bluuebunny/crossref_metadata_2025 huggingface dataset:
Voices of Teens and Young Adults on the Subject of Teleconsultation in the COVID-19 Context
Authors: Ziani Melissa , Trépanier Emmanuelle , Goyette Martin
Published: April 2022

This article describes the perceptions of adolescents and young adults aged 14 to 25 years who live in Québec (Canada) and obtained health services via teleconsultation for the first time, owing to the COVID-19 pandemic. Eleven young people who had received physical health services (medicine, physiotherapy, speech therapy, or nutritionist) participated in virtual semi-structured interviews. These interviews shed light on how these adolescents and young adults experienced the adaptation of the intervention and how effective they perceived the intervention to be. The article concludes with some thoughts for practitioners.
Gen Z: An Emerging Phenomenon
Authors: Mahapatra Gopal P. , Bhullar Naureen , Gupta Priyansha
Published: April 2022

This study explains how generations X, Y and Z share similarities and differences in work values and career preferences. The authors attempt to understand the work values and career preferences of Gen Z with a focus on India as the cultural context crucially contributes to generational differences ( Erickson, 2009 , Generational Differences Between India and the US, Harvard Business Review). While researchers portray that the generational values often develop in the formative years ( Strauss & Howe, 1992 ), this article attempts to understand the evolution of Gen Z in light of the COVID-19 pandemic and how it aligns with or urges change in prominent developmental theories. These findings can form a base for future research and potentially draw implications for organisations, managers, communities and individuals.
Inversion of Control in Employee–Employer Relation: Multiple Case Study of Generational Cohorts from State Government Sector
Authors: Rajan Soumya G.
Published: April 2022

The article embarks upon its investigation with the help of multiple case analysis to benefit some perspectives on organisational control. It studies certain generational cohorts of employees who engage with organisations that do not represent the usual spectrum of economic interests namely government organisations. The cases belong to generations that temporally lie closer to each other and the employees have retired from service. The case analyses the perception of evolving nature of control on employees. Direction, evaluation and discipline being the three areas that are increasingly discussed in control literature, the case particularly concentrates on revelations under these focal points as it journeys through their work lives. The article unearths a curious inversion of relationship between the employee and employer on account of increasing strengthening of knowledge of the employee. It also explains the apparent hesitation/delay in adopting new and upbeat technologies largely by the government structure.
Gender differences in mathematics achievement: A secondary analysis of Programme for International Student Assessment data from Shanghai
Authors: Kaiser Gabriele , Zhu Yan
Published: April 2022

As mathematics has been seen for decades as a stereotyped male domain, gender differences in mathematics learning have received strong attention from the public and academia. In China, the issue of gender equity in education is a particularly interesting topic to most families with the implementation of the one-child policy since the late 1970s. This study aims to study in more depth the role of gender on Shanghai students’ mathematics attainment from a perspective of three societal factors (i.e., one-child status at home, socioeconomic status, and school types) via a secondary analysis of the Programme for International Student Assessment 2012 Shanghai–China mathematics data. In contrast to the official report by Programme for International Student Assessment on Shanghai–China and in line with own previous studies, the current analyses reveal that 15-year-old students in Shanghai performed significantly different on two content-related subscales (i.e., change and relationships and quantity) and two processes-related subscales (i.e., formulate and interpret). Furthermore, significant gender differences were found with students from one-child families but not multi-children families. Among schools of different types in terms of academic tracks and performance levels, the gender differences were largest in the more selective model (general) schools and then vocational schools followed by ordinary (general) schools. Given the nested structure of the Programme for International Student Assessment data, this study found that, on average, a Shanghai boy would achieve significantly higher marks than a girl in Programme for International Student Assessment 2012 mathematics test. The paper closes with discussions on societal and educational implications about these gender disparities, which are still apparent in the current school system of Shanghai.
Sézary syndrome patient–derived models allow drug selection for personalized therapy
Authors: Gallardo Fernando , Andrades Evelyn , Iglesias Arnau , González Jessica , Solé Laura , Guillén Yolanda , Blanco Gonzalo , Colomo Luis , Gimeno Eva , Conde David , Rodriguez Eva , Bielsa-Marso Isabel , Iglesias Mar , Bellosillo Beatriz , Pujol Ramon M. , Regueiro José R. , Bigas Anna , Espinosa Lluís
Published: April 2022

Current therapeutic approaches for Sézary syndrome (SS) do not achieve a significant improvement in long-term survival of patients, and they are mainly focused on reducing blood tumor burden to improve quality of life. Eradication of SS is hindered by its genetic and molecular heterogeneity. Determining effective and personalized treatments for SS is urgently needed. The present work compiles the current methods for SS patient–derived xenograft (PDX) generation and management to provide new perspectives on treatment for patients with SS. Mononuclear cells were recovered by Ficoll gradient separation from fresh peripheral blood of patients with SS (N = 11). A selected panel of 26 compounds that are inhibitors of the main signaling pathways driving SS pathogenesis, including NF-kB, MAPK, histone deacetylase, mammalian target of rapamycin, or JAK/STAT, was used for in vitro drug sensitivity testing. SS cell viability was evaluated by using the CellTiter-Glo_3D Cell Viability Assay and flow cytometry analysis. We validated one positive hit using SS patient–derived Sézary cells xenotransplanted (PDX) into NOD-SCID-γ mice. In vitro data indicated that primary malignant SS cells all display different sensitivities against specific pathway inhibitors. In vivo validation using SS PDX mostly reproduced the responses to the histone deacetylase inhibitor panobinostat that were observed in vitro. Our investigations revealed the possibility of using high-throughput in vitro testing followed by PDX in vivo validation for selective targeting of SS tumor cells in a patient-specific manner.
Cell origin–dependent cooperativity of mutant Dnmt3a and Npm1 in clonal hematopoiesis and myeloid malignancy
Authors: SanMiguel Jennifer M. , Eudy Elizabeth , Loberg Matthew A. , Miles Linde A. , Stearns Tim , Mistry Jayna J. , Rauh Michael J. , Levine Ross L. , Trowbridge Jennifer J.
Published: April 2022

