bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling post-reionization H i distributions in fuzzy dark matter cosmologies using conditional normalizing flows
Authors: Dome Tibor , Azhar Rumail , Fialkov Anastasia
Published: December 2023

Upcoming 21-cm intensity mapping experiments like the Square Kilometer Array (SKA) hold significant potential to constrain the properties of dark matter. In this work, we model neutral hydrogen (H i) distributions using high-resolution hydrodynamical N-body simulations of both cold dark matter (CDM) and fuzzy dark matter (FDM) cosmologies in the post-reionization redshift range of z = 3.42−4.94. We show that the H i abundance decreases in FDM-like cosmologies. Extreme FDM models with m ∼ 10−22 eV are at odds with a range of measurements. Due to the increased halo bias, the H i bias increases, paralleled by the damped Lyman-α (DLA) bias which we infer from the cross-section of DLAs. The distribution of the latter in extreme FDM models has a high median at the low-mass end, which can be traced to the high column density of cosmic filaments. FDM models exhibit a very similar abundance of DLAs compared to CDM while sub-DLAs are already less abundant. We study the prospects of detecting the brightest H i peaks with SKA1-Low at z = 4.94, indicating moderate signal-to-noise ratios (SNRs) at angular resolution θA = 2 arcmin with a rapidly declining SNR for lower values of θA. After training the conditional normalizing flow network HIGlow on 2D H i maps, we interpolate its latent space of axion masses to predict the peak flux for a new, synthetic FDM cosmology, finding good agreement with expectations. This work thus underscores the potential of normalizing flows in capturing complex, non-linear structures within H i maps, offering a versatile tool for conditional sample generation and prediction tasks.
In-situ versus accreted Milky Way globular clusters: a new classification method and implications for cluster formation
Authors: Belokurov Vasily , Kravtsov Andrey
Published: December 2023

We present a new scheme for the classification of the in-situ and accreted globular clusters (GCs). The scheme uses total energy E and z-component of the orbital angular momentum and is calibrated using the [Al/Fe] abundance ratio. We demonstrate that this classification results in two GC populations with distinct spatial, kinematic, and chemical abundance distributions. The in-situ GCs are distributed within the central 10 kpc of the Galaxy in a flattened configuration aligned with the Milky Way (MW) disc, while the accreted GCs have a wide distribution of distances and a spatial distribution close to spherical. In-situ and accreted GCs have different $\rm [Fe/H]$ distributions with the well-known bimodality present only in the metallicity distribution of the in-situ GCs. Furthermore, the accreted and in-situ GCs are well separated in the plane of $\rm [Al/Fe]-[Mg/Fe]$ abundance ratios and follow distinct sequences in the age–$\rm [Fe/H]$ plane. The in-situ GCs in our classification show a clear disc spin-up signature – the increase of median Vϕ at metallicities −1.3 < [Fe/H] < −1 similar to the spin-up in the in-situ field stars. This signature signals the MW’s disc formation, which occurred ≈11.7−12.7 Gyr ago (or at z ≈ 3.1−5.3) according to in-situ GC ages. In-situ GCs with metallicities of $\rm [Fe/H]\gtrsim -1.3$ were thus born in the MW disc, while lower metallicity in-situ GCs were born during early, turbulent, pre-disc stages of the evolution of the Galaxy and are part of its Aurora stellar component.
An Overview of Sunspot Observations in the Early Maunder Minimum: 1645–1659
Authors: Hayakawa Hisashi , Carrasco Víctor M S , Aparicio Alejandro J P , Villalba Álvarez Joaquín , Vaquero José M
Published: December 2023

Within four centuries of sunspot observations, the Maunder Minimum (MM) in 1645–1715 has been considered a unique grand minimum with weak solar cycles in group numbers of sunspots and hemispheric asymmetry in sunspot positions. However, the early part of the MM (1645–1659) is poorly understood in terms of its source records and has accommodated diverse reconstructions of the contemporaneous group number. This study identified their source records, classidied them in three different categories (datable observations, general descriptions, and misinterpreted records), and revised their data. On this basis, we estimated the yearly mean group number using the brightest star method, derived the active day fraction (ADF), reconstructed the sunspot number based on ADF, and compared them with proxy reconstructions from the tree-ring data sets. Our results revised the solar activity in the early MM downward in yearly mean group numbers using the brightest star method and upward in the active day fraction and sunspot number estimates. Our results are consistent with the proxy reconstruction for 1645–1654 and show more realistic values for 1657–1659 (against the unphysical negative sunspot number). These records have paid little attention to sunspot positions, except for Hevelius' report on a sunspot group in the northern solar hemisphere in 1652 April. Therefore, slight caveats are required to discuss if the sunspot positions are located purely in the southern solar hemisphere throughout the MM.
An efficient and robust method to estimate halo concentration based on the method of moments
Authors: Wang Kai , Mo H J , Chen Yangyao , Schaye Joop
Published: December 2023

