bluuebunny/crossref_metadata_2025 huggingface dataset:
No evidence of word-level uncertainty in younger and older adults in self-paced reading
Authors: Cutter Michael G , Paterson Kevin B , Filik Ruth
Published: August 2021

In a self-paced reading study, we investigated whether older adults maintain a greater level of uncertainty about the identity of words in a sentence than younger adults, potentially due to deficits in visuo-perceptual processing of high-spatial frequencies associated with normal aging. In the experiment, 60 older adults and 60 younger adults read sentences in which an early preposition was either perceptually confusable with another word ( at; confusable with as) or not ( toward), and in which the reading of a subsequent ambiguous verb (e.g., tossed) should be affected by the confusability of the preposition, while the reading of an unambiguous verb (e.g., thrown) should not be. This design replicated that of an earlier study conducted by Levy et al. (2009) that found evidence in favour of participants maintaining uncertainty about the confusable preposition in go-past times during natural reading. However, in our study, there was no evidence that either younger or older adults maintained uncertainty about the identity of the perceptually confusable preposition, such that there was no interaction between the preposition’s form and subsequent verb ambiguity in self-paced reading times, although we did observe a main effect of verb ambiguity. This represents a failure to replicate the effect observed by Levy et al. when using a different experimental paradigm, and we consider potential causes of our findings at both a methodological and theoretical level.
Riding to the top – A systematic review on multidimensional performance indicators in surfing
Authors: Klingner Fabian C , Klingner Florian P , Elferink-Gemser Marije T
Published: August 2021

Identifying high-performing and promising athletes is an important task of national surf associations. However, the scientific foundation of performance indicators in surfing has only developed in recent years. This review aimed to (1) find out which performance characteristics discriminate between surfers of different skill levels, and (2) point out gaps in the existing literature and direct future studies by applying the Groningen Sport Talent Model (GSTM) to categorize findings. A systematic review of PubMed, Web of Science, MEDLINE and PsycInfo databases was performed according to the PRISMA guidelines. A total of thirty-one studies were included. Studies were found on anthropometric, physiological, technical, and tactical, but not on psychological characteristics of surfing performance. In total only six studies included female surfers. Findings suggest that a few performance indicators exist in relation to associations between physical capacities and surfing skill. For one, relative arm span seems to be beneficial to surfing performance and discriminates between differently skilled surfers. Additionally, 15 m and 400 m in-water paddle performance, as well as relative upper and lower-body strength also tend to be better in superior surfers. Technical skills, such as the ability to perform aerials and tube rides with a high completion rate, translate directly into an enhanced scoring potential and therefore success in surfing competitions. While a variety of characteristics for high-performance surfing are already indicated, future research needs to focus on developing reliable methods with higher ecological validity to assess these skills. Apart from the in-water paddle tests, most indicators lack a broadly accepted testing method. Especially, the field of psychological skills in surfing should be addressed more in the future.
Non-alcoholic fatty liver disease in pregnancy
Authors: Benson Charlotte S , Cobbold Jeremy F , Frise Charlotte J
Published: August 2021

Non-alcoholic fatty liver disease (NAFLD) is now the commonest liver pathology in the UK; however, relatively little is known about its course in pregnancy or the effect it has on maternal or fetal outcomes. Described here is a 24-year-old woman in her first pregnancy who presented with non-specific symptoms and raised alanine aminotransferase with ultrasonography of her liver showing changes of steatosis and suspicious for cirrhosis, leading to a diagnosis of NAFLD. The case illustrates the need for the clinician to have awareness of this increasingly prevalent condition and for multidisciplinary management.
Lack of regulation over antibiotic prescription and dispensation: A prospective cohort in a community setting
Authors: Choucair Jacques , Haddad Elie , Saliba Gebrael , Chehata Nabil , Makhoul Jennifer
Published: August 2021

Background:

The emergence of bacterial resistance caused health authorities to attempt to implement strict regulations for rational antibiotic prescription. However, supervision is often neglected in low- and middle-income countries, leading to inappropriate administration of antibiotics. The objective of our study is to highlight the lack of monitoring in the community setting of a middle-income country.

Material and methods:

We asked 68 patients presenting to an infectious diseases consultation office to report the antibiotic courses they had taken in the three months preceding their visit. We assessed for treatment indication, molecule choice, dosing and duration, as well as microbial cultures, demographics and specialty of the prescriber.

Results:

Among the 68 patients included in our study, we counted a total of 95 outpatient antibiotic courses, mostly composed of quinolones (36%), followed by amoxicillin-clavulanate (21%). The prescriber was most commonly a primary care physician, but we reported several cases of auto-medication and dispensation of antibiotics by pharmacists. Only 30% of cases had true indications for antibiotics.

Conclusion:

In sum, our results indicate an evident lack of regulation over the administration of antibiotics. This easy accessibility needs to be promptly addressed as we run the risk of inevitable bacterial resistance.
What are the predictors of hand hygiene compliance in the intensive care unit? A cross-sectional observational study
Authors: Madden Caoimhe , Lydon Sinéad , Walsh Chloe , O’Dowd Emily , Fox Susan , Vellinga Akke , Lambe Kathryn , Tujjar Omar , Greally Cathriona , Power Michael , Bates John , O’Connor Paul
Published: August 2021

Background:

Although appropriate hand hygiene (HH) practices are recognised as the most effective preventative strategy for infection, adherence is suboptimal. Previous studies in intensive care units (ICUs) have found differences in HH compliance between those moments that protect the patient, and those that protect the healthcare provider. However, such studies did not control for other variables known to impact HH compliance.

