bluuebunny/crossref_metadata_2025 huggingface dataset:
Analyzing the Perceived Utility of Covid-19 Countermeasures: The Role of Pronominalization, Moral Foundations, Moral Disengagement, Fake News Embracing, and Health Anxiety
Authors: Ansani Alessandro , Marini Marco , Cecconi Christian , Dragoni Daniele , Rinallo Elena , Poggi Isabella , Mallia Luca
Published: July 2021

An online survey (N = 210) is presented on how the perceived utility of correct and exaggerated countermeasures against Covid-19 is affected by different pronominalization strategies (impersonal form, you, we). In evaluating the pronominalization effect, we have statistically controlled for the roles of several personal characteristics: Moral Disengagement, Moral Foundations, Health Anxiety, and Embracing of Fake News. Results indicate that, net of personal proclivities, the you form decreases the perceived utility of exaggerated countermeasures, possibly due to simulation processes. As a second point, through a Structural Equation Model, we show that binding moral values (Authority, Ingroup, and Purity) positively predict both fake news embracing and perceived utility of exaggerated countermeasures, while individualizing moral values (Harm and Fairness) negatively predict fake news embracing and positively predict the perceived utility of correct countermeasures. Lastly, fake news embracing showed a doubly bad effect: not only does it lead people to judge exaggerated countermeasures as more useful; but, more dangerously, it brings them to consider correct countermeasures as less useful in the struggle against the pandemic.
The Influence of Adverse Childhood Experiences on Perpetration of Intimate Partner Violence Among Black Men: The Moderating Role of Alcohol Use
Authors: Lee Kerry A. , Bright Charlotte Lyn , Sacco Paul , Smith Melissa E.
Published: July 2021

This study examined the moderating role of alcohol use on the association between adverse childhood experiences (ACEs) and intimate partner violence (IPV) perpetration among Black men in the United States. We conducted bivariate and logistic regression analyses using data from Wave 2 of the National Epidemiologic Survey of Alcohol and Related Conditions (NESARC). Bivariate results revealed significant relationships between eight of the 10 ACE factors physical neglect; emotional, physical and sexual abuse; witnessing a mother being abused; and having a parent guardian with an alcohol and drug problem and who was incarcerated and IPV perpetration. Similarly, examination of the relationship between ACEs and alcohol use in adulthood also revealed significant associations, with the exception of exposure to emotional neglect, emotional and sexual abuse, and witnessing a mother being abused. Findings from the logistic regression models revealed that alcohol use significantly moderated the relationship between ACEs and IPV perpetration, but only for men exposed to 1, 2, and ≥4 adversities in childhood. However, alcohol use appeared to exacerbate the relationship between ACEs and IPV perpetration for men without childhood adversity. Implications for practice, policy, and areas for further research are discussed.
Dynamic modeling and design of controller for the 2-DoF serial chain actuated by a cable-driven robot based on feedback linearization
Authors: Bahrami Vahid , Kalhor Ahmad , Tale Masouleh Mehdi
Published: July 2021

This study intends to investigate a dynamic modeling and design of controller for a planar serial chain, performing 2-DoF, in interaction with a cable-driven robot. The under study system can be used as a rehabilitation setup which is helpful for those with arm disability. The latter goal can be achieved by applying the positive tensions of the cable-driven robot which are designed based on feedback linearization approach. To this end, the system dynamics formulation is developed using Lagrange approach and then the so-called Wrench-Closure Workspace (WCW) analysis is performed. Moreover, in the feedback linearization approach, the PD and PID controllers are used as auxiliary controllers input and the stability of the system is guaranteed as a whole. From the simulation results it follows that, in the presence of bounded disturbance based on Roots Mean Square Error (RMSE) criteria, the PID controller has better performance and tracking error of the 2-DoF robot joints are improved 15.29% and 24.32%, respectively.
Empowering Nurses: Communicating Potential Medication Misuse
Authors: Carlson Kelly A. , Potter Corey E.
Published: July 2021

BACKGROUND

In nursing education and practice, we prepare nurses on topics such as patient care, pathophysiology, pharmacology, nursing leadership, and nursing competencies. Unfortunately, we may be missing the mark when it comes to integrating these topics and applying them to situations that arise in health care such as medication misuse. Nurses work intimately with patients and can recognize potential medication misuse by reviewing medication regimens and assessing necessity of PRN patient requests. In cases where nurses suspect misuse, they may or may not feel comfortable addressing these concerns with other members of the health care team.

AIMS

Study aims were to assess the baseline of whether nurses are comfortable with their level of skill to recognize potential patient medication misuse and to assess nurses’ comfortability with communicating these concerns with other nurses, providers, and patients.

METHODS

This survey study was designed to obtain practical information about nurses understanding of misused and diverted prescription medications and level of comfort with expressing concerns about the use of central nervous system depressants to inform education, practice, and research. Three-hundred and fifty nurses at one hospital were invited to participate in an anonymous REDCap survey.

RESULTS

Thirty-five percent of the surveyed nurses returned the survey. Responding nurses were more comfortable sharing their own knowledge and the need for more education on the topic than they were discussing interdisciplinary communication.

