bluuebunny/crossref_metadata_2025 huggingface dataset:
Du skal itte trø i graset – vi tester det nemlig
Authors: Elverland Ellen , Jørgensen Marit , Dalmannsdóttir Sigríður
Published: November 2023

Grasdyrking og grovfôr til husdyr er den største landbruksproduksjonen i Nord-Norge – både i dag og for 100 år siden. Å kunne høste inn nok fôr til vinteren er viktig både for dyrene og økonomi.
Older Women and Political Agency: A Scoping Review of the Literature
Authors: Mazzucchelli Nicole , Hedrera Luciana , Iñíguez-Rueda Lupicinio , Reyes-Espejo María Isabel
Published: November 2023

Older women’s political agency has not been widely explored in the literature on ageing. In general, this group has been researched from the ageing characteristics perspective—decay, fragility, adaptive processes—or considering those dimensions in which their capacity for agency lessens ageing symptoms. However, the implications and political character of their practices tends to be ignored. This scoping review examines the approaches to older women’s political agency found in the 1975-2020 academic production. We conducted this scoping review according to PRISMA-ScR guidelines and Arksey and O’Malley’s (2005) methodological framework. Sixty-five articles were included in the revision and a full thematic content analysis of the selected corpus was conducted. Qualitative methods were incorporated in 75 % of the examined articles that were conducted in Canada, the United States, and the United Kingdom. Diverse approaches to the topic of political agency were identified with community participation, activism, and trajectories of coping and resilience standing out. The relational and collective character of the processes of agency are paramount in the specific strategies that women develop to face vital transitions. Older women’s political agency takes place in a range of social spaces, having a relevant impact at the social-public and the domestic level. A situated characterization of political agency in older women can help guide and redefine public actions, contributing to a greater recognition of these women’s experiences, actions, and contributions.
Microprocesos de coordinación entre directivos de establecimientos básicos chilenos y su administración municipal: estudio indagatorio de casos desde un enfoque interaccionalista y estratégico de la sociología de las organizaciones
Authors:   , Larraín Hudson Trinidad
Published: November 2023

El presente estudio se inscribe dentro del Área de Teoría y Políticas del Programa de Doctorado de la Facultad de Educación de la Universidad y se centra en el análisis de las relaciones que se establecen entre actores de la escuela y del municipio en el sistema escolar chileno. En un contexto de múltiples actores en el nivel local, interesa comprender cómo se coordinan los directivos de establecimientos básicos urbanos municipalizados y la autoridad que opera como interlocutor en tanto sostenedor educacional, es decir, la dirección o el departamento de administración de la educación de la respectiva municipalidad. Con este propósito, se desarrolló un estudio de casos en dos comunas que presentan características análogas en varios aspectos, como el tipo de figura legal de la administración de la educación municipal (DAEM), la matrícula total de la enseñanza básica comunal y la vulnerabilidad socio-educativa de la población escolar atendida. En cada una de ellas, se seleccionaron dos escuelas municipales con características opuestas en términos de matrícula, vulnerabilidad y rendimiento académico. La metodología utilizada se centró en las apreciaciones de informantes claves respecto de microprocesos locales de coordinación, mediante el análisis cualitativo de entrevistas a los directivos de los establecimientos educacionales y las respectivas autoridades de educación municipal de los casos seleccionados, e incluyó a representantes provinciales del Ministerio de Educación. La perspectiva teórica se enmarca dentro de la sociología de las organizaciones, y se nutre, principalmente, de los planteamientos de los autores Michel Crozier y Erhard Friedberg, y su enfoque estratégico que desde una perspectiva interaccionalista, considera tanto los elementos sistémicos como los intersubjetivos que inciden en los procesos de coordinación. Especial importancia adquirió el énfasis dado por Friedberg, en un marco teórico y empírico que propone conceptos para el análisis a nivel local de “la dinámica de la acción organizada”. A partir de los relatos de los informantes claves, el estudio plantea un conjunto de proposiciones o conjeturas para caracterizar la coordinación entre los actores en cuestión. No sólo como el conjunto de actividades articuladas en torno a un objetivo, sino como un complejo proceso compuesto por dimensiones normativas, estratégicas, basales y decisionales que dan cuenta de la tensión entre dimensiones que limitan y potencian la capacidad de acción colectiva de los actores locales en los sistemas educacionales actuales y, en particular, en el subsistema municipal chileno a nivel de la educación básica. Asimismo, se levantan hipótesis y proyecciones para futuras líneas de investigación y consideraciones para las políticas educacionales.
Enseñanza y evaluación de la comunicación difícil en las escuelas de enfermería en los últimos 5 años (2017 – 2022): un Scoping Review
Authors:   , Ramírez Delgado Paulina Alejandra
Published: November 2023

