bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Order Language Processing Difficulties in Patients With Schizophrenia: Cross-linguistic and Cross-cultural Results From the Hindi Version of a Newly Developed Language Test
Authors: Srivastava Jayesh , Sinha Vishal , Ketteler Daniel , Jagtiani Amit
Published: April 2022

Objective

To detect subtle linguistic performance deficits in patients with schizophrenia, a test battery was developed in Hindi vernacular language.

Method

It was a replication study of observational, analytical, and case-control design. Total of 86 participants, namely 43 patients with schizophrenia and 43 controls, were recruited into the study. The patients were evaluated by using PANSS (positive and negative symptoms scale for schizophrenia) for recruitment into the study. Participants from the general population were evaluated with GHQ-12 (General Health Questionnaire-12) to be found to fit as healthy controls. Subsequently, the linguistic performance of patients (on HLFT: Hindi linguistic function test) was compared with that of controls. The HLFT battery was designed, containing 3 blocks by using antonyms, synonyms, homonyms, hyperonyms, hyponyms, distractors, and adages.

Result

Patients scored significantly less than that of controls in identifying antonyms, distractors, and hyponyms while in identifying homonyms they scored significantly more than that of controls. At block I (antonyms) score of 15.5; at homonym score of 5.5; at hyponym (as in hyponym plus distractor combination) score of 2.5, the sensitivity and specificity for using them as a cutoff to screen for schizophrenia are 60.5% and 67.4%; 86% and 41.9%; 81.4% and 46.5%, respectively.

Conclusion

Ambiguity processing of taxonomic representation such as antonymia, homonymia, hypo-/hyperonymia, synonymia, and also understanding of adages might be significantly impaired in patients with schizophrenia. The HLFT battery could be used as a quick and sensitive instrument to detect and quantify the linguistic difficulties of patients with schizophrenia.
Getting Permission to Break the Rules: Clergy Respond to LGBTQ Exclusion in the United Methodist Church
Authors: Gilliland Claire Chipman , Krull Laura M
Published: April 2022

Organizational scholars expect organizations to conform to the norms and expectations of their institutional environments. In some cases, though, organizations may reject rules if they perceive a greater advantage to defiance than to conformity. This project analyzes a sample of sermons given by United Methodist Church (UMC) clergy surrounding the 2019 UMC General Conference. We focus on a subset of sermons in which clergy explicitly mention they will not follow denominational rules, meaning they will marry and ordain LGBTQ people, to investigate how clergy legitimize their rule breaking. We find that clergy draw on several sources of religious authority to justify their decisions, including meso-level structures in the UMC tradition, the autonomy of local congregations, and religious texts and leaders. This project provides empirical evidence of how organizations resist institutional pressure and construct their decision as legitimate, with implications for other organizations and for LGBTQ inclusion.
Not Your Grandma’s Fascism: Fame, Femininity, and Race in Far-Right Postcolonial India and Brazil
Authors: Leidig Eviane , Bayarri Gabriel
Published: April 2022

Much scholarship on the far right focuses on Europe and North America, whereas case studies outside of these regions are often neglected or not recognized as constituting the same phenomenon. In this article, we compare two democracies in the Global South—India and Brazil—to showcase far-right movements within these countries. We situate the “postcolonial neoliberal nationalism” that has shaped the basis of far-right claims in India and Brazil. To illuminate this, we explore female social media influencers within these far-right milieus, and their role in the reproduction of gender, class, and racial hierarchies. Combined with this are insights from media studies on influencer culture as a means of analyzing the performativity of far-right women to advance exclusionary agendas. Overall, we highlight the inherent contradictions and complexity of how far-right female influencers in the Global South are promoting local expressions of gendered indigeneity while also contributing to global far-right narratives.
Novel Posterior Anchoring Method Associated With Medial Meniscus Posterior Root Repair
Authors: Okazaki Yuki , Furumatsu Takayuki , Hiranaka Takaaki , Kintaka Keisuke , Zhang Ximing , Kodama Yuya , Kamatsuki Yusuke , Yamawaki Tadashi , Ozaki Toshifumi
Published: April 2022

Introduction:

Transtibial pullout repair is the gold standard surgical treatment for medial meniscus (MM) posterior root tear. However, posteromedial extrusion of the MM during knee flexion may remain a problem postoperatively.

Materials and Methods:

We used a novel posterior anchoring technique to help reduce posteromedial extrusion, applying two cinch sutures (TCSs) to the MM posterior horn and creating a bone tunnel at the center of the posterior root attachment to pullout the suture. Another bone tunnel was created at the posterior corner of the medial tibial plateau in the externally rotated knee flexion. The first anchor of an all-inside meniscal repair device was inserted through the inferior surface of the MM posterior horn with tensioning TCS and the second anchor into the bone tunnel. Tibial fixation of pullout sutures was performed using a bioabsorbable screw in 30 degrees knee flexion.

Conclusions:

Our posterior anchoring method, combined with conventional pullout repair with TCS, helped reduce posteromedial extrusion in patients with a MM posterior root tear.
SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY DETECTION OF BRUCH MEMBRANE AND CHORIOCAPILLARIS ABNORMALITIES IN SORSBY MACULAR DYSTROPHY
Authors: Iyer Prashanth G. , Zhou Hao , Zhang Qinqin , Chu Zhongdi , Shen Mengxi , Shi Yingying , Liu Jeremy , Trivizki Omer , Lam Byron L. , Wang Ruikang K. , Gregori Giovanni , Rosenfeld Philip J.
Published: April 2022

Purpose:

Swept-source optical coherence tomography angiography (SS-OCTA) was used to analyze Bruch membrane (BM) and choriocapillaris (CC) abnormalities in undiagnosed family members with Sorsby macular dystrophy (SMD).

