bluuebunny/crossref_metadata_2025 huggingface dataset:
Ashurbanipal, son of Esarhaddon, king of Assyria, 668–c. 631 BCE
Authors: Novotny Jamie
Published: July 2023

Ashurbanipal, probably the fourth eldest son of Esarhaddon (r. 680–669 bce), was the last great king of Assyria. When he ascended the throne in late 669 bce, Ashurbanipal, a ruler who is referred to in classical sources as Sardanapalos, inherited the then-world’s largest empire, whose vast territorial holdings stretched from the Zagros Mountains in the east to the Mediterranean Sea and Cilicia in the west. From his administrative capital Nineveh, he ruled Assyria with the aid of his trusted officials (including more than seventy-one provincial governors) and in close contact with no less than thirty-nine client states, including many important Phoenician port cities in the Levant. However, by the end of his long reign, which ended sometime after the first three months of 631 bce, the Assyrian Empire’s strength and territorial holdings significantly declined and, if its collapse had not yet been written on the wall, it was at least imaginable, something that would have been unthinkable when Ashurbanipal came to power thirty-eight years earlier. Few contemporary cuneiform sources shed light on his final years as king, including how and exactly when he died and was succeeded by his young son Ashur-etel-ilani (c. 630–627 bce), although it is abundantly clear that Assyria’s fortunes continued to dwindle. According to a later, semi-fictionalized account of his death by Ctesias of Cnidus, he committed suicide by burning down his palace around him when an army of Babylonians and Medes laid siege to Nineveh.
Diversity and Evolutionary History of Ti Plasmids of “tumorigenes” Clade of Rhizobium spp. and Their Differentiation from Other Ti and Ri Plasmids
Authors: Kuzmanović Nemanja , Wolf Jacqueline , Will Sabine Eva , Smalla Kornelia , diCenzo George C , Neumann-Schaal Meina
Published: July 2023

Agrobacteria are important plant pathogens responsible for crown/cane gall and hairy root diseases. Crown/cane gall disease is associated with strains carrying tumor-inducing (Ti) plasmids, while hairy root disease is caused by strains harboring root-inducing (Ri) plasmids. In this study, we analyzed the sequences of Ti plasmids of the novel “tumorigenes” clade of the family Rhizobiaceae (“tumorigenes” Ti plasmids), which includes two species, Rhizobium tumorigenes and Rhizobium rhododendri. The sequences of reference Ti/Ri plasmids were also included, which was followed by a comparative analysis of their backbone and accessory regions. The “tumorigenes” Ti plasmids have novel opine signatures compared with other Ti/Ri plasmids characterized so far. The first group exemplified by pTi1078 is associated with production of agrocinopine, nopaline, and ridéopine in plant tumors, while the second group comprising pTi6.2 is responsible for synthesis of leucinopine. Bioinformatic and chemical analyses, including opine utilization assays, indicated that leucinopine associated with pTi6.2 most likely has D,L stereochemistry, unlike the L,L-leucinopine produced in tumors induced by reference strains Chry5 and Bo542. Most of the “tumorigenes” Ti plasmids have conjugative transfer system genes that are unusual for Ti plasmids, composed of avhD4/avhB and traA/mobC/parA regions. Next, our results suggested that “tumorigenes” Ti plasmids have a common origin, but they diverged through large-scale recombination events, through recombination with single or multiple distinct Ti/Ri plasmids. Lastly, we showed that Ti/Ri plasmids could be differentiated based on pairwise Mash or average amino-acid identity distance clustering, and we supply a script to facilitate application of the former approach by other researchers.
Post-extubation use of high-flow nasal oxygenation induces upper airway leak and intrathoracic sepsis after successful Bentall procedure: A case report
Authors: Liao Yu-Yang , Wu Hsuan-Yin , Lam Chen-Fuh , Wang Yi-Ming
Published: July 2023

Rationale:

In recent few years, high-flow nasal oxygenation (HFNO) has been widely used for management of acute hypoxemic respiratory failure and during postextubation periods, including after endotracheal intubation general anesthesia (ETGA). However, HFNO generates positive pressure in the injured airway following removal of endotracheal tube may cause airway leaks. This is the first case report of severe airway leak syndrome following postextubation use of HFNO in surgical patients.

Patient concerns:

This case report describes a 75-year-old female with critical aortic stenosis who underwent an emergency Bentall procedure. HFNO (flow rate of 45 L/min) was applied after weaning from mechanical ventilation and removal of the endotracheal tube.

Diagnoses:

At 6 hours after HFNO application, subcutaneous emphysema in the neck bilaterally and face was noted, and the emphysema extended into the supraclavicular regions.

Interventions:

The HFNO cannula was removed soon after and the patient was re-intubated with an endotracheal tube the following day due to progressive respiratory insufficiency. Unfortunately, the patient general condition deteriorated, as the subcutaneous air collections progressed into deep tissue infections of the neck, mediastinal abscesses, and left-sided empyema. Patient received surgical interventions repeatedly to drain the mediastinal abscess and empiric antimicrobial therapy was given.

Outcomes:

The patient passed away about 2 months later due to uncontrollable sepsis.

