bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing the Degree of Market Power in the Rice Milling Industry of Sri Lanka: An Application of the NEIO Approach
Authors: Mufeeth Musthapha , Weerasooriya Senal , Weerahewa Jeevika
Published: April 2022

This study used the New Empirical Industrial Organization (NEIO) approach to estimate the presence and factors affecting the market power of the rice milling industry in Sri Lanka. Annual data from 1982 to 2019 were used for the analysis. The miller’s pricing and demand models were estimated using the non-linear Seemingly Unrelated Regression (SUR) estimation technique. The estimated conjectural variation elasticity and the Lerner index of the Sri Lankan rice milling industry were 0.348 and 0.677 correspondingly and the results were significantly (p < 0.05) different from zero and one respectively. This depicts that the rice milling market exhibits oligopoly power in setting the price of rice above its marginal cost. Market power was significantly (p < 0.05) reduced by the implementation of the Government Ceiling Price (GCP) on rice. The study findings suggest the importance of consistent implementation and monitoring of GCP policies to control the market power of the rice milling industry in Sri Lanka.

JEL Classification: D22, D43, L00
Trends in Location of Death Among Older Adult Americans After Falls
Authors: Cross Sarah H. , Anderson David M. , Cox Christopher E. , Agarwal Suresh , Haines Krista L.
Published: April 2022

Introduction: Fall-related mortality is increasing among older adults, yet trends and changes in the location of fall-attributed deaths are unknown; additionally, potential disparities are understudied. Methods: To assess trends/factors associated with place of death among older adult fall deaths in the US, a cross-sectional analysis of deaths using mortality data from 2003–2017 was performed. Results: Most deaths occurred in hospitals, however, the proportion decreased from 66.4% ( n = 9,095) to 50.7% ( n = 15,817). The proportion occurring in nursing facilities decreased from 15.9% ( n = 2175) to 15.3% ( n = 4,778), while deaths at home and in hospice facilities increased. Male, Black, Native American, and married decedents had increased odds of hospital death. Conclusion: As fall deaths increase among older adults, end-of-life needs of this population deserve increased attention. Research should explore needs and preferences of older adults who experience falls and their caregivers to reduce disparities in place of death and to ensure high quality of care is received.
Book review: Imtiaz Hussain (ed.). 2019. South Asia in Global Power Rivalry: Inside-out Appraisals from Bangladesh
Authors: Shaffer Ryan
Published: April 2022

Imtiaz Hussain (ed.). 2019. South Asia in Global Power Rivalry: Inside-out Appraisals from Bangladesh. Palgrave Macmillan. Xiii + 320 pp. (Hardcover). ISBN: 9789811372391.
Career Preferences among Nursing Students: A Cross-Sessional Study
Authors: Hsu Mei Hua Kerry , Ye Qian Hong , Ling Man Ho
Published: April 2022

Introduction

It is estimated that mores nurses are needed in the future, nursing students’ career preferences are important to contribute the shortage of nursing manpower in Macao. Little is known regarding the preferences for nursing students’ career preferences and related factors among nursing students.

Objective

To explore and investigate the career preferences and related factors among nursing students in Macao.

Methods

A descriptive, cross-sectional survey study design was adopted to assess career preferences and related factors among nursing students in Macao.

Results

In total, 217 nursing students completed surveys. The most favorite career preferences among nursing students were community health nursing, paediatric nursing, medical surgical nursing, and obstetric & gynecological nursing; while the least career preferences among nursing students were oncology and hospice nursing, mental health nursing, and ER nursing. Factors were related to “gender”, “education”, and “nursing is my first study preference” among Macao nursing students for career preferences.

Conclusion

The senior nursing students prefer working in community health nursing and the junior and female nursing students prefer working in pediatric nursing and obstetric and gynecological nursing. The more understandings of nursing students’ career preferences, the better nursing curriculum design and implication to promote nursing students’ intention for working in the least career preferences work.
Radial variations of broad-sense heritability in wood properties and classification of load–deflection curves in static bending for six half-sib families of Chamaecyparis obtusa
Authors: Takahashi Yusuke , Ishiguri Futoshi , Nezu Ikumi , Endo Ryota , Kobayashi Saki , Tanabe Jun , Matsushita Michinari , Ohshima Jyunichi , Yokota Shinso
Published: April 2022

Wood properties (annual ring width, tracheid length, microfibril angle [MFA], basic density, and air-dry density) and mechanical properties (modulus of elasticity [MOE], modulus of rupture [MOR], bending work, and compressive strength) in 34-year-old Chamaecyparis obtusa trees of six half-sib families were measured from pith to bark to clarify radial variations in inheritance of these traits and the relationships between wood properties and mechanical properties. In addition, within-tree and among-family differences in the load–deflection curves were discussed. Radial variations of all wood properties were fitted to linear or nonlinear mixed-effects models with random effects of families. The MFA was correlated with MOE in all radial positions, whereas air-dry density correlated with all mechanical properties in mature wood. Radial variations in broad-sense heritability differed between wood properties. A relatively higher broad-sense heritability was recognized in almost all wood properties for mature wood. Based on the results, it was concluded that mechanical properties in mature wood can be effectively improved using MFA and air-dry density as criteria. In addition, the types of load–deflection curve in mature wood differed from those in juvenile wood, suggesting that not only elastic properties, but also plastic properties in C. obtusa are affected by genetic controls, especially in mature wood.
Laparoscopic Heminephrectomy in Horseshoe kidney: single-center experience of four cases
Authors: Agrawal Shashank , Agrawal Anshul , Singh Abhishek G. , Sabnis Ravindra B. , Desai Mahesh R.
Published: April 2022