Aim:

To examine HH among healthcare workers (HCWs) in ICU settings, and identify whether there is a statistical difference in HH compliance between patient-protective and self-protective moments, while controlling for other variables known to influence HH compliance (i.e. professional role, unit and shift time).

Methods:

A cross-sectional observational study was conducted in four ICUs across three Irish hospitals. Compliance was assessed according to the WHO’s ‘five moments for hand hygiene’. HCW professional role, total number of ‘opportunities’ for HH and whether compliance was achieved were recorded.

Results:

A total of 712 HH opportunities were recorded, with an overall compliance rate of 56.9%. Logistic regression analysis revealed that physicians, allied healthcare professionals and auxiliary staff were less likely than nurses to engage in HH. HCWs were more likely to comply during night shifts compared to morning shifts, and with self-protective as compared to patient-protective HH moments.

Conclusion:

The information provided in this study provides a data-driven approach that ICUs can use to tailor HH interventions to where, when and for whom they are most required.
Detection of a COVID-19 cluster by universal SARS-CoV-2 testing in a geriatric hospital and implications for infection control management
Authors: Leo Fabian , Tsilimi Angelika , Hillmann Charlotte
Published: August 2021

Hospital-level COVID-19 testing strategies may require rapid changes depending on the dynamics of local epidemiology. A COVID-19 outbreak in a hospital near the authors’ institution, a Geriatric Medicine centre in Berlin, Germany, prompted the implementation of comprehensive SARS-CoV-2 testing. Serial nasopharyngeal swabs were collected from all patients and staff and analysed for SARS-CoV-2 virus RNA using quantitative real-time PCR. In total, 11 of 84 patients (13.1%) and 1 of 147 employees (0.68%) tested positive. Of the 11 positive patients, 9 (81.8%) were asymptomatic at the time of testing. The data were used as the basis for adjusting local COVID-19 containment measures. Only one staff-to-staff transmission was observed, and there was no patient-to-patient, patient-to-staff or staff-to-patient transmission. Three patients infected with SARS-CoV2 died, two deaths being attributable to advanced malignant disease and one to COVID-19–associated myocarditis. In conclusion, universal SARS-CoV-2 testing revealed a cluster of predominantly asymptomatic infections, enabled appropriate local COVID-19 containment decisions and presumably contributed to the prevention of in-hospital SARS-CoV-2 transmission.
Evaluation of infection prevention and control practices in Lassa fever treatment centers in north-central Nigeria during an ongoing Lassa fever outbreak
Authors: Obionu Ifeoma Maureen , Ochu Chinwe Lucia , Ukponu Winifred , Okwor Tochi , Dan-Nwafor Chioma , Ilori Elsie , Ihekweazu Chikwe
Published: August 2021

Background:

Outbreaks of Lassa fever (LF) in Nigeria have become more frequent, with increasing more healthcare worker infections. Prevention of infection is dependent on strict compliance to infection prevention and control (IPC) practices in treatment centres where patients are managed.

Objective:

To evaluate IPC practices during an ongoing LF outbreak in the two major tertiary hospitals serving as the referral LF treatment centres in the north-central region of Nigeria.

Methods:

This cross-sectional survey was carried out by the IPC subteam of the National Rapid Response Team of the Nigeria Centre for Disease Control (NCDC) deployed to Plateau State, north-central Nigeria during the 2019 LF outbreak. Information on IPC in these facilities was collected using the NCDC viral haemorrhagic fevers (VHFs) isolation and treatment facility IPC survey tool.

Results:

Both treatment centres had national VHF IPC isolation guidelines and few health workers had received IPC training. In both centres, there were no clearly demarcated entry points for staff going into clinical areas after putting on personal protective equipment, and there were also no standard operating procedures in place for reporting occupational exposure of staff to infected blood or body fluids in both centres.

Discussion:

The LF treatment centers located in Plateau State during the 2019 LF outbreak were not fully implementing the national VHF IPC guidelines. Periodic assessments of IPC are recommended for proper management of cases and effective control of LF in the State.
French female youth and sports inspectors and the challenge of neoliberalism during the Trente Glorieuses
Authors: Lebossé Clémence , Érard Carine , Vivier Christian
Published: August 2021

In a society where the politics of life is geared toward maximizing the physical and psychological dimensions of human capital to ensure economic growth, France’s Inspectorate for Youth and Sports played a key role in disseminating a new mode of governance of bodies and youth—a form of self-governance based on the rising neoliberal values that emerged during the period of the Trente Glorieuses. Representing a tiny minority in an essentially male bastion, a small number of women, cherry-picked for their expertise and effectiveness as inspectors, came to play a vital role in a new mode of youth governance aimed, against a backdrop of social control, at encouraging young people to assume greater self-responsibility and to take ownership of their physical education and activities. Guided by research in the human and social sciences as a basis for rethinking how physical education is taught in schools, women may be seen as key contributors to the emergence of a new ethos designed to develop the ability of French youth to adapt to the social and economic transformation of capitalist society by appealing to the psyche (superego) and self-regulation. Despite promoting a “differentialist feminism”.
Comprehensive molecular profiling to predict clinical outcomes in pancreatic cancer
Authors: Hong Jung Yong , Cho Hee Jin , Kim Seung Tae , Park Young Suk , Shin Sang Hyun , Han In Woong , Lee Jeeyun , Heo Jin Seok , Park Joon Oh
Published: August 2021

