bluuebunny/crossref_metadata_2025 huggingface dataset:
Multimodal imaging of soccer ball-related ocular posterior segment injuries
Authors: Carrera William , Ng Caleb , Koppinger Jayson , Saud Asma , Chen Judy J , Agarwal Anita , Johnson Robert N , Jumper J. Michael , Lujan Brandon , McDonald H. Richard
Published: March 2022

Purpose

To investigate the clinical and anatomic characteristics of soccer ball-induced posterior segment injuries in the era of modern multi-modal imaging.

Methods

Retrospective case series of patients with soccer ball injury and diagnostic imaging from 2007 to 2020 at a single vitreoretinal practice.

Results

Eight patients met inclusion criteria. Fundus photographs (FP) and optical coherence tomography (OCT) were obtained in eight patients, fundus autofluorescence (FAF) in five patients, fluorescein angiography (FA) in three patients, and en-face OCT and OCT-Angiography (OCT-A) were obtained in two patients each. FA and FAF identified traumatic pigment epitheliopathy secondary to commotio. Increased hypo-autofluorescence was associated with shallow, peripheral retinal detachment on FAF. OCT of the macula displayed outer retinal changes associated with commotio, and offered insight into the acute and subacute changes of traumatic macular hole formation. A patient displayed foveal hyper-reflectivity in the shape of an hourglass with retinal cyst at the level of the external limiting membrane (ELM) as seen on OCT and En-face OCT. A patient with commotio involving the macula lacked microvascular changes on OCT-A.

Conclusion

OCT, FA, and FAF imaging may aid in the work-up and management of the soccer ball-related posterior segment injuries.
Rheumatoid Cerebral Vasculitis in a Patient in Remission
Authors: El Hasbani Georges , El Ouweini Hala , Dabdoub Fatema , Hourani Roula , Jawad Ali SM , Uthman Imad
Published: March 2022

Cerebral vasculitis is a very rare extra-articular complication of rheumatoid arthritis (RA) that is often challenging to diagnose. Elevated titers of rheumatoid factor (RF), anti-cyclic citrullinated peptide antibodies (anti-CCP), and antinuclear antibodies (ANA) have been linked with severe complications. The absence of highly elevated titers of RF, anti-CCP, and ANA can complicate the diagnosis of RA-associated cerebral vasculitis. We report the case of a 59-year-old woman with long-standing arthritis maintained on rituximab and leflunomide who developed sudden headaches and altered level of consciousness. Laboratory work-up revealed normal lymphocyte count and mildly elevated total serum protein and anti-CCP with negative RF and ANA and no evidence for viral or bacterial infections. Cerebrospinal fluid analysis (CSF) showed slightly elevated anti-CCP with normal levels of CXCL-13 and interleukin 6 (IL-6). Brain magnetic resonance imaging (MRI) showed ill-defined lesion of high T2 signal. Using MR angiogram, MR perfusion, and MR spectroscopy, the diagnosis of rheumatoid cerebral vasculitis was confirmed. The patient was treated with intravenous methyl-prednisolone with fast complete improvement. We conclude that adequate immunosuppression in RA might not be able to prevent rare extra-articular manifestations such as rheumatoid cerebral vasculitis.
Coping strategy enhancement for the treatment of distressing voices in young people: A service evaluation within routine clinical practice
Authors: Hayward Mark , Frost Hazel , Naito Akira , Jones Anna-Marie
Published: March 2022

Background

Hearing voices is a common experience in young people, irrespective of diagnosis. This experience can be associated with distress, self-harm and an increased risk of attempting suicide. However, there are currently no evidence-based interventions which specifically target distressing voice hearing experiences in young people.

Method

This was a service evaluation exploring the engagement, outcomes and experiences of young people who were offered a brief 4-session intervention for distressing voices within a Child and Adolescent Mental Health Service (CAMHS) in the UK’s National Health Service. The intervention was based on the principles of Coping Strategy Enhancement (CSE).

Results

A total of 24 young people were offered the CSE intervention over a 20-month period. The intervention was completed by 15 young people. Pre-post outcomes suggested clinically meaningful reductions in the negative impact of voices for the majority of the young people. Qualitative feedback was positive and highlighted the value of both a space to talk about voice hearing experiences and a focus upon coping strategies.

Conclusions

The findings from this service evaluation suggest that CSE can be a brief, acceptable and helpful way for young people within a CAMHS context to start a therapeutic conversation about their distressing voice hearing experiences.
Effects of makeup air on atrium smoke conditions: A review
Authors: Lei Wenjun , Qi Yue , Li Angui , Mei Sen
Published: March 2022

