bluuebunny/crossref_metadata_2025 huggingface dataset:
Human Resource Development Should Aim to Make Closed Contexts More Open: A Meta Reaction to Wang and Doty, Russ-Eft, and Yoon
Authors: Poell Rob F.
Published: October 2022

In this meta reaction paper, I reflect on the initial paper by Wang and Doty (2022a), the two responses (Russ-Eft, 2022; Yoon, 2022), and the final response-to-respondents (Wang & Doty, 2022b). I focus on two observations that stood out for me, encompassing: (1) how HRD is defined; (2) what HRD should contribute to and to what extent the initial authors’ theorizing of HRD is actually “emancipatory.” First, I conclude that Wang and Doty’s systems perspective leaves little room for the individual agency and legitimate interests that various stakeholders have around the ways in which employee learning is organized. Connected with this, their treatment of “the mainstream HRD literature” is not convincing, which limits the rationale for and contribution of their own theorizing efforts. Second, I conclude that Wang and Doty’s work violates the ethical core of HRD and, moreover, falls short of being about “emancipatory theorizing” as they claim.
Negative Pressure Wound Therapy Promotes Wound Healing by Inhibiting Inflammation in Diabetic Foot Wounds: A Role for NOD1 Receptor
Authors: Wang Tao , Fan Longhua , Liu Jianjun , Tao Yue , Li Xu , Wang Xiaojun , Li Limeng
Published: October 2022

Aims: Diabetic foot results in frequent amputation and quality-of-life reduction in diabetes population. These lesions are featured by a prolonged and exaggerated inflammation with a significant impairment in local bacterial invasion. Negative pressure wound therapy (NPWT) attenuates hyperinflammation in the healing of diabetic foot wounds, but the potential mechanism of NPWT down-regulated inflammatory reaction still remains elusive. This study aims to explore the inflammatory signaling involved in the effect of NPWT on diabetic ulcer. Methods: Thirty patients with diabetic foot ulceration were divided into NPWT group (treated with NPWT, n = 10), NPWT + FK565 group (treated with NPWT combined with FK565 which is NOD1 receptor ligand, n = 10) and control group (n = 10). After two weeks treatment, samples were harvested and analyzed by histochemistry for infiltration of inflammatory cells, immunofluorescence stain for NOD1, western blotting for NOD1, RIP2 (Receptor interacting protein 2), IL-1β, TAK1 (Transforming growth factor-β-activated kinase1), p65 and real time-PCR for expression of NOD1 and RIP2. Results: NPWT could notably accelerate the diabetic wound healing through alleviating inflammatory reaction. The immunofluorescence analysis results revealed that NOD1 was mainly expressed in the cytoplasm and noticeably decreased after the NPWT treatment. And NPWT obviously decreased both the mRNA and protein level of NOD1 and RIP2. Moreover, The protein expression of IL-1β, TAK1 and p65 in the NPWT-group were significant decreased. Conclusion: NPWT effectively promotes wound healing by suppressing the wound inflammation in diabetic foot, which is mediated at least in part by suppression of NOD1 receptor.
A Stepwise Haemostasis Intraoperative Protocol Driven Reduction of Haematoma Rate Following Symptomatic Carotidendarterectomy
Authors: Baker Daryll M , Jacob Lebeth , Busuttil Andrew
Published: October 2022

Introduction

Carotid endarterectomy (CEA) for symptomatic stenosis reduces further stroke risk. Post-CEA haematoma increases the risk of complications including stroke. There are few studies considering protocols aimed at reducing post-CEA haematoma rates. Presented are the outcomes of a protocol developed to reduce this surgical complication.

Method

The protocol was implemented in 112 consecutive CEA. It involves stepwise additional measures to ensure haemostasis before wound closure. Attention to bleeding points is followed by light compression for 10 min. Protamine is then given if haemostasis has not been achieved. If after 20 min the problem persists Tranexamic acid is given. Following a further 20 min if haemostasis is not yet achieved a platelet transfusion is undertaken. Haematoma rates, return to theatre for post-operative haematoma and other complications were compared with 100 consecutive pre-protocol introduction CEA cases.

Results

Of 112 CEA patients, 19 received protamine, 8 protamine and tranexamic acid. One case required platelet transfusion. Neck haematoma rate fell from 10 to 3 cases ( P = .02, OR: 0.25 [95% CI .07-.94]), of which returned to theatre for haematoma evacuation fell from 6 to 1 case ( P = .03, OR: 0.14 [95% CI .02-1.19]). 30 day stroke and death rate reduced from 5% to 1.8% ( P = .11, OR: 0.35 [95% CI .07-1.82]).

Conclusion

The stepwise haemostasis intraoperative protocol can reduce post-CEA haematoma rates.
Study on relief grinding interference checking method of toroidal worm wheel hob
Authors: Rui Chengjie , Xu Jinyou , Zhang Yuhua
Published: October 2022

