bluuebunny/crossref_metadata_2025 huggingface dataset:
Weh, talaga?! Camp, queer body, and the posthuman
Authors: Campos Michael Sepidoza
Published: September 2024

Queer subjectivity invites discussions around gender performativity, culture, narratives of “coming out,” and identity politics. Postcolonial queer subjects—like those emerging from the Philippines—require additional layers of critique attending to language, practice, and resistance. This brief reflection will explore the place of camp, rampa, and posthuman worldviews in the constitution of Filipino queer bodies. It argues that as queer narratives become global—and normalized— camp and rampa offer a place where queerness can both expand critical theology and imaginations of the human.
The impact of limited access to digital health records on doctors and their willingness to adopt electronic health record systems
Authors: Bouh Mohamed Mehfoud , Hossain Forhad , Paul Prajat , Rahman Md Moshiur , Islam Rafiqul , Nakashima Naoki , Ahmed Ashir
Published: September 2024

Objective

Research over the past decade has extensively covered the benefits of electronic health records in developing countries. Yet, the specific impact of their limited access on doctors’ workload and clinical decision-making, particularly in Bangladesh, remains underexplored. This study investigates current patients’ medical history storage mechanisms and associated challenges. It explores how doctors in Bangladesh obtain and review patients’ past medical histories, identifying the challenges they face. Additionally, it examines whether limited access to digital health records is an obstacle in clinical decision-making and explores factors influencing doctors’ willingness to adopt electronic health record systems in such contexts.

Method

An online cross-sectional survey of 105 doctors with Bachelor of Medicine, Bachelor of Surgery/Bachelor of Dental Surgery (MBBS/BDS) degrees and at least 2 years of experience was conducted, covering (a) personal information, (b) workload, (c) patient history challenges, and (d) decision-making.

Results

Out of 105 participants, 51.4% of them use paper-based methods with 56% facing challenges, versus 20% using digital methods. Most (94.3%) interview patients directly, and 80.9% are interested in a web-based, comprehensive medical history system. An ordinal regression model identified that the physicians’ disciplines, workload, and efficiency level of the current workplace in facilitating patient history-taking variables significantly affected willingness to adopt the described electronic health record in the survey.

Conclusion

Doctors in Bangladesh encounter significant challenges related to workload and clinical decision-making, largely attributed to restricted access to patients’ past medical histories. Despite the prevalent use of paper-based records, there is a notable willingness among these medical professionals to embrace electronic health record systems, indicating a potential shift towards more efficient healthcare practices in the region.
Winners always cheat? Regional identity and the myth of a rigged 2022 Philippine presidential election
Authors: Rye Ranjit Singh
Published: September 2024

This article draws its analysis from the results of an assessment conducted in October 2022 of the May 2022 presidential election. The 2022 presidential election in the Philippines is an historical turning point not only for marking the return of the Marcos family to the country's highest office but also due to the initial claim of electoral fraud that raised concerns about the integrity of automated polling in the country. In the context of the May 2022 election, our findings do not identify any clear demographic pattern linked to a lack of confidence or skepticism regarding the credibility of the election results. Instead, compelling evidence indicates that the belief in a rigged election is limited to a specific subset of voters aligned with the geographical support base of a defeated presidential candidate. The findings contribute to nuancing electoral dynamics in the Philippines in a number of ways. First, they dispel the myth of an impaired election floated by media and other international watchdogs immediately after the election. Second, the findings suggest that as citizens navigate their democratic responsibilities, their regional identity becomes a lens through which the fairness, transparency, and legitimacy of the electoral system are ultimately contested.
Comparison of the clinical efficacy of dienogest and drospirone/ethinyl estradiol in the treatment of ovarian endometriosis cysts
Authors: Xiao Qian , Hong Liwei , Li Chun , Hong Sijie , Li Yunsong , Yu Dingding , Liu Hongli
Published: September 2024

Background:

Ovarian endometriosis cysts (OEC) are common chronic diseases occurring in women of reproductive age. Hormone therapy, including the use of oral contraceptives (COCs) and progestins, is widely employed in the treatment of endometriosis and OEC.

Objective:

This study aims to compare therapeutic effects of long-term daily use of dienogest (DNG, 2 mg) versus drospirenone (DRSP, 3 mg)/ethinyl estradiol (EE, 20 μg) daily on ovarian endometrial cysts, particularly focusing on cysts suppression.

Methods:

A retrospective analysis was conducted on 84 patients diagnosed with OEC, with 42 receiving DNG and 42 treated with DRSP/EE. After 6 months, assessments were made regarding pain symptoms, size of OEC, tumor markers, and adverse reactions.

Results:

After 6 months of treatment, both DNG and DRSP/EE effectively alleviated pain in patients with ovarian endometriotic cysts. DNG demonstrated more significant improvements than DRSP/EE in reducing tumor size, mainly in terms of higher drug efficacy and greater percentage of tumor shrinkage. However, DRSP/EE significantly reduced the expression of the tumor markers CA125 and CA199 in our study. Patients taking DNG had a higher likelihood of experiencing side effects than those on DRSP/EE, mainly vaginal bleeding and irregular menstrual periods.

