bluuebunny/crossref_metadata_2025 huggingface dataset:
A Comprehensive Analysis of Tobacco Smoking History as a Risk for Outcomes after Endoscopic Transsphenoidal Resection of Pituitary Adenoma
Authors: Min Susie , Zhang Grace , Hu Alex , Petito Gabrielle T. , Tripathi Siddhant H. , Shukla Geet , Kumar Adithya , Shah Sanjit , Phillips Katie M. , Forbes Jonathan A. , Zuccarello Mario , Andaluz Norberto O. , Sedaghat Ahmad R.
Published: February 2023

Objectives This study seeks to comprehensively analyze the impact of smoking history on outcomes after endoscopic transsphenoidal hypophysectomy (TSH) for pituitary adenoma.

Design This was a retrospective study.

Setting This study was done at the tertiary care center.

Participants Three hundred and ninety-eight adult patients undergoing TSH for a pituitary adenoma.

Main Outcome Measures Clinical and tumor characteristics and operative factors were collected. Patients were categorized as never, former, or active smokers, and the pack-years of smoking history was collected. Years since cessation of smoking was obtained for former smokers. Specific outcomes included postoperative cerebrospinal fluid (CSF) leak, length of hospitalization, 30-day return to the operating room, and 30-day readmission. Smoking history details were comprehensively analyzed for association with outcomes.

Results Any history of smoking tobacco was associated with return to the operating room (odds ratio [OR] = 2.67, 95% confidence interval [CI]: 1.05–6.76, p = 0.039), which was for persistent CSF leak in 58.3%. Among patients with postoperative CSF leak, any history of smoking was associated with need for return to the operating room to repair the CSF leak (OR = 5.25, 95% CI: 1.07–25.79, p = 0.041). Pack-years of smoking was positively associated with a return to the operating room (OR = 1.03, 95% CI: 1.01–1.06, p = 0.048). In all multivariable models, all negative outcomes were significantly associated with the covariate: occurrence of intraoperative CSF leak.

Conclusion This is the first study to show smoking may have a negative impact on healing of CSF leak repairs after TSH, requiring a return to the operating room. This effect appears to be dose dependent on the smoking history. Secondarily, intraoperative CSF leak as covariate in multivariable models was significantly associated with all negative outcomes.
Stromal Expression of CD10 in Breast Carcinoma and Its Association with Known Prognostic Factors—A Tissue Microarray-Based Study
Authors: Gaffoor Nidha , Krishnamurthy Jayashree
Published: February 2023

Background Breast cancer is an epithelial malignancy; however, stroma plays a key role with its stimulatory and inhibitory factors in modulating tumor invasion and metastasis. CD10, a matrix metalloproteinase, is known to regulate cell adhesion, migration and helps in determining the progression of tumor. This knowledge helps to identify specific signals that promote growth, dedifferentiation, invasion, metastasis and serve as target for better therapeutic management.

Objectives The aim of this study was to estimate frequency of expression of stromal CD10 and assess its prognostic significance in breast carcinomas by correlating with known prognostic factors.

Materials and Methods Morphological parameters of 62 cases of carcinoma breast were studied on H&E (hematoxylin and eosin) stained sections and expressions of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2/neu), and CD10 on manually constructed tissue microarray sections by immunohistochemistry (IHC). Staining pattern, percentage of stained cells, and intensity of stains were evaluated and IHC scoring of all markers was done. CD10 scores were correlated with the known prognostic factors (ER, PR, and HER2/neu). A p-value less than 0.05 was considered as significant.

Results Stromal expression of CD10 was found in 82.3% of cases and it was significantly associated with increasing tumor size (p = 0.012), increasing tumor grade (p = 0.001), lymph node metastasis (p = 0.018), necrosis (p = 0.008), lymphovascular invasion (p = 0.008), ER negativity (p = 0.001), PR negativity(p = 0.007), HER 2 positivity (p = 0.012), triple-negative molecular subtypes (p = 0.001), and poor prognostic groups (p = 0.01).

Conclusion CD10 can be used as an independent prognostic stromal marker and this will help to envisage new therapeutic strategies.
A Study of Focal and Segmental Glomerulosclerosis according to the Columbia Classification and Its Correlation with the Clinical Outcome
Authors: Nuguri Swapna , Swain Meenakshi , Padua Michelle de , Gowrishankar Swarnalata
Published: February 2023

Introduction Focal and segmental glomerulosclerosis (FSGS) is a leading cause of nephrotic syndrome in both adults and children. The “Columbia classification of FSGS” includes five variants; not otherwise specified (NOS), tip, perihilar, cellular, and collapsing variants that may have different prognostic and therapeutic implications.

Materials and Methods This is a retrospective study and was carried out in the Department of Histopathology, Apollo Hospitals, Hyderabad. Of a total of 11,691 kidney biopsies over a 7-year period, from 2006 to 2012, 824 cases were diagnosed as FSGS, of which 610 cases in which detailed clinical findings were available were included in this study. FSGS was then categorized according to the Columbia classification.

Results FSGS, NOS was the predominant histomorphological variant. Serum creatinine was significantly high in the collapsing variant, followed by NOS. Follow-up data was available for 103 cases,72.8% had complete remission, 10.6% had partial remission, and in 16.5 % there was no remission. Relapses were observed in 6.7% cases, two patients (1.9%) succumbed, and 4.8% cases progressed to chronic kidney disease.