Lessons:

Air leaks in the upper airway can occur during the use of post-extubation HFNO use, and the resulting subcutaneous emphysema can progress to severe intrathoracic infections in surgical patients who have a sternotomy wound. Therefore, HFNO-induced subcutaneous emphysema should be treated more aggressively in open thoracic or sternotomy surgeries to prevent the development of intrathoracic sepsis.
Nomogram including tumor deposition count to noninvasively evaluate the prognosis of rectal cancer patients: A retrospective study
Authors: Jin Yumei , Zhang Jun , Wang Yewu , Liu Shengmei , Yang Ling , Liu Siyun , Song Bing , Gu Hao
Published: July 2023

To build a nomogram model that includes tumor deposition (TDs) count to noninvasively evaluate the prognosis of patients with rectal cancer (RC). A total of 262 patients between January 2013 and December 2018 were recruited and divided into 2 cohorts: training (n = 171) and validation (n = 91). Axial portal venous phase computed tomography images were used to extract radiomic features, and the least absolute shrinkage and selection operator-Cox analysis was applied to develop an optimal radiomics model to derive the Rad-score. A Cox regression model combining clinicopathological factors and Rad-scores was constructed and visualized using a nomogram. And its ability to predict RC patients’ survival was tested by Kaplan–Meier survival analysis. The time-dependent concordance index curve was used to demonstrate the differentiation degree of model. Calibration and decision curve analyses were used to evaluate the calibration accuracy and clinical usefulness of the nomogram model, and the prediction performance of the nomogram model was compared with the clinical and radiomics models using the likelihood test. Computed tomography-based Rad-score, pathological tumor (pT) stageT4, and TDs count were independent risk factors affecting the prognosis of RC. The whole concordance index of the nomogram model for predicting the overall survival rates of RC was higher than that of the clinical and radiomics models in the training (0.812 vs 0.59, P = .019; 0.812 vs 0.714, P = .014) and validation groups (0.725 vs 0.585, P = .002; 0.725 vs 0.751, P = .256). The nomogram model could effectively predict patients’ overall survival rate (hazard ratio = 9.25, 95% CI = [1.17–72.99], P = .01). The nomogram model also showed a higher clinical net benefit than the clinical and radiomics models in the training and validation groups. The nomogram model developed in this study can be used to noninvasively evaluate the prognosis of RC patients. The TDs count is an independent risk factor for the prognosis of RC.
Clinical analysis of three patients with multiple endometrial cancer lesions treated by hysteroscopic surgery combined with progesterone: Case report
Authors: Wang Li , Cong Rimin , Zhang Lili , Zhang Danni , Wu Juntong
Published: July 2023

Rationale:

Endometrial cancer (EC) is one of three common malignant tumors of the female reproductive tract, exceeded by cervical cancer. It has an incidence rate ranging from 3% to 10% with an increasing trend in recent years.

Patient concerns:

To analyze the clinical effectiveness of hysteroscopic surgery combined with progesterone therapy in patients with multiple lesions of endometrial cancer with fertility preservation.

Diagnoses:

Multiple endometrial cancer lesions were present.

Interventions:

Three patients presented with menstrual cycle disorders, irregular vaginal bleeding, and endometrial thickening. Diffuse and local bulges of the endometrium can be seen under hysteroscopy. The histopathological results showed varying degrees of complex endometrial hyperplasia with canceration. Progesterone receptor was detected in lesion tissues through immunohistochemical examination.

Outcomes:

Case 1 fully recovered within 2 months, case 2 within 3 months, and case 3 within 9 months.

Lessons:

Our data suggested the clinical efficacy of hysteroscopic surgery combined with progesterone therapy in patients with early multiple endometrial cancer, providing the precious experience of the clinical presentation.
Pediatric Diving-Related Injuries in Swimming Pools Presenting to US Emergency Departments
Authors: Houlihan Nathan , Shah Ronit , Adams Alex , Talwar Divya , MacAlpine Elle M. , Weltsch Daniel , Mehta Nishank , Baldwin Keith , Ganley Theodore
Published: July 2023

Objectives

Recreational swimming/diving is among the most common physical activities in US children and a significant cause of morbidity across the United States. This study updates the national epidemiology of diving-related injuries.

Methods

The Consumer Product Safety Commission's National Electronic Injury Surveillance System database was queried for patients aged 0 to 19 from 2008 to 2020 who presented to any of the 100 National Electronic Injury Surveillance System-participating emergency departments for a diving-related injury. Dive characteristics such as dive height, dive skill, dive direction, and dive sequence were determined from case narratives.

Results

A total of 1202 cases were identified for analysis corresponding to a total national estimate of 37,387 diving related injuries during the period from 2008 to 2020 and a national incidence of 3.6 injuries per 100,000 population. Males accounted for 64% of injuries. The average yearly incidences of injury in the 10 to 14 and 15 to 19 age groups were identical at 5.8 per 100,000. Contact with the diving board or platform was the most common cause of injury (34%). Diving backwards or attempting a flip or handstand dive were associated with increased odds of sustaining an injury resulting from contact with the diving board or platform (odds ratio, 16.0 and 6.9, respectively). In 2020, the incidence of diving-related injury fell to 1.6 per 100,000 population.

Conclusions

Diving injuries are common in children and adolescents, especially in boys aged 10 to 19. There was a significant reduction in diving-related injury corresponding with the COVID-19 pandemic.
Ocular Trauma in Children
Authors: Sharifi Ali , Parvaz Parinaz , Sharifi Hamid , Farsi Maryam , Akbari Zahra
Published: July 2023

Objectives

This study aimed to determine the epidemiology of eye injuries in children and the influential factors involved.

