bluuebunny/crossref_metadata_2025 huggingface dataset:
Denosumab-induced hypocalcemia post bariatric surgery—a severe and protracted course: a case report
Authors: Awang Mohd Hazriq , Hatta Sharifah Faradila Wan Muhamad , Mohamad Aimi Fadilah , Ghani Rohana Abdul
Published: March 2023

Background

Denosumab is known to cause abnormalities in calcium homeostasis. Most of such cases have been described in patients with underlying chronic kidney disease or severe vitamin D deficiency. Previous bariatric surgery could also contribute to hypocalcemia and deterioration in bone health.

Case presentation

We present a case of a 61-year-old Malay female with worsening bilateral limb weakness, paresthesia, and severe carpopedal spasm a week after receiving subcutaneous denosumab for osteoporosis. She had a history of gastric bypass surgery 20 years ago. Post gastric bypass surgery, she was advised and initiated on lifelong calcium, vitamin D, and iron supplementations that she unfortunately stopped taking 5 years after surgery. Her last serum blood tests, prior to initiation on denosumab, were conducted in a different center, and she was told that she had a low calcium level; hence, she was advised to restart her vitamin and mineral supplements. Laboratory workup revealed severe hypocalcemia (adjusted serum calcium of 1.33 mmol/L) and mild hypophosphatemia (0.65 mmol/L), with normal magnesium and renal function. Electrocardiogram showed a prolonged QTc interval. She required four bolus courses of intravenous calcium gluconate, and three courses of continuous infusions due to retractable severe hypocalcemia (total of 29 vials of 10 mL of 10% calcium gluconate intravenously). In view of her low vitamin D level of 33 nmol/L, she was initiated on a loading dose of cholecalciferol of 50,000 IU per week for 8 weeks. However, despite a loading dose of cholecalciferol, multiple bolus courses, and infusions of calcium gluconate, her serum calcium hovered around only 1.8 mmol/L. After 8 days of continuous intravenous infusions of calcium gluconate, high doses of calcitriol 1.5 μg twice daily, and 1 g calcium carbonate three times daily, her serum calcium stabilized at approximately 2.0 mmol/L. She remained on these high doses for over 2 months, before they were gradually titrated down to ensure sustainability of a safe calcium level.

Conclusion

This case report highlights the importance of screening for risk factors for iatrogenic hypocalcemia and ensuring normal levels before initiating denosumab. The patient history of bariatric surgery could have worsened the hypocalcemia, resulting in a more severe presentation and protracted response to oral calcium and vitamin D supplementation.
The non-destructive investigation of a late antique knob bow fibula (Bügelknopffibel) from Kaiseraugst/CH using Muon Induced X-ray Emission (MIXE)
Authors: Biswas Sayani , Megatli-Niebel Isabel , Raselli Lilian , Simke Ronald , Cocolios Thomas Elias , Deokar Nilesh , Elender Matthias , Gerchow Lars , Hess Herbert , Khasanov Rustem , Knecht Andreas , Luetkens Hubertus , Ninomiya Kazuhiko , Papa Angela , Prokscha Thomas , Reiter Peter , Sato Akira , Severijns Nathal , Shiroka Toni , Seidlitz Michael , Vogiatzi Stergiani Marina , Wang Chennan , Wauters Frederik , Warr Nigel , Amato Alex
Published: March 2023

A knob bow fibula (Bügelknopffibel) of the Leutkirch type, which typologically belongs to the second half of the 4th and early 5th century CE, was excavated in 2018 in the Roman city of Augusta Raurica, present-day Kaiseraugst (AG, Switzerland). This was analyzed for the first time for its elemental composition by using the non-destructive technique of Muon Induced X-ray Emission (MIXE) in the continuous muon beam facility at the Paul Scherrer Institute (PSI). In the present work, the detection limit is 0.4 wt% with

$$\sim$$

∼

1.5 hours of measurement time. The fibula was measured at six different positions, at a depth of 0.3–0.4 mm inside the material. The experimental results show that the fibula is made of bronze, containing the main elements copper (Cu), zinc (Zn), tin (Sn) and lead (Pb). The compositional similarities/differences between different parts of the fibula reveal that it was manufactured as two “workpieces”. One workpiece consists of the knob (13.0±0.6 wt% Pb), bow (11.9±0.4 wt% Pb) and foot (12.5 ± 0.9 wt% Pb). These show a higher Pb content, suggesting a cast bronze. The spiral (3.2 ± 0.2 wt% Pb), which is part of the other workpiece, has a comparatively lower Pb content, suggesting a forged bronze.
Effects of additives containing a novel strain on the fermentation characteristics, structural carbohydrates, and α-tocopherol content of rice straw and corn stover silages
Authors: Wu Qifeng , Xiao Yu , Shao Tao , Zong Cheng , Li Mao , Liu Qinhua
Published: March 2023

