bluuebunny/crossref_metadata_2025 huggingface dataset:
Conversion from Intermittent Hemodialysis to Peritoneal Dialysis in Metastatic Catheter-Related Bloodstream Infection
Authors: Ghandour Mohamedanwar , Thimmisetty Ravi K. , Sondheimer James , Imran Nashat , Bhat Zeenat Y. , Osman-Malik Yahya Mohamed
Published: August 2023

Of all complications from central venous catheters (CVC) in end-stage renal disease (ESRD) patients, catheter-related bloodstream infection (CRBSI) is one of the most devastating consequences. The option of catheter salvage is not an effective measure with metastatic infections. However, in patients with severe vasculopathy and/or near end-stage vascular disease, preservation of the venous access should be given utmost importance as the luxury of utilizing another vascular site is markedly limited. Providing adequate renal replacement therapy in this group of patients can be remarkably challenging for nephrologists. We are presenting an ESRD patient with advanced vascular disease who developed metastatic CRBSI with worsening uremia who was successfully converted from intermittent hemodialysis (IHD) to peritoneal dialysis (PD). Our rationale was to minimize repeated intravascular procedures coupled with the presence of another intravascular device. This has led to a complete resolution of persistent bacteremia, with a steady improvement in the uremic state. Conversion from IHD to PD for persistent bacteremia with metastatic complications was seldom addressed in literature. In the absence of a significant contraindication to PD, it can be considered as a valid alternative possibility in order to interrupt this viscous cycle, especially in vasculopathic patients.
Biomarkers for Biodosimetry and Their Role in Predicting Radiation Injury
Authors: Aryankalayil Molykutty , Bylicky Michelle A. , Chopra Sunita , Dalo Juan , Scott Kevin , Ueda Yuki , Coleman C. Norman
Published: August 2023

Radiation-related normal tissue injury sustained during cancer radiotherapy or in a radiological or mass casualty nuclear incident is a major health concern. Reducing the risk and mitigating consequences of radiation injury could have a broad impact on cancer patients and citizens. Efforts to discover biomarkers that can determine radiation dose, predict tissue damage, and aid medical triage are underway. Exposure to ionizing radiation causes changes in gene, protein, and metabolite expression that needs to be understood to provide a holistic picture for treating acute and chronic radiation-induced toxicities. We present evidence that both RNA (mRNA, microRNA, long noncoding RNA) and metabolomic assays may provide useful biomarkers of radiation injury. RNA markers may provide information on early pathway alterations after radiation injury that can predict damage and implicate downstream targets for mitigation. In contrast, metabolomics is impacted by changes in epigenetics, genetics, and proteomics and can be considered a downstream marker that incorporates all these changes to provide an assessment of what is currently happening within an organ. We highlight research from the past 10 years to understand how biomarkers may be used to improve personalized medicine in cancer therapy and medical decision-making in mass casualty scenarios.
Education and Training in Addiction Medicine and Psychology across Europe: A EUFAS Survey
Authors: Bramness Jørgen G. , Leonhardt Marja , Dom Geert , Batalla Albert , Flórez Menéndez Gerardo , Mann Karl , Wurst Friedrich Martin , Wojnar Marcin , Drummond Colin , Scafato Emanuele , Gual Antoni , Ribeiro Cristina Maria , Cottencin Olivier , Frischknecht Ulrich , Rolland Benjamin
Published: August 2023

Introduction: Training in addiction medicine and addiction psychology is essential to ensure the quality of treatment for patients with substance use disorders. Some earlier research has shown varying training between countries, but no comprehensive study of addiction training across Europe has been performed. The present study by the European Federation for Addiction Societies (EUFAS) aimed to fill this gap. Methods: A Delphi process was used to develop a questionnaire on specialist training in addiction treatment in 24 European countries. The final questionnaire consisted of 14 questions on either addiction medicine or addiction psychology, covering the nature and content of the training and institutional approval, the number of academic professorial positions, and the estimated number of specialists in each country. Results: Information was not received from all countries, but six (Belgium, Denmark, Ireland, Italy, Poland, and Romania) reported no specialized addiction medicine training, while 17 countries did. Seven countries (Belgium, France, Ireland, Italy, Russia, Switzerland, and the Netherlands) reported no specialized addiction psychology training, while 14 countries did. Training content and evaluation methods varied. Approval was given either by governments, universities, or professional societies. Eighteen countries reported having professorships in addiction medicine and 12 in addiction psychology. The number of specialists in addiction medicine or psychology varied considerably across the countries. Discussion: The survey revealed a large heterogeneity in training in addiction medicine and addiction psychology across Europe. Several countries lacked formal training, and where formal training was present, there was a large variation in the length of the training. Harmonization of training, as is currently the case for other medical and psychology specializations, is warranted to ensure optimal treatment for this under-served patient group.
C-C Motif Chemokine Receptor 3-Mediated Extracellular Signal-Regulated Kinase 1/2 and p38 Mitogen-Activated Protein Kinase Signaling: Promising Targets for Human Airway Epithelial Mucin 5AC Induction by Eotaxin-2 and Eotaxin-3
Authors: Jo Sooyeon , Na Hyung Gyun , Choi Yoon Seok , Bae Chang Hoon , Song Si-Youn , Kim Yong-Dae
Published: August 2023

