bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial Validation of an Ecological Momentary Assessment Measure of Self-Efficacy to Manage Negative Emotions
Authors: Kleiman Evan M. , Rizvi Shireen L. , Duberstein Paul R.
Published: January 2023

Although ecological momentary assessment (EMA) provides an opportunity for the examination of intervention mechanisms in real time, there are few validated tools to assess key treatment mechanisms in EMA studies. Our focus in this study is a potentially critical treatment mechanism, improvement in self-efficacy for managing negative emotions. We examined the psychometric properties of the Patient-Reported Outcomes Measurement Information System (PROMIS) self-efficacy for managing negative emotions scale measured via EMA. Participants ( n = 145 college students) in a clinical trial of Dialectical Behavior Therapy skills completed four daily EMAs for 6 weeks (13,153 total responses). Results indicated (a) excellent internal consistency and good factor structure, (b) sufficient variability at both the between- and the within-persons levels, and (c) strong construct and predictive validity. This study supports the validity of an EMA measure of self-efficacy for managing negative emotions that can be used in real time, both in intervention studies and in observational research.
Mitogenic Effects of Brazilian Arthropod Venom on Isolated Islet Beta Cells: In Vitro Morphologic Ultrastructural and Functional Studies
Authors: Luca Giovanni , Calvitti Mario , Basta Giuseppe , Baroni Tiziano , Neri Luca M. , Becchetti Ennio , Capitani Silvano , Novaes Geovana , Correa-Giannella Maria Lucia , Kalapothakis Evanguedes , Engler Sylva Stuchi Maria , Eliaschewitz Freddy Goldberg , Sogayar Mari Cleide , Fanelli Carmine , Brunetti Paolo , Calafiore Riccardo
Published: January 2023

Background

One of the major pitfalls associated with use of isolated adult islets of Langerhans’ cells is their minimal mitotic capacity. Consequently, maintenance of a steady viable islet cell mass is very difficult. To explore how to enhance beta-cell mitogenesis, we have examined the effects of venom fractions extracted from a Brazilian scorpion on morphologic and functional beta-cell patterns. The venom was previously known to induce nesidioblastosis-like effects with chronic hypoglycemia and pancreatitis in animal models.

Methods

Venom fractions purified from Tityus bahiensis were incubated with batches of isolated rat islets, while a morphologic examination, glucose-stimulated insulin release, insulin content, and insulin messenger ribonucleic acid (mRNA) were carried out early during incubation. On fixation and double fluorescence immunolabeling (rhodamine for anti-insulin monoclonal antibodies; fluorescein for anti-5-bromodeoxyuridine), the preparations were imaged by confocal laser microscopy (CLM) for morphometric quantification of the mitoses. Insulin recovery and mRNA were also assessed at 21 days of culture.

Results

Under CLM examination, the beta-cell mitotic rate significantly rose from 1 to 12.8% for the venom-exposed islets. At day 7, insulin release and content were significantly lower for the venom-exposed than the control islets. However, at day 21 of culture, insulin release in response to static incubation with glucose and insulin mRNA from the venom-exposed islets was higher than controls ( p < .05).

Conclusions

Incubation with the scorpion venom induced a rapid and significant increase in the beta-cell proliferation not associated with a short-term increase in insulin secretion. The latter fully resumed and overcame controls later in culture, possibly after completion of the beta-cell expansion process.
Intercellular Adhesion Molecule 1 is Important for the Development of Severe Experimental Malaria but is Not Required for Leukocyte Adhesion in the Brain
Authors: Li Jie , Chang Wun-Ling , Sun Guang , Chen Hong-Li , Specian Robert D. , Berney Seth Mark , Kimpel Donald , Granger D. Neil , van der Heyde Henri C.
Published: January 2023

Plasmodium berghei-infected mice, a well-recognized model of experimental cerebral malaria (ECM), exhibit a systemic inflammatory response. Most investigators hypothesize that leukocytes bind to endothelial cells via intercellular adhesion molecule 1 (ICAM-1), which causes endothelial damage, increased microvascular permeability, and, ultimately, death. ICAM-1-deficient mice on an ECM-susceptible C57BL/6 background were significantly ( p = .04) protected from P. berghei mortality compared with ICAM-1 intact controls. ICAM-1 expression assessed by the dual radiolabeled monoclonal antibody technique was increased in the brain and lung in C57BL/6 mice on day 6 of P. berghei infection compared with uninfected controls (5.3-fold, p = .0003 for brain and 1.8-fold, p = .04 for lung). The increase in ICAM-1 expression coincided with significant ( p < .05) increases in microvascular permeability in the brain and lung. In contrast to the hypothesized role for ICAM-1, in vivo analysis by intravital microscopy of leukocyte rolling and adhesion in brain microvasculature of mice revealed markedly increased levels of leukocyte rolling and adhesion in ICAM-1-deficient mice on day 6 of P. berghei infection compared with uninfected controls. In addition, ICAM-1 expression and microvascular permeability were increased in infected ECM-resistant BALB/c mice compared with uninfected BALB/c controls. These results collectively indicate that although ICAM-1 contributes to the mortality of experimental malaria, it is not sufficient for the development of severe experimental malaria. In addition, ICAM-1 expressed on the endothelium or on leukocytes is not required for leukocyte rolling or adhesion to the brain microvasculature of mice during P. berghei malaria. Leukocyte rolling and adhesion in the brain vasculature during P. berghei malaria use different ligands than observed during inflammation in other vascular beds.
Impact of Medical Student Research in the Development of Physician-Scientists
Authors: Solomon Solomon S. , Tom Stephen C. , Pichert James , Wasserman David , Powers Alvin C.
Published: January 2023

Context

A decline in the number of physician-scientists has been identified in the United States for at least two decades. Although many mechanisms have been proposed to reverse this trend, most of these have concentrated on MD/PhD programs, research in subspecialty fellowships, and other approaches later in physician training. Few have emphasized early medical student research experiences as a contributing solution.

