bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetic Macular Oedema Guidelines: An Australian Perspective
Authors: Yuen Yew Sen , Gilhotra Jagjit Singh , Dalton Michelle , Aujla Jaskirat S. , Mehta Hemal , Wickremasinghe Sanj , Uppal Gurmit , Arnold Jennifer , Chen Fred , Chang Andrew , Fraser-Bell Samantha , Lim Lyndell , Shah Janika , Bowditch Ellie , Broadhead Geoffrey K.
Published: February 2023

The number of people living with diabetes is expected to rise to 578 million by 2030 and to 700 million by 2045, exacting a severe socioeconomic burden on healthcare systems around the globe. This is also reflected in the increasing numbers of people with ocular complications of diabetes (namely, diabetic macular oedema (DMO) and diabetic retinopathy (DR)). In one study examining the global prevalence of DR, 35% of people with diabetes had some form of DR, 7% had PDR, 7% had DMO, and 10% were affected by these vision‐threatening stages. In many regions of the world (Australia included), DR is one of the top three leading causes of vision loss amongst working age adults (20–74 years). In the management of DMO, the landmark ETDRS study demonstrated that moderate visual loss, defined as doubling of the visual angle, can be reduced by 50% or more by focal/grid laser photocoagulation. However, over the last 20 years, antivascular endothelial growth factor (VEGF) and corticosteroid therapies have emerged as alternative options for the management of DMO and provided patients with choices that have higher chances of improving vision than laser alone. In Australia, since the 2008 NHMRC guidelines, there have been significant developments in both the treatment options and treatment schedules for DMO. This working group was therefore assembled to review and address the current management options available in Australia.
Attached Smoking Room Is a Source of PM2.5 in Adjacent Nonsmoking Areas
Authors: Du Wei , Wang Jinze , Chen Yuanchen , Pan Bo , Shen Guofeng , Lin Nan
Published: February 2023

The smoking ban is not working in some entertainment venues in China. PM2.5 pollution induced by cigarette smoking in these places is still unknown. In this study, we took mahjong clubs as target places, monitored the real-time PM2.5 concentration, and recorded on-site inspection information to investigate the PM2.5 pollution characteristics induced by cigarette smoking. In occupied and smoking rooms, the geomean and median values of PM2.5 concentration were 276 and 347 μg/m3. The number of smoking persons in room is the dominant factor to enhance PM2.5 levels. For each additional person smoking in the room, PM2.5 increased by 32% (95% CI: 31%, 33%). Regarding adjacent nonsmoking rooms, PM2.5 increased due to the air penetration from smoking rooms and the increase trend usually had a lag time of 20 minutes. The geomean values of PM2.5 concentrations were 109 μg/m3 in the nonsmoking and occupied rooms and 148 μg/m3 in the vacant rooms. To close the door of the room is the most effective measure to alleviate the PM2.5 penetration. The geomean values of 24-hour and annual average excess exposure concentration if spending 5 hours/day and 2 days/week in mahjong club were 32.1 and 9.2 μg/m3, respectively; both exceeded the World Health Organization’s air quality guidelines, 15 and 5 μg/m3, respectively. Our results revealed severe PM2.5 pollution and exposure risk by cigarette smoking in entertainment venues, as well as the penetration effect on adjacent nonsmoking areas. The smoking bans should be strictly enforced in entertainment venues, and the setting of smoking areas in indoor public places should be scientific to avoid diffusion into nonsmoking areas.
Plumbagin Enhances the Anticancer Effects of PF Chemotherapy via Downregulation of the PI3K/AKT/mTOR/p70S6K Pathway in Human Tongue Squamous Cell Carcinoma
Authors: Pan Shu-Ting , Ye Fang-Fei , Huang Gan , Qiu Jia-Xuan
Published: February 2023

Cisplatin plus 5-fluorouracil (PF) is used as the standard neoadjuvant chemotherapy (also called preoperative chemotherapy) in the treatment of tongue squamous cell carcinoma (TSCC). Although PF chemotherapy reduces the distant metastasis of TSCC, the five-year survival rate has not significantly improved. In recent years, components considered in traditional Chinese medicine have been researched as adjuvant drugs for radiotherapy and chemotherapy. Plumbagin (PB) is a quinone component isolated from Plumbago zeylanica L. Notably, PB demonstrates numerous anticancer properties. In order to examine the chemosensitization effect of PB on PF and its associated mechanisms, in vitro experiments using TSCC Cal27 and cisplatin (CDDP)-resistant Cal27/CDDP cells were carried out in the present study, and the results were subsequently verified using nude mice xenografts. Results of the present study demonstrated that PB enhanced the anticancer effects of PF on the proliferation, migration, and invasion of Cal27 and Cal27/CDDP cells. Cell cycle assays demonstrated that both Cal27 and Cal27/CDDP cells were arrested in the S phase following the combined treatment of PF and PB. Moreover, the PF and PB combination group induced higher levels of apoptosis in Cal27 and Cal27/CDDP cells compared with the group treated with PF alone. In addition, the results of the present study demonstrated that combined PB and PF inhibited the PI3K/AKT/mTOR/p70S6K pathway in TSCC cells. Moreover, the weight and volumes of tumors in nude mice were reduced following treatment with a combination of PF and PB. Results of the present study also demonstrated that the expression levels of Ki67 were markedly reduced in the combined treatment group compared with the group treated with PF alone. In summary, the results of the present study demonstrated that PB enhanced the PF sensitivity of TSCC through induction of S-phase arrest and apoptosis via the PI3K/AKT/mTOR/p70S6K pathway.
Intensity Loss of ZnO Coated on Fiber Optic
Authors: Mohd Arif Noor Azie Azura , Shaari Sahbudin , Ehsan Abang Annuar
Published: February 2023