CONCLUSIONS

Empowering nurses to communicate this knowledge with others on the health care team has major public health implications to reduce the negative outcomes of misused medications.
A review on manufacture of polymeric foam cores for sandwich structures of complex shape in automotive applications
Authors: Chen Youming , Das Raj
Published: July 2021

In this work, polymeric foam thermoforming, foam injection moulding, bead foaming and film foaming were reviewed in an effort to explore feasible processes to manufacture sandwich structures of complex geometry for automotive applications. Injection moulded foams generally suffer from high density, poor cell morphologies and unnecessary skin layers. Foamable films currently available are pressure-induced. In order for foamable films to produce foam, high uniformly-distributed pressure needs to be applied, which makes it difficult to manufacture foam parts of three-dimensional complex geometry with foamable films. The majority of commercial high-performance foam cores can be thermoformed. Ideally, thermoformed foam cores would have good mechanical properties if high-performance foam sheets are used. However, the mechanical properties of foams might be reduced during the process of thermoforming, especially around corners. Bead foaming offers a high level of freedom in foam geometry to be moulded, and inserts can be integrated into foam cores during the process of moulding. Moreover, foam cores with high density in high stressed areas and low density in low stressed areas can be manufactured with foam beads of different densities. However, due to nonhomogeneous degree of fusion and weak bonds and voids between beads, bead foams generally show mechanical properties lower than their block counterpart. Relatively speaking, thermoforming with high-performance foam sheets and moulding with high-performance foam beads hold great potentials for mass production of sandwich cores of complex geometry for automotive applications. However, further investigation on the mechanical properties of thermoformed foams and high-performance bead foams is still in need to confirm their suitability.
A web-based model to enhance algorithmic thinking for novice programmers
Authors: Iqbal Malik Sohail , Mathew Roy , Tawafak Ragad M , Alfarsi Ghaliya
Published: July 2021

Algorithmic thinking is considered as one of the important steps toward learning to code for novices in programming education. In this study, algorithmic thinking was promoted by introducing a Problem Analysis Algorithmic Model (PAAM) in an Algorithms and Programming 1 (AP) course. A web-based application is developed to offer the PAAM model in the course. The application includes all teaching topics taught in the AP course. One-way cluster sampling and quantitative research were used in this research study. The impact of the PAAM model on novices was determined by conducting a survey. t-test was performed to analyze the students’ responses. The final exam grades for the last two semesters were compared to examine the effect of the PAAM model on students’ gain in the AP course. Results show that novice programmers appreciated the PAAM model in the AP course teaching processes and learning activities. The model supports novices to understand the programming question requirements (input, process, and output) and promotes algorithmic thinking. Moreover, the model helps students in learning problem-solving skills, understanding programming concepts and structures. It also focuses on students’ cognitive engagement and gain in programming. The model not only impacts positively on students’ gain but it also helps in reducing the attrition rates (failure and dropout) in the course.
Arthroscopic Distal Tibial Allograft for Posterior Glenoid Reconstruction
Authors: Hoyt Benjamin W. , Riccio Cory A. , LeClere Lance E. , Kilcoyne Kelly G. , Dickens Jonathan F.
Published: July 2021

Background:

Posterior glenoid bone loss occurs in more than two-thirds of patients with posterior glenohumeral instability, with 14% to 22% having greater than subcritical bone loss (13.5%), a marker for potential need for bony augmentation versus soft tissue-only procedures. Several techniques are described to augment either the version or volume of the glenoid surface including osteotomies, autograft transfers, and allograft tibia transfers.

Indications:

Arthroscopic-assisted allograft distal tibia bone block augmentation to the posterior glenoid is indicated for revision posterior instability procedures with posterior bone loss and in primary cases of posterior instability with critical bone loss.

Technique Description:

Arthroscopic posterior glenoid reconstruction with allograft distal tibia and posterior labral repair in the lateral position is presented. This technique uses standard instrument sets and requires no patient repositioning. The preplanned tibial bone block is prepared on a back table either prior to, or concurrently with, arthroscopic procedure. After creation of high posterior portal and standard anterior portal, a sucker-shaver and burr are used to create a perpendicular edge for apposition of the allograft tibia. The bone block is introduced through a longitudinal incision and underdelivered to the prepared surface under the liberated labrum. The articular surface of the graft and glenoid are aligned and cannulated screws are used to compress the bone block against the native glenoid. The posterior labral tissue is then mobilized over the graft and repaired to the native glenoid.

Results:

Arthroscopic distal tibial allograft augmentation for posterior bone loss restored stability and function in a small cohort of patients. Patients reported improved stability in the immediate postoperative course, with restoration of motion by 2 months. Push-ups, pull-ups, and return to full active duty without restrictions is allowed at 6 months postoperatively. Imaging at 3 months postoperatively has shown excellent graft healing.

Discussion:

The benefits of allograft tibia augmentation for posterior instability with glenoid bone loss include an anatomic joint surface restoration including articular cartilage, lack of donor site morbidity, and a minimally invasive approach. When performed arthroscopically, this technique permits concurrent posterior labral repair and anatomic reconstruction.
Complement mediates binding and procoagulant effects of ultralarge HIT immune complexes
Authors: Khandelwal Sanjay , Barnes Ayiesha , Rauova Lubica , Sarkar Amrita , Rux Ann H. , Yarovoi Serge V. , Zaitsev S. Sergei , Lambris John D. , Myoung Sooho S. , Johnson Alexandra , Lee Grace M. , Duarte Madelaine , Poncz Mortimer , Arepally Gowthami M. , Cines Douglas B.
Published: July 2021

