bluuebunny/crossref_metadata_2025 huggingface dataset:
Reproductive genetic carrier screening for cystic fibrosis, fragile X syndrome and spinal muscular atrophy: patterns of community and healthcare provider participation in a Victorian screening program
Authors: Leibowitz Ruth , Lewis Sharon , Emery Jon , Massie John , Smith Melanie , Delatycki Martin , Archibald Alison
Published: October 2022

Background The Royal Australian and New Zealand College of Obstetricians and Gynaecologists and The Royal Australian College of General Practice recommend that information on carrier screening for at least the most common inherited genetic conditions in our population, that is, thalassaemia, cystic fibrosis (CF), spinal muscular atrophy (SMA), and fragile X syndrome (FXS), should be offered to all women planning pregnancy or in early pregnancy regardless of family history or ethnicity. The aim of this study was to investigate patterns of participation by healthcare providers (HCP) and the community in screening. Methods Participation in a Victorian program screening for CF, SMA and FXS between September 2013 and October 2018 was analysed. Requesting HCP and patient data were extracted from screening request forms. Data were analysed with respect to profession of requesting HCP, and characteristics of women screened (age, pregnancy status, socioeconomic status, geographic location, and family history of CF, SMA or FXS). In total, 21 172 women and 1288 HCPs participated in the program over this period. Results There was a steep socioeconomic gradient in screening uptake, with nearly half the women screened (10 349) being in the highest socioeconomic quintile. The screening rate was much higher in metropolitan areas than in regional areas. Obstetricians made most of the requests for screening, whereas 20% of requests were by GPs. Most participating GPs only made a single screening request (78%) and very few GPs made >100 screening requests compared with obstetricians (0.2% vs 17%). GPs were more likely to screen women before pregnancy compared with obstetricians (47% vs 11%). Approximately 1.5% of Victorian women of child-bearing age and 3% of pregnant Victorian women were screened by this program over the period of this study. Conclusion This study highlights the translation gap between recommendations and practice, with marked inequity of access to reproductive genetic carrier screening in relation to socioeconomic status and geography. Increased participation by GPs could improve community access to reproductive genetic carrier screening, particularly access to preconception screening. Addressing the causes of inequity of access will allow more women and couples the opportunity to make informed choices about participation in screening.
Tailoring childhood immunisation services in a socioeconomically disadvantaged community in New South Wales, Australia: a cost analysis
Authors: Thomas Susan , Williamson Kirsten , Ling Rod , Dolja-Gore Xenia , Islam Fakhrul M. , Higgins Helen , Durrheim David N. , Searles Andrew
Published: October 2022

Background Using the World Health Organization’s ‘Guide to Tailoring Immunization Programmes’ (TIP), a three-step program was developed by health services in partnership with a marginalised community in New South Wales, Australia. The aim was to improve immunisation rates of 1-year-old children. For Step 1, nurses identified and monitored local children overdue for immunisation from a national register, and sent parents or family doctors reminders by mail or telephone. For Step 2, parents were offered appointments at a local health centre; and for Step 3, they were offered home visits. Methods An economic costing study was undertaken to examine the program’s resource use. Costs were collected between 1 June 2020 and 31 May 2021. Case records were obtained for 139 children. Results A total of 56 children became up to date after receiving TIP services; most after receiving Step 1 services (n = 37). Total annual costs (A$) for the program were $34 250 or $246 per case; or $612 per case becoming up to date. At $44 per case and $98 per case becoming up to date, Step 1B: personalised reminders, was the lowest costing step. Sensitivity analysis showed a possible 8% program savings through employment of nurses with a lower salary and use of video conference meetings. Conclusion This study provides information to the local health provider on the cost of TIP alongside their community-based programs. It also identified ways in which TIP could be made more cost-effective. Decision-makers can use this information to consider whether the investment in TIP is recommended.
Diurnal rhythms in testicular blood flow, testicular morphometry and reproductive hormones in Shiba goats
Authors: Samir Haney , Mandour Ahmed S. , Radwan Faten , Swelum Ayman A. , Yoshida Tomohiko , Tanaka Ryou , Nagaoka Kentaro , Watanabe Gen
Published: October 2022

