bluuebunny/crossref_metadata_2025 huggingface dataset:
DistTune: Distributed Fine-Grained Adaptive Traffic Speed Prediction for Growing Transportation Networks
Authors: Lee Ming-Chang , Lin Jia-Chun , Gran Ernst Gunnar
Published: May 2021

Over the past decade, many approaches have been introduced for traffic speed prediction. However, providing fine-grained, accurate, time-efficient, and adaptive traffic speed prediction for a growing transportation network where the size of the network keeps increasing and new traffic detectors are constantly deployed has not been well studied. To address this issue, this paper presents DistTune based on long short-term memory (LSTM) and the Nelder-Mead method. When encountering an unprocessed detector, DistTune decides if it should customize an LSTM model for this detector by comparing the detector with other processed detectors in the normalized traffic speed patterns they have observed. If a similarity is found, DistTune directly shares an existing LSTM model with this detector to achieve time-efficient processing. Otherwise, DistTune customizes an LSTM model for the detector to achieve fine-grained prediction. To make DistTune even more time-efficient, DisTune performs on a cluster of computing nodes in parallel. To achieve adaptive traffic speed prediction, DistTune also provides LSTM re-customization for detectors that suffer from unsatisfactory prediction accuracy due to, for instance, changes in traffic speed patterns. Extensive experiments based on traffic data collected from freeway I5-N in California are conducted to evaluate the performance of DistTune. The results demonstrate that DistTune provides fine-grained, accurate, time-efficient, and adaptive traffic speed prediction for a growing transportation network.
Are We Loving Our National Parks to Death? A Call for Research on Crime and Law Enforcement in the U.S. National Park System
Authors: Stadler William Andrew , Jonson Cheryl Lero , Gialopsos Brooke Miller
Published: May 2021

Despite a recent surge of visitation and frequent media accounts of lawlessness in America’s national parks, little empirical research has been dedicated to crime and law enforcement in the U.S. national park system. The absence of systematic crime and justice research within these protected spaces should raise concern, as recent park service data and intra-agency reports suggest visitor growth, funding and personnel declines, operational shortcomings, and technology constraints may endanger the capacity of the National Park Service (NPS) to adequately address anticipated crime threats in the 21st century. This call for research aims to raise awareness of the contemporary law enforcement challenges facing this federal agency and encourage the study of crime and justice issues within the U.S. national park system. We briefly examine the evolution and current state of NPS law enforcement and its associated challenges and conclude with a conceptual road map for future research occurring in these protected spaces.
Rethinking health policy student practicums through the application of the multiple streams framework: A case study
Authors: Anderson Kelly , Heenan Michael
Published: May 2021

Many university and college programs offer co-op placements or practicums as part of their curriculum, with the aim of providing real-world experience and opportunity for students to apply theory to practice. These practicums are not always grounded in the underlying management or policy theories the program teaches, instead they often focus on universal attributes such as task performance or general leadership. This case study describes how a University of Toronto Health Policy and Management student and an Executive from Ontario’s Ministry of Health redesigned the student’s practicum to be grounded in Kingdon’s Multiple Stream Policy Framework. The case demonstrates how the theoretical framework was applied to enhance their weekly mentorship discussions, and organize the student’s learnings relating to the Ministry’s policy on hospital capacity during the COVID-19 pandemic by viewing the work through the framework’s five streams.
Frailty is Associated With Frontal Cortex-Related Cognitive Function in Patients With Alzheimer Disease
Authors: Chang Yu San , Wang Chin Jen , Wu Chiu Hsiang , Wu Yu Hsuan , Lee Hsin Ning
Published: May 2021

Objective:

We compared the cognitive functions of Alzheimer disease (AD) patients who were robust, frail or pre-frail and hypothesized that declines in frontal cortex-related neuropsychological function would be associated with frailty.

Method:

One hundred and sixty outpatients aged 65 years or older with mild AD were enrolled. Cognitive function was assessed using the Cognitive Ability Screening Instrument and further classified into 4 clusters (recent memory, frontal cortex cluster, posterior cortex cluster, and orientation). Other variables included depressive mood, daily activities, body mass index, handgrip strength (HGS), and normal gait speed (NGS).

Results:

Performance in daily activities, and slower NGS than robust group. Both the frail and pre-frail groups had lower HGS and more depressive symptoms than robust group. Generalized linear with ordinal logistic analysis showed that increment in age, slowing in NGS, and worse frontal cortex cluster function associated with being in a higher level of frailty. The patients with depression symptoms were the odds of being in a higher level of frailty compared to those without depression symptoms.

