bluuebunny/crossref_metadata_2025 huggingface dataset:
16th International congress on antiphospholipid antibodies task force report on clinical manifestations of antiphospholipid syndrome
Authors: Sciascia Savino , Radin Massimo , Cecchi Irene , Levy Roger A , Erkan Doruk
Published: May 2021

The objectives of the 16th International Congress on Antiphospholipid Antibodies (aPL) Task Force on Clinical Manifestations of Antiphospholipid Syndrome (APS) were to critically analyze: a) the definition of “APS”; b) the current knowledge on non-traditional manifestations associated with aPL; and c) the risk stratification strategies in aPL-positive patients. The quality of evidence was assessed by the GRADE system. The task force concluded that: a) APS does not have a uniform definition given the heterogeneity of the clinical presentations and different aPL profiles; b) current literature supports the role for aPL testing in cases of thrombocytopenia and recurrent cardiac events but are limited by vast heterogeneity, providing an overall low-to-very low level of evidence; and c) risk stratification strategies in aPL-positive patients, such as aPL-Score and Global APS Score, can be useful in clinical practice. International multicenter studies are still highly needed to improve the quality of available evidence and consequently the strength of future recommendations.
Comparison of Clinical Characteristics and End-of-Life Care Between COVID-19 and Non-COVID-19 Muslim Patients During the 2020 Pandemic
Authors: Khalid Imran , Imran Maryam , Yamani Romaysaa M. , Imran Manahil , Akhtar Muhammad Ali , Khalid Tabindeh Jabeen
Published: May 2021

Background:

Little is known about end-of-life care among Muslim patients, particularly during Coronavirus disease 2019 (COVID) pandemic, which we report here.

Methods:

The clinical characteristics, end-of-life care and resuscitation status of Muslim patients who died in the ICU of our tertiary care hospital in year 2020 from COVID were compared to Non-COVID patients.

Results:

There were 32 patients in COVID and 64 in the Non-COVID group. A major proportion, mainly of Non-COVID patients, already had a hospice eligible terminal disease at baseline (p=.002). COVID patients were admitted to the ICU sooner after hospitalization (2.2 vs. 17 days), had prolonged duration of mechanical ventilation (18.5 vs. 6 days) and longer ICU stay (24 vs. 8 days) than non-COVID patients, respectively (p<.001). Almost all patients were “Full Code” initially. However, status was eventually changed to ‘do-not-attempt resuscitation’ (DNAR) in about 60% of the cohort. COVID patients were made DNAR late in their ICU stay, predominantly in the last 24 hours of life (p=.04). Until the very end, patients in both groups were on tube feeds, underwent blood draws and imaging, required high dose vasopressors, with few limitations or withdrawal of therapies. Family members were usually not present at bedside at time of death. There was minimal involvement of chaplain and palliative care services.

Conclusions:

Muslim COVID-19 patients had prolonged mechanical ventilation and ICU stay and a delayed decision to DNAR status than non-COVID Muslim patients. Limitation or withdrawal of therapy occurred infrequently. The utilization of chaplain and palliative care service needs improvement.
Prioritizing failure risks of components based on information axiom for product redesign considering fuzzy and random uncertainties
Authors: Liu Zhenhua , Chu Xuening , Ma Hongzhan , Zhang Mengting
Published: May 2021

The prioritization of the failure risks of the components in an existing product is critical for product redesign decision-making considering various uncertainties. Two issues need to be addressed in the failure risk prioritization process. One is the evaluation of the failure risk considering each failure mode for each component. Currently, many failure mode effects and analysis (FMEA) methods based on fuzzy logic seldom deal with the randomness in failure mode occurrence during the product operation stage. Therefore, in this research, the information axiom is extended to calculate the information contents of risk indices considering these two types of uncertainty. The second issue is the evaluation of the degree of failure risk for each of the components. The weighted sum of information content considering all failure modes is used to assess the risk of components based on a fuzzy logarithmic least squares method (FLLSM). Additionally, a case study to prioritize the failure risks of various components in a crawler crane is implemented to demonstrate the effectiveness of the developed approach.
Survival of the Recidivistic? Revealing Factors Associated with the Criminal Career Length of Multiple Homicide Offenders
Authors: Campedelli Gian Maria , Yaksic Enzo
Published: May 2021

Relying on a sample of 1,381 US-based multiple homicide offenders (MHOs), we study the duration of the careers of this extremely violent category of offenders through Kaplan–Meier estimation and Cox Proportional Hazard regression. We investigate the characteristics of such careers in terms of length and we provide an inferential analysis investigating correlates of career duration. The models indicate that MHOs employing multiple methods, younger MHOs and MHOs that acted in more than one US state have higher odds of longer careers. When controlling for career-based attributes, female MHOs are also correlated with longer careers.
Impact on refractive surgery due to increasing use of personal protection equipment: Insights from EUROCOVCAT group
Authors: Cummings Arthur B , Gildea Cian , Brézin Antoine P , Malyugin Boris E , Evren Kemer Ozlem , Kermani Omid , Prieto Isabel , Rejdak Robert , Teus Miguel A , Tognetto Daniele , Zweifel Sandrine , Toro Mario D
Published: May 2021

