bluuebunny/crossref_metadata_2025 huggingface dataset:
Kutane T-Zell-Lymphome – Update 2021
Authors: Kempf Werner , Mitteldorf Christina
Published: January 2022

Kutane T-Zell-Lymphome (CTCL) machen den Großteil aller primären kutanen Lymphome (CL) aus. 80 % aller Fälle von CTCL wiederum entfallen auf Mycosis fungoides (MF) und CD30-positive lymphoproliferative Erkrankungen der Haut. Das klinische Bild der verschiedenen Formen von CTCL zeigt Überschneidungen. Darum ist die klinisch-pathologische Korrelation von großer Bedeutung für die finale Diagnosestellung. Die MF zeigt einen charakteristischen Verlauf mit makuläre Läsionen (Patches), infiltrierte Plaques und, bei einem Teil der Patienten (10–20 %), Tumoren. Die Behandlung erfolgt stadienorientiert mit auf die Haut gerichteten Therapien wie UV-Lichttherapien und Kortikosteroiden in frühen Stadien der Erkrankung (Patch- und begrenztes Plaque-Stadium) und systemischen Therapien (Retinoide bzw. Rexinoide, Interferon, Monochemotherapie, zielgerichtete Therapie) und/oder Strahlentherapie (lokal oder Ganzkörperbestrahlung mit Elektronen) in fortgeschrittenen Stadien. Neuartige Ansätze umfassen zielgerichtete Therapien wie Mogamulizumab (Antikörper gegen CCR4) oder Brentuximab Vedotin (Antikörper gegen CD30) sowie Histon-Deacetylase-Inhibitoren. Angesichts des Impacts von zielgerichteten Therapien sind Biomarker wie CD30 nicht nur für die Diagnosestellung und korrekte Klassifikation eines Lymphoms im Einzelfall von großer Bedeutung, sondern als potenzielle Wirkstoff-Zielmoleküle auch für die Therapie. In der kürzlich überarbeiteten WHO-Klassifikation von 2017 und der aktualisierten WHO-EORTC-Klassifikation der CL von 2018 ist erstmals das CD8-positive akrale T-Zell-Lymphom als eigene, noch provisorische Entität aufgeführt. Diese Form zeigt charakteristische klinische, histologische und phänotypische Merkmale und eine hervorragende Prognose. Zu den seltenen, aber aggressiven CTCL zählen das primär kutane aggressive epidermotrope CD8-positive T-Zell-Lymphom und das kutane Gamma/Delta-T-Zell-Lymphom, die durch rasches Auftreten nekrotischer oder ulzerierender Plaques und Tumoren gekennzeichnet sind. Da bei diesen Formen die Prognose ungünstig ist, umfasst die Behandlung Polychemotherapien und hämatopoetische Stammzelltransplantationen.
Real-World Data for Lenvatinib in Hepatocellular Carcinoma (ELEVATOR): A Retrospective Multicenter Study
Authors: Welland Sabrina , Leyh Catherine , Finkelmeier Fabian , Jefremow André , Shmanko Kateryna , Gonzalez-Carmona Maria A. , Kandulski Arne , Jeliazkova Petia , Best Jan , Fründt Thorben W. , Djanani Angela , Pangerl Maria , Maieron Andreas , Greil Richard , Fricke Christina , Sookthai Disorn , Günther Rainer , Schmiderer Andreas , Wege Henning , Venerito Marino , Ehmer Ursula , Müller Martina , Strassburg Christian P. , Weinmann Arndt , Siebler Jürgen , Waidmann Oliver , Lange Christian M. , Saborowski Anna , Vogel Arndt
Published: January 2022

Background
Lenvatinib is approved as first-line treatment for patients with advanced hepatocellular carcinoma (HCC). The efficacy of lenvatinib in Caucasian real-world patients is insufficiently defined. The purpose of this study was to evaluate the efficacy of lenvatinib in a multi-center cohort (ELEVATOR) from Germany and Austria.

Methods
A retrospective data analysis of 205 patients treated with first-line systemic lenvatinib at 14 different sites was conducted. Overall survival, progression free survival, overall response rate and adverse event rates were assessed and analyzed.

Results
Patients receiving lenvatinib in the real-world setting reached a median overall survival of 12.8 months, which was comparable to the results reported from the REFLECT study. Median overall survival (mOS) and progression free survival (mPFS) was superior in those patients who met the inclusion criteria of the REFLECT study compared to patients who failed to meet the inclusion criteria (mOS 15.6 vs 10.2 months, HR 0.55, 95% CI 0.38-0.81, p=0.002; mPFS 8.1 vs 4.8 months HR 0.65, 95% CI 0.46-0.91, p=0.0015). For patients with an impaired liver function according to the Albumin-Bilirubin (ALBI) grade, or reduced ECOG performance status ≥2, survival was significantly shorter compared to patients with sustained liver function (ALBI grade 1) and good performance status (ECOG performance status 0), respectively (HR 1.69, 95% CI 1.07-2.66, p=0.023; HR 2.25, 95% CI 1.19-4.23, p=0.012). Additionally, macrovascular invasion (HR 1.55, 95% CI 1.02-2.37, p=0.041) and an AFP ≥200 ng/mL (HR 1.56, 95% CI 1.03-2.34, p=0.034) were confirmed as independent negative prognostic factors in our cohort of patients with advanced HCC.

