bluuebunny/crossref_metadata_2025 huggingface dataset:
Building a system dynamics model to analyze scenarios of COVID-19 policymaking in tourism-dependent developing countries: A case study of Cambodia
Authors: Li Shuangjin , Ma Shuang , Zhang Junyi
Published: January 2022

To control the COVID-19 pandemic, various policies have been implemented to restrict the mobility of people. Such policies, however, have resulted in huge damages to many economic sectors, especially the tourism sector and its auxiliary services. Focusing on Cambodia, this study presents a system dynamics (SD) model for assessing and selecting effective policy responses to contain the spread of COVID-19, while maintaining tourism development. Policies targeted in this study include international and domestic transportation bans, quarantine policy, tourist-centered protection measures, and enterprise-led protection measures. Two types of scenario analyses are conducted: one targets each policy separately and the other combines different policies. Among all scenarios, quarantine policy is evaluated to be the most effective policy as it balances the containment of the spread of COVID-19 and support for tourism development. This study provides a new way of guiding COVID-19 policymaking and exploring effective policies in the context of tourism.
What’s the problem with “screen time”? A content analysis of dominant voices and worries in three years of national print media
Authors: Størup Jan Ole , Lieberoth Andreas
Published: January 2022

This study examined the various ways in which Danish news media represented digital media as a problem over a period of three years. We present data from a content analysis of 263 newspaper articles and chi-squared analyses identifying associations between worries, voices, culprits, and those responsible for solving problems. We find professionals significantly responsible for framing problems with screen time in terms of mental health issues and addiction, while the broader discourse is one of, for example, time theft, video game addiction, and issues in schools. Technologies are often diffused using “screens” to describe a broad palette of devices/applications, are represented as responsible for distractions while the technology industry is held culpable for effects on social relations and addictive behaviors. We discuss how patterns in media coverage and expert use affects public understandings, and the overall findings that while technologies are represented as responsible for particular problems, the “screen” discourse is a space in which arguments shift between technologies, problems, and authorities.
“It's easy to dismiss it as simply a spiritual problem.” Experiences of mental distress within evangelical Christian communities: A qualitative survey
Authors: Lloyd Christopher E. M. , Hutchinson Jonathan
Published: January 2022

Evidence suggests that faith communities can support psychological wellbeing but can also potentially diminish wellbeing through stigma, imposed spiritualization, and marginalization. In particular, for evangelical Christianity, whose theological praxis typically accentuates literalist spiritual onto-etiologies, including the belief that mental distress can be treated solely through spiritual intervention (prayer, fasting, and deliverance), there may be negative implications for Christians with mental distress. The current qualitative survey examined the responses of 293 self-identified evangelical Christians, concerning their experiences of mental distress in relation to their church community. An inductive thematic analysis revealed five themes: 1) Tensions between Faith and Suffering; 2) Cautions about a Reductive Spiritualization; 3) Feeling Othered and Disconnected; 4) Faith as Alleviating Distress; and 5) Inviting an Integrationist Position. Findings reveal stigma and the totalizing spiritualization of mental distress can be experienced as both dismissive and invalidating and can problematize secular help-seeking. This lends support to previous research which has suggested that evangelical Christian communities tend to link mental distress to spiritual deficiencies, which can hold potentially negative consequences for their wellbeing. Nevertheless, a degree of complexity and nuance emerged whereby spiritual explanations and interventions were also experienced as sometimes helpful in alleviating suffering. Overall, findings suggest evangelical communities are increasingly adopting integrationist understandings of mental distress, whereby spiritual narratives are assimilated alongside the biopsychosocial. We argue that church communities and psychotherapeutic practitioners should support movement from a position of dichotomizing psychological suffering (e.g., spiritual vs. biopsychosocial) towards a spiritually syntonic frame, which contextualizes distress in terms of the whole person. Considerations for psychotherapeutic practice and further research are made.
Mesoscale modelling of recycled aggregate concrete under uniaxial compression of different strain rates
Authors: Zhou Xiao-Qing , Xie Li-Cheng
Published: January 2022

Studying the compressive behaviour of recycled aggregate concrete (RAC) under different strain rates in a mesoscale model is of considerable interest. In the mesoscale model in this paper, RAC is regarded as a five-phase composite material mainly comprising natural aggregates, old interface transition zone (ITZ), old cement mortar, new ITZ and new cement mortar. The existence of pore defects is also considered. Random round aggregates and oval aggregate models of different recycled coarse aggregate replacement rates (0%, 25%, 50%, 75% and 100%) are constructed in the mesoscale RAC model. The uniaxial compressive behaviour of the mesoscale RAC model under different strain rates is numerically simulated. Numerical results show that the material properties of the ITZs have an impact on material damage. The compressive strength of recycled concrete increases with the strain rate, showing dynamic strain rate effects. The dynamic increase in strength is not only due to the material property, but also due to the inertia confinement. A mesoscale model of RAC with 1% porosity is then established to study the influence of initial micro-defects in RAC on its mechanical properties. The numerical results are compared with those of RAC without initial pore defects. These results indicate that the existence of pores considerably affects the formation and development of cracks under static and dynamic uniaxial compressions and weakens the compressive strength of RAC materials.
The role of coaching identity and life purpose orientations in holistic athlete development
Authors: Yukhymenko-Lescroart Mariya A. , Sharma Gitima
Published: January 2022

