bluuebunny/crossref_metadata_2025 huggingface dataset:
Limitations of the “Indian one nation, one subscription” policy proposal and a way forward
Authors: Koley Moumita , Lala Kanchan
Published: January 2023

Indian science funding agencies have taken several policy measures to expedite access to scholarly knowledge. The proposed “one nation, one subscription” plan is one such initiative. The main aim of this initiative is to facilitate the availability and accessibility of research articles for all higher educational institutions (HEI). This paper reflects upon the suitability and aptness of this suggested policy through an analysis of Open Access (OA) publication trends. Using Scopus and other web sources, this article tracks how the OA publishing scenario (STEM fields) is changing in India and other top publishing countries. Based on the findings, we argue that a national subscription contract is limiting its scope by considering only the option of subscription and disregarding OA publishing options. However, subscription and open access publishing deals are short-term gains and will ultimately increase the dependency on commercial publishers. In the long term, encouraging research that helps solve local context-specific problems can only be addressed by strengthening the publishing infrastructure by national research funding agencies or respective higher educational institutions through publishing and promoting open access content.
Procyanidins Ameliorate Acetaminophen-induced Acute Liver Injury via Activating the Nrf-2/SOD-1 Signal Pathway
Authors: Xu Wanting , Liu Yan , Liu Qun , Chen Huan , Lei Langhuan , Shen Xiaojia , Liu Li
Published: January 2023

Background and Objectives

An overdose of acetaminophen (APAP) usually leads to acute liver injury, and oxidative stress is one of the fundamental mechanisms used to characterize it. Procyanidins (PCs) can reduce the oxidative stress in the liver of mice. This study aimed to investigate the potential protective role of PCs against APAP-induced acute liver injury.

Materials and Methods

Experiments were performed on male Kunming mice in six groups: phosphate-buffered saline, PCs, APAP, and PCs pretreated with 10, 50, and 100 mg/kg. The mice were peritoneally injected with PCs 30 min before the administration of APAP. First, survival rates of mice were scored every 12 hr for three days in succession. Furthermore, serum levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (T-Bil), total cholesterol (TC), triglyceride (TG), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and interleukin-1 (IL-6) were determined. Additionally, histological analysis and hepatic oxidative stress including the levels of superoxide dismutase (SOD), malondialdehyde (MDA), and glutathione (GSH) were assessed. Finally, the protein expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and SOD-1 was detected by Western blotting.

Results

The data indicated that PCs improved survival rates of APAP-induced liver injury in mice models. Moreover, PCs could reduce the elevated serum levels of ALT, AST, T-Bil, TC, TG, TNF-α, IL-1β, and IL-6 due to APAP exposure with a dose-dependent manner. Besides, PCs pretreatment attenuated hepatic histopathological damage and oxidative stress which manifested the increases of SOD and GSH, whereas the decrease of MDA. Furthermore, PCs enhanced the protein expression of Nrf2 and SOD-1 in the PCs pretreatment groups compared with the APAP group.

Conclusion

PCs ameliorated APAP-induced acute liver injury, and Nrf2 signaling pathway modulating antioxidative stress might be involved in it.
Nonlocal wave propagation analysis of a rotating nanobeam on a Pasternak foundation
Authors: Farhadipour Farshid , Mamandi Ahmad
Published: January 2023

In this paper, the wave propagation analysis of a cantilever rotating nanobeam modeled as a thin beam based on the Euler–Bernoulli theory on a Pasternak foundation has been investigated using the nonlocal theory of elasticity. The governing partial differential equation of motion for a uniform rotating nanobeam is derived using the Hamilton principle considering the nonlocal parameter of small scale effect. The Spectrum and dispersion relations of non-dimensional wave number are obtained analytically. The effect of changes of different parameters including nonlocal scale parameter, non-dimensional rotational speed, non-dimensional rotational wave frequency ratio, and shear stiffness of the Pasternak foundation on the wave dispersion behavior of the non-dimensional wave number and phase and group speeds dispersions for the rotating nanotube have been studied. It is observed that the wave dispersion characteristics of the rotating nanobeam are extremely influenced by rotational speed, wave number, nonlocal length scale parameter, and shear stiffness of the Pasternak foundation. Moreover, the propagated flexural wave has been shown to exhibit non-dispersive behavior at very high rotational speeds.
In Their Own Words: Sexual Assault Resistance Strategies Among Kenyan Adolescent Girls Following Participation in an Empowerment Self-Defense Program
Authors: Edwards Katie M. , Omondi Benjamin , Wambui Rose Alice , Darragh-Ford Elise , Apollo Rosebella , Devisheim Haim Haikel , Langat Nickson , Kaede Beth , Ntinyari Wendy , Keller Jennifer
Published: January 2023

The purpose of this study was to examine, via testimonial data, resistance strategies used to thwart a sexual assault among slum-dwelling Kenyan adolescent girls ( N  =  678) following their participation in an empowerment self-defense program ( IMpower). The majority (58.2%) of perpetrators were strangers; there were no differences in resistance strategies used between strangers versus known perpetrators (83.8% used verbal strategies, 33.2% used resistance strategies, 16.7% ran away, and 7.9% used distraction). Associations between resistance strategies and perpetrator tactics, number of assailants, location of the assault, and the presence of a bystander were also examined.
What makes a spokesperson? Delegation and symbolic power in Crimea
Authors: Hoffmann Alvina
Published: January 2023

