bluuebunny/crossref_metadata_2025 huggingface dataset:
CONCERTO: A randomized, placebo-controlled trial of oral laquinimod in relapsing-remitting multiple sclerosis
Authors: Comi Giancarlo , Dadon Yuval , Sasson Nissim , Steinerman Joshua R , Knappertz Volker , Vollmer Timothy L , Boyko Alexey , Vermersch Patrick , Ziemssen Tjalf , Montalban Xavier , Lublin Fred D , Rocca Maria A , Volkinshtein Rita , Rubinchick Svetlana , Halevy Nitsan , Filippi Massimo
Published: August 2021

Background:

Interventions targeting the adaptive immune response are needed in multiple sclerosis (MS).

Objective:

Evaluate laquinimod’s efficacy, safety, and tolerability in patients with relapsing-remitting multiple sclerosis (RRMS).

Methods:

CONCERTO was a randomized, double-blind, placebo-controlled, phase-3 study. RRMS patients were randomized 1:1:1 to receive once-daily oral laquinimod 0.6 or 1.2 mg or placebo for ⩽24 months ( n = 727, n = 732, and n = 740, respectively). Primary endpoint was time to 3-month confirmed disability progression (CDP). The laquinimod 1.2-mg dose arm was discontinued (1 January 2016) due to cardiovascular events at high doses. Safety was monitored throughout the study.

Results:

CONCERTO did not meet the primary endpoint of significant effect with laquinimod 0.6-mg versus placebo on 3-month CDP (hazard ratio: 0.94; 95% confidence interval: 0.67–1.31; p = 0.706). Secondary endpoint p values were nominal and non-inferential. Laquinimod 0.6 mg demonstrated 40% reduction in percent brain volume change from baseline to Month 15 versus placebo ( p < 0.0001). The other secondary endpoint, time to first relapse, and annualized relapse rate (an exploratory endpoint) were numerically lower (both, p = 0.0001). No unexpected safety findings were reported with laquinimod 0.6 mg.

Conclusion:

Laquinimod 0.6 mg demonstrated only nominally significant effects on clinical relapses and magnetic resonance imaging (MRI) outcomes and was generally well tolerated.

Clinical trial registration number:

ClinicalTrials.gov (NCT01707992).
White matter microstructural differences in children and genetic risk for multiple sclerosis: A population-based study
Authors: de Mol C Louk , Neuteboom Rinze F , Jansen Philip R , White Tonya
Published: August 2021

Background:

MS patients show abnormalities in white matter (WM) on brain imaging, with heterogeneity in the location of WM lesions. The “pothole” method can be applied to diffusion-weighted images to identify spatially distinct clusters of divergent brain WM microstructure.

Objective:

To investigate the association between genetic risk for MS and spatially independent clusters of decreased or increased fractional anisotropy (FA) in the brain. In addition, we studied sex- and age-related differences.

Methods:

3 Tesla diffusion tensor imaging (DTI) data were collected in 8- to 12-year-old children from a population-based study. Global and tract-based potholes (lower FA clusters) and molehills (higher FA clusters) were quantified in 3047 participants with usable DTI data. A polygenic risk score (PRS) for MS was calculated in genotyped individuals ( n = 1087) and linear regression analyses assessed the relationship between the PRS and the number of potholes and molehills, correcting for multiple testing using the False Discovery Rate.

Results:

The number of molehills increased with age, potholes decreased with age, and fewer potholes were observed in girls during typical development. The MS-PRS was positively associated with the number of molehills (β = 0.9, SE = 0.29, p = 0.002). Molehills were found more often in the corpus callosum (β = 0.3, SE = 0.09, p = 0.0003).

Conclusion:

Genetic risk for MS is associated with spatially distinct clusters of increased FA during childhood brain development.
‘Having money is not the essential thing . . . but . . . it gets everything moving’: Young Colombians Navigating Towards Uncertain Futures?
Authors: Marzi Sonja
Published: August 2021

In this article, I extend the discussion of aspirations as a conceptual tool by exploring how young Colombians plan to pursue them and by seeking to understand their aspirations as a way of navigating towards what they see as a good life. Drawing upon insights from fieldwork, I use Vigh’s concept of social navigation to emphasise the importance of the social environment, and the available opportunity structures and resources, which shape young people’s aspirations and their ideas of a good life but which, more importantly, influence their navigational strategies to pursue them. I argue that Colombian young people from poor backgrounds do have aspirations and that these go beyond educational and occupational goals. Their aspirations provide information about their desire for a more stable future in an uncertain world but do not necessarily match the opportunities available to them. The young Cartagenians featuring in this study, therefore, struggle to overcome contextual and structural constraints in their social navigation, which is aimed at achieving a good life. I conclude that the young people featured in this study live amid uncertainty about their future and follow a form of doxa in formulating their aspirations. However, while the combination of economic constraints and doxic aspirations that are usually unachievable create barriers to their imagined futures, the young people socially navigate according to the opportunities that emerge and become available to them, to achieve a form of what they perceive as a good life, whereby educational and occupational goals became a means to an end.
Parametric point-cloud slicing for facade retrofitting
Authors: Gámez Bohórquez Oscar , Derigent William , Bril El-Haouzi Hind
Published: August 2021

