bluuebunny/crossref_metadata_2025 huggingface dataset:
Better Than the Markets: Mutual Fund Managers’ Perceptions of the Rich
Authors: Kuusela Hanna
Published: March 2023

This article investigates the cultural perceptions and the common sense held by Finnish mutual fund managers on the very wealthy and the rich in times of growing inequalities and increased wealth accumulation at the top. By studying the financial intermediaries on the shop-floor level, who embody the promises of popular finance, the article describes how fund managers working for the small investors make sense of the inequalities caused by financialization. In the research interviews analysed in the article, the mutual fund managers perceive the rich as a necessary and salutary part of the contemporary economy, whose function is to be and behave better than the financialized markets. This common sense concerning the rich helps to legitimize increasing wealth accumulation at the top, so that the fund managers’ perceptions of the rich embody an ideological coalition between the working financiers and the super-rich rentiers, a coalition that contrasts starkly with the promises of popular finance.
Palliative care referral criteria and application in pediatric illness care: A scoping review
Authors: Bernier Carney Katherine M. , Goodrich George , Lao Amberly , Tan Zewen , Kiza Alfred Habamutaki , Cong Xiaomei , Hinderer Katherine A.
Published: March 2023

Background:

Specialty pediatric palliative care services can help to address unmet care needs for children with complex and serious illness. Current guidelines support the identification of unmet palliative care needs; however, it is unknown how these guidelines or other clinical characteristics influence pediatric palliative care referral in research and practice.

Aim:

To evaluate the identification and application of palliative care referral criteria in pediatric illness care and research.

Design:

A scoping review with a content analysis approach to summarize results.

Data sources:

Five electronic databases (PubMed, CINAHL, PsycINFO, SCOPUS, and Academic Search Premier) were used to identify peer-reviewed literature published in English between January 2010 and September 2021.

Results:

We included 37 articles focused on the referral of pediatric patients to palliative care teams. The identified categories of referral criteria were: disease-related; symptom-related; treatment communication; psychosocial, emotional, and spiritual support; acute care needs; end-of-life care needs; care management needs; and self-referrals for pediatric palliative care services. We identified two validated instruments to facilitate palliative care referral and seven articles which described population-specific interventions to improve palliative care access. Nineteen articles implemented a retrospective health record review approach that consistently identified palliative care needs with varying rates of service use.

Conclusions:

The literature demonstrates inconsistent methods for identifying and referring children and adolescents with unmet palliative care needs. Prospective cohort studies and clinical trials would inform more consistent pediatric palliative care referral practices. More research is needed on palliative care referral and outcomes in community-focused pediatrics.
Bias-Based Bullying in California Schools: The Impact of the 2016 Election Cycle
Authors: Gill Monique , Govier Diana
Published: March 2023

The purpose of this study is to examine the trends in bias-based bullying between 2013 and 2019 among California youth overall and by type of bias-based bullying and explore the extent to which Trump’s announcement of his candidacy for U.S. President in June 2015 impacted these bullying outcomes. We pooled the student-level survey data from multiple waves of the California Healthy Kids Survey. The final study sample included 2,817,487 middle- and high-school students (48.3% female, 47.9% male, and 3.7% not reported). We examined five specific types of bias-based bullying and any bias-based bullying overall. We employed logistic regression and calculated odds ratios to compare differences in the odds of bias-based bullying before and after Trump announced his candidacy for U.S. President. Between 2013 and 2019, approximately one in four students reported experiencing at least one type of bias-based bullying, based on race, ethnicity, or national origin being the most commonly reported. Trump’s announcement for candidacy was inconsistently associated with differences in the odds of bias-based bullying. Counties in which a higher proportion of the electorate voted for Trump had slightly higher odds of bullying for any bias-based bullying and for all specific types of bias-based bullying. Findings highlight the need for a commitment to protecting students from bullying regardless of their identity. Public health and education researchers and practitioners should draw on our growing understanding of the different dimensions of bullying in designing, implementing, and evaluating intervention approaches that address bias-based bullying, a particularly important cause given the growing polarization in the United States and the increasing salience of identity in the lead-up to and since the 2016 and 2020 elections.
Phthalonitrile resin reinforced silane surface modified boron carbide: Efficient neutrons screening and exceptional thermal properties
Authors: Abdous Slimane , Derradji Mehdi , Mehelli Oussama , Khiari Karim , Kadi Mohamed Elamine , Habes Abdelmalek , Ramdani Noureddine , Zegaoui Abdeljalil , Liu Wenbin
Published: March 2023

The design of lightweight neutron shields has been restricted for quite some time to the use of epoxy thermosets as the main building blocks. Meanwhile, the recent developments in the field of polymers suggest otherwise. Indeed, the phthalonitrile (PN) resins have taken the lead over traditional thermosets in many demanding applications. Therefore, in a vision to introduce newer matrices with better performances and to further expand the applications of the PN resins into the nuclear field, the neutron shielding efficiency along with the thermal resistance performances of the neat PN polymer and its subsequent silane surface-modified B4C-reinforced composites were investigated. The neutron shielding measurements were performed using an optimized experimental setup at the NUR research reactor in Algiers. The neat PN polymer displayed better thermal neutron screening performances than the epoxy and benzoxazine, with a macroscopic cross-section (Σ) of a 1.936 cm−1, equivalent to a mean free path (λ) of 0.358 cm. The effect of the particle amount was also studied to maximize the shielding ability of the developed materials. For instance, the PN composite containing 20 wt. % of B4C displayed an outstanding screening ratio of about 99.8% for a sample thickness of 13 mm. Finally, the remarkable findings were put into context by providing multifaceted comparisons with the available shielding materials.
An Update on the Pharmacological Aspects of Vaccines and Antivirals for the Management of Monkeypox
Authors: James Jerin , A Porkodi , P Kala , Rani Jamuna , V Sathyanarayanan
Published: March 2023