Background

Horseshoe kidney (HSK) is the most common congenital fusion anomaly and found in 1 in 400 of the general population (Grainger et al. in Ir Med J 76:315–317, 1983 Jul). Impaired drainage due to anomalous anatomy leads to ureteric obstruction resulting in hydronephrosis and nonfunctioning kidney.

Conventionally heminephrectomy is done by open technique; however, in the era of minimally invasive surgery, laparoscopic heminephrectomy in HSK has been described. Kidney location, aberrant vasculature and isthmus division are the most common obstacle encountered by the operating surgeon. Here we report our single-center experience in laparoscopic heminephrectomy in four patients with HSK.

Methods

Retrospective data were analyzed for four cases of laparoscopic heminephrectomy for nonfunctioning moiety in HSK operated between 2012 and 2020. Of these four patients, one case was converted to open approach in view of intra-operative bleeding. Computed tomography urogram (CTU) was done pre-operatively in all patients. Laparoscopic surgery was performed via transperitoneal approach.

Results

The mean age of the patients was 37 ± 5.38 years. Flank pain was noted in all cases while dysuria seen in two patients and one patient had fever. Mean operative time was 145 ± 26.92 min and estimated blood loss was 85 ± 55 ml. Various techniques for isthmectomy and lower pole resection were used including use of monopolar hook in laparoscopic suite, Ligasure and bipolar scissor in minimal invasive milieu and monopolar cautery in laparoscopic conversion to open procedure. Histopathological examination revealed chronic pyelonephritis in three cases and squamous cell carcinoma of renal pelvis in one case which was converted to open.

Conclusions

Laparoscopic heminephrectomy in HSK is doable. Preoperative CT urography along with CT angiography may provide important anatomical and vascular information which reduces intra-operative risks of vascular injury or calyceal entry. Vascular control of isthmus and transection of dilated and thinned out lower pole with cauterization of pelvicalyceal mucosa will provide uneventful surgical course.
Co-expression network analysis of environmental canalization in the ascidian Ciona
Authors: Sato Atsuko , Oba Gina M. , Aubert-Kato Nathanael , Yura Kei , Bishop John
Published: April 2022

Background

Canalization, or buffering, is defined as developmental stability in the face of genetic and/or environmental perturbations. Understanding how canalization works is important in predicting how species survive environmental change, as well as deciphering how development can be altered in the evolutionary process. However, how developmental gene expression is linked to buffering remains unclear. We addressed this by co-expression network analysis, comparing gene expression changes caused by heat stress during development at a whole-embryonic scale in reciprocal hybrid crosses of sibling species of the ascidian Ciona that are adapted to different thermal environments.

Results

Since our previous work showed that developmental buffering in this group is maternally inherited, we first identified maternal developmental buffering genes (MDBGs) in which the expression level in embryos is both correlated to the level of environmental canalization and also differentially expressed depending on the species’ gender roles in hybrid crosses. We found only 15 MDBGs, all of which showed high correlation coefficient values for expression with a large number of other genes, and 14 of these belonged to a single co-expression module. We then calculated correlation coefficients of expression between MDBGs and transcription factors in the central nervous system (CNS) developmental gene network that had previously been identified experimentally. We found that, compared to the correlation coefficients between MDBGs, which had an average of 0.96, the MDBGs are loosely linked to the CNS developmental genes (average correlation coefficient 0.45). Further, we investigated the correlation of each developmental to MDBGs, showing that only four out of 62 CNS developmental genes showed correlation coefficient > 0.9, comparable to the values between MDBGs, and three of these four genes were signaling molecules: BMP2/4, Wnt7, and Delta-like.

Conclusions

We show that the developmental pathway is not centrally located within the buffering network. We found that out of 62 genes in the developmental gene network, only four genes showed correlation coefficients as high as between MDBGs. We propose that loose links to MDBGs stabilize spatiotemporally dynamic development.
Eosinophilic enteritis accompanied by cytomegalovirus disease: a case report
Authors: Yamaga Yuichi , Mizuno Masahiro , Okae Shunji , Nio-Tamaoki Mikako , Masuo Kenji , Mashimo-Matsuo Yoko , Tanaka Junya , Nabeshima Motoshige
Published: April 2022

Background

Eosinophilic enteritis is a chronic inflammatory disorder of the intestinal tract that is characterized by eosinophil infiltration. Cytomegalovirus (CMV), a common virus, has a broad infectivity range. CMV is retained in the host body after infection. Impairment of host immune defences may reactivate the latent CMV, leading to symptoms of overt disease.