Macrobends are optical fiber structures suitable for detecting motion changes. This structure has been developed using single-mode fibers and a combination of single-mode and multimode fibers called hetero-core. In this study, a new macrobending structure was designed and developed by adding a nano-ZnO element to the fiber optic core based on Revolution 4.0. The addition of nanomaterial elements involves an etching process that uses harmful chemicals or high-cost laser technology. Therefore, hetero-core was applied in this study to replace the etching process. The ZnO-coated fiber optics with 10 (ZnO1), 20 (ZnO2), and 30 (ZnO3) times of dip coating were developed using the dip-coating method and characterized using scanning electron microscopy (SEM) and energy dispersive X-ray (EDX) spectroscopy. Sensitivity measurement was conducted with glued optical fiber in the form of bending using a tape with a bending dimension of 2.5 cm × 1.5 cm and a wavelength of 1,550 nm. Morphological characterization using SEM proves that nanoparticles are attached to the optical fiber, and the EDX characterization confirms that the nanoparticles are ZnO elements. Optical fiber sensor sensitivity using core sizes 9, 50–9–50, 50–9–50 (ZnO1), 50–9–50 (ZnO2), and 50–9–50 (ZnO3) achieved sensitivity values of 0.91, 1.61, 2.98, 3.34, and 3.51, respectively. This study successfully produced ZnO-coated optical fiber sensors with a hetero-core structure without performing the etching process and successfully increased the sensitivity of the sensors.
Evaluation of Problem-Based Learning in College of Medicine: An Indicator of Quality Education in a Hybrid Curriculum
Authors: Abed Sara Seraj , Al-Mansour Mubarak , Ahmed Sabina Nisar , Khan Muhammad Anwar , Martin Pedrito Nolasco , Shah Syed Waqas , Aga Syed Sameer
Published: February 2023

Background. A culture of quality is believed to drive institutes toward excellence through feedback. Multiple surveys at educational institute help to get a deeper insight into institutional performance and curricular execution. Since problem-based learning (PBL) is an important component of the hybrid curriculum, thus stakeholders’ opinion on PBL satisfaction is worth discussing. This study intended to determine the trends in students’ satisfaction with PBL over the years and to report on the importance of curricular changes that can be incorporated based on students’ needs. Methods. This is a descriptive cross-sectional study that was conducted at the College of Medicine (COM), King Saud Bin Abdul Aziz University for Health Sciences (KSAU-HS), Jeddah, Saudi Arabia. All male and female medical students, using consecutive sampling technique, were included in the study. End-of-course evaluation reports for the academic years ranging from 2013 to 2019 on PBL satisfaction, with a response rate of ≥60%, were included in this study. Results. Overall, students at the COM, Jeddah were satisfied with PBL. A declining but satisfactory trend followed by a sharp rise in satisfaction was observed in this study. Pearson correlation reported a positive relationship between PBL problems, tutors, and PBL sessions (r = 0.82,

p
<
0.001

). Conclusions. Transition from three sessions to two sessions per PBL case can be considered as an effective and efficient way of curricular execution. We found that the tutor, the case, and session dynamics were positively correlated after the incorporation of the feedback. Thus, highlighting the facts that inculcating a culture of responding to feedback can lead to innovations in medical teaching and can help to improve the curricular execution and students’ satisfaction.
Neutrophil Conversion to a Tumor-Killing Phenotype Underpins Effective Microbial Therapy
Authors: Yam Andrew O. , Bailey Jacqueline , Lin Francis , Jakovija Arnolda , Youlten Scott E. , Counoupas Claudio , Gunzer Matthias , Bald Tobias , Woodruff Trent M. , Triccas James A. , Goldstein Leonard D. , Gallego-Ortega David , Grey Shane T. , Chtanova Tatyana
Published: February 2023

The inflammatory microenvironment of solid tumors creates a protumorigenic milieu that resembles chronic inflammation akin to a subverted wound healing response. Here, we investigated the effect of converting the tumor microenvironment from a chronically inflamed state to one of acute microbial inflammation by injecting microbial bioparticles directly into tumors. Intratumoral microbial bioparticle injection led to rapid and dramatic changes in the tumor immune composition, the most striking of which was a substantial increase in the presence of activated neutrophils. In situ photoconversion and intravital microscopy indicated that tumor neutrophils transiently switched from sessile producers of VEGF to highly motile neutrophils that clustered to make neutrophil-rich domains in the tumor. The neutrophil clusters remodeled tumor tissue and repressed tumor growth. Single-cell transcriptional analysis of microbe-stimulated neutrophils showed a profound shift in gene expression towards heightened activation and antimicrobial effector function. Microbe-activated neutrophils also upregulated chemokines known to regulate neutrophil and CD8+ T-cell recruitment. Microbial therapy also boosted CD8+ T-cell function and enhanced the therapeutic benefit of checkpoint inhibitor therapy in tumor-bearing mice and provided protection in a model of tumor recurrence. These data indicate that one of the major effector mechanisms of microbial therapy is the conversion of tumor neutrophils from a wound healing to an acutely activated cytotoxic phenotype, highlighting a rationale for broader deployment of microbial therapy in the treatment of solid cancers.

