bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultraviolet Absorption Cross-Sections of Ammonia at Elevated Temperatures for Nonintrusive Quantitative Detection in Combustion Environments
Authors: Weng Wubin , Li Shen , Aldén Marcus , Li Zhongshan
Published: January 2021

Ammonia (NH3) is regarded as an important nitrogen oxides (NOx) precursor and also as an effective reductant for NOx removal in energy utilization through combustion, and it has recently become an attractive non-carbon alternative fuel. To have a better understanding of thermochemical properties of NH3, accurate in situ detection of NH3 in high temperature environments is desirable. Ultraviolet (UV) absorption spectroscopy is a feasible technique. To achieve quantitative measurements, spectrally resolved UV absorption cross-sections of NH3 in hot gas environments at different temperatures from 295 K to 590 K were experimentally measured for the first time. Based on the experimental results, vibrational constants of NH3 were determined and used for the calculation of the absorption cross-section of NH3 at high temperatures above 590 K using the PGOPHER software. The investigated UV spectra covered the range of wavelengths from 190 nm to 230 nm, where spectral structures of the [Formula: see text] transition of NH3 in the umbrella bending mode, v2, were recognized. The absorption cross-section was found to decrease at higher temperatures. For example, the absorption cross-section peak of the (6, 0) vibrational band of NH3 decreases from ∼2 × 10−17 to ∼0.5 × 10−17 cm2/molecule with the increase of temperature from 295 K to 1570 K. Using the obtained absorption cross-section, in situ nonintrusive quantification of NH3 in different hot gas environments was achieved with a detection limit varying from below 10 parts per million (ppm) to around 200 ppm as temperature increased from 295 K to 1570 K. The quantitative measurement was applied to an experimental investigation of NH3 combustion process. The concentrations of NH3 and nitric oxide (NO) in the post flame zone of NH3–methane (CH4)–air premixed flames at different equivalence ratios were measured.
A Little Something Goes a Long Way: Little in the Old Bailey Corpus
Authors: Claridge Claudia , Jonsson Ewa , Kytö Merja
Published: January 2021

Even though intensifiers have received a good deal of attention over the past few decades, downtoners, comprising diminishers and minimizers, have remained by and large a neglected category (but cf. Brinton, this issue). Among downtoners, the adverb little or a little stands out as the most frequent item. It is multifunctional and serves as a diminishing and minimizing intensifier and also in non-degree uses as a quantifier, frequentative, and durative. Therefore, the present paper is devoted to the structural and functional profile of ( a) little in Late Modern English speech-related data. The data source is the socio-pragmatically annotated Old Bailey Corpus (OBC, version 2.0), which allows, among other things, the investigation of the usage of the item among different speaker groups. Our research charts the semantic and formal uses of adverbial little. Downtoner uses outnumber non-degree uses in the data, and diminishing uses are more common than minimizing uses. The formal realization is predominantly a little, with very rare determinerless or modified instances, such as very little. Little modifies a wide range of “targets,” but most frequently adjectives and prepositional phrases, focusing on human states and circumstantial detail. With regard to variation and change, adverbial little declines in use over the 200 years and is used more commonly by speakers from the lower social ranks and by the lay, non-professional participants in the courtroom.
Intensification in Eighteenth Century Medical Writing
Authors: Hiltunen Turo
Published: January 2021

While intensifiers are primarily associated with informal spoken registers, they serve important interpersonal functions also in more formal registers like academic prose. The use of intensifiers in scientific writing has accordingly been explored in Present-Day English, and previous studies have also investigated diachronic changes in this register in Middle and Early Modern English. However, the Late Modern English period remains largely unexplored, despite the fact that at least in medical writing it represents an important transition period both intellectually and textually. To follow up on the trends and developments established in previous work, this paper explores the patterns of intensification in eighteenth century medical writing using Late Modern English Medical Texts (LMEMT; Taavitsainen et al. 2019), which contains a large collection of texts representing different areas of medicine. While the intensifiers that are selected for study are ubiquitous in the data, their frequency varies considerably between individual texts, and this variation is often linked to the characteristics of individual sub-registers. At the same time, the use of intensifiers in this period is characterized by stability rather than dramatic change, despite ongoing changes in the sociocultural context of medicine. Along with providing a detailed investigation of the frequency of the main intensifiers in different categories of medical writing of the period, the analysis describes their co-selection patterns with particular adjectives.
A Note Concerning the Dynamics of Government Bond Yields
Authors: Akram Tanweer
Published: January 2021

Keynes argued that the central bank can influence the long-term interest rate on government bonds and the shape of the yield curve mainly through the short-term interest rate. Several recent empirical studies that examine the dynamics of government bond yields not only substantiate Keynes’s view that the long-term interest rate responds markedly to the short-term interest rate but also have relevance for macroeconomic theory and policy. This article relates Keynes’s discussions of money, the state theory of money, financial markets, investors’ expectations, uncertainty, and liquidity preference to the dynamics of government bond yields for countries with monetary sovereignty. Investors’ psychology, herding behavior in financial markets, and uncertainty about the future reinforce the effects of the short-term interest rate and the central bank’s monetary policy actions on the long-term interest rate.