Case presentation

A Japanese female in her 70 s was admitted to a hospital due to diarrhoea and then transferred to our hospital. Laboratory data showed hypoalbuminemia. Computed tomography (CT) revealed oedema of the small intestine. Lower gastrointestinal endoscopy revealed oedema of the submucosa, without any remarkable changes in the mucosa of the terminal ileum. Histological examination of the terminal ileum revealed infiltration of > 20 eosinophils per high-power field (HPF). These findings aided in diagnosing eosinophilic enteritis. We administered methylprednisolone (500 mg/day) for three days, followed by tapering prednisolone. However, the patient’s general condition and hypoalbuminemia failed to improve. Immunoglobulin (Ig) G- CMV and IgM-CMV tests were positive. CMV antigenemia was extremely high. Therefore, we administered ganciclovir intravenously, which improved the patient’s condition. Furthermore, azathioprine was administered to taper and discontinue prednisolone without relapse of eosinophilic enteritis. This treatment helped stabilize the patient’s condition for approximately four years.

Conclusion

We present a case of eosinophilic enteritis accompanied by CMV disease during prednisolone treatment. The patient’s condition improved after administration of ganciclovir. Azathioprine aided in discontinuing prednisolone and stabilizing the patient’s condition for approximately four years.
Association between falls in elderly and the number of chronic diseases and health-related behaviors based on CHARLS 2018: health status as a mediating variable
Authors: Tang Shaoliang , Liu Meixian , Yang Tongling , Ye Chaoyu , Gong Ying , Yao Ling , Xu Yun , Bai Yamei
Published: April 2022

Objective

Falling is one of the main causes of death and morbidity in the elderly. This study aims to explore the association between elderly patients with chronic diseases and their health-related behaviors and falls in the elderly, and to provide clues for the prevention and intervention of injuries caused by falls in the elderly.

Methods

Based on the basic demographic characteristics data, number of chronic diseases, health-related behaviors, and physical and mental health data of 5867 elderly people aged 60 and above in the 2018 CHARLS data, this paper used ordered logit regression to analyze the correlation between chronic diseases and their health-related behaviors and falls of Chinese elderly. On this basis, it also distinguishes whether there is care or not, explores whether the related factors of falls of elderly people will be different, and tests the intermediary effect of health status to further explore its mechanism.

Results

The number of chronic diseases and health-related behaviors in the four dimensions of sleeptime, drinking, smoking, and activity are significantly correlated with falls in the elderly. Among them, health status plays a significant mediating role in the relationship of the number of chronic diseases and sleeptime and activity on the falls of the elderly. In addition, compared with the elderly without care, the risk of falls in the elderly in care is only related to the number of chronic diseases and sleeptime, while the elderly without care is related to the number of chronic diseases and multiple factors such as smoking, drinking and activity.

Conclusion

Falls are significantly associated with chronic disease and health-related behaviors, while risk or protective factors for falls vary according to whether older adults are cared for. Therefore, targeted interventions can be made for the factors that affect the fall of the elderly according to different situations.
Risk of malignancy in kidney transplant recipients: a nationwide population-based cohort study
Authors: Jung Su Woong , Lee Hyemi , Cha Jae Myung
Published: April 2022

Background

Post-transplant malignancy is major morbidity complicated in kidney transplantation (KT). In Korea, a few studies have investigated the sex- and age-dependent risk for post-transplant malignancy among KT recipients on a large scale.

Methods

We utilized a national health insurance database in Korea to investigate the relative risk of post-transplant malignancy in 12,634 KT recipients between 2007 and 2017. The same number of patients with acute appendicitis was included as a control group. The relative risk of malignancy was estimated using a multivariable-adjusted Cox model, and interaction analysis was performed to investigate age- and sex-predominant patterns.

Results

KT recipients had an overall 1.8-fold higher risk for post-transplant malignancy with an increased risk for 14 of 29 cancer types, among which Kaposi’s sarcoma, non-Hodgkin’s lymphoma, kidney, uterus, and bladder/urinary tract cancers were most prominent. Although the overall risk for post-transplant malignancy was similar between male and female KT recipients, head and neck cancer had a higher risk among male KT recipients, whereas non-Hodgkin’s lymphoma and bladder/urinary tract cancer had a higher risk among female KT recipients. Overall, the young (< 50 years) KT recipients had a higher risk for post-transplant malignancy than older ones (≥ 50 years), whose pattern was most prominent in non-Hodgkin’s lymphoma. In contrast, breast and nonmelanoma skin cancer showed a higher risk among older KT recipients.

Conclusion

KT recipients had an increased risk for a wide range of cancer types, some of which showed differential risk patterns with age and sex. Our result suggests that focused screening for predominant post-transplant malignancies may be an effective strategy for selected KT recipients.
Sudden respiratory and circulatory collapse after cesarean section: Amniotic fluid embolism or other reasons? – a case report
Authors: Zhang Jinxi , Yu Chao , Liu Hui , Zhu Qing
Published: April 2022

Background

For a healthy parturient, a cardiopulmonary collapse that suddenly occurs shortly after an uneventful caesarean section is a relatively rare event and presents a significant challenge for the anesthesia provider.