We propose an efficient and robust method to estimate the halo concentration based on the first moment of the density distribution, which is $R_1\equiv \int _0^{r_{\rm vir}}4\pi r^3\rho (r)\mathrm{ d}r/M_{\rm vir}/r_{\rm vir}$. We find that R1 has a monotonic relation with the concentration parameter of the Navarro–Frenk–White (NFW) profile, and that a cubic polynomial function can fit the relation with an error $\lesssim 3~{{\ \rm per\ cent}}$. Tests on ideal NFW haloes show that the conventional NFW profile fitting method and the Vmax/Vvir method produce biased halo concentration estimation by $\approx 10~{{\ \rm per\ cent}}$ and $\approx 30~{{\ \rm per\ cent}}$, respectively, for haloes with 100 particles. In contrast, the systematic error for our R1 method is smaller than 0.5  per cent even for haloes containing only 100 particles. Convergence tests on realistic haloes in N-body simulations show that the NFW profile fitting method underestimates the concentration parameter for haloes with ≲300 particles by $\gtrsim 20~{{\ \rm per\ cent}}$, while the error for the R1 method is $\lesssim 8~{{\ \rm per\ cent}}$. We also show other applications of R1, including estimating Vmax and the Einasto concentration ce ≡ rvir/r−2. The calculation of R1 is efficient and robust, and we recommend including it as one of the halo properties in halo catalogues of cosmological simulations.
G-quadruplexes control hepatitis B virus replication by promoting cccDNA transcription and phase separation in hepatocytes
Authors: Giraud Guillaume , Rodà Mélanie , Huchon Pélagie , Michelet Maud , Maadadi Sarah , Jutzi Daniel , Montserret Roland , Ruepp Marc-David , Parent Romain , Combet Christophe , Zoulim Fabien , Testoni Barbara
Published: December 2023

Phase separation regulates fundamental processes in gene expression and is mediated by the local concentration of proteins and nucleic acids, as well as nucleic acid secondary structures such as G-quadruplexes (G4s). These structures play fundamental roles in both host gene expression and in viral replication due to their peculiar localisation in regulatory sequences. Hepatitis B virus (HBV) covalently closed circular DNA (cccDNA) is an episomal minichromosome whose persistence is at the basis of chronic infection. Identifying the mechanisms controlling its transcriptional activity is indispensable to develop new therapeutic strategies against chronic hepatitis B. The aim of this study was to determine whether G4s are formed in cccDNA and regulate viral replication. Combining biochemistry and functional studies, we demonstrate that cccDNA indeed contains ten G4s structures. Furthermore, mutations disrupting two G4s located in the enhancer I HBV regulatory region altered cccDNA transcription and viral replication. Finally, we showed for the first time that cccDNA undergoes phase separation in a G4-dependent manner to promote its transcription in infected hepatocytes. Altogether, our data give new insight in the transcriptional regulation of the HBV minichromosome that might pave the way for the identification of novel targets to destabilize or silence cccDNA.
An impaired ubiquitin-proteasome system increases APOBEC3A abundance
Authors: Coxon Margo , Dennis Madeline A , Dananberg Alexandra , Collins Christopher D , Wilson Hannah E , Meekma Jordyn , Savenkova Marina I , Ng Daniel , Osbron Chelsea A , Mertz Tony M , Goodman Alan G , Duttke Sascha H , Maciejowski John , Roberts Steven A
Published: December 2023

Apolipoprotein B messenger RNA (mRNA) editing enzyme, catalytic polypeptide-like (APOBEC) cytidine deaminases cause genetic instability during cancer development. Elevated APOBEC3A (A3A) levels result in APOBEC signature mutations; however, mechanisms regulating A3A abundance in breast cancer are unknown. Here, we show that dysregulating the ubiquitin-proteasome system with proteasome inhibitors, including Food and Drug Administration-approved anticancer drugs, increased A3A abundance in breast cancer and multiple myeloma cell lines. Unexpectedly, elevated A3A occurs via an ∼100-fold increase in A3A mRNA levels, indicating that proteasome inhibition triggers a transcriptional response as opposed to or in addition to blocking A3A degradation. This transcriptional regulation is mediated in part through FBXO22, a protein that functions in SKP1–cullin–F-box ubiquitin ligase complexes and becomes dysregulated during carcinogenesis. Proteasome inhibitors increased cellular cytidine deaminase activity, decreased cellular proliferation and increased genomic DNA damage in an A3A-dependent manner. Our findings suggest that proteasome dysfunction, either acquired during cancer development or induced therapeutically, could increase A3A-induced genetic heterogeneity and thereby influence therapeutic responses in patients.
Genome-wide association studies reconstructing chronic kidney disease
Authors: Fountoglou Anastasios , Deltas Constantinos , Siomou Ekaterini , Dounousi Evangelia
Published: December 2023

