bluuebunny/crossref_metadata_2025 huggingface dataset:
‘Excellent in Point of Both Music and Words’
Authors: Ó Laoire Lillis , Nic An Airchinnigh Méadhbh , Williams Sean
Published: August 2024

This chapter explores the musical elements of the ritualized lament or keen in Irish oral traditions, examining both the written record about keening and recordings by four performers of the twentieth century: Seán Ó Conghaile, Kitty Gallagher/Cití Ní Ghallchobhair, Elizabeth Cronin, and Joe Heaney, in an attempt to understand the music more fully. Keening is no longer an aspect of Irish life, but its musical and cultural contexts remain in the form of performance practices ascribed mainly to women. The authors compare both the form and content of these recorded items with some other protective recordings traditionally connected with women, including a lullaby, three religious laments, and a herding song for a cow, and note that the musical links provide insight into how keening relates to other forms. A fuller exploration of keening with music as a central focus is a strong desideratum.
The Limits of Transitional Justice in Settler Colonial Contexts
Authors: Hand Samara
Published: August 2024

Against the backdrop of the Australian reconciliation process, this chapter explores the limits of transitional justice, including critiques about its liberal origins and focus on addressing individual human rights violations, as well as its emphasis on a ‘rupture point’, which fail to grasp the ongoing nature of settler colonialism and its impacts on Indigenous peoples. The chapter provides an analysis of the challenges settler colonial violence poses to the dominant transitional justice framework, which is heavily grounded in international human rights law. It examines the disconnect between this framework and the realities of ongoing settler colonialism, highlighting the need for a more critical and comprehensive approach that challenges existing norms of international human rights law. The chapter concludes by charting new perspectives in transitional justice, informed by settler colonial, decolonial, and post-humanist theories which aim to integrate Indigenous knowledges and practices into transitional justice, thus challenging the established international norms dominating the field.
The European Mesolithic in Mountain Landscapes
Authors: Butler Micheál , Cornelissen Marcel , Nyland Astrid J. , Posch Caroline , Kelley Samuel E. , Warren Graeme
Published: August 2024

The use of mountain environments is a recurrent, although not universal, feature of the Mesolithic across Europe. However, synthesis of this material is rare. This means that it is difficult to assess whether regional variation in archaeological evidence is a product of different activities in the past, different research traditions, different post-depositional landscape histories, or—most likely—complex local combinations of all three. To help move past this problem, we provide a comparative approach to the mountain Mesolithic of Western Austria, Southern Norway, Scotland, and the Swiss Alps. For each region, we provide an overview of how sites have been found and what kinds of evidence is present. This allows us to present some comparable and contrasting aspects of the evidence at a European level. In turn, this perspective reinforces the importance of particular kinds of archaeological practice, especially in terms of survey and public engagement, and to highlight potential threats to this archaeological resource.
Ethnic Politics and Land Grabbing
Authors: Moreda Tsegaye
Published: August 2024

The role of land in capital accumulation has gained prominence over the past two decades, primarily in the wake of the unprecedented expansion of highly contested large-scale “land grabs” or “land investments” across the global South. This chapter argues that the phenomenon of land grabbing has impacted the social relations regulating land access and livelihoods, including by heightening ethnic tensions. This is even more the case in multiethnic settings where different groups have distinct land claims and access to and competition for land and power are deeply contested and often have an interethnic character. Land-related conflicts, particularly in the context of contemporary land grabs, have increasingly taken the form of politicized ethnic conflicts, pitching majority Indigenous ethnic groups against ethnic minorities. The chapter shows that the ethnicization of land politics and conflict at local and national levels is often linked to the broader political economy on a global scale. The dynamics of global land-based accumulation are simultaneously shaped and constituted by national accumulation trajectories and how the state facilitates them, resulting in uneven development among ethnic homelands and groups. Such accumulation dynamics on a global scale often intersect with, and further reinforce, the salience of ethnic-based land politics at the local level. Ethnicity is certainly a key determining factor in land access, but it is not the only one. The convergence between ethnicity and class that unfolds within state-society interactions is particularly fundamental to contemporary land politics and, thus, to land conflict.
The Americas and the United Nations
Authors: Quiroga-Villamarin Daniel R.
Published: August 2024

Scholarly accounts of the engagement between “America” and the United Nations (UN) have often taken two separate approaches. On the one hand, some scholars understand “America” as a synonym for the United States. As such, they interrogate the role of this country in the international organization as a great power embedded in a North Atlantic geopolitical context. On the other hand, another perspective foregrounds “Latin America”—focusing on the actions of the southern states as an example of the influence of “minor powers” in this international organization. Rarely, however, are the “Americas” taken in tandem. Conversely, this chapter provides an account of the UN that places hemispheric relations between these separate understandings of “the Americas” at the forefront of the narrative (1939–1973). Alluding to Hobsbawm’s famous quip on Latin America as a “laboratory of historical change,” this chapter suggests that the dreams and nightmares of continental “good neighborliness” served as a template for latter imaginaries of global ordering.
Reformation Perspectives on Mary Magdalene from Luther to Zwingli and Calvin
Authors: Tyra Steven W.
Published: August 2024

