bluuebunny/crossref_metadata_2025 huggingface dataset:
Green Synthesis of Silver Nanoparticles (AgNPs), Structural Characterization, and their Antibacterial Potential
Authors: Asif Muhammad , Yasmin Riffat , Asif Rizwan , Ambreen Ana , Mustafa Madiha , Umbreen Shehla
Published: April 2022

Background

In the field of nanotechnology, the metallic nanoparticles are of remarkable interest because of their unique electronic, magnetic, chemical, and mechanical properties.

Purpose:

In the present work, silver nanoparticles (AgNPs) were synthesized using bio-reduction method.

Research Design:

Silver nitrate was used as metallic precursor and the extract of Moringa oleifera leaves with different concentrations was used as reducing as well capping agent. The extract exhibited strong potential in rapid reduction of silver ions for the synthesis of silver nanoparticles. The synthesized silver nanoparticles were characterized by UV-visible spectroscopy, X-ray diffraction (XRD), and scanning electron microscopy (SEM) techniques.

Results:

The absorption SPR peaks appeared in the range of 415 to 439 nm. SEM analysis exhibited that particles were spherical in shape with size distribution range from 10 nm to 25 nm. The synthesized silver nanoparticles were pure crystalline in nature as confirmed by the XRD spectra with average crystallite size 7 nm. In vitro antibacterial activity of the prepared silver nanoparticles colloidal samples as well the extract was studied using different concentrations of AgNPs (C1 = 100 μg/ml, C2 = 50 μg/ml, C3 = 25 μg/ml) by well diffusion method against Gram negative Escherichia coli. The antibacterial performance was assessed by measuring the zone of inhibition (ZOI).

Conclusions

The results suggested that AgNPs prepared by green approach can be considered as an alternative antibacterial agent.
Association of neutrophil-to-lymphocyte ratio with thirty-day mortality in acute peripheral arterial ischemia
Authors: Topcu Hatice , El Kılıc Helin
Published: April 2022

Background

Acute peripheral arterial ischemia (APAI) is an acute ischemic condition that develops as a result of embolism or thrombosis, and its morbidity and mortality are still high today. The objective of this study is to determine the effect of preoperative Neutrophil-to-Lymphocyte ratio (NLR) on mortality in patients admitted with the diagnosis of APAI.

Methods

178 patients who were diagnosed with acute peripheral arterial occlusion and underwent emergency embolectomy were evaluated retrospectively over a 7-year period. Patient demographics, clinical history, risk factors, comorbidity, and hemogram sub-parameters were documented. The endpoint of the patients was determined as death.

Results

A total of 178 patients were identified with a mean age 74.29±14.71 (range 28–111) years; among them, 105 (59%) were female. 18% patients (32/178) died within 30 days. Lower extremity involvement was present in 124 (69.7%) of the patients. A statistically significant difference was found between the mortality rates and blood parameters of the patients included in the study in terms of white blood count C-reactive protein (CRP), and age among those with normal distribution. Neutrophil, NLR, procalcitonin, lactate, aspartate aminotransferase, and urea; It was statistically significant in terms of mortality in our patients with APAI. NLR values of the deceased were determined as 7.98 ± 6.85.

Conclusions

APAI patients with high NLRs had significantly higher risks of 30-day mortality. The NLR can be used as a prognostic marker in these patients and warrants further investigation.
Ethical research landscapes in fragile and conflict-affected contexts: understanding the challenges
Authors: Shanks Kelsey , Paulson Julia
Published: April 2022

As the prevalence of conflict and fragility continue to rise around the world, research is increasingly heralded as a solution. However, current ethical guidelines for working in areas suffering from institutional and social fragility, insecurity or violent conflict have been heavily critiqued as highly abstract; focussed only on data collection; detached from the realities of academia in the Global South; and potentially extractive. This article seeks to respond to that assessment by spotlighting some of the most prevalent challenges researchers face in the pursuit of ethical working practices. It explores the material and epistemic injustices that often shape and underpin research structures and relationships in these contexts. The paper draws on the authors’ experiences of research in conflict-affected and fragile contexts over the last fifteen years and on workshop discussions with researchers based in fragile and conflict-affected contexts conducted in Amman, Bogotá and Dhaka in 2019-2020. The paper works from the premise that achieving ethical research in fragile spaces is not dependent solely on activity at the site of research, but also on decisions made across the entire ecosystem of a research project. It therefore interrogates the full research landscape, from funding models, to research design (including research topics, partnerships, methods, participant selection, and researcher positionality), to dissemination plans and ethical gatekeeping. The paper critically reflects on inequities in the processes of knowledge production about conflict and fragility and the key ethical challenges that researchers encounter. It highlights the need for further guidance, support and accountability to ensure ethical research practices.
The xanthate route to six-membered carbocycles
Authors: Zard Samir Z
Published: April 2022

Convergent routes to various six-membered carbocyclic architectures exploiting the unique radical chemistry of xanthates are described in this brief review. Three approaches are discussed. The first is the modification of existing cyclohexane building blocks, namely, cyclohexanones, cyclohexenones and cyclohexenes. The second deals with the construction of six-membered carbocycles by associating the chemistry of xanthates with classical ionic reactions, especially the Robinson annulation, the Michael addition and the Horner–Wadsworth–Emmons condensation. Finally, the third route is the formation of six-membered rings by direct six- exo and, but more rarely, six- endo cyclisation modes. Many of the complex structures presented herein would be tedious to obtain by more traditional methods.
Parental acceptability of pediatric forearm manipulations in a UK district hospital emergency department
Authors: Koris J , Deo S
Published: April 2022

Purpose:

Pediatric forearm fractures are a common presentation to Accident and Emergency departments. Standard treatment for the majority of these is manipulation under sedation within the department, followed by cast application. Concerns have been raised about the acceptability of such interventions, and reluctance to perform these procedures has led to increased admissions and manipulations performed under general anesthetic.

