bluuebunny/crossref_metadata_2025 huggingface dataset:
Modernism and Record Covers: Raising the Status of Jazz in Sweden
Authors: van Kan Mischa
Published: November 2021

By introducing a wider understanding of the discourse of modernism at the time that record covers were introduced, this article investigates record covers as a means through which various actors in the Swedish jazz scene connected jazz with modernist art forms. In the 1950s, specific designs for record sleeves became integrated into the ways in which jazz was mediated in Sweden, which coincided with wider debates about whether jazz could be seen as an art form.

The main question of this article is: How did the artwork on record covers influence the acceptance of jazz as an art form in Sweden? In responding to this question, the article aims to demonstrate that, in addition to written discourse, visual objects – in this case record covers – were of great importance to the rising status of jazz in Sweden in the 1950s and 1960s. More broadly, I argue that the visual elements in music cultures can be just as important, if not more so, than written forms of discourse, for negotiating the social status of music.
Acute scaphoid fractures: making decisions for treating a troublesome bone
Authors: Dias Joseph J. , Ring David , Grewal Ruby , Clementson Martin , Buijze Geert Alexander , Ho Pak-Cheong
Published: November 2021

Seven aspects of the management of acute scaphoid fractures are open to debate: Diagnosis of true fractures among suspected fractures, assessment of fracture displacement, cast immobilization strategies, the role of surgical fixation, proximal pole fractures, assessment of union, and the underlying objective of treatment. We reviewed current evidence, and our varied interpretations of it, to highlight areas of uncertainty where more evidence might be helpful.
The neurological risks of playing association football
Authors: Cockerell Oliver C , Iino Hayes Natalie , Sylvester Richard
Published: November 2021

Summary

Aims:

The present study aims to provide a narrative review of the literature surrounding concussion and head injury in football and its clarity in evaluating the risk of long-term neurological disease.

Findings:

Epidemiological studies have shown correlations between participation in professional football and increased incidence of neurodegenerative disease and there have been reports of chronic traumatic encephalopathy (CTE) in the brains of former players in autopsy. These findings have been assumed by some to be the result of repetitive brain injury from head injuries and/or from heading the ball over a player's career. Data linking increased heading exposure with dementia is conflicting, and studies are limited by the reliance on retrospection and undocumented reports of concussion. It remains unclear whether CTE is unique to sportsmen or a variant of dementia pathology endemic in the population.

Conclusions:

Although logically appealing, there is no current evidence that heading is the cause of neurodegeneration amongst footballers and risks should be balanced by the protective mental and physical benefits of the sport. Physicians have an important role in providing balanced views in this emotive and controversial area.
Debt Financing and Agency Cost on Profitability: Are Real Estate Firms’ Performance in India Getting Affected?
Authors: Mitra Pradip Kumar , Naik Omkar
Published: November 2021

This article tries to understand the relationship between agency cost, debt financing and Indian real estate companies’ performance. The study attempts to document the effect of debt on the firm’s profitability and then explores the reason behind such an impact by introducing the agency cost as a parameter. The study is conducted in two phases. Phase I is carried out to establish the relationship between debt financing and the firm’s financial performance. In Phase II, the study is conducted to understand the impact of agency cost on debt financing. Firms from the BSE Realty Index were selected for the period 2011–2018. Profitability is measured through return on equity (ROE), whereas debt financing is measured through the firm’s leverage ratio. The agency cost is measured through the asset utilisation ratio and general expense to sales ratio. Panel regression method is used to understand the impact of debt financing and agency cost on the firms’ profitability. The result of Phase I suggests a significant negative relationship between debt financing and the ROE and the result of Phase II suggests a positive relationship between the agency cost and debt financing. This means that reduction in agency cost will lead to lesser amount of debt financing thereby improving the firm’s financial performance.
Book review: Paul Wallace (Ed.), India’s 2019 Elections: The Hindutva Wave and Indian Nationalism
Authors: Vohra Ishta
Published: November 2021

Paul Wallace (Ed.), India’s 2019 Elections: The Hindutva Wave and Indian Nationalism (New Delhi: SAGE Publications, 2020), 428 pp. ₹1,395 (Hardback). ISBN: 978-93-5388-244-0.
Hybrid Transtibial Femoral Preparation for Transphyseal Anterior Cruciate Ligament Reconstruction: A Radiographic Comparison With the Transtibial and Anteromedial Portal Techniques
Authors: Jarvis D. Landry , Vance Danica D. , Reinke Emily K. , Riboh Jonathan C.
Published: November 2021

Background:

Transphyseal anterior cruciate ligament (ACL) reconstruction remains the most commonly used technique for pubescent patients. The transtibial (TT) drilling technique creates vertical and central femoral tunnels to minimize the physeal area of injury at the expense of a nonanatomic femoral tunnel. The hybrid TT (HTT) technique offers the potential of an anatomic femoral position with tunnel geometry similar to that using the TT technique.

