bluuebunny/crossref_metadata_2025 huggingface dataset:
Following the best of us to help them: Group member prototypicality and collective action
Authors: Di Bernardo Gian Antonio , Cocco Veronica Margherita , Paolini Stefania , Vezzali Loris , Stathi Sofia , Rubin Mark , Subašić Emina
Published: October 2021

While considering the role of group-level factors as predictors of collective action, research has overlooked the role of group prototypes in determining willingness to engage in collective action. To begin to investigate this area, we conducted two correlational studies ( Ns = 141 and 98) in high schools examining the association between prototypical ingroup members’ desire to engage in collective action and participants’ collective action on behalf of a disadvantaged group (immigrants). Results showed a positive association between these two variables. We also investigated boundaries of this effect, finding that the association emerged when participants lacked personal experiences with the disadvantaged group (cross-group friendships; Study 1) or identified more with their ingroup, an effect also found when including a behavioral measure of collective action (Study 2). Intentions to follow the prototypical ingroup member emerged as the mediator (Study 2). It is worth noting that our methodology allowed us to assess prototypicality in a naturalistic context by calculating a metacontrast ratio for each group member, in line with self-categorization theory’s conceptualization of prototypicality. We discuss the theoretical and practical implications, with reference to the role of prototypicality as a means of social influence and to developing social norms in the context of collective action.
Antiracism: Development and validation of a measure designed to identify White Americans who proactively fight to end discrimination toward Black Americans
Authors: LaCosse Jennifer , Krusemark Danielle , Foltz Jennifer , Plant E. Ashby
Published: October 2021

Despite reductions in traditional racial prejudice among non-Hispanic and non-Latino White Americans, Black Americans regularly experience discrimination. We argue that bias persists because although many White Americans espouse nonracist beliefs, far fewer actively work to combat the societal and institutional discrimination that impedes social change. In the current work, we were interested in identifying and measuring the belief systems associated with White Americans’ active participation in the fight against racial discrimination. In six studies, we developed and validated a measure of antiracism to tap into the belief that White people should proactively fight racial discrimination. Results established the convergent and discriminant validity of the measure and confirmed that antiracism was related to, but distinct from, personal nonracist beliefs. Moreover, higher levels of antiracism were associated with greater perceptions of racial discrimination, collective action intentions, willingness to condemn an officer in a racially motivated shooting, support for diversity tax incentives, and likelihood of signing up to receive information about volunteering for an equal rights organization. Results suggest antiracist beliefs may be the key to understanding White Americans’ active support for social change.
Socio-emotional struggles of young children during COVID-19 pandemic: Social isolation and increased use of technologies
Authors: Wijaya Raden Pasifikus Christa , Bunga Beatriks Novianti , Kiling Indra Yohanes
Published: October 2021

COVID-19 pandemic has caused young children to be isolated from their neighborhood only interacting with people living under the same roof as them, to avoid spreading the virus. Limited social interaction might have affected young children’s social and emotional development. This study aimed to explore the socio-emotional struggles of young children during the pandemic. Participants in the study were 12 mothers of young children living in West Timor, Indonesia. Data were obtained using the photovoice method. Thematic analysis resulted in four main themes, which are increased use of technologies, lack of social interaction, parents’ concerns, and boredom and increased need for stimuli. Findings in this study encourage mothers and related stakeholders to take extra precautions on maintaining children’s well-being during the COVID-19 pandemic.
“Do you talk normal?”: Piecing together learning experiences with emergent bilingual preschoolers
Authors: Miller Marsh Monica , Mariyam Mustary , Durant Kathleen , Zhulamanova Ilfa
Published: October 2021

Preschool teachers have a responsibility to create a sense of belonging for all children and families in their classroom community. Utilizing a funds of identity approach, this study examines how one preschool teacher uncovered the resources emergent bilingual children brought with them from home into school. She used this knowledge to intentionally create a play-based curriculum that strengthened relationships between and among children and provided spaces for the formation of positive social and educational identities. The participatory action research took place in a university laboratory school located in the Midwestern United States of America over a 2-year period. The study illuminates much about the lives of two emergent bilingual boys as they grow and learn in the quotidian space of the communal classroom environment.
Sexual Assault as a Contributor to Academic Outcomes in University: A Systematic Review
Authors: Molstad Taylor D. , Weinhardt Justin M. , Jones Rihannon
Published: October 2021

Sexual assault continues to be a prevalent and consequential experience for university students. The aim of this systematic review was to synthesize the literature on the academic consequences of the sexual assault for university students. There is currently no comprehensive review of the literature focusing on the academic consequences for university students who experienced sexual assault. This review was conducted based on searches from five databases including Academic Search Complete, Education Search Complete, Education Resources Information Center (ERIC), PsycINFO, and Google Scholar. We identified 13 articles that examined academic consequences of sexual assault during university. Across all studies, sexual assault was associated with more academic problems including lower grade point average, dropping out of university, and self-regulated learning problems. Although the number of articles is small, the results are consistent. Practically, this means that universities, those providing psychological services, and victims themselves need to understand that the consequences are not just physical and psychological but can also negatively impact academic achievement. Our review also identifies limitations in the literature regarding this topic such as methodological concerns, diversity and inclusion concerns, and the need for future work to investigate mediators of the relationship between sexual assault and academic outcomes. We offer recommendations for future research to combat the concerns identified. Development of interventions to support those who experience sexual assault during university necessitates overcoming the limitations identified.
Photodynamic Therapy With RLP068 and 630-nm Red LED Light in Foot Ulcers in Patients With Diabetes: A Case Series
Authors: Mancusi Rosario , Nosso Gabriella , Pecoraro Salvatore , Barricelli Mariella , Russo Andrea
Published: October 2021

