bluuebunny/crossref_metadata_2025 huggingface dataset:
Increasing aleurone layer number and pericarp yield for elevated nutrient content in maize
Authors: Paulsmeyer Michael N , Juvik John A
Published: June 2023

The bran is a nutritive fraction of the maize (Zea mays L.) kernel containing micronutrients, quality protein, and antioxidants beneficial for human health. Bran consists of two major components: aleurone and pericarp. Increasing this nutritive fraction would therefore have implications on biofortification of maize. Since quantification of these two layers is difficult, the goals of this study were to develop efficient techniques for analyzing these layers and to develop molecular markers for pericarp and aleurone yield. Two populations with various characteristics were genotyped using genotyping-by-sequencing. The first was a yellow corn population with contrasting pericarp thicknesses. The second was a blue corn population segregating for Intensifier1 alleles. Both populations segregated for the multiple aleurone layer (MAL) trait that is known to increase aleurone yield. In this study, it was found that MALs are mostly determined by a locus on chromosome 8, but several minor loci are also involved. The inheritance of MALs was complex and seemingly more additive than dominant. In the blue corn population, anthocyanin content increased 20 to 30% with the addition of MALs demonstrating its effectiveness at increasing aleurone yield. Elemental analysis was performed on MAL lines and indicated a role of MALs in increasing iron content in the grain. Iron content was increased 17.5% in the MAL lines over the single aleurone layer lines and 35.5% over the recurrent parent, Mo17. Zinc content was increased 15.5% in the MAL lines compared to the recurrent parent. QTL analyses are presented in this study on many pericarp, aleurone, and grain quality traits. Molecular markers were also tested for the MAL locus on chromosome 8, and candidate genes are discussed. Results of this study may assist plant breeders enhancing anthocyanin content and other beneficial phytonutrients in maize.
A transcriptional cofactor regulatory network for the C. elegans intestine
Authors: Horowitz Brent B , Nanda Shivani , Walhout Albertha J M
Published: June 2023

Chromatin modifiers and transcriptional cofactors (collectively referred to as CFs) work with DNA-binding transcription factors (TFs) to regulate gene expression. In multicellular eukaryotes, distinct tissues each execute their own gene expression program for accurate differentiation and subsequent functionality. While the function of TFs in differential gene expression has been studied in detail in many systems, the contribution of CFs has remained less explored. Here, we uncovered the contributions of CFs to gene regulation in the Caenorhabditis elegans intestine. We first annotated 366 CFs encoded by the C. elegans genome and assembled a library of 335 RNAi clones. Using this library, we analyzed the effects of individually depleting these CFs on the expression of 19 fluorescent transcriptional reporters in the intestine and identified 216 regulatory interactions. We found that different CFs regulate different promoters, and that both essential and intestinally expressed CFs have the greatest effects on promoter activity. We did not find all members of CF complexes acting on the same set of reporters but instead found diversity in the promoter targets of each complex component. Finally, we found that previously identified activation mechanisms for the acdh-1 promoter use different CFs and TFs. Overall, we demonstrate that CFs function specifically rather than ubiquitously at intestinal promoters and provide an RNAi resource for reverse genetic screens.
Balancing selection and candidate loci for survival and growth during larval development in the Mediterranean mussel, Mytilus galloprovincialis
Authors: Hua Zhihan , Churches Nathan , Nuzhdin Sergey V
Published: June 2023

Many marine bivalves have complex life histories with distinct developmental processes and genetic mechanisms. Larval development for most bivalves is often a prolonged and crucial physiological stage, where they suffer mass mortality due to early-acting genetic load. In this study, we describe genetic changes taking place within a single generation of families of the Mediterranean mussel Mytilus galloprovincialis over 23 days of larval development. Using replicated cultures and a pooled sequencing approach, we demonstrate that temporal balancing selection at the majority of loci preserve genetic variation in the early developmental stages of M. galloprovincialis. Balancing selection may be the mechanism which maintains standing genetic variation within the mussel genome and may improve the chances of survival and shield larvae from high levels of genetic load. Additionally, we used changes in allele frequencies to identify potential size-associated SNPs and viability-associated SNPs and found that patterns of genetic changes in directionally selected SNPs cannot be simply explained by traditional theories of genetic purging or directional selection without consideration of balancing selection. Finally, we observed a negative correlation between larval growth rates and survival, implying a potential trade-off relationship between the 2 commercially relevant phenotypes.
Prevalence, Awareness, Treatment, and Control of Hypertension Among Older Adults in the Philippines
Authors: Abalos Jeofrey B , Saito Yasuhiko , Ramos Miguel A , Cruz Grace T
Published: June 2023

Background

Little is known about the current prevalence and management of hypertension among older Filipinos. To address this gap, we examined the prevalence, awareness, treatment, and control of hypertension, as well as their correlates, among older Filipinos.