Heparin-induced thrombocytopenia (HIT) is a prothrombotic disorder mediated by ultra-large immune complexes (ULICs) containing immunoglobulin G (IgG) antibodies to a multivalent antigen composed of platelet factor 4 and heparin. The limitations of current antithrombotic therapy in HIT supports the need to identify additional pathways that may be targets for therapy. Activation of FcγRIIA by HIT ULICs initiates diverse procoagulant cellular effector functions. HIT ULICs are also known to activate complement, but the contribution of this pathway to the pathogenesis of HIT has not been studied in detail. We observed that HIT ULICs physically interact with C1q in buffer and plasma, activate complement via the classical pathway, promote codeposition of IgG and C3 complement fragments (C3c) on neutrophil and monocyte cell surfaces. Complement activation by ULICs, in turn, facilitates FcγR-independent monocyte tissue factor expression, enhances IgG binding to the cell surface FcγRs, and promotes platelet adhesion to injured endothelium. Inhibition of the proximal, but not terminal, steps in the complement pathway abrogates monocyte tissue factor expression by HIT ULICs. Together, these studies suggest a major role for complement activation in regulating Fc-dependent effector functions of HIT ULICs, identify potential non-anticoagulant targets for therapy, and provide insights into the broader roles of complement in immune complex–mediated thrombotic disorders.
The protein landscape of chronic lymphocytic leukemia
Authors: Meier-Abt Fabienne , Lu Junyan , Cannizzaro Ester , Pohly Marcel F. , Kummer Sandra , Pfammatter Sibylle , Kunz Laura , Collins Ben C. , Nadeu Ferran , Lee Kwang Seok , Xue Peng , Gwerder Myriam , Roiss Michael , Hüllein Jennifer , Scheinost Sebastian , Dietrich Sascha , Campo Elias , Huber Wolfgang , Aebersold Ruedi , Zenz Thorsten
Published: July 2021

Many functional consequences of mutations on tumor phenotypes in chronic lymphocytic leukemia (CLL) are unknown. This may be in part due to a scarcity of information on the proteome of CLL. We profiled the proteome of 117 CLL patient samples with data-independent acquisition mass spectrometry and integrated the results with genomic, transcriptomic, ex vivo drug response, and clinical outcome data. We found trisomy 12, IGHV mutational status, mutated SF3B1, trisomy 19, del(17)(p13), del(11)(q22.3), mutated DDX3X and MED12 to influence protein expression (false discovery rate [FDR] = 5%). Trisomy 12 and IGHV status were the major determinants of protein expression variation in CLL as shown by principal-component analysis (1055 and 542 differentially expressed proteins, FDR = 5%). Gene set enrichment analyses of CLL with trisomy 12 implicated B-cell receptor (BCR)/phosphatidylinositol 3-kinase (PI3K)/AKT signaling as a tumor driver. These findings were supported by analyses of protein abundance buffering and protein complex formation, which identified limited protein abundance buffering and an upregulated protein complex involved in BCR, AKT, MAPK, and PI3K signaling in trisomy 12 CLL. A survey of proteins associated with trisomy 12/IGHV-independent drug response linked STAT2 protein expression with response to kinase inhibitors, including Bruton tyrosine kinase and mitogen-activated protein kinase kinase (MEK) inhibitors. STAT2 was upregulated in unmutated IGHV CLL and trisomy 12 CLL and required for chemokine/cytokine signaling (interferon response). This study highlights the importance of protein abundance data as a nonredundant layer of information in tumor biology and provides a protein expression reference map for CLL.
Immune control of cytomegalovirus reactivation in stem cell transplantation
Authors: Degli-Esposti Mariapia A. , Hill Geoffrey R.
Published: July 2021

The reactivation of viruses from latency after allogeneic stem cell transplantation (SCT) continues to represent a major clinical challenge requiring sophisticated monitoring strategies in the context of prophylactic and/or preemptive antiviral drugs that are associated with significant expense, toxicity and rates of failure. Accumulating evidence has demonstrated the association of polyfunctional virus-specific T cells with protection from viral reactivation, affirmed by the ability of adoptively transferred virus-specific T cells to prevent and treat reactivation and disease. The roles of natural killer cells in early viral surveillance and of dendritic cells in priming of T cells have also been delineated. Most recently, a role for strain-specific humoral responses in preventing early cytomegalovirus (CMV) reactivation has been demonstrated in preclinical models. Despite these advances, many unknowns remain: what are the critical innate and adaptive responses over time; are the origin (eg, recipient vs donor) and localization (eg, in parenchymal tissue vs lymphoid organs) of these responses important; how does graft-versus-host disease and the prevention and treatment thereof (eg, high-dose steroids) affect the functionality and relevance of a particular immune axis; do the immune parameters that control latency, reactivation, and dissemination differ; and what is the impact of new antiviral drugs on the development of enduring antiviral immunity. Thus, although antiviral drugs have provided major improvements over the past two decades, understanding the immunological paradigms underpinning protective antiviral immunity after SCT offers the potential to generate nontoxic, immune-based therapeutic approaches for lasting protection from viral reactivation.
CAR-HEMATOTOX: a model for CAR T-cell–related hematologic toxicity in relapsed/refractory large B-cell lymphoma
Authors: Rejeski Kai , Perez Ariel , Sesques Pierre , Hoster Eva , Berger Carolina , Jentzsch Liv , Mougiakakos Dimitrios , Frölich Lisa , Ackermann Josephine , Bücklein Veit , Blumenberg Viktoria , Schmidt Christian , Jallades Laurent , Fehse Boris , Faul Christoph , Karschnia Philipp , Weigert Oliver , Dreyling Martin , Locke Frederick L. , von Bergwelt-Baildon Michael , Mackensen Andreas , Bethge Wolfgang , Ayuk Francis , Bachy Emmanuel , Salles Gilles , Jain Michael D. , Subklewe Marion
Published: July 2021

