bluuebunny/crossref_metadata_2025 huggingface dataset:
Advance care planning as perceived by marginalized populations: Willing to engage and facing obstacles
Authors: Izumi Shigeko (Seiko) , Garcia Ellen , Kualaau Andrew , Sloan Danetta E. , DeSanto-Madeya Susan , Candrian Carey , Anderson Elizabeth , Sanders Justin
Published: April 2024

Background

Health disparities exist in end-of-life (EOL) care. Individuals and communities that are marginalized due to their race, ethnicity, income, geographic location, language, or cultural background experience systemic barriers to access and receive lower quality EOL care. Advance care planning (ACP) prepares patients and their caregivers for EOL decision-making for the purpose of promoting high-quality EOL care. Low engagement in ACP among marginalized populations is thought to have contributed to disparity in EOL care. To advance health equity and deliver care that aligns with the goals and values of each individual, there is a need to improve ACP for marginalized populations.

Aim

To describe how patients from marginalized populations experience and perceive ACP.

Methods

We used an interpretive phenomenological approach with semi-structured qualitative interviews. Participants were recruited from four primary care clinics and one nursing home in a US Pacific Northwest city. Thirty patients from marginalized populations with serious illness participated in individual interviews between January and December 2021. Participants were asked to describe their experiences and perceptions about ACP during the interviews.

Results

The mean age of 30 participants was 69.5; 19 (63%) were women; 12 (40%) identified as Asian/Pacific Islanders, 10 (33%) as Black; and 9 (30%) were non-native English speakers. Our three key findings were: 1) patients from marginalized populations are willing to engage in ACP; 2) there were multiple obstacles to engaging in ACP; and 3) meaningful ACP conversations could happen when clinicians listen. Although participants from marginalized populations were willing to engage in ACP, a fragmented and restrictive healthcare system and clinicians’ biased behaviors or lack of interest in knowing their patients were obstacles. Participants who felt their clinicians took time and listened were encouraged to engage in ACP.

Conclusion

Patients from marginalized populations are willing to engage in ACP conversations despite a common belief otherwise. However, obstacles to meaningful ACP conversations with healthcare providers exist. Clinicians need to be aware of these obstacles and listen to build trust and engage marginalized patients in mutually meaningful ACP conversations.
Validation of the Italian version of a patient-reported outcome measure for Hereditary Spastic Paraplegia
Authors: Diella Eleonora , D’Angelo Maria Grazia , Stefan Cristina , Girardi Giulia , Morganti Roberta , Martinuzzi Andrea , Biffi Emilia
Published: April 2024

Background and aim

Patient-reported outcome measures (PROMs) are recognized as valuable measures in the clinical setting. In 2018 we developed the Italian version of the “Hereditary Spastic Paraplegia-Self Notion and Perception Questionnaire” (HSP-SNAP), a disease-specific questionnaire that collects personal perception on motor symptoms related to HSP such as stiffness, weakness, imbalance, reduced endurance, fatigue and pain. In this study our primary aim was to assess the questionnaire validity and reliability. Our secondary aim was to characterize the symptoms “perceived” by patients with HSP and compare them with those “perceived” by age-matched healthy subjects.

Methods

The 12-item HSP-SNAP questionnaire was submitted to 20 external judges for comprehensibility and to 15 external judges for content validity assessment. We recruited 40 subjects with HSP and asked them to fill the questionnaire twice for test-retest procedure. They also completed the Medical Outcome Survey Short Form (SF-36) and were evaluated by the Spastic Paraplegia Rating Scale and the Six-Minute Walk Test. We also recruited 44 healthy subjects who completed the HSP-SNAP once to test score variability.

Results

The HSP-SNAP content validity index was high (0.8±0.1) and the test-retest analysis showed high reliability (ICC = 0.94). The mean HSP-SNAP score (score range 0–48) of the HSP group was 22.2±7.8, which was significantly lower than healthy subjects (43.1±6.3). The most commonly perceived symptom was stiffness, followed by weakness and imbalance.

Conclusion

Although HSP-SNAP does not investigate non-motor symptoms and we validated only its Italian version, it showed good validity and reliability and it could be used in combination with other objective outcome measures for clinical purposes or as endpoints for future clinical rehabilitation studies.

Trial registration

Trial Registration: ClinicalTrial.gov, NCT04256681. Registered 3 February 2020.
Anti-prion drugs do not improve survival in novel knock-in models of inherited prion disease
Authors: Walsh Daniel J. , Rees Judy R. , Mehra Surabhi , Bourkas Matthew E. C. , Kaczmarczyk Lech , Stuart Erica , Jackson Walker S. , Watts Joel C. , Supattapone Surachai
Published: April 2024