Significance:

Intratumoral injection of microbial bioparticles stimulates neutrophil antitumor functions, suggesting pathways for optimizing efficacy of microbial therapies and paving the way for their broader utilization in the clinic.
Targeting Unc51-like Autophagy Activating Kinase 1 (ULK1) Overcomes Adaptive Drug Resistance in Acute Myelogenous Leukemia
Authors: Bhattacharya Seemana , Piya Sujan , Ma Huaxian , Sharma Priyanka , Zhang Qi , Baran Natalia , Ruvolo Vivian R. , McQueen Teresa , Davis R. Eric , Pourebrahim Rasoul , Konopleva Marina , Kantarjian Hagop , Cosford Nicholas D. P. , Andreeff Michael , Borthakur Gautam
Published: February 2023

Despite effective new therapies, adaptive resistance remains the main obstacle in acute myelogenous leukemia (AML) therapy. Autophagy induction is a key mechanism for adaptive resistance. Leukemic blasts at diagnosis express higher levels of the apical autophagy kinase ULK1 compared with normal hematopoietic cells. Exposure to chemotherapy and targeted agents upregulate ULK1, hence we hypothesize that developing ULK1 inhibitors may present the unique opportunity for clinical translation of autophagy inhibition. Accordingly, we demonstrate that ULK1 inhibition, by genetic and pharmacologic means, suppresses treatment-induced autophagy, overcomes adaptive drug-resistance, and synergizes with chemotherapy and emerging antileukemia agents like venetoclax (ABT-199). The study next aims at exploring the underlying mechanisms. Mechanistically, ULK1 inhibition downregulates MCL1 antiapoptotic gene, impairs mitochondrial function and downregulates components of the CD44-xCT system, resulting in impaired reactive oxygen species (ROS) mitigation, DNA damage, and apoptosis. For further validation, several mouse models of AML were generated. In these mouse models, ULK1 deficiency impaired leukemic cell homing and engraftment, delayed disease progression, and improved survival. Therefore, in the study, we validated our hypothesis and identified ULK1 as an important mediator of adaptive resistance to therapy and an ideal candidate for combination therapy in AML. Therefore, we propose ULK1 inhibition as a therapeutically relevant treatment option to overcome adaptive drug-resistance in AML.

Implications:

ULK1 drives a cell-intrinsic adaptive resistance in AML and targeting ULK1-mediated autophagy can synergize with existing and emerging AML therapies to overcome drug-resistance and induce apoptosis.
Female preferences for high vocal effort in singing mice
Authors: Burkhard Tracy Tran , Sachs E. Raney , Phelps Steven M.
Published: February 2023

Although vocalizations are essential to mammalian sociosexual behaviours, little is known about female preferences for male vocal displays in non-model mammalian species. Here, we characterized female preferences for the advertisement songs of male Alston’s singing mice (Scotinomys teguina). We developed procedures for inducing oestrus, using vaginal perforation as a morphological indicator of oestrus. We then broadcasted ‘high-effort’ and ‘low-effort’ songs recorded from wild-caught males to virgin laboratory-reared females, using a two-choice experiment. Our results indicate that females spent more time investigating speakers playing high-effort songs; surprisingly, this phonotactic response is independent of oestrus status. In wild singing mice, acoustic characteristics of high-effort male songs positively correlate with body condition. Our data suggest that females could use acoustic cues to select mates in good condition, thus providing preliminary support for adaptive mate choice hypotheses. More generally, our results support the hypothesis that elaborate Scotinomys song may be shaped by female choice.
A contribution to cavernicolous beetle diversity of South China Karst: eight new genera and fourteen new species (Coleoptera: Carabidae: Trechini)
Authors: TIAN MINGYI , HUANG SUNBIN , JIA XINYANG
Published: February 2023

The specific diversity of Chinese cave fauna of the ground beetle tribe Trechini is further enriched. Eight new genera and species of trechine beetles are reported from limestone caves in southern China karsts: Youtrechus zijunae n. gen., n. sp. (Xianning, southeastern Hubei Province), Wumengius fengi n. gen., n. sp. (Liupanshui, western Guizhou Province), Chenotrechus parvulus n. gen., n. sp. (Laibin, central Guangxi Zhuang Autonomous Region), Sinaphaenopoides zhaoyiae n. gen., n. sp. (Chenzhou, southern Hunan Province), Ecotrechus ruruiae n. gen., n. sp. Hurites yunxianicus n. gen., n. sp. (Shaoyang, central Hunan Province), Pangaphaenops seraphicus n. gen., n. sp. (Bama, northwestern Guangxi Zhuang Autonomous Region) and Zunotrechus zhaojieyui n. gen., n. sp. (Zunyi, northern Guizhou Province). All the above genera are monospecific. Generic diagnosis of each new genus, with discussions on its possible phylogenetic position within the tribe Trechini, and description of the type species are provided. The following new species of cavernicolous trechines are described: Dongodytes (Dongodytodes) pingjingae sp. n. (Hechi, northern Guangxi Zhuang Autonomous Region), Dongodytes (s. str.) mingruoae n. sp. (Du’an, Hechi, northern Guangxi Zhuang Autonomous Region), Deuveaphaenops (Furongius) huangheae n. sp. (Daozhen, Zunyi, northern Guizhou Province), Shilinotrechus zhangfani n. sp. (Mile, Honghe Hani & Yi Autonomous Prefecture, southeastern Yunnan Province), Guizhaphaenops (s. str.) wanghaoi n. sp. (Qinglong, Qianxinan Buyi & Miao Autonomous Prefecture, southwestern Guizhou Province), and Graciliblemus gui n. sp. (Liping, Qiandongnan Miao & Dong Autonomous Prefecture, southeastern Guizhou Province). Further generic characteristics of the genus Graciliblemus Deuve & Tian, 2016 are added. A distribution map for all above new taxa is given.
Challenges and Opportunities in Communicating Weather and Climate Information to Rural Farming Communities in Central Zimbabwe
Authors: Makuvaro Veronica , Chitata Tavengwa , Tanyanyiwa Emmanuel , Zirebwa Solomon
Published: February 2023

