bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship between Higher Chronic Opioid Therapy Dose and Specific Personality Traits in Individuals with Chronic Pain
Authors: McIntyre Amanda , Mehta Swati , Vanderlaan Danielle , Sequeira Keith , Loh Eldon , Teasell Robert
Published: June 2021

Objective. To evaluate the relationship between opioid use and specific personality traits among individuals with chronic pain stratified by morphine equivalent doses (MEQ). Design. Observational cohort study. Setting. Chronic pain outpatient clinic in Canada (2017–2019). Patients. Participants were included if they (1) were at least 18 years old, (2) had been diagnosed with chronic pain (pain >3 months), and (3) were able to read and write in English. Interventions. None. Main Outcome Measures. Completion of the following outcome measures: Acceptance and Action Questionnaire, Anxiety Sensitivity Index, Brief-Coping with Problems Experience 28-item, Brief Pain Inventory Short Form, CAGE-AID substance misuse screening tool, EuroQol-5D, Generalized Anxiety Disorder 7-item, and Patient Health Questionnaire 9-item. One-way analysis of variance compared outcomes between MEQ groups. Results. 215 individuals (64.2% female) were included with a mean age of 52.7 ± 11.7 years and time since pain onset of 14.1 ± 10.2 years (range 1–45). There were no significant differences between MEQ groups with respect to sociodemographic and clinical health variables except for gender and employment status and time since pain onset. After controlling for gender, time since pain onset, and average pain severity, patients with MEQ 90+ mg had significantly higher scores for experiential avoidance and anxiety sensitivity in addition to increased pain interference, greater depressive and anxiety symptoms, more dysfunctional coping, and poorer QoL than those with MEQ 1–89 mg or MEQ 0 mg. Conclusions. Compared to individuals using no or lower-dose opioids to treat chronic pain, those using high-dose opioids had higher scores on two maladaptive personality traits (i.e., anxiety sensitivity and experiential avoidance) which was associated with poorer mood, greater pain interference, lower quality of life, and dysfunctional coping. These maladaptive personality traits may help to explain how individuals with chronic pain utilize higher doses of opioid analgesics.
Astragalus Polysaccharides Enhance the Immune Response to OVA Antigen in BALB/c Mice
Authors: Zhou Yumei , Zong Yuhan , Liu Zihao , Zhao Haihong , Zhao Xiaoshan , Wang Ji
Published: June 2021

Vaccination has been identified as one of the most effective ways to prevent the transmission of infectious diseases in humans and animals. One of the most critical steps in vaccine development is the selection of a suitable adjuvant. Although various adjuvant candidates have been evaluated in the past few decades, only a limited amount of them are nontoxic and safe for human use. Astragalus polysaccharide (APS), due to its lack of toxicity, has been used as an immunomodulator to enhance immune responses. On the other hand, the immune effects of APS on ovalbumin are yet to be examined. Thus, in this study, we analyzed APS’s effects on the immune response to ovalbumin in BALB/c mice. We have also used the classic adjuvant CpG oligodeoxynucleotide as the positive control.
Observations on Performing Sine Waves with an Oscillator Ensemble
Authors: Bernier Nicolas
Published: June 2021

Founded in 2016 at Université de Montréal, Ensemble d’oscillateurs (French for “Oscillator Ensemble”) brings together 10 musicians around old analog test equipment oscillators that produce audio sine waves. The ensemble performs new compositions while also arranging early electronic pieces. In parallel, the project has developed itself as a space to gather information and reflect on sine wave–based music. In this article, the author presents some of the key considerations and challenges in the formation of Ensemble d’oscillateurs. Based on observations made throughout the development of a body of work using these audio oscillators, he then aims to open a discussion on some aspects of the historical trajectory of the use of sine waves in modern music.
Who (or What) Is an AI Artist?
Authors: Browne Kieran
Published: June 2021

The mainstream contemporary art world is suddenly showing interest in AI art. While this has enlivened the practice, there remains significant disagreement over who or what actually deserves to be called an AI artist. This article examines several claimants to the term and grounds these in art history and theory. It addresses the controversial elevation of some artists over others and accounts for these choices, arguing that the art market alienates AI artists from their work. Finally, it proposes that AI art’s interactions with art institutions have not promoted new creative possibilities but have instead reinforced conservative forms and aesthetics.
Art Exists Because the Viewer Exists: How François Morellet’s Triple X Neonly Influences Postural Control and Subjective Aesthetic Appreciation
Authors: Ward Lindsey M. , Morize Aurélien , Vernet Marine , Antoniades Chrystalina , Kapoula Zoï
Published: June 2021

The authors study the effects of viewing François Morellet’s Triple X Neonly (2012) on postural control and subjective appreciation. Participants were asked to view monocularly and binocularly. Their average forward-backward (anteroposterior) body sway root mean square (rms) velocity was significantly greater viewing it monocularly. Participants showed diverse reactions to the artwork, yet comments mainly concerned apparent movement and depth. The authors conclude that binocular viewing facilitates viewer appreciation of the proximity of the central X, thus requiring less energy to keep the body stable. This study confirms the artist’s success in involving viewers actively in their aesthetic experience through their eye and body movements.
Can Study of the Historical Jesus Escape its Typographical Captivity?
Authors: Horsley Richard A.
Published: June 2021

