bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of clown intervention for pain relief in children: A systematic review and meta‐analysis
Authors: Ding Yiwen , Yin Huiru , Wang Shuo , Meng Qiuyan , Yan Mingli , Zhang Yining , Chen Li
Published: January 2022

Background

Pain is common in children receiving medical procedures, and there is a lack of adequate awareness and management. In addition, children who undergo medical procedures involving pain may also experience stress, crying and prolonged hospitalisation. Clown intervention is a promising nonpharmacological intervention. However, studies on the effectiveness of clown intervention in pain management have reported conflicting findings.

Objective

To evaluate the effectiveness of clown intervention in relieving pain in children, as well as its effects on cortisol levels, crying duration and length of hospital stay.

Design

Systematic review and meta‐analysis of randomised controlled studies.

Data sources

PubMed, Web of Science (SCI), Embase, PsycINFO, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Weipu (VIP), Wanfang Data and SinoMed were systematically searched from inception date to December 31, 2020.

Review methods

Two reviewers independently used the Cochrane risk of bias tool to assess the risk of bias of the included studies. Meta‐analysis was conducted when data were available, otherwise, a narrative description was provided. Data were analysed using Review Manager 5.3. The review process is reported according to PRISMA.

Results

Nine studies including 852 children met the inclusion criteria. The results showed that compared with standard care, clown intervention was beneficial for relieving pain. Further subgroup analysis showed that it was more effective with children aged 2–7 years. The duration of crying after the procedure and the length of stay were shortened, but there was no significant difference in cortisol levels.

Conclusion

Clown intervention may be a promising way to relieve acute pain in children, especially those aged 2–7 years. It also seems to shorten the duration of crying and the length of hospital stays, but the effect on cortisol levels is still uncertain. More high‐quality randomised controlled trials are needed to confirm these results and take into account different age groups, cultural backgrounds and specific populations.
Rural and urban disparities in quality of home health care: A longitudinal cohort study (2014‐2018)
Authors: Ma Chenjuan , Devoti Andrea , O'Connor Melissa
Published: January 2022

Purpose

Home health care is one of the fastest growing health care sectors in the United States. However, little is known of differences in trends in quality performance between rural and urban home health agencies over time. This study aimed to examine disparities in quality performance between rural and urban home health agencies between 2014 and 2018.

Methods

This is a cohort study using 2014‐2018 national Home Health Compare data and Providers of Service Profile data, including 7,908 home health agencies, of which 1,537 were rural agencies. Quality performance measures included timely initiation of care, hospitalization, and emergency department (ED) visits. Two‐level hierarchical regression models were used to identify rural‐urban differences in these quality indicators over time when controlling organizational characteristics.

Findings

Rural agencies were less likely to be for‐profit and accredited, and more likely to be hospital‐based, serve both Medicare and Medicaid beneficiaries, and have hospice programs. Rural agencies consistently outperformed on timely initiation of care over time, and urban agencies consistently outperformed on hospitalization and ED visits over time. These gaps between rural and urban agencies were steady over time except the gap in hospitalization, which slightly narrowed over time (Coef. = 0.11, P = .001 for urban and year interaction term).

Conclusions

Significant differences exist in quality of care between rural and urban home health agencies and such differences have not been significantly narrowed over time. To reduce rural‐urban disparities, policy makers should take into account unique challenges faced by urban and rural agencies when making policy decisions.
Origen’s Theology of Fire and the Early Monks of Egypt
Authors: Stang Charles M.
Published: January 2022

Origen’s Peri archôn includes a description of the soul of Christ as an iron in God’s fire. Christ’s mind, “becoming wholly fire” (et tota ignis effecta) is the origin and the destiny of all minds, all those minds who “cooled” (psychesthai) into souls (psychai) and eventually became angels, humans, and demons. The iron in the fire of God is the defining figure for the divinized mind, an illustration of what all minds were in the beginning and will be again in the end. God’s fire, however, is not only divinizing, but also purifying, and perhaps also punishing. These three aspects are braided together in Origen’s surviving works into a distinctive theology of fire. This essay attempts to explain Origen’s theology of fire, and then to ask what becomes of it. We find evidence of it among the early monks of Egypt, including in Antony the Great. We find further evidence of it in the sayings collections of early Egyptian monasticism—the so‐called Apophthegmata patrum. Throughout the collections, but especially in the Alphabetical collection, we find monks bursting into flames: a worthy disciple of Arsenius sees him “as though he were all fire”; Joseph stretches his hands to heaven and his ten fingers become “like ten lamps of fire” —he enjoins another monk to “become altogether like fire,” insisting that it is a monk’s only proper pursuit. These stories come into sharper relief when we see them against the backdrop of Origen’s theology of fire.
Diversification dynamics of cheilostome bryozoans based on a Bayesian analysis of the fossil record
Authors: Moharrek Farideh , Taylor Paul D. , Silvestro Daniele , Jenkins Helen L. , Gordon Dennis P. , Waeschenbach Andrea
Published: January 2022