Hematotoxicity represents a frequent chimeric antigen receptor (CAR) T-cell–related adverse event and remains poorly understood. In this multicenter analysis, we studied patterns of hematopoietic reconstitution and evaluated potential predictive markers in 258 patients receiving axicabtagene ciloleucel (axi-cel) or tisagenlecleucel (tisa-cel) for relapsed/refractory large B-cell lymphoma. We observed profound (absolute neutrophil count [ANC] <100 cells per µL) neutropenia in 72% of patients and prolonged (21 days or longer) neutropenia in 64% of patients. The median duration of severe neutropenia (ANC < 500 cells per µL) was 9 days. We aimed to identify predictive biomarkers of hematotoxicity using the duration of severe neutropenia until day +60 as the primary end point. In the training cohort (n = 58), we observed a significant correlation with baseline thrombocytopenia (r = −0.43; P = .001) and hyperferritinemia (r = 0.54; P < .0001) on univariate and multivariate analysis. Incidence and severity of cytokine-release syndrome, immune effector cell–associated neurotoxicity syndrome, and peak cytokine levels were not associated with the primary end point. We created the CAR-HEMATOTOX model, which included markers associated with hematopoietic reserve (eg, platelet count, hemoglobin, and ANC) and baseline inflammation (eg, C-reactive protein and ferritin). This model was validated in independent cohorts, one from Europe (n = 91) and one from the United States (n = 109) and discriminated patients with severe neutropenia ≥14 days to <14 days (pooled validation: area under the curve, 0.89; sensitivity, 89%; specificity, 68%). A high CAR-HEMATOTOX score resulted in a longer duration of neutropenia (12 vs 5.5 days; P < .001) and a higher incidence of severe thrombocytopenia (87% vs 34%; P < .001) and anemia (96% vs 40%; P < .001). The score implicates bone marrow reserve and inflammation prior to CAR T-cell therapy as key features associated with delayed cytopenia and will be useful for risk-adapted management of hematotoxicity.
Psychological stress and health-related quality of life among tuberculosis patients: a prospective cohort study
Authors: Febi Ann Roy , Manu Mohan K. , Mohapatra Aswini Kumar , Praharaj Samir Kumar , Guddattu Vasudeva
Published: July 2021

Economic, social and psychological distress is common in individuals affected by tuberculosis (TB). However, the magnitude of distress, psychological interventions and their effect on the treatment outcomes are often under-evaluated. We examined the level of psychological stress and health-related quality of life (HRQoL) of such patients and the effect of antituberculosis therapy on them.

 Our prospective cohort study included newly diagnosed adult pulmonary and extrapulmonary TB patients. Assessment of psychological stress was done using the seven-item Generalised Anxiety Disorder questionnaire for anxiety and the nine-item Patient Health Questionnaire for depression. HRQoL was assessed by using the WHOQOL-BREF questionnaire.

 Of the 86 patients studied, 21 (24.4%) had anxiety symptoms at the baseline, which reduced to 5.8% and 1.2% at 2 months and treatment completion, respectively (p<0.001). Among the subjects, 18 (20.9%) patients had depression, which reduced to 7% and 2.3% at 2 months and treatment completion, respectively (p<0.001). All the mean domain scores of HRQoL were poor at the baseline, which showed improvement at treatment completion (p<0.001).

 Anxiety and depression were common among TB patients, and there was significant progressive reduction during and after treatment. TB had remarkable negative impacts on HRQoL, with the physical domain being the most affected, and all the domain scores showed significant improvement at treatment completion. Routine screening for depression and anxiety and timely referral to a psychiatrist are required in TB patients to improve the outcome of the disease and quality of life.
Genome-wide identification of ZmSnRK2 genes and functional analysis of ZmSnRK2.10 in ABA signaling pathway in maize (Zea mays L)
Authors: Long Tiandan , Xu Binjie , Hu Yufeng , Wang Yayun , Mao Changqing , Wang Yongbin , Zhang Junjie , Liu Hanmei , Huang Huanhuan , Liu Yinghong , Yu Guowu , Zhao Chunzhao , Li Yangping , Huang Yubi
Published: July 2021

Background

Phytohormone abscisic acid (ABA) is involved in the regulation of a wide range of biological processes. In Arabidopsis, it has been well-known that SnRK2s are the central components of the ABA signaling pathway that control the balance between plant growth and stress response, but the functions of ZmSnRK2 in maize are rarely reported. Therefore, the study of ZmSnRK2 is of great importance to understand the ABA signaling pathways in maize.