Prion diseases uniquely manifest in three distinct forms: inherited, sporadic, and infectious. Wild-type prions are responsible for the sporadic and infectious versions, while mutant prions cause inherited variants like fatal familial insomnia (FFI) and familial Creutzfeldt-Jakob disease (fCJD). Although some drugs can prolong prion incubation times up to four-fold in rodent models of infectious prion diseases, no effective treatments for FFI and fCJD have been found. In this study, we evaluated the efficacy of various anti-prion drugs on newly-developed knock-in mouse models for FFI and fCJD. These models express bank vole prion protein (PrP) with the pathogenic D178N and E200K mutations. We applied various drug regimens known to be highly effective against wild-type prions in vivo as well as a brain-penetrant compound that inhibits mutant PrPSc propagation in vitro. None of the regimens tested (Anle138b, IND24, Anle138b + IND24, cellulose ether, and PSCMA) significantly extended disease-free survival or prevented mutant PrPSc accumulation in either knock-in mouse model, despite their ability to induce strain adaptation of mutant prions. Our results show that anti-prion drugs originally developed to treat infectious prion diseases do not necessarily work for inherited prion diseases, and that the recombinant sPMCA is not a reliable platform for identifying compounds that target mutant prions. This work underscores the need to develop therapies and validate screening assays specifically for mutant prions, as well as anti-prion strategies that are not strain-dependent.
Broad-spectrum Delta-BA.2 tandem-fused heterodimer mRNA vaccine delivered by lipopolyplex
Authors: Du Pei , Huang Lei , Fang Yi , Zhao Fanfan , Li Qianyun , Ma Xuehui , Li Ruiqi , Chen Qian , Shen Haifa , Wang Qihui , Li Hangwen , Gao George Fu
Published: April 2024

Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, continues to mutate and generates new variants with increasingly severe immune escape, urging the upgrade of COVID-19 vaccines. Here, based on a similar dimeric RBD design as our previous ZF2001 vaccine, we developed a novel broad-spectrum COVID-19 mRNA vaccine, SWIM516, with chimeric Delta-BA.2 RBD dimer delivered by lipopolyplex (LPP). Unlike the popular lipid nanoparticle (LNP), this LPP-delivered mRNA expresses only in the injection site, which avoids potential toxicity to the liver. We demonstrated the broad-spectrum humoral and cellular immunogenicity of this vaccine to Delta and Omicron sub-variants in naïve mice and as booster shots. When challenged with Delta or Omicron live virus, vaccinated human angiotensin-converting enzyme (hACE2) transgenic mice and rhesus macaques were both protected, displaying significantly reduced viral loads and markedly relieved pathological damages. We believe the SWIM516 vaccine qualifies as a candidate for the next-generation broad-spectrum COVID-19 vaccine.
A study of illegal dumping near coastal zones and waterways in Grenada: Advancing waste management solutions and reducing marine litter
Authors: Graham Roxanne E. D.
Published: April 2024

The small island of Grenada, located in the south-eastern Caribbean, is grappling with the escalating issue of illegal dumping near its coastal zones and waterways. This study aims to investigate the causes of illegal dumping on the island, as well as potential solutions to mitigate its impact on the environment, public health, and the local economy. Using Geographic Information System (GIS) software, illegal dumpsites were mapped and the Lau, Whyte, and Law (2008) methodology for quantifying waste volume was applied to the study. Data were gathered manually via field work for over two months, including collecting information on illegal dumping sites’ waste type, quantity in terms of volume, and location, supplemented by photographs. Waste was classified into thirteen primary categories, such as construction and demolition (C&D), derelict vehicles and parts, electronic waste, glass, household/domestic waste, medical, healthcare, hygiene-related waste, metals, organic waste, paper and cardboard, plastics, textiles, used tires, white goods, and treated wood piles. The study estimated a total volume of approximately 35, 000 ft3 of waste from 29 unauthorized dumpsites. Out of these sites, C&D waste and plastics were the most dominant type of debris. The generated map offers valuable insights for Grenadian authorities to enhance their solid waste management system. It was revealed that rural and agricultural communities are more susceptible to illegal dumping and the underlying reasons for this issue was further investigated. Furthermore, interviews were conducted with key informants in waste management, marine pollution, and environmental and coastal affairs from other English-speaking Windward Islands. This approach facilitated the identification of shared patterns and the development of more effective, collaborative solutions across the country and region. The research findings can inform policy decisions and community-based initiatives aimed at reducing illegal dumping, fostering environmental responsibility, promoting sustainable waste management practices, and safeguarding the health and resilience of small island ecosystems.
Progesterone-Only Contraceptive-Induced Ischemic Colitis
Authors: Rajamanuri Medha , Garg Meher , Siddiqui Harris , Pannala Sreeram
Published: April 2024

Ischemic colitis (IC) occurs when there is a temporary lack of adequate blood supply to the intestines, particularly in vulnerable areas such as the splenic flexure and sigmoid colon, which lack sufficient collateral blood vessels. Although primarily seen in older individuals with atherosclerotic risk factors, IC can also be triggered by hormonal contraceptives in young women. Although estrogen-containing oral contraceptives are known to increase thromboembolic risk, the impact of progesterone is not well understood. We report a unique case of biopsy-confirmed IC in a previously healthy 30-year-old woman who presented with abdominal pain and bloody diarrhea 2 months after initiation of progesterone-only oral contraceptive. This occurrence, although rare, underscores the need for further research on the impact of progesterone on coagulation, especially concerning mesenteric arteries.
Comparison of the Efficacy Between the Dual Therapy of Tegoprazan and the Quadruple Therapy of Tegoprazan: A Randomized Controlled Multicenter Study
Authors: Liu Han-Ning , Wang Rui , Cao Yan , Xian Feng , Bi Xian-Jin , Wu Ding-Jian , Wang Bin , Wang Xing-Wei , Lan Chun-Hui
Published: April 2024

INTRODUCTION:

Tegoprazan (TPZ), a potassium-competitive acid blocker, exerts a strong acid-suppression effect and a rapid onset of action. However, research on TPZ-amoxicillin (TA) dual treatment is limited. Here, we compared the safety and efficacy of TPZ-amoxicillin dual treatment and TPZ, bismuth potassium citrate, amoxicillin, and clarithromycin (TBAC) quadruple therapy in patients newly diagnosed with H. pylori infection over a 14-day treatment period.

