
Published: April 2023

Receiver operating characteristic is a beneficial technique for evaluating the performance of a binary classification. The area under the curve of the receiver operating characteristic is an effective index of the accuracy of the classification process. While nonparametric point estimation has been well-studied under the ranked set sampling, it has received little attention under ranked set sampling variations. In order to set out to fill this gap, this article deals with the problem of estimating the area under the curve of the receiver operating characteristic based on paired ranked set sampling. New estimators of the area under the curve of the receiver operating characteristic based on paired ranked set sampling are proposed. Using the information supported by the concomitant variable, the additional area under the curve of the receiver operating characteristic estimators based on ranked set sampling as well as paired ranked set sampling are also introduced. It is shown either theoretically or numerically that the proposed estimators are consistent under the perfectness situation. It emerges that the concomitant-based estimators are shown to be superior to their competitors provided that the perfect assumption is not sharply violated. In contrast, kernel-based estimators are significantly superior relative to their rivals regardless of the quality of ranking. Finally, the application of the proposed procedures is also demonstrated by using empirical datasets in the context of medicine.
Cooperativism in Indigenous Culture and the Idea of Community Economy: Rethinking the Economic Space
Authors: Gogoi Rimon Bhuyan
Published: April 2023

This paper deals with the capitalocentrism of political economy discourses and diverse forms of collective economic practices in indigenous communities as bulwark against the hegemony that capitalocentrism creates. It refers to some important cooperative experiments across the world and examines in detail the collective customary practices of the Rabhas, an indigenous community of Assam. Being a community that historically revolved around the collective, much of its politico-economic autonomy and customary practices were interrupted by colonial occupation. The community struggles to keep many of its customary community practices alive and, in the process, has creatively adapted them into many modern institutions.
Anti-osteoporosis Effect of Cynaropicrin against Ovariectomy-induced Osteoporosis in Rats
Authors: Ye Hanlu , Wang Ke , Li Kai
Published: April 2023

Background

Osteoporosis is a progressive bone disease, which is characterized by high bone resorption, and low bone density and mass. Osteoporosis elevates the risk of bone fragility and fracture, which leads to significant morbidity and poor life quality.

Objectives

The current study focuses to explore the anti-osteoporosis activity of cynaropicrin against the ovariectomized (OVX)-induced osteoporosis in rats.

Materials and Methods

The OVX method was performed on the female rats to induce osteoporosis and then treated with 10 and 20 mg/kg of cynaropicrin, respectively, for 16 weeks. The uterus and femur tissues were excised from rats after the sacrification. The biomechanical properties of femur bones were analyzed to detect the stiffness, maximum load, young modulus, and energy absorption. The levels of acid phosphatase (ACP), bone-gla-protein (BGP), and estradiol (E2) in the serum were analyzed. The status of TNF-α, IL-6, IL-1β, osteoprotegerin (OPG), and receptor activator of nuclear factor-κB ligand (RANKL) was analyzed in the serum samples of experimental rats. The femur tissues were examined by histopathological analysis.

Results

The cynaropicrin treatment effectively increased the uterine and femoral weight in the OVX rats. The stiffness, maximum load, young modulus, energy, and femoral length were effectively increased by the cynaropicrin treatment. Cynaropicrin decreased the levels of BGP and ACP and increased the E2 level. The Cr, Ca, and P levels were appreciably increased and TNF-α, IL-6 and IL-1β levels were decreased by cynaropicrin on the OVX rats. The cynaropicrin treatment also increased the OPG and reduced the RANKL in the OVX rats. The histological findings revealed that cynaropicrin improved the femur trabecular bone microarchitecture in the OVX rats.

Conclusion

Our findings revealed that cynaropicrin increased the femoral weight and length, restored bone turnover markers and mineral profiles, and decreased inflammatory markers.
Influence of Drying Condition on Nutritional and Chemical Profile of Garcinia pedunculata Roxb. Fruit
Authors: Bhattacharjee Swarnali , Ramakrishnan Elancheran , Deb Prashanta Kumar , Sarma Partha Pratim , Choudhury Debopriya , Kabilan Senthamaraikannan , Devi Rajlakshmi
Published: April 2023

Background

Garcinia pedunculata (GP) Roxb. is a traditional medicinal plant used for treating gastrointestinal disorders. The fruit is always consumed in dried form in cuisines and as medicine.

Objectives

To study the effect of drying conditions (shade, oven, and traditional sun drying) on the nutritional profile of GP while assessing the choice of solvent extraction for the maximum phytocompounds extraction; their in vitro biological activities and chemical profiling.

Materials and Methods

The fruits were cut into thin 0.9 ± 0.3 cm slices and dried in the shade (25–30°C), sun (34–40°C), and oven (70–80°C). The extraction was done using methanol, hydromethanol, ethanol, hydroethanol, and water. HPLC and LC-ESI-MS/MS were used to identify the bioactive compounds.

