bluuebunny/crossref_metadata_2025 huggingface dataset:
Self-worth and bonding emotions are related to well-being in health-care providers: a cross-sectional study
Authors: Weilenmann Sonja , Schnyder Ulrich , Keller Nina , Corda Claudio , Spiller Tobias R. , Brugger Fabio , Parkinson Brian , von Känel Roland , Pfaltz Monique C.
Published: May 2021

Background

Interacting with patients can elicit a myriad of emotions in health-care providers. This may result in satisfaction or put providers at risk for stress-related conditions such as burnout. The present study attempted to identify emotions that promote provider well-being. Following eudaimonic models of well-being, we tested whether certain types of emotions that reflect fulfilment of basic needs (self-worth, bonding with patients) rather than positive emotions in general (as suggested by hedonic models) are linked to well-being. Specifically, we hypothesized that well-being is associated with positive emotions directed at the self, which reflect self-worth, and positive as well as negative emotions (e.g., worry) directed at the patient, which reflect bonding. However, we expected positive emotions directed at an object/situation (e.g., curiosity for a treatment) to be unrelated to well-being, because they do not reflect fulfilment of basic needs.

Methods

Fifty eight physicians, nurses, and psychotherapists participated in the study. First, in qualitative interviews, they reported their emotions directed at the self, the patient, or an object/situation during distressing interactions with patients. These emotions were categorised into positive emotions directed towards the self, the patient, and an object/situation, and negative emotions directed towards the patient that reflect bonding. Second, providers completed questionnaires to assess their hedonic and eudaimonic well-being. The well-being scores of providers who did and did not experience these emotions were compared.

Results

Providers who experienced positive emotions directed towards the self or the patient had higher well-being than those who did not. Moreover, for the first time, we found evidence for higher well-being in providers reporting negative patient-directed emotions during distressing interactions. There was no difference between providers who did and did not experience positive object/situation-directed emotions.

Conclusions

These findings may point towards the importance of “eudaimonic” emotions rather than just positive emotions in interactions with patients. Emotions such as contentment with oneself, joy for the patient’s improvement, and, notably, grief or worry for the patient may build a sense of self-worth and strengthen bonding with the patient. This may explain their association with provider well-being.
Does organizational vision really matter? An empirical examination of factors related to organizational vision integration among hospital employees
Authors: Slåtten Terje , Mutonyi Barbara Rebecca , Lien Gudbrand
Published: May 2021

Background

There seems to be a consensus that a vision for an organization is a valuable thing for organizations to have. However, research on organizational vision has predominantly been studied from a leadership perspective. In contrast to previous research, organizational vision in this paper takes an employee perspective. Specifically, the purpose is to examine factors associated with the integration of organizational vision among employees in hospital organizations. Consequently, it focuses on a relatively neglected domain within health services research.

Methods

A conceptual model, centred on the concept of organizational vision integration, was developed and tested on a sample (N = 1008) consisting of hospital employees. Partial least-squares structural equation modelling (PLS-SEM) was used to test the hypotheses, using SmartPLS 3 software. Furthermore, a bootstrapping test was used to inspect potential mediating effects. Specifically, the test assessed whether the proposed direct and indirect effects were statistically significant, and at the same time revealed the nature of the mediation effect.

Results

The results from the empirical study reveal three key findings: i) organizational vision integration among employees is directly and positively related to creative performance in their respective work role (β= 0.16). Organizational vision integration and employees’ psychological capital explains almost 40% (R2= 0.36) in employees’ creative performance, ii) psychological capital and employees’ perception of organizational attractiveness are directly and positively related to employees’ organizational vision integration (β= 0.19 andβ= 0.40, respectively) and explains about 30% (R2= 0.29) of employees’ organizational vision integration, iii) employees’ organizational vision integration mediates the relationship between employees’ psychological capital, perception of organizational attractiveness and employees’ creative performance.

Conclusions

Taking an employee perspective, this study contributes to revealing whether and how organizational vision matters and its impact on hospital employees’ work performance. To achieve organizational vision integration among hospital employees successfully, this study shows that it is important for hospital leaders to be aware of the pattern of impact of both personal as well as environmental-related factors.
Development and validation of the medical professionals resilience scale
Authors: Rahman Mardhati Ab , Yusoff Muhamad Saiful Bahri , Roslan Nurhanis Syazni , Mohammad Jamilah Al-Muhammady , Ahmad Anisa
Published: May 2021

Purpose

Most of the resilience scales were developed for the non-medical population, therefore the purpose of this study was developing and validating a resilience scale for medical professionals – namely Medical Professionals Resilience Scale (MeRS).

Methods

A questionnaire development and validation study was conducted. The resilience domains and items were identified and generated through a literature review. The content validation was carried out by content experts and the content validity index (CVI) was calculated. The face validation was performed by medical officers and the face validity index (FVI) was calculated. The final MeRS was administered to 167 medical officers, exploratory factor analysis (EFA) and reliability analysis were performed to assess MeRS’s factorial structure and internal consistency.

Results

Four domains with 89 items of medical professionals’ resilience were developed. Following that, the content and face validation was conducted, and a total of 41-items remained for construct validation. EFA extracted four factors, namely growth, control, involvement, and resourceful, with a total of 37 items. The items’ CVI and FVI values were more than 0.80. The final MeRS’s items had factor loading values ranged from 0.41 to 0.76, and the Cronbach’s alpha values of the resilience domains ranged from 0.72 to 0.89.

Conclusions

MeRS is a promising scale for measuring medical professionals’ resilience as it showed good psychometric properties. This study provided validity evidence in terms of content, response process, and internal structure that supported the validity of MeRS in the measurement of resilience domains among medical professionals.
The identification of novel gene mutations for degenerative lumbar spinal stenosis using whole-exome sequencing in a Chinese cohort
Authors: Jiang Xin , Chen Dong
Published: May 2021

Background

Degenerative lumbar spinal stenosis (DLSS) is a common lumbar disease that requires surgery. Previous studies have indicated that genetic mutations are implicated in DLSS. However, studies on specific gene mutations are scarce. Whole-exome sequencing (WES) is a valuable research tool that identifies disease-causing genes and could become an effective strategy to investigate DLSS pathogenesis.