Sustainability of rain-fed agriculture in semiarid regions is being threatened by climate variability and change. Weather and climate information (WCI) can be used to reduce the effects of this threat on agricultural production. WCI may be available, but is it readily accessible and communicated/disseminated efficiently to intended end users? Are stakeholders able to interpret the information to correctly inform decision-making? To answer these questions, in view of intermediate stakeholders (service providers to farmers), a study was carried out in two districts of the Midlands Province of Zimbabwe to identify the type and sources of WCI received by these stakeholders as well as constraints and opportunities to access, interpretation, and use of WCI. The study sample was drawn from the Midlands Provincial Drought Relief Committee, a link between the sources of WCI and the smallholder farmers. A questionnaire pretested for clarity and checked for internal consistency of themes using the standardized Cronbach’s alpha was used to collect data. Descriptive statistics were generated using SPSS (version 20.0). Findings were that WCI was sometimes not readily available or was received late. Approximately 36% of the intermediate stakeholders (service providers) passed on WCI to farmers in its original form, from the main source the Meteorological Services Department. It was also unfortunate to discover that 36% of the respondents had challenges interpreting WCI. Impediments to the use of WCI by farmers included scientific information not aligning with indigenous information, which is better understood by farmers, and lack of trust in WCI. It is imperative to improve access to WCI and to train stakeholders on interpretation and dissemination of WCI.

Significance Statement

Weather and climate information—if accurate, accessible, provided in a timely manner, and well understood—can be helpful in the farm decision-making process. Its usefulness is becoming more important with increased climatic variability and change. This paper highlights the challenges and opportunities for service providers in communicating and disseminating WCI. We believe that findings from the study will give direction to efficient utilization of the information by the various end users, for which smallholder farmers are the majority in most developing countries.
Efficacy of CT Value Along Portal Vein for Preoperative Prediction of Portal Vein Resection in Pancreatic Head Cancer
Authors: Ochiai Shigeto , Chiba Naokazu , Gunji Takahiro , Kobayashi Toshimichi , Sano Toru , Tomita Koichi , Shigoka Masatoshi , Tabuchi Satoshi , Hidaka Eiji , Wakiya Midori , Nakatsugawa Munehide , Kawachi Shigeyuki
Published: February 2023

Background

It is important for surgeons to determine whether combined portal vein (PV) resection (PVR) is necessary before surgery. The present study aimed to determine the ability of computed tomography (CT) value along the PV in predicting the necessity for concomitant PVR.

Methods

A total of 107 consecutive patients who underwent pancreaticoduodenectomy (PD) for invasive ductal carcinoma of the pancreatic head at our institute between September 2007 and September 2020 were reviewed retrospectively. Univariate analysis to predict PVR was performed with preoperative radiological valuables acquired by Synapse Vincent. The resected specimen near the PV or the PV notch was analyzed by histopathological findings.

Results

Only the CT value of the PV was independently associated with PVR (Mann-Whitney U test; P = .045, logistic regression test; P = .039). The outer boundary of the PV was unclear in the cases without pathological PV invasion and PVR due to the development of smooth muscle in the outer membrane of the PV and the proliferation of collagen fibers. The elastic fibers were arranged regularly in the notch portion of the PV in cases wherein PVR was not performed.

Discussion

The CT value along the PV was independently associated with PVR and is the only predictor of PVR. These results were very useful in predicting PVR preoperatively and were histopathologically supportive.
Angioembolization May Improve Survival in Patients With Severe Hepatic Injuries
Authors: Rozycki Grace F. , Sakran Joseph V. , Manukyan Mariuxi C. , Feliciano David V. , Radisic Amanda , You Bin , Hu Fang , Wooster Meghan , Noll Kathy , Haut Elliott R.
Published: February 2023

Introduction

Although reports on angioembolization (AE) show favorable results for severe hepatic trauma, information is lacking on its benefit in the management and mechanisms of injury (MOI). This study examined patient outcomes with severe hepatic injuries to determine the association of in-hospital mortality with AE. The hypothesis is that AE is associated with increased survival in severe hepatic injuries.