Conclusion This study showed that perihilar variant was less prevalent, with tip and cellular variants being more prevalent in Indian subcontinent compared to Western literature. Collapsing variant was also less common.
Ataxias: Hereditary, Acquired, and Reversible Etiologies
Authors: Lin Chi-Ying R. , Kuo Sheng-Han
Published: February 2023

A variety of etiologies can cause cerebellar dysfunction, leading to ataxia symptoms. Therefore, the accurate diagnosis of the cause for cerebellar ataxia can be challenging. A step-wise investigation will reveal underlying causes, including nutritional, toxin, immune-mediated, genetic, and degenerative disorders. Recent advances in genetics have identified new genes for both autosomal dominant and autosomal recessive ataxias, and new therapies are on the horizon for targeting specific biological pathways. New diagnostic criteria for degenerative ataxias have been proposed, specifically for multiple system atrophy, which will have a broad impact on the future clinical research in ataxia. In this article, we aim to provide a review focus on symptoms, laboratory testing, neuroimaging, and genetic testing for the diagnosis of cerebellar ataxia causes, with a special emphasis on recent advances. Strategies for the management of cerebellar ataxia is also discussed.
Cervical Cancer in SAARC Countries
Authors: Parikh Purvish M. , Mullapally Sujith Kumar , Hingmire Sachin , Kamal Uddin A. F. M. , Thinn M M. , Shahi Arun , Tshomo Ugyen , Mohan Indu , Kaur Satinder , Ghadyalpatil Nikhil
Published: February 2023

In the year 2020, a total of 342 000 women were estimated to die of cervical cancer, of which 90%) were expected amongst low- and middle-income countries (LMIC). Globally incidence of cervical cancer has reduced as a result of improved personal hygiene, better living conditions and higher application of opportunistic screening programs. Yet GLOBOCAN shows that absolute number of cases are still increasing.

We therefore conducted a 21 question multiple choice questionnaire online survey in Jan 2023 amongst 9 SAARC countries. A total of 367 replies were received and the representative answers for each country are being reported in this manuscript.

A good possibility of achieving World Health Assembly target (Nov 17, 2020) was felt only by Bhutan and Nepal. For screening, most countries (Bhutan, India, Myanmar, Nepal, Pakistan and Sri Lanka) recommend for all asymptomatic eligible patients. Public health experts have suggested VIA / VILI as the best solution for LMICs. However, a dual screening strategy (HPV DNA plus) cytology was preferred by doctors in Afghanistan, Bhutan, India, Myanmar, Pakistan and Sri Lanka.

Screening, triage and then treatment was the preferred by Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, Sri Lanka.

HPV vaccination was recommended in all girls between ages 10 to 26 years in Bangladesh, India, Myanmar, Nepal, Pakistan and Sri Lanka. All the 9 countries would use HPV vaccination to all eligible patients if the cost of the vaccine was reasonably low.

Our survey clearly outlines challenges faced in tackling cervical cancer in SAARC countries. We also provide consensus regarding several potential solutions that can be used in both public and private cervical cancer control programs.
Political instability patterns are obscured by conflict dataset scope conditions, sources, and coding choices
Authors: Raleigh Clionadh , Kishi Roudabeh , Linke Andrew
Published: February 2023

Conflict event datasets are used widely in academic, policymaking, and public spheres. Accounting for political violence across the world requires detailing conflict types, agents, characteristics, and source information. The public and policymaking communities may underestimate the impact of data collection decisions across global, real-time conflict event datasets. Here, we consider four widely used public datasets with global coverage and demonstrate how they differ by definitions of conflict, and which aspects of the information-sourcing processes they prioritize. First, we identify considerable disparities between automated conflict coding projects and researcher-led projects, largely resulting from few inclusion barriers and no data oversight. Second, we compare researcher-led datasets in greater detail. At the crux of their differences is whether a dataset prioritizes and mandates internal reliability by imposing initial conflict definitions on present events, or whether a dataset’s agenda is to capture an externally valid and comprehensive assessment of present violence patterns. Prioritizing reliability privileges specific forms of violence, despite the possibility that other forms actually occur; and leads to reliance on international and English-language information sources. Privileging validity requires a wide definition of political violence forms, and requires diverse, multi-lingual, and local sources. These conceptual, coding, and sourcing variations have significant implications for the use of these data in academic analysis and for practitioner responses to crisis and instability. These foundational differences mean that answers to “which country is most violent?”; “where are civilians most at risk?”; and “is the frequency of conflict increasing or decreasing?” vary according to datasets all purporting to capture the same phenomena of political violence.
New horizons in sepsis management in older patients
Authors: Putot Alain , Prendki Virginie
Published: February 2023

