bluuebunny/crossref_metadata_2025 huggingface dataset:
Exact augmented perpetual manifolds as a tool for the determination of similar rigid body modes: Corollary for determining backbone curves of autonomous systems
Authors: Georgiades Fotios
Published: September 2022

Perpetual points in mathematics have been defined recently, and their significance in describing the dynamics of systems is ongoing research. In mechanical engineering, the perpetual points of linear unforced mechanical systems are associated with rigid body motions, and they form the perpetual manifolds. The systems that admit perpetual manifolds of rigid body motions are called perpetual mechanical systems. The concept of perpetual manifolds has been extended to the exact augmented perpetual manifolds, whereas all the accelerations are equal but not necessarily zero. A theorem defines the conditions of external forces that lead to rigid body motion of externally forced mechanical systems. Herein, based on this theorem, a corollary is proven that, through a very simple framework, defines specifications to mechanical systems resulting in the existence of rigid body similar modes and can serve as a tool in the nonlinear normal modes (NNMs) theory for the determination of their backbone curves of dissipative mechanical systems. Further, on these, backbone curves can be used for passive vibration control design of N-degree-of-freedom (dof) mechanical systems. The verification of the theory has been done with the design of a 5-dof nonlinear perpetual mechanical system with three types of boundaries, linear, nonlinear smooth, and nonsmooth boundaries. The numerical simulations results are in excellent agreement with the theory. Although 5-dof mechanical systems have been examined, the corollary is valid for N-degree-of freedom systems. The corollary provides a simplified framework for the design of mechanical systems to admit rigid body modes for systems with a general configuration that is not obvious using traditional techniques. This work is rather significant in mechanical engineering because it provides a new tool firstly for determining similar NNMs of dissipative mechanical systems and secondly for the design of passive vibration control devices.
Toward a Uniform Classification of Nurse Practitioner Scope of Practice Laws
Authors: McMichael Benjamin J. , Markowitz Sara
Published: September 2022

Many states’ scope of practice laws limits the ability of nurse practitioners to deliver care by requiring physician supervision of their practices and prescribing activities. A robust literature has evolved around examining the role of these scope of practice laws in various contexts, including labor market outcomes, health care access, health care prices, and the delivery of care for specific diseases. Unfortunately, these studies use different, and sometimes conflicting, measures of scope of practice laws, limiting their comparability and overall usefulness to policymakers and future researchers. We address this salient problem by providing a recommended coding of nurse practitioner scope of practice laws over a 24-year period based on actual statutory and regulatory language. Our classification of scope of practice laws solves an important problem within this growing literature and provides a solid legal foundation for researchers as they continue to investigate the effects of these laws.
Dobbs: Navigating the New Quagmire and Its Impacts on Abortion and Reproductive Health Care
Authors: Kulczycki Andrzej
Published: September 2022

On June 24, 2022, the U.S. Supreme Court issued its decision on Dobbs v. Jackson Women’s Health Organization. By voting to uphold Mississippi’s law banning most abortions after 15 weeks, the Court overturned Roe v. Wade, eliminating the federal standard protecting a woman’s right to abortion and reversing nearly 50 years of legal precedent. The ruling returned regulation of abortion to the states, which are responding by implementing bans or protecting access to abortion. As political and legal conflicts escalate and individual horror stories emerge, the dangerous mirage presented by this misguided legal fix to a long-standing vexing issue will come into sharper relief. The Dobbs ruling is creating a new uncertain and treacherous landscape for women and health care professionals to navigate.
A study on the damage tolerance of durable redundant composite sandwich joints
Authors: Goyal Vinay K , Lundgren Eric C , Patel Dhruv N
Published: September 2022

A patented Durable Redundant Joint (DRJ) concept featuring multiple adhesive load-paths, via a novel composite preform insert, is being considered for joining composite sandwich panel segments. Applications are wide ranging from spacecraft bus structure to launch vehicle primary structure (i.e. interstage cylinders and payload fairings). Numerical and experimental investigations were performed to assess the DRJ’s performance. A fracture-based approach was used to evaluate this design. Ply-level mechanical properties for the material systems were generated, and a double cantilever beam coupon was designed and tested to estimate the Mode I critical energy release rate for the interface between two different composite prepreg material systems. The DRJ was tested and compared to testing of the more conventional splice joint (CSJ) design. Polytetrafluoroethylene (PTFE) inserts were used at the free edges of the joints to simulate debonds between the doubler and facesheet laminates. The DRJ coupons reached 32% greater in-plane tensile failure load compared to the CSJ coupons. Furthermore, the predicted increased strength for the DRJ design compared to the CSJ design was in remarkably good agreement with test data. Using the insight gained from these studies, three design attributes were investigated relative to increasing damage tolerance characteristics of the DRJ: (1) Insert stiffness, (2) Relative length between the doubler and the insert, and (3) The use of tapers at the ends of doublers.
Creation of an arteriovenous graft for hemodialysis using a previously placed stent graft: A case report
Authors: Zhan Shen , Zhang Lihong , Xiao Guanghui , Wang Yuzhu
Published: September 2022