JEL classifications: E12; E40; E43; E50; E58; E60; F30; G10; G12; H62; H63
Situational and Dispositional Factors in Rape Cognitions: The Roles of Social Media and the Dark Triad Traits
Authors: Lyons Minna , Rowe Alana , Waddington Rachel , Brewer Gayle
Published: January 2021

Previous research has established the importance of socially aversive personality traits (i.e., the Dark Triad) in rape cognitions (operationalized here as rape-supportive attitudes, rape victim empathy, and hostile masculinity). However, less is known about how sexist social media content influences attitudes toward rape cognitions depending on the personality of the individual. In an online experiment, after completing the Short Dark Triad-3 questionnaire, participants ( N = 180) were primed with either sexist or neutral tweets, rating them for acceptability, humor, rudeness, and ignorance. Participants then completed scales for rape-supportive attitudes, victim empathy, and hostile masculinity. Sexist tweets were rated as significantly less acceptable and humorous, and more rude and ignorant than neutral tweets. However, those high in the Dark Triad found the sexist tweets as funny and acceptable. Overall, exposure to the sexist tweets did not increase rape cognitions. Moreover, the Dark Triad traits had similar significant, positive correlations with rape-supportive attitudes, victim blame, and hostile masculinity in both sexist and neutral tweet conditions. Multiple regression analyses (controlling for gender) revealed that psychopathy was the strongest positive predictor for increased rape cognitions. Findings suggest that short exposure to sexist social media content may not influence rape cognitions, but that dispositional factors such as psychopathy are more important.
LncRNA PCAT1 Interacts with DKC1 to Regulate Proliferation, Invasion and Apoptosis in NSCLC Cells via the VEGF/AKT/Bcl2/Caspase9 Pathway
Authors: Liu Shi-Yuan , Zhao Zhi-Yu , Qiao Zhe , Li Shao-Min , Zhang Wei-Ning
Published: January 2021

Long noncoding RNAs (lncRNAs) are increasingly recognized as indispensable components of the regulatory network in the progression of various cancers, including nonsmall cell lung cancer (NSCLC). The lncRNA prostate cancer associated transcript 1 (PCAT1) has been involved in tumorigenesis of multiple malignant solid tumors, but it is largely unknown that what is the role of lncRNA-PCAT1 and how it functions in the progression of lung cancer. Herein, we observed that lncRNA PCAT1 expression was upregulated in both human NSCLC tissues and cell lines, which was determined by qualitative polymerase chain reaction analysis. Then, gain-and loss-of-function manipulations were performed in A549 cells by transfection with a specific short interfering RNA against PCAT1 or a pcDNA-PCAT1 expression vector. The results showed that PCAT1 not only promoted NSCLC cell proliferation and invasion but also inhibited cell apoptosis. Bioinformatics and expression correlation analyses revealed that there was a potential interaction between PCAT1 and the dyskerin pseudouridine synthase 1 (DKC1) protein, an RNA-binding protein. Then, RNA pull-down assays with biotinylated probes and transcripts both confirmed that PCAT1 directly bounds with DKC1 that could also promote NSCLC cell proliferation and invasion and inhibit cell apoptosis. Moreover, the effects of PCAT1 and DKC1 on NSCLC functions are synergistic. Furthermore, PCAT1 and DKC1 activated the vascular endothelial growth factor (VEGF)/protein kinase B (AKT)/Bcl-2/caspase9 pathway in NSCLC cells, and inhibition of epidermal growth factor receptor, AKT, or Bcl-2 could eliminate the effect of PCAT1/DKC1 co-overexpression on NSCLC cell behaviors. In conclusion, lncRNA PCAT1 interacts with DKC1 to regulate proliferation, invasion, and apoptosis in NSCLC cells via the VEGF/AKT/Bcl-2/caspase9 pathway.
Recycling of Stoma Losses: A Good Practice for Neonates with High Output Stomas—Our Experience and Comparison with Literature
Authors: Bindi Edoardo , Molinaro Francesco , Ferrara Francesco , Fusi Giulia , Taddei Alessandra , Sica Marina , Negro Simona , Tomasini Barbara , Detti Rita , Ditta Simona , Messina Mario , Angotti Rossella
Published: January 2021

Introduction:

The recycling of proximal stoma losses is known as a good practice to manage patients with high output stoma. In our center, we introduced this practice about 10 years ago. We revised our series before and after recycling protocol and we reviewed the literature.

Methods:

This is a retrospective study. We included all neonates who underwent ileostomy between 2000 and 2019. They were divided into two groups, Group A and Group B, before and after the introduction of recycling of stoma losses. Demographic data were included. Outcomes evaluated to demonstrate the efficacy of stools recycling were: weight at the time of anastomosis and at discharge, length of total parenteral nutrition, and time (expressed in days) between anastomosis and passage of the stools. Data were analyzed using Student’s t-test. P values <.05 were considered significant.

Results:

A total of 85 patients (29 females, 56 males) were included—Group A: 20 (24%) (13 males/7 females); Group B: 65 (76%) (43 males/22 females); Group A: 12/enterocolitis, 5/meconium-related ileum (MRI), 3/single intestinal perforation; Group B: 45 enterocolitis, 10/MRI, 8/single intestinal perforation, 1/an ileal atresia, 1/meconial peritonitis. Outcome about weight at anastomosis and discharge and about time of canalization were significant.

