bluuebunny/crossref_metadata_2025 huggingface dataset:
Virus inactivation on common indoor contract fabrics
Authors: Tracy Sharon , Derby Carol , Virjee Natasha , Hardwick Matthew
Published: April 2022

Background: During the COVID-19 pandemic, office workers were displaced from their places of employment. This situation caused a heightened interest in understanding viral disease transmission in indoor spaces including offices. Although data has been published on the survival of various coronaviruses including SARS-CoV-2 on a variety of surfaces, most related to impermeable materials common to healthcare environments. Methods: We studied two typical contract fabrics (polyester and wool) and cotton for HCoV-OC43 (ATCC #VR-1558) persistence up to 24 h using a modified ISO 18184 test protocol. Results: We found that HCoV-OC43 was undetectable after 12 h on cotton fabric, 24 h on polyester fabric, and was reduced by 93 +/− 6% within 24 h on wool fabric compared to an inoculum-only control. Differences in droplet-fabric contact angles were observed for the three fabrics, and absorption correlated with virus inactivation. Conclusions: Polyester and wool exhibit virus-inactivating properties similar to cotton, although the degree of inactivation is different between the three materials. Liquid absorption is likely a key factor involved in the inactivation process. When the results are extrapolated to real-world environmental temperature and relative humidity conditions, commonly used fabrics in interior offices spaces are determined as unlikely sources of human coronavirus transmission.
Public justification, gender, and the family
Authors: Kugelberg Elsa , Kugelberg Henrik D.
Published: April 2022

Social norms regulating carework and social reproduction tend to be inegalitarian. At the same time, such norms often play a crucial role when we plan our lives. How can we criticise objectionable practices while ensuring that people can organise their lives around meaningful and predictable rules? Gerald Gaus argues that only ‘publicly justified’ rules, rules that everyone would prefer over ‘blameless liberty,’ should be followed. In this paper, we uncover the inegalitarian implications of this feature of Gaus's framework. We show that because a society without clear social norms for how social reproduction and care work ought to be organised would be so unattractive, inegalitarian rules would pass Gaus's test. They would pass this test since they would nevertheless be better than ‘blameless liberty.’ Those who are disproportionately burdened by a rule are faced with the daunting task of showing that they would be better off under no rule, instead of merely having to show that they would be better off with a different rule.
EEG Spectral Power Analysis: A Comparison Between Heroin Dependent and Control Groups
Authors: Seif Maryam , Yousefi Mohammad Reza , Behzadfar Neda
Published: April 2022

Previous studies indicated that heroin abuse would result in abnormal functional organization of the brain. However, studies of heroin abuse- related brain dysfunction are scarce. The purpose of the present study was to investigate heroin effects on brain function by studying relationships between Electroencephalograph (EEG) spectral power and heroin abuse. The resting EEG signals were acquired from 15 male heroin dependent group and 15 male control group. The differences in the EEG components of each group were evaluated using the statistical Mann-Whitney examination and Davis Bouldin Index. The results show that heroin dependent group has an attenuated relative beta-2 power compared with other EEG frequency sub bands. Nevertheless, the results indicate heroin dependent group have an increase of power spectrum density for theta at all locations, as well as delta in the temporal, frontal and central areas compared with control group. Compared to control group, the heroin dependent group decreased its spectral power more than the control group in all three alpha bands. The present findings using the Davis Bouldin Index provide evidence that alpha-3 band in the FZ channel is more affected by heroin abuse than other frequency sub bands.
Telehealth adoption during the COVID-19 pandemic: A social media textual and network analysis
Authors: Anderson Joshua TL , Bouchacourt Lindsay M , Sussman Kristen L , Bright Laura F , Wilcox Gary B
Published: April 2022

Objective

The telemedicine industry has rapidly grown during the COVID-19 pandemic, and telemedicine has become a common form of care. The present study looks at the online conversation regarding telemedicine at the beginning of the pandemic and one year later. The Technology Acceptance Model is utilized to explain the findings.

Methods

Brandwatch and NUVI software captured social mentions on Twitter regarding telemedicine during the beginning of the pandemic (March 15, 2020–April 20, 2020) and one year later (March 12, 2021–April 19, 2021). SAS text-mining software analyzed the social mentions and organized them into ten unique topics for each time period. The research team analyzed the topics and organized them into themes. A network analysis was also performed to examine structure and influence within the network.

Results

In March–April 2020, the themes focused on the use of telehealth in general, telehealth for mental health applications, and Medicare covering telehealth services. In March–April 2021, the themes focused on news events regarding telehealth and the rise in prominence of telehealth services. The network analysis shows a shift in the distribution of telehealth information among influential accounts and reveals that the network became more connected, with a change in the control of information spread.

Conclusions

Technology Acceptance Model explains the social acceptance and spread of telemedicine. The transition in the conversation about telemedicine suggests a pattern of greater system use consistent with the Technology Acceptance Model. Telemedicine may have greatly increased in use because of the pandemic, but data suggests that its use may persist after the pandemic subsides.
Refining electronic medical records representation in manifold subspace
Authors: Wang Bolin , Sun Yuanyuan , Chu Yonghe , Zhao Di , Yang Zhihao , Wang Jian
Published: April 2022

Background

Electronic medical records (EMR) contain detailed information about patient health. Developing an effective representation model is of great significance for the downstream applications of EMR. However, processing data directly is difficult because EMR data has such characteristics as incompleteness, unstructure and redundancy. Therefore, preprocess of the original data is the key step of EMR data mining. The classic distributed word representations ignore the geometric feature of the word vectors for the representation of EMR data, which often underestimate the similarities between similar words and overestimate the similarities between distant words. This results in word similarity obtained from embedding models being inconsistent with human judgment and much valuable medical information being lost.

