bluuebunny/crossref_metadata_2025 huggingface dataset:
Relugolix for oral treatment of uterine leiomyomas: a dose-finding, randomized, controlled trial
Authors: Hoshiai Hiroshi , Seki Yoshifumi , Kusumoto Takeru , Kudou Kentarou , Tanimoto Masataka
Published: October 2021

Background

Uterine leiomyomas are the most common neoplasm affecting women and frequently cause heavy menstrual bleeding and pain. Gonadotropin-releasing hormone (GnRH) receptor antagonists provide fast symptom relief and show promise as a medical (non-surgical) treatment option and as a presurgical treatment to reduce leiomyoma size. The aim of this study was to evaluate the efficacy and safety of three dose levels of oral relugolix, a small molecule GnRH receptor antagonist, in Japanese women with uterine leiomyomas and heavy menstrual bleeding.

Methods

This phase 2, multicenter, double-blind, parallel-group study was conducted at 36 sites in Japan in women with uterine leiomyomas and heavy menstrual bleeding, defined as a pictorial blood loss assessment chart (PBAC) score of ≥ 120 in one menstrual cycle. Patients were randomized 1:1:1:1 to relugolix 10, 20, or 40 mg, or placebo, orally once daily for 12 weeks. The primary endpoint was the proportion of patients with a total PBAC score of < 10 from week 6 to 12. A sample size of 50 patients per group was estimated to provide ≥ 95% power, based on the comparison of relugolix 40 mg with placebo using a chi-square test with a significance level of 5% (two-sided).

Results

From November 2011 to September 2012, 216 patients were randomized and 214 patients (99.1%) were analyzed. The proportion (difference vs. placebo) of patients that achieved the primary endpoint in the placebo and 10-, 20-, and 40-mg relugolix groups were 0%, 20.8% (95% confidence interval [CI]: 9.3–32.3, P < .001), 42.6% (95% CI: 29.4–55.8, P < .001), and 83.3% (95% CI: 73.4–93.3, P < .001), respectively. Though treatment-emergent adverse events were similar between the 20- and 40-mg groups, the incidence rates were more frequent compared with the placebo group. Most of these adverse events were mild or moderate in intensity.

Conclusions

Relugolix decreased menstrual blood loss in women with uterine leiomyomas in a dose–response manner, and was generally well tolerated.

Clinical trial registration: ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT01452659, NCT01452659 (registered 17/10/2011); JAPIC Clinical Trial Information, https://www.clinicaltrials.jp, JapicCTI-111590 (registered 31/08/2011).
Molecular mimicry of NMDA receptors may contribute to neuropsychiatric symptoms in severe COVID-19 cases
Authors: Vasilevska Veronika , Guest Paul C. , Bernstein Hans-Gert , Schroeter Matthias L. , Geis Christian , Steiner Johann
Published: October 2021

Approximately 30% of individuals with severe SARS-CoV-2 infections also develop neurological and psychiatric complaints. In rare cases, the occurrence of autoimmune encephalitis has been reported after SARS-CoV-2 infection. In this systematic review, we have identified eight SARS-CoV-2-associated cases of anti-NMDA receptor encephalitis. All had cerebrospinal fluid antibodies against the NMDA receptor and a recent onset of working memory deficits, altered mental status, or psychiatric symptoms, such as confusion, agitation, auditory hallucination, catatonia and speech dysfunction. All patients received high-dose steroid and immunoglobulin therapeutics and conditions improved in each case. These findings suggest that clinical attention should be paid to warning signs of autoimmune encephalitis in severe COVID-19 cases. If characteristic features of autoimmune encephalitis are present, autoantibody diagnostics should be performed and confirmed cases should be treated with immunotherapy to minimize neurological impairments.
Long noncoding RNA SGO1-AS1 inactivates TGFβ signaling by facilitating TGFB1/2 mRNA decay and inhibits gastric carcinoma metastasis
Authors: Huang Donglan , Zhang Ke , Zheng Wenying , Zhang Ruixin , Chen Jiale , Du Nan , Xia Yuanyuan , Long Yan , Gu Yixue , Xu Jianhua , Deng Min
Published: October 2021

Background

Although thousands of long noncoding RNAs (lncRNAs) have been annotated, only a few lncRNAs have been characterized functionally. In this study, we aimed to identify novel lncRNAs involved in the progression of gastric carcinoma (GC) and explore their regulatory mechanisms and clinical significance in GC.

Methods

A lncRNA expression microarray was used to identify differential lncRNA expression profiles between paired GCs and adjacent normal mucosal tissues. Using the above method, the lncRNA SGO1-AS1 was selected for further study. Quantitative reverse transcription polymerase chain reaction (qRT-PCR) and in situ hybridization (ISH) were performed to detect SGO1-AS1 expression in GC tissues. Gain-of-function and loss-of-function analyses were performed to investigate the functions of SGO1-AS1 and its upstream and downstream regulatory mechanisms in vitro and in vivo.

Results

SGO1-AS1 was downregulated in gastric carcinoma tissues compared to adjacent normal tissues, and its downregulation was positively correlated with advanced clinical stage, metastasis status and poor patient prognosis. The functional experiments revealed that SGO1-AS1 inhibited GC cell invasion and metastasis in vitro and in vivo. Mechanistically, SGO1-AS1 facilitated TGFB1/2 mRNA decay by competitively binding the PTBP1 protein, resulting in reduced TGFβ production and, thus, preventing the epithelial-to-mesenchymal transition (EMT) and metastasis. In addition, in turn, TGFβ inhibited SGO1-AS1 transcription by inducing ZEB1. Thus, SGO1-AS1 and TGFβ form a double-negative feedback loop via ZEB1 to regulate the EMT and metastasis.