Context Testicular blood flow (TBF) is crucial for testicular function. The pattern of TBF in Shiba goats indicates seasonal variations. Aims This study aimed to investigate the effect of diurnal variations on TBF, testis volume (TV), testicular echogenicity, and reproductive hormones in goats over a 24-h period. Methods In three trials that went for three consecutive days each, 12 bucks were scanned using Triplex ultrasonography to assess the TV, pixel intensity of testicular echotexture (PIX), and Doppler indices of TBF (resistive index: RI and pulsatility index: PI) in four-time points a day (at 6.00, 12.00, 18.00, and 00.00 h). Concomitantly, the changes in circulating FSH, LH, inhibin, testosterone (T), estradiol (E2), cortisol, and melatonin were assessed. Key results Results revealed diurnal alterations in the calculated RI of TBF and the PIX of testicular parenchyma (P < 0.05). Lower RI values of the TBF were observed at 6.00 h compared to other time points. There were significant diurnal alterations in the levels of FSH (P < 0.05), LH (P < 0.05), T (P < 0.0001), E2 (P < 0.0001), cortisol (P < 0.0001), and melatonin (P < 0.0001). FSH attained a higher concentration at 18.00 h compared to 12.00 h. Concentrations of LH were significantly higher at 06.00 h compared to those at 18.00 h. Concentrations of T were significantly higher at 6.00 compared to other time points. E2 showed higher concentrations at 6.00 h and 00.00 h compared to 12.00 h and 18.00 h. On the contrary, concentrations of cortisol were significantly higher at 12.00 h and 18.00 h compared to 06.00 h and 00.00 h. The highest concentrations of melatonin were observed at 00.00 h compared to other time points, while the lowest concentrations were at 12.00 h. Conclusions Diurnal rhythm induces significant changes in TBF, testicular PIX, and circulating FSH, LH, T, E2, cortisol, and melatonin over the 24-h day. Implications The outcomes of the study are reflected in the advisability of monitoring the TBF at a fixed time a day to avoid the circadian rhythm effect.
Sonochemically synthesized mesoporous cobalt oxide nanoparticles for luminol-enhanced chemiluminescence sensing
Authors: Darbandi Masih , Alahmadi Maryam Sadat , Amjadi Mohammad , Hallaj Tooba
Published: October 2022

In recent years, mesoporous cobalt oxides have attracted more attention due to their exceptional physical and chemical properties and their important applications in various fields. The synthesis of cobalt oxides of various sizes, morphologies, and porosity is still a challenging process. In this report, mesoporous Co3O4 NPs with different porosity were synthesized through facile, one-step, and cost-effective routes, without using any complicated materials or instruments, via the sonochemical process. X-ray powder diffraction (XRD), BET, and transmission electron microscopy (TEM) were used to characterize the as-synthesized NPs. XRD technique was used to determine the crystal structure and phase of the NPs, BET to describe the porous nature of the NPs, and TEM to investigate the structure and morphology of the NPs. Next, the effect of as-synthesized Co3O4 NPs as a catalyst for the luminol-H2O2 chemiluminescence system was studied. Co3O4 NPs were chosen since they have nanoscale size, high specific surface area, and mesoporous nature. Therefore, these NPs can form more active sites and thus show unique catalytic activity than common ionic catalysts such as Co2+, Fe3+, Cu2+ used in the luminol-H2O2 CL system. Finally, this system was used to detect and measure H2O2 and glucose under optimal conditions. A good linear relationship was observed between the chemiluminescence intensity of the designed system and the concentration of H2O2 and glucose. A linear range like 0.25–10 pM for H2O2 and 1–30 nM for glucose was obtained. The excellent LOD of the proposed method for measuring H2O2 was about 0.07 pM, and for measuring glucose was about 0.14 nM.
Molecular dynamics simulations on the connectivity of topologically close-packed clusters in TiAl3 alloys
Authors: Gao Tinghong , Bian Zhetian , Gao Yue , Wang Bei , Liu Yutao , Xie Quan , Chen Qian , Xiao Qingquan , Liang Yongchao
Published: October 2022

Presently, there has been increasing attention on TiAl3, which is commonly used for fabricating power aviation devices owing to its good oxidation resistance and outstanding mechanical properties in high-temperature. As the microstructures determine the macroscopic properties of a material, we investigated the connectivity of icosahedral central atoms in TiAl3 using conventional methods in this study. The topologically close-packed (TCP) structures are present in supercooled liquids, metallic glasses, and metallic liquids. They are intrinsic to liquid metals and are an essential character of the structure in metallic glasses (MGs). However, because of the lack of the concept of connectivity of the TCP structures, we investigated connectivity from the icosahedral central atoms to TCP structures, and a formula was proposed to calculate the connectivity of the TCP structures. Based on the results, low temperatures and cooling rates are conducive to generate high connectivity between icosahedral central atoms and TCP structures. The proposed formula can characterize the connectivity of the TCP structures. These findings open new opportunities for conducting research on the connectivity of clusters in binary alloys.
Uncertainty evaluation in reference material characterization by double isotope dilution inductively coupled plasma mass spectrometry (ID-ICP-MS)
Authors: Lee Jong Wha
Published: October 2022

Double isotope dilution inductively coupled plasma mass spectrometry (ID-ICP-MS) is one of the most important measurement methods in the establishment of measurement standards for inorganic analysis. However, there is still no good consensus on approaches for uncertainty evaluation in double ID-ICP-MS. Particularly, approaches to treating the instrumental isotopic fractionation (IIF) phenomenon and correlation between uncertainty sources are diverse and often unclear in the literature. Here, an approach for uncertainty evaluation in double ID-ICP-MS measurements is described. Using three certified reference materials (CRMs), it is shown that the IIF effects cancel out and should not be included in the uncertainty budget. Further, a consistent way of considering correlated sources of uncertainty to prevent double counting of uncertainties is described in detail along with an example of measuring the mass fraction of magnesium in an oyster powder CRM.
Increasing risk from landfalling tropical cyclone-heatwave compound events to coastal and inland China
Authors: Wu Jie , Chen Yang , Liao Zhen , Gao Xuejie , Zhai Panmao , Hu Yamin
Published: October 2022

