bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptations in clinical examinations of medical students in response to the COVID-19 pandemic: a systematic review
Authors: Cartledge Sapphire , Ward Derek , Stack Rebecca , Terry Emily
Published: August 2022

Introduction

Clinical examinations (assessments) are integral to ensuring that medical students can treat patients safely and effectively. The COVID-19 pandemic disrupted traditional formats of clinical examinations. This prompted Medical Schools to adapt their approaches to conducting these examinations to make them suitable for delivery in the pandemic. This systematic review aims to identify the approaches that Medical Schools, internationally, adopted in adapting their clinical examinations of medical students in response to the COVID-19 pandemic.

Methods

Three databases and four key medical education journals were systematically searched up to 22 October 2021; a grey literature search was also undertaken. Two reviewers independently screened at title, abstract stage and full text stage against predefined eligibility criteria. Discrepancies were resolved by discussion and involvement of senior authors. Risk of bias assessment was performed using an adapted version of a pre-existing risk of bias assessment tool for medical education developments. Results were summarised in a narrative synthesis.

Results

A total of 36 studies were included, which documented the approaches of 48 Medical Schools in 17 countries. Approaches were categorised into in-person clinical examinations (22 studies) or online clinical examinations (14 studies). Authors of studies reporting in-person clinical examinations described deploying enhanced infection control measures along with modified patient participation. Authors of studies reporting online clinical examinations described using online software to create online examination circuits. All authors reported that adapted examinations were feasible, scores were comparable to previous years’ student cohorts, and participant feedback was positive. Risk of bias assessment highlighted heterogeneity in reporting of the clinical examinations.

Conclusions

This review identified two broad approaches to adapting clinical examinations in the pandemic: in-person and online. Authors reported it was feasible to conduct clinical examinations in the pandemic where medical educators are given sufficient time and resources to carefully plan and introduce suitable adaptations. However, the risk of bias assessment identified few studies with high reporting quality, which highlights the need for a common framework for reporting of medical education developments to enhance reproducibility across wider contexts. Our review provides medical educators with the opportunity to reflect on past practises and facilitate the design and planning of future examinations.
The effects of a nurse-led integrative medicine-based structured education program on self-management behaviors among individuals with newly diagnosed type 2 diabetes: a randomized controlled trial
Authors: Yu Xingfeng , Chau Janita Pak Chun , Huo Lanting , Li Xiaomei , Wang Dan , Wu Hongjuan , Zhang Yulian
Published: August 2022

Background

International guidelines advocate providing prompt structured education to individuals with diabetes at diagnosis. However, among the few eligible structured education programs, heterogeneous intervention regimens and inconsistent findings were reported. Eligible programs for Chinese individuals with diabetes are lacking. This study aimed to investigate the effects of a nurse-led integrative medicine-based structured education program on self-management behaviors, glycemic control and self-efficacy among individuals with newly diagnosed type 2 diabetes.

Methods

Employing a randomized controlled trial, 128 individuals with type 2 diabetes diagnosed in the preceding three to nine months were recruited from four university-affiliated tertiary hospitals in Xi’an City, Northwest China, and randomly allocated to the intervention or control groups after baseline assessments. Participants in the intervention group received a 4-week nurse-led integrative medicine-based structured education program, which is theoretically based on the Health Belief Model and Self-Efficacy Theory, in line with updated diabetes management guidelines, and informed by relevant systematic reviews. Participants in the control group received routine care. Self-management behaviors and self-efficacy were measured with the Summary of Diabetes Self-Care Activities and the Diabetes Management Self-Efficacy Scale at baseline, immediate post-intervention and 12 weeks following the intervention while Glycated Hemoglobin A was measured at baseline and the 12th-week follow-up. The intervention effects were estimated using the generalized estimating equation models.

Results

Participants in the intervention group exhibited significantly better self-management performance in specific diet regarding intake of fruits and vegetables at both follow-ups (β = 1.02, p = 0.011 and β = 0.98, p = 0.016, respectively), specific diet regarding intake of high-fat foods at the immediate post-intervention follow-up (β = 0.83, p = 0.023), blood glucose monitoring at the 12th-week follow-up (β = 0.64, p = 0.004), foot care at both follow-ups (β = 1.80, p <  0.001 and β = 2.02, p <  0.001, respectively), and medication management at both follow-ups (β = 0.83, p = 0.005 and β = 0.95, p = 0.003, respectively). The intervention also introduced significant improvements in Glycated Hemoglobin A (β = − 0.32%, p <  0.001), and self-efficacy at both follow-ups (β = 8.73, p <  0.001 and β = 9.71, p <  0.001, respectively).

Conclusions

The nurse-led integrative medicine-based structured education program could produce beneficial effects on multiple diabetes self-management behaviors, glycemic control and self-efficacy.