Cheilostomata is the most diverse and ecologically dominant order of bryozoans living today. We apply a Bayesian framework to estimate macroevolutionary rates of cheilostomes since the Late Jurassic across four datasets: (I) manually curated genus ranges; (II) published text‐mined genus ranges; (III) non‐revised Paleobiology Database (PBDB) records; (IV) revised and augmented PBDB records. All datasets revealed increased origination rates in the Albian, and a twin K–Pg and Danian extinction rate peak. High origination rates in the Late Selandian–Ypresian in Dataset I indicate the onset of an ascophoran‐grade radiation. Lineage‐through‐time plots confirm the macroevolutionary lag preceding the radiation of cheilostomes in the middle Cretaceous, and their renewed diversification in the late Paleocene and Eocene. A multivariate birth–death model indicates that origination rates are shaped by diversity‐dependent dynamics coupled with a positive correlation with sea surface temperature, while extinction rates negatively correlate with sea level. Text‐mined data provide broadly similar rate dynamics as manually curated data, although discrepancies could be attributed to the omission of key literature in Dataset II, and the inclusion of new published and unpublished data, and revised ranges in Dataset I. Revision and augmentation of PBDB occurrences were necessary to generate rate profiles akin to those of Datasets I and II and highlight the risks of using unedited occurrence data. Our results support the widely held assumption that diversification dynamics are controlled by both biotic and abiotic factors, and pave the way for integrating fossils with molecular phylogenies to study these processes in more detail.
Preferential freezing avoidance localised in anthers and embryo sacs in winteringDaphne kamtschaticavar.jezoensisflower buds visualised by magnetic resonance imaging
Authors: Ishikawa Masaya , Ide Hiroyuki , Tsujii Tetsuya , Stait‐Gardner Timothy , Kubo Hikaru , Matsushita Norihisa , Fukuda Kenji , Price William S. , Arata Yoji
Published: January 2022

To explore diversity in cold hardiness mechanisms, high resolution magnetic resonance imaging (MRI) was used to visualise freezing behaviours in winteringDaphne kamtschaticavar.jezoensisflower buds, which have naked florets and no bud scales. MRI images showed that anthers remained stably supercooled to the range from −14 to −21°C or lower while most other tissues froze by −7°C. Freezing of some anthers detected in MRI images between −14 and −21°C corresponded with numerous low temperature exotherms and also with the ‘all‐or‐nothing’ type of anther injuries. In ovules/pistils, only embryo sacs remained supercooled at −7°C or lower, but slowly dehydrated during further cooling. Cryomicroscopic observation revealed ice formation in the cavities of calyx tubes and pistils but detected no ice in embryo sacs or in anthers. The distribution of ice nucleation activity in floral tissues corroborated the tissue freezing behaviours. Filaments likely work as the ice blocking barrier that prevents ice intrusion from extracellularly frozen calyx tubes to connecting unfrozen anthers. Unique freezing behaviours were demonstrated inDaphneflower buds: preferential freezing avoidance in male and female gametophytes and their surrounding tissues (by stable supercooling in anthers and by supercooling with slow dehydration in embryo sacs) while the remaining tissues tolerate extracellular freezing.
Cardiac allograft vasculopathy: A review
Authors: Laks Jessica A. , Dipchand Anne I.
Published: January 2022

Background

Heart transplantation has become the standard of care for pediatric patients with end‐stage heart disease, and outcomes have consistently improved over the last few decades. CAV, however, remains a leading cause of morbidity and mortality in heart transplantation and is the leading cause of death beyond 3 years post‐transplantation. We sought out to provide an in‐depth overview of CAV in the pediatric heart transplant population.

Methods

Database searches were conducted in both Medline and Embase on the topic of cardiac vasculopathy in pediatric heart transplant recipients. The search used five broad concept terms: heart transplant; pediatric; CAV; diagnosis, prognosis, and risk factors; and guidelines and reviews. References were captured if there was at least one term in each of the concepts. The search was limited to articles in the English language.

Results

A total of 148 articles were identified via the literature search with further articles identified via review of references. Pediatric data regarding the etiology and development of CAV remain limited although knowledge about the immune and non‐immune factors playing a role are increasing. CAV continues to be difficult to detect with many invasive and non‐invasive methods available, yet their effectiveness in the detection of CAV remains suboptimal. There remains no proven medical intervention to treat or reverse established CAV disease, and CAV is associated with high rates of graft loss once detected. However, several medications are used in hopes of preventing, slowing progression, or modifying the outcomes.

Conclusion

This review provides a comprehensive overview of CAV, discusses its clinical presentation, risk factors, diagnostic tools used to identify CAV in the pediatric population, and highlights the current therapeutic options and the need for ongoing research.
Laparoscopic salpingectomy in Papio hamadryas for birth control in captivity
Authors: Lacitignola Luca , Laricchiuta Pietro , Imperante Annarita , Acquafredda Claudia , Stabile Marzia , Staffieri Francesco
Published: January 2022

Objective

To evaluate the feasibility of laparoscopic salpingectomy in baboons (Papio hamadryas). We hypothesized that laparoscopic salpingectomy could be performed in baboon species within a reasonable amount of surgical time, with minor complications occurring at low rates.

Study design

Case series and technique description.

Animals

Sixteen baboons (n = 16).

Methods

The surgical procedures were performed using the 3‐port technique, with 5 mm instruments and a telescope placed at the umbilical and hypogastric regions. A salpinx dissection was performed, using a radiofrequency bipolar vessel sealing device, from the fimbriae to the uterine attachments. We evaluated the surgical duration, learning curve, and intraoperative and early postoperative complications.

Results

Ten adult and 6 subadult baboons with a mean weight of 9.32 kg, a range of 4‐14.2 kg, and a standard deviation (SD) of 3.09 kg were included in the study. The total duration of surgery was 28.75 min (range, 16‐50 min; SD, 9.60 min). The installation phase was completed in a mean time of 7.68 min (range, 3‐15 min; SD, 3.43 min), and the time to complete the salpingectomy of both salpinges was 9.68 min (range, 4‐20 min; SD, 3.97 min). No complications were observed in the postoperative period.