Methods:

In a family with SMD (TIMP3 Tyr191Cys), SS-OCTA imaging was performed using the 6 × 6 mm scan patter and previously validated algorithms to detect abnormalities in BM and the CC, as well as the presence of reticular pseudodrusen and macular neovascularization. Genetic analyses were performed for TIMP3 mutations.

Results:

Of eight family members, two were previously diagnosed with SMD and six were asymptomatic. SS-OCTA imaging of the 33-year-old proband revealed type 1 macular neovascularization in the left eye and bilateral reticular pseudodrusen, thickening of BM, CC thinning, and increases in CC flow deficits. A TIMP3 mutation was confirmed. His niece, despite having no clinical evidence of SMD, showed BM thickening and CC thinning on SS-OCTA. A TIMP3 mutation was confirmed. The proband's younger nephew and niece also carried the TIMP3 mutation without clinical evidence of SMD. Two additional members had normal examinations, unremarkable SS-OCTA findings, and no TIMP3 mutation.

Conclusion:

Swept-source optical coherence tomography angiography imaging can detect BM and CC abnormalities in vivo in subjects unaware of their TIMP3 status in a family with SMD.
Normalized Kinematic Walking Symmetry Data for Individuals Who Use Lower-Limb Prostheses: Considerations for Clinical Practice and Future Research
Authors: Finco MG , Moudy Sarah C. , Patterson Rita M.
Published: April 2022

Introduction

Individuals who use unilateral transtibial or transfemoral prostheses have negative secondary health effects associated with decreased kinematic (e.g., spatiotemporal and joint angle) walking symmetry between prosthetic and intact limbs. Research studies have quantified kinematic walking symmetry, but studies can be difficult to compare owing to the inclusion of small sample sizes and differences in participant demographics, biomechanical parameters, and mathematical analysis of symmetry. This review aims to normalize kinematic walking symmetry research data across studies by level of limb loss and prosthetic factors to inform considerations in clinical practice and future research.

Methods

A search was performed on March 18, 2020, in PubMed, Scopus, and Google Scholar to encompass kinematic walking symmetry literature from the year 2000. First, the most common participant demographics, kinematic parameters, and mathematical analysis of symmetry were identified across studies. Then, the most common mathematical analysis of symmetry was used to recalculate symmetry data across studies for the five most common kinematic parameters.

Results

Forty-four studies were included in this review. The most common participant demographics were younger adults with traumatic etiology who used componentry intended for higher activity levels. The most common kinematic parameters were step length, stance time, and sagittal plane ankle, knee, and hip range of motion. The most common mathematical analysis was a particular symmetry index equation.

Conclusions

Normalization of data showed that symmetry tended to decrease as level of limb loss became more proximal and to increase with prosthetic componentry intended for higher activity levels. However, most studies included 10 or fewer individuals who were active younger adults with traumatic etiologies.

Clinical Relevance

Data summarized in this review could be used as reference values for rehabilitation and payer justification. Specifically, these data can help guide expectations for magnitudes of walking symmetry throughout rehabilitation or to justify advanced prosthetic componentry for active younger adults under 65 years of age with traumatic etiologies to payers.
Prognostic role of SPRY4-IT1 in female breast carcinoma and malignant tumors of the reproductive system
Authors: Qin Xiaoru , Yin Qifan , Gao Jin , Shi Xiaoming , Tang Jiachen , Hao Lingling , Li Pengfei , Zhu Jia , Wang Yuexin
Published: April 2022

Background:

The prognostic value of SPRY4-Intronic transcript 1 (SPRY4-IT1) in women suffering from breast carcinoma and malignant tumors of the reproductive system remains to be ascertained. Therefore, this paper attempted to assess the relationship between SPRY4-IT1 with the clinicopathological indicators and survival analysis in women suffering from breast carcinoma and malignant tumors of their reproductive organs through meta-analysis.

Method:

Related literature retrieved from Cochrane Library, Ovid, Embase, PubMed, the CNKI, and the Web of Science databases were reviewed. The latest article search was updated to September 1, 2021. The outcome indicators included as effective measures in the study were hazard ratio (HR), odds ratio (OR), and 95% confidence interval (CI). The Stata 12.0 software was used to analyze the data.

Results:

The elevated SPRY4-IT1 levels were indicative of poor overall survival (OS) [HR = 2.44, 95% CI = 1.35–4.43, P < .05], and were not related to Disease-Free Survival (DFS) [HR = 1.61, 95% CI = 0.50–5.18, P = .43] in female patients suffering from malignant tumors. In terms of lymph node metastasis (LNM) for the association between long noncoding RNA SPRY4-IT1(LncRNA SPRY4-IT1) and OS, elevated LncRNA SPRY4-IT1 implied poor OS with LNM [HR = 2.79, 95% CI: 1.81–4.28, P < .001]. Based on the aspect of the LNM for the association between LncRNA SPRY4-IT1 and DFS, SPRY4-IT1 was not correlated with DFS [HR = 0.97, 95% CI: 0.73–1.28, P = .81]. SPRY4-IT1 in the TNM stage was not related to OS [HR = 1.43, 95% CI: 0.55–3.70, P = .46]. In the TNM stage, SPRY4-IT1 was not related to DFS [HR = 1.68, 95% CI: 0.92–3.06, P = .09]. SPRY4-IT1 was found to be associated with lymph node metastasis (OR = 4.15, 95% CI: 2.75–6.25, P = .000) and TNM stage (OR = 2.89, 95% CI: 1.51–7.27 P = .02). No significant correlation was noted between SPRY4-IT1 and the age of the patients (OR = 0.89, 95% CI: 0.61–1.29 P = .54).