A novel α-tocopherol-producing bacteria strain was isolated and identified as Bacillus tequilensis QH1 (QH1). The effects of QH1 strain inoculation alone (QH), combined with cell wall degradation enzyme (QC), or Lactiplantibacillus plantarum subsp. plantarum YM3 and cell wall degradation enzyme (QLC) as the additives on the fermentation characteristics, structural carbohydrates, and α-tocopherol content of rice straw and corn stover silages were investigated, and without additives as the control (CON), in 4 replicates. After silages were kept in a laboratory cabinet (26–34 ℃) and the dark for 42 d, experimental silos (polyethylene plastic bags) were opened for analysis. The results exhibited that the control and additives-treated rice straw and corn stover were ensiled well, indicated by high lactic acid content and little butyric acid content. The QH and QC degraded structural carbohydrates, demonstrated by lower (P < 0.001) neutral detergent fiber (NDF) and acid detergent fiber (ADF) than the control, but did not enhance lactic acid fermentation, evidenced by lower (P < 0.001) lactic acid content in QH-treated silages compared with the control silages. The effect of QLC on degrading structural carbohydrates was influenced by material factors, evidenced by no role in decreasing the contents of NDF and ADF in rice straw silage and a good role in decreasing the contents of NDF and ADF in corn stover silage. However, the water-soluble carbohydrate (WSC) contents in both rice straw and corn stover silages were increased (P < 0.001) by QLC compared with the control. The control and additives-treated silages had much higher (P < 0.001) α-tocopherol content and lower (P < 0.001) chlorophyll content compared with the material before ensiling. Compared with the control, higher α-tocopherol content was found in QH-treated rice straw (P = 0.071) and corn stover silages (P < 0.05), and QLC-treated corn stover silage (P < 0.05). Therefore, the QH1 strain had the potential to be applied in rice straw silage production, and QLC was recommended to be applied in corn stover silage production.

Graphical Abstract
Secretory expression of β-1,3-glucomannanase in the oleaginous yeast Rhodosporidium toruloides for improved lipid extraction
Authors: Liang Shiyu , Zhang Yue , Lyu Liting , Wang Shuang , Zhao Zongbao K.
Published: March 2023

Lipids produced by oleaginous yeasts are considered as sustainable sources for the production of biofuels and oleochemicals. The red yeast Rhodosporidium toruloides can accumulate lipids to over 70% of its dry cell mass. To facilitate lipid extraction, a recombinant β-1,3-glucomannanase, MAN5C, has been applied to partially breakdown R. toruloides cell wall. In this study, R. toruloides NP11 was engineered for secretory expression of MAN5C to simplify the lipid extraction process. Specifically, a cassette contained a codon-optimized gene MAN5C was integrated into the genome of R. toruloides by Agrobacterium-mediated transformation. The engineered strain NP11-MAN5C was found with proper expression and secretion of active MAN5C, yet no notable compromise in terms of cell growth and lipid production. When NP11-MAN5C cell cultures were extracted with ethyl acetate without any pretreatment, 20% of total lipids were recovered, 4.3-fold higher than that of the parental strain NP11. When the cells were heat-treated followed by extraction with ethyl acetate in the presence of the culture broth supernatants, up to 93% of total lipids were recovered, confirming beneficial effects of MAN5C produced in situ. This study provides a new strategy to engineer oleaginous yeasts for more viable lipid extraction and down-stream processes.

Graphical Abstract
Study of wastewater treatment for freshwater production in a solar desalination unit
Authors: Baghizade Alireza , Farahbod Farshad , Alizadeh Omid
Published: March 2023

While desalination of water is energy intensive, traditional use of fossil fuels makes it not only costly, but also unsustainable and environmentally unfriendly; utilization of solar energy for desalination is therefore highly encouraged. This paper presents a study on the technical performance of a solar desalination unit located in Tehran city. The process is modeled using standard energy equations and performance indices are defined. The model simulation results are compared with experimental data from laboratory tests. This study observed that there is good agreement between the experimental data and the model simulation results. It is observed that the maximum solar radiation intensity is found in June and the highest evaporation rate in this month is about $$5\times {10}^{-3}\,{\mathrm{m}}^{3}$$

5
×

10

-
3

m

3

. It is found that the treatment efficacy of the plant decreases with increasing depth of wastewater. Performance of the desalination unit is found to be satisfactory.
Extracellular vesicles derived from mesenchymal stem cells — a novel therapeutic tool in infectious diseases
Authors: Manzoor Tasaduq , Saleem Afnan , Farooq Nida , Dar Lateef Ahmad , Nazir Junaid , Saleem Sahar , Ismail Sameena , Gugjoo Mudasir Bashir , Shiekh Parvaiz A. , Ahmad Syed Mudasir
Published: March 2023

Extracellular vesicles (EVs) are nano-sized lipid-bilayer encapsulated vesicles produced by the cells. These EVs are released into the surrounding space by almost all cell types. The EVs help in intercellular communication via their payloads which contain various proteins, lipids, and nucleic acids generated from the donor cells and allow for synergistic responses in surrounding cells. In recent years, EVs have been increasingly important in treating infectious diseases, including respiratory tract infections, urinary tract infections, wound infections, sepsis, and intestinal infections. Studies have confirmed the therapeutic value of mesenchymal stem cell-derived EVs (MSC-EVs) for treating infectious diseases to eliminate the pathogen, modulate the resistance, and restore tissue damage in infectious diseases. This can be achieved by producing antimicrobial substances, inhibiting pathogen multiplication, and activating macrophage phagocytic activity. Pathogen compounds can be diffused by inserting them into EVs produced and secreted by host cells or by secreting them as microbial cells producing EVs carrying signalling molecules and DNA shielding infected pathogens from immune attack. EVs play a key role in infectious pathogenesis and hold great promise for developing innovative treatments. In this review, we discuss the role of MSC-EVs in treating various infectious diseases.
A novel collapse prediction index for voltage stability analysis and contingency ranking in power systems
Authors: Mokred Salah , Wang Yifei , Chen Tiancong
Published: March 2023

