bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimal Clinically Important Difference and Patient Acceptable Symptom State in Patients With Knee Osteoarthritis Treated With PRP Injection
Authors: Boffa Angelo , Andriolo Luca , Franceschini Marco , Di Martino Alessandro , Asunis Emanuela , Grassi Alberto , Zaffagnini Stefano , Filardo Giuseppe
Published: October 2021

Background:

Although several injection-based treatments have been proposed to address knee osteoarthritis (OA), it is often difficult to understand the clinical relevance of the obtained results. The psychometric measures of minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were developed to better interpret study findings.

Purpose:

To establish the MCID and the PASS for the International Knee Documentation Committee (IKDC) Subjective score and the Knee injury and Osteoarthritis Outcome Score (KOOS) in patients treated with intra-articular platelet-rich plasma (PRP) injections for knee OA.

Study Design:

Case series; Level of evidence, 4.

Methods:

This study included 215 patients with knee OA (68% men, 32% women; age, 53.2 ± 11.3 years; body mass index, 26.8 ± 4.3 kg/m2) who underwent intra-articular PRP injections. Patients were assessed through the IKDC Subjective score and KOOS subscales, and the MCID and the PASS for both measures were independently calculated at 6 and 12 months post-injection. The MCID was calculated using the value equal to half of the standard deviation of the overall cohort improvement. The PASS was assessed using a 2-point scale ( satisfied or not satisfied), with threshold values being detected through a receiver operating characteristic curve analysis and the Youden index to maximize the sensitivity and the specificity of the threshold values.

Results:

All scores improved significantly from baseline to 6 months and baseline to 12 months ( P < .001 for all scores). All scores were stable from 6 to 12 months except for the KOOS Quality of Life subscale, which improved further ( P = .033). For the IKDC, the MCID values were 8.6 and 8.5 points and the PASS scores were 59.7 and 62.1 at 6 and 12 months, respectively. Overall, the MCID and the PASS for all KOOS subscales remained constant at the 2 follow-up points. The percentage of patients who achieved the MCID and the PASS was higher than 85% at both 6 and 12 months post-injection.

Conclusion:

This study provided the MCID and PASS thresholds for the IKDC and KOOS scores in patients with knee OA treated with PRP injections. These psychometric measures may allow a better interpretation of the clinical relevance of injection-based treatment outcomes for knee OA.
Reliability of Preoperative Planning Method That Considers Latent Medial Joint Laxity in Medial Open-Wedge Proximal Tibial Osteotomy
Authors: Ryu Dong Jin , Lee Sung-Sahn , Jung Eui Yub , Kim Joo Hwan , Shin Tae Soo , Wang Joon Ho
Published: October 2021

Background:

Soft tissue laxity around the knee joint has been recognized as a crucial factor affecting correction error during medial open-wedge proximal tibial osteotomy (MOWPTO). Medial laxity in particular, which represents the changes in joint-line convergence angle (JLCA), affects soft tissue correction.

Purpose:

The purpose of this study was to quantify medial laxity and develop a preoperative planning method that considers medial laxity.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

This study retrospectively reviewed 139 knees in 117 patients who underwent navigation-assisted MOWPTO from January 2014 to July 2019 for symptomatic medial compartment osteoarthritis with varus alignment >5°. We compared the results of 2 preoperative planning methods: conventional Miniaci (n = 47) and latent medial laxity reduction (LMLR) (n = 92). We evaluated the incidence of undercorrection, acceptable correction, and overcorrection. The radiologic parameters were analyzed using multiple linear regression with a stepwise selection model to establish an equation for the optimal preoperative planning method. The intraclass correlation coefficients (ICCs) of intraobserver, interobserver, and intermethod reliability were calculated.

Results:

The Miniaci method showed a higher incidence of overcorrection (55.3%) than the LMLR method (22.8%) at postoperative 6 months ( P = .0006). Multiple linear regression with a stepwise selection model revealed a high correlation coefficient ( R 2 = 0.888) for the following equation: Adjusted planned correction angle = 0.596 + 0.891 × Target correction angle – 0.255 × Δ JLCA valgus. Upon simplification, the following equation showed the highest intermethod ICC value (0.991): Target correction angle – ⅓Δ JLCA valgus, while the Miniaci method showed a relatively low ICC value of 0.875.

Conclusion:

There was a risk of overcorrection after MOWPTO using the conventional Miniaci method. An equation that considers medial laxity may help during preoperative planning for optimal correction during MOWPTO.
Organizational Information and Communication Technologies and Their Influence on Communication Visibility and Perceived Proximity
Authors: van Zoonen Ward , Sivunen Anu , Rice Ronald E. , Treem Jeffrey W.
Published: October 2021

This study investigates the relationships between the use of various organizational ICTs, communication visibility, and perceived proximity to distant colleagues. In addition, this study examines the interplay between visibility and proximity, to determine whether visibility improves proximity, or vice versa. These relationships are tested in a global company using two waves of panel survey data. ESM use increases communication visibility and perceived proximity, while controlling for prior levels of visibility, proximity, and the use of other organizational ICTs. The influence of ESM on network translucence and perceived proximity is generally stronger than the impact of other technologies on these outcomes. These results highlight the importance of considering various aspects of the technological landscape conjointly, as well as distinguishing the two dimensions of communication visibility. Finally, the results indicate that perceived proximity has causal priority over communication visibility, indicating that communication visibility exists partly as an attribution of perceived proximity to distant colleagues, and is not solely inferred from the use of organizational ICTs.
The Role of Interaural Differences, Head Shadow, and Binaural Redundancy in Binaural Intelligibility Benefits Among School-Aged Children
Authors: Ellen Peng Z. , Litovsky Ruth Y.
Published: October 2021

