bluuebunny/crossref_metadata_2025 huggingface dataset:
Televised Anti-Tobacco Media and Smoking Outcomes Among Heterosexual and Sexual Minority Adults in the United States
Authors: Titus Andrea R. , Thrasher James F. , Gamarel Kristi E. , Emery Sherry L. , Elliott Michael R. , Fleischer Nancy L.
Published: August 2022

Background

The prevalence of smoking is higher among sexual minority (SM) individuals compared with heterosexuals. The impact of televised anti-tobacco mass media campaigns on smoking outcomes among SMs is not known.

Aims

We examined whether televised anti-tobacco advertising was differentially associated with current smoking and smoking intensity for SM and heterosexual adults.

Method

We combined county-level anti-tobacco advertising data (gross rating points) with restricted, geocoded individual-level National Health Interview Survey data on smoking (2013–2015). We estimated associations between advertising and smoking outcomes, including potential effect modification by SM status.

Results

Greater anti-tobacco advertising exposure was associated with lower smoking prevalence (prevalence ratio [PR] = 0.97; 95% confidence interval [CI] = [0.94, 1.00]). Although the direction of the association differed for heterosexual and SM adults, differences were not statistically significant. No significant associations were observed with regard to smoking intensity.

Conclusion

Associations between anti-tobacco advertising and smoking were not significantly different for heterosexual and SM adults.
Relapsing antibody-negative patients with features of neuromyelitis optica spectrum disorders: Differences in N-acetylaspartate level in the cervical spinal cord indicate distinct underlying processes
Authors: Kossowski Bartosz , Kong Yazhuo , Klimiec-Moskal Elżbieta , Emir Uzay , Palace Jacqueline , Juryńczyk Maciej
Published: August 2022

Background:

Due to lack of biomarkers, antibody-negative patients with features of neuromyelitis optica spectrum disorders (NMOSD) are among the most challenging to diagnose and treat. Using unsupervised clustering, we recently identified ‘MS-like’, ‘spinal MS-like’, ‘classic NMOSD-like’ and ‘NMOSD-like with brain involvement’ subgroups in this cohort.

Objective:

We used magnetic resonance spectroscopy (MRS) to examine differences in the level of key metabolites in the spinal cord between the four identified subgroups.

Methods:

Twenty-five relapsing antibody-negative patients with NMOSD features classified by the unsupervised algorithm to one of the subgroups underwent a prospective cervical spinal cord MRS. Spectra from 16 patients fulfilled quality criteria and were included in the analysis.

Results:

Total N-acetylaspartate (tNAA), but not total choline (tCho) or myo-inositol (Ins), was significantly different between the four subgroups ( p = 0.03). In particular, tNAA was 47.8% lower in the ‘MS-like’ subgroup as compared with the ‘classic NMOSD-like’ subgroup ( p = 0.02). While we found a negative overall correlation between tNAA and disability score ( r = –0.514, p = 0.04) in the whole cohort, the disability score did not differ significantly between the subgroups to explain subgroup differences in tNAA level.

Conclusions:

Significant differences in the cervical spinal cord tNAA measurements confirm that the previously identified clinico-radiologic subgroups contain patients with distinct underlying disease processes.
Subversion, cyber operations, and reverse structural power in world politics
Authors: Maschmeyer Lennart
Published: August 2022

The Russian-sponsored influence campaign targeting the 2016 US Presidential Elections surprised policy-makers and scholars, highlighting a gap in theories of (cyber) power. Russia had used information technologies to project power, yet more subtly than prevailing militarized conceptions of cyber power predicted. Rather than causing damage and disruption, it turned sources of American power into vulnerabilities. Recent scholarship emphasizes this mechanism’s technological novelty. Instead, I argue this campaign demonstrated the importance of an undertheorized instrument of power: subversion. Integrating Intelligence scholarship and International Relations theory, this article develops an innovative theory of subversion as reverse structural power. Structural power shapes structures of interaction and the capacities of structural positions to the benefit of the holder of such power. Subversion reverses these benefits into harms. It exploits vulnerabilities in structures to secretly manipulate them, leveraging the capacities of structural positions to produce outcomes neither expected nor intended by the holders of structural power. Traditional subversion targets social structures, while cyber operations target sociotechnical structures: namely, Information Communications Technologies (ICTs) embedded in modern societies. The targeted structures differ, yet both rely on subversive techniques of exploitation that reverse structural power. Cyber operations are means of subversion. This theory helps explain two unresolved issues in cybersecurity: the capability–vulnerability paradox and the outsize role of non-state actors. Finally, I demonstrate the theory’s utility in a plausibility probe, examining the 2016 Election Interference Campaign. It shows this campaign did not use new “weapons,” but rather integrated traditional and sociotechnical means of subversion.
Understanding the dynamic of student engagement in project-based collaborative writing: Insights from a longitudinal case study
Authors: Zheng Yao , Yu Shulin , Tong Zhenan
Published: August 2022