Introducción: La comunicación difícil puede incidir negativamente en la relación con el paciente, la toma de decisiones, en la calidad de atención y satisfacción del usuario, y en el ambiente laboral. Objetivo: 1. Analizar las metodologías de enseñanza - aprendizaje de la comunicación difícil utilizadas en estudiantes de enfermería durante su formación, 2. Mapear los instrumentos utilizados para evaluar la comunicación difícil en estudiantes de enfermería durante su formación publicados entre el 2017 y el 2022, y 3. Identificar brechas de investigación en la literatura existente. Metodología: Se realizó un Scoping Review siguiendo recomendaciones PRISMA ScR, buscando artículos en las bases de datos PubMed, Web of Science, Scopus y LILACS entre los años 2017 y 2022 en relación con una estrategia de búsqueda; se aplicaron criterios de elegibilidad, se registraron los motivos de exclusión. Se analizó la calidad metodológica de los artículos incluidos y se realizó un análisis de contenido para resumir los resultados. Resultados: Se revisaron 1600 artículos y se seleccionaron 16 para su análisis final. Destaca la simulación clínica como una de las principales metodologías de enseñanza – aprendizaje; sin embargo, no se encontraron instrumentos específicos de evaluación de la comunicación difícil en enfermería. Conclusión: La simulación clínica con paciente simulado es el recurso más predominante. Se identifica la oportunidad de diseñar instrumentos que evalúen de manera específica la comunicación difícil.
Development of Center Learning Model for Children's Metacognitive Stimulation in Kindergarten
Authors: Yusuf Fatmawaty , Syam Husain , Samad Sulaiman , Bundu Patta
Published: November 2023

The purpose of this research is to provide an overview of the center learning model that can stimulate metacognitive abilities in children. The problems discussed are related to obtaining a comprehensive understanding of the requirements of the prototype model in the form of a center learning model that can stimulate children's metacognitive abilities that are valid, practical and effective. This research is a research and development that uses the Borg and Gall development model. The subject of the research relates to students aged 5-6 years in kindergarten. The results of research and development show that the development of a center-based learning model to stimulate children's metacognitive skills is needed. This is because the average level of understanding of teachers is still lacking, resulting in low achievement of children. Therefore, a systematic center-based learning model syntax is needed, which integrates the science process approach to foster curiosity and creative thinking, as well as the 5E continuum approach to improve children's problem solving skills at each stage of play. The overall validity of the model consisting of model books, guidebooks, and research instruments obtained an average validity score that fell into the valid category, indicating feasibility for use. The level of practicality in trials 1 and 2 was successfully implemented, as evidenced by the teacher's response which showed practicality and student activity which was classified as active during the stimulation process. This model has been declared effective because it is proven those children’s metacognitive achievement increases significantly when the center learning model is applied.
Economic Benefits of Onigambari Forest Reserves on the Host Communities
Authors: Ayetan G.  , Adekoya O. O.  , M. A. Agbeje , Y. T. Owoeye , E. O. Oyewusi , Ayeni O. H.
Published: November 2023

A multistage sampling was adopted in which purposive sampling was used to identify communities where government and non-governmental organization have their presence and the benefits they attract to these communities. Further, a stratified random sampling was used to administer 25 questionnaires in chosen four communities in each of the two axes of the forest reserve making a total of 8 communities and a grand total of 200 questionnaires. The benefits derived from the forest reserve are many, which include land for farming within the open spaces of the forest, logging, fuel wood extraction, medicinal herbs and shrub extractions, hunting and bush meat sales. It was recommended that young people should take advantage of the enormous opportunities around this forest reserve to get for themselves gainful business and employment opportunities. Government should also provide infrastructural facilities and amenities to the rural communities to make living there convenience for the people.
Repeatedly Malignant ST-Segment Elevation
Authors: Xiao YaoYuan , Tang MingXiang , Tang Yi
Published: November 2023

This case report describes a patient in their early 50s who presented with epigastric pain and jaundice and had significantly decreased heart rate after admission.
One Size Fits All—An Underappreciated Health Inequity
Authors: Tinetti Mary E. , Hladek Melissa deCardi , Ejem Deborah
Published: November 2023

This Viewpoint discusses why health priorities–tailored care, rather than the one-size-fits-all approach, is beneficial for marginalized individuals.
Risk of Bleeding Following Non–Vitamin K Antagonist Oral Anticoagulant Use in Patients With Acute Ischemic Stroke Treated With Alteplase
Authors: Tsai Tou-Yuan , Liu Yu-Chang , Huang Wan-Ting , Tu Yu-Kang , Qiu Shang-Quan , Noor Sameer , Huang Yong-Chen , Chou Eric H. , Lai Edward Chia-Cheng , Huang Huei-Kai
Published: November 2023

Importance

Current guidelines advise against intravenous alteplase therapy for treatment of acute ischemic stroke in patients previously treated with non–vitamin K antagonist oral anticoagulants (NOACs).

Objective

To evaluate the risk of bleeding and mortality after alteplase treatment for acute ischemic stroke among patients treated with NOACs compared to those not treated with NOACs.

Design, Setting, and Participants

This nationwide, population-based cohort study was conducted in Taiwan using data from Taiwan’s National Health Insurance Research Database from January 2011 through November 2020 and included 7483 patients treated with alteplase for acute ischemic stroke. A meta-analysis incorporating the results of the study with those of previous studies was performed, and the review protocol was prospectively registered with PROSPERO.

Exposures

NOAC treatment within 2 days prior to stroke, compared to either no anticoagulant treatment or warfarin treatment.

Main Outcomes and Measures

The primary outcome was intracranial hemorrhage after intravenous alteplase during the index hospitalization (the hospitalization subsequent to alteplase administration). Secondary outcomes were major bleeding events and mortality during the index hospitalization. Propensity score matching was used to control potential confounders. Logistic regression was used to estimate the odds ratio (OR) of outcome events. Meta-analysis was performed using a random-effects model.