Monkeypox is a self-limiting zoonotic disease caused by the monkeypox virus belonging to the genus of orthopox viruses. Initially considered an ‘African disease’, this infection has crossed the boundaries to affect other continents and it has raised tremendous concerns among the general public as well as the medical fraternity all over the world, particularly because of the lack of specific vaccinations and drugs for the management of the illness. Epidemiological evaluation of the current infection has reported that it is mainly transmitted through sexual contact in bisexual men, mostly whites, and in those with pre-existing human immunodeficiency virus infection. The most common presentations were skin rash, anogenital lesions, or mucosal lesions along with systemic symptoms. It has been established that the vaccines and drugs approved for the management of smallpox could be used for the management of the current monkeypox outbreak. Vaccinia Immune Globulin (VIG) and vaccines like JYNNEOS and ACAM2000 and antiviral drugs like tecovirimat, cidofovir (CDV), and brincidofovir are being considered for those patients with serious diseases. It is imperative for physicians to understand the pharmacological aspects of these drugs for delivering better care to patients with monkeypox, which is eventually essential for the containment of this infection. This review covers updates on vaccines as well as drugs for the prevention and management of monkeypox.
Beyond burnout II: A case series of doctors seen in a new publicly funded doctors’ mental health service
Authors: Lele Kiran , Mclean Loyola M , Peisah Carmelle
Published: March 2023

Objective

Doctors’ mental health has received increased focus recently and has been met with a variety of systemic responses. A Professional Support Unit (PSU) in a public hospital was established to address service gaps. This paper aims to describe the care of doctors referred to this service.

Methods

Participants in the first four cases were referred to the PSU and assessed by the first author.

Results

The cases revealed: (i) variety of referral sources, symptom presentations and backgrounds of doctors referred to a dedicated doctors’ health service; and (ii) the person-centred, multi-modal treatments and adjunctive services required.

Conclusion

Doctors’ mental health is an urgent priority, with direct impacts on patient safety and care. The mix of patients presented here suggest difficulties beyond burnout and highlight the workings of a new service model designed to complement existing services in the Australian context.
Green Atmospherics as Nature-Based Solutions and Patient Responses and Behaviors in Healthcare Establishments From Romania
Authors: Untaru Elena-Nicoleta , Han Heesup , Bălăşescu Simona , Kim Bona , Ariza-Montes Antonio
Published: March 2023

The present study aims to evaluate a conceptual framework that explains patients’ attachment to a healthcare establishment by considering the effect of a natural/green environment as nature-based solutions (NBS), mental health value, emotional wellbeing, and satisfaction. An online survey method was utilized to reach Romanian patients. Using this procedure, a total of 386 cases were used for the data analysis. Structural equation modeling was utilized as the data analysis method. Our findings reveal that natural/green environment as NBS significantly influences patients’ mental health value, emotional wellbeing, and satisfaction, which contributes to an increase in their attachment to the healthcare facility. In addition, the mediating role of mental health value, emotional wellbeing, and satisfaction is uncovered. Our results can help healthcare managers and researchers develop strategies to effectively integrate natural/green features as NBS in the interior spaces of healthcare settings.
Risk factors of loss of reduction after acromioclavicular joint dislocation treated with a hook plate
Authors: Lee Young Seok , Kim Doo Sup , Jung Ji Won , Jo Young-Hoon , Lee Chang-Hun , Lee Bong Gun
Published: March 2023

Background

Acromioclavicular joint fixation using a hook plate is effective for the treatment of acute acromioclavicular joint dislocation. However, several studies have reported some complications including loss of reduction after surgery for acromioclavicular joint dislocation. This study aimed to identify the risk factors associated with the loss of reduction after acromioclavicular joint dislocation surgery using a hook plate.

Methods

This was a retrospective study that assessed 118 patients with acromioclavicular joint dislocation, who were diagnosed between March 2013 and January 2019 and underwent surgical treatment using the hook plate (reduction loss group: n = 38; maintenance group: n = 80). The mean follow-up period was 29.9 months (range, 24–40 months). We assessed the range of motion, the American Shoulder and Elbow Surgeons score (ASES), visual analog scale score for pain, and a subjective shoulder value. Radiological assessment of coracoid clavicular distance was performed. The risk factors of reduction loss were analyzed using multivariable logistic regression analysis.

