bluuebunny/crossref_metadata_2025 huggingface dataset:
Adjuvant Therapy with Oncolytic Adenovirus Delta-24-RGDOX After Intratumoral Adoptive T-cell Therapy Promotes Antigen Spread to Sustain Systemic Antitumor Immunity
Authors: Jiang Hong , Shin Dong Ho , Yi Yanhua , Fan Xuejun , Gumin Joy , He Jiasen , Gillard Andrew G. , Lang Frederick F. , Gomez-Manzano Candelaria , Fueyo Juan
Published: March 2023

Cancer cell heterogeneity and immunosuppressive tumor microenvironment (TME) pose a challenge in treating solid tumors with adoptive cell therapies targeting limited tumor-associated antigens (TAA), such as chimeric antigen receptor T-cell therapy. We hypothesize that oncolytic adenovirus Delta-24-RGDOX activates the TME and promote antigen spread to potentiate the abscopal effect of adoptive TAA-targeting T cells in localized intratumoral treatment. Herein, we used C57BL/6 mouse models with disseminated tumors derived from B16 melanoma cell lines to assess therapeutic effects and antitumor immunity. gp100-specific pmel-1 or ovalbumin (OVA)-specific OT-I T cells were injected into the first subcutaneous tumor, followed by three injections of Delta-24-RGDOX. We found TAA-targeting T cells injected into one subcutaneous tumor showed tumor tropism. Delta-24-RGDOX sustained the systemic tumor regression mediated by the T cells, leading to improved survival rate. Further analysis revealed that, in mice with disseminated B16-OVA tumors, Delta-24-RGDOX increased CD8+ leukocyte density within treated and untreated tumors. Importantly, Delta-24-RGDOX significantly reduced the immunosuppression of endogenous OVA-specific CTLs while increasing that of CD8+ leukocytes and, to a lesser extent, adoptive pmel-1 T cells. Consequently, Delta-24-RGDOX drastically increased the density of the OVA-specific CTLs in both tumors, and the combination synergistically enhanced the effect. Consistently, the splenocytes from the combination group showed a significantly stronger response against other TAAs (OVA and TRP2) than gp100, resulted in higher activity against tumor cells. Therefore, our data demonstrate that, as an adjuvant therapy followed TAA-targeting T cells in localized treatment, Delta-24-RGDOX activates TME and promotes antigen spread, leading to efficacious systemic antitumor immunity to overcome tumor relapse.

Significance:

Adjuvant therapy with oncolytic viruses promotes antigen spread to potentiate localized intratumoral adoptive T-cell therapy with limited TAA targets, leading to sustainable systemic antitumor immunity to overcome tumor relapse.
Identification of a Novel de novo Splicing Mutation in Duchenne Muscular Dystrophy Gene in an Iranian Family
Authors: Kavousi Saeideh , Pourahmadiyan Azam , Soleymani Fatemeh , Noruzinia Mehrdad
Published: March 2023

Introduction: Duchenne muscular dystrophy (DMD) (NM_004006.3) is one of the most notable neuromuscular disorders of early years. The majority of DMD cases are caused by deletions or duplications in dystrophin, while point mutations are less prevalent in dystrophin abnormalities. It is a common knowledge that the severity of the disease depends on the effect of the mutation on the translational reading frame of the dystrophin mRNA. Case Report: We studied an 8-year-old boy with relevant clinical presentations for DMD. Deletion/duplication screening was performed by using multiplex ligation-dependent probe amplification, and whole-exome sequencing was conducted in order to identify potential variants. A novel de novo splice site variant was identified in the DMD gene (DMD: c.8548-2A>G). To explore the effect of a novel variant in DMD, various in silico analyses were carried out to investigate the pathogenicity of the causative variant. To study the structure of a DMD protein and information on how the genetic variant impacts splicing site in models of wild-type and mutated DMD, we carried out different computational studies. Sanger sequencing was performed for the purpose of variant confirmation and familial segregation analysis. Discussion: This novel de novo variant was predicted to have an effect on splicing, which leads to DMD due to its significant impacts on dystrophin functionality. The novel mutation would be expected to disrupt the protein structure.
Genética do câncer colorretal
Authors: Cotti Guilherme Cutait de Castro , Santos Fábio Pires de Souza , Sebastianes Fernando Moreno , Habr-Gama Angelita , Seid Victor Edmund , Martino Rodrigo Bronze de
Published: March 2023

O câncer colorretal (CCR) é uma das neoplasias de maior importância atualmente, tanto por sua prevalência como por sua incidência, correspondendo a 10% de todas as neoplasias nos EUA. Contudo, nos últimos 50 anos, sua mortalidade permaneceu praticamente inalterada. Desde que Morson, em 1978, descreveu pela primeira vez a seqüênciaadenoma-carcinoma, a elucidação da genética molecular envolvida na patogênese do CCR passou a ser estudada intensamente e muitos avanços foram obtidos. Vários genes como APC, DCC e p53, entre outros, foram identificados como participantes da seqüência adenoma-carcinoma, estando envolvidos na gênese tumoral baseada na teoria de múltiplos passos, onde o acúmulo de mutações genéticas em células instáveis é o fator principal que acaba por originar o câncer. Há dois tipos básicos de CCR: o esporádico, que corresponde a 85% do total de casos de CCR; e o familiar, com cerca de 15% dos casos e destaque para a Polipose Adenomatosa Familiar (PAF) e o Câncer Colorretal Hereditário não-poliposo (HNPCC). As pesquisas atuais vêm decifrando o mecanismo de ação de tais genes, buscando determinar a importância e valor prognóstico dos mesmos. Espera-se que a elucidação completa de tais mecanismos permita uma diminuição não só da mortalidade do CCR, mas também do impacto social imposto por tal doença. Ademais, a elaboraçãode tratamentos alternativos à cirurgia parece possível, através da terapia genética. Portanto, familiarizar-se com a Genética do Câncer Colorretal e os avanços nessa área torna-se imperativo para clínicos e cirurgiões da área digestiva.
Medicina física e reabilitação em doentes com dor crônica
Authors: Yeng Lin Tchia , Stump Patrick , Kaziyama Helena Hideko Seguchi , Teixeira Manoel Jacobsen , Imamura Marta , Greve Júlia M. D’Andrea
Published: March 2023

