bluuebunny/crossref_metadata_2025 huggingface dataset:
ITRAQ-based quantitative proteomic analysis of Fusarium moniliforme (Fusarium verticillioides) in response to Phloridzin inducers
Authors: Zhang Rong , Jiang Weitao , Liu Xin , Duan Yanan , Xiang Li , Wang Yanfang , Jiang Yuanmao , Shen Xiang , Chen Xuesen , Yin Chengmiao , Mao Zhiquan
Published: January 2021

Background

Apple replant disease (ARD) has been reported from all major fruit-growing regions of the world, and is often caused by biotic factors (pathogen fungi) and abiotic factors (phenolic compounds). In order to clarify the proteomic differences of Fusarium moniliforme under the action of phloridzin, and to explore the potential mechanism of F. moniliforme as the pathogen of ARD, the role of Fusarium spp. in ARD was further clarified.

Methods

In this paper, the quantitative proteomics method iTRAQ analysis technology was used to analyze the proteomic differences of F. moniliforme before and after phloridzin treatment. The differentially expressed protein was validated by qRT-PCR analysis.

Results

A total of 4535 proteins were detected, and 293 proteins were found with more than 1.2 times (P< 0.05) differences. In-depth data analysis revealed that 59 proteins were found with more than 1.5 times (P< 0.05) differences, and most proteins were consistent with the result of qRT-PCR. Differentially expressed proteins were influenced a variety of cellular processes, particularly metabolic processes. Among these metabolic pathways, a total of 8 significantly enriched KEGG pathways were identified with at least 2 affiliated proteins with different abundance in conidia and mycelium. Functional pathway analysis indicated that up-regulated proteins were mainly distributed in amino sugar, nucleotide sugar metabolism, glycolysis/ gluconeogenesis and phagosome pathways.

Conclusions

This study is the first to perform quantitative proteomic investigation by iTRAQ labeling and LC-MS/MS to identify differentially expressed proteins in F. moniliforme under phloridzin conditions. The results confirmed that F. moniliforme presented a unique protein profile that indicated the adaptive mechanisms of this species to phloridzin environments. The results deepened our understanding of the proteome in F. moniliforme in response to phloridzin inducers and provide a basis for further exploration for improving the efficiency of the fungi as biocontrol agents to control ARD.
Non-coding RNAs in polycystic ovary syndrome: a systematic review and meta-analysis
Authors: Mu Liangshan , Sun Xiaoting , Tu Mixue , Zhang Dan
Published: January 2021

Background

Genetic, environmental and epigenetical factors may play important roles in the pathogenesis of polycystic ovary syndrome (PCOS), however the etiology of PCOS remains unclear. Studies indicated that non-coding RNAs (ncRNAs) were involved in the occurrence and development of PCOS. Thus, we aim to perform a systematic review and meta-analysis to investigate the presence and dysregulated expression of ncRNAs in human PCOS.

Methods

We searched in PubMed, Medline, Web of Science and Embase until July 2019 and summarized all eligible publications focusing on microRNAs (miRNAs), long non-coding RNAs (lncRNAs), circular RNAs (circRNAs) and small interfering RNAs (siRNAs) in PCOS.

Results

Sixty-seven articles were included in our systematic review and 9 articles were included in meta-analysis. There is little overlap between studies when comparing miRNA profiles. Sensitivity analysis showed that the expression of miR-93 was upregulated in PCOS patients (WMD 0.75, P < 0.00001), without heterogeneity among remaining studies (I2 = 0%).

Conclusion

A large number of ncRNAs with altered levels were observed in plasma, serum, follicular fluid, granulosa cells or other issues from PCOS patients. Aberrant ncRNAs expression in PCOS may lead to aberrant steroidogenesis, adipocyte dysfunction, altered ovarian cell proliferation and/or apoptosis and have the potential to be used as diagnostic biomarkers.
Tools for measuring medical internship experience: a scoping review
Authors: Zhao Yingxi , Musitia Peris , Boga Mwanamvua , Gathara David , Nicodemo Catia , English Mike
Published: January 2021

Background

Appropriate and well-resourced medical internship training is important to ensure psychological health and well-being of doctors in training and also to recruit and retain these doctors. However, most reviews focused on clinical competency of medical interns instead of the non-clinical aspects of training. In this scoping review, we aim to review what tools exist to measure medical internship experience and summarize the major domains assessed.

Method

The authors searched MEDLINE, Embase, PsycINFO, ERIC, and the Cochrane Library for peer-reviewed studies that provided quantitative data on medical intern’s (house officer, foundation year doctor, etc.) internship experience and published between 2000 and 2019. Three reviewers screened studies for eligibility with inclusion criteria. Data including tools used, key themes examined, and psychometric properties within the study population were charted, collated, and summarized. Tools that were used in multiple studies, and tools with internal validity or reliability assessed directed in their intern population were reported.

