bluuebunny/crossref_metadata_2025 huggingface dataset:
Initial Evaluation Practices: A Survey of Early Childhood Personnel
Authors: Steed Elizabeth A. , Stein Rachel
Published: April 2021

We surveyed early childhood personnel in the U.S. state of Colorado to explore reported practices during the initial evaluation of young children for early intervention or preschool special education. One hundred early childhood personnel participated. Overall, reported evaluation practices and processes matched recommended practices and met legal guidelines, including gathering information from a variety of sources and the use of a family-guided and team-based approach. Reported challenges included not having enough time to collect information, struggles to arrange the evaluation, difficulties determining eligibility, and systems issues regarding working conditions, training, and collaboration across agencies. Translation and interpretation were the most commonly utilized culturally responsive practices; challenges working with translators and interpreters were noted along with the need to improve other culturally and linguistically responsive practices. Implications for practice are discussed, including ways to improve the initial evaluation process for all families to assure early identification and timely access to services.
A Systematic Review of Parent–Child Shared Book Reading Interventions for Infants and Toddlers
Authors: Lorio Ciera M. , Delehanty Abigail D. , Romano Mollie K.
Published: April 2021

Parents are encouraged to read to their children as early as possible. Multiple studies of parent–child shared book reading with children ages 3 years and older have shown positive outcomes on parent use of language-based strategies and child language development. However, few studies have included children under the age of 3; thus, little is known about interventions for parent–child shared book reading practices with infants and toddlers. In this systematic review, we examined 12 studies of interventions that included practice opportunities to support parent–child shared book reading practices with infants and toddlers between the ages of birth and 3 years. Across the studies, parents were taught to use interactive shared book reading strategies through a variety of teaching functions; however, only six studies included direct measurement of parent strategy use and child behaviors during shared book reading interactions. Directions for future research and the implications of this review are discussed.
Positive Emotions, Hope, and Life Satisfaction in Chinese College Students: How Useful is the Broaden-and-Build Model in Studying Well-being in Victims of Intimate Partner Violence?
Authors: Li Mingqi , Gu Yiwen , Ma Yue , Liu Mengfei , Tang Yunxiu
Published: April 2021

In recent works, Chang and colleagues have shown that hope partially mediates the association between positive emotions and life satisfaction in diverse adult groups. However, such a model has yet to be tested among adult victims of intimate partner violence. Accordingly, the objective of this study was to evaluate the broaden-and-build model of positive emotions involving hope agency and pathways as predictors of life satisfaction in a sample of Chinese college students ( N = 248; 152 females and 96 males) who self-reported experiencing intimate partner violence. Participants completed measures assessing prior exposure to intimate partner violence, positive emotions, hope, and life satisfaction. A multiple mediation model with 10,000 bootstraps was evaluated in which hope agency and pathways were examined as hypothesized mediators of the positive association found between positive emotions and life satisfaction in Chinese adult victims of intimate partner violence. Results of this analysis indicated that although positive emotions continued to have a significant direct association with life satisfaction, both hope agency and pathways were found to partially mediate this association. We discussed the importance of these initial findings in relation to positive emotions and hope as predictors of life satisfaction in victims of intimate partner violence.
Australian Early Childhood Teachers’ Understanding of Bullying
Authors: Ey Lesley-anne , Campbell Marilyn
Published: April 2021

School bullying is a global phenomenon with teachers often at the forefront of responding to this behavior. It is, therefore, important that teachers are able both to understand and articulate what bullying is and to recognize bullying behavior. Ninety-five Australian early childhood teachers participated in an online survey to define bullying, fighting and identify the differences between the two behaviors. They were also asked to identify from 20 scenarios whether the behaviors depicted traditional bullying behaviors, cyberbullying behaviors, non-bullying face-to-face behaviors or non-cyberbullying behaviors. Results found that teachers described some of the three characteristics of bullying, that is, the intention to harm, power difference, and repetition; however, many teachers had difficulty clearly explaining the distinguishing differences between bullying and fighting. The majority of teachers identified the bullying behaviors in the scenarios; however, some teachers misinterpreted some non-bullying behaviors as bullying. The need to increase teacher’s knowledge of bullying to support the prevention and intervention of bullying are discussed.
Gendered and Racialized Perceptions of Faculty Workloads
Authors: Misra Joya , Kuvaeva Alexandra , O’meara Kerryann , Culpepper Dawn Kiyoe , Jaeger Audrey
Published: April 2021

Faculty workload inequities have important consequences for faculty diversity and inclusion. On average, women faculty spend more time engaging in service, teaching, and mentoring, while men, on average, spend more time on research, with women of color facing particularly high workload burdens. We explore how faculty members perceive workload in their departments, identifying mechanisms that can help shape their perceptions of greater equity and fairness. White women perceive that their departments have less equitable workloads and are less committed to workload equity than white men. Women of color perceive that their departments are less likely to credit their important work through departmental rewards systems than white men. Workload transparency and clarity, and consistent approaches to assigning classes, advising, and service, can reduce women’s perceptions of inequitable and unfair workloads. Our research suggests that departments can identify and put in place a number of key practices around workload that will improve gendered and racialized perceptions of workload.
‘Things are not what they seem to be’: A proposal for the spectrum approach to conspiracy beliefs
Authors: Starcevic Vladan , Brakoulias Vlasios
Published: April 2021

Objective:

Conspiracy beliefs (also known as conspiracy theories) become more prominent at times of heightened uncertainty and inconsistent or conflicting explanations provided by the authorities for events like terrorist attacks or pandemics, such as COVID-19. This article aims to examine the relevance of conspiracy beliefs for psychiatry in the context of the dynamics of trust and mistrust.