Methods

We analyzed a nationally representative survey of Filipinos aged 60 years and older (N = 5 985) in the Philippines. Blood pressure (BP) measurements were taken using a digital BP apparatus. People with hypertension included those with a systolic BP ≥ 140 mmHg or a diastolic BP ≥ 90 mmHg, or those who reported current use of antihypertensive medication. People with undiagnosed hypertension were those who had measured hypertension but had not been diagnosed by a doctor as having hypertension, while people with untreated hypertension were those who had measured hypertension but not taking medication. Among those who were taking antihypertensive medication, respondents with measured hypertension were considered to have uncontrolled BP.

Results

Results showed that 69.1% of older Filipinos had hypertension, but only 61.6% of people with hypertension were aware of their hypertension and 51.5% were untreated. Sociodemographic factors, such as age, sex, education, and living arrangements, were significantly associated with hypertension prevalence, hypertension awareness, lack of treatment for hypertension, and/or suboptimal BP control.

Conclusion

We observed a high prevalence of hypertension among older Filipinos and a relatively low level of awareness and treatment of hypertension among them. While there are government efforts to address the growing prevalence of hypertension in the country, more efforts should be made to bring these government programs to older Filipinos.
Some Geometric Inequalities by the ABP Method
Authors: Pham Doanh
Published: June 2023

In this paper, we apply the so-called Alexandrov–Bakelman–Pucci (ABP) method to establish some geometric inequalities. We first prove a logarithmic Sobolev inequality for closed $n$-dimensional minimal submanifolds $\Sigma $ of $\mathbb S^{n+m}$. As a consequence, it recovers the classical result that $|\mathbb S^{n}| \leq |\Sigma |$ for $m = 1,2$. Next, we prove a Sobolev-type inequality for positive symmetric two-tensors on smooth domains in $\mathbb R^{n}$, which was established by D. Serre when the domain is convex. In the last application of the ABP method, we formulate and prove an inequality related to quermassintegrals of closed hypersurfaces of the Euclidean space.
‘Being a professional is not the same as acting professionally’—How digital technologies have empowered the creation and enactment of a new professional identity in law
Authors: Kronblad Charlotta , Jensen Søren Henning
Published: June 2023

This paper shows that digital technologies have empowered new work practices and identity work in the setting of the legal profession in five different countries. Using qualitative data from 33 interviews with legal tech lawyers, supported by workplace and conference observations and photographs, we analyse how legal tech lawyers use social and material attributes to craft and enact a new identity. This identity is distinctly different from the established professional identity of lawyers, showing that legal tech lawyers see, and express, themselves as legal professionals in a broader sense, rather than identifying with traditional law. This paper explains how technology has functioned as an enabler for them to craft this new identity, much influenced by how, where, and when their work is done. The paper supports and extends a sociomaterial approach to understanding the implications of digital transformation and shows the potential of looking into the development of professional identities in this transformation.
(020) Post-SSRI/SNRI Sexual Dysfunction: A review
Authors: Pukall C
Published: June 2023

Introduction

Post-SSRI-SNRI Sexual Dysfunction (PSSD) is conceptualized as distressing issues with sexual function/pleasure that emerge with SSRI/SNRI initiation and persist after SSRI/SNRI termination and depression remission, and that are not due to other contributors. Although there is increasing recognition of PSSD in clinical practice and research, it is not well understood, researched, or managed.

Objectives

To provide an overview of SSRIs/SNRIs and their side effects (sexual and otherwise), to present and evaluate the working definition of PSSD, to describe current etiological theories and management strategies of PSSD, and to highlight future directions.

Methods

A review of the literature was undertaken in order to understand the current conceptualization of PSSD. Particular attention was paid to sexual and nonsexual side effects of PSSD as well as etiological theories and management strategies.

Results

SSRIs and SNRIs often lead to sexual side effects, which may affect treatment adherence and compliance. A small subset of individuals may develop PSSD, in which distressing sexual dysfunction persists after termination of the SSRI/SNRI and can last months to years. Nonsexual side effects (e.g., cognitive, emotional) have also been reported, and the desire for informed consent as well as collaborative health care has been reported by those affected. PSSD has been recognized as a medical condition by the European Medicines Association since 2019.

Conclusions

PSSD is increasingly recognized as a potential side effect of SSRI/SNRI use, and concerted collaboration and effort is needed in order to comprehensively understand this condition and its management.

Disclosure

No.
(036) Chasing the Two-Headed Dragon: Using BDSM to Manage Pelvic Pain from Endometriosis
Authors: Brown K , Iverson L
Published: June 2023

Introduction

Endometriosis is a chronic gynecological condition that indiscriminately effects approximately 176 million women across the world. Three major symptoms – dysmenorrhea (painful menses), dyspareunia (painful intercourse), and infertility – are the most commonly seen both at diagnosis and throughout management of the condition.

Objectives

Pain due to endometriosis impacts a woman on a daily basis and management of this pain is as varied as the woman diagnosed. Research has been done on the utilization of alternative treatments ranging from yoga to spinal cord stimulation.

Methods

This presentation will present a firsthand experience of a woman engaging in BDSM (Bondage and discipline, Dominance and submission, Sadism, and Masochism) to manage her endometriosis pain. Using a clinical case report format, a history of the patient’s diagnosis, interventions, and treatment will be presented as well as how the patient came to utilize BDSM in response to debilitating endometriosis pain. The patient’s decision-making process as well as descriptions of actual engagement in BDSM and how it connects to management of the pain for the patient will be presented.