Conclusions:

Thus, this study provides evidence-based medical evidence for the target treatment of female breast carcinoma and malignant tumors of the reproductive system. The elevated level of SPRY4-IT1 was associated with poor prognosis of female breast cancer patients and of those having malignant tumors in their reproductive organs. In addition, the SPRY4-IT1 expression was also associated with the disease progression and metastasis.
Radiotherapy-induced isolated left main coronary artery disease presenting with cardiogenic shock
Authors: Li Bo , Liu Yuan , Lou Zhiyang , Zhang Weihua , Zhang Mingyou , Liu Quan
Published: April 2022

Rationale:

Mediastinal radiotherapy is a common practice for treating breast cancer and Hodgkin's lymphoma. Radiotherapy causes cardiovascular damage and has attracted increasing attention, particularly among Hodgkin's lymphoma patients, as they receive a higher dose of radiation.

Patient concerns:

A 36-year-old woman with a past medical history of Hodgkin's lymphoma presented with persistent chest pain for 3 hours. She experienced exertional chest pain 1 month before when she was climbing stairs, which disappeared after a few minutes with rest, but recurred with a similar level of exertion. Three hours before admission to the emergency room, the chest pain persisted and was accompanied by diaphoresis and dyspnea.

Diagnosis:

Cardiogenic shock caused by radiotherapy-induced left main coronary artery disease.

Interventions:

Urgent angiography revealed left main coronary artery stenosis. Intravascular ultrasonography showed diffuse fibrous proliferation in the left main coronary artery. Hemodynamic instability was resolved after drug-eluting stent implantation.

Outcomes:

The patient was discharged uneventfully 5 days after the procedure, with a prescription for dual antiplatelet and statin therapy. She was asymptomatic with good exercise tolerance at the 3-month follow-up.

Conclusion:

Radiotherapy-induced isolated left main coronary artery disease is a rare complication of cancer radiotherapy and can occur years or decades after treatment. Fibrous proliferation is a characteristic pathologic change in the exposed coronary arteries.
The effectiveness of Salvianolate injection for in-stent restenosis after percutaneous coronary intervention
Authors: Zhang Miao , Yuan Yue , Gao Ying , Lu Ruozhu , Deng Yue
Published: April 2022

Background:

In-stent restenosis (ISR) caused by vascular remodeling after percutaneous coronary intervention limits the long-term efficacy of this method. Salvianolate injection is now widely used in the clinical treatment of ISR. However, there is no systematic review or meta-analysis to evaluate the effects of Salvianolate injection on ISR.

Methods:

We will search articles in 8 electronic databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, the Web of Science, China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, Wanfang Database, and the Chinese Scientific Journal Database for randomized controlled trials of ISR treated by Salvianolate injection from their inception to February 27, 2022. The primary outcome measure will be the restenosis rate. The data meeting the inclusion criteria were analyzed by RevMan V.5.4 software. Two authors evaluated the study using the Cochrane collaborative risk bias tool. We will use a scoring method to assess the overall evidence supporting the main results.

Results:

This study will analyze the clinical effectiveness of Salvianolate injection in the treatment of ISR.

Conclusion:

The findings of this systematic review will provide evidence to evaluate the effectiveness of Salvianolate injection for the treatment of ISR.

INPLASY registration number:

INPLASY202220117.
Initiation of the pharmacist-delivered antidiabetic medication therapy management services in a tertiary care hospital in Nepal
Authors: Sapkota Binaya , Bokati Priyanka , Dangal Salina , Aryal Pooja , Shrestha Sunil
Published: April 2022

The medication therapy management (MTM) pharmacists follow the philosophy of pharmaceutical care to address individualistic medication therapy requirements in their practice settings.

The present study aimed to introduce the pharmacist-delivered MTM services among type 2 diabetes mellitus patients at a tertiary care hospital in Nepal.

Cross-sectional study was conducted at Patan Hospital, Lalitpur, Nepal, among 200 patients with type 2 diabetes mellitus from July to December 2019. The intervention included maintenance of medication profile for individual patients, and then MTM service was proposed based on 5 core elements of MTM services proposed by the American Pharmacists Association. Both antidiabetic and non-antidiabetic medicines were coded as per the anatomic, therapeutic, and chemical classification and defined daily dose assignment 2020 for documentation. The Charlson Comorbidity Index was used to index comorbidities. The drug interaction profile was checked with the Medscape Drug Interaction Checker.

Both fasting and postprandial blood sugar levels were significantly associated with age (P-values <.000 for both), baseline symptom (P-values .012 and .003 respectively), and diet plan proposed (P-values .049 and .011 respectively). Maximum cases of drug interactions requiring close monitoring were between metformin and insulin regular (i.e., 11, 5.5%).

