bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence of and risk factors for liver damage in patients with HIV‐1 mono‐infection receiving antiretroviral therapy
Authors: Huang Huihuang , Song Bing , Gao Lin , Cheng Juan , Mao Yufeng , Zhao Hua , Tu Bo , Huang Shun , Zhang Jieli , Chen Dianjie , Zhao Peng , Jiao Yan‐Mei , Jiang Tianjun
Published: March 2022

Objectives

The study aimed to investigate the incidence of and risk factors for liver damage in patients with human immunodeficiency virus type‐1 (HIV‐1) mono‐infection receiving antiretroviral therapy (ART).

Methods

We retrospectively analyzed the clinical data of patients who were diagnosed with HIV‐1 infection and initiated ART from January to December 2017. Among them, 382 patients with HIV‐1 mono‐infection and normal baseline liver function were included in the analysis. The incidence of liver damage at each follow‐up point, and possible risk factors for liver damage were evaluated via COX regression survival analyses.

Results

The overall incidence of liver damage (grade I–IV) was 27.23% (interquartile range [IQR]: 26.38%–28.72%). Grade I liver damage was most common and accounted for 22.13% of cases (IQR: 21.06%–24.04%), while grade II liver damage accounted for 3.40% of cases (IQR: 3.19%–4.26%). COX regression and survival analyses revealed that baseline body mass index (BMI), alanine aminotransferase (ALT) level, CD4+ T cell count, HIV‐1 viral load, and the antiretroviral regimen were significantly correlated with the occurrence of liver damage. Moreover, baseline ALT levels and HIV‐1 viral load were identified as independent risk factors for liver damage in patients with HIV‐1 mono‐infection.

Conclusion

Liver damage is common in patients with HIV‐1 mono‐infection undergoing ART. Patients with risk factors for liver damage should be well‐informed before the initiation of ART, and liver function should be closely monitored during ART even in patients with normal liver function before ART.
Loss to follow‐up among human immunodeficiency virus‐positive postpartum women and its predictive factors: A retrospective study
Authors: Li Jianwei , Li Aixin , Ye Jiangzhu , Shao Ying , Zhang Hongwei , Liu An , Li Zaicun , Zhang Guang , Sun Lijun
Published: March 2022

Objectives

Antiretroviral treatment (ART) is essential in preventing mother‐to‐child transmission of human immunodeficiency virus (HIV), and postpartum discontinuation of ART is associated with adverse outcomes. This study identified factors associated with postpartum follow‐up of HIV‐positive women.

Methods

This was a retrospective cohort study of 170 HIV‐infected pregnant women who received regular obstetric examination and delivered successfully in Beijing between 2003 and 2020.The women's sociodemographic, clinical, treatment, obstetric, and gestational characteristics were analyzed. Cox proportional hazards models were used to estimate adjusted hazard ratios (AHRs) of loss to follow‐up between levels of confounders.

Results

In the multivariable Cox proportional hazard models, women with a longer time from HIV diagnosis to delivery per year had a 1.4‐timeshigher risk (AHR = 1.433, 95% CI: 0.897–2.229) and a higher rate of loss to follow‐up than the other women. Perinatal health care (AHR = 0.003,95% CI: 0.000–0.105) and gestational age above 37 weeks at delivery (AHR = 0.294, 95% CI: 0.005–15.818) were associated with a longer follow‐up of postpartum HIV‐positive women, when compared to women who did not receive perinatal healthcare and who delivered before 37 weeks of gestation, respectively.

Conclusions

The longer time from HIV diagnosis to delivery, access to perinatal care, and full‐term gestation at delivery improved postpartum ART adherence and follow‐up among HIV‐positive women. Early initiation of ART, integration of adult ART into prevention of mother‐to‐child transmission, combination ART with maternal healthcare, and enhanced pregnancy care will improve ART adherence among HIV‐positive women after delivery.
Outcomes of persistent low‐level viremia among HIV patients on antiretroviral therapy: A prospective cohort study
Authors: Ding Haibo , Xu Junjie , Liu Jing , Wang Qi , Kang Jing , Li Xiaolin , Zhang Zining , Han Xiaoxu , Jiang Yongjun , Geng Wenqing , Shang Hong
Published: March 2022

Introduction

We aimed to investigate the relationship between low‐level viremia (LLV) and virological failure (VF), death, and non‐AIDS events (NAEs).

Methods

A prospective cohort study of people living with HIV (PLHIV) on antiretroviral therapy (ART) was conducted from 2011–2018 at an HIV clinic in Shenyang, China. The incidence of VF and the mortality and NAEs due to LLV were assessed. Cox proportional hazards regression was performed to investigate risk factors for VF, mortality, and NAEs.

Results

In total, 1288 patients, contributing 3915 person‐years of follow‐up (median follow‐up, 2.5 years [interquartile range: 2−4 years]), were enrolled. Thirty‐one patients (2.4%) experienced VF, 5 (0.4%) died, and 38 (3.0%) experienced NAEs. The risk of VF was significantly increased among patients with a viral load (VL) of 200–499 copies/mL (adjusted hazard ratio [aHR]: 14.92, 95% confidence interval [CI]: 5.92–37.60) or 500–999 copies/mL (aHR: 13.68, 95% CI: 3.61–51.87), but not among patients with a VL of 50–199 copies/mL (aHR: 3.10, 95% CI: 0.86–11.09). The risk of NAEs was significantly increased among patients with LLV (aHR: 7.33, 95% CI: 3.73–14.42). Compared to no LLV, a VL of 50–199 copies/mL (aHR: 4.11, 95% CI: 1.73–9.74), 200–499 copies/mL (aHR: 18.31, 95% CI: 6.66–50.33), and 500–999 copies/mL (aHR: 21.34, 95% CI: 5.69–80.01) showed higher risk of NAEs.

