bluuebunny/crossref_metadata_2025 huggingface dataset:
On Employment, Wage and Consumption: Impact of Nationwide Lockdown on Muslim Casual Workers
Authors: Mansoor Kashif , Khan Faraz
Published: June 2021

The effects of nationwide lockdown were disproportionate on informal workers. Based on a primary household survey conducted among Muslim casual labour working in Aligarh lock industries, we add to studies on the socio-economic impact of the lockdown. We find 44% reduction in employment rate and fall in daily wage for 60% of workers, in the post-lockdown period. A net job loss of 20% was found. The incidence of violation with the minimum wages is severe in the lock industries, and this has increased tremendously as high as 90% for some workers, in the post-lockdown. Muslim women were affected more than men, in terms of unemployment and wages. With little to no savings, the income loss during the lockdown has led to a rise in indebtedness with one-third of households incurring debt Rs. 5,000–10,000. More than 90% of them were found unable to pay rent and electricity bills. Protecting livelihoods and dignity of workers is a constitutional duty of the state. This has become even more demanding now.

JEL Codes: E21, E24, E26
Endometrial cancer: the role of MRI quantitative assessment in preoperative staging and risk stratification
Authors: Keles Duygu Koc , Evrimler Sehnaz , Merd Neslihan , Erdemoglu Evrim
Published: June 2021

Background

New methods to reduce subjectivity in preoperative magnetic resonance imaging (MRI) staging of endometrial cancer are needed.

Purpose

To investigate the role of MRI quantitative assessment in staging and risk stratification of endometrial cancer.

Material and Methods

Preoperative T2-weighted (T2W) images and diffusion-weighted imaging of 42 patients were analyzed retrospectively by two radiologists. Tumor area ratio (TAR) and tumor volume ratio (TVRseg) were calculated by semi-automatic segmentation of the tumor and uterus on T2W imaging and apparent diffusion coefficient (ADC). TVR was also calculated by the 3D metric method (TVRmetric). Mean ADCtumor was calculated. The patients were allocated to risk groups regarding the stage, grade, and lymphovascular invasion (LVI) status.

Results

TAR, TVRmetric, T2W TVRseg, and ADC TVRseg showed a significant difference between the superficial and deep myometrial invasion groups ( P < 0.001). All of these parameters showed a good diagnostic performance for detecting deep myometrial invasion (AUC>0.82), the highest accuracy rate (85%) was found with T2W TVRseg. LVI was significantly associated with TAR ( P = 0.002) and T2W TVRseg ( P = 0.014), while the cervical invasion was associated with TAR ( P = 0.03). ADCtumor was significantly lower in high-grade tumors ( P = 0.002). There was a significant difference in ADCtumor ( P = 0.002), TAR ( P = 0.004), and T2W TVRseg ( P = 0.038) between the low- and high-risk groups. AUC of TAR and T2W TVRseg for detecting high-risk groups were 0.80 and 0.77, respectively, while AUC of ADCtumor for the low-risk group was 0.75.

Conclusion

MRI quantitative assessments such as TAR, TVR, and ADCtumor may improve the accuracy of preoperative staging and can help in risk stratification of endometrial cancer.
High-dose diquat poisoning: a case report
Authors: Huang Yanxia , Zhang Renjing , Meng Mei , Chen Dechang , Deng Yunxin
Published: June 2021

Diquat is a widely used herbicide that is substituted for paraquat. With paraquat off the market, cases of diquat poisoning have been gradually increasing. The kidney is the most frequently impaired organ in diquat poisoning. Few cases of multiple organ failure caused by diquat have been reported.

We herein describe a 30-year-old man who orally ingested about 160 mL of enriched diquat. Despite aggressive treatment, the patient’s condition progressed to multiple organ failure and death. The pulmonary lesions in this patient were different from those previously reported. This patient did not die of renal failure but of severe respiratory failure. He exhibited three different stages of pulmonary disease.

The lung lesions in this case were unique. We hope that doctors will pay more attention to the lung lesions in patients with diquat poisoning in future and find new treatment methods to save the lives of such patients.
Behavioral Economics in the First-Year Experience
Authors: Lesser Mary H.
Published: June 2021

Many colleges and universities have put in place some form of freshman or first-year experience. This article suggests the use of a course in behavioral economics when the first-year experience has an academic basis and demonstrates how such a course can assist in the achievement of acculturation goals as well as help diagnose areas of strength and weakness in academic preparedness.