Results

Age (p = 0.049), sex (female, p = 0.03, odds ratio OR = 4.81), Rockwood type V (p = 0.049, OR = 2.20), and time from injury to surgery > 7 days (p = 0.018, OR = 2.59) were statistically significant factors in the reduction loss group. There were no significant differences in the clinical outcomes for range of motion, ASES, subjective shoulder value, and visual analog scale scores between the two groups. In the radiological results, preoperative coracoid clavicular distance (p = 0.039) and ratio (p = 0.001), and over-reduction (p = 0.023, OR = 0.40) were significantly different between the two groups. The multivariate logistic regression analysis identified the female sex (p = 0.037, OR = 5.88), a time from injury to surgery > 7 days (p = 0.019, OR = 3.36), and the preoperative coracoid clavicular displacement ratio of the injured shoulder (p < 0.001, OR = 1.03) as risk factors associated with reduction loss following surgery using a hook plate for acromioclavicular dislocation.

Conclusion

A delayed timing of surgery > 7 days, preoperative coracoid clavicular displacement ratio of the injured shoulder, and female sex were identified as risk factors for loss of reduction after surgery using a hook plate for acromioclavicular joint dislocation.

Level of evidence: Level IV; retrospective comparison; treatment study
α1A Adrenoreceptor blockade attenuates myocardial infarction by modulating the integrin-linked kinase/TGF-β/Smad signaling pathways
Authors: Alrasheed Nawal M. , Alammari Raghad B. , Alshammari Tahani K. , Alamin Maha A. , Alharbi Abeer O. , Alonazi Asma S. , Bin Dayel Anfal F. , Alrasheed Nouf M.
Published: March 2023

Background

Myocardial infarction (MI) is considered a public health problem. According to the World Health Organization, MI is a leading cause of death and comorbidities worldwide. Activation of the α1A adrenergic receptor is a contributing factor to the development of MI. Tamsulosin, an α1A adrenergic blocker, has gained wide popularity as a medication for the treatment of benign prostatic hyperplasia. Limited evidence from previous studies has revealed the potential cardioprotective effects of tamsulosin, as its inhibitory effect on the α1A adrenoceptor protects the heart by acting on the smooth muscle of blood vessels, which results in hypotension; however, its effect on the infarcted heart is still unclear. The mechanisms of the expected cardioprotective effects mediated by tamsulosin are not yet understood. Transforming growth factor-beta (TGF-β), a mediator of fibrosis, is considered an attractive therapeutic target for remodeling after MI. The role of α1A adrenoceptor inhibition or its relationships with integrin-linked kinase (ILK) and TGF-β/small mothers against decapentaplegic (Smad) signaling pathways in attenuating MI are unclear. The present study was designed to investigate whether tamsulosin attenuates MI by modulating an ILK-related TGF-β/Smad pathway.

Methods

Twenty-four adult male Wistar rats were randomly divided into 4 groups: control, ISO, TAM, and ISO + TAM. ISO (150 mg/kg, intraperitoneally) was injected on Days 20 and 21 to induce MI. Tamsulosin (0.8 mg/kg, orally) was administered for 21 days, prior to ISO injection for 2 consecutive days. Heart-to-body weight ratios and cardiac and fibrotic biomarker levels were subsequently determined. ILK, TGF-β1, p-Smad2/3, and collagen III protein expression levels were determined using biomolecular methods.

Results

Tamsulosin significantly attenuated the relative heart-to-body weight index (p < 0.5) and creatine kinase-MB level (p < 0.01) compared with those in the ISO control group. While ISO resulted in superoxide anion production and enhanced oxidative damage, tamsulosin significantly prevented this damage through antioxidant defense mechanisms, increasing glutathione and superoxide dismutase levels (p < 0.05) and decreasing lipid peroxide oxidation levels (p < 0.01). The present data revealed that tamsulosin reduced TGF-β/p-Smad2/3 expression and enhanced ILK expression.

Conclusion

Tamsulosin may exert a cardioprotective effect by modulating the ILK-related TGF-β/Smad signaling pathway. Thus, tamsulosin may be a useful therapeutic approach for preventing MI.
Utilizing ultrasound in suspected necrotizing enterocolitis with equivocal radiographic findings
Authors: Kallis Michelle P. , Roberts Bailey , Aronowitz Danielle , Shi Yan , Lipskar Aaron M. , Amodio John B. , Aggarwal Alpna , Sathya Chethan
Published: March 2023

Background

To examine the use of abdominal ultrasound (AUS) as a diagnostic adjunct in the diagnosis of necrotizing enterocolitis (NEC) in cases where abdominal radiography (AXR) is equivocal in order to reduce unnecessary antibiotic use in neonates.

Methods

Retrospective study (2017–2019) of infants undergoing NEC evaluation with equivocal AXR findings (n = 54). Paired AXR and AUS were reviewed with respect to presence or absence of pneumatosis. Concordance of AUS findings with decision to treat for NEC was evaluated.

Results

Among 54 infants where AXR was equivocal, AUS demonstrated presence of pneumatosis in 22 patients (41%), absence of pneumatosis in 31 patients (57%), and was equivocal in 1 patient. All patients with pneumatosis on AUS were treated for NEC. Of 31 patients without pneumatosis on AUS, 25 patients (78%) were not treated for NEC. Patients without pneumatosis on AUS received a significantly shorter mean duration of antibiotics compared to those with pneumatosis (3.3 days (+/− 4.8 days) vs 12.4 days (+/− 4.7 days)); p < 0.001). Of those patients not treated, none required treatment within 1 week following negative AUS.