Methods:

A prospective case series of all pediatric patients with forearm fractures who underwent a manipulation under sedation in the Accident and Emergency department was collected over 12 months. All parents were invited to complete an acceptability questionnaire, adapted from the Swedish Pyramid Questionnaire for Treatment, based on their experiences.

Results:

A total of 77 patients were included and their parents were asked to complete a Swedish Pyramid Questionnaire of Treatment. Forty-four parents (55%) agreed to fill out the questionnaire. Patient demographics and fracture characteristics were compared between the group that responded and those that did not, with no significant differences. Average level of satisfaction was 9.4/10 (range = 7–10). 98% of respondents were satisfied with the level of analgesia provided, but only 86% with the timeliness of administration.

Conclusion:

This parent-focused evaluation of treatment confirms high levels of parental satisfaction with the management of pediatric forearm fractures in Accident and Emergency, with regard to care, analgesia, and information. It provides insights about parental concern relating to the injury and their anxiety as information useful to further improving care, a template for assessing quality improvement and should be considered as part of further studies in this field.

Level of evidence:

Level IV case series.
Assessment of foot alignment and function for ambulatory children with cerebral palsy: Results of a modified Delphi technique consensus study
Authors: Davids Jon R , Shilt Jeff , Kay Robert , Dreher Thomas , Shore Benjamin J , McCarthy James , Shrader Wade , Graham Kerr , Veerkamp Matthew , Narayanan Unni , Chambers Hank , Novacheck Tom , Rhodes Jason , Van Campenhout Anja , Pierz Kristan , Theologis Tim , Rutz Erich
Published: April 2022

Purpose:

The purpose of this study was to establish consensus for the assessment of foot alignment and function in ambulatory children with cerebral palsy, using expert surgeon’s opinion through a modified Delphi technique.

Methods:

The panel used a five-level Likert-type scale to record agreement or disagreement with 33 statements regarding the assessment of foot alignment and function. Consensus was defined as at least 80% of responses being in the highest or lowest of two of the five Likert-type ratings. General agreement was defined as 60%–79% falling into the highest or lowest two ratings. There was no agreement if neither threshold was reached.

Results:

Consensus was achieved for 25 (76%) statements, general agreement for 4 (12%) statements, and lack of consensus for 4 (12%) of the statements. There was consensus that the functional anatomy of the foot is best understood by dividing the foot into three segments and two columns. Consensus was achieved concerning descriptors of foot segmental alignment for both static and dynamic assessment. There was consensus that radiographs of the foot should be weight-bearing. There was general agreement that foot deformity in children with cerebral palsy can be classified into three levels based on soft tissue imbalance and skeletal malalignment.

Conclusion:

The practices identified in this study can be used to establish best care guidelines, and the format used will be a template for future Delphi technique studies on clinical decision-making for the management of specific foot segmental malalignment patterns commonly seen in children with cerebral palsy.

Level of Evidence:

V
Testing a new method of osteosynthesis of forearm fractures in children; a prospective randomized controlled longitudinal study
Authors: Gyllenborg Lærke , Karbo Ture , Wong Christian
Published: April 2022

Purpose:

Displaced children’s forearms fractures are commonly treated surgically with Kirschner Wires or Elastic Stable Intramedullary Nails. The osteosynthesis system “Minimally Invasive Reduction and Osteosynthesis System” might be beneficial in the treatment of these fractures due to being minimally invasive while achieving fracture stability. In this exploratory prospective randomized controlled longitudinal study, we compared Minimally Invasive Reduction and Osteosynthesis System to Kirschner Wires and Elastic Stable Intramedullary Nails osteosynthesis.

Methods:

Twenty children were included consecutively to treatment with either conventional surgery (5 Kirschner Wires/5 Elastic Stable Intramedullary Nails) or Minimally Invasive Reduction and Osteosynthesis System (10). Evaluation of radiographic alignment and clinically of range of motion, pain status, grip strength, level of physical activity and scar size were compared after 3 months and after 5 years.

Results:

Surgical parameters of the duration of insertion- and removal-surgery, the need for postoperative casting and scar size were significantly better for Minimally Invasive Reduction and Osteosynthesis System. All osteosynthesis systems maintained radiographically fracture alignment at three months and 5 years follow-up. Clinical status regarding pain, grip strength difference, and return to recreational activities were not significantly different. The complication rates were nonsignificant, but MIROS had moderate severe complications of refractures, while mild complications occurred when operated on with Kirschner Wires/Elastic Stable Intramedullary Nails. Our study was sufficiently powered at 3 months, but the comparisons are suggestive at 5 years.

Conclusion:

In conclusion, Minimally Invasive Reduction and Osteosynthesis System is not significantly different to other surgical methods in radiological outcomes for forearm fractures in children. Minimally Invasive Reduction and Osteosynthesis System has the clinical benefit of omitting casting after surgery, obtaining reduced scar size, and shorter insertion and removal time without general anesthesia. However, moderately severe complications occurred.

