bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploiting the Transformation Temperature to Reform an Infolded Nitinol Self-Expanding Peripheral Stent
Authors: Medranda Giorgio A. , Forrestal Brian J. , Case Brian C. , Waksman Ron , Bernardo Nelson L.
Published: January 2022

Purpose:

Nickel-titanium (nitinol) alloys possess a special set of properties that allow for a wide range of applications. Specifically, the transformation temperature for self-expanding nitinol peripheral stents allows for easy crimping at or below room temperature and reformation at body temperature becoming superelastic.

Case Report:

We report the case of an elderly man with iliac stenting 1 month prior, who presented several weeks after recovering from coronavirus disease 2019 with recurrent anterior-wall ST-elevation myocardial infarction. This was complicated by deformation and infolding of the previously implanted nitinol self-expanding stent in his right common iliac artery (CIA). Understanding nitinol’s specific properties, we proceeded with rapid injections of iced saline to cool the nitinol stent to its transformation temperature while nudging the distal end of the stent with a partially inflated balloon. This maneuver softened the nitinol stent, allowing us to “unfold” and reappose it against the wall of the right CIA, resulting in successful restoration of the original shape of the nitinol self-expanding stent.

Conclusion:

This represents the first reported case describing treatment of an infolded nitinol self-expanding peripheral stent by exploiting the transformation temperature of nitinol using iced cold saline to successfully restore the stent’s original shape and structure.
Raising the Bar: Causal Evidence on Gender Differences in Risk-Taking From a Natural Experiment
Authors: Böheim René , Lackner Mario , Wagner Wilhelm
Published: January 2022

We investigate the risk-taking behavior of women and men in high-stakes jumping competitions. Results indicated that female and male athletes differ in the timing and extent of their reactions to an increase in the risk of failure. Male competitors increased risk-taking in the more risky environment immediately after the changes. Female athletes, however, increased risk-taking two years after the rule change. Over time, female athletes revert to pre-reform risk-taking levels, and male athletes’ continued to make more risky decisions in the new environment. We attribute our findings to gender differences in competitiveness and risk preferences.
Understanding role conflict and role ambiguity of school principals in Nepal
Authors: Khanal Jeevan , Ghimire Subekshya
Published: January 2022

In the context of developed countries, a lot of research has been done to uncover and identify the problems school leaders face in their work but little is known about the school leadership of underdeveloped countries. In a quest to discover contextual problems in terms of role conflict and role ambiguity of school leaders, this qualitative study tries to capture the experiences of principals in Nepal through in-depth interviews of six community school principals. The findings reveal that the major sources of role conflict and ambiguity for principals from Nepal are problematic power-sharing, low job autonomy, dual role conflict, limited professional development training, and lack of leadership knowledge. The study has several policy-level implications such as importance of hiring principals with proven leadership skills and increasing the leadership skills of current principals to ensure that they can tackle these challenges.
The media’s role in shaping the public opinion on education: A thematic and frame analysis of externalisation to world situations in the Portuguese media
Authors: Santos Íris , Carvalho Luís Miguel , Portugal e Melo Benedita
Published: January 2022

This article uses thematisation theory (Luhmann, 1996; Pissarra Esteves, 2016) and frame analysis (Entman, 1993) to analyse externalisations to world situations (Schriewer, 1990) in the Portuguese print media’s discussion of education. Our data constitutes news and opinion articles collected after each PISA cycle’s results was published. The analysis demonstrates that the education themes discussed in the media between 2001 and 2017 are consistent, despite occasionally being discussed more intensively, frequently following the themes highlighted by PISA reports and OECD media communications. The frames used for these themes are more diverse, changing according to the speaker’s agenda and viewpoints. Externalisations (frequently PISA, OECD, and other participants in the survey) serve as sources of authority that help in thematising and framing education. This process works as a mechanism of double reduction for the complexity of the social world, narrowing the possibilities of how education is seen and interpreted by the public.
Optimal timing of anticoagulation after acute ischemic stroke with atrial fibrillation (OPTIMAS): Protocol for a randomized controlled trial
Authors: Best Jonathan G , Arram Liz , Ahmed Norin , Balogun Maryam , Bennett Kate , Bordea Ekaterina , Campos Marta G , Caverly Emilia , Chau Marisa , Cohen Hannah , Dehbi Hakim-Moulay , Doré Caroline J , Engelter Stefan T , Fenner Robert , Freemantle Nick , Hunter Rachael , James Martin , Lip Gregory YH , Murray Macey L , Norrving Bo , Sprigg Nikola , Veltkamp Roland , Zaczyk Iwona , Werring David J ,   the OPTIMAS investigators
Published: January 2022

Rationale

Atrial fibrillation causes one-fifth of ischemic strokes, with a high risk of early recurrence. Although long-term anticoagulation is highly effective for stroke prevention in atrial fibrillation, initiation after stroke is usually delayed by concerns over intracranial hemorrhage risk. Direct oral anticoagulants offer a significantly lower risk of intracranial hemorrhage than other anticoagulants, potentially allowing earlier anticoagulation and prevention of recurrence, but the safety and efficacy of this approach has not been established.

