bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions of policy problems and solutions: Climate change and structural racism
Authors: Kantack Benjamin R. , Paschall Collin E.
Published: November 2022

Public policy debates in the United States about how to respond to complex issues like climate change and structural racism are often portrayed in polarized terms. Progressives are seen as advocating for transformational responses to major problems, while conservatives are portrayed as denying these problems’ existence. However, such depictions obscure the presence of a third bloc that acknowledges these problems’ existence but does not support drastic approaches to solving them. Using survey experiments, we examine the relationships between problem belief and solution support in these two issues areas. We find overlap between those who acknowledge the existence of these problems and those who oppose large-scale policy solutions. Furthermore, we observe that the solution proposed may influence attitudes toward the problem. Our results suggest that political scientists and policy activists overestimate the extent of denial of these problems and mistarget persuasive efforts by focusing on problem belief over solution support.
The Impact of Trade Openness and FDI on Nigeria’s Economic Growth: Revisiting the Unsettled Debate
Authors: Ari Yılmaz Onur , Jibir Adamu , Hassan Aisha Adamu
Published: November 2022

The association between trade openness, foreign direct investment (FDI) and economic growth has been thoroughly researched, producing contradictory and unsettled findings. The main reason behind such mixed results may be the lack of capital stock and labour force in the growth–trade relationship. In this study, we re-examine the impact of trade openness and FDI on economic growth. Hence, we used annual time series data for the period of 1996–2019. We evaluate the robustness of our findings by using more than one index of trade openness and by controlling relevant variables that are found significant in growth literature. The Autoregressive Distributed Lag (ARDL) model is used in this article. The results indicate that FDI and capital stock are linked to economic growth in the short and long term. Trade openness, on the other hand, has a negative impact not only on short-term but also on long-term growth. Furthermore, we discovered corruption, inflation and labour force to have significant negative association with economic growth. This connotes that openness to capital flows is more important to the Nigerian economy than trade openness. Thus, if complementary strategies are implemented, the negative association between economic growth and trade openness may be significantly reversed. These results, therefore, suggest the promotion of policies that support improvement in capital formation by private, public and foreign investors.

JEL Classification C13, F10, F43, N17, O40
Engaging Advanced Learners with Differentiated Online Learning
Authors: McKoy Stefanie , Merry Krystle E
Published: November 2022

With the growth of online, virtual, and blended learning, there has been an increase in the demand for access to differentiated, quality online resources that are both student- and teacher-friendly for advanced or gifted and talented learners. The included resources have one or more combinations of exploratory, meaningful, and relevant content, various critical thinking-related activities, opportunities to expand creativity, integration of game-based knowledge, collaboration with peers, and educational opportunities to communicate and interact with peers from multiple backgrounds, cultures, and ethnicities. To support advanced learners, the article highlights specific online programs and applications that focus on the 21st-century skills of communication, collaboration, creativity, and critical thinking. These technology sources assist teachers in differentiating their instruction to meet all students’ needs including those who are advanced.
9/11 steel: Distributed memorialization
Authors: Holleran Samuel , Holleran Max
Published: November 2022

Steel has become the de facto material to memorialize 9/11. In this article, we show how the vast majority of steel from the World Trade Center (200,000 tons) was recycled abroad but what remained was sacralized and made into local memorials. Using newspaper reports and materials obtained from a freedom of information request, the article analyzes how dispersed memorialization honored first responders across the United States (and abroad) enlarging both the geography of trauma and responsibility to remember. We connect the Port Authority of New York and New Jersey's curation, gifting, and transportation of 9/11 steel to a form of mourning with military antecedents as well as the deliberate focus on strength, masculinity, and participation in the War on Terror. Finally, we show how local memorialization democratized the process of ‘sacred steel' distribution while also tightly controlling what could be done with salvaged metal in order to make sure that relics remained communal, rather than personalized, objects.
The disability employment quota, between social policy and antidiscrimination
Authors: Revillard Anne
Published: November 2022

Many countries worldwide resort to quotas in order to favour the employment of disabled people. Yet, the quota as a policy tool has an ambivalent meaning: while it has been conceived as an advanced form of antidiscrimination policy tool in domains such as gender and racial inequalities, in the sector of disability, it has tended to be theorized as an outdated measure, belonging to a social welfare perspective opposed to the more recent equalitarian policy frame. This article revisits this theoretical debate on the disability employment quota by shifting the focus from a normative discussion to an empirical investigation of the meanings policymakers have endowed it with. I draw on the case of France, where the quota scheme is a cornerstone of disability employment policy: post–World War I provisions were at the origin of a series of reforms extending and reinforcing the quota, in 1957, 1987 and 2005 – leading to the current 6% disabled worker quota imposed to private and public organizations of 20 employees or more. Tracing the historical trajectory of this policy tool and its uses by means of parliamentary debates and secondary sources, I show how quotas in France have had more complex meanings than what the social welfare versus antidiscrimination dichotomy suggests. Before the rise of antidiscrimination policy, they were thought of as a progressive form of social policy, as opposed to more segregative interventions such as pensions or sheltered employment. The adoption of antidiscrimination provisions in 2005 then led to a hybridization between quotas and antidiscrimination policy.
A Bayesian hypothesis testing-based statistical decision philosophy for structural damage detection
Authors: Zhang Qiu-Hu , Ni Yi-Qing
Published: November 2022