Life purpose plays an important role in the wellbeing of adults. The current study considered domain-general and domain-specific purpose of NCAA coaches to examine whether purpose orientation in life predicted coaching purpose related to holistic athlete development directly and indirectly through coaching identity. A cross-sectional design was used. Collegiate coaches ( N = 380, 62.1% male) from NCAA Division I and III institutions completed questionnaires assessing purpose orientation (career-focused, others-growth, and self-growth), coaching identity (winning-centered, holistic development-centered), and coaching purpose related to athlete development (sport-specific competence, sport-general competence, confidence, connection, and character). Structural equation modeling indicated the following: Coaching purpose related to sport-specific competence was predicted directly and indirectly via winning-centered coaching identity by career-focused purpose orientation. The four dimensions of coaching purpose (sport-general competence, confidence, connection, and character) were predicted indirectly via development-centered coaching identity by others-growth purpose orientation and by career-focused purpose orientation. Others-growth purpose orientation emerged as a significant direct predictor of coaching purpose related to connection. Inconsistent mediation emerged between others-growth purpose orientation and coaching purpose related to confidence. Overall, the findings highlight that purpose orientation can predict coaching purpose and that coaching identity centered around athletes’ holistic development and growth plays a salient role in explaining these relationships.
Can urethral re-bulking improve the outcomes of a prior urethral bulking?
Authors: Giammò Alessandro , Ammirati Enrico , Geretto Paolo , Manassero Alberto , Squintone Luisella , Falcone Marco , Del Popolo Giulio , Pistolesi Donatella , Risi Oreste , Costantini Elisabetta , Giannantoni Antonella , Mancini Vito , Li Marzi Vincenzo , Agrò Enrico Finazzi , Pastorello Mauro , Musco Stefania , Gontero Paolo
Published: January 2022

Aims:

To analyze the outcomes of urethral re-bulking in the treatment of female stress urinary incontinence.

Materials and Methods:

We performed a multicenter observational retrospective study, which included all consecutive patients treated with urethral re-bulking for the treatment of persistent stress or mixed urinary incontinence after a previous urethral bulking. Objective outcomes were evaluated with the 24 h pad-test, while PGI-I questionnaires were administered to evaluate subjective outcomes. Clinical outcomes were assessed before re-bulking procedure and at last follow-up. Mann–Whitney’s U test was used for subgroup analysis. Shapiro-Wilk’s tests were used as normality tests.

Results:

In total, 62 patients who underwent urethral re-bulking between 2013 and 2020 in a multicenter setting were included. Most patients did not reach complete continence after the first procedure (n = 56) while the remainder reported recurrence of urinary incontinence after initial benefit. Median age at surgery was 66 (IQR: 55-73). Median overall follow-up was 30 months (IQR: 24-41). Median time occurred between the first procedure and reintervention was 12 months (IQR: 7-27). Bulking agents for the re-bulking procedures were bulkamid(n = 56), macroplastique(n = 4), and Prolastic(n = 2). A statistically significant reduction of median 24 h pad test from 100 g(IQR: 40-200) to 35 g(IQR: 0-120) was observed (p = 0.003). Dry rate after rebulking was 36.6%, while 85.4% patients declared themselves ‘very much improved’ or ‘much improved’ (PGI-I 1-2). Very few low-grade complications were observed (n = 4). A single case of major complication occurred.

Conclusions:

Urethral re-bulking can be an effective technique for the treatment of stress urinary incontinence refractory to a previous urethral bulking and can determine a cumulative benefit after the first procedure.
Evaluating an Inpatient Created Art Installation on Perceptions of the Physical Environment, Health Status, and Rehabilitation Motivation
Authors: Lakhani Ali , Waters Dan , Dema Salvatore
Published: January 2022

Objectives:

A methodology to assess the impact of involving end users in therapeutic activities to address the hospital physical environment is provided. The impact of participating in a recreational art creation program with the aim of developing an art installation on the immediate feelings of participants and their perception of the physical rehabilitation environment (PPRE) and motivation to participate in rehabilitation (MPR) is investigated.

Background:

Rehabilitation unit design has largely excluded the perspectives of end users with disability. Including their aesthetic design contributions moves beyond contemporary approaches where their perspectives are considered.

Methods:

A two-period, mixed-methods pre–post intervention design involving within and between group comparisons is proposed. During Period 1, program participants and nonparticipants completed admission (T1) and discharge (T2) surveys including PPRE and MPR measures developed by the authors. Surveys pre and post each art session were completed. The art installation will be implemented within unit corridors. Period 2 participants will complete a T1 survey and their physical environment perceptions compared to Period 1 participants.

Results:

Participating in the recreational art program significantly improved immediate levels of calmness, happiness, pain, and physical health. There is a positive relationship between environment perception and rehabilitation motivation.

Conclusions:

People with disability should be actively involved in healthcare environment design. Arts-based programs have relevance to people with neurological injury as it promotes essential sensory stimulation. The methodology and findings can encourage further work which involves end users in the design of healthcare environments and evaluates the impact of their involvement.
Revascularization or medical therapy for stable coronary artery disease patients with different degrees of ischemia: a systematic review and meta-analysis of the role of myocardial perfusion
Authors: Yong JingWen , Tian JinFan , Zhao Xin , Yang XueYao , Zhang MingDuo , Zhou Yuan , He Yi , Song XianTao
Published: January 2022

Objective:

This study explored the best treatment strategies for stable coronary artery disease (SCAD) patients with differing levels of ischemic severity.