Results

Of the 7483 included patients (mean [SD] age, 67.4 [12.7] years; 2908 [38.9%] female individuals and 4575 [61.1%] male individuals), 91 (1.2%), 182 (2.4%), and 7210 (96.4%) received NOACs, warfarin, and no anticoagulants prior to their stroke, respectively. Compared to patients who were not treated with anticoagulants, those treated with NOACs did not have significantly higher risks of intracranial hemorrhage (risk difference [RD], 2.47% [95% CI, −4.23% to 9.17%]; OR, 1.37 [95% CI, 0.62-3.03]), major bleeding (RD, 4.95% [95% CI, −2.56% to 12.45%]; OR, 1.69 [95% CI, 0.83-3.45]), or in-hospital mortality (RD, −4.95% [95% CI, −10.11% to 0.22%]; OR, 0.45 [95% CI, 0.15-1.29]) in the propensity score–matched analyses. Furthermore, the risks of bleeding and mortality were not significantly different between patients treated with NOACs and those treated with warfarin. Similar results were obtained in the meta-analysis.

Conclusions and Relevance

In this cohort study with meta-analysis, compared to no treatment with anticoagulants, treatment with NOACs prior to stroke was not associated with a higher risk of intracranial hemorrhage, major bleeding, or mortality in patients receiving intravenous alteplase for acute ischemic stroke.
Infertility and Risk of Autism Spectrum Disorder in Children
Authors: Velez Maria P. , Dayan Natalie , Shellenberger Jonas , Pudwell Jessica , Kapoor Dia , Vigod Simone N. , Ray Joel G.
Published: November 2023

Importance

Previous studies on the risk of childhood autism spectrum disorder (ASD) following fertility treatment did not account for the infertility itself or the mediating effect of obstetrical and neonatal factors.

Objective

To assess the association between infertility and its treatments on the risk of ASD and the mediating effect of selected adverse pregnancy outcomes on that association.

Design, Setting, and Participants

This was a population-based cohort study in Ontario, Canada. Participants were all singleton and multifetal live births at 24 or more weeks’ gestation from 2006 to 2018. Data were analyzed from October 2022 to October 2023.

Exposures

The exposure was mode of conception, namely, (1) unassisted conception, (2) infertility without fertility treatment (ie, subfertility), (3) ovulation induction (OI) or intrauterine insemination (IUI), or (4) in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI).

Main Outcome and Measures

The study outcome was a diagnosis of ASD at age 18 months or older. Cox regression models generated hazard ratios (HR) adjusted for maternal and infant characteristics. Mediation analysis further accounted for the separate effect of (1) preeclampsia, (2) cesarean birth, (3) multifetal pregnancy, (4) preterm birth at less than 37 weeks, and (5) severe neonatal morbidity.

Results

A total of 1 370 152 children (703 407 male [51.3%]) were included: 1 185 024 (86.5%) with unassisted conception, 141 180 (10.3%) with parental subfertility, 20 429 (1.5%) following OI or IUI, and 23 519 (1.7%) following IVF or ICSI. Individuals with subfertility or fertility treatment were older and resided in higher-income areas; the mean (SD) age of each group was as follows: 30.1 (5.2) years in the unassisted conception group, 33.3 (4.7) years in the subfertility group, 33.1 (4.4) years in the OI or IUI group, and 35.8 (4.9) years in the IVF or ICSI group. The incidence rate of ASD was 1.93 per 1000 person-years among children in the unassisted conception group. Relative to the latter, the adjusted HR for ASD was 1.20 (95% CI, 1.15-1.25) in the subfertility group, 1.21 (95% CI, 1.09-1.34) following OI or IUI, and 1.16 (95% CI, 1.04-1.28) after IVF or ICSI. Obstetrical and neonatal factors appeared to mediate a sizeable proportion of the aforementioned association between mode of conception and ASD risk. For example, following IVF or ICSI, the proportion mediated by cesarean birth was 29%, multifetal pregnancy was 78%, preterm birth was 50%, and severe neonatal morbidity was 25%.

Conclusions and Relevance

In this cohort study, a slightly higher risk of ASD was observed in children born to individuals with infertility, which appears partly mediated by certain obstetrical and neonatal factors. To optimize child neurodevelopment, strategies should further explore these other factors in individuals with infertility, even among those not receiving fertility treatment.
Survival of Patients With Head and Neck Merkel Cell Cancer
Authors: Nayak Ameeta Lubina , Pickett Arthur Travis , Delisle Megan , Dingley Brittany , Mallick Ranjeeta , Hamilton Trevor , Stuart Heather , Talbot Martha , McKinnon Gregory , Jost Evan , Thiboutot Eva , Francescutti Valerie , Samman Sal , Easson Alexandra , Schellenberg Angela , Merchant Shaila , La Julie , Vanderbeck Kaitlin , Wright Frances , Berger-Richardson David , Hebbard Pamela , Hershorn Olivia , Younan Rami , Patocskai Erica , Rodriguez-Qizilbash Samuel , Meguerditichian Ari , Tchuente Vanina , Kazandjian Suzanne , Mathieson Alex , Hossain Farisa , Hetu Jessika , Corsten Martin , Tohmé Angelina , Nessim Carolyn , Johnson-Obaseki Stephanie
Published: November 2023

Importance

Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine carcinoma. Due to its relatively low incidence and limited prospective trials, current recommendations are guided by historical single-institution retrospective studies.

Objective

To evaluate the overall survival (OS) of patients in Canada with head and neck MCC (HNMCC) according to American Joint Committee on Cancer 8th edition staging and treatment modalities.