Sepsis is a frequent disease in older people, characterised by an inappropriate systemic inflammatory response following an infection, leading to life-threatening organ dysfunctions. In the very old, sepsis is often difficult to diagnose, given the frequent atypical presentation. While there is no gold standard for the diagnosis of sepsis, new definitions published in 2016, aided by clinical–biological scores, namely Sequential Organ Failure Assessment (SOFA) and quick SOFA scores, allow earlier recognition of septic states at risk of poor outcome. The management of sepsis in itself differs little in older patients compared to younger subjects. However, the key question of whether or not to admit the patient to an intensive care setting has to be anticipated, depending on the sepsis severity but also on patient’s comorbidities and wishes. The earliness of acute management in older subjects with decreased immune defences and physiological reserves is an essential prognostic element. The early control of comorbidities is the main plus value of the geriatrician in the acute and post-acute management of older patients with sepsis.
Evolution and Trends of Facial Plastic Surgery and Facial Aesthetic Procedures in India: From Awakening to Revival
Authors: Shome Debraj , van der Hulst Rene R W J , Kumar Vaibhav , Booi Darren I , Mhatre Pranjal D
Published: February 2023

Facial aesthetic surgery is an emerging branch worldwide. India, a torchbearer country in facial plastic surgery, has seen tremendous growth in medical technology, resources, and clientele over the past century. This study aims to study past practices and current trends in facial plastic surgery and aesthetic procedures in India by individually addressing commonly performed nonsurgical procedures (Botox, Kybella [Allergan, Irvine, CA], fillers, threads, micro-focused ultrasound, and nonsurgical hair restoration), and surgical procedures (rhinoplasty, blepharoplasty, hair transplant, and facelift). It also aims to further elaborate on the scope of facial aesthetics and make recommendations on prospects in the field. A structured scoping review and a subsequent evidence-based synthesis were done following an extensive literature search on various databases such as PubMed (National Institutes of Health, Bethesda, MD), LILACS (Latin American and Caribbean Center on Health Sciences Information, São Paulo, Brazil), MEDLINE (National Library of Medicine, Bethesda, MD), EMBASE (Elsevier, Amsterdam, the Netherlands), and Cochrane (Wiley, Hoboken, NJ). The initial search yielded 703 articles, out of which 20 were found to be relevant to the present study and discussed. It was found that there is an upward trend in the growth of facial plastic surgery in India, and a gradual shift in patient attitude toward nonsurgical aesthetic procedures was seen. This article affirms the growth of facial aesthetic surgery in India by highlighting the recent development and trends in the practices of surgeons. It also addresses the shortcomings in the current administration and makes recommendations to fill the existing loopholes in plastic surgery.

Level of Evidence: 5
Deep palmar phenotyping in atopic eczema: patterns associated with filaggrin variants, disease severity and barrier function in a South Asian population
Authors: Thomas Bjorn R , Tan Xiang Li , Van Duijvenboden Stefan , Hogan Sarah C , Hughes Aaron J , Tawfik Soha S , Dhoat Sasha , Atkar Ravinder , Robinson Elizabeth J , Rahman Syedia R , Rahman Samiha , Ahmed Rehana A , Begum Rubina , Khanam Habiba , Bourne Emma L , Wozniak Eva L , Mein Charles A , Kelsell David P , O’Toole Edel A
Published: February 2023

Background

Hyperlinear palms are described as a feature of loss-of-function (LoF) variants in filaggrin (FLG).

Objectives

To explore the phenotype of participants (age < 31 years) with atopic eczema of Bangladeshi ancestry from East London and investigate which factors best associate with LoF FLG variants.

Methods

A cross-sectional study with participants recruited between May 2018 and December 2020. Patterns of palmar linearity were categorized and modelled with the Eczema Area and Severity Index (EASI), transepidermal water loss (TEWL), skin hydration (SH) and LoF FLG variants.

Results

There were 506 complete cases available. Five palm patterns were noted. The ‘prominent diamond’ pattern associated best with EASI [marginal effects (ME) 2.53, 95% confidence interval (CI) 1.74–3.67], SH (ME 0.85, 95% CI 0.78–0.96) and TEWL (ME 1.32, 95% CI 1.11–1.62). Using five palm patterns had some ability to discriminate LoF FLG variants [area under the receiver operator characteristic (AUROC) 76.32%, 95% CI 71.91–80.73], improving to 77.99% (73.70–82.28) with the addition of SH. In subgroup analysis with only fine perpendicular/prominent diamond patterns the AUROC was 89.11% (95% CI 84.02–94.19).

Conclusions

This was a single-centre study design with humans classifying clinical patterns. The stability of temperature and humidity was not guaranteed across TEWL and SH measurements despite using a climate-controlled room. Palm patterns associate with EASI and TEWL. The fine perpendicular/prominent diamond patterns are markers to detect the absence/presence of LoF FLG variants, respectively.
‘Relocating’ Adolescents from Risk beyond the Home: What Do We Learn When We Ask about Safety?
Authors: Wroe Lauren Elizabeth , Peace Delphine , Firmin Carlene
Published: February 2023

There is an absence of evidence supporting the use of ‘out-of-area placements’ to address risks adolescents face beyond the home. Approximately one in ten adolescents in England and Wales are ‘relocated’ from their hometowns by children’s social care teams due to these risks. Initial findings from the Independent Review of Children’s Social Care in England situate these relocations as a ‘failure’ to safeguard teenagers. Using participatory approaches to research design and data collection, this article asks what do we learn about the impact of relocations when we ask about safety? Activity-based, qualitative interviews were conducted with young people (n = 5), parents (n = 3) and professionals (n = 15) based in England and Scotland between 2020 and 2021, asking what worked and what didn’t when a relocation was chosen, and what was the perceived impact on safety. Interview data were thematically analysed in collaboration with young people and a Research Advisory Group of professionals, all with expertise in the area. Data indicated a tension between what professionals, and then parents and young people, thought was significant when planning relocations and an ambivalence about the impact of relocations. Considerations for safety planning are suggested to support young people’s holistic safety needs.
A review on the sealing structure and materials of fuel-cell stacks
Authors: Zhao Jinghui , Guo Huijin , Xing Yuchen , Ping Shaobo , Lin Weikang , Yang Yanbo , Wang Zixi , Ma Tiancai
Published: February 2023

