bluuebunny/crossref_metadata_2025 huggingface dataset:
Navigating Open Science as Early Career Feminist Researchers
Authors: Pownall Madeleine , Talbot Catherine V. , Henschel Anna , Lautarescu Alexandra , Lloyd Kelly E. , Hartmann Helena , Darda Kohinoor M. , Tang Karen T. Y. , Carmichael-Murphy Parise , Siegel Jaclyn A.
Published: September 2021

Open science aims to improve the rigor, robustness, and reproducibility of psychological research. Despite resistance from some academics, the open science movement has been championed by some early career researchers (ECRs), who have proposed innovative new tools and methods to promote and employ open research principles. Feminist ECRs have much to contribute to this emerging way of doing research. However, they face unique barriers, which may prohibit their full engagement with the open science movement. We, 10 feminist ECRs in psychology from a diverse range of academic and personal backgrounds, explore open science through a feminist lens to consider how voice and power may be negotiated in unique ways for ECRs. Taking a critical and intersectional approach, we discuss how feminist early career research may be complemented or challenged by shifts towards open science. We also propose how ECRs can act as grass-roots changemakers within the context of academic precarity. We identify ways in which open science can benefit from feminist epistemology and end with envisaging a future for feminist ECRs who wish to engage with open science practices in their own research.
The Role of Maternal Self-efficacy in the Link Between Childhood Maltreatment and Maternal Stress During Transition to Motherhood
Authors: Bentley Gabriella , Zamir Osnat
Published: September 2021

The transition to motherhood is a significant developmental milestone in many women’s lives. This transitional period may be more stressful for women with a history of childhood maltreatment (CM) than for women without such a history. This study tested whether parental self-efficacy (PSE) accounts for the link between CM and parental stress in mothers transitioning to motherhood. The study used a convenience sample of 1,306 first-time mothers of children aged two years or younger. Mothers filled out online self-report questionnaires assessing history of CM, PSE, and prenatal stress. Consistent with the hypotheses, exposure to CM was directly associated with greater parental stress. Also, PSE partially mediated the associations between CM and parental stress, such that mothers with a history of childhood abuse reported a lower level of PSE, which in turn was associated with greater parental stress. In conclusion, the study highlights the important role of negative cognitions related to parenting for maternal dysfunction following exposure to childhood abuse. These findings suggest a need to incorporate preventive interventions designed to promote PSE for mothers exposed to CM. Such programs may alleviate parental stress and further support the healthy development of the child.
Predictors of Attrition and Response in Cognitive Processing Therapy for Interpersonal Trauma Survivors with PTSD
Authors: Haven Sophie E. , Brown Wilson J. , Berfield Jillian B. , Bruce Steven E.
Published: September 2021

With the establishment of empirically validated treatments for posttraumatic stress disorder (PTSD), concerns remain regarding the effectiveness of such treatments in real-world clinical settings. Specifically, premature termination and treatment response limit the effectiveness of these interventions. The current study investigated factors potentially related to premature termination and treatment response in Cognitive Processing Therapy with Account (CPT-A). Participants in this study included 42 women ( Mage = 30.70 SDage = 9.40) with PTSD from exposure to interpersonal trauma. Demographic characteristics, pre-treatment symptoms of PTSD and depression, and transdiagnostic factors were examined as predictors of attrition and treatment response. Hierarchical regression and logistic regression models were analyzed to test the variance explained and predictive value of these factors. The present study revealed that age was a significant factor related to dropout from CPT-A whereas baseline PTSD symptom severity was significantly related to treatment response. Results of this study suggest the importance of the interrelationships among pre-treatment predictors as well as the consideration of attrition and treatment response as distinct metrics of treatment outcome. Further, these results inform the application of CPT-A for PTSD in survivors of interpersonal trauma, as consideration of the identified predictors of dropout and non-response at intake may contribute to treatment retention and response.
The quest of the king in the Wisdom of Solomon
Authors: Giszczak Mark
Published: September 2021

Historians largely agree that Hellenistic kingship was founded, not primarily on heredity, but on military achievement (MacDonald, 2015). The right to rule was thus militarily meritocratic, but philosophically unsteady, so kings felt the need to propagandize by commissioning writings peri basileias. Diogenes Laertius gives evidence that this type of kingship literature was widely produced in this era, though only fragments of these texts survive. The tracts attributed to Ecphantus, Diotogenes, and Sthenidas, along with the Letter of Aristeas, reveal that Hellenistic kingship was supported by a mythos that viewed obtaining kingship as a kind of moral achievement. The king’s virtues are emphasized as godlike and worthy of imitation by his subjects, as he embodies the law in his person. The Wisdom of Solomon reworks this kingship tradition by “democratizing” kingship (Newman, 2004) to all to call his readers to imitate Solomon’s choice of wisdom over folly. Solomon’s search for and embrace of wisdom (7:7; 8:2) takes the place of militaristic emphases and establishes a universalizable pattern for the moral quest of the individual. Wisdom domesticates a Hellenistic pattern of seeking wisdom and thus achieving kingly rule, which eventually allows one to be a benefactor of others. Wisdom is beneficent (7:23) and, rather than becoming a god, the wise Solomon benefits others with his wise and just rule (Wis 8:10–15; 9:12). Even the wise Israelites become benefactors to others (19:14). Thus, the quest of the king for wisdom follows a familiar outline of the journey of a king from obscurity, to conquest, to rule, to beneficence.
“Mystery” in the Wisdom of Solomon and 4QInstruction
Authors: Wold Benjamin
Published: September 2021