Results

In this study, the impact of three drying conditions has been investigated and established that shade-dried (ShD) has a better-preserved nutritional profile. In terms of phytochemical extraction, comparatively higher amounts of phenols (394.00 ± 12.28 mg Gallic acid equivalent (GAE)/g of dried sample) and flavonoids (72.62 ± 2.06 mg Quercetin/g of dried sample) were recorded in the shade-dried hydromethanolic extract (ShDMH), which was directly in line with the better antioxidant activity (IC50 for 1,1-diphenyl-2-picrylhydrazyl (DPPH), 647.99 ± 7.66 µg/mL, 2,2’-azino-bis(3-ethylbenzothiazoline)6-sulfonic acid (ABTS), 762.02 ± 18.74 µg/mL) and enzyme-inhibitory potential (IC50 for α- glucosidase 1908.06 ± 13.26 µg/mL and for lipase 613.59 ± 7.57 µg/mL) of this extract.

Conclusion

The conclusive evidence from this study indicates that shade drying and extraction with hydromethanolic solvent preserves most of the nutritional components and has a higher extraction yield with well-conserved phytochemical composition. Also, these bioactive compounds such as hydroxycitric acid, GB-1a, garcinone A, 9-hydroxycalabaxanthone, chlorogenic acid, and garcinol are present in these extracts. This fruit, although beneficial is still underutilized, and this outcome is believed to be significantly valuable for the further aspects of GP fruit-based nutraceutical or phytopharmaceutical development.
Brief intervention reduces prescription of sodium valproate in women of childbearing age
Authors: Goldspink Rachel , Pumipi Toni , Menkes David B
Published: April 2023

Objective

Sodium valproate’s teratogenicity has prompted increasing restrictions to its use. Our initial audit 2 years prior demonstrated continuing hazardous prescription to women of childbearing age in a New Zealand psychiatric inpatient unit, consistent with nationwide dispensing data.

Method

Following a service-wide educational intervention and application of “black box” warnings, we conducted a follow-up audit of valproate prescription in the same inpatient unit by reviewing records of women admitted over a 10-month period (March 2020–January 2021). Results were compared with local and international guidelines, and against data from our initial audit.

Results

Two hundred and sixty-one women of childbearing age were admitted over the sampling period, 26 of whom (10%) were prescribed valproate on discharge. Over three quarters (77%) of these patients had diagnoses other than bipolar affective disorder, valproates only approved psychiatric indication in New Zealand. Following intervention, significant improvements were observed in several key indicators of prescribing quality: pregnancy testing, documentation of contraception status, and discussion of teratogenic risk.

Conclusions

Following intervention, re-audit demonstrated reduced prescription of valproate and improved management of its teratogenic risk in women of childbearing age receiving inpatient psychiatric care. These results demonstrate the value of a systematic approach to improve prescribing practice.
Does Patient-Reported Outcome Measures Use at New Foot and Ankle Patient Clinic Visits Improve Patient Activation, Experience, and Satisfaction?
Authors: Bernstein David N. , Jones Courtney M. C. , Flemister A. Samuel , DiGiovanni Benedict F. , Baumhauer Judith F.
Published: April 2023

Background:

Patient-reported outcome measures (PROMs) can help predict clinical outcomes and improve shared clinical decision-making discussions. There remains a paucity of research assessing how the use of PROMs may drive improved patient experience and patient activation.

Methods:

New foot and ankle patients completed PROMIS physical function (PF), pain interference (PI), and depression assessments. Patients were then randomized to viewing and discussing their PROMIS scores with their surgeon or not. Following the clinic visit, patients completed a series of Clinician & Group Survey–Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) questions and the Patient Activation Measure (PAM). Responses to the CG-CAHPS questions and PAM were compared between the 2 groups and after clustering on surgeon. Potential interaction effects by social deprivation were also explored.

Results:

After enrolling patients but removing those lost to follow-up or with missing data, 97 and 116 patients remained in the intervention control cohorts, respectively. No difference was found in CG-CAHPS responses nor PAM scores between the 2 groups ( P > .05). All surgeons were highly rated by all patients. When clustered by surgeon, intervention subjects were less likely to indicate “top box” scores for the understanding domain of the CG-CAHPS question (OR 0.51, P < .001) and had decreased odds of high patient activation compared to control subjects (OR 0.67; P = .005). Among the most socially disadvantaged patients, there was no difference in control and intervention subjects in their likelihood of having high patient activation ( P = .09).