Methods

From January 2016 to December 2017, we recruited 50 unrelated patients with symptoms consistent with DLSS and 25 unrelated healthy controls. We conducted WES and exome data analysis to identify susceptible genes. Allele mutations firstly identified potential DLSS variants in controls to the patients’ group. We conducted a site-based association analysis to identify pathogenic variants using PolyPhen2, SIFT, Mutation Taster, Combined Annotation Dependent Depletion, and Phenolyzer algorithms. Potential variants were further confirmed using manual curation and validated using Sanger sequencing.

Results

In this cohort, the major classification variant was missense_mutation, the major variant type was single nucleotide polymorphism (SNP), and the major single nucleotide variation was C > T. Multiple SNPs in 34 genes were identified when filtered allele mutations in controls to retain only patient mutations. Pathway enrichment analyses revealed that mutated genes were mainly enriched for immune response-related signaling pathways. Using the Novegene database, site-based associations revealed several novel variants, including HLA-DRB1, PARK2, ACTR8, AOAH, BCORL1, MKRN2, NRG4, NUP205 genes, etc., were DLSS related.

Conclusions

Our study revealed that deleterious mutations in several genes might contribute to DLSS etiology. By screening and confirming susceptibility genes using WES, we provided more information on disease pathogenesis. Further WES studies incorporating larger DLSS patient cohorts are required to comprehend the genetic landscape of DLSS pathophysiology fully.
A cyclic nano-reactor achieving enhanced photodynamic tumor therapy by reversing multiple resistances
Authors: Liu Peng , Zhou Yanbin , Shi Xinyi , Yuan Yu , Peng Ying , Hua Surong , Luo Qiange , Ding Jinsong , Li Yong , Zhou Wenhu
Published: May 2021

Background

Photodynamic therapy (PDT) is a clinically implemented modality to combat malignant tumor, while its efficacy is largely limited by several resistance factors from tumor microenvironment (TME), such as hypoxia, anti-oxidant systems, and ATP-dependent tumor adaptive resistances. The aim of this work is to construct a multifunctional nanoplatform to remodel multiple resistant TME for enhanced PDT.

Results

Here, a targeting nano-reactor was facilely constructed to reverse the multiple resistances of PDT by incorporating glucose oxidase (GOx) and chlorin e6 (Ce6) into poly (D, L-lactic-co-glycolic acid) (PLGA)/ metal–organic framework (MOF) core–shell nanoassembly, with surface deposition of hyaluronic acid (HA) stabilized MnO2. The nano-reactor could selectively target tumor cells by virtue of surface HA modification, and once internalization, a few reactions were initiated to modulate TME. Glucose was consumed by GOx to inhibit ATP generation, and the produced H2O2was catalyzed by MnO2to generate O2for tumor hypoxia alleviation and photodynamic sensitization, and glutathione (GSH) was also effectively depleted by MnO2to suppress the tumor antioxidant defense. Consequently, the nano-reactor achieved robust PDT with amplified tumor therapy via intravenous injection.

Conclusions

This nano-reactor offers a multifunctional nanoplatform to sensitize TME-limited tumor treatment means via reversing multiple resistances.

Grpahic abstract
Calcitonin gene-related peptide regulates spinal microglial activation through the histone H3 lysine 27 trimethylation via enhancer of zeste homolog-2 in rats with neuropathic pain
Authors: An Qi , Sun Chenyan , Li Ruidi , Chen Shuhui , Gu Xinpei , An Shuhong , Wang Zhaojin
Published: May 2021

Background

Calcitonin gene-related peptide (CGRP) as a mediator of microglial activation at the transcriptional level may facilitate nociceptive signaling. Trimethylation of H3 lysine 27 (H3K27me3) by enhancer of zeste homolog 2 (EZH2) is an epigenetic mark that regulates inflammatory-related gene expression after peripheral nerve injury. In this study, we explored the relationship between CGRP and H3K27me3 in microglial activation after nerve injury, and elucidated the underlying mechanisms in the pathogenesis of chronic neuropathic pain.

Methods

Microglial cells (BV2) were treated with CGRP and differentially enrichments of H3K27me3 on gene promoters were examined using ChIP-seq. A chronic constriction injury (CCI) rat model was used to evaluate the role of CGRP on microglial activation and EZH2/H3K27me3 signaling in CCI-induced neuropathic pain.

Results

Overexpressions of EZH2 and H3K27me3 were confirmed in spinal microglia of CCI rats by immunofluorescence. CGRP treatment induced the increased of H3K27me3 expression in the spinal dorsal horn and cultured microglial cells (BV2) through EZH2. ChIP-seq data indicated that CGRP significantly altered H3K27me3 enrichments on gene promoters in microglia following CGRP treatment, including 173 gaining H3K27me3 and 75 losing this mark, which mostly enriched in regulation of cell growth, phagosome, and inflammation. qRT-PCR verified expressions of representative candidate genes (TRAF3IP2, BCL2L11, ITGAM, DAB2, NLRP12, WNT3, ADAM10) and real-time cell analysis (RTCA) verified microglial proliferation. Additionally, CGRP treatment and CCI increased expressions of ITGAM, ADAM10, MCP-1, and CX3CR1, key mediators of microglial activation in spinal dorsal horn and cultured microglial cells. Such increased effects induced by CCI were suppressed by CGRP antagonist and EZH2 inhibitor, which were concurrently associated with the attenuated mechanical and thermal hyperalgesia in CCI rats.

Conclusion

Our findings highly indicate that CGRP is implicated in the genesis of neuropathic pain through regulating microglial activation via EZH2-mediated H3K27me3 in the spinal dorsal horn.
Prediction of the risk of C5 palsy after posterior laminectomy and fusion with cervical myelopathy using a support vector machine: an analysis of 184 consecutive patients
Authors: Wang Haosheng , Tang Zhi-Ri , Li Wenle , Fan Tingting , Zhao Jianwu , Kang Mingyang , Dong Rongpeng , Qu Yang
Published: May 2021

Background

This study aimed to predict C5 palsy (C5P) after posterior laminectomy and fusion (PLF) with cervical myelopathy (CM) from routinely available variables using a support vector machine (SVM) method.