Collaborative writing is a pedagogical activity increasingly used in second language education. Despite the increased research on L2 students’ participation in collaborative writing, scant attention has been paid to student engagement in project-based collaborative writing and the possible engagement changes. This article reports on a longitudinal case study investigating the changes in student engagement of a group of five Chinese EFL undergraduates in project-based collaborative writing. The analysis of the data gathered by observations of group interactions, interviews, and student texts reveals three patterns of engagement changes: from active collaborators to ‘team escapers’, from a supporter to a ‘free rider’, and unchanged dedicated writers. The findings are discussed concerning the factors that could account for the engagement changes, including students’ language proficiency and learning needs as the individual factors and activity type as the contextual factor.
Bilingual phonological awareness as a function of language proficiency
Authors: Oz-Vecht Einat , Degani Tamar
Published: August 2022

Aims and objectives:

The present study examined whether phonological awareness reflects a stable construct or whether it varies by the different languages of bilingual speakers. In particular, the study tests to what extent language proficiency determines phonological awareness above and beyond language structural characteristics.

Methodology:

Bilingual adult speakers were tested as they afford within-participant comparisons to address this issue. Specifically, 29 Hebrew (L1)-English (L2) bilinguals were compared to 33 English (L1)-Hebrew (L2) bilinguals on a timed auditory rhyme judgment task including 270 word-pairs (90 English pairs, 90 Hebrew pairs, and 90 pseudo-Hebrew pairs).

Data and analysis:

Reaction times and dʹ on the rhyme judgment task were compared between the two bilingual groups to examine the role of language proficiency in predicting phonological awareness performance. Furthermore, rhyme judgments on Hebrew pairs were correlated with those on English pairs to provide within-participant index of phonological awareness stability.

Findings:

Rhyme judgment performance on the same set of words was affected by the strength of linguistic representations, as determined by language proficiency profile. English-Hebrew bilinguals performed better on English pairs, whereas Hebrew-English bilinguals performed better on Hebrew pairs. Moreover, within-group comparisons revealed that performance in the more proficient language was not correlated with performance in the less proficient language.

Originality:

By testing two groups of bilinguals who differ in their language dominance profile using the same set of materials (including both L1 and L2 pairs), the results reveal differences in phonological awareness abilities as a function of language proficiency that cannot be reduced to structural differences between the examined languages.

Significance:

The findings underscore the dynamic nature of phonological awareness abilities and carry implications for clinical diagnosis of bilingual populations, in that rhyme judgment performance in one language should not be taken to index expected abilities in the other language of bilingual speakers.
Differentiated integration in the European Union: Institutional effects, public opinion, and alternative flexibility arrangements
Authors: Schimmelfennig Frank , Leuffen Dirk , De Vries Catherine E
Published: August 2022

Research on differentiated integration (DI) in the European Union (EU) has focused on the causes, conditions, and patterns of differentiation in European integration. By contrast, we know less about its effects on institutional outcomes and public support; moreover, alternatives to de jure DI in providing flexibility are still rarely accounted for. This introduction to the special issue takes stock of, and discusses omissions, in the current literature on DI. We propose an analytical framework, centering on efficiency and legitimacy, to study the effects of different types of DI. We use this framework to motivate the choice and assess the contributions of the articles selected for this special issue.
Parametric investigation of agent-based modeling in algorithmic development of curved surfaces
Authors: Umashankar Bhoomika
Published: August 2022

Architects aspire to build iconic buildings and focus on experimenting with non-standard forms. The construction of non-standard forms is challenging. This has led many researchers and facade designers to develop and resolve the complexity of forms to simpler, buildable elements. In this progress, the tessellation of non-standard surfaces has experimented considerably with different approaches using computational tools. All the approaches from researchers or facade engineers have limited access for every designer. As they develop patented software or use any coding languages which are not accessed by any open-source platform. Hence in academia, it is difficult to experiment in this domain. This paper analyzes the existing panalization computational tools and different approaches used by researchers worldwide in developing complex curved surfaces. Analyzing the relevant cases led to identifying the gap in current research. This has led to investigate and explore a new algorithmic process using an existing computational tool: Agent-based modeling on an open-source tool (Grasshopper-Visual programming language), which is phase -1 of the Master’s thesis.
In vitro models for the experimental evaluation of mechanical thrombectomy devices in acute ischemic stroke
Authors: Liu Ronghui , He Hongping , Zhang Luo , Fan Yubo , Wang Jun , Wang Weidong
Published: August 2022

Mechanical thrombectomy has become an important method for the treatment of acute ischemic stroke for large vessel occlusions. The current hotspots of mechanical thrombectomy are optimizing the treatment methods, improving the recanalization rate and reducing complications. The in vitro model has become a common and convenient method for mechanical thrombectomy research. This review summarizes the in vitro model in the following aspects: the preparation of clot analogues; the experimental platform; the application of the in vitro model in the testing of thrombectomy devices; and the advantages, limitations and future trends of the in vitro experimental model. This review describes the characteristics and applications of the in vitro experimental model with the hope that the in vitro experimental model will be further improved and play a more effective role in the study of mechanical thrombectomy.
Exploring the effects of interchange rotations on high-intensity activities of elite futsal players
Authors: Ribeiro João Nuno , Gonçalves Bruno , Illa Jordi , Couceiro Micael , Sampaio Jaime , Travassos Bruno
Published: August 2022