Successful hemodialysis (HD) treatment depends on well-functioning arteriovenous access. Thrombosis and stenosis are the main causes of access failure. The current report describes the successful establishment of an arteriovenous graft for HD using a previously placed stent graft in an HD patient who developed multiple episodes of access stenosis and thrombosis.
Online adaptations of tree of life and beads of life groups alongside sustaining our community of peer trainers
Authors: Casdagli Lucy , Portnoy Sara , Flannery Halina , McParland James
Published: September 2022

Collective Narrative practices, such as Tree of life and Beads of life groups, have intentions of bringing people together to share their specialist knowledge and build a sense of community. We wanted to respond to the COVID-19 pandemic through making these groups accessible online to young people living with health conditions in order to counter the social isolation and disconnectedness created by the pandemic. This paper discusses our specific online adaptations for both these groups as well as online ‘Peer training’ events. Young people who have participated in a group are invited to join the project as peer trainers who help facilitate, engage group participants, witness their stories and consult to the project. We have included the voices of two of our peer trainer consultants on their experiences. We also briefly reflect on the recent development of trialling hybrid groups.
Difficult heritage on social network sites: An integrative review
Authors: Kelpšienė Ingrida , Armakauskaitė Donata , Denisenko Viktor , Kirtiklis Kęstas , Laužikas Rimvydas , Stonytė Renata , Murinienė Lina , Dallas Costis
Published: September 2022

Social network sites (SNS) have recently become an active ground for interactions on contested and dissonant heritage, on the heritage of excluded and subaltern groups, and on the heritage of collective traumatic past events. Situated at the intersection between heritage studies, memory studies, Holocaust studies, social media studies and digital heritage studies, a growing body of scholarly literature has been emerging in the past 10 years, addressing online communication practices on SNS. This study, an integrative review of a comprehensive corpus of 80 scholarly works about difficult heritage on SNS, identifies the profile of authors contributing to this emerging area of research, the increasing frequency of publication after 2017, the prevalence of qualitative research methods, the global geographic dispersion of heritage addressed, and the emergence of common themes and concepts derived mostly from the authors ‘home’ fields of memory studies, heritage studies and (digital) media studies.
‘Like the boy who cried wolf’: The tensions of hospitality and role of deconstruction in dyadic discursive therapy interactions with children and their caregivers
Authors: Reid Katherine , Mark Brough
Published: September 2022

There’s a particular ‘common sense’ required of the contemporary neoliberal subject to ‘self-regulate, self-fashion, and self-produce’ ( Houghton, 2019 : 618). Crucially, this work on the self happens within a political context of a dominant discourse which valorises the resilient, self-regulating and enterprising individual. It is somewhat unsurprising then, that children who struggle to contain intense emotions are referred to therapy. Their experience of therapy, however, ought to then be examined within this broader socio-political context. This article examines the power dynamics of a therapeutic encounter with a child ostensibly in need of greater emotional self-regulation. To investigate how children are positioned in therapy, therapy transcripts are investigated, drawing on Derrida’s concepts of hospitality and deconstruction. Utilising a critical discourse analysis of therapy transcripts, we explored the tensions in hosting children in therapy interactions from a counselling session with a 9-year-old girl, Emily, along with her female caregiver, Kate, and her social worker, in the role of therapist. Our Foucauldian inspired power analysis revealed these tensions at work in the therapeutic encounter. We show how Emily enacted her own deconstruction of the story ‘The boy who cried wolf’, opening the door to a relational understanding of emotional regulation. The findings highlight the need for social workers to engage in reflexive practice; to be able to listen to children without transforming their insights into opportunities to reinforce dominant narratives.
Grayscale−luminance converting polynomial function for digital images to determine Feu and Lav in a low-contrast artificial lit space
Authors: Chen P , Wang A , Wang L , Wu Y , Yu J
Published: September 2022

The evaluation of the spatial luminance coefficient, Feu, and average luminance, Lav, can improve the lighting quality from both subjective and objective aspects. In the design survey, the determination of these indicators relies on the manual sampling of the luminance of measurement points, which is time-consuming and labour-intensive. This article proposes a grayscale−luminance converting polynomial function, and a method for the determination of Feu and Lav from digital images via the function. The acceptability index, Nallow, is created as the key parameter of the polynomial function, which reduces the number of required measurement points to 9. Taking visual comfort as the criterion, three types of low-contrast working conditions with different luminance distributions – namely an actual scene, simulated scenes and experimental scenes – were set, the luminance ratios of which were less than 100 and the luminance of which was less than 1000 cd/m2. To minimise the error to within 10%, the piecewise function of Nallow determined by the luminance ratio was constructed, which is obtained via the data verification and correction of 20 working conditions. The experimental results of a test scene demonstrate that the accuracies of Feu and Lav produced by the proposed polynomial function were better than those produced by an exponential function.
Feasibility of Microbubble-Accelerated Low-Dose Thrombolysis of Peripheral Arterial Occlusions Using an Ultrasound Catheter
Authors: Doelare Sabrina A. N. , Nederhoed Johanna H. , Evers Josje M. , Roos Sebastiaan T. , Kamp Otto , Musters René J. P. , Wisselink Willem , Jongkind Vincent , Ebben Harm P. , Yeung Kak K.
Published: September 2022

Purpose:

Intra-arterial administration of microbubbles (MBs) through an ultrasound (US) catheter increases the local concentration of MBs into the thrombus and may further enhance outcomes of contrast-enhanced sonothrombolysis (CEST). The objective of this study was to evaluate the feasibility and lytic efficacy of intra-arterial infusion of MBs during US-enhanced thrombolysis in both in vitro and in vivo peripheral arterial occluded models.

