bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Shattered Assumption Theory to Understand How Cyberbullying Victimization is Linked With Perceived Control Among Chinese College Students
Authors: Wang Hongxia , Zhou Li , Lei Li
Published: August 2021

Perceived control (PC) is considered as one of the most basic psychological needs of human beings, and it is also an important index to measure individual mental health. Previous studies have shown that negative life experience is an important risk factor for predicting PC. With the prevalence of cyberbullying among college students, this study explored how cybervictimization (CV) was related to the PC, mediated through the personal belief in a just world (PBJW). Besides, this study examined the moderating role of interpersonal forgiveness (IF) in the direct relationship between CV and PC and the indirect connection through PBJW. It was expected that CV would negatively predict the PC, and the PBJW would mediate this relationship. The direct and indirect effects were stronger in individuals with low IF than those with high IF. In this study, 837 Chinese college students were invited to conduct an online survey using a convenient sampling method. Participants were asked to complete the measurement of CV, PBJW, IF, and PC. After controlling gender and age, the results revealed that CV could directly and negatively predict college students’ PC and indirectly predict the PC through the mediation of PBJW. Additionally, IF moderated the effect of CV on PBJW and PC. Unlike what we expected, the effect of CV on PBJW was stronger for low IF individuals than those with high IF, while the effect of CV on PC was stronger for high IF individuals than those with low IF. The unexpected orientation and other results were discussed.
Childhood memories of belonging among young Romanian migrants in Italy: A qualitative life-course approach
Authors: Scutaru Beatrice
Published: August 2021

This article uses a life-course approach to investigate how and why migrants’ feelings of belonging change between childhood and young adulthood. Drawing on 24 in-depth retrospective interviews with young Romanian migrants who moved to Italy as children, the paper shows how young migrants’ belonging is shaped by the nature of social relations and by the level of acceptance or exclusion expressed by others in the receiving and origin countries, under specific institutional and socioeconomic contexts. Overall, the study demonstrates how life-course methodologies are an essential tool to capture the dynamic, changing nature of belonging.
Visualization of wheel-rail contact area of running vehicle using film sensor
Authors: Fukagai Shinya , Toyama Takashi , Tanaka Takayuki , Kuzuta Masahito , Doi Hisayo
Published: August 2021

Proper evaluation of the wheel-rail contact is necessary to understand the dynamics of railway vehicles and the causes of wear and damage to components such as wheels and rails. Numerical methods are often used to evaluate the dynamic contact condition between the wheel and rail; however, there are few promising methods for experimental evaluation. It is important to develop a measurement method because the wheel-rail contact is easily changed owing to vehicle-track dynamic interactions. In this study, we used a film-based pressure sensor equipped with force-sensitive resistors to measure the contact area between the wheel and rail during vehicle operation. Using the film-based pressure sensor, we evaluated the geometry of the contact area and position. The validity of the measured contact position is evaluated by comparing it with the contact position based on the cross-sectional profiles of the wheel and rail and the wheelset displacement during a vehicle running.
Novel approach for validation of innovative modules for railway traffic management systems in a virtual environment
Authors: Liu Jin , Ulianov Cristian , Hyde Paul , Ruscelli Anna Lina , Cecchetti Gabriele
Published: August 2021

To increase operational efficiency, resilience and capacity of the railway system, the development of modern railway traffic management system (TMS) has attracted more and more attention in recent years. To support the development and implementation of the next generation of TMS and related applications, advanced data collection, transmission and processing approaches, digitalised databases, and virtual validation platforms, etc., are required. In the context of the TMS development (addressed by Technology Demonstrator 2.9 of Shift2Rail Innovation Programme 2), this support is to be provided by a scalable, interoperable and standardised communication platform for internal and external communication between different subsystems, applications and clients. This paper outlines the approach of the ongoing OPTIMA project aimed to develop a communication platform demonstrator for railway TMS based on a novel Integration Layer (IL) and its various interfaces to entities including integration layer services, TMS service, rail business service, external services and operator workstations. Further detailed discussion in this paper relates to the approach to validating the communication platform demonstrator as a functional entity, and as a virtual testing environment to validate railway traffic management and other applications. The validation approach for the applications tested on the communication platform demonstrator is also presented. The results of future implementation of this validation approach will be used to assess the functionality of the communications platform demonstrator developed, and the initial TMS applications tested on it, and form an important step towards developing and implementing IL based communications platforms for future TMSs.
Ideological Extremism Among Syrian Refugees Is Negatively Related to Intentions to Migrate to the West
Authors: Jasko Katarzyna , Webber David , Molinario Erica , Kruglanski Arie W. , Touchton-Leonard Katharine
Published: August 2021

