bluuebunny/crossref_metadata_2025 huggingface dataset:
The Environment as a Patient: A Content Analysis of Canadian Nursing Organizations and Regulatory Bodies Policies on Environmental Health
Authors: Mundie Courtney , Donelle Lorie
Published: October 2021

Background

Individual, community, and societal health is impacted by the environment, specifically by air, water and soil pollution, and climate change. Poor environmental conditions have been associated with many illness exacerbations. Although global nursing organizations have increased their environmental health focus, evidence is lacking that Canadian nurse leaders and organizations are similarly invested.

Purpose

The purpose of this analysis was to explore the policies of Canadian nursing regulatory bodies and associations on nursing practice specific to environmental health.

Methods

A content analysis of nursing focused position statements and competency documents was conducted to assess Canadian nursing policies in environmental health. Publicly available position statements and competency documents regarding health and the environment were retrieved from Canadian nursing regulatory colleges and nursing associations, the Canadian Nursing Associations, and the International Council of Nurses. All documents were coded inductively and thematically analyzed.

Results

In total, 22 documents were retrieved which consisted of 11 policy statements from nursing associations and 11 competency documents from nursing regulators and national associations. Four themes were generated: collaboration, language of engagement, nursing actions, and social justice.

Conclusion

There is a gap between nursing policies and competencies directing nursing action related to the health of the environment across Canada. There is an opportunity to improve eco-literacy within the nursing profession, undergraduate education and to produce nursing research on environmental health.
Preparation and characterization of conductive nerve guide conduit filled with dual drug-loaded nanofibers
Authors: Yan Xiumei , Yu Yi , Wang Shaobing , Xu Haixing , He Qundi , Wen Jing , Xu Jingyi , Li Kebi , Huang Zhijun , Xu Peihu
Published: October 2021

Peripheral nerve injury (PNI) has become one of the common clinical diseases. How to promote the regeneration and function recovery of the damaged peripheral nerve has been the focus of attention in the medical field. Evidence suggests that the longitudinal filling of oriented fibers in nerve guide conduit (NGC) is especially beneficial to the repair of long gap PNI. In this study, polypyrrole (PPy) nanospheres (PNSs) were prepared by the soft-templating method, and mixed with poly (lactic acid) (PLA) to prepare conductive PNSs/PLA NGC, and the optimal ratio of PNSs was 4.5%. PLA and vascular endothelial growth factor (VEGF) as shell, chitosan (CS) and paeoniflorin (PF) as core, oriented coaxial nanofibers were obtained and then filled into PNSs/PLA NGC. The composite NGC has excellent mechanical properties, electrical conductivity, hydrophilic properties, and degradation properties. Besides, the successive release of VEGF and PF can play a synergistic role in promoting nerve regeneration. In vitro experiments showed that the composite NGC was nontoxic and suitable for the adhesion and proliferation of nerve cells. In addition, PNSs combined with electrical stimulation (ES) can significantly promote the differentiation and proliferation of nerve cells, which is conducive to nerve regeneration. These positive results indicate that the composite NGC is a promising candidate in the repair of long gap PNI.
ASNTR’s Venture into a Hybrid Conference: Lessons Learned During the COVID-19 Pandemic
Authors: Sanberg Paul , Morrison Donna C , Bjugstad Kimberly
Published: October 2021

The 28th American Society for Neural Therapy and Repair (ASNTR) returned to the Sheraton Sand Key in Clearwater Beach, Florida after an 18 month hiatus. Like nearly all conferences during the pandemic, the ASNTR conference was held in person while offering a virtual option to the event. These formats are advantageous for those under travel restrictions or personal constraints, but they lack the spontaneity of in-person connections. Highlights from the meeting included the return of the Bernard Sanberg Memorial Award and the Roy Bakay Memorial lecture. The presidential lecture was given by Gabriel de Erausquin, who discussed the possibility of long-term CNS effects resulting from SARS-CoV2 infection. With both virtual and in-person events, including oral and poster presentations, the ASNTR managed to maintain the unique essence of this small important meeting.
The Effect of Firm Ownership on Time-to-recall
Authors: Tiwari Sejal , Muralidharan Etayankara
Published: October 2021

We examine the impact of firm ownership (public vs. private) and the perception of the reputation of the quality of suppliers of the country from where products are sourced on time-to-recall of defective products from the market. Operationalizing time-to-recall as the time that has elapsed from the date of first sale in the market to the date it was recalled, we test the influence of the interplay between firm ownership and perception of the reputation of the quality of suppliers of the country on time-to-recall using data on 400 toy recalls issued in the USA during 2007–2018. We find that time-to-recall is shorter for publicly traded firms than it is for private firms. This effect is more pronounced when the products are sourced from countries with poor perception of the reputation of the quality of suppliers. We discuss the research and managerial implications of our findings.
Effectiveness of an Adventure-based Cognitive Behavioral Program for Hong Kong University Students
Authors: Pan Jia-Yan , Zhuang Xiaoyu
Published: October 2021

