bluuebunny/crossref_metadata_2025 huggingface dataset:
Leadership
Authors: Roe Kevin
Published: September 2023

Leadership contains two main parts. Part 1 presents the basic framework. It starts with an introduction and moves on to look at trait theory and other behavioural models. It considers the style approach to leadership, situational and contingent leadership, charisma and transformational leadership, and authentic leadership. The second part looks at related themes. Chapters here consider psychodynamic approaches to leadership, emotional intelligence, ethical leadership, and diversity and leadership. Other topics covered include power, influence, authority, teams, change, development, and strategy.
War and peace: hired troops and military aid in Byzantine and English treaties, c.900–1200
Authors: Morris Ben
Published: September 2023

The rulers of Byzantium and England are well known for their centralized nature and their active approach to diplomacy. Both powers often utilized treaties to bolster their military forces, and to undermine those of their foes. Of course, allegiance was not always clear-cut, with many powers having complex relations with their neighbours and the treaties catering to the conflicting obligations of those involved. This article focuses on the treaties of two of the most bureaucratic powers of the medieval world who have comparable treaty corpuses, utilizing the theme of military service to show that treaties were primarily pragmatic documents.
Predictors of Hospital-related Outcomes of COVID-19 Infection in Patients With Inflammatory Bowel Disease in the Early Pandemic Phase: A Nationwide Inpatient Database Survey
Authors: Naseem Khadija , Sohail Abdullah , Quang Nguyen Vu , Khan Ahmad , Cooper Gregory , Lashner Bret , Katz Jeffry , Cominelli Fabio , Regueiro Miguel , Mansoor Emad
Published: September 2023

Background

Patients with inflammatory bowel disease (IBD) are at higher risk for severe COVID-19 infection. However, most studies are single-center, and nationwide data in the United States are lacking. This study aimed to investigate hospital-related outcomes and predictors of these outcomes in patients with IBD and COVID-19 infection.

Methods

The National Inpatient Sample and National Readmission database were queried for all the patient hospitalizations with IBD with concurrent COVID-19 in the study group and non-COVID-19 related hospitalizations in the control group. For patients under 18 years, elective and trauma-related hospitalizations were excluded. Primary outcomes included mortality, septic shock, mechanical ventilation, and intensive care utilization. Secondary outcomes included length of stay and total hospitalization costs.

Results

From this query, 8865 adult patients with IBD and COVID-19 were identified. These patients were relatively older (62.8 vs 57.7 years, P < .01), and the majority were females (52.1% with COVID-19 vs 55.2% without COVID-19). Patients with IBD and COVID-19 had higher mortality (12.24% vs 2.55%; P < .01), increased incidence of septic shock (7.9% vs 4.4%; P < .01), mechanical ventilation (11.5% vs 3.7%; P < .01), and intensive care utilization (12% vs 4.6%; P < .01). These patients also had higher mean length of stay (8.28 days vs 5.47 days; P < .01) and total hospitalization costs ($21 390 vs $16 468; P < .01) than those without COVID-19 infection.

Conclusions

Patients with IBD and COVID-19 have worse outcomes, with a higher incidence of severe COVID-19 disease, leading to higher mortality rates, longer lengths of stay, and increased total hospitalization costs. Encouraging preventive health measures and treating promptly with advanced COVID-19 therapies may improve outcomes and decrease the healthcare burden.
Distinct Neural Representations and Cognitive Behaviors Attributable to Naturally Developed Active Avoidance or Reactive Escape Strategies in the Male Rat
Authors: Jing Liang , Ma Chen , Xu Lin , Richter-Levin Gal
Published: September 2023

Background

The high individual variability in coping with stress is often attributed to genetic background differences, sustained environmental conditions, or a combination of both. However, the neural mechanisms underlying coping style variability are still poorly understood.

Methods

Here we examined the impact of a single extended emotional challenge on coping style variability and the associated involvement of the hippocampus, medial prefrontal cortex (mPFC), and periaqueductal gray (PAG). Male Sprague-Dawley rats (n = 170) were trained in an extended 2-way shuttle avoidance (eTWSA) task for 7 days, and daily avoidance rates were measured. Forced swim test, elevated plus maze, or Morris water maze was tested before or after eTWSA exposure. Excitotoxic lesion of the hippocampal dentate gyrus (DG) was performed by Ibotenic infusion. Transient pharmacological blocking of DG, mPFC, or PAG was performed by muscimol or CNQX+TTX infusion.

Results

Exposing rats to eTWSA was found to lead to naturally developing dichotomous, not continuous, coping styles, which we termed active avoidance (AA) or reactive escape (RE). Prior emotional responses did not predict the developing coping style. AA was associated with beneficial outcomes, including reduced behavioral despair and improved spatial learning. RE led to impaired spatial retrieval. AA was abolished by lesioning or pharmacological blocking of the DG. RE was prevented by blocking mPFC or PAG.