Introduction: Eotaxin-2 and -3 of the C-C chemokine subfamily function as potent chemoattractant factors for eosinophil recruitment and various immune responses in allergic and inflammatory airway diseases. Mucin 5AC (MUC5AC), a major gel-forming secretory mucin, is overexpressed in airway inflammation. However, the association between mucin secretion and eotaxin-2/3 expression in the upper and lower airway epithelial cells has not been fully elucidated. Therefore, in this study, we investigated the effects of eotaxin-2/3 on MUC5AC expression and its potential signaling mediators. Methods: We analyzed the effects of eotaxin-2 and -3 on NCI-H292 human airway epithelial cells and primary human nasal epithelial cells (HNEpCs) via reverse transcription-polymerase chain reaction, enzyme-linked immunosorbent assay, and western blotting. Along with immunoblot analyses with specific inhibitors and small interfering RNA (siRNA), we explored the signaling pathway involved in MUC5AC expression following eotaxin-2/3 treatment. Results: In HCI-H292 cells, eotaxin-2/3 activated the mRNA expression and protein production of MUC5AC. A specific inhibitor of C-C motif chemokine receptor 3 (CCR3), SB328437, suppressed eotaxin-2/3-induced MUC5AC expression at both the mRNA and protein levels. Eotaxin-2/3 induced the phosphorylation of extracellular signal-regulated kinase (ERK)-1/2 and p38, whereas pretreatment with a CCR3 inhibitor significantly attenuated this effect. Induction of MUC5AC expression with eotaxin-2/3 was decreased by U0126 and SB203580, specific inhibitors of ERK1/2 and p38 mitogen-activated protein kinase (MAPK), respectively. In addition, cell transfection with ERK1/2 and p38 siRNAs inhibited eotaxin-2/3-induced MUC5AC expression. Moreover, specific inhibitors (SB328437, U0126, and SB203580) attenuated eotaxin-2/3-induced MUC5AC expression in HNEpCs. Conclusion: Our results imply that CCR3-mediated ERK1/2 and p38 MAPK are involved in the signal transduction of eotaxin-2/3-induced MUC5AC overexpression.
Anti-TPO IgG/Total IgE Ratio: Biomarker for Omalizumab Response Prediction in Chronic Spontaneous Urticaria
Authors: Brás Rita , Esteves Caldeira Leonor , Bernardino Ana , Costa Célia
Published: August 2023

Background: According to recently published data, low total IgE, elevated IgG-anti-TPO, and a high IgG-anti-TPO/total IgE ratio are good biomarkers for subtype IIb autoimmune chronic spontaneous urticaria (CSU), which is frequently refractory to antihistamines and omalizumab. Objectives: The aim of the study was to evaluate IgG-anti-TPO/total IgE ratio’s utility in omalizumab response prediction. Methods: Retrospective study of CSU patients treated with omalizumab at a UCARE between January 2009 and February 2022. Patients were grouped according to response in the first 16 weeks of treatment: responders UAS7 < 7 versus partial/non-responders UAS7≥7. Total IgE, IgG-anti-TPO, and IgG-anti-TPO/total IgE ratio were compared. Other inflammatory biomarkers – eosinophils, basophils, C-reactive protein, erythrocyte sedimentation rate, and d-dimer – were analyzed. Statistical analysis: SPSS® (v25.0), p < 0.05 statistically significant. Results: Total of 175 patients, 140 (80%) women, median age 49 [9–88] years, mean CSU duration pre-omalizumab 5.6 ± 8.2 [0–54] years, omalizumab duration 3.2 ± 2.5 [0–12] years. 116 (66%) had angioedema, 77 (44%) inducible chronic urticaria, 60 (34%) atopy, 24 (14%) autoimmune disease. With omalizumab 300 mg q4 weeks, 69% were responders and 31% partial/non-responders. Although not reaching significant differences, mean total IgE values were lower and mean IgG-anti-TPO values were higher in partial/non-responders versus responders (152 vs. 242 kU/L, p = 0.207, and 38.3 vs. 25.7 U/mL, p = 0.408, respectively). A higher IgG-anti-TPO/total IgE ratio was significantly associated with poorer response to omalizumab (p = 0.040). A cut-off >0.154 increased 10 times the odd of poorer response [95% CI 4.62–22], AUC 0.872, p < 0.001, with 87.7% sensitivity, although the low specificity (22.4%) does not allow the assumption of response with values <0.154. Other laboratory biomarkers did not show significant differences between partial/non-responders versus responders. Conclusions: A high IgG-anti-TPO/total IgE ratio was a good biomarker of poor response to omalizumab in our CSU cohort, with a cut-off >0.154 increasing 10 times the odd of poorer response.
Significance of Ultra-Radical Surgery in Extensive Metastatic Ovarian Growing Teratoma Syndrome
Authors: Li Sijian , Wang Tao , Du Huayang , Tang Hui , Zhang Tianyu , Zhang Rundong , Zhang Xinyue , Yang Jiaxin
Published: August 2023

