bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring Mechanisms by Which Danggui Buxue Decoction Regulates Inflammation and Improves Renal Anemia Based on Network Pharmacology
Authors: Tu Can , Huang Guirui , Li Chuang , Cheng Li , Min Yonglong , Li Hongbo , Mao Dongdong , Xiong Fei
Published: May 2022

Background: Renal anemia occurs frequently in patients with chronic kidney disease (CKD) and is related to chronic inflammation. Danggui Buxue Decoction (DBD) can treat anemia and improve the chronic inflammation. However, whether DBD treatment attenuates anemia by regulating inflammation in CKD patients with renal anemia is unknown. Therefore, this study explored inflammation-related network targets of DBD in renal anemia therapy and verified the interaction between DBD active ingredients and inflammatory proteins by molecular docking. Methods: The main effective components and targets of DBD were screened using the Traditional Chinese Medicine System Pharmacology Database and Analysis Platform. Renal anemia-related biomolecules were searched in the GeneCards, OMIM, TTD, Pharmgkb, and DrugBank databases. Protein-protein interaction (PPI) data were downloaded from the STRING database and core targets were obtained. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses for core targets were performed. Finally, active ingredients and core biomolecules were determined using molecular docking. Results: Twenty-two active components and 158 targets for DBD treatment of renal anemia were screened, and an “ingredient-target” network was constructed. Twenty core target genes were screened from the PPI data. Vascular endothelial growth factor A, Signal Transducer and Activator of transcription 1, C-X-C motif chemokine ligand 8, post-transcriptional gene silencing 2, and interleukin (IL)-1β were identified as inflammatory proteins. GO items related to inflammation and DBD included lipopolysaccharide, cellular response to chemical stress, and oxidative stress-related reactions. KEGG enrichment analyses showed that core inflammatory pathways mainly involved the IL-17 signaling pathway, tumor necrosis factor signaling pathway, and phosphoinositide 3-kinase-protein kinase B signaling pathway. Molecular docking results indicated that the binding energy of quercetin, an active ingredient of DBD, to the 5 core proteins was less than −6 kcal·mol−1. Conclusion: DBD might have protective effects against renal anemia by improving inflammation. Quercetin might modulate multiple inflammatory proteins and pathways.
Antidepressant-Like Effect of Essential Oils From Citrus reticulata in Reserpine-Induced Depressive Mouse
Authors: Tang Minghui , Ai Yong , Zhu Siyang , Song Ni , Xu Xian , Liang Leyi , Rong Baoshan , Zheng Xiaomin , Zhang Lanyue , He Tinggang
Published: May 2022

Citrus reticulata Blanco has been widely used to cure some diseases such as cold, cough and indigestion. This study is aimed at determining the antidepressant-like effect of C. reticulata essential oils (CREOs) in reserpine-induced depression mice, as well as its possible mechanisms. The compositions of CREOs are firstly analyzed by gas chromatography-mass spectrometry (GC-MS), in which d-limonene is the main component. Moreover, the results from the forced swimming and tail suspension tests show that the inhalation of CREOs can significantly improve the depressive behavior of reserpine-induced depressed mice by reducing the weight of the mice and shortening the immobile time. After sniffing CREOs, the number of normal neurons in the hippocampus of reserpine-induced depressed mice is greatly increased. In addition, CREOs significantly increase the expression level of 5-hydroxytryptamine-1A receptors (5HT-1A), glucocorticoid receptors (GR) and brain-derived neurotrophic factor (BDNF) in the reserpine-treated mice brain tissue. Thus, these results have indicated that CREOs can be potential materials for drug and food development against depression.
One-on-one meetings between managers and direct reports: A new opportunity for meeting science
Authors: Flinchum Jonathan R. , Kreamer Liana M. , Rogelberg Steven G. , Gooty Janaki
Published: May 2022

Meeting science has advanced significantly in its short history. However, one-on-one (1:1) meetings have not been studied empirically as a focal topic despite making up nearly half of all workplace meetings. While some meeting science insights may apply to 1:1 meetings, others may not (or may function differently) due to conceptual, theoretical, and practical differences between meetings involving dyads and groups. Although 1:1 meetings come in various forms (e.g., peer-to-peer, employee-to-customer), we chose to use manager-direct report 1:1 meetings as an exemplar given their prevalence, theoretical relevance, and practical implications. In this paper, we first review some conceptual differences between dyads and groups. We then discuss how these differences likely manifest in the meeting context (before, during, and after meetings), and outline related propositions. Last, we leverage this conceptual framework and subsequent propositions to provide guidance for future research and theory on 1:1 meetings. In doing so, we hope this paper will act as the impetus for research and theory development on 1:1 meetings.
Evaluation of critical damage location of contact blast on conventionally reinforced one-way square concrete slab applying CEL-FEM blast modeling technique
Authors: Anas S.M. , Shariq Mohd , Alam Mehtab , Umair Mohammad
Published: May 2022