The literature lacks an understanding of the physical demands of team sports with unlimited substitutions (player interchange rotations). Because of this characteristic of the game, it is necessary to analyze the physical requirements through player rotation rather than analyzing global averages. The objective of this research is to investigate the relationship between high-intensity activities (HIA; sum of accelerations, decelerations, and high-speed running actions) performed per interchange rotations and match time variables (playtime, rest time, and work–rest ratio) in elite futsal players. A retrospective observational design was used. Twelve matches from an elite male team competing in the Premier Spanish Futsal League were analyzed using a local positioning system, yielding a total sample of 17 players. The number of HIA performed per interchange rotation varies between players and allows the identification of three distinct activity profiles—lower HIA (10 HIA), medium HIA (28 HIA), and higher HIA (38 HIA). Furthermore, these profiles were found to be stable alongside the existing interchange rotations throughout the match. Playtime ( F = 40.9, p < .001) and work–rest ratio ( F = 15.6, p < .001) are the time variables that best differentiate match activity profiles. Players with more playing time (4.6 ± 1.0 min) and a work–rest ratio equal to or greater than 1 (1.1 ± 0.6 a.u.) have a greater ability to repeat HIA per rotation.
Reduction in transfer of micro-organisms between patients and staff using short-sleeved gowns and hand/arm hygiene in intensive care during the COVID-19 pandemic: A simulation-based randomised trial
Authors: Vincent Laura , Ibrahim Mudathir , Kitchin Joanne , Pickering Claire , Wilson Jennie , Sorrentino Enrico , Salvagno Claudia , Earl Laurie , Ma Louise , Simpson Kathryn , Baker Rose , McCulloch Peter
Published: August 2022

Background

Current personal protective equipment (PPE) practices in UK intensive care units involve “sessional” use of long-sleeved gowns, risking nosocomial infection transmitted via gown sleeves. Data from the first wave of the COVID19 pandemic demonstrated that these changes in infection prevention and control protocols were associated with an increase in healthcare associated bloodstream infections. We therefore explored the use of a protocol using short-sleeved gowns with hand and arm hygiene to reduce this risk.

Methods

ICU staff were trained in wearing short-sleeved gowns and using a specific hand and arm washing technique between patients (experimental protocol). They then underwent simulation training, performing COVID-19 intubation and proning tasks using either experimental protocol or the standard (long-sleeved) control protocol. Fluorescent powder was used to simulate microbial contamination, detected using photographs under ultraviolet light. Teams were randomised to use control or experimental PPE first. During the simulation, staff were questioned on their feelings about personal safety, comfort and patient safety.

Results

Sixty-eight staff and 17 proning volunteers were studied. Experimental PPE completely prevented staff contamination during COVID-19 intubation, whereas this occurred in 30/67 staff wearing control PPE ( p = .003, McNemar). Proning volunteers were contaminated by staff in 15/17 control sessions and in 1/17 with experimental PPE ( p = .023 McNemar). Staff comfort was superior with experimental PPE ( p< .001, Wilcoxon). Their personal safety perception was initially higher with control PPE, but changed towards neutrality during sessions ( p < .001 start, 0.068 end). Their impressions of patient safety were initially similar ( p = .87), but finished strongly in favour of experimental PPE ( p < .001).

Conclusions

Short-sleeved gowns with hand and forearm cleansing appear superior to sessional long-sleeved gowns in preventing cross-contamination between staff and patients.
Gender Disparities in AP Computer Science Exams: Analysis of Trends in Participation and top Achievement
Authors: Bahar A. Kadir , Kaya Erdogan , Zhang Xiaolu
Published: August 2022

Using the test scores of more than 1,000,000 students who participated in the Advanced Placement Computer Science (AP CS) exams from 1997 to 2020, this study examined the direction and magnitude of the trends in gender disparity in participation and top achievement in advanced exams. The findings indicated that the male-to-female ratio (MFR) among AP Computer Science (CS) exam participants declined from 4.87 to 2.26 between 1997 and 2020. Similarly, the MFR among top scorers (students who scored 5 out of 5) in any type of AP CS exams declined rapidly, in favor of female students, from 8.00 to 2.14 during the same period. Possible implications of these findings for educators, particularly for AP CS teachers and school counselors, were also discussed in the context of the underrepresentation of females in computing fields.
Death and Dialysis Following Discharge From Chronic Kidney Disease Clinic: A Retrospective Cohort Study
Authors: Che Michael , Iliescu Eduard , Thanabalasingam Susan , Day Andrew G , White Christine A
Published: August 2022

Background:

Multidisciplinary care is recommended for patients with advanced chronic kidney disease (CKD). A formalized, risk-based approach to CKD management is being adopted in some jurisdictions. In Ontario, Canada, the eligibility criteria for multidisciplinary CKD care funding were revised between 2016 and 2018 to a 2 year risk of kidney replacement therapy (KRT) greater than 10% calculated by the 4-variable Kidney Failure Risk Equation (KFRE). Implementation of the risk-based approach has led to the discharge of prevalent CKD patients.