In complex listening environments, children can benefit from auditory spatial cues to understand speech in noise. When a spatial separation is introduced between the target and masker and/or listening with two ears versus one ear, children can gain intelligibility benefits with access to one or more auditory cues for unmasking: monaural head shadow, binaural redundancy, and interaural differences. This study systematically quantified the contribution of individual auditory cues in providing binaural speech intelligibility benefits for children with normal hearing between 6 and 15 years old. In virtual auditory space, target speech was presented from  + 90° azimuth (i.e., listener's right), and two-talker babble maskers were either co-located (+ 90° azimuth) or separated by 180° (–90° azimuth, listener's left). Testing was conducted over headphones in monaural (i.e., right ear) or binaural (i.e., both ears) conditions. Results showed continuous improvement of speech reception threshold (SRT) between 6 and 15 years old and immature performance at 15 years of age for both SRTs and intelligibility benefits from more than one auditory cue. With early maturation of head shadow, the prolonged maturation of unmasking was likely driven by children's poorer ability to gain full benefits from interaural difference cues. In addition, children demonstrated a trade-off between the benefits from head shadow versus interaural differences, suggesting an important aspect of individual differences in accessing auditory cues for binaural intelligibility benefits during development.
Knowledge Management-Based Nursing Care Educational Training: A Key Strategy to Improve Healthcare Associated Infection Prevention Behavior
Authors: Ahsan Ahsan , Dewi Elvira S. , Suharsono Tony , Setyoadi Setyoadi , Soplanit Venny G. , Ekowati Shilfi I. , Syahniar Nabila P. , Sirfefa Ratna S. , Kartika Annisa W. , Ningrum Evi H. , Noviyanti Linda W. , Laili Nurul
Published: October 2021

Introduction

Knowledge management-based nursing care has a positive effect in preventing healthcare associated infections (HAIs). Therefore, nursing professionals can utilize key strategies of knowledge management to support clinical decision making, reorganize nursing actions, and maximize patient outcomes.

Objectives

The aim of this study was to determine the effect of knowledge management-based nursing care educational training on HAI prevention behavior at the High Care Unit (HCU) of Saiful Anwar Hospital Malang.

Methods

A quasiexperimental design with a pretest, educational training intervention, and posttest were conducted on 15 nurses in the HCU of Saiful Anwar Hospital Malang, which lasted for 16 days. Furthermore, observation of nursing care documentation, nurses’ handwashing compliance, and presence of infection-causing bacteria in the HCU staff and environment (hands rub handle, medical record, and patient's bed) was carried out pre (day 1–7) and post training (day 10–16). Subsequently, educational training related to knowledge management-based nursing care was conducted for 2 days (day 8–9) by the Doktor Mengabdi Team of Universitas Brawijaya.

Results

The knowledge level and completeness of the nursing care documentation in the HCU room significantly increased after the training ( p < .05). Also, compliance to the six steps five moments of nurses’ handwashing increased after the training ( p > .05). Infection-causing bacteria were found in the HCU environment and staff before and after the training involving Pseudomonas stutzeri, Sphingomonas paucimobilis, Enterobacter cloacae, Staphylococcus aureus, Acinetobacter baumannii, Pasteurella pneumotropica, and Acinetobacter lwoffii. Therefore, increased knowledge of HCU nurses and complete documentation ( r = .890; p = .054), increased knowledge of HCU nurses and handwashing compliance ( r = .770; p = .086), and handwashing compliance and bacterial presence ( r = .816; p = .084) all had a positive correlation.

Conclusion

Knowledge management-based nursing care educational training increased infection prevention behavior in the HCU of Saiful Anwar Hospital Malang.
COVID-19 Skepticism in Relation to Other Forms of Science Skepticism
Authors: Scheitle Christopher P. , Corcoran Katie E.
Published: October 2021

Efforts to address the coronavirus disease 2019 (COVID-19) pandemic have encountered skepticism among the public, but COVID-19 is not the only medical or scientific issue that receives such skepticism. How does COVID-19 skepticism relate to other forms of science skepticism? Using new data from a nationally representative survey of U.S. adults, this study reveals that skepticism toward COVID-19 is similar to patterns of skepticism toward vaccines in general and, more interestingly, skepticism toward climate change. Patterns of skepticism toward evolution and genetically modified foods are more distinct from COVID-19 skepticism. Notably, even after accounting for other forms of science skepticism, political conservatism is significantly associated with greater skepticism toward COVID-19. Finally, contrary to some media narratives, the analysis reveals few racial or ethnic differences in skepticism toward COVID-19, and the differences that do exist indicate less skepticism among Black and Asian individuals relative to White individuals.
Selected and Annotated Bibliography of Anthropology for Missionaries
Authors: Smalley William A.
Published: October 2021