Nowadays, accidental explosions in residential and factory buildings are common owing to poor maintenance and mishandling of fuel gas and chemical explosive appliances leading to grievous injuries and infrastructure damages. Contact blast on slabs using explosives is noticed as a simpler act of subversion as compared to other components of the building and is more damaging than a close-in blast. In general, damage caused by contact blast is localized in the form of concrete cratering, scabbing, and rupture of the reinforcement. A recently published state-of-the-art review on the performance of reinforced concrete (RC) slabs under contact and close-in explosion loading scenario by the authors (Anas et al., 2021b) reveals the common perception for the location of contact blast to cause maximum damage is the centroid of the slab. It develops a curiosity with sufficient interest to investigate the effect of the location of contact explosive charge on the damage response of the slab. Several numerical techniques such as empirical, ConWEP (semi-empirical), Smooth Particle Hydrodynamics (mesh-free method), and Coupled-Eulerian-Lagrangian (CEL) are in use for simulation of blast loading on structures. Current literature reveals that the CEL is the most advanced and realistic blast modeling technique. This study applies Coupled-Eulerian–Lagrangian (CEL) formulation with finite element method (FEM) using the dynamic computer code ABAQUS/Explicit-v.6.15 to investigate the performance of singly reinforced one-way spanning concrete slab subjected to concentric contact blast loading. The numerical model is validated with the experiment results in the open literature. The validated model is then employed to investigate whether or not the maximum damage is really caused by the central location of the contact blast. For this purpose, one-quarter of the slab with nine symmetrical points (or locations) of contact blast of explosive charge, which reflect the coverage of the entire slab, in contact with the top face of the slab is considered in the study. Two constitutive material models, Concrete Damage Plasticity and Johnson–Cook, with strain rate effects are used to simulate the non-linear behavior of the concrete and steel, respectively. The results reveal that the most critical location of maximum damage to the slab is along the line of symmetry parallel to the supports at an eccentricity of B/4 from the centroid of the slab, where “B” is the width of the one-way slab.
Manual development for a multi-modal, dyadic intervention for persistent pain: A Qualitative Study
Authors: Fox Aimee L , Swink Laura A , Prabhu Neha , Fruhauf Christine A , Portz Jennifer D , Van Puymbroeck Marieke , Sharp Julia L , Leach Heather J , Schmid Arlene A
Published: May 2022

Background:

People who experience persistent pain often require help from a family member, partner, or friend. These caregivers frequently have pain but are often not included in interventions. Caregivers and care receivers who both experience pain are more likely to be socially isolated, and experience communication conflict and decreased quality of life. Interventions should target caregiving dyads to help them manage their pain together. However, there are few intervention manuals or research protocols developed to support the dyad.

Objective:

The purpose of this qualitative study was to explore the needs of caregiving dyads, including input from dyads and medical and allied health experts to inform the development of an intervention manual for dyads with persistent pain.

Method:

A total of 16 caregiving dyads experiencing persistent pain, one care receiver (caregiver could not participate), and 8 health experts, recruited from the community, participated in focus groups. Data were transcribed verbatim, uploaded into NVivo software, and analyzed using constant comparison qualitative methods.

Results:

Findings identified the importance of a new intervention to focus on modifiable approaches to managing pain as a dyad, addressing the emotional and psychological effects of experiencing pain as a dyad, and careful consideration of logistics to implement an intervention with dyads in persistent pain.

Conclusion:

These results highlight important considerations to meet the needs of caregiving dyads with pain. This study informed the development of the MY-Skills intervention, a novel program that merges self-management education with adaptive yoga to treat persistent pain in caregiving dyads.
Adult Wilms tumour: A case report
Authors: Mounnarath Eric Taing , Zwieky Walid , Aedo-Lopez Veronica , Fazli Obaidullah , Sheridan Berenice Jean
Published: May 2022

The Wilms tumour is the fourth most common paediatric malignancy. On the contrary, it is extremely rare in adults as it accounts for less than 1% of all renal malignancies. This scarcity of cases placed a significant challenge in generating evidence-based treatment. Hence, treatment of adult Wilms considerably varies between centres. Standardised guidelines based on international expert consensus for adults have been introduced to help steer management. However, reporting patient outcomes remains limited. In this article, a case study will be presented. This includes modalities of treatment, side effects, tolerability, and outcome. A 40-year-old gentleman with histology consistent with the Wilms tumour received adjuvant chemotherapy according to the UMBRELLA SIOP2016 adult guidelines. Such guidelines were originally adapted from the International Society of Paediatric Oncology protocol. The patient underwent eight cycles of vincristine, actinomycin-D, and doxorubicin and concurrent radiation therapy. Use of the UMBRELLA SIOP2016 adult guideline was shown effective at treating the Wilms tumour in this adult case with minimal severe toxicity. Ongoing follow-up is still needed to determine the long-term effects and prognosis of the patient.
Fecal microbiota transplantation is safe and tolerable in patients with multiple sclerosis: A pilot randomized controlled trial
Authors: Al Kait F. , Craven Laura J , Gibbons Shaeley , Parvathy Seema Nair , Wing Ana Christina , Graf Chantelle , Parham Kate A , Kerfoot Steven M , Wilcox Hannah , Burton Jeremy P , Kremenchutzky Marcelo , Morrow Sarah A , Casserly Courtney , Meddings Jon , Sharma Manas , Silverman Michael S.
Published: May 2022

Background

Patients with MS have an altered gut microbiota compared to healthy individuals, as well as elevated small intestinal permeability, which may be contributing to the development and progression of the disease.

Objective

We sought to investigate if fecal microbiota transplantation was safe and tolerable in MS patients and if it could improve abnormal intestinal permeability.