Case presentation

Amniotic fluid embolism (AFE) is characterized by acute and rapid collapse and is well known to the obstetric team. Our patient experienced sudden cardiovascular collapse, severe respiratory difficulty and hypoxia, in the absence of other explanations for these findings at the time, and thus AFE was immediately become the focus of the consideration. However, there is no quick, standard laboratory test for AFE, therefore the diagnosis is one of exclusion based on presenting symptoms and clinical course. After given symptomatic treatment, the patient made an uneventful initial recovery in a short period and developed a rash. We recognized that the postpartum shock was associated with delayed anaphylaxis of antibiotics.

Conclusions

These observations have implications for understanding whenever administering drugs in surgery, which may affect the anesthesiologist’s judgment regarding the complications of anesthesia. Even though serious complications of common perioperative drugs may rarely occur, anesthesia providers should be aware of the consideration. Early recognition and effective treatment are more important than prompt diagnosis.
PTSD is not the emblematic disorder of the COVID-19 pandemic; adjustment disorder is
Authors: Brunet Alain , Rivest-Beauregard Marjolaine , Lonergan Michelle , Cipolletta Sabrina , Rasmussen Andrew , Meng Xiangfei , Jaafari Nematollah , Romero Sara , Superka Julia , Brown Adam D. , Sapkota Ram P.
Published: April 2022

Background

Posttraumatic stress disorder (PTSD) has been hailed by some as the emblematic mental disorder of the COVID-19 pandemic, assuming that PTSD’s life-threat criterion was met de facto. More plausible outcomes like adjustment disorder (AD) have been overlooked.

Methods

An online cross-sectional survey was launched in the initial stage of the pandemic using a convenience sample of 5 913 adults to compare the prevalence of COVID-related probable PTSD versus probable AD. The abridged Impact of Event Scale – Revised (IES-6) assessed the severity of trauma- and stressor-related symptoms over the previous week. Demographic and pandemic-related data (e.g., receiving a formal diagnosis of COVID-19, job loss, loss of loved one, confinement, material hardship) were collected. A Classification and Regression Tree analysis was conducted to uncover the pandemic experiences leading to clinical ‘caseness’. Caseness was defined by a score > 9 on the IES-6 symptom measure and further characterized as PTSD or AD depending on whether the Peritraumatic Distress Inventory’s life-threat item was endorsed or not.

Results

The participants were predominantly Caucasian (72.8%), women (79.2%), with a university degree (85%), and a mean age of 42.22 (SD = 15.24) years; 3 647 participants (61.7%; 95%CI [60.4, 63.0]) met the threshold for caseness. However, when perceived life-threat was accounted for, only 6.7% (95%CI [6.1, 7.4]) were classified as PTSD cases, and 55% (95%CI [53.7, 56.2]) as AD cases. Among the AD cases, three distinct profiles emerged marked by the following: (i) a worst personal pandemic experience eliciting intense fear, helplessness or horror (in the absence, however, of any life-threat), (ii) a pandemic experience eliciting sadness/grief, and (iii) worrying intensely about the safety of significant others.

Conclusions

Studies considering the life-threat criterion as met de facto during the pandemic are confusing PTSD for AD on most counts. This misconception is obscuring the various AD-related idioms of distress that have emerged during the pandemic and the actual treatment needs.
The diagnostic and predictive potential of personality traits and coping styles in major depressive disorder
Authors: Ho Cyrus S. H. , Chua J. , Tay Gabrielle W. N.
Published: April 2022

Background

Major depressive disorder (MDD) is a global public health concern that is notably underdiagnosed and undertreated due to its complexity and subjective diagnostic methods. A holistic diagnostic procedure, which sufficiently considers all possible contributors to MDD symptoms, would improve MDD diagnosis and treatment. This study aims to explore whether personality and coping styles can predict MDD status and differentiate between depressed patients and healthy individuals.

Methods

Seventy healthy controls (N = 54 females) were matched to 70 MDD patients for age, sex, ethnicity, and years of education. MDD severity was measured using the Hamilton Depression Rating Scale, while personality traits and coping styles were measured by the Ten-Item Personality (TIPI) and Brief COPE questionnaires, respectively. Logistic regression analyses were conducted to investigate the diagnostic and predictive potential of personality and coping styles. Receiver operating characteristic (ROC) analyses were also conducted to examine their discriminative ability to distinguish between depressed and healthy individuals.

Results

Introversion, lack of organisation skills, and neuroticism were statistically significant in predicting MDD status. Dysfunctional coping strategies, such as denial and self-blame, were also shown to significantly predict MDD status. ROC analyses found both the TIPI questionnaire (AUC = 0.90), and dysfunctional coping (as measured by Brief COPE) (AUC = 0.90) to be excellent predictors of MDD.

Conclusions

Our findings demonstrate the diagnostic and predictive potential of personality and coping styles for MDD in the clinical setting. They also demonstrate the remarkable ability of personality and coping styles to differentiate between depressed patients and healthy controls.
An investigation of cannabis use for insomnia in depression and anxiety in a naturalistic sample
Authors: Kuhathasan Nirushi , Minuzzi Luciano , MacKillop James , Frey Benicio N.
Published: April 2022

Background

Little is known about cannabis use for insomnia in individuals with depression, anxiety, and comorbid depression and anxiety. To develop a better understanding of distinct profiles of cannabis use for insomnia management, a retrospective cohort study was conducted on a large naturalistic sample.