Conclusions

SGO1-AS1 functions as an endogenous inhibitor of the TGFβ pathway and suppresses gastric carcinoma metastasis, indicating a novel potential target for GC treatment.
Understanding and breaking the intergenerational cycle of abuse in families enrolled in routine mental health services: study protocol for a randomized controlled trial and two non-interventional trials investigating mechanisms of change within the UBICA II consortium
Authors: Neukel C. , Bermpohl F. , Kaess M. , Taubner S. , Boedeker K. , Williams K. , Dempfle A. , Herpertz S. C. ,   the UBICA-II consortium, Herpertz Sabine C. , Neukel Corinne , Bermpohl Felix , Kaess Michael , Brunner Romulad , Taubner Svenja , Volkert Jana , Georg Anna , Fleck Leonie , Fuchs Anna , von der Lühe Tabea , Mielke Emilia , Parzer Peter , Resch Franz , Roth Corinna , Seeger Fabian , Wenigmann Marc , Williams Katharina , Banzhaf Christian , Boedeker Katja , Brandl Eva , Dittrich Katja , Hindi-Attar Catherine , Kluczniok Dorothea , Plank Irene Sophia , Reuter Catherina , Ratayczak Judith , Schoofs Nikola , Winter Sybille , Bertsch Katja
Published: October 2021

Background

Parents’ mental illness (MI) and parental history of early life maltreatment (ELM) are known to be significant risk factors for poor parenting while poor parenting is a crucial mediator of the intergenerational continuity of child maltreatment. Hence, maltreatment prevention programs for families with an MI parent, which pay particular attention to experiences of ELM in the parent, are urgently needed. Parental mentalizing was previously found to mediate successful parenting. Interventions aimed at improving the parental mentalizing capacity reduced maltreatment risk in parents. The aim of the present study is to investigate the effectiveness of a mentalization-based parenting-counseling in acutely mentally ill parents currently treated at a psychiatric hospital.

Methods

Mentalization-based parenting-counseling (MB-PC) vs. enhanced standard clinical care (SCC+) will be administered in a cluster-randomized-controlled trial (RCT). Patients treated at psychiatric hospitals with children between 1.5 and 15 years will be included in the trial. MB-PC will be administered as a 12-h combined individual and group program enriched by social counseling (over a course of 5 weeks) as add-on to standard clinical care, while the control condition will be standard clinical care plus a 90-min psychoeducation workshop on positive parenting. Primary efficacy endpoint is self-reported parenting practices at follow-up. Embedded within the RCT will be two sub-studies investigating social cognition and dyadic synchrony as biobehavioral mechanisms of change.

Discussion

The main goal of the present study is to investigate ways to break the intergenerational continuity of maltreatment by assessing the benefits of a prevention program which aims at improving parenting in vulnerable mothers and fathers. MB-PC is a short, low-cost intervention which can be delivered by nurses and social workers and is applicable to MI patients with children with a broad range of diagnoses. If it is shown to be effective, it can be directly implemented into standard psychiatric hospital care thereby providing help to prevent child maltreatment.

Trial registration

German Clinical Trials Register DRKS00017398. Registered on 5 July 2019
Hispidin attenuates bleomycin-induced idiopathic pulmonary fibrosis via an anti-oxidative effect in A549 cells
Authors: Ren Chen-Xi , Jin Xin , Xie Dan-Ping , Guo Xiao-Yu , Yu Li-Yun , Cui Yu-Dong , Kwon Taeho , Sun Hu-Nan
Published: October 2021

Idiopathic pulmonary fibrosis (IPF) is a serious and irreversible chronic lung disease. Bleomycin (BLM) is an anticancer drug, which can cause severe lung toxicity. The main target of oxidative stress-induced lung injury is alveolar epithelial cells, which lead to interstitial fibrosis. The present study investigated whether hispidin (HP), which has excellent antioxidant activity, attenuates bleomycin-induced pulmonary fibrosis via anti-oxidative effects in A549 cells. We found that hispidin reduced bleomycin-induced fibrosis of A549 cells by reducing reactive oxygen species (ROS) levels and inhibiting epithelial-mesenchymal transition. Taken together, our data suggest that hispidin has therapeutic potential in preventing bleomycin-induced pulmonary fibrosis.
The interplay of Malm carbonate permeability, gravity-driven groundwater flow, and paleoclimate – implications for the geothermal field and potential in the Molasse Basin (southern Germany), a foreland-basin play
Authors: Schintgen Tom Vincent , Moeck Inga Sigrun
Published: October 2021