The conflict in Syria created a dire humanitarian situation, as nations around the world struggled with how best to deal with the more than 6.6 million Syrian refugees who fled their homes to escape aggression. Resistance to granting refugee status to individuals often originates in the belief that the influx of refugees endangers national security because of the presumably extremist religious and political beliefs that refugees hold. The present research surveyed Syrian refugees residing in Jordan, Lebanon, Turkey, and Iraq ( N = 1,000). The results revealed that the majority of surveyed refugees did not intend to migrate to the West and would rather return to their home country. More importantly, refugees most interested in moving to Western countries were the least likely to subscribe to Islamist extremism or to harbor negative sentiment toward the West. Theoretical and practical implications for addressing the current refugee crisis are discussed.
Eco-martyrdom: Positive elements of self-sacrifice
Authors: Bargdill Richard W. , Lankford Alan H. C. , Creed Rachel M. , Purrington William R. , Rios-Santos Kelly S. , Latourette Christopher T. , Guz-Montgomery Johanna B.
Published: August 2021

This theoretical article briefly explores the historical and modern concept of martyrdom and how it has taken on its current negative connotation due to suicide bombings after 9/11. The paper will review the literature on this more heavily studied form of martyrdom and then distinguish it from the less well-known area of “positive self-sacrifice.” The article asserts that this positive form is exemplified by the behavior of eco-martyrs: people who have given their life to protect the environment from further devastation. The paper will include the case of slain trade union leader and environmental activist Chico Mendes. Chico is an exemplar of the positive self-sacrifice seen in many eco-martyrs. Positive self-sacrifice is defined as prosocial and altruistic actions exhibited by a person who is so fused with their community’s survival that they focus on nothing but the well-being of the community (counterfinality). Since their community’s struggle is tied to an environmental conflict, they abide by an ecological self (humans are not superior to other beings) and over time display evidence of self-actualization and self-transcendence. Eco-martyrs are typically assassinated by the powerful organizations that they have been resisting.
The divergent narratives and strategies of unions in times of social-ecological crises: fracking and the UK energy sector
Authors: Kreinin Halliki
Published: August 2021

The issue of fracking highlights the variability of trade union approaches to the environment in the UK energy sector, as reflected in their narratives and strategic organising orientations. Stories alone cannot change the material interests underlying complex societal conflicts, yet transformative policies on the climate crisis cannot emerge without a coherent story about the environmental crises and possible solutions. This article uses unions’ positions on fracking as a proxy for opposing/supporting/hedging against climate action to see how divergent positions amongst the UK’s three biggest unions in the energy sector (UNISON, Unite and GMB) and the TUC are reinforced or challenged by internal union narratives and strategic foci. Drawing on four in-depth expert interviews and 148 union documents, the main union narratives and strategies are analysed and clustered. The article’s key insight is that unions’ specific narratives differ depending on a union’s orientation. Pro-fracking unions address the short-term immediate financial and material concerns of members and hence promote business partnerships, while anti-fracking unions develop broad-based grass-roots alliances to address the climate crisis. The key entry point for transformative coalitions lies in promoting a coherent and positive narrative about transformative change, in line with scientific evidence.
A Systematic Review of Parenting Scales Measurement Invariance/ Equivalence of by Race and Ethnicity: Recommendations for Inclusive Parenting Research
Authors: Rodriguez Violeta J. , La Barrie Dominique L. , Zegarac Miriam C. , Shaffer Anne
Published: August 2021

The limited inclusion of racial/ethnic minorities in the development and validation of parenting measures limits our understanding of whether parenting constructs are valid in racial and ethnic minorities. Tests of measurement invariance/equivalence (MI/E) of parenting measures can help evaluate the validity of parenting constructs among racial/ethnic minorities. This systematic review summarized studies on MI/E of parenting constructs by race/ethnicity and evaluated the strength of the evidence. A literature search was conducted using various databases and references to retrieve studies from the United States. Indeed, 10 studies were identified that tested for MI/E of eight parenting scales by race/ethnicity. Only one scale showed moderate evidence of MI/E, five showed weak evidence of MI/E, and two showed no evidence of MI/E. Most studies (80%) used factor analytic methods to test for MI/E, but only two studies (20%) examined all levels of invariance. These findings show that differences exist in how racial/ethnic minorities perceive parenting constructs. Further research is needed to develop more inclusive parenting measures, to protect against the ways in which biased measures may pathologize or misrepresent parenting practices among racial/ethnic minorities.
Chronic condition self-management is a social practice
Authors: Franklin Marika , Willis Karen , Lewis Sophie , Smith Lorraine
Published: August 2021

Self-management is widely promoted in Western health care policies as a way to address the impact of increasing rates of chronic conditions on health care systems. Mostly informed by psychological theories, self-management frameworks and interventions tend to target individual behaviours as demarcated from the many aspects of social life shaping these behaviours. Using Bourdieu’s theory of practice, we develop four propositions for a relational and socially situated (re)conceptualisation of self-management. First, self-management is a field with its own distinctive logics of practice; second, self-management goals are social practices, emerging through co-constituted patient–professional interactions; third, self-management is energised by legitimised capital; and fourth, what goals feel possible are shaped through embodied knowledge and lived experience (habitus), linked to capital. Collectively these propositions enable focus on both the meanings and resources patients and professionals bring to self-management, along with the dynamic and relational ways goals are produced through patient–professional interactions within the broader field of health care.
Examining the impact of daily exposure to body-positive and fitspiration Instagram content on young women’s mood and body image: An intensive longitudinal study
Authors: Fioravanti Giulia , Svicher Andrea , Ceragioli Giulia , Bruni Viola , Casale Silvia
Published: August 2021