Objective

To determine the effect of a medical student research experience on career choices and attitudes about biomedical research.

Design, Setting, and Participants

We jointly report 25 years of experience with National Institutes of Health (NIH)-sponsored Medical Student Research Fellowship programs (MSRFs) at two colleges of medicine, the University of Tennessee Health Science Center and Vanderbilt University. In both programs, students work during the summer of their first or second year of medical school on a research project that is mentored by an established scientist and participate in a structured program (lectures, visiting professor).

Main Outcome Measures

We gathered data using pre- and postresearch fellowship questionnaires to assess (a) quality of research experiences; (b) tabulation of productivity, that is, presentations, abstracts, publications, and awards; (c) long-term tracking of former program participants; (d) comparison of residency placements by medical student researchers; and (e) comments from former program participants on the effects of their students’ research experiences on career choices.

Results

During this time, approximately 1,000 medical students participated in the two programs. Follow-up data (for short-term evaluations, 96–132 respondents with a response rate > 82%; for long-term evaluations, 88–118 respondents with a response rate > 29–33%) strongly suggest (a) interest in an academic career increased, (b) one-third to half of former student respondents considered themselves to be in academic medicine, (c) the vast majority of students conducted additional research after their medical student research experience, and (d) a large number of students were currently doing research or had published or presented their work at scientific meetings.

Conclusions

Over two decades of experience with NIH-sponsored medical student research programs at two medical schools strongly support the ability of these programs to interest medical students in research and academic careers. MSRFs should be included in strategies to reverse the decline in the number of physician-scientists.
Oxidative Stress and Antioxidant Supplementation in the Management of Diabetic Cardiovascular Disease
Authors: Vega-López Sonia , Devaraj Sridevi , Jialal Ishwarlal
Published: January 2023

The diabetic state confers an increased propensity to accelerated atherogenesis. In addition to the established risk factors, there is evidence for increased oxidative stress in diabetes. Increased oxidative stress is manifested by increased lipid peroxidation, increased F2-isoprostanes, increased nitrotyrosine, and increased DNA damage. Also, in diabetics, there is increased superoxide release. With regard to diabetes, antioxidants such as α-tocopherol, α-lipoate, and ascorbic acid supplementation have been shown to be beneficial. Most importantly, α-tocopherol therapy, especially at high doses, clearly shows a benefit with regard to low-density lipoprotein oxidation, isoprostanes, and monocyte superoxide release. Thus, it appears that, in diabetes, antioxidant therapy could alleviate the increased attendant oxidative stress and emerge as an additional therapeutic modality.
Autoantibodies and Levels of Polychlorinated Biphenyls in Persons Living near a Hazardous Waste Treatment Facility
Authors: Schoenroth Leeanne , Chan Siu , Fritzler Marvin
Published: January 2023

Background

Increased autoantibody prevalence has been described in instances of high-dose exposure to polychlorinated biphenyls (PCBs). In 1996, an equipment malfunction at the Swan Hills Treatment Centre in Alberta, Canada, caused the release of gases containing PCBs into the ambient air. In view of the immune effects of PCBs and their potential as endocrine disruptors, we assessed autoantibody prevalence and looked for correlations with PCB levels.

Methods

Fifty-seven persons living within a 100 km radius of the waste treatment facility were assessed. Autoantibodies were measured by indirect immunofluorescence, double immunodiffusion, and immunoblotting. The levels of 26 congeners of PCBs were measured by gas chromatography and mass spectrometry. Provincial health records for physician visits and hospitalizations were reviewed for diagnoses of autoimmune disease.

Results

The prevalence of autoantibodies was 11% in the study participants and 0% in healthy controls. There was no correlation of PCB levels with autoantibody results. There was no associated increase in autoimmune disease noted on physician visits or hospitalizations. PCB levels were comparable to background levels reported for other populations.

Conclusion

A correlation of titers of autoantibodies in the sera of individuals at risk and the blood levels of PCBs was not found, and the prevalence of autoantibodies in the at-risk group was not statistically different ( p > .05) from that of an unexposed control group. The study group had higher titers of autoantibodies and some strong reactivity with intracellular antigens, but the significance of this observation may be understood only after long-term clinical assessments and follow-up.
Effects of Atorvastatin and Simvastatin on Low-Density Lipoprotein Subtraction Profile, Low-Density Lipoprotein Oxidizability, and Antibodies to Oxidized Low-Density Lipoprotein in Relation to Carotid Intima Media Thickness in Familial Hypercholesterolemia
Authors: van Tits Lambertus J. H. , Smilde Tineke J. , van Wissen Sanne , de Graaf Jacqueline , Kastelein John J. P. , Stalenhoef Anton F. H.
Published: January 2023

Background

Little is known about the effects of statins on the quality of circulating low-density lipoprotein (LDL) in relation to atherosclerosis progression.