Similar ideas and tropes found in the Wisdom of Solomon and 4QInstruction (4Q415–418, 423; 1Q26) have considerable significance for the study of early Jewish sapiential literature. One feature shared by both compositions is teaching about “mysteries.” Previous studies on these two wisdom writings conclude that there are distinct differences in what these mysteries are and how they function in the thought world of each composition. This article argues for an alternative understanding of mysteries in 4QInstruction to those presented in previous comparative studies. In light of this reassessment of mysteries, the Wisdom of Solomon and 4QInstruction are seen to participate within an intellectual space much closer to one another than previously perceived.
Cell Transplantation to Restore Lost Auditory Nerve Function is a Realistic Clinical Opportunity
Authors: Sekiya Tetsuji , Holley Matthew C.
Published: September 2021

Hearing is one of our most important means of communication. Disabling hearing loss (DHL) is a long-standing, unmet problem in medicine, and in many elderly people, it leads to social isolation, depression, and even dementia. Traditionally, major efforts to cure DHL have focused on hair cells (HCs). However, the auditory nerve is also important because it transmits electrical signals generated by HCs to the brainstem. Its function is critical for the success of cochlear implants as well as for future therapies for HC regeneration. Over the past two decades, cell transplantation has emerged as a promising therapeutic option for restoring lost auditory nerve function, and two independent studies on animal models show that cell transplantation can lead to functional recovery. In this article, we consider the approaches most likely to achieve success in the clinic. We conclude that the structure and biochemical integrity of the auditory nerve is critical and that it is important to preserve the remaining neural scaffold, and in particular the glial scar, for the functional integration of donor cells. To exploit the natural, autologous cell scaffold and to minimize the deleterious effects of surgery, donor cells can be placed relatively easily on the surface of the nerve endoscopically. In this context, the selection of donor cells is a critical issue. Nevertheless, there is now a very realistic possibility for clinical application of cell transplantation for several different types of hearing loss.
Nonlinearity in Global Crude Oil Benchmarks: Disentangling the Effect of Time Aggregation
Authors: Varghese George , Madhavan Vinodh
Published: September 2021

We model the first and second moments of global crude oil benchmarks, using iterative pre-whitened generalized autoregressive conditional heteroskedasticity (GARCH) models and, in doing so, validate the efficacy of such models in assimilating the neglected nonlinearities in the underlying data-generating processes. The benchmarks considered for this study are Brent, Dubai/Oman, and West Texas Intermediate (WTI) crude oil. While nonlinear serial dependence happens to be a stylized fact across different asset classes, it is our view that prior scholarly contributions have not adequately untangled the effect of data aggregation (in time) in the examination of nonlinear dependencies. In this context, the present study strives to untangle the critical role that time aggregation plays in the examination of nonlinearity in global crude oil benchmarks using data at daily, weekly as well as monthly time frequencies. Our findings are as follows: the optimum GARCH models perform well in capturing all of the neglected nonlinearity in monthly returns of the crude benchmarks. When it comes to daily and weekly returns, our study reveals traces of neglected nonlinearities that are not completely captured by GARCH models. Moreover, such residual traces of neglected nonlinear dependencies are relatively more pronounced at the granular levels and become more and more elusory as the data get aggregated in time.

JEL Codes: C22, C53, C58, G1, Q47
Use of Low-Flow Flowmeter to Titrate the FiO2 Delivered in Neonatal Resuscitation
Authors: Satpathy Swasthi Kabi , Upadhyay Manas Ranjan , Upadhyay Rajlaxmi , Dash Manoj Kumar , Nayak Alok Satyaprakash , Naik Sarthak
Published: September 2021

Introduction:

The oxygen concentration used in neonatal resuscitation has been a matter of debate with higher oxygen concentrations posing many adverse outcomes. Recent guidelines recommend use of blender to titrate FiO2 delivered during resuscitation. However, blender being unaffordable and unavailable at many peripheral institutions, we tried to use a low-flow flowmeter to titrate the oxygen and measure FiO2 delivered at different flow rates.

Methods:

From a central oxygen supply, oxygen flow was titrated using a low-flow flowmeter which was connected to a self-inflating bag and oximeter. Three variables were taken—volume of self-inflating bag, flow rate, and number of compressions per minute. FiO2 delivered with each variable, keeping the other two constant, was recorded.

