bluuebunny/crossref_metadata_2025 huggingface dataset:
How US judges manage a dilemma narrating their careers
Authors: Tracy Karen
Published: January 2023

In the United States the law espouses contrary principles about the relationship between identity categories, such as race and gender, and justice. On the one hand, a more representative judiciary is seen to be a way to ensure greater justice. On the other, the law is assumed to be “blind” to parties’ identities; race and gender of judges and litigants doesn’t matter. These contrary principles create a dilemma when judges narrate their career. This study examines interviews with 20 retired and senior judges, five judges of each of four racial-gender categories: Black and white men and women, culled from the city of Philadelphia’s Senior Judge Oral History Program. After providing specifics about the Senior Judge interviews, past research on gender and race influences on professional talk, and describing issues to consider in interviews, I analyze the interviews and show that judges deal with the dilemma of identities mattering AND identities not mattering by distinguishing two phases of life: how a person came to be a judge and what a person did as a judge. In explaining how one came to be a judge, the person’s race and gender were clear influences. In contrast, when judges narrated their work activities, what they did as a judge, there were few discursive tells revealing a judge’s race or gender. In concluding I consider the problems and advantages of managing this justice-identities dilemma in the fashion that these judges did and suggest a direction for future research.
Rupture: Towards a critical, emplaced, and experiential view of nature-society crisis
Authors: Mahanty Sango , Milne Sarah , Barney Keith , Dressler Wolfram , Hirsch Philip , To Phuc Xuan
Published: January 2023

We are currently seeing a global escalation in social and environmental disruption, yet concepts like the Anthropocene do not fully capture the intensity and generative scope of this crisis. ‘Rupture’ is being used as a term for specific and intense episodes of change, such as wildfires or toxic pollution releases. This is a useful addition to our lexicon for nature-society change but needs to be more robustly theorized. Defining rupture as an intense and adverse episode of nature-society disruption that ripples across scales, we elaborate four dimensions that account for rupture's sources and uncertain effects. The first two dimensions consider how rupture emerges in space and time from: (i) synergistic spatial, material, and socio-natural changes across scales; and (ii) the accumulation of slow violence that builds towards and is exposed by punctuated shifts and crisis moments. The second two dimensions consider the outcomes of rupture, namely: (iii) heightened uncertainty, insecurity, and socio-material deprivation, which are experienced in unequal and deeply affective ways; and (iv) the scope to catalyze diverse forms of agency that play out in uncertain ways. To illustrate our discussion, we draw from our long history of research on hydropower landscapes in the Mekong region.
Social contact and attitudes toward outsiders: The case of Japan
Authors: Horiuchi Yusaku , Ono Yoshikuni
Published: January 2023

Previous studies have shown that people oppose refugee resettlement more strongly after being exposed to frames that depict refugees as threatening. However, all people may not perceive such threats the same way. Based on contact theory, we hypothesize that the treatment effects of threatening frames on people’s opposition to refugee resettlement are conditional on their contact experience with foreign-national residents. The results of our pre-registered experiment in Japan indicate that exposure to threatening information does not change attitudes toward refugee resettlement among those living in municipalities where the number of foreign-national residents is rapidly increasing. Combined with the analyses of other subjective measures of contact with foreigners, some suggestive patterns emerge that natives with conscious and positive interactions with outgroup members may be unaffected by anti-refugee rhetoric and threatening frames.
Are physicians and medical students ready for artificial intelligence applications in healthcare?
Authors: AlZaabi Adhari , AlMaskari Saleh , AalAbdulsalam Abdulrahman
Published: January 2023

Background

Artificial intelligence (AI) Healthcare applications are listed in the national visions of some Gulf Cooperation Council countries. A successful use of AI depends on the attitude and perception of medical experts of its applications.

Objective

To evaluate physicians and medical students’ attitude and perception on AI applications in healthcare.

Method

A web-based survey was disseminated by email to physicians and medical students.

Results

A total of 293 (82 physicians and 211 medical students) individuals have participated (response rate is 27%). Seven participants (9%) reported knowing nothing about AI, while 208 (69%) were aware that it is an emerging field and would like to learn about it. Concerns about AI impact on physicians’ employability were not prominent. Instead, the majority (n=159) agreed that new positions will be created and the job market for those who embrace AI will increase. They reported willingness to adapt AI in practice if it was incorporated in international guidelines (30.5%), published in respected scientific journals (17.1%), or included in formal training (12.2%). Almost two of the three participants agreed that dedicated courses will help them to implement AI. The most commonly reported problem of AI is its inability to provide opinions in unexpected scenarios. Half of the participants think that both the manufacturer and physicians should be legally liable for medical errors occur due to AI-based decision support tools while more than one-third (36.77%) think that physicians who make the final decision should be legally liable. Senior physicians were found to be less familiar with AI and more concerned about physicians’ legal liability in case of a medical error.