Methods

In a double-blind, randomized trial of 325 patients with familial hypercholesterolemia (FH), we assessed the effects of high-dose atorvastatin (80 mg) and conventional-dose simvastatin (40 mg) on LDL subtraction profile ( n = 289), LDL oxidizability ( n = 121), and circulating autoantibodies to oxidized LDL ( n = 220). Progression of atherosclerosis was measured by carotid intima media thickness (IMT) ( n = 325).

Results

At baseline, the patients showed an intermediate LDL subtraction profile composed of three LDL subtractions (LDL1, LDL2, LDL3), with LDL2 as the predominant subtraction. A strong negative correlation was found between plasma triglycerides and the LDL subtraction profile ( r = - .64, p = .000). Both plasma levels of triglycerides and small dense LDL3 correlated weakly with baseline IMT ( r = .11, p = .04 and r = .15, p = .01, respectively; n = 289). No association was found between baseline IMT and oxidation parameters or circulating antibodies to oxidized LDL. Atorvastatin reduced triglycerides, LDL cholesterol, and all LDL subtractions to a greater extent than did simvastatin and led to regression of carotid IMT. However, LDL subtraction pattern and plasma levels of autoantibodies to oxidized LDL remained unchanged in both treatment groups, and LDL oxidizability increased minimally to a similar extent in both groups. Significant treatment differences were found for the rate of in vitro oxidation of LDL and the amount of dienes formed during in vitro oxidation of LDL, which both decreased more following atorvastatin than after simvastatin.

Conclusion

Change of IMT after statin treatment was associated with baseline IMT ( r = .41), LDL cholesterol ( r = -.20), and the amount of dienes formed during in vitro oxidation of LDL ( r = .28) but not with plasma levels of antibodies to oxidized LDL, in vitro LDL oxidizability, and LDL subtraction profile.
Simvastatin Induces Death of Multiple Myeloma Cell Lines
Authors: Gronich Naomi , Drucker Liat , Shapiro Hava , Radnay Judith , Yarkoni Shai , Lishner Michael
Published: January 2023

Background

Accumulating reports indicate that statins widely prescribed for hypercholesteromia have antineoplastic activity. We hypothesized that because statins inhibit farnesylation of Ras that is often mutated in multiple myeloma (MM), as well as the production of interleukin (IL)-6, a key cytokine in MM, they may have antiproliferative and/or proapoptotic effects in this malignancy.

Methods

U266, RPMI 8226, and ARH77 were treated with simvastatin (0–30 μM) for 5 days. The following aspects were evaluated: viability (IC50), cell cycle, cell death, cytoplasmic calcium ion levels, supernatant IL-6 levels, and tyrosine kinase activity.

Results

Exposure of all cell lines to simvastatin resulted in reduced viability with IC50s of 4.5 μM for ARH77, 8 μM for RPMI 8226, and 13 μM for U266. The decreased viability is attributed to cell-cycle arrest (U266, G1; RPMI 8226, G2M) and cell death. ARH77 underwent apoptosis, whereas U266 and RPMI 8226 displayed a more necrotic form of death. Cytoplasmic calcium levels decreased significantly in all treated cell lines. IL-6 secretion from U266 cells was abrogated on treatment with simvastatin, whereas total tyrosine phosphorylation was unaffected. Conclusions: Simvastatin displays significant antimyeloma activity in vitro. Further research is warranted for elucidation of the modulated molecular pathways and clinical relevance.
Effects of Carbon Monoxide Poisoning on Neutrophil Responses in Patients Treated with Hyperbaric Oxygen
Authors: Schnittger Vendela , Rosendahl Kerstin , Lind Folke , Palmblad Jan
Published: January 2023

Background

Carbon monoxide (CO) poisoning can cause tissue injury. Neutrophil granulocytes have been proposed to contribute to the injury, which may be ameliorated by hyperbaric oxygen (HBO2) treatment. We sought to assess the relationship between acute CO poisoning and blood neutrophil count, plasma cytokine, and Cortisol responses, as well as the mechanism behind the observed beneficiary effects of HBO2 treatment.

Methods

Eight patients (age 26–82 years) with severe acute CO poisoning were enrolled, concomitant with eight healthy controls (age 27–42 years), in a prospective, controlled, clinical study. The patients were given three HBO2 treatments (2.8 atmospheres absolute, 100 minutes) within the first 24 hours. The controls were given identical simultaneous HBO2 treatments. Venous blood samples were taken before and after each treatment.

Results

At the start of the HBO2 treatment, patients displayed significantly higher blood neutrophil counts ( p < .0001) and plasma Cortisol levels (p = .020) than controls, but the two groups had similar values for interleukin-8, granulocyte colony-stimulating factor (G-CSF), neutrophil H2O2 generation, and CD16 and CD18 surface expression. During the observation time, neutrophil H2O2 accumulation declined in patients and in controls ( p = .031), whereas the up-regulation of CD18 expression increased ( p = .002) in both groups. Moreover, G-CSF levels became significantly higher in patients than in controls ( p = .015). G-CSF levels also correlated significantly with neutrophil counts.