Methods

Demographics, age, sex, MOI, shock index (SI), ≥6 units packed red blood cells (PRBCs) per hospital length of stay (LOS), intensive care unit LOS, injury severity score (ISS), and AE were collected. The primary outcome was in-hospital mortality. Patients were stratified into groups according to MOI, AE, and operative vs non-operative management. Multivariable logistic regression determined the independent association of mortality with AE vs no AE and operative vs nonoperative management and modeled the odds of mortality controlling for MOI, AE vs no AE, age and ISS groups, SI >.9, and ≥6 units PRBCs/LOS.

Results

From 2013 to 2018, 2462 patients (1744 blunt; 718 penetrating) were treated for severe hepatic injuries. AE was used in only 21% of patients. Mortality rates increased with higher ISS and age. AE was associated with mortality when compared to patients who did not undergo AE. The strongest associations with mortality were ISS ≥25, transfusion ≥ 6 units PRBCs/LOS, and age ≥65 years.

Conclusions

AE is underutilized in severe hepatic trauma. AE may be a valuable adjunct in the treatment of severe hepatic injuries especially in older patients and those needing exploratory laparotomy.
Validity of Atherosclerotic Calcified Lesions Observed on Low-Dose Computed Tomography and Cardio-Ankle Vascular Index as Surrogate Markers of Atherosclerosis Progression
Authors: Homma Satoki , Kato Kiyoe
Published: February 2023

The significance of atherosclerotic calcified lesions observed on low-dose computed tomography (LDCT) performed during general checkups was investigated. The coronary arteries (CA), ascending aorta and aortic arch (AAAA), descending thoracic aorta (DTA), and abdominal aorta (AA) were examined. Semiquantitative calcified index analysis of the DTA and AA in terms of atherosclerosis risk factors and cardio-ankle vascular index (CAVI) measurements was also performed. We included 1594 participants (mean age: 59.2 years; range: 31–91 years). The prevalence of calcified lesions was 71.0%, 66.6%, 57.2%, and 37.9% in the AA, CA, AAAA, and DTA, respectively. Age-related advances in calcification among participants with no major risk factors, revealed that calcification appeared earliest in the AA, followed by the CA, AAAA, and DTA. Participants with calcified lesions in all arteries had a significantly greater CAVI than those without calcification. The CAVI was negatively correlated with low-density lipoprotein cholesterol levels, particularly in participants without calcified lesions in the DTA. Calcified lesions on LDCT could indicate the end stage of atherosclerotic lesions. The CAVI can be used to assess atherosclerotic changes at all stages of disease progression. A combination of LDCT and CAVI could be used as a routine non-invasive assessment of atherosclerosis.
First Nations Peoples in the forensic mental health system in New South Wales: Characteristics and rates of criminal charges post-release
Authors: Dean Kimberlie , Lyons Georgia , Johnson Anina , McEntyre Elizabeth
Published: February 2023

Background:

It is well established that First Nations Peoples in Australia are overrepresented within the criminal justice system. However, First Nations Peoples appear to be comparatively underrepresented in the forensic mental health system, and little is known about their outcomes once released from secure care.

Objective:

To compare the characteristics and rates of repeat criminal justice contact for a criminal charge of First Nations and non-First Nations forensic patients in New South Wales.

Methods:

Data on the sample were extracted from the New South Wales Mental Health Review Tribunal paper and electronic files matched to the Bureau of Crime Statistics and Research Reoffending Database. Characteristics of First Nations and non-First Nations patients were compared using univariate logistic regression analysis. Univariate and multivariate Cox proportional hazard regression was used to determine predictors of post-release criminal charges.

Results:

Key differences in the sociodemographic, clinical and forensic characteristics of First Nations compared with non-First Nations forensic patients were identified. The time to first criminal justice contact following release was significantly shorter for First Nations forensic patients ( p < 0.01).

Conclusion:

The findings of this study confirm that First Nations forensic patients have distinct and complex needs that are apparent at entry to the forensic mental health system and that their poorer criminal justice contact rates following release from secure care indicate that these needs are not being adequately met either during treatment or once in the community. Responses to these study findings must consider the complex and continuing impact of colonisation on First Nations Peoples, as well as the need for solutions to be culturally safe.
Lateral Entry into Government: A Recurring Theme in Administrative Reforms
Authors: Singh Sujata
Published: February 2023

The question of inducting fresh talent into government has been a subject of perennial debate. Several Committees and Commissions in post-Independence India have addressed this issue and suggested steps to attract talent from outside the government. The question of providing lateral entry and inter-service mobility is closely intertwined with whether there is a need to specialise, and, if so, at what stage in a civil servant’s career. An analysis of various Commission Reports provides useful insights into this issue. The article examines the suggestions made by various Commissions and their ramifications for Indian Administration. It explores the implications of lateral entry into the civil services and its impact on the administration.
Investigating the relation between L2 pauses, syntactic complexity, and pause location: Longitudinal data from L2-Spanish study-abroad learners
Authors: García-Amaya Lorenzo
Published: February 2023