Conclusions:

In addition to physical and psychological symptoms, frailty is associated with specific cognitive domains in patients with AD. A multidimensional approach should be used to assess the impact of intervention programs focusing on frail patients with AD.
Experiments and mechanistic modeling of viscosity effect on a multistage ESP performance under viscous fluid flow
Authors: Shi Yi , Zhu Jianjun , Wang Haoyu , Zhu Haiwen , Zhang Jiecheng , Zhang Hong-Quan
Published: May 2021

Assembled in series with multistage, Electrical Submersible Pumps (ESP) are widely used in offshore petroleum production due to the high production rate and efficiency. The hydraulic performance of ESPs is subjected to the fluid viscosity. High oil viscosity leads to the degradation of ESP boosting pressure compared to the catalog curves under water flow. In this paper, the influence of fluid viscosity on the performance of a 14-stage radial-type ESP under varying operational conditions, e.g. rotational speeds 1800–3500 r/min, viscosities 25–520 cP, was investigated. Numerical simulations were conducted on the same ESP model using a commercial Computational Fluid Dynamics (CFD) software. The simulated average pump head is comparable to the corresponding experimental data under different viscosities and rotational speeds with less than ±20% prediction error. A mechanistic model accounting for the viscosity effect on ESP boosting pressure is proposed based on the Euler head in a centrifugal pump. A conceptual best-match flowrate QBM is introduced, at which the impeller outlet flow direction matches the designed flow direction. The recirculation losses caused by the mismatch of velocity triangles and other head losses resulted from the flow direction change, friction loss and leakage flow etc., are included in the model. The comparison of model predicted pump head versus experimental measurements under viscous fluid flow conditions demonstrates good agreement. The overall prediction error is less than ±10%.
Utilizing Xenogeneic Cells As a Therapeutic Agent for Treating Diseases
Authors: Huang Chi-Ping , Yang Chi-Yu , Shyr Chih-Rong
Published: May 2021

The utilization of biologically produced cells to treat diseases is a revolutionary invention in modern medicine after chemically synthesized small molecule drugs and biochemically made protein drugs. Cells are basic units of life with diverse functions in mature and developing organs, which biological properties could be utilized as a promising therapeutic approach for currently intractable and incurable diseases. Xenogeneic cell therapy utilizing animal cells other than human for medicinal purpose has been studied as a new way of treating diseases. Xenogeneic cell therapy is considered as a potential regenerative approach to fulfill current unmet medical needs because xenogeneic cells could be isolated from different animal organs and expanded ex vivo as well as maintain the characteristics of original organs, providing a versatile and plenty cell source for cell-based therapeutics beside autologous and allogeneic sources. The swine species is considered the most suitable source because of the similarity with humans in size and physiology of many organs in addition to the economic and ethical reasons plus the possibility of genetic modification. This review discusses the old proposed uses of xenogeneic cells such as xenogeneic pancreatic islet cells, hepatocytes and neuronal cells as a living drug for the treatment of degenerative and organ failure diseases. Novel applications of xenogeneic mesenchymal stroma cells and urothelial cells are also discussed. There are formidable immunological barriers toward successful cellular xenotransplantation in clinic despite major progress in the development of novel immunosuppression regimens and genetically multimodified donor pigs. However, immunological barriers could be turn into immune boosters by using xenogeneic cells of specific tissue types as a novel immunotherapeutic agent to elicit bystander antitumor immunity due to rejection immune responses. Xenogeneic cells have the potential to become a safe and efficacious option for intractable diseases and hard-to-treat cancers, adding a new class of cellular medicine in our drug armamentarium.
Reasoned Action Approach Correlates of Fruit and Vegetable Diet Among African American Men Living With HIV: A Cross-Sectional Study
Authors: Kelly Terri-Ann , Kim Soojong , Jemmott Loretta S. , Icard Larry D. , Chittamuru Deepti , Jemmott John B.
Published: May 2021

Epidemiological evidence of the protective role of fruits and vegetables for a host of chronic health conditions is well-documented. However, there is a dearth of studies examining predictors of fruit and vegetable intake among African American men living with HIV. We report secondary analyses—multiple regression and logistic regression models fitted to examine the strength of the relationships between the reasoned action approach constructs; namely, attitudes, subjective norms, descriptive norms, self-efficacy and intention to consume fruits and vegetables, and self-reported adherence to 5-A-DAY guidelines. We used baseline data from a randomized controlled trial of a physical activity intervention trial with 302 African American men aged 40 years or older ( M = 53.9; SD = 7.2) living with HIV. Attitudes, subjective norms, descriptive norms, and self-efficacy were positively associated with intention to meet 5-A-DAY guidelines. More positive attitudes toward 5-A-DAY guidelines were associated with higher odds of meeting 5-A-DAY guidelines. More positive attitudes and self-efficacy were also positively associated with meeting the guidelines for intake of vegetable servings and fruit-and-vegetable servings combined. To increase fruit and vegetable intake among African American men living with HIV, interventions should be tailored to address the perceived benefits of consumption.
Two physical educators’ sense of purpose as an indicator of teaching sustainability over time in a high-poverty school setting
Authors: Ellison Douglas W
Published: May 2021