Makeup air is important for fire smoke control systems, and the effects of makeup air on atrium smoke conditions have long been a concern. Requirements for makeup air velocities and makeup air inlet arrangements are too broad in most standards. Herein, the relevant requirements for the design parameters of makeup air given in standards are summarized, and a comprehensive review of factors that influence makeup air and the corresponding effect on smoke management during atrium fires is provided. These influencing factors are divided into uncontrollable factors (wind, external temperature, the location of fire development and the power of the fire) and controllable factors (layout of makeup air inlets and mechanical makeup air velocity). Due to advancements in makeup air systems, the behavioural characteristics of occupants can now be taken into account in the design stage of makeup air systems. Regarding air supply in the breathing zone, the fresh air provided by a makeup air system can be directly supplied to occupants to reduce harmful effects of smoke and avoid casualties. However, determining how to effectively design a makeup air distribution system and the applicability of this type of air distribution in various complex fire conditions requires further study.
Investigation on the fire behaviour and propagation rule of fire overflow in the high-rise concave building structure
Authors: Lu Xin-Xiao , Shi Guo-Yu , Song Si-Yuan
Published: March 2022

The concave building structure (CBS) featured with a partial sunken façade is prevalent in the high-rise residence and comprehensive buildings. The building is a 3/4 enclosed longitudinal shaft that creates a new channel for longitudinal fire propagation. The objective of the paper is to reveal the dynamic mechanism of fire propagation in CBS. A small-scale experiment and Fire Dynamics Simulator (FDS) were conducted to investigate the fire behaviour. The results show that CBS could enhance the longitudinal propagation velocity of the flame and smoke with a slender profile. It could reduce the heat loss and create a higher space temperature than no-concave building structure (NBS). The maximum temperature and smoke concentration extended from the external facade centre to two flanks with the building height increase. Raising the structure factor extended the flame length from 7.0 m to 8.6 m. It exhibited a typical three stages of entrainment velocity growth: rapid growth, medium growth and slow growth. The flame transferred from the external façade to the lateral façade when the heat release rate was 8–10 MW. The research is essential to distinguish the hazardous region and provide a basis for architectural design and personal safe evacuation in the CBS fire scenario.
Enhancing the NOx and soot emissions reduction benefits of a low compression ratio light duty diesel engine by optimization of piston bowl design
Authors: Vikraman V , Anand K , Ramesh A
Published: March 2022

In the present work, the benefits of the low compression ratio (LCR) concept on simultaneous reduction of oxides of nitrogen (NOx) and soot emissions could be further enhanced by optimizing the piston bowl design using a 3-dimensional computational fluid dynamics (CFD) tool. A single-cylinder, direct-injection diesel engine was used for the present investigations. In its mass-production version, the engine had a compression ratio (CR) of 18:1 that was considered as the stock CR from which the LCR variants were derived. The initial and unoptimized piston design of the LCR variant with CR of 14:1 was arrived at using an offset bowl geometry from the stock compression ratio variant, and the corresponding benefits were quantified. The NO (nitric oxide) and soot reduction potential of the LCR variant could be further enhanced by adopting a step-by-step optimization procedure focused on the principal parameters of the bowl viz., piston bowl diameter, centre pip depth, reentrancy and bottom profile. Based on numerical investigations, an optimal piston bowl design could be arrived at that can significantly enhance the benefits of the LCR approach on NO and soot emissions. At a reference operating point of 2000 rpm and 40 N-m, by adopting the optimized profile, the NO reduction potential of the LCR variant could be improved from 10.3% to 40.2%. Moreover, the soot reduction potential could also be improved from 79.1% to 84.2%. The benefits of the optimized bowl design were also confirmed by engine dynamometer measurements across the engine’s operating speed range. Thus, it can be concluded that optimization of the piston bowl design specific to the LCR variant could enhance the NOx and soot emission benefits that can help diesel engines comply with the stringent emission regulations.
The Effect of Female Orgasm Frequency on Female Mate Selection: A Test of Two Hypotheses
Authors: Nebl Patrick J. , Gordon Anne K.
Published: March 2022

Female orgasm has been a mystery that psychologists have been attempting to understand for decades. Many have contended that female orgasm is a functionless by-product of male orgasm, while others have argued that female orgasm may be an adaptation in its own right, offering several adaptationist accounts of female orgasm. In the current research, we tested predictions derived from two hypotheses regarding adaptive functions of female orgasm: female orgasm indicates partner mate value or female orgasm promotes long-term, pair bonding. 199 female undergraduates participated in an experiment where they imagined themselves as a member of a romantic relationship provided in a scenario. Within these scenarios, the relationships varied between either short- or long-term and the frequency that the female experienced orgasm during intercourse varied between never, occasionally, and almost always. Participants answered questions regarding relationship satisfaction and perceptions of the fictional relationship. A series of analysis of variance (ANOVAs) indicated that females assigned to conditions of experiencing more frequent orgasms reported greater relationship satisfaction, across both short- and long-term relationships. The relationship between female orgasm frequency and relationship satisfaction was fully mediated by the female's perceived love for her hypothetical partner but not by perceptions of her hypothetical partner's commitment. Taken together, this study provides preliminary support for the hypothesis that female orgasm evolved as a mate-selection tool for females and promotes long-term, pair bonding but does not provide support for the hypothesis that female orgasm evolved as an indicator of male value.
Plant-based fibres in cement composites: A conceptual framework
Authors: Labib Wafa Abdelmajeed
Published: March 2022