Design, Setting, and Participants

A retrospective cohort study of 400 patients with a diagnosis of HNMCC between July 1, 2000, and June 31, 2018, was conducted using the Pan-Canadian Merkel Cell Cancer Collaborative, a multicenter national registry of patients with MCC. Statistical analyses were performed from January to December 2022.

Main Outcomes and Measures

The primary outcome was 5-year OS. Multivariable analysis using a Cox proportional hazards regression model was performed to identify factors associated with survival.

Results

Between 2000 and 2018, 400 patients (234 men [58.5%]; mean [SD] age at diagnosis, 78.4 [10.5] years) with malignant neoplasms found in the face, scalp, neck, ear, eyelid, or lip received a diagnosis of HNMCC. At diagnosis, 188 patients (47.0%) had stage I disease. The most common treatment overall was surgery followed by radiotherapy (161 [40.3%]), although radiotherapy alone was most common for stage IV disease (15 of 23 [52.2%]). Five-year OS was 49.8% (95% CI, 40.7%-58.2%), 39.8% (95% CI, 26.2%-53.1%), 36.2% (95% CI, 25.2%-47.4%), and 18.5% (95% CI, 3.9%-41.5%) for stage I, II, III, and IV disease, respectively, and was highest among patients treated with surgery and radiotherapy (49.9% [95% CI, 39.9%-59.1%]). On multivariable analysis, patients treated with surgery and radiotherapy had greater OS compared with those treated with surgery alone (hazard ratio [HR], 0.76 [95% CI, 0.46-1.25]); however, this was not statistically significant. In comparison, patients who received no treatment had significantly worse OS (HR, 1.93 [95% CI, 1.26-2.96)].

Conclusions and Relevance

In this cohort study of the largest Canada-wide evaluation of HNMCC survival outcomes, stage and treatment modality were associated with survival. Multimodal treatment was associated with greater OS across all disease stages.
Trends in Distance Traveled for Common Pediatric Conditions for Rural-Residing Children
Authors: McDaniel Corrie E. , Hall Matt , Berry Jay G.
Published: November 2023

This cohort study uses state inpatient data to assess changes in distance traveled over time for hospitalization of common pediatric conditions in rural-residing children.
Assessing the effectiveness of mitigating pesticide‐related disease risk among pesticide‐spraying drone operators in Taiwan
Authors: Wu Wei‐Te , Chen Jyun‐Ming , Chang Yu‐Yin , Lin Shian‐Da , Chen Shih‐Tzong , Hung Yu‐Tang
Published: November 2023

Objectives

The purpose of this study was to evaluate the risk of pesticide poisoning, liver and renal failure, dermatitis, respiratory problems, hypersensitivity pneumonitis, keratitis, and epilepsy among pesticide‐spraying personnel and to assess the effectiveness of a new method of aerial pesticide application in reducing this risk.

Methods

A total of 2268 pesticide spraying operators (1651 ground‐based field crop operators and 617 aerial pesticide spraying drone operators) who passed the national certification examination between 2010 and 2020 in Taiwan were included. Ground‐based operators served as the positive control group, while 2463 farmer controls were matched from the Farmers' Health Insurance database as the negative control group. Data from the National Health Insurance Research Database were used to track possible pesticide‐related disease cases. Logistic regression was employed to calculate odds ratios and 95% confidence intervals (95% CI).

Results

Drone operators had significantly reduced risks of dermatitis, asthma and chronic bronchitis compared to ground‐based operators. This was observed in allergic contact dermatitis (OR = 0.40, 95% CI: 0.24–0.68), unspecified contact dermatitis (OR = 0.58, 95% CI: 0.35–0.97), asthma (OR = 0.27, 95% CI: 0.12–0.60), and chronic bronchitis (OR = 0.24, 95% CI: 0.06–0.93), after adjusting for age, sex, working areas, and licensing years. However, no significant differences were found when comparing drone operators to matching farmers.

Conclusions

Aerial pesticide spraying using drones may contribute to a decreased risk of dermatitis, asthma and chronic bronchitis, suggesting potential health benefits for operators. Further field pesticide exposure surveys are recommended to validate these findings and assess health risk indicators.
Evaluating the effect of targeting body shape concerns on long‐term weight change
Authors: Olson KayLoni L. , Thaxton Tyler T. , Landers Jacob D. , Emery Charles F.
Published: November 2023

Objective

The goal of this follow‐up to a randomized proof‐of‐concept study was to determine if targeting body shape concern (BSC) has a clinically significant impact on long‐term weight change among adult women of higher body weight with BSC. A secondary aim was to observe the maintenance of body image improvements during follow‐up.

Method

In the original 4‐week trial, women were randomized to behavioral weight loss recommendations alone (control; n = 15) or combined with the evidence‐based body project intervention (n = 17). All participants were directed to continue monitoring diet and exercise through Week 8. The current analysis focused on follow‐up data collected on weight, BSC, internalized weight bias, internalized thin ideal, and body appreciation at 8 weeks, 6 months, and 12 months. Percent weight change was calculated from baseline and compared against clinical milestones of −2.5% and −5%. An intent‐to‐treat approach was used for individuals lost to follow‐up (n = 11).

Results

Body project participants achieved the clinically significant target of −2.5% weight loss by 12 months. Control participants did not reach the milestone and regained lost weight at 12 months. Neither condition reached the 5% clinical target. Both groups experienced improved body image, but body project participants maintained a greater magnitude of improvement in all measures except internalized thin ideal at 12 months.

Conclusion

The current study provides preliminary evidence that targeting BSC among women with BSC who want to lose weight may improve long‐term weight loss. Further intervention development and testing are warranted.