The Molasse Basin in Southern Germany is part of the North Alpine Foreland Basin and hosts the largest accumulation of deep geothermal production fields in Central Europe. Despite the vast development of geothermal energy utilization projects especially in the Munich metropolitan region, the evolution of and control factors on the natural geothermal field, more specifically the time-varying recharge and discharge governing groundwater and heat flow, are still debated. Within the Upper Jurassic (Malm) carbonate aquifer as the main geothermal reservoir in the Molasse Basin, temperature anomalies such as the Wasserburg Trough anomaly to the east of Munich and their underlying fluid and heat transport processes are yet poorly understood. We delineate the two end members of thermal–hydraulic regimes in the Molasse Basin by calculating two contrasting permeability scenarios of the heterogeneously karstified Malm carbonate aquifer along a model section through the Wasserburg Trough anomaly by means of two-dimensional numerical thermal-hydraulic modelling. We test the sensitivity of the thermal-hydraulic regime with regard to paleoclimate by computing the two Malm permeability scenarios both with a constant surface temperature of 9 °C and with the impact of paleo-temperature changes during the last 130 ka including the Würm Glaciation. Accordingly, we consider the hydraulic and thermal effects of periglacial conditions like permafrost formation and the impact of the numerous glacial advances onto the Molasse Basin. Thermal-hydraulic modelling reveals the effect of recurrent glacial periods on the subsurface targets of geothermal interest, which is minor compared to the effect of permeability-related, continuous gravity-driven groundwater flow as a major heat transport mechanism.
A comparison of the Food and Drug Administration’s and Health Canada’s regulatory decisions about failed confirmatory trials for oncology drugs: an observational study
Authors: Lexchin Joel
Published: October 2021

Background

Oncology drugs are frequently approved on the basis of surrogate outcomes that require further trials to confirm the benefits, but at times these trials fail and regulators need to decide whether to withdraw approval for the indication and/or to remove the drug from the market. This study compares decisions by the Food and Drug Administration and Health Canada about oncology drugs that were approved using either Accelerated Approval (FDA) or Notice of Compliance with conditions (NOC/c, Health Canada) and that failed confirmatory trials.

Methods

Drug/indications approved by the FDA through its Accelerated Approval Pathway and that later failed confirmatory studies were identified from a published study and additional information on these drugs was collected from Drugs@FDA. Health Canada websites were searched on September 11, 2021 for the same group of drugs to determine if they were approved in Canada under the NOC/c pathway for the same indication as in the US. Information from both the FDA and Health Canada about these products was entered into an Excel spreadsheet. Decisions about whether to withdraw the drugs or remove the failed indication for the drug and requirements for confirmatory studies were compared. In addition, the dates of decisions by the two agencies were compared.

Results

Ten drug/indications were available for comparison. Regulatory decisions were similar in 4 cases, different in 1 case and could not be determined in the remaining 5, in 1 case because decisions were pending in both countries and in the other 4, because the NOC/c had not been fulfilled in Canada. The requirements for the confirmatory studies were similar in both countries. Decisions were made earlier in the United States.

Conclusions

This study shows that decisions made by Health Canada and the FDA about whether to withdraw a drug or remove a failed indication when drug/indications fail a confirmatory trial are usually similar, although the sample size on which this conclusion is made is small. The clinical implications of these similarities and differences should be explored.
Analysis of the regional distribution of road traffic mortality and associated factors in Japan
Authors: Okui Tasuku , Park Jinsang
Published: October 2021

Background

Regional differences in road traffic (RT) mortality among municipalities have not been revealed in Japan. Further, the association between RT mortality and regional socioeconomic characteristics has not been investigated. We analyzed geographic differences in RT mortality and its associated factors using the Vital Statistics in Japan.

Methods

We used data on RT mortality by sex and municipality in Japan from 2013 to 2017. We calculated the standardized mortality ratio (SMR) of RT for each municipality by sex using an Empirical Bayes method. The SMRs were mapped onto a map of Japan to show the geographic differences. In addition, an ecological study investigated the municipal characteristics associated with the SMR using demographic socioeconomic, medical, weather, and vehicular characteristics as explanatory variables. The ecological study used a spatial statistical model.

Results

The mapping revealed that the number of municipalities with a high SMR of RT (SMR > 2) was larger in men than in women. In addition, SMRs of capital areas (Kanagawa and Tokyo prefectures) tended to be low in men and women. The regression analysis revealed that population density was negatively associated with the SMR in men and women, and the degree of the association was the largest among explanatory variables. In contrast, there was a positive association between the proportion of non-Japanese persons and SMR. The proportions of lower educational level (elementary school or junior high school graduates), agriculture, forestry, and fisheries workers, service workers, and blue-collar workers were positively associated with the SMR in men. The proportion of unemployed persons was negatively associated with the SMR in men.

Conclusions

Socioeconomic characteristics are associated with geographic differences in RT mortality particularly in men. The results suggested preventive measures targeted at men of low socioeconomic status and non-Japanese persons are needed to decrease RT mortality further.
Forensic investigation of flowslides triggered by the 2018 Sulawesi earthquake
Authors: Rohit Divyesh , Hazarika Hemanta , Maeda Tsubasa , Sumartini Wa Ode , Kokusho Takaji , Manafi Khajeh Pasha Siavash , Nurdin Sukiman
Published: October 2021

The Sulawesi earthquake with a moment magnitude of Mw 7.5 struck the Central Sulawesi region of the Sulawesi Island, Indonesia, on September 28, 2018. The epicenter of the earthquake was located in the mountainous region of Donggala Regency, in the neck of the Minahasa Peninsula in the Central Sulawesi Province of Indonesia. Although the epicenter was located in Donggala Regency, the greatest devastating effects were observed about 70 km south of the epicenter in the Palu Valley. The event was the first of its kind to cause large-scale flowslides simultaneously at four key locations such as Balaroa, Petobo, Jono Oge, and Sibalaya with extensive ground displacements ranging from several hundred meters to more than 1 km. This article reviews the field observations of geotechnical failures and infrastructure damage caused by liquefaction resulting from the shallow strike-slip earthquake at Palu City, Donggala Regency, and Sigi Regency. A geo-spatial analysis was performed on data collected from aerial drone imagery, along with portable dynamic cone penetration testing (PDCPT) in the field. The investigation revealed a highly stratified ground with alternating soil layers of varying permeability and very low bearing resistance at shallow depths. The investigation also helped in assessing the extent of damage caused by geotechnical failure to the residential infrastructures, irrigation structures, and roads.

