bluuebunny/crossref_metadata_2025 huggingface dataset:
Solving Crime for America's “Others”: Crime Clearance and Asian American Victims
Authors: Roberts Aki
Published: September 2023

Based on the theoretical notion that racial hierarchy influences inequality in criminal justice outcomes, previous crime clearance studies have included victims’ race as a salient predictor of clearance. However, Asian American victims are seldom studied, often dropped from the analysis or combined as “other” with smaller racial groups. The unique and dialectical position of Asian Americans in the U.S. racial stratification system, simultaneously considered as “honorary White” and stigmatized as “perpetual foreigner” and “yellow peril,” should attract more research interest in the area of racial inequality in criminal justice outcomes. Using National Incident-Based Reporting System (NIBRS) data, the current study examines racial/ethnic differences in crime clearance by arrest, with special attention given to Asian victims in comparison to White, Black, Hispanic, and Native American victims. The survival analysis found no statistically significant difference in crime clearance between White and Asian victims, with their clearance likelihood higher than for victims from other minority groups. The current analysis also found that the use of a simpler White/non-White dichotomy or placement of Asians in a broad “other” category risks obscuring important differences in crime clearance between Asians and other minority groups.
Exploring the Renewable Energy Linkages for SSEBased Organizations in India: Benefits of Scaling Up ‘Atmanirbhar Bharat’ at Microsocieties
Authors: Nag Tirthankar , Ganguly Boudhayan
Published: September 2023

The Indian government initiated the Atmanirbhar Bharat Abhiyan to make its citizens ‘atmanirbhar’, or self-reliant. We argue that self-reliance can be achieved through self-sufficiency at the societal level. Next, we review the extant literature on self-sufficiency and theorize its linkages with social and solidarity economy (SSE) in the context of electric power generation. The participatory and democratic nature of governance in decision-making processes is one of the main principles of the SSE sector. Variations in democratic governance and inclusive participation in SSE depend on SSE structure. Subsequently, we move into the focus areas of the article, where the purpose is to explore the linkages between the development of SSE initiatives and sustainable development goals focused on environmental protection and sustainable production and consumption. Scaling up and solarizing agricultural pump sets have been good initiatives at addressing issues around agriculture, water and electricity requirement. This study explores SSE initiatives that address these issues and explores scaling up and linking with institutions and policies at the macro level. The study presents empirical evidence of such initiatives in the renewable energy sector. This article is expected to contribute to the existing literature on SSEs and offer insights on how scaling up SSEs can help in sustainable rural development, which would lead to self-sufficiency and subsequently self-reliance at a societal level.

JEL Classifications: D71, Q20, P48
The Impact of Transformational Leadership Style on Nurses’ Job Satisfaction: An Integrative Review
Authors: Gebreheat Gdiom , Teame Hirut , Costa Emilia I
Published: September 2023

Introduction

The argument about whether leadership style affects nurses’ job satisfaction is centered around the impact of different leadership styles on the work environment and the quality of care provided by nurses. Therefore, this review was primarily aimed at assessing the impact of transformational leadership style on the job satisfaction of hospital nurses.

Methods

This is an integrative review conducted according to the Whittemore and Knafl's framework. Comprehensive literature searches were conducted in PubMed, MEDLINE, CINAHL, Web of Science, Research4Life, and APA PsychInfo. In addition, studies were included through hand-searching from different sources of grey literature and a reference list of identified articles. All English articles published between 2012 and 2023 reporting the impact of transformational leadership style on nurses’ job satisfaction were eligible for inclusion.

Results

Seventeen articles were included in the review, of which 16 were cross-sectional studies, while one was mixed. The majority ( n = 12) of the studies were conducted in at least two or more healthcare settings, with a total of 5841 nurses. Almost all ( n = 16) articles reported the positive influence of transformational leadership on nurses’ job satisfaction. In addition, the transformational leadership style was reported to have a positive impact on nurses’ intentions to stay at work, quality care, and patient outcomes.

Conclusion

By adopting a transformational leadership approach within clinical environments, there is a potential to boost nurses’ job satisfaction.
How I treat von Willebrand disorders in older adults
Authors: Poston Jacqueline N. , Kruse-Jarres Rebecca
Published: September 2023

von Willebrand disease (VWD) is the most common bleeding disorder and especially milder type 1 VWD might not be cared for in specialty clinics. VW factor levels rise with age, but the rise of these levels does not necessarily correlate with bleeding risk. A recent bleeding history combined with recent labs are important for hemostatic management decision during surgical interventions. Antifibrinolytics appear safe in the population of older adults, whereas desmopressin (DDAVP) should be used cautiously. Where needed, factor concentrates present a great treatment option. Acquired von Willebrand syndrome is vastly underrecognized, but likely to surface in the aging, especially in the setting of comorbidities, such as plasma-cell dyscrasias. Intravenous immunoglobulin can be an effective treatment in this scenario, but potentially increases thrombotic risk.
Elevated CDKN1A (P21) mediates β-thalassemia erythroid apoptosis, but its loss does not improve β-thalassemic erythropoiesis
Authors: Liang Raymond , Lin Miao , Menon Vijay , Qiu Jiajing , Menon Anagha , Breda Laura , Arif Tasleem , Rivella Stefano , Ghaffari Saghi
Published: September 2023

