bluuebunny/crossref_metadata_2025 huggingface dataset:
Increasing Student Retention Rates Through Engagement in a Comprehensive Second-Year Program
Authors: McDaniel Anne , Halper Leah R. , Van Jura Matthew , Fines Beth , Whittington M. Susie
Published: March 2022

The second year of college is a time when students remain at increased risk of departure. Compared to widely available first-year resources, institutional support for second-year students is more limited. The purpose of this study was to compare second-to-third year retention between students who participated in a comprehensive second-year experience program (SEP; n = 2,622) with students who did not participate ( n = 4,823). Because students’ participation in SEP was optional, we used propensity score matching to account for potential selection bias. Students who participated in SEP were retained at higher rates than students who did not participate, even when accounting for potential selection bias. Retention differences were especially notable among participants and nonparticipants from systemically minoritized backgrounds. These findings extend prior research that meaningful involvement in high-impact practices supports second-year students’ retention. We conclude with implications for leaders responsible for second-year programing on their campus.
Study on high velocity impact response of aramid fibers-epoxy/aluminum laminate composites toughened by ZrO2 and SiO2 nanoparticles
Authors: Abedi Mohammad Hossein , Eslami-Farsani Reza
Published: March 2022

The present study investigates the improvement in high-velocity impact response of fiber metal laminates through modification of epoxy using different percentages (0, 1, 3, and 5 wt.%) of SiO2 and ZrO2 nanoparticles. To ensure a good distribution of nanoparticles into epoxy resin, the nanoparticles were dispersed by a high-speed shear mixer followed by an ultrasonic device. By using the hand lay-up technique followed by a mold pressing process, FML samples were made of 2024-T3 aluminum sheets (0.5 mm thick) and woven Kevlar fabric impregnated with modified epoxy. The high-velocity impact test on FML samples was conducted to determine the influence of epoxy modification on their specific energy absorption. The study revealed that the modification of epoxy increased the specific energy absorption up to 130% and 91% at samples with 3 wt.% of SiO2 and 5 wt.% of ZrO2, respectively. It was also observed from scanning electron microscopy analysis that incorporation of ceramic nanoparticles changed the delamination failure mechanism of matrix cracking to fiber breakage. Furthermore, finite element simulation (FES) was additionally conducted with Abaqus to predict the residual velocity and model impact response. The simulation results agree well with experimental data.
Parents of the White Awokening
Authors: Underhill Megan R. , Simms Lauren
Published: March 2022

BLM activism brought academic discussions of systemic racism outside the walls of the university and into the mainstream. For the white parents in our study, this was a radically new way of thinking about race in the United States. However, as public conversations about racial inequality gained greater visibility, parents began to question their racial beliefs and practices. This article explores how white parents navigate their new understandings of race that challenged previous color-blind perspectives. Parents came to endorse new strategies of action with respect to the racial socialization of their children.
Social Value of the Child
Authors: Qamar Azher Hameed
Published: March 2022

This pictorial presentation of childhood aims to provide a visual depiction of the social value of the children in rural Punjabi socio-cultural context. I took these photographsin a village in south Punjab, Pakistan while doing an ethnographic inquiry about infant healthcare belief practices and the social value of the child in rural Punjab.
A Sociologist in Tech
Authors: Lee Monica
Published: March 2022

The technology industry offers exciting opportunities to practice social science research. Understanding the impact of technology on society and improving that impact is now a career path that utilizes advanced social scientific training and literature, from grand theory to empirical methods and studies. Applying this training to industry problems is enriching and brings about new appreciation for many types of scientific literature.
Foreign Yet Familiar: J. L. Borges’ Book of Imaginary Beings and Other Cultural Ferrymen in Japanese Fantasy Games
Authors: Escande Jessy
Published: March 2022

This paper considers J. L. Borges’ Book of Imaginary Beings as a vector for the cultural transfer of folkloric, mythological, religious, and literary motifs from foreign cultures to Japanese video games and collectible card games. My analysis relies upon Michel Espagne’s cultural transfer theories and discusses not only the Book of Imaginary Beings but also other vectors of transfer, such as the roleplaying game Dungeons & Dragons. I focus on four specific motifs from different cultural spheres, whose introduction to Japanese video games can be retraced to Borges’ bestiary: The carbuncle, the catoblepas, the peryton, and Kujata. Thus, this paper presents a case study of the cross-cultural influence of literary works on games. Furthermore, it underscores the need for a deeper consideration of the cultural influences found in games and of games as agents of cultural transfers.
The Economy of Time, the Rationalisation of Resources: Discipline, Desire and Deferred Value in the Playing of Gacha Games
Authors: Woods Orlando
Published: March 2022

This paper offers a counterpoint to existing research that explores the associations between gacha games and gambling. Whilst existing research tends to advance a view that playing these games is equivalent to gambling, I contend that such assertions rest on analyses that focus almost exclusively on investing money in the game. Moreover, they tend to view the game as separate from the structuring forces of everyday life. Arguing that players are embedded within a double structural frame that moderates the extent of seemingly ‘irrational’ playing behaviours, I reinterpret grinding as a form of temporal investment that is motivated by more ‘rationalised’ engagements with the gacha mechanic. Drawing on qualitative data derived from Singapore-based players of gacha games, I explore how discipline, desire and deferred value can lead to resource maximising behaviours that are rooted in a time-money trade-off. In turn, these agentic patterns of play can be seen to ‘game-the-game’.
Transfemoral Versus Subclavian Access for Transcatheter Aortic Valve Replacement
Authors: Yousef Sarah , Brown James A. , Kliner Dustin , Serna-Gallegos Derek , Toma Catalin , Sanon Saurabh , Mulukutla Suresh , Wang Yisi , Thoma Floyd W. , Sultan Ibrahim
Published: March 2022