Since the World Health Organization declared COVID-19 to be a pandemic on 11th March 2020, changes to social and sanitary practices have included significant issues in access and management of eye care during the COVID-19 pandemic. Additionally, the fear of loss, coupled with social distancing, lockdown, economic instability, and uncertainty, have led to a significant psychosocial impact that will have to be addressed. In the current COVID-19 pandemic, personal protective equipment such as face masks or face coverings have become a daily necessity. While “mass masking” along with hand hygiene and social distancing became more widespread, new issues began to emerge – particularly in those who wore spectacles as a means of vision correction. As we began to see routine patients again after the first lockdown had been lifted, many patients visited our clinics for refractive surgery consultations with a primary motivating factor of wanting spectacle independence due to the fogging of their spectacles as a result of wearing a mask. In this article, we report on new emerging issues in eye care due to the widespread use of masks and on the new unmet need in the corneal and cataract refractive surgery fields.
Nanomechanical behaviour of ZrO2 dispersed sisal-based polymeric composites
Authors: Biswas Bhabatosh , Hazra Biplab , Mukherjee Nillohit , Sinha Arijit
Published: May 2021

Alkali-treated sisal fibre-incorporated silanized ZrO2 dispersed unsaturated polyester composites were fabricated with a filler loading of 5, 15, 25, 35, 45 wt%, respectively. The mechanical characterization of the composites was suitably executed at the sub-micron scale using the nanoindentation technique. Various mechanical properties were derived from the standard nanoindentation measurements namely, nanohardness, reduced modulus, recovery index, residual depth, wear rate and indentation creep, respectively. A marked improvement in the mechanical properties of the unsaturated polyester matrix due to the incorporation of the fillers (sisal and/or ZrO2) was observed through indentation-derived parameters namely, nanohardness (∼186%), reduced modulus (∼175%), recovery index (∼62%), wear rate (∼63%) and indentation creep (∼33%), respectively. A simulated dynamic mechanical analysis was performed using the sinus mode of the nanoindentation technique. A similar enhancement in the dynamic mechanical properties of the matrix was further observed through dynamic mechanical analysis as storage modulus (∼71%), loss modulus (∼60%), loss factor (∼150%) and specific damping coefficient (∼200%), respectively.
The dark side of journalism: Understanding the phenomenology of conflicts in the newsroom and the mechanisms intended to solve them
Authors: Goyanes Manuel , Cañedo Azahara
Published: May 2021

The practice and structural conditions of the journalism craft provide fertile grounds for facilitating the emergence of conflicts in the newsroom. However, extant research on journalism studies have largely neglected the boundary conditions for their emergence and the individual and organizational mechanisms displayed to unravel them. Based on in-depth interviews with 40 Spanish journalists, we conceptualize newsrooms’ conflicts as the dark side of journalism and examine the structural and individual factors that nurtures their appearance. We also clarify the main strategies for conflict management, arguing that conflict resolution is typically based on informal mediation strategies, rather than institutionalized plans directly implemented by news organizations.
The increasing toll of racism and discrimination on California agricultural workers and their families under the Trump administration
Authors: Medel-Herrero Alvaro , Torreiro-Casal Monica , Hovey Joseph D , Rascon-Garcia Karla , Smiley-Jewell Suzette , Shumway Martha , Deeb-Sossa Natalia
Published: May 2021

Over 800,000 Mexican agricultural workers are employed in California each year, of which approximately 400,000 are estimated to be undocumented immigrants. Previous studies have found President Trump to be distinct in his anti-immigrant rhetoric and explicit verbal attacks of immigrants and refugees, which predicts hostile community attitudes towards immigrants and minorities. We convened 19 focus groups (FG) in diverse regions of California to gather information from Latina/o agriculture workers on the potential impact(s) of the Trump administration’s anti-immigrant rhetoric and immigration policy on this population. Widespread racism and discrimination were overwhelmingly noted in all FG sessions. Participants reported being the targets of increasingly hostile behavior, including hate crimes, that they attributed to anti-immigration rhetoric. Therefore, participants also reported an increasing sense of fear and psychological distress that led them to avoid community participation. Perceptions of racist and intentionally harmful policies contributed to reduced interactions with healthcare facilities and prompted both documented and undocumented participants to withdraw themselves and their children from public programs. For FG participants, the Trump administration’s anti-immigrant rhetoric and immigration policy severely impacted their community resulting in profound negative impacts on their economic well-being, education, and physical and emotional health.
The road worth taking, the life worth living, and the person worth being: Morality, authenticity and personhood in volunteer tourism and beyond
Authors: Kahana Netta
Published: May 2021

