bluuebunny/crossref_metadata_2025 huggingface dataset:
Are Young Adults Ready to Complete Advance Directives?
Authors: Young Yuchi , Stone Arianna , Perre Taylor
Published: January 2022

Introduction: The dual objective of this study is to examine the perspectives of young adults toward advance directives (ADs) and their preferences related to life-sustaining treatment and care options. Methods: Participants include graduate students (n = 30) attending a university in New York State. Data were collected using a structured survey questionnaire and Medical Orders for Life-Sustaining Treatment (MOLST) form. Bivariate summary statistics were performed to address the study aims. Results: The mean age of study participants was 24 years, 60% were female, 60% white, and 27% Black. Most (87%) participants reported being comfortable discussing death and end-of-life care and preferring to make their own decisions. Under the circumstance of no pulse and/or not breathing, 87% want CPR. With a pulse and respiration, 96% want artificially administered fluids and nutrition, 90% want a trial period of intubation and/or mechanical ventilation, 67% want to be sent to a hospital, 67% want antibiotics, and 53% want no limitations on medical intervention. Conclusion: Our findings extend upon previous research by quantifying young adults’ specific beliefs, experiences, and preferences regarding advance directives and life-sustaining interventions. Young adults in our study preferred maximum medical interventions for life-sustaining treatment and care. Given the troubling trends in unintended injury (eg, car crashes and drug overdose) as the leading cause of death among young adults, they should be given an opportunity to understand the options and treatments available and should be encouraged to complete an AD.
School Health Infrastructure and Students’ Elevated Body Mass Index
Authors: S. Bakarman Safiya , Weaver Michael , Scarton Lisa
Published: January 2022

School-age children with overweight or obesity continue to be problematic in the United States, and are associated with many health, social, and financial problems. Schools provide an excellent venue in which to promote healthy weight in students, and school nurses are well-positioned to play an essential role in controlling obesity. The number of studies reporting relationships among school health infrastructure and prevalence of elevated Body Mass Index (BMI) is limited. The present study explored associations between three components of school health infrastructure (staff, services, budget) and the proportion overweight or obese 1st, 3rd, and 6th grade students, after controlling for selected factors (race, county education level, county poverty level, rurality). Study results supported an independent association between elevated BMI and school health staff. Additionally, independent associations between elevated BMI and the following covariates were supported: household income, race, and parents’ educational level. There is an ultimate need for well-designed studies addressing these associations.
Osteochondral Lesions of the Tibial Plafond and Ankle Instability With Ankle Cartilage Lesions: Proceedings of the International Consensus Meeting on Cartilage Repair of the Ankle
Authors: Dahmen Jari , Bayer Steve , Toale James , Mulvin Conor , Hurley Eoghan T. , Batista Jorge , Berlet Gregory C. , DiGiovanni Christopher W. , Ferkel Richard D. , Hua Yinghui , Kearns Stephen , Lee Jin Woo , Pearce Christopher J. , Pereira Hèlder , Prado Marcelo P. , Raikin Steven M. , Schon Lew C. , Stone James W. , Sullivan Martin , Takao Masato , Valderrabano Victor , van Dijk C. Niek , Ali Zakariya , Altink J. Nienke , Buda Roberto , Calder James D. F. , Davey Martin S. , D’Hooghe Pieter , Gianakos Arianna L. , Giza Eric , Glazebrook Mark , Hangody Laszlo , Haverkamp Daniel , Hintermann Beat , Hogan MaCalus V. , Hunt Kenneth J. , Hurley Daire J. , Jamal M. Shazil , Karlsson Jón , Kennedy John G. , Kerkhoffs Gino M.M.J. , Lambers Kaj T. A. , McCollum Graham , Mercer Nathaniel P. , Nunley James A. , Paul Jochen , Savage-Elliott Ian , Shimozono Yoshiharu , Stufkens Sjoerd A. S. , Thermann Hajo , Thordarson David , Vannini Francesca , van Bergen Christiaan J. A. , Walls Raymond J. , Walther Markus , Yasui Youichi , Younger Alastair S. E. , Murawski Christopher D.
Published: January 2022

Background:

An international consensus group of experts was convened to collaboratively advance toward consensus opinions based on the best available evidence on key topics within cartilage repair of the ankle. The purpose of this article is to present the consensus statements on osteochondral lesions of the tibial plafond (OLTP) and on ankle instability with ankle cartilage lesions developed at the 2019 International Consensus Meeting on Cartilage Repair of the Ankle.

Methods:

Forty-three experts in cartilage repair of the ankle were convened and participated in a process based on the Delphi method of achieving consensus. Questions and statements were drafted within 4 working groups focusing on specific topics within cartilage repair of the ankle, after which a comprehensive literature review was performed and the available evidence for each statement was graded. Discussion and debate occurred in cases where statements were not agreed on in unanimous fashion within the working groups. A final vote was then held.

Results:

A total of 11 statements on OLTP reached consensus. Four achieved unanimous support and 7 reached strong consensus (greater than 75% agreement). A total of 8 statements on ankle instability with ankle cartilage lesions reached consensus during the 2019 International Consensus Meeting on Cartilage Repair of the Ankle. One achieved unanimous support, and seven reached strong consensus (greater than 75% agreement).