Background:

Pancreatic ductal adenocarcinoma (PDAC) has the worst prognosis among common cancers. The genomic landscape of PDAC is defined by four mutational pathways: kirsten rat sarcoma virus ( KRAS), cellular tumor antigen p53 ( TP53), cyclin dependent kinase inhibitor 2A ( CDKN2A), and SMAD family member 4 ( SMAD4). However, there is a paucity of data on the molecular features associated with clinical outcomes after surgery or chemotherapy.

Methods:

We performed comprehensive molecular characterization of tumor specimens from 83 patients with PDAC who received surgery, using whole-exome sequencing and ribonucleic acid sequencing on tumor and matched normal tissues derived from patients. We also systematically performed integrative analysis, combining genomic, transcriptomic, and clinical features to identify biomarkers and possible therapeutic targets.

Results:

KRAS (75%), TP53 (67%), CDKN2A (12%), SMAD4 (20%), and ring finger protein 43 ( RNF43) (13%) were identified as significantly mutated genes. The tumor-specific transcriptome was classified into two clusters (tumor S1 and tumor S2), which resembled the Moffitt tumor classification. Tumor S1 displayed two distinct subclusters (S1-1 and S1-2). The transcriptome of tumor S1-1 overlapped with the exocrine-like (Collisson)/ADEX (Bailey) subtype, while tumor S1-2 mostly consisted of the classical (Collisson)/progenitor (Bailey) subtype. In the analysis of combinatorial gene alterations, concomitant mutations of KRAS with low-density lipoprotein receptor related protein 1B (LRP1B) were associated with significantly worse disease-free survival after surgery ( p = 0.034). One patient (1.2%) was an ultrahypermutant with microsatellite instability. We also identified high protein kinase C lota ( PRKCI) expression as an overlapping, poor prognostic marker between our dataset and the TCGA dataset.

Conclusion:

We identified potential prognostic biomarkers and therapeutic targets of patients with PDAC. Understanding these molecular aberrations that determine patient outcomes after surgery and chemotherapy has the potential to improve the treatment outcomes of PDAC patients.
Secukinumab in axial spondyloarthritis: a narrative review of clinical evidence
Authors: Braun Jürgen , Kiltz Uta , Bühring Björn , Baraliakos Xenofon
Published: August 2021

Axial spondyloarthritis (axSpA) is a chronic inflammatory rheumatic disease characterized by inflammation and new bone formation in the axial skeleton. AxSpA is considered a spectrum of disease that includes two subtypes identified by the Assessment in SpondyloArthritis International Society classification criteria, namely, radiographic (r-axSpA usually referred to as ankylosing spondylitis) and non-radiographic axSpA (nr-axSpA). Although the burden of disease appears similar between the two classified subtypes, the degree of inflammation, as assessed by magnetic resonance imaging and C-reactive protein, and the degree of new bone formation are significantly higher in r-axSpA than in nr-axSpA. Nevertheless, axSpA is considered one disease with different courses. International guidelines for the management of axSpA have outlined treatment goals focused on control of signs and symptoms, inflammation, prevention of progressive structural damage, preservation of physical function, normalization of social participation and improvement of quality of life. The pathogenesis of axSpA has not been completely elucidated to date. A strong link between human leukocyte antigen B27 and axSpA, however, has been identified, and the success of anti-tumour necrosis factor and anti-interleukin (IL)-17A therapy has highlighted some of the key pro-inflammatory cytokines involved. The anti-IL-17A monoclonal antibody secukinumab is approved for the treatment of ankylosing spondylitis and nr-axSpA in the European Union and United States. In this narrative review, we discuss data for secukinumab in axSpA from randomized controlled trials, including MEASURE trials in AS and PREVENT in nr-axSpA, and real-world evidence.
Corticosteroid injection treatment for dactylitis in psoriatic arthritis
Authors: Carriero Antonio , Lubrano Ennio , Picerno Valentina , Padula Angela Anna , D’Angelo Salvatore
Published: August 2021

Dactylitis – a hallmark clinical feature of psoriatic arthritis (PsA) – that occurs in 30–50% of PsA patients, is a marker of disease severity for PsA progression, an independent predictor of cardiovascular morbidity and impairs the motor functions of PsA patients. There is a paucity of evidence for the treatment due to the absence of randomized controlled trials assessing dactylitis as a primary endpoint and current practice arises from the analysis of dactylitis as a secondary outcome. Corticosteroid (CS) injections for dactylitis in PsA patients are a therapeutic treatment option for patients with isolated dactylitis or for patients with flares in tendon sheaths, despite stable and effective systemic treatment. The aim of this narrative review is to briefly illustrate the clinical aspects of dactylitis in PsA, the imaging and clinimetric tools used to diagnose and monitor dactylitis, the current treatment strategies and principally to provide a comprehensive picture of the clinical efficacy and safety with ultrasound-guide and blind techniques of CS injections for dactylitis in PsA patients.
The Availability of Sharps Disposal Bins: A Survey of Airports in California
Authors: Zhang Jennifer Y. , Shang Trisha , Krisiunas Edward , Liepmann Dorian , Klonoff David C.
Published: August 2021