This work presents a method for retrieving 3D building contours usable in facade retrofitting projects, which uses a parametric modeling workflow that utilizes a point-cloud slicing method to retrieve such 3D contours. Since current commitments by European governments seek to reduce energy consumption as a means to reduce carbon emissions from building stock by 2050, facade retrofitting appears as an alternative for addressing operational and embedded building emissions. Within such a context, the main contribution of this work consists of a workflow and a 3D reconstruction solution that uses a parametric environment for capturing building topology and bypassing ground-level occlusions. A real case study and a strategy for converting 3D building contours into Industry Foundation Classes entities, directly from the parametric modeling environment, served as a scenario for testing the capabilities of a Grasshopper solution and open new perspectives for this approach.
Reconfigurable molds and a fabrication-aware design tool for manufacturing concrete grid structures
Authors: Baghi Ali , Kalantari Saleh , Baghi Aryan
Published: August 2021

The design and manufacturing of concrete elements need to be reconsidered in light of current trends in architectural geometry. Today, there is a movement toward greater customization and adaptability of concrete elements using “reconfigurable formworks” and “additive manufacturing.” Our study approached the issue of fabricating non-standardized concrete elements from the perspective of a “reconfigurable fabrication platform.” Specifically, we developed a method of fabricating geometrically diverse concrete joints by combining flexible pressure-enduring tubes with a rigid mechanism, resulting in an adaptive concrete-casting machine. This platform, which we named “Flexi-node,” can be used in conjunction with a relevant fabrication-aware digital design tool. Users can computationally design and fabricate a great variety of concrete joints using just one mold, with a minimum of material waste and with no distortion from hydrostatic pressure as would typically occur in a fully flexible formwork.
The Cancers-Specific Survival of Metastatic Pulmonary Carcinoids and Sites of Distant Metastasis: A Population-Based Study
Authors: Zhang Jiandong , Yu Qiongjie , He Yi , Hu Tingting , Chen Kun , Yang Zhihao , Zhang Xingbo , Cheng Dezhi , He Zhifeng
Published: August 2021

Background:

Lung cancer is the leading cause of cancer-related deaths and pulmonary carcinoids (PCs) account for almost 2% of all pulmonary malignancies. However, few published articles have reported prognosis and related factors of pulmonary carcinoid patients.

Material and Method:

The Surveillance, Epidemiology, and End Results (SEER) database was used to collect data of patients diagnosed with metastatic PCs from 2010 to 2016. The prognosis and survival of these patients were compared by employing Cox proportional hazards and the Kaplan-Meier survival analysis.

Results:

A total of 1763 patients were analyzed. The liver (668, 25.6%) was shown to be the most common metastatic site in the isolated organ metastasis cohort, followed by the lung (636, 24.4%), bone (562, 21.6%), and brain (460, 17.6%). Among the patients, the tumor metastasized to a single distant site included the liver, bone, lung, and brain. Cancer-specific survival (CSS) in metastatic PCs is determined by the site of metastasis and the total number of such sites. Pulmonary carcinoid patients with isolated liver metastasis manifested more favorable survival rates in comparison to patients having isolated metastasis in the lung, brain, or bone. The median CSS was 45, 7, 6, 5 months ( P = 0.011). The number of distant metastatic sites and the location of distant metastasis were found to be independent risk factors for CSS. For patients with distant isolated metastasis, liver metastasis ( P < 0.0001) had better CSS in comparison to those with bone metastasis. When compared to patients whose carcinoids had metastasized to the bones, patients with a brain ( P = 0.273) or lung ( P = 0.483) metastasis had the same CSS.

Conclusion:

Cancer-specific survival in metastatic PCs depends on the site of metastasis and the total number of such locations. PC patients with isolated liver metastasis manifested more favorable survival in comparison to patients with isolated metastasis in the lung, brain, or bone.
Building a Holistic Typology to Inform Service Delivery for Women on Community Supervision
Authors: Wanamaker Kayla A. , Brown Shelley L.
Published: August 2021

This study examines how risk and strength factors inform treatment typologies over time and how these typologies relate to reoffending outcomes for 1,684 women on community supervision in Alberta, Canada. Latent transition analysis was conducted using three assessment timepoints. Three profiles consistently emerged across timepoints: a Low need/low strength profile, a Low need/high strength profile with adversity and mental health concerns, and an Aggressive, high need/low strength profile, which had the highest rate of reoffending. Results underscore the utility of incorporating gender-neutral and gender-responsive needs and strengths in typological development. Treatment typologies help inform effective service delivery, programming, and supervision practices.
Pinocembrin Protects Cardiomyocytes Against Isoproterenol-Induced Hypertrophy
Authors: Sui Xin , Li Na , Shi Xiaozheng , Li Xiaohua , Han Dong , Qiu Zhidong , Deng Yue , Sun Guangwei
Published: August 2021

Cardiac hypertrophy is characterized by an increase in myocardial cell volume and extracellular matrix production. Persistent cardiac hypertrophy can cause dilated cardiomyopathy, heart failure, and even death. Pinocembrin (5,7-dihydroxyflavanone) is a type of flavonoid, extracted from propolis, that has antimicrobial, antioxidant, antiinflammatory, and anticancer properties. The results of the present study showed that pretreatment of isoproterenol (ISO)-treated H9c2 cardiomyocytes with pinocembrin reduced the messenger RNA levels of hypertrophic markers, including atrial natriuretic factor and βeta-myosin heavy chain, and inflammatory cytokines, such as tumor necrosis factor-α, interleukin-6, interleukin-1β, and interferon-γ, and also inhibited p65 phosphorylation and nuclear factor-kappa B (NF-κB) translocation. In addition, the activity of IκBα, an inhibitor of NF-κB, was increased while that of caspase-3 was reduced under these conditions. These results indicate that pinocembrin may inhibit ISO-induced myocardial hypertrophy by attenuating the NF-κB signaling pathway.
Idiopathic intracranial hypertension – a wider spectrum than headaches and blurred vision
Authors: Urbach H , Duman IE , Altenmüller DM , Fung C , Lützen N , Elsheikh S , Beck J
Published: August 2021

Background

The purpose of this study was to analyse less known clinical scenarios associated with idiopathic intracranial hypertension.