Aim

Optimal timing of anticoagulation after acute ischemic stroke with atrial fibrillation (OPTIMAS) will investigate whether early treatment with a direct oral anticoagulant, within four days of stroke onset, is as effective or better than delayed initiation, 7 to 14 days from onset, in atrial fibrillation patients with acute ischemic stroke.

Methods and design

OPTIMAS is a multicenter randomized controlled trial with blinded outcome adjudication. Participants with acute ischemic stroke and atrial fibrillation eligible for anticoagulation with a direct oral anticoagulant are randomized 1:1 to early or delayed initiation. As of December 2021, 88 centers in the United Kingdom have opened.

Study outcomes

The primary outcome is a composite of recurrent stroke (ischemic stroke or symptomatic intracranial hemorrhage) and systemic arterial embolism within 90 days. Secondary outcomes include major bleeding, functional status, anticoagulant adherence, quality of life, health and social care resource use, and length of hospital stay.

Sample size target

A total of 3478 participants assuming event rates of 11.5% in the control arm and 8% in the intervention arm, 90% power and 5% alpha. We will follow a non-inferiority gatekeeper analysis approach with a non-inferiority margin of 2 percentage points.

Discussion

OPTIMAS aims to provide high-quality evidence on the safety and efficacy of early direct oral anticoagulant initiation after atrial fibrillation-associated ischemic stroke. Trial registrations: ISRCTN: 17896007; ClinicalTrials.gov: NCT03759938
A Media Repertoires Approach to Selective Exposure: News Consumption and Political Polarization in Eastern Europe
Authors: Tóth Fanni , Mihelj Sabina , Štětka Václav , Kondor Katherine
Published: January 2022

In recent years, links between selective news exposure and political polarisation have attracted considerable attention among communication scholars. However, while the existence of selective exposure has been documented in both offline and online environments, the evidence of its extent and its impact on political polarisation is far from unanimous. To address these questions, and also to bridge methodological and geographical gaps in existing research, this paper adopts a media repertoires approach to investigate selective news exposure and polarisation in four Eastern European countries – the Czech Republic, Hungary, Poland and Serbia. Using a combination of population surveys, expert surveys and qualitative interviews, the data for the study were collected between November 2019 and May 2020. We identify five types of news repertoires based on their relative openness to counter-attitudinal sources, and show that selective news repertoires are present in 29% of the entire sample. Our findings also reveal significant cross-country differences, with the more selective news repertoires more prominent in countries characterised by higher levels of polarisation. Furthermore, while the selection of news sources is in line with people's electoral (and to a lesser extent ideological) preferences, our findings show that exposure to counter-attitudinal sources can also be strongly correlated with political and ideological leanings. Our qualitative data suggest that this is because exposure to counter-attitudinal sources can reinforce attitudes, and potentially contribute to polarisation. Qualitative data also highlight the influence of environmental factors (e.g., family), and suggest that selective news consumption is associated with normatively different conceptions of media trust.
The Most Dangerous Game: A Review of Head and Neck Injuries in American Football and Rugby
Authors: Richardson Jordan , Stanbouly Dani , Moynihan Harrison , Reynolds Renée M. , Recker Matthew J. , Markiewicz Michael R.
Published: January 2022

Study Design

The investigators designed and implemented a 20-year cross-sectional study using the National Electronic Injury Surveillance System database.

Objective

The purpose of this study is to estimate and compare hospital admission (danger) rates between rugby and football of those who presented to the emergency department with head and neck injuries after playing these sports.

Methods

The primary predictor variable was sport played. The primary outcome variable was danger, measured by hospital admission rates.

Results

Over the past 20 years, there has been a trend of decreasing incidence of injuries presenting to the emergency department in both sports. There was no difference in the rate of hospital admission when comparing football and rugby (OR, 1.2; P = .1). Male gender was associated with an increased risk of admission. Other variables associated with hospital admission included white racial group, injury taking place in the fall, being either young (15–24 years old) or senior (65 years of age and over), and being injured at school or at a sport/recreational facility.

Conclusions

There is no difference in danger as measured by admission rates between American football and rugby. There exists, however, several variables that are associated with admission when sustaining injury to the head and neck, when playing these two sports.
Mitigating the Spread of COVID-19: What are firms doing and what they need to do?
Authors: Butt Atif Saleem
Published: January 2022

The novel COVID-19 (coronavirus) has created havoc and massive disruption to firms’ business operations. While much literature has recently emerged on how this pandemic outbreak has affected the firms. Limited empirical studies to date exist on what actions firms are employing to reduce the spread of COVID-19 and further ensure business continuity. Our study attempts to fill this gap in management literature. This study employs a multiple case study methodology. Overall, 36 semi-structured interviews with eight different based in China were undertaken. Results reveal that Chinese firms are employing six distinct actions to control the spread of COVID-19 while ensuring that the business continues to run to its maximum capacity. In particular, firms are educating employees on the symptoms of COVID-19, implementing strict screening protocols, applying agile IT systems, revising their cash flow policies and conducting global scenario planning to mitigate the spread of COVID-19. This study concludes by discussing its implications for theory, alongside limitations and future research directions.
High School Experiences That Support Post-School Success: What Can We Learn?
Authors: Clavenna-Deane Beth A. , Coates Wendy R.
Published: January 2022