Physical education teachers with a strong sense of purpose are more resilient and maintain high-level performance over time. Therefore, this longitudinal, mixed-methods exploratory case study describes how two teachers’ (Gary and Wayne) sense of purpose in life and well-being has influenced their intent to remain teaching in high-poverty schools. This inquiry followed the two participants over four consecutive school years (2015–2019) and included eight formal interviews with Gary and Wayne, two administrations of the Ryff’s Psychological Well-Being Scale questionnaire, and one administration of the Teaching Sustainability Questionnaire over the four-year project. Gary’s and Wayne’s strong purpose in life contained central values that led to their intention to remain teaching in their high-poverty school context. This strong sense of purpose stemmed from their perceived internalized and externalized support associated with life experiences, familial influence, and the school environments where they worked. Gary’s and Wayne’s sense of purpose appeared to have a direct effect on their intention to remain teaching in the high-poverty schools where they were employed. Identifying a teacher’s sense of purpose and the extent to which it aligns with a specific school district’s mission/vision may be an important factor in recruiting and retaining teachers in high-poverty environments.
Palestinian children living amidst political and military violence deploy active protection strategies against psychological trauma: How agency can mitigate traumatic stress via life satisfaction
Authors: Veronese Guido , Cavazzoni Federica , Jaradah Alaa , Yaghi Shaher , Obaid Hania , Kittaneh Hala
Published: May 2021

This exploratory study assessed the association between agency and life satisfaction, as well as the potential for life satisfaction, in its turn, to alleviate trauma symptoms and reduce negative emotion in a group of children exposed to war and military violence in Palestine. Two hundred and fifty Palestinian children, who had been recruited at primary schools in urban and rural areas, and refugee camps, completed the Multilevel Student’s Life Satisfaction Scale, Children’s Hope Scale (CHS), Children’s Impact of Event Scale (CRIES) and Positive and Negative Affect Scales. We performed structural equation modelling to evaluate the effects of agency on negative emotions and trauma symptoms via life satisfaction. The participants appeared to play an agentic role in mobilizing their own life satisfaction, and the more satisfied they were with their lives, the less they suffered from trauma symptoms. In terms of clinical practice, we advocate more active and participatory approaches to fostering children’s agency, a complex construct in need of further investigation via mixed-method quanti-qualitative and ethnographic studies.
Overall health impacts of a potential increase in cycle commuting in Stockholm, Sweden
Authors: Sommar Johan Nilsson , Johansson Christer , Lövenheim Boel , Schantz Peter , Markstedt Anders , Strömgren Magnus , Stigson Helena , Forsberg Bertil
Published: May 2021

Aims:

To estimate the overall health impact of transferring commuting trips from car to bicycle.

Methods:

In this study registry information on the location of home and work for residents in Stockholm County was used to obtain the shortest travel route on a network of bicycle paths and roads. Current modes of travel to work were based on travel survey data. The relation between duration of cycling and distance cycled was established as a basis for selecting the number of individuals that normally would drive a car to work, but have a distance to work that they could bicycle within 30 minutes. The change in traffic flows was estimated by a transport model (LuTrans) and effects on road traffic injuries and fatalities were estimated by using national hospital injury data. Effects on air pollution concentrations were modelled using dispersion models.

Results:

Within the scenario, 111,000 commuters would shift from car to bicycle. On average the increased physical activity reduced the one-year mortality risk by 12% among the additional bicyclists. Including the number of years lost due to morbidity, the total number of disability adjusted life-years gained was 696. The amount of disability adjusted life-years gained in the general population due to reduced air pollution exposure was 471. The number of disability adjusted life-years lost by traffic injuries was 176. Also including air pollution effects among bicyclists, the net benefit was 939 disability adjusted life-years per year.

Conclusions:

Large health benefits were estimated by transferring commuting by car to bicycle.
Religious diversity through a super-diversity lens: National, sub-regional and socio-economic religious diversities in Melbourne
Authors: Bouma Gary , Arunachalam Dharma , Gamlen Alan , Healy Ernest
Published: May 2021

Melbourne’s religious diversity is increasing. This article reveals distinctive new configurations of ethno-religious diversity arising from immigration and residential mobility at a fine spatial level in different parts of one of the world’s most cosmopolitan cities – Melbourne. Using the lens of super-diversity, we see beyond multicultural groups to intersections of diversities, and identify new types of ethno-religious compound in neighbourhoods that were once defined by religious patterns of solidarity. We can no longer use religious labels to describe these evolving groups because they are not defined by any dominant religion; instead, we describe them in terms reflecting their other increasingly salient characteristics. At the local level in Melbourne, it is now necessary to refer to the existence not only of religious diversity but of a ‘diversity of diversities’ in patterns of religious identification.
Successful failure: The marketisation of failure in an entrepreneurial economy
Authors: Chua Collin
Published: May 2021

In our era of late capitalism, we can bear witness to the ongoing creative fashioning of successful failure into a commodity which has grown in value. This article discusses two topics: firstly, attitudes towards and narratives of failure in the entrepreneurial start-up space; and secondly, how ‘successful failure’ is increasingly becoming marketised beyond the entrepreneurial start-up space, as people face the escalating power of an injunction to ‘learn from failure’, and are expected to perform accordingly, as we now live within what has been described as an entrepreneurial economy. The example that initiated this line of research has been the phenomenon of ‘Fuckup Night’ events: ‘Fuckup Nights is a global movement and event series that shares stories of professional failure. Each month, in events across the globe, we get three to four people to get up in front of a room full of strangers to share their own professional fuckup. The stories of the business that crashes and burns, the partnership deal that goes sour and the product that has to be recalled, we tell them all’. In essence, the message is as follows: ‘Yes, you should tell everyone about your failures, as the path you have trod on the route to success’. The marketisation of triumphalist narratives of failure illustrates the rise of a new ‘ideology that justifies engagement in capitalism’, calling for ‘workforce participation’ in a new way (Boltanski and Chiapello, 2007 The New Spirit of Capitalism. London and New York: Verso: 8). This article examines and theorises the commoditisation of successful failure: how certain kinds of failure have been packaged and produced for impact, how – properly packaged – successful failure has become a profitable and lucrative asset and how new markets now thrive around these newly commodified narratives of failure. The article explores the context for the emergence of appropriate market conditions for the production, circulation and consumption of ‘successful failure’ as commodity.
Visualisation of law and legal Process: An opportunity missed
Authors: McLachlan Scott , Webley Lisa C
Published: May 2021