In adult acute myeloid leukemia (AML), the acquisition of driver somatic mutations may be preceded by a benign state termed clonal hematopoiesis (CH). To develop therapeutic strategies to prevent leukemia development from CH, it is important to understand the mechanisms by which CH-driving and AML-driving mutations cooperate. Here, we use mice with inducible mutant alleles common in human CH (DNMT3AR882; mouse Dnmt3aR878H) and AML (NPM1c; mouse Npm1cA). We find that Dnmt3aR878H/+ hematopoietic stem cells (HSCs), but not multipotent progenitor cell (MPP) subsets, have reduced cytokine expression and proinflammatory transcriptional signatures and a functional competitive advantage over their wild-type counterparts. Dnmt3aR878H/+ HSCs are the most potent cell type transformed by Npm1cA, generating myeloid malignancies in which few additional cooperating somatic mutation events were detected. At a molecular level, Npm1cA, in cooperation with Dnmt3aR878H, acutely increased the accessibility of a distinct set of promoters in HSCs compared with MPP cells. These promoters were enriched for cell cycling, PI3K/AKT/mTOR signaling, stem cell signatures, and targets of transcription factors, including NFAT and the chromatin binding factor HMGB1, which have been implicated in human AML. These results demonstrate cooperativity between preexisting Dnmt3aR878H and Npm1cA at the chromatin level, where specific loci altered in accessibility by Npm1cA are dependent on cell context as well as Dnmt3a mutation status. These findings have implications for biological understanding and therapeutic intervention in the transformation from CH to AML.
Outcomes after biochemical or clinical progression in patients with multiple myeloma
Authors: Goldman-Mazur Sarah , Visram Alissa , Kapoor Prashant , Dispenzieri Angela , Lacy Martha Q. , Gertz Morie A. , Buadi Francis K. , Hayman Suzanne R. , Dingli David , Kourelis Taxiarchis , Gonsalves Wilson , Warsame Rahma , Muchtar Eli , Leung Nelson , Binder Moritz , Fonder Amie , Hobbs Miriam , Hwa Yi Lisa , Kyle Robert A. , Rajkumar S. Vincent , Kumar Shaji K.
Published: April 2022

Almost all patients with multiple myeloma (MM) eventually relapse, either asymptomatically or with end-organ damage. However, it remains unclear whether initiating therapy at the time of biochemical progression (BP) improves the outcomes compared with initiating therapy at the clinical progression (CP) stage. Here, we retrospectively assessed 1347 patients with relapsed MM. Most progressions were BP (60.4%); 39.6% had CP. The most prevalent symptoms at relapse were new or evolving bone disease (80.9%), anemia (38.0%), and renal failure (12.7%). Patients with BP had longer median time from second-line treatment to the next treatment compared with patients who had CP (17.0 vs 9.6 months; P < .001) as well as longer median overall survival from first relapse (59.4 vs 26.2 months; P < .001). Male sex (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.02-2.18; P = .04), plasma cell labeling index ≥2% (OR, 1.58; 95% CI, 1.02-2.45; P = .04), and extramedullary disease at diagnosis (OR, 1.84; 95% CI, 1.08-3.13; P = .03) were associated with higher risk of CP, whereas very good partial remission or better had decreased risk of CP (OR, 0.62; 95% CI, 0.43-0.91; P = .02). To conclude, patients with CP have inferior postprogression outcomes compared with patients who have BP. Patients with deeper response to first-line therapy are less likely to develop CP. The presence of a specific CRAB (C, hypercalcemia; R, renal failure; A, anemia; B, bone disease) symptom at diagnosis predicts for the development of similar CRAB symptoms at relapse.
Effects of salinity acclimation on histological characteristics and miRNA expression profiles of scales in juvenile rainbow trout (Oncorhynchus mykiss)
Authors: Zhou Qi Ling , Wang Liu Yong , Zhao Xiao Long , Yang Yun Sheng , Ma Qian , Chen Gang
Published: April 2022

Background

The scales serve as an ideal model for studying the regulatory mechanism of bone homeostasis in fish. To explore the effect of salinity acclimation on bone metabolism of juvenile rainbow trout (Oncorhynchus mykiss), three sampling time points during salinity acclimation (7D, 14D and 21D) were selected to detect variations in histological characteristics. In the histological analysis, osteoblast marker enzymes alkaline phosphatase (ALP), osteoclast marker tartrate-resistant acid phosphatase (TRAcP) and calcium salt deposit areas (Von Kossa′s) were detected. Changes in calcium (Ca), phosphorus (P) and the molar mass ratio of calcium to phosphorus (Ca/P) in the scales were also detected by Inductively Coupled Plasma Mass Spectrometry (ICP-MS). In addition, the global MicroRNA (miRNA) expression profiles during salinity acclimation were examined using Illumina sequencing platform because of their important regulatory roles in teleost biological processes.

