bluuebunny/crossref_metadata_2025 huggingface dataset:
Putting a Spotlight on the Ostracizer: Intentional Workplace Ostracism Motives
Authors: Henle Christine A. , Shore Lynn M. , Morton John W. , Conroy Samantha A.
Published: May 2022

Workplace ostracism is a prevalent and detrimental type of mistreatment. To curtail this harmful behavior, researchers need to identify who is more likely to intentionally ostracize others at work and the motives that drive them to do so. Past reviews of workplace ostracism focus primarily on the outcomes of ostracism, and the few that address the antecedents often examine a limited set of variables. We examined themes in the ostracism literature and determined that employees intentionally ostracize others due to either punitive or defensive motives. Punitive motives are focused on protecting the interests of the group, whereas defensive motives pertain to defending the interests of the self. We present a model of the ostracizer based on these motives and the associated perceptions of threat and negative emotions that precipitate ostracism. Our model provides an extension of the workplace ostracism literature by presenting a testable theoretical framework, rooted in appraisal theory, to explain why and when employees are likely to ostracize others at work. We also provided suggestions for an expansion of the ostracizer motives literature, with the goal of encouraging research that provides greater understanding of the perspective of the ostracizer.
“That’s How They Label Us:” Gendered-Antiblackness, Black Fathers, and the Parenting of Black Children
Authors: Wallace Bakari A.
Published: May 2022

This study sought to understand how gendered-antiblackness shapes the experiences and perceptions of a group of Black working- and middle-class fathers–emanating from both the U.S. and abroad–and how this phenomenon determines their approach to, and practice of, fatherhood. I analyzed the interviews of ten Black fathers, half of whom were classified as working- or middle-class. The data are based on qualitative, in-depth semi-structured interviews, wherein findings indexed three overarching themes–racialized experiences, racialized perceptions, and fathering strategies and practices–that constitute how the participants in this study thought about fatherhood, gender, and race. Participants invoked race and racism as phenomena specific to their experiences as Black men and fathers. Additionally, participants described how their blackness and gender shaped their experientially-based definition of fatherhood and how they practice it.
Incidence of bleeding events in patients on concomitant tyrosine kinase inhibitors and selective serotonin reuptake inhibitors
Authors: Venkataraman Vinayak , Bales John R , Signorelli Jessie , Hobbs Gabriela S
Published: May 2022

Introduction

In this study, we aim to determine the risk of bleeding or thrombosis with concurrent use of tyrosine kinase inhibitors (TKIs) used to treat CML, and serotonin reuptake inhibitors (SSRIs).

Methods

We conducted a retrospective cohort study of patients with CP-CML cared for at Massachusetts General Hospital (MGH) between April 2016 to February 2021. Participants were included if diagnosed with CP-CML and began TKI treatment (imatinib, dasatinib, nilotinib, bosutinib, or ponatinib) after April 2016.

Results

One hundred patients were evaluated, eighty of whom were taking TKIs only (median age 55, 40% female), and twenty were taking TKI and SSRI concomitantly (median age 53.5, 55% female). Baseline demographics between these groups were similar across all variables. Patients in the TKI only group had 9 bleeding events and 3 thrombotic events. Patients in the combination group had 6 bleeding events and 1 thrombotic event. There was no difference between overall rates of major bleeding (4% v. 10%, p = 0.26) or thrombotic events (4% v. 5%, p = 1). However, patients in the combination group were more likely to have major intracranial bleeding events (0% v. 10%, p = 0.04), and there was a trend to significance for minor bleeding events (7.5% v. 20%, p = 0.11).

Conclusions

Concomitant use of TKIs and SSRIs does not appear to increase the total risk of bleeding or thrombotic events compared to patients on TKIs only. However, concomitant use of TKIs and SSRIs may increase risk of intracranial bleeding. Further work is needed to fully assess this risk.
The Nature and Scope of Educator Misconduct in K-12
Authors: Jeglic Elizabeth L. , Calkins Cynthia , Kaylor Leah , Margeotes Krystyn , Doychak Kendra , Blasko Brandy , Chesin Megan , Panza Nancy
Published: May 2022

Educator sexual misconduct is a serious problem in the United States (U.S.), with a 2004 Department of Education report estimating that 9.6% of K-12 students in the U.S. had experienced either verbal, visual, or physical educator misconduct at some point during their school career. However, since that report almost 20 years ago, there have been few large-scale studies examining the extent of the problem. As such, the current study, which uses a large sample from recent high school graduates in four U.S. states, offers updated data on the nature and scope of sexual misconduct in educational settings. Overall, 11.7% of the 6632 participants reported having experienced at least one form of educator sexual misconduct during Grades K-12, with 11% reporting sexual comments and less than 1% reporting other forms of sexual misconduct (e.g., receiving sexual photos/messages, being kissed, touched sexually, or engaging in sexual intercourse/oral sex). Those who reported misconduct showed significantly more difficulties in current psychosocial functioning than those who did not report educator misconduct. Academic teachers most often perpetrated the abuse (63%), followed by coaches and gym teachers (20%). Educators who engaged in sexual misconduct were primarily male (85%), whereas students who reported experiencing educator misconduct were primarily female (72%). Rates of disclosure to authorities were very low (4%) and some sexual grooming behaviors like gift giving (12%) and showing special attention (29%) were reported. These findings will be discussed as they pertain to the prevention of sexual misconduct within educational settings.
‘Anarchist technologies’: Anarchism, cybernetics and mutual aid in community responses to the COVID-19 crisis
Authors: Swann Thomas
Published: May 2022