Voltage instability is a serious phenomenon that can occur in a power system because of critical or stressed conditions. To prevent voltage collapse caused by such instability, accurate voltage collapse prediction is necessary for power system planning and operation. This paper proposes a novel collapse prediction index (NCPI) to assess the voltage stability conditions of the power system and the critical conditions of lines. The effectiveness and applicability of the proposed index are investigated on the IEEE 30-bus and IEEE 118-bus systems and compared with the well-known existing indices (Lmn, FVSI, LQP, NLSI, and VSLI) under several power system operations to validate its practicability and versatility. The study also presents the sensitivity assumptions of existing indices and analyzes their impact on voltage collapse prediction. The application results under intensive case studies prove that the proposed index NCPI adapts to several operating power conditions. The results show the superiority of the proposed index in accurately estimating the maximum load-ability and predicting the critical lines, weak buses, and weak areas in medium and large networks during various power load operations and contingencies. A line interruption or generation unit outage in a power system can also lead to voltage collapse, and this is a contingency in the power system. Line and generation unit outage contingencies are examined to identify the lines and generators that significantly impact system stability in the event of an outage. The contingencies are also ranked to identify the most severe outages that significantly cause voltage collapse because of the outage of line or generator.
Simulation of a ground-mounted prism in ABL flow using LES: on overview of error metrics and distribution
Authors: Xing Jin
Published: March 2023

The accuracy of wind loading predictions using Large Eddy Simulation (LES) is usually influenced by numerous model parameters, which can influence the obtained results. The validation of numerical simulations with traditional Wind Tunnel Test (WTT) is still an important task, necessary to increase our a priori knowledge of possible inaccuracies and set up mitigation strategies. In this study, LES is used to simulate the wind fields around an isolated model high-rise building, under seven wind attack angles and validated with WTT results. The influence of various settings and parameters on the model performance is studied. For the angle of attack showing higher inaccuracy, different mesh refinement strategies and turbulence models are tested. Results indicate that LES can accurately predict the mean and local maxima of the pressure coefficients for both perpendicular and skew wind attack angles, as well as reproduce global forces and their envelopes with very good accuracy. Conversely, pronounced errors are found in the prediction of the pressure coefficient standard deviation and the local minima. The highest deviations between LES and WTT are found close to the leading edge in correspondence of flow separations which are observed in WTT and not in LES for skew flows. The addition of boundary layer cells and the use of different subgrid models have very limited effectiveness in modifying the obtained results for the analysed case.
Antimicrobials in polymethylmethacrylate: from prevention to prosthetic joint infection treatment: basic principles and risk of resistance
Authors: Sabater-Martos Marta , Verdejo Miguel A. , Morata Laura , Muñoz-Mahamud Ernesto , Guerra-Farfan Ernesto , Martinez-Pastor Juan C. , Soriano Alex
Published: March 2023

Background

Excellent revisions about antibiotic-loaded bone cement (ALBC) have been recently published. In the present article, we review the principles and limitations of local antibiotic delivery in the context of recent advances in the pathogenesis of prosthetic joint infections (PJI), with particular attention paid to the potential association between ALBC and antimicrobial resistance.

Main body

Recalcitrance of PJI is related to the ability of pathogens to adapt to particular environments present in bone tissue and protect themselves from host immunity in different ways. Accordingly, delivery of high local antimicrobial concentrations using ALBC is needed. Most relevant clinical data showing the efficacy of ALBC for PJI prophylaxis and treatment are reviewed, and we dissected the limitations on the basis of the recent findings from animal models and suggested that aminoglycosides, in particular, could not be the best option. One of the major concerns associated with ALBC is the emergence of resistance because of theoretical prolonged exposure to low antibiotic concentrations. We summarize the mechanisms for the selection of resistant microorganisms, and we critically reviewed the evidence from animal models and clinical data from observational and registry studies and concluded that there is no evidence to support this association.

Conclusion

While waiting for better evidence from well-designed clinical trials, ALBC shows a beneficial effect as a prophylaxis in arthroplasty, and to avoid the colonization of spacers used for two-stage revision in patients with PJI. Experimental models and clinical evidence suggest the need to achieve high local antimicrobial concentrations to obtain the highest prophylactic and therapeutic effect. The current evidence does not support the risk of increasing resistance with use of ALBC. In the future, it is necessary to evaluate new carriers and different antimicrobials to improve clinical outcomes.
Single-stage revision for chronic periprosthetic joint infection after knee and hip arthroplasties: indications and treatments
Authors: Mu Wenbo , Ji Baochao , Cao Li
Published: March 2023

Single-stage revision for chronic periprosthetic joint infection has been introduced 40 years ago. This option is gaining more and more attention as well as popularity. It is a reliable treatment for the chronic periprosthetic joint infection after knee and hip arthroplasties when implemented by an experienced multi-disciplinary team. However, its indications and corresponding treatments remain controversial. This review focused on the indications and specific treatments related to the option, with an attempt to help surgeons to use this method with more favorable outcomes.
Personalised psychotherapy in primary care: evaluation of data-driven treatment allocation to cognitive–behavioural therapy versus counselling for depression
Authors: Bauer-Staeb Clarissa , Griffith Emma , Faraway Julian J. , Button Katherine S.
Published: March 2023

Background

Various effective psychotherapies exist for the treatment of depression; however, only approximately half of patients recover after treatment. In efforts to improve clinical outcomes, research has focused on personalised psychotherapy – an attempt to match patients to treatments they are most likely to respond to.