Conclusion

Physicians and medical students showed positive attitudes and willingness to learn about AI applications in healthcare. Introducing AI learning objectives or short courses in medical curriculum would help to equip physicians with the needed skills for AI-augmented healthcare system.
The Dark Side of Upward Social Comparison for Social Media Users: An Investigation of Fear of Missing Out and Digital Hoarding Behavior
Authors: Wang Haixia , Miao Peng , Jia Huiyuan , Lai Kaisheng
Published: January 2023

The digital age has seen a rise in digital hoarding behavior, which is defined as the behavior of accumulating digital files, resulting in stress and disorder. However, little is known about the causes and psychological mechanisms of digital hoarding. To address this research gap, this study proposed and empirically tested a moderated mediation model of social networking site (SNS) users’ causes of and psychological motivation for digital hoarding behavior using an online questionnaire method. We surveyed a total of 556 SNS users online. The results revealed that social comparison of this sort increased individuals’ digital hoarding behaviors and that fear of missing out (FoMO) mediated this effect. In addition, dispositional greed moderated the relationship between this comparison and FoMO as well as the relationship between FoMO and digital hoarding behavior such that these relationships were stronger for SNS users with high dispositional greed. Our research improves our understanding of the operative psychological mechanisms and boundary conditions in the relation between upward comparison via SNSs and digital hoarding behavior.
The Factors That Influence Chemotherapy Exposure Among Nurses: An Integrative Review
Authors: Abu-Alhaija Dania , Bakas Tamilyn , Shaughnessy Elizabeth , Miller Elaine
Published: January 2023

Background:

Exposure to chemotherapy is an occupational hazard predisposing nurses to severe health effects. The purpose of this integrative review was to identify the recent literature describing the risk factors for occupational exposure to chemotherapy among nurses.

Methods:

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology was employed to conduct the review. The databases searched were Scopus, PubMed, and CINAHL using the search terms “chemotherapy,” “drugs,” “exposure,” and “nurses.” Included articles were published between January 2010 and February 2022, published in peer-reviewed journals for research conducted in the United States, and written in English language. Excluded articles were studies that did not involve nurses in their samples. Review articles, books, theses, and dissertations were excluded as well. The Johns Hopkins Nursing Evidence-Based Practice Model was used to assess the level of evidence from the reviewed studies.

Findings:

Fourteen studies were included in this review. Ten studies were rated on Evidence Level III, two on Evidence Level II, one on Evidence Level I, and one on Evidence Level V. The main risk factors for occupational exposure were nurses’ knowledge of chemotherapy handling guidelines, nurses’ adherence to using the personal protective equipment, nurses’ health beliefs regarding chemotherapy exposure, and workplace-related factors such as workload and managerial support.

Conclusion:

Addressing the identified risk factors would protect nurses from chemotherapy exposure. More research on nurses’ health beliefs regarding chemotherapy exposure and the cues to adhere to chemotherapy handling guidelines in the work environment is needed.
When Should Bony Correction Be Considered in Addition to Medial Patellofemoral Ligament Reconstruction? Results of a Clinically Derived 2-Group Classification of Lateral Patellar Instability Based on 122 Patients at 2- to 5-Year Follow-up
Authors: Zimmermann Felix , Milinkovic Danko Dan , Zimmerer Alexander , Balcarek Peter
Published: January 2023

Background:

The need for concomitant bony procedures to realign pathoanatomic risk factors in addition to medial patellofemoral ligament reconstruction (MPFL-R) remains unclear.

Purpose:

To evaluate a clinically derived 2-part classification of lateral patellar instability aimed at identifying patients indicated for a concomitant bony procedure.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

The study included 122 patients (42 male, 80 female; mean ± SD age, 22 ± 6 years) who were assigned to a mild instability group (mIG) and a complex instability group (cIG) based on the reversed dynamic patellar apprehension test (ReDPAT) and J-sign. The mIG had a positive ReDPAT result <40° to 50° of knee flexion and an absent or low-grade J-sign (grade 1), and the cIG had a positive ReDPAT result >40° of knee flexion and/or a high-grade J-sign (grade 2 or 3). The mIG underwent isolated MPFL-R, and the cIG underwent MPFL-R and concomitant bony procedures depending on the established risk factor assessment. For evaluation, the BANFF Patellar Instability Instrument 2.0 (BPII 2.0) and numeric analog scale (0-10) for patellofemoral pain and subjective knee function were used. The minimal clinically important difference for the BPII 2.0 was ascertained by calculating half the standard deviation of baseline scores.

Results:

Radiographic analysis confirmed a significantly more pronounced pathoanatomic risk factor constellation in the cIG regarding severity of trochlear dysplasia, distal malalignment, and patellar height (all P < .05). At final follow-up, no patellar redislocation occurred in either group; 2 patients in the cIG reported patellar subluxation. Within both groups, all outcome scores improved significantly pre- to postoperatively (all P < .0001); no between-group difference was found regarding BPII 2.0 score and numeric analog scale for function. The minimal clinically important difference for the BPII 2.0 was met by 84% (32/38) of the mIG and 90% (76/84) of the cIG ( P = .36), but the cIG experienced more patellofemoral pain than the mIG (1.3 ± 1.6 vs 2.1 ± 2.1; P = .036).