Conclusion:

These consensus statements may assist clinicians in the management of these difficult clinical pathologies.

Level of Evidence:

Level V, mechanism-based reasoning.
Pathways and Structures: Evaluating Systems Changes in an NSF INCLUDES Alliance
Authors: Howley Caitlin , Campbell Johnavae , Cowley Kimberly , Cook Kimberly
Published: January 2022

In this article, we reflect on our experience applying a framework for evaluating systems change to an evaluation of a statewide West Virginia alliance funded by the National Science Foundation (NSF) to improve the early persistence of rural, first-generation, and other underrepresented minority science, technology, engineering, and mathematics (STEM) students in their programs of study. We begin with a description of the project and then discuss the two pillars around which we have built our evaluation of this project. Next, we present the challenge we confronted (despite the utility of our two pillars) in identifying and analyzing systems change, as well as the literature we consulted as we considered how to address this difficulty. Finally, we describe the framework we applied and examine how it helped us and where we still faced quandaries. Ultimately, this reflection serves two key purposes: (1) to consider a few of the challenges of measuring changes in systems, and (2) to discuss our experience applying one framework to address these issues.
The Vulnerability of the Developing Brain: Analysis of Highly Expressed Genes in Infant C57BL/6 Mouse Hippocampus in Relation to Phenotypic Annotation Derived From Mutational Studies
Authors: Lindlöf Angelica
Published: January 2022

The hippocampus has been shown to have a major role in learning and memory, but also to participate in the regulation of emotions. However, its specific role(s) in memory is still unclear. Hippocampal damage or dysfunction mainly results in memory issues, especially in the declarative memory but, in animal studies, has also shown to lead to hyperactivity and difficulty in inhibiting responses previously taught. The brain structure is affected in neuropathological disorders, such as Alzheimer’s, epilepsy, and schizophrenia, and also by depression and stress. The hippocampus structure is far from mature at birth and undergoes substantial development throughout infant and juvenile life. The aim of this study was to survey genes highly expressed throughout the postnatal period in mouse hippocampus and which have also been linked to an abnormal phenotype through mutational studies to achieve a greater understanding about hippocampal functions during postnatal development. Publicly available gene expression data from C57BL/6 mouse hippocampus was analyzed; from a total of 5 time points (at postnatal day 1, 10, 15, 21, and 30), 547 genes highly expressed in all of these time points were selected for analysis. Highly expressed genes are considered to be of potential biological importance and appear to be multifunctional, and hence any dysfunction in such a gene will most likely have a large impact on the development of abilities during the postnatal and juvenile period. Phenotypic annotation data downloaded from Mouse Genomic Informatics database were analyzed for these genes, and the results showed that many of them are important for proper embryo development and infant survival, proper growth, and increase in body size, as well as for voluntary movement functions, motor coordination, and balance. The results also indicated an association with seizures that have primarily been characterized by uncontrolled motor activity and the development of proper grooming abilities. The complete list of genes and their phenotypic annotation data have been compiled in a file for easy access.
Immigrant academic mothers negotiating ideal worker and mother norms during the COVID-19 pandemic: Duoethnography as a co-mentoring tool for transformative learning
Authors: Ghosh Rajashi , Chaudhuri Sanghamitra (Sonai)
Published: January 2022

How are immigrant academic mothers negotiating the confounding terrains of work and family during the pandemic? How can they support each other in learning how to resist the prevalent notions of ideal working and mothering amidst the demanding schedule of working remotely and parenting? This study addresses these questions through sharing a narrative of how two immigrant mothers in academia challenged and began the journey of transforming their gendered work and family identities. Building on personal essays and 6 weeks of extensive journaling that reflected our positionalities and experiences of motherhood, work-life, and intersections between work and home during the pandemic, we offer a fine-grained understanding of how we helped each other as co-mentors to identify moments of our lived experiences as triggers for transformative learning. In doing so, we realized how duoethnography could be more than just a research methodology in helping us co-construct a relational space to empathize and challenge each other’s perspectives about our roles as mothers and professors and the gendered nature of social forces shaping those roles.
Nurturing attachments group: A virtual group intervention for adults caring for traumatised children in the context of COVID-19
Authors: Lewis Matthew , Stirk Steven , Collie Harriet , Ansbro Yasmin , Johnson Rachel , Karyofylli Aspasia , Woolley Jeannette , Erin Libby
Published: January 2022

Background: Evidence indicates that the more traditional and behavioural parenting strategies are ineffective when parenting a child who has experienced developmental trauma. Recognising the need to parent with an attachment focus, the current paper evaluates the effectiveness of running the [Enfys] Nurturing Attachments Group, virtually, within the context of the COVID-19 pandemic. Method: A pilot feasibility study evaluated eight bespoke groups. Consenting professionals and co-professionals completed the Brief Parental Self-Efficacy Scale (BFSS), Care Questionnaire (CQ) and the Parental Reflective Functioning Questionnaire (PRFQ). Results: One hundred forty individuals attended the groups, with 51 (36%) completing both pre-and post-measures. The results provide evidence that professionals and co-professionals reported statistically significant positive increases on both the BPSS ( d = .55) and CQ ( d = .62). For the PRFQ, the results showed a statistically significant decrease on the Pre-mentalising sub scale, a non-significant mid-range score for Certainty about Mental States and a non-significant increase for Parental Interest and Curiosity in Mental States. Conclusion: The study has demonstrated initial viability of effectively facilitating the [Enfys] Nurturing Attachments Group, virtually. Importantly, it has also shown that the group can be run with professionals alongside co-professionals.
Perspectives of university health care students on mental health stigma in Nigeria: Qualitative analysis
Authors: Pederson Aderonke Bamgbose , Konadu Fokuo J. , Thornicroft Graham , Bamgbose Olamojiba , Ogunnubi Oluseun Peter , Ogunsola Kafayah , Oshodi Yewande O.
Published: January 2022

