bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-Term Administration of Anthraquinone Rhein on Induction of Constipation in Sprague-Dawley Rats via SCF/c-Kit Signaling Pathways
Authors: Zhang Bo , Huo Mingdong , Chen Zhicheng , Gao Feng , Liu Yan , Zhou Xingxin
Published: April 2021

Background and Study Aims. It has been shown that abuse of laxatives is becoming a serious problem; therefore, a comprehensive understanding of its effect and possible mechanism on colon motility is essential to select effective treatments and avoid their abuse. Herein, we aimed to investigate the long-term stimulation of rhein on induction of constipation in rats and its underlying mechanisms. Materials and Methods. After establishing rat models of constipation, the rats were randomly divided into two equal subgroups and administered daily with normal saline (model control group) or 10 ml/kg PEG4,000 (PEG-treated group). Simultaneously, normal Sprague-Dawley (SD) rats were administered with normal saline (normal group). Physiological and fecal parameters were calculated, and intestinal transmission function was evaluated. After scarification, colonic tissues were freshly prepared for histological localization detected by immunohistochemical analysis and for the expression of stem cell factor (SCF) and c-kit proteins determined by western blot assay. Results. Following the initiation of rhein-induced rat constipation, body weight was lost slightly, the first time of black stool discharge was obviously longer, and the fecal moisture and number of fecal pellets decreased distinctly as compared with normal group. A decreased expression of SCF and c-kit was detected in model control group in comparison with normal group. Notably, compared with model control group, neither the alterations of fecal parameters and intestinal transmission function were effectively restored, nor the expression of SCF and c-kit was markedly elevated after administration of PEG4,000 for 30 d. Conclusion. Long-term stimulation of rhein can develop the constipation via SCF/c-kit signaling pathway, yet the symptoms of constipation and colon power cannot be alleviated or restored by PEG4,000. Collectively, these findings strongly suggest that long-term use of anthraquinone laxatives should be avoided for clinical treatment of constipation.
Abnormal Default-Mode Network Homogeneity in Melancholic and Nonmelancholic Major Depressive Disorder at Rest
Authors: Yan Meiqi , Cui Xilong , Liu Feng , Li Huabing , Huang Renzhi , Tang Yanqing , Chen Jindong , Zhao Jingping , Xie Guangrong , Guo Wenbin
Published: April 2021

Background. Melancholic depression has been assumed as a severe type of major depressive disorder (MDD). We aimed to explore if there were some distinctive alterations in melancholic MDD and whether the alterations could be used to discriminate the melancholic MDD and nonmelancholic MDD. Methods. Thirty-one outpatients with melancholic MDD, thirty-three outpatients with nonmelancholic MDD, and thirty-two age- and gender-matched healthy controls were recruited. All participants were scanned by resting-state functional magnetic resonance imaging (fMRI). Imaging data were analyzed with the network homogeneity (NH) and support vector machine (SVM) methods. Results. Both patient groups exhibited increased NH in the right PCC/precuneus and right angular gyrus and decreased NH in the right middle temporal gyrus compared with healthy controls. Compared with nonmelancholic patients and healthy controls, melancholic patients exhibited significantly increased NH in the bilateral superior medial frontal gyrus and decreased NH in the left inferior temporal gyrus. But merely for melancholic patients, the NH of the right middle temporal gyrus was negatively correlated with TEPS total and contextual anticipatory scores. SVM analysis showed that a combination of NH values in the left superior medial frontal gyrus and left inferior temporal gyrus could distinguish melancholic patients from nonmelancholic patients with accuracy, sensitivity, and specificity of 79.66% (47/59), 70.97% (22/31), and 89.29%(25/28), respectively. Conclusion. Our findings showed distinctive network homogeneity alterations in melancholic MDD which may be potential imaging markers to distinguish melancholic MDD and nonmelancholic MDD.
Mobile Information Systems Usage and Doctor-Patient Relationships: An Empirical Study in China
Authors: Zhang Xin , Ma Liang , Ma Yanbo , Yang Xiao
Published: April 2021

How to improve the doctor-patient relationship has been a continuing topic in academia and management and there have been several attempts to utilize online communications to facilitate healthcare. The application of information technology to create an “Internet + medical care” platform has upended the traditional medical service model in China. As an example of the application of the Internet by the healthcare system, this paper investigates a mobile online appointment system used by hospitals. Data on system use came from questionnaires submitted by 225 patients and analyzed by the structural equation model method. The results showed that patients perceived the hospital’s online appointment system as an attempt at transparency to which they reacted positively. The patients’ perception of transparency promoted trust in the hospital and the doctors and positively affected their feelings of satisfaction, which, of course, improved the doctor-patient relationship. Patients’ perceptions of transparency, trust in the hospitals and doctors, and feelings of satisfaction played a partial mediator role between the availability of an online appointment system and better doctor-patient relationships. There were significant gender differences among patients in terms of their feelings of trust and satisfaction with the new appointment method and whether it really improved the doctor-patient relationship.
An MEC Architecture-Oriented Improved RRT Algorithm for Regional Trajectory Planning
Authors: Han Qingwen , Huang Ziyun , Zeng Lingqiu , Wu Yunqu , Ye Lei , Zu Hui , Lei Yu
Published: April 2021