Results

In this study, we propose a biomedical word embedding framework based on manifold subspace. Our proposed model first obtains the word vector representations of the EMR data, and then re-embeds the word vector in the manifold subspace. We develop an efficient optimization algorithm with neighborhood preserving embedding based on manifold optimization. To verify the algorithm presented in this study, we perform experiments on intrinsic evaluation and external classification tasks, and the experimental results demonstrate its advantages over other baseline methods.

Conclusions

Manifold learning subspace embedding can enhance the representation of distributed word representations in electronic medical record texts. Reduce the difficulty for researchers to process unstructured electronic medical record text data, which has certain biomedical research value.
Proteome profiling reveals changes in energy metabolism, transport and antioxidation during drought stress in Nostoc flagelliforme
Authors: Li Xiaoxu , Ding Miaomiao , Wang Meng , Yang Shujuan , Ma Xiaorong , Hu Jinhong , Song Fan , Wang Lingxia , Liang Wenyu
Published: April 2022

Background

Drought is an important abiotic stress that constrains the growth of many species. Despite extensive study in model organisms, the underlying mechanisms of drought tolerance in Nostoc flagelliforme remain elusive.

Results

We characterized the drought adaptation of N. flagelliforme by a combination of proteomics and qRT-PCR. A total of 351 differentially expressed proteins involved in drought stress adaptation were identified. It was found that the expression of several nutrient influx transporters was increased, including molybdate ABC transporter substrate binding protein (modA), sulfate ABC transporter substrate-binding protein (sbp) and nitrate ABC transporter (ntrB), while that of efflux transporters for toxic substances was also increased, including arsenic transporting ATPase (ArsA), potassium transporter (TrkA) and iron ABC transporter substrate-binding protein (VacB). Additionally, photosynthetic components were reduced while sugars built up during drought stress. Non-enzymatic antioxidants, orange carotenoid protein (OCP) homologs, cytochrome P450 (CYP450), proline (Pro) and ascorbic acid (AsA) were all altered during drought stress and may play important roles in scavenging reactive oxygen species (ROS).

Conclusion

In this study, N. flagelliforme may regulates its adaptation to drought stress through the changes of protein expression in photosynthesis, energy metabolism, transport, protein synthesis and degradation and antioxidation.

Highlights

• A total of 351 DEPs involved in adaptation to drought stress were identified.

• Changes in the expression of six OCP homologs were found in response to drought stress.

• Differential expression of transporters played an important role in drought stress adaptation.

• Most PSII proteins were downregulated, while PSI proteins were unchanged in response to drought stress.

• Sugar metabolism was upregulated in response to drought stress.
GmSPX8, a nodule-localized regulator confers nodule development and nitrogen fixation under phosphorus starvation in soybean
Authors: Xing Xinzhu , Du Hui , Yang Zhanwu , Li Xihuan , Kong Youbin , Li Wenlong , Zhang Caiying
Published: April 2022

Background

Biological nitrogen fixation (BNF) is an important nitrogen source for legume plants, and highly efficient nitrogen fixation requires sufficient phosphorus (P). However, the mechanism of maintaining nitrogen fixation of the legume nodules under low P concentration remains largely unknown.

Results

A nodule-localized SPX protein, GmSPX8, was discovered by transcriptome and functional analysis of its role in N2 fixation was characterized in soybean nodules. GmSPX8 was preferentially expressed in nodules and its expression was gradually increased during nodule development. And also the expression pattern was investigated using reporter gene β-glucuronidase (GUS) driven by the promoter of GmSPX8. GmSPX8 was greatly induced and the GUS activity was increased by 12.2% under P deficiency. Overexpression of GmSPX8 in transgenic plants resulted in increased nodule number, nodule fresh weight and nitrogenase activity by 15.0%, 16.0%, 42.5%, subsequently leading to increased N and P content by 17.0% and 19.0%, while suppression of GmSPX8 showed significantly impaired nodule development and nitrogen fixation efficiency under low P stress. These data indicated that GmSPX8 conferred nodule development and nitrogen fixation under low P condition. By yeast two-hybrid screening, GmPTF1 was identified as a potential interacting protein of GmSPX8, which was further confirmed by BiFC, Y2H and pull down assay. Transcript accumulation of GmPTF1 and its downstream genes such as GmEXLB1 and EXPB2 were increased in GmSPX8 overexpressed transgenic nodules, and in the presence of GmSPX8, the transcriptional activity of GmPTF1 in yeast cells and tobacco leaves was greatly enhanced.

Conclusions

In summary, these findings contribute novel insights towards the role of GmSPX8 in nodule development and nitrogen fixation partly through interacting with GmPTF1 in soybean under low P condition.
Acute transverse myelitis in an adult-patient with underlying ulcerative colitis: a case report
Authors: Yang Yi , Zhang Yan
Published: April 2022

Background

Ulcerative colitis (UC) is an idiopathic inflammatory bowel disease that limits to colon mucosa, which characterised by relapsing and remitting abdominal pain and diarrhea. Neurological complications in UC patients are usually underestimated. The most frequently reported neurological disorders associated with UC are peripheral neuropathy, cerebrovascular disease and demyelinating disease. However, acute transverse myelitis (TM) is rarely reported in UC patients.