The aim of the present study is to investigate the effect of daily exposure to body-positive and fitspiration Instagram posts on young women’s mood, body satisfaction, and appearance comparison tendency. One hundred and twenty-two young Italian women (Mage = 22.29 ± 2.26 years) were randomly assigned to three different conditions of daily exposure on Instagram (i.e., body-positive, fitspiration and neutral content) and followed with an experience sampling method over a period of 28 consecutive days. Comparisons between groups were performed via multilevel regression modelled as a linear growth model. Results showed that daily exposure to body-positive images was associated with the highest rates of growth of positive mood and body satisfaction. Daily exposure to fitspiration images was associated with the highest rates of growth of negative mood and appearance comparison. In conclusion, the body-positive movement may be considered in interventions aimed at improving young women’s body image. Fitspiration content on Instagram should be deemed inappropriate.
The Elephant in the Room in Presidential Politics: Informal Powers in Western Europe
Authors: Grimaldi Selena
Published: August 2021

Presidents’ informal powers remain under-investigated especially in Western European democracies. This gap might hamper the full understanding of how presidents ultimately behave and act. The objective of this article is twofold. First, it aims at adopting a definition of presidents’ informal powers by distinguishing them from formal ones and from informal institutions. Second, it distinguishes among different kind of informal powers by focusing on why presidents use them. To this end, a typology based on the following two criteria is proposed: (1) the existence of formal powers at disposal of the president in a specific sphere and (2) the evaluation of public support each individual president thinks to enjoy should they act or refrain. Four types of informal powers can be derived from these dimensions: substitutive informal powers, parallel informal powers, risk-taking informal powers and subverting informal powers.
We Have It Totally Under Control? Exploring the Effects of Ideology and Knowing Someone Diagnosed With COVID-19 on Evaluations of President Trump’s Leadership on the Pandemic
Authors: Byers Jason S. , Shay Laine P.
Published: August 2021

President Donald Trump has made various decisions, many controversial, to manage the coronavirus pandemic. The reaction to President Trump’s leadership has been met with a mixed response from the public. This raises an important question; what factors influence a citizen’s evaluation of President Trump’s response to the pandemic? We develop a theory that links a citizen knowing someone diagnosed with COVID-19 with their evaluation of President Trump’s management of the pandemic, with the expectation that this relationship is conditioned by a citizen’s ideology. Using data from two surveys, we find that knowing someone diagnosed with COVID-19 diminishes the effect ideology has on a citizen’s evaluation. Additionally, we find that a citizen’s evaluation of President Trump’s leadership on COVID-19 is associated with their vote choice in the 2020 U.S. Presidential Election. Overall, this article contributes to our understanding of public opinion on COVID-19 and its political ramifications.
Normative intercapillary distance and vessel density data in the temporal retina assessed by wide-field spectral-domain optical coherence tomography angiography
Authors: Liu Keke , Guo Yukun , You Qisheng , Hormel Tristan , Hwang Thomas S , Jia Yali
Published: August 2021

A limitation of conventional optical coherence tomography angiography (OCTA) is the limited field of view normally used in data acquisition. As the technology improves, larger fields of view that capture information away from the macular are being explored in order to provide an enhanced ability to detect pathology. However, normative measurements for important OCTA metrics like vessel density and intercapillary distance are not currently well-characterized in the peripheral retina. In this prospective study, we measured vessel density and intercapillary distance of the superficial vascular complex, ganglion cell layer plexus, and deep capillary plexus in montaged macular/temporal scans from 53 (33 men) healthy volunteers. Vessel density and intercapillary distance were also compared across different regions of the retina, including along arcs at separate distance from the fovea. Compared to the central macular region, the temporal retina had significantly lower vessel density, decreased thickness, and greater intercapillary distance in the superficial vascular complex, GCLP ganglion cell layer plexus, and deep capillary plexus (Wilcoxon rank sum test P < 0.001), with each of the plexuses examined here showing a general decrease in vessel density and an increase in intercapillary distance towards the temporal region. No significant difference was noted comparing corresponding vessel density and intercapillary distance regions above and below the macula, and multiple linear regression showed that age and intraocular pressure were not associated with vessel density and intercapillary distance in most models. Repeatability analysis reported as intraclass correlation coefficients demonstrated moderate to excellent reliability of vessel density and intercapillary distance in all OCTA layers. These results should help provide an enhanced baseline to help identify vascular pathology in the peripheral retina.
Moving people: Proper distance and global news coverage of migration in 2019
Authors: Robertson Alexa , Schaetz Nadja
Published: August 2021

Moving people comprise both a subject of news reports (of refugees, migrants and other people-on-the-move) and a way of reporting on the issues involved. Viewers can be moved and placed in a discursive relation to the displaced when news stories construct what Arendt called ‘proper distance’. This possibility is explored in the article, which compares coverage of migration issues in 2019 on four global television news channels: Al Jazeera English, BBC World, CNN International and RT. The results provide evidence of approaches that differ in striking and thought-provoking ways, giving global television news consumers different resources for making sense of a complicated global crisis.
The adaptability of Monday.com’s app-based software: Discover the company building a flexible business model that adapts to individual company needs
Authors: Manko Barbara A
Published: August 2021

