bluuebunny/crossref_metadata_2025 huggingface dataset:
Bioassays of Humoral Cardioprotective Factors Released by Remote Ischemic Conditioning in Patients Undergoing Coronary Artery Bypass Surgery
Authors: Lieder Helmut Raphael , Tüller Pia , Braczko Felix , Zandi Afsaneh , Kamler Markus , Thielmann Matthias , Heusch Gerd , Kleinbongard Petra
Published: May 2022

Remote ischemic conditioning (RIC) induces the release of circulating cardioprotective factors and attenuates myocardial ischemia/reperfusion injury. Evidence for such humoral cardioprotective factor(s) is derived from transfer with plasma (derivatives) from one individual undergoing RIC to another individual’s heart, even across species. With transfer into an isolated perfused heart, only a single plasma (derivative) sample can be studied with infarct size as endpoint, and therefore the comparison of samples before and after RIC or between RIC and placebo is hampered by the inter-individual variation of infarct sizes in isolated perfused hearts. We therefore developed a preparation of cardiomyocytes from a single mouse heart, where aliquots of the same heart can undergo hypoxia/reoxygenation (H/R) with exposure to buffer, RIC, or placebo samples without or with pharmacological blockade. To validate this approach, we used plasma dialysates taken before and after RIC from patients undergoing coronary bypass grafting who had experienced protection by RIC (troponin release ↓ by 28% vs placebo). The cardiomyocyte bioassay had little variation after H/R with buffer (mean ± standard deviation; 7% ± 2% viable cells) and demonstrated preserved viability after RIC (15% ± 5% vs 6% ± 3% before). For comparison, infarct size in isolated mouse hearts after global ischemia and reperfusion was 22% ± 14% of left ventricular mass after versus 42% ± 14% before RIC. Stattic, an inhibitor of signal transducer and activator of transcription (STAT)3 protein, abrogated protection in the cardiomyocytes. We have thus established a cardiomyocyte bioassay to analyze RIC’s protection which minimizes inter-individual variation and the use of animals.
Optimization of structural design with pendulum dynamic vibration absorber using genetic algorithm
Authors: Lee Hoo Min , Han Sol Ji , Kim Deok-Soo , Yoon Gil Ho
Published: May 2022

In this study, a genetic algorithm is introduced to determine optimal locations of pendulum dynamic vibration absorbers (PDVAs) in vibrating structures. A PDVA is composed of a pendulum system and spring-mass system, and aims to attenuate structural vibrations at two resonance frequencies, that is, the square root of stiffness over mass and square root of a length over gravity of the hosting structure. An optimization method involving nonlinear transient finite element analysis was applied to increase the engineering efficiency of PDVAs. With the incorporation of a genetic algorithm, the optimal locations of PDVAs in various structures can be determined and vibrations at the desired resonant frequencies can be attenuated. In addition, the Voronoi diagram concept is applied to realize a uniform distribution of PDVAs in vibrating structures. Several optimization examples were solved using the proposed genetic algorithm and demonstrated decreases in frequency responses by up to 98.6549%, showing the effectiveness of PDVAs in suppressing structural vibrations.
Assessment of Sleep Duration and Number of Awakenings Based on Ankle and Wrist Actigraphy in Medical Hospitalized Older Patients
Authors: Smichenko Juliana , Shochat Tamar , Zisberg Anna
Published: May 2022

Background

Most studies performed in the hospital assess sleep using self-reports; few rely on actigraphy. Although wrist actigraphy is commonly used for sleep assessment in field studies, in-hospital assessment may be challenging and cumbersome because other more necessary monitoring devices are often attached to patients’ upper limbs; these may affect interpretation of wrist activity data. Placement on the ankle may be a viable solution.

Objective

To compare total sleep time (TST) and number of awakenings (NOA) using concomitant wrist and ankle actigraphy, as well as self-reports in a sample of older adult patients hospitalized in medical units.

Methods

This was a prospective observational study. Objective sleep data were collected using ankle and wrist actigraphy, and subjective data using sleep diary. Repeated measures mixed model analysis was performed, adjusting for age, gender, sleep medications, symptoms severity, interaction between types of measure, and night number.

Results

Twenty-one older adults (65+) wore ankle and wrist actigraphy devices and subjectively estimated sleep parameters for an average of (2.15 ± 1.01) nights, with 40 nights available for analysis. TST was lower for wrist than ankle actigraphy ( F(2,87) = 7.92, p = .0007). Neither differed from self-reports. NOA differed between all types of measure (ankle, 8.58 ± 6.66; wrist, 15.49 ± 7.47; self-report, 1.81 ± 1.83; F(2,85) = 47.66, p < .001). No significant within-subject variations and no interaction between devices and repeated measures were found.

Conclusions

Despite differences between ankle and wrist assessments, all three methods provided consistent TST estimation within participants. Findings provide preliminary support for the use of ankle actigraphy for sleep assessment in hospital settings.
Association between blood-aqueous barrier disruption and extent of retinal detachment
Authors: Schoeneberger Verena , Eberhardt Somaie , Menghesha Leonie , Enders Philip , Cursiefen Claus , Schaub Friederike
Published: May 2022

Purpose

To investigate the association between anatomical features of rhegmatogenous retinal detachment (RRD) and the extent of blood-aqueous barrier disorder measured by non-invasiv laser flare photometry.