Methods

The study involved analysis of magnetic resonance imaging signs of idiopathic intracranial hypertension in patients with spontaneous rhinoliquorrhoea ( n = 7), in patients with temporal lobe epilepsy and surgically treated antero-inferior temporal lobe meningo-encephaloceles (n = 15), and in patients who developed clinical signs of idiopathic intracranial hypertension following the treatment of spontaneous intracranial hypotension ( n = 7).

Results

Three of six patients with spontaneous rhinoliquorrhoea and six of 15 operated patients with temporal lobe epilepsy due to temporal lobe meningo-encephaloceles showed magnetic resonance imaging signs of idiopathic intracranial hypertension and had a body mass index >30 kg/m2. Rebound high pressure headaches and sings of idiopathic intracranial hypertension occurred in seven of 44 surgically treated spontaneous intracranial hypotension patients.

Conclusions

Magnetic resonance imaging findings should guide the clinician to consider (idiopathic) intracranial hypertension when patients develop spontaneous rhinoliquorrhoea, temporal lobe epilepsy secondary to temporal lobe meningoencephaloceles or high pressure headaches in spontaneous intracranial hypotension. Whether idiopathic intracranial hypertension must be regarded as a differential diagnosis or as a cause, or whether there are common pathophysiological pathways that lead to signs of idiopathic intracranial hypertension in this wider spectrum of disease is the focus of further study.
Stepwise improvement in limb shaking achieved by staged angioplasty for severe carotid stenosis
Authors: Takahara Kento , Akiyama Takenori , Yoshida Keisuke , Yamada Hiroki , Oishi Yumiko , Kuranari Yuki , Katsumata Masahiro , Toda Masahiro
Published: August 2021

Cerebral hyperperfusion syndrome is a rare but severe complication of carotid artery stenting or carotid endarterectomy. Staged angioplasty is reportedly an effective strategy to avoid cerebral hyperperfusion syndrome. We encountered a case of internal carotid artery stenosis with a rare clinical presentation of limb shaking that was successfully improved by staged angioplasty. To our knowledge, there are no reported cases of limb shaking treated with staged angioplasty.

A 76-year-old woman presented with continuous chorea in her left lower limb and shoulder. Medical examination revealed a tiny cerebral infarction in the right corona radiata and severe right internal carotid artery stenosis. Angiography showed near occlusion of the right internal carotid artery. Staged angioplasty was performed to avoid the risk of cerebral hyperperfusion syndrome. The first angioplasty resulted in an expanded diameter of 2.5 mm and was followed by definitive carotid artery stenting using a closed-cell stent 3.5 weeks later. Limb shaking improved in a stepwise manner along with an improvement in internal carotid artery stenosis and distal flow state with no signs of cerebral hyperperfusion syndrome. Patients with internal carotid artery stenosis or occlusion presenting with limb shaking have been suggested to have impaired cerebrovascular reactivity, which is also thought to be a risk factor for cerebral hyperperfusion syndrome. The stepwise improvement in limb shaking observed in this case supports the idea that the pathophysiology of limb shaking is related to cerebral haemodynamic impairment. Measures to prevent cerebral hyperperfusion syndrome, including staged angioplasty, should be actively considered in patients with limb shaking because the symptoms themselves suggest severe hypoperfusion.
Tuberculous granuloma of maxillary antrum and ethmoid sinus mimicking malignancy and trigeminal neuralgia: A case report and review of the literature
Authors: Penjor Dorji , Chong Aun Wee
Published: August 2021

Tuberculosis is a multi-system disease, but paranasal sinuses involvement is uncommon, and most cases occur secondary to pulmonary tuberculosis. Tuberculous granuloma of the paranasal sinuses is rare and only a few cases are reported. Due to non-specific ways of clinical presentations, diagnosis of paranasal tuberculosis can be missed, delayed or confused with other entities like malignancy. We present an uncommon case of tuberculous granuloma of the left maxillary antrum and ethmoid sinus in a 56-year-old man which mimicked trigeminal neuralgia and malignancy. Medial maxillectomy and anterior ethmoidectomy with clearance of the lesion followed by antituberculous treatment prevented permanent loss of his vision. Depending on the chief complaints, patients may present to various specialties. Early cross-referral is important for early diagnosis, appropriate management and prevention of complications.
Myocardial infarction post COVID-19 vaccine – coincidence, Kounis syndrome or other explanation – time will tell
Authors: Maadarani Ossama , Bitar Zouheir , Elzoueiry Mahmoud , Nader Mohammad , Abdelfatah Mohamad , Zaalouk Tamer , Mohsen Mohamad , Elhabibi Mohamad
Published: August 2021

A case of ST elevation myocardial infarction reported post Coronavirus disease 2019 (COVID-19) vaccine. Probably premature to draw a link between COVID-19 vaccine and myocardial infarction.
Nephrologists’ Attitudes Regarding Psychosocial Care in Hemodialysis Units
Authors: Lehecka Aidan , Mendelssohn David , Hercz Gavril
Published: August 2021

Background:

There is a high prevalence of psychosocial issues affecting patients with kidney failure.