Os procedimentos de medicina física incluindo os meios físicos, a cinesioterapia, o uso de órteses e próteses, as imobilizações,a reabilitação psicossocial e os programas educativos são eficazes e seguros no tratamento da dor e na reabilitação dosdoentes com dor. Proporcionam também reabilitação mais rápida e reintegração mais apropriada dos doentes.
Avaliação funcional do doente com dor crônica
Authors: Yeng Lin Tchia , Teixeira Manoel Jacobsen , Romano Miriam A. , Greve Maria Julia D’Andrea , Kaziyama Helena H. S.
Published: March 2023

A avaliação de doentes com dor é necessária para estimar a magnitude e a natureza das variadas facetas da dor e de suas repercussões presentes, quantificar os resultados dos tratamentos e suas complicações, comparar resultados observados em momentos diferentes no mesmo doente ou em doentes diferentes, na mesma instituição ou outras instituições. Uma anamnese detalhada da dor e um exame físico global (neurológico e músculo-esquelético) são importantes na formulação das hipóteses diagnósticas e auxiliam na projeção de prognósticos a reduzir as complicações e possibilitam a seleção de esquemas terapêuticos mais racionais. Os métodos de avaliação devem ser consistentes, sensíveis, específicos e mensurar a dimensão avaliativa, sensitiva e afetiva, suas implicações nas atividades de vida diária e prática, suas repercussões psicossociais, os fatores que modificam a dor, atitudes frentea ela, crenças, determinar as doenças causais concorrentes ou conseqüentes, os antecedentes individuais e familiares, hábitos, dados do exame físico, déficits e incapacidades que possam fornecer subsídios para o diagnóstico das condições clínicas e das conseqüências da dor. Vários procedimentos de avaliação da dor e de funcionalidade foram desenvolvidos, alguns já validados e outros em vias de validação em nosso meio.
Correção cirúrgica da transposição das grandes artérias: 30 anos de operação de Jatene
Authors: Jatene Marcelo B. , Jatene Fabio B. , Monteiro Ana Cristina
Published: March 2023

Este artigo aborda alguns aspectos históricos das técnicas cirúrgicas para correção da transposição das grandes artérias, particularmente, da operação de Jatene, proposta em nosso meio, em 1975. Apresenta, ainda, uma breve descrição da técnica e as repercussões da mesma.
Características clínicas e morbidade de recém nascidos filhos de mães adolescentes em hospital universitário.
Authors: Fiorelli Lilian Renata , Krebs Vera Lúcia Jornada
Published: March 2023

Objetivo: Descrever as características clínicas e a morbidade entre os recém nascidosde mães adolescentes em hospital universitário. Métodos: Estudo observacional de 220 recém-nascidos de mães com idade < 19 anos, no período de abril a setembro de 2003, cujos dados foram obtidos por análise de prontuários. Para comparar as características neonatais de acordo com a idade materna utilizou-se o teste exato de Fisher. Resultados:Houve 1552 partos, sendo 220 (14,2%) mães adolescentes; 50% foram partos normais, 28,6% fórcipe e 21,4% cesárea. A idade materna variou entre 14,2 e 18,9 anos (média = 17,3),havendo 33 (15%) menores de 16 anos; 49,6% não fizeram pré-natal ou compareceram em até 5 consultas. O uso de drogas, ocorreu em 18,6% das mães. O peso de nascimento variou  de 430g a 4335g (3006 ± 587 g); houve 12,3% pré-termos, 12,7% recém-nascidos de baixo peso e 12 (5,4%) pequenos para idade gestacional. A asfixia perinatal ocorreu em 2,2% dos casos e 4,1% apresentaram malformações congênitas (malformações múltiplas, cardiopatia,displasia congênita do quadril, papiloma pré-auricular, hemangioma gigante). Em 49,5% dos casos ocorreram patologias, principalmente trauma obstétrico, desconforto respiratório, eicterícia com mortalidade de 1,8%. Conclusões: O pré-natal foi ausente ou incompleto em 49% das mães, sendo freqüente o uso de drogas durante a gestação. A freqüência de malformações foi semelhante à da população geral. A prematuridade, o peso de nascimento< 1500 g, a asfixia perinatal e a mortalidade foram significativamente maiores entre os recém nascidos de mães com idade < 16 anos.
Percepções e vivências da Enfermagem quanto à proibição do tabagismo em um hospital psiquiátrico
Authors: Oliveira Renata Marques de , Furegato Antonia Regina Ferreira
Published: March 2023