William A. Smalloy, Ph.D. is Associate Secretary in the Translations Department of the American Bible Society. He is also editor of the bi-monthly Journal, Practical Anthropology, published especially for missionaries, Dr. Smalley served for several years as a missionary under the Christian and Missionary Alliance in Indo-China, before coming to his present position. He is recognized as an authority in the fields of Bible translation and anthropology. Ed.
Christian Colleges and the Future
Authors: Fenn William P. , Orr Clara E.
Published: October 2021

Dr. William P. Fenn is General Secretary of the United Board for Christian Higher Education in Asia (formerly United Board for Christian Colleges in China). Ha was an educational missionary of the Presbyterian Church in the U. S. A. and Head of the Department of Foreign Languages at the University of Nanking from 1925 to 1942. From 1942 to 1949 he served as Director of the China Office of the United Board for Christian Colleges in China, and then returned to the U. S. A. He has travelled widely over Asia in the interests of Christian higher education. Ed.
Indigenous Art and Bible-Illustration
Authors: Lehmann Arno
Published: October 2021

We are happy to publish, with the author's permission, this important article by Professor Dr. Arno Lehmann, Dean of the Faculty of Theology, and Director of the Institute of Theology, of the Martin-Luther-Universität Halle-Wittenberg in Halle, East Germany. The article was first given as a lecture at the Study Conference on Bible Illustration at Edinburgh University, in September 1959, It was later published in Wissenschaftliche Zeitschrift der Martin-Luther-Universität Halle-Wittenberg, 9. Jahrg., Heft 1, February 1960.

Dr. Lehmann is a specialist in the study of indigenous Christian art and has published “Von der Kunst der jungen Kirchen,” in Die Zeichen der Zeit (Berlin) 1953, and one of the few books on the subject, Die Kunat der jungen Kirchen (Berlin: Evangelische Verlagsanstalt, 1955). Its 255 pages include numerous plates, many of them colored, and a bibliography. In preparation for publication in Berlin in 1961 is a second Volume, Afrcasiatio Christian Art.

We hope that this article will stimulate thinking and discussion throughout the Christian world. - Ed.
The Forthcoming Role of the Non-Christian Religious Systems as Contributory to Christian Theology
Authors: Jackson Herbert C.
Published: October 2021

The author of this article, the Rev. Herbert C. Jackson, Ph.D., will on July 1, 1961, become the new Director of the Missionary Research Library (see MRL News).

Dr. Jackson is now Professor of Comparative Religion and Missions and Chairman of the Historical Division, the Southern Baptist Theological Seminary, Louisville, Kentucky. He studied at William Jewell College and Southern Baptist Theological Seminary, and received his M.A. and Ph.D. degrees at Yale University. He is an ordained minister of the American Baptist Convention and served as a missionary of the American Baptist Foreign Mission Society in India for six years. Recently he spent a year on faculty fellowship, studying at the University of Ceylon and travelling throughout Asia. Professor Jackson has taught missions at Eastern Baptist Theological Seminary and at Southern Baptist Theological Seminary since 1954. He is a member of the North American Advisory Committee of the International Missionary Council.

Dr. Jackson's stimulating study of the relation of non-Christian religious systems to Christian theology was given as an address at Southern Baptist Theological Seminary in September, 1960. - Ed.
Christian Approach to Now-Christian Faiths: A Selected Bibliography on the World's Living Religions
Authors: Rahbar Daud , Cragg A. Kenneth
Published: October 2021

In the March issue of the Occasional Bulletin we published a masterly article by an American missionary scholar on the relation of non-Christian religious systems to Christian theology. In this issue we are privileged to publish a paper by a Pakistani scholar whose brilliant research on the ethical doctrine of the Qur'an has just come from the press, under the title God of Justice.

Dr. Rahbar's father was Chairman of the Department of Persian Studies at the Punjab University in Pakistan and Principal of the Oriental College of that University. Dr. Daud Rahbar took his M.A. degree in Arabia Literature from the Punjab University in 1947. Since then he has continued his studies at Cambridge University and has taught at Cambridge, McGill University in Montreal, Ankara University, and Hartford Theological Seminary where he is at present visiting Professor of Urdu and Pakistan Studies. Dr. Rahbar is a Christian. His paper, “Christian Approach to Non-Christian Faiths,” was read at the Consultation sponsored by the South Asia Committee of the D.F.M., October 31, 1960. It is followed by a review of Dr. Rahbar's new book, written especially for the MRL Occasional Bulletin by Dr. A. Kenneth Cragg, author of The Call of the Minaret, Sandals at the Mosoue, and other books.
An Attempt at a Theological Analysis of Missionary Motivation
Authors: Niebuhr H. Richard
Published: October 2021

This article represents a paper prepared under the direction of the Research Committee of the Division of Foreign Missions of the National Council of the Churches of Christ in the U.S.A. and presented in April, 1951, as part of the American preparatory study on The Missionary Obligation of the Church”, the theme of the Enlarged Meeting of the International Missionary Council in Willingen. Germany, in 1952 So far as we know, it has never been published. It is presented now because of its intrinsic value and because it is as timely as it was a decade ago, if not more so.