Conclusion

CO poisoning was associated with discrete changes of blood neutrophil counts, Cortisol, and G-CSF plasma concentrations. HBO2 treatment modulated neutrophil generation of H2O2 and surface expression of CD18. These changes may be part of the cascade of events leading to the sequelae of CO poisoning and their attenuation by HBO2.
Journal Impact Factors Do Not Equitably Reflect Academic Staff Performance in Different Medical Subspecialties
Authors: Epstein Richard J.
Published: January 2023

Background

The simplest variables to quantify on an academic curriculum vitae are the impact factors (IFs) of journals in which articles have been published. As a result, these measures are increasingly used as part of academic staff assessment. The present study tests the hypotheses that IFs exhibit patterns that are consistent between journals of different specialties and that these IFs reflect the quality of staff academic performance.

Methods

The IFs of a sample of journals from each of four medical specialties—medicine, oncology, genetics, and public and occupational health—were downloaded from the Science Citation Index and compared. Overall and specialty-specific journal IF frequencies were analyzed with respect to distribution patterns, averages, and skew.

Results

Approximately 91% of journal IFs fell within the 0 to 5 range, with 97% being less than 10. The overall IF distribution featured a positive skew and a mean of 2.5. Separate analysis of the journal specialty subsets revealed significant differences in IF means (genetics 3.4 > oncology 3.1 > medicine 2.0 > public health 1.6; p < .006), all of which well exceeded the respective IF medians. Journals from the general medicine category exhibited both the lowest IF median (0.7) and the most positively skewed distribution.

Conclusion

The distribution of IFs exhibits degrees of skew, numeric average, and spread that differ significantly between journal specialty subsets. This suggests that factors other than random variations underlie much of the IF variation between specialty journals and reduces the plausibility of a reliable correlation between IFs and the quality of academic staff performance. It is concluded that a dominant emphasis on IFs in academic recruitment and promotion may select for long-term faculty characteristics other than academic quality alone.
Spontaneous resolution of parafoveal macular hole post YAG hyaloidotomy in a case of Valsalva retinopathy
Authors: Gaur Sandhya , Singh Deependra V , Sharma Ajay
Published: January 2023

Purpose

To report a rare case of spontaneous resolution of parafoveal macular hole post YAG hyaloidotomy in case of Valsalva retinopathy.

Methods

Case Report.

Results

A 29-year-old female presenting with sudden diminution of vision in her left eye (LE) for two months following a bout of vomiting was diagnosed with pre-macular haemorrhage. Patient was planned for YAG hyaloidotomy on the same day followed by propped up positioning. On follow up haemorrhage was seen to be cleared around macula with corresponding improvement of visual acuity. Patient was found to have developed a parafoveal hole post procedure which spontaneously healed without any intervention. Visual acuity was subsequently improved with resolution of macular hole as seen on fundus imaging and Optical coherence tomography (OCT).

Conclusion

Pre-macular haemorrhage is quite common phenomenon in Valsalva retinopathy cases and YAG hyaloidotomy is an established surgical modality for management of the same in literature with good clinical outcomes. However, formation of macular hole is not very common but described in literature post procedure. It is a rare phenomenon to have spontaneous resolution of macular hole. Hence, observation can be an option for managing such cases.
Home-like care: Collaboration between parents and nurses in everyday situations when children are hospitalized
Authors: Sundal Hildegunn
Published: January 2023

When children are hospitalized, parents and nurses need to collaborate. This study aims to investigate how parents and nurses experience collaborating and sharing responsibilities and tasks when providing home-like care for hospitalized children in everyday situations. This qualitative study used a hermeneutic phenomenological approach with observations and interviews and was conducted in a general medical pediatric unit. Twelve parents of eleven hospitalized children between the ages of 1 and 6 years with various medical diagnoses and seventeen nurses who cared for those children participated in the study. Parents and nurses collaborated and shared responsibilities and tasks to provide home-like care for hospitalized children in everyday situations by making mealtimes seem familiar, maintaining customary sleeping patterns, adapting washing and dressing routines, and facilitating play and activity. Parents and nurses collaborated to maintain a familiar rhythm in an unfamiliar environment to enhance the children’s well-being. The nurses’ degree of involvement in the children’s everyday situations varied from little to moderate to strong, with parents assuming the main responsibilities. Nurses’ involvement in children’s everyday situations was variable, depending on the complexity of the situations.
Shear resistance and structural hardening resistance models for hybrid NSC-UHPC elements
Authors: Pharand Martin , Charron Jean-Philippe
Published: January 2023