Objective:

The primary objective of this study was to determine the frequency of occurrence of death and KRT initiation in patients discharged from CKD clinic.

Design:

Retrospective cohort study

Setting:

Single center multidisciplinary CKD clinic in Ontario, Canada

Patients:

Four hundred and twenty five patients seen at least once in 2013 at the multidisciplinary CKD clinic

Measurements:

Outcomes included discharge status, death, re-referral and KRT initiation. Reasons for discharge were recorded.

Methods:

Outcomes were extracted from available electronic medical records and the provincial death registry between the patient’s initial clinic visit in 2013 and January 1, 2020. KFRE-2 scores were calculated using the 4-variable KFRE equation. The hazard rates of death and KRT after discharge due to stable eGFR/low KFRE were compared to patients who remained in the clinic.

Results:

Of the 425 CKD patients, 69 (16%) and 19 (4%) were discharged to primary care and general nephrology, respectively. Of those discharged, 7 (8%) were re-referred to nephrology or CKD clinic, while only 2 (2%) discharged patients required subsequent KRT. The hazard of mortality was reduced after discharge from the clinic due to stable eGFR/low KFRE (adjusted HR = 0.45 [95% CI, 0.25-0.78, P = .005]).

Limitations:

Single center, observational retrospective study design and unknown kidney function over time post discharge for most patients

Conclusions:

Discharge of low risk patients from multidisciplinary CKD clinic appears feasible and safe, with fewer than 1 in 40 discharged patients subsequently initiated on KRT over the following 7 years.
Artificial intelligence–aided diagnosis model for acute respiratory distress syndrome combining clinical data and chest radiographs
Authors: Pai Kai-Chih , Chao Wen-Cheng , Huang Yu-Len , Sheu Ruey-Kai , Chen Lun-Chi , Wang Min-Shian , Lin Shau-Hung , Yu Yu-Yi , Wu Chieh-Liang , Chan Ming-Cheng
Published: August 2022

Objective

The aim of this study was to develop an artificial intelligence–based model to detect the presence of acute respiratory distress syndrome (ARDS) using clinical data and chest X-ray (CXR) data.

Method

The transfer learning method was used to train a convolutional neural network (CNN) model with an external image dataset to extract the image features. Then, the last layer of the model was fine-tuned to determine the probability of ARDS. The clinical data were trained using three machine learning algorithms—eXtreme Gradient Boosting (XGB), random forest (RF), and logistic regression (LR)—to estimate the probability of ARDS. Finally, ensemble-weighted methods were proposed that combined the image model and the clinical data model to estimate the probability of ARDS. An analysis of the importance of clinical features was performed to explore the most important features in detecting ARDS. A gradient-weighted class activation mapping (Grad-CAM) model was used to explain what our CNN sees and understands when making a decision.

Results

The proposed ensemble-weighted methods improved the performances of the ARDS classifiers (XGB + CNN, area under the curve [AUC] = 0.916; RF + CNN, AUC = 0.920; LR + CNN, AUC = 0.920; XGB + RF + LR + CNN, AUC = 0.925). In addition, the ML model using clinical data to present the top 15 important features to identify the risk factors of ARDS.

Conclusion

This study developed combined machine learning models with clinical data and CXR images to detect ARDS. According to the results of the Shapley Additive exPlanations values and the Grad-CAM techniques, an explicable ARDS diagnosis model is suitable for a real-life scenario.
Effectiveness of home care intervention on family ability to do caregiving at home and increase the independence among elderly with dementia
Authors: Sya’diyah Hidayatus , Nursalam  , Mahmudah  , Efendi Ferry
Published: August 2022

Background:

Dementia had effect on the dependence status of the elderly. Living in family can increase independence among elderly. The purpose of the study was to determine the effectiveness of home care intervention on the family’s ability to conduct caregiving at home as well as the independence of the elderly with dementia. Also, to determine the effect of family ability to conduct caregiving at home on the independence of the elderly with dementia.

Design and Methods:

This study used quasi-experimental with cross-sectional design. The sample size was 40 respondents into two groups and it was selected using simple random technique. Data were collected from January to June 2021. The intervention group received home care intervention, and the control group did not receive any treatment. The outcome was measured using questionnaire and analyzed using paired t-test and linear regression test.

Results:

This study showed that home care intervention is effective in improving the family’s ability to do home care ( p value <0.05) as well as the independence of the elderly with dementia ( p value <0.05). In addition, the ability of family to conduct caregiving at home had effect on the independence of the elderly with dementia ( p value <0.05).