Methods

Retrospective evaluation of consecutive patients with RRD that underwent surgery between November 2016 and October 2018. Descriptive evaluation of pre- and postoperative parameters and correlation to preoperative laser flare value, extent of retinal detachment and re-detachment rate were performed.

Results

266 patients (mean age 62.73 ± 10.40 years, 62.8% male) were included. Mean preoperative flare value was 11.0 ± 11.9 pc/ms. In pseudophakia flare values were higher than in phakia (12.7 ± 10.4 pc/ms versus 9.8 ± 12.9 pc/ms; p = 0.042). Flare increased and correlated significantly with the number of affected retinal quadrants (Q) (1 Q 6.4 ± 3.3 pc/ms; 2 Q 10.5 ± 8.8 pc/ms; 3 Q 15.6 ± 9.1 pc/ms; 4 Q 27.5 ± 33.3 pc/ms; p < 0.001; r = 0.40). Macular status correlated significantly with flare values (macula on 8.6 ± 7.1 pc/ms, off 13.1 ± 15.0 pc/ms; p = 0.004; r = 0.17).

Conclusion

The level of objective tyndallometry in RRD seems to be influenced by lens status and extent of retinal detachment. Thus, the greater the affected retinal area is, the more blood-aqueous barrier disruption seems to be present.
Oral health promotion and labour market prospects of socially disadvantaged and unemployed people – a randomised controlled trial
Authors: Sigsgaard Anna M. , Bolvig Iben , Jensen Katrine D. , Altmann Steffen , Hede Børge , Øzhayat Esben B.
Published: May 2022

Background:

Previous studies indicate that poor oral health may constitute a barrier for labour market success. This study examines whether an oral health promotion intervention has an effect on economic self-support, and proximity to the labour market, among socially disadvantaged unemployed people.

Methods:

From April–June 2018, we enrolled 273 vulnerable people on welfare benefits into a randomised controlled trial. Participants were allocated to either control ( n=159), or intervention ( n=114). Intervention consisted of individual support to improve individuals’ oral health by reducing significant barriers to dental care. Ten participants were excluded, leaving 263 participants (intervention n=110, control n=153) for analyses. A national register was used to assess economic self-support and proximity to the labour market within 1.5 years post-intervention. Items of information on health and socio-demographics were obtained from a questionnaire and from national registers. Logistic and multiple linear regression modelling was performed.

Results:

Overall, higher frequencies of economic self-support and proximity to the labour market were found in the intervention group, although no significant results were seen for economic self-support alone. Adjusted models revealed significantly higher odds (odds ratio=1.85, 95% confidence interval 1.08–3.17) among the intervention group of achieving proximity to the labour market after 12 months. After 18 months, the intervention group had on average obtained 5 more weeks (95% confidence interval 0.02–9.99) with proximity to the labour market.

Conclusions:

Overall, the oral health promotion intervention had a positive effect on proximity to the labour market in the intervention group, especially within the first year of the study. Our findings suggest that interventions promoting oral health among socially disadvantaged and unemployed groups may contribute to social rehabilitation.
Making sense of deepfakes: Socializing AI and building data literacy on GitHub and YouTube
Authors: McCosker Anthony
Published: May 2022

As a form of synthetic media built on the Internet’s extensive visual datasets with evolving machine learning techniques, deepfakes raise the specter of new types of informational harms and possibilities for image-based abuse. There are calls for three types of defensive response: regulation, technical controls, and improved digital or media literacy. Each is problematic by itself. This article asks what kind of literacy can address deepfake harms, proposing an artificial intelligence (AI) and data literacy framework to explore the potential for social learning with deepfakes and identify sites and methods for intervening in their cultures of production. The article applies contextual qualitative content analysis to explore the most popular GitHub repositories and YouTube accounts teaching “how to deepfake.” The analysis shows that these sites contribute to socializing AI and establishing cultures of social learning, offering potential sites of intervention and pointing to new methods for addressing AI and data harms.
Continuum damage dynamics of a large-scale flexible multibody system comprised of composite beams
Authors: Zhang Shixiong , Shi Wenjing , Wu Zhipei , Zhang Teng , Liu Cheng , Li Weijie
Published: May 2022

Herein, a continuum damage dynamic model of a large-scale flexible multibody system comprising composite beams is proposed based on the framework of the absolute nodal coordinate formulation. To accurately model the continuum damage dynamics of a multibody system, the Hashin criterion is adopted to describe damage initiation during dynamics. A type of nonlinear evolution law is used to characterize the value of material damage. Furthermore, a material stiffness degradation rule is introduced to describe the process of structural damage. A formulation for the damage element elastic force and its Jacobian are derived based on the second Piola–Kirchhoff stress tensor. Two dynamic numerical examples, including a deployment dynamic analysis of the spatial beam structural unit, are conducted to verify the availability and applicability of the proposed model.
Embracing the ‘inverted commas’, or How COVID-19 can show us new directions for ethnographic ‘fieldwork’
Authors: Eggeling Kristin Anabel
Published: May 2022