Trial registration

This study was retrospectively registered in the ClinicalTrials.gov. on 25/08/2017; registration number: NCT03261895.
Using a theory of change in monitoring, evaluating and steering scale-up of a district-level health management strengthening intervention in Ghana, Malawi, and Uganda – lessons from the PERFORM2Scale consortium
Authors: Kok Maryse , Bulthuis Susan , Dieleman Marjolein , Onvlee Olivier , Murphy Rebecca , Akweongo Patricia , Namakula Justine , Banda Hastings , Wyss Kaspar , Raven Joanna , Martineau Tim
Published: August 2022

Background

Since 2017, PERFORM2Scale, a research consortium with partners from seven countries in Africa and Europe, has steered the implementation and scale-up of a district-level health management strengthening intervention in Ghana, Malawi and Uganda. This article presents PERFORM2Scale’s theory of change (ToC) and reflections upon and adaptations of the ToC over time. The article aims to contribute to understanding the benefits and challenges of using a ToC-based approach for monitoring and evaluating the scale-up of health system strengthening interventions, because there is limited documentation of this in the literature.

Methods

The consortium held annual ToC reflections that entailed multiple participatory methods, including individual scoring exercises, country and consortium-wide group discussions and visualizations. The reflections were captured in detailed annual reports, on which this article is based.

Results

The PERFORM2Scale ToC describes how the management strengthening intervention, which targets district health management teams, was expected to improve health workforce performance and service delivery at scale, and which assumptions were instrumental to track over time. The annual ToC reflections proved valuable in gaining a nuanced understanding of how change did (and did not) happen. This helped in strategizing on actions to further steer the scale-up the intervention. It also led to adaptations of the ToC over time. Based on the annual reflections, these actions and adaptations related to: assessing the scalability of the intervention, documentation and dissemination of evidence about the effects of the intervention, understanding power relationships between key stakeholders, the importance of developing and monitoring a scale-up strategy and identification of opportunities to integrate (parts of) the intervention into existing structures and strategies.

Conclusions

PERFORM2Scale’s experience provides lessons for using ToCs to monitor and evaluate the scale-up of health system strengthening interventions. ToCs can help in establishing a common vision on intervention scale-up. ToC-based approaches should include a variety of stakeholders and require their continued commitment to reflection and learning on intervention implementation and scale-up. ToC-based approaches can help in adapting interventions as well as scale-up processes to be in tune with contextual changes and stakeholders involved, to potentially increase chances for successful scale-up.
Access to health and rehabilitation services for persons with disabilities in Sierra Leone – focus group discussions with stakeholders
Authors: Magnusson Lina , Kebbie Ismaila , Jerwanska Victoria
Published: August 2022

Background

In Sierra Leone persons with disabilities are at higher risk of living in poverty and have poor access to a fragile healthcare and rehabilitation services. The aim was to explore stakeholders’ perceptions of access to health and rehabilitation services for persons with disabilities in Sierra Leone.

Methods

Seven focus group discussions, including stakeholders working within the field of disability was conducted.

Results

The subthemes were: continuous stigmatisation of persons with disabilities throughout life; long distances and transportation issues to access health and rehabilitation facilities; financial constraints; infrastructural barriers to healthcare and rehabilitation services and healthcare personnel’s negative attitudes and inadequate knowledge towards persons with disabilities; rehabilitation and healthcare facilities lacking materials to provide quality services; lack of specialised services and rehabilitation personnel for complex rehabilitation and the need for continuous education of new and current rehabilitation personnel.

Conclusion

Local actors need to take charge and renew efforts made by international organisations by providing trained rehabilitation staff and quality rehabilitation services. Rehabilitation services need to be affordable and transportation costs covered for persons with disabilities to access healthcare and rehabilitation services. Continuous education of the public and health personnel about disability is necessary to reduce negative attitudes towards persons with disabilities.
Cultural adaptation of a diabetes self-management education and support (DSMES) programme for two low resource urban settings in Ghana, during the COVID-19 era
Authors: Lamptey Roberta , Davies Melanie J. , Khunti Kamlesh , Schreder Sally , Stribling Bernie , Hadjiconstantinou Michelle
Published: August 2022

Background

Type 2 diabetes is a significant public health problem globally and associated with significant morbidity and mortality. Diabetes self-management education and support (DSMES) programmes are associated with improved psychological and clinical outcomes. There are currently no structured DSMES available in Ghana. We sought to adapt an evidence-based DSMES intervention for the Ghanaian population in collaboration with the local Ghanaian people.

Methods

We used virtual engagements with UK-based DSMES trainers, produced locally culturally and linguistically appropriate content and modified the logistics needed for the delivery of the self-management programme to suit people with low literacy and low health literacy levels.

Conclusions

A respectful understanding of the socio-cultural belief systems in Ghana as well as the peculiar challenges of low resources settings and low health literacy is necessary for adaptation of any DSMES programme for Ghana. We identified key cultural, linguistic, and logistic considerations to incorporate into a DSMES programme for Ghanaians, guided by the Ecological Validity Model. These insights can be used further to scale up availability of structured DSMES in Ghana and other low- middle- income countries.
Medication use and risk of amyotrophic lateral sclerosis—a systematic review
Authors: Cui Can , Sun Jiangwei , McKay Kyla A. , Ingre Caroline , Fang Fang
Published: August 2022

Background

Studying whether medications act as potential risk factors for amyotrophic lateral sclerosis (ALS) can contribute to the understanding of disease etiology as well as the identification of novel therapeutic targets. Therefore, we conducted a systematic review to summarize the existing evidence on the association between medication use and the subsequent ALS risk.