As part of the deepening diversification of biblical studies, several lines of research are now undermining the print-cultural assumptions on which New Testament studies developed. The first section offers summaries of important inquiries into ancient communications media: the dominant oral communication and the uses of writing; revisionist text-criticism of manuscripts of texts later included in the Hebrew Bible; the oral-written cultivation of their cultural repertoire by Judean scribes; the parallel oral cultivation of Israelite popular tradition; revisionist criticism of Gospel texts; and the learning and oral performance of Gospel texts. These separate but related lines of research are undermining the standard print-cultural assumptions, concepts, and approaches of Jesus studies. The second section explores the implications of these researches that open toward an alternative view of what the sources are, a more comprehensive approach to the historical Jesus appropriate to ancient communications media, and a reconceptualization of Jesus studies.
Unconstitutionality of Access to Abortion for Embryo-Pathological Reasons
Authors: Młynarska-Sobaczewska Anna
Published: June 2021

This article comments on the Polish Constitutional Tribunal judgment delivered on 22 October 2020 on the unconstitutionality of the provision of the Act of 1993 allowing for the termination of pregnancy for embryo-pathological reasons. The author provides a commentary on the judgment from the point of view of its formal features and content and demonstrates that it violates in both respects the right to privacy and freedom from inhuman or degrading treatment, as it was passed without taking into account nor properly balancing the rights of a pregnant mother in a situation of particular vulnerability.
Scrutinising the Maritime Zones Around Australia’s Sub-Antarctic Islands
Authors: Galliford Karina
Published: June 2021

In 2016, the South China Sea Arbitral Tribunal was the first tribunal or court to interpret Article 121(3) of the United Nations Convention on the Law of the Sea. The Tribunal’s interpretation raises international law questions regarding the validity of claimed exclusive economic zones (eezs) and continental shelf maritime areas around many islands including Australia’s sub-Antarctic Islands. Owing to their geographical remoteness, harsh climates, lack of resources, as well as never been ‘home’ to any group of people in a settled way, questions have been raised as to the validity of Australia’s claimed maritime zones with respect to Article 121(3) in both pre- and post-South China Sea Arbitral Award commentary. The article assesses the validity of Australia’s claim by applying the Tribunal’s interpretation of Article 121(3) to the physical and historical facts of the Islands while raising alternate interpretations offered by prior and subsequent commentary. Three examples of possible State practice are reviewed for evidence of other interpretations that may have been agreed to by parties to the Convention. The findings are that Heard and Macquarie Islands are likely classified as islands entitled to an eez and continental shelf whereas McDonald Island is more likely to be an Article 121 ‘rock’.
The Criminal Jurisdiction and Applicable Law concerning the Fu Yuan Yu Leng 999 Case
Authors: Lee Seokwoo , Wang Jiayi
Published: June 2021

On 13 August 2017, a Chinese-flagged carrier vessel, Fu Yuan Yu Leng 999, entered the Galapagos Marine Reserve (gmr) without giving appropriate notice, on the captain’s explanation that he entered the area to shelter the vessel from strong winds. Ecuadorian naval aircraft and a coastguard ship began to pursue the vessel from the internal waters and it was intercepted within the territorial sea. This area belongs to the new marine sanctuary of the gmr, where high levels of protection are implemented, and all fishing activities are prohibited. This incident reflects that, as the world’s largest distant-water fisheries (dwf) nation, much more needs to be done by China to crack down on illegal, unreported and unregulated (iuu) fishing and to promote the orderly development of dwf.
Antarctic bryophyte research—current state and future directions
Authors: CÂMARA PAULO E.A.S. , CARVALHO-SILVA MICHELINE , STECH MICHAEL
Published: June 2021

Botany is one of the oldest sciences done south of parallel 60 °S, although few professional botanists have dedicated themselves to investigating the Antarctic bryoflora. After the publications of liverwort and moss floras in 2000 and 2008, respectively, new species were described. Currently, the Antarctic bryoflora comprises 28 liverwort and 116 moss species. Furthermore, Antarctic bryology has entered a new phase characterized by the use of molecular tools, in particular DNA sequencing. Although the molecular studies of Antarctic bryophytes have focused exclusively on mosses, molecular data (fingerprinting data and/or DNA sequences) have already been published for 36 % of the Antarctic moss species. In this paper we review the current state of Antarctic bryological research, focusing on molecular studies and conservation, and discuss future questions of Antarctic bryology in the light of global challenges.
500 million years of charted territory: functional ecological traits in bryophytes
Authors: STANTON DANIEL E. , COE KIRSTEN K.
Published: June 2021