Ultra-high performance concrete (UHPC) is being increasingly used as a thin overlay for deficient normal strength concrete (NSC) structural elements. Compared to reinforced NSC elements, hybrid NSC-UHPC elements have two stages' structural behaviour under high shear load before failure: monolithic action followed by a composite mechanical action. The composite mechanical action gives to hybrid elements a structural hardening capability after the occurrence of a diagonal shear crack and is not yet considered by most design standards. Two analytical models for hybrid elements under shear load are thus proposed to predict the shear resistance V R of the monolithic action and to predict the structural hardening resistance V Rsh of the composite mechanical action. The shear resistance model integrates the UHPC contribution in the estimation of the tensile strain at mid-height cross-section according to the general method of the Canadian code. The structural hardening behaviour is reproduced with a strut-and-tie system with plastic hinges, where the failure is controlled by the crushing of a concrete strut. Predictions of the proposed models are in very good agreement with 31 hybrid elements experimental results retrieved from the literature.
Multi-output displacement health monitoring model for concrete gravity dam in severely cold region based on clustering of measured dam temperature field
Authors: Gu Chongshi , Zhu Mingyuan , Wu Yan , Chen Bo , Zhou Fuqiang , Chen Weinan
Published: January 2023

Constructing an accurate dam displacement health monitoring (DHM) model is crucial to ensure the safety of the dam. However, previous studies on DHM focused on the analysis and prediction of a single measurement point, with little work on multiple measurement points, which leads to low efficiency in evaluating the overall status of dams. Furthermore, the majority of these models are based on hydraulic engineering in moderate climatic areas, which results in low accuracy when applied to severely cold regions. To address these issues, the HT cT model is proposed based on full consideration of extreme climate and engineering measures in cold regions, which replaces the commonly used harmonic function or air temperature with the features extracted from the measured temperature field after clustering as a temperature factor. The method effectively overcomes multicollinearity while ensuring accuracy. Moreover, multi-output least-square support vector regression (MOLSSVR), a multi-output model that can forecast multiple measurement points simultaneously, is proposed. By combining it with the HT cT, the efficiency of the model is significantly improved. In addition, grey wolf optimization (GWO) is introduced to search for the optimal hyperparameters of the coupling model. The feasibility, accuracy, robustness, and long-term predictive capability of the proposed model are validated with measured displacements of a concrete gravity dam in a severely cold region. The results show that the proposed model outperforms the four popular machine learning (ML) models, including two support vector regression (SVR)-based models and two neural network-based models, which illustrate that the proposed model has outstanding accuracy and excellent long-term predictive capability. It provides an accurate and efficient novel approach for dam displacement safety monitoring in severely cold regions.
Transfer learning-based data anomaly detection for structural health monitoring
Authors: Pan Qiuyue , Bao Yuequan , Li Hui
Published: January 2023

The structural health monitoring (SHM) data of civil infrastructure are inevitably contaminated due to sensor faults, environmental noise interference, and data transmission failures. Anomalous data severely disturb the subsequent structural modal identification, damage identification, and condition assessment. Therefore, it is critical to detect and clean SHM data before data analysis. This paper proposes a novel approach for data anomaly detection based on transfer learning, that makes full use of the similarity of the anomalous patterns across different bridges and shares the knowledge incorporated in a deep neural network to achieve high-accuracy data anomaly identification for bridge groups. In the proposed approach, first, a multivariate database for a source bridge is built by plotting and labeling the raw sequential data. Then, a convolutional neural network (CNN) for data anomaly classification is designed and trained with the database in different conditions. The original CNN with the highest accuracy is transferred to a new bridge with enhancement training using a small part of the target bridge data. To validate the performance of the proposed method, the multivariate SHM data for two real long-span bridges are employed, including the acceleration, strain, displacement, humidity, and temperature data. The results demonstrate that transfer learning leads to a better classification capacity for the case of scarce labeled training data compared with the original network.
Scotland’s alcohol crisis: A clinician’s perspective on a public health emergency
Authors: MacGilchrist Alastair
Published: January 2023

Worldwide, alcohol causes a death every 10 seconds. The harmful effects are much wider in terms of impaired health and wellbeing of those affected and their families, particularly the most disadvantaged. The wider societal impact and financial costs are huge. Scotland, which has a particularly unhealthy relationship with alcohol and where the cost of alcohol harm is estimated at £3.6 billion, has introduced innovative public health measures such as minimum unit pricing (MUP). However, the COVID-19 pandemic has seen the death toll rising. This article examines the history of alcohol harm and policy interventions in Scotland in recent decades. The lessons learned provide a range of measures of proven efficacy that clinicians and government should employ to tackle Scotland’s on-going alcohol crisis, and should be of interest to clinicians and policy makers everywhere.
Thoracolumbar spinal dural arteriovenous fistulae present with longer arteriovenous transit compared to cranial and cervical dural fistulae
Authors: Itsekzon-Hayosh Ze’ev , Hendriks Eef J , O’Reilly Sean T , Al Shahrani Rabab , Agid Ronit , Nicholson Patrick , Terbrugge Karel , Radovanovic Ivan , Andrade Hugo , Schaafsma Joanna D , Krings Timo
Published: January 2023

Background

Thoraco-lumbar spinal dural arteriovenous fistulae represent a rare subset of central nervous system vascular malformations. One of the unique features of spinal dural arteriovenous fistulae is their extremely low propensity to cause hemorrhage (either parenchymal or subarachnoid), with a distinct clinical presentation of myelopathy secondary to spinal venous congestion. The exact mechanism for this unique presentation is still unclear.

Methods

Following institutional review board approval, we retrospectively analyzed our prospectively maintained database of spinal dural arteriovenous fistulae and cranial (cr) DAVF cases presenting between 2008 and 2021. For all cases, angiograms were reviewed and arteriovenous transit times were calculated. Patient demographics, angiographic features, and clinical and radiological outcomes were assessed.

