bluuebunny/crossref_metadata_2025 huggingface dataset:
Mental healthcare services in Kenyan counties: a descriptive survey of four counties in Western Kenya
Authors: Kwobah Edith Kamaru , Turissini Matthew , Barasa Julius , Kimaiyo Mercy , Okeyo Lily , Araka Joash , Njiriri Faith , Matundura Richard , Jaguga Florence
Published: May 2023

Background

The government of Kenya has made progressive efforts towards improving mental health services in the country. However there is little documentation of mental health services in the counties that would support actualization of the legislative frameworks in the context of a devolved healthcare system. This study sought to document existing mental health services within 4 counties in Western Kenya.

Methods

We conducted a cross sectional descriptive survey of four counties using the World Health Organization, Assessment Instrument for Mental Health Systems (WHO-AIMS). Data was collected in 2021, with 2020 being the year of reference. We collected data from the facilities offering mental healthcare within the counties as well as from County health policy makers and leaders.

Results

Mental healthcare was provided at higher level facilities within the counties, with minimal structures at primary care facilities. No county had a stand-alone policy on mental health services or dedicated budget for mental healthcare. The national referral hospital, within Uasin-Gishu county, had a clear mental health budget for mental health. The national facility in the region had a dedicated inpatient unit while the other three counties admitted patients in general medical wards but had mental health outpatient clinics. The national hospital had a variety of medication for mental health care while the rest of the counties had very few options with antipsychotics being the most available. All the four counties reported submitting data on mental health to Kenya health information system (KHIS). There were no clearly defined mental healthcare structures in the primary care level except for funded projects under the National referral hospital and the referral mechanism was not well defined. There was no established mental health research in the counties except that which was affiliated to the national referral hospital.

Conclusion

In the four counties in Western Kenya, the mental health systems are limited and not well structured, are faced with limited human and financial resources and there is lack of county specific legistrative frameworks to support mental healthcare. We recommend that counties invest in structures to support provision of quality mental healthcare to the people they serve.
Ambient fine particulate matter and allergic symptoms in the middle-aged and elderly population: results from the PIFCOPD study
Authors: Wei Shanshan , Liao Jiping , Xue Tao , Yu Kunyao , Fu Xiuhua , Wang Ruiying , Dang Xiaomin , Zhang Cheng , Qiao Hua , Jiang Shujuan , Xiao Jianhong , Dong Lixia , Yin Jinzhi , Yan Xixin , Jia Weihua , Zhang Guifang , Chen Rui , Zhou Bo , Song Beibei , Li Jing , Yin Mengyu , Zhang Lina , Xie Liping , Dong Shaochen , Sun Jian , Gao Peng , Miao Bifang , Li Wei , He Lan , Ning Qian , Zhao Limin , Liu Hengyi , Cao Han , Wang Guangfa
Published: May 2023

Background

The associations between short- and long-term exposure to ambient fine particulate matter with an aerodynamic diameter ≤ 2.5 µm (PM2.5) and allergic symptoms in middle-aged and elderly populations remain unclear, particularly in China, where most cities have severe air pollution.

Methods

Participants (n = 10,142; age = 40–75 years) were recruited from ten regions in China from 2018 to 2021 for the Predictive Value of Inflammatory Biomarkers and Forced Expiratory Volume in 1 s (FEV1) for Chronic Obstructive Pulmonary Disease (PIFCOPD) study. Short-term (lag0 and lag0–7 day) and long-term (1-, 3- and 5-year) PM2.5 concentrations at residences were extracted from the air pollutant database known as Tracking Air Pollution (TAP) in China. Multivariate logistic regression models were used to estimate associations for short- and long-term PM2.5 exposure concentrations and long-term exposure models were additionally adjusted for short-term deviations.

Results

A 10 µg/m3 increase in PM2.5 on the day the allergic symptoms questionnaire was administered (lag0 day) was associated with higher odds of allergic nasal (1.09, 95% CI 1.05, 1.12) and eye symptoms (1.08, 95% CI 1.05, 1.11), worsening dyspnea caused by allergens (1.06, 95% CI 1.02, 1.10), and ≥ 2 allergic symptoms (1.07, 95% CI 1.03, 1.11), which was similar in the lag0–7 day concentrations. A 10 µg/m3 increase in the 1-year average PM2.5 concentration was associated with an increase of 23% for allergic nasal symptoms, 22% for eye symptoms, 20% for worsening dyspnea caused by allergens, and 21% for ≥ 2 allergic symptoms, similar to the 3- and 5-year average PM2.5 concentrations. These associations between long-term PM2.5 concentration and allergic symptoms were generally unchanged after adjustment for short-term deviations.

Conclusions

Short- and long-term exposure to ambient PM2.5 was associated with an increased risk of allergic nasal and eye symptoms, worsening dyspnea caused by allergens, and ≥ 2 allergic symptoms.

