bluuebunny/crossref_metadata_2025 huggingface dataset:
Peat definitions: A critical review
Authors: Lourenco Mauro , Fitchett Jennifer M , Woodborne Stephan
Published: October 2022

Peatlands are carbon-rich ecosystems that comprise the largest terrestrial carbon store. Peatland preservation has been acknowledged on the global scale as a key nature-based component in addressing climate change. Despite their importance, there is no globally recognised definitions for peat or peatland, which influences efforts in quantifying global peat carbon stocks. We present a critical review on peatland definitions, including peat nomenclature and changing criteria for peatland classification through time. We focus on two important criteria: the minimum depth of the surface organic layer and the minimum percentage of organic carbon. We highlight the disparity between definitions, peatland nomenclature and peatland classifications. It is challenging to determine whether one definition should take precedence over another, even when considering the most common criteria. We propose that future peatland definitions focus on carbon storage and potential greenhouse gas emissions. This involves four physical and chemical characteristics of the peatland deposit: (1) Peatland extent, (2) peat thickness, (3) peat carbon content and (4) peat bulk density (volumetric carbon content). The growth dynamics and carbon flux of the peatland deposit should also become a routine part of inventories. In future, international technical agencies and experts can advise on the standardisation of concept definitions and methods, these must focus on the preservation of peatlands from the perspective of climate science.
Longitudinal Predictors of Informant-Rated Involvement of People with Dementia in Everyday Decision-Making: Findings from the IDEAL Program
Authors: Sabatini Serena , Martyr Anthony , Gamble Laura D. , Collins Rachel , Matthews Fiona E. , Morris Robin G. , Rusted Jennifer M. , Pentecost Claire , Quinn Catherine , Clare Linda ,   behalf of the IDEAL study team
Published: October 2022

The extent to which people with dementia are involved in everyday decision-making is unclear. We explored informant-rated involvement of people with dementia in everyday decision-making over 2 years and whether functional, behavioral, and psychological factors related to the person with dementia and the caregiver explain variability in involvement of people with dementia in everyday decision-making. We used IDEAL data for 1182 people with dementia and their caregivers. Baseline mean score on the decision-making involvement scale was 31/45; it minimally declined over time. People with dementia who were female, single, and/or whose caregiver was younger had greater involvement in everyday decision-making than those without these characteristics. Better cognition, fewer functional difficulties, fewer neuropsychiatric symptoms, less caregiver stress, and better informant-rated relationship quality were associated with higher involvement in everyday decision-making. Cognitive and functional rehabilitation, and educational resources for caregivers, could prolong involvement of people with dementia in everyday decision-making.
Low Exposure to Home- and Community-Based Services Among U.S. Adults: Cause for Concern?
Authors: Siconolfi Daniel , Thomas Emma G. , Chen Emily K. , Friedman Esther M. , Shih Regina A.
Published: October 2022

Home- and community-based services (HCBS) facilitate community living for older adults and persons with disabilities, but limited awareness of HCBS is a significant barrier to access. Social exposure is one potential conduit for HCBS knowledge. To understand the general population’s social exposure to HCBS—that is, knowing someone who has used HCBS (including one’s self)—we fielded a survey item with a nationally representative panel of U.S. adults. An estimated 53% of U.S. adults reported not knowing anyone who had used HCBS. Exposure rates were low across specific HCBS types (6%–28%). Women had greater exposure than men for eight of the 11 HCBS. We also found differences by age, racial/ethnic identity, rurality, education, and income. Increasing the general public’s awareness of HCBS may facilitate access when services are needed, enhance readiness for aging in place, and increase the visibility and inclusion of older adults, persons with disabilities, and caregivers.
Opportunities for Community Pharmacists to Counsel Patients With Epilepsy and Seizure Clusters to Overcome Barriers and Foster Appropriate Treatment
Authors: Gidal Barry , Welty Timothy , Cokley Jon , Farrell Michelle , Shafer Patricia , Rabinowicz Adrian L. , Carrazana Enrique
Published: October 2022

Some patients with epilepsy experience seizure clusters, which may be defined as 2 or more seizures occurring within 24 hours. Left untreated, seizure clusters increase the risk for physical injury and may progress to status epilepticus, irreversible neurologic injury, and death. Rescue therapy is based on benzodiazepine treatment. Prompt, appropriate use should be specified in patients’ individualized seizure action plans. Most seizure clusters occur outside the hospital setting. The ideal rescue therapy allows for easy and quick administration by a nonmedical person, which may minimize the need for intervention by emergency medical personnel or transportation to the hospital. In the 2 decades before the approval of 2 intranasal benzodiazepines in 2019 and 2020, rectal diazepam was the only route of administration approved by the US Food and Drug Administration specifically for seizure clusters. Each of the approved intranasal formulations has a unique profile. Both offer a convenient and socially acceptable route of administration. Recognition of seizure clusters and timing of proper administration are key to successful use of rescue therapy. Pharmacists’ counseling plays an important role in reinforcing when and how to appropriately administer rescue therapies and the importance of consistently using rescue treatment when indicated to promote effective management. This review includes resources for pharmacists, patients, and caregivers; reviews currently available treatments; and discusses seizure action plans that support effective treatment of seizure clusters.
Somatotype Characteristics of a Mendelian Population from North India and Its association with Cognitive Impairment and Depression
Authors: Kaur Gurjinder , Gaur Rajan , Saraswathy Kallur Nava
Published: October 2022