Chronic kidney disease (CKD) is a major health problem with an increasing epidemiological burden, and is the 16th leading cause of years of life lost worldwide. It is estimated that more than 10% of the population have a variable stage of CKD, while about 850 million people worldwide are affected. Nevertheless, public awareness remains low, clinical access is inappropriate in many circumstances and medication is still ineffective due to the lack of clear therapeutic targets. One of the main issues that drives these problems is the fact that CKD remains a clinical entity with significant causal ambiguity. Beyond diabetes mellitus and hypertension, which are the two major causes of kidney disease, there are still many gray areas in the diagnostic context of CKD. Genetics nowadays emerges as a promising field in nephrology. The role of genetic factors in CKD’s causes and predisposition is well documented and thousands of genetic variants are well established to contribute to the high burden of disease. Next-generation sequencing is increasingly revealing old and new rare variants that cause Mendelian forms of chronic nephropathy while genome-wide association studies (GWAS) uncover common variants associated with CKD-defining traits in the general population. In this article we review how GWAS has revolutionized—and continues to revolutionize—the old concept of CKD. Furthermore, we present how the investigation of common genetic variants with previously unknown kidney significance has begun to expand our knowledge on disease understanding, providing valuable insights into disease mechanisms and perhaps paving the way for novel therapeutic targets.
Ibogaine and Noribogaine
Authors: Mash Deborah C. , Karukin Michael
Published: December 2023

Ibogaine is an indole alkaloid derived from the root bark of Tabernanthe iboga. The anti-addictive actions of ibogaine were first reported in the 1960s by persons using heroin. They offered personal testimonials that single oral doses of ibogaine abruptly blocked opioid withdrawal, and they remained drug-free after ibogaine exposure. Today, online forums describe ibogaine use for opioid withdrawal management by for-profit clinics and unskilled lay people, despite a lack of regulatory testing of ibogaine in human clinical trials. Discontinuation of opioid agonist therapy results in severely painful opioid withdrawal symptoms (OWS) that are followed by a persistent negative affect. For many patients seeking to discontinue opioids, the post-acute emotional disruption is a major obstacle for completion of full withdrawal. This chapter summarizes ibogaine’s clinical experience and open-label observational evidence that the drug is useful for treating the OWS and facilitating a transition to drug-free abstinence. The drug’s polypharmacy mode of action is considered in light of neuroadaptations in mu-opioid processes observed during acute withdrawal, which are mechanistically related to the protracted negative mood state that follows during opioid abstinence. Finally, the dark side of the unregulated use of ibogaine and concerns for patient safety are considered. The value proposition for development of ibogaine as a psychedelic drug product for addiction treatment will ultimately depend on the drug’s single dose regimen, benefits, risks, and safety measures demonstrated in controlled clinical trials.
Hate Speech Detection and Bias in Supervised Text Classification
Authors: Davidson Thomas R.
Published: December 2023

This chapter introduces hate speech detection, describing the process of developing annotated datasets, training machine learning models, and outlining the cutting-edge techniques used to improve these methods. The case of hate speech detection provides valuable insight into the promises and pitfalls of supervised text classification for sociological analyses. A key theme running through the chapter is that ostensibly minor methodological decisions—particularly those related to the development of training datasets—can have profound downstream impacts. In particular, the chapter examines racial bias in these systems, explaining why models intended to detect hate speech can discriminate against the groups they are designed to protect and discussing efforts to mitigate these problems. It argues that hate speech detection and other forms of content moderation should be an important topic of sociological inquiry as platforms increasingly use these tools to govern speech on a global scale.
Race and Intersecting Inequalities in Machine Learning
Authors: Alegria Sharla
Published: December 2023

The central problem of race and gender inequality in machine learning (ML) reflects how inequalities of the past can be captured and reproduced in the content, solutions, and applications that use large amounts of data to make decisions. This chapter provides examples to explain four key areas of concern about race and gender inequalities in ML technology: (a) in the data itself, (b) in the ways data are used in algorithms, (c) in the ways algorithms are optimized, and (d) in the ways ML applications are used in the social world. The chapter further extends the discussion to examine issues of privacy and data collection and the inequalities that emerge around the human work needed to create and sustain highly data-intensive ML tools. Finally, the chapter explores strategies for improving fairness and equity.
The Influence of International Law on Constitutional Law
Authors: Ejima Akiko
Published: December 2023

This chapter explores the dynamic relationship between international law and constitutional law in Asia. The chapter begins by examining how constitution building in Asian countries has been influenced by international law. Afterwards, it considers how constitutional systems in Asia address the applicability of international law in the domestic realm. It addresses questions such as whether international law is superior or subordinate to constitutional law. Finally, the chapter looks specifically at the implementation of international human rights treaties within constitutional systems in Asia. This chapter considers these issues in the context of East and Southeast Asia. The chapter also examines Japan, China, and South Korea as case studies.
The Baltic States
Authors: Mälksoo Lauri
Published: December 2023

This chapter focuses on how the three Baltic States—the Republics of Estonia, Latvia, and Lithuania—have encountered international law. Created in 1918, these nations have had a tumultuous history, being illegally occupied and annexed by the Soviet Union from 1940 to 1991 (with the interlude of German occupation in 1941–1944). Nevertheless, the role of international legal arguments goes further back in time, including during the periods of the Livonian War (1558–1583) and the Great Nordic War (1700–1721). The chapter demonstrates how the Baltic States are archetypical small States and how their experience of international law has oscillated between triumphalism and desperation.
Information-sharing and cooperation in networked collective action groups
Authors: Harrell Ashley , Wolff Tom
Published: December 2023