This article argues that spokespersons who claim to speak on behalf of a social group cannot escape the structural problem of delegation whereby speaking in someone’s name entails speaking instead of someone. This form of delegated and authorised silencing through the promise of empowerment imposes symbolic violence on a group which recognises the spokesperson as a valid representative, without recognising its own potential disenfranchisement. I build on Pierre Bourdieu’s sociological writings on language and symbolic power to theorise the trajectories of authorisation of spokespersons. In doing so, I critically engage with theories in International Relations which rely on a separation between speaker and audience to analyse the legitimation of political speech. Instead, I reformulate the speaker/audience relation through the concept of symbolic power and introduce the category of the spoken-for. When spokespersons struggle over symbolic power, they seek to impose social classificatory categories on social groups and spaces. I illustrate these dynamics in the context of human rights politics in Crimea, showing how various spokespersons are engaged in a symbolic struggle over ‘authenticity’ of their speech and the ‘universal’ of human rights. I conclude by suggesting new lines of inquiry to analyse creative strategies to mitigate the spokesperson problem.
Reading literature in/against the digital age: Shallow assumptions, deep problems, expectant pedagogies
Authors: Gordon Colette
Published: January 2023

Following the popular theme of Nicholas Carr’s The Shallows: What the Internet Is Doing to Our Brains (2010), various commentators observe the erosion of what used to be called ‘reading’, but is now increasingly referred to as ‘deep’ reading. University English departments offer ‘close reading’ of literary texts as a corrective to the digital shallows, while worrying about a general decline in reading, and reading ‘for pleasure’, attributed to the digital. However this decline is created equally by the procedures of the discipline, including its core practice of ‘close reading’ which emerged similarly from entangled anxieties about technology, mass media and low/high culture. It makes sense that literary reading would be eroded in educational contexts (which overdetermine reading), and not just because of the erosion of deep reading and ‘deep attention’. Training in literature may lead, ironically, to a loss in the ability to read and understand literary texts and to draw on multimodal narrative literacies. This paper proposes a practice of expectant reading that, supported by social annotation, can re-centre reading and restore narrative and frameworks of expectation constitutive of literary meaning, while embodying the contract between reader(s) and text, and facilitate socially distributed reading.
Carrying the same pregnancy: A bioethical overview on Reciprocal effortless IVF and similar techniques
Authors: Mangione Emanuele
Published: January 2023

Nowadays, novel techniques such as Reciprocal effortless in vitro fertilization (ReIVF) enable two individuals to “carry the same pregnancy,” that is to “carry” the same embryo in both their bodies. However, even though these techniques are likely to be increasingly requested, little is known about their safety and efficacy, and much less about their bioethical legitimacy and issues. Considering their uniqueness, this study assesses the compatibility of ReIVF as well as of another similar technique with the classical principles of medical ethics: autonomy, beneficence, nonmaleficence, and justice. The aim is twofold: (i) to start investigating whether these techniques and their underlying reasons are, or could ever be, bioethically justifiable and (ii) to make clinicians and any other potentially interested persons such as researchers, lawmakers and prospective parents themselves are more aware of the health and social implications of using these techniques. Hence, after a brief overview of the technical aspects of the procedures that allow two persons to carry the same pregnancy, this study offers a general moral framework that can be useful for starting to address some relevant aspects of these procedures, such as their benefits and harms on the health of the individuals involved, the reasons behind their use, and the possibility that they might be covered by states in the future. Finally, this study provides a bioethical overview on ReIVF as well as on similar techniques considering different perspectives, while also suggesting some questions and recommendations for further research.
Real-world study of flash glucose monitoring among adults with type 2 diabetes within the Swedish National Diabetes Register
Authors: Eeg-Olofsson Katarina , Svensson Ann-Marie , Franzén Stefan , Ahmed Ismail Hodan , Törnblom Michael , Levrat-Guillen Fleur
Published: January 2023

Background

The Swedish National Diabetes Register (NDR) initiated registration of the FreeStyle Libre® system and other continuous glucose monitoring (CGM) systems in June 2016. We investigated change in HbA1c for people with type 2 diabetes (T2DM) using FreeStyle Libre in Sweden.

Methods

We included adults with T2DM, registered in the NDR after January 1, 2014, and an index date for first use of FreeStyle Libre of June 2016 or later. Methodology was a before/after comparison of HbA1c within 6 months before the index date versus HbA1c around 6 and 12 months after the index date.

Results

711 adults with T2DM using FreeStyle Libre had HbA1c measurements within the study period . Mean HbA1c was significantly reduced at 6 months (−0.50%-unit) and at 12 months (−0.52%-unit) in this group. Degree of change was negatively correlated to baseline HbA1c. Reductions in HbA1c were observed in incident users of FreeStyle Libre with T2DM who were truly naïve to CGM or had unknown prior experience of CGM, and aged 25–74 years.