Objectives: This pilot study developed an adventure-based cognitive behavioral intervention (aCBI) program and tests its effectiveness in improving the mental health of Chinese university students in Hong Kong. Method: A total of 217 undergraduate students participated in an aCBI program in the form of an interdisciplinary general education course in a university in Hong Kong. A battery of standardized online questionnaires was administered to the students before joining and upon completion of the course, and at a 3-month follow-up test. Results: The participants showed a significant reduction of psychological distress, perceived stress, depressive symptoms, and negative thoughts and emotions and a significant increase of positive thoughts upon immediate completion of the program. The positive effects maintained at the 3-month follow-up test. Conclusion: The integration of cognitive behavioral intervention and adventure training in a class setting might be an effective and feasible approach for the mental health counseling of university students.
A deep dive into CDK4/6 inhibitors: Evaluating real world toxicities and treatment paradigms in the elderly population
Authors: Olazagasti Coral , Lee Chung-Shien , Liu Angel , Stefanov Dimitre , Cheng Kit
Published: October 2021

Background

Cyclin-dependent kinase 4/6 inhibitors have become part of the standard of care in the treatment of hormone receptor positive, Her2Neu negative metastatic breast cancer. There is concern regarding the efficacy and potential increased cyclin-dependent kinase 4/6 inhibitors toxicity in the geriatric population in the community compared to the clinical trial population.

Methods

We evaluated patients treated with cyclin-dependent kinase 4/6 inhibitors from 2015 to 2019 and stratified according to age ≥70 and <70 years. Complete blood count from the first two cycles was recorded. Rates of hematologic toxicities, dose interruptions and reductions, progression-free survival, and overall survival were compared between both groups. We sought to assess the hematologic toxicities between the age groups and the relationship between previous chemotherapy exposure, bone metastasis and starting cyclin-dependent kinase 4/6 inhibitors dose with progression-free survival and overall survival.

Results

A total of 202 patients were included, 73 were ≥70 years and 129 were <70 years of age. There was no association between age group and grade of neutropenia or thrombocytopenia. There was a profound association between progression-free survival and overall survival and starting dose, where patients with recommended starting dose had higher progression-free survival and overall survival than those with a reduced dose ( p = 0.0003 and p = 0.04).

Conclusions

Our study showed similar progression-free survival and overall survival between age groups without significant differences in neutropenia or thrombocytopenia toxicity. Nevertheless, we found an association between starting dose and progression-free survival and overall survival that has not been previously reported. Given the good tolerability across age groups and the improvement in progression-free survival and overall survival, patients should be treated at the cyclin-dependent kinase 4/6 inhibitors recommended dose and monitored appropriately.
Numerical investigation into thermal buckling of friction pairs in hydro-viscous drive under nonlinear radial temperature distribution
Authors: Wang Qiliang , Wang Jianmei , Cui Hongwei , Wang Jun , Zhang Fan
Published: October 2021

Thermal buckling deformation can significantly impact the operating performance of hydro-viscous drive. A thermal buckling finite element shell model was established with the nonlinear radial temperature as the thermal loading condition. The thermal buckling behavior of friction pairs was investigated under three different boundary constraints. Moreover, the influence of thickness and material parameters on the critical buckling temperature was discussed. The simulation results coincide with the failure modes of friction pairs in practice, and the most common ones are the coning mode and the potato chip mode. The ability to resist thermal buckling deformation can be improved as the thickness increases. In addition, the steel disc with outer edge simply supported is more prone to thermal buckling, because the critical temperature is minimum. The thermal expansion coefficient is the primary factor in thermal buckling study, which is inversely proportional to the critical temperature. These provide a theoretical basis for avoiding thermal failure of friction pairs in a hydro-viscous drive.
Adventurous femininities: The value of adventure for women travelers
Authors: Clarke Jasmine Fay , Previte Josephine , Chien P. Monica
Published: October 2021

Adventure tourism has become a diverse and lucrative industry but is continually portrayed and advertised through its reflection of masculinity. Guided by the lack of studies on women in adventure tourism, the aim of this study is to examine behavioral diversity, the value gained from adventure experience, and the masculinity and femininity of female adventure tourists. A snowball sample of 420 female adventure tourists was collected through utilizing an internet-based survey methodology. Three clusters of women were identified based on their femininity and masculinity scores; Normatively Masculine Adventurers, Androgynous Adventurers, and Normatively Feminine Adventurers. Novel to this study is the validation of an integrated measurement of experiential value and that adventure tourism provides a spectrum of intrinsic and extrinsic value to women participants, most notably emotional value and functional value. Androgynous Adventurers in particular received stronger value experiences. These findings demonstrate that gender-aware tourism can inform and direct how adventure tourism can be advertised and marketed to women.
Seroprevalence of anti-SARS-CoV-2 IgG antibodies, risk factors for infection and associated symptoms in Geneva, Switzerland: a population-based study
Authors: Richard Aude , Wisniak Ania , Perez-Saez Javier , Garrison-Desany Henri , Petrovic Dusan , Piumatti Giovanni , Baysson Hélène , Picazio Attilio , Pennacchio Francesco , De Ridder David , Chappuis François , Vuilleumier Nicolas , Low Nicola , Hurst Samia , Eckerle Isabella , Flahault Antoine , Kaiser Laurent , Azman Andrew S. , Guessous Idris , Stringhini Silvia
Published: October 2021

