bluuebunny/crossref_metadata_2025 huggingface dataset:
Electroacupuncture attenuates pulmonary vascular remodeling in a rat model of chronic obstructive pulmonary disease via the VEGF/PI3K/Akt pathway
Authors: Zhang Lanxi , Tian Yange , Zhao Peng , Jin Fanli , Miao Yufang , Liu Yang , Li Jiansheng
Published: February 2022

Background:

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. Pulmonary vascular remodeling is the main pathological feature of COPD. Vascular endothelial growth factor (VEGF), the key regulator of angiogenesis, mediates activation of the phosphoinositide 3-kinase (PI3K)/protein kinase B (Akt) pathway, which regulates the proliferation and migration of vascular endothelial cells and plays important roles in pulmonary angiogenesis and remodeling in COPD. Here, the efficacy of electroacupuncture (EA) with respect to regulation of microvascular remodeling induced by VEGF/PI3K/Akt was evaluated in a rat model of COPD.

Methods:

Rats were randomly assigned to blank, COPD model, EA and sham acupuncture (SA) groups. Rats in the EA group received EA at GV14, BL13 and BL23 three times per week, while those in the SA group, as a control, received shallow and minimal electrostimulation at sites 5–10 mm away from the traditional acupuncture point locations. After 2, 4 and 8 weeks of treatment, the optimal treatment duration was determined according to the results of lung function, lung pathology and inflammatory factor levels. Then, microvessel density, protein levels and mRNA expression of selected VEGF/PI3K/Akt pathway intermediates were determined by immunofluorescence, immunohistochemistry and Western blot analysis, and mRNA qRT-PCR, respectively.

Results:

EA improved lung function and lung tissue histopathology, with the best effect after 8 weeks of treatment, as noted by reduced density of lung microvessels and expression of angiogenesis-related factors (VEGF and endothelin (ET)-1). EA-treated COPD rats exhibited reduced VEGF, VEGF receptor 2 (VEGFR2), ET-1 mRNA and VEGF, VEGFR2, phosphorylated (p)-VEGFR2, PI3K, Akt, p-Akt, mammalian target of rapamycin (mTOR), and p-mTOR at the protein level in comparison with untreated and SA-treated COPD model rats.

Conclusion:

EA had beneficial effects on COPD in this animal model including reduced pulmonary vascular remodeling via mechanisms possibly related to the VEGF/PI3K/Akt pathway.
Non-destructive near infrared spectroscopy externally validated using large number sets for creation of robust calibration models enabling prediction of apple firmness
Authors: Marečková Martina , Danková Veronika , Zelený Lubor , Suran Pavol
Published: March 2022

Non-invasive flesh firmness prediction using near infrared spectroscopy has been perfected and validated on three apple varieties. Three novel calibration models were developed following three year's of repeated large-scale sampling of stored commercial apple varieties ‘Gala’, ‘Red Jonaprince’ and ‘Jonagored’. The spectroscopic results were compared directly with those obtained using the invasive method. Increased accuracy of calibration models was achieved with the newly established data collection model. The results exhibited coefficient of determination for calibration, R2, and ratio of prediction to deviation (RPD) in excess of 0.91 and 2.3, respectively, thus enabling excellent prediction of flesh firmness via a non-invasive and fast spectroscopic approach. The highest R2 obtained was 0.94, RPD 2.6, root mean square error of calibration 5.87 N, and root mean square error of cross-validation (internal) 6.75 N for variety ‘Red Jonaprince’. Our complex long-term study provided excellent external validated calibration models and the approach can help developing calibration models for commercial sorting lines using near infrared spectroscopy.
New blends of acrylamide/chitosan and potato peel waste as improved water absorbing polymers for diaper applications
Authors: Moustafa Mahmoud , Abu-Saied M. A. , Taha Tarek H. , Elnouby Mohamed , El Desouky EA , Alamri Saad , Alrumman Sulaiman , Shati Ali , Al-Khatani Mohmed , Alghamdii Huda , Al-Qthanin Rahmah , Al-Emam Ahmed
Published: February 2022

Valorization of environmental wastes into beneficial products is a global direction that is recently adopted. Potato peels are one of these wastes that are daily released to the environment in tremendous amounts. The current research is concerning by the extraction of starch polymer from potato peels waste and depending on its water uptake capacity to be used as a blending material in the currently applied diapers. Starch has been blended in different percentages with poly acrylamide (PAAM) and chitosan (CTS) polymers to increase their overall water capacity. The blended polymers were characterized by Fourier-transform infrared and Raman spectroscopy which confirmed the corresponding interaction among the three polymers depending on the detected functional groups. The thermal gravimetric analysis showed that the addition of starch to PAAM-CTS membrane increased the thermal stability and reduces the weight loss from 53.86% to 7.9%. The results of surface roughness were increased from 0.19 to 0.28 μm after the addition of starch which were highly matched with SEM images and suggesting the increasing of the swelling kinetics of the prepared membranes. Moreover, water uptake test as a physicochemical characterization revealed that the swelling ratio of PAAM-CTS membrane was around 48% which has been elevated to 92% after starch amendment. These results indicate that the addition of starch to polyacrylamide and chitosan blend can approximately duplicate their water-holding capacity which can repurpose it it to be widely applied in diapers applications.
BestAmong the Worst or Worst Among the Best? Socioemotional Wealth and Risk-Performance Returns for Family and Non-family Firms Under Financial Distress
Authors: Gómez-Mejia Luis R. , Chirico Francesco , Martin Geoffrey , Baù Massimo
Published: February 2022