Conclusion:

Highly rated foot and ankle surgeons who show and discuss PROM results may not improve patient experience or activation and may, in fact, decrease understanding or patient activation in select populations. Future work is needed to determine when PROM discussions are most beneficial and how best to present PROMs data, as we suspect that how the information was presented—and not the use of PROMs—resulted in our findings. Health literacy tools and/or communication training may better engage different patient groups regarding PROMs.

Level of Evidence:

Level I, randomized controlled trial.
Use of vitreous phenotype as a key clinical marker to identify Ocular-only Stickler syndrome in a family with Marfan syndrome
Authors: Malik Hammad , Soh Zack , Nixon Thomas R. W. , McNinch Annie , Richards Allan J. , Alexander Philip , Martin Howard , Snead Martin P.
Published: April 2023

This clinical report describes a family with both Marfan and ocular-only Stickler syndromes. We report 2 cases of ocular-only Stickler syndrome and 2 cases of Marfan syndrome concurrent with ocular-only Stickler syndrome. Type 1 Stickler syndrome and Marfan syndrome share many clinical similarities, and it can be difficult to differentiate them solely based on clinical presentation. Vitreous phenotyping allows for the identification of vitreous anomalies pathognomonic of Stickler syndrome, which can guide future gene sequencing. Having the accurate diagnosis of Marfan or type 1 Stickler syndrome is important, as patients with type 1 Stickler syndrome have higher rates of retinal detachment and will benefit from prophylaxis.
Factors Affecting Satisfaction With Inpatient Services Among Adult Patients Admitted to Arba Minch General Hospital, Southern Ethiopia: A Mixed Method Study
Authors: Sabo Kebede Gemeda , Mare Kusse Urmale , Berhe Hailemariam , Berhe Haftu
Published: April 2023

Previous studies on patient satisfaction in Ethiopia focused on satisfaction with nursing care and outpatient services. Therefore, this study aimed to assess factors affecting satisfaction with inpatient services among adult patients admitted to Arba Minch General Hospital, Southern Ethiopia. A mixed method cross-sectional study was conducted among randomly selected 462 admitted adult patients from March 7 to April 28, 2020. A standardized structured questionnaire and semi-structured interview guide were used to collect data. A total of 8 in-depth interviews were conducted to collect the qualitative data. SPSS version 20 was used to analyze the data, and a P-value <.05 in the multivariable logistic regression was used to declare the statistical significance of the predictor variables. The qualitative data was analyzed thematically. In this study, 43.7% of patients were satisfied with the inpatient services they received. Urban residences (AOR 95% CI 1.67 [1.00, 2.80]), educational status (AOR 95% CI 3.41 [1.21, 9.64]), treatment outcome (AOR 95% CI 2.28 [1.65, 4.32]), use of meal service (AOR 95% CI 0.51 [0.30, 0.85]), and duration of hospital stay (AOR 95% CI 1.98 [1.18, 2.06]) were the predictors of satisfaction with inpatient services. Compared to previous studies, the level of satisfaction with inpatient services was relatively low.
Lesion-level correspondence and longitudinal properties of paramagnetic rim and slowly expanding lesions in multiple sclerosis
Authors: Elliott Colm , Rudko David A , Arnold Douglas L , Fetco Dumitru , Elkady Ahmed M , Araujo David , Zhu Bing , Gafson Arie , Tian Zhe , Belachew Shibeshih , Bradley Daniel P , Fisher Elizabeth
Published: April 2023

Background:

Paramagnetic rim lesions (PRLs) and slowly expanding lesions (SELs) have been posited as markers of chronic active lesions (CALs).

Objective:

To assess the lesion-level concordance of PRLs and SELs in MS and to characterize changes in brain tissue integrity in CALs over time.

Methods:

MRIs were analyzed from a substudy of AFFINITY [NCT03222973], a phase 2 trial of opicinumab in relapsing MS. Assessments included (1) identification of SELs based on longitudinal MRIs over 72 weeks, and identification of PRLs on susceptibility-weighted imaging (SWI) filtered phase images at week 72; (2) evaluation of subject-level correlation of SEL and PRL counts, volumes, and degree of lesion-level overlap between SELs and PRLs; and (3) characterization of tissue integrity over time in overlapping and non-overlapping SELs and PRLs.

Results:

In 41 subjects, 119 chronic PRLs and 267 SELs were detected. Of 119 (39.5%) chronic PRLs, 47 co-localized with a SEL; 46/267 (17.2%) SELs co-localized with a PRL. PRLs co-localized with SELs showed expansion and worsening microstructural damage over time. SELs with and without co-localization with PRLs showed ongoing tissue damage.

Conclusions:

Chronic MS lesions identified as both PRL and SEL were associated with the most severe accumulation of tissue damage.