Background:

Sharps waste, especially medical sharps waste, can put those who come into contact with it at risk for injury and exposure to blood-borne pathogens. Options for self-injectors to dispose of their sharps while traveling vary greatly – from sharps containers in limited locations in some public restrooms to large kiosks centrally located to no containers at all. Currently, there is a lack of published data on sharps disposal bins in commercial airports. We surveyed commercial airports in California to assess the current state of sharps waste disposal. Many people with diabetes routinely use sharps every day for injecting medications or for self-monitoring glucose concentrations and these people, along with others who self-inject medications, must have a safe mechanism for sharps disposal when travelling by air.

Methods:

A five-question survey was sent to 30 commercial airports in California. Responses were collected and then analyzed based on the following three metrics: (1) the percentage of airports that responded and indicated that they had any sharps disposal bins, (2) the percentage of airports that responded and indicated that they had sharps disposal bins in over half their restrooms, and (3) the average percentage of bathrooms that have available sharps disposal bins in airports that responded to our survey.

Results:

Out of 30 commercial airports in California, we received survey responses from 13 airport representatives and direct email responses from 5 airport representatives. Out of 18 total responses, 11 airports (61.1%) reported that they had some form of available sharps disposal options. Out of the 13 survey responses, 6 airports (46.2%) reported that they had sharps disposal in over 50% of their restrooms.

Conclusion:

There is a lack of consistency in sharps waste disposal options among commercial airports in California. While many commercial airports in California offer sharps waste disposal options, not all commercial airports have sharps waste disposal options in all their public restrooms. There is room for improved availability of sharps disposal bins in California’s commercial airports.
Hypoxia Inducible Factor-1α Is a Regulator of Autophagy in Osteoarthritic Chondrocytes
Authors: Lu Junren , Peng Yi , Zou Jiapeng , Wang Jiayi , Lu Shunyi , Fu Tengfei , Jiang Libo , Zhang Chi , Zhang Jian
Published: August 2021

Objective

To investigate the relationship between hypoxia inducible factor-1α (HIF-1α) and the autophagic response in osteoarthritic chondrocytes (OA), under inflammatory insult as represented by in vitro OA model.

Methods

Human chondrocyte cell line C28/I2 was cultured in both normoxic and hypoxic conditions and treated with interleukin-1β (IL1β) to emulate OA inflammatory insult in vitro. Cellular HIF-1α expression was silenced using siRNA transfection and cellular autophagic (P62/LC3II) response and OA chondrocyte damage (COL2A1/MMP13) related proteins were examined using western blotting. Cellular mitophagic (BNIP3/PINK1/Parkin) and apoptotic (Caspase/Cleaved Caspase 3) were also evaluated to assess mitophagy-mediated cell death due to HIF-1α silencing.

Results

Chondrocyte basal autophagy levels were higher in a HIF-1α elevated environment and was more resistant to IL1β-induced inflammatory insult. Increase in autophagic proteins showed better chondrocyte repair, which resulted a lower level of reactive oxygen species production, and lesser damage to chondrocyte integrity. Silencing HIF-1α activates cellular PINK1/Parkin and BNIP3 mitophagic proteins, which leads to the activation of Caspase/Cleaved Caspase 3 apoptotic cascade.

Conclusion

Our results show that chondrocyte autophagy is dependent on HIF-1α expression, showing the importance of HIF-1α in hypoxic chondrocyte function in OA. Dysregulation of HIF-1α expression results in the activation of mitophagy-mediated apoptosis.
Ibrutinib effect in acquired von Willebrand syndrome secondary to Waldenström macroglobulinemia
Authors: Poza María , Íñiguez Rodrigo , Zamanillo Irene , Redondo Sara , Alonso Rafael , Martínez-López Joaquín , Jiménez-Ubieto Ana
Published: August 2021

The pathological increase of clonal IgM in Waldenström macroglobulinemia can be associated with acquired von Willebrand syndrome and can be a major risk of bleeding symptoms in this subgroup of patients with Waldenström macroglobulinemia. The Bruton tyrosine kinase inhibitor ibrutinib is one of the approved treatments for symptomatic Waldenström macroglobulinemia. However, some controversy exists regarding the use of ibrutinib in these patients with high risk of bleeding because of its antiaggregant effect that could increase the risk of bleeding. Here, we present the case of a patient with Waldenström macroglobulinemia with associated acquired von Willebrand syndrome and progressively significant bleeding symptoms, who experienced a rapid increase in von Willebrand factor with ibrutinib treatment, despite only reaching a partial response in IgM levels similar to those reached with other previous treatments. We suggest that the control over the monoclonal protein is not the only mechanism that explains the good response, improvement in the bleeding symptoms and von Willebrand factor levels. This fact could be explained by the reduced glycoprotein Ib receptor expression induced by ibrutinib and the consequent von Willebrand factor increase in peripheral blood.
Venetoclax combination therapy with hypomethylating agents in young adults with relapsed/refractory acute myeloid leukaemia
Authors: Báez-Gutiérrez Nerea , Rodríguez-Ramallo Héctor , Moreno María Antonia-Pérez , Arboli Eduardo-Rodriguez , Abdel-kader Martín Laila
Published: August 2021

