bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Stratification of QTc Prolongation in Critically Ill Patients Receiving Antipsychotics for the Management of Delirium Symptoms
Authors: Sadlonova Monika , Beach Scott R. , Funk Margo C. , Rosen Jordan H. , Ramirez Gamero Andres F. , Karlson Rebecca A. , Huffman Jeff C. , Celano Christopher M.
Published: December 2023

Background

Patients experiencing significant agitation or perceptual disturbances related to delirium in an intensive care setting may benefit from short-term treatment with an antipsychotic medication. Some antipsychotic medications may prolong the QTc interval, which increases the risk of potentially fatal ventricular arrhythmias. In this targeted review, we describe the evidence regarding the relationships between antipsychotic medications and QTc prolongation and practical methods for monitoring the QTc interval and mitigating arrhythmia risk.

Methods

Searches of PubMed and Cochrane Library were performed to identify studies, published before February 2023, investigating the relationships between antipsychotic medications and QTc prolongation or arrhythmias.

Results

Most antipsychotic medications commonly used for the management of delirium symptoms (eg, intravenous haloperidol, olanzapine, quetiapine) cause a moderate degree of QTc prolongation. Among other antipsychotics, those most likely to cause QTc prolongation are iloperidone and ziprasidone, while aripiprazole and lurasidone appear to have minimal risk for QTc prolongation. Genetic vulnerabilities, female sex, older age, pre-existing cardiovascular disease, electrolyte abnormalities, and non-psychiatric medications also increase the risk of QTc prolongation. For individuals at risk of QTc prolongation, it is essential to measure the QTc interval accurately and consistently and consider medication adjustments if needed.

Conclusions

Antipsychotic medications are one of many risk factors for QTc prolongation. When managing agitation related to delirium, it is imperative to assess an individual patient's risk for QTc prolongation and to choose a medication and monitoring strategy commensurate to the risks. In intensive care settings, we recommend regular ECG monitoring, using a linear regression formula to correct for heart rate. If substantial QTc prolongation (eg, QTc > 500 msec) is present, a change in pharmacologic treatment can be considered, though a particular medication may still be warranted if the risks of discontinuation (eg, extreme agitation, removal of invasive monitoring devices) outweigh the risks of arrhythmias.

Aims

This review aims to summarize the current literature on relationships between antipsychotic medications and QTc prolongation and to make practical clinical recommendations towards the approach of antipsychotic medication use for the management of delirium-related agitation and perceptual disturbances in intensive care settings.
Truth-telling to the seriously ill child – Nurses’ experiences, attitudes, and beliefs
Authors: El Ali Mandy , Licqurish Sharon , O'Neill Jenny , Gillam Lynn
Published: December 2023

Background

Nurses play an integral role in the care of children hospitalised with a serious illness. Although information about diagnostics, treatments, and prognosis are generally conveyed to parents and caregivers of seriously ill children by physicians, nurses spend a significant amount of time at the child’s bedside and have an acknowledged role in helping patients and families understand the information that they have been given by a doctor. Hence, the ethical role of the nurse in truth disclosure to children is worth exploring.

Methods

A systematic academic database and grey literature search strategy was conducted using CINAHL, Medline Psych Info, and Google Scholar. Keywords used included truth, children, nurse, disclosure, serious illness, and communication. A total of 17 publications of varying types were included in the final data set.

Ethical Considerations

As this was a review of the literature, there were no direct human participants. Empirical studies included in the review had received ethics approval.

Results

Of the 17 articles included in the review, only one directly reported on the experiences of nurses asked to withhold the truth from patients. Empirical studies were limited to HIV-positive children and children diagnosed with cancer and the dying child.

Conclusion

A paucity of literature exploring the experiences, attitudes, and beliefs of nurses with regard to truth-telling to seriously ill children is evident. Little consideration has been given to the role nurses play in communicating medical information to children in a hospital setting. The 17 articles included in the review focused on cancer, and HIV, diagnosis, and end-of-life care. Further research should be undertaken to explore the experiences and attitudes of nurses to clinical information sharing to children hospitalised with a wide range of serious illnesses and in diverse clinical scenarios.
Taming Global Citizenship Education Within Twitter’s Attention Economy
Authors: Shultz Lynette , Karsgaard Carrie
Published: December 2023

A contested concept that finds multiple theorisations and practices in relation to various ideological, geographical and cultural positionings, global citizenship education (GCE). has taken flight in the formal and non-formal education sectors over the past two decades, bringing together education-focused actors from government and civil society in dynamic relationships. With the proliferation of social media, GCE actors have taken to platforms such as Twitter for educational and communicative purposes, leading to the emergence of an attention economy surrounding GCE. This article utilises issue mapping to trace and visualise the performance of GCE by organisations in the Global North, comparing their formal organisational definitions with their communication of their GCE work over Twitter. While organisational public education and communications have long functioned within a competitive, neoliberal economy, this article focuses specifically on how the attention economy of Twitter contributes to the diffusion or capture of particular understandings of global citizenship through a GCE issue network.
The Search for Sustainability Amid Displacement: Exploring the Potential of Fast-growing Exotic Tree Species as Fuelwood Alternative for Refugees and Host Communities in Northern Uganda
Authors: Anywar Decimon , Shaban Kato Stonewall , Labeja Richard Louis , Loki Robert Okongo , Beyihayo Geoffrey Akiiki , Okello Collins , Haselip James
Published: December 2023