Conclusion

Laparoscopic salpingectomy in Papio hamadryas was feasible, with an acceptable surgical time, low invasiveness, and only minor technical perioperative complications.

Clinical significance

Laparoscopic salpingectomy could be a viable and safe therapeutic option in nonhuman primate birth‐control programs.
Commentary and Opinions: The Utilization of Social Media by Medical Residency Programs During COVID-19 Pandemic and Beyond
Authors: Malekafzali Leilynaz , Liu Chaocheng
Published: January 2022

As a result of COVID-19 pandemic, medical training has been greatly impacted globally. In Canada, out-of-province visiting clinical electives were cancelled. In addition, the Canadian Resident Matching Service (CaRMS) interviews were transitioned to being virtual since 2020. As residency programs are exploring new ways to overcome the challenges of elective cancellation, there has been a surge of residency program social media accounts on Instagram, Twitter, and Facebook. Social media serves as a platform for residency programs to promote themselves in addition to posting interactive educational materials. Moreover, social media residency accounts provide a platform for medical students to learn about the programs and network virtually with fellow applicants, residents, program directors, and faculty members. Overall, social media is becoming a popular and valuable tool for residency programs to connect with the applicants during COVID-19 pandemic and beyond. Among the different social media platforms, Instagram seems to be more appealing to both residency programs and the graduating medical students. We report our observations regarding selected Canadian residency program Instagram accounts. To maximize the success of using social media, it is important for the residency programs to consider the attitudes of applicants towards the residency social media accounts. Future studies are needed to assess the effectiveness of the Canadian residency program social media accounts for the final year students applying for these programs.
Reexamination of 2.5-Ga “whiff” of oxygen interval points to anoxic ocean before GOE
Authors: Slotznick Sarah P. , Johnson Jena E. , Rasmussen Birger , Raub Timothy D. , Webb Samuel M. , Zi Jian-Wei , Kirschvink Joseph L. , Fischer Woodward W.
Published: January 2022

New microscale observations show chemical signals for transient oxygen at 2.5 billion years ago formed after deposition.
Chemically induced protein cage assembly with programmable opening and cargo release
Authors: Stupka Izabela , Azuma Yusuke , Biela Artur P. , Imamura Motonori , Scheuring Simon , Pyza Elżbieta , Woźnicka Olga , Maskell Daniel P. , Heddle Jonathan G.
Published: January 2022

An artificial protein cage can be programmed to disassemble on demand.
Second Messenger c-di-GMP Modulates Exopolysaccharide Pea-Dependent Phenotypes via Regulation of
eppA
Expression in Pseudomonas putida
Authors: Xiao Yujie , Liang Qingyuan , He Meina , Wu Nianqi , Nie Liang , Chen Wenli , Huang Qiaoyun
Published: January 2022

Microbe-secreted EPSs are high-molecular-weight polysaccharides that have the potential to be used as industrially important biomaterials. The EPS Pea in
P. putida
is essential for wrinkly colony morphology and pellicle formation.
Inherent Heterogeneity of Influenza A Virus Stability following Aerosolization
Authors: Belser Jessica A. , Pulit-Penaloza Joanna A. , Brock Nicole , Creager Hannah M. , Gustin Kortney M. , Tumpey Terrence M. , Maines Taronna R.
Published: January 2022

Transmission of respiratory pathogens through the air can facilitate the rapid and expansive spread of infection and disease through a susceptible population. While seasonal influenza viruses are quite capable of airborne spread, there is a lack of knowledge regarding how well influenza viruses remain viable after aerosolization and whether influenza viruses capable of jumping species barriers to cause human infection differ in this property from seasonal strains.
The
cis
-2-Dodecenoic Acid (BDSF) Quorum Sensing System in Burkholderia cenocepacia
Authors: Wang Mingfang , Li Xia , Song Shihao , Cui Chaoyu , Zhang Lian-Hui , Deng Yinyue
Published: January 2022

It has been demonstrated that quorum sensing (QS) is widely employed by bacterial cells to coordinately regulate various group behaviors. Diffusible signal factor (DSF)-type signals have emerged as a growing family of conserved cell-cell communication signals.
The Complete Genome of
Chelonus insularis
Reveals Dynamic Arrangement of Genome Components in Parasitoid Wasps That Produce Bracoviruses
Authors: Mao Meng , Strand Michael R. , Burke Gaelen R.
Published: January 2022

Bracoviruses are a remarkable example of virus endogenization, because large sets of genes from a nudivirus ancestor continue to produce virions that thousands of wasp species rely upon to parasitize hosts. Understanding how these genes interact and have been coopted by wasps for novel functions is of broad interest in the study of virus evolution.
Virus-Like Particles Containing the E2 Core Domain of Hepatitis C Virus Generate Broadly Neutralizing Antibodies in Guinea Pigs
Authors: McGregor Joey , Hardy Joshua M. , Lay Chan-Sien , Boo Irene , Piontek Michael , Suckow Manfred , Coulibaly Fasséli , Poumbourios Pantelis , Center Rob J. , Drummer Heidi E.
Published: January 2022

There is currently no vaccine to prevent hepatitis C virus infection, which affects more than 71 million people globally and is a leading cause of progressive liver disease, including cirrhosis and cancer. Broadly neutralizing antibodies that recognize the E2 envelope glycoprotein can protect against heterologous viral infection and correlate with viral clearance in humans.
Vaccine-Associated Enhanced Respiratory Disease following Influenza Virus Infection in Ferrets Recapitulates the Model in Pigs
Authors: Kimble J. Brian , Wymore Brand Meghan , Kaplan Bryan S. , Gauger Phillip , Coyle Elizabeth M. , Chilcote Katarina , Khurana Surender , Vincent Amy L.
Published: January 2022