Conclusions:

Conspiracy beliefs may be situated on a spectrum of mistrust-related phenomena, which extends from healthy scepticism to persecutory delusions. They can be conceptualised as unfounded and fixed beliefs held with strong conviction about harm inflicted by powerful groups on the community or another group of people, usually with preserved insight that these beliefs differ from those that most people have and with reasons for having such beliefs not necessarily being implausible. It is important for conspiracy beliefs to be distinguished from persecutory delusions.
Chilblain-Like Lesions (CLL) Associated With COVID-19 (“COVID Toes”): A Systematic Review
Authors: Kashetsky Nadia , Mukovozov Ilya M. , Bergman James
Published: April 2021

Reports of chilblain-like lesions (CLL) coinciding with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection have been described in the literature, but this phenomenon has not been critically summarized. The aim of this paper is to summarize reports of CLL coinciding with SARS-CoV-2 infection to clarify the prevalence, clinical relevance, and prognostic value of these lesions. A literature search was conducted using the Embase, Pubmed, and Scopus databases from December 2019 to June 16, 2020 using the search terms (“COVID-19” OR “coronavirus” OR “2019-nCoV” OR “SARS-CoV-2”) AND (“chilblain-like” OR “COVID toes” OR “acral”). Papers that described skin changes in patients with suspected or confirmed COVID-19 were included. A total of 31 papers were summarized, representing 813 cases of CLL. Available data suggests an equal gender distribution, mean age of 21 years, and median age of 14 years. Mild extracutaneous symptoms were reported in 53% of cases and 47% were asymptomatic. CLL occurred an average of 16 days after extracutaneous symptoms. Patients with CLL were positive for SARS-CoV-2 in 15% of cases. Lesions were mainly described as asymptomatic and/or pruritic erythematous to violaceous acral macules and plaques. Partial or complete resolution occurred in 85% of cases in a mean of 13 days. The most common histologic findings were perivascular and perieccrine superficial and deep lymphocytic infiltrates. Although a causal relationship between CLL and SARS-CoV-2 has not been confirmed, the temporal association and 15% positive SARS-CoV-2 rate in affected individuals should not be ignored.
Radiation Awareness for Endovascular Abdominal Aortic Aneurysm Repair in the Hybrid Operating Room: An Instant Operator Risk Chart for Daily Practice
Authors: de Ruiter Quirina M. B. , Moll Frans L. , Hazenberg Constantijn E. V. B. , van Herwaarden Joost A.
Published: April 2021

Introduction:

While the operator radiation dose rates are correlated to patient radiation dose rates, discrepancies may exist in the effect size of each individual radiation dose predictors. An operator dose rate prediction model was developed, compared with the patient dose rate prediction model, and converted to an instant operator risk chart.

Materials and Methods:

The radiation dose rates (DRoperator for the operator and DRpatient for the patient) from 12,865 abdomen X-ray acquisitions were selected from 50 unique patients undergoing standard or complex endovascular aortic repair (EVAR) in the hybrid operating room with a fixed C-arm. The radiation dose rates were analyzed using a log-linear multivariable mixed model (with the patient as the random effect) and incorporated varying (patient and C-arm) radiation dose predictors combined with the vascular access site. The operator dose rate models were used to predict the expected radiation exposure duration until an operator may be at risk to reach the 20 mSv year dose limit. The dose rate prediction models were translated into an instant operator radiation risk chart.

Results:

In the multivariate patient and operator fluoroscopy dose rate models, lower DRoperator than DRpatient effect size was found for radiation protocol (2.06 for patient vs 1.4 for operator changing from low to medium protocol) and C-arm angulation. Comparable effect sizes for both DRoperator and DRpatient were found for body mass index (1.25 for patient and 1.27 for the operator) and irradiated field. A higher effect size for the DRoperator than DRpatient was found for C-arm rotation (1.24 for the patient vs 1.69 for the operator) and exchanging from femoral access site to brachial access (1.05 for patient vs 2.5 for the operator). Operators may reach their yearly 20 mSv year dose limit after 941 minutes from the femoral access vs 358 minutes of digital subtraction angiography radiation from the brachial access.

Conclusion:

The operator dose rates were correlated to patient dose rate; however, C-arm angulation and changing from femoral to brachial vascular access site may disproportionally increase the operator radiation risk compared with the patient radiation risk. An instant risk chart may improve operator dose awareness during EVAR.
Using a robotic teleoperation system for haptic exploration
Authors: Puyo Lina M Becerra , Capel Heather M , Phelan Shanon K , Wiebe Sandra A , Adams Kim D
Published: April 2021

Introduction

When children with physical impairments cannot perform hand movements for haptic exploration, they miss opportunities to learn about object properties. Robotics systems with haptic feedback may better enable object exploration.

Methods

Twenty-four adults and ten children without physical impairments, and one adult with physical impairments, explored tools to mix substances or transport different sized objects. All participants completed the tasks with both a robotic system and manual exploration. Exploratory procedures used to determine object properties were also observed.