METHODS:

A total of 236 patients newly diagnosed with H. pylori were enrolled in this multicenter, prospective, open-label, and randomized controlled study. Patients randomly received either TA dual or TBAC quadruple therapy. The incidence of adverse reactions and treatment compliance were recorded and then analyzed.

RESULTS:

The intention-to-treat analysis revealed that H. pylori eradication rates were 83.9% (95% confidence interval 78.2%–91.3%) and 81.4% (95% confidence interval 74.2%–88.5%) for the TA and TBAC groups, respectively, with no statistically significant difference between them (P = 0.606). The per-protocol analysis revealed that the H. pylori eradication rates were 88.3% and 84.8% for the TA and TBAC groups, respectively (P = 0.447). The incidence of adverse reactions was significantly lower in the TA group than in the TBAC group (4.2% vs 15.3%, P = 0.004). Moreover, the TA group demonstrated substantially higher treatment compliance than the TBAC group (94.1% vs 89.0%, P = 0.020).

DISCUSSION:

The TA dual therapy successfully eradicated H. pylori with a high eradication rate and a low incidence of adverse reactions. Therefore, this treatment is recommended as an alternative course for patients newly diagnosed with H. pylori infection.
Tethered spinal cord syndrome associated with spina bifida: clinical and radiological characteristics and indications for surgery (systematic review of the literature)
Authors: Ryabykh S. O. , Gorchakov S. A. , Kalashnikov A. A.
Published: April 2024

Objective. To analyze literature data on clinical and radiation characteristics of the tethered spinal cord syndrome in spina bifida and to define criteria for indications for surgical treatment.Material and Methods. A search for prospective cohort clinical studies evaluating the clinical and radiation picture and indications for surgicalcorrection of the tethered spinal cord syndrome associated with spina bifida, published in 2005–2023 was performed in the Pubmed, EMBASE, eLibrary and the Сochrane Library databases. The literature search was carried out by one researcher. The study was carried out in accordance with the international recommendations for writing systematic reviews and meta-analyses PRISMA. The levels of evidencefor reliability and grades of the strength of recommendations were evaluated according to the ASCO Guidelines.

Results. A total of 394 literature sources were found in the databases. Duplicate materials (n = 81) have been removed. When non-fulltext articles were excluded, only 28 out of 251 remained studies met the inclusion criteria and were analyzed. According to the level of evidence, 18 of them were classified as B level, and 10 – as C level.Conclusion. The components of the tethered spinal cord syndrome are a dystopic spinal cord cone, a shortened fixed filum terminale, and the presence of a lumbosacral lipoma. At the same time, there are currently no clear criteria for the integral assessment of the clinical and morphofunctional state of patients, and the available scales are not specific. The described MRI criteria are limited by the level of evidence, but despite this, they reflect a high level of consensus among experts, including that on the defining indications for surgical spinal corduntethering. The lack of clear indications for surgical intervention and the debatability of performing preventive untethering of the spinal cord require further study of the problem with an emphasis on analyzing the criteria for tethered spinal cord syndrome.
Spinal canal stenosis: comparative analysis of minimally invasive bilateral decompression through a unilateral approach and laminectomy
Authors: Aganesov A. G. , Aleksanyan M. M. , Gemdzhian E. G.
Published: April 2024

Objective. To analyze and compare the results of treatment of lumbar spinal stenosis using minimally invasive unilateral decompression and classical laminectomy.

Material and Methods. The retrospective comparative monocentric study included 68 patients (2 groups of 34 patients each) operated on in 2018–2021 for spinal stenosis in the lumbar spine who met certain eligibility criteria. Patients of one group were operated on using minimally invasive bilateral decompression through a unilateral approach, while patients in the other group were operated on using classical laminectomy. The results of surgical treatment were compared during 24 months by assessing pre- and postoperative indicators of the intensity of pain in the back and lower extremities using a 10-point VAS, and the patient’s functional activity – using the Oswestry index.

Results. A statistically significant clinical effect of surgical treatment was noticed in both groups. At the end of the follow-up period, the results of back pain relief in the minimally invasive surgery group were significantly better (0.3 vs 0.9, respectively), and the improvement in functional activity was comparable to the laminectomy group (8.8 vs 9.8, respectively). A clinical effect of pain relief in the lower extremities was obtained in both groups (up to 1.2 and 1.4, respectively). The length of hospital stay, time to activation, and volume of blood loss were significantly lower in minimally invasive decompression group.