This chapter provides an overview of Reformation perspectives on Mary Magdalene from Martin Luther to Huldrych Zwingli and John Calvin. It primarily focuses on varieties of Magdalene’s interpretation in continental Protestantism to the 1560s. In each case of the Lutheran, Swiss, and French Reformed schools, Mary’s story was adapted to serve the theologies and anxieties of the leaders who presented her to their evangelical flocks. The chapter cites that only Calvin managed a largely negative portrayal, and his influence on the continental Reformed community seems to have been limited even among his immediate peers. Essentially, Mary Magdalene was a difficult voice to silence, and her example continued to resonate loudly in Protestant proclamation and piety.
Regional Organizations
Authors: Debre Maria J.
Published: August 2024

Do regional organizations support democratization or further authoritarian rule? Research indicates that membership in regional organizations can help consolidate democratic transitions, while more recent studies also point out the possible stabilizing effects for authoritarianism. This chapter reviews this question to synthesize what is known about the foundation, design, and effects of regional organizations. By surveying a broad set of literatures from different sub-disciplines, the chapter seeks to make three interrelated points. First, authoritarian regimes have founded many regional organizations since 1945, spanning most world regions. Second, relatively little is known about the design of authoritarian ROs, such as their institutional authority and decision-making procedures, as well as activities of ROs in security and financial matters. Third, several, often overlapping, mechanisms can explain how autocratic clubs help to sustain authoritarian rule, specifically increased domestic and international legitimation, transnational repression, and rent-seeking capacities. The chapter concludes by discussing the role of authoritarian regional organizations for the future of global governance.
Chlorophyll Degradation and Its Physiological Function
Authors: Tanaka Ayumi , Ito Hisashi
Published: August 2024

Research on chlorophyll degradation has progressed significantly in recent decades. In the 1990s, the structure of linear tetrapyrrole, which is unambiguously a chlorophyll degradation product, was determined. From the 2000s until the 2010s, the major enzymes involved in chlorophyll degradation were identified, and the pheophorbide a oxygenase/phyllobilin pathway was established. This degradation pathway encompasses several steps: (i) initial conversion of chlorophyll b to 7-hydroxymethyl chlorophyll a, (ii) conversion of 7-hydroxymethyl chlorophyll a to chlorophyll a, (iii) dechelation of chlorophyll a to pheophytin a, (iv) dephytylation of pheophytin a to pheophorbide a, (v) opening of the macrocycle to yield a red chlorophyll catabolite (RCC) and (vi) conversion of RCC to phyllobilins. This pathway converts potentially harmful chlorophyll into safe molecules of phyllobilins, which are stored in the central vacuole of terrestrial plants. The expression of chlorophyll-degrading enzymes is mediated by various transcription factors and influenced by light conditions, stress and plant hormones. Chlorophyll degradation is differently regulated in different organs and developmental stages of plants. The initiation of chlorophyll degradation induces the further expression of chlorophyll-degrading enzymes, resulting in the acceleration of chlorophyll degradation. Chlorophyll degradation was initially considered the last reaction in senescence; however, chlorophyll degradation plays crucial roles in enhancing senescence, degrading chlorophyll–protein complexes, forming photosystem II and maintaining seed quality. Therefore, controlling chlorophyll degradation has important agricultural applications.
Molecular interactions of the chaperone CcmS and carboxysome shell protein CcmK1 that mediate β-carboxysome assembly
Authors: Cheng Jin , Li Chun-Yang , Meng Meng , Li Jian-Xun , Liu Shu-Jun , Cao Hai-Yan , Wang Ning , Zhang Yu-Zhong , Liu Lu-Ning
Published: August 2024

The carboxysome is a natural proteinaceous organelle for carbon fixation in cyanobacteria and chemoautotrophs. It comprises hundreds of protein homologs that self-assemble to form a polyhedral shell structure to sequester cargo enzymes, ribulose 1,5-bisphosphate carboxylase/oxygenase (Rubisco), and carbonic anhydrases. How these protein components assemble to construct a functional carboxysome is a central question in not only understanding carboxysome structure and function but also synthetic engineering of carboxysomes for biotechnological applications. Here, we determined the structure of the chaperone protein CcmS, which has recently been identified to be involved in β-carboxysome assembly, and its interactions with β-carboxysome proteins. The crystal structure at 1.99 Å resolution reveals CcmS from Nostoc sp. PCC 7120 forms a homodimer, and each CcmS monomer consists of five α-helices and four β-sheets. Biochemical assays indicate that CcmS specifically interacts with the C-terminal extension of the carboxysome shell protein CcmK1, but not the shell protein homolog CcmK2 or the carboxysome scaffolding protein CcmM. Moreover, we solved the structure of a stable complex of CcmS and the C-terminus of CcmK1 at 1.67 Å resolution and unveiled how the CcmS dimer interacts with the C-terminus of CcmK1. These findings allowed us to propose a model to illustrate CcmS-mediated β-carboxysome assembly by interacting with CcmK1 at the outer shell surface. Collectively, our study provides detailed insights into the accessory factors that drive and regulate carboxysome assembly, thereby improving our knowledge of carboxysome structure, function, and bioengineering.
Collagen VI deposition primes the glioblastoma microenvironment for invasion through mechanostimulation of β-catenin signaling
Authors: Cha Junghwa , Ding Erika A , Carvalho Emily M , Fowler Annabelle , Aghi Manish K , Kumar Sanjay
Published: August 2024