The COVID-19 pandemic that gripped the world since the end of 2019 has been felt most immediately both as a health crisis and an economic, social and political crisis. Secondary impacts of social distancing and lockdown in many countries have put strains on people’s capacities to provide essential food and medicines for themselves and their families. In response, outside of centralised government and voluntary sector frameworks, local mutual aid groups have emerged around the world as a primary site of community resilience. Given mutual aid’s strong links to the anarchist political tradition, for example in its identification by Kropotkin as a factor in evolution, this article suggests that these new mutual aid groups can be understood best through the related concept of self-organisation. Tying anarchist approaches to mutual aid and self-organisation together, it is argued that cybernetics and Stafford Beer’s Viable System Model (VSM) offer useful tools in helping both academic analysis and on-the-ground practice assess and improve the effectiveness of mutual aid in and beyond the COVID-19 crisis. The article offers a qualitative thematic analysis of anarchist and related texts published during the pandemic that reflect on mutual aid practice. In doing so, it highlights some of the challenges and tensions such self-organised mutual aid practice might face and proposes a participatory research agenda drawing on Beer’s VSM.
A simultaneous valuation model on positive and negative tourism benefits under suppressed consumption
Authors: Okuyama Tadahiro
Published: May 2022

This study aims to develop a benefit valuation model with household production under consumption suppressed by self-restraint, as observed during the coronavirus disease 2019 pandemic. This study proposes a model to measure the benefits of the value of time (VOT), value of environmental quality (VOQ), and value of self-restrained consumption (VOS). Numerical simulations show that 1) the benefits can be measured in a single modeling system, 2) the absolute VOS might be larger than the other benefits, 3) the VOS decreases exponentially with an increase in self-restrained consumption, and 4) the VOT may be sensitive to the degrees of the parameter values.
Olive oil tourism experiences: Effects on quality of life and behavioural intentions
Authors: Campón-Cerro Ana María , Di-Clemente Elide , Hernández-Mogollón José Manuel , Folgado-Fernández José Antonio
Published: May 2022

Gastronomic tourism experiences are revealed as a response to a rural environment that needs to bet on economic diversification and to meet an evolving tourist demand. This new tourist does not only seek to enjoy himself/herself when travelling, but also find personal enrichment. In addition, the olive oil culture represents an important diversification opportunity for the Spanish tourist offer. Therefore, the objective of this work is focused on analysing how motivational factors, involvement with the gastronomic product and the intention to engage in related tourist experiences can generate positive impacts on the tourist's perceived quality of life and on their behavioural intentions. This study is applied to the analysis of the potential of olive oil tourism in Spain. From an online survey, a sample of 690 individuals has been obtained. The results of this study confirm that the proposed model has a great capacity to predict the behaviour of the market in relation to the realisation of trips for the practice of experiences related to olive oil tourism. 77.9% of the behaviour of this variable comes from the influence of motivational factors, engagement and quality of life.
Challenges in obtaining accurate anthropometric measures for adults with severe obesity: A community-based study
Authors: Williamson Kath , Blane David N. , Lean Michael E.J.
Published: May 2022

Aims

The number of people with severe obesity (BMI ⩾40 kg/m2) is increasing rapidly, but is poorly documented, partly as a result of inappropriate standard anthropometric measurement methods for community-based people.

Methods

As part of a broader study, people receiving care services and with severe obesity were visited at home. The people were assessed for measurements using different weighing scales and a standard portable stadiometer. If the stadiometer could not be used, their half arm span and knee height were measured to estimate their height using standard predictive equations.

Results

Measurements were taken for 15 women and 10 men ( n = 25) aged 40–87 years (mean 62 years). Weights ranged from 98.4 to 211.8 kg (mean 150 kg), with 16 participants requiring bariatric scales. For the six people who were unable to stand, we used wheelchair scales ( n = 1), bed weighing scales ( n = 2), routine weights from care home records ( n = 2) or weight data from hospital records ( n = 1). The standard portable stadiometer could only be used for one person; the others required alternative measures from which to estimate height. Large body habitus obscured bony landmarks, meaning alternative measures gave diverse heights. Fourteen participants had a ⩾8 cm difference in height between estimates from half arm span and knee height measurements.