Results:

The data obtained was analyzed by fitting the study variables into a stepwise multiple linear regression model and a linear equation was obtained. The model R square obtained suggested strong linear relationship between flow rate and FiO2 delivered. The model showed statistically significant association between flow rate and FiO2 delivery, whereas association with other variables was statistically insignificant. Discussion: Our study suggests that 76.57% of change in FiO2 is determined by change in flow rate. The major advantage of this study would be at resource poor settings where a low-flow flowmeter which is more cost effective can be used to titrate the FiO2 delivered during neonatal resuscitation.
Quality of the sibling relationship when one sibling has autism spectrum disorder: A randomized controlled trial of a sibling support group
Authors: Zucker Ariel , Chang Yookyung , Maharaj Reena , Wang Wei , Fiani Theresa , McHugh Susan , Feinup Daniel M , Jones Emily A
Published: September 2021

When one sibling has autism spectrum disorder, the sibling relationship is often characterized by poorer quality with fewer interactions. Because sibling relationships provide a vital social framework for development, they have the capacity to be a risk or protective factor, depending on the quality of the relationship. One way to improve the quality of the sibling relationship is through typically developing sibling participation in a support group. In this study, researchers randomly assigned typically developing siblings to a 10-week support group or attention-only control group. Typically developing siblings in the support group showed significant improvements in the quality of their sibling relationship and interactions with their sibling with autism spectrum disorder compared to the control group. Autism spectrum disorder severity and externalizing behavior moderated the effects of the support group on positive affect. Findings suggest the positive impact of a support group on sibling relationships, a relationship that has the potential to be protective.

Lay abstract

The sibling relationship can be negatively impacted when one child has autism spectrum disorder. One way to improve the quality of that relationship is through typically developing sibling participation in a support group in which they learn about autism spectrum disorder and coping skills, develop a peer network, and discuss their feelings. Compared to participating in a similar group without a focus on autism spectrum disorder, siblings in the support group showed improvements in the quality of the sibling relationship. Findings suggest that sibling support groups can be a valuable resource to improve sibling relationship quality when one sibling has autism spectrum disorder.
Prisoners of their own device: Brexit as a failed negotiating strategy
Authors: Martill Benjamin
Published: September 2021

Brexit has occasioned a rightward shift in British politics as successive leaders have grappled with the difficulties of negotiating with the European Union and the vicissitudes of politics in the governing Conservative party. Explanations for the hardening of Eurosceptic preferences focus on the demands of ‘taking back control’ and the polarisation of post-referendum politics as key drivers. But they have not explored the ways in which negotiation strategies shaped – rather than reflected – domestic political developments. Drawing on two-level games accounts of ‘synergistic’ bargaining, this article argues both David Cameron and Theresa May sought to leverage Eurosceptic sentiment in their respective negotiations to make it more credible the United Kingdom would walk away if its demands were rejected. While both leaders failed to convey their resolve, they inadvertently strengthened Eurosceptic constituencies back home, contributing to the paucity – and the rejection – of their negotiated agreements.
A simplified He’s frequency–amplitude formulation for nonlinear oscillators
Authors: Ren Zi-Yin
Published: September 2021

Derived from an ancient Chinese algorithm, He’s frequency–amplitude formulation is an effective approach to finding an approximate solution of a nonlinear oscillator. In this article, based on He’s formulation, a simplified formulation is proposed. Some nonlinear oscillators are adopted as examples to demonstrate the solving process using this simplified formulation. Through the demonstration, it can be seen that the solving process is simplified.
“The truth of what’s happening” How Tibetan exile media develop and maintain journalistic authority
Authors: Crete-Nishihata Masashi , Tsui Lokman
Published: September 2021

Tibet is one of the most restrictive places in the world for press freedom, with information online and offline tightly controlled and censored by the Chinese government. Foreign correspondents are restricted from travelling to and reporting in Tibetan areas, while Tibetans who act as sources are often persecuted. Despite this level of repression, Tibetans still find ways to tell the rest of the world what is happening in Tibet. This paper explores how it is possible to authoritatively report on events in one of the world’s most restrictive places for press freedom. Instead of relying on a single individual or news organisation, we find that reporting is conducted through journalistic networks consisting of sources in Tibet, Tibetan exile journalists, and source intermediaries called ‘communicators’. Based on fieldwork and semi-structured interviews with Tibetan journalists and communicators we explore how they develop and maintain journalistic authority, while being in exile and having to deal with severe constraints to press freedom.
Digital Mega-Studies as a New Research Paradigm: Governing the Health Research of the Future
Authors: Bell Jessica , Prictor Megan , Davenport Lauren , O’Brien Lynda , Wake Melissa
Published: September 2021

‘Digital Mega-Studies’ are entirely or extensively digitised, longitudinal, population-scale initiatives, collecting, storing, and making available individual-level research data of different types and from multiple sources, shaped by technological developments and unforeseeable risks over time. The Australian ‘Gen V’ project exemplifies this new research paradigm. In 2019, we undertook a multidisciplinary, multi-stakeholder process to map Digital Mega-Studies’ key characteristics, legal and governance challenges and likely solutions. We conducted large and small group processes within a one-day symposium and directed online synthesis and group prioritisation over subsequent weeks. We present our methods (including elicitation, affinity mapping and prioritisation processes) and findings, proposing six priority governance principles across three areas—data, participation, trust—to support future high-quality, large-scale digital research in health.
The Need for Shared Nomenclature on Racism and Related Terminology in Psychology
Authors: Haeny Angela M. , Holmes Samantha C. , Williams Monnica T.
Published: September 2021