Results

Adults and children accurately identified appropriate tools for each task using manual exploration, but they were less accurate using the robotic system. The adult with physical impairment identified appropriate tools for transport in both conditions, however had difficulty identifying tools used for mixing substances. A new exploratory procedure was observed, Tapping, when using the robotic system.

Conclusions

Adults and children could make judgements on tool utility for tasks using both manual exploration and the robotic system, however they experienced limitations in the robotics system that require more study. The adult with disabilities required less assistance to explore tools when using the robotic system. The robotic system may be a feasible way for individuals with physical disabilities to perform haptic exploration.
Combined Hip Abductor and External Rotator Strengthening and Hip Internal Rotator Stretching Improves Pain and Function in Patients With Patellofemoral Pain Syndrome: A Randomized Controlled Trial With Crossover Design
Authors: Jellad Anis , Kalai Amine , Guedria Mohamed , Jguirim Mahbouba , Elmhamdi Sana , Salah Sana , Frih Zohra Ben Salah
Published: April 2021

Background:

Active rehabilitation has an important role in the management of patellofemoral pain syndrome (PFPS). Although some studies have shown the benefit of hip-muscle strengthening, the effect of combining hip-muscle stretching with strengthening has not yet been defined.

Purpose:

To evaluate the effect of combined strengthening of the hip external rotators and abductors and stretching of the hip internal rotators on pain and function in patients with PFPS.

Study Design:

Randomized controlled trial; Level of evidence, 2.

Methods:

A total of 109 patients with PFPS (75 female and 34 male; mean age, 31.6 ± 10.8 years) were first randomly assigned to protocol A (n = 67) of the A-B arm (AB group; standard rehabilitation) or protocol B (n = 42) of the B-A arm (BA group; standard rehabilitation with strengthening of the hip external rotators and abductors and stretching of the hip internal rotators). Each protocol consisted of 3 sessions a week for 4 weeks. After a washout period, corresponding to a symptom-free period, rehabilitation programs were crossed over. A visual analog scale (VAS) evaluating perceived pain, the Functional Index Questionnaire (FIQ), and the Kujala score were administered at baseline, the end of each rehabilitation protocol, and 12 weeks after the completion of the second protocol for each group.

Results:

Until the final follow-up, VAS, FIQ, and Kujala scores were significantly improved in both the A-B and B-A arms ( P < .05 for all). Compared with protocol A, protocol B provided significant improvement in terms of pain and function in both the BA (VAS and Kujala; P < .001) and AB (VAS and Kujala; P < .001) groups.

Conclusion:

Combined strengthening of the hip abductors and external rotators with stretching of the hip internal rotators provided better outcomes, which were maintained for at least 12 weeks, in terms of pain and function in patients with PFPS.
Redefinition of the formula for aldermanite, [Mg(H2O)6][Na(H2O)2Al3(PO4)2(OH,F)6]⋅H2O, and its crystal structure
Authors: Elliott Peter , Grey Ian E. , Willis Anthony C.
Published: April 2021

Aldermanite from Tom's quarry in the Kapunda–Angaston area of the Mount Lofty Ranges, South Australia has been characterised by electron microprobe analyses and single-crystal structure analysis. The empirical formula is Na0.72K0.13Ca0.06Mg1.15Al2.92(PO4)2.05[(OH)2.92F2.96]Σ5.88⋅8.91H2O, based on 23 anions. Analysis of a specimen from the type locality, the nearby Klemm's quarry, Moculta, gave a similar formula, Na0.59K0.06Ca0.36Mg0.92Al3.16(PO4)1.97[(OH)4.08F2.70]Σ6.78⋅8.36H2O. Na and F were not analysed in the original description of the mineral. The ideal end-member formula is [Mg(H2O)6][Na(H2O)2Al3(PO4)2(OH)6]⋅H2O, compared to the original formula of Mg5Al12(PO4)8(OH)22⋅nH2O withn≈ 32. Aldermanite is monoclinic,P21/cwitha= 13.524(3),b= 9.958(2),c= 7.013(1) Å and β = 97.40(3)°. The crystal structure of aldermanite is built from sawtooth layers ofcis- andtrans-corner-connected, Al-centred octahedra, decorated with corner-connected PO4tetrahedra to give (100) layers of composition Al3(PO4)2(OH,F)6. Interlayer Mg(H2O)6octahedra and H2O molecules hold the layers together through H bonding. The corner-connected octahedra form 6-membered rings that are centred by 8-coordinated Na and have a topology identical to a 3-octahedra-wide {110} slice of the pyrochlore structure. This pyrochlore element contains intersecting kagomé nets of Al atoms, parallel to (111) and (11$\bar{1}$) of cubic pyrochlore. Minerals of the walentaite group, as well as zirconolite-3Opolytypes have the same type of intersecting kagomé nets of small cations.
Deciphering the mechanisms of CC-122 resistance in DLBCL via a genome-wide CRISPR screen
Authors: Mo Zhongying , Wood Scott , Namiranian Shawn , Mizukoshi Reina , Weng Stephanie , Jang In Sock , Fontanillo Celia , Baughman Joshua M. , Silva-Torres Arianna , Slade Michelle , Khater Marwa , Wang Kai , Rolfe Mark , Lu Gang
Published: April 2021