Conclusion

The results indicate that a single exposure to a significant emotional challenge can lead, in otherwise healthy individuals, to dichotomous development of an active or reactive coping style with distinctive neural correlates and subsequent behavioral significance.
The Morphosyntax of Objects to Participles in the Qurʾān
Authors: van Putten Marijn
Published: September 2023

This paper examines how Quranic text treats the construction of a participle in predicative position when it is followed by a direct object. While the medieval grammarians typically say that the participle may be either followed by the object in the accusative or form a construct phrase with it regardless of the definiteness of the object, close examination of the behaviour of participles in predicative positions in the Quranic text shows that a clear correlation presents itself. Indefinite objects are marked with the accusative, whereas definite objects are formed through a genitive construction. This thus means that the linguistic register of the Qurʾān, different from other forms of Classical Arabic, represents a kind of differential object marking on the objects of predicative participles, differentiating between indefinite and definite objects.
The Christian Arabic dialect of Mērgī
Authors: Hassan Qasim
Published: September 2023

The area northeast of Mosul, a collection of villages with varying topography and terrain, is known for being a mosaic of ethnic and religious minorities. The village of Mērgī, the focus of interest in this paper, is one of the historical Christian settlements in the area, located on the southern foot of the Mount Maqlūb. Based on a fieldwork carried out in 2022 in Mērgī, this article investigates the linguistic situation in this village and carries out comparisons with the other well-documented related dialects in the vicinity.
Caveolin-1 scaffolding domain peptide prevents corpus cavernosum fibrosis and erectile dysfunction in bilateral cavernous nerve injury–induced rats
Authors: Xi Yuhang , Ge Yunlong , Hu Daoyuan , Xia Tian , Chen Jialiang , Zhang Chi , Cui Yubin , Xiao Hengjun
Published: September 2023

Background

Corpus cavernosum (CC) fibrosis significantly contributes to post–radical prostatectomy erectile dysfunction (pRP-ED). Caveolin-1 scaffolding domain (CSD)–derived peptide has gained significant concern as a potent antagonist of tissue fibrosis. However, applying CSD peptide on bilateral cavernous nerve injury (BCNI)–induced rats remains uninvestigated.

Aim

The aim was to explore the therapeutic outcome and underlying mechanism of CSD peptide for preventing ED in BCNI rats according to the hypothesis that CSD peptide may exert beneficial effects on erectile tissue and function following BCNI through limiting collagen synthesis in CC smooth muscle cells (CCSMCs) and CC fibrosis.

Methods

After completing a random assignment of male Sprague Dawley rats (10 weeks of age), BCNI rats received either saline or CSD peptide treatment, as opposed to sham-operated rats. The evaluations of erectile function (EF) and succedent collection and histological and molecular biological examinations of penile tissue were accomplished 3 weeks postoperatively. In addition, the fibrotic model of CCSMCs was used to further explore the mechanism of CSD peptide action in vitro.

Outcomes

The assessments of EF, SMC/collagen ratio, α-smooth muscle actin, caveolin-1 (CAV1), and profibrotic indicators expressions were conducted.

Results

BCNI rats exhibited significant decreases in EF, SMC/collagen ratio, α-SMA, and CAV1 levels, and increases in collagen content together with transforming growth factor (TGF)-β1/Smad2 activity. However, impaired EF, activated CC fibrosis, and Smad2 signaling were attenuated after 3 weeks of CSD peptide treatment in BCNI rats. In vitro, TGF-β1–induced CCSMCs underwent fibrogenetic transformation characterized by lower expression of CAV1, higher collagen composition, and phosphorylation of Smad2; then, the delivery of CSD peptide could significantly block CCSMC fibrosis by inactivating Smad2 signaling.

Clinical Implications

Based on available evidence of CSD peptide in the prevention of ED in BCNI rats, this study can aid in the development and clinical application of CSD peptide targeting pRP-ED.

Strengths and Limitations

This study provides data to suggest that CSD peptide protects against BCNI-induced deleterious alterations in EF and CC tissues. However, the available evidence still does not fully clarify the detailed mechanism of action of CSD peptide.

Conclusion

Administration of CSD peptide significantly retarded collagen synthesis in CCSMCs, limited CC fibrosis, and prevented ED via confrontation of TGF-β1/Smad signaling in BCNI rats.
The Leibowitzer Rebbe: Yeshayahu Leibowitz and Hasidism
Authors: Lewis Justin Jaron
Published: September 2023

The controversial Israeli public intellectual Yeshayahu Leibowitz (1903–1994) has jokingly been called “the Leibowitzer Rebbe.” The humor is in the obvious incongruity of associating Leibowitz with anything Hasidic. He was the most rationalist of religious thinkers and said disparaging things about Hasidism and its leaders. Yet Leibowitz and Hasidism are closer than they appear. Building on insights from other scholars, I will show the affinities between Leibowitz and some of the Hasidic masters. Drawing on his writings, interviews, and correspondence, I will demonstrate that Leibowitz read and cited Hasidic books; he engaged with Hasidic teachings, and acknowledged learning from them. I argue that a full understanding of his challenging thinking must take Hasidic sources into account. This paper makes a contribution to scholarship on Leibowitz, one of the most interesting modern Jewish thinkers, and to our understanding of the relationship of Hasidism with modern Judaism as a whole.
A closer look at the binary content of NGC 1850
Authors: Saracino S , Kamann S , Bastian N , Gieles M , Shenar T , Reindl N , Müller-Horn J , Usher C , Dreizler S , Hénault-Brunet V
Published: September 2023