Graphical Abstract
Endocrine response of early-hatching Asian Short-toed Lark nestlings exposed to cold temperature in a high-latitude grassland habitat
Authors: Shang Jing , Zhang Liang , Li Xinyu , Zhang Shuping
Published: October 2021

Background

In high latitude grassland habitats, altricial nestlings hatching in open-cup nests early in the breeding season must cope with cold temperature challenges. Thyroid hormones (triiodothyronine, T3and thyroxine, T4) and corticosterone play a crucial role in avian thermoregulation response to cold. Investigating the endocrine response of altricial nestlings to temperature variation is important for understanding the adaptive mechanisms of individual variation in the timing of breeding in birds.

Methods

We compared nest temperature, ambient temperature, body temperature, plasma T3, T4and corticosterone levels in Asian Short-toed Lark (Alaudala cheleensis) nestlings hatching in the early-, middle-, and late-stages of the breeding season in Hulunbuir grassland, northeast China.

Results

Mean nest temperature in the early-, middle- and late-stage groups was − 1.85, 3.81 and 10.23 °C, respectively, for the 3-day-old nestlings, and 6.83, 10.41 and 11.81 °C, respectively, for the 6-day-old nestlings. The nest temperature significantly correlated with body temperature, plasma T3, T4and corticosterone concentrations of nestlings. Body temperature of 3-day-old nestlings in the early and middle groups was significantly lower than that of the late group, but there was no significant difference between the nestlings in the early and middle groups. The T4and T3concentrations and the ratio of T3/T4of both 3- and 6-day-old nestlings in the early-stage group were significantly higher compared to the middle and late groups. The corticosterone levels of 3-day-old nestlings were significantly higher in the early-stage group compared to the middle- and late-stage groups.

Conclusion

Nestlings hatching early responded to cold temperature by increasing thyroid hormones and corticosterone levels even in the early days of post hatching development when the endothermy has not been established. These hormones may play a physiological role in neonatal nestlings coping with cold temperature challenges.
Outcomes of multiple gestation births compared to singleton: analysis of multicenter KID database
Authors: Kalikkot Thekkeveedu Renjithkumar , Dankhara Nilesh , Desai Jagdish , Klar Angelle L. , Patel Jaimin
Published: October 2021

Background

The available data regarding morbidity and mortality associated with multiple gestation births is conflicting and contradicting.

Objective

To compare morbidity, mortality, and length of stay (LOS) outcomes between multiple gestation (twin, triplet and higher-order) and singleton births.

Methods

Data from the national multicenter Kids’ Inpatient Database of the Healthcare Cost and Utilization Project from the years 2000, 2003, 2006, 2009, 2012, and 2016 were analyzed using a complex survey design using Statistical Analysis System (SAS) 9.4 (SAS Institute, Cary NC). Neonates with ICD9 and ICD10 codes indicating singletons, twins or triplets, and higher-order multiples were included. Mortality was compared between these groups after excluding transfer outs to avoid duplicate inclusion. To analyze LOS, we included inborn neonates and excluded transfers; who died inpatient and any neonates who appear to have been discharged less than 33 weeks PMA. The LOS was compared by gestational age groups.

Results

A total of 22,853,125 neonates were analyzed for mortality after applying inclusion-exclusion criteria; 2.96% were twins, and 0.13% were triplets or more. A total of 22,690,082 neonates were analyzed for LOS. Mean GA, expressed as mean (SD), for singleton, twins and triplets, were 38.30 (2.21), 36.39 (4.21), and 32.72 (4.14), respectively. The adjusted odds for mortality were similar for twin births compared to singleton (aOR: 1.004, 95% CI:0.960–1.051, p = 0.8521). The adjusted odds of mortality for triplet or higher-order gestation births were higher (aOR: 1.33, 95% CI: 1.128–1.575, p = 0.0008) when compared to the singleton births. Median LOS (days) was significantly longer in multiple gestation compared to singleton births overall (singletons: 1.59 [1.13, 2.19] vs. twins 3.29 [2.17, 9.59] vs. triplets or higher-order multiples 19.15 [8.80, 36.38], p < .0001), and this difference remained significant within each GA category.

Conclusion

Multiple gestation births have higher mortality and longer LOS when compared to singleton births. This population data from multiple centers across the country could be useful in counseling parents when caring for multiple gestation pregnancies.
Maternal minimum dietary diversity and associated factors among pregnant women, Southwest Ethiopia, 2021
Authors: Tilahun Abel Girma , Kebede Abebaw Molla
Published: October 2021

Background

Inadequate dietary diversity intake during pregnancy increases risks of intrauterine growth restriction, abortion, low birth weight, preterm birth, prenatal and infant mortality,and morbidity and has long-lasting health impacts. Dietary diversity during pregnancy promotes the health status of the mother and her fetus. This study aimed to assess the magnitude of minimum dietary diversity and associated factors among pregnant women attending antenatal care.