The pursuit of sustainability has necessitated more renewable resources in construction materials. Plant-based natural fibres, which can be found globally, are abundant, low-cost and renewable. Moreover, plant-based fibres can improve the mechanical properties of construction materials as a low-cost, environmentally friendly renewable option. Accordingly, a thorough understanding of the characteristics and drawbacks of plant fibres, focussing on their use in cement-based composites, is needed to explore their potential in structural applications. Therefore, this study developed a conceptual framework to assess the factors affecting plant-based natural fibres and cement composites. The paper further demonstrates the application of the proposed framework to predict associated challenges and offers appropriate solutions. Finally, date palm fibres are suggested for future applications of the proposed conceptual framework.
Estimation algorithm for vehicle state estimation using ant lion optimization algorithm
Authors: Liu Yingjie , Cui Dawei
Published: March 2022

In order to solve the problem of vehicle state estimation, an unscented Kalman filter state parameter estimator based on the Ant lion algorithm is proposed. Aiming at the uncertainty of the noise covariance matrix in the unscented Kalman filter (UKF) process, the Ant lion optimization algorithm (ALO) is used to optimize it. Based on the purpose, a 3-DOF nonlinear vehicle estimation model with Magic formula tire model was established firstly. Then the slalom road operating condition was simulated. The simulation results show that the estimated values of the key state variables are in better agreement with the virtual test values indicating the proposed algorithm having a good estimation performance. And also, compared with the estimation results of the UKF algorithm, the maximum error and the root mean square error of the estimation algorithm proposed in this paper are both smaller than the estimated value of the UKF algorithm. The results of a real-vehicle experiment demonstrate that the proposed method can be used effectively and accurately for solving the vehicle-state estimation problem. The study can provide precise status information for vehicle stability control under extreme conditions.
Residual life estimation of lithium-ion batteries based on nonlinear Wiener process with measurement error
Authors: Han Yangyang , Ma Changlin , Tang Shengjin , Wang Fengfei , Sun Xiaoyan , Si Xiaosheng
Published: March 2022

Residual life (RL) estimation is a key issue in the prognostics and health management (PHM). This paper proposes a heuristic algorithm for RL estimation based on the nonlinear Wiener process with measurement error (ME) and also proposes an unbiased parameters estimation method. First, we use the nonlinear Wiener process with ME to model the degradation process. Then, an analytical expression of parameters estimation results with restriction of the nonlinear coefficient and variance of ME is obtained and an unbiased parameters estimation method is also derived by analyzing the natures of parameters estimation. Moreover, an empirical unbiased parameters estimation method for the degradation data with different measurement times is also proposed. After that, we extend the heuristic algorithm to the nonlinear Wiener process with ME and some relevant conclusions are proved. Finally, some simulation examples and a case study of lithium-ion batteries are used for experimental verification. The results show that the unbiased parameters estimation method is superior to the traditional maximum likelihood estimation (MLE) method and the heuristic RL estimation method can overcome the influence of imperfect prior information for lithium-ion batteries based on the nonlinear Wiener process with ME.
Ideological variation in preferred content and source credibility on Reddit during the COVID-19 pandemic
Authors: Chipidza Wallace , Krewson Christopher , Gatto Nicole , Akbaripourdibazar Elmira , Gwanzura Tendai
Published: March 2022

In this exploratory study, we examine political polarization regarding the online discussion of the COVID-19 pandemic. We use data from Reddit to explore the differences in the topics emphasized by different subreddits according to political ideology. We also examine whether there are systematic differences in the credibility of sources shared by the subscribers of subreddits that vary by ideology, and in the tendency to share information from sources implicated in spreading COVID-19 misinformation. Our results show polarization in topics of discussion: the Trump, White House, and economic relief topics are statistically more prominent in liberal subreddits, and China and deaths topics are more prominent in conservative subreddits. There are also significant differences between liberal and conservative subreddits in their preferences for news sources. Liberal subreddits share and discuss articles from more credible news sources than conservative subreddits, and conservative subreddits are more likely than liberal subreddits to share articles from sites flagged for publishing COVID-19 misinformation.
Exploring Primary Care Non-Attendance: A Study of Low-Income Patients
Authors: Chapman Kyle A. , Machado Stephanie S. , van der Merwe Katie , Bryson Ashley , Smith Dwight
Published: March 2022

Introduction:

While evidence has been established on the impact of medical appointment non-attendance on the healthcare system and patient health, previous research has not focused on how poverty and rurality may influence patient experiences with non-attendance. This paper explores patient perceptions of non-attendance among those experiencing poverty in a rural U.S county to better inform providers to the context in which their patients make attendance-related decisions.

Methods:

Using a grounded theory approach, we conducted semi-structured interviews with 32 U.S. low-income adults in the rural Western U.S. who recurrently missed primary care appointments. We also used a questionnaire to assess individual characteristics related to health, resiliency, personal mastery, medical mistrust, life chaos, and adverse childhood experiences.

Results:

Participants identified 3 barriers to attending appointments: appointment disinterest, competing demands, and insufficient systems. Appointment disinterest stemmed from physical and mental health issues, misalignment between needs and treatment, and comfort with the provider. Competing demands included family responsibilities, employment, and relationships. Finally, participants reported that current scheduling and transportation systems were helpful but insufficient. To provide further context, participants also reported low overall health, moderate levels of medical mistrust, life chaos, and mastery, moderate to low resilience, and very a high number of adverse childhood experiences.