Mental illness is a significant public health burden in low- and middle-income countries. A wide treatment gap in mental health care exists within the Nigerian health care system and this gap is worsened by the presence of stigma associated with mental illness, which leads to delay in treatment or acts as a barrier to any care. In this study, our aim was to understand the factors that underlie mental illness stigma in order to inform the design of effective stigma-reducing interventions among health care students in Nigeria. We conducted four focus groups among university health care students in March 2019 in Nigeria. The students included nursing, pharmacy, and medical trainees from a university teaching hospital. We used an inductive-driven thematic analysis to identify codes and themes related to mental health stigma and conceptualization of mental health within the study group. Among the 40 participants, we identified how specific interpretations of religious and spiritual beliefs may be associated with stigmatizing behaviors such as social distancing and discrimination. Conceptualization of mental illness as a communicable disease and the attribution of mental illness to a moral failing contributed to stigma mechanisms. Overall, eight themes associated with mental health stigma and mental health-related concepts were found: spirituality, discrimination and devaluation, conceptualization of mental health, attribution theories, methods to reduce stigma, shortage of resources, violence and dangerousness, and maltreatment. We found that the co-existence of spiritual beliefs and biomedical and psychological models of mental health is a key factor to consider in the design of effective stigma-reducing interventions among university health students in Nigeria.
Source apportionment and health risk assessment of indoor volatile organic compounds
Authors: Bai Li , Dai Huageng , Wang Jun , Li Guangming
Published: January 2022

In extremely cold areas with long winter months and exceptionally cold weather, classrooms are inadequately ventilated, resulting in the continuous accumulation of indoor air pollutants that may endanger human health. This article uses adsorption tube sampling-thermal desorption-gas chromatography mass spectrometry to analyze the type and concentration of volatile organic compounds (VOCs) in the classroom. The source analysis and health risk assessment were performed, and the real-time concentration of total volatile organic compounds (TVOC) was computed using the multifunctional ventilation. The result shows that the air in the classroom contains 25 kinds of VOCs. Among them, the carcinogenic risk value of seven kinds of VOCs (3.40 × 10-5) exceeds the acceptable risk value (1 × 10-6) given by the U.S. Environmental Protection Agency (US EPA). There are 17 kinds of VOCs that pose a certain non-carcinogenic risk to the human body. After quantitative analysis by the principal component analysis (PCA) and the characteristic quantity concentration ratio method, human activities, furnishings, outdoor penetration, etc., were found to be main sources of VOCs in the classroom. In addition, TVOC concentration is directly proportional to class time. In winter, classrooms in severely cold areas must take necessary measures to reduce the concentration of VOCs and ensure students' health.
Theorising human trafficking through slow violence
Authors: Schwarz Corinne
Published: January 2022

Human trafficking is predominantly framed as a criminal justice issue with sensationalised, highly visible violence. Stereotypical figures of young women in danger, passively poised to be rescued by figures of the state or vigilante justice, animate public discourse and policy. Yet the reality of trafficking is often far more complex than the linear narratives presented in the mainstream. In this article, I argue that human trafficking is more readily accessible as slow violence, the accumulation and accretion of the consequences of systematic oppression over time. I use Nixon's Slow Violence and the Environmentalism of the Poor to articulate a stance against the flash of trafficking's ‘master narratives’. Slow violence offers three key elements for theorising human trafficking, i.e. that the harms are so gradual or delayed they: become imperceptible; compound over protracted durations of time; and may be so mundane and unspectacular to not even register as ‘violence’ in our vernacular. Aligned with a critical trafficking studies approach that draws attention to power dynamics and imbalances, slow violence focuses on the forms of exploitation and precarity that are taken for granted or assumed to be static. I use a collection of artifacts and examples from dominant anti-trafficking organisations and media to demonstrate the urgency required to both rethink trafficking against these flattening overgeneralisations and recommit to a transformative practice that makes more lives liveable. In the tradition of feminist anti-violence scholarship, I conclude by shifting from the micro-level examples of trafficking that fuel misinformation campaigns to the systems that perpetuate violence, exploitation and extraction – and must be eradicated if we are committed to ending human trafficking locally and globally.
Therapeutic Potential of Emodin for Gastrointestinal Cancers
Authors: McDonald Sierra J. , VanderVeen Brandon N. , Velazquez Kandy T. , Enos Reilly T. , Fairman Ciaran M. , Cardaci Thomas D. , Fan Daping , Murphy E. Angela
Published: January 2022