Qualitative researchers often refer to the sites they study as a ‘field’ and the work they do there as ‘fieldwork’. Setting both terms in inverted commas implies that their meaning stretches beyond clean categorisation of places or methods. Taking the example of ethnographic research during the coronavirus pandemic, I argue that embracing this excess meaning opens new research perspectives when fieldwork gets disrupted. As a more hopeful intervention into a debate currently focused on lost access, immobility and professional frustration, this article puts forward alternative readings of ‘fieldwork’ as a relational and emergent process in which proximity and knowledge production are bound to sensitive research practice more than to physical (co)presence. By tragic serendipity, I argue, COVID-19 has the potential to normalise such readings against the traditional gold standard of fieldwork as extended (and often expensive) research stays in places far-away from ‘home’.
Contingent and affective disruptions: Towards relational tourism geographies of what makes things food
Authors: de Jong Anna , Waitt Gordon
Published: May 2022

Human intentionality forms just one aspect in understanding the tourist’s engagement with food, and yet tends to dominate food tourism research; whilst food itself tends to remain somewhat ‘passive stuff’. A focus on the active presence of food we argue is rare in food tourism scholarship. This paper thus explores how tourist scholars offering insights into the practices and experiences of eating in tourism contexts have taken to spatial and relational approaches to explore what it means to eat during travel. We argue that tourist studies literature on food holds the potential to unlock the complexity of what tourists eat, and why. We do this by discussing two broad ‘spatial turns’ relating to tourism geographies of eating as relational. In doing this we attend to questions of how things become food through attunement to sociospatial-material relationships, experiences and situated practices. We show how these two relational approaches offer exciting research agendas that rethink food tourism not as a predetermined, structured human experience or touristic agenda – but as something that is ongoing, and made through individuals’ sensorial engagement with the social and material world.
Sanctuary as democratic non-cooperation
Authors: Lenard Patti Tamara
Published: May 2022

Across North America, Europe and Latin America, multiple sub-state jurisdictions have declared themselves to be migrant “sanctuaries”. By adopting sanctuary status, sub-state jurisdictions signal their welcoming attitude towards migrants as well their opposition to the state-level policies that target them for exclusion. In this article, I examine the place of sanctuary in the broader literature of political resistance and opposition in democratic states, and then whether it can be justified all things considered. I locate my examination in the political theory of federalism, to identify an expectation of cooperation – which, it appears, sanctuary jurisdictions are refusing to accept, usually with respect to immigration enforcement efforts. I refer to this form of opposition as “democratic non-cooperation” and identify its key features. I describe a “cooperation continuum”, to suggest that non-cooperation takes four main forms – evasion, non-engagement, disruption and obstruction – which I describe both in general terms and in relation to sanctuary practices in particular. Finally, I observe that the form of opposition that sanctuary is, is not limited to sanctuary: that is, there are other cases of this form of opposition in other policy domains, and moreover, not all of the objectives taken by those who deploy this form of opposition are progressive. Ultimately, this article's central contribution is to fleshing out modes of opposition in democratic spaces in general, by examining the morality of sanctuary actions taken around the world.
Use of tangible, educational and psychological support services among Chinese American dementia caregivers
Authors: Liu Jinyu , Lou Yifan , Cheung Ethan Siu Leung , Wu Bei
Published: May 2022

Background and Objectives

Though many studies have examined the service utilization of dementia caregivers, there is limited empirical evidence from Asian Americans in this field. Guided by Andersen’s behavioral model of health services use, we aimed to understand what factors were associated with utilizing multiple types of services among Chinese American dementia caregivers.

Research Design and Methods

We collected survey data from 134 Chinese dementia caregivers in New York City. Logistic regression models were conducted to test the associations between predisposing, enabling, and need factors and the likelihood of using tangible (home health aide, adult daycare, respite care), educational (lectures and workshops), and psychological (peer support groups and psychological counseling) support services.

Results

Several variables conceptualized by Andersen’s model, including caregiver’s knowledge about services, caring tasks, length of care and burden, and care recipient’s physical and cognitive deteriorations, were significantly associated with higher possibilities of using multiple types of services. Three sociocultural factors—residing in Chinatown, availability of alternative family caregivers, and diagnosis of cognitive deterioration—were also associated with higher likelihood of using educational or psychological services.

Discussion and Implications

The findings extend the existing literature on service utilization of caregivers by highlighting the importance of distinguishing types of services and considering sociocultural factors in future research and practice.
Shared book reading intervention for parents of infants and toddlers
Authors: Salley Brenda , Daniels Debora , Walker Corinne , Fleming Kandace
Published: May 2022

Shared book reading is a well-established vehicle for promoting child language and early development. Yet, existing shared reading interventions have primarily included only children age 3 years and older and high quality dialogic strategies have been less systematically applied for infants and toddlers. To address this gap, we have developed a book-sharing intervention for parents of 12-to 36-month-olds. The current study evaluated acceptability/usability and preliminary efficacy of book-sharing intervention in a randomized controlled trial. Parent-child dyads were randomized to either 8-week book-sharing intervention ( n = 15) or wait list control ( n = 15). Parent book-sharing skills were assessed at baseline, post-intervention, and 2-month follow-up. Results indicated parents found the intervention highly acceptable and useful. Parents receiving intervention demonstrated significant improvement in book-sharing strategies compared to controls at post-intervention and 2-month follow-up. The current study provides evidence for the benefit of a brief, low intensity, targeted intervention to enhance parent book-sharing with infants and toddlers.
Agent-based modeling and simulation of pandemic propagation in a school environment
Authors: Fouad Ahmad A , El Antably Ahmed
Published: May 2022