Introduction: The aim of the study was to evaluate the perioperative risks and outcomes of ultra-radical surgery in patients with extensive metastatic ovarian growing teratoma syndrome (GTS). Methods: We conducted a retrospective study of patients with extensive metastatic ovarian GTS treated in our hospital between 2000 and 2022. Patients’ clinical characteristics, surgical treatment, and outcomes were evaluated. Results: Overall, 13 patients were identified, and the median age at diagnosis of ovarian immature teratoma (IT) was 24 years (range: 5–37). The median interval between IT diagnosis and presenting GTS was 8 months (range: 2–60), with a median surgery delay of 5 months (range: 3–300). Peritoneum and liver were the most commonly affected sites (100%), followed by bowel (12 patients, 92.3%), diaphragm (12 patients, 92.3%), adnexa (9 patients, 69.2%), omentum (8 patients, 61.5%), uterus (7 patients, 53.8%), in the descending order. The mean operation time was 316 min (range: 180–625), and the mean blood loss volume was 992 mL (range: 200–5,000). Peritoneal metastasectomy (13 patients, 100%), diaphragmatic metastasectomy (12 patients, 92.3%), metastasis removal from the bowel (8 patients, 61.5%), partial hepatectomy (4 patients, 30.8%), bowel excision and anastomosis (1 patient, 7.7%) were also applied to achieve optimal debulking. R0 was achieved in 9 (69.2%) patients. A high rate of intraoperative blood transfusion (8 patients, 61.5%) and admission to the intensive care unit (9 patients, 69.2%) were observed, and the median postoperative hospitalization time was 8 days (range: 4–22). After a median follow-up of 3.3 years, 9 patients were free of disease, and 4 were alive with stable residual diseases. Conclusion: The survival outcomes in extensive metastatic ovarian GTS were satisfactory after ultra-radical surgery, while a proper therapeutic plan should be established due to the high perioperative risks.
A revision of the Cretaceous ant genus Zigrasimecia Barden & Grimaldi, 2013 (Hymenoptera: Formicidae: †Zigrasimeciinae)
Authors: CHAUL JÚLIO CEZAR MÁRIO
Published: August 2023

The extinct Cretaceous ant genus Zigrasimecia Barden & Grimaldi, the “iron maiden ants” from Myanmar, is revised, and five new species are described: †Z. boudinoti sp. nov., †Z. caohuijiae sp. nov.,†Z. chuyangsui sp. nov., †Z. perrichoti sp. nov., and †Z. thate sp. nov. Zigrasimecia hoelldobleri paratype (CNU-HYM-MA2019054) is removed from the type series. New diagnoses for all species are provided and species boundaries are discussed. Studied specimens that are not ideally preserved are presented and discussed, some of them are putative new species. Two identification keys for the genus are provided, a traditional, dichotomous key and an interactive, multi-entry key hosted online at the website www.Xper3.fr. I briefly discuss the unlikeliness of the genus Boltonimecia to belong to the subfamily Zigrasimeciinae, and also the taxonomic problem caused by the description of species based on alates and poorly preserved fossils.
A new deep-sea species of Renella (Amphipoda: Lysianassida: Pakynidae) from the Sea of Okhotsk
Authors: LABAY VJACHESLAV S.
Published: August 2023

A new amphipod species, Renella lowryi sp. nov., from the north-eastern slope of the Sea of Okhotsk (Russian Far East) is described. The new species is assigned to the genus Renella Lowry & Stoddart, 2012 because it is similar to the species of this genus in the main characters: in the structure of the mouthparts, the structure of gnathopods 1 and 2, corner of palm of gnathopod 1 with the complex of robust seta, pereopods 3–7, the shape of epimeron 3, uropods and telson. The new species similar to Renella sculptidentata (Ren, 1991) by the structure of antennae 1 and 2, mandible, maxilla 2 and maxilliped, but differs from it by the missing eyes, by the morphology of maxilla 1 outer plate: with 9 setal-teeth in 6/3 arrangement (in R. sculptidentata with 11 setal-teeth in 7/4 arrangement), by the shape of propodus of gnathopod 1 with medially convex anterior margin (in R. sculptidentata anterior margin straight medially), by the shape of propodus of gnathopod 2 with oblique distal margin (in R. sculptidentata distal margin is perpendicular), by the shape of basis of pereopod 5 with rounded posterior wing (in R. sculptidentata posterior wing subrectangular), by the weak armament of the anterior margin of the basis of pereopod 5 and anterior margin of merus of pereopods 5–7 (in R. sculptidentata anterior margins with few long setae), by the length of inner ramus of uropod 3 which subequal to proximal segment of outer ramus in length (in R. sculptidentata inner ramus shorter than proximal segment of outer ramus). Keys to the world species of the genus Renella is provided.
Projection of Future Heatwaves in the Pearl River Delta through CMIP6-WRF Dynamical Downscaling
Authors: Zuo Ziping , Fung Jimmy C. H. , Li Zhenning , Huang Yiyi , Wong Mau Fung , Lau Alexis K. H. , Lu Xingcheng
Published: August 2023

Recent worldwide heatwaves have shattered temperature records in many regions. In this study, we applied a dynamical downscaling method on the high-resolution version of the Max Planck Institute Earth System Model (MPI-ESM-1-2-HR) to obtain projections of the summer thermal environments and heatwaves in the Pearl River Delta (PRD) considering three shared socioeconomic pathways (SSP1-2.6, SSP2-4.5, and SSP5-8.5) in the middle and late twenty-first century. Results indicated that relative to the temperatures in the 2010s, the mean increases in the summer (June–September) daytime and nighttime temperatures in the 2040s will be 0.7°–0.8°C and 0.9°–1.1°C, respectively. In the 2090s, the mean difference will be 0.5°–3.1°C and 0.7°–3.4°C, respectively. SSP1-2.6 is the only scenario in which the temperatures in the 2090s are expected to be lower than those in the 2040s. When compared with those in the 2010s, hot extremes are expected to be more frequent, intense, extensive, and longer-lasting in the future in the SSP2-4.5 and SSP5-8.5 scenarios. In the 2010s, a heatwave occurred in the PRD lasted for 6 days on average, with a mean daily maximum temperature of 34.4°C. In the 2040s, the heatwave duration and intensity are expected to increase by 2–3 days and 0.2°–0.4°C in all three scenarios. In the 2090s, these values will become 23 days and 36.0°C in SSP5-8.5. Moreover, a 10-yr extreme high temperature in the 2010s is expected to occur at a monthly frequency from June to September in the 2090s.