Methods:

We conducted a comprehensive search of the PubMed, EMBASE, and Cochrane databases – searching for relevant articles through 4 February 2021. We selected studies comparing different treatments for patients with SCAD who had received ischemia assessments. The primary outcome was death. The secondary outcomes were major adverse cardiovascular events (MACEs) and myocardial infarction (MI).

Results:

A total of 11 studies, including 35,607 subjects, were selected for this meta-analysis. Results showed that, compared with medical therapy, revascularization could reduce MACE incidence (odds ratio (OR) 0.73, 95% confidence interval (CI): 0.57–0.94, p < 0.05) in SCAD patients with myocardial ischemia, but that it was not effective for patients without ischemia. For mild ischemia, the incidence of death (OR 0.78, 95% CI: 0.59–1.01, p = 0.063), MACE (OR 0.91, 95% CI: 0.48–1.70, p = 0.762), or MI (OR 1.44, 95% CI: 0.94–2.19, p = 0.093) was the same whether they were treated with revascularization or medical therapy. For moderate to severe ischemia, revascularization reduced the incidence of MACE (OR 0.59, 95% CI: 0.42–0.83, p < 0.05) and MI (OR 0.83, 95% CI: 0.71–0.98, p < 0.05), but the incidence of death (OR 0.73, 95% CI: 0.47–1.12, p = .145) was similar. For SCAD patients with severe ischemia, revascularization may confer survival benefits (OR 0.46, 95% CI: 0.21–1.00, p = 0.05).

Conclusion:

For SCAD patients with moderate to severe ischemia, revascularization reduces the MACE and MI incidences, but does not change the incidence of death. Evaluation for myocardial ischemia is vital when selecting a therapeutic strategy.
The need for a strategic therapeutic approach: multiple sclerosis in check
Authors: Inojosa Hernan , Proschmann Undine , Akgün Katja , Ziemssen Tjalf
Published: January 2022

Multiple sclerosis (MS) is the most common chronic autoimmune neurological disease. Its therapeutic management has drastically evolved in the recent years with the development of specific disease-modifying therapies (DMTs). Together with the established injectables, oral and intravenous alternatives are now available for MS patients with significant benefits to modulate the disease course. Certain drugs present with a higher efficacy than the others, profiles and frequencies of adverse events differentiate as well. Thus due to the several and different treatment alternatives, the therapeutic approach adopted by neurologists requires a tactical focus for a targeted, timed, and meaningful treatment decision. An integration of rational and emotional control with proper communication skills is necessary for shared decision-making with patients. In this perspective paper, we reinforce the necessary concept of strategic MS treatment approach using all available therapies based on scientific evidence and current experience. We apply a didactic analogy to the strategic game chess. The opening with oriented attack (i.e. already in early disease stages as clinical isolated syndrome), a correct choice of chess pieces to move (i.e. among the several DMTs), a re-assessment reaction to different scenarios (e.g. sustained disease activity, adverse events, and family planning) and the advantage of real-world data are discussed to try the best approach to ultimately successfully approach the best personalized MS treatment.
Garcinia kola treatment exhibits immunomodulatory properties while not affecting type 1 diabetes development in an experimental mouse model
Authors: Cetkovic-Cvrlje Marina , Rogan Shana , Barbaro Emily
Published: January 2022

Objective

T cells orchestrate an inflammatory response that destroys pancreatic insulin-producing β cells during the development of autoimmune type 1 diabetes (T1D). Garcinia kola Heckel (GK) is a plant widely exploited in West African traditional medicine. Some of the therapeutic effects of GK nut’s extract (GKE) have been suggested to be due to its anti-inflammatory potential. Since GKE has never been investigated in a T1D experimental model, nor in the T cells’ context, we aimed to determine whether GKE exhibits antidiabetic properties and affects T cells by its anticipated anti-inflammatory action.

Methods

The effect of aqueous GKE (aGKE) ingestion, 100 mg/kg daily by drinking water over the period of 6 weeks, has been tested in a low-dose streptozotocin-induced (LDSTZ) mouse model of autoimmune T1D. T cells were studied in vitro and in vivo in mice treated by aGKE.

Results

The results showed that aGKE treatment, which started a week before induction of disease, neither delayed the development of T1D, nor reduced glycemia severity. Interestingly, aGKE treatment did affect T cells and their function, significantly decreasing the frequency of helper (TH) and cytotoxic (TC) T cells, while elevating the levels of pro-inflammatory cytokines, TNF-α, IL-6, and IFN-γ, and suppressing IL-2.

Conclusion

In conclusion, our results did not confirm the antidiabetic property of GKE, while suggesting its therapeutic exploration in TH2-dependent pathologies that benefit from an aggravated TH1 response, such as allergies.
Dysregulation of let-7c-5p/Tyrosyl-DNA phosphodiesterase 1 axis indicates an unfavorable outcome in gastric cancer
Authors: Wang Lan , Zou Jing , Zhang Jing
Published: January 2022

Introduction

Tyrosyl-DNA phosphodiesterase 1 (TDP1) can repair oxidative damage-caused 3′-phosphoglycolates and promote cancer progression. However, the clinical significance of TDP1 and its correlation with microRNAs (miRNAs) in gastric cancer (GC) remains unknown.

