bluuebunny/crossref_metadata_2025 huggingface dataset:
Cream versus ointment: Randomized single‐blinded study on the adherence to treatment with topical methylprednisolone aceponate
Authors: Gregersen Deborah Maria , Peckruhn Melanie , Breternitz‐Gruhne Maria , Schiller Isabella , Schumacher Ulrike , Franke Lisa , Bahr Viola , Tittelbach Jörg , Elsner Peter
Published: November 2023

Background

Overall adherence in the treatment of chronic dermatoses is poor. Textbooks state an adherence dependence on galenics.

Trial Design

Prospective, randomized, parallel‐grouped, single‐blinded (investigator), monocentric clinical trial (phase IV) on the adherence to treatment of chronic mild to moderate hand eczema with topical methylprednisolone aceponate (MPA, Advantan®) in different vehicles.

Objectives and Endpoints

Primary objective was the assessment of the adherence depending on vehicle type in patients with chronic hand eczema. Secondary objective was improvement after a 4‐week treatment period. Primary Endpoint Adherence is defined as the percentage of patients applying at least aimed daily dose. Prescribed daily dose was defined as the planned number of applications per day (1) * surface (measured) * aimed amount per application (mg/cm2). Truly applicated daily dose was evaluated as individual mean amount per dose * individual mean number of applications per day.

Adherence was assumed, if

truly applicated daily dose is at least 75% of the prescribed daily dose and

the individual mean number of applications per day is at least 0.85.

Secondary Endpoint Efficacy was measured by improvement of Hand Eczema Severity Index (HECSI) and Investigator's Global Assessment (IGA) after a 4‐week treatment period and in addition to Quality of Life in Hand Eczema Questionnaire (QOLHEQ) and Visual Analogue Scale (VAS) to assess pruritus.

Methods

Number of participants randomized to each group 40, 80 total. Group 1 MPA‐C: Methylprednisolone aceponate 0.1% cream and barrier repair emollient (Bepanthen® Sensiderm). Group 2 MPA‐FO: Methylprednisolone aceponate 0.1% fatty ointment and barrier repair emollient (Bepanthen® Sensiderm). Adherence to treatment was compared via Fisher's exact test.

Results

Of the patients, 48% were adherent according to our definition. There was no significant difference between MPA‐C (42.1%) and MPA‐FO (54.1%; p = 0.36; group difference—12.0%, 95% CI—34.3%–11.5%). Generalized‐linear‐model‐analysis of adherence to study treatment with factors emollient use, treatment, time and treatment‐time interaction showed a parallel between adherence and amount of emollient use (odds ratio 1.74, p = 0.0038; 95% CI—1.22–2.52). Improvement of hand eczema was seen according to clinical scores without remarkable differences between the groups.

Conclusions

No dependence of adherence on galenics of topical treatment of chronic hand eczema could be proved. Patients who use more emollient tend to be more adherent to the topical treatment.
The impact of pseudoephedrine regulation at Australian pharmacies through Project Stop: A narrative review
Authors: Brookfield Samuel , Gartner Coral
Published: November 2023

Issues

Project Stop, a real‐time monitoring program for pseudoephedrine‐containing medicines, was initiated in 2005 by the Pharmacy Guild of Australia in collaboration with police in the state of Queensland. The program implemented an online database to record pseudoephedrine purchases (and attempted purchases) to prevent large‐scale diversion to methamphetamine production.

Approach

This narrative review aims to understand the overall impact of Project Stop, what evidence exists for this kind of intervention in Australia, and what lessons can be learned from its introduction. Systematic database searches were conducted in Embase, PubMed, Web of Science and Google Scholar, with 20 relevant sources selected for inclusion.

Key Findings

Project Stop successfully prevented some pseudoephedrine from being diverted from pharmacies to methamphetamine production. The intervention has been most effective in jurisdictions that made the program mandatory. Project Stop was also associated with a temporary decline in clandestine laboratory seizures in Queensland, changes in methamphetamine production methods and reduced voluntary treatment admissions for methamphetamine use. Implementation was not associated with an appreciable effect on secondary indicators, such as methamphetamine production and harmful use.

Implications

Future applications of a Project Stop model must ensure ongoing impact evaluation, assessment of its effect on individual's drug‐related behaviour and combine it with policies that address drug use as a health issue.

Conclusion

Project Stop has been narrowly successful in terms of reducing pseudoephedrine diversion and demonstrates the potential for third‐party policing practices directed at the consumer level, in collaboration with healthcare practitioners, rather than only regulating precursor wholesalers.
Indifference, Indeterminacy, and the Uncertainty Argument for Saving Identified Lives
Authors: Gilbertson Eric
Published: November 2023

In some cases where we are faced with a decision of whether to prioritize identified lives over statistical lives, we have no basis for assigning specific probabilities to possible outcomes. Is there any reason to prioritize either statistical or identified lives in such cases? The ‘uncertainty argument’ purports to show that, provided we embrace ex ante contractualism, we should prioritize saving identified lives in such cases. The argument faces two serious problems. First, it relies on the principle of indifference, and as such it leads to inconsistent assignments of epistemic probability to possible outcomes. Moreover, even if the uncertainty argument can be reformulated in order to avoid reliance on the principle of indifference, the uncertainty in such cases still undermines any judgment of which course of action – saving a statistical, or rather an identified life – involves the greater burden. The indeterminacy involved in the statistical group might be thought to undermine the argument that application of the principle of indifference leads to inconsistency in this case, but the thought that it does rests on a misunderstanding of the relationship between indeterminacy and reference.
MiR‐488‐3p facilitates wound healing through CYP1B1‐mediated Wnt/β‐catenin signaling pathway by targeting MeCP2
Authors: Zuo Chenchen , Fan Pengju , Yang Ying , Hu Chengjun
Published: November 2023

Introduction

Diabetic wounds are difficult to heal, but the pathogenesis is unknown. MicroRNAs (miRNAs) are thought to play important roles in wound healing. The effect of miR‐488‐3p in wound healing was studied in this article.