The management and healing of lower extremity ulcers have always been a complex health problem because the clinical course is typically chronic, the results are often poor, and the socioeconomic impact is considerable. The healing process of foot ulcers of people with diabetes is further hindered by the concomitant presence of obstructive arterial disease, neuropathy, and foot malformation. It is frequently associated with multiresistant infections and often results in micro/macro amputations. Photodynamic therapy employs a photosensitizer activated by light of a specific wavelength able to generate reactive oxygen species, which initiate further oxidative responses locally with components of the bacteria. The experience of the treatment center for the lower extremity ulcers in 17 persons with diabetes in Acerra (Italy) with photoactivated RLP068, reported here, corroborates the results of the clinical trials and of the previous case reports. In all cases, examined photodynamic therapy with photosensitizer RLP068 and red light at 630 nm was found to reduce lesion area and inflammation and to ensure the decrease of bacterial load, hence reducing treatment times and antibiotics use, improving patient outcomes, and reducing the incidence of amputations. The simultaneous combination of photodynamic therapy with other ancillary physical-based treatments such as therapeutic magnetic resonance or Bio-Electro-Magnetic-Energy-Regulation was observed to be safe, time-saving, and able to lead to faster healing.
Spiritual Transformation of Han: Four Levels of Transference in Self Psychology
Authors: Oh Whachul
Published: October 2021

The purpose of this article is to research han (an oppressed feeling in Korea) through spiritual approaches including self psychology. Han is an oppressive feeling in Korean society. This han, caused by splitting, can be a place for the beginning of healing. One can invest one’s instinctual energy in the right place in the feeble self, according to one’s deepest needs there, in that spot of fragility. Many Koreans have been suffering from a deceptive self-image and do not feel deserving of love or care because of the vicious han-ridden circle. If Koreans can attain healthy self-object experiences, they will no longer feel fragility in themselves
An integrated structure and control design of a coaxis planar parallel manipulator for pick-and-place applications based on elastic potential energy
Authors: Liao Bin , Gao Xingyu , Lou Yunjiang
Published: October 2021

During high-speed pick-and-place operations, elastic deformations are quite apparent if the mass of the manipulator is low. These irregular deformations are accompanied by vibrations, then errors. Since elastic potential energy reflects elastic deformation, the vibration of the whole manipulator can be controlled well when the elastic potential energy is decreased. In this article, to design manipulators with flexible links for pick-and-place operations, an integrated structure and control design framework is proposed. The dynamic model of a coaxis planar parallel manipulator is obtained by the finite element method, an effective method. A proportional–derivative controller is utilized for this industrial application. Simultaneously, the optimal structural and control parameters are derived by minimizing the elastic potential energy via integrated design, in which actuated systems and accuracies are regarded as constraints. Finally, simulations show that the performance of the parallel manipulator is improved by this design methodology.
Excisional Debridement for Chronic Achilles Insertional Tendinosis: A Novel Technique and Case Review
Authors: Gaston Tara E. , Skibicki Hope E. , Cheesman Quincy T. , Chapter Megan C. , Daniel Joseph N.
Published: October 2021

Background

Operative treatment of chronic Achilles insertional tendinosis (AIT) involves tendon debridement, removal of the retrocalcaneal bursitis, and excision of the calcaneal exostosis, often followed by repair of the Achilles tendon and deep tendon transfer. The literature describes a variety of techniques without a single standard of care.

Methods

This is a retrospective review of 57 patients treated with an excisional debridement of the central portion of the Achilles tendon. The novelty of this technique is that instead of complete detachment of the tendon from its insertion, only the central portion is debrided and excised. This allows for enhanced visibility of the calcaneal exostosis and increased healing with apposition of viable tendon during side-to-side repair.

Results

Patient-reported outcome scores and pain significantly improved from preoperatively to a minimum of 2 years postoperatively. Complications were similar to those previously reported, with superficial wound breakdown being the most common.

Conclusion

In conclusion, the use of this reliable, reproducible, and effective technique for the treatment of patients with chronic AIT is encouraged because it provides both enhanced visibility and allows complete resection of all pathological tissue.