Methods

Data were collected using the medicinal cannabis tracking app, Strainprint®, which allows users to monitor and track cannabis use for therapeutic purposes. The current study examined users managing insomnia symptoms in depression (n = 100), anxiety (n = 463), and comorbid depression and anxiety (n = 114), for a total of 8476 recorded sessions. Inferential analyses used linear mixed effects modeling to examine self-perceived improvement across demographic variables and cannabis product variables.

Results

Overall, cannabis was perceived to be efficacious across all groups, regardless of age and gender. Dried flower and oral oil were reported as the most used and most efficacious product forms. In the depression group, all strains were perceived to be efficacious and comparisons between strains revealed indica-dominant (Mdiff = 1.81, 95% CI 1.26–2.36, Padj < .001), indica hybrid (Mdiff = 1.34, 95% CI 0.46–2.22, Padj = .045), and sativa-dominant (Mdiff = 1.83, 95% CI 0.68–2.99, Padj = .028) strains were significantly more efficacious than CBD-dominant strains. In anxiety and comorbid conditions, all strain categories were perceived to be efficacious with no significant differences between strains.

Conclusions

In terms of perceptions, individuals with depression, anxiety, and both conditions who use cannabis for insomnia report significant improvements in symptom severity after cannabis use. The current study highlights the need for placebo-controlled trials investigating symptom improvement and the safety of cannabinoids for sleep in individuals with mood and anxiety disorders.
What are the reasons for refusing a COVID-19 vaccine? A qualitative analysis of social media in Germany
Authors: Fieselmann Jana , Annac Kübra , Erdsiek Fabian , Yilmaz-Aslan Yüce , Brzoska Patrick
Published: April 2022

Background

Vaccination against COVID-19 has been available in Germany since December 2020. However, about 30% of the population report not wanting to be vaccinated. In order to increase the willingness of the population to get vaccinated, data on the acceptance of vaccination and its influencing factors are necessary. Little is known about why individuals refuse the COVID-19 vaccination. The aim of this study was to investigate the reasons leading to rejecting vaccination, based on posts from three social media sites.

Methods

The German-language versions of Instagram, Twitter and YouTube were searched regarding negative attitudes towards COVID-19 vaccination. Data was extracted until a saturation effect could be observed. The data included posts created from January 20, 2020 to May 2, 2021. This time frame roughly covers the period from the first reports of the spread of SARS-CoV-2 up to the general availability of vaccines against COVID-19 in Germany. We used an interpretive thematic approach to analyze the data and to inductively generate codes, subcategories and categories.

Results

Based on 333 posts written by 323 contributing users, we identified six main categories of reasons for refusing a COVID-19 vaccination: Low perceived benefit of vaccination, low perceived risk of contracting COVID-19, health concerns, lack of information, systemic mistrust and spiritual or religious reasons. The analysis reveals a lack of information among users and the spread of misinformation with regard to COVID-19 and vaccination. Users feel inadequately informed about vaccination or do not understand the information available. These information gaps may be related to information not being sufficiently sensitive to the needs of the target group. In addition to limited information for the general population, misinformation on the internet can also be an important reason for refusing vaccination.

Conclusions

The study emphasizes the relevance of providing trustworthy and quality-assured information on COVID-19 and COVID-19 vaccination to all population groups. In addition, vaccinations should be easily accessible in order to promote the population’s willingness to be vaccinated.
E-Learning during COVID-19: perspectives and experiences of the faculty and students
Authors: Li Sisi , Zhang Chunhui , Liu Qijun , Tong Kuang
Published: April 2022

Background

Aimed to corroborate students' and faculty's experiences with e-learning during the current pandemic.

Methods

A cross-sectional study was conducted from February to June 2020. Seven surveys were distributed electronically to all undergraduate students and the faculty (4 to students and 3 to teachers) at the Southern Medical University (China). Descriptive statistics and t-tests were used to analyze the data. Statistical significance was set at p < .05.

Results

Most students had some exposure to e-learning prior to the all e-learning regiment, contrasted with close to 90% of teachers having no or very limited experience. Students' perceptions of the most helpful e-learning activities did not change significantly overall (Week 3 vs. Week 9). Approaching 60% of students (Week 9) did find online discussion/Q&A/forum helpful, an increase from less than 30% (Week 3). Among teachers, gaps emerged (Week 9) between e-teaching activities used and their perceived effectiveness. Despite pre-recorded lectures being the most frequently used method, the least gap was associated with live-stream lectures—the least used. Over time, teacher's perceived effectiveness of e-teaching vs. in-person teaching did not differ significantly overall. When the results among students (Week 7) and teachers (Week 9) were corroborated, a slightly higher percentage of teachers viewed online teaching to be less effective than in-person teaching and a slightly higher percentage of teachers viewed online teaching as far less effective. For preferred learning modes after the resumption of in-person learning, students' preferences did not differ significantly overall (Week 3 vs. week 9). Surveys conducted in Week 9 found that a slightly higher percentage of students (~ 70%) than teachers (~ 60%) preferred some forms of hybrid learning and a lower percentage of students preferred face-to-face learning only. Approximately three quarters of teachers responded that at least 50% of course materials could be mastered by students on their own.