Conclusion:

The home care intervention was effective in improving family ability and independence of elderly with dementia. This intervention was developed based on caregiver empowerment. It can be the guideline of family to conduct home care.
Micro Borrowing an Amalgam of Structure and Strategy: Evidence from India
Authors: Koride Padmavathi
Published: August 2022

Micro borrowing was either an outcome of structure in the credit environment (termed the outreach stream), or a strategic response of the borrowers (termed the sustainability stream). Furthermore, borrower personal effects drove borrowing behaviour. This study draws variables from both the streams of literature and tests them against the amount borrowed and purposes loans are borrowed for. Results show how borrowing behaviour is neither an outcome of pure structure nor pure strategy, but rather, is an interplay of both, and further influenced by personal effects. The survey data (consisting of 839 rural borrower responses, from four districts of erstwhile Andhra Pradesh in South India) was subjected to a rigorous statistical analysis. Results show how a larger number of banks in the villages (a structural constraint), enabled the borrowers to receive larger loans, who defaulted more (a strategic response). Men borrowed larger sums (a personal effect). A similar amalgam of structure, strategy and personal effects drive borrowing behaviour even after controlling for loan purpose and district fixed effects. Yet, when district effects are introduced, amount borrowed is agnostic to personal effects, and is driven purely by structure and strategy.

JEL Classifications: C25, C83, G51, Z13
A Unique Case of Syphilitic Hypopyon Panophthalmitis
Authors: Seely Mason , Deaner Jordan D. , Vajzovic Lejla
Published: August 2022

Purpose:

This work reports a unique case of syphilitic hypopyon panophthalmitis.

Methods:

A case report is presented.

Results:

A 25-year-old man with a history of HIV and intravenous (IV) drug use presented to an outside hospital with blurred vision and swelling of the right eye. Computed tomography was concerning for orbital cellulitis. On examination, he had limited extraocular motility, relative exophthalmos, periocular edema, 4+ anterior chamber cell, an irregular layering hypopyon, and no view of the fundus. Magnetic resonance imaging showed enhancement of the sclera, lateral rectus muscle, and lacrimal gland concerning for infectious or inflammatory panophthalmitis. The patient’s history and presentation were concerning for bacterial or fungal etiologies from an endogenous source. He began antimicrobial therapy. Diagnostic vitrectomy was unrevealing. Syphilis testing was positive. The patient showed improvement with IV antiluetic therapy.

Conclusions:

We present a case of syphilitic hypopyon panophthalmitis, a new constellation of findings in syphilitic ocular disease.
The Mediating Effect of Customer Focus on the Relationship Between Strategic Planning and Competitive Advantage in Railway Sector
Authors: Tryson Yangailo
Published: August 2022

Empirical studies have been conducted to investigate the association between strategic planning and competitive advantage. Many recent studies have shown that strategic planning helps organizations to gain competitive advantage over their rivals. However, other empirical studies found strategic planning to have no effect on competitive advantage. This study attempted to settle this inconclusive debate and included a mediating variable on this association using a data sample collected from Tanzania Zambia Railway Authority (TAZARA) employees who are in management. This research contributes to literature by determining the mediation effect of customer focus on the relationship between strategic planning and competitive advantage. The reliability, validity, and model fit were all checked using principal component analysis, factor analysis, and regression analysis in Jamovi software. The results reveal that a positive significant relationship exists between strategic planning and competitive advantage and also between customer focus and competitive advantage. Customer focus was found to partially mediate the association between strategic planning and competitive advantage. The study results may assist decision-makers in the railway sector to be more customer focusing and practicing strategic planning in order to survive this tense fierce competition of the twenty-first century. Scholars are recommended to replicate this study to other sectors and include other mediating/moderating variables.
Addressing the Needs of Victims: The Standpoint of Crime Victims Within the Obuasi Municipality
Authors: Ofori-Dua Kwadwo , Azumah Francess Dufie , Nachinaab John Onzaberigu , Mohammed Muazu
Published: August 2022

The criminal justice system lacks the protection for most victims and does not provide adequate compensation and rewards for an injury that individuals incurred during a crime experience to meet crime victims’ needs. After victims report a crime, they expect the judicial system to deliver justice to meet their needs in addressing their concerns. However, this is lacking in the criminal justice system. The focus of the study was to identify measures put in place to identify and address victims’ needs. Purposive and snowballing sampling techniques were used. Data were collected from 35 respondents; mainly crime victims and officials of the criminal justice system in the Obuasi Metropolis. A qualitative approach was adopted. The study found that the first step the victims felt their needs could be identified and addressed was, their point of reporting of crime incidence to the police but that was never the case. Hence, most crime victims want payback (replacement of lost properties), compensation and rewards from the offenders. According to most victims, imprisoning perpetrators alone does not meet victims’ needs. As crime had already been committed and nothing could be done to turn back the clock. This calls for more pragmatic approaches in addressing crime victims’ needs within the criminal justice system.
Rethink on Smart City: Technology Approach, Showcase Approach or Demand Approach?
Authors: Wu Zhiqiang
Published: August 2022

The author reveals three current approaches to build Smart Cities, i.e., technology-oriented, showcase-oriented and demand-oriented, and analyzes the causes, advantages, shortcoming and influences of the three approaches. In the conclusion, a composite approach with the demand approach as its core is advocated, which returns to the demands of the city that supports problem-solving, innovation, intelligent governance, economic development and regional synergy.
HMGB1 in the mPFC governs comorbid anxiety in neuropathic pain
Authors: Du Yu , Xu Ceng-Lin , Yu Jie , Liu Keyue , Lin Shi-Da , Hu Ting-Ting , Qu Feng-Hui , Guo Fang , Lou Guo-Dong , Nishibori Masahiro , Hu Wei-Wei , Chen Zhong , Zhang Shi-Hong
Published: August 2022

Background

Whether neuroinflammation causes comorbid mood disorders in neuropathic pain remains elusive. Here we investigated the role of high mobility group box 1 protein (HMGB1), a proinflammatory cytokine, in the medial prefrontal cortex (mPFC) in anxiety comorbidity of neuropathic pain.