Uganda hosts Africa’s largest refugee population, exceeding 1.5 million in early 2023. While commended for its progressive refugee policies, which grant freedom of movement and work opportunities, the influx of displaced people since 2015 has strained shared environmental resources, including slow-growing indigenous trees utilized for construction and fuel. Efforts to preserve indigenous biodiversity have promoted the growth and use of faster-growing exotic tree species. However, local communities often favor indigenous trees as fuel sources, despite limited evidence supporting their superiority. This study assessed fuel properties of selected indigenous and exotic tree species in Lamwo District, Northern Uganda. Laboratory analysis of wood samples revealed no significant differences in moisture content, fixed carbon, volatile matter, or Fuel Value Index (FVI) among the species. The study therefore recommends promoting fast-growing exotic species like Eucalyptus grandis, Caliandra calothyrsus, and Senna siamea, urging international agencies, NGOs, and community-led organizations to leverage the findings for behavior change campaigns. This approach would facilitate species regeneration, alleviate pressure on natural forests, and supplement Uganda’s investment strategy in Modern Energy Cooking Services (MECS) such as LPG and solar e-cooking technologies.
Concurrent administration of serotonergic antidepressants and ozanimod in participants with relapsing multiple sclerosis from the open-label extension DAYBREAK trial
Authors: Naismith Robert T , Cohen Jeffrey A , Bar-Or Amit , Comi Giancarlo , Selmaj Krzysztof W , Hartung Hans-Peter , Sheffield James K , Krakovich Anthony , Tatosian Daniel , Cheng Chun-Yen , Reardon Jennifer , Khaychuk Vadim , Riolo Jon V , Silva Diego , Cree Bruce AC
Published: December 2023

Background:

Monoamine oxidase (MAO) inhibitors can interact with selective serotonin reuptake inhibitors (SSRIs)/serotonin–norepinephrine reuptake inhibitors (SNRIs). There is clinical interest surrounding use of ozanimod with SSRIs/SNRIs because the major metabolites of ozanimod are weak inhibitors of MAO-B in vitro.

Objective:

To evaluate the incidence of treatment-emergent adverse events (TEAEs) potentially related to serotonin accumulation (SA) during concomitant ozanimod and SSRI/SNRI use by performing analyses of data from an open-label, oral ozanimod 0.92 mg trial (DAYBREAK; NCT02576717).

Methods:

SA narrow (serotonin syndrome, neuroleptic malignant syndrome, and hyperthermia malignant) and broad (terms potentially associated with SA) MedDRA v24.0 searches were performed using TEAE data from participants with relapsing multiple sclerosis who entered DAYBREAK from phase 3 studies (cutoff February 1, 2022). Incidences of TEAEs matching terms from each search were stratified by SSRI/SNRI use.

Results:

Of 2257 DAYBREAK participants, 274 (12.1%) used an SSRI/SNRI. No participants had TEAEs matching the SA narrow search terms. There was no significant difference in the percentage of participants with ⩾1 TEAE matching the SA broad search for those on versus off SSRIs/SNRIs (on: 12.4%, n = 34/274; off: 15.6%, n = 310/1982, nominal p = 0.1630).

Conclusion:

MedDRA searches showed no increase in TEAEs potentially associated with SA with concomitant SSRI/SNRI and ozanimod use.
A flexible Bayesian hierarchical quantile spatial model for areal data
Authors: Fernandez Rafael Cabral , Gonçalves Kelly Cristina Mota , de Morais Pereira João Batista
Published: December 2023

This article introduces a new class of nested models that extends the literature standard combination of spatial autoregressive model for areal data with parametric quantile regression by considering an asymmetric Laplace distribution for the random errors. In addition to being more flexible, the new proposed model can incorporate a hierarchical structure, allowing it to deal with clustered data. Such an approach produces a robust statistical method for modeling the quantiles of areal data distributed in a geographically hierarchical setting. The proposed non-hierarchical model is evaluated using a wellknown house pricing dataset and a simulation study. In addition, its hierarchical version is applied to a real dataset of math scores related to public high schools within the metropolitan area of Rio de Janeiro, Brazil.
A combined overdispersed longitudinal model for nominal data
Authors: Sercundes Ricardo K. , Molenberghs Geert , Verbeke Geert , Demétrio Clarice G.B. , da Silva Sila C. , Moral Rafael A.
Published: December 2023

Longitudinal studies involving nominal outcomes are carried out in various scientific areas. These outcomes are frequently modelled using a generalized linear mixed modelling (GLMM) framework. This widely used approach allows for the modelling of the hierarchy in the data to accommodate different degrees of overdispersion. In this article, a combined model (CM) that takes into account overdispersion and clustering through two separate sets of random effects is formulated. Maximum likelihood estimation with analytic-numerical integration is used to estimate the model parameters. To examine the relative performance of the CM and the GLMM, simulation studies were carried out, exploring scenarios with different sample sizes, types of random effects, and overdispersion. Both models were applied to a real dataset obtained from an experiment in agriculture. We also provide an implementation of these models through SAS code.
“I was having an internal conflict with myself.” COVID-19 vaccination decision-making processes among pregnant women
Authors: Narasimhan Subasri , Perry Tahira L , Johnson Leslie CM
Published: December 2023

Background:

Vaccination serves as an efficient primary means of control for infectious diseases. However, in the case of the COVID-19 pandemic, pregnant women within the United States had the lowest rates of COVID-19 vaccination and reported the lowest intent to vaccinate.

