bluuebunny/crossref_metadata_2025 huggingface dataset:
Seasonal Agricultural Work, Gendered Time Use, and its Implications for Nutrition
Authors: Rao Nitya
Published: March 2024

Women’s work is central to both agriculture and nutrition, yet the evidence on the links between them are weak. Using time use data from two Indian districts, this paper seeks to fill this gap. In principle, women’s agricultural work could have positive and negative implications for nutrition, through increased control over incomes resulting in improved diets to intensifying work burdens leading to tensions and trade-offs between their agricultural work and care responsibilities, as well as attention to their own health. The emerging evidence points to the nuanced ways in which social identity, seasonality, and context mediate to shape women’s work in agriculture and consequently food intakes and feeding practices. Overall, women’s work in agriculture seems to have a negative effect on household nutrition through two pathways: lack of adequate time for care work in peak agricultural seasons and seasonal energy deficits with consequent losses in body weight. Recognition of women’s contribution to both agricultural production and domestic reproduction, and supporting them adequately, is central to improving nutritional outcomes.
Coda
Authors: Schoenberger Casey
Published: March 2024

The Coda does not attempt summaries of individual chapters, which may be found in their respective “Conclusions” sections. Rather, it uses an example of a 1959 “plucked ballad” (táncí) adaptation of the story of Mulan to reflect on implications of the book’s arguments for issues of content and form. Probing the question of how to “date” a performance put together sixty-five years ago based on formulae transmitted from teacher to student for a good deal longer, reworking a 1,500-year-old story with tonal alternation and rhyming practice going back much further than that, this chapter argues against a modernist tendency to contrast adherence to form with freedom of expression. Rather, all poets and performers work with conceptual “chunks” of form and meaning of various sizes. Creativity consists in how poets and performers use social and material tools available to them to rearrange and reimagine what can be made of them.
Authoring Postcolonial Normality
Authors: Achille Étienne , PanaÏtÉ Oana
Published: March 2024

In Leurs enfants après eux (winner of the Goncourt Prize in 2018) by Nicolas Mathieu, the postcolonial emerges as a parallel structure established between alternating and intersecting coming-of-age narratives that stage two teenagers, Anthony, the ‘petit Blanc’, and Hacine, the ‘petit Arabe’. This chapter argues that Mathieu expands the poetics of small provincial lives by delving into the everydayness of postcolonial life in France’s suburban and post-industrial society. The representation of race and colonial legacy in Leurs enfants après eux, studied through a combined narratological and sociological lens, calls attention to the direct interventions of the implied author and their primary role in configuring the text’s postcolonial ethos. Through the implied author’s interventions, which are characterized by restraint and opacity, the novel manifests an ethics of care and empathy that adds an important dimension to the poetics of White writing.
Calling Out the iNovel
Authors: Achille Étienne , PanaÏtÉ Oana
Published: March 2024

The chapter focuses on a first-person narrative written by Nicolas Fargues, a 50-year-old White male who provokes the readership and defies expectations by creating the literary voice of a Black female narrator. While the text invites affective and intellectual consensus around its scathing attacks on White privilege, closer scrutiny of its verbal surface and patterns reveals that this fictionalization of race, far from foregrounding the specificity of a Black female voice, satisfies the expectations of a White audience. Drawing on literary applications of linguistic anthropology, and focusing on the use of technology, the iPhone, and social media as loci of conversation, the chapter shows that Nicolas Fargues develops a form of White iWriting which merely ventriloquizes race as an aesthetic surfeit that ensures the book’s unquestioning reception and commercial success.
For and Against Polemics
Authors: Menon Nandagopal R.
Published: March 2024

The discourses of supporters and critics of polemics point out what polemics do and how they are shaped by the shared condition of being a religious minority. Critics condemn and reject polemics as unethical and allege that they undermine boundaries between public and private, personal and political, and friend/brother and enemy. They see polemics as detrimental to Indian Muslims. Defenders of polemics argue, on the other hand, that they separate right from wrong, religion from politics, and friend/brother from enemy. Polemics provide an opportunity for Muslims to perform their citizenship in India. Both discourses are largely disconnected from theology and understand polemics in largely non-theological terms, though they are united in stressing that polemics isolate religion as a distinct social reality.
Longing for Theology
Authors: Menon Nandagopal R.
Published: March 2024

Religious mass publicity in the contemporary world—Hindu nationalism and Islamism in India, or the global Muslim protests against the Danish cartoons—is increasingly emptied of theology and saturated with biopolitical categories such as majority and minority or secular terminology like ‘hurt sentiments’. Yet elsewhere theology is also the object of desire as the marker of difference. Muslim groups in Kerala, who share much including the common religion of Islam, need theological mass-publicised polemics to magnify differences among them. Anthropologists desire theology to stay true to the discipline’s mission to study and introduce other ways of living and thinking to its publics, often in a comparative framework.
Relativistic kinetic theory
Authors: Choquet-Bruhat Yvonne
Published: March 2024