Case presentation

We report a case of a 39-year-old man presented with fatigue, muscle weakness, numbness in the lower limbs and fingers with underlying UC. Laboratory results revealed elevated neutrophil count, high-sensitivity C-reactive protein and erythrocyte sedimentation rate. Strip-shaped high signal intensity was identified in the cervical and thoracic spinal cord on T2-weighted magnetic resonance imaging. Acute TM was diagnosed. Significant improvements after intravenous high-dose methylprednisolone were observed.

Conclusion

We speculate that acute TM may be the extraintestinal manifestation of UC, which may be related to the abnormalities of cell-mediated and humoral immunity rather than the side effect of mesalazine.
The impact of chemotherapy and survival prediction by machine learning in early Elderly Triple Negative Breast Cancer (eTNBC): a population based study from the SEER database
Authors: Huang Kaiyan , Zhang Jie , Yu Yushuai , Lin Yuxiang , Song Chuangui
Published: April 2022

Purpose

We aimed to analysis the impact of chemotherapy and establish prediction models of prognosis in early elderly triple negative breast cancer (eTNBC) by using machine learning.

Methods

We enrolled 4,696 patients in SEER Database who were 70 years or older, diagnosed with primary early TNBC(larger than 5 mm), from 2010 to 2016. The propensity-score matched method was utilized to reduce covariable imbalance. Univariable and multivariable analyses were used to compare breast cancer-specific survival(BCSS) and overall survival(OS). Nine models were developed by machine learning to predict the 5-year OS and BCSS for patients received chemotherapy.

Results

Compared to matched patients in no-chemotherapy group, multivariate analysis showed a better survival in chemotherapy group. Stratified analyses by stage demonstrated that patients with stage II and stage III other than stage I could benefit from chemotherapy. Further investigation in stage II found that chemotherapy was a better prognostic indicator for patients with T2N0M0 and stage IIb, but not in T1N1M0. Patients with grade III could achieve a better survival by receiving chemotherapy, but those with grade I and II couldn’t. With 0.75 in 5-year BCSS and 0.81 in 5-year OS for AUC, the LightGBM outperformed other algorithms.

Conclusion

For early eTNBC patients with stage I, T1N1M0 and grade I-II, chemotherapy couldn’t improve survival. Therefore, de-escalation therapy might be appropriate for selected patients. The LightGBM is a trustful model to predict the survival and provide precious systemic treatment for patients received chemotherapy.
Magnetic resonance imaging characteristics predict pituitary function in non-functional pituitary macro-adenoma undergoing trans-sphenoidal surgery
Authors: Hassani Behrooz , Hashemi-Madani Nahid , Ataee Kachuee Manizhe , Khamseh Mohammad E.
Published: April 2022

Introduction

Maintaining the pituitary function after surgery is highly important. The aim of this study was to investigate the relationship between preoperative magnetic resonance imaging (MRI) characteristics and pituitary function after surgery of non-functional pituitary macroadenoma.

Methods

This retrospective study was performed between 2016 and 2018. Preoperative and postoperative MRI imaging data were retrieved from electronic registration system. The relationship between preoperative MRI characteristics and postoperative pituitary function as well as reconstruction of pituitary gland was investigated using regression models.

Results

Complete data were available for 44 patients. Before surgery, invisible normal tissue was observed in 23 patients (53.5%). Suprasellar extension and cavernous sinus invasion were seen in 36 patients (each one 49.1%). There was a significant reverse relationship between preoperative tumor size and postoperative thyroid stimulating hormone (TSH) (odds ratio (OR): − 0.99 (− 0.18, − 0.003),p = 0.04). In addition, we found a significant positive correlation between prolactin level after surgery and tumor size before surgery, (OR: 5.29 (1.65, 8.92),p = 0006). Moreover, postoperative panhypopituitarism was observed in 25% of patients with complete morphologic reconstitution of pituitary tissue. While the rate was 50% in patients with no or partial morphologic reconstruction of pituitary tissue.

Conclusion

Preoperative MRI characteristics predict TSH and prolactin level after operation. Furthermore, the adenoma size and volume prior to surgery are the main determinants of normal morphologic reconstruction of pituitary gland.
Clinicopathological and ultrasound features as risk stratification predictors of clinical and pathological nodal status in papillary thyroid carcinoma: a study of 748 patients
Authors: Zhang Cui , Li Baojun , Zhang Lei , Chen Fengjiao , Zhang Yanhua , Cheng Wen
Published: April 2022

Background

Papillary thyroid carcinoma (PTC) is the most common histological type of thyroid malignancy that tends to metastasize to cervical lymph nodes. In the present study, we aimed to investigate which clinicopathologic and ultrasound features of PTC are associated with clinical lymph node metastasis (LNM) and numbers of pathological LNM.

Methods

From January 2016 to December 2018, we identified a cohort of patients with PTC who underwent cervical ultrasonography and were diagnosed through operation and pathology. Clinical N1(cN1) and > 5 pathologic N1(pN1) were considered in the postoperative stratification to have an intermediate risk according to the 2015 ATA guidelines. Clinicopathological and ultrasound features in PTC patients were performed in accordance with the independent risk factors of cN1 and > 5pN1 respectively by using the univariate and multivariate analyses.