Multi-access Edge Computing (MEC), which could provide real-time computing ability, is considered as an effective approach to improve performance of Vehicular Ad Hoc Network (VANET). MEC could process regional vehicles information and generate real-time road hazard features, which could be used to realize trajectory planning progress of vehicles. In this paper, an MEC-oriented VANET infrastructure is presented, and a road hazard feature-based trajectory planning method is proposed. Back Propagation (BP) neural network is employed to predict road hazard feature changing, while a hazard-based cost function is defined. Then, an improved Rapidly Exploring Random Tree (RRT) algorithm is proposed for novel regional trajectory planning. A joint simulation is done based on SUMO and NS3 platforms. Simulation results verify the effectiveness and stability of the proposed algorithm.
In Vitro Anthelmintic Activity of Ethanol Stem Bark Extract of Albizia ferruginea (Guill. & Perr.) Benth
Authors: Tagoe Miriam , Boakye Yaw Duah , Agana Theresah Appiah , Boamah Vivian Etsiapa , Agyare Christian
Published: April 2021

Albizia ferruginea (Guill. & Perr.) Benth bark is used in the traditional medicine as a vermifuge. This study sought to determine the anthelmintic activity of the stem bark extract of Albizia ferruginea. The powdered A. ferruginea stem bark was extracted with ethanol. Phytochemical screening was carried out on A. ferruginea ethanol extract (AFE) and then screened for its anthelmintic property against Pheretima posthuma and Haemonchus contortus using the adult motility assay. The effect of AFE and its fractions on the anthelminthic activity of mebendazole and albendazole were also determined using the adult worm (P. posthuma) motility assay. AFE showed a dose-dependent anthelmintic activity against P. posthuma and H. contortus. The least concentration of AFE (0.5 mg/mL) paralyzed and killed P. posthuma within

272.50
±
12.42

 min and

354.50
±
5.06

 min of exposure, respectively. AFE at the least test concentration (0.14 mg/mL) caused paralysis and induced death of H. contortus, after at

63.50
±
2.98

and

254.96
±
2.44

 min of exposure, respectively. AFE extract at 0.25 and 0.125 mg/mL increased the paralytic and helminthicidal activities of albendazole. The paralytic and helminthicidal activities of mebendazole were reduced when combined with AFE (0.25 and 0.125 mg/mL). Among the three fractions obtained from AFE, the methanol fraction showed the highest anthelmintic activity. The methanol fraction at 0.5 mg/mL caused paralysis after

69.90
±
0.15

 min and death of worm after

92.53
±
0.74

 min of exposure. The petroleum ether and ethyl acetate fractions showed relatively low anthelmintic activity. Phytochemical screening of AFE revealed the presence of tannins, saponins, glycosides, alkaloids, and coumarins. The results from this study show that A. ferruginea possesses anthelmintic activity which gives credence to its folkloric use.
Evaluation of Performance in Colon Capsule Endoscopy Reading by Endoscopy Nurses
Authors: Handa Yukiko , Nakaji Konosuke , Hyogo Kayo , Kawakami Makiko , Yamamoto Tomomi , Fujiwara Akiko , Kanda Rika , Osawa Motoyasu , Handa Osamu , Matsumoto Hiroshi , Umegaki Eiji , Shiotani Akiko
Published: April 2021

Background. Although there are papers reporting on the accuracy of colon capsule endoscopy (CCE) compared with colonoscopy (CS), there are few reports on the detection rates of significant lesions by endoscopy nurses. We previously reported no significant difference in the detection rates for small bowel capsule endoscopy (SBCE) images among two well-trained physicians and one expert nurse. Objective. To evaluate the reading time and detection rate of the significant lesions of CCE images among novice and trained expert endoscopy nurses and novice physicians. Methods. CCE videos of 20 consecutive patients who performed both CCE and CS with clinically significant localized lesions were selected. Two trained expert endoscopy nurses, untrained two novice physicians, and novice three endoscopy nurses reviewed CCE videos. The detection rate of the lesions and reading time were compared among the three groups and were evaluated by comparison between the first and the second 10 videos. Results. The median reading time was the shortest (19 min) in the trained expert endoscopy nurses and the longest (45 min) in the novice nurses. The number of thumbnails tended to be more in the trained expert endoscopy nurses in the first 10-video reading. Although the detection rates of small polyps (<5 mm) were significantly lower (46.5%,

p
=
0.025

) in the novice nurses compared to the others, they were improved (35.2% to 63.5%,

p
=
0.015

) in the second 10 videos. The detection rates of tumor lesions by either one of two trained expert endoscopy nurses were higher compared to those by each novice physician. Conclusions. The trained expert endoscopy nurses for CCE reading can reduce physician's time and improve the diagnostic yield.
Potential Roles of Endoplasmic Reticulum Stress and Cellular Proteins Implicated in Diabesity
Authors: Mustapha Sagir , Mohammed Mustapha , Azemi Ahmad Khusairi , Yunusa Ismaeel , Shehu Aishatu , Mustapha Lukman , Wada Yusuf , Ahmad Mubarak Hussaini , Ahmad Wan Amir Nizam Wan , Rasool Aida Hanum Ghulam , Mokhtar Siti Safiah
Published: April 2021