Levels of Evidence:

Level IV: Retrospective case series
“Light cleaveth unto light”: Intermarriage discourse, LDS women of color, and the new racism
Authors: Khan Nazneen
Published: October 2021

Fifty years after Loving v. Virginia, oppositional attitudes toward interracial relationships are still advanced by religious institutions in the United States. Extant social science literature characterizes these attitudes as generated largely by Evangelical and Christian nationalist traditions where members harbor negative attitudes toward interracial relationships. Hidden behind this characterization are the significant, but less obvious ways in which non-Evangelical denominations construct and disseminate similar attitudes. Through discourse analysis and digital interviews with LDS women of color, this study uses the Church of Jesus Christ of Latter-day Saints (LDS or Mormon) as an entry point for examining intermarriage discourses in other faith traditions. Findings highlight that LDS messaging about interracial relationships shifted over time, integrating multiple racial frames in ways that expanded the scope of LDS racism with especially harsh implications for LDS women of color. Broader theoretical implications for the study of race, gender, and religion are discussed.
Quantifying available energy and anthropogenic energy use in the Mississippi River Basin
Authors: Turnbull Thomas , Renner Maik , Panwar Annu , Katsikis Nikos , Kleidon Axel , Schindler Alexander
Published: October 2021

The Mississippi River Basin is a vast near-planar surface, an area upon which sunlight falls and wind flows. Its gently banked geomorphology channels precipitation, sediment, biota, and human activity into a dynamic locus of regional Earth system interactions. This paper describes the major features of this region’s energy exchanges from a thermodynamic Earth systems perspective. This analysis is combined with descriptions of the historical and socio-political contexts that have helped shape energy use. In doing so, the paper contrasts the region’s available energy exchanges and flows with their anthropogenic diversion, providing an account of human impact at a regional scale. It also offers theoretical estimates of the potential availabilities of renewable energy. This is contrasted with a description of the geological formation of stocks of fossil energy in the region. On these bases, a number of maps are presented and an assessment of the region’s energy flows is offered. These exercises point to significant affordances for achieving regional de-fossilisation at the river basin scale.
A Sobering Look at Treatment Effectiveness of Military-Related Posttraumatic Stress Disorder
Authors: Levi Ofir , Ben Yehuda Ariel , Pine Daniel S. , Bar-Haim Yair
Published: October 2021

Approximately two thirds of veterans with posttraumatic stress disorder (PTSD) remain with the disorder following treatment. Pinpointing the per-symptom effectiveness of treatments in real-world clinical settings can highlight relevant domains for treatment augmentation and development. Baseline and posttreatment assessments of PTSD and depression were performed in 709 veterans with PTSD. PTSD remission was 39.4%. Treatment was least effective for intrusion symptoms and had no effect on flashbacks or on poor recall of traumatic features. Of veterans who remitted, 72.8% still met diagnostic criteria for at least one cluster. Poor clinical effectiveness was noted for depression; only 4.1% of the patients remitted following treatment. Treatments for veterans with PTSD show limited overall effectiveness in real-world settings. Enhancing treatment response may require enhancing provider fidelity and patient compliance with extant treatments or the development of new treatments that specifically target the symptoms of PTSD that do not respond well to extant treatments.
Chronic pelvic pain in a patient with Mayer-Rokitansky-Küster-Hauser syndrome: An unusual presentation
Authors: Jha Sangam , Kumari Surabhi , Shalini
Published: October 2021

Introduction:

MRKH syndrome, is a spectrum of congenital anomalies of unknown aetiology characterised by a variable degree of utero-vaginal agenesis in women with normal secondary sexual characteristics and a 46, XX karyotype.

Case report:

A 16 year old unmarried presented with absence of menses and chronic pelvic pain. MRKH with endometrioma was diagnosed on MRI. Laparoscopic removal of the Mullerian mass with endometriotic cyst was done. The diagnosis was subsequently confirmed on histology.

Conclusion:

This case highlights the atypical presentation of MRKH and reinforce the Sampsons theory of retrograde menstruation in the development of endometriosis. Patient with chronic pelvic pain and MRKH syndrome should be evaluated for endometriosis.
Collaboration, Compliance, and Cupcakes: A Classroom Exercise
Authors: Boehler Barbara-Ann , MacLean Tammy , O’Neill Regina
Published: October 2021

This in-class, 75-minute exercise creates a context for students to observe some of the challenges to cross-functional collaboration and offers insight into processes to achieve more successful outcomes. By demonstrating how a failure by compliance and business operations to work cross-functionally negatively impacts outcomes in the form of misaligned and ineffective corporate compliance procedures, students learn firsthand the importance of cross-functional collaboration. Given the ubiquity and importance of corporate ethics and compliance programs, this exercise fills an important pedagogical gap in management education.
Ocular Syphilis With Phlebitis and Paravenous Pigmentary Retinopathy
Authors: Mammo Danny A. , Lowder Careen Y. , Srivastava Sunil K.
Published: October 2021

Purpose:

Ocular syphilis can present as a wide variety of clinical phenotypes, among them panuveitis with vasculitis. Primary retinal phlebitis with resulting paravenous atrophy and pigmentary retinal degeneration is a rare presentation.

Methods:

A 53-year-old man presented with a 1-year history of bilateral blurry vision. Physical examination demonstrated bilateral anterior chamber and vitreous cell with vitreous haze, hyperemic optic nerves, and atrophic-appearing retina. The left eye demonstrated a nasal area of perivenular vascular sheathing with adjacent retinal whitening. Ancillary testing demonstrated predominantly perivenular leakage involvement.

Results:

Uveitic workup was positive for syphilis and HIV. The patient was treated with antiretroviral therapy and intravenous penicillin G. He developed progressive paravenous pigmentary changes and atrophy.