β-thalassemias are common hemoglobinopathies due to mutations in the β-globin gene that lead to hemolytic anemias. Premature death of β-thalassemic erythroid precursors results in ineffective erythroid maturation, increased production of erythropoietin (EPO), expansion of erythroid progenitor compartment, extramedullary erythropoiesis, and splenomegaly. However, the molecular mechanism of erythroid apoptosis in β-thalassemia is not well understood. Using a mouse model of β-thalassemia (Hbbth3/+), we show that dysregulated expression of the FOXO3 transcription factor is implicated in β-thalassemia erythroid apoptosis. In Foxo3−/−/Hbbth3/+ mice, erythroid apoptosis is significantly reduced, whereas erythroid cell maturation, and red blood cell and hemoglobin production are substantially improved even with elevated reactive oxygen species in double-mutant erythroblasts. However, persistence of elevated reticulocytes and splenomegaly suggests that ineffective erythropoiesis is not resolved in Foxo3−/−/Hbbth3/+. We found the cell cycle inhibitor Cdkn1a (cyclin-dependent kinase inhibitor p21), a FOXO3 target gene, is markedly upregulated in both mouse and patient–derived β-thalassemic erythroid precursors. Double-mutant p21/Hbbth3/+ mice exhibited embryonic lethality with only a fraction of mice surviving to weaning. Notably, studies in adult mice displayed greatly reduced apoptosis and circulating Epo in erythroid compartments of surviving p21−/−/Hbbth3/+ mice relative to Hbbth3/+ mice, whereas ineffective erythroid cell maturation, extramedullary erythropoiesis, and splenomegaly were not modified. These combined results suggest that mechanisms that control β-thalassemic erythroid cell survival and differentiation are uncoupled from ineffective erythropoiesis and involve a molecular network including FOXO3 and P21. Overall, these studies provide a new framework for investigating ineffective erythropoiesis in β-thalassemia.
Nonrelapse mortality after CAR T-cell therapy for large B-cell lymphoma: a LYSA study from the DESCAR-T registry
Authors: Lemoine Jean , Bachy Emmanuel , Cartron Guillaume , Beauvais David , Gastinne Thomas , Di Blasi Roberta , Rubio Marie-Thérèse , Guidez Stéphanie , Mohty Mohamad , Casasnovas Rene-Olivier , Joris Magalie , Castilla-Llorente Cristina , Haioun Corinne , Hermine Olivier , Loschi Michael , Carras Sylvain , Bories Pierre , Fradon Tom , Herbaux Charles , Sesques Pierre , Le Gouill Steven , Morschhauser Franck , Thieblemont Catherine , Houot Roch
Published: September 2023

CD19 chimeric antigen receptor (CAR) T cells can induce prolonged remissions and potentially cure a significant proportion of patients with relapsed/refractory large B-cell lymphomas. However, some patients may die of causes unrelated to lymphoma after CAR T-cell therapy. To date, little is known about the nonrelapse mortality (NRM) after CAR T-cell therapy. Using the French DESCAR-T registry, we analyzed the incidence and causes of NRM and identified risk factors of NRM. We report on 957 patients who received standard-of-care axicabtagene ciloleucel (n = 598) or tisagenlecleucel (n = 359) between July 2018 and April 2022, in 27 French centers. With a median follow-up of 12.4 months, overall NRM occurred in 48 patients (5.0% of all patients): early (before day 28 after infusion) in 9 patients (0.9% of all patients and 19% of overall NRM), and late (on/after day 28 after infusion) in 39 patients (4.1% of all patients and 81% of overall NRM). Causes of overall NRM were distributed as follows: 56% infections (29% with non–COVID-19 and 27% with COVID-19), 10% cytokine release syndromes, 6% stroke, 6% cerebral hemorrhage, 6% second malignancies, 4% immune effector cell associated neurotoxicities, and 10% deaths from other causes. We report risk factors of early NRM and overall NRM. In multivariate analysis, both diabetes and elevated ferritin level at lymphodepletion were associated with an increased risk of overall NRM. Our results may help physicians in patient selection and management in order to reduce the NRM after CAR T-cell therapy.
Evaluation of an emergency medicine point-of-care ultrasound curriculum adapted for a resource-limited setting in Guyana
Authors: Jhagru Rayal , Singh Rajiv , Rupp Jordan
Published: September 2023

Background

This is a cohort pilot study of senior emergency medicine residents and residency-trained emergency medicine registrars practicing in an urban tertiary academic hospital in Guyana in South America. The primary aim was to assess the effectiveness of the current adapted residency ultrasound training curriculum and guide future ultrasound-specific continuing medical education. Ultrasound image acquisition, interpretation, and integration of ultrasound findings into clinical medical decision-making competency were assessed in a multimodal fashion: a written assessment and a practical assessment.

Methods

This was a cross-sectional cohort pilot study of senior emergency medicine residents and registrars (residency graduates) practicing in Guyana, a low-middle-income country. Ultrasound image acquisition and interpretation competency were assessed in a multimodal fashion: a written assessment and a practical assessment. The results will be reported as simple percentages. Participants will be deemed competent if the combined score is greater than 80% on the assessment.

Results

All senior residents and graduates of the residency program were competent in the core point-of-care ultrasound applications. The senior residents averaged 89% proficiency, and the residency graduates subdivided based on years since graduation averaged 87–100% proficiency. The more experienced providers performed better on the practical portion of the evaluation. Evaluating the composite analysis of all the participants revealed the Extended Focused Assessment with Sonography in Trauma (EFAST) exam (96%) and cardiac exam (93%) were done with the most proficiency.