Conclusions

Standard practice commonly does not provide reliable measurements for people with severe obesity, particularly those with mobility difficulties. An inability to measure weight and height accurately can exclude people from appropriate care, obscuring the true numbers affected and the effectiveness of future service planning. Safe community care requires the availability of specialist scales and standardised methods for height estimation appropriate for older and disabled people with severe obesity.
Characterizing Cognition in Everyday Life of Older Adults With Subjective Cognitive Decline
Authors: Rotenberg Shlomit , Dawson Deirdre R.
Published: May 2022

Subjective cognitive decline (SCD), the subjective experience of worsening cognition with no objective cognitive impairment, poses a heightened risk for dementia. This study aimed to characterize cognition in the everyday life of people with SCD, is crucial for understanding and preventing further functional and cognitive decline. One hundred and thirty-five older adults (age 70.7±6.7) with SCD were assessed using functional-cognition measures: Multifactorial Memory Questionnaire (MMQ), Behavior Rating Inventory of Executive Function–Adult version (BRIEF-A), and Multiple Errands Test (MET). The resulted showed that older adults with SCD reported lower memory satisfaction (Hedges’s g = 0.41) on the MMQ, and worse metacognition on the BRIEF-A (Hedges’s g = 0.63) compared with published normative data. They completed an average of only 6/12 required tasks on the MET. The findings show functional difficulties related to SCD and inform the development of occupational therapy intervention for this population.
Synchronized Auditory Gamma Response to Frontal Transcranial Direct Current Stimulation (tDCS) and its Inter-Individual Variation in Healthy Humans
Authors: de la Salle Sara , Shah Urusa , Hyde Molly , Baysarowich Renee , Aidelbaum Robert , Choueiry Joëlle , Knott Verner
Published: May 2022

In schizophrenia, a disorder associated with N-methyl-D-aspartate receptor (NMDAR) hypofunction, auditory cortical plasticity deficits have been indexed by the synchronized electroencephalographic (EEG) auditory steady-state gamma-band (40-Hz) response (ASSR) and the early auditory evoked gamma-band response (aeGBR), both considered to be target engagement biomarkers for NMDAR function, and potentially amenable to treatment by NMDAR modulators. As transcranial direct current stimulation (tDCS) is likely dependent on NMDAR neurotransmission, this preliminary study, conducted in 30 healthy volunteers, assessed the off-line effects of prefrontal anodal tDCS and sham (placebo) treatment on 40-Hz ASSR and aeGBR. Anodal tDCS failed to alter aeGBR but increased both 40-Hz ASSR power, as measured by event-related spectral perturbations (ERSP), and phase locking, as measured by inter-trial phase consistency (ITPC). Inter-individual differences in tDCS-induced increases in ERSP were negatively related to baseline ERSPs. These findings provide tentative support for further study of tDCS as a potential NMDAR neuromodulatory intervention for synchronized auditory gamma response deficits.
Transit Time Flow Measurement in Robotic Totally Endoscopic Coronary Artery Bypass: What Do the Numbers Mean?
Authors: Yang Benjamin , Nisivaco Sarah , Torregrossa Gianluca , Balkhy Husam H.
Published: May 2022

Objective

Transit time flow measurement (TTFM) is valuable for assessing intraoperative graft patency in coronary artery bypass surgery (CAB). The significance of competitive native coronary flow on patency, as predicted by percentage of backflow (%BF) on TTFM, is unknown. This study aims to evaluate intraoperative TTFM parameters, and specifically %BF, in predicting graft patency in robotic totally endoscopic CAB (TECAB).

Methods

We reviewed TTFM parameters in 311 patients undergoing robotic off-pump TECAB at our institution between February 2016 and January 2020. Patients with sequential or Y grafts were excluded, leaving 277 patients with a total of 387 isolated end-to-side grafts (248 left internal mammary artery [LIMA], 149 right IMA [RIMA]). Mean graft flow, diastolic flow, pulsatility index, and %BF were measured intraoperatively. Early postoperative angiograms were obtained in 83 patients undergoing percutaneous coronary intervention for hybrid revascularization, with a total of 125 grafts. Angiograms were independently analyzed and separated into 2 groups based on IMA graft patency, which were patent (FitzGibbon A/B) and nonpatent (FitzGibbon O) groups.

Results

Early angiographic patency at a median of 31.0 days after surgery showed 123 (97.1%) patent grafts and 3 (2.9%) occluded grafts in both LIMA and RIMA grafts to both left anterior descending (LAD) and non-LAD targets. Mean graft flow was 77.4 ± 41.6 mL/min. There was no difference in mean flow, pulsatility index, or %BF between the patent and occluded grafts.

Conclusions

Excellent intraoperative flow parameters and early angiographic patency can be obtained via robotic, off-pump TECAB. Our data did not demonstrate an association between intraoperative TTFM evidence of competitive native coronary flow and early angiographic graft outcomes.
Applying Core Quality Criteria of Mixed Methods Research to an Empirical Study
Authors: Hirose Mariko , Creswell John W.
Published: May 2022

Quality criteria have been advanced for the mixed methods field, but the elements are often too numerous for new researchers, do not incorporate diverse perspectives (e.g., stakeholders and professional associations), and apply the criteria. This methodological article advances a shortlist of six criteria synthesized from diverse, recent sources. The six criteria are a rationale for mixed methods; quantitative, qualitative, and mixed methods questions; separate quantitative and qualitative data; a mixed method design and a diagram; integration in a joint display; and meta-inferences. The shortlist, the diverse sources of information used in developing the list, and its application in an empirical study provide essential criteria for new scholars in the field of mixed methods research.
Blurring Boundaries: Balancing between Distance and Proximity in Qualitative Research Studies With Vulnerable Participants
Authors: Garrels Veerle , Skåland Børge , Schmid Evi
Published: May 2022

Qualitative researchers who conduct in-depth interviews with vulnerable participants may experience certain challenges related to the vulnerability of their research subjects. Obtaining upsetting personal narratives may be emotionally taxing for the researcher, yet little knowledge is available as to how researchers are affected by this and which support could benefit them.