In recent years, one of the most successful advances in treating acute myeloid leukaemia (AML) has been the combination of the B-cell lymphoma 2 (BCL-2) inhibitor venetoclax with hypomethylating agents (decitabine or azacytidine). This combination treatment has an accelerated approval by the Food and Drug Administration for newly diagnosed AML adults who are 75 years of age or older or who have comorbidities and are not eligible to receive intensive induction chemotherapy. AML is the most common form of acute leukaemia in adults, with a median age at diagnosis of 68 years. Consequently, most of the patients included in the studies are elderly. Traditionally, young patients achieve higher remission rates compared with the elderly AML population. Although venetoclax combination therapy could become a treatment option for treating young patients with relapsed/refractory AML, this regimen has not been systematically tested in this setting. In this study, we summarize the currently available evidence on the treatment of venetoclax in combination with hypomethylating agents for the treatment of young relapsed/refractory AML patients, in addition to our experience in clinical practice with two case reports. Venetoclax, combined with hypomethylating agents, seems to be an effective option for young relapsed/refractory AML patients. However, due to the poor quality of the evidence, additional well-designed studies with greater numbers of patients are needed to confirm the effectiveness and safety of venetoclax combination regimens for this population.
Principles, methods, contributions, and limitations of design science research in marketing: Illustrative application to customer journey management
Authors: Jacob Florence , Pez Virginie , Volle Pierre
Published: August 2021

The purpose of this article is to present the principles, application methods, contributions, and limitations of the design science research methodology (DSRM), a research strategy based on design science research (DSR). After presenting the principles of DSRM, we show how to use this method by applying it to the problem of customer journey management. We make practical recommendations for applying the method, and discuss its contributions and limitations. By presenting a method that meets the requirements of both rigor and relevance, this article contributes to the renewal of research methods used in our discipline.
Vitamin D Status and Severe COVID-19 Disease Outcomes in Hospitalized Patients
Authors: Pecina Jennifer L. , Merry Stephen P. , Park John G. , Thacher Tom D.
Published: August 2021

Background:

Vitamin D deficiency may increase the risk of severe COVID-19 disease.

Objectives:

To determine if 25-hydroxyvitamin D [25(OH)D] levels in patients hospitalized for COVID-19 were associated with the clinical outcomes of days on oxygen, duration of hospitalization, ICU admission, need for assisted ventilation, or mortality.

Methods:

We conducted a retrospective study of 92 patients admitted to the hospital with SARS-CoV-2 infection between April 16, 2020 and October 17, 2020. Multivariable regression was performed to assess the independent relationship of 25(OH)D values on outcomes, adjusting for significant covariates and the hospitalization day the level was tested.

Results:

About 15 patients (16.3%) had 25(OH)D levels <20 ng/mL. Only 1 patient (3.4%) who had documented vitamin D supplementation prior to admission had 25(OH)D <20 ng/mL. Serum 25(OH)D concentrations were not significantly associated with any of our primary outcomes of days on oxygen, duration of hospitalization, intensive care unit (ICU) admission, need for mechanical ventilation, or mortality in any of the adjusted multivariable models. Adjusting for the hospital day of 25(OH)D sampling did not alter the relationship of 25(OH)D with any outcomes.

Conclusion:

Vitamin D status was not related to any of the primary outcomes reflecting severity of COVID-19 in hospitalized patients. However, our sample size may have lacked sufficient power to demonstrate a small effect of vitamin D status on these outcomes.
Practice Patterns and Training Needs Among Physicians Certifying Patients for Medical Marijuana in Florida
Authors: Sajdeya Ruba , Shavers Anna , Jean-Jacques Jennifer , Costales Brianna , Jugl Sebastian , Crump Carly , Wang Yan , Manfio Luran , Pipitone R. Nathan , Rosenthal Martha S. , Winterstein Almut G. , Cook Robert L.
Published: August 2021

Background:

Little is known about the clinical training or practice experiences among physicians who certify patients for medical marijuana. The objective of this study was to determine information sources, factors influencing recommendations, clinical practices in patient assessment, communications, and recommendations, and priority areas for additional training among physicians who certify patients for medical marijuana.

Methods:

A cross-sectional state-wide anonymous survey of registered medical marijuana physicians in Florida between June and October 2020 was administered. Numerical responses were quantified using counts and percentages. The frequencies for “often” and “always” responses were aggregated when appropriate.

Results:

Among 116 respondents, the mean (standard deviation) age was 57 (12) years old, and 70% were male. The most frequently used information sources were research articles (n = 102, 95%), followed by online sources (n = 99, 93%), and discussions with other providers and dispensary staff (n = 84, 90%). Safety concerns were most influential in patient recommendations (n = 39, 39%), followed by specific conditions (n = 30, 30%) and patient preferences (n = 26, 30%). Ninety-three physicians (92%) reported they “often” or “always” perform a patient physical exam. Eighty-four (77%) physicians provided specific administration route recommendations. Half (n = 56) “often” or “always” provided specific recommendations for Δ-9-tetrahydrocannabinol: cannabidiol ratios, while 69 (62%) “often” or “always” provided specific dose recommendations. Online learning/training modules were the most preferred future training mode, with 88 (84%) physicians “likely” or “very likely” to participate. The top 3 desired topics for future training were marijuana-drug interactions (n = 84, 72%), management of specific medical conditions or symptoms (n = 83, 72%), and strategies to reduce opioids or other drugs use (n = 78, 67%).