Conclusions:

Results point to the need for modified structures that allow low-income patients more control over their personal health and highlight opportunities for clinics to address patients’ lack of interest and fear in the medical encounter.
Scaling Out Virtual Interview Training for Transition-Age Youth: A Quasi-Experimental Hybrid Effectiveness-Implementation Study
Authors: Smith Matthew J. , Sherwood Kari , Ross Brittany , Oulvey Eugene A. , Monahan Julie A. , Sipovic Jessica E. , Atkins Marc S. , Danielson Elizabeth C. , Jordan Neil , Smith Justin D.
Published: March 2022

In a previous randomized controlled trial (RCT), Virtual Interview Training for Transition Age Youth (VIT-TAY) enhanced employment for autistic youth receiving transition services. For this study, a nonrandomized hybrid effectiveness-implementation trial evaluated whether VIT-TAY maintained its core implementation and effectiveness functions when scaled out to students with disabilities in 32 schools. Also, we compared the implementation and effectiveness between VIT-TAY and Virtual Reality Job Interview Training (VR-JIT; developed for adults and previously evaluated in students with disabilities). Core implementation functions did not differ between VIT-TAY and VR-JIT. Greater engagement with either training was significantly associated with employment (both p < .05). Overall, VIT-TAY was feasibly implemented with high adherence and may be effective at enhancing employment for students with disabilities. Limitations and implications for research and practice are discussed.
Demographic, Health and Pandemic-Related Determinants of COVID-19 Vaccination Intention Among Filipino Emerging Adults
Authors: Cleofas Jerome V. , Oducado Ryan Michael F.
Published: March 2022

Emerging adults have become more susceptible to COVID-19 because of the emergence of the Delta and Omicron variants. Vaccination can help protect them from contracting the virus. However, in the Philippines, vaccine acceptance rates are low. This cross-sectional study sought to determine the demographic, health, and pandemic-related determinants of COVID-19 vaccination intention among Filipino emerging adults. A total of 1692 Filipinos aged 18–24 years old participated in this study by answering an online survey. Findings reveal that 57.03% of the respondents do not intend to complete their COVID-19 vaccinations. Logistic regression analysis results suggest that less than “very good” self-reported health, lower life satisfaction, previous exposure to a COVID-19 patient, and lower pandemic fatigue were associated with greater odds of intending to vaccinate among Filipino emerging adults ( p < 0.05).
Influence of Mutual Support on Burnout among Intensive Care Unit Healthcare Professionals
Authors: Haruna Junpei , Unoki Takeshi , Ishikawa Koji , Okamura Hideaki , Kamada Yoshinobu , Hashimoto Naoya
Published: March 2022

Introduction

Burnout among healthcare professionals in intensive care units (ICUs) is a serious issue that leads to early retirement and medication errors. Their gender, lower years of experience, and lower education have been reported as risk factors. Simultaneously, mutual support—commonly referred to as “back-up behavior,” in which staff members support each other—is critical for team performance. However, little is known about the influence of mutual support among ICU healthcare professionals on burnout. The U.S. Agency for Healthcare Research and Quality refers to mutual support as the involvement of team members in: assisting one another, providing and receiving feedback, and exerting assertive and advocacy behaviors when patient safety is threatened.

Objective

This study aimed to verify the hypothesis that lower mutual support among ICU healthcare professionals is associated with increased probability of burnout.

Methods

A web-based survey was conducted from March 4 to 20, 2021. All ICU healthcare professionals in Japan were included. An invitation was sent via the mailing list of the Japanese Society of Intensive Care Medicine and asked to mail to local communities and social network services. We measured burnout severity using the Maslach Burnout-Human Services Survey and mutual support using the TeamSTEPPS Teamwork Perceptions Questionnaire, as well as occupational background. The cutoff value for burnout was predefined and conducted logistic regression.

Results

We received 335 responses, all of which were analyzed. The majority of respondents were nurses (58.5%), followed by physicians (18.5%) and clinical engineers (10.1%). The burnout group scored significantly lower on mutual support than the non-burnout group. After adjusting for covariates in a logistic regression, low mutual support was an independent factor predicting a high probability of burnout.

Conclusions

This study suggests that it is important to focus on mutual support among ICU healthcare professionals to reduce the frequency of burnout.
Connecting to the General Curriculum: Supporting Nonmusic Goals for Students With Disabilities
Authors: Draper Ellary A.
Published: March 2022

Students with disabilities often have difficultly applying information learned in one context to another, also called transfer. Music teachers can provide opportunities for students to transfer and make connections between classes to enhance their learning and encourage students to think differently about the content. By including nonmusic ideas, concepts, and skills, music teachers can reinforce learning for all students. This article includes suggestions for how general music teachers can include various nonmusic ideas, concepts, and skills in music instruction as well as specific ideas for inclusive music classrooms with students with disabilities.
Group Drumming as Conduit to Enhanced Self and Community Relationships
Authors: Varner Edward
Published: March 2022