In this article, a new statistical decision philosophy is developed to tackle structural damage detection problems which are defined in the context of novelty detection. In line with this philosophy, structural damage detection is achieved by deriving the posterior probability of damage presence from the Bayesian testing of two competing hypotheses, with the null and alternative hypotheses representing the undamaged and damaged states of a structure of concern, respectively. To resolve the tricky problem of prior appropriateness in Bayesian hypothesis testing, a general prior specification criterion is devised based on the notion of risk management, including the risk of false positive indication (an undamaged structure is incorrectly identified as damaged) and the risk of false negative indication (a damaged structure is incorrectly identified as undamaged). To determine an optimal risk level, two principles, namely the principle of posterior probability difference minimization (PPDM) and the principle of posterior probability product maximization (PPPM), are defined. The PPDM principle is to minimize the difference between the ability of a novelty detector to avoid a false positive and its ability to avoid a false negative, and the PPPM principle is to maximize the product of the two capabilities. Both principles essentially act as a means of achieving an optimal trade-off between the false positive and false negative risks stipulated in pursuing damage detection. To demonstrate the effectiveness of the proposed statistical decision philosophy for structural damage detection, experimental data obtained from a 5-story steel frame model and a 38-story concrete building model have been investigated.
Connectivity and Excitability Shape Seizure Circuits
Authors: Brodovskaya Anastasia , Kapur Jaideep
Published: November 2022

Mapping neuronal circuits that generate focal to bilateral tonic–clonic seizures is essential for understanding general principles of seizure propagation and modifying the risk of death and injury due to bilateral motor seizures. We used novel techniques developed over the past decade to study these circuits. We propose the general hypothesis that at the mesoscale, seizures follow anatomical projections of the seizure focus, preferentially activating more excitable neurons.
A Universal Device to Convert a Continuous Flow Assist Device to a Pulsatile Flow Device to Simulate Normal Blood Flow and Pressure Patterns
Authors: Gerrah Rabin
Published: November 2022

Background

Continuous follow assist devices (CFAD) are the most commonly used mechanical circulatory support devices. Compared to Pulsatile flow assist devices (PFAD), CFADs deliver a non-physiologic type of flow, which might contribute to complications related to lack of pulsatility in these devices. Moreover, lack of pulsatility complicates the clinical management of these patients who often present with good perfusion but with no palpable pulse and none or a negligible pulse pressure on blood pressure measurement.

Methods and results

Presented here is a concept of a universal converter device that can be added inline other CFADs to convert the flow from continuous to pulsatile, simulating a normal flow and pressure pattern. After initial implantation and stabilization with a CFAD, adding this converter might potentially provide the benefits of pulsatile physiologic flow. The device is made of 2 components connected in parallel, working in tandem in user determined cycles. The continuous flow through a specifically positioned openings create a smooth conversion to a pulsatile flow. This device can convert a continuous flow to a physiologic pulsatile flow to achieve a native-like flow pattern and potentially prevent some CFAD complications.

Conclusion

This paper presents the concept of pulsatility generation and simulation for other assist devices. Such a device can be a universal add-on or a supplemental option for CFADs.
Duplication of the internal maxillary artery: Anatomical and clinical considerations
Authors: Harmsen Irene E , Kim Cha-ney , Hendriks Eef J , Lindgren Antti , Krings Timo
Published: November 2022

Duplication of the internal maxillary artery (IMAX) results from a failed regression of either the embryological superficial or deep ring and is reported to be exceedingly rare. We present a patient with this rare anatomical variant who was treated by endovascular technique in the clinical context of an acute oropharyngeal hemorrhage.
Large thrombus in non-atherosclerotic thoracic ascending aorta as the source of acute upper limb ischemia in a young cocaine user
Authors: Lojo-Lendoiro Sara , Calvin-Álvarez Pablo , Mosquera-Barreiro Marta
Published: November 2022

Objectives

We present the case of a young woman cocaine user without other cardiovascular risk factors attended to the emergency service presenting signs of acute arterial ischemia on the right arm.

Methods

An angio-CT of the upper limb was performed, highlighting the occlusion of the radial and ulnar arteries and in addition revealed a floating thrombus in the posterior wall of the aortic arch.

Results

The patient underwent urgent surgery with transhumeral thrombectomy and four days later, she underwent surgery to remove the aortic thrombus.