Trial registration

Clinical trial ID: NCT03532893 (29 Mar 2018).
Hyperglycemia and O-GlcNAc transferase activity drive a cancer stem cell pathway in triple-negative breast cancer
Authors: Ayodeji Saheed A. , Bao Bin , Teslow Emily A. , Polin Lisa A. , Dyson Greg , Bollig-Fischer Aliccia , Fehl Charlie
Published: May 2023

Background

Enhanced glucose metabolism is a feature of most tumors, but downstream functional effects of aberrant glucose flux are difficult to mechanistically determine. Metabolic diseases including obesity and diabetes have a hyperglycemia component and are correlated with elevated pre-menopausal cancer risk for triple-negative breast cancer (TNBC). However, determining pathways for hyperglycemic disease-coupled cancer risk remains a major unmet need. One aspect of cellular sugar utilization is the addition of the glucose-derived protein modification O-GlcNAc (O-linked N-acetylglucosamine) via the single human enzyme that catalyzes this process, O-GlcNAc transferase (OGT). The data in this report implicate roles of OGT and O-GlcNAc within a pathway leading to cancer stem-like cell (CSC) expansion. CSCs are the minor fraction of tumor cells recognized as a source of tumors as well as fueling metastatic recurrence. The objective of this study was to identify a novel pathway for glucose-driven expansion of CSC as a potential molecular link between hyperglycemic conditions and CSC tumor risk factors.

Methods

We used chemical biology tools to track how a metabolite of glucose, GlcNAc, became linked to the transcriptional regulatory protein tet-methylcytosine dioxygenase 1 (TET1) as an O-GlcNAc post-translational modification in three TNBC cell lines. Using biochemical approaches, genetic models, diet-induced obese animals, and chemical biology labeling, we evaluated the impact of hyperglycemia on CSC pathways driven by OGT in TNBC model systems.

Results

We showed that OGT levels were higher in TNBC cell lines compared to non-tumor breast cells, matching patient data. Our data identified that hyperglycemia drove O-GlcNAcylation of the protein TET1 via OGT-catalyzed activity. Suppression of pathway proteins by inhibition, RNA silencing, and overexpression confirmed a mechanism for glucose-driven CSC expansion via TET1-O-GlcNAc. Furthermore, activation of the pathway led to higher levels of OGT production via feed-forward regulation in hyperglycemic conditions. We showed that diet-induced obesity led to elevated tumor OGT expression and O-GlcNAc levels in mice compared to lean littermates, suggesting relevance of this pathway in an animal model of the hyperglycemic TNBC microenvironment.

Conclusions

Taken together, our data revealed a mechanism whereby hyperglycemic conditions activated a CSC pathway in TNBC models. This pathway can be potentially targeted to reduce hyperglycemia-driven breast cancer risk, for instance in metabolic diseases. Because pre-menopausal TNBC risk and mortality are correlated with metabolic diseases, our results could lead to new directions including OGT inhibition for mitigating hyperglycemia as a risk factor for TNBC tumorigenesis and progression.
New opportunities for RGD-engineered metal nanoparticles in cancer
Authors: Qin Wei , Chandra Jyoti , Abourehab Mohammed A.S. , Gupta Neelima , Chen Zhe-Sheng , Kesharwani Prashant , Cao Hui-Ling
Published: May 2023

The advent of nanotechnology has opened new possibilities for bioimaging. Metal nanoparticles (such as gold, silver, iron, copper, etc.) hold tremendous potential and offer enormous opportunities for imaging and diagnostics due to their broad optical characteristics, ease of manufacturing technique, and simple surface modification. The arginine-glycine-aspartate (RGD) peptide is a three-amino acid sequence that seems to have a considerably greater ability to adhere to integrin adhesion molecules that exclusively express on tumour cells. RGD peptides act as the efficient tailoring ligand with a variety of benefits including non-toxicity, greater precision, rapid clearance, etc. This review focuses on the possibility of non-invasive cancer imaging using metal nanoparticles with RGD assistance.

Graphical abstract
Magnetic-activated cell sorting identifies a unique lung microbiome community
Authors: Dunlap Daniel G. , Yang Libing , Qin Shulin , Li Kelvin , Fitch Adam , Huang Laurence , McVerry Bryan J. , Hand Timothy W. , Methé Barbara A. , Morris Alison
Published: May 2023

Background

The advent of culture-independent, next-generation DNA sequencing has led to the discovery of distinct lung bacterial communities. Studies of lung microbiome taxonomy often reveal only subtle differences between health and disease, but host recognition and response may distinguish the members of similar bacterial communities in different populations. Magnetic-activated cell sorting has been applied to the gut microbiome to identify the numbers and types of bacteria eliciting a humoral response. We adapted this technique to examine the populations of immunoglobulin-bound bacteria in the lung.

Methods

Sixty-four individuals underwent bronchoalveolar lavage (BAL). We separated immunoglobulin G-bound bacteria using magnetic-activated cell sorting and sequenced the 16S rRNA gene on the Illumina MiSeq platform. We compared microbial sequencing data in IgG-bound bacterial communities compared to raw BAL then examined the differences in individuals with and without HIV as a representative disease state.

Results

Immunoglobulin G-bound bacteria were identified in all individuals. The community structure differed when compared to raw BAL, and there was a greater abundance of Pseudomonas and fewer oral bacteria in IgG-bound BAL. Examination of IgG-bound communities in individuals with HIV demonstrated the differences in Ig-bound bacteria by HIV status that were not seen in a comparison of raw BAL, and greater numbers of immunoglobulin-bound bacteria were associated with higher pulmonary cytokine levels.