Purpose/Hypothesis:

The purpose was to perform a radiographic comparison of the HTT technique with TT and anteromedial portal (AM) techniques in adolescent patients undergoing transphyseal ACL reconstruction. It was hypothesized that femoral tunnels created during HTT would be similar to TT tunnels but significantly more vertical and central than AM tunnels.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

We retrospectively screened primary transphyseal ACL reconstructions performed in adolescents at our institution between 2013 and 2019. The youngest 20 eligible patients were selected from each technique cohort: TT, AM, and HTT. Postoperative radiographs were assessed for the coronal femoral tunnel angle, as well as the location of the tunnel-physis penetration on the anteroposterior and lateral views. Physeal lesion surface area was calculated. Data were compared among the 3 groups using 1-way analysis of variance followed by pairwise comparisons.

Results:

Included were 47 patients with a mean ± SD age of 14.3 ± 1.2 years (n = 9 with TT, 18 with AM, and 20 with HTT techniques). The coronal tunnel angle was significantly more vertical in the TT (60.7° ± 7.2°) and HTT (54.4° ± 5.7) groups as compared with the AM group (48.8° ± 5.9; P = .0037 and P = .02, respectively). There was no significant difference between the TT and HTT groups ( P = .066). The only significant finding regarding femoral tunnel location was that the HTT tunnels (28.9% ± 4.8%) penetrated the physis more centrally than did the AM tunnels (20.0% ± 5.1%; P = .00002) on lateral radiographs.

Conclusion:

The HTT technique presents an option for transphyseal ACL reconstruction, with femoral tunnel obliquity and estimated physeal disruption similar to that of the TT technique and significantly less than that of the AM technique. The HTT technique also results in the most central physeal perforation of all techniques, predominantly in the sagittal plane.
Assessment of Patient Satisfaction with Generic Medication in Emerging Economy Using the Treatment Satisfaction Questionnaire for Medication
Authors: Dash Ajitabh
Published: November 2021

The purpose of this study was to explore the factors influencing patient satisfaction with generic medication in India using the treatment satisfaction questionnaire for medication (TSQM) scale. This study proposed a set of hypotheses that were tested using structural equation modeling (SEM). This study was based on primary data collected from 542 sample respondents using the judgmental sampling method. The findings of this study revealed an affirmative relationship of effectiveness and convenience with patient satisfaction with generic medication. The study's findings demonstrated that the TSQM is a psychometrically sound tool with high reliability and construct validity. Path analysis revealed that the effectiveness and convenience of generic medication contributed significantly to patient satisfaction, with standardized coefficients of 0.254 and 0.237, respectively.
Fostering Early Preclinical Experiences for Developing Knowledge, Skills, and Confidence in Key Residency Competencies Through Participation in a Medical Student Research Training Program
Authors: Sawarynski Kara E , Swanberg Stephanie M , Roach Victoria A , Taylor Tracey AH , Baxa Dwayne M.
Published: November 2021

Periods of academic transition are challenging and require medical students to adjust to new environments and expectations. Commonly cited areas of struggle include integrating into the interprofessional health care team, communication, organization and time management, and self-regulated learning. Consciously designing opportunities early in the preclinical curriculum to help students gradually build these competencies can be achieved within existing research training programs or projects. This perspective article reflects on how the medical student research training program at the Oakland University William Beaumont School of Medicine supports student growth in these areas beginning in the first year, so that students can directly apply these skills as they progress to the clinical years and beyond.
Parenchymal neuroinflammatory signaling and dural neurogenic inflammation in migraine
Authors: Erdener Şefik Evren , Kaya Zeynep , Dalkara Turgay
Published: November 2021

Background

Pain is generally concomitant with an inflammatory reaction at the site where the nociceptive fibers are activated. Rodent studies suggest that a sterile meningeal inflammatory signaling cascade may play a role in migraine headache as well. Experimental studies also suggest that a parenchymal inflammatory signaling cascade may report the non-homeostatic conditions in brain to the meninges to induce headache. However, how these signaling mechanisms function in patients is unclear and debated. Our aim is to discuss the role of inflammatory signaling in migraine pathophysiology in light of recent developments.

Body

Rodent studies suggest that a sterile meningeal inflammatory reaction can be initiated by release of peptides from active trigeminocervical C-fibers and stimulation of resident macrophages and dendritic/mast cells. This inflammatory reaction might be needed for sustained stimulation and sensitization of meningeal nociceptors after initial activation along with ganglionic and central mechanisms. Most migraines likely have cerebral origin as suggested by prodromal neurologic symptoms. Based on rodent studies, a parenchymal inflammatory signaling cascade has been proposed as a potential mechanism linking cortical spreading depolarization (CSD) to meningeal nociception. A recent PET/MRI study using a sensitive inflammation marker showed the presence of meningeal inflammatory activity in migraine with aura patients over the occipital cortex generating the visual aura. These studies also suggest the presence of a parenchymal inflammatory activity, supporting the experimental findings. In rodents, parenchymal inflammatory signaling has also been shown to be activated by migraine triggers such as sleep deprivation without requiring a CSD because of the resultant transcriptional changes, predisposing to inadequate synaptic energy supply during intense excitatory transmission. Thus, it may be hypothesized that neuronal stress created by either CSD or synaptic activity-energy mismatch could both initiate a parenchymal inflammatory signaling cascade, propagating to the meninges, where it is converted to a lasting headache with or without aura.