Methods

A systematic review was conducted in Medline, Embase, and Web of Science from the date of database establishment to December 10, 2021. References of identified articles were further searched for additional relevant articles. Studies were included if (1) published in English, (2) explored medication use as exposure and development of ALS as outcome, and (3) the design was a human observational study. Clinical trials, reviews, comments, editorials, and case reports were excluded. Quality assessment was performed using a pre-validated tool for non-randomized studies, the Newcastle–Ottawa Assessment Scale (NOS).

Results

Of the 4760 studies identified, 25 articles, including 13 case–control studies, five nested case–control studies, six cohort studies, and one retrospective chart review, were included in the review. Among these studies, there were 22 distinct study populations that included 171,407 patients with ALS, seven classes of medication examined, and 23 studies with a NOS ≥ 5. There was a general lack of agreement between studies on the associations of cholesterol-lowering drugs, anti-inflammatory drugs, immunosuppressants, antibiotics, oral contraceptives (OCs) or hormone replacement therapy (HRT), antihypertensive drugs, antidiabetics, and drugs for psychiatric and neurological disorders with the subsequent risk of ALS. However, it appeared that statins, aspirin, OCs/HRT, antihypertensives, and antidiabetics were unlikely related to a higher risk of ALS. The positive associations noted for antibiotics, antidepressants, and skeletal muscle relaxants might be attributable to prodromal symptoms of ALS.

Conclusions

There is currently no strong evidence to link any medication use with ALS risk.
Pheochromocytoma with Takotsubo Syndrome and acute heart failure: a case report
Authors: Yang Lin , Zhang Yiying , Hu Yanqun , Yang Zhi
Published: August 2022

Background

Pheochromocytoma is a neuroendocrine tumor that can overproduce catecholamines. Heart failure and Takotsubo Syndrome (TTS) caused by excessive catecholamines are uncommon pheochromocytoma complications.

Case presentation

A 27-year-old woman was referred to our center for further preoperative assessment and adrenalectomy. She came to the emergency ward with the typical symptoms of acute coronary syndrome and heart failure, including chest stuffiness, dyspnea, epigastric pain, and diaphoresis. The high level of 24-hour urinary vanillylmandelic acid and abdominal computed tomography findings supported the diagnosis of pheochromocytoma. Transthoracic echocardiography showed diffuse hypokinesis of the left ventricular wall with an ejection fraction of 23%. All symptoms and left ventricular function recovered rapidly after left laparoscopic adrenalectomy. Histopathology findings confirmed the diagnosis of pheochromocytoma. Based on the above findings, we eventually diagnosed her with pheochromocytoma-induced TTS.

Conclusions

This is a rare case of pheochromocytoma without hypertension complicated by TTS and acute heart failure. A diagnosis of pheochromocytoma-induced TTS should be considered for patients presenting with uncommon heart failure, even in patients without hypertension. Standard treatment is the surgical removal of the adrenal mass.
Mu heavy chain disease with MYD88 L265P mutation: an unusual manifestation of lymphoplasmacytic lymphoma
Authors: Baloda Vandana , Wheeler Sarah E. , Murray David L. , Kohlhagen Mindy C. , Vos Jeffrey A. , Yatsenko Svetlana A. , Agha Mounzer E. , Djokic Miroslav , Swerdlow Steven H. , Bailey Nathanael G.
Published: August 2022

Background

Mu heavy chain disease is a rare lymphoid neoplasm characterized by vacuolated bone marrow plasma cells and secretion of defective mu immunoglobulin heavy chains. The biological basis of mu heavy chain disease is poorly understood.

Case presentation

We report a case of mu heavy chain disease with MYD88 L265P mutation and deletion of 6q, genetic aberrations that are both strongly associated with lymphoplasmacytic lymphoma/Waldenström macroglobulinemia. Identification of the truncated mu immunoglobulin was facilitated by mass spectrometric analysis of the patient’s serum.

Conclusions

Mu heavy chain disease has been described as similar to chronic lymphocytic leukemia; however, the frequency of lymphocytosis in mu heavy chain disease has not been previously reported. We reviewed all previously published mu heavy chain disease reports and found that lymphocytosis is uncommon in the entity. This finding, along with the emerging genetic feature of recurrent MYD88 mutation in mu heavy chain disease, argues that at least a significant subset of cases are more similar to lymphoplasmacytic lymphoma than to chronic lymphocytic leukemia.
Outcome of necrotizing fasciitis and Fournier's gangrene with and without hyperbaric oxygen therapy: a retrospective analysis over 10 years
Authors: Mladenov Assen , Diehl Katharina , Müller Oliver , von Heymann Christian , Kopp Susanne , Peitsch Wiebke K.
Published: August 2022

Background

Necrotizing soft tissue infections (NSTI) require immediate radical debridement, broad-spectrum antibiotics and intensive care. Hyperbaric oxygen therapy (HBOT) may be performed adjunctively, but unequivocal evidence for its benefits is still lacking.

Methods

We performed a retrospective single-center study including 192 patients with necrotizing fasciitis or Fournier's gangrene to assess in-hospital mortality and outcome dependent on patient, disease and treatment characteristics with or without HBOT.