This was a novel initiative of the MTM services in a resource constraint country like Nepal and can show a clue for the pharmacists targeting such services in other similar settings.
A Pediatric-Specific View on Improved Nurse-Sensitive Indicators Related to Increased BSN or Higher Rates Over Time
Authors: Hupp Diane S. , Mastrangelo Beth , Nelson Kimberly A. , Weyant Donna M. , Schreiber James B.
Published: April 2022

Background:

Nurses obtaining higher levels of education has been recommended nationally for more than a decade to support improved patient outcomes.

Local Problem:

Organizational strategies were implemented to achieve a highly educated workforce at the project site over 14 years. However, there was no evaluation of relationship with increasing education levels and pediatric patient outcomes.

Methods:

A quality improvement project explored the relationship of Bachelor of Science in Nursing (BSN) or higher prepared nurses with 9 different nurse-sensitive indicators (NSIs). Educational preparation and NSI data were retrieved retrospectively from hospital databases from up to 14 years.

Results:

Moderate to moderately strong correlations were noted between the proportion of BSN or higher prepared nurses and 2 NSIs (central line–associated bloodstream infections, r = −0.55 and surgical site infections, r = −0.71). Four of the 9 indicators were approaching moderate correlation.

Conclusions:

Increasing the proportion of highly educated nurses at the project site correlated with improvements in select NSI outcomes.
Effect of the Coronary Arterial Diameter Derived From Coronary Computed Tomography Angiography on Fractional Flow Reserve
Authors: Liu Jincheng , Huang Suqin , Wang Xue , Li Bao , Ma Junling , Sun Hao , Xi Xiaolu , Sun Yutong , Zhang Liyuan , Liu Jian , Liu Zhuo , Liu Youjun
Published: April 2022

Background

Fractional flow reserve (FFR) is considered to be the criterion standard for the clinical diagnosis of functional myocardial ischemia. In this study, we explored the effect of the coronary arterial diameter derived from coronary computed tomography angiography on FFR.

Method

We retrospectively reviewed the clinical information of 131 patients with moderate coronary artery stenosis. To compare the mean diameter of stenotic vessels, patients were divided into ischemic and nonischemic groups. According to the clinical statistics of the diameter of the ischemic group and the nonischemic group, we established 8 ideal models of coronary artery diameter of 4 mm (40%, 50%, 60%, and 70% stenosis) and diameter of 3 mm (40%, 50%, 60%, and 70% stenosis). Two sets of numerical simulation experiments were carried out: experiment 1 evaluated the variation rate of CT-based computation of non-invasive fractional flow reserve (FFRCT) with vessel diameters of 4 mm and 3 mm under different stenosis rates, and experiment 2 explored the variation of FFRCT with vessel diameters of 4 mm and 3 mm under different cardiac outputs. We simulated changes in the flow of narrow blood vessels by changes in cardiac output.

Results

According to clinical statistics, the mean ± SD diameter of stenotic vessels in the ischemic and nonischemic groups was 3.67 ± 0.77 mm and 3.31 ± 0.64 mm (P < 0.05 for difference), respectively. In experiment 1, the FFRCT of coronary with a diameter of 4 mm was 0.86, 0.80, 0.66, and 0.35, and that with a diameter of 3 mm was 0.90, 0.84, 0.71, and 0.50, respectively. In experiment 2, the FFRCT of the coronary vessel diameter of 4 mm was 0.84, 0.80, 0.76, and 0.72, respectively. The FFRCT coronary vessels with a diameter of 3 mm were 0.87, 0.84, 0.80, and 0.76, respectively.

Conclusions

As the stenosis increases, compared with narrow blood vessel of small diameter, the narrow blood vessel with larger diameter is accompanied by faster flow rate changes and is more prone to ischemia.
High Body Mass Index and Change in Cervical Carotid Artery Position on Serial Scans: A Retrospective Study of an Unexplained Phenomenon
Authors: Nayate Ameya P. , Durieux Jared
Published: April 2022

Objective

The purpose of this study was to investigate the relationship between increased body mass index (BMI) and abdominal circumference and prevalence of the change of position of common and internal carotid arteries on serial imaging, termed wandering carotid artery.

Methods

We retrospectively reviewed computed tomography/magnetic resonance imaging neck scans and determined whether the common and internal carotid arteries moved in position on serial scans. We correlated patients' demographic and medical information along with abdominal circumference, BMI, location of the aortic arch, and area of soft tissue surrounding the carotid arteries with the prevalence of a wandering carotid artery.

Results

Computed tomography/magnetic resonance imaging neck performed on 56 randomly selected patients between 2017 and 2020 were reviewed. A total of 42.9% of the patients had a wandering common or internal carotid artery. The abdominal circumference and BMI were significantly higher in the patients with wandering carotid arteries compared with the patients without (abdominal circumference = 102.9 ± 14.13 vs 91.61 ± 13.9 cm [P = 0.01] and BMI = 34.27 ± 8.58 [obese] vs 26.21 ± 4.89 [overweight, P = 0.0001]). After adjusting for age, sex, hypertension, diabetes, atherosclerosis grade, and aortic arch location, the odds of wandering carotid artery was 1.23 (95% confidence interval, 1.1–1.44) times higher for every one-unit increase in BMI.