Conclusion
Overall, our data confirm the efficacy of lenvatinib as first-line treatment and did not reveal new or unexpected side effects in a large retrospective Caucasian real-world cohort, supporting the use of lenvatinib as meaningful alternative for patients that cannot be treated with IO-based combinations in first-line HCC.
Effect of Adjuvant Chemotherapy in Stage III Cervical Cancer Patients Treated with Concurrent Chemoradiation: A Multicenter Study
Authors: Atci Muhammed Mustafa , Akagunduz Baran , Demir Metin , Dönmez Yilmaz Binnur , Akin Telli Tugba , Can Orcun , Cil Ibrahim , Goktas Aydın Sabin , Ozyurt Neslihan , Onder Arif Hakan , Selvi Oguzhan , Sakin Abdullah
Published: January 2022

Introduction: A significant proportion of cervical cancer (CC) patients are diagnosed at a locally advanced stage. Concurrent chemoradiotherapy (CCRT) is the cornerstone of treatment for patients with locally advanced CC. However, the role of adjuvant chemotherapy (AC) after CCRT is controversial. In this study, we analyzed the efficacy of AC after CCRT in stage III CC patients. Methods: We performed a multicenter, retrospective analysis of 139 International Federation of Gynecology and Obstetrics stage III CC patients treated with CCRT of whom 45.3% received AC. Our goal was to determine the impact of AC on survival in these patients. Results: Five-year progression-free survival (PFS) was 37.5% and 16% in patients receiving CCRT with and without AC, respectively (p = 0.008). Median PFS was 30.9 months (CI 95% 14.8–46.9) and 16.6 months (CI 95% 9.3–23.9) in patients receiving CCRT with and without AC, respectively. Five-year overall survival (OS) was 78.2% and 28.4% in patients receiving CCRT with and without AC, respectively (p < 0.001). Median OS was 132.2 months (CI 95, %66.5–197.8) and 34.9 months (CI 95% 23.1–46.7) in patients receiving CCRT with and without AC, respectively. Conclusion: Our study suggests that AC provides OS and PFS benefit in stage III CC patients. Larger studies are needed to identify subgroups of patients who would benefit from AC.
Implementation of School-Based Management in Improving the Quality of Learning in the City of Bekasi
Authors: Mutiarawati Ade
Published: January 2022

The importance of evaluating the implementation of School Based Management in providing innovative learning improvements in improving the quality of education, but the reality is that there are still elementary school educational institutions that do not know much about the benefits of implementing School-Based Management. The objectives of this study are 1) Determine the implementation of School-Based Management in improving the quality of learning; 2) Determine the factors supporting and inhibiting the implementation of School-Based Management in improving the quality of learning. Methods: The type of research used is descriptive qualitative research. The research data collection method was carried out by observation, interviews, and documents. Analysis of research data was carried out by presenting data, reducing, and drawing conclusions. The research location was conducted at one of the elementary schools in Bekasi City. Results: This study showed that 1) The implementation of school-based management was carried out through well-executed planning, organizing, implementing, and supervising management process by the essence of management in an autonomous, flexible, participatory, transparent and accountable manner; 2) Supporting factors, namely the role of the community, parents and committees in school activities, complete class teachers and almost all of them meet academic quality. Conclusion: The inhibiting factor is active, creative, effective, and fun learning which requires a lot of funds, time, and energy because it has to be prepared but in implementation, it can be handled properly.
The Influence of Information Literacy Learning and Problem-based Learning on Students’ Learning Outcome in Social Science Subject at Public Junior High School 2 of Kendit in Situbondo
Authors: Na'im Mohamad , Boiman
Published: January 2022

The objectives of this study are aimed at: 1) analyzing the effect of Information Literacy Learning model on the learning outcome of eighth-grade students of Public Junior High School 2 of Kendit in Situbondo in social science subject; 2) analyzing the effect of Problem-based Learning model on the learning outcome of eighth-grade students of Public Junior High School 2 of Kendit in Situbondo in social science subject; 3) analyzing the differences in the learning outcome of eighth-grade students of Public Junior High School 2 of Kendit in Situbondo between the application of the Information Literacy Learning model and Problem-based Learning. This research is a correlational study. Based on the results of data analysis, the study has drawn several conclusions. First, there is a very significant influence, marked at 53.7%, of the Information Literacy Learning on learning outcome. Second, there is a significant effect of the Problem-based Learning on learning outcome, as evinced by a correlation magnitude of 57.7%. Third, the analysis has identified no significant difference between Information Literacy Learning and Problem-based Learning on learning outcome shows. This shows that both learning models are equally well applied to improve learning outcome.
A hospitalidade pelas dimensões do acolhimento e pertencimento: uma análise sobre a percepção do anfitrião-residente de Campos do Jordão
Authors: Mendes Bruna Castro , Cavenaghi Airton José
Published: January 2022