Conclusions

We report a novel application of magnetic-activated cell sorting to identify immunoglobulin G-bound bacteria in the lung. This technique identified distinct bacterial communities which differed in composition from raw bronchoalveolar lavage, revealing the differences not detected by traditional analyses. Cytokine response was also associated with differential immunoglobulin binding of lung bacteria, suggesting the functional importance of these communities.
To what extent do secondary effects shape migrants’ educational trajectories after lower-secondary education?
Authors: Busse Robin , Michaelis Christian , Nennstiel Richard
Published: May 2023

Research shows a heterogeneous picture of migration-related disparities regarding adolescents’ educational trajectories at the end of lower-secondary education. Among other disparities, migrants face large disadvantages with regard to the transition to vocational education and training (VET). They are, however, also more likely to change to upper-secondary school tracks at the end of lower-secondary education. Using longitudinal data drawn from the German National Educational Panel Study (NEPS, Starting Cohort 4), this study empirically captures patterns in school-leavers’ transition trajectories after lower-secondary education and empirically tests theoretical mechanisms of migration-related educational inequalities. Building on the concept of secondary effects of migrant origin, this study asks to what extent self-selection explains migration-related disparities in the educational trajectories at the end of lower-secondary education. Particular attention is devoted to the extent to which migration-related inequalities in adolescents’ transitions can be explained by differences in (1) rational choice factors and (2) the educational expectations and demands of parents and friends. The results show that rational choice factors and the educational expectations of social groups largely contribute to migration-related educational inequalities. The results provide important starting points for educational policy discussions on strategies and measures to address migration-related inequalities in the transition to VET.
Development of a flexible self-calculation scoring model to determine stroke occurrence
Authors: Kyeong Sunghyon , Kim Dae Hyun
Published: May 2023

Stroke has become a significant threat to global public health, the ideal solution to which is primary prevention. Identification and management of determinants of stroke among various variables in different datasets are essential steps for its primary prevention. This study aimed to develop a flexible scoring model, which can easily modify different datasets. The public dataset containing 41,931 cases with 643 occurrences of stroke was randomly divided into training, validation, and test datasets comprising 25,158 (60%), 8,386 (20%), and 8,387 (20%) cases, respectively. Three continuous variables (age, body mass index, and average glucose level) and seven categorical variables (heart disease, hypertension, sex, married/smoking/work/residence status) in the dataset were converted using the weight of evidence method. The significant variables among 10 transformed variables were selected using multivariable logistic regression analyses. The scoring model for stroke occurrence was developed in the training and validation datasets, and performance was evaluated in the test dataset. Age, average glucose level, heart disease, and hypertension were significant variables of stroke occurrence. The scoring model was easily calculated using four determinants and indicates that the stroke occurrence ranged from 0.04 to 12.50%. The performance of the scoring model on the test dataset was similar to that on the validation dataset. This novel point scoring model is flexible enough to modify various datasets and can be used for determinant identification. Furthermore, its simplicity allows individuals to manage determinants by self-calculating stroke occurrence. Our model contributes to primary prevention using determinant identification and management.
Use of RCC pile, anchor bolt and geogrid for building construction on the unstable slope
Authors: Jain Sanjaya Kumar , Nusari Mohammed Saleh , Shrestha Rajyaswori , Mandal Abhay Kumar
Published: May 2023

Rapid construction of buildings in urban area is creating lack of space available for new construction. This problem enforced to construct building on slope in hilly regions. However, the engineers and designers are concerned with the stability analysis of structures built on soil slopes, as it is difficult to achieve a uniform structural level on mountainous terrain. Also, it cannot be reduced to the same level of structural forms and part of base member may not be bound by an identical horizontal plane. The fundamental stability of the structure built on hill slope depends upon on its slope stability. Slope failure has been identified as one of the frequent devastating natural disasters that have claimed huge loss of property and lives. Therefore, in this research, “Phase 2 (2002)”, a Rocscience Finite Element (FE) program and “Slide”, a Rocscience limit equilibrium program were used to simulate and analyze a complex multi-staged model with RCC pile, Anchor Bolt and Geogrid for the stability analysis of slope. Bishop’s method was used to evaluate and analyze the factor of safety. Analysis of the two section (Section 1-1 and 2-2) of slope was taken into consideration for slope stability analysis. As per the analysis using the limit equilibrium approach, the factor of safety for existing slope at Section 1-1 and Section 1-1 was found to be 0.579 and 0.70 respectively. Moreover, it was found that the factor of safety of slope was increased significantly from 0.579 to 1.593 in Sections 1-1 and 0.70 to 1.319 in Section 2-2. In addition, the factor of safety of slope with strength reduction method is 1.408 and 1.05 for Sections 1 and 2 respectively after slope stabilization work in seismic condition. This shows that, the construction of buildings in slope terrain is possible, but it needs specialized excavation and slope protection work. RCC pile with anchor bolt and geogrid is one of the sustainable solutions for construction of structure in slope area.
Evaluation of the quality of patient involvement in a patient-led analysis of the lived experience of a rare disease
Authors: Lobban Dawn , Oliver Jacqui , Davio Kelly , Seddik Kenza , Porkess Veronica
Published: May 2023

Background

Patients themselves are best placed to provide insights on the lived experience and to lead the analysis of such insights to bring the patient voice into peer-reviewed literature. In doing so, they can meet the authorship criteria for subsequent research publications. It is important to evaluate patient engagement to identify ways to improve future collaborations. Here, we describe the approach taken during a patient-led and patient co-authored analysis of the lived experience of generalized myasthenia gravis, which may be applicable to other indications. We also assessed the quality of patient engagement throughout the research project.