Methods

Eighty cases of confirmed ocular trauma were included in this cross-sectional study. Data were obtained via a checklist containing demographic information, site of the insult, the interval between the injury and physician visit, trauma mechanism, and medical history, including previous history of ocular trauma.

Results

Among 80 children with ocular trauma, 72.5% (n = 58) were boys. A marked preponderance (46.2%) of injuries was seen in the age group younger than 6 years. The youngest patient was a 1-year-old, and the oldest was aged 17. Most (76.25%) of the incidents occurred indoors. A total of 67.5% of accidents were induced by sharp objects (knife and glass). Most accidents occurred in spring, whereas the least number of accidents occurred in winter. The corneoscleral laceration was the most common manifestation, followed by the laceration of the iris, uveal prolapse, hyphema, and cataracts. Furthermore, rare cases of retinal detachment, hypopyon, and corneal epithelial defects were seen.

Conclusions

The highest incidents of ocular trauma occurred in boys, especially those younger than 6 years. The high number of sharp object injuries is also concerning. These findings provide us with evidence that further educational interventions and supervision are required in these groups to minimize the possible devastating injuries before the opportunity even arises.
ZFHX3variants cause childhood partial epilepsy and infantile spasms with favorable outcomes
Authors: He Ming-Feng , Liu Li-Hong , Luo Sheng , Wang Juan , Guo Jia-Jun , Wang Peng-Yu , Zhai Qiong-Xiang , He Su-Li , Zou Dong-Fang , Liu Xiao-Rong , Li Bing-Mei , Ma Hai-Yan , Qiao Jing-Da , Zhou Peng , He Na , Yi Yong-Hong , Liao Wei-Ping
Published: July 2023

Background

TheZFHX3gene plays vital roles in embryonic development, cell proliferation, neuronal differentiation, and neuronal death. This study aims to explore the relationship betweenZFHX3variants and epilepsy.

Methods

Whole-exome sequencing was performed in a cohort of 378 patients with partial (focal) epilepsy. ADrosophila Zfh2knockdown model was used to validate the association betweenZFHX3and epilepsy.

Results

Compound heterozygousZFHX3variants were identified in eight unrelated cases. The burden ofZFHX3variants was significantly higher in the case cohort, shown by multiple/specific statistical analyses. InZfh2knockdown flies, the incidence and duration of seizure-like behavior were significantly greater than those in the controls. TheZfh2knockdown flies exhibited more firing in excitatory neurons. All patients presented partial seizures. The five patients with variants in the C-terminus/N-terminus presented mild partial epilepsy. The other three patients included one who experienced frequent nonconvulsive status epilepticus and two who had early spasms. These three patients had also neurodevelopmental abnormalities and were diagnosed as developmental epileptic encephalopathy (DEE), but achieved seizure-free after antiepileptic-drug treatment without adrenocorticotropic-hormone/steroids. The analyses of temporal expression (genetic dependent stages) indicated thatZFHX3orthologs were highly expressed in the embryonic stage and decreased dramatically after birth.

Conclusion

ZFHX3is a novel causative gene of childhood partial epilepsy and DEE. The patients of infantile spasms achieved seizure-free after treatment without adrenocorticotropic-hormone/steroids implies a significance of genetic diagnosis in precise treatment. The genetic dependent stage provided an insight into the underlying mechanism of the evolutional course of illness.

WHAT IS ALREADY KNOWN ON THIS TOPIC

The ZFHX3 protein plays an essential role in neurodevelopment. The relationship betweenZFHX3variants and human diseases remains unknown.

WHAT THIS STUDY ADDS

Eight pairs of compound heterozygousZFHX3variants were identified in eight unrelated patients with partial epilepsy, including two who evolved from early spasms.

HOW THIS STUDY MIGHT AFFECT RESEARCH, PRACTICE OR POLICY

TheZFHX3gene is a novel pathogenic gene of childhood partial epilepsy and developmental epileptic encephalopathy. The development-dependent expression pattern ofZFHX3explains the evolutional course of the illness, potentially being helpful in the management of the patients.
A systematic review of information source preference research
Authors: Zhong Huan , Han Zhengbiao
Published: July 2023

Purpose

This systematic literature review aims to elaborate on the research progress and features of information source preferences to help other researchers attain a more comprehensive understanding of the field.

Design/methodology/approach

Following a systematic review protocol, 139 research articles from 11 academic databases were analyzed.

Findings

Overall, five separate results were obtained: first, information source horizon theory is the main theoretical foundation of information source preferences research, while other theories have been applied less. Second, information source preference research has strong context sensitivity and involves health, work, consumption, learning, survival and development and emergencies. Third, preference criteria can be summarized into three categories: information characteristics, user characteristics, needs characteristics and corresponding specific criteria. Fourth, information source preferences are influenced by both internal and external factors, including five specific aspects, namely demographics, the user's cognition, the user's affection, capital and contextual factors. Fifth, this field is dominated by quantitative methods and an information horizon mapping method could be applied more.

Originality/value

This study is the first to reveal the general picture of information source preferences. It also elaborates on the characteristics of this field and presents potential development directions.
A systematic literature review of studies on women at the top of firm hierarchies: critique, gap analysis and future research directions
Authors: Ciappei Camilla , Liberatore Giovanni , Manetti Giacomo
Published: July 2023

Purpose

This study aims to holistically explore the academic literature on female leaders to identify the key topics and dynamics of the field.