The role of the endoplasmic reticulum (ER) has evolved from protein synthesis, processing, and other secretory pathways to forming a foundation for lipid biosynthesis and other metabolic functions. Maintaining ER homeostasis is essential for normal cellular function and survival. An imbalance in the ER implied stressful conditions such as metabolic distress, which activates a protective process called unfolded protein response (UPR). This response is activated through some canonical branches of ER stress, i.e., the protein kinase RNA‐like endoplasmic reticulum kinase (PERK), inositol‐requiring enzyme 1α (IRE1α), and activating transcription factor 6 (ATF6). Therefore, chronic hyperglycemia, hyperinsulinemia, increased proinflammatory cytokines, and free fatty acids (FFAs) found in diabesity (a pathophysiological link between obesity and diabetes) could lead to ER stress. However, limited data exist regarding ER stress and its association with diabesity, particularly the implicated proteins and molecular mechanisms. Thus, this review highlights the role of ER stress in relation to some proteins involved in diabesity pathogenesis and provides insight into possible pathways that could serve as novel targets for therapeutic intervention.
Changes in the Small RNA Expression in Endothelial Cells in Response to Inflammatory Stimulation
Authors: Liu Peixi , Hu Liuxun , Shi Yuan , Liu Yingjun , Yu Guo , Zhou Yingjie , An Qingzhu , Zhu Wei
Published: April 2021

Objective. Endothelial cell inflammation is a common pathophysiological process in many cardiovascular and cerebrovascular diseases. Small RNA is a kind of short nonprotein coding RNA molecule. Changes in the small RNA expression in endothelial cells have been linked to the development of cardiovascular and cerebrovascular diseases. We investigated and verified differentially expressed small RNAs in endothelial cells in response to inflammatory stimulation. Methods. Primary rat endothelial cells were obtained from Sprague‐Dawley rats and treated with 10 ng/ml TNF‐α for 24 hours. Small RNA sequencing was used to generate extensive small RNA data. Significantly differentially expressed small RNAs identified in the analysis were further confirmed by quantitative reverse transcription polymerase chain reaction (qRT‐PCR). Then, we investigated the tissue‐specific small RNA expression after RNA extraction from different tissues. Results. Small RNA sequencing demonstrated that 17 miRNAs, 1 piRNA, 10 snoRNAs, and 7 snRNAs were significantly differentially expressed. qRT‐PCR identified 3 miRNAs, 2 snoRNAs, and 2 snRNAs with significantly different expression. Analysis of the tissue‐specific expression showed that rno‐miR‐126a‐5p was predominantly expressed in the lung, rno‐miR‐146a‐5p in the intestines, and rno‐novel‐178 in the heart. Rno‐piR‐017330 was mainly expressed in the muscle. snoR‐8966.1 was predominantly expressed in the bone. snoR‐6253.1 was mostly expressed in the vessels and bone. snR‐29469.1 was mainly expressed in the bone, and snR‐85806.1 was predominantly expressed in the vessels and bone. Conclusions. We report for the first time the expression of small RNAs in endothelial cells under inflammatory conditions. TNF‐α can regulate the expression of small RNAs in endothelial cells, and their expression is tissue‐specific.
Dynamic Vision Sensor Tracking Method Based on Event Correlation Index
Authors: Lv Hengyi , Feng Yang , Zhang Yisa , Zhao Yuchen
Published: April 2021

Dynamic vision sensor is a kind of bioinspired sensor. It has the characteristics of fast response, large dynamic range, and asynchronous output event stream. These characteristics make it have advantages that traditional image sensors do not have in the field of tracking. The output form of the dynamic vision sensor is asynchronous event stream, and the object information needs to be provided by the relevant event cluster. This article proposes a method based on the event correlation index to obtain the object’s position, contour, and other information and is compatible with traditional tracking methods. Experiments show that this method can obtain the position information of the moving object and its continuous motion trajectory and analyze the influence of the parameters on the tracking effect. This method will have broad application prospects in security, transportation, etc.
Perceived Stress and Life Events in Patients Affected by Schizophrenia and Schizoaffective and Bipolar Disorder: Is There a Role for Self-Reported Basic Symptoms?
Authors: Parmigiani Giovanna , Mandarelli Gabriele , Tarsitani Lorenzo , Roselli Valentina , Gaviano Ilaria , Buscajoni Andrea , Biondi Massimo , Girardi Paolo , Ferracuti Stefano
Published: April 2021

Introduction: The stress-diathesis model of psychotic disorders describes, in vulnerable individuals, the role of psychosocial stress in the onset and exacerbation of psychotic symptoms. Another interesting approach to the study of vulnerability in the development of psychosis is represented by the basic symptoms concept. Objective: The present study aims at proposing an integration between these two models and investigating possible associations between psychotic symptoms, basic symptoms, perceived stress, and life events in a sample of patients affected by schizophrenia (SZ), schizoaffective (SA), and bipolar disorder with and without psychotic symptoms. Methods: 112 patients were recruited in two university hospitals. Severity of psychiatric symptoms (Positive and Negative Syndrome Scale, PANSS), basic symptoms (Frankfurt Complaint Questionnaire, FCQ), perceived stress (Stress-related Vulnerability Scale, SVS), and life events (Paykel’s interview for recent life events) were assessed. Results: Patients affected by bipolar disorder (both with and without psychotic symptoms) showed a higher number of independent life events (p < 0.01) and tended to report more frequently at least 1 life event in the previous 6 months (p < 0.01) than patients affected by SZ or SA disorder. No differences emerged between the study groups in perceived stress nor in measures of basic symptoms. In the whole sample, a logistic regression analysis showed that the SVS total score (p < 0.05) and PANSS total score (p < 0.001) were associated with the presence of psychotic symptoms. Conclusions: In the study sample, life events and basic symptoms did not play a major role in influencing psychotic symptoms, compared to the subjective perception of stress and the severity of psychopathology. Taken together, these results can be informative for rehabilitation therapies aimed at enhancing resilience and coping strategies in this vulnerable group of patients.
Micropore Closure Rates following Microneedle Application at Various Anatomical Sites in Healthy Human Subjects
Authors: Ogunjimi Abayomi Tolulope , Lawson Christine , Carr Jamie , Patel Krishna Kumar , Ferguson Nkanyezi , Brogden Nicole K.
Published: April 2021