The present article aims to understand the somatotype characteristics and its association with cognitive impairment (CI) and depression among 768 Jat men and women aged 30–80 years from an Mendelian population of north India. The somatotypes are evaluated using the Heath–Carter protocol. Cognition status is assessed through Mini-Mental State Examination scale, while the depression status is determined using Beck’s depression inventory questionnaire. Overall, the Jat population is found to be mesomorphic endomorph. A slight decrease in endomorphy and an increase in ectomorphy is observed with advancing age. Endomorphy is found to be more prevalent among individuals having CI and depression. In conclusion, as compared to other populations of India, the Jats of Haryana are more endomorphic and less mesomorphic. As the association of somatotypes with mental disabilities is still unclear, this issue needs further investigation. So, more population studies are necessary to elucidate their association.
Teaching through Pain: Finding Peace, of Sorts, after Unimaginable Loss
Authors: Wright Robin Redmon
Published: October 2022

This evocative autoethnography is an exploration of learning and perseverance during a particularly dark time in my personal and professional life. In a period of just over 3 years, my spouse and I dealt with the need for several surgeries, the Covid-19-Delta pandemic and subsequent isolation, social unrest, an insurrection in the U.S., and the tragic death of our son. Then, the D.Ed. program in which I teach was closed. Through this writing, I attempt to make meaning from these events and to share what I have learned.
A Reflexive Lens on Preparing and Conducting Semi-structured Interviews with Academic Colleagues
Authors: Buys Tania , Casteleijn Daleen , Heyns Tanya , Untiedt Hannelie
Published: October 2022

In qualitative research, researchers often conduct semi-structured interviews with people familiar to them, but there are limited guidelines for researchers who conduct interviews to obtain curriculum-related information with academic colleagues who work in the same area of practice but at different higher education institutions. Using a pragmatic constructivist stance, we address the practicalities of conducting semi-structured interviews with fellow educators who work in the same area of professional practice, where the researcher has to address the dual roles of “insider” and “outsider” as well as that of researcher and participant. Interviewing academic colleagues offers a unique opportunity for rich data collection, but researchers should adopt a flexible conversational style during interviewing within research parameters and be acutely aware of their positionality and fluidity of roles. This article contributes to existing knowledge by drawing on the work of previous scholars in various areas of research and research methodology thereby offering a practical and theoretical perspective on conducting qualitative research interviewing in higher education institutions where the role of researcher and participant can become blurred. These guidelines and insights will also benefit researchers who conduct research with peers who work together in the same area of expertise, in similar contexts and with whom there are varying levels of working relationships.
Analysing the dynamic co-movement between tourism and expected economic growth considering extreme events
Authors: Liu Jianxu , Ramos Vicente , Yang Bing , Wang Mengjiao , Sriboonchitta Songsak
Published: October 2022

In the post epidemic period, it is important to clarify the relationship between economic growth and tourism growth. The aim of this study is to characterize the co-movement between expected macroeconomic conditions and inbound tourism, focussing on the nonlinear relationship between these variables. Dynamic copula-based GJR-GARCH models are employed to measure nonlinear dependence. Total inbound tourism to Thailand and its disaggregation for its 10 main origin countries, are considered in the empirical study. The results show that there exists significant co-movement between expected economic growth and inbound tourism, and prove the importance of considering nonlinearities and extreme events. Also, copula nonlinear Granger causality is used to conclude that inbound tourism and expected economic growth have nonlinear bi-directional and unidirectional Granger causality relationship. Finally, this paper puts forward some policy suggestions to restore tourism and boost economic growth in the post epidemic period.
The use of technology for arts-based activities in older adults living with mild cognitive impairment or dementia: A scoping review
Authors: MacRitchie Jennifer , Floridou Georgia A. , Christensen Justin , Timmers Renee , de Witte Luc
Published: October 2022