A firm’s proactive engagement in risk, which has been deeply intertwined with the entrepreneurship literature, is essential to sustaining a firm’s long-term competitive advantage. Drawing on BAM’s mixed gamble logic in a family firm context, the present study offers a theoretical framework examining how firm risk returns differ in the contexts of distressed (the worst) and nondistressed (the best) family and nonfamily firms. We predict that family control moderates the risk taking-performance relationship. That is, compared with nonfamily firms, a mixed gamble featuring the prospect of socioemotional and financial losses leads family firms to extract higher financial returns from risk taking when in financial distress, but lower financial returns when they are not in financial distress. Our theoretical expectations are supported using a matched sample of Swedish firms.
Period 2 Suppresses the Malignant Cellular Behaviors of Colorectal Cancer Through the Epithelial-Mesenchymal Transformation Process
Authors: Xiong Yubo , Zhuang Yifan , Zhong Mengya , Qin Wenjuan , Huang Boyi , Zhao Jiabao , Gao Zhi , Ma Jingsong , Wu Zhengxin , Hong Xuehui , Yue Zhicao , Lu Haijie
Published: February 2022

Introduction

The PER2 (Period circadian regulator 2) gene is related to the circadian clock, and it has been deemed as a suppressor gene in osteosarcoma and lung carcinoma. However, the part of PER2 in CRC (colorectal cancer) needs to be further determined.

Methods

First, we collected clinical samples to detect PER2 expression in CRC. Then, we used cell transfection to knock down PER2 expression in CRC cell lines and performed a series of functional experiments to elucidate the effects of PER2 on CRC cells. We next verified whether PER2 affects the epithelial-mesenchymal transformation (EMT) process in CRC by conducting quantitative real-time PCR and western blotting.

Results

In the research, we revealed that the expression of PER2 decreased in CRC clinical samples. In addition, knocking down PER2 expression caused CRC cells to acquire malignant biological features. Finally, we found that PER2 knockdown may activate the Snail/Slug axis through inhibiting p53, therefore promote the activation of the EMT pathway.

Conclusion

In conclusion, low PER2 expression reinforces migration and activates EMT in CRC, suggesting that PER2 is closely related to CRC development and could be used as a potential treatment site in the clinic.
Local Therapy Combined With First-Line EGFR Tyrosine Kinase Inhibitor Achieves Favorable Survival in Patients With EGFR-Mutant Metastatic Non-Small Cell Lung Cancer
Authors: Lu Xiaotong , Wang Jingbo , Wang Chunyu , Liang Jun , Zhou Zongmei , Chen Dongfu , Feng Qinfu , Xiao Zefen , Hui Zhouguang , Lu Jima , Zhang Tao , Liu Wenyang , Wang Jianyang , Wang Xin , Deng Lei , Zhai Yirui , Bi Nan , Wang Luhua
Published: February 2022

Background:

EGFR tyrosine kinase inhibitor (TKI) is recommended as the first-line therapy for patients with EGFR-mutant metastatic non-small cell lung cancer (NSCLC). Yet, resistance often occurs in 1 year after therapy and most progressions occur at the initial sites of disease. Addition of local therapy to the first-line TKI therapy may delay the progression and provide survival benefit to the patients.

Methods:

From 2010 to 2017, metastatic NSCLC patients with EGFR activating mutations who received first-line TKI and relatively radical local therapy (RRLT) were reviewed. RRLT was defined as local curative therapy to the main site or any intensity of local therapy to all sites of disease. The Kaplan-Meier method and log-rank test were used for survival estimation and comparison.

Results:

A total of 45 patients were included in this retrospective study with a median follow-up of 48.0 months. The median progression-free survival (PFS) and overall survival (OS) was 17.0 months (95% confidence interval [CI]: 14.6-19.3) and 55.0 months (95% CI: 49.3-60.6), respectively. Univariate analysis indicated that age ⩽ 60 years ( P = .019), first-line TKI duration ⩾ 10 months ( P = .028), and accumulated TKI duration ⩾ 20 months ( P = .016) were significantly associated with favorable OS. Among the 36 patients who progressed during the follow-up, 55.8% of the progressions occurred at the new sites. RRLT combined with TKI did not show any severe toxicity to the patients.

Conclusions:

Combined application of RRLT and first-line TKI may improve the survival and alter the pattern of failure for metastatic NSCLC patients with EGFR activating mutations.
There’s nothing as practical as understanding the nature of theory: A phenomenographic study of management educators’ implicit theories of theory
Authors: Eichler Michael , Billsberry Jon
Published: February 2022

Although teaching in Business Schools takes a theory-driven perspective, there are multiple different interpretations of what this means. We make a contribution by examining how management educators define ‘theory’ and explore how differing definitions lead to variations in the way that teaching is conceptualised and designed. We adopt phenomenographic methods to reveal a five-level hierarchy of theory definitions ranging from simple descriptive notions of ‘theory as an idea’ to more explanatory definitions with causal and practice implications. This hierarchy shapes the way management educators design their teaching with those with the most sophisticated understanding of theory being the most practically focused in their teaching. Although all the interviewees view theory as having an interventional purpose to shape or change managerial action, management educators are haphazard in the ways they teach students to apply theory. We conclude by discussing the implications of these findings for the essential–non-essentialist debate in management education and suggest avenues for future research.
Using multi-layer nested network to optimise spatial structure of tourism development between urban and rural areas based on population mobility
Authors: Liu Zhao , Wang Fang , Xue Pengcheng , Xue Feng
Published: March 2022