Conclusion:

We believe that the recycling of stoma losses is a safe and effective practice in neonates with ileostomy. Our technique of recycling is simple and practical. The benefit/risk rate is certain, in our opinion, in favor of the benefits as showed from our data.
Home Care Aide Safety Concerns and Job Challenges During the COVID-19 Pandemic
Authors: Bandini Julia , Rollison Julia , Feistel Katie , Whitaker Laura , Bialas Armenda , Etchegaray Jason
Published: January 2021

Home care aides are on the frontlines providing care to vulnerable individuals in their homes during the COVID-19 pandemic yet are often excluded from policies to protect health care workers. The goal of this study was to examine experiences of agency-employed home care aides during the COVID-19 pandemic and to identify ways to mitigate concerns. We used an innovative journaling approach with thirty-seven aides as well as in-depth interviews with fifteen aides and leadership representatives from nine home health agencies in New York and Michigan. Workers described a range of concerns around workplace safety including uncertainty around whether a client had COVID-19, inadequate access to personal protective equipment and safe transportation, as well as fundamental changes to interactions with clients. Agencies also faced challenges acquiring personal protective equipment for their aides. This research points to needed resources to support home care aides and home health agencies both during a public health crisis and in the future.
Occupational Exposures in the Homecare Environment: Piloting an Observation Tool
Authors: Bien Elizabeth , Davis Kermit , Reutman Susan , Gillespie Gordon
Published: January 2021

The population of home healthcare workers (HHCWs) is rapidly expanding. Worker tasks and the unique home care environments place the worker at increased risks of occupational exposures, injury, and illness. Previous studies focusing on occupational exposures of HHCWs are limited to self-reports and would benefit from direct observations. The purpose of this study is to describe the occupational hazards observed in the unique work environment of home healthcare. HHCWs and home care patient participants were recruited from one home care agency in the Midwest to be observed during a routine home visit. This cross-sectional study used a trained occupational health nurse for direct observation of the occupational setting. Standardized observations and data collection were completed using the Home Healthcare Worker Observation Tool. The observer followed a registered nurse and occupational therapist into 9 patient homes observing visits ranging from 22 to 58 minutes. Hazards observed outside of and within the home include uneven pavements (n = 6, 67%), stairs without railings (n = 2, 22%), throw rugs (n = 7, 78%), unrestrained animals (n = 2, 22%), dust (n = 5, 56%), and mold (n = 2, 22%). Hand hygiene was observed prior to patient care 2 times (22%) and after patient care during 5 visits (56%). Observations have identified hazards that have the potential to impact workers’ and patients’ health. The direct observations of HHCWs provided opportunities for occupational safety professionals to understand the occupational exposures and challenges HHCWs encounter in the home care environment and begin to identify ways to mitigate occupational hazards.
Looking at the ‘field’ through a Zoom lens: Methodological reflections on conducting online research during a global pandemic
Authors: Howlett Marnie
Published: January 2021

For many social science scholars, the COVID-19 pandemic has forced us to re-think our approaches to research. As a result of new social distancing measures, those of us who conduct in-person qualitative and ethnographic research have faced significant challenges in accessing the populations and fields we study. Technology served as an incredibly useful tool for social interaction and research prior to the pandemic, and it has since become even more important as a way to engage with others. Although not all types of social research, or even all projects, lend themselves to online activities, digital communication platforms like Zoom, Skype, and Facebook have allowed many of us to continue our studies from a distance—in some cases, significant temporal and spatial distances away from our research sites. As such, it is important to consider how these different methodological approaches challenge our understandings of fieldwork. While the disadvantages of not physically accessing the places we study are clear, can mediated approaches offer (any) hope of the immersion we experienced with in-person fieldwork? If many of us are able to continue ethnographic research (in some form) without co-locating with our participants in our field sites, how are our studies fundamentally affected, as well as the ways we conceptualize the ‘field’ more largely? This paper explores these methodological and epistemological questions through reflections on conducting online research during the beginning of the COVID-19 pandemic.
A Little Help From Their Friends? How Social Factors Relate to Students' Sense of Belonging at a Large Public University
Authors: Anistranski Joseph A. , Brown B. Bradford
Published: January 2021

Sense of belonging plays a key role in college students' persistence and successful degree completion. This study evaluated how social factors contributed to students’ sense of belonging at a major Midwestern university when controlling for individual-level and academic factors. Hierarchical multiple regression analyses revealed that students’ sense of belonging was significantly associated with underrepresented backgrounds, personality traits, adjustment to college, and friendship variables. We discuss the potential implications of these relationships in promoting retention and student success.
A Place for Plant-Based Nutrition in US Medical School Curriculum: A Survey-Based Study
Authors: Morton Kara F. , Pantalos Diana C. , Ziegler Craig , Patel Pradip D.
Published: January 2021

Purpose. To evaluate medical students’ and family medicine residents’ perceptions of their current degree of nutrition training in general and regarding a whole-foods, plant-based (WFPB) diet. Methods. An original survey instrument was administered to medical students and family medicine residents. Quantitative and qualitative data were collected to evaluate perceptions of nutrition education in medical training, a WFPB diet, and ideas for nutrition-focused curricular reform. Results. Of the 668 trainees surveyed, 200 responded (response rate = 30%). Of these, 22% agreed that they received sufficient nutrition education in medical school and 41% agreed that a WFPB diet should be a focus. Respondents with personal experiences with a plant-based diet were more willing to recommend it to future patients. Common ideas for curricular reform were instruction on a WFPB diet along with other healthy dietary patterns, patient counseling, a dedicated nutrition course, and electives. Conclusions. Nutrition education in US medical training needs improvement to address the growing burden of obesity-related chronic disease. Proper nutrition and lifestyle modification should therefore play a larger role in the education of future physicians. A focus on plant-predominant diets, such as the WFPB diet, may be an acceptable and effective addition to current medical school curriculum, and deserves further study.
Exploring the role of Spanish judges in the investigation and prosecution of human trafficking for the purpose of sexual exploitation
Authors: Meneses-Falcón Carmen , Rúa-Vieites Antonio , Uroz-Olivares Jorge
Published: January 2021