The purpose of this column is to promote the use of group drumming as an important access point to improved self and community relationships that naturally develops the competencies of student self-awareness and social awareness in the general music classroom. Group drumming is a far-reaching activity with the capacity to improve and transform many of the traumatic life experiences endured by our students. The promise of group drumming to enhance individual well-being while simultaneously developing an inclusive community environment is a readily available tool within reach of almost every general music teacher. The approach can be used to enhance self-awareness in the moment, reduce anxiety, and provide access to successful experiences for students. Group drumming exposes participants to new ways of understanding themselves and others around them while creating important entry points to the SEL (social and emotional learning) competencies of both social awareness and self-awareness.
Losartan treatment attenuates hindlimb unloading-induced atrophy in the soleus muscle of female rats via canonical TGF-β signaling
Authors: Yoshihara Toshinori , Takaragawa Mizuki , Dobashi Shohei , Naito Hisashi
Published: March 2022

We investigated the protective effect of losartan, an angiotensin II type 1 receptor blocker, on soleus muscle atrophy. Age-matched male and female Wistar rats were subjected to hindlimb unloading, and the soleus muscle was removed on days 1 and 7 for analysis. Females showed greater reductions in relative weight and myofiber cross-sectional area of the soleus muscle than males on day 7 post-hindlimb unloading. Losartan partially protected females against muscle atrophy. Activation of the canonical TGF-β signaling pathway, assessed via Smad2/3 phosphorylation, was lower in females following losartan treatment and associated with lower levels of protein ubiquitination after 1 (myofibril) and 7 (cytosol) days of unloading. However, no effect was observed in non-canonical TGF-β signaling (p44/p42 and p38 MAPK phosphorylation) in males or females during unloading. Our results suggest that losartan provides partial protection against hindlimb unloading-induced soleus muscle atrophy in female rats, possibly associated with decreased canonical TGF-β signaling.
Cardiovascular disturbances in COVID-19: an updated review of the pathophysiology and clinical evidence of cardiovascular damage induced by SARS-CoV-2
Authors: Lawal Ismaheel O. , Kgatle Mankgopo M. , Mokoala Kgomotso , Farate Abubakar , Sathekge Mike M.
Published: March 2022

Severe acute respiratory coronavirus-2 (SARS-Co-2) is the causative agent of coronavirus disease-2019 (COVID-19). COVID-19 is a disease with highly variable phenotypes, being asymptomatic in most patients. In symptomatic patients, disease manifestation is variable, ranging from mild disease to severe and critical illness requiring treatment in the intensive care unit. The presence of underlying cardiovascular morbidities was identified early in the evolution of the disease to be a critical determinant of the severe disease phenotype. SARS-CoV-2, though a primarily respiratory virus, also causes severe damage to the cardiovascular system, contributing significantly to morbidity and mortality seen in COVID-19. Evidence on the impact of cardiovascular disorders in disease manifestation and outcome of treatment is rapidly emerging. The cardiovascular system expresses the angiotensin-converting enzyme-2, the receptor used by SARS-CoV-2 for binding, making it vulnerable to infection by the virus. Systemic perturbations including the so-called cytokine storm also impact on the normal functioning of the cardiovascular system. Imaging plays a prominent role not only in the detection of cardiovascular damage induced by SARS-CoV-2 infection but in the follow-up of patients’ clinical progress while on treatment and in identifying long-term sequelae of the disease.
Clinicians’ perceptions of barriers to cervical cancer screening for women living with behavioral health conditions: a focus group study
Authors: Mkuu Rahma S. , Staras Stephanie A. , Szurek Sarah M. , D’Ingeo Dalila , Gerend Mary A. , Goede Dianne L. , Shenkman Elizabeth A.
Published: March 2022

Background

Women with behavioral health (BH) conditions (e.g., mental illness and substance abuse) receive fewer cervical cancer (CC) screenings, are diagnosed at more advanced cancer stages, and are less likely to receive specialized treatments. The aim of this study was to identify barriers that healthcare providers face in providing CC screening to women with BH conditions.

Methods

Guided by the Consolidated Framework for Implementation Research, we conducted four focus groups in North Florida with 26 primary care and BH clinicians and staff to examine perceived barriers to CC screening among their patients with BH conditions to guide the future development of a tailored cervical cancer screening and follow-up intervention. Thematic analysis was used to analyze verbatim transcripts from audiotaped focus groups.

Results

Three main themes of barriers emerged from the data: 1) BH conditions related barriers included a history of trauma, stigma and discrimination, and uncontrolled comorbid conditions, 2) System level barriers related to lack of integration between BH and primary care, and 3) Similar barriers to the general population including lack of health insurance, insufficient processes to send out reminders, and challenges with communicating with patients.