We demonstrated the susceptibility of ferrets, a laboratory model species for human influenza A virus research, to vaccine-associated enhanced respiratory disease (VAERD) using an experimental model previously demonstrated in pigs. Ferrets developed clinical characteristics of VAERD very similar to that in pigs.
Clostridioides difficile Phosphoproteomics Shows an Expansion of Phosphorylated Proteins in Stationary Growth Phase
Authors: Smits Wiep Klaas , Mohammed Yassene , de Ru Arnoud H. , Cordo' Valentina , Friggen Annemieke H. , van Veelen Peter A. , Hensbergen Paul J.
Published: January 2022

In this paper, we present a comprehensive analysis of protein phosphorylation in the Gram-positive enteropathogen
Clostridioides difficile
. To date, only limited evidence on the role of phosphorylation in the regulation of this organism has been published; the current study is expected to form the basis for research on this posttranslational modification in
C. difficile
.
Developing an Amplification Refractory Mutation System-Quantitative Reverse Transcription-PCR Assay for Rapid and Sensitive Screening of SARS-CoV-2 Variants of Concern
Authors: Xiong Dongyan , Zhang Xiaoxu , Shi Mengjuan , Wang Nuo , He Ping , Dong Zhuo , Zhong Jie , Luo Jing , Wang Yong , Yu Junping , Wei Hongping
Published: January 2022

The current stage of the pandemic, led by SARS-CoV-2 variants of concern (VOCs), underscores the necessity to develop a cost-effective and rapid molecular diagnosis assay to differentiate the VOCs. In this study, over 1 million SARS-CoV-2 genomic sequences of high quality from GISAID were analyzed and a network of the common mutations of the lineages was constructed.
Destabilization of the Bacterial Interactome Identifies Nutrient Restriction-Induced Dysbiosis in Insect Guts
Authors: Marasco Ramona , Fusi Marco , Callegari Matteo , Jucker Costanza , Mapelli Francesca , Borin Sara , Savoldelli Sara , Daffonchio Daniele , Crotti Elena
Published: January 2022

Changes in diet play a role in reshaping the gut microbiome in animals, inducing dysbiotic configurations of the associated microbiome. Although studies have reported on the effects of specific nutrient contents on the diet, studies regarding the conditions altering the microbiome configurations and networking in response to diet changes are limited.
The Dark Side of Microbial Processes: Accumulation of Nitrate During Storage of Surface Water in the Dark and the Underlying Mechanism
Authors: Kumar Amit , Ng Daphne H. P. , Bairoliya Sakcham , Cao Bin
Published: January 2022

Microbial communities play an essential role in maintaining a healthy aquatic ecosystem. For example, in surface water reservoirs, microorganisms produce oxygen, break down toxic contaminants, and remove excess nitrogen.
Metatranscriptome Profiling of a Specialized Microbial Consortium during the Degradation of Nixtamalized Maize Pericarp
Authors: Serrano-Gamboa José Germán , Fócil-Espinosa Carlos Abraham , Cabello-Yeves Pedro J. , Coutinho Felipe H. , Rojas-Herrera Rafael Antonio , Sánchez-González Mónica Noel
Published: January 2022

Nixtamalized maize pericarp is an abundant residue of the tortilla industry. Consortium PM-06 efficiently degraded this substrate in 192 h.
Correlates of cardiorespiratory fitness among overweight or obese individuals with type 2 diabetes
Authors: Kaze Arnaud D , Agoons Dayawa Da , Santhanam Prasanna , Erqou Sebhat , Ahima Rexford S , Echouffo-Tcheugui Justin B
Published: January 2022

Introduction

Mechanistic studies suggest that type 2 diabetes is independently associated with low cardiorespiratory fitness (CRF). Little is known about the CRF profile in type 2 diabetes; we assessed the correlates of low CRF among overweight/obese adults with type 2 diabetes.

Research design and methods

A total of 4215 participants with type 2 diabetes and without cardiovascular disease underwent maximal exercise testing in the Look AHEAD (Action for Health in Diabetes) study. Low CRF was defined based on the Aerobics Center Longitudinal Study reference standards. Calorie intake and physical activity were assessed using questionnaires. Body fat composition was assessed using dual-energy X-ray absorptiometry.

Results

Waist circumference, systolic blood pressure, glycemic measures, whole body fat, caloric intake, and fat-free mass were inversely associated with fitness across sex (all p<0.001). Comparing with moderate or high CRF groups, the low CRF group was associated with higher adjusted odds of obesity (OR 3.19 (95% CI 1.95 to 5.20) in men, 3.86 (95% CI 2.55 to 5.84)) in women), abdominal obesity (OR 3.99 (95% CI 2.00 to 7.96) in men, 2.28 (95% CI 1.08 to 4.79) in women), hypertension (OR 1.74 (95% CI 1.09 to 2.77) in men, 1.44 (95% CI 1.02 to 2.05) in women), metabolic syndrome (OR 5.52 (95% CI 2.51 to 12.14) in men, 2.25 (95% CI 1.35 to 3.76) in women), use of beta-blocker (1.22 (95% CI 0.86 to 1.73) in men, 1.33 (95% CI 1.03 to 1.73) in women), and ACE inhibitor/angiotensin-receptor blocker (1.86 (95% CI 1.39 to 2.50) in men, 1.07 (95% CI 0.86 to 1.32) in women). Women with low CRF had higher odds of current smoking (2.02 (95% CI 1.25 to 3.28)).