Objetivo: conhecer a experiência dos profissionais de Enfermagem diante da implementação da proibição do tabagismo em um hospital psiquiátrico. Método: realizou-se um estudo qualitativo com 73 profissionais de Enfermagem de um hospital psiquiátrico do interior paulista utilizando a teoria Fundamentada nos Dados como referencial metodológico e o Interacionismo Simbólico como referencial teórico. Realizaram-se 1260 horas de observação participante com registros em diário de campo. Os dados foram analisados a partir das codificações aberta, axial e seletiva. Resultados: observaram-se diferentes facetas da proibição do fumo, tais como insegurança, pessimismo, resistência e boicote, especialmente na unidade de internação privada. Entretanto, muitos profissionais da Enfermagem apoiaram a proibição quando constataram os benefícios para os pacientes. Considerações finais: o processo de implementação da proibição do tabagismo foi acompanhado por dificuldades, porém, mostrou-se uma intervenção viável. Profissionais que inicialmente eram contra a proibição passaram a apoiá-la.
Use of hypnotics, sleep quality and Burnout syndrome in medical students
Authors: Chaves Emmanuella Passos , Ximenes Talita Mendes Bezerra , Rocha Priscila Brasil de Carvalho , Kubrusly Marcos , Peixoto Raquel Autran Coelho , Peixoto Junior Arnaldo Aires
Published: March 2023

Objective: the aim of this study was to investigate possible associations between Burnout, use of hypnotics and sleep quality among medical students. Method: a cross-sectional quantitative study was conducted among medical students of a university center of northeastern Brazil, with the problem-based learning (PBL) methodology. The Maslach Burnout Inventory-Student Survey, the Pittsburgh Sleep Quality Index (PSQI) and a sociodemographic questionnaire were applied among pre-clerkship students of the course. Results: the study included 523 students and found 48 (9.2%) with tridimensional diagnosis criteria for Burnout syndrome (BS). Poor sleep quality and use of hypnotic drugs for sleep were associated with BS (p < 0.001 and p = 0.003, respectively). There were no statistical differences in age, gender, religion, marital status, student financing and performing paid work, between individuals with and without BS. Conclusion: there was an association between BS, use of hypnotics and poor sleep quality among pre-clerkship medical students.
Activin Receptor-Like Kinase 3 Directly Couples Gαq (Guanine Nucleotide-Binding Protein Subunit αq)/ Gαq (Guanine Nucleotide-Binding Protein Subunit α11) to Regulate Vascular Contractility
Authors: Cai Zeyu , Xie Nan , Gong Ze , Yang Zhao , Lin Feng , Li Zhiqing , Dai Rongbo , Chen Yufei , Zhang Siting , Zhu Shirong , Zhou Shuhua , Lin Jingyu , Yu Fang , Liu Limei , Sun Jinpeng , Zhou Jing , Li Wei , Xiong Chunyang , Fu Yi , Cong Xin , Kong Wei
Published: March 2023

Background:

Vascular smooth muscle cell (VSMC) contractility is critical for blood pressure regulation and vascular homeostasis. Identifying the key molecule that maintains VSMC contractility may provide a novel therapeutic target for vascular remodeling. ALK3 (activin receptor-like kinase 3) is a serine/threonine kinase receptor, and deletion of ALK3 causes embryonic lethality. However, little is known about the role of ALK3 in postnatal arterial function and homeostasis.

Methods:

We conducted in vivo studies in a tamoxifen-induced postnatal VSMC-specific ALK3 deletion mice suitable for analysis of blood pressure and vascular contractility. Additionally, the role of ALK3 on VSMC was determined using Western blot, collagen-based contraction assay and traction force microscopy. Furthermore, interactome analysis were performed to identify the ALK3-associated proteins and bioluminescence resonance energy transfer assay was used to characterize Gαq activation.

Results:

ALK3 deficiency in VSMC led to spontaneous hypotension and impaired response to angiotensin II in mice. In vivo and in vitro data revealed that ALK3 deficiency impaired contraction force generation by VSMCs, repressed the expression of contractile proteins, and inhibited the phosphorylation of myosin light chain. Mechanistically, Smad1/5/8 signaling mediated the ALK3-modulated contractile protein expressions but not myosin light chain phosphorylation. Furthermore, interactome analysis revealed that ALK3 directly interacted with and activated Gαq (guanine nucleotide-binding protein subunit αq)/Gα11 (guanine nucleotide-binding protein subunit α11), thereby stimulating myosin light chain phosphorylation and VSMC contraction.