Materials and Methods

The gene methylation was measured by methylation specific PCR (MSP) assay. A dual‐luciferase reporter assay was adopted to analyze the interaction between miR‐488‐3p and MeCP2.

Results

Cytochrome P450 1B1 (CYP1B1) is a monooxygenase belonging to the cytochrome P450 family that aids in wound healing. Our findings showed that the miR‐488‐3p and CYP1B1 expression levels were much lower in wound tissues of diabetics with skin defects, but the methyl‐CpG‐binding protein 2 (MeCP2) level was significantly higher than that in control skin tissues. MiR‐488‐3p overexpression increased cell proliferation and migration, as well as HUVEC angiogenesis, while inhibiting apoptosis, according to function experiments. In vitro, MeCP2 inhibited wound healing by acting as a target of miR‐488‐3p. We later discovered that MeCP2 inhibited CYP1B1 expression by enhancing its methylation state. In addition, CYP1B1 knockdown inhibited wound healing. Furthermore, MeCP2 overexpression abolished the promoting effect of miR‐488‐3p on wound healing. It also turned out that CYP1B1 promoted wound healing by activating the Wnt4/β‐catenin pathway. Animal experiments also showed that miR‐488‐3p overexpression could accelerate wound healing in diabetic male SD rats.

Conclusions

MiR‐488‐3p is a potential therapeutic target for diabetic wound healing since it improved wound healing by activating the CYP1B1‐mediated Wnt4/‐catenin signaling cascade via MeCP2.
Sustainability of enhanced recovery after surgery programmes in gastrointestinal surgery: A scoping review
Authors: Byrnes Angela , Flynn Rachel , Watt Amanda , Barrimore Sally , Young Adrienne
Published: November 2023

Background

Enhanced Recovery After Surgery (ERAS) is an evidence‐based intervention that is well‐recognised across multiple surgical specialties as having potential to lead to improved patient and hospital outcomes. Little is known about sustainability of ERAS programmes.

Aims

This review aimed to describe available evidence evaluating sustainability of ERAS programmes in gastrointestinal surgery to understand: (a) how sustainability has been defined; (b) examine determinants of sustainability; (c) identify strategies used to facilitate sustainability; (d) identify adaptations to support sustainability; and (e) examine outcomes measured as indicators of sustainability of ERAS programmes.

Methods

This scoping review was conducted following the Joanna Briggs Institute's methodology. Research databases (PubMed, Embase, CINHAL) and the grey literature were searched (inception to September 2022) for studies reporting sustainability of ERAS programmes in gastrointestinal surgery. Included articles reported an aspect of sustainability (i.e., definition, determinants, strategies, adaptations, outcomes and ongoing use) at ≥2 years following initial implementation. Aspects of sustainability were categorised according to relevant frameworks to facilitate synthesis.

Results

The search strategy yielded 1852 records; first round screening excluded 1749, leaving 103 articles for full text review. Overall, 22 studies were included in this review. Sustainability was poorly conceptualised and inconsistently reported across included studies. Provision of adequate resources was the most frequently identified enabler to sustainability (n/N = 9/12, 75%); however, relatively few studies (n = 4) provided a robust report of determinants, with no study reporting determinants of sustainability and strategies and adaptations to support sustainability alongside patient and service delivery outcomes.

Conclusion

Improved reporting, particularly of strategies and adaptations to support sustainability is needed. Refinement of ERAS reporting guidelines should be made to facilitate this, and future implementation studies should plan to document and report changes in context and corresponding programme changes to help researchers and clinicians sustain ERAS programmes locally.
Temporal trends and projection of blindness and vision loss prevalence in older adults in BRICS countries
Authors: Chen Jianqi , Zhu Yingting , Li Zhidong , Chen Xuhao , Chen Xiaohong , Xie Rui , Zhang Yuan , Ye Guitong , Luo Ruiyu , Shen Xinyue , Lin Lifeng , Zhuo Yehong
Published: November 2023

Background

Blindness and vision loss (BVL) is a major global health issue affecting older adults, but its burden in transition countries has received limited attention. Therefore, we aimed to assess the trends in the burden of BVL among older adults between 1990 and 2019 across Brazil, Russia, India, China, and South Africa (BRICS), and predict the burden by 2040.

Methods

Data on BVL and its related causes were obtained from the Global Burden of Disease 2019 study. We investigated the temporal trends by calculating the average annual percentage change using joinpoint regression analysis. Subsequently, we performed Bayesian age‐period‐cohort modeling to estimate the burden of BVL and its related causes by 2040.

Results

Most BRICS countries experienced a significant decline (p < 0.05) in age‐standardized prevalence rates, and the decreasing trends tend to continue. However, by 2040, the number of BVL cases is expected to increase by approximately 50% across BRICS, with an estimated approximately 192, 170, 25, 17, and 7 million cases in China, India, Russia, Brazil, and South Africa, respectively. The related ranks of BVL causes are also estimated to change in the future, particularly in India.