For older adults living with mild cognitive impairment or dementia, creative arts-based activities can offer many benefits from enjoyment as leisure/recreation to an avenue to maintain cognitive, social and emotional wellbeing. With growing interest and recognition that technology could have potential to assist in delivering these activities in more accessible and personalised ways, a scoping review was undertaken to systematically examine the scientific literature for technology-assisted creative arts activities for older adults living with dementia. We searched PubMed, PsychINFO, Web of Science, Scopus and ACM Digital Library databases using keywords centering on population with dementia, an intervention using technology, and a context of creative arts, with no restrictions on the type of outcome measured. We retrieved 3739 records, with an additional 22 from hand-searching. 51 full-text articles met the inclusion and exclusion criteria. Findings of the review indicate technologies principally being designed for music activities (listening, and music-making), as well as storytelling and visual arts. The majority of devices were custom-made, with studies mainly reporting on validating the success of the device/intervention. This suggests most work in the field is currently at prototyping stage, although a few devices are now commercially available. Recommendations for future research includes involvement of participants reporting on their previous experiences in the arts and how this influences co-design choices, and inclusion of different severities of dementia in the participant/co-design group. Furthering device development past prototyping stage as well as collaboration between teams would enable comparisons to be made across different types of devices used for the same activity, and comparisons across arts-based activities that could lead to cross-disciplinary outcomes for the design of creative arts-based assistive technologies.
Utilizing Parent-Child Interaction Therapy with Trauma-Directed Interaction in a Young Male in Out of Home Care Who Had Experienced Trauma
Authors: Warren Jessica M. , Hanstock Tanya. L. , Hunt Sally A. , Halpin Sean A. , Warner-Metzger Christina M. , Gurwitch Robin
Published: October 2022

Child abuse and neglect in young children can lead to trauma-related stress symptoms that can be challenging to manage. Parent-Child Interaction Therapy (PCIT), a strong evidence-based behavioral parent training program used for young children with behavior issues, has been used in its traditional form with increasing frequency with children and families who have trauma histories, with clinicians tailoring PCIT to use with children who have experienced trauma. Trauma-Directed Interaction (TDI) is a new systematic adaption to the standard PCIT parent training program that has the potential to help treat trauma in younger children. TDI includes several trauma-informed techniques that are added to a course of standard PCIT treatment including psychoeducation regarding trauma, recognition of feelings, and emotional regulation. This case study illustrates the use of a manualized trauma adaptation to PCIT (TDI) with a three-year-old boy who had a history of child maltreatment and his caregiver. This case provides a summary of the progression of this intervention and the results obtained. Results from the case indicated that TDI treatment was effective in not only reducing child trauma and behavioral symptoms but also in reducing mild caregiver mental health concerns. The next steps for TDI treatment and need for further research are discussed.
Green Human Resource Management and Green Service Behaviour in Organisations: Examining Underlying Mechanism
Authors: Khan Kalimullah , Khan Qaisar , Jalaly Shakir , Shams Muhammad Shahid , Shah Tazeem Ali
Published: October 2022

This study aims to examine perceived green human resource management (GHRM) influence on perceived in-role and extra-role green service behaviour. Specifically, drawing upon social identity theory, authors tested how green commitment mediates the relationship between GHRM and employees’ green behaviour. The study employed cross-sectional research design in a non-contrived setting for data collection from 203 responses of banking sector employees in Afghanistan. Partial least squares structural equation modelling is applied by using SmartPLS 3 software. The empirical results confirmed that green commitment mediates the relationship between GHRM and employees’ in-role and extra-role green service behaviour. This study explores green commitment as novel mechanisms through which GHRM practices influence employees’ in-role and extra-role green behaviour in organisations.
Cerebral blood flow alterations in migraine patients with and without aura: An arterial spin labeling study
Authors: Fu Tong , Liu Lindong , Huang Xiaobin , Zhang Di , Gao Yujia , Yin Xindao , Lin Hai , Dai Yongming , Wu Xinying
Published: October 2022

Background

Migraine aura is a transient, fully reversible visual, sensory, or other central nervous system symptom that classically precedes migraine headache. This study aimed to investigate cerebral blood flow (CBF) alterations of migraine with aura patients (MwA) and without aura patients (MwoA) during inter-ictal periods, using arterial spin labeling (ASL).

Methods

We evaluated 88 migraine patients (32 MwA) and 44 healthy control subjects (HC) who underwent a three-dimensional pseudo-continuous ASL MRI scanning. Voxel-based comparison of normalized CBF was conducted between MwA and MwoA. The relationship between CBF variation and clinical scale assessment was further analyzed. The mean CBF values in brain regions showed significant differences were calculated and considered as imaging features. Based on these features, different machine learning–based models were established to differentiate MwA and MwoA under five-fold cross validation. The predictive ability of the optimal model was further tested in an independent sample of 30 migraine patients (10 MwA).

Results

In comparison to MwoA and HC, MwA exhibited higher CBF levels in the bilateral superior frontal gyrus, bilateral postcentral gyrus and cerebellum, and lower CBF levels in the bilateral middle frontal gyrus, thalamus and medioventral occipital cortex (all p values < 0.05). These variations were also significantly correlated with multiple clinical rating scales about headache severity, quality of life and emotion. On basis of these CBF features, the accuracies and areas under curve of the final model in the training and testing samples were 84.3% and 0.872, 83.3% and 0.860 in discriminating patients with and without aura, respectively.