Conclusion

Experimental studies in animals and emerging imaging findings from patients warrant further research to gain deeper insight to the complex role of inflammatory signaling in headache generation in migraine.
The origin and evolution of a two-component system of paralogous genes encoding the centromeric histone CENH3 in cereals
Authors: Elisafenko Evgeny A. , Evtushenko Elena V. , Vershinin Alexander V.
Published: November 2021

Background

The cereal family Poaceae is one of the largest and most diverse angiosperm families. The central component of centromere specification and function is the centromere-specific histone H3 (CENH3). Some cereal species (maize, rice) have one copy of the gene encoding this protein, while some (wheat, barley, rye) have two. We applied a homology-based approach to sequenced cereal genomes, in order to finally trace the mutual evolution of the structure of the CENH3 genes and the nearby regions in various tribes.

Results

We have established that the syntenic group or the CENH3 locus with the CENH3 gene and the boundaries defined by the CDPK2 and bZIP genes first appeared around 50 Mya in a common ancestor of the subfamilies Bambusoideae, Oryzoideae and Pooideae. This locus came to Pooideae with one copy of CENH3 in the most ancient tribes Nardeae and Meliceae. The βCENH3 gene as a part of the locus appeared in the tribes Stipeae and Brachypodieae around 35–40 Mya. The duplication was accompanied by changes in the exon-intron structure. Purifying selection acts mostly on αCENH3s, while βCENH3s form more heterogeneous structures, in which clade-specific amino acid motifs are present. In barley species, the βCENH3 gene assumed an inverted orientation relative to αCENH3 and the CDPK2 gene was substituted with LHCB-l. As the evolution and domestication of plant species went on, the locus was growing in size due to an increasing distance between αCENH3 and βCENH3 because of a massive insertion of the main LTR-containing retrotransposon superfamilies, gypsy and copia, without any evolutionary preference on either of them. A comparison of the molecular structure of the locus in the A, B and D subgenomes of the hexaploid wheat T. aestivum showed that invasion by mobile elements and concomitant rearrangements took place in an independent way even in evolutionarily close species.

Conclusions

The CENH3 duplication in cereals was accompanied by changes in the exon-intron structure of the βCENH3 paralog. The observed general tendency towards the expansion of the CENH3 locus reveals an amazing diversity of ways in which different species implement the scenario described in this paper.
Living with a chronic disease: insights from patients with a low socioeconomic status
Authors: Van Wilder Lisa , Pype Peter , Mertens Fien , Rammant Elke , Clays Els , Devleesschauwer Brecht , Boeckxstaens Pauline , De Smedt Delphine
Published: November 2021

Background

Little is known about how patients with low socioeconomic status (SES) experience their chronic disease, and how it impacts health-related quality of life (HRQoL). Compared to their more affluent counterparts, worse outcomes have been reported. A better understanding of the domains of HRQoL that are relevant to these specific populations is therefore needed. We explored the experiences of living with a chronic disease in low SES persons.

Methods

A qualitative interview study was performed in Flanders, Belgium. Semi-structured interviews were conducted in chronically ill patients, selected through purposive sampling. Interviews were audio-recorded and transcribed verbatim. Analysis followed an inductive and iterative approach.

Results

Fifteen patients were interviewed. Six major themes were identified: a heavy bag to carry, loss of autonomous life, inner and outer loneliness, emotional imbalance, unmet need for support, and coping strategies. Patients experienced their illness as an additional problem on top of all other problems (i.e. financial/social problems, traumatic life events). In general, the disease burden and non-disease burden were mutually reinforcing, resulting in greater dependency, greater risk of social isolation, greater psychological distress, and greater risk of impaired HRQoL.

Conclusions

This study is the first to provide detailed insight into the experiences of living with a chronic disease in low SES persons. A conceptual model is proposed that can be used in daily clinical practice to raise awareness among clinicians and health care providers that the patient’s needs go beyond the disease itself. Future research is needed to validate and test the model.
Which elements were significant in reducing obstetric anal sphincter injury? A prospective follow-up study
Authors: Rasmussen Ole Bredahl , Yding Annika , Andersen Charlotte Sander , Boris Jane , Lauszus Finn Friis
Published: November 2021

Background

To examine which elements of an obstetric anal sphincter injury (OASI) care bundle were protective for OASI. Several interventional trials showed that application of a care bundle involving a hands-on approach to perineal protection may reduce the risk of OASI. Previously, we found that only the element “hand on the fetal head” in itself was protective, although the risk of a type 2 error was calculated to be 50%.

Methods

A prospective follow-up study in an obstetric department in Denmark with 3200 deliveries per year. We included a cohort of 10,383 women giving birth vaginally from gestational week 22 + 0 from 2016 through 2019. We documented on a person-level the five elements of the care bundle together with maternal and obstetrical characteristics. The elements were 1) communication, 2) visible perineum, 3) hand on fetal head, 4) perineal support and 5) certification. Regression analysis was used for analysis of associations. The primary outcome measure was OASI.

Results

The total rate of OASI in vaginally delivering women was 1.9%. The incidence was 3.2% in nulliparous women giving birth vaginally. The rate of cesarean section was 16.5% and for episiotomy 2.4%. The reduction in the incidence of OASI was sustained since 2013. Hand on the fetal head and perineal support both were protective factors for OASI. In case of a nulliparous woman with a neonate weighing 3500 g giving birth spontaneously, the relative risk (RR) for OASI was 0.50 (95% CI 0.49- 0.51) with use of hand on the fetal head together with perineal support against no use. Similarly, with a nulliparous woman giving birth to a neonate of 3500 g by vacuum extraction, the RR for OASI was 0.65 (95% CI 0.62-0.68) against no use.