Results

The authors identified 92 studies that were included in the analysis. The majority of studies were conducted in the US (n = 30, 32.6%) and the UK (n = 20, 21.7%), and only 14 studies (15.2%) were conducted in low- and middle-income countries. Major themes examined for internship experience included well-being, educational environment, and work condition and environment. For measuring well-being, standardized tools like the Maslach Burnout Inventory (for measuring burnout), Patient Health Questionnaire-9 (depression), General Health Questionnaire-12 or 30 (psychological distress) and Perceived Stress Scale (stress) were used multiple times. For educational environment and work condition and environment, there is a lack of widely used tools for interns that have undergone psychometric testing in this population other than the Postgraduate Hospital Educational Environment Measure, which has been used in four different countries.

Conclusions

There are a large number of tools designed for measuring medical internship experience. International comparability of results from future studies would benefit if tools that have been more widely used are employed in studies on medical interns with further testing of their psychometric properties in different contexts.
Aspiration biopsy versus dilatation and curettage for endometrial hyperplasia prior to hysterectomy
Authors: Hwang Woo Yeon , Suh Dong Hoon , Kim Kidong , No Jae Hong , Kim Yong Beom
Published: January 2021

Background

To compare the diagnostic accuracy of aspiration biopsy and dilatation and curettage (D&C) in patients diagnosed with endometrial hyperplasia prior to hysterectomy.

Methods

We retrospectively reviewed medical records of 250 patients diagnosed with endometrial hyperplasia by endometrial sampling between July 2003 and March 2020. Endometrial sampling was performed by aspiration biopsy (n = 150) or D&C (n = 100), followed by hysterectomy within 6 months. Pathological findings of hysterectomy specimens of the two groups were compared to preoperative findings.

Results

The overall diagnostic concordance between endometrial sampling specimen including D&C and aspiration biopsy, and hysterectomy specimen was 51.0% (51/100) and 41.3% (62/150), respectively. Patients whose preoperative specimen was obtained by D&C were upgraded less significantly than those who underwent aspiration biopsy (21.0% vs 36.7%; P = 0.008). In particular, significantly fewer patients were upgraded after D&C than after aspiration biopsy in hyperplasia without atypia (12.5% vs 29.0%; P = 0.028). In addition, when the final pathological upgrade rate to endometrial carcinoma was evaluated between the two methods of endometrial sampling, significantly fewer cases were noted after D&C than after aspiration biopsy (15.0% vs 27.3%; P = 0.022).

Conclusions

In our study, D&C more accurately reflected the final diagnosis in patients with endometrial hyperplasia than aspiration biopsy based on the histological examination of hysterectomy specimens. When considering the management strategy for women with an endometrial hyperplasia diagnosis obtained by aspiration biopsy, physicians should consider the significant rate of upgraded diseases with this method of endometrial sampling.
Cannabinoids and orthopedic surgery: a systematic review of therapeutic studies
Authors: Vivace Bradley J. , Sanders Allyson N. , Glassman Steven D. , Carreon Leah Y. , Laratta Joseph L. , Gum Jeffrey L.
Published: January 2021

Background

Recent work has shed light on the potential benefits of cannabinoids for multimodal pain control following orthopedic procedures. The objective of this review was to summarize the available evidence of analgesic and opioid-sparing effects cannabinoids have in orthopedic surgery and identify adverse events associated with their use.

Methods

A systematic review of the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines including PubMed, EMBASE, MEDLINE, PsycINFO, and Google Scholar was performed to include all primary, therapeutic studies published on the use of cannabis, and cannabis-derived products in orthopedic surgery.

Results

The literature review returned 4292 citations. Thirteen publications were found to meet inclusion criteria. Four randomized controlled trials were evaluated while the remaining studies were of quasi-experimental design.

Conclusion

Research on cannabinoids in orthopedic surgery is mostly of a quasi-experimental nature and is mainly derived from studies where orthopedics was not the primary focus. The overall results demonstrate potential usefulness of cannabinoids as adjunctive analgesics and in mitigating opioid use. However, the current evidence is far from convincing. There is a need to produce rigorous evidence with well-designed randomized controlled trials specific to orthopedic surgery to further establish these effects.
Long-term experience with triheptanoin in 12 Austrian patients with long-chain fatty acid oxidation disorders
Authors: Zöggeler Thomas , Stock Katharina , Jörg-Streller Monika , Spenger Johannes , Konstantopoulou Vassiliki , Hufgard-Leitner Miriam , Scholl-Bürgi Sabine , Karall Daniela
Published: January 2021

Background

Long-chain fatty acid oxidation disorders (LC-FAOD) are a group of rare inborn errors of metabolism with autosomal recessive inheritance that may cause life-threatening events.
Treatment with triheptanoin, a synthetic seven-carbon fatty acid triglyceride compound with an anaplerotic effect, seems beneficial, but clinical experience is limited. We report our long-term experience in an Austrian cohort of LC-FAOD patients.