CC-122 is a next-generation cereblon E3 ligase–modulating agent that has demonstrated promising clinical efficacy in patients with relapsed or refractory diffuse large B-cell lymphoma (R/R DLBCL). Mechanistically, CC-122 induces the degradation of IKZF1/3, leading to T-cell activation and robust cell-autonomous killing in DLBCL. We report a genome-wide CRISPR/Cas9 screening for CC-122 in a DLBCL cell line SU-DHL-4 with follow-up mechanistic characterization in 6 DLBCL cell lines to identify genes regulating the response to CC-122. Top-ranked CC-122 resistance genes encode, not only well-defined members or regulators of the CUL4/DDB1/RBX1/CRBN E3 ubiquitin ligase complex, but also key components of signaling and transcriptional networks that have not been shown to modulate the response to cereblon modulators. Ablation of CYLD, NFKBIA, TRAF2, or TRAF3 induces hyperactivation of the canonical and/or noncanonical NF-κB pathways and subsequently diminishes CC-122–induced apoptosis in 5 of 6 DLBCL cell lines. Depletion of KCTD5, the substrate adaptor of the CUL3/RBX1/KCTD5 ubiquitin ligase complex, promotes the stabilization of its cognate substrate, GNG5, resulting in CC-122 resistance in HT, SU-DHL-4, and WSU-DLCL2. Furthermore, knockout of AMBRA1 renders resistance to CC-122 in SU-DHL-4 and U-2932, whereas knockout of RFX7 leads to resistance specifically in SU-DHL-4. The ubiquitous and cell line–specific mechanisms of CC-122 resistance in DLBCL cell lines revealed in this work pinpoint genetic alternations that are potentially associated with clinical resistance in patients and facilitate the development of biomarker strategies for patient stratification, which may improve clinical outcomes of patients with R/R DLBCL.
Biocompatible Nanoparticles as a Platform for Enhancing Antitumor Efficacy of Cisplatin–Tetradrine Combination
Authors: Liu Fangcen , Wang Xinyue , Liu Qin , Zhang Huan , Xie Li , Wang Qin , Li Lin , Li Rutian
Published: April 2021

Combination therapy has been a standard strategy in the clinical tumor treatment. We have demonstrated that combination of Tetradrine (Tet) and Cisplatin (CDDP) presented a marked synergistic anticancer activity, but inevitable side effects limit their therapeutic concentration. Considering the different physicochemical and pharmacokinetic properties of the two drugs, we loaded them into a nanovehicle together by the improved double emulsion method. The nanoparticles (NPs) were prepared from the mixture of poly(ethyleneglycol)–polycaprolactone (PEG–PCL) and polycarprolactone (HO-PCL), so CDDP and Tet can be located into the NPs simultaneously, resulting in low interfering effect and high stability. Images from fluorescence microscope revealed the cellular uptake of both hydrophilic and hydrophobic agents delivered by the NPs. In vitro studies on different tumor cell lines and tumor tissue revealed increased tumor inhibition and apoptosis rates. As to the in vivo studies, superior antitumor efficacy and reduced side effects were observed in the NPs group. Furthermore, 18FDG-PET/CT imaging demonstrated that NPs reduced metabolic activities of tumors more prominently. Our results suggest that PEG–PCL block copolymeric NPs could be a promising carrier for combined chemotherapy with solid efficacy and minor side effects.
Data missingness in the Michigan NEMSIS (MI-EMSIS) dataset: a mixed-methods study
Authors: Abir Mahshid , Taymour Rekar K. , Goldstick Jason E. , Malsberger Rosalie , Forman Jane , Hammond Stuart , Wahl Kathy
Published: April 2021

Objective

The study was done to evaluate levels of missing and invalid values in the Michigan (MI) National Emergency Medical Services Information System (NEMSIS) (MI-EMSIS) and explore possible causes to inform improvement in data reporting and prehospital care quality.

Methods

We used a mixed-methods approach to study trends in data reporting. The proportion of missing or invalid values for 18 key reported variables in the MI-EMSIS (2010–2015) dataset was assessed overall, then stratified by EMS agency, software platform, and Medical Control Authorities (MCA)—regional EMS oversight entities in MI. We also conducted 4 focus groups and 10 key-informant interviews with EMS participants to understand the root causes of data missingness in MI-EMSIS.

Results

Only five variables of the 18 studied exhibited less than 10% missingness, and there was apparent variation in the rate of missingness across all stratifying variables under study. No consistent trends over time regarding the levels of missing or invalid values from 2010 to 2015 were identified. Qualitative findings indicated possible causes for this missingness including data-mapping issues, unclear variable definitions, and lack of infrastructure or training for data collection.

Conclusions

The adoption of electronic data collection in the prehospital setting can only support quality improvement if its entry is complete. The data suggest that there are many EMS agencies and MCAs with very high levels of missingness, and they do not appear to be improving over time, demonstrating a need for investment in efforts in improving data collection and reporting.
A multidimensional approach to frailty compared with physical phenotype in older Brazilian adults: data from the FIBRA-BR study
Authors: Venturini Claudia , Sampaio Rosana Ferreira , de Souza Moreira Bruno , Ferriolli Eduardo , Neri Anita Liberalesso , Lourenço Roberto Alves , Lustosa Lygia Paccini
Published: April 2021

Background

Frailty is a predictor of negative health outcomes in older adults. The physical frailty phenotype is an often used form for its operationalization. Some authors have pointed out limitations regarding the unidimensionality of the physical phenotype, introducing other dimensions in the approach to frailty. This study aimed to create a multidimensional model to evaluate frailty in older Brazilian adults and to compare the dimensions of the model created among the categories of the physical frailty phenotype.