Studies of young clusters have shown that a large fraction of O-/early B-type stars are in binary systems, where the binary fraction increases with mass. These massive stars are present in clusters of a few Myr, but gradually disappear for older clusters. The lack of detailed studies of intermediate-age clusters has meant that almost no information is available on the multiplicity properties of stars with $M\lt 4\, {\rm M}_{\odot }$. In this study we present the first characterization of the binary content of NGC 1850, a 100 Myr-old massive star cluster in the Large Magellanic Cloud, relying on a VLT/MUSE multi-epoch spectroscopic campaign. By sampling stars down to M = 2.5 M⊙, we derive a close binary fraction of 24 ± 5 per cent in NGC 1850, in good agreement with the multiplicity frequency predicted for stars of this mass range. We also find a trend with stellar mass (magnitude), with higher mass (brighter) stars having higher binary fractions. We modelled the radial velocity curves of individual binaries using the joker and constrained the orbital properties of 27 systems, ∼17 per cent of all binaries with reliable radial velocities in NGC 1850. This study has brought to light a number of interesting objects, such as four binaries showing mass functions f(M) > 1.25 M⊙. One of these, star #47, has a peculiar spectrum, explainable with the presence of two discs in the system, around the visible star and the dark companion, which is a black hole candidate. These results confirm the importance and urgency of studying the binary content of clusters of any age.
BASS-XL: X-ray variability properties of unobscured active galactic nuclei
Authors: Tortosa Alessia , Ricci Claudio , Arévalo Patricia , Koss Michael J , Bauer Franz E , Trakhtenbrot Benny , Mushotzky Richard , Temple Matthew J , Ricci Federica , Rojas Lilayu Alejandra , Kawamuro Taiki , Caglar Turgay , Liu Tingting , Harrison Fiona , Oh Kyuseok , Powell Meredith Clark , Stern Daniel , Urry Claudia Megan
Published: September 2023

We investigate the X-ray variability properties of Seyfert 1 Galaxies belonging to the BAT AGN Spectroscopic Survey (BASS). The sample includes 151 unobscured (NH < 1022 cm−2) AGNs observed with XMM–Newton for a total exposure time of ∼27 ms, representing the deepest variability study done so far with high signal-to-noise XMM–Newton observations, almost doubling the number of observations analysed in previous works. We constrain the relation between the normalized excess variance and the 2–10 keV AGN luminosities, black hole masses, and Eddington ratios. We find a highly significant correlation between $\sigma _{\rm NXS}^2$ and MBH , with a scatter of ∼0.85 dex. For sources with high L2–10 this correlation has a lower normalization, confirming that more luminous (higher mass) AGNs show less variability. We explored the $\sigma _{\rm NXS}^2$ versus MBH relation for the sub-sample of sources with MBH estimated via the ‘reverberation mapping’ technique, finding a tighter anticorrelation, with a scatter of ∼0.65 dex. We examine how the $\sigma _{\rm NXS}^2$ changes with energy by studying the relation between the variability in the hard (3–10 keV) and the soft (0.2–1 keV)/medium (1–3 keV) energy bands, finding that the spectral components dominating the hard energy band are more variable than the spectral components dominating in softer energy bands, on time-scales shorter than 10 ks.
Self-gravity of debris discs can strongly change the outcomes of interactions with inclined planets
Authors: Poblete Pedro P , Löhne Torsten , Pearce Tim D , Sefilian Antranik A
Published: September 2023

Drastic changes in protoplanets’ orbits could occur in the early stages of planetary systems through interactions with other planets and their surrounding protoplanetary or debris discs. The resulting planetary system could exhibit orbits with moderate to high eccentricities and/or inclinations, causing planets to perturb one another as well as the disc significantly. The present work studies the evolution of systems composed of an initially inclined planet and a debris disc. We perform N-body simulations of a narrow, self-gravitating debris disc, and a single interior Neptune-like planet. We simulate systems with various initial planetary inclinations, from coplanar to polar configurations considering different separations between the planet and the disc. We find that except when the planet is initially on a polar orbit, the planet–disc system tends to reach a quasi-coplanar configuration with low vertical dispersion in the disc. When present, the Zeipel–Kozai–Lidov oscillations induced by the disc pump the planet’s eccentricity and, in turn, affect the disc structure. We also find that the resulting disc morphology in most of the simulations looks very similar in both radial and vertical directions once the simulations are converged. This contrasts strongly with massless disc simulations, where vertical disc dispersion is set by the initial disc-planet inclination and can be high for initially highly inclined planets. The results suggest caution in interpreting an unseen planet’s dynamical history based only on the disc’s appearance.
Voids and haloes-in-voids statistics as a probe of the expansion history of the Universe
Authors: Parkavousi Laya , Kameli Hamed , Baghram Shant
Published: September 2023

Structures in the Universe are arranged into the cosmic web. Distributions, statistics, and evolutions of the structures can be used as probes for cosmological models. We investigate the number density of voids and dark matter haloes-in-voids in the excursion set theory (EST). We study the Markov and non-Markov frameworks of EST in both spherical and ellipsoidal collapse models. Afterward, we compare the number density of voids and haloes-in-voids in the standard lambda cold dark matter and the reconstructed model. The reconstructed model is a model-independent reconstruction based on background observations. This work explores the effects of the collapse model barrier in the different EST frameworks on the statistics of voids and the statistics of haloes-in-voids. Finally, we find the hint that cosmological models can be distinguished by the number density of haloes-in-voids in the 1.0−2.5 redshift range. The maximum difference is observed in z ∼ 1.9.
Solving the pulsar equation using physics-informed neural networks
Authors: Stefanou Petros , Urbán Jorge F , Pons José A
Published: September 2023

In this study, Physics-Informed Neural Networks (PINNs) are skilfully applied to explore a diverse range of pulsar magnetospheric models, specifically focusing on axisymmetric cases. The study successfully reproduced various axisymmetric models found in the literature, including those with non-dipolar configurations, while effectively characterizing current sheet features. Energy losses in all studied models were found to exhibit reasonable similarity, differing by no more than a factor of three from the classical dipole case. This research lays the groundwork for a reliable elliptic Partial Differential Equation solver tailored for astrophysical problems. Based on these findings, we foresee that the utilization of PINNs will become the most efficient approach in modelling three-dimensional magnetospheres. This methodology shows significant potential and facilitates an effortless generalization, contributing to the advancement of our understanding of pulsar magnetospheres.
A revised age greater than 50 Myr for the young cluster IC 4665
Authors: Jeffries R D , Jackson R J , Binks A S
Published: September 2023