We have introduced in Chapter IX equations for perfect fluids in General Relativity as a direct consequence of the perfect fluid equations in Special Relativity and the equivalence principle. We have seen that they are quite satisfactory mathematically as well as physically. We have also seen that there are no compelling macroscopic considerations leading to satisfactory relativistic equations for dissipative fluids, even in Special Relativity. The classical Navier–Stokes equations lead, like the Fourier law of heat transfer, to equations of parabolic type, and hence to an infinite propagation speed of signals, which is incompatible with relativistic causality. The formal generalizations of these equations with the aim of obtaining hyperbolic equations lack general justification and there is no consensus about them.
Introduction and Roadmap
Authors: Lo Andrew W. , Zhang Ruixun
Published: March 2024

Chapter 1 motivates the adaptive markets hypothesis by reviewing the tension between the assumption of rationality underlying most economic theories and the documented departures from rationality due to behavioural anomalies. This tension is resolved by the adaptive view of financial markets, which leads to very different implications than the traditional investment paradigm. It concludes with a range of practical implications of adaptive markets, as well as a roadmap of the rest of the book, which is divided into five distinct parts: Foundations, Behaviour, Neurons, Financial Market Dynamics, and Financial Institutions and Adaptations. We conclude with an epilogue, and provide a notational glossary and proofs of all mathematical propositions in the Appendix.
Mutation
Authors: Lo Andrew W. , Zhang Ruixun
Published: March 2024

Chapter 3 proposes a simple evolutionary explanation for irrational behaviour using the binary choice framework introduced in Chapter 2. This framework shows that irrational behaviours are, in fact, necessary for evolution in stochastic environments because they provide much-needed diversity that confers survival benefits when certain environments arise. Furthermore, there is an optimal degree of irrationality in the population, depending on the degree of environmental randomness. Therefore, mutation provides an important link between rational and irrational behaviours, and hence a diversity of traits in any given generation. These results reconcile the debate between rational and irrational behaviour—both can and do emerge through the forces of natural selection operating on behaviours, as well as genes.
Cooperation
Authors: Lo Andrew W. , Zhang Ruixun
Published: March 2024

In Chapter 7 we develop an extension of Chapter 2’s binary choice model in which one individual’s behaviour can affect the reproductive success of another individual. In the presence of such interactions, natural selection does more than just shape behaviour to selfishly maximize fertility—it also seeks to minimize the correlation of fertility between individuals. In fact, correlation is a mechanism by which evolution can select for cooperation. This mechanism is distinct from standard biological explanations like kin selection, group selection, and reciprocity, and relies only on natural selection, and without recourse to notions of evolutionary stability.
The Role of Culture in Finance
Authors: Lo Andrew W. , Zhang Ruixun
Published: March 2024

Chapter 19 provides an overview of the role of culture according to psychologists, sociologists, and economists, and then presents a specific framework for analysing culture in the context of financial practices and institutions in which three questions are answered: (1) What is culture?; (2) Does it matter?; and (3) Can it be changed? This framework is applied to five concrete situations—Long-Term Capital Management; AIG Financial Products; Lehman Brothers and Repo 105; Société Générale’s rogue trader; and the US Securities and Exchange Commission and the Madoff Ponzi scheme—and a proposal to change culture via ‘behavioural risk management’ is presented.
The narrative nature of sexual life
Authors: Langdridge Darren
Published: March 2024

This chapter argues that in order to understand the nature of contemporary sexual citizenship, one needs to critically examine the narratives that underpin claims to citizenship. To that end, it introduces the importance of narrative and the work of Paul Ricoeur, in particular. The concept of narrative identity and how people construct themselves through the stories they tell is described as a way to connect the psychological and social-cultural. The narrative tradition in the social science is then introduced, with early foundational work from figures including Sarbin, Gergen, and Bruner discussed. The importance of tradition and critique within this narrative understanding is then explained as a key concept. The chapter concludes by exploring work on sexual storytelling, notably by Plummer; queer critique; and the value of tradition.
Sexual citizenship and a clash of rights
Authors: Langdridge Darren
Published: March 2024

This chapter presents two case studies where critique as a mode of political engagement has become detached from tradition. The first example concerns religiously motivated protests against sexual and gender diversity education in schools in the United Kingdom. This case highlights the failure of progressive organizations and communities to mobilize against religiously motivated prejudice against sexual and gender minorities. The second example concerns recent arguments between trans and gender critical activists that shows a similar absence of engagement between tradition and critique. This clash is further complicated through the radical nature of claims and use of a ‘cancel culture’ style of political engagement. It is argued that some difficult conversations need to be engaged in to turn down the emotional heat and re-engage with both tradition and critique.
Ecotourism
Authors: Moranda Scott
Published: March 2024

This chapter situates the history of ecotourism in the longer history of nature tourism. The chapter begins by identifying ecotourism’s origins in the 1970s and then makes the case for historical continuities between ecotourism and earlier forms of tourism, considering the themes of economic development, class, and environmentalism. The chapter then discusses historical works that highlight how neoliberalism shaped ecotourism after 1965. While neoliberal and postcolonial aspects of ecotourism cannot be ignored, the chapter argues that comparisons with older traditions of nature tourism can be beneficial, especially for thinking about ecotourism destinations as sites of cultural and social contestation. Beginning in the 1800s, nature tourism has led to economic and political exploitation, but the practice (and work) of tourism can contribute as well to identity formation, which can be essential to resisting or coopting tourism for other purposes.
Social Mobility through Immigrant Resentment: Explaining Latinx Support for Restrictive Immigration Policies and Anti-immigrant Candidates
Authors: Hickel Flavio Rogerio , Oskooii Kassra A R , Collingwood Loren
Published: March 2024