Public Significance

The results of this study suggest that targeting negative body image among adult women with high BSC might be a pathway to improve long‐term weight loss in behavioral weight management. This is aligned with precision medicine priorities to optimize weight‐related health care.
Conformational energies of biomolecules in solution: Extending the MPCONF196 benchmark with explicit water molecules
Authors: Plett Christoph , Grimme Stefan , Hansen Andreas
Published: November 2023

A prerequisite for the computational prediction of molecular properties like conformational energies of biomolecules is a reliable, robust, and computationally affordable method usually selected according to its performance for relevant benchmark sets. However, most of these sets comprise molecules in the gas phase and do not cover interactions with a solvent, even though biomolecules typically occur in aqueous solution. To address this issue, we introduce a with explicit water molecules solvated version of a gas‐phase benchmark set containing 196 conformers of 13 peptides and other relevant macrocycles, namely MPCONF196 [J. Řezáč et al., JCTC 2018, 14, 1254–1266], and provide very accurate PNO‐LCCSD(T)‐F12b/AVQZ' reference values. The novel solvMPCONF196 benchmark set features two additional challenges beyond the description of conformers in the gas phase: conformer–water and water–water interactions. The overall best performing method for this set is the double hybrid revDSDPBEP86‐D4/def2‐QZVPP yielding conformational energies of almost coupled cluster quality. Furthermore, some (meta‐)GGAs and hybrid functionals like B97M‐V and B97M‐D with a large basis set reproduce the coupled cluster reference with an MAD below 1 kcal mol . If more efficient methods are required, the composite DFT‐method rSCAN‐3c (MAD of 1.2 kcal mol) is a good alternative, and when conformational energies of polypeptides or macrocycles with more than 500–1000 atoms are in the focus, the semi‐empirical GFN2‐xTB or the MMFF94 force field (for very large systems) are recommended.
Understanding healthcare engagement for people who inject drugs
Authors: Heidari Omeid , Winiker Abigail , Dangerfield Derek T. , Wenzel Jennifer , Rodney Tamar , Mehta Shruti , Genberg Becky
Published: November 2023

People who inject drugs (PWID) are at an increased risk of multimorbid mental health and chronic diseases, which are frequently underdiagnosed and under‐treated due to systemic barriers and ongoing substance use. Healthcare engagement is essential to address these conditions and prevent excess morbidity and mortality. The goal of this study was to understand how PWID engage in care for their chronic health conditions and substance use treatment given the known historic and pervasive barriers. We conducted 24 semistructured qualitative interviews informed by the Behavioral Model for Vulnerable Populations between July–September 2019. Participants were sampled across a range of comorbidities, including co‐occurring mental health disorders. Thematic analysis was conducted to explore experiences of healthcare engagement for multimorbid chronic diseases, mental health, and treatment for substance use disorder. Mean age for participants was 58 years; 63% reported male sex and 83% reported Black race. Interviews yielded themes regarding healthcare access and wraparound services, positive patient–provider relationships, service integration for substance use treatment and mental health, healthcare needs alignment, medication of opioid use disorder stigma, and acceptance of healthcare. Taken together, participants described how these themes enabled healthcare engagement. Engagement in care is crucial to support health and recovery. Clinical implications include the importance of strengthening patient–provider relationships, encouraging integration of medical and mental health services, and counseling on substance use treatment options in a non‐ stigmatizing manner. Additionally, policy to reimburse wrap‐around support for substance use recovery can improve care engagement and outcomes related to chronic diseases, mental health, and substance use among PWID.

No Patient or Public Contribution: While we acknowledge and thank ALIVE participants for their time for data collection and sharing their perspectives, no ALIVE participants, other people who use drugs, and service users were involved in data collection, analysis or interpretation of data, or in preparation of the manuscript.
Role of QCD in moduli stabilization during inflation and axion dark matter
Authors: Kitano Ryuichiro , Suzuki Motoo , Yin Wen
Published: November 2023

Abstract

Ignorance of the initial condition for the axion dynamics in the early Universe has led us to consider an O(1) valued initial amplitude, and that prefers the decay constant, Fa, of the QCD axion to be an intermediate scale such as 1012 GeV in order to explain the dark matter abundance. We explore a cosmological scenario of Fa being much larger than 1012 GeV by considering the axion and modulus dynamics during inflation to set the initial amplitude. We show that if the volume modulus (radion) of the extra-dimension is stabilized mainly by the QCD contribution to the modulus potential during inflation, the QCD axion with the string-scale decay constant obtains a mass around the inflationary Hubble parameter. This means that the axion rolls down to the θ = 0 minimum during the inflation realizing almost vanishing initial amplitude, and the inflationary quantum fluctuation can be the dominant source of the current number density of axions. We find natural parameter regions where the axion explains the cold dark matter of the Universe, while the constraint on the isocurvature perturbation is avoided. The presence of the axion miniclusters or axion stars are predicted in a wide range of parameters, including the one explains the Subaru-HCS microlensing event.
Unconventional roles of chromatin remodelers and long non-coding RNAs in cell division
Authors: Prozzillo Yuri , Santopietro Maria Virginia , Messina Giovanni , Dimitri Patrizio
Published: November 2023