With the increased desire to engage in antiracist clinical research, there is a need for shared nomenclature on racism and related constructs to help move the science forward. This article breaks down the factors that contributed to the development and maintenance of racism (including racial microaggressions), provides examples of the many forms of racism, and describes the impact of racism for all. Specifically, in the United States, racism is based on race, a social construct that has been used to categorize people on the basis of shared physical and social features with the assumption of a racial hierarchy presumed to delineate inherent differences between groups. Racism is a system of beliefs, practices, and policies that operate to advantage those at the top of the racial hierarchy. Individual factors that contribute to racism include racial prejudices and racial discrimination. Racism can be manifested in multiple forms (e.g., cultural, scientific, social) and is both explicit and implicit. Because of the negative impact of racism on health, understanding racism informs effective approaches for eliminating racial health disparities, including a focus on the social determinants of health. Providing shared nomenclature on racism and related terminology will strengthen clinical research and practice and contribute to building a cumulative science.
How Microaggressions Reinforce and Perpetuate Systemic Racism in the United States
Authors: Skinner-Dorkenoo Allison L. , Sarmal Apoorva , André Chloe J. , Rogbeer Kasheena G.
Published: September 2021

The consequences of racial microaggressions are most often discussed at an interpersonal level. In this article, we contend that microaggressions play an important role in maintaining systems of racial oppression beyond the interpersonal context. Specifically, we illustrate how microaggressions establish White superiority in the United States by othering people of color (e.g., treating people of color as if they are not true citizens) and communicating that they are inferior (e.g., environmental exclusions and attacks, treating people of color as second-class citizens). We also present evidence that microaggressions play a role in protecting and reinforcing systemic racism. By obscuring systemic racism (e.g., false color blindness, denial of individual racism) and promoting ideas that maintain existing systemic inequalities (e.g., the myth of meritocracy, reverse-racism hostility), microaggressions provide cover and support for established systems of oppression. Overall, we find considerable evidence—from both empirical studies and real-world examples—that microaggressions contribute to the maintenance of systems of racial oppression in the United States. We conclude with a discussion of how we might begin to challenge this cycle by increasing awareness of systemic racism and the microaggressions that aid in its perpetuation.
Racial Awareness and Bias Begin Early: Developmental Entry Points, Challenges, and a Call to Action
Authors: Waxman Sandra R.
Published: September 2021

Overt expressions of racial intolerance have surged precipitously. The dramatic uptick in hate crimes and hate speech is not lost on young children. But how, and how early, do children become aware of racial bias? And when do their own views of themselves and others become infused with racial bias? This article opens with a brief overview of the existing experimental evidence documenting developmental entry points of racial bias in infants and young children and how it unfolds. The article then goes on to identify gaps in the extant research and outlines three steps to narrow them. By bringing together what we know and what remains unknown, the goal is to provide a springboard, motivating a more comprehensive psychological-science framework that illuminates early steps in the acquisition of racial bias. If we are to interrupt race bias at its inception and diminish its effects, then we must build strong cross-disciplinary bridges that span the psychological and related social sciences to shed light on the pressing issues facing our nation’s young children and their families.
Revisiting youth player development in Australian Rules Football: Is there a place for bio-banding?
Authors: Thurlow Fraser G , Kite Rich J , Cumming Sean P
Published: September 2021

Within a group of adolescent Australian Rules Football (ARF) players, individuals of the same chronological age can differ greatly in biological maturation, with some players maturing vastly earlier or later than their peers. Such large differences in maturity can cause a disparity between physical performance, influence the perceptions of talent, and affect training practice. In attempts to address such issues, this overview proposes the concept of bio-banding in ARF, which may be used periodically within the national talent pathway to optimise player development. Bio-banding is the process of grouping adolescent athletes into specific categories or ‘bands’ based on biological maturation, rather than chronological age. This review describes how bio-banding may be used to enhance player development in ARF, giving context to its background and implementation in other sports.
Diagnosing Overtraining Syndrome: A Scoping Review
Authors: Carrard Justin , Rigort Anne-Catherine , Appenzeller-Herzog Christian , Colledge Flora , Königstein Karsten , Hinrichs Timo , Schmidt-Trucksäss Arno
Published: September 2021

Context:

Overtraining syndrome (OTS) is a condition characterized by a long-term performance decrement, which occurs after a persisting imbalance between training-related and nontraining-related load and recovery. Because of the lack of a gold standard diagnostic test, OTS remains a diagnosis of exclusion.

Objective:

To systematically review and map biomarkers and tools reported in the literature as potentially diagnostic for OTS.

Data Sources:

PubMed, Web of Science, and SPORTDiscus were searched from database inception to February 4, 2021, and results screened for eligibility. Backward and forward citation tracking on eligible records were used to complement results of database searching.

Study Selection:

Studies including athletes with a likely OTS diagnosis, as defined by the European College of Sport Science and the American College of Sports Medicine, and reporting at least 1 biomarker or tool potentially diagnostic for OTS were deemed eligible.

Study Design:

Scoping review following the guidelines of the Joanna Briggs Institute and PRISMA Extension for Scoping Reviews (PRISMA-ScR).

Level of Evidence:

Level 4.

Data Extraction:

Athletes’ population, criteria used to diagnose OTS, potentially diagnostic biomarkers and tools, as well as miscellaneous study characteristics were extracted.