Design/methodology/approach

The authors systematically review 532 papers to explore the research on female leaders; based on objective and replicable criteria, the authors identify relevant papers and thus ensure the quality of the analysis. The bibliometric analysis and visualization support us in recognizing trends in this topic.

Findings

This study outlines the state of the art over the past decade by synthesizing theoretical contexts and critically discussing the main streams of research on sustainability, firm outcomes and barriers preventing women from reaching the upper echelons. The authors also explore empirical issues and highlight areas that entail new paths for future scholars.

Practical implications

The research provides novel evidence of the attempt internationally to increase female participation at the top of the firm hierarchy by analyzing firm outcomes, sustainability and the constraints faced by women in achieving these careers.

Social implications

The results show that the participation of women in leadership roles is not (only) a matter of compliance with current regulations. Through their ability to monitor key social and environmental issues from a long-term perspective and their attention to the internal control systems, companies more effectively pursue their financial and nonfinancial aims.

Originality/value

Using bibliographic and narrative analyses, this study reviews the literature on women at the top of the firm hierarchy with a focus on business research. The authors extend prior studies by investigating a larger pool of firm roles to provide a comprehensive understanding of this widely discussed topic.
Investigation of haematological, inflammatory and immunological response in naturally infected cattle with Theileria annulata
Authors: Aktas Mustafa Sinan , Eren Emre , Kucukler Sefa , Eroglu Muhammed Sertac , Ilgun Murat , Yanar Kerim Emre , Aydin Omer
Published: July 2023

In this study, we aimed to investigate haematological, pro‐inflammatory, inflammatory, anti‐inflammatory and immunological responses in naturally Theileria annulata‐infected cattle. The study material consisted of 25 Simmental cattle, 2–4 years of age, one of which was a control group consisting of healthy animals (Control group, n = 10), and the other was a Theileria group that include animals positive for Theileria annulata (Theileria group, n = 15). Haematological analysis (red blood cell [RBC], haemoglobin [HGB], haematocrit [HCT]), pro‐inflammatory (tumour necrosis factor‐α [TNF‐α], nuclear factor kappa B [NF‐ĸB] and interleukin‐1 beta, [IL‐1β]), inflammatory (neutrophil‐lymphocyte ratio [NLR]), anti‐inflammatory (interleukin‐10 [IL‐10]) and antimicrobial peptide (CAMP) analyses were performed by using ELISA kit from blood samples. It was found that the rectal temperature of the Theileria group was found to be significantly higher (p < .001) than that of the control group. Haematological and biochemical analysis revealed that the RBC and HGB count and HCT percentage decreased (p < .001), while NF‐ĸB (p < .001), TNF‐α (p = .002), IL‐1β (p < .001), IL‐10 (p = .012), NLR (p < .001) and CAMP (p = .037) levels increased in Theileria group compared to the control group. There was a strong correlation between NF‐ĸB and TNF‐α, NF‐ĸB and IL‐10, NLR and IL‐1β, NF‐ĸB and CAMP, TNF‐α and CAMP and IL‐10 and CAMP. As a result of this study, it was revealed that a pro‐inflammatory and immunological response also occurs along with the anti‐inflammatory response in the inflammatory process.
Genetic variants associated with leaf spot disease resistance in oil palm (Elaeis guineensis): A genome‐wide association study
Authors: Wibowo Cahyo S. , Apriyanto Ardha , Ernawan Reza , Neing Dionisius , Susilo Ricki , Cordell Heather J. , Gatehouse Angharad M. R. , Edwards Martin G.
Published: July 2023

Leaf spot is considered as a common disease of oil palm, caused primarily by Curvularia spp. fungi. This disease mainly affects the early stages of oil palm and if not adequately controlled can cause plant death. Among the methods available to control the disease, breeding resistant varieties is the most economically effective and promising strategy. A genome‐wide association study for leaf spot resistance was conducted on 210 individual tenera palms from seven different (origin) crosses. These palms were subsequently infected with Curvularia spp. pathogenic inoculum in a nursery trial located in an endemic area. The area under the disease progress curve was used as a phenotypic measure. In addition, a genotyping‐by‐sequencing (GBS) approach was used to obtain the genotyping data of each individual. We found two loci, at chromosome 2 and chromosome 13, that were significantly associated with leaf spot disease resistance. Six genetic variants at the two loci (five variants at chromosome 2 and one variant at chromosome 13) surpassed the threshold for genome‐wide significance (p < 106). These loci are linked with three widely known disease‐related genes, namely, resistance gene analogue 3 (RGA3), resistance gene analogue 4 (RGA4) and receptor‐like protein 9a (RLP9a). The loci identified here can be used for marker‐assisted selection when developing leaf spot disease‐resistant oil palm varieties.
The
Helicobacter pylori
CagA oncoprotein disrupts Wnt/PCP signaling and promotes hyperproliferation of pyloric gland base cells
Authors: Takahashi-Kanemitsu Atsushi , Lu Mengxue , Knight Christopher Takaya , Yamamoto Takayoshi , Hayashi Takuo , Mii Yusuke , Ooki Takuya , Kikuchi Ippei , Kikuchi Akira , Barker Nick , Susaki Etsuo A. , Taira Masanori , Hatakeyama Masanori
Published: July 2023

