bluuebunny/crossref_metadata_2025 huggingface dataset:
A Precision Medicine Approach to Metabolic Therapy for Breast Cancer in Mice
Authors: Akingbesote Ngozi D. , Norman Aaron , Zhu Wanling , Halberstam Alexandra A. , Zhang Xinyi , Foldi Julia R. , Lustberg Maryam B. , Perry Rachel J.
Published: December 2021

Increasing evidence highlights the possibility for approaches targeting metabolism as potential adjuvants to cancer therapy. Sodium-glucose transport protein 2 (SGLT2) inhibitors are the newest class of antihyperglycemic therapies, and have recently been highlighted as a novel therapeutic approach to breast cancer. To our knowledge, however, SGLT2 inhibitors have not been applied in the neoadjuvant setting as a precision medicine approach to combining metabolic therapy with standard of care therapy for this devastating disease. In this study we combine the SGLT2 inhibitor dapagliflozin with paclitaxel chemotherapy in both lean and obese mice. We show that dapagliflozin enhances the efficacy of paclitaxel, reducing tumor glucose uptake and prolonging survival in an insulin-dependent manner in some but not all breast tumors. Our data find a genetic signature for breast tumors most likely to respond to dapagliflozin in combination with paclitaxel. Tumors driven by mutations upstream of canonical insulin signaling pathways are likely to respond to such treatment, whereas tumors driven by mutations downstream of canonical insulin signaling are not. These data demonstrate that dapagliflozin enhances the response to chemotherapy in mice with breast cancer and suggest that breast cancer patients with driver mutations upstream of canonical insulin signaling may be most likely to benefit from this neoadjuvant approach. A clinical trial is currently in preparation, with an application recently submitted for Yale Human Investigations Committee approval, to test this hypothesis in breast cancer patients.

One Sentence Summary

We identify a driver mutation signature by which glucose-wasting metabolic therapy (dapagliflozin) enhances the efficacy of chemotherapy in mice with breast cancer.
Interferon-□ Exposure of Human iPSC-derived Neurons Alters Major Histocompatibility Complex I and Synapsin I Protein Expression
Authors: Pavlinek Adam , Matulevicute Rugile , Sichlinger Laura , Polit Lucia Dutan , Armeniakos Nikolaos , Vernon Anthony C. , Srivastava Deepak P.
Published: December 2021

Human epidemiological data links maternal immune activation during gestation with increased risk for neurodevelopmental disorders including schizophrenia. Animal models of maternal immune activation (MIA) provide causal evidence for this association and strongly suggest that inflammatory cytokines act is a critical link between maternal infection and aberrant offspring brain and behavior development. This includes evidence for reduced synapse formation, consistent with post-mortem and in vivo evidence of reduced synaptic density in schizophrenia. However, to what extent specific cytokines are necessary and sufficient for these effects remains unclear. Using a human cellular model, we recently demonstrated that acute exposure to interferon-□ (IFN□) recapitulates molecular and cellular phenotypes associated with neurodevelopmental disorders. Here, we extend this work to test whether IFN□ affects synapse formation in an induced neuron model that generates forebrain glutamatergic neurons. Using immunocytochemistry and quantitative PCR, we demonstrate that acute IFN□ exposure results in significantly increased MHCI expression at the mRNA and protein level. Furthermore, acute IFN□ exposure decreases synapsin I protein in neurons but does not affect synaptic gene mRNA levels. Interestingly, complement component 4A (C4A) mRNA is also significantly increased following acute IFN□ exposure. This study builds on our previous work by showing that IFN□-mediated disruption of relevant synaptic proteins can occur at early stages of synapse formation, potentially contributing to neurodevelopmental disorder phenotypes such as schizophrenia.
Social evolution of shared biofilm matrix components
Authors: Tai Jung-Shen B. , Mukherjee Saikat , Nero Thomas , Olson Rich , Tithof Jeffrey , Nadell Carey D. , Yan Jing
Published: December 2021

Biofilm formation is an important and ubiquitous mode of growth among bacteria. Central to the evolutionary advantage of biofilm formation is cell-cell and cell-surface adhesion achieved by a variety of factors, some of which are diffusible compounds that may operate as classical public goods – factors that are costly to produce but may benefit other cells. An outstanding question is how diffusible matrix production, in general, can be stable over evolutionary timescales. In this work, using Vibrio cholerae as a model, we show that shared diffusible biofilm matrix proteins are indeed susceptible to cheater exploitation, and that the evolutionary stability of producing these matrix components fundamentally depends on biofilm spatial structure, intrinsic sharing mechanisms of these components, and flow conditions in the environment. We further show that exploitation of diffusible adhesion proteins is localized within a well-defined spatial range around cell clusters that produce them. Based on this exploitation range and the spatial distribution of cell clusters, we construct a model of costly diffusible matrix production and relate these length scales to the relatedness coefficient in social evolution theory. Our results show that production of diffusible biofilm matrix components is evolutionarily stable under conditions consistent with natural biofilm habitats and host environments. We expect the mechanisms revealed in this study to be relevant to other secreted factors that operate as cooperative public goods in bacterial communities, and the concept of exploitation range and the associated analysis tools to be generally applicable.
Novel variants identified in CKAP2L in two siblings with Filippi Syndrome
Authors: Patrick Ryan J , Weimer Jill M , Davis-Keppen Laura , Landsverk Megan L
Published: December 2021