Proton-exchange-membrane fuel cells (PEMFCs) have the characteristics of zero emissions, a low operating temperature and high power density, and have great potential in improving energy-utilization efficiency. However, fuel cells are still quite expensive as a result of the cost of key components, including the membranes, catalysts and bipolar plates of PEMFCs. As a result of the cost and importance of these items, most researchers have focused on improving the lifetime and performance of fuel-cell stacks in recent years. In contrast, seals, sealants and adhesives play a more mundane role in the overall performance of a fuel cell, but failure of these materials can lead to reduced system efficiency, system failure and even safety issues. Little attention has been paid to the performance and durability of these products but as other fuel-cell components improve, these seals are becoming an even more critical link in the long-term performance of fuel cells. This article highlights the importance and background of fuel-cell seals. The latest research progress on the mechanical properties and structural optimization of different sealing materials is reviewed.
Topical cidofovir in monkeypox: our experience. Comment on ‘Monkeypox: is topical cidofovir a good idea’
Authors: Sobral-Costas Tristán Gabriel , Escudero-Tornero Rafael , Servera-Negre Guillermo , Bernardino Jose I , Arroyo Almudena Guitiérrez , Díaz-Menéndez Marta , Busto-Leis Jose Manuel , Álvarez Patricia Roces , Pinto Pedro Herranz , Cudós Elena Sendagorta
Published: February 2023

In response to the recent article by Rubio-Muñiz et al., and in agreement with the title of their interesting work, we consider that topical cidofovir is a valuable option for skin lesions caused by monkeypox based on a recent publication of ours.
Should we Target Complete Endoscopic Healing in Patients with Acute Severe Ulcerative Colitis?
Authors: Laharie David , Mary Jean-Yves
Published: February 2023

Background

Achieving endoscopic healing is a recommended target in ulcerative colitis [UC]. However, little is known about desirable goals in patients with acute severe UC [ASUC]. Taking advantage of the long-term follow-up of clinical trial patients with steroid-refractory ASUC, the present analysis aimed to quantify the observed association between the Mayo endoscopic sub-score [MES], 0 or 1, at clinical trial end and patients’ long-term disease outcome.

Methods

Patients in the prospective CYSIF clinical trial were included in the present analysis if they had achieved steroid-free clinical remission with an MES of 0 or 1 at the end of the trial, at day 98. Events during long-term follow-up had been retrospectively collected. The primary endpoint for this complementary analysis was the occurrence of an event, death or disease relapse [defined by recurrence of symptoms with need for a new systemic treatment or colectomy].

Results

Forty-four patients were included in the present analysis. When censoring follow-up at 5 years, six and nine events were observed among 26 and 18 patients having an MES of 0 and 1, respectively. Survival without disease relapse at 1, 2 and 5 years was respectively 88 ± 6, 81 ± 8 and 77 ± 8% in patients with MES of 0, and 72 ± 11, 53 ± 12 and 46 ± 12% in those with MES of 1 [hazard ratio: 2.8; 95% confidence interval: 1.0–8.0; p = 0.042].

Conclusion

In a cohort of patients admitted for ASUC in whom clinical and endoscopic healing has been achieved with a second-line medical therapy, better survival without disease relapse was observed with complete endoscopic healing.
A mystery-shopping study to test enforcement of minimum legal purchasing age in Lithuania in 2022
Authors: Miščikienė Laura , Tran Alexander , Petkevičienė Janina , Rehm Jürgen , Vaitkevičiūtė Justina , Galkus Lukas , Lange Shannon , Štelemėkas Mindaugas
Published: February 2023

Background

According to the Lithuanian law to prevent the sale of alcohol to customers below the legal minimum purchasing age of 20 years, young adults below 25 years must be asked to show an age-verification document when purchasing alcohol. The aim of this study was to assess whether off-premise outlets comply with the law.

Methods

In 2022, mystery-shopping study was carried out in three consecutive phases: (i) in a representative sample (n = 239) of off-premise alcohol outlets covering all Lithuanian district centres, (ii) after lifting the requirement to wear a mask and (iii) after warning the outlets that a mystery-shopping study was ongoing. Phases 2 and 3 were held in two cities. The mystery shopping involved attempts by young, but legally eligible customers to purchase alcohol. Across the three study phases, we compared compliance with the law by measuring overall success of purchase attempts and included situational characteristics (working day or weekend), time of day and number of customers in line as an additional predictor.

Results

Out of 239 attempts to purchase alcohol from off-premise outlets in the main phase of the study, 107 (or 44.8%) were considered to be successful (visits in which staff were willing to sell alcohol). There was a significantly higher chance of success to purchase alcohol with no ID request if a mystery shopper was the only customer in a queue and on weekends.