Conclusions

Overall, the perceived effectiveness of e-learning among students and teachers has not changed significantly over time. Nor have students' preferences shifted significantly for various learning modes after the in-person learning resumed. However, informative directional trends have emerged. Our research illustrates empirically the need to corroborate students' and instructors' experiences over time to inform more holistic improvements of e-learning.
Development of an auto-inducible expression system by nitrogen sources switching based on the nitrogen catabolite repression regulation
Authors: Yan Qin , Han Laichuang , Liu Xinyue , You Cuiping , Zhou Shengmin , Zhou Zhemin
Published: April 2022

Background

The construction of protein expression systems is mainly focused on carbon catabolite repression and quorum-sensing systems. However, each of these regulatory modes has an inherent flaw, which is difficult to overcome. Organisms also prioritize using different nitrogen sources, which is called nitrogen catabolite repression. To date, few gene regulatory systems based on nitrogen catabolite repression have been reported.

Results

In this study, we constructed a nitrogen switching auto-inducible expression system (NSAES) based on nitrogen catabolite regulation and nitrogen utilization in Aspergillus nidulans. The PniaD promoter that is highly induced by nitrate and inhibition by ammonia was used as the promoter. Glucuronidase was the reporter protein. Glucuronidase expression occurred after ammonium was consumed in an ammonium and nitrate compounding medium, achieving stage auto-switching for cell growth and gene expression. This system maintained a balance between cell growth and protein production to maximize stress products. Expressions of glycosylated and secretory proteins were successfully achieved using this auto-inducible system.

Conclusions

We described an efficient auto-inducible protein expression system based on nitrogen catabolite regulation. The system could be useful for protein production in the laboratory and industrial applications. Simultaneously, NSAES provides a new auto-inducible expression regulation mode for other filamentous fungi.
Anxiety, depression and associated factors among caretakers of children with atopic dermatitis
Authors: Su Wei , Chen Hongguang , Gao Ying , Qin Qin , Liu Boqi , Deng Wei , Wang Yuhan , Zhang Gaolei , Liu Xiaoyan
Published: April 2022

Background

The prevalence of anxiety and depression symptoms among caretakers of children with atopic dermatitis (AD) and associated factors is unclear. The study was designed to explore anxiety and depression symptoms among caretakers of AD, and screen factors associated with anxiety and depression symptoms.

Methods

A total of 901 children with AD and their caretakers were continuously enrolled and interviewed at dermatology department of Capital Institute of Pediatrics, Beijing, China. Children’s medication was administered by their caretakers. Caretakers’ anxiety and depression symptoms were evaluated by Hamilton Depression Rating Scale-17 and Hamilton Depression Rating Scale, while medication compliance was evaluated and divided into poor (< 6 points), moderate (6–7 points), and good (> 7 points) by Morisky Medication Adherence Scale. Multilevel ordered logistic regression was used to screen factors associated with caretakers’ anxiety and depression.

Results

Among caretakers, 41.5% had anxiety symptoms, 39.6% had depression symptoms, 51.4% have any of the two and 29.7% had both of the two. Factors associated with caretakers’ anxiety symptoms included longer duration of the illness (OR, 0.99, 95% CI 0.98–0.99) and taking care of children with severe AD (OR, 2.55, 95% CI 1.43–4.55). Factors associated with caretakers’ depression symptoms included higher educational level (OR, 0.56, 95% CI 0.39–0.80), taking care of children with moderate (OR, 2.01, 95% CI 1.15–3.50) and severe AD (OR, 3.99, 95% CI 2.10–7.59) and poor medication compliance (OR, 3.45, 95% CI 1.13–10.56).

Conclusions

Prevalence of anxiety and depression symptoms among caretakers of AD were high. Attention should be paid to caretakers of AD at higher risk for those psychological problems.
Maternal and newborn health for the urban poor: the need for a new mental model and implementation strategies to accelerate progress
Authors: McNab Shanon , Scudder Elaine , Syed Uzma , Freedman Lynn P.
Published: April 2022

Background

Urbanization challenges the assumptions that have traditionally influenced maternal and newborn health (MNH) programs. This landscaping outlines how current mental models for MNH programs have fallen short for urban slum populations and identifies implications for the global community. We employed a three-pronged approach, including a literature review, key informant interviews with global- and national-level experts, and a case study in Bangladesh.

Main body

Our findings highlight that the current mental model for MNH is inadequate to address the needs of the urban poor. Implementation challenges have arisen from using traditional methods that are not well adapted to traits inherent in slum settings. A re-thinking of implementation strategies will also need to consider a paucity of available routine data, lack of formal coordination between stakeholders and providers, and challenging municipal government structures. Innovative approaches, including with communications, outreach, and technology, will be necessary to move beyond traditional rural-centric approaches to MNH. As populations continue to urbanize, common slum dynamics will challenge conventional strategies for health service delivery. In addition, the COVID-19 pandemic has exposed weaknesses in a system that requires intersectoral collaborations to deliver quality care.