Conclusions

There is a higher prevalence of wandering common and internal carotid arteries in obese patients with large abdominal circumference irrespective of age, sex, diabetes, hypertension, or carotid atherosclerosis.
Commentary: Countering the Growing Problem of Radiologist Burnout
Authors: Patel Shruti , Chhabra Avneesh
Published: April 2022

This is an invited editorial on radiologist burnout, its presenting manifestations, toll on patient care and systems-based practice, and suggested remedies to mitigate stress and exhaustion.
Three-Dimensional Isotropic Versus Conventional Multisequence 2-Dimensional Magnetic Resonance Imaging of Sacroiliac Joints in Suspected Axial Spondyloarthritis
Authors: Gupta Anurag , Ratakonda Raghu , Boraiah Girish , Xi Yin , Chhabra Avneesh
Published: April 2022

Objectives

The aims of the study were to systematically evaluate the sacroiliac joints of a consecutive series of patients with clinically suspected axial spondyloarthritis and to compare the diagnostic efficacy of 3-dimensional (3D) imaging versus conventional multisequence 2D techniques for sacroiliitis.

Methods

In this cross-sectional multireader validation study, imaging studies of 104 consecutive patients with clinically suspected axial spondyloarthritis obtained with a rheumatology lumbosacral magnetic resonance imaging protocol were evaluated. Three-dimensional coronal oblique reconstructions parallel to the long axis of the sacrum were created. Two blinded readers evaluated 2D and 3D images separately for each study, and findings were compared with the reference standard for the final diagnosis and disease activity. Cohen κ and diagnostic performance measures on 2D and 3D imaging were evaluated and compared.

Results

With 2D versus 3D imaging, respectively, the sensitivity for detecting inflammatory cases was 57% versus 62% (P = 0.1007), the sensitivity for detecting mechanical cases was 89% versus 76% (P = 0.0312), the sensitivity for detecting active sacroiliitis was 49% versus 64% (P = 0.0014), and the specificity for detecting active sacroiliitis was 87% versus 76% (P = 0.0016). Interreader agreement of 2D imaging showed an overall range of κ = 0.27–0.85, and it was best for evaluation of bony ankylosis (κ = 0.85). Interreader agreement of 3D imaging was in an overall range of κ = 0.15–0.64.

Conclusions

Single 3D isotropic magnetic resonance imaging provided adequate assessment of sacroiliac joints in this study and demonstrated significantly higher sensitivity and lower specificity for detecting active sacroiliitis. The initial results indicate that 3D imaging could be used for future works for screening sacroiliitis and abdominopelvic enthesopathy.
A Qualitative Analysis of Methotrexate Self-injection Education Videos on YouTube
Authors: Wilson Hillary , Semaka Amy , Katz Steven Joseph
Published: April 2022

Background

Patients are increasingly turning to the Internet for health guidance, requiring awareness from clinicians of constantly changing resources and quality of available information. A previous study demonstrated a minority of YouTube videos were useful for teaching methotrexate (MTX) self-injection; however, YouTube content constantly evolves, and previous results may not represent current videos. This study provides an update on previous work from 2014 evaluating the quality of YouTube videos demonstrating self-administered subcutaneous MTX injections. Our aim was to evaluate how YouTube videos on MTX injection have changed and evaluate the current video quality.

Methods

“Methotrexate injection” was searched on YouTube. The first 75 videos were analyzed independently by 2 reviewers. Videos were classified as useful, misleading/irrelevant, or a personal patient view and rated for reliability, comprehensiveness, and quality.

Results

Of the 75 videos reviewed, 12 were classified as useful (16%), 43 misleading/irrelevant (57.3%), and 20 personal patient views (26.7%). Although this represents a substantial increase from previous results in the proportion of videos deemed misleading/irrelevant (57.3% vs. 27.5%) (p = 0.0011), their reliability and global quality scores were higher.

Conclusions

Concordant with the previous study, only a small proportion of the total videos were deemed useful videos for MTX injection specifically. However, reliability and global quality scores for all videos increased from the previous study, suggesting more videos provide reliable information with regard to MTX overall, even if it does not speak to self-injection directly. Logistics of the YouTube algorithm may still impede access to the “best” videos for patient teaching; therefore, clinicians should be prepared to recommend strategies for patients to find high-quality videos.
Dyadic Enrollment in a Phase 3 Mild Cognitive Impairment Clinical Trial
Authors: Hakhu Navneet R. , Gillen Daniel L. , Grill Joshua D. ,   for the Alzheimer’s Disease Cooperative Study
Published: April 2022

Background:

Dyadic enrollment of a participant and study partner is required in mild cognitive impairment (MCI) clinical trials, despite participants being functionally independent. Research examining how the study partner requirement impacts MCI trials remains limited.

Methods:

Using the Alzheimer’s Disease Cooperative Study donepezil and vitamin E MCI trial data, we quantified the proportions of enrolled spouse, adult child, and other dyads. We used multinomial regression to identify which baseline participant characteristics (age, sex, race and ethnicity, apolipoprotein E ε4 status, education, residence type) were associated with dyad type.

Results:

Among 769 randomized dyads, 73% were spousal, 14% adult child, and 13% other dyads. Adjusting for multiple comparisons, underrepresented racial and ethnic background (eg, comparing Hispanic to non-Hispanic White participants: adult child vs. spouse odds ratio = 5.86; 95% confidence interval: 2.09, 16.5; other vs. spouse odds ratio = 4.95; 95% confidence interval: 1.83, 13.4), female sex, age, nonhouse residence, and apolipoprotein E ε4 noncarriage were each associated with a higher odds of having an adult child, as well as an other, study partner at enrollment.

