bluuebunny/crossref_metadata_2025 huggingface dataset:
An Oncoplastic Approach to Primary Pediatric Pterygomaxillary Osteosarcoma
Authors: Ramirez Ashley L. , Townsend Alexandra N. , Weber Lee , Piccinini Pedro S. , Wolfe Erin M. , Taylor Marek W. , Haglund Thomas A. , Shraiteh Muhanad A. , Hannan Robert , Fader Maggie E. , Ragheb John , Wolfe S. Anthony , Steinberg Jordan P.
Published: March 2023

Osteosarcomas arising within the pterygomaxillary/infratemporal fossa region are rare among the pediatric population. Survival rates are most influenced by tumor resection with negative margins, which can be dependent on surgical accessibility of the tumor site. The pterygomaxillary/infratemporal fossa location poses several challenges to safe and adequate tumor resection, including proximity of the facial nerve and great vessels and scarring associated with traditional transfacial approaches. In this article, we present the case of a 6-year-old boy with an osteosarcoma of the left pterygomaxillary/infratemporal fossa region successfully managed with an “oncoplastic” approach, incorporating the use of CAD/CAM and mixed reality technologies.
Logic Plasticity and Bounded Custodial Work in Inter-Institutional Projects
Authors: Fortin Israël
Published: March 2023

I studied competing institutional logics in inter-institutional projects in aerospace to understand which logic would prevail when several logics compete in temporary organizing. While competing logic tensions between academia and the industry were expected, I additionally found competing logic tensions between multinationals and suppliers. I argue that the competing logic tensions originated from the informal roles that emerged from the interactions among the partners in the projects, which were predetermined by the complementary knowledge that initially justified the collaborations. These informal roles activated custodial work among the partners, which was bounded by logic plasticity. Contrary to what was expected, the more rigid logics prevailed over the most plastic logics in temporary organizing.
Making the Just: Critical Inquiry for Different Publics
Authors: Kuntz Aaron M.
Published: March 2023

I argue that inquiry, ethics, and justice extend a critical and dynamic relation, the force of which might charge an affirmative process of making a difference; productive challenges to normative convention that resonate on ontological levels. When considered within the material processes of crisis and grieving, the productive entanglement of inquiry, ethics, and justice is granted important direction, lending a critical entry point for confecting a difference through challenging the status quo such that it loses repetitious traction.
The role of intellectual disability and emotional regulation in the autism–depression relationship
Authors: Sáez-Suanes Gema P , García-Villamisar Domingo , Del Pozo Armentia Araceli
Published: March 2023

Research shows significant rates of depressive symptoms in people with autistic spectrum disorder and intellectual disabilities. Finding factors related to the development of depression in autism spectrum disorder and intellectual disability is necessary. Emotion regulation is associated with depression in autism spectrum disorder and intellectual disability. The role of the intellectual disability in this relationship is not clear, so it is necessary to clarify it. One hundred twenty-one adults (M = 35.46 years, SD = 9.46) with autism spectrum disorder and intellectual disabilities were evaluated to verify moderating role of intellectual disability and mediating role of emotion regulation. A moderated mediation analysis supported the moderated role of mild intellectual disability in the relationship mediated by emotional dysregulation between autism spectrum disorder and depression symptoms. These findings suggest that interventions designed to prevent or reduce depressive symptoms in people with autism spectrum disorder and mild intellectual disability should include among their goals emotional regulation.

Lay abstract

Many people with autism and intellectual disability have significant levels of depressive symptoms. However, this relationship is not clear. For this reason, knowing the factors that are associated with having depression in autism and intellectual disability is important. Emotion regulation is associated with depression in autism spectrum disorder and intellectual disability. After evaluating a group of people with autism and intellectual disability, we found that people with mild intellectual disability have problems regulating their emotions which lead them to develop depressive symptoms. These findings suggest that interventions designed to prevent or reduce depressive symptoms in people with autism spectrum disorder and mild intellectual disability should include among their goals emotional regulation.
Looking into backstage discussions in social work: A qualitative synthesis of recent empirical findings
Authors: Taghizadeh Larsson Annika , Olaison Anna , Österholm Johannes
Published: March 2023

Social work practice has a history of collegial, intra-, and interprofessional discussions that take place backstage, that is, without the presence of clients. Because of their backstage character, these discussions may be considered even more important to examine than meetings at which clients are present and that are in a way already open to the public. The purpose of the present review was to provide insight into this practice by identifying and synthesizing recent empirical findings from existing studies using naturalistic data, published in English in peer-reviewed journals.

Findings

We identified four types of interaction among practitioners in relation to the case discussed and three types of content that were raised and shared, as well as an apparent mismatch between formal reasons for the discussions and the purpose they serve in practice. A lack of common vocabulary for conceptualizing the discussions and of attention given to their backstage character was identified in the included studies.