The tools of running a business are big business themselves. Finding a way to efficiently streamline processes could save time, effort, and money, but getting to that point often requires retraining and fitting the process to the software rather than the software to the process. Having an all-in-one platform that adapts to business needs is the novel way some companies have begun to approach productivity tools, with Monday.com being a prime example of where the technology is leading. An easy-to-use interface depends on the user’s ability to grasp its setup, and by making an app-based platform, the founders are capitalizing on the iPhone generation. Monday.com is a prime example of a business offering a product for other businesses, and studying how they developed their software not only allows students to understand how such a tool can be useful in running a business, but also the innovative process behind creating a whole new way to do business.
Incorporating Acupuncture Into American Healthcare: Initiating a Discussion on Implementation Science, the Status of the Field, and Stakeholder Considerations
Authors: Miller David W. , Roseen Eric J. , Stone Jennifer A.M. , Gardiner Paula , Olson Juli , Rosen Shellie , Wayne Peter , Davis Robert , Coeytaux Remy ,   on behalf of the PCORI-SAR Stakeholder Group
Published: August 2021

Introduction

The field of implementation science is the study of methods that promote the uptake of evidence-based interventions into healthcare policy and practice. While acupuncture has gained significant traction in the American healthcare landscape, its journey has been somewhat haphazard and non-linear.

Methods

In June 2019, a group of thirty diverse stakeholders was convened by the Society for Acupuncture Research with the support of a Patient Centered Outcomes Research Institute, Eugene Washington Engagement Award. This group of stakeholders represented a diverse mix of patients, providers, academicians, researchers, funders, allied health professionals, insurers, association leaders, certification experts, and military program developers. The collective engaged in discussion that explored acupuncture’s status in healthcare, including reflections on its safety, effectiveness, best practices, and the actual implementation of acupuncture as seen from diverse stakeholder viewpoints.

Objectives

A primary goal was to consider how to utilize knowledge from the field of implementation science more systematically and intentionally to disseminate information about acupuncture and its research base, through application of methods known to implementation science. The group also considered novel challenges that acupuncture may present to known implementation processes.

Findings

This article summarizes the initial findings of this in-person meeting of stakeholders and the ongoing discussion among the subject matter experts who authored this report. The goal of this report is to catalyze greater conversation about how the field of implementation science might intersect with practice, access, research, and policymaking pertaining to acupuncture. Core concepts of implementation science and its relationship to acupuncture are introduced, and the case for acupuncture as an Evidence Based Practice (EBP) is established. The status of the field and current environment of acupuncture is examined, and the perspectives of four stakeholder groups––patients, two types of professional practitioners, and researchers––are explored in more detail.
The Good Place in Your Classroom: Recommendations for Teaching Management Ethics
Authors: van Esch Chantal , Tarr Emily , Frye John
Published: August 2021

The sitcom The Good Place can be used by management instructors to teach ethical frameworks and concepts. This series, familiar to many undergraduate students in the US, features a Professor of Ethics and Moral Philosophy who gives mini lectures applied to what the characters are experiencing. These mini lectures can be shown to undergraduates studying ethics in a full course or as a subsection of courses such as management, organizational behavior, or leadership. This article provides information on particular clips that management instructors can use, recommendations for discussion topics with prompts provided, and a comparative pedagogical analysis of using this resource.
Implementation and evaluation of a good prescribing tip email to reduce junior doctors' prescribing errors
Authors: Cooper Suzanne M , Fitzpatrick Raymond W
Published: August 2021

Background

Prescribing errors are common, occurring in 7% of in-patient medication orders in UK hospitals. Foundation Year 1 (F1) doctors have reported a lack of feedback on prescribing as a cause of errors.

Aim

To evaluate the effect of implementing a shared learning intervention to Foundation Year 1 doctors on their prescribing errors.

Methods

A shared learning intervention, ‘good prescribing tip’ emails, were designed and sent fortnightly to F1s to share feedback about common/serious prescribing errors occurring in the hospital. Ward pharmacists identified prescribing errors in newly prescribed in-patient and discharge medication orders for 2 weeks pre- and post-intervention during Winter/Spring 2017. The prevalence of prescribing errors was compared pre- and post-intervention using statistical analysis.

Results

Overall, there was a statistically significant reduction ( p < 0.05) in the prescribing error rate between pre-intervention (441 errors in 6190 prescriptions, 7.1%) and post-intervention (245 errors in 4866 prescriptions, 5.0%). When data were analysed by ward type there was a statistically significant reduction in the prescribing error rate on medical wards (6.8% to 4.5%) and on surgical wards (8.4% to 6.2%).

Conclusions

It is possible to design and implement a shared learning intervention, the ‘good prescribing tip’ email. Findings suggest that this intervention contributed to a reduction in the prevalence of prescribing errors across all wards, thereby improving patient safety.
Arthroscopic Repair of the Bankart Lesion Using Dual-Row Labral Repair
Authors: Loh Bryan , Lie Denny Tjiauw Tjoen
Published: August 2021

Background:

The most common technique described for bankart repair is the single-row labral repair. Recent interest has been the use of a dual-row, double pulley technique, first described by Zhang et al and popularized by Millett et al as the “bony Bankart bridge” technique. The aim of this study is to report a double-row all-suture labral fixation technique using knotless anchors.