Results

We collected 748 PTC patients in the final inclusion criteria. There were 688 cN0 cases and 60 cN1 cases. From the analyses, primary tumor size > 2 cm, capsule contact, extrathyroidal extensions (ETE) and central LNM remained independent risk factors for cN1 in PTC patients. In the 748 PTC patients, 707 cases had ≤ 5 pN1, and 41 cases had > 5 pN1. Multifocality, primary tumor size > 2 cm, capsule contact and ETE are significant independent risk factors for > 5 pN1.

Conclusions

We concluded that multifocality, primary tumor size > 2 cm, capsule contact, ETE and central LNM were independent risk factors for the intermediate risk stratification in patients with PTC. Ultrasonography is a good technique for the preoperative lymph node staging of PTC and is helpful for detecting LNM.
Dynamics in public perceptions and media coverage during an ongoing outbreak of meningococcal W disease in the Netherlands
Authors: de Vries Marion , Claassen Liesbeth , te Wierik Margreet J. M. , Timmermans Danielle R. M. , Timen Aura
Published: April 2022

Background

From 2015 to 2018, the Netherlands faced an outbreak of invasive meningococcal disease (IMD) caused by serogroup W. To counter the rise in infections, the government introduced a catch-up menACWY vaccination campaign for teenagers in 2018 and 2019. The outbreak situation induced substantial media attention and a run on menACWY vaccines outside the vaccination campaign. This study aimed to gain insights into the dynamics of public perceptions of and responses to the outbreak and the menACWY vaccination, and into the media coverage about the outbreak.

Methods

Three repeated surveys (N = 1110) between 2017 and 2019 were sent to parents of teenagers invited for a menACWY catch-up vaccination, other parents, and individuals with no under-age children. These surveys assessed IMD risk perceptions, attitudes towards the menACWY vaccination, trust in involved institutions, and willingness to vaccinate with the menACWY vaccine. Changes in the public perceptions and responses were studied with linear multilevel regression analyses. In addition, 103 national newspaper articles from the period 2017–2019 were thematically coded with themes about IMD and the menACWY vaccination.

Results

The survey results showed clear increases in perceived IMD severity, positive attitude towards the menACWY vaccination, and willingness to vaccinate over time. Perceived IMD vulnerability remained low across all three waves, and trust in involved institutions increased slightly. Differences between the survey groups were limited. The newspaper articles discussed the rise in infections extensively, the disease symptoms, and the possible fatal outcome of IMD. In addition, while many articles discussed the menACWY vaccine shortage, few discussed the safety or effectiveness of the vaccine.

Conclusion

The real-time insights into the interrelated dynamics of public perceptions, responses, and media coverage provide an integrated portrait of the social developments during this outbreak. The focus on IMD severity and the absence of doubt in the public discussion about vaccine safety may have played an important role in the societal response to this outbreak and the recommended vaccine.
Lung clearance index to characterize clinical phenotypes of children and adolescents with cystic fibrosis
Authors: Gambazza Simone , Ambrogi Federico , Carta Federica , Moroni Laura , Russo Maria , Brivio Anna , Colombo Carla
Published: April 2022

Background

Lung clearance index (LCI) is accepted as an early marker of lung disease in cystic fibrosis (CF), however the utility of LCI to identify subgroups of CF disease in the paediatric age group has never been explored. The aim of the study was to characterize phenotypes of children with CF using LCI as a marker of ventilation inhomogeneity and to investigate whether these phenotypes distinguished patients based on time to pulmonary exacerbation (PE).

Methods

Data were collected on patients with CF aged < 18 years old, attending the CF Center of Milan during outpatient follow-up visits between October 2014 and September 2019. Cluster analysis using agglomerative nesting hierarchical method was performed to generate distinct phenotypes. Time-to-recurrent event analysis investigated association of phenotypes with PE.

Results

We collected 313 multiple breath washout tests on 125 children aged 5.5–16.8 years. Cluster analysis identified two divergent phenotypes in children and adolescents of same age, presenting with almost normal FEV1 but with substantial difference in markers of ventilation inhomogeneity (mean LCI difference of 3.4, 95% Confidence Interval [CI] 2.6–4.2). A less severe phenotype was associated with a lower risk of PE relapse (Hazard Ratio 0.45, 95% CI 0.34–0.62).

Conclusions

LCI is useful in clinical practice to characterize distinct phenotypes of children and adolescents with mild/normal FEV1. A less severe phenotype translates into a lower risk of PE relapse.
Association of genetic variants in the Sirt1 and Nrf2 genes with the risk of metabolic syndrome in a Chinese Han population
Authors: Tao T. T. , Lin X. H. , Tang S. J. , Gui W. W. , Zhu W. F. , Li H.
Published: April 2022

Background

Metabolic syndrome (MetS) is a complex of interrelated risk factors, including central adiposity, increased blood pressure, hyperglycemia, elevated triglyceride levels and low high-density lipoprotein. Few studies have reported the genetic variants in theSirt1andNrf2genes (Sirt1rs7895833 A > G,Sirt1rs2273773 C > T andNrf2rs6721961 C > A) that increase the risk of type 2 diabetes mellitus and are correlated with some glycemic and metabolic traits in the Chinese Han population.

Methods

Our study recruited 141 individuals with MetS and 549 individuals without MetS to investigate the associations between three single nucleotide polymorphisms (SNPs) ofSirt1andNrf2and the risk of MetS in a Chinese Han population using the PCR-CTPP method.