Students with disabilities continue to lag behind their peers without disabilities in the area of post-school success. This study qualitatively analyzed individual responses from 6 years of post-school outcomes survey data in one state to identify positive experiences said to help students reach their post-school goals. Respondents reported nine themes as being the most helpful in meeting their goals after high school, including having supportive staff members, taking career development coursework, and developing success attributes such as self-advocacy. A negative experience theme also emerged in the analysis. Implications for educators are discussed related to emphasizing instruction in self-determination and career development. Implications for states are discussed related to the post-school outcomes data collection process.
A Review of Strategies to Improve Biomechanical Fixation in the Cervical Spine
Authors: Oitment Colby , Thornley Patrick , Koziarz Frank , Jentzsch Thorsten , Bhanot Kunal
Published: January 2022

Study Design

Systematic review.

Objectives

Review the surgical techniques and construct options aimed at improving the biomechanical strength of cervical constructs.

Methods

A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A search of the MEDLINE, Embase, and Cochrane Library databases was performed to identify all studies examining biomechanical strategies utilized in the osteoporotic cervical spine. Screening was performed in duplicate for all stages of the review process.

Results

An initial search returned 3887 articles. After deletion of duplications and review of abstracts and full text, 39 articles met inclusion criteria. Overall, the surgical techniques reviewed aimed at obtaining rigid fixation in the setting of poor bone quality, or dispersing the forces at the bone-implant interface. We identified 6 key techniques to improve biomechanical fixation. These include bicortical fixation, appropriate screw selection (size and trajectory), PMMA augmentation, load sharing techniques, consideration of ancillary fixation around the occipitocervical junction, and supplementing the construct with post-operative collar or halo.

Conclusion

The summation of the literature highlights a framework of modalities available to surgeons to improve biomechanical fixation in the cervical spine. While these may improve construct strength in the setting of osteoporosis, there is a paucity of evidence available to make recommendations in this patient population.
Tcf1 is essential for initiation of oncogenic Notch1-driven chromatin topology in T-ALL
Authors: Antoszewski Mateusz , Fournier Nadine , Ruiz Buendía Gustavo A. , Lourenco Joao , Liu Yuanlong , Sugrue Tara , Dubey Christelle , Nkosi Marianne , Pritchard Colin E. J. , Huijbers Ivo J. , Segat Gabriela C. , Alonso-Moreno Sandra , Serracanta Elisabeth , Belver Laura , Ferrando Adolfo A. , Ciriello Giovanni , Weng Andrew P. , Koch Ute , Radtke Freddy
Published: January 2022

NOTCH1 is a well-established lineage specifier for T cells and among the most frequently mutated genes throughout all subclasses of T cell acute lymphoblastic leukemia (T-ALL). How oncogenic NOTCH1 signaling launches a leukemia-prone chromatin landscape during T-ALL initiation is unknown. Here we demonstrate an essential role for the high-mobility-group transcription factor Tcf1 in orchestrating chromatin accessibility and topology, allowing aberrant Notch1 signaling to convey its oncogenic function. Although essential, Tcf1 is not sufficient to initiate leukemia. The formation of a leukemia-prone epigenetic landscape at the distal Notch1-regulated Myc enhancer, which is fundamental to this disease, is Tcf1-dependent and occurs within the earliest progenitor stage even before cells adopt a T lymphocyte or leukemic fate. Moreover, we discovered a unique evolutionarily conserved Tcf1-regulated enhancer element in the distal Myc-enhancer, which is important for the transition of preleukemic cells to full-blown disease.
Location of eosinophils in the airway wall is critical for specific features of airway hyperresponsiveness and T2 inflammation in asthma
Authors: Al-Shaikhly Taha , Murphy Ryan C. , Parker Andrew , Lai Ying , Altman Matthew C. , Larmore Megan , Altemeier William A. , Frevert Charles W. , Debley Jason S. , Piliponsky Adrian M. , Ziegler Steven F. , Peters Michael C. , Hallstrand Teal S.
Published: January 2022

Background

Eosinophils are implicated as effector cells in asthma, but the functional implications of the precise location of eosinophils in the airway wall is poorly understood. We aimed to quantify eosinophils in the different compartments of the airway wall and associate these findings with clinical features of asthma and markers of airway inflammation.

Methods

In this cross-sectional study, we utilised design-based stereology to accurately partition the numerical density of eosinophils in both the epithelial compartment and the subepithelial space (airway wall area below the basal lamina including the submucosa) in individuals with and without asthma and related these findings to airway hyperresponsiveness (AHR) and features of airway inflammation.

Results

Intraepithelial eosinophils were linked to the presence of asthma and endogenous AHR, the type that is most specific for asthma. In contrast, both intraepithelial and subepithelial eosinophils were associated with type 2 (T2) inflammation, with the strongest association betweenIL5expression and intraepithelial eosinophils. Eosinophil infiltration of the airway wall was linked to a specific mast cell phenotype that has been described in asthma. We found that interleukin (IL)-33 and IL-5 additively increased cysteinyl leukotriene (CysLT) production by eosinophils and that the CysLT LTC4along with IL-33 increasedIL13expression in mast cells and altered their protease profile.