Conclusions:

Syphilis can present with a wide variety of phenotypic manifestations and should also be considered in patients presenting with acute retinal phlebitis or paravenous atrophy in long-standing cases.
Transcriptome-wide characterization and functional analysis of Xyloglucan endo-transglycosylase/hydrolase (XTH) gene family of Salicornia europaea L. under salinity and drought stress
Authors: Tiika Richard John , Wei Jia , Cui Guangxin , Ma Yanjun , Yang Hongshan , Duan Huirong
Published: October 2021

Background

Salicornia europaea is a halophyte that has a very pronounced salt tolerance. As a cell wall manipulating enzyme, xyloglucan endotransglycosylase/hydrolase (XTH) plays an important role in plant resistance to abiotic stress. However, no systematic study of the XTH gene family in S. europaea is well known. PacBio Iso-Seq transcriptome sequence data were used for bioinformatics and gene expression analysis using real-time quantitative polymerase chain reaction (RT-qPCR).

Results

Transcriptome sequencing (PacBio Iso-Seq system) generated 16,465,671 sub-reads and after quality control of Iso-Seq, 29,520 isoforms were obtained with an average length of 2112 bp. A total of 24,869 unigenes, with 98% of which were obtained using coding sequences (CDSs), and 6398 possible transcription factors (TFs) were identified. Thirty-five (35) non-redundant potential SeXTH proteins were identified in S. europaea and categorized into group I/II and group III based on their genetic relatedness. Prediction of the conserved motif revealed that the DE(I/L/F/V)DF(I)EFLG domain was conserved in the S. europaea proteins and a potential N-linked glycosylation domain N(T)V(R/L/T/I)T(S/K/R/F/P)G was also located near the catalytic residues. All SeXTH genes exhibited discrete expression patterns in different tissues, at different times, and under different stresses. For example, 27 and 15 SeXTH genes were positively expressed under salt stress in shoots and roots at 200 mM NaCl in 24 h, and 34 SeXTH genes were also positively regulated under 48 h of drought stress in shoots and roots. This indicates their function in adaptation to salt and drought stress.

Conclusion

The present study discovered SeXTH gene family traits that are potential stress resistance regulators in S. europaea, and this provides a basis for future functional diversity research.
Outcome after intubation for septic shock with respiratory distress and hemodynamic compromise: an observational study
Authors: Yang Ting , Shen Yongchun , Park John G. , Schulte Phillip J. , Hanson Andrew C. , Herasevich Vitaly , Dong Yue , Bauer Philippe R.
Published: October 2021

Background

Acute respiratory failure in septic patients contributes to higher in-hospital mortality. Intubation may improve outcome but there are no specific criteria for intubation. Intubation of septic patients with respiratory distress and hemodynamic compromise may result in clinical deterioration and precipitate cardiovascular failure. The decision to intubate is complex and multifactorial. The purpose of this study was to evaluate the impact of intubation in patients with respiratory distress and predominant hemodynamic instability within 24 h after ICU admission for septic shock.

Methods

We conducted a retrospective analysis of a prospective registry of adult patients with septic shock admitted to the medical ICU at Mayo Clinic, between April 30, 2014 and December 31, 2017. Septic shock was defined by persistent lactate > 4 mmol/L, mean arterial pressure < 65 mmHg, or vasopressor use after 30 mL/kg fluid boluses and suspected or confirmed infection. Patients who remained hospitalized in the ICU at 24 h were separated into intubated while in the ICU and non-intubated groups. The primary outcome was hospital mortality. The first analysis used linear regression models and the second analysis used time-dependent propensity score matching to match intubated to non-intubated patients.

Results

Overall, 358 (33%) ICU patients were eventually intubated after their ICU admission and 738 (67%) were not. Intubated patients were younger, transferred more often from an outside facility, more critically ill, had more lung infection, and achieved blood pressure goals more often, but lactate normalization within 6 h occurred less often. Among those who remained hospitalized in the ICU 24 h after sepsis diagnosis, the crude in-hospital mortality was higher in intubated than non-intubated patients, 89 (26%) vs. 82 (12%), p < 0.001, as was the ICU mortality and ICU and hospital length of stay. After adjustment, intubation showed no effect on hospital mortality but resulted in fewer hospital-free days through day 28. One-to-one propensity resulted in similar conclusion.

Conclusions

Intubation within 24 h of sepsis was not associated with hospital mortality but resulted in fewer 28-day hospital-free days. Although intubation remains a high-risk procedure, we did not identify an increased risk in mortality among septic shock patients with predominant hemodynamic compromise.
Medical resilience and morality: a survey study on the opinions and actions of exemplary family physicians
Authors: Ruiz Moral Roger , Monge Martín Diana , Garcia de Leonardo Cristina , Alvarez Montero Santiago , Caballero Martínez Fernando
Published: October 2021

Background

Studies conducted to understand how family doctors develop resilience and deal with the challenges posed by work-related stress, usually have focused on identifying the elements that generate resilience from psychological perspectives and their impact on coping strategies. Few have explored the role that personal qualities and values that traditionally motivate family physicians can play as drivers of well-being and resilience.

Objectives

To explore attributes that exemplary family physicians (EFP) consider important for their work and the elements that, for them, are source of gratification and resources in the face of the adversities they encounter in their practice.