Applications

The review highlights an important area for further research and stresses the importance of not being blinded by formal purposes or ideological underpinnings in examining intra- and interprofessional discussions in social work; it shows that it is important to look into what is actually going on in practice.
Dual antiplatelet Use for extended period taRgeted to AcuTe ischemic stroke with presumed atherosclerotic OrigiN (DURATION) trial: Rationale and design
Authors: Kim Joon-Tae , Kang Jihoon , Kim Beom Joon , Kim Jun Yup , Han Moon-Ku , Cho Ki-Hyun , Park Man-Seok , Choi Kang-Ho , Park Jong-Moo , Kang Kyusik , Kim Yong Soo , Lee Soo Joo , Kim Jae Guk , Cha Jae-Kwan , Kim Dae-Hyun , Park Tai Hwan , Park Sang-Soon , Choi Jin Kyo , Lee Kyungbok , Park Kwang-Yeol , Jeong Hae-Bong , Lee Jun , Kwon Doo Hyuk , Cho Yong-Jin , Hong Keun-Sik , Park Hong-Kyun , Lee Byung-Chul , Yu Kyung-Ho , Oh Mi Sun , Lee Minwoo , Kim Dong-Eog , Gwak Dong-Seok , Choi Jay Chol , Kim Joong-Goo , Kang Chul-Hoo , Kwon Jee-Hyun , Kim Wook-Joo , Shin Dong-Ick , Yum Kyu Sun , Sohn Sung Il , Hong Jeong-Ho , Park Hyungjong , Kim Chulho , Lee Sang-Hwa , Lee Juneyoung , Gorelick Philip B , Norrving Bo , Bae Hee-Joon
Published: March 2023

Rationale:

The optimal duration of dual antiplatelet therapy (DAPT) with clopidogrel-aspirin for the large artery atherosclerotic (LAA) stroke subtype has been debated.

Aims:

To determine whether the 1-year risk of recurrent vascular events could be reduced by a longer duration of DAPT in patients with the LAA stroke subtype.

Methods and study design:

A total of 4806 participants will be recruited to detect a statistically significant relative risk reduction of 22% with 80% power and a two-sided alpha error of 0.05, including a 10% loss to follow-up. This is a registry-based, multicenter, prospective, randomized, open-label, blinded end point study designed to evaluate the efficacy and safety of a 12-month duration of DAPT compared with a 3-month duration of DAPT in the LAA stroke subtype. Patients will be randomized (1:1) to either DAPT for 12 months or DAPT for 3 months, followed by monotherapy (either aspirin or clopidogrel) for the remaining 9 months.

Study outcomes:

The primary efficacy outcome of the study is a composite of stroke (ischemic or hemorrhagic), myocardial infarction, and all-cause mortality for 1 year after the index stroke. The secondary efficacy outcomes are (1) stroke, (2) ischemic stroke or transient ischemic attack, (3) hemorrhagic stroke, and (4) all-cause mortality. The primary safety outcome is major bleeding.

Discussion:

This study will help stroke physicians determine the appropriate duration of dual therapy with clopidogrel-aspirin for patients with the LAA stroke subtype.

Trial registration:

URL: https://cris.nih.go.kr/cris . CRIS Registration Number: KCT0004407
Atrial Appendage Aneurysms: Natural History and Outcomes
Authors: Penfold Michael P. , Haq Ikram-Ul , Connolly Heidi M. , Dearani Joseph A. , Schaff Hartzell V. , Miranda William R. , Asirvatham Samuel J. , Killu Ammar M. , Arghami Arman , Stephens Elizabeth H.
Published: March 2023

Background

Left (LAAA) and right atrial appendage aneurysms (RAAA) are rare entities, and their natural history, management, and long-term outcomes are not well studied.

Methods

This retrospective review includes all patients from 2000 to 2021 with atrial appendage aneurysms at our institution identified using an electronic search tool. LAAA and RAAA were confirmed using multimodality imaging and intraoperative findings.

Results

We identified 13 (87%) patients with LAAA and 2 (13%) with RAAA. At diagnosis, 11 (73%) were female, mean age was 51.4  ±  18.8 years, and ejection fraction 56.5  ±  13.1%. Three (20%) patients had congenital heart disease including 2 (13%) with atrioventricular septal defects and 1 (7%) with congenitally corrected transposition. LAAA/RAAA was diagnosed due to new-onset atrial fibrillation (AF) in 6 (40%) patients and embolic stroke in 2 (13%). Ten patients had preexisting AF diagnosed 2.9  ±  1.4 years earlier at a mean age of 50.2  ±  15.5 years. Thrombus within the aneurysm was identified in 2 (15%) LAAA patients. All patients were on anticoagulation and follow-up of the cohort from diagnosis was 7.1  ±  6.2 years. Eleven (73%) patients were surgically managed with 7 (64%) lesions excised, 1 (9%) stapled, and 3 (27%) ligated. Postoperative complications occurred in 2 (18%) patients with 1 (7%) developing tricuspid regurgitation and another with pericardial effusion and tamponade.