Under the bidirectional flow pattern of urban and rural factors, the tourism industry has become an important way to promote the vitality of urban and rural areas because of rural gentrification and city migration. By constructing a ‘node-link-setting’ networked land use model, this paper maps the tourism flow and geographic space networks, proposes a multi-layer nested network theory with spatial relevance from the mobility perspective to solve practical problems, such as urban–rural dual opposition and functional segmentation. We studied the high-precision mobile smart phone signalling data combined geographical data of Yichang, analysed the dynamic change process and comprehensive development mode characteristics of tourism attractions in 92 villages and towns through the social network analysis, compared tourism flow network changes in Yichang over time to construct a tourism flow network of Yichang, analysed the level and location of tourism nodes in the network and classified the tourist destinations to reveal the spatial-temporal evolution process and change the rule of the tourism flow network. The differences were compared by constructing traffic geography and infrastructure networks. The purpose is to propose guidance countermeasures for regional village unit tourism facility construction and industrial development and to maintain the integrity of spatial correlation and structural optimisation.
Artfulness in the Organisational Playground: Actions and choices-Editorial
Authors: Warwick Rob , Traeger James , Khandekar Sujata , Riestra Maria
Published: February 2022

Let us start at the beginning of this Special Issue on Artfulness with the Call for Papers. As a reminder, we invited contributors to write from their experience and to experiment with bringing their entire selves to their organisational and community work. In the Call for Papers we highlighted that this means ‘not only the rational and logical parts of who we are, but also our creative, intuitive, relational and artistic abilities in their many forms’. We stressed that art can be both an artefact, for example, a painting, piece of music or even a project. Or it can be the creative processes we use, for example, the artfulness of how we work with others in an organisation or in creating art. We see lively tensions between the two. When the submissions came through, we were heartened by how authors/contributors had responded to the invitation in artful, creative and imaginative ways.
Robotic Off-Pump Totally Endoscopic Coronary Artery Bypass in Patients With Low Ejection Fraction
Authors: Peev Miroslav P. , Nisivaco Sarah , Torregrossa Gianluca , Arastu Aliasghar , Shahul Sajid , Balkhy Husam H.
Published: February 2022

Objective: Robotic totally endoscopic coronary bypass (R-TECAB) has been shown to be a safe and effective technique with excellent outcomes. The aim of this study is to assess the feasibility of R-TECAB in patients with low left ventricular ejection fraction (LVEF) and to report our midterm outcomes with up to 7-year follow-up. Methods: All patients undergoing R-TECAB at our institution between July 2013 and July 2020 were retrospectively reviewed. A total of 100 patients were identified with low LVEF defined as ≤40%. The preoperative characteristics, perioperative and postoperative outcomes, as well as the midterm results were reviewed. Results: The mean LVEF was 31%, and 62% of all patients had preexisting congestive heart failure. Of the cohort, 59% had 3-vessel disease and 6% underwent previous cardiac surgery. Multivessel TECAB was performed in 54%. Hybrid coronary revascularization occurred in 36 individuals. Two patients required cardiopulmonary bypass, and 35% were extubated in the operating room. No sternotomy conversions were required. One patient underwent reoperation for bleeding. No perioperative stroke, myocardial infarction, or mortality occurred. The left internal mammary artery graft patency was 97% at a mean of 1.6 months in the staged hybrid percutaneous coronary intervention group. At midterm follow-up the cardiac-related mortality was 5%. Heart transplant or left ventricular assist device was required in 4 patients, and 1 patient experienced a myocardial infarction. Freedom from major adverse cardiac events was 89%. Conclusions: Off-pump TECAB can be successfully performed in patients with low LVEF in the setting of an experienced and dedicated robotic cardiac surgery team. Our data demonstrate the feasibility of the technique with excellent perioperative and midterm outcomes.
Risk of Pneumothorax Requiring Pleural Drainage after Drainless VATS Pulmonary Wedge Resection: A Systematic Review and Meta-Analysis
Authors: Laven Iris E.W.G. , Daemen Jean H.T. , Janssen Nicky , Franssen Aimée J.P.M. , Gronenschild Michiel H.M. , Hulsewé Karel W.E. , Vissers Yvonne L.J. , de Loos Erik R.
Published: February 2022

Objective

Omitting pleural drainage after video-assisted thoracic surgery (VATS) for pulmonary wedge resections has been shown to be a safe approach to enhance recovery. However, major concerns remain regarding the risk of postoperative pneumothoraces requiring surgical interventions. Therefore, our objective was to provide conclusive evidence whether chest tube omission after VATS wedge resection is safe and does not increase the risk of pneumothoraces requiring pleural drainage.

Methods

Five scientific databases were searched. Studies comparing patients with (CT group) and without chest tube drainage (NCT group) after VATS wedge resection were evaluated. Outcomes included radiographically diagnosed pneumothoraces and pneumothoraces requiring pleural drainage, postoperative complications, hospitalization, and pain scores.