The cutting tooth density of the toroidal worm wheel hob affects the quality of the hobbed worm wheel surface. The more the number of the cutting teeth, the higher the accuracy of the hobbed worm wheel surfaces. However, if the tooth density is greater, it’s easier to cause the grinding wheel to interference with other cutting teeth when grinding the relief surfaces, and the structure of the adjacent cutting teeth will be damaged. Therefore, this paper studies the checking method of grinding interference of relief surfaces, and then puts forward a design method of the maximum cutting tooth density to avoid grinding interference. Based on the point contact generation method, a relief grinding method of the toroidal worm wheel hob is proposed, and the grinding motion model is established. By analyzing the grinding processes of each relief surface, the variation law of grinding interference is obtained, and the relief grinding checking method is established based on the defined interference angles. The maximum interference position is determined, and the maximum number of the cutting tooth to avoid grinding interference is obtained. The study provides the key theoretical basis for the precision manufacturing of the high-density complex toroidal worm wheel hob.
Reimagining accountability through educational leadership: Applying the metaphors of “agora” and “bazaar”
Authors: Kim Taeyeon
Published: October 2022

This study aims to explore reimagined accountability through collective efforts initiated by school leaders and to challenge the fixed notion of accountability prescribed by policy scripts. Drawing on studies highlighting humanizing leadership and the metaphors of “ agora” and “ bazaar,” I investigate how school leaders (re)construct and (re)define meanings of accountability in their daily practices. Using portraiture as research method, I analyze qualitative data collected through observation, interviews, and artifacts in a rural school in the United States, over the course of the 2018–2019 school year. In contrast to prevalent discourses around technical, performance-driven approaches to accountability, the principal and teachers in this portraiture illuminate a culture of accountability deeply rooted in care, respect, and shared responsibility to support students’ growth. This accountability space exemplifies student-centeredness, teachers’ professional agency, and belonging as community in the daily interactions and symbolic celebrations. I conclude this article by highlighting the importance of leadership in constructing school accountability by offering examples of habits of mind and practice to humanize school education. This research also extends policy enactment studies by exploring accountability portrayed in daily leadership practices.
Performative Feelings for Others: The Civil Repair of Organised Competitive Sports
Authors: Broch Trygve B
Published: October 2022

In many western nations, sport is an institutional component of civil society that may be considered from quite different outlooks. From the critical theorists’ viewpoint, sport reproduces social hierarchies through competition and then colonises our democratic life worlds. Scholars of civil society argue that sport actors manoeuvre civic relations and fend off anti-civil pressures to allow integration, belonging and collective decision-making. This article positions sport actors and audiences at the interstice between hierarchies and solidarity, amid competition and friendship. Using Civil Sphere Theory, I present a cultural sociology of performance that highlights how sport actors interpret the democratic character (or lack thereof) of their own and others’ sport actions. Drawing on eight months of participant field observations in Norwegian youth sport, I recreate an ethnographic tale of how coaches, players and spectators activate the civil sphere’s symbolic and affective codes for this purpose. This dramatic sequence of events, played out over the course of the season, shows how sport itself can be shaped by actors who bring the civil sphere to bear and make sport a facilitating input to the discourse of the Nordic civil sphere. This process, I conclude, is contingent on performances of the civil sphere that make sport a stage on which to display performative feelings for others. When sport actors challenge the divisive, hierarchal character of organised competition and carry out a civil repair of sport, they expand the limits of civil inclusion and momentarily create a sporting civil society.
Racial Disparities in Charges, Length of Stay, and Complications Following Adult Inpatient Epistaxis Treatment
Authors: Randhawa Avneet , Randhawa Karandeep S. , Tseng Christopher C. , Fang Christina H. , Baredes Soly , Eloy Jean Anderson
Published: October 2022

Background

Although recent studies have identified an association between race and adverse outcomes in head and neck surgeries, there are limited data examining the impact of racial disparities on adult inpatient outcomes following epistaxis management procedures.

Objective

To analyze the association between race and adverse outcomes in hospitalized patients undergoing epistaxis treatment.

Methods

This retrospective cohort analysis utilized the 2003 to 2014 National Inpatient Sample. International Classification of Diseases, Ninth Revision codes were used to identify cases with a primary diagnosis of epistaxis that underwent a procedure for epistaxis control. Cases with missing data were excluded. Higher total charges and prolonged length of stay (LOS) were indicated by values greater than the 75th percentile. Demographics, hospital characteristics, Elixhauser comorbidity score, and complications were compared among race cohorts using univariate chi-square analysis and one-way analysis of variance (ANOVA). The independent effect of race on adverse outcomes was analyzed using multivariate binary logistic regression while adjusting for the aforementioned variables.

Results

Of the 83 356 cases of epistaxis included, 80.3% were White, 12.5% Black, and 7.2% Hispanic. Black patients had increased odds of urinary/renal complications (odds ratio [OR] 2.148, 95% confidence interval [CI] 1.797-2.569, P < .001) compared to White patients. Additionally, Black patients experienced higher odds of prolonged LOS (OR 1.227, 95% CI 1.101-1.367, P < .001) and higher total charges (OR 1.257, 95% CI 1.109-1.426, P < .001) compared to White patients. Similarly, Hispanic patients were more likely to experience urinary/renal complications (OR 1.605, 95% CI 1.244-2.071, P < .001), higher total charges (OR 1.519, 95% CI 1.302-1.772, P < .001), and prolonged LOS (OR 1.157, 95% CI 1.007-1.331, P = .040) compared to White patients.

Conclusion

Race is an important factor associated with an increased incidence of complications in hospitalized patients treated for epistaxis.
A scoping review of feasibility, cost, access to rehabilitation services and implementation of telerehabilitation: Implications for low- and middle-income countries
Authors: Nizeyimana Eugene , Joseph Conran , Plastow Nicola , Dawood Gouwa , Louw Quinette A
Published: October 2022

Objective

To scope all published information reporting on the feasibility, cost, access to rehabilitation services, implementation processes including barriers and facilitators of telerehabilitation (TR) in low- and middle-income countries (LMICs) and high-income countries (HICs).