This article explores what volunteer tourists designate as moral in the practice of volunteering. Findings from in-depth interviews demonstrate how this experience’s moral worth relates to notions of moral personhood, rather than to responsibility for others. This article argues that in late modernity middle class volunteer tourists see the moral worth of the practice as resting on its capacity as an outlet for expression and cultivation of one’s true self. This emphasis reflects a contemporary ‘ethics of authenticity’, wherein being true to yourself is a moral principle and a contributing factor to a full existence. The article explores the ways this moral principle appears in interviewees’ wide moral perceptions and highlights the role of volunteer tourism in materializing these perceptions. By adding the moral layer to the quest for authenticity via tourism the article provides an insight into the role of tourism in peoples’ moral lives.
Experiential learning in building physics: The icebox challenge
Authors: McLeod Robert S , Hopfe Christina J
Published: May 2021

This pedagogical note presents a novel learning activity (the icebox challenge) that was designed to facilitate deep learning of building physics energy transfer principles through a planning, prediction and analysis process following the Kolb learning cycle. The success of this strategy was evidenced by students relating and collating their knowledge and theoretical ideas and applying them to successfully solve a series of complex and inter-related practical building physics problems.
Does social media addiction exist?
Authors: Theivendran Kasun
Published: May 2021

In science, medicine and technology, our discoveries and theories are constantly under scrutiny. Changes in society can create a need for new research and the questioning of topics previously thought to be understood. There are many examples that illustrate this, none more contentious than the subject of addiction. This article aims to explore our developing knowledge of behavioural addiction and examines social media in particular. Furthermore, the article considers the associated symptoms and the importance of their recognition to facilitate early identification of mental health disorders in primary care.
Flashed Müller-Lyer and Poggendorff Virtual Illusions
Authors: Anstis Stuart , Cavanagh Patrick
Published: May 2021

A moving frame can dramatically displace the perceived location of stimuli flashed before and after the motion. Here, we use a moving frame to rearrange flashed elements into the form of classic illusions. Without the moving frame, the initial arrangement of the flashed elements has no illusory effect. The question is whether the frame-induced displacement of position precedes or follows the processes underlying the illusions. This illusory offset of flashed chevrons does generate a Müller-Lyer illusion and the illusory offset of two line segments does create a Poggendorff illusion. We conclude that the site where the frame-induced position shift emerges must precede the site at which the Müller-Lyer and Poggendorf illusions arise.
Reproductive geography: Reproducing whiteness?
Authors: Bagelman Jen , Gitome Josephine
Published: May 2021

This dialogue begins with the question of ‘contraction’ and explores how this embodied concept may help expand our thinking on reproductive geographies. Following our interlocutors’ lead, we think with (and against) Jane Bennett and her work on dilation here. We go on to think about these contractions in relation to various ‘contracts’ – not least those forged between researcher and participant. Here we delve into questions of what a ‘non-participatory action research’ contract might look like. We then conclude by taking seriously the following question: why is there still a prevailing whiteness in reproductive geographies?
Ruptured Sinus of Valsalva Aneurysm: Use of Multimodality Imaging in Delineating Structure and Function
Authors: Kassab Kameel , Kaul Subuhi , Gomez Javier , Delafontaine Jean-Luc , Sawaqed Ray , Saini Abhimanyu
Published: May 2021

Sinus of Valsalva aneurysm is a rare defect that can present with fatal complications in case of rupture. Heart failure symptoms are common due to high fraction of the resultant shunt. Multimodality imaging and invasive hemodynamic assessment is essential for comprehensive evaluation of the defect and guiding surgical planning. We describe the case of a 40-year-old woman who presented with heart failure symptoms and was found to have ruptured sinus of Valsalva aneurysm on transthoracic echocardiogram. Cardiac computed tomography angiography further characterized the defect and the associated anomalies. Right heart catheterization assessed the hemodynamic significance of the left to right shunt. Intraoperative findings highlighted the associated congenital anomalies including supracristal ventricular septal defect. The use of intraoperative transesophageal echocardiography proved essential in detecting worsening of the right ventricular outflow track infundibular dynamic obstruction post repair thus delineating the importance of maintaining adequate cardiac preload. This case highlights a stepwise approach in the anatomical characterization of sinus of Valsalva aneurysm using multimodality imaging and the use of hemodynamic assessment and intraoperative imaging to guide surgical planning.
Is There a Benefit of Vitamin D Supplementation in Deficient Children and Adolescents Suffering from Obesity? A Meta-Analysis
Authors: Nassar May Fouad , Emam Ehab Khairy , Allam Mohamed Farouk
Published: May 2021