Conclusion

Low‐level viremia was associated with VF and NAEs. Patients with LLV, especially those with a VL ≥200 copies/mL, may need more frequent VL testing and NAE screening.
Pre‐treatment and acquired antiretroviral drug resistance among people living with HIV in Tianjin, China
Authors: Gao Liying , Xia Huan , Zeng Rui , Wu Yue , Zaongo Silvere D. , Hu Yue , Ma Ping
Published: March 2022

Objectives

This study investigated the prevalence and patterns of pre‐treatment and acquired HIV drug resistance mutations among people living with HIV (PLWH) on antiretroviral therapy (ART) for 12 (±3) months in Tianjin, China.

Methods

From Jan 2018 to Dec 2020, PLWH with HIV‐1 RNA greater than 1000 copies/mL visiting the ART clinic in the Tianjin Second People's Hospital were enrolled. Viral RNA isolated from blood samples were taken for genotypic resistance testing using an in‐house method. Major drug resistance mutations were analyzed for reverse transcriptase and protease Sanger sequences using the Stanford University HIV Drug Resistance Database. Multivariable Poisson regressions were used to evaluate the factors associated with drug resistance mutations.

Results

HIV drug resistance testing was successfully performed on 584 ART‐naive and 71 ART‐experienced participants. Pre‐treatment drug resistance mutation prevalence was 13.5% (79/584) to any antiretroviral drug, 12.5% (73/584) to non‐nucleoside reverse transcriptase inhibitors (NNRTIs), 1.5% (9/584) to nucleoside reverse‐transcriptase inhibitors (NRTIs), and 0.3% (2/584) to protease inhibitors (PIs). Acquired drug resistance to any antiretroviral drug among PLWH on ART with viral load >1000 copies/mL was 88.7% (63/71). The prevalence of mutation for NNRTIs, NRTIs, and PIs were 93.7% (59/63), 82.5% (52/63), and 3.2% (2/63), respectively.

Conclusions

Pre‐treatment and acquired drug resistance mutations were highly prevalent among PLWH in Tianjin; therefore, routine baseline genotypic resistance testing and adequate intervals of viral load surveillance are urgently needed for the long‐term treatment success. Our findings provide important evidence for first‐ and second‐line regimen drugs for PLWH, especially in China.
Opening the door on entry inhibitors in HIV: Redefining the use of entry inhibitors in heavily treatment experienced and treatment‐limited individuals living with HIV
Authors: Orkin Chloe , Cahn Pedro , Castagna Antonella , Emu Brinda , Harrigan P Richard , Kuritzkes Daniel R. , Nelson Mark , Schapiro Jonathan
Published: March 2022

Introduction

Entry inhibitors are a relatively new class of antiretroviral therapy and are typically indicated in heavily treatment experienced individuals living with HIV. Despite this, there is no formal definition of ‘heavily treatment experienced’. Interpretation of this term generally includes acknowledgement of multidrug resistance and reflects the fact that patients in need of further treatment options may have experienced multiple lines of therapy. However, it fails to recognize treatment limiting factors including contraindications, age‐associated comorbidities, and difficulty adhering to regimens.

Methods

This manuscript follows a roundtable discussion and aims to identify the unmet needs of those living with HIV who are in need of further treatment options, to broaden the definition of heavily treatment experienced and to clarify the use of newer agents, with an emphasis on the potential role of entry inhibitors, in this population.

Results/Conclusions

Within the entry inhibitor class, mechanisms of action differ between agents; resistance to one subclass does not confer resistance to others. Combinations of entry inhibitors should be considered in the same regimen, and if lack of response is seen to one entry inhibitor another can be tried. When selecting an entry inhibitor, physicians should account for patient preferences and needs as well as agent‐specific clinical characteristics. Absence of documented multidrug resistance should not exclude an individual from treatment with an entry inhibitor; entry inhibitors are a valuable treatment option for all individuals who are treatment limited or treatment exhausted. We should advocate for additional clinical trials that help define the role of entry inhibitors in people with exhausted/limited ART options other than drug resistance.
Frequency, reasons, correlates and predictors of missed nursing care in Turkey: A multi‐hospital cross‐sectional study
Authors: Taskiran Eskici Gulcan , Baykal Ulku
Published: March 2022

Aim

We aimed to examine the frequency, reasons, correlates and predictors of missed nursing care in Turkey.

Methods

This descriptive and cross‐sectional study sample consisted of 1310 nurses working in inpatient units of 10 public, university and private hospitals in Istanbul. Data were collected using the Nursing Teamwork Survey‐Turkish and the MISSCARE Survey‐Turkish between February and June 2019. Descriptive analysis, parametric comparative analysis, correlational analysis and regression analysis were used to analyse the data.

Results

The total occurrence of missed nursing care was 2.93 (on a scale of 1.00–4.00), which differed across 21 nursing care elements. The most frequently missed care was turning patients every 2 hours. Multiple regression analysis determined that nurses' tenure in the profession, patient–nurse ratio, days absent in the last 3 months and nursing teamwork significantly affected missed nursing care. Nursing teamwork alone accounted for 23.6% of the variance in missed nursing care.