Conclusions

Tailored CC screening interventions that address the unique needs of women with BH conditions are needed. Strategies that address improving trust between patients and healthcare providers, identifying avenues to improve receipt of screening during time-limited clinical visits, connecting BH and primary care providers, and addressing the social determinants of health have potential to improve CC screening rates for women with BH conditions.
Glycemic variability assessed by continuous glucose monitoring in hospitalized patients with community-acquired pneumonia
Authors: Olsen Mikkel Thor , Dungu Arnold Matovu , Klarskov Carina Kirstine , Jensen Andreas Kryger , Lindegaard Birgitte , Kristensen Peter Lommer
Published: March 2022

Background

Glycemic variability (GV) has only been sparsely studied in patients with community-acquired pneumonia (CAP). This study aimed to quantify in-hospital GV in CAP patients, including determining the impact of type 2 diabetes mellitus (T2DM) and glucocorticoid (GC) treatment on GV.

Methods

This is a prospective cohort study of CAP patients (N = 40) with or without T2DM and treated or not with GCs. The primary endpoint was GV measured as glucose standard deviation (SD), coefficient of variation (CV), and postprandial glucose excursions (PPGE) based on continuous glucose monitoring (CGM). Analysis of glucose data was split into daytime and nighttime when possible.

Results

Patients included had a mean age of 74 (range 55 to 91) years. SD (95%CI) increased by a factor of 1.93 (1.40 to 2.66) and 2.29 (1.38 to 3.81) in patients with T2DM and not treated with GCs during the daytime and the nighttime, respectively (both P < 0.01), and by a factor of 1.42 (1.04 to 1.97) in patients treated with GCs but without T2DM during the daytime (P = 0.031) compared to patients without T2DM and not treated with GCs. CV (95%CI) increased by 5.1 (0.0 to 10.1) and 8.1 (1.0 to 15.2) percentage points during the daytime and the nighttime, respectively, in patients with T2DM and not treated with GCs compared to patients without T2DM and not treated with GCs (P = 0.046 and P = 0.026, respectively). PPGE (95% CI) increased during lunch by 2.5 (0.7 to 4.3) mmol/L (45 (13 to 77) mg/dL) in patients with T2DM and treated with GCs compared to patients without T2DM and not treated with GCs (P = 0.018).

Conclusions

CAP patients receiving GCs, especially those with T2DM, are at great risk of developing high GV and therefore require clinical attention to mitigate GV. This applies particularly during the daytime. Results support the 1 to 2-h post-lunch screening procedure for glucocorticoid-induced hyperglycemia in patients without diabetes. SD was positively correlated with hospital length of stay.
Cytotoxic effects of different detergent containing children's toothpastes on human gingival epithelial cells
Authors: Birant Sinem , Duran Yazgul , Akkoc Tunc , Seymen Figen
Published: March 2022

Background

This study aimed to evaluate possible cytotoxic effects to gingival epithelial cells exposed to children toothpastes containing different detergent.

Methods

Tissues required for the isolation of human gingival epithelial cells were obtained by biopsy during the extraction of the impacted third molar tooth. Toothpaste solutions of different concentrations were prepared from five different children’s toothpastes with different detergent contents. Isolated gingival epithelial cells were stimulated with experimental groups consisting of toothpaste solutions (Colgate, Sensodyne, Splat, Nenedent, Perlodent) at different concentrations and a control group consisting of complete Dulbecco’s modified eagle medium. After the experiments, cell viability was evaluated using flow cytometry. 2 Way ANOVA was used to see the interaction effect of the main effects of toothpaste solution and concentration factors. Pairwise comparisons were made by Tukey post hoc tests. In the study, the significance level was taken as 0.05.

Results

As a result of the analysis, it was seen that the toothpaste solution and concentration factors and the interactions of these 2 factors were effective on the viable, early apoptotic, late apoptotic and necrotic cell rates. The statistically highest live cell ratios were detected in Splat’s toothpaste solutions (90.14% at 0.4% concentration) after the control group (90.82%) and the group with the lowest viability values was determined in Colgate group (75.74% at 0.4% concentration) (p < 0.05).

Conclusions

According to the results of the study, it was observed that toothpastes containing SLS affected the viability of cells more negatively than toothpastes with other detergent contents.
A scoping review of the evidence for community-based dementia palliative care services and their related service activities
Authors: O’Connor Niamh , Fox Siobhan , Kernohan W George , Drennan Jonathan , Guerin Suzanne , Murphy Aileen , Timmons Suzanne
Published: March 2022

Background

Palliative care is identified internationally as a priority for efficacious dementia care. Research into “effective models” of palliative care for people with dementia has been recommended by several European countries. To build an effective service-delivery model we must gain an understanding of existing models used in similar settings. The study aim is to identify core components of extant models of palliative care for people with dementia, and their families, who are living at home in the community.

Methods

A scoping review was employed. The search strategy was devised to identify all peer-reviewed research papers relating to the above aim. This process was iterative, and the search strategy was refined as evidence emerged and was reviewed. All types of study designs and both quantitative and qualitative studies of non-pharmacological interventions were considered for inclusion.

Results

The search identified 2,754 unique citations, of which 18 papers were deemed eligible for inclusion. Although a palliative care approach is recommended from early in the disease process, most evidence involves end-of-life care or advanced dementia and pertains to residential care. The majority of the research reviewed focused on the effects of advance care planning, and end-of-life care; specialist palliative care input, and/or generalist palliative care provided by dementia services to enable people to remain at home and to reduce costs of care. Community staff training in palliative care appeared to improve engagement with Specialist Palliative Care teams. Integration of dementia and palliative care services was found to improve care received for people with dementia and their carers.