Level of evidence:

Level II—a prospective comparative study
Single-Dose Intra-Cartilage Delivery of Kartogenin Using a Cationic Multi-Arm Avidin Nanocarrier Suppresses Cytokine-Induced Osteoarthritis-Related Catabolism
Authors: He Tengfei , Shaw Irfhan , Vedadghavami Armin , Bajpayee Ambika G.
Published: April 2022

Objective

Kartogenin (KGN) has proven as a both chondrogenic and chondroprotective drug for osteoarthritis (OA) therapy. However, being a small hydrophobic molecule, KGN suffers from rapid joint clearance and inability to penetrate cartilage to reach chondrocytes following intra-articular administration. As such multiple high doses are needed that can lead to off-target effects including stimulation and tissue outgrowth. Here we design charge-based cartilage targeting formulation of KGN by using a multi-arm cationic nano-construct of Avidin (mAv) that can rapidly penetrate into cartilage in high concentrations owing to weak-reversible electrostatic binding interactions with negatively charged aggrecan-glycosaminoglycans (GAGs) and form an extended-release drug depot such that its therapeutic benefit can be reaped in just a single dose.

Design

We synthesized 2 novel formulations, one with a releasable ester linker (mAv-OH-KGN, release half-life ~58 h) that enables sustained KGN release over 2 weeks and another with a non-releasable amide linker (mAv-NH-KGN) that relies on mAv’s ability to be uptaken and endocytosed by chondrocytes for drug delivery. Their effectiveness in suppressing cytokine-induced catabolism was evaluated in vitro using cartilage explant culture model.

Results

A single 100 μM dose of cartilage homing mAv-KGN was significantly more effective in suppressing cytokine-induced GAG loss, cell death, inflammatory response and in rescuing cell metabolism than a single dose of free KGN; multiple doses of free KGN were needed to match this therapeutic response.

Conclusion

mAv mediated delivery of KGN is promising and can facilitate clinical translation of KGN for OA treatment with only a single dose.
Ruptured cerebral aneurysm in isolated type A interrupted aortic arch managed by transradial endovascular route: A case report with literature review
Authors: Ahuja Chirag K , Joshi Manisha , Gupta Sunil K , Khandelwal N
Published: April 2022

Background and Introduction

Interrupted aortic arch (IAA) is a very rare congenital anomaly carrying high neonatal mortality rate if left untreated. Rarer still, is its presentation in teenage or adulthood. This condition has been found to be complicated with cerebral aneurysms, which is a consequence of hemodynamic stress and hypertension secondary to arch interruption. Cerebral aneurysms can further complicate the clinical course and lead to poor clinical outcomes, especially if ruptured.

Clinical Presentation

A 17-year-old female presented with ruptured basilar top aneurysm and was considered for endovascular coiling. Transfemoral access was chosen but the catheter could not be negotiated beyond proximal thoracic aorta. A computed tomographic angiography (CTA) of thorax and abdomen was performed, which showed isolated interruption of aortic arch. Subsequently, transradial route was used for coiling of the aneurysm.

Conclusion

To the best of our knowledge, the index case is one of the only seven cases of IAA with cerebral aneurysm that have been reported till date in medical literature. It also holds the unique distinction of being the first case of IAA with cerebral aneurysm treated by endovascular approach. Our case highlights the importance of transradial access in such pathological conditions.
Multiple recurrences of unknown primary tumor in a meningioma: A case report
Authors: Essibayi Muhammed Amir , Abdallah Anas , Özek Erdinç , Coban Ganime
Published: April 2022

Metastasis of a systemic tumor into a primary brain tumor has been rarely reported in the literature. These metastases could be seen mostly in meningiomas and in less frequently in the other intracranial tumors. Carcinoma of an unknown primary site (CUP) metastasizing into an intracranial meningioma is not a common occasion. According to the best of our knowledge, in this report, we present the first case with multiple recurrent CUP, which metastasized to intracranial meningioma, reported in the literature. The whole body was investigated with FDG PET/CT and biomarkers of the most common carcinomas for primary cancer. However, these tests showed no primary affected region. Despite all adjuvant therapies, the tumor had multiple recurrences. Such cases are still a challenge to offer optimal management.
Intra-procedural cerebral sinus thrombosis during endovascular treatment of idiopathic intracranial hypertension
Authors: Larco Jorge Arturo , Abbasi Mehdi , Kadirvel Ramanathan , Kallmes David F , Savastano Luis E , Brinjikji Waleed
Published: April 2022

Stenting of the intracranial venous sinuses has shown promising results in patients who are refractory to medical treatment of idiopathic intracranial hypertension (IIH). Among the reported complications associated with this procedure, in-stent thrombosis is an unreported one. We present a case of cerebral sinus thrombosis during endovascular treatment of IIH. A 33-year-old man with multiple comorbidities was presented with non-specific vision changes and headaches. Initial workup revealed a diagnosis of idiopathic intracranial hypertension which was treated medically but with no improvement. Therefore, cerebral sinus stenting was pursued. During the procedure, an in-stent thrombus was identified which was retrieved mechanically and was sent for histological and immunohistochemical evaluation. The retrieved thrombus was predominantly composed of RBCs (57.8%) followed by fibrin (30.78%), platelet (6.4%), and WBCs (5.95%), with high expression of CitH3 (neutrophil extra cellular traps specific marker) (10.9%), and CD66 (11.35%).
Prednisone plus IVIg compared with prednisone or IVIg for immune thrombocytopenia in pregnancy: a national retrospective cohort study
Authors: Zhu Xiao-Lu , Feng Ru , Huang Qiu-Sha , Liang Mei-Ying , Jiang Ming , Liu Hui , Liu Yi , Yao Hong-Xia , Zhang Lei , Qian Shen-Xian , Yang Tong-Hua , Zhang Jing-Yu , Shen Xu-Liang , Yang Lin-Hua , Hu Jian-Da , Huang Ren-Wei , Jiang Zhong-Xing , Wang Jing-Wen , Zhang Hong-Yu , Xiao Zhen , Zhan Si-Yan , Liu Hui-Xin , Wang Xing-Lin , Chang Ying-Jun , Wang Yu , Kong Yuan , Xu Lan-Ping , Liu Kai-Yan , Zhang Xiao-Hong , Yin Cheng-Hong , Li Yue-Ying , Wang Qian-Fei , Wang Jian-Liu , Huang Xiao-Jun , Zhang Xiao-Hui
Published: April 2022