Methods

We conducted a retrospective investigation based on 184 consecutive patients with CM after PLF, and data were collected from March 2013 to December 2019. Clinical and imaging variables were obtained and imported into univariable and multivariable logistic regression analyses to identify risk factors for C5P. According to published reports and clinical experience, a series of variables was selected to develop an SVM machine learning model to predict C5P. The accuracy (ACC), area under the receiver operating characteristic curve (AUC), and confusion matrices were used to evaluate the performance of the prediction model.

Results

Among the 184 consecutive patients, C5P occurred in 26 patients (14.13%). Multivariate analyses demonstrated the following 4 independent factors associated with C5P: abnormal electromyogram (odds ratio [OR] = 7.861), JOA recovery rate (OR = 1.412), modified Pavlov ratio (OR = 0.009), and presence of C4–C5 foraminal stenosis (OR = 15.492). The SVM model achieved an area under the receiver operating characteristic curve (AUC) of 0.923 and an ACC of 0.918. Additionally, the confusion matrix showed the classification results of the discriminant analysis.

Conclusions

The designed SVM model presented satisfactory performance in predicting C5P from routinely available variables. However, future external validation is needed.
COVID-19 in Africa: an ovarian victory?
Authors: Dufailu Osman A. , Afriyie-Asante Afrakoma , Gyan Bernard , Kwabena David Adu , Yeboah Helena , Ntiakoh Frank , Asare-Werehene Meshach
Published: May 2021

Coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) mainly attacks the respiratory system and is characterized by pneumonia, cytokine storm, coagulation disorders and severe immune downregulation. Although public health experts predicted worst outcomes in Africa, the incidence, hospitalization and mortality rates have been lower in Africa compared to other continents. Interestingly, lower incidence and mortality rates have been observed in women from Africa compared to their cohorts from other continents. Also, in the US non-Hispanic Black females have lower COVID-19 and death rates compared to their white counterparts. It’s unclear why this significant difference exists; however, the ovarian function, genetics and immunological statuses could play a major role. Women of African descent have elevated levels of estrogen compared with Caucasians hence we anticipate that estrogen might offer some protection against the SARS-CoV-2 infections. The racial differences in lifestyle, age and inaccessibility to contraceptive usage might also play a role. Here, we provide insight on how the high levels of estrogen in African women might contribute to the lower cases and fatalities in Africa. Specifically, estrogen might offer protection against COVID-19 by suppressing hyper-production of cytokines, promoting anti-inflammatory cytokines, stimulating antibody production and suppressing endoplasmic reticulum (ER) stress. This will as well provide useful information on how future pandemics could be managed using Africa as a case study.
Study on the reaction strategy of directional alkylation fulfilled by controlling the adsorption pose of benzene and methanol in space with Ru/HZSM-5
Authors: Wang Dongliang , Li Yanwei , Zhao Yu , Ji Dong , Dong Peng , Li Guixian
Published: May 2021

Background

The alkylation of benzene with methanol is an important synthetic method that is widely used in various chemical production processes. However, obtaining a high selectivity for xylene and annihilating the MTO side reaction remain challenges.

Results

In this work, a Ru/HZSM-5 catalyst was prepared using ZSM-5 as the precursor by a chemical precipitation method. Both XRD and TEM confirmed that Ru nanoparticles were evenly dispersed on the surface of the ZSM-5. The catalytic performance of benzene alkylation with methanol on the Ru/HZSM-5 catalyst was investigated. The results showed that the Ru/HZSM-5 catalyst could completely annihilate the MTO side reaction with a high conversion efficiency of benzene and selectivity for xylene, which resulted from the large gap between the transgression energy value of Ru and the ionization potential value of benzene, and the acidity of the catalyst changed greatly.

Conclusion

These findings may offer not only a new and efficient multifunctional catalyst for benzene alkylation but also fundamental insight into the catalytic mechanism of the Ru/HZSM-5 catalyst.
Lactate oxidative phosphorylation by annulus fibrosus cells: evidence for lactate-dependent metabolic symbiosis in intervertebral discs
Authors: Wang Dong , Hartman Robert , Han Chao , Zhou Chao-ming , Couch Brandon , Malkamaki Matias , Roginskaya Vera , Van Houten Bennett , Mullett Steven J. , Wendell Stacy G. , Jurczak Michael J. , Kang James , Lee Joon , Sowa Gwendolyn , Vo Nam
Published: May 2021

Background

Intervertebral disc degeneration contributes to low back pain. The avascular intervertebral disc consists of a central hypoxic nucleus pulpous (NP) surrounded by the more oxygenated annulus fibrosus (AF). Lactic acid, an abundant end-product of NP glycolysis, has long been viewed as a harmful waste that acidifies disc tissue and decreases cell viability and function. As lactic acid is readily converted into lactate in disc tissue, the objective of this study was to determine whether lactate could be used by AF cells as a carbon source rather than being removed from disc tissue as a waste byproduct.

Methods

Import and conversion of lactate to tricarboxylic acid (TCA) cycle intermediates and amino acids in rabbit AF cells were measured by heavy-isotope (13C-lactate) tracing experiments using mass spectrometry. Levels of protein expression of lactate converting enzymes, lactate importer and exporter in NP and AF tissues were quantified by Western blots. Effects of lactate on proteoglycan (35S-sulfate) and collagen (3H-proline) matrix protein synthesis and oxidative phosphorylation (Seahorse XFe96 Extracellular Flux Analyzer) in AF cells were assessed.

Results

Heavy-isotope tracing experiments revealed that AF cells imported and converted lactate into TCA cycle intermediates and amino acids using in vitro cell culture and in vivo models. Addition of exogenous lactate (4 mM) in culture media induced expression of the lactate importer MCT1 and increased oxygen consumption rate by 50%, mitochondrial ATP-linked respiration by 30%, and collagen synthesis by 50% in AF cell cultures grown under physiologic oxygen (2-5% O2) and glucose concentration (1-5 mM). AF tissue highly expresses MCT1, LDH-H, an enzyme that preferentially converts lactate to pyruvate, and PDH, an enzyme that converts pyruvate to acetyl-coA. In contrast, NP tissue highly expresses MCT4, a lactate exporter, and LDH-M, an enzyme that preferentially converts pyruvate to lactate.