Methods

A facility-based cross-sectional study was conducted among 274 pregnant women who attended antenatal care at Wacha primary hospital from January to February 2021. A systematic sampling method was used to select the study participants. The data were collected through face-to-face interviews using a structured and semi-structured questionnaire. Bivariate logistic regression was done to identify factors associated with maternal dietary diversity. Finally, multivariate logistic regression was done, and variables that showedPvalues of < 0.05 were considered statistically significant.

Result

The magnitude of minimum dietary diversity was 51% (95% CI: 44.5, 56.7). The mean (±SD) minimum dietary diversity score was 4.5 (± 1.268) with a minimum of 1 anda maximum of 8 food groups consumed out of ten food groups. Age fewer than 25 years (AOR 4.649; 95% CI; 1.404, 15.396), and the age group between 25 to 34 years (AOR 3.624; 95% CI: 1.315, 10.269), husband age group of 26 to 34 years (AOR 2.238; 95% CI; 1.028,4.873), and 35 to 44 years (AOR 3.555; 95% CI; 1.228,10.292) and nutrition awareness of women (AOR 2.182; 95% CI; 1.243, 3.829) were significantly associated with minimum dietary diversity.

Conclusion

The consumption of minimum dietary diversity of the pregnant mothers was found to be low. Women aged less than 25 and age between 25 to 34 years, husband’s age between 26 to 34 and 35 to 44 years, and nutrition awareness were the factors significantly associated with minimum dietary diversity. Therefore, providing nutrition education and counseling service warranted to promote maternal dietary diversity.
Feasibility study to assess the delivery of a novel isometric exercise intervention for people with stage 1 hypertension in the NHS: protocol for the IsoFIT-BP study including amendments to mitigate the risk of COVID-19
Authors: Wiles Jonathan , Rees-Roberts Melanie , O’Driscoll Jamie M. , Doulton Timothy , MacInnes Douglas , Short Vanessa , Pellatt-Higgins Tracy , Saxby Katie , Gousia Katerina , West Alan , Smith Maggie , Santer Ellie , Darby John , Farmer Chris K.
Published: October 2021

Background

Hypertension  (HTN) affects approximately 25% of the UK population and is a leading cause of mortality. Associated annual health care costs run into billions. National treatment guidance includes initial lifestyle advice, followed by anti-hypertensive medication if blood pressure (BP) remains high. However, adoption and adherence to recommended exercise guidelines, dietary advice and anti-hypertensive medication is poor. Four short bouts of isometric exercise (IE) performed 3 days per week (d/wk) at home elicits clinically significant reductions in BP in those with normal to high-normal BP. This study will determine the feasibility of delivering personalised IE to patients with stage 1 hypertension for whom lifestyle changes would be recommended before medication within NHS primary care.

Methods

This is a randomised controlled feasibility study. Participants were 18+ years, with stage 1 hypertension, not on anti-hypertensive medication and without significant medical contraindications. Trial arms will be standard lifestyle advice (control) or isometric wall squat exercise and standard lifestyle advice. Primary outcomes include the feasibility of healthcare professionals to deliver isometric exercise prescriptions in a primary care NHS setting and estimation of the variance of change in systolic BP. Secondary outcomes include accuracy of protocol delivery, execution of and adherence to protocol, recruitment rate, attrition, perception of intervention viability, cost, participant experience and accuracy of home BP. The study will last 18 months. Sample size of 100 participants (50 per arm) allows for 20% attrition and 6.5% incomplete data, based upon 74 (37 each arm) participants (two-sided 95% confidence interval, width of 1.33 and standard deviation of 4) completing 4 weeks. Ethical approval IRAS ID is 274676.

Discussion

Before the efficacy of this novel intervention to treat stage 1 hypertension can be investigated in any large randomised controlled trial, it is necessary to ascertain if it can be delivered and carried out in a NHS primary care setting. Findings could support IE viability as a prophylactic/alternative treatment option.

Trial registration

ISRCTN13472393, registered 18 August 2020
Burden of mental health symptoms and perceptions of their management in in-centre hemodialysis care: a mixed methods study
Authors: Schick-Makaroff Kara , Wozniak Lisa A. , Short Hilary , Davison Sara N. , Klarenbach Scott , Buzinski Robert , Walsh Michael , Johnson Jeffrey A.
Published: October 2021

Background

We aimed to describe (1) depressive and anxiety symptom burdens reported by adults on in-centre hemodialysis in Northern Alberta, Canada and (2) patients’ and nurses’ perceptions of managing such symptoms using routine patient-reported outcome measures (PROMs).

Methods

A longitudinal mixed methods approach was employed. Cluster randomized controlled trial data exposed the prevalence of positive screens (scores ≥ 3) for depressive (PHQ-2) and anxiety (GAD-2) symptoms. A descriptive qualitative approach was used to understand patients’ and nurses’ perceptions of managing these symptoms using the ESAS-r: Renal and EQ-5D-5L. Using purposeful sampling, patients and nurses were invited for interviews. Field notes were documented from 6 dialysis unit observations. Patients’ responses to open-ended survey questions and nurses’ electronic chart notes related to mental health were compiled. Thematic and content analyses were used.