When people provide for large-scale public goods, they often do not know what each individual group member is contributing. Instead, they commonly have access to the behaviors of their ties, in a broader network of others whose decisions are unknown. But network ties also serve as channels of communication, allowing behaviors to reach a larger audience. Here, we ask how public good production is affected in networks when people can share information about their ties’ behaviors with their other connections—and what behaviors they tend to share. We predict that networked collective action groups demonstrate higher levels of cooperation when their members can share information about their ties’ decisions with their other connections, compared with when they cannot. Informed by prior work, we consider two pathways by which information-sharing opportunities might shape cooperation in networked collective action groups: (i) as a means of coordinating one's own decisions with those of the larger group, including those to whom one is not directly tied, and (ii) as a reminder of possible reputational consequences for selfishness. Across two exploratory experiments (combined n = 7,014 contribution decisions, 49 groups), we demonstrate that opportunities to share information about others’ decisions promote public good production. The benefits occur even though people tend to share information about relatively selfish behaviors that, at first blush, might seem detrimental to cooperation. Our results build on prior work by showing that information-sharing prevents selfishness from becoming contagious by raising reputational concerns.
To be or not to be hallucinating: Implications of hypnagogic/hypnopompic experiences and lucid dreaming for brain disorders
Authors: Foffani Guglielmo
Published: December 2023

The boundaries between waking and sleeping—when falling asleep (hypnagogic) or waking up (hypnopompic)—can be challenging for our ability to monitor and interpret reality. Without proper understanding, bizarre but relatively normal hypnagogic/hypnopompic experiences can be misinterpreted as psychotic hallucinations (occurring, by definition, in the fully awake state), potentially leading to stigma and misdiagnosis in clinical contexts and to misconception and bias in research contexts. This Perspective proposes that conceptual and practical understanding for differentiating hallucinations from hypnagogic/hypnopompic experiences may be offered by lucid dreaming, the state in which one is aware of dreaming while sleeping. I first introduce a possible systematization of the phenomenological range of hypnagogic/hypnopompic experiences that can occur in the transition from awake to REM dreaming (including hypnagogic perceptions, transition symptoms, sleep paralysis, false awakenings, and out-of-body experiences). I then outline how metacognitive strategies used by lucid dreamers to gain/confirm oneiric lucidity could be tested for better differentiating hypnagogic/hypnopompic experiences from hallucinations. The relevance of hypnagogic/hypnopompic experiences and lucid dreaming is analyzed for schizophrenia and narcolepsy, and discussed for neurodegenerative diseases, particularly Lewy-body disorders (i.e. Parkinson's disease, Parkinson's disease dementia, and dementia with Lewy bodies), offering testable hypotheses for empirical investigation. Finally, emotionally positive lucid dreams triggered or enhanced by training/induction strategies or by a pathological process may have intrinsic therapeutic value if properly recognized and guided. The overall intention is to raise awareness and foster further research about the possible diagnostic, prognostic, and therapeutic implications of hypnagogic/hypnopompic experiences and lucid dreaming for brain disorders.
Of the Perfect and the Ordinary: Indistinguishability and Hallucination
Authors: Patel Shivam
Published: December 2023

The claim that perfect hallucination is introspectively indistinguishable from perception has been a centrepiece of philosophical theorizing about sense experience. The most common interpretation of the indistinguishability claim is modal: that it is impossible to distinguish perfect hallucination from perception through introspection alone. I run through various models of introspection and show that none of them can accommodate the modal interpretation. Rejecting the modal interpretation opens up two alternative interpretations of the indistinguishability claim. According to the generic interpretation, hallucination is indistinguishable from perception despite the existence of possible exceptions, while according to the actuality interpretation, the indistinguishability of hallucination from perception consists in the actual failure to distinguish hallucination from perception. These alternative understandings of the indistinguishability claim have a number of significant implications for the problem of perception, including the rejection of perfect hallucination and illusion in favour of our ordinary, non-philosophical concepts of these states.
A deep neural network based reverse radio spectrogram search algorithm
Authors: Ma Peter Xiangyuan , Croft Steve , Lintott Chris , Siemion Andrew P V
Published: December 2023

Modern radio astronomy instruments generate vast amounts of data, and the increasingly challenging radio frequency interference (RFI) environment necessitates ever-more sophisticated RFI rejection algorithms. The ‘needle in a haystack’ nature of searches for transients and technosignatures requires us to develop methods that can determine whether a signal of interest has unique properties, or is a part of some larger set of pernicious RFI. In the past, this vetting has required onerous manual inspection of very large numbers of signals. In this paper, we present a fast and modular deep learning algorithm to search for lookalike signals of interest in radio spectrogram data. First, we trained a β-variational autoencoder on signals returned by an energy detection algorithm. We then adapted a positional embedding layer from classical transformer architecture to a embed additional metadata, which we demonstrate using a frequency-based embedding. Next we used the encoder component of the β-variational autoencoder to extract features from small (∼715 Hz, with a resolution of 2.79 Hz per frequency bin) windows in the radio spectrogram. We used our algorithm to conduct a search for a given query (encoded signal of interest) on a set of signals (encoded features of searched items) to produce the top candidates with similar features. We successfully demonstrate that the algorithm retrieves signals with similar appearance, given only the original radio spectrogram data. This algorithm can be used to improve the efficiency of vetting signals of interest in technosignature searches, but could also be applied to a wider variety of searches for ‘lookalike’ signals in large astronomical data sets.
Preparing Compassionate Nurses
Authors: Thiel Linda M. , Wodwaski Nadine , Webber Elaine D.
Published: December 2023