Conclusion

Programs will need to be iterative and adaptive, reflective of sociodemographic features. Integrating the social determinants of health into evaluations, using participatory human-centered design processes, and innovative public-private partnerships may prove beneficial in slum settings. But a willingness to rethink the roles of all actors within the delivery system overall may be needed most.
Simulation CT-based radiomics for prediction of response after neoadjuvant chemo-radiotherapy in patients with locally advanced rectal cancer
Authors: Bonomo Pierluigi , Socarras Fernandez Jairo , Thorwarth Daniela , Casati Marta , Livi Lorenzo , Zips Daniel , Gani Cihan
Published: April 2022

Background

To report on the discriminative ability of a simulation Computed Tomography (CT)-based radiomics signature for predicting response to treatment in patients undergoing neoadjuvant chemo-radiation for locally advanced adenocarcinoma of the rectum.

Methods

Consecutive patients treated at the Universities of Tübingen (from 1/1/07 to 31/12/10, explorative cohort) and Florence (from 1/1/11 to 31/12/17, external validation cohort) were considered in our dual-institution, retrospective analysis. Long-course neoadjuvant chemo-radiation was performed according to local policy. On simulation CT, the rectal Gross Tumor Volume was manually segmented. A feature selection process was performed yielding mineable data through an in-house developed software (written in Python 3.6). Model selection and hyper-parametrization of the model was performed using a fivefold cross validation approach. The main outcome measure of the study was the rate of pathologic good response, defined as the sum of Tumor regression grade (TRG) 3 and 4 according to Dworak’s classification.

Results

Two-hundred and one patients were included in our analysis, of whom 126 (62.7%) and 75 (37.3%) cases represented the explorative and external validation cohorts, respectively. Patient characteristics were well balanced between the two groups. A similar rate of good response to neoadjuvant treatment was obtained in in both cohorts (46% and 54.7%, respectively; p = 0.247). A total of 1150 features were extracted from the planning scans. A 5-metafeature complex consisting of Principal component analysis (PCA)-clusters (whose main components are LHL Grey-Level-Size-Zone: Large Zone Emphasis, Elongation, HHH Intensity Histogram Mean, HLL Run-Length: Run Level Variance and HHH Co-occurence: Cluster Tendency) in combination with 5-nearest neighbour model was the most robust signature. When applied to the explorative cohort, the prediction of good response corresponded to an average Area under the curve (AUC) value of 0.65 ± 0.02. When the model was tested on the external validation cohort, it ensured a similar accuracy, with a slightly lower predictive ability (AUC of 0.63).

Conclusions

Radiomics-based, data-mining from simulation CT scans was shown to be feasible and reproducible in two independent cohorts, yielding fair accuracy in the prediction of response to neoadjuvant chemo-radiation.
SvAnna: efficient and accurate pathogenicity prediction of coding and regulatory structural variants in long-read genome sequencing
Authors: Danis Daniel , Jacobsen Julius O. B. , Balachandran Parithi , Zhu Qihui , Yilmaz Feyza , Reese Justin , Haimel Matthias , Lyon Gholson J. , Helbig Ingo , Mungall Christopher J. , Beck Christine R. , Lee Charles , Smedley Damian , Robinson Peter N.
Published: April 2022

Structural variants (SVs) are implicated in the etiology of Mendelian diseases but have been systematically underascertained owing to sequencing technology limitations. Long-read sequencing enables comprehensive detection of SVs, but approaches for prioritization of candidate SVs are needed. Structural variant Annotation and analysis (SvAnna) assesses all classes of SVs and their intersection with transcripts and regulatory sequences, relating predicted effects on gene function with clinical phenotype data. SvAnna places 87% of deleterious SVs in the top ten ranks. The interpretable prioritizations offered by SvAnna will facilitate the widespread adoption of long-read sequencing in diagnostic genomics. SvAnna is available athttps://github.com/TheJacksonLaboratory/SvAnna.
Phloem wedges in Malpighiaceae: origin, structure, diversification, and systematic relevance
Authors: Quintanar-Castillo Angélica , Pace Marcelo R.
Published: April 2022

Background

Phloem wedges furrowing the wood are one of the most notorious, widespread types of cambial variants in Angiosperms. Many lianas in Malpighiaceae show these variations in the arrangement of the secondary tissues. Here we explore their ontogeny, structure, and evolution in Malpighiaceae, where phloem wedges appeared multiple times, showing how they have contributed to the anatomical diversification of the family. Using a broad sampling with 143 species from 50 genera, covering all major lineages in Malpighiaceae, we crossed data from ontogeny, stem anatomy, and phylogenetic comparative methods to determine ontogenetic trajectories, final anatomical architectures, and evolution within the most recent phylogeny for the family.

Results

Phloem wedges appeared exclusively in lianas and disappeared in shrub lineages nested within liana lineages. At the onset of development, the vascular cambium is regular, producing secondary tissues homogeneously across its girth, but soon, portions of the cambium in between the leaf insertions switch their activity producing less wood and more phloem, initially generating phloem arcs, which progress into phloem wedges. In the formation of these wedges, two ontogenetic trajectories were found, one that maintains the continuity of the cambium, and another where the cambium gets dissected. Phloem wedges frequently remain as the main cambial variant in several lineages, while in others there are additional steps toward more complex cambial variants, such as fissured stems, or included phloem wedges, the latter a novel type of interxylary phloem first described for the family.