Conclusion

The assessment results of this pilot study suggest that the current residency ultrasound training curriculum adapted to the resources available is associated with sustained competency after graduation. There was minor attrition of knowledge amongst the senior physicians, but all senior residents and all participating residency graduates were competent in the core ultrasound applications.
Aquaculture ecosystem microbiome at the water-fish interface: the case-study of rainbow trout fed with Tenebrio molitor novel diets
Authors: Bruno Antonia , Sandionigi Anna , Panio Antonella , Rimoldi Simona , Orizio Flavio , Agostinetto Giulia , Hasan Imam , Gasco Laura , Terova Genciana , Labra Massimo
Published: September 2023

Background

Sustainable aquaculture relies on multiple factors, including water quality, fish diets, and farmed fish. Replacing fishmeal (FM) with alternative protein sources is key for improving sustainability in aquaculture and promoting fish health. Indeed, great research efforts have been made to evaluate novel feed formulations, focusing especially on the effects on the fish gut microbiome. Few studies have explored host-environment interactions. In the present study, we evaluated the influence of novel insect-based (Tenebrio molitor) fish diets on the microbiome at the water-fish interface in an engineered rainbow trout (Oncorhynchus mykiss) farming ecosystem. Using 16S rRNA gene metabarcoding, we comprehensively analyzed the microbiomes of water, tank biofilm, fish intestinal mucus, fish cutis, and feed samples.

Results

Core microbiome analysis revealed the presence of a highly reduced core shared by all sample sources, constituted byAeromonasspp., in both the control and novel feed test groups. Network analysis showed that samples were clustered based on the sample source, with no significant differences related to the feed formulation tested. Thus, the different diets did not seem to affect the environment (water and tank biofilm) and fish (cutis and intestinal mucus) microbiomes. To disentangle the contribution of feed at a finer scale, we performed a differential abundance analysis and observed differential enrichment/impoverishment in specific taxa, comparing the samples belonging to the control diet group and the insect-based diet group.

Conclusions

Omic exploration of the water-fish interface exposes patterns that are otherwise undetected. These data demonstrate a link between the environment and fish and show that subtle but significant differences are caused by feed composition. Thus, the research presented here is a step towards positively influencing the aquaculture environment and its microbiome.
Towards carotenoid biofortification in wheat: identification of XAT-7A1, a multicopy tandem gene responsible for carotenoid esterification in durum wheat
Authors: Rodríguez-Suárez C , Requena-Ramírez MD , Hornero-Méndez D , Atienza SG
Published: September 2023

Yellow pigment content, mainly due to the accumulation of carotenoids, is a quality trait in durum wheat grain as it confers the bright yellow color to pasta preferred by consumers. Also, carotenoids are essential nutrients exerting important biological functions in human health. Consequently, biofortification strategies have been developed in many crops to increase carotenoid content. In this context, carotenoid esterification is emerging as a new breeding target for wheat biofortification, as carotenoid esters have been found to promote both carotenoid accumulation and stability. Until recently, no carotenoid esters have been identified in significant proportions in durum wheat grains, and interspecific breeding programs have been started to transfer esterification ability from common wheat and Hordeum chilense.

In this work, XAT-7A1 is identified as the gene responsible for carotenoid esterification in durum wheat. Sequencing, copy number variation and mapping results show that XAT-7A1 is organized as tandem or proximal GDSL esterase/lipase copies in chromosome 7A. Three XAT-7A1 haplotypes are described: Type 1 copies, associated with high levels of carotenoid esters (diesters and monoesters) production and high expression in grain development; Type 2 copies, present in landraces with low levels of carotenoid esters (monoesters) or no esters; and Type 3 copies, without the signal peptide, resulting in zero-ester phenotypes.

The identification of XAT-7A1 is a necessary step to make the carotenoid esterification ability available for durum and bread wheat breeding, which should be focused on the Type 1 XAT-7A1 haplotype, which may be assessed as a single gene since XAT-7A1 copies are inherited together.
Police as first reponders improve out-of-hospital cardiac arrest survival
Authors: Jean Louis Clint , Cildoz Marta , Echarri Alfredo , Beaumont Carlos , Mallor Fermin , Greif Robert , Baigorri Miguel , Reyero Diego
Published: September 2023

Background

Police forces are abundant circulating and might arrive before the emergency services to Out-of-Hospital-Cardiac-Arrest victims. If properly trained, they can provide basic life support and early defibrillation within minutes, probably increasing the survival of the victims. We evaluated the impact of local police as first responders on the survival rates of out-of-hospital cardiac arrest victims in Navarra, Spain, over 7 years.

Methods

A retrospective analysis of an ongoing Out-of-Hospital Cardiac registry to compare the characteristics and survival of Out-of-Hospital-Cardiac-Arrest victims attended to in first place by local police, other first responders, and emergency ambulance services between 2014 and 2020.

Results

Of 628 cases, 73.7% were men (aged 68.9 ± 15.8), and 26.3% were women (aged 65,0 ± 14,7 years, p < 0.01). Overall survival of patients attended to by police in the first place was 17.8%, other first responders 17.4% and emergency services 13.5% with no significant differences (p > 0.1). Time to initiating cardiopulmonary resuscitation is significant for survival. When police arrived first and started CPR before the emergency services, they arrived at a mean of 5.4 ± 3 min earlier (SD = 3.10). This early police intervention showed an increase in the probability of survival by 10.1%.