This article explores how qualitative researchers from diverse research fields experience and deal with their encounters with research participants in vulnerable life situations. Information about this topic may inform research institutes how they can support the emotional wellbeing of researchers. Moreover, students and junior researchers who are getting acquainted with qualitative research may find it useful to learn about some challenges that may occur when doing research on vulnerable groups.

For this study, we conducted semi-structured interviews with nine researchers from various research fields within social sciences who had extensive experience in doing research with diverse vulnerable groups. We used thematic content analysis to analyze the interview data.

Findings from this study illustrate how conducting interviews with vulnerable research subjects may affect researchers emotionally. Several participants described negative experiences of emotional instability, powerlessness, and lasting impressions that made it difficult to “let go” of the research subjects. Some participants also highlighted positive effects of such encounters, such as personal growth. For all researchers, boundaries of the researcher role were a point of discussion, as these boundaries may seem less clear in practice than in theory. Research institutes could safeguard research ethics and enhance the psychological wellbeing of the researcher by providing researchers with adequate support systems.
Improving pediatric multiple sclerosis interventional phase III study design: a meta-analysis
Authors: Graves Jennifer S. , Thomas Marius , Li Jun , Shah Anuja R. , Goodyear Alexandra , Lange Markus R. , Schmidli Heinz , Häring Dieter A. , Friede Tim , Gärtner Jutta
Published: May 2022

Background:

To support innovative trial designs in a regulatory setting for pediatric-onset multiple sclerosis (MS), the study aimed to perform a systematic literature review and meta-analysis of relapse rates with interferon β (IFN β), fingolimod, and natalizumab and thereby demonstrate potential benefits of Bayesian and non-inferiority designs in this population.

Methods:

We conducted a literature search in MEDLINE and EMBASE from inception until 17 June 2020 of all studies reporting annualized relapse rates (ARR) in IFN β-, fingolimod-, or natalizumab-treated patients with pediatric-onset relapsing–remitting MS. These interventions were chosen because the literature was mainly available for these treatments, and they are currently used for the treatment of pediatric MS. Two researchers independently extracted data and assessed study quality using the Cochrane Effective Practice and Organization of Care – Quality Assessment Tool. The meta-analysis estimates were obtained by Bayesian random effects model. Data were summarized as ARR point estimates and 95% credible intervals.

Results:

We found 19 articles, including 2 randomized controlled trials. The baseline ARR reported was between 1.4 and 3.7. The meta-analysis-based ARR was significantly higher in IFN β-treated patients (0.69, 95% credible interval: 0.51–0.91) versus fingolimod (0.11, 0.04–0.27) and natalizumab (0.17, 0.09–0.31). Based on the meta-analysis results, an appropriate non-inferiority margin versus fingolimod could be in the range of 2.29–2.67 and for natalizumab 1.72–2.29 on the ARR ratio scale. A Bayesian design, which uses historical information for a fingolimod or natalizumab control arm, could reduce the sample size of a new trial by 18 or 14 patients, respectively.

Conclusion:

This meta-analysis provides evidence that relapse rates are considerably higher with IFNs versus fingolimod or natalizumab. The results support the use of innovative Bayesian or non-inferiority designs to avoid exposing patients to less effective comparators in trials and bringing new medications to patients more efficiently.
Seculum Est Speculum: Isaac Watts And Recovering the Use of Nature in Spiritual Formation
Authors: Stokes Britt
Published: May 2022

The link between nature and the spiritual life has been a mainstay in Christianity going back to the beginning of Scripture. However, our modern context has veered toward a humancentric emphasis in the use of nature for spiritual purposes. This article seeks to recover a framework for connecting nature and the spiritual life by analyzing and applying the writings of the hymn-writer Isaac Watts. Influenced by the English Puritans and the eighteenth-century English naturalists, Watts leverages the empirical and the spiritual to employ a theocentric natural theology in his hymnody, psalmody, and spiritual prose. Examining these writings of Watts, in turn, aid in recovering a faithful use of nature in spiritual formation within our modern Christian context.
Manifestations of radiation toxicity in the head, neck, and spine: An image-based review
Authors: Carr Carrie M , Benson John C , DeLone David R , Diehn Felix E , Kim Dong K , Ma Daniel , Nagelschneider Alex A , Madhavan Ajay A , Johnson Derek R
Published: May 2022

Background and purpose

Radiation therapy is an important component of treatment in patients with malignancies of the head, neck, and spine. However, radiation to these regions has well-known potential side effects, many of which can be encountered on imaging. In this manuscript, we review selected radiographic manifestations of therapeutic radiation to the head, neck, and spine that may be encountered in the practice of radiology.