Aims: To assess SARS-CoV-2 seroprevalence over the first epidemic wave in the canton of Geneva, Switzerland, as well as risk factors for infection and symptoms associated with IgG seropositivity. Methods: Between April and June 2020, former participants of a representative survey of the 20–74-year-old population of canton Geneva were invited to participate in the study, along with household members aged over 5 years. Blood samples were tested for anti-SARS-CoV-2 immunoglobulin G. Questionnaires were self-administered. We estimated seroprevalence with a Bayesian model accounting for test performance and sampling design. Results: We included 8344 participants, with an overall adjusted seroprevalence of 7.8% (95% credible interval 6.8–8.9). Seroprevalence was highest among 18–49 year-olds (9.5%), and lowest in 5–9-year-old children (4.3%) and individuals >65 years (4.7-5.4%). Odds of seropositivity were significantly reduced for female retirees and unemployed men compared to employed individuals, and smokers compared to non-smokers. We found no significant association between occupation, level of education, neighborhood income and the risk of being seropositive. The symptom most strongly associated with seropositivity was anosmia/dysgeusia. Conclusions: Anti-SARS-CoV-2 population seroprevalence remained low after the first wave in Geneva. Socioeconomic factors were not associated with seropositivity in this sample. The elderly, young children and smokers were less frequently seropositive, although it is not clear how biology and behaviours shape these differences.
“My freedom doesn’t care about your fear. My freedom doesn’t care about your feelings”: Postmodern and oppositional organizing in #OpenAmericaNow
Authors: Jarvis Caitlyn M , Eddington Sean M
Published: October 2021

In April 2020, amid the global COVID-19 pandemic, fringe political activists, conspiracy theorists, and far-right subcultures joined together to protest stay at home orders and social distancing decrees. Largely sharing information and organizing strategies on social media, these protestors adopted the Twitter hashtag #OpenAmericaNow to activate and mobilize supporters across the United States. In this study, we examine the online organizing of #OpenAmericaNow through analysis of 17,965 tweets to understand how fringe and conspiracy subcultures organized through oppositional consciousness raising. Our findings reveal multi-level discourses, which bridge identification on the micro-level with anti-elitist and post-truth logics on the macro-level. Theoretically, our study advances theorizing on postmodern organizing and conceptualizes alt-civic engagement, while also engaging in innovative methodological strategies useful for interrogating paradoxical and multi-level discourses.
Mandatory Mental Health Screening for Justice-Involved Youth: A National Priority
Authors: Christian Deneil D.
Published: October 2021

The prevalence of mental health disorders is higher among justice-involved youth than youth in the general population. Despite mental health being a pressing contemporary issue in the juvenile justice system, fewer than half of the states in the United States mandate the use of a mental health screening for youth in the juvenile justice system. The need to utilize a mental health screening tool in all 50 states should be a national priority. The Massachusetts Youth Screening Instrument-Version 2 (MAYSI-2) is the recommended screening tool that should be adopted nationally. Currently, 21 of the 24 states that mandate the use of a screening tool utilize MAYSI-2. Furthermore, it is recognized as having the most empirical evidence as an instrument at the juvenile justice system’s entry and transitional points.
The relationship between workload and adherence to professional codes of ethics among a sample of Iranian nurses
Authors: Dadkhah-Tehrani Mahsa , Adib-Hajbaghery Mohsen
Published: October 2021

Background

Many studies have investigated the adherence to professional codes of ethics by nurses. However, no study has explicitly examined the relationship between workload and adherence to professional codes of ethics among Iranian nurses.

Objective

This study aimed to explore the relationships between workload and adherence to professional codes of ethics among a sample of Iranian nurses.

Materials and Methods

A cross-sectional descriptive study was conducted on 213 nurses who were randomly selected from the different wards of Shahid Beheshti Hospital of Kashan, Iran. Data collection instruments included a personal characteristics questionnaire, the Nursing Ethics Questionnaire, and the National Aeronautics and Space Administration Task Load Index. The Chi-square, the Spearman correlation coefficient, the Kruskal–Wallis, and Mann–Whitney U tests were used to analyze the data.

Results

A majority of nurses were females (77.5%), married (79.3%), and permanently employed (55.4%). The mean of the overall perceived workload and adherence to professional codes of ethics were 76.36 ± 13.64 and 13.98 ± 2.58, that were at high and moderated level, respectively. Spearman correlation test showed no significant correlation between perceived workload and adherence to professional codes of ethics ( r = 0.03, P = 0.6). A significant difference was found between the mean scores of adherence to professional codes of ethics in nurses working in different departments ( P < 0.001).

Conclusion

Participating nurses perceived high levels of workload but their mean adherence to professional codes of ethics was at a moderate level. The perceived workload was indirectly correlated with adherence to professional codes of ethics.
In Love With the Virus: Reducing Harms, Promoting Dignity, and Preventing Hepatitis C Through Graphic Narratives
Authors: Bartoszko Aleksandra
Published: October 2021

This article describes a process of creating an ethnographic comic about injection drug use and hepatitis C, based on long-term ethnographic fieldwork in Norway. The project and the graphic publication titled The Virus were a collaboration between a social anthropologist, a graphic artist, and individuals who inject illegal drugs and are aimed at reducing bodily, social, and narrative harms related to drug use. The article argues that structurally informed interventions, such as this project, which account for the social, economic, and epistemological inequalities, benefit from taking phenomenological perspectives seriously. In our case, that attitude meant including participants’ positive associations with their current or former heroin and injecting drug usage, their stigmatized desires, and their emotions—such as love—related to the disease. The article describes the narrative, conceptual, aesthetic, and practical choices encountered in making The Virus to confront the dominant, authorized narratives in the field of drug use and hepatitis C. We sought to make choices that ultimately would not contribute to the (re)production of the very object of the prevention—stigma related to hepatitis C—but instead would create a new narrative(s) that forged a sense of purpose, recognition, and humanity.
The Datafication of Intimacy: Mobile Dating Apps, Dependency, and Everyday Life
Authors: De Ridder Sander
Published: October 2021