This systematic review/meta-analysis aims to highlight the effect of vitamin D supplementation in deficient children suffering from obesity. Published clinical studies on vitamin D supplementation in obese children and adolescents with vitamin D deficiency were identified through a comprehensive MEDLINE/PubMed search (from July 1966 to November 2017). Outcomes intended after vitamin D supplementation were improvements in vitamin D status, BMI alterations and appetite changes. The inclusion criteria were children aged 2 to 18 years of both sexes in clinical trials that specified the oral and/or intramuscular dose of vitamin D supplementation. Ten studies were retrieved, but only 6 were relevant. First, supplemented obese children and adolescents were compared to non-obese controls; thereafter, supplemented obese children and adolescents were compared to matching obese peers given placebo. Pooled risks from the 2 studies that evaluated the number of obese and non-obese children and adolescents who improved upon vitamin D supplementation revealed that obesity poses a risk for not benefiting from the vitamin D supplementation regardless of the dose and the duration of supplementation. Pooled results from the 6 retrieved studies that compared supplemented obese children and adolescents to matching non-obese or obese peers given placebo revealed significantly lower vitamin D levels in obese participants than in non-obese peers. Vitamin D levels are significantly lower in obese children and adolescents with obesity, posing a risk for not benefiting from vitamin D supplementation regardless of the dose and duration of supplementation.
Regime Security in Jordan Revisited: New Challenges to the Monarchy’s Resilience After the Arab Spring
Authors: Kikkawa Takuro
Published: May 2021

Jordan is one of the few authoritarian Arab regimes that survived region-wide mass protests during the Arab Spring, although the monarchy lacked enough force or resources to neutralize the dissident. This study analyzes the source of the resiliency of the Hashemite monarchy during 2011–2020 concerning regime security. The retreat of the Jordanian democratization movements in the early phase of the Arab Spring was the consequence of the opposition’s failure to achieve coordination and alignment, particularly the internal struggle of the Muslim Brotherhood regarding how to respond and its successful co-optation by the government. The scope of regime security in Jordan experienced a dramatic shift from appeasement to coercion around 2014 because of the eroding social order in neighboring states, represented by the influx of Syrian refugees into Jordan and the rise of the Islamic State in Iraq. Actions for securitization against Islamists, namely increased policing and tighter border control, were arranged through coercion and securing mass support in tandem. Jordan’s experience illustrates how this typically “weak state” secured its survival in this unprecedented, rapidly changing security situation.
From Skill to Spectacle: Sport as Commodity in the Age of Television in India
Authors: Jha Sonal
Published: May 2021

Through an examination of sports ads on television, this article attempts to analyse the process of commodification that sport in India has undergone with the advent of television in the 1980s and the economic liberalisation in 1991, which forms the context for the formation of the sport–media complex in the country. It identifies consumerism, exchange value and commodity fetishism as the key elements of commodification and analyses the ads through these categories in order to eventually establish the changes in the ideas and values about sport, which have occurred as a result of the production of sport for mass consumption.
Inhibition of lateral shoot formation by RNA interference and chemically induced mutations to genes expressed in the axillary meristem of Nicotiana tabacum L.
Authors: Hamano Kaori , Sato Seiki , Arai Masao , Negishi Yuta , Nakamura Takashi , Komatsu Tomoyuki , Naragino Tsuyoshi , Suzuki Shoichi
Published: May 2021

Background

Lateral branches vigorously proliferate in tobacco after the topping of the inflorescence portions of stems for the maturation of the leaves to be harvested. Therefore, tobacco varieties with inhibited lateral shoot formation are highly desired by tobacco farmers.

Results

Genetic inhibition of lateral shoot formation was attempted in tobacco. Two groups of genes were examined by RNA interference. The first group comprised homologs of the genes mediating lateral shoot formation in other plants, whereas the second group included genes highly expressed in axillary bud primordial stages. Although “primary” lateral shoots that grew after the plants were topped off when flower buds emerged were unaffected, the growth of “secondary” lateral shoots, which were detected on the abaxial side of the primary lateral shoot base, was significantly suppressed in the knock-down lines of NtLs, NtBl1, NtREV, VE7, and VE12. Chemically induced mutations to NtLs, NtBl1, and NtREV similarly inhibited the development of secondary and “tertiary” lateral shoots, but not primary lateral shoots. The mutations to NtLs and NtBl1 were incorporated into an elite variety by backcrossing. The agronomic characteristics of the backcross lines were examined in field trials conducted in commercial tobacco production regions. The lines were generally suitable for tobacco leaf production and may be useful as new tobacco varieties.

Conclusion

The suppressed expression of NtLs, NtBl1, NtREV, VE7, or VE12 inhibited the development of only the secondary and tertiary lateral shoots in tobacco. The mutant lines may benefit tobacco farmers by minimizing the work required to remove secondary and tertiary lateral shoots that emerge when farmers are harvesting leaves, which is a labor-intensive process.
The NAC side of the fruit: tuning of fruit development and maturation
Authors: Forlani Sara , Mizzotti Chiara , Masiero Simona
Published: May 2021

Fruits and seeds resulting from fertilization of flowers, represent an incredible evolutionary advantage in angiosperms and have seen them become a critical element in our food supply.