Trial Registration:

AFFINITY [NCT03222973].
Architecture for Anatomy: History, Affect, and the Material Reproduction of the Body in Two Medical School Buildings
Authors: Nott John
Published: April 2023

Medical schools are among the most important spaces for the history of the body. It is here that students come to know the anatomical bodies of their future patients and, through a process of cognitive and embodied practice, that the knowing bodies of future clinicians are also shaped. Practical and theoretical understandings of medicine are formed in these affective and historied buildings and in collaboration with a broad material culture of education. Medical schools are, however, both under-theorised and under-historicised. This article integrates ‘materialist’ considerations of the body with Henri Lefebvre’s philosophy of space and rhythm in order to compare two markedly different spaces – the 19th-century Anatomy Department at Semmelweis University in Hungary and the mid-20th-century ‘skills laboratory’ at Maastricht University in the Netherlands. This comparison suggests that biomedical bodies are variously shaped by the agential and affective material histories present in the everyday experience of contemporary medical education.
Nondipping blood pressure pattern predicts cardiovascular events and mortality in patients with atherosclerotic peripheral vascular disease
Authors: Dahle Nina , Ärnlöv Johan , Leppert Jerzy , Hedberg Pär
Published: April 2023

Background:

Patients with peripheral vascular disease (PVD) are often underdiagnosed and undertreated. Nocturnal nondipping blood pressure (BP) pattern, as diagnosed by ambulatory BP monitoring (ABPM), is associated with increased cardiovascular risk, but has not been studied in patients with PVD. We aimed to investigate if a nondipping BP pattern predicts cardiovascular events or all-cause death in outpatients with PVD.

Methods:

Consecutive outpatients with carotid or lower-extremity PVD were examined with 24-hour ABPM ( n = 396). Nondipping was defined as a < 10% fall in systolic BP level during night-time. We used Cox regression models adjusting for potential confounders. We also evaluated the incremental prognostic value of dipping status in the COPART risk score. Our primary composite outcome was cardiovascular events or all-cause death.

Results:

In the cohort (mean age 70; 40% women), 137 events occurred during a 5.1-year median follow-up; incident rate of 7.35 events per 100 person-years. Nondipping was significantly associated with outcome (hazard ratio 1.55, 95% CI 1.07–2.26, p = 0.021) in a fully adjusted model. When adding nondipping to the risk markers in the COPART risk score, the model fit significantly improved (χ2 7.91, p < 0.005) and the C-statistic increased from 0.65 to 0.67.

Conclusion:

In a cohort of outpatients with PVD, nondipping was an independent risk factor for future cardiovascular events or mortality and seemed to be a strong predictor in patients with carotid artery disease but not in lower-extremity PVD. Additional studies are needed to evaluate the clinical utility of ABPM for improved prevention in these high-risk patients. (ClinicalTrials.gov Identifier: NCT01452165)
Chronic thromboembolic pulmonary hypertension and the post-pulmonary embolism (PE) syndrome
Authors: Yuriditsky Eugene , Horowitz James M , Lau Joe F
Published: April 2023

Over a third of patients surviving acute pulmonary embolism (PE) will experience long-term cardiopulmonary limitations. Persistent thrombi, impaired gas exchange, and altered hemodynamics account for aspects of the postpulmonary embolism syndrome that spans mild functional limitations to debilitating chronic thromboembolic pulmonary hypertension (CTEPH), the most worrisome long-term consequence. Though pulmonary endarterectomy is potentially curative for the latter, less is understood surrounding chronic thromboembolic disease (CTED) and post-PE dyspnea. Advances in pulmonary vasodilator therapies and growing expertise in balloon pulmonary angioplasty provide options for a large group of patients ineligible for surgery, or those with persistent postoperative pulmonary hypertension. In this clinical review, we discuss epidemiology and pathophysiology as well as advances in diagnostics and therapeutics surrounding the spectrum of disease that may follow months after acute PE.
Patient safety for people experiencing advanced dementia in hospital: A video reflexive ethnography
Authors: Dadich Ann , Rodrigues Jade , De Bellis Anita , Hosie Annmarie , Symonds Tamsin , Prendergast Justin , Bevan Alan , Collier Aileen
Published: April 2023

Background

Patient safety for people experiencing dementia in acute hospitals is a global priority. Despite national strategies as well as safety and quality guidelines, how safety practices are enacted within the complexities of everyday work are poorly understood and articulated.

Methods

Using video reflexive ethnography, this 18-month study was conducted within an inpatient geriatric evaluation and management unit for people experiencing dementia and/or delirium in Australia. Patients, family members, and staff members participated by: allowing researchers to document fieldwork notes and video-record their practices and/or accounts thereof; and/or interpreting video-recordings with researchers to co-analyse and make sense of the data.