IC 4665 is one of only a dozen young open clusters with a ‘lithium depletion boundary’ (LDB) age. Using an astrometrically and spectroscopically filtered sample of cluster members, we show that both the positions of its low-mass stars in Gaia absolute colour–magnitude diagrams and the lithium depletion seen among its K- and early M-stars are discordant with the reported LDB age of $32^{+4}_{-5}$ Myr. Re-analysis of archival spectra suggests that the LDB of IC 4665 has not been detected and that the published LDB age should be interpreted as a lower limit. Empirical comparisons with similar data sets from other young clusters with better-established LDB ages indicate that IC 4665 is bracketed in age by the clusters IC 2602 and IC 2391 at 55 ± 3 Myr.
Proteinuria, measured or estimated albuminuria for risk prediction in patients with chronic kidney disease?
Authors: Kim Hyoungnae , Hyun Young Youl , Joo Young Su , Yun Hae-Ryong , Kim Yaeni , Jung Ji Yong , Jeong Jong Cheol , Kim Jayoun , Park Jung Tak , Yoo Tae-Hyun , Kang Shin-Wook , Oh Kook-Hwan , Han Seung Hyeok
Published: September 2023

Background

Although albuminuria is the gold standard for defining chronic kidney disease (CKD), total proteinuria has also been widely used in real-world clinical practice. Moreover, the superiority of the prognostic performance of albuminuria over proteinuria in patients with CKD remains inconclusive. Therefore, we aimed to compare the predictive performances of albuminuria and proteinuria in these patients.

Methods

From the Korean Cohort Study for Outcome in Patients with CKD we included 2099 patients diagnosed with CKD grades 1–5 who did not require kidney replacement therapy. We measured the spot urine albumin:creatinine ratio (mACR) and protein:creatinine ratio (PCR) and estimated the ACR (eACR) using the PCR. Kidney failure risk equation (KFRE) scores were calculated using the mACR, PCR and eACR. The primary outcome was the 5-year risk of kidney failure with replacement therapy (KFRT).

Results

The eACR significantly underestimated mACR in patients with low albuminuria levels. The time-dependent area under the receiver operating characteristics curve showed excellent predictive performance for all KFRE scores from the mACR, PCR and eACR. However, eACR was inferior to mACR based on the continuous net reclassification index (cNRI) and integrated discrimination improvement index (IDI) in all CKD cause groups, except for the group with an unclassified aetiology. Moreover, the cNRI and IDI statistics indicated that both eACR and PCR were inferior to mACR in patients with low albuminuria (<30 mg/g). Conversely, the predictive performance of PCR was superior in severe albuminuria and nephrotic-range proteinuria, in which the IDI and cNRI of the PCR were greater than those of the mACR.

Conclusions

The mACR, eACR and PCR showed excellent performance in predicting KFRT in patients with CKD. However, eACR was inferior to mACR in patients with low albuminuria, indicating that measuring rather than estimating albuminuria is preferred for these patients.
Sentiment and the belief in fake news during the 2020 presidential primaries
Authors: Adamo Christopher , Carpenter Jeffrey
Published: September 2023

The influence of misinformation on the political decision-making process became a major concern in the United States after the 2016 Presidential election. We study the impact of “fake news” in the 2020 election cycle by conducting an online experiment the day before the “Super Tuesday” primary elections. Respondents attempt to differentiate between fake and true news headlines that vary exogenously with respect to the emotive language in which they are written. In addition to confirming the effect of demographics and identifying a new determinant of beliefs, the illusion of personal objectivity, we find that the sentiment of a headline determines whether it is believed and correctly assessed. We also find that the effects of emotive language vary by political affiliation. These results suggest ways to protect oneself against misinformation and engage critically with the news.
Sleep in Development
Authors: Corcoran Hannah , Cook Fallon , Griffiths Amanda
Published: September 2023

This chapter, covering sleep from birth until eighteen years of age, describes the origins and importance of sleep in childhood for development, as well as presentations of medical and behavioral sleep disorders, sleep problems in neurodevelopmental and psychiatric disorders, and the role of sleep in lifelong health. Appreciating human development requires an in-depth understanding of sleep. Sleep needs and make-up vary across the life course. Healthy sleep in children needs to be appropriately timed and of adequate duration, and occurring with regularity, with minimal disruption. Disrupted sleep can interrupt normal developmental processes, and poor sleep in childhood has many short- and long-term negative consequences. Adequate management is important to ensure minimal impact on growth, health, cognition, and behavior.
Occupational impacts of early inflammatory arthritis: results from the National Early Inflammatory Arthritis Audit
Authors: Bechman Katie , Cook Emma S , Alveyn Edward , Houssien Abdullah , Stevens Martin , Russell Mark D , Adas Maryam , Amlani-Hatcher Paul , Norton Sam , Lempp Heidi , Ledingham Joanna M , Galloway James B , Walker-Bone Karen
Published: September 2023

Objectives

Inflammatory arthritis causes significant work disability. Studies regarding this frequently fail to report important contextual information such as employment type. Our objective was to explore work participation, by gender and occupation type, in early inflammatory arthritis.