Spatial behavior is a principal aspect for architects to consider. Unfortunately, it is sometimes hard to predict, as users of space seldom follow a standard routine. However, predicting user behavior in a space can potentially illuminate the entire design process. Moreover, it is a key factor in fighting the recent COVID-19 pandemic. Until most of the public gets their vaccine, health officials recommend social distancing as the primary means of fighting the pandemic. This paper uses an agent-based modeling and simulation (ABMS) approach to reproduce, analyze, and predict spatial behavior during the pandemic in a school environment and its impact on disease propagation. The simulation reproduces the behavior of teachers and students at a sample elementary school. By manipulating parameters that simulate the school officials' response to the pandemic, stakeholders can assess the most effective preventive measures. As a result of running multiple scenarios, the study demonstrates how varying starting conditions and alternate spatial behaviors could lead to different results, providing insight to stakeholders on how to handle disease spread in school environments.
Prevention of Perpetration of Intimate Partner Violence by Men and Boys in Low- and Middle-Income Countries: A Scoping Review of Primary Prevention Interventions
Authors: DeHond Allayna , Brady Forrest , Kalokhe Ameeta S.
Published: May 2022

Intimate partner violence (IPV) affects the health of women across the globe, with the greatest burden encountered by women in low- and middle-income countries (LMICs). This scoping review aims to summarize and critically examine primary prevention interventions addressing IPV perpetration by men and boys in LMICs and identify gaps in the evidence base. PubMed, EMbase, and PsychINFO were searched for articles published between January 2001 and October 2020 that examined the efficacy of primary prevention interventions to prevent IPV perpetration by men/boys in LMICs and reported on a quantitative outcome examining IPV perpetration. Data on study population, setting and design, intervention components, evaluation methods, and outcomes were extracted, and study quality was assessed using the Effective Public Health Practice Project tool. Of 8,392 articles, 16 intervention studies met inclusion criteria. All 16 were of moderate or weak quality. The majority were conducted in Africa, delivered by peers, theoretically grounded, and included content to challenge IPV acceptance and gender norms. Half demonstrated intervention efficacy in prevention of IPV perpetration; these studies tended to intervene at multiple levels of the Socio-Ecological Model, be delivered over a minimum of eight sessions, and utilize a validated IPV measure to assess intervention impact. In conclusion, the field of IPV perpetration prevention research in LMICs is rapidly evolving, with many interventions demonstrating promise. Future intervention studies should consider expanding to LMICs outside Africa, targeting school-age youth, exploring whether shorter intervention durations are effective, and addressing the methodological shortcomings noted in the quality assessment.
Prolonged Exposure Therapy in the Treatment of Functional Neurological Disorder and Posttraumatic Stress Disorder
Authors: Putica Andrea , O’Donnell Meaghan L. , Felmingham Kim L.
Published: May 2022

Functional neurological disorder (FND) symptoms resemble neurological symptoms but are unexplained by disease or injury to the body. Psychological trauma and posttraumatic stress disorder (PTSD) are prevalent among patients with FND. This is a case report of a 64-year-old female who began treatment 2 years after developing PTSD, generalised anxiety disorder, major depressive disorder and agoraphobia following a physical assault. She subsequently developed FND approximately 18 months later. Her FND symptomology was characterised by aphasia and paraplegia. These symptoms usually lasted for a period of hours to days and usually occurred on a weekly basis. She had not previously engaged in psychological therapy due to limited insight into the relationship between her psychological and physiological symptomology. She was treated with Prolonged Exposure for PTSD (PE), and by the last session, she no longer met the diagnostic criteria for either FND or PTSD disorder. PE successfully treated both PTSD and FND. Theoretical understandings of the mechanisms underpinning this improvement are discussed.
Street Nursing: Teaching and Improving Community Health
Authors: Cavazos Diana M.
Published: May 2022

Living on the streets continues to be a traumatic and dangerous lifestyle that creates many challenges in society, especially challenges related to community health and health care. In San Antonio, Texas, half of the unhoused population is Hispanic, aligning with national reports that document how Hispanics/Latinxs are overrepresented in the unhoused communities. Street Medicine™ programs are surfacing nationwide and around the world, frequently as medical schools’ initiatives, to provide medical care to unhoused populations, providing a unique learning opportunity for medical students and other health care disciplines, including Nursing. UT Health Street Nursing organization was formed in the context of a clinical rotation experience for the Population-Focused Health course while supporting and collaborating with Street Medicine SA. This initiative exposes nursing students to the reality of not having a place to live and the struggles vulnerable populations face to access and navigate health care services, discovering how Latinos generally have less access to quality health care and suffer from poor health.
Targeted Electromyographic Biofeedback With Endoanal Electrostimulation for Anal Incontinence
Authors: Martín Prieto L. , Pascual Migueláñez I. , Fernández Cebrián JM. , Martínez Puente MC. , Varillas-Delgado D. , Fernández Rodríguez M. , Pascual Montero JA.
Published: May 2022