Results:

The search yielded 5561 results, of which 39 met the eligibility criteria. Three diagnostic scores, namely the EROS-CLINICAL, EROS-SIMPLIFIED, and EROS-COMPLETE scores (EROS = Endocrine and Metabolic Responses on Overtraining Syndrome study), were identified. Additionally, basal hormone, neurotransmitter and other metabolite levels, hormonal responses to stimuli, psychological questionnaires, exercise tests, heart rate variability, electroencephalography, immunological and redox parameters, muscle structure, and body composition were reported as potentially diagnostic for OTS.

Conclusion:

Specific hormones, neurotransmitters, and metabolites, as well as psychological, electrocardiographic, electroencephalographic, and immunological patterns were identified as potentially diagnostic for OTS, reflecting its multisystemic nature. As exemplified by the EROS scores, combinations of these variables may be required to diagnose OTS. These scores must now be validated in larger samples and within female athletes.
Decreased Sleep and Subjective Well-Being as Independent Predictors of Injury in Female Collegiate Volleyball Players
Authors: Haraldsdottir Kristin , Sanfilippo Jennifer , McKay Lauren , Watson Andrew M.
Published: September 2021

Background:

The relationship among sleep duration, subjective well-being, and injury risk in athletes is poorly defined.

Purpose:

To evaluate the independent effects of sleep duration, sleep quality, and subjective well-being on in-season injuries in collegiate female volleyball athletes.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

During a 9-month competitive season, 17 female National Collegiate Athletic Association (NCAA) Division I volleyball players reported mood, fatigue, stress, soreness, sleep duration (hours), and sleep quality every morning. Well-being measures were recorded from 0 (worst) to 5 (best), and all time-loss injuries were recorded by the team athletic trainer. Separate mixed-effects logistic regression models were used to evaluate the effects of sleep and subjective well-being on in-season injury. Each well-being variable was also included in a separate mixed-effects logistic regression model with sleep duration as a covariate.

Results:

A total of 54 injuries were recorded during the study period. Compared with days without an injury, mood, fatigue, stress, soreness, sleep quality, and sleep duration were significantly worse the day before an injury occurred. In the separate prediction models, in-season injury was significantly predicted by fatigue (odds ratio [OR], 0.56 [95% CI, 0.36-0.86]; P = .008), mood (OR, 0.52 [95% CI, 0.35-0.78]; P = .002), stress (OR, 0.63 [95% CI, 0.42-0.94]; P = .023), soreness (OR, 0.54 [95% CI, 0.38-0.79]; P = .001), sleep quality (OR, 0.49 [95% CI, 0.34-0.7]; P < .001), and sleep duration (OR, 0.69 [95% CI, 0.55-0.87]; P = .001). In the multivariable models, sleep duration remained a significant independent predictor in each of the subsequent multivariable models (OR, 0.72-0.74; P < .05 for all), as did mood (OR, 0.55 [95% CI, 0.36-0.83); P = .005) and soreness (OR, 0.57 [95% CI, 0.39-0.83]; P = .003), while fatigue (OR, 0.65 [95% CI, 0.42-1]; P = .054) and stress (OR, 0.68 [95% CI, 0.45-1]; P = .061) no longer reached statistical significance.

Conclusion:

Increased sleep duration, mood, and decreased soreness were independently associated with a reduced risk of in-season injury in this cohort of female NCAA volleyball players.
Palliative care needs, concerns, and affirmative strategies for the LGBTQ population
Authors: Javier Noelle Marie
Published: September 2021

The Lesbian, Gay, Bisexual, Transgender, and Queer/Questioning population, also known as sexual and gender minorities, are an incredibly marginalized and vulnerable population that have been disproportionately affected by the provision, delivery, and optimal access to high-quality medical care including palliative, hospice, and end-of-life care. The long-standing and unique experiences shaped by positive and negative historical events have led to a better understanding of significant barriers and gaps in equitable healthcare for this population. The intersection of both internal and external stressors as well as minority identities in the context of discriminatory political and societal infrastructures have resulted in variable health outcomes that continues to be plagued by economic barriers, oppressive legislative policies, and undesirable societal practices. It could not be more urgent and timely to call upon the government and healthcare systems at large to execute reforms in policies and regulations, engage in cultural competency training, and promote cultural shifts in beliefs, attitudes, and practices that will ultimately recognize, prioritize, and address the needs of this population. After all, health care access is a universal right regardless of personal, social, political, and economic determinants of comprehensive medical care.
Education and household income and carotid intima-media thickness in Japan: baseline data from the Aidai Cohort Study in Yawatahama, Uchiko, Seiyo, and Ainan
Authors: Miyake Yoshihiro , Tanaka Keiko , Senba Hidenori , Hasebe Yasuko , Miyata Toyohisa , Higaki Takashi , Kimura Eizen , Matsuura Bunzo , Kawamoto Ryuichi
Published: September 2021

Background

Epidemiological evidence for the relationship between education and income and carotid intima-media thickness (CIMT) has been limited and inconsistent. The present cross-sectional study investigated this issue using baseline data from the Aidai Cohort Study.

Methods

Study subjects were 2012 Japanese men and women aged 34−88 years. Right and left CIMT were measured at the common carotid artery using an automated carotid ultrasonography device. Maximum CIMT was defined as the largest CIMT value in either the left or right common carotid artery. Carotid wall thickening was defined as a maximum CIMT value > 1.0 mm.