Methods

Nine patients with MS were recruited and provided monthly FMTs for up to six months. The primary outcome investigated was change in peripheral blood cytokine concentrations. The secondary outcomes were gut microbiota composition, intestinal permeability, and safety (assessed with EDSS and MRI).

Results

The study was terminated early and was subsequently underpowered to assess whether peripheral blood cytokines were altered following FMTs. FMTs were safe in this group of patients. Two of five patients had elevated small intestinal permeability at baseline that improved to normal values following FMTs. Significant, donor-specific, beneficial alterations to the MS patient gut microbiota were observed following FMT.

Conclusion

FMT was safe and tolerable in this cohort of RRMS patients, may improve elevated small intestinal permeability, and has the potential to enrich for an MS-protective microbiota. Further studies with longer follow-up and larger sample sizes are required to determine if FMT is a suitable therapy for MS.
A prospective study to validate the expanded timed get-up-and-go in a population with multiple sclerosis
Authors: Jakimovski Dejan , Kavak Katelyn S , Zakalik Karen , Bromley Lacey , Ozel Osman , Qutab Natasha , Eckert Svetlana P , Kolb Channa , Weinstock-Guttman Bianca
Published: May 2022

Background

Timed 25-foot walk (T25FW) test serves as gold standard in care of persons with multiple sclerosis (PwMS) and as walking measure of regulatory trials.

Objective

To validate and determine the clinical utility of Expanded Timed Get-Up and Go (ETGUG) as a disability measure in MS.

Methods

ETGUG intra-rater and inter-rater reproducibility was determined in 65 PwMS that were examined twice in two centres over 1-week. Values below the 5th and above the 95th percentile were considered minimally detectable change. A longitudinal cohort (32.4 months) of 145 PwMS from New York State MS Consortium (NYSMSC) was used for clinical validation as a predictor of disability worsening measured by Expanded Disability Status Scale (EDSS).

Results

ETGUG and T25FW had noteworthy intra-rater and inter-rater reproducibility (Cronbach coefficient>0.949). One-week ETGUG difference ranged from 15.07% to −14.84% (5th and 95th percentile). Over the NYSMSC follow-up, PwMS had significant slowing in walking as measured by ETGUG (20.8 to 25.9s, p = 0.009) but not by T25FW. 15% ETGUG worsening had similar ability to predict EDSS worsening when compared to 20% T25FW worsening (AUC 0.596 vs. 0.552).

Conclusion

Over 32-month follow-up, PwMS experience slowing in ETGUG walking time but not in T25FW. Although the scoring may be more challenging, ETGUG could be more sensitive to change and provide more comprehensive measure of lower extremity performance and ambulation in PwMS.
Advanced practice nurses’ experiences of evidence-based practice: A qualitative study
Authors: Ylimäki Saija , Oikarinen Anne , Kääriäinen Maria , Holopainen Arja , Oikarainen Ashlee , Pölkki Tarja , Meriläinen Merja , Lukkarila Pirjo , Taam-Ukkonen Minna , Tuomikoski Anna-Maria
Published: May 2022

Evidence-based practice (EBP) has been shown to improve patient safety as well as quality of care. Advanced practice nurses (APNs) have a vital role in the implementation of EBP. This study aimed to describe APNs’ experiences of EBP implementation. The study was a descriptive qualitative study and data were collected between May and August 2019 through interviews with APNs ( n = 12). The data were analyzed using inductive content analysis. The study was reported according to COREQ guidelines. The responses were divided into four main categories: EBP in clinical nursing; EBP leadership; implementation of supporting structures for EBP; and EBP in APNs’ work. APNs experienced: that the realization of EBP varied in clinical nursing, that there was a need for development in the leadership of EBP, variation in nurse leaders’ competence in EBP leadership, and a lack of resources for EBP.
The invention of Chinese “media tradition”: Mediatization of festival tradition and family cultural reproduction in contemporary China
Authors: Xie Zhuoxiao
Published: May 2022

The popularity of Internet and mobile media in China has weaken the collective TV viewing culture in Chinese families. Behind the decline of television, the China Central Television’s Spring Festival Gala Show (Gala Show) is hard to maintain its glory and gradually being questioned and challenged. Why does TV viewing and Gala Show still matter in some families but not the others? This paper conceptualizes and analyzes how and why the Gala Show became a media tradition, in the Chinese family-nation cultural reproduction for more than three decades. Based on twofold interviewing data collected by 2015 and 2021, respectively, the study found that the invented media tradition-the Gala Show, stimulates the cultural changes and continuity of Chinese family cultural traditions from the golden age of television (from the 1980s to the late 2000s) onwards. In the long processes of its cultural transformation, the evolving media tradition blends past and present cultural materials in the social institution, thus (re)shaping the cultural practices and values of the participants. Moreover, the interviews revealed that ordinary people read the roles of Gala Show as a media tradition in Chinese families differently, because the social implications of the Gala Show shifted and reacted to the social and cultural transformation from the age of television onwards. Finally, regarding the dynamic social changes in media technologies, Spring Festival customs, and collective TV viewing cultures, the Gala Show reflects the divergent structure of feeling of different generations and families’ social and technological nostalgia about the technology and cultural formats of television in digital era. The established media tradition to some extent maintains the sense of cultural continuity and particularly anchors a safe zoom particular in nuclear families.
Management of Haemarthrosis in Patients On Oral Anticoagulants
Authors: Dalrymple James , Davies Andrew , Biggs Alexandra , Rajcoomar Shahil , Gill Ian
Published: May 2022

Aims

Our aim was to investigate the management of patients who were admitted to hospital with an acute haemarthrosis whilst taking oral anticoagulants, and highlight the outcomes of different management strategies.