Methods

A comprehensive electronic search of PubMed, Scopus, PEDro, Cochrane library, EBSCOhost (Academic search premier, Africa-wide information, CINAHL, Eric, MEDLINE, Health sources - Nursing/Academic edition), Africa online, as well as ProQuest databases were conducted. To maximise the coverage of the literature, the reference lists of included articles identified through the search were also screened. The analysis included both descriptive summary and inductive thematic analysis.

Results

Twenty-nine studies were included. TR was reported to be feasible, cost-saving and improved access to rehabilitation services in both HICs and LMICs settings. Asynchronous methods using different mobile apps (Skype, WhatsApp, Google meet, Facebook messenger, Viber, Face time and Emails) were the most common mode of TR delivery. Barriers to the implementation were identified and categorised in terms of human, organisational, technical and clinical practice related factors. Facilitators for health professionals and patients/caregivers’ dyads were also identified.

Conclusion

TR could be considered a feasible service delivery mode in both HICs and LMICs. However, the mitigation of barriers such as lack of knowledge and technical skills among TR providers and service users, lack of secure platform dedicated for TR, lack of resources and connectivity issues which are particularly prevalent in LMICs will be important to optimise the benefits of TR.
Does Primary Care Availability Mediate the Relationship Between Rurality and Lower Life Expectancy in the United States?
Authors: Sharma Arjun , Basu Sanjay
Published: October 2022

Introduction:

Rural counties in the United States have lower life expectancy than their urban counterparts and comprise the majority of primary care provider (PCP) shortage areas. We evaluated whether PCP availability mediates the relationship between rurality and lower life expectancy.

Methods:

We performed a mediation analysis on a panel dataset which included county-level estimates (N = 3103) for the years 2010, 2015, and 2017, and on a subset containing only rural counties (N = 1973), with life expectancy as the outcome variable, urbanity as the independent variable, and PCP density as the mediating variable. County-level socio-demographic data were included as covariates.

Results and Conclusions:

PCP density mediated 10.1% of the relationship between urbanity and life expectancy in rural counties. Increasing PCP density in rural counties with PCP shortages to the threshold of being a non-shortage county (>1 physician/3500 population, as defined by the Health Resources and Services Administration) would be expected to increase mean life expectancy in the county by 26.1 days (95% confidence interval [CI]: 11.4, 49.3) and increasing it to the standards recommended by a Secretarial Negotiated Rulemaking Committee would be expected to increase mean life expectancy by 65.3 days (95% CI: 42.6, 87.5). PCP density is a meaningful mediator of the relationship between urbanity and life expectancy. The mediation effect observed was higher in rural counties compared to all counties. Understanding how PCP density may be increased in rural areas may be of benefit to rural life expectancy.
Obesity and Patient Activation: Confidence, Communication, and Information Seeking Behavior
Authors: Chang Ji Eun , Lindenfeld Zoe , Chang Virginia W.
Published: October 2022

Introduction/Objectives:

Patient activation describes the knowledge, skills, and confidence that allow patients to actively engage in managing their health. Prior studies have found a strong relationship between patient activation and clinical outcomes, costs of care, and patient experience. Patients who are obese or overweight may be less engaged than normal weight patients due to lower confidence or stigma associated with their weight. The objective of this study is to examine whether weight status is associated with patient activation and its sub-domains (confidence, communication, information-seeking behavior).

Methods:

This repeated cross-sectional study of the 2011 to 2013 Medicare Current Beneficiary Survey (MCBS) included a nationally representative sample of 13,721 Medicare beneficiaries. Weight categories (normal, overweight, obese) were based on body mass index. Patient activation (high, medium, low) was based on responses to the MCBS Patient Activation Supplement.

Results:

We found no differences in overall patient activation by weight categories. However, compared to those with normal weight, people with obesity had a higher relative risk (RRR 1.24; CI 1.09-1.42) of “low” rather than “high” confidence. Respondents with obesity had a lower relative risk (RRR 0.82; CI 0.73-0.92) of “low” rather than “high” ratings of communication with their doctor.

Discussion and Conclusions:

Though patients with obesity may be less confident in their ability to manage their health, they are more likely to view their communication with physicians as conducive to self-care management. Given the high receptivity among patients with obesity toward physician communication, physicians may be uniquely situated to guide and support patients in gaining the confidence they need to reach weight loss goals.
Retrospective Analysis of Ulnar Collateral Ligament Reconstructions in Major League Baseball Pitchers: A Comparison of the “Tall and Fall” Versus “Drop and Drive” Pitching Styles
Authors: Beaudry Mason F. , Beaudry Anna G. , Bradley James P. , Davis Scott , Baker Brent A. , Holland Glenn , Jacobson Bradley R. , Chetlin Robert D.
Published: October 2022

Background:

Previous pilot research has investigated differences in elbow valgus torque between the “tall and fall” (TF) and “drop and drive” (DD) pitching styles. Whether one of these pitching styles is associated with a greater rate of ulnar collateral ligament reconstruction (UCLR) is currently unknown.