Purpose. Anal incontinence (AI) is a disabling condition with a variable response to conservative physical therapies. We assess the utility of combining electromyographic biofeedback with endoanal electrostimulation targeted to the weakest areas of the pelvic floor using the MAPLe® probe (Multiple Array Probe Leiden Novuqare). Methods. Patients with AI unresponsive to conservative measures were assessed before and after treatment with anorectal manometry (ARM), electromyography (EMG), Wexner Continence Scoring, Visual Analog Scoring (VAS), FIQL and SF-12 quality of life determination. Results. Of 29 patients in the final analysis, there was an improvement in the mean Wexner continence score from 13.59 to 8.03 and a concomitant improvement in the reported VAS from 3.45 to 6.72. Both Wexner continence and VAS scores were maintained during follow-up. Maximum voluntary manometric contraction significantly improved from 91.76 mmHg to 110.33 mmHg with no changes in resting pressure. The EMG values ​​(μV) that significantly improved included the average and peak resistance, the average general voluntary contraction, and the average and peak voluntary contraction for both the external anal sphincter and the puborectalis. In the FIQL, behavior, depression and shame domains improved after treatment and during follow-up with lifestyle improvements detected at 6 and 12 months. Physical and mental components of the SF-12 improved at 6 and 12 months. Conclusions. Targeted electromyographic biofeedback and endoanal electrostimulation using MAPLe® probe in AI patients sustainably improves objective ARM and EMG parameters along with subjective reporting of continence severity, VAS, and quality of life.
Incorporating Nutrition Counseling into Lifestyle Medicine
Authors: Cepni Aliye B. , Crumbley Christine , Nadeem Saad , Ledoux Tracey A. , Johnston Craig A.
Published: May 2022

Despite considerable evidence that plant-based diets can significantly improve health, medical professionals seldom discuss this with their patients. This issue might occur due to minimal training received in medical education, lack of time, and low self-efficacy for counseling patients about diet. Nutrition and lifestyle change should be considered a core competency for all physicians and health professionals looking for cost-effective ways to improve patient health outcomes and reduce nutrition-related chronic diseases. Strategies for health professionals to acquire nutrition counseling skills in medical training and clinical practices are discussed.
Neurological Health: Not Merely the Absence of Disease: Current Wellbeing Instruments Across the Spectrum of Neurology
Authors: Ziegeler Benjamin , D’ Souza Wendyl , Vinton Anita , Mulukutla Sarah , Shaw Cameron , Carne Ross
Published: May 2022

Objective. Well-being and quality of life can vary independently of disease. Instruments measuring well-being and quality of life are commonly used in neurology, but there has been little investigation into the extent in which they accurately measure wellbeing/quality of life or if they merely reflect a diseased state of an individual. Design. Systematic searches, thematic analysis and narrative synthesis were undertaken. Individual items from instruments represented in ≥ 5 publications were categorised independently, without prior training, by five neurologists and one well-being researcher, as relating to ‘disease-effect’ or ‘Well-being’ with a study-created instrument. Items were additionally categorised into well-being domains. Data sources. MEDLINE, EMBASE, EMCARE and PsycINFO from 1990 to 2020 were performed, across the 13 most prevalent neurological diseases. Results. 301 unique instruments were identified. Multiple sclerosis had most unique instruments at 92. SF-36 was used most, in 66 studies. 22 instruments appeared in ≥ 5 publications: 19/22 ‘well-being’ outcome instruments predominantly measured disease effect (Fleiss kappa = .60). Only 1/22 instruments was categorised unanimously as relating to well-being. Instruments predominantly measured mental, physical and activity domains, over social or spiritual. Conclusions. Most neurological well-being or quality-of-life instruments predominantly measure disease effect, rather than disease-independent well-being. Instruments differed widely in well-being domains examined.
Severe papilledema and multiple hypercoagulability abnormalities in patient with dural arterio-venous fistulas
Authors: Tien Chi-Wei , Nicholson Patrick , Margolin Edward
Published: May 2022

A 54-year-old man noticed right-sided pulsatile tinnitus for the past six months and recently started experiencing transient visual obscurations when standing up. MRI demonstrated two separate brain dural arteriovenous fistulas (bdAVF) in sagittal and right sigmoid dural sinuses. Neuro-ophthalmological exam demonstrated severe bilateral optic disc edema with preserved visual acuity but early nerve fiber bundle defects on visual field testing. Hypercoagulable profile testing revealed very elevated D-dimer, significantly decreased protein S level and elevated homocysteine levels. This case highlights importance of referring all patients with bdAVFs for neuro-ophthalmological consultation as venous hypertension can cause increased intracranial pressure and resultant papilledema. Papilledema does not affect central vision until late stages when visual loss is irreversible thus screening for its presence and pre-treatment extent of peripheral visual loss is paramount. It also demonstrates that hypercoagulable workup should be initiated in all patients with bdAVF in order to prevent future thromboembolic events.
The value of adherence information during clinical pharmaceutical trials
Authors: Grayek Emily N , Fischhoff Baruch , Davis Alexander L , Krishnamurti Tamar
Published: May 2022

Background/Aims

The quality of the evidence used to evaluate a drug’s safety and efficacy depends, in part, on how well participants adhere to the prescribed drug-taking regime. There are multiple approaches to measure adherence in clinical trials, varying in their cost and accuracy. We demonstrate a method for evaluating the cost-effectiveness of common adherence monitoring methods, considering the costs and data quality for drugs that differ in how forgiving they are of nonadherence.