Materials and Methods:

SonoVue and Luminity MBs were infused at a flow rate of 20 mL/h through either the drug delivery lumen of the US catheter (DDC, n=20) or through the tube lumen of the vascular phantom (systematic infusion, n=20) during thrombolysis with a low-dose urokinase (UK) protocol (50 000 IU/h) with(out) US application to assess MB survivability and size by pre-treatment and post-treatment measurements. A human thrombus was placed into a vascular phantom of the flow system to examine the lytic effects of CEST by post-treatment D-dimer concentrations measurements of 5 treatment conditions (saline, UK, UK+US, UK+US+SonoVue, and UK+US+Luminity). Thrombolytic efficacy of localized MBs and US delivery was then investigated in vivo in 5 porcine models by arterial blood flow, microcirculation, and postmortem determined thrombus weight and remaining length.

Results:

US exposure significantly decreased SonoVue (p=0.000) and Luminity (p=0.000) survivability by 37% and 62%, respectively. In vitro CEST treatment resulted in higher median D-dimer concentrations for the SonoVue (0.94 [0.07–7.59] mg/mL, p=0.025) and Luminity (0.83 [0.09–2.53] mg/mL, p=0.048) subgroups when compared with thrombolysis alone (0.36 [0.02–1.00] mg/mL). The lytic efficacy of CEST examined in the porcine model showed an improved median arterial blood flow of 21% (7%–79%), and a median thrombus weight and length of 1.02 (0.96–1.43) g and 2.25 (1.5–4.0) cm, respectively. One allergic reaction and 2 arrhythmias were observed due to the known allergic reaction on lipids in the porcine model.

Conclusion:

SonoVue and Luminity can be combined with an US catheter and could potentially accelerate thrombolytic treatment of peripheral arterial occlusions.

Clinical Impact

Catheter-directed thrombolysis showed to be an effective alternative to surgery for acute peripheral arterial occlusions, but this technique is still associated with several limb and life-threatening complications. The effects of thrombolysis on clot dissolution may be further enhanced by intra-arterial administration of microbubbles through an ultrasound catheter. This study demonstrates the feasibility and lytic efficacy of intra-arterial infusion of microbubbles during US-enhanced thrombolysis in both in vitro and in vivo peripheral arterial occluded models.
Risk Factors and Preventive Measures for Anastomotic Leak in Colorectal Cancer
Authors: Zhao Yongqing , Li Bo , Sun Yao , Liu Qi , Cao Qian , Li Tao , Li Jiannan
Published: September 2022

Anastomotic leak (AL) represents one of the most detrimental complications after colorectal surgery. The patient-related factors and surgery-related factors leading to AL have been identified in previous studies. Through early identification and timely adjustment of risk factors, preventive measures can be taken to reduce potential AL. However, there are still many problems associated with AL. The debate about preventive measures such as preoperative mechanical bowel preparation (MBP), intraoperative drainage, and surgical scope also continues. Recently, the gut microbiota has received more attention due to its important role in various diseases. Although the underlying mechanisms of gut microbiota on AL have not been validated completely, new strategies that manipulate intrinsic mechanisms are expected to prevent and treat AL. Moreover, laboratory examinations for AL prediction and methods for blood perfusion assessment are likely to be promoted in clinical practice. This review outlines possible risk factors for AL and suggests some preventive measures in terms of patient, surgery, and gut microbiota.
Natural Course and Treatment of Symptomatic Spontaneous Isolated Superior Mesenteric Artery Dissection with Total True Lumen Occlusion
Authors: Huang Xianchen , Li Guanqiang , Zhang Xicheng , Chen Zhaolei , Xu Miao , Sun Yuan
Published: September 2022

Objective

We retrospectively investigated the association between the imaging features of spontaneous isolated superior mesenteric artery dissection (SISMAD) accompanied by total true lumen occlusion and the clinical symptoms to identify the patients at high risk and establish personalized therapeutic options.

Methods

Among 261 patients with SISMAD, we selected 37 with Yun’s type III dissection; 35 patients underwent successful conservative management and 2 patients underwent exploratory laparotomy. After discharge, all patients were periodically followed up on an outpatient basis. We recorded patients’ general condition, symptoms, time until symptom relief, imaging findings and follow-up results.

Results

All patients experienced acute abdominal pain prior to admission, with an onset time of 29.95 ± 24.66 hours. The mean time until relief of abdominal pain in patients who received conservative treatment was 42.17 ± 38.09 hours. Correlation analysis revealed no correlation between the length of dissection or of the occluded segment and abdominal pain intensity. Pain scores were lower and time until pain relief was shorter in patients with a definite arc of Riolan (AOR) on admission than in those without an AOR. No collateral circulation was observed in the two patients who underwent exploratory laparotomy, and distal intestinal perfusion was poor in these cases. Complete and partial remodeling of the superior mesenteric artery (SMA) was observed in 6 and 16 patients, respectively at the 12-month follow-up. Although the SMA remained occluded in 12 patients, abundant collateral circulation was detected. Three patients were lost to follow-up.