Methods

The relationship of TDP1 or let-7c-5p with the clinical outcomes of GC was determined by a tissue microarray and TCGA dataset. Cell viability and invasion were assessed by MTT and Transwell assays. Pearson correlation analysis, luciferase gene report, qRT-PCR, and Western blot analyses were used to analyze the interaction between TDP1 and let-7c-5p in GC tissues and cells.

Results

We found that TDP1 expression was elevated in GC tissues and associated with the dysregulation of let-7c-5p. Knockdown of TDP1 inhibited GC cell proliferation and invasion. let-7c-5p could be found to bind with TDP1, reduce its expression levels, and represent a predictive marker in GC.

Conclusion

Our findings demonstrated that dysregulation of let-7c-5p/TDP1 axis could predict a poor prognosis in GC.
Traditional Visual Language: A Geographical Semiotic Analysis of Indigenous Linguistic Landscape of Ancient Waterfront Towns in China
Authors: Sheng Rong , Buchanan John
Published: January 2022

This paper investigates the characteristics of the indigenous linguistic landscape and the features of traditional visual language under the conceptual framework of Geo-semiotics, which has been generally overlooked in the literature. As a case study of the indigenous linguistic landscape situated in ancient waterfront towns of China, the ethnographic data was collected through a field-based survey for 3 months by recording hundreds of photographs of top-down and bottom-up signs, conducting semi-structured questionnaires, and in-depth interviews in the heritage precincts. The results show that the Chinese language firmly occupies a dominant position. The use of Chinese semiotic assemblages and historical linguistic objects including handwritten font, traditional Chinese characters, and calligraphic nameplates facilitate the nostalgia visual communication in the context of urbanization. In this light, this paper contributes to preserving the indigenous linguistic landscape and Chinese semiotic artifact in the sociolinguistics approach.
Project-Based Learning of Diffusion and Osmosis: Opinions of Students of Physics and Technology at University of Novi Sad
Authors: Čavić Milan R. , Stanisavljević Jelena D. , Bogdanović Ivana Z. , Skuban Sonja J. , Pavkov-Hrvojević Milica V.
Published: January 2022

There are subjects which university students perceive as uninteresting and which they are reluctant to learn. The use of an appropriate approach to learning can contribute to the formation of positive students’ opinions on learning. Project-based learning (PjBL) is characterized by active research, problem-solving, and student-made projects which is nowdays usually facilitated by the use of computer and network technologies. The aim of this research is to assess opinions of students of physics and technology at University of Novi Sad, Republic of Serbia, on PjBL, as well as to analyze these opinions in connection to three different factors: gender, academic performance, and study program. The physics content Diffusion and Osmosis was realized using PjBL. This topic was chosen because of possible interdisciplinary concepts’ relations between physics, chemistry, and biology. After students’ group work on projects and their project reports, a survey was conducted. Research results showed that opinions of students participating in the research about PjBL were independent of their gender, academic performance, as well as whether they study physics or technology. All students had equally positive opinions on PjBL. Further implementation of PjBL is planned in the authors’ departments, along with the integrative implementation of PjBL in teaching science in collaboration with other departments at the university.
Heterotopic Ossification After Arthroscopic Procedures: A Scoping Review of the Literature
Authors: Zhou Liang , Gee Shawn M. , Hansen Joshua A. , Posner Matthew A.
Published: January 2022

Background:

Heterotopic ossification (HO) is the formation of bone in soft tissue resultant from inflammatory processes. Lesion formation after arthroscopic procedures is an uncommon but challenging complication. Optimal prophylaxis and management strategies have not been clearly defined.

Purpose:

To present a scoping review of the pathophysiology, risk factors, diagnostic modalities, prophylaxis recommendations, and current treatment practices concerning HO after arthroscopic management of orthopaedic injuries.

Study Design:

Scoping review; Level of evidence, 4.

Methods:

A scoping review via a PubMed search was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines. The search strategy was based on the terms “heterotopic ossification” AND “arthroscopy.” The clinical outcomes review included studies on the arthroscopic management of orthopaedic injuries in which the primary subject matter or a secondary outcome was the development of HO. An analysis of the pathophysiology, diagnostic modalities, and management options was reported.

Results:

A total of 43 studies (33,065 patients) reported on HO after hip arthroscopy, while 21 (83 patients) collectively reported on HO after arthroscopic procedures to the shoulder, elbow, knee, or ankle; however, management techniques were not standardized. Identified risk factors for HO included male sex and mixed impingement pathology, while intraoperative capsular management was not suggested as a contributing factor. Diagnosis of ossification foci was performed using radiography and computed tomography. The rate of HO after hip arthroscopy procedures approached 46% without prophylaxis, and administration of nonsteroidal anti-inflammatory drugs (NSAIDs) decreased occurrence rates to 4% but carries associated risks. External beam radiation has not been exclusively studied for use after arthroscopic procedures.