Conclusions

Atrial appendage aneurysm is a rare disease and nearly half of patients present with AF. Surgical treatment with concomitant AF ablation is a reasonable and safe management option.
Impact of Industry 4.0 Technology on International Posting of Workers
Authors: Bednarz Joanna , Schuster Carola , Rost Martin
Published: March 2023

Posting of workers is a common reality in all EU Member States and in all export-oriented industries. The problem relates to existing travel restrictions in connection with the COVID-19 pandemic and in the context of the carbon footprint of business travel. In this context, the development of new Industry 4.0 technologies plays a significant role. The aim of the article is to identify the impact of Industry 4.0 technology on the international posting of workers in light of the COVID-19 pandemic on example of the German chemical industry. The basis of the analysis are two factor conditions of the Diamond Model of M.E. Porter: innovation and human capital. A qualitative study was conducted with experts in Industry 4.0 that regularly post workers. The results indicate that the COVID-19 pandemic has accelerated the pace of technology adoption (especially Augmented Reality cluster). Industry 4.0 technologies enable companies to reduce the posting of workers. For this purpose, IT skills are now the most important, followed by communication, flexibility, and openness, as well as soft, team and didactic skills.

JEL Codes: F23, J61, O33
China’s Regulatory Framework for Transnational Higher Education: Development, Impacts, and Rationales
Authors: Yang Hongqing
Published: March 2023

China’s regulatory framework for transnational higher education (TNHE) is important for foreign higher education institutions (HEIs) to access the Chinese education market and for TNHE to operate in China. First, this research synthesizes China’s regulatory framework for TNHE. Second, through documentary analysis, this research examines policy development and its impacts on TNHE. Third, through institutional logics analysis, this research analyzes the rationales for policy development. It finds that the development of TNHE is driven by China’s development demands, the forces of social demands, and the challenges of globalization. China is expanding its openness to education by allowing for-profit, foreign majority-owned, and wholly foreign-owned HEIs and granting them legal status and more autonomy. TNHE is transiting from quantity to quality, China has established a quality assurance system. In the meantime, the development of TNHE is restricted by China’s concerns on national educational sovereignty. China always emphasizes its educational sovereignty and social values. This suggests that China aims to utilize TNHE to serve its development while guaranteeing its educational sovereignty and social values.
An Interpretive Structural Modelling (ISM) Approach to Evaluate Barriers to Resiliency in Indian Pharmaceutical Supply Chains
Authors: Ganguly Anirban , Farr John V.
Published: March 2023

The COVID-19 global pandemic, over the last year and a half, has managed to create massive disruptions in global supply chains and exposed their vulnerabilities, thereby reemphasizing the importance of resiliency. The current study aims to identify and prioritize, through the quantitative decision-making technique of Interpretive Structural Modelling (ISM), a set of barriers to resiliency for the pharmaceutical supply chain in India. The rationale behind choosing the Indian pharmaceutical supply chain was that the pharmaceutical sector in India supplies over half of the global demand for vaccines and generic drugs, and the trajectory of growth is indicated around US$100 billion by the year 2025, along with exporting pharmaceutical products to nearly 200 destination countries. The findings of the current study are expected to aid the decision-makers in evaluating the relative criticality and the interrelationship between the potential (and critical) barriers to supply chain resiliency, and in turn to develop strategic plans. This, in turn, can help to combat unforeseen supply chain disruptors such as COVID-19. This methodology and the findings of the study can be generalized for other supply chains.
Introducing a novel “real-time” outbreak alert and notification system to monitor SARS-CoV-2 outbreaks and case fatality in elderly care facilities, the Netherlands, 2020–2022
Authors: Meima Abraham , Whelan Jane , Dijks Jan , van der Hagen Nicoline , van Duuren Marco , Tjon-A-Tsien Aimée
Published: March 2023

Surveillance systems collating individual-level data may limit timely information sharing during rapidly evolving, infectious disease outbreaks. We present a digital outbreak alert and notification system ( MUIZ) in which institutional-level data are reported, allowing real-time outbreak monitoring in elderly care facilities (ECF). We describe trends in the number of outbreaks, mean case number per outbreak, and case-fatality rate (deaths/recovered + deaths) of SARS-CoV-2 in ECF notified through MUIZ in the Rotterdam area (April 2020-March 2022). Overall, 369 outbreaks were reported from 128 ECF that registered with MUIZ (approximately 85% of all ECF), and 114 (89%) notified at least one SARS-CoV-2 outbreak. Trends were consistent with the concurrent national epidemiology and societal control measures in place. MUIZ is a simple outbreak surveillance tool that was highly adopted and acceptable to users. Dutch PHS regions are increasingly adopting the system and it has potential for adaptation and further development in similar institutional outbreak settings.
Community health centers response to the need of dementia care
Authors: Suriastini Ni Wayan , Oktarina Dwi , Sikoki Bondan , Indriati Sunar , Umaroh Rodhiah , Alfah Dani , Lestari Kusmaintan Widya
Published: March 2023

Background:

Dementia prevalence among Indonesian older people is increasing. Community health centers (CHCs) as primary care providers have a responsibility to meet the need of their community. This study aims to measure the response of CHCs to the growing of dementia cases and to investigate factors associated with the knowledge of CHC staff on dementia symptoms in Special Region of Yogyakarta (DI Yogyakarta), Indonesia.

Design and methods:

This study used a cross-sectional design to obtain census data from 121 CHCs in DI Yogyakarta by interviewing 121 older person program managers of the CHCs via telephone between January and February 2021. Data on knowledge of 10 dementia symptoms, participation in dementia prevention and treatment with dementia, dementia/cognitive screening and coverage as well as factors associated with memory loss and change in mood and behavior were assessed. Data were analyzed using descriptive, bivariate, and multiple logistic regression.