Mobile dating apps are familiar in everyday life. Their data-driven operations offer algorithmically organized archives of people. This paper aims to offer a reflection on the datafication of intimacy, focusing on the social knowledge mobile dating apps produce on the building of close human connections. Drawing on interviews with young adults, I rely on an existential media analysis, exploring struggles with and around mobile dating apps. I argue that the datafication of intimacy is a particular way of experiencing intimacy, going beyond the socio-technological functions of mobile dating apps. I show how the datafication of intimacy is a mathematical mind-set characterized by commercialization and rationalization (predictability, controllability, convenience), building a relationship of interdependency between a data economy and intimacy. I conclude how this interdependency is an emotionally experienced, existential burden for people, it demands reflection on how data-driven technology has become environmental to building close human connections.
Staff and physician protection in neurointervention during the coronavirus disease-2019 pandemic: A summary review and recommendations
Authors: Maingard Julian , Mont’Alverne Francisco J , Chandra Ronil
Published: October 2021

The coronavirus disease-2019 pandemic, caused by the novel severe acute respiratory distress syndrome coronavirus 2, has to date resulted in an estimated global death toll of more than 1.5 million with more than 69 million reported cases worldwide. It has become increasingly clear that delivery of effective neurointerventional clinical care means maintaining an able and safe workforce in a rapidly changing environment. Staff and physician protection has become increasingly topical and relevant within the angiography suite both in peripheral and cardiac intervention and in neurointervention. The following review outlines the types of personal protective equipment relevant to neurointerventional care, summarises society guidelines and makes recommendations for the provision of safe care to both staff and patients.
Glomus tumor of the scapular neck with axillary nerve compression at the shoulder. A case report
Authors: Olmos Manuel Ignacio , Johnston Tyler Robert , Gonzalez Jean-François , Camuzard Olivier , Gauci Marc-Olivier
Published: October 2021

Background

Glomus tumors, also known as benign acral tumors are extremely rare. Previous glomus tumors from other regions of the body have been linked to neurological compression symptoms, however axillary compression at the scapular neck has never been described.

Case presentation

Here, we report a case of axillary nerve compression in a 47-year-old man, secondary to a glomus tumor of the neck of the right scapula, initially misdiagnosed with biceps tenodesis performed and no pain improvement. The magnetic resonance imaging demonstrated a well-contoured, 12 mm tumefaction at the inferior pole of the scapular neck T2-hyperintense and T1-isointense and interpreted as a neuroma. An axillary approach allowed the dissection of the axillary nerve, and the tumor was completely removed. The pathological anatomical analysis resulted in a nodular red lesion measuring 14 × 10 mm, delimited and encapsulated with a definitive diagnostic of glomus tumor. The neurologic symptoms and pain disappeared 3 weeks after surgery and the patient reported satisfaction with the surgical procedure. After 3 months, the results remain stable with a complete resolution of the symptoms.

Conclusions

In cases of unexplained and atypical pain in the axillary area, and to avoid potential misdiagnoses and inappropriate treatments, an in-depth exploration for a compressive tumor should be performed as a differential diagnosis.
Factors influencing the occurrence of electrolyte disorders in cancer patients
Authors: Alem Addis , Edae Chala Kenenisa , Kelta Wabalo Endriyas , Abera Tareke Amare , Ayalew Bedanie Almaz , Reta Wondu , Bariso Moyeta , Bekele Gadisa , Zawdie Belay
Published: October 2021

Objective:

The objective of this study was to determine the magnitude of electrolyte disorders and influencing factors among cancer patients in Southwest Ethiopia.

Methods:

Facility-based cross-sectional study was conducted in Jimma Medical Center (JMC). Eighty-four cancer patients admitted to JMC were recruited for this study. A structured questionnaire and serum electrolyte measurements were used for data collection. Bivariate and multiple logistic regression was employed to determine the association between electrolyte disorders and associated factors among admitted cancer patients. P value ⩽ 0.05 was used as a cut point to declare statistical significance.

Result:

The overall prevalence of electrolyte disorders was 60.7%. The presence or absence of comorbid diseases, age, body mass index (BMI), nutritional status, and current prescribed medication use were associated with electrolyte disorders. Younger patients had lower odds for electrolyte disorders (odds ratio (OR) = 0.128 (P value = 0.05) and OR = 0.08 (P value = 0.033)) for the first and the second quartile, respectively. Underweight patients had a threefold likelihood to develop electrolyte disorders (OR = 3.13 (P value = 0.043)) than having normal BMI. Compared with those in need of nutritional intervention, patients not in need of nutritional intervention had lower odds for the disorders (OR = 0.109 (P value = 0.006)). Medication had increased the likelihood of electrolyte disorders by 5.5 times than with no medication (P value = 0.023). Those who had comorbid disease had 10 times likely to develop electrolyte disorders than those who did not have comorbid diseases (P value = 0.004).