Since the late Cambrian era, bryophytes have been shaping terrestrial ecosystems through unique and diverse suites of anatomical, physiological, and morphological traits. In this review we highlight historical and recent work in bryophyte functional ecology, with an emphasis on knowledge gaps and opportunities for future work. While we cannot always avoid the temptation to contrast with tracheophyte (especially angiosperm) studies, our aim is to de-center that perspective in favor of a more universal understanding of functional land plant ecology. We therefore center our description on three core aspects of bryophytes that are poorly represented in tracheophyte studies: (I) dynamic water content (including poikilohydry and desiccation tolerance), (II) multiple scales of interaction with environment, and (III) reproduction and life history. We also highlight the diverse and wide-ranging influence bryophytes have on ecosystem processes, including primary productivity, nutrient cycling, hydrology, and ecological interactions with other species. Furthermore, while the study of bryophyte functional traits has rapidly grown in the past decade, important gaps in phylogenetic and geographic coverage persist and constrain the development of a more universal land plant functional ecology theory.
Cell wall polymers in the Phaeoceros placenta reflect developmental and functional differences across generations
Authors: HENRY JASON S. , LIGRONE ROBERTO , VAUGHN KEVIN C. , LOPEZ RENEE A. , RENZAGLIA KAREN S.
Published: June 2021

The placenta of hornworts is unique among bryophytes in the restriction of transfer cells that are characterized by elaborate wall labyrinths to the gametophyte generation. During development, cells around the periphery of the sporophyte foot elongate, forming smooth-walled haustorial cells that interdigitate with gametophyte cells. Using immunogold labeling with 22 antibodies to diverse cell wall polymers, we examined compositional differences in the developmentally and morphologically distinct cell walls of gametophyte transfer cells and sporophyte haustorial cells in the placenta of Phaeoceros. As detected by Calcofluor White fluorescence, cellulose forms the cell wall scaffolding in cells on both sides of the placenta. Homogalacturonan (HG) and rhamnogalacturonan I (RG-I) pectins are abundant in both cell types, and haustorial cells are further enriched in methyl-esterified HGs. The abundance of pectins in placental cell walls is consistent with the postulated roles of these polymers in cell wall porosity and in maintaining an acidic apoplastic pH favorable to solute transport. Xyloglucan hemicellulose, but not mannans or glucuronoxylans, are present in cell walls at the interface between the two generations with a lower density in gametophytic wall ingrowths. Arabinogalactan proteins (AGPs) are diverse along the plasmalemma of placental cells and are absent in surrounding cells in both generations. AGPs in placental cell walls may play a role in calcium binding and release associated with signal transduction as has been speculated for these glycoproteins in other plants. Callose is restricted to thin areas in cell walls of gametophyte transfer cells. In contrast to studies of transfer cells in other systems, no reaction to the JIM12 antibody against extensin was observed in Phaeoceros.
Kalanchoe subg. Alatae (Crassulaceae subfam. Kalanchooideae), a new rank for K. sect. Alatae
Authors: SMITH GIDEON F. , SHTEIN RONEN , KLEIN DAVID-PAUL
Published: June 2021

N/A
Predictive Value of Gross Extranodal Extension for Differentiated Thyroid Carcinoma Persistence/Recurrence
Authors: Kou Ying , Shen Guohua , Cheng Zhuzhong , Kuang Anren
Published: June 2021

Objective

We systematically investigated the predictive value of gross extranodal extension (gENE) for differentiated thyroid carcinoma persistence/recurrence.

Study Design

Retrospective study.

Setting

A tertiary care hospital.

Methods

This study was divided into 2 groups according to gENE status: the gENE group and non‐gENE group. We compared the disease persistence/recurrence rates of these 2 groups in the entire cohort and by individual risk group (intermediate/high risk), analyzed whether gENE was an independent risk factor for disease persistence/recurrence, and explored the impact of gENE‐specific features on disease persistence/recurrence.

Results

There were 989 patients who satisfied the inclusion criteria: 57 patients in the gENE group and 932 in the non‐gENE group. The disease persistence/recurrence rate of the gENE group was higher than that of the non‐gENE group in the entire cohort and by individual risk group (P <. 05 for each). Unexpectedly, the outcomes of the gENE group with intermediate risk were similar to those of the non‐gENE group with high risk (P =. 72). For the entire cohort, gENE was an independent predictor for disease persistence/recurrence (odds ratio, 2.89; 95% CI, 1.39‐6.00; P =. 005). Specific features of gENE (P >. 05 for each) were not related to disease persistence/recurrence.

Conclusion

Patients with gENE and intermediate risk might be regraded as high risk. Specific features of gENE have no impact on disease persistence/recurrence.
Proposal for the Standardization of Otolaryngology Residency Interview Offer Dates
Authors: Standiford Taylor C. , Pletcher Steven D. , Thorne Marc C.
Published: June 2021

The process of receiving and scheduling residency interviews for otolaryngology–head and neck surgery positions is chaotic, inducing unnecessary anxiety for applicants and introducing inefficiencies for programs. With incomplete information, applicants often accept all invitations they receive, resulting in interview hoarding and late cancellations. Various specialties have attempted to improve the interview offer and scheduling process through standardization of interview offer dates. In this commentary, we propose that otolaryngology programs adopt a uniform interview offer and scheduling date. We also advise programs commit to limiting the number of interview invitations to the number of interview slots available, and we review best practices to optimize the interview offer and scheduling process for both applicants and programs.
Modular Approach to Open Partial Horizontal Laryngectomy: Step‐by‐Step Anatomic Dissection
Authors: Molteni Gabriele , Bertolin Andy , Gazzini Luca , Sacchetto Andrea , Marchioni Daniele
Published: June 2021