Conclusions

These findings support disc lactate-dependent metabolic symbiosis in which lactate produced by the hypoxic, glycolytic NP cells is utilized by the more oxygenated AF cells via oxidative phosphorylation for energy and matrix production, thus shifting the current research paradigm of viewing disc lactate as a waste product to considering it as an important biofuel. These scientifically impactful results suggest novel therapeutic targets in disc metabolism and degeneration.
Repurposing beta-3 adrenergic receptor agonists for Alzheimer’s disease: beneficial effects in a mouse model
Authors: Tournissac Marine , Vu Tra-My , Vrabic Nika , Hozer Clara , Tremblay Cyntia , Mélançon Koralie , Planel Emmanuel , Pifferi Fabien , Calon Frédéric
Published: May 2021

Background

Old age, the most important risk factor for Alzheimer’s disease (AD), is associated with thermoregulatory deficits. Brown adipose tissue (BAT) is the main thermogenic driver in mammals and its stimulation, through β3 adrenergic receptor (β3AR) agonists or cold acclimation, counteracts metabolic deficits in rodents and humans. Studies in animal models show that AD neuropathology leads to thermoregulatory deficits, and cold-induced tau hyperphosphorylation is prevented by BAT stimulation through cold acclimation. Since metabolic disorders and AD share strong pathogenic links, we hypothesized that BAT stimulation through a β3AR agonist could exert benefits in AD as well.

Methods

CL-316,243, a specific β3AR agonist, was administered to the triple transgenic mouse model of AD (3xTg-AD) and non-transgenic controls from 15 to 16 months of age at a dose of 1 mg/kg/day i.p.

Results

Here, we show that β3AR agonist administration decreased body weight and improved peripheral glucose metabolism and BAT thermogenesis in both non-transgenic and 3xTg-AD mice. One-month treatment with a β3AR agonist increased recognition index by 19% in 16-month-old 3xTg-AD mice compared to pre-treatment (14-month-old). Locomotion, anxiety, and tau pathology were not modified. Finally, insoluble Aβ42/Aβ40 ratio was decreased by 27% in the hippocampus of CL-316,243-injected 3xTg-AD mice.

Conclusions

Overall, our results indicate that β3AR stimulation reverses memory deficits and shifts downward the insoluble Aβ42/Aβ40 ratio in 16-month-old 3xTg-AD mice. As β3AR agonists are being clinically developed for metabolic disorders, repurposing them in AD could be a valuable therapeutic strategy.
Recurrent noncirrhotic hyperammonemia causing acute metabolic encephalopathy in a patient with a continent ileocecal pouch: a case report
Authors: Skipina T. M. , Macbeth S. , Cummer E. L. , Wells O. L. , Kalathoor S.
Published: May 2021

Introduction

Acute encephalopathy, while a common presentation in the emergency department, is typically caused by a variety of metabolic, vascular, infectious, structural, or psychiatric etiologies. Among metabolic causes, hyperammonemia is relatively common and typically occurs in the setting of cirrhosis or liver dysfunction. However, noncirrhotic hyperammonemia is a rare occurrence and poses unique challenges for clinicians.

Case presentation

Here we report a rare case of a 50-year-old Caucasian female with history of bladder cancer status post chemotherapy, radical cystectomy, and ileocecal diversion who presented to the emergency department with severe altered mental status, combativeness, and a 3-day history of decreased urine output. Her laboratory tests were notable for hyperammonemia up to 289 μmol/L, hypokalemia, and hyperchloremic nonanion gap metabolic acidosis; her liver function tests were normal. Urine cultures were positive for Enterococcus faecium. Computed tomography imaging showed an intact ileoceal urinary diversion with chronic ileolithiasis. Upon administration of appropriate antibiotics, lactulose, and potassium citrate, she experienced rapid resolution of her encephalopathy and a significant reduction in hyperammonemia. Her hyperchloremic metabolic acidosis persisted, but her hypokalemia had resolved.

Conclusion

This case is an example of one of the unique consequences of urinary diversions. Urothelial tissue is typically impermeable to urinary solutes. However, when bowel segments are used, abnormal absorption of solutes occurs, including exchange of urinary chloride for serum bicarbonate, leading to a persistent hyperchloremic nonanion gap metabolic acidosis. In addition, overproduction of ammonia from urea-producing organisms can lead to abnormal absorption into the blood and subsequent oversaturation of hepatic metabolic capacity with consequent hyperammonemic encephalopathy. Although this is a rare case, prompt identification and treatment of these metabolic abnormalities is critical to prevent severe central nervous system complications such as altered mental status, coma, and even death in patients with urinary diversions.
Novel forward–backward algorithms for optimization and applications to compressive sensing and image inpainting
Authors: Suantai Suthep , Noor Muhammad Aslam , Kankam Kunrada , Cholamjiak Prasit
Published: May 2021

The forward–backward algorithm is a splitting method for solving convex minimization problems of the sum of two objective functions. It has a great attention in optimization due to its broad application to many disciplines, such as image and signal processing, optimal control, regression, and classification problems. In this work, we aim to introduce new forward–backward algorithms for solving both unconstrained and constrained convex minimization problems by using linesearch technique. We discuss the convergence under mild conditions that do not depend on the Lipschitz continuity assumption of the gradient. Finally, we provide some applications to solving compressive sensing and image inpainting problems. Numerical results show that the proposed algorithm is more efficient than some algorithms in the literature. We also discuss the optimal choice of parameters in algorithms via numerical experiments.
Cyberpsychiatry versus COVID-19: using video consultation to improve clinical care in an in-patient psychiatric unit
Authors: Moslehi Sarah , Aubrey-Jones Dominic , Knowles Melanie , Obeney-Williams Janet , Leveson Senem , Aref-Adib Golnar
Published: May 2021

