bluuebunny/crossref_metadata_2025 huggingface dataset:
Inhibition of ACSS2 attenuates alcoholic liver steatosis via epigenetically regulating de novo lipogenesis
Authors: Lu Yawen , Chen Yimeng , Hu Wenxin , Wang Meng , Wen Xiaodong , Yang Jie
Published: May 2023

Background and aims

Steatosis is the early pathological change in alcohol‐associated liver disease. However, its precise mechanism is still unclear. The present study is aimed to explore the role and mechanism of acetyl‐CoA synthetase 2 (ACSS2) in acute alcohol‐induced lipogenesis.

Methods

The increase in ACSS2 nuclear import and histone H3 acetylation were observed in mice after intraperitoneally injected with 2 g/kg ethanol or oral administration of 5 g/kg ethanol and also validated in hepatocytes stimulated with ethanol or acetate. The role of ACSS2 was further explored in liver‐specific ACSS2 knockdown mice fed with ethanol‐containing diet.

Results

Alcohol challenge induced hepatic lipid deposition and upregulated lipogenic genes in mice. It also promoted ACSS2 nuclear import and increased histone H3 acetylation. In hepatocytes, ethanol induced similar phenomena whereas ACSS2 knockdown blocked histone acetylation and lipogenic gene induction. P300/CBP associated factor (PCAF), but not general control nonderepressible 5, CREB‐binding protein (CBP) and p300, facilitated H3K9 acetylation responding to ethanol challenge. CUT&RUN assay showed the enrichment of acetylated histone H3K9 surrounding Fasn and Acaca promoters. These results indicated that ethanol metabolism promoted ACSS2 nuclear import to support lipogenesis via H3K9 acetylation. In alcohol‐feeding mice, liver‐specific ACSS2 knockdown blocked the interaction between PCAF and H3K9 and suppressed lipogenic gene induction in the liver, demonstrating the critical role of ACSS2 in lipogenesis.

Conclusions

Our study demonstrated that alcohol metabolism generated acetyl‐CoA in the nucleus dependently on nuclear ACSS2, contributing to epigenetic regulation of lipogenesis in hepatic steatosis. Targeting ACSS2 may be a potential therapeutical strategy for acute alcoholic liver steatosis.
Prognostic value of non‐invasive scores based on liver stiffness measurement, spleen diameter and platelets in HIV‐infected patients
Authors: Benmassaoud Amine , Macias Juan , Delamarre Adèle , Corma‐Gomez Anaïs , Guaraldi Giovanni , Milic Jovana , Rockstroh Jürgen K. , Van Bremen Kathrin , Tsochatzis Emmanuel , Mulay Akhilesh , Price Jennifer , Garvey Lucy J. , Lemoine Maud , Kablawi Dana , Lebouche Bertrand , Klein Marina B. , Ballesteros Luz R. , Boesecke Christopher , Schepis Filippo , Bhagani Sanjay , Cooke Graham , Berzigotti Annalisa , Hirose Kyoko , Pineda Juan A. , Ramanakumar Agnihotram V. , De‐Ledinghen Victor , Saeed Sahar , Sebastiani Giada
Published: May 2023

Background and Aims

People living with HIV (PLWH) are at high risk for advanced chronic liver disease and related adverse outcomes. We aimed to validate the prognostic value of non‐invasive scores based on liver stiffness measurement (LSM) and on markers of portal hypertension (PH), namely platelets and spleen diameter, in PLWH.

Methods

We combined data from eight international cohorts of PLWH with available non‐invasive scores, including LSM and the composite biomarkers liver stiffness‐spleen size‐to‐platelet ratio score (LSPS), LSM‐to‐Platelet ratio (LPR) and PH risk score. Incidence and predictors of all‐cause mortality, any liver‐related event and classical hepatic decompensation were determined by survival analysis, controlling for competing risks for the latter two. Non‐invasive scores were assessed and compared using area under the receiver operating curve (AUROC).

Results

We included 1695 PLWH (66.8% coinfected with hepatitis C virus). During a median follow‐up of 4.7 (interquartile range 2.8–7.7) years, the incidence rates of any liver‐related event, all‐cause mortality and hepatic decompensation were 13.7 per 1000 persons‐year (PY) (95% confidence interval [CI], 11.4–16.3), 13.8 per 1000 PY (95% CI, 11.6–16.4) and 9.9 per 1000 PY (95% CI, 8.1–12.2), respectively. The AUROC of LSM was similar to that of the composite biomarkers, ranging between 0.83 and 0.86 for any liver‐related event, 0.79–0.85 for all‐cause mortality and 0.87–0.88 for classical hepatic decompensation. All individual non‐invasive scores remained independent predictors of clinical outcomes in multivariable analysis.