Conclusion. Minimally invasive unilateral decompression of the spinal canal for lumbar spinal stenosis demonstrates a better effect in relieving back pain than classical laminectomy, with no significant difference in relieving pain in the lower extremities. The minimally invasive technique allows patients to rehabilitate as quickly as possible and return to everyday life and work. It has socio-economic advantages compared to classical laminectomy – a shorter period of activation and hospital treatment, and less blood loss.
Surgical stabilization for degenerative lesions of the lumbar spine in patients with reduced bone mineral density: a systematic literature review
Authors: Shirokikh I. V. , Vasilyev A. I. , Batrak Yu. M. , Peleganchuk V. A.
Published: April 2024

Objective. To analyze methods contributing to the improvement of clinical and radiological outcomes of surgical stabilization of the lumbar spine in conditions of reduced bone mineral density (BMD).

Material and Methods. A search for publications presenting the results of clinical studies of surgical treatment of patients with degenerative lesions of the lumbar spine and reduced BMD was conducted in English and Russian in the MEDLINE and Russian Science Citation Index (RSCI) databases using key words “osteoporosis”, “osteopenia”, “spinal surgery”, “spinal fusion” and related terms in titles and abstracts with a search depth of 20 years. After applying the inclusion and exclusion criteria, 17 clinical studies were selected for analysis.

Results. Among the large number of techniques and implant-associated factors affecting the success of surgical intervention for degenerative lesions of the lumbar spine and reduced BMD, high-quality clinical studies have proven the effectiveness of expandable screws, spinal fusion with cortical screw placement and cement augmentation with polymethyl methacrylate.

Conclusion. The combination of techniques for cortical pedicle screw placement, cement augmentation and the use of expandable screws makes it possible to achieve results in surgical treatment of patients with degenerative lesions of the lumbar spine with reduced BMD comparable with those in patients with normal BMD. Of particular importance is the preoperative assessment of the regional state of bone tissue, which should be carried out using quantitative CT or MRI studies.
Long-term results of treatment of a patient with basilar invagination complicated by distal kyphosis and compressive ischemic cervical myelopathy: a clinical case and a brief literature review
Authors: Stepanenko V. V. , Shamanin V. A. , Trashin A. V. , Shulev Yu. A.
Published: April 2024

Objective. To present a clinical case of surgical correction of a craniovertebral anomaly complicated after 8 years by distal junctional kyphosis, stenosis, antelisthesis of the C5 vertebra and compressive ischemic cervical myelopathy in the C5–C6 segment.Material and Methods. When treating a 56-year-old patient with multiple anomalies of the craniovertebral region, differentiated surgical technologies were consistently used due to the development of late complications. The sequence and rationale for surgical decision making is described.Results. Initially, the patient underwent transoral decompression and posterior occipitocervical fixation, and after 8 years - reinstallation of the system with distal extension of the instrumentation zone to the C7 vertebra with indirect posterior decompression of the spinal cord, anterior discectomy with direct decompression and cage fixation at the C5–C6 level. Regression of myelopathic syndrome, correction of orthopedic status and significant improvement in functional status were achieved.Conclusion. A rare clinical observation demonstrates a combination of basilar invagination with assimilation of the atlas, which has provided rationale for two-stage surgical treatment in one surgical session (1st stage – transoral resection of the dens and 2/3 of the C2 vertebral body with anterior decompression of the spinal cord, and 2nd stage – occipitocervical fixation). The use of extended systems in this case caused the development of a clinically significant syndrome of the distal adjacent level, which required repeated surgical treatment after 8 years.
Towards a sociolinguistics of in difference: stancetaking on others
Authors: Williams Quentin
Published: April 2024

This paper proposes a sociolinguistics of in difference, an inquiry-based approach to stancetaking on others. It describes how multilingual speakers in an online context orientate towards a stance-object and affiliate, align and negotiate difference through embodied performances, as part of advancing an ethics of responsibility for the other and aesthetic investments. In the analysis of such orientations, I draw on virtual interactional data to illustrate how in difference through stancetaking is entextualized in the aesthetic, embodied performance of parody, in so-called Coloured English, Kaaps and a mixture of other languages by an emerging R&B and pop group in Cape Town. I demonstrate how the group invest in embodied performances merge the material, linguistic, cultural and semiotic significance of the body to undermine fixity and categorization. But also, how push-back from YouTube commentators, influencers, reactors take up evaluative, affective and epistemic stances as they move from difference to in difference. I conclude with the argument that in order for us to take adequate account of an ethics of responsibility for the other and describing aesthetic investments in embodied performances we have to recalibrate our theoretical and methodological toolkit to understand what it means to use language with dignity, to encounter each other in spaces of dignity and to just be dignified in diversity.
Patients with antiphospholipid syndrome and a first venous or arterial thrombotic event: clinical characteristics, antibody profiles and estimate of the risk of recurrence
Authors: Pengo Vittorio , Sarti Luca , Antonucci Emilia , Bison Elisa , Pontara Elena , Cattini Maria Grazia , Denas Gentian , Poli Daniela , Palareti Gualtiero
Published: April 2024

Objectives

Thrombosis in antiphospholipid syndrome (APS) involves in most cases the venous circulation. Why in some patients thrombotic APS affects the arterial circulation and in particular cerebral circulation is unknown. In previous studies, both patient characteristics and antiphospholipid antibody types and titers have been associated with arterial thrombosis. Aim of this study was to compare the clinical characteristics and laboratory findings of venous and arterial thrombotic APS from a large series of patients.