Conclusions

The results indicate an insufficient level of age-verification control in Lithuania, and that additional action is needed to increase compliance.
Use of virtual reality technology in chainsaw operations, education and training
Authors: Capecchi Irene , Neri Francesco , Borghini Tommaso , Bernetti Iacopo
Published: February 2023

Wood harvesting operations represent one of the industrial sectors with the highest risk of accidents at work. In semi-mechanized logging operations, the great majority of accidents generally occur using chainsaws during tree felling. Unfortunately, these situations frequently cause serious injuries and even the deaths of workers. In numerous cases, the accidents occurred to people who were badly trained and inexperienced, with a short employment history. One solution to reduce these harmful events is to support workers employed in this sector with training applications. This paper presents a description of a research and training programme for operating with chainsaws in tree felling operations using a Virtual Reality (VR) application called ForestVRoom. This innovative education method was compared with the traditional theoretical lesson based on a slide show. The results of the training were verified through a statistical analysis of questionnaires administered to a sample of 45 students in undergraduate and master’s degree programmes at the School of Agriculture and Forestry at the University of Florence. We have shown that the combination of traditional didactics and symmetrical collaborative VR leads to an increase in knowledge and especially in the ability to understand situations in a real forest site. VR is a useful teaching tool that can complement conventional training methods because of its potential to provide an immersive and attractive experience that facilitates learning and recognition of situations in forest sites.
‘Surrounding yourself with beauty’: exploring the health promotion potential of a rural garden appreciation group
Authors: Symes Leith , Hadgraft Nyssa , Marsh Pauline , Nuttman Sonia , Kingsley Jonathan
Published: February 2023

Gardening has the potential to enhance health and well-being, through increased physical activity and social connectedness. However, while much is known about the benefits of garden activities, less is known about the potential health implications of more passive forms of engagement with gardens, for example, viewing gardens. In addition, much garden research is undertaken in urban settings, leaving little known about potential health impacts for rural populations. The present study explored these research gaps by gaining an understanding of the experiences and perspectives of members of a gardening appreciation group in rural Australia: The Colac Horticultural and Marvellous Property Appreciation Society (CHAMPAS). A phenomenological, qualitative methodology was applied, using semi-structured interviews for data collection. Eleven participants were selected using purposive and snowball sampling and the data were analysed by applying interpretive, reflexive thematic analysis. Four main themes and supporting sub-themes were generated. The four main themes were: (i) motivations for maintaining participation in CHAMPAS; (ii) social connections and friendships, formed from membership; (iii) sense of community and structure of CHAMPAS and (iv) the perceived health and well-being benefits of continued involvement in this group. This study found that members perceived health and well-being benefits stemmed from CHAMPAS facilitation of social connectedness, function as a community group and a way for members to share a love for home gardening. This study provides insights into the perceived and potential health-promoting effects of garden appreciation groups for rural populations.
The effectiveness of an online sexuality education module in promoting sexual knowledge and attitude change: a cluster randomized controlled trial
Authors: Chen Minne , Zimmer Catherine , Huang Sizhe , Tian Rui , Yang Boya , Li Meibao
Published: February 2023

This study assesses the ability of an online sexuality education (OSE) module (‘You and Me’) to enhance sexual and reproductive health (SRH) knowledge and attitudes among 10th-grade vocational high school students in China. We conducted a cluster randomized controlled trial, randomizing 29 vocational high schools to (i) receiving the module (intervention) or (ii) not receiving the module (control). Students completed a baseline questionnaire, then completed the module within 8 weeks and then completed a follow-up questionnaire within the following 2 weeks. We assessed the differences in intervention effects using hierarchical linear modeling. No significant differences between intervention and control groups were found for knowledge and attitude scores at baseline among the 2985 students included in the analyses. For the intervention group at follow-up, we observed significant improvements in SRH knowledge scores of approximately 20% for boys and girls although girls responded to the module with larger knowledge gains than boys. At follow-up, intervention group students also had higher SRH attitude scores toward views that are more contemporary than the control group. In addition, girls held more contemporary attitudes than boys. The comprehensive OSE module assessed is effective in improving SRH knowledge, and attitude among Chinese vocational high school students after the module is completed.
Curriculum reform and trainees’ perception of the pharmacy educational environment: a modified DREEM study
Authors: Yeoh Ting Ting , Kumwenda Ben , Chew Lita
Published: February 2023

Objectives

An undergraduate pharmacy curriculum reform was undertaken to meet the future healthcare demands of the people in Singapore. Understanding how educational reforms affect the learners’ perceptions of the learning environment is important for quality assurance. The primary aim of this study was to investigate how pharmacy trainees perceive their educational environment before and after curriculum reform. The secondary aim was to evaluate the strengths and areas for improvement of the educational environment in the new curriculum.

Methods

This was a retrospective cohort study of pharmacy trainees in Singapore. A modified version of the Dundee Ready Educational Environment Measure (mDREEM) was used to assess the pharmacy educational environment. Univariate analysis was used to compare the responses of trainees from the old and new curricula.

Key findings

The sample comprised 523 (93.7%) responses from the old and 677 (94.6%) from the new curriculum. The global mean scores for the mDREEM survey in the old and new curriculums were 150.4 and 156.2, respectively (P < 0.001). These results indicate that there was an increase in satisfaction with the new educational environment. In the new curriculum, the perceived educational environment varied across different pharmacy settings, and trainees rated their educational environment after graduation lower than that during their undergraduate training.