Conclusions

The privileged location and the sole amount of personnel of local police forces trained in life support and their fast delivery of defibrillators as first responders can improve the survival of out-of-hospital cardiac arrest victims.
Prevalence of vomiting and nausea and associated factors after chronic and acute gluten exposure in celiac disease
Authors: Ahonen Iida , Laurikka Pilvi , Koskimaa Sara , Huhtala Heini , Lindfors Katri , Kaukinen Katri , Kurppa Kalle , Kivelä Laura
Published: September 2023

Background

Vomiting and nausea seem to be relatively specific symptoms related to gluten ingestion in treated celiac disease. However, the overall prevalence and associated factors of these symptoms after chronic gluten exposure at celiac disease diagnosis and acute re-exposure during gluten challenge remain obscure.

Methods

Medical data on 815 adult celiac disease patients were collected at diagnosis from the medical records and through supplementary interviews. An additional 74 patients underwent a three-day (10 g/day) gluten challenge (wheat, barley, rye or a combination of the three grains) while in remission. Prevalence of vomiting/nausea and associated factors were evaluated in both cohorts. A literature review was conducted to summarize earlier studies.

Results

Twenty-eight (3%) patients presented with vomiting at diagnosis. They were less often screen-detected and suffered from extra-intestinal symptoms, and had more often abdominal pain (71% vs. 49%, p = 0.021), diarrhea (61% vs. 40%, p = 0.031), weight loss (36% vs. 17%, p = 0.019) and childhood symptoms (61% vs. 33%, p = 0.002) than those without vomiting (n = 787). The groups were comparable in other clinical-demographic data and in genetic, serological, and histological findings. Short-term gluten challenge provoked vomiting/nausea in 14/74 (19%) patients. They consumed gluten-free oats less often than those without these symptoms (64% vs. 92%, p = 0.017), whereas the groups did not differ in clinical-demographic features at diagnosis, presence of comorbidities, duration of gluten-free diet, or in other symptoms or grain used ingested during the challenge. According to the literature, prevalence of vomiting/nausea at celiac disease diagnosis has varied 3–46% and during gluten challenge 13–61%.

Conclusions

In chronic gluten exposure at celiac disease diagnosis, vomiting was associated with other gastrointestinal symptoms and onset of symptoms already in childhood, whereas regular consumption of oats may increase the tolerance against vomiting/nausea after acute re-exposure in treated celiac disease.
Impact of media compositions and culture systems on the immunophenotypes of patient-derived breast cancer cells
Authors: Ryu Seungyeon , Yoon So-Hyun , Song Junhyuk , Choi Yoonjung , Lee Sangeun , Baek Moonjou , Lee Han-Byoel , Jeon Sook Young , Jon Sangyong , Lee Daeyoup , Kim Hoe Suk , Han Wonshik
Published: September 2023

Background

Heterogeneous tumor cells are thought to be a significant factor in the failure of endocrine therapy in estrogen receptor-positive (ER+) cancers. Culturing patient-derived breast cancer cells (PDBCCs) provides an invaluable tool in pre-clinical and translational research for the heterogeneity of cancer cells. This study aimed to investigate the effects of different media components and culture methods on the BCSC-associated immunophenotypes and gene expression in ER + PDBCCs.

Methods

Ten patients with ER + breast cancer were employed in this study, six of whom had neoadjuvant chemotherapy and four of whom did not. PDBCCs were isolated by enzymatic methods using collagen I and hyaluronidase. PDBCCs were grown as monolayers in mediums with different compositions and as multicellular spheroid in a suspended condition. Collagen I-coated plate and ultralow attachment plate coated with polymer-X were used for monolayer and spheroid culture. Flow cytometry, immunofluorescent staining, RT-PCR, and RNA-sequencing were employed to examine the immunophenotype and genetic profile of PDBCCs.

Results

More than 95% of PDBCCs sustain EpCAM high/+/fibroblast marker- phenotypes in monolayer conditions by subculturing 3–4 times. A83-01 removal induced senescent cells with high β-galactosidase activity. PDBCCs grown as monolayers were characterized by the majority of cells having an EpCAM+/CD49f + phenotype. Compared to full media in monolayer culture, EGF removal increased EpCAM+/CD49f − phenotype (13.8-fold, p = 0.028), whereas R-spondin removal reduced it (0.8-fold, p = 0.02). A83-01 removal increased EpCAM+/CD24 + phenotype (1.82-fold, p = 0.023) and decreased EpCAM low/-/CD44+/CD24- phenotype (0.45-fold, p = 0.026). Compared to monolayer, spheroid resulted in a significant increase in the population with EpCAM-/CD49+ (14.6-fold, p = 0.006) and EpCAM low/-/CD44+/CD24- phenotypes (4.16-fold, p = 0.022) and ALDH high activity (9.66-fold, p = 0.037). ALDH1A and EMT-related genes were upregulated. In RNA-sequencing analysis between spheroids and monolayers, a total of 561 differentially expressed genes (2-fold change, p < 0.05) were enriched in 27 KEGG pathways including signaling pathways regulating pluripotency of stem cells. In a recurrence-free survival analysis based on the Kaplan-Meier Plotter database of the up-and down-regulated genes identified in spheroids, 15 up-, and 14 down-regulated genes were associated with poor prognosis of breast cancer patients.