Tropical cyclones (TCs) and heatwaves are amongst the most deadly and costly natural hazards. Despite considerable advances in understanding each of them, their occurrences in rapid sequence (e.g. in a week) that introduce disproportionately large impacts to infrastructure and human health have received far less attention. Based on dynamical downscaling simulations, we project that currently rare landfalling TC-heatwave compound events would be five to ten times more frequent in coastal Southeast China, and migrate northward and westward to the intact interior. It is the substantial increase in heatwaves that contributes most to the projected increase in frequency and novel emergence of compound events. There would be higher fraction of severer compound events composed of either intense TCs (in the top 10% historically) or exceptional heatwaves (above the historical 99.9th percentile), with coastal Southeast China even bracing for out-of-ordinary combinations of the two. On top of the unprecedented frequency, intensity and land exposure, future emergence of unseasonal compound events in South and Southeast China would further overwhelm local adaptive capacities.
Intra and interspecific variability of Quercus suber and Quercus canariensis, an intrinsic water-use efficiency approach for differentiation
Authors: Frouja Olfa , Hammami Majdi , Dakhlaoui Sarra , Wannes Wissem Aidi , Hessini Kamel , Msaada Kamel , Ben Ahmed Hela
Published: October 2022

In Tunisia, the oak forest is essentially restricted to the north-west (Kroumirie and Mogods), which is the wettest zone of the country. It forms ecosystems of great ecological and socio-economic interest. This is a significant source of income for local population. In addition, it contributes to soil conservation and is home to a rich and diversified fauna and flora and offers the region a picturesque landscape. This precious and fragile forest capital is currently threatened under the effect of various pressures, mainly the browsing of young plants being reconstituted and vegetative competition regarding resources of the environment. Hence the interest in studying the intra and interspecific variability of the oak, this study is essentially based on the morphological and physiological comparison of the two species of oak, Quercus suber and Quercus canariensis with their cohabitation in the same area, this variability was carried out by multivariate biostatistical analyzes using a set of data including morphological traits, isotopic analysis of the leaves, water use efficiency, as well as the phenolic composition and antioxidant activities of the leaves extracts. The results showed that leaf morphology and water use efficiency are discriminating factors for differentiation to choose the right specie that will be used for reforestation. The Q. canariensis specie growing in the Bni Mtir region was characterized by a high intrinsic water-use efficiency and high biomass recovery. These results let us suppose that Q. canariensis was the perfect specie for reforestation given its ability to produce a large amount of biomass with less water, which is what environmentalists demand.
Additive-assisted defect passivation of perovskite with metformin hydrochloride: toward high-performance p-i-n perovskite solar cells
Authors: Huang Zhezhi , Fu Jianfei , Ji Wenxi , Zhang Longgui , Chen Qiaoyun , Zhang Zelong , Zhou Yi , Song Bo
Published: October 2022

Defects at the grain boundaries and surfaces of perovskite thin films are the key factors that cause nonradiative recombination, thus restricting the performance of perovskite solar cells (Pero-SCs). By introducing foreign additives to manage the chemical environment of the precursor, perovskite films can obtain optimized morphology and reduced defects, thereby enhancing the photovoltaic performance and stability of derived Pero-SCs. Herein, we report the bifunctional molecule metformin hydrochloride (MetHCl), whose multidentate structure is capable of simultaneously passivating several sorts of defects in perovskite films. Concurrently, the strong binding ability to Pb2+ makes it impressive in regulating perovskite crystallization. The nonvolatile MetHCl can remain in the perovskite film, contributing to acquiring a high-quality film with denser grains and fewer pinholes. Finally, p-i-n Pero-SCs containing the MetHCl additive exhibited enhanced stability and achieved a champion power conversion efficiency of 21.59% with an open-circuit voltage of 1.17 V.
Total Positivity in Symmetric Spaces
Authors: Lusztig G.
Published: October 2022

In this paper we extend the theory of total positivity for reductive groups to the case of symmetric spaces.
Active Postlicensure Safety Surveillance for Recombinant Zoster Vaccine Using Electronic Health Record Data
Authors: Nelson Jennifer C , Ulloa-Pérez Ernesto , Yu Onchee , Cook Andrea J , Jackson Michael L , Belongia Edward A , Daley Matthew F , Harpaz Rafael , Kharbanda Elyse O , Klein Nicola P , Naleway Allison L , Tseng Hung-Fu , Weintraub Eric S , Duffy Jonathan , Yih W Katherine , Jackson Lisa A
Published: October 2022

Recombinant zoster vaccine (RZV) (Shingrix; GlaxoSmithKline, Brentford, United Kingdom) is an adjuvanted glycoprotein vaccine that was licensed in 2017 to prevent herpes zoster (shingles) and its complications in older adults. In this prospective, postlicensure Vaccine Safety Datalink study using electronic health records, we sequentially monitored a real-world population of adults aged ≥50 years who received care in multiple US Vaccine Safety Datalink health systems to identify potentially increased risks of 10 prespecified health outcomes, including stroke, anaphylaxis, and Guillain-Barré syndrome (GBS). Among 647,833 RZV doses administered from January 2018 through December 2019, we did not detect a sustained increased risk of any monitored outcome for RZV recipients relative to either historical (2013–2017) recipients of zoster vaccine live, a live attenuated virus vaccine (Zostavax; Merck & Co., Inc., Kenilworth, New Jersey), or contemporary non-RZV vaccine recipients who had an annual well-person visit during the 2018–2019 study period. We confirmed prelicensure trial findings of increased risks of systemic and local reactions following RZV. Our study provides additional reassurance about the overall safety of RZV. Despite a large sample, uncertainty remains regarding potential associations with GBS due to the limited number of confirmed GBS cases that were observed.
scSemiGAN: a single-cell semi-supervised annotation and dimensionality reduction framework based on generative adversarial network
Authors: Xu Zhongyuan , Luo Jiawei , Xiong Zehao
Published: October 2022