A proposta deste artigo é, a partir da perspectiva da hospitalidade, em sua dimensão de acolhimento e pertencimento, compreender a visão do anfitrião sobre a relação estabelecida pela atividade turística, entendendo que ele ocupa uma das posições limítrofes desta relação. Assim, o objetivo geral é compreender como a comunidade anfitriã de uma cidade turística, tendo como objeto a cidade de Campos do Jordão (SP), avalia o turismo e os atores envolvidos nesta atividade. Além disso, buscou-se identificar a percepção da comunidade local em relação à cidade, ao turismo e ao turista. A metodologia define-se pelo caráter exploratório, utilizando uma amostra não probabilística, classificada como sondagem de rua, totalizando 115 questionários aplicados em junho de 2020. O apoio ao turismo foi evidenciado, porém, alguns descontentamentos da população demonstram que os custos de ter o turismo como atividade principal na localidade começam a ser sentidos. Espera-se que este trabalho leve à compreensão dos impactos do turismo no cotidiano dos residentes, permitindo ações mais efetivas para o seu envolvimento e atuação no processo organizacional do turismo local.
Mineralocorticoid Receptor Antagonist Use and Hard Renal Outcomes in Real-World Patients With Chronic Kidney Disease
Authors: Oka Tatsufumi , Sakaguchi Yusuke , Hattori Koki , Asahina Yuta , Kajimoto Sachio , Doi Yohei , Kaimori Jun-Ya , Isaka Yoshitaka
Published: January 2022

Background:

Real-world evidence about mineralocorticoid receptor antagonist (MRA) use has been limited in chronic kidney disease, particularly regarding its association with hard renal outcomes.

Methods:

In this retrospective cohort study, adult chronic kidney disease outpatients referred to the department of nephrology at an academic hospital between January 2005 and December 2018 were analyzed. The main inclusion criteria were estimated glomerular filtration rate ≥10 and <60 mL/min per 1.73 m
2
and follow-up ≥90 days. The exposure of interest was MRA use, defined as the administration of spironolactone, eplerenone, or potassium canrenoate. The primary outcome was renal replacement therapy initiation, defined as the initiation of chronic hemodialysis, peritoneal dialysis, or kidney transplantation. A marginal structural model using inverse probability of weighting was applied to account for potential time-varying confounders.

Results:

Among a total of 3195 patients, the median age and estimated glomerular filtration rate at baseline were 66 years and 38.4 mL/min per 1.73 m
2
, respectively. During follow-up (median, 5.9 years), 770 patients received MRAs, 211 died, and 478 started renal replacement therapy. In an inverse probability of weighting-weighted pooled logistic regression model, MRA use was significantly associated with a 28%-lower rate of renal replacement therapy initiation (hazard ratio, 0.72 [95% CI, 0.53–0.98]). The association between MRA use and renal replacement therapy initiation was dose-dependent (
P
for trend <0.01) and consistent across patient subgroups. The incidence of hyperkalemia (>5.5 mEq/L) was somewhat higher in MRA users but not significant (hazard ratio, 1.14 [95% CI, 0.88–1.48]).

Conclusions:

MRA users showed a better renal prognosis across various chronic kidney disease subgroups in a real-world chronic kidney disease population.
On Learning Interpreted Languages with Recurrent Models
Authors: Paperno Denis
Published: January 2022

Can recurrent neural nets, inspired by human sequential data processing, learn to understand language? We construct simplified data sets reflecting core properties of natural language as modeled in formal syntax and semantics: recursive syntactic structure and compositionality. We find LSTM and GRU networks to generalize to compositional interpretation well, but only in the most favorable learning settings, with a well-paced curriculum, extensive training data, and left-to-right (but not right-to-left) composition.
The End of the United Nations?
Authors: Nasu Hitoshi
Published: January 2022

A dynamic shift in global power balance and the rapid pace of technological advances are likely to pose an existential threat to the United Nations (‘UN’) and its collective security system. The political impasse at the Security Council has undermined its ability to address international security crises in recent years. Proceeding with the assumption that the UN collective security system ceases to perform its function, this article provides a thought experiment (Gedankenexperiment) on how international law might operate and evolve in the absence of collective security enforcement. The primary focus of this inquiry is to what extent the fundamental structure of international law might revert to the pre- Charter era and how the modern development of international law achieved under the UN Charter might survive and set a course for normative restructuring. This article tests the hypothesis that the receding institutional capacity to contain destabilising behaviour will have a normative impact on the existing rules of international law, insofar as their modern development has depended upon the institutional framework for collective security. It does so by examining the normative impact in the following three areas of international law: (1) jus ad bellum; (2) the legal authority of regional institutions for collective security; and (3) restrictions on military support to a belligerent involved in international armed conflict under the law of neutrality. It finds that the legal implications of the demise of collective security are likely to be limited, with a gradual shift in State practice and an associated change in opinio juris as States interact with specific instances of security threats.
Resilience in Agroecosystems: An Index Based on a Socioecological Systems Approach
Authors: Suarez-Pardo Andrea , Villegas-Palacio Clara , Berrouet Lina
Published: January 2022