Results

The in-hospital mortality rate was 27.6%. Factors associated with increased mortality according to multivariate analysis were higher age, affection of multiple or problem localizations (odds ratio (OR) = 2.88, P = 0.003), ineligibility for HBOT despite clinical indication (OR = 8.59, P = 0.005), pathogens in blood cultures (OR = 3.36, P = 0.002), complications (OR = 10.35, P < 0.001) and sepsis/organ dysfunction (OR = 19.58, P < 0.001). Factors associated with better survival included vacuum-assisted wound closure (OR = 0.17, P < 0.001), larger number of debridements (OR = 0.83, P < 0.001) and defect closure with mesh graft (OR = 0.06, P < 0.001) or flap (OR = 0.09, P = 0.024). When participants were stratified into subgroups without requirement of HBOT (n = 98), treated with HBOT (n = 83) and ineligible for HBOT due to contraindications (n = 11), the first two groups had similar survival rates (75.5% vs. 73.5%) and comparable outcome, although patients with HBOT suffered from more severe NSTI, reflected by more frequent affection of multiple localizations (P < 0.001), sepsis at admission (P < 0.001) and intensive care treatment (P < 0.001), more debridements (P < 0.001) and a larger number of antibiotics (P = 0.001). In the subgroup ineligible for HBOT, survival was significantly worse (36.4%, P = 0.022).

Conclusion

These results point to a benefit from HBOT for treatment of NSTI in critically ill patients.
The MCP2 and the wrist plus two extensor compartments are the most affected and responsive joints/tendons out of the US7 score in patients with rheumatoid arthritis-an observational study
Authors: Podewski A. F. , Glimm A. M. , Fischer I. , Bruyn G. A. W. , Hanova P. , Hammer H. B. , Aga A. B. , Haavardsholm E. A. , Ramiro S. , Burmester G. R. , Backhaus M. , Ohrndorf S.
Published: August 2022

Background

There is no international consensus on an optimal ultrasound score for monitoring of rheumatoid arthritis (RA) on patient-level yet. Our aim was to reassess the US7 score for the identification of the most frequently pathologic and responsive joint/tendon regions, to optimize it and contribute to an international consensus. Furthermore, we aimed to evaluate the impact of disease duration on the performance of the score.

Methods

RA patients were assessed at baseline and after 3 and 6 months of starting/changing DMARD therapy by the US7 score in greyscale (GS) and power Doppler (PD). The frequency of pathologic joint/tendon regions and their responsiveness to therapy were analyzed by Friedman test and Cochrane-Q test respectively, including the comparison of palmar vs. dorsal regions (chi-square test). The responsiveness of different reduced scores and the amount of information retained from the original US7 score were assessed by standardized response means (SRM)/linear regression. Analyses were also performed separately for early and established RA.

Results

A total of 435 patients (N = 138 early RA) were included (56.5 (SD 13.1) years old, 8.2 (9.1) years disease duration, 80% female). The dorsal wrist, palmar MCP2, extensor digitorum communis (EDC) and carpi ulnaris (ECU) tendons were most frequently affected by GS/PD synovitis/tenosynovitis (wrist: 45%/43%; MCP2: 35%/28%; EDC: 30%/11% and ECU: 25%/11%) and significantly changed within 6 months of therapy (allp ≤0.003 by GS/PD). The dorsal vs. palmar side of the wrist by GS/PD (p < 0.001) and the palmar side of the finger joints by PD (p < 0.001) were more frequently pathologic. The reduced US7 score (GS/PD: palmar MCP2, dorsal wrist, EDC and ECU, only PD: dorsal MCP2) showed therapy response (SRM 0.433) after 6 months and retained 76% of the full US7 score’s information.

No major differences between the groups of early and established RA could be detected.

Conclusions

The wrist, MCP2, EDC, and ECU tendons were most frequently pathologic and responsive to therapy in both early and established RA and should therefore be included in a comprehensive score for monitoring RA patients on patient-level.
Investigating the power of eyes open resting state EEG for assisting in dementia diagnosis
Authors: Jennings Jack L. , Peraza Luis R. , Baker Mark , Alter Kai , Taylor John-Paul , Bauer Roman
Published: August 2022

Introduction

The differentiation of Lewy body dementia from other common dementia types clinically is difficult, with a considerable number of cases only being found post-mortem. Consequently, there is a clear need for inexpensive and accurate diagnostic approaches for clinical use. Electroencephalography (EEG) is one potential candidate due to its relatively low cost and non-invasive nature. Previous studies examining the use of EEG as a dementia diagnostic have focussed on the eyes closed (EC) resting state; however, eyes open (EO) EEG may also be a useful adjunct to quantitative analysis due to clinical availability.

Methods

We extracted spectral properties from EEG signals recorded under research study protocols (1024 Hz sampling rate, 10:5 EEG layout). The data stems from a total of 40 dementia patients with an average age of 74.42, 75.81 and 73.88 years for Alzheimer’s disease (AD), dementia with Lewy bodies (DLB) and Parkinson’s disease dementia (PDD), respectively, and 15 healthy controls (HC) with an average age of 76.93 years. We utilised k-nearest neighbour, support vector machine and logistic regression machine learning to differentiate between groups utilising spectral data from the delta, theta, high theta, alpha and beta EEG bands.

Results

We found that the combination of EC and EO resting state EEG data significantly increased inter-group classification accuracy compared to methods not using EO data. Secondly, we observed a distinct increase in the dominant frequency variance for HC between the EO and EC state, which was not observed within any dementia subgroup. For inter-group classification, we achieved a specificity of 0.87 and sensitivity of 0.92 for HC vs dementia classification and 0.75 specificity and 0.91 sensitivity for AD vs DLB classification, with a k-nearest neighbour machine learning model which outperformed other machine learning methods.