Results

In this study, 14 ZmSnRK2 genes were identified in the latest version of maize genome database. Phylogenetic analysis revealed that ZmSnRK2s are divided into three subclasses based on their diversity of C-terminal domains. The exon-intron structures, phylogenetic, synteny and collinearity analysis indicated that SnRK2s, especially the subclass III of SnRK2, are evolutionally conserved in maize, rice and Arabidopsis. Subcellular localization showed that ZmSnRK2 proteins are localized in the nucleus and cytoplasm. The RNA-Seq datasets and qRT-PCR analysis showed that ZmSnRK2 genes exhibit spatial and temporal expression patterns during the growth and development of different maize tissues, and the transcript levels of some ZmSnRK2 genes in kernel are significantly induced by ABA and sucrose treatment. In addition, we found that ZmSnRK2.10, which belongs to subclass III, is highly expressed in kernel and activated by ABA. Overexpression of ZmSnRK2.10 partially rescued the ABA-insensitive phenotype of snrk2.2/2.3 double and snrk2.2/2.3/2.6 triple mutants and led to delaying plant flowering in Arabidopsis.

Conclusion

The SnRK2 gene family exhibits a high evolutionary conservation and has expanded with whole-genome duplication events in plants. The ZmSnRK2s expanded in maize with whole-genome and segmental duplication, not tandem duplication. The expression pattern analysis of ZmSnRK2s in maize offers important information to study their functions. Study of the functions of ZmSnRK.10 in Arabidopsis suggests that the ABA-dependent members of SnRK2s are evolutionarily conserved in plants. Our study elucidated the structure and evolution of SnRK2 genes in plants and provided a basis for the functional study of ZmSnRK2s protein in maize.
Primary care implementation study to scale up early identification and brief intervention and reduce alcohol-related negative outcomes at the community level (PINO): study protocol for a quasi-experimental 3-arm study
Authors: Pussig Bram , Pas Lodewijk , Li Ann , Vermandere Mieke , Aertgeerts Bert , Matheï Catharina
Published: July 2021

Background

Primary healthcare-based Early Identification and Brief Intervention (EIBI) for hazardous and harmful alcohol use is both a clinically relevant and cost-effective strategy to reduce heavy drinking. Unfortunately, it remains poorly implemented in daily practice. Multiple studies have shown that training and support (T&S) programs can increase the use of EIBI. Nonetheless, gains have only been modest and short-term at best. Suggestions have been made to rely more on multicomponent programs that simultaneously address several barriers to the implementation of EIBI. The PINO-project aims to evaluate the added value of such a multicomponent program to improve EIBI delivery in daily practice.

Methods/design

A quasi-experimental three-arm implementation study in Flanders (Belgium) will assess the effects of tailored T&S to General Practitioners (GPs) with or without community mobilisation on EIBI delivery in general practice. The study lasts 18 months and will take place in three comparable municipalities. In municipality 1 and 2, GPs receive a tailored T&S program. The T&S is theoretically founded and tailored to the GPs’ views, needs and practice characteristics. Furthermore, community actions will be embedded within municipality 1 providing additional, contextual, support. In municipality 3, GPs are offered a minimal intervention to facilitate data collection.

The primary outcome is the proportion of adult patients screened for hazardous and harmful alcohol use at the end of an 18-month implementation period. The secondary outcome is the scaling up activity at municipal level in screening rates, as assessed every 3 months, and the proportion of patients who received an additional brief intervention when necessary. Furthermore, the correlation between the opinions and needs of the GP’s, their practice organisation and their EIBI performance will be explored.

Discussion

The PINO-project addresses the gap between what is theoretically possible and the current practice. This is an innovative study combining T&S at GP level with community actions. At the same time, it implements and evaluates practice T&S based on the theoretical domains framework.

Trial registration

This trial was approved by the Ethics Committee for Research of UZ/KU Leuven (reference number s63342 and G-2020-2177-R2(MAR)) and is registered on clinicaltrials.gov (NCT04398576) in May 2020.
E-prescribing and access to prescription medicines during lockdown: experience of patients in Aotearoa/New Zealand
Authors: Imlach Fiona , McKinlay Eileen , Kennedy Jonathan , Morris Caroline , Pledger Megan , Cumming Jacqueline , McBride-Henry Karen
Published: July 2021

Background

Health services internationally have been compelled to change their methods of service delivery in response to the global COVID-19 pandemic, to mitigate the spread of infection amongst health professionals and patients. In Aotearoa/New Zealand, widespread electronic delivery of prescriptions (e-prescribing) was enabled. The aim of the research was to explore patients’ experiences of how lockdown, changes to prescribing and the interface between general practices and community pharmacy affected access to prescription medications.

Method

The research employed a mixed-method approach. This included an online survey (n = 1,010) and in-depth interviews with a subset of survey respondents (n = 38) during the first COVID-19 lockdown (March–May 2020). Respondents were recruited through a snowballing approach, starting with social media and email list contacts of the research team. In keeping with the approach, descriptive statistics of survey data and thematic analysis of qualitative interview and open-ended questions in survey data were combined.

Results

For most respondents who received a prescription during lockdown, this was sent directly to the pharmacy. Most people picked up their medication from the pharmacy; home delivery of medication was rare (4%). Survey and interview respondents wanted e-prescribing to continue post-lockdown and described where things worked well and where they encountered delays in the process of acquiring prescription medication.

Conclusions

E-prescribing has the potential to improve access to prescription medication and is convenient for patients. The increase in e-prescribing during lockdown highlighted how the system could be improved, through better feedback about errors, more consistency across practices and pharmacies, more proactive communication with patients, and equitable prescribing costs.
The first report of co-existence of pulmonary tuberculosis and lung malignancy in a kidney transplant recipient: a case report and literature review
Authors: Fang Gang , Cheng Ning-Chang , Huang Li-Li , Xie Wei-Ping , Hu Chun-Mei , Chen Wei
Published: July 2021

Background

Along with the medical development, organ transplant patients increase dramatically. Since these transplant patients take immunosuppressants for a long term, their immune functions are in a suppressed state, prone to all kinds of opportunistic infections and cancer. However, it is rarely reported that the kidney transplant recipients (KTRs) have pulmonary tuberculosis and lung cancer simultaneously.

