bluuebunny/crossref_metadata_2025 huggingface dataset:
Emerging mental health problems during the COVID-19 pandemic among presumably resilient youth -a 9-month follow-up
Authors: Lehmann Stine , Skogen Jens Christoffer , Sandal Gro M. , Haug Ellen , Bjørknes Ragnhild
Published: January 2022

Background

The COVID-19 pandemic may have multifarious adverse effects on the mental health of some youth. To our knowledge, no study has followed young people beyond the first 6 months of the pandemic outbreak. The aim of this study was to examine 1) Change in internalizing, externalizing, and total mental health problems over two time-points with a nine-month interval during the COVID-19 outbreak and 2) Whether contextual and COVID-19-related factors contribute to change in mental health problems.

Methods

Youth within the municipality of Bergen aged 11-19 years were invited via SMS to participate in an online survey in April and again in December 2020. A total of 2997 (40% response rate) youth participated at baseline in the present study, and 1598 (53.3%) completed the second survey. At baseline, the mean age was 16.0 (standard deviations 1.7) years, about 60% were girls, and 93% were born in Norway. Comparison across time was approached using inferential statistics and mixed linear models with maximum likelihood estimation and mixed-effects logistic regression models.

Results

There was an overall increase in total mental health problems from the first weeks into lockdown to 9 months after the pandemic outbreak. The overall increase seems to be exclusively driven by internalizing difficulties, i.e., increases in emotional problems and peer problems. The level of externalizing difficulties, i.e., conduct problems and hyperactivity/inattention remained stable between the two time-points.

Conclusions

Our results imply that in the wake of the pandemic, one should be aware of emerging mental health problems among presumably resilient youth, in addition to the more expected and pronounced mental health needs of vulnerable groups. Efforts to reach out to the general youth population with preventive measures in schools may be important actions to normalize the situation for young people, and to identify those in need of more targeted mental health interventions.
Risk factors of perinatal depression in women: a systematic review and meta-analysis
Authors: Yang Kai , Wu Jing , Chen Xiangdong
Published: January 2022

Background

Perinatal depression in women is associated with high morbidity and mortality, and has attracted increasing attention. The investigation of risk factors of perinatal depression in women may contribute to the early identification of depressed or depression-prone women in clinical practice.

Material and Methods

A computerized systematic literature search was made in Cochrane Library, PubMed, Web of Science, and EMBASE from January 2009 to October 2021. All included articles were published in English, which evaluated factors influencing perinatal depression in women. Based on the recommendations of the Cochrane Collaboration protocols, Review Manager 5.3 was used as a statistical platform.

Results

Thirty-one studies with an overall sample size of 79,043 women were included in the review. Educational level (P = 0.0001, odds ratio [OR]: 1.40, 95% CI: [1.18,1.67]), economic status of families (P = 0.0001, OR: 1.69, 95%CI: [1.29,2.22]), history of mental illness (P < 0.00001, OR: 0.29, 95% CI: [0.18, 0.47]), domestic violence (P < 0.00001, OR: 0.24, 95% CI: [0.17,0.34]), perinatal smoking or drinking (P = 0.005, OR: 0.63; 95% CI [0.45, 0.87]; P = 0.008, OR: 0.43, 95% CI, [0.23 to 0.80]; respectively), and multiparity(P = 0.0003, OR: 0.74, 95% CI: [0.63, 0.87]) were correlated with perinatal depression in women. The stability of our pooled results was verified by sensitivity analysis and publication bias was not observed based on funnel plot results.

Conclusion

Lower educational level, poor economic status of families, history of mental illness, domestic violence, perinatal smoking or drinking, and multiparity serve as risk factors of perinatal depression in women.
Mechanisms of exposure and response prevention in obsessive-compulsive disorder: effects of habituation and expectancy violation on short-term outcome in cognitive behavioral therapy
Authors: Elsner Björn , Jacobi Tanja , Kischkel Eva , Schulze Daniel , Reuter Benedikt
Published: January 2022

Background

Exposure and response prevention is effective and recommended as the first choice for treating obsessive-compulsive disorders (OCD). Its mechanisms of action are rarely studied, but two major theories make distinct assumptions: while the emotional processing theory assumes that treatment effects are associated with habituation within and between exposure sessions, the inhibitory learning approach highlights the acquisition of additional associations, implying alternative mechanisms like expectancy violation. The present study aimed to investigate whether process variables derived from both theories predict short-term outcome.

Method

In a university outpatient unit, 110 patients (63 female) with OCD received manual-based cognitive-behavioral therapy with high standardization of the first two exposure sessions. Specifically, therapists repeated the first exposure session identically and assessed subjective units of distress as well as expectancy ratings in the course of exposure sessions. Based on these data, individual scores for habituation and distress-related expectancy violation were calculated and used for prediction of both percentage change on the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) and remission status after 20 therapy sessions.

Results

In a multiple regression model for percentage change, within-session habituation during the first exposure was a significant predictor, while in a logistic regression predicting remission status, distress-related expectancy violation during the first exposure revealed significance. A path model further supported these findings.

Conclusions

The results represent first evidence for distress-related expectancy violation and confirm preliminary findings for habituation, suggesting that both processes contribute to treatment benefits of exposure in OCD, and both mechanisms appear to be independent.
Patient-centered placement matching of alcohol-dependent patients based on a standardized intake assessment: process evaluation within an exploratory randomized controlled trial
Authors: Buchholz Angela , Berner Michael , Dams Judith , Rosahl Anke , Hempleman Jochen , König Hans-Helmut , Konnopka Alexander , Kriston Levente , Piontek Daniela , Reimer Jens , Röhrig Jeanette , Scherbaum Norbert , Silkens Anna , Kraus Ludwig
Published: January 2022

Background

In the implementation of placement matching guidelines, feasibility has been concerned in previous research. Objectives of this process evaluation were to investigate whether the patient-centered matching guidelines (PCPM) are consistently applied in referral decision-making from an inpatient qualified withdrawal program to a level of care in aftercare, which factors affect whether patients actually receive matched aftercare according to PCPM, and whether its use is feasible and accepted by clinic staff.