Methods

A cross-sectional study was conducted using data from 3569 participants (73.7 ± 6.6 years) from a multicenter and multidisciplinary survey (FIBRA-BR). A three-dimensional model was developed: physical dimension (poor self-rated health, vision impairment, hearing impairment, urinary incontinence, fecal incontinence, and sleeping disorder), social dimension (living alone, not having someone who could help when needed, not visiting others, and not receiving visitors), and psychological dimension (depressive symptoms, concern about falls, feelings of sadness, and memory problems). The five criteria of the phenotype created by Fried and colleagues were used to evaluate the physical frailty phenotype. The proposed multidimensional frailty model was analyzed using factorial analysis. Pearson’s chi-square test was used to analyze the associations between each variable of the multidimensional frailty model and the physical phenotype categories. Analysis of variance compared the multidimensional dimensions scores among the three categories of the physical frailty phenotype.

Results

The factorial analysis confirmed a model with three factors, composed of 12 variables, which explained 38.6% of the variability of the model data. The self-rated health variable was transferred to the psychological dimension and living alone variable to the physical dimension. The vision impairment and hearing impairment variables were dropped from the physical dimension. The variables significantly associated with the physical phenotype were self-rated health, urinary incontinence, visiting others, receiving visitors, depressive symptoms, concern about falls, feelings of sadness, and memory problems. A statistically significant difference in mean scores for physical, social, and psychological dimensions among three physical phenotype categories was observed (p < 0.001).

Conclusions

These results confirm the applicability of our frailty model and suggest the need for a multidimensional approach to providing appropriate and comprehensive care for older adults.
Mental ill-health during COVID-19 confinement
Authors: Jané-Llopis Eva , Anderson Peter , Segura Lidia , Zabaleta Edurne , Muñoz Regina , Ruiz Gemma , Rehm Jürgen , Cabezas Carmen , Colom Joan
Published: April 2021

Background

Confinement due to COVID-19 has increased mental ill-health. Few studies unpack the risk and protective factors associated with mental ill-health and addictions that might inform future preparedness.

Methods

Cross-sectional on-line survey with 37,810 Catalan residents aged 16+ years from 21 April to 20 May 2020 reporting prevalence of mental ill-health and substance use and associated coping strategies and behaviours.

Results

Weighted prevalence of reported depression, anxiety and lack of mental well-being was, respectively, 23, 26, and 75%, each three-fold higher than before confinement. The use of prescribed hypnosedatives was two-fold and of non-prescribed hypnosedatives ten-fold higher than in 2018. Women, younger adults and students were considerably more likely, and older and retired people considerably less likely to report mental ill-health. High levels of social support, dedicating time to oneself, following a routine, and undertaking relaxing activities were associated with half the likelihood of reported mental ill-health. Worrying about problems living at home, the uncertainty of when normality would return, and job loss were associated with more than one and a half times the likelihood of mental ill-health. With the possible exception of moderately severe and severe depression, length of confinement had no association with reported mental ill-health.

Conclusions

The trebling of psychiatric symptomatology might lead to either to under-identification of cases and treatment gap, or a saturation of mental health services if these are not matched with prevalence increases. Special attention is needed for the younger adult population. In the presence of potential new confinement, improved mental health literacy of evidence-based coping strategies and resilience building are urgently needed to mitigate mental ill-health.
“We are in this together:” dyadic-level influence and decision-making among HIV serodiscordant couples in Tanzania receiving access to PrEP
Authors: Fonner Virginia A. , Ntogwisangu Jacob , Hamidu Isihaka , Joseph Juliet , Fields Joshua , Evans Evans , Kilewo Jordan , Bailey Claire , Goldsamt Lloyd , Fisher Celia B. , O’Reilly Kevin R. , Ruta Theonest , Mbwambo Jessie , Sweat Michael D.
Published: April 2021

Background

A substantial number of new HIV infections in sub-Saharan Africa occur within stable couples. Biomedical prevention (pre-exposure prophylaxis, PrEP) and treatment (antiretroviral therapy, ART) can provide benefits to sexual partners and can be used to prevent infection within HIV serodiscordant couples. However, research is typically focused on individuals, not dyads, even when the intervention may directly or indirectly impact sexual partners. Gaps remain in understanding best practices for recruitment, informed consent, and intervention implementation in studies involving HIV prevention and treatment among heterosexual serodiscordant couples. This qualitative study was undertaken to understand and describe decision-making and dyadic-level influence among members of serodiscordant couples regarding (1) participation in a dyadic-based research study involving HIV self-testing and access to PrEP, and (2) utilization of PrEP and ART.

Methods

This qualitative study was nested within an observational cohort study assessing the acceptability of home-based couples’ HIV self-testing and uptake of dyadic care for serodiscordant couples involving facilitated referral for HIV-positive partners and access to PrEP for HIV-negative partners. Semi-structured in-depth interviews were conducted among a subset of study participants (n = 22) as well as individuals involved in serodiscordant relationships who chose not to participate (n = 9). Interviews focused on couples’ decision-making regarding study participation and dyadic-level influence on medication use. Interviews were transcribed verbatim and translated from Kiswahili into English. Data were analyzed using thematic analysis.