Case presentation

A 60-year-old male was admitted because of persistent lung shadow for 2 years without any obvious symptom 8 years after renal transplant. T-SPOT test was positive but other etiological examinations for Mycobacterium tuberculosis were negative. Chest CT scan revealed two pulmonary lesions in the right upper and lower lobe respectively. 18F-fluorodesoxyglucose positron-emission tomography (FDG-PET) CT found FDG intake increased in both pulmonary consolidation lesions. CT-guided percutaneous transthoracic needle biopsy revealed lung adenocarcinoma and tuberculosis. The video-assisted thoracoscopic surgery was operated to resect the malignancy lesions. The patient received specific anti-tuberculosis therapy and was discharged. At the follow-up of 6 months post drug withdrawal, the patient was recovered very well.

Conclusions

We for the first time reported co-existence of smear-negative pulmonary TB and lung adenocarcinoma in a KTR, which highlighted the clinical awareness of co-occurrence of TB and malignancy after renal transplant and emphasized the value of biopsy and 18F-FDG-PET in early diagnosis of TB and cancer.
Evaluation of algorithms using administrative health and structured electronic medical record data to determine breast and colorectal cancer recurrence in a Canadian province
Authors: Lambert Pascal , Pitz Marshall , Singh Harminder , Decker Kathleen
Published: July 2021

Background

Algorithms that use administrative health and electronic medical record (EMR) data to determine cancer recurrence have the potential to replace chart reviews. This study evaluated algorithms to determine breast and colorectal cancer recurrence in a Canadian province with a universal health care system.

Methods

Individuals diagnosed with stage I-III breast or colorectal cancer diagnosed from 2004 to 2012 in Manitoba, Canada were included. Pre-specified and conditional inference tree algorithms using administrative health and structured EMR data were developed. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) correct classification, and scaled Brier scores were measured.

Results

The weighted pre-specified variable algorithm for the breast cancer validation cohort (N = 1181, 167 recurrences) demonstrated 81.1% sensitivity, 93.2% specificity, 61.4% PPV, 97.4% NPV, 91.8% correct classification, and scaled Brier score of 0.21. The weighted conditional inference tree algorithm demonstrated 68.5% sensitivity, 97.0% specificity, 75.4% PPV, 95.8% NPV, 93.6% correct classification, and scaled Brier score of 0.39. The weighted pre-specified variable algorithm for the colorectal validation cohort (N = 693, 136 recurrences) demonstrated 77.7% sensitivity, 92.8% specificity, 70.7% PPV, 94.9% NPV, 90.1% correct classification, and scaled Brier score of 0.33. The conditional inference tree algorithm demonstrated 62.6% sensitivity, 97.8% specificity, 86.4% PPV, 92.2% NPV, 91.4% correct classification, and scaled Brier score of 0.42.

Conclusions

Algorithms developed in this study using administrative health and structured EMR data to determine breast and colorectal cancer recurrence had moderate sensitivity and PPV, high specificity, NPV, and correct classification, but low accuracy. The accuracy is similar to other algorithms developed to classify recurrence only (i.e., distinguished from second primary) and inferior to algorithms that do not make this distinction. The accuracy of algorithms for determining cancer recurrence only must improve before replacing chart reviews.
Content analysis of digital media coverage of the human papillomavirus vaccine school-entry requirement policy in Puerto Rico
Authors: Colón-López Vivian , Rivera-Figueroa Vilnery , Arroyo-Morales Glizette O. , Medina-Laabes Diana T. , Soto-Abreu Roxana , Rivera-Encarnación Manuel , Díaz-Miranda Olga L. , Ortiz Ana P. , Wells Katelyn B. , Vázquez-Otero Coralia , Hull Pamela C.
Published: July 2021

Background

In August 2018, Puerto Rico (PR) became the 4th state or territory in the United States to adopt a human papillomavirus (HPV) vaccine school-entry requirement, for students 11–12 years old. Evidence suggests that the content of media coverage may impact people’s perception of HPV vaccine and their willingness to vaccinate. This study aimed to analyze the content of digital news coverage related to the implementation of the policy in PR.

Methods

A content review was conducted of digital media published from January 2017 through December 2018. The content reviewed was carried out in two steps: 1) creating a matrix to summarize each article’s content about the policy and 2) qualitative analysis using a grounded theory approach.

Results

The search resulted in 34 articles obtained from 17 online local and international news outlets that reported the policy's implementation. Analyses showed that 61% of the news articles did not mention the number of required doses, and 79% discussed the new policy concerning cancer prevention. In 2017, news coverage focused mostly on describing the policy, while 2018 coverage focused on controversies surrounding the implementation. Neutral emergent codes included: 1) Description of the policy; 2) Information about HPV related cancers; and 3) General information about HPV vaccine. Negative emergent codes included: 1) infringement to patient and parental autonomy; 2) Hesitancy from the political sector, and 3) Hesitancy from groups and coalitions. Positive content included: 1) knowledge and acceptance of HPV vaccine for cancer prevention; 2) importance of education and protective sexual behaviors; and 3) new vaccination law proposal.