Conclusions

Non‐invasive scores based on LSM, spleen diameter and platelets predict clinical outcomes in PLWH. Composite biomarkers do not achieve higher prognostic performance compared to LSM alone.
Acute alcohol‐associated hepatitis: Latest findings in non‐invasive biomarkers and treatment
Authors: Yamazaki Tomoo , Schnabl Bernd
Published: May 2023

Acute alcohol‐associated hepatitis (AH) is a syndrome that occurs in heavy and long‐term drinkers and results in severe jaundice and liver failure. The mortality rate in severe cases is 20%–50% at 28 days, and in cases that do not improve despite appropriately timed corticosteroid therapy, the mortality rate reaches 70% at 6 months. The only curative treatment is early liver transplantation, but less than 2% of patients with severe AH are eligible. In order to improve the prognosis, diagnostic tools are needed to detect appropriate cases at risk of severe conditions, and new therapies need to be developed that can replace corticosteroids. Recent research has revealed that the pathogenesis of AH involves a complex of factors, including changes in the gut microbiota, inflammatory and cytokine signalling, oxidative stress and mitochondrial dysfunction, and abnormalities in the hepatic regenerative capacity. Non‐invasive diagnostic tools focusing on these specific pathologies have been reported in recent years. In addition, several novel agents targeting specific pathways are currently being developed and tested in clinical trials. This review will provide an overview of alcohol‐associated hepatitis and focus on the latest diagnostic tools, particularly non‐invasive biomarkers, and novel therapies.
Clinical study of puncture technique in single division of the trigeminal ganglion intumescentia
Authors: Zhang Liyong , Guo Yu , Xu Ji , He Yunfeng , Qi Zhenglei , Chen Henglin , Zhang Hengzhu
Published: May 2023

Objective

We explored the feasibility of single‐division puncture in the ophthalmic division, maxillary division, and mandibular division of the trigeminal ganglion intumescentia (TGI) and the feasibility of radiofrequency treatment of trigeminal neuralgia.

Methods

According to the previous anatomical image studies, 3D Slicer software was used to analyze the CT images of the patients. The trigeminal ganglion fossa (TGF) was used as the imaging sign. TGI was identified in the sagittal plane along the fiber. The puncture path starts from the TGI center‐foramen ovale line, extending outward to the epidermis as the needle insertion point, and extending inward to the division boundary. For lateral puncture, which is blocked by the mandible, the positions of closed mouth, open mouth, and over‐open mouth were used. Multiple targets were generated using straight electrodes and curved electrodes to achieve full coverage of TGI. According to the preoperative design, general anesthesia surgery was performed. Xper CT was used for imaging, and the puncture was guided by Xper Guide. Radiofrequency treatment of TGI was conducted.

Results

In total, 45 patients with trigeminal neuralgia underwent 50 single‐division TGI punctures. The procedure was smooth and the compliance with the design was good. Continuous radiofrequency (CRF) was performed, the VAS scores were 25 times at 70°C, 19 times at 65°C, two times at 60°C, and two times at 50°C (both in the ophthalmic division). Pulsed radiofrequency (PRF) was conducted two times. Within 24 h after the procedure, the VAS scores were all 0. From 1 to 7 days after the procedure, pain recurrence was found in three cases, of whom two cases received pulsed radiofrequency treatment. Patients were followed up for 1–24 months and there were no recurrence. After continuous radiofrequency at 65–70°C, the moderate tactile loss was observed, and nearly half of the patients had food residues on the surgical side after 6 months. After continuous radiofrequency at 60°C, there was mild tactile loss and no food residue. The tactile sensation was slightly decreased after continuous radiofrequency at 50°C, and the tactile sensation was normal the next day.

Conclusion

Trigeminal ganglion intumescentia single‐division radiofrequency is effective and feasible for the treatment of trigeminal neuralgia.
Theories of perceptual content and cases of reliable spatial misperception
Authors: Rubner Andrew
Published: May 2023

Perception is riddled with cases of reliable misperception. These are cases in which a perceptual state is tokened inaccurately any time it is tokened under normal conditions. On the face of it, this fact causes trouble for theories that provide an analysis of perceptual content in non‐semantic, non‐intentional, and non‐phenomenal terms, such as those found in Millikan (1984), Fodor (1990), Neander (2017), and Schellenberg (2018). I show how such theories can be extended so that they cover such cases without giving up their core commitments.
The good fit1
Authors: Yao Vida
Published: May 2023

Philosophers are now wary of conflating the “fittingness” or accuracy of an emotion with any form of moral assessment of that emotion. Justin D'Arms and Daniel Jacobson, who originally cautioned against this “conflation”, also warned philosophers not to infer that an emotion is inaccurate from the fact that feeling it would be morally inappropriate, or that it is accurate from the fact that feeling it would be morally appropriate. Such inferences, they argue, risk committing “the moralistic fallacy”, a mistake they claim is widespread throughout the work of contemporary and historical moral philosophers. I argue that many basic and familiar forms of moral assessment of the emotions are not subject to these arguments. I illustrate this by reconsidering the idea that to assess an emotion as “fitting” is to assess it as what a virtuous person would feel. After showing how assessments akin to this “virtue‐theoretical” notion of fit may be prevalent even outside of the Aristotelian tradition, I suggest some more charitable and philosophically productive interpretations of the philosophical views of the emotions that D'Arms and Jacobson criticize, and argue that we cannot coherently theorize about the fittingness conditions of the emotions in a morally neutral way.
Development of a novel immunoFET technology‐based POC assay for detection of Leishmania donovani and Leishmania major
Authors: Yentur Doni Nebiye , Bertani Paul J. , Volpedo Greta , Saljoughian Noushin , Varikuti Sanjay , Matlashewski Greg , Lu Wu , Satoskar Abhay R.
Published: May 2023