Discussion:

Increasing participation among nonspousal dyads may facilitate more inclusive and representative MCI trial samples.
The role of nitrogen-responsive regulators in controlling inorganic polyphosphate synthesis in Escherichia coli
Authors: Bowlin Marvin Q. , Long Abagail Renee , Huffines Joshua T. , Gray Michael Jeffrey
Published: April 2022

Inorganic polyphosphate (polyP) is synthesized by bacteria under stressful environmental conditions and acts by a variety of mechanisms to promote cell survival. While the kinase that synthesizes polyP (PPK, encoded by the ppk gene) is well known, ppk transcription is not activated by environmental stress and little is understood about how environmental stress signals lead to polyP accumulation. Previous work has shown that the transcriptional regulators DksA, RpoN (σ54) and RpoE (σ24) positively regulate polyP production, but not ppk transcription, in

Escherichia coli

. In this work, we examine the role of the alternative sigma factor RpoN and nitrogen starvation stress response pathways in controlling polyP synthesis. We show that the RpoN enhancer binding proteins GlnG and GlrR impact polyP production, and uncover a new role for the nitrogen phosphotransferase regulator PtsN (EIIANtr) as a positive regulator of polyP production, acting upstream of DksA, downstream of RpoN and apparently independently of RpoE. However, neither these regulatory proteins nor common nitrogen metabolites appear to act directly on PPK, and the precise mechanism(s) by which polyP production is modulated after stress remain(s) unclear. Unexpectedly, we also found that the genes that impact polyP production vary depending on the composition of the rich media in which the cells were grown before exposure to polyP-inducing stress. These results constitute progress towards deciphering the regulatory networks driving polyP production under stress, and highlight the remarkable complexity of this regulation and its connections to a broad range of stress-sensing pathways.
Pallidal neuromodulation of the explore/exploit trade-off in decision-making
Authors: Marcelino Ana Luísa de A. , Gray Owen , Al-Fatly Bassam , Gilmour William , Steele J Douglas , Kühn Andrea A. , Gilbertson Tom
Published: April 2022

Every decision that we make involves a conflict between exploiting our current knowledge of an action’s value or exploring alternative courses of action that might lead to a better, or worse outcome. The sub-cortical nuclei that make up the basal ganglia have been proposed as a neural circuit that may contribute to resolving this explore-exploit ‘dilemma’. To test this hypothesis, we examined the effects of neuromodulating the basal ganglia’s output nucleus, the globus pallidus interna, in patients who had undergone deep brain stimulation (DBS) for isolated dystonia. Neuromodulation enhanced the number of exploratory choices to the lower value option in a 2-armed bandit probabilistic reversal-learning task. Enhanced exploration was explained by a reduction in the rate of evidence accumulation (drift rate) in a reinforcement learning drift diffusion model. We estimated the functional connectivity profile between the stimulating DBS electrode and the rest of the brain using a normative functional connectome derived from heathy controls. Variation in the extent of neuromodulation induced exploration between patients was associated with functional connectivity from the stimulation electrode site to a distributed brain functional network. We conclude that the basal ganglia’s output nucleus, the globus pallidus interna, can adaptively modify decision choice when faced with the dilemma to explore or exploit.
Cerebral activity in monkeys Papio anubis during the perception of conspecific and heterospecific agonistic vocalizations: A functional Near Infrared Spectroscopy study
Authors: Debracque Coralie , Gruber Thibaud , Lacoste Romain , Meguerditchian Adrien , Grandjean Didier
Published: April 2022

Are conspecific emotional vocalizations special? Although often investigated in non-human primates using functional magnetic resonance imaging or positron emission tomography, it remains unclear whether the listening of conspecific vocal emotions leads to similar or different cerebral activations when compared to heterospecific calls (i.e. expressed by another primate species). Using a neuroimaging technique rarely employed in monkeys so far, functional Near Infrared Spectroscopy (fNIRS), the present study investigated cortical temporal activities during exposure to both conspecific and heterospecific calls in three female adult baboons (Papio anubis). The three subjects were lightly anesthetized and passively exposed to agonistic baboon and chimpanzee (Pan troglodytes) vocalizations, as well as energy matched white noises in order to control for this low-level acoustic feature. Despite inter-individual variabilities, permutation test analyses on the extracted OxyHemoglobin signal revealed for two subjects out of three significant differences between the passive listening of baboon versus chimpanzee stimuli. Additionally, in one subject, a modulation of the left temporal cortex activity was found for the perception of baboon calls contrasted to chimpanzee vocalizations as well as for the passive listening of baboon white noises compared to chimpanzee ones. Although the lack of generalization of those findings in all three subjects prevents us to drawn any conclusion and that more subjects would be needed, the hypothesis that baboons’ cortical temporal regions may be more sensitive to the processing of conspecific sounds compared to heterospecific stimuli is not excluded. Our study highlights that fNIRS may be a promising alternative to further investigate the auditory mechanisms at play in the right and left baboons’ temporal cortices for the processing of emotional vocalizations.
The primary care annual dementia review: a qualitative study of the views and experiences of service users and providers
Authors: Wheatley Alison , Brunskill Greta , Dow Johanne , Bamford Claire , Poole Marie , Robinson Louise
Published: April 2022

Background

In England and Wales, the Quality and Outcomes Framework (QOF) financially rewards GP practices for long-term conditions management, including completion of annual dementia reviews. There is limited evidence about how this works in practice and whether it meets patients’ and carers’ needs.

Methods

Data from five qualitative datasets were integrated and analysed thematically. Data comprised interviews, focus groups, and observations with 209 participants, including commissioners, managers and frontline staff in dementia services; people with dementia; carers; and policy experts.