Visual representation of the law and legal process can aid in recall and discussion of complicated legal concepts, yet is a skill rarely taught in law schools. This work investigates the use of flowcharts and similar process-oriented diagrams in contemporary legal literature through a literature review and concept-based content analysis. Information visualisations (infovis) identified in the literature are classified into 11 described archetypal diagram types, and the results describe their usage quantitatively by type, year, publication venue and legal domain. We found that the use of infovis in legal literature is extremely rare, identifying not more than 10 articles in each calendar year. We also identified that the concept flow diagram is most commonly used, and that Unified Modelling Language (UML) is the most frequently applied representational approach. This work posits a number of serious questions for legal educators and practicing lawyers regarding how infovis in legal education and practice may improve access to justice, legal education and lay comprehension of complex legal frameworks and processes. It concludes by asking how we can expect communities to understand and adhere to laws that have become so complex and verbose as to be incomprehensible even to many of those who are learned in the law?
A New Definition of Poststroke Spasticity and the Interference of Spasticity With Motor Recovery From Acute to Chronic Stages
Authors: Li Sheng , Francisco Gerard E. , Rymer W. Zev
Published: May 2021

The relationship of poststroke spasticity and motor recovery can be confusing. “True” motor recovery refers to return of motor behaviors to prestroke state with the same end-effectors and temporo-spatial pattern. This requires neural recovery and repair, and presumably occurs mainly in the acute and subacute stages. However, according to the International Classification of Functioning, Disability and Health, motor recovery after stroke is also defined as “improvement in performance of functional tasks,” i.e., functional recovery, which is mainly mediated by compensatory mechanisms. Therefore, stroke survivors can execute motor tasks in spite of disordered motor control and the presence of spasticity. Spasticity interferes with execution of normal motor behaviors (“true” motor recovery), throughout the evolution of stroke from acute to chronic stages. Spasticity reduction does not affect functional recovery in the acute and subacute stages; however, appropriate management of spasticity could lead to improvement of motor function, that is, functional recovery, during the chronic stage of stroke. We assert that spasticity results from upregulation of medial cortico-reticulo-spinal pathways that are disinhibited due to damage of the motor cortex or corticobulbar pathways. Spasticity emerges as a manifestation of maladaptive plasticity in the early stages of recovery and can persist into the chronic stage. It coexists and shares similar pathophysiological processes with related motor impairments, such as abnormal force control, muscle coactivation and motor synergies, and diffuse interlimb muscle activation. Accordingly, we propose a new definition of spasticity to better account for its pathophysiology and the complex nuances of different definitions of motor recovery.
A Guide to Conducting Online Focus Groups via Reddit
Authors: Richard Brendan , Sivo Stephen A. , Ford Robert C. , Murphy Jamie , Boote David N. , Witta Eleanor , Orlowski Marissa
Published: May 2021

Now more than ever there exists a need to conduct data collection online in a safe environment while ensuring that methodological rigor is not sacrificed. Widely available online platforms allow for text-based focus groups to be conducted quickly, easily, and efficiently, but protocols must be maintained to ensure they do not descend into casual observation of naturally occurring conversations. Various online platform options and their merits are discussed. Reddit is provided as a case study to illustrate the steps through which researchers can conduct an asynchronous online focus group. Key opportunities such as a similar quality of results, a lower cost, easier recruitment, and the ability to accommodate more sensitive topics are discussed, as well as challenges including a stigma against online focus groups, when they are most appropriate, and the potential for deviant behavior.
Resveratrol Oligosaccharides (Gluco-Oligosaccharides) Effectively Inhibit SARS-CoV-2 Infection: Glycoside (Polysaccharide) Approach for Treatment of COVID-19
Authors: Hamada Hiroki , Hamada Hatsuyuki , Shimoda Kei , Kuboki Atsuhito , Iwaki Takafumi , Kiriake Yuya , Ishihara Kohji
Published: May 2021

To examine the anti-SARS-CoV-2 effects of resveratrol oligosaccharides, human MRC5 lung cells, which had been infected with SARS-CoV-2, were incubated with different concentrations of resveratrol oligosaccharides. These suppressed the cell death induced by SARS-CoV-2 infection, more efficiently, at 0.1% concentration, than resveratrol itself. Resveratrol oligosaccharides effectively inhibited SARS-CoV-2 infection in the 5% to 10% concentration range, which indicates that these compounds could be useful anti-SARS-CoV-2 agents.
The sounds of silence: Democracy and the referendum on (FYRO)/(North) Macedonia
Authors: Veliu Liridona
Published: May 2021