Results

Safe care for people experiencing advanced dementia involved: negotiating risk via leadership, teamwork, and transparency; practice-based learning through situated adaptation; managing personhood versus protocols by doing the ‘right’ thing; joyful and meaningful work; as well as incorporating patient and family voices to do safety together.

Conclusion

Patient safety for people experiencing dementia requires continuous responsiveness and prioritising in the context of multiple risks by a staff collective with a shared purpose. Ongoing research to better understand how the nuances of patient safety unfold in everyday complex clinical realities in diverse contexts and with key stakeholders is required.
‘It has also happened to me’: Children’s peer exclusion experiences in Finnish pre-primary school through children’s narrations
Authors: Peltola Antonina , Karlsson Liisa , Kangas Jonna
Published: April 2023

Being part of a peer group and feeling a sense of belonging increases the well-being of children in early childhood education and care (ECEC). Still, children face exclusion and rejection by peers. This study examined children’s peer exclusion experiences in pre-primary school settings, investigating children’s voices and perspectives through researching children’s narratives. Ten children participated in the interviews in Finnish pre-primary school during spring 2018. Children’s narrations about exclusion took place during free play time in children’s peer groups. Results showed common features but also a variety of children’s experiences and strategies when facing exclusion, and suggests that children with positive experiences with peers can cope with occasional exclusion. Children had a clear understanding of exclusion and they were capable of expressing their experiences verbally. Furthermore, by researching children’s narratives, we can increase our understanding of peer exclusion in early childhood educational settings.
“Never Good Enough”: Player Identities, Experiences, and Coping Strategies of Women in Czech Video Game Journalism
Authors: Fousek Krobová Tereza , Švelch Jan
Published: April 2023

In this article, we examine the position of women in Czech video game journalism and the strategies they use to cope with sexism. To this end, we conducted eight in-depth interviews with currently active women journalists. According to our respondents, their work is judged more harshly because they are women and they have to deal with gender boundaries and stereotypes, sometimes conforming to them to prevent further harassment. In this regard, our respondents were criticized (as well as praised) for their physical appearance and treated as less competent than their male colleagues. All respondents agreed that they were repeatedly told by various parties—players, colleagues, and developers—that they were not good enough as game journalists (and never would be). We argue that women game journalists are pronouncedly affected by sexism and misogyny as their expert role directly challenges toxic gaming masculinities.
Leisure education in youth with developmental disabilities: Effects on individual quality of life, adaptive behavior, and family quality of life
Authors: Badia Marta , Pérez Beatriz , Orgaz Begoña M. , Gómez-Vela María
Published: April 2023

Leisure participation enhances the learning of adaptive skills and the quality of life in youth with developmental disabilities. The goal of this study was to evaluate the effects of a leisure education program in individuals with developmental disabilities in terms of adaptive behavior and quality of life. Nine participants divided into two small groups and their families were included. A quasi-experimental design was employed to determine whether there was a program effect. The Adaptive Behavior Assessment System, the KIDSCREEN-27, and the Family Quality of Life Scale were administered before and after the intervention. There was a significant increase in social, home, and school skills as well as a better perception of quality of life in relationships with parents, social support, and school. In addition, the program affected the family’s perception of practical and emotional support. Findings provide support for the application of this leisure program to enhance quality of life outcomes.
Friendship, Intimacy, and the Contradictions of Therapy Culture
Authors: Eramian Laura , Mallory Peter , Herbert Morgan
Published: April 2023

While therapy culture has long been a part of the repertoires through which people think about and practice their romantic relationships, it has been less prominent in how they envision friendship. However, based on our interviews on experiences of friendlessness in an Atlantic Canadian city, we show that therapeutic styles increasingly shape how people orient to friendship, even as friends rarely seek formal therapy to manage their conflicts. This article focuses on how modern therapy culture, with its emphasis on individual wellbeing, self-knowledge, and ‘healthy’ rather than ‘toxic’ relationships, presents people with conflicting cultural imperatives for how to practice their friendships. On the one hand, therapy culture encourages people to seek out friends to whom they can disclose their most intimate feelings and experiences – friends who will offer support, understanding, and validation. On the other hand, therapy culture equally cautions that one must maintain ‘boundaries’ to protect oneself from friends’ personal revelations or ‘traumas.’ We ask what these dual imperatives mean for modern friendship and how people experience the tension between them. We argue that one reason modern friendship can be difficult is that divulging one’s intimate feelings or experiences to a friend can be interpreted as either building intimacy or burdening others with one’s problems, or crucially, both at the same time. Our findings lead us to ask how therapy culture might increasingly turn friendship into a reflexive object or something else to ‘optimize’ rather than providing an escape from relationships that demand ‘work.’
Parent-Adolescent Communication About Reproductive Health Issues in Nigeria
Authors: Aliyu Taofeek Kolawole , Aransiola Joshua Oyeniyi
Published: April 2023