Significance Statement

Pearl River Delta (PRD) has been experiencing record-shattering heatwaves in recent years. This study aims to investigate the future trends of summer heatwaves in the PRD by modeling three future scenarios including a sustainable scenario, an intermediate scenario, and a worst-case scenario. Except for the sustainable scenario, summer temperatures in the intermediate and worst-case scenarios will keep increasing, and heatwaves will become more frequent, intense, extensive, and longer-lasting. In the worst-case scenario, extreme heat events that occurred once in 10 years in the 2010s will shorten to once a month in the 2090s. A better understanding of heatwave trends will benefit implementing climate mitigation methods, urban planning, and improving social infrastructure.
Sea Ice Loss, Water Vapor Increases, and Their Interactions with Atmospheric Energy Transport in Driving Seasonal Polar Amplification
Authors: Chung Po-Chun , Feldl Nicole
Published: August 2023

The ice–albedo feedback associated with sea ice loss contributes to polar amplification, while the water vapor feedback contributes to tropical amplification of surface warming. However, these feedbacks are not independent of atmospheric energy transport, raising the possibility of complex interactions that may obscure the drivers of polar amplification, in particular its manifestation across the seasonal cycle. Here, we apply a radiative transfer hierarchy to an idealized aquaplanet global climate model coupled to a thermodynamic sea ice model. The climate responses and radiative feedbacks are decomposed into the contributions from sea ice loss, including both retreat and thinning, and the radiative effect of water vapor changes. We find that summer sea ice retreat causes winter polar amplification through ocean heat uptake and release, and the resulting decrease in dry energy transport weakens the magnitude of warming. Moreover, sea ice thinning is found to suppress summer warming and enhance winter warming, additionally contributing to winter amplification. The water vapor radiative effect produces seasonally symmetric polar warming via offsetting effects: enhanced moisture in the summer hemisphere induces the summer water vapor feedback and simultaneously strengthens the winter latent energy transport in the winter hemisphere by increasing the meridional moisture gradient. These results reveal the importance of changes in atmospheric energy transport induced by sea ice retreat and increased water vapor to seasonal polar amplification, elucidating the interactions among these physical processes.
An “Unsettling” Journey? Hong Kong’s Exodus to Taiwan and Australia After the 2019 Protests
Authors: Li Yao-Tai , Liao Bin-Jou
Published: August 2023

This article compares the considerations, expectations, and realizations of Hong Kongers migrating to Taiwan and Australia. Based on interviews with 22 Hong Konger migrants, we identified some key drivers for Hong Kongers who moved to Taiwan or Australia. The findings add insights into the spatial–temporal nexus of migration and extend the static push–pull model by including migrants’ changing perceptions about the sociopolitical conditions of different destinations. In addition to offering a more nuanced understanding of migrants’ perceptions of and adaptations to the sociopolitical environment of the host society, we highlight that, after moving to Taiwan or Australia, Hong Kong migrants experience a gap between what they imagined at the time of migrating and the reality (political, social, and/or cultural). The imagination of the sociopolitical community in the destination countries before they leave and the gap between pre- and post-migration experiences constitute the “unsettling” characteristic of the recent Hong Kong exodus after 2019.
Cultivating Attention as a Surgical Resident: Sabbath as Resistance
Authors: Howell Thomas Clark
Published: August 2023

Despite our being created in right relationship with the Sabbath and holy time, we often have a dysfunctional relationship with rest, time, and ceasing. Our dysfunctional relationship with time, our hurriedness, has created an illness: “hurry sickness.” In medicine, our hurry sickness is often transformed into a supposed virtue we call efficiency. As a surgical resident, I am evaluated on and celebrated for my efficiency. If hurry and efficiency have created an illness, what is our remedy? Theologians propose the Sabbath as the cure to our hurry sickness. The Sabbath is the proper treatment but cannot be traditionally observed by most surgical trainees. Therefore, I explore elements of the Sabbath that can be practiced by surgical residents.
Source identification and accumulation restoration of complex oil reservoirs in Mahu Sag, Junggar Basin
Authors: Zhi Dongming , Liu Wendong , Hu Wenxuan , Cao Jian , Zheng Menglin , Wang Tao
Published: August 2023