Conclusions

Phloem wedges evolved exclusively in lianas, with two different ontogenies explaining the 10 independent origins of phloem wedges in Malpighiaceae. The presence of phloem wedges has favored the evolution of even more complex cambial variants such as fissured stems and interxylary phloem.
Quantifying lung cancer heterogeneity using novel CT features: a cross-institute study
Authors: Wang Zixing , Yang Cuihong , Han Wei , Sui Xin , Zheng Fuling , Xue Fang , Xu Xiaoli , Wu Peng , Chen Yali , Gu Wentao , Song Wei , Jiang Jingmei
Published: April 2022

Background

Radiomics-based image metrics are not used in the clinic despite the rapidly growing literature. We selected eight promising radiomic features and validated their value in decoding lung cancer heterogeneity.

Methods

CT images of 236 lung cancer patients were obtained from three different institutes, whereupon radiomic features were extracted according to a standardized procedure. The predictive value for patient long-term prognosis and association with routinely used semantic, genetic (e.g., epidermal growth factor receptor (EGFR)), and histopathological cancer profiles were validated. Feature measurement reproducibility was assessed.

Results

All eight selected features were robust across repeat scans (intraclass coefficient range: 0.81–0.99), and were associated with at least one of the cancer profiles: prognostic, semantic, genetic, and histopathological. For instance, “kurtosis” had a high predictive value of early death (AUC at first year: 0.70–0.75 in two independent cohorts), negative association with histopathological grade (Spearman’s r: − 0.30), and altered expression levels regarding EGFR mutation and semantic characteristics (solid intensity, spiculated shape, juxtapleural location, and pleura tag; all p < 0.05). Combined as a radiomic score, the features had a higher area under curve for predicting 5-year survival (train: 0.855, test: 0.780, external validation: 0.760) than routine characteristics (0.733, 0.622, 0.613, respectively), and a better capability in patient death risk stratification (hazard ratio: 5.828, 95% confidence interval: 2.915–11.561) than histopathological staging and grading.

Conclusions

We highlighted the clinical value of radiomic features. Following confirmation, these features may change the way in which we approach CT imaging and improve the individualized care of lung cancer patients.
Prognostic stratification of patients with AJCC 2018 pN1 disease in stage III oral squamous cell carcinoma
Authors: Tsai Ming-Hsien , Chuang Hui-Ching , Lin Yu-Tsai , Huang Tai-Lin , Fang Fu-Min , Lu Hui , Chien Chih-Yen
Published: April 2022

Background

Oral cancer with pT1-3N1 without extracapsular extension of the lymph node is classified as stage III according to the eighth edition of the AJCC staging system. Outcomes of a subgroup of patients classified as having stage III oral cancer with single nodal metastasis are observed to be various clinically. Therefore, such clinical outcomes for subgroup analyses in this cohort are necessary.

Methods

Patients with pT1-3N1 (based on the eighth edition of the AJCC staging system) oral cancer who underwent surgery between 2007 and 2016 were enrolled retrospectively for survival analyses.

Results

A total of 105 patients—including 28 patients with pT1N1 disease and 77 patients with pT2-3N1 disease—participated in the study. Pathological T classification was the only statistically significant prognosticator according to univariate analysis. The patients with pT1N1 disease showed better 5-year overall survival (OS), disease specific survival (DSS), and disease free survival (DFS) than those with pT2-3N1 disease (pT1N1 vs pT2-3N1, OS: 96.4% vs 72.2%, p = 0.004; DSS: 96.4% vs 77.3%, p = 0.021; DFS: 84.6% vs 62.3%, p = 0.023). Besides, there was no potential clinicopathological confounder which is significant associated with different pathological T classifications in this unique cohort.

Conclusions

Patients in the pT1N1 subgroup have significantly favorable prognosis than those with pT2-3N1 disease. Down-staging and reclassifying pT1N1 subgroup patients with oral cancer may be considered in tumor staging.

Graphical Abstract
TNF-α inhibitor induced pigmented purpuric dermatoses: a case report
Authors: Jhaveri Divita , Zhao Frances
Published: April 2022

Background

We present a rare case of TNF-α inhibitor induced pigmented purpuric dermatoses (PPD) and explore its mechanisms and management.

Case presentation

A 44-year-old woman presented with non-pruritic non-tender petechial rash on bilateral lower limbs after being started on Adalimumab, with the rash progressing to worsen on Golimumab, both used for managing her seronegative peripheral arthritis. Laboratory panel revealed a negative vasculitis screen and skin biopsy confirmed the condition. After ceasing the TNF-α inhibitors and changing to Secukinumab, an Interleukin-17 inhibitor, the lesions stopped erupting and slowly resolved.

Conclusion

PPD is a benign skin condition and has been associated with various medications and exposure to chemicals in the literature. Different mechanisms have been proposed in the literature however its exact aetiology is unknown. To date, there is no standardized treatment however patients should be reassured that PPD is benign and will often regress by itself once the causative agent has been removed.