Conclusions

This real‐world study on the Swedish NDR shows that people with T2DM using FreeStyle Libre system for 6 and 12 months significantly reduced their HbA1c.
Predictors of Accessibility Tool Use on a Low-Stakes Computer-Based Math Test
Authors: Witmer Sara E. , Bouck Emily C.
Published: January 2023

One perceived advantage of computer-based testing is that accessibility tools can be embedded within the testing format, allowing students with disabilities to use them when necessary to remove unique barriers within testing. However, an important assumption is that students activate and use the tools when needed. Initial data from large-scale computer-based testing suggest many students with disabilities are not using them; information is needed to understand why. Both computer skills and motivation are likely necessary for students to use accessibility tools; therefore, we explored whether prior computer use, math motivation, and test motivation predicted accessibility tool use on a national math test. We further explored the relationship between accessibility tool use and test performance. Accessibility tool use was relatively infrequent. Test motivation was weakly associated with text-to-speech use. Use of eliminate choice and scratchwork tools were weakly associated with performance. When combined with related empirical work, findings suggest a potential need to improve student test motivation and corresponding use of accessibility tools to improve validity of low-stakes test scores. However, given the weak relationships identified between tool use and performance, evidence-based math interventions are anticipated to be more helpful for improving math performance than mere promotion of accessibility tool use.
Pomegranate Peel Extract Sensitizes Hepatocellular Carcinoma Cells to Ionizing Radiation, Induces Apoptosis and Inhibits MAPK, JAK/STAT3, β-Catenin/NOTCH, and SOCS3 Signaling
Authors: Elbakry Mustafa M. M. , ElBakary Nermeen M. , Hagag Sanaa A. , Hemida Eman H. A.
Published: January 2023

Tumor resistance is typically blamed for the failure of radiotherapy and chemotherapy to treat cancer in clinic patients. To improve the cytotoxicity of tumor cells using radiation in conjunction with specific tumor-selective cytotoxic drugs is crucial. Pomegranate has received overwhelmingly positive feedback as a highly nutritious food for enhancing health and treating a variety of ailments. In the present study, we aimed to examine the effects as well as mechanism of action of pomegranate peel extract (PPE) and/or γ-radiation (6-Gy) on hepatocellular carcinoma (HCC) cell lines HepG2. The findings of this study showed that PPE treatment of HepG2 cells considerably slowed the proliferation of cancer cells, and its combination with γ-irradiation potentiated this action. As a key player in tumor proliferation, and inflammatory cascade induction, the down-regulation of STAT3 following treatment of irradiated and non-irradiated HepG2 cells with PPE as recorded in the present work resulted in reduction of tumor growth, via modulating inflammatory response manifested by (down-regulation of TLR4 expression and NFKB level), suppressing survival markers expressed by reduction of JAK, NOTCH1, β-catenin, SOCS3, and enhancing apoptosis (induction of tumor PPAR-γ and caspase-3) followed by changes in redox tone (expressed by increase in Nrf-2, SOD and catalase activities, and decrease in MDA concentration). In conclusion, PPE might possess a considerable therapeutic potential against HCC in addition to its capability to enhance response of HepG2 cells to gamma radiation,
Open Surgery for Abdominal Aortic Aneurysm: 980 Consecutive Patient Outcomes from a High-Volume Centre in the United Kingdom
Authors: Blair Robert , Harkin Denis , Johnston Dorothy , Lim Adrian , McFetridge Lisa , Mitchell Hannah
Published: January 2023

Background

Controversy persists regarding the optimal treatment for large abdominal aortic aneurysm (AAA), highlighted by the publication of the National Institute for Health and Care Excellence (NICE) guideline (NG156) on March 2020. The pendulum of opinion swings once more from endovascular to open surgical treatment. We report our experience over the last 15 years in treating consecutive AAA by open surgery.

Methods

A retrospective review of a prospectively collected vascular database of all patients undergoing infra-renal open abdominal aortic aneurysm repair (OR) repair from 2004 to 2019 at the largest aneurysm centre in the United Kingdom. OR for elective and emergency (ruptured and symptomatic) outcomes included early morbidity and 30-day mortality, and long-term survival.

Results

1017 patients underwent OR between 2004-2019, on application of our inclusion-criteria 994 patients formed our cohort for analysis (81.2% male) with a mean age 73.6 ± 7.8 years treated by OR for AAA. In that group 672 were elective and 308 were emergency (for ruptured or symptomatic). Overall 30 day mortality was 11.3%, elective 30 day mortality was 2.5%, and emergency 30 day mortality was 29.9%. 30 day re-intervention rate was 9.5%, (elective 7.0%, emergency 15.9%). Survival at 1000 days for elective repair was 72 v 46.7% for emergency and at 2000 days was 43.4% for elective v 25% for emergency.

Conclusion

Our data confirm that open surgery for AAA can be performed in large volume centres quite safely. Elective and Emergency surgery does affect early 30 day mortality but does not influence long-term outcome.
Critical Professional Development: A Necessary Risk?
Authors: Wrenn Melissa , Gregory Kristen , Gallagher Jennifer
Published: January 2023

Amy Yarborough, a veteran teacher and curriculum resource leader in a rural district in Virginia, facilitates a professional learning community focused on social justice and equity-oriented instructional practices. When allegations of teaching critical race theory are reported via the state’s email tip line and community social media groups, Amy is asked to present her professional learning community materials to the local school board. In the midst of stakeholder protests and media scrutiny, Amy must decide how to explain her professional decisions. Current and future educational leaders interested in issues related to race and equity will consider the roles of policy and the public in influencing teachers’ lessons.
COVID-19-associated mental health impact on menstruation physiology: A survey study among medical students in Jordan
Authors: Aolymat Iman , Al-Tamimi Mohammad , Almomani Hafez , Abu-Hassan Diala Walid , Alzayadneh Ebaa M , Al-Husban Naser , Al Haj Mahmoud Sameer , Alsheikh Ayman
Published: January 2023

Background:

The coronavirus disease 2019 pandemic has been an extraordinarily stressful situation in recent years. Stress is a physiological reaction to negative stimuli that is regulated by different neuroendocrine pathways. The female reproductive function is maintained by the menstrual cycle, which is negatively affected by hyperstimulation of stress signals.