Conclusion

AUS is a valuable tool for evaluating the presence or absence of pneumatosis in the setting of equivocal AXR. Absence of pneumatosis on AUS informs clinical decision making and reduces unnecessary treatment and antibiotic usage.
Improving quality of life in patients with rare autoimmune liver diseases by structured peer-delivered support (Q.RARE.LI): study protocol for a transnational effectiveness-implementation hybrid trial
Authors: Uhlenbusch Natalie , Bal Arpinder , Balogh Boglárka , Braun Annika , Geerts Anja , Hirschfield Gideon , Janik Maciej K. , Lohse Ansgar W. , Milkiewicz Piotr , Papp Mária , Poppe Carine , Schramm Christoph , Löwe Bernd
Published: March 2023

Background

Psychosocial support is a crucial component of adequate rare disease care, but to date psychosocial support needs of this patient population are insufficiently met. Within Q.RARE.LI, we strive to evaluate the effectiveness of a structured, transdiagnostic, and location-independent psychosocial support intervention in routine care of patients with rare autoimmune liver diseases in five countries and prepare its implementation.

Methods

Within an effectiveness-implementation hybrid trial, we aim to a) investigate the effectiveness of the intervention in routine care in five diverse healthcare systems and b) assess implementation outcomes, examine and prepare the implementation context, and develop country-specific implementation strategies. To assess effectiveness, we will include N = 240 patients with rare autoimmune liver diseases. Within a two-armed randomized controlled trial (allocation ratio 1:1), we will compare structured and peer-delivered psychosocial support in addition to care-as-usual (CAU) with CAU alone. Outcomes will be assessed via electronic database entry prior to intervention, directly after, and at a three-month follow-up. Our primary effectiveness outcome will be mental health-related quality of life at post-assessment. Secondary outcomes include depression and anxiety severity, perceived social support, helplessness, and disease acceptance. Implementation outcomes will be assessed within a mixed-methods process evaluation. In a quantitative cross-sectional survey, we will examine perceived acceptability and feasibility in patients, peer-counselors, and healthcare providers involved in delivery of the intervention. In qualitative focus groups, we will analyze the implementation context and determine barriers and facilitators for implementation with different stakeholders (patients and/or representatives, peer-counselors, healthcare providers, health insurers). Based on these results, we will derive country-specific implementation strategies and develop a concrete implementation plan for each country.

Discussion

The intervention is expected to help patients adjust to their disease and improve their mental quality of life. The transdiagnostic and location-independent program has the potential to reach patients for psychosocial support who are usually hard to reach. By preparing the implementation in five countries, the project can help to make low-threshold psychosocial support available to many patients with rare diseases and improve comprehensive healthcare for an often neglected group.

Trial registration

ISRCTN15030282
Effect of joint line orientation parameters on initial bone resection in mechanically aligned total knee arthroplasty: a retrospective clinicoradiological correlation study
Authors: Wen Liang , Yu Yang , Ma Desi , Wang Zhiwei
Published: March 2023

Background

Discrepancies in bone resection between the medial and lateral compartments are very common in total knee arthroplasty (TKA) when mechanical alignment (MA) is used. The purpose of this study was to explore whether and how joint line orientation affects the initial bone resection in mechanically aligned TKA.

Methods

A total of 194 patients (225 knees) diagnosed with osteoarthritis (OA) were included. Virtual bone resection was conducted in the coronal view using full-length weight-bearing radiographs according to the technical requirements of MA, and the reliability of the virtual resection was verified via intraoperative caliper measurements. Correlation and regression analyses were conducted between the initial bone resection within the extension gap (EG) and various parameters, including the hip-knee-ankle (HKA) angle, mechanical lateral distal femoral angle (mLDFA), joint line congruence angle (JLCA), and medial proximal tibial angle (MPTA). Moreover, the correlation between intraoperative bone resection adjustments and joint line orientation parameters was also investigated.

Results

All knees in the current case series were artificially divided into 4 subgroups: subgroup 1, containing 148 varus knees (65.8%) with valgus femurs; subgroup 2, containing 48 varus knees (21.3%) with varus femurs; subgroup 3, containing 17 valgus knees (7.6%) with varus tibias; and subgroup 4, containing 12 valgus knees (5.3%) with valgus tibias. In subgroup 1, the mLDFA and MPTA were positively correlated with the initial bone resection with regression coefficients of 0.670 and 0.089, respectively. Moreover, in all varus knees, intraoperative bone resection adjustments were negatively correlated with mLDFA and MPTA, with categorical regression coefficients of -0.426 and − 0.230, respectively.

Conclusion

When MA-TKAs are performed in varus knees with valgus femurs, the initial bone resection within the EG is mainly positively correlated with mLDFA, while the intraoperative bone resection adjustment is significantly correlated with mLDFA and MPTA in all varus knees.
The cross-sectional area ratio of a specific part of the flexor pollicis longus tendon- a stable sonographic measurement for trigger thumb: a cross-sectional trial
Authors: Zhu Wenbin , Zhou Huan , Hu Zhe , Chen Hongyan , Liu Juan , Li Jin , Feng Xiaoyuan , Li Xueqin
Published: March 2023

Background

Trigger thumb is a pathologic condition of the digital pulleys and flexor tendons. To find a cutoff value of the cross-sectional area ratio of specific parts of the flexor pollicis longus tendon to diagnosis trigger thumb in the high-frequency ultrasound examination.

