bluuebunny/crossref_metadata_2025 huggingface dataset:
Salivary leukocyte esterase activity by SillHa is a risk indicator of periodontal disease
Authors: Ishii Kyoko , Venkataiah Venkata Suresh , Kajiwara Takako , Umezawa Kouta , Suzuki Shigeto , Nakano Masato , Sawaguchi Mayu , Yahata Yoshio , Saito Masahiro
Published: March 2023

Background

There is increasing evidence that diagnostic salivary tests measuring inflammatory biomarkers are being developed to assess inflammatory status for early detection, prevention, and progression of periodontal disease. Therefore, the aim of the present study was to investigate and identify the salivary biomarker that can predict the inflammatory status of periodontal disease.

Methods

A total of 36 patients (28 women and 8 men) with an average age of 57 years were investigated. Unstimulated saliva was collected from the recruited subjects and analyzed using SillHa, a saliva-testing device that measures bacteria count, saliva buffer capacity, acidity, leukocyte esterase, protein, and ammonia. Periodontal parameters were then obtained by clinical examination and initial periodontal therapy was performed. Data obtained with SillHa were compared with clinical periodontal parameters at baseline, re-examination (three months from baseline), and final examination (six months from re-examination).

Results

Leukocyte esterase activity in saliva measured by SillHa; BOP and PCR measured by clinical examination showed a significant difference between baseline and final examination and between re-examination and final examination. Patients in the lower median group (group 1) had a significant difference in leukocyte esterase activity between baseline and final examination and re-examination and final examination. In addition, patients in Group 1 had significantly lower BOP between baseline and final examination. While patients in the higher median group (group 2) showed a modest decrease in leukocyte esterase activity, which was significant only between baseline and final examination, no significant changes were observed concerning BOP. Furthermore, the associated systemic disease was observed in 30% and 81.2% of group 1 and 2 patients, respectively.

Conclusion

The results suggest that leukocyte esterase activity in saliva measured by SillHa could serve as a reliable diagnostic marker for monitoring inflammatory status in periodontal disease.
The step in time study: A feasibility study of a mobile app for measuring walking ability after massage treatment in patients with osteoarthritis
Authors: Grace Sandra , Engel Roger , Barnes Larisa Ariadne Justine , Bradbury Joanne
Published: March 2023

Background

Massage therapy is a popular intervention for those suffering osteoarthritis, however, there is a paucity of evidence to support its effectiveness in osteoarthritis. A simple measure that could potentially assess the benefits of massage treatment is walking speed which is a predictor of mobility and survival length, particularly in ageing populations. The primary aim of the study was to assess the feasibility of using a phone app to measure walking ability in people with osteoarthritis.

Methods

This feasibility study used a prospective, observational design to collect data from massage practitioners and their clients over a 5-week period. Feasibility outcomes included practitioner and client recruitment and protocol compliance. The app MapMyWalk was used to record average speed for each walk. Pre-study surveys and post-study focus groups were conducted. Clients received massage therapy in a massage clinic and were instructed to walk in their own local community for 10 min every other day. Focus group data were analysed thematically. Qualitative data from clients’ pain and mobility diaries were reported descriptively. Average walking speeds were graphed for each participant in relation to massage treatments.

Results

Fifty-three practitioners expressed interest in the study, 13 completed the training, with 11 successfully recruiting 26 clients, 22 of whom completed the study. 90% of practitioners collected all required data. A strong motivation for participating practitioners was to contribute to evidence for massage therapy. Client compliance with using the app was high, but low for completing pain and mobility diaries. Average speed remained unchanged for 15 (68%) clients and decreased for seven (32%). Maximum speed increased for 11 (50%) clients, decreased for nine (41%) and remained unchanged for two (9%). However, data retrieved from the app were unreliable for walking speed.

Conclusions

This study demonstrated that it is feasible to recruit massage practitioners and their clients for a study involving mobile/wearable technology to measure changes in walking speed following massage therapy. The results support the development of a larger randomised clinical trial using purpose-built mobile/wearable technology to measure the medium and long-term effects of massage therapy on people with osteoarthritis.
Communication and cooperation challenges in the online classroom in the COVID-19 era: a qualitative study
Authors: Salarvand Shahin , Mousavi Masoumeh-Sadat , Rahimi Majid
Published: March 2023

Background

The increasing prevalence of COVID-19 affected all aspects of life, including education. Communication and interaction are vital in any form of education. This study explained health profession educators’ and students’ experiences regarding the challenges of communication and cooperation in exclusively online classrooms during the COVID-19 era.

Methods

The present descriptive explanatory qualitative study examined health profession educators’ and students’ experiences with exclusively online classrooms during the COVID-19 era. They were included in the study by purposive sampling. In-depth and semi-structured telephone interviews were conducted to collect data. The content analysis presented by Graneheim and Lundman was used to analyze the data. The present study employed four strength criteria: credibility, confirmability, transferability, and dependability.

Results

The results of the present study included communication and cooperation challenges in exclusively online classrooms related to the COVID-19 pandemic. Two themes emerged from 400 open codes: lack of students’ socialization and communication-related concerns, which each had subcategories.