Technique:

Step 1: glenohumeral debridement, and preparation of the glenoid labral and Bankart. The patient is first placed in the beach-chair position and surface landmarks are created. The standard posterior portal is first created and the glenohumeral joint is evaluated. Once the lesion is identified, the relevant working anterosuperior and anteroinferior portals are established using the outside-in technique. The synovitis is debrided to allow visualization and the labrum is liberated from the anterior glenoid. The Bankart lesion fragment is liberated, and partial fragments are osteotomized. With the anterolateral portal as the viewing portal, the anterior rim of the glenoid is now decorticated using a motorized shaver and rasp to create a bleeding bony surface. Step 2: the low rim anchor (5:30 o’clock). At the anterior-inferior aspect of the glenoid, the drill guide is positioned as low as possible (5:30 o’clock position for the right shoulder) and about 7 to 10 mm medial to the rim of the glenoid. The first 1.8 mm single-loaded suture anchor (Q-FIX All-Suture Anchor) is then inserted via the posterior portal. Step 3: the anterior-inferior-medial (AIM) anchor (4 o’clock). Step 4: the knotless high rim anchor (3 o’clock). Step 5: tying of sutures. The sutures from each anchor are tied in a mattress configuration, eventually creating a suture bridge over the labral repair

Discussion/Conclusion:

This dual row labral repair technique allows for maximum compression and contact between the fragment and the glenoid bed, allowing healing over a contact area rather than just the rim. The other added advantage is the use of curved tip anchors which allow negotiation of difficult corners, especially in the 5 to 6 o’clock position.
Development of a competency model for general practitioners after standardized residency training in China by a modified Delphi method
Authors: Wei Yun , Wang Feiyue , Pan Zhaolu , Wang Meirong , Jin Guanghui , Liu Yanli , Lu Xiaoqin
Published: August 2021

Background

The “5 + 3” residency training is the main stream general practitioner training program in China. However, a competency model is absent for evaluating the clinical competence attained by general practitioners after training. This study was conducted to develop a consensus set of competencies for general practitioners after standardized residency training in China.

Methods

A modified Delphi process was deployed to develop the competency model, including two stages: (1) generation of an initial set of competencies derived from literature review, behavioral observation of GP–patient consultations, and critical incidents interview of GPs; (2) a 2-round, web-based Delphi survey of experts in general practice, selected using purposive sampling, to prioritize and gain consensus on the essential competencies of GPs.

Results

From literature review, behavioral observation, and critical incidents interview, 46 competencies in 7 domains were identified. After two rounds of Delphi survey of 28 participants (the mean age was 47.9 [9.3] years and 64.3% were women) representing a range of health professionals (GPs, managers, and researchers), a consensus was reached on 50 competencies categorized into 7 domains.

Conclusion

A consensus-based competency model for general practitioners in China has been identified which may be used to evaluate the general practitioners’ clinical competence after standardized training.
A rare case of nivolumab-related myasthenia gravis and myocarditis in a patient with metastatic gastric cancer
Authors: Komatsu Masaru , Hirai Motoharu , Kobayashi Kazuaki , Hashidate Hideki , Fukumoto Junki , Sato Aki , Usuda Hideki , Tanaka Komei , Takahashi Kazuyoshi , Kuwabara Shirou
Published: August 2021

Background

Although rare, several immune-related adverse effects can be life-threatening. Here, we describe a metastatic gastric cancer patient presenting with nivolumab-related myasthenia gravis and myocarditis, a previously unreported adverse effect of gastric cancer treatment.

Case presentation

A 66-year-old man with metastatic gastric cancer visited the emergency department because of dizziness after the first dose of nivolumab. Diagnoses of nivolumab-related myasthenia gravis and myocarditis were established. Myocardial biopsy results and anti-acetylcholine receptor antibody positivity confirmed the diagnoses. Despite plasma exchange and intravenous methylprednisolone and immunoglobulin administration, the patient’s general condition gradually worsened, and he died.

Conclusions

Strict monitoring for cardiac and neuromuscular symptoms after nivolumab administration is necessary to rapidly treat these adverse effects.
SARS-CoV-2 identified by transmission electron microscopy in lymphoproliferative and ischaemic intestinal lesions of COVID-19 patients with acute abdominal pain: two case reports
Authors: Martin-Cardona Albert , Lloreta Trull Josep , Albero-González Raquel , Paraira Beser Marta , Andújar Xavier , Ruiz-Ramirez Pablo , Tur-Martínez Jaume , Ferrer Carme , De Marcos Izquierdo José Angel , Pérez-Madrigal Anna , Goiburú González Laura , Espinós Perez Jorge , Esteve Maria
Published: August 2021

Background

SARS-CoV-2 may produce intestinal symptoms that are generally mild, with a small percentage of patients developing more severe symptoms. The involvement of SARS-CoV-2 in the physiopathology of bowel damage is poorly known. Transmission electron microscopy (TEM) is a useful tool that provides an understanding of SARS-CoV-2 invasiveness, replication and dissemination in body cells but information outside the respiratory tract is very limited. We report two cases of severe intestinal complications (intestinal lymphoma and ischaemic colitis) in which the presence of SARS-CoV-2 in intestinal tissue was confirmed by TEM. These are the first two cases reported in the literature of persistence of SARS-CoV-2 demonstrated by TEM in intestinal tissue after COVID 19 recovery and SARS-CoV-2 nasopharyngeal clearance.

