bluuebunny/crossref_metadata_2025 huggingface dataset:
An integrated queueing-inventory-routing problem in a green dual-channel supply chain considering pricing and delivery period: a case study of construction material supplier
Authors: Abbaspour Solmaz , Aghsami Amir , Jolai Fariborz , Yazdani Maziar
Published: August 2022

The current paper presented a stochastic integrated queueing-inventory-routing problem into a green dual-channel supply chain considering an online retailer with a vehicle-routing problem (VRP) and a traditional retailing channel with an M/M/C queueing system. A mixed-integer non-linear programming model (MINLP) is presented to address the integrated VRP and M/M/C queueing system. The suggested model makes decisions about optimal routing, delivery time interval to customers, number of servers in traditional retailers, inventory replenishment policies, and retailers’ price. For the first time, this model considers two retailing channels simultaneously under different uncertainty, including demand, delivery lead time, service time, and delivery time interval to customers. The inventory model also follows a continuous-time Markov chain. The small-scale test problems are solved using GAMS software. Since the problem is NP-hard, this study conducts a comprehensive comparative analysis of the performance of 13 different metaheuristics. The ant lion optimiser, dragonfly algorithm, grasshopper optimisation algorithm, Harris-hawks optimisation, moth-flame optimisation algorithm, multi-verse optimizer, sine cosine algorithm, salp-swarm algorithm, the whale optimisation algorithm, grey-wolf optimiser, genetic algorithm, differential evolution, and particle swarm optimization are algorithms that were chosen for this study. Comprehensive statistical tests were conducted to evaluate the performance of these methods. Furthermore, the model is executed for construction material producers as a case study. Finally, sensitivity analyses were conducted on crucial model parameters; and managerial insights were recommended.
Misperception of Multiple Risks in Medical Decision-Making
Authors: Mourali Mehdi , Yang Zhiyong
Published: August 2022

How do consumers combine multiple risk items when forming overall risk judgments? Drawing on the fuzzy trace theory and categorical averaging, this research finds that adding a low-risk item to a high-risk item reduces the overall risk perception because people reason categorically about risk. They impose categorical distinctions on quantitative risk information, and when combining categorical information, they tend to average across categories instead of adding. Eight studies in the context of medical and health product decisions (N = 5,152) provide convergent evidence showing that when items in different risk tiers are considered together, they are consistently evaluated in a subtractive manner, leading to a higher likelihood of taking the objectively riskier medication (studies 1A, 1B, 1C, and 2). This effect is eliminated when the probability of one side effect is exceedingly high (study 3) or when the task requires reliance on verbatim representation of probabilities (study 4). The effect also disappears when risk information is presented graphically in a way that emphasizes the additive property of multiple risks (studies 5A and 5B). The findings have important implications for the fields of risk perception, risk communication, and consumer health and medical decision-making.
Nutrition Research Funding Trends and Focus Areas at the US National Cancer Institute
Authors: Trujillo Elaine B , Hays Cameron , Regan Karen , Ross Sharon , Seifried Harold
Published: August 2022

Background

Evidence for diet and nutrition’s role in the cancer continuum is inconsistent and requires further study. Although more investigation is needed, the National Cancer Institute (NCI) funding for nutrition has decreased.

Methods

To examine nutrition research funding at the NCI, a portfolio analysis was undertaken for fiscal year (FY) 2018. Nutrition and other cancer-related terms were searched using the National Institutes of Health Query View and Report grants management dashboard. Grants were categorized by mechanism, funding status, applicant characteristics, funding opportunity announcement type, award type, and study characteristics.

Results

A total of 18 233 NCI grant applications were submitted in FY 2018; 12% were funded. Of the 653 nutrition-related grant applications received, 69 (11%) were funded. Funding status of nutrition grants did not differ statistically based on the type of funding opportunity announcement and were higher for applications classified as investigator initiated. Early stage investigators’ nutrition applications were funded less than other investigators. Only 4% and 6% of overall and funded nutrition grant applications were submitted by registered dietitian nutritionist primary investigators, respectively. Average FY 2018 award amounts for funded nutrition and overall grant applications were approximately US $399 000 and approximately US $703 000, respectively. Although the percentage of NCI nutrition grants funded was similar to other grant funding at NCI in FY 2018, between FY 2012 and FY 2018, NCI decreased overall nutrition funding by 44%.

Conclusions

Average grant award amounts for nutrition were less compared with overall NCI-funded grant applications and other topics. Our analysis highlights potential opportunities for greater investment in nutrition research at the NCI.
Post-polypectomy syndrome—a rare complication in colonoscopy procedures: a case report
Authors: Romo Julián A , Peña Jorge David , López Laura A , Figueroa Carlos , Garzon Horacio , Recamán Andrea
Published: August 2022