Results

Twelve independent miRNA libraries were constructed, a total of 664 known and 92 putative novel miRNAs were identified. A total of 290 differentially expressed (DE) miRNAs were found in clusters with significant trends in the cluster analysis, and five types of clustering patterns were obtained; 22,374 DE predicted target genes of the aforementioned 290 DE miRNAs were obtained, 5957 of which clustered in six types of clustering patterns with a significant trend. To better understand the functions of the DE miRNAs, GO and KEGG analysis was performed on the 5957 target genes, as a result, they were significantly enriched in bone metabolism related signaling pathways such as MAPK signaling pathway, Calcium signaling pathway, Wnt signaling pathway, Mineral absorption and NF-kappa B signaling pathway. Six DE miRNAs were randomly selected and their expression were verified by quantitative real-time PCR (qRT-PCR), the expression trends were consistent with the results of transcriptome sequencing.

Conclusions

The DE miRNAs and DE target genes identified in this study might play an important role in regulation of bone metabolism during salinity acclimation, relative genes or pathways could serve as key candidates for further studies to elucidate molecular mechanism of teleost bone metabolism, and help performing salinity acclimation and developing marine culture of salmonid species.
Comparative transcriptome analysis provides insights into the molecular mechanisms of high-frequency hearing differences between the sexes of Odorrana tormota
Authors: Chen Zhuo , Liu Yao , Liang Rui , Cui Chong , Zhu Yanjun , Zhang Fang , Zhang Jie , Chen Xiaohong
Published: April 2022

Background

Acoustic communication is important for the survival and reproduction of anurans and masking background noise is a critical factor for their effective acoustic communication. Males of the concave-eared frog (Odorrana tormota) have evolved an ultrasonic communication capacity to avoid masking by the widespread background noise of local fast-flowing streams, whereas females exhibit no ultrasonic sensitivity. However, the molecular mechanisms underlying the high-frequency hearing differences between the sexes of O. tormota are still poorly understood.

Results

In this study, we sequenced the brain transcriptomes of male and female O. tormota, and compared their differential gene expression. A total of 4,605 differentially expressed genes (DEGs) between the sexes of O. tormota were identified and eleven of them were related to auditory based on the annotation and enrichment analysis. Most of these DEGs in males showed a higher expression trend than females in both quantity and expression quantity. The highly expressed genes in males were relatively concentrated in neurogenesis, signal transduction, ion transport and energy metabolism, whereas the up-expressed genes in females were mainly related to the growth and development regulation of specific auditory cells.

Conclusions

The transcriptome of male and female O. tormota has been sequenced and de novo assembled, which will provide gene reference for further genomic studies. In addition, this is the first research to reveal the molecular mechanisms of sex differences in ultrasonic hearing between the sexes of O. tormota and will provide new insights into the genetic basis of the auditory adaptation in amphibians during their transition from water to land.
Visual expertise modulates baseline brain activity: a preliminary resting-state fMRI study using expertise model of radiologists
Authors: Zhang Ting , Dong Minghao , Wang Hongmei , Jia Rui , Li Fu , Ni Xiaoli , Jin Chenwang
Published: April 2022

Background

visual expertise and experience modulate evoked brain activity in response to training-related stimuli. However, few studies have considered how the visual experience is represented in the resting state brain activity. This study tried to investigate the way visual experience, i.e., visual recognition expertise, modulates baseline brain neuronal activity in the resting state using the model of radiologists.

Methods

The amplitude of low-frequency (< 0.08 Hz) fluctuation (ALFF) was used as the metric of baseline brain activity and a visual expertise model of radiologists to investigated this question. The visual recognition skill enables them to accurately identify pathological information in medical images. After the behavior measurement, a cohort group of radiology interns (n = 22) and a group of matched layperson (n = 22) were selected for inclusion in the study. The resting state functional magnetic resonance imaging (fMRI) scans were performed for all of the subjects.

Results

Higher ALFF in the right fusiform gyrus and the left orbitofrontal cortex were observed, and the ALFF in the fusiform gyrus was correlated with the intern radiologists’ behavioral expertise(all results corrected for multiple comparisons).

Conclusions

Visual experience modulates the baseline brain activity in both high-level visual cortex and high-order cognitive cortex, indicating the engagement of both top-down and bottom-up facilitation. We provide a novel perspective to how visual experience modulated cortical brain activity by introducing the resting state changes. Also, we propose that our current study may provide novel ideas for the development of new training protocols in medical school.
Epidural analgesia information sessions provided by anesthetic nurses: impact on satisfaction and anxiety of parturient women a prospective sequential study
Authors: Cherel Quentin , Burey Julien , Rousset Julien , Picard Anne , Mirza Dimitra , Dias Christina , Jacquet Hélène , Mariani Paule , Raffegeau Nathalie , Saupin Isabelle , Bornes Marie , Lapidus Nathanaël , Quesnel Christophe , Garnier Marc
Published: April 2022

Background

Information on epidural analgesia delivered to parturient women is frequently incomplete, making it difficult for expectant mothers to make an appropriate choice for their delivery. We assessed the impact of a multimodal information session on epidural analgesia delegated to anesthetic nurses on new-mothers’ satisfaction.