Conclusions

While the evidence for integration of dementia and palliative care services is promising, further high-quality research is necessary particularly to identify the key components of palliative care for people living with dementia. This is imperative to enable people with dementia to inform their own care, to stay living at home for as long as possible, and, where appropriate, to die at home.
Health related quality of life among pregnant women living with HIV in Kenya, results from comparing a patient generated index and the Euroqol 5 dimension 3 level
Authors: Mwangi Jonathan , Ternent Laura , Ujiji Patricia Opondo Awiti , Were Edwin , Ekström Anna Mia
Published: March 2022

Background

Standardized tools are used to measure health-related quality of life (HRQoL) and they focus on selected physical, emotional, and social functioning. This approach may miss out on the heterogeneity of HRQoL among various sub-populations. The patient-generated index (PGI) is a tool used to measure HRQoL based on patients' expectations. Among patients living with HIV, HRQoL is an important indicator as the world moves beyond the UNAIDS 90-90-90 goals, towards the so-called fourth 90 that aims at good HRQoL. We compared the PGI and the Euroqol 5 Dimension 3-level (EQ-5D-3L) to identify areas of importance to pregnant women living with HIV affecting thier HRQoL.

Methods

Through convenience sampling, we surveyed 100 pregnant women living with HIV attending antenatal and postnatal clinics in Western Kenya, using both the PGI and the EQ-5D-3L questionnaires. A PGI score and EQ-5D-3L index were generated for each participant. Data from the PGI was also summarized into themes. The PGI scores and EQ-5D-3L index scores were correlated using Pearson correlation.

Results

From the PGI tool, 64% of the women reported having two to three main priority areas of their lives affected by their HIV status. These areas centered on themes of economic wellbeing (84% of the women), physical health (58%), psychological/emotional health (49%), and relationships (28%). The mean PGI score was 2.01 [SD = 1.10; median 1.10]. The majority of the women reported having no problems in any of the 5 dimensions captured in the EQ-5D-3L. The mean EQ-5D-3L score was 0.94 [SD = 1.10; median 1.00]. Both the EQ-5D-3L and the PGI showed less than perfect HRQoL. There was no correlation between the PGI and the EQ-5D-3L scores.

Conclusion

The PGI may capture aspects of contextual social and emotional life for Kenyan pregnant women living with HIV that are not identified by generic tools. Highlighting areas of importance to patients’ HRQoL is key as focus shifts towards the fourth 90 and may also inform the design of care programs aligned to patient needs.
A week long “pep” talk – initial and 2–3-year longitudinal data on the Ottawa Psychiatry Enrichment Program (OPEP)
Authors: Lee Elliott Kyung , Morra Alexandra , Bazaid Khalid , Bezzahou Abdellah , Simas Kevin , Taplin Christopher , Chun Soojin , Fiedorowicz Jess G. , Douglass Alan Bruce
Published: March 2022

Background

Recruitment to psychiatry as a career has been challenging in Canada and abroad despite the known shortage and increasing burden of psychiatric issues globally. Deterrents to choosing psychiatry as a career include its negative stigma and paucity of knowledge about the field. The study goal was to evaluate the Ottawa Psychiatry Enrichment Program (OPEP), a one-week extracurricular program about psychiatry as a career for 1st and 2nd year medical students. We hypothesized OPEP would improve students’ attitudes towards psychiatry, and positive changes would be sustained 2–3 years later following their residency match. We hypothesized there would be a high recruitment of OPEP attendees to psychiatry programs.

Methods

1st and 2nd year medical students from Canada applied to OPEP. Attendees completed the Attitudes Towards Psychiatry Questionnaire (ATP-30) at three times: before OPEP (PreOPEP), after OPEP (PostOPEP) and after their Canadian Residency Matching Service (CaRMs) match 2–3 years later. OPEP ATP-30 scores were compared to third-year student ATP-30 scores before and after their psychiatry rotation. Data were analysed using Friedman non-parametric ANOVA and post hoc testing by either Wilcoxon rank sum test, Wilcoxon matched pairs signed rank test, or parametric Welch independent t-test as appropriate. Effect sizes of group mean differences were calculated using Cohen’s “d”.

Results

Between 2017–2018, 29/53 Canadian applicants were selected for OPEP. 100%, 93.1% and 75.8% of OPEP students completed the PreOPEP, PostOPEP, and CaRMs ATP-30 surveys respectively. 43% of OPEP attendees matched to psychiatry. PostOPEP ATP-30 scores (mean = 133, median = 137, SD = 10.6) were significantly higher than PreOPEP ATP-30 (mean score = 121, median = 122, SD = 9.3, p < 0.001) and CaRMS ATP-30 (mean = 126, median = 127, SD = 12.3, p < 0.02) scores. OPEP effect size on ATP-30 scores was large (d = 1.2) but decreased 2–3 years later (p = 0.078, d = 0.44). 97/202 students completed the ATP-30 before and after their psychiatry rotation (clerkship). Clerkship effect size on improvement in ATP-30 was moderate (d = 0.39). There was a non-significant difference between OPEP CaRMS ATP-30 and post clerkship ATP-30 scores (median 127 vs 121, p = 0.056).