The aim of this review article is to focus on the unconventional roles of epigenetic players (chromatin remodelers and long non-coding RNAs) in cell division, beyond their well-characterized functions in chromatin regulation during cell differentiation and development. In the last two  decades, diverse experimental evidence has shown that subunits of SRCAP and p400/TIP60 chromatin remodeling complexes in humans relocate from interphase nuclei to centrosomes, spindle or midbody, with their depletion yielding an array of aberrant outcomes of mitosis and cytokinesis. Remarkably, this behavior is shared by orthologous subunits of the Drosophila melanogaster DOM/TIP60 complex, despite fruit flies and humans diverged over 700 million years ago. In short, the available data support the view that subunits of these complexes are a new class of moonlighting proteins, in that they lead a "double life": during the interphase, they function in chromatin regulation within the nucleus, but as the cell progresses through mitosis, they interact with established mitotic factors, thus becoming integral components of the cell division apparatus.  By doing so, they contribute to ensuring the correct distribution of chromosomes in the two daughter cells and, when dysfunctional, can cause genomic instability, a condition that can trigger tumorigenesis and developmental diseases. Research over the past few years has unveiled a major contribution of long non-coding RNAs (lncRNAs) in the epigenetics regulation of gene expression which also impacts on cell division control. Here, we focus on possible structural roles of lncRNAs in the execution of cytokinesis: in particular, we suggest that specific classes of lncRNAs relocate to the midbody to form an architectural scaffold ensuring its proper assembly and function during abscission. Drawing attention to experimental evidence for non-canonical extranuclear roles of chromatin factors and lncRNAs has direct implications on important and novel aspects concerning both the epigenetic regulation and the evolutionary dynamics of cell division with a significant impact on differentiation, development, and diseases.
Mentale Flexibilität durch implizites soziales Lernen
Authors: Taubner Svenja , Sharp Carla
Published: November 2023

In diesem Beitrag wird die Idee eines transtheoretischen Metamodells entwickelt, das besonders auf Veränderungsprozesse bei schweren psychischen Erkrankungen wie Persönlichkeitsstörungen ausgerichtet ist. Als ein Kernprozess der Veränderung wird mentale Flexibilität definiert; diese kann durch implizites soziales Lernen gefördert werden. Empfohlen werden bestimmte Haltungen und Techniken, die abgeleitet werden, aus der Mentalisierungsbasierten Therapie (MBT) und den Lernkomponenten, die in dem Bezugspersonen-Kind-Programm „Mediational Intervention for Sensitizing Caregivers (MISC)“ entwickelt wurden. Ziel der Therapie ist, den epistemischen Lern-Highway zu öffnen und das Mentalisieren während der Sitzungen zu trainieren, um letztlich die kognitive Flexibilität außerhalb des Therapieraums zu verbessern. Der Veränderungsprozess in Richtung mentaler Flexibilität ersetzt die Idee einer korrigierenden emotionalen Erfahrung, weil sich diese – zumindest für die Behandlung von Persönlichkeitsstörungen – als weniger wirksam oder sogar schädlich erwiesen hat. Durch die Integration von MBT und MISC entsteht zudem die Möglichkeit, auf einer granularen Ebene verhaltensverankerte und daher beobachtbare Handlungen von Therapeut:innen zu trainieren und zu beobachten. Dies eröffnet die Möglichkeit, Mikroprozesse zu beobachten und zu steuern. Daher wird vorgeschlagen, die Aufmerksamkeit und das Verständnis auf implizites Lernen innerhalb therapeutischer Beziehungen zu lenken, d. h. auf die Verinnerlichung einer neuen Denkweise in Bezug auf spezifische Lebensereignisse, die eine Anpassung erfordern. Durch mentale Flexibilität entstehen flexible Anpassungsfähigkeiten, die Patient:innen autonom machen und in Zukunft in der Prozessforschung weiteruntersucht werden sollten.
Are degenerative findings detected on traction MR arthrography of the hip associated with failure of arthroscopic femoroacetabular impingement surgery?
Authors: Lerch Till D. , Nanavati Andreas K. , Heimann Alexander F. , Meier Malin K. , Steppacher Simon D. , Wagner Moritz , Brunner Alexander , Vavron Peter , Schmaranzer Ehrenfried , Schwab Joseph M. , Tannast Moritz , Schmaranzer Florian
Published: November 2023

Objectives

To identify preoperative degenerative features on traction MR arthrography associated with failure after arthroscopic femoroacetabular impingement (FAI) surgery.

Methods

Retrospective study including 102 patients (107 hips) undergoing traction magnetic resonance arthrography (MRA) of the hip at 1.5 T and subsequent hip arthroscopic FAI surgery performed (01/2016 to 02/2020) with complete follow-up. Clinical outcomes were assessed using the International Hip Outcome Tool (iHOT-12) score. Clinical endpoint for failure was defined as an iHOT-12 of < 60 points or conversion to total hip arthroplasty. MR images were assessed by two radiologists for presence of 9 degenerative lesions including osseous, chondrolabral/ligamentum teres lesions. Uni- and multivariate Cox regression analysis was performed to assess the association between MRI findings and failure of FAI surgery.

Results

Of the 107 hips, 27 hips (25%) met at least one endpoint at a mean 3.7 ± 0.9 years follow-up. Osteophytic changes of femur or acetabulum (hazard ratio [HR] 2.5–5.0), acetabular cysts (HR 3.4) and extensive cartilage (HR 5.1) and labral damage (HR 5.5) > 2 h on the clockface were univariate risk factors (all p < 0.05) for failure. Three risk factors for failure were identified in multivariate analysis: Acetabular cartilage damage > 2 h on the clockface (HR 3.2, p = 0.01), central femoral osteophyte (HR 3.1, p = 0.02), and femoral cartilage damage with ligamentum teres damage (HR 3.0, p = 0.04).