Open partial laryngectomies still play an important role in contemporary conservative management of laryngeal cancer. A comprehensive and systematic classification of open partial horizontal laryngectomies (OPHLs) was presented by the European Laryngological Society working committee in 2014. The aim of this video is to show the main surgical steps in OPHL using a cadaveric dissection and to explain the modular approach for removal of laryngeal tumors.
Investigation into the surface integrity of crankshaft by barrel finishing
Authors: Chang Chao , Ma Zhen , Yang Shengqiang , Gao Zhixiong , Liang Guoxiang
Published: June 2021

With the advancement of processing technology, the surface quality of crankshafts has become very demanding, especially in locations with severe friction and wear, such as the main shaft and connecting rod journals. Barrel finishing technology is widely applicable to the surface processes of large- and medium-sized parts as a typical free-grinding processing method with the characteristics of low processing cost, high processing efficiency, and simple processing equipment. In this study, a horizontal spindle barrel finishing machine is applied to the crankshaft parts. The surface integrity of the crankshaft is systematically evaluated before and after the finishing processing. The experimental results show that the surface integrity of the crankshaft is significantly improved after the finishing processing, which further improves the wear resistance of the part surface and increases the bearing capacity.
Expanding Support Services for Adults Born With Cleft Lip and/or Palate in the United Kingdom: An Exploratory Evaluation of the Cleft Lip and Palate Association Adult Services Programme
Authors: Ardouin Kenny , Davis Nicky , Stock Nicola Marie
Published: June 2021

Background:

The largest group of people living with repaired cleft lip and/or palate (CL/P) are adults. Previous research has identified unmet treatment and psychosocial needs, yet few interventions exist. This article outlines 3 interventions developed by the Cleft Lip and Palate Association as part of its 3-year community-based Adult Services Programme; an Adults Conference, a series of panel discussions (“Cleft Talk”) streamed in podcast/video format, and a Leaver’s Pack of resources for adults wishing to return to cleft care.

Methods:

Feedback from attendees of the Adults Conferences (2018-2019) was collected using specifically developed evaluation forms. Streaming metrics and social media interactions were extracted for Cleft Talk panel discussions (2019-2020). The Leaver’s Pack was piloted in 2020, using an online evaluation form. Specialist health professionals were invited to provide feedback or participate in a one-to-one interview regarding their perceived impact of the program.

Results:

All 3 interventions across the different modalities received support from participating adults, demonstrating potential to meet adults’ needs across the life span. Health professionals also offered support for the program, viewing the interventions as a valuable adjunct to formal medical CL/P services.

Conclusions:

This exploratory evaluation indicates that peer- and community-led interventions, in combination with ongoing access to specialist medical care, can have a range of positive impacts for adults with CL/P. There is scope for similar initiatives to be developed internationally and for individuals with other craniofacial conditions. Not-for-profit organizations are encouraged to routinely evaluate their interventions to create a stronger evidence base for their valuable work.
Reconstruction of the full-length transcriptome of cigar tobacco without a reference genome and characterization of anion channel/transporter transcripts
Authors: Zhang Hui , Jin Jingjing , Xu Guoyun , Li Zefeng , Zhai Niu , Zheng Qingxia , Lv Hongkun , Liu Pingping , Jin Lifeng , Chen Qiansi , Cao Peijian , Zhou Huina
Published: June 2021

Background

Cigar wrapper leaves are the most important raw material of cigars. Studying the genomic information of cigar tobacco is conducive to improving cigar quality from the perspective of genetic breeding. However, no reference genome or full-length transcripts at the genome-wide scale have been reported for cigar tobacco. In particular, anion channels/transporters are of high interest for their potential application in regulating the chloride content of cigar tobacco growing on coastal lands, which usually results in relatively high Cl− accumulation, which is unfavorable. Here, the PacBio platform and NGS technology were combined to generate a full-length transcriptome of cigar tobacco used for cigar wrappers.

Results

High-quality RNA isolated from the roots, leaves and stems of cigar tobacco were subjected to both the PacBio platform and NGS. From PacBio, a total of 11,652,432 subreads (19-Gb) were generated, with an average read length of 1,608 bp. After corrections were performed in conjunction with the NGS reads, we ultimately identified 1,695,064 open reading frames including 21,486 full-length ORFs and 7,342 genes encoding transcription factors from 55 TF families, together with 2,230 genes encoding long non-coding RNAs. Members of gene families related to anion channels/transporters, including members of the SLAC and CLC families, were identified and characterized.

Conclusions

The full-length transcriptome of cigar tobacco was obtained, annotated, and analyzed, providing a valuable genetic resource for future studies in cigar tobacco.
Evaluation of Jatropha curcas L. leaves mulching on wheat growth and biochemical attributes under water stress
Authors: Irshad Muhammad , Ullah Faizan , Fahad Shah , Mehmood Sultan , Khan Asif Ullah , Brtnicky Martin , Kintl Antonin , Holatko Jiri , Irshad Inam , El-Sharnouby Mohamed , EL Sabagh Ayman , Datta Rahul , Danish Subhan
Published: June 2021

Background

Organic mulches are widely used in crop production systems. Due to their benefits in improving soil fertility, retention of soil moisture and weed control. Field experiments were conducted during wheat growing seasons of 2018–2019 and 2019–2020 to evaluate the effects of Jatropha leaves mulch on the growth of wheat varieties ‘Wadan-17’ (rainfed) and ‘Pirsabaq-2013’ (irrigated) under well irrigated and water stress conditions (non-irrigated maintaining 40% soil field capacity). Jatropha mulch was applied to the soil surface at 0, 1, 3 and 5 Mg ha−1 before sowing grains in the field. Under conditions of water stress, Jatropha mulch significantly maintained the soil moisture content necessary for normal plant growth.