Objective: This study sought to compare outcomes of transcatheter aortic valve replacement (TAVR) performed through subclavian access with those performed through transfemoral access. Methods: This was an observational study utilizing an institutional TAVR database from 2010 to 2018. All patients undergoing a TAVR via a transfemoral (TF-TAVR) or subclavian (SC-TAVR) approach were included in the study. The groups were analyzed for differences in operative mortality and postoperative outcomes. Multivariable Cox analysis was performed to identify variables associated with long-term survival after TAVR. Results: Of the 1,095 patients identified, 133 patients underwent SC-TAVR and 962 patients underwent TF-TAVR. Patients who underwent SC-TAVR were younger, more likely to have chronic lung disease and peripheral vascular disease, had higher Society of Thoracic Surgeons predicted risk of mortality scores, and were more likely to have self-expanding valves placed ( P < 0.05). Operative mortality was similar between the TF-TAVR (2.7%) and SC-TAVR (3.8%) groups. There were no significant differences in stroke, length of stay, 30-day readmission, blood transfusions, acute kidney injury, need for permanent pacemaker, paravalvular leak, or major vascular complications between the groups ( P > 0.05). The unadjusted Kaplan-Meier survival estimate for TF-TAVR was significantly higher than for SC-TAVR ( P = 0.009, log-rank). However, on multivariable Cox analysis, subclavian access was not significantly associated with an increased hazard of death as compared with transfemoral access ( P = 0.21). Conclusions: Outcomes of SC-TAVR are comparable to those of TF-TAVR. Subclavian access may be a favorable alternative approach when TF-TAVR is contraindicated.
Induced Pluripotent Stem Cells and Hormesis
Authors: Calabrese Edward J
Published: March 2022

This paper represents the first assessment of agent-induced hormetic dose responses in induced pluripotent stem cells and their derived cells. The hormetic dose responses were induced by a broad range of chemicals, including pharmaceuticals (eg, metformin), dietary supplements/extracts from medicinal plants (eg, curcumin), and endogenous agents (eg, melatonin). The paper assesses the mechanistic foundations of these induced hormetic dose responses, their therapeutic implications and comparison with hormetic responses in multiple adult and embryonic stem cells.
Kinds of Replication: Examining the Meanings of “Conceptual Replication” and “Direct Replication”
Authors: Derksen Maarten , Morawski Jill
Published: March 2022

Although psychology’s recent crisis has been attributed to various scientific practices, it has come to be called a “replication crisis,” prompting extensive appraisals of this putatively crucial scientific practice. These have yielded disagreements over what kind of replication is to be preferred and what phenomena are being explored, yet the proposals are all grounded in a conventional philosophy of science. This article proposes another avenue that invites moving beyond a discovery metaphor of science to rethink research as enabling realities and to consider how empirical findings enact or perform a reality. An enactment perspective appreciates multiple, dynamic realities and science as producing different entities, enactments that ever encounter differences, uncertainties, and precariousness. The axioms of an enactment perspective are described and employed to more fully understand the two kinds of replication that predominate in the crisis disputes. Although the enactment perspective described here is a relatively recent development in philosophy of science and science studies, some of its core axioms are not new to psychology, and the article concludes by revisiting psychologists’ previous calls to apprehend the dynamism of psychological reality to appreciate how scientific practices actively and unavoidably participate in performativity of reality.
Effect of Yang He Decoction on Treatment of Bone Tuberculosis via Phosphoinositide 3-Kinases/Protein Kinase B and Mitogen-Activated Protein Kinase Signaling Pathways
Authors: Zhang Qiang , Ma Wanli , Wang Qing , Gao Hua , Sun Jianmin
Published: March 2022

Yang He Decoction (YHD), a classical Chinese medicine prescription, is used to treat bone and joint diseases. However, there are few mechanism studies for YHD on the use of YHD to treat bone tuberculosis (BT) and the corresponding mechanism of action of YHD. In the present study, the chemical ingredients of YHD and targets of the ingredients were revealed by a network pharmacology method, and an ingredient–target–disease network was visualized and analyzed. Then, gene ontology enrichment analysis and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis were carried out. In addition, molecular docking was performed to clarify the binding of the key active ingredients of YHD to the key targets. Further, an in vitro model of Mycobacterium tuberculosis-induced BT was established, and a mechanism for the inhibitory effect of YHD on the differentiation of RAW 264.7 cells into osteoclasts was investigated. A total of 138 active ingredients in YHD and 50 targets between YHD ingredients and BT were identified. The phosphatidylinositol 3-kinase–protein kinase B (PI3K–Akt) and mitogen-activated protein kinase (MAPK) signaling pathways were the key pathways involved in the anti-BT effect of YHD. Moreover, the in vitro results showed that YHD inhibited the differentiation of RAW 264.7 cells into osteoclasts. YHD decreased the levels of tumor necrosis factor-α and interleukin-1β, increased the levels of superoxide dismutase and glutathione peroxide, and decreased the level of malondialdehyde. Further, YHD inhibited the protein and messenger RNA expression of PI3K/Akt, p38 MAPK, and c-Jun N-terminal kinase. These findings show that YHD is a promising anti-BT agent that suppresses the PI3K/Akt and MAPK signaling pathways to inhibit the differentiation of RAW 264.7 cells into osteoclasts and ameliorate inflammation and oxidative stress.
Novel homozygous mutation of PNLIP gene in congenital pancreatic lipase deficiency: an extended family study
Authors: Kamal Naglaa M. , Saadah Omar I. , Alheraiti Shahad S. , Attar Ruwayd , Alsufyani Asmaa D. , El-Shabrawi Moratda H.F. , Sherief Laila M.
Published: March 2022

Introduction:

Congenital pancreatic lipase deficiency (MIM 614338) is a rare genetic disorder caused by homozygous mutation in the PNLIP gene. Few cases have been reported worldwide and among them, few cases were genetically confirmed.