Conclusion

In this study, CBF abnormalities of MwA were identified in multiple brain regions, which might help better understand migraine-stroke connection mechanisms and may guide patient-specific decision-making.
lncRNA PVT1: a novel oncogene in multiple cancers
Authors: Li Ruiming , Wang Xia , Zhu Chunming , Wang Kefeng
Published: October 2022

Long noncoding RNAs are involved in epigenetic gene modification, including binding to the chromatin rearrangement complex in pre-transcriptional regulation and to gene promoters in gene expression regulation, as well as acting as microRNA sponges to control messenger RNA levels in post-transcriptional regulation. An increasing number of studies have found that long noncoding RNA plasmacytoma variant translocation 1 (PVT1) plays an important role in cancer development. In this review of a large number of studies on PVT1, we found that PVT1 is closely related to tumor onset, proliferation, invasion, epithelial–mesenchymal transformation, and apoptosis, as well as poor prognosis and radiotherapy and chemotherapy resistance in some cancers. This review comprehensively describes PVT1 expression in various cancers and presents novel approaches to the diagnosis and treatment of cancer.
Transcriptome analysis reveals the roles of phytohormone signaling in tea plant (Camellia sinensis L.) flower development
Authors: Xu Xiaohan , Tao Jing , Xing Anqi , Wu Zichen , Xu Yuqin , Sun Yi , Zhu Jiangyuan , Dai Xiang , Wang Yuhua
Published: October 2022

Background

Tea plant (Camellia sinensis (L.) O. Kuntze) is an important economic tea crop, but flowering will consume a lot of nutrients of C. sinensis, which will seriously affect the nutritional growth of C. sinensis. However, there are few studies on the development mechanism of C. sinensis flower, and most studies focus on a single C. sinensis cultivar.

Results

Here, we identified a 92-genes’ C. sinensis flower development core transcriptome from the transcriptome of three C. sinensis cultivars ('BaiYe1', 'HuangJinYa' and 'SuChaZao') in three developmental stages (bud stage, white bud stage and blooming stage). In addition, we also reveal the changes in endogenous hormone contents and the expression of genes related to synthesis and signal transduction during the development of C. sinensis flower. The results showed that most genes of the core transcriptome were involved in circadian rhythm and autonomous pathways. Moreover, there were only a few flowering time integrators, only 1 HD3A, 1 SOC1 and 1 LFY, and SOC1 played a dominant role in the development of C. sinensis flower. Furthermore, we screened out 217 differentially expressed genes related to plant hormone synthesis and 199 differentially expressed genes related to plant hormone signal transduction in C. sinensis flower development stage.

Conclusions

By constructing a complex hormone regulation network of C. sinensis flowering, we speculate that MYC, FT, SOC1 and LFY play key roles in the process of endogenous hormones regulating C. sinensis flowering development. The results of this study can a provide reference for the further study of C. sinensis flowering mechanism.
The association between age and vital signs documentation of trauma patients in prehospital settings: analysis of a nationwide database in Japan
Authors: Shinohara Mafumi , Muguruma Takashi , Toida Chiaki , Gakumazawa Masayasu , Abe Takeru , Takeuchi Ichiro
Published: October 2022

Background

Emergency medical service (EMS) providers are the first medical professionals to make contact with patients in an emergency. However, the frequency of care by EMS providers for severely injured children is limited. Vital signs are important factors in assessing critically ill or injured patients in the prehospital setting. However, it has been reported that documentation of pediatric vital signs is sometimes omitted, and little is known regarding the performance rate of vital sign documentation by EMS providers in Japan. Using a nationwide data base in Japan, this study aimed to evaluate the relationship between patients’ age and the documentation of vital signs in prehospital settings.

Methods

This study was a secondary data analysis of the Japan Trauma Data Bank. The inclusion criterion was patients with severe trauma, as defined by an Injury Severity Score ≥ 16. Our primary outcome was the rate of recording all four basic vital signs, namely blood pressure, heart rate, respiratory rate, and level of consciousness in the prehospital setting among different age groups. We also compared the prehospital vital sign completion rate, that is, the rate at which all four vital signs were recorded in a prehospital setting based on age groups. Multivariate analysis was performed to evaluate factors associated with the prehospital vital sign completion rate.

Results

We analyzed 75,777 severely injured patients. Adults accounted for 94% (71400) of these severely injured patients, whereas only 6% of patients were children. The rate of prehospital recording of vital signs was lower in children ≤5 years than in adult patients for all four vital signs. When the adult group was used as a reference, the adjusted odds ratios of vital sign completion rate in infants (0 years), younger children (1–5 years), older children (6–11 years), and teenagers (12–17 years) were 0.09, 0.30, 0.78, and 0.87, respectively.

Conclusions

Analysis of the nationwide trauma registry showed that younger children tended to have a lower rate of vital sign documentation in prehospital settings.
Statistical methods and graphical displays of quality of life with survival outcomes in oncology clinical trials for supporting the estimand framework
Authors: Sakamaki Kentaro , Kawahara Takuya
Published: October 2022

Background

Although there are discussions regarding standards of the analysis of patient-reported outcomes and quality of life (QOL) in oncology clinical trials, that of QOL with death events is not within their scope. For example, ignoring death can lead to bias in the QOL analysis for patients with moderate or high mortality rates in the palliative care setting. This is discussed in the estimand framework but is controversial. Information loss by summary measures under the estimand framework may make it challenging for clinicians to interpret the QOL analysis results. This study illustrated the use of graphical displays in the framework. They can be helpful for discussions between clinicians and statisticians and decision-making by stakeholders.