Conclusions

The level of missed nursing care was found to be high, and labour resources issues were the most important reason. Nurse professionals should apply interventions to improve nurses' work environment factors such as patient–nurse ratio and nursing teamwork to reduce the incidence of missed nursing care.
Harnessing taxonomically diverse and metabolically versatile genus Paracoccus for bioplastic synthesis and xenobiotic biodegradation
Authors: Puri Akshita , Bajaj Abhay , Singh Yogendra , Lal Rup
Published: March 2022

The genus Paracoccus represents a taxonomically diverse group comprising more than 80 novel species isolated from various pristine and polluted environments. The species are characterized as coccoid-shaped Gram-negative bacteria with versatile metabolic attributes and classified as autotrophs, heterotrophs and/or methylotrophs. The present study highlights the up-to-date global taxonomic diversity and critically discusses the significance of genome analysis for identifying the genomic determinants related to functional attributes mainly bioplastic synthesis and biodegradation potential that makes these isolates commercially viable. The analysis accentuates polyphasic and genomic attributes of Paracoccus spp. which could be harnessed for commercial applications and emphasizes the need of integrating genome-based computational analysis for evolutionary species and functional diversification. The work reflects on the underexplored genetic potential for bioplastic synthesis which can be harnessed using advanced genomic methods. It also underlines the degradation potential and possible use of naturally-occurring pollutant-degrading Paracoccus isolates for the development of a biodegradation system and efficient removal of contaminants. The work contemplates plausible use of such potent isolates to establish the plant-microbe interaction, contributing toward contaminated land reclamation. Overall, the work signifies the need and application of genome analysis to identify and explore the prospective potential of Paracoccus spp. for environmental application toward achieving sustainability.
Gap between risk factors and prevention strategies? A nationwide survey of fall prevention among medical and surgical patients
Authors: Xia Lixia , Zheng Yining , Lin Zheng , Chen Peng , Mei Kewen , Zhao Jing , Liu Yilan , Song Baoyun , Gao Hongmei , Sun Chao , Yang Hui , Wang Ying , Song Kuiqi , Yang Yan , Luan Xiaorong , Wen Xianxiu , Yin Xin , Fu Adan , Cai Yinghua , Xie Liling , Li Yaling , Lu Jieyu , Wu Xinjuan , Wang Rong , Gu Zejuan
Published: March 2022

Aims

This study aimed to determine the extent to which nurses report assessing evidence‐based falls risk factors and implementing targeted prevention for medical and surgical patients in China.

Design

This study was a national online survey.

Methods

The respondents were registered nurses working in medical and surgical units in 662 Chinese hospitals. The data concerning the falls risk factor assessments and targeted interventions implemented by nurses were collected online by the Nursing Management Committee of the Chinese Nursing Association in China in 2019.

Results

In total, 68 527 valid questionnaires were returned (95.0%). In medical and surgical units, nurses were most likely to report assessing balance, mobility and strength (81.6%) and orthostatic hypotension (76.4%) in falls patients and least likely to report assessing continence (61.3%) and feet and footwear (55.8%). Ensuring the use of appropriate footwear (79.3%) and managing syncope, dizziness and vertigo (73.8%) were the most common multiple interventions, while managing postural hypotension (48.8%) and cognitive impairment (48.4%) was the least common. Nine falls risk factors with clearly matched multifactorial interventions were identified in medical and surgical units (68.2%–97.1%).

Conclusions

The implementation of multifactorial interventions in medical and surgical wards is inconsistent as reported by nurses in medical and surgical wards. Throughout China, nurses are generally concerned about falls risk factors and prevention for their patients; however, limited attention has been focused on continence, feet and footwear assessment and the management of cognitive impairment. Evidence‐based falls prevention should be further tailored to the specific risk factors of each patient.

Impact

Best practice guidelines for falls prevention in hospitals have been developed and published, and it is important for nurses to use these guidelines to guide practice. Our findings identify that in routine care, healthcare providers and hospitals can prevent falls.
Web‐based self‐management intervention for patients with cancer: A meta‐analysis and systematic review
Authors: Zhang Xiaoping , Ma Lina , Feng Li
Published: March 2022

Aim

This study is conducted to synthesize the effects of web‐based self‐management intervention on patients with cancer.

Evaluation

We searched Web of Science, PubMed, Embase and Cochrane library databases for related randomized controlled trials from inception through 2021. Reference lists of included studies were also searched for additional qualified studies. For quantitative data synthesis, standardized mean differences were used to eliminate the influence caused by different scales. Narrative synthesis was also performed.

Key issues

Nine in 1149 studies were included for narrative and quantitative analysis. The pooled data suggested that patients in the intervention group had better quality of life (standardized mean difference = 1.091, 95% confidence interval: 0.155–2.028) and lower depression (standardized mean difference = −1.634, 95% confidence interval: −2.980 to −0.287) than those in the control group. The result of narrative synthesis is that patients receiving intervention had lower cancer or symptom distress and higher self‐efficacy than those in the control group.