In preparation for a curriculum revision, a cross-sectional, descriptive mixed-method research study sought to describe senior-level students' perspectives of Mercy and Jesuit faith-based tradition values integration in a pre-licensure BSN program. Integration of values was examined in both clinical settings and didactic classes. Students strongly articulated the importance of the school's values and mission to their future role as professional nurses. However, although value integration is occurring, greater attention to mission and values is needed in the clinical area.
The association of menopause with cardiometabolic disease risk factors in low- and middle-income countries: a systematic review and meta-analyses
Authors: Chikwati Raylton P. , Chikowore Tinashe , Mahyoodeen Nasrin Goolam , Jaff Nicole G. , George Jaya A. , Crowther Nigel J.
Published: December 2023

Importance

Menopause is an integral part of women's health, and studies in high-income countries have shown an increase in cardiometabolic disease (CMD) risk factors in postmenopausal compared with premenopausal women. However, to date, no study has combined and assessed such studies across low- and middle-income countries. This would better inform early monitoring and intervention strategies for reducing CMD risk factor levels in midlife women in these regions.

Objective

This study aimed to evaluate evidence from the literature on differences in CMD risk factors between premenopausal and postmenopausal midlife women living in low- and middle-income countries.

Evidence Review

A systematic review with meta-analysis of original articles of all study designs from the databases PubMed, PubMed Central, Scopus, and ISI Web of Science was conducted from conception until April 24, 2023. Studies that met the inclusion criteria were included in the analysis. Quality assessment of the articles was done using the Newcastle-Ottawa Scale, adapted for each study design. The study protocol was registered with the International Prospective Register of Systematic Reviews and adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. For the meta-analysis, fixed-effects models were used to pool the odds ratios (OR), as measures of association.

Findings

Our search identified 4,849 relevant articles: 44 for the systematic review and 16 for the meta-analysis, in accordance with our inclusion criteria. Compared with premenopausal women, the postmenopausal stage was associated with metabolic syndrome (OR, 1.18 [95% CI, 1.11-1.27]), high waist-to-hip ratio (OR, 1.22 [95% CI, 1.12-1.32]), hypertension (OR, 1.10 [95% CI, 1.04-1.16]), elevated triglycerides (OR, 1.16 [95% CI, 1.11-1.21]), and elevated plasma glucose (OR, 1.21 [95% CI, 1.15-1.28]).

Conclusions and Relevance

This study confirmed that CMD risk factors are present at higher levels in postmenopausal than premenopausal women. This demonstrates an urgent need for public health policies that focus on early monitoring and interventions targeted at reducing CMD risk and related adverse outcomes in midlife women in these nations.
Assessing spontaneous sensory neuron activity using in vivo calcium imaging
Authors: Ingram Sonia , Chisholm Kim I. , Wang Feng , De Koninck Yves , Denk Franziska , Goodwin George L.
Published: December 2023

Heightened spontaneous activity in sensory neurons is often reported in individuals living with chronic pain. It is possible to study this activity in rodents using electrophysiology, but these experiments require great skill and can be prone to bias. Here, we have examined whether in vivo calcium imaging with GCaMP6s can be used as an alternative approach. We show that spontaneously active calcium transients can be visualised in the fourth lumbar dorsal root ganglion (L4 DRG) through in vivo imaging in a mouse model of inflammatory pain. Application of lidocaine to the nerve, between the inflamed site and the DRG, silenced spontaneous firing and revealed the true baseline level of calcium for spontaneously active neurons. We used these data to train a machine learning algorithm to predict when a neuron is spontaneously active. We show that our algorithm is accurate in 2 different models of pain: intraplantar complete Freund adjuvant and antigen-induced arthritis, with accuracies of 90.0% ±1.2 and 85.9% ±2.1, respectively, assessed against visual inspection by an experienced observer. The algorithm can also detect neuronal activity in imaging experiments generated in a different laboratory using a different microscope configuration (accuracy = 94.0% ±2.2). We conclude that in vivo calcium imaging can be used to assess spontaneous activity in sensory neurons and provide a Google Colaboratory Notebook to allow anyone easy access to our novel analysis tool, for the assessment of spontaneous neuronal activity in their own imaging setups.
Opioid characteristics and nonopioid interventions associated with successful opioid taper in patients with chronic noncancer pain
Authors: Jung Monica , Xia Ting , Ilomäki Jenni , Pearce Christopher , Nielsen Suzanne
Published: December 2023