Objectives:

To explore the decision-making process for COVID-19 vaccination for people pregnant during the pandemic.

Design:

A secondary analysis of data from a mixed-methods study that examined the impact of COVID-19 on experiences of prenatal care, birth support, and delivery in the Southern United States.

Methods:

This study used a descriptive phenomenological approach to thematically analyze in-depth interviews ( n = 20) with adult women who were pregnant by January 2020 and had their prenatal care and delivery during the pandemic beginning in March 2020. The transcripts were de-identified, coded, and thematically analyzed to saturation to identify drivers of COVID-19 vaccine decision-making based on COVID-19 vaccination status and timing. Comparative analyses were conducted to assess differences in decision-making processes based on race/ethnicity and parity. Participants also completed a sociodemographic survey that included their COVID-19 vaccination status.

Results:

Two themes emerged, the weighing of parallel risks and priorities from different sources resulting in vaccine decisional conflict and the need to reconcile that conflict via multiple strategies. All participants weighed priorities and risks from multiple areas of their lives and described internal conflict around vaccination. Participants described tailoring decisions to household dynamics, reconciling public and private values around vaccination, and the impact of their identities on the decision-making process. While many described concerns over vaccine safety and fetal health, uniquely, many highlighted weighing the impact of prior pregnancy loss history, with some choosing other preventive measures like social distancing or mask-wearing, which they deemed less risky.

Conclusion:

Pregnant people make complex COVID-19 vaccination decisions, which must be considered in future vaccine messaging and advocacy for this group.
A retrospective study on the status of sexually transmitted co-infections in university hospitals in Korea from 2017 to 2021
Authors: Lee Sun Jung , Jang Tae Su , Kim Jae Kyung
Published: December 2023

Background:

The prevalence of sexually transmitted infections (STIs) remains high worldwide. Despite the worldwide increase in the incidence of STIs every year, there are few reports on the frequency of STIs with different pathogens according to age and gender. Accordingly, a study was conducted to determine trends in co-infection with STIs by age and gender in Cheonan, South Korea from 2017 to 2021.

Objectives:

To identify trends by age or sex in co-infection of STIs in this region.

Design:

A retrospective study was conducted on clinical samples examined at Dankook University Hospital from January 2017 to November 2021. A total of 3297 specimens were collected from patients visiting Dankook University Hospital (Cheonan, Korea), and statistical analysis was performed on patients ranging in age from 1 day to 93 years.

Methods:

Multiplex polymerase chain reaction, the most efficient method to diagnose a bacterial infection, was performed using an MJ Research PTC-200 Thermal Cycler (Marshall Scientific, Richmond, VA, USA) and a Seeplex STD Detection Kit (Seegene, Seoul, Republic of Korea). The co-infection rate with STI pathogens was analyzed according to age and sex.

Results:

Of the 3297 clinical samples, 1017 (30.9%) tested positive for sexually transmitted pathogens, ranging from one to six co-infections. Analysis of the co-infection rate by age revealed that the average age gradually decreased as the total number of co-infection pathogens increased. The co-infection percentage and age distribution of STIs differed according to sex. Co-infection was more prevalent in female patients. Furthermore, co-infection in male patients occurred frequently in the 30–39-year-old group, while those in female patients occurred in the 20–29- and 30–39-year-old groups.

Conclusion:

Our statistical analysis showed that STI co-infections were more common among younger than older people. Therefore, it helps in recognizing STIs at a young age and provides possible indicator data to prevent STIs at a young age. In addition, further research is needed on co-infection in other regions.
The association between mobile dating app use and relationship status satisfaction: A survey study
Authors: Bleize Daniëlle N. M. , van Stekelenburg Aart , Tamboer Sanne L.
Published: December 2023

Connecting with others through mobile dating apps has become one of the most popular ways for people to meet. These apps might help people find a suitable partner and, thus, achieve a satisfactory love life. To examine whether mobile dating apps deliver on their potential for positive relationship outcomes, this study investigates if and how the use of these apps is related to satisfaction with one's relationship status. In a survey study, we compared previous and current users of mobile dating apps with people who have never used such apps ( n= 1,054, from the United States or United Kingdom, younger than 35). Results showed that dating app users score lower on satisfaction with their relationship status than non-users. This negative association between dating app use and satisfaction was stronger for women than it was for men. The most crucial factor in relationship status satisfaction, however, is whether people are in a relationship or not. Future research should aim to disentangle the causal order of the association between mobile dating app use and relationship status satisfaction, and investigate if these apps have the potential to improve users’ satisfaction with their relationship status in the long term through facilitating romantic relationships.
Validation of automated pipeline for the assessment of a motor speech disorder in amyotrophic lateral sclerosis (ALS)
Authors: Simmatis Leif ER , Robin Jessica , Pommée Timothy , McKinlay Scotia , Sran Rupinder , Taati Niyousha , Truong Justin , Koyani Bharatkumar , Yunusova Yana
Published: December 2023

Background and objective

Amyotrophic lateral sclerosis (ALS) frequently causes speech impairments, which can be valuable early indicators of decline. Automated acoustic assessment of speech in ALS is attractive, and there is a pressing need to validate such tools in line with best practices, including analytical and clinical validation. We hypothesized that data analysis using a novel speech assessment pipeline would correspond strongly to analyses performed using lab-standard practices and that acoustic features from the novel pipeline would correspond to clinical outcomes of interest in ALS.