Conclusion

Web‐based self‐management intervention improved lives of cancer survivors.
Reduced volumetric parameters of the placenta and extravillous trophoblastic cells in complicated pregnancies may lead to intrauterine growth restriction and small for gestational age birth
Authors: Sheibak Nadia , Heidari Zahra , Mahmoudzadeh‐Sagheb Hamidreza , Narouei Mahdieh
Published: March 2022

Aim

We undertook this study to determine quantitative changes of the placenta, focusing on extravillous trophoblastic cells (EVTs) in pregnancies with intrauterine growth restriction (IUGR) and small for gestational age (SGA) compared to the control group.

Methods

Placentas from pregnancies complicated with SGA‐IUGR (n = 10) and control group (n = 10) were obtained after cesarean surgery and evaluated using stereological assays after routine tissue processing and Masson's trichrome staining. Mann–Whitney U‐test was employed, and the level of statistical significance was set at p <0.05.

Results

Our results showed that the volumetric parameters, including the total volume and volume density of chorionic villi, intervillous spaces, blood vessels in chorionic villi, and syncytiotrophoblast, decreased significantly in the SGA‐IUGR group compared to control placentas (p <0.05). Also, total volume, number of EVTs, volume, the diameter of cytoplasm, and diameter of the nucleus in these cells were significantly lower in the SGA‐IUGR group (p <0.05). In addition, the nucleus to cytoplasm ratio of EVTs was also higher in the SGA‐IUGR group (p <0.05).

Conclusions

There are several significant histological and stereological differences in the placenta, particularly its EVTs from the SGA‐IUGR group compared to the control group. It seems that histological changes in the placental tissues could be helpful for the retrospective explanations of pregnancy complications.
In What Ways We Depend: Academic Dependency Theory and the Development of East Asian Sociology
Authors: Lee Chengpang , Chen Ying
Published: March 2022

Since it was framed 20 years ago, Syed Farid Alatas's theory of academic dependence has made a long‐lasting impact within the global social science field, and has elevated the previous discussion on academic dependence. In this essay, we critically examine his theory of academic dependence with an original dataset that contains 22 top sociology institutions in East Asia, including China, Japan, South Korea, Singapore, Hong Kong, and Taiwan. We further engage the data, and theory within the global higher education ranking system, a theme that had not yet emerged when he framed his theory of academic dependence. Our findings suggest that (1) higher rankings do not create job opportunities for locally trained PhDs; (2) emphasis on the number of publications is still prevalent; (3) adopting the standards set up by the ranking agency re‐enforces the existing global division of academic labor. Overall, sociology in these societies after 20 years is now more dependent, rather than autonomous from, the Western academic center.
Economic impact of selective use of contrast for routine follow‐up MRI of patients with multiple sclerosis
Authors: Mattay Raghav R. , Davtyan Karapet , Rudie Jeffrey D. , Mattay Govind S. , Jacobs Dina A. , Schindler Matthew , Loevner Laurie A. , Schnall Mitchell D. , Bilello Michel , Mamourian Alexander C. , Cook Tessa S.
Published: March 2022

Background and Purpose

Imaging and autopsy studies show intracranial gadolinium deposition in patients who have undergone serial contrast‐enhanced MRIs. This observation has raised concerns when using contrast administration in patients who receive frequent MRIs. To address this, we implemented a contrast‐conditional protocol wherein gadolinium is administered only for multiple sclerosis (MS) patients with imaging evidence of new disease activity on precontrast imaging. In this study, we explore the economic impact of our new MRI protocol.

Methods

We compared scanner time and Medicare reimbursement using our contrast‐conditional methodology versus that of prior protocols where all patients received gadolinium.

Results

For 422 patients over 4 months, the contrast‐conditional protocol amounted to 60% decrease in contrast injection and savings of approximately 20% of MRI scanner time. If the extra scanner time was used for performing MS follow‐up MRIs in additional patients, the contrast‐conditional protocol would amount to net revenue loss of $21,707 (∼3.7%).

Conclusions

Implementation of a new protocol to limit contrast in MS follow‐up MRIs led to a minimal decrease in revenue when controlled for scanner time utilized and is outweighed by other benefits, including substantial decreased gadolinium administration, increased patient comfort, and increased availability of scanner time, which depending on type of studies performed could result in additional financial benefit.
Urodynamically proven lower urinary tract dysfunction in children after COVID‐19: A case series
Authors: Selvi Ismail , Dönmez Muhammet İrfan , Ziylan Orhan , Oktar Tayfun
Published: March 2022

Case

Since the declaration of COVID‐19 as a pandemic, other unexpected symptoms related to the infection besides the respiratory system have been reported. Although a few case reports have revealed that adult patients with COVID‐19 also complained of urinary frequency and nocturia, the exact pathophysiology is still unclear. In this case series, we present three children aged 14 to 17 years with urodynamically proven lower urinary tract dysfunction (LUTD) following COVID‐19.

Outcome

None of the patients had constipation or bowel disorder before the diagnosis of COVID‐19. In addition, neurological examination and related imaging revealed no signs of etiological factors. The median time from diagnosis of COVID‐19 infection to the onset of lower urinary tract symptoms was 3 months. Incomplete bladder emptying/urinary retention supported by increased bladder compliance, high post‐micturition residual urine volumes, and absence of detrusor pressure increase during the voiding phase in the pressure flow study (acontractile detrusor in two patients and hypocontractile detrusor in one patient) were observed.

