bluuebunny/crossref_metadata_2025 huggingface dataset:
Outcomes of etravirine-based antiretroviral treatment in treatment-experienced children and adolescents living with HIV in Europe and Thailand
Authors: European Pregnancy and Paediatric Infections Cohort Collabor  , Lyons Alex , Thompson Lindsay , Chappell Elizabeth , Ene Luminita , Galli Luisa , Goetghebuer Tessa , Jourdain Gonzague , Noguera-Julian Antoni , Kahlert Christian R , Königs Christoph , Kosalaraksa Pope , Lumbiganon Pagakrong , Marczyńska Magdalena , Marques Laura , Navarro Marissa , Naver Lars , Okhonskaia Liubov , Prata Filipa , Puthanakit Thanyawee , Ramos Jose T , Samarina Anna , Thorne Claire , Voronin Evgeny , Turkova Anna , Giaquinto Carlo , Judd Ali , Collins Intira J
Published: August 2022

Background

Etravirine (ETR) is approved as a component of second or third-line antiretroviral treatment (ART) for children living with HIV. We assessed the outcomes of ETR-based ART in children in routine care in Europe and Thailand.

Methods

Data on children aged <18 years at ETR start were pooled from 17 observational cohorts. Characteristics at ETR start, immunological and virological outcomes at 12 months, discontinuations, adverse events (AEs) and serious adverse events (SAEs) were described. Follow-up was censored at ETR discontinuation, death or last visit.

Results

177 children ever received ETR. At ETR start, median [IQR] age was 15 [12,16] years, CD4 count 480 [287, 713] cells/mm3, 70% had exposure to ≥3 ART classes and 20% had viral load (VL) <50 copies/mL. 95% received ETR in combination with ≥1 potent drug class, mostly protease inhibitor-based regimens. Median time on ETR was 24 [7, 48] months. Amongst those on ETR at 12 months ( n=141), 69% had VL<50 copies/mL. Median CD4 increase since ETR start ( n=83) was 147 [16, 267] cells/mm3. Overall, 81 (46%) discontinued ETR by last follow-up. Median time to discontinuation was 23 [8, 47] months. Common reasons for discontinuation were treatment simplification (19%), treatment failure (16%) and toxicity (12%). Eight children (5%) had AEs causally associated with ETR, all dermatological/hypersensitivity reactions. Two were SAEs, both Stevens–Johnson Syndrome in children on regimens containing ETR and darunavir and were causally related to either drugs; both resolved following ART discontinuation.

Conclusion

Children receiving ETR were predominantly highly treatment-experienced, over two-thirds were virally suppressed at 12 months.
Let’s do this together: Do the quantity and the quality of collaborative learning predict achievement among college students?
Authors: Anghel Ella
Published: August 2022

Collaborative learning (CL) is a common teaching strategy in colleges that involves actively working in groups to achieve a goal. Several studies and theories endorse it as contributing to students’ achievement, motivation, and higher-order thinking skills. However, these studies are inconsistent in the way they define and operationalize CL. For example, they do not separate the quantity and the quality of CL, nor do they distinguish between course-specific and general attitudes toward CL. The study suggests that researchers should define CL more precisely, and demonstrates this approach using a case study ( N = 38). This study examines whether the quality and quantity of group work predicted course achievement after controlling for prior achievement, individual-level motivation, and social ties among students. Quality of CL was operationalized as positive attitudes toward CL in the current course and in general, and quantity of CL was operationalized as the frequency of interactions among group members. Social ties were measured using Social Network Analysis (SNA) which allows researchers to identify the number and strength of connections among students. Findings suggest that positive attitudes toward CL in the current course predicted higher achievement levels, but the frequency of interactions and positive attitudes toward CL in general were associated with lower achievement levels. That is, in the current context, course-specific quality of CL was positively associated with achievement, but other ways of operationalizing CL were not, and in fact had negative relationships with achievement. The study also demonstrates the use of SNA when exploring students’ relationships; it shows that they were associated with course performance but that this association diminished after controlling for students’ attitudes. Overall, it is recommended that researchers clarify what they intend to measure when exploring CL, as this can have an important impact on findings.
Assessing Adolescent Metacognitive Skills to Support Transition Planning: Age-Related Change and Domain Specificity
Authors: Poll Gerard H. , Petru Janis
Published: August 2022

Metacognitive ability supports both self-regulated academic learning and effective social communication. It is critical to adolescents’ ability to successfully transition from secondary education to adult contexts, underscoring the need to understand age-related changes beyond childhood. There have been conflicting findings on whether metacognition is a general ability that applies to both learning and social communication, or an ability specific to each domain. In this observational study, 35 transition-age adolescents (14–22 years) of varied social communication abilities completed measures of metacognition for learning and metacognition for social communication. Each metacognitive measure included self-knowledge and self-regulation components. Metacognition for social communication increased with participant age but metacognition for learning did not. Metacognitive measures for learning and social communication did not significantly correlate. The self-regulation component of metacognition for social communication predicted pragmatic language ability, but self-regulation for learning did not. The findings suggest that metacognition is a domain-specific ability that contributes to social communication competence.
Jewish Perversion as Strategy of Domination: The anti-Semitic Subtext of Anti-gender Discourse
Authors: Graff Agnieszka
Published: August 2022