Methods

We analyzed data from three standard speech assessment tasks (i.e., vowel phonation, passage reading, and diadochokinesis) in 122 ALS patients. Data were analyzed automatically using a pipeline developed by Winterlight Labs, which yielded 53 acoustic features. First, for analytical validation, data were analyzed using a lab-standard analysis pipeline for comparison. This was followed by univariate analysis (Spearman correlations between individual features in Winterlight and in-lab datasets) and multivariate analysis (sparse canonical correlation analysis (SCCA)). Subsequently, clinical validation was performed. This included univariate analysis (Spearman correlation between automated acoustic features and clinical measures) and multivariate analysis (interpretable autoencoder-based dimensionality reduction).

Results

Analytical validity was demonstrated by substantial univariate correlations (Spearman's ρ > 0.70) between corresponding pairs of features from automated and lab-based datasets, as well as interpretable SCCA feature groups. Clinical validity was supported by strong univariate correlations between automated features and clinical measures (Spearman's ρ > 0.70), as well as associations between multivariate outputs and clinical measures.

Conclusion

This novel, automated speech assessment feature set demonstrates substantial promise as a valid tool for analyzing impaired speech in ALS patients and for the further development of these technologies.
Relation between school education aims and Finnish adolescents’ global mindedness: The mediating role of tolerance
Authors: Huang Haoyan , Liang Naizhi , Zhang Yixin , Li Wanyi , Wang Naiyi
Published: December 2023

Global mindedness is increasingly crucial for individual, national, and global flourishing, and thus obtains great emphasis in school education. This study aimed to examine the associations between adolescents’ global mindedness and three-dimensional school education aims (aims for academic achievement, employability, and narrow-sense holistic development). We further explored the role of adolescents’ tolerance that might explain the associations. A total of 2448 15-year-old Finnish adolescents were selected and two-level hierarchical liner modeling was employed. Results showed that (1) academic achievement aim played a positive role in adolescents’ global mindedness, whereas narrow-sense holistic development aim and employability aim showed insignificant and negative effect on it, respectively; and (2) adolescents’ tolerance mediated the associations of these three school education aims and global mindedness. Findings identified the fundamental contribution of academic achievement aim to global mindedness, and imply schools to integrate global education with academic education, as well as to forbid the discouragement for tolerance and global mindedness in employability education.
A Scoping Literature Review on Evidence-Based Strategies to Increase Cervical Cancer Screening
Authors: Bonuck Kathryn J. , Angier Heather , McCrimmon Sara , Holderness Heather , Erroba Jeremy , Huguet Nathalie , DeVoe Jennifer E. , Carney Patricia A.
Published: December 2023

Previous reviews of strategies to increase cervical cancer screening are more than 10 years old, the U.S. continues to fall short of the Healthy People 2030 cervical cancer screening goal, and guidelines were revised in 2018, therefore an updated review of the existing literature is needed. We conducted a scoping review using electronic databases PubMed, Scopus, and Ovid Medline that included publication dates between 2012 and 2021 to answer the question, “Which strategies implemented in U.S. primary care settings have been most successful in increasing rates of cervical cancer screening since the 2012 US Preventative Services Task Force cervical cancer screening guidelines were published?” We mapped findings to pre-specified implementation strategy categories. After initially identifying 399 articles, we excluded 350 due to duplicates or not meeting review criteria, leaving 49 articles for full review. We excluded 37 of these during full-text review and identified 2 additional articles from the manual search of reference lists for a total of 14 studies for abstraction. Eleven articles reported on strategies resulting in increased cervical cancer screening, and 3 did not. Clinic workflow re-design strategies showed the greatest promise in improving cervical cancer screening rates, education strategies for patients had mixed results, and quality management strategies were not effective. These findings suggest clinical workflow re-structures and patient education strategies can increase cervical cancer screening in primary care settings. Results are particularly important in settings that care for underserved populations, as these settings may need additional implementation strategies to decrease cervical cancer screening disparities.
Causes and Institutional Responsesof Social Unrest in South African Universities
Authors: Omodan Bunmi Isaiah
Published: December 2023

This paper explores the root causes of student unrest in South African universities and evaluates the institutional responses to these protests, otherwise regarded as social unrest. The study is lensed through social movement theory and institutional theory. The study adopted transformative paradigm under qualitative approach and participatory research design to analyze the experiences of universities in South Africa that have experienced significant social unrest in recent years. Focus group discussion was conducted with university management staff, student activists, and security officers of the selected universities. The findings showed that lack of access, socio-economic inequalities, ineffective communication, and open engagement are the primary causes of social unrest. In contrast, providing equitable access, economic liberation, effective communication, and open engagement is the possible institutional response that alleviates social unrest on university campuses. Hence, promoting equitable access and economic liberation coupled with effective communication and open engagement among stakeholders was recommended.
A New Instrument for Measuring Customers’ Perceptions of Service Warmth: A Big Data and Machine Learning Approach
Authors: Liu Tao , Shi Kewei , Hu Lingli , Liu Yuqing , Liu Yunyao
Published: December 2023