Methods

Neuropathic pain was induced by partial transection of the infraorbital nerve (p-IONX) or partial sciatic nerve ligation (PSL) in mice and evaluated by measuring nociceptive thresholds to mechanical and heat stimulation. Anxiety-like behaviors were assessed by elevated plus maze, light dark box and open field tests. Aversive or anti-aversive effect was detected by conditioned place preference test. Neuronal activity was evaluated by single-unit and patch clamp recordings. The contribution of mPFC pyramidal neurons to anxiety was further examined by selectively inhibiting them by optogenetics. HMGB1 expression was measured by immunohistochemistry and western blotting. Antagonism of HMGB1 was achieved by injecting anti-HMGB1 monoclonal antibody (mAb) intracerebrally or intraperitoneally.

Results

Anxiety-like behaviors were presented earlier after p-IONX than after PSL. HMGB1 expression was upregulated in the mPFC temporally in parallel to anxiety onset, rather than in other regions associated with anxiety. The upregulation of HMGB1 expression and its translocation from the nucleus to cytoplasm in the mPFC occurred predominantly in neurons and were accompanied with activation of microglia and astrocytes. Infusion of anti-HMGB1 mAb into the mPFC during the early and late phases after either p-IONX or PSL alleviated anxiety-like behaviors and aversion without changing pain sensitization, while local infusion of exogenous ds-HMGB1, the proinflammatory form of HMGB1, into the mPFC induced anxiety and aversion but not pain sensitization in naïve mice. In addition to reversing established pain sensitization and anxiety simultaneously, intraperitoneal injection of anti-HMGB1 mAb reduced HMGB1 upregulation and suppressed the hyperexcitability of layer 2/3 pyramidal neurons in the mPFC after p-IONX. Moreover, optogenetic inhibition of mPFC pyramidal neurons alleviated anxiety in p-IONX mice.

Conclusion

These results demonstrate that HMGB1 in the mPFC drives and maintains anxiety comorbidity in neuropathic pain by increasing the excitability of layer 2/3 pyramidal neurons, and justify antagonism of HMGB1, e.g., neutralization by mAb, as a promising therapeutic strategy for neuropathic pain with anxiety comorbidity.
Abrikossoff's tumor of the penis: a case report
Authors: Zerda Ilyass , Saouli Amine , Bilgo Abdoulazizi , Karmouni Tarik , El Khader Khalid , Koutani Abdellatif , Andaloussi Ahmed Iben Attya
Published: August 2022

Background

Granular cell tumors (GCTs) also called Abrikossoff's tumor are rare tumors of often benign neurogenic origin, mainly located in the craniocervical region, rarely found in the external genitals. We report in this article the case report of a purely cutaneous case of rare clinical presentation at the level of the penis.

Case presentation

We report the case of a man, aged 54, with no history, consulted for a nodular lesion on the penis evolving for a year. a nodular cutaneous plate, indurated 3 cm in large diameter, painless and mobile in relation to the deep plane. The lymph node areas were free, and the remainder of the skin examination was without abnormalities.

Conclusions

Granular cell tumors (GCTs) also called Abrikossoff's tumor are rare tumors of often benign neurogenic origin, mainly located in the craniocervical region, rarely found in the external genitalia, the diagnosis is based on anatomopathology study completed by immunohistochemistry, and treatment consists of complete surgical excision of the tumor.
Impact of fetal exposure to mycotoxins on longissimus muscle fiber hypertrophy and miRNA profile
Authors: Greene M. A. , Udoka A. N. S. , Powell R. R. , Noorai R. E. , Bruce T. , Duckett S. K.
Published: August 2022

Background

Longissimus muscle samples were collected from lambs exposed in utero to mycotoxins [E-, endophyte-free tall fescue seed without ergot alkaloids (negative control) or E + , endophyte-infected tall fescue seed containing ergot alkaloids] during mid-gestation (MID; E + /E-) or late-gestation (LATE; E-/E +) harvested at two developmental stages (FETAL, gestational d133) or (MAT, near maturity, 250 d of age; n = 3/treatment/developmental stage). Muscle samples were examined to determine the impact of in utero mycotoxin exposure on skeletal muscle fiber hypertrophy and the miRNA profile at FETAL and MAT.