Methods

We used self-reported experience surveys based on the Patient Focused Medicines Development Patient Engagement Quality Guidance criteria for assessing patient engagement. The surveys were adapted to focus on individual projects and assessed eight domains using a five-point Likert scale. In September 2020, we invited eight patient council members to complete a self-reported experience survey following qualitative lived experience data generation. We calculated the average experience score as a percentage of the maximum possible score. Patient authors (n = 1) and non-patient authors (n = 3) were invited to complete a similar survey in November 2021, with questions customized for relevance, to evaluate the authorship experience following publication of the research.

Results

Overall, patient council members had a positive experience of taking part in this study, with an average experience score of 90% (71.6/80.0; n = 8). The patient author and non-patient authors rated their authorship experience highly, with average experience scores of 92% (78.0/85.0) and 97% (63.3/65.0), respectively. There were key aspects that contributed to the overall project success (e.g., ensuring that all participants were aligned on the project objectives at the outset and understood their roles and responsibilities). We also identified elements of the approach that could be improved in future collaborations.

Conclusion

In this patient-led analysis, patient council members, patient authors and non-patient authors had a positive experience of being involved in the project. We gained useful insights into elements that contributed to the project’s success and ways to improve future patient-led projects on the lived experience.
Self-inflicted penetrating brain injuries with preserved neurological function: a case series
Authors: Shaukat Shuja , Zaidi Syeda Mahrukh Fatima , Khatri Adil , Siddiqui Mishal Shan , Khulsai Muhammad Sameer , Ansari Abdul Basit , Ayesha Shabih , Khan Atiq Ahmed , Imran Muhammad
Published: May 2023

Background

Penetrating trauma to the brain is a rare mode of self-harm in individuals with depressive psychosis. It may have variable presentations ranging from intact neurological status to non-survivable damage and the subjects may be surprisingly apathetic to pain. It is even unusual for such an injury to have an excellent prognosis despite coming late to clinical attention.

Case presentations

We report two cases of patients with psychotic depression who attempted suicide by hammering nails into their heads. On imaging, deep penetration within the brain parenchyma was noted; however, neither case had any neurological deficit or symptoms attributable to brain trauma.

Conclusions

Self-inflicted penetrating brain injuries with peculiar objects such as nails are rarely encountered in practice. They need prompt management for their removal and addressing the underlying mental health illnesses.
Large-vessel-occlusion in patients with previous ischemic stroke: an analysis of adherence to secondary preventive medication for different etiologies
Authors: Kohlhase Konstantin , Schäfer Jan Hendrik , Tako Lisa Marie , Willems Laurent M. , Hattingen Elke , Bohmann Ferdinand O. , Grefkes Christian , Rosenow Felix , Strzelczyk Adam
Published: May 2023

Background

Large vessel occlusion (LVO) is a severe condition that carries a high risk of morbidity and mortality, underscoring the importance of effective prevention strategies. This retrospective study aimed to analyze the intake of preventive medication at the time of hospitalization in a cohort of recurrent stroke patients presenting with acute LVO.

Methods

The study assessed the intake of either platelet aggregation inhibitors (PAI), oral anticoagulants (OAC) or statins at admission in patients with recurrent stroke and correlated it with the final classification of LVO. The frequency of those secondary preventive medication in recurrent stroke patients was defined as primary endpoint. The Modified Rankin Scale (mRS) at discharge was used as a functional outcome and defined as a secondary outcome measure.

Results

This study included 866 patients who were treated for LVO between 2016 and 2020, of whom 160 (18.5%) had a recurrent ischemic stroke. OAC (25.6% vs. 14.1%, p < 0.01), PAI (50.0% vs. 26.0%, p < 0.01), or statin therapy (50.6% vs. 20.8%, p < 0.01) at admission were significantly more frequent in recurrent stroke patients compared to patients with a first-time stroke. Concerning LVO etiology in recurrent stroke patients, OAC at admission was taken in 46.8% of cardioembolic LVO, whereas PAI and statin at admission in macroangiopathic LVO were administered to 40.0%; neither PAI nor OAC was taken in 26.0%, 28.3%, and 31.6% of cardioembolic, macroangiopathic, or cryptogenic strokes, respectively. Regardless of stroke recurrence or etiology, there was an increase in mRS at discharge.