Un his death in 1962, Dr. Niebuh was for many years Professor of Theology and Christian Ethics in the Yale University Divinary School. The article is published with the kind permission of Mrs. H. Richard Niebuhr.
The Service of Theology to World Mission Today
Authors: Scherer James A.
Published: October 2021

This article is a reconstruction and amplification of an address delivered at the 43rd Annual Meeting of the Lutheran Foreign Missions Conference of North America. James A. Scherer is Dean of the School of Missions at the Lutheran School of Theology at Chicago, located in Maywood, Illinois. –Editor.
Christian Vocation and the Missionary Call
Authors: Long Charles H.
Published: October 2021

This is a reprint of an article prepared as a part of the International Missionary Council Study of “The Missionary Obligation of the Church”, preparatory to the Enlarged Meeting of the IMC held in Willingen, Germany, in July 1952 and published in The International Review of Missions, Vol. 39 (1950), pp. 409–417. It is reprinted by permission from the IRM, from the Overseas Department of the National Council of the Protestant Episcopal Church in the U. S. A., and from the author.

The Reverend Charles H. Long, Jr. served for many years as a missionary in China under the Protestant Episcopal Church. This article is chosen for reprinting because it deals with an issue perhaps more live and crucial than was the case a decade ago, and because it is apropos of a new study of missionary motivation, training, and withdrawal being undertaken by the Missionary Research Library.
The Missionary Obligation of Theology
Authors: Jackson Herbert C.
Published: October 2021

The following address was delivered at Crczer Theological Seminary, Chemer, Pennsylvania, on November 19, 1963, as the opening lecture of Mission Emphasis Week. Dr. Jackson is Director of the Missionary Research Library.
Religious Syncretism in the Caribbean: A Study of the Persistence of African and Indian Belief
Authors: Wipfler William L.
Published: October 2021

It is generally assumed that a “higher” culture will inevitably absorb or eradicate a “lower” culture with which it comes in contact. While it is obvious that the cultures of the conquerors have prevailed as the directing force in the various areas of the Caribbean, it is also true that they have never eliminated the influence of those religions with which they came in contact from the very beginning of the era of colonization.

It is the purpose of this study, therefore, to examine two specific areas of contact (Mexico and Haiti) and attempt to:

(1) Discover the factors within colonial development that contributed to the persistence of primitive religion;

(2) Consider which elements of primitive religion have persisted; and,

(3) Consider which elements of the Christian religion were readily accepted, reinterpreted and integrated into the folk religion.
Perspectives on Development from mao Tse-Tung
Authors: Stowe David M.
Published: October 2021

In current thinking about the mission of the church no topic is more prominent than “development.” Its urgency springs from awakened Christian conscience concerning the vast disabilities suffered by a large part of the world's population in comparison with relatively affluent “Christian” nations of the West. Many missionary leaders have come to the conviction that traditional Christian activities in aid of the poor have treated symptoms rather than causes. “Development,” then, seeks to get at fundamental issues of poverty, hunger, ignorance, hopelessness and to help people find their own way to a more abundant, more “human” life.

What is distinctively Christian about these concerns, or about the actions undertaken to deal with them? What have the churches in mission to offer that secular agencies, or even anti-Christian movements, cannot match or excel? A striking perspective from which to view some of these questions is provided by the ideology of Communist China, widely believed to be the most successful society to undertake self-development in our time. Without attempting to make specific comparisons, this essay outlines the developmental thought of Mao Tse-tung in a way which facilitates self-analysis and evaluation by Christians.
Where have all the Women Gone?
Authors: Derby Marian
Published: October 2021

Dr. R. Pierce Beaver has made an important contribution to the history of Christian missions in his recent book “All Loves Excelling.” 1 Much of the historical content of this paper has been drawn from his book. (It is my hope that the reader may be inspired to obtain a copy of Dr. Beaver's book for study and reflection;) The book bears the subtitle “American Protestant Women in World Mission” and tells the story of the rise and fall of Woman's Foreign Missionary Societies.

It is the purpose of this paper to look at this history from the perspective of a time when there is a rising consciousness on the part of women in many countries of the possibilities of a new role in society. This includes a potentially new role in the church, with women moving out on new mission frontiers. While this cannot be considered a mere repetition of history, it has enough in common with the woman's missionary movement of the last century to merit a look at these Woman's Missionary Societies and to learn from them.
Making sense: Reflections on an event-based memoir in an existential mode
Authors: Robertson Leslie A
Published: October 2021

I began this contemplation of skull and mind after a concussion in 2017 meant that I had to stop reading and engaging in the variety of daily, cognitive activities that comprise academic work. Making Sense documents the subjective sensorium of this injury through a multimedia memoir and autoethnographic analysis that is attuned to ‘existential modalities’. I contemplate an emerging, perceptual repertoire alongside other knowledge practices that recognize the more surreal dimensions of a life-interrupted. Materiality and colour and painting (and text) are considered as evocative modes for apprehending embodied experience and textures of memory and imagination. As an experiment with methodologies of perception, Making Sense includes an abridged, event-based memoir (in stone, text and paintings). An animated pptx version is linked.
Youth and Parent Perspectives on the Acceptability of a Group Physical Activity and Coping Intervention for Adolescents With Type 1 Diabetes
Authors: DeJonckheere Melissa , Joiner Kevin L. , Ash Garrett I. , Savoye Mary , Adams Mackenzie , Weinzimer Stuart A. , Sadler Lois S. , Grey Margaret
Published: October 2021

Purpose

To examine youth and parent perspectives on the acceptability of Bright 1 Bodies, a group physical activity and coping intervention for adolescents with type 1 diabetes mellitus (T1DM).