Parent-adolescent communication about sexual and reproductive health (SRH) issues is associated with healthy sexual outcomes in adolescents. The increasing evasion of this discourse at the home front in sub-Saharan Africa is receiving greater academic and public health attention. In many Nigerian households, adolescents lack access to informative and undiluted communication with their parents, a situation that is worse for adolescents dwelling in slums. This study documented SRH issues and patterns of parent-adolescent communication in selected slums of Ibadan, Southwestern, Nigeria. A mixed sequential explanatory research was carried out in 10 selected slums in Ibadan, Oyo State, Nigeria. A structured questionnaire scripted on open data kits (ODK) and vignette for Focus Group Discussion (FGD) were used to obtain data from parents and adolescents. A sample of 796 parent-adolescent dyads was interviewed for the quantitative strand, and 8 FGDs were conducted for the qualitative component. Analytical techniques utilized for quantitative data included descriptive (frequency counts and percentages) and inferential (chi-square) statistics, while descriptive and interpretative analyses were adopted for qualitative data. Communication regarding SRH issues occurs in many households, but indirectly. A higher proportion of mothers discuss all SRH issues with their adolescents and better than fathers. While female adolescents engage their parents only on limited topics, the consequences of sexual behaviors are the least discussed. The chi-square values for each topic were not significant for parents and adolescents, however, only the discussion of preventive sexual practice was significant for parents (0.042) at a significant level of 0.05 and adolescents (0.000) at a significant level of 0.01. The findings of this study suggest that sexual education training intervention is germane to enhancing parent-adolescent communication on SRH issues for parents and adolescents.
Online Retail Service Quality: What Matters Most for Customer Satisfaction?
Authors: Singh Sonali , Jasial Sumeet Singh , Misra Richa , Bansal Ajay
Published: April 2023

With technological advancements, the availability of low-cost smartphones and internet connectivity, the online retail industry has gained traction. A pandemic-related lockdown has fuelled the fire. Consequently, it becomes important to identify the factors defining online retail service quality (ORSQ), which affect customer satisfaction and customer engagement behaviour. First, a qualitative study was conducted to identify ORSQ factors and reliability, ease of use, customer-friendly policies, problem handling and security were found to be the most vital ones for Indian consumers. Further, a quantitative study was attempted to determine the impact of ORSQ factors on consumer satisfaction and customer engagement behaviour. While testing these relationships, website familiarity was considered as a moderating variable between ORSQ factors and customer satisfaction. The findings of the study suggest that the identified ORSQ factors influence customer satisfaction and customer engagement behaviour in turn. The moderating effect of website familiarity was also established on customer satisfaction. For the analysis, Smart PLS 3.0 was used.
Entrepreneurship and Economic Growth: The Moderating Role of Governance Quality
Authors: Khyareh Mohsen Mohammadi
Published: April 2023

The role of institutional quality is important for the development of entrepreneurship and economic growth. With this question in mind, it is crucial to understand why some countries have higher economic growth and more entrepreneurial activity than others, and what factors determine the relationship between entrepreneurship and growth. Hence, the aim of this research is to identify the moderating effect of governance quality in terms of 6 sub-indices, including voice and accountability, political stability, government effectiveness, regulatory quality, rule of law and control of corruption based on a sample of 54 countries participating in the Global Entrepreneurship Monitor (GEM) project during 2008–2020. The results show that the quality of governance increases the positive relationship between entrepreneurial activity and economic growth. In particular, all sub-indicators of governance quality seem to be moderators between entrepreneurship and economic growth. This study has implications both from a theoretical point of view (promoting the application of institutional economics in entrepreneurship–growth nexus) and from a practical point of view (providing insight into policies that improve the governance quality) promoting entrepreneurial activity and economic growth.
Managing Acute Intermediate Risk Pulmonary Thromboembolism in a Patient Who Developed Heparin-Induced Thrombocytopenia: Review of Current Guidelines and Literature
Authors: Asllanaj Blerina , Benge Elizabeth , Bhatia Sapna , McWhorter Yi
Published: April 2023

Intermediate-risk pulmonary embolism describes hemodynamically stable patients with evidence of right ventricular strain, whereas high-risk pulmonary embolism comprises hemodynamic decompensation resulting in cardiogenic shock. The clinical manifestations of the two aforementioned conditions are challenging to treat in the setting of heparin-induced thrombocytopenia (HIT). Without immediate therapeutic anticoagulation, patients can subsequently deteriorate and require additional advanced therapies, with the end-goal of restoring pulmonary artery perfusion. We present the case of a male with bilateral intermediate-risk pulmonary emboli who developed type 2 HIT prompting different selection of appropriate management strategies.
Success of Patient and Family Advisory Councils: The Importance of Metrics
Authors: Lewis Barbara
Published: April 2023

