bluuebunny/crossref_metadata_2025 huggingface dataset:
Identifying factors causing decline in physical functionality of geriatric population
Authors: Asim Muhammad , Aftab Muhammad , Bhatti Sajjad Haider , Ahmad Tanvir , Ali Shah Syed Muhammad , Akram Muhammad
Published: June 2021

The objective of the study was to find major correlates of decline in the physical functionality of the geriatric population. The main focus was the evaluation of demographic, social, economic, and health-related factors that have a potential impact on physical functionality. A sample of 423 elderly people were selected from district Faisalabad, Pakistan by using a snowball sampling approach. Statistical analysis was performed using frequency analysis and some tests for association like chi-square, Cramer’s V, and gamma coefficient. It was observed that 42.8% of the respondents were independent in doing their all-routine work and the physical functional status decline was observed partially in 35.2% and completely in 22.0% of the respondents. Using frequency analysis and association measures, age, education, marital status, living with family, having an independent source of income, level of social network and support, having exercise routine were found to be significantly associated with functional status of elders. The study concluded that besides age and other demographic factors that cannot be controlled, the socio-economic factors can be improved to substantially reduce the decline in the physical functionality of the geriatric population.
Participant’s Roles and Cognitive Relations in Niger Delta Conflict News Discourse
Authors: Ononye Chuka Fred , Esan Olaosun Ibrahim , Yunana Ahmed
Published: June 2021

Media studies on Niger Delta (ND) conflict discourse have largely utilized stylistic, pragmatic, and critical discourse analytical tools in exploring media representation of news actors and ideologies in news texts but have not accommodated such issues as participants’ roles and cognitive relations in the discourse. This paper analyses the contexts of ND conflict news reporting with a view to revealing not only the participant’s role relations involved, but also the lexico-semantic resources they are characterized by. Forty newspaper reports on ND conflicts (20 from four ND-based newspapers— The Tide, New Waves, The Pointer and Pioneer, and 20 from four national newspapers— The Punch, The Guardian, Vanguard and THISDAY), published between 2003 and 2009, were sampled and subjected to discourse analysis, with insights from van Dijk’s context models and aspects of relational semantics. Four types of role were identified, viz. interactional (embracing the participants in conflict), communicative (relating to the production roles), social (involving group membership), and instrumental (dealing with the entities utilized in actualizing specific goals). The cognitive foci of these roles are associated with participants’ goals and beliefs, and these inform the participants’ position and hence role in the conflict events. Linguistically, the interactional and social roles are marked by synonymous and converse lexical items, while the communicative and instrumental roles are indexed by homonymous and antonymous lexical features. The findings corroborate the fact that there is an interaction between participant roles and cognitive relations in the ND conflict events reported in Nigerian newspapers.
Experiences of College Students With Children During the COVID-19 Pandemic
Authors: Manze Meredith G. , Rauh Lauren , Smith-Faust Polly , Watnick Dana
Published: June 2021

College students with children are a unique subset of emerging adults, whose lives were disrupted by the COVID-19 pandemic, challenging their pursuit for education and financial independence. We sought to understand barriers and facilitators to their academic persistence during the first wave of COVID-19 in New York City. We conducted 37 in-depth interviews with students, faculty, and staff at six community colleges within a public university about their experiences during the pandemic and analyzed data using a modified approach to grounded theory. Students, faculty, and staff recognized the magnified and expanded roles and responsibilities of student parents. Students discussed the challenges they endured because of the diminished time from these new responsibilities. They shared strategies implemented and sacrifices made to manage. Support from faculty and staff was critical to their academic persistence. Increased faculty flexibility and synthesizing information about remote resources can help student parents better manage during the pandemic.
Telemedicine in Spine Surgery: Global Perspectives and Practices
Authors: Riew Grant J. , Lovecchio Francis , Samartzis Dino , Louie Philip K. , Germscheid Niccole , An Howard , Cheung Jason Pui Yin , Chutkan Norman , Mallow Gary Michael , Neva Marko H. , Phillips Frank M. , Sciubba Daniel , El-Sharkawi Mohammad , Valacco Marcelo , McCarthy Michael H. , Makhni Melvin C. , Iyer Sravisht
Published: June 2021

Study Design:

Cross-sectional, anonymous, international survey.

Objectives:

The COVID-19 pandemic has resulted in the rapid adoption of telemedicine in spine surgery. This study sought to determine the extent of adoption and global perspectives on telemedicine in spine surgery.

Methods:

All members of AO Spine International were emailed an anonymous survey covering the participant’s experiences with and perceptions of telemedicine. Descriptive statistics were used to depict responses. Responses were compared among regions.

Results:

485 spine surgeons participated in the survey. Telemedicine usage rose from <10.0% to >39.0% of all visits. A majority of providers (60.5%) performed at least one telemedicine visit. The format of “telemedicine” varied widely by region: European (50.0%) and African (45.2%) surgeons were more likely to use phone calls, whereas North (66.7%) and South American (77.0%) surgeons more commonly used video ( P < 0.001). North American providers used telemedicine the most during COVID-19 (>60.0% of all visits). 81.9% of all providers “agreed/strongly agreed” telemedicine was easy to use. Respondents tended to “agree” that imaging review, the initial appointment, and postoperative care could be performed using telemedicine. Almost all (95.4%) surgeons preferred at least one in-person visit prior to the day of surgery.

