bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing staff’s experience of appearance issues in various nursing situations
Authors: Bringsén Åsa , Sjöbeck Johanna , Petersson Pia
Published: October 2021

Background

Health care professionals frequently interact with unknown patients in a process involving appearance-based judgements and priority-setting, all of which has an effect on health care equality. The healthcare provider–patient interaction is also highly relevant for the awareness and support of patients’ appearance concerns, with an associated possibility for improving patients’ satisfaction with their appearance and health. The aim was therefore to explore nursing staff’s experience of patients’ appearance issues in various nursing situations, with the purpose to facilitate awareness raising and knowledge development.

Method

A qualitative research approach with focus group interviews was chosen due to the exploratory aim of the study. Five semi-structured focus group interviews were conducted with 24 nursing staff in total (19 women and five men). The participants’ ages varied (20 to 45 years) as did their professional nursing experience. The interviews lasted approximately one hour, were digitally recorded, transcribed verbatim and analysed through thematic analysis.

Results

The thematic analysis resulted in the two themes Patient perspective and Professional nursing role, with associated subthemes. The findings showed the importance and impact of appearance issues in nursing situations and how these are linked to the health of the patients. Some groups of patients were identified as more vulnerable than others, which was associated with health care inequalities and health disparities. Value-based strategies along with knowledge, and skills for holistic person-centred care were identified as important resources for the development of appearance-related awareness and support in various nursing situations.

Conclusion

Strategies for improvement can be realised through the educational system for nursing staff, but mainly by using collective reflective learning forums in different workplaces. An empowerment approach is considered a useful framework for the implementation of holistic person-centred care, functioning as a resource for appearance-related awareness and support in various nursing situations. However, more research is needed on the complex and challenging phenomenon of appearance issues in nursing situations. Knowledge development related to successful person-centred strategies for appearance-related awareness and support is important, especially strategies with a salutogenic perspective.
How does job mobility relate to work commitment among rural healthcare workers? a cross-sectional study in western China
Authors: Liu Jinlin , Mao Ying , Zhu Bin
Published: October 2021

Background

Rural healthcare workers (RHWs) are the core of the rural health system. The antecedents of turnover of RHWs have been well studied, but little is known about the consequences of job mobilities among RWHs. This study aimed to identify the association between job mobility and the work commitment of RHWs in China.

Methods

Based on a three-stage random sampling method, a cross-sectional survey was conducted in 11 western provinces in China. A total of 3783 RHWs, consisting of 2245 doctors and 1538 nurses, were included in our study. Confirmatory factor analysis, Pearson’s chi-squared test, one-way ANOVA, linear regression analysis, and binary logistic regression analysis were performed for data analyses.

Results

46.3% of RHWs reported the experience of job mobility in the past. Work commitment of RHWs was not very high; specifically, the mean scores of pride in, concern for, and dedication to work were 3.54, 3.81, and 3.61 (out of a maximum of 5), respectively, and 29.9% presented turnover intent. RHWs’ overall experience of job mobility in the past was significantly associated with an increased odds of having the turnover intent. With respect to the last job mobilities of RHWs, the last job changes that occurred in the last 3 years, especially these lateral (i.e., job changes between two healthcare institutions at the same hierarchical level) and upward (i.e., job changes from a healthcare institution at a lower hierarchical level to current institution) mobilities, were significantly associated with a high level of work commitment (i.e., pride in, concern for, and dedication to work) among RHWs. However, the lateral mobilities in the last four to 5 years and the downward mobilities (i.e., job changes from a healthcare institution at a higher hierarchical level to current institution) 6 years ago or more significantly increased the odds of having turnover intent among RHWs, and RHWs whose last job changes were other mobilities (i.e., job changes from a non-healthcare institution to a healthcare institution) in the last four to 5 years reported had a significantly low level of pride in and concern for work and an increased odds of having the turnover intent.

Conclusions

The study suggests that the overall experience of job mobility in the past is a threat to RHWs’ work commitment to their current healthcare institutions. The honeymoon-hangover pattern exists in the association between a single job change and RHWs’ work commitment. Managers of rural healthcare institutions should pay more attention to these RHWs with the experience of job mobility to enhance their work commitment.
Integrated single-cell and bulk RNA sequencing analysis identifies a cancer associated fibroblast-related signature for predicting prognosis and therapeutic responses in colorectal cancer
Authors: Zheng Hang , Liu Heshu , Ge Yang , Wang Xin
Published: October 2021

Background

Cancer-associated fibroblasts (CAFs) contribute notably to colorectal cancer (CRC) tumorigenesis, stiffness, angiogenesis, immunosuppression and metastasis, and could serve as a promising therapeutic target. Our purpose was to construct CAF-related prognostic signature for CRC.