Findings

Four main themes were developed: (i) perceived benefits of annual review; (ii) variability and (in)visibility of annual review; (iii) logistics; and (iv) external influences and constraints.

Variability in both the completion and quality of QOF annual dementia reviews was attributed by some to limited nuance in the current QOF dementia indicator. Many patients and carers were unaware that an annual dementia review had occurred. Participants suggested that many GPs lack the required competencies and/or capacity for successful dementia reviews.

Conclusions

Work is urgently needed to improve the quality of annual dementia reviews. Potential strategies include changing the financial reimbursement to reflect both quality and quantity, so the review is tailored to the needs of the individual and their family; the creation of standardised templates; collaborative working within primary care and across sectors; and integrating dementia reviews into other long-term conditions.

Key points

QOF annual dementia reviews are a key opportunity for providing support for people with dementia in England and Wales

Current provision of annual reviews varies both in completion rates and quality

Strategies for improvement include improving quality indicators, implementing standardised templates, and improving primary care capacity and capability to carry out reviews
Burden and bacteriological profile of sepsis among adult medical emergencies presenting to a national referral hospital in Kampala, Uganda
Authors: Nyesiga Sharon , Nakibuuka Jane , Kajumbula Henry , Ssenyonga Ronald , Byakika-Kibwika Pauline
Published: April 2022

Introduction

Sepsis, defined as life-threatening organ dysfunction due to dysregulated host response to infection can result from any infection. In 2017, an estimated 48.9 million incident cases of sepsis and 11.8 million sepsis-related deaths were reported globally. Bacterial infection is the major cause of sepsis. Data about sepsis burden is derived almost exclusively from studies in high-income countries yet mortality from sepsis is disproportionately higher in low- and middle-income countries. We aimed to determine the prevalence of sepsis, bacteriological profile of causes, antimicrobial susceptibility patterns, and in-hospital outcomes among adult medical emergencies presenting to Kiruddu National Referral Hospital in Kampala, Uganda.

Methods

We conducted a prospective cohort study between December 2018 and July 2019 in which patients presenting to the medical emergency ward with sepsis were consecutively enrolled; blood was drawn for aerobic blood cultures, antimicrobial susceptibility patterns were determined and patients were followed up for in-hospital outcomes.

Results

Of 1,657 patients screened during the study period, 243(14.7%) had sepsis, the median age was 45 years (IQR 32,65) and the majority were female (55.6%). Among patients with sepsis; 46 (18.9%) had positive aerobic blood cultures. Staphylococcus aureus was the most common isolate (31/46, 67.4%) with a predominance of Methicillin-Resistant Staphylococcus aureus (MRSA) (20/31, 64.5%). Of the 243 patients followed up, 143 (58.9%) died in hospital with an average length of stay of 4.9 days (SD 5.5) for those who died and 10.2 (SD 7.6) for those that were discharged alive. None of the patients was admitted to ICU.

Conclusions

Sepsis was common (14.7%) among adult medical emergencies and it was associated with a high in-hospital mortality rate (58.9%). Positive blood cultures were predominantly Staphylococcus aureus and nearly a third of these were Methicillin-Resistant.
Diagnosis and treatment of opioid-related disorders in a South African private sector medical insurance scheme: a cohort study
Authors: Tlali Mpho , Scheibe Andrew , Ruffieux Yann , Cornell Morna , Wettstein Anja E , Egger Matthias , Davies Mary-Ann , Maartens Gary , Johnson Leigh F , Haas Andreas D
Published: April 2022

Background

The use of opioids is increasing globally, but data from low- and middle-income countries on opioid-related mental and behavioural disorders (hereafter referred to as opioid-related disorders) are scarce. This study examines the incidence of opioid-related disorders, opioid agonist use, and excess mortality among persons with opioid-related disorders in South Africa’s private healthcare sector.

Methods

We analysed longitudinal data of beneficiaries (≥ 11 years) of a South African medical insurance scheme using reimbursement claims from Jan 1, 2011, to Jul 1, 2020. Beneficiaries were classified as having an opioid-related disorder if they received an opioid agonist (buprenorphine or methadone) or an ICD-10 diagnosis for harmful opioid use (F11.1), opioid dependence or withdrawal (F11.2-4), or an unspecified or other opioid-related disorder (F11.0, F11.5-9). We calculated adjusted hazard ratios (aHR) for factors associated with opioid-related disorders, estimated the cumulative incidence of opioid agonist use after receiving an ICD-10 diagnosis for opioid dependence or withdrawal, and examined excess mortality among beneficiaries with opioid-related disorders.

Results

Of 1,251,458 beneficiaries, 1,286 (0.1%) had opioid-related disorders. Between 2011 and 2020, the incidence of opioid-related disorders increased by 12% (95% CI 9%-15%) per year. Men, young adults in their twenties, and beneficiaries with co-morbid mental health or other substance use disorders were at increased risk of opioid-related disorders. The cumulative incidence of opioid agonist use among beneficiaries who received an ICD-10 diagnosis for opioid dependence or withdrawal was 18.0% (95% CI 14.0-22.4) 3 years after diagnosis. After adjusting for age, sex, year, medical insurance coverage, and population group, opioid-related disorders were associated with an increased risk of mortality (aHR 2.28, 95% CI 1.84-2.82). Opioid-related disorders were associated with a 7.8-year shorter life expectancy.

