bluuebunny/crossref_metadata_2025 huggingface dataset:
Habits and Routines of Adults in Early Recovery From Substance Use Disorder: Clinical and Research Implications From a Mixed Methodology Exploratory Study
Authors: Kitzinger Robert H , Gardner Jennifer A , Moran Mariann , Celkos Carly , Fasano Nicole , Linares Eric , Muthee Joyce , Royzner Gabby
Published: February 2023

The purpose of this exploratory, non-experimental mixed methods study was to analyze the habits and routines of adults in early recovery (>3 months) from substance use disorder (SUD). Participants (N = 14) were recruited from an intensive outpatient treatment (IOP) program for substance use disorders. Data collection consisted of a demographic survey, a researcher developed Daily Occupational Questionnaire (DOQ), and follow-up semi-structured interviews with 5 randomly selected participants. Quantitative results indicate rest as the most frequently engaged in activity on the most busy (31.0%) and least busy day (36.6%). There was no significant difference, t(13) = 0.117, P = .909, between newly established activities on the most busy and least busy day. Qualitative themes included 1. The most difficult time of day is often related to patterns of unused time. 2. When there is a lack of structure or unoccupied time, they return to their previously established positive supports. 3. There is a need for consistency and structure for developing anticipated/perceived routines. Implications for all healthcare and clinical providers working with this population, as well as research suggestions, are outlined.
Interferon-gamma Mediated Metabolic Pathways in Hospitalized Patients During Acute and Reconvalescent COVID-19
Authors: Gietl Mario , Burkert Francesco , Seiwald Stefanie , Böhm Anna , Hofer Stefanie , Gostner Johanna M , Piater Talia , Geisler Simon , Weiss Guenter , Loeffler-Ragg Judith , Sonnweber Thomas , Tancevski Ivan , Pizzini Alex , Sahanic Sabina , Fuchs Dietmar , Bellmann-Weiler Rosa , Kurz Katharina
Published: February 2023

Background:

Fatigue, sleep disturbance, and neurological symptoms during and after COVID-19 are common and might be associated with inflammation-induced changes in tryptophan (Trp) and phenylalanine (Phe) metabolism.

Aim:

This pilot study investigated interferon gamma inducible biochemical pathways (namely Trp catabolism, neopterin, tyrosine [Tyr], and nitrite formation) during acute COVID-19 and reconvalescence.

Patients and methods:

Thirty one patients with moderate to severe COVID-19 admitted to the University Hospital of Innsbruck in early 2020 (March-May) were followed up. Neurotransmitter precursors Trp, Phe, Tyr as well as kynurenine (Kyn), neopterin, nitrite, and routine laboratory parameters were analyzed during acute infection and at a follow-up (FU) 60 days thereafter. Clinical symptoms of patients (neurological symptoms, fatigue, sleep disturbance) were recorded and associations with concentrations of laboratory parameters investigated.

Results and conclusion:

Almost half of the patients suffered from neurological symptoms (48.4%), the majority of patients experienced sleep difficulties (56.7%) during acute COVID-19. Fatigue was present in nearly all patients. C-reactive protein (CRP), interleukin-6 (IL-6), neopterin, Kyn, Phe concentrations were significantly increased, and Trp levels depleted during acute COVID-19. Patients with sleep impairment and neurological symptoms during acute illness presented with increased CRP and IL-6 concentrations, Trp levels were lower in patients with sleep disturbance. In general, inflammatory markers declined during reconvalescence. A high percentage of patients suffered from persistent symptoms at FU (neurological symptoms: 17.2%, fatigue: 51.7%, sleeping disturbance: 34.5%) and had higher CRP concentrations. Nitrite and Phe levels were lower in patients with sleeping difficulties at FU and Kyn/Trp ratio, as indicator of IDO activity, was significantly lower in patients with neurological symptoms compared to patients without them at FU. In summary, inflammation induced alterations of amino acid metabolism might be related to acute and persisting symptoms of COVID-19.
Tribological behaviour of polycarbonate urethane against Ti-6Al-4V for long-term resilient
Authors: Jacob Daniel Glad Stephen , Muniyandi Prakash
Published: February 2023

Polycarbonate urethane has gained popularity as a bearing material to replace the existing hard polymeric materials in artificial joints. However, the viability of using polycarbonate urethane in artificial disc replacement over its metal counterpart is the challenge addressed in this research work. The present study is carried out to find the tribological behaviour of polycarbonate urethane against Ti-6Al-4V, which is the most frequently used endplate material in artificial disc replacement. The wear test is performed in pin-on-disc tribometer under lubricated condition using Hank's balanced salt solution with the variation in load as 10, 15, and 20 N, speed as 0.31, 0.63, and 0.94 m/s, and the number of cycles being 10,000, 25,000, and 50,000. A long-term wear evaluation is carried out to find the wear behaviour of polycarbonate urethane against Ti-6Al-4V. The wear is measured based on gravimetric analysis, and microscopic images are taken to analyze the wear pattern. The multi-objective optimization is also carried out to study the effect of control parameters. The wear pattern reveals that polycarbonate urethane has good tribological behaviour against Ti-6Al-4V. As the number of cycles increases, the polycarbonate urethane worn surfaces were found to be smooth. These results indicate that the polycarbonate urethane exhibits good resilience even after prolonged use.
Gendering the carceral web: Public sector reform, technology and digital (in)justice
Authors: Birkett Gemma
Published: February 2023