Motivation

Cell-type annotation plays a crucial role in single-cell RNA-seq (scRNA-seq) data analysis. As more and more well-annotated scRNA-seq reference data are publicly available, automatical label transference algorithms are gaining popularity over manual marker gene-based annotation methods. However, most existing methods fail to unify cell-type annotation with dimensionality reduction and are unable to generate deep latent representation from the perspective of data generation.

Results

In this article, we propose scSemiGAN, a single-cell semi-supervised cell-type annotation and dimensionality reduction framework based on a generative adversarial network, to overcome these challenges, modeling scRNA-seq data from the aspect of data generation. Our proposed scSemiGAN is capable of performing deep latent representation learning and cell-type label prediction simultaneously. Through extensive comparison with four state-of-the-art annotation methods on diverse simulated and real scRNA-seq datasets, scSemiGAN achieves competitive or superior performance in multiple downstream tasks including cell-type annotation, latent representation visualization, confounding factor removal and enrichment analysis.

Availability and implementation

The code and data of scSemiGAN are available on GitHub: https://github.com/rafa-nadal/scSemiGAN.

Supplementary information

Supplementary data are available at Bioinformatics online.
Mitotic exchange in female germline stem cells is the major source of Sex Ratio chromosome recombination in Drosophila pseudoobscura
Authors: Koury Spencer
Published: October 2022

Sex Ratio chromosomes in Drosophila pseudoobscura are selfish X chromosome variants associated with 3 nonoverlapping inversions. In the male germline, Sex Ratio chromosomes distort the segregation of X and Y chromosomes (99:1), thereby skewing progeny sex ratio. In the female germline, segregation of Sex Ratio chromosomes is mendelian (50:50), but nonoverlapping inversions strongly suppress recombination establishing a 26-Mb haplotype (constituting ∼20% of the haploid genome). Rare crossover events located between nonoverlapping inversions can disrupt this haplotype, and recombinants have sometimes been found in natural populations. We recently reported on the first lab-generated Sex Ratio recombinants occurring at a rate of 0.0012 crossovers per female meiosis. An improved experimental design presented here reveals that these recombination events were at least 4 times more frequent than previously estimated. Furthermore, recombination events were strongly clustered, indicating that the majority arose from mitotic exchange in female germline stem cells and not from meiotic crossing-over in primary oocytes. Finally, asymmetric recovery of complementary recombinants was consistent with unequal exchange causing the recombination-induced viability defects. Incorporating these experimental results into population models for Sex Ratio chromosome evolution provided a substantially better fit to natural population frequencies and allowed maintenance of the highly differentiated 26-Mb Sex Ratio haplotype without invoking strong epistatic selection. This study provides the first estimate of spontaneous mitotic exchange for naturally occurring chromosomes in Drosophila female germline stem cells, reveals a much higher Sex Ratio chromosome recombination rate, and develops a mathematical model that accurately predicts the rarity of recombinant Sex Ratio chromosomes in natural populations.
Associations between water insecurity and depression among refugee adolescents and youth in a humanitarian context in Uganda: cross-sectional survey findings
Authors: Logie Carmen H , Okumu Moses , Loutet Miranda , Berry Isha , Taing Lina , Lukone Simon Odong , Kisubi Nelson , Sokolovic Nina , Kyambadde Peter
Published: October 2022

Background

Water insecurity is linked to poor mental health through intrapersonal, relational and community-based stressors. We examined water insecurity and depression among refugee youth in Bidi Bidi, Uganda.

Methods

We conducted a cross-sectional survey and multivariable ordinal logistic regression to examine associations between water insecurity and depression severity, adjusting for gender, resilience, social support and food insecurity.

Results

Among participants (n=115; mean age: 19.7 y, SD 2.3), 80.0% reported water insecurity and 18.3% had moderate/severe depression symptoms. Water insecurity was independently associated with higher levels of depression severity (adjusted OR: 5.61; 95% CI 1.20 to 26.30; p=0.03).