Introduction: The continuous availability of open micropores is crucial for a successful microneedle (MN) drug delivery strategy. However, micropore lifetime depends on intrinsic skin functional and anatomical characteristics, which vary significantly at different anatomical sites. Objective: This pilot study explored if differences exist in micropore closure timeframes at 3 anatomical sites – upper arm, volar forearm, and abdomen. Methods: Healthy subjects (n = 35) self-identifying as Asian (n = 9), Bi-/multiracial (n = 2), Black (n = 9), Latino (n = 6), and White (n = 9) completed the study. The upper arm, volar forearm, and abdomen were treated with MNs; skin impedance and transepidermal water loss (TEWL) were measured at baseline and post-MN to confirm micropore formation. Impedance was measured for 3 days to evaluate micropore lifetime. Measurements of L*, which quantifies the skin lightness/darkness, were made using a tristimulus colorimeter. Micropore lifetime was determined by comparing baseline and post-MN impedance measurements, and micropore closure half-life was predicted using mathematical modeling. Results: Post-MN increase in TEWL and decrease in impedance were significant (p < 0.05), confirming successful micropore formation at all anatomical sites. When data were analyzed according to subject self-identified racial/ethnic groups, the mean micropore closure time at the abdomen (63.09 ± 13.13 h) was longer than the upper arm (60.34 ± 14.69 h) and volar forearm (58.29 ± 16.76 h). The predicted micropore closure half-life at anatomical sites was the abdomen (25.86 ± 14.96 h) ≈ upper arm (23.69 ± 13.67 h) > volar forearm (20.2 ± 11.99 h). Differences were not statistically significant between groups. Objective categorization by L* showed that the darker skin may be associated with longer micropore closure time at the abdomen site. Conclusions: Our results suggest that anatomical site of application may not be a source of significant variability in micropore closure time. These findings may help reduce the number of physiological parameters that need to be explicitly considered when developing drug products to support MN-assisted drug delivery strategies.
Accuracy of Breast Fine-Needle Aspiration Biopsy Using the International Academy of Cytology Yokohama System in Clinico-Radiologically Indeterminate Lesions: Initial Findings Demonstrating Value in Lesions of Low Suspicion of Malignancy
Authors: Agrawal Shruti , Anthony Michael Leonard , Paul Pranoy , Singh Divya , Agarwal Akansha , Mehan Anoushika , Singh Ashok , Joshi Prashant Pranesh , Kumar Arvind , Syed Anjum , Ravi Bina , Rao Shalinee , Chowdhury Nilotpal
Published: April 2021

Background: Fine-needle aspiration biopsy (FNAB) in breast lesions offers accurate results in differentiating benign and malignant lesions. However, its role is unclear when core-needle biopsy (CNB) is available, the latter providing additional information regarding tumor grade, invasion, and hormone receptor status in malignant lesions. In benign breast lesions, especially in BIRADS category 4a and 4b, FNAB, and CNB provide similar pathological information, whereby FNAB may serve as a more rapid and cost-effective investigation. The study was planned to reevaluate the diagnostic accuracy of FNAB in BIRADS category 4a, 4b, and 4c lesions. Materials and Methods: FNAB and biopsy reports of all patients with breast lesions sent between September 1, 2018, and November 30, 2020, were collected and the International Academy of Cytology (IAC) Yokohama category and BIRADS score were recorded for each case. The rate of malignancy and the accuracy of FNAB in diagnosing malignancy were calculated for each BIRADS 4a, 4b, and 4c subgroup. Results: A total of 249 cases of BIRADS 4 lesions had corresponding cytology and histopathology diagnoses. FNAB showed high diagnostic accuracy in all BIRADS groups. A benign categorization was associated with a very low number of false-negative diagnoses, especially in BIRADS 4a lesions. Conclusion: The study reconfirms the excellent accuracy of breast FNAB using the IAC Yokohama system in diagnosing breast malignancies. Furthermore, BIRADS 4a lesions found to be belonging to the cytological benign category may be excluded from CRB and kept on clinical follow-up.
Metodologia para classificação de hidrossítios: rio Selho, no Concelho de Guimarães, distrito de Braga, Portugal
Authors: Foleto Eliane Maria , Costa Francisco Silva
Published: April 2021