Conclusions

Lack of students’ socialization and communication problems were identified as the participants’ main experiences. Defects in teacher training due to the sudden transition to virtual education, acquiring a professional identity that is possible in in-person education was also flawed. The participants experienced challenges in their class activities, leading to a decrease in trust, a lack of motivation to learn from students, and teachers’ teaching. Policymakers and authorities should adopt new tools and techniques to improve exclusively virtual education outcomes.
Simultaneous determination of protoporphyrin IX and magnesium protoporphyrin IX in Arabidopsis thaliana and Camellia sinensis using UPLC-MS/MS
Authors: Zhang Chenyu , Ma Chunlei , Zhu Li , Yao Mingzhe
Published: March 2023

Backgrounds

Insertion of Mg2+ into protoporphyrin IX (PPIX) to produce magnesium-protoporphyrin IX (Mg-PPIX) was the first step toward chlorophyll biosynthesis, which not only imparts plants green pigmentation but underpins photosynthesis. Plants that blocked the conversion of PPIX to Mg-PPIX displayed yellowish or albino-lethal phenotypes. However, the lack of systematic study of the detection method and the metabolic difference between species have caused the research on chloroplast retrograde signaling controversial for a long time.

Results

An advanced and sensitive UPLC-MS/MS strategy for determining PPIX and Mg-PPIX was established in two metabolic different plants, Arabidopsis thaliana (Columbia-0) and Camellia sinensis var. sinensis. Two metabolites could be extracted by 80% acetone (v/v) and 20% 0.1 M NH4OH (v/v) without hexane washing. Since the Mg-PPIX could be substantially de-metalized into PPIX in acidic conditions, analysis was carried out by UPLC-MS/MS with 0.1% ammonia (v/v) and 0.1% ammonium acetonitrile (v/v) as mobile phases using negative ion multiple reaction monitoring modes. Interestingly, it could be easier to monitor these two compounds in dehydrated samples rather than in fresh samples. Validation was performed in spiked samples and mean recoveries ranged from 70.5 to 916%, and the intra-day and inter-day variations were less than 7.5 and 10.9%, respectively. The limit of detection was 0.01 mg·kg− 1 and the limit of quantification was 0.05 mg·kg− 1. The contents of PPIX (1.67 ± 0.12 mg·kg− 1) and Mg-PPIX (3.37 ± 0.10 mg·kg− 1) in tea were significantly higher than in Arabidopsis (PPIX: 0.05 ± 0.02 mg·kg− 1; Mg-PPIX: 0.08 ± 0.01 mg·kg− 1) and they were only detected in the leaf.

Conclusions

Our study establishes a universal and reliable method for determining PPIX and Mg-PPIX in two plants using UPLC-MS/MS. This procedure will facilitate studying chlorophyll metabolism and natural chlorophyll production.
Inferring the impact of humanitarian responses on population mortality: methodological problems and proposals
Authors: Checchi Francesco
Published: March 2023

Reducing excess population mortality caused by crises due to armed conflict and natural disasters is an existential aim of humanitarian assistance, but the extent to which these deaths are averted in different humanitarian responses is mostly unknown. This information gap arguably weakens governance and accountability. This paper considers methodological challenges involved in making inferences about humanitarian assistance’s effect on excess mortality, and outlines proposed approaches. Three possible measurement questions, each of which contributes some inferential evidence, are presented: (1) whether mortality has remained within an acceptable range during the crisis (for which different direct estimation options are presented); (2) whether the humanitarian response is sufficiently appropriate and performant to avert excess mortality (a type of contribution analysis requiring in-depth audits of the design of humanitarian services and of their actual availability, coverage and quality); and (3) the actual extent to which humanitarian assistance has reduced excess deaths (potentially the most complex question to answer, requiring application of causal thinking and careful specification of the exposure, and for which either quasi-experimental statistical modelling approaches or a combination of verbal and social autopsy methods are proposed). The paper concludes by considering possible ‘packages’ of the above methods that could be implemented at different stages of a humanitarian response, and calls for investment in improved methods and actual measurement.
Clinical and biological heterogeneities in triple-negative breast cancer reveals a non-negligible role of HER2-low
Authors: Hu Xi′e , Yang Ping , Chen Songhao , Wei Gang , Yuan Lijuan , Yang Zhenyu , Gong Li , He Li , Yang Lin , Peng Shujia , Dong Yanming , He Xianli , Bao Guoqiang
Published: March 2023

Background

HER2-low could be found in some patients with triple-negative breast cancer (TNBC). However, its potential impacts on clinical features and tumor biological characteristics in TNBC remain unclear.

Methods

We enrolled 251 consecutive TNBC patients retrospectively, including 157 HER2-low (HER2low) and 94 HER2-negtive (HER2neg) patients to investigate the clinical and prognostic features. Then, we performed single-cell RNA sequencing (scRNA-seq) with another seven TNBC samples (HER2negvs. HER2low, 4 vs. 3) prospectively to further explore the differences of tumor biological properties between the two TNBC phenotypes. The underlying molecular distinctions were also explored and then verified in the additional TNBC samples.