Methods

We performed a prospective sequential study including parturient women who gave birth with epidural analgesia. During the first period, information on epidural analgesia was delivered by anesthetists during the scheduled anesthesia consultation, according to French standard-of-care. Then, a dedicated information session about epidural analgesia provided by anesthetic nurses was implemented. The primary endpoint was the satisfaction of women with the quality of information received. Main secondary endpoints were knowledge of women about epidural analgesia, anxiety before epidural catheter placement, and satisfaction with delivery.

Results

259 and 298 women were included during the first and second periods respectively, among whom 178 and 188 were analyzed. Information on epidural analgesia delivered by anesthetic nurses was associated with improvement of new-mothers’ satisfaction with information received (9 (8–10) vs. 10 (9–10) –p < 0.001). Moreover, information delivered by anesthetic nurses was associated with decreased anxiety before epidural catheter placement (4 (1–8) vs. 3 (1–6) –p = 0.006) and increased satisfaction with delivery (8 (7–10) vs. 9 (8–10) –p = 0.01). Women’s knowledge on epidural analgesia was durably increased when information was delivered by anesthetic nurses compared to conventional information by anesthetists. After adjustment, the only variable associated with both new mothers’ satisfaction with information and delivery was the information session taught by anesthetic nurses.

Conclusions

Information sessions on epidural analgesia delivered by anesthetic nurses was associated with improved satisfaction of women with their delivery. Such information sessions may be used in maternity wards to improve new-mothers’ childbirth experience.
Subclinical cardiovascular disease and frailty risk: the atherosclerosis risk in communities study
Authors: Jia Yu , Li Dongze , Yu Jing , Liu Yi , Li Fanghui , Li Wentao , Zhang Qin , Gao Yongli , Zhang Wei , Zeng Zhi , Zeng Rui , Liao Xiaoyang , Zhao Qian , Wan Zhi
Published: April 2022

Background

Cardiovascular disease (CVD) is associated with a greater frailty risk, but it remains unknown if pathways that contribute to CVD are associated with the frailty risk. Thus, we aimed to investigate whether elevations in high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) for those without known CVD at baseline are associated with a higher frailty risk.

Methods

This study used data from the Atherosclerosis Risk in Communities study. Cardiac biomarkers were measured from stored plasma samples collected at Visit 2 (1991–1993). Frailty was recorded at Visit 5 (2011–2013). Cox regression models were used to determine the association of cardiac biomarkers with frailty risk.

Results

Overall, 360/5199 (6.9%) participants aged 55.1 ± 5.1 years developed frailty during a median follow-up of 21.7 years. The incidence of frailty was significantly higher in participants with hs-cTnT ≥14 ng/L (vs. < 14 ng/L: 17.9% vs. 6.7%) or NT-proBNP ≥300 pg/ml (vs. < 300 pg/ml: 19.7% vs. 6.8%) (all P < 0.001). Comparing higher vs. lower cut-off levels of either hs-cTnT (14 ng/l) or NT-proBNP (300 pg/ml) demonstrated a greater than two-fold higher frailty risk, with hazard ratios (HRs) of 2.13 (95% confidence interval (CI): 1.130–4.01, P = 0.020) and 2.61 (95% CI: 1.28–5.33, P = 0.008), respectively. Individuals with both elevated hs-cTnT and NT-proBNP had a higher frailty risk than those without it (HR: 4.15; 95% CI: 1.50–11.48, P = 0.006).

Conclusions

High hs-cTnT and NT-proBNP levels are strongly associated with incident frailty in the community-dwelling population without known CVD. Subclinical cardiac damage (hs-cTnT) and/or wall strain (NT-proBNP) may be the key pathway of CVD patients developing frailty. Detection of hs-cTnT and NT-proBNP may help for early screening of high-risk frailty and providing individualised intervention.

Trial registration

URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005131.
Tracking and risk of abdominal and general obesity in children between 4 and 9 years of age. The Longitudinal Childhood Obesity Study (ELOIN)
Authors: Ortiz-Marrón Honorato , Ortiz-Pinto Maira Alejandra , Cabañas Pujadas Gloria , Martínez Mosquera José Galo , Lorente Miñarro Marien , Menchero Pinos Francisca , Ordobás Gavín María , Galán Iñaki
Published: April 2022

Background

Studies have shown that overweight and obesity conditions tend to be stable from childhood and adolescence to adulthood. Unfortunately, little is known about the evolution of abdominal obesity during childhood. The aim of this study was to evaluate the temporal variations and risk of general and abdominal obesity between 4, 6, and 9 years of age.

Methods

Measurements of children in the ELOIN study taken at the three follow-ups of 4, 6, and 9 years of age were included (N = 1,902). Body mass index and waist circumference were recorded via physical examination. General obesity was determined according to the criteria of the World Health Organization (WHO) and abdominal obesity according to the cut-off points proposed by the International Diabetes Federation (IDF). Prevalence ratios (PRs) were estimated by sex and family affluence using generalized estimating equation models and relative risks (RRs) of obesity were obtained via Poisson regression.