Com o objetivo de criar uma metodologia especifica para classificação de hidrossítios, propõe-se que, na avaliação dos locais interesse hidrológico (LIH), o valor patrimonial seja definido pelos critérios ecológico, estético, sociocultural e complementar, seus respectivos indicadores e classes. Para facilitar o mecanismo da avaliação, criou-se a Ficha de Levantamento Hidrológico, validada em dois LIH do rio Selho no Concelho de Guimarães, Distrito de Braga, Portugal. Como resultado, a proposta para a classificação de hidrossítios demonstra coerência teórico-metodológica com a condição hídrica verificada em campo, o que valida os critérios, indicadores, classes com os respectivos índices percentuais. Após a ponderação dos valores atribuídos às classes, a metodologia demonstra que os LIH do rio Selho não têm valoração suficiente para ser considerados hidrossítios, por apresentarem alguns problemas ambientais; mas, embora não tenham atrativos monumentais, merecem medidas de proteção e o reconhecimento de seu valor hídrico.
Adoption of PCSK9 Inhibitors Among Patients With Atherosclerotic Disease
Authors: Dayoub Elias J. , Eberly Lauren A. , Nathan Ashwin S. , Khatana Sameed Ahmed M. , Adusumalli Srinath , Navar Ann Marie , Giri Jay , Groeneveld Peter W.
Published: April 2021

Background

PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitors represent a promising class of lipid‐lowering therapy, although their use has been limited by cost concerns.

Methods and Results

A retrospective cohort study was conducted using a nationwide commercial claims database comprising patients with atherosclerotic cardiovascular disease (ASCVD), aged 18 to 64 years. We identified the number of patients with ASCVD started on a PCSK9 inhibitor from the dates of US Food and Drug Administration approval in quarter 3 2015 through quarter 2 2019. Secondary objectives identified the proportions of patients started on a PCSK9 inhibitor in various ASCVD risk groups based on statin use and baseline low‐density lipoprotein cholesterol. We identified 126 419 patients with ASCVD on either PCSK9 inhibitor or statin therapy. Among these patients, 1168 (0.9%) filled a prescription for a PCSK9 inhibitor. The number of patients initiating a PCSK9 inhibitor increased from 2 patients in quarter 3 2015 to 119 patients in quarter 2 2019, corresponding to an increase from 0.05% to 2.5% of patients with ASCVD already on statins who started PCSK9 inhibitor therapy. Of patients with ASCVD with high adherence to a high‐intensity statin, 13 643 had low‐density lipoprotein cholesterol ≥70 mg/dL, and in this subgroup, 119 (0.9%) patients initiated a PCSK9 inhibitor.

Conclusions

Few patients started PCSK9 inhibitors from 2015 through mid‐2019, despite increasing trial evidence of efficacy, guidelines recommending PCSK9 inhibitors in high‐risk patients with ASCVD, and price reductions during this period. The magnitude of price reductions may not yet be sufficient to influence use management strategies aimed to limit PCSK9 inhibitor use.
Antihypertensive Drugs for Secondary Prevention After Ischemic Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis
Authors: Boncoraglio Giorgio B. , Del Giovane Cinzia , Tramacere Irene
Published: April 2021

Background and Purpose:

Approximately 30% of ischemic strokes occur after a previous stroke or transient ischemic attack. Arterial hypertension is one of the best established risk factors for first and recurrent stroke, both ischemic and hemorrhagic. Guidelines for the secondary prevention of ischemic stroke support the use of blood pressure (BP)–lowering drugs in most patients. However, the evidence for these recommendations comes from meta-analyses that included both ischemic and hemorrhagic stroke patients, whereas these 2 conditions differ quantitatively in several aspects. With this systematic review and meta-analysis, we aimed at summarizing the current evidence on BP-lowering drugs for secondary prevention in patients with ischemic stroke or transient ischemic attack.

Methods:

We searched MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials up to January 31, 2020. We included randomized controlled trials comparing any specific BP-lowering drug, as monotherapy or combination, with either a control or another BP-lowering drug.

Results:

Eight studies that enrolled 33 774 patients with ischemic stroke or transient ischemic attack were included in the meta-analysis. Mean follow-up was 25 months (range, 3–48). Moderate-quality evidence indicated that a subsequent stroke occurred in 7.9% (ischemic in 7.4% or hemorrhagic in 0.6%) of patients taking any type of BP-lowering drug compared with 9.7% of patients taking placebo (odds ratio, 0.79 [95% CI, 0.66–0.94]; absolute risk difference, −1.9% [95% CI, −3.1% to −0.5%]). Moderate-quality evidence indicated that mortality occurred similarly in patients taking any type of BP-lowering treatment compared with placebo, with an absolute risk of 7.3% and 7.9%, respectively (odds ratio, 1.01 [95% CI, 0.92–1.10]; absolute risk difference, 0.1% [95% CI, −0.6% to 0.7%]).

Conclusions:

The use of BP-lowering drugs in patients with ischemic stroke or transient ischemic attack is associated with a 1.9% risk reduction of stroke but does not affect the all-cause mortality risk.
4. Essays and Reviews Controversy
Authors: Yeandle David
Published: April 2021

This chapter traces the consequences of Hunt’s refusal to sign a petition condemning the controversial Essays and Reviews. By this time (1860), he had arrived at Edmonton (4), from whence he was dismissed on account of his liberal theology and acceptance of Essays and Reviews. As he had no licence, he had no recourse to the Bishop. Further applications, following another advertisement in the Record, ensue, each of which Hunt details, some of which had bizarre conditions attached.
A Novel Thyroid Ultrasound Proficiency Metric Designed Through a Multidisciplinary Delphi Approach
Authors: Hu Yinin , Michaels Alex D. , Khot Rachita , Schenk Worthington G. , Hanks John B. , Smith Philip W.
Published: April 2021

Background

Thyroid ultrasounds extend surgeons’ outpatient capabilities and are essential for operative planning. However, most residents are not formally trained in thyroid ultrasound. The purpose of this study was to create a novel thyroid ultrasound proficiency metric through a collaborative Delphi approach.