Conclusion

This study highlights that conservative treatment should be attempted as first-line therapy in most patients with Yun’s type III SISMAD. Complete AOR can contribute to remission of clinical symptoms during the acute stage. Poor distal blood flow of occluded vessels may serve as an important indicator for identification of patients at high risk of ischemic intestinal necrosis.
Endovascular Aorto-Iliac Reconstruction vs. Aortobifemoral Bypass as First Choice for a Durable Revascularization for Aorto-Iliac Occlusive Disease
Authors: Choudhry Asad J. , Shaw Palma M.
Published: September 2022

Introduction

Aortoiliac occlusive disease (AIOD) is defined as atherosclerotic obstruction of the distal abdominal aorta and iliac arteries. Multiple options exist for management of AIOD including endovascular aortoiliac reconstruction and aortobifemoral bypass. As new technologies are developed, the best approach to manage this condition is evolving.

Methods

We performed a literature review to assess the current state of endovascular aortoiliac reconstruction and aortobifemoral bypass as options for revascularization of aortoiliac occlusive disease.

Conclusion

Endovascular aortoiliac reconstruction and aortobifemoral bypass are both feasible and clinically effective options for management of aortoiliac occlusive disease. No randomized controlled trial has been performed to show one option to be more effective than the other. Recent literature demonstrates comparable long-term patency, limb salvage and survival among endovascular approaches to the treatment of AIOD with quicker recovery, lower costs and improved quality of life when compared to open aortobifemoral bypass (ABF) surgery. Selection of procedure should be tailored to the individual patient in order to develop an effective long-term successful strategy for management of aortoiliac occlusive disease. Further study is warranted to define durability of these endovascular approaches as well as patient specific characteristics that influence outcomes.
Complementary therapies in substance use recovery with pregnant women and girls
Authors: Flannigan Katherine , Odell Bryce , Rizvi Imad , Murphy Lisa , Pei Jacqueline
Published: September 2022

Objectives:

Supporting women and girls who are pregnant and experiencing substance use challenges is a high priority for researchers, clinicians, and policymakers. Complementary therapies (CTs) can be effective forms of treatment in some contexts and populations; however, research on the use of CTs in substance use recovery with pregnant women and girls is scarce. To fill this gap, we conducted a mixed methods study using survey data collected at a women’s recovery center in Canada. Our objectives were to describe CTs provided at the program; identify what CTs are perceived by participants as most/least positive; and explore factors that may impact participant experiences with CTs.

Methods:

We analyzed feedback responses from 255 women and girls ( Mage = 27.5 years, range 15–64) using Pearson chi-square tests, logistic regression, and inductive content analysis.

Results:

The most frequently provided CTs were yoga, energy-related activities (e.g. reiki, reflexology), and meditation. Among the most common CTs, participants provided the highest endorsements for massage and physical activity, and the lowest endorsements for yoga and drumming. Across CTs, whether participants looked forward to an activity contributed significantly to whether they found it helpful, would like to do it again, and planned to continue engaging in the activity after leaving the program. Four broad contextual factors were identified that may impact experiences and perspectives about CTs: (1) goodness of fit, (2) self-awareness, (3) growth, and (4) healing and holistic wellbeing.

Conclusions:

This study provides novel evidence on the potential impacts of CTs in substance use treatment for pregnant women and girls, and important contextual factors to consider when implementing these approaches.
An Exploration of Vertical and Social Accountability in the Elected Tier of Local Government: Evidence from Kazakhstan
Authors: Zhumashov Yerkebulan
Published: September 2022

This study explores the functioning of the lowest elected tier of local government in Kazakhstan that governs villages, towns and small cities. While the existing literature on this issue mostly relies on quantitative data, document reviews and comparative analysis with foreign countries, this study explores new angles on the subject through the qualitative interview method. In so doing, this investigation evaluates the strengths and weaknesses of the lowest elected tier of local governments, their vertical interaction with higher-level local government and social engagement. The following conclusions have been obtained. First, providing authority to aul akims (heads of the lowest elected tier of local government) to develop budgets from locally collected revenue creates unequal opportunities for service provision. This is because the capacity of such local governments to collect taxes varies by population size, geographical features and remoteness from large cities. Second, aul akims now allocate more funds than before, but financing conditions still make them dependent on higher authorities. Third, recent requirements stipulating that aul akims discuss local issues in a local community meeting have made the heads much more socially accountable. Finally, legislation that regulates the functioning of aul akims is complex and incomplete. Based on these findings, this study suggests a number of practical recommendations for policymakers, contributes to existing knowledge via enhancing contextual information and provides directions for future research.
Risk Factors for Athletic Pubalgia in Collegiate Football Student-Athletes: A Retrospective Cohort Study
Authors: Neuville Alexander J. , Benge Clint L. , Tjong Vehniah K. , Lund Brian S. , Baer Geoffrey S. , Walczak Brian E.
Published: September 2022

Background:

Athletic pubalgia (AP) is an increasingly recognized injury among young athletes. This study aimed to evaluate the characteristics associated with AP in college football players.