Methods

We evaluated 271 healthy volunteers and 57 patients with clinical diagnosis of trigger thumb. The cross-sectional area of the metacarpophalangeal joint of flexor pollicis longus tendon (C1) and the cross-sectional area of the midpoint of the first metacarpal of flexor pollicis longus tendon (C2) were analyzed.

Results

There is no difference between gender, age and left and right hands in the ratio of C1 to C2 (C1/ C2). The mean of C1/ C2 in the healthy thumb was 0.983 ± 0.103, which was significantly smaller in comparison to the diseased thumb (P < 0.05). Based on the receiver operating characteristic curve, we chose the diagnostic cut-off value for the C1/ C2 to be 1.362 and 1.153 in order to differ a trigger thumb from children and adults.

Conclusions

The C1/ C2 of the healthy thumb was relatively stable, with a mean value of 0.983 ± 0.103. The cutoff value of C1/C2 to distinguish healthy thumb from diseased thumb in children and adults were 1.362 and 1.153, respectively.
The effect of sandblasting versus acid etching on the surface roughness and biaxial flexural strength of CAD/CAM resin-matrix ceramics (In vitro study)
Authors: Muhammed Heba A. , Mahmoud Elsayed M. , Fahmy Amal E. , Nasr Dina M.
Published: March 2023

Background

CAD/CAM resin matrix ceramics are one of the materials used in dental offices. The long-term success of the restoration depends on the bond strength of the restoration to the tooth and other materials; thus, surface treatment of the restoration is necessary to achieve this. But such treatment may affect the restoration strength. The purpose of this study is to assess the impact of various surface treatments on the surface roughness (Ra) and the biaxial flexural strength of two CAD-CAM resin-matrix ceramics.

Methods

Thirty-six-disc-shaped specimens, each measuring 1.2 mm in thickness and 12 mm in diameter, were machined from two resin-matrix ceramic blocks (Lava Ultimate and Cerasmart) (n = 18). Based on the surface treatments, each material was divided into 3 groups: control (no treatment), 50-μm Al2O3 sandblasting, or 9% hydrofluoric acid etching (n = 6). The surface roughness (Ra) was evaluated by the 3D laser scanning microscope. Then, specimens were aged by thermal cycling (5000 cycles) and tested for biaxial flexural strength using a universal testing machine at a crosshead speed of 1.0 mm/min.

Results

No significant differences in flexural strength or Ra were found for Lava Ultimate among the surface treatment groups. For Cerasmart, only the sandblasting group showed significantly higher Ra values than the control group. Also, the Ra values for the sandblasting group were significantly higher than those for the acid etching group. The flexural strengths of the sandblasting and acid etching groups for Cerasmart were statistically similar, and both were significantly lower than the control group.

Conclusions

Although all of the applied surface conditioning techniques improved Ra, they had a negative impact on the flexural strength of resin-matrix ceramics. Thus, clinicians should utilize the appropriate surface treatment techniques, taking into account their effects on the surface roughness and mechanical properties of resin-matrix ceramics.
Using the embryo-uterus statistical model to predict pregnancy chances by using cleavage stage morphokinetics and female age: two centre-specific prediction models and mutual validation
Authors: van Marion Eva S. , Baart Esther B. , Santos Margarida , van Duijn Linette , van Santbrink Evert J. P. , Steegers-Theunissen Régine P. M. , Laven Joop S. E. , Eijkemans Marinus J. C.
Published: March 2023

Background

The predictive capability of time-lapse monitoring (TLM) selection algorithms is influenced by patient characteristics, type and quality of data included in the analysis and the used statistical methods. Previous studies excluded DET cycles of which only one embryo implanted, introducing bias into the data. Therefore, we wanted to develop a TLM prediction model that is able to predict pregnancy chances after both single- and double embryo transfer (SET and DET).

Methods

This is a retrospective study of couples (n = 1770) undergoing an in vitro fertilization cycle at the Erasmus MC, University Medical Centre Rotterdam (clinic A) or the Reinier de Graaf Hospital (clinic B). This resulted in 2058 transferred embryos with time-lapse and pregnancy outcome information. For each dataset a prediction model was established by using the Embryo-Uterus statistical model with the number of gestational sacs as the outcome variable. This process was followed by cross-validation.

Results

Prediction model A (based on data of clinic A) included female age, t3-t2 and t5-t4, and model B (clinic B) included female age, t2, t3-t2 and t5-t4. Internal validation showed overfitting of model A (calibration slope 0.765 and area under the curve (AUC) 0.60), and minor overfitting of model B (slope 0.915 and AUC 0.65). External validation showed that model A was capable of predicting pregnancy in the dataset of clinic B with an AUC of 0.65 (95% CI: 0.61–0.69; slope 1.223, 95% CI: 0.903–1.561). Model B was less accurate in predicting pregnancy in the dataset of clinic A (AUC 0.60, 95% CI: 0.56–0.65; slope 0.671, 95% CI: 0.422–0.939).