Leishmaniasis is considered as one of the 20 neglected tropical diseases. Current methods of leishmanial diagnosis depend on conventional laboratory‐based techniques, which are time‐consuming, costly and require special equipment and trained personnel. In this context, we aimed to provide an immuno field effect transistors (ImmunoFET) biosensor that matches the conventional standards for point‐of‐care (POC) monitoring and detection of Leishmania (L.) donovani/Leishmania major. Crude antigens prepared by repeated freeze thawing of L. donovani/L. major stationary phase promastigotes were used for ELISA and ImmunoFETs. Lesishmania‐specific antigens were serially diluted in 1× PBS from a concentration of 106–102 parasites/mL. A specific polyclonal antibody‐based sandwich ELISA was established for the detection of Leishmania antigens. An immunoFET technology‐based POC novel assay was constructed for the detection of Leishmania antigens. Interactions between antigen–antibody at the gate surface generate an electrical signal that can be measured by semiconductor field‐effect principles. Sensitivity was considered and measured as the change in current divided by the initial current. The final L. donovani/L. major crude antigen protein concentrations were measured as 1.50 mg/mL. Sandwich ELISA against the Leishmania 40S ribosomal protein detected Leishmania antigens could detect as few as 100 L. donovani/L. major parasites. An immunoFET biosensor was constructed based on the optimization of aluminium gallium nitride/gallium nitride (AlGaN/GaN) surface oxidation methods. The device surface was composed by an AlGaN/GaN wafer with a 23 nm AlGaN barrier layer, a 2 μm GaN layer on the silicon carbide (SiC) substrate for Leishmania binding, and coated with a specific antibody against the Leishmania 40S ribosomal protein, which was successfully detected at concentrations from 106 to 102 parasites/mL in 1× PBS. At the concentration of 104 parasites, the immunoFETs device sensitivities were 13% and 0.052% in the sub‐threshold regime and the saturation regime, respectively. Leishmania parasites were successfully detected by the ImmunoFET biosensor at a diluted concentration as low as 150 ng/mL. In this study, the developed ImmunoFET biosensor performed well. ImmunoFET biosensors can be used as an alternative diagnostic method to ELISA. Increasing the sensitivity and optimization of immuno‐FET biosensors might allow earlier and faster detection of leishmaniasis.
Is dual testing for hepatitis C necessary? Modelling the risk of removing hepatitis C antibody testing for Australian blood donations
Authors: Roy Choudhury Avijoy , Hoad Veronica C. , Seed Clive , Bentley Peter
Published: May 2023

Background and Objectives

Parallel testing of blood donations for hepatitis C virus (HCV) antibody and HCV RNA by nucleic acid testing (NAT) has been standard practice in Australia since 2000. Meanwhile, NAT technologies have improved, and HCV has become a curable disease. This has resulted in a significant reduction in the risk and clinical consequences of HCV transmission through transfusion. This study aimed to estimate the residual risk (RR) under various testing options to determine the optimal testing strategy.

Materials and Methods

A developed deterministic model calculated the RR of HCV transmission for four testing strategies. A low, mid and high estimate of the RR was calculated for each. The testing strategies modelled were as follows: universal dual testing, targeted dual testing for higher risk groups (first‐time donors or transfusible component donations) and universal NAT only.

Results

The mid estimate of the RR was 1 in 151 million for universal dual testing, 1 in 111 million for targeted dual testing of first‐time donors, 1 in 151 million for targeted dual testing for transfusible component donations and 1 in 66 million for universal NAT only. For all testing strategies, all estimates were considerably less than 1 in 1 million.

Conclusion

Antibody testing in addition to NAT does not materially change the risk profile. Even conservative estimates for the cessation of anti‐HCV predict an HCV transmission risk substantially below 1 in 1 million. Therefore, given that it is not contributing to blood safety in Australia but consuming resources, anti‐HCV testing can safely be discontinued.
Effectiveness of high-flow nasal cannula oxygen in apneic oxygenation during intubation in high-risk surgical patients: a systematic review protocol
Authors: Sekhar Praba , Thiruvenkatarajan Venkatesan , Sekhar Vimal , van Wijk Roelof , Barker Timothy
Published: May 2023

Objective:

This review will investigate the effectiveness of high-flow nasal oxygen in apneic oxygenation through safe apnea time and other ventilation parameters in patients at high risk of oxygen desaturation during induction and tracheal intubation for anesthesia management.

Introduction:

High-risk surgical patient groups include obese patients, those with suspected or known obstructive sleep apnea, and critically ill patients, who are at risk of rapid oxygen desaturation during intubation. Conventional oxygen administration in induction and intubation of patients undergoing general anesthesia include nasal cannulas, simple face masks, Venturi, buccal oxygenation, bag-valve mask ventilation, and non-invasive ventilation. High-flow nasal oxygen has emerged as a novel technique, and is advantageous because it increases positive end-expiratory pressure and oxygen delivered.

Inclusion criteria:

Eligible studies will include high-risk surgical patients aged 18 or above requiring endotracheal intubation in both emergency and elective anesthetic settings. High-risk patients are defined as those with suspected or known obstructive sleep apnea, obesity (BMI > 35), or critically ill patients (scored the American Society of Anesthesiologists classification as 3 or above).

Methods:

The review will follow the JBI methodology for systematic reviews of effectiveness. Databases to be searched include MEDLINE, Embase, and Scopus. Reference lists of selected studies will then be hand-searched for additional eligible studies. The primary outcome will be safe apnea time, with secondary outcomes including oxygen and carbon dioxide parameters, and adverse events (eg, gastric distension). Studies will, where possible, be pooled in statistical meta-analyses with data heterogeneity assessed using the standard χ
2 and I
2 tests.

