bluuebunny/crossref_metadata_2025 huggingface dataset:
Translation, cross-cultural adaptation, reliability, and construct validity of the Brazilian Portuguese version of the Basic Psychological Needs in Exercise Scale
Authors: Karloh Manuela , Gavenda Simone G , Araújo Juliana , Alexandre Hellen F , Silva Isabela JCS , Gulart Aline A , Munari Anelise B , Vlachopoulos Symeon P , Matias Thiago S , Mayer Anamaria F
Published: November 2023

This study aims to translate, culturally adapt, and test the reliability and construct validity of the Brazilian Portuguese version of the Basic Psychological Needs in Exercise Scale (BPNES) for patients with Chronic Obstructive Pulmonary Disease (COPD) and Interstitial Lung Disease (ILD). Pulmonary function, dyspnea, quality of life, anxiety and depression symptoms, and functional status were assessed, and two raters independently applied the BPNES. BPNES scores were compared between raters' applications to assess reliability, internal consistency, and agreement. Confirmatory Factor Analysis was used to assess the factor structure of the BPNES model.

Results

59 patients were included (61% with COPD and 39% with ILD). BPNES factor scores were not significantly different between raters’ assessments ( p > 0.05). The internal consistency was 0.70 for autonomy, 0.76 for competence, and 0.80 for relatedness. Inter-rater and test-retest reliability were good to very good for autonomy (ICC = 0.78, 95%CI 0.62–0.87; ICC = 0.75, 95%CI 0.57–0.86, respectively), competence (ICC = 0.81, 95%CI 0.68–0.89; ICC = 0.65, 95%CI 0.43–0.80, respectively), and relatedness (ICC = 0.79, 95%CI 0.65–0.88; ICC = 0.70, 95%CI 0.50–0.83, respectively). Significant correlations were observed between BPNES factors and quality of life, anxiety, depression, and functional status. In conclusion, this study confirmed the reliability and construct validity of the Brazilian Portuguese version of the BPNES in patients with COPD and ILD.
A Digital Diabetes Storytelling Intervention for the Hmong Community: A Pilot Study
Authors: Brown Kathryn M , Silveira Cassandra , Xiong Serena , Lumpkin Nirmal , Carlin Caroline , Pang Catherine J , Schafer Katherine Montag
Published: November 2023

Hmong-Americans experience higher rates of diabetes and poorer diabetes-related health outcomes than their White peers. Traditional methods of diabetes education do not reach Hmong patients effectively due to known socioeconomic and literacy barriers. The purpose of this study is to examine the acceptability of a culturally informed diabetes self-management education video tool, using digital storytelling that was created using a community-engaged approach, administered in a single academic clinic that sees a large percentage of Hmong patients. The video tool was successful in the areas of acceptability, story transformation, and story identification; 96% of participants stated that the video felt like something from their community, 88% stated that they could identify with the story, 79% stated that they wanted to know what happened next, and 70% of participants reported that they were motivated to do something different after watching. New methods to improve diabetes education and improve health outcomes in Hmong communities are needed. Culturally informed digital storytelling is one tool, which may be used to improve diabetes health outcomes in this population.
Does the Worst of Both Worlds Effect Run Through Cognition? Testing Perceived Peer Delinquency/Drug Use and Moral Neutralization as Mediating Mechanisms
Authors: Walters Glenn D.
Published: November 2023

In an effort to understand the mechanisms responsible for the worst of both worlds (WBW) effect wherein drug-crime comorbidity leads to significantly more future adjustment problems than either crime or drug use alone, a multiple-mediator path analysis was performed. This study consisted of a multivariate analysis of four waves of data from the Gang Reduction and Education Training (GREAT) study provided by 2900 (1412 boys, 1488 girls) respondents. There was approximately one year between each adjacent wave. It was determined that the WBW effect was the result of linkages between two first-stage mediators (perceived peer delinquency and perceived peer drug use) and one second-stage mediator (moral neutralization). From these results it was surmised that drug-crime comorbidity led to increased perceived and actual peer deviance which then fueled a rise in moral neutralization beliefs through social learning and cognitive channels. The rise in neutralization beliefs, in turn, enhanced the child’s odds of becoming involved in future delinquency. Given that the perceived peer delinquency and peer drug use main effects and their interaction predicted a rise in moral neutralization, the effect of perceived peer deviance on antisocial cognition appears to be both cumulative and interactive.
Centers for medicare & medicaid services designate the first ten pharmaceuticals for negotiation under the medicare drug price negotiation program
Authors: Pejic P. Branko
Published: November 2023

The Centers for Medicare & Medicaid Services has made the initial designation of 10 pharmaceuticals for negotiation under the Medicare Drug Price Negotiation Program, and the Industry has fired the first salvo of legal challenges to the constitutionality of the Program.  This article provides an initial high level review of the Program and Industry challenges, which are not expected to be resolved until the cases work their way before the U.S. Supreme Court.
Thermal properties and Life Cycle Assessment of new eco-sandwich panel for building thermal insulation
Authors: Er-rradi Hafida , Mghazli Mohamed Oualid , Jilbab Abdelilah , Bojji Chakib , Idchabani Rachida
Published: November 2023