Methods

The study was conducted as process evaluation within an exploratory randomized controlled trial in four German psychiatric clinics offering a 7-to-21 day qualified withdrawal program for patients suffering from alcohol dependence, and with measurements taken during detoxification treatment and six months after the initial assessment. PCPM were used with patients in the intervention group by feeding back to them a recommendation for a level of care in aftercare that had been calculated from Measurements in the Addictions for Triage and Evaluation (MATE) and discussed with the staff on the treatment unit. As measurements, The MATE, the Client Socio-Demographic and Service Receipt Inventory—European Version, a documentation form, the Control Preference Scale, and the Motivation for Treatment Scale were administered. A workshop for the staff at the participating trial sites was conducted after data collection was finished.

Results

Among 250 patients participating in the study, 165 were interviewed at follow-up, and 125 had received aftercare. Although consistency in the application of PCPM was moderate to substantial within the qualified withdrawal program (Cohen’s kappa ≥ .41), it was fair from discharge to follow-up. In multifactorial multinomial regression, the number of foregoing substance abuse treatments predicted whether patients received more likely undermatched (Odds Ratio=1.27; p=.018) or overmatched (Odds Ratio=0.78; p=.054) treatment. While the implementation process during the study was evaluated critically by the staff, they stated a potential of quality assurance, more transparency and patient-centeredness in the use of PCPM.

Conclusions

While the use of PCPM has the potential to enhance the quality of referral decision making within treatment, it may not be sufficient to determine referral decisions for aftercare.

Trial Registration

German Clinical Trials Register DRKS00005035. Registered 03/06/2013.
Usefulness and safety of transbronchial lung cryobiopsy for reassessment of treatment in the clinical course of diffuse parenchymal lung disease
Authors: Sato Yozo , Baba Tomohisa , Kitamura Hideya , Niwa Takashi , Komatsu Shigeru , Hagiwara Eri , Iwasawa Tae , Okudela Koji , Takemura Tamiko , Ogura Takashi
Published: January 2022

Background

The usefulness and safety of transbronchial lung cryobiopsy (TBLC) for reassessment of diffuse parenchymal lung disease (DPLD) with progression is still unknown. Our purpose was to clarify the usefulness and safety of TBLC for reassessment of DPLD with progression.

Methods

This retrospective study included 31 patients with DPLD diagnosed by surgical lung biopsy who progressed in the clinical course and underwent TBLC for reassessment between January 2017 and September 2019 at Kanagawa Cardiovascular & Respiratory Center. Two pulmonologists independently selected the clinical diagnosis, treatment strategy, and confidence level of the treatment strategy based on clinical and radiological information with and without pathological information from TBLC. A consensus was reached among the pulmonologists regarding the clinical diagnosis, treatment strategy, and confidence level of the treatment strategy. Complications of TBLC were also examined.

Results

Seven (22.6%), 5 (16.1%), and 6 (19.4%) of clinical diagnosis was changed after TBLC for Pulmonologist A, for Pulmonologist B, and for consensus, respectively. The treatment strategy was changed in 7 (22.6%), 8 (25.9%), and 6 (19.4%) cases after TBLC for Pulmonologist A, for Pulmonologist B and for consensus, respectively. The definite or high confidence level of the consensus treatment strategy was 54.8% (17/31) without TBLC and 83.9% (26/31) with TBLC. There were 6 cases of moderate bleeding, but no other complications were noted.

Conclusions

Pathological information from TBLC may contribute to decision-making in treatment strategies for the progression of DPLD, and it may be safely performed.
Muscle weakness is associated with non-contractile muscle tissue of the vastus medialis muscle in knee osteoarthritis
Authors: van den Noort Josien C. , van der Leeden Marike , Stapper Gerard , Wirth Wolfgang , Maas Mario , Roorda Leo D. , Lems Willem F. , Dekker Joost , van der Esch Martin
Published: January 2022

Background

Quadriceps weakness is assumed to be associated with compositional properties of the vastus medialis muscle in patients with knee osteoarthritis (OA).

Methods

The aim was to determine the association of non-contractile muscle tissue in the vastus medialis muscle, measured with routine MRI, with muscle extensor strength in patients with knee OA. Sagittal T1-weighted 3T MRI of 94 patients with knee OA, routinely acquired in clinical practice were used for analysis. Using the MRI’s, the amount of non-contractile muscle tissue in the vastus medialis muscle was measured, expressed as a percentage of (non)-contractile tissue, dichotomized into a low and a high non-contractile percentage group. Muscle strength was assessed by isokinetic measurement of knee extensors and by conduction of the Get-Up and Go (GUG) test. In regression analyses, associations of percentage of non-contractile muscle tissue with muscle strength and GUG time were determined and controlled for sex, age, BMI and radiographic severity.

Results

A high percentage of non-contractile muscle tissue (> 11.2%) was associated with lower muscle strength (B = -0.25,P = 0.006) and with longer GUG time (B = 1.09,P = 0.021). These associations were specifically confounded by sex and BMI, because these two variables decreased the regression coefficient (B) with > 10%.

Conclusions

A high percentage of non-contractile muscle tissue in the vastus medialis muscle measured by clinical T1-weighted 3T MRI is associated with muscle weakness. The association is confounded by sex and BMI. Non-contractile muscle tissue seems to be an important compositional property of the vastus medialis muscle underlying quadriceps weakness.
The most used questionnaires for evaluating satisfaction, usability, acceptance, and quality outcomes of mobile health
Authors: Hajesmaeel-Gohari Sadrieh , Khordastan Firoozeh , Fatehi Farhad , Samzadeh Hamidreza , Bahaadinbeigy Kambiz
Published: January 2022

Background

Various questionnaires are used for evaluating satisfaction, usability, acceptance, and quality outcomes of mobile health (mHealth) services. Using the best one to meet the needs of an mHealth study is a challenge for researchers. Therefore, this study aimed to review and determine the frequently used questionnaires for evaluating the mentioned outcomes of mHealth services.

Methods

The PubMed database was searched for conducting this review in April 2021. Papers that used a referenced questionnaire to evaluate the satisfaction, usability, acceptance, or quality outcomes of mHealth were included. The first author’s name, year of publication, evaluation outcome, and evaluation questionnaire were extracted from relevant papers. Data were analyzed using descriptive statistics.