Post-polypectomy syndrome (PPS) is a complication that may arise after some colonoscopy procedures that require electrocoagulation, due to a transmural burn, which irritates the serous membrane. Its clinical presentation is similar to the one of intestinal perforation, but it has a favorable prognosis, and does not require surgical treatment. We report the case of a 55-year-old woman diagnosed with a polyp in the ascending colon, who was admitted for an endoscopic resection. After the procedure, she complained of nausea, emesis and abdominal pain in the right iliac fossa. She was transferred to the emergency department. An abdominal tomography showed cecal wall thickening without pneumoperitoneum. Therefore, the diagnosis of PPS was made and was managed with bowel rest, parenteral fluids and antibiotics, with full recovery. Despite of its low incidence, it is important to suspect this syndrome to avoid unnecessary surgical treatment and initiate medical management right away.
Of Bug Crushers and Barbaric Clerks: The Fabricated History of Jewish Family Names in Karl Emil Franzos’ ‘Namensstudien’ (1880)
Authors: Czakai Johannes
Published: August 2022

This article analyses the 1880 essay ‘Namensstudien’ by Austrian writer Karl Emil Franzos, which significantly shaped established knowledge of Jewish family names and their alleged origins. Although Franzos’ claims have been questioned since their publication, his essay—including two later versions from 1888 and 1897—is still widely referenced in studies on the history of Jewish family names. Based on a thorough historical examination, this article demonstrates that Franzos’ text is an example of literary, fabricated history and should thus not be mistaken for a historiographical reference work on the adoption of family names by Jews in the eighteenth century.
Lysine 27 dimethylation of Drosophila linker histone dH1 contributes to heterochromatin organization independently of H3K9 methylation
Authors: Bernués Jordi , Izquierdo-Boulstridge Andrea , Reina Oscar , Castejón Lucía , Fernández-Castañer Elena , Leal Núria , Guerrero-Pepinosa Nancy , Bonet-Costa Carles , Vujatovic Olivera , Climent-Cantó Paula , Azorín Fernando
Published: August 2022

Post-translational modifications (PTMs) of core histones are important epigenetic determinants that correlate with functional chromatin states. However, despite multiple linker histone H1s PTMs have been identified, little is known about their genomic distribution and contribution to the epigenetic regulation of chromatin. Here, we address this question in Drosophila that encodes a single somatic linker histone, dH1. We previously reported that dH1 is dimethylated at K27 (dH1K27me2). Here, we show that dH1K27me2 is a major PTM of Drosophila heterochromatin. At mitosis, dH1K27me2 accumulates at pericentromeric heterochromatin, while, in interphase, it is also detected at intercalary heterochromatin. ChIPseq experiments show that >98% of dH1K27me2 enriched regions map to heterochromatic repetitive DNA elements, including transposable elements, simple DNA repeats and satellite DNAs. Moreover, expression of a mutated dH1K27A form, which impairs dH1K27me2, alters heterochromatin organization, upregulates expression of heterochromatic transposable elements and results in the accumulation of RNA:DNA hybrids (R-loops) in heterochromatin, without affecting H3K9 methylation and HP1a binding. The pattern of dH1K27me2 is H3K9 methylation independent, as it is equally detected in flies carrying a H3K9R mutation, and is not affected by depletion of Su(var)3–9, HP1a or Su(var)4–20. Altogether these results suggest that dH1K27me2 contributes to heterochromatin organization independently of H3K9 methylation.
The BAF A12T mutation disrupts lamin A/C interaction, impairing robust repair of nuclear envelope ruptures in Nestor–Guillermo progeria syndrome cells
Authors: Janssen Anne , Marcelot Agathe , Breusegem Sophia , Legrand Pierre , Zinn-Justin Sophie , Larrieu Delphine
Published: August 2022

Nestor–Guillermo progeria syndrome (NGPS) is caused by a homozygous alanine-to-threonine mutation at position 12 (A12T) in barrier-to-autointegration factor (BAF). It is characterized by accelerated aging with severe skeletal abnormalities. BAF is an essential protein binding to DNA and nuclear envelope (NE) proteins, involved in NE rupture repair. Here, we assessed the impact of BAF A12T on NE integrity using NGPS-derived patient fibroblasts. We observed a strong defect in lamin A/C accumulation to NE ruptures in NGPS cells, restored upon homozygous reversion of the pathogenic BAF A12T mutation with CRISPR/Cas9. By combining in vitro and cellular assays, we demonstrated that while the A12T mutation does not affect BAF 3D structure and phosphorylation by VRK1, it specifically decreases the interaction between BAF and lamin A/C. Finally, we revealed that the disrupted interaction does not prevent repair of NE ruptures but instead generates weak points in the NE that lead to a higher frequency of NE re-rupturing in NGPS cells. We propose that this NE fragility could directly contribute to the premature aging phenotype in patients.
Structural insights into the dual activities of the two-barrel RNA polymerase QDE-1
Authors: Cui Ruixue , Li Hao , Zhao Jin , Li Xuhang , Gan Jianhua , Ma Jinbiao
Published: August 2022