Lightweight eco-materials are in high demand in many sectors, such as aerospace, industry, and building due to their several characteristics. The present paper is an experimental investigation of the thermal characteristics of novel sandwich panels made with local and ecological materials namely agglomerated cork for the core and bio-composite materials for the skin. Three configurations (symmetric, asymmetric, and two layers) were studied with different cork core thicknesses. Density values have been measured and compared. Thermal characterization consists of determining thermal conductivity and specific heat using a HFM apparatus; whilst thermal diffusivity and thermal effusivity have been calculated using the experimental findings. The panels are lightweight and thermally insulating. The values of thermal conductivity are in the range 0.071 and 0.102 W.m−1.K−1. The comparison between experimental results of thermal conductivity to theoretical values highlights the accuracy of method for multi-layer thermal characterization and the good adhesion between layers. Finally, a life cycle assessment of the new sandwich panels has been carried out and compared with common insulation materials. The sandwich panels are efficient in terms of embodied energy and CO2 emissions compared to commercialized insulators and some insulators based on recycled or natural materials, the embodied energy for symmetric configuration with 4 cm cork core are 79.73, 94.75, and 89.35 MJ/FU corresponding to an embodied carbon 5.33, 6.32, and 6.01 CO2/FU respectively. They can be classified in the middle between synthetic and natural insulators. Based on the findings, it was concluded that utilizing these sandwich panels as construction materials for interior paneling or partition walls could offer benefits in terms of being environmentally sustainable and cost-efficient.
Levels of policy drivers: Introducing and demonstrating an analytical framework for education policy spread
Authors: Besche-Truthe Fabian
Published: November 2023

A plethora of scholars investigate how policies spread globally. This paper establishes an analytical framework to structure empirical macro-quantitative research on global education policy spread and enable this analysis to be more comprehensive. Different theories and concepts of drivers for education policy are structured into three distinct levels of origin: the domestic, and the horizontal and vertical interrelational level of policy drivers (LoPD). Analyzing education policy spread considering these levels, it will be argued, enriches analysis normally focusing only on one single level. An exemplary empirical application on the spread of Adult Basic Education policies suggests the merits of this framework. While not contradicting existing theories, it allows a more thorough analysis of mechanisms of policy spread. Hence, the LoPD framework can serve as a springboard to analyze policy spread in a more structured and holistic way. Thus, it can focus macro-quantitative research on education policy spread on optimizing measures.
Component-based perfect replacement optimizations for series and parallel systems consisting of repairable dependent components
Authors: Kazempoor Jaber , Habibirad Arezou
Published: November 2023

In this paper, we consider the preventive perfect replacement and replacement by a new one policies for some arbitrary selected components in the repairable series and parallel systems with dependent components. These policies are also extended to other systems. In fact, regardless of the kind of system, the policies are applied to any system with a survival function that can be calculated as a known function of their component’s survival functions. The dependent structure of these components is formulated regarding copula frameworks. In addition, two optimal maintenance policies in accordance with the maximum expected life for a series and parallel system and minimum/maximum relative risk of a component for a series/parallel system have been provided. The problem issue of finding the optimal relative risk of a component is new and has not been proposed up to now. Although the optimal life extension of a system has been investigated previously, through a replacement policy of the whole system, in this study, the life of a series or parallel system is optimally extended through a replacement policy of some of its dependent components. The existence of the optimal solution has been shown for all copula functions and furthermore, some numerical results are detailed regarding the Gumbel, Frank, Joe, Clayton, FGM, Normal, and AMH copulas.
Stable housing, ‘home’ and desistance: Views from Aotearoa New Zealand
Authors: Low Grace , Lindsay Latimer Cinnamon , Mills Alice
Published: November 2023

There has been little theoretical development concerning the role of housing and the more subjective notion of ‘home’ in supporting desistance from crime. Through narrative interviews with 16 men with histories of imprisonment in Aotearoa New Zealand, this article explores key psycho-social benefits of home that support men to desist from crime. The article expands knowledge on the role of place and space in desistance by emphasising that to fully engage with the desistance process, those leaving prison need more than a roof over their heads; they need a home with psycho-social benefits that enhance their sense of wellbeing and ontological security. It is argued that a home provides a crucial setting for those leaving prison to ‘do’ desistance, and it is imperative that reintegration policy and practice recognise the psycho-social benefits of home.
Conocimientos sobre COVID-19 en población general adulta tras dos años de pandemia
Authors: Ceñera Fernández Jennifer , González Esteban Laura , Moure García Camino , Cernuda Martínez José Antonio
Published: November 2023

Objetivo:

identificar el nivel de conocimientos sobre la COVID-19 que tiene la población adulta residente en Gijón (España) después de dos años de pandemia.

Métodos:

se realizó un estudio descriptivo transversal entre marzo del 2021 y marzo del 2022. Los datos se obtuvieron mediante un cuestionario telefónico sobre una muestra estratificada de tres zonas básicas de salud de Gijón, España (Calzada, Zarracina y Parque-Somió). El tamaño muestral se compuso de 305 personas. Se empleó el análisis ji-cuadrado para estudiar la relación entre variables categóricas y ANOVA para comparar las medias de la puntuación total por zona básica. Se realizaron regresiones logísticas para calcular las odds ratio entre la variable dependiente (poseer conocimientos avanzados) y las independientes (variables sociodemográficas). Se construyó un modelo predictivo entre la existencia o no de conocimiento avanzado y las variables independientes mediante regresión logística.