Conclusion:

Our study noted significant geographical differences in the rate of telemedicine adoption and the platform of telemedicine utilized. The results suggest a significant increase in telemedicine utilization, particularly in North America. Spine surgeons found telemedicine feasible for imaging review, initial visits, and follow-up visits although the vast majority still preferred at least one in-person preoperative visit.
Temporal Trends and Severity in Injury and Illness Incidence in the National Basketball Association Over 11 Seasons
Authors: Bullock Garrett S. , Ferguson Tyler , Vaughan Jake , Gillespie Desiree , Collins Gary , Kluzek Stefan
Published: June 2021

Background:

There is a paucity of current data describing injuries in professional basketball players. Utilizing publicly available injury data will allow for greater transparency for stakeholders to use the data as a shared resource to create future basketball injury prevention programs.

Purpose:

To describe injury and illness incidence, severity, and temporal trends in National Basketball Association (NBA) players. Among those who develop time-loss injury or illness, we estimated severity based on games missed because of injury or illness.

Study Design:

Descriptive epidemiology study.

Methods:

Publicly available NBA data were extracted through a reproducible computer-programmed process from the 2008 to 2019 seasons. Data were externally validated by 2 independent reviewers through other publicly available data sources. Injury and illness were calculated per 1000 athlete game-exposures (AGEs). Injury severity was calculated as games missed because of injury or illness. Injury and illness data were stratified by body part, position, severity (slight, minor, moderate, or severe), month, and year.

Results:

A total of 1369 players played a total of 302,018 player-games, with a total of 5375 injuries and illnesses. The overall injury and illness incidence was 17.80 per 1000 AGEs. The median injury severity was 3 games (interquartile range, 0-6 games) missed per injury. Overall, 33% of injuries were classified as slight; 26%, as minor; 26%, as moderate; and 15%, as severe. The ankle (2.57 injuries/1000 AGEs), knee (2.44 injuries/1000 AGEs), groin/hip/thigh (1.99 injuries/1000 AGEs), and illness (1.85 illnesses/1000 AGEs) had the greatest incidence of injury and illness. Neither injury or illness incidence nor severity was different among basketball playing positions. Injury incidence demonstrated increasing incremental trends with season progression. Injuries were similar throughout the 11-year reporting period, except for a substantial increase in the lockout-shortened 2012 season.

Conclusion:

The ankle and knee had the greatest injury incidence. Injury incidence was similar among basketball positions. Injury incidence increased throughout the season, demonstrating the potential relationship between player load and injury incidence.
Association of Sports Participation With Osteoarthritis: A Systematic Review and Meta-Analysis
Authors: Bestwick-Stevenson Thomas , Ifesemen Onosi S. , Pearson Richard G. , Edwards Kimberley L.
Published: June 2021

Background:

The association between participating in sport and osteoarthritis is not fully understood.

Purpose:

To investigate the association between osteoarthritis and participating in sports not listed in previous reviews: American football, archery, baseball, bobsleigh, curling, handball, ice hockey, shooting, skeleton, speed skating, and wrestling.

Study Design:

Systematic review; Level of evidence, 3.

Methods:

We searched 4 electronic databases and hand searched recent/in-press editions of relevant journals. The criteria for study selection were case-control studies, cohort studies, nested case-control studies, and randomized trials with a control group that included adults to examine the effect of exposure to any of the included sports on the development of osteoarthritis.

Results:

The search returned 6197 articles after deduplication. Nine studies were included in the final review, covering hip, knee, and ankle osteoarthritis. There were no studies covering archery, baseball, skeleton, speed skating, or curling. The 6 sports included in the review were analyzed as a collective; the results of the meta-analysis indicated that participation in the sports analyzed was associated with an increased risk of developing osteoarthritis of the hip (relative risk [RR] = 1.67 [95% confidence interval (CI), 1.15-2.41]; P = .04), knee (RR = 1.60 [95% CI, 1.23-2.08]; P < .001), and ankle (RR = 7.08 [95% CI, 1.24-40.51]; P = .03) as compared with controls. Meta-analysis suggested a significantly increased likelihood of developing hip osteoarthritis through participating in wrestling (RR = 1.78 [95% CI, 1.20-2.64]; P = .004) and ice hockey (RR = 1.70 [95% CI, 1.27-2.29]; P < .001), while there was no significant difference through participating in handball (RR = 2.50 [95% CI, 0.85-7.36]; P = .10). Likelihood of developing knee osteoarthritis was significantly increased in wrestling (RR = 2.22 [95% CI, 1.59-3.11]) and ice hockey (RR = 1.52 [95% CI, 1.18-1.96]; both P < .002). According to the meta-analysis, shooting did not have a significant effect on the RR of knee osteoarthritis as compared with other sports (RR = 0.43 [95% CI, 0.06-2.99]; P = .39).