Conclusion

Joint damage detected by preoperative traction MRA is associated with failure 4 years following arthroscopic FAI surgery and yields promise in preoperative risk stratification.

Clinical relevance statement

Evaluation of negative predictors on preoperative traction MR arthrography holds the potential to improve risk stratification based on the already present joint degeneration ahead of FAI surgery.

Key Points

• Osteophytes, acetabular cysts, and extensive chondrolabral damage are risk factors for failure of FAI surgery.

• Extensive acetabular cartilage damage, central femoral osteophytes, and combined femoral cartilage and ligamentum teres damage represent independent negative predictors.

• Survival rates following hip arthroscopy progressively decrease with increasing prevalence of these three degenerative findings.

Graphical Abstract
Long-term cardiotoxicity in germ cell cancer survivors after platinum-based chemotherapy: cardiac MR shows impaired systolic function and tissue alterations
Authors: Beitzen-Heineke Antonia , Rolling Christina Charlotte , Seidel Christoph , Erley Jennifer , Molwitz Isabel , Muellerleile Kai , Saering Dennis , Senftinger Juliana , Börschel Niklas , Engel Nils Wolfgang , Bokemeyer Carsten , Adam Gerhard , Tahir Enver , Chen Hang
Published: November 2023

Objectives

Long-term toxicities of germ cell cancer (GCC) treatment are of particular importance in young men with a life expectancy of several decades after curative treatment. This study aimed to investigate the long-term effects of platinum-based chemotherapy on cardiac function and myocardial tissue in GCC survivors by cardiac magnetic resonance (CMR) imaging.

Methods

Asymptomatic GCC survivors ≥ 3 years after platinum-based chemotherapy and age-matched healthy controls underwent CMR assessment, including left ventricular (LV) and right ventricular (RV) ejection fraction (EF), strain analysis, late gadolinium enhancement (LGE) imaging, and T1/T2 mapping.

Results

Forty-four survivors (age 44 [interquartile range, IQR 37–52] years; follow-up time 10 [IQR 5–15] years after chemotherapy) and 21 controls were evaluated. LV- and RVEF were lower in GCC survivors compared to controls (LVEF 56 ± 5% vs. 59 ± 5%, p = 0.017; RVEF 50 ± 7% vs. 55 ± 7%, p = 0.008). Seven percent (3/44) of survivors showed reduced LVEF (< 50%), and 41% (18/44) showed borderline LVEF (50–54%). The strain analysis revealed significantly reduced deformation compared to controls (LV global longitudinal strain [GLS] -13 ± 2% vs. -15 ± 1%, p < 0.001; RV GLS -15 ± 4% vs. -19 ± 4%, p = 0.005). Tissue characterization revealed focal myocardial fibrosis in 9 survivors (20%) and lower myocardial native T1 times in survivors compared to controls (1202 ± 25 ms vs. 1226 ± 37 ms, p = 0.016). Attenuated LVEF was observed after two cycles of platinum-based chemotherapy (54 ± 5% vs. 62 ± 5%, p < 0.001).

Conclusion

Based on CMR evaluation, combination chemotherapy with cumulative cisplatin ≥ 200 mg/m2 is associated with attenuated biventricular systolic function and myocardial tissue alterations in asymptomatic long-term GCC survivors.

Clinical relevance statement

Platinum-based chemotherapy is associated with decreased systolic function, non-ischemic focal myocardial scar, and decreased T1 times in asymptomatic long-term germ cell cancer survivors. Clinicians should be particularly aware of the risk of cardiac toxicity after platinum-based chemotherapy.

Key Points

• Platinum-based chemotherapy is associated with attenuation of biventricular systolic function, lower myocardial T1 relaxation times, and non-ischemic late gadolinium enhancement.

• Decreased systolic function and non-ischemic late gadolinium enhancement are associated with a cumulative cisplatin dose of  ≥ 200 mg/m2.

• Cardiac MRI can help to identify chemotherapy-associated changes in cardiac function and tissue in asymptomatic long-term germ cell cancer survivors.

Graphical Abstract
End-to-end learning for joint depth and image reconstruction from diffracted rotation
Authors: Mel Mazen , Siddiqui Muhammad , Zanuttigh Pietro
Published: November 2023

Monocular depth estimation is an open challenge due to the ill-posed nature of the problem at hand. Deep learning techniques proved capable of producing acceptable depth estimation accuracy but the lack of robust depth cues within RGB images severally limits their performance. Coded aperture-based methods using phase and amplitude masks encode strong depth cues within 2D images by means of depth-dependent Point Spread Functions (PSFs) at the price of a reduced image quality. In this paper, we propose a novel end-to-end learning approach for depth from diffracted rotation. A phase mask that produces a Rotating Point Spread Function (RPSF) as a function of defocus is jointly optimized with the weights of a depth estimation neural network. To this aim, we introduce a differentiable physical model of the aperture mask and exploit an accurate simulation of the camera imaging pipeline. Our approach requires a significantly less complex model and less training data, yet it outperforms existing methods for monocular depth estimation on indoor benchmarks. In addition, we address the image degradation problem by incorporating a non-blind and nonuniform image deblurring module to recover the sharp all-in-focus image from its blurred counterpart.
The influence of epidural anesthesia in pregnancies with scheduled vaginal breech delivery at term: a hospital-based retrospective analysis
Authors: Allert Roman , Brüggmann Dörthe , Raimann Florian J. , Zander Nadja , Louwen Frank , Jennewein Lukas
Published: November 2023

Introduction

Epidural anesthesia is a well-established procedure in obstetrics for pain relief in labor and has been well researched as it comes to cephalic presentation. However, in vaginal intended breech delivery less research has addressed the influence of epidural anesthesia. The Greentop guideline on breech delivery states that there’s little evidence and recommends further evaluation.