Conclusions

The findings of our study indicate that the combination of both EC and EO quantitative EEG features improves overall classification accuracy when classifying dementia types in older age adults. In addition, we demonstrate that healthy controls display a definite change in dominant frequency variance between the EC and EO state. In future, a validation cohort should be utilised to further solidify these findings.
The role of the aging microenvironment on the fate of PDGFRβ lineage cells in skeletal muscle repair
Authors: Lu Aiping , Tseng Chieh , Guo Ping , Gao Zhanguo , Whitney Kaitlyn E. , Kolonin Mikhail G. , Huard Johnny
Published: August 2022

Background

During aging, perturbation of muscle progenitor cell (MPC) constituents leads to progressive loss of muscle mass and accumulation of adipose and fibrotic tissue. Mesenchymal stem cells (MSCs) give rise to adipocytes and fibroblasts that accumulate in injured and pathological skeletal muscle through constitutive activation of platelet-derived growth factor receptors (PDGFRs). Although the role of the PDGFRα has been widely explored, there is a paucity of evidence demonstrating the role of PDGFRβ in aged skeletal muscle.

Methods

In this study, we investigated the role of PDGFRβ lineage cells in skeletal muscle during aging by using Cre/loxP lineage tracing technology. The PDGFR-Cre mice were crossed with global double-fluorescent Cre reporter mice (mTmG) that indelibly marks PDGFRβ lineage cells. Those cells were analyzed and compared at different ages in the skeletal muscle of the mice.

Results

Our results demonstrated that PDGFRβ lineage cells isolated from the muscles of young mice are MPC-like cells that exhibited satellite cell morphology, expressed Pax7, and undergo myogenic differentiation producing myosin heavy chain expressing myotubes. Conversely, the PDGFRβ lineage cells isolated from muscles of old mice displayed MSC morphology with a reduced myogenic differentiation potential while expressing adipogenic and fibrotic differentiation markers. PDGFRβ lineage cells also gave rise to newly regenerated muscle fibers in young mice after muscle injury, but their muscle regenerative process is reduced in old mice.

Conclusions

Our data suggest that PDGFRβ lineage cells function as MPCs in young mice, while the same PDGFRβ lineage cells from old mice undergo a fate switch participating in adipose and fibrotic tissue infiltration in aged muscle. The inhibition of fate-switching in PDGFRβ lineage cells may represent a potential approach to prevent fibrosis and fatty infiltration in skeletal muscle during the aging process.
Land, sugar and pastoralism in Ethiopia: Comparing the impact of the Omo-Kuraz sugar projects on local livelihoods and food (in) security in the lower Omo Valley
Authors: Gebeyehu Adane Kebede , Abbink Jon
Published: August 2022

This study assesses the impact of a large, state-sponsored sugar plantation scheme on agro-pastoralists’ livelihoods and local land use change in southern Ethiopia, specifically in the lower Omo Valley. The study compares the local perceptions on the ongoing Omo-Kuraz sugar project — sugar cane plantations and a cane-crushing factory — and describes how it has affected local communities’ environmental and livelihood strategies vis-à-vis the alleged ‘new development opportunities’. Focus group discussion, key informant interviews, and field observations were applied to get in-depth information about the socio-economic and environmental impacts of large scale land acquisitions. The results show that the implementation of large scale land acquisitions in the lower Omo Valley has put enormous pressure on local land use and land management systems. The Omo-Kuraz I and II projects, started in 2011, neither met the stated economic purposes of the then Ethiopian federal government nor satisfied the pastoral communities’ needs. The LSAI project is still highly contentious among the local community, the project office, and the local government. Our study recommends that shifting the perspective towards the local agro-pastoralists’ activities, understanding their views and ways of ‘using’ the environment, and creating a broader consultation platform with them may create opportunities for cooperation and synergy to optimize benefits and sustainably adapt the development project to the local context.
Beneficial effects of Cyclosporine A in combination with Nortriptyline on germ cell-specific apoptosis, oxidative stress and epididymal sperm qualities following testicular ischemia/reperfusion in rats: a comparative study
Authors: Yazdani Iraj , Majdani Raheleh , Ghasemnejad-berenji Morteza , Dehpour Ahmad Reza
Published: August 2022

Background

Testicular torsion is a pathological condition which needs emergency surgical intervention. However, after surgical reperfusion, oxidative stress factors cause to germ cell apoptosis. The study was planned to evaluate the efficacy of simultaneous use of Cyclosporine A (CsA) and Nortriptyline (Nort) to repair testicular damages in an experimental torsion/detorsion (T/D) rat model.

Methods

Male rats (n = 112) were allocated into 7 groups 16 each in; (Group 1); Control group, (Group 2); T/D group, (Group 3–4); CsA 1 and 5 mg/kg, (Group 5–6); Nort 2 and 10 mg/kg and (Group 7); concurrent group, CsA (1 mg/kg) + Nort (2 mg/kg). Right uni-lateral torsion was inducted by twisting testis 720 degrees in the clockwise direction for 1 h. For short-term and mid-term studies, lipid peroxidation, antioxidant enzyme activities, caspase-3 level, histopathological changes and germ cell apoptosis were evaluated. Moreover, in long-term investigation, semen analysis was performed.