Methods

We performed bioinformatics analysis on single-cell transcriptome data derived from Gene Expression Omnibus (GEO) and identified 208 differentially expressed cell markers from fibroblasts cluster. Bulk gene expression data of CRC was obtained from The Cancer Genome Atlas (TCGA) and GEO databases. Univariate Cox regression and least absolute shrinkage operator (LASSO) analyses were performed on TCGA training cohort (n = 308) for model construction, and was validated in TCGA validation (n = 133), TCGA total (n = 441), GSE39582 (n = 470) and GSE17536 (n = 177) datasets. Microenvironment Cell Populations-counter (MCP-counter) and Estimate the Proportion of Immune and Cancer cells (EPIC) methods were applied to evaluated CAFs infiltrations from bulk gene expression data. Real-time polymerase chain reaction (qPCR) was performed in tissue microarrays containing 80 colon cancer samples to further validate the prognostic value of the CAF model. pRRophetic and Tumor Immune Dysfunction and Exclusion (TIDE) algorithms were utilized to predict chemosensitivity and immunotherapy response. Human Protein Atlas (HPA) databases and immunohistochemistry were used to evaluate the protein expressions.

Results

A nine-gene prognostic CAF-related signature was established in training cohort. Kaplan–Meier survival analyses revealed patients with higher CAF risk scores were correlated with adverse prognosis in each cohort. MCP-counter and EPIC results consistently revealed CAFs infiltrations were significantly higher in high CAF risk group. Patients with higher CAF risk scores were more prone to not respond to immunotherapy, but were more sensitive to several conventional chemotherapeutics, suggesting a potential strategy of combining chemotherapy with anti-CAF therapy to improve the efficacy of current T-cell based immunotherapies. Univariate and multivariate Cox regression analyses verified the CAF model was as an independent prognostic indicator in predicting overall survival, and a CAF-based nomogram was then built for clinical utility in predicting prognosis of CRC.

Conclusion

To conclude, the CAF-related signature could serve as a robust prognostic indicator in CRC, which provides novel genomics evidence for anti-CAF immunotherapeutic strategies.
Perceptions of adolescent pregnancy in the rural context and the Colombian armed conflict: a qualitative approach based on social determination of health
Authors: Palacios-Perdomo Herlan , Acosta-Ramírez Naydú
Published: October 2021

Background

Adolescent pregnancy in rural areas is a persistent health problem that has still not properly been understood. Studies with qualitative perspectives that address this phenomenon as a complex social process, which involves the recognition of the voices of the actors involved and the analysis of the specific context in which it takes place, are limited.

Objective

This research explored the perceptions of young people and other social actors (municipalities of Palmira and El Cerrito in Colombia) of the social forces and dimensions of the social determination of adolescent pregnancy in the Amaime river basin. These geographic areas have been scenes of armed violence with various groups in combat within the context of a long-standing political conflict in Colombia. After the 2016 Havana agreements were signed, peacebuilding has been underway in its territories.

Methods

A qualitative study that implemented focus groups and semi-structured interviews was conducted. The theoretical approach of social determination of health proposed by Breilh was used to study the social process entailed in adolescent pregnancy. Perceptions about social conditions, specific ways of life, and lifestyles were addressed. Galtung and Fischer’s theoretical approach on violence and peacebuilding was also incorporated to enrich the understanding of the Colombian context. The analysis was conducted with approaches from phenomenology.

Results

Living conditions with strong social stigma and demand for social, political, and cultural opportunities were found. Regarding ways of life, little communication and information about sex education was perceived. As for lifestyles, there are youthful behaviors infused by sociocultural traditions that affect life projects and sexual behavior. Gender relations are precarious, and there are various types of violence that limit effective peacebuilding.

Conclusions

This study contributes to a priority issue in sexual and reproductive health, with an approach that generates analytical elements to comprehensively expand the social and health interventions required.
Double jeopardy from the COVID-19 pandemic: risk of exposure and income loss in Portugal
Authors: Gama Ana , Alves Joana , Costa Daniela , Laires Pedro A. , Soares Patrícia , Pedro Ana Rita , Moniz Marta , Solinho Luísa , Nunes Carla , Dias Sónia
Published: October 2021

Background

Increasing evidence indicates that the first wave of the COVID-19 pandemic had immediate health and social impact, disproportionately affecting certain socioeconomic groups. Assessing inequalities in risk of exposure and in adversities faced during the pandemic is critical to inform targeted actions that effectively prevent disproportionate spread and reduce social and health inequities. This study examines i) the socioeconomic and mental health characteristics of individuals working in the workplace, thus at increased risk of COVID-19 exposure, and ii) individual income losses resulting from the pandemic across socioeconomic subgroups of a working population, during the first confinement in Portugal.

Methods

This study uses data from ‘COVID-19 Barometer: Social Opinion’, a community-based online survey in Portugal. The sample for analysis comprisedn = 129,078 workers. Logistic regressions were performed to estimate the adjusted odds ratios (AOR) of factors associated with working in the workplace during the confinement period and with having lost income due to the pandemic.

Results

Over a third of the participants reported working in the workplace during the first confinement. This was more likely among those with lower income [AOR = 2.93 (2.64-3.25)], lower education [AOR = 3.17 (3.04-3.30)] and working as employee [AOR = 1.09 (1.04-1.15)]. Working in the workplace was positively associated with frequent feelings of agitation, anxiety or sadness [AOR = 1.14 (1.09-1.20)] and perception of high risk of infection [AOR = 11.06 (10.53-11.61)]. About 43% of the respondents reported having lost income due to the pandemic. The economic consequences affected greatly the groups at increased risk of COVID-19 exposure, namely those with lower education [AOR = 1.36 (1.19-1.56)] and lower income [AOR = 3.13 (2.47-3.96)].