Conclusions

Most of the media coverage in PR was neutral and included limited information related to the vaccine, HPV, and HPV-related cancers. Neutral and negative themes could influence public concerns regarding the new policy, as well as HPV vaccination rates in PR.
Laparoscopic specimen extraction in vitro: preliminary experience
Authors: Huang Yuanbi , Yi Tian , He Huajie , Li Qiguang , Long Xian , Hu Gaohua , Chen Qiwei , Li Yongpeng , Chen Rongchao , Yi Xianlin
Published: July 2021

Background

The last procedure performed by the surgeon in laparoscopic surgery is to extract the specimen through the smallest incision possible. This experiment aimed to explore the maximum diameter of specimens that can be extracted through auxiliary incisions of different lengths and shapes by in vitro physical experiments.

Materials and methods

We used the abdominal wall with the muscle layer, fixed on a square wooden frame, to simulate the human abdominal wall. Then, specimen extraction ports were made with circular, inverted Y-shaped and straight-line incisions of different sizes and lengths, and specimens of different sizes were made from tissues of different species. These specimens were extracted from different incisions with a force gauge. The tension value (N) was measured, and records were made of the length or diameter of the smallest auxiliary incision through which a given specimen could pass, as well as the largest specimen diameter that could pass through an incision of a given size. This experiment provides us with preliminary experience-based knowledge of how to choose the appropriate auxiliary incision for surgical specimen extraction according to the diameter of the specimen.

Results

The maximum diameters of specimens that could be extracted with circular ostomy diameters of 2.4, 2.7 and 3.3 cm were 4.0, 4.5 and 6.0 cm, respectively. Specimens with diameters of 6.0, 8.0 and 10.0 cm could be extracted through inverted Y-shaped incisions with a length around the umbilicus of 1 cm and an extension length of 1.0, 3.0, and 4.0 cm, respectively. Moreover, these same specimens could be extracted through inverted Y-shaped incisions with a length around the umbilicus of 2 cm and extension lengths of 0.0, 1.0 and 2.0 cm. Tough tissue specimens (made from chicken gizzards) with diameters of 1.0, 2.0, 4.0 and 6.0 cm, respectively, could be removed through straight-line incisions measuring 1.0, 2.0, 3.0 and 4.0 cm in length.

Conclusion

Along with preoperative imaging, surgical planning and trocar position, the shape and length of auxiliary incisions can be used to improve the extraction of specimens via laparoscopic surgery.
Repurposing FDA approved drugs as radiosensitizers for treating hypoxic prostate cancer
Authors: Bibby Becky A. S. , Thiruthaneeswaran Niluja , Yang Lingjian , Pereira Ronnie R. , More Elisabet , McArt Darragh G. , O’Reilly Paul , Bristow Robert G. , Williams Kaye J. , Choudhury Ananya , West Catharine M. L.
Published: July 2021

Background

The presence of hypoxia is a poor prognostic factor in prostate cancer and the hypoxic tumor microenvironment promotes radioresistance. There is potential for drug radiotherapy combinations to improve the therapeutic ratio. We aimed to investigate whether hypoxia-associated genes could be used to identify FDA approved drugs for repurposing for the treatment of hypoxic prostate cancer.

Methods

Hypoxia associated genes were identified and used in the connectivity mapping software QUADrATIC to identify FDA approved drugs as candidates for repurposing. Drugs identified were tested in vitro in prostate cancer cell lines (DU145, PC3, LNCAP). Cytotoxicity was investigated using the sulforhodamine B assay and radiosensitization using a clonogenic assay in normoxia and hypoxia.

Results

Menadione and gemcitabine had similar cytotoxicity in normoxia and hypoxia in all three cell lines. In DU145 cells, the radiation sensitizer enhancement ratio (SER) of menadione was 1.02 in normoxia and 1.15 in hypoxia. The SER of gemcitabine was 1.27 in normoxia and 1.09 in hypoxia. No radiosensitization was seen in PC3 cells.

Conclusion

Connectivity mapping can identify FDA approved drugs for potential repurposing that are linked to a radiobiologically relevant phenotype. Gemcitabine and menadione could be further investigated as potential radiosensitizers in prostate cancer.
Erectile dysfunction and associated factors among diabetic patients at, Hawassa, Southern, Ethiopia
Authors: Zeleke Maradona , Hailu Dejene , Daka Deresse
Published: July 2021

Background

Erectile dysfunction is an inability to initiate and have a persistent erection firm enough to have satisfying sexual intercourse. The prevalence of erectile dysfunction in diabetic men is considerably high, but it is often underdiagnosed and under-managed.

Objective

This study aimed to determine erectile dysfunction and associated factors among diabetic patients at, Hawassa, Southern, Ethiopia.

Methods

The institution-based cross-sectional study was conducted on 352 adult male diabetic patients randomly selected from Adare general and Hawassa comprehensive specialized hospitals using a simple random sampling technique. The number of patients to be selected from each hospital was proportionally assigned based on the total population of diabetes mellitus patients following chronic care during the study period. The descriptive statistics and multiple logistic regressions (bivariate and multivariate analysis) were carried out.

Result

The prevalence of erectile dysfunction was 72.2% (95%CI, 1.76–3.68). After adjusting all factors, old age, diabetes duration, drinking alcohol, and poor glycemic control had shown significant association with erectile dysfunction.