Results

After T/D induction, testis abnormalities both functional and structural were appeared. Pre- and post-treatment with CsA and Nort, separately, reduced MDA and caspase-3 levels, normalized antioxidant levels, ameliorate tissue injury and improved sperm criteria.

Conclusion

The antioxidant and anti-apoptotic characteristics of CsA and Nort and their protective effects have been shown in our study. Concurrent administration of CsA and Nort in selected low-dose indicated a significant positive effect as compared to the individual drug interventions on the reversal of T/D induced oxidative stress in short-term, apoptosis, and histologic changes in mid-term, as well as semen criteria in the long-term appraisal.
A curious case of pulmonary hypertension in a child
Authors: Ahmed A. Shaheer , Divani Gaurav Kumar , Gupta Shivank
Published: August 2022

Background

Pulmonary hypertension in young children can be due to a myriad of conditions. Few aetiologies of pulmonary hypertension are potentially reversible. An extensive workup for the cause of pulmonary hypertension is a must before attributing it to idiopathic pulmonary hypertension. We describe an uncommon aetiology of pulmonary hypertension in a young boy.

Case presentation

A 12-year-old child, with past history of tubercular pleural effusion, presented with dyspnoea on exertion and easy fatiguability for 2 years. He was evaluated elsewhere and was being treated as primary pulmonary hypertension with pulmonary vasodilators. The child was revaluated since the clinical features were not completely favouring the diagnosis. On detailed evaluation, a diagnosis of constrictive pericarditis was made. He was referred for pericardiectomy.

Conclusions

Constrictive pericarditis presenting with severe pulmonary hypertension without congestive symptoms is very rare. In patients presenting with pulmonary hypertension, always look for a reversible cause before labeling them as idiopathic PAH.
Implementation and Impact of Choosing Wisely Recommendations in Oncology
Authors: Nagarajah Sonieya , Powis Melanie Lynn , Fazelzad Rouhi , Krzyzanowska Monika K. , Kukreti Vishal
Published: August 2022

The Choosing Wisely (CW) campaign, launched in 2012, includes oncology-specific recommendations to promote evidence-based care and deimplementation of low-value practices. However, it is unclear to what extent the campaign has prompted practice change. We systematically reviewed the literature to evaluate the uptake of cancer-specific CW recommendations focusing on the period before the declaration of the COVID-19 pandemic. We used Grimshaw's deimplementation framework to thematically group the findings and extracted information on implementation strategies, barriers, and facilitators from articles reporting on active implementation. In the 98 articles addressing 32 unique recommendations, most reported on passive changes in adherence pre-post publication of CW recommendations. Use of active surveillance for low-risk prostate cancer and reduction in staging imaging for early breast cancer were the most commonly evaluated recommendations. Most articles assessing passive changes in adherence pre-post CW publication reported improvement. All articles evaluating active implementation (10 of 98) reported improved compliance (range: 3%-73% improvement). Most common implementation strategies included provider education and/or stakeholder engagement. Preconceived views and reluctance to adopt new practices were common barriers; common facilitators included the use of technology and provider education to increase provider buy-in. Given the limited uptake of oncology-specific CW recommendations thus far, more attention toward supporting active implementation is needed. Effective adoption of CW likely requires a multipronged approach that includes building stakeholder buy-in through engagement and education, using technology-enabled forced functions to facilitate change along with policy and reimbursement models that disincentivize low-value care. Professional societies have a role to play in supporting this next phase of CW.
Harmonic calibration of quadrature phase interferometry
Authors: Ferrero Baptiste , Bellon Ludovic
Published: August 2022

The two output signals of quadrature phase interferometers allow to benefit both from the high sensitivity of interferometry (working inside a fringe) and from an extended input range (counting fringes). Their calibration to reach a linear output is traditionally performed using Heydemann’s correction, which involves fitting one output versus the other by an ellipse. Here we present two alternative methods based on the linear response of the measurement to a sinusoidal input in time, which enables a direct calibration with an excellent linearity. A ten fold improvement with respect to the usual technique is demonstrated on an optical interferometer measuring the deflection of scanning force microscopy cantilevers.
Revisiting quantum relativistic effects from phase transition by the catastrophe theory
Authors: Wu Jiu Hui , Zhou Kejiang , Yang Shao Kun
Published: August 2022

In this paper we start from the Schrödinger equation to revisit some classical quantum mechanics from the perspective of phase transition process. Here the relativistic effect of particles moving at high speed can be regarded as the phase transition process when the velocity variable increases. Considering that the catastrophe theory could describe qualitatively any phase transition process, we adopt the simplest folding catastrophe type as the potential function in the Schrödinger equation to obtain a revised Schrödinger relativistic equation through the dimensionless analysis first, and then further to derive out the steady-state Klein-Gordon equation and Dirac relativistic equation gradually. These results reveal that the quantum relativistic effect could be considered as the phase transition process, which could be described by adopting the catastrophe models as the potential function in the classical Schrödinger equation.
Development of the relativistic runaway avalanches in the lower atmosphere above mountain altitudes
Authors: Chilingarian A. , Hovsepyan G. , Karapetyan T. , Sargsyan B. , Zazyan M.
Published: August 2022