The hotel industry is placing increasing emphasis on customers’ perception of service warmth. However, the current methods for measuring customers’ perception of service warmth are limited to sample surveys. Thus, a two-stage quantitative approach was adopted in this study to develop a novel measuring instrument. By leveraging big data analysis and machine learning techniques, a weighted lexicon of 95 words was identified, which can be utilized to assess customers’ perception of enthusiasm toward P2P accommodation services. The effectiveness of this new measurement tool was tested through two methods: a five-fold cross-validation approach and multiple regression with controlled variables. The instrument developed in this study enables comparable measurement results of perceived service enthusiasm across different accommodation units. Furthermore, this research contributes to the knowledge of measurement instrument development in the era of big data. The practical implications of using the weighted word list are also discussed.
COVID-19 Vaccine Communications on Instagram and Vaccine Uptake in Young Adults: A Content Assessment and Public Engagement Analysis
Authors: Ford Caitlin , MacKay Melissa , Thaivalappil Abhinand , McWhirter Jennifer , Papadopoulos Andrew
Published: December 2023

In Canada, during the pandemic, young adults (18–29 year-olds) represented one of the least-vaccinated age groups against COVID-19. These low vaccination rates, and high infection rates, left young people vulnerable to severe infections and created a risk for transmission to immunocompromised populations. Given young adults’ unique characteristics, to encourage vaccination among this demographic, public health and government officials must adopt an audience-centred approach to communication. We sought to understand if the vaccine messages from 8 Canadian federal government Instagram accounts met the needs of young adults based two frameworks: Guiding Principles for Crisis Communication (compassion and empathy, conversational tone, transparency, clarity, call to action and correction of misinformation), and the 5C Model for Vaccine Hesitancy (confidence, complacency, constraints, collective responsibility, and risk calculation). Across 159 posts that mentioned COVID-19 vaccines, there was limited incorporation of best practices, suggesting the government’s communication strategy did not meet the needs of young people.
Bimanual Technique With Perfluoro-N-Octane for Human Amniotic Membrane Transplantation in Refractory Optic Disc Pit Maculopathy
Authors: Busquets Miguel
Published: December 2023

Purpose: To describe a patient with optic disc pit (ODP) maculopathy who presented with poor vision and treatment outcomes. Methods: An amniotic membrane transplantation (AMT) was performed using a bimanual technique with perfluoro-N-octane endotamponade after failure of other techniques to yield resolution of subretinal fluid (SRF). Results: Successful adhesion of the human amniotic membrane graft to the host resulted in sustained resolution of the SRF and significant improvement in visual acuity within 2 weeks. Conclusions: AMT is a viable therapeutic option for patients with vision loss associated with submacular fluid from ODPs. The bimanual technique with perfluorocarbon assistance provides the vitreoretinal surgeon with an additional technical alternative for surgical treatment of ODP maculopathy.
The ethnographic B movie: Centering the uncertain, absurd and low quality in collaborative filmmaking
Authors: Epp Jared
Published: December 2023

This paper discusses an experimental modality of ethnographic filmmaking that my interlocutor/collaborator and I came to call the ‘ethnographic B movie’. I explore what I mean by the term and describe its use as novel approach to collaborative multimodal research. I argue that this approach – which encourages unprofessionalism, low quality, absurdity and caprice – provides an opportunity to centre research contexts, ontologies and epistemologies on the fringes or margins of conventional anthropological content, thought and context. Through situating the approach within ideas of arts-based research or research-creation the ethnographic B movie becomes a way to take the process of filmmaking as ethnography for the sake of an open and co-imaginative world. In the ethnographic B movie as filmic approach and representational frame, communicable meaning and narrative coherence are substituted for the spirit of co-creation, and interlocutor-driven content.
Diminished airway host innate response in people with cystic fibrosis who experience frequent pulmonary exacerbations
Authors: Houston Claire J. , Alkhatib Aya , Einarsson Gísli G. , Tunney Michael M. , Taggart Clifford C. , Downey Damian G.
Published: December 2023

Rationale

Pulmonary exacerbations are clinically impactful events that accelerate cystic fibrosis (CF) lung disease progression. The pathophysiological mechanisms underlying an increased frequency of pulmonary exacerbations have not been explored.

Objectives

To compare host immune response during intravenous antibiotic treatment of pulmonary exacerbations in people with CF who have a history of frequentversusinfrequent exacerbations.

Methods

Adults with CF were recruited at onset of antibiotic treatment of a pulmonary exacerbation and were categorised as infrequent or frequent exacerbators based on their pulmonary exacerbation frequency in the previous 12 months. Clinical parameters, sputum bacterial load and sputum inflammatory markers were measured on day 0, day 5 and at the end of treatment. Shotgun proteomic analysis was performed on sputum using liquid chromatography-mass spectrometry.