Gastrointestinal (GI) cancers cause one-third of all cancer-related deaths worldwide. Natural compounds are emerging as alternative or adjuvant cancer therapies given their distinct advantage of manipulating multiple pathways to both suppress tumor growth and alleviate cancer comorbidities; however, concerns regarding efficacy, bioavailability, and safety are barriers to their development for clinical use. Emodin (1,3,8-trihydroxy-6-methylanthraquinone), a Chinese herb-derived anthraquinone, has been shown to exert anti-tumor effects in colon, liver, and pancreatic cancers. While the mechanisms underlying emodin’s tumoricidal effects continue to be unearthed, recent evidence highlights a role for mitochondrial mediated apoptosis, modulated stress and inflammatory signaling pathways, and blunted angiogenesis. The goals of this review are to (1) highlight emodin’s anti-cancer properties within GI cancers, (2) discuss the known anti-cancer mechanisms of action of emodin, (3) address emodin’s potential as a treatment complementary to standard chemotherapeutics, (4) assess the efficacy and bioavailability of emodin derivatives as they relate to cancer, and (5) evaluate the safety of emodin.
A Case Study Using Papaya Leaf Extract to Reverse Chemotherapy-Induced Thrombocytopenia in a GBM Patient
Authors: Koehler Abigail , Rao Rohan , Rothman Yehudit , Gozal Yair M. , Struve Timothy , Alschuler Lise , Sengupta Soma
Published: January 2022

Chemotherapy-induced thrombocytopenia (CIT) is a critical condition in which platelet counts are abnormally reduced following the administration of chemotherapeutic compounds. CIT poses a treatment conundrum to clinicians given the increased risk of spontaneous bleeding, obstacles to surgical management of tumors, and exclusion from clinical trials. Treatment of CIT involves the removal of the offending agent combined with platelet infusion or thrombopoietin agonist treatment. However, due to the autoimmune and infection risks associated with infusions, this treatment is only reserved for patients with critically low platelet counts. One potential solution for patients in the mid to low platelet count range is Carica papaya leaf extract (CPLE). In this case, we report the novel use of CPLE as a method of bolstering platelet counts in a patient presenting with CIT. The patient was initiated on CPLE therapy consisting of 1 tablespoon twice daily with meals. Following CPLE treatment, the patient’s platelet counts rebounded from less than 10,000/µL to 113,000/µL. This clinical vignette supports the use of CPLE in the clinical context of CIT when thrombopoietin agonists are not a viable option. The potential benefits of CPLE as a method for increasing platelet count deserve further exploration, especially as a treatment option for refractory patients or those ill-suited for other traditional thrombocytopenia therapies.
HARM revisited: Etiology of subarachnoid hyperintensities in brain FLAIR MRI
Authors: Althaus Katharina , Kasel Martin , Ludolph Albert C , Kassubek Jan , Kassubek Rebecca
Published: January 2022

Background:

The hyperintense acute reperfusion marker (HARM) describes a phenomenon with a hyperintense signal in the subarachnoid space in Fluid-Attenuated Inversion Recovery (FLAIR) magnetic resonance imaging (MRI) sequences, presumably based on blood–brain barrier breakdown in acute stroke with reperfusion. However, this imaging phenomenon was described in other medical conditions.

Aim:

Determination of the prevalence and associated clinical findings of this phenomenon in a large sample of patients with different neurological conditions.

Methods:

This is retrospective, single-center, observational study of 23,948 cerebral MRIs acquired in a Neurological University Clinic over 5 years. The prevalence of HARM, the underlying diagnosis, and damage pattern were examined by chart analysis; MRI was analyzed regarding the type of acute lesions, extent of microangiopathic lesions, and whether gadolinium-based contrast agent (GBCA) was given.

Results:

Among the MRI data, 84 images (0.35%) from 61 patients were HARM-positive without a subarachnoid signal abnormality in any other sequence. Etiologies were heterogeneous; 35 patients had a cerebrovascular disease (CVD; 19 patients received recanalization therapy), 12 patients had an inflammatory central nervous system (CNS) disease and 14 patients had epilepsy. GBCA was applied to 64% of the patients.

Conclusion:

HARM was a rare radiological finding in a range of different neurological pathologies, not limited to stroke, or to previous reperfusion therapy and was not dependent on previous GBCA administration. Our data suggest that the term is too narrow in terms of the concepts of the underlying pathology. We propose to use the term FLAIR Subarachnoid Hyperintensity (“FLASH”) phenomenon which might better reflect the observation that the radiological sign can be associated with a variety of central neurological conditions without a straightforward association with therapy.
Prevalence of, and risk factors for, cognitive impairment in lacunar stroke
Authors: Ohlmeier Laura , Nannoni Stefania , Pallucca Claudia , Brown Robin B , Loubiere Laurence , Markus Hugh S ,   for the DNA Lacunar 2 Investigators
Published: January 2022

Background:

Small vessel disease (SVD) is associated with vascular cognitive impairment (VCI) but why VCI occurs in some, but not other patients, is uncertain. We determined the prevalence of, and risk factors for, VCI in a large cohort of patients with lacunar stroke.

Methods:

Participants with magnetic resonance imaging (MRI)-confirmed lacunar stroke were recruited in the multicenter DNA Lacunar 2 study and compared with healthy controls. A logistic regression model was used to determine which vascular risk factors and MRI parameters were independent predictors of VCI, assessed using the Brief Memory and Executive Test (BMET).