Oil sources and accumulations in complex oil reservoirs of superimposed basins are difficult to identify and recover because of multiple kitchens and multistage charging processes. Constraining the oil sources and characterizing their accumulation patterns is a critical challenge. In this study, 46 crude oils from the Upper Wuerhe Formation, a widely distributed oil reservoir in the Mahu Sag of the Junggar Basin, NW China, are geochemically characterized to assess their sources and spatial distribution. These oils are divided into four groups: group I oils (characterized by high β-carotane and gammacerane concentrations, low C21/C23 and (C19 + C20)/C23 tricyclic terpane ratios, and low Pr/Ph ratios); group II oils (characterized by low β-carotane and gammacerane concentrations, high C21/C23 and (C19 + C20)/C23 tricyclic terpane ratios, and moderate Pr/Ph ratios); group III oils (very high Pr/Ph ratio (>3), the lowest β-carotane and gammacerane concentrations, and low tricyclic terpane concentration, but relatively high C19 and C20 tricyclic terpane abundance); and group IV oils (refered to here as geochemically hybrid, and inferred to be sourced from mixed P1f and C/P1j source rocks). The integration of oil-source correlation and geological framework indicates that oils generated from multiple kitchens are more likely to be near-sourced accumulations, providing a plausible example for oil accumulation in a complex oil reservoir of superimposed basin with several sets of kitchens and multistage oil charging history. The results show that multisource and multistage hydrocarbon accumulation is a common characteristic of prolific superimposed basins. The oil accumulation pattern must be established by carefully characterizing sources and charging processes to reduce the risk of exploration activities.
Assessment of common extensor tendon vascularization using superb microvascular imaging: a potential tool in the evaluation of extracorporeal shock wave therapy and therapeutic ultrasound effectiveness in lateral epicondylitis
Authors: Ustabaşıoğlu Fatma , Günay Burak , Samancı Cesur , Emre Ustabaşıoğlu Fethi
Published: August 2023

Background

Lateral epicondylitis, also known as tennis elbow, is the most common elbow pain in the adult age group.

Purpose

To evaluate common extensor tendon (CET) vascularity with superb microvascular imaging (SMI) before and after extracorporeal shock wave therapy (ESWT) and ultrasound (US) treatment in patients with lateral epycondylitis and to compare the effects of two different treatments on tendon vascularity.

Material and Methods

Patients with lateral epycondylitis were divided into two groups; 30 patients were treated with ESWT (group 1) and 30 patients were treated with therapeutic US (group 2). We performed a high-frequency (14-MHz) linear array transducer to evaluate tendon anatomy and vascularity before and after treatment in both groups.

Results

The decrease in Patient-Rated Tennis Elbow Evaluation (PRTEE) score after treatment was statistically significant compared to pre-treatment for both groups ( P < 0.001). Likewise, the decrease in visual analog scale (VAS) score after treatment was statistically significant compared to pre-treatment for both groups ( P < 0.001). A significant difference was found between the CET SMI values of group 1 and group 2 after treatment, according to the chi-square test ( P < 0.001). In the post-treatment VAS and PRTEE comparison of both groups, the score reduction in group 1 was higher than in group 2, and this decrease was statistically significant ( P < 0.001).

Conclusion

We can evaluate CET vascularization with the SMI method as a new potential diagnostic tool in comparing the effectiveness of different treatments in cases of lateral epicondylitis.
Change detection versus change localization for faces, houses, and words
Authors: Ventura Paulo , Pereira Alexandre , Cruz Francisco , Delgado João , Faustino Bruno , Guerreiro José Carlos
Published: August 2023

Holistic processing aids in the discrimination of visually similar objects, but it may also come with a cost. Indeed holistic processing may improve the ability to detect changes to a face while impairing the ability to locate where the changes occur. We investigated the capacity to detect the occurrence of a change versus the capacity to detect the localization of a change for faces, houses, and words. Change detection was better than change localization for faces. Change localization outperformed change detection for houses. For words, there was no difference between detection and localization. We know from previous studies that words are processed holistically. However, being an object of visual expertise processed holistically, visual words are also a linguistic entity. Previously, the word composite effect was found for phonologically consistent words but not for phonologically inconsistent words. Being an object of visual expertise for which linguistic information is important, letter position information, is also crucial. Thus, the importance of localization of letters and features may augment the capacity to localize a change in words making the detection of a change and the detection of localization of a change equivalent.
Vasculature of the Suprachiasmatic Nucleus: Pathways for Diffusible Output Signals
Authors: Yao Yifan , Green Isabella K. , Taub Alana B. , Tazebay Ruya , LeSauter Joseph , Silver Rae
Published: August 2023

Transplant studies demonstrate unequivocally that the suprachiasmatic nucleus (SCN) produces diffusible signals that can sustain circadian locomotor rhythms. There is a vascular portal pathway between the SCN and the organum vasculosum of the lamina terminalis in mouse brain. Portal pathways enable low concentrations of neurosecretions to reach specialized local targets without dilution in the systemic circulation. To explore the SCN vasculature and the capillary vessels whereby SCN neurosecretions might reach portal vessels, we investigated the blood vessels (BVs) of the core and shell SCN. The arterial supply of the SCN differs among animals, and in some animals, there are differences between the 2 sides. The rostral SCN is supplied by branches from either the superior hypophyseal artery (SHpA) or the anterior cerebral artery or the anterior communicating artery. The caudal SCN is consistently supplied by the SHpA. The rostral SCN is drained by the preoptic vein, while the caudal is drained by the basal vein, with variations in laterality of draining vessels. In addition, several key features of the core and shell SCN regions differ: Median BV diameter is significantly smaller in the shell than the core based on confocal image measurements, and a similar trend occurs in iDISCO-cleared tissue. In the cleared tissue, whole BV length density and surface area density are significantly greater in the shell than the core. Finally, capillary length density is also greater in the shell than the core. The results suggest three hypotheses: First, the distinct arterial and venous systems of the rostral and caudal SCN may contribute to the in vivo variations of metabolic and neural activities observed in SCN networks. Second, the dense capillaries of the SCN shell are well positioned to transport blood-borne signals. Finally, variations in SCN vascular supply and drainage may contribute to inter-animal differences.
Examining the Second-Order Factor Structure of the Gender Minority Stress and Resilience Scale
Authors: Dolezal Michael L. , Decker Melissa , Littleton Heather
Published: August 2023