Conclusions:

Our study revealed that in addition to canonical Smad1/5/8 signaling, ALK3 modulates VSMC contractility through direct interaction with Gαq/Gα11, and therefore, might serve as a potential target for modulating aortic wall homeostasis.
Hobbes Among the Savages: Politics, War, and Enmity in the So-called State of Nature
Authors: Hillani Allan M.
Published: March 2023

In this article I argue that Thomas Hobbes’s theory of the “state of nature” should be understood as describing a thoroughly political situation. Hobbes’s exemplification of the state of nature by resorting to the “savages” of America should be taken in its ultimately paradoxical character, one that puts in question the stark opposition between a prepolitical natural state and the properly political state resulting from the “social contract.” Through the lenses of ethnographic studies and anthropological theory, I propose a reinterpretation of Hobbes’s characterization of the state of nature as a state of war. In the first section, I present my interpretation of Hobbes’s understanding of war, arguing that war is characterized not by actual battle but by the uncertainty of conflict, already entailing a social dimension to it. In the second section, I engage with Pierre Clastres’s theory of the society against the State to discuss how, for Amerindian peoples, war not only has a social character but is itself the basis of sociality. In the last section, I discuss Eduardo Viveiros de Castro’s theory of potential affinity to propose that Hobbes’s state of nature is also a form of schematization of alterity as enmity. I conclude by showing how this provides an understanding of peace as a precarious situation, one that is the outcome of ethical practices ultimately independent from the State.
Hate Speech and Atrocity Prevention in Asia: Patterns, Trends and Strategies
Authors: Jacob Cecilia , Morada Noel M.
Published: March 2023

This article introduces the conceptual and analytical framework for this special issue on hate speech and atrocity prevention in Asia. It defines hate speech and incitement, and explains the process and context through which hate speech and incitement operates as a risk factor for atrocities. It also provides an explanation of the international legal framework regulating hate speech and incitement that informs the approach of the articles in this issue.
Large Fraction of Winter Precipitation Variability in Two Major Himalayan Basins Explained by Atmospheric Rivers
Authors: Lyngwa Rosa Vellosa , Hassan Waqar Ul , Nayak Munir Ahmad , Azam Mohd. Farooq
Published: March 2023

Atmospheric rivers (ARs) have the potential to generate large-impact hydrometeorological events over mountainous topography. In this study, we investigate ARs’ impacts on the hydrology of Indus basin (IB) and Ganga basin (GB), two highly populated basins of the Himalayas. We used the recently developed 37-yr-long ERA5-based AR database over the Himalayas to explore the influence of ARs on total and extreme precipitation, snowfall, and floods over these basins. We find that ARs contribute ∼25% to the annual rainfall in the IB and ∼15% in the GB. Over the mountainous regions, ARs contribute more than 50% to winter precipitation in Karakoram (KA), Hindu–Kush (HK), central (CH), and western Himalayas (WH), and respectively explain over 75%, 57%, 42%, and 30% of their interannual variability. The seasonal rainfall extremes over the mountain foothills are most often (50%–100%) associated with ARs in winter and spring, whereas the summer and autumn extremes over the plains and mountains foothills appear moderately associated with ARs (10%–40%). The two most catastrophic flood events (2014 Kashmir flood and 2013 Uttarakhand flood) in these basins are found to be linked with category 5 ARs. Upon further examination of floods over a long period, we noted that 56% and 73% of the floods in IB and GB, respectively, are related to ARs. Thus, our results establish that the variance of ARs is a major source of hydroclimate variability in the two Himalayan basins.
Camera placement optimization for CCTV in rail transit using BIM
Authors: Xie Zhengyuan , Liu Xia , Li Yazhuo , Zhang Hong , Xiang Qing
Published: March 2023

In an environment where completely automated lines are gaining popularity, station service employees are declining yearly while passenger volume increases. In many cities, the need for station video surveillance with “complete coverage without dead ends” has been high. The traditional layout scheme based on design experience estimates often results in large blind spots and low efficiency in monitoring. In order to solve this problem, based on BIM technology, this work develops a quantified camera layout optimization approach employing an improved genetic algorithm. The plan includes three modules: the data extraction, which extracts the spatial information of the functional area from the BIM model to generate a data image; the optimization module, which adopts the improved genetic algorithm and uses the pixel coordinates provided by the data image to realize the camera pre-deployment; the visualization module, which designs the simulation plug-in through BIM secondary development technology, simulates and verifies the pre-deployment, and provides the solutions. The approach’s effectiveness was confirmed by verifying the deployment optimization at the station platform level. The optimal solution’s camera coverage is 27.2% better than the experience-based camera layout.
Good Match, Deep Love: Three Studies Examining the Celebrity Endorsement’s Influence on Destination Brand Love
Authors: Zhang Hui , Xu Honggang
Published: March 2023

Destination brand love plays an important role in contributing to the competitive advantage of a destination. Based on the meaning transfer theory, match-up hypothesis, schema theory, etc., this study proposed a hierarchical model that examines the effects of three pairs of congruences among “celebrity,” “destination brand,” and “tourist” on destination brand love. A triangulation-based research design, taking Hong Kong, Shanghai, and New Zealand as focal destination brands, was used to collect data to test the hypotheses. The results showed that tourist/destination congruence and destination brand trust sequentially mediate the influence of celebrity/destination congruence and celebrity/tourist congruence on destination brand love. Tourist/destination congruence, attitude toward the ad, and attitude toward the destination sequentially mediate the influence of celebrity/destination congruence and celebrity/tourist congruence on destination brand love.
Deploying Cultural Knowledge of Nature to Construct the Nature Sports Experience
Authors: Farrelly Francis , Beverland Michael
Published: March 2023

A tourist’s cultural construction of nature can shape their nature sports experience. It can also impact how they perceive the destinations where they engage in nature sports. This ethnography identifies how international tourists on a surfing trip in Australia draw on their cultural knowledge of nature to assign meaning to their experiences and surroundings. The nature sports experience is influenced by three types of cultural knowledge applied to nature: declarative, evaluative, and procedural. Interaction with nature activates that knowledge. Theoretical contributions include offering a comprehensive explanation for how cultural knowledge of nature can transform the nature sports experience and providing a more complete picture of how cultural knowledge impacts the tourist’s interpretation of a destination. Applied implications involve drawing on different types of cultural knowledge to create compelling nature sports and destination promotion campaigns.
Local problems, global solutions? Making it rain in Hong Kong c. 1890–1930
Authors: Williamson Fiona
Published: March 2023