Prevailing studies on silence and democracy, in spite of silence’s inherently ambiguous nature, focus on subscribing meaning(s) to silence. Such attempts of turning silence into speech, point to an adversary relationship between silence and democratic theory. First, this article conducts an onto-epistemological critique of democratic theory’s treatment of silence (as meaning). Second, it suggests that there are self-reflective analytical benefits for scholars of democratic theory should they broaden up their gaze from silence as meaning toward silence-as-doing. This article argues that this can be done by shifting the epistemological focus from interpreting possible meanings behind the nonvoters’ silence into analyzing the context and/of interpretations of silence as ambiguous. Third, to illustrate this, the article uses the 2018 name referendum in North Macedonia which shows how the speech-centered approach of democratic theory is utilized to serve political goals rather than reaching the democratic ideal of “everyone having a vo-ice/te.”
New data on nordite-(Ce) and the establishment of the nordite supergroup
Authors: Dal Bo Fabrice , Gulbransen Emil Holtung , Friis Henrik
Published: May 2021

A nomenclature scheme has been set up for the nordite supergroup of minerals, which have the general formula A2BXYZT6O17 and where A = Na; B = Na, Ca; X = Sr, Ca, Ba; Y = REE, Sr; Z = Zn, Fe, Mn, Mg and T = Si. The nordite supergroup includes nordite-(La), nordite-(Ce), ferronordite-(La), ferronordite-(Ce) and manganonordite-(Ce), as well as meieranite which is considered as an unassigned member of the nordite supergroup. In the known nordite-group minerals the Y site is occupied by rare earth elements (REE), while in meieranite the Y site is occupied by Sr. The dominant element on the tetrahedral Z site determines the prefix used in the mineral name. New rootnames must be given to species with a different dominant element on the A, B or X sites. Nordite supergroup minerals are orthorhombic, although nordite-group minerals and meieranite crystallise in the Pcca and P21nb space groups, respectively. The proposed nomenclature scheme for the nordite supergroup has been approved by the Commission on New Minerals, Nomenclature and Classification (CNMNC) of the International Mineralogical Association (IMA). In addition, new chemical and structural investigations were performed on nordite-(Ce) from Illutalik (Igdlutalik), South Greenland, leading to the first crystal structure refinement for nordite-(Ce).
Integrative genomics of the mammalian alveolar macrophage response to intracellular mycobacteria
Authors: Hall Thomas J. , Mullen Michael P. , McHugo Gillian P. , Killick Kate E. , Ring Siobhán C. , Berry Donagh P. , Correia Carolina N. , Browne John A. , Gordon Stephen V. , MacHugh David E.
Published: May 2021

Background

Bovine TB (bTB), caused by infection with Mycobacterium bovis, is a major endemic disease affecting global cattle production. The key innate immune cell that first encounters the pathogen is the alveolar macrophage, previously shown to be substantially reprogrammed during intracellular infection by the pathogen. Here we use differential expression, and correlation- and interaction-based network approaches to analyse the host response to infection with M. bovis at the transcriptome level to identify core infection response pathways and gene modules. These outputs were then integrated with genome-wide association study (GWAS) data sets to enhance detection of genomic variants for susceptibility/resistance to M. bovis infection.

Results

The host gene expression data consisted of RNA-seq data from bovine alveolar macrophages (bAM) infected with M. bovis at 24 and 48 h post-infection (hpi) compared to non-infected control bAM. These RNA-seq data were analysed using three distinct computational pipelines to produce six separate gene sets: 1) DE genes filtered using stringent fold-change and P-value thresholds (DEG-24: 378 genes, DEG-48: 390 genes); 2) genes obtained from expression correlation networks (CON-24: 460 genes, CON-48: 416 genes); and 3) genes obtained from differential expression networks (DEN-24: 339 genes, DEN-48: 495 genes). These six gene sets were integrated with three bTB breed GWAS data sets by employing a new genomics data integration tool—gwinteR. Using GWAS summary statistics, this methodology enabled detection of 36, 102 and 921 prioritised SNPs for Charolais, Limousin and Holstein-Friesian, respectively.

Conclusions

The results from the three parallel analyses showed that the three computational approaches could identify genes significantly enriched for SNPs associated with susceptibility/resistance to M. bovis infection. Results indicate distinct and significant overlap in SNP discovery, demonstrating that network-based integration of biologically relevant transcriptomics data can leverage substantial additional information from GWAS data sets. These analyses also demonstrated significant differences among breeds, with the Holstein-Friesian breed GWAS proving most useful for prioritising SNPS through data integration. Because the functional genomics data were generated using bAM from this population, this suggests that the genomic architecture of bTB resilience traits may be more breed-specific than previously assumed.
Circular RNA circFADS2 is overexpressed in sepsis and suppresses LPS-induced lung cell apoptosis by inhibiting the maturation of miR-15a-5p
Authors: Hong Xiaoyang , Li Shuanglei , Wang Jie , Zhao Zhe , Feng Zhichun
Published: May 2021

Background

Circular RNA circFADS2 plays protective roles in LPS-induced inflammation, which promotes sepsis, suggesting its involvement in sepsis.