Results

In total, 66 patients presenting with confirmed thoracolumbar spinal dural arteriovenous fistulaes were identified and compared to patients presenting with cervical spinal dural arteriovenous fistulaes ( n  =  10), ruptured crDAVFs ( n  =  32) and unruptured crDAVFs ( n  =  20). Mean age in the target group was 66  ±  13 versus 57–62 in the other groups, p < 0.05 on one-way analysis of variance; with 80% males versus 50%–65% in other groups. Mean arteriovenous transit time in the thoracolumbar group measured 1.98 s ± 0.96 versus 0.25–0.5 s range in other groups ( p < 0.0001 on one-way analysis of variance).

Conclusion

Prolonged arteriovenous transit times may represent a distinct feature of thoracolumbar spinal dural arteriovenous fistulaes. This may, amongst other factors, play a role in the observed lesser likelihood of hemorrhagic complications compared to other dural arteriovenous shunts.
Pulmonary infection is associated with an increased IL-6 in acute exacerbation chronic obstructive pulmonary disease
Authors: Tang Leilei , Zhang Lingdi , Mei Xuan , Yu Jiawen , Jiang Guojun
Published: January 2023

Objective

Acute Exacerbation Chronic Obstructive Pulmonary Disease (AECOPD) is associated with an acute worsening of respiratory symptoms that have effects on lung function, quality of life and health economic burden. In addition, the development of pulmonary infections is a common complication of Chronic Obstructive Pulmonary Disease (COPD). In the pathophysiology of AECOPD, interleukin (IL)-6 is a pleiotropic cytokine that can be produced by inflammatory and primary lung epithelial cells in response to a variety of different stimuli. We aim to investigate the correlation between serum cytokine levels and AECOPD with pulmonary infection.

Methods

37 AECOPD patients diagnosed with pulmonary infection and 33 patients diagnosed with AECOPD only were selected. All COPD patients were diagnosed according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) criteria. Serum samples for C-reactive protein (CRP) and cytokines were obtained from the patients immediately after admission. Serum concentrations of cytokines were measured using a fluorescent bead immunoassay on a flow cytometer. Logistic regression was used to identify risk factors for AECOPD co-infection of the lungs.

Results

Serum characterization of our cohort showed patients with AECOPD and pulmonary infection had higher levels of IL-6 and IL-10 compared with the AECOPD group, and IL-6 was independently associated with AECOPD with pulmonary infection. ROC curve analysis showed that IL-6 was a useful predictor of the incidence of pulmonary infection in AECOPD patients.

Conclusions

Our findings highlight the role of IL-6 in the pathogenesis of AECOPD with pulmonary infection.
The holistic approach to the CHRNA7 gene, hsa-miR-3158-5p, and 15q13.3 hotspot CNVs in migraineurs
Authors: Yasin Sedat , Görücü Yılmaz Şenay , Geyik Sırma , Oğuzkan Balcı Sibel
Published: January 2023

Migraine is a neurological disease characterized by severe headache attacks. Combinations of different genetic variations such as copy number variation (CNV) in a gene and microRNA (miRNA) expression can provide a holistic approach to the disease as a pathophysiological, diagnostic, and therapeutic target. CNVs, the Cholinergic Receptor Nicotinic Alpha 7 Subunit ( CHRNA7) gene, and expression of gene-targeting miRNAs ( hsa-miR-548e-5p and hsa-miR-3158-5p) in migraineurs ( n = 102; with aura, n = 43; without aura, n = 59) and non-migraines ( n = 120) aged 15–60 years, comparative, case–control study was conducted. Genetic markers were compared with biochemical parameters (BMI, WBC, Urea, GFR, ESR, CRP, HBG). All analyzes were performed by quantitative Real-Time PCR (q-PCR) and fold change was calculated with the 2−ΔΔCT method. The diagnostic power of the CHRNA7 gene, CNV, and miRNAs were analyzed with the receiver operating curve (ROC). CHRNA7 gene and hsa-miR-3158-5p are down-regulated in migraineurs and the gene is controlled by this miRNA via CNVs ( p < .05). Both deletion and duplication were detected in patients with migraine for CVN numbers ( p = .05). The number of CNV deletions was higher than duplications. When CHRNA7-CNV- hsa-miR-3158-5p was modeled together in the ROC analysis, the area under the curve (AUC) was 0.805, and the diagnostic power was “good”. In migraineurs, the CHRNA7 gene can be controlled by hsa-miR-3158-5p via CNVs to modulate the mechanism of pain. These three genetic markers have diagnostic potential and may be used in antimigraine treatments.
Persuasive Benefits of Self-Generated Arguments: Moderation and Mechanism
Authors: Xu Mengran , Wegener Duane T.
Published: January 2023

We aimed to derive a more systematic understanding of the persuasive advantages of self- versus other-generated arguments. Through three initial data collections ( Ntotal = 492) and another two large preregistered studies ( Ns = 528 and 496), we found that when people experienced a low level of difficulty (measured or manipulated) generating the arguments, self-generated arguments were more persuasive than other-generated arguments. However, when people experienced a high level of difficulty (measured or manipulated), the typical self-persuasion advantage was reduced significantly. Factor analyses identified perceptions of argument quality as a plausible and replicated mediator of the persuasive advantage of self-generated over other-generated arguments.
Acceptable, useful, and ineffective? Recent retirees’ experiences of a 12-month activity tracker-based physical activity intervention
Authors: Tuominen Miika , Koski Pasi , Axelin Anna , Stenholm Sari , Leskinen Tuija
Published: January 2023

Objective

Activity trackers appear cost-effective and acceptable intervention tools for promoting physical activity among older adults, particularly in the short-term. However, long-term studies focused on participants’ experiences continue to be scarce. This study evaluated participants’ experiences of a 12-month activity tracker-driven physical activity intervention.