This study explores the difficulties that Spanish judges face during the judicial investigation and trial of the trafficking of human beings for sexual exploitation. Here, we highlight the issues of judges’ lack of training and the saturation of the courts due to the excessive work that these crimes entail. To collect data, responses from 71 Spanish judges were collected through a questionnaire, and nine semi-structured interviews were conducted in three Spanish provinces (Barcelona, Malaga and Madrid). Noteworthy findings include the fact that almost half of the judges had dealt with a case involving this type of crime and that a third ended up closing the case. In the responses received, the lack of victims’ collaboration in the judicial process was highlighted as one of the difficulties as was the lack of resources to investigate these crimes and the involvement of other crimes.
The Impact of a Recently Approved Automated Insulin Delivery System on Glycemic, Sleep, and Psychosocial Outcomes in Older Adults With Type 1 Diabetes: A Pilot Study
Authors: Bisio Alessandro , Gonder-Frederick Linda , McFadden Ryan , Cherñavvsky Daniel , Voelmle Mary , Pajewski Michael , Yu Pearl , Bonner Heather , Brown Sue A.
Published: January 2021

Background:

Older adults with type 1 diabetes (≥65 years) are often under-represented in clinical trials of automated insulin delivery (AID) systems. We sought to test the efficacy of a recently FDA-approved AID system in this population.

Methods:

Participants with type 1 diabetes used sensor-augmented pump (SAP) therapy for four weeks and then used an AID system (Control-IQ) for four weeks. In addition to glucose control variables, patient-reported outcomes (PRO) were assessed with questionnaires and sleep parameters were assessed by actigraphy.

Results:

Fifteen older adults (mean age 68.7 ± 3.3, HbA1c of 7.0 ± 0.8) completed the pilot trial. Glycemic outcomes improved during AID compared to SAP. During AID use, mean glucose was 146.0 mg/dL; mean percent time in range (TIR, 70-180 mg/dL) was 79.6%; median time below 70 mg/dL was 1.1%. The AID system was in use 92.6% ± 7.0% of the time. Compared to SAP, while participants were on AID the TIR increased significantly (+10%, P = .002) accompanied by a reduction in both time above 180 mg/dL (−6.9%, P = .005) and below 70 mg/dl (−0.4%, P = .053). Diabetes-related distress decreased significantly while using AID ( P = .028), but sleep parameters remained unchanged.

Conclusions:

Use of this AID system in older adults improved glycemic control with high scores in ease of use, trust, and usability. Participants reported an improvement in diabetes distress with AID use. There were no significant changes in sleep.
Ultrasound-Guided Injection of Dextrose Versus Corticosteroid in Chronic Plantar Fasciitis Management: A Randomized, Double-Blind Clinical Trial
Authors: Raissi Gholamreza , Arbabi Amin , Rafiei Maryam , Forogh Bijan , Babaei-Ghazani Arash , Khalifeh Soltani Shayesteh , Ahadi Tannaz
Published: January 2021

Design

Chronic plantar fasciitis (PF) is a common cause of chronic heel pain, with different conventional treatment options. In this randomized clinical trial, the effect of ultrasound-guided injection of dextrose versus corticosteroid in chronic PF was evaluated and compared.

Methods

A total of 44 patients suffering from chronic PF who visited the physical medicine and rehabilitation clinic were enrolled in the study. Two table-randomized groups were formed. They received an ultrasonography-guided, single injection of either 40 mg methylprednisolone or 20% dextrose. Numeric Rating Scale (NRS), Foot and Ankle Ability Measure questionnaire with 2 subscales, Activities of Daily Living (FAAM-A) and Sports (FAAM-S), along with ultrasonographic parameters were evaluated before and at 2 and 12 weeks after the injection. Results. A total of 40 participants completed the study. Both interventions significantly improved pain and function at 2 and 12 weeks postinjection. After 2 weeks, compared with the dextrose prolotherapy, the corticosteroid group had significantly lower daytime and morning NRS scores (2.55 vs 4.1, P = .012, and 2.75 vs 4.65, P = .004), higher FAAM-S (66.84 vs 54.19; P = .047), and lower plantar fascia thickness at insertion and 1 cm distal to the insertion zone (3.89 vs 4.29 mm, P = .004, and 3.13 vs 3.48 mm, P = .002), whereas FAAM-A was similar in both groups ( P = .219). After 12 weeks, all study variables were statistically similar between corticosteroid and dextrose prolotherapy groups. No injection-related side effects were recorded in either group.

Conclusion

Both methods are effective. Compared with dextrose prolotherapy, our results show that corticosteroid injection may have superior therapeutic effects early after injection, accompanied by a similar outcome at 12 weeks postinjection.