Various polls suggest that Donald Trump has enjoyed the support of a sizable minority of the Latinx electorate despite his racially offensive rhetoric and support for some of the most restrictive immigration policies in recent memory. Building on Social Identity Theory and Self-Categorization Theory, we contend that some Latinxs harbor negative stereotypes about immigrants, blame them for the status devaluation of the Latinx community, and cognitively distinguish themselves from Latinx immigrants. Rather than viewing anti-immigrant policies, rhetoric, and politicians as a direct status threat, those exhibiting this “Latinx Immigrant Resentment (LIR)” may regard them as a means to enhance the status and interests of “prototypical” Latinxs by signaling their distinction from “atypical” Latinxs. To evaluate this theory, we use the 2020 American National Election Study (ANES) and 2016 Collaborative MultiRacial Post-Election Survey (CMPS) as a proof-of-concept to first confirm that negative immigrant stereotypes and cognitive intragroup distinctions are associated with increased support for Donald Trump and restrictive immigration policies. We then introduce a more refined measure of LIR by fielding online surveys of US Latinxs administered through Lucid in 2020–2021 (N = 1,164) and 2021/22 (N = 1,017). We demonstrate the validity of this measure and its predictive power for attitudes toward Donald Trump, Ron DeSantis, and restrictive immigration policies after accounting for a range of rival explanations.
Dispersion state analysis in hot melt extruded, highly drug-loaded 3D printing filaments applying Raman microscopy
Authors: Tidau Marius , Finke Jan Henrik
Published: March 2024

Objectives

Highly drug-loaded polymer formulations are favorable intermediates in pharmaceutical applications, for example, for the individualized production of medicines via 3D printing with the maximum flexibility regarding dose strength and drug combination in a single dosage form. However, high-disperse drug loads are challenging for the process itself and the (intermediate) product properties, making the knowledge about the dispersion state of the drug particles achieved by the production process helpful to overcome such challenges.

Methods

Therefore, a novel dispersion state analysis technique based on scanning Raman microscopy is proposed in the present study and applied to HPMC filaments loaded with 20 wt%, 40 wt%, and 60 wt% theophylline. The qualitative and quantitative evaluations of the scans were correlated to melt viscosities, process data, and mechanical properties of the filaments.

Key findings

The analyses revealed not only an increasing particle size reduction with increasing drug load and thus increasing viscosity and mechanical energy input. The particle size reduction also caused a change in the filaments’ mechanical properties from elastic ductile to rigid brittle. Furthermore, an alignment of the elongated drug particles with the frozen three-dimensional flow pattern of the extruder and not only with the extrusion direction was elucidated.

Conclusions

Therefore, the necessity to investigate the dispersion state further is highlighted for future studies on highly drug-loaded polymer formulations, providing a novel measuring technique applicable to challenging pharmaceutical formulations.
Bee Vectoring Technology Using Clonostachys rosea as a Biological Control for Botrytis Fruit Rot of Strawberry in Florida
Authors: Bolognesi Mayara , Zuniga Adrian I. , Cordova Leandro G. , Mallinger Rachel , Peres Natalia A.
Published: March 2024

Botrytis fruit rot (BFR), caused by Botrytis cinerea, is a major strawberry disease. The intensive use of fungicides for its management has resulted in resistance to several fungicide groups, requiring alternatives to BFR management. In this study, we evaluated the efficacy of bee vectoring technology (BVT) using Clonostachys rosea as a fungal biological control agent for BFR. BVT involves the use of bumble bees to carry C. rosea to strawberry flowers, where it can compete with B. cinerea. Three experiments were conducted on commercial farms in Florida during the 2016–17, 2017–18, and 2018–19 strawberry seasons. Treatments consisted of a nontreated control, fungicide standard program, BVT, and BVT + fungicide program. Fruits were harvested twice a week throughout the season to determine BFR incidence and yield, and postharvest activity was quantified during selected harvests. Temperature effect on mycelial growth was also determined for B. cinerea and C. rosea. The BVT + fungicide program reduced BFR incidence compared with the nontreated control in all seasons. However, BVT treatment by itself was not effective in improving yields or reducing disease incidence, likely due to highly favorable weather conditions for BFR in Florida. In addition, the low attractiveness of strawberry flowers to bumble bees and the fact that C. rosea is a better colonizer of strawberry leaves than flowers could also be limiting the effectiveness of BVT. Therefore, the BVT may be used in combination with fungicides to reduce BFR in strawberry production in Florida, but its cost-effectiveness still needs to be determined.
Developing Crowdsourced Clinical Registry Studies
Authors: Jones Carolynn Thomas , Walker Jeremy , McMullen Rachel L. , Pappas Peter G.
Published: March 2024