Conclusions

Despite high-quality healthcare, this study suggested a significant proportion of patients with recurrent stroke who were either non-adherent or insufficiently adherent to secondary preventive medication. Given the disability associated with LVO, improving patients’ medication adherence and identifying unknown stroke causes are crucial for effective prevention strategies.
Computed tomography reference values estimation for femoral neck shaft angle in Egyptian healthy adults of both sexes
Authors: Ahmad Medhat Ibraheem Mohammad , Bushra Marina Talaat , Galal Ahmed Talat , Ouies Salwa Mohammed
Published: May 2023

Background

Accurate measurement of the femoral neck shaft angle (NSA) is critical for the diagnosis and treatment of hip pathology, but its current reference values remain limited in the Egyptian adult population. This study was designed to provide reference that is reliable for femoral NSA measured by computed tomography (CT) in Egyptian healthy adults of both sexes. This was a cross-sectional descriptive study and analysis of the femoral NSA of healthy Egyptian adults of both sexes measured by CT. Six hundred hips in 300 adults (aged 18 and 60 years; 300 females) were evaluated in the simulated anterior pelvic plane (APP) and the rotation-corrected coronal reconstruction femoral neck plane (FNP) on both sides. We compared the measurements with age and sex, and a two-tailed nonparametric Wilcoxon test was used to discover differences between both measurements.

Results

The mean NSA was 129.46° ± 5.06°, with a mean value of 129.65° ± 4.13° for males and 129.28° ± 3.71° for females. Simulated APP had a higher mean NSA 129.6° (range 115.7°–146.7°; SD 5.06°) than rotation-corrected coronal reconstruction in the FNP 127.73° (range 115.3°–144.6°; SD 4.9°). It was observed that there was a significant variation in the measurements of NSA between the two methods. The side influenced the NSA significantly on both views (p < 0.001); no significant differences were found between age and gender.

Conclusions

The current study attempts to develop population-specific data for femoral NSA reference values in Egyptian communities. No considerable difference was measured in NSA among males and females. It was observed that there was a side difference, with the NSA value being higher on the left than the right. We noted also that proper measurement of NSA is made possible by using NSA values obtained from rotation-corrected coronal reconstruction in the FNP. We anticipate that the findings will contribute to a better understanding of proximal femur morphology and may aid the majority of our population in selecting an implant that is compatible with hip anatomy.
Engineering properties of concrete incorporating waste glass as natural sand substitution with tin can fiber: experimental and ANN application
Authors: Ahmed Tanvir , Mita Ayesha Ferdous , Ray Sourav , Haque Mohaiminul
Published: May 2023

Disposal of waste material is causing environmental issues all around the world. Waste glass and tin can are two such products that impose detrimental effects on the environment. One feasible approach is to utilize these discarded materials as constituents of concrete. This study investigates the performance of concrete prepared with glass waste as fine aggregate (GWA) and tin can fiber (TCF) in terms of workability, fresh density, compressive, and splitting tensile strength as desired concrete properties. An Artificial Neural Network (ANN) approach has been adopted for developing predictive models to simulate the impact of these waste materials on concrete properties. Experimental findings demonstrate that the worability of concrete mix decreases with increasing GWA and TCF contents in the mix. Increasing TCF percentages results in an increase in fresh density of concrete; however, a declining pattern in fresh density has been observed with increasing GWA percentage in the concrete mix. Compressive strength at all curing ages shows positive trends till 20% GWA and 1% TCF incorporation in concrete. Similar pattern has been observed for splitting tensile strength up to 10% GWA and 0.5% TCF. Constructed models are feasible for prediction of the desired concrete properties as verified by various statistical parameters. Sensitivity analysis reports that TCF has a greater influence on concrete properties than GWA.
Digital solutions in musculoskeletal health
Authors: Gudbergsen Henrik
Published: May 2023

Musculoskeletal disorders (MSDs) are a common cause of disability and reduced quality of life, and the burden of MSDs is a global concern. To tackle the projected increase in the burden of MSDs digital technologies are perceived as critical in the context of complementing traditional healthcare services.
Comparing measurements of lithium treatment efficacy in people with bipolar disorder: systematic review and meta-analysis
Authors: Ulrichsen Andrea , Hampsey Elliot , Taylor Rosie H. , Gadelrab Romayne , Strawbridge Rebecca , Young Allan H.
Published: May 2023

Background

Lithium has long been recognised as an effective treatment for bipolar disorder. Its relative efficacy has been measured with a diverse range of clinical outcomes, resulting in differences in efficacy reporting that have not been systematically reviewed.

Aims

We aimed to identify and compare the various measures of lithium efficacy employed in interventional studies for people with bipolar disorder.

Method

Database (PubMed, Web of Science) and hand searches were performed to identify studies that assessed a clinical response in patients with bipolar disorder who received lithium, up to the end of 2021. We included primary human interventional studies without excluding specific study designs, bipolar disorder subtypes, duration or dosage of lithium treatment. Continuous outcome effects were meta-analysed; binary outcomes were synthesised visually and narratively. The Cochrane risk-of-bias tool was used to assess study-level risk of bias.

Results

Seventy-one studies were included (N = 30 542). Approximately two-thirds of participants attained a clinically significant improvement in manic or depressive symptoms, and over 50% achieved remission. About a third required hospital admission (study length 2–12 years) and around 50% needed further treatment to stay well or had recurrence of symptoms; the latter two outcomes tended to be assessed over long-term maintenance periods.