Pathogenic variants in CKAP2L have previously been reported in Filippi Syndrome (FS), a rare autosomal recessive, craniodigital syndrome characterized by microcephaly, syndactyly, short stature, intellectual disability, and dysmorphic facial features. To date, fewer than ten patients with pathogenic variants in CKAP2L associated with FS have been reported. All of the previously reported probands have presumed loss-of-function variants (frameshift, canonical splice site, starting methionine) and all but one have been homozygous for a pathogenic variant. Here we describe two brothers who presented with microcephaly, micrognathia, syndactyly, dysmorphic features, and intellectual disability. Whole exome sequencing of the family identified a missense variant, c.2066G>A (p.Arg689His), in trans with a frameshift variant, c.1169_1173del (p.Ile390LysfsTer4), in CKAP2L. To our knowledge, these are the first patients with FS to be reported with a missense variant in CKAP2L and only the second family to be reported with two variants in trans.
Fatty acid profile and lipid indices of the porker meat supplemented with pro-health herbal probiotics, ascorbic acid and allicin
Authors: Goluch Zuzanna Sabina , Rybarczyk Artur , Drozd Arleta , Drozd Radosław
Published: December 2021

Purpose

The objective of this study is to assess whether pro-health herbal probiotics, ascorbic acid and allicin added to the finishing diets of hybrid pig influenced the intramuscular fat (IMF) content inlongissimus lumborum(LL) muscle, the fatty acid profile and lipid quality indices, as it has an impact on human health.

Design/methodology/approach

After 80 days of equal fattening, the pigs were divided into the control group (CT,n = 30 received commercially allowed and applicable antibiotics) and the experimental group (EX,n = 30), which until 95 days of rearing were supplied with fermented herbs extract (FHE Multikraft® Austria) with probioticsSaccharomyces cerevisiae,Lactobacillus casei,Lactobacillusplantarum, L-ascorbic acid and extract of garlic (10% allicin). After slaughter, crude fat content and fatty acid profile were determined in LL muscle samples, and on that basis lipid indices were calculated.

Findings

Supplementation with FHE, probiotics, L-ascorbic acid and allicin has significantly impacted the crude fat content in the meat and the percentage of fatty acids content: tricosanoic (C23:0), heptadecanoid (C17:1n-7), eicosanic (C22:1 11cisn-9) and eicosatrienoic (C20:3 11cisn-3), in comparison to CT group. Amongst lipid quality indices, IMF in LL of pigs from EX group, the C18:2n-6/C18:3n-3 ratio is characterised by a significantly higher value and thus is more beneficial to the health of the consumer.

Originality/value

The authors have indicated that using FHE, probiotic supplements with ascorbic acid and allicin in commercial fattening of pigs, as an alternative for antibiotic growth promoters (AGP), improves the fatty acid profile of the meat.
Cultural distance and expatriates’ psychological adjustment: the moderating role of perceived social supports
Authors: Akhimien Okharedia Goodheart , Adekunle Simon Ayo
Published: December 2021

Purpose

The purpose of this study is to investigate the relationship between cultural distance and psychological adjustment of expatriates in Nigeria and perceived social supports moderating the relationship.

Design/methodology/approach

The study used a cross-sectional survey research design. Data were collected through 236 validly filled questionnaires by expatriates working in different industries in Nigeria. The research variables were measured using appropriate validated scales developed by different experts. Data collected were analyzed using frequency, percentages, mean and standard deviation. Correlation and regression analyses were conducted to establish the relationships among the variables.

Findings

The study found that the distance between expatriates’ home and Nigeria on each of the dimensions of cultural values: power distance, individualism, masculinity, uncertainty avoidance cultural value, long-term orientation and indulgence negatively influence the psychological adjustment of the expatriates in Nigeria. The study demonstrated that the larger the distance between expatriates’ home and Nigeria's cultural values, the larger the difficulties in the psychological adjustment of expatriates in the country.

Practical implications

This study provides useful insights and a better understanding to both present and future global human resource practitioners, multinational organizations, international institutions and local organizations operating in Nigeria with a global mindset on the cultural profiles of expatriates that are critical to adjust to working, social interactions and living environments in Nigeria.

Originality/value

It provides practical guidance to global human resource practitioners and employers on dimensions of cultural values distance between Nigeria and the home countries of expatriates that should be considered when deciding on, searching for, selecting, recruiting and relocating expatriates to work and live in Nigeria.
Collaborate as a flock in the organization: how selection and synthesis influence knowledge convergence within a complex adaptive system
Authors: Magnanini Silvia , Trabucchi Daniel , Buganza Tommaso , Verganti Roberto
Published: December 2021

Purpose

This study aims to investigate how two collaborative methods – selection and synthesis – influence knowledge convergence when people articulate a new strategic direction driving transformation within the organization.