Objective:

We sought to examine Canadian nephrologists’ attitudes and opinions regarding the importance of renal patient psychosocial care, nephrologists’ roles, and experience with psychosocial care in addition to what barriers, if any, prevent these physicians from providing psychosocial care to their patients.

Design:

A self-administered, survey questionnaire.

Setting:

Online.

Sample:

Canadian Society of Nephrology members who predominantly work in clinical care with adult, in-center hemodialysis patients.

Measurements:

Measurements of the survey include demographics, training, and nephrologists’ opinions regarding their role in administering psychosocial care, potential administrative and patient time constraints, accessibility of other health care workers for this activity, and factors that influence or impede physicians’ ability to address their patients’ psychosocial needs.

Methods:

A self-administered survey was sent to almost 500 members of the Canadian Society of Nephrology between November 2018 and December 2018. The survey questionnaire was designed to gather opinions and attitudes on psychosocial care delivery as well as potential influencing factors on nephrologists’ ability to provide this care. A univariate statistical analysis was used to analyze survey responses.

Results:

A total of 30 nephrologists responded to the survey, generating a 6% response rate. Respondents varied across provinces, with the majority being staff nephrologists (80%). While over 94% of respondents either agreed or strongly agreed that focus on psychosocial care improves patient outcomes, only 43% felt that staff nephrologists were suited to provide this care to patients; 97% of respondents believed social workers to be the most suited to provide this. Lack of additional supporting health care members, the need for additional training, too many administrative duties, and empathy fatigue were some of the predominant barriers respondents felt prevented them from addressing the psychosocial care of their patients.

Limitations:

A low response rate for the survey was obtained, roughly 6%, limiting our ability to draw definitive conclusions. Survey answers by respondents may be different from those by nonrespondents. Answers may be subject to social desirability and/or selection bias.

Conclusion:

Nephrologists believe that the current psychosocial care of patients in hemodialysis units is inadequate. However, further research is necessary to elucidate the barriers nephrologists face in providing psychosocial care and the changes required to most effectively implement optimal psychosocial care for patients with kidney failure in hemodialysis units.
Does Increasing Product Complexity and Diversity Cause Economic Growth in the Long-Run? A GMM Panel VAR Evidence
Authors: Udeogu Ejike , Roy-Mukherjee Shampa , Amakom Uzochukwu
Published: August 2021

Using aggregate data from 31 Organization for Economic Co-operation and Development (OECD) countries covering periods from 1982 to 2017, this study examines the notion that the level of product complexity is a good determinant of economic growth in the long run. We use the impulse-response function (IRF) computed from the consistent generalized method of moment panel vector autoregressive (GMM pVAR) model to estimate the response of the real output growth to a change in the economic complexity index. The IRF shows that the economic complexity index has a significant impact on economic growth; a 1 standard deviation shock to the economic complexity index at time 0 contributes around 2.34 percentage points to the average rate of growth of output within the first period. The point estimates are positive and significant up to the third period. The cumulative IRF shows that the aggregate impact on economic growth is about 4.4% in the long run. Compared to some widely used innovation proxies such as the gross expenditure on research and development and secondary school enrollment, the economic complexity index performs relatively better in our model in determining economic growth in the long run.
Incite to Practice: Development of a Realist-Informed Program Theory to Support Implementation of Intersectoral Partnerships
Authors: Irvine Fitzpatrick Linda , Maciver Donald , Forsyth Kirsty
Published: August 2021

Policy internationally is supportive of intersectoral partnerships (ISPs) for promoting positive outcomes among people with complex social, psychological, and physical needs. This realist-informed study describes the development of a program theory to provide insight into enactment of effective ISPs. Interviews were completed with 18 senior staff with leadership roles in six ISPs, including voluntary, statutory, and commercial organizations, supporting people with complex health and social care needs. An iteratively developed and refined program theory, termed the “Incite” model, was developed, with collaboration with participants and an advisory group, including people with lived experience. Important contextual conditions that emerged included organizational culture, historical perspectives, policy, and social determinants of health. Mechanisms included desire for change, creating safe psychological spaces, establishing shared values, and talking about power. Outcomes included transformed world view, increased psychological safety, clarity of purpose, fluidity of relationships, and power shifting. Three phases of partnership development were also identified within the model. This study has led to a clearer, more rigorous, and systematic understanding, with recommendations for how ISPs might be developed or expanded. How the Incite model may be operationalized is discussed, as well as implications for policy, practice, and research.
Sprue-Like Enteropathy and Liver Injury: A Rare Emerging Association with Olmesartan
Authors: Odak Mihir , Udongwo Ndausung , Alfraji Nasam , Zheng Min , Zaidi Saddam
Published: August 2021