Review registration:

PROSPERO CRD42022312145
Magneto-Convective Transport of Immiscible Binary Fluids in Inclined Channel
Authors: Kumar Mahesh , Mondal Pranab Kumar
Published: May 2023

This work theoretically investigates the interfacial transport of immiscible fluid layers in an inclined fluidic channel in the presence of magnetofluidic actuation. Immiscible binary system consists of both non-Newtonian fluid (top layer) and Newtonian fluid (bottom layer), while the Carreau fluid model is used to describe the rheology of non-Newtonian layer. We develop a theoretical framework consistent with the homotopy analysis method (HAM) to obtain the approximate analytical solutions for the underlying thermofluidic transport features. By depicting the auxiliary parameter curve (ℏ-curve) of flow velocity and temperature distribution, we ascertain the effective reliability of the theoretical method developed here. We demonstrate both velocity and temperature variations in the channel for a set of involving parameters pertinent to this analysis. Albeit the flow configuration considered in this analysis is not complex, yet, the method developed here seems to be efficient in capturing underling transport features, retaining the simultaneously acted implications of fluid rheology and magnetohydrodynamics. Form the consistency observed in predicting the flow velocity for any values of shear-thinning parameter, including nonintegers, our semi-analytical method is deemed pertinent to predict the thermohydrodynamics of immiscible multilayer system even by accurately capturing the intervening effects of fluid rheology and applied fields.
Model Establishment of Chip Air Cooling Process and Its Proportional Integral Differential Tuning
Authors: Xu Linmeng , Zhao Wanying , Li Junhui
Published: May 2023

Chip junction temperature is a key factor affecting the normal operation of the chip. The development of integrated circuit technology brings about high integration and low cost, but it also puts forward higher requirements for the cooling system. This paper focuses on the air cooling of the chip, builds a hardware test platform based on MCS-52, the general name of the intel series microcontroller unit, and sets up a mathematical model of the air cooling process of the chip on the matlab platform based on the principle of energy conservation, heat transfer theory and finite element method. By proposing the equivalent convective heat transfer coefficient, the thermal resistance of the system can be well estimated. This model can easily realize the joint simulation of chip, heat radiator, and control strategy, which overcomes the disadvantage that traditional finite element simulation software are difficult to combine with control strategy. In addition, based on the model, the proportional integral differential (PID) control parameters are automatically optimized, achieving excellent temperature control effect, and proving the feasibility of optimizing the control parameters through the model.
Input–output wavepacket description of two photons interacting with a V-type three-level atom in an optical cavity
Authors: Hassan Arkan , Gea-Banacloche Julio
Published: May 2023

We study the interaction of a V-type atom in a cavity with incident single- and two-photon wavepackets and derive an exact formula, valid in all parameter regimes, relating the spectrum of the outgoing wavepackets to the incident one. We present detailed results for several special input pulses and consider the potential performance of the system as a CPHASE gate for initial pulses in a product state. We find values of the cavity, atomic, and pulse parameters that yield a conditional phase shift of π, albeit with a relatively small overlap between the incoming and outgoing pulse forms.
The role of continental subduction in mantle metasomatism and carbon recycling revealed by melt inclusions in UHP eclogites
Authors: Borghini Alessia , Nicoli Gautier , Ferrero Silvio , O’Brien Patrick J. , Laurent Oscar , Remusat Laurent , Borghini Giulio , Milani Sula
Published: May 2023

Subduction is the main process that recycles surface material into the mantle. Fluids and melts derived by dehydration and partial melting reactions of subducted continental crust, a major reservoir of volatiles (i.e., H
2
O and CO
2
) and incompatible elements, can substantially metasomatize and refertilize the mantle. Here, we investigate glassy inclusions of silicate melt of continental origin found in Variscan ultrahigh-pressure eclogites to assess the continental crust contribution to mantle metasomatism and the journey of volatiles, carbon in particular, to the deep roots of mountain belts. We argue that the melt preserved in these inclusions is the agent responsible for mantle metasomatism and subsequent ultrapotassic magmatism in the Variscides. We propose that continental subduction can redistribute a substantial volume of carbon in the continental lithosphere, which is subsequently transferred to the continental crust during postcollisional magmatism and stored for a time length longer than that of the modern carbon cycle.
An electrically driven single-atom “flip-flop” qubit
Authors: Savytskyy Rostyslav , Botzem Tim , Fernandez de Fuentes Irene , Joecker Benjamin , Pla Jarryd J. , Hudson Fay E. , Itoh Kohei M. , Jakob Alexander M. , Johnson Brett C. , Jamieson David N. , Dzurak Andrew S. , Morello Andrea
Published: May 2023

The spins of atoms and atom-like systems are among the most coherent objects in which to store quantum information. However, the need to address them using oscillating magnetic fields hinders their integration with quantum electronic devices. Here, we circumvent this hurdle by operating a single-atom “flip-flop” qubit in silicon, where quantum information is encoded in the electron-nuclear states of a phosphorus donor. The qubit is controlled using local electric fields at microwave frequencies, produced within a metal-oxide-semiconductor device. The electrical drive is mediated by the modulation of the electron-nuclear hyperfine coupling, a method that can be extended to many other atomic and molecular systems and to the hyperpolarization of nuclear spin ensembles. These results pave the way to the construction of solid-state quantum processors where dense arrays of atoms can be controlled using only local electric fields.
The Integrator complex regulates microRNA abundance through RISC loading
Authors: Kirstein Nina , Dokaneheifard Sadat , Cingaram Pradeep Reddy , Valencia Monica Guiselle , Beckedorff Felipe , Gomes Dos Santos Helena , Blumenthal Ezra , Tayari Mina Masoumeh , Gaidosh Gabriel Stephen , Shiekhattar Ramin
Published: May 2023