Results

Compared with HER2neg TNBC, HER2low TNBC patients exhibited malignant clinical features with larger tumor size (P = 0.04), more lymph nodes involvement (P = 0.02), higher histological grade of lesions (P < 0.001), higher Ki67 status (P < 0.01), and a worse prognosis (P < 0.001; HR [CI 95%] = 3.44 [2.10–5.62]). Cox proportional hazards analysis showed that neoadjuvant systemic therapy, lymph nodes involvement and Ki67 levels were prognostic factors in HER2low TNBC but not in HER2neg TNBC patients. ScRNA-seq revealed that HER2low TNBC which showed more metabolically active and aggressive hallmarks, while HER2neg TNBC exhibited signatures more involved in immune activities with higher expressions of immunoglobulin-related genes (IGHG1, IGHG4, IGKC, IGLC2); this was further confirmed by immunofluorescence in clinical TNBC samples. Furthermore, HER2low and HER2neg TNBC exhibited distinct tumor evolutionary characteristics. Moreover, HER2neg TNBC revealed a potentially more active immune microenvironment than HER2low TNBC, as evidenced by positively active regulation of macrophage polarization, abundant CD8+ effector T cells, enriched diversity of T-cell receptors and higher levels of immunotherapy-targeted markers, which contributed to achieve immunotherapeutic response.

Conclusions

This study suggests that HER2low TNBC patients harbor more malignant clinical behavior and aggressive tumor biological properties than the HER2neg phenotype. The heterogeneity of HER2 may be a non-negligible factor in the clinical management of TNBC patients. Our data provide new insights into the development of a more refined classification and tailored therapeutic strategies for TNBC patients.
Microbiome differences in sugarcane and metabolically engineered oilcane accessions and their implications for bioenergy production
Authors: Yang Jihoon , Sooksa-nguan Thanwalee , Kannan Baskaran , Cano-Alfanar Sofia , Liu Hui , Kent Angela , Shanklin John , Altpeter Fredy , Howe Adina
Published: March 2023

Oilcane is a metabolically engineered sugarcane (Saccharum spp. hybrid) that hyper-accumulates lipids in its vegetable biomass to provide an advanced feedstock for biodiesel production. The potential impact of hyper-accumulation of lipids in vegetable biomass on microbiomes and the consequences of altered microbiomes on plant growth and lipid accumulation have not been explored so far. Here, we explore differences in the microbiome structure of different oilcane accessions and non-modified sugarcane. 16S SSU rRNA and ITS rRNA amplicon sequencing were performed to compare the characteristics of the microbiome structure from different plant compartments (leaf, stem, root, rhizosphere, and bulk soil) of four greenhouse-grown oilcane accessions and non-modified sugarcane. Significant differences were only observed in the bacterial microbiomes. In leaf and stem microbiomes, more than 90% of the entire microbiome of non-modified sugarcane and oilcane was dominated by similar core taxa. Taxa associated with Proteobacteria led to differences in the non-modified sugarcane and oilcane microbiome structure. While differences were observed between multiple accessions, accession 1566 was notable in that it was consistently observed to differ in its microbial membership than other accessions and had the lowest abundance of taxa associated with plant-growth-promoting bacteria. Accession 1566 is also unique among oilcane accessions in that it has the highest constitutive expression of the WRI1 transgene. The WRI1 transcription factor is known to contribute to significant changes in the global gene expression profile, impacting plant fatty acid biosynthesis and photomorphogenesis. This study reveals for the first time that genetically modified oilcanes associate with distinct microbiomes. Our findings suggest potential relationships between core taxa, biomass yield, and TAG in oilcane accessions and support further research on the relationship between plant genotypes and their microbiomes.
Global prevalence and species diversity of tick-borne pathogens in buffaloes worldwide: a systematic review and meta-analysis
Authors: El-Alfy El-Sayed , Abbas Ibrahim , Elseadawy Rana , Saleh Somaya , Elmishmishy Bassem , El-Sayed Shimaa Abd El-Salam , Rizk Mohamed Abdo
Published: March 2023

Background

Buffaloes are important contributors to the livestock economy in many countries, particularly in Asia, and tick-borne pathogens (TBPs) commonly infect buffaloes, giving rise to serious pathologies other than their zoonotic potential.

Methods

The present investigation focuses on the prevalence of TBPs infecting buffaloes worldwide. All published global data on TBPs in buffaloes were collected from different databases (e.g., PubMed, Scopus, ScienceDirect, and Google Scholar) and subjected to various meta-analyses using OpenMeta[Analyst] software, and all analyses were conducted based on a 95% confidence interval.