Methods

Clinical faculty experienced in thyroid ultrasound participated on a Delphi panel to design the thyroid Ultrasound Proficiency Scale (UPS-Thyroid). Participants proposed items under the categories of Positioning, Technique, Image Capture, Measurement, and Interpretation. In subsequent rounds, participants voted to retain, revise, or exclude each item. The process continued until all items had greater than 70% consensus for retention. The UPS-Thyroid was pilot tested across 5 surgery residents with moderate ultrasound experience. Learning curves were assessed with cumulative sum.

Results

Three surgeons and 4 radiologists participated on the Delphi panel. Following 3 iterative Delphi rounds, the panel arrived at >70% consensus to retain 14 items without further revisions or additions. The metric included the following items on a 3-point scale for a maximum of 42 points: Positioning (1 item), Technique (4 items), Image Capture (2 items), Measurement (2 items), and Interpretation (5 items). A pilot group of 5 residents was scored against a proficiency threshold of 36 points. Learning curve inflection points were noted at between 4 to 7 repetitions.

Conclusions

A multidisciplinary Delphi approach generated consensus for a thyroid ultrasound proficiency metric (UPS-Thyroid). Among surgery residents with moderate ultrasound experience, basic proficiency at thyroid ultrasound is feasible within 10 repetitions.
Trusting Automation: Designing for Responsivity and Resilience
Authors: Chiou Erin K. , Lee John D.
Published: April 2021

Objective

This paper reviews recent articles related to human trust in automation to guide research and design for increasingly capable automation in complex work environments.

Background

Two recent trends—the development of increasingly capable automation and the flattening of organizational hierarchies—suggest a reframing of trust in automation is needed.

Method

Many publications related to human trust and human–automation interaction were integrated in this narrative literature review.

Results

Much research has focused on calibrating human trust to promote appropriate reliance on automation. This approach neglects relational aspects of increasingly capable automation and system-level outcomes, such as cooperation and resilience. To address these limitations, we adopt a relational framing of trust based on the decision situation, semiotics, interaction sequence, and strategy. This relational framework stresses that the goal is not to maximize trust, or to even calibrate trust, but to support a process of trusting through automation responsivity.

Conclusion

This framing clarifies why future work on trust in automation should consider not just individual characteristics and how automation influences people, but also how people can influence automation and how interdependent interactions affect trusting automation. In these new technological and organizational contexts that shift human operators to co-operators of automation, automation responsivity and the ability to resolve conflicting goals may be more relevant than reliability and reliance for advancing system design.

Application

A conceptual model comprising four concepts—situation, semiotics, strategy, and sequence—can guide future trust research and design for automation responsivity and more resilient human–automation systems.
The use of sodium nitrite for deliberate self-harm, and the online suicide market: Should we care?
Authors: Sedhai Yub Raj , Atreya Alok , Basnyat Soney , Phuyal Prabin , Pokhrel Sagar
Published: April 2021

Sodium nitrite is a common household product with a variety of uses such as curing meat, food additive, colouring agent, anti-freezing agent and disinfectant. We report a case of sodium nitrite intoxication for deliberate self-harm and discuss the increasing number of such cases in recent times.
WHO recommendation and India’s practice on tetanus vaccination—How much is too much?
Authors: Priya P Karpaga , Parija Pragyan P , Kujur Anubhuti
Published: April 2021

Tetanus is one of the dreaded fatal diseases which is of public health importance. Reducing the morbidity and mortality due to tetanus, especially maternal and neonatal, is one of the major aims of health organizations around the world. Vaccination against tetanus is one of the most salient interventions. In order to ensure the unerring vaccination practices, the World Health Organization has been updating its position papers on all vaccines. To enable India to follow the appropriate vaccine policy, this article highlights the category and situation-based schedule of tetanus toxoid vaccination.
Actions for Queering American Public Administration
Authors: Larson Samantha June
Published: April 2021

Lesbian, gay, bisexual, transgender, and queer (LGBTQ+) visibility has exponentially grown over the past half century. In one lifetime, America has borne witness to the Stonewall Riots, AIDS epidemic, legalization of same-sex marriage, and debates for transgender individuals to openly serve in the military. Yet, scholarship in top public administration journals has rarely examined how LGBTQ+ milestones relate to policy development, implementation, and service-delivery. This exposes a discrepancy between what scholars study, what practitioners face, and what queer communities need. Building on the Social Equity Manifesto, this manuscript offers recommendations for incorporating queer perspectives into research, teaching, and instruction, offering a more inclusive and intersectional agenda.
Neighborhood Attributes and Well-Being Among Older Adults in Urban Areas: A Mixed-Methods Systematic Review
Authors: Padeiro Miguel , de São José José , Amado Carla , Sousa Liliana , Roma Oliveira Carla , Esteves Alina , McGarrigle Jennifer
Published: April 2021

Expanding urbanization rates have engendered increasing research examining linkages between urban environments and older adults’ well-being. This mixed-methods systematic review synthesizes the evidence for the influence of urban neighborhoods’ attributes on older adults’ well-being. We searched for literature published up to December 2020 across six databases and performed quality assessment and thematic analysis. The results, based on 39 identified studies, showed that natural areas in neighborhoods and a sense of community are the attributes most often associated with positive effects on well-being. Transit-related variables, urban furniture, and access to healthcare are also positively related to well-being. Neighborhoods may promote well-being more effectively when these elements are considered. However, almost half of the studies did not include all environmental dimensions simultaneously, and self-reported instruments were largely preferred over more objective assessments of the environment. Future research should thus holistically examine physical, social, and service-related attributes to produce more robust evidence.
The longitudinal association between marital and psychological functioning in socioeconomically disadvantaged relationships
Authors: Kanter Jeremy B. , Proulx Christine M.
Published: April 2021