Results:

The knowledge of dementia symptoms among health workers was low (15%–37%). CHCs had not yet received training on dementia prevention and treatment (58%). Only a few of CHCs treated patient with dementia (36%). Dementia screening and coverage were also low. Engaged in dementia training were more likely to have higher knowledge of dementia symptoms, particularly memory loss and changes in mood and behavior.

Conclusions:

Dementia training and education are needed to increase knowledge among care providers which would eventually improve CHC response to dementia. Priority should also be in place to support dementia care management.
Unintended Consequences of Expanding Teacher Preparation Pathways: Does Alternative Licensure Attenuate New Teacher Pay?
Authors: Guthery Sarah , Bailes Lauren P.
Published: March 2023

Texas reduced new teacher preparation requirements in 2001 to allow more alternate paths to licensure. Within 5 years, this policy change resulted in more than half of the state’s new teachers being alternatively licensed. Using a series of first difference models, this study examines the relationship between the increased supply of new teachers in Texas and new teacher salaries prior to the policy change and in the 15 years thereafter. We find that the policy change did increase the supply of new teachers via alternative licensing, but pay for new EC-6 teachers declined by 2%–13% with differential effects based on the rate at which districts hired alternatively licensed teachers.
Spatial model for predictive recovery monitoring based on hazard, built environment, and population features and their spillover effects
Authors: Patrascu Flavia Ioana , Mostafavi Ali
Published: March 2023

The ability to proactively monitor the trajectory of post-disaster recovery is valuable for resource allocation prioritization. Existing knowledge, however, lacks models and insights for quantifying and proactively monitoring post-disaster community recovery. This study examines models that could predict population activity recovery at the scale of the census block group (CBG). Population activity recovery is measured by using location-based human mobility visitation patterns to essential points-of-interest (POIs) in the context of the 2017 Hurricane Harvey in Harris County, Texas. The study examined the association between the population activity recovery duration and 32 features split into four categories: (1) physical vulnerability and access, (2) hazard exposure and impact, (3) proactive actions and (4) population features. Several types of spatial regression models were evaluated to determine their ability to capture this relationship. The Spatial Durbin Model was identified as the best fit for assessing direct, spillover, and total effects of features on population activity recovery at the CBG level. The results show the extent of physical vulnerability, measured by road network density, prolongs the duration of population activity recovery by a combination of direct and spillover effects. Also, the extent of access to essential facilities, measured based on the number of POIs, shortens the duration of population activity recovery. Correspondingly, the extent of flooding is not a significant feature in explaining the population recovery duration in CBGs. The results show that better preparedness, measured by extent of POIs visitations prior to hurricane landing, is associated with faster population activity recovery. In terms of population attributes, the total number of people, the percentage of minorities, and the percentage of Black and Asian subpopulations are significant features in the model for predicting the duration of population activity recovery. The study outcome offers data-driven insights for understanding the determinants of population activity recovery and provides a new model tool for predictive recovery monitoring based on evaluating the direct, spillover, and total effects of features. These findings can identify areas with slower or more rapid recovery to inform emergency managers and public officials in ensuring equitable resource allocation prioritization.
Cost Analysis and Reimbursement of Weightbearing Computed Tomography
Authors: Alexander Nathaniel B. , Sarfani Shumaila , Strickland Carson D. , Richardson David R. , Murphy G. Andrew , Grear Benjamin J. , Bettin Clayton C.
Published: March 2023

Background:

Weightbearing computed tomography (WBCT) is becoming a valuable tool in the evaluation of foot and ankle pathology. Currently, cost analyses of WBCT scanners in private practice are lacking in the literature. This study evaluated the costs of acquisition, utilization, and reimbursements for a WBCT at a tertiary referral center, information of particular interest to practices considering obtaining such equipment.

Methods:

All WBCT scans performed at a tertiary referral center over the 55-month period (August 2016 to February 2021) were retrospectively evaluated. Patient demographics, pathology location, etiology, subspecialty of the ordering provider, and whether the study was unilateral or bilateral were collected. Reimbursement was calculated based on payor source as a percentage of Medicare reimbursement for lower extremity CT. The number of total scans performed per month was evaluated to determine revenue generated per month.

Results:

Over the study period, 1903 scans were performed. An average of 34.6 scans were performed each month. Forty-one providers ordered WBCT scans over the study period. Foot and ankle fellowship-trained orthopaedic surgeons ordered 75.5% of all scans. The most common location of pathology was the ankle, and the most common etiology was trauma. The device was cost neutral at 44.2 months, assuming reimbursement for each study was commensurate with Medicare rates. The device became cost neutral at approximately 29.9 months when calculating reimbursement according to mixed-payor source.

Conclusion:

As WBCT scan becomes more widely used for evaluation of foot and ankle pathology, practices may be interested in understanding the financial implications of such an investment. To the authors’ knowledge, this study is the only cost-effectiveness analysis of WBCT based in the United States. We found that in a large, multispecialty orthopaedic group, WBCT can be a financially viable asset and a valuable diagnostic tool for a variety of pathologies.