Methods

We conducted an extensive literature review of known complications of radiation therapy in the head, neck, and spine. We excluded intracranial and pulmonary radiation effects from our search. We selected complications that had salient, recognizable imaging findings. We searched our imaging database for illustrative examples of these complications.

Results

Based on our initial literature search and imaging database review, we selected cases of radiation-induced tumors, radiation tissue necrosis (osteoradionecrosis and soft tissue necrosis), carotid stenosis and blowout secondary to radiation, enlarging thyroglossal duct cysts, radiation myelopathy, and radiation-induced vertebral compression fractures.

Conclusions

We describe the clinical and imaging features of selected sequelae of radiation therapy to the head, neck, and spine, with a focus on those with characteristic imaging findings that can be instrumental in helping to make the diagnosis. Knowledge of these entities and their imaging findings is crucial for accurate diagnosis. Not only do radiologists play a key role in early detection of these entities, but many of these entities can be misinterpreted if one is not familiar with them.
Endovascular coiling of recurrent trapped pseudoaneurysm of petrous ICA across the distal barrier: When the other way round is the only way around!
Authors: Hosur Bharat , Ahuja Chirag K , Tripathi Manjul , Mohindra Sandeep , Vyas Sameer , Singh Paramjeet
Published: May 2022

Background

The pseudoaneurysms of the internal carotid artery (ICA) at the skull base form a unique subset of craniofacial pseudoaneurysms with varied diagnostic and therapeutic challenges. Recurrence in a surgically treated pseudoaneurysm may become a nightmare due to very limited number of open and endovascular options.

Report

We report a rare case of recurrent pseudoaneurysm of petrous ICA, which presented with massive epistaxis following an initial successful occlusion by surgical trapping of the parent arterial segment with surgical clip. Cerebral angiography revealed filling of the pseudoaneurysm by small arterial channels from the external carotid, contralateral internal carotid and basilar arterial branches and emptying through the “slipped” distal clip. After a meticulous analysis of the cerebral angiogram, the recurrent pseudoaneurysm was eventually embolized retrogradely through the “slipped” clip after crossing the anterior communicating artery taking a contralateral internal carotid access.

Conclusion

Scrupulous planning and execution of ICA pseudoaneurysms is necessary to prevent recurrence. Naturally occuring collateral routes through the Circle of Willis aid in treatment of “unreachable” vascular lesions.
Severe digital ischemia as an unrecognized manifestation in patients with antisynthetase autoantibodies: Case series and systematic literature review
Authors: Yoshida Akira , Gono Takahisa , Okazaki Yuka , Shirai Yuichiro , Takeno Mitsuhiro , Kuwana Masataka
Published: May 2022

Objective:

Severe digital ischemia, including digital ulcers and gangrene, is considered rare in patients with antisynthetase antibodies. This study aimed to elucidate the clinical features of antisynthetase-positive patients complicated with digital ulcers and/or gangrene using a systematic literature review and case series in a single-center cohort.

Methods:

A systematic literature review was conducted to identify reports describing antisynthetase-positive cases with digital ulcers and/or gangrene. Our cohort of consecutive patients with antisynthetase antibodies was stratified by the history of severe digital ischemia. Demographic and clinical features and outcomes in patients with severe digital ischemia identified in the systematic literature review and our cohort were compared with those in patients without severe digital ischemia in our cohort.

Results:

The systematic literature review revealed 12 antisynthetase-positive patients with severe digital ischemia from one case series and eight case reports. Seven (7%) of 100 patients with antisynthetase antibodies in our cohort had a record of severe digital ischemia. Severe digital ischemia was often found at presentation and was associated with the classification of systemic sclerosis with or without myositis overlap. Clinical features associated with severe digital ischemia in antisynthetase-positive patients included Raynaud’s phenomenon ( p < 0.001), digital pitting scars ( p = 0.001), and nailfold capillary abnormality ( p = 0.02). Outcomes of severe digital ischemia were generally favorable with vasodilators.

Conclusion:

Severe digital ischemia is an overlooked complication in antisynthetase-positive patients. Antisynthetase antibodies should be measured in patients presenting with digital ulcers or gangrene, especially in those with systemic sclerosis phenotype and features associated with antisynthetase antibodies in the absence of systemic sclerosis-specific autoantibodies.
Sleep pattern and predictors of daily versus as-needed hypnotics use in middle-aged and older adults with insomnia
Authors: Tanielian Maria , Antoun Jumana , Sidani Munir , Halabi Ahmad , Hoballah Malak , Hawatian Kegham , Assaf Georges
Published: May 2022

Introduction

This study aims to examine the sleep pattern and predictors of daily vs. as-needed use of hypnotics in middle-aged and older adults with insomnia.

Methods

Patients aged 50–75 who use hypnotics for insomnia were identified via electronic medical records and were recruited. Data about sociodemographics, mood and cognitive screening measures, and questions related to sleep patterns were collected through an interview conducted over the phone.