Background:

The responses of intravenous immunoglobulin (IVIg) or corticosteroids as the initial treatment on pregnancy with ITP were unsatisfactory. This study aimed to assess the safety and effectiveness of prednisone plus IVIg versus prednisone or IVIg in pregnant patients with immune thrombocytopenia (ITP).

Methods:

Between 1 January 2010 and 31 December 2020, 970 pregnancies diagnosed with ITP at 19 collaborative centers in China were reviewed in this observational study. A total of 513 pregnancies (52.89%) received no intervention. Concerning the remaining pregnancies, 151 (33.04%) pregnancies received an initial treatment of prednisone plus IVIg, 105 (22.98%) pregnancies received IVIg alone, and 172 (37.64%) pregnancies only received prednisone.

Results:

Regarding the maternal response to the initial treatment, no differences were found among the three treatment groups (41.1% for prednisone plus IVIg, 33.1% for prednisone, and 38.1% for IVIg). However, a significant difference was observed in the time to response between the prednisone plus IVIg group (4.39 ± 2.54 days) and prednisone group (7.29 ± 5.01 days; p  < 0.001), and between the IVIg group (6.71 ± 4.85 days) and prednisone group ( p < 0.001). The median prednisone duration in the monotherapy group was 27 days (range, 8–195 days), whereas that in the combination group was 14 days (range, 6–85 days). No significant differences were found among these three treatment groups in neonatal outcomes, particularly concerning the neonatal platelet counts. The time to response in the combination treatment group was shorter than prednisone monotherapy. The duration of prednisone application in combination group was shorter than prednisone monotherapy. The combined therapy showed a lower predelivery platelet transfusion rate than IVIg alone.

Conclusion:

These findings suggest that prednisone plus IVIg may represent a potential combination therapy for pregnant patients with ITP.
The clinical effectiveness and cost effectiveness of clozapine for inpatients with severe borderline personality disorder (CALMED study): a randomised placebo-controlled trial
Authors: Crawford Mike J. , Leeson Verity C. , Evans Rachel , Barrett Barbara , McQuaid Aisling , Cheshire Jack , Sanatinia Rahil , Lamph Gary , Sen Piyal , Anagnostakis Katina , Millard Louise , Qurashi Inti , Larkin Fintan , Husain Nusrat , Moran Paul , Barnes Thomas R.E. , Paton Carol , Hoare Zoe , Picchioni Marco , Gibbon Simon
Published: April 2022

Background:

Data from case series suggest that clozapine may benefit inpatients with borderline personality disorder (BPD), but randomised trials have not been conducted.

Methods:

Multicentre, double-blind, placebo-controlled trial. We aimed to recruit 222 inpatients with severe BPD aged 18 or over, who had failed to respond to other antipsychotic medications. We randomly allocated participants on a 1:1 ratio to receive up to 400 mg of clozapine per day or an inert placebo using a remote web-based randomisation service. The primary outcome was total score on the Zanarini Rating scale for Borderline Personality Disorder (ZAN-BPD) at 6 months. Secondary outcomes included self-harm, aggression, resource use and costs, side effects and adverse events. We used a modified intention to treat analysis (mITT) restricted to those who took one or more dose of trial medication, using a general linear model fitted at 6 months adjusted for baseline score, allocation group and site.

Results:

The study closed early due to poor recruitment and the impact of the COVID-19 pandemic. Of 29 study participants, 24 (83%) were followed up at 6 months, of whom 21 (72%) were included in the mITT analysis. At 6 months, 11 (73%) participants assigned to clozapine and 6 (43%) of those assigned to placebo were still taking trial medication. Adjusted difference in mean total ZAN-BPD score at 6 months was -3.86 (95% Confidence Intervals = -10.04 to 2.32). There were 14 serious adverse events; 6 in the clozapine arm and 8 in the placebo arm of the trial. There was little difference in the cost of care between groups.

Interpretation:

We recruited insufficient participants to test the primary hypothesis. The study findings highlight problems in conducting placebo-controlled trials of clozapine and in using clozapine for people with BPD, outside specialist inpatient mental health units.

Trial registration

ISRCTN18352058. https://doi.org/10.1186/ISRCTN18352058
Upper tract CT urogram for the surveillance of high-risk non-muscle invasive bladder cancer–are we over-screening patients?
Authors: Martin Jennifer K , Fenton Naomi , Carruthers Paul , Warren Katherine S , Ash-Miles Janice , Burden Helena P
Published: April 2022

Objective:

The European Association of Urology (EAU) recommends annual upper tract imaging for high-risk (HR), non-muscle invasive bladder cancer (NMIBC). We evaluated the incidence of upper tract recurrence found during imaging surveillance for HR NMIBC and appraised our imaging strategy and patient radiation exposure.