Conclusion:

Electrolyte disorders were prevalent in cancer patients. Age, BMI, nutritional condition, comorbid disease, and prescribed drugs were the predictors of electrolyte disorders in cancer patients. Authors recommend routine screening of electrolyte disorders in cancer patients and special emphasis on controlling and managing risk factors.
Long-term Efficacy of Perampanel in a Child with Dravet Syndrome
Authors: Turón-Viñas Eulàlia , Díaz-Gómez Asunción , Coca Elisabet , Dougherty Lucía , Ruiz Carlos , Boronat Susana
Published: October 2021

Dravet syndrome is a genetic developmental and epileptic encephalopathy (DEE) mostly due to mutations in SCN1A gene. Perampanel is a selective and non-competitive alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor antagonist. There is increasing experience in the use of perampanel in this syndrome; however, there is still a lack of evidence of sustained benefit years after the beginning of the treatment.

We report a twelve-year-old girl who was diagnosed with Dravet Syndrome when she was 2 years old and has been on perampanel since she was 7. Her genetic test showed a de novo previously described heterozygous SCN1A mutation in the 24th exon (c.4547C>A, p.Ser1516*). She received previous antiseizure drug combinations with little benefit. When perampanel was started, there was a complete resolution of her spontaneous seizures that has continued five years later. More studies are needed to investigate if there is an association between this excellent response and the genotype of our patient.
Effectiveness of the BNT162b2mRNA COVID-19 vaccine in patients with hematological neoplasms in a nationwide mass vaccination setting
Authors: Mittelman Moshe , Magen Ori , Barda Noam , Dagan Noa , Oster Howard S. , Leader Avi , Balicer Ran
Published: October 2021

Evidence regarding the effectiveness of COVID-19 vaccine in patients with impaired immunity is limited. Initial observations suggest a lower humoral response in these patients. We evaluated the relative effectiveness of the mRNA BNT162b2 vaccine in patients with hematological neoplasms compared with matched controls. Data on patients with hematological neoplasms after 2 vaccine doses were extracted and matched 1:1 with vaccinated controls. Subpopulation analyses focused on patients receiving therapy for hematological neoplasm, patients without treatment who were only followed, and recipients of specific treatments. The analysis focused on COVID-19 outcomes from days 7 through 43 after the second vaccine dose in these areas: documented COVID-19 infection by polymerase chain reaction; symptomatic infection; hospitalizations; severe COVID-19 disease; and COVID-19–related death. In a population of 4.7 million insured people, 32 516 patients with hematological neoplasms were identified, of whom 5017 were receiving therapy for an active disease. Vaccinated patients with hematological neoplasms, compared with vaccinated matched controls, had an increased risk of documented infections (relative risk [RR] 1.60, 95% CI 1.12-2.37); symptomatic COVID-19 (RR 1.72, 95% CI 1.05-2.85); COVID-19–related hospitalizations (RR 3.13, 95% CI 1.68-7.08); severe COVID-19 (RR 2.27, 95% CI 1.18-5.19); and COVID-19–related death (RR 1.66, 95% CI 0.72-4.47). Limiting the analysis to patients on hematological treatments showed a higher increased risk. This analysis shows that vaccinated patients with hematological neoplasms, in particular patients receiving treatment, suffer from COVID-19 outcomes more than vaccinated individuals with intact immune system. Ways to enhance COVID-19 immunity in this patient population, such as additional doses, should be explored.
Deregulation of circ_003912 contributes to pathogenesis of erosive oral lichen planus by via sponging microRNA-123, -647 and -31 and upregulating FOXP3
Authors: Huang Zhen , Liu Fen , Wang Wenjuan , Ouyang Shaobo , Sang Ting , Huang Zikun , Liao Lan , Wu Jun
Published: October 2021

Background

The FOXP3/miR-146a/NF-κB axis was previously reported to modulate the induction and function of CD4+ Treg cells to alleviate oral lichen planus. Also, other signaling pathways including microRNA-155-IFN-γ loop and FOXP3/miR-146a/TRAF6 pathways were reported to be involved in the pathogenesis of oral lichen planus. In this study, we aimed to investigate the molecular mechanism underlying the pathogenesis of EOLP.

Method

CircRNA microarray was used to observe the expression of candidate circRNAs in CD4+ T-cells collected from different groups. Real-time PCR and Western blot were conducted to observe the changes in the expression of different miRNAs, mRNAs and proteins. Flow cytometry was performed to compare the counts of Treg cells in the HC and EOLP groups, and ELISA was performed to evaluate the changes in the expression of inflammatory cytokines.

Result

No obvious differences were seen between the HC and EOLP groups in terms of age and gender. Among all candidate circRNAs, the expression of circ_003912 was most dramatically elevated in CD4+ T-cells collected from the EOLP group. The levels of miR-1231, miR-31, miR-647, FOXP3 mRNA and miR-146a were decreased while the expression of TRAF6 mRNA was increased in CD4+ T-cells collected from the EOLP group. The count of Treg cells in the EOLP group was dramatically increased. The levels of inflammatory cytokines including IL-4 IFN-γ, IL-10 and IL-2 were influenced by the presence of circ_003912. In CD4+ T-cells in the EOLP group, the levels of IL-4 and IL-10 were decreased while the levels of IFN-γ and IL-2 were increased. The presence of miR-1231, miR-31 and miR-647 all obviously inhibited the expression of circ_003912, which was validated to sponge the expression of above miRNAs. Also, FOXP3 mRNA was proved to be targeted by miR-1231, miR-31 and miR-647. Transfection of circ_003912 up-regulated the expression of circ_003912, miR-146a and FOXP3 mRNA/protein while down-regulating the expression of miR-1231, miR-31, miR-647, and TRAF6 mRNA/protein. The levels of inflammatory cytokines including IL-4 IFN-γ, IL-10 and IL-2 as well as the speed of cell proliferation were influenced by circ_003912.