Results

This research showed that the risk of MetS was 2.41 times higher for the AA genotype (P = 0.038) and 1.94 times higher for the AG genotype (P = 0.016) compared with carriers of the GG genotype. The serum levels of low-density lipoprotein cholesterol and HOMA-IR were significantly higher (P < 0.05) in carriers of the AA genotype ofSirt1rs7895833 than in carriers of the AG and GG genotypes in the general population. The serum level of total cholesterol in the AA genotype was lower (P = 0.033) than that in the other two genotypes. However, the genotype frequencies ofSirt1rs2273773 andNrf2rs6721961 in the MetS group were not significantly different from those in the control subjects, and those two genetic variants were not correlated with metabolic traits.

Conclusions

These results underscore the contributions of SNPs ofSirt1rs7895833 to MetS susceptibility as well as glycemic and metabolic traits in a Chinese population.
A two-stage deep learning architecture for radiographic staging of periodontal bone loss
Authors: Jiang Linhong , Chen Daqian , Cao Zheng , Wu Fuli , Zhu Haihua , Zhu Fudong
Published: April 2022

Background

Radiographic periodontal bone loss is one of the most important basis for periodontitis staging, with problems such as limited accuracy, inconsistency, and low efficiency in imaging diagnosis. Deep learning network may be a solution to improve the accuracy and efficiency of periodontitis imaging staging diagnosis. This study aims to establish a comprehensive and accurate radiological staging model of periodontal alveolar bone loss based on panoramic images.

Methods

A total of 640 panoramic images were included, and 3 experienced periodontal physicians marked the key points needed to calculate the degree of periodontal alveolar bone loss and the specific location and shape of the alveolar bone loss. A two-stage deep learning architecture based on UNet and YOLO-v4 was proposed to localize the tooth and key points, so that the percentage of periodontal alveolar bone loss was accurately calculated and periodontitis was staged. The ability of the model to recognize these features was evaluated and compared with that of general dental practitioners.

Results

The overall classification accuracy of the model was 0.77, and the performance of the model varied for different tooth positions and categories; model classification was generally more accurate than that of general practitioners.

Conclusions

It is feasible to establish deep learning model for assessment and staging radiographic periodontal alveolar bone loss using two-stage architecture based on UNet and YOLO-v4.
“I have to do twice as well” – managing everyday racism in a Swedish medical school
Authors: Kristoffersson Emelie , Hamberg Katarina
Published: April 2022

Background

Mounting evidence suggests that medical students from cultural/ethnic minority backgrounds face recurring and more or less subtle racist oppression, i.e., everyday racism. Insights into how they handle these inequalities, though, are scarce – especially in a Swedish context. In this interview study we therefore explored and analyzed the strategies used by racialized minority medical students to manage episodes of everyday racism – and their underlying motives and considerations.

Methods

Individual interviews were carried out with 15 medical students (8 women, 7 men) who self-identified as having ethnic- or cultural minority backgrounds. Inspired by constructivist grounded theory, data were collected and analyzed simultaneously.

Results

Participants strove to retain their sense of self as active students and professional future physicians – as opposed to passive and problematic ‘Others’. Based on this endeavor, they tried to manage the threat of constraining stereotypes and exclusion. Due to the power relations in medical education and clinical placement settings as well as racialized students’ experience of lacking both credibility and support from bystanders, few dared to speak up or report negative treatment. Instead, they sought to avoid racism by withdrawing socially and seeking safe spaces. Or, they attempted to adopt a professional persona that was resistant to racial slights. Lastly, they tried to demonstrate their capability or conform to the majority culture, in attempts to refute stereotypes.

Conclusions

Racism is not caused by the exposed individuals’ own ways of being or acting. Therefore, behavioral changes on the part of minority students will not relieve them from discrimination. Rather, strategies such as adaptation and avoidance run the risk of re-inscribing the white majority as the norm for a medical student. However, as long as racialized minority students stand alone it is difficult for them to act in any other way. To dismantle racism in medical education, this study indicates that anti-racist policies and routines for handling discrimination are insufficient. School management should also acknowledge racially minoritized students’ experiences and insights about racist practices, provide students and supervisors with a structural account of racism, as well as organize training in possible ways to act as a bystander to support victims of racism, and create a safer working environment for all.
Barriers and gaps in headache education: a national cross-sectional survey of neurology residents in Denmark
Authors: Do Thien Phu , Dømgaard Mikala , Stefansen Simon , Kristoffersen Espen Saxhaug , Ashina Messoud , Hansen Jakob Møller
Published: April 2022

Background

A major barrier to adequate headache care is the relative lack of formal education and training of healthcare professionals. Concerted efforts should be made to pinpoint major gaps in knowledge in healthcare professionals to facilitate better educational policies in headache training. The aim of this study was to identify deficiencies and barriers in headache training among residents in neurology in Denmark.

Methods

We conducted a national cross-sectional survey of residents in neurology in Denmark from April 2019 to September 2019. The survey included questions on participant demographics, knowledge of and barriers in headache disorders, guidelines and diagnostic tools usage, contact with primary and tertiary care, medication overuse, and non-pharmacological interventions. Furthermore, respondents were asked to provide a ranked list from most to least interesting for six sub-specializations/disorders, i.e., cerebrovascular disease, dementia, epilepsy, headache, multiple sclerosis, Parkinson's disease.

Results

Sixty (40%) out of estimated a population of ~ 150 resident across Denmark accepted the invitation. Of these, 54/60 (90%) completed the survey. Although two-thirds, 35/54 (65%), of the respondents had prior formalized training in headache disorders, we identified gaps in all explored domains including diagnosis, management, and referral patterns. Particularly, there was an inconsistent use of guidelines and diagnostic criteria from the Danish Headache Society (2.74 (± 1.14)), the Danish Neurological Society (3.15 (± 0.86)), and the International Classification of Headache Disorders (2.33 (± 1.08)); 1: never/have not heard of, 4: always. Headache was ranked second to last out of six sub-specializations in interest.