Level of Evidence:

Level III, diagnostic.
Individual and organizational factors as predictors of early evidence-based practice adoption in Michigan high schools: Baseline data from an implementation trial
Authors: Choi Seo Youn , Rusch Amy , Lane Annalise , Liebrecht Celeste , Bilek Emily L. , Eisenberg Daniel , Andrews Carolyn , Perry Morgan , Smith Shawna N.
Published: March 2023

Background

Adolescents increasingly access mental health services in schools. School mental health professionals (SPs; school counselors, social workers, etc.) can offer evidence-based mental health practices (EBPs) in schools, which may address access gaps and improve clinical outcomes. Although some studies have assessed factors associated with EBP adoption in schools, additional research focusing on SP- and school-level factors is warranted to support EBP implementation as SPs’ mental health delivery grows.

Methods

Baseline data were collected from SPs at Michigan high schools participating in a statewide trial to implement SP-delivered cognitive behavioral therapy (CBT) to students. Models examined factors associated with attitudes about EBPs, implementation climate, and implementation leadership, and their associations with CBT knowledge, training attendance, and pre-training CBT delivery.

Results

One hundred ninety-eight SPs at 107 schools (87%) completed a baseline survey. The mean Evidence-Based Practice Attitude Scale (EBPAS) total score was 2.9, and school-aggregated mean scores of the Implementation Climate Scale (ICS) and Implementation Leadership Scale (ILS) were 1.83 and 1.77, respectively, all on a scale ranging from 0 ( low) to 4 ( high). ICS and ILS scores were lower than typically reported in clinical settings, while EBPAS scores were higher. School characteristics were not significantly associated with EBPAS, ICS, or ILS scores, but scores did differ by SP role. Higher EBPAS scores were associated with more CBT knowledge (average marginal effect for 1 SD change [AME] = 0.15 points) and a higher probability of training completion (AME = 8 percentage points). Higher ICS scores were associated with a higher probability of pre-training CBT delivery (AME = 6 percentage points), and higher ILS scores were associated with higher probability of training completion (AME = 10 percentage points).

Conclusions

Our findings suggest that SPs’ attitudes toward EBPs and organizational support were positively associated with early signs of implementation success. As schools increasingly fill the adolescent mental healthcare access gap, efforts to strengthen both provider attitudes toward EBP and strategic organizational factors supporting EBP delivery will be key to encouraging EBP uptake in schools.
Dissatisfaction of Out-of-Pocket Costs and Problems Paying Medical Bills Among Medicare Beneficiaries With Type 2 Diabetes
Authors: Peng Ng Boon , Stewart Morgan P. , Kwon Seoyon , Hawkins Georgianne Tiu , Park Chanhyun
Published: March 2023

Purpose

The purpose of the study was to examine the relationship between satisfaction of Medicare coverage for out-of-pocket costs and problems paying medical bills among Medicare beneficiaries with type 2 diabetes.

Methods

The 2019 Medicare Current Beneficiary Survey Public Use File, a nationally representative sample of Medicare beneficiaries aged ≥65 years with type 2 diabetes, was analyzed (n = 2178). A survey-weighted multivariable logit regression model was conducted to examine the association between satisfaction of Medicare coverage for out-of-pocket costs and problems paying medical bills, adjusted for sociodemographics and comorbidities.

Results

Among study beneficiaries, 12.6% reported problems paying medical bills. Among those with and without problems paying medical bills, 59.5% and 12.8%, respectively, were dissatisfied with out-of-pocket costs. In the multivariable analysis, beneficiaries who were dissatisfied with out-of-pocket costs were more likely to report problems paying medical bills than those who were satisfied. Younger beneficiaries, beneficiaries with lower incomes, those with functional limitations, and those with multiple comorbidities were more likely to report problems paying medical bills.

Conclusions

Despite having health care coverage, more than one-tenth of Medicare beneficiaries with type 2 diabetes reported problems paying medical bills, which raises concerns about delaying or forgoing needed medical care due to unaffordability. Screenings and targeted interventions that identify and reduce financial hardships associated with out-of-pocket costs should be prioritized.
Bufalin-loaded vitamin E succinate-grafted chitosan oligosaccharide/RGD-conjugated TPGS mixed micelles inhibit intraperitoneal metastasis of ovarian cancer
Authors: Xu Lan , Ma Shuli , Fan Bozhen , Yuan Zeting , Yin Peihao
Published: March 2023

Background

Intraperitoneal metastasis is one of the major causes of the high mortality rate of ovarian cancer. Bufalin (BU) is an effective component of the traditional Chinese medicine Chansu that exerts antitumor effects, including metastasis inhibition. In our previous studies, we found that BU inhibited the migration and invasion of ovarian cancer cells. However, the application of BU is limited due to its insolubility, toxicity and imprecise targeting. The aim of this study was to use vitamin E succinate (VES)-grafted chitosan oligosaccharide (CSO)/arginine-glycine-aspartic acid peptide (RGD)-conjugated d-alpha-tocopheryl polyethylene glycol 1000 succinate (TPGS) mixed micelles (VeC/T-RGD MMs) to deliver BU to ovarian cancer cells to inhibit intraperitoneal metastasis. Moreover, the toxicity of BU was reduced by coating it with the mixed micelles to increase its biocompatibility for practical applications.