Resultados:

se encontraron diferencias en la puntuación media del nivel de conocimientos entre Parque-Somió y Calzada ( p = 0.000) y Parque-Somió y Zarracina ( p = 0.045), obteniendo mayor puntuación media la de Parque-Somió. Se observó una asociación entre el nivel de conocimientos y las variables medio de información utilizado ( p = 0.018), edad ( p = 0.036), zona básica de salud ( p = 0.000), nivel educativo ( p = 0.000) e historia previa de contacto estrecho ( p = 0.004).

Conclusiones:

el nivel de conocimientos avanzado se presenta sobre todo en las zonas básicas de salud con mayor nivel socioeconómico, población con nivel educativo alto, de 25 a 45 años, que se ha informado por su entorno y con historia previa de seguimiento por ser contacto estrecho.
Wearable in-ear pulse oximetry validly measures oxygen saturation between 70% and 100%: A prospective agreement study
Authors: Bubb Catherina AB , Weber Michael , Kretsch Nadine , Heim Ralph , Zellhuber Incinur , Schmid Sebastian , Kagerbauer Simone M , Kreuzer Johannes , Schaller Stefan J , Blobner Manfred , Jungwirth Bettina
Published: November 2023

Objectives

Postoperative monitoring outside intensive and post-anaesthesia care units is seldom, partly due to lack of suitable and approved systems. We therefore aim to validate the oxygen saturation (SpO2) and pulse rate measurement of the in-ear sensor c-med° alpha with a reference pulse oximeter.

Methods

This prospective agreement study was conducted in 12 healthy (ASA 1) adult (18–50 years) volunteers according to the EN ISO 80601-2-61. The sitting volunteers were equipped with the finger pulse oximeter Rad-5 and two c-med° alpha sensors in each ear. The inspiratory oxygen content was reduced via a tight-fitting breathing mask to achieve five defined plateaus with stable SpO2 between 99% and 70%. The deviation of the SpO2 and pulse rate measurements of the c-med° alpha from those of the Rad-5 was calculated using the mean square error (Arms). Bias and limits of agreement between both devices were calculated using the Bland-Altman technique. The precision was compared based on the repeatability coefficients.

Results

The c-med° alpha measured SpO2 had an Arms = 1.9% relative to the Rad-5, a non-significant bias (−0.1% (-0.2% to 0.0%)), levels of agreement from −4.0% to 3.8%, and the same repeatability coefficient (0.8% vs. 0.8%). The c-med° alpha measured pulse rate did not deviate from the one measured with the certified finger pulse oximeter (bias: 0.1 min−1 (0 to 0.1 min−1), level of agreement: −3.6 to 3.7 min−1, Arms: 1.8 min−1).

Conclusions

The c-med° alpha fulfils the EN ISO 80601-2-61 standard and is sufficiently accurate for measuring SpO2 and pulse rate in healthy adults at rest.

Trial registration

EUDAMED No. CIV-21-03-036033
China's Policy Actions to Lead Teacher Development With Evaluation Reform
Authors: Li (李廷洲) Tingzhou , Zhang (张罗) Luo
Published: November 2023

Purpose

This study introduces a policy with great strategic significance and far-reaching impact by analyzing the background, measures, and future development trends of teacher evaluation reform in China.

Design/Approach/Methods

This study primarily conducts a policy text analysis of the section on teacher evaluation of the Overall Plan for Deepening the Reform of Educational Evaluation in the New Era.

Findings

The Overall Plan for Deepening the Reform of Educational Evaluation in the New Era was drafted to enhance the quality of Chinese teachers and address many problems in teacher evaluation. It comprised four sections: teachers’ professional ethics, teaching effectiveness, evaluation models and methods, and honorary titles. The policy has distinctive features such as the high status and authority of the issuing body, a holistic and systematic nature, and an orientation toward practical issues. This article proposes three major policy foresights: promoting implementation through the force of political trends, giving schools autonomy in teacher evaluations, and implementing progressive reforms.

Originality/Value

This study conducted a specialist analysis of the policy in combination with the real scenario and institutional environment of Chinese teacher evaluation, which could encourage international peers to better understand Chinese teacher evaluation policies and promote policy learning and dissemination internationally.
Defining the Spectrum of Hypoplastic Left Heart Syndrome (HLHS)
Authors: Jacobs Jeffrey P. , Bleiweis Mark S. , Cohen Meryl S. , Lopez Leo , Peek Giles J. , Franklin Rodney C. G. , Tchervenkov Christo I.
Published: November 2023

The 2021 International Paediatric and Congenital Cardiac Code and the Eleventh Revision of the International Classification of Diseases provide the following definition for hypoplastic left heart syndrome (HLHS): “Hypoplastic left heart syndrome (HLHS) is defined as a spectrum of congenital cardiovascular malformations with normally aligned great arteries without a common atrioventricular junction, characterized by underdevelopment of the left heart with significant hypoplasia of the left ventricle including atresia, stenosis, or hypoplasia of the aortic or mitral valve, or both valves, and hypoplasia of the ascending aorta and aortic arch.” Although HLHS with intact ventricular septum (HLHS + IVS) and HLHS with ventricular septal defect (HLHS + VSD) are different cardiac phenotypes, both of these lesions are part of the spectrum of HLHS.
Achievements, challenges, and opportunities: Redesigning higher education in East Asia for a better future
Authors: Yang Lili
Published: November 2023