Results

Over 100 articles discussing the prevalence and species diversity of TBPs in buffaloes were retrieved. Most of these reports focused on water buffaloes (Bubalus bubalis), whereas a few reports on TBPs in African buffaloes (Syncerus caffer) had been published. The pooled global prevalence of the apicomplexan parasites Babesia and Theileria, as well as the bacterial pathogens Anaplasma, Coxiella burnetii, Borrelia, Bartonella, and Ehrlichia in addition to Crimean-Congo hemorrhagic fever virus, were all evaluated based on the detection methods and 95% confidence intervals. Interestingly, no Rickettsia spp. were detected in buffaloes with scarce data. TBPs of buffaloes displayed a fairly high species diversity, which underlines the high infection risk to other animals, especially cattle. Babesia bovis, B. bigemina, B. orientalis, B. occultans and B. naoakii, Theileria annulata, T. orientalis complex (orientalis/sergenti/buffeli), T. parva, T. mutans, T. sinensis, T. velifera, T. lestoquardi-like, T. taurotragi, T. sp. (buffalo) and T. ovis, and Anaplasma marginale, A. centrale, A. platys, A. platys-like and “Candidatus Anaplasma boleense” were all were identified from naturally infected buffaloes.

Conclusions

Several important aspects were highlighted for the status of TBPs, which have serious economic implications for the buffalo as well as cattle industries, particularly in Asian and African countries, which should aid in the development and implementation of prevention and control methods for veterinary care practitioners, and animal owners.

Graphical Abstract
Pay more for me, I’m from the mountains! The role of the EU Mountain Product term and other credence attributes in consumers’ valuation of lamb meat
Authors: Cei Leonardo , Defrancesco Edi , Gatto Paola , Pagliacci Francesco
Published: March 2023

On-farm product differentiation represents a valuable opportunity for mountain agriculture. Consumers appreciate mountain products’ characteristics, but when signalling instruments are lacking, consumers might not be able to recognize (and pay for) them. Through a choice experiment, this paper considers consumers’ willingness to pay for three attributes (mountain origin through the EU Mountain Product term; local endangered landrace; agroecosystems stewardship through rotational grazing). It considers lamb meat production and North-Eastern Italian consumers, also exploring attitudes towards food and differences across groups of consumers. The highest willingness to pay is associated with the EU Mountain Product term, but communication strategies and public information provision are needed to enhance consumers’ overall knowledge.
Gut commensal Enterocloster species host inoviruses that are secreted in vitro and in vivo
Authors: Burckhardt Juan C. , Chong Derrick H. Y. , Pett Nicola , Tropini Carolina
Published: March 2023

Background

Bacteriophages in the family Inoviridae, or inoviruses, are under-characterized phages previously implicated in bacterial pathogenesis by contributing to biofilm formation, immune evasion, and toxin secretion. Unlike most bacteriophages, inoviruses do not lyse their host cells to release new progeny virions; rather, they encode a secretion system that actively pumps them out of the bacterial cell. To date, no inovirus associated with the human gut microbiome has been isolated or characterized.

Results

In this study, we utilized in silico, in vitro, and in vivo methods to detect inoviruses in bacterial members of the gut microbiota. By screening a representative genome library of gut commensals, we detected inovirus prophages in Enterocloster spp. (formerly Clostridium spp.). We confirmed the secretion of inovirus particles in in vitro cultures of these organisms using imaging and qPCR. To assess how the gut abiotic environment, bacterial physiology, and inovirus secretion may be linked, we deployed a tripartite in vitro assay that progressively evaluated bacterial growth dynamics, biofilm formation, and inovirus secretion in the presence of changing osmotic environments. Counter to other inovirus-producing bacteria, inovirus production was not correlated with biofilm formation in Enterocloster spp. Instead, the Enterocloster strains had heterogeneous responses to changing osmolality levels relevant to gut physiology. Notably, increasing osmolality induced inovirus secretion in a strain-dependent manner. We confirmed inovirus secretion in a gnotobiotic mouse model inoculated with individual Enterocloster strains in vivo in unperturbed conditions. Furthermore, consistent with our in vitro observations, inovirus secretion was regulated by a changed osmotic environment in the gut due to osmotic laxatives.

Conclusion

In this study, we report on the detection and characterization of novel inoviruses from gut commensals in the Enterocloster genus. Together, our results demonstrate that human gut-associated bacteria can secrete inoviruses and begin to elucidate the environmental niche filled by inoviruses in commensal bacteria.
In silico prioritisation of microRNA-associated common variants in multiple sclerosis
Authors: Fashina Ifeolutembi A. , McCoy Claire E. , Furney Simon J.
Published: March 2023

Background

Genome-wide association studies (GWAS) have highlighted over 200 autosomal variants associated with multiple sclerosis (MS). However, variants in non-coding regions such as those encoding microRNAs have not been explored thoroughly, despite strong evidence of microRNA dysregulation in MS patients and model organisms. This study explores the effect of microRNA-associated variants in MS, through the largest publicly available GWAS, which involved 47,429 MS cases and 68,374 controls.

Methods

We identified SNPs within the coordinates of microRNAs, ± 5-kb microRNA flanking regions and predicted 3′UTR target-binding sites using miRBase v22, TargetScan 7.0 RNA22 v2.0 and dbSNP v151. We established the subset of microRNA-associated SNPs which were tested in the summary statistics of the largest MS GWAS by intersecting these datasets. Next, we prioritised those microRNA-associated SNPs which are among known MS susceptibility SNPs, are in strong linkage disequilibrium with the former or meet a microRNA-specific Bonferroni-corrected threshold. Finally, we predicted the effects of those prioritised SNPs on their microRNAs and 3′UTR target-binding sites using TargetScan v7.0, miRVaS and ADmiRE.