Conclusion

The media composition and spheroid culture method change in the BCSCs and EMT markers of PDBCCs, implying the importance of defining the media composition and culture method for studying PDBCCs in vitro.
Clinical and imaging factors that can predict contagiousness of pulmonary tuberculosis
Authors: Unnewehr Markus , Meyer-Oschatz Florian , Friederichs Hendrik , Windisch Wolfram , Schaaf Bernhard
Published: September 2023

Background

Knowledge on predicting pulmonary tuberculosis (PTB) contagiosity in the hospital admission setting is limited. The objective was to assess clinical and radiological criteria to predict PTB contagiosity.

Methods

Retrospective analysis of 7 clinical, 4 chest X-ray (CXR) and 5 computed tomography (CT) signs in 299 PTB patients admitted to an urban tertiary hospital from 2008 to 2016. If the acid fact bacilli stain was positive (AFB+) on admission, the case was considered high contagiosity.

Results

Best predictors for high PTB contagiosity (AFB+) were haemoptysis (OR 4.33), cough (3.00), weight loss (2.96), cavitation in CT (2.75), cavitation in CXR (2.55), tree-in-bud-sign in CT (2.12), German residency of the patient (1.89), and abnormal auscultation findings (1.83). A previous TB infection reduced the risk of contagiosity statistically (0.40). Radiographic infiltrates, miliary picture, and pleural effusion were not helpful in predicting high or low contagiosity. 34% of all patients were clinically asymptomatic (20% of the highly contagious group, 50% of the low contagious group).

Conclusion

Haemoptysis, cough and weight loss as well as cavitation and tree-in-bud sign in CXR/CT can be helpful to predict PTB contagiosity and to improve PTB management.
Surgical outcomes of percutaneous endoscopic lumbar discectomy in obese adolescents with lumbar disc herniation
Authors: Qu Lianjun , Wang Yongli , Wang Fei , Zhang Songou
Published: September 2023

In recent years, with improved living standards, adolescent obesity has been increasingly studied. The incidence of lumbar disc herniation (LDH) in obese adolescents is increasing yearly. No clinical studies have reported the use of percutaneous endoscopic lumbar discectomy (PELD) in obese adolescent lumbar disc herniation (ALDH) patients. This study evaluated the preliminary surgical outcomes of PELD in obese ALDH patients. Fifty-one ALDH patients underwent single-level PELD surgery between January 2014 and January 2020. Patients were divided into an obese group and a normal group. Patient characteristics and surgical variables were compared between the two groups. The VAS, ODI, and SF-36 scales were used preoperatively and postoperatively to evaluate the clinical efficacy. In this study, 19 patients were included in the obese group, and 28 were included in the normal group. There was no significant difference in age, sex, duration of low back pain, duration of leg pain, or operative level between the obese and normal groups preoperatively. The obese group had a longer operative time (OT) (101.9 ± 9.0 min vs. 84.3 ± 11.0 min, P < 0.001), more fluoroscopy exposures (41.0 ± 5.8 vs. 31.6 ± 7.0, P < 0.001) and a longer time to ambulation (29.9 ± 4.0 vs. 25.0 ± 2.9, p < 0.001) than the normal group. The groups did not significantly differ in complications. The VAS score for back and leg pain and the ODI and SF-36 score for functional status improved significantly postoperatively. The PELD procedure is a safe and feasible method for treating LDH in obese adolescents. Obese ALDH patients require a longer OT, more fluoroscopy exposures and a longer time to get out of bed than normal ALDH patients. However, PELD yields similar clinical outcomes in obese and normal ALDH patients.
Carious status and socio-behavioral risk factors among 12 year-old children in South-Central region in Romania
Authors: Sfeatcu Ruxandra , Cărămidă Mariana , Sava-Rosianu Ruxandra , Matichescu Marius Lupșa , Galuscan Atena , Dumitrache Mihaela Adina
Published: September 2023

Background

Regular screenings at children population level are necessary in order to assess communities’ need for education, prevention, as well as early detection and intervention programs The study aims to assess dental caries experience and oral health-related behaviors among Romania children from the South and Central region.

Methods

The cross-sectional study conducted in 2019–2020 is part of the national survey “Romanian Oral Health Survey”, under the endorsement of the World Health Organization (WHO). The stratified, randomized and representative sample included 98 children of 12 years of age. The assessment included a clinical examination, using International Caries Detection and Assessment System (ICDAS) and the Oral Health Questionnaire for Children recommended by the World Health Organization.

Results

Results revealed that the frequency of caries-free children among 12 year-olds was 36.7% and the mean DMFT was 2.89. Regarding the oral health-related habits, 38.8% of children brushed twice daily; the consumption of sugary foods multiple times per day has been frequently met and 11.2% at the age of 12 never visited the dental office.

Conclusions

The findings revealed that caries prevalence was high and behaviors negatively influence oral health. The presented data are of utmost importance for Romanian policy makers to promote oral health education among children, to support consistent preventive oral health campaigns and to stimulate dental attendance, irrespective of children’ living areas or gender.
Syrian refugee women’s access to family planning services and modern contraception during overlapping crises in Bekaa, Lebanon
Authors: Mourtada Rima , Melnikas Andrea J.
Published: September 2023

Background

Political, financial, and pandemic crises in Lebanon have affected both provision of reproductive health services including family planning and modern contraception methods as well as women’s interest and ability to seek those services. This study aims to explore the impact of the compounding crises on the provision and use of family planning services including modern contraception methods for Syrian refugees in Lebanon focusing on the perspectives of Syrian refugee women.