Conclusions

Findings suggest water insecurity was commonplace and associated with depression. Water insecurity could be integrated in refugee mental health promotion by policymakers and community-based programmers.
Supernova remnant W51C: optical and X-ray emission analysis
Authors: Reyes-Iturbide J , Ramírez-Ballinas I , Rosado M , Núñez D , Ambrocio-Cruz P , Arias L , Gabbasov R
Published: October 2022

We present observations of the optical and X-ray emission from the Galactic supernova remnant W51C. From [S ii] Fabry–Pérot interferometry and H α and [S ii] images we detect filaments that are part of the optical counterpart of the supernova remnant. We obtain the kinematic distance to W51C, showing that it is one of the shortest distances reported in the literature. We also estimate other physical properties such as the velocity of the shock induced in the cloudlets emitted at optical wavelengths and the electron density of those cloudlets. From XMM–Newton observatory archival data, we obtain images of the diffuse X-ray emission of this supernova remnant. The spectrum of the X-ray emission is explored to estimate X-ray parameters such as luminosity and temperature of the hot plasma in the supernova remnant. We fit a thermal model with a plasma temperature of 1.4 keV for an X-ray thermal luminosity of 2.0 × 1036 erg s−1. With the parameters described above we test the model proposed by White & Long to explain the mixed morphology observed in W51C. We obtain an initial energy of the supernova explosion of 8.4 × 1050 erg and an age of 13 000 yr. The derived initial energy is typical of supernova remnants, but in disagreement with respect to older estimations that found higher values and suggested that W51C was the result of the explosion of two supernovae.
African-Centered Social Work in the 21st Century: A Content Analysis
Authors: Lateef Husain , Gale Adrian , Boyd Donte , Arab Hassan , Amoako Emmanuel , Williams Ed-Dee
Published: October 2022

Endorsement of African-centered theory and practice are widespread within Black communities across the United States. The usage of African-centered frameworks is also common among many Black social workers. However, past research suggests that African-centered theory and subsequent models of practice are marginalized within social work literature and curricula. Since advocacy began for the inclusion of African-centered approaches to practice during the mid to late 1990s, there have been no strategic analyses tracing how African-centered scholarship has advanced within social work. This study sought to examine to what extent the African-centered framework is included within scholarship among prominent social work journals. A content analysis was conducted of articles in six major social work journals published between 2000 and 2019. A total of 42 articles met the criteria for inclusion. While there has been a level of change in the number of published articles of African-centered social work, findings suggest that relative to other practice modalities/models, African-centered scholarship is noticeably lacking in social work literature. The article concludes with implications to advance culturally responsive research and practice with communities of African descent.
Butler-Sloss v The Charity Commission: ESG investment guidance in need of elaboration
Authors: Broadway Luke
Published: October 2022

In Butler-Sloss v The Charity Commission the High Court granted the trustees of environmental protection charities permission to enact a policy that excluded investments incompatible with the Paris Climate Agreement. Though a sound conclusion, the court’s reasoning, when taken alongside the policy proposed by the claimant charities, generates investment guidance that is unsuited for practical implementation. This article commences with an analysis of the judgment’s approach to risk and returns. Although the court’s position on reputation risk is commendable, the dicta focusing on portfolio risk, as well as the lack of distinction between income and capital returns, introduce serious liquidity threats. These difficulties undermine the institutional relevance of the charitable trust. In its second part the article advances to explore the court’s overextension of the powers of trustees to invest on moral grounds. At best this extension conflicts with a trustee’s duty to diversify their fund’s portfolio, and at worst it risks allowing trustees to completely bypass financial considerations. It is concluded that more elaborate ESG investment guidance is needed.
Ambulatory anesthesia and discharge: an update around guidelines and trends
Authors: Rohi Ayda , Olofsson Maria E.T. , Jakobsson Jan G.
Published: October 2022

Purpose of review

Provide an oversight of recent changes in same-day discharge (SDD) of patient following surgery/anesthesia.

Recent findings

Enhanced recovery after surgery pathways in combination with less invasive surgical techniques have dramatically changed perioperative care. Preparing and optimizing patients preoperatively, minimizing surgical trauma, using fast-acting anesthetics as well as multimodal opioid-sparing analgesia regime and liberal prophylaxis against postoperative nausea and vomiting are basic cornerstones. The scope being to maintain physiology and minimize the impact on homeostasis and subsequently hasten and improve recovery.

The increasing adoption of enhanced protocols, including the entire perioperative care bundle, in combination with increased use of minimally invasive surgical techniques have shortened hospital stay. More intermediate procedures are today transferred to ambulatory pathways; SDD or overnight stay only. The traditional scores for assessing discharge eligibility are however still valid. Stable vital signs, awake and oriented, able to ambulate with acceptable pain, and postoperative nausea and vomiting are always needed. Drinking and voiding must be acknowledged but mandatory. Escort and someone at home the first night following surgery are strongly recommended. Explicit information around postoperative care and how to contact healthcare in case of need, as well as a follow-up call day after surgery, are likewise of importance. Mobile apps and remote monitoring are techniques increasingly used to improve postoperative follow-up.
The Relationship Between Sleep Traits and Tinnitus in UK Biobank: A Population-Based Cohort Study
Authors: Peng Jiajia , Dong Yijun , Luo Yaxin , Qiu Ke , Cheng Danni , Rao Yufang , Song Yao , Pang Wendu , Mu Xiaosong , Hu Chunhong , Chen Hongchang , Zhang Wei , Xu Wei , Ren Jianjun , Zhao Yu
Published: October 2022

Objectives:

Understanding the association between sleep traits and tinnitus could help prevent and provide appropriate interventions against tinnitus. Therefore, this study aimed to assess the relationship between different sleep patterns and tinnitus.