While glioblastoma (GBM) progression is associated with extensive extracellular matrix (ECM) secretion, the causal contributions of ECM secretion to invasion remain unclear. Here we investigate these contributions by combining engineered materials, proteomics, analysis of patient data, and a model of bevacizumab-resistant GBM. We find that GBM cells cultured in engineered 3D hyaluronic acid hydrogels secrete ECM prior to invasion, particularly in the absence of exogenous ECM ligands. Proteomic measurements reveal extensive secretion of collagen VI, and collagen VI-associated transcripts are correspondingly enriched in microvascular proliferation regions of human GBMs. We further show that bevacizumab-resistant GBM cells deposit more collagen VI than their responsive counterparts, which is associated with marked cell-ECM stiffening. COL6A3 deletion in GBM cells reduces invasion, β-catenin signaling, and expression of mesenchymal markers, and these effects are amplified in hypoxia. Our studies strongly implicate GBM cell-derived collagen VI in microenvironmental remodeling to facilitate invasion.
Comparing Physical Activity and Exercise Experiences, Values, and Beliefs of Latino, Latina, and/or Latine People and Non-Latino, Non-Latina, and/or Non-Latine People With Parkinson Disease: A Qualitative Study
Authors: Colón-Semenza Cristina , Darbandsari Paria , Carolan Kelsi , Marquez David X , Gorin Amy
Published: August 2024

Objective

The objective of this study was to examine and compare the beliefs, values, experiences, and barriers to and facilitators of exercise in Latino/a/e (Latino, Latina, and/or Latine) people and non-Latino/a/e (non-Latino, non-Latina, and/or non-Latine) people with Parkinson disease (PD).

Methods

This study involved a qualitative research design with data collection via focus groups of Latino/a/e and non-Latino/a/e people with PD. A semistructured interview protocol was used, and a theoretical (social ecological model) thematic analysis was used for data analysis.

Results

Twenty-five individuals (15 non-Latino/a/e and 10 Latino/a/e) participated across 5 focus groups. While there were several common themes among both groups, 7 themes related to exercise in the management of PD were unique to Latino/a/e participants: generalized versus specific knowledge of exercise components; family can have both facilitating and impeding roles; finances influence access to exercise and physical therapy; prior emotional experiences related to exercise and PD affect the future use of exercise; group exercise can have both facilitating and impeding roles; availability and access to a variety of modes and stratification of exercise classes for people with PD facilitate exercise; and cultural beliefs and expectations can impede the use of exercise at the population level.

Conclusion

Latino/a/e people with PD have overlapping and unique themes related to the use of exercise. Distinctive factors must be addressed in physical activity interventions and during physical therapists’ care of people with PD to maximize the use of exercise and ultimately improve health equity in this overburdened and underserved population.

Impact

Physical therapists should provide information and education to their Latino/a/e patients with PD and family members on the frequency, intensity, type, and time of exercise and how to safely participate in physical activity in the home and community to best manage PD. Physical therapists and exercise professionals should work at the environmental level to increase access to affordable, culturally tailored, PD-specific exercise services and enhance community knowledge of PD.
The role of 25-OH vitamin D in Alzheimer’s disease through Mendelian randomization and MRI
Authors: Fu Ling-Ling , Vollkommer Tobias , Fuest Sandra , Gosau Martin , Feng Hongchao , Yan Ming , Smeets Ralf , Burg Simon , Friedrich Reinhard E
Published: August 2024

Introduction

The mechanism underlying the relationship between Alzheimer’s disease (AD) and minerals (serum calcium, copper, iron, magnesium, zinc), vitamins (25-OH vitamin D, vitamin A1 [retinol], B9 [folic acid], B12, C) is unclear.

Methods

In a two-step Mendelian randomization analysis, the association between positive nutritional elements and 3935 magnetic resonance images (MRI) phenotypes was examined, and the mediation proportion was calculated. Horizontal pleiotropy and heterogeneity of MR were assessed using MR-Egger, Cochran’s Q test, MR-PRESSO. RESULTS: 25-OH vitamin D (P = 0.0019, OR = 0.6179, 95% CI = 0.4562–0.8368, inverse weighted variance [IVW]) is negatively associated with AD among 10 nutrients. The mediation proportion of the effect of vitamin D on AD mediated by IDP_dMRI_TBSS_L3_Superior_fronto-occipital_fasciculus_L was ∼7.08%.

Discussion

Our results support 25-OH vitamin D as a causal protective factor for Alzheimer disease. It was found that the Superior_fronto-occipital_fasciculus_L may play a minimal mediating role.
Incidence of chronic recurrent multifocal osteomyelitis in children and adolescents in the UK and Republic of Ireland
Authors: Chia Daphne Theresa , Toms Andoni Paul , Sanghrajka Anish , Ramanan Athimalaipet V , Killeen Orla G , Ilea Cristina , Mahmood Kamran , Compeyrot-Lacassagne Sandrine , Bailey Kathryn , Martin Neil , Armon Kate , Suo Chenqu
Published: August 2024

Objectives

Chronic recurrent multifocal osteomyelitis (CRMO), also known as chronic non-bacterial osteomyelitis (CNO), is a rare autoinflammatory condition affecting the bones in children and teenagers. The actual incidence of CRMO remains uncertain. The objective of this study was to identify the incidence of CRMO in children and young people under the age of 16 years in the United Kingdom (UK) and Republic of Ireland (ROI). We also aimed to delineate the demographics, clinical presentation, investigations, initial management and healthcare needs for children and adolescents with CRMO.