Results

A common myth about BDSM is that it is about the desire to experience or inflict pain. In this case, it is the actual control and power over the pain as well as the displacement of pain that mitigates the experience of endometriosis pain for this patient.

Conclusions

Considered an “invisible illness,” many women with endometriosis express their feelings of loss in their quality of life across multiple facets including their primary intimate relationship. By expanding a clinician’s repertoire with additional methods of pain management for women with endometriosis and other pelvic pain experiences broadens the opportunity for improved quality of life for the patient and the couple.

Disclosure

No.
(048) Management of Sexual Dysfunction: Can Color Scheme in Areas of Intimacy be a Possible Management Intervention?
Authors: Chaudhry Z , Bachmann G
Published: June 2023

Introduction

There are several psychological factors that can affect sexual dysfunction, such as stress, anxiety, or depression. Evaluating color schemes in areas of intimacy may be one of the potential ways to address the psychological issues contributing to the sexual dysfunction. That is, suggesting to those with sexual dysfunction an evaluation of the color scheme in their usual area of intimacy should be considered. Further, understanding the effect of color on sexual dysfunction may be important when couples decorate their bedrooms as it can allow couples to understand which colors to avoid and which colors to incorporate in this process.

Objectives

To review the role of color in psychological wellness.

Methods

A systematic literature review was conducted on Google Scholar to examine data on the role of color and psychological health.

Results

There were scant data that explored the role of color in the scientific literature. Further, although none of the research specifically linked color to sexual performance, there were scant data suggesting color may have an indirect impact through improving psychological wellness. Data from two specific studies, one done in Japan and the other in Switzerland did report that both suicide and aggressive behavior were impacted by color. In Tokyo, Japan, in response to the escalating suicide rates, an initiative was undertaken to situate blue LED lamps in about 71 Tokyo train stations. The installation of blue lights was nothing new in Japan and, in fact, blue lights had been installed in the streets in order to reduce crime rates. With the installation of these blue lights there was reported an 84% decrease in suicides. A Swiss study, conducted in a prison, sought to evaluate which colors decreased aggression amongst inmates, specifically male inmates. In order to do so, certain Swiss prisons were painted in a pink color in order to target inmates’ “masculinity.” There was a specific shade of pink from this study which was deemed to be the most effective and it was named ‘Cool Down Pink.’ The methods used to quantify inmate aggression were blood pressure and physical observations. By using the color pink, these Swiss prisons were able to decrease aggression amongst their inmates.

Conclusions

Based on limited research, it appears that color may have a psychological impact on an individual. Although no studies have addressed color and sexual wellness, if psychological wellness is improved, it follows that sexual dysfunction may also improve. The color blue from the Tokyo study infers that this color may reduce depression or even stress and allow for a calm feeling in the mind. When taking sexual dysfunction into account, it follows that if couples incorporate more blue into their areas of intimacy, that sexual function may improve though decreasing anxiety, stress, or depression. Color in areas of intimacy is an area that should be furthered explored, as bedroom color may positively impact sexual function.

Disclosure
(049) Why isn’t Women’s Sexual Health Part of the Conversation? The Case of Vulvodynia
Authors: Bajzak K , Gustafson D , Logan G , Badaiki W , Graham W , Duggan N
Published: June 2023

Introduction

Vulvodynia is a complex pelvic pain condition that affects up to one in four women at some time in their lives. Patients report that primary care providers lack knowledge essential to diagnosis and management of this condition.

Objectives

The aim of this three-phase study was to identify ways of addressing the barriers to diagnosis and management of vulvodynia for women living in rural, northern and remote communities in XX. This paper reports on the second phase and asked: 1) How do family physicians and nurse practitioners describe their awareness and experience with diagnosing and managing vulvodynia? and 2) How would they like to receive information that addresses this knowledge gap?

Methods

Phase two of this qualitative case study collected data using an intake survey and individual and group interviews with a purposive sample of family physicians and nurse practitioners practicing in Newfoundland and Labrador. Surveys were completed prior to interviews and gathered data about demographics and vulvodynia awareness. Interviews were conducted in person or via teleconference between October 2018 and April 2019 and using standardized open-ended prompts. Audio-taped interviews were transcribed, de-identified and coded thematically. Two researchers independently analyzed all data.

Results

Two major themes emerged: a) lack of awareness about the condition and b) four barriers to having a sexual health conversation (the dynamics of discomfort, making the time, generational differences between patient and provider, and the gendering of practitioner responsibilities). Primary care providers also identified their preferred methods for addressing gaps in their knowledge.

Conclusions

Diagnosis and management of vulvodynia requires skilled communication and specific knowledge of this pelvic pain condition. Providing primary care providers with a simple toolkit has the potential to address reported lack of awareness about vulvodynia and the identified barriers to initiating a sexual health conversation.