Conclusions

The social gradient in risk of exposure and in economic impact of the pandemic can result in an accumulated vulnerability for socioeconomic deprived populations. The COVID-19 pandemic seems to have a double effect in these groups, contributing to heightened disparities and poor health outcomes, including in mental health. Protecting the most vulnerable populations is key to prevent the spread of the disease and mitigate the deepening of social and health disparities. Action is needed to develop policies and more extensive measures for reducing disproportionate experiences of adversity from the COVID-19 pandemic among most vulnerable populations.
Experimental and computational modeling for signature and biomarker discovery of renal cell carcinoma progression
Authors: Cooley Lindsay S. , Rudewicz Justine , Souleyreau Wilfried , Emanuelli Andrea , Alvarez-Arenas Arturo , Clarke Kim , Falciani Francesco , Dufies Maeva , Lambrechts Diether , Modave Elodie , Chalopin-Fillot Domitille , Pineau Raphael , Ambrosetti Damien , Bernhard Jean-Christophe , Ravaud Alain , Négrier Sylvie , Ferrero Jean-Marc , Pagès Gilles , Benzekry Sebastien , Nikolski Macha , Bikfalvi Andreas
Published: October 2021

Background

Renal Cell Carcinoma (RCC) is difficult to treat with 5-year survival rate of 10% in metastatic patients. Main reasons of therapy failure are lack of validated biomarkers and scarce knowledge of the biological processes occurring during RCC progression. Thus, the investigation of mechanisms regulating RCC progression is fundamental to improve RCC therapy.

Methods

In order to identify molecular markers and gene processes involved in the steps of RCC progression, we generated several cell lines of higher aggressiveness by serially passaging mouse renal cancer RENCA cells in mice and, concomitantly, performed functional genomics analysis of the cells. Multiple cell lines depicting the major steps of tumor progression (including primary tumor growth, survival in the blood circulation and metastatic spread) were generated and analyzed by large-scale transcriptome, genome and methylome analyses. Furthermore, we performed clinical correlations of our datasets. Finally we conducted a computational analysis for predicting the time to relapse based on our molecular data.

Results

Through in vivo passaging, RENCA cells showed increased aggressiveness by reducing mice survival, enhancing primary tumor growth and lung metastases formation. In addition, transcriptome and methylome analyses showed distinct clustering of the cell lines without genomic variation. Distinct signatures of tumor aggressiveness were revealed and validated in different patient cohorts. In particular, we identified SAA2 and CFB as soluble prognostic and predictive biomarkers of the therapeutic response. Machine learning and mathematical modeling confirmed the importance of CFB and SAA2 together, which had the highest impact on distant metastasis-free survival. From these data sets, a computational model predicting tumor progression and relapse was developed and validated. These results are of great translational significance.

Conclusion

A combination of experimental and mathematical modeling was able to generate meaningful data for the prediction of the clinical evolution of RCC.
Early definitive internal fixation for infected nonunion of the lower limb
Authors: Yoon Yong-Cheol , Oh Chang-Wug , Cho Jae-Woo , Oh Jong-Keon
Published: October 2021

Background

The management of an infected nonunion of long bones is difficult and challenging. A staged procedure comprising radical debridement followed by definitive internal fixation was favored. However, no standard treatment has been established to determine the appropriate waiting period between initial debridement and definitive internal fixation. We propose a management method that incorporates early definitive internal fixation in infected nonunion of the lower limb.

Methods

Thirty-four patients (28 men and 6 women; mean age 46.09 years; range 25–74 years) with infected nonunion of the tibia or femur were included. Initial infected bone resection and radical debridement were performed in each patient in accordance with the preoperative plans. Definitive surgery was performed 2–3 weeks after the resection (4 weeks after flap surgery was required), and a third surgery was performed to fill the bone defect through bone grafting or transport (three-stage surgery). In cases of unplanned additional surgery, the reason for the requirement was analyzed, and radiological and functional results were investigated in accordance with the Association for the Study and Application of the Method of Ilizarov criteria.

Results

Bone union was achieved in all patients, and treatment was conducted as planned preoperatively in 28 patients (28/34, 82.35%). The mean interval between primary debridement and secondary definitive fixation was 2.76 weeks (range 2–4 weeks). Six unplanned additional surgeries were performed, and the infection relapsed in two cases. The radiological and functional outcomes were good or better in 32 and 31 patients, respectively.

Conclusions

Early definitive surgery can be performed to treat infected nonunion by thorough planning and implementation of radical resection, active response to infection, restoration of defective bones, and soft tissue healing through a systemic approach.
Assessing antibody decline after chemotherapy of early chronic Chagas disease patients
Authors: Murphy Niamh , Cardinal M. Victoria , Bhattacharyya Tapan , Enriquez Gustavo F. , Macchiaverna Natalia P. , Alvedro Alejandra , Freilij Héctor , Martinez de Salazar Pablo , Molina Israel , Mertens Pascal , Gilleman Quentin , Gürtler Ricardo E. , Miles Michael A.
Published: October 2021

Background

Chagas disease remains a significant public health problem in Latin America. There are only two chemotherapy drugs, nifurtimox and benznidazole, and both may have severe side effects. After complete chemotherapy of acute cases, seropositive diagnosis may revert to negative. However, there are no definitive parasitological or serological biomarkers of cure.