Conclusion

The findings demonstrate that curricular reforms can alter trainees’ perception of their educational environment. In our subgroup analyses, trainees’ perceptions of their educational environment changed as they progressed from the undergraduate to the postgraduate training phase. Further work is needed to explore the cause-and-effect relationships between curriculum design and implementation and the resulting perceived educational environment.
The Dislocation of LGBT Politics: Pride, Globalization, and Geo-Temporality in Uganda and Serbia
Authors: Slootmaeckers Koen , Bosia Michael J
Published: February 2023

Scholars consider the translatability and efficacy of “western” LGBT politics as they diffuse, but pay little attention to the role of its histories and cultures as geo-temporal phenomena. Focusing on Pride events, this article demonstrates how such oversights inhibit a full account of the widely diverse impacts of similar actions in different places. We explore the ways in which Pride events, as a mode of activism, go global and integrate in vastly different contexts: Serbia and Uganda. Paying particular attention to acts of violence and the instrumentalization of Pride as geopolitical, we argue that divergent outcomes connect to the diffusion of Pride as creative of geo-temporal dislocations of politics and history. Incorporating the concept of extraversion, we demonstrate that the intertwining of the domestic and international facilitates the transformation of politics in terms of foreseen outcomes and unintended consequences. Overall, we propose a framework that advances an understanding of homophobic and homophilic politics as instrumentalizations of geo-temporal dislocations that underpin the global fight for LGBT rights. As a challenge to the progress narrative nearly intrinsic to western international relations, this approach is useful to explore processes that shape other types of transnational politics, such as democracy, climate change, and peace movements.
What Relations Matter?
Authors: Klasche Benjamin , Poopuu Birgit
Published: February 2023

What relations matter? This question sits at the heart of this article and addresses in a more thoroughgoing way the methodological and ethico-political problems that some relational thinkers have debated. We are interested in deep relationalism and the methodological problem of delineating which relations matter in a reality defined by an ever-unfolding web of relations. By acknowledging the relationality of critical international relations (IR) theories, this methodological puzzle is explored by recognizing the situatedness of relations that are being analyzed. Moreover, this helps us to start a conversation on the ethical and political dimensions of deeply relational approaches. By placing the ontological work of deep relationalism in dialogue with the epistemological and ethico-political aspects of critical theory, we are putting forth an account of critical relationalism. Furthermore, we are not only arguing for a critical approach to relationalism but also adding to one of the main methodological debates in relationalism that asks us to carefully consider which relations matter (for our analysis) and how we should access them? Finally, this piece advocates for more plural grounds for relationalism in IR to critically reflect on which relations our theoretical approaches can take us to and why this matters.
Allograft reconstruction of acetabular labrum has comparable outcomes to labral refixation
Authors: Abdelaal Mohammad S , Sutton Ryan M , Atillasoy Cenk , Parvizi Javad
Published: February 2023

The acetabular labrum plays an important role in hip stability, intra-articular fluid pressurization and force distribution. For irreparable labral pathology, labral reconstruction is an increasingly adopted technique shown to decrease hip pain and improve function. We evaluated survivorship and clinical outcomes of allograft labral reconstruction using the mini-open anterior surgical approach. Twelve patients who underwent labral reconstruction using a semitendinosus tendon allograft (reconstruction group) were matched 1:3 based on age, gender, body mass index, year of surgery, preoperative Tönnis grade, previous hip surgery, residual hip pathology and extent of acetabular chondral lesion to a control group of 36 patients who underwent direct labral repair with anchors (refixation group). At a minimum follow-up of 2 years, patient-reported outcomes, radiological findings and failure rates were compared. The average age was 31.3 years (±13.6) for reconstruction and 34.7 (±10.2) for refixation. Both groups had similar preoperative symptomatic periods (P = 0.3), prevalence of residual hip pathology (P = 1.0) and prevalence of prior hip surgeries (P = 1.0). both groups had a significant improvement of modified Harris Hip scores and 36-Item Short-Form Health Survey physical scores. There was no statistically significant difference in conversion rates to total hip arthroplasty (25% versus 8.3%, P = 0.2); however, time to conversion was significantly longer in the reconstruction group (3.58 years ±1.04) compared to the refixation group (1.20 years± 0.93; P = 0.04). In conclusion, at a minimum of 2 years of follow-up, mini-open labrum reconstruction for severe insufficiency of acetabular labrum demonstrated comparable improvements in functional outcomes and significantly longer survivorship compared to labral refixation.
International politics and oil trade: evidence from Russian oil exports
Authors: Mityakov Sergey , Portnykh Margarita , Tsui Kevin K
Published: February 2023

Oil is often considered a “political” good affected by the changes in international political relations. Using a novel dataset on Russian oil-exporting companies over 1999–2011, we find that a worsening in political relations between Russia and an oil-importing country results in a considerable reduction in oil shipments by Russian oil exporting firms into that country, the effect being stronger for state-owned firms. Using leadership changes in oil importing countries as exogenous shocks to political relations, we show that this relationship is causal. However, total exports revenue of Russian oil exporting firms is not affected much, as they seem to be able to recover losses incurred in one market by increasing their sales in other markets. At the same time, the countries importing oil from Russia (especially the ones heavily dependent on Russian oil) see their total oil and energy imports decline.
A new species of small-eared shrew (Soricidae, Cryptotis) from El Triunfo Biosphere Reserve, Chiapas, Mexico
Authors: Guevara Lázaro
Published: February 2023