Conclusions

Low CRF was associated with increased odds of cardiometabolic correlates in a large cohort of adults with type 2 diabetes.
Effect of maternal height on the risk of caesarean section in singleton births: evidence from a large-scale survey in India
Authors: Marbaniang Strong P , Lhungdim Hemkhothang , Chaurasia Himanshu
Published: January 2022

Objective

This study examines the association of maternal height with caesarean section (CS) in India. It is hypothesised that maternal height has no significant effect on the risk of undergoing caesarean section.

Design

A cross-sectional study based on a nationally representative large-scale survey data (National Family Health Survey-4), conducted in 2015–2016.

Setting and participants

Analysis is based on 125 936 women age 15–49 years, having singleton live births. Logistic regression has been performed to determine the contribution of maternal height to the ORs of CS birth, adjusting for other exposures. Restricted cubic spline was used as a smooth function to model the non-linear relationship between height and CS. Height data were decomposed using the restricted cubic spline with five knots located at the 5th, 27.5th, 50th, 72.5th and 95th, percentiles.

Primary and secondary outcome measures

The main outcome variable of interest in the study is CS. Maternal height is the key explanatory variable. Other explanatory variables are age, parity, sex of child, birth weight, wealth index, place of residence, place of child delivery and household health insurance status.

Results

The results reveal that the odds of undergoing CS significantly decrease with increase in maternal heights. Mothers with a height of 120 cm (adjusted OR (AOR): 5.08; 95% CI 3.83 to 6.74) were five times more likely, while mothers with height of 180 cm were 23% less likely (AOR: 0.77; 95% CI 0.62 to 0.95) to undergo CS as compared with mothers with height of 150 cm.

Conclusions

Shorter maternal height is linked to a higher risk of CS. Our findings could be used to argue for policies that target stunting in infant girls and avoid unnecessary CS, as there is potential effect on growth during adolescence and early adulthood, with the goal to increase their adult heights, thereby lowering their risk of CS and adverse delivery outcomes.
Does performance at the intercollegiate Membership of the Royal Colleges of Surgeons (MRCS) examination vary according to UK medical school and course type? A retrospective cohort study
Authors: Ellis Ricky , Brennan Peter A , Scrimgeour Duncan S G , Lee Amanda J , Cleland Jennifer
Published: January 2022

Objectives

The knowledge, skills and behaviours required of new UK medical graduates are the same but how these are achieved differs given medical schools vary in their mission, curricula and pedagogy. Medical school differences seem to influence performance on postgraduate assessments. To date, the relationship between medical schools, course types and performance at the Membership of the Royal Colleges of Surgeons examination (MRCS) has not been investigated. Understanding this relationship is vital to achieving alignment across undergraduate and postgraduate training, learning and assessment values.

Design and participants

A retrospective longitudinal cohort study of UK medical graduates who attempted MRCS Part A (n=9730) and MRCS Part B (n=4645) between 2007 and 2017, using individual-level linked sociodemographic and prior academic attainment data from the UK Medical Education Database.

Methods

We studied MRCS performance across all UK medical schools and examined relationships between potential predictors and MRCS performance using χ2analysis. Multivariate logistic regression models identified independent predictors of MRCS success at first attempt.

Results

MRCS pass rates differed significantly between individual medical schools (p<0.001) but not after adjusting for prior A-Level performance. Candidates from courses other than those described as problem-based learning (PBL) were 53% more likely to pass MRCS Part A (OR 1.53 (95% CI 1.25 to 1.87) and 54% more likely to pass Part B (OR 1.54 (1.05 to 2.25)) at first attempt after adjusting for prior academic performance. Attending a Standard-Entry 5-year medicine programme, having no prior degree and attending a Russell Group university were independent predictors of MRCS success in regression models (p<0.05).

Conclusions

There are significant differences in MRCS performance between medical schools. However, this variation is largely due to individual factors such as academic ability, rather than medical school factors. This study also highlights group level attainment differences that warrant further investigation to ensure equity within medical training.
Do consultants do what they say they do? Observational study of the extent to which clinicians involve their patients in the decision-making process
Authors: Driever Ellen M , Stiggelbout Anne M , Brand Paul L P
Published: January 2022

Objectives

To assess whether consultants do what they say they do in reaching decisions with their patients.

Design

Cross-sectional analysis of hospital outpatient encounters, comparing consultants’ self-reported usual decision-making style to their actual observed decision-making behaviour in video-recorded encounters.

Setting

Large secondary care teaching hospital in the Netherlands.

Participants

41 consultants from 18 disciplines and 781 patients.

Primary and secondary outcome measure

With the Control Preference Scale, the self-reported usual decision-making style was assessed (paternalistic, informative or shared decision making). Two independent raters assessed decision-making behaviour for each decision using the Observing Patient Involvement (OPTION)5 instrument ranging from 0 (no shared decision making (SDM)) to 100 (optimal SDM).

Results

Consultants reported their usual decision-making style as informative (n=11), shared (n=16) and paternalistic (n=14). Overall, patient involvement was low, with mean (SD) OPTION5 scores of 16.8 (17.1). In an unadjusted multilevel analysis, the reported usual decision-making style was not related to the OPTION5 score (p>0.156). After adjusting for patient, consultant and consultation characteristics, higher OPTION5 scores were only significantly related to the category of decisions (treatment vs the other categories) and to longer consultation duration (p<0.001).