Methods

Participants’ experiences were assessed qualitatively using open-ended questionnaire items ( n = 113) and semi-structured interviews conducted after the 12-month intervention ( n = 27). Quantitative items assessed the perceived ease-of-use and usefulness of the activity tracker during the intervention. Qualitative data was analyzed using thematic analysis and Wilcoxon signed-rank tests were used to examine changes in the perceived ease-of-use and usefulness over time.

Results

The 113 participants completing the 12-month intervention were on average 65.2 ( SD 1.0) years old and 81.4% women with 92.3% providing activity tracker data on at least 2 weeks per each intervention month. In the qualitative analysis, four main themes with 20 subthemes were identified: (a) burdens of participation, (b) affective attitudes of using the activity tracker, (c) perceived effects of using the activity tracker, and (d) no perceived behavioral effects. At 12 months, the participants found activity trackers mainly easy to use (mean 4.6, SD 0.6), reliable (mean 3.6, SD 1.2), motivating (mean 3.9, SD 1.0), and helpful in reducing sitting (mean 3.7, SD 1.0) with no changes observed during the intervention.

Conclusions

The participants’ experiences were highly varied suggesting that tailored intervention designs are likely to be required for effectively using activity trackers to promote long-term changes in daily activity among older adults.
Step-Wise Management of Anemia in Patients With Chronic Kidney Disease in Primary Care: Qualitative Study
Authors: Delanerolle Gayathri , Forbes Anna , van Vlymen Jeremy , Gallagher Hugh , Cole Nicholas , Hassan Simon , Tahir Mohammad , Bankhead Clare , Chan Tom , Swift Pauline A. , Suckling Rebecca , Macdougall Iain C. , Joy Mark , de Lusignan Simon
Published: January 2023

Introduction:

Anemia is common in chronic kidney disease (CKD) and is associated with increased cardiovascular risk and reduced quality of life, but is often sub-optimally managed. Most patients are managed in primary care alongside other comorbidities. Interventions to improve the management of anemia in CKD in this setting are needed.

Methods:

We conducted a qualitative study to evaluate how an audit-based education (ABE) intervention might improve the management of anemia in CKD. We explored outcomes that would be relevant to practitioners and patients, that exposed variation of practice from National Institute for Health and Care Excellence (NICE) guidelines, and whether the intervention was feasible and acceptable.

Results:

Practitioners (n = 5 groups) and patients (n = 7) from 4 London general practices participated in discussions. Practitioners welcomed the evidence-based step-wise intervention. However, prescribing erythropoiesis-stimulating agents (ESAs) was felt to be outside of their scope of practice. There was a gap between NICE guidance and clinical practice in primary care. Iron studies were not well understood and anemia management was often conservative or delayed. Patients were often unaware of having CKD, and were more concerned about their other comorbidities, but largely trusted their GPs to manage them appropriately.

Conclusions:

The first steps of the intervention were welcomed by practitioners, but they expressed concerns about independently prescribing ESAs. Renal physicians and GPs could develop shared care protocols for ESA use in primary care. There is scope to improve awareness of renal anemia, and enhance knowledge of guideline recommendations; and our intervention should be modified accordingly.
The Bone Bridge for Tibial ACL Graft Fixation: A Biomechanical Analysis of Different Tibial Fixation Methods for ACL Reconstruction
Authors: Peez Christian , Greßmann Marvin , Raschke Michael J. , Glasbrenner Johannes , Briese Thorben , Frank Andre , Herbst Elmar , Kittl Christoph
Published: January 2023

Background:

The tibial fixation site is considered the weak link in anterior cruciate ligament (ACL) reconstruction, and conflicting results regarding the biomechanical properties of various fixation methods have been reported.

Purpose:

To examine knots tied over a bone bridge and its biomechanical properties as a suitable tibial fixation method in ACL reconstruction.

Study Design:

Controlled laboratory study.

Methods:

We divided 40 fresh-frozen porcine tibiae into 4 equal groups to evaluate flexor tendon grafts set with standard tibial fixation techniques: (1) bone bridge (BB group), (2) suspension button (SB group), (3) combined interference screw and bone bridge (IFS/BB group), and (4) combined interference screw and suspension button (IFS/SB group). Each construct was subjected to cyclic loading (1500 cycles, 50-250 N, 1 Hz) with a servohydraulic materials testing machine to measure elongation; load-to-failure testing (displacement rate: 25 mm/s) was then performed. Load to failure, stiffness, and yield load were compared between constructs using 1-way analysis of variance.