Methods

Following a pilot study with seven Bolivian migrants to Spain, we tested 71 serum samples from chronic patients (mean age 12.6 years) inhabiting the Argentine Chaco region. Benznidazole chemotherapy (5–8 mg/kg day, twice daily for 60 days) was administered during 2011–2016. Subsequently, pre-and post-chemotherapy serum samples were analysed in pairs by IgG1 and IgG ELISA using two different antigens and Chagas Sero K-SeT rapid diagnostic tests (RDT). Molecular diagnosis by kDNA-PCR was applied to post-treatment samples.

Results

Pilot data demonstrated IgG1 antibody decline in three of seven patients from Bolivia 1 year post-treatment. All Argentine patients in 2017 (averaging 5 years post-treatment), except one, were positive by conventional serology. All were kDNA-PCR-negative. Most (91.5%) pre-treatment samples were positive by the Chagas Sero K-SeT RDT, confirming the predominance of TcII/V/VI. IgG1 and IgG of Argentine patients showed significant decline in antibody titres post-chemotherapy, with either lysate (IgG, P = 0.0001, IgG1, P = 0.0001) or TcII/V/VI peptide antigen (IgG, P = 0.0001, IgG1, P = 0.0001). IgG1 decline was more discriminative than IgG. Antibody decline after treatment was also detected by the RDT. Incomplete treatment was associated with high IgG1 post-treatment titres against lysate (P = 0.013), as were IgG post-treatment titres to TcII/V/VI peptide (P = 0.0001). High pre-treatment IgG1 with lysate was associated with Qom ethnicity (P = 0.045). No associations were found between gender, age, body mass index and pre- or post-treatment antibody titres.

Conclusions

We show that following chemotherapy of early chronic Chagas disease, significant decline in IgG1 antibody suggests cure, whereas sustained or increased IgG1 is a potential indicator of treatment failure. Due to restricted sensitivity, IgG1 should not be used as a diagnostic marker but has promise, with further development, as a biomarker of cure.

Graphical abstract

We show that following chemotherapy of early chronic Chagas disease, a significant decline in IgG1 antibody suggests cure, whereas sustained or increased IgG1 is a potential indicator of treatment failure. Due to restricted sensitivity, IgG1 should not be used as a diagnostic marker but has promise, with further development, as a biomarker of cure.
Impact of BMI and waist circumference on epigenome-wide DNA methylation and identification of epigenetic biomarkers in blood: an EWAS in multi-ethnic Asian individuals
Authors: Chen Yuqing , Kassam Irfahan , Lau Suk Hiang , Kooner Jaspal S. , Wilson Rory , Peters Annette , Winkelmann Juliane , Chambers John C. , Chow Vincent T. , Khor Chiea Chuen , van Dam Rob M. , Teo Yik-Ying , Loh Marie , Sim Xueling
Published: October 2021

Background

The prevalence of obesity and its related chronic diseases have been increasing especially in Asian countries. Obesity-related genetic variants have been identified, but these explain little of the variation in BMI. Recent studies reported associations between DNA methylation and obesity, mostly in non-Asian populations.

Methods

We performed an epigenome-wide association study (EWAS) on general adiposity (body mass index, BMI) and abdominal adiposity (waist circumference, WC) in 409 multi-ethnic Asian individuals and replicated BMI and waist-associated DNA methylation CpGs identified in other populations. The cross-lagged panel model and Mendelian randomization were used to assess the temporal relationship between methylation and BMI. The temporal relationship between the identified CpGs and inflammation and metabolic markers was also examined.

Results

EWAS identified 116 DNA methylation CpGs independently associated with BMI and eight independently associated with WC at false discovery rate PFDR < 0.05 in 409 Asian samples. We replicated 110 BMI-associated CpGs previously reported in Europeans and identified six novel BMI-associated CpGs and two novel WC-associated CpGs. We observed high consistency in association direction of effect compared to studies in other populations. Causal relationship analyses indicated that BMI was more likely to be the cause of DNA methylation alteration, rather than the consequence. The causal analyses using BMI-associated methylation risk score also suggested that higher levels of the inflammation marker IL-6 were likely the consequence of methylation change.

Conclusion

Our study provides evidence of an association between obesity and DNA methylation in multi-ethnic Asians and suggests that obesity can drive methylation change. The results also suggested possible causal influence that obesity-related methylation changes might have on inflammation and lipoprotein levels.
Refractory ineffective triggering during pressure support ventilation: effect of proportional assist ventilation with load-adjustable gain factors
Authors: Haudebourg Anne-Fleur , Maraffi Tommaso , Tuffet Samuel , Perier François , de Prost Nicolas , Razazi Keyvan , Mekontso Dessap Armand , Carteaux Guillaume
Published: October 2021

Background

Ineffective triggering is frequent during pressure support ventilation (PSV) and may persist despite ventilator adjustment, leading to refractory asynchrony. We aimed to assess the effect of proportional assist ventilation with load-adjustable gain factors (PAV+) on the occurrence of refractory ineffective triggering.

Design

Observational assessment followed by prospective cross-over physiological study.

Setting

Academic medical ICU.