Results

Overall, 9 studies (3 randomized controlled trials) were included ( N = 928). Meta-analysis showed significantly more radiographically diagnosed pneumothoraces in the NCT group (risk ratio [RR] = 2.58, 95% confidence interval [CI]: 1.56 to 4.29, P < 0.001; I 2 = 0%). However, no significant differences were found in postoperative pneumothoraces requiring pleural drainage (RR = 1.72, 95% CI: 0.63 to 4.74, P = 0.29; I 2 = 0%) or complications (RR = 0.77, 95% CI: 0.39 to 1.52, P = 0.46; I 2 = 0%). Furthermore, the NCT group showed significantly shorter hospitalization (mean difference = −1.26, 95% CI: −1.56 to −0.95, P < 0.001) with high heterogeneity ( I 2 = 58%, P = 0.02), and lower pain scores on postoperative day 1 (standard mean difference [SMD] = −0.98, 95% CI: −1.71 to −0.25, P = 0.009; I 2 = 92%) and postoperative day 2 (SMD = −1.28, 95% CI: −2.55 to −0.01, P = 0.05; I 2 = 96%) compared with the CT group.

Conclusions

VATS wedge resection without routine chest tube placement is suggested as a safe and less invasive approach in selected patients that does not increase the risk of a pneumothorax requiring pleural drainage.
Arthroplasty of the Proximal Interphalangeal Joint With the TACTYS Prosthesis: Clinical and Radiographic Results With a Mean Follow-up of 5 Years
Authors: Philips Tim , Vanmierlo Bert , Goubau Jean F.
Published: February 2022

Background:

Degenerative arthritis of the proximal interphalangeal (PIP) joint of the long fingers is a common disorder affecting mainly a female middle-aged population. Conservative treatment is often effective, but in some cases, pain can persist which can lead to invalidating function. Besides denervation and arthrodesis, arthroplasty is a valuable alternative treatment. The goal of this retrospective study was to determine the clinical and radiological outcomes of the TACTYS prosthesis with a mean follow-up of more than 5 years.

Methods:

Between October 2005 and August 2019 10 joints in 9 patients, one patient had two prostheses in two separate fingers (4 males and 6 women) were treated for painful degenerative arthritis of the long fingers with a TACTYS prosthesis (Stryker Inc, Kalamazoo, Michigan). Power grip and pinch force were tested preoperatively and postoperatively, and the functional outcome survey is performed using the Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), recall QuickDASH, and Patient-Rated Wrist Evaluation standardized questionnaires scored of 100 and the Visual Analog Scale (VAS) from 0 to 10.

Results:

Mean follow-up was 65.70 months (range: 23-106). Mean age was 71.5 years (range: 64-83). QuickDASH score evolved from 68.43 to 41.92, range of motion from 37.5° to 45.1°, VAS from 6.65 to 1/10. Power grip and precision pinch evolved from 16.44 to 20.80 kg and 1.97 to 2.85 kg, respectively.

Conclusions:

TACTYS arthroplasty can be proposed for people who have been treated long enough with unsuccessful conservative treatment. Infection rate is still the highest complication, which can evolve in invalidating arthrodesis. It should be proposed exceptionally if the PIP joint arthritis causes invalidating functional pain.
Recurrent deep venous thrombosis of lower extremities as a result of compression of large horseshoe kidney cysts in double inferior vena cava - Successfully treatment with sclerotherapy
Authors: Mutavdzic Perica , Dragas Marko , Galun Danijel , Mašulović Dragan , Tomić Ivan , Sladojević Miloš , Zlatanović Petar , Davidovic Lazar
Published: February 2022

Background

Horseshoe kidney is a well-known congenital anomaly and the most common anomaly of the upper urinary tract. This condition is rarely associated with anomalous inferior vena cava (IVC). Polycystic horseshoe kidney is a very rare occurrence and however IVC anomalies common with polycistic disease are an increasingly recognized risk factor for iliofemoral deep venous thrombosis.

Method

We present a case of 75-year-old patient with recurrent deep vein thrombosis (DVT) of right leg as a result of compression of large horseshoe kidney cysts in double inferior vena cava.

Results

Large renal cyst were successful treated percutaneously punctured for the relief of compression and received injection of acidic solutions of 95% ethanol under ultrasound guidance for prevention against re-accumulation of cyst fluid.

Conclusion

Percutaneous aspiration with ultrasound guidance with injection of sclerosing solutions as a relatively simple procedure and can be the method of choice for treatment of renal cysts. Also, any recurrent deep vein thrombosis on lower extremity requires additional evaluation in the form of an ultrasound or multidetector computed tomography examination of the abdomen.
Neural correlates of cognitive control in women with a history of sexual violence suggest altered prefrontal cortical activity during cognitive processing
Authors: Sinko Laura , Regier Paul , Curtin Adrian , Ayaz Hasan , Rose Childress Anna , Teitelman Anne M
Published: February 2022

Objective:

Women’s experiences of sexual violence can be not only psychologically and physically traumatizing but may also have lasting effects on brain functions, including cognitive control relating to the inhibition and processing of emotion. Thus, the purpose of this pilot study is to explore underlying neural correlates of sexual violence’s impact on cognitive control in women.

Methods:

Thirty women (aged 21–30 years) participants underwent a quantitative survey along with an affect-congruent Go-NoGo task. Prefrontal activity was monitored using functional near-infrared spectroscopy, a portable neuroimaging technology. An analysis of variance tested for main effects of the condition (Go versus NoGo), group (sexual violence versus no prior sexual violence), and potential interactions.