Results

The prevalence of carotid wall thickening was 13.0%. In participants under 60 years of age (n = 703) and in those aged 60 to 69 years (n = 837), neither education nor household income was associated with carotid wall thickening or with maximum CIMT. Among those aged 70 years or older (n = 472), however, higher educational level, but not household income, was independently related to a lower prevalence of carotid wall thickening: the multivariate-adjusted odds ratio for high vs. low educational level was 0.43 (95% confidence interval 0.21−0.83, p for trend = 0.01). A significant inverse association was observed between education, but not household income, and maximum CIMT (p for trend = 0.006).

Conclusions

Higher educational level may be associated with a lower prevalence of carotid wall thickening and a decrease in maximum CIMT only in participants aged 70 years or older.
When disasters strike the emergency department: a case series and narrative review
Authors: Barten Dennis G. , Klokman Vincent W. , Cleef Sigrid , Peters Nathalie A. L. R. , Tan Edward C. T. H. , Boin Arjen
Published: September 2021

Introduction

Emergency departments (EDs) are reasonably well prepared for external disasters, such as natural disasters, mass casualty incidents, and terrorist attacks.

However, crises and disasters that emerge and unfold within hospitals appear to be more common than external events. EDs are often affected. Internal hospital crises and disasters (IHCDs) have the potential to endanger patients, staff, and visitors, and to undermine the integrity of the facility as a steward of public health and safety. Furthermore, ED patient safety and logistics may be seriously hampered.

Methods

Case series of 3 disasters within EDs. Narrative overview of the current IHCD-related literature retrieved from searches of PubMed databases, hand searches, and authoritative texts.

Discussion

The causes of IHCDs are multifaceted and an internal disaster is often the result of a cascade of events. They may or may not be associated with a community-wide event. Examples include fires, floods, power outages, structural damage, information and communication technology (ICT) failures, and cyberattacks. EDs are particularly at-risk. While acute-onset disasters have immediate consequences for acute care services, epidemics and pandemics are threats that can have long-term sequelae.

Conclusions

Hospitals and their EDs are at-risk for crises and their potential escalation to hospital disasters. Emerging risks due to climate-related emergencies, infectious disease outbreaks, terrorism, and cyberattacks pose particular threats. If a hospital is not prepared for IHCDs, it undermines the capacity of administration and staff to safeguard the safety of patients. Therefore, hospitals and their EDs must check and where necessary enhance their preparedness for these contingencies.
Feasibility study of simultaneous multislice diffusion kurtosis imaging with different acceleration factors in the liver
Authors: Xu Hui , Zhang Nan , Yang Da-Wei , Ren Ahong , Ren Hao , Zhang Qian , Zhu Jin-Xia , Li Gui-Jin , Yang Zheng-Han
Published: September 2021

Background

Simultaneous multislice diffusion-weighted imaging (SMS-DWI) has been used to reduce image acquisition time. The purpose of this study was to investigate the feasibility of diffusion kurtosis imaging (DKI) based on the SMS technique in the liver and the influence of this method compared with that of conventional DWI sequences on image quality and DKI-derived quantitative parameters.

Methods

Forty volunteers underwent SMS-DWI sequences with acceleration factors of 2 and 3 (SMS2-DWI, SMS3-DWI) and conventional DWI (C-DWI) of the liver with three b-values (50, 800, 2000 s/mm2) in a 3T system. Qualitative image quality parameters and quantitative measurements of the signal-to-noise ratio (SNR), mean kurtosis (MK), mean apparent diffusivity (MD) and apparent diffusion coefficient (ADC) for the liver were compared between the three sequences.

Results

The scan times of C-DWI, SMS2-DWI, and SMS3-DWI were 4 min 11 s, 2 min 2 s, and 1 min 34 s, respectively. For all image quality parameters, there were no significant differences observed between C-DWI and SMS2-DWI (all p > 0.05) in the images with b-values of 800 and 2000 s/mm2. C-DWI and SMS2-DWI exhibited better scores than SMS3-DWI (all p < 0.01) in the images with b-values of 2000 s/mm2. In the images with b-values of 800 s/mm2, C-DWI and SMS2-DWI exhibited better scores than SMS3-DWI for artefacts and overall image quality (all p < 0.01), and C-DWI exhibited better scores than SMS3-DWI for the visibility of intrahepatic vessels (p < 0.001). There were no significant differences in the sharpness of the right lobe edge (p = 0.144), conspicuity of the left lobe (p = 0.370) or visibility of intrahepatic vessels (p = 0.109) between SMS2-DWI and SMS3-DWI. There were no significant differences in the sharpness of the right lobe edge (p = 0.066) or conspicuity of the left lobe (p = 0.131) between C-DWI and SMS3-DWI. For the b-value of 800 s/mm2, there were no statistically significant differences between SMS2-DWI and C-DWI (p = 1.000) or between SMS2-DWI and SMS3-DWI (p = 0.059), whereas SMS3-DWI had a significantly lower SNR than C-DWI (p = 0.024). For the DKI-derived parameters (MK and MD) and ADC values, there were no significant differences between the three sequences (MK, p = 0.606; MD, p = 0.831; ADC, p = 0.264).