Patients and methods:

A 3-year-old girl presented with abundant greasy diarrhea started at the age of 2 years. Work up of steatorrhea including molecular testing of PNLIP gene in the patient and her family was done.

Results:

A novel homozygous variant c.1257G > A (p. Trp419Ter) of the PNLIP gene was detected in the patient. Her parents and two siblings were carriers for the same mutation. Pancreatic enzyme therapy was introduced, and a multidisciplinary team was involved with the education for the need for the lifelong use of pancreatic enzymes, and genetic counseling was carried out. There was a great improvement of steatorrhea with pancreatic enzymes treatment.

Conclusions:

PNLIP deficiency should be suspected in patients with steatorrhea who have low pancreatic lipase and an otherwise normal health and appropriate growth.
Virtual reality as a tool to promote wellbeing in the workplace
Authors: Adhyaru Jai Shree , Kemp Charlotte
Published: March 2022

Background

NHS staff are disproportionately impacted by workplace stress, threatening not only quality of service delivery, but the sustainability, of this vital healthcare system. There is an urgent need for accessible and cost-effective interventions that promote the wellbeing of this integral workforce.

Aim

The aim of this study was to explore the potential propensity of a short virtual reality (VR) nature experience, delivered during the workday, to induce positive mood states NHS clinicians.

Method

NHS clinicians working in a fast-paced trauma service were offered the opportunity to take part in a short virtual reality (VR) relaxation session, during their working day, in which they were able to explore the “Green Meadows” experience available within the Nature Treks application. An indication of physiological arousal (heart rate) was obtained, and subjective measures of emotional state were employed to assess the effect of the intervention on participants’ mood. Further, feedback was gathered to provide an initial indication of the acceptability of the experience.

Results

Analysis of data from 39 clinicians revealed that, following the VR experience, participants reported significantly increased feelings of happiness ( p < 0.001) and relaxation ( p < 0.001), and significantly decreased feelings of sadness ( p = 0.003), anger ( p < 0.001) and anxiety ( p < 0.001). No significant differences in reported levels of surprise ( p = 0.603) or vigour ( p = 0.566) were found. Further, the experience was associated with a significant reduction in heart-rate ( p = 0.025), and had high acceptability ratings, despite participants’ varied experience with computers and VR technology.

Conclusions

The findings of this study indicate that the administration of VR for the promotion of NHS staff wellbeing in the workplace is a potentially fruitful avenue of exploration that warrants further investigation.
Genetic variants related to systemic lupus erythematosus revealed using bioinformatics
Authors: Shuoshan Xie , Changjuan Xiao , Honglin Zhu , Qinghua Zeng , Shaxi Ouyang , Qi Wang , Lihua Zhang
Published: March 2022

Objectives

Systemic lupus erythematosus (SLE) is an autoimmune disease involving multiple organs and is characterized by immune inflammation. The pathogenesis of SLE is complex and involves genetic and environmental components.

Methods

In this study, single nucleotide polymorphisms (SNPs) closely related to SLE were searched through integration analysis of public gene expression profiles from Gene Expression Omnibus and European Bioinformatics Institute data, and immunochip data in a genome-wide association study.

Results

SLE-associated SNPs were identified in 17 genes common among datasets. The mRNA expression levels of three genes among them were verified to differ between SLE patients and healthy controls subjects based on real-time polymerase chain reaction and sequencing of peripheral blood mononuclear cells (PBMCs). The GG genotype frequency of rs116253043 in LY6G6D was significantly lower in SLE patients and the GC genotype frequency of rs328 on LPL was significantly higher in SLE patients than in controls. VARS2 levels were significantly higher in SLE PBMCs than controls, but there was no significant difference in allele or genotype frequencies of the two SNPs (rs115470445 [C/T] and rs114394807 [A/G]) between groups.

Conclusion

Our results suggest that the GG genotype of rs116253043 plays a protective role against SLE, whereas the C allele of rs328 is a risk factor for SLE and rs116253043 with the GC genotype is an SLE-susceptibility SNP.
Extreme Thrombocytosis in Refractory ITP Post-Splenectomy With Associated Fatal Thromboembolism
Authors: Nedumannil Rithin , Leitinger Emma , Juneja Surender
Published: March 2022

Thrombopoietin (TPO)-receptor agonists have heralded a paradigm shift in the treatment of refractory immune thrombocytopenia (ITP). Reactive thrombocytosis has been described as a secondary effect of such therapies. However, the phenomenon of extreme thrombocytosis with morphology mimicking a myeloproliferative neoplasm (MPN) followed by fatal thromboembolism is unusual in this setting. Caution is required in the diagnosis of refractory ITP as well as TPO-receptor agonist dosing in such cases.
Relationship between brain iron deposition and mitochondrial dysfunction in idiopathic Parkinson’s disease
Authors: Prasuhn Jannik , Göttlich Martin , Gerkan Friederike , Kourou Sofia , Ebeling Britt , Kasten Meike , Hanssen Henrike , Klein Christine , Brüggemann Norbert
Published: March 2022

Background

The underlying pathophysiology of Parkinson's disease is complex, involving different molecular pathways, including brain iron deposition and mitochondrial dysfunction. At a molecular level, these disease mechanisms are likely interconnected. Therefore, they offer potential strategies for disease-modifying treatments. We aimed to investigate subcortical brain iron deposition as a potential predictor of the bioenergetic status in patients with idiopathic Parkinson’s disease.