Methods

This is an exploratory study carried out by online survey. Eighty six doctors regarded as exemplary by their colleagues answered 7 close and 4 open-ended questions that explored their job satisfaction, the elements of their work that reward them, the difficulties and problems they usually encounter, the resources they use to cope with those problems, and the personal qualities they consider central to their work. Four researchers conducted a thematic (deductive and inductive) analysis of the free text responses received. Based on the results obtained, and through an iterative discussion process, the researchers proposed an integrated set of qualities at the core of their professionalism.

Results

88.4% (76) of the doctors said they were satisfied with their work. However, they face problems (202 comments), including demanding patients, insensitive managers with unshared interests/care goals, excessive paperwork, work overload, or time pressures. Sources of gratification point to personal identity; clinical, relational, and collaborative efficiency; a holistic and comprehensive practice (centred on individuals); and a continuous search for excellence (149) and the root of their resources (135). These elements, in turn, corresponded to the attributes considered essential for the practice of family medicine (131).

Conclusions

For EFPs, certain professional values give meaning to their clinical practice and are a source of well-being and resources. This central focus on professional values and qualities can help for better understand the burnout nature and expand the type of action that promotes resilience. Further studies using a less structured qualitative research will be needed to confirm/expand these results.
Cognitive frailty is a robust predictor of falls, injuries, and disability among community-dwelling older adults
Authors: Rivan Nurul Fatin Malek , Singh Devinder Kaur Ajit , Shahar Suzana , Wen Goh Jing , Rajab Nor Fadilah , Din Normah Che , Mahadzir Hazlina , Kamaruddin Mohd Zul Amin
Published: October 2021

Background

Cognitive frailty, a combination of physical frailty and cognitive impairment, is associated with functional decline in older adults. However, there is limited information if cognitive frailty predicts the incidence of falls, injuries, and disability. In this study, we aimed to determine the ability of cognitive frailty in predicting the incidence of falls, injuries and disability among multi-ethnic older adults in Malaysia at 5 years follow-up.

Methods

In this prospective cohort study, a total of 400 participants aged 60 years and above were successfully followed up at 5 years. Participants’ socio-demographic, medical history, psycho-social, physical, cognitive and dietary intake information was obtained. Cognitive frailty was defined as comorbid physical frailty (> 1 Fried criteria) and mild cognitive impairment (Petersen criteria). Univariate analysis was performed for all variables, followed by hierarchical binary logistic regression (BLR) analysis to identify the ability of CF in predicting the incidence of falls, injuries, and disability. The significant value was set at p < 0.05.

Results

Cognitive frailty was found to be associated with greater risk of adverse consequences after adjusting for covariates. Both cognitive frailty (Adjusted Odd ratio (Adj OR) = 2.98, 95% confidence interval (CI): 1.78–4.99, p < 0.05) and physical frailty (Adj OR = 2.88, 95% CI: 1.19–6.99, p < 0.05) were significant predictors of incidence of falls. Risk of injuries was also significantly increased with the presence of cognitive frailty (Adj OR = 3.06, 95% CI: 1.23–7.60, p < 0.05) and physical frailty (Adj OR = 3.04, 95% CI: 1.75–5.28, p < 0.05). In addition, cognitive frailty (Adj OR = 5.17, 95% CI: 1.11–24.21, p < 0.05) and physical frailty (Adj OR = 4.99, 95% CI: 1.11–22.57, p < 0.05) were shown to significantly predict the incidence of disability among older adults.

Conclusion

Cognitive frailty is a robust predictor of falls, injuries, and disability in older adults. Possible early multi-domain preventive and management strategies of cognitive frailty that contribute to adverse consequences are required to decrease further functional decline and promote independence in older adults.
Support system diversity among family caregivers of stroke survivors: a qualitative study exploring Asian perspectives
Authors: Tyagi Shilpa , Luo Nan , Tan Chuen Seng , Tan Kelvin Bryan , Tan Boon Yeow , Menon Edward , Venketasubramanian N. , Loh Wei Chin , Fan Shu Hui , Yang Kenneth Lam Thuan , Chan Audrey Swee Ling , Farwin Aysha , Lukman Zunairah Binti , Koh Gerald Choon-Huat
Published: October 2021

Background

Caregiving is a global phenomenon which is bound to increase in tandem with the aging population worldwide. Stroke is a condition common in older people that requires complex caregiving necessitating provision of adequate support to the caregivers. Past literature consists of limited accounts of types and organization of support arrangements needed by different caregivers. We aimed to describe the support system of caregivers of stroke survivors in Singapore, highlighting differences across the different caregiver identities (i.e. spouse, adult-child, etc.).

Methods

We conducted a qualitative descriptive study in the community setting involving 61 purposively sampled and recruited stroke survivors and caregivers. Semi-structured interviews were conducted, and transcripts were analysed using thematic analysis.

Results

Our findings were summarized across the following 4 themes: 1) cultural influence and caregiving; 2) caregiver support system with the following sub-themes: 2.1) dyadic caregiver support type, 2.2) extended caregiver support type, 2.3.) distributed caregiver support type and 2.4) empowering caregiver support type; 3) breaks in care of stroke survivor and 4) complex relationship dynamics. We operationalized the caregiver support system as comprising of type, people and activities that enable the caregiver to participate in caregiving activities sustainably. While spouse caregivers preferred dyadic and extended support systems positioning themselves in a more central caregiving role, adult-child caregivers preferred distributed support system involving family members with paid caregivers playing a more central role.