This article presents an agroecosystem resilience index (ARI) relative to two types of exogenous drivers: biophysical and socioeconomic threats. The ARI is based on a theoretical framework of socioecological systems and draws upon multicriteria analysis. The multicriteria consist of variables related to natural, productive, socioeconomic, and institutional systems that are weighted and grouped through expert judgment. The index was operationalized in the Rio Grande basin (RGB), in the Colombian Andes. The ARI was evaluated at the household level using information from 99 RGB households obtained through workshops, individual semistructured interviews, and surveys. The ARI is a continuous variable that ranges between 0 and 1 and results in five categories of resilience: very low, low, medium, high, and very high. When faced with climate change impacts, 19% of households showed low resilience, 64% showed medium resilience, and 16% showed high resilience according to the ARI. When faced with price fluctuations, 23% of households showed low resilience, 65% showed medium resilience, and 11% showed high resilience. Key variables associated with high resilience include the diversity of vegetation cover, households that have forests on their properties, a high degree of connectivity with other patches of forest, diversification of household economic activities, profitability of economic activities, availability of water sources, and good relationships with local institutions.
The Effect of COVID-19 Pandemic on the Global Supply Chain Operations: A System Dynamics Approach
Authors: Heidary Mojtaba Hajian
Published: January 2022

Epidemic outbreaks are one of the important sources of the risk in the global supply chains. Before the COVID-19 pandemic, global industries that were unprepared for disruptions experienced a decline due to the pandemic. A global supply chain is a complex system set of dynamics that could be analyzed by the system dynamics approach. In this article, the impact of the recent pandemic on the global supply chain is simulated in different scenarios. A system dynamic model is developed to carry out the simulations. In order to consider the impact of the pandemic on the exogenous and endogenous variables, a force majeure factor is defined in the model. Global features considered in this article are the export and import operations, the exchange rate and the rate of tariff. In this article, a scenario analysis is performed to analyze two important factors of the global supply chain: force majeure factor and delivery delay. Results showed that improving the flexibility of production capacity is one of the important strategies that global supply chain managers should pursue.

JEL Codes: F23, P45, C15, C63, E37, F17
Study on Stress Management of College Teachers Based on Employee Assistance Program
Authors: Fan Xin
Published: January 2022

Employee assistance program (EAP) is a service mode for organizations to effectively manage employees’ psychology and behavior to improve their work efficiency. As the problems of teachers’ stress and mental health are so serious that cannot be ignored, in order to understand their psychological stress and the demands for EAP, a survey was conducted among 386 college teachers, on their working pressure and pressure management by self-made questionnaires. The results show that besides the interpersonal relationships, teachers in colleges and universities have greater stress and the stress sources are more various, and they are supposed to have stronger subjective needs for the EAP. However, few college teachers have received EAP services, and the teachers who received EAP services are not the most stressed people. Thus, the EAP should be promoted inside universities to provide supportive services for teachers’ career development.
For feminist geographies of austerity
Authors: Hall Sarah Marie
Published: January 2022

Austerity policies and austere socio-economic conditions in the UK have had acute consequences for everyday life and, interconnectedly, the political and structural regimes that impact upon the lives of women and marginalised groups. Feminist geographies have arguably been enlivened and reinvigorated by critical engagements with austerity, bringing to light everyday experiences, structural inequalities and multi-scalar socio-economic relations. With this paper I propose five areas of intervention for further research in this field: social reproduction, everyday epistemologies, intersectionality, voice and silence, and embodied fieldwork. To conclude, I argue for continuing feminist critique and analyses given the legacies and futures of austerity.
The Temporal Relationship Between Self-Acceptance and Generativity over Two Decades
Authors: Joshanloo Mohsen
Published: January 2022

Generativity is defined as a concern for the well-being of future generations, which involves both caring and a will to extend the self into the future. Extant research indicates that generativity plays an important role in successful aging. The present study sought to examine the temporal relationship between self-acceptance and generativity over about 2 decades. The data were drawn from the three waves of the Midlife in the United States (MIDUS) project, collected with intervals of about 10 years ( N = 4,167). The random-intercept cross-lagged panel model was used for data analysis. It was found that self-acceptance prospectively predicted generativity, whereas generativity did not predict self-acceptance. Thus, coming to terms with various aspects of one’s personality and past life contributes to higher future levels of generativity.
‘The Enabling Role of Internal Organizational Communication in Insider Threat Activity – Evidence From a High Security Organization’
Authors: Rice Charis , Searle Rosalind H.
Published: January 2022

This paper explores the role of internal communication in one under-researched form of organizational crisis, insider threat – threat to an organization, its people or resources, from those who have legitimate access. In this case study, we examine a high security organization, drawing from in-depth interviews with management and employees concerning the organizational context and a real-life incident of insider threat. We identify the importance of three communication flows (top-down, bottom-up, and lateral) in explaining, and in this case, enabling, insider threat. Derived from this analysis, we draw implications for communication and security scholars, as well as practitioners, concerning: the impact of unintentional communication, the consequences of selective silence and the divergence in levels of shared understanding of security among different groups within an organization.
Level of Stress and Coping Strategies Seen Among Parents of Neonates Admitted in NICU
Authors: Pathak Geetanjali , Dixit Rahul , Singh Niranjan K. , Vijaywargiya Taruna , Lal Narottam
Published: January 2022

Aim

To assess the level of stress and coping strategies in parents of neonates admitted in Neonatal Intensive Care Unit (NICU) at a tertiary care centre in North India.