Methods

Adolescents participated in 12 weekly sessions of moderate to vigorous physical activity and discussion with peers with T1DM. Adolescents completed an exit survey measuring satisfaction with the intervention on a 5-point Likert scale. Semistructured interviews were conducted with adolescents and at least one parent. Qualitative description was used to develop themes that summarize the acceptability of the intervention.

Results

Mean scores for survey subscales were: 4.5 (SD = 0.39) for program components and strategies, 4.4 (SD = 0.44) for comfort with the intervention, and 4.3 (SD = 0.62) for instructors. Themes included: (1) adolescents and parents valued being around others with T1DM and their families, (2) the intervention helped adolescents gain knowledge and reinforce diabetes self-management behaviors, (3) challenges included convenience and sustaining participant engagement, and (4) adolescents intended to sustain physical activity and diabetes self-management behaviors after the intervention.

Conclusions

Adolescents and parents viewed the intervention as acceptable across multiple domains. Participants valued the group aspect of the intervention, and future interventions would benefit from integrating social interactions with others with T1DM.
Barriers to Type 2 Diabetes Management Among Older Adult Haitian Immigrants
Authors: Magny-Normilus Cherlie , Whittemore Robin , Wexler Deborah J. , Schnipper Jefferey L. , Nunez-Smith Marcella , Fu Mei R.
Published: October 2021

Purpose

The purpose of this study was to describe the experiences of older adult Haitian immigrants in managing type 2 diabetes mellitus (T2DM).

Methods

A descriptive qualitative approach using semistructured interviews was conducted with 20 older adult Haitian immigrants with T2DM. Interviews were transcribed verbatim and categorized using NVivo. An iterative descriptive data analysis method was used to examine the data, compare codes, challenge interpretations, and develop themes inductively.

Results

Older adult Haitian immigrants reported that T2DM affected every aspect of their lives. Financial hardship and social isolation were described as the major barriers to T2DM management, which forced them to choose between basic needs and health care, and at times, they had to forgo medications or avoid seeking medical care. They recognized that creating and maintaining good community support was the key to self-management of T2DM.

Conclusions

Financial hardship and social isolation have a tremendous impact on the ability of older Haitian immigrants to manage T2DM effectively. It is challenging to modify these barriers through individual efforts, and clinical, research, and public efforts may be necessary to address these concerns.
Emerging approaches to improve allogeneic hematopoietic cell transplantation outcomes for nonmalignant diseases
Authors: DeFilipp Zachariah , Hefazi Mehrdad , Chen Yi-Bin , Blazar Bruce R.
Published: October 2021

Many congenital or acquired nonmalignant diseases (NMDs) of the hematopoietic system can be potentially cured by allogeneic hematopoietic cell transplantation (HCT) with varying types of donor grafts, degrees of HLA matching, and intensity of conditioning regimens. Unique features that distinguish the use of allogeneic HCT in this population include higher rates of graft failure, immune-mediated cytopenias, and the potential to achieve long-term disease-free survival in a mixed chimerism state. Additionally, in contrast to patients with hematologic malignancies, a priority is to completely avoid graft-versus-host disease in patients with NMD because there is no theoretical beneficial graft-versus-leukemia effect that can accompany graft-versus-host responses. In this review, we discuss the current approach to each of these clinical issues and how emerging novel therapeutics hold promise to advance transplant care for patients with NMDs.
Erythroid overproduction of erythroferrone causes iron overload and developmental abnormalities in mice
Authors: Coffey Richard , Jung Grace , Olivera Joseph D. , Karin Gabriel , Pereira Renata C. , Nemeth Elizabeta , Ganz Tomas
Published: October 2021

The hormone erythroferrone (ERFE) is produced by erythroid cells in response to hemorrhage, hypoxia, or other erythropoietic stimuli, and it suppresses the hepatic production of the iron-regulatory hormone hepcidin, thereby mobilizing iron for erythropoiesis. Suppression of hepcidin by ERFE is believed to be mediated by interference with paracrine bone morphogenetic protein (BMP) signaling that regulates hepcidin transcription in hepatocytes. In anemias with ineffective erythropoiesis, ERFE is pathologically overproduced, but its contribution to the clinical manifestations of these anemias is not well understood. We generated 3 lines of transgenic mice with graded erythroid overexpression of ERFE and found that they developed dose-dependent iron overload, impaired hepatic BMP signaling, and relative hepcidin deficiency. These findings add to the evidence that ERFE is a mediator of iron overload in conditions in which ERFE is overproduced, including anemias with ineffective erythropoiesis. At the highest levels of ERFE overexpression, the mice manifested decreased perinatal survival, impaired growth, small hypofunctional kidneys, decreased gonadal fat depots, and neurobehavioral abnormalities, all consistent with impaired organ-specific BMP signaling during development. Neutralizing excessive ERFE in congenital anemias with ineffective erythropoiesis may not only prevent iron overload but may have additional benefits for growth and development.
ALL blasts drive primary mesenchymal stromal cells to increase asparagine availability during asparaginase treatment
Authors: Chiu Martina , Taurino Giuseppe , Dander Erica , Bardelli Donatella , Fallati Alessandra , Andreoli Roberta , Bianchi Massimiliano G. , Carubbi Cecilia , Pozzi Giulia , Galuppo Laura , Mirandola Prisco , Rizzari Carmelo , Tardito Saverio , Biondi Andrea , D’Amico Giovanna , Bussolati Ovidio
Published: October 2021