This editorial piece sets out the background of the special issue ‘Redesigning higher education in East Asia for a better future’. On the one hand, East Asian higher education has made phenomenal achievements in the last two decades, in both quantity and quality. On the other hand, it faces lingering intrinsic and extrinsic challenges. A major source of the intrinsic challenges is the persisting tensions between the local cultures and the imported modern Western university model. The extrinsic challenges are related with the global power dynamics in higher education, manifested in global knowledge asymmetries, academic dependence, and the center-periphery continuum in the global higher education system. Focusing on the efforts and opportunities in East Asian higher education, the nine articles of this special issue center around the question of ‘how can higher education in East Asia be redesigned to advance its own development and contributions to society?’ Diverse perspectives are employed to explore East Asian higher education at macro, meso, and micro levels, surrounding three themes. It is hoped that this issue can contribute to the ongoing exploration of higher education in East Asia and attract more attention from worldwide higher education researchers to study this rich and important field.
What Happens When Privilege Boundaries are Falling? Declining Marriage Rates in Counties that Most Strongly Resisted Marriage Equality
Authors: McVeigh Rory , Carbonaro William , Ambord Paige
Published: November 2023

From 1998 to 2008, conservative activists placed initiatives on ballots in 30 states seeking preemptively to ban marriage for LGBTQ couples. They succeeded in every state, commonly with lopsided vote tallies. We examine what has happened to marriage rates in communities where those battles took place, as beliefs pertaining to marriage equality became more progressive in the nation as a whole and as state-level bans soon fell under the weight of state legislation and state and federal judicial rulings. Counterintuitively, we find that marriage rates have declined the most in communities where opposition to marriage equality was strongest in the early 2000s—so much so, in fact, that they are now indistinguishable from marriage rates in communities where opposition to marriage equality was weaker.
Documenting the Rise of Anxiety in the United States across Space and Time by Using Text Analysis of Online Review Data
Authors: Kovács Balázs
Published: November 2023

In this article, the author demonstrates how one can use large-scale and publicly available online review data to study the rise in anxiety in the United States. Using the anxiety keyword list from the dictionary compiled by Linguistic Inquiry and Word Count, the author analyzed the text of approximately 7 million online reviews submitted by Yelp reviewers across 13 U.S. states from 2006 to 2021. The overall pattern confirms existing discourse that anxiety has been constantly rising in Western societies since 2000. Beyond documenting the overall pattern, online review data enable the disaggregation of this pattern by geographies, price levels, and individuals, thereby providing a more comprehensive and detailed picture than previously documented in existing literature. Additional analysis shows that anxiety is increasing faster than other emotions, such as anger and sadness.
“Optimizing” Health in the Time of COVID-19: How Neoliberal Health Orientations Dictate Families’ Responses
Authors: Steinberg Hillary , Mollborn Stefanie
Published: November 2023

Neoliberal health orientations that emphasize specific health behaviors provide frameworks for how class-advantaged Americans understand themselves and their health. The family is a consequential pathway for such privilege to be enacted. Using dyadic interviews with U.S. parents and teenagers, the authors explore how families in two middle- to upper-middle-class, health-conscious cities reoriented their beliefs and practices around health in response to coronavirus disease 2019. Neoliberal health orientations were still the logic many families used to approach health, even as public health messaging focused on protecting vulnerable groups. The authors find that before and during the pandemic, teenagers experienced intense pressure to maintain a classed, thin body via diet, participation in sports, and exercise. Families that adhered closely to neoliberal ideals and encouraged these practices felt that their health behaviors boosted immune defenses against coronavirus disease 2019. However, parents and teenagers worried about the worsening of their fitness and diet. The authors discuss implications for public health and inequalities.
Heart rate turbulence in acute ischemic stroke
Authors: Stengl Helena , Ganeshan Ramanan , von Rennenberg Regina , Hellwig Simon , Herm Juliane , Krause Thomas , Bauer Axel , Endres Matthias , Georg Haeusler Karl , Scheitz Jan F , Nolte Christian H
Published: November 2023

Background:

Heart rate turbulence (HRT), an ECG-based marker of autonomic cardiac regulation, has shown high prognostic value in patients with established cardiovascular diseases, while data in patients with acute ischemic stroke are scarce.

Patients and methods:

The HRT parameters turbulence onset and turbulence slope were analyzed using Holter-ECG recordings from patients with acute ischemic stroke, consecutively enrolled in the prospective observational HEBRAS study. HRT was categorized as normal (category 0; both parameters normal), abnormal (category 1; one parameter abnormal), or severely abnormal (category 2; both parameters abnormal). Outcomes of interest were functional outcome according to modified Rankin Scale (mRS) score at 3 months, mortality at 1 year, newly detected atrial fibrillation (AF), and evidence of focal myocardial fibrosis on cardiovascular MRI.