Design:

A cross-sectional analysis using baseline data (2006–2010, n = 168,064) by logistic regressions was conducted to evaluate the association between sleep traits (including the overall health sleep score and five sleep behaviors) and the occurrence (yes/no), frequency (constant/transient), and severity (upsetting/not upsetting) of tinnitus. Further, a prospective analysis of participants without tinnitus at baseline (n = 9581) was performed, who had been followed-up for 7 years (2012–2019), to assess the association between new-onset tinnitus and sleep characteristics. Moreover, a subgroup analysis was also carried out to estimate the differences in sex by dividing the participants into male and female groups. A sensitivity analysis was also conducted by excluding ear-related diseases to avoid their confounding effects on tinnitus (n = 102,159).

Results:

In the cross-sectional analysis, participants with “current tinnitus” (OR: 1.13, 95% CI: 1.04–1.22, p = 0.004) had a higher risk of having a poor overall healthy sleep score and unhealthy sleep behaviors such as short sleep durations (OR: 1.09, 95% CI: 1.04–1.14, p < 0.001), late chronotypes (OR: 1.09, 95% CI: 1.05–1.13, p < 0.001), and sleeplessness (OR: 1.16, 95% CI: 1.11–1.22, p < 0.001) than those participants who “did not have current tinnitus.” However, this trend was not obvious between “constant tinnitus” and “transient tinnitus.” When considering the severity of tinnitus, the risk of “upsetting tinnitus” was obviously higher if participants had lower overall healthy sleep scores (OR: 1.31, 95% CI: 1.13–1.53, p < 0.001). Additionally, short sleep duration (OR: 1.22, 95% CI: 1.12–1.33, p < 0.001), late chronotypes (OR: 1.13, 95% CI: 1.04–1.22, p = 0.003), and sleeplessness (OR: 1.43, 95% CI: 1.29–1.59, p < 0.001) showed positive correlations with “upsetting tinnitus.” In the prospective analysis, sleeplessness presented a consistently significant association with “upsetting tinnitus” (RR: 2.28, p = 0.001). Consistent results were observed in the sex subgroup analysis, where a much more pronounced trend was identified in females compared with the males. The results of the sensitivity analysis were consistent with those of the cross-sectional and prospective analyses.

Conclusions:

Different types of sleep disturbance may be associated with the occurrence and severity of tinnitus; therefore, precise interventions for different types of sleep disturbance, particularly sleeplessness, may help in the prevention and treatment of tinnitus.
Analysis of Factors Contributing to Perioperative Mohs Micrographic Surgery Anxiety: Patient Survey Study at an Academic Center
Authors: Kokoska Ryan E. , Szeto Mindy D. , Steadman Laryn , Au Jeremiah H. , Somani Ally-Khan
Published: October 2022

BACKGROUND

High perioperative patient anxiety is predictive of worse postoperative pain and quality of life. Several Mohs micrographic surgery (MMS) patient characteristics influence anxiety; however, the contributions of certain factors remain uncertain.

OBJECTIVE

Investigate factors influencing perioperative MMS patient anxiety, especially those with debated impact or unclear data.

METHODS

The authors surveyed 145 adult patients receiving MMS performed by a single MMS surgeon from 2018 to 2020. Patients self-reported demographics, history, and 10-point visual analog scale anxiety assessments at multiple stages. Health care provider (HCP)–perceived anxiety assessments were queried. A stepwise multiple regression modeling approach was used to explore potential factors.

RESULTS

Younger age, female sex, and a self-reported history of anxiety confirmed by prior HCP diagnosis were significant predictors of pre-MMS anxiety. Postoperative anxiety increased with more layers removed and higher pre-MMS anxiety. HCP–perceived patient anxiety increased with younger patient age, more layers removed, prior skin cancer removal, and HCP-perceived pre-MMS patient anxiety.

CONCLUSION

Anxiety-reducing interventions should target young female patients with a history of HCP-diagnosed anxiety, and patients with more layers removed. Prior skin cancer removal is associated with increased HCP-perceived intraoperative patient anxiety; however, it is not significant for patient-reported anxiety. Pre-MMS consultation may not be effective for anxiety reduction.
Sebaceous Carcinoma of the Face Treated With Mohs Micrographic Surgery
Authors: Meer Elana , Nguyen Brian , Luna Gabriela L. , Kim Diana , Bautista Sana , McGeehan Brendan , Giordano Cerrene , Etzkorn Jeremy , Miller Christopher , Briceño César A.
Published: October 2022

BACKGROUND

Mohs micrographic surgery (MMS) for sebaceous carcinoma (SC) may reduce local recurrence rates, but published case series have small cohorts and limited follow-up. Mohs micrographic surgery is particularly suitable for sensitive functional and cosmetic locations, such as the face, because it facilitates tissue conservation using complete peripheral and deep margin assessment before reconstruction. Coordinated care between Mohs and oculoplastic surgeons has not been described.

OBJECTIVE

To assess rates of local recurrence and metastasis after MMS of facial SC and to describe coordinated care between Mohs and oculoplastic surgeons.

MATERIALS AND METHODS

Retrospective review identified facial SC cases treated with MMS at a single institution from January 2005 to August 2020. Tumor characteristics and outcomes were recorded. Descriptive and predictive analyses were performed.