Conclusion:

Patients with a high-grade J-sign and/or a positive ReDPAT finding beyond 40° to 50° of knee flexion exhibited a significantly more pronounced pathoanatomic risk factor constellation; however, the correction of modifiable risk factors led to similarly good outcomes to patients who underwent isolated MPFL-R. A slightly higher level of patellofemoral pain after bony procedures was evident in these patients.
Psychometric Properties of an Instrument to Determine the Factors Affecting Treatment Adherence Among Patients Receiving Hemodialysis in Sri Lanka
Authors: Lasanthika Chalani , Wanigasuriya Kamani , Hettiaratchi Usha , Amarasekara Thamara Dilhani , Evangeline Goonewardena Christine Sampatha
Published: January 2023

Nonadherence is a widespread problem among patients receiving hemodialysis, while contributing factors are underexplored due to lack of a validated instrument. The study aimed to develop and validate a new disease-specific instrument determining the factors affecting treatment adherence behaviors among patients receiving hemodialysis in a Sri Lankan hospital. The content validation process using a modified Delphi technique suggested 42-item instrument with an average Item-level Content Validity Index (I-CVI) of 0.94. Subsequent principal component analysis (PCA) revealed 5 components with 17 items (patient-centered psychological and physical factors, factors associated with health care, hemodialysis therapy-related factors, socioeconomic factors, and factors associated with the continuity of the treatment), explaining 67.24% total variance. The reliability estimate based on Mislevy and Bock for each component greater than 0.8 and overall standardized Cronbach's alpha of 0.605, indicated acceptable internal consistency reliability. Root mean square residual (RMSR) and weighted root mean square residual (WRMR) indices of 0.084 and 0.059, respectively, indicated acceptable model fit. The final 17-item instrument provides a valid measure for the factors affecting treatment adherence behaviors of the patients receiving hemodialysis in a Sri Lankan hospital.
Dalit Discrimination in Higher Education: A Malady Without Remedies
Authors: Brahmanandam T.
Published: January 2023

Education is one of the most potential variables and relates to different indicators of socio-economic development. Going beyond the campaign for universal literacy, which is otherwise supported by constitutional and statutory provisions, the article seeks to explore the presence as well as the dominance of Scheduled Castes (SC) in Higher Education and gets into the paradoxes of social and bureaucratic structures that facilitate or impede SC entry to and continue with higher education. At this juncture, it seems to be imperative to search for an alignment between constitutional mandates on one hand and social and bureaucratic constraints on the other. Moreover, the relevant methodological framework has been adopted to put facts and figures into perspective, to identify the reason for their slow progress in higher education and to locate the reasons why the reservation policy failed to assist them as per the expectations of the founding fathers of the constitution.
Novel insights into the phenotype and long-term D-gal treatment in PGM1-CDG: a case series
Authors: Radenkovic Silvia , Johnsen Christin , Schulze Andreas , Lail Gurnoor , Guilder Laura , Schwartz Kaitlin , Schultz Matthew , Mercimek-Andrews Saadet , Boyer Suzanne , Morava Eva
Published: January 2023

Phosphoglucomutase-1-congenital disorder of glycosylation (PGM1-CDG) (OMIM: 614921) is a rare autosomal recessive inherited metabolic disease caused by the deficiency of the PGM1 enzyme. Like other CDGs, PGM1-CDG has a multisystemic presentation. The most common clinical findings include liver involvement, rhabdomyolysis, hypoglycemia, and cardiac involvement. Phenotypic severity can vary, though cardiac presentation is usually part of the most severe phenotype, often resulting in early death. Unlike the majority of CDGs, PGM1-CDG has a treatment: oral D-galactose (D-gal) supplementation, which significantly improves many aspects of the disorder. Here, we describe five PGM1-CDG patients treated with D-gal and report both on novel clinical symptoms in PGM1-CDG as well as the effects of the D-gal treatment. D-gal resulted in notable clinical improvement in four patients, though the efficacy of treatment varied between the patients. Furthermore, there was a significant improvement or normalization in transferrin glycosylation, liver transaminases and coagulation factors in three patients, creatine kinase (CK) levels in two, while hypoglycemia resolved in two patients. One patient discontinued the treatment due to urinary frequency and lack of clinical improvement. Furthermore, one patient experienced recurrent episodes of rhabdomyolysis and tachycardia even on higher doses of therapy. D-gal also failed to improve the cardiac function, which was initially abnormal in three patients, and remains the biggest challenge in treating PGM1-CDG. Together, our findings expand the phenotype of PGM1-CDG and underline the importance of developing novel therapies that would specifically treat the cardiac phenotype in PGM1-CDG.
Improving climate resilience: Reduced-order mechanical modelling of a temperature-adaptable sun protection facade system
Authors: Ou Yating , Schneider Maxie , Hückler Alex , Köllner Anton , Völlmecke Christina
Published: January 2023

Analytical models to describe the mechanical behaviour of an adaptive sun protection facade system (Adaptex) are presented. First, a one-dimensional (1D) rigid link model is developed. Stretching and bending deformation of textile bands are represented with the aid of extensional and rotational springs respectively. The model is described by two generalized coordinates only. The second analytical model employs a continuous description based on the Kirchhoff plate theory. The Rayleigh–Ritz method is applied to analyse the deformation behaviour of the textile bands. In comparison with the experimental results, it can be found that the continuous model simulates the real deformation of the facade system, thus its morphological behaviour, very effectively. The results of a parametric study indicate that the stiffness of the textile bands, the geometric dimensions and the position of load application have significant effects on the deformation behaviour.
Kriging and local climate zones – key to higher accuracy in range prediction?
Authors: Herzlieb Thomas , Sturm Johannes H. L.
Published: January 2023