Objectives:

This study evaluates the effect of the coronavirus disease 2019 outbreak on menstrual function and mental health, exploring the relationship between them.

Design:

The current study uses a cross-sectional, survey-based design.

Methods:

During this cross-sectional study, an online self-completion questionnaire was conducted among a sample of 385 Jordanian female medical students during the pandemic. The survey compared menstrual characteristics, depression, anxiety, and stress 10 months after the coronavirus disease 2019 pandemic with 10 months prior. Paired t-test, McNemar’s test, Pearson’s correlation, and multiple linear regression model were employed to analyze data using SPSS software.

Results:

The mean age of female medical student respondents was 19.89 years. Data showed that the menstrual cycle length significantly increased during the coronavirus disease 2019 pandemic compared with 10 months prior (32.23 days versus 30.02 days, p = 0.019). The average number of heavy bleeding days also increased during the coronavirus disease 2019 pandemic (2.82 days versus 2.42 days, p = 0.002). The proportion of females with heavy bleeding amount was more than doubled during the pandemic of coronavirus disease 2019 compared with before (27.3% versus 10.4%, p = 0.000). Unpleasant menstrual signs such as nausea and/or vomiting, breast pain, and urinary urgency were significantly increased during the pandemic ( p = 0.000, p = 0.008, and p = 0.024, respectively). During coronavirus disease 2019, a positive association between total Depression, Anxiety, and Stress Scale-21 Questionnaire score and heavy bleeding was identified ( p < 0.05). The findings also indicated that mental disorders and the incidence of amenorrhea, nausea and/or vomiting, and urinary urgency were positively correlated during the coronavirus disease 2019 pandemic. The multiple regression analysis revealed associations between several menstrual characteristics such as amenorrhea and severity of bleeding with coronavirus disease 2019-related depression, anxiety, and stress.

Conclusion:

This study revealed that the stress related to the pandemic of coronavirus disease 2019 could affect the female menstrual cycle and hence the quality of women’s life. Therefore, this study could serve as a baseline for planning and introducing stress mitigation interventions in crisis situations to improve the physiological and mental well-being of females and improve their quality of life.
Blue Circle Health: A Novel Patient-Centered Model of Health Care Delivery for Low-Income Patients With Type 1 Diabetes
Authors: Bruggeman Brittany S. , Walker Ashby F. , Peters Anne L. , D’Avolio Leonard W. , Haller Michael J.
Published: January 2023

Analog insulins, insulin pumps, and continuous glucose monitors (CGM) have revolutionized type 1 diabetes (T1D) treatment over the last 50 years. Nevertheless, less than 20% of patients in the United States reach guideline-based HbA1c targets. The dysfunctional delivery of U.S. health care has further worsened glycemic outcomes among structurally disadvantaged groups such as non-Hispanic Black and low-income populations. Administrative complexities resulting from mixed insurance coverage and delivery systems, incongruity between effective policies and reimbursement, structural racism, and implicit biases have led to high diabetes care-related costs, provider scarcity and burnout, and patient diabetes distress. The Extension for Community Healthcare Outcomes (ECHO) Diabetes tele-education outreach model was created to increase self-efficacy among primary care providers through a combination of weekly didactic sessions led by a team of diabetes experts and access to community-based peer coaches. As an evolution of ECHO Diabetes, Blue Circle Health has been established as a philanthropically funded health care delivery system, using a whole-person, individualized approach to T1D care for adults living in underserved communities. The program will provide direct-to-patient telehealth services, including diabetes education, management, and related psychological care regardless of ability to pay. Community-based diabetes support coaches will serve as the primary point of contact, or guide on the “Blue Circle Health Member Journey.” Access to needed insulins, supplies, and CGMs will be provided at no cost to the individual. Through a continuous learning and improvement model, a person-centered, equitable, accessible, and effective health care delivery model will be built for people living with T1D.
Higher Derived Time in Range With IDegLira Versus Insulin Glargine U100 in People With Type 2 Diabetes
Authors: Philis-Tsimikas Athena , Aroda Vanita R. , De Block Christophe , Billings Liana K. , Liebl Andreas , Sivarathinasami Ramsathish , D’Cruz John M. , Lingvay Ildiko
Published: January 2023

Background:

Derived time in range (dTIR), calculated from self-monitored blood glucose (SMBG-dTIR) profiles, has demonstrated correlation with risk of cardiovascular and microvascular complications. This post hoc analysis of the DUAL V and DUAL VIII trials aimed to compare dTIR with an insulin degludec/liraglutide fixed-ratio combination (IDegLira) versus insulin glargine 100 units/mL (glargine U100) in people with type 2 diabetes (T2D).

Materials and Methods:

Nine-point SMBG profiles were taken more than 24 hours at baseline and end of trial (EOT: 26 weeks [DUAL V] and 104 weeks [DUAL VIII]) and used to derive the percentage of readings within target range (70-180 mg/dL). Estimated treatment differences (ETDs, IDegLira–glargine U100) were analyzed using analysis of covariance, with treatment as fixed effects and baseline response as a covariate.