Methods

A retrospective review was performed of all orthopaedic admissions over a 42-month period (January 2015-July 2018) to the Orthopaedic Department of a London District General Hospital. All patients admitted with a spontaneous joint haemarthrosis and concomitant use of oral anticoagulants was identified. Anonymised data was placed on a secure trust database.

Findings

A total of 31 patients were included. 22 patients (71%) had their anticoagulant temporarily held during admission. 9 patients (29%) had their anticoagulation reversed with 10 mg of vitamin K. In 5 patients the haemarthrosis was aspirated either on admission or during their hospital stay. The overall mean length of stay in patients with a haemarthrosis was 6.8 days (median 3 days). There was no significant difference in length of stay when patients' anticoagulation was held compared to when the anticoagulation was continued. No patients suffered a thrombotic event in the 60 days following discharge. No adverse events were recorded following joint aspiration.

Conclusion

Continuing patients' anticoagulants did not increase the length of hospital stay in this study, no thrombotic events were recorded. There is currently no consensus on the management of haemarthrosis in patients on oral anticoagulants. Further research may focus on assessing the effect of management adjuncts on patient outcomes to aid the development of clinical guidelines.
Impact of Team-Based Learning Versus Lecture-Based Learning on Chinese Radiology Education: A Scoping Review and Meta-Analysis
Authors: Bingjie Li , Chunyi Yan , Haoyan Liang , Qing Chen , xuelei Ma
Published: May 2022

This meta-analysis aimed to evaluate the effectiveness of team-based learning in radiology education. Data sources and selection criteria Databases were searched from inception up to August 2019 and included Pubmed, Medline, Embase, China National Knowledge Infrastructure (CNKI), Chinese Wanfang Database, and Chinese VIP. Randomized trials comparing teaching approaches for medical imaging of which provide the outcomes of theoretical scores and/or practical scores were included. Data were extracted independently by two authors and double-checked for accuracy. Outcomes included knowledge scores and practical scores. We pooled data using random-effects meta-analysis. Twelve trials involving 1,371 participants were included. Team-based learning teaching method had positive impacts on theoretical scores compared with the lecture-based learning or traditional teaching method (SMD = 1.07, 95% CI [0.50, 1.63]) and it positively improved skill scores (SMD = 0.68, 95% CI [0.19, 1.17]). Team-based learning could not only improve theoretical and skill scores in medical imaging courses but also encourage students to learn by themselves. Participants believed team-based learning raised their learning interest, team cooperation ability, and interpersonal communication skills. The heterogeneity of the included studies must be noticed and large well-designed and well-conducted trials are urgently needed.
A Comparative Case Study of Hospice and Hospital End-of-Life Care for Aging Adults With Developmental Disabilities
Authors: McGinley Jacqueline M. , Marsack-Topolewski Christina N.
Published: May 2022

Greater attention is being paid to issues surrounding end-of-life care for aging adults with developmental disabilities. The purpose of this qualitative study was to explore the end-of-life experiences of two aging adults with developmental disabilities and life-limiting serious illnesses who received care in settings in the United States. Using a comparative case study design, data from three sources (records, staff, surrogates) were collected sequentially and triangulated via within and cross-case analyses. Although the setting and design limit the generalizability of these findings, the feasibility of delivering high quality care to adults with developmental disabilities as they age and experience terminal illnesses is supported. Insights are presented regarding how nurses can address barriers by adapting policies and practices to accommodate the distinct needs that arise as people with developmental disabilities age, become seriously ill, and reach life’s end.
Prevalence and Social Risk Factors of Functional Limitations Among Slum-Dwelling Older Adults: Findings From the Nairobi Urban Health and Demographic Surveillance System
Authors: Gyasi Razak M. , Aboderin Isabella , Asiki Gershim
Published: May 2022

Objective: In this study, we investigate the patterns and the risk factors of functional limitations in a sample of 1323 slum-dwelling older adults in Kenya who participated in the Nairobi Urban Health and Demographic Surveillance Systems. Methods: We conducted crude and adjusted logistic regression analyses to evaluate the associations. Results: The prevalence of activities of daily living (ADL) and instrumental ADL (IADL) limitations were approximately 5% and 8%, respectively; some 4.5% reported both limitations. Estimates varied significantly between sexes and age ( p < .001). After adjustments, age, female, and Garre ethnic group were associated with ADL and IADL limitations. ADL decline was determined by co-residence (aOR = 0.93, 95% CI = 0.34–0.95), household size (aOR = 1.19, 95% CI = 1.04–1.37) and educational level (aOR = 0.45, 95% CI = 0.05–0.72). Conclusions: Older slum-dwellers in Nairobi experience functional impairments with marked age and sex differences. These findings may encourage salient policy planning and public health interventions to promote healthy aging in informal settlements.
The Impact of Global Health Experiences on the Emergency Medicine Residency Milestones
Authors: Hayward Alison Schroth , Lee Sean S. , Douglass Katherine , Jacquet Gabrielle A. , Hudspeth James , Walrath Jessica , Dreifuss Bradley A. , Baird Janette , Tupesis Janis P.
Published: May 2022

OBJECTIVES

Identify the impact of experiences in global health (GH) on the Accreditation Council for Graduate Medical Education (ACGME) competencies in emergency medicine (EM) residents and describe the individual characteristics of EM residents with global health experience compared to those without.