MicroRNA (miRNA) homeostasis is crucial for the posttranscriptional regulation of their target genes during development and in disease states. miRNAs are derived from primary transcripts and are processed from a hairpin precursor intermediary to a mature 22-nucleotide duplex RNA. Loading of the duplex into the Argonaute (AGO) protein family is pivotal to miRNA abundance and its posttranscriptional function. The Integrator complex plays a key role in protein coding and noncoding RNA maturation, RNA polymerase II pause-release, and premature transcriptional termination. Here, we report that loss of Integrator results in global destabilization of mature miRNAs. Enhanced ultraviolet cross-linking and immunoprecipitation of Integrator uncovered an association with duplex miRNAs before their loading onto AGOs. Tracing miRNA fate from biogenesis to stabilization by incorporating 4-thiouridine in nascent transcripts pinpointed a critical role for Integrator in miRNA assembly into AGOs.
PhoPQ Regulates Quinolone and Cephalosporin Resistance Formation in Salmonella Enteritidis at the Transcriptional Level
Authors: Hu Mengjun , Zhang Yuyan , Huang Xiaozhen , He Mu , Zhu Jinyu , Zhang Zengfeng , Cui Yan , He Shoukui , Shi Xianming
Published: May 2023

The prevalence of quinolone and cephalosporin-resistant
S.
Enteritidis is of increasing clinical concern. Thus, it is imperative to identify novel therapeutic targets with which to treat
S.
Enteritidis-associated infections.
Comparative Activities of Novel Therapeutic Agents against Molecularly Characterized Clinical Carbapenem-Resistant
Enterobacterales
Isolates
Authors: Teo Jocelyn Qi-Min , Chang Hong Yi , Tan Si Hui , Tang Cheng Yee , Ong Rick Twee-Hee , Ko Karrie Kwan Ki , Chung Shimin Jasmine , Tan Thuan Tong , Kwa Andrea Lay-Hoon
Published: May 2023

This study determined the susceptibilities of carbapenem-resistant
Enterobacterales
isolates to various novel antimicrobial agents (ceftazidime-avibactam, imipenem-relebactam, meropenem-vaborbactam, eravacycline, and plazomicin). Whole-genome sequencing was performed for all strains.
Heterogeneity among Clinical Intestinal Escherichia coli Isolates upon Acquired Streptomycin Resistance
Authors: Lopez Lacey R. , Miller Claire M. , Jeyachandran Joanna N. , Li Chuang , Simpson Kenneth W. , Arthur Janelle C.
Published: May 2023

We demonstrate that Str
R
, commonly acquired through a single point mutation in
rpsL
(a gene encoding part of the 30S bacterial ribosome), strikingly alters the morphology and behavior of a key intestinal AIEC strain, NC101. These changes include remarkably diminished aggregation and significantly increased motility, traits that are linked to AIEC-defining features and disease development.
Alteration of
adeS
Contributes to Tigecycline Resistance and Collateral Sensitivity to Sulbactam in Acinetobacter baumannii
Authors: Yang Yunxing , Liu Xiaochen , Zhou Danyan , He Jintao , Chen Qiong , Xu Qingye , Wu Shenghai , Zhang Weiying , Yao Yue , Fu Ying , Hua Xiaoting , Yu Yunsong , Wang Xianjun
Published: May 2023

Collateral sensitivity (CS) has become an increasingly common evolutionary trade-off during adaptive bacterial evolution. Here, we report a novel combination of tigecycline (TGC) resistance and CS to sulbactam (SUL) in
A. baumannii
.
Morphology and Sedimentary Cover Structure of Long Segments of the Gakkel Ridge
Authors: Piskarev A. L. , Kaminsky V. D. , Poselov V. A. , Kireev A. A. , Savin V. A. , Smirnov O. E. , Bezumov D. V. , Ovanesian G. I. , Elkina D. V.
Published: May 2023

The rift valley of the Gakkel Ridge was divided into three segments according to sub-bottom profiling and seismoacoustic studies carried out by R/V Akademik Fedorov at the Gakkel Ridge in 2019–2020, and on seismic data of 2011–2015. West of 75° E, the rift valley crosses the Gakkel Ridge approximately in the middle, as was expected based on the assumption that the rift valley runs along the spreading axis that formed this ridge. East of 75° E, the rift valley shifts to the southwestern edge of the ridge, and, thus, it can be concluded that the spreading axis jumped to its present position relatively recently (in the Pliocene). Finally, to the south of the the Gakkel caldera (about 120° E, 81° N), the rift valley is manifested in the sections as a young graben through many kilometers of sediments.
Narrative medicine-based intervention in primary care to reduce polypharmacy: results from the cluster-randomised controlled trial MultiCare AGENDA
Authors: Schäfer Ingmar , Kaduszkiewicz Hanna , Mellert Christine , Löffler Christin , Mortsiefer Achim , Ernst Annette , Stolzenbach Carl-Otto , Wiese Birgitt , Abholz Heinz-Harald , Scherer Martin , van den Bussche Hendrik , Altiner Attila
Published: May 2023

Objectives

To determine if patient-centred communication leads to a reduction of the number of medications taken without reducing health-related quality of life.