Results

Average age of patients (n = 408) was 64.0 years (SD 15.4), 57% were male, and 87% were not working; 29% screened positive for depressive symptoms, 21% for anxiety symptoms, and 16% for both. From patient (n = 10) and nurse (n = 8) interviews, unit observations, patient survey responses (n = 779) and nurses’ chart notes (n = 84), we discerned that PROMs (ESAS-r: Renal/EQ-5D-5L) had the potential to identify and prompt management of mental health concerns. However, opinions differed about whether mental health was within kidney care scope. Nonetheless, participants agreed there was a lack of mental health resources.

Conclusions

Prevalence of depressive and anxiety symptoms aligned with existing literature. Tensions regarding mental health management highlight the need for systemic decisions about how routine PROM use, including mental health assessment, may be optimized to meet patients’ needs.
Biocontrol potential of entomopathogenic fungi, nematodes and bacteria against Rhynchophorus ferrugineus (Olivier)
Authors: Yasin Muhammad , Wakil Waqas , Qayyum Mirza Abdul , Ali Sajjad , Sajjad Asif , Aqueel Muhammad Anjum , Shakeel Muhammad
Published: October 2021

Background

The red palm weevil (RPW), Rhynchophorus ferrugineus (Olivier) (Coleoptera: Curculionidae), is a serious threat to date palms across the globe, causing heavy yield losses. The pest inflicts damage to palms stem and destroys vascular system; resultantly lower the vigor and affect the growth and yield. For ecological farming system, biological control of the pest is gaining increased interest due to hosts’ specificity, safety to human, animal and non-target organisms, and their compatibility to environment.

Results

In laboratory assay, Beauveria bassiana, Heterorhabditis bacteriophora and Bacillus thuringiensis var. kurstaki (Bt-k) alone and in combination against sixth instar larvae and adults of four distinct populations of RPW were applied. H. bacteriophora was more effective, followed by B. bassiana and Bt-k in alone treatments. While in combined treatments, the highest mortality was recorded for H. bacteriophora + B. bassiana combination (100% for both stages), followed by H. bacteriophora + Bt-k, (larvae 100%; adults 94.24%) and B. bassiana + Bt-k treatments (larvae: 87.01%; adults: 80.53%). Maximum rate of mycosis (larvae 85.74%; adults 69.07%), sporulation (larvae 189.22 conidia ml−1; adults 164.56 conidia ml−1), cadavers affected by nematodes (larvae 92.4%; adults 81.29%) and nematode production (larvae 178.78 IJs ml−1; adults 153.44 IJs ml−1) was observed where B. bassiana or H. bacteriophora was applied alone and the lowest (larvae 122.78 IJs ml−1; adults: 103.22 IJs ml−1) was recorded for H. bacteriophora + B. bassiana combination.

Conclusions

Entomopathogens can be effectively used alone and/or in integration to control RPW populations. Natural capability of entomopathogens to infect and disseminate into other hosts makes them excellent biocontrol agents to be incorporated in the IPM plan of RPW and to make palm growers confident with the use of the most promising microbial control agents.
Novel insights into irritability: the relationship between subjective experience, age and mood
Authors: Bell Erica , Malhi Gin S. , Mannie Zola , Boyce Philip , Bryant Richard , Inder Maree , Porter Richard J.
Published: October 2021

Background

The relationship between irritability as a subjective experience and the behavioural indicators typically used to measure the construct are not known. Its links to mood, and contextual relationships, vary with age and are yet to be thoroughly examined.

Aims

First, to interrogate the relationship between the subjective experience of irritability and mood, and that with its behavioural indicators. Second, to determine how these relationships vary with age and over time.

Method

This study examined data from a previous clinical trial of adolescents and young adults (N = 82) with bipolar disorder, who received a psychological intervention over 18 months. Participants completed a battery of questionnaires, which included assessments of irritability. Analyses of covariance were conducted to examine the interaction between mood symptoms, subjective measures of irritability, behavioural measures of irritability and age over time.

Results

Subjective irritability scores differed significantly over time when controlling for manic, but not depressive, symptom scores. Further, subjective irritability significantly differed when controlling for behavioural measures of irritability (temper outbursts and argumentativeness). There were significant interactions between scores of depressive symptoms, temper outbursts and subjective irritability with age, wherein younger participants showed no correlation between depressive symptoms and temper outbursts. In addition, younger participants showed lower correlations between subjective irritability and both depressive and temper outburst scores, than older participants.

Conclusions

Subjective irritability is linked to mood morbidity and behavioural outbursts, and these relationships are contingent on age. Our novel findings suggest that subjective irritability should be assessed in greater detail in patients with mood disorders.
Editor's Note
Authors: Bové Paul A.
Published: October 2021

Charles Bernstein is a major crossing point for poetry and poetics. His art and discussion of poetry exploit and develop the vernaculars of language as they echo across time and international borders and national languages.
Interview with Alí Calderón
Authors: Bernstein Charles
Published: October 2021

In 2018, Mexican poet Alí Calderón interviewed Charles Bernstein for his influential web magazine Círculo de poesía. The interview is published here in English for the first time. Bernstein addresses the poetics of “hybridity” and the possibilities for poetic disruption. The discussion ends with Bernstein's then new poem, written for John Ashbery on the day he died.
Introduction to Charles Bernstein's Distinguished Wenqin Yao Lectures at Zhejiang University, Hangzhou, Fall 2019
Authors: Perloff Marjorie
Published: October 2021