Patients

Ineffective triggering was detected during PSV by a twice-daily inspection of the ventilator’s screen. The impact of pressure support level (PSL) adjustments on the occurrence of asynchrony was recorded. Patients experiencing refractory ineffective triggering, defined as persisting asynchrony at the lowest tolerated PSL, were included in the physiological study.

Interventions

Physiological study: Flow, airway, and esophageal pressures were continuously recorded during 10 min under PSV with the lowest tolerated PSL, and then under PAV+ with the gain adjusted to target a muscle pressure between 5 and 10 cmH2O.

Measurements

Primary endpoint was the comparison of asynchrony index between PSV and PAV+ after PSL and gain adjustments.

Results

Among 36 patients identified having ineffective triggering under PSV, 21 (58%) exhibited refractory ineffective triggering. The lowest tolerated PSL was higher in patients with refractory asynchrony as compared to patients with non-refractory ineffective triggering. Twelve out of the 21 patients with refractory ineffective triggering were included in the physiological study. The median lowest tolerated PSL was 17 cmH2O [12–18] with a PEEP of 7 cmH2O [5–8] and FiO2 of 40% [39–42]. The median gain during PAV+ was 73% [65–80]. The asynchrony index was significantly lower during PAV+ than PSV (2.7% [1.0–5.4] vs. 22.7% [10.3–40.1], p < 0.001) and consistently decreased in every patient with PAV+. Esophageal pressure–time product (PTPes) did not significantly differ between the two modes (107 cmH2O/s/min [79–131] under PSV vs. 149 cmH2O/s/min [129–170] under PAV+, p = 0.092), but the proportion of PTPes lost in ineffective triggering was significantly lower with PAV+ (2 cmH2O/s/min [1–6] vs. 8 cmH2O/s/min [3–30], p = 0.012).

Conclusions

Among patients with ineffective triggering under PSV, PSL adjustment failed to eliminate asynchrony in 58% of them (21 of 36 patients). In these patients with refractory ineffective triggering, switching from PSV to PAV+ significantly reduced or even suppressed the incidence of asynchrony.
Examining employees creativity in commercial bank of Ethiopia Woldia branches
Authors: Kassa Erstu Tarko
Published: October 2021

Creativity is the ability to combine unique ideas, identifying new ways, systems and products in the organization. Creative workers in the organization can transform their organization to higher level by inventing new systems. This study tried to examine employees’ creativity in the bank at commercial bank of Ethiopia Woldia branches. The researcher used an institutional-based cross-sectional design and followed a mixed research approach. The researcher applied a census method to participate in respondents from four branches, which were on duty 182 employees in commercial bank of Ethiopia. The collected data were analyzed by using multiple regression method after proving the quality of the data. The study finding revealed that autonomy, supervisors’ support and role ambiguity significantly affects the creativity of employees in the workplace. The remaining variables self-efficacy and job complexity have no statistically significant effect on employees’ creativity in the bank.
Colorado’s first year of extreme risk protection orders
Authors: Barnard Leslie M. , McCarthy Megan , Knoepke Christopher E. , Kaplan Sabrina , Engeln James , Betz Marian E.
Published: October 2021

Background

Extreme Risk Protection Orders (ERPOs) are a relatively new type of law that are being considered or implemented in many states in the United States. Colorado’s law went into effect on January 1, 2020, after significant controversy and concern over potential misuse of the law to confiscate weapons; many (n = 37 of 64) counties declared themselves “2nd Amendment (2A) sanctuaries” and said they would not enforce the law. Here, reviewed the patterns of use of the law during its first year.

Methods

We obtained all court records for ERPO petitions filed between January 1 and December 31, 2020. Data elements were abstracted by trained staff using a standardized guide. We calculated the proportion of petitions that were approved or denied/dismissed, identified cases of obvious misuse, and examined patterns by 2A county status.

Finding and results

In 2020, 109 ERPO petitions were filed in Colorado; of these, 61 were granted for a temporary ERPO and 49 for a full (year-long) ERPO. Most petitions filed by law enforcement officers were granted (85%), compared to only 15% of petitions filed by family or household members. Of the 37 2A sanctuary counties, 24% had at least one petition filed, versus 48% of non-2A sanctuary counties. Across the 2A counties, there were 1.52 ERPOs filed per 100,000 population, compared to 2.05 ERPOs filed per 100,000 in non-2A counties. There were 4 cases of obvious law misuse; none of those petitions resulted in an ERPO or firearm confiscation.

Conclusion

State-level studies suggest ERPOs may prevent firearm injuries. Robust implementation, however, is critical for maximal effect. Understanding ERPO experiences and challenges can inform policy creation and enaction in other states, including identifying how best to address concerns and facilitate evaluation.
A case of thymoma-associated multiorgan autoimmunity including polymyositis and myocarditis
Authors: Furuta Chihiro , Yano Motoki , Numanami Hiroki , Yamaji Masayuki , Taguchi Rumiko , Haniuda Masayuki
Published: October 2021

Background

Polymyositis and myocarditis associated with thymoma are exceptionally rare conditions and usually accompanied by myasthenia gravis (MG) and have been recognized as critical conditions. Thymoma-associated multiorgan autoimmunity was reported recently with skin, liver, and intestinal manifestations similar to those seen in graft-versus-host disease.