Conclusions

We conclude that intraepithelial eosinophils are associated with endogenous AHR and T2 inflammation and may interact with intraepithelial mast cellsviaCysLTs to regulate airway inflammation.
Neural correlates of face processing associated with development of social communication in 12-month infants with familial risk of autism spectrum disorder
Authors: Glauser Joshua , Wilkinson Carol L. , Gabard-Durnam Laurel J. , Choi Boin , Tager-Flusberg Helen , Nelson Charles A.
Published: January 2022

Background

Differences in face processing in individuals with ASD is hypothesized to impact the development of social communication skills. This study aimed to characterize the neural correlates of face processing in 12-month-old infants at familial risk of developing ASD by (1) comparing face-sensitive event-related potentials (ERP) (Nc, N290, P400) between high-familial-risk infants who develop ASD (HR-ASD), high-familial-risk infants without ASD (HR-NoASD), and low-familial-risk infants (LR), and (2) evaluating how face-sensitive ERP components are associated with development of social communication skills.

Methods

12-month-old infants participated in a study in which they were presented with alternating images of their mother’s face and the face of a stranger (LR = 45, HR-NoASD = 41, HR-ASD = 24) as EEG data were collected. Parent-reported and laboratory-observed social communication measures were obtained at 12 and 18 months. Group differences in ERP responses were evaluated using ANOVA, and multiple linear regressions were conducted with maternal education and outcome groups as covariates to assess relationships between ERP and behavioral measures.

Results

For each of the ERP components (Nc [negative-central], N290, and P400), the amplitude difference between mother and stranger (Mother-Stranger) trials was not statistically different between the three outcome groups (Nc p = 0.72, N290 p = 0.88, P400 p = 0.91). Marginal effects analyses found that within the LR group, a greater Nc Mother-Stranger response was associated with better expressive language skills on the Mullen Scales of Early Learning, controlling for maternal education and outcome group effects (marginal effects dy/dx = 1.15; p < 0.01). No significant associations were observed between the Nc and language or social measures in HR-NoASD or HR-ASD groups. In contrast, specific to the HR-ASD group, amplitude difference between the Mother versus Stranger P400 response was positively associated with expressive (dy/dx = 2.1, p < 0.001) and receptive language skills at 12 months (dy/dx = 1.68, p < 0.005), and negatively associated with social affect scores on the Autism Diagnostic Observation Schedule (dy/dx = − 1.22, p < 0.001) at 18 months.

Conclusions

In 12-month-old infant siblings with subsequent ASD, increased P400 response to Mother over Stranger faces is positively associated with concurrent language and future social skills.
Aird: a computation-oriented mass spectrometry data format enables a higher compression ratio and less decoding time
Authors: Lu Miaoshan , An Shaowei , Wang Ruimin , Wang Jinyin , Yu Changbin
Published: January 2022

Background

With the precision of the mass spectrometry (MS) going higher, the MS file size increases rapidly. Beyond the widely-used open format mzML, near-lossless or lossless compression algorithms and formats emerged in scenarios with different precision requirements. The data precision is often related to the instrument and subsequent processing algorithms. Unlike storage-oriented formats, which focus more on lossless compression rate, computation-oriented formats concentrate as much on decoding speed as the compression rate.

Results

Here we introduce “Aird”, an opensource and computation-oriented format with controllable precision, flexible indexing strategies, and high compression rate. Aird provides a novel compressor called Zlib-Diff-PforDelta (ZDPD) for m/z data. Compared with Zlib only, m/z data size is about 55% lower in Aird average. With the high-speed decoding and encoding performance of the single instruction multiple data technology used in the ZDPD, Aird merely takes 33% decoding time compared with Zlib. We have downloaded seven datasets from ProteomeXchange and Metabolights. They are from different SCIEX, Thermo, and Agilent instruments. Then we convert the raw data into mzML, mgf, and mz5 file formats by MSConvert and compare them with Aird format. Aird uses JavaScript Object Notation for metadata storage. Aird-SDK is written in Java, and AirdPro is a GUI client for vendor file converting written in C#. They are freely available at https://github.com/CSi-Studio/Aird-SDK and https://github.com/CSi-Studio/AirdPro.

Conclusions

With the innovation of MS acquisition mode, MS data characteristics are also constantly changing. New data features can bring more effective compression methods and new index modes to achieve high search performance. The MS data storage mode will also become professional and customized. ZDPD uses multiple MS digital features, and researchers also can use it in other formats like mzML. Aird is designed to become a computing-oriented data format with high scalability, compression rate, and fast decoding speed.
Combined PD-1/PD-L1 and tumor-infiltrating immune cells redefined a unique molecular subtype of high-grade serous ovarian carcinoma
Authors: Liu Ping , Chen Ruoxu , Zhang Xudong , Fu Ruiting , Tao Lin , Jia Wei
Published: January 2022

Background

High-grade serous ovarian carcinoma is highly heterogeneous, and although many studies have been conducted to identify high-grade serous ovarian carcinoma molecular subtypes that are sensitive to immunotherapy, no precise molecular subtype has been proposed to date. Immune cell infiltration and immune checkpoints are highly correlated with immunotherapy. Here, we investigated immune cell infiltration and immune checkpoint values for prognosis and precise immunotherapy for high-grade serous ovarian carcinoma based on molecular subtype classification.