Methods

We reviewed the time-to-deterioration analysis, prioritized composite outcome approach, semi-competing risk analysis, survivor analysis, linear mixed model for repeated measures, and principal stratification approach. We summarized attributes of estimands and graphs in the statistical analysis and evaluated them in various hypothetical randomized controlled trials.

Results

Graphs for each analysis method provide different information and impressions. In the time-to-deterioration analysis, it was not easy to interpret the difference in the curves as an effect on QOL. The prioritized composite outcome approach provided new insights for QOL considering death by defining better conditions based on the distinction of OS and QOL. The semi-competing risk analysis provided different insights compared with the time-to-deterioration analysis and prioritized composite outcome approach. Due to the missing assumption, graphs by the linear mixed model for repeated measures should be carefully interpreted, even for descriptive purposes. The principal stratification approach provided pure comparison, but the interpretation was difficult because the target population was unknown.

Conclusions

Graphical displays can capture different aspects of treatment effects that should be described in the estimand framework.
Neuromyelitis optica spectrum disease coexisting with subacute combined degeneration: a case report
Authors: Zeng Yixuan , Bai Runtao , Zhou Yanxia , Ren Lijie
Published: October 2022

Background

Subacute combined degeneration (SCD) is a demyelinating disease characterized by vitamin B12 deficiency related segmental degeneration of the dorsal or lateral columns of the spinal cord. However, few cases have been reported as a comorbidity of SCD and neuromyelitis optica spectrum disease (NMOSD).

Case presentation

Herein, we describe a female patient (61-year-old) who had sensory deficits, paresthesia, and weakness of the distal extremities for over 2 months. She then received an initial diagnosis of SCD with typical inverted “V-sigh” hyperintensities over the posterior aspect of the spinal cord in magnetic resonance imaging (MRI - T2-weighted imaging), as well as megaloblastic anaemia in blood examinations. From the past history, there was no evidence of a dietary deficiency or gastric abnormalities. However, traditional treatment with vitamin B12 supplementation was ineffective. Hence, a demyelinating antibody examination showed that she had antibodies targeting aquaporin 4 (AQP4) in both the cerebrospinal fluid and serum, leading to the diagnosis of NMOSD. Her clinical symptoms were obviously improved after treatment with intravenous glucocorticoids.

Conclusion

People who have nutritional deficiency or altered gastrointestinal function are more likely to develop SCD. This case raises the awareness that the poor therapeutic effects of simple vitamin B12 supplementation could be explained by immunoreactions against AQP4. A better recognition will be of great importance for the correct diagnosis of the comorbidity, as well as for essential treatment and even a better prognosis.
Early clinical course of biopsy-proven IgA vasculitis nephritis
Authors: Butzer Sarina , Hennies Imke , Gimpel Charlotte , Gellermann Jutta , Schalk Gesa , König Sabine , Büscher Anja K. , Lemke Anja , Pohl Martin
Published: October 2022

Background

IgA vasculitis (IgAV) is the most common form of systemic vasculitis in childhood and frequently involves the kidney. A minority of patients with IgA vasculitis nephritis (IgAVN), especially those presenting with heavy proteinuria and/or kidney failure at onset, are at risk of chronic end-stage kidney disease. For deciding upon treatment intensity, knowledge of the short-term clinical course of IgAVN is needed to improve treatment algorithms.

Methods

For this retrospective multicenter study, the medical records of 66 children with biopsy-proven IgAVN were reviewed. Age, gender, medical history and therapeutic interventions were recorded. Laboratory data included serum creatinine, albumin, urinary protein excretion (UPE) and glomerular filtration rate (eGFR). Threshold values were determined for each parameter, full remission was defined as no proteinuria and eGFR > 90 ml/min/1.73m2.

Results

Median age at onset of IgAVN was 8.9 years. 14.1% of the children presented with nephrotic syndrome, 50% had an eGFR below 90 ml/min/1.73 m2 and 51.5% showed cellular crescents in renal histology. The treatment regimens varied notably. Forty-four patients were treated with immunosuppression; 17 patients with crescents or nephrotic syndrome were treated with corticosteroid (CS) pulse therapy. After 6 months, UPE had decreased from 3.7 to 0.3 g/g creatinine and the proportion of patients with a decreased eGFR had fallen from 50.0% to 35.5%. Thirteen children (26.5%) achieved full remission within 6 months.

Conclusions

In most patients with IgAVN proteinuria decreases slowly and kidney function improves, but full remission is reached only in a minority after 6 months. Persistent heavy proteinuria in the first two months rarely developed into long-term proteinuria. Therefore, decisions for more intense treatment should take into account the course of UPE over time.