Results:

ETDs for change from baseline to EOT in dTIR were significantly greater with IDegLira versus glargine U100 in DUAL V (4.18%, P = .027) and DUAL VIII (5.17%, P = .001). The proportions of people achieving ≥70% dTIR at EOT with IDegLira and glargine U100, respectively, were 62% and 60% in DUAL V ( P = .7541), and 50% and 26% in DUAL VIII ( P < .0001). The proportion achieving a ≥5% increase in dTIR from baseline to EOT with IDegLira and glargine U100 was 63% in both groups in DUAL V ( P = .9043), and 44% and 25%, respectively, in DUAL VIII ( P < .0001).

Conclusions:

IDegLira was associated with significantly greater increases in dTIR versus basal insulin alone in people with T2D.

Trial ID(s):

ClinicalTrials.gov, NCT01952145 (DUAL V); ClinicalTrials.gov, NCT02501161 (DUAL VIII)
Memes as Instructional Tools for Experiential Information Processing in Public Speaking Courses
Authors: Sharma Daneshwar
Published: January 2023

Students process information in two modes: cognitive and experiential. Case studies and stories are generally used as tools for experiential information processing. This article uses memes as an instructional tool to deliver information for experiential information processing in a public speaking course. The effectiveness of memes as an instructional tool is assessed through a questionnaire in terms of their overall effectiveness and its memorability, concreteness, and course orientation. The findings suggest that memes can be used effectively as instructional tools like stories to make the students understand, discuss, and engage with course content.
The Top 10 Soft Skills in Business Today Compared to 2012
Authors: Fletcher Shannon , Thornton Kristen R. V.
Published: January 2023

The work environment has drastically changed in the last 10 years, necessitating a new look at which soft skills are most relevant in today’s workplace. Because of COVID-19, organizations had to rapidly adjust where and how they work. According to the Pew Research Center, 71% of adults, who can perform their work responsibilities from home, are now working remotely. Then, the workplace shifted again during the “Great Resignation” where an all-time record of 24 million employees left their jobs between April and September 2021. This shift is ever more important as research in the last decade indicates that soft skills are being valued more compared to hard skills during the hiring process. The current study replicated Robles’s (2012) study of soft skills to find which soft skills are most relevant to a thriving work environment in 2022. Results indicate that soft skills emphasizing employee initiative and including others in processes are most relevant today, including Adaptable, Agency, Conscientious, Contextual Awareness, Create Clarity, Curiosity, Engage the Mess, Genuine Care, Integrity, Partnership, Play, Positive Energy, Social Skills, and Suppress the Noise.
Evaluating and Improving Department Racial Climate through Action Research
Authors: Gordon Daanika , Pollak Lauren , Costa Sophia , Ting Olivia , Setow Nicole
Published: January 2023

This essay describes a learning experience that utilized participatory action research to improve the racial climate of a sociology department at a predominantly White institution. Through systematic inquiry, we developed initiatives and proposed recommendations to create more welcoming, supportive, and affirming environments for students of color and students from other historically oppressed communities. We see our work as a model that develops applied research skills, elevates the expertise of students, and lays the groundwork for meaningful institutional action.
Comparison of Therapeutic Effect and Safety of Oral and Rectal Use of Acetaminophen on Patent Ductus Arteriosus in Preterm Infants: Clinical Randomized Trial
Authors: Vakiliamini Mazyar , Daryoushi Hooman , Babaei Homa , Chegene Lorestani Roya , Rostamian Mosayeb , Akya Alisha , Habibi Reza , Ghadiri Keyghobad
Published: January 2023

The prevalence of patent ductus arteriosus (PDA) in preterm infants is high. There is little information about the therapeutic effect and safety of rectal acetaminophen in the treatment of PDA. We aimed to compare the therapeutic effect and safety of oral and rectal acetaminophen on PDA in preterm infants. This study was a single-blind randomized clinical trial using 40 preterm infants. The cases were hospitalized in the neonatal intensive care unit of Mohammad Kermanshahi and Imam Reza hospitals of Kermanshah. Subjects were randomly divided into 2 groups, the first group was treated with oral acetaminophen and the second group was treated with rectal acetaminophen. The presence of PDA and response to treatment was assessed based on pre- and post-treatment echocardiographic criteria. The likelihood of complications or prohibition of acetaminophen use was assessed with paraclinical tests before and after treatment. The neonates were in the age range of 30 to 35 weeks. Twenty-one cases (52.5%) were boys and 19 cases (47.5%) were girls. Two cases in the oral-acetaminophen group and 1 case in the rectal-acetaminophen group needed the second round of treatment. There was no difference between the success of treatment and the type of treatment. The study showed that there was no difference between PDA treatment of preterm infants with oral and rectal acetaminophen. Also, no side effects were observed in treatment with any of the treatments. Therefore, it could be suggested that in infants who are intolerant to oral acetaminophen, the rectal form can be used.
Macroeconomic Determinants of India’s Participation in Global Value Chains: An Empirical Evidence
Authors: Sharma Sharadendu , Arora Rahul
Published: January 2023

Global value chains (GVCs) have significantly changed the world trade scenario. Many developed countries gained benefits through production fragmentation, and it has worked as hope for the developing world. India is also one of the participants but its share in global GVC space is very limited. The recent pandemic comes with a lot of opportunities for India to emerge as a new GVC hub in the Asia-Pacific region. This requires the study of factors determining the extent of India’s participation in GVCs. The present article is an attempt in this direction wherein various factors determining the forward and backward participation levels are identified. At a macro level, the study found the positive role of technology advancement, domestic capital and industrial capacity in promoting the level of participation in GVCs, while the role of net FDI inflows is found to be negative. This highlights the requirement for conducive policies to reap the maximum benefits associated with foreign capital. India is already observing the benefits and growing, but still, it has to cover a long path. The time has come to make an image of the brand India in the world and reap maximum benefits from the GVC participation.