Marital functioning is associated with individuals’ psychological functioning. However, it is unclear if the association between marital and individual functioning extends to socioeconomically disadvantaged newlyweds (those with low educational attainment/income), and if changes in psychological distress differ between husbands and wives. Using three waves of data from 530 couples in the Supporting Healthy Marriage study, we investigated if improvements and deterioration in marital satisfaction were differentially associated with patterns of individuals’ psychological distress. We also examined if spouses’ divergent marital change patterns were associated with distress trajectories. For wives, improvements in marital satisfaction were more strongly associated with decreases in psychological distress compared to declines in satisfaction. Additionally, wives’ psychological distress was more adversely impacted than was husbands’ when they reported worse marital functioning. We provide empirical and practical implications for helping reduce disparities in psychological functioning observed in low-income populations.
Perioperative, protective use of extracorporeal membrane oxygenation in complex thoracic surgery
Authors: Zhang Yan , Luo Ming , Wang Bo , Qin Zhen , Zhou Ronghua
Published: April 2021

Background:

Extracorporeal membrane oxygenation (ECMO) is increasingly used in patients undergoing complex thoracic surgical procedures. However, studies reporting the clinical outcomes of these patients are limited to case reports, without real consensus. Our aim was to evaluate the perioperative use of ECMO as respiratory and/or circulatory support in thoracic surgery: indications, benefits, and perioperative management.

Methods:

Between May 2013 and December 2018, we reviewed the clinical data of 15 patients (11 males and 4 females; mean age: 47 years old; range, 25–73 years) undergoing ECMO-assisted thoracic surgery in our hospital.

Results:

Of the 15 patients, 10 cases received peripheral veno-arterial (VA) ECMO and five cases received veno-venous (VV) ECMO. Indications for ECMO were pulmonary transplantation with hard-to-maintain oxygenation (n = 5), traumatic main bronchial rupture (n = 2), traumatic lung injury (n = 1), airway tumor leading to severe airway stenosis (n = 2), huge thoracic mass infiltrated vena cava (n = 5). The ECMO duration was 1–51 hours. All patients were successfully extubated and weaned from ECMO postoperatively. The main complications were hemorrhage (26.7%), infection (33.3%), acute hepatic dysfunction (33.3%), and venous thrombosis (26.7%). There was only one hospital death and postoperative one-year survival rate was 86%.

Conclusion:

Our experience indicates that ECMO is a feasible method for complex trachea-bronchial surgery, huge thoracic mass excision and lung transplantation, and the ECMO-related risks may be justified. With further accumulation of experience with ECMO, a more sophisticated protocol for management of critical airway or heart failure problems in thoracic surgeries can be derived.
Does extracorporeal shock wave therapy decrease spasticity of ankle plantar flexor muscles in patients with stroke: A randomized controlled trial
Authors: Yoldaş Aslan Şerife , Kutlay Sehim , Düsünceli Atman Ebru , Elhan Atilla Halil , Gök Haydar , Küçükdeveci Ayse Adile
Published: April 2021

Objective:

To evaluate the effectiveness of radial extracorporeal shock wave therapy on ankle flexor spasticity in stroke survivors and to reveal changes in the fibroelastic components of muscle.

Design:

Randomized controlled trial.

Setting:

Inpatient neuro-rehabilitation clinic of a university hospital.

Participants:

Stroke patients with ankle flexor spasticity.

Interventions:

Patients were randomized to three groups; radial extracorporeal shock wave therapy, sham, or control. Active and sham therapy were administered two sessions/week for two weeks. All patients received conventional rehabilitation.

Main measures:

The primary outcome was Modified Ashworth Scale. Secondary outcomes were the Tardieu Scale and elastic properties of plantar flexor muscles assessed by elastography (strain index). All assessments were performed before, immediately after the treatment, and four weeks later at follow-up.

Results:

Fifty-one participants were enrolled (active therapy n = 17, sham n = 17, control n = 17). Modified Ashworth scores showed a significant decrease in the active therapy group (from 2.47 ± 0.72 to 1.41 ± 0.62) compared to sham (from 2.19 ± 1.05 to 2.06 ± 1.12) and control (from 2.06 ± 0.85 to 2.00 ± 0.73) groups immediately after the treatment ( P < 0.001). Tardieu results were also in concordance ( P < 0.001), however this effect was not preserved at follow-up. Elastic properties of the ankle flexors were improved in all groups at both assessments after the therapy showing significant decreases in strain index ( P < 0.001). However, there was no difference among the groups in terms of improvement in elastography.

Conclusion:

Radial extracorporeal shock wave therapy has short-term anti-spastic effects on ankle flexor muscles when used as an adjunct to conventional rehabilitation.
Antidepressant action of transcranial direct current stimulation in olfactory bulbectomised adolescent rats
Authors: Waye Shannon C , Dinesh O Chandani , Hasan SM Nageeb , Conway Joshua D , Raymond Roger , Nobrega José N , Blundell Jacqueline , Bambico Francis Rodriguez
Published: April 2021

Background:

Antidepressant drugs in adolescent depression are sometimes mired by efficacy issues and paradoxical effects. Transcranial direct current stimulation (tDCS) could represent an alternative.