The gender minority stress and resilience (GMSR) theory and associated measure are widely utilized in research investigating the stress, resilience, and psychological health experiences of gender nonconforming (GNC) individuals. GMSR theory specifies that distal stress and proximal stress experiences adversely affect the psychological health of GNC individuals, while resilience factors help buffer against these deleterious impacts. Moreover, GMSR theory clearly specifies a second-order factor structure such that distal stress experiences are comprised of gender-based victimization, rejection, discrimination, and non-affirmation; proximal stress experiences are comprised of internalized transphobia, negative expectations for the future, and gender identity nondisclosure; and pride and community connectedness constitute resilience factors. However, despite widespread use of the GMSR measure, including validating its use among Italian, Spanish, and adolescent GNC individuals, all research to date has only queried the first-order factor structure of the measure. The present study therefore evaluated the second-order factor structure of the GMSR measure among a sample of 234 GNC college students. Results suggested that the second-order factor structure provided a reasonable fit to the data but did not fit the data exceptionally well. Moreover, results suggested that the first-order factor structure with correlated factors provided a better fit to the data than did the second-order model. Thus, while this study found support for the second-order factor structure, it appears that the first-order structure may be better suited for research use. Secondarily, the GMSR measure appears valid for use among GNC undergraduates. Additional research is needed to further validate the measure’s second-order factor structure, and future research should consider trimming redundant items from the GMSR to address known fit issues.
The Effect of Investment Inefficiency on Expected Returns
Authors: Chacko Jains P. , Padmakumari Lakshmi
Published: August 2023

The majority of Indian firms have a promoter and family-owner-dominated ownership structure; therefore, the agency problem prevailing in such a setting would be the conflict of interest between the majority and minority shareholders. This motivated us to examine the adverse effect of not investing at the level implied by the firms’ characteristics, termed investment inefficiency, on the ex-ante measure of expected returns, the implied cost of capital. Our study finds a positive relationship between investment inefficiency and expected returns in the baseline results estimated using pooled ordinary least squares (OLS) and the robustness results estimated using a two-step generalized method of moments (GMM). The sample of the study consists of listed firms in India from 2016 to 2021.

JEL Codes: G11, G31
Bound in an Imbalanced Relationship: Family Caregivers and Migrant Live-In Care-Workers of Frail Older Persons in Israel
Authors: Cohen-Mansfield Jiska , Golander Hava
Published: August 2023

Migrant care-workers (MCWs) are often the main caregivers for frail older persons. We examined the complex relationship between MCWs and primary family caregivers (PFCs) in Israel to better understand how MCWs and PFCs perceive the formal and informal nature of their relationship. Given the high prevalence of two-income families who are unavailable for caregiving, the relationships among MCWs, PFCs, and care-recipients warrants examination, particularly when PFCs serve as managers of care and the care-recipient has dementia. The sample of 116 MCWs and 117 PFCs included 92 MCW–PFC pairs who were part of a larger study on home care for frail older persons. A mixed-methods approach was used involving quantitative (correlations/paired t-tests) and qualitative (grounded theory framework) analyses conducted on data obtained from structured interviews. A significant correlation was found between ratings of the quality of the relationship by MCWs and PFCs, although PFCs rated it significantly more positively than MCWs. MCWs’ ratings of their relationship with the PFCs were significantly correlated with their ratings of the quality of their relationship with the care-recipient. Four main thematic categories emerged from the qualitative analysis: (1) communication, (2) dependence, (3) relationship quality, and (4) triad: MCW–PFC–care-recipient. For each theme, we present perspectives of MCWs and PFCs, reflecting either “closeness” or “distance” in their relationship. The findings highlight the complexity of such relationships, with the potential for a meaningful positive bond or mistrust or abuse. The study provides a basis for testing methods for ameliorating the negative experiences described by some participants.
Passive and H∞ control based on non-fragile observer for a class of uncertain nonlinear systems with input time-delay
Authors: Chen Hua , Long Xinyuan , Tang Yao , Xu Rui
Published: August 2023

In this paper, passive control and H ∞ state feedback based on non-fragile observer are presented for a class of uncertain, nonlinear and input time-delay systems. Firstly, taking uncertainties, nonlinearities and input time-delay into account, non-fragile observer and controller are designed and the perturbations of controller gain and observer gain are processed. Secondly, for the dynamic disturbances, an appropriate non-fragile state feedback controller based on the observation is selected to prove that the states of closed-loop system can be passive and stabilized with H ∞ performance for continuous time system. Moreover, the problems such as time-delay are handled in virtue of Lyapunov method and linear matrix inequalities (LMIs). Finally, the simulation results demonstrate the validity of the proposed control design method.
Nationalized anti-feminism: A collusion between nationalism and gender-equal sexism
Authors: He Renyi
Published: August 2023