METHODS

From 2015 to 2018, 117 residents from 13 nationally accredited United States EM residency training programs were surveyed. Specifically, the survey gathered demographic data and information regarding timing, type, location and duration of short term experiences in global health (STEGH). The survey collected both qualitative and quantitative data regarding resident experiences, including number of procedures performed and self-assessment of the impact on their residency milestones. ACGME milestone data from survey respondents was collected from each resident's training program coordinators. Chi-squared analysis and t-tests were conducted to assess differences between residents with STEGH and those without. A generalized linear model (GLM) was utilized to assess the effects of time and experience with interaction on achieving milestones in each of the competency domains, to compare milestone achievement over time between residents with STEGH and those without.

RESULTS

Out of 117 EM residents, 60 were female (44%), the mean age was 30 years (standard deviation = 3.1), and 84 (71.8%) reported STEGH in general, including prior to residency (64.5%). 33 (28.2%) reported having completed STEGH during residency. The results of the GLM analysis showed that residents with STEGH during residency had significantly higher scores compared to those without the experience or STEGH pre-residency across all six competencies

CONCLUSIONS

STEGH in EM residents was associated with higher milestone achievement in certain ACGME competency domains including medical knowledge, practice-based learning and improvement, and professionalism. Participation in STEGH during residency appeared to show the strongest effect, with higher scores across all six competencies.
Does Social Legitimacy Matter in an Indian’s Decision to Start a New Venture?
Authors: Khan Adil , Arafat Mohd Yasir , Saleem Imran
Published: May 2022

This study aims to explain the determinants of entrepreneurship among Indian individuals. The researchers have examined the role of social (legitimacy) and personal (personality, competency and financial resources) factors related to an individual’s new venture creation in India. This study utilises the data set of 3,403 Indian respondents from the latest available individual-level data collected by the Global Entrepreneurship Monitor. Binary logistic regression has been employed to test the study’s proposed hypotheses. The results indicate that constructs related to financial resources, entrepreneurial personality and entrepreneurial competencies significantly predict the individual’s decision to start a new venture. However, in contrast to many previous studies, factors related to social legitimacy (social status and professional attraction) were not significant in determining the start-up decision. Policy implications have been discussed.
Vascular risk factors and staging of atherosclerosis in patients and controls: The Norwegian Stroke in the Young Study
Authors: Nawaz Beenish , Fromm Annette , Øygarden Halvor , Eide Geir Egil , Saeed Sahrai , Meijer Rudy , Bots Michiel L , Sand Kristin Modalsli , Thomassen Lars , Næss Halvor , Waje-Andreassen Ulrike
Published: May 2022

Objectives:

We studied the prevalence of vascular risk factors (RFs) among 385 ischaemic stroke patients ⩽60 years and 260 controls, and their association with atherosclerosis in seven vascular areas.

Methods:

History of cardiovascular events (CVE), hypertension, diabetes mellitus (DM), dyslipidaemia, pack-years of smoking (PYS), alcohol, and physical inactivity were noted. Blood pressure, body mass index (BMI), waist-hip ratio (WHR), lipid profile, epicardial adipose tissue (EAT), visceral abdominal adipose tissue (VAT), and subcutaneous abdominal adipose tissue were measured. Numeric staging of atherosclerosis was done by standardized examination of seven vascular areas by right and left carotid and femoral intima-media thickness, electrocardiogram, abdominal aorta plaques, and the ankle-arm index. All results were age and sex-adjusted. Poisson regression analysis was applied.

Results:

At age ⩽49 years at least one RF was present in 95.6% patients versus 90.0% controls. Compared to controls, male patients and middle-aged female patients showed no significant differences. Young female patients compared to young female controls had a higher burden of RFs (94.3% vs 88.6%, p = 0.049). Poisson regression analysis combined for patients and controls, adjusted for age and sex, showed numeric staging of atherosclerosis associated with age, prior CVE, hypertension, DM, dyslipidaemia, PYS, alcohol, BMI, WHR, EAT, VAT, and an increased number of risk factors. Adjusted for all risk factors, numeric staging of atherosclerosis was associated with increasing age, hypertension, DM, PYS, and BMI.

Conclusion:

Vascular risk factors are highly prevalent in young- and middle-aged patients and controls, and are predictors of established atherosclerosis at study inclusion. Focus on main modifiable vascular RFs in primary prevention, and early and aggressive secondary treatment of patients are necessary to reduce further progression of atherosclerosis.
Once versus twice daily direct oral anticoagulants in patients with recent stroke and atrial fibrillation
Authors: Polymeris Alexandros A , Zietz Annaelle , Schaub Fabian , Meya Louisa , Traenka Christopher , Thilemann Sebastian , Wagner Benjamin , Hert Lisa , Altersberger Valerian L , Seiffge David J , Lyrer Flurina , Dittrich Tolga , Piot Ines , Kaufmann Josefin , Barone Lea , Dahlheim Ludvig , Flammer Sophie , Avramiotis Nikolaos S , Peters Nils , De Marchis Gian Marco , Bonati Leo H , Gensicke Henrik , Engelter Stefan T , Lyrer Philippe A
Published: May 2022

Background:

Data on the safety and effectiveness of once-daily (QD) versus twice-daily (BID) direct oral anticoagulants (DOAC) in comparison to vitamin K antagonists (VKA) and to one another in patients with atrial fibrillation (AF) and recent stroke are scarce.