The UK government's Transforming Our Justice System agenda represents an emerging system of penal governance. Its cumulative impact, manifested through the mainstreaming of virtual hearings, a system of automatic online convictions and the Single Justice Procedure is a story yet to tell, with the potential impact on marginalised women simply a footnote. Such women, well-documented victims of the legal aid cuts as well as the digital divide, must comply with and negotiate the requirements of the carceral web alone. Pursuance of the reforms, representing the next instalment in the neo-liberal justice agenda, exposes another example of life at the penal–welfare nexus. This precarious territory has burgeoned since government-imposed austerity, with implications for self-criminalisation, net-widening and social justice. Reforms couched in the language of ‘efficiency’ and ‘common sense’ are likely to run in direct opposition to what marginalised women might need (or respond well to) and may jeopardise official reductionist strategies.
Feasibility and usability of a personalized mHealth app for self-management in the first year following breast cancer surgery
Authors: Lim Ji Young , Kim Yoon , Yeo Seung Mi , Chae Byung Joo , Yu Jonghan , Hwang Ji Hye
Published: February 2023

This study investigated the feasibility and usability of a personalized mobile health (mHealth) app for self-management during the year following breast cancer surgery. Twenty-nine participants were instructed to use an app and smart band immediately after discharge. Only 18 completed the study. Their perceived necessity and satisfaction for main domains and app were assessed at 1, 2, 4, 6, 9, and 12 months. A self-reporting questionnaire assessed usability at 12 months. Consequently, retention rate as measures of feasibility showed a mean of 75.8%. Exercise and diet management were the most accessed app domains. Perceived necessity was higher than satisfaction. The mean usability score was 80.2. Most participants found the app useful and effective as a delivery for healthcare. Further, 94% of them were willing to pay for and recommend it. Thus, mHealth app can help breast cancer patients improve their healthy behaviors and healthcare further. This study provides insights for designing long-term randomized controlled trials using mHealth interventions.
Evaluating the impact of lifelong education on older adults: A case study from Hong Kong
Authors: Law Vincent TS , Yee Hilary HL , Ng Tommy KC , Fong Ben YF
Published: February 2023

In light of its low fertility rate and long life span, Hong Kong is facing the challenge of a rapidly ageing population. To foster successful ageing, learning throughout life regardless of age is promoted as lifelong learning. A total of 20 older adults who are studying the Diploma in Active Ageing at the School of Professional Education and Executive Development of The Hong Kong Polytechnic University participated in a questionnaire survey while 16 older adult students participated in individual in-depth interviews in the present study. The results show that those who have received both informal and formal learning opportunities experienced positive changes to their physical, psychological and social health. The participants reported that the current lifelong learning policy provides insufficient financial support and insufficient promotion of formal education for older adults. For older adults to pursue further education, there is a need to provide more generous subsidies and relax age eligibility restrictions. To sustain lifelong learning, both informal and formal education for older adults should be promoted equally in order to meet the diverse interests and ability of older learners.
The inherent fruits of educational endeavour
Authors: Hogan Pádraig
Published: February 2023

This contribution begins by reviewing a widespread inherited idea in Western civilisations: that education is an undertaking to be controlled, at least in all essentials, by some superior body; not by educational practitioners. As a subordinate practice then, and depending on the political, religious or ideological colour of the controlling body’s outlook, education may be called upon to serve widely different purposes, often conflicting ones. Against this historical pattern I propose the notion of education not as a subordinate practice but as a practice in its own right, with demands that arise from its own inherent purposes. Despite being overshadowed by institutionalised forces in the history of Western education, the philosophical ancestry of education as a practice in its own right is robust and energetic. It reaches back beyond Plato and Aristotle to the example of Socrates, specifically the practical Socrates captured in the early dialogues of Plato. In supporting the case for education as a practice in its own right, I will explore the kinds of experience that lie at the heart of the practice and the character of the kinds of fruit that flow from it. These features distinguish education from other practices and from deficient forms of educational practice itself. Arising from this exploration, an analysis will be carried out of the capabilities and relationships that constitute educational practice, as the particular kind of practice that it is.
Professed Democracy Support and Openness to Politically Congenial Authoritarian Actions Within the American Public
Authors: Malka Ariel , Costello Thomas H.
Published: February 2023

Elites degrade democracy in part because of incentives that arise from public opinion. We report pre-registered and exploratory tests of which Americans are most likely to support democracy-degrading action, focusing on three distinct democracy attitudes assessed in a large demographically representative sample 5 weeks before the 2020 election. Professed opposition to democracy was relatively rare and most common among citizens who felt disengaged with politics. But a different pattern of findings emerged for attitudes toward (1) flagrant, politically congenial authoritarian policy action and (2) election subversion framed with a pro-democracy justification. These anti-democratic attitudes were relatively common, related to cultural conservatism among both Republicans and Democrats, and – consistent with an “involved-but-ignorant” hypothesis – highest among those who combined strong political interest with low political sophistication. We recommend an increased focus on attitudes toward flagrant, contextualized, and politically cued authoritarian actions, including actions framed in pro-democracy terms.
Cultivating Qualitative Researchers: Lessons Learned During a Pandemic
Authors: Parsons Cristina C. , Hehn Matthew T. , Loudenback Andrea J. , Burke Hannah K. , Fox Aimee L. , Spratt Laura M. , Brazile Mollie , Alarawi Rana , Zarestky Jill
Published: February 2023