Objective

The aim of this study was to compare maternal and neonatal outcomes in vaginally intended breech deliveries at term with and without an epidural anesthesia.

Design

This study was a retrospective cohort study.

Sample

This study included 2122 women at term with a singleton breech pregnancy from 37 + 0 weeks of pregnancy on and a birth weight of at least 2500 g at the obstetric department of University hospital Frankfurt from January 2007 to December 2018.

Methods

Neonatal and maternal outcome was analyzed and compared between women receiving “walking” epidural anesthesia and women without an epidural anesthesia.

Results

Fetal morbidity, measured with a modified PREMODA score, showed no significant difference between deliveries with (2.96%) or without (1.79%; p = 0.168) an epidural anesthesia. Cesarean delivery rates were significantly higher in deliveries with an epidural (35 vs. 26.2%, p = 0.0003), but after exclusion of multiparous women, cesarean delivery rates were not significantly different (40.2% cesarean deliveries with an epidural vs. 41.5%, p = 0.717). As compared to no epidurals, epidural anesthesia in vaginal delivery was associated with a significantly higher rate of manual assistance (33.8 versus 52.1%) and a longer duration of birth (223.7 ± 194 versus 516.2 ± 310 min) (both p < 0.0001)".

Conclusion

Epidural anesthesia can be offered as a safe option for pain relief without increasing neonatal or maternal morbidity and mortality. Nevertheless, it is associated with a longer birth duration and manually assisted delivery.
One-stage combined ENT and dental surgical treatment of odontogenic sinusitis: a prospective study
Authors: Kocum Petr , Šedý Jiří , Traboulsi Joseph , Jirák Petr
Published: November 2023

Purpose

The study analyses outcomes of the surgical treatment of odontogenic sinusitis that concurrently address sinusitis and its dental source.

Methods

A total of 364 adult patients were included, representing 13% of all patients we have operated on for any rhinosinusitis over the past 18 years. The diagnosis was based on both ENT and dental examinations including CT imaging. Patients were divided into three groups: (1) FESS with dental surgery without antrotomy, (2) FESS with intraoral antrotomy, and (3) intraoral surgery without FESS. The mean postoperative follow-up was 15 months.

Results

First group involved 64%, second group 31%, and third group 6% of the cases. The one-stage combined ENT and dental approach was used in 94% of cases (group 1 and 2) with a success rate of 97%. Concerning FESS, maxillary sinus surgery with middle meatal antrostomy only was performed in 54% of patients. Oroantral communication flap closure was performed in 56% of patients (success rate 98%). Healing was achieved within 3 months. The majority (87%) of patients were operated on unilaterally for unilateral findings. Over the past 18 years, a 6% increase of implant-related odontogenic sinusitis was observed.

Conclusion

Odontogenic sinusitis is common, tending to be unilateral and chronic. Its dental source needs to be uncovered and treated and should not be underestimated. Close cooperation between ENT and dental specialists has a crucial role in achieving optimal outcomes. The one-stage combined surgical approach proves to be a reliable, safe, fast and effective treatment.
Philemon and Baucis death: a literature review
Authors: Sottmann Lukas , Schmeling Andreas
Published: November 2023

Double death, i.e., two bodies at a scene, is relatively rare. The double death from natural causes of two close persons is called Philemon and Baucis death in the medicolegal literature. Despite being mentioned for the first time more than 50 years ago, all detailed case reports on this case constellation are from the last 15 years. A comprehensive review of the literature on this phenomenon has not yet been published. In this article, we review the available literature on Philemon and Baucis death. Pathophysiologically, it can be assumed that this phenomenon is a sub-form of so-called psychogenic death. Therefore, we equally review the literature on sudden cardiac death due to acute psychological stress.
Opportunities and challenges in combining immunotherapy and radiotherapy in esophageal cancer
Authors: Zhang Xinyu , Cai Xinsheng , Yan Chaoguang
Published: November 2023

Background

Immunotherapy has shown promise in the treatment of esophageal cancer, but using it alone only benefits a small number of patients. Most patients either do not have a significant response or develop secondary drug resistance. The combination of radiotherapy and immunotherapy appears to be a promising approach to treating esophageal cancer.

Purpose

We reviewed milestone clinical trials of radiotherapy combined with immunotherapy for esophageal cancer. We then discussed potential biomarkers for radiotherapy combined with immunotherapy, including programmed cell death-ligand 1 (PD-L1) status, tumor mutation burden (TMB), tumor-infiltrating lymphocytes, ct-DNA, imaging biomarkers, and clinical factors. Furthermore, we emphasize the key mechanisms of radiation therapy-induced immune stimulation and immune suppression in order to propose strategies for overcoming immune resistance in radiation therapy (RT). Lastly, we discussed the emerging role of low-dose radiotherapy (LDRT) , which has become a promising approach to overcome the limitations of high-dose radiotherapy.

Conclusion

Radiotherapy can be considered a triggering factor for systemic anti-tumor immune response and, with the assistance of immunotherapy, can serve as a systemic treatment option and potentially become the standard treatment for cancer patients.