Methods

Expression of circFADS2, mature miR-15a-5p, and miR-15a-5p precursor in plasma samples from sepsis patients and healthy controls was determined by RT-qPCR. The circFADS2 expression vector was transfected in lung cells, followed by the measurement of the expression levels of mature miR-15a-5p and miR-15a-5p precursor to study the role of circFADS2 in miR-15a-5p maturation. Cell apoptosis was analyzed by cell apoptosis assay.

Results

CircFADS2 was upregulated in sepsis and inversely correlated with mature miR-15a-5p, but not miR-15a-5p precursor. In lung cells, circFADS2 overexpression decreased the level of mature miR-15a-5p, but not miR-15a-5p precursor. LPS treatment decreased miR-15a-5p expression and increased circFADS2 level. Cell apoptosis analysis showed that circFADS2 overexpression reduced miR-15a-5p overexpression-induced apoptosis of LPS-treated lung cells.

Conclusions

CircFADS2 is upregulated in sepsis to suppress LPS-induced lung cell apoptosis by inhibiting miR-15a-5p maturation.
Impairments in brain perfusion, executive control network, topological characteristics, and neurocognition in adult patients with asymptomatic Moyamoya disease
Authors: He Shihao , Liu Ziqi , Wei Yanchang , Duan Ran , Xu Zongsheng , Zhang Cai , Yuan Li , Li Tian , Ma Ning , Lou Xin , Liu Xiaoyuan , Wang Rong
Published: May 2021

Background

Asymptomatic Moyamoya disease (MMD) impairs hemodynamic and cognitive function. The relationship between these changes, cerebral blood flow (CBF), and network connectivity remains largely unknown. The aim of this study was to increase understanding of the relationship between CBF, functional networks, and neurocognition in adults with asymptomatic MMD. We compared CBF and functional status in 26 patients with MMD and 20 healthy controls using arterial spin labeling and resting state functional magnetic resonance imaging sequences. At the same time, a detailed cognitive test was performed in 15 patients with no cerebral or lumen infarction who were selected by magnetic resonance imaging-T2 FLAIR screening.

Results

Compared to the controls, the patients showed varying degrees of decline in their computational ability (simple subtraction, p = 0.009; complex subtraction, p = 0.006) and short-term memory (p = 0.042). The asymptomatic MMD group also showed decreased CBF in the left anterior central and left inferior frontal gyri of the island flap with multiple node abnormalities in the brain network and reduced network connectivity. There was a significant association of these changes with cognitive decline in the MMD group.

Conclusions

In patients with asymptomatic MMD, disturbance of CBF and impaired brain network connections may be important causes of cognitive decline and appear before clinical symptoms.

Clinical trial registration-URL: http://www.chictr.org.cn

Unique identifier: ChiCTR1900023610
Rupture of an epidural filter connector during bolus administration of local anesthetic: a case report
Authors: Nahrwold Daniel A. , Muncey Aaron R. , Aldawoodi Nasrin N. , Evans Raymond M. , Hoffman Jamie P.
Published: May 2021

Background

Epidural catheters are routinely placed for many surgical procedures and to treat various pain conditions. Known complications arising from epidural catheter equipment malfunction include epidural pump failure, epidural catheter shearing, epidural catheter connector failure, epidural filter connector cracking, and loss-of-resistance syringe malfunction. Practitioners need to be aware of these potentially dangerous complications and take measures to mitigate the chances of causing significant patient harm. We report on the complete breakage of an epidural filter connector during epidural bolus administration of local anesthetic by hand with a syringe.

Case presentation

A B. Braun Perifix® epidural catheter was placed in a 73-year-old male scheduled for radical prostatectomy. During the operation, a continuous infusion of local anesthetic was administered through the epidural catheter in addition to general endotracheal anesthesia. At the conclusion of surgery and after extubation, the patient endorsed incisional pain. The epidural filter connector broke in half as a bolus of local anesthetic was administered by hand with a syringe. The local anesthetic sprayed widely throughout the room as the fragmented epidural filter connector became a projectile object that recoiled and struck the patient.

Conclusions

This incident placed the patient and surrounding healthcare providers at substantial risk for injury and infection from the fractured epidural filter connector becoming a projectile object and from the local anesthetic spray. The most plausible cause of this event was from a large amount of pressure being applied to the filter connector. This may have occurred by excessive force being applied by hand to the syringe, by the presence of a clogged filter, or by the catheter being kinked or blocked proximal to the filter. Being aware of this deleterious complication and potentially modifying existing epidural bolus techniques, such as using smaller syringes with less applied force and checking all epidural components vigilantly prior to and during bolus administration, can help anesthesia providers deliver the safest possible care to patients with epidural catheters.
PRimary care rEsponse to domestic violence and abuse in the COvid-19 panDEmic (PRECODE): protocol of a rapid mixed-methods study in the UK
Authors: Szilassy Eszter , Barbosa Estela Capelas , Dixon Sharon , Feder Gene , Griffiths Chris , Johnson Medina , De Simoni Anna , Wileman Vari , Panovska-Griffiths Jasmina , Dowrick Anna
Published: May 2021

Background

The implementation of lockdowns in the UK during the COVID-19 pandemic resulted in a system switch to remote primary care consulting at the same time as the incidence of domestic violence and abuse (DVA) increased. Lockdown-specific barriers to disclosure of DVA reduced the opportunity for DVA detection and referral.