Conclusions

The limited patient involvement that we observed was not associated with the consultants’ self-reported usual decision-making style. Consultants appear to be unconsciously incompetent in shared decision making. This can hinder the transfer of this crucial communication skill to students and junior doctors.
Live attenuated bacterium limits cancer resistance to CAR-T therapy by remodeling the tumor microenvironment
Authors: Guo Fengguang , Das Jugal K , Kobayashi Koichi S , Qin Qing-Ming , A Ficht Thomas , Alaniz Robert C , Song Jianxun , Figueiredo Paul De
Published: January 2022

The tumor microenvironment (TME) is characterized by the activation of immune checkpoints, which limit the ability of immune cells to attack the growing cancer. To overcome immune suppression in the clinic, antigen-expressing viruses and bacteria have been developed to induce antitumor immunity. However, the safety and targeting specificity are the main concerns of using bacteria in clinical practice as antitumor agents. In our previous studies, we have developed an attenuated bacterial strain (Brucella melitensis 16M ∆vjbR, henceforth Bm∆vjbR) for clinical use, which is safe in all tested animal models and has been removed from the select agent list by the Centers for Disease Control and Prevention. In this study, we demonstrated that Bm∆vjbR homed to tumor tissue and improved the TME in a murine model of solid cancer. In addition, live Bm∆vjbR promoted proinflammatory M1 polarization of tumor macrophages and increased the number and activity of CD8+ T cells in the tumor. In a murine colon adenocarcinoma model, when combined with adoptive transfer of tumor-specific carcinoembryonic antigen chimeric antigen receptor CD8+ T cells, tumor cell growth and proliferation was almost completely abrogated, and host survival was 100%. Taken together, these findings demonstrate that the live attenuated bacterial treatment can defeat cancer resistance to chimeric antigen receptor T-cell therapy by remodeling the TME to promote macrophage and T cell-mediated antitumor immunity.
Dusty trades and associated rheumatoid arthritis in a population-based study in the coal mining counties of Appalachia
Authors: Schmajuk Gabriela , Trupin Laura , Yelin Edward H , Blanc Paul D
Published: January 2022

Objectives

We previously showed increased coal mining-associated risk of rheumatoid arthritis (RA). Using additional survey data, we sought to delineate this risk further.

Methods

We used data from two cross-sectional, random-digit-dial, population-based surveys (males;≥50 years) in selected counties in the Appalachian region of the inland, mid-Atlantic USA with elevated pneumoconiosis mortality. Surveys ascertained age, smoking, coal mining and non-coal silica exposure jobs. In a subset, we surveyed ergonomic exposures, scored by intensity. We queried diagnosis of RA, corticosteroid use, and, in a subset, use of disease modifying antirheumatic drugs (DMARDs). Multivariable logistic regression modelled RA risk (defined by glucocorticoid or DMARDs use) associated with coal mining employment, other silica exposure, smoking status, and age and ergonomic exposures.

Results

We analysed data for 2981 survey respondents (mean age 66.6 years; 15% current, 44% ex-smokers). The prevalence of glucocorticoid-treated and DMARD-treated RA was 11% and 4%, respectively. Glucocorticoid-treated RA was associated with coal mining (OR 3.5; 95% CI 2.5 to 4.9) and non-coal mining silica exposure (OR 3.2; 95% CI 2.4 to 4.4). For DMARD-treated RA, the odds associated with coal mining and other silica remained elevated: OR 2.3 (95% CI 1.18, 4.5) and OR 2.7 (95% CI 1.51, 5.0), respectively. In the same model, the highest intensity ergonomic exposure also was associated with increased odds of RA (OR 4.3; 95% CI 1.96 to 9.6).

Conclusions

We observed a strong association between coal mining and other silica-exposing dusty trades and RA. Clinicians and insurers should consider occupational histories in the aetiology of RA.
Comprehensive Dutch market data analysis shows that e-liquids with nicotine salts have both higher nicotine and flavour concentrations than those with free-base nicotine
Authors: Pennings Jeroen L A , Havermans Anne , Pauwels Charlotte G G M , Krüsemann Erna J Z , Visser Wouter F , Talhout Reinskje
Published: January 2022

Objectives

Recent years have seen an increase in e-liquids containing nicotine salts. Nicotine salts are less harsh and bitter than free-base nicotine and therefore can facilitate inhalation. Because inhalation-facilitating ingredients are banned in the European Union, we assessed the occurrence and characteristics of nicotine salt-containing e-liquids notified for the Netherlands.

Methods

We analysed data for 39 030 products, submitted by manufacturers in the European Union Common Entry Gate system, as extracted on 30 June 2020.

Results

Nicotine salts were present in 13% of e-liquids, especially in pod-related e-liquids (73%) and e-liquids registered from 2018 onwards (over 25%). We found six nicotine salt ingredients (NSIs): nicotine lactate, salicylate, benzoate, levulinate, ditartrate and malate. Nicotine salts also occurred as nicotine–organic acid ingredient combination (NAIC), like nicotine and benzoic acid. Nicotine concentrations were twofold higher in e-liquids with NSI (median 14 mg/mL) and NAIC (11 mg/mL) than for free-base nicotine (6 mg/mL). E-liquids with NSI contained a fourfold higher number (median n=17) and concentration (median 31.0 mg/mL) of flavour ingredients than e-liquids with free-base nicotine (n=4, 7.4 mg/mL). In NAIC-containing e-liquids, these were threefold higher (n=12, 21.5 mg/mL). E-liquids with nicotine salts were less often tobacco flavoured but more often had fruity or sweet flavours.