Disclosure

No.
(059) Estetrol(E4) is a Unique Estrogen With Selective Actions in Tissues Which Are Distinctly Different From the Actions of SERMs
Authors: Foidart J , Arnal J , Lenfant F , Taziaux M , Houtman R , Jost M
Published: June 2023

Introduction

Estetrol (E4) acts as a typical estrogen (E) agonist in stimulating the endometrium, and when administered to postmenopausal women in various doses, reverses vaginal atrophy and decreases vasomotor symptoms. However, in contrast to other Es administered orally, E4 demonstrates a minimal hepatic effect and does not stimulate breast proliferation. Data in pre and postmenopausal women show minimal stimulatory effects on triglycerides, sex hormone binding globulin, corticosteroid-binding globulin, and angiotensinogen. Similarly, E4 exerts minimal effects on coagulation markers, and when combined with drospirenone as a combined oral contraceptive does not increase the generation of thrombin as measured by the activated protein C resistance ratio, unlike the use of ethinyl estradiol.

Objectives

Because of the tissue selectivity of E4, this study sought to better delineate the molecular mode of action of E4.

Methods

Selective E Receptor Modulators (SERMs) exhibit specific cell and tissue estrogenic, neutral or anti-estrogenic activities. SERMs interact with the ligand binding domain of the E Receptor alpha (ERα) in a way that is distinct from that of E. By preventing the kinking of helix 12 in ERα, SERMs recruit other co-receptor activators and inhibitors that are responsible for SERM action. We compared in replicates the binding pattern and affinities of 154 motifs of ERα co- regulator activators and repressors to complexes of ERα with Estradiol (E2), Estriol (E3) or E4 in a specific Pam Gene assay (Broekema et al. Endocrinology. 2018; 159:2397).

Results

The pattern of co-receptor binding in the presence of E4 was identical to that elicited by E2 and E3, but with a 50-fold lower potency. This pattern is strikingly distinct from that observed with 4-hydroxytamoxifen or raloxifen. These data together with previously published studies of the crystalline structures of ERα with E2, E3 or E4 complexes confirm that E4 interacts with nuclear ERα in a manner identical to that of the other Es (Abot et al. EMBO Mol Med. 2014; 6:1328). Previous studies have shown that E4 inhibits the activity of the membrane ERα, and blocks the stimulatory action of E2 in this membrane ERα subpopulation.

Conclusions

In conclusion, E4 is a unique E with specific actions in tissues, demonstrating absence of specific membrane receptor effects, and no interaction with ERα in the way characteristic of SERMs. The unique profile of E4 activity with lower hepatic effects (minimal or no effects on triglycerides and coagulation) may ultimately translate into safer clinical use.

Disclosure

Yes - Mithra Pharmaceuticals, Women's Health.

Industry initiated, executed and funded study – Yes.
(064) Trigger Point Release of Post Partum Pudendal Compression Relieves Persistent Genital Arousal: Case Report
Authors: Wood T
Published: June 2023

Introduction

There is very little literature available on Persistent Genital Arousal Disorder (PGAD). Recent consensus definitions have emerged from the ISSWSH working group on PGAD to expel the myth that PGAD is merely in the minds of those who suffer from it. Dr. Goldstein, et al have published research and criteria for diagnosis, and management of this condition which can be a very distressing one. Novel Non-Invasive treatment modalities are needed for the management of PGAD to prevent distress, and/or unnecessary surgery, in these patients.

Objectives

To determine if local trigger point treatment of the area surrounding the Pudendal Nerve as it passes the piriformis muscle, will cause relief of Persistent Genital Arousal Disorder (PGAD) in a patient suffering for the 8 months since childbirth.

Methods

I present a case of a new mother who suffered from severe PGAD emerging following a precipitous and somewhat traumatic childbirth. The persistent arousal was distracting, upsetting, intolerable, and only somewhat (10-20%) temporarily mitigated by very regular self-stimulation, and also with regular pelvic floor physio, in a busy new mom, who had had no such concerns before-hand. She presented to me at 8 months post-partum, with an 8 month history of PGAD. Based on history of presenting illness, the source of problem was determined to be most likely in pelvis, and potentially caused by entrapment/compression of the Pudendal Nerve. Informed Consent was obtained to attempt trigger point release of the tissues surrounding the Pudendal Nerve posteriorly, as it enters the pelvis. Using a posterior approach, using a 27g 1.5cm bevelled needle, to an area cleaned by alcohol swab, micro-dissection release was performed of area surrounding tissue the Pudendal N as it passes the piriformis muscle. Patient reported immediate and sustained relief of symptoms.

Results

Trigger point needling to the tissue superior to, surrounding, and including the piriformis muscle via the posterior approach caused immediate and sustained relief of the patient’s symptoms. Repeat needle treatment to this area, alternating with physiotherapy for guided relaxation and release of surrounding tissues, resolved patient’s PGAD symptoms by >95% during treatment and >85% 1 year after treatment cessation.

Conclusions

Trigger Point needle treatment of tissues of the muscles and piriformis muscles relieved PGAD symptoms initially caused by Pudendal Nerve entrapment/compression second to precipitous childbirth. This non-invasive approach for immediate and sustained relief of Persistent Genital Arousal Disorder should be widely taught to practitioners of Sexual Medicine, and considered in patients with neurological causes for their distressing symptoms, arising from the pelvic area.