Design

Two-arm cluster-randomised controlled trial.

Setting

55 primary care practices in Hamburg, Düsseldorf and Rostock, Germany.

Participants

604 patients 65 to 84 years of age with at least three chronic conditions.

Interventions

Within the 12-month intervention, general practitioners (GPs) had three 30 min talks with each of their patients in addition to routine consultations. The first talk aimed at identifying treatment targets and priorities of the patient. During the second talk, the medication taken by the patient was discussed based on a ‘brown bag’ review of all the medications the patient had at home. The third talk served to discuss goal attainment and future treatment targets. GPs in the control group performed care as usual.

Primary outcome measures

We assumed that the number of medications taken by the patient would be reduced by 1.5 substances in the intervention group and that the change in the intervention group’s health-related quality of life would not be statistically significantly inferior to the control group.

Results

The patients took a mean of 7.0±3.5 medications at baseline and 6.8±3.5 medications at follow-up. There was no difference between treatment and control group in the change of the number of medications taken (0.43; 95% CI −0.07 to 0.93; P=0.094) and no difference in health-related quality of life (0.03; −0.02 to 0.08; P=0.207). The likelihood of receiving a new prescription for analgesics was twice as high in the intervention group compared with the control group (risk ratio, 2.043; P=0.019), but the days spent in hospital were reduced by the intervention (−3.07; −5.25 to −0.89; P=0.006).

Conclusions

Intensifying the doctor–patient dialogue and discussing the patient’s agenda and personal needs did not lead to a reduction of medication intake and did not alter health-related quality of life.

Trial registration number

NCT46272088; Pre-results.
Feasibility of personalised remote long-term follow-up of people with
cochlear implants: a randomised controlled trial
Authors: Cullington Helen , Kitterick Padraig , Weal Mark , Margol-Gromada Magdalena
Published: May 2023

Introduction

Substantial resources are required to provide lifelong postoperative
care to people with cochlear implants. Most patients visit the clinic
annually. We introduced a person-centred remote follow-up pathway,
giving patients telemedicine tools to use at home so they would only
visit the centre when intervention was required.

Objectives

To assess the feasibility of comparing a remote care pathway with
the standard pathway in adults using cochlear implants.

Design

Two-arm randomised controlled trial. Randomisation used a
minimisation approach, controlling for potential confounding factors.
Participant blinding was not possible, but baseline measures occurred
before allocation.

Setting

University of Southampton Auditory Implant Service: provider of
National Health Service care.

Participants

60 adults who had used cochlear implants for at least 6
months.

Interventions

Control group (n=30) followed usual care pathway.

Remote care group (n=30) received care remotely for 6 months
incorporating: home hearing in noise test, online support tool and
self-adjustment of device (only 10 had compatible equipment).

Main outcome measures

Primary: change in patient activation; measured using the Patient
Activation Measure.

Secondary: change in hearing and quality of life; qualitative
feedback from patients and clinicians.

Results

One participant in the remote care group dropped out. The remote
care group showed a greater increase in patient activation than the
control group. Changes in hearing differed between the groups. The
remote care group improved on the Triple Digit Test hearing test; the
control group perceived their hearing was worse on the Speech, Spatial
and Qualities of Hearing Scale questionnaire. Quality of life remained
unchanged in both groups. Patients and clinicians were generally
positive about remote care tools and wanted to continue.

Conclusions

Adults with cochlear implants were willing to be randomised and
complied with the protocol. Personalised remote care for long-term
follow-up is feasible and acceptable, leading to more empowered
patients.

Trial registration number

NCT14644286.
Qualitative process study to explore the perceived burdens and benefits of a digital intervention for self-managing high blood pressure in Primary Care in the UK
Authors: Morton Katherine , Dennison Laura , Bradbury Katherine , Band Rebecca Jane , May Carl , Raftery James , Little Paul , McManus Richard J , Yardley Lucy
Published: May 2023

Objectives

Digital interventions can change patients’ experiences of managing their health, either creating additional burden or improving their experience of healthcare. This qualitative study aimed to explore perceived burdens and benefits for patients using a digital self-management intervention for reducing high blood pressure. A secondary aim was to further our understanding of how best to capture burdens and benefits when evaluating health interventions.

Design

Inductive qualitative process study nested in a randomised controlled trial.

Setting

Primary Care in the UK.

Participants

35 participants taking antihypertensive medication and with uncontrolled blood pressure at baseline participated in semistructured telephone interviews.

Intervention

Digital self-management intervention to support blood pressure self-monitoring and medication change when recommended by the healthcare professional.

Analysis

Data were analysed using inductive thematic analysis with techniques from grounded theory.

Results

Seven themes were developed which reflected perceived burdens and benefits of using the intervention, including worry about health, uncertainty about self-monitoring and reassurance. The analysis showed how beliefs about their condition and treatment appeared to influence participants’ appraisal of the value of the intervention. This suggested that considering illness and treatment perceptions in Burden of Treatment theory could further our understanding of how individuals appraise the personal costs and benefits of self-managing their health.

Conclusions

Patients’ appraisal of the burden or benefit of using a complex self-management intervention seemed to be influenced by experiences within the intervention (such as perceived availability of support) and beliefs about their condition and treatment (such as perceived control and risk of side effects). Developing our ability to adequately capture these salient burdens and benefits for patients could help enhance evaluation of self-management interventions in the future. Many participants perceived important benefits from using the intervention, highlighting the need for theory to recognise that engaging in self-management can include positive as well as negative aspects.