Case presentation

During the first pandemic peak (1st March–30th April 2020) 932 patients were admitted in Hospital Universitari Mútua Terrassa due to COVID-19, 41 (4.4%) required cross-sectional imaging techniques to assess severe abdominal pain and six of them (0.64%) required surgical resection. SARS-CoV-2 in bowel tissue was demonstrated by TEM in two of these patients. The first case presented as an ileocaecal inflammatory mass which turned to be a B-cell lymphoma. Viral particles were found in the cytoplasm of endothelial cells of damaged mucosa. In situ hybridization was negative in tumour cells, thus ruling out an oncogenic role for the virus. SARS-CoV-2 remained in intestinal tissue 6 months after nasopharyngeal clearance, suggesting latent infection. The second patient had a severe ischaemic colitis with perforation and SARS-CoV-2 was also identified in endothelial cells.

Conclusions

Severe intestinal complications associated with COVID-19 are uncommon. SARS-CoV-2 was identified by TEM in two cases, suggesting a causal role in bowel damage.
Paraoxonase 1 gene (PON1) variants concerning hepatitis C virus (HCV) spontaneous clearance in hemodialysis individuals: a case–control study
Authors: Grzegorzewska Alicja E. , Mostowska Adrianna , Warchoł Wojciech , Jagodziński Paweł P.
Published: August 2021

Background

To explore associations between PON1 rs854560, rs662, 705,379, HCV clearance, and interactions between tested PON1 single nucleotide variants (SNVs) and interferon-λ4 gene (IFNL4) rs368234815 variant in hemodialyzed individuals.

Methods

The study included 83 HD individuals who spontaneously resolved HCV infection (all had known IFNL4 rs368234815 variant) and 104 individuals with persistently positive blood tests for HCV RNA (102 were IFNL4 rs368234815 variant successfully genotyped). We genotyped PON1 by high-resolution melt analysis (rs662) or predesigned TaqMan SNV Genotyping Assay (rs854560, rs705379). We used a logistic regression model to assess the association between genetic data and HCV outcome while adjusting for clinical confounding variables. Epistatic interactions between tested PON1 SNVs and IFNL4 rs368234815 were analyzed by the multifactor dimensionality reduction method.

Results

In the recessive inheritance model, PON1 rs662 GG (OR 9.94, 95% CI 1.20–82.7, P = 0.022) and rs854560 TT (OR 4.31, 95% CI 1.62–11.5, P = 0.003) genotypes were associated with a higher probability for HCV clearance. The haplotype composed of rs662A_rs854560A_rs705379 was not associated with spontaneous HCV clearance. The IFNL4 rs368234815 TT/TT variant was equally distributed among individuals bearing different PON1 SNVs. The epistatic gene–gene analysis did not reveal the interaction between tested PON1 SNVs and IFNL4 rs368234815 (P = 0.094). Regression model, including the PON1 rs662 GG genotype, the PON1 rs854560 genotype, the IFNL4 rs368234815 TT/TT genotype, age at RRT onset, RRT duration, and chronic glomerulonephritis as possible explanatory variables for spontaneous HCV clearance, showed that significant predictors of spontaneous HCV clearance were the IFNL4 rs368234815 TT/TT genotype (OR 2.607, 95% CI 1.298—5.235, P = 0.007), PON1 rs854560 TT (OR 6.208, 1.962–19.644, P = 0.002), PON1 rs662 GG (OR 10.762, 1.222–94.796, P = 0.032), and RRT duration (OR 0.930, 95% CI 0.879–0.984, P = 0.011).

Conclusion

In HD individuals, PON1 rs662 GG and rs854560 TT are associated with a higher frequency of spontaneous HCV clearance.
Genome-wide profiling of alternative splicing in glioblastoma and their clinical value
Authors: Li Youwei , Guo Dongsheng
Published: August 2021

Background

Alternative splicing (AS), one of the main post-transcriptional biological regulation mechanisms, plays a key role in the progression of glioblastoma (GBM). Systematic AS profiling in GBM is limited and urgently needed.

Methods

TCGA SpliceSeq data and the corresponding clinical data were downloaded from the TCGA data portal. Survival-related AS events were identified through Kaplan–Meier survival analysis and univariate Cox analysis. Then, splicing correlation network was constructed based on these AS events and associated splicing factors. LASSO regression followed by multivariate Cox analysis was performed to validate independent AS biomarkers and to construct a risk prediction model. Enrichment analysis was subsequently conducted to explore potential signaling pathways of these AS events.