Conclusions

The different burdens and trends of BVL across BRICS reflected the different stages of population health transition. Effective eye disease prevention requires appropriate public health interventions. Developing effective health policies and services for older adults is urgently needed in BRICS countries.
Exploring the effectiveness of emotionally focused therapy for depressive symptoms and relationship distress among couples in Taiwan: A single‐arm pragmatic trial
Authors: Tseng Chi‐Fang , Wittenborn Andrea K. , Morgan Preston C. , Liu Ting
Published: November 2023

This is the first study to explore the effectiveness of emotionally focused couple therapy (EFT) for depressive symptoms and relationship distress among couples in Taiwan. This one‐arm pragmatic trial assessed the clinical outcomes of 17 couples using multilevel modeling to investigate changes in depressive symptoms and relationship distress throughout treatment. Over half of the participants were moderately depressed and moderately distressed at baseline. Multilevel models revealed decreased depressive symptoms over time, with a small increase toward the end of treatment. However, no significant changes were observed in relationship distress over time. The study was limited by the low “dose” of EFT (M = 7 sessions) received by participants and the small sample size (n = 17). A comprehensive discussion of the findings from a cultural perspective was provided. Future research is needed to further examine the effectiveness of EFT for couples in Taiwan and Asia.
Endoscopic and surgical treatment of non‐neoplastic proximal duodenal ulceration in dogs, and anatomical study of proximal duodenal vascularisation
Authors: Sabetti M. C. , Cola V. , Foglia A. , Stanzani D. , Galiazzo G. , Perfetti S. , Tagliavia C. , Pisoni L. , Pietra M.
Published: November 2023

Objectives

Proximal duodenal ulceration is often characterised by continuous bleeding, and treatment is challenging. The aims of this study were to investigate the role of vascularisation in proximal duodenal ulceration and describe clinical aspects, endoscopic features and treatment in dogs.

Material and Methods

Polyurethane foam casts of gastroduodenal vessels were obtained from five dogs which had died from disorders unrelated to the digestive system. In addition, 12 dogs having proximal duodenal ulcers diagnosed by endoscopic examination were enrolled in a treatment trial. After the endoscopic diagnosis of a duodenal ulcer, all the dogs were treated medically and, in the absence of resolution, were subsequently treated by endoscopic electrocauterisation or by surgery.

Results

A submucosal vascular network was evident in all the casts, with a prominent venous plexus seen exclusively in the first half inch of the duodenum. In clinical cases, on endoscopic examination, the duodenal ulcer was located at the proximal part of the duodenum, involving the mesenteric portion of the wall. The dogs not responding to medical treatment (6/12) were treated with endoscopic electrocauterisation, surgical coagulation or resection of the proximal duodenal portion. All the dogs survived until discharge, and the median survival time following discharge was 107.5 days.

Clinical Significance

Based on the anatomical details highlighted in this study, the continuous bleeding observed in our patients may have been due to the prominent venous plexus evidenced at the level of the proximal duodenum. Surgical and endoscopic treatments in six patients resolved the ulcer bleeding with no recurrences noted during follow‐up.
Incorporating digital animation in a school play: multimodal literacies, structure of feeling and resources of hope
Authors: Cannon Michelle , Bryer Theo , Hawley Sara
Published: November 2023

In this study, we reflect on our work with 10‐ and 11‐year‐olds in an inner London primary school developing a multimodal school play that integrated digital animation into a more conventionally structured Year 6 production. We are media literacy, drama and cultural studies researchers and teachers, arguing for more inclusive, holistic and multimodal schooled literacy practices. We explore roles and opportunities for enactment that the multimodal school play offers, while looking at pupil empowerment through the mobilisation of pupils' existing capabilities and sensitivities. We present a case study that employs semi‐structured interviews and observations from which we construct visual and analytic narratives with a focus on participants' practices and responses. Raymond Williams's ‘structure of feeling’ and ‘Resources of Hope’ help us make sense of our data. In particular, we note the emergence of new roles through literacy practices that incorporate the tools and artefacts of animation. We highlight the affective dimension and inclusive nature of emergent literacy practices that integrate interactive drama and meaning‐making with digital media and look at how these practices have the potential to disrupt entrenched classroom hierarchies and tackle inequalities, particularly for children who are disenfranchised by schooling and traditional school literacy practices.
Compositional heterogeneity of insoluble organic matter extracted from asteroid Ryugu samples
Authors: Quirico Eric , Bonal Lydie , Kebukawa Yoko , Amano Kana , Yabuta Hikaru , Phan Van T. H. , Beck Pierre , Rémusat Laurent , Dartois Emmanuel , Engrand Cecile , Martins Zita , Bejach Laure , Dazzi Alexandre , Deniset‐Besseau Ariane , Duprat Jean , Mathurin Jérémie , Montagnac Gilles , Barosch Jens , Cody George D. , De Gregorio Bradley , Enokido Yuma , Hashiguchi Minako , Kamide Kanami , Kilcoyne David , Komatsu Mutsumi , Matsumoto Megumi , Mostefaoui Smail , Nittler Larry , Ohigashi Takuji , Okumura Taiga , Sandford Scott , Shigenaka Miho , Stroud Rhonda , Suga Hiroki , Takahashi Yoshio , Takeichi Yasuo , Tamenori Yusuke , Verdier‐Paoletti Maximilien , Wakabayashi Daisuke , Yamashita Shohei , Nakamura Tomoki , Naraoka Hiroshi , Noguchi Takaaki , Okazaki Ryuji , Yurimoto Hisayoshi , Sakamoto Kanako , Tachibana Shogo , Watanabe Sei‐Ichiro , Tsuda Yuichi , Yada Toru , Nishimura Masahiro , Nakato Aiko , Miyazaki Akiko , Yogata Kasumi , Abe Masanao , Okada Tatsuaki , Usui Tomohitro , Yoshikawa Makoto , Saiki Takanao , Tanaka Satoshi , Terui Fuyuto , Nakazawa Satoru
Published: November 2023