Hypothesis:

Repetitive explosive movements that require aggressive core muscle activation results in AP in collegiate football players.

Study Design:

Retrospective cohort design.

Level of Evidence:

Level 3.

Methods:

Football student-athletes at a single Division I collegiate institution from January 2010 to December 2019 were included in the study. The primary outcome measure was surgery for AP. The odds of AP were determined using logistic regression, with the dependent variable being whether or not the student-athlete received AP surgery. Independent variables included Olympic weightlifting (OWL) exposure, primary playing position (skill position vs nonskill position), and body mass index (BMI).

Results:

A total of 1154 total student-athlete exposures met the inclusion criteria. Of the 576 student-athletes exposed to OWL (OWL occurred throughout entire calendar year), 20 developed AP, whereas 7 student-athletes not exposed to OWL (OWL was not performed at any point during calendar year) developed AP. Student-athletes exposed to OWL had a 2.86 (95% CI, 1.25-7.35; P = 0.02) times higher odds of AP than players not exposed after controlling for primary playing position and BMI. Skill position players had a 9.32 (95% CI, 1.71-63.96; P = 0.01) times higher odds of AP than nonskill position players when controlling for BMI and OWL training.

Conclusion:

Modifiable factors that increase exposure to repetitive explosive activities, such as OWL and playing a skill position, may be important considerations in developing AP.

Clinical Relevance:

The cause of AP is multifactorial and poorly understood. Identifying factors associated with AP informs athletes, athletic trainers, physicians, and coaches.
The Percentage of PNAd-Expressing Vessels is Correlated with Disease Severity in Eosinophilic Chronic Rhinosinusitis
Authors: Kato Eiichi , Tsutsumiuchi Toshiki , Muramoto Akifumi , Tokunaga Takahiro , Fujieda Shigeharu , Kobayashi Motohiro
Published: September 2022

Background

Eosinophilic chronic rhinosinusitis (ECRS) is a chronic inflammatory condition of the paranasal sinuses characterized by intractable nasal polyps with prominent eosinophil infiltration. These eosinophils are presumably recruited from peripheral blood via vessels expressing peripheral lymph node addressin (PNAd), a set of glycoproteins decorated with 6-sulfo sialyl Lewis x (sLex) glycans that serve as L-selectin ligands. Based on the severity classification algorithm proposed by the Japanese Epidemiological Survey of Refractory Eosinophilic Chronic Rhinosinusitis (JESREC) study group, ECRS is divided into mild, moderate and severe groups; however, as yet there are few reports comparing the clinicopathological differences among these groups.

Objective

Our goal was to elucidate clinicopathological differences among the three different severities of ECRS with special reference to eosinophils and PNAd-expressing vessels.

Methods

We performed quantitative immunohistochemical analysis of PNAd-expressing vessels using surgical specimens of nasal polyps from patients exhibiting varying severity of ECRS ( n = 35) and from individuals with non-ECRS ( n = 10). To this end, we immunostained tissue sections with anti-PNAd and anti-CD34 monoclonal antibodies, and then determined the number of vessels immunolabeled with each antibody.

Results

The number of eosinophils infiltrating nasal polyps was correlated with ECRS severity. We also found that the PNAd + /CD34 + vessel ratio, namely, the percentage of PNAd-expressing vessels among all vessels, was positively correlated not only with ECRS severity but also with the number of eosinophils infiltrating nasal polyps formed in ECRS.

Conclusion

These results strongly suggest that PNAd-expressing vessels play at least a partial role in eosinophil recruitment to nasal polyps and consequent severity of ECRS.
Relevance of infections on the outcomes of patients with myelodysplastic syndromes, chronic myelomonocytic leukemia, and acute myeloid leukemia treated with hypomethylating agents: a cohort study from the GESMD
Authors: Vilorio-Marqués Laura , Castañón Fernández Christelle , Mora Elvira , Gutiérrez Lorena , Rey Bua Beatriz , Jiménez Lorenzo Maria José , Díaz Beya Marina , Vara Pampliega Miriam , Molero Antonieta , Sánchez-García Joaquín , Calabuig Marisa , Cedena Maria Teresa , Chen-Liang Tzu , Díaz Santa Johana Alejandra , Padilla Irene , Hernández Francisca , Díez Rosana , Asensi Pedro , Xicoy Blanca , Sanz Guillermo , Valcárcel David , Diez-Campelo María , Bernal Teresa
Published: September 2022

Background:

The consequences of infectious toxicity of hypomethylating agents (HMAs) on overall survival (OS) of patients diagnosed with high-risk myeloid neoplasms have not been thoroughly investigated.

Objectives:

We aimed to evaluate whether infectious events (IEs) negatively influenced the results of HMA treatment in a real-world setting.

Design:

Observational study.