Conclusions:

This survey of over 100 medical marijuana physicians indicates that their clinical practices rely on a blend of research and anecdotal information sources. While physicians report clinical factors as influential during patient recommendation, patient assessment practices and treatment regimen recommendations vary substantially and rely on experimental approaches. More research is needed to inform evidence-based practice and training, especially considering details on drug interactions, risk-benefit of treatment for specific clinical conditions, and strategies to reduce opioid use.
Challenges Facing Family Caregivers of Children With Disabilities During COVID-19 Pandemic in Palestine
Authors: Zahaika Dalia , Daraweesh Diana , Shqerat Sondos , Arameen Dalia , Halaweh Hadeel
Published: August 2021

Background:

COVID-19 has caused great changes in all aspects of life which affected all people especially vulnerable groups such as children with disabilities (CWD) and their families.

Objective:

This study aimed to examine the challenges facing caregivers of CWD during the pandemic, and to explore these challenges from various physical, social, psychological, and financial aspects.

Methods:

A cross-sectional design was conducted in Palestine, a total of 130 caregivers of CWD completed a survey consisting of demographic and clinical characteristics questionnaire and the short version of the burden scale for family caregivers (BSFC-s) between March and May 2021.

Results:

Most of the caregivers were mothers (76.9%), the mean age of the children was (6.09 ± 3.43 years). The majority (88.5%) of the caregivers felt physically exhausted, about (75.4%) had decreased living standards, and (86.2%) indicated that caregiving is taking their strength. A high burden score was recorded, the mean BSFC-s score was 20.17 ± 5.57. Significant differences in BSFC-s scores were recorded based on the type of disability, and child’s ability to take care of oneself, P < .05. The total scores of the BSFC-s were positively correlated with the physical, social, psychological, and financial challenges facing the caregivers ( P < .001).

Conclusions:

COVID-19 has caused increased burdens on the caregivers of CWD and a negative impact on the child’s mobility accompanying a lack of access to health and rehabilitation services. Vital factors are to be considered in developing strategic health and rehabilitative plans for promoting better care for caregivers and their CWD during lockdown restrictions time.
The Audience’s Perspective: Decline of Mythical Elements in Films
Authors: Zhang Pengxia , Liu Mingzheng , Li Dandan , Dong Yue
Published: August 2021

Myths have always been a source of inspiration for literary and artistic creation because of their surreal image and idealized vision. To inherit the national culture and the spirit, many films eastern and western take mythical elements as a medium of meaning. So, has the appearance of mythical elements in the films received a positive response from the audience? Based on the films ( n = 919) released in mainland China cinemas from September 2015 to September 2018, this article uses the method of regression analysis and Latent Dirichlet allocation topic model to verify the relationship between mythical elements and audience acceptance. The results show that (a) mythical elements have no significant impact on the box office revenues; (b) and have no positive impact on the film ratings; (c) there is no significant mythical topic in the film reviews of mythical films, which shows that the public in modern society does not show sensitivity to the mythical elements in films. Finally, we discuss the possible causes of the results and put forward corresponding suggestions for the producers of mythical films.
Workplace Violence Prevention: Flagging Practices and Challenges in Hospitals
Authors: Ferron Era Mae , Kosny Agnieszka , Tonima Sabrina
Published: August 2021

Background:

Flagging is a standardized way to communicate the risk of patient violence to workers. We add to the limited body of research on flagging by describing hospitals’ approaches to and challenges with flagging patients with a history of violent behavior.

Methods:

We used a qualitative case study approach of hospitals in Ontario, Canada and their patient flagging practices. Key informants and our advisory committee identified 11 hospitals to invite to participate. Hospitals assisted in recruiting frontline clinical and allied health workers and managers to an interview or focus group. A document analysis of hospitals’ flagging policies and related documents was conducted. Thematic analysis was used to analyze interview and focus group data.

Findings:

Five hospitals participated. Of the five hospitals, four had a flagging policy where frontline clinical workers ( n = 58), frontline allied health workers ( n = 31), and managers ( n = 42) participated in an interview ( n = 43) or focus group ( n = 15). Participants described three challenges: patient stigmatization, patient privacy, and gaps in policy and procedures.