Measurements and main results

Many sputum proteins were differentially enriched between infrequent and frequent exacerbators (day 0 n=23 and day 5 n=31). The majority of these proteins had a higher abundance in infrequent exacerbators and were secreted innate host defence proteins with antimicrobial, antiprotease and immunomodulatory functions. Several differentially enriched proteins were validated using ELISA and Western blot including secretory leukocyte protease inhibitor (SLPI), lipocalin-1 and cystatin SA. Sputum from frequent exacerbators demonstrated potent ability to cleave exogenous recombinant SLPI in a neutrophil elastase dependent manner. Frequent exacerbators had increased sputum inflammatory markers (interleukin (IL)-1β and IL-8) and total bacterial load compared to infrequent exacerbators.

Conclusions

A diminished innate host protein defence may play a role in the pathophysiological mechanisms of frequent CF pulmonary exacerbations. Frequent exacerbators may benefit from therapies targeting this dysregulated host immune response.
NUAK1 coordinates growth factor-dependent activation of mTORC2 and Akt signaling
Authors: Palma Mario , Riffo Elizabeth , Farias Alejandro , Coliboro-Dannich Viviana , Espinoza-Francine Luis , Escalona Emilia , Amigo Roberto , Gutiérrez José L. , Pincheira Roxana , Castro Ariel F.
Published: December 2023

Background

mTORC2 is a critical regulator of cytoskeleton organization, cell proliferation, and cancer cell survival. Activated mTORC2 induces maximal activation of Akt by phosphorylation of Ser-473, but regulation of Akt activity and signaling crosstalk upon growth factor stimulation are still unclear.

Results

We identified that NUAK1 regulates growth factor-dependent activation of Akt by two mechanisms. NUAK1 interacts with mTORC2 components and regulates mTORC2-dependent activation of Akt by controlling lysosome positioning and mTOR association with this organelle. A second mechanism involves NUAK1 directly phosphorylating Akt at Ser-473. The effect of NUAK1 correlated with a growth factor-dependent activation of specific Akt substrates. NUAK1 induced the Akt-dependent phosphorylation of FOXO1/3a (Thr-24/Thr-32) but not of TSC2 (Thr-1462). According to a subcellular compartmentalization that could explain NUAK1’s differential effect on the Akt substrates, we found that NUAK1 is associated with early endosomes but not with plasma membrane, late endosomes, or lysosomes. NUAK1 was required for the Akt/FOXO1/3a axis, regulating p21CIP1, p27KIP1, and FoxM1 expression and cancer cell survival upon EGFR stimulation. Pharmacological inhibition of NUAK1 potentiated the cell death effect induced by Akt or mTOR pharmacological blockage. Analysis of human tissue data revealed that NUAK1 expression positively correlates with EGFR expression and Akt Ser-473 phosphorylation in several human cancers.

Conclusions

Our results showed that NUAK1 kinase controls mTOR subcellular localization and induces Akt phosphorylation, demonstrating that NUAK1 regulates the growth factor-dependent activation of Akt signaling. Therefore, targeting NUAK1, or co-targeting it with Akt or mTOR inhibitors, may be effective in cancers with hyperactivated Akt signaling.
Effect of organic mineral supplementation in reducing oxidative stress in Holstein calves during short-term heat stress and recovery conditions
Authors: Son A-Rang , Kim Seon-Ho , Islam Mahfuzul , Miguel Michelle , Naing Ye Pyae , Lee Sang-Suk
Published: December 2023

Background

This study investigated the effects of inorganic and organic minerals on physiological responses, oxidative stress reduction, and rumen microbiota in Holstein bull calves (123.81 ± 9.76 kg; 5 months old) during short-term heat stress (HS) and recovery periods. Eight Holstein calves were randomly assigned to four treatment groups: no mineral supplementation (Con), inorganic minerals (IM), organic minerals (OM), and high-concentration organic minerals (HOM) and two thermal environments (HS and recovery) using 4 × 2 factorial arrangement in a crossover design of four periods of 35 d. Calves were maintained in a temperature-controlled barn. The experimental period consisted of 14 d of HS, 14 d of recovery condititon, and a 7-d washing period.

Results

Body temperature and respiration rate were higher in HS than in the recovery conditions (P < 0.05). Selenium concentration in serum was high in the HOM-supplemented calves in both HS (90.38 μg/dL) and recovery periods (102.00 μg/dL) (P < 0.05). During the HS period, the serum cortisol was 20.26 ng/mL in the HOM group, which was 5.60 ng/mL lower than in the control group (P < 0.05). The total antioxidant status was the highest in the OM group (2.71 mmol Trolox equivalent/L), followed by the HOM group during HS, whereas it was highest in the HOM group (2.58 mmol Trolox equivalent/L) during the recovery period (P < 0.05). Plasma malondialdehyde and HSP70 levels were decreased by HOM supplementation during the HS and recovery periods, whereas SOD and GPX levels were not significantly affected (P > 0.05). The principal coordinate analysis represented that the overall rumen microbiota was not influenced by mineral supplementation; however, temperature-induced microbial structure shifts were indicated (PERMANOVA: P < 0.05). At the phylum level, Firmicutes and Actinobacteria decreased, whereas Fibrobacteres, Spirochaetes, and Tenericutes increased (P < 0.05), under HS conditions. The genus Treponema increased under HS conditions, while Christensenella was higher in recovery conditions (P < 0.05).