Under the best of circumstances, learning to conduct qualitative research is challenging, both intellectually and emotionally. Engaging in such learning in difficult situations, such as a global pandemic, may heighten challenges while creating opportunities for truly deep learning. The purpose of this paper is to provide methodological insights to guide the growth of new qualitative researchers and inform the design of introductory methods courses based on the learning experiences of a group of graduate students conducting their first qualitative research projects. We present students’ experiences with choosing and planning a project, navigating relationships with study participants, and conducting observations and interviews. Explicit connections to qualitative methodology are offered for every stage of student research engagement. An analysis of the student authors’ experiences highlights the associated learning and innovation necessary to adapt to adversity when conducting qualitative research. Advancements in research reciprocity and human connection are presented, as experienced by the student authors. We conclude with implications and insights for teaching and learning qualitative research and ethical considerations that transcend pandemic circumstances. It is the intent of this manuscript to support the development of deep reflexive practice for new qualitative researchers, effective instructional approaches for those who teach research methods, and an insight into the power of diverse student researchers learning new skills together for the global research community.
Resolvin D1 attenuates mechanical allodynia after burn injury: Involvement of spinal glia, p38 mitogen-activated protein kinase, and brain-derived neurotrophic factor/tropomyosin-related kinase B signaling
Authors: Zhao Xiaona , Li Xinxin , Guo Huiling , Liu Panmei , Ma Minyu , Wang Yanping
Published: February 2023

Resolvin D1 (RvD1) suppresses inflammatory, postoperative, and neuropathic pain. The present study assessed the roles and mechanisms of RvD1 in mechanical allodynia after burn injury. A rat model of burn injury was established for analyses, and RvD1 was injected intraperitoneally. Pain behavior and the expression levels of spinal dorsal horn Iba-1 (microglia marker), GFAP (astrocyte marker), p-p38 mitogen-activated protein kinase (MAPK), brain-derived neurotrophic factor (BDNF), and tropomyosin-related kinase B (TrkB) were detected by behavioral and immunocytochemical assays. The results showed that RvD1 attenuated mechanical allodynia after burn injury, prevented microglial and astroglial activation, and downregulated p-p38 MAPK in microglia and BDNF/TrkB following burn injury. Similarly, inhibition of p38 MAPK and BDNF/TrkB signaling attenuated mechanical allodynia after burn injury. In addition, inhibition of p38 MAPK prevented spinal microglial activation and downregulated BDNF/TrkB following burn injury. Furthermore, inhibition of BDNF/TrkB signaling prevented spinal microglial activation and downregulated p-p38 MAPK within spinal microglia. Taken together, this study demonstrated that RvD1 might attenuate mechanical allodynia after burn injury by inhibiting spinal cord glial activation, microglial p38 MAPK, and BDNF/TrkB signaling in the spinal dorsal horn.
Bedside naso-jejunal placement is more difficult, but successful in patients with COVID-19 in critical care: A retrospective service evaluation of a dietitian-led service
Authors: Phillips Mary E , Zekavica Jessica , Kumar Rajesh , Lahiri Rajiv , Kirk-Bayley Justin , Patel Amish , Frampton Adam E
Published: February 2023

The COVID-19 pandemic presented clinical and logistical challenges in the delivery of adequate nutrition in the critical care setting. The use of neuromuscular-blocking drugs, presence of maxilla-facial oedema, strict infection control procedures, and patients placed in a prone position complicated feeding tube placement. We audited the outcomes of dietitian-led naso-jejunal tube (NJT) insertions using the IRIS® (Kangaroo, USA) device, before and during the COVID-19 pandemic. NJT placement was successful in 78% of all cases ( n = 50), and 87% of COVID-19 cases. Anaesthetic support was only required in COVID-19 patients (53%). NJT placement using IRIS was more difficult but achievable in patients with COVID-19.
Is social capital higher in areas with a higher density of historic assets? Analyses of 11,112 adults living in England
Authors: Mak HW , Gallou E , Fancourt D
Published: February 2023

Aims:

Previous evidence suggests that engagement with heritage such as visiting heritage sites provides benefits for people’s mental and social wellbeing, and helps to establish social capital. However, far less is known about whether living in areas of historic built environment also helps build social capital. Furthermore, it remains unclear how the association between historic built environment and social capital may vary across heritage engagement frequency and areas of deprivation levels. This study was therefore designed to explore the cross-sectional relationship between historic built environment and social capital.

Methods:

Analysis was based on three datasets: Understanding Society: The UK Household Longitudinal Study Waves 5 (2013/2015) and 6 (2014/2016), 2019 National Heritage List for England, and 2015 English Index of Multiple Deprivation (IMD). Ordinary least squares (OLS) regressions were applied to estimate the relationships between historic built environment (listed buildings, scheduled monuments, and registered parks and gardens) and social capital (personal relationships, social network support, civic engagement, and trust and cooperative norms).