Conclusions

Both hand on the fetal head and perineal support were associated with a reduced risk of OASI.
Aqueous humor cytokine levels through microarray analysis and a sub-analysis based on optical coherence tomography in wet age-related macular degeneration patients
Authors: Joo Jin-Ho , Kim Hyejee , Shin Jae-Ho , Moon Sang Woong
Published: November 2021

Background

To identify disease-specific cytokine and growth factor profile differences in the aqueous humor between wet age-related macular degeneration (AMD) patients and age-matched controls and to correlate their levels with the optical coherence tomography (OCT) findings.

Methods

Aqueous humors were obtained from 13 wet AMD eyes and 10 control eyes. Twenty cytokines and growth factors were measured using a RayBio antibody microarray technology in wet AMD and control eyes.

Results

The samples obtained from wet AMD patients exhibited a significantly increased expression of MCP-1, MIP-1α, MIP-1β, and vascular endothelial growth factor (VEGF). Subretinal fluid (SRF) patients showed significantly lower levels of proinflammatory cytokines, such as IL-1α and GM-CSF, than those without SRF. Pigment epithelial detachments (PED) patients showed lower levels of inflammatory cytokines, such as GM-CSF, IFN-γ, and TNF-α, than those without PED. Subretinal tissue (SRT) patients showed a higher level of IFN-γ than those without SRT. Compared with the controls, type 1 macular neovascularization (MNV) patients showed increased levels of MCP-1, MIP-1α, and MIP-1β, but not VEGF (p = 0.083). However, type 2 MNV patients showed increased levels of MCP-1 and VEGF (p = 0.040 and p = 0.040).

Conclusion

Inflammatory cytokines varied according to the type of AMD- and OCT-based parameters. Our observation of low levels of VEGF in patients with type 1 MNV implies that the inhibition of VEGF alone appears to be insufficient treatment for these patients and that cytokines such as MCP-1, MIP-1α, and MIP-1β should be modulated. And the presence of SRF in MNV may be associated with a positive prognosis because we found relatively low levels of proinflammatory cytokines.
Mortality and clinical characteristics of multisystem inflammatory syndrome in children (MIS-C) associated with covid-19 in critically ill patients: an observational multicenter study (MISCO study)
Authors: Acevedo Lorena , Piñeres-Olave Byron Enrique , Niño-Serna Laura Fernanda , Vega Liliana Mazzillo , Gomez Ivan Jose Ardila , Chacón Shayl , Jaramillo-Bustamante Juan Camilo , Mulett-Hoyos Hernando , González-Pardo Otto , Zemanate Eliana , Izquierdo Ledys , Mejìa Jaime Piracoca , González Jose Luis Junco , Duran Beatriz Giraldo , Gonzalez Carolina Bonilla , Preciado Helen , Marun Rafael Orozco , Alvarez-Olmos Martha I , Alzate Carolina Giraldo , Rojas Jorge , Salazar-Uribe Juan Carlos , Anaya Juan-Manuel , Fernández-Sarmiento Jaime
Published: November 2021

Background

The clinical presentation and severity of Multisystem Inflammatory Syndrome in Children associated with COVID-19 (MIS-C) is widespread and presents a very low mortality rate in high-income countries. This research describes the clinical characteristics of MIS-C in critically ill children in middle-income countries and the factors associated with the rate of mortality and patients with critical outcomes.

Methods

An observational cohort study was conducted in 14 pediatric intensive care units (PICUs) in Colombia between April 01, 2020, and January 31, 2021. Patient age ranged between one month and 18 years, and each patient met the requirements set forth by the World Health Organization (WHO) for MIS-C.

Results

There were seventy-eight children in this study. The median age was seven years (IQR 1-11), 18 % (14/78) were under one year old, and 56 % were male. 35 % of patients (29/78) were obese or overweight. The PICU stay per individual was six days (IQR 4-7), and 100 % had a fever upon arrival to the clinic lasting at least five days (IQR 3.7-6). 70 % (55/78) of patients had diarrhea, and 87 % (68/78) had shock or systolic myocardial dysfunction (78 %). Coronary aneurysms were found in 35 % (27/78) of cases, and pericardial effusion was found in 36 %. When compared to existing data in high-income countries, there was a higher mortality rate observed (9 % vs. 1.8 %; p=0.001). When assessing the group of patients that did not survive, a higher frequency of ferritin levels was found, above 500 ngr/mL (100 % vs. 45 %; p=0.012), as well as more cardiovascular complications (100 % vs. 54 %; p = 0.019) when compared to the group that survived. The main treatments received were immunoglobulin (91 %), vasoactive support (76 %), steroids (70.5 %) and antiplatelets (44 %).