The comparative analysis of three thunderstorms on Aragats in May 2021 demonstrates that relativistic runaway electron avalanches (RREAs) can reach very low altitudes above the Earth’s surface on mountain altitudes. RREAs which reach the Earth’s surface are registered by the particle detectors as thunderstorm ground enhancements (TGEs) —large enhancements of electron and gamma ray fluxes, sometimes exceeding the fair-weather background fluxes up to a hundred times. By comparing the energy spectra of electrons and gamma rays it is possible to estimate the height above the ground where an RREA terminates and avalanche particles exit the accelerating field. For the several TGEs registered on Aragats, this estimate varied between 50 and 150 meters. The threshold electric field can reachon heights of. When a lightning’s active zone is above particle detectors RREAs last tens of seconds to a few minutes, until lightning flashes terminate electron acceleration. If the lightning activity is far from the detector site, TGEs are extended for a few tens of minutes and smoothly decay and TGE has a more or less symmetrical shape.
Screening Accuracy of the 50 g-Glucose Challenge Test in Twin Compared With Singleton Pregnancies
Authors: Hiersch Liran , Shah Baiju R , Berger Howard , Geary Michael , McDonald Sarah D , Murray-Davis Beth , Guan Jun , Halperin Ilana , Retnakaran Ravi , Barrett Jon , Melamed Nir
Published: August 2022

Context

The optimal 50 g-glucose challenge test (GCT) cutoff for the diagnosis of gestational diabetes mellitus (GDM) in twin pregnancies is unknown.

Objective

This work aimed to explore the screening accuracy of the 50 g-GCT and its correlation with the risk of large for gestational age (LGA) newborn in twin compared to singleton pregnancies. A population-based retrospective cohort study (2007-2017) was conducted in Ontario, Canada. Participants included patients with a singleton (n = 546 892 [98.4%]) or twin (n = 8832 [1.6%]) birth who underwent screening for GDM using the 50 g-GCT.

Methods

We compared the screening accuracy, risk of GDM, and risk of LGA between twin and singleton pregnancies using various 50 g-GCT cutoffs.

Results

For any given 50 g-GCT result, the probability of GDM was higher (P = .0.007), whereas the probability of LGA was considerably lower in the twin compared with the singleton group, even when a twin-specific growth chart was used to diagnose LGA in the twin group (P < .001). The estimated false-positive rate (FPR) for GDM was higher in twin compared with singleton pregnancies irrespective of the 50 g-GCT cutoff used. The cutoff of 8.2 mmol/L (148 mg/dL) in twin pregnancies was associated with an estimated FPR (10.7%-11.1%) that was similar to the FPR associated with the cutoff of 7.8 mmol/L (140 mg/dL) in singleton pregnancies (10.8%).

Conclusion

The screening performance of the 50 g-GCT for GDM and its correlation with LGA differ between twin and singleton pregnancies.
Zero Relative in African American English
Authors: Sistrunk Walter
Published: August 2022

This paper carefully describes African American relative clauses and the range of structures that favor zero subject relatives. Several scholars have suggested that existential sentences and predicate nominatives are not relative clauses. Given the prevalence of existential sentences and predicate nominatives in numerous studies, whether zero subject relatives exist in African American English is questionable. However, this paper avoids the debate to determine whether existential or predicate nominatives involve relativization. Instead, this article looks at other constructions that correlate with zero subject relative in AAE, namely resumption. A thorough examination reveals that relative clauses with these constructions align with typical relative clauses with overt relativizers. The syntax of African American English must compensate for the absence of the relativizer, and it uses two strategies to do so; the first is (1) resumption, and the second is (2) intonation. When zero subject relatives appear bare, relying only on intonation, where rising intonation marks the end of the relative clause and the left edge of the main clause, there is potential for ambiguity. Last, this manuscript shows that the syntax utilizes resumption to avoid parsing errors and resolve structural ambiguities that could potentially result in garden-path sentences.
“You Need Money to Live in Prison”
Authors: Bardelli Tommaso , Gillespie Zach , Tu Thuy Linh N.
Published: August 2022

In the United States, going to jail or prison increasingly comes with a hefty price tag for incarcerated persons. As states continue to cut public spending, individuals are required to cover costs for basic necessities, such as food, health care, and telecommunications. Most have to rely on financial support from friends and family members to make ends meet during incarceration, thus drawing further resources from already vulnerable communities. Based on ethnographic interviews with formerly incarcerated individuals, and on the personal experience of one of the authors with the New York penal system, this article explores the effects of budget cuts and austerity measures on the everyday lives of the incarcerated, as well as the myriad forms of labor that prisoners perform to fill the gaps in institutional commitments.
An “Anxiety Epidemic” in the Financialized University
Authors: Haiven Max , Komporozos-Athanasiou Aris
Published: August 2022