JEL Classifications: A20, A22, D90, D91
Benefits, Challenges, and Social Impact of Health Care Providers’ Adoption of Social Media
Authors: Khan Md Irfanuzzaman , Loh Jennifer (M.I.)
Published: June 2021

With the advent of telecommunication technologies and social media, many health care professionals are using social media to communicate with their patients and to promote health. However, the literature reveals a lacuna in our understanding of health care professionals’ perception of their behavioral intentions to use innovations. Using the Unified Technology Acceptance Framework (unified theory of acceptance and use of technology), in-depth interviews were conducted with 16 Australian health care experts to uncover their intent and actual use of social media in their medical practices. Results revealed that social media tools offered five significant benefits such as (i) enhanced communication between health care professionals and their patients, (ii) community support, (iii) enabled e-learning, (iv) enhanced professional network, and (v) expedited health promotion. However, result also revealed barriers to social media usage including (i) inefficiency, (ii) privacy concerns, (iii) poor quality of information, (iv) lack of trust, and (v) blurred professional boundary. Peer influence and supporting conditions were also found to be determinants of social media adoption behaviors among health care professionals. This study has important implications for health care providers, patients, and policy makers on the responsible use of social media, health promotion, and health communication. This research is also among the very few studies that explore Australian health care professionals’ intent and actual use of innovations within a health care setting.
Clinical Significance of Kinetics of Low-Density Lipoprotein Cholesterol and Its Prognostic Value in Limited Stage Small Cell Lung Cancer Patients
Authors: Liu Tingting , Zhou Ting , Luo Fan , Yang Yunpeng , Zhao Shen , Huang Yan , Zhao Hongyun , Zhang Li , Zhao Yuanyuan
Published: June 2021

Objectives:

To investigate the clinical significance of dynamic alteration of serum lipids in limited stage small cell lung cancer (LS-SCLC) patients and the risk that different lipid profiles poses to patients’ health.

Methods:

We retrospectively analyzed the variation trends and prognostic values of serum lipids in 310 LS-SCLC patients who had received standard chemotherapy between 2002 and 2017. In addition to serum lipid level, which were measured at the time of pretreatment, after-chemotherapy and during disease progression and later analyzed, the dynamic lipid alteration trend and its correlation to progression-free survival (PFS) and overall survival (OS) were also statistically analyzed using Log-rank test and COX regression analyses.

Results:

A significant decrease in HDL-C level was observed after standard chemotherapy (Post-CT baseline = −0.08 ± 0.34, P < 0.001), and this trend of reduction was further enhanced by thoracic radiotherapy ( P = 0.046). Increase in LDL-C level was also observed to be associated with higher likelihood of disease progression ( P = 0.003). Moreover, the extent of the increase in LDL-C was also associated with the number of progression sites, as patients with higher increase in LDL-C in exhibiting a progression at more than 2 sites outside thorax ( P = 0.037). The patients’ median PFS and OS were 14.04 months (95%CI: 25.12-33.81) and 22.40 months (95%CI: 33.19-42.13), respectively. For both PFS and OS, LDL-C elevation remained an independent prognostic factor in the multivariate model ( P = 0.007 and P = 0.022, respectively).

Conclusion:

Overall, for LS-SCLC patients, standard chemotherapy decreases the level of HDL-C, the level of increase in LDL-C could predict disease progression and even the number of progression sites, and LDL-C elevation could be an independent prognostic factor for poor OS and PFS.
Cardiovascular Disease in Rheumatoid Arthritis: Risk Factors, Autoantibodies, and the Effect of Antirheumatic Therapies
Authors: Fazeli Mir Sohail , Khaychuk Vadim , Wittstock Keith , Breznen Boris , Crocket Grace , Pourrahmat Mir-Masoud , Ferri Leticia
Published: June 2021

Objective:

To scope the current published evidence on cardiovascular risk factors in rheumatoid arthritis (RA) focusing on the role of autoantibodies and the effect of antirheumatic agents.

Methods:

Two reviews were conducted in parallel: A targeted literature review (TLR) describing the risk factors associated with cardiovascular disease (CVD) in RA patients; and a systematic literature review (SLR) identifying and characterizing the association between autoantibody status and CVD risk in RA. A narrative synthesis of the evidence was carried out.

Results:

A total of 69 publications (49 in the TLR and 20 in the SLR) were included in the qualitative evidence synthesis. The most prevalent topic related to CVD risks in RA was inflammation as a shared mechanism behind both RA morbidity and atherosclerotic processes. Published evidence indicated that most of RA patients already had significant CV pathologies at the time of diagnosis, suggesting subclinical CVD may be developing before patients become symptomatic. Four types of autoantibodies (rheumatoid factor, anti-citrullinated peptide antibodies, anti-phospholipid autoantibodies, anti-lipoprotein autoantibodies) showed increased risk of specific cardiovascular events, such as higher risk of cardiovascular death in rheumatoid factor positive patients and higher risk of thrombosis in anti-phospholipid autoantibody positive patients.

Conclusion:

Autoantibodies appear to increase CVD risk; however, the magnitude of the increase and the types of CVD outcomes affected are still unclear. Prospective studies with larger populations are required to further understand and quantify the association, including the causal pathway, between specific risk factors and CVD outcomes in RA patients.
Joint bodies in the European Union's international agreements: Delegating powers to the European Commission in EU external relations
Authors: Gastinger Markus , Dür Andreas
Published: June 2021