Conclusions

A floating thrombus in a non-atherosclerotic ascending aorta conditioning peripheral embolism with upper limbs ischemia is a very rare entity that has to be evaluated finding and treating the origin of the pathology.
Open-source automated insulin delivery systems and formal healthcare: A qualitative study of challenges in the interaction between service-users with type 1 diabetes and healthcare professionals
Authors: Raimond Linda H , O’Donnell Shane , Bøggild-Damkvist Tobias , Filges Tine , Lomborg Kirsten
Published: November 2022

Objectives

To explore the challenges that open-source automated insulin delivery systems pose to the encounter between service-users and healthcare professionals and how these challenges might be addressed in the future.

Methods

Five adult service-users and six healthcare professionals participated in semi-structured interviews. A six-step thematic analysis was conducted, the focus being on challenges and needs for improvement of the interactions.

Results

The analysis revealed three overarching challenges and wishes: (1) Lack of exchange of experiences. Service-users are reticent about disclosing their use of the systems to healthcare professionals. (2) Unclear ethical responsibility. Service-users are aware of their responsibility and guidelines can help to alleviate healthcare professional's legal responsibility; however, ambiguities around ethical responsibility for healthcare professionals remain an impediment to meaningful clinical interactions. (3) Unresolved individual and mutual expectations. Service-users expect better access to technology and focus on psychosocial aspects. In contrast, healthcare professionals fear the burden associated with the rising technical expectations.

Conclusion

Transparency and openness towards open-source systems need to be part of service-user and healthcare professionals interaction. Requirements for future care include improved knowledge about the systems, an openminded approach towards user-driven initiatives among healthcare professionals, and a focus on psychosocial aspects in the interaction.
Climate Change and Substance-Use Behaviors: A Risk-Pathways Framework
Authors: Vergunst Francis , Berry Helen L. , Minor Kelton , Chadi Nicholas
Published: November 2022

Climate change is undermining the mental and physical health of global populations, but the question of how it is affecting substance-use behaviors has not been systematically examined. In this narrative synthesis, we find that climate change could increase harmful substance use worldwide through at least five pathways: psychosocial stress arising from the destabilization of social, environmental, economic, and geopolitical support systems; increased rates of mental disorders; increased physical-health burden; incremental harmful changes to established behavior patterns; and worry about the dangers of unchecked climate change. These pathways could operate independently, additively, interactively, and cumulatively to increase substance-use vulnerability. Young people face disproportionate risks because of their high vulnerability to mental-health problems and substance-use disorders and greater number of life years ahead in which to be exposed to current and worsening climate change. We suggest that systems thinking and developmental life-course approaches provide practical frameworks for conceptualizing this relationship. Further conceptual, methodological, and empirical work is urgently needed to evaluate the nature and scope of this burden so that effective adaptive and preventive action can be taken.
Prebiotic Effects of Chinese Herbal Polysaccharides on NAFLD Amelioration: The Preclinical Progress
Authors: Jiang Li-Yan , Kan Yu-Na , Yu Zhi-Pu , Jian Bai-Yu , Yao Shu-Juan , Lv Li-Yan , Liu Ji-Cheng
Published: November 2022

Nonalcoholic fatty liver disease (NAFLD) is caused by fatty degeneration of liver cells, and there are currently no effective treatments. Numerous investigations have demonstrated that Chinese herbal medicines (CHMs) are effective against NAFLD. Polysaccharides (PS), the major components of most CHM, are primarily taken orally to be degraded and fermented by gut microbiota, which makes them a promising multivalent and multifunctional prebiotic candidate for NAFLD. In this review, the experimental evidence to prevent and treat NAFLD using the unique prebiotic effects of PS isolated from CHM are summarized to discuss additional treatment options for NAFLD.
Review of Herbal Medicines for the Treatment of Depression
Authors: Peng Siqi , Zhou Yalan , Lu Meng , Wang Qingzhong
Published: November 2022

Depression, a mental illness that is receiving increasing attention, is caused by multiple factors and genes and adversely affects social life and health. Several hypotheses have been proposed to clarify the pathogenesis of depression, and various synthetic antidepressants have been introduced to treat patients with depression. However, these drugs are effective only in a proportion of patients and fail to achieve complete remission. Recently, herbal medicines have received much attention as alternative treatments for depression because of their fewer side effects and lower costs. In this review, we have mainly focused on the herbal medicines that have been proven in clinical studies (especially randomized controlled trials and preclinical studies) to have antidepressant effects; we also describe the potential mechanisms of the antidepressant effects of those herbal medicines; the cellular and animal model of depression; and the development of novel drug delivery systems for herbal antidepressants. Finally, we objectively elaborate on the challenges of using herbal medicines as antidepressants and describe the benefits, adverse effects, and toxicity of these medicines.
Addition of trastuzumab emtansine (T-DM1) in a human epidermal growth factor receptor 2–overexpressed metastatic carcinoma of the gallbladder patient to enhance survival: A case study
Authors: Lavingia Viraj , Thummar Vipulkumar , Mehta Priya
Published: November 2022