The COVID-19 pandemic has resulted in unique challenges for in-patients across the National Health Service as visitors, both family and friends, are prevented from visiting patients owing to infection prevention and control measures. The Attend Anywhere platform was used as the basis of a quality improvement project to mitigate the detrimental effects of reduced social contact for patients. The use of video conferencing led to increased subjective satisfaction for both patients and healthcare professionals, thereby providing further evidence of the benefit that this emerging technology has on healthcare delivery.
Secondary Cytoreduction and Carboplatin Hyperthermic Intraperitoneal Chemotherapy for Platinum-Sensitive Recurrent Ovarian Cancer: An MSK Team Ovary Phase II Study
Authors: Zivanovic Oliver , Chi Dennis S. , Zhou Qin , Iasonos Alexia , Konner Jason A. , Makker Vicky , Grisham Rachel N. , Brown Amy K. , Nerenstone Stacy , Diaz John P. , Schroeder Eric D. , Langstraat Carrie L. , Paroder Viktoriya , Lakhman Yulia , Soldan Krysten , Su Katy , Gardner Ginger J. , Andikyan Vaagn , Guo Jianxia , Jewell Elizabeth L. , Long Roche Kara , Troso-Sandoval Tiffany , Lichtman Stuart M. , Moukarzel Lea A. , Dessources Kimberly , Abu-Rustum Nadeem R. , Aghajanian Carol , Tew William P. , Beumer Jan , Sonoda Yukio , O'Cearbhaill Roisin E.
Published: May 2021

PURPOSE

The purpose of this phase II study was to evaluate hyperthermic intraperitoneal chemotherapy (HIPEC) with carboplatin for recurrent ovarian cancer during secondary cytoreductive surgery.

MATERIALS AND METHODS

Patients were intraoperatively randomly assigned to carboplatin HIPEC (800 mg/m2for 90 minutes) or no HIPEC, followed by five or six cycles of postoperative IV carboplatin-based chemotherapy, respectively. Based on a binomial single-stage pick-the-winner design, an arm was considered winner if ≥ 17 of 49 patients were without disease progression at 24 months post-surgery. Secondary objectives included postoperative toxicity and HIPEC pharmacokinetics.

RESULTS

Of 98 patients, 49 (50%) received HIPEC. Complete gross resection was achieved in 82% of the HIPEC patients and 94% of the standard-arm patients. Bowel resection was performed in 37% of patients in the HIPEC arm compared with 65% in the standard ( P = .008). There was no perioperative mortality and no difference in use of ostomies, length of stay, or postoperative toxicity. At 24 months, eight patients (16.3%; 1-sided 90% CI, 9.7 to 100) were without progression or death in the HIPEC arm and 12 (24.5%; 1-sided 90% CI, 16.5 to 100) in the standard arm. With a medium follow-up of 39.5 months, 82 patients progressed and 37 died. The median progression-free survival in the HIPEC and standard arms were 12.3 and 15.7 months, respectively (hazard ratio, 1.54; 95% CI, 1 to 2.37; P = .05). There was no significant difference in median overall survival (52.5 v 59.7 months, respectively; hazard ratio, 1.39; 95% CI, 0.73 to 2.67; P = .31). These analyses were exploratory.

CONCLUSION

HIPEC with carboplatin was well tolerated but did not result in superior clinical outcomes. This study does not support the use of HIPEC with carboplatin during secondary cytoreductive surgery for platinum-sensitive recurrent ovarian cancer.
Interdisciplinary Approach to Thrombosis Management in COVID-19 at a Large Academic Center
Authors: Gaddh Manila , Maier Cheryl L.
Published: May 2021

There is an increasing recognition of association of COVID-19 with a distinct coagulopathy and increased risk of thrombosis. Unfortunately, effective strategies to prevent and treat thrombosis in this patient population remain uncertain. In the setting of a worsening pandemic, there is an urgent need to provide practical guidance to the clinicians on management of the coagulopathy, while waiting for the results from large systematic trials to establish best practices. At our institution, we convened an interdisciplinary group of 25 experts in the field of thrombosis from different medical specialties to review available literature and brainstorm management strategies. The group provided a 3-tiered anticoagulation algorithm for patients with COVID-19 along with a pathway for multidisciplinary review of difficult or refractory cases, which are described in this manuscript. In these unprecedented times where medical decision making is made difficult by both the novelty of the disease and paucity of robust data, clinical algorithms such as the one presented here may prove to be helpful for frontline providers caring for individual patients.
Rare Variants in Triglycerides-Related Genes Increase Pancreatitis Risk in Multifactorial Chylomicronemia Syndrome
Authors: Paquette Martine , Amyot Julie , Fantino Manon , Baass Alexis , Bernard Sophie
Published: May 2021

Context

Severe hypertriglyceridemia (fasting triglycerides [TG] concentration ≥10 mmol/L) can be caused by multifactorial chylomicronemia syndrome (MCS) or familial chylomicronemia syndrome (FCS). Both conditions are associated with an increased risk of acute pancreatitis. The clinical differences between MCS patients with or without a rare variant in TG-related genes have never been studied.

Objective

To compare the clinical and biochemical characteristics of FCS, positive-MCS patients, and negative-MCS patients, as well as to investigate the predictors of acute pancreatitis in MCS patients.

Methods

All patients referred at the clinic for severe hypertriglyceridemia underwent genetic testing for the 5 canonical genes involved in TG metabolism (LPL, APOC2, GPIHBP1, APOA5, and LMF1) using next-generation sequencing.

Results

A total of 53 variant negative-MCS, 22 variant positive-MCS and 28 FCS subjects were included in this retrospective cross-sectional study. A significant difference was observed in the prevalence of pancreatitis (9%, 41%, and 61%) and multiple pancreatitis (6%, 23%, and 46%) in the negative-MCS, the positive-MCS, and the FCS groups, respectively (P < 0.0001). Predictors of pancreatitis among MCS subjects included the presence of a rare variant, lower apolipoprotein B, as well as higher gamma-glutamyl transferase, maximal TG value, and fructose consumption.