Methods

We carried out 12 Focus Group Discussions (FGDs) with 119 Syrian refugee women recruited from two cities in West Bekaa, Lebanon from inside and outside the informal tented settlements. We used Skype video calls to moderate the FGDs due to the limited mobility at the time of the study because of Covid-19. We used thematic analyses to analyse the data.

Results

The crises seemed to exacerbate supply side barriers, which influenced provision of family planning services and women’s demand for them. These included Covid-19 regulations and maltreatment by staff at public health facilities, disruption of outreach reproductive health services that provide family planning and modern contraception, and reduced supply of modern contraception methods. On the demand side, women reported financial limitations in accessing and paying for services, concern over being infected with Covid-19, and concerns about insecurity.

Conclusions

We suggest possible interventions to address these challenges and better reach these populations. These include using mobile health technology (mHealth) that may provide contraceptive counselling and/or can inform refugee women about where they may receive family planning and modern contraception. These services may also support Syrian refugees to access care they are entitled to receive and may also address disruptions in service provision due to overlapping crises, including availability and rising costs of contraceptives. These can be coupled with mobile outreach reproductive health services that provide family planning. We also suggest considering the provision of Long Acting Reversible Contraception (LARC) for Syrian refugee women, which would reduce a barrier of needing to revisit health facilities to obtain an additional supply of contraception pills.
Magnitude of malaria and associated factors among febrile adults in Siraro District Public Health facilities, West Arsi Zone, Oromia, Ethiopia 2022: a facility-based cross-sectional study
Authors: Lakew Yosef Yohanes , Fikrie Anteneh , Godana Sisay Bedane , Wariyo Fatuma , Seyoum Wongelawit
Published: September 2023

Background

Despite significant efforts made to control malaria in Ethiopia, the disease remains one of the top public health problems in the country. Baseline malaria prevalence and associated factor at high malaria area is important to guide malaria control interventions, there was paucity of information regarding the study area. Therefore, the aim of this study was to determine prevalence of malaria and associated factors among febrile adults in Siraro district health facilities, West Arsi Zone, Oromia, Ethiopia.

Methods

Institution-based cross-sectional study was conducted among 317 febrile adult patients at Siraro district health facilities. Structured pre-tested questionnaires were used to collect data. Epi-data version 3.1 and SPSS version 23 were used for data entry and analysis respectively. In order to identify factors associated with malaria infection bivariable and multivariable binary logistic regression analysis was employed, The Adjusted Odds Ratio (AOR) with a 95% confidence interval (CI) and p-value of < 0.05 was computed to show the strength of the association.

Results

The overall prevalence of malaria at the study area was 130 (41.0%) [(95% CI 35.3–46.7)]. Occupation (being farmer) [(AOR = 6.05; 95% CI 1.38, 26.49)], having poor knowledge on malaria transmission [(AOR = 2.95 95%; CI 1.48–5.88)], house with wood wall [(AOR = 2.71; 95% CI 1.34–5.49)], and number of windows (≥ 3) in the house [(AOR = 6.82; 95% CI 1.05, 44.40)] were identified to be significantly associated with magnitude of malaria in the study area.

Conclusion

The prevalence of malaria at the study area was high as compared with the national wide figures. Being farmer, having poor knowledge on malaria transmission, and housing condition (house with wood wall and houses with three and above windows) were found to be significantly associated with malaria infection in the study area. Therefore, there has to be an emphasis on addressing the factors by providing sustainable health education for the communities to improve their housing condition and knowledge of community on the way of malaria prevention.
Out of balance: conflicts of interest persist in food chemicals determined to be generally recognized as safe
Authors: Matouskova Klara , Neltner Thomas G. , Maffini Maricel V.
Published: September 2023

Manufacturers of chemicals added to food are responsible for determining that the use of their products is safe. There are two major legal definitions of chemicals in food: (1) food additives which includes ingredients and chemicals indirectly entering food from packaging and processing equipment, and (2) generally recognized as safe (GRAS) substances mostly used as ingredients. The law requires food additives to undergo approval by the U.S. Food and Drug Administration (FDA) before they are sold, but it GRAS substances are exempted from pre-market approval. In 1997, FDA created a voluntary program for manufacturers to submit their chemical’s safety determination in the form of a GRAS notice to the agency. Manufacturers make GRAS determinations regardless of whether they voluntarily submit a notice to FDA for review. They rely on their own employees, the employee of a hired consulting firm or a panel of experts, known as GRAS panel, to review the safety information. Because this process determines whether a chemical is safe for use in food, conflicts of interest and biases need to be avoided or minimized to credibly ensure food is safe. Recently, FDA has published guidance for industry on best practices to convene GRAS panels to manage conflicts of interest and reduce biases that have plagued the process. Here, we perform a qualitative assessment of the compliance of GRAS panels with basic elements of FDA’s guidance. We assessed 403 GRAS notices filed by FDA between 2015 and 2020 and identified whether a GRAS panel was convened and by whom, its members, affiliations, and relationships between panelists and panel conveners. Then, we compared FDA’s recommendations against the information included in the notices voluntarily submitted by manufacturers. We found no evidence that GRAS panels have adhered to FDA’s guidance. Panels are populated from a very small pool of professionals; we found that seven panel members alone occupied almost half of all available panel positions and that they often serve together. Against guidance recommendations, ad-hoc panels have been substituted by panels with recurring members in hired consulting firms’ payroll. The widespread persistence of conflicts of interest, appearance of conflict and bias in GRAS determinations continue to put the health of Americans at risk and undermine confidence in the safety of food ingredients in the US market. FDA should require notice for all GRAS determinations including how the financial conflicts of interest of those who make these determinations are minimized.
Pathways of lymph node metastasis and prognosis after right hemicolectomy for cecal cancer: results from a retrospective single center
Authors: Yu Liang , Liu Zhun , Chen Zhifen , Wang Xiaojie , Xu Zongbin , Jiang Weizhong , Huang Ying , Lin Huiming , Chi Pan
Published: September 2023