Subjects/patients (or materials) and methods:

Two hundred and eighty-six patients between 2014 and 2019 with HR NMIBC (G3 tumour or T1 tumour or CIS, as per National Institute for Clinical Excellence (NICE) guidelines), were included in the study. The total number of computed tomography (CT) scans performed, the average radiation dose administered and the incidence rate of upper tract disease for each patient were recorded and analysed using a Microsoft Excel database.

Results:

The incidence rate of upper tract recurrence diagnosed during CT follow-up was 4/286 (1.4%). Three had a successful laparoscopic nephroureterectomy, the fourth was medically unfit for surgery. In total, 2.8% (8/286) were found to have other urological diagnoses. Patients received a CT scan on average every 13 months, with a mean radiation dose of 11.5 mSv.

Conclusion:

This study found that patients with HR NMIBC have a lower risk of upper tract recurrence than previously reported, which might support a guideline change to eliminate unnecessary radiation exposure during follow-up.

Level of evidence:

Not applicable for this multi-centre audit
Vote-by-mail policy and the 2020 presidential election
Authors: McGhee Eric , Paluch Jennifer , Romero Mindy
Published: April 2022

Mail voting became unusually controversial in the 2020 presidential election. Many observers, including former President Trump, believed that more accessible vote by mail would encourage higher turnout at the expense of Republicans. While the literature has tested some of these claims, it has not offered a more comprehensive causal assessment of vote-by-mail policy, nor has any study looked at these questions in the context of the extraordinary 2020 election. We examine the effect of mail ballot access policies both before and during the 2020 pandemic election with county-level data and a variety of methodological approaches. Our results suggest that making it easier to vote by mail—especially mailing every voter a ballot—generally does increase turnout, both before and during the 2020 election. By contrast, the same policies do not have robust partisan effects, and in many models, they tilt the results in a more Republican direction. While some of our findings are sensitive to model specification, the positive turnout effect of mailing every voter a ballot is robust to many alternative approaches. The confirmation of the existing understanding of universally mailed ballots suggests the basic dynamics of the reform are immune to a wide range of disruptive forces.
Socializing Targets of Older Adults’ SNS Use: Social Strain Mediates the Relations Between Older Adults’ SNS Use With Friends and Well-Being Outcomes
Authors: Tng Germaine Yue Qi , Yang Hwajin
Published: April 2022

Studies have yielded mixed findings regarding the relation between older adults’ social networking site (SNS) use and well-being. Drawing on socioemotional selectivity theory, we sought to examine whether older adults’ SNS use with different socializing targets (i.e., family vs friends) would differentially predict global, social, and mental well-being outcomes indexed by life satisfaction, loneliness, and depressive symptoms, respectively. Furthermore, we examined whether social support and social strain would mediate, in parallel, the relations between SNS use and well-being outcomes. We recruited healthy, community-dwelling older adults (ages 60–93 years, N = 69). Using the PROCESS macro, we found that SNS use with friends, but not family, predicted poorer life satisfaction and greater loneliness via increased social strain. However, SNS use with neither friends nor family was linked to depressive symptoms. Furthermore, social support failed to account for the relations between SNS use and well-being indices. These results held when we controlled for a host of covariates—age, gender, education level, income, marital status, and overall physical health. Our findings reconcile disparate findings in the literature by elucidating that older adults’ SNS use with different socializing targets asymmetrically predicts life satisfaction and loneliness via varying degrees of perceived social strain.
Joint Effect of In-Role Behavior and Task-Interdependence on Job Burnout Among Early Career Healthcare Professionals
Authors: Kanwal Sara , Naveed Waliha , Afzal Farman
Published: April 2022

Explicitly, young professionals are at risk of facing the rigorous dilemmas of job burnout through victimization due to poor job performance in a multifaceted environment. Therefore, the present study aims to identify the relationship between innovative behavior, the joint role of in-role behavior and task interdependence, victimization, and job burnout in healthcare organizations. However, a cross-sectional sample of 330 early career healthcare professionals from public and private hospitals operating in Pakistan is included in the analysis which provides evidence for the generalizability of the research findings. Partial least structure equation modeling is implemented to test the proposed model of job burnout. Consequently, study results show a significant level of job burnout through victimization, leading to distress mental health, innovativeness, and job performance of early careers. However, investigation of job burnout has disclosed severe consequences which give meaningful direction for healthcare managers, to strengthen creative capabilities and performance of early careers by implementing useful strategies to reduce job burnout and other factors linked to job burnout.
A Real-Time Bidding Gamification Service of Retailer Digital Transformation
Authors: Kao Chang-Yi , Chueh Hao-En
Published: April 2022

Real-time bidding (RTB), which holds bids for advertisers to choose when and where to display their advertisements with desired budgets, is one way to improve effectiveness. We proposed supply side platform (SSP) and demand side platform (DSP) to integrate supplier side and demand side as solution. The proposed method combines two digital technology service, gamified RTB and mobile location-based analysis (LBA). In order to make target customers make interactions actively with the advertisement contents, the idea of gamification is employed to increase customer participation. By the coupons in the gamifying RTB App, it have increased the coupon usage rate of 16.7% and 11.6% in the restaurant and apparel industries. It is a successfully digital transformation marketing service for retail industries. The gamified RTB plays an important role in making old business circles accept new technologies for the renewal of promotion strategies and help find the business directions in the future.
Hepatitis B–Associated Lupus-Like Glomerulonephritis Successfully Treated With Antiretroviral Drugs and Prednisone: A Case Report and Literature Review
Authors: Roy Sasmit , Gupta Rohan , Adapa Sreedhar , Bose Subhashish , Garcha Amarinder
Published: April 2022