Trial registration number

NCT13790648
Providing psychological support to people in intensive care: development and feasibility study of a nurse-led intervention to prevent acute stress and long-term morbidity
Authors: Wade Dorothy , Als Nicole , Bell Vaughan , Brewin Chris , D’Antoni Donatella , Harrison David A , Harvey Mags , Harvey Sheila , Howell David , Mouncey Paul R , Mythen Monty , Richards-Belle Alvin , Smyth Deborah , Weinman John , Welch John , Whitman Chris , Rowan Kathryn M
Published: May 2023

Objectives

Adverse psychological outcomes, following stressful experiences in critical care, affect up to 50% of patients. We aimed to develop and test the feasibility of a psychological intervention to reduce acute stress and prevent future morbidity.

Design

A mixed-methods intervention development study, using two stages of the UK Medical Research Council framework for developing and testing complex interventions. Stage one (development) involved identifying an evidence base for the intervention, developing a theoretical understanding of likely processes of change and modelling change processes and outcomes. Stage two comprised two linked feasibility studies.

Setting

Four UK general adult critical care units.

Participants

Stage one: former and current patients, and psychology, nursing and education experts. Stage two: current patients and staff.

Outcomes

Feasibility and acceptability to staff and patients of content and delivery of a psychological intervention, assessed using quantitative and qualitative data. Estimated recruitment and retention rates for a clinical trial.

Results

Building on prior work, we standardised the preventative, nurse-led Provision Of Psychological support to People in Intensive Care (POPPI) intervention. We devised courses and materials to train staff to create a therapeutic environment, to identify patients with acute stress and to deliver three stress support sessions and a relaxation and recovery programme to them. 127 awake, orientated patients took part in an intervention feasibility study in two hospitals. Patient and staff data indicated the complex intervention was feasible and acceptable. Feedback was used to refine the intervention. 86 different patients entered a separate trial procedures study in two other hospitals, of which 66 (80% of surviving patients) completed questionnaires on post-traumatic stress, depression and health 5 months after recruitment.

Conclusion

The ‘POPPI’ psychological intervention to reduce acute patient stress in critical care and prevent future psychological morbidity was feasible and acceptable. It was refined for evaluation in a cluster randomised clinical trial.

Trial registration number

NCT61088114
Feasibility of data linkage in the PARAMEDIC trial: a cluster randomised trial of mechanical chest compression in out-of-hospital cardiac arrest
Authors: Ji Chen , Quinn Tom , Gavalova Lucia , Lall Ranjit , Scomparin Charlotte , Horton Jessica , Deakin Charles D , Pocock Helen , Smyth Michael A , Rees Nigel , Brace-McDonnell Samantha J , Gates Simon , Perkins Gavin D
Published: May 2023

Objectives

There is considerable interest in reducing the cost of clinical trials. Linkage of trial data to administrative datasets and disease-specific registries may improve trial efficiency, but it has not been reported in resuscitation trials conducted in the UK. To assess the feasibility of using national administrative and clinical datasets to follow up patients transported to hospital following attempted resuscitation in a cluster randomised trial of a mechanical chest compression device in out-of-hospital cardiac arrest.

Methods

Hospital data on trial participants were requested from Hospital Episode Statistics (HES), the Intensive Care National Audit and Research Centre, and Myocardial Ischaemia National Audit Project and National Audit of Percutaneous Coronary Interventions, using unique patient identifiers. Linked data were received between June 2014 and June 2015.

Results

Of 4471 patients randomised in the pre-hospital randomised assessment of a mechanical compression device in cardiac arrest (PARAMEDIC) trial, 2398 (53.6%) were not known to be deceased at emergency department arrival and were eligible for linkage. We achieved an overall match rate of 86.7% in the combined HES accident and emergency, inpatient and critical care dataset, with variable match rates (4.2%–80.4%) in individual datasets. Patient demographics, cardiac arrest-related characteristics and major outcomes were predominantly similar between HES matched and unmatched groups, in the linkage apart from location, response time and return of spontaneous circulation (ROSC) at handover.

Conclusions

This study shows that it is feasible to track patients from the prehospital setting through to hospital admission using routinely available administrative datasets with a moderate to high degree of success. This approach has the potential to complement the trial data with the demographic and clinical management information about the studied cohort, as well as to improve the efficiency and reduce the costs of follow-up in cardiac arrest trials.

Clinical trial registration

NCT08233942Post-results.
Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: a qualitative study with illustrative case studies
Authors: Tickell Alice , Byng Richard , Crane Catherine , Gradinger Felix , Hayes Rachel , Robson James , Cardy Jessica , Weaver Alice , Morant Nicola , Kuyken Willem
Published: May 2023

Objectives

This study aimed to describe the recovery journeys of people with a history of recurrent depression who took part in a psychosocial programme designed to teach skills to prevent depressive relapse (mindfulness-based cognitive therapy (MBCT)), alongside maintenance antidepressant medication (ADM).

Design

A qualitative study embedded within a multicentre, single blind, randomised controlled trial (the PREVENT trial).

Setting

Primary care urban and rural settings in the UK.

Participants

42 people who participated in the MBCT arm of the parent trial were purposively sampled to represent a range of recovery journeys.

Interventions

MBCT involves eight weekly group sessions, with four refresher sessions offered in the year following the end of the programme. It was adapted to offer bespoke support around ADM tapering and discontinuation.