Results

The BU-loaded VeC/T-RGD MMs (BU@MMs) had an average diameter of 161 ± 1.4 nm, a zeta potential of 4.49 ± 1.54 mV and a loading efficiency of 2.54%. The results showed that these micelles inhibited cell proliferation, induced apoptosis, and reduced the migration and invasion of A2780 and SKOV3 cells. Further studies indicated that BU@MMs enhanced the levels ofe-cadherin and decreased the expression levels of N-cadherin, vimentin and Snail in vitro. In addition, the mixed micelles effectively enhanced the anticancer effect and inhibited intraperitoneal metastasis in intraperitoneal metastatic models. The BU@MMs exhibited fewer toxic side effects than BU, indicating better biocompatibility and biosafety for in vivo applications.

Conclusions

Our studies show that BU@MMs are a potential multifunctional nano-drug delivery system that can effectively inhibit the intraperitoneal metastasis of ovarian cancer.
Genetic parameters for various semen production and quality traits and indicators of male and female reproductive performance in Nellore cattle
Authors: Carvalho Felipe E. , Ferraz José Bento S. , Pedrosa Victor B. , Matos Elisangela C. , Eler Joanir P. , Silva Marcio R. , Guimarães José D. , Bussiman Fernando O. , Silva Barbara C. A. , Cançado Fernando A. , Mulim Henrique A. , Espigolan Rafael , Brito Luiz F.
Published: March 2023

Background

Given the economic relevance of fertility and reproductive traits for the beef cattle industry, investigating their genetic background and developing effective breeding strategies are paramount. Considering their late and sex-dependent phenotypic expression, genomic information can contribute to speed up the rates of genetic progress per year. In this context, the main objectives of this study were to estimate variance components and genetic parameters, including heritability and genetic correlations, for fertility, female precocity, and semen production and quality (andrological attributes) traits in Nellore cattle incorporating genomic information.

Results

The heritability estimates of semen quality traits were low-to-moderate, while moderate-to-high estimates were observed for semen morphological traits. The heritability of semen defects ranged from low (0.04 for minor semen defects) to moderate (0.30 for total semen defects). For seminal aspect (SMN_ASPC) and bull reproductive fitness (BULL_FIT), low (0.19) and high (0.69) heritabilities were observed, respectively. The heritability estimates for female reproductive traits ranged from 0.16 to 0.39 for rebreeding of precocious females (REBA) and probability of pregnancy at 14 months (PP14), respectively. Semen quality traits were highly genetically correlated among themselves. Moderate-to-high genetic correlations were observed between the ability to remain productive in the herd until four years of age (stayability; STAY) and the other reproductive traits, indicating that selection for female reproductive performance will indirectly contribute to increasing fertility rates. High genetic correlations between BULL_FIT and female reproductive traits related to precocity (REBA and PP14) and STAY were observed. The genetic correlations between semen quality and spermatic morphology with female reproductive traits ranged from -0.22 (REBA and scrotal circumference) to 0.48 (REBA and sperm vigor). In addition, the genetic correlations between REBA with semen quality traits ranged from -0.23 to 0.48, and with the spermatic morphology traits it ranged from -0.22 to 0.19.

Conclusions

All male and female fertility and reproduction traits evaluated are heritable and can be improved through direct genetic or genomic selection. Selection for better sperm quality will positively influence the fertility and precocity of Nellore females. The findings of this study will serve as background information for designing breeding programs for genetically improving semen production and quality and reproductive performance in Nellore cattle.
A low BUN/creatinine ratio predicts histologically confirmed acute interstitial nephritis
Authors: Salvador López Giacoman , Carolina González Fuentes , Jesús Robles Dávila , Virgilia Soto Abraham María , Susana Román Acosta , Jonathan Chávez Íñiguez , Luis Salas Pacheco José , Claudio Ronco
Published: March 2023

Introduction

In hospitalized patients with acute renal injury (AKI), acute tubulointerstitial nephritis (AIN) constitutes one of the leading etiologies. The objective of this study was to identify clinical and biochemical variables in patients with AKI associated with kidney biopsy-confirmed AIN.

Methods

For our prospective study, we recruited hospitalized patients aged 18 years and older who were diagnosed with AKI based on biochemical criteria. Prior to enrollment, each patient was assessed with a complete metabolic panel and a kidney biopsy.

Results

The study consisted of 42 patients (with a mean age of 45 years) and equal numbers of male and female patients. Diabetes and hypertension were the main comorbidities. Nineteen patients had histological findings consistent with AIN. There was a correlation between histology and the BUN/creatinine ratio (BCR) (r = -0.57, p = 0.001). The optimal Youden point for classifying AIN via a receiver operating characteristic (ROC) curve analysis was a BCR ≤ 12 (AUC = 0.73, p = 0.024). Additionally, in diagnosing AIN, BCR had a sensitivity of 76%, a specificity of 81%, a positive predictive value of 81%, a negative predictive value of 76%, and OR of 14 (95% CI = 2.6 to 75.7, p = 0.021). In the multivariable analysis, BCR was the sole variable associated with AIN.