Aims/methods:

We tested the antidepressant action of prefrontal tDCS and paroxetine (20 mg/kg, intraperitoneal) in olfactory bulbectomised (OBX) adolescent rats. Using enzyme-linked immunosorbent assays and in situ hybridisation, we examined treatment-induced changes in plasma brain-derived neurotrophic factor (BDNF) and brain serotonin transporter (SERT) and 5-HT-1A mRNA.

Results:

OBX-induced anhedonia-like reductions in sucrose preference (SP) correlated with open field (OF) hyperactivity. These were accompanied by decreased zif268 mRNA in the piriform/amygdalopiriform transition area, and increased zif268 mRNA in the hypothalamus. Acute paroxetine (2 days) led to a profound SP reduction, an effect blocked by combined tDCS–paroxetine administration. Chronic (14 days) tDCS attenuated hyperlocomotion and its combination with paroxetine blocked OBX-induced SP reduction. Correlations among BDNF, SP and hyperlocomotion scores were altered by OBX but were normalised by tDCS–paroxetine co-treatment. In the brain, paroxetine increased zif268 mRNA in the hippocampal CA1 subregion and decreased it in the claustrum. This effect was blocked by tDCS co-administration, which also increased zif268 in CA2. tDCS-paroxetine co-treatment had variable effects on 5-HT1A receptors and SERT mRNA. 5-HT1A receptor changes were found exclusively within depression-related parahippocampal/hippocampal subregions, and SERT changes within fear/defensive response-modulating brainstem circuits.

Conclusion:

These findings point towards potential synergistic efficacies of tDCS and paroxetine in the OBX model of adolescent depression via mechanisms associated with altered expression of BDNF, 5-HT1A, SERT and zif268 in discrete corticolimbic areas.
Selective attention to emotional stimuli and emotion recognition in patients with major depression: The role of mineralocorticoid and glutamatergic NMDA receptors
Authors: Nowacki Jan , Wingenfeld Katja , Kaczmarczyk Michael , Chae Woo Ri , Salchow Paula , Deuter Christian Eric , Piber Dominique , Otte Christian
Published: April 2021

Background:

Mineralocorticoid receptors (MR) are highly expressed in limbic brain areas and prefrontal cortex, which are closely related to selective attention to emotional stimuli and emotion recognition. Patients with major depressive disorder (MDD) show alterations in MR functioning and both cognitive processes. MR stimulation improves cognitive processes in MDD and leads to glutamate release that binds upon N-methyl-D-aspartate receptors (NMDA-R).

Aims:

We examined (1) whether MR stimulation has beneficial effects on selective attention to emotional stimuli and on emotion recognition and (2) whether these advantageous effects can be improved by simultaneous NMDA-R stimulation.

Methods:

We examined 116 MDD patients and 116 healthy controls matched for age ( M = 34 years), sex (78% women), and education in the following conditions: no pharmacological stimulation (placebo), MR stimulation (0.4 mg fludrocortisone + placebo), NMDA-R stimulation (placebo + 250 mg D-cycloserine (DCS)), MR + NMDA-R stimulation (fludrocortisone + DCS). An emotional dot probe task and a facial emotion recognition task were used to measure selective attention to emotional stimuli and emotion recognition.

Results:

Patients with MDD and healthy individuals did not differ in task performance. MR stimulation had no effect on both cognitive processes in both groups. Across groups, NMDA-R stimulation had no effect on selective attention but showed a small effect on emotion recognition by increasing accuracy to recognize angry faces.

Conclusions:

Relatively young unmedicated MDD patients showed no depression-related cognitive deficits compared with healthy controls. Separate MR and simultaneous MR and NMDA-R stimulation revealed no advantageous effects on cognition, but NMDA-R might be involved in emotion recognition.
Altered regional cerebral blood flow in obstructive sleep apnea is associated with sleep fragmentation and oxygen desaturation
Authors: Yan Lirong , Park Hea Ree , Kezirian Eric J. , Yook Soonhyun , Kim Jae-Hun , Joo Eun Yeon , Kim Hosung
Published: April 2021

Altered cerebral perfusion has been reported in obstructive sleep apnea (OSA). Using dynamic susceptibility contrast MRI, we compared cerebral perfusion between male OSA patients and male healthy reference subjects and assessed correlations of perfusion abnormalities of OSA patients with sleep parameters and neuropsychological deficits at 3 T MRI, polysomnography and neuropsychological tests in 68 patients with OSA and 21 reference subjects. We found lower global and regional cerebral blood flow and cerebral blood volume, localized mainly in bilateral parietal and prefrontal cortices, as well as multiple focal cortical and deep structures related to the default mode network and attention network. In the correlation analysis between regional hypoperfusion and parameters of polysomnography, different patterns of regional hypoperfusion were distinctively associated with parameters of intermittent hypoxia and sleep fragmentation, which involved mainly parietal and orbitofrontal cortices, respectively. There was no association between brain perfusion and cognition in OSA patients in areas where significant association was observed in reference subjects, largely overlapping with nodes of the default mode network and attention network. Our results suggest that impaired cerebral perfusion in important areas of functional networks could be an important pathomechanism of neurocognitive deficits in OSA.