Aim

The present research aimed to evaluate the benefit of a data-driven model to support clinical decision-making in differential treatment allocation to cognitive–behavioural therapy versus counselling for depression.

Method

The present analysis used electronic healthcare records from primary care psychological therapy services for patients receiving cognitive–behavioural therapy (n = 14 544) and counselling for depression (n = 4725). A linear regression with baseline sociodemographic and clinical characteristics was used to differentially predict post-treatment Patient Health Questionnaire (PHQ-9) scores between the two treatments. The benefit of differential prescription was evaluated in a held-out validation sample.

Results

On average, patients who received their model-indicated optimal treatment saw a greater improvement (by 1.78 PHQ-9 points). This translated into 4–10% more patients achieving clinically meaningful changes. However, for individual patients, the estimated differences in benefits of treatments were small and rarely met the threshold for minimal clinically important differences.

Conclusion

Precision prescription of psychotherapy based on sociodemographic and clinical characteristics is unlikely to produce large benefits for individual patients. However, the benefits may be meaningful from an aggregate public health perspective when applied at scale.
Louis IX and the Triumphal Cross of Constantine
Authors: Gaposchkin M. Cecilia
Published: March 2023

This article examines the material and ideological meaning of the three relics of the True Cross acquired by Louis IX in 1241 and 1242, which were venerated, along with the Crown of Thorns, in the Sainte-Chapelle, as part of the broader project of building Capetian sacral kingship in the High Middle Ages. Although cross relics flooded Western Christendom after 1204, these three relics, acquired directly from the Byzantine emperor, were specifically associated with Constantine and Heraclius and their historic military victories against enemies of Christian empire. The article identifies one of the three relics, known to contemporaries as the crux triumphalis in Latin and the croix de victoire in French, which Byzantine emperors were said to have carried into battle, as a relic that Louis IX then brought with him on his crusade of 1249–50 to Egypt, in hopes of martialing its historic power against the infidel in battle.
Sertoli cells are the source of stem cell factor for spermatogenesis
Authors: Peng Yi Jacky , Tang Xinyu Thomas , Shu Hui Sophie , Dong Wenjie , Shao Hongfang , Zhou Bo O.
Published: March 2023

Several cell types have been proposed to create the required microenvironment for spermatogenesis. However, expression patterns of the key growth factors produced by these somatic cells have not been systematically studied and no such factor has been conditionally deleted from its primary source(s), raising the question of which cell type(s) are the physiological sources of these growth factors. Here, using single-cell RNA sequencing and a series of fluorescent reporter mice, we found that stem cell factor (Scf), one of the essential growth factors for spermatogenesis, was broadly expressed in testicular stromal cells, including Sertoli, endothelial, Leydig, smooth muscle and Tcf21-CreER+ stromal cells. Both undifferentiated and differentiating spermatogonia were associated with Scf-expressing Sertoli cells in the seminiferous tubule. Conditional deletion of Scf from Sertoli cells, but not any other Scf-expressing cells, blocked the differentiation of spermatogonia, leading to complete male infertility. Conditional overexpression of Scf in Sertoli cells, but not endothelial cells, significantly increased spermatogenesis. Our data reveal the importance of anatomical localization for Sertoli cells in regulating spermatogenesis and that SCF produced specifically by Sertoli cells is essential for spermatogenesis.
A Drosophila chemical screen reveals synergistic effect of MEK and DGKα inhibition in Ras-driven cancer
Authors: La Marca John E. , Ely Robert W. , Diepstraten Sarah T. , Burke Peter , Kelly Gemma L. , Humbert Patrick O. , Richardson Helena E.
Published: March 2023

Elevated Ras signalling is highly prevalent in human cancer; however, targeting Ras-driven cancers with Ras pathway inhibitors often leads to undesirable side effects and to drug resistance. Thus, identifying compounds that synergise with Ras pathway inhibitors would enable lower doses of the Ras pathway inhibitors to be used and also decrease the acquisition of drug resistance. Here, in a specialised chemical screen using a Drosophila model of Ras-driven cancer, we have identified compounds that reduce tumour size by synergising with sub-therapeutic doses of the Ras pathway inhibitor trametinib, which targets MEK, the mitogen-activated protein kinase kinase, in this pathway. Analysis of one of the hits, ritanserin, and related compounds revealed that diacyl glycerol kinase α (DGKα, Dgk in Drosophila) was the critical target required for synergism with trametinib. Human epithelial cells harbouring the H-RAS oncogene and knockdown of the cell polarity gene SCRIB were also sensitive to treatment with trametinib and DGKα inhibitors. Mechanistically, DGKα inhibition synergises with trametinib by increasing the P38 stress-response signalling pathway in H-RASG12V SCRIBRNAi cells, which could lead to cell quiescence. Our results reveal that targeting Ras-driven human cancers with Ras pathway and DGKα inhibitors should be an effective combination drug therapy.
StARD9 is a novel lysosomal kinesin required for membrane tubulation, cholesterol transport and Purkinje cell survival
Authors: Sterling Felicity R. , D'Amico Jon , Brumfield Alexandria M. , Huegel Kara L. , Vaughan Patricia S. , Morris Kathryn , Schwarz Shelby , Joyce Michelle V. , Boggess Bill , Champion Matthew M. , Maciuba Kevin , Allen Philip , Marasco Eric , Koch Grant , Gonzalez Peter , Hodges Shannon , Leahy Shannon , Gerstbauer Erica , Hinchcliffe Edward H. , Vaughan Kevin T.
Published: March 2023