Conclusions

Overall knowledge on headache disorders amongst neurology residents in Denmark do not meet the expectations set out by national and international recommendations. Stakeholders should make strategic initiatives for structured education in headache for improved clinical outcomes in parallel with costs reduction through resource optimization.
Level and predictors of nurse caring behaviors among nurses serving in inpatient departments in public hospitals in Harari region, eastern Ethiopia
Authors: Kibret Haregeweyn , Tadesse Barkot , Debella Adera , Degefa Meron , Regassa Lemma Demissie
Published: April 2022

Background

Nursing practice is centered on caring and nurses’ behaviour has an impact on the quality of patient care and it is predictive of patient satisfaction,however, many nurses, in reality, do not exhibit caring behavior when providing nursing care to clients. This study was aimed to assess the level and predictors of nurse caring behaviors among nurses serving in inpatient departments in public hospitals in Harari Region of Ethiopia from March 10 to April 10, 2021.

Method

A cross-sectional study was conducted among 300 nurses providing inpatient service in public hospitals in the Harari region of eastern Ethiopia. All permanent nurses working in major inpatient services of two public hospitals, namely Jugal General Hospital (JGH) and Hiwot Fana Specialized University Hospital (HFSUH) were included. The English version of the CNPI-Nurse scale was used to determine the level of caring behavior. The association was reported using the crude and adjusted odds ratios along with the 95% confidence interval. The statistical significance of the association was declared at p-value < 0.05.

Result

The caring behavior was classified as high and low based on the median score. According to this study only 51.67% (95% CI:45.97, 57.35%) of nurses had good caring behavior. The odds of having good caring behavior were 2.22 (AOR = 2.22, 95%CI: 1.20, 4.10) times higher among nurses working in good working environment compared to those who work in bad working environment. Nurses who were satisfied with their job had 2.79 (AOR: 2.79, 95%CI: 1.54, 5.08) times higher odds of good caring behavior than those who were not satisfied with their job. Similarly, nurses who had a lower workload had a 3.01 (AOR: 3.01, 95%CI: 1.70, 5.33) times higher probability of having good caring behavior from nurses compared to nurses who reported having a high workload.

Conclusion

The level of nurses caring behavior is not satisfactory and it is influenced by working environment characteristics, job satisfaction and workload. Therefore it necessary to creat conducive working environment, provide adequate time and resources inorder to improve the level of nurses caring behaviour.
Consumption and cost trends of EGFR TKIs: influences of reimbursement and national price negotiation
Authors: Wu Di , Xie Jianxiang , Dai Huizhen , Fang Wentong
Published: April 2022

Background

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) have been widely used in the treatment of EGFR mutation non-small-cell lung cancer. The Chinese government has made great efforts to improve the availability and affordability of these drugs. The aim of this study was to investigate the trends in the consumption and cost of EGFR TKIs in Nanjing, a developed city in China, and evaluate the influence of health insurance coverage and national price negotiation on drug consumption.

Methods

Data about EGFR TKIs applications in 2010–2019 were extracted from Jiangsu Medicine Information Institute. Five types of EGFR TKIs were included. Consumption was expressed in defined daily doses (DDDs) and expenditure. The correlation between defined daily cost (DDC) and DDDs was analyzed by Pearson's correlation test.

Results

The DDC, number of DDDs and expenditure of EGFR TKIs changed little from 2010 to 2015. National price negotiation was initiated as a policy and low-price generic gefitinib came into the market in 2016. Three types of EGFR TKIs moved into the coverage of the national health insurance since 2017. Hence, the DDC decreased, and the number of DDDs increased significantly year by year since 2016. The first generation TKIs always made up of comprised the majority of the total consumption. The predominantly prescribed TKIs were gefitinib and icotinib. DDC was negatively correlated with the number of DDDs. The number of DDDs increased significantly after health insurance enrollment, price negotiation and generic drug replacement.

Conclusion

The consumption of EGFT TKIs has increased and the DDC of EGFR TKIs has decreased since 2016. These trends may be attributed to drug reimbursement, price negotiation and generic drug replacement. Further efforts are needed to translate the high consumption of EGFR TKIs into clinical benefits.
A novel HIF1α-STIL-FOXM1 axis regulates tumor metastasis
Authors: Wang Yi-Wei , Chen Shu-Chuan , Gu De-Leung , Yeh Yi-Chen , Tsai Jhih-Jie , Yang Kuo-Tai , Jou Yuh-Shan , Chou Teh-Ying , Tang Tang K.
Published: April 2022

Background

Metastasis is the major cause of morbidity and mortality in cancer that involves in multiple steps including epithelial–mesenchymal transition (EMT) process. Centrosome is an organelle that functions as the major microtubule organizing center (MTOC), and centrosome abnormalities are commonly correlated with tumor aggressiveness. However, the conclusive mechanisms indicating specific centrosomal proteins participated in tumor progression and metastasis remain largely unknown.