The Cryptotis goodwini species group of small-eared shrews (Eulipotyphla, Soricidae) includes at least 12 species discontinuously distributed in the cloud forests from southern Mexico to Honduras. Its taxonomy is still under study, with several species described only in the last decade. Previous genetic studies have highlighted that a population from El Triunfo Biosphere Reserve in Chiapas, Mexico, previously assigned to C. goodwini, is evolutionarily divergent from the other known species. However, the available specimens from this region have not been examined rigorously. Herein, I use morphological and biogeographic analyses to evaluate the taxonomic status of this population. The results confirm that it is an independent lineage, which I describe here as a new species endemic to Mexico. Overall, this is the largest shrew within the C. goodwini group. Its morphological and genetic distinction is probably due to long-term geographic isolation in the mountains of El Triunfo. I present what is now the first and only record of C. goodwini (sensu stricto) for Mexico. Finally, I identify some priority regions to direct field surveys on the C. goodwini species group to better understand its richness and distribution.
Prostate cancer grade migration and facility-level treatment trends for grade group 1 disease
Authors: Borregales Leonardo D , Tzeng Michael , Ramaswamy Ashwin , Gu Xiangmei , Davuluri Meenakshi , Nagar Himanshu , Hu Jim C
Published: February 2023

Overdiagnosis and overtreatment of low-grade prostate cancer (PCa) reflect poor quality of care and prompted changes to guidelines over the past decade. We used the National Cancer Database to characterize Gleason Grade Group (GG)1 PCa diagnosis trends and assess facility-level treatment variability. Between 2010 and 2019, GG1 PCa incidence had a clinically and statistically significant decline, from 45% to 25% at biopsy and from 33% to 9.8% at radical prostatectomy (RP) pathology. Similarly, active surveillance (AS) uptake significantly increased to 49% and 62% among nonacademic and academic sites, respectively. Decreasing rates of definitive therapies were identified: among academic sites, RP decreased from 61.1% to 25.3% and radiation therapy (RT) from 25.2% to 12%, whereas among nonacademic sites, RP decreased from 53.6% to 28% and RT from 37.8% to 21.9% (Ptrend < .001). Declines in the diagnosis and treatment of low-grade disease demonstrate an encouraging shift in PCa epidemiology. However, heterogeneity in AS utilization remains and reflects opportunities for improvement.
Differential immunophenotypes of neuronal cytoplasmic inclusions in the dentate gyrus of multiple system atrophy and their association with clinicopathological features
Authors: Homma Taku , Mochizuki Yoko , Tobisawa Shinsuke , Komori Takashi , Takahashi Kazushi
Published: February 2023

Although hippocampal pathologies of multiple system atrophy (MSA) and their association with dementia have been reported, no studies have reported clinicopathological differences among MSA patients with and without neuronal cytoplasmic inclusions (NCIs) in the dentate gyrus (dntNCIs). We investigated hippocampal NCI pathology in 18 MSA patient autopsies, focusing on phosphorylated α-synuclein (pAS)- and phosphorylated tau (pT)-positive dntNCIs. There were 8 MSA patients without and 10 with dntNCIs. The latter group was subclassified by immunophenotype: those with pAS-positive dntNCIs (pAS-dntNCI subtype), those with pT-positive dntNCIs (pT-dntNCI subtype), and those with both types of dntNCIs. MSA patients with dntNCIs survived longer with prolonged tracheostomy and had dementia more frequently than those without dntNCIs. The brain weights of patients with dntNCIs were lower than those without dntNCIs. The presence of dementia was similar among the dntNCI subtypes. The pAS-dntNCI subtype was associated with longer survival and smaller brain weights; the pT-dntNCI subtype exhibited more frequent tau pathologies than the pAS-dntNCI subtype. Thus, MSA with dntNCIs is a possible pathological subtype of longer survivors that correlates with longer disease duration, prolonged tracheostomy, and high frequency of dementia. Understanding clinicopathological differences in MSA patients with and without dntNCIs may lead to improved personalized management strategies.
Phenylethanoid glycosides extract from Cistanche deserticola ameliorates atherosclerosis in apolipoprotein E-deficient mice and regulates intestinal PPARγ-LXRα-ABCA1 pathway
Authors: Jia Xiubin , Liu Boyan , Xue Junli , Liu Yunchao , Zhang Jingjun , Qin Shucun , Zhang Ying
Published: February 2023

Objectives

This study was aimed to evaluate the protective effects of phenylethanoid glycosides extract from Cistanche deserticola against atherosclerosis and its molecular mechanism.

Methods

Total phenylethanoid glycosides were extracted and purified from C. deserticola, and the C. deserticola extract (CDE) was used to treat a mice model of atherosclerosis.

Key findings

CDE containing 81.00% total phenylethanoid glycosides, with the contents of echinacoside and acteoside being 31.36% and 7.23%, respectively. A 13-week of CDE supplementation (1000 mg/kg body weight/day) significantly reduced atherosclerotic lesions in the aortic sinus and entire aorta in ApoE−/− mice fed with a high-fat diet. In addition, varying doses of CDE (250, 500 and 1000 mg/kg body weight/day) lowered plasma total cholesterol, triglyceride and non-high-density lipoprotein cholesterol levels. Transcriptomic analysis of the small intestine revealed the changes enriched in cholesterol metabolic pathway and the activation of Abca1 gene. Further validation using real-time quantitative PCR and western blot confirmed that CDE significantly increased the mRNA levels and protein expressions of ABCA1, LXRα and PPARγ.