The COVID-19 crisis has led to a global resurgence of nationalism, which can be observed from major political events like presidential elections to everyday culture such as video games. In a recent online debate over sexualized female characters, Chinese male gamers excessively incorporated nationalist discourses to justify their anti-feminist arguments. Their discursive campaign provides an opportunity to explore the rising nationalist sentiment in the post-pandemic era and the linkage between nationalism and sexism as well. This study analyzed male players’ online posts and generalized their discursive strategies – the true gamer identity, anti-political correctness rhetoric, and the gender antagonism accusation – to incorporate nationalist discourse to make their anti-feminist arguments more persuasive and subtle. The study also explains how this anti-feminism fits in with frames of gender-equal sexism, and how the findings can help understand information interpretation tactics employed by misogynists.
The Reality of Tonic Immobility in Victims of Sexual Violence: “I was Paralyzed, I Couldn’t Move”
Authors: de la Torre Laso Jesús
Published: August 2023

Tonic immobility (TI) is a state of temporary, involuntary motor inhibition that occurs in states of intense fear and has been studied among victims of sexual violence. Studies on TI are scarce and mainly focus on rape victims. The present study is a literature review of research that has examined TI in women victims of sexual violence. A database search was carried out using the Preferred data elements for systematic reviews and meta-analyses (PRISMA) method. In order to be included in the analysis, the manuscripts had to deal exclusively with research involving samples of subjects and the study analyzed TI in victims of sexual violence. In all, 11 manuscripts met the above criteria and were included in the review. Research describes that TI is characterized by two factors: fear and immobility. Quantitative research was conclusive in affirming the presence of a state of paralysis and fear in TI. The immobility factor is the determining factor in explaining the victim’s lack of defense or resistance and causes effects such as trembling, physical and mental paralysis, inability to vocalize, and eye closure. In addition, TI has been correlated with long-term negative clinical manifestations as victims are more likely to suffer from post-traumatic stress disorder. These findings contribute to an understanding of TI in victims of sexual violence. Therefore, legal and care practitioners must be able to recognize TI to understand the victim’s behavior, differentiate it from consent, and to be able to assist in their recovery.
Expanding the analytical scope of tools for advancing representative bureaucracy: A comparative analysis of Hong Kong and Macau
Authors: Li Wei
Published: August 2023

Studying the contexts and features of locally-relevant tools of representative bureaucracy (RB) adopted in Hong Kong and Macau during the decolonizing and post-colonial periods could contribute to the literature of RB originated from Western contexts. The study found that political contexts of societal pressure, decolonization, and power handover to China have been driving the choice of RB tools in two places. Political contexts also explained different and similar implementation paces and effects of RB tools in two places. The paper suggests that the analysis of RB shall not be limited to one or two passive RB tools that target government input but be expanded to include the choice and effects of RB tools that target government processes, output, and outcome. The expanded analytical scope of RB will be useful for post-colonial contexts where the colonial legacies often co-exist with unequal representation among groups, and where state capacity is often weak.
Lipohypertrophy and Insulin: An Update From the Diabetes Technology Society
Authors: Tian Tiffany , Aaron Rachel E. , Huang Jingtong , Yeung Andrea M. , Svensson Jannet , Gentile Sandro , Forbes Angus , Heinemann Lutz , Seley Jane Jeffrie , Kerr David , Klonoff David C.
Published: August 2023

Lipohypertrophy is a common skin complication associated with insulin-treated diabetes. The impact of lipohypertrophy as a contributing factor to suboptimal glycemic control, glucose variability, and hypoglycemia is often under-recognized by health care professionals. In a recent Webinar on April 26, 2023, Diabetes Technology Society asked international experts to provide updates on the latest knowledge related to lipohypertrophy for practicing clinicians and educators, researchers, and industries involved in insulin delivery. A recording of the Webinar is freely available on the Diabetes Technology Society Web site ( https://www.diabetestechnology.org/ ).
Capturing the Work of Patients' Family Members in the Medical Intensive Care Unit Using Naturalistic Observations
Authors: Papautsky Elizabeth Lerner , Abdulbaseer Ummesalmah
Published: August 2023

Background:

The contributions of cognitive and behavioral work of patients' family members in intensive care units remain largely unrecognized.

Objective:

The objective of this study was to develop a framework of outwardly observable family work, with specific focus on describing the physical space.

Methods:

We conducted approximately 50 hrs of naturalistic observations of family activities on a medical intensive care unit (MICU) at a large, Midwestern teaching hospital.

Results:

We created a framework of activities that include requesting, receiving, or delivering either information or action, along with examples. Further, we identified clinician and staff roles with whom families interact and characterized the physical spaces in which interactions take place.

Conclusions:

Knowledge contribution is a proposed framework of family activities in the MICU. It has the potential to guide and be further described by future research and to inform development of human-centered family-facing interventions to support cognitive and behavioral cognitive and behavioral work.
Glucocorticoid-Induced Transcript 1(GLCCI1) SNP rs37937 Is Associated With the Risk of Developing Allergic Rhinitis and the Response to Intranasal Corticosteroids in a Chinese Han Population
Authors: Liang Xu , Jin Peng , Zhan Changcui , Zhao Li , Zi Xiaoxue , Zhi Lili , Yu Kena
Published: August 2023

Background

Evidence has shown that glucocorticoid-induced transcript 1 (GLCCI1) single nucleotide polymorphism (SNP) rs37937 is associated with asthma.

Objectives

The objective of this study was to investigate whether the GLCCI1 SNP rs37937 is a risk factor for allergic rhinitis (AR) in a Chinese Han population.