Case presentation

A 77-year-old female presented to our department with exacerbation of ptosis and local recurrence of thymoma. Chest computed tomography revealed local recurrence of thymoma. Following 6 month observation, erythema on the extremities and body trunk suddenly appeared. Afterwards, the patient developed progressive muscle weakness and fatigue. We diagnosed as myocarditis and polymyositis. She was transferred to the intensive-care unit and received artificial ventilation. Steroid pulse therapy was induced immediately. The blood test findings were markedly improved, but the symptoms of MG and weakness of the muscles persisted. Various treatment including eculizumab was induced, and the symptoms of MG and weakness of the muscles were improved. On the 136th day of hospitalization, she was discharged.

Conclusion

We were able to cure this patient, as we were able to start treatment immediately after the appearance of severe symptoms. An early diagnosis and treatment are important for curing such patients.
The complete mitochondrial genome of Ophiocordyceps gracilis and its comparison with related species
Authors: Abuduaini Aifeire , Wang Yuan-Bing , Zhou Hui-Ying , Kang Rui-Ping , Ding Ming-Liang , Jiang Yu , Suo Fei-Ya , Huang Luo-Dong
Published: October 2021

In this study, the complete mitochondrial genome ofO. graciliswas sequenced and assembled before being compared with related species.As the second largest mitogenome reported in the family Ophiocordycipitaceae, the mitogenome ofO. gracilis(voucher OG201301) is a circular DNA molecule of 134,288 bp that contains numerous introns and longer intergenomic regions. UCA was detected as anticodon in tRNA-Sec ofO. gracilis, while comparative mitogenome analysis of nine Ophiocordycipitaceae fungi indicated that the order and contents of PCGs and rRNA genes were considerably conserved and could descend from a common ancestor in Ophiocordycipitaceae. In addition, the expansion of mitochondrial organization, introns, gene length, and order ofO. graciliswere determined to be similar to those ofO. sinensis, which indicated common mechanisms underlying adaptive evolution inO. gracilisandO. sinensis. Based on the mitochondrial gene dataset (15 PCGs and 2 RNA genes), a close genetic relationship betweenO. gracilisandO. sinensiswas revealed through phylogenetic analysis. This study is the first to investigate the molecular evolution, phylogenetic pattern, and genetic structure characteristics of mitogenome inO. gracilis. Based on the obtained results, the mitogenome ofO. graciliscan increase understanding of the genetic diversity and evolution of cordycipitoid fungi.
Detection of alternative lengthening of telomeres mechanism on tumor sections
Authors: Claude Eloïse , de Lhoneux Guillaume , Pierreux Christophe E. , Marbaix Etienne , de Ville de Goyet Maëlle , Boulanger Cécile , Van Damme An , Brichard Bénédicte , Decottignies Anabelle
Published: October 2021

The vast majority of adult cancer cells achieve cellular immortality by activating a telomere maintenance mechanism (TMM). While this is mostly achieved by the de-silencing of hTERTtelomerase gene expression, an alternative homologous recombination-based and telomerase-independent mechanism, known as ALT (Alternative Lengthening of Telomeres), is frequently activated in a subset of tumors, including paediatric cancers. Being absent from normal cells, the ALT mechanism offers interesting perspectives for new targeted cancer therapies. To date, however, the development of better translationally applicable tools for ALT detection in tumor sections is still needed. Here, using a newly derived ALT-positive cancer cell mouse xenograft model, we extensively examined how the previously known ALT markers could be used as reliable tools for ALT diagnosis in tumor sections. We found that, together with the detection of ultra-bright telomeric signals (UBS), an ALT hallmark, native telomeric FISH, that detects single-stranded C-rich telomeric DNA, provides a very sensitive and robust tool for ALT diagnosis in tissues. We applied these assays to paediatric tumor samples and readily identified three ALT-positive tumors for which the TMM was confirmed by the gold-standard C-circle amplification assay. Although the latter offers a robust assay for ALT detection in the context of research laboratories, it is more difficult to set up in histopathological laboratories and could therefore be conveniently replaced by the combination of UBS detection and native telomeric FISH.
ENZ-metamaterial–induced perfect transparency for the highly directive plano-concave lens
Authors: Jia Y. M. , Yang R. , Weng Z. B.
Published: October 2021

We propose an ENZ-metamaterial–based transparent sandwich design consisting of periodic slits in a metal screen integrated with ENZ metamaterials for the exploration of superior transmissions. An equivalent circuit is proposed to reveal the interactions between the slit array and ENZ metamaterials when electromagnetic fields are penetrating through, and indicates that the involvement of ENZ metamaterials with the frequency dispersion behaviors can create the perfect match for total transmissions. On this basis, we further propose the design of plano-concave lens with the non-uniform ENZ metamaterial interlayer and demonstrate the superior collimation and focusing of electromagnetic fields at specific frequency points with perfect transparency. These findings may initiate the quest for building up more advanced electromagnetic devices tailored to specific applications with extreme parameter metamaterials.
Aging Men With Insufficient Vitamin D Have a Higher Mortality Risk: No Added Value of its Free Fractions or Active Form
Authors: Dejaeger Marian , Antonio Leen , Bouillon Roger , Moors Hannes , Wu Frederick C W , O’Neill Terence W , Huhtaniemi Ilpo T , Rastrelli Giulia , Forti Gianni , Maggi Mario , Casanueva Felipe F , Slowikowska-Hilczer Jolanta , Punab Margus , Gielen Evelien , Tournoy Jos , Vanderschueren Dirk
Published: October 2021

Context

Low total 25-hydroxyvitamin D (25(OH)D) has been associated with mortality. Whether vitamin D in its free form or 1,25-dihydroxyvitamin D (1,25(OH)2D), provide any additional information is unclear.