Helicobacter pylori
strains that deliver the oncoprotein CagA into gastric epithelial cells are the major etiologic agents of upper gastric diseases including gastric cancer. CagA promotes gastric carcinogenesis through interactions with multiple host proteins. Here, we show that CagA also disrupts Wnt-dependent planar cell polarity (Wnt/PCP), which orients cells within the plane of an epithelium and coordinates collective cell behaviors such as convergent extension to enable epithelial elongation during development. Ectopic expression of CagA in
Xenopus laevis
embryos impaired gastrulation, neural tube formation, and axis elongation, processes driven by convergent extension movements that depend on the Wnt/PCP pathway. Mice specifically expressing CagA in the stomach epithelium had longer pyloric glands and mislocalization of the tetraspanin proteins VANGL1 and VANGL2 (VANGL1/2), which are critical components of Wnt/PCP signaling. The increased pyloric gland length was due to hyperproliferation of cells at the gland base, where Lgr5
+
stem and progenitor cells reside, and was associated with fewer differentiated enteroendocrine cells. In cultured human gastric epithelial cells, the N terminus of CagA interacted with the C-terminal cytoplasmic tails of VANGL1/2, which impaired Wnt/PCP signaling by inducing the mislocalization of VANGL1/2 from the plasma membrane to the cytoplasm. Thus, CagA may contribute to the development of gastric cancer by subverting a Wnt/PCP-dependent mechanism that restrains pyloric gland stem cell proliferation and promotes enteroendocrine differentiation.
Refractive index sensing of human blood using patterned photonic crystal containing defects
Authors: Tiwari S. , Vyas Ajay Kumay , Dixit Yogesh , Sudhir Bale Ajay , Dixit Achyutesh
Published: July 2023

This work presents an innovative platform of a multi-channel one-dimensional photonic crystal (1-DPC) based on blood refractive index data of different patients in the aspect of the main protein components like hemoglobin. This photonic crystal (PC) contains a defect center infiltrated with plasma using a microorder size syringe. When binary silica and III–V semiconductor (InSb) materials are combined, they increase the refractive index difference between the alternate layers of the composite material, resulting in a wide photonic band gap (PBG). We use the well-known transfer matrix method (TMM) to observe the reflectance of various blood samples that were previously published. We assess and contrast the influence of different refractive index data on the dynamic shift in PBG calculation for novel superior and resourceful sensor in the prevention of microscopic organisms such as SARS-CoV-2, the virus linked with COVID-19. Yet, the performance of this PC has more moral content and unlimited casting efficacy in the face of an incurable virus.
One-Point and Multiline Calibration Fiber-Optic Laser-Ablation Spark-Induced Breakdown Spectroscopy for Quantitative Analysis of Elements in Aluminum Alloys
Authors: Liao Yipeng , He Xiaoyong , Wu Xi
Published: July 2023

Rapid and accurate analysis of element concentrations in aluminum alloys is crucial due to their widespread use in modern industry. This paper proposes a one-point and multiline calibration fiber-optic laser-ablation spark-induced breakdown spectroscopy (OP-MLC FO-LA-SIBS) for the quantitative analysis of elements in aluminum alloys. The experimental system utilizes a compact fiber laser as the laser-ablation source and spark discharge to enhance the atomic emission. A portable multichannel fiber spectrometer is used to quickly collect spectra in the nongated mode. The concentrations of four elements (Mg, Cr, Cu, and Mn) in four aluminum alloy samples were calculated using the simple and efficient OP-MLC method, which involves taking another sample with a similar matrix as the standard sample. The average relative errors (AREs) for Mg, Cr, Cu, and Mn were 6.38%, 28.09%, 21.92%, and 18.97%, respectively. When the certified concentrations are greater than 0.02 wt.%, the ARE is only 13.04%. The OP-MLC FO-LA-SIBS system is compact, features simple spectra processing, and offers effective measurement, providing a convenient method for rapid and efficient quantitative analysis of elements in aluminum alloys in industrial production.
Novel TTN Mutation Causing Severe Congenital Myopathy and Uncertain Association with Infantile Hydrocephalus
Authors: Balasundaram Palanikumar , Avulakunta Indirapriya Darshini , Delfiner Leslie , Levy Paul , Forman Katie R.
Published: July 2023

Arthrogryposis multiplex congenita (AMC) is characterized by nonprogressive symmetric contractures of multiple joints with normal intellect and normal systemic examination. AMC is often due to fetal akinesia, which has neurologic, muscular, and connective tissue etiologies. We present a case of AMC due to a variant in the titin (TTN) gene in a term neonate. The infant is homozygous for this variant, c.38442dup, which is predicted to result in a truncated protein (p.Pro12815Thr fs∗37, NM_001267550.2). A literature search (PubMed) failed to find reports of this TTN variant. The variant was classified as pathogenic and submitted to ClinVar. Titin is the body’s largest protein, expressed in skeletal and cardiac muscles and encoded by the TTN gene. Due to its large size (364 exons), the TTN gene has been difficult to sequence; the number of variants in the TTN gene and the spectrum of titinopathies are probably underestimated.
Temporomandibular Disorders among Dental Students in Pakistan: Assessment of Prevalence, Severity, and Associated Factors Based on Questionnaire
Authors: Nazir Muhammad Ashraf , Izhar Faisal , Hassan Shafia , Tanvir Maha , Nemat Faris , Ashraf Muhammad Waleed , Alamri Abdulaziz
Published: July 2023