Neurospora crassa protein QDE-1, a member of the two-barrel polymerase superfamily, possesses both DNA- and RNA-dependent RNA polymerase (DdRP and RdRP) activities. The dual activities are essential for the production of double-stranded RNAs (dsRNAs), the precursors of small interfering RNAs (siRNAs) in N. crassa. Here, we report five complex structures of N-terminal truncated QDE-1 (QDE-1ΔN), representing four different reaction states: DNA/RNA-templated elongation, the de novo initiation of RNA synthesis, the first step of nucleotide condensation during de novo initiation and initial NTP loading. The template strand is aligned by a bridge-helix and double-psi beta-barrels 2 (DPBB2), the RNA product is held by DPBB1 and the slab domain. The DNA template unpairs with the RNA product at position –7, but the RNA template remains paired. The NTP analog coordinates with cations and is precisely positioned at the addition site by a rigid trigger loop and a proline-containing loop in the active center. The unique C-terminal tail from the QDE-1 dimer partner inserts into the substrate-binding cleft and plays regulatory roles in RNA synthesis. Collectively, this work elucidates the conserved mechanisms for DNA/RNA-dependent dual activities by QDE-1 and other two-barrel polymerase superfamily members.
A New Method for Relating Zircon Crystallisation to Petrogenetic Events
Authors: Miller Laura A , Cawood Peter A , Berry Andrew J
Published: August 2022

The trace element contents of zircon can provide unique insights into tectonothermal events, however, interpreting these data and identifying correlations with specific magmatic/metamorphic events can be challenging. This limits our ability to construct temporally constrained petrogenetic histories of complex metamorphic terranes. Unlocking the information that the rare earth element (REE) patterns of zircon contain is difficult because of the need to quantify differences. We have parametrised the shape of zircon REE patterns in terms of three independent parameters: average abundance, slope, and curvature. Quantifying REE patterns using independent shape parameters is similar to the use of REE ratios but is an improvement as (1) it uses information from all 14 REE rather than just two; (2) the use of two independent parameters (e.g. slope and curvature) is a more robust discriminant than the use of a single ratio; and (3) subtle variations in shape are easily distinguished enabling trends in the REE patterns of large datasets to be identified. Quantitative models were constructed showing how the shapes of the REE patterns of zircon change due to the co-crystallisation of other metamorphic minerals (monazite, apatite, and garnet). Diagnostic changes in shape enable the REE contents of zircon crystals or crystal zones to be accurately related to the growth of specific minerals and hence metamorphic events. The results were used to interpret the REE patterns of zircons from high-grade metamorphic terranes, which have experienced multiple deformation events (Val Malenco, Italy; Betic Cordillera, Spain; Seram, Indonesia; Lewisian Gneiss Complex, Scotland; Napier Complex, East Antarctica) and clearly identified zircon that crystallised in the presence of garnet. Quantitative comparison enabled zircon that crystallised prior to, synchronously with, or after garnet to be identified. Similar models can be used to interpret the REE patterns of monazite. This allows the relative timing of the growth of these minerals to be accurately constrained, which given the importance of zircon for geochronology and garnet for geobarometry has the potential to provide insights into the evolution of a metamorphic event.
An electroencephalogram biomarker of fentanyl drug effects
Authors: Balanza Gustavo A , Bharadwaj Kishore M , Mullen Andrew C , Beck Amanda M , Work Erin C , McGovern Francis J , Houle Timothy T , Eric T Pierce , Purdon Patrick L
Published: August 2022

Opioid drugs influence multiple brain circuits in parallel to produce analgesia as well as side effects, including respiratory depression. At present, we do not have real-time clinical biomarkers of these brain effects. Here, we describe the results of an experiment to characterize the electroencephalographic signatures of fentanyl in humans. We find that increasing concentrations of fentanyl induce a frontal theta band (4 to 8 Hz) signature distinct from slow-delta oscillations related to sleep and sedation. We also report that respiratory depression, quantified by decline in an index of instantaneous minute ventilation, occurs at ≈1700-fold lower concentrations than those that produce sedation as measured by reaction time. The electroencephalogram biomarker we describe could facilitate real-time monitoring of opioid drug effects and enable more precise and personalized opioid administration.
Generating string field theory solutions with matter operators from KBc algebra
Authors: Hata Hiroyuki , Takeda Daichi , Yoshinaka Jojiro
Published: August 2022

The KBc algebra is a subalgebra that has been used to construct classical solutions in Witten’s open string field theory, such as the tachyon vacuum solution. The main purpose of this paper is to give various operator sets that satisfy the KBc algebra. In addition, since those sets can contain matter operators arbitrarily, we can reproduce the solution of Kiermaier, Okawa, and Soler, and that of Erler and Maccaferri. Starting with a single D-brane solution on the tachyon vacuum, we replace the original KBc in it with an appropriate set to generate each of the above solutions. Thus, it is expected that the KBc algebra, combined with the single D-brane solution, leads to a more unified description of classical solutions.
Timing of MeCP2 Expression Determines Midbrain Dopamine Neuron Phenotype Specification
Authors: He Xi-Biao , Guo Fang , Li Kexuan , Yan Jiaqing , Lee Sang-Hun
Published: August 2022