Conclusion:

HO is a known complication after arthroscopic management of orthopaedic injuries. NSAID prophylaxis has been demonstrated to be effective after hip arthroscopy procedures. Patients with persistent symptoms and mature lesions may be indicated for surgical excision, although variability is present in patient-reported outcome scores postoperatively.
Outcomes of relapsed B-cell acute lymphoblastic leukemia after sequential treatment with blinatumomab and inotuzumab
Authors: Wudhikarn Kitsada , King Amber C. , Geyer Mark B. , Roshal Mikhail , Bernal Yvette , Gyurkocza Boglarka , Perales Miguel-Angel , Park Jae H.
Published: January 2022

Novel monoclonal antibody (mAb)-based therapies targeting CD19 and CD22 (blinatumomab and inotuzumab) have shown high rates of complete remission (CR) and been used as a bridging treatment to potentially curative allogeneic hematopoietic stem cell transplantation (alloHSCT) in adults with relapsed or refractory (R/R) B-cell acute lymphoblastic leukemia (B-ALL). However, limited data exist on the outcome of patients resistant to both mAbs as well as responses to each agent when progressed after the alternate antigen-targeted mAb. Herein, we report outcomes of 29 patients with R/R B-ALL previously treated with both blinatumomab and inotuzumab. Twenty-five patients (86.2%) received blinatumomab as first mAb (mAb1), and CD19-negative/dim relapses were observed in 44% of the patients. Inotuzumab induced CR in 68% of the patients for post-blinatumomab relapse regardless of CD19 expression status. The median time between mAb1 and mAb2 was 99 days. Twelve (63.2%) of 19 patients who achieved remission after mAb2 underwent alloHSCT. The median time from mAb2 to alloHSCT was 37.5 days. Acute graft-versus-host disease and nonrelapse mortality were observed in 58.3% (grade 3 or higher, 25%) and 41.7%, respectively. With a median follow-up of 16.8 months after mAb2, 19 patients (65.5%) relapsed, and 21 patients (72.4%) have died. Overall survival was not different between alloHSCT and non-alloHSCT patients. In conclusion, patients with B-ALL who relapsed after blinatumomab could be successfully rescued by inotuzumab as a bridge to alloHSCT but represent an ultra-high-risk group with poor overall survival. Further studies, including novel consolidation and treatment sequence, may improve outcomes of these patients.
Benefits of newborn screening and hematopoietic cell transplant in infantile Krabbe disease
Authors: Page Kristin M. , Ream Margie A. , Rangarajan Hemalatha G. , Galindo Rafael , Mian Ali Y. , Ho Mai-Lan , Provenzale James , Gustafson Kathryn E. , Rubin Jennifer , Shenoy Shalini , Kurtzberg Joanne
Published: January 2022

Infantile Krabbe disease (IKD) can be treated with hematopoietic cell transplantation (HCT) if done during the first weeks of life before symptoms develop. To facilitate this, newborn screening (NBS) has been instituted in 8 US states. An application to add IKD to the recommended NBS panel is currently under review. In this report, the outcomes of newborns with IKD diagnosed through NBS and treated with HCT are presented. The unique challenges associated with NBS for this disease are discussed, including opportunities for earlier diagnosis and streamlining treatment referrals. This is a retrospective review of six infants with IKD detected by NBS who were referred for HCT. The timing from diagnosis to HCT was examined, and both HCT and neurodevelopmental outcomes are described. Neurologic testing before HCT revealed evidence of active IKD in all infants. All underwent HCT between 24 and 40 days of age, were successfully engrafted, and are alive 30 to 58 months later (median, 47.5 months). All are gaining developmental milestones albeit at a slower pace than unaffected age-matched peers. Gross motor function is most notably affected. NBS for these patients enabled early access to HCT, the only currently available treatment of infants with IKD. All children are alive and have derived developmental and neurologic benefits from timely HCT. Long-term follow up is ongoing. Optimization of HCT and further development of emerging therapies, all of which must be delivered early in life, are expected to further improve outcomes of infants with IKD.
Incidence and time trends of second primary malignancies after non-Hodgkin lymphoma: a Swedish population-based study
Authors: Joelsson Joel , Wästerlid Tove , Rosenquist Richard , Jakobsen Lasse Hjort , El-Galaly Tarec C. , Smedby Karin E. , Eloranta Sandra
Published: January 2022

Considering treatment changes and an improved prognosis of non-Hodgkin lymphoma (NHL) over time, knowledge regarding long-term health outcomes, including late effects of treatment, has become increasingly important. We report on time trends of second primary malignancies (SPMs) in Swedish NHL patients, encompassing the years before as well as after the introduction of anti-CD20 antibody therapy. We identified NHL patients in the Swedish Cancer Register 1993 to 2014 and matched comparators from the Swedish Total Population Register. The matched cohort was followed through 2017. By linking to the Swedish Lymphoma Register, subcohort analyses by NHL subtype were performed. Flexible parametric survival models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs) of SPM among patients and comparators. Among 32 100 NHL patients, 3619 solid tumors and 217 myelodysplastic syndrome (MDS)/acute myeloid leukemia (AML) cases were observed, corresponding to a 40% higher rate of solid tumors (HRsolid tumors = 1.4; 95% CI, 1.4-1.5) and a 5-fold higher rate of MDS/AML (HRMDS/AML = 5.2; 95% CI, 4.4-6.2) than for comparators. Overall, the observed excess risks for solid tumors or MDS/AML remained stable over the study period, except for follicular lymphoma, where the excess rate of MDS/AML attenuated with time (P for trend = .012). We conclude that NHL survivors have an increased risk of both solid tumors and hematologic malignancies, in particular MDS/AML. Stable excess risks over time indicate that contemporary treatment standards are not associated with modified SPM risk. Encouragingly, decreasing rates of MDS/AML were noted among patients with follicular lymphoma, possibly due to the increasing use of nonchemotherapy-based treatments.
Distribution, characterization, and antibiotic resistance of hypervirulent Klebsiella pneumoniae isolates in a Chinese population with asymptomatic bacteriuria
Authors: Li Jun , Li Yanbing , Tang Mengli , Xia Fengjun , Min Changhang , Hu Yongmei , Wang Haichen , Zhang Jingyi , Zou Mingxiang
Published: January 2022