Conclusions

Multisystem Inflammatory Syndrome in Children due to SARS-CoV-2 in critically ill children living in a middle-income country has some clinical, laboratory, and echocardiographic characteristics similar to those described in high-income countries. The observed inflammatory response and cardiovascular involvement were conditions that, added to the later presentation, may explain the higher mortality seen in these children.
National or population level interventions addressing the social determinants of mental health – an umbrella review
Authors: Shah Neha , Walker Ian F. , Naik Yannish , Rajan Selina , O’Hagan Kate , Black Michelle , Cartwright Christopher , Tillmann Taavi , Pearce-Smith Nicola , Stansfield Jude
Published: November 2021

Background

Social circumstances in which people live and work impact the population’s mental health. We aimed to synthesise evidence identifying effective interventions and policies that influence the social determinants of mental health at national or scaled population level. We searched five databases (Cochrane Library, Global Health, MEDLINE, EMBASE and PsycINFO) between Jan 1st 2000 and July 23rd 2019 to identify systematic reviews of population-level interventions or policies addressing a recognised social determinant of mental health and collected mental health outcomes. There were no restrictions on country, sub-population or age. A narrative overview of results is provided. Quality assessment was conducted using Assessment of Multiple Systematic Reviews (AMSTAR 2). This study was registered on PROSPERO (CRD42019140198).

Results

We identified 20 reviews for inclusion. Most reviews were of low or critically low quality. Primary studies were mostly observational and from higher income settings. Higher quality evidence indicates more generous welfare benefits may reduce socioeconomic inequalities in mental health outcomes. Lower quality evidence suggests unemployment insurance, warm housing interventions, neighbourhood renewal, paid parental leave, gender equality policies, community-based parenting programmes, and less restrictive migration policies are associated with improved mental health outcomes. Low quality evidence suggests restriction of access to lethal means and multi-component suicide prevention programmes are associated with reduced suicide risk.

Conclusion

This umbrella review has identified a small and overall low-quality evidence base for population level interventions addressing the social determinants of mental health. There are significant gaps in the evidence base for key policy areas, which limit ability of national policymakers to understand how to effectively improve population mental health.
Challenges of paediatric palliative care in Romania: a focus groups study
Authors: Pacurari Nadia , De Clercq Eva , Dragomir Monica , Colita Anca , Wangmo Tenzin , Elger Bernice S.
Published: November 2021

Background

The availability of palliative care facilities for children vary considerably among the European member states. In Romania, a country where health expenditure is among the lowest in Europe, palliative care has been mainly provided by charitable organizations. Despite the high number of children needing palliative care, there is scant literature and research available on paediatric palliative care in Romania. The study explores the viewpoints of various paediatric oncology providers with regard to paediatric palliative care provision in Romania.

Methods

Four mixed focus groups were conducted at four university-affiliated paediatric oncology centres located in three distinct Romanian regions (Bucuresti-llfov, Nord-Est and Nord-Vest). The focus groups were analyzed using thematic coding.

Results

For many healthcare professionals, emotional burden inherent to the profession; unhealthy work-life balance and understaffing were among the biggest barriers to the successful integration of pediatric palliative care. The lack of staff was attributed to a shortage of financial resources, and to the persisting cultural stigma surrounding palliative care and oncology. Also political turmoil was identified as an important obstacle to palliative care implementation.

Conclusion

Significant barriers persist limiting the broader implementation of pediatric palliative care in Romania. In order to render palliative care in pediatric oncology more sustainable, more attention should be paid to the mental health care of healthcare professionals working in this field, to the development of mobile palliative care services and to the emigration of skilled medical staff.
Manoeuvring between interplay and context- an ethnographic study of social interaction in encounters between registered nurses, older patients and their relatives
Authors: Johnsson Anette , Boman Åse , Wagman Petra , Pennbrant Sandra
Published: November 2021

Background

Social interactions between registered nurses, older patients and their relatives are essential and play a central role in developing a successful care relationship in healthcare encounters. How nurses interact with patients affects the patient’s well-being. Limited time and demands for efficiency influence the encounter and complaints from patients and relatives often concern social interactions. Therefore, the aim of this study was to explore the social interaction in encounters between registered nurses, older patients and their relatives at a department of medicine for older people.

Methods

The study has an ethnographic approach including participatory observations (n = 21) and informal field conversations (n = 63), followed by a thematic analysis with an abductive approach reflecting Goffman’s interactional perspective.

Result

The result revealed a pattern where the participants manoeuvred between interplay and context. By manoeuvring, they defined roles but also created a common social situation. Nurses led the conversation; patients followed and described their health problems, while relatives captured the moment to receive and provide information. Finally, nurses summarised the encounter using ritual language, patients expressed gratitude through verbal and non-verbal expressions, while relatives verbally confirmed the agreements.

Conclusion

The social interaction between registered nurses, older patients and relatives was shaped by a pattern where the participants manoeuvred between interplay and context. When all participants assume responsibility for the social interaction, they become active and listen to each other. The approach adopted by nurses is crucial, thus training in communication and social interaction skills are important. When the asymmetry due to imbalance, is reduced, less misunderstanding and a satisfactory care relationship can be achieved.
Genetic optimisation of bacteria-induced calcite precipitation in Bacillus subtilis
Authors: Hoffmann Timothy D. , Paine Kevin , Gebhard Susanne
Published: November 2021

Background

Microbially induced calcite precipitation (MICP) is an ancient property of bacteria, which has recently gained considerable attention for biotechnological applications. It occurs as a by-product of bacterial metabolism and involves a combination of chemical changes in the extracellular environment, e.g. pH increase, and presence of nucleation sites on the cell surface or extracellular substances produced by the bacteria. However, the molecular mechanisms underpinning MICP and the interplay between the contributing factors remain poorly understood, thus placing barriers to the full biotechnological and synthetic biology exploitation of bacterial biomineralisation.