In many international agreements, the European Union sets up joint bodies such as ‘association councils’ or ‘joint committees’. These institutions bring together European Union and third-country officials for agreement implementation. To date, we know surprisingly little about how much discretion the European Commission enjoys in them. Drawing on a principal–agent framework, we hypothesise that the complexity of agreements, the voting rule, conflict within the Council, and agency losses can explain Commission discretion in these institutions. Drawing on an original dataset covering nearly 300 such joint bodies set up by the European Union since 1992, we find robust empirical support for all expectations except for the agency loss thesis. Our findings suggest that the European Commission is the primary actor in the implementation of many of the European Union's international agreements, allowing it to influence EU external relations beyond what is currently acknowledged in the literature.
Weighted mixed-effects dose–response models for tables of correlated contrasts
Authors: Orsini Nicola
Published: June 2021

Recognizing a dose–response pattern based on heterogeneous tables of contrasts is hard. Specification of a statistical model that can consider the possible dose–response data-generating mechanism, including its variation across studies, is crucial for statistical inference. The aim of this article is to increase the understanding of mixed-effects dose–response models suitable for tables of correlated estimates. One can use the command drmeta with additive (mean difference) and multiplicative (odds ratios, hazard ratios) measures of association. The postestimation command drmeta_graph greatly facilitates the visualization of predicted average and study-specific dose–response relationships. I illustrate applications of the drmeta command with regression splines in experimental and observational data based on nonlinear and random-effects data-generation mechanisms that can be encountered in health-related sciences.
Speaking Stata: Front-and-back plots to ease spaghetti and paella problems
Authors: Cox Nicholas J.
Published: June 2021

The spaghetti problem arises in graphics when multiple time series or other functional traces show mostly a tangled mess. The related paella problem (often experienced but not usually named as such) arises for multiple patterns combined in scatterplots. This column is a sequel to those in Stata Journal 10: 670–681 (2010) and 19: 989–1008 (2019). The focus is on what are here called front-and-back plots, in which each subset of data is shown separately with the other subsets as backdrop. The strategy is thus a hybrid of two more common strategies, showing each subset separately (juxtaposing) and showing subsets together (superimposing). A new command, fabplot, is introduced and used in examples.
Motion coordination for humanoid jumping using maximized joint power
Authors: Chen Xuechao , Liao Wenxi , Yu Zhangguo , Qi Haoxiang , Jiang Xinyang , Huang Qiang
Published: June 2021

Jumping capability of humanoid robots can be considered as one of the cruxes to improve the performance of future humanoid robot applications. This paper presents an optimization method on a three-linkage system to achieve a jumping behavior, which is followed by the clarification of the mathematical modeling and motor-joint model with practical factors considered. In consideration of the constraints of ZMP and the performance of the motor, the output power of the joint motors is maximized as much as possible to achieve a higher height. Finally, the optimization method is verified by the simulation and experiment. Different from other electric driven robots, which take the output power of the joint as the constraint, we maximize the output power of the joint to optimize the hopping performance of the robot. Realizing dynamic jumping of humanoid robots can also provide a solid foundation for further research on running, which can greatly enhance the environmental adaptability.
Balancing Bees and Livestock: Pastoralist Knowledge, Perceptions and Implications for Pollinator Conservation in Rangelands, Northern Tanzania
Authors: Mpondo Faith Thomas , Ndakidemi Patrick A. , Treydte Anna C.
Published: June 2021

Insect pollinators provide numerous ecosystem services that support other living organisms. While pollinators play a large role in cropping systems, little is known about their presence and function in rangeland ecosystems, which have recently become fragmented and overexploited at an extraordinary rate. We assessed local Maasai knowledge on insect pollinators and how pollinators affect livelihood diversification in Simanjiro rangelands, Tanzania. Through questionnaires, key informant interviews, focus group discussions, and field observations, we found varied insect knowledge among Maasai herders. Lasioglossum of sub genus Ipomalictus and Syriphidae were the least commonly recognized pollinators as only 24%, and 7% of participants could identify them, respectively. Responses varied significantly between men and women (F = 7.397, p = .007). Commiphora africana, Acacia mellifera and Albizia anthelmintica were noted as most important bee forage plants while observations showed Aspilia mossambicensis, Justicia debile and Acacia tortilis. Most (77%) of Maasai herders showed limited ability to link pollinators and rangeland wellbeing. Beekeeping contributed to livelihood diversification for 61% of respondents, with women participating more frequently than men (χ2 = 46.962, p = .0001). Beekeeping was positively influenced by education level ( R = .421, p < .0001) and occupation ( R = .194, p = .009). Pollinator declines were attributed to climate change (47%), agriculture (37%), and habitat destruction (8%). We conclude that Maasai have limited knowledge of common pollinator groups and their roles. Community outreach and training should bridge the knowledge gap in pastoralist communities to fully realize pollinator benefits and highlight the importance of rangeland health.
Making the Future Visible: Reflections Twenty Years on
Authors: Tibbs Hardin
Published: June 2021

A commentary after twenty years by the author of “Making the Future Visible,” written in 1999 and previously only circulated informally. Expanding on the idea of a “psychological landscape of the future” proposed in the 1999 paper, the author recalls the background and motivation for the original paper, and proposes that there are three psychologically distinct types of future—Cognitive, Affective, and Conative—each of which should be developed in any futures work intended to lead to strategic action. The identification and development of these three types of future also provides a means of resolving the so-called “scenarios to strategy problem.”
Ireland: Curtailment of the right to silence through statutory adverse inferences
Authors: Daly Yvonne M.
Published: June 2021