The PRECODE (PRimary care rEsponse to domestic violence and abuse in the COvid-19 panDEmic) study will comprise quantitative analysis of the impact of the pandemic on referrals from IRIS (Identification and Referral to Improve Safety) trained general practices to DVA agencies in the UK and qualitative analysis of the experiences of clinicians responding to patients affected by DVA and adaptations they have made transitioning to remote DVA training and patient support.

Methods/Design

Using a rapid mixed method design, PRECODE will explore and explain the dynamics of DVA referrals and support before and during the pandemic on a national scale using qualitative data and over four years of referrals time series data.

We will undertake interrupted-time series and non-linear regression analysis, including sensitivity analyses, on time series of referrals to DVA services from routinely collected data to evaluate the impact of the pandemic and associated lockdowns on referrals to the IRIS Programme, and analyse key determinants associated with changes in referrals.

We will also conduct an interview- and observation-based qualitative study to understand the variation, relevance and feasibility of primary care responses to DVA before and during the pandemic and its aftermath.

The triangulation of quantitative and qualitative findings using rapid analysis and synthesis will enable the articulation of multiscale trends in primary care responses to DVA and complex mechanisms by which these responses have changed during the pandemic.

Discussion

Our findings will inform the implementation of remote primary care and DVA service responses as services re-configure. Understanding the adaptation of clinical and service responses to DVA during the pandemic is crucial for the development of evidence-based, effective remote support and referral beyond the pandemic.

Trial registration

PRECODE is an observational epidemiologic study, not an intervention evaluation or trial. We will not be reporting results of an intervention on human participants.
Meta-analysis of the effects of smooth endoplasmic reticulum aggregation on birth outcome
Authors: Zhang Hongqin , Hu Wenhui , Zhong Ying , Guo Zhenhua
Published: May 2021

Background

Smooth endoplasmic reticulum aggregation (SERa, SER+) has been reported to increase the risk of birth malformations and other abnormal outcomes, miscarriage, and perinatal complications. Other studies, however, suggest that SER+ embryos may develop into healthy infants. One report indicates that 25% of in vitro fertilization (IVF) centers discard SER+ oocytes. Thus, we investigated the effect of SER+ on birth outcomes in IVF and intracytoplasmic sperm injection.

Methods

We performed a literature search using PubMed, ScienceDirect, Cochrane, Embase, Ovid, and Scopus. We found a total of 1500 relevant studies between 1978 and 2020 and conducted a meta-analysis to study the effects of SER+ on live births, birth weight, and the number of metaphase II (MII) oocytes retrieved per cycle.

Results

Eleven eligible studies were included. If the SER+ zygote was evaluated again at the embryo transfer (ET) stage, SER+ did not affect birth or infant body weight. Stimulated ovaries producing too many oocytes per cycle were positively correlated with SER+ (OR = 1.28, 95% CI = 0.41–2.15; p = 0.004). SER+ was positively correlated with oocyte maturation rate, and observed heterogeneity in a previous meta-analysis was likely due to maternal age. Our data also showed that SER+ cycles produced more oocytes but achieved the same number of births from ET.

Conclusions

The use of SER+ MII oocytes is rare, with the collection of many oocytes in 1 cycle potentially inducing SER+. SER+ may be more common than we originally thought, as some SER+ is found in all oocytes. Although SER+ positively affected oocyte maturation rate, it did not affect births. We hypothesized that this is because the best embryos are chosen at every step of the process, and the oocytes with the poorest characteristics are removed. We therefore suggest a standard method for measuring SER+. Although embryos produced from SER+ cycles can be used, they should only be transferred when no other suitable embryos are available over several cycles.
The role of undergraduate medical students training in respect for patient confidentiality
Authors: Beltran-Aroca Cristina M , Ruiz-Montero Rafael , Labella Fernando , Girela-López Eloy
Published: May 2021

Background

Encouraging professional integrity is vital for providing a standard of excellence in quality medical care and education and in promoting a culture of respect and responsibility. The primary objective of this work consisted of studying the relationship of medical students to the right to patient privacy in Spain, specifically by analysing the conditions for accessing patient clinical histories (CHs).

Methods

A cross-sectional study was conducted based on a questionnaire sent by e-mail to final-year students at 41 Spanish universities. It had 14 multiple choice and closed questions framed in 3 large blocks. The first question addressed basic general knowledge issues on the right to privacy and the obligation for confidentiality. The two remaining blocks were made up of questions directed towards evaluating the frequency with which certain requirements and action steps related to students attending patients were performed and regarding the guarantees associated with accessing and handling patient CHs both on paper and in the Electronic Medical Record.