Purpose:

To determine the proportion of Major League Baseball (MLB) pitchers using the TF and DD pitching styles who underwent UCLR over a 10-year period.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

The demographic characteristics of pitchers who underwent UCLR between 2007 and 2017 were obtained via the open-source database MLB Player Analysis Tommy John Surgery List. Other information, such as previous UCLR and pitching videos and graphics, was obtained from other open-source databases. A comprehensive, 2-dimensional, kinesiology-based multicomponent definition of each pitching style was formulated and used to categorize the included pitchers into the TF and DD groups. Statistical comparisons and contrasts were made using chi-square and Pearson correlation tests.

Results:

Included were 223 MLB pitchers (mean ± SD age, 27.5 ± 3.6 years; body mass index [BMI], 27.6 ± 2.2; throwing velocity, 92.9 ± 2.6 mph [149.5 ± 4.2 km/h]) who underwent UCLR between 2007 and 2017. Of these pitchers, 162 were categorized as TF pitchers (72.6%) and 61 as DD pitchers (27.4%). Pitching velocity for injured pitchers was significantly correlated to BMI ( P < .001). We found no significant associations of pitching style with year of UCLR ( P = .941), BMI ( P = .549), age ( P = .647), handedness ( P = .501), or average pitch velocity ( P = .921).

Conclusion:

The study findings demonstrated that a higher proportion of UCL-injured MLB pitchers (72.6%) used the TF pitching style. Further research is needed to explore the potential association between pitching style and UCL injury.
Do multinational enterprises with better social performance have a higher likelihood of cross-border acquisition completion? Analyzing the role of reputation for social performance in cross-border acquisitions
Authors: Waqar Wafa Tariq , Ma Yan
Published: October 2022

The social performance (SP) of a firm is associated with many positive organizational outcomes. Nonetheless, little is known about the effect of the SP of a multinational enterprise (MNE) on the likelihood of cross-border acquisition completion (CBAC). Investigating the link between MNEs’ SP and the likelihood of CBAC is important because it will increase our understanding of how stakeholders reward MNEs with better reputations. Drawing on the signaling and reputation for SP literature, we explore how acquisition complexity, reputational risk, and firm visibility influence CBAC. Based on a sample of 578 cross-border deals undertaken by acquirers in the noncyclical consumer industry (NCCI), our results support a positive relationship between MNEs’ SP and the likelihood of CBAC and strengthening moderating effects of acquirer size and public targets.

JEL CLASSIFICATIONS: G34, M16
Recommendations for Providing Medication Adherence Support After Pediatric Hematopoietic Stem Cell Transplant: Caregivers’ Lived Experience
Authors: Chardon Marie L. , Klages Kimberly L. , Joffe Naomi E. , Pai Ahna L. H.
Published: October 2022

Background. Medication adherence is challenging after pediatric hematopoietic stem cell transplant (HCT), particularly after hospital discharge. Post-HCT medication adherence is important to manage morbidity and mortality risk. Designing interventions that are effective and acceptable to caregivers is key to improving post-HCT medication adherence. This study aimed to characterize caregiver preferences about medication adherence support from their child's medical team. Methods. Twenty-nine caregivers of children who received an HCT completed semi-structured qualitative interviews about their experience with, and recommendations for improving, medication adherence support provided by the medical team. Twenty-two caregivers also completed a card sort task to clarify the content of received support and caregiver recommendations for future HCT families. Results. Thematic analysis revealed eight themes grouped into two categories: Communication Is Key and Practical Medication Adherence Support. Caregivers emphasized the importance of communication in helping them manage their child's outpatient medications and provided suggestions to further strengthen communication. The types of practical medication adherence support used varied across caregivers highlighting the importance of tailoring adherence support to each family's needs. Caregivers also identified all the domains as potentially helpful for other families. Discussion. Findings suggest that caregivers prefer that efforts to improve outpatient medication adherence post-HCT prioritize the medical team initiating frequent, clear, and open communication about medications, and provide educational materials on adherence (e.g., handouts). Results also indicate that practical medication adherence supports should be offered based on family preferences but that families may particularly appreciate tips about addressing medication challenges based on other caregivers’ lived experience.
The moral rent gap: Views from an edge of an urban world
Authors: Wyly Elvin
Published: October 2022

For more than 40 years, Neil Smith's rent gap theory of gentrification has been one of the most influential concepts in critical urban research. In recent years, however, the rent gap has been challenged as an economically deterministic tool suitable only for the study of inner city land parcels in certain types of deindustrializing cities of the Global North. But what if the rent gap was never really about economics, but instead about moral outrage? And what happens when moral and ethical questions about access to urban space are extended across multiple human generations? This article develops the concept of the moral rent gap: juxtapositions, tensions, and often irreconcilable contradictions in the present use of urban land in the context of intergenerational debts and responsibilities. Parcels of urban land are not clear, Cartesian locations, but are portals into multidimensional transformations of space and time produced through diverse, competing moral claims to the benefits of urban life.
The use of bladder voiding efficiency in assessing benign prostatic enlargement
Authors: Kapesa Philimon , Bowa Kasonde
Published: October 2022

Background

The management of benign prostatic enlargement (BPE) in low resource settings poses a major challenge in Africa. The objective of the study was to investigate the accuracy of Bladder Voiding Efficiency (BVE) to assess lower Urinary Tract Symptoms (LUTS) among BPE patients in a low resource setting.