Results:

The hybrid fixation constructs (IFS/BB and IFS/SB groups) showed significantly better biomechanical properties than the isolated extracortical fixation constructs (BB and SB groups) ( P < .05 for all). There were no differences between the isolated extracortical fixation constructs or between the hybrid fixation constructs in elongation or load to failure; however, stiffness of the IFS/BB group was significantly higher than that of the IFS/SB group (175.3 ± 16.6 vs 144.9 ± 20.1 N/mm, respectively; P < .05). Stiffness between the SB and BB groups was not significantly different.

Conclusion:

Hybrid fixation had superior biomechanical performance compared with isolated extracortical fixation. However, tibial graft fixation using a bone bridge either as isolated extracortical fixation or combined with an interference screw for hybrid fixation showed equivalent biomechanical properties compared with suspension button–based graft fixation.

Clinical Relevance:

The clinical use of a bone bridge for tibial graft fixation could reduce the cost for ACL reconstruction and lower the rate of implant-associated issues.
Analysis of co-expression and gene regulatory networks associated with sterile lemma development in rice
Authors: Luo Xi , Wei Yidong , Zheng Yanmei , Wei Linyan , Wu Fangxi , Cai Qiuhua , Xie Huaan , Zhang Jianfu
Published: January 2023

Background

The sterile lemma is a unique organ of the rice (Oryza sativa L.) spikelet. However, the characteristics and origin of the rice sterile lemma have not been determined unequivocally, so it is important to elucidate the molecular mechanism of the development of the sterile lemma.

Results

In the paper, we outline the regulatory mechanism of sterile lemma development by LONG STERILE LEMMA1 (G1), which has been identified as the gene controlling sterile lemma development. Based on the comprehensive analyses of transcriptome dynamics during sterile lemma development with G1 alleles between wild-type (WT) and mutant (MT) in rice, we obtained co-expression data and regulatory networks related to sterile lemma development. Co-transfection assays of rice protoplasts confirmed that G1 affects the expression of various phytohormone-related genes by regulating a number of critical transcription factors, such as OsLBD37 and OSH1. The hormone levels in sterile lemmas from WT and MT of rice supports the hypotheses that lower auxin, lower gibberellin, and higher cytokinin concentrations are required to maintain a normal phenotype of sterile lemmas.

Conclusion

The regulatory networks have considerable reference value, and some of the regulatory relationships exhibiting strong correlations are worthy of further study. Taken together, these work provided a detailed guide for further studies into the molecular mechanism of sterile lemma development.
Impact of multimodal strategies including a pay for performance strategy in the improvement of infection prevention and control practices in healthcare facilities during an Ebola virus disease outbreak
Authors: Kabego Landry , Kourouma Mamadou , Ousman Kevin , Baller April , Milambo Jean-Paul , Kombe John , Houndjo Bienvenu , Boni Franck Eric , Musafiri Castro , Molembo Siya , Kalumuna Stéphanie , Tshongo Moise , Biringiro John Ndizihiwe , Moke Nancy , Kumutima Clarisse , Nkita Justin , Ngoma Polydor , Azzouz Chedly , Okum Raphaël , Yao Michel , Chamla Dick , Gueye Abdou Salam , Fall Ibrahima Soce
Published: January 2023

Background

Strategy to mitigate various Ebola virus disease (EVD) outbreaks are focusing on Infection Prevention and Control (IPC) capacity building, supportive supervision and IPC supply donation. This study was conducted to assess the impact of a Pay for Performance Strategy (PPS) in improving IPC performance in healthcare facilities (HF) in context of the 2018–2019 Nord Kivu/ Democratic Republic of the Congo EVD outbreak.

Methods

A quasi-experimental study was conducted analysing the impact of a PPS on the IPC performance. HF were selected following the inclusion criteria upon informed consent from the facility manager and the National Department of Health. Initial and process assessment of IPC performance was conducted by integrating response teams using a validated IPC assessment tool for HF. A bundle of interventions was then implemented in the different HF including training of health workers, donation of IPC kits, supportive supervision during the implementation of IPC activities, and monetary reward. IPC practices in HF were assessment every two weeks during the intervention period to measure the impact. The IPC assessment tool had 34 questions aggregated in 8 different thematic areas: triage and isolation capacity, IPC committee in HF, hand hygiene, PPE, decontamination and sterilization, linen management, hospital environment and Waste management. Data were analysed using descriptive statistics and analytical approaches according to assumptions. R software (version 4.0.3) was used for all the analyses and a p-value of 0.05 was considered as the threshold for statistically significant results.

Results

Among 69 HF involved in this study, 48 were private facilities and 21 state facilities. The median baseline IPC score was 44% (IQR: 21–65%); this IPC median score reached respectively after 2, 4, 6 and 8 weeks 68% (IQR: 59–76%), 79% (71–84%), 76% (68–85%) and 79% (74–85%). The improvement of IPC score was statistically significative. Spearman’s rank-order correlation revealed the associated between proportion of trained HW and IPC score performance after 8 weeks of interventions (rs = .280, p-value = 0.02).

Conclusion

Pay for Performance Strategy was proved effective in improving healthcare facilities capacity in infection prevention and control practice in context of 2018 EVD outbreak in Nord Kivu. However, the strategy for long-term sustainability of IPC needs further provision. More studies are warranted on the HW and patients’ perceptions toward IPC program implementation in context of Nord Kivu Province.