Conclusions:

Both DNG and DRSP/EE are effective in treating ovarian endometrial cysts. DNG appears to be superior in terms of tumor reduction, while DRSP/EE more significantly decreases the expression of the tumor markers and has fewer side effects.
Media Sentiment and Its Role in Shaping IPO Performance
Authors: Singh Amit Kumar , Shrivastav Rohit Kumar , Harjai Priya
Published: September 2024

The media performs an essential role in providing information regarding initial public offerings (IPOs) to investors. Often, public information about IPO companies is scarce and investors find it difficult to comprehend complex documents, making media a cost-effective and authentic source of information. This study explores how media sentiment affects the underpricing and initial aftermarket performance of IPOs using 3,124 media articles published from April 2019 to March 2022. In doing so, the authors employed textual sentiment analysis using the Loughran and McDonald dictionary to deduce the media net sentiment score. Subsequently, robust regression is conducted by incorporating the media sentiment, the volume of media articles, and other control variables. The result mentions that the way media present information has the potential to influence the decision of retail investors. The net sentiment score shows that the positive information in the media article makes investors optimistic about the prospects of the business. It boosts their confidence and creates more demand for shares, thereby increasing the IPO’s first-day market-adjusted abnormal return. Further, it has been discovered that media sentiment significantly influences initial aftermarket performance primarily due to the limited trading history available for the IPO company during the initial stage.
Anconeus Exertional Compartment Syndrome and Posterolateral Rotatory Elbow Instability: A Clinical Association and Rare Cause of Elbow Pain
Authors: Hoy Gregory , James Trefor , Jarman Paul , Warby Sarah
Published: September 2024

Background:

Anconeus compartment syndrome is a rarely reported compartment syndrome in the anconeus muscle compartment of the forearm. It has anatomic and pathophysiological associations with posterolateral rotatory instability (PLRI) of the elbow.

Purpose:

To present the history, management, and outcomes of 4 patients with anconeus compartment syndrome. Secondary aims were to (1) establish normative anconeus pressures and (2) measure the volume of this compartment with and without PLRI in cadavers.

Study Design:

Case series; Level of evidence, 4.

Methods:

Four patients with clinical signs of anconeus compartment syndrome (2 gymnasts, 1 swimmer, and 1 footballer/weightlifter) were identified over a 3-year period (2015-2017 inclusive). Patient history, sporting activity, physical examination, anconeus compartment pressures, and treatment outcomes were recorded. Manometry of the anconeus compartment in 2 healthy male controls was performed to establish normative compartment pressures. Anconeus volumetric anatomy and the effect of creating PLRI on compartment volume was investigated in 4 cadaveric elbows.

Results:

All 4 patients had microtraumatic PLRI, and 2 patients had anconeus hypertrophy. Anconeus compartment pressures at rest and at 2-minutes postexercise were median 28.0 and 67.5 mm Hg, respectively, in the patients and mean 16.5 and 18 mm Hg, respectively, in the controls. Simultaneous fasciotomy and PLRI reconstructive procedures were performed in 2 patients, with outcomes showing full return to competition. Fasciotomy alone was performed in 2 patients to allow return to competition, with both requiring later reconstruction to address PLRI. Cadaver dissection revealed that the anconeus compartment was extremely small and that creation of PLRI reduced the direct volume of the compartment and increased the distance between the anconeus origin and insertion.

Conclusion:

Our case series demonstrated that anconeus compartment syndrome can occur in upper limb-dominant athletes in the presence of PLRI and anconeus hypertrophy. Pain is relieved by fasciotomy, but definitive treatment of the underlying instability prevents further symptomatology.
Risk of Autism Spectrum Disorder (ASD) Among 18 to 48 Month Old Children: A Multi-Center Study in Qatar
Authors: Sameea Aisha Abdulraheem , Abd El-Wahab Ekram Wassim , Osman Sherif Omar
Published: September 2024

Background. Little is known about autism spectrum disorder (ASD) in Qatar. The lack of consensus in ASD screening has led to differences in the reported prevalence with escalating rates over time. Objective(s). To screen for ASD and to identify associate factors among Qatary children aged 18 to 48 months. Methods. A cross-sectional study included 600 eligible children at 10 Primary Health Care Centers (PHCCs) in Qatar. Identification of ASD was based on the M-CHAT™ criteria. Results. The number of ASD screen-positive children in the M-CHAT™ was 25.13 per 10.000, and was significantly associated with older maternal age (10.5%) and history of neonatal hyperbilirubinemia (20.0%) [AOR] = 4.88; 95%[CI]: 1.50-16.30)]. The Odds of detecting ASD was lower in children below 2 years of age (AOR = 0.92; 95% CI: 0.87-0.98]). Conclusion. This study demonstrates the utility of M-CHAT™ for ASD screening in PHCCs. Identification of the factors associated with positive ASD screening can highlight areas suitable for future intervention.
Are you in or are you out? A longitudinal person-centered study of health and entrance and exit into self-employment
Authors: Bergman Louise E. , Bujacz Aleksandra , Leineweber Constanze , Toivanen Susanna , Bernhard-Oettel Claudia
Published: September 2024

This study addresses the scarcity of research on health developments in the heterogeneous group of self-employed workers. It aims at understanding typical health progressions in this group and associations with demographic factors, work characteristics, and self-employment decisions. We investigate health profiles based on mental health problems, self-rated health, and work satisfaction, as well as transitions between them in relation to work effort, reward, overcommitment, demographic characteristics, and entrance and exit into self-employment. Using latent transition analysis, we analyzed data from the Swedish Longitudinal Occupational Survey of Health (SLOSH), including data from 593 participants. We identified four distinct, stable health profiles, revealing associations with work effort, reward, overcommitment, and self-employment decisions. No meaningful relations existed for demographic characteristics. Overall, the findings offer a comprehensive perspective on the health dynamics of self-employed individuals, their associations with work characteristics and decisions to enter and exit self-employment.