Methods

Thirty patients with idiopathic Parkinson's disease underwent multimodal MR imaging (T1, susceptibility-weighted imaging, SWI) and31phosphorus magnetic resonance spectroscopy imaging. SWI contrast-to-noise ratios served as a measure for brain iron deposition in the putamen, caudate, globus pallidus, and thalamus and were used in a multiple linear regression model to predict in-vivo energy metabolite ratios.

Results

Subcortical brain iron deposition, particularly in the putamen and globus pallidus, was highly predictive of the region-specific amount of high-energy-containing phosphorus metabolites in our subjects.

Conclusions

Our study suggests that brain iron deposition but not the variability of individual volumetric measurements are highly predictive of mitochondrial impairment in vivo. These findings offer the opportunity, e.g., by using chelating therapies, to improve mitochondrial bioenergetics in patients with idiopathic Parkinson's disease.
Transcriptome analyses shed light on floral organ morphogenesis and bract color formation in Bougainvillea
Authors: Zhang Wenping , Zhou Qun , Lin Jishan , Ma Xinyi , Dong Fei , Yan Hansong , Zhong Weimin , Lu Yijing , Yao Yuan , Shen Xueting , Huang Lixian , Zhang Wanqi , Ming Ray
Published: March 2022

Background

Bougainvillea is a popular ornamental plant with brilliant color and long flowering periods. It is widely distributed in the tropics and subtropics. The primary ornamental part of the plant is its colorful and unusual bracts, rich in the stable pigment betalain. The developmental mechanism of the bracts is not clear, and the pathway of betalain biosynthesis is well characterized in Bougainvillea.

Results

At the whole-genome level, we found 23,469 protein-coding genes by assembling the RNA-Seq and Iso-Seq data of floral and leaf tissues. Genome evolution analysis revealed that Bougainvillea is related to spinach; the two diverged approximately 52.7 million years ago (MYA). Transcriptome analysis of floral organs revealed that flower development of Bougainvillea was regulated by the ABCE flower development genes; A-class, B-class, and E-class genes exhibited high expression levels in bracts. Eight key genes of the betalain biosynthetic pathway were identified by homologous alignment, all of which were upregulated concurrently with bract development and betalain accumulation during the bract initiation stage of development. We found 47 genes specifically expressed in stamens, including seven highly expressed genes belonging to the pentose and glucuronate interconversion pathways. BgSEP2b, BgSWEET11, and BgRD22 are hub genes and interacted with many transcription factors and genes in the carpel co-expression network.

Conclusions

We assembled protein-coding genes of Bougainvilea, identified the floral development genes, and constructed the gene co-expression network of petal, stamens, and carpel. Our results provide fundamental information about the mechanism of flower development and pigment accumulation in Bougainvillea, and will facilitate breeding of cultivars with high ornamental value.
Potential for the lung recruitment and the risk of lung overdistension during 21 days of mechanical ventilation in patients with COVID-19 after noninvasive ventilation failure: the COVID-VENT observational trial
Authors: Yaroshetskiy Andrey I. , Avdeev Sergey N. , Politov Mikhail E. , Nogtev Pavel V. , Beresneva Victoria G. , Sorokin Yury D. , Konanykhin Vasily D. , Krasnoshchekova Anna P. , Merzhoeva Zamira M. , Tsareva Natalia A. , Trushenko Natalia V. , Mandel Irina A. , Yavorovskiy Andrey G.
Published: March 2022

Background

Data on the lung respiratory mechanics and gas exchange in the time course of COVID-19-associated respiratory failure is limited. This study aimed to explore respiratory mechanics and gas exchange, the lung recruitability and risk of overdistension during the time course of mechanical ventilation.

Methods

This was a prospective observational study in critically ill mechanically ventilated patients (n = 116) with COVID-19 admitted into Intensive Care Units of Sechenov University. The primary endpoints were: «optimum» positive end-expiratory pressure (PEEP) level balanced between the lowest driving pressure and the highest SpO2 and number of patients with recruitable lung on Days 1 and 7 of mechanical ventilation. We measured driving pressure at different levels of PEEP (14, 12, 10 and 8 cmH2O) with preset tidal volume, and with the increase of tidal volume by 100 ml and 200 ml at preset PEEP level, and calculated static respiratory system compliance (CRS), PaO2/FiO2, alveolar dead space and ventilatory ratio on Days 1, 3, 5, 7, 10, 14 and 21.

Results

The «optimum» PEEP levels on Day 1 were 11.0 (10.0–12.8) cmH2O and 10.0 (9.0–12.0) cmH2O on Day 7. Positive response to recruitment was observed on Day 1 in 27.6% and on Day 7 in 9.2% of patients. PEEP increase from 10 to 14 cmH2O and VT increase by 100 and 200 ml led to a significant decrease in CRS from Day 1 to Day 14 (p < 0.05). Ventilatory ratio was 2.2 (1.7–2,7) in non-survivors and in 1.9 (1.6–2.6) survivors on Day 1 and decreased on Day 7 in survivors only (p < 0.01). PaO2/FiO2 was 105.5 (76.2–141.7) mmHg in non-survivors on Day 1 and 136.6 (106.7–160.8) in survivors (p = 0.002). In survivors, PaO2/FiO2 rose on Day 3 (p = 0.008) and then between Days 7 and 10 (p = 0.046).