Conclusion/Application to practice:

Flagging patients with a history of violent behavior is one intervention that hospitals use to keep workers safe. While violence prevention was important to study participants, a number of factors can affect implementation of a flagging policy. Study findings suggest that hospital leadership should mitigate patient stigmatization (real and perceived) and perception of patient rights infringement by educating all managers and frontline workers on the purpose of flagging and the relationship between occupational health and safety and privacy regulations. Leadership should also actively involve frontline workers who are the most knowledgeable about how policies work in practice.
Potential Destructive Binaural Interaction Effects in Auditory Steady-State Response Measurements
Authors: Watson Sam , Laugesen Søren , Epp Bastian
Published: August 2021

An aided sound-field auditory steady-state response (ASSR) has the potential to be used to objectively validate hearing-aid (HA) fittings in clinics. Each aided ear should ideally be tested independently, but it is suspected that binaural testing may be used by clinics to reduce test time. This study simulates dichotic ASSR sound-field conditions to examine the risk of making false judgments due to unchecked binaural effects. Unaided ASSRs were recorded with a clinical two-channel electroencephalography (EEG) system for 15 normal hearing subjects using a three-band CE-Chirp® stimulus. It was found that the noise corrected power of a response harmonic can be suppressed by up to 10 dB by introducing large interaural time differences equal to half the time period of the stimulus envelope, which may occur in unilateral HA users. These large interaural time differences also changed the expression of ASSR power across the scalp, resulting in dramatically altered topographies. This would lead to considerably lower measured response power and possibly nondetections, evidencing that even well fit HAs are fit poorly (false referral), whereas monaural ASSR tests would pass. No effect was found for simulated lateralizations of the stimulus, which is beneficial for a proposed aided ASSR approach. Full-scalp ASSR recordings match previously found 40 Hz topographies but demonstrate suppression of cortical ASSR sources when using stimuli in interaural envelope antiphase.
Analysis of Regulative Systems for Heritage Protection in Nigeria
Authors: Fajemirokun Bola
Published: August 2021

Rapid population growth in Nigeria means that the contestation for land, housing and infrastructure will intensify with serious implications for heritage protection. The federal government is currently implementing its economic recovery and growth plan (ERGP) with the aim of reducing poverty and inequality through job creation and restoring economic growth in a more diversified and competitive economy. The ERGP prioritizes tourism and the creative industries but is mainly silent about heritage protection. The problem is that the focus on economic benefits and yields from non-material and propagative aspects of culture obscures the critical issues that are affecting the regulative systems for heritage protection. This article therefore presents a detailed analysis of the nature and scope of these regulative systems in Nigeria with a view to determining the extent of their efficacy and impacts and it further makes recommendations on the way forward.
G protein coupled estrogen receptor attenuates mechanical stress-mediated apoptosis of chondrocyte in osteoarthritis via suppression of Piezo1
Authors: Sun Yi , Leng Ping , Guo Pengcheng , Gao Huanshen , Liu Yikai , Li Chenkai , Li Zhenghui , Zhang Haining
Published: August 2021

Background

Apoptosis of chondrocyte is involved in osteoarthritis (OA) pathogenesis, and mechanical stress plays a key role in this process by activation of Piezo1. However, the negative regulation of signal conduction mediated by mechanical stress is still unclear. Here, we elucidate that the critical role of G protein coupled estrogen receptor (GPER) in the regulation of mechanical stress-mediated signal transduction and chondrocyte apoptosis.

Methods

The gene expression profile was detected by gene chip upon silencing Piezo1. The expression of GPER in cartilage tissue taken from the clinical patients was detected by RT-PCR and Western blot as well as immunohistochemistry, and the correlation between GPER expression and OA was also investigated. The chondrocytes exposed to mechanical stress were treated with estrogen, G-1, G15, GPER-siRNA and YAP (Yes-associated protein)-siRNA. The cell viability of chondrocytes was measured. The expression of polymerized actin and Piezo1 as well as the subcellular localization of YAP was observed under laser confocal microscope. Western blot confirmed the changes of YAP/ Rho GTPase activating protein 29 (ARHGAP29) /RhoA/LIMK /Cofilin pathway. The knee specimens of osteoarthritis model were stained with safranin and green. OARSI score was used to evaluate the joint lesions. The expressions of GPER and YAP were detected by immunochemistry.

Results

Expression profiles of Piezo1- silenced chondrocytes showed that GPER expression was significantly upregulated. Moreover, GPER was negatively correlated with cartilage degeneration during OA pathogenesis. In addition, we uncovered that GPER directly targeted YAP and broadly restrained mechanical stress-triggered actin polymerization. Mechanism studies revealed that GPER inhibited mechanical stress-mediated RhoA/LIMK/cofilin pathway, as well as the actin polymerization, by promoting expression of YAP and ARHGAP29, and the YAP nuclear localization, eventually causing the inhibition of Piezo1. YAP was obviously decreased in degenerated cartilage. Silencing YAP caused significantly increased actin polymerization and activation of Piezo1, and an increase of chondrocyte apoptosis. In addition, intra-articular injection of G-1 to OA rat effectively attenuated cartilage degeneration.

Conclusion

We propose a novel regulatory mechanism underlying mechanical stress-mediated apoptosis of chondrocyte and elucidate the potential application value of GPER as therapy targets for OA.
HAZ Characterization and Mechanical Properties of QP980-DP980 Laser Welded Joints
Authors: Xue Junliang , Peng Peng , Guo Wei , Xia Mingsheng , Tan Caiwang , Wan Zhandong , Zhang Hongqiang , Li Yongqiang
Published: August 2021