Results

“High antigen-presenting cells infiltration molecular subtype of high-grade serous ovarian carcinoma” was identified in immune cell infiltration profiles. Each of the three immune cell infiltration clusters (A, B, and C) demonstrated distinct immune cell characterization, with immune cell infiltration cluster C exhibiting high antigen-presenting cell infiltration, improved prognosis, and higher sensitivity to immunotherapy. Programmed death-1/programmed death ligand 1 has a prognostic and predictive role that can help classify molecular subtypes.

Conclusions

Our findings redefined a unique molecular subtype of high-grade serous ovarian carcinoma, suggesting that high-grade serous ovarian carcinoma patients with higher antigen-presenting cell infiltration and programmed death-1/programmed death ligand 1 expression can benefit from precise immunotherapy.
Subsidy policy selection of elderly care service projects under uncertain actual demand: a real options analysis based on China’s experience
Authors: Song Huan , Ji Kehan , Sun Tao
Published: January 2022

Background

Elderly care service projects (ECSPs) aim to provide care services with the help of market forces on the supply side to satisfy the huge demand of the elderly. Subsidies play an important role in motivating the investors to invest in the ECSPs immediately. The optimal subsidy scheme should balance the policy costs and the investors’ interests.

Methods

Based on the policy background of China, this study applied the real options theory to compare the effects of construction subsidy and operating subsidy on achieving policy goals from the perspective of uncertain actual demand. It introduced numerical examples to identify the optimal subsidy scheme and embedded the data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) to verify the uncertainty of actual demand.

Results

The results showed that in the context of uncertain actual demand, operating subsidy has greater advantages in reducing investment thresholds, saving subsidy costs and increasing spillover values. Moreover, a sound quality supervision system, a differentiated operating subsidy scheme and a sustainable growth market demand environment are conducive to increasing the long-term interests of the government and the investors.

Conclusions

The study emphasized the importance of subsidy selection in the context of uncertain actual demand, and provided a practical reference for policy designers in China and other developing countries to choose the optimal subsidy scheme for the ECSPs.
Spatial inequalities in skilled birth attendance in India: a spatial-regional model approach
Authors: Mishra Prem Shankar , Sinha Debashree , Kumar Pradeep , Srivastava Shobhit
Published: January 2022

Background

Despite a significant increase in the skilled birth assisted (SBA) deliveries in India, there are huge gaps in availing maternity care services across social gradients - particularly across states and regions. Therefore, this study applies the spatial-regression model to examine the spatial distribution of SBA across districts of India. Furthermore, the study tries to understand the spatially associated population characteristics that influence the low coverage of SBA across districts of India and its regions.

Methods

The study used national representative cross-sectional survey data obtained from the fourth round of National Family Health Survey, conducted in 2015-16. The effective sample size was 259,469 for the analysis. Moran’s I statistics and bivariate Local Indicator for Spatial Association maps were used to understand spatial dependence and clustering of deliveries conducted by SBA coverage in districts of India. Ordinary least square, spatial lag and spatial error models were used to examine the correlates of deliveries conducted by SBA.

Results

Moran’s I value for SBA among women was 0.54, which represents a high spatial auto-correlation of deliveries conducted by SBA over 640 districts of India. There were 145 hotspots for deliveries conducted by SBA among women in India, which includes almost the entire southern part of India. The spatial error model revealed that with a 10% increase in exposure to mass media in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Interestingly, also with the 10% increase in the four or more antenatal care (ANC) in a particular district, the deliveries conducted by SBA increased significantly by 2.5%. Again, if there was a 10% increase of women with first birth order in a particular district, then the deliveries conducted by SBA significantly increased by 6.1%. If the district experienced an increase of 10% household as female-headed, then the deliveries conducted by SBA significantly increased by 1.4%.

Conclusion

The present study highlights the important role of ANC visits, mass media exposure, education, female household headship that augment the use of an SBA for delivery. Attention should be given in promoting regular ANC visits and strengthening women’s education.
Barriers to initiating and maintaining participation in parkrun
Authors: Reece L. J. , Owen K. , Graney M. , Jackson C. , Shields M. , Turner G. , Wellington C.
Published: January 2022

Interventions that increase population physical activity are required to promote health and wellbeing. parkrun delivers community-based, 5 km events worldwide yet 43% who register never participate in a parkrun event. This research had two objectives; i) explore the demographics of people who register for parkrun in United Kingdom, Australia, Ireland, and don’t initiate or maintain participation ii) understand the barriers to participating in parkrun amongst these people. Mandatory data at parkrun registration provided demographic characteristics of parkrun registrants. A bespoke online survey distributed across the three countries captured the reasons for not participating or only participating once. Of 680,255 parkrun registrants between 2017 and 19, 293,542 (43%) did not participate in any parkrun events and 147,148 (22%) only participated in one parkrun event. Females, 16–34 years and physically inactive were more likely to not participate or not return to parkrun. Inconvenient start time was the most frequently reported barrier to participating, with females more likely than males to report the psychological barrier of feeling too unfit to participate. Co-creating strategies with and for people living with a chronic disease, women, young adults, and physically inactive people, could increase physical activity participation within parkrun.
Traditional and complementary medicine (TCM) usage and its association with Patient Assessment of Chronic Illness Care (PACIC) among individuals with metabolic syndrome in primary care
Authors: Basri Nor Farha , Ramli Anis Safura , Mohamad Mariam , Kamaruddin Khairatul Nainey
Published: January 2022