Methods

We retrospectively assessed clinical outcome and total hospitalization days per year before and after start with triheptanoin by reviewing medical records of 12 Austrian LC-FAOD patients

Results

For 12 Austrian LC-FAOD patients at three metabolic centers, triheptanoin was started shortly after birth in 3/12, and between 7.34 and 353.3 (median 44.5; mean 81.1) months of age in 9/12 patients. For 11 pediatric patients, mean duration of triheptanoin intake was 5.3 (median 3.9, range 1.2–15.7) years, 10/11 pediatric patients have an ongoing intake of triheptanoin. One patient quit therapy due to reported side effects. Total hospitalization days per year compared to before triheptanoin treatment decreased by 82.3% from 27.1 (range 11–65) days per year to 4.8 (range 0–13) days per year, and hospitalization days in the one year pre- compared to the one year post-triheptanoin decreased by 69.8% from 27.1 (range 4–75) days to 8.2 (range 0–25) days. All patients are in good clinical condition, show normal psychomotor development and no impairment in daily life activities.

Conclusion

In this retrospective observational study in an Austrian LC-FAOD cohort, triheptanoin data show improvement in disease course. Triheptanoin appears to be a safe and beneficial treatment option in LC-FAOD. For further clarification, additional prospective randomized controlled trials are needed.
The sequence of disease-modifying anti-rheumatic drugs: pathways to and predictors of tocilizumab monotherapy
Authors: Solomon Daniel H. , Xu Chang , Collins Jamie , Kim Seoyoung C. , Losina Elena , Yau Vincent , Johansson Fredrik D.
Published: January 2021

Background

There are numerous non-biologic and biologic disease-modifying anti-rheumatic drugs (bDMARDs) for rheumatoid arthritis (RA). Typical sequences of bDMARDs are not clear. Future treatment policies and trials should be informed by quantitative estimates of current treatment practice.

Methods

We used data from Corrona, a large real-world RA registry, to develop a method for quantifying sequential patterns in treatment with bDMARDs. As a proof of concept, we study patients who eventually use tocilizumab monotherapy (TCZm), an IL-6 antagonist with similar benefits used as monotherapy or in combination. Patients starting a bDMARD were included and were followed using a discrete-state Markov model, observing changes in treatments every 6 months and determining whether they used TCZm. A supervised machine learning algorithm was then employed to determine longitudinal patient factors associated with TCZm use.

Results

7300 patients starting a bDMARD were followed for up to 5 years. Their median age was 58 years, 78% were female, median disease duration was 5 years, and 57% were seropositive. During follow-up, 287 (3.9%) reported use of TCZm with median time until use of 25.6 (11.5, 56.0) months. Eighty-two percent of TCZm use began within 3 years of starting any bDMARD. Ninety-three percent of TCZm users switched from TCZ combination, a TNF inhibitor, or another bDMARD. Very few patients are given TCZm as their first DMARD (0.6%). Variables associated with the use of TCZm included prior use of TCZ combination therapy, older age, longer disease duration, seronegative, higher disease activity, and no prior use of a TNF inhibitor.

Conclusions

Improved understanding of treatment sequences in RA may help personalize care. These methods may help optimize treatment decisions using large-scale real-world data.
Generalized Ponce’s inequality
Authors: Muñoz Julio
Published: January 2021

We provide a generalization of a remarkable inequality by A. C. Ponce whose consequences are essential in several fields, such as a characterization of Sobolev spaces or nonlocal modelization.
Modeling of pressure–volume controlled artificial respiration with local derivatives
Authors: Acay Bahar , Inc Mustafa , Chu Yu-Ming , Almohsen Bandar
Published: January 2021

We attempt to motivate utilization of some local derivatives of arbitrary orders in clinical medicine. For this purpose, we provide two efficient solution methods for various problems that occur in nature by employing the local proportional derivative defined by the proportional derivative (PD) controller. Under some necessary assumptions, a detailed exposition of the instantaneous volume in a lung is furnished by conformable derivative and such modified conformable derivatives as truncated M-derivative and proportional derivative. Moreover, we wish to investigate the performance of the above-mentioned operators in applications by plotting several graphs of the governing equations.
Mixed nonlocal boundary value problem for implicit fractional integro-differential equations via ψ-Hilfer fractional derivative
Authors: Thaiprayoon Chatthai , Sudsutad Weerawat , Ntouyas Sotiris K.
Published: January 2021

In this paper, we investigate the existence and uniqueness of a solution for a class of ψ-Hilfer implicit fractional integro-differential equations with mixed nonlocal conditions. The arguments are based on Banach’s, Schaefer’s, and Krasnosellskii’s fixed point theorems. Further, applying the techniques of nonlinear functional analysis, we establish various kinds of the Ulam stability results for the analyzed problem, that is, the Ulam–Hyers stability, generalized Ulam–Hyers stability, Ulam–Hyers–Rassias stability, and generalized Ulam–Hyers–Rassias stability. Finally, we provide some examples to illustrate the applicability of our results.
Non-prescription dispensing of antibiotic agents among community drug retail outlets in Sub-Saharan African countries: a systematic review and meta-analysis
Authors: Belachew Sewunet Admasu , Hall Lisa , Selvey Linda A.
Published: January 2021

Background

The development of antimicrobial resistance, which is partially attributable to the overuse and/or misuse of antibiotics in health care, is one of the greatest global public health challenges. In Sub-Saharan African (SSA) countries, non-prescribed dispensing of antibiotics in community drug retail outlets (CDROs) has been flagged as one of the contributing factors for the widespread misuse of antibiotics in the community.