Conclusions

Our findings highlight caregiver identity as a surrogate for the differences in the caregiver support systems. Practical implications include imparting relationship-building skills to the stroke survivor-caregiver dyads to sustain dyadic support system and educating clinicians to include differences in caregiving arrangements of stroke survivors in practising family-centred care.
Are maternal and child health initiatives helping to reduce under-five mortality in Ghana? Results of a quasi-experimental study using coarsened exact matching
Authors: Kolekang Augusta , Sarfo Bismark , Danso-Appiah Anthony , Dwomoh Duah , Akweongo Patricia
Published: October 2021

Background

Despite a 53 % decline in under-five mortality (U5M) worldwide during the period of the Millennium Development Goals (MDGs), U5M remains a challenge. Under-five mortality decline in Ghana is slow and not parallel with the level of coverage of child health interventions. The interventions promoted to improve child survival include early initiation of breastfeeding, clean postnatal care, and skilled delivery. This study sought to assess the effectiveness of these interventions on U5M in Ghana.

Methods

A quasi-experimental study was conducted using secondary data of the 2008 and 2014 Ghana Demographic and Health Surveys. Coarsened Exact Matching and logistic regression were done. The interventions assessed were iron intake, early initiation of breastfeeding, clean postnatal care, hygienic disposal of stool, antenatal care visits, skilled delivery, intermittent preventive treatment of malaria in pregnancy, and tetanus toxoid vaccine.

Results

There were 2,045 children under-five years and 40 (1.9 %) deaths in 2008. In 2014, the total number of children under-five years was 4,053, while deaths were 53(1.2 %). In 2014, children less than one month old formed 1.6 % of all children under-five years, but 47.8 % of those who died. Mothers who attended four or more antenatal care visits were 78.2 % in 2008 and 87.0 % in 2014. Coverage levels of improved sanitation and water connection in the home were among the lowest, with 11.6 % for improved sanitation and 7.3 % for water connection in the home in 2014. Fifty-eight (58), 1.4 %, of children received all the eight (8) interventions in 2014, and none of those who received all these interventions died. After controlling for potential confounders, clean postnatal care was associated with a 66% reduction in the average odds of death (aOR = 0.34, 95 %CI:0.14–0.82), while early initiation of breastfeeding was associated with a 62 % reduction in the average odds of death (aOR = 0.38, 95 % CI: 0.21–0.69).

Conclusions

Two (clean postnatal care and early initiation of breastfeeding) out of eight interventions were associated with a reduction in the average odds of death. Thus, a further decline in under-five mortality in Ghana will require an increase in the coverage levels of these two high-impact interventions.
Efficacy and safety of fixed doses of intranasal Esketamine as an add-on therapy to Oral antidepressants in Japanese patients with treatment-resistant depression: a phase 2b randomized clinical study
Authors: Takahashi Nagahide , Yamada Aya , Shiraishi Ayako , Shimizu Hiroko , Goto Ryosuke , Tominaga Yushin
Published: October 2021

Background

Esketamine nasal spray (Spravato) in conjunction with oral antidepressants (ADs) is approved in the European Union, United States, and other markets for treatment-resistant depression (TRD). Efficacy, safety, and tolerability of esketamine nasal spray in Japanese patients with TRD needs to be assessed.

Methods

This Phase 2b, randomized, double-blind (DB), placebo-controlled study was conducted in adult Japanese patients with TRD meeting the Diagnostic and Statistical Manual of Mental Disorders (fifth edition) criteria of major depressive disorder with nonresponse to ≥ 1 but < 5 different ADs in the current episode at screening. Patients were treated with a new oral AD for 6 weeks (prospective lead-in phase); nonresponders were randomized (2:1:1:1) to placebo or esketamine (28-, 56-, or 84-mg) nasal spray along with the continued use of AD for 4 weeks (DB induction phase). Responders (≥50% reduction from baseline in the Montgomery-Asberg Depression Rating Scale [MADRS] total score) from the DB induction phase continued into the 24-week posttreatment phase and patients who relapsed could participate in a 4-week open-label (OL) second induction (flexibly-dosed esketamine). The primary efficacy endpoint, change from baseline in the MADRS total score at Day 28 in the DB induction phase, was based on mixed-effects model using repeated measures pairwise comparisons using a Dunnett adjustment.

Results

Of the 202 patients randomized in the DB induction phase (esketamine [n = 122] or placebo [n = 80]), the MADRS total scores decreased from baseline to Day 28 of the DB induction phase (− 15.2, − 14.5, − 15.1, and − 15.3 for esketamine 28 mg, 56 mg, 84 mg, and placebo groups, respectively), indicating an improvement in depressive symptoms; however, the difference between the esketamine and placebo groups was not statistically significant. The most common treatment-emergent adverse events during the DB induction phase in the combined esketamine group (incidences ranging from 12.3 to 41.0%) were blood pressure increased, dissociation, dizziness, somnolence, nausea, hypoaesthesia, vertigo, and headache; the incidence of each of these events was > 2-fold higher than the corresponding incidence in the placebo group.

Conclusions

Efficacy of esketamine plus oral AD in Japanese TRD patients was not established; further investigation is warranted. All esketamine doses were safe and tolerated.