Conclusion

We observed that LUTD (eg, incomplete bladder emptying, urinary retention) can be prominent some time after the diagnosis of COVID‐19. Even though psychogenic or neurogenic causes may not be excluded completely, clinicians should be aware of a recent COVID‐19 infection in children with sudden‐onset LUTD.
Follow‐up and growing‐up formula promotion among Mexican pregnant women and mothers of children under 18 months old
Authors: Vilar‐Compte Mireya , Hernández Cordero Sonia , Castañeda‐Márquez Ana C. , Rollins Nigel , Kingston Gillian , Pérez‐Escamilla Rafael
Published: March 2022

Milk formula sales have grown globally, particularly through follow‐up formulas (FUF) and growing‐up milks (GUM). Marketing strategies and weak regulatory and institutional arrangements are important contributors to caregivers' decisions about child feeding choices. This study describes maternal awareness, beliefs, and normative referents of FUFs and GUMs among Mexican pregnant women and mothers of children 0–18 months (n = 1044) through the lens of the theory of reasoned action (TRA). A cross‐sectional survey was undertaken in two large metropolitan areas of Mexico. Descriptive analyses were conducted following the constructs of the TRA. One‐third of the participants had heard about FUFs, mainly through health professionals (51.1%) and family (22.2%). Once they had heard about FUFs, the majority (80%) believed older infants needed this product due to its benefits (hunger satisfaction, brain development, and allergy management). One quarter of the participants were already using or intended to use FUFs; the majority had received this recommendation from doctors (74.6%) and mothers/mothers‐in‐law (25%). Similarly, 19% of the women had heard about GUMs. The pattern for the rest of TRA constructs for GUMs was similar to FUFs. Mexican women are exposed to FUFs and GUMs, once women know about them, the majority believe older infant and young children need these products, stating perceived benefits that match the poorly substantiated marketing claims of breast‐milk substitutes. Health professionals, particularly doctors, act as marketing channels for FUFs and GUMs. Marketing of FUFs and GUMs represents a threat to breastfeeding in Mexico and a more protective regulatory and institutional environment is needed.
Spatial representations in sensory modalities
Authors: Cheng Tony
Published: March 2022

Some sensory modalities, such as sight, touch and audition, are arguably spatial, and one way to understand these spatial senses is to investigate spatial representations in them. Here I focus on a specific element in this area—the interplay between perspectival variation and spatial constancy—and discuss recent interdisciplinary works on this topic. With these relevant experimental works, we will see clearly how traditional controversies in philosophy, for example, whether we perceive perspectival shapes as well as objective shapes, and whether any sensory field should be postulated in senses other than vision, can benefit from considerations in empirical sciences.
A nationalist party with non‐nationalistic voters? Discussing the limits of nationalism in party categorisation
Authors: Lobera Josep , Roch Juan
Published: March 2022

Are populism and nationalism two inseparable dimensions? The controversial argument is that both exclusionary and inclusionary populism draw on nationalist representations and traditions to construct their political discourse. In the case of Podemos, several scholars have argued that this party presents a nationalistic character based on its invocation of the ‘patria’ and a demarcated, imagined political community. This article relies on an original data set in order to test this hypothesis related to Podemos's supply and demand. With regard to supply, we explore four party manifestos to elucidate how Podemos refers to the nation, Spanish identity, sovereignty and immigration. To evaluate demand, we analyse the party's supporters' political attitudes and values regarding the nation, assimilation of immigrants and national preferentialism. Our results show that Podemos's supporters express lower levels of national identification than the remainder of the population. Similarly, the former analysis reveals a pro‐immigration position and a tendency of the party Podemos to avoid issues related to national identity. Departing from these results, we draw several implications on the use of nationalism for the categorisation of political parties and, in particular, left‐wing populism.
The making of sects: Boundary making and the sectarianisation of the Syrian uprising, 2011–2013
Authors: Zeno Basileus
Published: March 2022

‘Sectarianism’ has been frequently used by politicians, activists, journalists and even some academics to explain causes and dynamics of the Syrian uprising and the subsequent civil war. However, this state of affairs contrasts sharply with the kinds of symbols and rhetoric used by the predominantly peaceful protesters who took to the streets in Syria in 2011. Drawing on interpretivist approach and thick‐description, this article traces how local and supralocal activists' reactions to the regime's violence and its master narrative culminated in the activation and politicisation of the category of ‘sect’ as a residual sociality. I argue that the increasing visibility of sectarian frameworks and the demobilisation of non‐sectarian actors were parts of boundary‐making strategies pursued by local and supralocal actors who capitalised on regime violence and regional sectarian framing and sought to have a monopoly over the symbolic representation of the uprising. The effectiveness of the sectarianisation process was contingent on the escalation of violence, the militarisation and internationalisation of the uprising, and the transnationalisation of sectarian networks. Taking Syria as a case study, this article demonstrates how conflicts, or violence,become‘ethnic’ or ‘sectarian‐coded’ and how macro social phenomenon influences microlevel behaviour, perspectives and strategies of boundary making.
Effect of percutaneous electrical nerve field stimulation on mechanosensitivity, sleep, and psychological comorbidities in adolescents with functional abdominal pain disorders
Authors: Santucci Neha R , King Christopher , El‐Chammas Khalil I. , Wongteerasut Anundorn , Damrongmanee Alisara , Graham Kahleb , Fei Lin , Sahay Rashmi , Jones Cheryl , Cunningham Natoshia R. , Coghill Robert C
Published: March 2022

Background

Percutaneous electrical nerve field stimulation (PENFS) improves symptoms in adolescents with functional abdominal pain disorders (FAPDs). However, little is known about its impact on sleep and psychological functioning. We evaluated the effects of PENFS on resting and evoked pain and nausea, sleep and psychological functioning, and long‐term outcomes.