Results:

A total of 912 lacunar stroke patients and 425 controls were included, with mean ( SD) age of 64.6 (12.26) and 64.7 (12.29) years, respectively. VCI was detected in 38.8% lacunar patients and 13.4% controls. In a logistic regression model, diabetes mellitus (odds ratio (OR) = 1.98 (95% confidence interval (CI) = 1.40–2.80), p < 0.001) and higher body mass index (BMI) (OR = 1.03 (95% CI = 1.00–1.05), p = 0.029) were independently associated with increased risk of VCI, and years of full-time education with lower risk (OR = 0.92 (95% CI = 0.86–0.99), p = 0.018). When entering both lacune count and white matter hyperintensity (WMH) in the same logistic regression model, only WMH grade was significantly associated with VCI (OR = 1.46 (95% CI = 1.24–1.72), p < 0.001).

Conclusion:

VCI is common in lacunar stroke patients, affecting almost 40%. This prevalence suggests that it should be routinely screened for in clinical practice. Risk factors for VCI in patients with lacunar stroke include diabetes mellitus, depressive symptoms, higher BMI, and WMH severity, while education is protective.
Venous outflow profiles are associated with early edema progression in ischemic stroke
Authors: van Horn Noel , Heit Jeremy J , Kabiri Reza , Broocks Gabriel , Christensen Soren , Mlynash Michael , Meyer Lukas , Schoenfeld Michael H , Lansberg Maarten G , Albers Gregory W , Fiehler Jens , Wintermark Max , Faizy Tobias D
Published: January 2022

Background:

In patients with acute ischemic stroke due to large vessel occlusion (AIS–LVO), development of extensive early ischemic brain edema is associated with poor functional outcomes, despite timely treatment. Robust cortical venous outflow (VO) profiles correlate with favorable tissue perfusion. We hypothesized that favorable VO profiles (VO+) correlate with a reduced early edema progression rate (EPR) and good functional outcomes.

Methods:

Multicenter, retrospective analysis to investigate AIS–LVO patients treated by mechanical thrombectomy between May 2013 and December 2020. Baseline computed tomography angiography (CTA) was used to determine VO using the cortical vein opacification score (COVES); VO+ was defined as COVES ⩾ 3 and unfavorable as COVES ⩽ 2. EPR was determined as the ratio of net water uptake (NWU) on baseline non-contrast CT and time from symptom onset to admission imaging. Multivariable regression analysis was performed to assess primary (EPR) and secondary outcome (good functional outcomes defined as 0–2 points on the modified Rankin scale).

Results:

A total of 728 patients were included. Primary outcome analysis showed VO+ (β: –0.03, SE: 0.009, p = 0.002), lower presentation National Institutes of Health Stroke Scale (NIHSS; β: 0.002, SE: 0.001, p = 0.002), and decreased time from onset to admission imaging (β: –0.00002, SE: 0.00004, p < 0.001) were independently associated with reduced EPR. VO+ also predicted good functional outcomes (odds ratio (OR): 5.07, 95% CI: 2.839–9.039, p < 0.001), while controlling for presentation NIHSS, time from onset to imaging, general vessel reperfusion, baseline Alberta Stroke Program Early CT Score, infarct core volume, EPR, and favorable arterial collaterals.

Conclusions:

Favorable VO profiles were associated with slower infarct edema progression and good long-term functional outcomes as well as better neurological status and ischemic brain alterations at admission.
The role of preoperative opioid use in shoulder surgery—A systematic review
Authors: Al-Mohrej Omar A , Prada Carlos , Madden Kim , Shanthanna Harsha , Leroux Timothy , Khan Moin
Published: January 2022

Background

Emerging evidence suggests preoperative opioid use may increase the risk of negative outcomes following orthopedic procedures. This systematic review evaluated the impact of preoperative opioid use in patients undergoing shoulder surgery with respect to preoperative clinical outcomes, postoperative complications, and postoperative dependence on opioids.

Methods

EMBASE, MEDLINE, CENTRAL, and CINAHL were searched from inception to April, 2021 for studies reporting preoperative opioid use and its effect on postoperative outcomes or opioid use. The search, data extraction and methodologic assessment were performed in duplicate for all included studies.

Results

Twenty-one studies with a total of 257,301 patients were included in the final synthesis. Of which, 17 were level III evidence. Of those, 51.5% of the patients reported pre-operative opioid use. Fourteen studies (66.7%) reported a higher likelihood of opioid use at follow-up among those used opioids preoperatively compared to preoperative opioid-naïve patients. Eight studies (38.1%) showed lower functional measurements and range of motion in opioid group compared to the non-opioid group post-operatively.

Conclusion

Preoperative opioid use in patients undergoing shoulder surgeries is associated with lower functional scores and post-operative range of motion. Most concerning is preoperative opioid use may predict increased post-operative opioid requirements and potential for misuse in patients.