Range prediction of electric vehicles requires knowledge of many parameters, including information about the vehicle environment. As an alternative to onboard measurement, external data sources (secondary data) can be used. The presented methods are suitable for estimating climatic data for vehicle application including urban areas and areas of complex topography. Compared to an inverse distance weighting approach for ambient temperature values, Kriging yields better overall accuracy especially for areas of complex topography, improving accuracy in urban regions, however, remains a challenge. An approach to improve accuracy in urban areas by considering local climate zones in the selection of secondary data sources produces mixed results.
Possibilities are quantum
Authors: Faggin Federico
Published: January 2023

Creative possibilities require imagination, intuition, vision, creativity, comprehension, and inventiveness, properties that are associated with human consciousness and free will. New developments in quantum information theory have allowed to recently postulate with high confidence that consciousness and free will are properties of quantum systems in pure quantum states. This new development allows saying that possibilities emerge from the quantum level of reality since a classical world is deterministic, that is, algorithmic and predictable, and thus incapable of real creativity. Only a creative agent like a human being could imagine real possibilities in a near-infinite combinatorial sea of patterns, and then figure out some intelligent way to realize them. Even if nature were aimlessly creating random patterns someone should have the comprehension to recognize a creative possibility among them. But comprehension is a non-algorithmic property that requires consciousness.
How entrepreneurs turn the possible into the real—and sometimes change the world
Authors: Baron Robert A.
Published: January 2023

The words possibility and opportunity are often viewed as synonyms. In the field of entrepreneurship, though, they have different meanings. Possibilities refer to what might be in the future but does not now exist. Opportunities refer to possibilities that can be developed into something real—new products, services, processes. Entrepreneurs evaluate opportunities in terms of their feasibility, potential for development, and whether people will want and use them if available; they then attempt to choose the ones highest on these dimensions. Several factors play a role in entrepreneurs’ success in identifying potentially valuable opportunities, including the findings of relevant research, entrepreneurs’ active search for opportunities, recognition of patterns among apparently unrelated factors, and in some instances, chance. When successful in creating something new and better than what currently exists, entrepreneurs can change human life and—sometimes—the world around us.
Factor XII contributes to thrombotic complications and vaso-occlusion in sickle cell disease
Authors: Sparkenbaugh Erica M. , Henderson Michael W. , Miller-Awe Megan , Abrams Christina , Ilich Anton , Trebak Fatima , Ramadas Nirupama , Vital Shantel , Bohinc Dillon , Bane Kara L. , Chen Chunsheng , Patel Margi , Wallisch Michael , Renné Thomas , Gruber Andras , Cooley Brian , Gailani David , Kasztan Malgorzata , Vercellotti Gregory M. , Belcher John D. , Gavins Felicity E. , Stavrou Evi X. , Key Nigel S. , Pawlinski Rafal
Published: January 2023

A hypercoagulable state, chronic inflammation, and increased risk of venous thrombosis and stroke are prominent features in patients with sickle cell disease (SCD). Coagulation factor XII (FXII) triggers activation of the contact system that is known to be involved in both thrombosis and inflammation, but not in physiological hemostasis. Therefore, we investigated whether FXII contributes to the prothrombotic and inflammatory complications associated with SCD. We found that when compared with healthy controls, patients with SCD exhibit increased circulating biomarkers of FXII activation that are associated with increased activation of the contact pathway. We also found that FXII, but not tissue factor, contributes to enhanced thrombin generation and systemic inflammation observed in sickle cell mice challenged with tumor necrosis factor α. In addition, FXII inhibition significantly reduced experimental venous thrombosis, congestion, and microvascular stasis in a mouse model of SCD. Moreover, inhibition of FXII attenuated brain damage and reduced neutrophil adhesion to the brain vasculature of sickle cell mice after ischemia/reperfusion induced by transient middle cerebral artery occlusion. Finally, we found higher FXII, urokinase plasminogen activator receptor, and αMβ2 integrin expression in neutrophils of patients with SCD compared with healthy controls. Our data indicate that targeting FXII effectively reduces experimental thromboinflammation and vascular complications in a mouse model of SCD, suggesting that FXII inhibition may provide a safe approach for interference with inflammation, thrombotic complications, and vaso-occlusion in patients with SCD.
Autoimmune hemolytic anemia during pregnancy and puerperium: an international multicenter experience
Authors: Fattizzo Bruno , Bortolotti Marta , Fantini Norma N. , Glenthøj Andreas , Michel Marc , Napolitano Mariasanta , Raso Simona , Chen Frederick , McDonald Vickie , Murakhovskaya Irina , Vos Josephine Mathilde Iris , Patriarca Andrea , Mingot-Castellano Maria Eva , Giordano Giulio , Scarrone Margherita , González-López Tomás José , Trespidi Laura , Prati Daniele , Barcellini Wilma
Published: January 2023