Results

We have identified 30 candidate microRNA-associated variants which meet at least one of our prioritisation criteria. Among these, we highlighted one microRNA variant rs1414273 (MIR548AC) and four 3′UTR microRNA-binding site variants within SLC2A4RG (rs6742), CD27 (rs1059501), MMEL1 (rs881640) and BCL2L13 (rs2587100). We determined changes to the predicted microRNA stability and binding site recognition of these microRNA and target sites.

Conclusions

We have systematically examined the functional, structural and regulatory effects of candidate MS variants among microRNAs and 3′UTR targets. This analysis allowed us to identify candidate microRNA-associated MS SNPs and highlights the value of prioritising non-coding RNA variation in GWAS. These candidate SNPs could influence microRNA regulation in MS patients. Our study is the first thorough investigation of both microRNA and 3′UTR target-binding site variation in multiple sclerosis using GWAS summary statistics.
Collateral consequences of COVID-19 for people on probation and parole
Authors: LeMasters Katherine , Benson Angela , Corsi Christopher , Krajewski Taylor , Seide Kapriskie , Brinkley-Rubinstein Lauren , Nowotny Kathryn
Published: March 2023

Background

While the severe detrimental impact of COVID-19 on incarcerated people is well known, little is known about the experience of COVID-19 on those on community supervision. Our objective was to better understand the experience of the COVID-19 pandemic and its collateral consequences for those on community supervision (e.g., probation, parole). Beginning in December 2020, we conducted 185 phone surveys about COVID-19 with participants in The Southern Pre-Exposure Prophylaxis (PrEP) Study across its three sites - Florida, Kentucky, and North Carolina. We conducted rapid assessment interviews with both closed- and open-ended questions. We calculated descriptive statistics for close-ended questions and conducted a content analysis for open-ended questions.

Results

The COVID-19 pandemic affected those on community supervision through their experiences in the community and while incarcerated with over one-quarter of participants being reincarcerated during this time. In addition to many (128/185) experiencing COVID-19 symptoms, about half (85/185) of participants reported a diagnosis in their network with 16 of those participants losing loved ones to the pandemic. Participants experienced disruptions to their social network, healthcare, and livelihoods. Though many maintained their support systems, others felt isolated and depressed. Experiences during COVID-19 exacerbated difficulties already faced by those with criminal involvement.

Conclusions

The public health community must recognize those experiencing probation and parole, not only those housed in carceral facilities, as disproportionately impacted by the COVID-19 pandemic. We must tailor programs and services to meet their needs.
A biomechanical comparison between robotic and conventional total knee arthroplasty (TKA) in resection accuracy: a meta‐analysis on cadaveric specimens
Authors: Sequeira Sean B. , Duvall Grant T. , Boucher Henry
Published: March 2023

Purpose

Robotic total knee arthroplasty (TKA) has seen a rapid increase in utilization with recent literature suggesting that implant accuracy and resection are better optimized than in conventional TKA. The purpose of this study was to evaluate the biomechanical properties of robotic‐assisted versus conventional TKA in minimizing biplanar femoral and tibial resection error in cadaveric specimens.

Methods

A systematic review and meta‐analysis was performed by searching through PubMed, Cochrane library, and Embase to identify studies that analyzed the biomechanical properties of robotic assisted and conventional TKA, according to standard PRISMA guidelines. Evaluated outcomes included femoral coronal resection error (deg), femoral sagittal resection error (deg), tibial coronal resection error (deg), and tibial sagittal resection error (deg).

Results

Seven studies met inclusion criteria, including a total of 140 cadaveric specimens (robotic: 70, conventional: 70), for resection accuracy between robotic and conventional TKA. Pooled analysis from seven studies revealed a significant difference in femoral coronal and sagittal resection error in favor of robotic systems compared to conventional systems (p < 0.001 & p < 0.001, respectively). The pooled analysis from seven studies revealed a significant difference in tibial sagittal resection error in favor of robotic systems compared to conventional systems following TKA (p = 0.012). Posthoc power analysis revealed a power of 87.2%.

Conclusion

The use of robotic TKA is associated with lower femoral coronal, lower femoral sagittal and tibial sagittal resection error compared to conventional TKA. It should be noted that these findings are purely biomechanical – surgeons should interpret these findings along with clinical differences between conventional and robotic systems to determine which system is best for each patient.
Successful conversion surgery following chemotherapy with an immune checkpoint inhibitor in an older adult patient with stage IVB esophageal squamous cell carcinoma: a case report
Authors: Kawazoe Tetsuro , Ito Shuhei , Ohgaki Kippei , Fujinaka Yoshihiko , Funakoshi Hiroki , Otake Akihiko , Wang Huanlin , Morita Kazutoyo , Fushimi Fumiyoshi , Ikeda Yoichi
Published: March 2023

Background

Chemotherapy and chemoradiotherapy are common treatments for esophageal squamous cell carcinoma with distant metastasis; however, the prognosis remains poor, and complete remission is difficult to achieve. Here, we report a case of an older adult patient with esophageal squamous cell carcinoma who underwent surgery following combined treatment of immunotherapy and chemotherapy and achieved pathological complete response.