Results:

Fifteen of 30 women reported a history of childhood (n = 5) and/or adult (n = 12) sexual violence. Those with sexual violence histories reported significantly higher depression, anxiety, and posttraumatic stress symptoms, as well as increased impulsivity compared to their peers. Behavioral performance did not differ between the groups; however, functional near-infrared spectroscopy data revealed a significant (group × condition) interaction in Optodes 13 and 16. Women with histories of sexual violence had a significantly lower response during the “NoGo” condition and a heightened response during the “Go” condition, in the right dorsolateral prefrontal cortex.

Conclusion:

These results suggest altered prefrontal cortical activity during cognitive processing in women with a history of sexual violence, showing hypoactivity during response inhibition and hyperactivity to the positive stimuli. These findings have strong translational promise for innovative assessment and prevention of untoward effects among women with sexual violence.
A population-based study in resected esophageal or gastroesophageal junction cancer aligned with CheckMate 577
Authors: Pape Marieke , Vissers Pauline A.J. , Beerepoot Laurens V. , van Berge Henegouwen Mark I. , Lagarde Sjoerd M. , Mook Stella , Moehler Markus , van Laarhoven Hanneke W.M. , Verhoeven Rob H.A.
Published: February 2022

Background:

Results of CheckMate 577 show an improved disease-free survival for patients with resected esophageal or gastroesophageal junction cancer treated with adjuvant nivolumab compared with placebo (22.4 versus 11.0 months). Population-based data can provide insights in outcomes from clinical practice. The aim of our study was to investigate disease-free and overall survival in a nationwide population aligned with the inclusion criteria of CheckMate 577.

Patients and Methods:

Resected patients with stage II/III esophageal or gastroesophageal junction cancer (2015–2016) treated with neoadjuvant chemoradiotherapy were selected from the Netherlands Cancer Registry. Patients with cervical esophageal cancer, irradical resection, or complete pathological response were excluded. Disease-free and overall survival were assessed from 12 weeks after resection using Kaplan-Meier methods. In addition, to adjust for differences in characteristics between CheckMate 577 and our population-based cohort, a matching-adjusted indirect comparison was performed for pathological lymph node status and pathological tumor status.

Results:

We identified 634 patients. Sixty percent of patients were diagnosed with recurrence or were deceased at the end of follow-up. Median disease-free survival was 19.7 months and median overall survival was 32.2 months. After the matching procedure, the median disease-free survival was 17.2 months and median overall survival was 28.2 months.

Conclusions:

Disease-free survival in our population-based study was considerably longer than the placebo population of CheckMate-577 (19.7 versus 11.0 months). Possible explanations are differences in characteristics, quality of esophageal cancer care, or differential strategies for evaluation of recurrence. In the Netherlands postoperative imaging is not part of the standard follow-up as opposed to the standard postoperative imaging in the CheckMate 577 trial. The difference in postoperative imaging could partially explain the longer disease-free survival observed in our study. Quality and optimization of current treatment modalities remain important aspects of esophageal cancer care.
Application of the Meet-URO score to metastatic renal cell carcinoma patients treated with second- and third-line cabozantinib
Authors: Rebuzzi Sara Elena , Cerbone Luigi , Signori Alessio , Santoni Matteo , Murianni Veronica , De Giorgi Ugo , Procopio Giuseppe , Porta Camillo , Milella Michele , Basso Umberto , Massari Francesco , Maruzzo Marco , Iacovelli Roberto , Battelli Nicola , Carmisciano Luca , Banna Giuseppe Luigi , Buti Sebastiano , Fornarini Giuseppe
Published: February 2022

Background:

The addition of neutrophil-to-lymphocyte ratio (NLR) and bone metastases to the International Metastatic RCC Database Consortium (IMDC) score (by the Meet-URO score) has been shown to better stratify pretreated metastatic renal cell carcinoma (mRCC) patients receiving nivolumab. This study aimed to validate the Meet-URO score in patients receiving cabozantinib to assess its predictivity and prognostic role.

Methods:

A multicenter retrospective analysis evaluated mRCC patients receiving ⩾second-line cabozantinib. NLR, IMDC score and bone metastases were assessed before the start of cabozantinib. The primary endpoint was overall survival (OS). Harrell’s c-index was calculated to compare the accuracy of the prediction of the two scores.

Results:

Overall, 174 mRCC patients received cabozantinib as second and third line (51.7% and 48.3%, respectively) with a median follow-up of 6.8 months. A shorter median overall survival (mOS) was observed for the IMDC poor-risk group, NLR ⩾3.2 and the presence of bone metastases, while the IMDC intermediate-risk group had a similar mOS to the favourable-risk one. Applying the Meet-URO score, three risk groups were identified: group 1 (55.2% of patients) with a score of 0–3, group 2 (38.5%) with a score of 4–8 and group 3 (6.3%) with a score of 9. Compared to group 1 (mOS: 39.4 months), a statistically significant worse mOS was observed in group 2 (11.2 months) and group 3 (3.2 months) patients, respectively. The Meet-URO c-index score was 0.640, showing a higher discriminative ability than the IMDC score ( c-index: 0.568).