Materials and methods

It was a descriptive/observational cross-sectional study of 3 year duration with a sample size of 224. All parents willing to participate and who could understand English or Hindi were included in the study after the informed consent. Stress levels and coping strategies were assessed using a validated questionnaire between 2nd to 7th day of admission. Demographic data was collected and parental stress and coping was quantified using likert scale. The data was analyzed using SPSS Version 20.0.

Results

Most of the parents were moderately stressed (93.3%). The most impactful stress domain was ‘Emotional’ and the most impactful question out of that domain was ‘constant fear of child’s recovery’. Of all the coping strategies, cognitive strategy was mostly used by parents. There was a negative correlation between stress and coping strategies (r = –0.09) but the result was statistically insignificant (p-value = 0.16). Of all the demographic variables, the birth order of the baby was significantly related to stress (p-value < 0.05), while parent’s education, monthly family income and area of residence were significantly related to coping (p-value < 0.05, <0.05 and <0.001, respectively).

Conclusion

Most of the parents were moderately stressed, with cognitive strategy being the most used by parents as the coping mechanism.
Utilizing alkali-activated materials as ordinary Portland cement replacement to study the bond performance of fiber-reinforced polymer bars in seawater sea-sand concrete
Authors: Cao Ruiming , Zhang Bai , Wang Luming , Ding Jianming , Chen Xianhua
Published: January 2022

Alkali-activated materials (AAMs) are considered an eco-friendly alternative to ordinary Portland cement (OPC) for mitigating greenhouse-gas emissions and enabling efficient waste recycling. In this paper, an innovative seawater sea-sand concrete (SWSSC), that is, seawater sea-sand alkali-activated concrete (SWSSAAC), was developed using AAMs instead of OPC to explore the application of marine resources and to improve the durability of conventional SWSSC structures. Then, three types of fiber-reinforced polymer (FRP) bars, that is, basalt-FRP, glass-FRP, and carbon-FRP bars, were selected to investigate their bond behavior with SWSSAAC at different alkaline dosages (3%, 4%, and 6% Na2O contents). The experimental results manifested that the utilization of the alkali-activated binders can increase the splitting tensile strength ( ft) of the concrete due to the denser microstructures of AAMs than OPC pastes. This improved characteristic was helpful in enhancing the bond performance of FRP bars, especially the slope of bond-slip curves in the ascending section (i.e., bond stiffness). Approximately three times enhancement in terms of the initial bond rigidity was achieved with SWSSAAC compared to SWSSC at the same concrete strength. Furthermore, compared with the BFRP and GFRP bars, the specimens reinforced with the CFRP bars experienced higher bond strength and bond rigidity due to their relatively high tensile strength and elastic modulus. Additionally, significant improvements in initial bond stiffness and bond strength were also observed as the alkaline contents (i.e., concrete strength) of the SWSSAAC were aggrandized, demonstrating the integration of the FRP bars and SWSSAAC is achievable, which contributes to an innovative channel for the development of SWSSC pavements or structures.
‘But you’re white’: An autoethnography of whiteness and white privilege in East Asian universities
Authors: Moosavi Leon
Published: January 2022

It is well established within the field of Critical Whiteness Studies that white privilege routinely materialises in Western universities. Yet, even though a third wave of Critical Whiteness Studies is increasingly focussing on whiteness in non-Western contexts, there has been insufficient attention toward whether white privilege also exists in East Asian universities. This article seeks to explore this issue by offering an autoethnography in which the author, a mixed-race academic who is racialised as white on some occasions and as a person of colour on others, critically interrogates whiteness in East Asian higher education. It is argued that those who are racialised as white are privileged in East Asian universities and may even seek to actively sustain this. In departing from the dominant understanding of whiteness as always-and-only privileging, this article also explores the extent to which white academics in East Asia may also be disadvantaged by their whiteness.
Triple combination of BET plus PI3K and NF-κB inhibitors exhibit synergistic activity in adult T-cell leukemia/lymphoma
Authors: Daenthanasanmak Anusara , Bamford Richard N. , Yoshioka Makoto , Yang Shyh-Ming , Homan Philip , Karim Baktiar , Bryant Bonita R. , Petrus Michael N. , Thomas Craig J. , Green Patrick L. , Miljkovic Milos D. , Conlon Kevin C. , Waldmann Thomas A.
Published: January 2022

Adult T-cell leukemia/lymphoma (ATL) is an aggressive T-cell lymphoproliferative malignancy caused by human T-cell leukemia virus type 1 (HTLV-1). ATL is an orphan disease with no curative drug treatment regimens urgently needing new combination therapy. HTLV-1-infected cells rely on viral proteins, Tax and HBZ (HTLV-1-b-ZIP factor), to activate the transcription of various host genes that are critical for promoting leukemic transformation. Inhibition of bromodomain and extraterminal motif (BET) protein was previously shown to collapse the transcriptional network directed by BATF3 super-enhancer and thereby induced ATL cell apoptosis. In the current work, by using xenograft, ex vivo, and in vitro models, we demonstrated that I-BET762 (BETi) synergized with copanlisib (PI3Ki) and bardoxolone methyl (NF-κBi) to dramatically decrease the growth of ATL cells. Mechanistically, the triple combination exhibited synergistic activity by down-regulating the expression of c-MYC while upregulating the level of the glucocorticoid-induced leucine zipper (GILZ). The triple combination also enhanced apoptosis induction by elevating the expression of active caspase-3 and cleaved PARP. Importantly, the triple combination prolonged the survival of ATL-bearing xenograft mice and inhibited the proliferation of ATL cells from peripheral blood mononuclear cells (PBMCs) of both acute and smoldering/chronic ATL patients. Therefore, our data provide the rationale for a clinical trial exploring the multiagent combination of BET, PI3K/AKT, and NF-κB inhibitors for ATL patients and expands the potential treatments for this recalcitrant malignancy.
Growth and chemotaxis of nematodes reduced upon exposure to Third Fork Creek surface water
Authors: Gerald Carresse , Deshazo Boris , Patterson Hayden , Spence Porché
Published: January 2022