Levels of Evidence:

Level II
Heterozygous mutation SLFN14 K208N in mice mediates species-specific differences in platelet and erythroid lineage commitment
Authors: Stapley Rachel J. , Smith Christopher W. , Haining Elizabeth J. , Bacon Andrea , Lax Sian , Pisareva Vera P. , Pisarev Andrey V. , Watson Steve P. , Khan Abdullah O. , Morgan Neil V.
Published: January 2021

Schlafen 14 (SLFN14) has recently been identified as an endoribonuclease responsible for cleaving RNA to regulate and inhibit protein synthesis. Early studies revealed that members of the SLFN family are capable of altering lineage commitment during T-cell differentiation by using cell-cycle arrest as a means of translational control by RNase activity. SLFN14 has been reported as a novel gene causing an inherited macrothrombocytopenia and bleeding in human patients; however, the role of this endoribonuclease in megakaryopoiesis and thrombopoiesis remains unknown. To investigate this, we report a CRISPR knock-in mouse model of SLFN14 K208N homologous to the K219N mutation observed in our previous patient studies. We used hematological analysis, in vitro and in vivo studies of platelet and erythrocyte function, and analysis of spleen and bone marrow progenitors. Mice homozygous for this mutation do not survive to weaning age, whereas heterozygotes exhibit microcytic erythrocytosis, hemolytic anemia, splenomegaly, and abnormal thrombus formation, as revealed by intravital microscopy, although platelet function and morphology remain unchanged. We also show that there are differences in erythroid progenitors in the spleens and bone marrow of these mice, indicative of an upregulation of erythropoiesis. This SLFN14 mutation presents distinct species-specific phenotypes, with a platelet defect reported in humans and a severe microcytic erythrocytosis in mice. Thus, we conclude that SLFN14 is a key regulator in mammalian hematopoiesis and a species-specific mediator of platelet and erythroid lineage commitment.
The effect of ketogenic diets on neurogenesis and apoptosis in the dentate gyrus of the male rat hippocampus
Authors: Irfannuddin Irfannuddin , Sarahdeaz Siti Fazzaura Putri , Murti Krisna , Santoso Budi , Koibuchi Noriyuki
Published: January 2021

Ketogenic diets (KD) have become popular diet to lose weight. However, the effect of such diets on brain function has not yet been clarified. Thus, we aimed to study the effects of KD on the neurogenesis and apoptosis in the dentate gyrus by assessing the expression of Ki-67 and Caspase-3. Rats (n = 24) were divided into four groups: control (normal diet), ketogenic diet (KD), time-restricted diet (TRD), and the combination of high-fat and time-restricted diet (CD) groups. The expression of Ki-67 in the TRD and CD groups was higher compared to others (P < 0.05), whereas no such difference was observed in the KD group. The number of Capase-3-positive cells decreased significantly in the TRD group (P < 0.05), but such decrease was not observed in the CD group. These results indicate that, although KD could be effective in reducing the body weight, possible adverse effect in the brain cannot be ignored.
N-3-oxo-octanoyl-homoserine lactone-mediated priming of resistance to Pseudomonas syringae requires the salicylic acid signaling pathway in Arabidopsis thaliana
Authors: Liu Fang , Zhao Qian , Jia Zhenhua , Song Cong , Huang Yali , Ma Hong , Song Shuishan
Published: January 2021

Backgroud

Many Gram-negative bacteria useN-acyl-homoserine lactones (AHLs) to communicate each other and to coordinate their collective behaviors. Recently, accumulating evidence shows that host plants are able to sense and respond to bacterial AHLs. Once primed, plants are in an altered state that enables plant cells to more quickly and/or strongly respond to subsequent pathogen infection or abiotic stress.

Results

In this study, we report that pretreatment withN-3-oxo-octanoyl-homoserine lactone (3OC8-HSL) confers resistance against the pathogenic bacteriumPseudomonas syringaepv.tomatoDC3000 (PstDC3000) in Arabidopsis. Pretreatment with 3OC8-HSL and subsequent pathogen invasion triggered an augmented burst of hydrogen peroxide, salicylic acid accumulation, and fortified expression of the pathogenesis-related genesPR1andPR5. UponPstDC3000 challenge, plants treated with 3OC8-HSL showed increased activities of defense-related enzymes including peroxidase, catalase, phenylalanine ammonialyase, and superoxide dismutase. In addition, the 3OC8-HSL-primed resistance toPstDC3000 in wild-type plants was impaired in plants expressing the bacterialNahGgene and in thenpr1mutant. Moreover, the expression levels of isochorismate synthases (ICS1), a critical salicylic acid biosynthesis enzyme, and two regulators of its expression,SARD1andCBP60g, were potentiated by 3OC8-HSL pretreatment followed by pathogen inoculation.

Conclusions

Our data indicate that 3OC8-HSL primes the Arabidopsis defense response upon hemibiotrophic bacterial infection and that 3OC8-HSL-primed resistance is dependent on the SA signaling pathway. These findings may help establish a novel strategy for the control of plant disease.
Validity and reliability of an adapted questionnaire measuring knowledge, awareness and practice regarding familial hypercholesterolaemia among primary care physicians in Malaysia
Authors: Azraii Ahmad Baihaqi , Ramli Anis Safura , Ismail Zaliha , Abdul-Razak Suraya , Badlishah-Sham Siti Fatimah , Mohd-Kasim Noor Alicezah , Ali Norsiah , Watts Gerald F. , Nawawi Hapizah
Published: January 2021

Background

Primary care physicians (PCP) play an important role in detecting Familial Hypercholesterolaemia (FH) early. However, knowledge, awareness and practice (KAP) regarding FH among Malaysian PCP are not well established, and there was no validated tool to assess their FH KAP. Thus, the aim of this study was to adapt an FH KAP questionnaire and determine its validity and reliability among Malaysian PCP.