Background

Traditional and Complementary Medicine (TCM) is widely used particularly among patients with chronic diseases in primary care. However, evidence is lacking regarding TCM use among patients with Metabolic Syndrome (MetS) and its association with patients’ experience on chronic disease conventional care that they receive. Therefore, this study aims to determine the prevalence and pattern of TCM use, compare the patients’ experience of chronic disease care using the Patient Assessment of Chronic Illness Care - Malay version (PACIC-M) questionnaire between TCM users and non-users and determine the factors associated with TCM use among patients with MetS in primary care.

Methodology

A cross-sectional study was conducted at a university primary care clinic. Patients aged 18 to 80 years old with MetS were recruited. Socio-demographic characteristic, clinical characteristics and information on TCM use and its pattern were recorded in a proforma. Patient’s experience of chronic disease conventional care was measured using PACIC-M questionnaire. The comparison of PACIC-M mean score between TCM users and non-users was measured using independent t-test. The factors associated with TCM use were determined by simple logistic regression (SLogR), followed by multiple logistic regression (MLogR).

Results

Out of 394 participants, 381 (96.7%) were included in the final analysis. Of the 381 participants, 255 (66.9%) were TCM users (95% CI 62.7, 71.7). Only 36.9% of users disclosed about TCM use to their health care providers (HCP). The overall mean PACIC-M score was 2.91 (SD ± 0.04). TCM users had significantly higher mean PACIC-M score compared to non-users (2.98 ± 0.74 vs 2.75 ± 0.72, p = 0.01). The independent factors associated with TCM use were being female (Adj. OR 2.50, 95% CI 1.55, 4.06), having high education level (Adj. OR 2.16, 95% CI 1.37, 3.41) and having high overall PACIC-M mean score (Adj. OR 1.49, 95% CI 1.10, 2.03).

Conclusion

TCM use was highly prevalent in this primary care clinic. However, the disclosure rate of TCM use to HCP was low. Females, those with high education and high PACIC-M mean score were more likely to use TCM. Further research should explore the reasons for their TCM use, despite having good experience in conventional chronic disease care.
Panax notoginseng saponins reverse P-gp-mediated steroid resistance in lupus: involvement in the suppression of the SIRT1/FoxO1/MDR1 signalling pathway in lymphocytes
Authors: Pan Feng , Li Yue-jin , Lu Ying
Published: January 2022

Background

P-glycoprotein (P-gp)-mediated steroid resistance (SR) has been suggested to play a significant role in lupus nephritis (LN) treatment failure. Panax notoginseng saponins (PNS), the main effective components of the traditional Chinese medicine notoginseng, exhibited potent reversal capability of P-gp-mediated SR, but its mechanism remains unknown. This study aimed to investigate the effect of PNS on reversing SR in lupus and its underlying mechanism in vivo and in vitro.

Methods

In this study, an SR animal and splenic lymphocyte model were established using low-dose methylprednisolone (MP). Flow cytometry was used to detect the effect of PNS on reversing P-gp-mediated SR and the expression of P-gp in different T-cells phenotypes. Serum levels of ANA and dsDNA in lupus mice were measured by ELISA. Apoptosis was identified by Annexin V-FITC/PI staining. RT–PCR and Western blotting were used to detect the protein and mRNA expression levels of SIRT1, FoxO1, and MDR1 in SR splenic lymphocytes from lupus mice (SLCs/MPs).

Results

PNS could reverse the SR in lupus mice. Simultaneously, PNS increased the apoptotic effect of MP on SLCs/MP cells. The increased accumulation of rhodamine-123 (Rh-123) indicated that intracellular steroid accumulation could be increased by the action of PNS. Moreover, PNS decreased the expression of P-gp levels. Further experiments elucidated that the SIRT1/FoxO1/MDR1 signalling pathway existed in SLCs/MP cells, and PNS suppressed its expression level to reverse SR. The expression of P-gp in Th17 from SLCs/MP cells was increased, while PNS could reduce its level in a more obvious trend.

Conclusion

The present study suggested that PNS reversed P-gp-mediated SR via the SIRT1/FoxO1/MDR1 signalling pathway, which might become a valuable drug for the treatment of SR in lupus. Th17 might be the main effector cell of PNS reversing SR.
An educational approach for early student self-assessment in clinical periodontology
Authors: Ramlogan Shaun , Raman Vidya
Published: January 2022

Background

Self-assessment is a mandated educational requirement for use in dental undergraduate programmes. It is weakly supported for use in early clinical training and studies are criticized for the conceptual and methodology shortfalls. The aim of the study was to compare the alignment of student self-assessment to both staff assessment and written exams in early clinical training using an educational approach.

Methods

In 2014-2015, 55 third-year dental students completed three educational sessions comprising of (a) classroom teaching (lecture, video) with post-lesson written exam and (b) clinical activity with student self-assessment, staff assessment and student reflection. An intra-individual analysis approach, staff validation, and student scoring standardization were implemented. Cognitive (clinical competency) and non-cognitive (professionalism) items were separated in the analyses.