Methods

Data were retrieved from the Start 2 antiphospholipid, a multicenter prospective register of long-term collected data from Thrombosis Centers in Italy.

Results

Of 167 patients with thrombotic APS, 114 (68 %) had a venous and 53 (32 %) had an arterial event as first clinical manifestation. Several clinical characteristics and risk factors were different among groups in univariate analysis. Using logistic regression analysis, reduced creatinine clearance and hyperlipidemia were independent variable for the occurrence of arterial APS. Notably, no difference in antiphospholipid antibody profiles and aβ2-Glycoprotein I levels were found between groups. A higher adjusted global antiphospholipid syndrome score (aGAPSS) was found in arterial group indicating a possible high recurrence rate in arterial APS.

Conclusions

These data have pathophysiological and clinical implication since associated conditions might predispose patients to arterial rather than venous events and call to a close monitoring and treatment of arterial APS due to their increased tendency to recurrence.
Anxiety and depression during post covid-19 lockdown period among medical students, and it’s relation with stress and smartphone addiction in India
Authors: Vengadessin Nivetha , Ramasubramani Premkumar , Saya Ganesh Kumar
Published: April 2024

Objectives

Medical profession, a competitive and ever-updating field which requires great commitment, imposes a stressful environment for students. Our study aimed to find the prevalence and factors associated with psychological illness.

Methods

A cross-sectional analytical study was done among medical students in Puducherry. A stratified random sampling strategy was incorporated to achieve a calculated sample size of 384. The presence of anxiety and depression, perceived stress and addiction to the phone were assessed using the Hospital Anxiety and Depression Scale, Perceived Stress Scale, and Smartphone Addiction Scale – short version. Prevalence of anxiety and depression was summarized as a proportion with a 95 % confidence interval (CI). The prevalence ratio (PR) for the factors associated was estimated using log-binomial regression.

Results

With the response from 383 students, the prevalence of anxiety and depression was 39.4 % (95 %CI: 34.5–44.3 %) and 26.6 % (22.2–31.1 %). Perceived stress was moderate in 68.2 % and high in 14 % of students. Higher age (aPR=1.49), female gender (aPR=1.22), tobacco or alcohol use (aPR=1.24), smartphone addiction (aPR=2.09) and high stress (aPR=1.93) were the predictors of anxiety among medical students in our study. Use of tobacco or alcohol (aPR=2.07), smartphone addiction (aPR=1.96) and high stress (aPR=1.72) were the predictors of depression.

Conclusions

Anxiety was more prevalent than depression among the medical students. Use of tobacco or alcohol, smartphone addiction and stress increase the risk of psychological morbidity. Medical training should have a module on coping mechanisms to overcome psychological illness and have better mental well-being.
Teacher emotions and the emotional labour of modern language (ML) teachers working in UK secondary schools
Authors: King Jim , Almukhaild Haydab , Mercer Sarah , Babic Sonja , Mairitsch Astrid , Sulis Giulia
Published: April 2024

The present paper seeks to explore the contextual factors shaping the emotional labour experiences of secondary school teachers and explain the ways these educators manage their emotions. Data were generated through a series of 20 in-depth, semi-structured interviews with modern language (ML) teachers in the UK. The findings showed that teachers experienced primarily negative forms of emotional labour and these experiences were driven by five interrelated contextual factors: the lack of institutional support, heavy workload, low perceived status of MLs, students’ lack of motivation, and classroom misbehaviour. To manage their emotions, the study reveals that teachers used a wide range of coping mechanisms such as suppression, venting, social support, positive reframing, and the development of positive student–teacher relationships. In light of our results, we call for the emotional dimension of teaching to be better integrated into training programmes, an improvement in working conditions and better support mechanisms for teachers.
Diurnal 11-ketotestosterone and 17-hydroxyprogesterone saliva profiles in paediatric classical congenital adrenal hyperplasia
Authors: Dubinski Ilja , Bechtold-Dalla Pozza Susanne , Bidlingmaier Martin , Hawley James , Keevil Brian , Kunz Sonja , Nowotny Hannah Franziska , Reisch Nicole , Schiergens Katharina , Tschaidse Lea , Schmidt Heinrich
Published: April 2024

Objectives

The most suitable biochemical markers for therapy adjustment in patients with congenital adrenal hyperplasia are controversial. 11-Oxygenated androgens are a promising new approach. The objective of this study was to investigate the diurnal rhythm of 11-ketotestosterone in children and adolescents in saliva and to correlate it with salivary 17-hydroxyprogesterone.