Conclusion

HOM supplementation during HS reduced cortisol concentrations and increased total antioxidant status in Holstein bull calves, suggesting that high organic mineral supplementation may alleviate the adverse effects of HS.
The diverse functions of Pseudomonas syringae syringae van Hall effectors in regulating the plant immune response
Authors: Wang Xiang , Yan Fei , Ma Guojing , Li Aixia , Liu Lijing
Published: December 2023

Sorghum relies on its immune system to defend against various pathogens, including Pseudomonas syringae syringae van Hall (Pss van Hall). However, the sorghum immune system is largely unknown. Reports on pathogenic effectors have provided valuable insights into the plant immune system; thus, we aimed to identify Pss van Hall effectors that can regulate the sorghum defense response in this study. Here, we first established the sorghum-Pss van Hall pathosystem and found that type III effectors played critical roles in the virulence of Pss van Hall to sorghum. To predict its effectors, the whole genome of Pss van Hall was sequenced, and 18 effector-coding genes were identified. Among them, five effectors belong to the core effectors of Pseudomonas syringae pathovars, and two may be monocot pathogen-specific effectors. Pss van Hall triggered the hypersensitive response (HR) in Nicotiana benthamiana. We found that the effectors of Pss van Hall can be divided into cell death inducers and immune repressors by examining their functions in HR induction and repression of PTI marker gene, ROS production, and pathogen growth. Finally, the roles of core effectors HopAJ2 and HopAN1, and specific effector HopAX1 were further confirmed in the sorghum-Pss van Hall pathosystem. Importantly, the functions of HopAN1 and HopAX1 in regulating plant immunity were reported for the first time. We believe that the identification of these effectors will facilitate the continued exploration of the sorghum immune system.
Gender Dysphoria in a Patient With Ovotesticular Disorder of Sex Development
Authors: Moreno Telma , Ribeiro Sara , Rodrigues Pedro
Published: December 2023

Ovotesticular disorder of sex development (OT-DSD) is a rare condition characterized by the presence of both ovarian and testicular tissue in the gonads. Management and sex designation of these patients depend on several factors, and an underlying potential for gender dysphoria should be acknowledged. We present a case of a patient diagnosed with 46,XX OT-DSD at 12 months old who was attributed a female sex designation but started manifesting gender dysphoria during adolescence. Gender identity is an important factor to consider on long-term follow-up of OT-DSD patients.
Psychotic decompensation in the course of SARS-COV-2 infection - case report
Authors: Metelska Aleksandra , Permoda-Pachuta Agnieszka Anna
Published: December 2023

Introduction: SARS-CoV-2 is a single-stranded RNA virus belonging to the group of coronaviruses. Among patients infected with the COVID virus, neuropsychiatric symptoms are observed, such as dizziness and headaches, anxiety, depression, as well
as delusions and hallucinations. Psychotic symptoms have been observed in patients infected with SARS-CoV-2 without a prior psychiatric history.
Aim: The purpose of this study was to present a case of a patient with neuropsychiatric symptoms, most likely caused by a past COVID infection, and to present possible pathophysiological mechanisms explaining neuropsychiatric symptoms in the course
of SARS-CoV-2 infection.
Material and methods: Literature review was carried out using electronic databases: PubMed, Google Scholar, using the following keywords: SARS-COV-2, neuropsychiatric symptoms, reactive psychosis, cytokine storm, limiting the search scope to 2019-2023. Publications in English were used. The patient's medical records, results of laboratory and imaging tests and descriptions of psychological tests were used to describe the case.
Case description: A 27-year-old patient, not previously treated psychiatrically, with a recent COVID-19 infection, who developed acute, quickly passing psychotic symptoms in the form of persecutory delusions and visual and auditory hallucinations in a short period of time.
Discussion: The effect of the SARS-CoV-2 virus on the central nervous system is not fully understood - the literature presents several possible mechanisms underlying the neuropsychiatric manifestations of SARS-CoV-19 infection, which include viral infiltration into the central nervous system, dysregulation of the cytokine network and
excitotoxicity and translocation of intestinal microbes.

Keywords: SARS-COV-2, neuropsychiatric symptoms, reactive psychosis, cytokine storm
Dental education: not immune to AI and immersive technologies
Authors: Aerts Carla
Published: December 2023

Digital learning methods are here to stay – how do we maximise their effectiveness to ensure trainees benefit the most?
Lateral facial profile of β-thalassemia major in Javanese children: a photogrammetric analysis
Authors: Parengkuan Wulan Geraldine , Kuswandari Sri , Soeprihati Indah Titien
Published: December 2023

BACKGROUND Impairment of globin chain synthesis in patients with β-thalassemia major causes ineffective erythropoiesis. This condition triggers bone marrow hyperplasia and can lead to craniofacial bone abnormalities. This study aimed to evaluate the lateral facial profile of β-thalassemia major, identify any differences when compared with a control group of similar age and ethnicity, and reveal the facial profile of β-thalassemia major in Javanese children.

METHODS This cross-sectional study included 35 β-thalassemia major children aged 7–15 years. They were divided into 3 groups based on their age. Lateral facial photogrammetry was taken by measuring the forehead protrusion and nasolabial angle. Data were then mapped to the normal group of children in the same age group and descriptively analyzed using SPSS software.

RESULTS The 1 and 2 SD group had a higher prevalence of β-thalassemia major in children aged 7–9 years for both sexes. The older age group had a closer mean value to those of children without thalassemia.