The pathological accumulation of cholesterol is a signature feature of Niemann–Pick type C (NPC) disease, in which excessive lipid levels induce Purkinje cell death in the cerebellum. NPC1 encodes a lysosomal cholesterol-binding protein, and mutations in NPC1 drive cholesterol accumulation in late endosomes and lysosomes (LE/Ls). However, the fundamental role of NPC proteins in LE/L cholesterol transport remains unclear. Here, we demonstrate that NPC1 mutations impair the projection of cholesterol-containing membrane tubules from the surface of LE/Ls. A proteomic survey of purified LE/Ls identified StARD9 as a novel lysosomal kinesin responsible for LE/L tubulation. StARD9 contains an N-terminal kinesin domain, a C-terminal StART domain, and a dileucine signal shared with other lysosome-associated membrane proteins. Depletion of StARD9 disrupts LE/L tubulation, paralyzes bidirectional LE/L motility and induces accumulation of cholesterol in LE/Ls. Finally, a novel StARD9 knock-out mouse recapitulates the progressive loss of Purkinje cells in the cerebellum. Together, these studies identify StARD9 as a microtubule motor protein responsible for LE/L tubulation and provide support for a novel model of LE/L cholesterol transport that becomes impaired in NPC disease.
The influence of nutrients on the increased risk of developing endometriosis
Authors: Zwierzyńska Anna , Gruszka Jakub , Adamczyk-Gruszka Olga
Published: March 2023

Diet and nutrition are fundamental to women's health. This condition is affected by both deficiencies and excesses of nutrients. Nutrition affects gene expression, susceptibility to disease through various mechanisms. It affects the expression of genes by changing them, and also affects various diseases, including endometriosis. This disease is quite common and often has a negative impact on women's quality of life.
Simulation and objective structured clinical examination in learning to manage eclampsia in Morocco
Authors: Changuiti Omaima , Benfatah Mohamed , Marfak Abdelghafour , Mochhoury Latifa , Chebabe Milouda , Saad Elmadani , Hilali Abderraouf , Youlyouz-Marfak Ibtissam
Published: March 2023

Background/Aims

Eclampsia is a major cause of maternal mortality worldwide. Simulation is an innovative pedagogical method to teach eclampsia management, while objective structured clinical examinations are effective in assessing midwifery students’ clinical skills. This study’s aim was to determine the impact of simulation and objective structured clinical examinations in teaching eclampsia management, and explore students’ satisfaction and self‑confidence. Methods This repeated measures study involved 31 second year midwifery students who participated in an objective structured clinical examination before and after a simulation on eclampsia management, and evaluated their experience using the National League for Nursing student satisfaction and self‑confidence learning scale.

Results

The mean post‑simulation score was significantly higher than pre‑simulation (P<0.001). The students showed significantly high levels of satisfaction.

Conclusions

Joining simulation and objective structured clinical examinations is effective in teaching and assessing student midwives on the management of eclampsia.
Culture, traditional beliefs and practices during pregnancy among the Madurese tribe in Indonesia
Authors: Rachmayanti Riris Diana , Diana Rian , Anwar Faisal , Khomsan Ali , Riyadi Hadi , Christianti Dyan Fajar , Kusuma Rendra , Siswantara Pulung , Muthmainnah Muthmainnah , Bayumi Febrianti Qisti Arrum , Riswari Aninditya Ardhana
Published: March 2023

Background

Understanding cultural context is crucial to providing respectful maternity care. This study’s aim was to explore pregnancy culture, beliefs and traditions among the Madurese tribe of Indonesia.

Methods

This qualitative study was conducted in the Sumenep district. In-depth interviews and focus group discussions were held with 67 key informants: pregnant women, their family members, traditional birth attendants, and community, religious and traditional/indigenous leaders.