In Ireland, the right to silence has been significantly impacted by the legislative introduction of adverse inference provisions. In specified circumstances, with varying threshold requirements, a suspect’s failure to answer questions or provide information during Garda (police) questioning can form the basis of an inference against them at trial. Ireland has not opted in to either Directive 2016/343/EU on the strengthening of certain aspects of the presumption of innocence or Directive 2013/48/EU on the right of access to a lawyer in criminal proceedings. This article examines the constitutional and common law context of the protection of the right to silence in Ireland; the operation, and expansion, of the statutory inference regime; the lack of legislative provision for a right to legal assistance during Garda interview; and relevant European Court of Human Rights jurisprudence. While there are some benefits to overt legislation and safeguards attached to the drawing of inferences from pre-trial silence, the question must be asked whether a detained suspect in Ireland truly has a protected right to silence in real terms, given the proliferation of inference provisions.
Exploring the Impact of Technology-Facilitated Abuse and Its Relationship with Domestic Violence: A Qualitative Study on Experts’ Perceptions
Authors: Fiolet Renee , Brown Cynthia , Wellington Molly , Bentley Karen , Hegarty Kelsey
Published: June 2021

Technology-facilitated abuse can be a serious form of domestic violence. Little is known about the relationship between technology-facilitated abuse and other types of domestic violence, or the impact technology-facilitated abuse has on survivors. The aim of this interpretative descriptive study is to understand domestic violence specialist service providers’ perspectives on the impact of technology-facilitated abuse, and the link between technology-facilitated abuse and other forms of domestic violence. A qualitative approach using 15 semi-structured interviews were undertaken with Australian domestic violence specialist practitioners, and three themes were identified through data coding using inductive thematic analysis. Another form of control describes technology-facilitated abuse behaviors as enacting controlling behaviors using new mediums. Amplifies level of fear characterizes the impact of technology-facilitated abuse. A powerful tool to engage others describes opportunities technology offers perpetrators to abuse through engaging others. Findings highlight technology-facilitated abuse’s complexity and integral role in domestic violence and can assist clinicians to understand the impact and harm that can result from technology-facilitated abuse.
Nutritional Status and Its Association with Cognitive Function among School Aged Children at Soddo Town and Soddo Zuriya District, Southern Ethiopia: Institution Based Comparative Study
Authors: Honja Kabero Tesfaye , Bosha Tafese , Feleke Fentaw Wassie , Haile Weldegebreal Demewoz , Stoecker Barbara
Published: June 2021

About 1 billion stunted school-aged children are growing up with impaired mental development which can lead to low cognitive performance, reduced school achievement, and low productivity. But there is scarce evidence on cognitive function, school performance and their associated factors among school aged children. The main aim of this study was to assess cognitive function, school performance and determine their association with nutritional status among school children aged 7 to 10 years at Soddo Town and Soddo Zuriya Woreda, Wolaita Zone, Southern Ethiopia. Institutional comparative cross-sectional study was conducted on a total sample of 178 primary school children. The Raven’s Color Progressive Matrices (RCPM) and selected tests from Kaufman assessment battery for children second edition were used. Mid-year average students’ examination result was also used. Data were analyzed by using SPSS version 25, WHO Anthro plus, and independent sample t-test. Bivariate and multivariate linear regression analyses were also used. Mean (±SD) cognitive test scores of urban study participants was 18.7 ± 3.4 for RCPM which was higher ( P < .001) as compared to rural (16.5 ± 3.3). The urban mean cognitive test scores was also higher for both pattern reasoning and visual processing with ( P < .001) as compared to rural counterparts. School performance was higher ( P < .001) for urban. Maternal education ( P < .002) and wealth index ( P < .006) were positively predicted while stunting ( P < .001) negatively predicted cognitive function test scores and school performance. Cognitive function and school performance of study participants were associated with their nutritional status and rural participants had significantly lower mean scores as compared to urban counterparts. Further study should be done to community level.
Physcraper: a Python package for continually updated phylogenetic trees using the Open Tree of Life
Authors: Sánchez-Reyes Luna L. , Kandziora Martha , McTavish Emily Jane
Published: June 2021

Background

Phylogenies are a key part of research in many areas of biology. Tools that automate some parts of the process of phylogenetic reconstruction, mainly molecular character matrix assembly, have been developed for the advantage of both specialists in the field of phylogenetics and non-specialists. However, interpretation of results, comparison with previously available phylogenetic hypotheses, and selection of one phylogeny for downstream analyses and discussion still impose difficulties to one that is not a specialist either on phylogenetic methods or on a particular group of study.

Results

Physcraper is a command-line Python program that automates the update of published phylogenies by adding public DNA sequences to underlying alignments of previously published phylogenies. It also provides a framework for straightforward comparison of published phylogenies with their updated versions, by leveraging upon tools from the Open Tree of Life project to link taxonomic information across databases. The program can be used by the nonspecialist, as a tool to generate phylogenetic hypotheses based on publicly available expert phylogenetic knowledge. Phylogeneticists and taxonomic group specialists will find it useful as a tool to facilitate molecular dataset gathering and comparison of alternative phylogenetic hypotheses (topologies).