Conclusion

In this study, we investigated the molecular mechanisms underlying the pathogenesis of EOLP which involved the functioning of circ_003912. We first demonstrated that circ_003912 was up-regulated in CD4+ T-cells of the EOLP group. And miRNAs including miR-1231, miR-31 and miR-647 were sponged by circ_003912 and down-regulated in CD4+ T cells of the EOLP group, which subsequently up-regulated the expression of FOXP3 and miR-146a, and resulted in the inhibition of NF-kB.
All-Dielectric Phase-Gradient Metasurface Performing High-Efficiency Anomalous Transmission in the Near-Infrared Region
Authors: Wu Tiesheng , Liu Zhihui , Wang Yiping , Zhang Huixian , Yang Zuning , Cao Weiping , Yang Dan
Published: October 2021

We propose and numerically demonstrate a phase-gradient metasurface with high anomalous transmission efficiency and a large anomalous refraction angle that consists of discontinuous regular hexagonal nanorods supported by a silica substrate. The metasurface achieves high anomalous transmission efficiency and a full 2$$\pi$$
π
phase shift for the wavelength range of 1400–1600 nm. At a central wavelength of approximately 1529 nm, the total transmission efficiency reaches 96.5%, and the desired anomalous transmission efficiency reaches 96.2%, with an anomalous refraction angle as large as 30.64. With the adjustment of the period and the number of nanorods per periodic interval, the anomalous transmission efficiency exceeds 69.6% for a large anomalous refraction angle of 68.58. The superior performance of the proposed design may pave the way for its application in optical wavefront control devices.
Light control of catechin accumulation is mediated by photosynthetic capacity in tea plant (Camellia sinensis)
Authors: Xiang Ping , Zhu Qiufang , Tukhvatshin Marat , Cheng Bosi , Tan Meng , Liu Jianghong , Wang Xingjian , Huang Jiaxin , Gao Shuilian , Lin Dongyi , Zhang Yue , Wu Liangyu , Lin Jinke
Published: October 2021

Background

Catechins are crucial in determining the flavour and health benefits of tea, but it remains unclear that how the light intensity regulates catechins biosynthesis. Therefore, we cultivated tea plants in a phytotron to elucidate the response mechanism of catechins biosynthesis to light intensity changes.

Results

In the 250 μmol·m− 2·s− 1 treatment, the contents of epigallocatechin, epigallocatechin gallate and total catechins were increased by 98.94, 14.5 and 13.0% respectively, compared with those in the 550 μmol·m− 2·s− 1 treatment. Meanwhile, the photosynthetic capacity was enhanced in the 250 μmol·m− 2·s− 1 treatment, including the electron transport rate, net photosynthetic rate, transpiration rate and expression of related genes (such as CspsbA, CspsbB, CspsbC, CspsbD, CsPsbR and CsGLK1). In contrast, the extremely low or high light intensity decreased the catechins accumulation and photosynthetic capacity of the tea plants.

The comprehensive analysis revealed that the response of catechins biosynthesis to the light intensity was mediated by the photosynthetic capacity of the tea plants. Appropriately high light upregulated the expression of genes related to photosynthetic capacity to improve the net photosynthetic rate (Pn), transpiration rate (Tr), and electron transfer rate (ETR), which enhanced the contents of substrates for non-esterified catechins biosynthesis (such as EGC). Meanwhile, these photosynthetic capacity-related genes and gallic acid (GA) biosynthesis-related genes (CsaroB, CsaroDE1, CsaroDE2 and CsaroDE3) co-regulated the response of GA accumulation to light intensity. Eventually, the epigallocatechin gallate content was enhanced by the increased contents of its precursors (EGC and GA) and the upregulation of the CsSCPL gene.

Conclusions

In this study, the catechin content and photosynthetic capacity of tea plants increased under appropriately high light intensities (250 μmol·m− 2·s− 1 and 350 μmol·m− 2·s− 1) but decreased under extremely low or high light intensities (150 μmol·m− 2·s− 1 or 550 μmol·m− 2·s− 1). We found that the control of catechin accumulation by light intensity in tea plants is mediated by the plant photosynthetic capacity. The research provided useful information for improving catechins content and its light-intensity regulation mechanism in tea plant.
Association of atrial arrhythmias with thrombospondin-1 in patients with acute myocardial infarction
Authors: Liao Wenkai , Xu Li , Pan Yuxia , Wei Jie , Wang Peijia , Yang Xinchun , Chen Mulei , Gao Yuanfeng
Published: October 2021

Objectives

Atrial remodeling is the main developmental cause of atrial arrhythmias (AA), which may induce atrial fibrillation, atrial flutter, atrial tachycardia, and frequent premature atrial beats in acute myocardial infarction (AMI) patients. Thrombospondin-1 (TSP-1) has been shown to play an important role in inflammatory and fibrotic processes, but its role in atrial arrhythmias is not well described. The purpose of this study was to investigate the role of TSP-1 in AMI patients with atrial arrhythmias.