Conclusion

We observed that the MCS individuals who carried a rare variant have an intermediate phenotype between FCS and negative-MCS subjects. Since novel molecules such as the antisense oligonucleotide against APOC3 mRNA showed high efficacy in reducing TG levels in patients with multifactorial chylomicronemia, identification of higher-risk MCS patients who would benefit from additional treatment is essential.
Tafazzin Deficiency Reduces Basal Insulin Secretion and Mitochondrial Function in Pancreatic Islets From Male Mice
Authors: Cole Laura K , Agarwal Prasoon , Doucette Christine A , Fonseca Mario , Xiang Bo , Sparagna Genevieve C , Seshadri Nivedita , Vandel Marilyne , Dolinsky Vernon W , Hatch Grant M
Published: May 2021

Tafazzin (TAZ) is a cardiolipin (CL) biosynthetic enzyme important for maintaining mitochondrial function. TAZ affects both the species and content of CL in the inner mitochondrial membrane, which are essential for normal cellular respiration. In pancreatic β cells, mitochondrial function is closely associated with insulin secretion. However, the role of TAZ and CL in the secretion of insulin from pancreatic islets remains unknown. Male 4-month-old doxycycline-inducible TAZ knock-down (KD) mice and wild-type littermate controls were used. Immunohistochemistry was used to assess β-cell morphology in whole pancreas sections, whereas ex vivo insulin secretion, CL content, RNA-sequencing analysis, and mitochondrial oxygen consumption were measured from isolated islet preparations. Ex vivo insulin secretion under nonstimulatory low-glucose concentrations was reduced ~52% from islets isolated from TAZ KD mice. Mitochondrial oxygen consumption under low-glucose conditions was also reduced ~58% in islets from TAZ KD animals. TAZ deficiency in pancreatic islets was associated with significant alteration in CL molecular species and elevated polyunsaturated fatty acid CL content. In addition, RNA-sequencing of isolated islets showed that TAZ KD increased expression of extracellular matrix genes, which are linked to pancreatic fibrosis, activated stellate cells, and impaired β-cell function. These data indicate a novel role for TAZ in regulating pancreatic islet function, particularly under low-glucose conditions.
Petrarch's Civilized Barbarians
Authors: Godman Peter
Published: May 2021

This article focuses on the significance of two letters in Petrarch's Rerum familiarum libri which were probably composed in or around 1351, arguably but not demonstrably on the basis of previous versions, and addressed to Cardinal Giovanni Colonna, who had passed away during the plague of 1348. Petrarch's letters enable us to perceive how he shaped his early experiences in the mold of his later misfortunes. Imperialism, cultural and political, provided Petrarch in 1351 with rhetorical materials to refashion setbacks endured during the previous decade, which had turned his attention back to Germany and a Roman empire that no longer existed. That is why Familiares 1.4 and 1.5 single out, among several other places in Northern Europe which he reports having visited, two German towns, Aachen and Cologne. The letters offer testimony of Petrarch's attitude toward “barbarians,” seen in the light of his cultural politics.
Milk and Miracles: Heteroglossia and Dissent in Venetian Religious Art after the Council of Trent
Authors: Sperling Jutta
Published: May 2021

This essay investigates Benedetto Caliari's Nativity of the Virgin (1576) with its provocative and unorthodox depiction of a bare-breasted wet-nurse in the context of both Protestant and Catholic criticism of “indecent” religious imagery. Reformers on both sides drew a connection between the Virgin Mary's ostentatious display of her lactating breasts and her presumed, derided, or hoped-for miracle-working capacities or intercessory powers. In post-Tridentine Venice, several artists, including Tintoretto and Veronese, all of whom were connected to the Scuola de’ Mercanti that commissioned Caliari's painting, employed religious breastfeeding imagery in a wide array of iconographies in order to express dissent with the Counter-Reformation church's emphasis on orthodoxy. In contrast to writers, artists were able to claim a certain degree of nonconformity and freedom from prosecution. In light of Mikhail Bakhtin's concept of heteroglossia, it is argued that religious lactation imagery after Trent produced irony, parody, doubt, and dissent.
Analysis of medication-related osteonecrosis of the jaw with bone SPECT/CT: relationship between patient characteristics and maximum standardized uptake value
Authors: Ogawa Ruri , Ogura Ichiro
Published: May 2021

Objective:

To analyze medication-related osteonecrosis of the jaw (MRONJ) with bone single photon emission computed tomography (SPECT)/CT, especially relationship between patient characteristics and maximum standardized uptake value (SUV).

Methods:

48 patients with MRONJ who underwent bone SPECT/CT were prospectively included. MRONJ patients were included 34 osteoporosis and 14 bone metastases from 6 lung cancer, 6 breast cancer and 2 rectal cancer. The maximum SUV of the MRONJ patient characteristics were analyzed such as gender, location, underlying disease, medication and staging of MRONJ by Mann–Whitney U test. P-values lower than 0.05 indicate significant differences.

Results:

Regarding underlying disease, maximum SUV of patients with osteoporosis (18.69 ± 8.57) were significantly higher than those with bone metastases (12.28 ± 4.32, p = 0.005). Furthermore, maximum SUV of MRONJ was a significant difference for medication (denosumab: 13.62 ± 5.70 and minodronate: 22.98 ± 11.73, p = 0.009) and staging of MRONJ (Stage 2: 15.59 ± 8.06 and Stage 3: 21.51 ± 7.15, p = 0.014).