Patients and methods:

Based on prospectively obtained data from the observational registry Novel-Oral-Anticoagulants-in-Ischemic-Stroke-Patients(NOACISP)-LONGTERM (NCT03826927) from Basel, Switzerland, we compared the occurrence of the primary outcome – the composite of recurrent ischemic stroke, major bleeding, and all-cause death – among consecutive AF patients treated with either VKA, QD DOAC, or BID DOAC following a recent stroke using Cox proportional hazards regression including adjustment for potential confounders.

Results:

We analyzed 956 patients (median age 80 years, 46% female), of whom 128 received VKA (13.4%), 264 QD DOAC (27.6%), and 564 BID DOAC (59%). Over a total follow-up of 1596 patient-years, both QD DOAC and BID DOAC showed a lower hazard for the composite outcome compared to VKA (adjusted HR [95% CI] 0.69 [0.48, 1.01] and 0.66 [0.47, 0.91], respectively). Upon direct comparison, the hazard for the composite outcome did not differ between patients treated with QD versus BID DOAC (adjusted HR [95% CI] 0.94 [0.70, 1.26]). Secondary analyses focusing on the individual components of the composite outcome revealed no clear differences in the risk-benefit profile of QD versus BID DOAC.

Discussion and conclusion:

The overall benefit of DOAC over VKA seems to apply to both QD and BID DOAC in AF patients with a recent stroke, without clear evidence that one DOAC dosing regimen is more advantageous than the other.
“Rude and in Defiance of Authority”: Arizona Anti-Mexican American Studies Legislation and the Discursive Positioning of the “Rude” Student of Color
Authors: Howerton Gloria
Published: May 2022

This article considers a style of civility discourse centered on perceived “rudeness” of youth, particularly youth of color (YOC) and its use as a political strategy that positions YOC as both uncivil and lacking agency. It is constructed as a racialized concept of rudeness that positions YOC as unreliable narrators and problem students whose voices can be dismissed when it comes to educational policy that directly impacts them. I refer to this discourse as “rudeness rhetoric.” It takes on a key role in the (re)production of the school as a political site of white supremacist citizen production. I focus on Arizona politicians’ mobilization of rudeness rhetoric as justification for legislation targeting Tucson Unified School District’s (TUSD) Mexican American Studies (MAS) program for termination. I rely on triangulation of multiple sources and methods, including observation of meetings and the trial concerning the constitutionality of anti-MAS legislation, plaintiff evidence, documents and public statements by politicians, and online commentary concerning MAS. I find that, while politicians and the Arizona Department of Education engaged accusations that MAS promoted anti-white racism, they used rudeness rhetoric to frame the program as harmful, charging that it produced rude students based on protests politicians associated with MAS. Focusing on “rude” YOC allowed politicians to reframe legislative attacks on ethnic studies and move debate over MAS away from racial animus in the legislation. Rather than one explosive moment in which the rudeness rhetoric performed its political work, it snaked throughout multiple venues from political arenas to the courtroom to the media.
Impaired exercise capacity in post–COVID-19 syndrome: the role of VWF-ADAMTS13 axis
Authors: Prasannan Nithya , Heightman Melissa , Hillman Toby , Wall Emma , Bell Robert , Kessler Anna , Neave Lucy , Doyle Andrew , Devaraj Akshitha , Singh Deepak , Dehbi Hakim-Moulay , Scully Marie
Published: May 2022

Post-COVID syndrome (PCS), or long COVID, is an increasingly recognized complication of acute SARS-CoV-2 infection, characterized by persistent fatigue, reduced exercise tolerance, chest pain, shortness of breath, and cognitive slowing. Acute COVID-19 is strongly linked with an increased risk of thrombosis, which is a prothrombotic state quantified by an elevated von Willebrand factor (VWF) antigen (Ag)/ADAMTS13 ratio that is associated with severity of acute COVID-19 infection. We investigated whether patients with PCS also had evidence of a prothrombotic state associated with symptom severity. In a large cohort of patients referred to a dedicated post-COVID-19 clinic, thrombotic risk, including VWF(Ag)/ADAMTS13 ratio, was investigated. An elevated VWF(Ag)/ADAMTS13 ratio (≥1.5) was present in nearly one-third of the cohort and was 4 times more likely to be present in patients with impaired exercise capacity, as evidenced by desaturation ≥3% and/or an increase in lactate level >1 from baseline on a 1-minute sit-to-stand test and/or a 6-minute walk test (P < .0001). Of 276 patients, 56 (20%) had impaired exercise capacity, of which 55% (31/56) had a VWF(Ag)/ADAMTS13 ratio ≥1.5 (P < .0001). Factor VIII and VWF(Ag) were elevated in 26% and 18%, respectively, and support a hypercoagulable state in some patients with PCS. These findings suggest possible ongoing microvascular/endothelial dysfunction in the pathogenesis of PCS and suggest a role for antithrombotic therapy in the treatment of these patients.
Ewe breed differences in the cervical transcriptome at the follicular phase of a synchronised oestrous cycle
Authors: Abril-Parreño Laura , Meade Kieran G. , Krogenæs Anette Kristine , Druart Xavier , Cormican Paul , Fair Sean
Published: May 2022