Current research indicates that tapering opioids may improve pain and function in patients with chronic noncancer pain. However, gaps in the literature remain regarding the choice of opioid and nonopioid interventions to support a successful taper. This study used an Australian primary care data set to identify a cohort of patients on long-term opioid therapy commencing opioid taper between January 2016 and September 2019. Using logistic regression analysis, we compared key clinical factors associated with differing taper outcomes. Of a total of 3371 patients who commenced taper, 1068 (31.7%) completed taper within 12 months. In the 3 months after commencement of taper, compared with those who did not complete taper, patients who successfully completed opioid taper were less likely to be prescribed buprenorphine (odds ratio [OR] 0.691; 95% CI: 0.530-0.901), fentanyl (OR, 0.429; 95% CI: 0.295-0.622), and long-acting (LA) opioids, including methadone (OR, 0.349; 95% CI: 0.157-0.774), oxycodone–naloxone (OR, 0.521; 95% CI: 0.407-0.669), and LA tapentadol (OR, 0.645; 95% CI: 0.461-0.902), but more likely to be prescribed codeine (OR, 1.308; 95% CI: 1.036-1.652). Compared with those who did not complete taper, patients who successfully tapered were less likely to be prescribed any formulations of oxycodone (short-acting [SA]: OR, 0.533; 95% CI: 0.422-0.672, LA: OR, 0.356; 95% CI: 0.240-0.530) and tramadol (SA: OR, 0.370; 95% CI: 0.218-0.628, LA: OR, 0.317; 95% CI: 0.234-0.428). The type of opioid prescribed in the months after commencement of taper seems to influence the taper outcomes. These findings may inform prospective studies on opioid taper.
Hearing loss and dementia in older adults: A narrative review
Authors: Huang Alison R. , Lin Frank R.
Published: December 2023

The prevalence of hearing loss is high among older adults; globally, 65% of adults over 60 years have hearing loss. Over the past decade, evidence from epidemiologic studies has linked hearing loss to nearly two times greater risk of dementia. The hypothesized mechanistic pathways through which hearing loss could contribute to increased dementia risk include the effects of hearing on greater cognitive load, changes in brain structure and function, and decreased social engagement. These mechanistic pathways may be modified by management of hearing loss using existing intervention (eg, hearing aids). Hearing treatment may be an effective intervention for slowing cognitive decline in some older adults. In this review, we update existing reviews of the current epidemiologic research on the association between hearing loss and dementia risk and discuss hypothesized mechanisms of this association. We also discuss management of hearing loss as a potential intervention for slowing cognitive decline and reducing dementia risk.
Plasma Interleukin-13 Levels Correlate With the Severity of Symptoms Induced by Functional Dyspepsia
Authors: Leites Marcos , Olano Carolina , Freire Teresa
Published: December 2023

Objective:

Functional dyspepsia (FD) is a gastrointestinal functional disorder of the upper gastrointestinal tract that affects the quality of life of patients and poses a significant economic burden. It has been proposed that the local inflammatory immune response at the duodenum is associated with an increase in intestinal permeability, favoring the recruitment of Th2 cells and granulocyte degranulation. Moreover, systemic immune response could also be related to the symptoms of FD. The objective of this study was to evaluate the systemic immune response in Uruguayan patients with FD by analyzing the cytokine levels in plasma and the frequency of circulating T cells associated with duodenal recruitment.

Patients and Methods:

An analytic and cross-sectional study in 30 patients with FD and 15 healthy controls (HCs) was carried out. Patients were diagnosed with FD according to the Roma IV Committee definition. Cytokine levels were measured in plasma by a specific assay. Expression of α4β7 and CC chemokine receptor9 in circulating T cells was evaluated by flow cytometry.

Results:

Higher levels of interleukin (IL)-5, IL-13, and IL-8 and lower levels of IL-10 and IL-12p70 were detected in patients with FD than in HC. Furthermore, a positive linear correlation between IL-13 and the severity of FD symptoms was found. CD4+ T cells from patients with FD expressed higher levels of α4β7 and CC chemokine receptor9 than those from HC.

Conclusions:

An increase of Th2-like cytokines and a positive correlation between the levels of plasma IL-13 and the severity of symptoms in patients with FD from Uruguay were detected.
Post-traumatic recurrent ulnar nerve dislocation at the elbow: a rare case report
Authors: Nguyen Huu Manh , Tran Quyet , Vu Duc Viet , Trung Dung Tran
Published: December 2023

Introduction and importance:

Several authors have also made reference to a less prevalent condition known in elbow as ulnar nerve subluxation. However, this particular condition tends to manifest primarily in young individuals who engage in professional sports or activities involving extensive use of the forearm. A more severe form of ulnar nerve subluxation, which is ulnar nerve dislocation, gives rise to a characteristic dislocation and relocation of the nerve at the elbow during flexion and extension of the forearm. Due to the rarity of this condition in clinical settings and its predominant occurrence as subluxation in younger patients, there are instances where traumatic ulnar nerve dislocation can be overlooked and misdiagnosed with two commonly encountered pathological conditions as ulnar nerve entrapment or medial epicondylitis.

Case presentation:

The authors present a 51-year-old male with chronic pain when moving his right forearm following a fall that caused a direct force injury to his elbow. The patient was misdiagnosed and treated as medial epicondylitis and early-stage ulnar nerve entrapment. However, the symptoms did not improve for a long time. The authors performed the ulnar nerve anterior transposition surgery using the subcutaneous transposition technique and the result is very good without any pain.