Results

A total of 245 valid replies were considered. A total of 67.8 % of participants were women, with an average age of 24.05 ± 3.49 years. Up to 90.6 % were aware that confidentiality affected the data in CHs, although 43.3 % possessed non-anonymized photocopies of patient clinical reports outside the healthcare context, and only 49.8 % of the students were always adequately identified. A total of 59.2 % accessed patient CHs on some occasions by using passwords belonging to healthcare professionals, 77.2 % of them did not have the patients’ express consent, and 71.9 % accessed a CH that was not anonymised.

Conclusions

The role of healthcare institutions and universities is considered to be fundamental in implementing educational measures regarding the risks and ethical and legal problems arising from the use of CHs among professionals and students. A thorough study of medical ethics is needed through the analysis of clinical cases and direct exposure to situations in which the patient’s confidentiality is questioned.
Head to head randomized trial of two decision aids for prostate cancer
Authors: Fagerlin Angela , Holmes-Rovner Margaret , Hofer Timothy P. , Rovner David , Alexander Stewart C. , Knight Sara J. , Ling Bruce S. , A.Tulsky James , Wei John T. , Hafez Khaled , Kahn Valerie C. , Connochie Daniel , Gingrich Jeffery , Ubel Peter A.
Published: May 2021

Background

While many studies have tested the impact of a decision aid (DA) compared to not receiving any DA, far fewer have tested how different types of DAs affect key outcomes such as treatment choice, patient–provider communication, or decision process/satisfaction. This study tested the impact of a complex medical oriented DA compared to a more simplistic decision aid designed to encourage shared decision making in men with clinically localized prostate cancer.

Methods

1028 men at 4 VA hospitals were recruited after a scheduled prostate biopsy. Participants completed baseline measures and were randomized to receive either a simple or complex DA. Participants were men with clinically localized cancer (N = 285) by biopsy and who completed a baseline survey. Survey measures: baseline (biopsy); immediately prior to seeing the physician for biopsy results (pre- encounter); one week following the physician visit (post-encounter). Outcome measures included treatment preference and treatment received, knowledge, preference for shared decision making, decision making process, and patients’ use and satisfaction with the DA.

Results

Participants who received the simple DA had greater interest in shared decision making after reading the DA (p = 0.03), found the DA more helpful (p’s < 0.01) and were more likely to be considering watchful waiting (p = 0.03) compared to those receiving the complex DA at Time 2. While these differences were present before patients saw their urologists, there was no difference between groups in the treatment patients received.

Conclusions

The simple DA led to increased desire for shared decision making and for less aggressive treatment. However, these differences disappeared following the physician visit, which appeared to change patients’ treatment preferences.

Trial registration This trial was pre-registered prior to recruitment of participants.
Lasofoxifene as a potential treatment for therapy-resistant ER-positive metastatic breast cancer
Authors: Lainé Muriel , Fanning Sean W. , Chang Ya-Fang , Green Bradley , Greene Marianne E. , Komm Barry , Kurleto Justyna D. , Phung Linda , Greene Geoffrey L.
Published: May 2021

Background

Endocrine therapy remains the mainstay of treatment for estrogen receptor-positive (ER+) breast cancer. Constitutively active mutations in the ligand binding domain of ERα render tumors resistant to endocrine agents. Breast cancers with the two most common ERα mutations, Y537S and D538G, have low sensitivity to fulvestrant inhibition, a typical second-line endocrine therapy. Lasofoxifene is a selective estrogen receptor modulator with benefits on bone health and breast cancer prevention potential. This study investigated the anti-tumor activity of lasofoxifene in breast cancer xenografts expressing Y537S and D538G ERα mutants. The combination of lasofoxifene with palbociclib, a CDK4/6 inhibitor, was also evaluated.

Methods

Luciferase-GFP tagged MCF7 cells bearing wild-type, Y537S, or D538G ERα were injected into the mammary ducts of NSG mice (MIND model), which were subsequently treated with lasofoxifene or fulvestrant as single agents or in combination with palbociclib. Tumor growth and metastasis were monitored with in vivo and ex vivo luminescence imaging, terminal tumor weight measurements, and histological analysis.

Results

As a monotherapy, lasofoxifene was more effective than fulvestrant at inhibiting primary tumor growth and reducing metastases. Adding palbociclib improved the effectiveness of both lasofoxifene and fulvestrant for tumor suppression and metastasis prevention at four distal sites (lung, liver, bone, and brain), with the combination of lasofoxifene/palbociclib being generally more potent than that of fulvestrant/palbociclib. X-ray crystallography of the ERα ligand binding domain (LBD) shows that lasofoxifene stabilizes an antagonist conformation of both wild-type and Y537S LBD. The ability of lasofoxifene to promote an antagonist conformation of Y537S, combined with its long half-life and bioavailability, likely contributes to the observed potent inhibition of primary tumor growth and metastasis of MCF7 Y537S cells.

Conclusions

We report for the first time the anti-tumor activity of lasofoxifene in mouse models of endocrine therapy-resistant breast cancer. The results demonstrate the potential of using lasofoxifene as an effective therapy for women with advanced or metastatic ER+ breast cancers expressing the most common constitutively active ERα mutations.