Olmesartan-induced enteropathy is an underreported phenomenon, first described in 2012. While olmesartan’s antihypertensive properties were confirmed early on, its association with a sprue-like enteropathy was subsequently noted. Although this association has been reported with olmesartan, there have been few reports of this association with other angiotensin-receptor blockers. We present a case of a 79-year-old male who presented with diarrhea, weight loss, jaundice, and transaminitis. Further history revealed that he had been taking olmesartan 40 mg daily for hypertension. Workup of his diarrhea and jaundice included duodenal and liver biopsies revealed findings consistent with a sprue-like enteropathy and an autoimmune hepatitis-like pattern. On discontinuation of olmesartan, his 1-month follow-up revealed significant improvement in his clinical status as well as his liver function tests. Olmesartan is an effective antihypertensive medication; however, physicians must be mindful of its side effect of causing a sprue-like enteropathy and liver injury. Patients should be counseled on discontinuing olmesartan, and they should be started on an alternative therapy for hypertension.
Comparison of Weightbearing and Nonweightbearing Juvenile Osteochondritis Dissecans Lesions of the Lateral Femoral Condyle
Authors: Zhou Liang , Gee Shawn M. , Wilson Philip L. , Huang Sharon , Wagner K. John , Ellis Henry B.
Published: August 2021

Background:

Repetitive microtrauma may contribute to osteochondritis dissecans (OCD) lesions of the femoral condyle. The effect of differential loading between OCD weightbearing (WB) zones has not been studied.

Purpose:

To determine whether clinical and radiographic variables differ by WB zone in lateral femoral condyle OCD lesions.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We retrospectively reviewed a consecutive series of patients aged <18 years with lateral femoral condyle OCD lesions presenting at a single institution between 2004 and 2018. Patients with OCD lesions outside of the lateral femoral condyle were excluded. Lesions were localized on radiographs using the Cahill and Berg classification, referencing the Blumensaat line and an extension of the posterior femoral cortex. Progeny bone characteristics evaluated at baseline and 24-month follow-up included ossification, distinct borders from parent bone, and displacement. Baseline lesion dimensions were measured on magnetic resonance imaging (MRI) scans. We evaluated posttreatment pain level, return-to-activity rate, and patient-reported outcome measures (PROMs) including the Pediatric International Knee Documentation Committee score, Knee injury and Osteoarthritis Outcome Score, and Pediatric Functional Activity Brief Scale.

Results:

A total of 62 lateral femoral condyle OCD lesions (mean follow-up, 24.1 months) presented within the study period: 26 WB lesions and 36 nonweightbearing (NWB) lesions. At presentation, no differences between the lesion types were observed in symptom chronicity or symptomatology. NWB lesions were deeper on MRI scans (sagittal depth, 7.11 vs 5.96 mm; P = .046; coronal depth ratio, 0.05 vs 0.01 mm; P = .003), were more likely to develop progeny bone (69.4% vs 44%; P = .047), and demonstrated higher radiographic healing rates (52.8% vs 24%; P = .025) compared with WB lesions. PROMs at follow-up were available for 25 of 62 patients (40.3%), with no statistically significant differences between cohorts at any time. Return to full activity was observed in 72% of WB and 82.1% of NWB lesions ( P = .378).

Conclusion:

Lateral femoral condyle OCD lesions of the knee in WB and NWB zones presented similarly at initial evaluation; however, NWB lesions demonstrated higher rates of progeny bone formation and radiographic healing at mean 2-year follow-up.
Can We Talk? Improving Employee Contextual Performance Using Motivating Language and Feedback Orientation
Authors: Elsner Twesme Emily , Werner Jon M. , Simha Aditya
Published: August 2021

This study sought to determine whether motivating language theory and feedback orientation theory connect, and if so, whether or not this impacts employee contextual performance in the workplace. Survey data was collected from 458 individuals (142 undergraduate students, and a national sample of 316 employees). Statistically significant relationships were observed between motivating language and feedback orientation, between motivating language and contextual performance, and between feedback orientation and contextual performance. Feedback orientation was found to moderate the relationship between motivating language and contextual performance. Implications and generalizability of these theories to other settings are presented.
Patients’ Satisfaction on the Service Quality of Upazila Health Complex in Bangladesh
Authors: Rumi Maruf Hasan , Makhdum Niaz , Rashid Md. Harunur , Muyeed Abdul
Published: August 2021

This article attempts to measure the state of satisfaction of patients over the quality of health care as well as identify the crucial factors that affect the patients’ satisfaction in Upazila Health Complex (UHC). The quantitative approach was used following a structured questionnaire survey method. Four hundred visitors of 2 UHCs in Meherpur district were randomly selected as respondents for the study. The Statistical Package for Social Science IBM version 24 and R software (version 4.0.2) were used to run descriptive statistics, χ2 test, confirmatory factor analysis, and principal component analysis for quantitative data analysis. The data reveal that the overall satisfaction score is (2.75 ± 0.943). A 3-dimension model of service quality is found to have a significant relationship with patients’ satisfaction at the rural level. Care providers’ attitude and responsiveness in service delivery are found to be the most vital factor, while the tangibles and accessibility factors moderately influence the patient’s satisfaction on the service quality at UHCs.
Leveraging Orientation and Learning Transfer to Launch Capstone Consulting Projects
Authors: Wysong Scott , Blanke Sandra , Olson Jude , Maellaro Rosemary
Published: August 2021