Results

The prevalence of general obesity was 5.1%, 9.1%, and 15.6% at 4, 6, and 9 years, respectively, yielding a PR of 3.05 (95%CI: 2.55–3.60) (9 years old relative to 4 years). The prevalence of abdominal obesity was 6.8%, 8.4%, 14.5% at 4, 6, and 9 years, respectively, and the PR was 2.14 (95%CI: 1.82–2.51) (9 years old relative to 4 years). An inverse correlation was observed between both general and abdominal obesity and socioeconomic status. Among participants with general or abdominal obesity at 4 years of age, 77.3% and 63.6% remained in their obesity classification at 9 years, respectively, and 3.4% and 3.5% presented general or abdominal obesity also at 6 and 9 years of age, respectively. The RRs of general and abdominal obesity at 9 years were 4.61 (95%CI: 2.76–7.72) and 4.14 (95%CI: 2.65–6.48) for children classified with obesity at 4 years of age, increased to 9.36 (95%CI: 7.72–11.35) and 9.56 (95%CI: 7.79–11.74) for children who had obesity at 6 years, and up to 10.27 (95%CI: 8.52–12.37) and 9.88 (95%CI: 8.07–12.11) for children with obesity at both 4 and 6 years, respectively.

Conclusions

General and abdominal obesity begin at an early age and increase over time, showing an inverse correlation with socioeconomic status. In addition, general and abdominal obesity at 9 years are strongly associated with being classified with obesity at 4 and 6 years, so preventive interventions should be established at very early ages.
Silver diamine fluoride, atraumatic restorations, and oral health-related quality of life in children aged 5–13 years: results from the CariedAway school-based cluster randomized trial
Authors: Ruff Ryan Richard , Barry Godín Tamarinda J. , Small Topaz Murray , Niederman Richard
Published: April 2022

Objective

Silver diamine fluoride (SDF) is a non-surgical treatment for the arrest and prevention of dental caries that results in irreversible black staining of dental decay. The objective of this study was to evaluate the short-term impact of SDF treatment on oral health-related quality of life (OHRQoL) relative to a standard package of glass ionomer sealants and atraumatic restorative treatment (ART) in children aged 5–13 years.

Methods

CariedAway is a pragmatic, longitudinal, cluster-randomized non-inferiority trial of non-surgical interventions for caries. Secondary study outcomes included OHRQoL and academic performance. Oral health-related quality of life was measured at each study visit using the Child Oral Health Impact Profile. Change in OHRQoL was assessed using linear regression and non-inferiority was determined using t tests.

Results

160 children with an average age of 8.7 years completed quality of life assessments. Untreated decay at baseline (approximately 25%) was associated with significantly worse OHRQoL and treatment in both groups resulted in incremental improvement: children receiving SDF improved their OHRQoL scores from 16.44 (SD = 11.12) to 14.62 (SD = 11.90), and those receiving traditional sealants and atraumatic restorations slightly improved from 16.65 (SD = 10.56) to 16.47 (SD = 11.09). Quality of life in children receiving silver diamine fluoride was non-inferior to those receiving sealants and ART at least 6 months post-treatment (mean difference = 1.85, 95% CI = − 2.10, 5.80), and change in OHRQoL did not depend on the severity of baseline decay.

Conclusions

OHRQoL is related to untreated dental caries, and observed changes following SDF treatment were non-inferior relative to standard preventive therapies.
Evaluating quality of care at the end of life and setting best practice performance standards: a population-based observational study using linked routinely collected administrative databases
Authors: Oosterveld-Vlug Mariska G. , Heins Marianne J. , Boddaert Manon S. A. , Engels Yvonne , Heide Agnes van der , Onwuteaka-Philipsen Bregje D. , Reyners Anna K. L. , Francke Anneke L.
Published: April 2022

Background

A high percentage of people dying at home, and a low percentage of people being admitted to hospital and dying there are regarded as indicators of appropriate care at the end of life. However, performance standards for these quality indicators are often lacking, which makes it difficult to state whether an indicator score falls between the ranges of good or poor quality care. The aim of this study was to assess quality indicators concerning place of death and hospital care utilization in people with diseases relevant for palliative care, and to establish best practice performance standards based on indicator scores in 31 regions in the Netherlands.

Methods

A retrospective nationwide population-based observational study was conducted, using routinely collected administrative data concerning persons who died in 2017 in the Netherlands with underlying causes relevant for palliative care (N = 109,707). Data from four registries were linked for analysis. Scores on eight quality indicators concerning place of death and hospital care utilization were calculated, and compared across 31 healthcare insurance regions to establish relative benchmarks.

Results

On average, 36.4% of the study population died at home (range between regions 30.5%-42.6%) and 20.4% in hospital (range 16.6%-25.5%). Roughly half of the population who received hospital care at any time in the last year of life were found to (also) receive hospital care in the last month of life. In the last month, 32.0% of the study population were admitted to hospital (range 29.4-36.4%), 5.3% to an Intensive Care Unit (range 3.2-6.9%) and 23.9% visited an Emergency Department (range 21.0-27.4%). In the same time period, less than 1% of the study population was resuscitated in hospital or received tube or intravenous feeding in hospital.

Conclusions

The variation between regions points towards opportunities for practice improvement. The best practice performance standards as set in this study serve as ambitious but attainable targets for those regions that currently do not meet the standards. Policymakers, healthcare providers and researchers can use the suggested performance standards to further analyze causes of variance between regions and develop and test interventions that can improve practice.
Role of SPAK–NKCC1 signaling cascade in the choroid plexus blood–CSF barrier damage after stroke
Authors: Wang Jun , Liu Ruijia , Hasan Md Nabiul , Fischer Sydney , Chen Yang , Como Matt , Fiesler Victoria M. , Bhuiyan Mohammad Iqbal H. , Dong Shuying , Li Eric , Kahle Kristopher T. , Zhang Jinwei , Deng Xianming , Subramanya Arohan R. , Begum Gulnaz , Yin Yan , Sun Dandan
Published: April 2022

Background

The mechanisms underlying dysfunction of choroid plexus (ChP) blood–cerebrospinal fluid (CSF) barrier and lymphocyte invasion in neuroinflammatory responses to stroke are not well understood. In this study, we investigated whether stroke damaged the blood–CSF barrier integrity due to dysregulation of major ChP ion transport system, Na+–K+–Cl− cotransporter 1 (NKCC1), and regulatory Ste20-related proline-alanine-rich kinase (SPAK).