Methods

Fifty-one samples of steroid day-profiles from 17 patients were additionally analysed for 11-ketotestosterone, retrospectively. All patients were treated in our university outpatient clinic for paediatric endocrinology between 2020 and 2022. Steroid day-profiles of 17 patients could be examined. The cohort showed a balanced sex ratio. The median age was 13 years. The measurements for 17-hydroxyprogesterone were carried out during routine care by immunoassay. The measurements of 11-ketotestosterone were performed from frozen saliva samples using an implemented in-house protocol for liquid chromatography–tandem mass spectrometry (LC-MS/MS). The most important outcome were the absolute values for 11-ketotestosterone, their diurnal rhythmicity and the correlation with 17-hydroxyprogesterone.

Results

Both steroids show a circadian diurnal rhythm. 17-hydroxyprogesterone and 11-ketotestosterone correlate significantly. 11-Ketotestosterone showed a positive correlation with BMI at all times of the day.

Conclusions

11-Ketotestosterone shows circadian rhythmicity in our cohort and correlates with 17-hydroxyprogesterone. These findings serve as an important basis for prospective research into 11-oxygenated androgens as therapeutic markers in paediatrics. However, 11-ketotestosterone appears to be very dependent on BMI.
New distribution and breeding record of Wroughton’s free-tailed bat (Otomops wroughtoni) (Chiroptera: Molossidae) from Meghalaya, India
Authors: Patel Rajkumar D. , Kulkarni Vinodkumar , Kumari K. Shraddha , Kumara Honnavalli N. , V. Karunakaran P. , Santhanakrishnan Babu , Puttaswamaiah Rajesh
Published: April 2024

The Wroughton’s free-tailed bat (Otomops wroughtoni) is classified as Data Deficient under IUCN Red List due to inadequate information on its distribution, population, and ecology. The species was previously recorded from Belgaum district of Karnataka and from East Khasi Hills and Jaintia Hills districts of Meghalaya and from Cambodia, represented by a single specimen. Through our study on Chiroptera taxa across 19 Community Reserves between October 2021 and January 2022 using physical search, mist netting and acoustic study we have identified a new colony of O. wroughtoni from the Mikadogre village in South Garo Hills District of Meghalaya, which extends the current distribution to 135 km from the nearest known distribution site. Interestingly, unlike other known roosts of O. wroughtoni which are in large caves with high roofs and deep crevices or cupolas, this roost was in the open limestone cliff located next to a stream. In addition to this, we have also documented the breeding colony of the species from a previously known site at Pynurkba. This new finding emphasises that there are more potential roosts across the Northeast region of India with similar habitats and altitudes waiting to be identified.
Autologous liver transplantation for unresectable hepatobiliary malignancies in enhanced recovery after surgery model
Authors: Liu Weifeng , Li Guogang , Jin Yitian , Feng Yihui , Gao Zhenzhen , Liu Xingyu , Zhou Bo , Zheng Xiang , Pei Xiangru , Ying Yulian , Yu Qian , Yan Sheng , Hu Chenlu
Published: April 2024

Ex vivo liver resection combined with autologous liver transplantation offers the opportunity to treat otherwise unresectable hepatobiliary malignancies and has been applied in clinic. The implementation of enhanced recovery after surgery (ERAS) program improves the outcome of surgical procedures. This is a retrospective single-center study including 11 cases of patients with liver cancer that underwent autologous liver transplantation and received ERAS: cholangiocarcinoma of the hilar region (n = 5), intrahepatic cholangiocarcinoma (n = 3), gallbladder cancer (n = 1), liver metastasis from colorectal cancer (n = 1), and liver metastasis from gastrointestinal mesenchymal tumor (n = 1). There were no deaths within 30 days and major complications occurred in two patients, and four patients were readmitted upon the first month after the surgery. Median hospital stay was 20 days (range 13–44) and median open diet was Day 4 (range 2–9) after surgery and median early post-operative activity was Day 5 (range 2–9) after surgery. In conclusion, autologous liver transplantation is feasible in the treatment of otherwise unresectable hepatobiliary malignancies, and our study showed favorable results with autologous liver transplantation in ERAS modality. ERAS modality provides a good option for some patients whose tumors cannot be resected in situ and offers a chance for rapid recovery.
Das literarische Schaffen Manfred Winklers – Werkübersicht, Genese und Textpraktiken
Authors: Tempian Monica
Published: April 2024

Though awarded the Israeli Prime Minister’s Prize for Hebrew Literature in 1999, the multifaceted Manfred Winkler (1922–2014), encompassing roles as a German and Hebrew poet, survivor-writer, translator, painter, and sculptor, has only recently garnered sustained scholarly attention. This delayed recognition can be attributed, in part, to Winkler’s lifelong commitment to traversing geographical, national, ideological, and linguistic boundaries throughout his extensive career. It is only in the wake of a burgeoning interest in the life narratives of German-language refugees and immigrants to Israel, alongside their transcultural literary contributions, that the cultural and historical significance of Winkler’s poetry has come to light. This article delves into Winkler’s literary corpus and its inception, drawing upon the latest insights and research findings obtained through the author’s archival and editorial work since 2014. It provides an overview of the predominant themes, writing practices, and tendencies within the works of this multilingual author and (self-)translator. Winkler, through his poignant portrayal of the traumas of war and the memories of the Holocaust and the Jewish-Arab conflict – with a sense of grief rather than from a position of judgment – delineates the fault lines and pivotal moments of nearly the entire 20th century.
Enhanced Pb2+ adsorption using recyclable magnetic sodium alginate in a network structure for high renewable capacity
Authors: Dong Liming , Sun Hua , Wang Danfeng , Wang Shifan
Published: April 2024