Conclusion

Lung recruitability was low in COVID-19 and decreased during the course of the disease, but lung overdistension occurred at «intermediate» PEEP and VT levels. In survivors gas exchange improvements after Day 7 mismatched CRS.

Trial registration

ClinicalTrials.gov, NCT04445961. Registered 24 June 2020—Retrospectively registered.
The abnormal distribution of peripheral B1 cells and transition B cells in patients with idiopathic dilated cardiomyopathy: a pilot study
Authors: Tang Quan , Cen Zhihong , Lu Jing , Dong Jingwei , Qin Lin , Lu Feiyu , Wu Weifeng
Published: March 2022

Background

The aberrant distribution of peripheral B cell subsets is associated with the pathogenesis of a variety of inflammatory and autoimmune diseases. However, the distribution of peripheral B cell subsets in patients with idiopathic dilated cardiomyopathy (DCM) remains to be elucidated.

Methods

Twenty-seven patients with idiopathic DCM (DCM group), 18 control patients with heart failure (HF group) and 21 healthy individuals (HC group) were included in this study. Peripheral B cell subsets were analysed using multicolour flow cytometry. The plasma β1 adrenergic receptor (β1-AR) autoantibody titre was determined using ELISA. Additionally, clinical features were also collected.

Results

Compared with the HF and HC groups, the percentage of B1 cells was significantly decreased, whereas the percentage of transitional B cells (Tr) was significantly increased in the DCM group. Notably, the percentage of B1 cells was significantly lower in patients with β1-AR autoantibody-positive DCM than in β1-AR autoantibody-negative patients. The correlation analysis showed that the percentage of B1 cells was negatively correlated with N-terminal pro-brain natriuretic peptide (NT-proBNP) levels and positively correlated with the left ventricular ejection fraction in patients with DCM.

Conclusion

As shown in the present study, the percentage of B1 cells in the peripheral blood of patients with idiopathic DCM is abnormally decreased, especially in β1-AR autoantibody-positive patients, while the percentage of Tr cells is significantly increased, indicating that B1 cells and Tr cells may be implicated in the pathogenesis of idiopathic DCM. The decrease in the percentage of B1 cells is directly related to the severity of DCM.
Difficulty and help with activities of daily living among older adults living alone during the COVID-19 pandemic: a multi-country population-based study
Authors: Chen Shanquan , Jones Linda A. , Jiang Shan , Jin Huajie , Dong Dong , Chen Xi , Wang Dan , Zhang Yun , Xiang Li , Zhu Anna , Cardinal Rudolf N.
Published: March 2022

Background

Older adults who live alone and have difficulties in activities of daily living (ADLs) may have been more vulnerable during the COVID-19 pandemic. However, little is known about pandemic-related changes in ADL assistance (such as home care, domiciliary care) and its international variation. We examined international patterns and changes in provision of ADL assistance, and related these to country-level measures including national income and health service expenditure.

Methods

We analysed data covering 29 countries from three longitudinal cohort studies (Health and Retirement Study, English Longitudinal Study of Aging, and Survey of Health, Ageing and Retirement in Europe). Eligible people were aged ≥50 years and living alone. Outcomes included ADL difficulty status (assessed via six basic ADLs and five instrumental ADLs) and receipt of ADL assistance. Wealth-related inequality and need-related inequity in ADL assistance were measured using Erreygers’ corrected concentration index (ECI). Correlations were estimated between prevalence/inequality/inequity in ADL assistance and national health-related indicators. We hypothesized these measures would be associated with health system factors such as affordability and availability of ADL assistance, as well as active ageing awareness.

Results

During COVID-19, 18.4% of older adults living alone reported ADL difficulties (ranging from 8.8% in Switzerland to 29.2% in the USA) and 56.8% of those reporting difficulties received ADL assistance (ranging from 38.7% in the UK to 79.8% in Lithuania). Females were more likely to receive ADL assistance than males in 16/29 countries; the sex gap increased further during the pandemic. Wealth-related ECIs indicated socioeconomic equality in ADL assistance within 24/39 countries before the pandemic, and significant favouring of the less wealthy in 18/29 countries during the pandemic. Needs-related ECIs indicated less equity in assistance with ADLs during the pandemic than before. Our hypotheses on the association between ADL provision measures and health system factors were confirmed before COVID-19, but unexpectedly disconfirmed during COVID-19.

Conclusion

This study revealed an unequal (and in some countries, partly needs-mismatched) response from countries to older adults living alone during the COVID-19 pandemic. The findings might inform future research about, and policies for, older adults living alone, particularly regarding social protection responses during crises.
A case report of serpentine-like syndrome and review of literature
Authors: Song Shijing , Wang Jingjing , Han Jijing , Xuan Yinghua , Zhi Wenxue , Wu Qingqing
Published: March 2022

Background

Serpentine-like syndrome (SLS) is a rare foetal abnormality, characterized by brachioesophagus, secondary intrathoracic stomach and vertebral deformity. Herein, we report a case of SLS diagnosed based on imaging, genetic examination and autopsy findings.

Case presentation

From the 19th to 23rd weeks of gestation, the foetus presented with brachioesophagus, secondary intrathoracic stomach, intrathoracic spleen with poly-spleen malformation, spinal deformity and diaphragm dysplasia, and some abdominal organs were partly located in the thoracic cavity. After extensive counselling, the couple opted to terminate the pregnancy. Whole genome sequencing and autopsy were performed. Then, the foetus was diagnosed with SLS.