Design/methodology/approach

The study is based on a longitudinal field experiment developed in four organizations involving 82 employees over a three-month process. Inspired by dynamics governing flocks as complex adaptive systems, selection and synthesis have been separately used in two sets of companies. Primary and secondary data have been largely collected and analyzed throughout the whole process.

Findings

This study describes how the two alternative methods differently influenced two kinds of knowledge convergence. While selection triggers a general and static knowledge convergence and the propagation of individual knowledge over time, synthesis fosters a local and dynamic knowledge convergence where individuals tend to propagate knowledge generated collectively.

Research limitations/implications

This research offers insights into understanding the influence of alternative collaborative methods on the creation and propagation of knowledge when people are converging toward a new strategic direction. From a theoretical perspective, it contributes to complex adaptive system theory, highlighting the role of knowledge convergence and emergence through collaboration.

Practical implications

This research offers insights to managers who deal with the complexity of the engagement of different stakeholders during collaborative processes, offering some actionable takeaways to foster knowledge convergence by alternatively employing selection and synthesis.

Originality/value

This paper contributes to the management and social information processing literature emphasizing the role of knowledge convergence emerging from the complex interactions among multiple stakeholders.
Real Estate Insights The human factor: the “unknown unknowns” in the real estate development process
Authors: Worzala Elaine , Wyman David
Published: December 2021

Purpose

Volatility, Uncertainty, Complexity and Ambiguity (VUCA) are terms the military have coined to describe the environment they often operate in. This paper examines how this decision-making framework can be used to better inform real estate investment and development. In celebration of this journal's 40th anniversary, we also explore how VUCA can be related to and expand on the teachings of Dr. James A. Graaskamp who published his seminal piece on the Fundamentals of Real Estate Development (1981) the same year. In that piece, he highlights the importance of paying attention to the human factor, the consumers of real estate.

Design/methodology/approach

This is a thought piece on an alternative decision-making framework that can help capture the dynamic environment that commercial real estate investors and developers are currently working in. VUCA captures the difficulty of predicting the future in a world of accelerating, unpredictable change. This is particularly important in today's rapidly changing world caused not only by the current COVID-19 pandemic but also the exponential growth of the proptech industry as well as the increasing risks and opportunities associated with climate change that continues to impact the built environment.

Findings

This is not a traditional research project with empirical findings. We are presenting an alternative framework for thinking about making investment decisions in these current volatile, uncertain, complex and ambiguous times today and in the future. In addition, the importance of multidisciplinary training and the human factor are stressed.

Research limitations/implications

There are no limitations to this research as it is the ideas of the authors. Implications are to help real estate investors, developers and educators better understand the environment that they are working in.

Practical implications

VUCA captures better the dynamic nature of real estate investments compared to traditional analysis. It helps one better analyze the risks and returns but also to acknowledge that there is a lot you cannot predict and there are many exogenous variables that can, at times, completely change the rules of the game. Flexibility and adaptability are essential tools for working in a VUCA environment. In addition, the human factor plays an increasingly important role and real estate investors and developers that clearly understand this and focus on the consumer will likely be more successful.

Originality/value

We believe that this is the first time that VUCA has been used in the real estate academic literature.
Research of resilience and elastic properties of short pastry with the meals of soy, sunflower and milk thistle
Authors: Mihailik Vitalii , Vitriak Oksana , Danyliuk Inna , Valko Mykola , Mamai Olga , Popovych Tatyana , Ryabinina Anna , Vishnevskaya Lyudmila , Burak Valentyna , Vognivenko Ludmila
Published: December 2021

Purpose

The purpose of this paper is to study the resilience and elastic properties of short pastry with the meals of soy, sunflower and milk thistle.

Design/methodology/approach

Recent studies in the emerging food technologies of short pastry with use of meals were considered. Their focus on the improvement of the functional peculiarities of short pastry and benefits for people were the defining characteristics of the studies.

Findings

Model food compositions have been developed from soybean meal, sunflower meal and milk thistle for adding them to semi-finished short pastry products. The technology of short pastry confectionery made from short pastry with oilseed meal has been scientifically substantiated and developed. The chemical composition of shortbread cookies with the use of oilseed meal was calculated. The developed technology increased protein content by 2.5 times, cellulose content – by six times, significantly increased mineralization in the developed confectionery products. The content of calcium increased by 172.9 mg, selenium – by 13.06 mcg, iodine – by 2.76 mcg and vitamin E by 2.4 mg.

Practical implications

The developed technology of short pastry with a model composition of the meal can be used in practice. The use of a meal composition is a promising direction to improve the brittleness of short pastry products. The developed pastry products made from short pastry with added meal can be introduced into catering establishments as functional products with improved biological value.