JEL CLASSIFICATION: J62; J81; L26
Perception and Contributing Factors of Academic Incivility Among Undergraduate Nursing Students in India
Authors: Rajagopal Johncyrani , Arulappan Judie , Matua Gerald Amandu , Kanagaraj Puvaneswari , Pandarakutty Suthan , Rafi Mohammed
Published: September 2024

Introduction

Academic incivility in students has the potential to undermine the learning process because it affects both the perpetrator and the educator. This results from the reduced trust between students and faculty resulting in a reduction in productivity, thereby impeding the learning process.

Objectives

The study was conducted to understand the perception and factors contributing to academic incivility among undergraduate nursing students.

Methods

A descriptive cross-sectional survey was conducted. A total of 250 undergraduate nursing students studying in three nursing colleges in India participated in the study. A convenience sampling approach was used to recruit the participants. A 13-item Uncivil Behavior in Clinical Nursing Education (UBCNE) tool was used to collect the data.

Results

The study found that 7.56% of the sampled nursing students always indulged in uncivil behavior, 9.51% of them often indulged in uncivilized activities, while 20.06% of them reported sometimes indulging in uncivil behavior. This means that 37.45% of the nursing students sampled engaged in some forms of uncivil behavior. In contrast, the study found that 62.55% of the nursing students never indulge in uncivilized activities. The contributing factors of academic incivility were the academic setting, the student's academic preparation, the teacher's attitude, emotional disturbance, substance abuse, cultural issues, and social issues. There was no significant association between the demographic variables and the level of perception on academic incivility among nursing students at p < .05.

Conclusion

It is important to understand the perceptions and factors that predispose students to engage in uncivil behavior given the prevalence of this educational challenge. Corrective strategies are needed to educate the perpetrators about the ill effects of their actions.
Normal but Different: Autistic Adolescents Who Score Within Normal Ranges on Standardized Language Tests Produce Frequent Linguistic Irregularities in Spontaneous Discourse
Authors: Zane Emily R , Grossman Ruth B
Published: September 2024

Background and aims

A substantial minority of autistic individuals score within typical ranges on standard language tests, suggesting that autism does not necessarily affect language acquisition. This idea is reflected in current diagnostic criteria for autism, wherein language impairment is no longer included. However, some work has suggested that probing autistic speakers’ language carefully may reveal subtle differences between autistic and nonautistic people's language that cannot be captured by standardized language testing. The current study aims to test this idea, by determining whether a group of autistic and nonautistic individuals who score similarly on a standardized test show differences in the number of unconventional and erroneous language features they produce in a spontaneous language sample.

Methods

Thirty-eight older children and adolescents (19 autistic; 19 nonautistic), between the ages of 10 and 18, were recruited. Both participant groups scored within normal ranges on standardized language and IQ tests. Participants engaged in a “double interview” with an experimenter, during which they were first asked questions by the experimenter about themselves, and then they switched roles, so that it was the participant's turn to ask the experimenter questions. Participants’ language during the interview was transcribed and analyzed for linguistic irregularities, including both semantic anomalies and morphosyntactic errors.

Results

Group membership accounted for significant variance in irregularity frequency; autistic participants produced more linguistic irregularities than nonautistic participants. Scores on a standardized language test did not improve model fit. Secondary analyses involving irregularity type (semantic vs. morphosyntactic) showed that group differences were primarily driven by relatively high numbers of semantic unconventionalities produced by the autistic group. While the autistic group made more morphosyntactic errors than the nonautistic group, differences in these numbers were only marginally significant.

Conclusions and implications

These findings suggest that a commonly used standardized language test does not adequately predict the number and perhaps type of language irregularities produced by some older autistic children and adolescents during spontaneous discourse. Results also suggest that differences in language use, especially semantic differences, may characterize autistic language, even the language produced by people who score within normal ranges on standardized language tests. It is debatable whether differences reflect underlying language impairments and/or a linguistic style adopted/preferred by autistic speakers. In this paper, we discuss both possibilities and offer suggestions to future research for teasing these possibilities apart.
How water sector reforms institutionalised domination and repression in Tunisia’s authoritarian regimes
Authors: Bhalla Sophie
Published: September 2024

This paper analyses how water reforms in Tunisia’s authoritarian regimes came to shape mechanisms of domination, repression, and co-optation anchored in the everyday politics of water allocation and use. The historical study of the water-agriculture nexus in Tunisia (1950–2011) argues that the sector served as a practical and symbolic vehicle to legitimise, produce, and reinforce authoritarian practices and regimes. Drawing on the dialectic of the state and society, this analysis showcases the links between agricultural water governance and practices of state-building. Water policy- and decision-making are put in the context of past political agendas and social unrest, explaining underlying societal perceptions and motivations. On the basis of this analysis, this paper hopes to inspire modest and realistic policy reforms that strategically address contemporary legacy barriers to good water governance.
What to Do and What Not to Do: Strategic Entrepreneurial Challenges at My Indian Stay Because of COVID-19 Realities
Authors: Bhattacharyya Som Sekhar , Fernandes Christo
Published: September 2024