Results

In total, 247 papers were included in the study. Questionnaires were used for usability (40%), quality (34.5%), acceptance (8.5%), and satisfaction (4%) outcomes, respectively. System usability scale (36.5%), mobile application rating scale (35.5%), post study system usability questionnaire (6%), user mobile application rating scale (5%), technology acceptance model (4.5%), computer system usability questionnaire (2.5%), net promoter score (2%), health information technology usability evaluation scale (2%), the usefulness, satisfaction, and ease of use (1.5%), client satisfaction questionnaire (1.5%), unified theory of acceptance and use of technology (1.5%), questionnaire for user interaction satisfaction (1%), user experience questionnaire (1%), and after-scenario questionnaire (1%) were the most used questionnaires, respectively.

Conclusion

Despite the existence of special questionnaires for evaluating several outcomes of mHealth, general questionnaires with fewer items and higher reliability have been used more frequently. Researchers should pay more attention to questionnaires with a goal-based design.
Prognostic factors of patients with left-sided obstructive colorectal cancer: post hoc analysis of a retrospective multicenter study by the Japan Colonic Stent Safe Procedure Research Group
Authors: Endo Shungo , Isohata Noriyuki , Kojima Koichiro , Kadono Yoshihiro , Amano Kunihiko , Otsuka Hideo , Fujimoto Tatsuya , Egashira Hideto , Saida Yoshihisa ,   the Japan Colonic Stent Safe Procedure Research Group, Takayasu K. , Ushigome M. , Ebi M. , Sumida Y. , Asai S. , Nasu K. , Shiratori T. , Kawamura T. , Ohki T. , Naota H. , Matsushita H. , Watanabe N. , Kohyama A. , Kuwai T. , Saito S. , Ohta K. , Kimura T. , Okamura O.
Published: January 2022

Background

There are many reports on the choice of treatment for and prognosis of left-sided obstructive colorectal cancer; however, few studies have focused on the prognostic factors of left-sided obstructive colorectal cancer. Therefore, we analyzed the prognostic factors using a post hoc analysis of a retrospective multicenter study in Japan.

Methods

A total of 301 patients were enrolled in this study to investigate the prognostic factors for relapse-free survival. The relationships between sex, age, decompression for bridge to surgery, depth of invasion, lymph node metastasis, postoperative complications, adjuvant chemotherapy, carcinoembryonic antigen, carbohydrate antigen 19-9, neutrophil-to-lymphocyte ratio, and relapse-free survival were examined.

Results

No change in the decompression method, T3 cancer, negative postoperative complications (grades 0–1 of Clavien-Dindo classification), and adjuvant chemotherapy during Stage III indicated a significantly better prognosis in a Cox univariate analysis. Lymph node metastasis was not selected as a prognostic factor. Excluding patients with <12 harvested lymph nodes (possible stage migration), lymph node metastasis was determined as a prognostic factor. In a Cox multivariate analysis, change in the decompression method, depth of invasion, lymph node metastasis (excluding N0 cases with <12 harvested lymph nodes), and adjuvant chemotherapy were prognostic factors.

Conclusions

Similar to those in nonobstructive colorectal cancer, depth of invasion and lymph node metastasis were prognostic factors in left-sided obstructive colorectal cancer, and patients with <12 dissected lymph nodes experienced stage migration. Stage migration may result in disadvantages, such as not being able to receive adjuvant chemotherapy.
Reactive oxygen species reprogram macrophages to suppress antitumor immune response through the exosomal miR-155-5p/PD-L1 pathway
Authors: Li Xiang , Wang Shaomin , Mu Wei , Barry Jennifer , Han Anna , Carpenter Richard L. , Jiang Bing-Hua , Peiper Stephen C. , Mahoney Mỹ G. , Aplin Andrew E. , Ren Hong , He Jun
Published: January 2022

Background

Cancer cells have an imbalance in oxidation-reduction (redox) homeostasis. Understanding the precise mechanisms and the impact of the altered redox microenvironment on the immunologic reaction to tumors is limited.

Methods

We isolated exosomes from ovarian cancer cells through ultracentrifuge and characterized by Western-blots and Nanoparticle Tracking Analysis. 2D, 3D-coculture tumor model, and 3D live cell imaging were used to study the interactions between tumor cells, macrophages and CD3 T cells in vitro. The role of exosomal miR-155-5p in tumor growth was evaluated in xenograft nude mice models and immune-competent mice models. Flow cytometry and flow sorting were used to determine the expression levels of miR-155-5p and PD-L1 in ascites and splenic macrophages, and the percentages of CD3 T cells subpopulations.

Results

The elevation of reactive oxygen species (ROS) greatly downregulated exosomal miR-155-5p expression in tumor cells. Neutralization of ROS with N-acetyl-L-cysteine (NAC) increased the levels of miR-155-5p in tumor exosomes that were taken up by macrophages, leading to reduction of macrophage migration and tumor spheroid infiltration. We further found that programmed death ligand 1 (PD-L1) is a functional target of miR-155-5p. Co-culture of macrophages pre-treated with NAC-derived tumor exosomes or exosomal miR-155-5p with T-lymphocytes leading to an increased percentage of CD8+T-lymphocyte and a decreased CD3+T cell apoptosis through PD-L1 downregulation. Tumor growth in nude mice was delayed by treatment with NAC-derived tumor exosomes. Delivery of tumor exo-miR-155-5p in immune-intact mice suppressed ovarian cancer progression and macrophage infiltration, and activated CD8+T cell function. It is of note that exo-miR-155-5p inhibited tumor growth more potently than the PD-L1 antibody, suggesting that in addition to PD-L1, other pathways may also be targeted by this approach.

Conclusions

Our findings demonstrate a novel mechanism, ROS-induced down-regulation of miR-155-5p, by which tumors modulate the microenvironment that favors tumor growth. Understanding of the negative impact of ROS on the tumor immune response will improve current therapeutic strategies. Targeting miR-155-5p can be an alternative approach to prevent formation of an immunosuppressive TME through downregulation of PD-L1 and other immunosuppressive factors.