Results:

HRT was assessed in 335 patients in sinus rhythm (median age 69 years, 37% female, median NIHSS score 2 on admission), including 262 (78%) with normal HRT, 47 (14%) with abnormal and 26 (8%) with severely abnormal HRT. Compared with normal HRT, severely abnormal HRT was associated with increased disability [higher mRS] at 3 months (adjusted odds ratio [aOR]: 2.9, 95% confidence interval [CI]: 1.3–6.6), new AF (aOR: 3.5, 95% CI: 1.1–10.6), MRI-detected myocardial fibrosis (aOR: 5.8, 95% CI: 1.3–25.9), but not with mortality at 1 year after stroke (aOR: 3.0, 95% CI: 0.7–13.9). Abnormal HRT was not associated with the analyzed outcomes.

Conclusions:

Severely abnormal HRT was associated with increased disability and previously unknown cardiac comorbidities. The potential role of HRT in selecting patients for extended AF monitoring and cardiac imaging should be further investigated.
Relative spatial variability in building heights and its spatial association: Application for the spatial clustering of harmonious and inharmonious building heights in Tokyo
Authors: Usui Hiroyuki
Published: November 2023

Whether or not a streetscape skeleton – the 3D spaces of streets defined by the arrangement of surrounding buildings – is vertically harmonious depends to a large extent on the degree of difference between the heights of buildings adjacent to one another, known as the relative spatial variability in building heights. Surprisingly, this subject has been overlooked in previous studies examining the harmony of streetscapes. Data on precise building heights are indispensable for evaluating the relative spatial variability in building heights and its spatial association. The recent relaxation of data limitations on precise building heights in Tokyo enabled us to identify the relative spatial variability in building heights and quantify its spatial association. Therefore, in this paper we aim to answer the following question: where are harmonious or inharmonious building heights locally clustered? To this end, we computed the spatial association of the relative spatial variability in building heights as a set of edges whose indices enabled us to evaluate the local indicator of spatial association (LISA). Subsequently, we statistically demarcated locally harmonious and inharmonious building heights without having to set predetermined basic spatial units. In this respect, our methods and findings are novel and can contribute to establishing a new method for measuring the variability in vertical streetscape skeletons, which is important for developing urban design policies.
Inequalities in experiencing urban functions. An exploration of human digital (geo-)footprints
Authors: Calafiore Alessia , Samardzhiev Krasen , Rowe Francisco , Fleischmann Martin , Arribas-Bel Daniel
Published: November 2023

Studies on mobility inequalities have so far mostly relied on Survey data or Censuses. While such studies have demonstrated that inequalities strongly influence everyday mobility choices, these data sources lack granular information on people’s movements on a daily basis. By capitalising on high spatio-temporal resolution data provided by Spectus.ai, this study aims at investigating how the deprivation level of the area where people live influences the kinds of urban environment they are more likely to use for their everyday activities. To do this, raw GPS trajectories collected in 2019 in Great Britain (GB) are transformed into semantic trajectories where short-time changes and the functional nature of urban contexts are acknowledged as two key dimensions to understand human spatial behaviours. Hourly sequences of stops are extracted from GPS trajectories and enriched with contextual information based on a new area-based classification detecting urban functions. The data exploration shows that some human patterns are widely common across all levels of deprivation, such as the tendency to be mostly exposed to the urban context near the home location. At the same time, we show that differences exist, especially between those who live in the most deprived areas and those who live in the least deprived areas of GB. It appears that people living in the most deprived areas tend to have a less regular working pattern and be more exposed to urban-based functions and well-served areas, while those living in the least deprived areas have a more regular working patterns and are mostly exposed to the countryside and low-density areas. Our approach and results provide new insights on the temporal and contextual dimensions of mobility inequalities, informing on who is exposed to issues characterising certain urban environments.
Our Experience with rTMS in a Stroke
Authors: Ojha Pawan T. , Gaikwad Abhijit , Kharat Sumit , Ojha Nishu , Nagendra Shashank , Yadav Jayendra , Maniyar Aamna
Published: November 2023

Background

Repetitive Transcranial Magnetic Stimulation (r-TMS), a non-invasive brain stimulation method, appears promising in augmenting post-stroke recovery and requires further evaluation.

Aims and Objective

To study the effect of r-TMS treatment on motor function in patients with strokes of different duration and types.

Methods

A prospective, single center study was conducted to study the effect of bilateral motor cortex rTMS treatment in 100 consecutive patients with either ischemic or hemorrhagic stroke of any duration. Measured outcomes were changes in NIHSS, MRC grading for motor power, MAS (modified Ashworth scale) for spasticity and mRS (modified Rankin Score) from baseline to follow-up visit at 90 days. Paired T test was used for comparing the outcomes.

Results

77% subjects were males, 82% had ischemic stroke, median age was 58.5 years, and median NIHSS score was 11. We observed favorable changes in outcome measures after treatment. mRS < = 2 at 90 days was observed in 85.71% of patients with acute stroke, 64.51% of subacute and 55.88% of chronic strokes (p value < 0.002). Acute stroke had higher rates of limb power improvement (94.28%) than subacute (70.96%) or chronic strokes (41.17%) (p value = < 0.01). Post-stroke spasticity reduction was also observed after rTMS. Patients with infarcts or hemorrhages had no significant differences. No significant adverse events were seen.