Conclusions

An abundance of measurements have been used to assess lithium's clinical effects, across several study designs. Despite the resultant high heterogeneity, an overall picture of lithium's effects emerges that supports previous literature; between half and two-thirds of patients respond well to lithium across varying outcome measures, baseline mood states, study durations and bipolar disorder subtypes.
Rise of Antibody-Drug Conjugates: The Present and Future
Authors: Shastry Mythili , Gupta Avantika , Chandarlapaty Sarat , Young Matthew , Powles Thomas , Hamilton Erika
Published: May 2023

Antibody-drug conjugates (ADCs) embody a simple, but elegant, vision for cancer therapy—the delivery of a potent cytotoxic agent to tumor cells with minimal damage to normal cells—so-called smart chemo. Although there were significant challenges in achieving this milestone culminating in the first Food and Drug Administration approval in 2000, subsequent advancements in technology have led to rapid drug development with regulatory approvals for ADCs targeting a variety of tumor types. The most successful application for solid tumors has been in breast cancer, with ADCs becoming the standard of care across traditional human epidermal growth factor receptor 2 (HER2)+, hormone receptor+ (HR+) and triple-negative disease subtypes. Moreover, the improved features and gains in potency with the development of ADCs have expanded the treatment-eligible population to those with low/heterogeneous expression of the target antigen on the tumor with trastuzumab deruxtecan or in the case of sacituzumab govitecan, agnostic to target expression. Despite their antibody-directed homing, these novel agents come with their share of toxicities obligating appropriate patient selection and vigilant monitoring while on treatment. As more ADCs are included in the treatment armamentarium, mechanisms of resistance need to be studied and understood for optimal sequencing. Modifying the payload to use immune-stimulating agents or combination therapies with immunotherapy and other effective targeted therapies may further extend the utility of these agents in the treatment of solid tumors.
Preoperative Ultrasound-Guided Internal Branch Block of Superior Laryngeal Nerve Reduces Postoperative Sore Throat Caused by Double Lumen Endotracheal Intubation: A Randomized Trial
Authors: Chen Zheping , Jin Yanwu , Lu Guodong , Jin Yuelong , Feng Chang , Zhao Xin
Published: May 2023

BACKGROUND:

Postoperative sore throat (POST) is one of the more common side effects of tracheal intubation patients under general anesthesia (GA) after extubation using double-lumen endobronchial tubes (DLTs). The internal branches of the superior laryngeal nerve (SLN) block (iSLNB) have been reported to anesthetize the larynx for airway manipulation (such as awake tracheal intubation) and pain treatment efficiently. We hypothesized that ultrasound-guided iSLNB (US-guided iSLNB) combined with GA would ameliorate the incidence and severity of POST and hoarseness.

METHODS:

Patients (n = 82) undergoing thoracoscopic resection of pulmonary nodules/lobes/segments with one-lung ventilation (OLV) under GA were randomized into 2 groups depending on whether performed with iSLNB (S group, n = 41) or not (C group, n = 41) under GA. Patients in the S group received US-guided iSLNB bilaterally before surgery. POST and hoarseness were assessed at 2, 6, and 24 hours after surgery. The primary outcome of this study was the incidence of POST at 6 hours after surgery between groups.

RESULTS:

The overall accumulated incidence of POST was lower in the S goup than in the C group (9/41 vs 20/41; 95% CI, 0.30 [0.11–0.77]; P = .011). The incidence and severity of POST was lower in the S group than in the C group at 2 hours (9/41 vs 20/41; 95% CI, 0.30 [0.11–0.77]; P = .008 and P = .004) and 6 hours after (7/41 vs 17/41; 95% CI, 0.29 [0.10–0.81]; P = .012 and P = .015) surgery. The incidence and severity of POST at 24 hours after surgery was nonsignificant. However, the incidence and severity of hoarseness was comparable between the 2 groups at 2, 6, and 24 hours after surgery.

CONCLUSIONS:

Preoperative US-guided iSLNB could significantly ameliorate the incidence and severity of POST induced by double-lumen bronchial catheter intubation
Editors’ Introduction
Authors: Goulding Marc , Meade Teresa , Power Margaret
Published: May 2023

This essay explores several key themes regarding political imprisonment and confinement. Neither governments nor activists agree on who is and who is not a political prisoner. Governments routinely deny they imprison people for political reasons. Instead, they consistently seek to criminalize those they detain as part of their effort to maintain the legitimacy of their rule and delegitimize those who act against it. A common definition of who is and who is not a political prisoner does not exist among prisoners, activists, or supporters. No international organizations or national bodies have developed a shared description of what constitutes a political prisoner. Instead, as this essay and the articles that follow illustrate, the subject is a matter of debate and discussion.
“Uncle Sugar’s Belles”
Authors: Alfin Kathleen E.
Published: May 2023

This article examines the confinement of Liberian women by US Army Forces in Liberia (USAFIL) for the purpose of regulated prostitution during World War II. The racial makeup of USAFIL as an overwhelmingly African American unit and its deployment to the only sovereign Black republic in Africa created what US Army officials called “an exceptional situation.” This essay explores what army leaders meant by “exceptional” and the resultant creation of “exceptional measures” to control sexual liaisons between American soldiers and women in Liberia. Sexual relations between Black GIs and Liberian women defied the racist segregationist logic used by American military leaders to police Black GIs’ sexuality elsewhere during the war. USAFIL officials consequently racialized venereal disease and prostitution to justify confining and regulating Black Liberian women’s bodies in the name of soldiers’ health, as well as to uphold their racial and military authority. Shifting perspectives, this case study then considers how women in Liberia resisted army regulation of their sexuality and what they gained and lost through sex work, despite their confinement. Finally, this essay analyzes USAFIL’s regulation of prostitution in a transnational comparative context to illuminate the exceptional authority US Army officials assumed and asserted over women and prostitution in Liberia.
Political Prison and the Rise of State Violence in Argentina during the 1960s and 1970s
Authors: D’Antonio Débora
Published: May 2023