For a comparison of treatment effects, patient numbers were too small. Prospective, randomized controlled trials are necessary to clarify risk factors and the effect of immunosuppressive therapies.
Are changes in pain associated with changes in heart rate variability in patients treated for recurrent or persistent neck pain?
Authors: Bakken Anders Galaasen , Eklund Andreas , Warnqvist Anna , O’Neill Søren , Hallman David M. , Axén Iben
Published: October 2022

Background

Persistent or recurrent neck pain is associated with perturbations in the autonomic nervous system balance, and nociceptive stimulation has been seen to influence this balance. However, very few prospective studies have addressed the extent to which changes in pain associate with changes in autonomic cardiac regulation. Therefore, we investigated if changes in pain vary with changes in heart rate variability in a cohort of patients treated for persistent or recurrent neck pain.

Method

This analysis is based on data from a randomized controlled trial in which participants were given home stretching exercises with or without spinal manipulative therapy for two weeks. As the effectiveness of the intervention (home stretching exercises and spinal manipulative therapy) was found to be equal to the control (home stretching exercises alone), all 127 participants were studied as one cohort in this analysis. During the intervention, pain levels were recorded using daily text messages, and heart rate variability was measured in the clinics three times over two weeks. Two approaches were used to classify patients based on changes in pain intensity: 1) Clinically important changes in pain were categorized as either "improved" or "not improved" and, 2) Pain development was measured using pain trajectories, constructed in a data driven approach. The association of pain categories and trajectories with changes in heart rate variability indices over time were then analysed using linear mixed models.

Results

Heart rate variability did not differ significantly between improved and not-improved patients, nor were there any associations with the different pain trajectories.

Conclusions

In conclusion, changes in pain after home stretching exercises with or without spinal manipulative therapy over two weeks were not significantly associated with changes in heart rate variability for patients with persistent or recurrent neck pain. Future studies should rely on more frequent measurements of HRV during longer treatment periods.

Trial registration

The trial was registered at ClinicalTrials.gov, registration number: NCT03576846.
Fracture of the lateral process of the talus with associated deltoid ligament injury: a report of 2 cases
Authors: Jin Xiang-Yun , Xiao Wei-Yuan , He Tao , Dong Yu-Qi , Zhang Chao
Published: October 2022

Background

Fractures of the lateral process of the talus (LTPF) are rare and only rarely are associated ligamentous injuries. The injury mechanism is commonly considered to be similar with ankle sprains, where excessive varus of the hindfoot leads to avulsion fractures of the lateral process of the talus. However, previous cadaveric studies have suggested that LTPF was more likely to be caused by eversion or external rotation force with dorsiflexion of the ankle. But no clinical evidence has been provided.

Case presentation

Two patients presented to the emergency department with ankle pain after ankle eversion or external rotation. Physical examination revealed tenderness and swelling on both medial and lateral sides of the ankles. Plain radiographs and computed tomography revealed LTPF and medial soft tissue swelling, and magnetic resonance imaging confirmed a discontinuity of the deltoid ligament in Case 1. Surgical exploration revealed rupture of the superficial layer of the deltoid ligaments with intact deep layer in both patients. Treatment included fixation of the lateral process of the talus with headless compression screws and repair of deltoid ligaments. Both patients achieved excellent clinical outcomes 1 year post injury.

Conclusion

There are many possibilities of the injury mechanism of LTPF. These two cases provided clinical evidence that eversion or external rotation force, in addition to inversion, was also an important mechanism of LTPF.
Trainee doctors’ perceptions of the surgeon stereotype and its impact on professional identification: a qualitative study
Authors: Wainwright David , Harris Michael , Wainwright Elaine
Published: October 2022

Background

The demography of the medical profession is changing as more women join the workforce. Traditional assumptions about the personal qualities required to be a successful surgeon may change as more women join the specialty. While exploring the attitudes and beliefs of doctors in their second ‘Foundation’ year of post-graduate training (FY2) about their choice of specialty, evidence emerged about how the stereotype of the surgeon influences professional identification and beliefs about person-specialty fit.

Methods

Qualitative telephone interviews with 24 FY2 doctors, 17 women and 7 men, in South-West England.

Results

Many participants reported exposure to stereotypes about the personal qualities desirable in a surgeon. Senior doctors and other trainees were the primary source of these stereotypical views. Experience on surgical placements could either reinforce stereotypes or challenge them, the latter particularly where senior surgeons provided positive role models. As more women enter the surgical specialties, they are increasingly challenging the traditional stereotype and sub-culture.