Inverse relations, or ‘trade-off effects’, are a common outcome of interlanguage development: a learner may increase performance in one linguistic domain while simultaneously decreasing performance in another. In this study, we investigate the relationships between one aspect of fluency (pause usage) and two aspects of syntactic complexity (utterance length and subordination) in relation to the location of pauses (between-clause or within-clause) in second-language (L2) oral narratives. The longitudinal analysis is based on monologic data produced by 16 English-speaking L2 learners of Spanish who participated in a seven-week study-abroad program in Spain. Overall, the learners decreased their silent-pause rate over the course of the program while concurrently increasing their number of syntactically complex clauses. Notably, the data suggest a systematic trade-off between pausing and complexity: the learners consistently produced more pauses (i.e. decreased fluency performance) during the elocution of the most complex clauses involving clausal subordination (i.e. increased complexity performance) in comparison to utterances lacking such subordination. We contextualize the findings within models of oral production and discuss how this research generates new insight into the processing factors that modulate pause usage in L2 speech.
How do spatial factors of green spaces contribute to flood regulation in urban areas? A systematic mapping approach
Authors: Razzaghi Asl Sina , Pearsall Hamil
Published: February 2023

Flooding is increasing in urban areas around the world, leading to loss of life and property damage, and cities are using urban green spaces (UGS) for flood regulation. The spatial attributes of UGS have an important role in controlling and regulating urban flooding, and there is a need for a systematic map on how spatial factors of UGS, such as shape, size, location, or connectivity, impact flooding in urban areas. The objectives of this study are to analyze and synthesize published material to evaluate the impacts of the spatial dimensions of UGS on flood regulation and to identify knowledge gaps and future research directions. Pertinent literature was reviewed and synthesized using the systematic mapping method. The results of this study show that previous research on spatial configuration have examined how variables such as slope, DEM, green space coverage, and landscape shape index impact runoff reduction. Slope was found to be an important, but not determining factor in flood regulation. There is a need for further research on how the geographic context of urban regions, including climatic conditions and land use changes, impacts UGS functionality. Additionally, there is a need for further research on how the spatial configuration of UGS impacts flood vulnerability and intensity, two under-addressed yet important topics in urban flooding.
Update on headaches associated with physical exertion
Authors: González-Quintanilla Vicente , Madera Jorge , Pascual Julio
Published: February 2023

Background

Headaches associated with physical exertion include headache precipitated by coughing or other Valsalva maneuvers, headache brought on by prolonged physical exercise, sexual headaches and cardiac cephalalgia.

Objective

To review and update the clinical characteristics, etiologies, pathophysiology and management of these headaches related to exertion.

Methods

In depth review of the publications, both in PubMed and in the main textbooks, of the different headaches induced by physical exercise.

Results

Cough, exercise and sexual headaches can be primary or secondary; therefore, complementary studies are mandatory to rule out structural lesions. However, clinical characteristics, such as an old age and response to indomethacin for cough headache or being a young male and response to beta-blockers for exercise and sexual headaches, plus a normal examination are suggestive of a primary etiology. Etiology for secondary varieties, as posterior fossa lesions for cough headache or vascular malformations for exercise and sexual headaches, are also different. Finally, headache as a distant manifestation of myocardial ischemia, also known as “cardiac cephalalgia”, appears at exertion in around two-thirds of cases and typically lasts less than 30 minutes and is relieved by nitroglycerine.

Conclusions

Primary and secondary cough headache can usually be suspected based on clinical characteristics and separated from exercise and sexual headaches, which share many aspects. Cardiac cephalalgia is not necessarily an exertional headache and should be considered in adult patients with short lasting headaches and patent vascular risk factors.
Retinal vessel dynamics analysis as a surrogate marker for raised intracranial pressure in patients with suspected idiopathic intracranial hypertension
Authors: Hagen Snorre Malm , Wibroe Elisabeth Arnberg , Korsbæk Johanne Juhl , Andersen Mikkel Schou , Nielsen Asger Bjørnær , Nortvig Mathias Just , Beier Dagmar , Poulsen Frantz Rom , Jensen Rigmor Højland , Hamann Steffen
Published: February 2023

Introduction

Retinal vessel dynamics analysis has proven to be a viable, non-invasive surrogate marker for increased intracranial pressure. We aimed to test this method in patients with suspected idiopathic intracranial hypertension.

Methods

Patients with suspected idiopathic intracranial hypertension were prospectively enrolled for hand-held fundus-videography during diagnostic lumbar puncture. After extracting optic disc images, peripapillary arteriole-to-venule-ratios were measured using machine-learning algorithms with manual identification control. A general linear model was applied to arteriole-to-venule-ratios and corresponding lumbar opening pressures to estimate cerebrospinal fluid pressure.

Results

Twenty-five patients were included with a significant difference in arteriole-to-venule-ratio between patients with ( n = 17) and without ( n = 8) idiopathic intracranial hypertension (0.78 ± 0.10 vs 0.90 ± 0.08, p = 0.006). Arteriole-to-venule-ratio correlated inversely with lumbar opening pressure (slope regression estimate −0.0043 (95% CI −0.0073 to −0.0023), p = 0.002) and the association was stronger when lumbar opening pressure exceeded 15 mm Hg (20 cm H2O) (slope regression estimate −0.0080 (95% CI −0.0123 to −0.0039), p < 0.001). Estimated cerebrospinal fluid pressure predicted increased lumbar opening pressure >20 mm Hg (27 cm H2O) with 78% sensitivity and 92% specificity (AUC 0.81, p = 0.02). A stand-alone arteriole-to-venule-ratio measurement predicting lumbar opening pressure >20 mm Hg (27 cm H2O) was inferior with a 48% sensitivity and 92% specificity (AUC 0.73, p = 0.002).