Results

We noted a decrease in plant height, shoot and root fresh/dry weight, leaf area, leaf relative water content (LRWC), chlorophyll, and carotenoid content due to water stress. However, water stress caused an increase in leaf and root phenolics content, leaf soluble sugars and electrolytes leakage. We observed that Jatropha mulch maintained LRWC, plant height, shoot and root fresh/dry weight, leaf area and chlorophyll content under water stress. Moreover, water stress adverse effects on leaf soluble sugar content and electrolyte leakage were reversed to normal by Jatropha mulch.

Conclusion

Therefore, it may be concluded that Jatropha leaves mulch will minimize water stress adverse effects on wheat by maintaining soil moisture and plant water status.
Exploring life-space in the nursing home. An observational longitudinal study
Authors: Sverdrup Karen , Bergh Sverre , Selbæk Geir , Benth Jūratė Šaltytė , Husebø Bettina , Røen Irene Mari , Thingstad Pernille , Tangen Gro Gujord
Published: June 2021

Background

Traditional performance-based measurements of mobility fail to recognize the interaction between the individual and their environment. Life-space (LS) forms a central element in the broader context of mobility and has received growing attention in gerontology. Still, knowledge on LS in the nursing home (NH) remains sparse. The aim of this study was to identify LS trajectories in people with dementia from time of NH admission, and explore characteristics associated with LS over time.

Methods

In total, 583 people with dementia were included at NH admission and assessed biannually for 3 years. LS was assessed using the Nursing Home Life-Space Diameter. Association with individual (age, sex, general medical health, number of medications, pain, physical performance, dementia severity, and neuropsychiatric symptoms) and environmental (staff-to-resident ratio, unit size, and quality of the physical environment) characterises was assessed. We used a growth mixture model to identify LS trajectories and linear mixed model was used to explore characteristics associated with LS over time.

Results

We identified four groups of residents with distinct LS trajectories, labelled Group 1 (n = 19, 3.5%), Group 2 (n = 390, 72.1%), Group 3 (n = 56, 10.4%), Group 4 (n = 76, 14.0%). Being younger, having good compared to poor general medical health, less severe dementia, more agitation, less apathy, better physical performance and living in a smaller unit were associated with a wider LS throughout the study period.

Conclusion

From NH admission most NH residents’ LS trajectory remained stable (Group 2), and their daily lives unfolded within their unit. Better physical performance and less apathy emerged as potentially modifiable characteristics associated with wider LS over time. Future studies are encouraged to determine whether LS trajectories in NH residents are modifiable, and we suggest that future research further explore the impact of environmental characteristics.
Symptomatic treatment (using NSAIDS) versus antibiotics in uncomplicated lower urinary tract infection: a meta-analysis and systematic review of randomized controlled trials
Authors: Ong Lopez Albert Macaire C. , Tan Charles Jeffrey L. , Yabon Antonio S. , Masbang Armin N.
Published: June 2021

Background

Current guidelines recommend empiric antibiotics as first-line treatment for uncomplicated UTI. Despite proven benefits in treatment, antibiotic resistance rates remain on the rise. This meta-analysis aims to determine whether non-steroidal anti-inflammatory drugs can serve as an effective and safe option in the treatment of uncomplicated lower UTI among non-pregnant women compared to antibiotics.

Methods

A systematic literature search in PUBMED, CENTRAL, and ACP databases from inception to April 2021 was conducted to identify randomized controlled trials that compare the use of non-steroidal anti-inflammatory drugs versus antibiotics in non-pregnant women ≥18 years old with uncomplicated lower urinary tract infection. Primary outcomes were symptom resolution of UTI by Day 3 or 4 of intervention, and upper UTI complications. Secondary outcomes include persistence of positive urine culture despite treatment and need for another rescue antibiotic. Random and fixed-effects model for dichotomous data using Mantel-Haenszel and Peto odds method were reported at 95% CI followed by sensitivity analysis for substantial heterogeneity.

Results

Four RCTs involving 1165 patients were analyzed. The probability of having a symptom resolution by Day 3 or 4 with NSAID use is only less than three-fourths of that with antibiotic treatment (RR: 0.69, 95% CIs [0.55, 0.86], p = 0.0008, I2 = 73%, moderate certainty of evidence). The odds of developing upper UTI complications with use of NSAIDs are 6.49 to 1 for antibiotics (Peto OR: 6.49, 95% CIs [3.02, 13.92], p < 0.00001, I2 = 0%, moderate certainty of evidence). Secondary analysis showed that the NSAID group is 2.77x more likely to have persistence of a positive microbiologic urine culture than the antibiotic group (RR: 2.77, 95% CIs [1.95, 3.94], p < 0.00001, I2 = 36%, moderate certainty of evidence). Treatment with NSAIDs are three times more likely to use a secondary or rescue antibiotic due to persistent or worsening symptoms as compared to antibiotics (RR: 3.16, 95% CIs [2.24, 4.44], p < 0.00001, I2 = 47%, low certainty of evidence).