We report a Fourier transform infrared analysis of functional groups in insoluble organic matter (IOM) extracted from a series of 100–500 μm Ryugu grains collected during the two touchdowns of February 22 and July 11, 2019. IOM extracted from most of the samples is very similar to IOM in primitive CI, CM, and CR chondrites, and shows that the extent of thermal metamorphism in Ryugu regolith was, at best, very limited. One sample displays chemical signatures consistent with a very mild heating, likely due to asteroidal collision impacts. We also report a lower carbonyl abundance in Ryugu IOM samples compared to primitive chondrites, which could reflect the accretion of a less oxygenated precursor by Ryugu. The possible effects of hydrothermal alteration and terrestrial weathering are also discussed. Last, no firm conclusions could be drawn on the origin of the soluble outlier phases, observed along with IOM in this study and in the preliminary analysis of Ryugu samples. However, it is clear that the HF/HCl residues presented in this publication are a mix between IOM and the nitrogen‐rich outlier phase.
Protohistory: Unending intuitions
Authors: Odeyemi Idowu
Published: November 2023

Philosophers ponder on how to do philosophy and how to do it well. This pondering has divided metaphilosophers' concern about philosophical methodology into two groups, which we could label “pro‐history” and “pro‐intuition.” The claim (and belief) of philosophers who are in the “pro‐history” group can be found in this sentence by Robert Pasnau (2011): “The discipline of philosophy benefits from a serious, sustained engagement with its history.” Those in the “pro‐intuition” group believe that for philosophy not to slide into the realm of irrelevance it must rely on intuitions to make sense of our present ontologies, rather than study history of philosophy. This paper argues that both proponents of the pro‐history and those of the pro‐intuition approach are wrongheaded. It argues for what it calls protohistory. Protohistory here refers to the method of doing philosophy in which the intuitions of philosophers are informed by the history of philosophy (though not directly influenced by it but indirectly informed by it).
How words matter: A psycholinguistic argument for meaning revision
Authors: Koch Steffen
Published: November 2023

Linguistic interventions aim to change our linguistic practices. A commonly discussed type of linguistic intervention is meaning revision, which seeks to associate existing words with new or revised meanings. But why does retaining old words matter so much? Why not instead introduce new words to express the newly defined meanings? Drawing on relevant psycholinguistic research, this paper develops an empirically motivated, general, and practically useful pro tanto reason to retain rather than replace the original word during the process of conceptual improvement.
Species classification of Antarctic pack‐ice seals using very high‐resolution imagery
Authors: Wethington Michael , Gonçalves Bento C. , Talis Emma , Şen Bilgecan , Lynch Heather J.
Published: November 2023

We introduce a semiautomated machine learning method that employs high‐resolution imagery for the species‐level classification of Antarctic pack‐ice seals. By incorporating the spatial distribution of hauled‐out seals on ice into our analytical framework, we significantly enhance the accuracy of species identification. Employing a Random Forest model, we achieved 97.4% accuracy for crabeater seals and 98.0% for Weddell seals. To further refine our classification, we included three linearity measures: mean distance to a group's regression line, straightness index, and sinuosity index. Additional variables, such as the number of neighboring seals within a 250 m radius and distance of individual seals to the sea ice edge, also contributed to improved accuracy. Our study marks a significant advancement in the development of a cost‐effective, unified Antarctic seal monitoring system, enhancing our understanding of seal spatial behavior and enabling more effective population tracking amid environmental changes.
Raise your pitch! Changes in the acoustic emissions of resident bottlenose dolphins in the proximity of vessels
Authors: Sobreira Filipa V. , Luís Ana R. , Alves Inês S. , Couchinho Miguel N. , dos Santos Manuel E.
Published: November 2023

Maritime traffic is a major contributor of anthropogenic disturbance for cetaceans, especially for coastal populations, such as that of resident common bottlenose dolphins (Tursiops truncatus) in the Sado estuary (Portugal). Animals have been found to adjust their vocal behavior by changing vocal rates, or call frequency and/or duration, to overcome masking effects of underwater noise. To evaluate the potential impacts of boat traffic on the acoustic behavior of these dolphins, emission rates and acoustic characteristics of whistles and burst‐pulsed signals were analyzed with and without boats operating nearby. In this study, no significant differences were found for emission rates of each type of vocal element in the presence of vessels. However, significant differences were found in acoustic parameters, namely changes in frequency and duration, for whistles and for pulsed sounds (creaks, grunts, squeaks, and gulps). These changes, such as a shift in vocal frequencies and production of shorter signals, may represent behavioral strategies to compensate for the noisy environment. Although resident bottlenose dolphins in the Sado region seem to have developed some tolerance to vessel noise, continuous noise exposure and noise‐induced frequency shifts in vocal outputs could have indirect fitness costs for this population.
Low‐ and high‐volume blood‐flow restriction treadmill walking both improve maximal aerobic capacity independently of blood volume
Authors: Thompson K. M. A. , Gamble A. S. D. , Kontro H. , Lee J. B. , Burr J. F.
Published: November 2023

Aim

Assess the effect of low‐ and high‐volume blood flow restriction training (BFR) on maximal aerobic capacity (VO2max) and determine if alteration in VO2max is mediated through changes in hemoglobin mass (Hbmass) and blood volume.