Case presentation

An 80-year-old woman presenting with difficulty swallowing was referred to our hospital. She was diagnosed with esophageal squamous cell carcinoma with distant metastasis of the lymph node at the dorsal side of the IVC and the left supraclavicular lymph node. She was treated with pembrolizumab, cisplatin, and 5-fluorouracil. After four pharmacotherapy courses, primary tumor and metastatic lymph node shrinkage was observed. The patient underwent thoracoscopic subtotal esophagectomy and regional lymph node dissection. The lymph node at the dorsal side of the IVC was not resected, and the left supraclavicular lymph node was removed. Histological examination revealed complete response with no residual tumor or lymph node metastasis. The patient had no recurrence 10 months postoperatively without adjuvant chemotherapy.

Conclusions

Conversion surgery following preoperative therapy, including immunotherapy, may be an effective treatment strategy for improving survival in patients with esophageal squamous cell carcinoma even among older adult patients.
Culturally adapted family intervention for people with schizophrenia in Indonesia (FUSION): a development and feasibility study protocol
Authors: Renwick Laoise , Susanti Herni , Brooks Helen , Keliat Budi-anna , Bradshaw Tim , Bee Penny , Lovell Karina
Published: March 2023

Background

Mental illnesses comprise the single largest source of health-related economic burden globally, and low- and middle-income countries are disproportionately affected. The majority of people with schizophrenia who need treatment do not receive it and are often wholly reliant on family caregivers for daily care and support. Family interventions have an exceptionally robust evidence base for their efficacy in high-resource settings, but it is unknown whether they can produce equivalent effects in some low-resource settings where cultural beliefs, explanatory models of illness and contextual socio-economic issues differ.

Methods

This protocol describes the methods for a randomised controlled trial to determine the feasibility of testing culturally adapt and refine an evidence-based, family intervention for relatives and caregivers of people with schizophrenia in Indonesia. The feasibility and acceptability of implementing our adapted, co-produced intervention via task shifting in primary care settings will be evaluated using the Medical Research Council framework for complex interventions. We will recruit 60 carer-service-user dyads and randomise them in a 1:1 ratio either to receive our manualised intervention or continue to receive treatment as usual. Healthcare workers in primary care settings will be trained to deliver family interventions using our manualised intervention by a family intervention specialist. Participants will complete the ECI, IEQ, KAST and GHQ. Service-user symptom level and relapse status will be measured using the PANSS at baseline, post-intervention and 3 months later by trained researchers. Fidelity to the intervention model will be measured using the FIPAS. Qualitative evaluation will further assist with refining the intervention, evaluating trial processes and evaluating acceptability.

Discussion

National healthcare policy in Indonesia supports the delivery of mental health services in a complex network of primary care centres. This study will provide important information on the feasibility of delivering family interventions for people with schizophrenia via task shifting in primary care settings in Indonesia and allow further refinement of the intervention and trial processes.
Investigation of the effects of physical activity level on functionality level and quality of life in the postpartum period
Authors: Bulguroglu Halil I. , Bulguroglu Merve , Gevrek P. T. Cansu
Published: March 2023

Background

Physical activity, known to have positive effects in every period of life, may decrease due to anatomical and physiological changes and increased responsibilities in the postpartum period. This study aimed to understand how women's physical activity levels, functional levels, and quality of life are affected in the postpartum period and to emphasize the importance of physical activity levels in the postpartum period.

Methods

The population of our study was planned as a cross-sectional study of postpartum women who applied to a private center. The sample consists of 101 volunteer postpartum women participating in the study. Physical activity levels; with the International Physical Activity Questionnaire (IPAQ), postpartum functional levels; with the Inventory of Functional Status After Childbirth (IFSAC), postpartum quality of life level; with Maternal Postpartum Quality of Life (MAPP-QOL) were evaluated.

Results

It was determined that the amount of physical activity of postpartum women was 928.347 ± 281.27 MET-min/week, which means low physical activity level, and 35.64% were not physically active. The mean total score of IFSAC was 2.13 ± 0.79, and the mean total score of MAPP-QOL was 16.93 ± 6.87. It was determined that there was a positive and significant correlation (p < 0.05) between IPAQ and IFSAC (r = 0.034) and MAPP-QOL (r = 0.214). A significant difference was found when the IFSAC and MAPP-QOL scores were compared between the three groups with different physical activity levels (p < 0.05).