Results

Three major themes were identified: (1) HIV as “two people’s secret” and the elevated role of partner support in serodiscordant relationships; (2) the intersectional role of HIV-status and gender on decision-making; (3) the relational benefits of PrEP, including psychosocial benefits for the couple that extend beyond prevention.

Conclusions

The study found that couples made joint decisions regarding study participation and uptake of HIV-related medication. Relational autonomy and dyadic-level influence should be considered within research and programs involving HIV serodiscordant couples.
Development and validation of the Cystic Fibrosis Decisional Balance for Physical Activity scale (CF-DB-PA)
Authors: Filleul Valentine , Ladune Raphaëlle , Gruet Mathieu , Falzon Charlène , Fuchs Amélie , Mély Laurent , Hayotte Meggy , Vallier Jean-Marc , Giovannetti Philippe , Ramel Sophie , Vuillemin Anne , Corrion Karine , d’Arripe-Longueville Fabienne
Published: April 2021

Background

People with cystic fibrosis (pwCF) derive several physiological and psychological benefits from regular physical activity (PA), but the practice is lower than recommended. Knowledge about the facilitators of and barriers to PA at the individual level is important to act positively on PA behaviors. This study validated the Cystic Fibrosis Decisional Balance for Physical Activity scale (CF-DB-PA) for adults with CF.

Methods

French adults with CF were recruited in several specialist centres in France. The CF-DB-PA scale was validated following a quantitative study protocol comprising four stages: (1) tests of the clarity and relevance of a preliminary 44-item version and reduction analysis, (2) confirmatory factor analysis and tests of dimensionality through equation modelling analysis, (3) tests of reliability with Cronbach alphas for the internal consistency and a test–retest with a 2-to-3 week interval for temporal stability, and 4) tests of construct validity with Spearman correlations to measure the associations between each subscale and the theoretically related constructs (i.e., quality of life, PA and exercise tolerance).

Results

A total of 201 French adults with CF participated in the validation study. The CF-DB-PA comprises 23 items divided into two factors: facilitators of and barriers to PA. Each factor is divided into three subscales: physical, psychological and environmental. The factors (facilitators and barriers) can be used independently or combined as a whole. A general score of decisional balance for PA can also be calculated. The bi-factor model presented satisfactory adjustment indexes: χ2 (194) = 362.33; p < .001; TLI = .87; CFI = .90; RMSEA = .067. The scale showed satisfactory internal consistency (Cronbach’s α = .77). The test–retest reliability was not significant for either subscale, indicating stability over time. The facilitators subscale correlated significantly with the self-reported score of PA (r = .33, p < .01) and quality of life (r = .24, p < .05). The barriers subscale correlated significantly with the self-reported scores of PA (r =  − .42, p > .01), quality of life (r =  − .44, p < .01), exercise tolerance (r =  − .34, p < .01) and spirometry tests (r =  − .30, p < .05).

Conclusions

The CF-DB-PA is a reliable and valid questionnaire assessing the decisional balance for PA, the facilitators of and the barriers to PA for adults with CF in French-speaking samples.
Letter to the Editor: Non-selective bilateral internal iliac artery embolization is a safe and effective way in hemorrhage control for hemodynamically unstable pelvic fractures
Authors: Li Hui , Hu Ping
Published: April 2021

A recently published article by Lai et al. in BMC Musculoskeletal Disorders trying to show that patients with pelvic fractures undergoing non-selective internal iliac artery embolization may lead to a higher rate of surgical site infection. The authors also noted that only a small percentage of patients with contrast extravasation detected by emergency contrast-enhanced CT were subsequently confirmed by angiography, thus, considered that the value of enhanced CT in predicting arterial injury was limited. The authors also believe that embolization of the main stem may cause incomplete hemostasis due to the abundant collateral circulations in the pelvic cavity. Although the author’s findings are mentioned in other studies, the article’s data and pictures only partially supported its inferences, and the conclusions cannot be drawn directly. In this Correspondence, we tried to reinterpret the additional findings in the article from our perspective. Through this discussion, we hope that more colleagues can re-understand the safety and effectiveness of non-selective internal iliac artery embolization in treating hemodynamically unstable pelvic fractures during the early resuscitation stage.
Trust and professionalism in science: medical codes as a model for scientific negligence?
Authors: Desmond Hugh , Dierickx Kris
Published: April 2021

Background

Professional communities such as the medical community are acutely concerned with negligence: the category of misconduct where a professional does not live up to the standards expected of a professional of similar qualifications. Since science is currently strengthening its structures of self-regulation in parallel to the professions, this raises the question to what extent the scientific community is concerned with negligence, and if not, whether it should be. By means of comparative analysis of medical and scientific codes of conduct, we aim to highlight the role (or lack thereof) of negligence provisions in codes of conduct for scientists, and to discuss the normative consequences for future codes of conduct.

Methods

We collected scientific and medical codes of conduct in a selection of OECD countries, and submitted each code of conduct to comparative textual analysis.