Methods

The expression levels of centriolar/centrosomal genes in various types of cancers were first examined by in silico analysis of the data derived from The Cancer Genome Atlas (TCGA), Gene Expression Omnibus (GEO), and European Bioinformatics Institute (EBI) datasets. The expression of STIL (SCL/TAL1-interrupting locus) protein in clinical specimens was further assessed by Immunohistochemistry (IHC) analysis and the oncogenic roles of STIL in tumorigenesis were analyzed using in vitro and in vivo assays, including cell migration, invasion, xenograft tumor formation, and metastasis assays. The transcriptome differences between low- and high-STIL expression cells were analyzed by RNA-seq to uncover candidate genes involved in oncogenic pathways. The quantitative polymerase chain reaction (qPCR) and reporter assays were performed to confirm the results. The chromatin immunoprecipitation (ChIP)-qPCR assay was applied to demonstrate the binding of transcriptional factors to the promoter.

Results

The expression ofSTILshows the most significant increase in lung and various other types of cancers, and is highly associated with patients’ survival rate. Depletion of STIL inhibits tumor growth and metastasis. Interestingly, excess STIL activates the EMT pathway, and subsequently enhances cancer cell migration and invasion. Importantly, we reveal an unexpected role of STIL in tumor metastasis. A subset of STIL translocate into nucleus and associate with FOXM1 (Forkhead box protein M1) to promote tumor metastasis and stemness via FOXM1-mediated downstream target genes. Furthermore, we demonstrate that hypoxia-inducible factor 1α (HIF1α) directly binds to theSTILpromoter and upregulates STIL expression under hypoxic condition.

Conclusions

Our findings indicate that STIL promotes tumor metastasis through the HIF1α-STIL-FOXM1 axis, and highlight the importance of STIL as a promising therapeutic target for lung cancer treatment.
Correction to: Transhiatal esophagectomy as a treatment for locally advanced adenocarcinoma of the gastroesophageal junction: postoperative and oncologic results of a single-center cohort
Authors: Meillat Hélène , Niziers Vincent , Zemmour Christophe , Ewald Jacques , Ratone Jean-Philippe , Dermeche Slimane , Guiramand Jérôme
Published: April 2022

An amendment to this paper has been published and can be accessed via the original article.
CircZDBF2 up-regulates RNF145 by ceRNA model and recruits CEBPB to accelerate oral squamous cell carcinoma progression via NFκB signaling pathway
Authors: Rong Liang , Chen Bo , Liu Ke , Liu Bingyao , He Xinyao , Liu Juan , Li Junxia , He Maodian , Zhu Lei , Liu Ke , Shi Xiaolei , Shuai Yi , Jin Lei
Published: April 2022

Background

Oral squamous cell carcinoma (OSCC), as one of the commonest malignancies showing poor prognosis, has been increasingly suggested to be modulated by circular RNAs (circRNAs). Through GEO (Gene Expression Omnibus) database, a circRNA derived from ZDBF2 (circZDBF2) was uncovered to be with high expression in OSCC tissues, while how it may function in OSCC remains unclear.

Methods

CircZDBF2 expression was firstly verified in OSCC cells via qRT-PCR. CCK-8, along with colony formation, wound healing, transwell and western blot assays was performed to assess the malignant cell behaviors in OSCC cells. Further, RNA pull down assay, RIP assay, as well as luciferase reporter assay was performed to testify the interaction between circZDBF2 and RNAs.

Results

CircZDBF2 expressed at a high level in OSCC cells and it accelerated OSCC cell proliferation, migration, invasion as well as EMT (epithelial-mesenchymal transition) process. Further, circZDBF2 sponged miR-362-5p and miR-500b-5p in OSCC cells to release their target ring finger protein 145 (RNF145). RNF145 expressed at a high level in OSCC cells and circZDBF2 facilitated RNF145 transcription by recruiting the transcription factor CCAAT enhancer binding protein beta (CEBPB). Moreover, RNF145 activated NFκB (nuclear factor kappa B) signaling pathway and regulated IL-8 (C-X-C motif chemokine ligand 8) transcription.

Conclusion

CircZDBF2 up-regulated RNF145 expression by sponging miR-362-5p and miR-500b-5p and recruiting CEBPB, thereby promoting OSCC progression via NFκB signaling pathway. The findings recommend circZDBF2 as a probable therapeutic target for OSCC.

Graphical Abstract
DEPTH2: an mRNA-based algorithm to evaluate intratumor heterogeneity without reference to normal controls
Authors: Song Dandan , Wang Xiaosheng
Published: April 2022

Background

Intratumor heterogeneity (ITH) is associated with tumor progression, unfavorable prognosis, immunosuppression, genomic instability, and therapeutic resistance. Thus, evaluation of ITH levels is valuable in cancer diagnosis and treatment.

Methods

We proposed a new mRNA-based ITH evaluation algorithm (DEPTH2) without reference to normal controls. DEPTH2 evaluates ITH levels based on the standard deviations of absolute z-scored transcriptome levels in tumors, reflecting the asynchronous level of transcriptome alterations relative to the central tendency in a tumor.

Results

By analyzing 33 TCGA cancer types, we demonstrated that DEPTH2 ITH was effective in measuring ITH for its significant associations with tumor progression, unfavorable prognosis, genomic instability, reduced antitumor immunity and immunotherapy response, and altered drug response in diverse cancers. Compared to other five ITH evaluation algorithms (MATH, PhyloWGS, ABSOLUTE, DEPTH, and tITH), DEPTH2 ITH showed a stronger association with unfavorable clinical outcomes, and in characterizing other properties of ITH, such as its associations with genomic instability and antitumor immunosuppression, DEPTH2 also displayed competitive performance.