Background

Asymptomatic bacteriuria (ASB) frequently occurs among all ages and may develop into urinary tract infections (UTIs). Hypervirulent Klebsiella pneumoniae (hvKP) has become a new threat to human health. In our study, we aimed to investigate the epidemiological characteristics of hvKP in population with ASB.

Results

A total of 61 K. pneumoniae isolates were collected from 7530 urine samples between October and December 2020. The strains were sensitive to most of the antimicrobial agents tested, but a polymyxin resistant strain was found (MIC>16 μg/mL). Three serotypes were detected, including K1 (16.4%, 10/61), K5 (1.6%, 1/61) and K57 (3.2%, 2/61). Four strains (KPNY9, KPNY31, KPNY40, and KPNY42) carried a combination of two or more hypervirulent markers (peg-344, iroB, iucA, prmpA, and prmpA2), and their survival rates after Galleria mellonella infection were lower than those of the other strains (40.0 vs. 70.0%), suggesting that they were hvKP. These hvKP strains with lower biofilm forming ability than classical K. pneumoniae (0.2625 ± 0.0579 vs. 0.6686 ± 0.0661, P = 0.033) were identified as belonging to K2-ST65, K2-ST86, K57-ST592, and K2-ST5559 (a new ST type). KPNY31 (ST5559) shared a close genetic relationship with KPNY42 (ST86) and other ST86 isolates, which have been detected in both nosocomial and community-acquired infections.

Conclusions

The hvKP with relatively weak biofilm formation was detected in a population with ASB, which was more likely to cause bacteremia and serious consequences. A novel sequence type (ST5559) hvKP derived from ST86 was found. Therefore, hvKP should be monitored in the population with ASB.
Physiological mechanism of strigolactone enhancing tolerance to low light stress in cucumber seedlings
Authors: Zhou Xinpeng , Tan Zhanming , Zhou Yaguang , Guo Shirong , Sang Ting , Wang Yu , Shu Sheng
Published: January 2022

Strigolactone is a newly discovered type of plant hormone that has multiple roles in modulating plant responses to abiotic stress. Herein, we aimed to investigate the effects of exogenous GR24 (a synthetic analogue of strigolactone) on plant growth, photosynthetic characteristics, carbohydrate levels, endogenous strigolactone content and antioxidant metabolism in cucumber seedlings under low light stress. The results showed that the application of 10 μM GR24 can increase the photosynthetic efficiency and plant biomass of low light-stressed cucumber seedlings. GR24 increased the accumulation of carbohydrates and the synthesis of sucrose-related enzyme activities, enhanced antioxidant enzyme activities and antioxidant substance contents, and reduced the levels of H2O2and MDA in cucumber seedlings under low light stress. These results indicate that exogenous GR24 might alleviate low light stress-induced growth inhibition by regulating the assimilation of carbon and antioxidants and endogenous strigolactone contents, thereby enhancing the tolerance of cucumber seedlings to low light stress.
Development and validation of a risk nomogram for postoperative acute kidney injury in older patients undergoing liver resection: a pilot study
Authors: Yu Yao , Zhang Changsheng , Zhang Faqiang , Liu Chang , Li Hao , Lou Jingsheng , Xu Zhipeng , Liu Yanhong , Cao Jiangbei , Mi Weidong
Published: January 2022

Background

Postoperative acute kidney injury (AKI) is associated with poor clinical outcomes. Early identification of high-risk patients of developing postoperative AKI can optimize perioperative renal management and facilitate patient survival. The present study aims to develop and validate a nomogram to predict postoperative AKI after liver resection in older patients.

Methods

A retrospective observational study was conducted involving data from 843 older patients scheduled for liver resection at a single tertiary high caseload general hospital between 2012 and 2019. The data were randomly divided into training (70%, n = 599) and validation (30%, n = 244) datasets. The training cohort was used to construct a predictive nomogram for postoperative AKI with the logistic regression model which was confirmed by a validation cohort. The model was evaluated by receiver operating characteristic (ROC) curve, calibration plot, and decision curve analysis in the validation cohort. A summary risk score was also constructed for identifying postoperative AKI patients.