Relapsing or occurring de novo autoimmune hemolytic anemia (AIHA) during pregnancy or puerperium is a poorly described condition. Here, we report 45 pregnancies in 33 women evaluated at 12 centers from 1997 to 2022. Among the 20 women diagnosed with AIHA before pregnancy, 10 had a relapse. An additional 13 patients developed de novo AIHA during gestation/puerperium (2 patients had AIHA relapse during a second pregnancy). Among 24 hemolytic events, anemia was uniformly severe (median Hb, 6.4 g/dL; range, 3.1-8.7) and required treatment in all cases (96% steroids ± intravenous immunoglobulin, IVIG, 58% transfusions). Response was achieved in all patients and was complete in 65% of the cases. Antithrombotic prophylaxis was administered to 8 patients (33%). After delivery, rituximab was administered to 4 patients, and cyclosporine was added to 1 patient. The rate of maternal complications, including premature rupture of membranes, placental detachment, and preeclampsia, was 15%. Early miscarriages occurred in 13% of the pregnancies. Fetal adverse events (22% of cases) included respiratory distress, fetal growth restriction, preterm birth, AIHA of the newborn, and 2 perinatal deaths. In conclusion, the occurrence of AIHA does not preclude the ability to carry out a healthy pregnancy, provided close monitoring, prompt therapy, and awareness of potential maternal and fetal complications.
Single-cell spatial explorer: easy exploration of spatial and multimodal transcriptomics
Authors: Pont Frédéric , Cerapio Juan Pablo , Gravelle Pauline , Ligat Laetitia , Valle Carine , Sarot Emeline , Perrier Marion , Lopez Frédéric , Laurent Camille , Fournié Jean Jacques , Tosolini Marie
Published: January 2023

Background:

The development of single-cell technologies yields large datasets of information as diverse and multimodal as transcriptomes, immunophenotypes, and spatial position from tissue sections in the so-called ’spatial transcriptomics’. Currently however, user-friendly, powerful, and free algorithmic tools for straightforward analysis of spatial transcriptomic datasets are scarce.

Results:

Here, we introduce Single-Cell Spatial Explorer, an open-source software for multimodal exploration of spatial transcriptomics, examplified with 9 human and murine tissues datasets from 4 different technologies.

Conclusions:

Single-Cell Spatial Explorer is a very powerful, versatile, and interoperable tool for spatial transcriptomics analysis.
Circ VRK1/microRNA-17/PTEN axis modulates the angiogenesis of human brain microvascular endothelial cells to affect injury induced by oxygen-glucose deprivation/reperfusion
Authors: Yang Lei , Du Hong , Zhang Xuejing , Gao Bulang , Zhang Dongliang , Qiao Zongrong , Su Xianhui , Bao Tong , Han Siqin
Published: January 2023

Background

Circular RNAs (circRNAs) can act as microRNA (miRNA) sponges, thus regulating gene expression. The role of circRNAs in the process of oxygen-glucose deprivation/reoxygenation (OGD/R) is unclear. Here, we explored the mechanism underlying Circ VRK1 in human brain microvascular endothelial cells (HBMVECs) injury induced by OGD/R.

Methods

The OGD/R cell model was established in HBMVECs. The microarray was applied to detect differentially expressed circRNAs, followed by subcellular fractionation assay. Colony formation assay, flow cytometry, ELISA, tube formation, Transwell and western blot assays were performed for loss-of-function assay. HE staining, TTC staining, immunohistochemistry and western blot were performed in an established mouse model. The relationships between Circ VRK1 and miR-17, and between miR-17 and PTEN were detected by bioinformatics and dual-luciferase assays. Rescue experiments were conducted in vitro and in vivo, and PI3K/AKT activity was detected by Western Blot.

Results

Circ VRK1, predominantly present in the cytoplasm of cells, was upregulated in the HBMVECs exposed to OGD/R. Circ VRK1 downregulation decreased proliferation, migration, tube formation, inflammatory factors and oxidative stress, while increased apoptosis in HBMVECs. Moreover, Circ VRK1 silencing reduced neurological damage, cerebral infarct size, CD34-positive cell counts and VEGF expression in mice. Circ VRK1 mediated PTEN expression and the PI3K/AKT pathway by targeting miR-17. Deletion of miR-17 inhibited the effects of Circ VRK1 siRNA, and silencing of PTEN suppressed the effects of miR-17 inhibitor.

Conclusion

Circ VRK1 was upregulated during OGD/R. Circ VRK1 downregulation regulates PTEN expression by targeting miR-17, thereby promoting PI3K/AKT pathway activity to alleviate OGD/R injury.
Influence of sex, age and diabetes on brain transcriptome and proteome modifications following cerebral ischemia
Authors: Ramiro Laura , Faura Júlia , Simats Alba , García-Rodríguez Paula , Ma Feifei , Martín Luna , Canals Francesc , Rosell Anna , Montaner Joan
Published: January 2023

Ischemic stroke is a major cause of death and disability worldwide. Translation into the clinical setting of neuroprotective agents showing promising results in pre-clinical studies has systematically failed. One possible explanation is that the animal models used to test neuroprotectants do not properly represent the population affected by stroke, as most of the pre-clinical studies are performed in healthy young male mice. Therefore, we aimed to determine if the response to cerebral ischemia differed depending on age, sex and the presence of comorbidities. Thus, we explored proteomic and transcriptomic changes triggered during the hyperacute phase of cerebral ischemia (by transient intraluminal middle cerebral artery occlusion) in the brain of: (1) young male mice, (2) young female mice, (3) aged male mice and (4) diabetic young male mice. Moreover, we compared each group's proteomic and transcriptomic changes using an integrative enrichment pathways analysis to disclose key common and exclusive altered proteins, genes and pathways in the first stages of the disease. We found 61 differentially expressed genes (DEG) in male mice, 77 in females, 699 in diabetics and 24 in aged mice. Of these, only 14 were commonly dysregulated in all groups. The enrichment pathways analysis revealed that the inflammatory response was the biological process with more DEG in all groups, followed by hemopoiesis. Our findings indicate that the response to cerebral ischemia regarding proteomic and transcriptomic changes differs depending on sex, age and comorbidities, highlighting the importance of incorporating animals with different phenotypes in future stroke research studies.
Neutrophil-to-lymphocyte ratio as a predictor of in-hospital complications and overall mortality in Takotsubo syndrome preceded by physical triggers
Authors: Ahn Hyo-Jeong , Kang Jeehoon , Lee So-Ryoung , Park Jin Joo , Lee Hae-Young , Choi Dong-Ju , Cho Hyun-Jai
Published: January 2023