RESULTS

Forty-nine cases were reviewed with a mean follow-up of 51 months. The most common sites were periorbital, infraorbital cheek, and nasal ala. No patients experienced regional recurrence after MMS. One patient with Muir–Torre syndrome developed metastatic recurrence (at 82.9 months). All patients underwent 2-stage reconstruction with dermatology-performed MMS and oculoplastic reconstruction.

CONCLUSION

Collaboration between Mohs and oculoplastic surgeons with a tissue-sparing approach of MMS can reduce recurrence and optimize cosmesis and function for central facial SC.
Rate and Characteristics of Incompletely Excised Cutaneous Squamous Cell Carcinoma: A Dermatological Daily Practice Multicenter Prospective Cohort Study
Authors: van Lee Charlotte B. , Kouloubis Nina , Wakkee Marlies , Kelleners-Smeets Nicole W.J. , Nellen Ruud G.L. , van Rengen Annik , de Vijlder Hanke C. , Wijne Leon C.C. , Nijsten Tamar , van den Bos Renate R.
Published: October 2022

BACKGROUND

Incomplete excision of squamous cell carcinoma (cSCC) is associated with an increased risk of recurrence, metastasis, and mortality.

OBJECTIVE

To determine the rate and characteristics of incompletely excised cSCC in a dermatological daily practice setting.

METHODS

Prospective study of all patients who gave informed consent, with a cSCC treated with standard excision (SE) at 1 of 6 Departments of Dermatology in the Netherlands between 2015 and 2017. Pathological reports were screened to detect all incompletely excised cSCCs.

RESULTS

A total of 592 patients with 679 cSCCs were included, whereby most cases were low risk cSCC (89%). The rate of incompletely excised cSCC was 4% (n = 26), and the majority were high-risk cSCCs of which 24 invaded the deep excision margin.

CONCLUSION

This prospective study showed that in a dermatological setting, the risk of an incompletely excised cSCC is low (4%) for a cohort that was dominated by low-risk cSCCs. Most incompletely excised cSCCs were of high risk, and incompleteness was almost always at the deep margins. These results suggest that for high-risk cSCC, one should pay attention especially to the deep margin when performing SE, and/or microscopic surgery should be considered.
Perimenopause meets life: observations from the Women Living Better Survey
Authors: Woods Nancy Fugate , Coslov Nina , Richardson Marcie K.
Published: October 2022

Objective

The purpose of these analyses was to test a predictive quantitative model relating personal characteristics, reproductive aging stages, health behaviors, roles, stressors, and satisfaction with life roles to bothersome symptoms experienced during the late reproductive stage and the menopausal transition (MT).

Methods

Participants (N = 2,406) aged 35 to 55 years completed the Women Living Better Survey online between March to August 2020, and 1,529 met the inclusion criteria and provided menstrual cycle data for staging reproductive aging. They were recruited from the Women Living Better newsletter and from other online groups of midlife women. Hierarchical regression analysis using a two-stage model tested the effect of several factors on each of five bothersome symptom groups: brain fog, volatile mood, fatigue/pain, vasomotor/sleep disruption, and anxiety/vigilance symptoms. In stage I, personal characteristics, reproductive aging stage, and health behaviors were examined, and in stage II roles (ie, caregiver, partner, employment-related), satisfaction with life roles and stressors associated with roles were added.

Results

More bothersome brain fog symptoms were associated with less education, MT (vs late reproductive stage), low satisfaction with life roles, and greater health-related and overcommitment stress (all P < 0.005). More bothersome volatile mood symptoms were associated with health-related, partner relationship, and other relationship stress. More bothersome fatigue/pain symptoms were associated with less education and greater difficulty paying for basics and health-related and other relationship stress. Vasomotor/sleep-onset symptoms were associated with less education, MT, and health-related and work stress. More bothersome anxiety/vigilance symptoms were associated with less education, more difficulty paying for basics, and health and work stress.

Conclusions

Recognizing that midlife stress comes from many role- and relationship-related sources and that several of these stressors are associated with greater symptom bother supports the importance of proactive identification and management of sources of stress.
The exciting and magical journey of components from compound formulae to where they fight
Authors: Meng Ning , Lyu Yun , Zhang Xiaoyu , Chai Xin , Li Kefeng , Wang Yuefei
Published: October 2022

With its long-term empirical clinical practice and increasing number of health benefits reported, Chinese Materia Medica (CMM) is gaining increasing global acceptance. Importantly, the identification of chemical constituents in vitro and exposed forms in vivo is a prerequisite for understanding how CMM formulae prevent and treat diseases. This review systematically summarizes the exciting and magical journey of CMM components from compound formulae to where they fight, the possible structural transformation of CMM components in vitro and in vivo, and their pharmacological contribution. When a decoction is prepared, significant chemical reactions are observed, including degradation and production of polymers and self-assembling supramolecules, leading to the construction of a component library with diverse decoction structures. After ingestion, compounds pass through the intestinal and blood-brain barriers and undergo a more wonderful journey involving the gut microbiota, microbial enzymes, and endogenous drug-metabolizing enzymes (mainly liver enzymes). At this stage, they are modified and assembled into novel and complex compounds, such as newly generated metabolites, conjugates, and self-assembling superamolecules. This review might provide a strategic orientation to explore the active compounds of CMM formulae in vivo.
The effect of Mitomycin-C in neoadjuvant concurrent chemoradiotherapy for rectal cancer
Authors: Wang Ling-Wei , Liu Yu-Shih , Jiang Jeng-Kai
Published: October 2022

Background:

Neoadjuvant concurrent chemoradiotherapy (nCCRT) followed by total mesorectal excision has become the standard of care for advanced rectal cancer, but the most effective regimen of chemotherapeutic agents has not yet been determined. The purpose of this study is to determine the effect of Mitomycin-C (MMC) in nCCRT for rectal cancer.