Background

Cervical artificial insemination (AI) with frozen-thawed semen results in unacceptably low pregnancy rates internationally. The exception is in Norway, where vaginal deposition of frozen-thawed semen to a natural oestrous routinely yields pregnancy rates in excess of 70%. Previous studies by our group has demonstrated that this is due to differences in cervical sperm transport. However, a potentially important contributory factor is that ewes are inseminated to a natural oestrous in Norway but to a synchronised oestrous across most of the rest of the world. In this study, we interrogated the gene expression of the sheep cervix of four ewe breeds with known differences in pregnancy rates following cervical AI using frozen-thawed semen under the effect of exogenous hormones to synchronise the oestrous cycle. These four ewe breeds (n = 8 to 11 ewes per breed) are from two countries: Ireland (Belclare and Suffolk; medium and low fertility, respectively) and Norway (Norwegian White Sheep (NWS) and Fur; both with high fertility compared to the Irish ewe breeds).

Results

RNA extracted from cervical biopsies collected from these breeds was analysed by RNA-sequencing and differential gene expression analysis. Using the low-fertility Suffolk breed as a reference level; 27, 1827 and 2641 genes were differentially expressed in Belclare, Fur and NWS ewes, respectively (P <  0.05 and FC > 1.5). Gene ontology (GO) analysis revealed that Fur and NWS had an up-regulation of enriched pathways involved in muscle contraction and development compared to Suffolk. However, there was a down-regulation of the immune response pathway in NWS compared to Suffolk. In addition, GO analysis showed similar expression patterns involved in muscle contraction, extracellular matrix (ECM) development and cell-cell junction in both Norwegian ewe breeds, which differed to the Irish ewe breeds.

Conclusions

This novel study has identified a number of conserved and breed-specific biological processes under the effect of oestrous synchronisation that may impact cervical sperm transport during the follicular phase of the reproductive cycle.
QTL mapping of drought-related traits in the hybrids of Populus deltoides ‘Danhong’×Populus simonii ‘Tongliao1’
Authors: Du Changjian , Sun Pei , Cheng Xingqi , Zhang Lei , Wang Lijuan , Hu Jianjun
Published: May 2022

Background

Poplar trees provide a large amount of wood material, but many parts of the world are arid or semi-arid areas because of insufficient annual precipitation, which seriously affects the growth of poplar trees. Populus simonii ‘Tongliao1’ shows strong tolerance to stress environments, and Populus deltoides ‘Danhong’ shows a stronger growth rate in a suitable environment. To identify drought tolerance-related QTLs and genes, an F1 population derived from the cross between the ‘Danhong’ and ‘Tongliao 1’ Populus was assessed under drought stress.

Results

We measured drought-related traits such as the relative height growth, relative diameter growth, leaf senescence number, specific leaf area, and leaf relative water content in the population under control and drought environments. The results showed that drought stress reduced the plant height relative growth, ground diameter relative growth, specific leaf area and leaf relative water content and increased the number of leaf drops. A total of 208 QTLs were identified by QTL mapping analysis, and they consisted of 92, 63 and 53 QTLs under control, drought stress treatment and drought index conditions, respectively. A molecular identification marker for drought tolerance, np2841, which was associated with a QTL (qDLRWC-LG10-1) for relative leaf water content, was initially developed. We mined 187 candidate genes for QTL regions of five traits under a drought environment. The reference genome annotation for Populus trichocarpa and a homologous gene analysis of Arabidopsis thaliana identified two candidate genes, Potri.003G171300 and Potri.012G123900, with significant functions in response to drought stress. We identified five key regulatory genes (Potri.006G273500, Potri.007G111500, Potri.007G111600, Potri.007G111700, and Potri.007G111800) related to drought tolerance through the poplar coexpression network.

Conclusion

In this study, our results indicate that the QTLs can effectively enhance the drought tolerance of poplar. It is a step closer towards unravelling the genetic basis of poplar drought tolerance-related traits, and to providing validated candidate genes and molecular markers for future genetic improvement.
Association of serum sclerostin and osteoprotegerin levels with the presence, severity and prognosis in patients with acute myocardial infarction
Authors: Shui Xing , Dong Ruimin , Wu Zhen , Chen Zefeng , Wen Zheqi , Tang Leile , Xie Xujing , Chen Lin
Published: May 2022

Background

Bone-related proteins (such as sclerostin and osteoprotegerin [OPG]) are involved in the development of atherosclerosis. However, the relationship between bone-related proteins and acute myocardial infarction (AMI) has not been extensively evaluated. The purpose of this study was to assess the association of serum sclerostin and OPG with the presence, severity and prognosis in patients with AMI.