Conclusion

Our study demonstrates a novel approach to the development of a TLM prediction model by applying the EU statistical model. With further development and validation in clinical practice, our prediction model approach can aid in embryo selection and decision making for SET or DET.
α7 Nicotinic acetylcholine receptor: a key receptor in the cholinergic anti-inflammatory pathway exerting an antidepressant effect
Authors: Liu Huiyang , Zhang Xiaomei , Shi Peng , Yuan Jiyuan , Jia Qiang , Pi Chao , Chen Tao , Xiong Linjin , Chen Jinglin , Tang Jia , Yue Ruxu , Liu Zerong , Shen Hongping , Zuo Ying , Wei Yumeng , Zhao Ling
Published: March 2023

Depression is a common mental illness, which is related to monoamine neurotransmitters and the dysfunction of the cholinergic, immune, glutamatergic, and neuroendocrine systems. The hypothesis of monoamine neurotransmitters is one of the commonly recognized pathogenic mechanisms of depression; however, the drugs designed based on this hypothesis have not achieved good clinical results. A recent study demonstrated that depression and inflammation were strongly correlated, and the activation of alpha7 nicotinic acetylcholine receptor (α7 nAChR)-mediated cholinergic anti-inflammatory pathway (CAP) in the cholinergic system exhibited good therapeutic effects against depression. Therefore, anti-inflammation might be a potential direction for the treatment of depression. Moreover, it is also necessary to further reveal the key role of inflammation and α7 nAChR in the pathogenesis of depression. This review focused on the correlations between inflammation and depression as well-discussed the crucial role of α7 nAChR in the CAP.
A role for heritable transcriptomic variation in maize adaptation to temperate environments
Authors: Sun Guangchao , Yu Huihui , Wang Peng , Lopez-Guerrero Martha , Mural Ravi V. , Mizero Olivier N. , Grzybowski Marcin , Song Baoxing , van Dijk Karin , Schachtman Daniel P. , Zhang Chi , Schnable James C.
Published: March 2023

Background

Transcription bridges genetic information and phenotypes. Here, we evaluated how changes in transcriptional regulation enable maize (Zea mays), a crop originally domesticated in the tropics, to adapt to temperate environments.

Result

We generated 572 unique RNA-seq datasets from the roots of 340 maize genotypes. Genes involved in core processes such as cell division, chromosome organization and cytoskeleton organization showed lower heritability of gene expression, while genes involved in anti-oxidation activity exhibited higher expression heritability. An expression genome-wide association study (eGWAS) identified 19,602 expression quantitative trait loci (eQTLs) associated with the expression of 11,444 genes. A GWAS for alternative splicing identified 49,897 splicing QTLs (sQTLs) for 7614 genes. Genes harboring both cis-eQTLs and cis-sQTLs in linkage disequilibrium were disproportionately likely to encode transcription factors or were annotated as responding to one or more stresses. Independent component analysis of gene expression data identified loci regulating co-expression modules involved in oxidation reduction, response to water deprivation, plastid biogenesis, protein biogenesis, and plant-pathogen interaction. Several genes involved in cell proliferation, flower development, DNA replication, and gene silencing showed lower gene expression variation explained by genetic factors between temperate and tropical maize lines. A GWAS of 27 previously published phenotypes identified several candidate genes overlapping with genomic intervals showing signatures of selection during adaptation to temperate environments.

Conclusion

Our results illustrate how maize transcriptional regulatory networks enable changes in transcriptional regulation to adapt to temperate regions.
HOPPSA update: changes in the study protocol of Hysterectomy and OPPortunistic SAlpingectomy, a registry-based randomized controlled trial
Authors: Idahl Annika , Liv Per , Darelius Anna , Collins Elin , Sundfeldt Karin , Pålsson Mathias , Strandell Annika
Published: March 2023

Background

The HOPPSA trial is a multi-center national registry-based randomized controlled trial to test the safety and effectiveness of performing opportunistic salpingectomy at hysterectomy to reduce the risk of epithelial ovarian cancer (EOC). The study protocol was first published in January 2019 and is available at https://trialsjournal.biomedcentral.com/articles/10.1186/s13063-018-3083-8. Here, we report amendments made to the study protocol since commencement of the trial.

Changes in methods and analysis

The primary outcomes analyses have been changed. (1) Complications will be analyzed using binomial generalized estimating equation (GEE) with log link function, while the unadjusted analyses according to Miettinen and Nurminen will be performed as a sensitivity analysis. (2) Absolute change in Menopause Rating Scale (MRS) will primarily be analyzed using a mixed effects model, adjusted for baseline MRS and center as a random effect. (3) Time to EOC will be analyzed using the mixed effects Cox regression model with center as random effect, while the unadjusted log-rank test will be performed as a sensitivity analysis.

The primary outcome Complications will be based solely on the specific assessment in the GynOp quality registry. The Clavien-Dindo classification will be evaluated as a secondary outcome.

Furthermore, MRS is also measured three years postoperatively to better pinpoint the onset of menopausal symptoms.

Discussion

The changes to the protocol mainly concern the analyses of data. No changes to recruitment, randomization, intervention, or follow-up of primary outcomes have been made. An interim analysis during 2021 concluded that the study should continue until the target sample size is reached.