Conclusion:

The likelihood of developing hip and knee osteoarthritis was increased for ice hockey and wrestling athletes, and the risk of developing hip osteoarthritis was increased for handball athletes. The study also found that participation in the sports examined, as a collective, resulted in an increased risk of developing hip, knee, and ankle osteoarthritis.
Earth in practice: Uncertainty, expertise and the expected Istanbul earthquake
Authors: Kayaalp Ebru , Arslan Onur
Published: June 2021

In 1999, two devastating earthquakes occurred in Northwestern Turkey, which claimed around 18,000 lives. Since the disaster, many scientific studies and projects, both international and national, have been conducted, concluding that another earthquake at the magnitude of at least six will hit Istanbul. Even though there is a consensus among scientists that an earthquake will happen in Istanbul, there is a plethora of different theories and arguments about the anticipated earthquake. This paper is an historical account of how different technoscientific practices have enacted different North Anatolian Faults stretching across Anatolia and Marmara Sea. The multiplicity of the fault does not emerge as an epistemic problem of having different perspectives, but it is an ontological question of how plural realities are being made in different scientific practices. We argue that scientific uncertainties emerge when these different faults do not fit together in technoscientific circles and across public venues.
Experimental study on drilling characteristics of the hybrid sisal–jute fibre epoxy composites
Authors: Singh Harpreet , Dewangan Bhishm , Jain P. K.
Published: June 2021

Natural fibre composites have received worldwide attention due to their good mechanical properties, lightweight and low density. Due to these advantages, the natural fibre composites have been used in various engineering applications. Drilling is one of the most frequent machining operations performed on hybrid sisal–jute polymer composites, to assemble the numerous structural components by using mechanical joining process. Furthermore, the machining of fibre reinforced composite material has attracted several researchers because of its non-homogeneous and anisotropic structure. The present research work concerns with the experimental studies on the drilling process of hybrid sisal–jute epoxy composite, using three different types of drill geometry (twist drill, step drill and core drill). The significance of the current work aims to reveal the effect of drill geometry configuration and drilling parameters in terms of drilling-induced force and damages (delamination and surface roughness) for the drilling of hybrid natural fibre composites. Drilling forces, drilling-induced damages and hole quality attributes were experimentally investigated for different drill geometries. The delamination and surface roughness type damages are revealed by microscopic analysis with the help of scanning electron microscope (SEM). The results show that twist drill is best suited for the hole- and force-induced damages.
A Process Evaluation of a Youth-Led Sexual Violence Prevention Initiative
Authors: Waterman Emily A. , Hutchison Courtney A. , Edwards Katie M. , Hopfauf Skyler L. , Simon Briana , Banyard Victoria L.
Published: June 2021

One promising strategy to prevent sexual violence (SV) is to involve youth as leaders in developing prevention initiatives. Few peer-led prevention initiatives have been evaluated; thus, it is particularly important to examine the implementation of such programs in process evaluations. This article describes a process evaluation of a youth-led, community-based SV prevention initiative. Our aims were to (a) track the number and timing of prevention initiative events, (b) assess perceptions of the initiative among youth in the community, (c) evaluate perceived benefits and drawbacks of the initiative among youth who attended events, and (d) explore perceptions of the initiative’s impact among highly involved youth. We used data from multiple sources (i.e., implementation tracking, surveys with youth, semi-structured interviews) and from multiple types of youth (i.e., youth in the general population, youth who attended programming events, and youth who were highly involved, such as completing an internship). The program was highly acceptable to youth. They reported gaining both SV prevention skills (e.g., bystander skills) and more general skills (e.g., leadership, communication) through involvement with the initiative. We identified several key features that contributed to the success of events, such as a supportive and non-judgmental environment, content that felt useful to youth, and time for interaction with peers. However, some challenges such as negative peer behavior at events emerged as potential pitfalls of the initiative. These insights can be used by researchers and practitioners to further develop and refine peer-led prevention initiatives.
PRC2 loss of function confers a targetable vulnerability to BET proteins in T-ALL
Authors: Andrieu Guillaume P. , Kohn Milena , Simonin Mathieu , Smith Charlotte L. , Cieslak Agata , Dourthe Marie-Émilie , Charbonnier Guillaume , Graux Carlos , Huguet Françoise , Lhéritier Véronique , Dombret Hervé , Spicuglia Salvatore , Rousselot Philippe , Boissel Nicolas , Asnafi Vahid
Published: June 2021