Many studies have been conducted to reveal how fruit matures while protecting growing seeds and ensuring their dispersal. As result, several transcription factors involved in fruit maturation and senescence have been isolated both in model and crop plants. These regulators modulate several cellular processes that occur during fruit ripening such as chlorophyll breakdown, tissue softening, carbohydrates and pigments accumulation.

The NAC superfamily of transcription factors is known to be involved in almost all these aspects of fruit development and maturation. In this review, we summarise the current knowledge regarding NACs that modulate fruit ripening in model species (Arabidopsis thaliana and Solanum lycopersicum) and in crops of commercial interest (Oryza sativa, Malus domestica, Fragaria genus, Citrus sinensis and Musa acuminata).
Leveraging electronic health records to improve management of noncommunicable diseases at primary healthcare centres in Saudi Arabia: a qualitative study
Authors: Hazazi Ahmed , Wilson Andrew
Published: May 2021

Background

Electronic Health Records (EHRs) can contribute to the earlier detection and better treatment of chronic diseases by improving accuracy and accessibility of patient data. The Saudi Ministry of Health (MOH) implemented an EHR system in all primary health care clinics (PHCs) as part of measures to improve their performance in managing chronic disease. This study examined the perspective of physicians on the current scope and content of NCDs management at PHCs including the contribution of the EHR system.

Methods

Semi-structured interviews were conducted with 22 physicians working in chronic disease clinics at PHCs covering a range of locations and clinic sizes. The participants were selected based on their expertise using a combination of purposive and convenience sampling. The interviews were transcribed, analyzed and coded into the key themes.

Results

Physicians indicated that the availability of the EHR helped organise their work and positively influenced NCDs patient encounters in their PHCs. They emphasised the multiple benefits of EHR in terms of efficiency, including the accuracy of patient documentation and the availability of patient information. Shortcomings identified included the lack of a patient portal to allow patients to access information about their health and lack of capacity to facilitate multi-disciplinary care for example through referral to allied health services. Access to the EHR was limited to MOH primary healthcare centres and clinicians noted that patients also received care in private clinics and hospitals.

Conclusion

While well regarded by clinicians, the EHR system impact on patient care at chronic disease clinics is not being fully realised. Enabling patient access to their EHR would be help promote self-management, a core attribute of effective NCD management. Co-ordination of care is another core attribute and in the Saudi health system with multiple public and private providers, this may be substantially improved if the patients EHR was accessible wherever care was provided. There is also a need for enhanced capacity to support improving patient’s nutrition and physical activity.
Prevalence of group B streptococcus colonization in pregnant women in Jiangsu, East China
Authors: Ge Yanmei , Pan Fei , Bai Rui , Mao Yuan , Ji Wenli , Wang Fenfang , Tong Huacheng
Published: May 2021

Background

Group B streptococcus (GBS) is the leading cause of early-onset neonatal sepsis. However, GBS was infrequently reported in the developing world in contrast to western countries. This study assessed the prevalence of GBS colonization among pregnant women in Jiangsu, East China, and revealed the difference of GBS infection between culture and PCR.

Methods

A total of 16,184 pregnant women at 34 to 37 weeks’ gestation aged 16–47 years were recruited from Nanjing Kingmed Center for Clinical Laboratory. Nine thousand twenty-two pregnant women received GBS screening by PCR detection only. Seven thousand one hundred sixty-two pregnant women received GBS screening by bacterial culture and GBS-positive samples were tested for antibiotic resistance.

Results

The overall GBS positive rate was 8.7% by PCR and 3.5% by culture. Colonization rate was highest in the “25–29 years” age group. The 249 GBS-positive samples which detected by culture were all sensitive to penicillin. The prevalence of resistance to erythromycin, clindamycin, and levofloxacin was 77.5, 68.3, and 52.2%, respectively.

Conclusions

This study revealed the data on the prevalence of GBS colonization in pregnant women at 34 to 37 weeks’ gestation in Jiangsu, East China. It compared the difference of the sensitivity to detect GBS between PCR and culture. PCR was expected to become a quick method in pregnancy women conventional detection of GBS infection.
Persistent Newcastle disease virus infection in bladder cancer cells is associated with putative pro-survival and anti-viral transcriptomic changes
Authors: Chan Lee-Chin , Kalyanasundram Jeevanathan , Leong Sze-Wei , Masarudin Mas Jaffri , Veerakumarasivam Abhi , Yusoff Khatijah , Chan Soon-Choy , Chia Suet-Lin
Published: May 2021

Background

Newcastle disease virus (NDV) is an oncolytic virus with excellent selectivity against cancer cells, both in vitro and in vivo. Unfortunately, prolonged in vitro NDV infection results in the development of persistent infection in the cancer cells which are then able to resist NDV-mediated oncolysis. However, the mechanism of persistency of infection remains poorly understood.

Methods

In this study, we established persistently NDV-infected EJ28 bladder cancer cells, designated as EJ28P. Global transcriptomic analysis was subsequently carried out by microarray analysis. Differentially expressed genes (DEGs) between EJ28 and EJ28P cells identified by the edgeR program were further analysed by Gene Set Enrichment Analysis (GSEA) and Ingenuity Pathway Analysis (IPA) analyses. In addition, the microarray data were validated by RT-qPCR.