Conclusion

Gendered stereotypes about surgical roles persist, and for some this can hinder professional identification with the role. Positive role models and mentoring can encourage and support women who are interested a surgical career to identify with the role, but there is a need for a broader debate encompassing job redesign and surgical identities.
Both indirect maternal and direct fetal genetic effects reflect the observational relationship between higher birth weight and lower adult bone mass
Authors: Xia Jiang-Wei , Zhang Lin , Li Jin , Yuan Cheng-Da , Zhu Xiao-Wei , Qian Yu , Khederzadeh Saber , Gu Jia-Xuan , Xu Lin , Gao Jian-Hua , Liu Ke-Qi , Karasik David , Xie Shu-Yang , Chen Guo-Bo , Zheng Hou-Feng
Published: October 2022

Background

Birth weight is considered not only to undermine future growth, but also to induce lifelong diseases; the aim of this study is to explore the relationship between birth weight and adult bone mass.

Methods

We performed multivariable regression analyses to assess the association of birth weight with bone parameters measured by dual-energy X-ray absorptiometry (DXA) and by quantitative ultrasound (QUS), independently. We also implemented a systemic Mendelian randomization (MR) analysis to explore the causal association between them with both fetal-specific and maternal-specific instrumental variables.

Results

In the observational analyses, we found that higher birth weight could increase the adult bone area (lumbar spine, β-coefficient= 0.17, P < 2.00 × 10−16; lateral spine, β-coefficient = 0.02, P = 0.04), decrease bone mineral content-adjusted bone area (BMCadjArea) (lumbar spine, β-coefficient= − 0.01, P = 2.27 × 10−14; lateral spine, β-coefficient = − 0.05, P = 0.001), and decrease adult bone mineral density (BMD) (lumbar spine, β-coefficient = − 0.04, P = 0.007; lateral spine; β-coefficient = − 0.03, P = 0.02; heel, β-coefficient = − 0.06, P < 2.00 × 10−16), and we observed that the effect of birth weight on bone size was larger than that on BMC. In MR analyses, the higher fetal-specific genetically determined birth weight was identified to be associated with higher bone area (lumbar spine; β-coefficient = 0.15, P = 1.26 × 10−6, total hip, β-coefficient = 0.15, P = 0.005; intertrochanteric area, β-coefficient = 0.13, P = 0.0009; trochanter area, β-coefficient = 0.11, P = 0.03) but lower BMD (lumbar spine, β-coefficient = − 0.10, P = 0.01; lateral spine, β-coefficient = − 0.12, P = 0.0003, and heel β-coefficient = − 0.11, P = 3.33 × 10−13). In addition, we found that the higher maternal-specific genetically determined offspring birth weight was associated with lower offspring adult heel BMD (β-coefficient = − 0.001, P = 0.04).

Conclusions

The observational analyses suggested that higher birth weight was associated with the increased adult bone area but decreased BMD. By leveraging the genetic instrumental variables with maternal- and fetal-specific effects on birth weight, the observed relationship could be reflected by both the direct fetal and indirect maternal genetic effects.
Metabolic control analysis enables rational improvement of E. coli l-tryptophan producers but methylglyoxal formation limits glycerol-based production
Authors: Schoppel Kristin , Trachtmann Natalia , Korzin Emil J. , Tzanavari Angelina , Sprenger Georg A. , Weuster-Botz Dirk
Published: October 2022

Background

Although efficientl-tryptophan production using engineeredEscherichia coliis established from glucose, the use of alternative carbon sources is still very limited. Through the application of glycerol as an alternate, a more sustainable substrate (by-product of biodiesel preparation), the well-studied intracellular glycolytic pathways are rerouted, resulting in the activity of different intracellular control sites and regulations, which are not fully understood in detail. Metabolic analysis was applied to well-known engineeredE. colicells with 10 genetic modifications. Cells were withdrawn from a fed-batch production process with glycerol as a carbon source, followed by metabolic control analysis (MCA). This resulted in the identification of several additional enzymes controlling the carbon flux tol-tryptophan.

Results

These controlling enzyme activities were addressed stepwise by the targeted overexpression of 4 additional enzymes (trpC,trpB,serB,aroB). Their efficacy regardingl-tryptophan productivity was evaluated under consistent fed-batch cultivation conditions. Although process comparability was impeded by process variances related to a temporal, unpredictable break-off inl-tryptophan production, process improvements of up to 28% with respect to thel-tryptophan produced were observed using the new producer strains. The intracellular effects of these targeted genetic modifications were revealed by metabolic analysis in combination with MCA and expression analysis. Furthermore, it was discovered that theE. colicells produced the highly toxic metabolite methylglyoxal (MGO) during the fed-batch process. A closer look at the MGO production and detoxification on the metabolome, fluxome, and transcriptome level of the engineeredE. coliindicated that the highly toxic metabolite plays a critical role in the production of aromatic amino acids with glycerol as a carbon source.