Results

Longissimus weight was greater (P < 0.05) in E + /E- lambs compared to E-/E + lambs at MAT; however, FETAL longissimus weight did not differ (P > 0.10) between fescue treatments. Type I fiber cross sectional area was larger (P < 0.10) for E + /E- than E-/E + at MAT but did not differ (P > 0.10) between fescue treatments at FETAL. Type II fiber area was larger (P < 0.05) at MAT in E + /E- compared to E-/E + but did not differ (P < 0.05) between fescue treatments at FETAL. Cross-sectional Type I and Type II longissimus muscle fiber area increased (P < 0.05) from FETAL to MAT by 6.86-fold and 10.83-fold, respectively. The ratio of Type II:Type I muscle fibers was lower (P = 0.04) at MAT compared to FETAL. There were 120 miRNA differentially expressed (q < 0.05) between FETAL and MAT. Maternal fescue treatment did not alter (q > 0.05) expression of miRNAs in the longissimus muscle. miR-133, -29a, -22-3p, and -410-3p were identified as highly significant with a log2 fold change > 4. In vitro satellite cell cultures showed that selected miRNAs (miR-22-3p, 29a, 27a, and 133a) are differentially regulated during proliferation and differentiation indicating a role of miRNA in muscle hypertrophy.

Conclusions

Exposure to mycotoxins did not alter fiber type but had long-term impacts on postnatal muscle hypertrophy and cross-sectional area. The miRNA profile of the longissimus was not altered by Maternal mycotoxin exposure at FETAL or MAT. Developmental age altered the miRNA transcriptome and mRNA expression of known genes related to muscle growth. These results indicate that Maternal exposure to E + fescue seed during LATE gestation can alter postnatal muscle hypertrophy in sheep; however, these changes are not regulated by the miRNA transcriptome of the longissimus muscle.
Analysis of the genetic diversity and population structure of Monochasma savatieri Franch. ex Maxim using novel EST-SSR markers
Authors: Yang Wanling , Bai Zhiyi , Wang Fuqiang , Zou Mingzhu , Wang Xinru , Xie Jiankun , Zhang Fantao
Published: August 2022

Background

Monochasma savatieri Franch. ex Maxim is a medicinally valuable herb. However, the collection and protection of the wild germplasm resources of M. savatieri are still insufficient, and their genetic diversity and population structure have been poorly studied.

Results

We collected and examined 46 M. savatieri individuals from Fujian, Hunan, Jiangxi, and Zhejiang provinces for genetic diversity and population structure, using 33 newly developed expressed sequence tag-simple sequence repeat (EST-SSR) markers. Applying these markers, we detected a total of 208 alleles, with an average of 6.303 alleles per locus. The polymorphic information content varied from 0.138 to 0.884 (average: 0.668), indicating a high level of polymorphism. At the population level, there was a low degree of genetic diversity among populations (I = 0.535, He = 0.342), with Zhejiang individuals showing the highest genetic diversity among the four populations (Fst = 0.497), which indicated little gene flow within the M. savatieri populations (Nm = 0.253). Mantel test analysis revealed a significant positive correlation between geographical and genetic distance among populations (R2 = 0.3304, p < 0.05), and structure and principal coordinate analyses supported classification of populations into three clusters, which was consistent with the findings of cluster analysis.

Conclusions

As a rare medicinal plants, the protection of M. savatieri does not look optimistic, and accordingly, protective efforts should be beefed up on the natural wild populations. This study provided novel tools and insights for designing effective collection and conservation strategies for M. savatieri.
Effects of ultrasound-guided alveolar recruitment manoeuvres compared with sustained inflation or no recruitment manoeuvres on atelectasis in laparoscopic gynaecological surgery as assessed by ultrasonography: a randomized clinical trial
Authors: Wu Xiong-zhi , Xia Hai-mei , Zhang Ping , Li Lei , Hu Qiao-hao , Guo Su-ping , Li Tian-yuan
Published: August 2022

Background

The majority of patients may experience atelectasis under general anesthesia, and the Trendelenburg position and pneumoperitoneum can aggravate atelectasis during laparoscopic surgery, which promotes postoperative pulmonary complications. Lung recruitment manoeuvres have been proven to reduce perioperative atelectasis, but it remains controversial which method is optimal. Ultrasonic imaging can be conducive to confirming the effect of lung recruitment manoeuvres. The purpose of our study was to assess the effects of ultrasound-guided alveolar recruitment manoeuvres by ultrasonography on reducing perioperative atelectasis and to check whether the effects of recruitment manoeuvres under ultrasound guidance (visual and semiquantitative) on atelectasis are superior to sustained inflation recruitment manoeuvres (classical and widely used) in laparoscopic gynaecological surgery.

Methods

In this randomized, controlled, double-blinded study, women undergoing laparoscopic gynecological surgery were enrolled. Patients were randomly assigned to receive either lung ultrasound-guided alveolar recruitment manoeuvres (UD group), sustained inflation alveolar recruitment manoeuvres (SI group), or no RMs (C group) using a computer-generated table of random numbers. Lung ultrasonography was performed at four predefined time points. The primary outcome was the difference in lung ultrasound score (LUS) among groups at the end of surgery.