Methods

We conducted monthly surveys among all paediatric consultants and paediatric orthopaedic surgeons to identify patients newly diagnosed with CRMO between October 2020 and November 2022. A standardized questionnaire was sent to reporting clinicians to collect further information.

Results

Over the surveillance period, 288 patients were reported, among which, 165 confirmed and 20 probable cases were included in the analysis. The highest incidences were among 8–10 year-olds. A two-to-one female-to-male difference in incidence was observed, and male patients were more likely to present with multifocal disease. A negative correlation was observed between reporting clavicular and leg pain. Investigation-wise, 80.0% of patients were reported to have undergone whole-body MRI and 51.1% had bone biopsies. The most common initial treatments were NSAIDs (93.9%) and bisphosphonates (44.8%).

Conclusion

This study estimates an average annual CRMO incidence of 0.65 cases per 100 000 children and adolescents in the UK and ROI. These findings establish a crucial baseline for ongoing research and improvement in the care of individuals with CRMO.
Rheumatoid arthritis and the risk of ischaemic stroke after diagnosis of atrial fibrillation: a Norwegian nationwide register study
Authors: Kerola Anne M , Ikdahl Eirik , Engebretsen Ingrid , Bugge Christoffer , Semb Anne Grete
Published: August 2024

Objectives

RA patients have an increased risk for cardiovascular diseases, including atrial fibrillation (AF), but the impact of RA on ischaemic stroke risk in the context of AF remains unknown. We explored whether the risk of ischaemic stroke after diagnosis of AF is further increased among patients with RA compared with non-RA patients.

Methods

In the nationwide Norwegian Cardio-Rheuma Register, we evaluated cumulative incidence and hazard rate of ischaemic stroke after the first AF diagnosis (2750 individuals with RA and 158 879 without RA between 2010 and 2017) by using a competing risk model with a 3-month delayed entry.

Results

The 5-year unadjusted cumulative incidence of ischaemic stroke was 7.3% (95% CI: 5.9–8.7%) for patients with RA and 5.0% (95% CI: 4.9–5.2%) for patients without RA. Unadjusted univariate analyses indicated that AF patients with RA had a HR of 1.36 (95% CI: 1.13, 1.62) for ischaemic stroke compared with those without RA. Sex- and age-adjusted HR for ischaemic stroke in RA patients with AF was 1.25 (95% CI: 1.05, 1.50), and the effect size remained unchanged after adjustment for diabetes, hypertension, atherosclerotic cardiovascular disease and oral anticoagulant (OAC) treatment. RA patients were less likely to receive OAC treatment than non-RA patients (adjusted odds ratio 0.88, 95% CI: 0.80, 0.97).

Conclusion

RA patients diagnosed with AF are at a further increased risk for stroke compared with non-RA patients with AF, and less likely to receive OAC treatment, emphasizing the need to improve stroke prevention in AF patients with RA.
On the valuation skills of corporate bond mutual funds
Authors: Cici Gjergji , Zhang Pei (Alex)
Published: August 2024

The corporate bond market is larger, more illiquid, and presumably less efficient than the equity market. These features provide numerous profit opportunities for corporate bond mutual funds that are unique to the corporate bond market. However, whether corporate bond mutual funds have the valuation skills needed to take advantage of these opportunities is unclear. We introduce a novel measure to assess the valuation skills of investment-grade corporate bond mutual funds, which we refer to as the valuation accuracy score (VAS). VAS recognizes funds holding more underpriced and less overpriced corporate bonds as ex-ante having better valuation skills. It predicts future fund performance, is stable over time, and is unrelated to other sources of skill. Investors chase the performance of higher-VAS funds more aggressively and exhibit a convex flow–performance relation among these funds.
Impact of NPSR1 gene variation on the neural correlates of phasic and sustained fear in spider phobia—an imaging genetics and independent replication approach
Authors: Leehr Elisabeth J , Brede Leonie S , Böhnlein Joscha , Roesmann Kati , Gathmann Bettina , Herrmann Martin J , Junghöfer Markus , Schwarzmeier Hanna , Seeger Fabian R , Siminski Niklas , Straube Thomas , Klahn Anna Luisa , Weber Heike , Schiele Miriam A , Domschke Katharina , Lueken Ulrike , Dannlowski Udo
Published: August 2024

The functional neuropeptide S receptor 1 (NPSR1) gene A/T variant (rs324981) is associated with fear processing. We investigated the impact of NPSR1 genotype on fear processing and on symptom reduction following treatment in individuals with spider phobia. A replication approach was applied [discovery sample: Münster (MS) nMS = 104; replication sample Würzburg (WZ) nWZ = 81]. Participants were genotyped for NPSR1 rs324981 [T-allele carriers (risk) versus AA homozygotes (no-risk)]. A sustained and phasic fear paradigm was applied during functional magnetic resonance imaging. A one-session virtual reality exposure treatment was conducted. Change of symptom severity from pre to post treatment and within session fear reduction were assessed. T-allele carriers in the discovery sample displayed lower anterior cingulate cortex (ACC) activation compared to AA homozygotes independent of condition. For sustained fear, this effect was replicated within a small cluster and medium effect size. No association with symptom reduction was found. Within-session fear reduction was negatively associated with ACC activation in T-allele carriers in the discovery sample. NPSR1 rs324981 genotype might be associated with fear processing in the ACC in spider phobia. Interpretation as potential risk-increasing function of the NPSR1 rs324981 T-allele via impaired top-down control of limbic structures remains speculative. Potential association with symptom reduction warrants further research.
Diversity and directionality: friends or foes in sustainability transitions?
Authors: Bulah Brit M , van Mierlo Barbara , Beumer Koen , Gerritsen Alwin L , Negro Simona O , Hekkert Marko P , Klerkx Laurens
Published: August 2024