Conclusion

The Physcraper workflow showcases the benefits of doing open science for phylogenetics, encouraging researchers to strive for better scientific sharing practices. Physcraper can be used with any OS and is released under an open-source license. Detailed instructions for installation and usage are available at https://physcraper.readthedocs.io.
Genome-wide identification and expression analysis of Raffinose synthetase family in cotton
Authors: Cui Ruifeng , Wang Xiaoge , Malik Waqar Afzal , Lu Xuke , Chen Xiugui , Wang Delong , Wang Junjuan , Wang Shuai , Chen Chao , Guo Lixue , Chen Quanjia , Ye Wuwei
Published: June 2021

Background

The Raffinose synthetase (RAFS) genes superfamily is critical for the synthesis of raffinose, which accumulates in plant leaves under abiotic stress. However, it remains unclear whether RAFS contributes to resistance to abiotic stress in plants, specifically in the Gossypium species.

Results

In this study, we identified 74 RAFS genes from G. hirsutum, G. barbadense, G. arboreum and G. raimondii by using a series of bioinformatic methods. Phylogenetic analysis showed that the RAFS gene family in the four Gossypium species could be divided into four major clades; the relatively uniform distribution of the gene number in each species ranged from 12 to 25 based on species ploidy, most likely resulting from an ancient whole-genome polyploidization. Gene motif analysis showed that the RAFS gene structure was relatively conservative. Promoter analysis for cis-regulatory elements showed that some RAFS genes might be regulated by gibberellins and abscisic acid, which might influence their expression levels. Moreover, we further examined the functions of RAFS under cold, heat, salt and drought stress conditions, based on the expression profile and co-expression network of RAFS genes in Gossypium species. Transcriptome analysis suggested that RAFS genes in clade III are highly expressed in organs such as seed, root, cotyledon, ovule and fiber, and under abiotic stress in particular, indicating the involvement of genes belonging to clade III in resistance to abiotic stress. Gene co-expressed network analysis showed that GhRFS2A-GhRFS6A, GhRFS6D, GhRFS7D and GhRFS8A-GhRFS11A were key genes, with high expression levels under salt, drought, cold and heat stress.

Conclusion

The findings may provide insights into the evolutionary relationships and expression patterns of RAFS genes in Gossypium species and a theoretical basis for the identification of stress resistance materials in cotton.
Transcriptional responses in jejunum of two layer chicken strains following variations in dietary calcium and phosphorus levels
Authors: Reyer Henry , Oster Michael , Ponsuksili Siriluck , Trakooljul Nares , Omotoso Adewunmi O. , Iqbal Muhammad A. , Muráni Eduard , Sommerfeld Vera , Rodehutscord Markus , Wimmers Klaus
Published: June 2021

Background

Calcium (Ca) and phosphorus (P) are essential nutrients that are linked to a large array of biological processes. Disturbances in Ca and P homeostasis in chickens are associated with a decline in growth and egg laying performance and environmental burden due to excessive P excretion rates. Improved utilization of minerals in particular of P sources contributes to healthy growth while preserving the finite resource of mineral P and mitigating environmental pollution. In the current study, high performance Lohmann Selected Leghorn (LSL) and Lohmann Brown (LB) hens at peak laying performance were examined to approximate the consequences of variable dietary Ca and P supply. The experimental design comprised four dietary groups with standard or reduced levels of either Ca or P or both (n = 10 birds per treatment group and strain) in order to stimulate intrinsic mechanisms to maintain homeostasis. Jejunal transcriptome profiles and the systemic endocrine regulation of mineral homeostasis were assessed (n = 80).

Results

Endogenous mechanisms to maintain mineral homeostasis in response to variations in the supply of Ca and P were effective in both laying hen strains. However, the LSL and LB appeared to adopt different molecular pathways, as shown by circulating vitamin D levels and strain-specific transcriptome patterns. Responses in LSL indicated altered proliferation rates of intestinal cells as well as adaptive responses at the level of paracellular transport and immunocompetence. Endogenous mechanisms in LB appeared to involve a restructuring of the epithelium, which may allow adaptation of absorption capacity via improved micro-anatomical characteristics.

Conclusions

The results suggest that LSL and LB hens may exhibit different Ca, P, and vitamin D requirements, which have so far been neglected in the supply recommendations. There is a demand for trial data showing the mechanisms of endogenous factors of Ca and P homeostasis, such as vitamin D, at local and systemic levels in laying hens.
Pediatric nurses in pediatricians’ offices: a survey for primary care pediatricians
Authors: Dall’Oglio Immacolata , Rosati Giovanni Vitali , Biagioli Valentina , Tiozzo Emanuela , Gawronski Orsola , Ricci Riccardo , Garofalo Antonio , Piga Simone , Gramaccioni Simone , Di Maria Claudio , Vanzi Valentina , Querciati Alessandra , Alvaro Rosaria , Biancalani Luciana , Buonomo Ersilia , Doria Mattia , Villani Alberto
Published: June 2021

Background

The role played by nurses in caring for children in pediatricians’ officies in the community is crucial to ensure integrated care. In Italy, pediatricians are responsible for the health of children aged 0–14 years living in the community. This study aimed to describe Italian primary care pediatricians’ opinions about the usefulness of several nursing activities that pediatric nurses could perform in pediatricians’ offices.