This orientation session was designed to prepare students for their final MBA Capstone project, leverage lessons learned from graduates, transfer prior learning about teams and project management, and launch consulting projects with actual clients. Companies have used orientation sessions to onboard new employees for many years to improve productivity and innovation. Comparatively, the use of student orientation sessions is an understudied area. Our exploratory survey of 68 Capstone students on the completion of their course indicates that they benefit from this session, and subsequently have demonstrated marked improvement in teamwork and client deliverables according to their professors. This article addresses the elements of the orientation session that can be replicated and implemented by other professors teaching similar courses. We recommend that future research continue to examine this pedagogy.
Crafting ecologies of existence: More than human community making in Colombian textile craftivism
Authors: Tacchetti Maddalena , Quiceno Toro Natalia , Papadopoulos Dimitris , Puig de la Bellacasa María
Published: August 2021

Based on ethnographic work with several women’s textile making collectives in Colombia, this article approaches their crafting practices as everyday doings of socio-ecological reparation, in the midst of social and environmental devastation caused by the armed conflict. Rather than focusing on the relevance of their activities for political activism and historical memory, an ecological perspective allows us to emphasise their work as a mundane, more than social process of communal regeneration. We discuss how women in these collectives, after painful and violent displacements, craft new ecologies of existence: relations and interdependencies within more than human worlds that cultivate new modes of care and attention, values and sensibilities in precarious living spaces. Ecological reparation is an everyday, vital, ongoing practice essential for community resurgence and for re-establishing collectivities that sustain liveable worlds.
Distribution of antibiotic-resistant bacteria in aerobic composting of swine manure with different antibiotics
Authors: Song Tingting , Li Hongna , Li Binxu , Yang Jiaxun , Sardar Muhammad Fahad , Yan Mengmeng , Li Luyao , Tian Yunlong , Xue Sha , Zhu Changxiong
Published: August 2021

Background

Livestock manure is an important reservoir of antibiotic-resistant bacteria (ARB) and antibiotic-resistance genes (ARGs). The bacterial community structure and diversity are usually studied using high-throughput sequencing that cannot provide direct evidence for ARB changes. Thus, little is known about the distribution of ARB, especially in the presence of different antibiotics in composting process. In this study, the fate of ARB was investigated in aerobic composting of swine manure, using chlortetracycline, sulfamethoxazole, lincomycin, and ciprofloxacin as typical antibiotics. The abundance and species of ARB were analyzed systematically to evaluate their ecological risk at different stages of composting.

Results

The absolute abundance of total ARB decreased, while the relative abundance increased on day 2. The relative abundance of lincomycin-resistant bacteria was higher than other ARBs during the whole composting process. The absolute abundance of four ARBs was 9.42 × 106–2.51 × 102 CFU/g (lincomycin- > chlortetracycline- > sulfamethoxazole- > ciprofloxacin- > multiple antibiotic-resistant bacteria), and they were not completely inactivated at the end of composting. Antibiotics led to a partial proliferation of ARBs including Corynebacterium, Sporosarcina, Solibacillus, and Acinetobacter. Especially, Corynebacterium, a pathogenic genus, was observed in chlortetracycline and lincomycin treatments.

Conclusion

Among the antibiotics studied, lincomycin showed the highest ecological risk, due to it expanded the range of lincomycin-resistant bacteria at the phyla level (Firmicutes, Actinobacteria, and Proteobacteria). The principal co-ordinates analysis indicated that the bacterial community structure was primarily associated with the composting stages rather than antibiotic types. Possible potential hosts and the related to the decrease of ARGs abundance were indicated based on the network analysis. The decrease of culturable Proteobacteria and the increase of culturable Firmicutes (Solibacillus, Bacillus) partially explained the high degradation rate of various ARGs with the progress of composting in this study. These results provided important information for the control of antibiotic resistance in composting.
Comparative genomics of two inbred lines of the potato cyst nematode Globodera rostochiensis reveals disparate effector family-specific diversification patterns
Authors: van Steenbrugge Joris J.M. , van den Elsen Sven , Holterman Martijn , Sterken Mark G. , Thorpe Peter , Goverse Aska , Smant Geert , Helder Johannes
Published: August 2021

Background

Potato cyst nematodes belong to the most harmful pathogens in potato, and durable management of these parasites largely depends on host-plant resistances. These resistances are pathotype specific. The currentGlobodera rostochiensispathotype scheme that defines five pathotypes (Ro1 - Ro5) is both fundamentally and practically of limited value. Hence, resistant potato varieties are used worldwide in a poorly informed manner.

Results

We generated two novel reference genomes ofG. rostochiensisinbred lines derived from a Ro1 and a Ro5 population. These genome sequences comprise 173 and 189 scaffolds respectively, marking a ≈ 24-fold reduction in fragmentation as compared to the current reference genome. We provide copy number variations for 19 effector families. Four dorsal gland effector families were investigated in more detail. SPRYSECs, known to be implicated in plant defence suppression, constitute by far the most diversified family studied herein with 60 and 99 variants in Ro1 and Ro5 distributed over 18 and 26 scaffolds. In contrast, CLEs, effectors involved in feeding site induction, show strong physical clustering. The 10 and 16 variants cluster on respectively 2 and 1 scaffolds. Given that pathotypes are defined by their effectoromes, we pinpoint the disparate nature of the contributing effector families in terms of sequence diversification and loss and gain of variants.

Conclusions

Two novel reference genomes allow for nearly complete inventories of effector diversification and physical organisation within and between pathotypes. Combined with insights we provide on effector family-specific diversification patterns, this constitutes a basis for an effectorome-based virulence scheme for this notorious pathogen.
Prediction of biological age and all-cause mortality by 12-lead electrocardiogram in patients without structural heart disease
Authors: Hirota Naomi , Suzuki Shinya , Arita Takuto , Yagi Naoharu , Otsuka Takayuki , Yamashita Takeshi
Published: August 2021

Background

There is a well-established relationship between 12-lead electrocardiogram (ECG) and age and mortality. Furthermore, there is increasing evidence that ECG can be used to predict biological age. However, the utility of biological age from ECG for predicting mortality remains unclear.