Methods

This cross-sectional validation study involved Malaysian PCP with ≥ 1-year work experience in the primary care settings. In Phase 1, the original 19-item FH KAP questionnaire underwent content validation and adaptation by 7 experts. The questionnaire was then converted into an online survey instrument and was face validated by 10 PCP. In Phase 2, the adapted questionnaire was disseminated through e-mail to 1500 PCP. Data were collected on their KAP, demography, qualification and work experience. The construct validity was tested using known-groups validation method. The hypothesis was PCP holding postgraduate qualification (PCP-PG-Qual) would have better FH KAP compared with PCP without postgraduate qualification (PCP-noPG-Qual). Internal consistency reliability was calculated using Kuder Richardson formula-20 (KR-20) and test–retest reliability was tested on 26 PCP using kappa statistics.

Results

During content validation and adaptation, 10 items remained unchanged, 8 items were modified, 1 item was moved to demography and 7 items were added. The adapted questionnaire consisted of 25 items (11 knowledge, 5 awareness and 9 practice items). A total of 130 out of 1500 PCP (response rate: 8.7%) completed the questionnaire. The mean percentage knowledge score was found to be significantly higher in PCP-PG-Qual compared with PCP-noPG-Qual (53.5, SD ± 13.9 vs. 35.9, SD ± 11.79), t(128) = 6.90, p < 0.001. The median percentage awareness score was found to be significantly higher in PCP-PG-Qual compared with PCP-noPG-Qual (15.4, IqR ± 23.08 vs. 7.7, IqR ± 15.38), p = 0.030. The mean percentage practice score was significantly higher in PCP-PG-Qual compared with PCP-noPG-Qual (69.2, SD ± 17.62 vs. 54.4, SD ± 19.28), t(128) = 3.79, p < 0.001. KR-20 value was 0.79 (moderate reliability) and average Kappa was 0.796 (substantial agreement).

Conclusion

This study has proven that the 25-item adapted FH KAP questionnaire is valid and reliable. It can be used to measure and establish FH KAP among PCP in Malaysia.
The correlation between lipoprotein(a) and coronary atherosclerotic lesion is stronger than LDL-C, when LDL-C is less than 104 mg/dL
Authors: Li Chuang , Chen Qiwen , Zhang Mei , Liu Yin , Chu Yushun , Meng Fanpeng , Wang Jianyu , Tang Jie , Luo Jian , Niu Xiulong , Wei Maoti
Published: January 2021

Background

Lp(a) and LDL-C are both risk factors of atherosclerotic cardiovascular disease (ASCVD). But there was a contradiction point in LDL-C and Lp(a) control. The appropriate level of LDL-C and Lp(a) in the prevention of ASCVD is still pending.

Objective

To investigate the correlation of Lp(a) and coronary atherosclerotic lesion, and find out the balance point in LDL-C and Lp(a) control.

Method

3449 patients were divided to coronary atherosclerotic heart disease (CAHD) Group and Non-CAHD Group based on the result of coronary angiography. The clinical characteristics were compared, and Logistic regressions were applied to find the CAHD risk factors in total, High-LDL-C Group (LDL-C ≥ 100 mg/dL) and Low-LDL-C Group (LDL-C < 100 mg/dL) patients. Spearman correlation analysis of Lp(a), LDL-C and Gensini Score was performed in patients with different LDL-C concentration.

Results

Except male and diabetes, the traditional CAHD risk factors were well matched between two groups. But triglyceride, LDL-C and Lp(a) were higher, HDL-C and Apo-A1 were lower in CAHD group (2771). In the Logistic regression analysis, diabetes, LDL-C and Lp(a) are risk factors of CAHD in all patients, while in High-LDL-C Group, they were age, LDL-C, non-HDL-C and ApoB, in Low-LDL-C Group, they were age, Lp(a) and ApoB. Lp(a) correlated with Gensini with coefficient r = 0.41 in all patients, 0.67 in Low-LDL-C Group and 0.32 in High-LDL-C Group. The coefficient r for Lp(a) and Gensini decreased, while the r for LDL-C and Gensini increased with LDL-C concentration increasing. The two fitted lines of rs crossed at LDL-C = 2.7 mmol/L (104 mg/dL).

Conclusion

Lp(a) was the risk factor of CAHD in patients with LDL-C < 100 mg/dL. The correlation between Lp(a) and Gensini was influenced by LDL-C concentration, and the correlation was stronger than LDL-C when LDL-C < 104 mg/dl.
The association between caregiver burden, distress, psychiatric morbidity and healthcare utilization among persons with dementia in Singapore
Authors: Lau Jue Hua , Abdin Edimansyah , Jeyagurunathan Anitha , Seow Esmond , Ng Li Ling , Vaingankar Janhavi Ajit , Chong Siow Ann , Subramaniam Mythily
Published: January 2021

Background

Caregivers of persons with dementia (PWD) face high caregiving burden, distress related to responsive behaviours, and psychiatric morbidity. The present paper examines how these are associated with healthcare utilization of the PWD in Singapore.