Methods

An online survey with pediatricians working in primary care in Italy was conducted between April–December 2018. A 40-item questionnaire was used to assess four types of nursing activities: clinical care, healthcare education, disease prevention, and organizational activities. The answers ranged from 1 (not useful at all) to 6 (very useful). Moreover, three open-ended questions completed the questionnaire.

Results

Overall, 707 pediatricians completed the online survey. Participants were mainly female (63%), with a mean age of 57.74 (SD = 6.42). The presence of a pediatric nurse within the pediatrician’s office was considered very useful, especially for healthcare education (Mean 4.90; SD 1.12) and disease prevention (Mean 4.82; SD 1.11). Multivariate analysis confirmed that pediatricians ‘with less working experience’, ‘having their office in a small town’, and ‘collaborating with a secretary and other workers in the office’ rated the nurse’s activities significantly more useful.

Conclusions

A pediatric nurse in the pediatrician’s office can significantly contribute to many activities for children and their families in the community. These activities include clinical care, healthcare education, disease prevention, and the organizational processes of the office. Synergic professional activity between pediatricians and pediatric nurses could ensure higher health care standards in the primary care setting.
Tumor-to-tumor metastasis of diffuse large B cell lymphoma to gastric adenocarcinoma via CXCL12 (SDF-1)/CXCR4 axis: a case report
Authors: Kamihara Yusuke , Murai Sayaka , Kikuchi Shohei , Wada Akinori , Murakami Jun , Dang Nam H. , Sato Tsutomu
Published: June 2021

Background

Tumor-to-tumor metastasis is the rare phenomenon in which one tumor exhibits metastatic deposits from another. To the best of our knowledge, there has been no prior reported case of tumor-to-tumor metastasis of a diffuse large B cell lymphoma (DLBCL) to a primary gastric adenocarcinoma.

Case presentation

A 70-year-old man presented with chest discomfort. An echocardiogram showed the presence of a right ventricular tumor. A positron emission tomogram showed multiple foci of abnormal activity in right cervical lymph nodes, cardiac wall, and stomach. A right cervical lymph node biopsy specimen revealed histological features of DLBCL. An esophagogastroduodenoscopy showed a large circumferential ulceration on the gastric body. Subsequent biopsy revealed adenocarcinoma cells surrounded by infiltrating lymphoma cells. On immunohistochemical staining, lymphoma cells were positive for CXCR4 and adenocarcinoma cells were positive for CXCL12/SDF-1. The patient was treated with six cycles of R-CHOP chemotherapy regimen, resulting in a complete remission.

Conclusions

This patient’s case implies that the interaction between a chemokine and its receptor may be the underlying mechanism for the observed tumor-to-tumor metastasis. Specifically, our case would suggest an involvement of the CXCL12 (SDF-1)/CXCR4 axis in the observed metastasis of DLBCL to primary gastric adenocarcinoma.
Domain-specific self-perceptions of aging are associated with different gait patterns in older adults: a cross-sectional latent profile analysis
Authors: Blawert Anne , Krumpoch Sebastian , Freiberger Ellen , Wurm Susanne
Published: June 2021

Background

Previous studies have pointed to the impact of self-perceptions of aging (SPA) on self-reported physical function in later life. However, less is known about associations of SPA with objectively measured physical function, especially gait. Research that examined other psychological variables and objectively measured gait has focused on single gait parameters such as gait speed, which seems to fall short for the complexity of this movement. Some approaches have proposed ways to identify gait patterns in specific patient groups, but not in community samples. Our goal was (a) to identify gait patterns based on a combination of important gait parameters in a community sample, and (b) to investigate differential associations of gain- and loss-related SPA with these gait patterns.

Methods

The study used an electronic walkway to assess gait parameters of 150 community dwelling adults aged 71–93 years (61.0% women) at their usual and maximum gait speed. SPA were assessed with a questionnaire. We used latent profile analysis (LPA) to identify groups exhibiting distinct gait patterns and binary logistic regression to investigate associations of SPA with these groups, controlling for personality traits, number of illnesses, age, gender, and education. To compare overall function between groups, a t-test for scores in the Short Physical Performance Battery was used.

Results

LPA revealed two distinct groups in both gait speed conditions. The fit group exhibited a stable, well-coordinated and faster gait pattern, while the functionally limited group’s gait pattern was less stable, less coordinated and slower. The odds of belonging to the functionally limited group were increased by loss-related SPA at usual gait speed, while the odds of belonging to the fit group were increased by gain-related SPA at individual maximum speed.