Discussion and conclusions

SLS is characterized by multiorgan deformities and is associated with poor prognosis. Multiorgan deformities can be detected on prenatal sonography using three-dimensional ultrasound technology.
A compound heterozygous mutation in the S-Antigen Visual Arrestin SAG gene in a Chinese patient with Oguchi type one: a case report
Authors: Deng Zhen , Fan Fangli , Tang Danyan , Wu Yifeng , Shu Yujie , Wu Kunlin
Published: March 2022

Background

Oguchi disease is a rare autosomal recessive form of congenital quiescent night blindness. Oguchi disease has been found to be associated with gene mutations in SAG and GRK1, which are vital factors in the recovery phase of phototransduction after light stimuli. We report a case of Oguchi disease with novel heterozygous mutations in SAG.

Case presentation

A 7-year-old girl with a history of night blindness since childhood, was referred to our hospital. Ophthalmologic examinations included visual acuity, fundus examinations, fundus photography, spectral-domain optical coherence tomography, electroretinographic (ERG). Mutation screening of the SAG and GRK1 genes was performed. This patient exhibited typical clinical characteristics of Oguchi disease, including night blindness, golden fundus with the Mizuo–Nakamura phenomenon, packed structure of the parafovea in optical coherence tomography and reduced a-waves and b-waves in scotopic 3.0 ERG. Genetic testing revealed a heterozygous change in nucleotide c.72_75+15delATCGGTGAGTGGTGCACAA in exon 2 of the SAG gene in this patient, her unaffected mother and younger brother. A splicing alteration of nucleotide c.376-2A>C was identified in exon 6 of the SAG gene with heterozygous status in this patient and her unaffected father.

Conclusions

Compound heterozygosity of a nonsense p.S25X mutation in exon 2 and a splicing alteration in exon 6 of the SAG gene is the cause of this patient with Oguchi type 1 disease in China.
Correlates of suicide risk among Black and White adults with behavioral health disorders in criminal-legal systems
Authors: Lawson Spencer G. , Lowder Evan M. , Ray Bradley
Published: March 2022

Background

Adults with behavioral health disorders in criminal-legal systems are at heightened risk of suicide relative to the general population. Despite documented racial disparities in criminal processing and behavioral health treatment, few studies have examined racial differences in suicide risk in this already high-risk population. This study examined 1) the correlates of suicide risk in this population overall and by race and 2) the moderating role of race in these associations.

Methods

We investigated correlates of clinician-rated suicide risk at baseline in a statewide sample of 2,827 Black and 14,022 White adults with criminal-legal involvement who engaged in community-based behavioral health treatment. Regression-based approaches were used to model suicide risk and test for evidence of interaction effects.

Results

Findings showed the strongest correlates of suicide risk were greater behavioral health needs, evidence of self-harm, and a primary mental health diagnosis or co-occurring diagnosis. In race-specific analyses, correlates of suicide risk were mostly similar for both Black and White clients, with a couple exceptions. Interaction terms testing between-group effects on correlates of suicide risk were non-significant.

Conclusions

Adults with behavioral health disorders in criminal-legal systems experience similar risk factors for suicide as the general population. Similar to prior research, we found that Black adults, in particular, are at lower risk for suicide overall. Contrary to expectations, we found similarities in correlates of suicide risk across race in our sample of felony-level adults with behavioral health disorders in the criminal-legal system. Prior research shows that behavioral health professionals should be cognizant of cultural factors when developing a comprehensive approach to suicide care and treatment. Our findings show correlates of suicide risk are largely stable in Black and White adults involved in criminal-legal systems, suggesting culturally responsive treatment for suicide risk should target shared risk factors.
The new useful high-resolution computed tomography finding for diagnosing fibrotic hypersensitivity pneumonitis: “hexagonal pattern”: a single-center retrospective study
Authors: Okabayashi Hiroko , Fukuda Taiki , Iwasawa Tae , Oda Tsuneyuki , Kitamura Hideya , Baba Tomohisa , Takemura Tamiko , Sakagami Takuro , Ogura Takashi
Published: March 2022

Background

Centrilobular nodules, ground-glass opacity (GGO), mosaic attenuation, air trapping, and three-density pattern were reported as high-resolution computed tomography (HRCT) findings characteristic of fibrotic hypersensitivity pneumonitis (HP). However, it is often difficult to differentiate fibrotic HP from idiopathic pulmonary fibrosis (IPF). In fibrotic HP, the HRCT sometimes shows tortoiseshell-like interlobular septal thickening that extends from the subpleural lesion to the inner layers. This finding is called “hexagonal pattern,” and this study is focused on the possibility that such finding is useful for differentiating fibrotic HP from IPF.

Methods

This study included patients with multidisciplinary discussion (MDD) diagnosis of fibrotic HP or IPF undergoing surgical lung biopsy between January 2015 and December 2017 in Kanagawa Cardiovascular and Respiratory Center. Two radiologists have evaluated the HRCT findings without clinical and pathological information.

Results

A total of 23 patients were diagnosed with fibrotic HP by MDD and 48 with IPF. Extensive GGO, centrilobular nodules, and hexagonal pattern were more frequent findings in fibrotic HP than in IPF. No significant difference was observed between the two groups in the presence or absence of mosaic attenuation, air trapping, or three-density pattern. In the multivariate logistic regression, the presence of extensive GGO and hexagonal pattern was associated with increased odds ratio of fibrotic HP. The sensitivity and specificity of the diagnosis of fibrotic HP in the presence of the hexagonal pattern were 69.6% and 87.5%, respectively.