Biliary tract cancers are clinically and genetically heterogeneous cancer type with a worst prognosis among gallbladder adenocarcinoma patients. Systemic therapeutic options for metastatic biliary tract cancers are fewer, and there are limited treatment choices for the patients who progress on first line apart from symptomatic treatment. Thus, a biomarker-guided personalized treatment approach needs to be explored among biliary tract cancer subtypes. We encountered a case of 53-year-old male patient with human epidermal growth factor receptor 2 (HER2, ERBB2) positive metastatic gallbladder cancer, treated with first-line gemcitabine and cisplatin combination–based chemotherapy along with trastuzumab followed by second-line treatment with mFOLFIRINOX. On progression in third line, treated with single agent ado-trastuzumab emtansine targeting human epidermal growth factor receptor 2 and got survival benefit of nearly 6 months. This is the first reported case from India that explored the possibility and impact of ado-trastuzumab emtansine in advanced gallbladder cancer after exhausting standard treatment options. It highlights the possibility of exploring ado-trastuzumab emtansine for treatment resilient, human epidermal growth factor receptor 2-positive and advanced gallbladder adenocarcinoma.
Open surgical treatment of superior vena cava syndrome due to invasive thymoma
Authors: Kawaida Taiki , Tanabe Hiroaki , Kotani Mitsuhisa , Kato Yuji , Toyama Masaaki , Nomori Hiroaki
Published: November 2022

Here we describe a case of open surgery for superior vena cava syndrome due to invasive thymoma. An 85-year-old woman presented with facial swelling and exertional dyspnea. Computed axial tomography revealed a thymoma in the mediastinum, extending to the superior vena cava, right atrium, and bilateral brachiocephalic veins. Endovascular therapy did not seem feasible because superior vena cava appeared totally occluded, and stenting could cause tumor embolism to the pulmonary arteries. Open surgery facilitated macroscopically complete and successful tumor resection. If long-term survival seems possible, open surgery could be a viable treatment option for superior vena cava syndrome that is ineligible for endovascular therapy.
Aortobronchial fistula after Bentall procedure treated with elective arch replacement: A case report
Authors: Mitsuishi Atsuyuki , Miura Yujiro , Yoshida Keisuke , Moriki Toshihiro , Katsumata Yoshifumi
Published: November 2022

Aortobronchial fistula often requires emergency surgery as it causes rapidly progressing respiratory failure. Some patients present with recurrent hemoptysis episodes. We report the case of a patient who was saved by elective surgery after aortobronchial fistula following aortic pseudoaneurysm rupture into the lung. An 84-year-old man, who had undergone mechanical Bentall replacement of the ascending aorta 20 years ago, complained of persistent fever. Computed tomography indicated a pseudoaneurysm at the distal anastomosis of the ascending aorta, and an urgent surgery was planned. During hospitalization, his aneurysm ruptured, suddenly penetrating the right lung and triggering acute respiratory failure and unconsciousness before the planned urgent operation. Mechanical ventilation was immediately provided; his respiratory status remarkably improved through intensive care and medical therapy. After nutritional status recovery, partial arch replacement was performed as an elective operation without any intervention for the injured lung. He did not exhibit any respiratory or neurological complications postoperatively.
Escitalopram-induced akathisia in a patient with major depressive disorder: A rare case report
Authors: Arshad Hareem , Sana Sana , Sajnani Pardeep Kumar , Owolabi Oluwasayo , Anand Ayush
Published: November 2022

Medication-induced akathisia is restlessness with excessive movements developing after initiation/ increasing or decreasing the dose of drugs. Herein, we reported the case of a 38-year-old widowed mother of two children, a known case of major depressive disorder and type 2 diabetes mellitus, who presented with akathisia for 1 month following the use of escitalopram. The patient scored 3 on the Barnes Akathisia Rating Scale global assessment. She was managed by decreasing the offending agent dose and adding clonazepam and propranolol. Her condition gradually improved, and she did not have akathisia by the end of 2 weeks. It is crucial to identify medication-induced akathisia as it is rare and associated with suicidality. Hence, a high index of clinical suspicion and adequate management are warranted.
Associations of clonal hematopoiesis with recurrent vascular events and death in patients with incident ischemic stroke
Authors: Arends Christopher M. , Liman Thomas G. , Strzelecka Paulina M. , Kufner Anna , Löwe Pelle , Huo Shufan , Stein Catarina M. , Piper Sophie K. , Tilgner Marlon , Sperber Pia S. , Dimitriou Savvina , Heuschmann Peter U. , Hablesreiter Raphael , Harms Christoph , Bullinger Lars , Weber Joachim E. , Endres Matthias , Damm Frederik
Published: November 2022