Objective

The current review aimed to estimate the proportion of non-prescription antibiotics requests or consultations that resulted in provision of antibiotics without a valid prescription among CDROs in SSA region, and describe the type of antibiotics dispensed.

Methods

A literature search was conducted using PubMed, CINAHL, Scopus and Google Scholar. We also searched reference lists of relevant articles. Random effect model meta-analysis was employed to determine the pooled proportion of over the counter sale of antibiotics. Subgroup and meta-regression was undertaken to explore the potential cause of heterogeneity in effect size across studies.

Results

Of 671 total citations retrieved, 23 met the inclusion criteria (seven cross-sectional questionnaire-based surveys and 16 cross-sectional client-based studies). The overall pooled proportion of non-prescription antibiotics requests or consultations that resulted in supply of antibiotics without prescription was 69% (95% CI 58–80). Upper respiratory tract infections and/or acute diarrhoea were the most frequently presented case scenarios, and amoxicillin and co-trimoxazole were the most frequently dispensed antibiotics to treat those symptoms.

Conclusions

Non-prescribed dispensing of antibiotics was found to be a common practice among CDROs in several SSA countries. Ease of access to and overuse of antibiotics can potentially accelerate the emergence of resistance to antibiotics available in the region. Our review highlights the need for a stringent enforcement of existing policies and/or enacting new regulatory frameworks that would regulate antibiotic supply, and training and educational support for pharmacy personnel (e.g. pharmacists, pharmacy assistants) regarding judicious use of antibiotics and the importance of antimicrobial stewardship.
Exploring determinants of hand hygiene compliance in LTCFs: a qualitative study using Flottorps’ integrated checklist of determinants of practice
Authors: Lescure Dominique , Haenen Anja , de Greeff Sabine , Voss Andreas , Huis Anita , Hulscher Marlies
Published: January 2021

Background

Elderly residents in long-term care facilities (LTCFs) are vulnerable to healthcare-associated infections. Although hand hygiene is a leading measure for preventing infection, the compliance of healthcare workers is low. The aim of this study is to identify determinants that influence hand hygiene compliance of nursing staff in LTCFs. This information on determinants can eventually be used to develop a tailored implementation strategy for LTCFs.

Methods

This is an explorative, descriptive study using qualitative methods. We performed semi-structured focus group discussions with 31 nurses and nurse assistants from five Dutch LTCFs. Our focus group discussions continued until no new information could be identified from the data. We used Flottorps’ comprehensive checklist for identifying determinants of practice (the TICD checklist) to guide data collection and analysis. The audiotapes were transcribed verbatim and two authors independently analysed the transcripts with Atlas.ti software.

Results

LTCFs for the elderly have setting specific determinants that are decisive in explaining hand hygiene compliance. Most of these determinants are related to the residents with whom nurses build close relationships and for whom they want to create a homelike atmosphere. Residents can complicate the provision of care with unpredictable behaviour, being unwilling to receive care or use shared facilities. Our study also discovered setting-transcending determinants related to knowledge, professional interactions, guidelines, and incentives/resources.

Conclusions

Nurses in LTCFs are constantly pursuing a balance between working hygienically, responding adequately to acute care needs, and maintaining a homelike environment for their residents. As a result, setting-specific determinants affect hand hygiene compliance, as do the known determinants that are important in other care settings. To improve compliance in LTCFs, interventions should be selected on a theoretical base while linking these determinants to change interventions.

Trial registration

Registration number 50-53000-98-113, Compliance With Hand Hygiene in Nursing Homes: Go for a Sustainable Effect (CHANGE) on ClinicalTrials.gov. Date of registration 28-6-2016.
Designing a relational model to identify relationships between suspicious customers in anti-money laundering (AML) using social network analysis (SNA)
Authors: Shaikh Abdul Khalique , Al-Shamli Malik , Nazir Amril
Published: January 2021

The stability of the economy and political system of any country highly depends on the policy of anti-money laundering (AML). If government policies are incapable of handling money laundering activities in an appropriate way, the control of the economy can be transferred to criminals. The current literature provides various technical solutions, such as clustering-based anomaly detection techniques, rule-based systems, and a decision tree algorithm, to control such activities that can aid in identifying suspicious customers or transactions. However, the literature provides no effective and appropriate solutions that could aid in identifying relationships between suspicious customers or transactions. The current challenge in the field is to identify associated links between suspicious customers who are involved in money laundering. To consider this challenge, this paper discusses the challenges associated with identifying relationships such as business and family relationships and proposes a model to identify links between suspicious customers using social network analysis (SNA). The proposed model aims to identify various mafias and groups involved in money laundering activities, thereby aiding in preventing money laundering activities and potential terrorist financing. The proposed model is based on relational data of customer profiles and social networking functions metrics to identify suspicious customers and transactions. A series of experiments are conducted with financial data, and the results of these experiments show promising results for financial institutions who can gain real benefits from the proposed model.
Norepinephrine versus ephedrine for hypotension prophylaxis during cesarean section under spinal anesthesia
Authors: Elagamy Ashraf E. , Kamaly Aiman M. , Shahin Mohamed I. , Saleh Mohamed
Published: January 2021

Background

Spinal anesthesia is the preferred anesthetic method for elective cesarean sections (C.S.) due to considerable risks regarding airway management associated with physiological changes of pregnancy. Hypotension is reported to occur in up to 80% of spinal anesthesia cases. Many approaches have been tried to prevent spinal hypotension, e.g., fluid loading, vasopressors, or both. The aim of this prospective, randomized, double blind study is to compare the administration of intermittent i.v. boluses of norepinephrine and ephedrine to guard against the hypotensive effect of spinal anesthesia during cesarean delivery.