Results

Lung ultrasound scores in the UD group were significantly lower than those in both the SI group and the C group immediately after the end of surgery (7.67 ± 1.15 versus 9.70 ± 102, difference, -2.03 [95% confidence interval, -2.77 to -1.29], P < 0.001; 7.67 ± 1.15 versus 11.73 ± 1.96, difference, -4.07 [95% confidence interval, -4.81 to -3.33], P < 0.001;, respectively). The intergroup differences were sustained until 30 min after tracheal extubation (9.33 ± 0.96 versus 11.13 ± 0.97, difference, -1.80 [95% confidence interval, -2.42 to -1.18], P < 0.001; 9.33 ± 0.96 versus 10.77 ± 1.57, difference, -1.43 [95% confidence interval, -2.05 to -0.82], P < 0.001;, respectively). The SI group had a significantly lower LUS than the C group at the end of surgery (9.70 ± 1.02 versus 11.73 ± 1.96, difference, -2.03 [95% confidence interval, -2.77 to -1.29] P < 0.001), but the benefit did not persist 30 min after tracheal extubation.

Conclusions

During general anesthesia, ultrasound-guided recruitment manoeuvres can reduce perioperative aeration loss and improve oxygenation. Furthermore, these effects of ultrasound-guided recruitment manoeuvres on atelectasis are superior to sustained inflation recruitment manoeuvres.

Trial registration

Chictr.org.cn, ChiCTR2100042731, Registered 27 January 2021, www.chictr.org.cn.
Experiences of treatment-resistant mental health conditions in primary care: a systematic review and thematic synthesis
Authors: Talbot Amelia , Lee Charlotte , Ryan Sara , Roberts Nia , Mahtani Kamal R. , Albury Charlotte
Published: August 2022

Background

Most adults fail to achieve remission from common mental health conditions based on pharmacological treatment in primary care alone. There is no data synthesising the reasons. This review addresses this gap through a systematic review and thematic synthesis to understand adults’ experiences using primary care for treatment-resistant mental health conditions (TRMHCs). We use the results to produce patient-driven recommendations for better support in primary care.

Methods

Eight databases were searched from inception to December 2020 for qualitative studies reporting research on people’s experience with TRMHCs in primary care. We included the following common mental health conditions defined by NICE: anxiety, depression, panic disorder, post-traumatic stress, and obsessive-compulsive disorder. Two reviewers independently screened studies. Eligible studies were analysed using an aggregative thematic synthesis.

Results

Eleven studies of 4456 were eligible. From these eleven studies, 4 descriptive themes were developed to describe a cycle of care that people with TRMHCs experienced in primary care. In the first stage, people preferred to self-manage their mental health and reported barriers that prevented them from seeing a GP (e.g., stigma). People felt it necessary to see their GP only when reaching a crisis point. In the second stage, people were usually prescribed antidepressants, but were sceptical about any benefits they had to their mental health. In the third stage, people self-managed their mental health (e.g., by adjusting antidepressant dosage). The fourth stage described the reoccurrence of mental health and need to see a GP again. The high-order theme, ‘breaking the cycle,’ described how this cycle could be broken (e.g., continuity of care).

Conclusions

People with TRMHCs and GPs could break the cycle of care by having a conversation about what to do when antidepressants fail to work. This conversation could include replacing antidepressants with psychological interventions like talking therapy or mindfulness.
The association of aerobic, resistance, and combined exercises with the handgrip strength of middle-aged and elderly Korean adults: a nationwide cross-sectional study
Authors: Sung Joo Hye , Son Se Rhim , Baek Seol-Hee , Kim Byung-Jo
Published: August 2022

Background

Handgrip strength (HGS), an indicator of overall muscle strength, is a key component in sarcopenia diagnosis. Although exercise is an effective strategy to prevent sarcopenia, the most appropriate exercise type targeting sarcopenia needs to be established. This study aimed to investigate the relationship between the physical activity (PA) patterns and HGS.

Methods

This was a cross-sectional study using the data from the 7th Korea National Health and Nutrition Examination Survey (2016–2018). The study population included 12,814 adults aged ≥ 40 years. According to the World Health Organization PA guidelines for public health, both aerobic (moderate to vigorous PA ≥ 150 min/week) and resistance exercises (≥ 2 sessions/week) are recommended. Study participants were categorized into one of the four groups depending on their adherence to each of two exercise guidelines (“neither,” “aerobic only,” “resistance only,” and “combined”). By defining normal HGS cutoff values as the lowest quartile of HGS from the population aged 20 years and above, we classified participants as “preserved” HGS group if their HGS was equal to or above the cutoff values. A Poisson regression model was used to calculate adjusted prevalence ratios (APRs) for preserved HGS across the four PA guideline adherences stratified by age and sex groups.

Results

In middle-aged adults, the “combined” exercise group was independently associated with the preserved HGS (male, age 50–59 years, APR = 1.072; male, age 60–69 years, APR = 1.180; female, age 50–59 years, APR = 1.112; female, age 60–69 years, APR = 1.188). For adults aged ≥ 70 years, meeting only aerobic or resistance exercise guidelines showed a positive association with HGS before adjusting for other health-related variables. In males of ≥ 70 years, the APR of preserved HGS was highest in the “combined” exercise group (“resistance only,” APR = 1.459, “combined,” APR = 1.664), while in women aged ≥ 70 years, the significance was lost after adjusting for covariates.

Conclusions

Adults meeting both aerobic and resistance exercise guidelines were associated with the highest prevalence of preserved HGS. Performing both types of exercise might be the most effective way to prevent sarcopenia that should be investigated in future clinical trials.