Objective

To determine what level of 25(OH)D is predictive for mortality and if free 25(OH)D or 1,25(OH) 2 D concentrations have any added value.

Methods

This prospective cohort comprised 1915 community-dwelling men, aged 40 to 79 years. Intervention included determination of association of total and free 25(OH)D and 1,25(OH) 2 D concentrations with survival status. Vitamin D results were grouped into quintiles. For total 25(OH)D, specific cutoff values were also applied. Cox proportional hazard models were used adjusted for center, body mass index, smoking, alcohol, physical activity, season of blood sample, kidney function, and number of comorbidities.

Results

A total of 469 (23.5%) men died during a mean follow-up of 12.3 ± 3.4 years. Compared to those with normal vitamin D values (> 30 µg/L), men with a total 25(OH)D of less than 20 µg/L had an increased mortality (hazard ratio [HR] 2.03 [95% CI, 1.39-2.96]; P < .001). Likewise, men in the lowest 3 free 25(OH)D quintiles (< 4.43 ng/L) had a higher mortality risk compared to the highest quintile (HR 2.09 [95% CI, 1.34-3.25]; P < .01). Mortality risks were similar across all 1,25(OH)2D and vitamin D binding protein quintiles.

Conclusion

Aging men with vitamin D deficiency have a 2-fold increased mortality risk. Determinations of either the free fractions of vitamin D or measurement of its active form offer no additional information on mortality risks.
Brain Mechanisms of Pain and Dysautonomia in Diabetic Neuropathy: Connectivity Changes in Thalamus and Hypothalamus
Authors: Chao Chi-Chao , Tseng Ming-Tsung , Hsieh Paul-Chen , Lin Chien-Ho (Janice) , Huang Shin-Leh , Hsieh Sung-Tsang , Chiang Ming-Chang
Published: October 2021

Context

About one-third of diabetic patients suffer from neuropathic pain, which is poorly responsive to analgesic therapy and associated with greater autonomic dysfunction. Previous research on diabetic neuropathy mainly links pain and autonomic dysfunction to peripheral nerve degeneration resulting from systemic metabolic disturbances, but maladaptive plasticity in the central pain and autonomic systems following peripheral nerve injury has been relatively ignored.

Objective

This study aimed to investigate how the brain is affected in painful diabetic neuropathy (PDN), in terms of altered structural connectivity (SC) of the thalamus and hypothalamus that are key regions modulating nociceptive and autonomic responses.

Methods

We recruited 25 PDN and 13 painless (PLDN) diabetic neuropathy patients, and 27 healthy adults as controls. The SC of the thalamus and hypothalamus with limbic regions mediating nociceptive and autonomic responses was assessed using diffusion tractography.

Results

The PDN patients had significantly lower thalamic and hypothalamic SC of the right amygdala compared with the PLDN and control groups. In addition, lower thalamic SC of the insula was associated with more severe peripheral nerve degeneration, and lower hypothalamic SC of the anterior cingulate cortex was associated with greater autonomic dysfunction manifested by decreased heart rate variability.

Conclusion

Our findings indicate that alterations in brain structural connectivity could be a form of maladaptive plasticity after peripheral nerve injury, and also demonstrate a pathophysiological association between disconnection of the limbic circuitry and pain and autonomic dysfunction in diabetes.
Pyongyang Modern: Architecture of Multiplicity in Postwar North Korea
Authors: Kim Cheehyung Harrison
Published: October 2021

This article explores North Korea’s postwar reconstruction through the variegated features of architectural development in Pyongyang. The rebirth of Pyongyang as the center of both state authority and work culture is distinctly represented by architecture. In this setting, architecture as theory and practice was divided into two contiguous and interconnected types: monumental structures symbolizing the utopian vision of the state and vernacular structures instrumental to the regime of production in which the apartment was an exemplary form. The author makes three claims: first, Pyongyang’s monumental and vernacular architectural forms each embody both utopian and utilitarian features; second, the multiplicity of meaning exhibited in each architectural form is connected to the transnational process of bureaucratic expansion and industrial developmentalism; and third, North Korea’s postwar architectural history is a lens through which state socialism of the twentieth century can be better understood—not as an exceptional moment but as a constituent of globalized modernity, a historical formation dependent on the collusive expansion of state power and industrial capitalism. A substantial part of this article is a discussion of the methods and sources relevant to writing an architectural history of North Korea.
Adjacent Histories
Authors: Armstrong-Price Amanda , Napolin Julie Beth
Published: October 2021