T-cell acute lymphoblastic leukemia (T-ALL) is a group of aggressive hematological cancers with dismal outcomes that are in need of new therapeutic options. Polycomb repressor complex 2 (PRC2) loss-of-function alterations were reported in pediatric T-ALL, yet their clinical relevance and functional consequences remain elusive. Here, we extensively analyzed PRC2 alterations in a large series of 218 adult T-ALL patients. We found that PRC2 genetic lesions are frequent events in T-ALL and are not restricted to early thymic precursor ALL. PRC2 loss of function associates with activating mutations of the IL7R/JAK/STAT pathway. PRC2-altered T-ALL patients respond poorly to prednisone and have low bone marrow blast clearance and persistent minimal residual disease. Furthermore, we identified that PRC2 loss of function profoundly reshapes the genetic and epigenetic landscapes, leading to the reactivation of stem cell programs that cooperate with bromodomain and extraterminal (BET) proteins to sustain T-ALL. This study identifies BET proteins as key mediators of the PRC2 loss of function-induced remodeling. Our data have uncovered a targetable vulnerability to BET inhibition that can be exploited to treat PRC2-altered T-ALL patients.
Clinical relevance of clonal hematopoiesis in persons aged ≥80 years
Authors: Rossi Marianna , Meggendorfer Manja , Zampini Matteo , Tettamanti Mauro , Riva Emma , Travaglino Erica , Bersanelli Matteo , Mandelli Sara , Antonella Galbussera Alessia , Mosca Ettore , Saba Elena , Chiereghin Chiara , Manes Nicla , Milanesi Chiara , Ubezio Marta , Morabito Lucio , Peano Clelia , Soldà Giulia , Asselta Rosanna , Duga Stefano , Selmi Carlo , De Santis Maria , Malik Karolina , Maggioni Giulia , Bicchieri Marilena , Campagna Alessia , Tentori Cristina A. , Russo Antonio , Civilini Efrem , Allavena Paola , Piazza Rocco , Corrao Giovanni , Sala Claudia , Termanini Alberto , Giordano Laura , Detoma Paolo , Malabaila Aurelio , Sala Luca , Rosso Stefano , Zanetti Roberto , Saitta Claudia , Riva Elena , Condorelli Gianluigi , Passamonti Francesco , Santoro Armando , Sole Francesc , Platzbecker Uwe , Fenaux Pierre , Bolli Niccolò , Castellani Gastone , Kern Wolfgang , Vassiliou George S. , Haferlach Torsten , Lucca Ugo , Della Porta Matteo G.
Published: June 2021

Clonal hematopoiesis of indeterminate potential (CHIP) is associated with increased risk of cancers and inflammation-related diseases. This phenomenon becomes common in persons aged ≥80 years, in whom the implications of CHIP are not well defined. We performed a mutational screening in 1794 persons aged ≥80 years and investigated the relationships between CHIP and associated pathologies. Mutations were observed in one-third of persons aged ≥80 years and were associated with reduced survival. Mutations in JAK2 and splicing genes, multiple mutations (DNMT3A, TET2, and ASXL1 with additional genetic lesions), and variant allele frequency ≥0.096 had positive predictive value for myeloid neoplasms. Combining mutation profiles with abnormalities in red blood cell indices improved the ability of myeloid neoplasm prediction. On this basis, we defined a predictive model that identifies 3 risk groups with different probabilities of developing myeloid neoplasms. Mutations in DNMT3A, TET2, ASXL1, or JAK2 were associated with coronary heart disease and rheumatoid arthritis. Cytopenia was common in persons aged ≥80 years, with the underlying cause remaining unexplained in 30% of cases. Among individuals with unexplained cytopenia, the presence of highly specific mutation patterns was associated with myelodysplastic-like phenotype and a probability of survival comparable to that of myeloid neoplasms. Accordingly, 7.5% of subjects aged ≥80 years with cytopenia had presumptive evidence of myeloid neoplasm. In summary, specific mutational patterns define different risk of developing myeloid neoplasms vs inflammatory-associated diseases in persons aged ≥80 years. In individuals with unexplained cytopenia, mutational status may identify those subjects with presumptive evidence of myeloid neoplasms.
RNAseq and quantitative proteomic analysis of Dictyostelium knock-out cells lacking the core autophagy proteins ATG9 and/or ATG16
Authors: Xiong Qiuhong , Song Ning , Li Ping , Fischer Sarah , Konertz Roman , Wagle Prerana , Glöckner Gernot , Wu Changxin , Eichinger Ludwig
Published: June 2021

Background

Autophagy is an evolutionary ancient mechanism that sequesters substrates for degradation within autolysosomes. The process is driven by many autophagy-related (ATG) proteins, including the core members ATG9 and ATG16. However, the functions of these two core ATG proteins still need further elucidation. Here, we applied RNAseq and tandem mass tag (TMT) proteomic approaches to identify differentially expressed genes (DEGs) and proteins (DEPs) in Dictyostelium discoideum ATG9‾, ATG16‾ and ATG9‾/16‾ strains in comparison to AX2 wild-type cells.

Result

In total, we identified 332 (279 up and 53 down), 639 (487 up and 152 down) and 260 (114 up and 146 down) DEGs and 124 (83 up and 41 down), 431 (238 up and 193 down) and 677 (347 up and 330 down) DEPs in ATG9‾, ATG16‾ and ATG9‾/16‾ strains, respectively. Thus, in the single knock-out strains, the number of DEGs was higher than the number of DEPs while in the double knock-out strain the number of DEPs was higher. Comparison of RNAseq and proteomic data further revealed, that only a small proportion of the transcriptional changes were reflected on the protein level. Gene ontology (GO) analysis revealed an enrichment of DEPs involved in lipid metabolism and oxidative phosphorylation. Furthermore, we found increased expression of the anti-oxidant enzymes glutathione reductase (gsr) and catalase A (catA) in ATG16‾ and ATG9‾/16‾ cells, respectively, indicating adaptation to excess reactive oxygen species (ROS).