My Indian Stay.com was started by Shan Ghelot and Umesh Agrawal. Shan for My Indian Stay.com had been leading the Indian strategy and operations initiatives. While Umesh was involved in leading technological development and digital marketing. By early 2015, the platform became the largest player in Goa by beating all the competitors. This was significant because Goa as a state located in western India was a big market for domestic as well as the lucrative foreign tourists. In the year 2016, My Indian Stay launched pan India operations with a new interface. This was done with advanced technologies with secured messaging facility but with a secured calling facility. By March 2020, COVID 19 pandemic and its associated economic and physical lockdown turned the travel, hotel, tourism, and allied industries into a tailspin. Shan became immersed in thoughts regarding business sustenance and continuity of My Indian Stay.
Reproductive and oncologic outcomes in young women with uterine sarcoma undergoing fertility-sparing treatment: a systematic review
Authors: Etrusco Andrea , Agrifoglio Vittorio , Laganà Antonio Simone , Gliozheni Elko , Caringella Annamaria , Stanziano Antonio , Cicinelli Ettore , Chiantera Vito , Giannini Andrea , Alsannan Baydaa , Barra Fabio , D’Amato Antonio
Published: September 2024

Background:

Uterine sarcomas (US) are rare cancer of possible occurrence even in women of childbearing age. To date, total hysterectomy is the standard treatment in the early stages. The possibilities of carrying out fertility-sparing treatments (FST) to save the fertility of women with unfulfilled reproductive desires are described in the literature, but to date, they can only be considered experimental.

Objective:

The aim of this systematic review was to evaluate the oncological and reproductive outcomes of women with different histological types of US undergoing FST.

Design:

Systematic review.

Data sources and methods:

Electronic databases were searched for English-language studies describing FST for US until January 31, 2024.

Results:

Forty-five papers which met the abovementioned inclusion criteria, were included in the qualitative analysis. Quantitative analysis was not possible because of the heterogeneity of the data. A descriptive summary of the results according to the histotype of US was provided. Six hundred forty-one patients of childbearing age with US and undergoing FST. After treatment with FST, 89 (13.9%) disease recurrences and 107 (16.7%) pregnancies were recorded.

Conclusion:

In selected cases of early-stage US, FST may be proposed. However, the patient must be informed of the real possibility of recurrence and potentially difficult achievement of pregnancy. Additional well-designed prospective studies and clinical trials are needed to address the knowledge gaps and enhance clinical decision-making in this population.

Trial registration:

PROSPERO ID: CRD42024509356.
Surgical and Endoscopic Approaches to Management of Submucosal Tumors of the Gastroesophageal Junction: Technical Considerations and Systematic Review of the Literature
Authors: Doulamis Ilias P. , Poulos Constantine , Servais Elliot L.
Published: September 2024

Background:

Gastroesophageal junction (GEJ) submucosal tumors are comprised predominantly of leiomyomas, followed by gastrointestinal stromal tumors.

Methods:

Herein we provide a comprehensive review of GEJ submucosal tumors including a systematic review of the literature.

Results:

Computed tomography, esophagogastroduodenoscopy, and endoscopic ultrasound are the most commonly used diagnostic imaging modalities. Surgical resection via laparoscopy is the most common treatment approach, with simultaneous upper endoscopy utilized in approximately half of the cases. Concomitant fundoplication is performed by certain groups to minimize risk for postoperative leak, gastroesophageal reflux, and esophagitis.

Conclusions:

Prospective studies evaluating long-term outcomes are needed to help guide treatment.
Dispersed Images of the Partially Eclipsed Sun and Solar Corona as Proxies for Spectrometer Nonidealities
Authors: Scheeline Alexander
Published: September 2024

Limitations in spectrograph behavior are difficult to visualize because aberrations, noise, and nonlinearity are largely mitigated in modern designs. Nevertheless, spectral resolution and precision are often subtly degraded by coma, astigmatism, stray light, noise, and distortion. The unique source geometry available during a solar eclipse allows a demonstration of some of these effects. Images from the eclipse of 8 April 2024 are presented and discussed.
Participant observation for inquiry-based learning: a document analysis of exam papers from an internship-course for master’s students in health services research in Germany
Authors: Ullrich Charlotte , Ziegler Sandra , Armbruster Alicia , Wensing Michel , Klafke Nadja
Published: September 2024

Inquiry-based learning (IBL) is a type of problem-based learning. While IBL aims at reflecting the work of practicing researchers, only some students will pursue an academic career. We therefore designed a course that provides opportunities for IBL by applying participant observation to internship work experience inside and outside academia. Using this internship course as an example, we investigated, how master’s students in health science executed an IBL assignment regarding the application of participant observation and presentation of findings. In addition, the understanding of occupational fields provided through the IBL assignment was examined.

To determine whether learning objectives were met, a document analysis of IBL assignments comprising presentation slides and field protocols was performed. Within content analysis, a category grid was used examining (a) suitability of chosen research objectives, (b) execution of field protocols, (c) sufficiency of reporting and (d) extent of reflection.