This article demonstrates how anti-gender discourse – originating in the Vatican and spreading through ultra-conservative networks such as the World Congress of Families – draws on traditions of conspiratorial anti-Semitism. The repressed link takes two forms: displacement (Judaization of sexual minorities) and attribution of blame (Jews having invented ‘gender’ to destroy Christianity). The first section outlines the structural and historical kinship between the two discourses. Anti-gender discourse continues the 19th-century strand of European anti-Semitism that operates as a cultural code for anti-modernism, reproducing its conspiratorial and polarizing structure and repeating the stereotypes of gendered anti-Semitism. Part two examines an example of disguised anti-Semitic subtext: Gabriele Kuby's Global Sexual Revolution (2015), a central text of anti-genderism, is shown to draw on the writings of E. Michael Jones, a ‘Radical Catholic Traditionalist’. Jones claims that Jews have been plotting for centuries to destroy Western Civilization and enjoys a certain popularity with the Polish right. The final section reflects on the elusiveness of the anti-Semitic subtext and its dependence on cultural context. The displacement of Jews by ‘gender’ facilitates the mainstreaming of right-wing extremism and helps legitimize radical-right groups as political players.
Interleukin-1 gene (IL-1) polymorphism in patients with Behçet’s Disease, and its relationship with disease manifestations
Authors: Özkan Ümit , Ulutaş Firdevs , Tepeli Emre , Çobankara Veli
Published: August 2022

Objective

The objective of this study was to investigate whether interleukin-1 (IL-1) gene polymorphisms are associated with susceptibility to Behçet’s disease (BD) and clinical manifestations of the disease.

Methods

In this cross-sectional study, we enrolled 110 patients with BD and age-and gender-matched 120 healthy controls. Five polymorphic regions of the IL-1 gene including rs 1800587 (IL1A-889 C/T), rs 2234650 (IL1R1), rs 16944 (IL1B-511 C/T), rs 315952 (IL1RN), and rs1143634 (IL1B-3954 C/T) were analyzed by using the real-time polymerase chain reaction system. Allele frequencies and genotypes were compared between groups. p ≤ 0.05 was accepted as statistically significant.

Results

The mean age of the patients with BD was 41 ± 12.4 years. The two groups were similar in terms of the age and gender distribution. The vast majority of BD patients had mucocutaneous involvement. The mean disease duration was 83.7 ± 67.8 months among the patients. The frequencies of each polymorphism in the IL-1 gene were similar between patients with BD and healthy controls.

Conclusion

The frequencies of variable IL-1 gene polymorphisms were similar between patients with BD and healthy controls.
Quality or Control: High-Needs Principals’ Perceptions of a PSEL-Based Evaluation System
Authors: Bailes Lauren P. , Ahmad Seher , Saylor Michael , Vitale Meaghan N.
Published: August 2022

This study investigated whether principals in high-needs schools reported different perceptions of a PSEL-based principal evaluation system than did principals in non high-needs schools. We employed a sequential mixed-methods approach in which semi-structured interviews followed an initial survey administration. High-needs and non high-needs principals reported statistically significantly different perceptions of the state’s evaluation system. We find that principals perceive wide variation in the resources allocated to their schools as well as the use of the performance rubric to measure their effectiveness. Additionally, principals identified principal supervisors as a major lever in the perceived fairness and flexibility of the evaluation system.
Women’s Intrasexual Competitiveness and Jealousy Across the Ovulatory Cycle: A Hormone-Based Study
Authors: Stern Julia , Hildebrand Tabea , Casto Kathleen
Published: August 2022

Research on social status competition among women suggests that underlying hormonal shifts associated with the ovulatory cycle systematically drive alterations in preferences and behavior. Specifically, it is proposed that the fertile window, marked by heightened estradiol and lower progesterone levels, is related to increased psychological motivation for intrasexual social comparison, leading to increasing competitiveness and jealousy. In this pre-registered, longitudinal study, 257 women provided saliva samples for hormone assays, rated the attractiveness of other women, and self-reported intrasexual competitiveness and jealousy across four testing sessions. Multilevel analyses revealed no compelling evidence for (hormone-related) cycle shifts in intrasexual competitiveness, attractiveness ratings, or jealousy. Rather, women higher in intrasexual competitiveness seem to rate other women as more attractive in general. We discuss how our results contribute to a growing body of literature suggesting that women’s social attitudes and preferences are more stable and less hormonally influenced than previously assumed.
Susceptibility phase imaging of deep gray matter: Presenting the effects of slice orientation
Authors: Hamed Mahmoud R , Eissa Amir , Elsamahy Mohamed , M Elsayed Tamer , Gohary MI El-
Published: August 2022

Susceptibility-weighted image (SWI) is a T2* gradient echo sequence, which is highly sensitive to substances that have magnetic properties. The phase and magnitude of SWI can play an important role in the diagnosis of several diseases. The phase data is highly affected by spatial variations in the main magnetic field of the magnetic resonance imaging (MRI) scanner. The axial acquisition is the frequent plane alignment while acquiring SWI in diagnostic imaging. Clinical requirements often lead to changing of the alignment angles due to variability in patient positioning and anatomy. For many patients undergoing brain MRI, the line of the anterior and posterior commissure AC-PC can vary in direction with respect to the transverse plane of the MRI system. We investigated whether there exist significant effect on phase data of SWI, and this is due to oblique orientation. The obtained results showed significant differences in phase values between axial and anatomically alignments.
Turnaround and human resource strategies during the COVID-19 crisis
Authors: Rivera-Prieto Juan Carlos , Santana Monica , López-Cabrales Álvaro
Published: August 2022