Results

In this study, we adopted a bottom-up approach of systematically engineering Bacillus subtilis, which has no detectable intrinsic MICP activity, for biomineralisation. We showed that heterologous production of urease can induce MICP by local increases in extracellular pH, and this can be enhanced by co-expression of urease accessory genes for urea and nickel uptake, depending on environmental conditions. MICP can be strongly enhanced by biofilm-promoting conditions, which appeared to be mainly driven by production of exopolysaccharide, while the protein component of the biofilm matrix was dispensable. Attempts to modulate the cell surface charge of B. subtilis had surprisingly minor effects, and our results suggest this organism may intrinsically have a very negative cell surface, potentially predisposing it for MICP activity.

Conclusions

Our findings give insights into the molecular mechanisms driving MICP in an application-relevant chassis organism and the genetic elements that can be used to engineer de novo or enhanced biomineralisation. This study also highlights mutual influences between the genetic drivers and the chemical composition of the surrounding environment in determining the speed, spatial distribution and resulting mineral crystals of MICP. Taken together, these data pave the way for future rational design of synthetic precipitator strains optimised for specific applications.
Evaluation of pilot implementation of seasonal malaria chemoprevention on morbidity in young children in Northern Sahelian Ghana
Authors: Ansah Patrick O. , Ansah Nana A. , Malm Keziah , Awuni Dennis , Peprah Nana , Dassah Sylvester , Yarig Sobe , Manful Charles , Agbenyeri John , Awoonor-Williams John , Ofosu Wilfred , Oduro Abraham R.
Published: November 2021

Background

In Sahelian Africa, the risk of malaria increases with the arrival of the rains, particularly in young children. Following successful trials, the World Health Organization (WHO) recommended the use of seasonal malaria chemoprevention (SMC) in areas with seasonal peak in malaria cases. This study evaluated the pilot implementation of SMC in Northern Ghana.

Methods

Fourteen communities each serving as clusters were selected randomly from Lawra District of Upper West Region as intervention area and West Mamprusi District in the Northern Region as the non-intervention area. The intervention was undertaken by the National Malaria Control Programme in collaboration with regional health directorates using sulfadoxine-pyrimethamine plus amodiaquine and standard WHO protocols. Before and after surveys for malaria parasitaemia and haemoglobin levels as well as monitoring for malaria morbidity and mortality were undertaken.

Results

At the end of the intervention, participant retention was 92.9% (697/731) and 89.5% (634/708) in the intervention and the non-intervention areas, respectively. The proportion of children with asexual parasites reduced by 19% (p = 0.000) in the intervention and increased by 12% (p = 0.000) in the non-intervention area. Incidence rates of severe malaria were 10 and 20 per 1000 person-years follow up in the intervention and comparison areas, respectively with P.E of 45% (p = 0.62). For mild malaria, it was 220 and 170 per 1000 person-years in intervention and comparison area, respectively with PE of - 25% (p = 0.31). The proportion of children with anaemia defined as Hb< 11.0 g/dl reduced from 14.2% (52.8–38.6%) in the intervention area as compared to an increase of 8.1% (54.5% to 62.6) the non-intervention arm, Mean Hb reduced by 0. 24 g/dl (p = 0.000) in the non-intervention area and increased of 0.39 g/dl (p = 000) in the intervention area.

Conclusions

The feasibility and effectiveness of SMC introduction in Northern Ghana was demonstrated as evidenced by high study retention, reduction in malaria parasitaemia and anaemia during the wet season.
Circular RNAs in acute myeloid leukemia
Authors: Singh Vijendra , Uddin Mohammed Hafiz , Zonder Jeffrey A. , Azmi Asfar S. , Balasubramanian Suresh Kumar
Published: November 2021

Although mechanistic studies clarifying the molecular underpinnings of AML have facilitated the development of several novel targeted therapeutics, most AML patients still relapse. Thus, overcoming the inherent and acquired resistance to current therapies remains an unsolved clinical problem. While current diagnostic modalities are primarily defined by gross morphology, cytogenetics, and to an extent, by deep targeted gene sequencing, there is an ongoing demand to identify newer diagnostic, therapeutic and prognostic biomarkers for AML. Recent interest in exploring the role of circular RNA (circRNA) in elucidating AML biology and therapy resistance has been promising. This review discerns the circular RNAs’ evolving role on the same scientific premise and attempts to identify its potential in managing AML.
Multifaceted glycoadjuvant@AuNPs inhibits tumor metastasis through promoting T cell activation and remodeling tumor microenvironment
Authors: Xu Xiaojing , Gan Minfeng , Ge Youzhen , Yi Cheng , Feng Tianyun , Liu Mengjie , Wu Cenhao , Chen Xiang , Zhang Weidong , Zhao Lixiang , Zou Jun
Published: November 2021

Abstarct

Background

Cytosine-phosphate-guanine (CpG) dinucleotides has been used as adjuvants for cancer immunotherapy. However, unmodified CpG are not very efficient in clinical trials. Glucose, ligand of C-type lectin receptors (CLRs), can promote DC maturation and antigen presentation, which is the first step of induction of adaptive immune responses. Therefore, conjugation of type B CpG DNA to glucose-containing glycopolymers may enhance the therapeutic effects against tumor by CpG-based vaccine.