Hospital Patient and Family Advisory Councils have been around for over 40 years. Yet, their adoption is waning with only slightly more than 50% of hospitals fielding Councils, which are composed of patient and family volunteers, who provide feedback to hospital staff. Demonstrating the value of Councils is critically important to their success and sustainability. Hospitals can ensure Council success by adopting these initiatives: (1) Highlight the importance of measuring program impacts to Council liaisons and members, (2) Educate members and staff about the three types of impacts defined by the Agency for Healthcare Research Quality, (3) Describe the steps to ensure that the value of the Council is well documented, and (4) Provide tools and training for the Council and staff to conduct robust measurements and analysis. When Councils measure their impact, their value to hospitals and leadership will increase.
Familial Exudative Vitreoretinopathy–Like Phenotype in a Patient With Microcephaly and TUBGCP6 Mutations
Authors: Sengillo Jesse D. , Ashkenazy Noy , Shoji Marissa K. , Iyer Prashanth , Robles-Holmes Hailey K. , Lopez Ashley , Yannuzzi Nicolas A. , Negron Catherin I. , Berrocal Audina M.
Published: April 2023

Purpose: To describe a case of microcephaly, unilateral retinal fold, and familial exudative vitreoretinopathy (FEVR)–like phenotype in the context of 2 TUBGCP6 variants. Methods: A case and its findings were analyzed. Results: A 4-month-old boy with no family history of eye disease presented by referral for management of presumed persistent fetal vasculature in the left eye. An external examination showed microcephaly. The patient grimaced to light in both eyes, and the anterior segments were unremarkable. On dilated fundus examination, diffuse chorioretinal atrophy was present bilaterally. In the left eye, a retinal fold emanated from the optic nerve head. There was early termination of retinal vasculature, especially in zone 3 in the left eye, resembling a FEVR-like phenotype. Panel-based genetic testing was performed and found 2 mutations in TUBGCP6. Conclusions: Microcephaly, chorioretinopathy, and retinal folds may be associated with TUBGCP6 mutations and masquerade as PFV.
More on why Lakisha and Jamal didn’t get interviews: Extending previous findings through a reproducibility study
Authors: Obenauer William G.
Published: April 2023

In 2004, Bertrand and Mullainathan published an innovative piece of research that involved sending nearly 5,000 fictitious resumes to employers. Their paper is commonly cited for finding that applicants with White-sounding names benefitted more from experience on their resumes and received 50 percent more invitations to interview than other applicants. The current research, however, demonstrates that while Bertrand and Mullainathan made a critically important contribution to the literature on employment discrimination, there is still much more that we can learn from their data. Through a reanalysis of Bertrand and Mullainathan's data, we find that discriminatory effects were stronger in conditions in which a job posting's experience requirements were ambiguous, applicants with first names of Arabic origin experienced higher levels of discrimination than applicants with other non-White-sounding names, and that the discriminatory effects of having an African-American-sounding name could not be empirically differentiated from the discriminatory effects associated with a name's frequency within the overall population. Our findings contribute to the literature on human information processing and offer important practical contributions regarding how employers can potentially reduce discrimination in selection processes. Additionally, we offer important suggestions for the development of racial manipulations in future experimental research.
Return emergency department visits for recurrent pulmonary embolism symptoms in children and adolescents
Authors: Egan-Sherry Dana , Grosse Philip , Cooper James D.
Published: April 2023

Rates of pulmonary embolism (PE) in children have steadily increased over the past 2 decades. Patient outcomes after hospital discharge are poorly understood, and many patients experience recurrent or persistent chest pain or dyspnea, prompting a return to care. This retrospective cohort study of patients diagnosed with PE at a large children’s hospital over a 9.5-year period was performed to evaluate rates of return to the emergency department (ED) for PE-related symptoms, and to determine the utility of repeat computed tomography angiography (CTA) in this population. Ninety-six patients were diagnosed with PE during the study period. Forty-two percent of patients (n = 40) returned to the ED for PE-related symptoms and a total of 74 repeat CTAs were performed. Among those who had return visits, the mean number of return visits was 3 and the mean number of repeat CTAs was 1.8. The median time to return to the ED was 34 days. Logistic regression analysis identified increased age and female sex as risk factors for return ED visits. Eight percent of the cohort experienced PE recurrence. Recurrent PE was observed only in those with persistent or new thrombotic risk factors and was uncommon in those who remained on appropriate anticoagulation. Future work should focus on the development of a risk stratification system to identify patients at low risk of recurrence in order to minimize repeat CTA imaging.
Glycyrrhizin, an inhibitor of HMGB1 induces autolysosomal degradation function and inhibits Helicobacter pylori infection
Authors: Khan Uzma , Karmakar Bipul Chandra , Basak Priyanka , Paul Sangita , Gope Animesh , Sarkar Deotima , Mukhopadhyay Asish Kumar , Dutta Shanta , Bhattacharya Sushmita
Published: April 2023