Midbrain dopamine (DA) neurons are associated with locomotor and psychiatric disorders. DA phenotype is specified in ancestral neural precursor cells (NPCs) and maintained throughout neuronal differentiation. Here we show that endogenous expression of MeCP2 coincides with DA phenotype specification in mouse mesencephalon, and premature expression of MeCP2 prevents in vitro cultured NPCs from acquiring DA phenotype through interfering NURR1 transactivation of DA phenotype genes. By contrast, ectopic MeCP2 expression does not disturb DA phenotype in the DA neurons. By analyzing the dynamic change of DNA methylation along DA neuronal differentiation at the promoter of DA phenotype gene tyrosine hydroxylase (Th), we show that Th expression is determined by TET1-mediated de-methylation of NURR1 binding sites within Th promoter. Chromatin immunoprecipitation assays demonstrate that premature MeCP2 dominates the DNA binding of the corresponding sites thereby blocking TET1 function in DA NPCs, whereas TET1-mediated de-methylation prevents excessive MeCP2 binding in DA neurons. The significance of temporal DNA methylation status is further confirmed by targeted methylation/demethylation experiments showing that targeted de-methylation in DA NPCs protects DA phenotype specification from ectopic MeCP2 expression, whereas targeted methylation disturbs phenotype maintenance in MeCP2-overexpressed DA neurons. These findings suggest the appropriate timing of MeCP2 expression as a novel determining factor for guiding NPCs into DA lineage.
Scalp Nerve Block, Local Anesthetic Infiltration, and Postoperative Pain After Craniotomy: A Systematic Review and Network Meta-analysis of Randomized Trials
Authors: Luo Mengqiang , Zhao Xu , Deng Meng , Hu Yue , Yang Xiaoyu , Mei Zubing , Meng Lingzhong , Wang Yingwei
Published: August 2022

The most efficacious methods for controlling postoperative pain in craniotomy remain unknown. A systematic review and network meta-analysis were performed to compare the efficacies of different strategies of scalp nerve block (SNB), scalp infiltration (SI), and control in patients undergoing craniotomy. MEDLINE, Embase, and CENTRAL databases were searched for randomized controlled trials. The primary outcome was postoperative 24-hour pain score, and the secondary outcome was opioid consumption within the first 24 hour after surgery. The effect was estimated using the between-group mean difference and ranked using the surface under the cumulative ranking curve (SUCRA) score. Twenty-four randomized trials were identified for inclusion. SNB using ropivacaine reduced postoperative 24-hour pain score when compared with control (mean difference [95% credible interval], –2.04 [–3.13, –0.94]; low quality), and when compared with SI using ropivacaine (–1.77 [–3.04, –0.51]; low quality) or bupivacaine (–1.96 [–3.65, –0.22]; low quality). SNB using ropivacaine was likely the most efficacious method for pain control (SUCRA, 91%), and also reduced opioid consumption within the first postoperative 24 hours as compared with control (mean difference [95% credible interval], –11.91 [–22.42, –1.4]; low quality). SNB using bupivacaine, lidocaine, and epinephrine combined, and SNB using ropivacaine, were likely the most efficacious methods for opioid consumption reduction (SUCRA, 88% and 80%, respectively). In summary, different methods of SNB / SI seem to have different efficacies after craniotomy. SNB using ropivacaine may be superior to other methods for postcraniotomy pain control; however, the overall quality of evidence was low.
Surgical Technique: Lateral Plate Osteosynthesis of Proximal Phalanx Fractures
Authors: Lim Zhixue , Foo Anthony Tun Lin , Das De Soumen
Published: August 2022

Dorsal plate fixation of proximal phalanx (PP) fractures is a conventional approach but interferes with the extensor mechanism and results in stiffness. Biomechanical studies have shown that laterally placed plates on the proximal phalanges are equally stable and rigid. This technique obviates the issue of tendon adhesion and may result in better postoperative range of motion and lower secondary procedures such as removal of implant and tenolysis. The low adoption of this technique may be related to lack of familiarity with the surgical approach. We describe our surgical technique with lateral plating of PP fractures and present our case that lateral plate osteosynthesis is an acceptable surgical fixation option for PP fractures, which extends the hand surgeon’s armamentarium for more challenging and comminuted fractures.
Diagnosis and treatment of unusual multiorgan Echinococcus hydatid cysts
Authors: Drocchi Giovanni , Santucciu Cinzia , Mastrandrea Scilla , Sanguedolce Francesco , Madonia Massimo
Published: August 2022

Background

Echinococcosis is a zoonotic disease caused by Echinococcus granulosus. Usually, the liver is the most affected organ, accounting for approximately 70% to 85% of cases. The lungs represent 20% of the cases. Fewer than 10% are found in other sites, including the bone, brain, spleen, and kidneys.

Case presentation

A young man was referred to a local hospital for dull pain in the right flank, fever, and mild cough. Computed tomography showed 2 large cysts: the first involved the left lung and measured 130 × 90.5 × 120 mm, whereas the second cyst was located in the right kidney and measured 130 × 100 × 120 mm. Surgery was performed to remove both lesions in 2 separate surgical sessions.