Mechanisms underlying the resistance of acute lymphoblastic leukemia (ALL) blasts to l-asparaginase are still incompletely known. Here we demonstrate that human primary bone marrow mesenchymal stromal cells (MSCs) successfully adapt to l-asparaginase and markedly protect leukemic blasts from the enzyme-dependent cytotoxicity through an amino acid trade-off. ALL blasts synthesize and secrete glutamine, thus increasing extracellular glutamine availability for stromal cells. In turn, MSCs use glutamine, either synthesized through glutamine synthetase (GS) or imported, to produce asparagine, which is then extruded to sustain asparagine-auxotroph leukemic cells. GS inhibition prevents mesenchymal cells adaptation to l-asparaginase, lowers glutamine secretion by ALL blasts, and markedly hinders the protection exerted by MSCs on leukemic cells. The pro-survival amino acid exchange is hindered by the inhibition or silencing of the asparagine efflux transporter SNAT5, which is induced in mesenchymal cells by ALL blasts. Consistently, primary MSCs from ALL patients express higher levels of SNAT5 (P < .05), secrete more asparagine (P < .05), and protect leukemic blasts (P < .05) better than MSCs isolated from healthy donors. In conclusion, ALL blasts arrange a pro-leukemic amino acid trade-off with bone marrow mesenchymal cells, which depends on GS and SNAT5 and promotes leukemic cell survival during l-asparaginase treatment.
Gilteritinib-induced upregulation of S100A9 is mediated through BCL6 in acute myeloid leukemia
Authors: Zavorka Thomas Megan E. , Jeon Jae Yoon , Talebi Zahra , Buelow Daelynn R. , Silvaroli Josie , Campbell Moray J. , Sparreboom Alex , Pabla Navjot , Baker Sharyn D.
Published: October 2021

Drug resistance and relapse are common challenges in acute myeloid leukemia (AML), particularly in an aggressive subset bearing internal tandem duplications (ITDs) of the FLT3 receptor (FLT3-ITD+). The tyrosine kinase inhibitor gilteritinib is approved for the treatment of relapse/refractory AML with FLT3 mutations, yet resistance to gilteritinib remains a clinical concern, and the underlying mechanisms remain incompletely understood. Using transcriptomic analyses and functional validation studies, we identified the calcium-binding proteins S100A8 and S100A9 (S100A8/A9) as contributors to gilteritinib resistance in FLT3-ITD+ AML. Exposure of FLT3-ITD+ AML cells to gilteritinib increased S100A8/A9 expression in vivo and in vitro and decreased free calcium levels, and genetic manipulation of S100A9 was associated with altered sensitivity to gilteritinib. Using a transcription factor screen, we identified the transcriptional corepressor BCL6, as a regulator of S100A9 expression and found that gilteritinib decreased BCL6 binding to the S100A9 promoter, thereby increasing S100A9 expression. Furthermore, pharmacological inhibition of BCL6 accelerated the growth rate of gilteritinib-resistant FLT3-ITD+ AML cells, suggesting that S100A9 is a functional target of BCL6. These findings shed light on mechanisms of resistance to gilteritinib through regulation of a target that can be therapeutically exploited to enhance the antileukemic effects of gilteritinib.
Cytomegalovirus retinitis in patients of non-Hodgkin’s lymphoma: clinical presentations and outcomes
Authors: Reddy Subhakar , Tyagi Mudit , Behera Shashwat , Pappuru Rajeev R. , Dave Vivek P. , Basu Soumyava , Agrawal Hitesh
Published: October 2021

Background

Cytomegalovirus (CMV) retinitis in patients with Non-Hodgkin’s Lymphoma (NHL) can occur even in the presence of high CD 4 counts and can behave differently when compared to CMV retinitis in human immunodeficiency (HIV) patients. It, therefore, becomes important to understand its varied presentations and the challenges in management of these cases. The aim of this study was to analyse the various patterns of presentations and outcomes of CMV Retinitis in patients with NHL.

Study design

A retrospective chart review of seven eyes of four patients of NHL presenting with CMV retinitis between June 2017 and May 2020 was done.

Methods

Clinical patterns of CMV Retinitis, CD4 counts at the time of presentation and the duration of treatment along with recurrences and time for recurrence of retinitis were assessed.

Results

Granular or indolent retinitis (6 out of 7 eyes) was the commonest form of CMV retinitis in patients of NHL. Three patients had a presenting CD4 count above 150 cells/mm3 and none of them were below 50 cells/mm3. Floaters were the commonest presenting complaint. All patients had vitritis and majority of the patients (3 out of 4) had anterior chamber (AC) inflammation. Two out of the 4 patients had a recurrence (mean time 33.8 days) after stopping the maintenance phase of ganciclovir and one patient had significant myelosuppression related to oral valganciclovir which required discontinuation of the drug.