Conclusions

As a result, it was observed that the physical activity levels of women in the postpartum period were low, negatively affecting their functionality and quality of life.
Urinary catecholamine excretion, cardiovascular variability, and outcomes in tetanus
Authors: Du Duc Hong , Hao Nguyen Quan Nhu , Van Hao Nguyen , Thanh Tran Tan , Loan Huynh Thi , Yen Lam Minh , Thuy Tran Thi Diem , Thuy Duong Bich , Nguyen Nguyen Thanh , Dung Nguyen Thi Phuong , Kestelyn Evelyne , Duong Ha Thi Hai , Phong Nguyen Thanh , Tuyen Pham Thi , Phu Nguyen Hoan , Nghia Ho Dang Trung , Hanh Bui Thi Bich , Oanh Pham Kieu Nguyet , Tho Phan Vinh , Nhat Phung Tran Huy , Khanh Phan Nguyen Quoc , Wyncoll Duncan , Day Nicholas P. J. , Van Vinh Chau Nguyen , van Doorn H. Rogier , Van Tan Le , Geskus Ronald B. , Thwaites C. Louise
Published: March 2023

Severe tetanus is characterized by muscle spasm and cardiovascular system disturbance. The pathophysiology of muscle spasm is relatively well understood and involves inhibition of central inhibitory synapses by tetanus toxin. That of cardiovascular disturbance is less clear, but is believed to relate to disinhibition of the autonomic nervous system. The clinical syndrome of autonomic nervous system dysfunction (ANSD) seen in severe tetanus is characterized principally by changes in heart rate and blood pressure which have been linked to increased circulating catecholamines. Previous studies have described varying relationships between catecholamines and signs of ANSD in tetanus, but are limited by confounders and assays used. In this study, we aimed to perform detailed characterization of the relationship between catecholamines (adrenaline and noradrenaline), cardiovascular parameters (heart rate and blood pressure) and clinical outcomes (ANSD, mechanical ventilation required, and length of intensive care unit stay) in adults with tetanus, as well as examine whether intrathecal antitoxin administration affected subsequent catecholamine excretion. Noradrenaline and adrenaline were measured by ELISA from 24-h urine collections taken on day 5 of hospitalization in 272 patients enrolled in a 2 × 2 factorial-blinded randomized controlled trial in a Vietnamese hospital. Catecholamine results measured from 263 patients were available for analysis. After adjustment for potential confounders (i.e., age, sex, intervention treatment, and medications), there were indications of non-linear relationships between urinary catecholamines and heart rate. Adrenaline and noradrenaline were associated with subsequent development of ANSD, and length of ICU stay.
Blood pressure management in ischemic stroke patients undergoing mechanical thrombectomy
Authors: De Georgia Michael , Bowen Theodore , Duncan K. Rose , Chebl Alex Bou
Published: March 2023

The relationship between presenting blood pressure in acute ischemic stroke patients and outcome is complex. Several studies have demonstrated a U-shaped curve with worse outcomes when blood pressure is high or low. The American Heart Association/American Stroke Association guidelines recommend values of blood pressure < 185/110 mmHg in patients treated with intravenous t-PA and “permissive hypertension” up to 220/120 mmHg in those not treated with intravenous t-PA. The optimal blood pressure target is less clear in patients undergoing mechanical thrombectomy. Before thrombectomy, the guidelines recommend a blood pressure < 185/110 mmHg though patients with even lower systolic blood pressures may have better outcomes. During and after thrombectomy, the guidelines recommend a blood pressure < 180/105 mmHg. However, several studies have suggested that during thrombectomy the primary goal should be to prevent significant low blood pressure (e.g., target systolic blood pressure > 140 mmHg or MAP > 70 mmHg). After thrombectomy, the primary goal should be to prevent high blood pressure (e.g., target systolic blood pressure < 160 mmHg or MAP < 90 mmHg). To make more specific recommendations, large, randomized-control studies are needed that address factors such as the baseline blood pressure, timing and degree of revascularization, status of collaterals, and estimated risk of reperfusion injury.
Acoustoelastic Mori-Tanaka model for third-order elastic constants of fractured rocks
Authors: Fu Bo-Ye , Fu Li-Yun , Deng Wubing , Han Tongcheng
Published: March 2023

Insights into the stress-dependent elastic moduli of fractured rocks are important in monitoring geopressure and tectonic stress. This can be addressed by the theory of acoustoelasticity that describes elastic nonlinearity due to the cubic strain-energy function through third-order elastic constants (TOECs). The acoustoelastic TOECs are strictly valid for an isotropic homogeneous medium. The extension to fractured rocks remains largely unaddressed. A group of fractures (ellipses) is embedded into a homogeneous background medium subjected to a uniform confining pressure. We formulate an acoustoelastic Mori-Tanaka (MT) model for the effective TOECs of fractured rocks which can be defined as the weighted average of individual TOECs between the background and fractures in terms of respective volume fractions and stiffnesses. For homogeneously distributed fractures, the stress-induced strains are isotropic in the background and in the fractures. For aligned fractures, the resulting anisotropic strains over the background and fractures make the rock a vertical transverse isotropic medium. The effective elastic moduli and TOECs of fractured rocks depend on background elastic moduli, fracture contents, aspect ratios, and fracture orientations. The prestressed aligned fractures induce nonlinear effects on the effective TOECs that increase with increasing fracture contents and decreasing aspect ratios. We validate the acoustoelastic MT model by experimental data and investigate its limitation by comparing it with finite-element simulations.
“Limitless Black Resonance”: The Grotesque Sonority of Dambudzo Marechera and Sony Labou Tansi
Authors: Newman Scott
Published: March 2023