Results

Negligence is invariably listed as an infraction of the norms of integrity in medical codes of conduct, but only rarely so in the scientific codes. When the latter list negligence, they typically do not provide any detail on the meaning of ‘negligence’.

Discussion

Unlike codes of conduct for professionals, current codes of conduct for scientists are largely silent on the issue of negligence, or explicitly exclude negligence as a type of misconduct. In the few cases where negligence is stipulated to constitute misconduct, no responsibilities are identified that would help prevent negligence. While we caution against unreasonable negligence provisions as well as disproportionate sanctioning systems, we do argue that negligence provisions are crucial for justified trust in the scientific community, and hence that there is a very strong rationale for including negligence provisions in codes of conduct.
Experimental infection with the hookworm, Necator americanus, is associated with stable gut microbial diversity in human volunteers with relapsing multiple sclerosis
Authors: Jenkins Timothy P. , Pritchard David I. , Tanasescu Radu , Telford Gary , Papaiakovou Marina , Scotti Riccardo , Cortés Alba , Constantinescu Cris S. , Cantacessi Cinzia
Published: April 2021

Background

Helminth-associated changes in gut microbiota composition have been hypothesised to contribute to the immune-suppressive properties of parasitic worms. Multiple sclerosis is an immune-mediated autoimmune disease of the central nervous system whose pathophysiology has been linked to imbalances in gut microbial communities.

Results

In the present study, we investigated, for the first time, qualitative and quantitative changes in the faecal bacterial composition of human volunteers with remitting multiple sclerosis (RMS) prior to and following experimental infection with the human hookworm,Necator americanus(N+), and following anthelmintic treatment, and compared the findings with data obtained from a cohort of RMS patients subjected to placebo treatment (PBO). Bacterial 16S rRNA high-throughput sequencing data revealed significantly decreased alpha diversity in the faecal microbiota ofPBOcompared toN+subjects over the course of the trial; additionally, we observed significant differences in the abundances of several bacterial taxa with putative immune-modulatory functions between study cohorts.Parabacteroideswere significantly expanded in the faecal microbiota ofN+ individuals for which no clinical and/or radiological relapses were recorded at the end of the trial.

Conclusions

Overall, our data lend support to the hypothesis of a contributory role of parasite-associated alterations in gut microbial composition to the immune-modulatory properties of hookworm parasites.
Expression analysis of centrin gene in promastigote and amastigote forms of leishmania infantum iranian isolates: a promising target for live attenuated vaccine development against canine leishmaniasis
Authors: Abbaszadeh Afshar Mohammad Javad , Elikaee Samira , Saberi Reza , Mohtasebi Sina , Mohebali Mehdi
Published: April 2021

Background

Leishmania parasites express various essential proteins in different growth phases (logarithmic/stationary) and forms (promastigote/amastigote). Targeting the genes encoding such proteins paves the way for controlling these parasites. Centrin is an essential gene, which its protein product seems to be vital for the proliferation of Leishmania parasites. Herein, this study was contrived to analyze the expression level of the centrin gene in different growth phases and forms of Leishmania infantum (L. infantum) parasites isolated from various endemic areas of canine leishmaniasis (CanL) in Iran.

Results

All three collected isolates were identified as L. infantum using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Real-time reverse transcription (RT)-PCR revealed a statistically significant up-regulation (3.13-fold) in the logarithmic phase promastigotes compared to stationary ones (p < 0.01), whereas centrin was expressed equally in intracellular amastigotes at different time points during cell culture. Also, our finding revealed a slight up-regulation of the centrin gene (1.22-fold) in the intracellular amastigotes compared to logarithmic phase promastigotes, which was found statistically non-significant (p > 0.05).

Conclusions

Centrin gene in Iranian isolates of L. infantum is more expressed in exponential than stationary phases and seems to be considered as a promising target in the development of a genetically modified live attenuated vaccine for CanL control.
Mesenchymal stem/stromal cell-based therapy: mechanism, systemic safety and biodistribution for precision clinical applications
Authors: Zhuang Wei-Zhan , Lin Yi-Heng , Su Long-Jyun , Wu Meng-Shiue , Jeng Han-Yin , Chang Huan-Cheng , Huang Yen-Hua , Ling Thai-Yen
Published: April 2021

Mesenchymal stem/stromal cells (MSCs) are a promising resource for cell-based therapy because of their high immunomodulation ability, tropism towards inflamed and injured tissues, and their easy access and isolation. Currently, there are more than 1200 registered MSC clinical trials globally. However, a lack of standardized methods to characterize cell safety, efficacy, and biodistribution dramatically hinders the progress of MSC utility in clinical practice. In this review, we summarize the current state of MSC-based cell therapy, focusing on the systemic safety and biodistribution of MSCs. MSC-associated risks of tumor initiation and promotion and the underlying mechanisms of these risks are discussed. In addition, MSC biodistribution methodology and the pharmacokinetics and pharmacodynamics of cell therapies are addressed. Better understanding of the systemic safety and biodistribution of MSCs will facilitate future clinical applications of precision medicine using stem cells.
Childhood traffic-related air pollution and adverse changes in subclinical atherosclerosis measures from childhood to adulthood
Authors: Farzan Shohreh F. , Habre Rima , Danza Phoebe , Lurmann Frederick , Gauderman W. James , Avol Edward , Bastain Theresa , Hodis Howard N. , Breton Carrie
Published: April 2021

Background

Chronic exposure to air pollutants is associated with increased risk of cardiovascular disease (CVD) among adults. However, little is known about how air pollution may affect the development of subclinical atherosclerosis in younger populations. Carotid artery intima-media thickness (CIMT) is a measure of subclinical atherosclerosis that provides insight into early CVD pathogenesis.