Historical analyses of human rights violations in Argentina during the late Cold War have often focused on the fate of desaparecidos, the disappeared who were kidnapped, tortured, and sometimes murdered in clandestine detention centers during the 1976–83 military dictatorship. Instead, this article rethinks the chronology and nature of state violence in Argentina, examining how the situation of political prisoners in regular prisons officially recognized by the state was already deteriorating in 1960s, even under civilian regimes. The military achieved increasing control over the penitentiary system, especially after 1966, driving this institution away from the goal of reforming criminals and reshaping it as a tool to incarcerate political dissidents, who were treated as subversives with diminishing legal rights. This encroachment over the penitentiary intensified throughout the years, showing that the military used state institutions to control social conflict before 1976 and that it did so also through legal means and outside concealed clandestine spaces.
“This Argument Is Far from Over”
Authors: Felber Garrett , Ward Stephen
Published: May 2023

This article explores the implications of a 1974 political debate between the radical priest Daniel Berrigan and the revolutionary theorists James Boggs and Grace Lee Boggs regarding support for the political prisoner Martin Sostre, as well as the meaning of the designation political prisoner itself. To begin, the article outlines and contextualizes their opposing positions—Berrigan’s view, common among radicals at the time, that all imprisonment is political, and the Boggses’ fear that lumping together political and nonpolitical prisoners would result in theoretical and political miscalculations, such as mistaking the rebellion of the most oppressed for fundamental revolutionary change. Such analysis highlights the stakes of these characterizations for revolutionary struggle. In particular, the dialogue between Berrigan and the Boggses reveals the limits of static definitions of political subjecthood and shows how studying and learning from these historical debates can help to create more nuanced, flexible, and capacious political visions and practices.
Just before Freedom
Authors: Belej Cecilia
Published: May 2023

This Curated Spaces features a visual essay of photographs made by Alicia Sanguinetti, an Argentinean political prisoner of Alejandro Lanusse’s military government, on the last day of her captivity in Villa Devoto prison in Buenos Aires. Sanguinetti and her fellow political prisoners of the 1966–73 dictatorship were released by the democratic president Héctor Cámpora on the day he took office. This event, which occurred on May 25, 1973, is known as the Devotazo. Sanguinetti took these photographs—a roll of thirty-six black-and-white images—with a camera that her brother smuggled into the prison. The text includes comments by Alicia Sanguinetti from her interview with the author.
“Tie a Yellow Ribbon for the Working Man”: Environmental Conflict and Working-Class Politics in Oregon Timber Country, 1970–Present
Authors: Beda Steven C.
Published: May 2023

This article focusing on Oregon's timber industry contributes to recent efforts to chart the longer history of working-class conservativism, while also arguing that environmental change and conflict played a central role in shaping the political leanings and class identities of white, rural workers in resource extraction industries. It pays particular attention to Oregon's independent contracting and milling operations—small, often family-owned enterprises where the lines separating labor and capital were blurry at best and where bosses and employers alike viewed unions and working-class radicals with deep skepticism. Independent contractors became the dominant form of labor relations in Oregon's timber industry in the 1970s, largely because of changes to the forest wrought by decades of overharvests and the flight of large timber corporations. Workers unmoored by capital flight increasingly turned to independent contractors and thus began to believe that their economic futures depended on maintaining close ties with their employers. This sense grew stronger in the late 1980s and early 1990s, when Oregon environmentalists began seeking new restrictions on logging to protect the habitat of the northern spotted owl — restrictions that threatened to further reduce timber-based employment and exacerbate the economic problems of rural, timber-dependent communities. Workers and employers joined together in more visible coalitions, held together by a shared populist outrage at the urban, liberal, and affluent elite who, in their view, were responsible for their economic precarity. This view remains evident in Oregon today, where a new movement that joins bosses and workers, Timber Unity, has coalesced to fight proposed legislation intended to address climate change.
Sexually Dimorphic Pattern of Pain Mitigation Following Prophylactic Regenerative Peripheral Nerve Interface (RPNI) in a Rat Neuroma Model
Authors: Dehdashtian Amir , Timek Jagienka H. , Svientek Shelby R. , Risch Mary Jane , Bratley Jared V. , Riegger Anna E. , Kung Theodore A. , Cederna Paul S. , Kemp Stephen W. P.
Published: May 2023

BACKGROUND:

Treating neuroma pain is a clinical challenge. Identification of sex-specific nociceptive pathways allows a more individualized pain management. The Regenerative Peripheral Nerve Interface (RPNI) consists of a neurotized autologous free muscle using a severed peripheral nerve to provide physiological targets for the regenerating axons.

OBJECTIVE:

To evaluate prophylactic RPNI to prevent neuroma pain in male and female rats.