49 IBL assignments from the years 2020–2022 were included. Sides of IBL observations were: (a) organizations providing health care (n = 28); (b) administrations of health care (n = 8); and (c) research institutes (n = 13). Within students’ field protocols, the level of detail of descriptions differed. 30 assignments included reflection on the methods used and research experience. In about a third of IBL assignments, indication of observation type, theoretical background and data analysis was missing.

Using participant observation of internship work-experience for IBL can serve as a teaching tool for students to develop methodological skills. For future courses, we developed a checklist to strengthen reporting, reflection and use of theory. As internships are often integrated in degree programs in health sciences similar courses could be implemented in different programs, given qualified methodological guidance.
It takes two peroxisome proliferator-activated receptors (PPAR-β/δ and PPAR-γ) to tango idiopathic pulmonary fibrosis
Authors: Boateng Eistine , Bonilla-Martinez Rocio , Ahlemeyer Barbara , Garikapati Vannuruswamy , Alam Mohammad Rashedul , Trompak Omelyan , Oruqaj Gani , El-Merhie Natalia , Seimetz Michael , Ruppert Clemens , Günther Andreas , Spengler Bernhard , Karnati Srikanth , Baumgart-Vogt Eveline
Published: September 2024

Background

Idiopathic pulmonary fibrosis (IPF) is characterized by aberrant lung epithelial phenotypes, fibroblast activation, and increased extracellular matrix deposition. Transforming growth factor-beta (TGF-β)1-induced Smad signaling and downregulation of peroxisomal genes are involved in the pathogenesis and can be inhibited by peroxisome proliferator-activated receptor (PPAR)-α activation. However, the three PPARs, that is PPAR-α, PPAR-β/δ, and PPAR-γ, are known to interact in a complex crosstalk.

Methods

To mimic the pathogenesis of lung fibrosis, primary lung fibroblasts from control and IPF patients with comparable levels of all three PPARs were treated with TGF-β1 for 24 h, followed by the addition of PPAR ligands either alone or in combination for another 24 h. Fibrosis markers (intra- and extracellular collagen levels, expression and activity of matrix metalloproteinases) and peroxisomal biogenesis and metabolism (gene expression of peroxisomal biogenesis and matrix proteins, protein levels of PEX13 and catalase, targeted and untargeted lipidomic profiles) were analyzed after TGF-β1 treatment and the effects of the PPAR ligands were investigated.

Results

TGF-β1 induced the expected phenotype; e.g. it increased the intra- and extracellular collagen levels and decreased peroxisomal biogenesis and metabolism. Agonists of different PPARs reversed TGF-β1-induced fibrosis even when given 24 h after TGF-β1. The effects included the reversals of (1) the increase in collagen production by repressing COL1A2 promoter activity (through PPAR-β/δ activation); (2) the reduced activity of matrix metalloproteinases (through PPAR-β/δ activation); (3) the decrease in peroxisomal biogenesis and lipid metabolism (through PPAR-γ activation); and (4) the decrease in catalase protein levels in control (through PPAR-γ activation) and IPF (through a combined activation of PPAR-β/δ and PPAR-γ) fibroblasts. Further experiments to explore the role of catalase showed that an overexpression of catalase protein reduced collagen production. Additionally, the beneficial effect of PPAR-γ but not of PPAR-β/δ activation on collagen synthesis depended on catalase activity and was thus redox-sensitive.

Conclusion

Our data provide evidence that IPF patients may benefit from a combined activation of PPAR-β/δ and PPAR-γ.
Dietary fibers boost gut microbiota-produced B vitamin pool and alter host immune landscape
Authors: Grant Erica T. , Parrish Amy , Boudaud Marie , Hunewald Oliver , Hirayama Akiyoshi , Ollert Markus , Fukuda Shinji , Desai Mahesh S.
Published: September 2024

Background

Dietary fibers can alter microbial metabolic output in support of healthy immune function; however, the impact of distinct fiber sources and immunomodulatory effects beyond short-chain fatty acid production are underexplored. In an effort to discern the effects of diverse fibers on host immunity, we employed five distinct rodent diets with varying fiber content and source in specific-pathogen-free, gnotobiotic (containing a 14-member synthetic human gut microbiota), and germ-free mice.

Results

Broad-scale metabolomics analysis of cecal contents revealed that fiber deprivation consistently reduced the concentrations of microbiota-produced B vitamins. This phenomenon was not always explained by reduced biosynthesis, rather, metatranscriptomic analyses pointed toward increased microbial usage of certain B vitamins under fiber-free conditions, ultimately resulting in a net reduction of host-available B vitamins. Broad immunophenotyping indicated that the local gut effector immune populations and activated T cells accumulate in a microbiota-dependent manner. Supplementation with the prebiotic inulin recovered the availability of microbially produced B vitamins and restored immune homeostasis.

Conclusions

Our findings highlight the potential to use defined fiber polysaccharides to boost microbiota-derived B vitamin availability in an animal model and to regulate local innate and adaptive immune populations of the host.
Dose advantage of abdominal deep inspiratory breath-hold (aDIBH) in postoperative adjuvant radiotherapy for left breast cancer
Authors: Lai Junming , Luo Hui , Hu Shuang , Zhong Fangyan , Chen Rui , Lin Hong
Published: September 2024

Purpose

We explored the dosimetric efficacy of the abdominal deep inspiration breath hold (aDIBH) technique using an audio-guided device in patients with left breast cancer undergoing postoperative adjuvant radiotherapy compared to free breathing (FB).