Methods

In the present study, 120 pregnant female undergoing elective CS were randomly divided into “group E” for ephedrine and “group N” for norepinephrine, 60 female in each group. Standard spinal anesthetic technique using 25 spinal needle under complete aseptic technique with injection of 1.8–2.2 ml of heavy bupivacaine 0.5% plus 25 μg of fentanyl according to female height. Group E will receive 10 mg of i.v. diluted ephedrine as hypotension prophylaxis, and group N will receive 16 μg as hypotension prophylaxis at the time of intrathecal block. Measurements of intraoperative episodes of hypotension and their treatment with the same dose of the studied drug in each group, incidence of intraoperative nausea and vomiting, and APGAR score of baby at 1 and 5 min will be recorded.

Results

Compared with ephedrine, norepinephrine maintained maternal blood pressure. Further, it was associated with lower numbers of hypotension episodes, but more frequency of bradycardia during cesarean delivery.

Conclusion

Norepinephrine can be used as an alternative vasopressor to maintain maternal blood pressure during spinal anesthesia for cesarean delivery, with no adverse effect on neonatal outcome.
Impacts of increasing fine fuel loads on acorn germination and early growth of oak seedlings
Authors: Nation Rachel E. , Alexander Heather D. , Denny Geoff , McDaniel Jennifer K. , Paulson Alison K.
Published: January 2021

Background

Prescribed fire is increasingly used to restore and maintain upland oak (QuercusL. spp.) ecosystems in the central and eastern US. However, little is known about how prescribed fire affects recently fallen acorns under different fine fuel loads, which can vary with stand composition and basal area, burn season, and fire frequency. We conducted plot-level (1 m2) burns in an upland oak stand in northern Mississippi, USA, during December 2018, using single (i.e.,ambient), double, and triple fine fuel loads, representative of those in nearby unburned and recently fire-treated, closed-canopy stands. Pre burn, we placed 30 acorns each of white oak (Quercus albaL.) and Shumard oak (Quercus shumardiiBuckley) ~1 cm below the litter surface in five plots of each fuel treatment. Immediately post burn, we planted unburned and burned acorns in a greenhouse. After ~50% of each species’ unburned acorns germinated, we measured percent germination and height, basal diameter, and leaf number of germinating seedlings weekly for 11 weeks. Then, we harvested seedlings to determine above- and belowground biomass.

Results

The single fuel treatment reduced acorn germination rates of both species to ~40% compared to ~88% in unburned acorns. When burned in double and triple fuel loads, acorns of both species had a <5% germination rate. There was no difference in basal diameter, leaf number, or biomass of seedlings from burned versus unburned acorns for either species. However, seedlings originating from burned acorns of both species were ~11% shorter than those from unburned acorns. Thus, both species responded similarly to fuel load treatments.

Conclusions

Acorns of both species exhibited greater survival with lower fine fuel loads, and consequently lower percent fuel consumption. Acorns germinating post fire generally produced seedlings with growth patterns similar to seedlings originating from unburned acorns. These findings indicate that regular, repeated prescribed fires or canopy reductions that limit fine fuel accumulation and create heterogeneous fuel beds are likely to increase acorn germination rates relative to unburned sites or those with recently introduced fire.
Interleukin-6 and C-reactive protein/albumin ratio as predictors of COVID-19 severity and mortality
Authors: El-Shabrawy Mohamed , Alsadik Maha E. , El-Shafei Maher , Abdelmoaty Ahmed A. , Alazzouni Ahmed S. , Esawy Marwa M. , Shabana Marwa A.
Published: January 2021

Background

Coronavirus disease 2019 (COVID-19) was announced in early December 2019. The pandemic situation is declared. This study aimed to evaluate the role of biomarkers in estimating the severity and predicting the prognosis of COVID-19.

Results

A total of 116 confirmed patients were included in this study. The patients were evaluated clinically. The disease severity was assessed. The measured and calculated laboratory tests were done. The primary outcome is the 30-day mortality. Patients were assigned to the severe (14.7%) and non-severe (85.3%) groups. At IL-6 level of 32.3 pg/mL (the highest Youden’s index = 0.77), IL-6 can differentiate severe from non-severe patients with 82.4% sensitivity and 94.4% specificity. IL-6 can predict the severity [odds ratio of 87.7 (95% CI = 18.9-408.2) (P < 0.0001)]. After adjustment to the significant clinical and laboratory parameters, IL-6 had an adjusted odds ratio of 30.8 (95% CI = 1.1-728.3) (P = 0.046). A high CRP/albumin ratio of > 11.4 was associated with COVID-19 mortality [hazard ratio = 59.9 (95% CI = 7.4–488.3) (P < 0.0001)]. High CRP/albumin ratio had an adjusted hazard ratio of 26.5 (95% CI = 2.6-270.7) after adjustment of age and presence of co-morbidities (P = 0.006).