Literature on mission-specific innovation systems (MIS) highlights the crucial role of directionality when achieving sustainability transitions, while diversity literature emphasizes the need to keep diverse directions open. Like directionality, diversity is created by innovation system actors to tackle the complex and uncertain nature of transitions. While these two literature strands are presented largely independent of one another, both are deemed necessary to achieve sociotechnical transitions. We thus aim to uncover how diversity and directionality unfold in parallel in a MIS. We conduct a qualitative single-case study of the Wageningen alternative protein ecosystem to provide insights into the types of sociotechnological trajectories actors pursue and how different selection environments shape the development of each solution. We observe a mission exhibiting a clear direction toward (meat) substitutes. Underlying this mission, diversity is visible. We propose that the interplay between diversity and directionality in a MIS can be best understood by distinguishing two different sociotechnical “levels” in which they play out: the levels of transition paths (“first-order” directionality) and search directions (“second-order” directionality). We therefore call for a more nuanced understanding of the role of diversity and directionality in transitions.
Effects of turmeric, ginger, cinnamon, and garlic essential oils on HSP70, NFκB, oxidative DNA damage, inflammatory cytokines, and oxidative markers in broiler chickens
Authors: Jimoh Olatunji Abubakar , Ayodele Ayoola Doris , Ojo Olayinka Abosede , Okin-Aminu Hafsat Ololade , Olarotimi Olumuyiwa Joseph
Published: August 2024

In recent years, the use of natural bioactive compounds derived from spices has garnered significant interest in poultry production due to their potential to modulate immune responses and oxidative stress. An investigation into the roles of spices essential oils (EO) on inflammatory cytokines, HSP70 and oxidative markers of broiler chickens was conducted in this study. Four spices consisting of garlic, ginger, turmeric, and cinnamon were processed to obtain their respective EO. Two hundred 1-d-old arbo acre broilers were allotted to 5 treatments consisting of B1 (control), B2 (garlic EO), B3 (ginger EO), B4 (Turmeric EO), and B5 (cinnamon EO), with EOs administered to drinking water at 30% (v/v) in a 49-d trial. Blood was sampled for assessment of hematological parameters, and serum obtained were assayed for inflammatory cytokines, antioxidant activities, nuclear factor kappa B (NFκB), 8-hydroxydeoxyguanosine (8-OHdG), and heat shock protein 70 (HSP70) levels using standard procedures. Results obtained revealed that cinnamon EO enhanced erythrocytic indices, leukocyte profile, catalase, glutathione peroxidase and interleukin 10, lowers interleukin 1 beta (IL-1β) and interferon gamma (IFN-γ), enhanced HSP70 and higher 8-OHdG levels in chicken. Garlic EO enhanced monocytes and superoxide dismutase, while reduced IFN-γ and HSP70, but increased IL-1β and tumor necrosis factor alpha (TNF-α) NFκB in broiler chickens. Ginger EO also enhanced erythrocytic indices, total antioxidant activity, lowered IFN-γ and lipid peroxidation, while turmeric EO enhanced total antioxidant activity, catalase and lowered IFN-γ and increased 8ohdg in broiler chickens. In conclusion, this study revealed that ginger and turmeric EO were more beneficial in preventing oxidative DNA damage, cinnamon EO enhanced serum oxidative status and lowered pro-inflammatory cytokines, while garlic EO reduced HSP70 in broiler chickens.
Effects of an Avatar-Based Simulation on Family Nurse Practitioner Students’ Self-Evaluated Suicide Prevention Knowledge and Confidence
Authors: Bryant Rebecca , Vogt Marjorie , Miller Char
Published: August 2024

Family nurse practitioners (FNPs) are often gatekeepers and can recognize the warning signs of suicidality yet may lack adequate education or self-confidence in identifying people in crisis. The purpose of this research was to evaluate the effectiveness of an online suicide prevention simulation with 53 FNP students. Pre/post responses were found to be statistically significant across all preparedness and attitudinal items following the Kognito© training (p < .001). Online, avatar-based suicide prevention training with FNP students may be effective in improving participants’ perceived preparedness and self-confidence with patients at risk for suicidality.
Immunosenescence and its related comorbidities in older people living with HIV
Authors: He Xiao-Yan , Wang Xiu-Wen , Li Shuang , Li Na , Li Wei , Hu Yan , Guo Na , Zheng Yong-Tang , Zheng Hong-Yi , Su Bin
Published: August 2024