Methods

A total of 35 patients with early stage left breast cancer underwent two computed tomography simulation scans each with aDIBH and FB after breast-conserving surgery. Treatment planning was optimized using the Pinnacle3 9.10 planning system. The heart, left anterior descending coronary artery (LADCA), and left lung was defined as organs at risk (OARs). The dosimetric differences in the planning target volume (PTV) and OARs were compared between aDIBH and FB.

Results

Compared with FB, the heart moved farther caudally and away from the chest wall, and the volume of heart became smaller under aDIBH due to expansion of the lungs. The D mean of the heart, LADCA and left lung of aDIBH were respectively reduced by 332.79 ± 264.61 cGy (P < 0.001), 1290.37 ± 612.09 cGy (P < 0.047) and 69.94 ± 117.73 cGy (P < 0.001). The V20 and V30 of the OARs were also significantly reduced with statistical differences (P < 0.05). In addition, there was no significant difference in the dosimetric parameters of the PTV between the two groups (P > 0.05).

Conclusions

Implementation of the aDIBH technique for postoperative radiotherapy after breast-conserving surgery of the left breast cancer could reduce irradiation of the heart dose, LADCA dose and left lung dose, without compromising target coverage.
Investigating patient eligibility for anti-amyloid monoclonal antibody treatment of Alzheimer's disease: real-world data from an Austrian psychiatric memory clinic population
Authors: Defrancesco Michaela , Gizewski Elke R. , Mangesius Stephanie , Galijasevic Malik , Virgolini Irene , Kroiss Alexander , Marksteiner Josef , Jehle Juliane , Doganyigit Burak , Hofer Alex
Published: September 2024

Background

Pharmacological treatment options for patients with dementia owing to Alzheimer's disease are limited to symptomatic therapy. Recently, the US Food and Drug Administration approved the monoclonal antibody lecanemab for the treatment of amyloid-positive patients with mild cognitive impairment (MCI) and early Alzheimer´s dementia. European approval is expected in 2024. Data on the applicability and eligibility for treatment with anti-amyloid monoclonal antibodies outside of a study population are lacking.

Aims

This study examined eligibility criteria for lecanemab in a real-world memory clinic population between 1 January 2022 and 31 July 2023.

Method

We conducted a retrospective, single-centre study applying the clinical trial eligibility criteria for lecanemab to out-patients of a specialised psychiatric memory clinic. Eligibility for anti-amyloid treatment was assessed following the phase 3 inclusion and exclusion criteria and the published recommendations for lecanemab.

Results

The study population consisted of 587 out-patients. Two-thirds were diagnosed with Alzheimer's disease (probable or possible Alzheimer's disease dementia in 43.6% of cases, n = 256) or MCI (23%, n = 135), and 33.4% (n = 196) were diagnosed with dementia or neurocognitive disorder owing to another aetiology. Applying all lecanemab eligibility criteria, 11 (4.3%) patients with dementia and two (1.5%) patients with MCI would have been eligible for treatment with this compound, whereas 13 dementia (5.1%) and 14 (10.4%) MCI patients met clinical inclusion criteria, but had no available amyloid status.

Conclusions

Even in a memory clinic with a good infrastructure and sufficient facilities for dementia diagnostics, most patients do not meet the eligibility criteria for treatment with lecanemab.
Early detection and intervention through the lens of the neurodevelopmental framework: the salience of developmental years and related services
Authors: Raballo Andrea , Poletti Michele , Preti Antonio
Published: September 2024

Broadening prediction efforts from imminent psychotic symptoms to neurodevelopmental vulnerabilities can enhance the accuracy of diagnosing severe mental disorders. Early interventions, especially during adolescence, are vital as these disorders often follow a long prodromal phase of neurodevelopmental disturbances. Child and adolescent mental health services should lead a developmentally-sensitive model for timely, effective detection and intervention.
Chronopsychiatry
Authors: Smith Daniel J. , McGlashan Elise , Gottlieb John , Meyer Nicholas , Jones Matt W.
Published: September 2024