Methods

A total of 220 individuals including 109 AR patients and 111 healthy subjects were included. The genotyping of GLCCI1 rs37973 was performed by the SNaPshot method. The correlations of rs37973 polymorphism, AR risk, and clinical characteristics were further analyzed, as well as the treatment response to intranasal corticosteroids (INCS) in AR patients of different genotypes.

Results

Three GLCCI1 rs37973 SNP genotypes were identified in both AR patients and healthy subjects. Significant association between rs37973 polymorphism and AR under allele model, dominant model, heterozygote model, and homozygote model were shown. The A allele frequency of SNP rs37973 in AR was significantly higher than that in controls. The serum total immunoglobulin E (IgE) in AR patients of AA genotype was significantly higher than in patients of GA and GG genotype, and the serum total IgE in GA genotype was significantly higher than in GG genotype. Interestingly, after 4 weeks of INCS treatment for AR patients, the improvement of the nasal itching score, sneezing score, runny nose score, total nasal symptom score, and visual analog scale score of the GG genotype were worse than the AA or GA genotype.

Conclusion

The GLCCI1 rs37937 polymorphism is associated with the risk of developing AR and the response to INCS treatment in the Chinese Han population.
Cost-Effectiveness Analysis of Regenerative Endodontics versus MTA Apexification
Authors: Naved N. , Umer F. , Khowaja A.R.
Published: August 2023

Introduction:

With the introduction of stem cell engineering in dentistry, regenerative endodontics has emerged as a potential alternative to mineral trioxide aggregate (MTA) apexification in the management of necrotic immature permanent teeth. However, the utility of this modality in terms of cost-effectiveness has not yet been established. Therefore, we performed cost-effectiveness analysis to determine the dominant treatment modality that would influence decision making from the private payer perspective.

Methods:

A Markov model was constructed with a necrotic immature permanent tooth in a 7-y-old patient, followed over the lifetime using TreeAge Pro Healthcare 2022. Transition probabilities were estimated based on the existing literature. Costs were estimated based on United States health care, and cost-effectiveness was determined using Monte Carlo microsimulations. The model was validated internally by sensitivity analyses, and face validation was performed by an experienced endodontist and health economist.

Results:

In the base-case scenario, regenerative endodontics did not turn out to be a dominant treatment option as it was associated with an additional cost of USD$1,012 and fewer retained tooth-years (15.48 y). Likewise, in the probabilistic sensitivity analysis, regenerative endodontics was again dominated by apexification against different willingness-to-pay values.

Conclusion:

Based on current evidence, regenerative endodontic treatment was not cost-effective compared with apexification in the management of necrotic immature permanent teeth over an individual's lifetime.

Knowledge Transfer Statement:

The study provides valuable insight regarding the cost valuation and cost-efficacy of regenerative endodontic treatment versus apexification in the management of necrotic immature permanent teeth, as this would aid in effective clinical decision making, allowing for the functional allocation of resources.
“Post-renal acute kidney injury in patients with cancer: Clinical presentation and kidney and patient outcomes”
Authors: Sousa Círia , Reis Marina , Ferreira Hugo , Coelho Inês , Chuva Teresa , Paiva Ana , Maximino Costa José
Published: August 2023

Background:

Post-renal acute kidney injury (PR–AKI) is frequent in patients with cancer requiring emergent intervention. With our study we aimed to describe the clinical features and prognostic factors for kidney and overall survival (OS) in cancer patients with PR–AKI.

Methods:

This is a single-center retrospective study that included 306 cancer patients with PR–AKI admitted from January 2011 to December 2021. Previous kidney function, AKI episode, and progression to end-stage kidney disease (ESKD) were compared. Kaplan Meier and Cox proportional regression methods were used for survival analyses.

Results:

The most frequent type of malignancy was the prostate (52, 17%) followed by the uterus (50, 16.3%). The mean baseline eGFR was 62 ml/min/1.73 m2. AKI stage 3 was present in 157 patients (51.3%) and renal replacement therapy (RRT) was performed in 19 patients (6%). At discharge, 197 patients (64.4%) had a quick recovery, and during follow-up 8 (2.6%) patients progressed to ESKD. The risk factors associated with ESKD were previous decreased kidney function (eGFR<30 ml min 1.73m2) (HR 33.275, [95% CI, 3.997–277.002], p = 0.001); glomerular disease, (HR 8.353, [95%CI, 1.022–68.279], p=0.048); concomitant prerenal AKI (HR 5.670, [95% CI, 1.143–28.131], p = 0.034); and need of RRT (HR 19.519, [95% CI, 4.871–78.215], p < 0.001). Median OS was 6 months (IQR 1–24 months). We found differences in the global survival over 60 months, with longtime survivors including patients with Bricker (42.6% vs16.4%) and genito-urinary cancer (27.6% vs 11.7%). Gastric cancer (HR 2.943, [95%CI, 1.837–4.714], p<0.001), metastatic disease (HR 1.913, [95%CI, 1.464–2.499], p < 0.001), and direct tumoral invasion (HR 1.519, [95%CI, 1.115–2.070], p = 0.008) were related with a decreased survival.

Conclusions:

Gastric cancer, metastatic disease, and direct tumoral invasion were predictors of short survival. The main predictors of evolution to ESKD were previous kidney function, concomitant glomerular disease, and the need for RT.