The late nineteenth to early twentieth century saw a small but dedicated rise in experimental rainmaking. The possibility that humanity might one day be able to control the weather – especially to alleviate drought – was very attractive to governments and private investors. The late nineteenth century was an era of scientific optimism and a number of rainmaking experiments across the world had brought the potential for weather control out of the realms of discourse and literature and further into tangible near-future science. There has been a small but thorough historiographical literature on this subject, focusing largely on American, British, and Australian efforts. This article seeks to build on this by exploring the little-known history of rainmaking in Hong Kong before 1930, centering on a case study of a particular experiment intended to alleviate the disastrous drought of 1928–9. As was the case elsewhere, Hong Kong’s rainmaking efforts raised as much skepticism as they did support, with the government, scientists, and the general public in two minds about whether making rain was even possible. As such, this article aims to interrogate the concepts of the sociotechnical imaginary and the history of failure, while also contributing to the wider story of meteorological knowledge-making.
Do Beliefs That Older Adults Are Inflexible Serve as a Barrier to Racial Equality?
Authors: Chaney Kimberly E. , Chasteen Alison L.
Published: March 2023

Past research has demonstrated that older adults are stereotyped as less malleable than young adults. Moreover, beliefs that people are less malleable are associated with lower confrontations of prejudice, as perpetrators are seen as less capable of changing their (prejudiced) behavior. The present research sought to integrate these lines of research to demonstrate that endorsement of ageist beliefs that older adults are less malleable will lead to a lower confrontation of anti-Black prejudice espoused by older adults. Across four experimental studies ( N = 1,573), people were less likely to confront anti-Black prejudice espoused by an 82-year-old compared with a 62-, 42-, or 20-year-old, due, in part, to beliefs that older adults are less malleable. Further exploration demonstrated that malleability beliefs about older adults were held across young, middle-aged, and older adult samples. These findings demonstrate how stereotypes about older adults can impede racial equality.
Exploring the effects of learning assistants on instructional team–student interactions in statics
Authors: Bracho Perez Valerie Vanessa , Coso Strong Alexandra
Published: March 2023

Within a mechanical engineering curriculum, Statics is often a barrier course for students, as their performance in Statics can impact their overall academic success. Recent efforts to enhance students’ learning in fundamental engineering courses have included integrating learning assistants (LAs), undergraduate peers who have previously excelled in the course, into the course's instructional team. The purpose of this study is to explore one enactment of a Statics classroom with LAs, the interactions that characterize it, and the impact it has on the students and instructional teams. A qualitative case study of a statics course with LAs was conducted leveraging Kranzfelder and colleagues’ teaching discourse moves framework to deductively and inductively analyze the data collected. The value of having LAs within Statics was prevalent throughout the interactions and from the perspective of the LAs, instructors, and students. However, the LAs remained an untapped resources for many in the course. The results of this study have implications for mechanical engineering departments, Statics instructors and LAs, and research.
Barriers to international physician recruitment in Nova Scotia, Canada
Authors: Manchanda Karuna , Murphy Matthew
Published: March 2023

A healthcare staffing crisis has been brewing in Canada since 1993. Recently worsened by the COVID-19 pandemic and increasing immigration, it has severely impacted rural and remote areas of the country like the province of Nova Scotia. Researchers have considered international physician recruitment as a long-term solution, but it comes with its own challenges. In addition to an extensive literature search, qualitative interviews were conducted with various representatives from the Nova Scotia health ecosystem as part of this article. Identifying challenges to international physician recruitment from different perspectives, recommendations include bringing legislative and/or policy changes to increase candidate seats and developing new pathways to bring international medical graduates to Nova Scotia from other countries. The article includes interview responses from official authorities involved in physician recruitment, author recommendations to remove barriers to international physician recruitment, and recruitment and retention initiatives currently being implemented in the province.
Identifying a “Miscarriage of Justice”: Factors Influencing a Successful Appeal Against a Guilty Plea Conviction in Australia
Authors: Nash Caitlin , Dioso-Villa Rachel , Porter Louise
Published: March 2023

While the difficulties in appealing a guilty plea conviction are widely acknowledged, little research has investigated how appellate courts handle guilty plea convictions. This study addresses this gap by examining Australian appellate court judgments in which a guilty plea conviction was contested, comparing successful appeals where a guilty plea conviction was overturned ( n = 193) against unsuccessful appeals where a guilty plea conviction remained ( n = 375). Hierarchical multiple logistic regression analysis revealed that, independent of other case characteristics, legal representation on appeal and support from legal actors significantly predicted a successful appeal, while significant predictors of an unsuccessful appeal included male defendants, defendants who received a term of imprisonment, and those who argued they were pressured to plead guilty. The findings highlight the significant influence of legal and extra-legal factors on appellate decision-making beyond the grounds of appeal raised by the defendant, raising important policy implications for the post-conviction process.
Cell Therapies for Autism Spectrum Disorder Based on New Pathophysiology: A Review
Authors: Nabetani Makoto , Mukai Takeo , Taguchi Akihiko
Published: March 2023