Methods

A total of 219 patients with AMI who underwent percutaneous coronary intervention and with no previous arrhythmias were included. TSP-1 were analyzed in plasma samples. Patients were classified into 2 groups, namely, with and without AA during the acute phase of MI. Continuous electrocardiographic monitoring was used for AA diagnosis in hospital.

Results

Twenty-four patients developed AA. Patients with AA had higher TSP-1 levels (29.01 ± 25.87 μg/mL vs 18.36 ± 10.89 μg/mL, p < 0.001) than those without AA. AA patients also tended to be elderly (65.25 ± 9.98 years vs 57.47 ± 10.78 years, p < 0.001), had higher Hs-CRP (39.74 ± 43.50 mg/L vs 12.22 ± 19.25 mg/L, p < 0.001) and worse heart function. TSP-1 (OR 1.033; 95% CI 1.003–1.065, p = 0.034), Hs-CRP (OR 1.023; 95% CI 1.006–1.041, p = 0.008), age (OR 1.067; 95% CI 1.004–1.135, p = 0.038) and LVDd (OR 1.142; 95% CI 1.018–1.282, p = 0.024) emerged as independent risk factors for AA in AMI patients.

Conclusion

TSP-1 is a potential novel indicator of atrial arrhythmias during AMI.

Graphical abstract
Cytokeratin 18 can help predict liver fibrosis in HCV infected patients with type 2 diabetes mellitus
Authors: Li Fang , Lei Feifei , Wen Chengcai , Ge Qiu , Zhu Liyao
Published: October 2021

Background

To investigate the predictive values of cytokeratin 18 for liver fibrosis in hepatitis C virus (HCV) infected patients with type 2 diabetes mellitus (T2DM).

Methods

252 HCV-infected patients with T2DM between January 2012 and August 2017 were retrospectively reviewed. Pearson/spearman correlation analysis was used to detect the correlation in the entire cohort. Multivariate linear regression was used to identify independent predictors and logistic regression was for establishing models. Combination models that incorporated CK18 and other methods (i.e. transient elastography, aspartate transaminase-to-platelet ratio index (APRI) and fibrosis-4 index (FIB-4)] were developed in a training cohort of 132 patients. Performance of models was evaluated through discrimination ability and clinical benefits. An internal validation was conducted in 120 consecutive patients.

Results

CK18 was found significantly associated with fibrosis scores (r = 0.452, P < .001). CK18 and albumin were confirmed as independent predictors for fibrosis. For predicting significant fibrosis in the validation cohort, the observed AUC values of APRI + CK18 (AUC 0.83) and FIB-4 + CK18 (AUC 0.84) were higher than those of APRI (AUC 0.61) and FIB-4 (AUC 0.65). For predicting advanced fibrosis and cirrhosis, the AUC values of FIB-4 + CK18 (AUC 0.74 and 0.77, respectively) were significantly higher than those of FIB-4 (AUC 0.61 of both). Decision curve analysis confirmed the more clinical benefits can be provided by being combined with CK18.

Conclusions

CK18 is an independent predictor of liver fibrosis for HCV-infected patients with T2DM. Noninvasive methods incorporate CK18 and other biomarker indices can have better performance for diagnosing fibrosis and help clinical decision-making.
Access to primary care and cognitive impairment: results from a national community study of aging Americans
Authors: Mullins Megan A. , Bynum Julie P. W. , Judd Suzanne E. , Clarke Philippa J.
Published: October 2021

Background

Despite a growing burden of Alzheimer’s Disease and related dementias (ADRD) in the US, the relationship between health care and cognitive impairment prevention is unclear. Primary care manages risk causing conditions and risk reducing behaviors for dementia, so we examine the association between individual and area-level access to primary care and cognitive impairment in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study.

Methods

REGARDS participants with a cognitive assessment and vascular measurements at their baseline visit were included in this cross-sectional analysis. Cognitive impairment was defined as a Six-Item Screener (SIS) score < 5. Primary care supply, primary care utilization and emergency department (ED) utilization were measured at the primary care service area (PCSA) level based on participant’s address. Individual access to care was self-reported. Models were adjusted for confounding by demographics, socioeconomic status and behavioral risk factors.

Results

Among 25,563 adults, living in a PCSA with low primary care supply was associated with 25% higher odds of cognitive impairment (OR 1.25 CI 1.07-1.45). Not having a regular source of medical care was associated with 14% higher odds of cognitive impairment (OR 1.14 CI 1.02-1.28), and living in a PCSA with high emergency department utilization was associated with 12% higher odds of cognitive impairment (OR 1.12 CI 1.02-1.23).

Conclusions

Our results are an important first step in understanding how health care may prevent cognitive impairment. They highlight the importance of primary care and suggest future work clarifying its role in preventing cognitive decline is imperative.
De-labelling penicillin allergy in acutely hospitalized patients: a pilot study
Authors: Steenvoorden Linde , Bjoernestad Erik Oeglaend , Kvesetmoen Thor-Agne , Gulsvik Anne Kristine
Published: October 2021

Background

Penicillin allergy prevalence is internationally reported to be around 10%. However, the majority of patients who report a penicillin allergy do not have a clinically significant hypersensitivity. Few patients undergo evaluation, which leads to overuse of broad-spectrum antibiotics. The objective of this study was to monitor prevalence and implement screening and testing of hospitalized patients.