Kidney involvement with hepatitis B virus is varied and mostly limited to nephrotic syndrome with membranous nephropathy and nephritic syndrome with membranous proliferative glomerulonephritis. Lupus nephritis is associated with nephritic or nephrotic range proteinuria with most common finding of sub-endothelial electron-dense deposits and immunological stain demonstrating full-house picture with all immunological marker staining. Our case discusses a young male patient presenting with rapidly worsening renal function along with proteinuria, found to be positive for both hepatitis B core antibody along with hepatitis B surface antibody plus positive anti-neutrophilic antibody but negative anti-double-stranded DNA. Kidney biopsy demonstrated hepatitis B–associated lupus-like glomerulonephritis. He responded successfully with antiretroviral therapy and high-dose prednisone. Patient did not need lupus-specific treatment and recovered with antiretroviral therapy only. Hepatitis B–associated lupus-like glomerulonephritis has rarely been reported and possess a diagnostic and therapeutic challenge to all nephrologists.
Graphene/Polyimide Nanofibrous Mat for High-Efficiency Filtration
Authors: Meng Depeng , Zhang Yihe , Wu Juntao
Published: April 2022

The development of novel nanofibrous filters has received much attention. Nanofibrous nonwoven mats are applicable in air filtration, but their structural characteristics lead to weak mechanical properties. By incorporating graphene with polyimide, we fabricated nanofibrous mats for air filtration. The results indicate that these mats are highly efficient (up to 99.1%) for air filtration and have strength improvement and thermal stability. These mats are expected to be applied for extreme conditions.
Correlation of Postoperative Imaging With MRI and Clinical Outcome After Cartilage Repair of the Ankle: A Systematic Review and Meta-analysis
Authors: Waltenspül Manuel , Zindel Christoph , Altorfer Franziska C. S. , Wirth Stephan , Ackermann Jakob
Published: April 2022

Background:

Magnetic resonance imaging (MRI) is commonly used for evaluation of ankle cartilage repair, yet its association with clinical outcome is controversial. This study analyzes the correlation between MRI and clinical outcome after cartilage repair of the talus including bone marrow stimulation, cell-based techniques, as well as restoration with allo- or autografting.

Methods:

A systematic search was performed in MEDLINE, Embase, and Cochrane Collaboration. Articles were screened for correlation of MRI and clinical outcome. Guidelines of Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) were used. Chi-square test and regression analysis were performed to identify variables that determine correlation between clinical and radiologic outcome.

Results:

Of 2687 articles, a total of 43 studies (total 1212 cases) were included with a mean Coleman score of 57 (range, 33-70). Overall, 93% were case series, and 5% were retrospective and 2% prospective cohort studies. Associations between clinical outcome and ≥1 imaging variable were found in 21 studies (49%). Of 24 studies (56%) using the composite magnetic resonance observation of cartilage repair tissue (MOCART) score, 7 (29%) reported a correlation of the composite score with clinical outcome. Defect fill was associated with clinical outcome in 5 studies (12%), and 5 studies (50%) reported a correlation of T2 mapping and clinical outcome. Advanced age, shorter follow-up, and larger study size were associated with established correlation between clinical and radiographic outcome ( P = .021, P = .028, and P = .033).

Conclusion:

Interpreting MRI in prediction of clinical outcome in ankle cartilage repair remains challenging; however, it seems to hold some value in reflecting clinical outcome in patients with advanced age and/or at a shorter follow-up. Yet, further research is warranted to optimize postoperative MRI protocols and assessments allowing for a more comprehensive repair tissue evaluation, which eventually reflect clinical outcome in patients after cartilage repair of the ankle. Level of Evidence: Level III, systematic review and meta-analysis.
The Hidden Shadow Pandemic of Marital Rape During COVID-19 Pandemic Outbreak: A Critical Role of Women’s March for Awareness of Rape, Consent, and Sexual and Reproductive Rights
Authors: Mukhtar Sonia , Mukhtar Shamim
Published: April 2022

Introduction:

Aurat March–the women’s rights movement has left an indelible imprint on a contradictive ensemble of a revolutionary women’s rights demand in a conventional socializing segment of society. Women’s March is an intersectional, intergenerational and inclusive feminist discourse centrally concerned with the health, education, engagement, advocacy, gender equality, freedom and empowerment. Anecdotal discourse of Aurat March, enacted amidst COVID-19 pandemic, is centrally concerned with achieving space in private and public sphere and equal sexual and reproductive rights in the marriage institution.

Method:

A broad research of literature and online data base related to marital rape using PsycINFO, PsycNet, PubMed, ERIC, EMBASE, Scopus, Google Scholar and Elsevier was undertaken. Manual searches of the specific intimate partner violence journals (e.g., Journal of Interpersonal Violence, Journal of Family Issues) and news articles were also included.