Conclusion:

Maximum SUV assessed by SPECT/CT was significantly increased in MRONJ patients with osteoporosis and Stage 3. Bone SPECT/CT could be an effective tool for the analysis of MRONJ.
How do German schools cope with the Covid-19 pandemic? School during the corona pandemic in Germany
Authors: Bauer Petra , Kolb Christine Isabella , Wiedemann Alexandra
Published: May 2021

This article points out how German schools deal with the Covid-19 pandemic during and after the first national wide lockdown in spring 2020. The article describes the steps taken by the German Government concerning measures to combat the corona pandemic and the associated development of the framework conditions for schools. The different perspectives of teachers, students and parents during this time are reviewed based on the following studies KiCo and JuCo, a nationwide online survey about experiences and perspectives of young people during the corona measures by the research association “Kindheit – Jugend – Familie in der Corona-Zeit” and JIMplus 2020, an additional corona survey on media handling during school closure by Medienpädagogischer Forschungsverbund Südwest (mpfs). Finally, there will be a discussion based on the representative study “Deutsches Schulbarometer Spezial” about how teachers cope with the new tasks related to the corona crisis.
Στάσεις και Αντιλήψεις εκπαιδευτικών ΕΠΑ.Λ. για την εξ αποστάσεως διδασκαλία όπως εφαρμόστηκε με την προσέγγιση "Μαθαίνουμε στο σπίτι"
Authors: Κορρές Δημήτριος , Σοφός Αλιβίζος (Λοΐζος)
Published: May 2021

Σκοπός της έρευνας είναι η διερεύνηση  των αντιλήψεων και των στάσεων που έχουν οι εκπαιδευτικοί των ΕΠΑΛ Κυκλάδων & Δωδεκανήσου για την εξ αποστάσεως εκπαίδευση και για τις επιπτώσεις του COVID-19 στην ακολουθητέα εκπαιδευτική διαδικασία. Ως ερευνητικό εργαλείο χρησιμοποιήθηκε το δομημένο ερωτηματολόγιο το οποίο συμπληρώθηκε ηλεκτρονικά από 126 εκπαιδευτικούς, όλων των ειδικοτήτων, οι οποίοι εργάζονται στα συγκεκριμένα ΕΠΑΛ. Τα αποτελέσματα της έρευνας καταδεικνύουν αφενός ότι οι εκπαιδευτικοί αναγνωρίζουν τα πλεονεκτήματα εφαρμογής της εξ αποστάσεως διδασκαλίας στην εκπαιδευτική διαδικασία και αφετέρου ότι εκφράζουν ορισμένες ανησυχίες για την αποτελεσματικότητα των συγκεκριμένων μεθόδων στην επίτευξη των μαθησιακών στόχων. Τα αποτελέσματα της έρευνας συμβάλλουν στην αναγνώριση των στάσεων, των αντιλήψεων και των προβληματισμών που έχουν οι εκπαιδευτικοί ως προς τη νέα εκπαιδευτική πραγματικότητα και δύναται να αξιοποιηθούν από τους φορείς άσκησης εκπαιδευτικών πολιτικών με σκοπό την αποτελεσματικότερη εφαρμογή των ΤΠΕ στην εποχή του COVID-19.
Η επίδραση της «κοινωνικής αποστασιοποίησης» κατά τη διάρκεια της πανδημίας Covid-19 σε μαθητές της Δευτεροβάθμιας Εκπαίδευσης στην περιοχή της Θεσσαλίας
Authors: Τσιχουρίδης Χαρίλαος , Μπατσίλα Μαριάνθη , Πέτρου Νικόλαος , Ρουσσάκης Ιωάννης
Published: May 2021

Στην παρούσα έρευνα επιχειρείται η διερεύνηση και η καταγραφή των αντιλήψεων μαθητών Δευτεροβάθμιας Εκπαίδευσης σχετικά με την επίδραση του εγκλεισμού και της κοινωνικής αποστασιοποίησης εξαιτίας της πανδημίας Covid-19, σε παράγοντες της σχολικής και κοινωνικής τους ζωής εστιάζοντας στην επικοινωνία τους με τους εκπαιδευτικούς και τους συμμαθητές τους, στην αντιμετώπιση των σχολικών τους υποχρεώσεων και στις διαδικασίες μάθησης, στην αγωνία τους για την ολοκλήρωση των σπουδών τους, καθώς επίσης και στην άποψή τους για την εξ αποστάσεως εκπαίδευση. Στην έρευνα συμμετείχαν 144 μαθητές Γενικών Λυκείων από την περιοχή της Θεσσαλίας καταγράφοντας τις απόψεις τους σε πέντε περιόδους, που καλύπτουν χρονικά όλη την περίοδο (Μάρτιος – Μάϊος 2020). Τα αποτελέσματα είναι αποκαλυπτικά της επιρροής που είχε η περίοδος ισχύος του εγκλεισμού κοινωνικής αποστασιοποίησης στη σχολική και κοινωνική ζωή των μαθητών και μπορούν να αποτελέσουν αφετηρία για περαιτέρω μελέτη.
Μυστικοί πράκτορες εναντίον κορωνοϊού
Authors: Σαμούχος Πέτρος
Published: May 2021

Το διαθεματικό project «Μυστικοί πράκτορες εναντίον κορωνοϊού» υλοποιήθηκε από τους μαθητές της Β΄ Δημοτικού του 6ου Δημοτικού Σχολείου Λιβαδειάς κατά τη διάρκεια της πανδημίας. Η παρούσα εργασία έχει ως στόχο να παρουσιάσει μια ολοκληρωμένη διδακτική πρόταση ασύγχρονης εξ αποστάσεως εκπαίδευσης και να αναδείξει τα οφέλη που προκύπτουν από την κινητοποίηση του μαθησιακού ενδιαφέροντος και της αυτενέργειας των μαθητών. Οι μαθητές μέσω πρωτότυπων και παιγνιωδών δραστηριοτήτων έκαναν παρατηρήσεις για τα μικρόβια, υιοθέτησαν κανόνες ατομικής υγιεινής, έκαναν επανάληψη στα διδακτικά αντικείμενα της τάξης, ασχολήθηκαν με τη ρομποτική και ανέπτυξαν τη δημιουργικότητά τους. Το project επεδίωξε και πέτυχε την ενεργή συμμετοχή των γονέων των μαθητών σε όλες τις εκφάνσεις του. Με την υλοποίησή του ενεργοποιήθηκε το ενδιαφέρον των μαθητών για τη μαθησιακή διαδικασία  και ανέπτυξαν μεταγνωστικές δεξιότητες υιοθετώντας και εφαρμόζοντας στην πράξη κανόνες ατομικής υγιεινής. Τέλος με την ολοκλήρωσή του πραγματοποιήθηκε εσωτερική αξιολόγηση τόσο από τους μαθητές όσο και από τον εκπαιδευτικό.
Στήριξη διεπιστημονικών αναστοχασμών στη σύγχρονη διδασκαλία Μαθηματικών και Φυσικών Επιστημών: ανάμεσα στο δια ζώσης και το εξ αποστάσεως
Authors: Κρητικός Γεώργιος , Μούτσιος-Ρέντζος Ανδρέας , Καλαβάσης Φραγκίσκος
Published: May 2021