Financialization is transforming social subjects and institutions, including the university. This article explores overlooked links between the financialization of public postsecondary education on both sides of the North Atlantic and the ongoing “anxiety epidemic” among students (and, indeed, staff). The article argues that the “anxious university” represents a unique space to study the economic, political, social, and cultural impact of the rise in power and influence of the financial sector. By unraveling the complex sociological dimensions of the anxiety epidemic, we offer a vantage on the emergence of new forms and platforms of struggle within, against, and beyond financialization.
Dhx38 is required for the maintenance and differentiation of erythro-myeloid progenitors and hematopoietic stem cells by alternative splicing
Authors: Tu Jiayi , Yu Shanshan , Li Jingzhen , Ren Mengmeng , Zhang Yangjun , Luo Jiong , Sun Kui , Lv Yuexia , Han Yunqiao , Huang Yuwen , Ren Xiang , Jiang Tao , Tang Zhaohui , Williams Mark Thomas Shaw , Lu Qunwei , Liu Mugen
Published: August 2022

Mutations that occur in RNA-splicing machinery may contribute to hematopoiesis-related diseases. How splicing factor mutations perturb hematopoiesis, especially in the differentiation of erythro-myeloid progenitors (EMPs), remains elusive. Dhx38 is a pre-mRNA splicing-related DEAH box RNA helicase, for which the physiological functions and splicing mechanisms during hematopoiesis currently remain unclear. Here, we report that Dhx38 exerts a broad effect on definitive EMPs as well as the differentiation and maintenance of hematopoietic stem and progenitor cells (HSPCs). In dhx38 knockout zebrafish, EMPs and HSPCs were found to be arrested in mitotic prometaphase, accompanied by a ‘grape’ karyotype, owing to the defects in chromosome alignment. Abnormal alternatively spliced genes related to chromosome segregation, the microtubule cytoskeleton, cell cycle kinases and DNA damage were present in the dhx38 mutants. Subsequently, EMPs and HSPCs in dhx38 mutants underwent P53-dependent apoptosis. This study provides novel insights into alternative splicing regulated by Dhx38, a process that plays a crucial role in the proliferation and differentiation of fetal EMPs and HSPCs.
Development of dim-light vision in the nocturnal reef fish family Holocentridae. I: Retinal gene expression
Authors: Fogg Lily G. , Cortesi Fabio , Lecchini David , Gache Camille , Marshall N. Justin , de Busserolles Fanny
Published: August 2022

Developmental changes to the visual systems of animals are often associated with ecological shifts. Reef fishes experience a change in habitat between larval life in the shallow open ocean to juvenile and adult life on the reef. Some species also change their lifestyle over this period and become nocturnal. While these ecological transitions are well documented, little is known about the ontogeny of nocturnal reef fish vision. Here, we used transcriptomics to investigate visual development in 12 representative species from both subfamilies, Holocentrinae (squirrelfishes) and Myripristinae (soldierfishes), in the nocturnal coral reef fish family, Holocentridae. Results revealed that the visual systems of holocentrids are initially well adapted to photopic conditions with pre-settlement larvae having high levels of cone opsin gene expression and a broad cone opsin gene repertoire (8 genes). At reef settlement, holocentrids started to invest more in their scotopic visual system, and compared with adults, showed upregulation of genes involved in cell differentiation/proliferation. By adulthood, holocentrids had well developed scotopic vision with high levels of rod opsin gene expression, reduced cone opsin gene expression and repertoire (1–4 genes) and upregulated phototransduction genes. Finally, although the two subfamilies shared similar ecologies across development, their visual systems diverged after settlement, with Myripristinae investing more in scotopic vision than Holocentrinae. Hence, both ecology and phylogeny are likely to determine the development of the holocentrid visual system.
Sport-Specific Crossover Point Differences during a Maximal Oxygen Consumption Test
Authors: Stanzione Joseph R. , Brooks George A. , Bruneau Michael L. , French Duncan N. , Nasser Jennifer A. , Smith Sinclair A. , Volpe Stella L.
Published: August 2022

Introduction/Purpose

The crossover point occurs during exercise when one transitions energy substrates from fat to carbohydrate predominance. The crossover point varies in an intensity-dependent manner; however, less is known about its specificity in sports with varying metabolic demands. The purpose of our study was to determine if various sports yield differences in the time to crossover and heart rate and percentage of maximal oxygen consumption (V˙O2max) at crossover during a standardized exercise protocol.

Methods

A total of 77 athletes (39 women, 38 men; 39.1 ± 10.4 yr of age) were measured for respiratory exchange ratio during a modified Taylor V˙O2maxtreadmill test. Sports included running (n= 20), triathlon (n= 20), rowing (n= 20), and CrossFit (n= 17). A one-way ANOVA determined differences in time to crossover. A Kruskal–Wallis test was applied to determine differences between sport types for percent V˙O2maxand heart rate at crossover. Bonferroni correction procedures were used to control the family-wise error rate and maintain alpha levels atP< 0.05.

Results

Average time to crossover for all athletes was 3:43 ± 1:12 min. Times to crossover for runners, triathletes, rowers, and CrossFit athletes were 4:16 ± 0:58, 3:28 ± 1:08, 4:00 ± 1:23, and 3:01 ± 0:58 min, respectively. Significant differences were observed between groups for time to crossover (P= 0.007) and percent V˙O2maxat crossover (P= 0.01). Pairwise analyses revealed that runners had a significantly longer time to crossover compared with CrossFit athletes (P= 0.009). Triathletes’ percent V˙O2maxat crossover was significantly lower than rowers (P= 0.04) and runners (P= 0.04).

Conclusions

We found significant differences in time to crossover between runners and CrossFit athletes, which suggests that substrate use may be dependent on sport type.