Methods

All patients admitted to the medical department in a local hospital in Oslo, Norway, with a self-reported penicillin allergy were screened using an interview algorithm to categorize the reported allergy as high-risk or low-risk. Patients with a history of low-risk allergy underwent a direct graded oral amoxicillin challenge to verify absence of a true IgE-type allergy.

Results

257 of 5529 inpatients (4.6%) reported a penicillin allergy. 191 (74%) of these patients underwent screening, of which 86 (45%) had an allergy categorized as low-risk. 54 (63%) of the low-risk patients consented to an oral test. 98% of these did not have an immediate reaction to the amoxicillin challenge, and their penicillin allergy label could thus be removed. 42% of the patients under treatment with antibiotics during inclusion could switch to treatment with penicillins immediately after testing, in line with the national recommendations for antibiotic use.

Conclusions

The prevalence of self-reported penicillin allergy was lower in this Norwegian population, than reported in other studies. Screening and testing of hospitalized patients with self-reported penicillin allergy is a feasible and easy measure to de-label a large proportion of patients, resulting in immediate clinical and environmental benefit. Our findings suggest that non-allergist physicians can safely undertake clinically impactful allergy evaluations.
Primary gross tumor volume is prognostic and suggests treatment in upper esophageal cancer
Authors: Chen Yuanmei , Huang Qiuyuan , Chen Junqiang , Lin Yu , Huang Xinyi , Wang Qifeng , Yang Yong , Chen Bijuan , Ye Yuling , Zheng Binglin , Qi Rong , Chen Yushan , Xu Yuanji
Published: October 2021

Background

To aid clinicians strategizing treatment for upper esophageal squamous cell carcinoma (ESCC), this retrospective study investigated associations between primary gross tumor volume (GTVp) and prognosis in patients given surgical resection, radiotherapy, or both resection and radiotherapy.

Methods

The population comprised 568 patients with upper ESCC given definitive treatment, including 238, 216, and 114 who underwent surgery, radiotherapy, or combined radiotherapy and surgery. GTVp as a continuous variable was entered into the multivariate Cox model using penalized splines (P-splines) to determine the optimal cutoff value. Propensity score matching (PSM) was used to adjust imbalanced characteristics among the treatment groups.

Results

P-spline regression revealed a dependence of patient outcomes on GTVp, with 30 cm3 being an optimal cut-off for differences in overall and progression-free survival (OS, PFS). GTVp ≥30 cm3 was a negative independent prognostic factor for OS and PFS. PSM analyses confirmed the prognostic value of GTVp. For GTVp < 30 cm3, no significant survival differences were observed among the 3 treatments. For GTVp ≥30 cm3, the worst 5-year OS rate was experienced by those given surgery. The 5-year PFS rate of patients given combined radiotherapy and surgery was significantly better than that of patients given radiotherapy. The surgical complications of patients given the combined treatment were comparable to those who received surgery, but radiation side effects were significantly lower.

Conclusion

GTVp is prognostic for OS and PFS in upper ESCC. For patients with GTVp ≥30 cm3, radiotherapy plus surgery was more effective than either treatment alone.
Screening for post-traumatic stress disorder among adolescents following floods- a comparative study from private and public schools in Kerala, India
Authors: Mathew Geethu , Varghese Aby Dany , Sabu Ans Mary , Joseph Aleena
Published: October 2021

Introduction

Disasters can have deep physical and psychological impact among survivors. An extraordinary southwest monsoon has unleashed floods and landslides in Kerala state in 2018. Adolescents are more vulnerable to psychological impairment after a disaster and trauma during initial stages of life can etch an indelible signature in the individual’s development and may lead to future disorders.

Objectives

1. To screen for PTSD and associated factors among adolescents 8 months post floods in selected schools in flood-affected areas of Alleppey district of Kerala 2. To compare the proportion of adolescents screened positive for PTSD in public and private schools.

Methodology

A 3-month, Cross-sectional study was done among 670 adolescents in private and public schools using stratified sampling in Alleppey district. The study tool included a structured questionnaire that collected information on sociodemographics, flood-related variables, Trauma screening questionnaire and academic performance.

Results

The mean age of the participants was 16.03 ± 0.73 years with almost equal gender distribution. One-third of students reported flood-related damage to house/property, and a few lost their pets. Nearly 50% of the students reported that they still re-experience and get upsetting memories about flood events. The prevalence of probable PTSD noted to be 34.9%. We observed that 31% of students in public school screened positive for PTSD compared to 38.8% of private school students. (odds ratio = 1.409, CI 1.024–1.938). Male gender (Odds ratio = 1.503, CI 1.093–2.069), higher age (Odds ratio = 1.701, CI 1.120–2.585), damage during floods (Odds ratio = 2.566, CI 1.814–3.630), presence of morbidity (Odds ratio = 3.568, CI 1.888–6.743), camp stay (Odds ratio = 3.788, CI 2.364–6.067) and loss of pets (Odds ratio = 3.932, CI 2.019–7.657) were the factors significantly associated with PTSD. We noted a deterioration in academic performance in 45.9% of students who screened positive for PTSD.

Conclusion and recommendations

High prevalence of stress disorder highlights the need for early identification and intervention for PTSD and including trained counsellors as a part of the disaster management team in future.