Conclusion

Hexagonal pattern is a useful finding for differentiating fibrotic HP from IPF.
Association between socioeconomic status and severity of oral epithelial dysplasia using a Taiwanese Nationwide Oral Mucosal Screening Program: a retrospective analysis
Authors: Chiang Tien-En , Lin Yu-Chun , Wu Chi-Tsung , Wu Sheng-Tang , Chen Yuan-Wu
Published: March 2022

Background

The study aimed to investigate the association between socioeconomic status and severity of oral epithelial dysplasia (OED) using current data from the Taiwanese Nationwide Oral Mucosal Screening Program (TNOMSP).

Methods

This retrospective analysis was conducted in the Department of Oral and Maxillofacial Surgery at a general hospital in Taipei, Taiwan. A total of 134 participants were analysed from a previous study database of 150 patients. The inclusion criteria included age > 20 years and a history of either tobacco or betel nut use. Background information, including para-habits such as betel and tobacco use, was analysed using the Pearson chi-square (χ2) test; furthermore, the correlation of background information with OED severity was investigated using logistic regression (mild or moderate/severe).

Results

High school education level (P < 0.001), poor self-awareness (P = 0.002), current betel use (P < 0.001), and tobacco use (P = 0.003) were highly correlated with moderate- and severe OED (P < 0.05). The odds ratio (OR) of education status above senior high school was 0.03 (95% confidence interval [CI] 0.01–0.15, P < 0.001), while that of junior high school was 1. Current betel chewing (OR 6.57 [95% CI 1.17–37.0], P = 0.033) was significantly associated with OED severity compared with never or ex-use of betel.

Conclusions

We found a strong correlation between the severity of OED and current betel use and low education status. The current study revealed that the socioeconomic status, poor self-awareness, and para-habit history of the patients with OED should be evaluated to identify high-risk individuals using TNOMSP.
Evaluation of the initial 12 months of a routine cryptococcal antigen screening program in reduction of HIV-associated cryptococcal meningitis in Uganda
Authors: Enock Kagimu , Julius Kiwanuka , Griffith Bridget C. , Abila Derrick Bary , Rutakingirwa Morris K. , Kasibante John , Kandole Kiiza Tadeo , Kwizera Richard , Semeere Aggrey , Meya David B.
Published: March 2022

Background

Asymptomatic Cryptococcal Antigenemia (CrAg) patients develop meningitis within a month of testing positive. Pre-emptive antifungal therapy can prevent progression to Cryptococcal meningitis (CM). In April 2016, a national CrAg screening program was initiated in 206 high-volume health facilities that provide antiretroviral therapy in Uganda. We report the evaluation of the CrAg screening cascade focusing on linkage to care, fluconazole therapy for 10 weeks and 6 months follow up, and ART initiation in a subset of facilities.

Methods

We conducted a retrospective, cross-sectional survey of patients with CD4 < 100 at seven urban and seven rural facilities after 1 year of program implementation. We quantified the number of patients who transitioned through the steps of the CrAg screening cascade over six-months follow-up. We defined cascade completion as a pre-emptive fluconazole prescription for the first 10 weeks. We conducted semi-structured interviews with lab personnel and clinic staff to assess functionality of the CrAg screening program. Data was collected using REDCap.

Results

We evaluated 359 patient records between April 2016 to March 2017; the majority (358/359, 99.7%) were from government owned health facilities and just over half (193/359, 53.8%) had a median baseline CD4 cell count of < 50 cell/μL. Overall, CrAg screening had been performed in 255/359 (71.0, 95% CI, 66.0–75.7) of patients’ records reviewed, with a higher proportion among urban facilities (170/209 (81.3, 95% CI, 75.4–86.4)) than rural facilities (85/150 (56.7, 95% CI, 48.3–64.7)). Among those who were CrAg screened, 56/255 (22.0, 95% CI, 17.0–27.5%) had cryptococcal antigenemia, of whom 47/56 (83.9, 95% CI, 71.7–92.4%) were initiated on pre-emptive therapy with fluconazole and 8/47 (17.0, 95% CI, 7.6–30.8%) of these were still receiving antifungal therapy at 6 months follow up. At least one CNS symptom was present in 70% (39/56) of those with antigenemia. In patients who had started ART, almost 40% initiated ART prior to CrAg screening. Inadequacy of equipment/supplies was reported by 15/26 (58%) of personnel as a program barrier, while 13/26 (50%) reported a need for training about CM and CrAg screening.

Conclusion

There was a critical gap in the follow-up of patients after initiation on fluconazole therapy. ART had been initiated in almost 40% of patients prior to CrAg screening.. Higher antigenemia patients presenting with CNS symptoms could be related to late presentation. There is need to address these gaps after a more thorough evaluation.
ECNano: A cost-effective workflow for target enrichment sequencing and accurate variant calling on 4800 clinically significant genes using a single MinION flowcell
Authors: Leung Amy Wing-Sze , Leung Henry Chi-Ming , Wong Chak-Lim , Zheng Zhen-Xian , Lui Wui-Wang , Luk Ho-Ming , Lo Ivan Fai-Man , Luo Ruibang , Lam Tak-Wah
Published: March 2022

Background

The application of long-read sequencing using the Oxford Nanopore Technologies (ONT) MinION sequencer is getting more diverse in the medical field. Having a high sequencing error of ONT and limited throughput from a single MinION flowcell, however, limits its applicability for accurate variant detection. Medical exome sequencing (MES) targets clinically significant exon regions, allowing rapid and comprehensive screening of pathogenic variants. By applying MES with MinION sequencing, the technology can achieve a more uniform capture of the target regions, shorter turnaround time, and lower sequencing cost per sample.