Conclusions

DEPTH2 is expected to have a wider spectrum of applications in evaluating ITH in comparison to other algorithms.
The effect of diabetes on surgical versus percutaneous left main revascularization outcomes: a systematic review and meta-analysis
Authors: d’Entremont Marc-André , Yagi Ryuichiro , Salia Soziema J. S. , Zhang Shuqi , Shaban Lamyaa , Bene-Alhasan Yakubu , Papatheodorou Stefania , Couture Étienne L. , Huynh Thao , Nguyen Michel , Hamaya Rikuta
Published: April 2022

Background

The optimal method of coronary revascularization for diabetes mellitus (DM) patients with left main coronary artery disease (LMCAD) is controversial in the drug-eluting stent (DES) era.

Methods

We performed a systematic review and meta-analysis comparing DES-based percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG) for LMCAD in DM patients and tested for effect measure modification (EMM) by diabetes for adverse events. We included all randomized controlled trials (RCTs) and observational studies comparing CABG to DES-based PCI including DM patients with LMCAD published up to March 1, 2021. We completed separate random-effects meta-analyses for four RCTs (4356 patients, mean follow-up of 4.9 years) and six observational studies (9360 patients, mean follow-up of 5.2 years).

Results

In RCTs among DM patients, DES-based PCI, compared to CABG, was associated with a 30% increased relative risk (RR) (RR 1.30, 95% CI 1.09–1.56, I2 = 0%), while among non-DM patients, there was a 25% increased relative risk (RR 1.25, 95% CI 1.07–1.44, I2 = 0%) for the composite endpoint of all-cause mortality, myocardial infarction, stroke, and unplanned revascularization (MACCE). There was no evidence of EMM (p-value for interaction = 0.70). The mean weighted SYNTAX score was 25.7. In observational studies, there was no difference between DES-based PCI and CABG for all-cause mortality in patients with DM (RR 1.13, 95% CI 0.91–1.40, I2 = 0%).

Conclusions

CABG was superior to PCI for LMCAD in RCTs in DM patients for MACCE. Heart teams may consider DM as one of the many components in the clinical decision-making process, but may not want to consider DM as a primary deciding factor between DES-based PCI and CABG for LMCAD with low to intermediate anatomical complexity in the other coronary arteries.

Study registration

CRD42021246931 (PROSPERO).
Liushen Capsules, a promising clinical candidate for COVID-19, alleviates SARS-CoV-2-induced pulmonary in vivo and inhibits the proliferation of the variant virus strains in vitro
Authors: Ma Qinhai , Lei Biao , Chen Ruihan , Liu Bin , Lu Wencong , Jiang Haiming , Chen Zexing , Guo Xiaowen , Wang Yutao , Zhang Lu , Chen Qiaoyan , Li Xiaobo , Yang Zifeng
Published: April 2022

Background

Coronavirus disease 2019 (COVID-19) causes a global pandemic and has devastating effects around the world, however, there are no specific antiviral drugs and vaccines for the constant mutation of SARS-CoV-2.

Purpose

In this study, we evaluted the antiviral and anti-inflammatory activities of Liushen Capsules (LS) on different novel coronavirus in vitro, studied its therapeutic effects on novel SARS-CoV-2 infected mice and observed the LS’s clinical efficacy and safety in COVID-19.

Methods

The antiviral and aiti-inflammatory effects of LS on the 501Y.V2/B.1.35 and G/478K.V1/ B.1.617.2 strains were determined in vitro. A hACE2 mouse model of novel SARS-CoV-2 pneumonia was established. Survival rates, histological changes, inflammatory markers, lung virus titers and the expression of the key proteins in the NF-κB/MAPK signaling pathway was detected by western blotting and immumohistochemical staining in the lungs were measured. Subsequently, the disease duration, prognosis of disease, time of negative nucleic acid and the cytokines levels in serum were used to assess the efficacy of treatment with LS in patients.

Results

The results showed that LS (2, 1, 0.5 μg/mL) could significantly inhibit the replication of the two SARS-CoV-2 variants and the expression of pro-inflammatory cytokines (IL-6, IL-8, IP-10, CCL-5, MIP-1α, IL-1α) induced by the virus in vitro. As for the survival experiment in mice, the survival rate of virus group was 20%, while LS-treatment groups (40, 80, 160 mg/kg) could increase the survival rate to 60, 100 and 100%, respectively. LS (40, 80, 160 mg/kg) could significantly decrease the lung titers in mice and it could improve the pathological changes, inhibit the excessive inflammatory mediators (IFN-α, IFN-γ, IP-10, MCP-1) and the protein expression of p-NF-κB p65 in mice. Moreover, LS could significantly decrease SARS-CoV-2-induced activation of p-NF-κB p65, p-IκBα, and p-p38 MAPK and increase the protein expression of the IκBα. In addition, the patient got complete relief of symptoms after being treated with LS for 6 days and was proven with negative PCR test after being treated for 23 days. Finally, treatment with LS could reduce the release of inflammatory cytokines (IL-6, PDGF-AA/BB, Eotaxin, MCP-1, MIP-1α, MIP-1β, GRO, CCL-5, MCP-3, IP-10, IL-1α).

Conclusion

LS effectively alleviated novel SARS-CoV-2 or variants induced pneumonia in vitro and in vivo, and improved the prognosis of COVID-19. In light of the efficacy and safety profiles, LS could be considered for the treatment of COVID-19 with a broad-spectrum antiviral and anti-inflammatory agent.