This article examines the figuring of Black voices in literature, specifically addressing the grotesque sonority of Anglophone and Francophone African writing. The analysis focuses on the Zimbabwean Dambudzo Marechera’s stuttered speech in the semi-autobiographical short fiction The House of Hunger (1978) and the Congolese Sony Labou Tansi’s tropical sounds in the dictator novels La vie et demie (1979) and Les septs solitudes de Lorsa Lopez (1985). The article argues that the authors reprise colonial misconceptions of Africa as a noisy continent and parody racist mishearings of Black voices as illegible or dissonant in order to establish a literal and conceptual proximity of voice to violence. Marechera and Sony Labou Tansi thus identify the truly grotesque brutality of colonialism, including its sounded modes of bodily regulation, racist accent policing, ableist speech norms, and inimical linguistic control. The authors reject notions of proper speech and beautiful sound altogether. Instead, they turn to screaming, stuttering, and other postlingual utterances to cast doubt on the governability of sounded language in both graphic and phonic iterations. The article contributes to postcolonial literary criticism and sound studies by revising approaches to orality in African writing and racialized sound in literature more broadly.
Plausible Intimacies
Authors: Norgaard Lara
Published: March 2023

This essay analyzes representations of Asia in the satirical 1911 short story “O homem que sabia javanês” (“The Man Who Knew Javanese”) by Brazilian author Lima Barreto. Like much of Barreto’s work, the short story critiques the deterministic categories of scientific racism popular in elite circles during the First Brazilian Republic. However, this essay asserts that the references to Java in the story are not arbitrary means through which to carry out that critique. Instead, drawing on Lisa Lowe’s concept of residual intimacies and Bruno Carvalho’s engagement of cartografia letrada (lettered cartography), it argues that Barreto crafts a fiction of plausible contact between Brazil and Java, revealing transpacific spatial and racial entanglements that categories of canonized knowledge at the turn of the twentieth century failed to manage and control. Barreto imagines Java on the streets of Rio, revealing the tangible closeness of two experiences categorized as different and distant. The essay considers how the plausible yet fictional intimacies in this literary counternarrative conceptually reorient readers toward both the Pacific and the Atlantic.
In Praise of Idling: Johnson, Austen, and Literary Leisure
Authors: Yahav Amit S.
Published: March 2023

This essay examines the theory of leisure that Samuel Johnson presents in his Idler series and that Jane Austen engages in her novel Mansfield Park. Just as productivity and vigilance are becoming unassailable values, Johnson and Austen publish popular works designed to insert breaks into the culture of ceaseless striving. Their theory of leisure revalues idling as a state of beneficial, albeit transient, mindlessness and develops forms of representation that, instead of cultivating an edifying point of view—of refined knowledge, judgment, or feeling—promotes an occasional letting go. Johnson uses the proliferation and Austen the suspension of points of view to defend the value of reading materials that solicit relaxation and afford cheap pleasures for the many, or at least the many more. Both the Idler and Mansfield Park advocate for the redistribution of leisure in time rather than across classes of persons, thus transforming idling from a characterological deficiency into a periodic respite that is necessary for all and that all are entitled to.
“One Unique You”
Authors: Cachoian-Schanz Deanna , Schwerzmann Katia
Published: March 2023

Starting with the apparatus of DNA testing that produces and reifies ethnoracial differences and identities, this article articulates two layers of analysis. The larger implications of this analysis are to be understood in the articulation between these two layers. The first layer regards the neocolonial construction of an ethnosubject anchored in the racialization of DNA. This racialization consists of two steps. First, race is naturalized and biologized anew through the technological procedure of DNA decoding and data comparison. Second, race is reculturalized through its substitution with ethnicity. This step enables the neutralization of the politically antiliberal connotations of the rebiologization of race. The second layer of analysis connects this rebiologization of race to neocolonial processes of value extraction and biopolitical techniques of surveillance. The implications of these developments are attended to by interrogating the directions taken by DNA datafication in terms of both surveying and surveilling. At center stage is the question of the modulation of the individual's access—to countries and services—enabled by their datafication. Thus, the question of access is the question of how boundaries are drawn, who draws them, and how porous they are depending on the characteristics of the individual's biological data.
Why Do Households Leave School Value Added on the Table? The Roles of Information and Preferences
Authors: Ainsworth Robert , Dehejia Rajeev , Pop-Eleches Cristian , Urquiola Miguel
Published: March 2023

Romanian households could choose schools with one standard deviation worth of additional value added. Why do households leave value added “on the table”? We study two possibilities: (i) information and (ii) preferences for other school traits. In an experiment, we inform randomly selected households about schools' value added. These households choose schools with up to 0.2 standard deviations of additional value added. We then estimate a discrete choice model and show that households have preferences for a variety of school traits. As a result, fully correcting households' beliefs would eliminate at most a quarter of the value added that households leave unexploited. (JEL D12, D83, I21, I28)