Methods

From December 2017 to March 2018, patients with benign prostatic enlargement (BPE) and Lower Urinary Tract Symptoms (LUTS) were recruited into the study. The study was a prospective cross-sectional study. Participants had the International Prostate Symptom Score (IPSS) recorded followed by evaluation of their Bladder Voiding Efficiency (BVE). The BVE was calculated as the ratio of the volume of Urine voided over total volume of Urine in the bladder at the time of the void. The data were analysed to show the Sensitivity and Specificity of BVE in symptomatic LUTS. The Pearson correlation co-efficient between IPSS and BVE was analysed.

Results

The study recruited 94 participants. The age range was 45 to 85 year. The mean age was 68.1 years. The sensitivity of BVE to detect severe LUTS was 97.97%, while the specificity of BVE to detect mild to moderate disease was 97.78%. The correlation coefficient between IPSS and BVE was negatively correlated at 0.89, and this was statistically significant (P < 0.001).

Conclusion

The Bladder Voiding Efficiency (BVE) is a highly sensitive and specific test in our population to detect LUTS. It is well correlated to the International Prostate Severity Score in this study population.
Comparing diagnostic performance of Cantonese-Chinese version of Rome IV criteria and a short Reference Standard for functional dyspepsia in China
Authors: Ho Leonard , Chen Shuijiao , Ho Fai Fai , Wong Charlene H. L. , Ching Jessica Y. L. , Cheong Pui Kuan , Wu Irene X. Y. , Liu Xiaowei , Leung Ting Hung , Wu Justin C. Y. , Chung Vincent C. H.
Published: October 2022

Introduction

Functional dyspepsia (FD) is diagnosed based on self-reported symptoms and negative upper gastrointestinal endoscopic findings. The Rome criteria were not adopted as a diagnostic instrument in clinical guidelines due to their complexity. Different guidelines used relatively simple symptom assessment schemes with contents that vary significantly. A previously evaluated short Reference Standard may serve as a more standardised tool for guidelines. We evaluated its diagnostic accuracy against the Rome IV criteria in a cross-sectional study in Hong Kong.

Methods

A total of 220 dyspeptic patients sampled consecutively from a tertiary hospital and the community completed the Rome IV diagnostic questionnaire, which was translated into Cantonese-Chinese, and the Reference Standard. Sensitivity, specificity, positive and negative likelihood ratios (LRs), and area under the receiver operating characteristics curve (AUC), with 95% confidence intervals (CIs), were calculated.

Results

Among the participants, 160 (72.7%) fulfilled the Reference Standard with negative upper gastrointestinal endoscopic results. The Reference Standard identified patients with Rome IV-defined FD with 91.1% (95% CI 82.6%–96.4%) sensitivity and 37.6% (95% CI 29.6%–46.1%) specificity. The positive and negative LRs were 1.46 (95% CI 1.26–1.69) and 0.24 (95% CI 0.11–0.49), respectively. The AUC value was 0.64 (95% CI 0.59–0.69).

Conclusions

The Reference Standard can rule out patients without Rome IV-defined FD. It may be used as an initial screening tool for FD in settings where the use of the Rome IV criteria is impractical. It may also provide a uniform definition and diagnostic rule for future updates of clinical guidelines.
Long-term outcome of lamivudine/dolutegravir dual therapy in HIV-infected, virologically suppressed patients
Authors: Maggiolo Franco , Gulminetti Roberto , Pagnucco Layla , Digaetano Margherita , Cervo Adriana , Valenti Daniela , Callegaro Annapaola , Mussini Cristina
Published: October 2022

Background

The use of DTG-containing two-drug regimens is one of the most promising solutions to the need to ease the management of HIV treatment without harming its efficacy and safety. We report long- term results in patients switched, while virologically suppressed, to the combination of dolutegravir (DTG) plus lamivudine (3TC).

Methods

This is a prospective, clinical, uncontrolled cohort enrolling ART-experienced people living with HIV (PLWH) with HIV-RNA < 50 copies/ml for 6 months or longer, negative hepatitis B virus surface antigen, and without known M184V/I mutations. Kaplan-Meiers curves are used to describe persistency of virological suppression on therapy and a Cox regression model to evaluate baseline characteristics and the risk of stopping therapy.

Results

218 individuals switched their regimen since 2015. The mean estimated follow-up was of 64.3 months (95% CI 61.3–67.3) for approximately 1000 patient/years. After 5 years of follow-up, 77.1% were still on the DTG-3TC combination. No virologic failure was detected throughout the whole study period, and only 15 subjects presented single isolated viral blips above 50 copies/ml. Most patients stopped therapy because of reasons unrelated to study drugs (lost to follow-up; patients’ decision; moved to other Centers), but due to the unselected nature of the casuistry; 11 subjects died in the 5 years of follow-up mostly because of pre-existing co-morbidities (6 neoplastic diseases and 2 end-stage liver disease). The median baseline CD4 count was 669 cells/mcl (IQR 483–927). After 5 years it raised to 899 cells/mcl (IQR 646–1160) (P < 0.001) without a significant change of CD8 counts that lowered from 767 cells/mcl (IQR 532–1034) to 683 cells/mcl (IQR 538–988). Consequently, the CD4/CD8 ratio varied from 0.93 (IQR 0.60–1.30) to 1.15 (IQR 0.77–1.45) (P < 0.0001). A non-significant (P = 0.320) increment of mean creatinine, 0.06 mg/dl in magnitude, was observed over the whole follow-up.