Results

A total of 132 TCGA GBM samples and 45,610 AS events were included in our study, among which 416 survival-related AS events were identified. An AS correlation network, including 54 AS events and 94 splicing factors, was constructed, and further functional enrichment was performed. Moreover, the novel risk prediction model we constructed displayed moderate performance (the area under the curves were > 0.7) at both one, two and three years.

Conclusions

Survival-related AS events may be vital factors of both biological function and prognosis. Our findings in this study can deepen the understanding of the complicated mechanisms of AS in GBM and provide novel insights for further study. Moreover, our risk prediction model is ready for preliminary clinical applications. Further verification is required.
Fine particulate matter constituents associated with emergency room visits for pediatric asthma: a time-stratified case–crossover study in an urban area
Authors: Ho Yu-Ni , Cheng Fu-Jen , Tsai Ming-Ta , Tsai Chih-Min , Chuang Po-Chun , Cheng Chi-Yung
Published: August 2021

Background

Global asthma-related mortality tallies at around 2.5 million annually. Although asthma may be triggered or exacerbated by particulate matter (PM) exposure, studies investigating the relationship of PM and its components with emergency department (ED) visits for pediatric asthma are limited. This study aimed to estimate the impact of short-term exposure to PM constituents on ED visits for pediatric asthma.

Methods

We retrospectively evaluated non-trauma patients aged younger than 17 years who visited the ED with a primary diagnosis of asthma. Further, measurements of PM with aerodynamic diameter of < 10 μm (PM10), PM with aerodynamic diameter of < 10 μm (PM2.5), and four PM2.5 components (i.e., nitrate (NO3−), sulfate (SO42−), organic carbon (OC), and elemental carbon (EC)) were collected between 2007 and 2010 from southern particulate matter supersites. These included one core station and two satellite stations in Kaohsiung City, Taiwan. A time-stratified case-crossover study was conducted to analyze the hazard effect of PM.

Results

Overall, 1597 patients were enrolled in our study. In the single-pollutant model, the estimated risk increase for pediatric asthma incidence on lag 3 were 14.7% [95% confidence interval (CI), 3.2–27.4%], 13.5% (95% CI, 3.3–24.6%), 14.8% (95% CI, 2.5–28.6%), and 19.8% (95% CI, 7.6–33.3%) per interquartile range increments in PM2.5, PM10, nitrate, and OC, respectively. In the two-pollutant models, OC remained significant after adjusting for PM2.5, PM10, and nitrate. During subgroup analysis, children were more vulnerable to PM2.5 and OC during cold days (< 26 °C, interaction p = 0.008 and 0.012, respectively).

Conclusions

Both PM2.5 concentrations and its chemical constituents OC and nitrate are associated with ED visits for pediatric asthma. Among PM2.5 constituents, OC was most closely related to ED visits for pediatric asthma, and children are more vulnerable to PM2.5 and OC during cold days.
Evaluation of the “safe multidisciplinary app-assisted remote patient-self-testing (SMART) model” for warfarin home management during the COVID-19 pandemic: study protocol of a multi-center randomized controlled trial
Authors: Chen Lei , Zhou Yang-Zhao , Zhou Xin-Min , Liu Li-Ming , Xu Ping , Zhang Xia , Tan Sheng-Lan
Published: August 2021

Background

Warfarin treatment requires frequent monitoring of INR (international normalized ratio) to adjust dosage in a therapeutic range. In China, patients living in small towns usually go to tertiary hospitals to get warfarin monitoring and dosing, resulting in low frequencies of follow-ups and high incidence of complications. Influenced by the COVID-19 pandemic, patients on warfarin have further reduced their visits to healthcare institutions. While patient self-testing (PST) via using a point-of-care testing device for INR measuring at home has been widely used in developed countries and demonstrated improved clinical outcomes compared to usual care in clinics, it is rarely applied in developing countries, including China. This proposed study will develop and assess the “Safe Multidisciplinary App-assisted Remote patient-self-Testing (SMART) model” for warfarin home management in China during the COVID-19 pandemic.

Methods

This is a multi-center randomized controlled trial. We will carry out the study in three county hospitals, three small tertiary hospitals and three large tertiary hospitals with anticoagulation clinics in Hunan province of China. Eligible patients will be randomly assigned to the SMART model group (n = 360) or the control group (usual care clinic group, n = 360; anticoagulation clinic group, n = 120). Patients in the SMART model group do PST at home once every two to 4 weeks. Controls receive usual care in the clinics. All the patients will be followed up through outpatient clinics, phone call or online interviews at the 3rd, 6th, 9th and 12th month. The percentage of time in therapeutic range (TTR), incidence of warfarin associated major bleeding and thromboembolic events and costs will be compared between the SMART model group and control groups.

Discussion

Patients in the SMART model group would show improved TTR, lower incidence of complications and better quality of life compared to the control groups. Our design, implementation and usage of the SMART model will provide experience and evidence in developing a novel model for chronic disease management to solve the problem of healthcare service maldistribution, an issue particularly obvious in developing countries during the COVID-19 pandemic.