Background

Helicobacter pylori is a key agent for causing gastric complications linked with gastric disorders. In response to infection, host cells stimulate autophagy to maintain cellular homeostasis. However, H. pylori have evolved the ability to usurp the host’s autophagic machinery. High mobility group box1 (HMGB1), an alarmin molecule is a regulator of autophagy and its expression is augmented during infection and gastric cancer. Therefore, this study aims to explore the role of glycyrrhizin (a known inhibitor of HMGB1) in autophagy during H. pylori infection.

Main methods

Human gastric cancer (AGS) cells were infected with the H. pylori SS1 strain and further treatment was done with glycyrrhizin. Western blot was used to examine the expression of autophagy proteins. Autophagy and lysosomal activity were monitored by fluorescence assays. A knockdown of HMGB1 was performed to verify the effect of glycyrrhizin. H. pylori infection in in vivo mice model was established and the effect of glycyrrhizin treatment was studied.

Results

The autophagy-lysosomal pathway was impaired due to an increase in lysosomal membrane permeabilization during H. pylori infection in AGS cells. Subsequently, glycyrrhizin treatment restored the lysosomal membrane integrity. The recovered lysosomal function enhanced autolysosome formation and concomitantly attenuated the intracellular H. pylori growth by eliminating the pathogenic niche. Additionally, glycyrrhizin treatment inhibited inflammation and improved gastric tissue damage in mice.

Conclusion

This study showed that inhibiting HMGB1 restored lysosomal activity to ameliorate H. pylori infection. It also demonstrated the potential of glycyrrhizin as an antibacterial agent to address the problem of antimicrobial resistance.
Potent dual MAGL/FAAH inhibitor AKU-005 engages endocannabinoids to diminish meningeal nociception implicated in migraine pain
Authors: Della Pietra Adriana , Krivoshein Georgii , Ivanov Konstantin , Giniatullina Raisa , Jyrkkänen Henna-Kaisa , Leinonen Ville , Lehtonen Marko , van den Maagdenberg Arn M. J. M. , Savinainen Juha , Giniatullin Rashid
Published: April 2023

Background

Engaging the endocannabinoid system through inhibition of monoacylglycerol lipase (MAGL) and fatty acid amide hydrolase (FAAH), degrading endocannabinoids (endoCBs) 2-arachidonoylglycerol (2-AG) and anandamide (AEA), was proposed as a promising approach to ameliorate migraine pain. However, the activity of MAGL and FAAH and action of endoCB on spiking activity of meningeal afferents, from which migraine pain originates, has not been explored thus far. Therefore, we here explored the analgesic effects of endoCB enhancement in rat and human meningeal tissues.

Methods

Both MAGL and FAAH activity and local 2-AG and AEA levels were measured by activity-based protein profiling (ABPP) and LC–MS/MS, respectively, in rat meninges obtained from hemiskulls of P38-P40 Wistar rats and human meninges from elderly patients undergoing non-migraine related neurosurgery. The action on endoCBs upon administration of novel dual MAGL/FAAH inhibitor AKU-005 on meningeal afferents excitability was tested by investigating paired KCl-induced spiking and validation with local (co-)application of either AEA or 2-AG. Finally, the specific TRPV1 agonist capsaicin and blocker capsazepine were tested.

Results

The basal level of 2-AG exceeded that of AEA in rat and human meninges. KCl-induced depolarization doubled the level of AEA. AKU-005 slightly increased spontaneous spiking activity whereas the dual MAGL/FAAH inhibitor significantly decreased excitation of nerve fibres induced by KCl. Similar inhibitory effects on meningeal afferents were observed with local applications of 2-AG or AEA. The action of AKU-005 was reversed by CB1 antagonist AM-251, implying CB1 receptor involvement in the anti-nociceptive effect. The inhibitory action of AEA was also reversed by AM-251, but not with the TRPV1 antagonist capsazepine. Data cluster analysis revealed that both AKU-005 and AEA largely increased long-term depression-like meningeal spiking activity upon paired KCl-induced spiking.

Conclusions

In the meninges, high anti-nociceptive 2-AG levels can tonically counteract meningeal signalling, whereas AEA can be engaged on demand by local depolarization. AEA-mediated anti-nociceptive effects through CB1 receptors have therapeutic potential. Together with previously detected MAGL activity in trigeminal ganglia, dual MAGL/FAAH inhibitor AKU-005 appears promising as migraine treatment.

Graphical Abstract