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder characterized by difficulties in social communication, repetitive behaviors, and restricted interests, with onset early in life. The prevalence of ASD has increased worldwide in the last two decades. However, there is currently no effective therapy for ASD. Therefore, it is important to develop new strategies for ASD treatment. Evidence for the relationship between ASD and neuroinflammation, ASD and microglia, and ASD and glucose metabolism has increased rapidly in recent decades. We reviewed 10 clinical studies on cell therapies for individuals with ASD. Almost all studies showed good outcomes and no remarkable adverse events. Over the past decades, the neurophysiological characteristics of ASD have been shown to be impaired communication, cognition, perception, motor skills, executive function, theory of mind, and control of emotions. Recent studies have focused on the roles of immune pathology, such as neuroinflammation, microglia, cytokines, and oxidative stress, in ASD. We also focused on glucose metabolism in patients with ASD. The significance of gap junction–mediated cell–cell interactions between the cerebral endothelium and transplanted cells was observed in both bone marrow mononuclear cells and mesenchymal stromal cells transplantation. Owing to the insufficient number of samples, cell therapies, such as umbilical cord blood cells, bone marrow mononuclear cells, and mesenchymal stromal cells, will be a major challenge for ASD. As a result of these findings, a new paradigm for cell therapy for autism may emerge.
Catastrophic Health Expenditure and Poverty Impact Due to Mental Illness in India
Authors: Yadav Jeetendra , Allarakha Shaziya , John Denny , Menon Geetha R. , Venkateswaran Chitra , Singh Ravinder
Published: March 2023

Majority of people in low- and middle-income countries with mental illness do not receive healthcare, leading to chronicity, suffering and increased costs of care. This study estimated the out-of-pocket expenditure (OOPE), catastrophic health expenditure (CHE), and poverty impact due to mental illness in India. Data was acquired from the 76th round data of the National Sample Survey (NSS) on the theme ‘Persons with Disabilities in India Survey’, July–December 2018. Data of 6,679 persons who reported mental illness during the survey was included for analysis. OOPE, CHE, poverty impact and state differentials of healthcare expenditure on mental illness were analysed using standard methods. In total, 18.1% of the household’s monthly consumption expenditure was spent on healthcare on mental illness. About 59.5% and 32.5% of the households were exposed to CHE based on 10% and 20% thresholds, respectively. About 20.7% of the households were forced to become poor from non-poor due to treatment care expenditure on mental illness. Our study suggests the critical need to accelerate on various measures for early diagnosis and management of mental health issues along with financial risk protection for reducing financial impact of healthcare expenditure on mental illness among households in India.
Book review: Farhana Ibrahim and Tanuja Kothiyal (eds.), South Asian Borderlands: Mobility, History, Affect
Authors: Balasubramaniam Madhura
Published: March 2023

Farhana Ibrahim and Tanuja Kothiyal (eds.), South Asian Borderlands: Mobility, History, Affect. Cambridge University Press, 2021, pp. 294, ₹822 (hardback), ISBN: 978-1-108-84451-2.
Trajectories of Oral Anticoagulation Adherence and Associated Clinical Outcomes During Long-Term Anticoagulation Among Medicare Beneficiaries With Venous Thromboembolism
Authors: Park Haesuk , Jones Bobby L. , Huang Pei-Lin , Kang Hye-Rim , Dietrich Eric A. , DeRemer Christina E. , Lo-Ciganic Wei-Hsuan
Published: March 2023

Background:

Little is known about anticoagulation medication nonadherence patterns impacting effectiveness and safety outcomes in clinical practice.

Objective:

We identified adherence trajectories of extended therapy with direct-acting oral anticoagulants (DOACs) and warfarin after 6 months initial anticoagulant therapy among Medicare beneficiaries with venous thromboembolism (VTE). We further assessed the associated recurrent VTE and major bleeding risks.

Methods:

Using group-based trajectory models, this retrospective cohort study identified distinct beneficiary subgroups with similar adherence patterns of extended-phase anticoagulant treatment (DOACs or warfarin) for patients with VTE who completed 6 months of initial anticoagulant treatment. We examined associations between adherence trajectories and risks of recurrent VTE and major bleeding using inverse probability treatment weighted Cox proportional hazards models.

Results:

Compared with no extended treatment, consistently high DOAC adherence was associated with decreased recurrent VTE risk (hazard ratio [HR] = 0.33, 95% confidence interval [CI] = 0.21-0.51) without increased major bleeding risk, and consistently high warfarin adherence was associated with decreased recurrent VTE risk (HR = 0.62, 95% CI = 0.40-0.95) and increased major bleeding risk (HR = 1.64, 95% CI = 1.12-2.41). Gradually declining adherence to DOACs (HR = 1.80, 95% CI = 1.07-3.03) or warfarin (HR = 2.34, 95% CI = 1.57-3.47) was associated with increased bleeding risk with no change in recurrent VTE risk.