Conclusion

These long-term results over 5 years reinforce the durability and good tolerability of DTG-3TC. Our results continue to support the recommended switch use of this 2DR as a well-accepted treatment option for ART-experienced PLWH.
Improving chronic kidney disease detection and treatment in the United States: the chronic kidney disease cascade of care (C3) study protocol
Authors: Lamprea-Montealegre Julio A. , Joshi Priya , Shapiro Abigail S. , Madden Erin , Navarra Krista , Potok O. Alison , Gregg L. Parker , Podchiyska Tanya , Robinson Amy , Goldstein Mary K. , Peralta Carmen A. , Jassal Simerjot K. , Navaneethan Sankar D. , Rifkin Dena. E. , Wang Virginia , Shlipak Michael G. , Estrella Michelle M.
Published: October 2022

Background

There are major gaps in the implementation of guideline-concordant care for persons with chronic kidney disease (CKD). The CKD Cascade of Care (C3) initiative seeks to improve CKD care by improving detection and treatment of CKD in primary care.

Methods

C3 is a multi-modal initiative deployed in three major academic medical centers within the Department of Veterans Affairs (VA) Health Care System: San Francisco VA, San Diego VA, and Houston VA. The main objective of the first phase of C3 described in this protocol is to establish the infrastructure for universal CKD detection among primary care patients at high-risk for CKD with a triple-marker screen comprising cystatin C, creatinine, and albuminuria. Across the three sites, a comprehensive educational intervention and the integration of primary care-based clinical champions will be employed with the goal of improving CKD detection and treatment. The San Francisco VA will also implement a practice-facilitation intervention leveraging telehealth and health informatics tools and capabilities for enhanced CKD detection. Parallel formative evaluation across the three sites will assess the feasibility and acceptability of integrating cystatin C as part of routine CKD detection in primary care practice. The effectiveness of the interventions will be assessed using a pre-post observational design for change in the proportion of patients tested annually for CKD. Secondary outcomes will assess change in the initiation of cardio-kidney protective therapies and in nephrology referrals of high-risk patients.

Discussion

The first phase of C3 is a multi-facility multi-modal initiative that aims to improve CKD care by implementing a triple-marker screen for enhanced CKD detection in primary care.
Effects of urinary extracellular vesicles from prostate cancer patients on the transcriptomes of cancer-associated and normal fibroblasts
Authors: Sadovska Lilite , Zayakin Pawel , Bajo-Santos Cristina , Endzeliņš Edgars , Auders Jānis , Keiša Laura , Jansons Juris , Lietuvietis Vilnis , Linē Aija
Published: October 2022

Background

Increasing evidence suggests that cancer-derived extracellular vesicles (EVs) alter the phenotype and functions of fibroblasts and trigger the reprogramming of normal fibroblasts into cancer-associated fibroblasts (CAFs). Here, we for the first time studied the effects of urinary EVs from PC patients and healthy males on the transcriptional landscape of prostate CAFs and normal foreskin fibroblasts.

Methods

Patient-derived prostate fibroblast primary cultures PCF-54 and PCF-55 were established from two specimens of PC tissues. EVs were isolated from urine samples of 3 patients with PC and 2 healthy males and used for the treatment of prostate fibroblast primary cultures and normal foreskin fibroblasts. The EV-treated fibroblasts were subjected to RNA sequencing analysis.

Results

RNA sequencing analysis showed that the fibroblast cultures differed significantly in their response to urinary EVs. The transcriptional response of foreskin fibroblasts to the urinary EVs isolated from PC patients and healthy controls was very similar and mostly related to the normal functions of fibroblasts. On the contrary, PCF-54 cells responded very differently - EVs from PC patients elicited transcriptional changes related to the regulation of the cell division and chromosome segregation, whereas EVs from healthy males affected mitochondrial respiration. In PCF-55 cells, EVs from both, PC-patients and controls induced the expression of a number of chemokines such as CCL2, CCL13, CXCL1, CXCL8, whereas pathways related to regulation of apoptotic signaling and production of cell adhesion molecules were triggered specifically by EVs from PC patients.

Conclusion

This study demonstrates that urinary EVs from PC patients and healthy controls elicit distinct transcriptional responses in prostate CAFs and supports the idea that EVs contribute to the generation of functional heterogeneity of CAFs. Moreover, this study suggests that the changes in the gene expression pattern in EV recipient cells might serve as a novel type of functional cancer biomarkers.
Subtype distribution of lymphomas in northwestern Iran: a retrospective analysis of 659 cases according to World Health Organization classification
Authors: Jalili Javad , Vahedi Amir , Danandehmehr Amin , Aynechi Parya , Esfahani Ali , Roosta Yousef , Nateghian Hooman , Ghafouri Asbagh Amirhosein , Hajihoseinlou Fateme
Published: October 2022

Background

The distribution of lymphoma subtypes differs strikingly by geographic variations. However, there is limited information on this research in northern Iran. This study aims to evaluate the incidence, subtype, age, sex, and extranodal distribution of lymphomas diagnosed according to the latest WHO classification in a large referral center in northwest Iran.

Methods

In a retrospective study, the medical records of all patients with a diagnosis of lymphoma made between 2018 and 2021 were retrieved from the pathology archive of Imam Reza Medical Center, Tabriz. Lymphoma diagnosis was also made based on the appreciation of morphologic and immunophenotypic features and genetic characteristics in the context of clinical presentation.