Objective. To evaluate the prevalence, severity, and associated factors of temporomandibular disorder (TMD) among dental students. Methods. This cross-sectional study was performed on undergraduate dental students from four dental colleges in Punjab, Pakistan. Fonseca’s questionnaire was used to measure the prevalence and severity of the TMD among the study participants. Bivariate and multiple logistic regression analyses were performed. Results. Of 364 dental students, 323 returned the completed questionnaires and the response rate of the study was 88.7%. The study included 52.6% males and 47.4% females. The prevalence of TMD was 66.9% with mild TMD in 40.90%, moderate TMD in 14.6%, and severe TMD in 11.50% of the participants. Psychological stress (29.6%), malocclusion (20%), and hypersensitivity (19.5%) were common among participants. The mean TMD score of the sample was 31.54 ± 24.86 which was significantly higher among participants with no/school-educated mothers (

P
=
0.021

) and fathers (

P
=
0.002

). The participants with arthritis (72.81 ± 32.19) and malocclusion (59.46 ± 31.09) and those who received orthodontic treatment (53.21 ± 34.21) demonstrated higher TMD. After controlling for other study variables, the participants with arthritis were 4.71 times more likely to have moderate/severe TMD (

P
=
0.042

) than those without arthritis. Similarly, the participants with malocclusion had significantly higher odds (OR = 3.57,

P
=
0.029

) of having moderate/severe TMD than those without malocclusion. Conclusion. This sample of dental students demonstrated a high prevalence and severity of TMD. The participants with arthritis and malocclusion demonstrated higher TMD. The study findings underscore the importance of prevention, early diagnosis, and management of TMD among the dental students.
Measurement properties of the Spinal Appearance Questionnaire in adolescents with idiopathic scoliosis: a systematic review
Authors: Malaquias Lorenna Costa , da Silva Maria Clara Monteiro , Menezes Dhara Yasmin Andrade , Magalhães Maurício Oliveira
Published: July 2023

Background

Scoliosis is defined as a three-dimensional deformity of the spine characterized by lateral tilt and axial rotation of the vertebrae. Its magnitude in the frontal plane is identified by a Cobb angle greater than 10o. The aim of the study was to systematically examine the clinimetric properties of the Spinal Appearance Questionnaire (SAQ) in its cross-cultural adaptations in different languages.

Methods

Medline (PubMed), CINAHL, EMBASE, Science Direct, PsycINFO and WorldWideScience.org databases were used for screening studies until July 16, 2022. In this study, records on the development, evaluation and translation of the SAQ instrument in adolescents with idiopathic scoliosis were included. In addition, two independent reviewers defined whether the studies were eligible and analyzed their psychometric properties of internal consistency, reliability, content validity, cross-cultural validity, construct validity and structural validity, according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN). The modified GRADE was applied for evidence synthesis.

Results

A total of 95 articles were selected by title and abstract. After removing duplicates and reading and searching the references, a total of 13 studies were included in this review. The original version of the SAQ was described in English, and the instrument was translated into Polish, Canadian French, Simplified Chinese, Spanish (Europe), Danish, Traditional Chinese, Portuguese (Brazil), Korean, German, Turkish and Persian. The evidence was moderate for construct validity, low for internal consistency, and very low for reliability and cross-cultural validity; the content and structural validity properties did not present minimum data for classification.

Conclusion

The quality of the evidence regarding the clinimetric properties of the SAQ instrument in adolescents with idiopathic scoliosis was low due to the absence of clinimetric properties or dubious methodological quality. However, for clinical practice and research, we recommend the use of the instrument to assess the self-perception of the spine in adolescents. For future translations and adaptations, we recommend the use of the COSMIN guidelines.
Postoperative analgesia for upper gastrointestinal surgery: a retrospective cohort analysis
Authors: Pirie Katrina P. , Wang Andy , Yu Joanna , Teng Bao , Doane Matthew A. , Myles Paul S. , Riedel Bernhard
Published: July 2023

Background

Thoracic epidural analgesia is commonly used for upper gastrointestinal surgery. Intrathecal morphine is an appealing opioid-sparing non-epidural analgesic option, especially for laparoscopic gastrointestinal surgery.

Methods

Following ethics committee approval, we extracted data from the electronic medical records of patients at Royal North Shore Hospital (Sydney, Australia) that had upper gastrointestinal surgery between November 2015 and October 2020. Postoperative morphine consumption and pain scores were modelled with a Bayesian mixed effect model.

Results

A total of 427 patients were identified who underwent open (n = 300), laparoscopic (n = 120) or laparoscopic converted to open (n = 7) upper gastrointestinal surgery. The majority of patients undergoing open surgery received a neuraxial technique (thoracic epidural [58%, n = 174]; intrathecal morphine [21%, n = 63]) compared to a minority in laparoscopic approaches (thoracic epidural [3%, n = 4]; intrathecal morphine [12%, n = 14]). Intrathecal morphine was superior over non-neuraxial analgesia in terms of lower median oral morphine equivalent consumption and higher probability of adequate pain control; however, this effect was not sustained beyond postoperative day 2. Thoracic epidural analgesia was superior to both intrathecal and non-neuraxial analgesia options for both primary outcomes, but at the expense of higher rates of postoperative hypotension (60%, n = 113) and substantial technique failure rates (32%).