Background

Third Fork Creek is a historically impaired urban stream that flows through the city of Durham, North Carolina.Caenorhabditis elegans(C. elegans) are non-parasitic, soil and aquatic dwelling nematodes that have been used frequently as a biological and ecotoxicity model. We hypothesize that exposure to Third Fork Creek surface water will inhibit the growth and chemotaxis ofC. elegans. Using our ring assay model, nematodes were enticed to cross the water samples to reach a bacterial food source which allowed observation of chemotaxis. The total number of nematodes found in the bacterial food source and the middle of the plate with the water source was recorded for 3 days.

Results

Our findings suggest a reduction in chemotaxis and growth on day three in nematodes exposed to Third Fork Creek water samples when compared to the control (pvalue < 0.05). These exploratory data provide meaningful insight to the quality of Third Fork Creek located near a Historically Black University.

Conclusions

Further studies are necessary to elucidate the concentrations of the water contaminants and implications for human health. The relevance of this study lies within the modelC.elegansthat has been used in a plethora of human diseases and exposure research but can be utilized as an environmental indicator of water quality impairment.
Heat shock transcription factor (Hsf) gene family in common bean (Phaseolus vulgaris): genome-wide identification, phylogeny, evolutionary expansion and expression analyses at the sprout stage under abiotic stress
Authors: Zhang Qi , Geng Jing , Du Yanli , Zhao Qiang , Zhang Wenjing , Fang Qingxi , Yin Zhengong , Li Jianghui , Yuan Xiankai , Fan Yaru , Cheng Xin , Du Jidao
Published: January 2022

Background

Common bean (Phaseolus vulgaris) is an essential crop with high economic value. The growth of this plant is sensitive to environmental stress. Heat shock factor (Hsf) is a family of antiretroviral transcription factors that regulate plant defense system against biotic and abiotic stress. To date, few studies have identified and bio-analyzed Hsfs in common bean.

Results

In this study, 30 Hsf transcription factors (PvHsf1–30) were identified from the PFAM database. The PvHsf1–30 belonged to 14 subfamilies with similar motifs, gene structure and cis-acting elements. The Hsf members in Arabidopsis, rice (Oryza sativa), maize (Zea mays) and common bean were classified into 14 subfamilies. Collinearity analysis showed that PvHsfs played a role in the regulation of responses to abiotic stress. The expression of PvHsfs varied across different tissues. Moreover, quantitative real-time PCR (qRT-PCR) revealed that most PvHsfs were differentially expressed under cold, heat, salt and heavy metal stress, indicating that PvHsfs might play different functions depending on the type of abiotic stress.

Conclusions

In this study, we identified 30 Hsf transcription factors and determined their location, motifs, gene structure, cis-elements, collinearity and expression patterns. It was found that PvHsfs regulates responses to abiotic stress in common bean. Thus, this study provides a basis for further analysis of the function of PvHsfs in the regulation of abiotic stress in common bean.
Gender differences in positive screen for depression and diagnosis among older adults in Chile
Authors: Moreno Ximena , Gajardo Jean , Monsalves María José
Published: January 2022

Background

Different factors are associated with late life depression and diagnosis, including gender. It has also been reported that depression among older people is underdiagnosed. As a result, the mental health needs of this group are insufficiently met. The aim of this study was to explore gender differences in the factors associated with positive screens for depression and self-reported diagnosis among older adults in Chile.

Methods

Data from 3786 older adults who participated in the Social Protection Survey in 2016 were analysed. PHQ-9 was used to identify screen-positive cases. Self-reported diagnosis of depression was used to determine the proportion of people with a screen-positive result who had received a diagnosis of depression. Logistic regression models were used to determine sociodemographic and health factors associated with depression and underdiagnosis in older men and women.

Results

The prevalence of a screen-positive result was 20.91% (5.83% major depressive disorder) among men, and 36.38% (12.43% major depressive disorder) among women. 18.77% of men and 34.11% of women with a positive depression screening had received a diagnosis. More educated men were more likely to receive a diagnosis. Older age was associated with a lower probability of diagnosis among older women.

Conclusions

Our results suggest that depressive disorders are undiagnosed in a high proportion of older adults in Chile. Gender is a relevant factor in the underdiagnosis of depression in this group. Further research is needed to understand the factors involved in these gaps, to improve detection and provide timely support and treatment.
Distribution of risk factors of ischemic stroke in Chinese young adults and its correlation with prognosis
Authors: Wu Xiaoke , Zou Yutian , You Shoujiang , Zhang Yanlin
Published: January 2022

Background

The risk factors for ischemic stroke in young people are complex, varied and closely related to prognosis. This study aims to analyze the risk factors for ischemic stroke in Chinese young people and to explore the main factors influencing the prognosis.