Conclusions

A substantial and increasing share of e-liquids in the Netherlands contains nicotine salts. Their characteristics can make such e-liquids more addictive and more attractive, especially to young and beginning users. Policymakers are advised to consider regulating products containing nicotine salts.
Monitoring compliance with Senegal’s tobacco products packaging and labelling requirements 6 months after implementation of the law
Authors: Sagna Mamadou Bamba , Rosemeyer Mary Clare , Ba Oumar , Diouf Fatou , Walter Karoline , Camara Bityeki Bintou , Carmona Maria G , Sebrie Ernesto Marcelo
Published: January 2022

Introduction

As of December 2021, 22 countries and one jurisdiction in WHO African Region (AFRO) have adopted pictorial health warning labels on tobacco packaging, but only 13 have implemented them. In 2014, Senegal enacted a comprehensive tobacco control law, which requires strong provisions on tobacco packaging and labelling. The objective of this study was to assess the level of compliance with these provisions in Senegal 6 months after implementation.

Methods

Data collection took place in Senegal’s capital city of Dakar across 12 districts in February 2018, following the Tobacco Pack Surveillance System Field Protocol developed by the Institute for Global Tobacco Control at Johns Hopkins Bloomberg School of Public Health. Unique tobacco packs were purchased from a total of 48 tobacco vendors, and compliance with new packaging and labelling provisions was assessed.

Results

In total, seven unique cigarette packs were confirmed to be legally available for sale in Dakar, Senegal. All packs complied with all health warning provisions (type, size, location, language and quitline information) as well as bans on quantitative emissions yields. However, no pack complied with the descriptive constituents and emissions statement required on the lateral side, and four of the seven packs violated the ban on misleading brand descriptors.

Conclusions

AFRO countries have made substantial progress in adopting comprehensive tobacco control laws that bring them closer into alignment with the Framework Convention on Tobacco Control. This study found areas of effective implementation of FCTC recommended packaging and labelling requirements, as well as areas in need of stronger enforcement.
Nisin induces apoptosis in cervical cancer cells via reactive oxygen species generation and mitochondrial membrane potential changes
Authors: Sadri Houri , Aghaei Mahmoud , Akbari Vajihe
Published: January 2022

Nisin, an antimicrobial peptide produced by Lactococcus lactis, is widely used as a safe food preservative and has recently attracted the attention of researchers as a potential anticancer agent. The cytotoxicity of nisin against human cervical cancer cell lines (HeLa), human ovarian carcinoma cell lines (OVCAR-3 and SK-OV-3), and human umbilical vein endothelial cells (HUVECs) was evaluated using an MTT assay. The apoptotic effect of nisin was identified by Annexin-V/propidium iodide assay, which was further confirmed by western blotting analysis, mitochondrial membrane potential (ΔΨm) analysis, and reactive oxygen species (ROS) assay. The MTT assay showed concentration-dependent cytotoxicity of nisin towards cancer cell lines, with IC50 values of 11.5–23 µM, but less toxicity against normal endothelial cells. Furthermore, the treatment of cervical cancer cells with 12 µM nisin significantly (P < 0.05) increased the Bax/Bcl-2 ratio (4.9 fold), reduced ΔΨm (70%), and elevated ROS levels (1.7 fold). These findings indicate that nisin may have anticancer and apoptogenic activities through mitochondrial dysfunction and oxidative stress damage in cervical cancer cells.
Paleolimnological perspectives on the shifting geographic template of permafrost landscapes and its implications for Arctic freshwater biodiversity
Authors: Korosi Jennifer B. , Coleman Kristen A. , Hoskin Grace N. , Little Amanda J. , Stewart Emily M. , Thienpont Joshua R.
Published: January 2022

Geographic context matters when trying to understand how permafrost thaw impacts northern freshwater biodiversity in a warming climate. Most risk to fresh water from thawing permafrost is associated with abrupt thaw processes known as thermokarst. Lake sediments can provide a record of thermokarst landscape development and associated biogeochemical and biodiversity trends over long timescales, providing a tool to link thermokarst geomorphology with freshwater biodiversity. We describe how paleolimnology, with its inherent emphasis on long-term perspectives, can characterize the shifting geographic template of warming thermokarst landscapes and its implications for biodiversity. We suggest aligning thermokarst lake paleolimnological research with hypothesis-testing frameworks used by permafrost hydrologists and biogeochemists and by the Freshwater Circumpolar Biodiversity Monitoring Program and advocate for knowledge co-production with northern Indigenous communities. Lastly, we stress the importance of considering geographic context in the choice of study sites to ensure that diverse thermokarst landscapes are represented (especially those most vulnerable to warming) and that the fine-scale differences in limnological settings that influence ecosystem response to thermokarst stressors are accounted for.
Indistinguishable elements in the origins of quantum statistics. The case of Fermi–Dirac statistics
Authors: Pérez Enric , Ibáñez Joana
Published: January 2022

In this paper, we deal with the historical origins of Fermi–Dirac statistics, focusing on the contribution by Enrico Fermi of 1926. We argue that this statistics, as opposed to that of Bose–Einstein, has been somewhat overlooked in the usual accounts of the old quantum theory. Our main objective is to offer a critical analysis of Fermi’s seminal paper and its immediate impact. Secondly, we are also interested in assessing the status of the particle concept in the years 1926–1927, especially regarding the germ of quantum indistinguishability. We will see, for example, that the first applications of the Fermi–Dirac statistics to the study of metals or stellar matter had a technical nature, and that their main instigators barely touched upon interpretative matters. Finally, we will discuss the reflections and remarks made in these respects in two famous events in physics of 1927, the Como conference and the fifth Solvay congress.
Tanshinone IIA: New Perspective on the Anti-Tumor Mechanism of A Traditional Natural Medicine
Authors: Zhang Wenfeng , Liu Cun , Li Jie , Lu Yiping , Li Huayao , Zhuang Jing , Ren Xin , Wang Mengmeng , Sun Changgang
Published: January 2022