This brief introduction to Charles Bernstein's work, given in Hangzhou, China, in November 2019, on the occasion of Bernstein's Distinguished Lectureship, discusses the basic principles of Language poetics as put forward in the early books Content's Dream and A Poetics. From the first, Bernstein emphasized the idea that poetry is not the expression of feeling but a constructivist art in which language is taken out of its normal context and recharged. In “Artifice of Absorption,” Bernstein insists that the poet uses all the tools at his command to create a new kind of absorption, arresting the reader's attention. Difficulty is thus inherent to poetry—a difficulty challenging the reader to rise to the challenge of what it means to read poetry. A few examples like “Standing Target” are discussed briefly.
A Delegation-Based Theory of Expertise
Authors: Ambrus Attila , Baranovskyi Volodymyr , Kolb Aaron
Published: October 2021

We investigate information aggregation and competition in a delegation framework. An uninformed principal is unable to perform a task herself and must choose between one of two biased and imperfectly informed experts. In the focal equilibrium, experts exaggerate their biases, anticipating an ideological winner’s curse. We show that having a second expert can benefit the principal, even when equally or more biased than the first expert. The principal can benefit from commitment to an “element of surprise” and prefers experts with equal rather than opposite biases. (JEL D82, D83)
A Simple Method for Bounding the Elasticity of Growing Demand with Applications to the Analysis of Historic Antitrust Cases
Authors: Mullin Wallace P. , Snyder Christopher M.
Published: October 2021

We propose a simple method, requiring only minimal data, for bounding demand elasticities in growing, homogeneous-product markets. Since growing demand curves cannot cross, shifts in market equilibrium over time can be used to “funnel” the demand curve into a narrow region, bounding its slope. Our featured application assesses the antitrust remedy in the 1952 DuPont decision, ordering incumbents to license patents for commercial plastics. We bound the demand elasticity significantly below 1 in many post-remedy years, inconsistent with monopoly, supporting the remedy’s effectiveness. A second application investigates whether the 1911 dissolution of American Tobacco fostered competition in the cigarette market. (JEL K21, L24, L65, L66, N41, N42, O34)
Obsolescence of Capital and Investment Spikes
Authors: Fishman Arthur , Jovanovic Boyan
Published: October 2021

The prospect of capital obsolescence inhibits investment. Investors thus become more optimistic when the obsolescence of their capital slows down. We propose a model with no fixed costs of investment, and random technological progress that induces obsolescence of capital in place. Spikes occur precisely when technological progress slows down. Moreover, the more variable the progress, the larger are the spikes. Cross-industry data show that where price of capital declines are more variable, investment spikes are larger. (JEL D21, D41, D42, G31, O31, O33)
Prosecutor Quality, Witness Participation, Crime, and Reform
Authors: Daughety Andrew F. , Reinganum Jennifer F.
Published: October 2021

We develop a model wherein concerns about prosecutor quality reduce the willingness of witnesses to cooperate with prosecutors. This causes an increase in the crime rate and in wrongly convicted innocent defendants. Because citizens are taxpayers and may be victims, perpetrators, witnesses, or falsely accused defendants, they care about the prosecutor’s quality. They update beliefs about this quality based on the disposition of cases. If the prosecutor’s believed quality falls below a threshold, then a majority of voters chooses to replace the prosecutor with a challenger, in expectation of reform. We compare the majority’s choice with that of a social planner. (JEL D83, K41, K42)
Capital empreendedor: mais capital, mais empreendimentos
Authors: Cernev Adrian Kemmer , Menegon Letícia , Delsin Driely , Garcia Mariana
Published: October 2021

A Capital Empreendedor é um marketplace de serviços financeiros que conecta pequenas e médias empresas que necessitam de crédito a investidores e instituições financeiras. Tendo oferecido mais de R$ 1 bilhão em crédito em seus dois anos de existência, a empresa pretende expandir suas operações a fim de se tornar a maior fintech facilitadora de crédito do País. Para tanto, faz-se necessário decidir de que forma o capital da empresa será aumentado. Abordando novos modelos de negócio e plataformas digitais, este caso enfoca a pertinência dos modelos de investimento financeiro em diferentes estágios de desenvolvimento de uma startup.
Dilemas entre o real e o virtual na internacionalização: o caso Rilix
Authors: Martins Ananda Ferreira , De Vasconcellos Sílvio Luís , Calixto Cyntia Vilasboas
Published: October 2021

O caso estabelece um paralelo entre os dilemas de Selena e a experiência de internacionalização da Rilix, startup que desenvolve softwares e equipamentos de realidade virtual. Contratada recentemente Selena lida com os desafios da expansão da empresa e com seus próprios desafios profissionais.
ComBio e o nó do caroço de açaí: incluir ou não fornecedores comunitários?
Authors: Nogueira Fernando do Amaral , Villela Malu , Larroudé Elisa
Published: October 2021

A ComBio Energia – certificada como Empresa B – vende serviços de geração de vapor para indústrias. Para tanto, usa como combustível resíduos de biomassa, gerando economia e diminuindo impacto ambiental. Sua operação no Pará contempla expandir o uso de caroço de açaí como fonte de biomassa, com duas possibilidades de fornecedores: indústrias de médio porte ou batedores de açaí – pequenos comerciantes que fazem descarte incorreto desse resíduo. Para decidir, a ComBio precisa equilibrar desafios logísticos, sociais, ambientais e econômicos.
Emotive Sources of Post-truth
Authors: Juruś Dariusz
Published: October 2021