Conclusion and relevance:

This real-world evidence suggests persistently adhering to extended DOAC therapy is associated with lower recurrent VTE risk without increasing major bleeding among Medicare beneficiaries with VTE. Persistently adhering to extended warfarin therapy was associated with lower recurrent VTE risk but higher major bleeding risk.
Incidence and Risk Factors of Admission Deep Vein Thrombosis in Patients With Traumatic Fracture: A Multicenter Retrospective Study
Authors: Zhang Li , Liu Xiaobing , Pang Peng , Luo Zhenguo , Cai Wenbo , Li Wangyang , Hao Jianhong
Published: March 2023

To identify risk factors of admission deep vein thrombosis (DVT) in patients with traumatic fractures. Medical records of 1596 patients with traumatic fractures were reviewed. According to the ultrasound reports of the lower extremity veins, patients were assigned to the DVT or non-DVT group. Univariate and multivariate logistic regression analyses were used to identify the independent risk factors of DVT, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of the D-dimer level for DVT. DVT admission incidence was 20.67%. Statistically significant differences were revealed between the 2 groups in terms of age, sex, fracture site, presence of hypertension, coronary heart disease, stroke, smoking status, time from injury to admission, and levels of fasting blood glucose, hemoglobin, fibrinogen, D-dimer, and hematocrit. Multivariate analysis results showed that age above 50 years, female, above-knee fracture, cigarette smoking, injury-to-admission delay beyond 48 h, low hemoglobin levels, high fasting blood glucose levels, and high D-dimer levels were independent risk factors for admission DVT. ROC analysis showed that the D-dimer level was effective for the prediction of admission DVT in patients with peri-knee and below-knee fractures (area under the curve [AUC] = 0.7296, cutoff point = 1.21 mg/L). An age over 50 years, female, above-knee fracture, smoking, injury-to-admission delay beyond 48 h, decreased hemoglobin level, and increased fasting blood glucose and D-dimer levels were found to be potential independent risk factors for admission DVT. In patients with peri-knee and below-knee fractures, the plasma D-dimer level was effective in predicting admission DVT.
Fetal Supraventricular Tachycardia: Histologic Evidence of Accessory Pathways Due to Incomplete Annulus Fibrosus Formation
Authors: Fritsch Michael K. , Gotteiner Nina , Rehman Jamaal A. , Price Erica , Ernst Linda M.
Published: March 2023

Background:

Atrioventricular (AV) reentrant tachycardia is a common type of supraventricular tachycardia (SVT) that occurs in the fetus and neonate. Although many tachycardias resolve within several weeks of birth or respond to medical management, disruptions in the cardiac annulus fibrosus and development of additional accessory pathways may lead to refractory dysrhythmia resulting in fetal hydrops and ultimately, fetal death.

Objectives:

While accessory pathways have been well documented anatomically in adult and childhood tachyarrhythmias, there are no reports of the histology of these pathways in human fetuses with SVT.

Research Design, Subjects, Measures:

This is a small case series of 2 fetuses with a history of SVT that resulted in fetal hydrops.

Results:

In both cases, examination of the cardiac conduction system was unremarkable and examination of the atrioventricular junction revealed a focally thinned and/or discontinuous annulus fibrosus with documented direct continuity between the atrial and ventricular myocardium in 1 case.

Conclusions:

This case series demonstrates that thinning or absence of the annulus fibrosus is a feature seen in fetal SVT, and the development of subsequent aberrant AV connections due to defective formation of the annulus fibrosus suggests a possible cause for these arrhythmias.
Rethinking Metaverse Tourism: A Taxonomy and an Agenda for Future Research
Authors: Yang Fiona X. , Wang Ye
Published: March 2023

The metaverse is expected to be a game changer that starts a new epoch for digital commons and content creation in all aspects of tourism. Both opportunities and challenges will ensue. Current tourism research remains minimal with regard to this “next generation of the Internet,” and the logic of its applications in tourism is still unknown. The metaverse does not only enhance customer experiences; it also, as reality and virtuality converge, changes the paradigms, norms, rules, and the way we define experiences. To fill this gap, in this conceptual paper we scrutinize the past, present, and future of the metaverse, with a focus on the tourism domain. In particular, this research sorts out the key technologies of metaverse applications and pioneers the exploration of virtuality–reality amalgamation by theorizing a “4Is” taxonomy of metaverse tourism: imitation, intensification, interaction, and integration. An agenda is set for future research.
Doxycycline sclerotherapy in patients with periorbital lymphatic malformation: A case series and literature review
Authors: Lai Kenneth K.H. , Kwok Yuen Ting , Lam Stacey C. , Lam Matthew C.W. , Yuen Hunter K.L.
Published: March 2023

Purpose

To describe and report the outcomes of doxycycline sclerotherapy in patients with periorbital lymphatic malformations(LMs).

Basic procedures

A retrospective review of consecutive patients diagnosed with periorbital LMs and who received doxycycline sclerotherapy at Hong Kong Eye Hospital and Queen Elizabeth Hospital, Hong Kong between January 2016 and June 2022. Doxycycline was prepared with a concentration of 100 mg diluted in 10 mL water for injection. A 23-gauge needle aiming at the center of the macrocyst was used to aspirate fluid from the lesion; this was then followed by an intralesional injection of 0.5 to 2 ml of doxycycline depending on the size of the cavity.

Main findings

A total of eight patients(six females) were included in this study. All of them received doxycycline sclerotherapy for periorbital LMs(five extraconal, three intraconal). The median age for receiving sclerotherapy was 29 years old. Seven patients had macrocystic LMs, and one had mixed macro- and microcystic LM. Two of the LMs had venous components radiologically. The average number of sclerotherapy treatment in one patient was 1.4 ± 0.7times. Seven of the eight patients had excellent response radiologically or clinically. One patient showed a satisfactory response after three cycles of sclerotherapy. No recurrence was experienced at median follow-up of 14 months. None of the patients experienced visual threatening or systemic complication.