Trial registration

ClinicalTrials.gov Identifier: NCT02918318. Registered: 28 September 2016.
Education on palliative care for Parkinson patients: development of the “Best care for people with late-stage Parkinson’s disease” curriculum toolkit
Authors: Gatsios Dimitrios , Antonini Angelo , Gentile Giovanni , Konitsiotis Spyridon , Fotiadis Dimitrios , Nixina Irini , Taba Pille , Weck Christiane , Lorenzl Stefan , Lex Katharina Maria , Paal Piret
Published: October 2021

Background

Palliative care education among all stakeholders involved in the care of patients with late-stage Parkinson’s disease is not adequate. In fact, there are many unmet educational and training needs as confirmed with a targeted, narrative literature review.

Methods

To address these needs we have developed the “Best Care for People with Late-Stage Parkinson’s Disease” curriculum toolkit. The toolkit is based on recommendations and guidelines for training clinicians and other healthcare professionals involved in palliative care, educational material developed in recent research efforts for patients and caregivers with PD and consensus meetings of leading experts in the field. The final version of the proposed toolkit was drafted after an evaluation by external experts with an online survey, the feedback of which was statistically analysed with the chi-square test of independence to assess experts’ views on the relevance and importance of the topics. A sentiment analysis was also done to complement statistics and assess the experts positive and negative sentiments for the curriculum topics based on their free text feedback.

Results

The toolkit is compliant with Kern’s foundational framework for curriculum development, recently adapted to online learning. The statistical analysis of the online survey, aiming at toolkit evaluation from external experts (27 in total), confirms that all but one (nutrition in advanced Parkinson’s disease) topics included, as well as their objectives and content, are highly relevant and useful.

Conclusions

In this paper, the methods for the development of the toolkit, its stepwise evolution, as well as the toolkit implementation as a Massive Open Online Course (MOOC), are presented. The “Best Care for People with Late-Stage Parkinson’ s disease” curriculum toolkit can provide high-quality and equitable education, delivered by an interdisciplinary team of educators. The toolkit can improve communication about palliative care in neurological conditions at international and multidisciplinary level. It can also offer continuing medical education for healthcare providers.
Equine vitiligo-like depigmentation in grey horses is related to genes involved in immune response and tumor metastasis
Authors: Druml Thomas , Brem Gottfried , Velie Brandon , Lindgren Gabriella , Horna Michaela , Ricard Anne , Grilz-Seger Gertrud
Published: October 2021

Background

In horses, the autoimmune disease vitiligo is characterized by the loss of melanocytes and results in patchy depigmentation of the skin around the eyes, muzzle and the perianal region. Vitiligo-like depigmentation occurs predominantly in horses displaying the grey coat colour and is observed at a prevalence level of 26.0–67.0% in grey horses compared with only 0.8–3.5% in non-grey horses. While the polygenetic background of this complex disease is well documented in humans, the underlying candidate genes for this skin disorder in horses remain unknown. In this study we aim to perform a genome-wide association study (GWAS) for identifying putative candidate loci for vitiligo-like depigmentation in horses.

Methods

In the current study, we performed a GWAS analysis using high-density 670 k single nucleotide polymorphism (SNP) data from 152 Lipizzan and 104 Noriker horses, which were phenotyped for vitiligo-like depigmentation by visual inspection. After quality control 376,219 SNPs remained for analyses, the genome-wide Bonferroni corrected significance level was p < 1.33e-7.

Results

We identified seven candidate genes on four chromosomes (ECA1, ECA13, ECA17, ECA20) putatively involved in vitiligo pathogenesis in grey horses. The highlighted genes PHF11, SETDB2, CARHSP1 and LITAFD, are associated with the innate immune system, while the genes RCBTB1, LITAFD, NUBPL, PTP4A1, play a role in tumor suppression and metastasis. The antagonistic pathogenesis of vitiligo in relation to cancer specific enhanced cell motility and/or metastasis on typical melanoma predilection sites underlines a plausible involvement of RCBTB1, LITAFD, NUBPL, and PTP4A1.

Conclusions

The proposed candidate genes for equine vitiligo-like depigmentation, indicate an antagonistic relation between vitiligo and tumor metastasis in a horse population with higher incidence of melanoma. Further replication and expression studies should lead to a better understanding of this skin disorder in horses.
CircCD44 plays oncogenic roles in triple-negative breast cancer by modulating the miR-502–5p/KRAS and IGF2BP2/Myc axes
Authors: Li Jie , Gao Xinya , Zhang Zhanqiang , Lai Yuanhui , Lin Xunxun , Lin Bo , Ma Maoguang , Liang Xiaoli , Li Xixi , Lv Weiming , Lin Ying , Zhang Nu
Published: October 2021

Background

Emerging studies have revealed the potent functions of circRNAs in breast cancer tumorigenesis. However, the biogenesis, biofunction and mechanism of circRNAs in triple-negative breast cancer (TNBC) are largely unknown.

Methods

High-throughput RNA sequencing was applied to identify dysregulated circRNAs in TNBCs and paired normal tissues. RNA pulldown and luciferase assays were performed to investigate the interaction between circular CD44 (circCD44, also annotated as hsa_circ_0021735) and miR-502–5p. RNA pulldown and RIP assays were used to investigate the interaction between circCD44 and IGF2BP2. Cell viability, colony formation, migration/invasion assays and in vivo tumorigenesis were used to investigate circCD44 biological functions.