Methods

This study prospectively enrolled 152 patients attacked by acute chest pain. Serum sclerostin and OPG were detected within the first 24 h after AMI diagnosis by ELISA kits. The AMI predictive efficacy of sclerostin and OPG were analyzed by receiver operating characteristics (ROC) curve. Univariable and multivariable linear regression analyses were performed to determine the association between bone-related proteins and scores indicating the severity of coronary artery occlusion. Moreover, prognostic values were assessed by Kaplan–Meier curves and Cox regression analysis.

Results

There were 92 patients in AMI group, 60 in non-AMI group. Serum levels of sclerostin and OPG were significantly higher in AMI group than in non-AMI group (all p < 0.001), which showed predictive value for the presence of AMI (all p < 0.001). The area under the ROC curve values of sclerostin and OPG were 0.744 and 0.897, respectively. A multivariable linear regression analysis demonstrated that Ln-transformed sclerostin (β = 0.288, p = 0.009) and Ln-transformed OPG (Ln-OPG: β = 0.295, p = 0.019) levels were associated with GENISINI score, independently of conventional clinical parameters. In addition, Ln-OPG levels were still positively associated with GRACE score after adjustments (β = 0.320, p = 0.001). During a 1-year follow-up, patients above the median of sclerostin levels had higher incidence of major adverse cardiac events (MACE) than those below the median (p = 0.028). It was also observed that the MACE rates were higher in patients above the median of OPG levels, though no statistic importance (p = 0.060). After adjusting conventional risk factors by multivariate Cox regression, Ln-OPG was associated with incident MACE (hazard ratio = 2.188 [95% confidence intervals 1.102–4.344], p = 0.025).

Conclusions

Bone-related proteins could exert a potential role in early risk stratification and prognosis assessment in patients with AMI.
The role of primary care in informing and supporting people with limited health literacy in the Netherlands during the COVID-19 pandemic: a qualitative interview study
Authors: Knottnerus Bart , Heijmans Monique , Rademakers Jany
Published: May 2022

Background

During the coronavirus disease 2019 (COVID-19) pandemic, people have been confronted with a large amount of information about the virus and the governmental measures against its spreading. However, more than a quarter of individuals have limited health literacy (HL), meaning that they have difficulty finding, understanding, and applying health information. The purpose of this interview study was to investigate how individuals with limited HL acquire information about COVID-19 and governmental measures, what difficulties they experience in understanding and applying it, and what may be needed to overcome these difficulties. We also addressed other problems that they might face as a result of the pandemic. Using our findings, we aimed to make recommendations on the possible role of primary care in informing and supporting patients with limited HL during the pandemic.

Methods

Between June and October 2020, 28 individuals with limited HL were interviewed by phone (age range 20–84). The interviews were semi-structured and focused on the first months of the pandemic in the Netherlands (March/April/May 2020).

Results

The participants generally found COVID-19-related information abundant and complicated, and sometimes contradictory. Information provision by their own health care professionals was highly appreciated, especially in the context of chronic illnesses. General health care problems resulting from COVID-19 measures were postponement of regular care and difficulty with digital contacts.

Conclusions

Individuals with limited HL may benefit from provision of COVID-19-related information and support by their own health care providers. This applies in particular to patients with chronic illnesses. Primary care professionals are in the ideal position to take this role.
HIV virological non-suppression is highly prevalent among 18- to 24-year-old youths on antiretroviral therapy at the Kenyan coast
Authors: Nyongesa Moses K. , Mwatasa Mwaganyuma H. , Kagonya Vincent A. , Mwambingu Gabriel , Ngetsa Caroline , Newton Charles R. J. C. , Abubakar Amina
Published: May 2022

Background

In sub-Saharan Africa, data on virologic outcomes of young people living with HIV (YLWH) enrolled on antiretroviral therapy (ART) remains scarce. In this study, we describe the prevalence of HIV virological non-suppression (VNS) and its associated factors among YLWH aged 18–24 years from the Kenyan coast.

Methods

Data were analyzed for 384 YLWH who participated in a larger cross-sectional study conducted between November 2018 and September 2019 in two counties at the Kenyan coast (Kilifi and Mombasa). Descriptive statistics were used to summarize sample characteristics and logistic regression was used for statistical modeling of factors associated with VNS. In this study, VNS was defined as plasma viral load ≥ 1000 copies/mL.

Results

Among these YLWH with a mean age of 20.7 years (SD = 2.2); 55.5% females, the overall prevalence of VNS was 32.0% (95% Confidence interval (95% CI): 27.5, 36.9%). In the multivariable logistic regression analysis, being from a largely rural setting (adjusted Odds Ratio (aOR) 1.73, 95% CI 1.10, 2.71; p = 0.02), underweight (aOR 1.87, 95% CI 1.16, 3.01; p = 0.01) and low self-reported ART adherence (aOR 2.83, 95% CI 1.34, 6.00; p = 0.01) were significantly associated with higher odds of VNS in YLWH.

Conclusions

In this study, high levels of VNS were observed among YLWH and this was significantly associated with rural residency, nutritional and ART adherence problems. ART adherence counselling and nutritional support and education should be intensified in this setting targeting YLWH residing mostly in rural areas. Given the high frequency of VNS, there is need to closely monitor viral load and profile HIV drug resistance patterns in youths from the Kenyan coast with confirmed virologic failure. The latter will help understand whether drug resistance also contributes to poor viral suppression in addition to, or exclusive of suboptimal ART adherence.