Results

Persistently NDV-infected EJ28 bladder cancer cells were successfully established and confirmed by flow cytometry. Microarray analysis identified a total of 368 genes as differentially expressed in EJ28P cells when compared to the non-infected EJ28 cells. GSEA revealed that the Wnt/β-catenin and KRAS signalling pathways were upregulated while the TGF-β signalling pathway was downregulated. Findings from this study suggest that the upregulation of genes that are associated with cell growth, pro-survival, and anti-apoptosis may explain the survivability of EJ28P cells and the development of persistent infection of NDV.

Conclusions

This study provides insights into the transcriptomic changes that occur and the specific signalling pathways that are potentially involved in the development and maintenance of NDV persistency of infection in bladder cancer cells. These findings warrant further investigation and is crucial towards the development of effective NDV oncolytic therapy against cancer.
Childhood obesity prevention policies in Iran: a policy analysis of agenda-setting using Kingdon’s multiple streams
Authors: Taghizadeh Shahnaz , Khodayari-Zarnaq Rahim , Farhangi Mahdieh Abbasalizad
Published: May 2021

Background

Pediatric obesity is one of the most important health challenges of the twenty-first century. Primary prevention of childhood obesity, can lessen its consequences. This study aims to assess childhood obesity prevention policies in Iran through a policy analysis of agenda-setting using Kingdon’s multiple streams.

Methods

A qualitative study was conducted using in-depth interviews with 39 key informants and document review from different stages of the policymaking process of childhood and adolescent obesity prevention programs in Iran. The analysis of documents and interviews were guided based on Kingdon’s multiple streams (problem, policy and political streams).

Results

The important factors of the problem stream were the high prevalence of childhood and adolescent obesity and its risk factors in Iran. In the policy stream, a focus on preventing non-communicable diseases in the health system, increasing the workforce in health centers, promoting health school programs, and creating healthy eating buffets in schools was identified. Under the political stream, the impact of the WHO ECHO program in 2015 and the implementation of the health system transformation plan in Iran in the new government took place after 2013, caused the Iran ECHO program entered the agenda and implemented from 2016.

Conclusions

Now that a window of opportunity for childhood and adolescent obesity prevention policymaking has been created, the problems such as the therapeutic approach in the health system, the existence of sanctions against Iran and outbreak of coronavirus disease-19 (COVID-19), have hindered the successful implementation of this policy and the opportunity window has not been well used. However, actors need political support from the high levels of government to keep this policy on the agenda.
Prognostic significance of low TSH concentration in patients with COVID-19 presenting with non-thyroidal illness syndrome
Authors: Gong Jing , Wang Ding-kun , Dong Hui , Xia Qing-song , Huang Zhao-yi , Zhao Yan , Chen Xing , Yuan Fen , Li Jing-bin , Lu Fu-er
Published: May 2021

Background

Low free triiodothyronine (FT3) levels are related to a poor prognosis deterioration in patients with COVID-19 presenting with non-thyroidal illness syndrome (NTI). This study was designed to explore whether free thyroxin (FT4) or thyroid stimulating hormone (TSH) levels affected the mortality of patients with COVID-19 presenting with NTI.

Methods

Patients with COVID-19 complicated with NTI who were treated at our hospital were included in this retrospective study. Patients were divided into low TSH and normal TSH groups, as well as low and normal-high FT4 group, according to the reference range of TSH or FT4 levels. The 90-day mortality and critical illness rates were compared among patients with low and normal TSH levels, as well as among patients with low FT4 levels and normal-high FT4 levels; in addition, differences in demographic and laboratory data were compared. A Kaplan-Meier analysis and Cox proportional hazards models were used to assess the associations of TSH and FT4 levels with mortality.

Results

One hundred fifty patients with low FT3 levels and without a history of thyroid disease were included, 68% of whom had normal FT4 and TSH levels. Critical illness rates (74.07% VS 37.40%,P = 0.001) and mortality rates (51.85% VS 22.76%,P = 0.002) were significantly higher in the low TSH group than in the normal TSH group. Although no significant difference in the critical illness rate was found (P = 0.296), the mortality rate was significantly higher in the low FT4 group (P = 0.038). Low TSH levels were independently related to 90-day mortality (hazard ratio = 2.78, 95% CI:1.42–5.552,P = 0.003).