Conclusions

Echinococcosis is a compulsorily notifiable disease. Collaboration between medical doctors from different specializations is necessary. A multidisciplinary approach is important for the correct therapeutic management of the disease. Furthermore, the high possibility of recurrence makes the long-term follow-up mandatory.
Skipping the Line: Inequality in Access to Developmental-Behavioral Care
Authors: McCafferty Shawna , Pereira-Smith Silvia , Koshy Anson J. , Valdez Purnima , Nyp Sarah S.
Published: August 2022

CASE:

The mother of an 18-month-old boy contacted the developmental and behavioral pediatrics clinic to request an evaluation because of concerns that her son is not using any words and only recently began walking. The child's mother became upset when she was notified that the clinic policy requires receipt of a formal request for evaluation from the primary care physician and that the first available appointment was in 9 months. Later that day, the child's grandmother contacted the clinic and reported that she is a member of the Donor Society affiliated with the university/medical system. Membership in the Donor Society is granted to individuals who have met specific philanthropic thresholds benefiting the university. One benefit to members of the Donor Society is the ability to access subspecialty medical services for themselves and their family members, across all disciplines, within 5 business days of their request.

After confirming the details of the Donor Society promise with the philanthropic department of the hospital, a small committee of professionals within the clinic gathered to discuss the implications of this promised benefit to Donor Society members. This clinic is the only source for specialized, multidisciplinary developmental-behavioral health care that accepts public insurance within a 200-mile radius. The current waitlist for evaluation is 9 to 15 months depending on the reason for referral, and approximately 75% of patients on the waitlist receive some form of public assistance and/or live in a rural or underserved area. During the discussion, it was noted that there are 2 developmental-behavioral pediatric clinicians who practice within a cash-based private practice setting in the community. The waitlist for that practice was recently reported to be 3 to 6 months depending on the reason for evaluation, but that practice also requires a referral from the primary care physician before scheduling an initial evaluation.

How would you recommend that the clinicians in the developmental and behavioral pediatrics clinic respond to the request to fulfill the promises made by the university to members of the Donor Society? How does a promise such as this one made to the Donor Society affect structural inequalities within the health care system and what strategies could be used to mitigate further inequalities that may result?
Dynapenic-abdominal obesity as an independent risk factor for chronic kidney disease in postmenopausal women: a population-based cohort study
Authors: Choi Youngju , Cho Jinkyung , Kim Jiyeon , Bae Jun Hyun , Cho Eun-Jeong , Chang Eunwook , Joa Kyung-Lim , Kim Junghoon , Park Dong-Ho , Kang Ju-Hee , Kwak Hyo-Bum
Published: August 2022

Objective

Low muscle strength and obesity lead to a higher risk of chronic kidney disease (CKD). Perimenopause is associated with a natural decline in muscle strength and an increase in visceral adiposity. Dynapenic obesity, which is the coexistence of low muscle strength and obesity, is expected to synergistically increase the prevalence of CKD in postmenopausal women. The aim of this study was to determine combined associations of dynapenia and obesity with CKD in postmenopausal women.

Methods

This study used data from the Korean National Health and Nutrition Examination Survey, 2016 to 2019. The study included 4,525 postmenopausal women aged 42 to 80 years that were classified into four groups based on waist circumference (≥85 cm) and hand grip strength (<18 kg): normal, dynapenic, obese, or dynapenic-obese. According to the Kidney Disease: Improving Global Outcomes, we defined CKD as an estimated glomerular filtration rate <60 mL/min per 1.73 m2. Complex sample logistic regression models were conducted to determine the relationships among coexistence of dynapenia, abdominal obesity, and the risk of CKD.

Results

Dynapenic-abdominal obese group displayed lower estimated glomerular filtration rate levels than other groups (P < 0.05 for all data). The prevalence rates of CKD were 15.5%, 7.8%, 6.2%, and 2.4% in the dynapenic-abdominal obese, dynapenic, abdominal obese, and normal groups, respectively (P < 0.001). Complex sample logistic regression analyses, after adjusting for age, height, health behaviors, and comorbidities, showed that the odds ratio for CKD with respect to dynapenic-abdominal obesity was 1.82 (95% confidence interval, 1.19-2.79) and to abdominal obesity was 1.54 (95% confidence interval, 1.07-2.22) than in the normal group.

Conclusions

This study demonstrated that dynapenic-abdominal obesity, as determined by low handgrip strength and high waist circumference values, was associated with increased risk of CKD in postmenopausal women.
Nurses' Role in Addressing Social Determinants of Health
Authors: Ogbolu Yolanda
Published: August 2022

In recent years there has been increased interest in the social determinants of health (SDoH) by nurses and other healthcare professionals. Numerous seminars and discussions among nurses and other health professionals have focused on addressing social, economic, and environmental factors that impact the health and wellbeing of individuals and communities. Although these conversations are important and represent a movement towards health and social justice, they may be insufficient to address health inequities. There is an urgent need to move beyond community surveillance to implementing health equity programs and policies, especially in marginalized communities. Such is the case in Baltimore City, Maryland, where a nurse-led, community-based network of stakeholders transformed a grassroots health equity model to a state-mandated SDoH Taskforce focusing on a local community. The purpose of this column is to present a short case study that helps nurses understand their potential role in advancing health equity through policy.
The Lived Experience of Medication for Opioid Use Disorder
Authors: Techau Aimee , Gamm Emily , Roberts Mia , Garcia Lorraine
Published: August 2022

Purpose of the Study

Buprenorphine and methadone, when used as maintenance therapy in opioid use disorder (OUD), can significantly reduce the risk of death after an opioid overdose. Despite the many benefits, medication for OUD (MOUD) remains controversial and underutilized. The aim of this study was to (a) identify studies that explicate the lived experience of MOUD, (b) conduct a methodologically sound critical quality assessment, (c) conduct a metasynthesis of identified qualitative studies, and (d) analyze the results through the lenses of critical social justice, feminist standpoint, and social theories to inform a more culturally responsive, effective, and holistic approach to treatment to increase the utilization of and receptivity to MOUD in the treatment of OUDs.