Conclusion

Retinal vessel dynamics analysis with the described model for estimating cerebrospinal fluid pressure is a promising non-invasive method with a high sensitivity and specificity for detecting elevated intracranial pressure at follow-up assessments of patients with confirmed idiopathic intracranial hypertension if initial lumbar opening pressure and arteriole-to-venule-ratio data are available.
Update on primary headache associated with sexual activity and primary thunderclap headache
Authors: Lin Po-Tso , Chen Shih-Pin , Wang Shuu-Jiun
Published: February 2023

Background

This narrative review aims to provide an update on primary headache associated with sexual activity and primary thunderclap headache.

Methods

We conducted a literature search on PubMed with the keywords “headache associated with sexual activity”, “sexual headache”, “orgasmic cephalalgia”, and “coital cephalalgia” in addition to “thunderclap headache” to assess the appropriateness of all published articles in this review.

Results

Primary headache associated with sexual activity is a “primary” headache precipitated by sexual activity, which occurs as sexual excitement increases (progressive at onset), or manifests as an abrupt and intense headache upon orgasm (thunderclap at onset) or combines these above two features. Primary headache associated with sexual activity is diagnosed after a thorough investigation, including appropriate neuroimaging studies, to exclude life-threatening secondary causes such as subarachnoid hemorrhage. According to the criteria of the third edition of the International Classification of Headache Disorders, primary thunderclap headache is also a diagnosis by exclusion. The pathophysiology of primary headache associated with sexual activity and primary thunderclap headache remains incompletely understood. Treatment may not be necessary for all patients since some patients with primary headache associated with sexual activity and primary thunderclap headache have a self-limiting course.

Conclusion

A comprehensive neuroimaging study is needed for distinguishing primary headache associated with sexual activity or primary thunderclap headache from secondary causes. Primary headache associated with sexual activity and primary thunderclap headache are self-limited diseases and the prognoses are good, but some patients with primary headache associated with sexual activity may have a prolonged course.
The effectiveness of botulinum toxin for chronic tension-type headache prophylaxis: A systematic review and meta-analysis
Authors: Dhanasekara Chathurika S , Payberah Daniel , Chyu Joanna Y , Shen Chwan-Li , Kahathuduwa Chanaka N
Published: February 2023

Background

A systematic and meta-analysis was conducted to examine the evidence of the effects of botulinum toxin A on chronic tension-type headache.

Methods

Cochrane, Embase, Ovid, ProQuest, PubMed, Scopus, Web-of-Science databases, and ClinicallTrials.gov registry were systematically searched for studies examining the effects of botulinum toxin A on tension-type headaches. The records were screened by two independent reviewers using pre-determined eligibility criteria. DerSimonian Liard random-effects meta-analyses were performed using the ‘meta’ package (5.2-0) in R (4.2.0). Risk of bias and quality of evidence were assessed using the Cochrane Collaboration’s Tool RoB 2 and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Clinical significance was determined using pre-defined minimal clinically important differences.

Results

Eleven controlled trials were included (390 botulinum toxin A, 297 controls). Botulinum toxin A was associated with significant improvements in standardized headache intensity (−0.502 standard deviations [−0.945, −0.058]), headache frequency (−2.830 days/month [−4.082, −1.578]), daily headache duration (−0.965 [−1.860, −0.069]) and the frequency of acute pain medication use (−2.200 days/month [−3.485, −0.915]) vs controls. Botulinum toxin A-associated improvements exceeded minimal clinically important differences for headache intensity, frequency, and acute pain medication use. A 79% (28%, 150%) greater response rate was observed for botulinum toxin A vs controls in improving chronic tension-type headache. Treatment of eight chronic tension-type headache patients was sufficient to elicit a therapeutic response in one patient.

Conclusions

Corroborating the current mechanistic evidence, our meta-analysis supports the utility of botulinum toxin A for managing chronic tension-type headaches. However, due to limitations in the quality of evidence, adequately-powered high-quality controlled trials examining the effects of Botulinum toxin A on chronic tension-type headache are warranted.

Registration

Protocol preregistered in PROSPERO International Prospective Register of Systematic Reviews (CRD42020178616)
Diagnosis of idiopathic intracranial hypertension: A proposal for evidence-based diagnostic criteria
Authors: Korsbæk Johanne Juhl , Jensen Rigmor Højland , Høgedal Lisbeth , Molander Laleh Dehghani , Hagen Snorre Malm , Beier Dagmar
Published: February 2023

Background

Based on expert opinion, abducens nerve palsy and a neuroimaging criterion (≥3 neuroimaging signs suggestive of elevated intracranial pressure) were added to the diagnostic criteria for idiopathic intracranial hypertension. Our objective was to validate this.

Methods

This prospective study included patients with new-onset idiopathic intracranial hypertension for a standardized work-up: interview, neuro-ophthalmological exam, lumbar puncture, neuroimaging. Neuroimaging was evaluated by a blinded neuroradiologist.

Results

We included 157 patients classified as idiopathic intracranial hypertension (56.7%), probable idiopathic intracranial hypertension (1.9%), idiopathic intracranial hypertension without papilledema (idiopathic intracranial hypertension-without papill edema; 0%), suggested idiopathic intracranial hypertension-without papill edema (4.5%), or non-idiopathic intracranial hypertension (36.9%). Moderate suprasellar herniation was more common in idiopathic intracranial hypertension than non-idiopathic intracranial hypertension (71.4% versus 47.4%, p < 0.01), as was perioptic nerve sheath distension (69.8% versus 29.3%, p < 0.001), flattening of the globe (67.1% versus 11.1%, p < 0.001) and transverse sinus stenosis (60.2% versus 18.9%, p < 0.001). Abducens nerve palsy was of no diagnostic significance. Sensitivity of ≥3 neuroimaging signs was 59.5% and specificity was 93.5%.