Conclusions

Our study provides the first combined transcriptome and proteome analysis of ATG9‾, ATG16‾ and ATG9‾/16‾ cells. Our results suggest, that most changes in protein abundance were not caused by transcriptional changes, but were rather due to changes in protein homeostasis. In particular, knock-out of atg9 and/or atg16 appears to cause dysregulation of lipid metabolism and oxidative phosphorylation.
Aspergillus flavus induced oxidative stress and immunosuppressive activity in Spodoptera litura as well as safety for mammals
Authors: Kaur Mandeep , Chadha Pooja , Kaur Sanehdeep , Kaur Amarjeet
Published: June 2021

Background

In the last few decades, considerable attention has been paid to entomopathogenic fungi as biocontrol agents, however little is known about their mode of action and safety. This study aimed to investigate the toxicity ofAspergillus flavusin insectSpodoptera lituraby analyzing the effect of fungal extract on antioxidant and cellular immune defense. In antioxidant defense, the lipid peroxidation (Malondialdehyde content) and antioxidant enzymes activities (Catalase, Ascorbate peroxidase, Superoxide dismutase) were examined. In cellular immune defense, effect ofA. flavusextract was analyzed on haemocytes using Scanning Electron Microscopy (SEM). Furthermore, mammalian toxicity was analyzed with respect to DNA damage induced in treated rat relative to control by comet assay using different tissues of rat (blood, liver, and kidney).

Results

Ethyl acetate extract ofA. flavuswas administrated to the larvae ofS.liturausing artificial diet method having concentration 1340.84 μg/ml (LC50of fungus). The effect was observed using haemolymph of insect larvae for different time intervals (24, 48, 72 and 96). In particular, Malondialdehyde content and antioxidant enzymes activities were found to be significantly (p ≤ 0.05) increased in treated larvae as compared to control.A. flavusethyl acetate extract also exhibit negative impact on haemocytes having major role in cellular immune defense. Various deformities were observed in different haemocytes like cytoplasmic leakage and surface abnormalities etc. Genotoxicity on rat was assessed using different tissues of rat (blood, liver, and kidney) by comet assay. Non-significant effect ofA. flavusextract was found in all the tissues (blood, liver, and kidney).

Conclusions

Overall the study provides important information regarding the oxidative stress causing potential and immunosuppressant nature ofA. flavusagainstS. lituraand its non toxicity to mammals (rat), mammals (rat), suggesting it an environment friendly pest management agent.
Memantine ameliorates cognitive deficit in AD mice via enhancement of entorhinal–CA1 projection
Authors: Li Peng , Xu Jin , Gu Huanhuan , Peng Hua , Yin You , Zhuang Jianhua
Published: June 2021

Background

Memantine, a low- to moderate-affinity uncompetitive N-methyl-D-aspartate receptor antagonist, has been shown to improve cognitive functions in animal models of Alzheimer’s disease (AD). Here we treated APP/PS1 AD mice with a therapeutic dose of memantine (20 mg/kg/day) and examined its underlying mechanisms in ameliorating cognitive defects.

Methods

Using behavioral, electrophysiological, optogenetic and morphology approaches to explore how memantine delay the pathogenesis of AD.

Results

Memantine significantly improved the acquisition in Morris water maze (MWM) in APP/PS1 mice without affecting the speed of swimming. Furthermore, memantine enhanced EC to CA1 synaptic neurotransmission and promoted dendritic spine regeneration of EC neurons that projected to CA1.

Conclusions

Our study reveals the underlying mechanism of memantine in the treatment of AD mice.
Evidence-based oral antiplatelet therapy among hospitalized Chinese patients with acute myocardial infarction: results from the Chinese acute myocardial infarction registry
Authors: Tang Xiaofang , Liu Lifu , Yang Jingang , Gao Zhan , Zhao Xueyan , Qiao Shubin , Gao Runlin , Wang Zhifang , Yuan Jinqing , Yang Yuejin
Published: June 2021

Background

Oral antiplatelet therapy is the cornerstone of treatment for acute myocardial infaction (AMI). However, detailed usage data on oral antiplatelet therapy are lacking.

Methods

Using data from a nationally representative sample of patients with AMI, the detailed usage of oral antiplatelet therapy was analyzed in 40,202 consecutive eligible patients.

Results

The proportions of patients with AMI taking loading doses of aspirin and P2Y12 inhibitors were relatively low (62.2% and 63.6%, respectively), whereas approximately 90% of patients received maintenance doses of aspirin, P2Y12 inhibitors, and dual antiplatelet therapy. The proportions of patients taking loading doses of aspirin and P2Y12 inhibitors gradually decreased with age. Male sex, an educational level of at least college, an interval from onset to treatment of < 24 h, and primary PCI use were associated with a higher proportion of patients taking a loading dose of antiplatelet therapy, whereas those receiving conservative treatment had a lower rate of antiplatelet use (all P < 0.05). The proportion of patients taking loading doses of aspirin was highest in the western region, and that of patients taking loading doses of P2Y12 inhibitors was highest in the eastern region (P < 0.05). In addition, 76.7% of patients with ST-elevation MI and 91% of patients with non-ST-elevation MI received 300-mg loading dose of clopidogrel.

Conclusions

The proportion of patients with AMI receiving loading doses of aspirin and P2Y12 inhibitors during hospitalization was relatively low, and this rate was affected by many factors, such as age, sex, educational level, region of residence, and the interval from onset to treatment. The underutilization of guideline-based P2Y12 inhibitors was also problematic. Hence, quality improvement initiatives are needed to enhance adherence to guidelines to improve consistent use of oral antiplatelet therapy.