Design and Methods

Metasynthesis is the deliberate process of synthesizing data from multiple qualitative studies to create a new interpretation of previously published research. Our metasynthesis focused on forming a new interpretation of the lived experience of MOUD. Of the 292 studies identified, eight met inclusion criteria. The overall quality of the studies was variable. The study population included adults aged ≥ 18 years with OUD or dependency.

Results

Metasynthesis produced three overarching themes: (a) The duplexity of MOUD creates ambivalence in how a person experiences MOUD; (b) the structure of treatment and systemic influences matter, and (c) MOUD as a stepping-stone with multiple meanings in recovery.

Implications

Understanding experiential dualities allows professionals to see from other perspectives and can inform interventions and treatment structures as well as serve as a backdrop for social change. The synthesized new meaning of MOUD was an ambivalent experience influenced by intersectionality.
Where It Really Counts
Authors: Parekh Tarang , Cuellar Alison E. , Farina-Morse Marissa , Spencer Nancy , Sutter Rebecca E.
Published: August 2022

Objective

The Peer Engaged Empowered Recovery (PEER) program is a county collaboration between specialty behavioral health and probation departments to address substance use and related problems by providing team-based peer recovery specialist (PRS) services. The study aimed to assess the feasibility and potential effectiveness of PEER and propose recommendations.

Method

Eligible clients released from jail had suspected substance use disorder and were assigned to the local drug court, on pretrial probation, or considered of high risk of recidivism. Clients were offered PRS support for 6 months. Client-reported data, administrative data on services, and survey data from program stakeholders were assessed.

Result

The program successfully identified clients with substance use disorder who had high to very high levels of need for social determinants of health, comorbid mental illness and other chronic conditions, and a high recidivism risk. Clients were served predominantly by phone despite complex needs. The sustainability of the PEER program was rated as stable along many dimensions except funding stability.

Conclusion

The PEER pilot program was well targeted. The average level of health and social need among clients was high, and many were difficult for PRS to contact. PRS services, which are currently undifferentiated in the state, may need to be risk-stratified in the future to take into account health and social factors and to align caseloads, reimbursement, and training.
Effects of Unemployment on Opioid Use Treatment Trajectories
Authors: Mumba Mercy Ngosa , Davis Lori , Smith Natalia Langer , Evans Teairra , Castillo Rachael
Published: August 2022

Living with an opioid use disorder (OUD) can make finding and sustaining employment a significant challenge and is only expected to get worse in the COVID-19 environment. For most individuals in OUD treatment, being employed is an important part of their recovery journey. Employment has several benefits, including reductions in preoccupation with symptoms, social isolation, risk of suicide, hopelessness, and economic instability, which if not addressed often result in homelessness. Therefore, employment is an important social determinant of health, especially among those with OUD. Employment success and OUD, however, may vary based on race, age, gender, and socioeconomic status. Return to work support as states begin to reopen will be critically important to improve treatment outcomes for individuals with OUD in a post-COVID-19 environment, requiring utilizations of evidence-based interventions. Nurses, particularly psychiatric mental health and addiction nurses, should routinely screen for employment needs of their patients with OUD and connect them to the necessary support services. Finally, nurses should advocate for regulatory reform that allows for employment support services to be billable and integrated in psychiatric and behavioral health services just like other mental health services.
Medications for Opioid Use Disorder During Incarceration
Authors: McDermott-Winger Erin R. , Latham Christine L.
Published: August 2022

The opioid epidemic has had a devastating impact on incarcerated individuals, with significantly higher rates of opioid use disorder (OUD) and risk of opioid overdose than the general public. Medications for OUD (MOUDs) are currently used with an interdisciplinary approach with good outcomes, but MOUD-approved medications are grossly underutilized in this population. Post incarceration, individuals without MOUDs have lessened their opioid tolerance after abstinence, resulting in staggering death rates or reincarceration from OUD. This article will describe the barriers within the criminal justice system that impede the provision of appropriate treatment for OUD. A structural intervention approach that addresses the barriers will be discussed, as well as patient outcomes associated with MOUDs, and recommendations for education, practice, and future research.
Addressing Disparities for Persons With Substance Use Disorders in Rural Communities
Authors: Heitkamp Thomasine L. , Fox LaVonne F.
Published: August 2022