Methods

gCpG was developed by chemical conjugation of type B CpG DNA to glucose-containing glycopolymers. The therapeutic effects of gCpG-based vaccine were tested in both murine primary melanoma model and its metastasis model.

Results

gCpG based tumor vaccine inhibited both primary and metastasis of melanoma in mice which was dependent on CD8 + T cells and IFNγ. In tumor microenvironment, gCpG treatment increased Th1 and CTL infiltration, increased M1 macrophages, decreased Tregs and MDSCs populations, and promoted inflammatory milieu with enhanced secretion of IFNγ and TNFα. The anti-tumor efficacy of gCpG was dramatically enhanced when combined with anti-PD1 immunotherapy.

Conclusions

We confirmed that gCpG was a promising adjuvant for vaccine formulation by activating both tumor-specific Th1 and Tc1 responses, and regulating tumor microenvironments.

Graphical Abstract
Ten-year survival of ceramic-on-ceramic total hip arthroplasty in patients younger than 60 years: a systematic review and meta-analysis
Authors: El-Desouky Ihab Ibraheam , Helal Albaraa Hassan , Mansour Ali Mohamed Reda
Published: November 2021

Background

Total hip arthroplasty (THA) with ceramic-on-ceramic (CoC) was created to minimise wear debris and aseptic loosening. A decade ago, a meta-analysis showed a 10-year survival rate of just 89%. Based on the excellent tribology of the current CoC, significant improvement of implant survivorship is expected. In patients younger than 60, we conducted a meta-analysis to assess 10-year survival and complications after using current primary CoC THA.

Materials and methods

PubMed, Scopus, EMBASE, Virtual Health Library, and Cochrane Library were used to scan for published trials that met the inclusion criteria until January 2019. The qualified studies were subjected to a systematic review and proportional analysis, and the randomised controlled trials (RCTs) were included in a comparison meta-analysis.

Results

Thirteen studies were included 156 findings. The total number of hips was 2278. Nine studies were cohort, and four were RCTs between ceramic and polyethylene cups. The analysis revealed an average age of 44 years (range 24–54). The 10-year survival 96% (95% CI; 95.4–96.8%), aseptic loosening rate 0.516. (95% CI; 0.265–0.903), ceramic fracture rate 0.620 (95% CI; 0.34–1.034) and squeaking rate 2.687 (95% CI; 1.279–4.593). A comparison meta-analysis revealed the risk ratio (RR) for revision was 0.27 (95% CI; 0.15–0.47), and for aseptic loosening 0.15 (0.03–0.70) favouring CoC, while RR for component fracture was 1.62 (95% CI; 0.27–9.66) favouring the polyethylene.

Conclusion

In patients under sixty, current CoC THAs are correlated with better 10-year outcomes than before and have high survivorship rates.

Level of evidence: Level I.
Long noncoding RNA SNHG25 promotes the malignancy of endometrial cancer by sponging microRNA-497-5p and increasing FASN expression
Authors: He Yuhua , Xu Shuifang , Qi Yi , Tian Jinfang , Xu Fengying
Published: November 2021

Background

Small nucleolar RNA host gene 25 (SNHG25), a long noncoding RNA, has been well-studied in epithelial ovarian cancer. However, the specific functions of SNHG25 in endometrial cancer (EC) have not been studied yet. In this study, we aimed to elucidate the clinical significance of SNHG25 in EC and determine the regulatory activity of SNHG25 on the tumor-associated EC phenotype. We also thoroughly explored the molecular mechanisms underlying SNHG25 function in EC.

Methods

Gene expression was measured using quantitative real-time polymerase chain reaction. The detailed functions of SNHG25 in EC were examined by performing loss-of-function experiments. Moreover, the regulatory mechanisms involving SNHG25, microRNA-497-5p, and fatty acid synthase (FASN) were unveiled using the luciferase reporter assay and RNA immunoprecipitation.

Results

We observed a high level of SNHG25 in EC using the TCGA dataset and our study cohort. Patients with a high SNHG25 level had shorter overall survival than those with a low SNHG25 level. SNHG25 deficiency resulted in tumor-repressing activities in EC cells by decreasing cell proliferation, migration, and invasion and promoting cell apoptosis. Furthermore, the function of SNHG25 depletion in impairing tumor growth in vivo was confirmed. SNHG25 sequestered miR-497-5p as a competing endogenous RNA in EC and consequently positively regulated FASN expression. Thus, the decrease in miR-497-5p or increase in FASN could neutralize the modulatory actions of SNHG25 knockdown in EC cells.