Conclusion:

This analysis showed that the Meet-URO score provides a more accurate prognostic stratification than the IMDC score in mRCC patients treated with ⩾second-line cabozantinib besides nivolumab. Moreover, it is an easy-to-use tool with no additional costs for clinical practice (web-calculator is available at: https://proviso.shinyapps.io/Meet-URO15_score/ ). Future investigations will include the application of the Meet-URO score to the first-line immunotherapy-based combination therapies.
Atezolizumab and bevacizumab in patients with advanced hepatocellular carcinoma with impaired liver function and prior systemic therapy: a real-world experience
Authors: de Castro Tiago , Jochheim Leonie S. , Bathon Melanie , Welland Sabrina , Scheiner Bernhard , Shmanko Kateryna , Roessler Daniel , Ben Khaled Najib , Jeschke Matthias , Ludwig Johannes M. , Marquardt Jens U. , Weinmann Arndt , Pinter Matthias , Lange Christian M. , Vogel Arndt , Saborowski Anna
Published: February 2022

Objective:

Evaluation of the efficacy and safety of atezolizumab/bevacizumab in a real-world HCC cohort, including patients with impaired liver function and prior systemic therapy.

Methods:

Retrospective analysis of 147 HCC patients treated with atezolizumab/bevacizumab at six sites in Germany and Austria.

Results:

The overall response rate and disease control rate were 20.4% and 51.7%, respectively. Seventy-three patients (49.7%) met at least one major exclusion criterion of the IMbrave150 trial (IMbrave-OUT), whereas 74 patients (50.3%) were eligible (IMbrave-IN). Median overall survival (mOS) as well as median progression-free survival (mPFS) was significantly longer in IMbrave-IN versus IMbrave-OUT patients [mOS: 15.0 months (95% confidence interval (CI): 10.7–19.3] versus 6.0 months (95% CI: 3.2–8.9; p < 0.001) and mPFS: 8.7 months (95% CI: 5.9–11.5) versus 3.7 months (95% CI: 2.7–4.7; p < 0.001)]. Prior systemic treatment did not significantly affect mOS [hazard ratio (HR): 1.32 (95% CI: 0.78–2.23; p = 0.305)]. mOS according to ALBI grades 1/2/3 were 15.0 months (95% CI: not estimable), 8.6 months (95% CI: 5.4–11.7), and 3.2 months (95% CI: 0.3–6.1), respectively. ALBI grade and ECOG score were identified as independent prognostic factors [ALBI grade 2 versus 1; HR: 2.40 (95% CI: 1.34 – 4.30; p = 0.003), ALBI grade 3 versus 1; HR: 7.28 (95% CI: 3.30–16.08; p < 0.001), and ECOG ⩾2 versus 0; HR: 2.09 (95% CI: 1.03 – 4.23; p = 0.042)], respectively. Sixty-seven patients (45.6%) experienced an adverse event classified as CTCAE grade ⩾3. Patients in the IMbrave-OUT group were at increased risk of hepatic decompensation with encephalopathy (13.7% versus 1.4%, p = 0.004) and/or ascites (39.7% versus 9.5%; p < 0.001).

Conclusion:

In this real-world cohort, efficacy was comparable to the results of the IMbrave150 study and not affected by prior systemic treatment. ALBI grade and ECOG score were independently associated with survival. IMbrave-OUT patients were more likely to experience hepatic decompensation.
Laboratory Testing in the School Setting: Are You CLIA Compliant?
Authors: Moran Vicki , Bultas Margaret
Published: February 2022

Nurses are qualified to design, manage, supervise, and deliver health care in a public health setting such as the school. Considering this, school nurses should understand regulations necessary to aid in the care of children, especially related to point-of-care laboratory testing for the assessment and treatment of health conditions. The pandemic and resulting mitigation strategy of COVID-19 testing adopted by some schools, has raised questions about the need for school nurses to comply with the Clinical Laboratory Improvement Amendments (CLIA). CLIA was established to improve the quality of laboratory test results and school nurses who perform blood glucose monitoring and urine dipstick testing fall under the CLIA waiver category. Therefore, school nurses should be knowledgeable about CLIA certification. By developing policies and procedures for testing, completing the CLIA certificate of waiver, and following best laboratory practices, school nurses will be delivering high-quality nursing care in their health room.
Mantle cell lymphoma management trends and novel agents: where are we going?
Authors: Pu Jeffrey J. , Savani Malvi , Huang Nick , Epner Elliot M.
Published: February 2022

The heterogeneity in disease pathology, the unpredictability in disease prognosis, and the variability in response to therapy make mantle cell lymphoma (MCL) a focus of novel therapeutic development. MCL is characterized by dysregulated expression of cyclin D1 through a chromosome t(11;14) translocation. MCL international prognostic index (MIPI), ki-67 proliferation index, and TP53 mutation status are currently utilized for prognostication. With advances in pharmacokinetic analysis and drug discovery, treatment strategy has evolved from chemotherapy to combination of targeted, epigenetic, and immune therapies. In this review, we discuss investigational and newly approved treatment approaches. In a short time, the US Food and Drug Administration (FDA) has approved five agents for the treatment of MCL: lenalidomide, an immunomodulatory agent; bortezomib, a proteasome inhibitor; and ibrutinib, acalabrutinib, and zanubrutinib, all Bruton kinase inhibitors. Epigenetic agents (e.g. cladribine and vorinostat), mammalian target of rapamycin (mTOR) inhibitors (e.g. temsirolimus and everolimus), and monoclonal antibodies and/or antibody-drug conjugates (e.g. obinutuzumab, polatuzumab, and ublituximab) are promising therapeutic agents currently under clinical trial investigation. Most recently, chimeric antigen receptor (CAR)-T cell therapy and bispecific T-cell engager (BiTE) therapy even open a new venue for MCL treatment. However, due to its intricate pathology nature and high relapse incidence, there are still unmet needs in developing optimal therapeutic strategies for both frontline and relapsed/refractory settings. The ultimate goal is to develop innovative personalized combination therapy approaches for the purpose of delivering precision medicine to cure this disease.
Reactivation of varicella-zoster virus following mRNA COVID-19 vaccination in a patient with moderately differentiated adenocarcinoma of rectum: A case report
Authors: Munasinghe BM , Fernando UPM , Mathurageethan M , Sritharan Durga
Published: February 2022