JEL Codes: F14, F40, O24
Evaluation of the Impact of Regional Trade Agreements on Indian Exports
Authors: Bharti Saurabh Kumar , Nisa Syeedun
Published: January 2023

This article scrutinises the repercussion of the regional trade agreements on Indian exports. The gravity model has been used for the analysis of two decades of panel data from 30 countries, spanning from 2001 to 2019. The gravity equation is estimated by the Ordinary Least Square (OLS) and Poisson pseudo-maximum likelihood (PPML) techniques using panel data regression. The PPML approach addresses the heteroskedasticity bias that is typically present in the OLS method. The study has revealed that the PPML results are more encouraging than those obtained based on the traditional OLS approach. According to the empirical findings, India’s trading partners in South Asia benefit more from its economic integration than India does. However, the measurement of country-specific degrees of globalisation has a negligible effect on fostering trade across select nations.

JEL Codes: C1, F1, F2, F6
Hospital Expenditures Under Global Budgeting and Single-Payer Financing: An Economic Analysis, 2021–2030
Authors: Gaffney Adam W. , Himmelstein David U. , Woolhandler Steffie , Kahn James G.
Published: January 2023

U.S. hospitals provide large amounts of low-value care and devote inordinate resources to administration, while some hospitals leverage market power to realize large profits. Meanwhile, many rural and safety net hospitals are financially distressed. The coexistence of waste and want suggests that U.S. hospital financing is neither efficient nor equitable. We model the economic consequences of adopting the mode of hospital payment used in Canada and the U.S. Veterans Health Administration and proposed in the leading congressional single-payer Medicare-for-All bill: global budgeting. Our models assume increased utilization due to expanded and upgraded coverage; gradual reductions in administrative costs from simplified payment; and the elimination of hospital profits, with hospital capital expenditures funded by explicit grants rather than from profits or borrowing. We estimate that non-federal hospital operating budgets will total $17.2 trillion between 2021 and 2030 under current law versus $14.7 trillion under single-payer with global budgeting. This difference reflects $520 billion in foregone profits and $1,984 billion in reduced expenditures on hospital administration; expenditures on clinical operating budgets, however, would be higher than under current law, funded out of profits.
Evaluation of inherited germline mutations in cancer susceptibility genes among pancreatic cancer patients: a single-center study
Authors: Tavano Francesca , Gioffreda Domenica , Fontana Andrea , Palmieri Orazio , Gentile Annamaria , Latiano Tiziana , Latiano Anna , Latiano Tiziana Pia , Scaramuzzi Matteo , Maiello Evaristo , Bazzocchi Francesca , Perri Francesco
Published: January 2023

Background

Germline mutations in cancer susceptibility genes were identified in pancreatic cancer (PanC) patients with a sporadic disease and in those unselected for family cancer history.

Methods

With the aim to determine the prevalence of germline predisposition genes mutations in PanC, and to evaluate whether they were associated with the presence of PanC, we profiled a custom AmpliSeq panel of 27 cancer susceptibility genes in 47 PanC patients and 51 control subjects by using the Ion Torrent PGM system.

Results

Multigene panel testing identified a total of 31 variants in 27 PanC (57.4%), including variants with pathogenic/likely pathogenic effect, those of uncertain significance, and variants whose clinical significance remains currently undefined. Five patients carried more than one variant in the same gene or in different genes. Eight patients (17.0%) had at least one pathogenic/likely pathogenic variant in four main genes: CFTR (10.6%), BRCA2 (8.5%), ATM and CHEK2 (2.1%). Pathogenic/likely pathogenic mutation were identified in patients with positive PanC family history (20%) or in patients without first-degree relatives affected by PanC (13.6%). All the BRCA2 mutation carriers were unselected PanC patients. The presence of mutations in BRCA2 was significantly associated with an increased occurrence of PanC and with positive family history for endometrial cancer (p = 0.018).

Conclusions

This study confirmed the potential remarkable contribution of BRCA2 in assessing the presence of PanC. Overall our findings supported the recommendation of offering the germline testing to all the PanC patients with the intent to reduce the number of underdiagnosed carriers of mutations in predisposition genes, and not to preclude their relatives from the opportunity to benefit from surveillance programs.
Alteration in branching morphogenesis via YAP/TAZ in fibroblasts of fetal lungs in an LPS-induced inflammation model
Authors: Ko Hung-Shuo , Laiman Vincent , Tsao Po-Nien , Chen Chung-Ming , Chuang Hsiao-Chi
Published: January 2023

Background

Chorioamnionitis is a common cause of preterm birth and leads to serious complications in newborns. The objective of this study was to investigate the role of the Hippo signaling pathway in lung branching morphogenesis under a lipopolysaccharide (LPS)-induced inflammation model.

Materials and methods

IMR-90 cells and ex vivo fetal lungs were treated with 0, 10, 30, or 50 μg/ml LPS for 24 and 72 h. Supernatant levels of lactate dehydrogenase (LDH), interleukin (IL)-6, IL-8, Chemokine (C-X-C motif) ligand 1(CXCL1), branching and the surface area ratio, Yes-associated protein (YAP), transcription coactivator with PDZ-binding motif (TAZ), fibroblast growth factor 10 (FGF10), fibroblast growth factor receptor II (FGFR2), SRY-box transcription factor 2 (SOX2), SOX9, and sirtuin 1 (SIRT1) levels were examined. Differentially expressed genes in fetal lungs after LPS treatment were identified by RNA-sequencing.