Crowdsourced registries have been used to quickly gather information, especially during emerging public health concerns. Registries that began during the COVID-19 pandemic were used to rapidly answer key questions on coinfections, experimental treatments, and morbidity and mortality outcomes. Registries are also used more frequently to support clinical trials and track long-term outcomes in patient populations. This article reviews registry methodology, including the collection of data from crowdsourcing and real-world sources, that can be applied to nurse researcher and clinical research nurse skill sets. The authors illustrate a recently reported crowdsourced COVID-19 and cryptococcal disease registry that followed project management strategies and the Agency for Healthcare Research and Quality registry guidelines for planning, execution, and analysis of registries and other research methods.
Reducing Sternal Wound Infection Rates in Patients Undergoing Cardiothoracic Surgery with Sternotomy
Authors: Fonseca Maria Alcina , Cooper Lise
Published: March 2024

Local problem:

Sternal wound infections (SWIs), whether superficial or deep, are associated with increased morbidity, mortality, and costs. From 2016 to 2017, our facility saw a 50% decrease in SWIs among patients undergoing cardiothoracic surgery with sternotomy. From 2017 to 2018, however, we identified a 33% increase in SWIs, prompting us to address our cardiac nurses' sternal wound care education and practice.

Purpose:

The purpose of our quality improvement (QI) project was to identify opportunities for improvement in postoperative sternal incision care and to implement evidence-based processes to reduce the incidence of SWIs among cardiothoracic surgery patients.

Methods:

A literature review was performed to identify interventions focused on evidence-based SWI reduction. During the first quarter of 2019, our postoperative incision care guidelines were revised and released to staff, a new surgical wound cleansing product was supplied, and RN education was provided. Cardiac nurses were surveyed in April 2019 to identify any remaining knowledge and practice deficits and to assess their adherence to the new guidelines. The survey responses helped us to further improve our nurse education. We also provided periodic nurse reeducation and enhanced patient and family education. All such interventions were implemented by the end of June 2019.

Results:

Between January and June 2019, we had one SWI. From July 2019 through December 2020, an 18-month period, we experienced zero SWIs. Although beginning in 2021, we saw an increase in SWIs—four in 2021 and five in 2022—our incidence rates remain below 0.5% and we continue to work toward an SWI goal of zero.

Conclusion:

This QI project identified opportunities for improvement, implemented evidence-based strategies for wound care and education, and successfully achieved a zero SWI rate for a period of 18 months.
Utility of Follow-up Radiographs in Type 1 Supracondylar Humerus Fractures
Authors: Nihalani Shrey , Bloodworth Adele , Frith Katie , Ashley Philip , Williams Kevin A. , Conklin Michael J.
Published: March 2024

Objective:

Supracondylar humerus (SCH) fractures are common among pediatric patients, with the severity categorized using the Gartland classification system. Type 1 SCH fractures are nondisplaced and treated with immobilization, while more displaced fractures require surgery. The need for follow-up radiographs, particularly for type 1 fractures, is an area where evidence is lacking. This study investigates the clinical value and financial implications of follow-up radiographs for type 1 SCH fractures, hypothesizing that they do not alter clinical management and, therefore, represent an unnecessary expense.

Methods:

This retrospective cohort study, approved by the Institutional Review Board, focused on patients under 18 with nondisplaced SCH fractures treated nonoperatively. One hundred one type 1 SCH fractures, in which the fracture was visible on presenting radiographs, were chosen from patients presenting between January 2021 and December 2022. Charts were reviewed for demographic information, time of cast removal, and complications. A pediatric orthopaedic surgeon and orthopaedic resident reviewed the radiographs to confirm the injury to be a type 1 SCH fracture.

Results:

Among the 101 patients, after the initial presentation, 79 attended an interim visit and 101 attended a “3-week follow-up” at an average of 23 days postinjury. All patients underwent radiographs during these visits for a total of 180 radiographs after confirmation of type 1 SCH fracture. No changes in management resulted from follow-up radiographs. One instance of refracture was noted ~3 months after cast removal. There were 180 superfluous follow-up radiographs taken at subsequent clinic visits. The total charge for these radiographs was $76,001.40, averaging $752.49 per patient.

Conclusion:

Follow-up radiographs for type 1 SCH fractures did not lead to changes in clinical management, aligning with previous findings in more severe SCH fractures. This approach can reduce costs, radiation exposure, and clinic time without compromising patient care. The study can reassure providers and parents about the lack of necessity for follow-up radiographs to document healing.

Level of Evidence:

Level—IV.
Oxidative Stress in Postbariatric Patients: A Systematic Literature Review Exploring the Long-term Effects of Bariatric Surgery
Authors: Pradel-Mora Jessica Juliana , Marín Gerardo , Castillo-Rangel Carlos , Hernández-Contreras Karla Aketzalli , Vichi-Ramírez Micheel Merari , Zarate-Calderon Cristofer , Herran Motta Fanny Stella
Published: March 2024

Background:

The present study investigates the impact of oxidative stress after bariatric surgery in patients with obesity. This field of study has gained great interest in recent years due to the role that oxidative stress plays in metabolic diseases. Obesity, by itself, can generate an increase in reactive oxygen and nitrogen species, intensifying cellular damage and promoting the progression of adverse metabolic conditions. In this context, bariatric surgery emerges as a candidate capable of modifying oxidative stress biomarkers, facilitating the patient’s metabolic recovery.