With the aging of the global population, older people living with HIV (OPLWH) have emerged as a focal point in HIV/AIDS research. Although antiretroviral therapy has demonstrated positive effects in OPLWH, concerns persist regarding overall poor immune reconstitution and elevated rates of age-related comorbidities, such as cardiovascular disease, bone disease, and cognitive impairment. This review aims to elucidate the mechanisms underlying immunosenescence and the interaction of immunosenescence with HIV infection, further exploring its role in the pathogenesis of HIV infection during aging. Aging-induced involution of the immune system, along with chronic inflammation and infection, can induce immunosenescence, leading to immune dysfunction that impairs the effective control of HIV infection. In addition, HIV infection induces immunosenescence through persistent inflammation and immune activation, even under treatment. The combined effects of aging and HIV infection accelerate the progression of immunosenescence in OPLWH, increasing their susceptibility to multiple age-related diseases. The unfavorable prognosis observed among OPLWH is largely attributed to increased levels of immunosenescence. A comprehensive understanding of the relationship between immunosenescence and HIV infection is crucial for developing targeted therapeutic strategies for this vulnerable population.
Perioperative hypothermia and stress jeopardize antimetastatic immunity and TLR-9 immune activation: potential mediating mechanisms (experimental studies)
Authors: Sandbank Elad , Matzner Pini , Eckerling Anabel , Sorski Liat , Rossene Ella , Nachmani Ido , Ben-Eliyahu Shamgar
Published: August 2024

Background:

The perioperative period often involves stress responses and surgery-induced hypothermia, which were suggested to hinder antimetastatic immunity and promote cancer metastasis. During this critical period, immunotherapies are rarely used, given contraindications to surgery. However, recent preclinical studies support the feasibility of perioperative TLR-9 activation using CpG-C.

Materials and methods:

Herein, we employed hypothermic-stress and normothermic-stress paradigms to assess their impact on perioperative CpG-C immune stimulation and resistance to experimental hepatic metastasis of CT26 colorectal cancer in BALB/c mice.

Results:

Perioperative hypothermic wet-cage stress markedly abrogated CpG-C-induced increase in plasma IL-12 levels, a persistent deleterious effect across different CpG-C doses and administration routes. These effects were not attenuated by blocking glucocorticoids, adrenergic, or opioid signaling, nor by adrenalectomy, suggesting a direct immunosuppressive impact of hypothermia on immunocytes. Indeed, normothermic wet-cage stress, which induced a similar corticosterone response, caused significantly less deleterious effects on IL-12 levels, hepatic NK cell maturation and cytotoxicity, and CT26 metastasis. Additionally, in-vitro exposure of PBMCs to 33°C markedly decreased CpG-C-induced IL-12 production. Last, two normothermic stress paradigms, tilt&light and restraint, did not jeopardize CpG-C-induced IL-12 response nor resistance to CT26 metastases. Interestingly, attenuating glucocorticoid signaling under tilt&light conditions improved CpG-C efficacy.

Conclusions:

Overall, these findings suggest that perioperative hypothermic stress can jeopardize antimetastatic immunity and resistance to metastasis, and prevent perioperative response to immune stimulation and its beneficial antimetastatic impacts, effects that are not mediated through classical neuroendocrine stress responses, but potentially through direct hypothermic impact on leukocytes. These findings may have clinical implications in operated cancer patients, many of whom suffer hypothermic stress.
Tympanic Membrane Regeneration Therapy for Pediatric Tympanic Membrane Perforation
Authors: Kanemaru Shin-ichi , Kita Shin-ichiro , Kanai Rie , Yamaguchi Tomoya , Kumazawa Akiko , Yuki Ryohei , Yoshida Misaki , Miwa Toru , Harada Hiroyuki , Maetani Toshiki
Published: August 2024

Objective

To evaluate tympanic membrane regeneration therapy (TMRT) for pediatric tympanic membrane perforations (TMPs).

Study Design

Intervention study.

Setting

Research institute hospital.

Patients

In this study, 20 patients with chronic TMP (M/F: 13/7, 13/8 ears, age 0–15 years) treated with TMRT were evaluated. As comparison, 20 pediatric patients with chronic TMP who underwent myringoplasty/tympanoplasty were included.

Interventions

For the TM repair procedure, the edge of the TMP was disrupted mechanically, and gelatin sponge immersed in basic fibroblast growth factor was placed inside and outside the tympanic cavity and covered with fibrin glue. The TMP was examined 4 ± 1 weeks later. The protocol was repeated up to four times until closure was complete.

Main Outcome Measures

Closure of the TMP and hearing improvement were evaluated at 16 weeks after the final regenerative procedure. Adverse events were monitored.

Results

The mean follow-up period was 427.1 days. The TM regenerated in all cases, but pinhole reperforation occurred in two cases, and the final closure rate was 90.5% (19 of 21). Hearing improved to 24.9 ± 7.6 dB on average before surgery and to 13.8 ± 5.4 dB after surgery. The AB gap improved from 12.9 ± 8.0 to 5.2 ± 3.5 dB.

The myringoplasty/tympanoplasty group had significantly lower AB gap improvement compared with the TMRT group. There were no adverse events.

Conclusions

TMRT can be expected to regenerate near-normal TMs with a high closure ratio, resulting in better-hearing improvement compared with the myringoplasty/tympanoplasty group, and is an effective treatment for children with long life expectancy.
Endolymphatic Sac Tumors Associated With von Hippel–Lindau: A Case Report Highlighting Opportunity for Novel Orphan Drug Therapy
Authors: Tan Donald , Fujiwara Rance J.T. , Tan Christopher , Isaacson Brandon , Hunter Jacob B.
Published: August 2024

Objective

To discuss the potential benefit of belzutifan therapy in a patient with von Hippel–Lindau (VHL) disease–associated endolymphatic sac tumor (ELST).