Results

A sample of 66 participants was recruited, of which 69.7% were females. Three quarters (49/66, 74.2%) used hypnotics daily, with 43% (21/49) of daily hypnotics users sleeping more than 8 h per night. Two-fifths (26/66, 39.4%) of participants still had clinically significant insomnia even after taking hypnotics. After adjusting for age, years of hypnotics use, sleeping hours per night, PHQ-2 score, and frequency of pain at night, the logistic regression model showed that younger age (p = 0.023) and longer sleeping hours per night (p = 0.025) were significantly associated with daily hypnotics use when compared to as needed hypnotics use.

Conclusion

Many hypnotic users still have clinically significant insomnia and poor quality of sleep as reflected by perceived longer sleep duration and more daytime napping which could be related to drug-related residual sedation. Hypnotic use may not be the best solution for insomnia treatment in an older population, and physicians should regularly reassess the use of hypnotics.
Effects of textured food masticatory performance in older people with different dental conditions
Authors: Park Young-Sook , Hong Han-Pyo , Ryu Soo-rack , Lee Suyong , Shin Weon-Sun
Published: May 2022

Background

Physiological deterioration (aging, poor dental status, and reduced tongue pressure) makes chewing difficult. This study aimed to investigate the chewing patterns of older people with or without dentures, evaluate the textural and masticatory properties of texture-modified radish Kimchi, and investigate the correlation between dental status and tongue pressure. Additionally, differences in the subjective–objective concordance of texture-modified Kimchi were investigated using the preference test.

Methods

This study included 32 Korean women aged between 65 and 85 years. Masticatory behavior was recorded by electromyography, and tongue pressure was measured using the Iowa Oral Performance Instrument. A preference test, with hardness as the relevant textural property, determined the participants’ preferences among the test samples (food with a homogeneous structure—radish Kimchi). To assess preference differences, a questionnaire suitable for older people was designed. The preference for cooked radish Kimchi with various blanching times based on overall acceptability and self-reporting of preference was investigated to develop elderly-friendly food. The subjective scores indicated whether the sample (radish Kimchi) was hard or soft based on the chewing ability of the participants. Dental status, muscle activities, and tongue pressure were considered for the food design with optimized texture. The relationship between subject score and mastication properties were examined using multiple regression analysis.

Results

The number of chews and chewing time increased with hardness, significantly activating the masseter and temporalis muscles. The evaluation of masseter muscle activity, particularly for level-6 radish Kimchi, showed that older people with complete dentures chewed less actively than those with natural teeth (p < 0.05). The older people with natural teeth (18.94 ± 10.27 kPa) exhibited higher tongue pressure than those with complete dentures (10.81 ± 62.93 kPa), and the difference was statistically significant (p < 0.01). Older people preferred food with familiar tastes and textures. An association was found between the subjective hardness score and the objective hardness level. The perceived hardness intensity was linked to the chewing ability of the participant. Denture wearers exhibited a lower chewing ability, and at level 6, they perceived greater hardness of food than those with natural teeth.

Conclusions

Developing food with a modified texture can bridge the gap between physiological and psychological aspects of food texture; texture-modified radish Kimchi, with limited blanching time, may be favorable for older people.
Ultrasound-based radiomics analysis for preoperative prediction of central and lateral cervical lymph node metastasis in papillary thyroid carcinoma: a multi-institutional study
Authors: Tong Yuyang , Zhang Jingwen , Wei Yi , Yu Jinhua , Zhan Weiwei , Xia Hansheng , Zhou Shichong , Wang Yuanyuan , Chang Cai
Published: May 2022

Background

An accurate preoperative assessment of cervical lymph node metastasis (LNM) is important for choosing an optimal therapeutic strategy for papillary thyroid carcinoma (PTC) patients. This study aimed to develop and validate two ultrasound (US) nomograms for the individual prediction of central and lateral compartment LNM in patients with PTC.

Methods

A total of 720 PTC patients from 3 institutions were enrolled in this study. They were categorized into a primary cohort, an internal validation, and two external validation cohorts. Radiomics features were extracted from conventional US images. LASSO regression was used to select optimized features to construct the radiomics signature. Two nomograms integrating independent clinical variables and radiomics signature were established with multivariate logistic regression. The performance of the nomograms was assessed with regard to discrimination, calibration, and clinical usefulness.

Results

The radiomics scores were significantly higher in patients with central/lateral LNM. A radiomics nomogram indicated good discrimination for central compartment LNM, with an area under the curve (AUC) of 0.875 in the training set, the corresponding value in the validation sets were 0.856, 0.870 and 0.870, respectively. Another nomogram for predicting lateral LNM also demonstrated good performance with an AUC of 0.938 and 0.905 in the training and internal validation cohorts, respectively. The AUC for the two external validation cohorts were 0.881 and 0.903, respectively. The clinical utility of the nomograms was confirmed by the decision curve analysis.