Conclusion

IL-6 level could effectively discriminate COVID-19 severity. CRP/albumin ratio was an independent risk factor for 30-day mortality rate in patients with COVID-19. IL-6 and CRP/albumin ratio seem to be valuable biomarkers in evaluating the severity and prognosis of COVID-19, respectively.
Patient Perceptions of Treatment Benefit and Toxicity in Advanced Cancer: A Prospective Cross-Sectional Study
Authors: Patell Rushad , Einstein David , Miller Eric , Dodge Laura , Halleck Jennifer , Buss Mary
Published: January 2021

PURPOSE:

Prior studies show that many patients receiving palliative cancer therapies misperceive likelihood of cure. Patients’ understanding of treatment benefits and risks beyond cure is unknown. We explore patient perceptions of palliative treatment in the novel therapeutic era.

METHODS:

We surveyed patients with advanced solid cancers and their oncologists regarding benefits and risks of palliative therapies. We assessed perceived likelihood of tumor response, survival benefit, symptom palliation, and side effects. We used generalized estimating equations to calculate least squares means of misperception (patient-assessed minus physician-assessed likelihood of benefit), accounting for clustering by physician, and compared the degree of misperception by participant characteristics.

RESULTS:

Of the 119 patients enrolled, median age was 65 years (range, 59-73 years), 55% were male, and 56% had prior treatment. Treatments included chemotherapy (60%), immunotherapy (24%), and targeted therapy (15%). Compared with their oncologists, patients overestimate curability (median misperception, 20%; interquartile range [IQR], 0 to 60), chances of tumor response (median, 20%; IQR, 0 to 40), symptom palliation (median, 10%; IQR, −10 to 30), and survival benefit (median, 20%; IQR, 0 to 40). Toxicity was relatively accurately estimated (median, 0.5%; IQR, −20 to 20). Immunotherapy was associated with higher risk of misperception of tumor response and toxicity. Misperceptions of tumor response and curability did not correlate (r = 0.13, P = .15).

CONCLUSION:

Compared with their oncologists, patients overestimated chances of tumor response, symptom palliation, and survival benefit, but accurately perceived likelihood of toxicity. There was no strong correlation between perception of curability and other goals of therapy. Communication focused on treatment goals alongside risks may reduce misperceptions and facilitate informed choices by patients.
Nutrition in Cancer Care: A Brief, Practical Guide With a Focus on Clinical Practice
Authors: Liposits Gabor , Orrevall Ylva , Kaasa Stein , Österlund Pia , Cederholm Tommy
Published: January 2021

This overview aims to create an understanding of the nutritional issues concerning patients with cancer and provide evidence-based practical guidance to healthcare professionals (physicians, nurses, and dietitians), caregivers, and all others involved in the care of patients with cancer. The focus of this paper is therefore on providing a simple guide for daily clinical practice. The theoretical background and in-depth comprehensive reviews of malnutrition are described elsewhere. Nutrition plays a crucial role in cancer care. It affects treatment tolerability, outcomes, and quality of life. However, a focus on nutrition is still lacking among oncologists because of insufficient training in nutrition topics received during graduate and postgraduate training and an underestimation of its importance. The consequences of the disease and its treatment, such as anorexia-sarcopenia-cachexia, are therefore still often overlooked, underdiagnosed, and undertreated. The authors have summarized the most important challenges, evidence-based recommendations, and common clinical scenarios to bridge the gap between comprehensive guidelines and clinical practice, where brief concrete advice is preferred to systematic reviews. Furthermore, an easy applicable overview is provided, which can be used as a guide during daily routines.
Anesthesiology Residents’ Experiences and Perspectives of Residency Training
Authors: Sun Huaping , Chen Dandan , Warner David O. , Zhou Yan , Nemergut Edward C. , Macario Alex , Keegan Mark T.
Published: January 2021

BACKGROUND:

Anesthesiology residents’ experiences and perspectives about their programs may be helpful in improving training. The goals of this repeated cross-sectional survey study are to determine: (1) the most important factors residents consider in choosing an anesthesiology residency, (2) the aspects of the clinical base year that best prepare residents for anesthesia clinical training, and what could be improved, (3) whether residents are satisfied with their anesthesiology residency and what their primary struggles are, and (4) whether residents believe their residency prepares them for proficiency in the 6 Accreditation Council for Graduate Medical Education (ACGME) Core Competencies and for independent practice.

METHODS:

Anesthesiologists beginning their US residency training from 2013 to 2016 were invited to participate in anonymous, confidential, and voluntary self-administered online surveys. Resident cohort was defined by clinical anesthesia year 1, such that 9 survey administrations were included in this study—3 surveys for the 2013 and 2014 cohorts (clinical anesthesia years 1–3), 2 surveys for the 2015 cohort (clinical anesthesia years 1–2), and 1 survey for the 2016 cohort (clinical anesthesia year 1).