Patients

Case report.

Interventions

Clinical details of a patient with residual ELST after hearing preservation surgery who initiated belzutifan therapy postoperatively for concurrent renal cell carcinoma, as well as literature review of belzutifan and ELST.

Main Outcome Measures

The patient remained without radiologic evidence of growth of her residual tumor at 17 months post-initiation of belzutifan. It is unknown whether this represents therapeutic drug effect, nonviability of residual tumor, or slow tumor growth not captured radiographically within the duration of follow-up.

Conclusions

Belzutifan could have direct therapeutic benefit in patients with VHL-associated ELST.
Use of glucagon-like-peptide 1 receptor agonist in the treatment of childhood obesity
Authors: Kavarian Patil N. , Mosher Tierra L. , Abu El Haija Marwa
Published: August 2024

Purpose of review

Pediatric obesity is a growing epidemic. Lifestyle modifications remain central to obesity treatment, however pharmacologic options have gained traction, particularly glucagon-like peptide-1 receptor agonists (GLP-1RA). This review aims to summarize evidence on the use of GLP-1RAs in the management of pediatric obesity, physiological mechanisms of action of GLP-1RAs and their role in appetite regulation and glucose homeostasis and address the challenges and special considerations surrounding GLP-1RA use.

Recent findings

Recent studies have highlighted the efficacy of GLP-1RAs, such as exenatide, liraglutide, and semaglutide, in promoting weight loss and improving metabolic parameters in children and adolescents. GLP-1RA's efficacy extends beyond glycemic control to include weight loss mechanisms such as delayed gastric emptying (gastroparesis), and appetite suppression. Semaglutide, the newest GLP-1RA, holds potential for substantial weight loss in adolescents and demonstrates a similar safety and efficacy as seen in adults.

GLP-1RAs may offer a promising adjunct therapy for pediatric obesity, particularly in cases where lifestyle interventions alone are insufficient. However, further research is needed to elucidate long-term safety and efficacy outcomes and to address potential disparities in access to care. Overall, this review highlights the relevance and timeliness of incorporating GLP-1RAs into the comprehensive management of pediatric obesity.
Unraveling the spectrum of airway complications following lung transplantation: a comprehensive overview
Authors: Dhanani Zehra , Criner Rachel , Criner Gerard J.
Published: August 2024

Purpose of review

This review delves into the intricate landscape of airway complications post lung transplantation. With the rising prevalence of end-stage lung disease and the increasing number of lung transplantation worldwide, understanding and effectively managing airway complications are crucial. Given the nuanced nature of these complications and the array of treatment options available, this review aims to provide a comprehensive overview of how to identify, classify, mitigate risk factors for, and manage these complications.

Recent findings

Several donor, recipient, and surgical risk factors are associated with the increased risk of airway complications. In managing these complications, bronchoscopic interventions, notably balloon dilation and stenting, are pivotal. Although self-expanding metallic stents offer versatility, silicone stents are preferred in certain scenarios for their durability. Emerging techniques such as biodegradable stents and advancing imaging modalities show promise in mitigating complications and improving outcomes.

These findings underscore the significance of a multidisciplinary approach and personalized treatment algorithms in managing airway complications post lung transplantation. By elucidating specific indications and complications of treatment modalities, this review serves as a valuable resource for optimally managing airway complications. Ongoing research into novel interventions holds promise for further enhancing outcomes in this challenging clinical setting.
Comparison of the effect of use of preoperative mexiletine tablets and control on reducing postoperative pain in patients undergoing abdominal surgery
Authors: Saadat Fakhr Masoud , Jadididavodabadi Abolfazl , Rezvanfar Kiana , Amini Zahra , Amiri Koosha , Narimani Zamanabadi Mahnaz
Published: August 2024

Objective:

Postoperative pain is a major concern for patients and healthcare providers following abdominal surgery. This study aimed to compare the effectiveness of mexiletine in reducing postoperative pain in patients undergoing abdominal surgery.

Methods:

In this double-blind randomized controlled trial, 34 patients were divided into two groups. One group received 600 mg of mexiletine tablets, while the other group received vitamin C tablets (control) two hours before surgery. Postoperative pain levels were assessed at 6, 12, and 24 h by using the Visual Analog Scale (VAS). Additionally, the amount of narcotics received within the first 24 h after surgery was recorded.

Results:

The results showed that the average postoperative pain score in patients who received mexiletine was significantly lower than in those who received vitamin C tablets (P<0.001). Furthermore, the average amount of narcotics received after surgery was significantly lower in the mexiletine group compared to the control group (P=0.03). Pain scores at 6, 12, and 24 h after surgery were also significantly lower in the mexiletine group (P<0.001).

Conclusion:

Mexiletine was effective in reducing postoperative pain and the need for narcotics in patients undergoing abdominal surgery. This study highlights the potential of mexiletine as a valuable preoperative intervention for postoperative pain management.
Mesenchymal stem cells suppress inflammation by downregulating interleukin-6 expression in intestinal perforation animal model
Authors: Setiawan Eko , Putra Agung , Nabih Dimas Irfan , Ovaditya Shafira Zahra , Rizaldy Rheza
Published: August 2024

Introduction:

Intestinal perforation has significant fatality due to sepsis contamination and prolonged inflammation. Studies showed that mesenchymal stem cells (MSCs) secreted cytokines and growth factors to reduce inflammation. This study aims to reveal the role of MSCs in controlling inflammation in intestinal perforation wound healing by measuring interleukin-6 (IL-6) and leukocytes in injured tissue.