Background

The recommended operation for cecum cancer (CC) is right hemicolectomy (RH) in some Western countries while the principle of D3 lymphadenectomy in Japan recommends resecting approximately 10 cm from the tumor edge. Therefore, the optimal surgical approach for cecum cancer (CC) remains controversial. We conducted this retrospective study to explore the pattern of lymph node metastasis and better surgical procedures for CC.

Methods

A total of 224 cecum cancer patients from January 1, 2014, to December 31, 2021, were retrospectively included in the final study. The pattern of lymph node metastasis (LNM) was investigated.

Results

A total of 113 (50.4%, 113/224) patients had pathologically confirmed LNM. The most frequent metastatic site was no. 201 lymph node (46%, 103/224), while 20 (8.9%, 20/224) patients had LNM in no. 202 lymph node, and 8 (3.6%, 8/224) patients had LNM in no. 203 lymph node. Only 1 (0.4%, 1/224) patient had LNM in no. 221 lymph node, four (1.8, 4/224%) patients had LNM in no. 223 lymph node, and no patients had LNM in no. 222 lymph node. LNM in no. 223 lymph node was significantly associated with a poor prognosis. Multivariate analysis indicated that LNM in no. 223 lymph node (HR = 4.59, 95% CI 1.18–17.86, P = 0.028) was the only independent risk factor associated with worse disease-free survival (DFS).

Conclusions

The LNM in no. 223 lymph node for cecum cancer was rare. Therefore, standard right hemicolectomy excision is too extensive for most CC cases.
Incidence of anti-platelet factor4/polyanionic antibodies, thrombocytopenia, and thrombosis after COVID-19 vaccination with ChAdOx1 nCoV-19 in Thais
Authors: Boonyawat Kochawan , Phojanasenee Tichayapa , Noikongdee Phichchapha , Police Pornnapa , Chantrathammachart Pichika , Niparuck Pimjai , Puavilai Teeraya , Phuphuakrat Angsana , Angchaisuksiri Pantep
Published: September 2023

Background

The prevalence of anti-platelet factor 4 (PF4)/polyanionic antibodies occurring after vaccination with ChAdOx1 nCoV-19 is low. Most of these antibodies are not associated with vaccine-induced thrombotic thrombocytopenia. It remains unknown whether these antibodies are preexisting or occur as a result of vaccination. In this study, we demonstrated the incidence of anti-PF4/polyanionic antibodies, thrombocytopenia, and thrombosis after vaccination with ChAdOx1 nCoV-19 in a large cohort of Thais.

Methods

We conducted a prospective study in a cohort of health care workers and members of the general population who received COVID-19 vaccination with ChAdOx1 nCoV-19. Blood collection for complete blood count, D-dimer, and anti-PF4/polyanionic antibodies was performed before vaccination (day 0), day 10, and day 28 after vaccination. Anti-PF4/polyanionic antibodies were detected using enzyme-link immunosorbent assay (ELISA). Functional assay was performed for all positive ELISA tests.

Results

A total of 720 participants were included in the study. 214 participants received both the first and second doses, 91 participants received only the first, 51 received only the second, and 364 received the third booster dose of ChAdOx1 nCoV-19. Median age was 42 years (IQR, 34–53). 67% of participants were female. Three participants developed seroconversion, yielding an incidence of vaccination-induced anti-PF4/polyanionic antibodies of 0.42% (95% confidence interval 0.08, 1.23). Fourteen (1.9%) participants had preexisting anti-PF4/polyanionic antibodies before the vaccination but their optical density of anti-PF4/polyanionic antibodies did not significantly increase over time. None of the anti-PF4/polyanionic positive sera induced platelet aggregation. Abnormal D-dimer levels following vaccination were not different among the positive and negative anti-PF4/polyanionic groups (11.8% vs. 13.2%, p = 0.86). Thrombocytopenia occurred in one person with negative anti-PF4/polyanionic antibodies. No clinical thrombosis or bleeding occurred.

Conclusion

We found a low incidence of seroconversion of anti-PF4/polyanionic antibodies after vaccination with ChAdOx1 nCoV-19 in Thais. Most of the anti-PF4/polyanionic antibodies were preexisting and did not significantly increase after vaccination with ChAdOx1 nCoV-19. Following vaccination, some participants with anti-PF4/polyanionic antibodies had elevated D-dimer levels, while only one developed thrombocytopenia and no thrombotic events were observed.
Evaluating the scaling up of an effective implementation intervention (PACE) to increase the delivery of a mandatory physical activity policy in primary schools
Authors: Hall Alix , Lane Cassandra , Wolfenden Luke , Wiggers John , Sutherland Rachel , McCarthy Nicole , Jackson Rebecca , Shoesmith Adam , Lecathelinais Christophe , Reeves Penny , Bauman Adrian , Gillham Karen , Boyer James , Naylor Patti-Jean , Kerr Nicola , Kajons Nicole , Nathan Nicole
Published: September 2023

Background

Physically Active Children in Education (PACE) is an effective implementation intervention for increasing the number of minutes classroom teachers schedule physical activity each week. To date, evaluations of PACE have included a smaller number of schools from only one region in New South Wales Australia. If PACE is to have population-wide benefits we must be able to deliver this support to a larger number of schools across multiple regions. This study aimed to evaluate the scale-up of PACE.