Methods

This was a single-center cohort study from a cardiology specialized hospital. A total of 19,170 patients registered in this study from February 2010 to March 2018. ECG was analyzed in a final 12,837 patients after excluding those with structural heart disease or with pacing beats, atrial or ventricular tachyarrhythmia, or an indeterminate axis (R axis > 180°) on index ECG. The models for biological age were developed by principal component analysis (BA) and the Klemera and Doubal’s method (not adjusted for age [BAE] and adjusted for age [BAEC]) using 438 ECG parameters. The predictive capability for all-cause death and cardiovascular death by chronological age (CA) and biological age using the three algorithms were evaluated by receiver operating characteristic analysis.

Results

During the mean follow-up period of 320.4 days, there were 55 all-cause deaths and 23 cardiovascular deaths. The predictive capabilities for all-cause death by BA, BAE, and BAEC using area under the curves were 0.731, 0.657, and 0.685, respectively, which were comparable to 0.725 for CA (p = 0.760, 0.141, and 0.308, respectively). The predictive capabilities for cardiovascular death by BA, BAE, and BAEC were 0.682, 0.685, and 0.692, respectively, which were also comparable to 0.674 for CA (p = 0.775, 0.839, and 0.706, respectively). In patients aged 60–74 years old, the area under the curves for all-cause death by BA, BAE, and BAEC were 0.619, 0.702, and 0.697, respectively, which tended to be or were significantly higher than 0.482 for CA (p = 0.064, 0.006, and 0.005, respectively).

Conclusion

Biological age by 12-lead ECG showed a similar predictive capability for mortality compared to CA among total patients, but partially showed a significant increase in predictive capability among patients aged 60–74 years old.
A retrospective analysis of incident pregnancy in phase 1 and 2a HIV-1 vaccine study participants does not support concern for adverse pregnancy or birth outcomes
Authors: Stranix-Chibanda Lynda , Yu Chenchen , Isaacs Margaret Brewinski , Allen Mary , Andriesen Jessica , Walsh Stephen R.
Published: August 2021

Background

Pregnancies occur during HIV-1 vaccine clinical trials, despite requirements for women of reproductive potential to use effective contraception. Deployment of an effective HIV-1 vaccine regimen will likely target adolescents and young adults and therefore safety for pregnant and breastfeeding women will need to be addressed.

Methods

We performed a retrospective, cross-protocol analysis to identify and compare pregnancy outcomes reported in 53 Phase 1 and Phase 2a HIV-1 vaccine clinical trials conducted by the HIV Vaccine Trials Network (HVTN).

Results

Two thousand six hundred seventy-three women of reproductive potential were identified and 193 pregnancies were reported. 39 of 53 (74%) studies had at least one pregnancy reported with an overall pregnancy rate of 3.15 per 100 woman-years (w-yr). While active contraception use was required during study participation, 13 of the 53 studies also contained a long-term follow up period during which pregnancy was no longer discouraged. The pregnancy rate during main study participation was 3.09 per 100 w-yr, while pregnancies occurred at a slightly greater rate in the long-term follow up period (3.22 per 100 w-yr). Adverse pregnancy outcomes were reported at similar rates between vaccinees and placebo recipients when vaccine vectors, adjuvant used, or geographic region were examined.

Conclusion

Although there is considerable heterogeneity amongst the different vaccine trials, there appears to be no obvious indication of increased risk of adverse pregnancy or birth outcomes in these early phase HIV-1 vaccine studies. More complete data on pregnancy outcomes should be collected in early phase HIV-1 vaccine clinical trials to better inform subsequent efficacy trials.
Veno-arterial extracorporeal membrane oxygenation for severe fever with thrombocytopenia syndrome with fulminant myocarditis: a case report
Authors: Kim Uh. Jin , Park Hyukjin , Kim Kye Hun , Kim Dong Min , Kim Seung Eun , Kang Seung Ji , Park Kyung-Hwa , In Jung Sook
Published: August 2021

Background

The clinical spectrum of severe fever with thrombocytopenia syndrome (SFTS) is wide, which can range from fever to multiple organ failure. Conservative therapy plays a key role in the treatment of SFTS. However, severe cases of SFTS, such as fulminant myocarditis, may require mechanical hemodynamic support.

Case presentation

This report presents a case of a 59-year old woman diagnosed with SFTS by reverse-transcription polymerase chain reaction. The patient had no initial symptoms of cardiac involvement and rapidly developed hemodynamic instability 3 days after hospitalization. She suffered from chest pain and had elevated cardiac enzymes. In the absence of atrio-ventricular conduction abnormalities, left ventricular dysfunction, and coronary artery abnormalities by coronary angiography, she was diagnosed with fulminant myocarditis. At that time, her pulse rate nearly dropped to 0 bpm and she developed near complete akinesia of the heart despite vasopressor administration. Veno-arterial extracorporeal membrane oxygenation (ECMO) was initiated with other supportive measures and she fully recovered after 21 days.