Social implications

Developed pastry products can be used as functional products with improved biological value, which is important for people’s health and has positive effects on the human body.

Originality/value

The use of meals of soy, sunflower and milk thistle in short pastry increases its nutritional and biological value, which improves the impact on the human body. The developed pastry products can be introduced as functional products with improved biological value, which is important for the improvement of people’s health in different countries of the world.
The relationship between dietary inflammatory index and metabolic syndrome in patients with rheumatoid arthritis
Authors: Sheikhi Teymour , Pasdar Yahya , Moludi Jalal , Moradinazar Mehdi , Abdollahzad Hadi
Published: December 2021

Purpose

Inflammation plays a significant role in incidence of metabolic syndrome (MetS), whose risk can be reduced through modifying the diet. Considering the importance of incidence of MetS among patients with rheumatoid arthritis (RA), this study aims to determine the relationship between dietary inflammatory index (DII) and MetS in these patients.

Design/methodology/approach

This study was performed on 261 adults 35–65 years of age suffering from RA. The patients were among the participants in Ravansar non-communicable disease prospective study. DII was calculated based on food frequency questionnaire. The components of MetS were measured according to the protocol of prospective epidemiological research studies in Iran cohort. Data analysis was carried out using univariate and multivariate logistic regression model by modifying the confounding variables.

Findings

In patients with RA, prevalence of MetS was 37.5%. The mean of DII in RA patients with MetS and without MetS was −2.3 ± 1.5 and −2.2 ± 1.6, respectively, with no significant difference between two groups. After modifying the variables of age and gender, the odds of increasing waist circumference (WC) were near 1.9 times greater in the fourth quartile (pro-inflammatory diet) compared to the first quartile of DII (anti-inflammatory diet) (P = 0.03). The odds of developing hypertension was approximately 1.3 times greater in the fourth compared to the first quartile of DII (P = 0.034). The odds of developing MetS increased by 27% in the fourth quartile in comparison to the first one, though this increase was not statistically significant.

Originality/value

In RA patients, with increase in DII score, the WC and blood pressure had increased. The DII had no significant relationship with MetS. Further studies are essential across larger populations to confirm the findings.
Investigation into the effect of resin finish on the functional characteristics of plain fabrics using different curing methods
Authors: Naeem Farhana , Asim Fareha , Tufail Muhammad
Published: December 2021

Purpose

Cellulosic fabric and plain weave are the most commonly used material in home textiles. The poor wrinkling, dimensional stability and pilling are some of the problems faced during usage. The textile industries apply resin finish to improve these characteristics. The purpose of this study is to improve pilling resistance, dimensional stability and smoothness appearance (SA) of rayon and rayon/cotton plain fabrics using different concentrations of dimethyloldihydroxyethylene urea (DMDHEU) and acrylic copolymer. The finish was fixed using two different fixation methods.

Design/methodology/approach

Three concentrations, 40, 100 and 150 g/l of Arkofix NF (DMDHE based) and Appretan N9211 (acrylic copolymer), were taken. The finish was applied at normal and shock cure. The effects of finish on pilling resistance, dimensional stability, smoothness, tear strength, light fastness, Berger whiteness and yellowness index of plain fabrics were investigated.

Findings

The changes in the characteristics of the finished fabrics were compared with unfinished fabrics. This study revealed that at 40 g/l of Arkofix NF and Appretan N9211 using a normal cure would improve the pilling resistance, dimensional stability and SA of the plain fabrics. Whereas, there was no adverse effect observed on tear strength, light fastness, Berger whiteness and yellowness index of plain fabrics at these conditions.

Originality/value

Unlike the previous studies, this paper proposed the single finish formulation where the functional characteristics of the plain rayon and rayon cotton fabrics meet the general requirement of a customer.
Long‐term fertilization and tillage regimes have limited effects on structuring bacterial and denitrifier communities in a sandy loam UK soil
Authors: Moulton‐Brown Claire E. , Feng Tianer , Kumar Shreiya Shivagni , Xu Luxi , Dytham Calvin , Helgason Thorunn , Cooper Julia M. , Moir James W. B.
Published: December 2021

Denitrification causes loss of available nitrogen from soil systems, thereby reducing crop productivity and increasing reliance on agrochemicals. The dynamics of denitrification and denitrifying communities are thought to be altered by land management practices, which affect the physicochemical properties of the soil. In this study, we look at the effects of long‐term tillage and fertilization regimes on arable soils following 16 years of treatment in a factorial field trial. By studying the bacterial community composition based on 16S rRNA amplicons, absolute bacterial abundance and diversity of denitrification functional genes (nirK, nirS and nosZ), under conditions of minimum/conventional tillage and organic/synthetic mineral fertilizer, we tested how specific land management histories affect the diversity and distribution of both bacteria and denitrification genes. Bacterial and denitrifier communities were largely unaffected by land management history and clustered predominantly by spatial location, indicating that the variability in bacterial community composition in these arable soils is governed by innate environmental differences and Euclidean distance rather than agricultural management intervention.
Catholic Emancipation and the Idea of Religious Liberty in 1830s New South Wales
Authors: Irving‐Stonebraker Sarah
Published: December 2021