RESULTS:

The overall response rate was 36% (4707 responses to 12,929 invitations). On a 5-point Likert scale with 1 as “very unimportant” and 5 as “very important,” quality of clinical experience (4.7–4.8 among the cohorts) and departmental commitment to education (4.3–4.5) were rated as the most important factors in anesthesiologists’ choice of residency. Approximately 70% of first- and second-year residents agreed that their clinical base year prepared them well for anesthesiology residency, particularly clinical training experiences in critical care rotations, anesthesiology rotations, and surgery rotations/perioperative procedure management. Overall, residents were satisfied with their choice of anesthesiology specialty (4.4–4.5 on a 5-point scale among cohort-training levels) and their residency programs (4.0–4.1). The residency training experiences mostly met their expectations (3.8–4.0). Senior residents who reported any struggles highlighted academic more than interpersonal or technical difficulties. Senior residents generally agreed that the residency adequately prepared them for independent practice (4.1–4.4). Of the 6 ACGME Core Competencies, residents had the highest confidence in professionalism (4.7–4.9) and interpersonal and communication skills (4.6–4.8). Areas in residency that could be improved include the provision of an appropriate balance between education and service and allowance for sufficient time off to search and interview for a postresidency position.

CONCLUSIONS:

Anesthesiology residents in the United States indicated they most value quality of clinical training experiences and are generally satisfied with their choice of specialty and residency program.
Anesthetic Management of Robotic Thymectomy in a Patient With Morvan Syndrome: A Case Report
Authors: Royston Sara E. , Hartigan Philip M.
Published: January 2021

Morvan syndrome (MvS) is a rare acquired paraneoplastic autoimmune neuromyotonia with central and autonomic nervous system involvement that has been incompletely described in the literature. We describe the successful administration of general anesthesia for robotic thymectomy to an MvS patient with severe encephalopathy, cardiac dysautonomia, and peripheral nerve hyperexcitation. Importantly, thymus removal provided effective source control with eventual resolution of MvS symptoms. MvS is briefly reviewed and novel observations are described of related interactions between nondepolarizing neuromuscular blockade (NDNMB) and bispectral index (BIS).
“Much Might Be Said on Both Sides”
Authors: Donatini Hilary Teynor
Published: January 2021

Sir Roger de Coverley, representative of the landed gentry in The Spectator, is typically read as a lovable, old-fashioned eccentric and comic object. Closer attention to the series of essays set in and around Sir Roger’s Worcestershire estate — especially numbers 117, 122, and 130 — reveals that the baronet’s work as a justice of the peace stimulates Mr. Spectator’s moral development. Sir Roger’s intimate relationships with his inferiors and his quasi-familial approach to problem-solving challenge Mr. Spectator’s worldview, allowing Addison and Steele to express their ideas through an interplay of voices. Mr. Spectator’s evolving first-person perspective, animated by the loose, ad hoc structures of the justice’s work, where determining the beginning and ending of a legal action is often difficult, clarifies Sir Roger’s exemplary functions in the text. This essay argues that The Spectator functions as a provocative inquiry into ideology rather than a vehicle for Whiggish politics through a narrative point of view that responds to the characters and settings it encounters, most significantly the figure of the country magistrate. The Spectator’s adoption of the magistrate’s structures of judgment elucidates the role of the rural justice of the peace in eighteenth-century English society and law.
Presenting “Truth” in Early Eighteenth-Century Travel Narratives
Authors: Rogers Shef
Published: January 2021

This essay clarifies the bibliographical history of the three published accounts of the sufferings of a Dutch sailor abandoned on Ascension Island in 1726 for sodomy, but is ultimately less concerned with what actually happened than with how the story was represented in each of three versions and with what those changes might tell us about shifts in expectations of fiction readers between 1726 and 1740. It also examines how later critics have responded to the story to demonstrate that ideas about credibility are relative and socially determined. While narrative theory generally argues that “the more information we have on a narrator, the more concrete will be our sense of the quality and distinctness of his or her voice,” this case study questions that relationship, at least for the early novel, when narrative techniques and readerly practices were still being developed.
Gender, Sovereignty, and the Discourse of Rights in Native Women’s Activism
Authors: Barker Joanne
Published: January 2021

Drawing from Native feminist theories and sovereignty studies, this essay examines the 1983 and 1985 amendments and the activism that led to their development and passage as an instance of the co-constitutive relationship of gender and sovereignty. By looking at how the discourse of rights was mobilized from very different contexts to very different ends by various constituencies of Indian men, women, and their allies, this essay modestly opens the conflicts surrounding gender politics and women’s rights in Native sovereignty movements. I hope to provide a forum for thinking about the kinds of social reformations that are needed to bring about social equity between and for men and women in Indian communities—an equity that is an essential aspect of decolonization and social justice for Native peoples in North America.
What Is Reproductive Justice?
Authors: Price Kimala
Published: January 2021