Methods

We propose a simulation approach to estimate the value of evidence about adherence, considering both costs of collection and potential errors in interpreting clinical trial results. We demonstrate the approach with a simulated clinical trial of nitrendipine, a common calcium channel blocker. We consider two trial designs, one using pretrial adherence to “enrich” the trial sample and one without an enrichment strategy. We use scenarios combining high and low values of two key properties of a clinical trial: participant adherence and drug forgiveness.

Results

Under the conditions of these simulations, the most cost-effective adherence monitoring approach depends on both trial participant adherence and drug forgiveness. For example, the enrichment strategy is not cost-effective for the base scenario (high forgiveness and high adherence), but is for other scenarios. We also estimate the effects of evaluable patient analysis, a controversial procedure that excludes nonadherent participants from the analyses, after a trial is completed.

Conclusions

Our proposed approach can guide drug regulators and developers in designing efficient clinical trials and assessing the impact of nonadherence on trial results. It can identify cost-effective adherence-monitoring methods, given available knowledge about the methods, drug, and patients’ expected adherence.
The effectiveness of antioxidant therapy (vitamin C) in an experimentally induced mouse model of ovarian endometriosis
Authors: Hoorsan Hayedeh , Simbar Masoumeh , Tehrani Fahimeh Ramezani , Fathi Fardin , Mosaffa Nariman , Riazi Hedyeh , Akradi Loghman , Nasseri Sherko , Bazrafkan Shayan
Published: May 2022

Objectives:

This study investigates the therapeutic effect of vitamin C on the development of endometrial lesions and fecundity disorders in the ovarian induction model of mouse endometriosis.

Methods:

Ovarian endometriosis was surgically induced in 14 NMRI female mice (treatment group, N = 7) and (control group, N = 7). Three days after the second surgery (to assess endometriotic implant), the mice were randomized into two intervention groups: control (placebo) and treatment (50 mg/kg vitamin C every two days orally for four weeks) groups. In the oestrus phase, the mice were sacrificed. In macroscopic assessment, endometriotic implants were evaluated in size, volume, weight, growth score and adhesion score. The microscopic assessment examined the ovarian tissue (the number of antral follicles, corpus luteum and atretic follicles) and endometriotic lesion (histologic and trichrome fibrosis scores).

Results:

Post-treatment implant volume, growth score, adhesion extent score and adhesion severity score were significantly lower in the treatment group (vitamin C) in comparison with the control group (placebo) (p < 0.0001). The difference between the median weight of endometriotic implants, epithelialization of implant tissue, trichrome fibrosis scores and follicle number in the two groups (treatment and control) was statistically significant (p < 0.05). Atretic follicles were significantly decreased after vitamin C therapy (p < 0.05). Although the numbers of corpus luteum seemed to be more preserved in specimens from the control group, there was no statistical significance between the two groups’ histological scores.

Conclusion:

As a result, we may imply that vitamin C has a significant effect on reducing the induction and growth of endometrial implants, improving the fecundity function of ovaries, and consequently prevention of endometriosis-associated cancers. Further research is needed to improve targeted interventions resulting in the prevention and treatment of human endometriosis.
Cervical screening uptake: A cross-sectional study of self-reported screening attitudes, behaviours and barriers to participation among South Asian immigrant women living in Australia
Authors: Alam Zufishan , Ann Dean Judith , Janda Monika
Published: May 2022

Introduction:

Cervical cancer remains a major cause of morbidity and mortality among women from low and lower middle-income countries, as well as underserved population subgroups in high-income countries. Migration from South Asia to Australia has increased over the last decade, and immigrant women from this region have been reported as a subgroup, with less than optimal cervical screening participation in Australia. This study examined cervical screening uptake and associated behavioural attitudes among South Asian immigrant women living in Queensland Australia.

Methods:

A cross-sectional, Internet-based survey was used to collect data from a convenience sample of 148 South Asian women living in Queensland. The main outcome measure was receipt of cervical screening test ever (yes/no) and its recency (within 2 years/more than 2 years). The survey also examined participants’ views on barriers towards screening and ways to enhance it.

Results:

Of 148 women who completed the survey, 55.4% (n = 82) reported ever having a cervical screening test before and 43.9% (n = 65) reported having it in previous two years. Not having a previous cervical screening test was significantly associated with duration of stay in Australia for less than five years, not having access to a regular general practitioner (GP), not being employed, having low cervical cancer knowledge level and not knowing if cervical screening test is painful or not. Most commonly reported barriers to screening uptake included considering oneself not at risk, lack of time and lack of information. The most favoured strategy among participants was encouragement by GP and awareness through social media advertisements.