Results

The practices included fourth-and seventh-month rituals, pregnancy massage and behavioural taboos and suggestions. Conclusions Most Madurese tribe practices are harmless. Healthcare providers must appreciate and integrate prevailing traditional beliefs and practices with other efforts to reduce maternal mortality.
An everyday hero
Authors: Dixon Tiegan
Published: March 2023

Tiegan Dixon is an apprentice at Bupa Dental Care High Lane, who has just been awarded Trainee of the Year at Bupa’s annual Everyday Hero awards.
Finding your balance
Authors: Williams Amber
Published: March 2023

Amber Williams outlines how dental nurses can achieve that elusive balance between work and life at home.
Changes at work
Authors: Colson Alec
Published: March 2023

Alec Colson breaks down the intricacies of flexible working legislation.
Equitable, sustainable and acceptable long-term care in Malawi? Unpacking the implied universalism of key terms in international ageing policy discourse
Authors: Freeman Emily
Published: March 2023

Indications of a care deficit for older adults in Africa and the need for long-term care that is acceptable for recipients and providers is well established, as are calls for its format to be ‘home-grown’. However, there is a discrepancy between the desire for evidenced African solutions, and the framing of both the problem and possible solutions derived from the Global North. This article draws on qualitative data from men and women needing and providing care in rural southern Malawi to challenge the implied universalism of the key terms of reference in the African long-term care discourse: ‘care’ and ‘family’.
Reduction of converging distance change in an aquatic display formed with aerial imaging by retro-reflection in conjugated optical structure
Authors: Kudo Daiki , Yasugi Masaki , Ninomiya Nao , Suyama Shiro , Yamamoto Hirotsugu
Published: March 2023

This paper proposes an optical system for aquatic display that shows an image in water. The aquatic image is formed by utilizing aerial imaging by retro-reflection, which converges light by a retro-reflector and a beam splitter. Refraction on intersection between air and another material causes spherical aberration, which changes light-converging distance. In order to reduce the converging distance change, the light-source component is filled with water so that the optical system becomes conjugate including the medium. We analyzed converging of light in water by simulations. Furthermore, we have confirmed effectiveness of conjugated optical structure experimentally by use of a prototype.
Laser written mirror profiles for open-access fiber Fabry-Perot microcavities
Authors: Hessenauer Jannis , Weber Ksenia , Benedikter Julia , Gissibl Timo , Höfer Johannes , Giessen Harald , Hunger David
Published: March 2023

We demonstrate laser-written concave hemispherical structures produced on the endfacets of optical fibers that serve as mirror substrates for tunable open-access microcavities. We achieve finesse values of up to 200, and a mostly constant performance across the entire stability range. This enables cavity operation also close to the stability limit, where a peak quality factor of 1.5 × 104 is reached. Together with a small mode waist of 2.3 µm, the cavity achieves a Purcell factor of C ∼ 2.5, which is useful for experiments that require good lateral optical access or otherwise large separation of the mirrors. Laser-written mirror profiles can be produced with a tremendous flexibility in shape and on various surfaces, opening new possibilities for microcavities.
Two-photon 3D printed spring-based Fabry–Pérot cavity resonator for acoustic wave detection and imaging
Authors: Wei Heming , Wu Zhangli , Sun Kexuan , Zhang Haiyan , Wang Chen , Wang Kemin , Yang Tian , Pang Fufei , Zhang Xiaobei , Wang Tingyun , Krishnaswamy Sridhar
Published: March 2023

Optical fiber microresonators have attracted considerable interest for acoustic detection because of their compact size and high optical quality. Here, we have proposed, designed, and fabricated a spring-based Fabry–Pérot cavity microresonator for highly sensitive acoustic detection. We observed two resonator vibration modes: one relating to the spring vibration state and the other determined by the point-clamped circular plate vibration mode. We found that the vibration modes can be coupled and optimized by changing the structure size. The proposed resonator is directly 3D printed on an optical fiber tip through two-photon polymerization and is used for acoustic detection and imaging. The experiments show that the device exhibits a high sensitivity and low noise equivalent acoustic signal level of 2.39  mPa/Hz1/2 at 75 kHz that can detect weak acoustic waves, which can be used for underwater object imaging. The results demonstrate that the proposed work has great potential in acoustic detection and biomedical imaging applications.
Electromagnetically induced transparency-like effect in a lithium niobate resonator via electronic control
Authors: Yang Liu , Zhuang Yongyong , Zhang Yifan , Zhang Yaojing , Zhang Shuangyou , Xu Zhuo , Del’Haye Pascal , Wei Xiaoyong
Published: March 2023

In this study, we theoretically proposed a method to achieve an electromagnetically induced transparency (EIT)-like effect in a whispering gallery mode resonator (WGMR) and experimentally validated the method in a lithium niobate (LN) device. Benefitting from the electro-optic and inverse piezoelectric effects of the LN material, two modes of the LN WGMR that are close in frequency can be tuned at different tuning rates, resulting in EIT-like resonance lineshapes. By varying the electric field applied to the LN WGMR, the full dynamic of the EIT-like phenomenon can be precisely controlled. The experimental results agreed well with the calculations based on the coupled mode theory. Moreover, we observed a hysteresis resulting from the photorefractive effect of LN. We believe our proposed method and demonstrated devices offer a way to control an EIT-like effect, which could have potential applications in light storage, quantum information processing, and enhanced sensing techniques.
Personality variation is eroded by simple social behaviours in collective foragers
Authors: Rands Sean A. , Ioannou Christos C.
Published: March 2023