Methods

Participants' Hbmass (CO‐rebreathe), single, and double‐leg VO2max and blood volume regulating hormonal responses (renin and copeptin) were measured before and after BFR training. Training consisted of treadmill walking either (1) twice‐daily for 4week (CON and BFRHV) or (2) twice‐weekly for 6week (BFRLV). Each session consisted of five intervals (3 min, 5% incline, 5 km/h, 100% of lowest occlusion pressure), with 1 min of standing rest between sets.

Results

VO2max increased using both training exposures, in as quickly as 2‐weeks (BFRLV baseline to 4week: +315 ± 241 mL (8.7%), p = 0.02; BFRHV baseline to 2week: +360 ± 261 mL (7.9%), p < 0.01), for the BFRLV and BFRHV groups, with no change in CON. Single‐ and double‐leg VO2max improved proportionately (single/double‐leg VO2max ratio: BFRLV 78 ± 4.9–78 ± 5.8%, BFRHV 79 ± 6.5–77 ± 6.5%), suggesting that the mechanism for increased VO2max is not solely limited to central or peripheral adaptations. Hbmass remained unchanged across groups (CON: +10.2 ± 34 g, BFRLV: +6.6 ± 42 g, BFRHV: +3.2 ± 44 g; p = 0.9), despite a significant release of blood volume regulating hormones after initial BFR exposure (renin +20.8 ± 21.9 ng/L, p < 0.01; copeptin +22.0 ± 23.8 pmol/L, p < 0.01), which was blunted following BFRHV training (renin: +13.4 ± 12.4 ng/L, p = 0.09; copeptin: +1.9 ± 1.7 pmol/L, p = 0.98).

Conclusion

BFR treadmill walking increases VO2max irrespective of changes in Hbmass or blood volume despite a large release of blood volume regulating hormones in response to BFR treadmill walking.
Retrospective evaluation of admission total plasma protein as a predictor of red blood cell transfusion requirement in dogs diagnosed with traumatic and nontraumatic hemoabdomen: 90 dogs (2009–2019)
Authors: Buseman Miranda , Blong April E. , Yuan Lingnan , Mochel Jonathan P. , Walton Rebecca A. L.
Published: November 2023

Objective

To evaluate the association of admission total plasma protein (TPP) and the administration of red blood cell transfusions in dogs with diagnosed hemoabdomen. To secondarily evaluate additional point‐of‐care parameters associated with red blood cell transfusion administration.

Design

Retrospective study between 2009 and 2019.

Setting

University veterinary teaching hospital.

Animals

Ninety dogs admitted to a university veterinary teaching hospital after a diagnosis of traumatic or nontraumatic hemoabdomen (NTH).

Measurements and Main Results

Medical records were retrospectively reviewed; signalment, point‐of‐care diagnostics, and transfusion administration information was recorded. A total of 47 dogs (traumatic hemoabdomen 11/26; NTH 36/64) received packed red blood cell transfusions. For each 1 g/dL unit decrease in TPP, dogs had an increased odds ratio (OR) of 2.14 (95% confidence interval [CI]: 1.44–3.40, P < 0.001) of receiving a red blood cell transfusion. Dogs diagnosed with NTH were more likely to receive a red blood cell transfusion than dogs with a traumatic hemoabdomen (OR: 2.78, 95% CI: 1.11–7.141, P = 0.03). Lower PCV values (OR: 1.08, 95% CI: 1.04–1.12, P < 0.001), bicarbonate values (OR: 1.3, 95% CI: 1.09–1.56, P = 0.003), and base excess (OR: 1.27, 95% CI: 1.1–1.49, P = 0.003) were associated with a higher likelihood of red blood cell transfusion. Additionally, higher lactate (OR: 1.35, 95% CI: 1.16–1.63, P < 0.001) and Acute Patient Physiologic and Laboratory Evaluation (APPLE)fast scores (OR: 1.10, 95% CI: 1.04–1.17, P < 0.001) were associated with increased red blood cell transfusion administration.

Conclusions

Low admission TPP, independent of low PCV, was associated with red blood cell transfusions regardless of underlying cause. For each 1 g/dL unit decrease in TPP on presentation, dogs were approximately 2 times more likely to receive a red blood cell transfusion during hospitalization. Other factors that were associated with increased transfusion administration included presenting PCV, PCV/TPP ratio, bicarbonate, base excess, lactate, and APPLEfast scores.
Evaluation of hemostatic derangements associated with canine anaphylaxis and the relationship to syndrome severity
Authors: Smith M. Ryan , Wurlod Virginie A. , Liu Chin‐Chi
Published: November 2023

Objective

To describe hemostatic derangements associated with canine anaphylaxis and to assess for association with syndrome severity.

Design

Prospective observational study.

Setting

University teaching hospital.

Animals

Twenty‐seven client‐owned dogs, recruited from November 2018 to January 2022, diagnosed with anaphylaxis of varying severity were included. Study inclusion required presentation <6 hours after initiation of clinical signs, no medications or history of illness within the prior 2 weeks, lack of comorbidities expected to affect hemostasis, and lack of a disease state that could alternatively explain the clinical presentation.

Interventions

Blood samples were collected within the first hour of presentation for CBC, serum biochemistry, prothrombin time (PT), activated partial thromboplastin time (aPTT), and viscoelastic coagulation testing for use with a cartridge‐based point‐of‐care device.

Measurements and main results

Clotting time and clot formation time were prolonged, alpha angle and maximum clot firmness were decreased, PT and aPTT were prolonged, and platelet counts were lower in severe cases compared to mild and moderate cases. There were no differences for any parameter between mild and moderate cases. The presence or absence of abdominal effusion was not associated with hemostatic status.