This study presents the synthesis of a magnetic sodium alginate hydrogel for efficient adsorption of heavy metal ions. The hydrogel, composed of sodium alginate, demonstrates a network structure that facilitates effective metal ion adsorption. Utilizing magnetic forces, the hydrogel can be easily separated and regenerated, exhibiting excellent recyclability. Compared to traditional adsorbents, the magnetic sodium alginate hydrogel shows significantly improved adsorption capacity, particularly for Pb2+ ions. At pH ca. 4 and an adsorption time of 120 min, the hydrogel achieves a maximum adsorption capacity of 137 mg/g for Pb2+, with an adsorption rate of 83 %. The adsorption kinetics follow a pseudo-second-order equation, while thermodynamically, the process adheres to the Freundlich adsorption model, with capacity positively correlated with temperature and concentration. The negative ΔH value indicates an exothermic and spontaneous adsorption process. In competitive adsorption experiments, the hydrogel demonstrates strong selective adsorption towards Pb2+. It also exhibits excellent reusability, maintaining 80 % adsorption capacity after 10 cycles. The magnetic sodium alginate composite material possesses favorable recyclability and convenient magnetic separation properties, offering significant potential in various applications.
Women Who Stopped Working Due to Their Husband’s Opposition in Egypt
Authors: Iparraguirre Jose Louis , Hadi Zeina Amr Hosny Zaki Mohamed Abdel
Published: April 2024

This paper investigates a neglected reason underlying the low female labor participation rates in Egypt: husbands’ opposition. We find that opposition falls with increasing levels of educational attainment and chronological age of the husband. Age at first marriage, religious affiliation, wealth, and the extent to which a husband upholds traditional views regarding the participation of women in the labor market and gender equality in general were not significant. We also report an inverse relationship between the likelihood of husband’s opposition and the number of children in the household, which suggests that financial considerations may outstrip normative considerations.
Transcranial direct current stimulation is more effective than pregabalin in controlling nociceptive and anxiety-like behaviors in a rat fibromyalgia-like model
Authors: de Souza Vanessa Silva , Medeiros Liciane Fernandes , Stein Dirson João , de Oliveira Camila Lino , Medeiros Helouise Richardt , Dussan-Sarria Jairo Alberto , Caumo Wolnei , de Souza Andressa , Torres Iraci L. S.
Published: April 2024

Objectives

Despite the fact that fibromyalgia, a widespread disease of the musculoskeletal system, has no specific treatment, patients have shown improvement after pharmacological intervention. Pregabalin has demonstrated efficacy; however, its adverse effects may reduce treatment adherence. In this context, neuromodulatory techniques such as transcranial direct current stimulation (tDCS) may be employed as a complementary pain-relieving method. Consequently, the purpose of this study was to evaluate the effect of pregabalin and tDCS treatments on the behavioral and biomarker parameters of rats submitted to a fibromyalgia-like model.

Methods

Forty adult male Wistar rats were divided into two groups: control and reserpine. Five days after the end of the administration of reserpine (1 mg/kg/3 days) to induce a fibromyalgia-like model, rats were randomly assigned to receive either vehicle or pregabalin (30 mg/kg) along with sham or active- tDCS treatments. The evaluated behavioral parameters included mechanical allodynia by von Frey test and anxiety-like behaviors by elevated plus-maze test (time spent in opened and closed arms, number of entries in opened and closed arms, protected head-dipping, unprotected head-dipping [NPHD], grooming, rearing, fecal boluses). The biomarker analysis (brain-derived neurotrophic factor [BDNF] and tumor necrosis factor-α [TNF-α]) was performed in brainstem and cerebral cortex and in serum.

Results

tDCS reversed the reduction in the mechanical nociceptive threshold and the decrease in the serum BDNF levels induced by the model of fibromyalgia; however, there was no effect of pregabalin in the mechanical threshold. There were no effects of pregabalin or tDCS found in TNF-α levels. The pain model induced an increase in grooming time and a decrease in NPHD and rearing; while tDCS reversed the increase in grooming, pregabalin reversed the decrease in NPHD.

Conclusions

tDCS was more effective than pregabalin in controlling nociception and anxiety-like behavior in a rat model-like fibromyalgia. Considering the translational aspect, our findings suggest that tDCS could be a potential non-pharmacological treatment for fibromyalgia.
Intrinsic Neural Excitability Biases Allocation and Overlap of Memory Engrams
Authors: Delamare Geoffroy , Tomé Douglas Feitosa , Clopath Claudia
Published: April 2024