Conclusions

The findings (a) suggest LPA as a useful approach to investigate complex gait patterns considering several gait parameters simultaneously, and (b) provide first evidence for differential associations of gain- and loss-related SPA with gait patterns at usual and maximum gait speed. Intervention studies addressing gait in older adults should additionally address gain-related views on aging.
Bidirectional relationship between subjective age and frailty: a prospective cohort study
Authors: Li Yuxiao , Liu Minhui , Miyawaki Christina E. , Sun Xiaocao , Hou Tianxue , Tang Siyuan , Szanton Sarah L.
Published: June 2021

Background

Subjective age refers to how young or old individuals experience themselves to be and is associated with health status, behavioral, cognitive, and biological processes that influence frailty. However, little research has examined the relationship between subjective age and frailty among older adults. This study examined the bidirectional association between subjective age and frailty among community-dwelling older adults.

Methods

We used data from the 2011 to 2015 waves of the National Health and Aging Trends Study. Our sample consists of 2,592 community-dwelling older adults with complete data on main outcome variables. Subjective age was measured by asking participants, “What age do you feel most of the time?” Based on the five phenotypic criteria: exhaustion, unintentional weight loss, low physical activity, slow gait, and weak grip strength, frailty was categorized into robust = 0, pre-frailty = 1 or 2; frailty = 3 or more criteria met. Generalized estimating equation models were used to examine the concurrent and lagged association between subjective age and frailty.

Results

Participants were, on average, 75.2 ± 6.8 years old, non-Hispanic whites (76 %), female (58 %). 77 % of the participants felt younger, 18 % felt the same, and 5 % felt older than their chronological age. About 45 %, 46 %, and 9 % of the participants were robust, pre-frailty and frailty in the first wave, respectively. Generalized estimating equations revealed that an “older” subjective age predicted a higher likelihood of pre-frailty and frailty (OR, 95 % CI = 1.93, 1.45–2.56).

Conclusions

These findings suggest that people with older subjective age are more likely to be pre-frail/frail. Subjective age could be used as a quick and economical screening for those who are potentially frailty or at risk for frailty.
Effect of Vitamin C on mortality of critically ill patients with severe pneumonia in intensive care unit: a preliminary study
Authors: Mahmoodpoor Ata , Shadvar Kamran , Sanaie Sarvin , Hadipoor Mir Reza , Pourmoghaddam Mohammad Ata , Saghaleini Seied Hadi
Published: June 2021

Background

Critically ill patients frequently suffer from vitamin C deficiency. Previous studies showed that high doses of vitamin C administration had conflicting results on clinical outcomes in patients with severe sepsis, burns, and trauma. Because of the high incidence and morbidity/mortality with severe pneumonia, we aimed to investigate the effect of administration of high dose vitamin C in critically ill patients with severe pneumonia.

Methods

Eighty critically ill patients with pneumonia were enrolled in this randomized double-blinded clinical trial. Patients with a CURB-65 score > 3, one major criterion, or ≥ 3 minor criteria were considered as severe pneumonia. Patients were randomly assigned to intervention or placebo groups receiving standard treatment plus 60 mg/kg/day vitamin C as a continuous infusion or normal saline in the same volume correspondingly for 96 h. Serum levels of vitamin C were noted at baseline and 48 h after vitamin C administration. Duration of mechanical ventilation, ICU length of stay, PaO2/FiO2, and mortality rate were noted for all patients till the 28th day. Any complications related to the vitamin C administration were recorded.

Results

Duration of mechanical ventilation and vasopressor use were significantly lower in the intervention group (p: < 0.001 and 0.003, respectively). Baseline levels of vitamin C in both groups did not have a significant difference but its levels increased in the intervention group and decreased in the control group during the study period. Mortality rate insignificantly decreased in the intervention group (p = 0.17). Three patients showed hypotension and tachycardia during the administration of vitamin C which was self-limited with decreasing the dose of vitamin C.

Our results showed that the intravenous administration of a relatively high dose of vitamin C to critically ill patients with severe pneumonia was safe and could decrease the inflammation, duration of mechanical ventilation, and vasopressor use without any significant effect on mortality.

Trial registration: IRCT registration number: IRCT20190312043030N1, Registration date: 2019-08-26, Seied Hadi Saghaleini.
Risk factors and biofilm formation analyses of hospital-acquired infection of Candida pelliculosa in a neonatal intensive care unit
Authors: Zhang Zhijie , Cao Yu , Li Yanjian , Chen Xufang , Ding Chen , Liu Yong
Published: June 2021

Background

Candida pelliculosais an ecological fungal species that can cause infections in immunocompromised individuals. Numerous studies globally have shown thatC. pelliculosainfects neonates. An outbreak recently occurred in our neonatal intensive care unit; therefore, we aimed to evaluate the risk factors in this hospital-acquired fungal infection.

Methods

We performed a case-control study, analysing the potential risk factors for neonatal infections ofC. pelliculosaso that infection prevention and control could be implemented in our units. Isolated strains were tested for drug resistance and biofilm formation, important factors for fungal transmission that give rise to hospital-acquired infections.

Results

The use of three or more broad-spectrum antimicrobials or long hospital stays were associated with higher likelihoods of infection withC. pelliculosa. The fungus was not identified on the hands of healthcare workers or in the environment. All fungal isolates were susceptible to anti-fungal medications, and after anti-fungal treatment, all infected patients recovered. Strict infection prevention and control procedures efficiently suppressed infection transmission. Intact adhesin-encoding genes, shown by genome analysis, indicated possible routes for fungal transmission.