Conclusion

A BCR ≤ 12 identifies AIN in patients with AKI. This study is the first to prospectively assess the relationship between renal biopsy results and BCR.
A case report of a collision tumor composed of pancreatic ductal adenocarcinoma and peri-pancreatic mucosa-associated lymphoid tissue lymphoma
Authors: Hirai Ryuji , Omae Ken-ichi , Yodoya Mitsuko , Fujie Syunji , Fujii Masayoshi , Iwata Kazuma , Imanishi Kentaro , Kurihara Eisuke , Yoshida Kazuhiro , Jida Masaru , Kobayashi Kazuyasu , Kanaya Yoshiaki , Maruyama Syuichiro
Published: March 2023

Background

Collision tumors are composed of two distinct tumor components. Collision tumors composed of pancreatic ductal adenocarcinoma and malignant lymphoma occurring in the pancreas have not been previously described in the scientific literature. In this case report, we describe a unique patient with a collision tumor composed of pancreatic ductal adenocarcinoma and peri-pancreatic mucosa-associated lymphoid tissue (MALT) lymphoma occurring in the pancreas.

Case presentation

An 82-year-old woman presented to our hospital complaining of dizziness. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large lymphoid lesion spreading from the peri-pancreatic tissue heading to the hepatic hilar plate, involving the hepatoduodenal ligament and the entire duodenum, also showing a hard tumor in the pancreas head. We performed echo-guided needle biopsies for each tumor and diagnosed a collision tumor composed of pancreatic ductal adenocarcinoma and low-grade B cell lymphoma. The patient underwent pancreaticoduodenectomy. The resected specimen showed an elastic hard tumor, 90 × 75 mm in size, located in the pancreatic head, and a whitish-yellow hard tumor involving the lower bile duct, 31 mm in size, located in the center of the pancreatic head. Pathological and immunohistochemical examination proved that pancreatic ductal adenocarcinoma and MALT lymphoma originating from the peri-pancreatic head collided in the pancreatic head.

Conclusions

To best of our knowledge, this is the first report of a surgically resected collision tumor of pancreatic ductal adenocarcinoma and MALT lymphoma originating from the peri-pancreatic head. A needle biopsy is useful when inconsistent findings are observed on diagnostic CT and MRI of tumor lesions since there is the possibility of a collision tumor.
A comment-driven evidence appraisal approach to promoting research findings into practice when only uncertain evidence is available
Authors: Wang Shuang , Kilicoglu Halil , Du Jian
Published: March 2023

Background

Comments in PubMed are usually short papers for supporting or refuting claims, or discussing methods and findings in original articles. This study aims to explore whether they can be used as a quick and reliable evidence appraisal instrument for promoting research findings into practice, especially in emergency situations such as COVID-19 in which only missing, incomplete or uncertain evidence is available.

Methods

Evidence–comment networks (ECNs) were constructed by linking COVID-19-related articles to the commentaries (letters, editorials or brief correspondence) they received. PubTator Central was used to extract entities with a high volume of comments from the titles and abstracts of the articles. Among them, six drugs were selected, and their evidence assertions were analysed by exploring the structural information in the ECNs as well as the sentiment of the comments (positive, negative, neutral). Recommendations in WHO guidelines were used as the gold standard control to validate the consistency, coverage and efficiency of comments in reshaping clinical knowledge claims.

Results

The overall positive/negative sentiments of comments were aligned with recommendations for/against the corresponding treatments in the WHO guidelines. Comment topics covered all significant points of evidence appraisal and beyond. Furthermore, comments may indicate the uncertainty regarding drug use for clinical practice. Half of the critical comments emerged 4.25 months earlier on average than the guideline release.

Conclusions

Comments have the potential as a support tool for rapid evidence appraisal as they have a selection effect by appraising the benefits, limitations and other clinical practice issues of concern in existing evidence. We suggest as a future direction an appraisal framework based on the comment topics and sentiment orientations to leverage the potential of scientific commentaries supporting evidence appraisal and decision-making.
Provider-initiated HIV testing uptake and socio-economic status among women in a conflict zone in the Central African Republic: a mixed-methods cross-sectional study
Authors: Utheim Mari Nythun , Isaakidis Petros , Van den Bergh Rafael , Géraud Bantas Bata Ghislain , Mabvouna Rodrigue Biguioh , Omsland Tone Kristin , Heen Espen , Dahl Cecilie
Published: March 2023

Introduction

In the Central African Republic (CAR), HIV/AIDS is the main cause of death in women aged 15–49 years. Increased testing coverage is essential in prevention of HIV/AIDS, especially in areas where conflict hinders access to health care. Socio-economic status (SES) has been shown to be associated with HIV testing uptake. We investigated whether “Provider-initiated HIV testing and counselling” (PITC) could be implemented in a family planning clinic in an active conflict zone in the Central African Republic to reach women of reproductive age and assessed whether socioeconomic status was associated with testing uptake.