Graphical Abstract
Surveillance and laboratory collaboration in response to an outbreak of Vibrio parahaemolyticus, Plesiomonas shigelloides, and Aeromonas hydrophila in Sekondi-Takoradi, Ghana: a case series
Authors: Owusu Michael , Nkrumah Bernard , Mensah Ebenezer Kofi , Lamptey Jones , Acheampong Godfred , Sambian David , Sylverken Augustina , Emery Shannon , Robinson Lucy Maryogo , Sefa Solomon Asante , Amoako Eric , Amedzro Irene , Chinbuah Slyvester , Asante Kwame , Adu-Sarkodie Yaw , Opare David
Published: January 2022

Background

The detection of epidemic-prone pathogens is important in strengthening global health security. Effective public health laboratories are critical for reliable, accurate, and timely testing results in outbreak situations. Ghana received funding as one of the high-risk non-Ebola affected countries to build and strengthen public health infrastructure to meet International Health Regulation core capacities. A key objective was to build laboratory capacities to detect epidemic-prone diseases.

Case presentation

In June 2018, a local hospital received eight patients who presented with acute diarrhea. A sample referral system for Ghana has not been established, but the Sekondi Zonal Public Health Laboratory staff and mentors collaborated with Disease Surveillance Officers (DSOs) to collect, package, and transport stool specimens from the outbreak hospital to the Public Health Laboratory for laboratory testing. The patients included seven females and one male, of Fante ethnicity from the Fijai township of Sekondi-Takoradi Municipality. The median age of the patients was 20 years (interquartile range: 20–29 years). Vibrio parahaemolyticus was identified within 48 hours from four patients, Plesiomonas shigelloides from one patient, and Aeromonas hydrophila from another patient. There was no bacteria growth from the samples from the two other patients. All patients were successfully treated and discharged.

Conclusion

This is the first time these isolates have been identified at the Sekondi Zonal Public Health Laboratory, demonstrating how rapid response, specimen transportation, laboratory resourcing, and public health coordination are important in building capacity towards achieving health security. This capacity building was part of the United States Centers for Disease Control and Prevention engagement of international and local partners to support public health laboratories with supplies, diagnostic equipment, reagents, and logistics.
STABILISE; treatment of aortic dissection, a single Centre experience
Authors: Mitreski Goran , Flanders Damian , Maingard Julian , Robinson Domenic , Chuen Jason , Matalanis George , Seevanayagam Siven , Kok Hong Kuan , Ranatunga Dinesh , Asadi Hamed , Brooks Duncan Mark
Published: January 2022

Purpose

To outline the process of the STABILISE technique and its use; reporting patient outcomes and midterm follow up for complicated aortic dissection.

Materials and methods

Single centre retrospective analysis from January 2011 to January 2021 using the STABILISE technique which utilises balloon assistance to facilitate intimal disruption and promote aortic relamination.

Results

Sixteen patients underwent endovascular aortic repair with the STABILISE technique for aortic dissection over the study period. Fourteen patients (14/16; 88%) had acute dissection. Two of 16 (12%) were chronic. The median age of the patient cohort was 61 years (range 32–80 years) and consisted of a male majority (n = 11; 69%). The median time from diagnosis to intervention was 5 days (1–115 days; IQR 1–17.3). More than half (56%) had surgical repair of a acute type A aortic dissection prior to radiological intervention. The procedure was technically successful with no procedural mortality. Two patients were lost to follow up and two died in the post-operative period. Twelve patients had ongoing follow up with an average number of 2.9 ± 1.6 scans performed. Follow up was available in thirteen patients (81%) with a median follow up period of 1097 days (IQR 707–1657). The rate of re-intervention (n = 2/16; 13%) requiring additional stenting was in line with published re-intervention data (15%). Follow up showed a reduction in false lumen size following treatment with total luminal dimensions remaining stable over the follow-up period.

Conclusion

The STABILISE technique as a procedure for complicated aortic dissection, either acute or chronic, appears safe with stable mid-term aortic remodelling and patient outcomes.

Level of evidence

Level 3, Retrospective cohort study.
Intracranial silicone oil migration with encephalopathy: a rare case report
Authors: Puthiyakam Juvaina , Nalakath Najma , Ezhuthullathil Devarajan , Arakkal Faiz Riyaz , Monthampally Saanida , Prasad Athira
Published: January 2022

Background

Intraocular silicone oil (SiO) tamponade is a popular modality of treatment of rhegmatogenous retinal detachment. It can, however, rarely lead to an incompletely understood phenomenon known as intracranial migration of SiO. Though usually benign, this entity is often misinterpreted as a tumour or haemorrhage.

Case presentation

We present a case report of a patient with acute progressive encephalopathy and intracranial migration of intravitreal silicone. We also put forward the possibility of toxic effects of intracranial SiO on the central nervous system.

Conclusion

Clinicians and radiologists should be aware of the rare complication of intravitreal SiO tamponade. Eliciting the history of intraocular SiO tamponade and identifying the key imaging features on ultrasonography of the orbit, CT of the head, and MRI of the brain will help in avoiding unnecessary interventions or delays in the management of the patients from misdiagnosing it as haemorrhage or tumour.
Translating Research to Action: The Development of a Pediatric Palliative Cancer Care Advocacy Tool in Eurasia
Authors: Ehrlich Bella S. , Yakimkova Taisiya , Batmunkh Tsetsegsaikhan , Mishkova Volha , Movsisyan Narine , Kirgizov Kirill , Borisevich Marina , Kizyma Roman , Graetz Dylan E. , McNeil Michael J. , Vinitsky Anna , Smelov Vitaly , Corbex Marilys , Lam Catherine G. , Kaye Erica C. , Baker Justin N. , Agulnik Asya
Published: January 2022

PURPOSE

The Assessing Doctors' Attitudes on Palliative Treatment study was conducted in 11 Eurasian countries to assess physician knowledge of and structural barriers to integration of palliative care into pediatric oncology. After publication, regional collaborators identified the need to disseminate country-specific study results locally and provide policy recommendations to inform stakeholders.