Methods

Sham or ischemic stroke was induced in C57Bl/6J mice. Changes on the SPAK–NKCC1 complex and tight junction proteins (TJs) in the ChP were quantified by immunofluorescence staining and immunoblotting. Immune cell infiltration in the ChP was assessed by flow cytometry and immunostaining. Cultured ChP epithelium cells (CPECs) and cortical neurons were used to evaluate H2O2-mediated oxidative stress in stimulating the SPAK–NKCC1 complex and cellular damage. In vivo or in vitro pharmacological blockade of the ChP SPAK–NKCC1 cascade with SPAK inhibitor ZT-1a or NKCC1 inhibitor bumetanide were examined.

Results

Ischemic stroke stimulated activation of the CPECs apical membrane SPAK–NKCC1 complex, NF-κB, and MMP9, which was associated with loss of the blood–CSF barrier integrity and increased immune cell infiltration into the ChP. Oxidative stress directly activated the SPAK–NKCC1 pathway and resulted in apoptosis, neurodegeneration, and NKCC1-mediated ion influx. Pharmacological blockade of the SPAK–NKCC1 pathway protected the ChP barrier integrity, attenuated ChP immune cell infiltration or neuronal death.

Conclusion

Stroke-induced pathological stimulation of the SPAK–NKCC1 cascade caused CPECs damage and disruption of TJs at the blood–CSF barrier. The ChP SPAK–NKCC1 complex emerged as a therapeutic target for attenuating ChP dysfunction and lymphocyte invasion after stroke.
Minimally invasive anterolateral approach versus direct anterior approach total hip arthroplasty in the supine position: a prospective study based on early postoperative outcomes
Authors: Liu Hongwen , Yin Li , Li Jiao , Liu Shaojiang , Tao Qifeng , Xu Jie
Published: April 2022

Background

Minimally anterolateral approach (MAA) and direct anterior approach (DAA) have been reported as beneficial for total hip arthroplasty (THA) due to their ability to reduce postoperative pain and lead to quicker rehabilitation by preserving muscle insertions. As there is an ongoing debate on the effect of these two approaches on early postoperative outcomes, this prospective study aimed to assess the difference in early clinical, radiological, and patient-reported outcomes between the two minimally invasive approaches.

Methods

A total of 98 patients, 50 in the MAA group and 48 in the DAA group, were included in the study. Patients with complete data were evaluated preoperatively and postoperatively at 2, 6, and 12 weeks. Clinical measurements, including the ability to climb stairs and walk, 6-min walk test (6MWT), the Forgotten Joint Scale (FJS-12), Japanese Orthopedic Association (JOA) Hip scores, radiological evaluation, and complications were analyzed.

Results

There were no significant differences in clinical outcomes and implant alignments between MAA and DAA groups. In regards to patient-reported outcomes, the FJS-12 was significantly higher in the MAA group compared to group DAA at 2 and 6 weeks postoperatively. However, there was no significant difference in the FJS-12 between the two groups 12 weeks after surgery. The differences also included shorter operative times (62.4 ± 9.05 min vs. 71 ± 8.01 min), less blood loss (132.6 ± 43.31 ml vs. 159.23 ± 37.25 ml), lower Hb drop (29.56 ± 8.02 g/L vs. 36.4 ± 7.12 g/L), and fewer blood transfusions in the MAA group (4.0% vs. 18.8%). The incidence of the lateral femoral cutaneous nerve (LFCN) neuropraxia after surgery was 7 (14.6%) in the DAA group and 0 in the MAA group. One fracture was found in each group and managed conservatively.

Conclusion

MAA and DAA approach yielded excellent and similar early clinical outcomes. However, better patient-reported outcomes could be achieved by MAA THA. The MAA resulted in a safer approach associated with shorter operative times, less blood loss, lower Hb drop, fewer blood transfusions, and LFCN neuropraxia than DAA. A longer follow-up is needed to further examine differences between these procedures.
TE Density: a tool to investigate the biology of transposable elements
Authors: Teresi Scott J. , Teresi Michael B. , Edger Patrick P.
Published: April 2022

Background

Transposable elements (TEs) are powerful creators of genotypic and phenotypic diversity due to their inherent mutagenic capabilities and in this way they serve as a deep reservoir of sequences for genomic variation. As agents of genetic disruption, a TE’s potential to impact phenotype is partially a factor of its location in the genome. Previous research has shown TEs’ ability to impact the expression of neighboring genes, however our understanding of this trend is hampered by the exceptional amount of diversity in the TE world, and a lack of publicly available computational methods that quantify the presence of TEs relative to genes.