Trial registration

ClinicalTrials.gov, NCT03045965. Registered 8 February 2017.
Gut dysbiosis is associated with aortic aneurysm formation and progression in Takayasu arteritis
Authors: Manabe Yusuke , Ishibashi Tomohiko , Asano Ryotaro , Tonomura Shuichi , Maeda Yuichi , Motooka Daisuke , Ueda Jin , Yanagawa Masahiro , Edamoto-Taira Yuko , Chikaishi-Kirino Tomomi , Masaki Takeshi , Inagaki Tadakatsu , Nakamura Shota , Katada Yoshinori , Okazawa Makoto , Narazaki Masashi , Ogo Takeshi , Kumanogoh Atsushi , Nakaoka Yoshikazu
Published: March 2023

Background

Takayasu arteritis (TAK) is an autoimmune large vessel vasculitis that affects the aorta and its major branches, eventually leading to the development of aortic aneurysm and vascular stenosis or occlusion. This retrospective and prospective study aimed to investigate whether the gut dysbiosis exists in patients with TAK and to identify specific gut microorganisms related to aortic aneurysm formation/progression in TAK.

Methods

We analysed the faecal microbiome of 76 patients with TAK and 56 healthy controls (HCs) using 16S ribosomal RNA sequencing. We examined the relationship between the composition of the gut microbiota and clinical parameters.

Results

The patients with TAK showed an altered gut microbiota with a higher abundance of oral-derived bacteria, such asStreptococcusandCampylobacter, regardless of the disease activity, than HCs. This increase was significantly associated with the administration of a proton pump inhibitor used for preventing gastric ulcers in patients treated with aspirin and glucocorticoids. Among patients taking a proton pump inhibitor,Campylobacterwas more frequently detected in those who underwent vascular surgeries and endovascular therapy for aortic dilatation than in those who did not. Among the genus ofCampylobacter,Campylobacter gracilisin the gut microbiome was significantly associated with clinical events related to aortic aneurysm formation/worsening in patients with TAK. In a prospective analysis, patients with a gut microbiome positive forCampylobacterwere significantly more likely to require interventions for aortic dilatation than those who were negative forCampylobacter. Furthermore, patients with TAK who were positive forC. gracilisby polymerase chain reaction showed a tendency to have severe aortic aneurysms.

Conclusions

A specific increase in oral-derivedCampylobacterin the gut may be a novel predictor of aortic aneurysm formation/progression in patients with TAK.
Chest computed tomography findings typical of COVID-19 pneumonia in Germany as early as 30 December 2019: a case report
Authors: Petersen Antonia , Nagel Sebastian , Hamm Bernd , Taupitz Matthias
Published: March 2023

Background

The first cases of coronavirus disease 2019 were officially confirmed in Germany and its European neighbors in late January 2020. In France and Italy, there is evidence that coronavirus disease 2019 was spreading as early as December 2019.

Case presentation

We report on a 71-year-old male patient from Germany who was admitted to our hospital on 30 December 2019 with pneumonia of unclear etiology and chest computed tomography findings typical of COVID-19 pneumonia.

Conclusion

This case may indicate that coronavirus disease 2019 was already spreading in Germany as early as December 2019.
Fixed point results of Jaggi–Suzuki-type hybrid contractions with applications
Authors: Jiddah Jamilu Abubakar , Shagari Mohammed Shehu , Noorwali Maha , Kanwal Shazia , Aydi Hassen , De La Sen Manuel
Published: March 2023

In this manuscript, a novel general class of contractions, called Jaggi–Suzuki-type hybrid (G-α-ϕ)-contraction, is introduced and some fixed point theorems that cannot be deduced from their akin in metric spaces are proved. The dominance of this family of contractions is that its contractive inequality can be specialized in various manners, depending on multiple parameters. Nontrivial comparative examples are constructed to validate the assumptions of our obtained theorems. Consequently, a number of corollaries that reduce our result to some prominent results in the literature are highlighted and analyzed. Additionally, we examine Ulam-type stability and well-posedness for the new contraction proposed herein. Finally, one of our obtained corollaries is applied to set up unprecedented existence conditions for solution to a class of integral equations. For future aspects of our results, an open problem is noted concerning the discretized population balance model, whose solution may be analyzed using the techniques established herein.
Teaching away from school: do school digital support influence teachers’ well-being during Covid-19 emergency?
Authors: Diaz Lema Melisa L. , Rossi Lidia , Soncin Mara
Published: March 2023

The Covid-19 pandemic coerced the closure of most schools around the world and forced teachers and students to change teaching and learning methods. Emergency Remote Teaching (ERT) generated consequences to teachers and students in terms of learning outcomes and personal well-being. This study focuses on teachers’ individual and working environment well-being in ERT conditions and intends to explore which factors related to the provision of digital equipment and the implementation of digital strategies by schools explain the school effect on both typologies of well-being during the Covid-19 emergency. To do so, data collected in the Responses to Educational Disruption Survey (REDS) across three countries were used, and a two-step analysis was conducted. A first step involves the use of linear mixed effect models to assess the school effect on teachers individual and working environment well-being. In the second step Regression Trees (RT) are used to investigate which factors and policies related to digital tools explained the identified school effects. The results show that schools and countries played a role in determining teachers perceived well-being during the Covid-19 disruption, in particular the school level explains more than 7% of the work environment well-being and 8% of individual one. In the second step of the analysis results show that a high positive effect on school environment well-being is observed when the school’s activity is not influenced by policies limiting the use of online tools and when teacher’s readiness for remote teaching, like the development of technical skills and the provision of internet access and digital devices, is met. To the best of our knowledge, this is the first study that evaluates the impact of digital tactics and instruments provided by schools on teachers’ well-being on a large scale.
Finite element analysis of medial closing and lateral opening wedge osteotomies of the distal femur in relation to hinge fractures
Authors: Meisterhans Michel , Flury Andreas , Zindel Christoph , Zimmermann Stefan M. , Vlachopoulos Lazaros , Snedeker Jess G. , Fucentese Sandro F.
Published: March 2023