Results

LPS at 50 μg/ml increased IL-6 and IL-8 in IMR-90 cells and increased IL-6, CXCL1 and LDH in fetal lungs. The branching ratio significantly increased by LPS at 30 μg/ml compared to the control but the increased level had decreased by 50 μg/ml LPS exposure. Exposure to 50 μg/ml LPS increased phosphorylated (p)-YAP, p-YAP/YAP, and p-TAZ/TAZ in IMR-90 cells, whereas 50 μg/ml LPS decreased FGF10 and SOX2. Consistently, p-YAP/YAP and p-TAZ/TAZ were increased in fibronectin+ cells of fetal lungs. Moreover, results of RNA-sequencing in fetal lungs showed that SMAD, FGF, IκB phosphorylation, tissue remodeling and homeostasis was involved in branching morphogenesis following exposure to 50 μg/ml LPS. The p-SIRT1/SIRT1 ratio increased in IMR-90 cells by LPS treatment.

Conclusions

This study showed that regulation of the Hippo pathway in fibroblasts of fetal lungs was involved in branching morphogenesis under an inflammatory disease such as chorioamnionitis.
Data quality assessment in emergency medical services: an objective approach
Authors: Mashoufi Mehrnaz , Ayatollahi Haleh , Khorasani-Zavareh Davoud , Talebi Azad Boni Tahere
Published: January 2023

Background

In emergency medical services, high quality data are of great importance for patient care. Due to the unique nature of this type of services, the purpose of this study was to assess data quality in emergency medical services using an objective approach.

Methods

This was a retrospective quantitative study conducted in 2019. The research sample included the emergency medical records of patients who referred to three emergency departments by the pre-hospital emergency care services (n = 384). Initially a checklist was designed based on the data elements of the triage form, pre-hospital emergency care form, and emergency medical records. Then, data completeness, accuracy and timeliness were assessed.

Results

Data completeness in the triage form, pre-hospital emergency care form, and emergency medical records was 52.3%, 70% and 57.3%, respectively. Regarding data accuracy, most of the data elements were consistent. Measuring data timeliness showed that in some cases, paper-based ordering and computer-based data entry was not sequential.

Conclusion

Data quality in emergency medical services was not satisfactory and there were some weaknesses in the documentation processes. The results of this study can inform the clinical and administrative staff to pay more attentions to these weaknesses and plan for data quality improvement.
Psychosocial factors and caregiver burden among primary family caregivers of frail older adults with multimorbidity
Authors: Chan Cheuk Ying , De Roza Jacqueline Giovanna , Ding Gabriel Teck Yong , Koh Hui Li , Lee Eng Sing
Published: January 2023

Background

Provision of care for frail older adults with multiple chronic diseases (multimorbidity) poses increasing challenge for family caregivers. Our study aims to evaluate to what extent caregiving competence, social support and positive aspects of caregiving can mitigate the effect of burden experienced by family caregivers of frail older adults with multimorbidity.

Methods

A descriptive cross-sectional study was conducted in 2 primary care clinics. Family caregivers of older adults aged 65 years and above were invited to complete interviewer-administered questionnaires. Descriptive statistics were used to describe sociodemographic and clinical data. Caregiver’s burden was measured using the Zarit Burden Interview (ZBI). Mann–Whitney U test was used to compare differences in Caregiving Competence Scale (CCS), short Positive Aspects of Caregiving (S-PAC) and modified Medical Outcome Study Social support (mMOS-SS). Multivariable logistic regression was used to analyse factors associating with caregiver burden.

Results

A total of 188 participants were recruited. 71.8% reported caregiver burden (ZBI score ≥ 10). Caregivers who perceived burden had significantly lower CCS, S-PAC and mMOS-SS scores than those who did not (10.0 vs 11.6; 26.8 vs 29.8; 24.8 vs 31.4, p < 0.001 respectively). Factors significantly associated with higher odds of perceived burden were presence of alternative caregivers (OR 3.3, 95% CI 1.09, 10.19, p = 0.04), use of community resources (OR 4.4, 95% CI 1.15, 16.83, p = 0.03) and time spent caregiving per week (OR 1.1, 95% CI 1.02, 1.10, p = 0.003).

Discussion and conclusion

This study found that caregivers had high perception of burden as demand in caregiving may increase. Anticipating caregiver burden and social support needs may be important part of managing these frail older adults.
Disseminated nontuberculous mycobacterial infection in a patient with idiopathic CD4 lymphocytopenia and IFN-γ neutralizing antibodies: a case report
Authors: Goto Ryo , Shiota Seiji , Kaimori Ryo , Horinouchi Noboru , Utsunomiya Nishimizu Rie , Yamamoto Kyoko , Miyazaki Eishi
Published: January 2023

Background

Disseminated nontuberculous mycobacterial (NTM) infection usually occurs in immunodeficient patients, such as those with human immunodeficiency virus infection and idiopathic CD4 lymphopenia. However, disseminated NTM diseases have also been reported in immunocompetent patients. Autoantibodies to interferon-gamma (IFN-γ) are known to be involved in disseminated NTM disease, although anti-IFN-γ antibodies are mainly seen in immunocompetent patients rather than those with immunodeficiency. Here, we report a rare case of disseminated NTM patient with idiopathic CD4 lymphopenia and anti-IFN-γ antibodies.