Conclusion

The nomograms proposed here have favorable performance for preoperatively predicting cervical LNM, hold promise for optimizing the personalized treatment, and might greatly facilitate the decision-making in clinical practice.
The LPA-CDK5-tau pathway mediates neuronal injury in an in vitro model of ischemia-reperfusion insult
Authors: Wang Yaya , Zhang Jie , Huang Liqin , Mo Yanhong , Wang Changyu , Li Yiyi , Zhang Yangyang , Zhang Zhaohui
Published: May 2022

Lysophosphatidic acid (LPA) is a common glycerol phospholipid and an important extracellular signaling molecule. LPA binds to its receptors and mediates a variety of biological effects, including the pathophysiological process underlying ischemic brain damage and traumatic brain injury. However, the molecular mechanisms mediating the pathological role of LPA are not clear. Here, we found that LPA activates cyclin-dependent kinase 5 (CDK5). CDK5 phosphorylates tau, which leads to neuronal cell death. Inhibition of LPA production or blocking its receptors reduced the abnormal activation of CDK5 and phosphorylation of tau, thus reversing the death of neurons. Our data indicate that the LPA-CDK5-Tau pathway plays an important role in the pathophysiological process after ischemic stroke. Inhibiting the LPA pathway may be a potential therapeutic target for treating ischemic brain injury.
Insulin resistance, leptin and adiponectin in lean and hypothyroid children and adolescents with obesity
Authors: El Amrousy Doaa , El-Afify Dalia , Salah Shaimaa
Published: May 2022

Background

Obesity usually complicates hypothyroidism. Adipokines like leptin and adiponectin secreted by adipose tissue modulate insulin resistance (IR), appetite, and obesity. The association between adipokines, IR, and thyroid hormone has not been sufficiently studied in children. We investigated leptin and adiponectin as well as IR and their association with thyroid hormone in both lean and hypothyroid children and adolescents with obesity.

Methods

The study included 30 lean hypothyroid, 30 hypothyroid children and adolescents with obesity, and 30 healthy lean children as the control group. Serum thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), free thyroxine (fT4), fasting blood glucose, fasting insulin, homeostatic model assessment method of insulin resistance (HOMA-IR), leptin, and adiponectin levels were estimated in all participants.

Results

Fasting insulin, HOMA-IR, and leptin levels were significantly elevated in hypothyroid children compared to the control group; more in hypothyroid children with obesity. In contrast, adiponectin levels were significantly lower in the hypothyroid children with obesity compared to the lean hypothyroid children and controls. HOMA-IR was positively correlated to TSH and BMI but inversely correlated with fT3 and fT4 in hypothyroid children. There was no correlation between IR and either leptin or adiponectin levels. Leptin and adiponectin levels correlated well with BMI in hypothyroid children and adolescents with obesity.

Conclusion

Insulin resistance and leptin levels are increased in hypothyroid children and adolescents; more in those with obesity. IR is not related to leptin and adiponectin levels, however, leptin and adiponectin levels correlate well with BMI in hypothyroid children and adolescents with obesity.

Impact

Insulin resistance (IR) and leptin levels increase in hypothyroid children and adolescent; more with obesity. IR is not related to leptin and adiponectin levels, however leptin and adiponectin levels correlated well with BMI in hypothyroid children and adolescents with obesity.
Associations between self-reported psychological symptom severity and gut microbiota: further support for the microgenderome
Authors: Ganci Michael , Suleyman Emra , Butt Henry , Ball Michelle
Published: May 2022

Background

Research into the brain-gut-microbiota axis (BGMA) continues to reveal associations between gut microbiota (GM) and psychological symptom expression, inspiring new ways of conceptualising psychological disorders. However, before GM modulation can be touted as a possible auxiliary treatment option, more research is needed as inconsistencies in previous findings regarding these associations are prevalent. Additionally, the concept of the microgenderome, which proposes that GM may interact with sex hormones, has received limited attention in studies using human samples to date. However, such research has demonstrated sex specific associations between GM and psychological symptom expression.

Method

This cross-sectional retrospective study explores associations between GM species (identified through faecal microbial analysis) and symptom severity across four psychological domains (Depressive, Neurocognitive, Stress and Anxiety, and Sleep and Fatigue) for males (N = 1143) and females (N = 3467) separately.

Results

GM species from several genera including Bifidobacterium, Clostridium, Enterococcus, and Leuconostoc were found to be differentially associated with psychological symptom severity for males and females. As such, the findings of the current study provide support for the concept of the microgenderome.

Conclusion

While further research is needed before their implementation in psychological treatment plans, the current findings suggest that modulation of GM at the species level may hold promise as auxiliary diagnostic or treatment options. These findings may give further insight into a client’s presenting problem from a more holistic, multidisciplinary perspective. The clear sex divergence in associations between GM and symptoms give insight into sex discrepancies in susceptibility to psychological disorders.
Lymphocyte predominance in blood, pleural fluid, and tumour stroma; a prognostic marker in pleural mesothelioma
Authors: De Fonseka Duneesha , Arnold David T. , Morley Anna J. , Brett Mary , Bhatt Nidhi , Edey Anthony , Daly Richard , Bibby Anna C. , Maskell Nick A.
Published: May 2022

Background

As promising novel treatments develop for malignant pleural mesothelioma (MPM), early prognostication has become increasingly important. Circulating and local inflammatory cells are known to play a significant role in other tumour types. We assessed the proportion of lymphocyte populations within blood, pleural fluid and tumour stroma to prognosticate patients with MPM at diagnosis.