The QP980-DP980 dissimilar steel joints were fabricated by fiber laser welding. The weld zone (WZ) was fully martensitic structure, and heat-affected zone (HAZ) contained newly-formed martensite and partially tempered martensite (TM) in both steels. The super-critical HAZ of the QP980 side had higher microhardness (~ 549.5 Hv) than that of the WZ due to the finer martensite. A softened zone was present in HAZ of QP980 and DP980, the dropped microhardness of softened zone of the QP980 and DP980 was Δ 21.8 Hv and Δ 40.9 Hv, respectively. Dislocation walls and slip bands were likely formed at the grain boundaries with the increase of strain, leading to the formation of low angle grain boundaries (LAGBs). Dislocation accumulation more easily occurred in the LAGBs than that of the HAGBs, which led to significant dislocation interaction and formation of cracks. The electron back-scattered diffraction (EBSD) results showed the fraction of LAGBs in sub-critical HAZ of DP980 side was the highest under different deformation conditions during tensile testing, resulting in the failure of joints located at the sub-critical HAZ of DP980 side. The QP980-DP980 dissimilar steel joints presented higher elongation (~ 11.21%) and ultimate tensile strength (~ 1011.53 MPa) than that of DP980-DP980 similar steel joints, because during the tensile process of the QP980-DP980 dissimilar steel joint (~ 8.2% and 991.38 MPa), the strain concentration firstly occurred on the excellent QP980 BM. Moreover, Erichsen cupping tests showed that the dissimilar welded joints had the lowest Erichsen value (~ 5.92 mm) and the peak punch force (~ 28.4 kN) due to the presence of large amount of brittle martensite in WZ and inhomogeneous deformation.
Disconnectome of the migraine brain: a “connectopathy” model
Authors: Silvestro Marcello , Tessitore Alessandro , Caiazzo Giuseppina , Scotto di Clemente Fabrizio , Trojsi Francesca , Cirillo Mario , Esposito Fabrizio , Tedeschi Gioacchino , Russo Antonio
Published: August 2021

Background

In the past decades a plethora of studies has been conducted to explore resting-state functional connectivity (RS-FC) of the brain networks in migraine with conflicting results probably due to the variability and susceptibility of signal fluctuations across the course of RS-FC scan. On the other hand, the structural substrates enabling the functional communications among the brain connectome, characterized by higher stability and reproducibility, have not been widely investigated in migraine by means of graph analysis approach. We hypothesize a rearrangement of the brain connectome with an increase of both strength and density of connections between cortical areas specifically involved in pain perception, processing and modulation in migraine patients. Moreover, such connectome rearrangement, inducing an imbalance between the competing parameters of network efficiency and segregation, may underpin a mismatch between energy resources and demand representing the neuronal correlate of the energetically dysfunctional migraine brain.

Methods

We investigated, using diffusion-weighted MRI imaging tractography-based graph analysis, the graph-topological indices of the brain “connectome”, a set of grey matter regions (nodes) structurally connected by white matter paths (edges) in 94 patients with migraine without aura compared to 91 healthy controls.

Results

We observed in migraine patients compared to healthy controls: i) higher local and global network efficiency (p < 0.001) and ii) higher local and global clustering coefficient (p < 0.001). Moreover, we found changes in the hubs topology in migraine patients with: i) posterior cingulate cortex and inferior parietal lobule (encompassing the so-called neurolimbic-pain network) assuming the hub role and ii) fronto-orbital cortex, involved in emotional aspects, and visual areas, involved in migraine pathophysiology, losing the hub role. Finally, we found higher connection (edges) probability between cortical nodes involved in pain perception and modulation as well as in cognitive and affective attribution of pain experiences, in migraine patients when compared to healthy controls (p < 0.001). No correlations were found between imaging and clinical parameters of disease severity.

Conclusion

The imbalance between the need of investing resources to promote network efficiency and the need of minimizing the metabolic cost of wiring probably represents the mechanism underlying migraine patients’ susceptibility to triggers. Such changes in connectome topography suggest an intriguing pathophysiological model of migraine as brain “connectopathy”.
Expression of the circular RNAs in astaxanthin promotes cholesterol efflux from THP-1 cells based on RNA-seq
Authors: Liu Jie , Wei Yue , Lin Yong , Zhang Peiwen , Zhang Zhexiao , Huang Hairong , Wu Hongfu , Zou Tangbin
Published: August 2021

Background

It is reported that circular RNAs (circRNAs) play a key role in atherosclerosis (AS). Foam cell formation, which is the main feature of AS, can be significantly inhibited by cholesterol efflux.

Methods

We established a model of astaxanthin (AST) promoting cholesterol efflux from macrophages through oil red O staining, real-time quantitative PCR (qRT-PCR), and western blot and used RNA sequencing to detect the expression of circRNAs in AST-treated and untreated THP-1 cells. Finally, siRNA transfection screened out circRNAs that were significantly differentially expressed. The data analysis was performed by Student’s t test and P < 0.05 was considered statistically significant.

Results

In the model of AST promoting cholesterol efflux from THP-1 cells, there were a total of 7276 circRNAs differentially expressed, among which the top 25 upregulated and the top 25 downregulated circRNAs were selected based on the log2 (fold change). GO analysis showed that differential expression of circRNAs in biological process (2066/3098; 66.69%), molecular function (543/3098; 17.53%), and cellular component (489/3098; 15.78%). Based on KEGG analysis, RNA transport was the most enriched pathway. Finally, we obtained 3 significantly upregulated circRNAs by siRNA transfection and qRT-PCR.

Conclusions

The 3 differentially expressed circRNAs may play an important role in the process of AST promoting cholesterol efflux and may be used as biomarkers to prevent AS.