Memories are thought to be stored in neural ensembles known as engrams that are specifically reactivated during memory recall. Recent studies have found that memory engrams of two events that happened close in time tend to overlap in the hippocampus and the amygdala, and these overlaps have been shown to support memory linking. It has been hypothesized that engram overlaps arise from the mechanisms that regulate memory allocation itself, involving neural excitability, but the exact process remains unclear. Indeed, most theoretical studies focus on synaptic plasticity and little is known about the role of intrinsic plasticity, which could be mediated by neural excitability and serve as a complementary mechanism for forming memory engrams. Here, we developed a rate-based recurrent neural network that includes both synaptic plasticity and neural excitability. We obtained structural and functional overlap of memory engrams for contexts that are presented close in time, consistent with experimental and computational studies. We then investigated the role of excitability in memory allocation at the network level and unveiled competitive mechanisms driven by inhibition. This work suggests mechanisms underlying the role of intrinsic excitability in memory allocation and linking, and yields predictions regarding the formation and the overlap of memory engrams.
Risk-Taking Is Associated with Decreased Subjective Value Signals and Increased Prediction Error Signals in the Hot Columbia Card Task
Authors: Wüllhorst Raoul , Wüllhorst Verena , Endrass Tanja
Published: April 2024

It remains a pressing concern to understand how neural computations relate to risky decisions. However, most observations of brain–behavior relationships in the risk-taking domain lack a rigorous computational basis or fail to emulate of the dynamic, sequential nature of real-life risky decision-making. Recent advances emphasize the role of neural prediction error (PE) signals. We modeled, according to prospect theory, the choices ofn = 43 human participants (33 females, 10 males) performing an EEG version of the hot Columbia Card Task, featuring rounds of sequential decisions between stopping (safe option) and continuing with increasing odds of a high loss (risky option). Single-trial regression EEG analyses yielded a subjective value signal at centroparietal (300–700 ms) and frontocentral (>800 ms) electrodes and in the delta band, as well as PE signals tied to the feedback-related negativity, P3a, and P3b, and in the theta band. Higher risk preference (total number of risky choices) was linked to attenuated subjective value signals but increased PE signals. Higher P3-like activity associated with the most positive PE in each round predicted stopping in the present round but not risk-taking in the subsequent round. Our findings indicate that decreased representation of decision values and increased sensitivity to winning despite low odds (positive PE) facilitate risky choices at the subject level. Strong neural responses when gains are least expected (the most positive PE on each round) adaptively contribute to safer choices at the trial-by-trial level but do not affect risky choice at the round-by-round level.
Basic Properties of Coordinated Neuronal Ensembles in the Auditory Thalamus
Authors: Hu Congcong , Hasenstaub Andrea R. , Schreiner Christoph E.
Published: April 2024

Coordinated neuronal activity has been identified to play an important role in information processing and transmission in the brain. However, current research predominantly focuses on understanding the properties and functions of neuronal coordination in hippocampal and cortical areas, leaving subcortical regions relatively unexplored. In this study, we use single-unit recordings in female Sprague Dawley rats to investigate the properties and functions of groups of neurons exhibiting coordinated activity in the auditory thalamus—the medial geniculate body (MGB). We reliably identify coordinated neuronal ensembles (cNEs), which are groups of neurons that fire synchronously, in the MGB. cNEs are shown not to be the result of false-positive detections or by-products of slow-state oscillations in anesthetized animals. We demonstrate that cNEs in the MGB have enhanced information-encoding properties over individual neurons. Their neuronal composition is stable between spontaneous and evoked activity, suggesting limited stimulus-induced ensemble dynamics. These MGB cNE properties are similar to what is observed in cNEs in the primary auditory cortex (A1), suggesting that ensembles serve as a ubiquitous mechanism for organizing local networks and play a fundamental role in sensory processing within the brain.
Biophysical Modeling of Frontocentral ERP Generation Links Circuit-Level Mechanisms of Action-Stopping to a Behavioral Race Model
Authors: Diesburg Darcy A. , Wessel Jan R. , Jones Stephanie R.
Published: April 2024

Human frontocentral event-related potentials (FC-ERPs) are ubiquitous neural correlates of cognition and control, but their generating multiscale mechanisms remain mostly unknown. We used the Human Neocortical Neurosolver's biophysical model of a canonical neocortical circuit under exogenous thalamic and cortical drive to simulate the cell and circuit mechanisms underpinning the P2, N2, and P3 features of the FC-ERP observed after Stop-Signals in the Stop–Signal task (SST;N = 234 humans, 137 female). We demonstrate that a sequence of simulated external thalamocortical and corticocortical drives can produce the FC-ERP, similar to what has been shown for primary sensory cortices. We used this model of the FC-ERP to examine likely circuit-mechanisms underlying FC-ERP features that distinguish between successful and failed action-stopping. We also tested their adherence to the predictions of the horse-race model of the SST, with specific hypotheses motivated by theoretical links between the P3 and Stop process. These simulations revealed that a difference in P3 onset between successful and failed Stops is most likely due to a later arrival of thalamocortical drive in failed Stops, rather than, for example, a difference in the effective strength of the input. In contrast, the same model predicted that early thalamocortical drives underpinning the P2 and N2 differed in both strength and timing across stopping accuracy conditions. Overall, this model generates novel testable predictions of the thalamocortical dynamics underlying FC-ERP generation during action-stopping. Moreover, it provides a detailed cellular and circuit-level interpretation that supports links between these macroscale signatures and predictions of the behavioral race model.