Methods

Written feedback and structured in-depth interviews were collected in the 2 years after participants undertook MBCT. Data were analysed using thematic analysis and case studies constructed to illustrate the findings.

Results

People with recurrent depression have unique recovery journeys that shape and are shaped by their pharmacological and psychological treatment choices. Their journeys typically include several over-arching themes: (1) beliefs about the causes of depression, both biological and psychosocial; (2) personal agency, including expectations about their role in recovery and treatment; (3) acceptance, both of depression itself and the recovery journey; (4) quality of life; (5) experiences and perspectives on ADM and ADM tapering-discontinuation; and (6) the role of general practitioners, both positive and negative.

Conclusions

People with recurrent depression describe unique, complex recovery journeys shaped by their experiences of depression, treatment and interactions with health professionals. Understanding how several themes coalesce for each individual can both support their recovery and treatment choices as well as health professionals in providing more accessible, collaborative, individualised and empowering care.

Trial registration number

Clinical trial numberNCT26666654; post results.
Impact of loneliness on suicidal ideation during the COVID-19 pandemic: findings from a cross-sectional online survey in Japan
Authors: Tachikawa Hirokazu , Matsushima Midori , Midorikawa Haruhiko , Aiba Miyuki , Okubo Ryo , Tabuchi Takahiro
Published: May 2023

Objectives

We aim to reveal how loneliness relates to suicidal ideation following the onset of the COVID-19 pandemic.

Design

Cross-sectional online survey.

Setting

Community cohort study in Japan.

Participants

The second wave of a large web-based survey, Japan COVID-19 and Society Internet Survey, was conducted in February 2021, and we analysed the data of 6436 men and 5380 women who were aged 20–59 years.

Main outcome measures

The prevalence ratios (PRs) of suicidal ideation due to loneliness, depression, social isolation and decline in income during the pandemic and other sociodemographic and economic information were adjusted in the analysis.

Statistical methods

Estimations were conducted by separating a male and female sample. The survey weight (inverse probability weighting) was applied for analyses, and a Poisson regression model was used with all the potential confounders adjected.

Results

Overall, 15.1% of male and 16.3% of female participants were found to have had suicidal ideation during the COVID-19 pandemic. Among them, 23% of male and 20% of female participants experienced suicidal ideation for the first time. The results of the Poisson regression suggested that those who were feeling lonely had higher PRs for suicidal ideation (4.83 for men (95% CI, 3.87 to 6.16) and 6.19 for women (95% CI, 4.77 to 8.45)). The relationship between loneliness and suicidal ideation remained robust even after adjusting for depression, although there were declines in PRs. Additionally, the results showed that those who were lonely, and continued to feel lonely during the pandemic, had the highest PRs of suicidal ideation.

Conclusion

Loneliness had both direct and indirect effects on suicidal ideation mediated through depression. Those who felt lonelier during the pandemic had the highest risk of suicidal ideation. It is necessary to adopt national measures focused on providing psychological support to people who feel lonely to prevent them from taking their own lives.
Knowledge and practice of cervical cancer screening and its associated factors among women attending maternal health services at public health institutions in Assosa Zone, Benishangul-Gumuz, Northwest Ethiopia, 2022: a cross-sectional study
Authors: Gelassa Firaol Regea , Nagari Shalama Lekasa , Jebena Desalegn Emana , Belgafo Dabeli , Teso Daniel , Teshome Debela
Published: May 2023

Background

Cervical cancer ranks as the second most frequent cancer among all women in Ethiopia and the second most frequent cancer among women between 15 and 44 years of age, resulting in over 4884 moralities annually. Although there is a focus on health promotion through teaching and screening in Ethiopia’s intended transition toward universal healthcare, there is little information available on baseline levels of knowledge and screening uptake related to cervical cancer.

Objectives

This study explored the levels of knowledge and screening rates of cervical cancer along with its associated factors among women of reproductive age in Assosa Zone, Benishangul-Gumuz, Ethiopia in 2022.

Methodology

A facility-based cross-sectional study was conducted. A systematic sampling technique was used to select 213 reproductive-age women from selected health institutions, from 20 April 2022 to 20 July 2022. A validated and pretested questionnaire was used for data collection. Multi-logistic regression analyses were done to identify factors independently associated with cervical cancer screening. Adjusted OR with 95% CI was estimated to measure the strength of association. The level of statistical significance was declared at a p value of <0.05. The results were presented in tables and figures.

Result

Knowledge of cervical cancer screening in this study was 53.5%, and 36% of respondents had practised cervical cancer screening. Family history of cervical cancer (AOR)=2.5, 95% CI (1.04 to 6.44)), place of residence (AOR=3.68, 95% CI (2.23, 6.54)) and availability of health services at nearby (AOR=2.03, 95% CI (1.134, 3.643)) were significantly associated with knowledge of cervical cancer screening, while educational status (AOR=2.811, 95% CI (1.038 to 7.610)), knowing someone diagnosed with cervical cancer (AOR=8.3, 95% CI (2.4, 28.69)), Knowledge of cervical cancer(AOR=2.17, 95%CI(1.077, 4.384) and feeling feeling at risk (AOR=3.26 95% CI (1.52, 5.04)) were associated with the practice of cervical cancer screening.

Conclusion and recommendation

Knowledge and practice of cervical cancer screening in this study were low. Therefore, the reproductive women must be encouraged to have early cervical cancer screening at precancerous stage by informing their susceptibility to cervical cancer.