Conclusions

We found that thoracic epidural analgesia was superior to intrathecal morphine, and intrathecal morphine was superior to non-neuraxial analgesia, in terms of reduced postoperative morphine requirements and the probability of adequate pain control in patients who underwent upper gastrointestinal surgery. However, the benefits of thoracic epidural analgesia and intrathecal morphine were not sustained across all time periods regarding control of pain. The study is limited by its retrospective design, heterogenous group of upper gastrointestinal surgeries and confounding by indication.
When Veterinary Drugs Reach Human Hospitals: A Problem-Based Learning Discussion
Authors: Binda Dhanesh D. , Gonzalez Mauricio , Rosales Victoria , Black William , Ortega Rafael
Published: July 2023

The delivery of drugs from the manufacturer to the hospital is a complex process. Despite numerous safeguards, lapses may occur, creating the potential for patient harm. Recently, an urban tertiary care medical center received a shipment of isoflurane bottles labeled for veterinary use. This error was not identified until the veterinary isoflurane reached the operating room automated medication dispensing system. No patients received the anesthetic. This report describes how such an error occurred, explains the differences between veterinary and human medications, and emphasizes the importance of vigilance in the drug supply chain to prevent patient harm.
Stigmatization and Self-Perception regarding issues related to Mental Health: A qualitative survey from a lower and middle-income country
Authors: Ikhtiar Khan Shaffaque , Irfan Muhammad
Published: July 2023

Objective: To assess the understanding of the patients with common mental disorders, towards issues related to their mental health.

Methods: This qualitative study was conducted from December 2018 to April 2020. Thirty-four patients, suffering from common mental disorders, were interviewed in public and private sector hospitals of Peshawar. The interviews were recorded, transcribed, translated into English, and themes were generated from their responses. Content analysis was carried out on the data obtained. The themes resulting from each interview were then further comparatively analyzed.

Results: The mean age of the sample was 31.9±10.61 years. Most of the patients (n=24, 70.6%) were aware that the nature of their illness was a psychological one with a majority (n=17, 50%) describing it with the symptoms of headache or burden on the head. Most of the patients (n=14, 41.1%) were unaware of the general public opinion towards mental disorders but those who were aware described these with stigmatizing descriptions e.g., “people call them crazy” etc. Most of the patients (n=20, 58.8%) were unaware about their own opinion regarding their illness and some said that they tried to conceal their illness from others. Unfortunately, most of the patients (n=19, 55.8%) were not aware of mental healthcare professionals or the existence of psychiatry as a profession.

Conclusion: Stigma, both public and personal, was quite high, which caused patients to feel compelled to conceal their illness. There was also a general lack of knowledge with regard to mental disorders in our society. The general public opinion about mental health professionals was not favorable.

doi: https://doi.org/10.12669/pjms.39.5.7487

How to cite this: Khan SI, Irfan M. Stigmatization and Self-Perception regarding issues related to Mental Health: A qualitative survey from a lower and middle-income country. Pak J Med Sci. 2023;39(5):---------. doi: https://doi.org/10.12669/pjms.39.5.7487

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Satiation in Fisher Markets and Approximation of Nash Social Welfare
Authors: Garg Jugal , Hoefer Martin , Mehlhorn Kurt
Published: July 2023

We study linear Fisher markets with satiation. In these markets, sellers have earning limits, and buyers have utility limits. Beyond applications in economics, they arise in the context of maximizing Nash social welfare when allocating indivisible items to agents. In contrast to markets with either earning or utility limits, markets with both limits have not been studied before. They turn out to have fundamentally different properties. In general, the existence of competitive equilibria is not guaranteed. We identify a natural property of markets (termed money clearing) that implies existence. We show that the set of equilibria is not always convex, answering a question posed in the literature. We design an FPTAS to compute an approximate equilibrium and prove that the problem of computing an exact equilibrium lies in the complexity class continuous local search ([Formula: see text]; i.e., the intersection of polynomial local search ([Formula: see text]) and polynomial parity arguments on directed graphs ([Formula: see text])). For a constant number of buyers or goods, we give a polynomial-time algorithm to compute an exact equilibrium. We show how (approximate) equilibria can be rounded and provide the first constant-factor approximation algorithm (with a factor of 2.404) for maximizing Nash social welfare when agents have capped linear (also known as budget-additive) valuations. Finally, we significantly improve the approximation hardness for additive valuations to [Formula: see text].

Funding: J. Garg was supported by the National Science Foundation [Grant CCF-1942321 (CAREER)]. M. Hoefer was supported by Deutsche Forschungsgemeinschaft [Grants Ho 3831/5-1, Ho 3831/6-1, and Ho 3831/7-1].
infância em relações entre avós e netos: vínculo, amor e potência de vida
Authors: Castro Liana Garcia
Published: July 2023

This article, based on grandparents' narratives collected in a doctoral research project, aims to weave together reflections on childhood, intergenerational bonding, and love. Seven grandmothers and three grandfathers, between fifty-one and seventy-one years old, participated in the research; nine residents of the city of Rio de Janeiro and one of Niterói, Brazil. In addition, narratives were collected from six of their grandchildren, all of them between five and twelve years old, and residents of Rio de Janeiro, Niterói, Brasília and Montevideo, Uruguay. Conducted during the Covid-19 pandemic, our methodological strategy involved interviews conducted on Zoom. Interviews with the adults were conducted individually, and collectively with the children. The themes that emerged in the grandparents' narratives led to  reflections on the relationship between adults and children that are emblematic of the conception of childhood found in Walter Benjamin's work,  as well as the philosophical anthropology of Martin Buber and the psychoanalysis of Donald Winnicott. The emphasis of the research participants was on affective security, built on the basis of small, everyday gestures, which result in an atmosphere of mutual support between children and adults. From these affectionate encounters between the youngest and the oldest, what we characterize as a “childlike force” is  established—an energy field that produces new existential possibilities. The narratives collected here teach us new ways of being adult through our relationships with children: in our encounter with the lifeworlds of the youngest among us, we re-encounter our own deeper sensibilities, and regain the ability to play, to create, and to reinvent ourselves in relearning the joy of beginnings.
Commuting
Authors: Gannon Victoria
Published: July 2023