Results

Here, we have developed a tool to more easily quantify TE presence relative to genes through the use of only a gene and TE annotation, yielding a new metric we call TE Density. Briefly defined as the proportion of TE-occupied base-pairs relative to a window-size of the genome. This new pipeline reports TE density for each gene in the genome, for each type descriptor of TE (order and superfamily), and for multiple positions and distances relative to the gene (upstream, intragenic, and downstream) over sliding, user-defined windows. In this way, we overcome previous limitations to the study of TE-gene relationships by focusing on all TE types present in the genome, utilizing flexible genomic distances for measurement, and reporting a TE presence metric for every gene in the genome.

Conclusions

Together, this new tool opens up new avenues for studying TE-gene relationships, genome architecture, comparative genomics, and the tremendous diversity present of the TE world. TE Density is open-source and freely available at: https://github.com/sjteresi/TE_Density.
External chest-wall compression in prolonged COVID-19 ARDS with low-compliance: a physiological study
Authors: Bastia Luca , Rezoagli Emanuele , Guarnieri Marcello , Engelberts Doreen , Forlini Clarissa , Marrazzo Francesco , Spina Stefano , Bassi Gabriele , Giudici Riccardo , Post Martin , Bellani Giacomo , Fumagalli Roberto , Brochard Laurent J. , Langer Thomas
Published: April 2022

Background

External chest-wall compression (ECC) is sometimes used in ARDS patients despite lack of evidence. It is currently unknown whether this practice has any clinical benefit in patients with COVID-19 ARDS (C-ARDS) characterized by a respiratory system compliance (Crs) < 35 mL/cmH2O.

Objectives

To test if an ECC with a 5 L-bag in low-compliance C-ARDS can lead to a reduction in driving pressure (DP) and improve gas exchange, and to understand the underlying mechanisms.

Methods

Eleven patients with low-compliance C-ARDS were enrolled and underwent 4 steps: baseline, ECC for 60 min, ECC discontinuation and PEEP reduction. Respiratory mechanics, gas exchange, hemodynamics and electrical impedance tomography were recorded. Four pigs with acute ARDS were studied with ECC to understand the effect of ECC on pleural pressure gradient using pleural pressure transducers in both non-dependent and dependent lung regions.

Results

Five minutes of ECC reduced DP from baseline 14.2 ± 1.3 to 12.3 ± 1.3 cmH2O (P < 0.001), explained by an improved lung compliance. Changes in DP by ECC were strongly correlated with changes in DP obtained with PEEP reduction (R2 = 0.82, P < 0.001). The initial benefit of ECC decreased over time (DP = 13.3 ± 1.5 cmH2O at 60 min, P = 0.03 vs. baseline). Gas exchange and hemodynamics were unaffected by ECC. In four pigs with lung injury, ECC led to a decrease in the pleural pressure gradient at end-inspiration [2.2 (1.1–3) vs. 3.0 (2.2–4.1) cmH2O, P = 0.035].

Conclusions

In C-ARDS patients with Crs < 35 mL/cmH2O, ECC acutely reduces DP. ECC does not improve oxygenation but it can be used as a simple tool to detect hyperinflation as it improves Crs and reduces Ppl gradient. ECC benefits seem to partially fade over time. ECC produces similar changes compared to PEEP reduction.
Virome in the cloaca of wild and breeding birds revealed a diversity of significant viruses
Authors: Shan Tongling , Yang Shixing , Wang Haoning , Wang Hao , Zhang Ju , Gong Ga , Xiao Yuqing , Yang Jie , Wang Xiaolong , Lu Juan , Zhao Min , Yang Zijun , Lu Xiang , Dai Ziyuan , He Yumin , Chen Xu , Zhou Rui , Yao Yuxin , Kong Ning , Zeng Jian , Ullah Kalim , Wang Xiaochun , Shen Quan , Deng Xutao , Zhang Jianmin , Delwart Eric , Tong Guangzhi , Zhang Wen
Published: April 2022

Background

Wild birds may harbor and transmit viruses that are potentially pathogenic to humans, domestic animals, and other wildlife.

Results

Using the viral metagenomic approach, we investigated the virome of cloacal swab specimens collected from 3182 birds (the majority of them wild species) consisting of > 87 different species in 10 different orders within the Aves classes. The virus diversity in wild birds was higher than that in breeding birds. We acquired 707 viral genomes from 18 defined families and 4 unclassified virus groups, with 265 virus genomes sharing < 60% protein sequence identities with their best matches in GenBank comprising new virus families, genera, or species. RNA viruses containing the conserved RdRp domain with no phylogenetic affinity to currently defined virus families existed in different bird species. Genomes of the astrovirus, picornavirus, coronavirus, calicivirus, parvovirus, circovirus, retrovirus, and adenovirus families which include known avian pathogens were fully characterized. Putative cross-species transmissions were observed with viruses in wild birds showing > 95% amino acid sequence identity to previously reported viruses in domestic poultry. Genomic recombination was observed for some genomes showing discordant phylogenies based on structural and non-structural regions. Mapping the next-generation sequencing (NGS) data respectively against the 707 genomes revealed that these viruses showed distribution pattern differences among birds with different habitats (breeding or wild), orders, and sampling sites but no significant differences between birds with different behavioral features (migratory and resident).