Disclosure

No.
Neuro-Oncology Compendium for the Boards and Clinical Practice
Authors: Mrugala Maciej M. , Gatson Na Tosha , Clarke Jennifer L. , Kurz Sylvia C. , Nevel Kathryn S.
Published: June 2023

This compendium was created to cover the most important subjects in the field of Neuro-Oncology, so that readers will be able to find high-yield information presented in a concise yet comprehensive format. Each chapter highlights information of critical importance by using specifically designed text boxes. In addition, to facilitate consolidation of newly learned information, each chapter ends with flash cards and multiple-choice questions with an answer key. The volume also features two full length practice tests (100 questions each) to allow for simulated mini exams. This book has seven parts that cover subjects needed to master clinical neuro-oncology. Part I is dedicated to neuropathology and touches upon the newly published fifth edition of the World Health Organization Classification of Tumors of the Central Nervous System (CNS)—WHO CNS5. Part II is dedicated specifically to problems affecting adult population while Part III discusses pediatric brain tumors. Parts IV and V include chapters dedicated to the principles of multidisciplinary management of neuro-oncologic disorders including neurosurgical approaches, radiotherapy and medical, and device-based therapies. Chapters on neurological complications from systemic and neurological cancers and neuro-oncological emergencies are covered as well. Part VI is focused on genetically driven neuro-oncological disorders. Part VII covers methodology of clinical trials, clinic and hospital procedures in neuro-oncology as well as issues relevant to elderly populations. Importantly, this section of the book also includes chapters on palliative care and issues specific to neuro-oncologic problems affecting women. Over seventy authors from institutions on three continents contributed to this work.
Introduction to the handbook
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate
Published: June 2023

This chapter provides an overview and rationale of the book. It contains the philosophy of the handbook, setting out how it is organised, the relationship between psychiatry and law, and the definitions and tensions of forensic psychiatry and legal psychiatry. It goes on to outline forensic service and teams, the development of the role of the modern forensic psychiatrist, and the history and future of forensic psychiatry.
Risk assessment
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate
Published: June 2023

This chapter begins with the difference between risk in a psychological setting as opposed to, for instance, a surgical setting. It outlines the techniques and values of risk assessment, and then approaches to the subject. Risk of violence and associated assessments are explained, as is the risk of sexual offending and associated instruments. The risk of suicide and self-harm, including areas for extra concern, are detailed. Other specific risks such as arson are included, and finally assessment in non-clinical settings is covered.
Ethical decision-making
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate
Published: June 2023

This chapter covers ethical decision making. It begins with an introduction of how to apply the principles discussed in the chapter. It then describes approaches to medical ethics, the development of codes, and clinical ethics committees. It goes on to approaches to ethical reasoning, including utilitarianism, deontology, virtue ethics, the Four Principles, and makes comparisons between theories. It goes on to cover values-based practice, and finally covers ethics and the law.
Professional duties and personal integrity
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate
Published: June 2023

This chapter provides an overview of the professional duties and personal integrity of the forensic psychiatrist. It begins with professional guidelines and codes and moves on to the question of whether – and to what extent – there is a duty to prevent violence. It describes competing interests and role conflicts that may affect a forensic psychiatrist, and then covers professional roles and relationships. It includes a section on boundary violations, then outlines acknowledging uncertainty and what happens when a professional opinion is changed, and the reporting process. Finally, it covers supervision, peer review, and reflective practice.
Civil law
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán , Williams Hannah Kate
Published: June 2023

This chapter covers civil laws as it relates to forensic psychiatrist. It starts with tort law and negligence, then goes to clinical negligence law and professional regulatory law. Family law, employment and equality law, and immigration and extradition law are all outlined. The chapter concludes with a summary of inquest law.
Oxford Casebook of Forensic Psychiatry
Authors: Eastman Nigel , Adshead Gwen , Fox Simone , Latham Richard , Whyte Seán
Published: June 2023

Designed as a companion to the Oxford Specialist Handbook of Forensic Psychiatry, second edition, this new casebook complements the domains of both theory and practice put forward in the handbook, but also works as a standalone volume for those who wishes to enhance their decision-making in cases they may confront in their discipline. Organised into three sections, the casebook allows the practitioner to think through not only the technical medical aspects of real-life clinical cases, but also the legal and ethical aspects. Part A provides an introduction to the theory and practice of decision-making; Part B presents cases across clinical, legal, and ethical domains; and Part C offers frameworks for critiquing decisions. This robustly discursive approach to a fact-based but also value-laden discipline enhances the opportunity to put knowledge into practice. The Oxford Casebook of Forensic Psychiatry expresses the concept that ‘knowing is the only part of deciding’, offering an essential practitioner’s guide to decision-making in clinical, forensic, and legal psychiatry.
Kelvin–Helmholtz instability at the interface of H ii region and molecular cloud under the influence of ambipolar diffusion: a discontinuous model of the interface
Authors: Yaghouti S Akram
Published: June 2023