Στην παρούσα εργασία μελετάμε τους διεπιστημονικούς αναστοχασμούς που αναπτύσσονται ανάμεσα σε εκπαιδευτικούς Μαθηματικών και Φυσικών Επιστημών, έχοντας σχεδιάσει ένα διεπιστημονικό αναστοχαστικό εργαλείο, τόσο για τη δια ζώσης, όσο και για τη διαδικτυακή αλληλεπίδραση των εκπαιδευτικών. Στο πλαίσιο αυτού του εργαλείου, οι εκπαιδευτικοί μελετούν χωρία από σχολικά εγχειρίδια, εστιάζοντας στη μαθηματική σημειογραφία, η οποία αποτελεί τον πυρήνα της επικοινωνίας των ιδεών των Μαθηματικών και των Φυσικών Επιστημών. Ο σχεδιασμός του εργαλείου περιλαμβάνει στάδια στα οποία οι εκπαιδευτικοί απαντούν αρχικά ατομικά, στη συνέχεια σε ομάδες του ίδιου κλάδου και, στο τελικό στάδιο, ανταλλάσσουν απόψεις στην ολομέλεια. Σύμφωνα με τα αποτελέσματα της έρευνας, οι σχολιασμοί των εκπαιδευτικών διαφορετικών ειδικοτήτων εμφανίζουν αποκλίσεις, αλλά και συγκλίσεις, ενώ όλοι/ες σημειώνουν τη σημασία της διεπιστημονικής συνεργασίας και αλληλεπίδρασης μεταξύ των εκπαιδευτικών και μεταξύ των συγγραφέων των σχολικών εγχειριδίων για την βελτίωση της διδασκαλίας και μάθησης των μαθημάτων των Μαθηματικών και των Φυσικών Επιστημών.
Η Εμπειρία της Εξ Αποστάσεως Εκπαίδευσης στην Τεχνική Εκπαίδευση σε Έκτακτες Συνθήκες
Authors: Ψάνη Αγλαΐα , Μακρυγιάννης Παναγιώτης , Κοτσιφάκος Δημήτριος
Published: May 2021

Τα μαθήματα στις σχολικές μονάδες της Επαγγελματικής Εκπαίδευσης και Κατάρτισης (ΕΕΚ) (Επαγγελματικά Λύκεια και Εργαστηριακά Κέντρα), όπως σε όλα τα σχολεία, τους μήνες Μάρτιο, Απρίλιο και Μάιο του 2020 δεν πραγματοποιήθηκαν με τους γνωστούς τρόπους διδασκαλίας και μάθησης. Ως μέτρο αντιμετώπισης της διάδοσης του Κορωνοϊού (COVID-19), επιβλήθηκε η κατάστασης απομόνωσης και εγκλεισμού. Τα μαθήματα στις σχολικές μονάδες της ΕΕΚ οργανώθηκαν με μορφές εξ’ αποστάσεως εκπαίδευσης, τηλεδιασκέψεις και ασύγχρονες ηλεκτρονικές τάξεις. Σκοπός του άρθρου είναι να καταγράψει αφενός τις επιπτώσεις από τη βίαιη μετάβαση η οποία επιχειρήθηκε λόγω της λήψης έκτακτων μέτρων στην εκπαιδευτική κοινότητα της ΕΕΚ, και αφετέρου να αποτυπώσει τα στοιχεία, τα ειδικά χαρακτηριστικά και αντιφάσεις μεταξύ αναμενόμενου, επιθυμητού και εφικτού τα οποία προέκυψαν μέσα σε πραγματικές συνθήκες των δομών της ΕΕΚ.
Κλείσιμο σχολείων. Και τώρα τι; - Μια διερεύνηση των απόψεων των εκπαιδευτικών για τη σύγχρονη και ασύγχρονη εκπαίδευση
Authors: Μπακιρτζή Ιωάννα
Published: May 2021

Το παρόν άρθρο πραγματεύεται στάσεις και προβληματισμούς για τη σύγχρονη και ασύγχρονη εκπαίδευση, όπως αυτά παρουσιάστηκαν από εκπαιδευτικούς πρωτοβάθμιας εκπαίδευσης, κατά την περίοδο των κλειστών σχολείων, λόγω της πανδημίας του κορωνοϊού. Η μέθοδος που ακολουθήθηκε ήταν η ποιοτική ερευνητική μέθοδος με κύριο εργαλείο συλλογής δεδομένων την εξ αποστάσεως συνέντευξη. Η έρευνα διεξήχθη με 23 εκπαιδευτικούς από την ευρύτερη περιοχή της Θεσσαλονίκης. Για την ανάλυση των δεδομένων αξιοποιήθηκε η θεματική ανάλυση. Τα θέματα που προέκυψαν αφορούσαν στις στάσεις των εκπαιδευτικών για τη σύγχρονη και ασύγχρονη εκπαίδευση, τα προβλήματα που αντιμετώπισαν καθώς και κάποιες προτάσεις βελτίωσης. Η έλλειψη επιμόρφωσης, η ύπαρξη τεχνικών προβλημάτων, η παρουσία πρωτόγνωρων συναισθημάτων εξαιτίας της πανδημίας αποτέλεσαν τις κύριες αναφορές προβλημάτων. Έχοντας αναγνωρίσει τα εμπόδια, οι εκπαιδευτικοί προχώρησαν στη διατύπωση βελτιωτικών αλλαγών με την ενημέρωση και την υποστήριξη να βρίσκονται στο πρώτο πλάνο. Έτσι, ενώ το μονοπάτι της σύγχρονης και ασύγχρονης εκπαίδευσης με τη χρήση συγκεκριμένων πλατφορμών φάνηκε σύντομο, ίσως άνοιξε ο μακρύς και απάτητος δρόμος της ανοιχτής εξ αποστάσεως εκπαίδευσης.