Methods

In a pilot study of 70 participants from the Southern California Children’s Health Study, we investigated CIMT progression from childhood to adulthood. Using carotid artery ultrasound images obtained at age 10 and follow-up images at age 21–22, we examined associations between childhood ambient and traffic-related air pollutants with changes in CIMT over time and attained adult CIMT using linear mixed-effects models adjusted for potential confounders.

Average residential childhood exposures (i.e., birth to time of measurement at 10–11 years) were assigned for regional, ambient pollutants (ozone, nitrogen dioxide, particulate matter, interpolated from regulatory air monitoring data) and traffic-related nitrogen oxides (NOx) by road class (modeled using the CALINE4 line source dispersion model). Traffic density was calculated within a 300-m residential buffer.

Results

For each 1 standard deviation (SD) increase in childhood traffic-related total NOx exposure, we observed greater yearly rate of change in CIMT from childhood to adulthood (β: 2.17 μm/yr, 95% CI: 0.78–3.56). Increases in annual rate of CIMT change from childhood to adulthood also were observed with freeway NOx exposure (β: 2.24 μm/yr, 95% CI: 0.84–3.63) and traffic density (β: 2.11 μm/yr, 95% CI: 0.79–3.43). Traffic exposures were also related to increases in attained CIMT in early adulthood. No associations of CIMT change or attained level were observed with ambient pollutants.

Conclusions

Overall, we observed adverse changes in CIMT over time in relation to childhood traffic-related NOx exposure and traffic density in our study population. While these results must be cautiously interpreted given the limited sample size, the observed associations of traffic measures with CIMT suggest a need for future studies to more fully explore this relationship.
Harnessing the digital potential of the next generation of health professionals
Authors: Wong Brian L. H. , Khurana Mark P. , Smith Robert D. , El-Omrani Omnia , Pold Ave , Lotfi Amine , O’Leary Charlotte A. , Saminarsih Diah S.
Published: April 2021

Digital technologies are rapidly being integrated into a wide range of health fields. This new domain, often termed ‘digital health’, has the potential to significantly improve healthcare outcomes and global health equity more broadly. However, its effective implementation and responsible use are contingent on building a health workforce with a sufficient level of knowledge and skills to effectively navigate the digital transformations in health. More specifically, the next generation of health professionals—namely youth—must be adequately prepared to maximise the potential of these digital transformations. In this commentary, we highlight three priority areas which should be prioritised in digital education to realise the benefits of digital health: capacity building, opportunities for youth, and an ethics-driven approach. Firstly, capacity building requires educational frameworks and curricula to not only be updated, but to also place an emphasis on interdisciplinary learning. Secondly, opportunities are important for youth to meaningfully participate in decision-making processes and gain invaluable practical experiences. Thirdly, training in digital ethics and the responsible use of data as a standard component of education will help to safeguard against potential future inequities resulting from the implementation and use of digital health technologies.
Dodging COVID-19 infection: low expression and localization of ACE2 and TMPRSS2 in multiple donor-derived lines of human umbilical cord-derived mesenchymal stem cells
Authors: Hernandez Jonathan J. , Beaty Doyle E. , Fruhwirth Logan L. , Lopes Chaves Ana P. , Riordan Neil H.
Published: April 2021

Background

Mesenchymal stem cells derived from human umbilical cord (hUC-MSCs) have immunomodulatory properties that are of interest to treat novel coronavirus disease 2019 (COVID-19). Leng et al. recently reported that hUC-MSCs derived from one donor negatively expressed Angiotensin-Converting Enzyme 2 (ACE2), a key protein for viral infection along with Transmembrane Serine Protease 2 (TMPRSS2). The purpose of this study was to quantify the expression of ACE2 and TMPRSS2 in hUC-MSCs lots derived from multiple donors using molecular-based techniques in order to demonstrate their inability to be a host to SARS-CoV-2.

Methods

Expression of ACE2 and TMPRSS2 was analyzed in 24 lots of hUC-MSCs derived from Wharton's jelly via quantitative polymerase chain reaction (qPCR), Western Blot, immunofluorescence and flow cytometry using 24 different donors.

Results

hUC-MSCs had significantly lower ACE2 (p = 0.002) and TMPRSS2 (p = 0.008) expression compared with human lung tissue homogenates in Western blot analyses. Little to no expression of ACE2 was observed in hUC-MSC by qPCR, and they were not observable with immunofluorescence in hUC-MSCs cell membranes. A negative ACE2 and TMPRSS2 population percentage of 95.3% ± 15.55 was obtained for hUC-MSCs via flow cytometry, with only 4.6% ACE2 and 29.5% TMPRSS2 observable positive populations.

Conclusions

We have demonstrated negative expression of ACE2 and low expression of TMPRSS2 in 24 lots of hUC-MSCs. This has crucial implications for the design of future therapeutic options for COVID-19, since hUC-MSCs would have the ability to “dodge” viral infection to exert their immunomodulatory effects.