Level of evidence

Level IV, Systematic review.
Evaluation on Intestinal Permeability of Phlorotannins Using Caco-2 Cell Monolayers
Authors: Murata Naoki , Keitoku Saki , Miyake Hideo , Tanaka Reiji , Shibata Toshiyuki
Published: January 2022

Among the phlorotannins of seaweed polyphenols, eckols which have a dibenzodioxin linkage are known to have various physiological functions. The purpose of this study was to investigate the intestinal epithelial absorption of eckols using Caco-2 cell monolayers of the small intestinal membrane model. Each compound permeated from the apical (AP) side to the basolateral (BL) side in the monolayers was identified and quantitated by liquid chromatography-mass spectrometry with electrospray ionization. In the transport assays using five types of eckols (eckol, fucofuroeckol A, phlorofucofuroeckol A, dieckol, and 8,8'-bieckol), only the monomeric eckol showed limited transepithelial absorption with relatively small apparent permeability values (0.30  ±  0.04  ×  10−8 cm/s). Analyzing the Hanks’ balanced salt solution in the receiver on the BL side showed that phloroglucinol was detected in all experimental sections using eckols, and it's concentration increased with time over the course of the incubation. The other molecules corresponding to the unconjugated and conjugated metabolites of eckols were not detected in the AP and BL sides through the assays. These results suggest that eckols, including monomeric eckol, may be decomposed into phloroglucinol in the intestinal epithelium and the resulting phloroglucinol permeates to the BL side.
ICYMI: RT and Youth-Oriented International Broadcasting as (Geo)Political Culture Jamming
Authors: Saunders Robert A , Crilley Rhys , Chatterje-Doody Precious N
Published: January 2022

Research in political communication has recently begun to explore the role of non-Western English-language state-funded international broadcasters (NEIBs) in influencing international audiences. Despite this, there has been little attention given to understanding how NEIBs engage and influence young people in ‘Western’ democracies. Our article addresses this gap by providing a detailed analysis of RT's English-language, youth-orientated news product ICYMI. Launched in 2018, ICYMI is a social media-based news brand that consists of a series of 2–3-min videos that deliver satirical takes on recent global events including military conflict, financial scandals, and culture clashes. Our findings, which examine the first year of the platform's activity, show that ICYMI is a novel form of engagement, one that is not easily categorised as either public diplomacy or propaganda, nor can it be described as traditional journalism. Instead, we label this approach as geopolitical culture jamming. In this article, we conduct a discourse analysis of 45 videos published on YouTube by ICYMI over its first year to examine how the platform attempts to influence how young people relate to traditional foreign policy discourses. Our empirical analysis centres on how viewers engage with and interpret ICYMI's videos with the aim of addressing how RT may be influencing younger audiences, particularly its core demographic of Anglophone white males whose comments reflect an attachment to ICYMI's populist, anti-elite worldview.
Auditory Subjective-Straight-Ahead Blurs during Significantly Slow Passive Body Rotation
Authors: Honda Akio , Tsunokake Sayaka , Suzuki Yôiti , Sakamoto Shuichi
Published: January 2022

This paper reports on the deterioration in sound-localization accuracy during listeners’ head and body movements. We investigated the sound-localization accuracy during passive body rotations at speeds in the range of 0.625–5 °/s. Participants were asked to determine whether a 30-ms noise stimuli emerged relative to their subjective-straight-ahead reference. Results indicated that the sound-localization resolution degraded with passive rotation, irrespective of the rotation speed, even at speeds of 0.625 °/s.
Differentials in prevalence and correlates on uptake of tetanus toxoid and intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy: A community-based cross-sectional study in The Gambia
Authors: Barrow Amadou , Barrow Sulayman , Jobe Amienatta
Published: January 2022

Objectives:

The study examined the differentials in prevalence and correlates on the uptake of tetanus toxoid and intermittent preventive treatment of malaria among pregnant women in The Gambia.

Methods:

The 2018 data from The Gambia Multiple Indicators Cluster Survey were analyzed. Data from 6143 women of reproductive age who have given birth were extracted for the analysis. Percentages and Chi-square tests were used. In addition, a multivariable logistic regression model was used to calculate the adjusted odds ratios (with a corresponding 95% confidence interval). The level of significance was set at p < 0.05.

Results:

The prevalence of tetanus toxoid uptake among women in The Gambia was 88.2%, while that of the adequate tetanus toxoid doses was 34.8%. The prevalence of intermittent preventive treatment with sulfadoxine-pyrimethamine uptake among maternal women in The Gambia was 98.6%, while that of the adequate intermittent preventive treatment with sulfadoxine-pyrimethamine doses taken was 34.3%. The identified statistically significant covariates of tetanus toxoid immunization and intermittent preventive treatment with sulfadoxine-pyrimethamine uptake includes women’s age, local government areas, parity, use of radio, use of newspaper, and antenatal care visits.