In the highly complex world of human resource management (HRM), organizations need to maintain both an inward and an outward approach in times of crisis. To adequately manage human resources, it is necessary to consider the environment and the literature on turnaround strategy. This study combines the literature on both turnaround and HRM to focus on problem antecedents/causes and their impact on companies. A case study of an airline was conducted, enriched with a rhetorical signal analysis of managerial communications and stakeholder responses. The objective was to explore the company’s turnaround strategies, human resource strategies, and institutional pressures during the COVID-19 pandemic. It was found that to overcome the crisis, it is necessary to recognize antecedents of decline, turnaround strategies, human resource (HR) strategies and practices, institutional pressures on HRM, the emotional tone and temporal focus of managerial communications as well as stakeholder responses.

JEL CLASSIFICATION: M50
Association of Socioeconomic Status With Relapse After Ponseti Method Treatment of Idiopathic Clubfeet
Authors: Akinyoola Lawrence A. , Gunderson Zachary , Sun Seungyup , Fitzgerald Ryan , Caltoum Christine B. , Christman Tyler W. , Bielski Robert , Loder Randall T.
Published: August 2022

Background:

The Ponseti method is today’s standard treatment of idiopathic talipes equinovarus (ITEV). Compliance with foot abduction bracing (FABO) and socioeconomic factors have been shown to impact treatment outcome. We wished to further study socioeconomic factors using the Area Deprivation Index (ADI), a more comprehensive way to evaluate socioeconomic status, which has not been done before.

Methods:

All TEV patients from 2010 through 2019 treated with the Ponseti method were reviewed. Standard demographic variables, as well as the number of casts to complete initial correction, FABO compliance, and occurrence of relapse were tabulated. Socioeconomic level was quantified with the 2018 ADI.

Results:

There were 168 children; 151 had typical and 17 complex TEV. Average follow-up was 4.3 ± 1.8 years; relapse occurred in 46%. There were no significant differences in the percentage of relapse by sex, race, or ADI. FABO noncompliance was present in 46%. Relapse increased with increasing time of follow-up and FABO noncompliance (76% vs 21%, P < 10−6). Multivariate logistic regression analysis revealed that only FABO compliance and length of follow-up were associated with relapse. The OR of relapse for FABO noncompliance was 17.9 (7.6, 42.4, P < 10–6) and for follow-up >4 years the OR was 4.97 (2.1, 11.70, P = .0003).

Conclusion:

The outcome of the Ponseti method for TEV treatment is dependent on local circumstances. In our state, socioeconomic status, as determined by the ADI, was not associated with the occurrence of relapse. Thus, each center needs to assess its results, and analyze its own reasons for relapse. There were no other demographic variables associated with relapse except FABO compliance and length of follow-up. Parents should be strongly advised that FABO compliance and follow-up appears paramount to achieving the best results, and that complex TEV are at greater risk for relapse.

Level of Evidence:

Level IV, case series
Full-length transcriptome-referenced analysis reveals crucial roles of hormone and wounding during induction of aerial bulbils in lily
Authors: Li Jingrui , Sun Meiyu , Li Hui , Ling Zhengyi , Wang Di , Zhang Jinzheng , Shi Lei
Published: August 2022

Aerial bulbils are important vegetative reproductive organs in Lilium. They are often perpetually dormant in most Lilium species, and little is known about the induction of these vegetative structures. The world-famous Oriental hybrid lily cultivar ‘Sorbonne’, which blooms naturally devoid of aerial bulbils, is known for its lovely appearance and sweet fragrance. We found that decapitation stimulated the outgrowth of aerial bulbils at lower stems (LSs) and then application of low and high concentrations of IAA promoted aerial bulbils emergence around the wound at upper stems (USs) of ‘Sorbonne’. However, the genetic basis of aerial bulbil induction is still unclear. Herein, ‘Sorbonne’ transcriptome has been sequenced for the first time using the combination of third-generation long-read and next-generation short-read technology. A total of 46,557 high-quality non-redundant full-length transcripts were generated. Transcriptomic profiling was performed on seven tissues and stems with treatments of decapitation and application of low and high concentrations of IAA, respectively. Functional annotation of 1918 DEGs within stem samples of different treatments showed that hormone signaling, sugar metabolism and wound-induced genes were crucial to bulbils outgrowth. The expression pattern of auxin-, shoot branching hormone-, plant defense hormone- and wound-inducing-related genes indicated their crucial roles in bulbil induction. Then we established five hormone- and wounding-regulated co-expression modules and identified some candidate transcriptional factors, such as MYB, bZIP, and bHLH, that may function in inducing bulbils. High connectivity was observed among hormone signaling genes, wound-induced genes, and some transcriptional factors, suggesting wound- and hormone-invoked signals exhibit extensive cross-talk and regulate bulbil initiation-associated genes via multilayered regulatory cascades. We propose that the induction of aerial bulbils at LSs after decapitation can be explained as the release of apical dominance. In contrast, the induction of aerial bulbils at the cut surface of USs after IAA application occurs via a process similar to callus formation. This study provides abundant candidate genes that will deepen our understanding of the regulation of bulbil outgrowth, paving the way for further molecular breeding of lily.
Systemic immune-inflammation index within the first postoperative hour as a predictor of severe postoperative complications in upper abdominal surgery: a retrospective single-center study
Authors: Jiao Yang , Zhang Xiao , Liu Mei , Sun Yu’e , Ma Zhengliang , Gu Xiaoping , Gu Wei , Zhu Wei
Published: August 2022

Background

Systemic pro-inflammatory factors play a critical role in mediating severe postoperative complications (SPCs) in upper abdominal surgery (UAS). The systemic immune-inflammation index (SII) has been identified as a new inflammatory marker in many occasions. The present study aims to determine the association between SII and the occurrence of SPCs after UAS.