Method

A total of 444 patients aged 16 to 45 years with ischemic stroke admitted to Suzhou tertiary hospital from 2011 to 2019 were retrospectively analyzed. Risk factors were identified according to the IPSS definition of pediatric stroke and the TOAST classification. All patients were followed up, and the modified Rankin score was used to evaluate the prognosis. Logistic regression analysis was used to explore the influencing factors of poor prognosis.

Results

Among the patients, 12 risk factors were found according to the IPSS definition of pediatric stroke, and 5 types of stroke were found according to the TOAST classification. A total of 299 patients had a good prognosis. Anemia, venous sinus thrombosis, isolated large-vessel occlusion, and high baseline NIHSS score were significant risk factors.

Conclusion

The IPSS definition enables patients to be classified on the basis of more risk factors than other classification methods. The prognosis of ischemic stroke in young people is generally good in the 5 years following the event. Anemia, venous sinus thrombosis, isolated large-vessel occlusion and high baseline NIHSS score were associated with poor prognosis.
Burden, risk factors and outcomes associated with gestational diabetes in a population-based cohort of pregnant women from North India
Authors: Bahl Stuti , Dhabhai Neeta , Taneja Sunita , Mittal Pratima , Dewan Rupali , Kaur Jasmine , Chaudhary Ritu , Bhandari Nita , Chowdhury Ranadip
Published: January 2022

Background

The burden of gestational diabetes mellitus (GDM) appears to be increasing in India and may be related to the double burden of malnutrition. The population-based incidence and risk factors of GDM, particularly in lower socio-economic populations, are not known. We conducted analyses on data from a population-based cohort of pregnant women in South Delhi, India, to determine the incidence of GDM, its risk factors and association with adverse pregnancy outcomes (stillbirth, preterm birth, large for gestational age babies) and need for caesarean section.

Methods

We analyzed data from the intervention group of the Women and Infants Integrated Interventions for Growth Study (WINGS), an individually randomized factorial design trial. An oral glucose tolerance test (OGTT) was performed at the time of confirmation of pregnancy, and for those who had a normal test (≤140 mg), it was repeated at 24–28 and at 34–36 weeks. Logistic regression was performed to ascertain risk factors associated with GDM. Risk ratios (RR) were calculated to find association between GDM and adverse pregnancy outcomes and need for caesarean section.

Results

19.2% (95% CI: 17.6 to 20.9) pregnant women who had at least one OGTT were diagnosed to have GDM. Women who had prediabetes at the time of confirmation of pregnancy had a significantly higher risk of developing GDM (RR 2.08, 95%CI 1.45 to 2.97). Other risk factors independently associated with GDM were woman’s age (adjusted OR (AOR) 1.10, 95% CI 1.06 to 1.15) and BMI (AOR 1.04, 95% CI 1.01 to 1.07). Higher maternal height was found to be protective factor for GDM (AOR 0.98, 95% CI 0.96 to 1.00). Women with GDM, received appropriate treatment did not have an increase in adverse outcomes and no increased need for caesarean section

Conclusions

A substantial proportion of pregnant women from a low to mid socio-economic population in Delhi had GDM, with older age, higher BMI and pre-diabetes as important risk factors. These findings highlight the need for interventions for prevention and provision of appropriate management of GDM in antenatal programmes.

Clinical trial registration

Clinical Trial Registry – India, #CTRI/2017/06/008908 (http://ctri.nic.in/Clinicaltrials/pmaindet2.php?trialid=19339&EncHid=&userName=society%20for%20applied%20studies).
Association between social phobia and the risk of arrhythmia using the Korean National Sample Cohort: a retrospective cohort study
Authors: Kim Hyunkyu , Jeong Wonjeong , Kim Seung Hoon , Seo Jun Ho , Ryu Jin Sun , Kim You-seok , Seok Jeong-Ho , Jang Sung-In , Park Eun-Cheol
Published: January 2022

Background

Social phobia shares symptoms with arrhythmias, such as palpitations and chest discomfort. However, it is unclear how social phobia is associated with the actual risk of arrhythmia. This study aimed to investigate whether social phobia is associated with the risk of arrhythmia using a nationally representative sample cohort.

Methods

This retrospective cohort study assessed data from the 2002–2013 Korean National Health Insurance Service National Sample Cohort. Using 1:3 propensity score matching for sex, age, income, and insurance status, 1514 patients with social phobia and 4542 control group patients were included in the study. Social phobia and arrhythmia were defined per the International Classification of Diseases, 10th revision. Using cox proportional hazard regression, hazard ratios (HRs) were calculated to estimate the risk of arrhythmia in patients with social phobia.

Results

There were statistically significant associations between social phobia history and elevated risks of arrhythmia. Patients with social phobia had a higher risk of arrhythmia after adjusting with covariates (HR = 1.78, 95%CI = 1.25–2.55). Among different types of arrhythmias, atrial fibrillation and flutter presented the highest risk (HR = 2.20, CI = 1.06–4.57) compared to paroxysmal tachycardia (HR = 1.07, CI = 0.39–2.91) and other cardiac arrhythmias (HR = 1.83, CI = 1.16–2.89).