Conclusion:

The current utilization rate for adequate intermittent preventive treatment with sulfadoxine-pyrimethamine and tetanus toxoid immunization during pregnancy in The Gambia is very low and even below universal levels. The country needs to strengthen more and effective mass media advocacy programs that would target both rural and urban populace, and motivate maternal women to ensure adequate vaccination against malaria and tetanus.
The life, death and diversity of pro-government militias: The fully revised pro-government militias database version 2.0
Authors: Carey Sabine C , Mitchell Neil J , Paula Katrin
Published: January 2022

This article presents version 2.0 of the Pro-Government Militias Database (PGMD). It is increasingly clear that it is untenable to assume a unified security sector, as states often rely on militias to carry out security tasks. The PGMD 2.0 provides new opportunities for studying questions such as when states rely on militias, how they chose among different types and the consequences for stability and peace. We detail how the PGMD 2.0 provides new information on the characteristics, behaviour, life cycle and organization of 504 pro-government militias across the globe between 1981 and 2014.
Synthetic ACTH for Treatment of Glomerular Diseases: A Case Series
Authors: Jauhal Arenn , Prasad Bhanu , Rousseau-Gagnon Mathieu , Ouellet Gabriel , A Hladunewich Michelle
Published: January 2022

Rationale:

Synthetic adrenocorticotropic hormone (Tetracosactide) has been used in the treatment of refractory glomerular diseases. Literature surrounding the use of this medication is limited to small case series and there is conflicting data on the rate of adverse events associated with this medication.

Presenting concerns of the patient:

Glomerulonephritis not in remission after at least 6 months of treatment with conservative care. Stable doses of concurrent immunosuppression were permitted.

Diagnoses:

Membranous nephropathy, IgA nephropathy, minimal change disease, and focal and segmental glomerulosclerosis.

Intervention:

Intramuscular synthetic adrenocorticotropic hormone (Tetracosactide, Synacthen Depot) with doses of either 1 mg weekly or 1 mg twice weekly.

Outcomes:

Five of 12 patients had at least a partial remission with Tetracosactide. Median time to response was 6 months for responders. Five of the 12 patients had adverse events documented, 2 of which led to treatment discontinuation. No patients with focal and segmental glomerulosclerosis responded to treatment.

Lessons Learned:

Higher rate of adverse events than previously reported with synthetic adrenocorticotropic hormone and uncertain treatment efficacy.
The role of positive psychological constructs in diet and eating behavior among people with metabolic syndrome: A qualitative study
Authors: Carrillo Alba , Feig Emily H , Harnedy Lauren E , Huffman Jeff C , Park Elyse R , Thorndike Anne N , Kim Sonia , Millstein Rachel A
Published: January 2022

Positive Psychological (PP) constructs (e.g., optimism and gratitude) may impact the adherence to healthy behaviors, including diet, though prior studies have shown mixed findings. This qualitative study explored the relationships between PP constructs and dietary behaviors among 21 adults with metabolic syndrome through semi-structured interviews. Directed content analysis led to five themes: eating healthfully leads to PP constructs, PP constructs lead to eating healthfully, eating healthfully prevents negative emotions, healthy behaviors associated with diet, and an upward healthy spiral. Given the close relationship between PP constructs and diet, these may be targeted to improve diet in risk populations through interventions that promote well-being.
Research on the mechanisms of taraxerol for the treatment of gastric cancer effect based on network pharmacology
Authors: Huo Bingjie , Song Yanru , Tan Bibo , Li Jianbo , Zhang Jie , Zhang Fengbin , Chang Liang
Published: January 2022

Background: Modern pharmacological studies have shown that traditional Chinese medicine (TCM) Taraxacum mongolicum possesses anti-cancer activity. Taraxerol (TRX) is a pentacyclic triterpene isolated from T. mongolicum, which is widely used in clinical treatment, and its anti-cancer effects have been extensively studied. However, the effects and molecular mechanism of TRX in gastric cancer (GC) have not been fully explicated. Methods: We used public databases to derive information on potential targets of TRX and proteins related to GC. Also, STRING and R3.6.2 software were used to analyze the protein–protein interaction (PPI). The Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were done to explain the potential mechanism underlying the regulatory role of TRX in GC. The role of TRX in GC was verified by 3-(4,5)-dimethylthiahiazo (-z-y1)-3,5-di- phenytetrazoliumromide (MTT) assay, apoptosis analysis, Transwell assay, and wound healing assay, and the key signaling pathways were verified. Results: We identified 135 potential targets for the treatment of GC via network pharmacological analysis. GO and KEGG enrichment analysis showed that steroid hormone receptor activity and the PI3K/AKT signaling pathway were the biological processes and pathways with the highest degree of enrichment. Additionally, cellular experiments revealed that TRX inhibited the proliferation, migration, and invasion of GC cells as well as induced G1 phase arrest and apoptosis in GC cells. Conclusion: Here, we used multi-target and multi-pathway network pharmacological analysis to verify the anti-cancer activity of TRX in GC. Also, in vitro experimental data were used to derive the potential molecular mechanism.
Clinical characteristics of patients with acquired immunodeficiency syndrome having respiratory symptoms as the initial manifestations: A retrospective study
Authors: Chen Xianqiu , Zhou Ying , Zhang Yuan , Shi Jingyun , Chen Yanan , Li Huiping
Published: January 2022