Conclusion

CMV retinitis in NHL patients is usually of an indolent or granular type and can occur even in the presence of high CD4 counts as compared to patients with HIV. These patients may require a long term maintenance in view of frequent recurrences after discontinuation of treatment.
Multi-tiered analyses of honey bees that resist or succumb to parasitic mites and viruses
Authors: Weaver Daniel B. , Cantarel Brandi L. , Elsik Christine G. , Boncristiani Dawn L. , Evans Jay D.
Published: October 2021

Background

Varroa destructor mites, and the numerous viruses they vector to their honey bee hosts, are among the most serious threats to honey bee populations, causing mortality and morbidity to both the individual honey bee and colony, the negative effects of which convey to the pollination services provided by honey bees worldwide. Here we use a combination of targeted assays and deep RNA sequencing to determine host and microbial changes in resistant and susceptible honey bee lineages. We focus on three study sets. The first involves field sampling of sympatric western bees, some derived from resistant stock and some from stock susceptible to mites. The second experiment contrasts three colonies more deeply, two from susceptible stock from the southeastern U.S. and one from mite-resistant bee stock from Eastern Texas. Finally, to decouple the effects of mites from those of the viruses they vector, we experimentally expose honey bees to DWV in the laboratory, measuring viral growth and host responses.

Results

We find strong differences between resistant and susceptible bees in terms of both viral loads and bee gene expression. Interestingly, lineages of bees with naturally low levels of the mite-vectored Deformed wing virus, also carried lower levels of viruses not vectored by mites. By mapping gene expression results against current ontologies and other studies, we describe the impacts of mite parasitism, as well as viruses on bee health against two genetic backgrounds. We identify numerous genes and processes seen in other studies of stress and disease in honey bee colonies, alongside novel genes and new patterns of expression.

Conclusions

We provide evidence that honey bees surviving in the face of parasitic mites do so through their abilities to resist the presence of devastating viruses vectored by these mites. In all cases, the most divergence between stocks was seen when bees were exposed to live mites or viruses, suggesting that gene activation, rather than constitutive expression, is key for these interactions. By revealing responses to viral infection and mite parasitism in different lineages, our data identify candidate proteins for the evolution of mite tolerance and virus resistance.
Incidence of osteoporosis and ambient air pollution in South Korea: a population-based retrospective cohort study
Authors: Shin Jinyoung , Kweon Hyuk Jung , Kwon Kyoung Ja , Han Seol-Heui
Published: October 2021

Background

This study investigated the associations between exposure to ambient air pollutants and the incidence of osteoporosis using the Korean National Insurance Service–National Sample Cohort.

Methods

This nationwide, population-based, retrospective cohort study included 237,149 adults aged ≥40 years that did not have a diagnosis of osteoporosis at baseline between January 1, 2003, and December 31, 2015. Osteoporosis was defined as claim codes and prescriptions of bisphosphonates or selective estrogen receptor modulators at least twice annually. After matching values for PM10, NO2, CO, and SO2 during the 2002–2015 time period and PM2.5 in 2015 with residential areas, the incidence of osteoporosis was analyzed using a Cox proportional hazards regression model according to the quartile of average yearly concentrations of pollutants.

Results

Overall 22.2% of the study subjects, 52,601 (male: 5.6%, female: 37.6%) adults in total, were newly diagnosed with osteoporosis and treated. Exposure to PM10 was positively associated with incidence of osteoporosis (Q4: 1798 per 100,000 person-years vs. Q1: 1655 per 100,000 person-years). The adjusted hazard ratio (HR) with 95% confidence interval (CI) of Q4 in PM10 was 1.034 (1.009–1.062). The effect of PM10 on osteoporosis incidence was distinct in females (adjusted sub-HR: 1.065, 95% CI: 1.003–1.129), subjects aged < 65 years (adjusted sub-HR: 1.040, 95% CI: 1.010–1.072), and for residents in areas with low urbanization (adjusted sub-HR: 1.052, 95% CI: 1.019–1.087). However, there was no increase in osteoporosis based on exposure to NO2, CO, SO2, or PM2.5.

Conclusions

Long-term exposure to PM10 was associated with newly diagnosed osteoporosis in Korean adults aged ≥40 years. This finding can aid in policy-making that is directed to control air pollution as a risk factor for bone health.
The impact of hospital accreditation on the quality of healthcare: a systematic literature review
Authors: Hussein Mohammed , Pavlova Milena , Ghalwash Mostafa , Groot Wim
Published: October 2021

Background

Accreditation is viewed as a reputable tool to evaluate and enhance the quality of health care. However, its effect on performance and outcomes remains unclear. This review aimed to identify and analyze the evidence on the impact of hospital accreditation.

Methods

We systematically searched electronic databases (PubMed, CINAHL, PsycINFO, EMBASE, MEDLINE (OvidSP), CDSR, CENTRAL, ScienceDirect, SSCI, RSCI, SciELO, and KCI) and other sources using relevant subject headings. We included peer-reviewed quantitative studies published over the last two decades, irrespective of its design or language. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two reviewers independently screened initially identified articles, reviewed the full-text of potentially relevant studies, extracted necessary data, and assessed the methodological quality of the included studies using a validated tool. The accreditation effects were synthesized and categorized thematically into six impact themes.