Conclusions

Low FT4 and TSH concentrations were associated with mortality in patients with COVID-19 presenting with NTI; moreover, low TSH levels were an independent risk factor for mortality in these patients.
Unlocking the potential of insect and ruminant host symbionts for recycling of lignocellulosic carbon with a biorefinery approach: a review
Authors: Rajeswari Gunasekaran , Jacob Samuel , Chandel Anuj Kumar , Kumar Vinod
Published: May 2021

Uprising fossil fuel depletion and deterioration of ecological reserves supply have led to the search for alternative renewable and sustainable energy sources and chemicals. Although first generation biorefinery is quite successful commercially in generating bulk of biofuels globally, the food versus fuel debate has necessitated the use of non-edible feedstocks, majorly waste biomass, for second generation production of biofuels and chemicals. A diverse class of microbes and enzymes are being exploited for biofuels production for a series of treatment process, however, the conversion efficiency of wide range of lignocellulosic biomass (LCB) and consolidated way of processing remains challenging. There were lot of research efforts in the past decade to scour for potential microbial candidate. In this context, evolution has developed the gut microbiota of several insects and ruminants that are potential LCB degraders host eco-system to overcome its host nutritional constraints, where LCB processed by microbiomes pretends to be a promising candidate. Synergistic microbial symbionts could make a significant contribution towards recycling the renewable carbon from distinctly abundant recalcitrant LCB. Several studies have assessed the bioprospection of innumerable gut symbionts and their lignocellulolytic enzymes for LCB degradation. Though, some reviews exist on molecular characterization of gut microbes, but none of them has enlightened the microbial community design coupled with various LCB valorization which intensifies the microbial diversity in biofuels application. This review provides a deep insight into the significant breakthroughs attained in enrichment strategy of gut microbial community and its molecular characterization techniques which aids in understanding the holistic microbial community dynamics. Special emphasis is placed on gut microbial role in LCB depolymerization strategies to lignocellulolytic enzymes production and its functional metagenomic data mining eventually generating the sugar platform for biofuels and renewable chemicals production.
Adaptive laboratory evolution of β-caryophyllene producing Saccharomyces cerevisiae
Authors: Godara Avinash , Kao Katy C.
Published: May 2021

Background

β-Caryophyllene is a plant terpenoid with therapeutic and biofuel properties. Production of terpenoids through microbial cells is a potentially sustainable alternative for production. Adaptive laboratory evolution is a complementary technique to metabolic engineering for strain improvement, if the product-of-interest is coupled with growth. Here we use a combination of pathway engineering and adaptive laboratory evolution to improve the production of β-caryophyllene, an extracellular product, by leveraging the antioxidant potential of the compound.

Results

Using oxidative stress as selective pressure, we developed an adaptive laboratory evolution that worked to evolve an engineered β-caryophyllene producing yeast strain for improved production within a few generations. This strategy resulted in fourfold increase in production in isolated mutants. Further increasing the flux to β-caryophyllene in the best evolved mutant achieved a titer of 104.7 ± 6.2 mg/L product. Genomic analysis revealed a gain-of-function mutation in the a-factor exporter STE6 was identified to be involved in significantly increased production, likely as a result of increased product export.

Conclusion

An optimized selection strategy based on oxidative stress was developed to improve the production of the extracellular product β-caryophyllene in an engineered yeast strain. Application of the selection strategy in adaptive laboratory evolution resulted in mutants with significantly increased production and identification of novel responsible mutations.
LINC01158 works as an oncogene in glioma via sponging miR-6734-3p to boost CENPK expression
Authors: Sun Zhenxing , Wei Naili , Yao Shenglian , Wang Guihuai , Sun Yaxing , Wang Zhenze , Yuan Dan
Published: May 2021

Background

Long non-coding RNAs (lncRNAs) have been certified to play vital biological functions in glioma and have received considerable attention in the recent literature. Nonetheless, the role of LINC01158 in glioma remains to be elucidated.

Methods

qRT-PCR, western blot and GEPIA database were applied for reporting the expression of CENPK and LINC01158 in glioma and the correlation between LINC01158 and CENPK expression. EdU, colony formation, CCK-8, caspase-3 activity and TUNEL assays probed the impacts of LINC01158 on glioma cell growth. Subcellular fractionation and FISH assays revealed the cellular distribution of LINC01158. Luciferase reporter and RIP assays examined ceRNA network of LINC01158, CENPK and miR-6734-3p.

Results

LINC01158 and CENPK were both overexpressed in glioma and a positive regulation of LINC01158 on CENPK was corroborated. LINC01158 served a pro-proliferative and anti-apoptotic part in glioma by sponging miR-6734-3p to augment CENPK.

Conclusion

LINC01158 enhances CENPK by serving as sponge for miR-6734-3p to facilitate glioma development, proposing LINC01158 as a new player in glioma.
Promoting equity in breastfeeding through peer counseling: the US Breastfeeding Heritage and Pride program
Authors: Rhodes Elizabeth C , Damio Grace , LaPlant Helen Wilde , Trymbulak Walter , Crummett Carrianne , Surprenant Rebecca , Pérez-Escamilla Rafael
Published: May 2021

Background

In the United States, Black and Hispanic mothers have lower breastfeeding rates compared with White mothers. To address breastfeeding inequities, the Breastfeeding Heritage and Pride program (BHP) provides breastfeeding support for predominately low-income minority mothers in Connecticut and Massachusetts. We described the process of designing BHP, the program model, and its impact on breastfeeding outcomes.