Herpes zoster which is the reactivation of varicella-zoster virus, a pathogenic human alpha-herpes virus, following primary infection or chicken pox, is known to occur especially in advanced age and in the immunocompromised among other predisposing factors. COVID-19 vaccination-induced immunomodulation is a novel scenario, hypothesized to be a result of shifting of T-lymphocyte population towards vaccine-induced naïve CD8+ subset, offsetting the balance of varicella-zoster virus responsive T-helper cells, thereby defecting the cell-mediated immunity which suppresses the latent varicella-zoster virus. The exact mechanism, however, is still elusive. Herein, we discuss a case of reactivation of varicella-zoster virus following BNT162b2 mRNA COVID-19 vaccine in an elderly female on oral medication for long-term diabetes and hypertension with good control who has undergone local radiotherapy for an underlying adenocarcinoma of rectum awaiting surgical resection, highlighting the key features of pathogenesis of the disease in relation to COVID-19 vaccination with a pertinent survey of the literature. This case report highlights the importance of differentiating vaccine-related cutaneous reactions with clinically more significant adverse events, early specific therapy thus preventing poorer acute and chronic outcomes.
Prevention of Surgical Site Infections in Spine Surgery: An International Survey of Clinical Practices Among Expert Spine Surgeons
Authors: Tkatschenko Dimitri , Hansen Sonja , Koch Julia , Ames Christopher , Fehlings Michael G. , Berven Sigurd , Sekhon Lali , Shaffrey Christopher , Smith Justin S. , Hart Robert , Kim Han Jo , Wang Jeffrey , Ha Yoon , Kwan Kenny , Hai Yong , Valacco Marcelo , Falavigna Asdrubal , Taboada Néstor , Guiroy Alfredo , Emmerich Juan , Meyer Bernhard , Kandziora Frank , Thomé Claudius , Loibl Markus , Peul Wilco , Gasbarrini Alessandro , Obeid Ibrahim , Gehrchen Martin , Trampuz Andrej , Vajkoczy Peter , Onken Julia
Published: February 2022

Study Design

Questionnaire-based survey.

Objectives

Surgical site infection (SSI) is a common complication in spine surgery but universal guidelines for SSI prevention are lacking. The objectives of this study are to depict a global status quo on implemented prevention strategies in spine surgery, common themes of practice and determine key areas for future research.

Methods

An 80-item survey was distributed among spine surgeons worldwide via email. The questionnaire was designed and approved by an International Consensus Group on spine SSI. Consensus was defined as more than 60% of participants agreeing to a specific prevention strategy.

Results

Four hundred seventy-two surgeons participated in the survey. Screening for Staphylococcus aureus (SA) is not common, whereas preoperative decolonization is performed in almost half of all hospitals. Body mass index (BMI) was not important for surgery planning. In contrast, elevated HbA1c level and hypoalbuminemia were often considered as reasons to postpone surgery. Cefazoline is the common drug for antimicrobial prophylaxis. Alcohol-based chlorhexidine is mainly used for skin disinfection. Double-gloving, wound irrigation, and tissue-conserving surgical techniques are routine in the operating room (OR). Local antibiotic administration is not common. Wound closure techniques and postoperative wound dressing routines vary greatly between the participating institutions.

Conclusions

With this study we provide an international overview on the heterogeneity of SSI prevention strategies in spine surgery. We demonstrated a large heterogeneity for pre-, peri- and postoperative measures to prevent SSI. Our data illustrated the need for developing universal guidelines and for testing areas of controversy in prospective clinical trials.
Bringing in Theory Building and Social-Political Context to Understand and Reduce Inequality: A Commentary
Authors: van de Werfhorst Herman G.
Published: February 2022

The ambition to move from understanding inequality to (also) reducing inequality is laudable and important for the field of sociology. Discussing the contributions to this special collection, the author encourages current developments in our field to identify causal effects of interventions. However, the author has two concerns with this development, partly shared with the contributions to this collection. First, to bridge the split between the certainty a policy maker wants and the uncertainty that is fundamental to scientific knowledge, we should be focused more on theory building and hypotheses testing, using various methods to study similar research problems, collaborating with organizations in the fields that we study. Second, we could be more concerned with the social and political context within which reforms may or may not be implemented. Policy makers and researchers can be more specific about the values underlying proposed interventions or in society at large.
A case of atezolizumab-associated tubulointerstitial nephritis
Authors: Zakharova Elena V , Makarova Tatyana A , Vorobyeva Olga A
Published: February 2022

Patients with bladder cancer commonly present with post-renal acute kidney injury (AKI). Here we describe a rare case of AKI, developed within 15 months of the anti-programmed death-ligand 1 antibody therapy in a patient with bladder cancer and normally functioning suprapubic urinary catheter.
The Biopolitics of Caste: Analysing the (Dis)honour Killings in South India
Authors: Ashok Gurram , Rupavath Ramdas
Published: February 2022