Historians do not typically associate the use of concepts like “civil and religious freedom” and “liberty of conscience” with colonial New South Wales. Indeed, for many years, historians assumed that the people of New South Wales were largely indifferent to religious ideas, and often unthinkingly sectarian. The research presented here suggests we revise this assumption. When the Roman Catholic Relief Act 1829 passed through the Parliament of the United Kingdom in 1829, it triggered a lively and genuinely intellectual discussion in New South Wales about religious liberty and its implications. Through a careful analysis of the colony's 1830s press, I argue that there existed a robust discussion about the nature of religious freedom: its theology, its history, and its relationship to the legal and political question of establishment. This period provides an interesting vignette of, and point of entry into, the broader issue of the role of religion in colonial New South Wales.
Comparative effectiveness of different treatment modalities for active, moderate‐to‐severe Graves' orbitopathy: a systematic review and network meta‐analysis
Authors: Li Hongxun , Yang Lihong , Song Yi , Zhao Xinheng , Sun Chunhua , Zhang Lei , Zhao Hong , Pan Ye
Published: December 2021

To compare the effects of different treatment modalities on active, moderate‐to‐severe Graves' orbitopathy (GO). We searched PubMed and Embase for randomized controlled trials published up to 30 Nov 2020, of different modalities for the treatment of active, moderate‐to‐severe GO. We performed Bayesian network meta‐analyses. This study is registered with PROSPERO (CRD42020166287). Fifteen RCTs were identified. Network meta‐analysis showed that in comparison with placebo, teprotumumab, mycophenolate plus intravenous glucocorticoids (IVGCs), mycophenolate, rituximab, azathioprine, IVGCs, orbital radiotherapy, oral glucocorticoids (OGCs) were effective treatments (ordered from most effective to least effective). Teprotumumab was more efficacious in reducing proptosis than IVGCs. No significant difference in changes in diplopia grade was recorded between teprotumumab, rituximab, orbital radiotherapy and IVGCs. Low (4.5–5 g), middle (6 g) and high (7–8 g) cumulative doses of IVGCs were shown to be more effective than OGC in improving the overall response rate, but the very low‐group (<3 g) seemed to have a lower risk of adverse events. We found that teprotumumab offered the highest level of efficacy in terms of the overall response rate and was more efficacious in reducing proptosis than IVGCs. With regard to different dosages of IVGCs, the cumulative dose of 4.5–5 g of IVGCs seems to be the most appropriate schedule in terms of efficacy and safety outcomes. Due to the limited number of patients treated with teprotumumab and the lack of comparison with other effective therapeutics, teprotumumab might not become the standard first‐line therapy for active, moderate‐to‐severe GO.
Large‐scale health insurance study showed that antibiotic use in infancy was associated with an increase in atopic dermatitis
Authors: Tsuchida Tetsuya , Yoshida Satomi , Takeuchi Masato , Kawakami Koji
Published: December 2021

Aim

This retrospective large‐scale study examined the association between prescribing antibiotics for infants and subsequent atopic dermatitis (AD).

Methods

The data covered the period from 1 January 2005 to 31 December 2014 and were extracted from a Japanese health insurance claims database. The exposure was being prescribed antibiotics at less than 12 months of age and the outcome was a subsequent diagnosis of AD. The primary analysis method was multivariable Cox proportional hazard regression analysis. A sibling‐matched analysis was also performed to adjust for shared familial and environmental confounders.

Results

This study comprised 85 954 infants: 8654 (10.1%) who had received antibiotics and 77 300 who had not. AD was diagnosed in 1183 (13.7%) and 10 325 (13.4%) infants respectively. The exposed group was more likely to develop AD than the non‐exposed group, but this association disappeared when we carried out the secondary, sibling‐matched analysis of the two groups. Other risk factors for AD were macrolides, aminoglycosides, food allergies and histamine H1 receptor antagonists.

Conclusion

Antibiotic use in infancy was associated with a subsequent increase in the incidence of AD. This association should be considered when prescribing antibiotics, but antibiotic use may not be a critical factor for the development of AD.
“Make them mature properly”: Protective restriction of children from the adult world in China's suburban schools
Authors: Zhang Min
Published: December 2021

The protective restriction of children moving into adulthood has attracted growing attention among the public and experts. This article ethnographically explores how China's suburban teachers practice a selective restriction to help children mature properly. It demonstrates that while educators work to mitigate students' concrete contact with the adult environments, they also inculcate students with the harsh realities of the adult world. It contends that educators' paradoxical attitudes are closely related to the transitional view of childhood in contemporary Chinese society. Consequently, this ideal childhood with appropriate maturity has become a delicate status to achieve and—more importantly—not to overdo.
Redo‐surgery after failed colorectal or coloanal anastomosis: Morbidity, mortality and factors predictive of success. A retrospective study of 200 patients
Authors: Calmels Mélanie , Collard Maxime K. , O’Connell Lauren , Voron Thibault , Debove Clotilde , Chafai Najim , Parc Yann , Lefevre Jérémie H.
Published: December 2021

Aim

In cases of anastomotic failure after colorectal (CRA) or coloanal anastomosis (CAA), revision of the anastomosis is an ambitious surgical option that can be proposed in order to maintain bowel continuity. Our aim was to assess postoperative morbidity, risk of failure and risk factor for failure in patients after CRA or CAA.