Clinical discussion:

The ulnar nerve can naturally be subluxed or dislocated if Osborne’s ligament is loose or when there are anatomical variations in the medial epicondyle. In some case, this ligament can be ruptured by trauma. The symptoms of ulnar instability are caused by friction neuritis. Dynamic ultrasound of the ulnar nerve in two positions show clearly this condition.

Conclusion:

Post-traumatic ulnar nerve dislocation is a rare condition, and the recurrent characteristic of it leads to neuritis or neuropathy. The condition can be overlooked or misdiagnosed as medial epicondylitis or early-stage ulnar nerve entrapment. The nerve transposition surgery will give good result.
Embracing My Stoma: Psychosocial Adjustment of Indonesian Colorectal Cancer Survivors Living With a Stoma
Authors: Afiyanti Yati , Milanti Ariesta , Wahidi Kemala Rita , Fitch Margaret
Published: December 2023

Background

After surgical treatment of colorectal cancer (CRC), most survivors need to have an ostomy, which can lead to restrictions in their psychological and social functioning. How Indonesian CRC survivors adjust to living well with the stoma remains an understudied area.

Objective

This study aimed to explore the lived experiences of Indonesian CRC survivors living with a stoma regarding their psychosocial adjustment.

Methods

This study adopted Heidegger’s interpretive phenomenology approach. Using semistructured in-depth interviews, data were collected until saturation from 11 CRC survivors. Data were analyzed using thematic analysis, with a Heideggerian stance.

Results

Three themes with corresponding subthemes were identified: (1) achieving self-reconciliation (subthemes: stoma as a savior, embracing the stoma’s existence, being confident as an ostomate), (2) getting tremendous social support (subthemes: getting support from partner, family and community, and peer ostomates), and (3) making practical adjustments in daily life (subthemes: adjustment in clothing, food and drink, physical activities and exercise, religious activities, and traveling). These 3 themes describe the essence of the “lived psychosocial experiences of the CRC survivors with stoma.”

Conclusions

In contrast to previous study findings conducted primarily in Western countries, most of the Indonesian CRC survivors living with a stoma described positive psychosocial adjustment regarding their ostomy. In this work, social support and cultural-religious aspects made a significant contribution to this adjustment.

Implications for Practice

Healthcare professionals, especially nurses, can use this knowledge in providing psychosocial support for CRC survivors with ostomy to facilitate a smooth adaptation and adjustment journey.
Affirming Care for Transgender and Gender-Diverse Youth
Authors: Roosevelt Lee K. , Kattari Leonardo , Yingling Charles
Published: December 2023

Nurses play a critical role in providing gender-affirming care for transgender and gender-diverse youth. With heightened debate about the clinical care for transgender and gender-diverse youth in the national and global spotlight, now more than ever before nurses must equip themselves with the knowledge and the evidence spanning more than 4 decades that support the clinical use of gender-affirming care for youth and young adults. By exploring gender development and gender-affirming care approaches through the lifespan perspective, this review provides an up-to-date discussion about best practices and clinical implications for providing equitable care for transgender and gender-diverse youth from birth to childhood and through adolescence developmental phases. A transgender and gender-diverse youth's future willingness to access health care is dependent on how positive their interactions are with their care team at this sensitive moment in their life. Nurses must not let political rhetoric impede their practice and ethical guidelines to provide competent, skilled, and unbiased care. Knowledgeable, informed, and empowered nurses can provide life-saving care to transgender and gender-diverse youth and their families.
Mpox in people living with HIV
Authors: Maan Irfaan , Kohli Manik , Gilson Richard
Published: December 2023

Purpose of review

The 2022 global outbreak of mpox disproportionally affected people with HIV (PWH). We review the data on the presentation, treatment, and prevention of mpox in PWH.

Recent findings

Most PWH with mpox had a mild and self-limiting illness, no different to people without HIV. A higher rate of rectal symptoms has been reported among PWH and those with advanced HIV disease were at higher risk of severe disease, hospitalization, and death. Treatment with antivirals was widely used in hospitalized patients without any randomized control trial data to support its use and without any data specifically in PWH. Use of smallpox vaccines to prevent mpox is safe in PWH regardless of CD4+ cell count. There is limited data on efficacy in those with lower CD4+ cell count and on long-term protective efficacy.

PWH should be offered vaccination against mpox in line with national guidelines. PWH should be individually risk-assessed for severe mpox, based on their CD4+ cell count and co-morbidities and ideally recruited into treatment trials to build an evidence base on efficacy. HIV and other sexually transmitted infection testing should be offered to all people diagnosed with mpox.
Krukenberg Tumors in Young Women: Computed Tomography and Magnetic Resonance Imaging Diagnosis
Authors: Ghahremani Gary G.
Published: December 2023

Introduction

The purpose of this report was to present the computed tomography (CT) and magnetic resonance imaging (MRI) features of Krukenberg tumors and to review the pertinent clinical data about the rising incidence of this malignancy among young women.

Material and Methods

This series included 8 women who ranged in age from 24 to 44 years (mean, 36.3 years). They were diagnosed to have Krukenberg tumors during a 5-year period (2011–2016). All patients were evaluated by abdominal CT and pelvic or transvaginal sonography. Five of them also had MRI of the abdomen, and 3 had positron emission tomography scans.