Methods

Included in this study were 310 patients with upper abdominal tumors who received UAS and subsequently were transferred to the anesthesia intensive care unit between November 2020 and November 2021 in Nanjing Drum Hospital. SPCs, including postoperative pulmonary complications (PPCs), major adverse cardiac and cardiovascular events, postoperative infections and delirium, were recorded during the hospital stay. The clinical features of the patients with and without SPCs were compared by Student’s t-test or Fisher’s exact test as appropriate. Risk factors associated with SPC occurrence were evaluated by univariable and multivariable logistic regression analyses. Receiver operating characteristic (ROC) curve analysis was used to establish a cut-off level of SII value to predict SPCs.

Results

Of the 310 patients receiving UAS, 103 patients (33.2%) presented at least one SPC, including PPCs (n = 62), adverse cardiovascular events (n = 22), postoperative infections (n = 51), and delirium (n = 5). Both preoperative SII and 1-h postoperative SII in patients with SPCs were significantly higher than those in patients without SPCs. Multivariate analysis showed that 1-h postoperative SII was an independent predictor for SPC occurrence (OR = 1.000, 95% CI 1.000–1.000, P = 0.007), together with postoperative C-reactive protein, postoperative arterial lactate, postoperative oxygenation-index and older age. The ROC curve showed that the optimal cutoff value of 1-h postoperative SII to predict SPCs was 754.6078 × 109/L, with an 88.3% sensitivity and a 29% specificity. Multivariate analysis also confirmed that 1-h postoperative SII > 754.6078 × 109/L was associated with increased SPC occurrence (OR = 2.656, 95% CI 1.311–5.381, P = 0.007).

Conclusion

Our findings demonstrated an association between the higher level of 1-h postoperative SII and SPCs, suggesting that 1-h postoperative SII, especially categorized 1-h postoperative SII using cutoff value, may be a useful tool for identifying patients at risk of developing SPCs.
The difference of the retinal structural and microvascular characteristics in patients with MOGAD-ON and AQP4-ON
Authors: Yao Yajun , Li Xindi , Xu Yun , Liang Xiaofang , Yang Liu , Shi Fu-Dong , Zhang Xinghu , Tian De-Cai , Zhang Xuxiang
Published: August 2022

Background

Antibodies against myelin-oligodendrocyte-glycoprotein (MOG-Abs) associated disease (MOGAD) has been recognized as a disease entity. Optic neuritis (ON) is the most common symptom in MOGAD. To demonstrate the differences in retinal microvascular characteristics between patients with MOGAD-ON and aquaporin-4 antibody (AQP4-Ab) positive ON.

Methods

In a prospective study, optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) were used to measure retinal and microvascular parameters.

Results

Twenty-six MOGAD-ON eyes, 40 AQP4-ON eyes, and 60 control eyes were included in the study. The thickness of RNFL and GCC in MOGAD-ON eyes was significantly lower than that of HC (p < 0.001, respectively), but comparable to AQP4-ON eyes. The vessel density in retina capillary plexus (RCP) was reduced significantly in MOGAD-ON than that in AQP4-ON (p < 0.05, respectively). The visual accuracy was positively correlated with vessel density of superficial RCP in MOG-ON (p = 0.001) and positively correlated with the thickness of the inner retina layer in AQP4-ON (p < 0.001).

Conclusion

The retinal neuro-axonal damages between MOGAD-ON and AQP4-ON were comparable. Unlike AQP4-ON eyes, microvascular densities were significantly reduced in MOGAD-ON and were positively correlated with the deterioration of visual acuity in MOGAD-ON.

Trial registration

Clinical and Imaging Patterns of Neuroinflammation Diseases in China (CLUE, NCT: 04106830).
Whether the infracardiac bursa protect right pleura during laparoscopic radical operation of Siewert type II adenocarcinoma of esophagogastric junction?
Authors: Lin Zeyu , Zeng Haiping , Xiong Wenjun , Li Jin , Chen Yan , Luo Lijie , Zheng Yansheng , Zhang Zhuoxuan , Wang Wei
Published: August 2022

Background

Transthoracic single-port assisted laparoscopic five-step maneuver inferior mediastinal lymphadenectomy for Siewert type II adenocarcinoma of esophagogastric junction (AEG) has superiority in lower mediastinal lymph nodes dissection and digestive tract reconstruction. However, the right pleura was probably ruptured in this surgical technique. The aim of this study was to explore whether the infracardiac bursa (ICB) exposed could protect right pleura.