METHODS

The Assessing Doctors' Attitudes on Palliative Treatment report was developed with Eurasian and St Jude pediatric palliative care and oncology experts to summarize study findings and deliver country-level data to local stakeholders. In parallel, an assessment was developed to explore how regional collaborators intend to use the report to improve local advocacy and dissemination of research findings. The country report and assessment were translated to English, Russian, and Mongolian.

RESULTS

Country-specific two-page reports display study findings on pediatric palliative care education, access to pediatric palliative care services, and barriers to and timing of integration with cancer care, alongside clinical and policy recommendations. These reports were distributed to collaborators in 11 countries. Assessment results (N = 30) demonstrated that regional collaborators planned to distribute the report to institutional and government stakeholders, aiming to increase access to pediatric palliative care services (77%), establish a community-based palliative care network (70%), and increase opportunities for specialization (70%).

CONCLUSION

We describe the development of an evidence-based advocacy tool to inform local health and education policy in Eurasia. This summary report of study findings, translated to local languages and adapted to a broader audience, is currently used to advocate for greater access and quality of palliative care for children with cancer. This work may serve as the basis for future dissemination efforts of scientific research.
Role of Endothelin-1 Receptors in Limiting Leg Blood Flow and Glucose Uptake During Hyperinsulinemia in Type 2 Diabetes
Authors: Young Benjamin E , Padilla Jaume , Finsen Stine H , Fadel Paul J , Mortensen Stefan P
Published: January 2022

Skeletal muscle insulin resistance is a hallmark of individuals with type 2 diabetes mellitus (T2D). In healthy individuals insulin stimulates vasodilation, which is markedly blunted in T2D; however, the mechanism(s) remain incompletely understood. Investigations in rodents indicate augmented endothelin-1 (ET-1) action as a major contributor. Human studies have been limited to young obese participants and focused exclusively on the ET-1 A (ETA) receptor. Herein, we have hypothesized that ETA receptor antagonism would improve insulin-stimulated vasodilation and glucose uptake in T2D, with further improvements observed during concurrent ETA + ET-1 B (ETB) antagonism. Arterial pressure (arterial line), leg blood flow (LBF; Doppler), and leg glucose uptake (LGU) were measured at rest, during hyperinsulinemia alone, and hyperinsulinemia with (1) femoral artery infusion of BQ-123, the selective ETA receptor antagonist (n = 10 control, n = 9 T2D) and then (2) addition of BQ-788 (selective ETB antagonist) for blockade of ETA and ETB receptors (n = 7 each). The LBF responses to hyperinsulinemia alone tended to be lower in T2D (controls: ∆161 ± 160 mL/minute; T2D: ∆58 ± 43 mL/minute, P = .08). BQ-123 during hyperinsulinemia augmented LBF to a greater extent in T2D (% change: controls: 14 ± 23%; T2D: 38 ± 21%, P = .029). LGU following BQ-123 increased similarly between groups (P = .85). Concurrent ETA + ETB antagonism did not further increase LBF or LGU in either group. Collectively, these findings suggest that during hyperinsulinemia ETA receptor activation restrains vasodilation more in T2D than controls while limiting glucose uptake similarly in both groups, with no further effect of ETB receptors (NCT04907838).
Making Queer Asiatic Worlds: Performance and Racial Interaction in North American Visual Novels
Authors: Patterson Christopher B.
Published: January 2022

This paper argues that video games expose the presumptions separating “Asian America” and “Asia” in the traditional senses of isolation, origination, and presumed distance. It does so by focusing on the most “Asiatic” genre of video games today, the North American visual novel, which offers a counterdiscourse to normative modes of play and attempts to offer utopic spaces to reflect upon the “real” genres of race and neo–Cold War geopolitics. Using theories of performance from Dorinne Kondo and others, the author shows how queer indie visual novels are primarily aspirational, in that they build queer, utopic, and seemingly anti-racist worlds through the Asiatic space of the visual novel form. In so doing, they also allow players to explore the Asiatic as a means of repairing the traumas and distances of American imperial cultures. The article analyzes four visual novels to make this argument: three by non-racially-identifying North American designers—Doki Doki Literature Club! (2017) by Dan Salvato, Analogue: A Hate Story (2012) by Christine Love, and Heaven Will Be Mine (2018) by Aevee Bee—and Butterfly Soup (2017), a game by the queer Asian/American designer Brianna Lei. If games make the boundaries of Asia and America irrelevant, visual novels explore this irrelevance through Asiatic irreverence.
Authentic-Deconstructionist Games and Tragic Historiography in Assassin’s Creed III
Authors: Joyce Stephen
Published: January 2022

This paper examines the historiographic potential of video games with Assassin’s Creed III (2012) as a paradigmatic example that shows the aesthetic and political challenges games face in telling counterhistories of marginalized peoples. The article argues that Ubisoft’s Assassin’s Creed series, perhaps the premier historical gaming franchise, has developed an authentic-deconstructionist genre that offers convincing simulacra of historical places and events while using games’ multimedia affordances to question how historical knowledge is constructed. In Assassin’s Creed III, this authentic-deconstructionist method is applied to the story of an Indigenous man trying to protect his tribe from white settlers during the American Revolution. However, the game is critically weakened by the historiographic problem of emplotting this tragic tale in the heroic epic of the nation’s founding. This narrative disjunction is exacerbated by the medium’s lack of an internal aesthetic tradition of tragedy to draw on; mainstream games are generally contests of skill in which success brings victory, rather than the defeat necessary for a tragic outcome. However, despite its weaknesses, the game and its transmedia expansions sparked widespread discussions about Indigenous peoples during this historical period and helped advance gaming as a serious medium for critical perspectives on American history.
Gaming Borders: The Rhetorics of Gamification and National Belonging inPapers, Please
Authors: Kafer Gary
Published: January 2022