Methods

Data are from the National Early Inflammatory Arthritis Audit for 2018–2020. At diagnosis, clinicians collected information on demographics, inflammatory arthritis disease activity, and working status. Participants completed patient-reported outcomes at baseline, 3 months and 12 months, including occupation and Work Productivity and Activity Impairment (WPAI). Descriptive analyses of work participation and WPAI scores by occupational class at all time points were performed. Regression models were used to examine associations between WPAI score and occupation.

Results

In all, 12 473 people received a diagnosis of inflammatory arthritis and reported employment status, among whom 5999 (47%) were in paid work for at least 20 hours/week. At diagnosis, the working cohort had statistically significant lower measures of disease activity (P < 0.001). Occupational data were available for 3694 individuals. At diagnosis, 2793 completed a WPAI; 200 (7.2%) had stopped work and 344 (12.3%) changed jobs because of inflammatory arthritis symptoms. There was a high burden of absenteeism (30%) and presenteeism (40%). Compared with managerial or professional workers, the burden of work disability was greater among those in routine (manual) occupations. During follow-up, 9.4% of WPAI completers stopped work and 14.6% changed roles. Work drop-out occurred almost entirely among people doing routine jobs.

Conclusion

It is easier to retain work in certain employment sectors. Participation in routine jobs is more affected, which may widen health inequalities.
XEN 45 Gel Stent Implantation in Open Angle Glaucoma: 5-Year Results of a Prospective Study
Authors: Torbey Julien , Paillard Archibald , Rao Harsha L. , Gillman Kevin , Bravetti Giorgio E. , Mermoud André , Mansouri Kaweh
Published: September 2023

Précis:

XEN 45 Gel Stent is safe and effective for 3 years. The study results provide useful insight into the outcome of XEN 45 Gel Stent surgery over 5 years in daily clinical practice.

Purpose:

To evaluate 5-year outcomes of XEN 45 gel stent implantation (XEN) in patients with open angle glaucoma.

Methods:

This is a prospective, single-center, interventional study. XEN implantation either alone (XEN) or combined with phacoemulsification (Phaco + XEN) was performed on 170 consecutive eyes (126 patients) with uncontrolled intraocular pressure (IOP) or disease progression despite medical treatment. “Complete” surgical success at 60 months was defined as unmedicated IOP ≤15 mm Hg and a relative IOP reduction ≥20% from medicated baseline, while “qualified” success allowed fewer ocular hypotensive medications than at baseline. Other definitions of success with various IOP targets were also analyzed. Secondary outcomes included mean IOP and IOP-lowering medication changes and rates of reoperations.

Results:

Mean age was 78.1±9.2 years, and 70.3% were female. Mean medicated IOP decreased from 19.8±7.7 mm Hg [19.6±7.1 (XEN) vs. 19.8±7.0 mm Hg (Phaco+XEN)] at baseline to 12.6±3.1 mm Hg [12.5± 3.1 (XEN) vs. 12.6±3.1 (Phaco+XEN)] at 5 years (−37.0%; P < 0.001). Medications decreased from 2.0±1.3 [2.0±1.3 (XEN) vs. 2.0±1.3 (Phaco+XEN)] to 0.8±1.1 [0.8±1.1 (XEN) vs. 0.8±1.1 (Phaco + XEN)] (−60%; P<0.001). Needling was performed in 84 eyes (49%), and 19.4% underwent a secondary surgical intervention. Complete success at 3 years was a strong predictor of success at 5 years (odds ratio: 3.06, P<0.01), while needling was associated with higher rates of failure (odds ratio: 3.6, P<0.01).

Conclusions:

At 5 years, XEN gel stent implantation was a safe procedure and achieved clinically meaningful IOP and medication reduction. Success at 3 years is a predictor of success at 5 years. Needling correlates with higher failure rates.
6-Year Efficacy and Safety of iTrack Ab-Interno Canaloplasty as a Stand-Alone Procedure and Combined With Cataract Surgery in Primary Open Angle and Pseudoexfoliative Glaucoma
Authors: Koerber Norbert , Ondrejka Simon
Published: September 2023

Précis:

Significant reductions in intraocular pressure (IOP) and the number of medications are sustained up to 6 years postoperatively for eyes that underwent ab-interno canaloplasty using the iTrack microcatheter, either as a stand-alone procedure or combined with cataract surgery.

Purpose:

The purpose of this study was to evaluate the long-term effectiveness of iTrack (Nova Eye Medical Inc.) ab-interno canaloplasty for reducing IOP and the number of glaucoma medications in patients with primary open angle (POAG) and pseudoexfoliative glaucoma.

Methods:

A retrospective single-center consecutive case series. Patients were treated with either ab-interno canaloplasty performed as a stand-alone procedure or combined with cataract surgery and were followed for up to 6 years. iTrack was used to circumferentially catheterize and viscodilate the Schlemm canal over 360 degrees. Primary efficacy endpoints included IOP and number of glaucoma medications at 12, 24, 36, 48, 60, and 72 months after surgery.

Results:

Twenty-seven eyes of 22 patients, with a mean age of 76.9±6.3 years, were recruited. Mean IOP was reduced significantly from 19.9±5.2 mm Hg (n=27) at baseline (no washout) to 14.6±3.3 mm Hg at the 6-year follow-up (n=18; P<0.001). The number of medications was significantly reduced from 1.9±1 at baseline to 0.9±0.9 at 6 years (n=18; P=0.005). At all time points, there was no statistical difference between POAG (n=16) and pseudoexfoliative (n=11) eyes, nor between stand-alone procedures (n=4) and those combined with phacoemulsification (n=23). At 72 months, the mean reduction in IOP was 27% while 53% in the number of medications. No serious complications were recorded.