Methods:

A systematic review was carried out, identifying 30 studies found in databases such as PubMed, Scopus, Web of Science, and Google Scholar. It looked at the link between oxidative stress and recovery after bariatric surgery in patients. The selection of studies was based on the measurement of oxidative stress biomarkers before and after surgical intervention.

Results:

The results reveal a significant decrease in oxidative stress biomarkers after bariatric surgery. However, a notable variability in antioxidant activity is observed between different patients, as well as a significant influence of comorbidities.

Conclusions:

Bariatric surgery is postulated as an effective intervention in reducing oxidative stress in patients with obesity, enhancing antioxidant activity and improving patient recovery. This finding highlights the importance of considering oxidative stress management as an integral part of postoperative care, suggesting the need to implement complementary treatment strategies to optimize health outcomes.
Introducing a Customized Low-Cost Macular Buckle
Authors: Kortuem Friederike C. , Ziemssen Focke , Neubauer Jonas , Bartz-Schmidt Karl Ulrich , Dimopoulos Spyridon
Published: March 2024

Purpose:

To demonstrate a novel surgical technique that is a low-cost alternative to commercial implants for macular buckling in high myopia.

Methods:

A silicon encircling band serves as the anchor. A second silicon circling band is employed, with a 10-mm silicon strip to widen the posterior scleral indentation. This band is inserted posteriorly into the lateral and inferior rectus muscles and pushed behind the globe, orienting it in a superior-temporal to inferior-nasal position with the silicone strip directly under the macula. For better visualization, the placement of the macular buckle is done under the microscope.

Results:

The placement of the macular buckle led to reattachment of the central retina in treated patients during long-term follow-up. This technique eliminates the need for detaching a rectus muscle. Visual acuity remained stable throughout the follow-up period.

Conclusion:

This customized macular buckle technique can improve the anatomical outcome in patients with central retinal detachment due to high myopia.
Building Medical Device Supply Chain Resilience With the US Food and Drug Administration
Authors: Zhuang Chen , Block Frank E.
Published: March 2024

Medical device supply chain shortages have the potential to negatively impact patient care when patients and caregivers are unable to obtain the medical devices they need. The US Food and Drug Administration (FDA), specifically the Center for Devices and Radiological Health, received expanded authorities requiring medical device manufacturers to notify the FDA of any interruption or discontinuance of medical devices during or in advance of a public health emergency. The clinical community, in particular, healthcare technology managers, can provide additional information and perspective to the FDA by voluntarily reporting any device availability concerns. This will provide the FDA with more data about the current supply chain landscape and drive communication about the issue. Ultimately, improved information sharing will help ensure devices are available when and where they are needed to protect the health of the nation's patients and healthcare workers into the future.
Nursing Innovation
Authors: Beaudet Oriana
Published: March 2024

Organizations that foster psychologically safe environments create space for innovative cultures to emerge. The prioritization of nurse-led innovation signals broader cultural values around learning, a willingness to invest in people and their ideas, and an organizational focus around growth and operational excellence. Embracing innovative behaviors can propel emerging areas of nursing science, practice, and workforce solutions. This month's Magnet® Perspectives explores innovation and the critical role of nurse leadership in shaping today's healthcare environment, and the future of nursing.
The Voice of Travel Nurses
Authors: Hickey Patricia A. , Connor Jean Anne , Whiting Jon , Wood Laura J.
Published: March 2024

OBJECTIVE

The aim of this study was to explore the experience and perceived value of travel nurses in a children's hospital.

BACKGROUND

Children's hospitals face unique challenges related to highly specialized care requirements and workforce expansion limitations. Travel nurses can augment nurse staffing capacity during times of intense demand and may offer insights as organizations seek to strengthen work environments.

METHODS

Pediatric travel nurses currently contracted at the hospital were invited to participate in a focus group or interview. Content analysis was used to summarize information and identify themes.

RESULTS

From the 56 participants, 5 themes emerged. The themes were financial, flexibility, searching for healthy work environments, nursing care, and solutions.

CONCLUSIONS

Hearing the voices of travel nurses may offer valuable feedback to strengthen future professional practice environments.
Sustained morphine exposure alters spinal NMDA receptor and astrocyte expression and exacerbates chronic pain behavior in female rats
Authors: Gonçalves Sara V. , Woodhams Stephen G. , Li Li , Hathway Gareth J. , Chapman Victoria
Published: March 2024

Introduction:

Sustained opioid use has long-term negative impacts on future pain experience, particularly in women. This study aimed to investigate the underlying spinal neurobiology of this clinical observation in an experimental model of joint pain.

Objectives:

In this study, we tested the hypothesis that sustained opioid treatment exacerbates chronic pain responses and alters spinal cord dorsal horn astrogliosis and the expression of GluN2B-containing N-methyl-d-aspartate receptors in female rats.