Results:

We found that people living in places with greater historic built environment experienced higher levels of personal relationships, social network support, and civic engagement. However, these associations were attenuated once rurality was adjusted. Individuals living in areas of greater levels of historic built environment displayed higher levels of trust and cooperative norms, even after adjusting for all relevant covariates. Heritage engagement frequency was found to moderate the association between historic built environment and personal relationships. Similarly, IMD was also found to moderate the association between historic built environment and trust and cooperative norms.

Conclusion:

These findings highlight the importance of neighbourhood environment in building social capital in communities. Particularly, areas with heritage assets may provide both socially inviting and aesthetically pleasing environments that could help strengthen community and restore pride in place.
Objective Photoanalysis of Feminizing Frontal Cranioplasty Outcomes
Authors: David Abel P. , House Adrian E. , Targ Sonia , DeBusk W. Taylor , Park Andrea , Knott P. Daniel , Seth Rahul
Published: February 2023

Study Design

Retrospective analysis at a tertiary care center.

Objective

This study describes a method of analyzing postoperative results using lateral view clinical photographs to create normalized projection ratios of the glabella and radix.

Methods

We reviewed preoperative and postoperative photographs of 15 patients. All photographs were in the lateral view Frankfort horizontal plane. We calculated the distances between the (a) tragus and cornea, (b) cornea and radix, (c) cornea and glabella, and the (θ) nasofrontal angle.

Results

Fifteen sets of patient photographs were analyzed and found that there was a favorable 14% reduction at the radix and an even greater reduction (78.9%) at the glabella. The nasofrontal angle was improved to a more feminine range from 131.84° preoperatively to 145.86° postoperatively.

Conclusions

Normalized projection ratios of the glabella and radix, along with the nasofrontal angle, can be used to objectively measure outcomes of frontal feminizing cranioplasty.
Resting metabolic rate in healthy Singaporeans: Performance of the Harris-Benedict equation and a new predictive model
Authors: Tan Natalie Filipa Mei Xuan , Tham Kwang Wei , Ho Chun Keong Eric , Ng Cindy Li Whye
Published: February 2023

Background

Prediction equations for resting metabolic rate (RMR) are valuable in managing patients’ weight; however, no accurate equation exists for Singaporeans.

Objective

To develop and cross-validate a predictive regression equation for RMR in Singaporeans, using indirect calorimetry as the reference method.

Methods

104 healthy Singaporeans (34.3 ± 12.2 years) participated, comprising 34 men and 70 women. Anthropometric measurements and demographics information were obtained from participants. RMR was measured via indirect calorimetry (TrueOne 2400 system). Stepwise regression analysis was used to develop the most parsimonious predictive equation. Performance of the equation was evaluated using ordinary least products (OLP) regression and Bland–Altman analysis, whilst internal cross-validation was performed by use of the predicted residual sum of squares (PRESS) method. To compare the new equation with existing ones, the performance of the Harris-Benedict equation was also evaluated.

Results

The best predictive equation takes the form RMR(kcal) = 918 + 16.5(weight)-135.7(gender) - 1152(Waist-to-height-ratio) +0.014(International Physical Activity Questionnaire Score), where gender = 1 (female) or 0 (male). OLP regression revealed no systematic bias for the new equation. Bland–Altman analysis showed that its total (systematic and random) error was 212 kcal. Internal model validation using the PRESS method revealed minimal reduction in predictive accuracy. In contrast, OLP regression showed a significant pattern of over-prediction by the Harris-Benedict equation (y-intercept = −280 kcal; 95%CI, −100 to −461 kcal).

Conclusions

Our new equation outperformed the Harris-Benedict equation in accurately predicting RMR in Singaporeans. Comprising easily obtained anthropometric and self-reported measures, we envisage its potential relevance in clinical and epidemiological settings.
AES-CSFS: an automatic evaluation system for corneal sodium fluorescein staining based on deep learning
Authors: Wang Shaopan , He Jiezhou , He Xin , Liu Yuwen , Lin Xiang , Xu Changsheng , Zhu Linfangzi , Kang Jie , Wang Yuqian , Li Yong , Guo Shujia , Zhang Yunuo , Luo Zhiming , Liu Zuguo
Published: February 2023

Background:

Corneal fluorescein sodium staining is a valuable diagnostic method for various ocular surface diseases. However, the examination results are highly dependent on the subjective experience of ophthalmologists.

Objectives:

To develop an artificial intelligence system based on deep learning to provide an accurate quantitative assessment of sodium fluorescein staining score and the size of cornea epithelial patchy defect.

Design:

A prospective study.

Methods:

We proposed an artificial intelligence system for automatically evaluating corneal staining scores and accurately measuring patchy corneal epithelial defects based on corneal fluorescein sodium staining images. The design incorporates two segmentation models and a classification model to forecast and assess the stained images. Meanwhile, we compare the evaluation findings from the system with ophthalmologists with varying expertise.