Conclusions

SMS-DWI with an acceleration factor of 2 is feasible for the liver, resulting in considerable reductions in scan time while maintaining similar image quality, comparable DKI parameters and ADC values compared with those of C-DWI.
Study protocol for OptimalTTF-2: enhancing Tumor Treating Fields with skull remodeling surgery for first recurrence glioblastoma: a phase 2, multi-center, randomized, prospective, interventional trial
Authors: Mikic N. , Poulsen F. R. , Kristoffersen K. B. , Laursen R. J. , Guldberg T. L. , Skjøth-Rasmussen J. , Wong E. T. , Møller S. , Dahlrot R. H. , Sørensen J. C. H. , Korshøj A. R.
Published: September 2021

Background

OptimalTTF-2 is a randomized, comparative, multi-center, investigator-initiated, interventional study aiming to test skull remodeling surgery in combination with Tumor Treating Fields therapy (TTFields) and best physicians choice medical oncological therapy for first recurrence in glioblastoma patients. OptimalTTF-2 is a phase 2 trial initiated in November 2020. Skull remodeling surgery consists of five burrholes, each 15 mm in diameter, directly over the tumor resection cavity. Preclinical research indicates that this procedure enhances the effect of Tumor Treating Fields considerably. We recently concluded a phase 1 safety/feasibility trial that indicated improved overall survival and no additional toxicity. This phase 2 trial aims to validate the efficacy of the proposed intervention.

Methods

The trial is designed as a comparative, 1:1 randomized, minimax two-stage phase 2 with an expected 70 patients to a maximum sample size of 84 patients. After 12-months follow-up of the first 52 patients, an interim futility analysis will be performed. The two trial arms will consist of either a) TTFields therapy combined with best physicians choice oncological treatment (control arm) or b) skull remodeling surgery, TTFields therapy and best practice oncology (interventional arm). Major eligibility criteria include age ≥ 18 years, 1st recurrence of supratentorial glioblastoma, Karnofsky performance score ≥ 70, focal tumor, and lack of significant co-morbidity. Study design aims to detect a 20% increase in overall survival after 12 months (OS12), assuming OS12 = 40% in the control group and OS12 = 60% in the intervention group. Secondary endpoints include hazard rate ratio of overall survival and progression-free survival, objective tumor response rate, quality of life, KPS, steroid dose, and toxicity. Toxicity, objective tumor response rate, and QoL will be assessed every 3rd month. Endpoint data will be collected at the end of the trial, including the occurrence of suspected unexpected serious adverse reactions (SUSARs), unacceptable serious adverse events (SAEs), withdrawal of consent, or loss-to-follow-up.

Discussion

New treatment modalities are highly needed for first recurrence glioblastoma. Our proposed treatment modality of skull remodeling surgery, Tumor Treating Fields, and best practice medical oncological therapy may increase overall survival significantly.

Trial registration

ClinicalTrials.gov Identifier: NCT0422399, registered 13. January 2020.
Serologic and urinary characteristics of laboratory-confirmed genitourinary tuberculosis at a tertiary hospital in the Philippines
Authors: So Paolo Nikolai H. , Villanueva Anthony Russell T.
Published: September 2021

Background

Genitourinary tuberculosis (GUTB) is known to cause high rates of structural organ damage, however, literature on its biochemical manifestations is limited. Additionally, local studies in the Philippine setting, where cases are rampant, are few and dated. This study aimed to determine the serologic and urinary profile of patients with GUTB admitted at a tertiary hospital within January 2009 to March 2020 and their association with short-term outcomes.

Methods

This retrospective study included 112 patients with laboratory-confirmed GUTB (i.e., positivity in acid-fast smear, polymerase chain reaction, culture, or histology). Demographic data, clinical characteristics, laboratory and radiologic findings, histopathology reports, treatment, and short-term outcomes were recorded.

Results

Bladder (54.5%) and kidney (36.4%) were the most affected organs. The male:female ratio was 1:1.15, and the mean age was 35.79 ± 18.29 years. Weakness (14.29%) was the most common chief complaint. A majority presented with anemia (83.04%), while several had leukocytosis (41.96%) and thrombocytosis (26.79%). Hypoalbuminemia (58.10%), impairment of renal function (36.94%), and electrolyte abnormalities such as hyponatremia (50.93%), hypercalcemia (20.19%), and hypokalemia (21.82%) were common. Proteinuria (67.96%) and pyuria (67.96%) were the most frequent abnormal findings, followed by hematuria (51.46%), acidic urine (45.63%) and low specific gravity (31.07%). Age, leukocytosis, and the need for pressors were all significantly associated with mortality (p values of <0.001, 0.010, and <0.001, respectively).

Conclusions

The young age at presentation with severe clinical and laboratory manifestations may reflect local epidemiology as TB continues to be widespread in the country. Apart from the more commonly cited abnormalities in literature, multiple electrolyte imbalances and urinary concentration defects were also observed in many cases, possibly indicating tubulointerstitial involvement—a complication increasingly mentioned in case reports. As several patient characteristics were found to be associated with the high mortality rates observed in the study, further research is recommended to explore predictive modeling.
The increasing impact of length of stay “outliers” on length of stay at an urban academic hospital
Authors: Hughes Andrew H. , Horrocks David , Leung Curtis , Richardson Melissa B. , Sheehy Ann M. , Locke Charles F. S.
Published: September 2021

Background

As healthcare systems strive for efficiency, hospital “length of stay outliers” have the potential to significantly impact a hospital’s overall utilization. There is a tendency to exclude such “outlier” stays in local quality improvement and data reporting due to their assumed rare occurrence and disproportionate ability to skew mean and other summary data. This study sought to assess the influence of length of stay (LOS) outliers on inpatient length of stay and hospital capacity over a 5-year period at a large urban academic medical center.