Methods

We retrospectively collected and evaluated the clinical and pathological data of patients who underwent five-step maneuver of transthoracic single-port assisted laparoscopic lower mediastinal lymphadenectomy for Siewert II AEG at Guangdong Provincial Hospital of Chinese Medicine between May 2017 and February 2022.

Results

A total of 49 patients were eligible, including 31 patients in ICB exposed group (group A) and 18 patients in ICB unexposed group (group B). There were no statistically significant differences in baseline characteristics between the two groups. 4 patients (12.9%) had right pleura rupture in group A, while 14 patients (77.8%) in group B, and the difference was statistically significant (p < 0.001). Compared with group B, the extubation time of endotracheal intubation (10.0 (6.0 ~ 12.0) vs. 13.0 (8.0 ~ 15.0) min,p = 0.003) and thoracic drainage tube stay (6.0 (5.0 ~ 7.0) vs. 8.0 (6.0 ~ 10.5) days,p = 0.041) were significantly shorted in the group A. The drainage volume of thorax (351.61 ± 125.00 vs. 418.61 ± 207.86 mL,p = 0.146) was non-significant less and the rate of complications (3.2% vs. 11.1%,p = 0.074) was non-significant lower in group A compared with group B. The postoperative hospital stay (9.0 (8.0,13.0) vs. 9.0 (8.0,12.0) days,p = 0.983) were similar in two groups. No serious adverse event occurred in any patient.

Conclusions

The ICB exposed could protect the right pleura and may promote postoperative recovery, which may be used as an anatomical marker in inferior mediastinal lymphadenectomy.
Organisational structures and processes for health and well-being: insights from work integration social enterprise
Authors: Joyce Andrew , Moussa Batool , Elmes Aurora , Campbell Perri , Suchowerska Roksolana , Buick Fiona , Barraket Jo , Carey Gemma
Published: August 2022

Background

Previous research on employee well-being for those who have experienced social and economic disadvantage and those with previous or existing mental health conditions has focused mainly on programmatic interventions. The purpose of this research was to examine how organisational structures and processes (such as policies and culture) influence well-being of employees from these types of backgrounds.

Methods

A case study ethnographic approach which included in-depth qualitative analysis of 93 semi-structured interviews of employees, staff, and managers, together with participant observation of four social enterprises employing young people.

Results

The data revealed that young people were provided a combination of training, varied work tasks, psychosocial support, and encouragement to cultivate relationships among peers and management staff. This was enabled through the following elements: structure and space; funding, finance and industry orientation; organisational culture; policy and process; and fostering local service networks.. The findings further illustrate how organisational structures at these workplaces promoted an inclusive workplace environment in which participants self-reported a decrease in anxiety and depression, increased self-esteem, increased self-confidence and increased physical activity.

Conclusions

Replicating these types of organisational structures, processes, and culture requires consideration of complex systems perspectives on implementation fidelity which has implications for policy, practice and future research.
The Gross Developmental Potential (GDP2): a new approach for measuring human potential and wellbeing
Authors: Halfon Neal , Chandra Anita , Cannon Jill S. , Gardner William , Forrest Christopher B.
Published: August 2022

Many factors influence the health and well-being of children and the adults they will become. Yet there are significant gaps in how trajectories of healthy development are measured, how the potential for leading a healthy life is evaluated, and how that information can guide upstream policies and investments. The Gross Developmental Potential (GDP2) is proposed as a new capabilities-based framework for assessing threats to thriving and understanding progress in achieving lifelong health and wellbeing. Moving beyond the Gross Domestic Product’s (GDP) focus on economic productivity as a measure of progress, the GDP2 focuses on seven essential developmental capabilities for lifelong health and wellbeing. The GDP2 capability domains include Health -living a healthy life; Needs-satisfying basic human requirements; Communication-expressing and understanding thoughts and feelings; Learning-lifelong learning; Adaption -adapting to change; Connections -connecting with others; and Community -engaging in the community. The project team utilized literature reviews and meetings with the subject and technical experts to develop the framework. The framework was then vetted in focus groups of community leaders from three diverse settings. The community leaders' input refined the domains and their applications. This prototype GDP2 framework will next be used to develop specific measures and indices and guide the development of community-level GDP2 dashboards for local sense-making, learning, and application.
Favorable, arduous or fatal postoperative pathway within 90 days of lung transplantation
Authors: Tran-Dinh Alexy , Bouzid Donia , El Kalai Adnan , Atchade Enora , Tanaka Sébastien , Lortat-Jacob Brice , Jean-Baptiste Sylvain , Zappella Nathalie , Boudinet Sandrine , Castier Yves , Mal Hervé , Mordant Pierre , Messika Jonathan , Montravers Philippe
Published: August 2022

Introduction

The maximum gain in quality of life after lung transplantation (LT) is expected between six months and one year after LT, as the occurrence of chronic lung allograft dysfunction may mask the beneficial effects beyond one year. Thus, the postoperative period could be the cornerstone of graft success. We sought to describe the factors present before postoperative admission to the ICU and associated with favorable, arduous or fatal pathway within 90 days of LT.

Materials and methods

We conducted a retrospective single-center study between January 2015 and December 2020. Using multinomial regression, we assessed the demographic, preoperative and intraoperative characteristics of patients associated with favorable (duration of postoperative mechanical ventilation < 3 days and alive at Day 90), arduous (duration of postoperative mechanical ventilation ≥ 3 days and alive at Day 90) or fatal (dead at Day 90) pathway within 90 days of LT.