Results

CircCD44 is an uncharacterized circRNA, which is highly expressed in TNBC, and its expression is negatively correlated with the prognosis of TNBC patients. CircCD44 promotes TNBC proliferation, migration, invasion and tumorigenesis at least partially by sponging miR-502–5p and interacting with IGF2BP2.

Conclusion

Our data suggested that overexpressed circCD44 promotes TNBC progression. CircCD44 is potentially a novel diagnostic and therapeutic marker for TNBC patients.
Diverse inflammatory threats modulate astrocytes Ca2+ signaling via connexin43 hemichannels in organotypic spinal slices
Authors: Panattoni Giulia , Amoriello Roberta , Memo Christian , Thalhammer Agnes , Ballerini Clara , Ballerini Laura
Published: October 2021

Neuroinflammation is an escalation factor shared by a vast range of central nervous system (CNS) pathologies, from neurodegenerative diseases to neuropsychiatric disorders. CNS immune status emerges by the integration of the responses of resident and not resident cells, leading to alterations in neural circuits functions. To explore spinal cord astrocyte reactivity to inflammatory threats we focused our study on the effects of local inflammation in a controlled micro-environment, the organotypic spinal slices, developed from the spinal cord of mouse embryos. These organ cultures represent a complex in vitro model where sensory-motor cytoarchitecture, synaptic properties and spinal cord resident cells, are retained in a 3D fashion and we recently exploit these cultures to model two diverse immune conditions in the CNS, involving different inflammatory networks and products. Here, we specifically focus on the tuning of calcium signaling in astrocytes by these diverse types of inflammation and we investigate the mechanisms which modulate intracellular calcium release and its spreading among astrocytes in the inflamed environment. Organotypic spinal cord slices are cultured for two or three weeks in vitro (WIV) and exposed for 6 h to a cocktail of cytokines (CKs), composed by tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1 β) and granulocyte macrophage-colony stimulating factor (GM-CSF), or to lipopolysaccharide (LPS). By live calcium imaging of the ventral horn, we document an increase in active astrocytes and in the occurrence of spontaneous calcium oscillations displayed by these cells when exposed to each inflammatory threat. Through several pharmacological treatments, we demonstrate that intracellular calcium sources and the activation of connexin 43 (Cx43) hemichannels have a pivotal role in increasing calcium intercellular communication in both CKs and LPS conditions, while the Cx43 gap junction communication is apparently reduced by the inflammatory treatments.
Correction to: Gut microbiota influence tumor development and Alter interactions with the human immune system
Authors: Ge Yanshan , Wang Xinhui , Guo Yali , Yan Junting , Abuduwaili Aliya , Aximujiang Kasimujiang , Yan Jie , Wu Minghua
Published: October 2021

An amendment to this paper has been published and can be accessed via the original article.
Meglitinide (repaglinide) therapy in permanent neonatal diabetes mellitus: two case reports
Authors: Razzaghy-Azar Maryam , Nourbakhsh Mitra , Talea Ali , Mohammad Amoli Mahsa , Nourbakhsh Mona , Larijani Bagher
Published: October 2021

Background

Permanent neonatal diabetes mellitus (PNDM) presents with dehydration and hyperglycemia, which usually occurs during the first 12 months of life. Activating mutations of beta-cell adenosine triphosphate-sensitive potassium [KATP] channel subunits that cause opening of the channel are associated with PNDM. Some patients with PNDM respond to administration of a sulfonylurea derivative, which has long action on blood glucose even during hypoglycemia and has an apoptotic effect on beta cells. However, there have been no reports regarding treatment with meglitinide (repaglinide), which has rapid and short duration of action during the rise in blood glucose after meals that is more similar to beta cell function. It has no effects during hypoglycemia, so it does not cause neurological damage, and has no apoptotic effect on beta cells. We report herein the effects of repaglinide administration in the management and clinical outcome of two patients with PNDM during 9 and 10 years of follow-up.

Case presentation

Two Iranian infants were brought to our institution with poor general condition, dehydration, lethargy, and poor feeding. They had diabetic ketoacidosis at 52 days and 3.5 months of age, respectively. Their genetic analysis revealed mutations in the KCNJ11 gene encoding KIR6.2, so they both had PNDM. After treatment of diabetic ketoacidosis with insulin, they responded to sulfonylurea (glibenclamide) treatment, but were switched to repaglinide because of blood sugar fluctuations in terms of hyper- and hypoglycemia. Repaglinide was administered with the dosage of 0.04 mg/kg/day divided before every meal.

Results

The patients were 10 and 9 years old at the last visit, with normal growth parameters. The values of self-monitored blood glucose were well-controlled, and the hemoglobin A1C (HbA1C) levels ranged from 3.6 to 6.4% during the follow-up period. There was no complication of diabetes, neurological disorder, or adverse effects related to repaglinide.

Conclusion

In every neonate or infant < 6 months of age with diabetes mellitus, PNDM should be considered. A trial of oral repaglinide can be performed and substituted for glibenclamide for prevention of hypoglycemia, neurological damage, and apoptosis of beta cells during long-term administration.