Clonal hematopoiesis (CH) is common among older people and is associated with an increased risk of atherosclerosis, inflammation, and shorter overall survival. Age and inflammation are major risk factors for ischemic stroke, yet the association of CH with risk of secondary vascular events and death is unknown. We investigated CH in peripheral blood DNA from 581 patients with first-ever ischemic stroke from the Prospective Cohort With Incident Stroke–Berlin study using error-corrected targeted sequencing. The primary composite end point (CEP) consisted of recurrent stroke, myocardial infarction, and all-cause mortality. A total of 348 somatic mutations with a variant allele frequency ≥1% were identified in 236 of 581 patients (41%). CH was associated with large-artery atherosclerosis stroke (P = .01) and white matter lesion (P < .001). CH-positive patients showed increased levels of proinflammatory cytokines, such as interleukin-6 (IL-6), interferon gamma, high-sensitivity C-reactive protein, and vascular cell adhesion molecule 1. CH-positive patients had a higher risk for the primary CEP (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.04-2.31; P = .03), which was more pronounced in patients with larger clones. CH clone size remained an independent risk factor (HR, 1.30; 95% CI, 1.04-1.62; P = .022) in multivariable Cox regression. Although our data show that, in particular, larger and TET2- or PPM1D-mutated clones are associated with increased risk of recurrent vascular events and death, this risk is partially mitigated by a common germline variant of the IL-6 receptor (IL-6R p.D358A). The CH mutation profile is accompanied by a proinflammatory profile, opening new avenues for preventive precision medicine approaches to resolve the self-perpetuating cycle of inflammation and clonal expansion.
Multi-objective optimization of particle gluing operating parameters in particleboard production based on improved machine learning algorithms
Authors: Zhang Beilong , Hua Jun , Cai Liping , Gao Yunbo , Li Yilin
Published: November 2022

Particle gluing operating parameters in particleboard (PB) production have an important influence on the mechanical properties of PBs. This study developed a multi-objective optimization model based on support vector regression (SVR) optimized by the non-dominated sorted genetic algorithm-II (NSGA2) to realize the multi-objective accurate prediction of PB mechanical properties (modulus of elasticity (MOE), modulus of rupture (MOR), and internal bonding (IB) strength) by adjusting particle gluing operating parameters. The NSGA2-SVR multi-objective prediction model was trained by 496 groups of experimental data of particle gluing operating parameters and PB mechanical properties. The prediction results of the NSGA2-SVR multi-objective prediction model were evaluated by 124 groups of experimental data and compared with the prediction results of the back propagation neural network (BPNN) model, general regression neural network (GRNN) model, and SVR model. The mean absolute percentage errors (MAPEs) of the NSGA2-SVR model were 49.11%, 33.64%, and 24.20% lower than that of the BPNN model, GRNN model, and SVR model, respectively. The Theil’s inequality coefficients (TICs) of the NSGA2-SVR model were 40.93%, 27.39%, and 18.58% lower than that of the BPNN model, GRNN model, and SVR model, respectively. The results showed that the multi-objective prediction model based on NSGA2-SVR has a superior fitting and higher prediction accuracy for the prediction performance of particle gluing operating parameters, and the NSGA2-SVR model can be applied to the multi-objective synchronous prediction of particle gluing operating parameters in the PB production line.
Multimorbidity and long-term disability and physical functioning decline in middle-aged and older Americans: an observational study
Authors: Aubert Carole E. , Kabeto Mohammed , Kumar Navasuja , Wei Melissa Y.
Published: November 2022

Background

Multimorbidity is highly prevalent and associated with several adverse health outcomes, including functional limitations. While maintaining physical functioning is relevant for all adults, identifying those with multimorbidity at risk for faster rates of physical functioning decline may help to target interventions to delay the onset and progression of disability. We quantified the association of multimorbidity with rates of long-term disability and objective physical functioning decline.

Methods

In the Health and Retirement Study, we computed the Multimorbidity-Weighted Index (MWI) by assigning previously validated weights (based on physical functioning) to each chronic condition. We used an adjusted negative binomial regression to assess the association of MWI with disability (measured by basic and instrumental activities of daily living [ADLs, IADLs]) over 16 years, and linear mixed effects models to assess the association of MWI with gait speed and grip strength over 8 years.

Results

Among 16,616 participants (mean age 67.3, SD 9.7 years; 57.8% women), each additional MWI point was associated with a 10% increase in incidence rate of disability (IRR: 1.10; 95%CI: 1.09, 1.10). In 2,748 participants with data on gait speed and grip strength, each additional MWI point was associated with a decline in gait speed of 0.004 m/s (95%CI: -0.006, -0.001). The association with grip strength was not statistically significant (-0.01 kg, 95%CI: -0.73, 0.04). The rate of decline increased with time for all outcomes, with a significant interaction between time and MWI for disability progression only.