Methods

The data of 399 caregiver-PWD dyads were extracted from a national cross-sectional survey. PWD completed the Client Service Receipt Inventory, which provided information on their healthcare utilization (i.e. emergency service use, hospital admission, length of stay in hospital, and number of outpatient visits) within a frame of 3 months. The Zarit Burden Interview  (ZBI), Neuropsychiatric Inventory Questionnaire (NPI-Q), and Self Reporting Questionnaire (SRQ-20) were administered to caregivers. Information on severity of dementia, physical multimorbidity of the PWD, household composition, and caregivers’ sociodemographic characteristics such as age, gender, and education were collected. Variables significantly associated with healthcare utilization in the univariate analyses were selected and included in the final regression models. Emergency service use and hospital admission were investigated using logistic regression analyses, whilst negative binomial models were utilized for length of stay in hospital and number of outpatient visits.

Results

After adjusting for significant correlates such as dementia severity and multimorbidity, only caregiver distress from responsive behaviours was positively associated with emergency room utilization, while caregiver burden was positively associated with length of hospital stay in the final regression model. Psychiatric morbidity was associated with healthcare utilization outcomes at the univariate level but did not reach statistical significance in final models.

Conclusion

The study identifies caregiver variables associated with the healthcare utilization of PWD. Policy makers and healthcare professionals should provide interventions to ease burden and distress amongst caregivers of PWD.
Phenotype, molecular characterisation and risk factors for postoperative meningitis caused by ESBL-producing-Enterobacteriaceae: a six years multi-Centre comparative cohort study
Authors: Zheng Guanghui , Cao Yanfei , Liu Chunhong , Qian Lingye , Cai Yumeng , Cui Miaomiao , Sun Huiting , Hong Lv , Yuan Jun , Zhang Lina , Zhang Guojun
Published: January 2021

Background

To determine the phenotype, molecular characterisation and risk factors of postoperative meningitis induced by Extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (EPE) in China.

Methods

We performed a multi-centre comparative cohort study of postoperative meningitis patients infected with Enterobacteriaceae in 4 neurosurgical centres in China from January 2014 to December 2019. Phenotype and molecular characteristics of the isolates were reviewed and tested, and independent risk factors of the EPE meningitis were evaluated by binary logistic regression.

Results

In total, 220 Enterobacteriaceae include 78 EPE were available in this study. 85.6% (67/78) ESBL-related genes were tested, and blaSHV (14.9%) and blaSHV + blaTEM + blaCTX-M-9 (20.9%) were found to be the most frequent mono and combined ESBL-related genes harboured by Enterobacteriaceae. On binary logistic analysis, craniotomy (OR. 2.583, 95% C.I. 1.274–5.235, P = 0.008) and malignancy (OR. 2.406, 95% C.I. 1.299–4.456, P = 0.005) were the associated independent risk factors to meningitis induced by EPE.

Conclusions

To the best of our knowledge, this is the largest series focusing on risk factors of EPE meningitis which has been conducted in China. Craniotomy and malignancy were independent risk factors for EPE meningitis. The risk factors identified may be further utilized in clinical practice and research to avoid and reduce the mortality in future.
A unique case of multiple calvarial hemangiomas with one large symplastic hemangioma
Authors: Bantan Najwa Abdalkabeer A. , Abouissa Ahmed H. , Saeed Muhammad , Alwalily Mustafa Hassan , Balkhoyour Kamal Bakour , Ashour Khalid Mohammad , Hassan Amal Ali , Falemban Afnan Hisham , Taher Mohiuddin M.
Published: January 2021

Background

Symplastic hemangioma is a benign superficial abnormal buildup of blood vessels, with morphological features which can mimic a pseudo malignancy. A few cases have been reported in the literature. We report here, a unique case of calvarial symplastic hemangioma, which is the first case in the calvarial region.

Case presentation

A 29-year-old male patient, with a left occipital calvarial mass since childhood, that gradually increased in size with age, was associated with recurrent epileptic fits controlled by Levetiracetam (Keppra), with no history of trauma. He presented to the emergency room with a recent headache, vomiting, frequent epileptic fits and a decrease in the level of consciousness 1 day prior to admission. A CT scan showed three diploic, expansile, variable sized lytic lesions with a sunburst appearance; two that were biparietal, and one that was left occipital, which were all suggestive of calvarial hemangiomas. However, the large intracranial soft tissue content, within the hemorrhage of the occipital lesion was concerning. The patient had refused surgery over the years; however, after the last severe presentation, he finally agreed to treatment.

The two adjacent, left parietal and occipital lesions were treated satisfactorily using preoperative embolization, surgical resection, and cranioplasty. Histopathology revealed cavernous hemangiomas, in addition to symplastic hemangioma (pseudo malignancy features) on top at the occipital lesion. The right parietal lesion was not within the surgical field; therefore, it was left untouched for follow-up.

Conclusions

Histopathology and radiology examinations confirmed the diagnosis as symplastic hemangioma, on top of a pre-existing cavernous hemangioma. To the best of our knowledge, this is the first case of a calvarial symplastic hemangioma, which we report here.
Assessing knowledge and skills of maternity care professionals regarding neonatal hyperbilirubinaemia: a nationwide survey
Authors: van der Geest Berthe A. M. , Theeuwen Imke M. , Reiss Irwin K. M. , Steegers Eric A. P. , Been Jasper V.
Published: January 2021

Background

Neonatal hyperbilirubinaemia is a physiologic phenomenon, but, when severe, may cause lifelong disability. Maternity care assistants (MCAs) play an important role in timely recognition of severe neonatal jaundice. We assessed knowledge and skills of MCAs regarding neonatal hyperbilirubinaemia.