Conclusion

rTMS appears to be safe in our study population and could be effectively delivered at different time points to augment post-stroke motor recovery.
Gastric Electrical Stimulation is an Effective Treatment Modality for Symptoms of GERD in Patients With Gastroparesis and VACTERL Association
Authors: Pagan-Bolivar Andrea , Mathur Prateek , Naing Le Yu , Stocker Abigail , Carson Samuel , Fallat Mary , Abell Thomas L.
Published: November 2023

Patients with VACTERL Association have multiple gastrointestinal comorbidities extending into adulthood. The term VACTERL stands for vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula (TEF) with or without esophageal atresia (EA), renal anomalies, and limb abnormalities. Symptoms of gastroesophageal reflux disease (GERD), such as heartburn and acid regurgitation, are common in this population, and patients with EA have a higher risk. Multiple therapies have been suggested to treat symptoms of GERD in patients with gastroparesis and VACTERL Association, including acid suppression therapy and treating the underlying gastroparesis. If left untreated, patients who had EA can experience severe complications, including erosive esophagitis, Barrett’s esophagus (BE), peptic strictures, esophageal cancer, and decrease in quality of life. We present 2 cases of patients with VACTERL Association with prior EA, gastroparesis and underlying symptoms of GERD that were successfully treated with gastric electrical stimulation (GES).
The Impact of Gastroparesis on Medical Therapy for Gastroesophageal Reflux Disease
Authors: Reddy Alexander , Gyawali C. Prakash , Patel Amit
Published: November 2023

Symptoms suspicious for gastroesophageal reflux disease (GERD) represent frequent indications for medical presentation, as do symptoms potentially compatible with delayed gastric emptying. In this clinical setting, care must be taken to characterize patient symptoms accurately, and also appropriately evaluate for pathophysiologic processes including visceral hypersensitivity, rumination syndrome, supragastric belching, cannabinoid hyperemesis, and cyclic vomiting syndrome. While proton pump inhibitors (PPI) are the foundation of medical management of GERD, delayed gastric emptying is a downstream factor that can promote gastroesophageal reflux and warrants tailored clinical management. Specifically, patients with refractory symptoms in the setting of GERD and delayed gastric emptying may benefit from personalized adjunct medical therapy with prokinetics.
Supporting transracially adopted children in white K-12 schools: Strategies for empowerment and inclusion
Authors: Sutton Carole , Beese Jane , Slater Lindsay
Published: November 2023

The transracial adoption of children into white communities is a growing phenomenon. Unfortunately, transracially adopted children are more likely to face identity issues, mental health concerns, and racism in white K-12 schools due to their lack of access to understanding, support, and resources. In order for transracially adopted children to thrive academically and emotionally, it is essential that educators become aware of the unique challenges transracial families face. In this paper, we will examine the challenges transracially adopted children face in white K-12 schools and provide strategies for educators to create welcoming learning communities that empower transracially adopted children and their transracial families.
Inhibition of glutaminase-1 in DLBCL potentiates venetoclax-induced antitumor activity by promoting oxidative stress
Authors: Gomez Solsona Beatriz , Horn Heike , Schmitt Anja , Xu Wendan , Bucher Philip , Heinrich Aylin , Kalmbach Sabrina , Kreienkamp Nina , Franke Maik , Wimmers Florian , Schuhknecht Laurentz , Rosenwald Andreas , Zampieri Mattia , Ott German , Lenz Georg , Schulze-Osthoff Klaus , Hailfinger Stephan
Published: November 2023

Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma in adults, but first-line immunochemotherapy fails to produce a durable response in about one-third of the patients. Because tumor cells often reprogram their metabolism, we investigated the importance of glutaminolysis, a pathway converting glutamine to generate energy and various metabolites, for the growth of DLBCL cells. Glutaminase-1 (GLS1) expression was robustly detected in DLBCL biopsy samples and cell lines. Both pharmacological inhibition and genetic knockdown of GLS1 induced cell death in DLBCL cells regardless of their subtype classification, whereas primary B cells remained unaffected. Interestingly, GLS1 inhibition resulted not only in reduced levels of intermediates of the tricarboxylic acid cycle but also in a strong mitochondrial accumulation of reactive oxygen species. Supplementation of DLBCL cells with α-ketoglutarate or with the antioxidant α-tocopherol mitigated oxidative stress and abrogated cell death upon GLS1 inhibition, indicating an essential role of glutaminolysis in the protection from oxidative stress. Furthermore, the combination of the GLS1 inhibitor CB-839 with the therapeutic BCL2 inhibitor ABT-199 not only induced massive reactive oxygen species (ROS) production but also exhibited highly synergistic cytotoxicity, suggesting that simultaneous targeting of GLS1 and BCL2 could represent a novel therapeutic strategy for patients with DLBCL.
Effects of IL-1β inhibition on anemia and clonal hematopoiesis in the randomized CANTOS trial
Authors: Woo Janghee , Lu Darlene , Lewandowski Andrew , Xu Huilei , Serrano Pablo , Healey Margaret , Yates Denise P. , Beste Michael T. , Libby Peter , Ridker Paul M. , Steensma David P.
Published: November 2023