Conclusion

Multimorbidity, as weighted on physical functioning, was associated with long-term disability, including faster rates of disability progression, and decline in gait speed. Given the importance of maintaining physical functioning and preserving functional independence, MWI is a readily available tool that can help identify adults to target early on for interventions.
TURN-IT: a novel turning intervention program to improve quality of turning in daily life in people with Parkinson’s disease
Authors: King LA , Carlson-Kuhta P , Wilhelm JL , Lapidus JA , Dale ML , Talman LS , Barlow N , Mancini M , Horak FB
Published: November 2022

Background

People with Parkinson’s disease (PD) have a high fall rate and many falls are associated with turns. Despite this, there is minimal research on effects of rehabilitation on the quality of turns. Further, quantifying turns in the home may have broader implications since rehabilitation of turns would ideally improve turning in real world mobility.

Methods

Sixty people with PD and a history of falls will be randomized to receive either a novel TURNing InTervention (TURN-IT) or no intervention (control group). The TURN-IT group will be seen for 6 weeks (18 visits) for an individualized, progressive program that is based on the specific constraints of turning in PD. Wearable sensors will be used to measure 7 days of mobility, including turns, before and after intervention or control period. In addition, blinded assessments of gait, mobility and turns will occur before and after intervention for both groups and falls will be monitored for twelve months post intervention with bimonthly email questionnaires.

Discussion

This study has the potential to change how we rehabilitate and assess turning in people with PD and falls. There are several novel aspects to our study including a comprehensive turning-focused intervention that is tailored to the underlying constraints that impair turning in people with PD. Further, our outcome measure of turning quality during 7 days of daily life is novel and has implications for determining real-life changes after rehabilitation. The ultimate goal of this rehabilitation intervention is to improve how patients turn in daily life and to reduce falls.

Trials registration

This protocol is registered at clinicaltrials.gov; #NCT04897256; https://clinicaltrials.gov/ct2/show/NCT04897256?term=Horak&cond=Parkinson+Disease&draw=2&rank=4.
Recurrent Guillain-Barré syndrome presenting as pharyngeal-cervical-brachial variant with three species of ganglioside antibodies:case report
Authors: Luan Haihui , Zhang Peng , Zhen Mingqing , Li Mei , Wang Xiaowei , Xu Jianghua
Published: November 2022

Background

Guillain-Barré syndrome (GBS) is generally considered to be monophasic, and recurrent GBS (RGBS) is very rare. Pharyngeal-cervical-brachial (PCB) is a less common variant of GBS. There have been no cases reported describing RGBS showing different phenotype presenting as PCB variant with three species of ganglioside antibodies.

Case presentation

 We report a case of a 77-year-old female patient with GT1a, GD1a and sulfatide-seropositive PCB-GBS after prior episode of AMAN-GBS 13 years ago. Our patient showed oropharyngeal and cervicobrachial weakness associated with areflexia in the upper limbs and partially improved after 5 days of IVIG and physiotherapy.

Conclusion

This study reports a rare case characterized as recurrent GBS after a long period, showing different phenotypes in different episodes with three different species of ganglioside antibodies. Further studies are required to obtain better understanding of RGBS and PCB variant.
Inhibitory effect of anti-Scg3 on corneal neovascularization: a preliminary study
Authors: Jin He , Yang Binbin , Jiang Dongdong , Ding Zhixiang , Xiong Yu , Zeng Xinsheng
Published: November 2022

Background

Corneal neovascularization (CNV) is an important disease that causes blindness. Secretogranin III (Scg3) has emerged as a new influencing factor of neovascularization. This study analyzed the Scg3 antibody’s inhibitory effect on CNV and and explored its preliminary mechanism.

Methods

Human umbilical vein endothelial cells (HUVECs) were treated with Scg3 and anti-Scg3. Cell proliferation, wound healing migration and tube formation assays were performed. Healthy adult New Zealand rabbits were randomly selected to be alkali burned and establish the corneal neovascularization (CNV) model. The rabbits were randomly divided into 3 groups (the high concentration group, low concentration group and control group). Different doses of anti-Scg3 and PBS were administered to the rabbits. Clinical examinations, immunostaining, quantitative real-time polymerase chain reaction (qPCR) and western blotting analyses were performed postoperatively.

Results

In the in vitro study, the Scg3 antibody mixture inhibited Scg3-induced endothelial cell proliferation and angiogenesis. In the in vivo study, significant CNV was observed in the control group. Confocal microscopy also revealed considerable active neovascularization in the control group. There was no obvious CNV growth in the high concentration group. Additionally, CD31, LYVE1 and CD45 expression was significantly inhibited after treatment with a high concentration of Scg3 antibody. The qPCR and western blotting analyses revealed that the levels of ERK in the low concentration group and high concentration group were higher than those in the control group at 7 days and 14 days. The levels of VEGF in the control group were significantly increased compared with those in the high concentration group. In all three groups, the levels of Akt were not significantly different at any time point.