Conclusions

This case indicates that SFTS can cause fulminant myocarditis even without evidence of cardiac involvement at presentation. When symptoms and/or signs of acute heart failure develop in patients with SFTS, myocarditis should be suspected and the patient should be promptly evaluated. Additionally, mechanical hemodynamic support like ECMO can be a lifesaving tool in the treatment of fulminant myocarditis.
The potential role of T2*-weighted multi-echo data image combination as an imaging marker for intraplaque hemorrhage in carotid plaque imaging
Authors: Truong My , Håkansson Claes , HaileMichael Makda , Svensson Jonas , Lätt Jimmy , Markenroth Bloch Karin , Siemund Roger , Gonçalves Isabel , Wassélius Johan
Published: August 2021

Background

Carotid atherosclerotic plaques with intraplaque hemorrhage (IPH) are associated with elevated stroke risk. IPH is predominantly imaged based on paramagnetic properties of the upstream hemoglobin degradation product methemoglobin. This is an explorative observational study to test the feasibility of a spoiled gradient echo based T2* weighted MRI sequence (3D MEDIC) for carotid plaque imaging, and to compare signs suggestive of the downstream degradation product hemosiderin on 3D MEDIC with signs of methemoglobin on a T1wBB sequence.

Methods

Patients with recent TIA or stroke were selected based on the presence on non-calcified plaque components on CTA to promote an enriched prevalence of IPH in the material. Patients (n = 42) underwent 3T MRI with 3D MEDIC and 2D turbo spin echo T1w black blood (T1wBB). Images were independently evaluated by two neuroradiologists and Cohens Kappa was used for inter-reader agreement for each sequence.

Results

The technical feasibility for 3D MEDIC, was 34/42 patients (81%). Non-calcified plaque components with susceptibility effect without simultaneous T1-shortening—a combination suggestive of hemosiderin, was seen in 13/34 of the plaques. An equally large group display elevated T1w signal in combination with signal loss on 3D MEDIC, a combination suggestive of both hemosiderin and methemoglobin. Cohen’s kappa for inter-reader agreement was 0.64 (CI 0.345–0.925) for 3D MEDIC and 0.94 (CI 0.81–1.00) for T1wBB.

Conclusions

3D MEDIC shows signal loss, without elevated T1w signal on T1wBB, in non-calcified tissue in many plaques in this group of patients. If further studies, including histological verification, confirm that the 3D MEDIC susceptibility effect is indeed caused by hemosiderin, 3D MEDIC could aid in the detection of IPH, beyond elevation of T1w signal.
The relationship between ambient temperature and fasting plasma glucose, temperature-adjusted type 2 diabetes prevalence and control rate: a series of cross-sectional studies in Guangdong Province, China
Authors: Luo Jiali , He Guanhao , Xu Yanjun , Chen Zihui , Xu Xiaojun , Peng Jiewen , Chen Shaowei , Hu Jianxiong , Ji Guiyuan , Liu Tao , Zeng Weilin , Li Xing , Xiao Jianpeng , Guo Lingchuan , He Qun , Ma Wenjun
Published: August 2021

Background

There existed evidence that type 2 diabetes mellitus (T2DM) prevalence and control rate have seasonal variation. Our study aimed to examine the ambient temperature and fasting plasma glucose (FPG) association and estimate temperature-adjusted T2DM prevalence and control rate.

Methods

Four cross-sectional health surveys with 26,350 respondents were conducted in Guangdong Province from 2007 to 2015. Multistage cluster sampling was used to recruit study participants. The data of demographic characteristics, lifestyle factors, diet and use of hypoglycemic medicine, height, weight, FPG and meteorological information were collected. And an inverse distance-weighted method was employed to estimate daily temperature exposures at the individual’ s residential district/county. Base on World Health Organization 2006 criteria, participants were divided into normal fasting glucose (NFG) participants (n = 23,877), known T2DM patients (n = 916) and newly detected T2DM patients (n = 1557). Generalized additive mixed model was employed to evaluate the nonlinear associations between temperature and FPG among different T2DM subgroups. The T2DM prevalence and control rate were estimated based on temperature-FPG association.

Results

The curves of temperature and FPG were downward parabola for total, NFG and known T2DM groups, while it was “U”-shaped for newly detected T2DM patients. When temperature decreased from 30 °C to 4 °C, the FPG significantly increased 0.24 (95%CI: 0.15, 0.33) mmol/L, 0.10 (95%CI: 0.06, 0.14) mmol/L and 1.34 (95%CI: 0.56, 2.12) mmol/L in total, NFG and known T2DM groups, respectively. Compared to 19 °C, newly detected T2DM patients’ FPGs were increased 0.73 (95%CI: 0.13, 1.30) mmol/L at 4 °C and 0.53 (0.00, 1.07) mmol/L at 30 °C. The model-estimated temperature-adjusted T2DM prevalence had a down and up trend, with 9.7% at 5 °C, 8.9% at 20 °C and 9.4% at 30 °C, respectively. At 5, 10, 15, 20, 25 and 30 °C, the model-estimated temperature-adjusted T2DM control rates were 33.2, 35.4, 38.2, 43.6, 49.1 and 55.2%.

Conclusion

Temperature was negatively associated with FPG for NFG and known T2DM subgroups, while their association was U-shape for newly detected T2DM patients. Hence, the temperature-adjusted T2DM prevalence show a dip/peak pattern and T2DM control rate display a rising trend when temperature increase. Our findings suggest temperature should be considered in T2DM clinic management and epidemiological survey.