Canakinumab, a monoclonal antibody targeting proinflammatory cytokine interleukin-1β (IL-1β), improved hemoglobin levels while preventing recurrent cardiovascular events in the Canakinumab Anti-inflammatory Thrombosis Outcomes Study (CANTOS). This cardiovascular (CV) preventive effect was greater in patients with TET2 mutations associated with clonal hematopoiesis (CH). The current proteogenomic analysis aimed to understand the clinical response to canakinumab and underlying proteomic profiles in the context of CH and anemia. The analysis included 4595 patients from the CANTOS study who received either canakinumab or placebo and evaluated multiplexed proteomics (4785 proteins) using SomaScan and targeted deep sequencing for CH mutations. Incident anemia was more common in the presence of CH mutations but reduced by canakinumab treatment. Canakinumab treatment was significantly associated with higher hemoglobin increment in patients with concurrent CH mutations and anemia than patients with CH mutations without anemia or without CH mutations. Compared with those without CH mutations, the presence of CH mutations was associated with proteomic signatures of inflammation and defense response to infection, as well as markers of high-risk CV disease which was further enhanced by the presence of anemia. Canakinumab suppressed hepcidin, proinflammatory cytokines, myeloid activation, and complement pathways, and reversed pathologically deregulated pathways to a greater extent in patients with CH mutations and anemia. These molecular findings provide evidence of the clinical use of IL-1β blockade and support further study of canakinumab for patients with concurrent anemia and CH mutations. This study was registered at www.clinicaltrials.gov as #NCT01327846.
Performance of the MeltPro TB assay as initial test for diagnosis of pulmonary tuberculosis with drug-resistance detection
Authors: Liu Zhi-bin , Cheng Li-ping , Pan Hong-qiu , Wu Xiao-cui , Lu Fu-hui , Cao Jie , Wang Lei , Wei Wei , Chen Hong-yu , Sha Wei , Sun Qin
Published: November 2023

Background

The MeltPro TB assay (MeltPro) is a molecular rapid diagnostic test designed for detecting resistance to antituberculosis drugs. However, the performance of MeltPro as an initial diagnostic test for simultaneously detecting the presence of Mycobacterium tuberculosis (MTB) and drug resistance has not been evaluated. This study aims to assess the performance of MeltPro as initial diagnostic test for simultaneous detection of MTB and drug resistance in clinical samples from patients with presumptive pulmonary tuberculosis (PTB).

Methods

A retrospective analysis was conducted on 1283 patients with presumptive PTB from two clinical centers, out of which 875 were diagnosed with PTB. The diagnostic accuracy of MeltPro, Xpert MTB/RIF (Xpert), and MGIT 960 for PTB detection was evaluated. Rifampicin (RIF), isoniazid (INH), ethambutol (EMB), streptomycin (STR), and fluoroquinolone (FQ) resistance were detected using MeltPro, with Xpert and/or the broth microdilution plate method (MYCOTB) results as references.

Results

For the diagnosis of PTB, MeltPro showed a sensitivity of 69.0%, which was similar to Xpert (72.7%; P > 0.05) and higher than MGIT (58.1%; P < 0.001). The specificity of MeltPro was 97.1%, similar to Xpert (98.0%; P > 0.05). In smear-negative patients, MeltPro's sensitivity was 50.9%, similar to Xpert (56.5%; P > 0.05), and higher than MGIT (33.1%; P < 0.001). Based on Xpert and/or MYCOTB results, MeltPro exhibited a sensitivity and specificity of 98.3% and 99.2%, respectively, for detecting RIF resistance. Based on MYCOTB results, MeltPro's sensitivity for detecting resistance to INH, EMB, STR, and FQ was 96.4%, 89.1%, 97.5%, and 90.3%, respectively, with specificities of 96.0%, 96.0%, 95.2%, and 99.4%, respectively.

Conclusion

The MeltPro TB assay could potentially be an effective alternative as the initial test for rapid diagnosis of PTB with drug-resistance detection in clinical practice.
An Improved Time-Domain Inverse Technique for Localization and Quantification of Rotating Sound Sources
Authors: Zhang Xiaozheng , Li Yinlong , Zhang Yongbin , Bi Chuanxing , Li Jinghao , Xu Liang
Published: November 2023

The time-domain inverse technique based on the time-domain rotating equivalent source method has been proposed to localize and quantify rotating sound sources. However, this technique encounters two problems to be addressed: one is the time-consuming process of solving the transcendental equation at each time step, and the other is the difficulty of controlling the instability problem due to the time-varying transfer matrix. In view of that, an improved technique is proposed in this paper to resolve these two problems. In the improved technique, a de-Dopplerization method in the time-domain rotating reference frame is first applied to eliminate the Doppler effect caused by the source rotation in the measured pressure signals, and then the restored pressure signals without the Doppler effect are used as the inputs of the time-domain stationary equivalent source method to locate and quantify sound sources. Compared with the original technique, the improved technique can avoid solving the transcendental equation at each time step, and facilitate the treatment of the instability problem because the transfer matrix does not change with time. Numerical simulation and experimental results show that the improved technique can eliminate the Doppler effect effectively, and then localize and quantify the rotating nonstationary or broadband sources accurately. The results also demonstrate that the improved technique can guarantee a more stable reconstruction and compute more efficiently than the original one.
Genomic formation of Tibeto-Burman speaking populations in Guizhou, Southwest China
Authors: Chen Jinwen , Zhang Han , Yang Meiqing , Wang Rui , Zhang Hongling , Ren Zheng , Wang Qiyan , Liu Yubo , Chen Jing , Ji Jingyan , Zhao Jing , He Guanglin , Guo Jianxin , Zhu Kongyang , Yang Xiaomin , Ma Hao , Wang Chuan-Chao , Huang Jiang
Published: November 2023