Methods:

Subcutaneous morphine (3 mg/kg) or saline was administered twice daily for 1 week before inducing a model of joint knee pain (intra-articular injection of 2 mg of monosodium iodoacetate [MIA]) in adult female Sprague-Dawley rats, with pain-free controls receiving 50 µL of saline. Pain behavior (weight-bearing and mechanical paw withdrawal thresholds) was measured at baseline and at intervals thereafter. Twice-daily morphine/saline treatment was continued for up to 3 weeks after intra-articular injections, and spinal cord tissue was collected for Western blot analyses.

Results:

Area under the curve analysis of weight-bearing asymmetry confirmed a significant exacerbation of pain behavior in the morphine/MIA group, compared with the saline/MIA group (F(3,18) = 46.3, P < 0.0001), despite comparable joint damage in both groups. Sustained morphine treatment was associated with significant elevations in dorsal horn expression of astrocytic glial fibrillary acidic protein (27 ± 5% increase) and neuronal GluN2B (80 ± 30% increase), but not microglial IBA1, irrespective of the model of joint pain.

Conclusion:

These data suggest that sustained morphine treatment in female rats drives spinal cord plasticity, including spinal astrogliosis and the expression of GluN2B-containing N-methyl-d-aspartate receptors, priming the dorsal horn to incoming sensory inputs and producing exacerbated pain responses.
Comparative Effectiveness of Tofacitinib and Adalimumab in Axial Spondyloarthritis
Authors: Goswami Rudra Prosad , Sinha Debanjali , Chatterjee Moumita , Bhadu Danveer , Das Shyamashis
Published: March 2024

Introduction

Tofacitinib, an oral Janus kinase inhibitor, is a putative choice in the treatment of axial spondyloarthritis (AxSpA). The objective of this study was to compare the effectiveness and tolerability of tofacitinib with adalimumab, in AxSpA, in a real-world clinical setting.

Methods

In this multicentric medical records review study, adult patients with active AxSpA treated with either tofacitinib 5 mg twice daily or adalimumab 40 mg subcutaneously fortnightly were recruited. Effectiveness was measured with Ankylosing Spondylitis Disease Activity Score (ASDAS) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Drug-cost analysis was calculated with Incremental Cost-Effectiveness Ratio (ICERdrug).

Results

Among the 266 patients, 135 were treated with tofacitinib and 131 with adalimumab (follow-up: 6.5 ± 1.6 months). Mean improvement of BASDAI (3.39 ± 0.09 vs. 3.14 ± 1.16, respectively) and that of ASDAS (1.78 ± 0.68 vs. 2.07 ± 2.08, respectively) were comparable between the adalimumab and tofacitinib groups. A higher proportion of patients achieved BASDAI50 response in the second (49.5% vs. 31.6%) and fourth month (83.9% vs. 62.8%) and ASDAS low disease activity in the fourth month (71.6% vs. 47.9%) in the adalimumab group. All disease activity measurements were similar by the sixth month in both groups. A higher proportion of patients in the tofacitinib group than in the adalimumab group required change in therapy (14.8% vs. 7.6%, respectively). ICERdrug for adalimumab compared with tofacitinib was US $188.8 per patient in the adalimumab group for each person-month with BASDAI <4.

Conclusions

Tofacitinib showed comparable effectiveness with adalimumab in patients with AxSpA at the sixth month, despite lesser response in the initial months, with favorable ICERdrug.
Prolonged hourly neurological examinations are associated with increased delirium and no discernible benefit in mild/moderate geriatric traumatic brain injury
Authors: Fonseca Ricardo A. , Canas Melissa , Diaz Leonardo , Aldana Jose A. , Afzal Hussain , De Filippis Alejandro , Del Toro Drew , Day Aaron , McCarthy Jennifer , Stansfield Kristin , Bochicchio Grant V. , Niziolek Grace , Kranker Lindsay M. , Rosengart Matthew R. , Hoofnagle Mark , Leonard Jennifer
Published: March 2024

BACKGROUND

Serial neurological examinations (NEs) are routinely recommended in the intensive care unit (ICU) within the first 24 hours following a traumatic brain injury (TBI). There are currently no widely accepted guidelines for the frequency of NEs. Disruptions to the sleep-wake cycles increase the delirium rate. We aimed to evaluate whether there is a correlation between prolonged hourly (Q1)-NE and development of delirium and to determine if this practice reduces the likelihood of missing the detection of a process requiring emergent intervention.

METHODS

A retrospective analysis of patients with mild/moderate TBI, admitted to the ICU with serial NEs, was performed. Cohorts were stratified by the duration of exposure to Q1-NE, into prolonged (≥24 hours) and nonprolonged (<24 hours). Our primary outcomes of interest were delirium, evaluated using the Confusion Assessment Method; radiological progression from baseline images; neurological deterioration (focal neurological deficit, abnormal pupillary examination, or Glasgow Coma Scale score decrease >2); and neurosurgical procedures.