Conclusion

The occurrence of erectile dysfunction in this study community is very high. Drinking alcohol, poor glycemic control, age, and duration of diabetes were predictors of erectile dysfunction in this study area. Assessment and management of erectile dysfunction in the diabetic clinic should be part of routine medical care during follow-up visits with diabetic patients. Healthcare providers should emphasize screening and treating older patients and those who have had a diabetes diagnosis for a longer duration.
Symptoms, symptom relief and support in COVID-19 patients dying in hospitals during the first pandemic wave
Authors: Martinsson Lisa , Bergström Jonas , Hedman Christel , Strang Peter , Lundström Staffan
Published: July 2021

Background

At the time of the first wave of the COVID-19 pandemic in Sweden, little was known about how effective our regular end-of-life care strategies would be for patients dying from COVID-19 in hospitals. The aim of the study was to describe and evaluate end-of-life care for patients dying from COVID-19 in hospitals in Sweden up until up until 12 November 2020.

Methods

Data were collected from the Swedish Register of Palliative Care. Hospital deaths during 2020 for patients with COVID-19 were included and compared to a reference cohort of hospital patients who died during 2019. Logistic regression was used to compare the groups and to control for impact of sex, age and a diagnosis of dementia.

Results

The COVID-19 group (1476 individuals) had a lower proportion of women and was older compared to the reference cohort (13,158 individuals), 81.8 versus 80.6 years (p < .001). Breathlessness was more commonly reported in the COVID-19 group compared to the reference cohort (72% vs 43%, p < .001). Furthermore, anxiety and delirium were more commonly and respiratory secretions, nausea and pain were less commonly reported during the last week in life in the COVID-19 group (p < .001 for all five symptoms). When present, complete relief of anxiety (p = .021), pain (p = .025) and respiratory secretions (p = .037) was more often achieved in the COVID-19 group. In the COVID-19 group, 57% had someone present at the time of death compared to 77% in the reference cohort (p < .001).

Conclusions

The standard medical strategies for symptom relief and end-of-life care in hospitals seemed to be acceptable. Symptoms in COVID-19 deaths in hospitals were relieved as much as or even to a higher degree than in hospitals in 2019. Importantly, though, as a result of closing the hospitals to relatives and visitors, patients dying from COVID-19 more frequently died alone, and healthcare providers were not able to substitute for absent relatives.
Management of uterine cystic adenomyosis by laparoscopic surgery: case report
Authors: Zhao Cheng-Zhi , Wang Bin , Zhong Chun-yan , Lu Shen-tao , Lei Li
Published: July 2021

Background

Endometriosis of the uterine body can be manifested as diffuse solid lesions or cystic lesions. The former is common, while the latter is rare, especially for cystic adenomyosis larger than 5 cm.

Case presentation

A 30-year-old woman was admitted for severe and worsening dysmenorrhea. Ultrasound examination revealed a rare well-circumscribed cystic lesion about 5.5 × 4 × 5.0 cm. CA-125 level was slightly elevated. She accepted laparoscopic surgery and the adenomyotic tissues were excised. The histopathology of the specimen demonstrated the endometrial glands in the walls of cysts and an area of extensive hemorrhage can be seen in the inner wall of cyst. The patient made a good recovery after surgery and her symptoms complete resoluted.

Conclusions

This is a rare case of a cystic adenomyotic lesion that was treated by laparoscopic surgery.
Family with sequence similarity 13 member A mediates TGF-β1-induced EMT in small airway epithelium of patients with chronic obstructive pulmonary disease
Authors: Zhu Jinyuan , Wang Faxuan , Feng Xueyan , Li Beibei , Ma Liqiong , Zhang Jin
Published: July 2021

Background

To explore the role of family with sequence similarity 13 member A (FAM13A) in TGF-β1-induced EMT in the small airway epithelium of patients with chronic obstructive pulmonary disease (COPD).

Methods

Small airway wall thickness and protein levels of airway remodeling markers, EMT markers, TGF-β1, and FAM13A were measured in lung tissue samples from COPD and non-COPD patients. The correlations of FAM13A expression with COPD severity and EMT marker expression were evaluated. Gain- and loss-of-function assays were performed to explore the functions of FAM13A in cell proliferation, motility, and TGF-β1-induced EMT marker alterations in human bronchial epithelial cell line BEAS-2B.

Results

Independent of smoking status, lung tissue samples from COPD patients exhibited significantly increased small airway thickness and collagen fiber deposition, along with enhanced protein levels of remodeling markers (collagen I, fibronectin, and MMP-9), mesenchymal markers (α-SMA, vimentin, and N-cadherin), TGF-β1, and FAM13A, compared with those from non-COPD patients. FAM13A expression negatively correlated with FEV1% and PO2in COPD patients. In small airway epithelium, FAM13A expression negatively correlated with E-cadherin protein levels and positively correlated with vimentin protein levels. In BEAS-2B cells, TGF-β1 dose-dependently upregulated FAM13A protein levels. FAM13A overexpression significantly promoted cell proliferation and motility in BEAS-2B cells, whereas FAM13A silencing showed contrasting results. Furthermore, FAM13A knockdown partially reversed TGF-β1-induced EMT marker protein alterations in BEAS-2B cells.

Conclusions

FAM13A upregulation is associated with TGF-β1-induced EMT in the small airway epithelium of COPD patients independent of smoking status, serving as a potential therapeutic target for anti-EMT therapy in COPD.