Methods

Patient ages 11–19 years with FAPD requiring PENFS as standard care were recruited. Evoked pain was elicited by a Water Load Symptom Provocation Task (WL‐SPT) before and after four weeks of treatment. Pain, gastrointestinal symptoms, sleep, somatic symptoms, and physical and psychological functioning were assessed. Actigraphy was used to measure daily sleep–wake patterns.

Key Results

Twenty patients (14.3 ± 2.2 years old) with FAPD were enrolled. Most patients were females (70%) and white (95%). During pain evoked by WL‐SPT, visual analog scale (VAS) pain intensity and nausea were lower following PENFS compared with baseline (p = 0.004 and p = 0.02, respectively). After PENFS, resting VAS pain unpleasantness (p = 0.03), abdominal pain (p < 0.0001), pain catastrophizing (p = 0.0004), somatic complaints (0.01), functional disability (p = 0.04), and anxiety (p = 0.02) exhibited significant improvements, and some were sustained long‐term. Self‐reported sleep improved after PENFS (p's < 0.05) as well as actigraphy‐derived sleep onset latency (p = 0.03).

Conclusions and Inferences

We demonstrated improvements in resting and evoked pain and nausea, sleep, disability, pain catastrophizing, somatic complaints, and anxiety after four weeks of PENFS therapy. Some effects were sustained at 6–12 months post‐treatment. This suggests that PENFS is a suitable alternative to pharmacologic therapy.
Evidence of cortical thickness increases in bilateral auditory brain structures following piano learning in older adults
Authors: Worschech Florian , Altenmüller Eckart , Jünemann Kristin , Sinke Christopher , Krüger Tillmann H. C. , Scholz Daniel S. , Müller Cécile A. H. , Kliegel Matthias , James Clara E. , Marie Damien
Published: March 2022

Morphological differences in the auditory brain of musicians compared to nonmusicians are often associated with life‐long musical activity. Cross‐sectional studies, however, do not allow for any causal inferences, and most experimental studies testing music‐driven adaptations investigated children. Although the importance of the age at which musical training begins is widely recognized to impact neuroplasticity, there have been few longitudinal studies examining music‐related changes in the brains of older adults. Using magnetic resonance imaging, we measured cortical thickness (CT) of 12 auditory‐related regions of interest before and after 6 months of musical instruction in 134 healthy, right‐handed, normal‐hearing, musically‐naive older adults (64–76 years old). Prior to the study, all participants were randomly assigned to either piano training or to a musical culture/music listening group. In five regions—left Heschl's gyrus, left planum polare, bilateral superior temporal sulcus, and right Heschl's sulcus—we found an increase in CT in the piano training group compared with the musical culture group. Furthermore, CT of the right Heschl's gyrus could be identified as a morphological substrate supporting speech in noise perception. The results support the conclusion that playing an instrument is an effective stimulator for cortical plasticity, even in older adults.
Role of Exosomal miR‐223 in Chronic Skeletal Muscle Inflammation
Authors: Tian Yuan , Wang Tie‐shan , Bu He , Shao Guo , Zhang Wei , Zhang Li
Published: March 2022

As skeletal muscle is one of the largest organs in the body, its damage can directly reflect a decline in somatic function, thus, further affecting daily life and health. Inflammation is a prerequisite for the repair of injured skeletal muscles. Chronic inflammation induced by inadequate repair in skeletal muscle aggravates tissue injury. Exosomes regulate inflammatory responses to facilitate the repair of skeletal muscle injury. Moreover, exosomal miR‐223 with high specificity is the most abundant miRNA in peripheral blood and regarded as biomarkers for inflammation post skeletal muscle injury, which warrants further investigation. Available studies have demonstrated that exosomal miR‐223 negatively correlates with TNF‐α levels in serum and regulates the canonical inflammatory NF‐κB signaling pathway. miR‐223 is a negative feedback regulator with great potential for adjusting inflammatory imbalance and promoting skeletal muscle repair. The research on the regulation of negative feedback factors in the inflammatory signaling pathway is essential in biology and medicine. Therefore, this review mainly elaborates the formation, heterogeneity and markers of exosomes and points out exosomal miR‐223 as a beneficial role in chronic skeletal muscle inflammation and can be expected to be a potential therapeutic target for skeletal muscle damage.
Arthroscopy‐Assisted Reduction and Fixation of Femoral Head and Acetabulum Fractures: A Systematic Review of the Literature
Authors: Söylemez Mehmet Salih , Kemah Bahattin , Poyanli Oguz
Published: March 2022

Objective

To perform a systematic review to determine the current arthroscopic techniques of the fixation of femoral head and acetabulum fractures and assess the radiological and functional outcomes reported in literature written in English.

Methods

This review was performed by searching PubMed, Cochrane Library, Scopus, and Web of Science without a filter for time limitation in line with Preferred Reporting Items for Systematic Reviews Protocols (PRISMA‐P) guidelines. Two authors took part in screening and evaluating the literature between December 2020 and January 2021. The terms acetabulum fracture, reduction, fixation, femur head fracture, fracture dislocation of the hip, hip trauma and arthroscopy or arthroscopic, and their combinations were used to search four database engines in the titles and abstracts of the reported papers. Only papers with English titles and abstracts were included. The assessment of the data related to descriptions of the techniques, indications for fracture fixation using arthroscopy, and patient‐related outcomes.