Methods:

We obtained data from 412 non-selected consecutive patients from 23 Spanish hospitals who were diagnosed with high-risk myelodysplastic syndrome, chronic myelomonocytic leukemia, or acute myeloid leukemia and were treated with HMA. HMAs received after chemotherapy or stem cell transplant were excluded. All IEs were recorded. Outcomes included OS, modifications to the pre-planned treatment, incidence and characteristics of IEs, hospitalization, red blood cell transfusions, and factors associated with infection.

Results:

The rate of infection was 1.2 per patient/year. Next-cycle delay ( p = 0.001) and hospitalizations ( p = 0.001) were significantly influenced by IEs. Transfusion requirements during each cycle were significantly higher after infection compared with cycles without infection (coefficient = 1.55 [95% confidence interval (CI) = 1.26–1.84], p < 0.001). The median number of cycles was lower in patients experiencing any infection during the first four cycles (5 [3–8] versu 8 [5–16], p < 0.001). In the multivariable analysis, factors associated with lower OS were having any infection during the first four cycles (hazard ratio (HR) = 1.43 [95% CI = 1.09–1.88], p = 0.01), bone marrow blasts ⩾30% (HR = 2.13 [95% CI = 1.14–3.96], p = 0.01), adverse cytogenetics (HR = 1.70 [95% CI = 1.30–2.24], p < 0.001), and platelet count <50 × 109/l (HR = 1.69 [95% CI = 1.3–2.2], p < 0.001). BM blasts >20% (HR = 1.57 [95% CI = 1.19–2.01], p < 0.001) and adverse cytogenetics (HR = 1.7 [95% CI = 1.35–2.14], p < 0.001) were associated with infection, whereas hemoglobin >9 g/dl (HR = 0.65 [95% CI = 0.51–0.82], p < 0.001) and higher platelet count (HR = 0.997 [95% CI = 0.996–0.998], p = 0.016) protected from it.

Conclusion:

HMA infectious toxicity worsens OS, hinders the adherence to antineoplastic treatment and results in significant morbidity. Preventive strategies are fundamental in vulnerable patients.
Inducing Paranoia is Linked to Increased Resting Amygdala Cerebral Blood Flow in Healthy Individuals
Authors: Pinkham Amy , Bass Emily , Klein Hans , Springfield Cassi , Kent Jerillyn , Aslan Sina
Published: September 2022

Among individuals with schizophrenia, paranoia has been linked to increased resting cerebral blood flow (CBF) in amygdala, suggesting that amygdala hyperactivity may be a mechanism for paranoid ideation. The present study tested this possible mechanism by assessing whether experimentally inducing paranoia in non-clinical, healthy participants resulted in increased amygdala CBF. Sixty-three undergraduates completed initial measurements of paranoia and resting CBF, via pseudo-continuous arterial spin labeling (pCASL) imaging, and were then randomly assigned to either a paranoia induction ( n = 32) or control ( n = 31) condition before completing a second pCASL scan and another paranoia assessment. Following the induction procedure, individuals in the paranoia induction condition reported fewer positive perceptions of others and greater state anxiety. Resting relative CBF values extracted from right amygdala also demonstrated an increase in CBF over time for individuals in the paranoia induction condition but a decrease in CBF over time for individuals in the control condition. Left amygdala showed no significant effects. These results support the idea that increased resting activity of the amygdala may be a neurobiological mechanism for paranoia.
Morality and Ethics in Government Schools: The Dilemmas of a Christian Educator1
Authors: O'Rourke Bernadette
Published: September 2022

But I hear a cry from ordinary Christians in Australia, many of whom have stopped going to regular worship, for a more clearly articulated framework of thinking about life's issues which would enable them to respond Christianly in an instinctive way, as dilemmas, choices, moral issues and relationships difficulties face them in daily work, in the neighbourhood and at home. They ask, “what difference does it make to my behaviour and attitudes if I am a Christian?” (Nichols 1997, p. 2)
Where is the Truth in History? How does the Discipline of History Relate to ‘The Faith of the Gospel’ (PHIL. 1:27)?
Authors: Judge E. A.
Published: September 2022

History began as the first of the Arts, using personal investigation to judge human affairs. Philosophy defined the nature of the cosmos using logic to show that it was complete, and therefore incapable of change. After a millennium Aristotle's doctrine of the eternity of the universe was refuted. The saga of creation in Genesis gave the world a history, open to testing by experiment. The gospel of Paul expected that the old would pass awaj in the end. History would not now repeat itself, so rhetorical lessons were displaced by verbatim citation to document developments.
The Effect of COVID on Oral Reading Fluency During the 2020–2021 Academic Year
Authors: Domingue Benjamin W. , Dell Madison , Lang David , Silverman Rebecca , Yeatman Jason , Hough Heather
Published: September 2022

Education has faced unprecedented disruption during the COVID pandemic. Understanding how students have adapted as we have entered a different phase of the pandemic and some communities have returned to more typical schooling will inform a suite of policy interventions and subsequent research. We use data from an oral reading fluency (ORF) assessment—a rapid assessment taking only a few minutes that measures a fundamental reading skill—to examine COVID’s effects on children’s reading ability during the pandemic. We find that students in the first 200 days of the 2020–2021 school year tended to experience slower growth in ORF relative to prepandemic years. We also observe slower growth in districts with a high percentage of English language learners and/or students eligible for free and reduced-price lunch. These findings offer valuable insight into the effects of COVID on one of the most fundamental skills taught to children.
Subcutaneous immunoglobulin therapy for refractory skin thickening in rapidly progressive systemic sclerosis: A case report and literature review
Authors: Cacciapaglia Fabio , Stano Stefano , Fornaro Marco , Iannone Florenzo
Published: September 2022