Conclusions

The use of three or more broad-spectrum antimicrobials or a lengthy hospital stay is theoretically associated with the risk of infection withC. pelliculosa. Strains that we isolated are susceptible to anti-fungal medications, and these were eliminated by treating all patients with an antifungal. Transmission is likely via adhesion to the cell surface and biofilm formation.
Evaluating an app-guided self-test for influenza: lessons learned for improving the feasibility of study designs to evaluate self-tests for respiratory viruses
Authors: Zigman Suchsland Monica L. , Rahmatullah Ivan , Lutz Barry , Lyon Victoria , Huang Shichu , Kline Enos , Graham Chelsey , Cooper Shawna , Su Philip , Smedinghoff Sam , Chu Helen Y. , Sewalk Kara , Brownstein John S. , Thompson Matthew J. ,   on behalf of Seattle Flu Study investigators
Published: June 2021

Background

Seasonal influenza leads to significant morbidity and mortality. Rapid self-tests could improve access to influenza testing in community settings. We aimed to evaluate the diagnostic accuracy of a mobile app-guided influenza rapid self-test for adults with influenza like illness (ILI), and identify optimal methods for conducting accuracy studies for home-based assays for influenza and other respiratory viruses.

Methods

This cross-sectional study recruited adults who self-reported ILI online. Participants downloaded a mobile app, which guided them through two low nasal swab self-samples. Participants tested the index swab using a lateral flow assay. Test accuracy results were compared to the reference swab tested in a research laboratory for influenza A/B using a molecular assay.

Results

Analysis included 739 participants, 80% were 25–64 years of age, 79% female, and 73% white. Influenza positivity was 5.9% based on the laboratory reference test. Of those who started their test, 92% reported a self-test result. The sensitivity and specificity of participants’ interpretation of the test result compared to the laboratory reference standard were 14% (95%CI 5–28%) and 90% (95%CI 87–92%), respectively.

Conclusions

A mobile app facilitated study procedures to determine the accuracy of a home based test for influenza, however, test sensitivity was low. Recruiting individuals outside clinical settings who self-report ILI symptoms may lead to lower rates of influenza and/or less severe disease. Earlier identification of study subjects within 48 h of symptom onset through inclusion criteria and rapid shipping of tests or pre-positioning tests is needed to allow self-testing earlier in the course of illness, when viral load is higher.
Characteristics of diffusion-weighted and blood oxygen level-dependent magnetic resonance imaging in Tubulointerstitial nephritis: an initial experience
Authors: Su Tao , Yang Xuedong , Wang Rui , Yang Li , Wang Xiaoying
Published: June 2021

Background

Diffusion-weighted (DW) and blood oxygen level-dependent (BOLD) magnetic resonance imaging are classical sequences of functional MR, but the exploration in non-transplanted kidney disease is limited. Objects: To analyze the characteristics of apparent diffusion coefficient (ADC) and R2* value using DW and BOLD imaging in tubulointerstitial nephritis (TIN).

Methods

Four acute TIN, thirteen chronic TIN patients, and four controls were enrolled. We used multiple gradient-echo sequences to acquire 12 T2*-weighted images to calculate the R2* map. DW imaging acquired ADC values by combining a single-shot spin-echo echo-planar imaging pulse sequence and the additional motion probing gradient pulses along the x,y, z-axes with two b values:0 and 200, as well as 0 and 800 s/mm2. ATIN patients performed DW and BOLD magnetic resonance at renal biopsy(T0) and the third month(T3). We assessed the pathological changes semiquantitatively, and conducted correlation analyses within functional MR, pathological and clinical indexes.

Results

In ATIN, ADCs were significantly lower(b was 0,200 s/mm2, 2.86 ± 0.19 vs. 3.39 ± 0.11, b was 0,800 s/mm2, 1.76 ± 0.12 vs. 2.16 ± 0.08, P < 0.05) than controls, showing an obvious remission at T3. Cortical and medullary R2* values (CR2*,MR2*) were decreased, significant difference was only observed in MR2*(T0 24.3 ± 2.1vs.T3 33.1 ± 4.1,P < 0.05). No relationship was found between functional MR and histopathological indexes.MR2* had a close relationship with eGFR (R = 0.682,P = 0.001) and serum creatinine(R = -0.502,P = 0.012). Patients with lower ADC when b was 0,200 s/mm2 showed more increase of ADC(R = -0.956,P = 0.044) and MR2*(R = -0.949,P = 0.05) after therapy. In CTIN group, lowered MR2* and MR2*/CR2* provided evidence of intrarenal ischemia. CTIN with advanced CKD (eGFR< 45) had significantly lower ADCb200 value.

Conclusions

We observed the reduction and remission of ADC and R2* values in ATIN case series. ATIN patients had concurrently decreased ADCb800 and MR2*. The pseudo normalization of CR2* with persistently low MR2* in CTIN suggested intrarenal hypoxia.