Results

Perfect agreement was detected between the two reviewers during all steps of the review process (κ = 0.81–1.00). Although a meta‐analysis was planned to be carried out, no randomized controlled study comparing either the radiological or functional results of different surgical techniques was detected in the literature. Nineteen studies were included in the study. Of these, 15 were retrospective case reports and four were case series. Twenty‐seven patients were operated on for acetabulum fractures (18 male/nine female). The mean age was 28.3 years (range, 15–53 years). High‐energy traumas including motor vehicle accidents were the most common reason (81%). The duration of follow‐up was a mean of 32 months (range, 12–68 months). Sixteen patients were operated on for femur fractures (12 male/three female). The mean age was 30.1 years (range, 17–50 years). Motor vehicle accident was the most common trauma (70%). Duration of follow‐up had a mean of 18 months (range, 4–60 months). Patient‐related outcomes were excellent for reported cases in both groups despite the fact that an objective scoring system was not used for most of the cases. Moreover, there was no consensus on surgical indications or the techniques.

Conclusions

The techniques of arthroscopic‐assisted fixation of acetabulum and femoral head fracture are so heterogeneous that conclusions cannot be made at this time, but there is potential for this method of treatment to become more popular as the devices used in the procedure develop and as exposure to and experience with hip arthroscopy improves. Further descriptions of reduction and fixation techniques and analysis of outcomes of RCTs are needed.
Clinical and demographic factors associated with pediatric difficult intravenous access in the operating room
Authors: Ballard Heather A. , Hajduk John , Cheon Eric C. , King Michael R. , Barsuk Jeffrey H.
Published: March 2022

Background

Pediatric intravenous catheter insertion can be difficult in the operating room due to the technical challenges of small diameter vessels and the need to rapidly gain intravenous access in anesthetized children. Few studies have examined factors associated with difficult vascular access in the operating room, especially accounting for the increased possibility to use ultrasound guidance.

Aims

The primary aim of the study was to identify factors associated with pediatric difficult vascular access in the operating room. Our primary hypothesis was that Black race, Hispanic ethnicity, and ultrasound use would be associated with pediatric difficult vascular access.

Methods

We performed a retrospective analysis of prospectively collected data from a cohort of pediatric patients who had intravenous catheters inserted in the operating room at an academic tertiary care children's hospital from March 2020 to February 2021. We measured associations among patients who were labeled as having difficult vascular access (>2 attempts at access) with demographic, clinical, and hospital factors.

Results

12 728 intravenous catheter insertions were analyzed. Multivariable analysis showed significantly higher odds of difficult vascular access with Black non‐Hispanic race (1.43, 95% CI: 1.06–1.93, p = .018), younger age (0.93, 95% CI: 0.89–0.98, p = .005), overweight (1.41, 95% CI: 1.04–1.90, p = .025) and obese body mass index (1.56, 95% 95% CI: 1.12–2.17, p = .008), and American Society of Anesthesiologists physical status III (1.54, 95% CI:1.11–2.13, p = .01). The attending anesthesiologist compared to all other practitioners (certified registered nurse anesthetist: (0.41, 95% CI: 0.31–0.56, p < .001, registered nurse: 0.25, 95% CI: 0.13–0.48, p < .001, trainee: 0.21, 95% CI: 0.17–0.28, p‐value <.001 with attending as reference variable) and ultrasound use (2.61, 95% CI: 1.85–3.69, p < .001) were associated with successful intravenous catheter placement.

Conclusions

Black non‐Hispanic race/ethnicity, younger age, obese/overweight body mass index, American Society of Anesthesiologists physical status III, and ultrasound were all associated with pediatric difficult vascular access in the operating room.
Medium‐term expenditure frameworks: Credible instrument or mirage?
Authors: Raudla Ringa , Douglas James W. , MacCarthaigh Muiris
Published: March 2022

Medium‐term expenditure frameworks (MTEFs) are typically viewed as instruments to expand budget horizons beyond one year and to limit spending growth over the medium term (usually three to five years). In response to the fiscal crisis and EU requirements, many countries in Europe have adopted MTEFs over the past decade. We use elite interviews to examine whether the formal enactment of such frameworks has led to changes in actual budget practices in Finland, Austria, Portugal, and Ireland. Our analysis shows that the newly adopted MTEFs have not acted as binding constraints on fiscal policy.
Genetic origin and expression patterns of acetohydroxyacid synthase multigene family inBrassica junceaandB. carinataand their progenitors
Authors: Wang Hongmei , Lv Huijie , Sha Tianjin , Huang Qianxin , Guo Yuan , Hu Shengwu
Published: March 2022