Background

Takotsubo syndrome (TTS) with physical triggers has worse short- and long-term clinical courses than those with emotional triggers. However, predictive factors associated with poor outcomes of TTS with physical triggers are unknown.

Methods

We included 231 patients identified as TTS preceded by physical triggers at two tertiary referral hospitals from 2010 to 2019. In-hospital complications (IHC)—a composite of malignant arrhythmia, need for mechanical circulatory support or mechanical ventilation, and in-hospital death—and overall mortality were retrospectively reviewed. The associations with clinical features were evaluated by multivariable logistic and Cox regression analyses.

Results

The mean age was 69.3 ± 11.6 years, and 85 (36.8%) were male. The in-hospital complications rate was 46.8%. During a median follow-up of 883 days, 96 (41.6%) had died, and overall mortality was 13.6% per patient-year. Higher neutrophil-to-lymphocyte ratio (NLR) was associated with a higher risk of IHC (area under the receiver operating characteristic curve = 0.73; positive and negative predictive value = 60.9% and 67.2% for NLR ≤ 12); odds ratio (OR) with 95% confidence interval (CI) was 1.03 (1.01–1.05), p = 0.010. Subsequently, higher NLR was also related to a greater risk of overall mortality; patients with high NLR (NLR > 12) exhibited poor long-term survival than those with low NLR (NLR ≤ 5): hazard ratio (95% CI), 3.70 (1.72–7.94) with p < 0.001.

Conclusions

A high NLR at initial presentation is associated with an increased risk of IHC and overall mortality in TTS preceded by physical triggers. Given that the treatment of TTS is mainly supportive, intensive monitoring with careful follow-up would be warranted in patients with high NLR.
Correlation between input on public health services and work motivation among primary health workers in China
Authors: Li Jia , Yu Yahang , Hei Luping , Yuan Beibei
Published: January 2023

Background

The integration of public health services into primary health care has been advocated and practiced worldwide for better management of preventable diseases. Health policy makers in China have started the reforms to better integrate public health services and clinical services, but public health services in China still remained neglected in primary health system. This study aimed to explore the input of Chinese primary health workers on delivering public health services and its association with their intrinsic working motivation in China.

Methods

Data were collected from a cross-sectional survey conducted in 2019. Participants in this survey included 803 primary health workers in 75 primary health institutions in China. Questions about the input on clinical and public health services delivery and intrinsic working motivation were asked. A multiple linear regression model was adopted to investigate the correlation between intrinsic working motivation and the time input on public health service. The robustness of this model was checked with a generalized linear model.

Results

Intrinsic motivation was found to have negative association with health workers’ input on public health (β: -1.01, p < 0.05), with the robustness checked with a generalized linear model. The significance of this association differed in the group of urban community health centers and rural township health center. Other factors that had significant relationship with the input on public health services include the being nurses instead of doctors (p < 0.01), being a member of family doctor team (p < 0.01), recognition on relative importance of clinical services (p < 0.01), and perception on better exterior support (p < 0.01).

Conclusion

With higher intrinsic working motivation, primary health workers tended to spend less time on public health services. It reflected that doctors and nurses in primary healthcare institutions still perceived clinical treatment services as their main work responsibility and source of career recognition. Organizational level supports and system level policies should guide the primary health workers to increase their awareness on the importance of public health services and to cultivate their internal interests on public health services, in order to ensure sustainable input and performance improvement on public health services in primary health system in China.
Positive aspects of caregiving among informal caregivers of persons with dementia in the Asian context: a qualitative study
Authors: Yuan Qi , Zhang Yunjue , Samari Ellaisha , Jeyagurunathan Anitha , Goveas Richard , Ng Li Ling , Subramaniam Mythily
Published: January 2023

Background

Positive aspects of caregiving are important coping resources for informal caregivers of persons with dementia (PWD). However, existing studies mostly focused on caregivers from western societies and less attention was paid to the potential cultural differences. This study aims to explore positive aspects of caregiving in the Asian context.

Methods

A qualitative methodology with semi-structured interviews was adopted. A total of 29 informal caregivers of PWD in Singapore were interviewed from Apr 2019 to Dec 2020. All the interviews were audio-recorded and transcribed verbatim for the analysis. Inductive thematic analysis was conducted.

Results

The results revealed a total of three major themes with 11 sub-themes including: 1) positive aspects within self (i.e., better understanding of dementia and caregiving, personal growth, role satisfaction, and improved awareness of self-care); 2) positive aspects between caregiver and PWD (i.e., chance to demonstrate filial piety towards PWD, happiness and positive attitudes of PWD, positive interactions with PWD, and closer relationships with PWD); and 3) positive aspects between caregiver and others (i.e., empathy towards other caregivers, befriending peers, and sharing dementia and caregiving knowledge with others).