Conclusions

Global hemostatic derangements consistent with hypocoagulability are a prominent feature of severe anaphylaxis in dogs and should be considered for routine evaluation.
On the role of vertical resolution for resolving mesoscale eddy dynamics and the prediction of ocean sound speed variability
Authors: Touret Richard X. , Liu Guangpeng , McKinley Matthew , Bracco Annalisa , Sabra Karim G.
Published: November 2023

This work investigates how vertical resolution affects the prediction of ocean sound speed through a suite of regional simulations covering the DeSoto Canyon in the Gulf of Mexico. Simulations have identical horizontal resolution of 0.5 km, partially resolving submesoscale dynamics, and vertical resolution from 30 to 200 terrain-following layers. The focus is on mesoscale eddies and how modeled sound speeds vary whenever more vertical baroclinic modes are resolved. While domain-averaged sound speed profiles do not differ substantively, the standard deviation increases for increasing resolution due to the sharper representation of mesoscale circulations underneath the mixed layer and their associated density anomalies.
Spectral analysis of strident fricatives in cisgender and transfeminine speakers
Authors: Houle Nichole , Lerario Mackenzie P. , Levi Susannah V.
Published: November 2023

The spectral features of /s/ and /ʃ/ carry important sociophonetic information regarding a speaker's gender. Often, gender is misclassified as a binary of male or female, but this excludes people who may identify as transgender or nonbinary. In this study, we use a more expansive definition of gender to investigate the acoustics (duration and spectral moments) of /s/ and /ʃ/ across cisgender men, cisgender women, and transfeminine speakers in voiced and whispered speech and the relationship between spectral measures and transfeminine gender expression. We examined /s/ and /ʃ/ productions in words from 35 speakers (11 cisgender men, 17 cisgender women, 7 transfeminine speakers) and 34 speakers (11 cisgender men, 15 cisgender women, 8 transfeminine speakers), respectively. In general, /s/ and /ʃ/ center of gravity was highest in productions by cisgender women, followed by transfeminine speakers, and then cisgender men speakers. There were no other gender-related differences. Within transfeminine speakers, /s/ and /ʃ/ center of gravity and skewness were not related to the time proportion expressing their feminine spectrum gender or their Trans Women Voice Questionnaire scores. Taken together, the acoustics of /s/ and /ʃ/ may signal gender group identification but may not account for within-gender variation in transfeminine gender expression.
Early enterovirus translation deficits extend viral RNA replication and elicit sustained MDA5-directed innate signaling
Authors: Dobrikov Mikhail I. , Dobrikova Elena Y. , Nardone-White Dasean T. , McKay Zachary P. , Brown Michael C. , Gromeier Matthias
Published: November 2023

Enteroviruses (EVs)—positive-sense single-strand RNA viruses of
Picornaviridae
—are among the most common human viral pathogens. Unlike other cytoplasmic viral RNAs (vRNAs), which are detected by RIG-I, sensing of EV RNAs is mediated primarily by MDA5. EVs evolved with rapid, cytotoxic life cycles as a means of host cell interference, ostensibly to suppress MDA5-orchestrated antiviral type-I interferon (IFN) responses. At the core of this strategy are viral 2A protease (2A
pro
)-directed cleavage of the eukaryotic initiation factor (eIF)4G—the central translation initiation scaffold and ribosome adaptor—and degradation of nuclear pores. EV MDA5 agonism has an intriguing innate footprint, characterized by polar TBK1-IFN regulatory factor 3 (IRF3) signaling, which fuels sustained type-I IFN release to provide context for antitumor CD8
+
T-cell priming after
in situ
cancer vaccination. Here we compared EV-host interactions between wild-type EVs and the highly attenuated recombinant polio:rhinovirus chimera and cancer immunotherapy agent (PVSRIPO) to test how targeted inhibition of discrete steps in the viral life cycle affects the innate antiviral response. Our investigations demonstrate that sustained MDA5-TBK1-IRF3 signaling elicited by PVSRIPO is the result of inefficient immediate 2A
pro
-directed eIF4G degradation, while wild-type EVs counter host innate type-I IFN defenses via rapid eIF4G cleavage. The MDA5-directed innate signature of profoundly attenuated EVs may provide efficient innate immune-stimulatory assets, for example, in
in situ
cancer vaccination strategies.

IMPORTANCE

Multiple pattern recognition receptors sense vRNAs and initiate downstream innate signaling: endosomal Toll-like receptors (TLRs) 3, 7, and 8 and cytoplasmic RIG-I-like receptors (RLRs) RIG-I, and MDA5. They engage distinct signaling scaffolds: mitochondrial antiviral signaling protein (RLR), MyD88, and TLR-adaptor interacting with SLC15A4 on the lysosome (TLR7 and TLR8) and toll/IL-1R domain-containing adaptor inducing IFN (TLR3). By virtue of their unusual vRNA structure and direct host cell entry path, the innate response to EVs uniquely is orchestrated by MDA5. We reported that PVSRIPO’s profound attenuation and loss of cytopathogenicity triggers MDA5-directed polar TBK1-IRF3 signaling that generates priming of polyfunctional antitumor CD8
+
T-cell responses and durable antitumor surveillance
in vivo
. Here we unraveled EV-host relations that control suppression of host type-I IFN responses and show that PVSRIPO’s deficient immediate host eIF4G cleavage generates unopposed MDA5-directed downstream signaling cascades resulting in sustained type-I IFN release.
Lung transplant in chronic HIV infection
Authors: Yarlagadda Keerthi , Werne Rachel , Sinha Neeraj
Published: November 2023

Lung transplantation is the treatment of choice for many end-stage chronic lung conditions. Chronic Human Immunodeficiency Virus (HIV) infection is considered a relative contraindication for lung transplantation. In the era of Highly Active Antiretroviral Therapy (HAART), there has been an increase in the number of HIV-positive patients living with chronic lung conditions. In this paper, we aim to summarise the available literature in the field of lung transplantation in HIV-positive patients. We also present our experience of an HIV-positive woman who underwent lung transplantation for chronic interstitial lung disease from an HIV-negative donor.