The movement of groups can be heavily influenced by ‘leader’ individuals who differ from the others in some way. A major source of differences between individuals is the repeatability and consistency of their behaviour, commonly considered as their ‘personality’, which can influence both position within a group as well as the tendency to lead. However, links between personality and behaviour may also depend upon the immediate social environment of the individual; individuals who behave consistently in one way when alone may not express the same behaviour socially, when they may be conforming with the behaviour of others. Experimental evidence shows that personality differences can be eroded in social situations, but there is currently a lack of theory to identify the conditions where we would expect personality to be suppressed. Here, we develop a simple individual-based framework considering a small group of individuals with differing tendencies to perform risky behaviours when travelling away from a safe home site towards a foraging site, and compare the group behaviours when the individuals follow differing rules for aggregation behaviour determining how much attention they pay to the actions of their fellow group-members. We find that if individuals pay attention to the other members of the group, the group will tend to remain at the safe site for longer, but then travel faster towards the foraging site. This demonstrates that simple social behaviours can result in the repression of consistent inter-individual differences in behaviour, giving the first theoretical consideration of the social mechanisms behind personality suppression.
Fluctuations in chromatin state at regulatory loci occur spontaneously under relaxed selection and are associated with epigenetically inherited variation in C. elegans gene expression
Authors: Wilson Rachel , Le Bourgeois Maxime , Perez Marcos , Sarkies Peter
Published: March 2023

Some epigenetic information can be transmitted between generations without changes in the underlying DNA sequence. Changes in epigenetic regulators, termed epimutations, can occur spontaneously and be propagated in populations in a manner reminiscent of DNA mutations. Small RNA-based epimutations occur in C. elegans and persist for around 3–5 generations on average. Here, we explored whether chromatin states also undergo spontaneous change and whether this could be a potential alternative mechanism for transgenerational inheritance of gene expression changes. We compared the chromatin and gene expression profiles at matched time points from three independent lineages of C. elegans propagated at minimal population size. Spontaneous changes in chromatin occurred in around 1% of regulatory regions each generation. Some were heritable epimutations and were significantly enriched for heritable changes in expression of nearby protein-coding genes. Most chromatin-based epimutations were short-lived but a subset had longer duration. Genes subject to long-lived epimutations were enriched for multiple components of xenobiotic response pathways. This points to a possible role for epimutations in adaptation to environmental stressors.
Factors influencing the use of multiple HIV prevention services among transport workers in a city in southwestern Uganda
Authors: Betunga Benjamin , Atuhaire Phionah , Nakasiita Catherine , Kanyamuneza Christa , Namiiro Proscovia , Tugume Joseph , Hairat Matovu , Sarki Ahmed M. , Mugabi Benedicto , Lilian Birungi , Mugisha Richard , Kumakech Edward , Asiimwe John Baptist
Published: March 2023

The use of multiple HIV prevention services has been found to decrease the risk of acquiring HIV when tailored to individuals at risk of HIV exposure, including transport workers. Therefore, we assessed the uptake of multiple HIV prevention services (≥2) and associated factors among transport workers in a city in Southwestern Uganda. This cross-sectional study comprised motorcycle taxi riders, motor vehicle and truck drivers, aged 18 to 55 years who were selected and responded to an interviewer-administered questionnaire, between November 2021 and February 2022. Data was analyzed using descriptive statistical and modified Poisson regression analyses. Out of 420 participants, 97.6% were male, with a median age of 28 years and the majority were aged <34 years (84.6%). Overall, less than half (45.3%) of the participants had used multiple (≥2) HIV prevention services within a one-year period. Many participants had used condoms (32.2%) followed by voluntary HIV counseling and testing (27.1%), and safe male circumcision (17.3%). Most participants who tested for HIV had ever used condoms (16.2%), followed by those who received safe male circumcision and had ever used condoms (15%), and those who tested for HIV and had started on antiretroviral therapy (ART) (9.1%). In the adjusted model, factors that were significantly associated with the use of multiple HIV prevention services included religion (aPR = 1.25, 95% CI = 1.05–1.49), the number of concurrent sex partners (aPR = 1.33, 95% CI = 1.10–1.61), prior HIV testing and awareness of HIV serostatus (aPR = 0.55, 95% CI = 0.43–0.70), awareness of HIV prevention services (aPR = 2.49, 95% CI = 1.16–5.38), and financial payment to access HIV services (aPR = 2.27, 95% CI = 1.47–3.49). In conclusion, the uptake of multiple HIV prevention services among transport workers remains suboptimal. Additionally, individual behavioral factors influence the use of multiple HIV services compared with other factors. Therefore, differentiated strategies are needed to increase the utilization of HIV prevention services among transport workers.
Quality of care for postpartum hemorrhage: A direct observation study in referral hospitals in Kenya
Authors: Clarke-Deelder Emma , Opondo Kennedy , Achieng Emmaculate , Garg Lorraine , Han Dan , Henry Junita , Guha Moytrayee , Lightbourne Alicia , Makin Jennifer , Miller Nora , Otieno Brenda , Borovac-Pinheiro Anderson , Suarez-Rebling Daniela , Menzies Nicolas A. , Burke Thomas , Oguttu Monica , McConnell Margaret , Cohen Jessica
Published: March 2023