RESULTS

A total of 522 patients were included. No significant differences were found in demographics. Patients in the prolonged Q1-NE group (26.1%) had higher Injury Severity Score with similar head Abbreviated Injury Score, significantly higher delirium rate (59% vs. 35%, p < 0.001), and a longer hospital/ICU length of stay when compared with the nonprolonged Q1-NE group. No neurosurgical interventions were found to be performed emergently as a result of findings on NEs. Multivariate analysis demonstrated that prolonged Q1-NE was the only independent risk factor associated with a 2.5-fold increase in delirium rate. The number needed to harm for prolonged Q1-NE was 4.

CONCLUSION

Geriatric patients with mild/moderate TBI exposed to Q1-NE for periods longer than 24 hours had nearly a threefold increase in ICU delirium rate. One of five patients exposed to prolonged Q1-NE is harmed by the development of delirium. No patients were found to directly benefit as a result of more frequent NEs.

LEVEL OF EVIDENCE

Prognostic and Epidemiological; Level IV.
Current diagnosis and management of acute colonic diverticulitis: What you need to know
Authors: Kodadek Lisa M. , Davis Kimberly A.
Published: March 2024

Acute colonic diverticulitis is a common disease treated by acute care surgeons. Acute uncomplicated colonic diverticulitis involves thickening of the colon wall with inflammatory changes and less commonly requires the expertise of a surgeon; many cases may be treated as an outpatient with or without antibiotics. Complicated diverticulitis involves phlegmon, abscess, peritonitis, obstruction, stricture, and/or fistula and usually requires inpatient hospital admission, treatment with antibiotics, and consideration for intervention including operative management. This review will discuss what the acute care surgeon needs to know about diagnosis and management of acute colonic diverticulitis.
Recessive variants in the intergenicNOS1AP-C1orf226locus cause monogenic kidney disease responsive to anti-proteinuric treatment
Authors: Buerger Florian , Salmanullah Daanya , Liang Lorrin , Gauntner Victoria , Krueger Kavita , Qi Maggie , Sharma Vineeta , Rubin Alexander , Ball David , Lemberg Katharina , Saida Ken , Merz Lea Maria , Sever Sanja , Issac Biju , Sun Liang , Guerrero-Castillo Sergio ,   Nephrotic Syndrome Study Network (NEPTUNE), Gomez Alexis C. , McNulty Michelle T. , Sampson Matthew G. , Al-Hamed Mohamed H. , Saleh Mohammed M. , Shalaby Mohamed , Kari Jameela , Fawcett James P. , Hildebrandt Friedhelm , Majmundar Amar J.
Published: March 2024

In genetic disease, an accurate expression landscape of disease genes and faithful animal models will enable precise genetic diagnoses and therapeutic discoveries, respectively. We previously discovered that variants inNOS1AP, encoding nitric oxide synthase 1 (NOS1) adaptor protein, cause monogenic nephrotic syndrome (NS). Here, we determined that an intergenic splice product of NOS1AP/Nos1apand neighboringC1orf226/Gm7694, which precludes NOS1 binding, is the predominant isoform in mammalian kidney transcriptional and proteomic data.Gm7694-/-mice, whose allele exclusively disrupts the intergenic product, developed NS phenotypes. In two human NS subjects, we identified causativeNOS1APsplice variants, including one predicted to abrogate intergenic splicing but initially misclassified as benign based on the canonical transcript. Finally, by modifying genetic background, we generated a faithful mouse model ofNOS1AP-associated NS, which responded to anti-proteinuric treatment. This study highlights the importance of intergenic splicing and a potential treatment avenue in a mendelian disorder.
A method for measuring mitochondrial DNA copy number in pediatric populations
Authors: Maggo Simran , North Liam Y. , Ozuna Aime , Ostrow Dejerianne , Yander Grajeda I , Hesmedin Hakimjavadi , Cotter Jennifer A. , Judkins Alexander R. , Levitt Pat , Gai Xiaowu
Published: March 2024

The mitochondrion is a multifunctional organelle that modulates multiple systems critical for homeostasis during pathophysiological stress. Variation in mitochondrial DNA (mtDNA) copy number (mtDNAcn), a key mitochondrial change associated with chronic stress, is an emerging biomarker for disease pathology and progression. mtDNAcn can be quantified from whole blood samples using qPCR to determine the ratio of nuclear DNA to mtDNA. However, the collection of blood samples in pediatric populations, particularly in infants and young children, can be technically challenging, yield much smaller volume samples, and can be distressing for the patients and their caregivers. Therefore, we have validated a mtDNAcn assay utilizing DNA from simple buccal swabs (Isohelix SK-2S) and report here it’s performance in specimens from infants (age = <12 months). Utilizing qPCR to amplify ∼200bp regions from two mitochondrial (ND1, ND6) and two nuclear (BECN1, NEB) genes, we demonstrated absolute (100%) concordance with results from low-pass whole genome sequencing (lpWGS). We believe that this method overcomes key obstacles to measuring mtDNAcn in pediatric populations and creates the possibility for development of clinical assays to measure mitochondrial change during pathophysiological stress.
Navigating stroke care during the COVID-19 pandemic: A scoping review
Authors: Ménard Alixe , Yang Michelle , Oostlander Samantha , Sarwal Kanika , Manji Irfan , O’Sullivan Tracey , Fraser Sarah
Published: March 2024

Background

Previous viral outbreaks have highlighted implications for the management of complex health conditions. This study delves into the repercussions of the COVID-19 pandemic on stroke care, by examining evidence of shifts in healthcare utilization, the enduring effects on post-stroke recovery, and the overall quality of life experienced by stroke survivors.