Conclusion

Antibiotic treatment was more effective than use of non-steroidal anti-inflammatory drugs for acute uncomplicated lower urinary tract infection with an overall moderate certainty of evidence.
Autonomic dysreflexia associated with cervical spinal cord gliofibroma: case report
Authors: Mizuno Hiroyuki , Honda Fumiaki , Ikota Hayato , Yoshimoto Yuhei
Published: June 2021

Background

Autonomic dysreflexia (AD) is an abnormal reflex of the autonomic nervous system normally observed in patients with spinal cord injury from the sixth thoracic vertebra and above. AD causes various symptoms including paroxysmal hypertension due to stimulus. Here, we report a case of recurrent AD associated with cervical spinal cord tumor.

Case presentation

The patient was a 57-year-old man. Magnetic resonance imaging revealed an intramedullary lesion in the C2, C6, and high Th12 levels. During the course of treatment, sudden loss of consciousness occurred together with abnormal paroxysmal hypertension, marked facial sweating, left upward conjugate gaze deviation, ankylosis of both upper and lower extremities, and mydriasis. Seizures repeatedly occurred, with symptoms disappearing after approximately 30 min. AD associated with cervical spinal cord tumor was diagnosed. Histological examination by tumor biopsy confirmed the diagnosis of gliofibroma. Radiotherapy was performed targeting the entire brain and spinal cord. The patient died approximately 3 months after treatment was started.

Conclusions

AD is rarely associated with spinal cord tumor, and this is the first case associated with cervical spinal cord gliofibroma. AD is important to recognize, since immediate and appropriate response is required.
Pregnancy-specific stress and sensitive caregiving during the transition to motherhood in adolescents
Authors: Scorza Pamela , Merz Emily C. , Spann Marisa , Steinberg Emily , Feng Tianshu , Lee Seonjoo , Werner Elizabeth , Peterson Bradley S. , Monk Catherine
Published: June 2021

Background

Maternal prenatal stress is associated with worse socio-emotional outcomes in offspring throughout childhood. However, the association between prenatal stress and later caregiving sensitivity is not well understood, despite the significant role that caregiving quality plays in child socio-emotional development. The goal of this study was to examine whether dimensions of pregnancy-specific stress are correlated with observer-based postnatal maternal caregiving sensitivity in pregnant adolescents.

Methods

Healthy, nulliparous pregnant adolescents(n = 244; 90 % LatinX) reported on their pregnancy-specific stress using the Revised Prenatal Distress Questionnaire (NuPDQ). Of these 244, 71 participated in a follow-up visit at 14 months postpartum. Videotaped observations of mother-child free play interactions at 14 months postpartum were coded for maternal warmth and contingent responsiveness. Confirmatory factor analysis of the NuPDQ supported a three-factor model of pregnancy-specific stress, with factors including stress about the social and economic context, baby’s health, and physical symptoms of pregnancy.

Results

Greater pregnancy-specific stress about social and economic context and physical symptoms of pregnancy was associated with reduced maternal warmth but not contingent responsiveness.

Conclusions

Heightened maternal stress about the social and economic context of the perinatal period and physical symptoms of pregnancy may already signal future difficulties in caregiving and provide an optimal opening for early parenting interventions.
“What kind of man gets depressed after having a baby?” Fathers’ experiences of mental health during the perinatal period
Authors: Hambidge Sarah , Cowell Amy , Arden-Close Emily , Mayers Andrew
Published: June 2021

Background

To date, information and support has been focused on mothers, with evidence that healthcare professionals overlook fathers’ mental health, and that fathers receive little or no support for themselves during the perinatal period. However, recently, fathers’ mental health has become an area of interest.

Methods

This study explored the support fathers receive for their own mental health during the perinatal period. A qualitative questionnaire was distributed on social media networks and completed by twenty-nine fathers.

Results

Thematic analysis produced three main themes: Factors Influencing Fathers’ Mental Health, Consequences of Poor Mental Health in Fathers and Solutions to Improve Fathers’ Mental Health.

Conclusions

The findings from this study highlighted important implications about fathers’ mental health and the need to support them more effectively. Fathers’ reluctance to seek support and the limited support available need to be addressed. Fathers in this study perceived that perinatal health professionals view ‘mothers as the priority’. It is clear that health professionals need more training on how to recognise that fathers are also important and need support for their mental health.
Identification of an independent immune-genes prognostic index for renal cell carcinoma
Authors: Li Guangyao , Wei Xiyi , Su Shifeng , Wang Shangqian , Wang Wei , Wang Yichun , Meng Xianghu , Xia Jiadong , Song Ninghong , Qin Chao
Published: June 2021

Background

Considerable evidence has indicated an association between the immune microenvironment and clinical outcome in ccRCC. The purpose of this study is to extensively figure out the influence of immune-related genes of tumors on the prognosis of patients with ccRCC.