This editorial summarises the clinical relevance of ‘chronopsychiatry’, defined as the interface between circadian science and mental health science. Chronopsychiatry represents a move towards time-variable perspectives on neurobiology and symptoms, with a greater emphasis on chronotherapeutic interventions.
Bone Accrual Trajectories in Children and Adolescents With Perinatal HIV Infection
Authors: DiMeglio Linda Anne , Yu Wendy , Kalkwarf Heidi J , Brummel Sean , Chen Janet S , Geffner Mitchell E , McFarland Elizabeth J , Mirza Ayesha , Patel Kunjal , Shiau Stephanie , Jacobson Denise L ,   For the Pediatric HIV/AIDS Cohort Study, Chadwick Ellen , Hernandez-Diaz Sonia , Jao Jennifer , Williams Paige , Salomon Liz , Seage George R , Salomon Liz , Van Dyke Russell , Chadwick Ellen , Davis Patrick , Siminski Suzanne , Wolbach Tracy , Borkowsky William , Chadwick Ellen , Lartey Emanuela (Lela) , Kalra Rohit , Malee Kathleen , Paul Mary , Buschur Shelley , McMullen-Jackson Chivon , Harris Lynnette , Purswani Murli , Cavallo Martha , Baig Mahboobullah Mirza , Villegas Alma , Robinson Lisa-Gaye , Bernegger Alan , Garvie Patricia , Burchett Sandra K , Anderson Michelle E , Salois Christine M , Wiznia Andrew , Burey Marlene , Shaw Ray , Dieudonne Arry , Johnson Juliette , Surowiec Karen , Chen Janet S , White Taesha , Grant Mitzie , Knapp Katherine , Odero Erick , Wilkins Megan , Rosario Nicolas , Rios Heida , Olivera Vivian , Silio Margarita , Gabriel Medea , Sirois Patricia , Spector Stephen A , Loughran Megan , Figueroa Veronica , Nichols Sharon , McFarland Elizabeth , Chambers Carrie , Kwon Christine , McEnvoy Robin , Scott Gwendolyn , Alvarez Grace , Caffroni Juan , Cuadra Anai
Published: September 2024

Context

Low bone mineral density (BMD) has been reported in children and adolescents living with perinatally acquired HIV (PHIV). Little is known about their bone accrual through puberty compared to an uninfected healthy cohort.

Objective

To compare bone accrual in PHIV and healthy children.

Design

PHIV children aged 7 to 16 years had dual-energy X-ray absorptiometry at entry, at 2 years, and then at least 2 years later. Bone accrual was compared to healthy children from the Bone Mineral Density in Childhood Study (BMDCS).

Setting

US academic clinical research centers.

Patients

172 PHIV; 1321 BMDCS.

Analysis

We calculated height-adjusted whole-body and spine BMD and bone mineral content (BMC) Z-scores in PHIV using BMDCS reference curves. We fit piecewise weighted linear mixed effects models with change points at 11 and 15 years, adjusted for age, sex, race, height Z-score, and Tanner stage, to compare BMD and BMC Z-scores across actual age by cohort.

Main Outcome Measure

BMD/BMC Z-scores.

Results

Height-adjusted whole-body BMD and BMC Z-scores in PHIV were lower across age compared to BMDCS children. Spine BMD Z-score across age was higher in PHIV after height adjustment. Whole-body and spine bone area tended to be lower in PHIV children. PHIV children had slower accrual in whole-body and spine bone area before 14 years. After 15 years, bone area accruals were similar, as were height-adjusted spine BMC Z-scores, across age.

Conclusion

PHIV children had persistent deficits in all measures except height-adjusted spine BMD and BMC Z-scores. Data are needed on PHIV children followed to adulthood.
Deciphering the Presentation and Etiologies of Hypophysitis Highlights the Need for Repeated Systematical Investigation
Authors: Miquel Lea , Testud Benoit , Albarel Frederique , Sahakian Nicolas , Cuny Thomas , Graillon Thomas , Brue Thierry , Dufour Henri , Schleinitz Nicolas , Kaplanski Gilles , Ebbo Mikael , Castinetti Frederic
Published: September 2024

Context

Hypophysitis is defined as an inflammation of the pituitary gland and/or infundibulum.

Objective

Our aim was to characterize the initial course and evolution of patients with hypophysitis according to the different etiologies.

Methods

Retrospective observational study conducted in a university referral hospital center. Patients over 15 years of age were included if they had a diagnosis of hypophysitis between January 2014 and October 2023, with the exclusion of hypophysitis secondary to immune checkpoint inhibitors.

Results

Sixty-one patients (64% women; median age, 34 years) were included. Polyuria–polydipsia, headache, and asthenia were present in 64%, 48%, and 44% of cases respectively. At diagnosis, at least 1 anterior pituitary deficiency was present in 91.5% of cases and vasopressin deficiency in 56%. Magnetic resonance imaging was abnormal in 97% of cases. Secondary hypophysitis was found in 46% of cases (n = 28), including sarcoidosis in 28% (n = 17) and L (Langerhans) group histiocytoses in 13.1% (n = 8). Among patients with secondary hypophysitis, pituitary deficiency preceded systemic manifestations in 23% and occurred concomitantly in 23% of cases. Patients were treated in 36% of cases (glucocorticoids, surgery), without improvement of pituitary hormone deficits.

Conclusion

A systemic etiology of hypophysitis was found in almost half of the patients. Pituitary disorders preceded the systemic disease in a quarter of the cases. This emphasizes the importance of a systematic repeated workup looking for a secondary etiology of hypophysitis in these patients.
Neuregulin 1 Signaling Attenuates Tumor Necrosis Factor α–Induced Female Rat Luteal Cell Death
Authors: Banerjee Saswati , Oguljahan Babayewa , Thompson Winston E , Chowdhury Indrajit
Published: September 2024