The use of immunoglobulin is a therapeutic option with increasing evidence of efficacy for different rheumatologic autoimmune systemic diseases. Some studies concerning immunoglobulin use in systemic sclerosis have been published with encouraging results. We present the case of a young woman diagnosed with rapidly progressive diffuse cutaneous systemic sclerosis, refractory to therapy with methotrexate and rituximab, which presented a relevant skin improvement after one year of subcutaneous immunoglobulin (2 g/kg cumulative monthly dose, refracted in weekly administrations). Furthermore, a narrative literature review of the evidence for alternative treatments with a focus on immunoglobulin use for systemic sclerosis skin involvement was carried out.
Single-cell analysis of immune cell transcriptome during HIV-1 infection and therapy
Authors: Pollara Justin , Khanal Santosh , Edwards R. Whitney , Hora Bhavna , Ferrari Guido , Haynes Barton F. , Bradley Todd
Published: September 2022

Background

Cellular immune responses are phenotypically and functionally perturbed during HIV-1 infection, with the majority of function restored upon antiretroviral therapy (ART). Despite ART, residual inflammation remains that can lead to HIV-related co-morbidities and mortality, indicating that ART does not fully restore normal immune cell function. Thus, understanding the dynamics of the immune cell landscape during HIV-1 infection and ART is critical to defining cellular dysfunction that occurs during HIV-1 infection and imprints during therapy.

Results

Here, we have applied single-cell transcriptome sequencing of peripheral blood immune cells from chronic untreated HIV-1 individuals, HIV-1-infected individuals receiving ART and HIV-1 negative individuals. We also applied single-cell transcriptome sequencing to a primary cell model of early HIV-1 infection using CD4+ T cells from healthy donors. We described changes in the transcriptome at high resolution that occurred during HIV-1 infection, and perturbations that remained during ART. We also determined transcriptional differences among T cells expressing HIV-1 transcripts that identified key regulators of HIV-1 infection that may serve as targets for future therapies to block HIV-1 infection.

Conclusions

This work identified key molecular pathways that are altered in immune cells during chronic HIV-1 infection that could remain despite therapy. We also identified key genes that are upregulated during early HIV-1 infection that provide insights on the mechanism of HIV-1 infection and could be targets for future therapy.
Dynamic transcriptome and network-based analysis of yellow leaf mutant Ginkgo biloba
Authors: Sun Yue , Bai Pan-Pan , Gu Kai-Jie , Yang Shao-Zong , Lin Han-Yang , Shi Cong-Guang , Zhao Yun-Peng
Published: September 2022

Background

Golden leaf in autumn is a prominent feature of deciduous tree species like Ginkgo biloba L., a landscape tree widely cultivated worldwide. However, little was known about the molecular mechanisms of leaf yellowing, especially its dynamic regulatory network. Here, we performed a suite of comparative physiological and dynamic transcriptional analyses on the golden-leaf cultivar and the wild type (WT) ginkgo to investigate the underlying mechanisms of leaf yellowing across different seasons.

Results

In the present study, we used the natural bud mutant cultivar with yellow leaves “Wannianjin” (YL) as materials. Physiological analysis revealed that higher ratios of chlorophyll a to chlorophyll b and carotenoid to chlorophyll b caused the leaf yellowing of YL. On the other hand, dynamic transcriptome analyses showed that genes related to chlorophyll metabolism played key a role in leaf coloration. Genes encoding non-yellow coloring 1 (NYC1), NYC1-like (NOL), and chlorophyllase (CLH) involved in the degradation of chlorophyll were up-regulated in spring. At the summer stage, down-regulated HEMA encoding glutamyl-tRNA reductase functioned in chlorophyll biosynthesis, while CLH involved in chlorophyll degradation was up-regulated, causing a lower chlorophyll accumulation. In carotenoid metabolism, genes encoding zeaxanthin epoxidase (ZEP) and 9-cis-epoxy carotenoid dioxygenase (NCED) showed significantly different expression levels in the WT and YL. Moreover, the weighted gene co-expression network analysis (WGCNA) suggested that the most associated transcriptional factor, which belongs to the AP2/ERF-ERF family, was engaged in regulating pigment metabolism. Furthermore, quantitative experiments validated the above results.

Conclusions

By comparing the golden-leaf cultivar and the wide type of ginkgo across three seasons, this study not only confirm the vital role of chlorophyll in leaf coloration of YL but also provided new insights into the seasonal transcriptome landscape and co-expression network. Our novel results pinpoint candidate genes for further wet-bench experiments in tree species.
Patient-initiated cardiovascular monitoring with commercially available devices: How useful is it in a cardiology outpatient setting? Mixed methods, observational study
Authors: A’Court Christine , Jenkins Wilfred , Reidy Claire , Papoutsi Chrysanthi
Published: September 2022

Background

The availability, affordability and utilisation of commercially available self-monitoring devices is increasing, but their impact on routine clinical decision-making remains little explored. We sought to examine how patient-generated cardiovascular data influenced clinical evaluation in UK cardiology outpatient clinics and to understand clinical attitudes and experiences with using data from commercially available self-monitoring devices.