Trial registration The Chinese Acute Myocardial Infarction Registry; Trial registration number: ChiCTR-ONC-12002636; Registered 31 October 2012; http://www.chictr.org.cn/showproj.aspx?proj=6916
Association analysis of maternal MTHFR gene polymorphisms and the occurrence of congenital heart disease in offspring
Authors: Sun Mengting , Wang Tingting , Huang Peng , Diao Jingyi , Zhang Senmao , Li Jinqi , Luo Liu , Li Yihuan , Chen Letao , Liu Yiping , Wei Jianhui , Song Xinli , Sheng Xiaoqi , Qin Jiabi
Published: June 2021

Background

Although many studies showed that the risk of congenital heart disease (CHD) was closely related to genetic factors, the exact pathogenesis is still unknown. Our study aimed to comprehensively assess the association of single nucleotide polymorphisms (SNPs) of maternal MTHFR gene with risk of CHD and its three subtypes in offspring.

Methods

A case–control study involving 569 mothers of CHD cases and 652 health controls was conducted. Thirteen SNPs were detected and analyzed.

Results

Our study showed that genetic polymorphisms of maternal MTHFR gene at rs4846052 and rs1801131 were significantly associated with risk of CHD in the homozygote comparisons (TT vs. CC at rs4846052: OR = 7.62 [95%CI 2.95–19.65]; GG vs. TT at rs1801131: OR = 5.18 [95%CI 2.77–9.71]). And six haplotypes of G–C (involving rs4846048 and rs2274976), A–C (involving rs1801133 and rs4846052), G–T (involving rs1801133 and rs4846052), G–T–G (involving rs2066470, rs3737964 and rs535107), A–C–G (involving rs2066470, rs3737964 and rs535107) and G–C–G (involving rs2066470, rs3737964 and rs535107) were identified to be significantly associated with risk of CHD. Additionally, we observed that a two-locus model involving rs2066470 and rs1801131 as well as a three-locus model involving rs227497, rs1801133 and rs1801131 were significantly associated with risk of CHD in the gene–gene interaction analyses. For three subtypes including atrial septal defect, ventricular septal defect and patent ductus arteriosus, similar results were observed.

Conclusions

Our study indicated genetic polymorphisms of maternal MTHFR gene were significantly associated with risk of fetal CHD in the Chinese population. Additionally, there were significantly interactions among different SNPs on risk of CHD. However, how these SNPs affect the development of fetal heart remains unknown, and more studies in different ethnic populations and with a larger sample are required to confirm these findings.
Conditions and barriers for quality improvement work: a qualitative study of how professionals and health centre managers experience audit and feedback practices in Swedish primary care
Authors: Arvidsson Eva , Dahlin Sofia , Anell Anders
Published: June 2021

Background

High quality primary care is expected to be the basis of many health care systems. Expectations on primary care are rising as societies age and the burden of chronic disease grows. To stimulate adherence to guidelines and quality improvement, audit and feedback to professionals is often used, but the effects vary. Even with carefully designed audit and feedback practices, barriers related to contextual conditions may prevent quality improvement efforts. The purpose of this study was to explore how professionals and health centre managers in Swedish primary care experience existing forms of audit and feedback, and conditions and barriers for quality improvement, and to explore views on the future use of clinical performance data for quality improvement.

Methods

We used an explorative qualitative design. Focus groups were conducted with health centre managers, physicians and other health professionals at seven health centres. The interviews were audio recorded, transcribed and analysed using qualitative content analysis.

Results

Four different types of audit and feedback that regularly occurred at the health centres were identified. The main part of the audit and feedback was “external”, from the regional purchasers and funders, and from the owners of the health centres. This audit and feedback focused on non-clinical measures such as revenues, utilisation of resources, and the volume of production. The participants in our study did not perceive that existing audit and feedback practices contributed to improved quality in general. This, along with lack of time for quality improvement, lack of autonomy and lack of quality improvement initiatives at the system (macro) level, were considered barriers to quality improvement at the health centres.

Conclusions

Professionals and health centre managers did not experience audit and feedback practices and existing conditions in Swedish primary care as supportive of quality improvement work. From a professional perspective, audit and feedback with a focus on clinical measures, as well as autonomy for professionals, are necessary to create motivation and space for quality improvement work. Such initiatives also need to be supported by quality improvement efforts at the system (macro) level, which favour transformation to a primary care based system.
Oral status of older people in medium to long-stay health and social care setting: a systematic review
Authors: Ruiz-Roca Juan Antonio , Fuentes Dora Martín , Gómez García Francisco J. , Martínez-Beneyto Yolanda
Published: June 2021

Background

Older patients who spend long periods hospitalized or those who are in a situation of institutionalization represent a risk group in this regard, as many of them suffer a degree of dependence and need help to perform the basic tasks of personal care. It is therefore important to learn more of the oral health status of this group of patients in order to make a proper assessment of the situation and to develop protocols for its management. The purpose of the study was to conduct a systematic review to ascertain the oral health status of older people patients admitted to institutions or hospitalized for a long period of time.

Methods

a systematic review of the literature published in two different databases (PubMed, Embase and Cochrane Library) was carried out, with 12 different combinations of keywords based on the following selection criteria: studies published in the last 5 years, in English and/or Spanish and/or Portuguese, with samples of ≥30 patients, performed in patients older than 65 years, admitted to any type of institution and/or hospital center for at least 7 days and in which the state of hard and/or soft tissues of the oral cavity were evaluated in some way. The selected articles were subjected to a thorough analysis.