Results

A total of 269 lung transplant patients were analyzed. Maximum graft cold ischemic time ≥ 6 h and intraoperative blood transfusion ≥ 3 packed red blood cells were associated with arduous and fatal pathway at Day 90, whereas intraoperative ECMO was strongly associated with fatal pathway.

Conclusion

No patient demographics influenced the postoperative pathway at Day 90. Only extrinsic factors involving graft ischemia time, intraoperative transfusion, and intraoperative ECMO determined early postoperative pathway.
Factors influencing terminal cancer patients’ autonomous DNR decision: a longitudinal statutory document and clinical database study
Authors: Chen Ru-Yih , Li Ying-Chun , Hsueh Kuang-Chieh , Wang Fu-Wei , Chen Hong-Jhe , Huang Tzu-Ya
Published: August 2022

Objective

Much of our knowledge of patient autonomy of DNR (do-not-resuscitate) is derived from the cross-sectional questionnaire surveys. Using signatures on statutory documents and medical records, we analyzed longitudinal data to understand the fact of terminal cancer patients’ autonomous DNR decision-making in Taiwan.

Methods

Using the medical information system database of one public medical center in Taiwan, we identified hospitalized cancer patients who died between Jan. 2017 and Dec. 2018, collected their demographic and clinical course data and records of their statutory DNR document types, letter of intent (DNR-LOI) signed by the patient personally and the consent form signed by their close relatives.

Results

We identified 1,338 signed DNR documents, 754 (56.35%) being DNR-LOI. Many patients had the first DNR order within their last week of life (40.81%). Signing the DNR-LOI was positively associated with being under the care of a family medicine physician prior to death at last hospitalization and having hospice palliative care and negatively associated with patient age ≥ 65 years, no formal education, having ≥ 3 children, having the first DNR order to death ≤ 29 days, and the last admission in an intensive care unit.

Conclusions

A substantial proportion of terminal cancer patients did not sign DNR documents by themselves. It indicates they may not know their actual terminal conditions and lose the last chance to grasp time to express their life values and wishes. Medical staff involving cancer patient care may need further education on the legal and ethical issues revolving around patient autonomy and training on communicating end-of-life options with the patients. We suggest proactively discussing DNR decision issues with terminal cancer patients no later than when their estimated survival is close to 1 month.
In-vitro determination of antimicrobial activities of Eruca sativa seed oil against antibiotic-resistant gram-negative clinical isolates from neonates: a future prospect
Authors: Bassyouni Rasha H. , Kamel Zeinat , Algameel Alkassem Ahmed , Ismail Ghada , Gaber Sylvana N.
Published: August 2022

Background

The aim of this study is investigate the antimicrobial effect of plant oils against bacterial strains isolated from neonatal asymptomatic bacteriuria (ABU) and to evaluate the antiseptic effect of the most potent one.

Methods

The antimicrobial effect of 17 plant oils were tested against 15- gram-negative bacterial strains recovered from cases of neonatal ABU (11 Escherichia. coli, 3 Klebsiella pneumonia, and 1 Pseudomonas aeruginosa) using the agar well diffusion method. The micro-dilution method was performed to investigate the minimum inhibitory concentrations (MIC) and the minimum bactericidal concentrations (MBC) in concentrations ranging from 1.95 μg/ml to 500 μg/ml. The evaluation of the antiseptic activity of the Eruca sativa (arugula) seed oil was investigated using time-kill assay in concentrations ranging from 50 μg/ml to 0.195 μg/ml.

Results

All tested oils showed variable antimicrobial activities against the tested strains. Arugula, wheat germ, cinnamon, parsley, dill, and onion oils were the most active oils. Among them, arugula oil was the most active oil with MIC50 and MIC90 were 3.9 μg/ml and 31.3 μg/ml respectively. MBC50 and MBC90 of arugula oil were 15.6 μg/ml and 125μg/ml respectively. The time-kill assay of arugula oil indicated that a concentration of 100 μg/ml completely killed nine of the tested strains after 10 min and reduced the CFU/ml of the rest of the strains by 3 log10 at the same time interval.

Conclusion

Arugula seed oil could be a potentially used as an antiseptic especially for neonates.
Allied health professionals’ perceptions of research in the United Kingdom national health service: a survey of research capacity and culture
Authors: Comer Christine , Collings Richard , McCracken Alison , Payne Carol , Moore Ann
Published: August 2022

Background

With growing recognition of the importance of research in allied healthcare, the new Health Education England (HEE) research strategy articulates a need to transform Allied Health Professional (AHP) identities, culture and roles. An understanding of current AHP research capacity and culture is first required.

Methods

A cross-sectional survey targeted AHPs working in NHS health and social care settings across the United Kingdom. The validated Research Capacity and Culture tool was modified and distributed through research and professional networks. Aggregate median scores for perceived research success were categorised as adequate, more than, or less than adequate.

Results

Of 3344 participants, 3145 identified as HEE-defined AHPs. Individual- and organisation-level research success was perceived as adequate (median scores 4 (IQR 2 to 6); 4 (IQR 2 to 7) respectively). Team-level research success was rated less than adequate (median score 2 (IQR 1–5)).