Conclusions

The existence of a highly diverse virome highlights the challenges in elucidating the evolution, etiology, and ecology of viruses in wild birds.
Modulating the electrocatalytic activity of N-doped carbon frameworks via coupling with dual metals for Zn–air batteries
Authors: Park Jung Hyun , Shin Jae-Hoon , Ju Jong-Min , Lee Jun-Hyeong , Choi Chanhee , So Yoonhee , Lee Hyunji , Kim Jong-Ho
Published: April 2022

N-Doped carbon electrocatalysts are a promising alternative to precious metal catalysts to promote oxygen reduction reaction (ORR). However, it remains a challenge to design the desired active sites on carbon skeletons in a controllable manner for ORR. Herein, we developed a facile approach based on oxygen-mediated solvothermal radical reaction (OSRR) for preparation of N-doped carbon electrocatalysts with a pre-designed active site and modulated catalytic activity for ORR. In the OSRR, 2-methylimidazole reacted with Co and Mn salts to form an active site precursor (MnCo-MIm) in N-methyl-2-pyrrolidone (NMP) at room temperature. Then, the reaction temperature increased to 140 °C under an oxygen atmosphere to generate NMP radicals, followed by their polymerization with the pre-formed MnCo-MIm to produce Mn-coupled Co nanoparticle-embedded N-doped carbon framework (MnCo-NCF). The MnCo-NCF showed uniform dispersion of nitrogen atoms and Mn-doped Co nanoparticles on the carbon skeleton with micropores and mesopores. The MnCo-NCF exhibited higher electrocatalytic activity for ORR than did a Co nanoparticle only-incorporated carbon framework due to the improved charge transfer from the Mn-doped Co nanoparticles to the carbon skeleton. In addition, the Zn–air battery assembled with MnCo-NCF had superior performance and durability to the battery using commercial Pt/C. This facile approach can be extended for designing carbon electrocatalysts with desired active sites to promote specific reactions.

Graphical Abstract
The role of epistemological beliefs in STEM faculty’s decisions to use culturally relevant pedagogy at Hispanic-Serving Institutions
Authors: Shultz Mollee , Nissen Jayson , Close Eleanor , Van Dusen Ben
Published: April 2022

Background

The growing understanding of the oppressive inequities that exist in postsecondary education has led to an increasing need for culturally relevant pedagogy. Researchers have found evidence that beliefs about the nature of knowledge predict pedagogical practices. Culturally relevant pedagogy supports students in ways that leverage students’ own cultures through three tenets: academic success, cultural competence, and sociopolitical consciousness. If STEM practitioners believe that their disciplines are culture-free, they may not enact culturally relevant pedagogy in their courses. We investigated how and in what forms 40 faculty from mathematics, physics, chemistry, and biology departments at Hispanic-Serving Institutions enacted culturally relevant pedagogy. We used the framework of practical rationality to understand how epistemological beliefs about the nature of their discipline combined with their institutional context impacted instructors’ decision to enact practices aligning with the three tenets of culturally relevant pedagogy.

Results

In total, 35 instructors reported using practices that aligned with the academic success tenet, nine instructors with the cultural competence tenet, and one instructor with the sociopolitical consciousness tenet. Instructors expressed and even lauded their disciplines’ separation from culture while simultaneously expressing instructional decisions that aligned with culturally relevant pedagogy. Though never asked directly, six instructors made statements reflecting a “culture-free” belief about knowledge in their discipline such as “To me, mathematics has no color.” Five of those instructors also described altering their teaching in ways that aligned with the academic success tenet. The framework of practical rationality helped explain how the instructors’ individual obligation (to the needs of individual students) and interpersonal obligation (to the social environment of the classroom) played a role in those decisions.

Conclusions

Instructors’ ability to express two contradictory views may indicate that professional development does not have to change an instructor’s epistemological beliefs about their discipline to convince them of the value of enacting culturally relevant pedagogy. We propose departmental changes that could enable instructors to decide to cultivate students’ cultural competence and sociopolitical consciousness. Our findings highlight the need for future research investigating the impacts of culturally relevant pedagogical content knowledge on students’ experiences.
Dietary fat intake and quality in long-term care residents in two cohorts assessed 10 years apart
Authors: Jyväkorpi Satu K. , Suominen Merja H. , Strandberg Timo E. , Salminen Karoliina , Niskanen Riikka T. , Roitto Hanna-Maria , Saarela Riitta K. T. , Pitkälä Kaisu H.
Published: April 2022

Purpose

To describe and compare detailed dietary fat intake, fat quality and associative factors between two measuring points 10 years apart of residents living in long-term care facilities, and to reflect how fat composition and fat quality corresponds to current nutrition recommendations.

Methods

In 2007 long-term care residents (n = 374) of 25 assisted-living facilities and nursing homes and in 2017–18 long-term care residents (n = 486) of 17 respective facilities in Helsinki metropolitan area were recruited for this study. Information on the residents’ heights, demographic information and use of calcium and vitamin D supplementation were retrieved from medical records. Residents’ clinical assessment included Clinical Dementia Rating (CDR), the Mini Nutritional Assessment (MNA) and questionnaire related to nutrition care. Participants’ energy and fat intake were determined from 1--2-day food diaries kept by the ward nurses, and fat quality indicators calculated.

Results

Age, gender distribution, MNA score or body mass index did not differ between the two cohorts. Residents’ cognitive status, subjective health and mobility were poorer in 2017 compared to 2007. Total fat and saturated fatty acid (SFA) intakes were higher and fat quality indicators lower in the 2017 cohort residents than in the 2007 cohort residents. Sugar intake, male gender, eating independently, eating larger amounts and not having dry mouth predicted higher SFA intake in the 2017 cohort.

Conclusions

The fat quality in long-term care residents in our study worsened in spite of official recommendations between the two measurement points.