Results

There were medium correlations (Spearman’s rho, r) between student self-assessment and staff assessment scores for cognitive items (r, 0.32) and for non-cognitive items (r, 0.44) for all three combined sessions. There were large correlations for individual sessions. Compared to the post-lesson written exam, students showed small correlation (r, 0.22, 0.29) and staff showed medium correlation (r, 0.31, 0.34) for cognitive and non-cognitive items. Students showed improvements in their mean scores for both cognitive (t-test; p > 0.05) and non-cognitive items (t-test; p = 0.000). Mean scores of students were not different statistically from that of staff (p > 0.05).

Conclusions

Students may adequately act as self-assessors at the beginning of their clinical work in periodontology. Self-assessment may potentially improve the clinical performance. Self-assessment may be nurtured through clear guidelines, educational training strategies, feedback and reflection leading to better evaluative judgement and lifelong learning.
Iron in airway macrophages and infective exacerbations of chronic obstructive pulmonary disease
Authors: Ho Terence , Nichols Matthew , Nair Gayatri , Radford Katherine , Kjarsgaard Melanie , Huang Chynna , Bhalla Anurag , Lavigne Nicola , Mukherjee Manali , Surette Michael , Macri Joseph , Nair Parameswaran
Published: January 2022

Background

Excess pulmonary iron has been implicated in the pathogenesis of lung disease, including asthma and COPD. An association between higher iron content in sputum macrophages and infective exacerbations of COPD has previously been demonstrated.

Objectives

To assess the mechanisms of pulmonary macrophage iron sequestration, test the effect of macrophage iron-loading on cellular immune function, and prospectively determine if sputum hemosiderin index can predict infectious exacerbations of COPD.

Methods

Intra- and extracellular iron was measured in cell-line-derived and in freshly isolated sputum macrophages under various experimental conditions including treatment with exogenous IL-6 and hepcidin. Bacterial uptake and killing were compared in the presence or absence of iron-loading. A prospective cohort of COPD patients with defined sputum hemosiderin indices were monitored to determine the annual rate of severe infectious exacerbations.

Results

Gene expression studies suggest that airway macrophages have the requisite apparatus of the hepcidin-ferroportin axis. IL-6 and hepcidin play roles in pulmonary iron sequestration, though IL-6 appears to exert its effect via a hepcidin-independent mechanism. Iron-loaded macrophages had reduced uptake of COPD-relevant organisms and were associated with higher growth rates. Infectious exacerbations were predicted by sputum hemosiderin index (β = 0.035, p = 0.035).

Conclusions

We demonstrate in-vitro and population-level evidence that excess iron in pulmonary macrophages may contribute to recurrent airway infection in COPD. Specifically, IL-6-dependent iron sequestration by sputum macrophages may result in immune cell dysfunction and ultimately lead to increased frequency of infective exacerbation.
MR-based radiomics-clinical nomogram in epithelial ovarian tumor prognosis prediction: tumor body texture analysis across various acquisition protocols
Authors: Wang Tianping , Wang Haijie , Wang Yida , Liu Xuefen , Ling Lei , Zhang Guofu , Yang Guang , Zhang He
Published: January 2022

Background

Epithelial ovarian cancer (EOC) is the most malignant gynecological tumor in women. This study aimed to construct and compare radiomics-clinical nomograms based on MR images in EOC prognosis prediction.

Methods

A total of 186 patients with pathologically proven EOC were enrolled and randomly divided into a training cohort (n = 130) and a validation cohort (n = 56). Clinical characteristics of each patient were retrieved from the hospital information system. A total of 1116 radiomics features were extracted from tumor body on T2-weighted imaging (T2WI), T1-weighted imaging (T1WI), diffusion weighted imaging (DWI) and contrast-enhanced T1-weighted imaging (CE-T1WI). Paired sequence signatures were constructed, selected and trained to build a prognosis prediction model. Radiomic-clinical nomogram was constructed based on multivariate logistic regression analysis with radiomics score and clinical features. The predictive performance was evaluated by receiver operating characteristic curve (ROC) analysis, decision curve analysis (DCA) and calibration curve.

Results

The T2WI radiomic-clinical nomogram achieved a favorable prediction performance in the training and validation cohort with an area under ROC curve (AUC) of 0.866 and 0.818, respectively. The DCA showed that the T2WI radiomic-clinical nomogram was better than other models with a greater clinical net benefit.

Conclusion

MR-based radiomics analysis showed the high accuracy in prognostic estimation of EOC patients and could help to predict therapeutic outcome before treatment.
Eligibility criteria for pediatric patients who may benefit from anti SARS-CoV-2 monoclonal antibody therapy administration: an Italian inter-society consensus statement
Authors: Lanari Marcello , Venturini Elisabetta , Pierantoni Luca , Stera Giacomo , Castelli Gattinara Guido , Esposito Susanna Maria Roberta , Favilli Silvia , Franzoni Emilio , Fusco Eleonora , Lionetti Paolo , Maffeis Claudio , Marseglia Gianluigi , Massella Laura , Midulla Fabio , Zanobini Alberto , Zecca Marco , Villani Alberto , Staiano Annamaria , Galli Luisa ,   Other Collaborators, Blasi Francesco , Di Giorgio Angelo , Donà Daniele , Licari Amelia , Martinelli Massimo , Mastrangelo Antonio , Miraglia del Giudice Michele , Nicolini Giangiacomo , Pugliese Fabrizio , Striano Pasquale , Valerio Giuliana
Published: January 2022

The fast diffusion of the SARS-CoV-2 pandemic have called for an equally rapid evolution of the therapeutic options.