Conclusions

In the UK, AHPs working in NHS health and social care perceive individual and organisational level research skill/success to be adequate. In contrast, inadequacies in research skill/support at team level were exposed, which may hinder successful integration of allied health research into everyday health and social care practice. Recommendations are made with reference to the HEE AHP research strategy.
Out-of-pocket payment and patients’ treatment choice for assisted reproductive technology by household income: a conjoint analysis using an online social research panel in Japan
Authors: Maeda Eri , Jwa Seung Chik , Kumazawa Yukiyo , Saito Kazuki , Iba Arisa , Yanagisawa‑Sugita Ayako , Kuwahara Akira , Saito Hidekazu , Terada Yukihiro , Fukuda Takashi , Ishihara Osamu , Kobayashi Yasuki
Published: August 2022

Background

Economic disparities affect access to assisted reproductive technology (ART) treatment in many countries. At the time of this survey, Japan provided partial reimbursement for ART treatment only for those in low- or middle-income classes due to limited governmental budgets. However, the optimal level of financial support by income class remains unclear.

Methods

We conducted a conjoint analysis of ART in Japan in January 2020. We recruited 824 women with fertility problems aged 25 to 44 years via an online social research panel. They completed a questionnaire of 16 hypothetical scenarios measuring six relevant ART attributes (i.e., out-of-pocket payment, pregnancy rate, risk of adverse effects, number of visits to outpatient clinics, consultation hours and kindness of staff) and their relations to treatment choice.

Results

Mixed-effect logistic regression models showed that all six attributes significantly influenced treatment preferences, with participants valuing out-of-pocket payment the most, followed by pregnancy rates and kindness of staff. Significant interactions occurred between high household income (≥ 8 million JPY) and high out-of-pocket payment (≥ 500,000 JPY). However, the average marginal probability of the highest-income patients (i.e., ≥ 10 million JPY, ineligible for the subsidy) receiving ART treatment at the average cost of 400,000 JPY was 47%, compared to 56 − 61% of other income participants, who opted to receive ART at an average cost of 100,000 JPY after a 300,000 JPY subsidy.

Conclusion

Our results suggest that out-of-pocket payment is the primary determinant in patients’ decision to opt for ART treatment. High-income patients were more likely to choose treatment, even at a high cost, but their income-based ineligibility for government financial support might discourage some from receiving treatment.
The multiple effects of REG1 deletion and SNF1 overexpression improved the production of S-adenosyl-l-methionine in Saccharomyces cerevisiae
Authors: Chen Hailong , Chai Xiaoqin , Wang Yan , Liu Jing , Zhou Guohai , Wei Pinghe , Song Yuhe , Ma Lingman
Published: August 2022

Background

Saccharomyces cerevisiae is often used as a cell factory for the production of S-adenosyl-l-methionine (SAM) for diverse pharmaceutical applications. However, SAM production by S. cerevisiae is negatively influenced by glucose repression, which is regulated by a serine/threonine kinase SNF1 complex. Here, a strategy of alleviating glucose repression by deleting REG1 (encodes the regulatory subunit of protein phosphatase 1) and overexpressing SNF1 (encodes the catalytic subunit of the SNF1 complex) was applied to improve SAM production in S. cerevisiae. SAM production, growth conditions, glucose consumption, ethanol accumulation, lifespan, glycolysis and amino acid metabolism were analyzed in the mutant strains.

Results

The results showed that the multiple effects of REG1 deletion and/or SNF1 overexpression exhibited a great potential for improving the SAM production in yeast. Enhanced the expression levels of genes involved in glucose transport and glycolysis, which improved the glucose utilization and then elevated the levels of glycolytic intermediates. The expression levels of ACS1 (encoding acetyl-CoA synthase I) and ALD6 (encoding aldehyde dehydrogenase), and the activity of alcohol dehydrogenase II (ADH2) were enhanced especially in the presence of excessive glucose levels, which probably promoted the conversion of ethanol in fermentation broth into acetyl-CoA. The gene expressions involved in sulfur-containing amino acids were also enhanced for the precursor amino acid biosynthesis. In addition, the lifespan of yeast was extended by REG1 deletion and/or SNF1 overexpression. As expected, the final SAM yield of the mutant YREG1ΔPSNF1 reached 8.28 g/L in a 10-L fermenter, which was 51.6% higher than the yield of the parent strain S. cerevisiae CGMCC 2842.

Conclusion

This study showed that the multiple effects of REG1 deletion and SNF1 overexpression improved SAM production in S. cerevisiae, providing new insight into the application of the SNF1 complex to abolish glucose repression and redirect carbon flux to nonethanol products in S. cerevisiae.
Efficient infection of non-human primates with purified, cryopreserved Plasmodium knowlesi sporozoites
Authors: Chakravarty Sumana , Shears Melanie J. , James Eric R. , Rai Urvashi , KC Natasha , Conteh Solomon , Lambert Lynn E. , Duffy Patrick E. , Murphy Sean C. , Hoffman Stephen L.
Published: August 2022

Background

Plasmodium falciparum (Pf) sporozoite (SPZ) vaccines are the only candidate malaria vaccines that induce > 90% vaccine efficacy (VE) against controlled human malaria infection and the only malaria vaccines to have achieved reproducible VE against malaria in adults in Africa. The goal is to increase the impact and reduce the cost of PfSPZ vaccines by optimizing vaccine potency and manufacturing, which will benefit from identification of immunological responses contributing to protection in humans. Currently, there is no authentic animal challenge model for assessing P. falciparum malaria VE. Alternatively, Plasmodium knowlesi (Pk), which infects humans and non-human primates (NHPs) in nature, can be used to experimentally infect rhesus macaques (Macaca mulatta) to assess VE.