Principle conclusions

Our preliminary experience with doxycycline sclerotherapy has shown encouraging results for the treatment of macrocystic or mixed-type periorbital LMs, with a favourable safety profile. Further clinical trials with longer follow-ups are warranted on this topic.
Normalization of Large-Scale Transcriptome Data Using Heuristic Methods
Authors: Yosef Arthur , Shnaider Eli , Schneider Moti , Gurevich Michael
Published: March 2023

In this study, we introduce an artificial intelligent method for addressing the batch effect of a transcriptome data. The method has several clear advantages in comparison with the alternative methods presently in use. Batch effect refers to the discrepancy in gene expression data series, measured under different conditions. While the data from the same batch (measurements performed under the same conditions) are compatible, combining various batches into 1 data set is problematic because of incompatible measurements. Therefore, it is necessary to perform correction of the combined data (normalization), before performing biological analysis. There are numerous methods attempting to correct data set for batch effect. These methods rely on various assumptions regarding the distribution of the measurements. Forcing the data elements into pre-supposed distribution can severely distort biological signals, thus leading to incorrect results and conclusions. As the discrepancy between the assumptions regarding the data distribution and the actual distribution is wider, the biases introduced by such “correction methods” are greater. We introduce a heuristic method to reduce batch effect. The method does not rely on any assumptions regarding the distribution and the behavior of data elements. Hence, it does not introduce any new biases in the process of correcting the batch effect. It strictly maintains the integrity of measurements within the original batches.
An Occupation-Based Lifestyle Lecture Intervention as Part of Inpatient Addiction Recovery Treatment: Exploring Occupational Performance, Balance and Personal Recovery
Authors: Ryan Deirdre , Naughton Marie , de Faoite Meabh , Dowd Tara , Morrissey Ann-Marie
Published: March 2023

Introduction:

Substance use disorders (SUDs) and addictive behaviours are growing problems which negatively impact health and wellbeing. Occupational therapy can support recovery by facilitating engagement in everyday activities that promote health. To date, the inclusion of occupational therapy in addiction recovery is limited and the evidence base for occupation-focused interventions is lacking. This study explores the impact of an occupational therapy-led intervention on self-reported occupational performance and occupational balance issues for people living with SUDs within an inpatient addiction service.

Methodology:

A quantitative pre and post-test study was implemented. The Canadian Personal Recovery Outcome Measure (C-PROM) was the sole outcome measure. The C-PROM is a self-report measure which aims to measure personal views of recovery based on rating activity engagement. The cohort of participants were recruited from referrals into 2 inpatient addiction recovery treatment programmes using purposive sampling. Descriptive statistics were run, and a Wilcoxon Signed Rank Test was used to analyse pre and post-test scoring.

Results:

Sixteen participants (9 male and 7 female) completed the intervention and outcome measure. The majority of participants (31.3%, n = 5) were between 45 and 54 years old. 25% of the sample (n = 4) were in the 35 to 44 age bracket while 18.8% (n = 3) were aged 55 to 64. The majority of participants (68.8%, n = 11) reported substance misuse as their main healthcare concern. The mean score on the C-PROM was significantly higher after participants received the intervention when compared with baseline scoring.

Conclusion:

Following engagement with an occupational therapist-led intervention participants reported increased engagement in activities and occupational performance. Participants also reported improved occupational balance and increased awareness of personal recovery needs. Further research is required to explore the effectiveness of this intervention in larger samples and to explore the transferability and sustainability of skills post discharge.
Experiences of Farmers Market Vendors in a Healthy Food Incentive Program
Authors: Silva Rosario , Gannon Matthew A. , Presley Jessica H. , Long Christopher R. , Medrano Rosalinda , Vaughan Jenni A. , English Emily S. , McElfish Pearl A.
Published: March 2023

Healthy food incentive programs for Supplemental Nutrition Assistance Program participants, often implemented in farmers markets, have shown promise in improving the purchase and consumption of fruits and vegetables. However, variation in program context, program strategies, and participant populations has produced gaps in knowledge about which healthy food incentive program implementation strategies are most effective, and few studies have focused on farmers market vendors’ experiences. This study evaluated experiences of farmers market vendors who participated in the Northwest Arkansas Double Your Dollars (NWA DYD) healthy food incentive program intended to increase access to healthy foods for local Hispanic/Latino and Marshallese community members with low incomes. Data were collected from a convenience sample of vendors participating in NWA DYD at the three largest participating markets on the last Saturday in October 2021. Program staff collected quantitative, categorical, and open-ended data through face-to-face surveys. Forty-one vendors completed the survey. Vendors believed NWA DYD was beneficial and easy to use, expanded their customer base, and increased participation of Hispanic/Latino and Marshallese shoppers. Vendors also identified challenges in participation related to administrative burdens and delayed reimbursements. Vendors did not identify NWA DYD as a driver for expanded production for the upcoming growing season. Vendors’ experiences at NWA DYD provide implications for others interested in implementing effective healthy food incentive programs. Improving access to farmers markets through effective healthy food incentive programs is an important step toward increasing consumption of fresh, healthy foods among communities with low incomes facing elevated prevalence of chronic disease.