Discussion

Findings from this study improved our understanding on positive aspects of caregiving among informal caregivers of PWD in the Asian context. In addition to similar themes across cultures such as personal growth, our study identified a few unique themes like improved awareness of self-care and chances to demonstrate filial piety. For future studies targeting Asian caregivers, it is necessary to include these cultural-specific positive aspects of caregiving.
Trends in utilisation of ultrasound by older Australians (2010–2019)
Authors: Gaget Virginie , Inacio Maria C. , Tivey David R. , Jorissen Robert N. , Babidge Wendy J. , Visvanathan Renuka , Maddern Guy J.
Published: January 2023

Background

Older people have increasingly complex healthcare needs, often requiring appropriate access to diagnostic imaging, an essential component of their health and disease management planning. Ultrasound is a safe imaging tool used to diagnose several conditions commonly experienced by older people such as deep vein thrombosis.

Purpose

To evaluate the utilisation of major ultrasound services by Australians ≥ 65 years old between 2009- and 2019.

Methods

This population-based and yearly cross-sectional study of ultrasound utilisation per 1,000 Australians ≥ 65 years old was conducted using publicly available data sources. Overall, examination site and age- and sex-specific incidence rate (IR) of ultrasound per 1,000 people, adjusted incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated using negative binomial regression models.

Results

Over the study period, the crude utilisation of ultrasound increased by 83% in older Australians. Most ultrasound examinations were conducted on extremities (39%) and the chest (21%), with 25% of all ultrasounds investigating the vascular system. More men than women use ultrasounds of the chest (184/1,000 vs 268/1,000 people), particularly echocardiograms (177/1,000 vs 261/1,000 people), and abdomen (88/1,000 vs 92/1,000 people), especially in those ≥ 85 years old. Hip and pelvic ultrasound were used more by women than men (212/1,000 vs 182/1,000 people). There were increases in vascular abdominal (IRR:1.07, 95%CI:1.06–1.08) and extremeties (IRR:1.06, 95%CI:1.05–1.07) ultrasounds over the study period, particularly in ≥ 75 years old men.

Conclusions

Ultrasound is a common and increasingly used diagnostic tool for conditions commonly experienced by older Australians.
MR imaging phenotypes and features associated with pathogenic mutation to predict recurrence or metastasis in breast cancer
Authors: Shao Zhenzhen , Yu Jinpu , Cheng Yanan , Ma Wenjuan , Liu Peifang , Lu Hong
Published: January 2023

Objectives

Distant metastasis remains the main cause of death in breast cancer. Breast cancer risk is strongly influenced by pathogenic mutation.This study was designed to develop a multiple-feature model using clinicopathological and imaging characteristics adding pathogenic mutations associated signs to predict recurrence or metastasis in breast cancers in high familial risk women.

Methods

Genetic testing for breast-related gene mutations was performed in 54 patients with breast cancers. Breast MRI findings were retrospectively evaluated in 64 tumors of the 54 patients. The relationship between pathogenic mutation, clinicopathological and radiologic features was examined. The disease recurrence or metastasis were estimated. Multiple logistic regression analyses were performed to identify independent factors of pathogenic mutation and disease recurrence or metastasis. Based on significant factors from the regression models, a multivariate logistic regression was adopted to establish two models for predicting disease recurrence or metastasis in breast cancer using R software.

Results

Of the 64 tumors in 54 patients, 17 tumors had pathogenic mutations and 47 tumors had no pathogenic mutations. The clinicopathogenic and imaging features associated with pathogenic mutation included six signs: biologic features (p = 0.000), nuclear grade (p = 0.045), breast density (p = 0.005), MRI lesion type (p = 0.000), internal enhancement pattern (p = 0.004), and spiculated margin (p = 0.049). Necrosis within the tumors was the only feature associated with increased disease recurrence or metastasis (p = 0.006). The developed modelIincluding clinico-pathologic and imaging factors showed good discrimination in predicting disease recurrence or metastasis. Comprehensive model II, which included parts of modelIand pathogenic mutations significantly associated signs, showed significantly more sensitivity and specificity for predicting disease recurrence or metastasis compared to Model I.

Conclusions

The incorporation of pathogenic mutations associated imaging and clinicopathological parameters significantly improved the sensitivity and specificity in predicting disease recurrence or metastasis. The constructed multi-feature fusion model may guide the implementation of prophylactic treatment for breast cancers at high familial risk women.
Histone methyltransferase SETD1A interacts with notch and promotes notch transactivation to augment ovarian cancer development
Authors: Chai Hongjuan , Pan Chunpeng , Zhang Mingyang , Huo Haizhong , Shan Haiyan , Wu Jugang
Published: January 2023

Background

High expression of SETD1A, a histone methyltransferase that specifically methylates H3K4, acted as a key oncogene in several human cancers. However, the function and underlying molecular mechanism of SETD1A in ovarian cancer (OV) remain markedly unknown.

Methods

The expression of SETD1A in OV were detected by Western blot and analyzed online, and the prognosis of STED1A in OV were analyzed online. The protein and mRNA levels were determined by Western blot and RT-qPCR. The cell proliferatin, migration and invasion were measured by CCK-8 and transwell assays. The protein interaction was detected by co-IP assay. The interaction between protein and DNA was performed by ChIP assay. The tumor growth in vivo was performed by xenograft tumor model.