Conclusions

OPEP ameliorated attitudes toward Psychiatry, but improvement deteriorated longitudinally. Strategies for program design, and innovations to boost/retain improvements during clerkship years are discussed.
BET proteins are essential for the specification and maintenance of the epiblast lineage in mouse preimplantation embryos
Authors: Tsume-Kajioka Mami , Kimura-Yoshida Chiharu , Mochida Kyoko , Ueda Yoko , Matsuo Isao
Published: March 2022

Background

During mammalian preimplantation development, as the fertilized egg develops and differentiates, three cell lineages become specified: trophectoderm (TE), epiblast, and primitive endoderm (PrE). Through two steps of cell fate decisions, 16-cell blastomeres develop into TE and an inner cell mass (ICM), and thereafter, the latter differentiates into pluripotent epiblast and PrE. Although bromodomain and extra-terminal domain (BET) proteins, such as BRD4, are necessary for the transcriptional activation of genes involved in the maintenance of mouse embryonic stem cells by occupying their enhancers, their roles in the development of mouse preimplantation are unknown.

Results

To evaluate the effect of BET protein deficiency on cell lineage formation, we cultured preimplantation embryos in the presence of JQ1, which blocks the binding of BET bromodomains to acetylated-histones. We found BET inhibition blocked the transcriptional activation of genes, such asNanog,Otx2, andSox2, important for the formation of the epiblast lineage in blastocysts. Expression studies with lineage-specific markers in morulae and blastocysts revealed BET proteins were essential for the specification and maintenance of the epiblast lineage but were dispensable for the formation of primarily extraembryonic TE and PrE lineages. Additional Ingenuity Pathway Analysis and expression studies with a transcriptionally active form of signal transducer and activator of the transcription 3 (STAT3) suggested BET-dependent activation was partly associated with the STAT3-dependent pathway to maintain the epiblast lineage. To identify BET proteins involved in the formation of the epiblast lineage, we analyzed mutant embryos deficient inBrd4,Brd2, and double mutants. Abolishment of NANOG-positive epiblast cells was only evident inBrd4/Brd2double-deficient morulae. Thus, the phenotype of JQ1-treated embryos is reproduced not by aBrd4- orBrd2-single deficiency, but onlyBrd4/Brd2-double deficiency, demonstrating the redundant roles of BRD2 and BRD4 in the specification of the epiblast lineage.

Conclusions

BET proteins are essential to the specification and maintenance of the epiblast lineage by activating lineage-specific core transcription factors during mouse preimplantation development. Among BET proteins, BRD4 plays a central role and BRD2 a complementary role in the specification and maintenance of epiblast lineages. Additionally, BET-dependent maintenance of the epiblast lineage may be partly associated with the STAT3-dependent pathway.
Hematopoietic differentiation is characterized by a transient peak of entropy at a single-cell level
Authors: Dussiau Charles , Boussaroque Agathe , Gaillard Mathilde , Bravetti Clotilde , Zaroili Laila , Knosp Camille , Friedrich Chloé , Asquier Philippe , Willems Lise , Quint Laurent , Bouscary Didier , Fontenay Michaela , Espinasse Thibault , Plesa Adriana , Sujobert Pierre , Gandrillon Olivier , Kosmider Olivier
Published: March 2022

Background

Mature blood cells arise from hematopoietic stem cells in the bone marrow by a process of differentiation along one of several different lineage trajectories. This is often represented as a series of discrete steps of increasing progenitor cell commitment to a given lineage, but as for differentiation in general, whether the process is instructive or stochastic remains controversial. Here, we examine this question by analyzing single-cell transcriptomic data from human bone marrow cells, assessing cell-to-cell variability along the trajectories of hematopoietic differentiation into four different types of mature blood cells. The instructive model predicts that cells will be following the same sequence of instructions and that there will be minimal variability of gene expression between them throughout the process, while the stochastic model predicts a role for cell-to-cell variability when lineage commitments are being made.

Results

Applying Shannon entropy to measure cell-to-cell variability among human hematopoietic bone marrow cells at the same stage of differentiation, we observed a transient peak of gene expression variability occurring at characteristic points in all hematopoietic differentiation pathways. Strikingly, the genes whose cell-to-cell variation of expression fluctuated the most over the course of a given differentiation trajectory are pathway-specific genes, whereas genes which showed the greatest variation of mean expression are common to all pathways. Finally, we showed that the level of cell-to-cell variation is increased in the most immature compartment of hematopoiesis in myelodysplastic syndromes.

Conclusions

These data suggest that human hematopoietic differentiation could be better conceptualized as a dynamical stochastic process with a transient stage of cellular indetermination, and strongly support the stochastic view of differentiation. They also highlight the need to consider the role of stochastic gene expression in complex physiological processes and pathologies such as cancers, paving the way for possible noise-based therapies through epigenetic regulation.