Conclusion

The expression of Scg3 could affect the growth of HUVECs in vitro. Treatment with a high concentration (0.5 µg/mL) of Scg3 antibody reduced the inflammatory response and inhibited the growth of corneal neovascularization after corneal alkali burn injury in rabbits. The MEK/ERK pathway might play an important role in the inhibitory effect of anti-Scg3.
Examining bidirectional associations between perceived social support and psychological symptoms in the context of stressful event exposure: a prospective, longitudinal study
Authors: Thomas Sarah , Kanske Philipp , Schäfer Judith , Hummel Katrin Veronika , Trautmann Sebastian
Published: November 2022

Background

After stressful event exposure, higher perceived social support is a well-established correlate of decreased risk for psychological symptoms, including depressive, anxiety and posttraumatic stress (PTS) symptoms. However, longitudinal data on the direction of this association and the stability of perceived social support are scarce and have yielded mixed results, with a particular lack of prospective studies. We aimed to investigate changes in perceived social support and bidirectional associations between perceived social support and psychological symptoms in a prospective, longitudinal study.

Methods

A sample of German soldiers was assessed before and after deployment to Afghanistan. Group-based trajectory modelling was used to investigate the stability of perceived social support and to identify possible distinguishable trajectories of perceived social support. Bidirectional associations between perceived social support (general and workplace) and psychological symptoms (depressive, anxiety and PTS) were examined using gamma regressions.

Results

Average levels of perceived general social support did not change, while perceived workplace social support increased slightly (t(344) = 5.51,p < .001). There were no distinguishable trajectories of perceived social support. Higher perceived general (Mean ratio (MR) = 0.84, 95% CI = [0.74, 0.95]) and workplace social support (MR = 0.82, 95% CI = [0.72, 0.92]) predicted lower depressive symptoms, but not anxiety or PTS symptoms. Only higher PTS (MR = 0.95, 95% CI = [0.91, 0.99]) and higher depressive symptoms (MR = 0.96, 95% CI = [0.93, 0.99]) predicted lower perceived general social support.

Conclusions

Perceived social support can remain relatively stable under exposure to environmental stressors such as military deployment. Higher perceived social support could protect against depressive symptoms via a stress-buffering mechanism, while support may need to be more tailored to individual needs for a protection against PTS symptoms. Individuals with elevated depressive and PTS symptoms might have impaired abilities or opportunities to access social support after stressful event exposure. Future studies could investigate distressing social emotions and associated maladaptive social cognitions as possible mechanisms in the association between symptoms and lower perceived social support. Especially with respect to PTS symptoms, future studies could focus on conditions that enable individuals to benefit from social support.
Lyme borreliosis in Belgium: a cost-of-illness analysis
Authors: Geebelen Laurence , Devleesschauwer Brecht , Lernout Tinne , Tersago Katrien , Parmentier Yves , Van Oyen Herman , Speybroeck Niko , Beutels Philippe
Published: November 2022

Background

Lyme borreliosis (LB) is the most common tick-borne disease in Europe and North America, yet its economic burden remains largely unknown. This study aimed to estimate the economic cost associated with the different clinical manifestations of LB in Belgium.

Methods

An incidence approach and societal perspective were used to estimate the total cost-of-illness for LB in Belgium. Costs were calculated for patients with erythema migrans (EM) or disseminated/late LB, including patients who developed post-treatment Lyme disease syndrome (PTLDS). Direct medical, direct non-medical (transportation & paid help) and indirect non-medical costs (productivity losses) were included in the analysis. Ambulatory cost data were collected through a prospective cohort study from June 2016 to March 2020, in which patients with LB were followed up 6 to 12 months after diagnosis. Hospitalization costs were retrieved from the Minimal Clinical Data registry, a mandatory registry for all Belgian hospitals, linked to the Minimal Financial Data registry. Costs were expressed in 2019 euros.

Results

The total annual cost associated with clinical manifestations of LB in Belgium was estimated at €5.59 million (95% UI 3.82–7.98). Of these, €3.44 million (95% UI 2.05–5.48) or 62% was related to disseminated/late LB diagnoses and €2.15 million (95% UI 1.30–3.26) to EM. In general, direct medical costs and productivity losses accounted for 49.8% and 46.4% of the total costs, respectively, while direct non-medical costs accounted for only 3.8%. The estimated mean costs were €193 per EM patient and €5,148 per disseminated/late LB patient. While patients with PTLDS seemed to have somewhat higher costs compared to patients without PTLDS, the number of patients was too small to have representative estimates.

Conclusions

We estimate the total annual direct medical costs, direct non-medical and indirect non-medical costs associated with LB to exceed €5.5 million per year, almost evenly distributed between EM (40%) and disseminated/late LB (60%). EM costs 26 times less per patient but occurs also 16 times more frequently than disseminated/late LB. The cost burden remains limited by comparison to other infectious diseases due to the relative lower incidence.
Assessing core capacities for addressing public health emergencies of international concern at designated points of entry in cameroon during the COVID-19 Pandemic
Authors: Ndoungué Viviane Fossouo , Ngapagna Arouna Njayou , Kouadio Serge Agbo , Djinguebey Raoul , Gnigninanjouena Oumarou , Eyangoh Sara , Nguefack-Tsague Georges , Djeunga Hugues C. Nana , Njajou Omer
Published: November 2022

Background

Points of Entry (POEs) are at the frontline for prevention, detection and response to international spread of diseases. The objective of this assessment was to ascertain the current level of existing International Health Regulations (IHR) core capacities of designated airports, ports and ground crossings in Cameroon and identify critical gaps for capacity building for prevention, early warning and response to public health threats including COVID-19.