For typical flow velocities in the interstellar medium (ISM), the Kelvin–Helmholtz instability (KHI) may result in the development of structures in molecular clouds near the interface between the clouds and H ii regions flowing past them (Berné et al. 2010). Ambipolar diffusion (AD) is one of the significant mechanisms considered frequently in the dynamics of molecular clouds. It may play a relevant role in the development of the KHI in the interface of the H ii region and the molecular clouds. Here, we examine the role of AD in the evolution of the KHI, using linear perturbation analysis. We model the interaction of two regions as a planar discontinuity separating two fluids in relative motion. Linear analysis, for a certain range of magnetosonic Mach number of flow ($\mathcal {M}_{sA1}\lt 1$), shows that AD has a destabilizing effect on the KHI and consequently decreases the e-fold time-scale of instability. The results indicate that AD is more effective on the KHI for large magnetosonic Mach numbers than for low magnetosonic Mach numbers. This may give rise to the development of larger numbers of KH structures in high-velocity flows. The results also indicate that AD is more effective for perturbation wavelengths $\lambda _{\rm KH} \ \lt \ 1\rm pc$ than for $\lambda _{\rm KH}\gt 1\rm pc$. This nominates a length-scale ($L=1 \rm \, pc$) above which AD is not important for the formation of KH structures. Conforming to the results, AD is proposed as a triggering factor in the development of the small-scale KH structures in the regions of high-velocity streams in ISM.
Low-pass whole-genome and targeted sequencing of cell-free DNA from cerebrospinal fluid in pediatric patients with central nervous system tumors
Authors: O’Halloran Katrina , Yellapantula Venkata , Christodoulou Eirini , Ostrow Dejerianne , Bootwalla Moiz , Ji Jianling , Cotter Jennifer , Chapman Nicholas , Chu Jason , Margol Ashley , Krieger Mark D , Chiarelli Peter A , Gai Xiaowu , Biegel Jaclyn A
Published: June 2023

Background

Central nervous system tumors are the most common pediatric solid tumors and the most frequent cause of cancer-related morbidity in childhood. Significant advances in understanding the molecular features of these tumors have facilitated the development of liquid biopsy assays that may aid in diagnosis and monitoring response to therapy. In this report, we describe our comprehensive liquid biopsy platform for detection of genome-wide copy number aberrations, sequence variants, and gene fusions using cerebrospinal fluid (CSF) from pediatric patients with brain, spinal cord, and peripheral nervous system tumors.

Methods

Cell-free DNA was isolated from the CSF from 55 patients, including 47 patients with tumors and 8 controls.

Results

Abnormalities in cell-free DNA were detected in 24 (51%) patients including 11 with copy number alterations, 9 with sequence variants, and 7 with KIAA1549::BRAF fusions. Positive findings were obtained in patients spanning histologic subtypes, tumor grades, and anatomic locations.

Conclusions

This study demonstrates the feasibility of employing this platform in routine clinical care in upfront diagnostic and monitoring settings. Future studies are required to determine the utility of this approach for assessing response to therapy and long-term surveillance.
Acupuncture for premature ejaculation: a systematic review and meta-analysis
Authors: Zhang Hui , Colonnello Elena , Sansone Andrea , Wang Fu , Guo Jun , Wang Chunling , Zhang Yan , Jannini Emmanuele A
Published: June 2023

Background

Although acupuncture is widely used to treat premature ejaculation (PE), its effectiveness remains highly controversial.

Aim

To evaluate the efficacy and safety of acupuncture on PE.

Methods

According to the relevant keywords, 11 major English and Chinese databases were searched for randomized controlled trials (RCTs) of acupuncture alone or in combination with other treatments for PE. The quality of evidence across studies was assessed by the GRADEpro tool.

Outcomes

Study outcome measures included the intravaginal ejaculation latency time (IELT), the Premature Ejaculation Diagnostic Tool (PEDT), the Chinese Index of Premature Ejaculation–5 (CIPE-5), treatment success rate, and adverse events.

Results

Seven trials were included in this review for a total of 603 participants. A low quality of evidence suggests that it is not possible to determine whether acupuncture, as compared with a selective serotonin reuptake inhibitor, has an advantage in improving the IELT (standardized mean difference [SMD], −1.75; 95% CI, −6.12 to 2.63; P = .43, I2 = 98%), PEDT scores (SMD, 0.32; 95% CI, −0.68 to 1.32; P = .53, I2 = 85%), and treatment success rate (risk ratio, 0.69; 95% CI, 0.41-1.14; P = .15). However, participants receiving acupuncture had a lower CIPE-5 (SMD, −1.06; 95% CI, −1.68 to −0.44; P < .01). As compared with sham acupuncture, acupuncture significantly improved the IELT (SMD, 1.47; 95% CI, 1.01-1.92; P < .01, I2 = 0%) and PEDT scores (SMD, −1.23; 95% CI, −1.78 to −0.67; P < .01, I2 = 37%). When compared with other treatments alone, a combined treatment with acupuncture can significantly improve the IELT (SMD, 7.06; 95% CI, 2.53-11.59; P < .01, I2 = 97%), CIPE-5 (SMD, 0.84; 95% CI, 0.45-1.22; P < .01, I2 = 0%), and treatment success rate (SMD, 1.60; 95% CI, 1.18-2.16; P < .01, I2 = 53).