Methods:

From 2000 to 2017, patients with rectal adenocarcinoma who received nCCRT followed by radical surgery were enrolled in our study. The patients were retrospectively separated into two groups according to nCCRT regimens (with or without MMC). Other factors related to cancer down-staging after nCCRT, disease-free survival (DFS) and overall survival (OS) were analyzed.

Results:

One hundred ninety-five patients received radiotherapy (RT) + MMC + oral tegafur-uracil (UFUR), and 191 patients received RT + UFUR without MMC as neoadjuvant CCRT. Adding MMC might increase the down-staging rate (odds ratio [OR] = 1.520, p = 0.058), and down-staging had significant effect to improve OS (OR = 1.726, p = 0.002) and DFS (OR = 2.185, p < 0.001). The OS and DFS were improved in patients who received MMC, although this result did not reach a statistically significant difference. There was a higher incidence of low-grade toxicities in the MMC group, especially neutropenia, genitourinary side effects, and dermatological side effects (p < 0.001).

Conclusion:

Adding MMC to the regimen of nCCRT for rectal adenocarcinoma is shown to increase tumor down-staging rate and improve disease-free and OS, although these benefits come at the cost of increased low-grade toxicities. Prospective randomized studies are needed to explore the role of MMC in nCCRT for rectal cancer.
A Critical Appraisal of Evidence on the Efficacy and Safety of Serotonergic Psychedelic Drugs as Emerging Antidepressants
Authors: Ledwos Nicole , Rosenblat Joshua D. , Blumberger Daniel M. , Castle David J. , McIntyre Roger S. , Mulsant Benoit H. , Husain M. Ishrat
Published: October 2022

Purpose/Background

There has been resurgence of interest in the therapeutic use of serotonergic (“classic”) psychedelics in major depressive disorder (MDD) and end-of-life distress. This commentary offers a critical appraisal of current evidence for antidepressant effects of classic psychedelics from contemporary clinical trials and highlights pitfalls that should be addressed before clinical translation.

Methods/Procedures

A narrative review was conducted to identify clinical trials of serotonergic psychedelics for the treatment of MDD and end-of-life distress. Trials published between January 1990 and May 2022 were identified on PubMed using combinations of search terms.

Findings/Results

Psilocybin, lysergic acid diethylamide, and ayahuasca have clinical trials to evaluate antidepressant effects. Two studies showed preliminary positive effects of single-dose ayahuasca for treatment-resistant depression. Similar results were seen in lysergic acid diethylamide for end-of-life distress. Small randomized clinical trials (RCTs) of psilocybin combined with psychotherapy showed superiority to waitlist controls and comparable efficacy and safety to an active comparator in MDD, with additional RCTs showing efficacy in end-of-life distress. Adverse events associated with psychedelics were reported as mild and transient. Small homogenous samples, expectancy bias, functional unblinding, and lack of consensus and standardization of psychotherapy are major limitations of all studies.

Implications/Conclusions

Given the methodological limitations of published RCTs, the evidence supporting the efficacy and safety of serotonergic psychedelics for depression is currently of low level. Future research should assess the role of expectancy and psychedelic effects in moderating and mediating treatment response. Innovative trial designs are needed to overcome functional unblinding. For now, psychedelics should remain experimental interventions used within clinical trials.
Clinician Perspectives on Cannulation for Extracorporeal Cardiopulmonary Resuscitation: A Mixed Methods Analysis
Authors: Wanigasekara Devindi , Pellegrino Vincent A. , Burrell Aidan JC. , Aung Nyein , Gregory Shaun D.
Published: October 2022

Out-of-hospital cardiac arrest is a leading cause of mortality with survival rates of less than 10%. In selected patients, survival may be improved via timely application of extracorporeal cardiopulmonary resuscitation (ECPR). However, ECPR is a complex and resource intensive intervention with a high risk of complications that impair widespread clinical adoption. This study employed a mixed approach of qualitative interview analysis embedded with quantitative data collection to uncover the major hurdles faced by clinicians during ECPR initiation. We conducted semi-structured interviews with eight ECPR intensive care specialists with 2–10 years of experience working at a large, tertiary ECPR center in Australia. Clinicians identified dilation as the most time-consuming step, followed by draping, and decision-making during extracorporeal membrane oxygenation patient selection. The most challenging step was the decision-making for patient selection, followed by dilation and imaging. These findings uncovered key barriers to ECPR, and identified priority areas for further research and clinical training. Major logistical hindrances will require well-defined protocols and improved clinical training. Engineering innovations in the identified areas may improve the delivery of ECPR, making it simpler and faster to deliver.