Even after 75 years of independence, India witnesses the increasing violence unleashed by the upper caste families against the individuals for inter-caste love or marriage. The objective of this article is to critically engage with the operational aspects of Michel Foucault’s biopolitics of caste system in enforcing endogamy in the marital relationship between two individuals. Caste as a social institution governs every aspect of Dalit’s life, ranging from cradle to graveyard. As such, the increasing incidents of (dis)honour killings, from South India, reflect the idea of endogamy, with the ulterior motto of controlling the sexuality of the Dalits and women, thereby ensuring the purity of the caste Hindu society. Thus, the patriarchy is an inseparable element of caste system in controlling the freedom of women in choosing her partner and it is prevalent in sub-castes of Dalit folds also. The question of discrimination and practice of endogamy within Dalit communities should be addressed in marching towards annihilation of the caste.
Organizational Routines as a Source of Ethical Blindness
Authors: Kump Barbara , Scholz Markus
Published: February 2022

Organizational research has shown that decision-makers can be subject to ethical blindness, a temporary inability to see the ethical dimension of a situation at hand. Previous theoretical approaches have identified organizational routines—recurring multi-actor practices—as important indirect context factors of ethical blindness. The present article argues that earlier theorizing is incomplete. Organizational routines may be a much more direct cause of ethical blindness and they may play a much stronger role in fostering unintentional unethical behavior than is currently acknowledged. As its main contribution, the article synthesizes research on unethical organizational behavior with findings on the micro-foundations of organizational routines to systematically theorize about when and how routines can directly cause ethical blindness. Given that organizational routines are not only a main pillar of organizational research but an indispensable part of organizational life, an increased understanding of their role in creating ethical blindness is of high theoretical and practical relevance. In particular, a routine-based explanation of ethical blindness may help in identifying and counteracting “everyday” unethical practices that are prevalent in modern business organizations.
Identification of drought responsive Elaeis guineensis WRKY transcription factors with sensitivity to other abiotic stresses and hormone treatments
Authors: Lee Fong Chin , Yeap Wan Chin , Appleton David Ross , Ho Chai-Ling , Kulaveerasingam Harikrishna
Published: February 2022

Background

The ability of plants to withstand and thrive in an adverse environment is crucial to ensure their survivability and yield performance. The WRKY transcription factors (TFs) have crucial roles in plant growth, development and stress response, particularly drought stress. In oil palm, drought is recognized as one of the major yield limiting factors. However, the roles of WRKY TFs in the drought response of oil palm is unclear.

Results

Herein, we studied the transcriptome of drought treated oil palm leaf and identified 40 differentially expressed genes (DEGs) of WRKY TFs, of which 32 DEGs were upregulated and 8 DEGs were downregulated in response to drought stress in oil palm. They were categorized into Groups I to IV based on the numbers of WRKY domain and the structural difference in the zinc finger domain. Multiple stress- and hormone-responsive cis-regulatory elements were detected in the drought responsive oil palm EgWRKY (Dro-EgWRKY) genes. Fourteen of the 15 selected oil palm WRKY (EgWRKY) genes demonstrated a tissue-specific expression profile except for EgWRKY28 (Group I), which was expressed in all tissues tested. The expression levels of 15 candidate EgWRKYs were upregulated upon salinity and heat treatments, while several genes were also inducible by abscisic acid, methyl jasmonate, salicylic acid and hydrogen peroxide treatments. Members of the Group III WRKY TFs including EgWRKY07, 26, 40, 52, 59, 73 and 81 displayed multiple roles in drought- and salinity-response under the modulation of phytohormones.

Conclusions

EgWRKY TFs of oil palm are involved in phytohormones and abiotic stress responses including drought, salinity and heat. EgWRKY07, 26, 59 and 81 from Group III maybe important regulators in modulating responses of different abiotic stresses. Further functional analysis is required to understand the underlying mechanism of WRKY TFs in the regulatory network of drought stress.
Dynamic mRNA and miRNA expression of the head during early development in bighead carp (Hypophthalmichthys nobilis)
Authors: Luo Weiwei , Wang Junru , Zhou Ying , Pang Meixia , Yu Xiaomu , Tong Jingou
Published: March 2022

Background

Head of fish species, an exquisitely complex anatomical system, is important not only for studying fish evolution and development, but also for economic values. Currently, although some studies have been made on fish growth and body shapes, very limited information is available on the molecular mechanism of head development.

Results

In this study, RNA sequencing (RNA–Seq) and small RNA sequencing (sRNA–Seq) technologies were used to conduct integrated analysis for the head of bighead carp at different development stages, including 1, 3, 5, 15 and 30 Dph (days post hatch). By RNA-Seq data, 26 pathways related to growth and bone formation were identified as the main physiological processes during early development. Coupling this to sRNA–Seq data, we picked out six key pathways that may be responsible for head development, namely ECM receptor interaction, TNF signaling pathway, osteoclast differentiation, PI3K–Akt signaling pathway, Neuroactive ligand–receptor interaction and Jak–STAT signaling pathway. Totally, 114 important candidate genes from the six pathways were obtained. Then we found the top 20 key genes according to the degree value by cytohubba, which regulated cell growth, skeletal formation and blood homeostasis, such aspik3ca,pik3r1,egfr,vegfa,igf1anditga2b. Finally, we also acquired 19 key miRNAs playing multiple roles in the perfection of various tissues in the head (such as brain, eye and mouth) and mineralization of head bone system, such as let–7e, miR–142a–5p, miR–144–3p, miR–23a–3p and miR–223.

Conclusions

Results of this study will be informative for genetic mechanisms of head development and also provide potential candidate targets for the interaction regulation during early growth in bighead carp.