Methods

All consecutive patients who underwent redo‐CRA/CAA in our institution between 2007–2018 were retrospectively included. The success of redo‐CRA/CAA was defined by the restoration of bowel continuity 12 months after the surgery.

Results

Two hundred patients (114 male: 57%) were analyzed. The indication for redo‐CRA/CAA was chronic pelvic infection in 74 patients (37%), recto‐vaginal or urinary fistula in 59 patients (30%), anastomotic stenosis in 36 patients (18%) and redo anastomosis after previous anastomosis takedown in 31 patients (15%). Twenty‐three percent of the patients developed a severe postoperative complication. Anastomotic leakage was diagnosed in 39 patients (20%). One‐year‐success of the redo‐CRA/CAA was obtained in 80% of patients. In multivariate analysis, only obesity was associated with redo‐CRA/CAA failure (p = 0.042). We elaborated a pre‐operative predictive score of success using the four variables: male sex, age > 60 years, obesity and history of pelvic radiotherapy. The success of redo‐CRA/CAA was 92%, 86%, 80% and 62% for a preoperative predictive score value of 0, 1, 2 and ≥3, respectively (p = 0.010).

Conclusions

In case of failure of primary CRA/CAA, bowel continuity can be saved in 4 out of 5 patients by redo‐CRA/CAA despite 23% suffering severe postoperative morbidity.
Physical fitness tests as an indicator of potential athletes in a large sample of youth
Authors: Henriques‐Neto Duarte , Hetherington‐Rauth Megan , Magalhães João Pedro , Correia Inês , Júdice Pedro B. , Sardinha Luís B.
Published: December 2021

Background

Promoting youth sports participation is an excellent strategy to improve health and high‐level sports competition around the world.

Aims

The aim of this study was to analyse the potential of commonly used physical‐fitness (PF) tests to discriminate against athletes from non‐athletes in young populations.

Material and Methods

One thousand eight hundred and thirty‐one youth people were analysed (boys: 514 non‐athletes and 401 athletes; girls: 722 non‐athletes and 194 athletes) aged 10–18 years (y). Cardiorespiratory fitness (CRF), muscular fitness (MF), agility and speed were tested using PF tests.

Results

Application of receiver operating characteristics curves was used to assess the discriminatory potential of each PF for distinguishing athletes from non‐athletes, with an area under the curve (AUC) higher than 65% (0.65). In the oldest groups (≥16 y), the speed test at 20 m in boys (AUC = 0.70) and horizontal jump test in girls (AUC = 0.75) were the best discriminators, while the push‐up‐test (AUC 10–11 y boys = 0.68, AUC 14–15 y boys = 0.68, AUC 10–11 y girls = 0.73, AUC 12–13 y girls = 0.87) and the PACER (AUC boys: 12–13 y = 0.68 and AUC girls 14–15 y = 0.73) appeared to be better discriminators than other PF tests, for the younger age‐groups.

Conclusion

The speed‐test at 20 m and the horizontal‐jump were the best PF to identify older adolescents with athletic potential, while the PACER and push‐up tests were the most discriminatory for the younger adolescents.
Gay Politics Goes Mainstream: Democrats, Republicans and Same‐sex Relationships
Authors: Fernández Raquel , Parsa Sahar
Published: December 2021

Attitudes towards same‐sex relationships in the USA have changed radically over a relatively short period of time. After remaining fairly constant for over two decades, opinions became more favourable starting in 1992—a presidential election year in which the Democratic and Republican Parties took opposing stands over the status of gay people in society. What roles did political parties and their leaders play in this process of cultural change? Using a variety of techniques, including machine learning, we show that the partisan opinion gap emerged substantially prior to 1992—in the mid to late 1980s—and did not increase as a result of the political debates in 1992–3. Furthermore, we identify people with a college‐and‐above education as the potential ‘leaders’ of the process of partisan divergence.
Two‐dimensional transthoracic echocardiographic demonstration of reduction in fibrin content in purulent pericarditis following intrapericardial fibrinolytic agent administration
Authors: Abdelsalam Mahmoud , Nathanial Cyril , Elmarzouky Zeyad , Dulal Subash , Habib Usama , Ahmed Maram , Ashiq Amir , Nanda Navin
Published: December 2021