Frustrated by the individualist approach of the “choice” paradigm used by the mainstream reproductive rights movement in the United States, a growing coalition of women of color organizations and their allies have sought to redefine and broaden the scope of reproductive rights by using a human rights framework. Dubbing itself “the movement for reproductive justice,” this coalition connects reproductive rights to other social justice issues such as economic justice, education, immigrant rights, environmental justice, sexual rights, and globalization, and believes that this new framework will encourage more women of color and other marginalized groups to become more involved in the political movement for reproductive freedom. Using narrative analysis, this essay explores what reproductive justice means to this movement, while placing it within the political, social, and cultural context from which it emerged.
The ideal repository for hosting data from clinical trials: blueprint using business process management
Authors: Gabelica Mirko , Sapunar Damir , Marušić Matko , Puljak Livia
Published: January 2021

In this article, we suggest a blueprint for an ideal open-access repository for clinical trial data with a description of a model of such a repository using a business process analysis approach. Firstly, we suggested which features an ideal repository should have. Secondly, we used business process management software to describe the whole process, from the decision to share clinical trial data to either publication of data in a repository or discarding data. The research community, legislators and society at large should be interested in a transparent open-access repository that will host clinical trial data. We hope this work can inspire relevant stakeholders to engage in discussion about the necessity of creating such repository, and that we will witness the creation of such a repository in the near future.
The SPECTRUM Consortium: a new UK Prevention Research Partnership consortium focussed on the commercial determinants of health, the prevention of non-communicable diseases, and the reduction of health inequalities
Authors: Horton Marie , Perman-Howe Parvati R. , Angus Colin , Bishop Julie , Bogdanovica Ilze , Brennan Alan , Britton John , Brose Leonie S. , Brown Jamie , Collin Jeff , Dockrell Martin , Fitzgerald Niamh , Friel Sharon , Gillespie Duncan , Gilmore Anna B. , Hill Sarah E. , Knai Cecile , Langley Tessa , Martin Sancha , McNeill Ann , Moore Graham , Munafò Marcus R. , Murray Rachael L. , Opazo Breton Magdelena , Pearce Jamie , Petticrew Mark , Reid Garth , Robson Deborah , Rutter Harry , Shahab Lion , Shortt Niamh , Smith Katherine , Syrett Keith , Bauld Linda
Published: January 2021

The main causes of non-communicable diseases (NCDs), health inequalities and health inequity include consumption of unhealthy commodities such as tobacco, alcohol and/or foods high in fat, salt and/or sugar. These exposures are preventable, but the commodities involved are highly profitable. The economic interests of ‘Unhealthy Commodity Producers’ (UCPs) often conflict with health goals but their role in determining health has received insufficient attention. In order to address this gap, a new research consortium has been established. This open letter introduces the SPECTRUM (Shaping Public hEalth poliCies To Reduce ineqUalities and harM) Consortium: a multi-disciplinary group comprising researchers from 10 United Kingdom (UK) universities and overseas, and partner organisations including three national public health agencies in Great Britain (GB), five multi-agency alliances and two companies providing data and analytic support. Through eight integrated work packages, the Consortium seeks to provide an understanding of the nature of the complex systems underlying the consumption of unhealthy commodities, the role of UCPs in shaping these systems and influencing health and policy, the role of systems-level interventions, and the effectiveness of existing and emerging policies. Co-production is central to the Consortium’s approach to advance research and achieve meaningful impact and we will involve the public in the design and delivery of our research. We will also establish and sustain mutually beneficial relationships with policy makers, alongside our partners, to increase the visibility, credibility and impact of our evidence. The Consortium’s ultimate aim is to achieve meaningful health benefits for the UK population by reducing harm and inequalities from the consumption of unhealthy commodities over the next five years and beyond.
Customer's Loyalty of Indonesia Cellular Operators in The Pandemic of COVID-1
Authors:   Faculty of Economic & Business, Telkom University, Rachmawati Indira
Published: January 2021

Abstract. The cellular operators business in Indonesia has significantly increased during pandemic of COVID-19 since the issuance of the government regulation regarding work from home and study from home. The increasing number of subscribers is getting higher along with the increasing high churn rate. The intention of the study was to determine the potential predictors of customer's loyalty to cellular operators. The findings show, First, user experience directly influences loyalty. Second, corporate image is revealed to strengthen the effect of user experience on switching barriers and subsequent impact on loyalty, which indicates that a good corporate image can increase customer loyalty. Third, satisfaction and switching barriers mediate the relationship between user experience and loyalty. This implies that if users perceive a good experience with their operators, they will satisfied and loyal to the current operator. In line with this situation, if there are too many barriers to switch to other operators and they believe getting value for money, they will remain loyal. The conceptual research framework proposed can be differentiated between users who perceived corporate image is high and those who perceived corporate image is low; they can be differentiated between pre-paid and post-paid cellular users. The contribution of this study lies in the fact that the path between the five dimensions of user experience to loyalty of cellular operator, the combination with the mediator of satisfaction and switching barrier to loyalty, the moderating role of corporate image which affects the direction and strengthen the relationship between user experience and switching barriers. Keywords: Cellular operators, corporate image, COVID-19, loyalty, user experience