Sino-Tibetan is the most prominent language family in East Asia. Previous genetic studies mainly focused on the Tibetan and Han Chinese populations. However, due to the sparse sampling, the genetic structure and admixture history of Tibeto-Burman-speaking populations in the low-altitude region of Southwest China still need to be clarified. We collected DNA from 157 individuals from four Tibeto-Burman-speaking groups from the Guizhou province in Southwest China. We genotyped the samples at about 700,000 genome-wide single nucleotide polymorphisms. Our results indicate that the genetic variation of the four Tibeto-Burman-speaking groups in Guizhou is at the intermediate position in the modern Tibetan-Tai-Kadai/Austronesian genetic cline. This suggests that the formation of Tibetan-Burman groups involved a large-scale gene flow from lowland southern Chinese. The southern ancestry could be further modelled as deriving from Vietnam’s Late Neolithic-related inland Southeast Asia agricultural populations and Taiwan’s Iron Age-related coastal rice-farming populations. Compared to the Tibeto-Burman speakers in the Tibetan-Yi Corridor reported previously, the Tibeto-Burman groups in the Guizhou region received additional gene flow from the southeast coastal area of China. We show a difference between the genetic profiles of the Tibeto-Burman speakers of the Tibetan-Yi Corridor and the Guizhou province. Vast mountain ranges and rivers in Southwest China may have decelerated the westward expansion of the southeast coastal East Asians. Our results demonstrate the complex genetic profile in the Guizhou region in Southwest China and support the multiple waves of human migration in the southern area of East Asia.
Cingulate white matter mediates the effects of fecal Ruminococcus on neuropsychiatric symptoms in patients with amyloid-positive amnestic mild cognitive impairment
Authors: Hung Chun-Che , Chao Yi-Ping , Lee Yejin , Huang Chi-Wei , Huang Shu-Hua , Chang Chiung-Chih , Cheng Chia-Hsiung
Published: November 2023

Background

Microbiota-gut-brain axis interacts with one another to regulate brain functions. However, whether the impacts of gut dysbiosis on limbic white matter (WM) tracts contribute to the neuropsychiatric symptoms (NPS) in patients with amyloid-positive amnestic mild cognitive impairment (aMCI+), have not been explored yet. This study aimed to investigate the mediation effects of limbic WM integrity on the association between gut microbiota and NPS in patients with aMCI+.

Methods

Twenty patients with aMCI + and 20 healthy controls (HCs) were enrolled. All subjects underwent neuropsychological assessments and their microbial compositions were characterized using 16S rRNA Miseq sequencing technique. Amyloid deposition inspected by positron emission tomography imaging and limbic WM tracts (i.e., fornix, cingulum, and uncinate fasciculus) detected by diffusion tensor imaging were additionally measured in patients with aMCI+. We employed a regression-based mediation analysis using Hayes’s PROCESS macro in this study.

Results

The relative abundance of genera Ruminococcus and Lactococcus was significantly decreased in patients with aMCI + versus HCs. The relative abundance of Ruminococcus was negatively correlated with affective symptom cluster in the aMCI + group. Notably, this association was mediated by WM integrity of the left cingulate gyrus.

Conclusions

Our findings suggest Ruminococcus as a potential target for the management of affective impairments in patients with aMCI+.
Delayed diagnosis of Lemierre’s syndrome in a patient with severe coronavirus disease 2019: importance of comprehensive oral and neck examination – a case report
Authors: Miura Tomotaka , Fukuda Hirotsugu , Kawada Hiroshi , Kaga Tetsuro , Matsuo Masayuki , Sakai Tsutomu , Yoshida Shozo , Okada Hideshi , Ogura Shinji , Tetsuka Nobuyuki
Published: November 2023

Background

Given the widespread prevalence of the coronavirus disease 2019 (COVID-19), oral and neck examinations tend to be avoided in patients with suspected or confirmed COVID-19. This might delay the diagnosis of conditions such as Lemierre’s syndrome, which involves symptoms resembling COVID-19-related throat manifestations.

Case presentation

A 24-year-old man without any underlying conditions was diagnosed with COVID-19 7 days before presentation. He was admitted to another hospital 1 day before presentation with severe COVID-19 and suspected bacterial pneumonia; accordingly, he was started on treatment with remdesivir and meropenem. Owing to bacteremic complications, the patient was transferred to our hospital for intensive care. On the sixth day, the patient experienced hemoptysis; further, a computed tomography (CT) scan revealed new pulmonary artery pseudoaneurysms. Successful embolization was performed to achieve hemostasis. In blood cultures conducted at the previous hospital, Fusobacterium nucleatum was isolated, suggesting a cervical origin of the infection. A neck CT scan confirmed a peritonsillar abscess and left internal jugular vein thrombus; accordingly, he was diagnosed with Lemierre’s syndrome. The treatment was switched to ampicillin/sulbactam, based on the drug susceptibility results. After 6 weeks of treatment, the patient completely recovered without complications.

Conclusion

This case highlights the significance of thorough oral and neck examinations in patients with suspected or diagnosed COVID-19 for the detection of throat and neck symptoms caused by other conditions.