Results

This study includes a total of 659 patients with lymphoma diagnosed from 2018 to 2021. The number of lymphoma patients were increased each year, with 51 (7.7%), 96 (14.6%), 244 (40.7%), and 268 (40.7%) reported from 2018 to 2021, respectively. 59% of the patients were men. The participants’ mean age was 50.5 ± 19.8 years, while the mean age at diagnosis was 49.3 ± 19.6 years. 2.1% were precursor lymphoid neoplasm, 61.6% were mature B cell neoplasm, 8.8% were mature T cell neoplasm, and 27.5% were Hodgkin lymphoma. The most prevalent subtype of mature B-cell lymphoma was DLBCL (55.1%), followed by SLL (18.7%). Extranodal involvement was seen in 40.5% of all cases.

Conclusion

The subtype distribution of lymphomas in northwest Iran is reported and compared with studies all over the world and inside Iran.
Familial risk associated with lung cancer as a second primary malignancy in first-degree relatives
Authors: Ji Jianguang , Sundquist Jan , Sundquist Kristina , Zheng Guoqiao
Published: October 2022

Background

Aggregation of lung cancer (LCa) in family members is well-documented. However, little is known on the familial risk of LCa when first-degree relatives (FDRs, parents or siblings) are diagnosed with LCa as a second primary malignancy (LCa-2). We aimed to investigate whether and to what extent a family history of LCa-2 was associated with an increased LCa risk.

Methods

In this Swedish national cohort we identified 127,865 individuals who had one FDR affected by LCa as a first primary cancer (LCa-1) and 15,490 individuals who had one FDR affected by LCa-2, respectively. We then estimated relative risk (RR) of LCa using those without cancer family history as reference.

Results

The number of LCa-2 has been increasing annually and rather similarly in men and women in the last decade. Familial RR of LCa was 1.96 (95%, 1.85–2.07) for LCa-1 family history and 1.89 for LCa-2 (1.62–2.21). Risk was especially high when FDR was diagnosed with early-onset LCa-2 and when siblings were affected by LCa-2. The RR was 1.53 (1.10–2.12) when LCa-2 in FDR was diagnosed within 26 months after first primary cancer, and it increased to 2.16 (1.62–2.90) when LCa-2 was diagnosed between 74 to 154 months. Higher risk was observed for first primary cancer of the ovary (4.45, 1.85–10.7), nervous system (3.49, 1.45–8.38), upper aerodigestive tract (2.83, 1.78–4.49) and cervix (2.55, 1.41–4.61), and for non-Hodgkin lymphoma (3.13, 1.57–6.27).

Conclusions

LCa risk is associated with diagnosis of LCa-2 in FDR to a similar degree as LCa-1 in FDRs.
Anatomical distance affects functional connectivity at rest in medicine-free obsessive–compulsive disorder
Authors: Lv Dan , Ou Yangpan , Chen Yunhui , Ding Zhenning , Ma Jidong , Zhan Chuang , Yang Ru , Shang Tinghuizi , Zhang Guangfeng , Bai Xiaoyu , Sun Zhenghai , Xiao Jian , Wang Xiaoping , Guo Wenbin , Li Ping
Published: October 2022

Background

Brain functional abnormalities at rest have been observed in obsessive–compulsive disorder (OCD). However, whether and how anatomical distance influences functional connectivity (FC) at rest is ambiguous in OCD.

Methods

Using resting-state functional magnetic resonance imaging data, we calculated the FC of each voxel in the whole-brain and divided FC into short- and long-range FCs in 40 medicine-free patients with OCD and 40 healthy controls (HCs). A support vector machine (SVM) was used to determine whether the altered short- and long-range FCs could be utilized to distinguish OCD from HCs.

Results

Patients had lower short-range positive FC (spFC) and long-range positive FC (lpFC) in the left precentral/postcentral gyrus (t = -5.57 and -5.43; P < 0.05, GRF corrected) and higher lpFC in the right thalamus/caudate, left thalamus, left inferior parietal lobule (IPL) and left cerebellum CrusI/VI (t = 4.59, 4.61, 4.41, and 5.93; P < 0.05, GRF corrected). Furthermore, lower spFC in the left precentral/postcentral gyrus might be used to distinguish OCD from HCs with an accuracy of 80.77%, a specificity of 81.58%, and a sensitivity of 80.00%.

Conclusion

These findings highlight that anatomical distance has an effect on the whole-brain FC patterns at rest in OCD. Meanwhile, lower spFC in the left precentral/postcentral gyrus might be applied in distinguishing OCD from HCs.
Malaria outbreak facilitated by increased mosquito breeding sites near houses and cessation of indoor residual spraying, Kole district, Uganda, January-June 2019
Authors: Nabatanzi Maureen , Ntono Vivian , Kamulegeya John , Kwesiga Benon , Bulage Lilian , Lubwama Bernard , Ario Alex. R. , Harris Julie
Published: October 2022

Background

In June 2019, surveillance data from the Uganda’s District Health Information System revealed an outbreak of malaria in Kole District. Analysis revealed that cases had exceeded the outbreak threshold from January 2019. The Ministry of Health deployed our team to investigate the areas and people affected, identify risk factors for disease transmission, and recommend control and prevention measures.

Methods

We conducted an outbreak investigation involving a matched case-control study. We defined a confirmed case as a positive malaria test in a resident of Aboke, Akalo, Alito, and Bala sub-counties of Kole District January–June 2019. We identified cases by reviewing outpatient health records. Exposures were assessed in a 1:1 matched case-control study (n = 282) in Aboke sub-county. We selected cases systematically from 10 villages using probability proportionate to size and identified age- and village-matched controls. We conducted entomological and environmental assessments to identify mosquito breeding sites. We plotted epidemic curves and overlaid rainfall, and indoor residual spraying (IRS). Case-control exposures were combined into: breeding site near house, proximity to swamp and breeding site, and proximity to swamp; these were compared to no exposure in a logistic regression analysis.