Postpartum hemorrhage (PPH) is the leading cause of maternal mortality in Kenya. The aim of this study was to measure quality and timeliness of care for PPH in a sample of deliveries in referral hospitals in Kenya. We conducted direct observations of 907 vaginal deliveries in three Kenyan hospitals from October 2018 through February 2019, observing the care women received from admission for labor and delivery through hospital discharge. We identified cases of “suspected PPH”, defined as cases in which providers indicated suspicion of and/or took an action to manage abnormal bleeding. We measured adherence to World Health Organization and Kenyan guidelines for PPH risk assessment, prevention, identification, and management and the timeliness of care in each domain. The rate of suspected PPH among the observed vaginal deliveries was 9% (95% Confidence Interval: 7% - 11%). Health care providers followed all guidelines for PPH risk assessment in 7% (5% - 10%) of observed deliveries and all guidelines for PPH prevention in 4% (3% - 6%) of observed deliveries. Lowest adherence was observed for taking vital signs and for timely administration of a prophylactic uterotonic. Providers did not follow guidelines for postpartum monitoring in any of the observed deliveries. When suspected PPH occurred, providers performed all recommended actions in 23% (6% - 40%) of cases. Many of the critical actions for suspected PPH were performed in a timely manner, but, in some cases, substantial delays were observed. In conclusion, we found significant gaps in the quality of risk assessment, prevention, identification, and management of PPH after vaginal deliveries in referral hospitals in Kenya. Efforts to reduce maternal morbidity and mortality from PPH should emphasize improvements in the quality of care, with a particular focus on postpartum monitoring and timely emergency response.
Michigan men’s diabetes project II: Protocol for peer-led diabetes self-management education and long-term support in Black men
Authors: Hawkins Jaclynn , Sengupta Srijani , Kloss Katherine , Kurnick Katie , Ewen Alana , Nwawkwo Robin , Funnell Martha , Mitchell Jamie , Jones Lenette , Piatt Gretchen
Published: March 2023

Previous literature has indicated that Black men are twice as likely to develop type 2 diabetes compared to their non-Hispanic White counterparts and are also more likely to have associated complications. Furthermore, Black men have lower access to quality health care, and masculinity norms have been shown to hinder them from seeking the limited care that is available. In this study, we aim to investigate the effect of peer-led diabetes self-management education and long-term ongoing support on glycemic management. The first phase of our study will consist of modification of existing diabetes education content to be more appropriate for the population of interest, Then, in the second phase, we will conduct a randomized controlled trial to test the intervention. Participants randomized to the intervention arm will receive diabetes self-management education, structured diabetes self-management support, and a more flexible ongoing support period. Participants randomized to the control arm will receive diabetes self-management education. Diabetes self-management education will be taught by certified diabetes care and education specialists, while the diabetes self-management support and ongoing support period will be facilitated by fellow Black men with diabetes who will be trained in group facilitation, patient-provider communication strategies, and empowerment techniques. The third phase of this study will consist of post-intervention interviews and dissemination of findings to the academic community. The primary goal of our study is to determine whether long-term peer-led support groups in conjunction with diabetes self-management education are a promising solution to improve self-management behaviors and decrease A1C levels. We will also evaluate the retention of participants throughout the study, which has historically been an issue in clinical studies focused on the Black male population. Finally, the results from this trial will determine whether we can proceed to a fully-powered R01 trial or if other modifications of the intervention are necessary.

Trial registration: Registered at ClinicalTrials.gov with an ID of NCT05370781 on May 12, 2022.
Expanded characterization of in vitro polarized M0, M1, and M2 human monocyte-derived macrophages: Bioenergetic and secreted mediator profiles
Authors: Hickman Elise , Smyth Timothy , Cobos-Uribe Catalina , Immormino Robert , Rebuli Meghan E. , Moran Timothy , Alexis Neil E. , Jaspers Ilona
Published: March 2023

Respiratory macrophage subpopulations exhibit unique phenotypes depending on their location within the respiratory tract, posing a challenge to in vitro macrophage model systems. Soluble mediator secretion, surface marker expression, gene signatures, and phagocytosis are among the characteristics that are typically independently measured to phenotype these cells. Bioenergetics is emerging as a key central regulator of macrophage function and phenotype but is often not included in the characterization of human monocyte-derived macrophage (hMDM) models. The objective of this study was to expand the phenotype characterization of naïve hMDMs, and their M1 and M2 subsets by measuring cellular bioenergetic outcomes and including an expanded cytokine profile. Known markers of M0, M1 and M2 phenotypes were also measured and integrated into the phenotype characterization. Peripheral blood monocytes from healthy volunteers were differentiated into hMDM and polarized with either IFN-γ + LPS (M1) or IL-4 (M2). As expected, our M0, M1, and M2 hMDMs exhibited cell surface marker, phagocytosis, and gene expression profiles indicative of their different phenotypes. M2 hMDMs however were uniquely characterized and different from M1 hMDMs by being preferentially dependent on oxidativte phosphorylation for their ATP generation and by secreting a distinct cluster of soluble mediators (MCP4, MDC, and TARC). In contrast, M1 hMDMs secreted prototypic pro-inflammatory cytokines (MCP1, eotaxin, eotaxin-3, IL12p70, IL-1α, IL15, TNF-β, IL-6, TNF-α, IL12p40, IL-13, and IL-2), but demonstrated a relatively constitutively heightened bioenergetic state, and relied on glycolysis for ATP generation. These data are similar to the bioenergetic profiles we previously observed in vivo in sputum (M1) and BAL (M2)-derived macrophages in healthy volunteers, supporting the notion that polarized hMDMs can provide an acceptable in vitro model to study specific human respiratory macrophage subtypes.