Acetohydroxyacid synthase (AHAS), the key enzyme in the branched‐chain amino acids leucine, isoleucine, and valine biosynthesis pathway, has gained intensive investigation because it is the target of five different AHAS herbicides widely used to control weeds in farmland. In the present study, theAHASgene family inBrassica junceaandB. carinataand their progenitor species was characterized in combination with bioinformatics, gene‐specific PCR and qRT‐PCR analyses. The results indicated thatB. junceacontains fourAHASgenes, of them,BjuAHAS3andBjuAHAS4originated from the A genome donor ofB. rapa, whereasBjuAHAS6andBjuAHAS7from the B genome donor ofB. nigra.BjuAHAS3andBjuAHAS6are predicted to be functional and constitutively expressed in all vegetative and reproductive tissues in the testedB. junceaaccessions.B. carinatacontains fiveAHASgenes, of them,BcaAHAS1,BcaAHAS2, andBcaAHAS5originated from the C genome donor ofB. oleracea, whereasBcaAHAS6andBcaAHAS7came from the B genome donor ofB. nigra.BcaAHAS1,BcaAHAS2, andBcaAHAS6are predicted to be functional.BcaAHAS1andBcaAHAS6are constitutively expressed in all vegetative and reproductive tissues in the testedB. carinataaccessions, however,BcaAHAS2is mainly expressed in siliques. In addition, translocation events for theAHAS1,AHAS2, andAHAS7genes occurred when the three amphidiploids speciesB. napus,B. juncea, andB. carinatawere formed by hybridization of their respective diploid species. The findings in this study will provide important basic information for the breeding of herbicide‐resistant varieties inB. junceaandB. carinata.
Non‐native species limit stream restoration benefits for brook trout
Authors: Huntsman Brock M. , Merriam Eric R. , Rota Christopher T. , Todd Petty J.
Published: March 2022

Success of stream restoration can be difficult to define because many interacting abiotic and biotic factors across spatio‐temporal scales can have measurable effects. Consequently, failure in habitat restoration to achieve targeted biological goals may reflect interactions of habitat restoration with unaccounted risks that have yet to be addressed on the landscape. This is particularly true within invaded landscapes, where habitat restoration can benefit non‐native competitors as much as the native fishes for which restoration is designed. We tested for interacting effects of a reach scale habitat restoration effort and non‐native trout competition on habitat use by a brook trout (Salvelinus fontinalis) metapopulation within a productive main stem corridor of the Shavers Fork watershed, West Virginia. We used a joint species occupancy model within a BACI sampling design to show that brook trout occupancy of main stem habitat was highest post‐restoration within restored sampling reaches, but this benefit to native brook trout was conditional on brown trout (Salmo trutta) not being present within the main stem habitat. Collectively these results indicate that habitat restoration was only beneficial for native brook trout when non‐native trout were absent from the restored sampling area. Proactive approaches to restoration will be integral for supporting resilient ecosystems in response to future anthropogenic threats (e.g. climate change), and we have shown that such actions will only be successful if non‐native competitors do not also benefit from the restoration actions.
Unexplored freshwater communities in post‐mining ponds: effect of different restoration approaches
Authors: Poláková Martina , Straka Michal , Polášek Marek , Němejcová Denisa
Published: March 2022

Many studies examining plant and terrestrial invertebrate communities have revealed the high conservation potential of spoil heaps. On the other hand, the freshwater communities inhabiting post‐mining ponds within these human‐made habitats are almost unexplored. We focused on aquatic macroinvertebrate, zooplankton, and phytoplankton communities in the littoral zones of 24 ponds situated on spoil heaps created after lignite mining in the Czech Republic. We compared environmental factors, taxa richness, and conservation value (number of threatened aquatic macroinvertebrate species) in the ponds, based on the type of restoration approach applied, that is, technical reclamation, spontaneous succession, and their combination (semi‐spontaneous succession). While macroinvertebrate and zooplankton taxa richness did not differ significantly between the three types of pond, the phytoplankton community did, with the highest taxa richness recorded in technically established ponds. From a nature conservation point of view, the spontaneously developed ponds hosted almost twice as many threatened macroinvertebrates as the other ponds; nevertheless, even the technically constructed ponds hosted considerable populations of rare species, e.g. the regionally extinct beetle Limnebius nitidus (Marsham, 1802), and contributed to the overall conservation value of the spoil heaps. The most significant driver structuring post‐mining pond freshwater communities was the percentage of vegetation in the littoral zone.
Improving fire risk communication between authorities and micro‐entrepreneurs: A mental models study of Ghanaian central market fires
Authors: Nyame‐Asiamah Frank , Boasu Bismark Yeboah , Kawalek Peter , Buor Daniel
Published: March 2022

This study conceptualizes how fire management authorities can empower nonexpert public to participate in fire risk communication processes and increase their own responsibilities for managing fire preventive, protective and recovery processes effectively. Drawing narratives from 10 disaster management experts working at government institutions and nine micro‐entrepreneurs operating self‐sustaining businesses in different merchandized lines in Ghana, we analyzed the data thematically and explored new insights on mental models to generate a two‐way fire risk communication model. The findings suggest that fire management authorities planned fire disasters at the strategic level, collaborated with multiple stakeholders, disseminated information through many risk communication methods, and utilized their capabilities to manage fire at the various stages of fire risk communication, but the outcomes were poor. The micro‐entrepreneurs sought to improve fire management outcomes through attitude change, law enforcement actions, strengthened security and better public trust building. The study has implications for policymakers, governments, and risk communication authorities of developing countries to strengthen their fire disaster policies to minimize commercial fire incidents and address the damaging effects of fire on people's livelihoods, businesses, properties, and environments. Our proposed two‐way fire risk communication model is a new theoretical lens for experts and the nonexpert public to assess each other's beliefs about risk information and manage fire risk communication effectively at all stages.