Abstract: The Summer 2023 Issue. Ploughshares is an award-winning journal of new writing. Since 1971, Ploughshares has discovered and cultivated the freshest voices in contemporary American literature, and now provides readers with thoughtful and entertaining literature in a variety of formats. Find out why the New York Times named Ploughshares "the Triton among minnows." The Summer 2023 Issue, guest-edited by Tom Perrotta, features poetry and prose by Marianne Leone, Cheryl Lu-Lien Tan, Andre Dubus III, Fabio Morabito, Jen Trynin, Olufunke Grace Bankole, and Jess Walter, among others.
Study of risk perception consumption behavior of sports tourism in China
Authors: Li Gang , Cheng Yan , Cai Jie
Published: July 2023

In order to further implement the "Healthy China 2030 Planning Outline" and actively develop the sports tourism industry, this study analyzed the independent variables and dependent variables that affect the urban residents’ sports tourism risk perception consumption behavior.Finally, the simultaneous regression, stepwise regression and hierarchical regression models of sports tourism risk perception consumption behavior of urban residents are constructed. The purpose is to help people effectively screen all kinds of risks in the process of sports tourism, promote the growth of sports consumption, and provide theoretical and practical guidance for the development of sports tourism
Analytical validation, sample stability, and clinical evaluation of a new high-sensitivity cardiac troponin I immunoassay for use in dogs, with comparison to a previous ultrasensitive assay
Authors: Wesselowski Sonya , Lidbury Jonathan , Saunders Ashley B. , Gordon Sonya G. , Suchodolski Jan S. , Steiner Joerg M.
Published: July 2023

Cardiac troponin I (cTnI) is considered the gold standard biomarker for myocardial injury and shows a high degree of homology between humans and dogs. The ADVIA Centaur XP High-Sensitivity Troponin I (AC-cTnI-HS) assay has been validated for use in humans but not dogs. The study objectives were to analytically validate the AC-cTnI-HS assay in dogs, to assess correlation between the AC-cTnI-HS and a previous ADVIA Centaur TnI-Ultra (AC-cTnI-U) assay, to assess cTnI sample storage stability, and to clinically evaluate the AC-cTnI-HS assay in healthy dogs and dogs with cardiac disease. Canine serum samples were used for analytical validation. Intra- and inter-assay variability, dilutional parallelism, and spiking recovery were assessed. Samples from 196 client-owned dogs were evaluated (healthy dogs (n = 39) or dogs with congenital heart disease (n = 54), myxomatous mitral valve disease (n = 68), dilated cardiomyopathy (n = 15), or myocarditis (n = 20)). Inter- and intra-assay coefficient of variation (%CV) was between 2.8–41.4% and 3.8–30.2%, respectively, with pools with concentrations >20 pg/mL all having %CVs <10%. The observed to expected ratios for dilutional parallelism and spiking recovery experiments ranged between 92.3 and 266.7.0% and 84.3 and 108%, respectively. A strong correlation between the AC-cTnI-HS and AC-cTnI-U assays was observed (Spearman’s ρ = 0.927), though a proportional bias existed, with AC-cTnI-HS assay concentrations being proportionally lower than AC-cTnI-U assay concentrations. Serum samples stored at -80°C had stable cTnI measurements for up to 2.7 years and after a single freeze-thaw cycle. Healthy dogs and dogs with congenital heart disease had significantly lower cTnI concentrations than dogs in the other three groups. The AC-cTnI-HS assay precisely, reproducibly, and accurately measures cTnI concentrations in dog serum with cTnI concentrations >20 pg/mL.
The Rising Costs of Alcohol-Associated Liver Disease in the United States
Authors: Julien Jovan , Ayer Turgay , Tapper Elliot B. , Chhatwal Jagpreet
Published: July 2023

INTRODUCTION:

Alcohol-associated liver disease (ALD) is rising in the United States because of an increase in high-risk drinking, but population-level ALD cost is unknown. Our aim was to project the direct and indirect costs associated with ALD in the US population through 2040.

METHODS:

We used a previously validated microsimulation model of alcohol consumption and ALD with model parameters estimated from publicly available data sources, including the National Epidemiologic Survey Alcohol and Related Conditions-III, the Center for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research, the Bureau of Labor Statistics, and published studies informing the impact of alcohol consumption on ALD severity in the United States resident population. The simulated scenario included current and projected ALD-associated costs.

RESULTS:

From 2022 to 2040, the ALD is projected to cost $880 billion, $355 billion in direct healthcare-related costs, and $525 billion in lost labor and economic consumption. The annual cost of ALD is projected to increase from $31 billion in 2022 to $66 billion (118% increase) in 2040. Although the female population makes up 29% of these costs in 2022, by 2040 on a per annum basis, female costs would be 43% of the total annual expenditure.

DISCUSSION:

Increased consumption of alcohol in the US population, especially in females, will cause a steep rise in the economic burden of ALD in the United States. These findings highlight the need for planners and policymakers to plan for the increased impact of liver disease in the United States.