This article provides an overview of the barriers to accessing intervention, treatment, and recovery supports for persons impacted by substances in rural communities. It defines “rural” and the complications of accessing intervention and treatment services in rural communities including the limitations of accessibility, availability, affordability, and acceptability of care. Ten suggestions, based on needs in rural communities and evidence-based practices, are outlined. They include suggestions for addressing the shortage of care providers in rural communities; educating and training professionals who are willing to adopt evidence-based practices; advancing a population health approach; addressing the limitation of substance use intervention and access to treatment because of stigma; adopting Screening, Brief Intervention, and Referral to Treatment and integrated care; ensuring support to address alcohol, stimulant, and opioid use disorder; offering culturally competent care; addressing the limitations of funding to access care in rural areas; and expanding the use of technology to deliver telehealth services. The recommendations are practical and support both the current and future health and behavioral health workforce serving people with substance use disorders in rural communities and health care administrators. If implemented, this will begin to address the disparities people residing in rural areas experience in securing treatment for substance use disorder and expand access to support for early intervention for people at risk through the adoption of evidence-based practices.
Speech in Noise With Bilateral Active Bone Conduction Implant for Conductive and Mixed Hearing Loss
Authors: Canale Andrea , Ndrev Drita , Sapino Silvia , Bianchi Carlotta , Bordino Valerio , Albera Andrea
Published: August 2022

Objective

To evaluate speech in noise results and subjective benefit in bilateral active bone conduction implant (ABCI) for bilateral mixed hearing loss.

Study Design

Prospective, comparative.

Setting

Ear, Nose and Throat Unit, Department of Surgical Sciences, University of Turin.

Patients

Seven patients with conductive/mixed hearing loss.

Intervention(s)

Patients underwent simultaneous or sequential bilateral surgery for ABCI.

Main Outcome Measure(s)

The speech intelligibility in noise was assessed with the Ita Matrix test in summation, squelch and head shadow settings. First, the tests were performed with one device activated in the ear with lower speech recognition score, then with both devices. Patients filled in an Abbreviated Profile of Hearing Aid Benefit (APHAB) questionnaire to investigate the hearing aid benefit.

Results

When bilateral devices were activated, an improvement of signal-to-noise ratio was observed in all settings. The difference between bilateral and unilateral stimulation is 4.66 dB (p = 0.016) in the summation, 2.24 dB (p = 0.047) in the squelch, 7.50 dB (p = 0.016) in the head shadow setting.

Looking at the APHAB global score (GS), patients report lower mean scores, hence less difficulties, when using two devices (GS, 21.9%; standard deviation (SD), 8.28) rather than one (GS, 33.0%; SD, 10.24) (p = 0.018).

Conclusion

In symmetric mixed bilateral hearing loss, rehabilitation with an ABCI fitted bilaterally shows audiologic advantages in speech perception in noise, not only thanks to the summation effect and by reducing head shadow but also by improving the binaural unmasking based on the squelch effect. Audiometric outcomes are confirmed by the GSs obtained in the APHAB questionnaire.
Successful treatment of cardiac sarcoidosis based on clinical suspicion and advanced cardiac imaging: A case report
Authors: Aguilar-Gallardo Jose S. , Arreaza Javier , Omar Alaa , Lasam Glenmore , Contreras Johanna P.
Published: August 2022

Introduction:

Confirming the diagnosis of cardiac sarcoidosis (CS) is a challenging task as we often do not count with histopathologic evidence. However, prompt initiation of treatment is sometimes necessary, and advanced cardiac imaging along with key clinical findings can play a crucial role in the diagnostic workup.

Patient concerns:

A 77-year-old male with a history of heart failure presented with chest pain and shortness of breath. He was found to have an acute drop in left ventricular ejection fraction associated with frequent premature ventricular contractions and nonsustained ventricular tachycardia. Coronary angiogram was negative for acute coronary syndrome. Advanced cardiac imaging with cardiac magnetic resonance raised suspicion of CS, and steroids were started empirically. Endomyocardial biopsy was attempted but was not successful.

Diagnosis:

The patient’s presentation was highly suggestive of cardiac sarcoidosis.

Interventions:

Corticosteroids, diuresis, guideline-directed medical therapy for heart failure.

Outcomes:

The patient’s symptoms and ventricular arrhythmias improved on steroids. Subsequent FDG-PET revealed increased uptake in a pattern consistent with CS.

Conclusion:

This clinical scenario highlights the importance of advanced cardiac imaging and clinical findings for the diagnosis of CS and exposes the practical need for a standardized, noninvasive strategy to the diagnosis of CS.
Effects of bracing on pelvic parameters in adolescent idiopathic scoliosis: A retrospective study
Authors: Li Kepeng , Ma Guoju , Zhao Heyi , Han Ye , Zuo Jinzeng , Miao Jun , Zhang Jingan , Wang Xijie
Published: August 2022