Conclusions:

iTrack ab-interno canaloplasty performed as a stand-alone procedure or in combination with cataract surgery significantly reduced IOP and number of medications in patients with POAG up to 6 years after the procedure. To the authors’ knowledge, this is the longest ab-interno canaloplasty follow-up available in the literature.
The Role of Adenovirus in Hepatitis of Unknown Etiology Among Children in Turkey, July 2022 to January 2023
Authors: Demirbuğa Asuman , Hançerli Törün Selda , Metin-Akcan Özge , Yücel Aylin , Yahşi Aysun , Bayhan Gülsüm İclal , Emre Irmak , Öztürk Birol , Kaba Özge , Kutluk Günsel , Tural-Kara Tuğçe , Erbaş İrem Ceren , Özdem-Alataş Şilem , Akça Mehtap , Özgökçe- Özmen Berfin , Aslan Sevgi , Çakici Özlem ,   on behalf of the TURK-Adenovirus Hepatitis Study Group
Published: September 2023

Background:

In the first half of 2022, the increase in cases of severe acute hepatitis in children with no epidemiological link and unknown cause has aroused concern worldwide. In this study, we aimed to determine the frequency of adenovirus in children with hepatitis of unknown origin in Turkey.

Methods:

In this study, which was conducted with the participation of 16 centers from Turkey, between July 2022 and January 2023, 36 pediatric patients under the age of 18 who met the definition of acute hepatitis were included.

Results:

Twenty (55,6%) of patients were female and 16 (44,4%) were male, with a mean age of 41.55 ± 39.22 (3-192) months. The most common symptoms were fever (66.7%), weakness (66.7%), loss of appetite (66.7%), fatigue (61.1%), vomiting (61.1%), and diarrhea (47.2%). Six (16 %) children had acute hepatic failure. Eight of the 15 children (46%) had respiratory viral infections (rhinovirus/enterovirus, n = 4; rhinovirus + parainfluenza, n = 1; parainfluenza, n = 1, SARS-CoV-2 n = 2). Adenovirus was detected in 16 (44%) patients. Adenovirus and coinfections were detected in 7 patients. History of diarrhea and fatigue in the last month was significantly higher in the adenovirus group (P = 0.023 and 0.018). One child who had both adenovirus and rhinovirus infection required liver transplantation; all others recovered with supportive care.

Conclusion:

There were no deaths in our series; however, the number of cases, etiology, and severity of the clinical course may have differed between countries owing to differences in case definitions, laboratory facilities, or regional genetic differences.
Epidemiology of RSV Bronchiolitis Among Young Children in Central New York Before and After the Onset of the COVID-19 Pandemic
Authors: Daniels Danielle , Wang Dongliang , Suryadevara Manika , Wolf Zachary , Nelson Christopher B. , Suh Mina , Movva Naimisha , Reichert Heidi , Fryzek Jon P. , Domachowske Joseph B.
Published: September 2023

Background:

Respiratory syncytial virus (RSV) bronchiolitis is the leading cause of hospitalizations among infants in the United States. Unpredictability in RSV seasonality has occurred following the onset of the coronavirus disease 2019 (COVID-19) pandemic. Local surveillance networks can enhance the ability to appropriately time prophylaxis when exposure risk is highest.

Methods:

A retrospective, cohort study was conducted to describe the epidemiologic patterns of RSV disease among outpatient, emergency department and inpatient encounters in children <5 years in Central New York before and after the onset of the COVID-19 pandemic. Local data were collected from October 2015 to January 2023 and compared to state-level data. Linear regression models were used to identify clinical and sociodemographic differences before and after the pandemic.

Results:

Local variation in RSV seasonality was noted prior to the COVID-19 pandemic, however highly atypical circulation patterns appeared in the post-COVID-19 era. Since March 2020, patterns for local and state-defined RSV seasons have remained atypical (local season onset in 2021: week 27 and 2022: week 27; state season onset in 2021: week 31 and 2022: week 38). After adjusting for increases in testing, RSV bronchiolitis cases were not significantly different during pre- and post-pandemic eras. In comparison to the 2021 bronchiolitis season, the 2022 season had a higher proportion of RSV cases despite decreased testing.

Conclusions:

Temporal patterns for RSV have shifted during the COVID-19 pandemic. Local surveillance networks may be advantageous in trending community-level RSV activity to optimize prophylaxis administration. Changes in RSV testing patterns occurred throughout the study period and should be accounted for when describing infant and childhood RSV disease.
Exploring the Effectiveness of Group Cognitive Stimulation Training in People With Schizophrenia: A Randomized Controlled Trial
Authors: CHANG Chia-Chi , WU Hua-Shan , HONG Chen-Jee , LIU Chieh-Yu , CHEN Chi-Wen , YANG Chiu-Yueh
Published: September 2023

Background

Schizophrenia is a chronic degenerative brain disease. Cognitive impairment, the core symptom of this disease, affects the mood and social functioning of patients severely. Nonpharmacological therapies that both improve cognitive function and are suitable for patients with schizophrenia remain underdeveloped.

Purpose

This article was designed to explore the effects of group cognitive stimulation training (GCST) on cognitive function and social function in people with schizophrenia.