Clinical Implications

The results suggest a significant effect of acupuncture in the treatment of certain important indicators of PE; however, this finding needs to be treated with caution because of the quality of the RCTs included.

Strengths and Limitations

Comprehensive inclusion of available RCTs has been performed. However, limitations include a low number of studies and a lack of detailed information to allow subgroup analysis.

Conclusion

The present systematic review and meta-analysis show that acupuncture has a significant effect on several subjective PE parameters, such as improving the feeling of control over ejaculation and distress, particularly when used in an integrated way. However, due to the low quality of evidence, acupuncture still needs larger well-designed RCTs to be confirmed.
Inclusion ofYucca schidigeraextract into finishing diets: impacts on ruminal, physiological, and productive responses of feedlot cattle
Authors: Mackey Shea J , Cooke Reinaldo F , Pickett Autumn T , Batista Luis F D , Mendes Egleu D M , Rincker Michael J , Colombo Eduardo A
Published: June 2023

This experiment compared ruminal, physiological, and productive responses of feedlot cattle receiving Yucca schidigera extract to replace or fed in conjunction with monensin + tylosin. Angus-influenced steers (n = 120) were ranked by body weight (BW; 315 ± 3 kg) and allocated to 4 groups of 30 steers each. Groups were housed in 1 of 4 drylot pens (30 × 12 m) equipped with GrowSafe feeding systems (4 bunks/pen) during the experiment (day −14 to slaughter). On day 0, groups were randomly assigned to receive a diet containing (2 × 2 factorial): 1) no inclusion or inclusion of monensin + tylosin (360 mg and 90 mg/steer daily, respectively) and 2) no inclusion or inclusion of Y. schidigera extract (4 g/steer daily). Steers were slaughtered in 3 groups balanced by treatment combination (36 steers on day 114, 36 steers on day 142, and 48 steers on day 169). Blood was sampled on days 0, 28, 56, and 84, and the day before shipping to slaughter. On day 41, eight rumen-cannulated heifers (BW = 590 ± 15 kg) were housed with steers (1 pair/pen). Pairs rotated among groups every 21 d, resulting in a replicated 4 × 4 Latin square (n = 8/treatment combination) with 14-d washout intervals. Heifers were sampled for blood and rumen fluid at the beginning and end of each 21-d period. Monensin + tylosin inclusion decreased (P < 0.01) feed intake and improved (P = 0.02) feed efficiency of steers, but did not alter (P ≥ 0.17) steer BW gain or carcass merit traits. Inclusion of Y. schidigera extract did not impact (P ≥ 0.30) steer performance and carcass characteristics. Plasma glucose, insulin, insulin-like growth factor-I, and urea-N concentrations were not affected (P ≥ 0.16) by monensin + tylosin, nor by Y. schidigera extract inclusion in steers and heifers. Ruminal pH in heifers was increased (P = 0.04) by monensin + tylosin, and also by (P = 0.03) Y. schidigera extract inclusion. Rumen fluid viscosity was reduced (P = 0.04) by Y. schidigera extract, and rumen protozoa count was increased (P < 0.01) by monensin + tylosin inclusion. The proportion of propionate in the ruminal fluid was increased (P = 0.04) by monensin + tylosin, and tended (P = 0.07) to be increased by Y. schidigera extract inclusion. Hence, Y. schidigera extract yielded similar improvements in rumen fermentation compared with monensin + tylosin, but without increasing performance and carcass quality of finishing cattle. No complimentary effects were observed when combining all these additives into the finishing diet.
Reduced Readmission and Increased Patient Satisfaction in Post–Cardiac Arrhythmia Ablation
Authors: Bott Kristin A. , Rose Suzanne J. , Malcolm Millicent M. , Shellman Juliette
Published: June 2023

Background:

Hospital readmissions within 30 days post–cardiac arrhythmia ablation are typically related to postoperative complications and arrhythmia recurrence and considered mostly preventable.

Purpose:

To evaluate the impact of a cardiac ablation patient education program on hospital readmissions and patient satisfaction.

Methods:

An education intervention was established for patients who underwent cardiac ablation based on the Project RED framework. Hospital readmissions rates 30 days postprocedure and satisfaction via a single-blinded posttest design were assessed to evaluate the program.

Results:

Those in the intervention group had a significantly lower rate of 30-day readmissions (7.1% vs 53.3%, P = .014). A large magnitude of effect and higher total patient satisfaction scores were also seen in the intervention group (M = 633, SD = 78) than in the control group (M = 508, SD = 137, P = .005).