Results

Postoperative AKI occurred in 155 (18.4%) patients and was highly associated with in-hospital mortality (5.2% vs. 0.7%, P <  0.001). The six predictors selected and assembled into the nomogram included age, preexisting chronic kidney disease (CKD), non-steroidal anti-inflammatory drugs (NSAIDs) usage, intraoperative hepatic inflow occlusion, blood loss, and transfusion. The predictive nomogram performed well in terms of discrimination with area under ROC curve (AUC) in training (0.73, 95% confidence interval (CI): 0.68–0.78) and validation (0.71, 95% CI: 0.63–0.80) datasets. The nomogram was well-calibrated with the Hosmer-Lemeshow chi-square value of 9.68 (P = 0.47). Decision curve analysis demonstrated a significant clinical benefit. The summary risk score calculated as the sum of points from the six variables (one point for each variable) performed as well as the nomogram in identifying the risk of AKI (AUC 0.71, 95% CI: 0.66–0.76).

Conclusion

This nomogram and summary risk score accurately predicted postoperative AKI using six clinically accessible variables, with potential application in facilitating the optimized perioperative renal management in older patients undergoing liver resection.

Trial registration

NCT04922866, retrospectively registered on clinicaltrials.gov on June 11, 2021.
The association of allergic asthma and carotid intima-media thickness in adolescence: data of the prospective early vascular ageing (EVA)-Tyrol cohort study
Authors: Winder Bernhard , Kiechl Sophia J. , Gruber Nadja M. , Bernar Benoît , Gande Nina , Staudt Anna , Stock Katharina , Hochmayr Christoph , Geiger Ralf , Griesmacher Andrea , Anliker Markus , Kiechl Stefan , Kiechl-Kohlendorfer Ursula , Knoflach Michael ,   the Early Vascular Ageing (EVA)-Tyrol Study Group, Reiter Carmen , Schreiner Christina , Klingenschmid Julia , Marxer Julia , Kothmayer Martina , Pircher Maximilian , Bock-Bartl Manuela , Asare Mandy , Bohl Maximilian , Pechlaner Raimund
Published: January 2022

Background

In recent years, there has been increasing evidence that asthma is associated with atherosclerosis and cardiovascular disease. However, data in children and adolescents are scarce and conflicting. We aimed to assess the impact of asthma with and without an allergic component on the carotid intima-media thickness in a large pediatric population.

Methods

The community-based early vascular ageing-Tyrol cohort study was performed between May 2015 and July 2018 in North, East (Austria) and South Tyrol (Italy) and recruited youngster aged 14 years and above. Medical examinations included anthropometric measurements, fasting blood analysis, measurement of the carotid intima-media thickness by high-resolution ultrasound, and a physician guided interview.

Results

The mean age of the 1506 participants was 17.8 years (standard deviation 0.90). 851 (56.5%) participants were female. 22 subjects had a physician diagnosis of non-allergic asthma, 268 had inhalative allergies confirmed by a positive radio-allergo-sorbent-test and/or prick test, and 58 had allergic asthma. Compared to healthy controls, participants with non-allergic asthma (411.7 vs. 411.7 µm; p = 0.932) or inhalative allergy (420.0 vs. 411.7 µm; p = 0.118) did not have significantly higher carotid intima-media thickness (cIMT). However, participants with allergic asthma had significantly higher cIMT (430.8 vs. 411.7; p = 0.004) compared to those without and this association remained significant after multivariable adjustment for established cardiovascular risk factors.

Conclusion

Allergic asthma in the youth is associated with an increased carotid intima-media thickness. Physicians should therefore be aware of allergic asthma as a potential cardiovascular risk factor in children and adolescents.

Trial Registration Number The EVA-Tyrol Study has been retrospectively registered at clinicaltrials.gov under NCT03929692 since April 29, 2019.
Routine use of low-dose glucarpidase following high-dose methotrexate in adult patients with CNS lymphoma: an open-label, multi-center phase I study
Authors: Schaff Lauren R. , Lobbous Mina , Carlow Dean , Schofield Ryan , Gavrilovic Igor T. , Miller Alexandra M. , Stone Jacqueline B. , Piotrowski Anna F. , Sener Ugur , Skakodub Anna , Acosta Edward P. , Ryan Kevin J. , Mellinghoff Ingo K. , DeAngelis Lisa M. , Nabors Louis B. , Grommes Christian
Published: January 2022

Background

High-dose methotrexate (HD-MTX) has broad use in the treatment of central nervous system (CNS) malignancies but confers significant toxicity without inpatient hydration and monitoring. Glucarpidase is a bacterial recombinant enzyme dosed at 50 units (u)/kg, resulting in rapid systemic MTX clearance. The aim of this study was to demonstrate feasibility of low-dose glucarpidase to facilitate MTX clearance in patients with CNS lymphoma (CNSL).

Methods

Eight CNSL patients received HD-MTX 3 or 6 g/m2 and glucarpidase 2000 or 1000u 24 h later. Treatments repeated every 2 weeks up to 8 cycles.

Results

Fifty-five treatments were administered. Glucarpidase 2000u yielded > 95% reduction in plasma MTX within 15 min following 33/34 doses (97.1%) and glucarpidase 1000u yielded > 95% reduction following 15/20 doses (75%). Anti-glucarpidase antibodies developed in 4 patients and were associated with MTX rebound. In CSF, glucarpidase was not detected and MTX levels remained cytotoxic after 1 (3299.5 nmol/L, n = 8) and 6 h (1254.7 nmol/L, n = 7). Treatment was safe and well-tolerated. Radiographic responses in 6 of 8 patients (75%) were as expected following MTX-based therapy.