Methods

Files containing 2498 immune-related genes were obtained from the Immunology Database and Analysis Portal (ImmPort), and the transcriptome data and clinical information relevant to patients with ccRCC were identified and downloaded from the TCGA data-base. Univariate and multivariate Cox regression analyses were used to screen out prognostic immune genes. The immune risk score model was established in light of the regression coefficient between survival and hub immune-related genes. We eventually set up a nomogram for the prediction of the overall survival for ccRCC. Kaplan-Meier (K-M) and ROC curve was used in evaluating the value of the predictive risk model. A P value of < 0.05 indicated statistically significant differences throughout data analysis.

Results

Via differential analysis, we found that 556 immune-related genes were expressed differentially between tumor and normal tissues (p < 0. 05). The analysis of univariate Cox regression exhibited that there was a statistical correlation between 43 immune genes and survival risk in patients with ccRCC (p < 0.05). Through Lasso-Cox regression analysis, we established an immune genetic risk scoring model based on 18 immune-related genes. The high-risk group showed a bad prognosis in K-M analysis. (p < 0.001). ROC curve showed that it was reliable of the immune risk score model to predict survival risk (5 year over survival, AUC = 0.802). The model indicated satisfactory AUC and survival correlation in the validation data set (5 year OS, Area Under Curve = 0.705, p < 0.05). From Multivariate regression analysis, the immune-risk score model plays an isolated role in the prediction of the prognosis of ccRCC. Under multivariate-Cox regression analysis, we set up a nomogram for comprehensive prediction of ccRCC patients’ survival rate. At last, it was identified that 18 immune-related genes and risk scores were not only tremendously related to clinical prognosis but also contained in a variety of carcinogenic pathways.

Conclusion

In general, tumor immune-related genes play essential roles in ccRCC development and progression. Our research established an unequal 18-immune gene risk index to predict the prognosis of ccRCC visually. This index was found to be an independent predictive factor for ccRCC.
A phase II study of the PI3K inhibitor copanlisib in combination with the anti-CD20 monoclonal antibody rituximab for patients with marginal zone lymphoma: treatment rationale and protocol design of the COUP-1 trial
Authors: Grunenberg Alexander , Kaiser Lisa M. , Woelfle Stephanie , Schmelzle Birgit , Viardot Andreas , Möller Peter , Barth Thomas F. E. , Muche Rainer , Dreyhaupt Jens , Raderer Markus , Kiesewetter Barbara , Buske Christian
Published: June 2021

Background

Advanced stage marginal zone lymphoma (MZL) is an incurable indolent B-cell lymphoma, for which a wide variety of treatments ranging from single agent rituximab to more dose intense immunochemotherapy exists. One of the major goals in this palliative setting is to develop chemotherapy-free treatments, which approach the efficacy of immunochemotherapies, but avoid chemotherapy associated toxicity in this often elderly patient population. The PI3K inhibitor copanlisib has recently shown remarkable clinical activity in refractory or relapsed indolent B–cell lymphomas, among them MZL. Based on these data, copanlisib monotherapy was granted breakthrough designation by the FDA for the treatment of adult patients with relapsed marginal zone lymphoma who have received at least two prior therapies. However, data are still limited in particular for MZL. Based on this, the COUP-1 trial aims at testing the toxicity and efficacy of copanlisib in combination with rituximab in treatment naive and relapsed MZL.

Methods

COUP-1 is a prospective, multicenter, single-arm, open-label, non-randomized phase II trial of 6 cycles (28 days cycle) of copanlisib (60 mg intravenous day 1, 8, 15) and rituximab (375 mg/m2 intravenous day 1) in the induction phase followed by a maintenance phase of copanlisib (d1, d15 every 4 weeks for a maximum of 12 cycles) and rituximab (d1 every 8 weeks for a maximum of 12 cycles) in patients aged ≥18 years with previously untreated or relapsed MZL in need of treatment. A total of 56 patients are to be enrolled. Primary endpoint is the complete response (CR) rate determined 12 months after start of induction therapy. Secondary endpoints include the overall response (OR) rate, progression free survival (PFS), overall survival (OS), safety and patient related outcome with quality of life.

The study includes a translational bio-sampling program with the prospect to measure minimal residual disease. The study was initiated in November 2019.

Discussion

The COUP-1 trial evaluates the efficacy and toxicity of the treatment of copanlisib in combination with rituximab in patients with MZL and additionally offers the chance for translational research in this heterogenous type of lymphoma.

Trial registration

ClinicalTrials.gov: NCT03474744. Registration date: 03/23/2018.
Functions and clinical significance of KLRG1 in the development of lung adenocarcinoma and immunotherapy
Authors: Yang Xiaodong , Zheng Yuexin , Han Zhihai , Zhang Xiliang
Published: June 2021

Background

As a marker of differentiation, Killer cell lectin like receptor G1 (KLRG1) plays an inhibitory role in human NK cells and T cells. However, its clinical role remains inexplicit. This work intended to investigate the predictive ability of KLRG1 on the efficacy of immune-checkpoint inhibitor in the treatment of lung adenocarcinoma (LUAD), as well as contribute to the possible molecular mechanisms of KLRG1 on LUAD development.