Results:

For the segmentation task of cornea boundary and cornea epithelial patchy defect area, our proposed method can achieve the performance of dice similarity coefficient (DSC) is 0.98/0.97 and Hausdorff distance (HD) is 3.60/8.39, respectively, when compared with the manually labeled gold standard. This method significantly outperforms the four leading algorithms (Unet, Unet++, Swin-Unet, and TransUnet). For the classification task, our algorithm achieves the best performance in accuracy, recall, and F1-score, which are 91.2%, 78.6%, and 79.2%, respectively. The performance of our developed system exceeds seven different approaches (Inception, ShuffleNet, Xception, EfficientNet_B7, DenseNet, ResNet, and VIT) in classification tasks. In addition, three ophthalmologists were selected to rate corneal staining images. The results showed that the performance of our artificial intelligence system significantly outperformed the junior doctors.

Conclusion:

The system offers a promising automated assessment method for corneal fluorescein staining, decreasing incorrect evaluations caused by ophthalmologists’ subjective variance and limited knowledge.
Understanding the Current Landscape of Kidney Disease in Canada to Advance Precision Medicine Guided Personalized Care
Authors: Kitzler Thomas M. , Chun Justin
Published: February 2023

Purpose of Review:

To understand the impact of kidney disease in Canada and the priority areas of kidney research that can benefit from patient-oriented, precision medicine research using novel technologies.

Sources of Information:

Information was collected through discussions between health care professionals, researchers, and patient partners. Literature was compiled using search engines (PubMed, PubMed central, Medline, and Google) and data from the Canadian Organ Replacement Register.

Methods:

We reviewed the impact, prevalence, economic burden, causes of kidney disease, and priority research areas in Canada. After reviewing the priority areas for kidney research, potential avenues for future research that can integrate precision medicine initiatives for patient-oriented research were outlined.

Key Findings:

Chronic kidney disease (CKD) remains among the top causes of morbidity and mortality in the world and exerts a large financial strain on the health care system. Despite the increasing number of people with CKD, funding for basic kidney research continues to trail behind other diseases. Current funding strategies favor existing clinical treatment and patient educational strategies. The identification of genetic factors for various forms of kidney disease in the adult and pediatric populations provides mechanistic insight into disease pathogenesis. Allocation of resources and funding toward existing high-yield personalized research initiatives have the potential to significantly affect patient-oriented research outcomes but will be difficult due to a constant decline of funding for kidney research.

Limitations:

This is an overview primarily focused on Canadian-specific literature rather than a comprehensive systematic review of the literature. The scope of our findings and conclusions may not be applicable to health care systems in other countries.
Molecular detection of feline hemoplasmas and retroviruses in free-roaming and shelter cats within a university campus
Authors: Yamakawa Ana Carolina , Haisi Amanda , Kmetiuk Louise Bach , Pellizzaro Maysa , Mendes Juliana Cristina Rebonato , Canavessi Aurea Maria Oliveira , Ullmann Leila Sabrina , de Castro Wagner Antônio Chiba , Pessoa Araújo Júnior João , Santos Andrea Pires dos , Biondo Alexander Welker
Published: February 2023

Objectives

The aim of the present study was to assess the frequency of hemoplasma, feline immunodeficiency virus (FIV) and feline leukemia virus (FeLV) infections in cats living in an on-campus shelter and free-roaming cats within a university campus in Brazil.

Methods

Blood samples were tested using quantitative PCR for hemoplasma, FIV and FeLV. Positive hemoplasma samples were sequenced. Associations between hemoplasma detection and living situation, sex, flea and/or tick parasitism, and coinfection with FIV and FeLV, were assessed using Fisher’s exact test and the respective odds ratios were calculated.

Results

Overall, 6/45 (13.3%) cats tested positive: four (8.9%) were infected with ‘ Candidatus Mycoplasma haemominutum’ and two (4.4%) with Mycoplasma haemofelis. All positive samples were from free-roaming cats (6/15; 40.0%) and had statistically significantly lower packed cell volumes ( P = 0.037). Although 5/23 (21.7%) males and 1/22 (4.6%) females were positive, no statistically significant association between sex and hemoplasma infection was found ( P = 0.19). Viral quantitative PCR (qPCR) was performed on 43/45 samples, among which 2/43 (4.7%) were positive for FIV and none for FeLV. Only one cat (2.3%) was coinfected with hemoplasma and FIV ( P = 0.26). In addition, 4/6 (66.7%) cats that tested positive for hemoplasmas were infested by fleas ( P = 0.0014) and/or ticks ( P = 0.25).