CONCLUSIONS The forehead and maxillary profile of Javanese β-thalassemia major children tended to be protrusive, especially in the 7–9 years age group, while the older age groups had closer mean values to those of children without thalassemia.
The Books on the Bedside Table: Re-Reading "Mother" in E. L. Doctorow's Ragtime
Authors: Lambert Christina J.
Published: December 2023

Abstract: This essay examines the character of Mother in E. L. Doctorow's 1975 novel, Ragtime , through the lens of the literature that sits on her nightstand: an antisuffragist text by Molly Elliot Seawell and a pamphlet about family limitation by Margaret Sanger. Mother's character stands with one foot in the world of radical feminism and another in the milieu of antisuffragists. This context reframes her interactions with marginalized figures in the narrative and undermines her supposedly happy ending. Reading Mother in view of these texts makes her a dynamic character in the novel, revealing her inner life and agency.
Low SNR multimirror Fabry–Perot pressure sensor optic spectrum signal analysis and demodulation via SVM-KNN regressors
Authors: Yang Yiguang , Geng Dahe , Chen Hao , Li Xujin , Zhang Weihong , Yuan Yibo , Meng Xiangqian , Wenhong Li
Published: December 2023

We demonstrate an ensemble learning based method to solve the problem
of low SNR Fabry–Perot sensor spectrum signal demodulation. Taking the
eight-layer approximate coefficients of a multilevel discrete wavelet
transform as input features, an ensemble model that combines multiple
SVM and KNN learners is trained. Bootstrap and booting techniques are
introduced for better modeling performance and stability. It is shown
that the performance of the proposed ensemble model based on SVM-KNN
regressors is excellent; an accuracy of 0.46%F.S. relative mean error
is achieved. This method could provide insight into the construction
of a large scale fiber based Fabry–Perot sensor network.
Rapid clearing and imaging of Mohs and melanoma surgical margins using a low-cost tissue processor
Authors: Huang Chi Z. , Montague Jenna E. , Ching-Roa Vincent D. , Drage Michael G. , Ibrahim Sherrif F. , Giacomelli Michael G.
Published: December 2023

Tissue clearing methods render biological tissues transparent while
maintaining tissue structure, enabling visualization of entire
tissues. Recent developments in tissue clearing have predominantly
emphasized preserving intrinsic fluorescent proteins or aqueous-based
tissue clearing and so typically involve complex procedures and long
processing times. The utilization of tissue clearing protocols in
standard of care histology settings has been less well explored, and
protocols for rapid clearing of human tissue specimens are limited.
This study presents a novel rapid clearing protocol and demonstrates a
low-cost tissue processor for high volume rapid tissue clearing that
can be intergraded into standard histology workflow. We demonstrate
rapid clearing in dermatological specimens, including both nonmelanoma
and melanoma excisions.
SERS microfluidic chip integrated with double amplified signal off-on strategy for detection of microRNA in NSCLC
Authors: Zhu Jiashan , Luo Jinhua , Hua Zhaolai , Feng Xiang , Cao Xiaowei
Published: December 2023

In this work, based on Fe3O4@AuNPs and double
amplified signal Off-On strategy, a simple and sensitive SERS
microfluidic chip was constructed to detect microRNA associated with
non-small cell lung cancer (NSCLC). Fe3O4@AuNPs
have two advantages of SERS enhanced and magnetic adsorption, the
introduction of microfluidic chip can realize double amplification of
SERS signal. First, the binding of complementary ssDNA and hpDNA moved
the Raman signaling molecule away from
Fe3O4@AuNPs, at which point the signal was
turned off. Second, in the presence of the target microRNA, they were
captured by complementary ssDNA and bound to them. HpDNA restored the
hairpin conformation, the Raman signaling molecule moved closer to
Fe3O4@AuNPs. At this time, the signal was turned
on and strong Raman signal was generated. And last, through the
magnetic component of SERS microfluidic chip,
Fe3O4@AuNPs could be enriched to realize the
secondary enhancement of SERS signal. In this way, the proposed SERS
microfluidic chip can detect microRNA with high sensitivity and
specificity. The corresponding detection of limit (LOD) for miR-21
versus miR-125b was 6.38 aM and 7.94 aM, respectively. This SERS
microfluidic chip was promising in the field of early detection of
NSCLC.
Enhanced sensitivity distributed sensing of magnetic fields in optical fiber using random Bragg grating
Authors: Leymonerie Antoine , Boisvert Jean-Sébastien , Juszczak Léonie , Loranger Sébastien
Published: December 2023

We show that the use of random optical grating using UV exposure (ROGUE) can significantly reduce the noise floor of an optical frequency domain reflectometry (OFDR) measurement of Faraday rotation in the polarization. We compare it with unexposed spun fiber, which shows a S/P minimum ratio (signal noise floor) 20 dB higher than when using our ROGUE. High sensitivity magnetic field measurements are achieved by spatially filtering (setting a gage length) the derivative of the S/P ratio’s evolution. An example of a calibrated electromagnet spatially resolved B-field measurement is demonstrated, which can measure fields down to 10 mT with 10 cm spatial resolution. The potential for current sensing using the ROGUE apparatus is discussed and simulation shows a noise floor of ∼1 A with 40 probing loops spatial resolution.