Methods

From January 2014 through December 2019, 169,645 consecutive inpatient cases were analyzed and assigned an expected LOS based on national academic center benchmarks. Cases in the top 1% of national sample LOS by diagnosis were flagged as length of stay outliers.

Results

From 2014 to 2019, mean outlier LOS increased (40.98 to 45.11 days), as did inpatient LOS with outliers excluded (5.63 to 6.19 days). Outlier cases increased both in number (from 297 to 412) and as a percent of total discharges (0.98 to 1.56%), and outlier patient days increased from 6.7 to 9.8% of total inpatient plus observation days over the study period.

Conclusions

Outlier cases utilize a disproportionate and increasing share of hospital resources and available beds. The current tendency to exclude such outlier stays in data reporting due to assumed rare occurrence may need to be revisited. Outlier stays require distinct and targeted interventions to appropriately reduce length of stay to both improve patient care and maintain hospital capacity.
An increase of phosphatidylcholines in follicular fluid implies attenuation of embryo quality on day 3 post-fertilization
Authors: Wang Ju , Zheng Wei , Zhang Shuoping , Yan Keqiang , Jin Miao , Hu Huiling , Ma Zhen , Gong Fei , Lu Guangxiu , Ren Yan , Lin Liang , Lin Ge , Hu Liang , Liu Siqi
Published: September 2021

Background

Although oocyte quality is the dominant factor determining embryo quality, few studies have been conducted to evaluate embryo quality based on the metabolites related to the oocyte. With quantification of the follicular fluid (FF) metabolites, in assisted reproductive technology (ART), this study sought to evaluate the embryo or oocyte quality through an informative approach.

Results

An evaluation model consisting of 17 features was generated to distinguish the embryo quality on day 3 post-fertilization, and phosphatidylcholines (PCs) were the key contributors to the evaluation. The model was extended to the patients under different ages and hyperstimulations, and the features were further enriched to facilitate the evaluation of the embryo quality. The metabolites were clustered through pathway analysis, leading to a hypothesis that accumulation of arachidonic acid induced by PCs might weaken embryo quality on day 3 post-fertilization.

Conclusions

A discriminating model with metabolic features elicited from follicular fluid was established, which enabled the evaluation of the embryo or oocyte quality even under certain clinical conditions, and the increase of PCs in follicular fluid implies the attenuation of embryo quality on day 3 post-fertilization.
Y chromosomal noncoding RNAs regulate autosomal gene expression via piRNAs in mouse testis
Authors: Reddy Hemakumar M. , Bhattacharya Rupa , Tiwari Shrish , Mishra Kankadeb , Annapurna Pranatharthi , Jehan Zeenath , Praveena Nissankararao Mary , Alex Jomini Liza , Dhople Vishnu M. , Singh Lalji , Sivaramakrishnan Mahadevan , Chaturvedi Anurag , Rangaraj Nandini , Shiju Thomas Michael , Sreedevi Badanapuram , Kumar Sachin , Dereddi Ram Reddy , Rayabandla Sunayana M. , Jesudasan Rachel A.
Published: September 2021

Background

Deciphering the functions of Y chromosome in mammals has been slow owing to the presence of repeats. Some of these repeats transcribe coding RNAs, the roles of which have been studied. Functions of the noncoding transcripts from Y chromosomal repeats however, remain unclear. While a majority of the genes expressed during spermatogenesis are autosomal, mice with different deletions of the long arm of the Y chromosome (Yq) were previously also shown to be characterized by subfertility, sterility and sperm abnormalities, suggesting the presence of effectors of spermatogenesis at this location. Here we report a set of novel noncoding RNAs from mouse Yq and explore their connection to some of the autosomal genes expressed in testis.

Results

We describe a set of novel mouse male-specific Y long arm (MSYq)-derived long noncoding (lnc) transcripts, named Pirmy and Pirmy-like RNAs. Pirmy shows a large number of splice variants in testis. We also identified Pirmy-like RNAs present in multiple copies at different loci on mouse Y chromosome. Further, we identified eight differentially expressed autosome-encoded sperm proteins in a mutant mouse strain, XYRIIIqdel (2/3 Yq-deleted). Pirmy and Pirmy-like RNAs have homology to 5′/3′UTRs of these deregulated autosomal genes. Several lines of experiments show that these short homologous stretches correspond to piRNAs. Thus, Pirmy and Pirmy-like RNAs act as templates for several piRNAs. In vitro functional assays reveal putative roles for these piRNAs in regulating autosomal genes.

Conclusions

Our study elucidates a set of autosomal genes that are potentially regulated by MSYq-derived piRNAs in mouse testis. Sperm phenotypes from the Yq-deleted mice seem to be similar to that reported in inter-specific male-sterile hybrids. Taken together, this study provides novel insights into possible role of MSYq-derived ncRNAs in male sterility and speciation.