Trial registration

ChiCTR, ChiCTR 2000038984. Registered 11 October, 2020.
Decoding pathogenesis factors involved in the progression of ATLL or HAM/TSP after infection by HTLV-1 through a systems virology study
Authors: Zarei Ghobadi Mohadeseh , Emamzadeh Rahman , Teymoori-Rad Majid , Mozhgani Sayed-Hamidreza
Published: August 2021

Background

Human T-cell Leukemia Virus type-1 (HTLV-1) is a retrovirus that causes two diseases including Adult T-cell Leukemia/Lymphoma (ATLL cancer) and HTLV-1 Associated Myelopathy/Tropical Spastic Paraparesis (HAM/TSP, a neurodegenerative disease) after a long latency period as an asymptomatic carrier (AC). There are no obvious explanations about how each of the mentioned diseases develops in the AC carriers. Finding the discriminative molecular factors and pathways may clarify the destiny of the infection.

Methods

To shed light on the involved molecular players and activated pathways in each state, differentially co-expressed modules (DiffCoEx) algorithm was employed to identify the highly correlated genes which were co-expressed differently between normal and ACs, ACs and ATLL, as well as ACs and HAM/TSP samples. Through differential pathway analysis, the dysregulated pathways and the specific disease-genes-pathways were figured out. Moreover, the common genes between the member of DiffCoEx and differentially expressed genes were found and the specific genes in ATLL and HAM/TSP were introduced as possible biomarkers.

Results

The dysregulated genes in the ATLL were mostly enriched in immune and cancer-related pathways while the ones in the HAM/TSP were enriched in immune, inflammation, and neurological pathways. The differential pathway analysis clarified the differences between the gene players in the common activated pathways. Eventually, the final analysis revealed the involvement of specific dysregulated genes including KIRREL2, RAB36, and KANK1 in HAM/TSP as well as LTB4R2, HCN4, FZD9, GRIK5, CREB3L4, TACR2, FRMD1, LHB, FGF3, TEAD3, GRIN2D, GNRH2, PRLH, GPR156, and CRHR2 in ATLL.

Conclusion

The identified potential prognostic biomarkers and therapeutic targets are proposed as the most important platers in developing ATLL or HAM/TSP. Moreover, the proposed signaling network clarifies the differences between the functional players in the activated pathways in ACs, ATLL, and HAM/TSP.
The CXCL13/CXCR5-chemokine axis in neuroinflammation: evidence of CXCR5+CD4 T cell recruitment to CSF
Authors: Harrer Christine , Otto Ferdinand , Pilz Georg , Haschke-Becher Elisabeth , Trinka Eugen , Hitzl Wolfgang , Wipfler Peter , Harrer Andrea
Published: August 2021

Background

C-X-C chemokine ligand 13 (CXCL13) is frequently elevated in cerebrospinal fluid (CSF) in a variety of inflammatory central nervous system (CNS) diseases, has been detected in meningeal B cell aggregates in brain tissues of multiple sclerosis patients, and proposedly recruits B cells into the inflamed CNS. Besides B cells also follicular helper T (Tfh) cells express the cognate receptor C-X-C chemokine receptor type 5 (CXCR5) and follow CXCL13 gradients in lymphoid tissues. These highly specialized B cell helper T cells are indispensable for B cell responses to infection and vaccination and involved in autoimmune diseases. Phenotypically and functionally related circulating CXCR5+CD4 T cells occur in blood. Their co-recruitment to the inflamed CSF is feasible but unresolved.

Methods

We approached this question with a retrospective study including data of all patients between 2017 and 2019 of whom immune phenotyping data of CXCR5 expression and CSF CXCL13 concentrations were available. Discharge diagnoses and CSF laboratory parameters were retrieved from records. Patients were categorized as pyogenic/aseptic meningoencephalitis (ME, n = 29), neuroimmunological diseases (NIMM, n = 22), and non-inflammatory neurological diseases (NIND, n = 6). ANOVA models and Spearman’s Rank-Order correlation were used for group comparisons and associations of CXCL13 levels with immune phenotyping data.

Results

In fact, intrathecal CXCL13 elevations strongly correlated with CXCR5+CD4 T cell frequencies in the total cohort (p < 0.0001, r = 0.59), and ME (p = 0.003, r = 0.54) and NIMM (p = 0.043, r = 0.44) patients. Moreover, the ratio of CSF-to-peripheral blood (CSF/PB) frequencies of CXCR5+CD4 T cells strongly correlated with CXCL13 levels both in the total cohort (p = 0.001, r = 0.45) and ME subgroup (p = 0.005, r = 0.50), indicating selective accumulation. ME, NIMM and NIND groups differed with regard to CSF cell counts, albumin quotient, intrathecal IgG, CXCL13 elevations and CXCR5+CD4 T cells, which were higher in inflammatory subgroups.

Conclusion

The observed link between intrathecal CXCL13 elevations and CXCR5+CD4 T cell frequencies does not prove but suggests recruitment of possible professional B cell helpers to the inflamed CSF. This highlights CSF CXCR5+CD4 T cells a key target and potential missing link to the poorly understood phenomenon of intrathecal B cell and antibody responses with relevance for infection control, chronic inflammation and CNS autoimmunity.