Results

We screened a total of 17,830 studies, of which 76 empirical studies that examined the impact of accreditation met our inclusion criteria. These studies were methodologically heterogeneous. Apart from the effect of accreditation on healthcare workers and particularly on job stress, our results indicate a consistent positive effect of hospital accreditation on safety culture, process-related performance measures, efficiency, and the patient length of stay, whereas employee satisfaction, patient satisfaction and experience, and 30-day hospital readmission rate were found to be unrelated to accreditation. Paradoxical results regarding the impact of accreditation on mortality rate and healthcare-associated infections hampered drawing firm conclusions on these outcome measures.

Conclusion

There is reasonable evidence to support the notion that compliance with accreditation standards has multiple plausible benefits in improving the performance in the hospital setting. Despite inconclusive evidence on causality, introducing hospital accreditation schemes stimulates performance improvement and patient safety. Efforts to incentivize and modernize accreditation are recommended to move towards institutionalization and sustaining the performance gains.

PROSPEROregistration number CRD42020167863.
Insights into financial technology (FinTech): a bibliometric and visual study
Authors: Li Bo , Xu Zeshui
Published: October 2021

This paper conducted a comprehensive analysis based on bibliometrics and science mapping analysis. First, 848 publications were obtained from Web of Science. Their fundamental characteristics were analyzed, including the types, annual publications, hot research directions, and foci (by theme analysis, co-occurrence analysis, and timeline analysis of author keywords). Next, the prolific objects (at the level of countries/regions, institutions, journals, and authors) and corresponding pivotal cooperative relationship networks were used to highlight who pays attention to FinTech. Furthermore, the citation structures of authors and journals were investigated, including citation and co-citation. Additionally, this paper presents the burst detection analysis of cited authors, journals, and references. Finally, combining the analysis results with the current financial environment, the challenges and future development opportunities are discussed further. Accordingly, a comprehensive study of the FinTech documents not only reviews the current research characteristics and trajectories but also helps scholars find the appropriate research entry point and conduct in-depth research.
Reaction of stock market returns to COVID-19 pandemic and lockdown policy: evidence from Nigerian firms stock returns
Authors: Raifu Isiaka Akande , Kumeka Terver Theophilus , Aminu Alarudeen
Published: October 2021

Given the effects COVID-19 pandemic on the financial sectors across the world, this study examined the reaction of stock returns of 201 firms listed in the Nigerian Stock Exchange to the COVID-19 pandemic and lockdown policy. We deployed both Pooled OLS and Panel VAR as estimation methods. Generally, the results from POLS show the stock market returns of the Nigerian firms reacted negatively more to the global COVID-19 confirmed cases and deaths than the domestic COVID-19 confirmed cases and deaths and lockdown policy. The results of the impulse response functions revealed that the effects of COVID-19 confirmed cases and deaths and lockdown policy shocks on stock returns oscillate between negative and positive before the stock market returns converge to the equilibrium in the long run. The FEVD results showed that growth in the COVID-19 confirmed cases, deaths and lockdown policy shocks explained little variations in stock market returns. Given our finding, we advocate for the relaxation of policy of lockdown and the combine use of monetary and fiscal policies to mitigate the negative effect of COVID-19 pandemic on stock market returns in Nigeria.
Primary closure of superior partial sternal cleft in a 2-month-old girl: case report
Authors: Tanriverdi Halil Ibrahim , Doğaneroğlu Fulya , Genç Abdülkadir , Yılmaz Ömer
Published: October 2021

Background

Sternal cleft is a quite rare malformation. It is seen 1 out of 100,000 live births and makes up less than 1% of all chest wall deformities, seen more often among females. The deformity can be partial or complete. Partial deformities can be superior or inferior. It is generally diagnosed at birth when paradoxical respiratory movements are seen. Patients are often asymptomatic when they are born and generally other abnormalities accompany. As sternal clefts can be repaired primarily at early ages, they are repaired using autologous or synthetic grafts in the following years. We present a 2-month-old girl with superior partial sternal cleft repaired primary and accompanying hemangiomas in this case report.

Case presentation

A girl who was born in another center and had a sternal cleft, who did not have any problems in the early period, was admitted to our hospital with respiratory distress at the age of 43 days. The patient was monitored with mechanical ventilator support, and there were hemangiomas around his left ear and lips. There were paradoxical respiratory movements in front of the heart, in the upper midline of the chest. Three-dimensional computed tomography showed that the upper part of the sternum did not develop, and there were hypoplasic sternal bars on both sides. It was evaluated as superior partial sternal cleft, and surgery was planned. In the operation, the sternal bars were released from the pericardium and pleura. The periosteum in the medial of both sternal bars was then released and connected in the midline, in front of the pericardium.

Conclusion

Although neonates with a sternal cleft are asymptomatic at birth, respiratory symptoms may develop in later periods. In addition, because the structures are more flexible in the neonatal period, the primary repair of the cleft is easier and the risk of cardiac compression is lower. In our case, sternal bars could be approached primary, and no chondral grafts, patches, or steel wires were required.