Careful candidate selection, along with management focused on closer monitoring, may result in favourable outcomes, including improved longevity among HIV-positive patients with chronic lung disease.
COVID-19 severity is associated with the risk of gastrointestinal bleeding
Authors: Hibiya Shuji , Fujii Takashi , Fujii Toshimitsu , Suzuki Shinji , Kondo Mayumi , Ooka Shinya , Furumoto Yohei , Azuma Seishin , Tanaka Kei , Kurata Hitoshi , Tanaka Shohei , Kurosaki Masayuki , Nagayama Kazuyoshi , Kusano Fumihiko , Iizuka Yasuhiro , Kawamura Takahiro , Ikemiyagi Hidekazu , Sakita Shinya , Yauchi Tsunehito , Watanabe Hideki , Kawamoto Ami , Matsuyama Yusuke , Ohtsuka Kazuo , Okamoto Ryuichi
Published: November 2023

Objective

The association between the severity of COVID-19 and gastrointestinal (GI) bleeding is unknown. This study aimed to determine whether the severity of COVID-19 is a risk factor for GI bleeding.

Design

A multicentre, retrospective cohort study was conducted on hospitalised patients with COVID-19 between January 2020 and December 2021. The severity of COVID-19 was classified according to the National Institute of Health severity classification. The primary outcome was the occurrence of GI bleeding during hospitalisation. The main analysis compared the relationship between the severity of COVID-19 and the occurrence of GI bleeding. Multivariable logistic regression analysis was performed to evaluate the association between the severity of COVID-19 and the occurrence of GI bleeding.

Results

12 044 patients were included. 4165 (34.6%) and 1257 (10.4%) patients had severe and critical COVID-19, respectively, and 55 (0.5%) experienced GI bleeding. Multivariable analysis showed that patients with severe COVID-19 had a significantly higher risk of GI bleeding than patients with non-severe COVID-19 (OR: 3.013, 95% CI: 1.222 to 7.427). Patients with critical COVID-19 also had a significantly higher risk of GI bleeding (OR: 15.632, 95% CI: 6.581 to 37.130). Patients with severe COVID-19 had a significantly increased risk of lower GI bleeding (OR: 10.349, 95% CI: 1.253 to 85.463), but the risk of upper GI bleeding was unchanged (OR: 1.875, 95% CI: 0.658 to 5.342).

Conclusion

The severity of COVID-19 is associated with GI bleeding, and especially lower GI bleeding was associated with the severity of COVID-19. Patients with severe or critical COVID-19 should be treated with caution as they are at higher risk for GI bleeding.
Baduanjin exercise for chronic non-specific low back pain: protocol for a series of N-of-1 trials
Authors: Zhai Jingbo , Liu Ai Feng , Yu Weijie , Guo Tianci
Published: November 2023

Introduction

Chronic non-specific low back pain (CNLBP) is one of the most common health problems worldwide. According to the clinical guideline released by the American College of Physicians, exercise has been recommended for the treatment of chronic LBP. In recent years, traditional Chinese medicine (TCM) is becoming increasingly popular for the management of chronic LBP. Baduanjin exercise is one of the exercise therapies in TCM. N-of-1 trial is a randomised cross-over self-controlled trial suitable for patients with this chronic disease. A series of similar N-of-1 trials can be pooled to estimate the overall and individual therapeutic effects synchronously by hierarchical Bayesian analysis. And N-of-1 trials are considered as a good tool for evaluating the therapeutic effect of TCM. Therefore, this study aims to conduct a series of N-of-1 trials with hierarchical Bayesian analysis for assessing whether Baduanjin exercise is effective and safe for CNLBP.

Methods and analysis

This study conducts a series of N-of-1 trials on Baduanjin exercise for the management of CNLBP. Fifty participants will receive 1–3 treatment cycles. They will be randomised into a Baduanjin exercise or waiting list group for a week during the two periods of each treatment cycle. The primary outcome is the 10-point Visual Analogue Scale. The secondary outcomes include the Oswestry Disability Index, the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire and the Short Form Health Survey 12. Statistical analysis will be conducted with WinBUGS V.1.4.3 software. Overall and individual therapeutic effects will be estimated synchronously by hierarchical Bayesian analysis.

Ethics and dissemination

This study is approved by the Medical Ethics Committee of Tianjin University of TCM (reference number TJUTCM-EC20220005). Our findings will be published in a peer-reviewed journal or international conference.

Trial registration number

ChiCTR2200063307.
Needle-tip electrocautery versus steel scalpel incision in neurosurgery: study protocol for a prospective single-centre randomised controlled double-blind trial
Authors: Xu Wei , Fang Mei , Wang Zexu , Wang Jiayan , Tao Chuanyuan , Ma Lu , Li Li , Hu Xin
Published: November 2023

Introduction

Electrocautery is used widely in surgical procedures, but making skin incision has routinely been performed with scalpel rather than electrocautery, for fear that electrocautery may cause poor incision healing, excessive scarring and increased wound complication rates. More and more studies on general surgery support the use of electrocautery for skin incision, but research comparing the two modalities for scalp incision in neurosurgery remains inadequate. This trial aims to evaluate the safety and efficacy of needle-tip monopolar for scalp incision in supratentorial neurosurgery compared with steel scalpel.