The Human recombinant monoclonal antibodies (mAbs) have recently been approved by the Food and Drug Administration (FDA) and by the Italian Medicines Agency (AIFA) in subjects aged ≥12 with SARS-CoV-2 infection and specific risk factors.

Currently the indications are specific for the use of two different mAbs combination: Bamlanivimab+Etesevimab (produced by Eli Lilly) and Casirivimab+Imdevimab (produced by Regeneron).

These drugs have shown favorable effects in adult patients in the initial phase of infection, whereas to date few data are available on their use in children.

AIFA criteria derived from the existing literature which reports an increased risk of severe COVID-19 in children with comorbidities. However, the studies analyzing the determinants for progression to severe disease are mainly monocentric, with limited numbers and reporting mostly generic risk categories.

Thus, the Italian Society of Pediatrics invited its affiliated Scientific Societies to produce a Consensus document based on the revision of the criteria proposed by AIFA in light of the most recent literature and experts’ agreement.

This Consensus tries to detail which patients actually have the risk to develop severe disease, analyzing the most common comorbidities in children, in order to detail the indications for mAbs administration and to guide the clinicians in identifying eligible patients.
Effects of deworming medication on anaemia among children aged 6–59 months in sub-Saharan Africa
Authors: Bauleni Andy , Tiruneh Fentanesh N. , Mwenyenkulu Tisungane E. , Nkoka Owen , Chirwa Gowokani C. , Gowelo Steve , Chipeta Michael G. , Ntenda Peter A. M.
Published: January 2022

Background

Despite the limited knowledge regarding the effects of deworming medication (DM) on nutritional indicators in sub-Saharan Africa (SSA), deworming programmes continue to be implemented in resource-limited countries. Therefore, the current study aimed to examine the effects of DM on anaemia among children aged 6–59 months in SSA.

Methods

The analysis was performed using data obtained from 17 demographic and health surveys (DHSs) conducted in SSA. Children were considered to be anaemic if their haemoglobin (Hb) concentration was less than 11.0 g/dl, adjusting for altitude. To account for both multiple measures at the cluster level and the clustering of children within the same country, generalized linear mixed models were used to analyse the anaemia outcomes in 50,075 children aged 6–59 months.

Results

Overall, anaemia was reported in 61.8% of the children, and their median Hb concentration was 10.5 g/dl (interquartile range 9.4–11.5). The prevalence of anaemia ranged from 34.5% in Rwanda to 81.1% in Mali. Multivariate analyses showed that children who did not receive DM had increased odds of being anaemic (adjusted odds ratio [aOR]: 1.11; 95% confidence interval [CI] 1.07–1.16).

Conclusions

The current study revealed that DM can decrease the risk of anaemia among preschool-age children (pre-SAC) in SSA. Thus, tailored public health programmes aimed at reducing childhood anaemia need to consider deworming. However, longitudinal studies are needed to validate the association that has been reported in this cross-sectional study.

Graphical Abstract
Long-term glycemic variability and risk of stroke in patients with diabetes: a meta-analysis
Authors: Ren Xiaoli , Wang Zhiyun , Guo Congfang
Published: January 2022

Objectives

Long-term glycemic variability has been related to increased risk of vascular complication in patients with diabetes. However, the association between parameters of long-term glycemic variability and risk of stroke remains not fully determined. We performed a meta-analysis to systematically evaluate the above association.

Methods

Medline, Embase, and Web of Science databases were searched for longitudinal follow-up studies comparing the incidence of stroke in diabetic patients with higher or lower long-term glycemic variability. A random-effect model incorporating the potential heterogeneity among the included studies were used to pool the results.

Results

Seven follow-up studies with 725,784 diabetic patients were included, and 98% of them were with type 2 diabetes mellitus (T2DM). The mean follow-up duration was 7.7 years. Pooled results showed that compared to those with lowest category of glycemic variability, diabetic patients with the highest patients had significantly increased risk of stroke, as evidenced by glycemic variability analyzed by fasting plasma glucose coefficient of variation (FPG-CV: risk ratio [RR] = 1.24, 95% confidence interval [CI] 1.11 to 1.39, P < 0.001; I2 = 53%), standard deviation of FPG (FPG-SD: RR = 1.16, 95% CI 1.02 to 1.31, P = 0.02; I2 = 74%), HbA1c coefficient of variation (HbA1c-CV: RR = 1.88, 95% CI 1.61 to 2.19 P < 0.001; I2 = 0%), and standard deviation of HbA1c (HbA1c-SD: RR = 1.73, 95% CI 1.49 to 2.00, P < 0.001; I2 = 0%).

Conclusions

Long-term glycemic variability is associated with higher risk of stroke in T2DM patients.