Conclusions and relevance

These results show that even if the free-roaming cat population is clinically healthy and has adequate access to food, it may present flea infestation and hemoplasma infection with lower packed cell volume values.
Regorafenib-Induced Radiation Recall Presenting as Acute Blood Loss Anemia With Rectal Bleeding and Severe Proctitis
Authors: Urella Madhulika , Shenouda Mina , Pacioles Toni
Published: February 2023

Radiation recall is a rare inflammatory reaction that occurs in an area that was subjected to prior irradiation that is usually triggered by certain drugs or chemotherapy agents. This reaction is drug-specific for each individual and occurs in about 6% to 9% of the patients receiving chemotherapy after radiation therapy. We report a case of radiation recall–induced severe proctitis which is thought to be triggered by administration of regorafenib for stage IV rectal adenocarcinoma with lung metastases. We present a 65-year-old female patient who was initially diagnosed with stage III T4N1M0 rectal adenocarcinoma that was treated with neoadjuvant concurrent chemoradiotherapy, followed by low anterior resection. The tumor was pathologically staged a ypT3 yN1 with a partial response to the treatment. After the surgery, the patient was found to have lung nodules consistent with metastatic disease, when she was treated initially with folinic acid, fluorouracil, and oxaliplatin, plus bevacizumab. The patient had further disease progression with metastases in her lungs despite treatment with several chemotherapy agents. She was started on regorafenib, an oral vascular endothelial growth factor inhibitor, as a fourth line of therapy. However, in a month after initiation of oral regorafenib, and 9 months after the prior radiation treatment, the patient presented to the emergency room with a complaint of bright red blood per rectum. She was diagnosed with severe radiation proctitis that was treated therapeutically with argon plasma coagulation. This particular case serves as a reminder that although infrequent and rare, radiation recall may result in an inflammatory reaction in an organ such as rectum. To the best of our knowledge, this regorafenib-induced severe proctitis secondary to radiation recall has not been reported in the literature before.
Screening of Iron Deficiency Anemia in Children Using Mentzer Index in Pakistan: A Cross Sectional Study
Authors: Sherali Atika , Ahad Abdul , Tikmani Shiyam Sunder , Sohail Suman
Published: February 2023

The objective of the study was to determine the diagnostic accuracy of Mentzer Index in children with hypochromic microcytic anemia by taking serum ferritin levels as a gold standard. This cross-sectional study was conducted in the Department of Pediatric Medicine, Liaquat National Hospital Karachi, from 1st January to 30th June 2022. Children age 1 to 5 years and both genders were included in this study. Children who have had a history of blood transfusion in the past 3 months or Thalassemia or blood disorders, chronic liver disease or kidney diseases, and children with malignancy and congenital abnormalities were excluded. Eligible children were enrolled after taking written informed consent. Complete blood count (CBC) and serum ferritin were sent to the laboratory. Sensitivity, specificity, diagnostic accuracy, and likelihood ratio were calculated taking serum ferritin levels as a gold standard. A total of 347 subjects were enrolled. The median age was 26 (IQR-18) months and 42.9% were males. The most common symptom was fatigue 40.9%. The sensitivity of the Mentzer index was 80.7% while the specificity was 77.7%. Similarly, the positive predictive value (PPV) was 56.8% while the negative predictive value (NPV) was 91.6%. Finally, the accuracy of the Mentzer index in determining iron deficiency anemia was 78.4%. Diagnostic accuracy was 78.4% and the likelihood ratio was 3.6. Mentzer index is a valuable tool in the early detection of IDA in children. It has got high sensitivity, specificity diagnostic accuracy, and likelihood ratio.
Surrogacy Contract: Issues and Challenges
Authors: Gupta Purnima , Moitra Disha
Published: February 2023

The recent addition of the laws relating to surrogacy in India has widened the scope of this practice and opened the gates for discussions as to the contractual obligations of the parties. This article talks about how the laws relating to surrogacy evolved in India after independence. It also emphasizes the rights of the parties as mentioned in the Surrogacy Regulation Bill, 2020. Further, it focuses on the surrogacy contracts and the issues and challenges with the same taking into consideration the brfeach of surrogacy contract.
The Emerging Role of Biological Sex in Cell Therapy for Spinal Cord Injury
Authors: Tucker Ashley , Dulin Jennifer N
Published: February 2023

Neural progenitor cell (NPC) transplantation is a promising potential therapy for replacing spinal cord neurons and glial cells following spinal cord injury (SCI). Despite the rapid advancement of NPC transplantation to SCI clinical trials, we still lack understanding of fundamental biology underlying how NPC grafts interact with the injured host nervous system. Our recent study demonstrated a potent effect of biological sex mismatch between donor and host on graft immune rejection. Here we discuss the implications of this study in the context of clinical trials for SCI, and important topics for future research in SCI cell transplantation.
Paramedicine: A new research-focused international journal committed to advancing and transforming the profession
Authors: Simpson Paul M
Published: February 2023

The Australasian College of Paramedicine is pleased to introduce Paramedicine, its relaunched, official peer-reviewed scientific journal. Paramedicine is the culmination of two decades of research publishing in paramedicine, and represents a game-changing evolution in partnership with Sage Publishing. Paramedicine’s vision is to advance and transform the discipline of paramedicine through high-quality research dissemination and discourse. Paramedicine’s mission is to deliver excellence in paramedicine through an international research forum that inspires robust discussion, enables research translation, encourages innovative thinking and informs leadership. Paramedicine will be distinctively different in what it will offer authors and how it will impact the profession internationally. It is a paramedic-led journal that has a clear focus on high-quality research underpinned by excellent science, embraces diverse quantitative and qualitative methodologies and seeks to create an uplift in the paramedicine research publishing experience for authors and readers. Through its professional publishing partnership with Sage Publishing, Paramedicine will pursue an international agenda that brings together the diverse systems, models of care, practice settings and professional philosophies that characterise paramedicine internationally, creating a connected dialogue aimed at advancing the profession.
Engineering donor lymphocytes with Fas ligand protein effectively prevents acute graft-versus-host disease
Authors: Shrestha Pradeep , Turan Ali , Batra Lalit , Gulen Ayse Ece , Sun Zhengda , Tan Helen , Askenasy Nadir , Shirwan Haval , Yolcu Esma S.
Published: February 2023