Conclusion:

This study provided insights into factors that need consideration when developing future targeted interventions.
Investigating the role of working memory resources across aesthetic and non-aesthetic judgements
Authors: Bara Ionela , Binney Richard J , Ramsey Richard
Published: May 2022

Aesthetic judgements dominate much of daily life by guiding how we evaluate objects, people, and experiences in our environment. One key question that remains unanswered is the extent to which more specialised or largely general cognitive resources support aesthetic judgements. To investigate this question in the context of working memory, we examined the extent to which a working memory load produces similar or different response time interference on aesthetic compared with non-aesthetic judgements. Across three pre-registered experiments that used Bayesian multi-level modelling approaches ( N > 100 per experiment), we found clear evidence that a working memory load produces similar response time interference on aesthetic judgements relative to non-aesthetic (motion) judgements. We also showed that this similarity in processing across aesthetic versus non-aesthetic judgements holds across variations in the form of art (people vs. landscape; Experiments 1–3), medium type (artwork vs. photographs; Experiment 2), and load content (art images vs. letters; Experiments 1–3). These findings suggest that across a range of experimental contexts, as well as different processing streams in working memory (e.g., visual vs. verbal), aesthetic and motion judgements commonly rely on a domain-general cognitive system, rather than a system that is more specifically tied to aesthetic judgements. In doing so, these findings shine new light on the working memory resources that support aesthetic judgements, as well as on how domain-general cognitive systems operate more generally in cognition.
Clinical outcome of patients undergoing preoperative chest physiotherapy in elective upper abdominal surgeries
Authors: Singh Vikram , Agumbe Pai Sreekar , Hosmath Vijaykumar
Published: May 2022

Upper abdominal surgeries are associated with postoperative pulmonary complications. This study aimed to evaluate the effectiveness of preoperative chest physiotherapy on the clinical outcome in upper abdominal surgery patients. Fifty patients were equally randomised into control (general care) and intervention (preoperative chest physiotherapy) groups. Forced vital capacity, forced expiratory volume, incidence of postoperative pulmonary complications, duration of surgery and days spent in intensive unit care were recorded. The intergroup difference in the spirometric values was significant post-surgery. A total of 11 patients experienced postoperative pulmonary complications. Significant difference in the mean duration of surgery and duration of stay in the intensive care unit in both the study groups was observed. Incidence of postoperative pulmonary complications was significantly associated with number of days spent in the intensive care unit. Significant increase in the spirometric values post-surgery in the intervention group implies the importance of preoperative chest physiotherapy in reducing postoperative complications.
Gap between self-evaluation and actual hand hygiene compliance among health-care workers
Authors: Hagiya Hideharu , Takase Ryosuke , Sazumi Yosuke , Nishimura Yoshito , Honda Hiroyuki , Otsuka Fumio
Published: May 2022

Hand hygiene (HH) compliance among health-care workers has not satisfactorily improved despite multiple educative approaches. Between October 2019 and February 2020, we performed a self-evaluation test and a direct observation for the compliance of the 5 Moments for Hand Hygiene program advocated by the World Health Organization at two Japanese hospitals. Average percentages of self-evaluated HH compliance were as follows: (i) 76.9% for “Before touching a patient,” (ii) 85.8% for “Before clean/aseptic procedures,” (iii) 95.9% for “After body fluid exposure/risk,” (iv) 84.0% for “After touching a patient,” and (v) 69.2% for “After touching patient surroundings.” On the other hand, actual HH compliance was 11.7% for “Before touching a patient” and 18.0% for “After touching a patient or patient surroundings.” The present study demonstrated a big gap between self-evaluation and actual HH compliance among nurses working at hospitals, indicating the need of further providing the education in infection prevention.
Novel insights into the biomarkers and therapies for primary central nervous system lymphoma
Authors: Zhai Yujia , Zhou Xiangxiang , Wang Xin
Published: May 2022

Primary central nervous system lymphoma (PCNSL) is a rare and highly aggressive extranodal type of non-Hodgkin lymphoma. After the introduction and widespread use of high-dose-methotrexate (HD-MTX)-based polychemotherapy, treatment responses of PCNSL have been improved. However, long-term prognosis for patients who have failed first-line therapy and relapsed remains poor. Less invasive diagnostic markers, including the circulating tumor DNAs (ctDNAs), microRNAs, metabolomic markers, and other novel biomarkers, such as a proliferation inducing ligand (APRIL) and B-cell activating factor of the TNF family (BAFF), have shown potential to distinguish PCNSL at an early stage, and some of them are related with prognosis to a certain extent. Recent insights into novel therapies, including Bruton tyrosine kinase (BTK) inhibitors, immunomodulatory drugs, immune checkpoint inhibitors, PI3K/mTOR inhibitors, and chimeric antigen receptor (CAR) T cells, have revealed encouraging efficacy in treatment response, whereas the duration of response and long-term survival of patients with relapsed or refractory PCNSL (r/r PCNSL) need further improvement. In addition, the diagnostic efficiency of novel markers and the antitumor efficacy of novel therapies are needed to be assessed further in larger clinical trials. This review provides an overview of recent research on novel diagnostic markers and therapeutic strategies for PCNSL.
Thomas Merton’s Spiritual Formation and Writings on Racism: From Harlem, Through Louisville, To Birmingham
Authors: Harris Daniel Ethan
Published: May 2022