Game media have long participated in projects of nation building by remediating historical, political, and social relations in ways that reinforce affective processes of national belonging. The genre of border games in particular is well-known for staging the discursive and symbolic value of national boundaries through the deployment of specific gameplay mechanics and storytelling elements. However, as this essay argues, border games do more than merely represent borders in games; they reflect how borders themselves might be experienced as games within the cultural logic of gamification. Through an analysis of Lucas Pope’s independently produced American video game Papers, Please (2013), this article interrogates gamification as a rhetorical process that communicates how play dynamics sustain the procedural logics of border security and citizenship. Such logics, the game suggests, are marked by the installment of a series of rule-based interactions that modulate affect within the sociotechnical mechanics of state-sanctioned racism to enable the proper flow of both play and mobility. However, through failure, the game also reveals gamification to be an incomplete diagram of control, one where the priming of affect rubs up against the sociopolitical frictions that shape individual play experiences. Ultimately, this article argues that border games like Papers, Please enable players to experiment with the forms of national belonging that subtend our experiences of gamification.
Burr Hole Microsurgery for Middle Cerebral Artery Aneurysms: A Clinical Case Series
Authors: Lepsveridze Levan , Semenov Maksim , Stepanyan Georgy , Abudeev Sergey
Published: January 2022

BACKGROUND:

Minimally invasive microsurgery has become popular in neurosurgery. Burr hole microsurgery is another more modern minimally invasive technique that allows surgical treatment of various intracranial pathologies through an extreme small craniotomy. This article presents the first application of the burr hole approach for microsurgical clipping of cerebral aneurysms.

OBJECTIVE:

To assess the feasibility and outcomes of using the burr hole microsurgical technique in cerebral aneurysm surgery.

METHODS:

From March 2020 to August 2020, 3 patients with unruptured middle cerebral artery aneurysms underwent burr hole microsurgical clipping.

RESULTS:

Three patients with middle cerebral bifurcation aneurysms were successfully treated. The duration of surgery was from 62 to 83 min (median 72.5). Postoperatively, no new neurological symptoms, complications, or mortality were observed in all the cases.

CONCLUSION:

Burr hole microsurgery is an advanced neurosurgical method. Although the surgery is performed through a small burr hole approximately 14 mm in size, safe and successful treatment of normal-sized middle cerebral artery aneurysms using standard microsurgical principles and technique is possible.
Long-Term Cryopreservation of Ready-to-Use DNA-Modified Gold Nanoparticle Derivatives: Effect of Preservation Temperature on Their DNA Dissociation and Functional Stability
Authors: Juji Shotaro , Oishi Motoi
Published: January 2022

The effect of preservation temperature on the DNA dissociation and functional stability of two types of DNA-modified gold nanoparticles (GNPs) was studied. The cryopreservation of both GNPs for 56 days has fully prevented the DNA dissociation and maintained the toehold-mediated DNA displacement reaction capacity without any aggregation of GNPs.
Iatrogenic stroke caused by cerebral air embolism and acute reperfusion therapy using hyperbaric oxygen
Authors: Strømsnes Torbjørn Austveg , Røed Ine , Strøm Hanna , Advani Rajiv , Biernat Donata , Ihle-Hansen Hege
Published: January 2022

Objective:

Air embolisms are mostly iatrogenic and a rare yet dreaded complication following percutaneous procedures. Intravascular entrapment of air can result in occlusion of end arteries and subsequent tissue ischemia and infarction. Cerebrovascular occlusions caused by air embolisms are time-sensitive and an uncommon cause of ischemic stroke, warranting an alternative acute management and reperfusion strategy.

Methods:

During a CT-guided lung biopsy, the patient developed left-sided paresis and sensory deficits prior to loss of consciousness. CT revealed air in the aorta, both ophthalmic arteries and vessels in the right parietal region. The patient was swiftly air-lifted to the nearest hyperbaric oxygen chamber for an alternate emergency reperfusion therapy. The following eight days the patient received hyperbaric oxygen therapy and gradually improved. Nine days after symptom onset he was discharged with a minor left facial palsy.

Conclusions

Cerebrovascular occlusions are critical events regardless of etiology. Air embolism is rare but potentially catastrophic and can occur during both percutaneous procedures and surgeries. Vigilance and knowledge of this potential complication are needed to rapidly provide beneficial treatment. That is, high flow oxygen and correct positioning pending hyperbaric oxygen therapy.
Βασική έρευνα
Authors: Τασσόπουλος Ανδρέας
Published: January 2022