Methods

This BHP case study is based on in-depth interviews with BHP designers and implementers, peer counselors, and clients; a literature review of BHP impact evaluation studies; and a review of BHP materials. To guide the analysis and organize results, we used the Community Energy Balance Framework, an equity-oriented, multi-level framework for fostering healthy lifestyles.

Results

The Hispanic Health Council designed BHP to address barriers to breastfeeding identified through formative qualitative research with the Latino community, namely lack of role models, limited social support, embarrassment when breastfeeding in public, lack of breastfeeding knowledge, and a norm of formula feeding. According to the BHP model, clients receive education and support through in-person home and hospital visits supplemented by phone calls, beginning prenatally and continuing through one year postpartum. Counseling is delivered by peer counselors, women who have successfully breastfed, have similar cultural roots and life experiences as the clients they serve, and have completed intensive training on lactation management and communication skills. International Board Certified Lactation Consultants provide clinical guidance and ongoing training to peer counselors, as well as direct support to clients, if more specialized knowledge and clinical expertise is needed. Clients facing housing and food insecurity or other socio-economic obstacles that may negatively influence breastfeeding and health and well-being more broadly are connected to other health and social services needed to address their social determinants of health needs, including health care access and food and rent assistance programs. To continuously improve service delivery, BHP has a robust monitoring and evaluation system. In two randomized-controlled trials, BHP was shown to improve breastfeeding initiation and duration of any and exclusive breastfeeding.

Conclusions

BHP highlights the importance of community-engaged formative research for informing breastfeeding program design. It also provides an evidence-based example of a program model that offers a continuum of breastfeeding support, considers cultural-contextual influences on breastfeeding and social determinants of health, and incorporates continuous quality improvement.
Plasma interleukin-6 is a potential predictive biomarker for postoperative delirium among acute type a aortic dissection patients treated with open surgical repair
Authors: Lv Xiao-Chai , Lin Yong , Wu Qing-song , Wang Lei , Hou Yan-ting , Dong Yi , Chen Liang-wan
Published: May 2021

Objectives

The relationship between inflammatory cytokines and postoperative delirium (POD) remains to be further investigated, especially in patients undergoing acute type A aortic dissection (AAD). Interleukin-6 (IL-6) is involved in the inflammatory process and has recently been identified as a biomarker of cerebral dysfunction. We explored the hypothesis that IL-6 was one of the critical causes of POD after surgical repair of AAD.

Methods

Plasma IL-6 was measured using electrochemiluminescence technology in patients preoperatively and 24 h, 48 h, and 72 h after surgical repair of acute type A aortic dissection. After the first three postoperative days, delirium was evaluated twice daily using the Confusion Assessment Method. ROC curves were used to evaluate the ability of IL-6 measurements to distinguish POD.

Results

The incidence of POD was 14.03% (31 of 221 patients). The patients in the POD group were significantly older than the patients in the non-POD group (56.48 ± 11.68 years vs 52.22 ± 10.50 years,P = 0.040). Plasma IL-6 concentrations were significantly higher in the POD group than in the non-POD group at three time points: preoperatively, after 24 h, and after 48 h. The AUC values corresponding to IL-6 preoperatively and 24 h after surgery were 0.73 and 0.72, respectively.

Conclusions

Cerebral dysfunction after the surgical repair of AAD shows elevated stress levels and inflammatory responses. Plasma IL-6 is a potential biomarker to predict the onset of POD in acute type A aortic dissection patients following surgical repair.
The Acute Cardiorespiratory and Cerebrovascular Response to Resistance Exercise
Authors: Perry Blake G. , Lucas Samuel J. E.
Published: May 2021

Resistance exercise (RE) is a popular modality for the general population and athletes alike, due to the numerous benefits of regular participation. The acute response to dynamic RE is characterised by temporary and bidirectional physiological extremes, not typically seen in continuous aerobic exercise (e.g. cycling) and headlined by phasic perturbations in blood pressure that challenge cerebral blood flow (CBF) regulation. Cerebral autoregulation has been heavily scrutinised over the last decade with new data challenging the effectiveness of this intrinsic flow regulating mechanism, particularly to abrupt changes in blood pressure over the course of seconds (i.e. dynamic cerebral autoregulation), like those observed during RE. Acutely, RE can challenge CBF regulation, resulting in adverse responses (e.g. syncope). Compared with aerobic exercise, RE is relatively understudied, particularly high-intensity dynamic RE with a concurrent Valsalva manoeuvre (VM). However, the VM alone challenges CBF regulation and generates additional complexity when trying to dissociate the mechanisms underpinning the circulatory response to RE. Given the disparate circulatory response between aerobic and RE, primarily the blood pressure profiles, regulation of CBF is ostensibly different. In this review, we summarise current literature and highlight the acute physiological responses to RE, with a focus on the cerebral circulation.