Conclusions

This study demonstrates feasibility of planned-use low-dose glucarpidase for MTX clearance and supports the hypothesis that glucarpidase does not impact MTX efficacy in the CNS.

Clinical trial registration

NCT03684980 (Registration date 26/09/2018).
Maslinic acid activates renal AMPK/SIRT1 signaling pathway and protects against diabetic nephropathy in mice
Authors: Gao Huijuan , Wu Hong
Published: January 2022

Background

Diabetic nephropathy has been a devastating complication. Clinically, there is an urgent need for nephroprotective agents to delay the onset of diabetic nephropathy and ameliorate its symptoms. Maslinic acid is a pentacyclic triterpene acid with protective effect on multiple organs against oxidative stress and inflammation. In this research, we hypothesized that maslinic acid protects renal function against diabetic nephropathy.

Methods

C57BL/6 J male mice administrated with 50 mg/kg of Streptozocin (STZ) daily were used to establish diabetic mouse model (blood glucose levels > 300 mg/dL). Urinary levels of albumin, total proteins, and creatinine were analyzed by an automatic analyzer. H&E staining was used to evaluate renal damage. qRT-PCR and ELISA were performed to investigate the inflammation and oxidative stress in renal tissues. Western blot was used to assess the activation of AMPK signaling.

Results

Maslinic acid treatment alleviated the loss of body weight and blood glucose in diabetic mice. Renal structure and function were protected by maslinic acid in diabetic mice. 20 mg/kg maslinic acid treatment for 8 weeks significantly alleviated the oxidative stress and inflammation in the kidney of diabetic rats. Maslinic acid treatment activated the renal AMPK/SIRT1 signaling pathway.

Conclusion

Maslinic acid ameliorates diabetic nephropathy and activates the renal AMPK/SIRT1 signaling pathway.
Evaluation of rotary file system (Kedo-S-Square) in root canal preparation of primary anterior teeth using cone beam computed tomography (CBCT)-in vitro study
Authors: Mohamed Rasha H. , Abdelrahman Amina M. , Sharaf Aly A.
Published: January 2022

Background

In recent years, pediatric endodontics has witnessed various advances including use of rotary files in pulpectomy. This study aimed to comparatively evaluate taper, amount of dentin removal and instrumentation time of the pediatric rotary Kedo-S Square file,
hand K-files and H-files in primary canines using cone beam computed tomography (CBCT).

Methods

60 primary canines were randomly assigned into three groups; A1 Kedo-S-Square rotary file (group I), hand stainless steel K file (group II) and hand stainless steel H file (group III). Teeth were mounted in vinyl poly siloxane impression material templates to be scanned before and after instrumentation by CBCT scans using Ondemand 3D software. Shaping ability of the files were evaluated in terms of taper of the canal and amount of dentin remaining of each group. Instrumentation time was recorded using a digital stopwatch.

Results

Kedo-S Square removed a significantly less amount of dentin in both apical (P < 0.002) and coronal thirds (P < 0.014). Taper of the preparations showed significant differences as Kedo-S Square file showed good taper in maximum number of root canals, while maual K- and H-files showed poor taper in maximum number of root canals (P < 0.0001). Rotary Kedo-S Square files required less instrumentation time (P < 0.0001).

Conclusion

The use of rotary Kedo-S Square files resulted in better conservation of tooth structure, superior tapering ability and least instrumentation time compared to hand K- and H-files.
Staff perceptions of the management of mental health presentations to the emergency department of a rural Australian hospital: qualitative study
Authors: Pawaskar Rishaan , Mahajan Neha , Wangoo Eklavya , Khan Wafa , Bailey Jannine , Vines Robyn
Published: January 2022

Introduction

Current research demonstrates higher prevalence of mental health related emergency department (ED) presentations in rural areas, despite similar overall prevalence of these conditions in rural and metropolitan contexts. This stems from shortages in availability of specialised mental health professionals, greater stigma against mental illness, greater socioeconomic disadvantages, and access to means of self-harm in rural regions. Little is known, however, about the specific characteristics of mental health presentations to rural emergency departments (EDs) in Australia. Additionally, studies have shown that ED staff feel uncomfortable managing mental health presentations to ED due to factors such as lack of confidence and stigma against mental illnesses.

Aim

This qualitative study sought to examine ED staff perceptions regarding the management of mental health presentations in a rural Australian ED.

Methods

A qualitative study design was used, incorporating semi-structured interviews of current ED staff. Ten interviews were conducted in person or over the phone by two researchers and thematically analysed to draw out key themes from the data.

Results

Staff perceived deficiencies in availability of mental health expertise, de-escalation, and referral pathways as major barriers to effective patient management. These factors contributed to increased retention of mental health patients in ED due to uncertainties regarding their definitive care. Despite acknowledging the value of practical experience with mental health presentations as the best way of increasing clinician confidence, staff expressed a desire for more face-to-face training to better equip them to respond to mental health presentations.

Conclusion

A combination of departmental and hospital-wide issues in conjunction with individual staff attitudes regarding mental health conditions contributes to issues in mental health patient care in this ED. In particular, limited training in mental health and resources available to ED staff affects confidence in managing mental health presentations and contributes to prolonged time to definitive treatment.