Conclusions

The incidence of patients diagnosed with or treated for an opioid-related disorder in the private sector is increasing rapidly. People with opioid-related disorders are a vulnerable population with substantial psychiatric comorbidity who often die prematurely. Evidence-based management of opioid-related disorders is urgently needed to improve the health outcomes of people with opioid-related disorders.
Objective crystallographic symmetry classifications of a noisy crystal pattern with strong Fedorov-type pseudosymmetries and its optimal image-quality enhancement
Authors: Moeck Peter
Published: April 2022

Statistically sound crystallographic symmetry classifications are obtained with information-theory-based methods in the presence of approximately Gaussian distributed noise. A set of three synthetic patterns with strong Fedorov-type pseudosymmetries and varying amounts of noise serve as examples. Contrary to traditional crystallographic symmetry classifications with an image processing program such asCRISP, the classification process does not need to be supervised by a human being and is free of any subjectively set thresholds in the geometric model selection process. This enables crystallographic symmetry classification of digital images that are more or less periodic in two dimensions (2D), also known as crystal patterns, as recorded with sufficient structural resolution from a wide range of crystalline samples with different types of scanning probe and transmission electron microscopes. Correct symmetry classifications enable the optimal crystallographic processing of such images. That processing consists of the averaging over all asymmetric units in all unit cells in the selected image area and significantly enhances both the signal-to-noise ratio and the structural resolution of a microscopic study of a crystal. For sufficiently complex crystal patterns, the information-theoretic symmetry classification methods are more accurate than both visual classifications by human experts and the recommendations of one of the popular crystallographic image processing programs of electron crystallography.
Investigation on microstructure and corrosion behavior of rolled Mg-1.5Zn-xCa-xCe alloy
Authors: Zhang Cheng , Peng Cheng , Huang Jin , Zhao Yanchun , Han Tingzhuang , Wang Guangang , Wu Liang , Huang Guangsheng
Published: April 2022

Purpose

This study aims to investigate the effect of microalloyed Ca and Ce on microstructure and corrosion behavior of Mg-1.5Zn alloy. Mg-1.5Zn-xCa-xCe alloys were prepared by melting, extrusion and rolling processes.

Design/methodology/approach

The effects of adding Ca and Ce elements alone or adding Ca and Ce elements simultaneously on the microstructure and corrosion resistance of Mg-1.5Zn-xCa-xCe (x = 0 or 0.2 Wt.%) alloys were studied by scanning electron microscopy, hydrogen evolution tests and electrochemical experiments.

Findings

The addition of Ca and Ce elements alone or the addition of Ca and Ce elements had little impact on the grain size of the rolled and annealed Mg-1.5Zn-xCa-xCe alloy, but had a greater effect on the type and quantity of the second phase.

Originality/value

The order of the corrosion rates for the three alloys was Mg-1.5Zn-0.2Ca < Mg-1.5Zn-0.2Ca-0.2Ce < Mg-1.5Zn-0.2Ce. Mg-1.5Zn-0.2Ca showed the best corrosion resistance, which was related to the second phase and corrosion products.
The Egyptian stock market's reaction to the COVID-19 pandemic
Authors: Abouelfarag Hanan AbdelKhalik , Qutb Rasha
Published: April 2022

Purpose

The purpose of this study is to empirically examine the impact of the novel coronavirus (COVID-19) on Egyptian stock market returns and volatility between July 2018 and June 2021.

Design/methodology/approach

This study utilizes a generalized autoregressive conditional heteroskedasticity (GARCH) model to examine the impact of COVID-19 on two basic stock market indices (EGX30 and EGX100). In addition, the heteroskedasticity corrected model (HCM) was employed to differentiate between the effects of each subsequent wave of the pandemic.

Findings

The results of the GARCH model revealed that all COVID-19 variables have a significant impact on the daily returns of EGX100, but an insignificant impact on that of EGX30. The mortality rate and transmission speed increased the market volatility of EGX30 daily returns. The results of the HCM confirmed that the Egyptian stock market reacted more nervously to the first wave than to the second, while the impact was not detected in the third wave.

Practical implications

This study provides useful insights to investors and policymakers in handling the negative influence of unanticipated events. To retain economic stability, the Egyptian government can impose fiscal stimuli and consider policies to combat the impact of the pandemic.

Originality/value

This study is one of the first attempts to differentiate between the effects of subsequent waves of the pandemic on the stock market in Egypt, one of the largest economies in Africa.
Blending absorptive capacity with open innovation: a bibliometric review
Authors: Bhadauria Shraddha , Singh Vinay
Published: April 2022

Purpose

This paper aims to explore the relationship between open innovation (OI) and absorptive capacity (AC) using a bibliometric analysis of existing literature.

Design/methodology/approach

The bibliometric analysis is used to review the covered research articles in the Web of Science (WoS) database. The time span covered over 20 years from the year 2000 to 2020.

Findings

The study suggests that it is an attracting and growing field for researchers, and there exists a close relationship between OI and AC. Further, the literature has parted into three research streams (1) AC and OI: dependency and interchangeability; (2) OI and its future avenues (3) OI and AC: critical factor for firm innovation performance which elaborate various future scopes to study.

Research limitations/implications

The study's limitations exist with the biasness in database selection criteria, such as the possible non-inclusion of crucial articles.

Practical implications

The study’s implications are to discern close association and path dependency of AC and OI; and facilitate the innovation performance of the firm via developing of AC.

Originality/value

The approach used is a novelty, and the conclusions can better understand the relationship between both terms (OI and AC). Thus, it can help increase firm innovation performance.