In this conversation, composed through written correspondence, Julie Beth Napolin and Amanda Armstrong-Price discuss aspects of Denise Riley’s “Am I That Name?” in light of contemporary feminist debates, including debates within black feminism and transfeminism. The authors begin by considering the significance of Riley’s unconventional title, outlining what might be at stake—and what might be occluded—in the title’s allusion to Sojourner Truth’s interjection, “Ain’t I a woman?” Allusion and juxtaposition form key aspects of Riley’s approach to historical representation, which involves reading sources on sex and gender for what they say about adjacent historical categories and constellating discrepant historical situations in ways that speak to ongoing conundrums about identity and alliance. With respect to the latter, the authors consider the historical situation—in feminism and more generally—that occasioned Riley’s 1988 work while also reading her work in relation to the challenges of our current moment. Riley’s phenomenological account of the inconstancy of gendered being is read for its resonances with contemporary transfeminist work while her broader oeuvre is brought to bear on some of the scraps of phobic common sense—the voices without mouths—that circulate online and work to forestall what remain urgent acts of alliance.
Usher syndrome type 1-associated gene, pcdh15b, is required for photoreceptor structural integrity in zebrafish
Authors: Miles Amanda , Blair Clarke , Emili Andrew , Tropepe Vincent
Published: October 2021

Blindness associated with Usher syndrome type 1 (USH1) is typically characterized as rod photoreceptor degeneration, followed by secondary loss of cones. The mechanisms leading to blindness are unknown because most genetic mouse models only recapitulate auditory defects. We generated zebrafish mutants for one of the USH1 genes, protocadherin-15b (pcdh15b), a putative cell adhesion molecule. Zebrafish Pcdh15 is expressed exclusively in photoreceptors within calyceal processes (CPs), at the base of the outer segment (OS) and within the synapse. In our mutants, rod and cone photoreceptor integrity is compromised, with early and progressively worsening abnormal OS disc growth and detachment, in part due to weakening CP contacts. These effects were attenuated or exacerbated by growth in dark and bright-light conditions, respectively. We also describe novel evidence for structural defects in synapses of pcdh15b mutant photoreceptors. Cell death does not accompany these defects at early stages, suggesting that photoreceptor structural defects, rather than overt cell loss, may underlie vision deficits. Thus, we present the first genetic animal model of a PCDH15-associated retinopathy that can be used to understand the aetiology of blindness in USH1.

This article has an associated First Person interview with the first author of the paper.
Are stress granules the RNA analogs of misfolded protein aggregates?
Authors: Ripin Nina , Parker Roy
Published: October 2021

Ribonucleoprotein granules are ubiquitous features of eukaryotic cells. Several observations argue that the formation of at least some RNP granules can be considered analogous to the formation of unfolded protein aggregates. First, unfolded protein aggregates form from the exposure of promiscuous protein interaction surfaces, while some mRNP granules form, at least in part, by promiscuous intermolecular RNA–RNA interactions due to exposed RNA surfaces when mRNAs are not engaged with ribosomes. Second, analogous to the role of protein chaperones in preventing misfolded protein aggregation, cells contain abundant “RNA chaperones” to limit inappropriate RNA–RNA interactions and prevent mRNP granule formation. Third, analogous to the role of protein aggregates in diseases, situations where RNA aggregation exceeds the capacity of RNA chaperones to disaggregate RNAs may contribute to human disease. Understanding that RNP granules can be considered as promiscuous, reversible RNA aggregation events allow insight into their composition and how cells have evolved functions for RNP granules.
Factors associated with knowledge, attitudes and preventive practices towards COVID-19 in health care professionals in Lima, Peru
Authors: Rivera-Lozada Oriana , Galvez Cesar Augusto , Castro-Alzate Elvis , Bonilla-Asalde Cesar Antonio
Published: October 2021

Background: Nowadays, we are facing a disease caused by SARS-CoV-2, known globally as COVID-19, which is considered a threat to global health due to its high contagiousness and rapid spread.

Methods: Analytical cross-sectional study in 302 health professionals. An online questionnaire consisting of questions about knowledge, attitudes and practices (KAP) towards COVID-19 was applied. Socio-demographic, occupational and comorbidities factors were explored. Simple and multiple logistic regression models were used to identify factors associated with KAP.

Results: Of the total, 25.2%, 31.5% and 37.4% had high levels of knowledge, preventive practices and risk perception attitudes respectively. Being married aOR=6.75 IC(1.46-31.2) p=0.014, having a master's degree aOR=0.4, IC(0.21-0.80) p=0.009, having a working day with less than ten hours ORa=0.49 IC(0.25-0.95) p=0.036 and obesity aOR=0.38 IC (0.15-0.95) p=0.039 were associated with a low level of knowledge of COVID-19. The variables associated with preventive practices were being over the age of 50 aOR=0.52 IC(0.27-0.98) p=0.007, working in the hospitalization area aOR=1.86 IC(1.08-3.18) p= 0.018 and having comorbidities such as arterial hypertension aOR=0.28 IC(0.081-0.99) p=0.02 and obesity aOR=0.35 IC(0.14-0.83) p=0.019. In relation to negative attitudes towards COVID-19, it was found that physical contact with patients with a confirmed diagnosis aOR=1.84 IC (1.14-2.97) p=0.006 and having asthma aOR=2.13 IC(1.081-4.22) p=0.029 were associated with these attitudes.

Conclusion: Our study revealed that health professionals have an insufficient level of knowledge of COVID-19. This is why we recommend implementing strategies such as health literacy programs among health care workers. Thus, they can help develop positive attitudes towards the acquisition of self-care habits at work that, in turn, improve their confidence so that health care workers can provide adequate care for their patients and protect themselves.