The corpus luteum (CL) is a transient ovarian endocrine structure that maintains pregnancy in primates during the first trimester and in rodents during the entire pregnancy by producing steroid hormone progesterone (P4). CL lifespan, growth, and differentiation are tightly regulated by survival and cell death signals through luteotrophic and luteolytic factors, including the epidermal growth factor (EGF)-like factor family. Neuregulin 1 (NRG1), a member of the EGF family, mediates its effect through ErbB2/3 receptors. However, the functional role of NRG1 in luteal cells (LCs) is unknown. Thus, this study investigated the role of NRG1 and its molecular mechanism of action in rat LC. Our experimental results suggest a strong positive correlation between steroidogenic acute regulatory protein (StAR) and NRG1 expression in mid-CL and serum P4 and estrogen (E2) production. In contrast, there was a decrease in StAR and NRG1 expression and P4 and E2 production with an increase in tumor necrosis factor α (TNFα) expression in regressing CL. Further in vitro studies in LCs showed that the knockdown of endogenous Nrg1 promoted the expression of proinflammatory and proapoptotic factors and decreased prosurvival factor expression. Subsequently, treatment with exogenous TNFα under these experimental conditions profoundly elevated proinflammatory and proapoptotic factors. Further analysis demonstrated that the phosphorylation status of ErbB2/3, PI3K, Ak strain transforming or protein kinase B (Akt), and ErK1/2 was significantly inhibited under these experimental conditions, whereas the treatment of TNFα further inhibited the phosphorylation of ErbB2/3, PI3K, Akt, and ErK1/2. Collectively, these studies provide new insights into the NRG1-mediated immunomodulatory and prosurvival role in LCs, which may maintain the function of CL.
Working Status in Patients With Untreated Unruptured Intracranial Aneurysms: A Descriptive Longitudinal Study
Authors: Majewska Paulina , Sandvei Marie Søfteland , Gulati Sasha , Müller Tomm B. , Hara Karen Walseth , Romundstad Pål Richard , Solheim Ole
Published: September 2024

BACKGROUND AND OBJECTIVES:

Many patients with unruptured intracranial aneurysms (UIAs) remain untreated if the risk of treatment exceeds the estimated risk of aneurysm rupture, potentially leading to diagnosis-related stress and anxiety. Working status may serve as a marker for the total level of function including mental health and psychological burden of the condition. The aim of the study was to assess the working status before and after a diagnosis of an untreated UIA.

METHODS:

This was a retrospective nationwide registry-based descriptive longitudinal study. It included all working-age patients diagnosed with an UIA in Norway between 2008 and 2018 and 1:1 age-matched and sex-matched controls without a diagnosis of an intracranial aneurysm that were randomly selected from the Norwegian population. The history of sickness absence in the period of 1 year before and after diagnosis was retrieved from The Norwegian Labour and Welfare Administration records and compared between the groups.

RESULTS:

In total, 2141 patients and 2141 controls were included in the study. Proportion of working patients decreased from 62.1% (95% CI 60.0%-64.1%) 1 year before the diagnosis to 51.3% (95% CI 49.1%-53.4%) 1 year after the diagnosis (P < .001). In comparison, the proportion of working controls decreased from 77.9% (95% CI 76.1%-79.6%) 1 year before day 0 to 73.4% (95% CI 71.5%-75.2%) 1 year after day 0 (P = .001). The odds of working were 86.7% lower among the patients than among the controls (odds ratio 0.133, 95% CI 0.091-0.194; P < .001) when controlled for the baseline working status. The older the individuals, the less likely they were to work (odds ratio 0.908, 95% CI 0.889-0.926; P < .001).

CONCLUSION:

The work participation of patients diagnosed with UIA is low prediagnosis compared with the general population and decreases significantly postdiagnosis.
Mature microRNA-binding protein QKI suppresses extracellular microRNA let-7b release
Authors: Min Kyung-Won , Choi Kyoung-Min , Mun Hyejin , Ko Seungbeom , Lee Ji Won , Sagum Cari A. , Bedford Mark T. , Kim Young-Kook , Delaney Joe R. , Cho Jung-Hyun , Dawson Ted M. , Dawson Valina L. , Twal Waleed , Kim Dong-Chan , Panganiban Clarisse H. , Lang Hainan , Zhou Xin , Shin Seula , Hu Jian , Heise Tilman , Kwon Sang-Ho , Kim Dongsan , Kim Young Hwa , Kang Sung-Ung , Kim Kyungmin , Lewis Sydney , Eroglu Ahmet , Ryu Seonghyun , Kim Dongin , Chang Jeong Ho , Jung Junyang , Yoon Je-Hyun
Published: September 2024

Argonaute (AGO), a component of RNA-induced silencing complexes (RISCs), is a representative RNA-binding protein (RBP) known to bind with mature microRNAs (miRNAs) and is directly involved in post-transcriptional gene silencing. However, despite the biological significance of miRNAs, the roles of other miRNA-binding proteins (miRBPs) remain unclear in the regulation of miRNA loading, dissociation from RISCs and extracellular release. In this study, we performed protein arrays to profile miRBPs and identify 118 RBPs that directly bind to miRNAs. Among those proteins, the RBP quaking (QKI) inhibits extracellular release of the mature microRNA let-7b by controlling the loading of let-7b into extracellular vesicles via additional miRBPs such as AUF1 (also known as hnRNPD) and hnRNPK. The enhanced extracellular release of let-7b after QKI depletion activates Toll-like receptor 7 (TLR7) and promotes the production of proinflammatory cytokines in recipient cells, leading to brain inflammation in the mouse cortex. Thus, this study reveals the contribution of QKI to the inhibition of brain inflammation via regulation of extracellular let-7b release.