Methods

Sanaria has, therefore, produced purified, vialed, cryopreserved PkSPZ and conducted challenge studies in several naïve NHP cohorts. In the first cohort, groups of three rhesus macaques each received doses of 5 × 102, 2.5 × 103, 1.25 × 104 and 2.5 × 104 PkSPZ administered by direct venous inoculation. The infectivity of 1.5 × 103 PkSPZ cryopreserved with an altered method and of 1.5 × 103 PkSPZ cryopreserved for four years was tested in a second and third cohort of rhesus NHPs. The lastly, three pig-tailed macaques (Macaca nemestrina), a natural P. knowlesi host, were challenged with 2.5 × 103 PkSPZ cryopreserved six years earlier.

Results

In the first cohort, all 12 animals developed P. knowlesi parasitaemia by thick blood smear, and the time to positivity (prepatent period) followed a non-linear 4-parameter logistic sigmoidal model with a median of 11, 10, 8, and 7 days, respectively (r2 = 1). PkSPZ cryopreserved using a modified rapid-scalable method infected rhesus with a pre-patent period of 10 days, as did PkSPZ cryopreserved four years prior to infection, similar to the control group. Cryopreserved PkSPZ infected pig-tailed macaques with median time to positivity by thin smear, of 11 days.

Conclusion

This study establishes the capacity to consistently infect NHPs with purified, vialed, cryopreserved PkSPZ, providing a foundation for future studies to probe protective immunological mechanisms elicited by PfSPZ vaccines that cannot be established in humans.
Genetic polymorphism of circumsporozoite protein of Plasmodium falciparum among Chinese migrant workers returning from Africa to Henan Province
Authors: He Zhi-quan , Zhang Qun-qun , Wang Dan , Hu Ya-bo , Zhou Rui-min , Qian Dan , Yang Cheng-yun , Lu De-ling , Li Su-hua , Liu Ying , Zhang Hong-wei
Published: August 2022

Background

Plasmodium falciparum malaria is recognized as a major global public health problem. The malaria vaccine was important because the case fatality rate of falciparum malaria was high. Plasmodium falciparum circumsporozoite protein (PfCSP) is one of the potential vaccine candidates, but the genetic polymorphism of PfCSP raises concerns regarding the efficacy of the vaccine. This study aimed to investigate the genetic polymorphism of PfCSP and provide data for the improvement of PfCSP-based vaccine (RTS,S malaria vaccine).

Methods

Blood samples were collected from 287 Chinese migrant workers who were infected with P. falciparum and returning from Africa to Henan Province during 2016–2018. The Pfcsp genes were analysed to estimate the genetic diversity of this parasite.

Results

The results showed that there were two mutations at the N-terminus of imported Pfcsp in Henan Province, including insertion amino acids (58.71%, 118/201) and A → G (38.81%, 78/201). The number of repeats of tetrapeptide motifs (NANP/NVDP/NPNP/NVDA) in the central repeat region ranged mainly from 39 to 42 (97.51%, 196/201). A total of 14 nonsynonymous amino acid changes were found at the C-terminus. The average nucleotide difference (K) of imported Pfcsp in Henan Province was 5.719, and the haplotype diversity (Hd) was 0.964 ± 0.004. The estimated value of dN-dS was 0.047, indicating that the region may be affected by positive natural selection. The minimum number of recombination events (Rm) of imported Pfcsp in Henan Province was close to that in Africa. The analysis of genetic differentiation showed that there may be moderate differentiation between East Africa and North Africa (Fst = 0.06484), and the levels of differentiation in the other regions were very small (Fst < 0.05).

Conclusions

The N-terminus of Pfcsp was relatively conserved, and the central repeat region and the Th2R and Th3R regions of the C-terminus were highly polymorphic. The gene polymorphism pattern among Chinese migrant workers returning from Africa to Henan Province was consistent with that in Africa. The geographical pattern of population differentiation and the evidence of natural selection and gene recombination suggested that the effect of polymorphism on the efficacy of PfCSP-based vaccines should be considered.
ALEX versus ISAC multiplex array in analyzing food allergy in atopic children
Authors: Sonneveld Laura J. H. , Emons Joyce A. M. , Arends Nicolette J. T. , Landzaat Lonneke J. , Veenbergen Sharon , Schreurs Marco W. J.
Published: August 2022

ALEX multiplex array is a relatively new multiplex allergy test which analyses more than 120 allergen extracts and 170 molecular components. ISAC is the most used and studied multiplex array to date, offering 112 molecular components. In ten atopic children with multiple food allergies good agreement was observed between ALEX and ISAC sIgE results for nearly all shared food components. Presence of larger number of allergens in ALEX could help clinicians to improve personalized dietary advice. However more positive sensitizations with unknown clinical relevance were found by ALEX, potentially increasing clinical complexity. Pediatric allergists should be aware of this, especially in young atopic children with (severe) eczema who have not introduced all sorts of food yet.