Methods

All Dutch MCAs (n = 9065) were invited to fill out a questionnaire assessing knowledge, expertise, and handling of neonatal jaundice. Additionally, we developed an e-learning and provided training sessions to a subgroup of MCAs (n = 99), and assessed their knowledge on neonatal hyperbilirubinaemia before and after the training.

Results

One thousand four hundred sixty-five unique online questionnaires were completed (response 16.2%). The median number of correctly answered knowledge questions was 5 (out of six; IQR 1). Knowledge was significantly better when respondents had had in-service training on neonatal hyperbilirubinaemia in the previous year (p = 0.024). Although 82% of respondents felt highly skilled or skilled to assess jaundice, accuracy of estimation of total serum bilirubin levels by assessing skin colour was generally poor and prone to underestimation. Among participants attending a training session, those who completed the e-learning beforehand had higher pre-training scores (5 (IQR 1) vs. 4 (IQR 2); p < 0.001). The median post-training score was higher than pre-training (6 (IQR 1) vs. 5 (IQR 2); p < 0.001).

Conclusions

Background knowledge of MCAs regarding neonatal hyperbilirubinaemia was adequate, but can be improved by further training. Estimation of total serum bilirubin levels based on skin colour was often inadequate. Approaches to improve timely recognition of jaundiced neonates are needed.
Early visual quality outcomes after small-incision lenticule extraction surgery for correcting high myopic astigmatism
Authors: Hou Xiangtao , Du Kaixuan , Wen Dan , Hu Shengfa , Hu Tu , Li Chenling , Tang Yanhui , Wu Xiaoying
Published: January 2021

Background

To evaluate early optical quality outcomes after small-incision lenticule extraction (SMILE) surgery for correcting high myopic astigmatism.

Methods

This retrospective study enrolled 55 eyes from 37 patients who had preoperative myopic astigmatism of ≥2.00 diopters (D) who had been treated with SMILE surgery. Preoperatively, the mean cylinder was − 2.41 ± 0.54 D (range, − 2.00 D to − 4.50 D). The preoperative and postoperative visual outcomes, refraction, and higher-order aberration (HOA) at 1 and 3 months were compared. Refractive astigmatism changes were analyzed by the Alpins vector method.

Results

Three months after SMILE surgery, the average cylinder was − 0.14 ± 0.31 D, and the average astigmatism vector was − 0.09 D × 6.34°. The angle of error (AofE) was limited to within ±10°, and the magnitude of error was limited to within ±1.0 D in all patients. The correction index (CI) was 0.98 ± 0.07, the index of success (IOS) was 0.08 ± 0.13, and the flattening index (FI) was 0.97 ± 0.07. Significant positive correlations were found between IOS and |AofE| (P = 0.000); negative correlations were found between FI and |AofE| (P = 0.000). The postoperative total HOA, spherical aberration, vertical coma aberration, and trefoil 30° were increased significantly compared with preoperative measurements, and the increase in HOA was closely related to preoperative astigmatism (P < 0.05).

Conclusions

SMILE has preferable outcomes for correcting high myopic astigmatism. Axis rotation during the surgery might influence the undercorrection of astigmatism. The increase of HOA after surgery is related to preoperative astigmatism.
Barriers to using HIV pre-exposure prophylaxis (PrEP) and sexual behaviour after stopping PrEP: a cross-sectional study in Germany
Authors: Koppe Uwe , Marcus Ulrich , Albrecht Stefan , Jansen Klaus , Jessen Heiko , Gunsenheimer-Bartmeyer Barbara , Bremer Viviane
Published: January 2021

Background

Persistence of individuals at risk of HIV with Pre-Exposure Prophylaxis (PrEP) is critical for its impact on the HIV epidemic. We analysed factors associated with stopping PrEP, barriers that may deter people from continuing PrEP and investigated sexual behaviour after stopping PrEP.

Methods

Current and former PrEP users in Germany were recruited to complete an anonymous online survey on PrEP use and sexual behaviour. Participants were recruited through dating apps, a PrEP community website, anonymous testing sites and peers. The results were analysed using descriptive methods and logistic regression.

Results

We recruited 4848 current and 609 former PrEP users in two study waves (July–October 2018, April–June 2019). Former PrEP users were more likely 18–29 years old than current users (adjusted OR = 1.6, 95% confidence interval (CI) 1.1–2.3). Moreover, they were more often unhappy with their sex life, which was more pronounced in former daily PrEP users (aOR = 4.5, 95% CI 2.9–7.1) compared to former on-demand users (aOR = 1.8, 95% CI 1.1–2.9, pinteraction = 0.005). The most common reason for stopping PrEP was a reduced need for PrEP (49.1%). However, 31.4% of former users identified logistic reasons and 17.5% stopped due to side effects. Former PrEP users using PrEP < 3 months were more likely to stop PrEP due to concerns over long-term side effects (32.0% vs. 22.5%,p = 0.015) and not wanting to take a chemical substance (33.2% vs. 24.0%,p = 0.020) compared to former PrEP users who used PrEP for longer. After stopping PrEP, 18.7% of former PrEP users indicated inconsistent condom use while having ≥4 sex partners within the previous 6 months. Former PrEP users with many partners and inconsistent condom use more often indicated logistic reasons for stopping (46.5% vs. 27.9%,p < 0.001) than did other former PrEP users.

Conclusions

To maximise persistence with PrEP we need to develop strategies for younger PrEP users, reduce logistic barriers to access PrEP, and to develop effective communication on side-effect management. Moreover, prevention strategies for people stopping PrEP are required, since some remain at high risk for HIV.