Methods

Women aged 15–49 years were recruited from a free family planning clinic run by Médecins Sans Frontières in the capital Bangui. An asset-based measurement tool was created based on analysis of qualitative in-depth interviews. Measures of socioeconomic status were constructed from the tool, also by using factor analysis. Logistic regression was used to quantify the association between SES and HIV testing uptake (yes/no), while controlling for potential confounders: age, marital status, number of children, education level and head of household.

Results

A total of 1419 women were recruited during the study period, where 87.7% consented to HIV testing, and 95.5% consented to contraception use. A total of 11.9% had never been tested for HIV previously. Factors negatively associated with HIV testing uptake were: being married (OR = 0.4, 95% CI 0.3–0.5); living in a household headed by the husband as opposed to by another person (OR = 0.4, 95% CI 0.3–0.6), and lower age (OR = 0.96, 95% CI 0.93–0.99). Higher level of education (OR = 1.0, 95% CI 0.97–1.1) and having more children aged under 15 (OR = 0.92, 95% CI 0.81–1.1) was not associated with testing uptake. In multivariable regression, testing uptake was lower in the higher SES groups, but the differences were not significant (OR = 0.80, 95% CI 0.55–1.18).

Conclusions

The findings show that PITC can be successfully implemented in the patient flow in a family planning clinic, without compromising contraception uptake. Within the PITC framework in a conflict setting, socioeconomic status was not found to be associated with testing uptake in women of reproductive age.
X chromosome dosage and the genetic impact across human tissues
Authors: Viuff Mette , Skakkebæk Anne , Johannsen Emma B. , Chang Simon , Pedersen Steen Bønlykke , Lauritsen Katrine Meyer , Pedersen Mette Glavind Bülow , Trolle Christian , Just Jesper , Gravholt Claus H.
Published: March 2023

Background

Sex chromosome aneuploidies (SCAs) give rise to a broad range of phenotypic traits and diseases. Previous studies based on peripheral blood samples have suggested the presence of ripple effects, caused by altered X chromosome number, affecting the methylome and transcriptome. Whether these alterations can be connected to disease-specific tissues, and thereby having clinical implication for the phenotype, remains to be elucidated.

Methods

We performed a comprehensive analysis of X chromosome number on the transcriptome and methylome in blood, fat, and muscle tissue from individuals with 45,X, 46,XX, 46,XY, and 47,XXY.

Results

X chromosome number affected the transcriptome and methylome globally across all chromosomes in a tissue-specific manner. Furthermore, 45,X and 47,XXY demonstrated a divergent pattern of gene expression and methylation, with overall gene downregulation and hypomethylation in 45,X and gene upregulation and hypermethylation in 47,XXY. In fat and muscle, a pronounced effect of sex was observed. We identified X chromosomal genes with an expression pattern different from what would be expected based on the number of X and Y chromosomes. Our data also indicate a regulatory function of Y chromosomal genes on X chromosomal genes.

Fourteen X chromosomal genes were downregulated in 45,X and upregulated in 47,XXY, respectively, in all three tissues (AKAP17A,CD99,DHRSX,EIF2S3,GTPBP6,JPX,KDM6A,PP2R3B,PUDP,SLC25A6,TSIX,XIST,ZBED1,ZFX). These genes may be central in the epigenetic and genomic regulation of sex chromosome aneuploidies.

Conclusion

We highlight a tissue-specific and complex effect of X chromosome number on the transcriptome and methylome, elucidating both shared and non-shared gene-regulatory mechanism between SCAs.
Horse-riding hazards: an observational cohort study mapping equestrian related injuries at a Scandinavian trauma centre
Authors: Franzén Lindgren Emilie , Hammarqvist Folke , Ahl Hulme Rebecka
Published: March 2023

Introduction

Horse-riding is practiced on a regular basis by 500,000 people in Sweden. It is reputed to be one of the most dangerous sports. On average, there were 1756 acute injuries and three fatalities each year between 1997 and 2014 in Sweden related to horses. The primary aim of this study was to outline the injury spectrum related to equestrian activities cared for at a large Swedish trauma centre. The secondary aim was to identify trends in clinical outcomes and to investigate the association between age and such outcomes.

Material and methods

The electronic medical records system at Karolinska University Hospital was queried for patients cared for due to equestrian related trauma between July 2010 and July 2020. Complementary data were gathered using the hospital’s Trauma Registry. No exclusion criteria were applied. Descriptive statistics were used to outline the injury spectrum. Age was split into four categories which were compared using the Kruskal–Wallis H test or the Chi-squared test. Logistic regression was used to analyse correlations between age and outcomes.

Results

A total of 3036 patients were included with 3325 injuries identified as equestrian related. The hospital admission rate was 24.9%. The cohort had one death. Regression analysis showed significant associations between decreasing risk of upper extremity injury (p < 0.001), increasing risk of vertebral fractures (p = 0.001) and increasing risk of thoracic injury (p < 0.001) with increasing age.

Conclusions

Equestrian activities are not without risks. The morbidity is high, and injuries are taken seriously by the medical profession, reflected by the high admission rate. There are age-related variations in the injury spectrum. Older age appears to predispose to vertebral fractures and thoracic injuries. Other factors than age appear more important in determining the need for surgery or admission to ICU.