Results

SETD1A was overexpressed in OV and a predictor of poor prognosis. Overexpression of SETD1A augmented the abilities of cell proliferation, migration, and invasion in MRG1 and OVCAR5 cells. In comparison, SETD1A knockdown suppressed cell growth, migration, and invasion in SKOV3 and Caov3 cells. Specifically, SETD1A enhanced Notch signaling by promoting the expression of Notch target genes, such as Hes1, Hey1, Hey2, and Heyl. Mechanistically, SETD1A interacted with Notch1 and methylated H3K4me3 at Notch1 targets to enhance Notch signaling. In addition, restoration of Notch1 in SETD1A-knockdown OV cells recovered cell proliferation, migration and invasion, which was inhibited by SETD1A knockdown. Furthermore, reduction of SETD1A suppressed tumorigenesis in vivo.

Conclusion

In conclusion, our results highlighted the key role of SETD1A in OV development and proved that SETD1A promotes OV development by enhancing Notch1 signaling, indicating that SETD1A may be a novel target for OV treatment.
Suprachoroidal injection of triamcinolone acetonide plus intravitreal bevacizumab in diabetic macular edema: a randomized pilot trial
Authors: Fazel Farhad , Malekahmadi Mohammad , Feizi Awat , Oliya Behrooz , Tavakoli Mehdi , Fazel Mohammadreza
Published: January 2023

Background

To investigate the efficacy of injecting suprachoroidal triamcinolone acetonide (SCTA) plus intravitreal bevacizumab (IVB) into patients with center-involving diabetic macular edema (CI-DME).

Methods

In this phase 2/3 randomized controlled pilot trial, sixty-six eyes with CI-DME and best-corrected visual acuity (BCVA) of at most 20/50 Snellen chart were randomly assigned into two groups. Monotherapy arm received sham injection plus 3 monthly IVB doses and combination arm received a single dose of SCTA and 3 monthly IVB doses. The mean improvements in BCVA and Central subfield thickness (CST), over the three-month was considered the main efficacy outcomes.

Results

The mean BCVA improvements were obtained respectively as − 0.20 ± 0.20 log [minimum angle of resolution (MAR)] (P = 0.004) and 0.37 ± 0.24 log MAR (P < 0.001) in monotherapy and combination arms [between-group analysis (P = 0.014)]. Significant improvements were also observed in CST (P = 0.019) in the combination arm compared to the other. No adverse events (elevated intraocular pressure, cataract) were observed in any of the study arms.

Conclusion

Significant improvements in BCVA and retinal anatomical outcomes demonstrated the additive effects of SCTA to those of anti-vascular endothelial growth factors with no short-term side effects and this combination appears to be a promising option in the management of patients with CI-DME.

Trial registration

The trial was registered in Iranian Registry of Clinical Trials (IRCT20200314046761N1).
High prevalence of refractive errors in an elderly population; a public health issue
Authors: Hashemi Alireza , Khabazkhoob Mehdi , Hashemi Hassan
Published: January 2023

Purpose

To determine the prevalence of myopia and hyperopia and their associated demographic and ocular factors in people 60 years of age and above.

Methods

The sampling was performed using a multi-stage stratified random cluster sampling method. The complete demographic and case history information were collected through an interview. Then, all participants underwent optometric examinations including measurement of uncorrected and best-corrected visual acuity, objective, and subjective refraction. Myopia and hyperopia were defined as a spherical equivalent (SE) refraction worse than -0.50 diopters (D) and + 0.50 D, respectively.

Results

Three thousand three hundred ten of 3791 invitees participated, and the data of 3263 individuals were analyzed for this report. The mean age of participants was 68.25 ± 6.53 (60 to 97) years, and 1895 (58.1%) of them were female (number of male/female participants = 1368/1895). The prevalence of myopia and hyperopia was 31.65% (95% CI: 29.68 -33.61) and 45.36% (95% CI: 43.36 -47.37), respectively. The prevalence of severe myopia and hyperopia was 1.14% (95% CI: 0.73 -1.55) and 2.27% (95% CI: 1.57 -2.97), respectively. Based on the results of multiple logistic regression, the prevalence of myopia had a statistically significant direct relationship with age (OR: 1.04; p < 0.001), history of glaucoma surgery (OR:2.75; p < 0.001), pseudophakia (OR: 2.27; p < 0.001), axial length (OR:3.05; p < 0.001), and mean keratometry (OR:1.61; p < 0.001). The education level was significantly inversely related to the myopia prevalence. Moreover, a history of glaucoma surgery (OR:0.44; p < 0.001), pseudophakia (OR = 0.15; p < 0.001), axial length (OR:35; p < 0.001) and mean keratometry (OR:0.62; p < 0.001) were significantly inversely related to the prevalence of hyperopia. 19% and 40.02% of myopic and hyperopic patients had complete visual acuity after correction of refractive error, respectively.

Conclusion

The prevalence of refractive errors was high in the Iranian elderly population. A large percentage of the elderly still did not have complete visual acuity after the correction of refractive errors indicating the necessity for attention to other ocular diseases in this age group. The history of cataract and glaucoma surgery could be associated with a myopic shift of refractive error.