Conclusions

The depletion of SNHG25 impedes the oncogenicity of EC by targeting the miR-497-5p/FASN axis. The newly elucidated SNHG25/miR-497-5p/FASN pathway may be a promising target for the molecular-targeted management of EC.
Gradual increasing dyslipidemia in treatment-naive male patients with human immunodeficiency virus and treated with tenofovir plus lamivudine plus efavirenz for 3 years
Authors: Liu Dafeng , Zhang Xinyi , Kang Jun , Gao Fengjiao , He Yinsheng , He Shenghua
Published: November 2021

Introduction

Since the development of antiretroviral therapy (ART) with TDF plus 3TC plus EFV, this specific regimen has not been studied enough with long-term lipid and uric acid monitoring.

Methods

A prospective follow-up cohort study was performed. Sixty-one treatment-naive male patients with human immunodeficiency virus (HIV) were divided into three groups based on their baseline CD4+ cell count (26, 12, and 23 patients in the < 200, 200 to 350, and > 350 groups, respectively). The lipid and purine metabolism parameters of the patients over 144 weeks were analyzed.

Result

Within 144 weeks, TG, LDL-c, TC and HDL-c gradually increased, especially TC and HDL-c (P = 0.001, 0.000, respectively). Moreover, the percentages of hyper-cholesterolemia, hyper LDL cholesterolemia, hyper-triglyceridemia and low HDL cholesterolemia also gradually increased, especially low HDL cholesterolemia significantly increased (P = 0.0007). The lower the baseline CD4+ cell counts were, the higher the TG levels and the lower the TC, LDL-c and HDL-c levels were. But there was significant difference of only baseline LDL-c levels between the three groups (P = 0.0457). No significant difference of the UA level and the percentages of hyperuricemia was found between the different follow-up time point groups or between the three CD4+ cell counts groups (all P > 0.05). The risk factors for dyslipidemia included age, anthropometric parameters and follow-up weeks, and for hyperuricemia was virus load.

Conclusions

Gradual increasing dyslipidemia was found in male patients with human immunodeficiency virus primarily treated with tenofovir plus lamivudine plus efavirenz for 3 years. There-fore lipid metabolism parameters should be closely monitored during long-term ART with the TDF plus 3TC plus EFV regimen.
Financial literacy among Finnish adolescents in PISA 2018: the role of financial learning and dispositional factors
Authors: Silinskas Gintautas , Ahonen Arto K. , Wilska Terhi-Anna
Published: November 2021

The aim or the present study was to examine the relative importance of financial education in school and families and dispositional factors (competitiveness, work mastery, meta-cognition) in predicting financial literacy among Finnish adolescents. The data on the 4328 Finnish 15-year-olds was drawn from the PISA 2018 assessment. Financial literacy was measured by tests, and financial education and dispositional factors were assessed by adolescent questionnaires. First, the results showed that financial education in school was positively associated with adolescents’ financial literacy skills, whereas parental involvement in financial matters did not relate or related negatively to financial literacy scores. Second, dispositional factors, such as competitiveness, work mastery, and meta-cognition (effective strategies to understand/remember information, to summarize information, and to evaluate source credibility) were the strongest positive predictors of the financial literacy scores. Overall, the present study emphasizes that certain social factors (schools and families) and especially dispositional characteristics (personality/motivation and critical thinking/learning strategies) may shape the development of the financial skills of adolescents.
Hypoglycaemic activity of Smilax canellifolia Mill. rhizomes: a bioassay-guided isolation and identification of synergistic compounds
Authors: Peddie Davia A. , Bryan Sophia J. , Francis Sheena , Alexander-Lindo Ruby L.
Published: November 2021

Background

Smilax canellifolia Mill. is a native shrub used in commercial root tonics as an aphrodisiac, stimulant, and pain reliever. Traditional medicine incorporates the rhizomes of S. canellifolia for the treatment of anaemia, rheumatoid arthritis, and diabetes in Jamaica and its diaspora. In particular, the use of this plant in the management of diabetes has yet to receive any scientific evaluation. In this study, the hexane crude extract of S. canellifolia rhizomes (SCH) was investigated to determine its hypoglycaemic activity in normal Sprague-Dawley rats and to identify the compounds contributing to this activity.

Methods

The hypoglycaemic compounds were isolated using bioactivity-guided purification which involved hypoglycaemic screening using an Oral Glucose Tolerance Test (via intravenous administration of SCH and its fractions). Purification was performed using column chromatography, and the bioactive fractions were elucidated using spectroscopic techniques (IR; GC-MS; 1H NMR and 13C NMR).

Results

Administration of SCH at 50 mg/kg body weight (BW) to normal S-D rats produced a reduced glycaemic response, notably from the 90 to the 150-min intervals when compared with the control, dimethyl sulfoxide (p < 0.05). Purification of this extract yielded four main fractions, SCH1 – SCH4, of which SCH3 and SCH4 displayed significant hypoglycaemia. Further purification of both SCH3 and SCH4 led to the isolation of sub-fractions SCH3.6 and SCH4.2, respectively. Using spectroscopic techniques stigmasterol (1) and β-sitosterol (2) from SCH3.6; and the fatty acids palmitic acid (3), oleic acid (4), and stearic acid (5) from SCH4.2 were identified as the major compounds with significant hypoglycaemic activities comparable to that of glibenclamide.

Conclusion

This study demonstrates that the rhizomes of Smilax canellifolia contain several bioactive constituents that are responsible for its hypoglycaemic activity and may be beneficial in the management of hyperglycaemia and complications associated with diabetes.