Εισαγωγή και στόχοι: Ο όρος βακτηριακή διαμετάθεση περιγράφει τη δίοδο ζώντων βακτηρίων ή ενδοτοξίνης από το γαστρεντρικό σωλήνα σε εξωεντερικούς ιστούς και παρατηρείται συχνά μετά από βλάβη ισχαιμιας- επαναιμάτωσης. Σκοπός της παρούσας μελέτης ήταν να αναζητήσει βακτηριακή διαμετάθεση μετά από καρδιακή ανακοπή και αναζωογόνηση σε χοίρους στους οποίους χορηγήθηκε γενική αναισθησία με ενδοφλέβια προποφόλη. Υλικό και μέθοδοι: Δεκαοχτώ θήλεις χοίροι Landrace/Large White διαμοιράστηκαν τυχαίως σε τρεις ομάδες: ομάδα ελέγχου (CON), ομάδα καρδιακής ανακοπής (CA) και ομάδα καρδιακής ανακοπής και αναζωογόνησης (CA-CPR). Στην ομάδα ελέγχου διενεργήθει μόνο monitoring υπό αναισθησία για δύο ώρες. Στην ομάδα καρδιακής ανακοπής, τα ζώα δεν αναζωογονήθηκαν και υποβλήθηκαν σε νεκροτομή οχτώ λεπτά μετά τη πρόκληση καρδιακής ανακοπής. Στην ομάδα αναζωογόνησης, πραγματοποιήθηκε καρδιοαναπνευστική αναζωογόνηση έως την επίτευξη επαναφοράς της αυτόματης κυκλοφορίας, ενώ ακολούθησε monitoring για δυο ώρες. Τα ζώα των ομάδων CON και CA-CPR υπέστησαν νεκροτομή μετά τη πάροδο 24 ωρών. Ο έλεγχος για ενδεχόμενη βακτηριακή διαμετάθεση περιελάμβανε καλλιέργειες αίματος και ιστών καθώς και μέτρηση συγκέντρωσης ενδοτοξίνης σε συστηματική και πυλαία κυκλοφορία. Ο υπολογισμός των επιπέδων μαλονδιαλδεΰδης και η ιστολογική ανάλυση εντέρου πραγματοποιήθηκαν με σκοπό την εκτίμηση της ιστικής βλάβης ισχαιμιας / επαναιμάτωσης. Αποτελέσματα: Η μαλονδιαλδεΰδη, ένας ευρέως χρησιμοποιούμενος δείκτης οξειδωτικού στρες, εμφάνισε σημαντικά υψηλότερες συγκεντρώσεις στην ομάδα αναζωογόνησης σε σχέση με την ομάδα ελέγχου σε ομογενοποιημένο ειλεό (p=0.016). Οι αντίστοιχες συγκεντρώσεις σε ομογενοποιημένο κόλον ήταν σημαντικά υψηλότερες στην ομάδα αναζωογόνησης σε σχέση με την ομάδα ελέγχου (p=0.004) και με την ομάδα καρδιακής ανακοπής (p=0.016). Επιπλέον ανευρέθησαν σημαντικά υψηλότερα επίπεδα ενδοτοξίνης στη πυλαία κυκλοφορία στην ομάδα αναζωογόνησης, συγκριτικά με την ομάδα ελέγχου (p=0.026) και την ομάδα καρδιακής ανακοπής (p=0.026). Ο αριθμός των θετικών, για E. coli, καλλιεργειών μεσεντερίων λεμφαδένων ήταν μεγαλύτερος στην ομάδα αναζωογόνησης σε σχέση με τις άλλες δυο ομάδες, χωρίς αυτή η διαφορά αυτή να είναι στατιστικά σημαντική (p=0.407). Συμπεράσματα: Η συγκέντρωση μαλονδιαλδεΰδης και τα επίπεδα ενδοτοξίνης στη πυλαία κυκλοφορία δεν αυξάνουν κατά τη διάρκεια της καρδιακής ανακοπής, παρά μόνον μετά από καρδιοαναπνευστική αναζωογόνηση και επαναφορά αυτόματης κυκλοφορίας. Παρά το μεγαλύτερο αριθμό των θετικών ιστικών καλλιεργειών μεσεντερίων λεμφαδένων στην ομάδα αναζωογόνησης, δε παρατηρήθηκε στατιστικά σημαντική διαφορά, πιθανά λόγω του περιορισμένου χρόνου παρακολούθησης.
Σιωπηρές συμβάσεις εργασίας την εποχή της κρίσης
Authors: Ασπρούλης Αριστείδης
Published: January 2022

Η διατριβή μελετά τις σιωπηρές συμβάσεις εργασίας, δηλαδή τις διαδικασίες που λαμβάνουν χώρα στο σιωπηρό φάσμα της εργασίας και τις διερευνά στο διάστημα από το 2008 έως σήμερα, με σκοπό να αναδείξει τον αντίκτυπο της Κρίσης στις ζωές των εργαζόμενων και στις αντιλήψεις τους γύρω από την εργασία και την κοινωνική προστασία. Η έρευνα εστιάζει σε τρεις βασικούς τομείς: την υγεία και τον τρόπο με τον οποίο την αντιμετωπίζουν οι εργαζόμενοι, το εργασιακό ήθος και τις προσδοκίες ζωής. Για την πραγματοποίηση της έρευνας επιλέχθηκε ως ιδανική μελέτη περίπτωσης το εργοστάσιο της ΔΕΗ στη Μεγαλόπολη. Πραγματοποιήθηκε ποιοτική έρευνα πεδίου, μέσα από ανοιχτές συνεντεύξεις σε 40 εργαζόμενους, επιτόπια παρατήρηση και συγκέντρωση οπτικού υλικού. Προηγήθηκε βιβλιογραφική και ερευνητική επισκόπηση των σιωπηρών συμβάσεων εργασίας μέσα από τις τέσσερις σχολές της κοινωνιολογίας, όπως και ιστορική επισκόπηση του υπό εξέταση οργανισμού. Ιδιαίτερη έμφαση δόθηκε στη σημασία που έχει η κοινωνιολογική ανάλυση των σιωπηρών συμβάσεων εργασίας σε καιρό Κρίσης για την Κοινωνική Πολιτική. Η διατριβή εξηγεί με ποιους τρόπους το χαμένο κοινωνικό κύρος των εργαζόμενων, η πλήρης αποδοχή των ανέντιμων πρακτικών ως τρόποι επιβίωσης μέσα στο εργοστάσιο, τα οικονομικά και κοινωνικά αδιέξοδα και η απουσία εναλλακτικής, σε συνδυασμό με την κοινωνική απομόνωση από την τοπική κοινότητα λόγω του στίγματος του «Δεητζή» ως συνώνυμο του βολεμένου/ανήθικου και το γενικότερο αίσθημα απογοήτευσης, ενοχής, απόγνωσης και κυνισμού στο οποίο έχουν περιέλθει, οδήγησαν σιωπηλά κατά την περίοδο της Κρίσης σε ένα νέο κυρίαρχο εργασιακό ήθος κοινωνικής ανομίας και αλλοτρίωσης, εντός του οποίου οι αντιλήψεις των εργαζομένων για την κοινωνική προστασία στερούνται πίστης απέναντι σε οποιαδήποτε μορφή κοινωνικής αλληλεγγύης. Η διατριβή καταλήγει με ένα θεωρητικό ερώτημα γύρω από τη βιωσιμότητα ή μη ενός αναδυόμενου καπιταλιστικού μοντέλου το οποίο διαφαίνεται ότι δεν θα προϋποθέτει ούτε το ελάχιστο της κοινωνικής συνοχής.
Ο Μεσοπλατωνισμός στη φιλοσοφία του Marsilio Ficino
Authors: Νοβέντα-Μενίν Ιάκοπο
Published: January 2022