To evaluate the effects of Chêneau bracing on Cobb’s angle (CA) and spinopelvic parameters in adolescent idiopathic scoliosis (AIS) patients. In this retrospective study, we evaluated 51 AIS patients who received Chêneau bracing treatment between January 2020 and August 2021. The prebracing and in-bracing radiographs were analyzed about the spinopelvic parameters. The CA, pelvic coronal obliquity angle, thoracolumbar kyphosis (TLK), lumbar lordosis (LL), pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS), sagittal vertical angle, and coronal vertical angle were measured. Paired t-test was used to compare prebracing and in-bracing spinopelvic parameters. The Pearson correlation analysis was used to identify the relationships between the variations in the spinopelvic parameters. The mean age at the initiation of bracing was 13.6 ± 1.5 years. The mean prebracing CA was 24.0° ± 6.3°. There were no statistically significant differences between prebracing and in-bracing measurements of sagittal and coronal vertical angles. However, there were statistically significant differences between the prebracing and in-bracing measurements of the CA, pelvic coronal obliquity angle, TLK, LL, PT, and SS. A significant correlation was observed between PT and thoracolumbar kyphosis variations in the sagittal plane. The pelvic coronal obliquity angle variation was correlated to the prebracing pelvic coronal obliquity angle in the coronal plane. Chêneau’s bracing effects of AIS can be extended to the pelvis. Affected by the Chêneau brace, the pelvis should be retro-rotated correspondingly to TLK hyperkyphosis on the sagittal plane, whereas in the coronal plane, pelvic obliquity was improved independently. The effect of Chêneau braces on the pelvic parameters should be fully considered before bracing treatment.
A survey of the clinical practice followed by Korean medicine doctors for scoliosis: Preliminary data for clinical practice guidelines
Authors: Sung Won-Suk , Choi Seong-Kyeong , Jo Hyo-Rim , Park Seo-Hyun , Lee Sun-Haeng , Lee Yoon-Jae , Ha In-Hyuk , Seo Byung-Kwan , Yang Hoe-Cheon , Hong Seung-Ug , Keum Dong-Ho , Kim Eun-Jung
Published: August 2022

Scoliosis is a spinal disease in which the Cobb angle is >10°. Scoliosis treatment can be surgical or conservative, and clinical practice guidelines (CPGs) for conservative treatments have been updated since 2006. There have been several articles regarding the efficacy and safety of Korean medicine (KM) in treating scoliosis, but there are no CPGs. Our study investigated the current clinical practice using a survey for the future establishment of KM-CPGs. The survey mainly comprised clinical practice status, diagnosis, treatment, progress and prognosis, and perception of KM on scoliosis, with reference to existing surveys of other musculoskeletal disorders and scoliosis-related articles. A web-based survey was conducted from February 16, 2021 to February 28, 2021. We found that 60% of KM doctors (KMDs) respondents treated patients with scoliosis, and they valued radiographical measurements and scoliosis-related factors in the diagnosis. KMDs used multiple KM treatments, including acupuncture, Chuna, cupping, pharmacopuncture, and herbal medicine, and they emphasized the importance of KM more in nonstructural scoliosis than in structural scoliosis. Although the perception of the prognosis of scoliosis was in agreement with that suggested by previous guidelines, KMDs showed outstanding focus on reduction of symptoms of scoliosis and improvement of quality of life. Despite some limitations, including low participation and the need for consulting other medical practitioners, our study may be helpful for the development of KM-CPGs because it is the first to analyze the perceptions of KMDs on scoliosis and to collect preliminary data that are of significance for preparing clinical guidelines.
Optical coherence tomography angiography in retinitis pigmentosa: A narrative review
Authors: Lu Bingwen , Chao Guojun , Xie Like
Published: August 2022

Retinitis pigmentosa (RP) is a group of inherited retinal disorders characterized by progressive rod and cone photoreceptor degeneration. Changes in retinal vasculature have long been associated with RP. Optical coherence tomography angiography (OCTA) is a novel imaging technology that enables noninvasive visualization of the retinal and choroidal microvasculature. OCTA enables quantification of microvascular changes in the retinal capillary plexus and choriocapillaris, in addition to qualitative feature description. Therefore, OCTA has the potential to become an important tool for better understanding, early detection, progression, and treatment of RP. In this review, we focus on the applications of OCTA in clinical research on RP. We also discuss future improvements in the OCTA technology for RP management. We believe that the advancement of the OCTA technique will ultimately lead to a better understanding of RP and aid in the prevention of visual impairment.
Factors associated with delayed hospital presentation for patients with acute stroke in Makkah: A cross-sectional study
Authors: Alkhotani Amal M. , Almasoudi Aseel , Alzahrani Jawaher , Alkhotani Emad , Kalkatawi Mamdouh , Alkhotani Alaa
Published: August 2022

Despite the recent advancements in the treatment of acute ischemic stroke, the delayed patient arrival to emergency department or hospital serve as crucial factor for the selection of appropriate intervention program. This study was aimed to identify factors associated with late hospital arrival for patients with acute ischemic stroke in Makkah, Saudi Arabia. A prospective cross-sectional study was carried out at Al-Noor Specialist Hospital among 98 enrolled patients with the mean age of 60.4 ± 10.3 years over the period of March 2019 and June 2019. The data were collected through review of patient records and interview of patients and attendants. Fifty-four of these (55%) presented early (within 4.5 hours) and 44 (45%) presented late (after 4.5 hours). Factor associated with late arrival included low educational level (P = .01) and unemployment status (P = .033). The relationship between time of presentation and computed tomography findings showed statis,tically significant relationship between the former and early computed tomography findings (P = .017). A statistically significant relationship between time of presentation and knowledge of stroke was also observed (P = .013). Increased public awareness is important in order to minimize the time between stroke onset and emergency room presentation.