Conclusion

Moderate suprasellar herniation, distension of the perioptic nerve sheath, flattening of the globe and transverse sinus stenosis were associated with idiopathic intracranial hypertension. We propose that idiopathic intracranial hypertension can be defined by two out of three objective findings (papilledema, opening pressure ≥25 cm cerebrospinal fluid and ≥3 neuroimaging signs).
Early Postoperative MRI Evaluation of a Fascia Lata Autograft With and Without Polypropylene Mesh Augmentation After Superior Capsular Reconstruction
Authors: Ben Hui , Kholinne Erica , Zeng Chu Hui , So Sang-Pil , Lee Jun-Bum , Sun Yucheng , Koh Kyoung-Hwan , Jeon In-Ho
Published: February 2023

Background:

Recently, a polypropylene mesh has been introduced and reported to improve clinical outcomes after superior capsular reconstruction (SCR) using a fascia lata autograft (FLA). However, mesh-related events such as a foreign body response may trigger inflammation, which might affect graft healing and remodeling.

Purpose/Hypothesis:

The aim was to investigate whether the healing and remodeling of an FLA were affected by the use of a mesh by comparing the signal intensity of an FLA-alone group vs an FLA + Mesh group on postoperative magnetic resonance imaging (MRI). The hypothesis was that the use of a mesh would decrease the MRI signal intensity of FLA during the early postoperative phase.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who had undergone SCR using an FLA with or without a mesh between March 2013 and August 2021 were retrospectively analyzed. Follow-up MRI was performed at 3 months. A total of 78 patients (24 in the FLA group and 54 in the FLA + Mesh group) with intact grafts were included. Graft remodeling was evaluated by analyzing the signal-to-noise quotient (SNQ) at the humeral, mid-substance, and glenoid sites. Theoretically, lower SNQ ratios indicate higher strength and better healing of the graft.

Results:

The mean SNQ was 30.603 (range, 11.790-72.710) in the FLA group and 18.367 (range, 4.464-69.500) in the FLA + Mesh group ( P < .001). Furthermore, significant differences were found between the 2 groups at the humeral and mid-substance sites (37.863 [range, 5.092-81.187] vs 15.512 [range, 1.814-80.869], P < .001; and 29.168 [range, 6.103-73.900] vs 16.878 [range, 2.454-92.416], P = .003; respectively). However, there was no difference between the 2 groups at the glenoid site (25.346 [range, 7.565-86.353] vs 20.354 [range, 3.732-88.468], P = .057).

Conclusion:

At the 3-month follow-up, the FLA + Mesh group showed a lower MRI signal intensity than the FLA group. The healing and remodeling of an FLA may be enhanced when a mesh is used.
Care Managers in the Aging Network: Increasing Self-Efficacy in Human Service Providers
Authors: Mbao Mbita , Keefe Bronwyn , Almeida Joanna , Hamilton-Mason Johnnie
Published: February 2023

One in four older adults has Behavioral Health (BH) concerns, and over 63% are not receiving services. Older adults living in the community depend on the aging network for home- and community-based services and care managers are critical providers in this network. However, most care managers' current education and training are inadequate to care for older adults with BH needs. This study evaluated the effectiveness of training on the perceived self-efficacy of care managers working with older adults with BH needs. The study used a quasi-experimental design with a pre- and post-test approach and convenience sampling ( n = 90). We found a significant difference in mean self-efficacy scores, from pre-test (M = 62.31, SD = 10.11) to post-test (M = 65.88, SD = 7.40) related to working with clients with mental health problems. In addition, we found a significant difference between the mean pre-test (M = 59.81, SD = 10.68) and post-test score (M = 65.60, SD = 9.85) related to working with clients with substance use problems.
Idiotic or Columbo’s Wife? Constitutional Conventions in the Czech Republic
Authors: Hájek Lukáš
Published: February 2023

Academics usually look for constitutional conventions in Westminster-style democracies, such as the United Kingdom, Canada, or Australia. Nevertheless, growing evidence from practice shows that constitutional conventions are similarly essential attributes of even substantially different political regimes. This article is the first paper to systematically deal with constitutional conventions in the Czech Republic. To be more specific, I identify eight existing constitutional conventions there: (1) respect for the parliamentary majority, (2) institution of a formateur, (3) simultaneous existence of two prime ministers, (4) new cabinet’s statement of policy, (5) delegation of negotiation and ratification of international treaties, (6) appointment of a (vice-)governor of the Czech National Bank without a countersignature, (7) missing signature of the president under laws, and (8) single vice-chairperson of the Supreme Court. On one hand, the scrutiny shows that constitutional conventions play an already established and important role even in a Central European democracy. On the other hand, the lack of political respect for unwritten rules and the relative immaturity of Czech democracy confirm that constitutional conventions are as fragile (or as strong) as political actors allow. Thanks to these facts, the study of constitutional conventions in the post-communist country is a precious laboratory with universal findings even for long-existing democracies.