Η παρούσα διατριβή εστιάζει στα θεωρητικά στοιχεία της μεσοπλατωνικής περιόδου (80 π.Χ. – 220 μ.Χ.) που εντοπίζονται στο φιλοσοφικό έργο του Marsilio Ficino (1433-1499), ο οποίος υπήρξε εξέχων εκπρόσωπος της ιταλικής Αναγέννησης. Κύριος θεωρητικός άξονας της εν λόγω έρευνας είναι η προσέγγιση σύμφωνα με την οποία στη διαμόρφωση της φιλοσοφίας του Marsilio Ficino εξέχουσα θέση κατέχει η συμβολή του Μεσοπλατωνισμού, πέραν των άλλων ιστοριοφιλοσοφικών επιρροών που έχουν ήδη αναγνωριστεί από την ακαδημαϊκή έρευνα στον στοχασμό του Ιταλού φιλοσόφου. Συνεπώς, βασικότερο στόχο της μελέτης αυτής αποτελεί η ανάδειξη του καθοριστικού ρόλου του μεσοπλατωνικού στοχασμού στη φιλοσοφία του Ficino, από όπου αναδύονται, αφ’ ενός, μια πιο ολοκληρωμένη εικόνα του θεωρητικού πλαισίου εντός του οποίου έλαβε χώρα η αναγέννηση του Πλατωνισμού τον 15° αιώνα, καθώς και, αφ’ ετέρου, ο πρωτοποριακός τρόπος με τον οποίο ο Ιταλός φιλόσοφος προσέγγιζε τη διαχρονική εξέλιξη της πλατωνικής παράδοσης. Επιχειρείται επίσης η ανάδειξη της ιστοριοφιλοσοφικής σημασίας του Μεσοπλατωνισμού για τη μεταγενέστερη διάδοση της πλατωνικής φιλοσοφίας. Η παρούσα διατριβή ακολουθεί, συνεπώς, δύο κύριους μεθοδολογικούς άξονες: προσεγγίζει, κατ’ αρχάς, τα σημαντικότερα θέματα της μεσοπλατωνικής φιλοσοφίας και ανιχνεύει, εν συνεχεία, την πρόσληψη της αντίστοιχης συλλογιστικής στο έργο του Ficino, βάσει της ερμηνείας συναφών χωρίων που αναδεικνύουν αυτή την πρόσληψη. Προκειμένου να αναδειχθεί ο ρόλος του Μεσοπλατωνισμού στο έργο του Ιταλού φιλοσόφου, λαμβάνεται υπ’ όψιν όλο το εύρος του έργου του, επισημαίνοντας καίρια στοιχεία του στοχασμού του, ούτως ώστε να κατανοηθούν βαθύτερα τόσο η φιλοσοφική στοχοθεσία όσο και ο ερμηνευτικός προσανατολισμός του Marsilio Ficino.
Στρατηγικές επικοινωνίας στη Ναυτιλία σε περιόδους κρίσεων
Authors: Μπίσιας Ηλίας
Published: January 2022

Η δημόσια εικόνα της ελληνικής ναυτιλίας αλλά και οι λόγοι που οδηγούν φορείς εκπροσώπησης επαγγελματικών συμφερόντων ή εργοδοτών να επανεξετάζουν τις στρατηγικές τους, συντεταγμένα και συλλογικά, ειδικά σε περιόδους κρίσεων, απασχολούν έντονα και συστηματικά τόσο την επιχειρηματική όσο και την επιστημονική κοινότητα. H παρούσα διατριβή πραγματεύεται τη στρατηγική επικοινωνίας που σχεδίασε και υιοθέτησε το συλλογικό όργανο εκπροσώπησης του ελληνικού εφοπλισμού κατά την πρώιμη μεταπολιτευτική περίοδο (1975-1981). Η συγκεκριμένη περίοδος, αν και παραμένει ανεξίτηλη στη συλλογική μνήμη της ναυτιλιακής κοινότητας, αποτελεί μια σχετικά ανεξερεύνητη εποχή τόσο για τις σχέσεις του ελληνικού εφοπλισμού με το κράτος όσο και για τη στρατηγική επικοινωνίας που αναπτύχθηκε προκειμένου να βελτιωθούν οι δίαυλοι επικοινωνίας με την ελληνική κυβέρνηση, την ελληνική και διεθνή ναυτεργασία αλλά και τα ΜΜΕ. Η δεκαετία 1970-1980 είναι, εξάλλου, διεθνώς συνυφασμένη με μια εποχή συστηματικής οργάνωσης και ανάπτυξης επαγγελματικών οργανώσεων, εργατικών συνδικάτων και θεσμικών φορέων εκπροσώπησης οικονομικών συμφερόντων. Είναι επίσης μια εποχή όπου οι κοινωνίες, ειδικά στην Ευρώπη, απαιτούσαν από τις βιομηχανίες τους μεγαλύτερη εξωστρέφεια, διαφάνεια και κοινωνική υπευθυνότητα.
Environmental drivers influencing the abundance of round sardinella (Sardinella aurita) and European sprat (Sprattus sprattus) in different areas of the Mediterranean Sea
Authors: DE FELICE ANDREA , IGLESIAS MAGDALENA , SARAUX CLAIRE , BONANNO ANGELO , TIČINA VJEKOSLAV , LEONORI IOLE , VENTERO ANA , HATTAB TAREK , BARRA MARCO , GAŠPAREVIĆ DENIS , BIAGIOTTI ILARIA , BOURDEIX JEAN-HERVE , GENOVESE SIMONA , JURETIĆ TEA , ARONICA SALVATORE , MALAVOLTI SARA
Published: January 2022

Data on Sardinella aurita (round sardinella) and Sprattus sprattus (European sprat) in the Mediterranean Sea are limited due to their scarce commercial interest, at least in European countries. Yet, these two small pelagic fish, sitting at opposite ends of the thermal range, could be interesting sentinel species to monitor the effects of climate change in the basin. Using the Mediterranean International Acoustic Surveys (MEDIAS) – the most extensive source of information on these species – we analyzed their biomass in several geographical subareas of the central and western Mediterranean Sea in relation to satellite-derived environmental parameters. Our findings highlight that the S. aurita biomass responded to temperature, salinity, chlorophyll concentration and sea level anomaly, depending on the GSA examined, whereas the S. sprattus biomass correlated significantly with salinity in GSA 6, with salinity and chlorophyll concentration in GSA 7, and with sea level anomaly in GSA 17. These data widen our knowledge of the factors that contribute to the ecology of these species. Further studies of their spatial distribution and of their interactions with other small pelagic species, predators and prey are needed to depict a more comprehensive scenario.