Alloreactive T-effector cells (Teffs) are the major culprit of acute graft-versus-host disease (aGVHD) associated with hematopoietic stem cell transplantation. Ex vivo nonspecific depletion of T cells from the donor graft impedes stem cell engraftment and posttransplant immune reconstitution. Teffs upregulate Fas after activation and undergo Fas ligand (FasL)–mediated restimulation-induced cell death (RICD), an important mechanism of immune homeostasis. We targeted RICD as a means to eliminate host-reactive Teffs in vivo for the prevention of aGVHD. A novel form of FasL protein chimeric with streptavidin (SA-FasL) was transiently displayed on the surface of biotinylated lymphocytes, taking advantage of the high-affinity interaction between biotin and streptavidin. SA-FasL–engineered mouse and human T cells underwent apoptosis after activation in response to alloantigens in vitro and in vivo. SA-FasL on splenocytes was effective in preventing aGVHD in >70% of lethally irradiated haploidentical mouse recipients after cotransplantation with bone marrow cells, whereas all controls that underwent transplantation with nonengineered splenocytes developed aGVHD. Prevention of aGVHD was associated with an increased ratio of CD4+CD25+FoxP3+ T regulatory (Tregs) to Teffs and significantly reduced transcripts for proinflammatory cytokines in the lymphoid organs and target tissues. Depletion of Tregs from the donor graft abrogated the protection conferred by SA-FasL. This approach was also effective in a xenogeneic aGVHD setting where SA-FasL–engineered human PBMCs were transplanted into NSG mice. Direct display of SA-FasL protein on donor cells as an effective means of eliminating alloreactive Teffs in the host represents a practical approach with significant translation potential for the prevention of aGVHD.
Influence of different methods for calculating gestational age at birth on prematurity and small for gestational age proportions: a systematic review with meta-analysis
Authors: Vitral Gabriela Luiza Nogueira , Romanelli Roberta Maia de Castro , Leonel Tiago Alves , Souza Gaspar Juliano de , Aguiar Regina Amélia Lopes Pessoa de , Reis Zilma Silveira Nogueira
Published: February 2023

Background

Recognizing premature newborns and small-for-gestational-age (SGA) is essential for providing care and supporting public policies. This systematic review aims to identify the influence of the last menstrual period (LMP) compared to ultrasonography (USG) before 24 weeks of gestation references on prematurity and SGA proportions at birth.

Methods

Systematic review with meta-analysis followed the recommendations of the PRISMA Statement. PubMed, BVS, LILACS, Scopus-Elsevier, Embase-Elsevier, and Web-of-Science were searched (10–30-2022). The research question was: (P) newborns, (E) USG for estimating GA, (C) LMP for estimating GA, and (O) prematurity and SGA rates for both methods. Independent reviewers screened the articles and extracted the absolute number of preterm and SGA infants, reference standards, design, countries, and bias. Prematurity was birth before 37 weeks of gestation, and SGA was the birth weight below the p10 on the growth curve. The quality of the studies was assessed using the New-Castle-Ottawa Scale. The difference between proportions estimated the size effect in a meta-analysis of prevalence.

Results

Among the 642 articles, 20 were included for data extraction and synthesis. The prematurity proportions ranged from 1.8 to 33.6% by USG and varied from 3.4 to 16.5% by the LMP. The pooled risk difference of prematurity proportions revealed an overestimation of the preterm birth of 2% in favor of LMP, with low certainty: 0.02 (95%CI: 0.01 to 0.03); I2 97%). Subgroup analysis of USG biometry (eight articles) showed homogeneity for a null risk difference between prematurity proportions when crown-rump length was the reference: 0.00 (95%CI: -0.001 to 0.000; I2: 0%); for biparietal diameter, risk difference was 0.00 (95%CI: -0.001 to 0.000; I2: 41%). Only one report showed the SGA proportions of 32% by the USG and 38% by the LMP.

Conclusions

LMP-based GA, compared to a USG reference, has little or no effect on prematurity proportions considering the high heterogeneity among studies. Few data (one study) remained unclear the influence of such references on SGA proportions. Results reinforced the importance of qualified GA to mitigate the impact on perinatal statistics.

Trial registration

Registration number PROSPERO: CRD42020184646.
Late-onset toxic anterior segment syndrome after ICL implantation: two case reports
Authors: Li Li , Zhou Qizhi
Published: February 2023

Background

Toxic anterior segment syndrome (TASS) is a non-infectious inflammation that can occur after any anterior segment procedure. This case report presents two relatively rare late-onset TASS cases after V4c implantable collamer lens (ICL) operation.