Purpose

Intraoperative hinge fractures in distal femur osteotomies represent a risk factor for loss of alignment and non‐union. Using finite element analysis, the goal of this study was to investigate the influence of different hinge widths and osteotomy corrections on hinge fractures in medial closed‐wedge and lateral open‐wedge distal femur osteotomies.

Methods

The hinge was located at the proximal margin of adductor tubercle for biplanar lateral open‐wedge and at the upper border of the lateral femoral condyle for biplanar medial closed‐wedge distal femur osteotomies, corresponding to optimal hinge positions described in literature. Different hinge widths (5, 7.5, 10 mm) were created and the osteotomy correction was opened/closed by 5, 7.5 and 10 mm. Tensile and compressive strain of the hinge was determined in a finite element analysis and compared to the ultimate strain of cortical bone to assess the hinge fracture risk.

Results

Doubling the correction from 5 to 10 mm increased mean tensile and compressive strain by 50% for lateral open‐wedge and 48% for medial closed‐wedge osteotomies. A hinge width of 10 mm versus 5 mm showed increased strain in the hinge region of 61% for lateral open‐wedge and 32% for medial closed‐wedge osteotomies. Medial closed‐wedge recorded a higher fracture risk compared to lateral open‐wedge osteotomies due to a larger hinge cross‐section area (60–67%) for all tested configurations. In case of a 5 mm hinge, medial closed‐wedge recorded 71% higher strain in the hinge region compared to lateral open‐wedge osteotomies.

Conclusion

Due to morphological features of the medial femoral condyle, finite element analysis suggests that lateral‐open wedge osteotomies are the preferable option if larger corrections are intended, as a thicker hinge can remain without an increased hinge fracture risk.
Clinical characteristics of Guillain–Barre syndrome in COVID-19: a systematic review and meta-analysis of observational studies
Authors: Yusari I Gusti Agung Ayu Andra , Sudira Putu Gede , Samatra Dewa Putu Gde Purwa
Published: March 2023

Background

Guillain–Barre syndrome (GBS) is a complication that occurs in patients with Coronavirus Disease (COVID-19) infection. The spectrum of symptoms varies from mild to severe symptoms, even death. The study aimed to compare the clinical manifestations in GBS patients with and without COVID-19 comorbidity.

Results

A systematic review and meta-analysis of cohort and cross-sectional studies was conducted comparing the characteristics and course of GBS disease in the COVID-19 positive and COVID-19 negative groups. Four articles were selected with a total sample of 61 COVID-19 positive and 110 COVID-19 negative GBS patients. Based on clinical manifestations, COVID-19 infection increased the likelihood of tetraparesis (OR: 2.54; 95% CI 1.12–5.74; p = 0.03) and the presence of facial nerve involvement (OR: 2.34; 95% CI 1.00–5.47; p = 0.05). Demyelinating type GBS or AIDP was more common in the COVID-19 positive group (OR: 2.32; 95% CI 1.16–4.61; p = 0.02). COVID-19 in GBS significantly increased the need for intensive care (OR: 3.32; 95% CI 1.48–7.46; p = 0.004) and the use of mechanical ventilation (OR: 2.42; 95% CI 1.00–5.86; p = 0.05).

Conclusions

GBS following COVID-19 infection showed more severe variations in clinical characteristics compared to the group of GBS patients without COVID-19. Early detection of GBS, especially the typical manifestations post COVID-19 infection, is very important to carry out intensive monitoring and early management before the patient's condition worsens.
Diffuse refractory coronary artery spasm after off-pump coronary artery bypass grafting: a case series
Authors: Abraham Benson , Nair Kannan Ramachandran , Sulaiman Sajith
Published: March 2023

Background

Diffuse coronary artery spasm after coronary artery bypass grafting may cause disastrous circulatory collapse and death if not detected and managed promptly.

Case presentation

Four out of 387 patients who underwent uneventful off-pump coronary artery bypass grafting between January 2019 and December 2021 at our centre developed unexplained arrhythmias and hypotension within 2 to 6 h of the postoperative period. Coronary angiogram showed diffuse coronary vasospasm involving both grafted and ungrafted native coronary arteries. Vasospasm was refractory to intracoronary vasodilators in all these cases. All of the patients recovered completely with the use of intravenous verapamil infusion and intraaortic balloon pump support.

Conclusions

Coronary artery spasm should remain in the differential diagnosis in patients developing unexplained arrhythmias and haemodynamic instability following coronary artery bypass grafting. Prompt diagnosis with coronary angiogram and proper management strategy using calcium channel blockers and intraaortic balloon pump can revert this deadly complication. Surgical intervention may delay precious time needed for therapeutic intervention.