Materials and methods:

A total of 48 rat models with a 10-mm longitudinal incision at the small intestine were divided into four groups: sham, control, Treatment group 1 (T1) injected with MSC doses of 1.5×106 cells and Treatment group 2 (T2) with 3×106 cells. IL-6 expressions were determined using western blot analysis, whereas the leukocyte infiltrations were assessed using the histopathological examination. All variables were evaluated on day 3 and 7.

Results:

Leukocyte infiltration is significantly lower in T1 and T2 compared to control group in day 3 and 7 (P<0.05), while there were no differences between the two treatment groups. The expression of IL-6 was found to be significantly lower in the T1 and T2 groups compared to the control group on days 3 and 7 (P<0.05), with no significant differences observed between the two treatment groups.

Conclusion:

MSCs administration in rats with intestinal perforation reduced inflammation by controlling leukocyte infiltration and IL-6 expression.
Socio-economic factors and rural-urban differences in patients undergoing emergency laparotomy
Authors: Pouke Anne , Ylimartimo Aura , Nurkkala Juho , Lahtinen Sanna , Koskela Marjo , Vakkala Merja , Kaakinen Timo , Raatiniemi Lasse , Liisanantti Janne
Published: August 2024

Background:

Emergency laparotomy (EL) is a common surgical procedure with high rates of mortality and complications. Socio-economic circumstances and regional differences have an influence on the utilization of care and outcomes in many diagnostic groups, but there are only a few studies focusing on their effect in EL population. The aim of this study was to examine the socio-economic and regional differences in the rate of EL within one tertiary care hospital district.

Methods:

Retrospective single-center study of 573 patients who underwent EL in Oulu University Hospital between May 2015 and December 2017. The postal code area of each patient’s home address was used to determine the socio-economic status and rurality of the location of residence.

Results:

The age-adjusted rate of EL was higher in patients from low-income areas compared to patients from high-income areas [1.46 ((95% CI 1.27–1.64)) vs. 1.15 (95% CI, 0.96–1.34)]. The rate of EL was higher in rural areas compared to urban areas [1.29 (95% CI 1.17–1.41 vs. 1.42 (1.18–1.67)]. Peritonitis was more common in patients living in low-income areas. There were no differences in operation types or mortality between the groups.

Conclusions:

The study findings suggest that there are socio-economic and regional differences in the need of EL. The patients living in low-income areas had a higher rate of EL and a higher rate of peritonitis. These differences cannot be explained by patient demographics or comorbidities alone.
Management of non-lesional super-refractory status epilepticus: a rare case report
Authors: Albalawi Rawan , Aljthalin Raseel , Khan Sonia , Fouly Raghad , Alshahrani Mohammed , Alsahli Hamoud , Alhashemi Moustafa
Published: August 2024

Introduction and importance:

Super-refractory status epilepticus is defined as status epilepticus that continues or recurs 24 h or more after the initiation of anesthetic therapy(continuum), a serious medical emergency with a potential for significant morbidity and mortality. Cortisectomy with invasive EEG recording electrocorticography (ECoG) can be a successful treatment option for super-refractory status epilepticus in selected cases after medical management has failed.

Case presentation:

The authors present a case of a young lady who suffered a super-refractory status epilepticus and failed five different anti-seizure medications, coma-producing agents, IVIG. After failure of multiple medical and sedative therapy cortisectomy was done with the use of invasive EEG recording electrocorticography (ECoG) to tailor and localize the epileptogenic zone.

Clinical discussion:

When dealing with status epilepticus (SE) that is refractory to treatment, early surgical intervention should be taken into consideration as a viable option. Although there are only a few published cases of SE treated with epilepsy surgery, these cases have shown positive outcomes. In fact, one study demonstrated a significant improvement in seizure control for patients with SE who underwent surgical treatment using these techniques.

Conclusion:

Cortisectomy, which is a rare and invasive procedure, could be considered as a potential treatment for patients who have not responded to multiple medical and sedative therapies.
Reducing Diarrhea in Critically Ill Patients Receiving Enteral Nutrition Support
Authors: He Mei , Wang Ying , Wang Hui , Wang Mei , Du Mei J. , Xiong Jie , Li Chun L. , Huang Shu , Zhang Xin Y.
Published: August 2024

Background:

Diarrhea during enteral nutrition may induce various complications and increase the nursing workload.

Local Problem:

The diarrhea rate in our intensive care units (ICUs) was 37.14% from May to July 2021. Nurses reported a moderate to heavy burden regarding care for those with diarrhea.

Methods:

A pre-post implementation design was used to evaluate the impact of evidence-based interventions for diarrhea screening and prevention.

Interventions:

A diarrhea risk screening tool and countermeasures were developed through an extensive literature review. Tools were integrated into the electronic health record system.

Results:

The rate of diarrhea decreased from 37.14% to 17.33% (P = .000). Nurse’s compliance with practice standards increased for diarrhea assessment, risk factor screening, agent choice, and countermeasures provision (P < .05).

Conclusions:

The evidence-based tools developed for this project helped decrease the diarrhea rate in our ICUs.