Methods and analysis

In this prospective, randomised, double-blind trial, 120 eligible patients who are planned to undergo supratentorial neurosurgery will be enrolled. Patients will be randomly assigned to two groups. In controlled group scalp incision will be made with a scalpel from the epidermis to the galea aponeurotica, while in intervention group scalp will be first incised with a steel scalpel from the epidermis to the dermis, and then the subcutaneous tissue and galea aponeurotica will be incised with needle-tip monopolar on cutting mode. The primary outcomes are scar score (at 90 days). The secondary outcomes include incision pain (at 1 day, on discharge, at 90 days) and alopecia around the incision (at 90 days), incision blood loss and incision-related operation time (during operation), incision infection and incision healing (on discharge, at 2 weeks, 90 days).

Ethics and dissemination

This trial will be performed according to the principles of Declaration of Helsinki and good clinical practice guidelines. This study has been validated by the ethics committee of West China Hospital. Informed consent will be obtained from each included patient and/or their designated representative. Final results from this trial will be promulgated through publications.

Trial registration number

ChiCTR2200063243.
Time trends and patterns in opioid prescription use following orthopaedic surgery in Ontario, Canada, from 2004/2005 to 2017/2018: a population-based study
Authors: Canizares Mayilee , Power J Denise , Perruccio Anthony V , Veillette Christian , Mahomed Nizar , Rampersaud Y Raja
Published: November 2023

Objectives

Increased use of opioids and their associated harms have raised concerns around prescription opioid use for pain management following surgery. We examined trends and patterns of opioid prescribing following elective orthopaedic surgery.

Design

Population-based study.

Setting

Ontario, Canada.

Participants

Ontario residents aged 66+ years who had elective orthopaedic surgery from April 2004 to March 2018.

Primary and secondary outcome measures

Postoperative opioid use (short term: within 90 days of surgery, prolonged: within 180 days and chronic: within 1 year), specific opioids prescribed, average duration (days) and amount (morphine milligram equivalents) of the initial prescription by year of surgery.

Results

We included 464 460 elective orthopaedic surgeries in 2004/2005–2017/2018: 80% of patients used opioids within 1 year of surgery—25.1% were chronic users. There was an 8% increase in opioid use within 1 year of surgery, from 75.1% in 2004/2005 to 80.9% in 2017/2018: a 29% increase in short-term use and a decline in prolonged (9%) and chronic (22%) use. After 2014/2015, prescribed opioid amounts initially declined sharply, while the duration of the initial prescription increased substantially. Across categories of use, there was a steady decline in coprescription of benzodiazepines and opioids.

Conclusions

Most patients filled opioid prescriptions after surgery, and many continued filling prescriptions after 3 months. During a period of general increase in awareness of opioid harms and dissemination of guidelines/policies aimed at opioid prescribing for chronic pain, we found changes in prescribing practices following elective orthopaedic surgery. Findings illustrate the potential impact of guidelines/policies on shaping prescription patterns in the surgical population, even in the absence of specific guidelines for surgical prescribing.
Investigating the associations of age of initiation and other psychosocial factors of singular alcohol, tobacco and marijuana usage on polysubstance use: analysis of a population-based survey in Jamaica
Authors: Lalwani Kunal , Whitehorne-Smith Patrice , McLeary Joni-Gaye , Albarus Neena , Abel Wendel
Published: November 2023

Objectives

This study aimed to examine concurrent polysubstance use of alcohol, tobacco and marijuana and determine correlations with access to marijuana, friend and familial drug use habits, risk perception and the age of initiation associated with the singular use of these substances.

Design

A secondary data analysis.

Setting

Used the Jamaica National Drug Prevalence Survey 2016 dataset.

Participants

Involved the entire dataset comprising 4623 randomly selected respondents between 12 and 65 years old.

Outcome measures

Primary outcome: concurrent polysubstance use recorded as using two or more of alcohol, tobacco and marijuana. Predictor variables include risk perception and age of initiation of singular alcohol, tobacco and marijuana use, ease of marijuana access and family and friend alcohol and illegal drug use.

Results

Approximately 58%–66% of respondents commenced singular alcohol, tobacco or marijuana use under 17. Participants commencing marijuana use at 11 years and under and between 12 and 17 were 3.346 and 4.560 times more likely to report past month concurrent polysubstance use (p=0.030 and p<0.001). Respondents who did not believe that smoking tobacco sometimes (p=0.049), and smoking marijuana sometimes and often was harmful, had increased odds of concurrent polysubstance use (p=0.047 and p<0.001, respectively). Respondents who indicated access to marijuana as easy were significantly more likely to report past month concurrent polysubstance use compared with those who reported access as difficult (p=0.002). Participants who indicated that friends or family members get drunk and take illegal drugs were associated with 1.722 and 1.864 increased odds of reporting past month concurrent polysubstance use (p=0.004 and p=0.017, respectively).

Conclusions

Decreased perceived risk, childhood and adolescent age of initiation and easy access to marijuana were significantly associated with polysubstance use among Jamaicans. The influence of friends and family members’ drug and alcohol use behaviours on individuals developing polysubstance use habits further endorses the need for interventions.