Methods

An uncontrolled before and after study, with 100 schools from three regions was conducted. Participating schools received PACE for approximately 12 months. We assessed the following outcomes: delivery of the evidence-based intervention (EBI) (i.e. minutes of physical activity scheduled by classroom teachers per week); delivery of the implementation strategies (i.e. reach, dose delivered, adherence and indicators of sustainability); and key determinants of implementation (i.e. acceptability of strategies and cost). Data were collected via project officer records, and principal and teacher surveys. Linear mixed models were used to assess EBI delivery by evaluating the difference in the mean minutes teachers scheduled physical activity per week from baseline to follow-up. Descriptive data were used to assess delivery of the implementation strategies and their perceived acceptability (i.e. PACE). A prospective, trial-based economic evaluation was used to assess cost.

Results

Delivery of the EBI was successful: teachers increas their average minutes of total physical activity scheduled across the school week by 26.8 min (95% CI: 21.2, 32.4, p < 0.001) after receiving PACE. Indicators for delivery of implementation strategies were high: 90% of consenting schools received all strategies and components (reach); 100% of strategies were delivered by the provider (dose); >50% of schools adhered to the majority of strategies (11 of the 14 components); and acceptability was > 50% agreement for all strategies. The incremental cost per additional minute of physical activity scheduled per week was $27 per school (Uncertainty Interval $24, $31).

Conclusions

PACE can be successfully delivered across multiple regions and to a large number of schools. Given the ongoing and scalable benefits of PACE, it is important that we continue to extend and improve this program while considering ways to reduce the associated cost.
Application of radiomics-based multiomics combinations in the tumor microenvironment and cancer prognosis
Authors: Kang Wendi , Qiu Xiang , Luo Yingen , Luo Jianwei , Liu Yang , Xi Junqing , Li Xiao , Yang Zhengqiang
Published: September 2023

The advent of immunotherapy, a groundbreaking advancement in cancer treatment, has given rise to the prominence of the tumor microenvironment (TME) as a critical area of research. The clinical implications of an improved understanding of the TME are significant and far-reaching. Radiomics has been increasingly utilized in the comprehensive assessment of the TME and cancer prognosis. Similarly, the advancement of pathomics, which is based on pathological images, can offer additional insights into the panoramic view and microscopic information of tumors. The combination of pathomics and radiomics has revolutionized the concept of a “digital biopsy”. As genomics and transcriptomics continue to evolve, integrating radiomics with genomic and transcriptomic datasets can offer further insights into tumor and microenvironment heterogeneity and establish correlations with biological significance. Therefore, the synergistic analysis of digital image features (radiomics, pathomics) and genetic phenotypes (genomics) can comprehensively decode and characterize the heterogeneity of the TME as well as predict cancer prognosis. This review presents a comprehensive summary of the research on important radiomics biomarkers for predicting the TME, emphasizing the interplay between radiomics, genomics, transcriptomics, and pathomics, as well as the application of multiomics in decoding the TME and predicting cancer prognosis. Finally, we discuss the challenges and opportunities in multiomics research. In conclusion, this review highlights the crucial role of radiomics and multiomics associations in the assessment of the TME and cancer prognosis. The combined analysis of radiomics, pathomics, genomics, and transcriptomics is a promising research direction with substantial research significance and value for comprehensive TME evaluation and cancer prognosis assessment.
CBX3 promotes clear cell renal carcinoma through PI3K/AKT activation and aberrant immunity
Authors: Chen Jiasheng , Lin Yuxin , zheng Shukai , Chen Qingshan , Tang Shijie , Zhong Xiaoping
Published: September 2023

Background

A chromobox homologue 3 (CBX3) is elevated in various cancers and significantly contributes to the promotion of malignant behavior; despite this, its exact involvement in clear cell renal cell carcinoma (ccRCC) is yet unknown.

Methods

The Cancer Genome Atlas database served to evaluate CBX3 production and its connection to survival in patients with ccRCC. Our team evaluated the effects of knockdown of CBX3 levels in ccRCC cell populations using in vitro together with in vivo models. CBX3, proteins related to death, and epithelial-to-mesenchymal transition (EMT)-related proteins were measured in ccRCC cells using western blotting and immunohistochemical assays. Through the analysis of Kyoto Encyclopedia of Genes and Genomes (KEGG) and GeneOntology (GO) and Gene Set Enrichment Analysis (GSEA), the biological processes and signal pathways related to CBX3 expression were identified. Immune-related activity reduced by CBX3 was assessed using various online tools.

Results

Both genomic and protein expression showed that CBX3 was upregulated in ccRCC. Further functional analyses revealed that CBX3 played a crucial role in enhancing cell growth, migration, and EMT in vitro along with in vivo. Moreover, the study results provided distinct mechanistic evidence that CBX3 exerts its pathological functions in ccRCC by activating the PI3K/AKT pathway. Finally, immunoassays revealed that CBX3, a possible biomarker of ccRCC, was significantly associated with immunity.

Conclusions

Our results suggest that the overexpression of CBX3 promotes ccRCC advancement through PI3K/AKT activation and even immunological dysregulation, making it a potentially viable and beneficial therapeutic target.