Thomas Merton addressed racism frequently and forcefully from 1963 until his death in 1968. While commentary on racial unrest written from the tranquility of a monastery seems paradoxical, viewing the development of Merton’s thought on racism through the framework of Adrian van Kaam’s Formative Action Pattern shows that Merton’s contemplative spirituality is integrally connected to his valuable insights on racism. Van Kaam’s pattern describes a “from-through-to” movement, which allows characterization of Merton’s thought on racism from Harlem, through Louisville, to Birmingham, representing Merton’s own journey through the lens of these locations of critical events in his writings on racism. Today’s racial conflicts invite reexamination of Merton’s writings, reengagement with the monastic wisdom which cultivated them, and renewed commitment to shared rules of life capable of sustaining the spirituality of those involved in ministries of social justice.
A chronological and geographical analysis of personal reports of COVID-19 on Twitter from the UK
Authors: Golder Su , Klein Ari Z , Magge Arjun , O’Connor Karen , Cai Haitao , Weissenbacher Davy , Gonzalez-Hernandez Graciela
Published: May 2022

Objective

Given the uncertainty about the trends and extent of the rapidly evolving COVID-19 outbreak, and the lack of extensive testing in the United Kingdom, our understanding of COVID-19 transmission is limited. We proposed to use Twitter to identify personal reports of COVID-19 to assess whether this data can help inform as a source of data to help us understand and model the transmission and trajectory of COVID-19.

Methods

We used natural language processing and machine learning framework. We collected tweets (excluding retweets) from the Twitter Streaming API that indicate that the user or a member of the user's household had been exposed to COVID-19. The tweets were required to be geo-tagged or have profile location metadata in the UK.

Results

We identified a high level of agreement between personal reports from Twitter and lab-confirmed cases by geographical region in the UK. Temporal analysis indicated that personal reports from Twitter appear up to 2 weeks before UK government lab-confirmed cases are recorded.

Conclusions

Analysis of tweets may indicate trends in COVID-19 in the UK and provide signals of geographical locations where resources may need to be targeted or where regional policies may need to be put in place to further limit the spread of COVID-19. It may also help inform policy makers of the restrictions in lockdown that are most effective or ineffective.
A Comprehensive Approach to the Management of Patients With HLHS and Related Malformations: An Analysis of 83 Patients (2015-2021)
Authors: Bleiweis Mark S. , Peek Giles J. , Philip Joseph , Fudge James C. , Sullivan Kevin J. , Co-Vu Jennifer , DeGroff Curt , Vyas Himesh V. , Gupta Dipankar , Shih Renata , Pietra Biagio “Bill” A. , Fricker Frederick Jay , Cruz Beltran Susana C. , Arnold Michael A. , Wesley Mark C. , Pitkin Andrew D. , Hernandez-Rivera Jose F. , Lopez-Colon Dalia , Barras Wendy E. , Stukov Yuriy , Sharaf Omar M. , Neal Dan , Nixon Connie S. , Jacobs Jeffrey P.
Published: May 2022

Background: Some patients with hypoplastic left heart syndrome (HLHS) and HLHS-related malformations with ductal-dependent systemic circulation are extremely high-risk for Norwood palliation. We report our comprehensive approach to the management of these patients designed to maximize survival and optimize the utilization of donor hearts. Methods: We reviewed our entire current single center experience with 83 neonates and infants with HLHS and HLHS-related malformations (2015-2021). Standard-risk patients (n = 62) underwent initial Norwood (Stage 1) palliation. High-risk patients with risk factors other than major cardiac risk factors (n = 9) underwent initial Hybrid Stage 1 palliation, consisting of application of bilateral pulmonary bands, stent placement in the patent arterial duct, and atrial septectomy if needed. High-risk patients with major cardiac risk factors (n = 9) were bridged to transplantation with initial combined Hybrid Stage 1 palliation and pulsatile ventricular assist device (VAD) insertion (HYBRID + VAD). Three patients were bridged to transplantation with prostaglandin. Results: Overall survival at 1 year = 90.4% (75/83). Operative Mortality for standard-risk patients undergoing initial Norwood (Stage 1) Operation was 2/62 (3.2%). Of 60 survivors: 57 underwent Glenn, 2 underwent biventricular repair, and 1 underwent cardiac transplantation. Operative Mortality for high-risk patients with risk factors other than major cardiac risk factors undergoing initial Hybrid Stage 1 palliation without VAD was 0/9: 4 underwent transplantation, 1 awaits transplantation, 3 underwent Comprehensive Stage 2 (with 1 death), and 1 underwent biventricular repair. Of 9 HYBRID + VAD patients, 6 (67%) underwent successful cardiac transplantation and are alive today and 3 (33%) died while awaiting transplantation on VAD. Median length of VAD support was 134 days (mean = 134, range = 56-226). Conclusion: A comprehensive approach to the management of patients with HLHS or HLHS-related malformations is associated with Operative Mortality after Norwood of 2/62 = 3.2% and a one-year survival of 75/83 = 90.4%. A subset of 9/83 patients (11%) were stabilized with HYBRID + VAD while awaiting transplantation. VAD facilitates survival on the waiting list during prolonged wait times.