Methods

Mixed methods study combining: a) quantitative and qualitative content analysis of 1373 community cardiology clinic letters, recording consultations between January–September 2020 including periods with different Covid-19 related restrictions, and b) semi-structured qualitative interviews and group discussions with 20 cardiology-affiliated clinicians at the same NHS Trust.

Results

Patient-generated cardiovascular data were described in 185/1373 (13.5%) clinic letters overall, with the proportion doubling following onset of the first Covid-19 lockdown in England, from 8.3% to 16.6% (p < 0.001). In 127/185 (69%) cases self-monitored data were found to: provide or facilitate cardiac diagnoses (34/127); assist management of previously diagnosed cardiac conditions (55/127); be deployed for cardiovascular prevention (16/127); or be recommended for heart rhythm evaluation (10/127). In 58/185 (31%) cases clinicians did not put the self-monitored data to any evident use and in 12/185 (6.5%) cases patient-generated data prompted an unnecessary referral. In interviews and discussions, clinicians expressed mixed views on patient-generated data but foresaw a need to embrace and plan for this information flow, and proactively address challenges with integration into traditional care pathways.

Conclusions

This study suggests patient-generated data are being used for clinical decision-making in ad hoc and opportunistic ways. Given shifts towards remote monitoring in clinical care, accelerated by the pandemic, there is a need to consider how best to incorporate patient-generated data in clinical processes, introduce relevant training, pathways and governance frameworks, and manage associated risks.
Secondary respiratory early and late infections in mechanically ventilated patients with COVID-19
Authors: Ceballos María Elena , Nuñez Carolina , Uribe Javier , Vera María Magdalena , Castro Ricardo , García Patricia , Arriata Gabriel , Gándara Vicente , Vargas Camila , Dominguez Angélica , Cerón Inés , Born Pablo , Espíndola Eduardo
Published: September 2022

Background

Patients with COVID-19 receiving mechanical ventilation may become aggravated with a secondary respiratory infection. The aim of this study was to describe secondary respiratory infections, their predictive factors, and outcomes in patients with COVID-19 requiring mechanical ventilation.

Methods

A cohort study was carried out in a single tertiary hospital in Santiago, Chile, from 1st June to 31st July 2020. All patients with COVID-19 admitted to the intensive care unit that required mechanical ventilation were included.

Results

A total of 175 patients were enrolled, of which 71 (40.6%) developed at least one secondary respiratory infection during follow-up. Early and late secondary infections were diagnosed in 1.7% and 31.4% respectively. Within late secondary infections, 88% were bacterial, 10% were fungal, and 2% were of viral origin. One-third of isolated bacteria were multidrug-resistant. Bivariate analysis showed that the history of corticosteroids used before admission and the use of dexamethasone during hospitalization were associated with a higher risk of secondary infections (p = 0.041 and p = 0.019 respectively). Multivariate analysis showed that for each additional day of mechanical ventilation, the risk of secondary infection increases 1.1 times (adOR = 1.07; 95% CI 1.02–1.13, p = 0.008)

Conclusions

Patients with COVID-19 admitted to the intensive care unit and requiring mechanical ventilation had a high rate of secondary infections during their hospital stay. The number of days on MV was a risk factor for acquiring secondary respiratory infections.
Exploring Iraqi people’s perception about early marriage: a qualitative study
Authors: Saleh Abubakir M. , Othman Samir M. , Ismail Kameran H. , Shabila Nazar P.
Published: September 2022

Background and objective

Early marriage is prevalent in Iraq, but the factors related to this behavior, especially people's attitudes about it, have not been well studied. It has been proven that early marriage seriously threatens young girls' lives and health. This study aimed to explore the perception of people about early marriage in the Iraqi Kurdistan region.

Methods

A qualitative method was employed to carry out this study in 2020. Data were collected through 16 focus group discussions in different health centers in Erbil, Iraq. Each focus group included 8–12 participants who had the experience of early marriage. The transcripts of the focus groups were analyzed through the six methodological activities of Van Manen. The trustworthiness of the data was confirmed by using qualitative data evaluation criteria.

Results

Different themes and subthemes regarding the ideal age of marriage, attitudes toward marriage, reasons for early marriage, advantages and disadvantages of early marriage, and practice of early marriage in the community emerged from focus group discussions. Most participants identified early marriage as inappropriate social behavior that should not be practiced. Reasons for early marriage included poor economic status, protection of girls and boys, low educational level, and respect for old traditions of the community. Divorce and violence against women were the main disadvantages of early marriage.

Conclusion

There is a generally negative attitude towards early marriage, and the practice's disadvantages and health and psychological consequences are well recognized in Iraqi Kurdistan Region. However, different social, traditional, economic, educational, and religious factors encourage early marriage in the region. Further research is recommended in other governorates in the area to have a more precise and representative idea about the topic.