Methods

A scoping review was conducted following the Joanna Briggs Institute Methodology for Scoping Reviews. The search strategy encompassed electronic databases (APA PsycInfo, Embase, Medline, and CINAHL). English language articles published between December 2019 and January 2022 were included, focusing on individuals who experienced a stroke during the COVID-19 pandemic. Data extraction involved identifying study characteristics and significant findings, facilitating a qualitative and narrative synthesis of the gathered evidence.

Results

Seven domain summaries were identified. They all described the aspects of systemic transformations in stroke care during the COVID-19 pandemic: (1) patient behavior and awareness; (2) telemedicine and remote care; (3) delays in treatment; (4) impact on healthcare resources; (5) quality of care; (6) changes in stroke severity; and (7) reduction in stroke admissions.

Conclusions

This study underscored the critical need to encourage swift patient response to acute stroke symptoms, by finding new avenues for treatment, mitigating hospital-related infection fears, and advocating for the establishment of centralized stroke centers. These measures are integral to optimizing stroke care delivery and ensuring timely interventions, particularly in the challenging context of a pandemic.
AsianMus musculus: Subspecies Divergence, Genetic Diversity, and Historical Biogeography
Authors: Afzali Yaser Amir
Published: March 2024

The house mouse,Mus musculus, is a model organism that has greatly contributed to evolutionary research. Despite its significance, there remain gaps in our understanding of its phylogeography and population genetic structure in Asian regions. This comprehensive study, aims to elucidate the evolutionary history, genetic diversity, and distribution patterns ofM. musculus. A diverse dataset of 281M. musculussamples from across Asia was collected, covering 101 localities in 19 countries. Phylogenetic analysis using Cytochromeb(Cytb) and D-Loop (DL) region, unveiled well-supported lineages. These lineages correspond to four major subspecies:Mus musculus musculus,M. m. domesticus,M. m. castaneus, andM. m. bactrianus. The analysis suggests a monophyletic origin of these subspecies approximately 0.59 million years ago (Mya), followed by two main lineages: one consisting ofM. m. domesticus(∼0.59 Mya) and the other comprisingM. m. castaneus,M. m. bactrianus, andM. m. musculus(∼0.56 Mya). Genetic diversity varied among subspecies, withM. m. domesticusexhibiting the highest diversity due to its extensive global distribution andM. m. bactrianusexhibiting the lowest diversity due to restriction in the southwest Asia. Pairwise genetic distances andFSTvalues confirmed significant genetic differentiation among the subspecies, underlining their historical isolation. Additionally, a Mantel test indicated that geographical distance played a pivotal role in shaping genetic differentiation. Demographic analysis revealed evidence of population expansions inM. m. domesticus,M. m. musculus, andM. m. castaneus, whileM. m. bactrianusshowed characteristics of neutral selection and genetic drift. Species distribution modeling, assessing both Current Conditions and the Last Glacial Maximum, indicated habitat shifts and losses during glacial periods, particularly in the eastern and northern regions of Asia. However, each subspecies displayed unique responses to climatic changes, reflecting their distinct ecological adaptations. Historical biogeography analysis pointed to complex origins and a network of dispersal and vicariance events that led to the contemporary distribution of subspecies. Deserts and Xeric Shrublands emerged as critical areas for diversification and speciation. This study contributes to our understanding of the phylogeography and population genetics ofM. musculusin Asia, highlighting the significance of geographical factors and climatic fluctuations in shaping its evolutionary history and genetic diversity.
Interpretable Spatial Gradient Analysis for Spatial Transcriptomics Data
Authors: Liang Qingnan , Solis Soto Luisa , Haymaker Cara , Chen Ken
Published: March 2024

Cellular anatomy and signaling vary across niches, which can induce gradated gene expressions in subpopulations of cells. Such spatial transcriptomic gradient (STG) makes a significant source of intra-tumor heterogeneity and can influence tumor invasion, progression, and response to treatment. Here we reportLocal Spatial Gradient Inference(LSGI), a computational framework that systematically identifies spatial locations with prominent, interpretable STGs from spatial transcriptomic (ST) data. To achieve so, LSGI scrutinizes each sliding window employing non-negative matrix factorization (NMF) combined with linear regression. With LSGI, we demonstrated the identification of spatially proximal yet opposite directed pathway gradients in a glioblastoma dataset. We further applied LSGI to 87 tumor ST datasets reported from nine published studies and identified both pan-cancer and tumor-type specific pathways with gradated expression patterns, such as epithelial mesenchymal transition, MHC complex, and hypoxia. The local gradients were further categorized according to their association to tumor-TME (tumor microenvironment) interface, highlighting the pathways related to spatial transcriptional intratumoral heterogeneity. We conclude that LSGI enables highly interpretable STG analysis which can reveal novel insights in tumor biology from the increasingly reported tumor ST datasets.