The search for natural and efficacious antineoplastic drugs, with minimal toxicity and side effects, is an important part of antitumor drug research and development. Tanshinone IIA is the most evaluated lipophilic active component of Salvia miltiorrhiza. Tanshinone IIA is a path-breaking traditional drug applied in cardiovascular treatment. It has also been found that tanshinone IIA plays an important role in the digestive, respiratory and circulatory systems, as well as in other tumor diseases. Tanshinone IIA significantly inhibits the proliferation of several types of tumors, blocks the cell cycle, induces apoptosis and autophagic death, in addition to inhibiting cell migration and invasion. Among these, the regulation of tumor-cell apoptosis signaling pathways is the key breakthrough point in several modes of antitumor therapy. The PI3K/AKT/MTOR signaling pathway and the JNK pathway are the key pathways for tanshinone IIA to induce tumor cell apoptosis. In addition to glycolysis, reactive oxygen species and signal transduction all play an active role with the participation of tanshinone IIA. Endogenous apoptosis is considered the main mechanism of tumor apoptosis induced by tanshinone IIA. Multiple pathways and targets play a role in the process of endogenous apoptosis. Tanshinone IIA can protect chemotherapy drugs, which is mainly reflected in the protection of the side effects of chemotherapy drugs, such as neurotoxicity and inhibition of the hematopoietic system. Tanshinone IIA also has a certain regulatory effect on tumor angiogenesis, which is mainly manifested in the control of hypoxia. Our findings indicated that tanshinone IIA is an effective treatment agent in the cardiovascular field and plays a significant role in antitumor therapeutics. This paper reviews the pharmacological potential and inhibitory effect of tanshinone IIA on cancer. It is greatly anticipated that tanshinone IIA will be employed as an adjuvant in the treatment of various cancers.
Astragalus Total Saponins Ameliorate Peritoneal Fibrosis by Promoting Mitochondrial Synthesis and Inhibiting Apoptosis
Authors: Li Zheng-Hong , Xu Rong , Shi Jun , Yu Man-Shu , Zhong Yu , He Wei-Ming , Cao Li-Ping , Sheng Mei-Xiao
Published: January 2022

Peritoneal fibrosis (PF) is a disease caused by prolonged exposure of the peritoneum to high levels of dialysis fluid. Astragalus total saponins (ATS) is a phytochemical naturally occurring in Radix Astragali that has anti-inflammatory and anti-oxidant properties. In this study, we constructed an in vivo model of PF using 4.25% glucose-containing administered intraperitoneally to rats and incubated peritoneal mesothelial cells (PMCs) with 4.25% glucose-containing peritoneal dialysis fluid to construct an in vitro model of PF. Furthermore, siRNA of PGC-1[Formula: see text] was used to inhibit the expression of PGC-1[Formula: see text] to further investigate the mechanism of the protective effect of ATS on PF. In both in vivo and in vitro models, ATS treatment showed a protective effect against PF, with ATS reducing the thickness of peritoneal tissues in PF rats, increasing the viability of PMCs, increasing the mitochondrial membrane potential and reducing apoptosis ratio. ATS treatment also reduced the expressions of peritoneal fibrosis markers (Smad2, p-Smad2 and [Formula: see text]-SMA) and apoptosis markers (Caspase3, cleaved-Caspase3 and Bax) and restored the expressions of mitochondrial synthesis proteins (PGC-1[Formula: see text], NRF1 and TFAM) in ATS-treated peritoneal tissues or PMCs. Furthermore, in the presence of PGC-1[Formula: see text] inhibition, the protective effect of ATS on PF was blocked. In conclusion, ATS treatment may be an effective therapeutic agent to inhibit high glucose-induced in peritoneal fibrosis through PGC-1[Formula: see text]-mediated apoptosis.
Slack Due-Window Assignment Scheduling Problem with Deterioration Effects and a Deteriorating Maintenance Activity
Authors: Jia Xue , Lv Dan-Yang , Hu Yang , Wang Ji-Bo , Wang Zhi , Wang Ershen
Published: January 2022

This paper studies the slack due-window assignment scheduling problem with deterioration effects and a deterioration maintenance activity on a single-machine. The machine deteriorates during the machining process, and at a certain moment performs a deterioration maintenance activity, that is, the duration time of the maintenance activity is a linear function of the maintenance starting time. It is needed to make a decision on when to schedule the deteriorating maintenance activity, the optimal common flow allowances and the sequence of jobs to minimize the weighted penalties for the sum of earliness and tardiness, weighted number of early and delayed, and weighted due-window starting time and size. This paper proposes a polynomial time algorithm to solve this problem.
Dirac particle in Aharonov–Bohm–Coulomb field: Path integral treatment
Authors: Merdaci A. , Boudiaf N. , Chetouani L.
Published: January 2022

Exact Green’s function related to a Dirac particle submitted to the combination of Aharonov–Bohm and Coulomb potentials in [Formula: see text]) coordinate space is analytically calculated via path integral formalism. The Pauli matrices which describe the spin dynamics are replaced by two fermionic oscillators via the Schwinger model. The energy spectrum as well as the corresponding normalized wave functions are extracted following this approach. The interesting properties of the spinors are thus deduced after symmetrization. According to the symmetric form for Green’s function, it is shown that the non-relativistic limit of the Dirac particle is undertaken with much ease.