Methods

A randomized controlled trial was conducted. The 76 participants were allocated into either the experimental or control group using blocked randomization. The participants were all patients with chronic schizophrenia recruited from seven rehabilitation units in northern Taiwan who were 20–65 years old and scored 10–25 on the Montreal Cognitive Assessment Taiwan Version. The experimental group received the 60-minute GCST twice a week for 7 weeks, whereas the control group received standard treatment. All outcome indicators were analyzed at baseline and after intervention using generalized estimating equations. The primary outcome indicators included cognitive function assessed using the Taiwan version of the Montreal Cognitive Assessment, working memory assessed using the Wechsler Memory Scale–Third Edition, and executive function assessed using the Taiwanese version of the Frontal Assessment Battery. The secondary outcome indicator was social function assessed using the Social Function Scale–Taiwan short version.

Results

Generalized estimating equation modeling revealed the experimental group exhibited significant improvement in Montreal Cognitive Assessment total score (B = 1.33, SE = 0.65, p = .040) and Social Function Scale–Taiwan short version (B = 9.55, SE = 2.38, p < .001) after adjusting for nine covariates. No significant differences between the two groups in terms of working memory (B = 4.79, SE = 2.66, p = .071) or executive function (B = 0.53, SE = 0.63, p = .399) were found.

Conclusions/Implications for Practice

The results indicate that GCST positively impacts overall cognitive and social functions but not higher-order cognitive function (working memory and executive function). In clinical settings, GCST may be applied to improve cognitive function in people with schizophrenia. The findings of this study may inform the practice of mental health nurses to improve cognitive function in patients in clinical care.
Prospective Physician Assistant Student Perspectives on an In-Person vs. Virtual Admissions Interview Process
Authors: Love Elissa , Thompson Kathleen , Elliott Elizabeth
Published: September 2023

Purpose

The pandemic strained many usual methods of communication and training, forcing changes to selection processes for health professions programs. The purpose of this study was to determine, through interviewee feedback, the effectiveness of a virtual interview process when compared with a previous in-person interview process at one physician assistant (PA) program.

Methods

During the pandemic, the PA program adapted to a virtual holistic interview process to include interaction with current students and faculty. The effectiveness of the virtual platform was measured comparatively using the program's existing interviewee evaluation format for previous in-person experiences.

Results

Prepandemic data showed high ratings from interviewees regarding the interview process. Intrapandemic data suggest an interview process can be duplicated in a virtual format without compromising experience and goals of the program.

Conclusions

Through virtual interviews during a pandemic, the PA program mirrored the effectiveness of their previous in-person experience.
Perceived Need for Mental Health Care in a Cohort of Persons With Inflammatory Bowel Disease
Authors: Bernstein Charles N. , Dolovich Casandra , Prichodko Madelaine , Fisk John D. , Graff Lesley A. , Patten Scott B. , Bolton James , Hitchon Carol , Marrie Ruth Ann ,   for the CIHR Team in Defining the Burden and Managing the Effects of Immune-mediated Inflammatory Disease
Published: September 2023

Background:

Psychiatric comorbidity is common in inflammatory bowel disease (IBD) and can negatively affect disease outcomes. We explored the perceived need for mental health care among persons with IBD.

Study:

Persons with IBD completed self-report questionnaires, including the Hospital Anxiety and Depression Scale (HADS), and reported whether they wanted help with their mood. Each was also assessed using the Structured Clinical Interview for DSM-IV-TR Axis-I Disorders (SCIDs). We used logistic regression analyses to determine factors associated with the perceived need for mental health care.

Results:

Of 245 participants, 28% met the criteria for a past diagnosis of depression or anxiety disorder by SCID, and nearly 23% met the criteria for a current diagnosis of depression or anxiety disorder. One-third (n = 74) reported a perceived need for mental health care. Among those meeting criteria for a current SCID diagnosis of depression or anxiety, only 58% reported needing mental health care. Need for mental health care was reported by 79% of persons currently treated for either depression or 71% treated for anxiety. Persons with a perceived need for mental health care had higher mean HADS for depression and HADS for anxiety scores and also higher IBD symptom activity scores. Of those reporting no perceived need for mental health care, 13% had a current diagnosis of depression or anxiety disorder by SCID; even fewer had symptoms of depression or anxiety.

Conclusions:

Symptoms of depression or anxiety are more important than a formal diagnosis of depression or anxiety in predicting which persons with IBD will perceive a need for mental health care.
Elastography for Evaluation of Regression in Liver Fibrosis After Surgical Biliary Drainage for Benign Biliary Strictures
Authors: Rajendran Jayapal , Irrinki Santhosh , Gupta Vikas , Singh Virendra , Sinha Saroj Kanth. , lal Anupam , Kurdia Kailash , Das Ashim , Yadav Thakur Deen
Published: September 2023

Background:

Hepatic fibrosis and secondary biliary cirrhosis are consequences of long-standing benign biliary strictures. Evidence on the reversibility of fibrosis after the repair is incongruous.

Methodology:

A prospective observational study on patients who underwent Roux-en-Y hepaticojejunostomy for benign biliary stricture. A liver biopsy was performed during repair and correlated with preoperative elastography. The improvement in liver functions and regression of fibrosis was compared with preoperative liver function tests and elastography.