Methods

Using data from the Gene Expression Omnibus, the Cancer Genome Atlas and the Genotype-Tissue Expression, we compared the expression of KLRG1 and its related genes Bruton tyrosine kinase (BTK), C-C motif chemokine receptor 2 (CCR2), Scm polycomb group protein like 4 (SCML4) in LUAD and normal lung tissues. We also established stable LUAD cell lines with KLRG1 gene knockdown and investigated the effect of KLRG1 knockdown on tumor cell proliferation. We further studied the prognostic value of the four factors in terms of overall survival (OS) in LUAD. Using data from the Gene Expression Omnibus, we further investigated the expression of KLRG1 in the patients with different responses after immunotherapy.

Results

The expression of KLRG1, BTK, CCR2 and SCML4 was significantly downregulated in LUAD tissues compared to normal controls. Knockdown of KLRG1 promoted the proliferation of A549 and H1299 tumor cells. And low expression of these four factors was associated with unfavorable overall survival in patients with LUAD. Furthermore, low expression of KLRG1 also correlated with poor responses to immunotherapy in LUAD patients.

Conclusion

Based on these findings, we inferred that KLRG1 had significant correlation with immunotherapy response. Meanwhile, KLRG1, BTK, CCR2 and SCML4 might serve as valuable prognostic biomarkers in LUAD.
Enrolling a rural community pharmacy as a Vaccines for Children provider to increase HPV vaccination: a feasibility study
Authors: Daniel Casey L. , Lawson Frances , Vickers Macy , Green Chelsea , Wright Anna , Coyne-Beasley Tamera , Lee Hee Y. , Turberville Stacie
Published: June 2021

Background

Human papillomavirus (HPV) is the most common sexually transmitted infection in the U.S. with over 80 million infected individuals. High-risk strains are associated with 6 different cancers. Although infection is preventable, U.S. vaccination rates remain suboptimal and there are noted disparities between urban and rural communities due to economic barriers, lack of access, and low awareness and education.

Methods

The current pilot study sought to overcome these barriers through an interprofessional collaborative enrolling a community pharmacy in a rural, medically underserved Alabama county as a Vaccines for Children (VFC) provider to provide free vaccines to eligible adolescents. Program evaluation was conducted to determine the intervention’s feasibility. Potential efficacy was assessed by analyzing county-level HPV vaccination uptake and completion rates using state immunization registry data.

Results

Over the 8-month study, 166 total vaccines were administered to 89 adolescents ages 10–18, including 55 doses of HPV vaccine, 53 doses of Tdap vaccine, 45 doses of meningococcal vaccine, and 13 doses of influenza vaccine. Among these adolescents, mean age was 12.6 years old, and 64 (71.9%) were VFC patients. The pharmacy recorded an increase in total vaccine administration of 158.8%, an increase in prescription revenue of 34.8%, and an increase in total revenue by 24.4% during the course of the study, compared to the previous year.

Conclusions

Findings from the current work demonstrate the potential of this strategy and can serve as a blueprint for statewide and national dissemination and implementation to ultimately increase access to vaccination services, increase vaccination rates, and reduce urban-rural vaccine disparities.
Reuse of face masks among adults in Hong Kong during the COVID-19 pandemic
Authors: Lee Linda Yin-king , Chan Issac Chun-wing , Wong Owen Pak-man , Ng Yaki Hoi-ying , Ng Crystal Kit-ying , Chan Max Hin-wa , Ng Joe Ka-chun , Koo Hailey Hei-tung , Lam Suk-ting , Chu Ada Cho-wai , Wong Rachel Yuen-shan , Leung Heidi Po-ying , Pun Angel Lok-ching
Published: June 2021

Background

During the COVID-19 pandemic, over 99% of adults in Hong Kong use face masks in public. With the limited supply of face masks in the market and the uncertainty about the future development of COVID-19, reusing face masks is a legitimate way to reduce usage. Although this practice is not recommended, reusing face masks is common in Hong Kong. This study aimed to examine the practice of reusing face masks among adults in Hong Kong during the COVID-19 pandemic and its association with their health beliefs toward this health crisis.

Methods

A cross-sectional descriptive study was conducted. A quota sample of 1000 adults was recruited in Hong Kong in April 2020. Guided by the Health Belief Model, the subjects were invited to answer questions on their practice of reusing face masks and health beliefs toward COVID-19 through telephone interview. Their practice on reuse, storage, and decontamination of used face masks were summarized by descriptive statistics. The difference in health beliefs between the subjects who reused and did not reuse face masks was examined by conducting an independent t test. The association between health beliefs and reuse of face masks was determined by conducting a logistic regression analysis.

Results

One-third (n = 345, 35.4%) of the subjects reused face masks in an average of 2.5 days. Among them, 207 subjects stored and 115 subjects decontaminated their used face masks by using various methods. The subjects who reused face masks significantly perceived having inadequate face masks (t = 3.905;p <  0.001). Having a higher level of perception of having inadequate face masks increased the likelihood of reusing face masks (OR = 0.784; CI 95%: 0.659–0.934;p = 0.006).

Conclusion

Despite having 90 face masks in stock, the adults who reused face masks significantly perceived that they had inadequate face masks. Concerted effort of health care professionals, community organizations, and the government will improve individuals’ practice in use of face masks and alleviate their actual and perceived feeling of having inadequate face masks, which lead them to reuse.