Method

We introduced a cost-effective optimized workflow, ECNano, comprising a wet-lab protocol and bioinformatics analysis, for accurate variant detection at 4800 clinically important genes and regions using a single MinION flowcell. The ECNano wet-lab protocol was optimized to perform long-read target enrichment and ONT library preparation to stably generate high-quality MES data with adequate coverage. The subsequent variant-calling workflow, Clair-ensemble, adopted a fast RNN-based variant caller, Clair, and was optimized for target enrichment data. To evaluate its performance and practicality, ECNano was tested on both reference DNA samples and patient samples.

Results

ECNano achieved deep on-target depth of coverage (DoC) at average > 100× and > 98% uniformity using one MinION flowcell. For accurate ONT variant calling, the generated reads sufficiently covered 98.9% of pathogenic positions listed in ClinVar, with 98.96% having at least 30× DoC. ECNano obtained an average read length of 1000 bp. The long reads of ECNano also covered the adjacent splice sites well, with 98.5% of positions having ≥ 30× DoC. Clair-ensemble achieved > 99% recall and accuracy for SNV calling. The whole workflow from wet-lab protocol to variant detection was completed within three days.

Conclusion

We presented ECNano, an out-of-the-box workflow comprising (1) a wet-lab protocol for ONT target enrichment sequencing and (2) a downstream variant detection workflow, Clair-ensemble. The workflow is cost-effective, with a short turnaround time for high accuracy variant calling in 4800 clinically significant genes and regions using a single MinION flowcell. The long-read exon captured data has potential for further development, promoting the application of long-read sequencing in personalized disease treatment and risk prediction.
Oral susceptibility to ivermectin is over fifty times greater in a wild population of Anopheles albimanus mosquitoes from Belize than the STECLA laboratory reference strain of this mosquito
Authors: Dreyer Staci M. , Morin Kelsey J. , Magaña Marla , Pott Marie , Leiva Donovan , Achee Nicole L. , Grieco John P. , Vaughan Jefferson A.
Published: March 2022

Background

The STECLA strain of Anopheles albimanus has been in continuous colony for many years and is the reference strain on which genomic studies for the species are based. Recently, the STECLA strain was demonstrated to be much less susceptible to ivermectin ingested in a blood meal (4-day LC50 of 1468 ng/ml) than all other Anopheles species tested to-date (LC50 values range from 7 to 56 ng/ml). The ability of An. albimanus to survive ingestion of ivermectin at concentrations far beyond that typically found in the blood of ivermectin-treated people or livestock (i.e., 30–70 ng/ml) could invalidate the use of ivermectin as a malaria vector control strategy in areas where An. albimanus is a primary vector.

Methods

To investigate this, host-seeking An. albimanus were captured in northern Belize and used in membrane feeding bioassays of ivermectin, employing the same methods as described earlier with the STECLA strain.

Results

Field-collected An. albimanus in Belize were 55 times more susceptible to ingested ivermectin than were the STECLA reference strain. Oral susceptibility to ivermectin in wild An. albimanus from Belize (4-day LC50 of 26 ng/ml) was equivalent to that of other Anopheles species tested.

Conclusions

Contrary to initial assessments using a highly inbred strain of mosquito, laboratory studies using a field population indicate that ivermectin treatment of livestock could reduce An. albimanus populations in areas of Central America and the Caribbean where malaria transmission may occur. Toxicity screening of ivermectin and other systemic parasiticides for malaria control should examine wild populations of the vector species being targeted.
Therapeutic nucleus-access BNCT drug combined CD47-targeting gene editing in glioblastoma
Authors: Chen Jiejian , Dai Qi , Yang QiYao , Bao Xiaoyan , Zhou Yi , Zhong Haiqing , Wu Linjie , Wang Tiantian , Zhang Zhicheng , Lu Yiying , Zhang Zhentao , Lin Mengting , Han Min , Wei Qichun
Published: March 2022

Glioblastoma is the most common brain primary malignant tumor with the highest mortality. Boron neutron capture therapy (BNCT) can efficiently kill cancer cells on the cellular scale, with high accuracy, short course and low side-effects, which is regarded as the most promising therapy for malignant brain tumors like glioma. As the keypoint of BNCT, all boron delivery agents currently in clinical use are beset by insufficient tumor uptake, especially in the tumor nucleus, which limits the clinical application of BNCT. In this study, nuclear targeting of boron is achieved by DOX-CB, consisting of doxorubicin (DOX) and carborane (CB) utilizing the nuclear translocation property of DOX. The nucleus of GL261 cells takes up almost three times the concentration of boron required for BNCT. To further kill glioma and inhibit recurrence, a new multifunctional nanoliposome delivery system DOX-CB@lipo-pDNA-iRGD is constructed. It combines DOX-CB with immunotherapy strategy of blocking macrophage immune checkpoint pathway CD47-SIRPα by CRISPR-Cas9 system, coupling BNCT with immunotherapy simultaneously. Compared with clinical drug Borocaptate Sodium (BSH), DOX-CB@lipo-pDNA-iRGD significantly enhances the survival rate of tumor-bearing mice, reduces tumor stemness, and improves the prognosis. The excellent curative effect of this nanoliposome delivery system provides an insight into the combined treatment of BNCT.

Graphical Abstract