Results

The search strategy covered 1.014 articles: 689 from Pubmed and 325 from Cochrane Library. After applying the eligibility criteria, five articles were selected for our review. The level of evidence of the articles was, a sample of 773 patients most of them were women with an average age older than 70 years old.

Conclusions

The oral health of patients aged more than 65 is worse than that of the rest population. Long hospital stays or being institutionalized in a residence makes this group susceptible to a worsening of their oral health status. It is necessary to develop protocols for the oral health care of these patients, accompanied by training programs for the personnel responsible.
Short-term and long-term safety and efficacy of tenofovir alafenamide, tenofovir disoproxil fumarate and entecavir treatment of acute-on-chronic liver failure associated with hepatitis B
Authors: Li Juan , Hu Chunhua , Chen Yi , Zhang Rou , Fu Shan , Zhou Mimi , Gao Zhijie , Fu Mengjun , Yan Taotao , Yang Yuan , Li Jianzhou , Liu Jinfeng , Chen Tianyan , Zhao Yingren , He Yingli
Published: June 2021

Background & Aims

There is limited evidence on the efficacy and safety of nucleos(t) ide analogues (NAs) in the treatment of HBV-ACLF. Our objective was to evaluate the outcomes among TAF, TDF and ETV, three first-line antivirals against chronic hepatitis B, in patients with HBV-ACLF.

Methods

Patients with HBV-related ACLF were recruited and received daily TAF (25 mg/d), TDF (300 mg/d) and ETV (0.5 mg/d). They were prospectively followed-up. The primary endpoint was overall survival at week 12 and week 48, the secondary endpoints were virological response and biochemical response.

Results

Forty gender and age matched eligible subjects were recruited and divided into three groups: TAF group, TDF group and ETV group. By week 48, 8 (80%) patients in TAF group, 6 (60%) patients in TDF group and 17 (85%) patients in ETV group survived without liver transplantation (P = 0.251). After 4 weeks of NAs treatment, all three groups showed paralleling reduction of HBV DNA levels. All three groups presented similar biochemical responses at week 4, patients treated with TAF showed a priority in total bilirubin reduction, albumin and cholesterol maintenance. Additionally, although there was no significant difference in changes of serum urea, serum creatinine, serum cystatin C and estimated GFR among the three groups by treatment week 4, TDF showed unfavorable renal safety even in short -term treatment. The treatment using NAs was well-tolerated and there was no serious drug-related adverse event reported.

Conclusions

TAF, TDF and ETV are of similar efficacy and safety in short-term and long-term treatment of HBV-ACLF.

Trial registration

This study is ongoing and is registered with ClinicalTrials.gov, NCT03640728 (05/02/2019).
Clinical and experimental phenotype of azole-resistant Aspergillus fumigatus with a HapE splice site mutation: a case report
Authors: Ito Yuya , Takazono Takahiro , Koga Satoru , Nakano Yuichiro , Ashizawa Nobuyuki , Hirayama Tatsuro , Tashiro Masato , Saijo Tomomi , Yamamoto Kazuko , Imamura Yoshifumi , Miyazaki Taiga , Yanagihara Katsunori , Izumikawa Koichi , Mukae Hiroshi
Published: June 2021

Background

The recent increase in cases of azole-resistant Aspergillus fumigatus (ARAf) infections is a major clinical concern owing to its treatment limitations. Patient-derived ARAf occurs after prolonged azole treatment in patients with aspergillosis and involves various cyp51A point mutations or non-cyp51A mutations. The prognosis of patients with chronic pulmonary aspergillosis (CPA) with patient-derived ARAf infection remains unclear. In this study, we reported the case of a patient with ARAf due to HapE mutation, as well as the virulence of the isolate.

Case presentation

A 37-year-old male was presented with productive cough and low-grade fever. The patient was diagnosed with CPA based on the chronic course, presence of a fungus ball in the upper left lobe on chest computed tomography (CT), positivity for Aspergillus-precipitating antibody and denial of other diseases. The patient underwent left upper lobe and left S6 segment resection surgery because of repeated haemoptysis during voriconazole (VRC) treatment. The patient was postoperatively treated with VRC for 6 months. Since then, the patient was followed up without antifungal treatment but relapsed 4 years later, and VRC treatment was reinitiated. Although an azole-resistant isolate was isolated after VRC treatment, the patient did not show any disease progression in either respiratory symptoms or radiological findings. The ARAf isolated from this patient showed slow growth, decreased biomass and biofilm formation in vitro, and decreased virulence in the Galleria mellonella infection model compared with its parental strain. These phenotypes could be caused by the HapE splice site mutation.