Results

The primary cancer was located in the stomach of 7 patients and in the colon in 1. The initial presentation was due to large pelvic mass and abdominal distention by ascites in 3 patients, gastrointestinal symptoms in 4, and small bowel obstruction by carcinoma of the ascending colon in 1 woman. Ovarian metastases were demonstrated on the initial imaging examination of 5 patients and developed as metachronous lesion during follow-up in 3 cases. Six women died 3 to 23 months (mean, 11 months) after the diagnosis. One has survived for 6 years after extensive surgery, and 1 was lost to follow-up.

Conclusions

Krukenberg tumors are being diagnosed with an increasing frequency because of well-documented rising incidence of gastric and colorectal carcinomas among young women. Therefore, those presenting with gastrointestinal cancer should have careful imaging of their ovaries for possible metastases, and conversely, the clinical or sonographic detection of bilateral ovarian masses would require evaluation by CT or MRI of the abdomen in search for a potential primary gastrointestinal cancer. This report highlights the CT and MRI features of this neoplastic process and reviews the current concepts about its development and management.
Quantitative comparison on the similarities and differences of Mongolian medicines in the treatment of liver diseases between China and Mongolia based on data mining
Authors: Huang Congying , Zhou Baochang , Chen Aruhan , La Budanbaila , Ye Yu , Liu Yibo , Zhang Xinyu , Sun Yanhong , Bo Agula , Li Minhui
Published: December 2023

Objective

The R language was used to quantitatively compare the medication patterns of Mongolian medicines used for the treatment of liver diseases between China and Mongolia, with a view to provide a reference for the research and clinical application of Mongolian medicines in the treatment of liver diseases.

Methods

The Mongolian medicinal prescriptions used for treating liver disease in Mongolia were collected from the Mongolian Pharmacy and Mongolian Treatment Guide for Common diseases in Mongolian Medicine, and those used in China were collected from the Inner Mongolia Standard for Mongolian Proprietary Medicine and Annotation of Mongolian Medicine Preparation Specifications. After the database was established, the frequency, properties, and tastes of the Mongolian medicines were analyzed, and R studio was used for the association rules analysis and cluster analysis.

Results

A total of 27 prescriptions used in Inner Mongolia, China, were collected involving 105 Mongolian medicines, with a total frequency of 284. Among them, there were 18 high-frequency medicines (frequency ≥5), which had a frequency of 147, accounting for 51.76% of the total frequency. The medicine with the highest frequency (14, 4.93%) was Carthamus tinctorius L.. The analysis of the medicine data in China revealed 15 association rules.

A total of 21 prescriptions used in Mongolia were collected, involving 92 Mongolian medicines, with a total frequency of 254. Among them, there were 17 high-frequency (frequency ≥5) medicines, with a total frequency of 124 (48.82%). The medicine with the highest frequency (13, 5.12%) was Carthamus tinctorius L.. The analysis of the medicine data in Mongolia revealed 79 association rules.

In both regions, the high-frequency medicines used for treating liver disease commonly had cool or warm property with bitter or sweet taste.

Conclusions

Carthamus tinctorius L., Terminalia chebula Retz., and other Mongolian medicines are commonly used to treat liver diseases in Inner Mongolia and Mongolia. The Mongolian medicines with cool or warm property and bitter, sweet, or astringent taste are commonly used to protect the liver.
Safety Assessment of Five Candidate Probiotic Lactibacilli using Comparative Genome Analysis
Authors: Altavas Patrick Josemaria del Rosario , Amoranto Mia Beatriz , Kim Sang Hoon , Kang Dae-Kyung , Balolong Marilen , Dalmacio Leslie Michelle
Published: December 2023

Microorganisms belonging to the Lactobacillus genus complex (LGC) are often used for oral consumption and are generally considered safe but can exhibit pathogenesis in rare and specific cases. Therefore, screening and understanding genetic factors that may contribute to pathogenicity can yield valuable insights regarding probiotic safety. Limosilactobacillus mucosae LM1, Lactiplantibacillus plantarum SK151, Lactiplantibacillus plantarum BS25, Limosilactobacillus fermentum SK152, and Lactobacillus johnsonii PF01 are current probiotics of interest; however,  their safety profiles have not been explored.  The genome sequences of LM1, SK151, SK152, and PF01 were downloaded from the NCBI GenBank, while that of L. plantarum BS25 was newly sequenced. These genomes were then annotated using the Rapid Annotation using Subsystem Technology (RAST) tk pipeline. Subsequently, a command line BLAST was performed against the Virulence Factor Database (VFDB) and the Comprehensive Antibiotic Resistance Database (CARD) to identify potential virulence factors and antibiotic resistance (AR) genes. Furthermore, ResFinder was used to detect acquired AR genes. The query against the VFDB identified genes that have a role in bacterial survivability, platelet aggregation, surface adhesion, biofilm formation and immunoregulation; and no acquired AR genes were detected using CARD and ResFinder. The study shows that the query strains exhibit genes identical to those present in pathogenic bacteria with the genes matched primarily having roles related to survival and surface adherence.