Results

Of 18,737 confirmed case-patients (AR = 68/1,000), Aboke sub-county residents (AR = 180/1,000), children < 5 years (AR = 94/1,000), and females (AR = 90/1,000) were most affected. Longitudinal analysis of surveillance data showed decline in cases after an IRS campaign in 2017 but an increase after IRS cessation in 2018–2019. Overlay of rainfall and case data showed two malaria upsurges during 2019, occurring 35–42 days after rainfall increases. Among 141 case-patients and 141 controls, the combination of having mosquito breeding sites near the house and proximity to swamps increased the odds of malaria 6-fold (OR = 6.6, 95% CI = 2.24–19.7) compared to no exposures. Among 84 abandoned containers found near case-patients’ and controls’ houses, 14 (17%) had mosquito larvae. Adult Anopheles mosquitoes, larvae, pupae, and pupal exuviae were identified near affected houses.

Conclusion

Stagnant water formed by increased rainfall likely provided increased breeding sites that drove this outbreak. Cessation of IRS preceded the malaria upsurges. We recommend re-introduction of IRS and removal of mosquito breeding sites in Kole District.
A2A adenosine receptor agonist reduced MMP8 expression in healthy M2-like macrophages but not in macrophages from ankylosing spondylitis patients
Authors: Sadatpour Omid , Ebrahimi Mohammad Taha , Akhtari Maryam , Ahmadzadeh Nooshin , Vojdanian Mahdi , Jamshidi Ahmadreza , Farhadi Elham , Mahmoudi Mahdi
Published: October 2022

Background

Ankylosing spondylitis (AS) is an inflammatory autoimmune disease that mostly affects different joints of the body. Macrophages are the predominant cells that mediate disease progression by secreting several pro-inflammatory mediators. Different receptors are involved in macrophages’ function including the adenosine receptors (AR). Our main objective in this study was to assess the effect of applying A2A adenosine receptor agonist (CGS-21,680) on the gene expression of inflammatory mediators including bone morphogenetic proteins (BMP)-2, 4 and matrix metalloproteinases (MMP)-3, 8, 9, and 13 on the macrophages from AS patients compared to healthy macrophages.

Methods

Monocytes were isolated from the whole blood of 28 individuals (AS patients and healthy controls in a 1:1 ratio). Macrophages were differentiated using macrophage colony-stimulating factor (M-CSF), and flow cytometry was performed to confirm surface markers. CGS-21,680 was used to treat cells that had been differentiated. Using SYBR green real-time PCR, relative gene expression was determined.

Results

Activating A2AAR diminished MMP8 expression in healthy macrophages while it cannot reduce MMP8 expression in patients’ macrophages. The effect of A2AAR activation on the expression of BMP2 and MMP9 reached statistical significance neither in healthy macrophages nor in the patients’ group. We also discovered a significant positive connection between MMP8 expression and patient scores on the Bath ankylosing spondylitis functional index (BASFI).

Conclusion

Due to the disability of A2AAR activation in the reduction of MMP8 expression in patients’ macrophages and the correlation of MMP8 expression with BASFI index in patients, these results represent defects and dysregulations in the related signaling pathway in patients’ macrophages.
Ayurvedic formulations Guduchi and Madhuyashti triggers JNK signaling mediated immune response and adversely affects Huntington phenotype
Authors: Singh Surabhi , Tapadia Madhu G.
Published: October 2022

Background

Huntington’s disease manifests due to abnormal CAG trinucleotide expansion, in the first exon of the Huntingtin gene and disease progression involves genetic, immune, and environmental components. The pathogenesis is characterized by the formation of Inclusion Bodies, disruption of neuronal circuitry, cellular machinery, and apoptosis, resulting in gradual and progressive loss of neuronal cells, ultimately leading to nervous system dysfunction. Thus, the present study was conducted to assess the effect of two Ayurvedic formulations, Guduchi and Madhuyashti, on Huntington’s phenotype, using Drosophila as a model system.

Method

The Huntington phenotype was ectopically induced in the Drosophila eye using the UAS-GAL4 binary system and the effect of the two Ayurvedic formulations were assessed by feeding the progenies on them. Degeneration was observed microscopically and Real Time-PCR was done to assay the alterations in the different transcripts of the innate immune pathways and JNK signaling pathway. Immunostaining was performed to assay different gene expression patterns.

Result

The present study shows that Guduchi and Madhuyashti, endowed with immunomodulatory and intellect promoting properties, aggravates polyQ mediated neurodegeneration. We provide evidence that these formulations enhance JNK signaling by activating the MAP 3 K, dTAK1, which regulates the expression of Drosophila homologue for JNK. Sustained, rather than a transient expression of JNK leads to excessive production of Anti-Microbial Peptides without involving the canonical transcription factors of the Toll or IMD pathways, NF-κB. Enhanced JNK expression also increases caspase levels, with a concomitant reduction in cell proliferation, which may further contribute to increased degeneration.

Conclusion

This is a report linking the functional relevance of Guduchi and Madhuyashti with molecular pathways, which can be important for understanding their use in therapeutic applications and holds promise for mechanistic insight into the mammalian counterpart.