Conclusions:

Results of this study support the implementation of an enhanced cardiac arrhythmia patient education intervention with consideration of identified facilitators and barriers.
Tumor Volume on PSMA PET as a Prognostic Biomarker in Prostate Cancer Patients Treated With Cabazitaxel
Authors: Shagera Qaid Ahmed , Karfis Ioannis , Sideris Spyridon , Guiot Thomas , Woff Erwin , Martinez-Chanza Nieves , Roumeguere Thierry , Gil Thierry , Flamen Patrick , Artigas Carlos
Published: June 2023

Purpose

The aim of this study was to evaluate the prognostic value of 68Ga-labeled prostate-specific membrane antigen (PSMA) PET/CT in metastatic castration-resistant prostate cancer patients receiving second-line chemotherapy with cabazitaxel.

Methods

All patients with metastatic castration-resistant prostate cancer who underwent a PSMA PET/CT within 8 weeks before initiating the cabazitaxel treatment were retrospectively evaluated. The whole-body PSMA total tumor volume (PSMA-TV) was measured for each patient. Other factors such as prostate-specific antigen, hemoglobin, lactate dehydrogenase, and alkaline phosphatase were recorded. A log-rank cutoff finder was used to define the PSMA-TV optimal cutoff. Survival analyses were performed using Cox regression and Kaplan-Meier methods.

Results

In total, 32 patients were included, receiving a median of 6 cycles of cabazitaxel (range, 2–10). After a median follow-up of 12 months, 28 patients presented disease progression, and 18 died. Baseline PSMA-TV presented a significant association with progression-free survival (PFS) and overall survival (OS; P = 0.035 and P = 0.002, respectively). Optimal PSMA-TV cutoffs were 515 mL for PFS and 473 mL for OS. Patients with low volume presented longer PFS and OS than those with high volume: median PFS, 21 versus 12 weeks, respectively (hazard ratio, 0.33; P = 0.017); and median OS, 24 versus 8.5 months, respectively (hazard ratio, 0.21; P = 0.002). On the multivariable analyses, PSMA-TV remained an independent predictor of OS (P = 0.016).

Conclusion

Our results show that total tumor volume measured on PSMA PET/CT is a prognostic biomarker in patients treated with cabazitaxel. High PSMA-TV before treatment initiation is associated with shorter PFS and OS.
Practical cancer cachexia management in palliative care – a review of current evidence
Authors: Duffy Tony , Kochanczyk Martin
Published: June 2023

Purpose of review

To explore the current evidence relating to the practical management of cancer cachexia in palliative care.

Recent findings

The authors found a growing evidence base including the publication of several expert guidelines since 2020. Guidelines identified the need for individualised nutritional and physical exercise support as the mainstay of cachexia management. Dietician and allied health professional referrals are recommended for the best patient outcomes. Limitations of nutritional support and exercise are acknowledged. Patient outcomes from multimodal anti-cachexia therapy are awaited at this time. Communication about the mechanisms of cachexia and nutritional counselling are identified as ways to reduce distress. Evidence supporting the use of pharmacological agents remains insufficient to make recommendations. Corticosteroids and progestins may be offered for symptom relief in refractory cachexia, taking into consideration well-documented side effects. Emphasis is placed on adequately managing nutritional impact symptoms. A specific role for palliative care clinicians and the use of existing palliative care guidelines in managing cancer cachexia were not identified.

Current evidence recognises the inherently palliative nature of cancer cachexia management, and practical guidance correlates with the tenets of palliative care. Individualised approaches to support nutritional intake, physical exercise and alleviate symptoms that accelerate cachexia processes are currently recommended.
Metabolomic profiling and bactericidal effect of Polyalthia longifolia (Sonn.) Twaites. stem bark against methicillin-resistant Staphylococcus aureus
Authors: Siwe Gael Tchokomeni , Simo Marguerite Kamdem , Maharjan Rukesh , Amang Andre Perfusion , Mezui Christophe , Tan Paul Vernyuy
Published: June 2023

Objective. The present study was carried out to establish the chemical profile of the methanolic extract of Polyalthia longifolia stem bark and investigate its antibacterial property against some human pathogenic bacteria.

Methods. The extract was analysed using liquid and gas chromatography coupled to mass spectrometry. Antibacterial activity of P. longifolia extract against some human pathogenic bacteria was screened using the AlamarBlue method, and MIC and MBC were determined.

Results and Conclusion. Liquid chromatography-mass spectrometry (LC-MS) revealed the presence of 21 compounds among which 12 were identified. Gas chromatography-mass spectrometry (GC-MS) allowed identification of 26 compounds, the three major ones being the following: cis vaccenic acid (17.79 %), 3-ethyl-3-hydroxyandrostan-17-one (13.80 %) and copaiferic acid B (12.82 %). P. longifolia extract was active against Gram-positive bacteria with MIC ranging from 1 to 2 mg ml−1 and MBC from 2 to 6 mg ml−1. This study demonstrated the bactericidal effect of the methanolic extract of Polyalthia longifolia stem bark against some human pathogenic bacteria, including methicillin-resistant

S. aureus

. This effect could be related to the presence in the extract of a broad diversity of well-known compounds with established pharmacological properties. These results support the ethnomedicinal use of P. longifolia stem bark in Cameroon for the management of methicillin-resistant

S. aureus

(MRSA)-related infections.