We describe an adult patient who presented with purulent pericarditis (PP) in whom two‐dimensional transthoracic echocardiography demonstrated a marked decrease in the area of the right ventricular (RV) wall together with the overlying fibrin following intrapericardial administration of a fibrinolytic agent. Documentation of this decrease by measurements performed and illustrated on two‐dimensional images has not been reported previously in an adult patient with PP, to the best of our knowledge.
Accuracy of an epidemiological oropharyngeal dysphagia screening for older adults
Authors: Magalhães Junior Hipólito Virgilio , Pernambuco Leandro de Araújo , Cavalcanti Renata Veiga Andersen , Silva Roberta Gonçalves da , Lima Kenio Costa , Ferreira Maria Angela Fernandes
Published: December 2021

Objective

The aim of this study was to determine the accuracy of an epidemiological screening questionnaire for oropharyngeal dysphagia in older people.

Background

Determining the cut‐off point and the accuracy of the self‐reported epidemiological questionnaire for screening oropharyngeal dysphagia in older adults is important for mass screening, which may estimate the prevalence of oropharyngeal dysphagia.

Materials and Methods

This was a cross‐sectional diagnostic study with a convenience sample of 70 older adults over 60 years of age of both sexes, aged between 60 and 90 years (mean age 69.2; SD, 7.6). It used a screening questionnaire with nine ordered items response options resulted in a score ranging from 0 to 18. The criterion test was the fiberoptic endoscopic evaluation of swallowing, with analysis of the receiver operating characteristic (ROC), with a 5% significance level.

Results

Oropharyngeal dysphagia frequency by the criterion test was 73%, with no significant difference between age and sex. The area under the ROC curve was 0.88 (95% confidence interval: 0.79‐0.98) above the cut‐off point 3. This screening questionnaire showed good parameters of sensitivity (80%), specificity (89%), positive predictive value (95%), negative predictive value (63%), positive likelihood ratio (7.64), negative likelihood ratio (0.22) and accuracy (83%).

Conclusions

This questionnaire may be a satisfactory screening tool for estimating the prevalence of oropharyngeal dysphagia in older adults.
Learning your limits: Nurses' experiences of caring for young unaccompanied refugees in acute psychiatric care
Authors: Gabrielsson Sebastian , Karim Hannan , Looi Git‐Marie Ejneborn
Published: December 2021

Young unaccompanied refugees come in contact with acute psychiatric care due to pre‐existing mental health conditions as well as stressful and traumatic experiences before, during, and after migration. Previous research on nurses’ experiences of caring for refugees has primarily reported on difficulties related to cultural differences and communication and how nurses might distrust refugees. This study aimed to describe registered nurses’ experiences of caring for young unaccompanied refugees in acute psychiatric care. Semi‐structured interviews with ten nurses were analysed using a method for qualitative content analysis. Data were collected in Sweden during 2019 and 2020. Results describe nurses’ experiences of caring for young unaccompanied refugees in acute psychiatric care in one theme: learning your limits and three sub‐themes: feeling powerless but doing what you can; taking a stance in a politicized environment; and being frustrated and in need of support. Findings highlight the potential and limitations of mental health nursing, the importance of reflection and peer support, and the importance of viewing the roles and responsibilities of mental health nurses and nursing in a societal context. These findings suggest that nurses can make a difference for young unaccompanied refugees in acute psychiatric care. However, in doing so, nurses need support in realizing what they can and cannot achieve. The study is reported in accordance with the COREQ guidelines.
Major limb amputation and mortality in patients with neuro‐ischaemic lower extremity wounds managed in a tertiary hospital: Focus on the differences among patients with diabetes, peripheral arterial disease and both
Authors: Meng Lingyan , Graves Nicholas , Du Ruo Chen , Lee Jia Yi , Chue Koy Min , Binte Taufiq Chong Ah Hoo Nur Nabila Farhana , Nazeha Nuraini , Ng Yi Zhen , Harding Keith , Ho Pei
Published: December 2021

A majority of lower extremities neuro‐ischaemic wounds (NIU) are related to: (a) only diabetes (DM); (b) only peripheral artery disease (PAD); (c) co‐existing diabetes and peripheral artery disease (DM‐PAD). This study aims to characterise the major clinical outcomes of forementioned three groups of lower extremity wound patients in Singapore. Patients hospitalised for lower extremity NIU between January 2014 and October 2017 in a tertiary hospital in Singapore were analysed. Patients' major limb amputation and mortality were assessed using Cox regression models. Cumulative survival and amputation‐free survival among the three classified groups were calculated using Kaplan‐Meier analysis. Compared with patients with only DM, those in the PAD group and the DM‐PAD group had higher risk of major limb amputation (adjusted hazard ratio: 2.47, 95% CI: 1.65‐3.70; adjusted hazard ratio: 2.01, 95% CI: 1.53‐2.65 respectively) and mortality (adjusted hazard ratio: 2.36, 95% CI: 1.57‐3.55; adjusted hazard ratio: 2.46, 95% CI: 1.86‐3.26 respectively). The 3‐year survival and amputation‐free survival were lowest in the DM‐PAD group (52.1% and 41.5% respectively), followed by the PAD group (53.3% and 44.6% respectively) and the DM group (74.2% and 68.5% respectively). Lower extremity NIU patients with PAD or DM‐PAD were found to have poorer clinical prognosis than those with DM only.
Why a UBI Will Never Be High Enough
Authors: Heath Joseph
Published: December 2021