Case presentation

A 64-year-old Asian male presented with fever, back pain, anorexia and weight loss. Physical examination revealed subcutaneous masses in the forehead, sternoclavicular joint, and right inguinal region. Computed tomography showed multiple osteosclerotic changes with soft structures and osteolytic changes. Both blood and sputum cultures were positive for Mycobacterium intracellulare, confirming the presence of disseminated NTM infection. Histopathological evaluation of the subcutaneous mass in the right inguinal region showed numerous granulomas consisting of epithelioid cells with Langhans-type giant cells. He was diagnosed with idiopathic CD4 lymphocytopenia. Interestingly, he also had anti-IFN-γ autoantibodies with suppression of IFN-γ-dependent signal transducer and activator of transcription 1 (STAT1) phosphorylation. Two-drug combination therapy with clarithromycin and ethambutol was started for the NTM infection, which resulted in a favorable disease course.

Conclusions

In patients with disseminated NTM infection, idiopathic CD4 lymphocytopenia and anti-IFN-γ autoantibody-positive immunodeficiency can be coexisted. It is necessary to clarify the pathogenesis and clinical course of CD4 lymphocytopenic conditions and IFN-γ neutralizing antibody-positive in the disseminated NTM disease.
Palbociclib plus endocrine therapy in hormone receptor-positive and HER2 negative metastatic breast cancer: a multicenter real-world study in the northwest of China
Authors: Yang Jiao , Zhao Bing , Ling Xiaoling , Li Donghui , Zhao Jiuda , Lv Yonggang , Wang Guangxi , Liu Xinlan , Li Nanlin , Yang Jin
Published: January 2023

Background

Real-world data of Palbociclib are insufficient in China. This study aimed to investigate the treatment pattern and real-world outcomes in hormone receptor positive and human epidermal growth factor 2 receptor negative (HR+/HER2-) metastatic breast cancer (MBC) patients treated with Palbociclib in the northwest of China.

Methods

HR+/HER2- MBC patients who received Palbociclib in 8 centers from July 2017 to September 2019 were retrospectively included in this study. Real-world objective response rate (ORR), progression-free survival (PFS) and safety profiles were analyzed. The survival curves were plotted by the Kaplan-Meier method to analyze PFS, which was verified by the log-rank test.

Results

In total, 211 women were eligible for the analysis. A total of 85 patients (40.3%), 78 (37.0%), and 48 (22.7%) received Palbociclib in the first-, second-, third- or later-line setting, respectively. 46 patients achieved partial response and 145 patients experienced stable disease, with an ORR of 21.8% and a disease control rate of 90.5%. Following a median follow-up period of 14.2 months, the median PFS was 12.2 months (95% confidence interval, 10.1-14.3 m), and the median overall survival was not reached. Early Palbociclib initiation, sensitivity or acquired resistance to endocrine therapy, estrogen receptor and progesterone receptor double positivity, less than 3 metastatic sites, without visceral metastasis, bone metastasis only, without prior chemotherapy or endocrine therapy were associated with a prolonged PFS in MBC (All P < 0.05). The most common grade 3 or 4 adverse events (AE) was neutropenia (36.5%), and the most common nonhematologic AE was fatigue (10.9%). No patient experienced AE leading to treatment discontinuation.

Conclusion

Palbociclib plus endocrine therapy exhibited favorable effectiveness and manageable toxicities in the real-world setting, supporting their use in Chinese patients with HR+/HER2 − MBC.
The prognostic value of the advanced lung cancer inflammation index in patients with gastrointestinal malignancy
Authors: Zhang Lilong , Zhao Kailiang , kuang Tianrui , Wang Kunpeng , Chai Dongqi , Qiu Zhendong , Liu Rongqiang , Deng Wenhong , Wang Weixing
Published: January 2023

Background

Systemic inflammation is crucial for the development and progression of cancers. The advanced lung cancer inflammation index (ALI) is considered to be a better indicator of systemic inflammation than current biomarkers. However, the prognostic value of the ALI in gastrointestinal neoplasms remains unclear. We performed the first meta-analysis to explore the association between ALI and gastrointestinal oncologic outcomes to help physicians better evaluate the prognosis of those patients.

Methods

Eligible articles were retrieved using PubMed, the Cochrane Library, EMBASE, and Google Scholar by December 29, 2022. Clinical outcomes were overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), and cancer-specific survival (CSS).

Results

A total of 18 articles with 6898 patients were included in this meta-analysis. The pooled results demonstrated that a low ALI was correlated with poor OS (HR = 1.914, 95% CI: 1.514–2.419, P < 0.001), DFS (HR = 1.631, 95% CI: 1.197–2.224, P = 0.002), and PFS (HR = 1.679, 95% CI: 1.073–2.628, P = 0.023) of patients with gastrointestinal cancers. Subgroup analysis revealed that a low ALI was associated with shorter OS (HR = 2.279, 95% CI: 1.769–2.935, P < 0.001) and DFS (HR = 1.631, 95% CI: 1.197–2.224, P = 0.002), and PFS (HR = 1.911, 95% CI: 1.517–2.408, P = 0.002) of patients with colorectal cancer. However, the ALI was not related to CSS in the patients with gastrointestinal malignancy (HR = 1.121, 95% CI: 0.694–1.812, P = 0.640). Sensitivity analysis supported the stability and dependability of the above results.

Conclusion

The pre-treatment ALI was a useful predictor of prognosis in patients with gastrointestinal cancers.