Conclusions

Our results demonstrate the beneficial effects of C. deserticola on atherosclerotic plaques and lipid homeostasis, and it is, at least partially, by activating PPARγ-LXRα-ABCA1 pathway in small intestine.
Disentangling positive and negative partisanship in social media interactions using a coevolving latent space network with attractors model
Authors: Zhu Xiaojing , Caliskan Cantay , Christenson Dino P , Spiliopoulos Konstantinos , Walker Dylan , Kolaczyk Eric D
Published: February 2023

We develop a broadly applicable class of coevolving latent space network with attractors (CLSNA) models, where nodes represent individual social actors assumed to lie in an unknown latent space, edges represent the presence of a specified interaction between actors, and attractors are added in the latent level to capture the notion of attractive and repulsive forces. We apply the CLSNA models to understand the dynamics of partisan polarization in US politics on social media, where we expect Republicans and Democrats to increasingly interact with their own party and disengage with the opposing party. Using longitudinal social networks from the social media platforms Twitter and Reddit, we quantify the relative contributions of positive (attractive) and negative (repulsive) forces among political elites and the public, respectively.
Growth–defence trade-off in rice: fast-growing and acquisitive genotypes have lower expression of genes involved in immunity
Authors: de Tombeur Felix , Pélissier Rémi , Shihan Ammar , Rahajaharilaza Koloina , Fort Florian , Mahaut Lucie , Lemoine Taïna , Thorne Sarah J , Hartley Sue E , Luquet Delphine , Fabre Denis , Lambers Hans , Morel Jean-Benoît , Ballini Elsa , Violle Cyrille
Published: February 2023

Plant ecologists and molecular biologists have long considered the hypothesis of a trade-off between plant growth and defence separately. In particular, how genes thought to control the growth–defence trade-off at the molecular level relate to trait-based frameworks in functional ecology, such as the slow–fast plant economics spectrum, is unknown. We grew 49 phenotypically diverse rice genotypes in pots under optimal conditions and measured growth-related functional traits and the constitutive expression of 11 genes involved in plant defence. We also quantified the concentration of silicon (Si) in leaves to estimate silica-based defences. Rice genotypes were aligned along a slow–fast continuum, with slow-growing, late-flowering genotypes versus fast-growing, early-flowering genotypes. Leaf dry matter content and leaf Si concentrations were not aligned with this axis and negatively correlated with each other. Live-fast genotypes exhibited greater expression of OsNPR1, a regulator of the salicylic acid pathway that promotes plant defence while suppressing plant growth. These genotypes also exhibited greater expression of SPL7 and GH3.2, which are also involved in both stress resistance and growth. Our results do not support the hypothesis of a growth–defence trade-off when leaf Si and leaf dry matter content are considered, but they do when hormonal pathway genes are considered. We demonstrate the benefits of combining ecological and molecular approaches to elucidate the growth–defence trade-off, opening new avenues for plant breeding and crop science.
Ex vivowound model on porcine skin for the evaluation of the antibiofilm activity of polyhexamethylene biguanide and ciprofloxacin
Authors: Guedes Glaucia Morgana de Melo , Pinheiro Rodrigo Machado , Freitas Alyne Soares , Pereira Vinicius Carvalho , Gomes Francisco Ivanilsom Firmiano , Cordeiro Rossana de Aguiar , Sidrim José Júlio Costa , Rocha Marcos Fábio Gadelha , Castelo-Branco Debora de Souza Collares Maia
Published: February 2023

This study aimed to standardize the use of an ex vivo wound model for the evaluation of compounds with antibiofilm activity. The in vitro susceptibility of Staphylococcus aureus ATCC 29213 and Pseudomonas aeruginosa ATCC 27853 to ciprofloxacin and polyhexamethylene biguanide (PHMB) was evaluated in planktonic and biofilm growth. The effects of ciprofloxacin and PHMB on biofilms grown on porcine skin explants were evaluated by colony-forming unit (CFU) counting and confocal microscopy. Minimum inhibitory concentrations (MICs) against S. aureus and P. aeruginosa were, respectively, 0.5 and 0.25 µg mL−1 for ciprofloxacin, and 0.78 and 6.25 µg mL−1 for PHMB. Minimum biofilm eradication concentrations (MBECs) against S. aureus and P. aeruginosa were, respectively, 2 and 8 µg mL−1 for ciprofloxacin, and 12.5 and >25 µg mL−1 for PHMB. Ciprofloxacin reduced (P < 0.05) log CFU counts of the biofilms grown ex vivo by 3 and 0.96 for S. aureus and P. aeruginosa, respectively, at MBEC, and by 0.58 and 8.12 against S. aureus and P. aeruginosa, respectively, at 2xMBEC. PHMB (100 µg/mL) reduced (P < 0.05) log CFU counts by 0.52 for S. aureus and 0.68 log for P. aeruginosa, leading to an overall decrease (P < 0.05) in biofilm biomass. The proposed methodology to evaluate the susceptibility of biofilms grown ex vivo led to reproducible and reliable results.