The first part of this paper briefly presents the phenomenon of post-truth, which is then confronted with emotivism, a position of 20th-century ethics or metaethics that ascribes an emotive and evocative meaning to ethical judgements, rather than a descriptive one. The second part shows briefly the theories of two main representatives of this view, namely A.J. Ayer and Charles Stevenson. The third part focuses on the objections to emotivism, primarily presented by Alasdair MacIntyre. Finally, the influence of emotivism on post-truth is discussed.
Implied Ambiguity: Mean-Variance Inefficiency and Pricing Errors
Authors: Hara Chiaki , Honda Toshiki
Published: October 2021

We investigate the optimal portfolio choice problem for an investor who has a utility function of the smooth ambiguity model. We identify necessary and sufficient conditions for a given portfolio to be optimal for such an investor. We define the implied ambiguity of a portfolio as the smallest ambiguity aversion coefficient with which the portfolio is optimal, and the measure of ambiguity perception as the part of the variability in asset returns that can be attributed to the ambiguity. We show that there are one-to-one relations between the implied ambiguity, the Sharpe ratio, and the pricing errors when the portfolio is taken as the pricing portfolio, and that the measure of ambiguity perception is determined by the Sharpe ratio and the alpha. Based on the U.S. stock market data, we assess how ambiguity averse the representative investor is and what types of stocks the investor perceives as having more ambiguous returns than others.

This paper was accepted by Manel Baucells, behavioral economics and decision analysis.
Not just a job
Authors: Silver Rebecca
Published: October 2021

Dental Nursing talks to Rebecca Silver about her professional journey
Functional Outcome in Arthroscopic ACL Reconstruction with Immediate Full Weight Bearing Mobilization- Retrospective Study
Authors: Vijayamohan Vijayamohan , Gopal V Shyam , Chandran Mohana , Antony Aleena
Published: October 2021

Rehabilitation following anterior cruciate ligament surgery continues to evolve, with the current emphasis being on immediate weight bearing
and range of motion, and progressive muscular strengthening, proprioception, dynamic stability, and neuromuscular control drills.
In this study we evaluate the functional outcome of Immediate full weight bearing mobilization following arthroscopic ACL (Anterior Cruciate
Ligament) reconstruction with quadrupled hamstring graft using endobutton and bioscrew.
With the advancement of fixation techniques immediate weight bearing mobilization after arthroscopic ACL reconstruction can give better
functional outcome and improved patient satisfaction. Although further large volume multicentric research is needed for establishing a
standardized rehabilitation protocol following arthroscopic ACL reconstruction, immediate weight bearing doesn’t cause any complications
and has better outcome as per our study.
Keywords: Arthroscopic reconstruction; ACL; Immediate weight bearing.
Spectrum of Imaging Findings In Rotator Cuff Tears – A Descriptive Review
Authors: Patil Anupama , Babhulkar, Joban , Mahadeokar Pranav
Published: October 2021

The rotator cuff is instrumental in movements of the shoulder, while at the same time producing balanced compressive forces to stabilise the glenohumeral joint (dynamic stabiliser) Cuff tears are usually diagnosed clinically but before a decision regarding surgery is taken, some form of cross-sectional imaging, USG and/or MRI, is a must. This descriptive review is an attempt to highlight key concepts from the existing literature, along with our experience to image these injuries and assist the clinicians to formulate protocols in the day to day management of
rotator cuff pathologies.
Keywords: Rotator cuff injuries; Cuff tears ; Cuff arthropathy; Post operative imaging.
Classification Systems in Rotator Cuff Tears
Authors: Chidambaram Ram , Mukhopadhyay Reet
Published: October 2021

Rotator cuff pathology is one of the most common conditions affecting the shoulder joint. Several classification systems have been used to describe rotator cuff tears in orthopedic literature. However, no comprehensive classification inclusive of all types and characteristics currently exists. Rotator cuff tears are classified based on various parameters. These include: 1. Tear depth 2. Tear Size/Extent 3. Tear Retraction 4. Tendon Quality 5. Tear Progression 6. Arthroscopic Classification. This review article aims to establish an algorithm based on the various existing classification systems so as to arrive at the best surgical or non-surgical solution as well as prognosticate the patient regarding the outcome. Special consideration needs to be made for massive tears which are irreparable.
Keywords: Rotator cuff tears; Rotator cuff tear classification; Massive irreparable rotator cuff tears; Partial rotator cuff tears; Subscapularis tears; Geometric Classification; Arthroscopic Classification; Rotator cuff retraction; Rotator cuff tendon quality; Prognosis for Rotator Cuff tears.
Treatment of Femoral Neck Non-Union Using Bone Cell Therapy: A Case Report
Authors: Mehra Arvind
Published: October 2021

Introduction: Management of non-union and/or malunited fractures remains a challenge and achieving complete and permanent union with current standard of care is difficult. Treatments that can allow localized and accelerated three-dimensional bone formation can offer an encouraging outcome.

Case Report: We present a case of a middle-aged woman with femoral neck non-union, treated with a novel bone cell therapy. Fracture union was achieved within 75 days post-cell implantation. At 10-month post-cell therapy, clinical outcome in our patient was quite satisfactory and the patient is doing very well without pain or any symptoms. and reports excellent quality of life.

Conclusion: We recommend the use of bone cell therapy that can provide accelerated bone healing and clinical benefits in the short-term significant long-term clinical benefits for the patient.

Keywords: Non-union fracture, femoral neck, bone cell therapy, autologous osteoblasts.