Methods

Data were collected from April to May 2020 in 5 designated POEs: Yaounde Nsimalen International Airport (YIA), Douala international Airport (DIA), Douala Autonomous Port (DAP), Garoua-Boulai ground crossing, Kye-Ossi ground crossing which were all selected for their high volume of passenger and goods traffic. The World Health Organization (WHO) assessment tool for core capacity requirements at designated airports, ports and ground crossings was used to collect data on three technical capacities: (i) communication and coordination, (ii) Capacities at all times and (iii) capacities to respond to Public Health Emergencies of International Concern (PHEIC).

Results

All the investigated POEs scored below 50% of capacities in place. YIA recorded the highest percentage for all groups of capacities, coordination and communication and for core capacity at all times with a percentage of 42%, 58% and 32% respectively. For core capacity to respond to PHEIC, all the POEs recorded below 50%. The DAP and all ground crossings lacked trained personnel for inspection of conveyances. Only DIA had a public health emergency plan. There is no isolation/quarantine and transport capacity at the POEs.

Conclusion

All POEs assessed did not meet IHR standards and need significant improvement to fulfill the IHR requirements. Unstructured communication channels between stakeholders make the implementation of IHR challenging. A coordination mechanism, with clear functions and structure, is necessary for well-coordinated response efforts to health emergencies at POEs. This assessment will serve as a baseline to inform planning and IHR implementation at designated POEs in Cameroon.
Psychological experience of Juvenile patients’ parents in Fangcang shelter hospital during the Omicron wave of COVID-19 pandemic in Shanghai, China: a qualitative study
Authors: Wu Hongmei , Liao Kexi , Yang Caidie , Zhou Nian , Dou Heng , Xu Zhi , Chu Lingling , Song Caiping , Luo Chunmei
Published: November 2022

Objective

To explore the psychological experience of Juvenile patient’s parents in Fangcang shelter hospital during the Omicron wave of COVID-19 pandemic.

Methods

A qualitative study was conducted by using a phenomenological research method. Sixteen parents of juvenile patients with COVID-19 were recruited from National Exhibition and Convention Center (Shanghai, China) Fangcang shelter hospital (FSH) using purposive sampling. Data were collected by face-to-face in-depth interviews over 27 days, from April 9 to May 6, 2022. The interview data were analyzed using Colaizzi seven-step analysis method.

Results

The psychological experiences of the parents of juvenile patients in the Fangcang shelter hospital were summarized into three themes: "perception regarding the FSH", "worried about the unmet needs of juvenile patients ", and "the psychological burden after discharge". These themes were classified into 9 sub-themes, including the acceptance of FSH, adaptability to FSH, concerns about cross-infection in the FSH, special needs of infants and young children, psychological needs of preschool children, the learning demands of school-age children, concern about re-positive, fear of sequelae, worry about social acceptance.

Conclusion

Juvenile patients and their parents in the Fangcang shelter hospitals have both positive and negative experiences. It is suggested that facilities for minors should be planned in advance. Humanistic care for adolescent patients and health education for the public are also critical.
Primary ovarian insufficiency quality of life scale (POIQOLS): development and psychometric properties
Authors: Golezar Samira , Keshavarz Zohreh , Ramezani Tehrani Fahimeh , Ebadi Abbas , Zayeri Farid , Golezar Mohammad Hossein
Published: November 2022

Background

Primary ovarian insufficiency is menopause before the age of 40. It can affect the quality of life of afflicted women. Because there is no instrument available for measuring the quality of life of these women, the present study was carried out to develop and assess the psychometric properties of the quality of life scale for women with primary ovarian insufficiency.

Methods

This exploratory sequential mixed method study was performed in two phases. In the qualitative phase (item generation), semi-structured in-depth interviews were conducted with 16 women having primary ovarian insufficiency, and a literature review was performed to generate initial items pool. In the quantitative phase (psychometric evaluation), the face, content, and construct validity (exploratory factor analysis), as well as reliability (internal consistency and test–retest methods), were evaluated. Besides, the responsiveness and interpretability were investigated.

Results

During the first phase of the study, the initial item pool was generated with 132 items. After the face and content validity, the number of items was reduced to 40. The results of exploratory factor analysis yielded a 28 item scale with six factors. These factors explained 58.55% of the total variance. The Cronbach’s alpha for each factor was more than 0.7. Furthermore, the intraclass correlation coefficient for the entire scale was 0.95.

Conclusions

The primary ovarian insufficiency quality of life scale (POIQOLS) is a valid and reliable tool for accessing the quality of life of women with primary ovarian insufficiency.