Results:

A Total of 47 patients [mean age—38.9 y (Range: 21 to 66)] with iatrogenic benign biliary stricture were included. A strong female preponderance was noted. High strictures (type III and IV) comprised 72.7% of the study group. The median interval (injury to repair) was 7 months (2 to 72 mo). The median duration of jaundice was 3 months (1 to 20 mo). Both factors had a significant correlation with the stage of fibrosis (P=0.001 and P=0.03, respectively). Liver biopsy revealed stage I, II, III, and IV fibrosis in 26 (55.3%), 11 (23.4%), 2 (4.3%), and 2(4.3%), respectively. The remaining 6 (12.8%) had no fibrosis. The severity of fibrosis had a good correlation with preoperative liver stiffness measurement-value on FibroScan. Significant improvement in liver function tests (bilirubin—3.55±3.48 vs. 0.59±0.52; Albumin—3.85±0.61 vs. 4.14±0.37; ALP—507.66±300.65 vs. 167±132.07; P value 0.00) and regression of fibrosis (liver stiffness measurement; 10.42±5.91 vs. 5.85±3.01, P value 0.00) was observed after repair of the strictures.

Conclusion:

Improved biliary function and regression of liver fibrosis can be achieved with timely repair of benign biliary stricture and it is feasible to be evaluated using elastography.
Therapeutic effects of biological treatments on AA amyloidosis associated with inflammatory bowel disease: a case report and literature review
Authors: Alhalabi Marouf , Alaa Eddin Kamal , Abbas Ahmad
Published: September 2023

AA amyloidosis is a rare and significant complication of long-term inflammation that can be caused by a variety of disorders, including inflammatory bowel disease, and is linked to an increased risk of morbidity and mortality. To date, there has been no effective direct treatment, and treatment aims at treating the underlying condition with potent immunosuppression to limit inflammatory activity and, as a result, switch off amyloidogenesis. Theoretically, biological treatment can control AA amyloidosis by inducing and maintaining inflammatory bowel disease remission and inhibiting the synthesis of Serum Amyloid A, which is an acute phase reactant and precursor protein of AA amyloidosis that accumulates in the organs. We report the first case of ustekinumab’s therapeutic effect after infliximab’s loss of response in AA amyloidosis associated with Crohn’s disease. We also conducted a literature review of the therapeutic effect of biological treatment on AA amyloidosis.
JAK inhibitors for the treatment of inflammatory bowel disease: results of an international survey of perceptions, attitudes, and clinical practice
Authors: Honap Sailish , Irving Peter M. , Samaan Mark A.
Published: September 2023

Background

Janus kinase inhibitors (JAKi) are small molecule drugs with demonstrated efficacy in inflammatory bowel disease (IBD). However, widespread utilisation may be hindered by safety concerns.

Aims

This is the first study assessing risk-benefit perceptions and clinical practices of those using JAKi for IBD.

Methods

A prospective, cross-sectional study was conducted using a 23-item survey distributed to IBD healthcare providers worldwide.

Results

Of 385 respondents from 48 countries, 72% were tertiary-centre based and 50% were gastroenterologists with ≥10 years experience. JAKi were commonly used outside market authorisation (31%), though many (17%) were unconfident discussing JAKi risk-benefit profile and 7% had never prescribed JAKi. If venous thromboembolism risks were present, 15% preferentially referred for surgery than initiate JAKi; 21% would do this even if the patient was already anticoagulated. For patients relapsing on dose reduction, 8% would switch treatment rather than dose escalate. Conversely, 45% felt that cardiovascular safety concerns from post-marketing studies were irrelevant to IBD. Despite the lack of detailed, long-term safety data, safety profiles of JAK1-selective drugs were perceived to be favourable to tofacitinib by most (62%).

Conclusion

The study indicates that while clinical practice appears to be in keeping with international guidance, a significant minority remain deterred by safety concerns.
Three-dimensional computed tomography analysis of the atlanto-dental interval in a healthy Karachi population: a single-center retrospective cross-sectional study
Authors: Sultan Anum , Bhugio Sanobar , Shaikh Omer A. , Swaleh Faizan S. , Subhash Komal , Khan Yameena N. , Mala Ali , Hasibuzzaman Md. Al
Published: September 2023

Background:

The atlantoaxial joint has a complex anatomical configuration and has a wide range of mobility. Traumatic, inflammatory, and neoplastic joint pathologies frequently affect this joint. The aim of this retrospective cross-sectional study was to evaluate the atlanto-dental intervals (ADI) in patients who underwent computed tomography (CT) scans of the neck and cervical spine in at a Tertiary Care Hospital in Karachi, Pakistan.

Methods:

This was a retrospective cross-sectional study conducted at a tertiary care hospital in Karachi between 1 January 2021 and 31 December 2021, following approval from the hospital ethical review committee. Patients above the age of 15 who underwent CT scans were included, while individuals with a history of cervical trauma, infection, rheumatoid arthritis, or congenital anomalies, as well as those younger than 15 years old, were excluded. CT scans were performed using a multidetector scanner utilizing a standardized protocol. Sagittal and coronal images were reconstructed. ADI measurements, including anterior ADI (AADI), posterior ADI (PADI), and lateral ADI (LADI) on both sides, were determined using appropriate bone window settings. A radiologist with a minimum of 3 years of experience analyzed the CT scans.

Results:

The mean age of the patients was 49.3±17.7 years (age range: 16–85 years). The mean AADI was 1.4±0.4 mm, with a range of 0.0–2.1 mm. The mean PADI was 19.1±1.9 mm, with a range of 13.8–24.6 mm. The mean left LADI measurement was 3.3±1.2 mm with a range of 1.2–10.0 mm, and the mean right LADI measurement was 3.2±1.1 mm with a range of 1.2–6.3 mm.

Conclusion:

Our study examined the ADI in patients who underwent CT scans of the neck and cervical spine in Karachi. The findings provide valuable insights into the relationship between ADI measurements, age, and sex. These results contribute to our understanding of the anatomical variations in this region, which may aid in the diagnosis and management of cervical spine disorders.