Conclusion

This study identified the association between social phobia and the risk of arrhythmia in a South Korean representative cohort. These results suggest that social phobia should be treated properly to reduce arrhythmia risks.
Factors associated with food safety compliance among street food vendors in Can Tho city, Vietnam: implications for intervention activity design and implementation
Authors: Huynh-Van Ba , Vuong-Thao Vy , Huynh-Thi-Thanh Tuyen , Dang-Xuan Sinh , Huynh-Van Tung , Tran-To Loan , Nguyen-Thi-Thao Nguyen , Huynh-Bach Cuc , Nguyen-Viet Hung
Published: January 2022

Background

Street food plays a valuable role in several Asian countries including Vietnam. Improving the safety of street food is an important responsibility for many local food authorities. This study aims to characterize the business profile of fixed and mobile street food vendors, and to compare their compliance with the food safety criteria.

Methods

A cross-sectional study was conducted using a questionnaire and observational checklist to assess the ten Vietnamese food safety criteria prescribed under Decision No. 3199/2000/QD-BYT for street food vendors in Can Tho city. A total of 400 street food vendors, composed of fixed and mobile vendors, in urban areas of the city were randomly selected for the survey.

Results

The study showed significant differences between the two types of street food vendors in educational level (p= 0.017); business profile, including types of foods vended, area in use, number of employees, training in food safety, and business registration paperwork; and the status of compliance with the ten-food hygiene and safety criteria (p< 0.01). Poisson regression analysis found that education attainment (IRR = 1.228,p= 0.015), food safety training (IRR = 4.855,p< 0.01), total business capital (IRR = 1.004, p = 0.031) and total area in use (IRR = 1.007,p= 0.001) appeared to be significantly positively associated with food safety and hygiene compliance. In contrast, mobile vending type was negatively associated with the likelihood of adhering to the ten criteria (IRR = 0.547,p= 0.005).

Conclusions

These findings emphasize the need for training and education programs to improve food safety knowledge and practice among street food vendors. Basic infrastructure and services, especially clean water, proper sanitation, and waste disposal facilities, should be provided to help street food vendors better practice food safety and hygiene regulations.
The burden of diarrhea, etiologies, and risk factors in India from 1990 to 2019: evidence from the global burden of disease study
Authors: Behera Deepak Kumar , Mishra Sanghamitra
Published: January 2022

Background

This study aims to measure the burden of diarrhea in India and analyze the trend of mortality associated with it for the past 30 years. We also intend to find the prevailing etiology and risk factors associated with diarrheal mortality in India.

Methods

The study has used the latest round of Global Burden of Disease (GBD) study-2019. GBD data is available across age groups and gender-wise over the period from 1990 to 2019. The study has identified 13 etiologies for the cause of diarrhea deaths and 20 risk factors to analyze the burden of disease.

Results

Our study shows, childhood diarrhea has declined over the years significantly, yet contributes to a larger share of DALYs associated with the disease. Among all the death cases of Diarrhea, in 2019, the most prevalent disease-causing pathogen is found to be Campylobacter. But Adenovirus is the major contributor to childhood diarrheal deaths. Though the burden of diarrhea is declining over the period, still there is a need to progress the interventions to prevent and control diarrhea rapidly to avoid the huge number of deaths and disabilities experienced in India.

Conclusions

Consumption of safe and clean water, proper sanitation facility in every household, required nutrition intake by mother and child, safe breastfeeding and stool disposal practices and careful case management, rotavirus vaccination are some of the effective interventions to be implemented all over the country. Further, evidence-based policies should be made and implemented to sustain diarrhea prevention programs.
Orientation of medical trainees to a new clinical environment (the ready-steady-go model): a constructivist grounded theory study
Authors: Wiese Anél , Bennett Deirdre
Published: January 2022

Background

High-quality orientation of trainees entering a new clinical workplace is essential to support education and patient safety. However, few consultants receive extensive formal training to support new trainees and must create their own ways of integrating newcomers into their clinical team and work environment. We aim to conceptualise the strategies consultants use in the early stages of working with new trainees that will be useful for future faculty development in this area.

Methods

We used constructivist grounded theory (CGT) methodology by interviewing fifteen consultants in three medical specialties, to explore how trainees are integrated into a new clinical environment. We used CGT principles and procedures (iteration, constant comparison, and theoretical sampling) to analyse and construct a conceptual interpretation of the empirical data.

Results

Consultants’ central concern when introduced to a new cohort of trainees was that they had the required knowledge and skills (ready), were adapted and integrated into the new workplace and clinical team (steady), and safely participating in practice (go). Consultants used two broad strategies: formal orientation and informal orientation. Both these approaches had the common goal of intensifying interaction between consultants and trainees to get trainees to a position where they were ready, adapted, integrated, and participating safely and efficiently in practice. Several disruptors were identified by participants that delayed and sometimes completely inhibited the orientation process.

Conclusions

The model of orientation constructed through this research could be a valuable tool to support faculty development initiatives, the reflective learning practice of clinical supervisors, and curriculum design. The disruptors were identified as valid priorities for improving trainee orientation in postgraduate medical education. Future research should involve a longitudinal approach to explore trainee engagement with orientation upon entering a new clinical workplace.