Result:

This analysis provides epistemological and media representation grounds for strategy and intervening analysis on the re-construction of the narrative of semantics of stereotyped gender roles. Further, this paper is embedded in the measure of women’s rights, bodily autonomy, sexual and reproductive rights, differential context of consent between sex and rape within the institution of marriage.
Characterization of metabolic alterations of chronic lymphocytic leukemia in the lymph node microenvironment
Authors: Chen Zhenghao , Simon-Molas Helga , Cretenet Gaspard , Valle-Argos Beatriz , Smith Lindsay D. , Forconi Francesco , Schomakers Bauke V. , van Weeghel Michel , Bryant Dean J. , van Bruggen Jaco A. C. , Peters Fleur S. , Rathmell Jeffrey C. , van der Windt Gerritje J. W. , Kater Arnon P. , Packham Graham , Eldering Eric
Published: April 2022

Altered metabolism is a hallmark of both cell division and cancer. Chronic lymphocytic leukemia (CLL) cells circulate between peripheral blood (PB) and lymph nodes (LNs), where they receive proliferative and prosurvival signals from surrounding cells. However, insight into the metabolism of LN CLL and how this may relate to therapeutic response is lacking. To obtain insight into CLL LN metabolism, we applied a 2-tiered strategy. First, we sampled PB from 8 patients at baseline and after 3-month ibrutinib (IBR) treatment, which forces egress of CLL cells from LNs. Second, we applied in vitro B-cell receptor (BCR) or CD40 stimulation to mimic the LN microenvironment and performed metabolomic and transcriptomic analyses. The combined analyses indicated prominent changes in purine, glucose, and glutamate metabolism occurring in the LNs. CD40 signaling mostly regulated amino acid metabolism, tricarboxylic acid cycle (TCA), and energy production. BCR signaling preferably engaged glucose and glycerol metabolism and several biosynthesis routes. Pathway analyses demonstrated opposite effects of in vitro stimulation vs IBR treatment. In agreement, the metabolic regulator MYC and its target genes were induced after BCR/CD40 stimulation and suppressed by IBR. Next, 13C fluxomics performed on CD40/BCR-stimulated cells confirmed a strong contribution of glutamine as fuel for the TCA cycle, whereas glucose was mainly converted into lactate and ribose-5-phosphate. Finally, inhibition of glutamine import with V9302 attenuated CD40/BCR-induced resistance to venetoclax. Together, these data provide insight into crucial metabolic changes driven by the CLL LN microenvironment. The prominent use of amino acids as fuel for the TCA cycle suggests new therapeutic vulnerabilities.
Two SERPINC1 variants affecting N-glycosylation of Asn224 cause severe thrombophilia not detected by functional assays
Authors: de la Morena-Barrio Maria Eugenia , Suchon Pierre , Jacobsen Eva Marie , Iversen Nina , Miñano Antonia , de la Morena-Barrio Belén , Bravo-Pérez Carlos , Padilla Jose , Cifuentes Rosa , Asenjo Susana , Deleuze Jean François , Trégouët David Alexandre , Lozano Maria Luisa , Vicente Vicente , Sandset Per Morten , Morange Pierre Emmanuel , Corral Javier
Published: April 2022

Antithrombin deficiency, the most severe congenital thrombophilia, might be underestimated, as some pathogenic variants are not detected by routine functional methods. We have identified 2 new SERPINC1 variants, p.Glu227Lys and p.Asn224His, in 4 unrelated thrombophilic patients with early and recurrent thrombosis that had normal antithrombin activity. In one case, the mutation was identified by whole genome sequencing, while in the 3 remaining cases, the mutation was identified by sequencing SERPINC1 based on a single functional positive finding supporting deficiency. The 2 variants shared a common functional defect, an impaired or null N-glycosylation of Asn224 according to a eukaryotic expression model. Carriers had normal anti-FXa or anti-FIIa activities but impaired anti-FVIIa activity and a detectable loss of inhibitory function when incubating the plasma for 1 hour at 41°C. Moreover, the β glycoform of the variants, lacking 2 N-glycans, had reduced secretion, increased heparin affinity, no inhibitory activity, and a potential dominant–negative effect. These results explain the increased thrombin generation observed in carriers. Mutation experiments reflected the role that Lysine residues close to the N-glycosylation sequon have in impairing the efficacy of N-glycosylation. Our study shows new elements involved in the regulation of N-glycosylation, a key posttranslational modification that, according to our results, affects folding, secretion, and function, providing new evidence of the pathogenic consequence of an incorrect N-glycosylation of antithrombin. This study supports that antithrombin deficiency is underestimated and encourages the development of new functional and genetic tests to diagnose this severe thrombophilia.
Thrombocytopenia and splenic platelet-directed immune responses after IV ChAdOx1 nCov-19 administration
Authors: Nicolai Leo , Leunig Alexander , Pekayvaz Kami , Esefeld Max , Anjum Afra , Rath Justina , Riedlinger Eva , Ehreiser Vincent , Mader Magdalena , Eivers Luke , Hoffknecht Marie-Louise , Zhang Zhe , Kugelmann Daniela , Rossaro Dario , Escaig Raphael , Kaiser Rainer , Polewka Vivien , Titova Anna , Petzold Tobias , Spiekermann Karsten , Iannacone Matteo , Thiele Thomas , Greinacher Andreas , Stark Konstantin , Massberg Steffen
Published: April 2022

Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are based on a range of novel platforms, with adenovirus-based approaches (like ChAdOx1 nCov-19) being one of them. Recently, a novel complication of SARS-CoV-2–targeted adenovirus vaccines has emerged: immune thrombocytopenia, either isolated, or accompanied by thrombosis (then termed VITT). This complication is characterized by low platelet counts, and in the case of VITT, also by platelet-activating platelet factor 4 antibodies reminiscent of heparin-induced thrombocytopenia, leading to a prothrombotic state with clot formation at unusual anatomic sites. Here, we detected antiplatelet antibodies targeting platelet glycoprotein receptors in 30% of patients with proven VITT (n = 27) and 42% of patients with isolated thrombocytopenia after ChAdOx1 nCov-19 vaccination (n = 26), indicating broad antiplatelet autoimmunity in these clinical entities. We use in vitro and in vivo models to characterize possible mechanisms of these platelet-targeted autoimmune responses leading to thrombocytopenia. We show that IV but not intramuscular injection of ChAdOx1 nCov-19 triggers platelet-adenovirus aggregate formation and platelet activation in mice. After IV injection, these aggregates are phagocytosed by macrophages in the spleen, and platelet remnants are found in the marginal zone and follicles. This is followed by a pronounced B-cell response with the emergence of circulating antibodies binding to platelets. Our work contributes to the understanding of platelet-associated complications after ChAdOx1 nCov-19 administration and highlights accidental IV injection as a potential mechanism of platelet-targeted autoimmunity. Hence, preventing IV injection when administering adenovirus-based vaccines could be a potential measure against platelet-associated pathologies after vaccination.
Anaplasma phagocytophilum in Marmota himalayana
Authors: Duan Ran , Lv Dongyue , Fan Rong , Fu Guoming , Mu Hui , Xi Jinxiao , Lu Xinmin , Chun Hua , Hua Jun , He Zhaokai , Qin Shuai , Huang Yanyan , Xiao Meng , Yang Jinchuan , Jing Huaiqi , Wang Xin
Published: April 2022

Background

Human granulocytic anaplasmosis is a tick-borne zoonotic disease caused by Anaplasma phagocytophilum. Coinfections with A. phagocytophilum and other tick-borne pathogens are reported frequently, whereas the relationship between A. phagocytophilum and flea-borne Yersnia pestis is rarely concerned.

Results

A. phagocytophilum and Yersnia pestis were discovered within a Marmota himalayana found dead in the environment, as determined by 16S ribosomal rRNA sequencing. Comparative genomic analyses of marmot-derived A. phagocytophilum isolate demonstrated its similarities and a geographic isolation from other global strains. The 16S rRNA gene and GroEL amino acid sequence identity rates between marmot-derived A. phagocytophilum (JAHLEX000000000) and reference strain HZ (CP000235.1) are 99.73% (1490/1494) and 99.82% (549/550), respectively. 16S rRNA and groESL gene screenings show that A. phagocytophilum is widely distributed in marmots; the bacterium was more common in marmots found dead (24.59%, 15/61) than in captured marmots (19.21%, 29/151). We found a higher Y. pestis isolation rate in dead marmots harboring A. phagocytophilum than in those without it (2 = 4.047, p < 0.05). Marmot-derived A. phagocytophilum was able to live in L929 cells and BALB/c mice but did not propagate well.

Conclusions

In this study, A. phagocytophilum was identified for the first time in Marmota himalayana, a predominant Yersinia pestis host. Our results provide initial evidence for M. himalayana being a reservoir for A. phagocytophilum; moreover, we found with the presence of A. phagocytophilum, marmots may be more vulnerable to plague. Humans are at risk for co-infection with both pathogens by exposure to such marmots.
Inter-observer agreement of preoperative cardiopulmonary exercise test interpretation in major abdominal surgery
Authors: Franssen Ruud F. W. , Eversdijk Anne J. J. , Kuikhoven Mayella , Klaase Joost M. , Vogelaar F. Jeroen , Janssen-Heijnen Maryska L. G. , Bongers Bart C.
Published: April 2022

Background

Accurate determination of cardiopulmonary exercise test (CPET) derived parameters is essential to allow for uniform preoperative risk assessment. The objective of this prospective observational study was to evaluate the inter-observer agreement of preoperative CPET-derived variables by comparing a self-preferred approach with a systematic guideline-based approach.

Methods

Twenty-six professionals from multiple centers across the Netherlands interpreted 12 preoperative CPETs of patients scheduled for hepatopancreatobiliary surgery. Outcome parameters of interest were oxygen uptake at the ventilatory anaerobic threshold (V̇O2VAT) and at peak exercise (V̇O2peak), the slope of the relationship between the minute ventilation and carbon dioxide production (V̇E/V̇CO2-slope), and the oxygen uptake efficiency slope (OUES). Inter-observer agreement of the self-preferred approach and the guideline-based approach was quantified by means of the intra-class correlation coefficient.

Results

Across the complete cohort, inter-observer agreement intraclass correlation coefficient (ICC) was 0.76 (95% confidence interval (CI) 0.57–0.93) for V̇O2VAT, 0.98 (95% CI 0.95–0.99) for V̇O2peak, and 0.86 (95% CI 0.75–0.95) for the V̇E/V̇CO2-slope when using the self-preferred approach. By using a systematic guideline-based approach, ICCs were 0.88 (95% CI 0.74–0.97) for V̇O2VAT, 0.99 (95% CI 0.99–1.00) for V̇O2peak, 0.97 (95% CI 0.94–0.99) for the V̇E/V̇CO2-slope, and 0.98 (95% CI 0.96–0.99) for the OUES.

Conclusions

Inter-observer agreement of numerical values of CPET-derived parameters can be improved by using a systematic guideline-based approach. Effort-independent variables such as the V̇E/V̇CO2-slope and the OUES might be useful to further improve uniformity in preoperative risk assessment in addition to, or in case V̇O2VAT and V̇O2peak are not determinable.