The aim of the study was to investigate clinical features of patients with AIDS having respiratory symptoms as initial manifestations and help in the early diagnosis. Eighty-eight patients admitted to the Shanghai Pulmonary Hospital were included in the study. General data, clinical manifestations, laboratory tests, chest computed tomography (CT) imaging features, treatments, and prognosis were analyzed. Peripheral leukopenia, lymphopenia, hypoxemia, and reduced percentage of CD4+ T lymphocytes were found in 25.6%, 43.6%, 27.5%, and 94.9% of the patients, respectively. Pneumocystis jirovecii pneumonia (PCP) was the most frequent cause of opportunistic pulmonary infection. Patients with PCP had more bilateral lung involvement and ground-glass shadow in CT manifestations. A follow-up of the 43 patients transferred to the Public Health Center showed improvement in 27 (62.8%), stabilization in 4 (9.3%), worsening in 1 (2.3%), and death in 11 (25.6%) patients. Detailed medical history recording, screening of human immunodeficiency virus antibody, and flow cytometry would improve the diagnostic efficiency of AIDS in patients with diffuse ground-glass shadow in chest CT. Early and empirical treatment could improve the prognosis.
Systemic lupus erythematosus after delivery and myasthenia gravis with COL6A1 gene mutation: A case report
Authors: Xu Yanqiu , Zhang Ying , Hu Hongming , Tan Jie , Wu Bin
Published: January 2022

The coexistence of systemic lupus erythematosus (SLE) and myasthenia gravis (MG) is rarely reported, especially the appearance of SLE before MG. In addition to the production of autoantibodies after thymectomy, gene mutation may be an important contributing factor to the overlap of SLE and MG. Here, we report a case of a female patient diagnosed with SLE before MG and found to carry the heterozygous variation COL6A1 c. 2608G>A. We propose that this gene variation weakens the function of COL6A1 and indirectly activates STAT1, resulting in the phenotype of these two autoimmune diseases. This report suggests that it is feasible to explore common pathogenic genes in SLE and MG through future large-scale research.
Delegitimising Data Subjects’ Economic Interests During Automatic Propertisation of Their Data: A Comparative Study of Data Protection on Social Media Platforms in the UK and China
Authors: Xue Janet Hui
Published: January 2022

Social media platforms (SMPs) generate revenue from the automatic propertisation of data contributed by users (i.e. they process these data algorithmically to feed products and services they sell to other customers, especially advertisers). This comparative study of the UK and China builds on key law and policy documents as well as in-depth interviews with 25 experts. We find that neither the human rights–based regulatory approach in the UK nor the impact-based approach of China provides users with economically meaningful forms of redress for harm suffered due to insufficient protection of their rights as data subjects. The study reveals the reasons for this: (1) by analysing data subjects’ rights in data protection law and establishing whether these rights preserve the economic interests of data subjects pertaining to their data; (2) by spelling out the conditions under which users can exercise their rights and (3) through an in-depth analysis of the existing mechanisms, which are not suitable to protect data subjects’ economic interests during automatic propertisation. This also helps us to understand the social impacts of China’s recently approved Personal Information Protection Law. Finally, it suggests two possible ways to improve the balance between the economic interests of data controllers and data subjects.
CO2 laser resurfacing for burn and traumatic scars of the hand and upper extremity
Authors: Cox Cameron , Bettiol Patrick , Le Audrey , MacKay Brendan J , Griswold John , McKee Desirae
Published: January 2022

Background

Scar formation is a normal part of the proliferative phase in wound healing where collagen is remodelled to better approximate normal skin. When collagen is not effectively redistributed, excessive scarring may occur. Recently, CO2 laser has emerged as an adjunct in improving scar quality via remodelling and redistribution of dermal collagen fibres. Due to the paucity of literature related to its use in the hands and upper extremities, we created a study to examine its effects on hypertrophic scars focused on the hands and upper extremities.

Methods

Patients treated with CO2 laser for hypertrophic scars of the hand and upper extremity were included. The Vancouver Scar Scale (VSS) and Patient and Observer Scar Assessment Scale (POSAS) were used to assess the progression of scar quality. Unpaired t-tests were performed to determine statistical difference between pre- and post-treatment scores on each scale. Pearson correlation coefficients were used to understand the relationship between number of treatments and scar quality.

Results

Of the 90 patients enrolled, 54 patients completed serial scar assessment forms. All patient and observer-reported POSAS domains showed improvement ( P < 0.05) apart from Itching. All VSS domains showed improvement ( P < 0.05). There was moderate correlation between overall patient-reported opinion of scar quality and Discoloration, Stiffness and Thickness, and strong correlation between overall patient opinion and Irregularity (r = 0.715). All observer-reported domains were strongly correlated (r = 7.56–8.74) with overall observer opinion of scar quality.

Conclusion

The results of this study may further substantiate CO2 laser as a treatment modality for excessive scarring in a variety of surgical subspecialties.

Lay Summary

Complex trauma and burns that impact the skin sometimes result in abnormal healing of the skin called, “hypertrophic scarring”. In our study we assessed how using focused CO2 laser therapy impacts patients and health care provider assessment of wound progression. Our results were based upon patient reported and healthcare provider observations based upon two standardized forms the Vancouver Scar Scale (VSS) and the Patient and Observer Scar Assessment Scale (POSAS). What we found is that after CO2 Laser Therapy, our 64 patients with 77 treated scars received on average almost 3 treatments and these treatments helped them with physical function and improved aesthetic appearance of their scars. The health care providers also found that the treatments improved functional and aesthetic end points. Overall, our study helps substantiate the body of evidence that using CO2 laser therapy improves aesthetics and function of hypertrophic scars in the upper extremity.