Case presentation

One 25-year-old woman and one 31-year-old woman suddenly had vision loss in monocular for 1 week after biocular V4c ICL operations and with no subjective complaints. They both presented fibrin formation in the anterior chamber such as keratic precipitates and white pus on the surface of the ICL. Fundus examination was normal. After 4 to 5 weeks of topical and oral steroid treatment, visual acuity and fibrin formation in the anterior chamber improved during the follow-up.

Conclusions

TASS should be suspected in any patient during the late period following ICL surgery; Once TASS is diagnosed, adequate treatment with intensive steroid therapy can be implemented.
Identification and validation of novel lung adenocarcinoma subtypes and construction of prognostic models: based on cuprotosis-related genes
Authors: Wang Guangyao , Wang Anqiao , Wang Li , Xu Guanglan , Hong Xiaohua , Fang Fang
Published: February 2023

Cuprotosis is a novel and unique form of cell death that is of great value in a variety of cancers. However, the prognostic role of cuprotosis-related genes (CRGs) in lung cancer remains undetermined. We compared the expression profile of CRGs in lung adenocarcinoma (LUAD) patients, revealing the genetic alterations and inter-gene correlations of CRGs. Based on 13 CRGs, LUAD patients could be well differentiated into two molecular subgroups, and the differentially expressed genes (DEGs) in these molecular subtypes were identified. Furthermore, 10 cuprotosis pattern-related DEGs with a significant prognostic value were obtained for constructing a prognostic model. Through validation in an external validation set, the prognostic model based on the CRGs-risk score showed the robust and effective predictive ability and served as an independent prognostic indicator for LUAD patients. Therefore, combining the CRGs-risk score with multiple factors such as clinicopathological characteristics, a quantitative nomogram was developed to predict the survival and prognosis of LUAD patients, improving the clinical application value of the CRGs-risk score. In the low CRGs-risk score group, the related immune cell infiltration was increased and the immune function was activated in LUAD patients. This study may add to the knowledge of CRGs in LUAD, partly contribute to evaluating the prognosis of LUAD patients, and provide direction for the development of targeted therapy and immunotherapy.
Impact of bone-implant gap size on the interfacial osseointegration: an in vivo study
Authors: Huang Kangkang , Wu Tingkui , Lou Jigang , Wang Beiyu , Ding Chen , Gong Quan , Rong Xin , Liu Hao
Published: February 2023

Background

The bone-implant gap resulted from morphological mismatch between cervical bony endplates and implant footprint may have adverse impact on bone-implant interfacial osseointegration of cervical disc arthroplasty (CDA). The purpose of the study was to evaluate the impact of bone-implant gap size on the interfacial osseointegration in a rabbit animal model.

Methods

A series of round-plate implants with different teeth depth (0.5 mm, 1.0 mm, 1.5 mm and 2.0 mm) was specifically designed. A total of 48 New Zealand white rabbits were randomly categorized into four groups by the implants they received (0.5 mm: group A, 1.0 mm: group B, 1.5 mm: group C, 2.0 mm: group D). At 4th and 12th week after surgery, animals were sacrificed. Micro-CT, acid fuchsin and methylene blue staining and hematoxylin and eosin (HE) staining were conducted.

Results

At 4th week and 12th week after surgery, both micro-CT and HE staining showed more new bone formation and larger bone coverage in group A and group B than that in group C and group D. At 12th week, the bone biometric parameters were significantly superior in group C when compared with group D (p < 0.05). At 12th week, hard tissue slicing demonstrated larger portion of direct contact of new bone to the HA coating in group A and group B.

Conclusions

Bone-implant gap size larger than 1.0 mm negatively affected bone-implant osseointegration between compact bone and HA coated implant surface.
The association of dietary approaches to stop hypertension (DASH) with the odds of diabetic nephropathy and metabolic markers in women: a case–control study
Authors: Mirzababaei Atieh , Abaj Faezeh , Hajishizari Sara , Bahrampour Niki , Noori Sahar , Barekzai Ahmad Mujtaba , Hosseininasab Dorsa , Clark Cain C. T. , Mirzaei Khadijeh
Published: February 2023

Objectives

Epidemiologic studies have reported that diet is associated with diabetes and its complications through different pathways. We sought to examine the associations between the Dietary Approaches to Stop Hypertension (DASH) diet and the odds of diabetic nephropathy (DN) developing in Iranian women with existing type 2 diabetes.

Methods

In this case–control study, 105 women with DN and 105 controls, matched for age and diabetes duration, were selected from the Kowsar Diabetes Clinic in Semnan, Iran. DASH, estimated using dietary intake, was assessed using a validated and reliable food frequency questionnaire with 147 items. Anthropometric measurements were assessed for all subjects. Logistic regression was performed to examine the association between DASH and the odds of developing DN.

Results

After controlling for potential confounders, subjects in the highest intake of DASH diet adherence have 84% lower odds of DN, compared to those with the lowest intake (OR = 0.16, 95% CI = 0.07–0.34, P < 0.001). Among DASH diet subcategories, intakes of vegetables (80%), fruits (88%), nuts and legumes (87%), and low-fat dairy (73%) decreased the risk of DN after adjustment for confounders (P < 0.001).

Conclusions

This study showed that the DASH diet is associated with lower odds of DN development in women with type 2 diabetes.