Conclusions

A detailed process analysis of a newl-tryptophan producer strain revealed that several of the 4 targeted genetic modifications of theE. colil-tryptophan producer strain proved to be effective, and, for others, new engineering approaches could be derived from the results. As a starting point for further strain and process optimization, the up-regulation of MGO detoxifying enzymes and a lowering of the feeding rate during the last third of the cultivation seems reasonable.
The recent advancements in the early detection of cancer biomarkers by DNAzyme-assisted aptasensors
Authors: Kamali Hossein , Golmohammadzadeh Shiva , Zare Hamed , Nosrati Rahim , Fereidouni Mohammad , Safarpour Hossein
Published: October 2022

Clinical diagnostics rely heavily on the detection and quantification of cancer biomarkers. The rapid detection of cancer-specific biomarkers is of great importance in the early diagnosis of cancers and plays a crucial role in the subsequent treatments. There are several different detection techniques available today for detecting cancer biomarkers. Because of target-related conformational alterations, high stability, and target variety, aptamers have received considerable interest as a biosensing system component. To date, several sensitivity-enhancement strategies have been used with a broad spectrum of nanomaterials and nanoparticles (NPs) to improve the limit and sensitivity of analyte detection in the construction of innovative aptasensors. The present article aims to outline the research developments on the potential of DNAzymes-based aptasensors for cancer biomarker detection.

Graphical Abstract
Preclinical development of carrier-free prodrug nanoparticles for enhanced antitumor therapeutic potential with less toxicity
Authors: Shim Man Kyu , Yang Suah , Park Jooho , Yoon Jun Sik , Kim Jinseong , Moon Yujeong , Shim Nayeon , Jo Mihee , Choi Yongwhan , Kim Kwangmeyung
Published: October 2022

Background

Nanomedicine has emerged as a promising strategy for cancer treatment. The most representative nanomedicine used in clinic is PEGylated liposomal doxorubicin DOXIL®, which is first FDA-approved nanomedicine. However, several shortcomings, such as low drug loading capacity, low tumor targeting, difficulty in mass production and potential toxicity of carrier materials, have hindered the successful clinical translation of nanomedicines. In this study, we report a preclinical development process of the carrier-free prodrug nanoparticles designed as an alternative formulation to overcome limitations of conventional nanomedicines in the terms of technical- and industrial-aspects.

Results

The carrier-free prodrug nanoparticles (F68-FDOX) are prepared by self-assembly of cathepsin B-specific cleavable peptide (FRRG) and doxorubicin (DOX) conjugates without any additional carrier materials, and further stabilized with Pluronic F68, resulting in high drug loading (> 50%). The precise and concise structure allow mass production with easily controllable quality control (QC), and its lyophilized powder form has a great long-term storage stability at different temperatures (− 4, 37 and 60 °C). With high cathepsin B-specificity, F68-FDOX induce a potent cytotoxicity preferentially in cancer cells, whereas their cytotoxicity is greatly minimized in normal cells with innately low cathepsin B expression. In tumor models, F68-FDOX efficiently accumulates within tumor tissues owing to enhanced permeability and retention (EPR) effect and subsequently release toxic DOX molecules by cathepsin B-specific cleavage mechanism, showing a broad therapeutic spectrum with significant antitumor activity in three types of colon, breast and pancreatic cancers. Finally, the safety of F68-FDOX treatment is investigated after single-/multi-dosage into mice, showing greatly minimized DOX-related toxicity, compared to free DOX in normal mice.

Conclusions

Collectively, these results provide potential preclinical development process of an alternative approach, new formulation of carrier-free prodrug nanoparticles, for clinical translation of nanomedicines.
Changes in physical activity after joining a bikeshare program: a cohort of new bikeshare users
Authors: Auchincloss Amy H. , Michael Yvonne L. , Niamatullah Saima , Li Siyu , Melly Steven J. , Pharis Meagan L. , Fuller Daniel
Published: October 2022

Background

There are hundreds of bikeshare programs worldwide, yet few health-related evaluations have been conducted. We enrolled a cohort of new bikeshare members in Philadelphia (Pennsylvania, USA) to assess whether within-person moderate and vigorous physical activity (MVPA) increased with higher use of the program and whether effects differed for vulnerable sub-groups.

Methods

During 2015–2018, 1031 new members completed baseline and one-year follow-up online surveys regarding their personal characteristics and past 7-day MVPA minutes per week (minutes per week with- and without walking). Participants were linked to their bikeshare trips to objectively assess program use. Negative binomial (for continuous outcomes) and multinomial (for categorical outcomes) regression adjusted for person characteristics (socio-demographics, health), weather, biking-infrastructure, and baseline biking.

Results

Participant median age was 30, 25% were of Black or Latino race/ethnicity, and 30% were socioeconomically disadvantaged. By follow-up, personal bike ownership increased and 75% used bikeshare, although most used it infrequently. Per 10 day change in past year (PY) bikeshare use, non-walking MVPA min/wk increased 3% (roughly 6 min/wk, P < 0.014). More days of bikeshare was also associated with change from inactive to more active (odds ratio for ≥ 15 days in PY vs. no bikeshare use 1.80, CI 1.05–3.09, P < 0.03). Results were consistent across vulnerable sub-groups. In general, impacts on MVPA were similar when exposure was personal bike or bikeshare.

Conclusions

Bikeshare facilitated increases in cycling, slightly increased non-walking MVPA, and showed potential for activating inactive adults; however, for larger program impact, members will need to use it more frequently.