Methods

Consecutive patients diagnosed with biopsy-proven MPM were prospectively recruited to an observational cohort study and followed up for a minimum of 7.5 years. Blood and pleural fluid results at presentation were extracted from the medical records. Biopsy specimens were independently reviewed by 2 pathologists who scored the degree of lymphocytic and neutrophilic infiltration.

Results

Baseline results were available for 184 patients. The predominant pleural fluid cell type was calculable for 84 patients and 118 patients had biopsy specimens available for review. A low blood neutrophil/lymphocyte ratio (NLR < 4) inferred a better prognosis with a median survival of 420 days versus 301 days (p < 0.01). Survival was better for patients with a lymphocyte-predominant pleural effusion (430 vs 306 days, p < 0.01). Lymphocyte infiltration of tumour stroma was also associated with improved survival (n = 92, survival 430 days) compared with neutrophilic or acellular samples (n = 26, survival 342 days p < 0.01). In multivariable modelling lymphocyte predominance in blood, pleural fluid and tumour stroma were all associated with a better prognosis.

Conclusions

Lymphocyte predominance within tumour stroma, pleural fluid or blood infers a better prognosis in patients with MPM.
Improved surgical procedure of primary constrained total knee arthroplasty which enables use of the femoral diaphyseal straight extension stem
Authors: Kawahara Shinya , Mawatari Taro , Matsui Gen , Hamai Satoshi , Akasaki Yukio , Tsushima Hidetoshi , Nakashima Yasuharu
Published: May 2022

Background

In performing primary constrained total knee arthroplasties (TKA) to imbalanced knees, the offset stem is sometimes compelled to use, although this is associated with surgical difficulties. We developed a modified procedure which might be able to fit the anteroposterior (AP) and mediolateral (ML) position of the femoral component simultaneously with the straight stem. Purposes of this study were to evaluate usefulness of the modified procedure both in computer simulations and actual surgeries.

Methods

We included 32 knees that had undergone primary TKA using constrained implants because of the coronal imbalance. In the component-first procedure, the distal femur was prepared to fit the AP and ML position of the femoral component simultaneously at first, as in primary TKA. Finally, the stem hole is created based on the femoral component position (the component-first procedure). The femoral component and extension stem were simulated using the three-dimensional planning software (ZedKnee) following the component-first procedure. We investigated the suitability of the straight stem through computer simulation and evaluation of actual surgeries. Clinical and radiographical outcomes were also evaluated at the latest follow-up.

Results

The component-first procedure enabled the AP and ML position of the femoral component to be fitted simultaneously with the straight stem in simulations and actual surgeries in all cases. The stem diameter was not significantly different between simulations and actual surgeries (13.9 and 13.7 mm on average, respectively, p = 0.479) and almost similar from intraclass correlation coefficient analysis (kappa value 0.790). Clinical and radiographical outcomes were almost similar to primary TKA cases and there was no case of component loosening, cortical bone hypertrophy around the stem and stem-tip pain.

Conclusions

Our improved surgical procedure may facilitate use of the constrained implant for more cases of primary TKA in imbalanced knees without the usual surgical difficulties.

Trial registration

Retrospectively registered.
Diagnostic dilemmas: a multi-institutional retrospective analysis of adrenal incidentaloma pathology based on radiographic size
Authors: Zekan David , King Robert Scott , Hajiran Ali , Patel Apexa , Deem Samuel , Luchey Adam
Published: May 2022

Introduction/background

Adrenal incidentalomas (AIs) are masses > 1 cm found incidentally during radiographic imaging. They are present in up to 4.4% of patients undergoing CT scan, and incidence is increasing with usage and sensitivity of cross-sectional imaging. Most result in diagnosis of adrenal cortical adenoma, questioning guidelines recommending removal of all AIs with negative functional workup. This retrospective study analyzes histological outcome based on size of non-functional adrenal masses.

Material and methods

10 years of data was analyzed from two academic institutions. Exclusion criteria included patients with positive functional workups, those who underwent adrenalectomy during nephrectomy, < 18 years, and incomplete records. AI radiologic and histologic size, histologic outcome, laterality, imaging modality, gender, and age were collected. T-test was used for comparison of continuous variables, and the two-sided Fisher’s exact or chi-square test were used to determine differences for categorical variables. Univariate analysis of each independent variable was performed using simple logistic regression.

Results

73 adrenalectomies met the above inclusion criteria. 60 were detected on CT scan, 12 on MRI, and one on ultrasound. Eight of 73 cases resulted in malignant pathology, 3 of which were adrenocortical carcinoma (ACC). Each ACC measured > 6 cm, with mean radiologic and pathologic sizes of 11.2 cm and 11.3 cm. Both radiologic and pathologic size were significant predictors of malignancy (p = 0.008 and 0.011).

Conclusions

Our results question the generally-accepted 4 cm cutoff for excision of metabolically-silent AIs. They suggest a 6 cm threshold would suffice to avoid removal of benign lesions while maintaining sensitivity for ACC.