Conclusions

This is the first to report a case demonstrating the clinical manifestation of a CPA patient infected with ARAf with a HapE splice site mutation, which was consistent with the in vitro and in vivo attenuated virulence of the ARAf isolate. These results imply that not all the ARAf infections in immunocompetent patients require antifungal treatment. Further studies on the virulence of non-cyp51A mutations in ARAf are warranted.
Antibiotic prescriptions and risk factors for antimicrobial resistance in patients hospitalized with urinary tract infection: a matched case-control study using the French health insurance database (SNDS)
Authors: Opatowski Marion , Brun-Buisson Christian , Touat Mehdi , Salomon Jérôme , Guillemot Didier , Tuppin Philippe , Watier Laurence
Published: June 2021

Background

Antibiotic resistance is increasing among urinary pathogens, resulting in worse clinical and economic outcomes. We analysed factors associated with antibiotic-resistant bacteria (ARB) in patients hospitalized for urinary tract infection, using the comprehensive French national claims database.

Methods

Hospitalized urinary tract infections were identified from 2015 to 2017. Cases (due to ARB) were matched to controls (without ARB) according to year, age, sex, infection, and bacterium. Healthcare-associated (HCAI) and community-acquired (CAI) infections were analysed separately; logistic regressions were stratified by sex.

Results

From 9460 cases identified, 6468 CAIs and 2855 HCAIs were matched with controls. Over a 12-months window, the risk increased when exposure occurred within the last 3 months. The following risk factors were identified: antibiotic exposure, with an OR reaching 3.6 [2.8–4.5] for men with CAI, mostly associated with broad-spectrum antibiotics; surgical procedure on urinary tract (OR 2.0 [1.5–2.6] for women with HCAI and 1.3 [1.1–1.6] for men with CAI); stay in intensive care unit > 7 days (OR 1.7 [1.2–2.6] for men with HCAI). Studied co-morbidities had no impact on ARB.

Conclusions

This study points out the critical window of 3 months for antibiotic exposure, confirms the impact of broad-spectrum antibiotic consumption on ARB, and supports the importance of prevention during urological procedures, and long intensive care unit stays.
Utilizing single-cell RNA sequencing for analyzing the characteristics of PBMC in patients with Kawasaki disease
Authors: Fan Xue , Zhou Yuhan , Guo Xin , Xu Mingguo
Published: June 2021

Background

Kawasaki disease (KD) is the main cause of acquired heart disease in children and can lead to coronary artery lesions. This present study was designed to analyze the characteristics of KD peripheral blood mononuclear cells (PBMC) through single-cell RNA sequencing (scRNA-seq) and to explore the potential molecular mechanism of KD.

Methods

PBMC was collected from one healthy child and one KD patient, and was used to single-cell RNA sequencing for cell clusters identification and differently expressed gene (DEG) determination. GO function enrichment analysis of DEG in B cell and T cells were performed to explore the most active biological function in KD immune cells.

Results

Twelve cell clusters can be identified in two samples. Compared with healthy child, naive CD8+ T cell, T helper cell and B cell in KD child were decreased, mainly immune-related T cells, and natural killer T (NKT) cell were increased. Cell activation, lymphocyte activation and regulation of immune system process were 3 GO function shared by all four types of T cells and B cell.

Conclusions

Immune cell disorder appears in the KD patient at single cell level by scRNA-seq.
COVID-19 uncertainty and sleep: the roles of perceived stress and intolerance of uncertainty during the early stage of the COVID-19 outbreak
Authors: Wu Dan , Yang Tingzhong , Hall Daniel L. , Jiao Guihua , Huang Lixin , Jiao Can
Published: June 2021

Background

The COVID-19 pandemic brings unprecedented uncertainty and stress. This study aimed to characterize general sleep status among Chinese residents during the early stage of the outbreak and to explore the network relationship among COVID-19 uncertainty, intolerance of uncertainty, perceived stress, and sleep status.

Methods

A cross-sectional correlational survey was conducted online. A total of 2534 Chinese residents were surveyed from 30 provinces, municipalities, autonomous regions of China and regions abroad during the period from February 7 to 14, 2020, the third week of lockdown. Final valid data from 2215 participants were analyzed. Self-report measures assessed uncertainty about COVID-19, intolerance of uncertainty, perceived stress, and general sleep status. Serial mediation analysis using the bootstrapping method and path analysis were applied to test the mediation role of intolerance of uncertainty and perceived stress in the relationship between uncertainty about COVID-19 and sleep status.

Results

The total score of sleep status was 4.82 (SD = 2.72). Age, place of residence, ethnicity, marital status, infection, and quarantine status were all significantly associated with general sleep status. Approximately half of participants (47.1%) reported going to bed after 12:00 am, 23.0% took 30 min or longer to fall asleep, and 30.3% slept a total of 7 h or less. Higher uncertainty about COVID-19 was significantly positively correlated with higher intolerance of uncertainty (r = 0.506, p < 0.001). The mediation analysis found a mediating role of perceived stress in the relationship between COVID-19 uncertainty and general sleep status (β = 0.015, 95%C.I. = 0.009–0.021). However, IU was not a significant mediator of the relationship between COVID-19 uncertainty and sleep (β = 0.009, 95%C.I. = − 0.002–0.020). Moreover, results from the path analysis further showed uncertainty about COVID-19 had a weak direct effect on poor sleep (β = 0.043, p < 0.05); however, there was a robust indirect effect on poor sleep through intolerance of uncertainty and perceived stress.

Conclusions

These findings suggest that intolerance of uncertainty and perceived stress are critical factors in the relationship between COVID-19 uncertainty and sleep outcomes. Results are discussed in the context of the COVID-19 pandemic, and practical policy implications are also provided.