METHODS:

F344 rats of each sex were assigned to neuroma, prophylactic RPNI, or sham groups. Neuromas and RPNIs were created in both male and female rats. Weekly pain assessments including neuroma site pain and mechanical, cold, and thermal allodynia were performed for 8 weeks. Immunohistochemistry was used to evaluate macrophage infiltration and microglial expansion in the corresponding dorsal root ganglia and spinal cord segments.

RESULTS:

Prophylactic RPNI prevented neuroma pain in both sexes; however, female rats displayed delayed pain attenuation when compared with males. Cold allodynia and thermal allodynia were attenuated exclusively in males. Macrophage infiltration was mitigated in males, whereas females showed a reduced number of spinal cord microglia.

CONCLUSION:

Prophylactic RPNI can prevent neuroma site pain in both sexes. However, attenuation of both cold allodynia and thermal allodynia occurred in males exclusively, potentially because of their sexually dimorphic effect on pathological changes of the central nervous system.
Cell-based optimization and characterization of genetically encoded location-based biosensors for Cdc42 or Rac activity
Authors: Mahlandt Eike K. , Kreider-Letterman Gabriel , Chertkova Anna O. , Garcia-Mata Rafael , Goedhart Joachim
Published: May 2023

Rac (herein referring to the Rac family) and Cdc42 are Rho GTPases that regulate the formation of lamellipoda and filopodia, and are therefore crucial in processes such as cell migration. Relocation-based biosensors for Rac and Cdc42 have not been characterized well in terms of their specificity or affinity. In this study, we identify relocation sensor candidates for both Rac and Cdc42. We compared their (1) ability to bind the constitutively active Rho GTPases, (2) specificity for Rac and Cdc42, and (3) relocation efficiency in cell-based assays. Subsequently, the relocation efficiency was improved by a multi-domain approach. For Rac1, we found a sensor candidate with low relocation efficiency. For Cdc42, we found several sensors with sufficient relocation efficiency and specificity. These optimized sensors enable the wider application of Rho GTPase relocation sensors, which was showcased by the detection of local endogenous Cdc42 activity at assembling invadopodia. Moreover, we tested several fluorescent proteins and HaloTag for their influence on the recruitment efficiency of the Rho location sensor, to find optimal conditions for a multiplexing experiment. This characterization and optimization of relocation sensors will broaden their application and acceptance.
Reticular-Chemical Approach to Soft-Matter Self-Assembly: Why Are srs and noh Nets Realized in Thermotropics?
Authors: Saito Kazuya , Yamamura Yasuhisa
Published: May 2023

Interface geometry and skeletal graphs are two complementary characterizations of micro-phase separated organizations in soft matter. This paper explores the possibility of analyzing the latter instead of the former to gain insight into aggregation structures. Analyses of the ideality of vertices geometry (closeness to equiangular three-coordination) and the spatial homogeneity of the vertex distribution strongly suggest that the pair of noh nets, recently proposed for thermotropic liquid crystals of rodlike molecules without the interface between counter-chiral domains, is beneficial besides the srs twins if cubic symmetry is presumed as an experimental input.
The Radical Flank Revisited: How Regulatory Discretion Shapes the Effectiveness of Social Activism on Business Outcomes
Authors: Grandy Jake B. , Hiatt Shon R.
Published: May 2023

Although scholarship has highlighted how stakeholders can influence business outcomes, few studies have examined how simultaneous, different tactics interact to impact firms. Critical to understanding this interaction is the radical flank effect, which asserts that the moderate and radical elements of social activist tactics can interact to either enhance or diminish a movement’s ability to accomplish its goals. However, research is unclear about when and whether the radical flank effect enhances or diminishes activist influence, nor has it empirically analyzed factors that influence the direction of the effect. To address these limitations, we explore one such factor—regulatory agency discretion, or regulators’ flexibility to interpret and implement public policies. Drawing on management and political sociology studies, we argue that discretion affects the salience of regulatory accountability to the public and thereby alters the radical flank effect on business outcomes in regulated markets. We analyze stakeholder opposition to U.S. hydroelectric power facilities from 1987 to 2019. The results show that high discretion enhances the radical flank effect and detrimentally affects business outcomes, whereas low discretion reverses the radical flank effect and favorably affects business outcomes.

Funding: This work was supported by the Kauffman Foundation Doctoral Dissertation Fellowship and the Harvard Business School Division of Research.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/orsc.22.16104 .
Keeping safe at work
Authors: Peate Ian
Published: May 2023

Creating healthy work environments is a collective and an individual responsibility. It requires collaborative efforts of employers and employees, health and care managers, healthcare assistants (HCAs) and assistant practitioners (APs). There is much that can be learnt from one another. Several aspects of legislation are in place that compel organisations and individuals to ensure a safe working environment. This article provides a discussion regarding health and safety at work, with a focus on stress, its impact and its management.
The level of physical activity among chronic kidney disease patients
Authors: Ribeiro Quinette , D’Silva Cherishma , Kulkarni Manjunath J
Published: May 2023

Physical activity can help patients overcome complications associated with chronic kidney disease. However, levels of physical activity tend to be low among individuals with chronic kidney disease when compared to the general population
Organ utilisation and decisionmaking under risk
Authors: Inston Nicholas
Published: May 2023

Using three case studies as an illustration, Nicholas Inston explores balancing risk and benefit in organ utilisation