Schemes to replace traditional welfare programmes with a universal basic income (UBI) are sometimes presented as a way to reduce overall economic inequality. But because they lower the implicit marginal taxation rate of individuals entering the workforce, they have the effect of increasing economic inequality between those who opt out of the workforce and those who choose to participate. This article examines the effect that an increase in this income gap can be expected to have on the perceived adequacy of the UBI payment level as an alternative to paid employment. The first question involves the extent to which individuals living on UBI payments will assess the adequacy of their condition by comparing themselves to those who are adjacent to them in the income distribution. If this looms large in their assessment, then the UBI, by increasing inequality within this segment of the income distribution, will tend to increase the perception of its own inadequacy. The second question involves the importance of the consumption of positional goods in determining the adequacy of the UBI. If these are significant then again this will increase the perception of inadequacy, because those in paid employment will enjoy a great deal more than those who opt out.
Signaling hostility: The relationship between witnessing weight‐based discrimination in medical school and medical student well‐being
Authors: Meadows Angela , Barreto Manuela , Dovidio John F. , Burke Sara E. , Wittlin Natalie M. , Herrin Jeph , van Ryn Michelle , Phelan Sean M.
Published: December 2021

Environments that are hostile to one or more marginalized groups are known to have a negative effect on the mental health and well‐being of both targets and observers. Anti‐fat attitudes have been well documented in medical education, including the use of derogatory humor and discriminatory treatment toward higher‐weight patients. However, to date, it is not known what effect observing weight stigma and discrimination during medical school has on medical students’ psychological health and wellbeing, sense of belonging, and medical school burnout. The present study surveyed a total of 3994 students enrolled across 49 US medical schools at the start of their first year and at the end of their fourth year. Participants reported the frequency with which they had observed stigmatizing and discriminatory behaviors targeted at both higher‐weight patients and higher‐weight students during their four years of medical school. Observed weight stigma was prevalent, and was associated with worse psychological and general health, reduced medical school belonging and increased medical school burnout. The indirect effects of observed weight stigma on medical school burnout, via belonging, psychological health, and general health, were statistically significant in the sample as a whole, but were more pronounced in higher‐weight students. This effect may be explained, in part, by the relationship between observed stigma and medical school belonging. Higher levels of observed stigma were associated with reduced feelings of belonging in higher‐weight but not normative‐weight students. Top‐down institutional culture change is needed to rectify this situation, which is detrimental to both students and patients.
Synthesis of clinical practice guideline recommendations for the primary health care of chronic musculoskeletal pain
Authors: Ernstzen Dawn V. , Hillier Susan L. , Louw Quinette A.
Published: December 2021

Rationale and Aims

The prevalence of chronic musculoskeletal pain (CMSP) is high and rising. The multidimensional impact of CMSP on individuals necessitates multidisciplinary evidence‐based strategies to prevent and manage chronic pain. Primary health care (PHC) is the first point of care in many healthcare systems and evidence implementation at this point is important. We aim to describe the process of development of a comprehensive list of evidence‐based recommendations derived from different high‐quality clinical practice guidelines (CPGs) to inform the PHC healthcare of adults with CMSP.

Method

A systematic review was conducted of CPGs that focussed on PHC management of CMSP in adults. CPGs were identified by searching 13 guideline clearinghouses and five online databases. Eligible CPGs were critically appraised using Appraisal of Guidelines Research and Evaluation, Version II (AGREE II). A stepwise systematic process was followed to identify a core set of recommendations. This process comprised the following: extract recommendations; analyze recommendations; synthesize recommendations by assimilating similar recommendations; determine the strength of the body of evidence underpinning the recommendations and produce a list of synthesized recommendations.

Results

Six high‐quality CPGs were identified, providing 156 recommendations. These were condensed to 42 statements covering topics about the approach to care, assessment, advice and education, referral, pharmacological management, physical therapy, electrotherapy, psychological therapy, complementary therapy and self‐management. The set of recommendations encompasses a person‐centered approach, collaborative decision making, a biopsychosocial approach, patient education and empowerment towards self‐management.

Conclusion

The process of developing composite recommendations from multiple CPGs enables end‐users to access comprehensive information on managing CMSP in PHC settings that is not available from one singular CPG. The content and evidence base for recommendations varied between CPGs. A similar stepwise process may be used to develop a core set of recommendations for other health conditions, where multiple, diverse CPGs exist.
Liver damage promotes pro‐inflammatory T‐cell responses against apolipoprotein B‐100
Authors: Plochg Bastian F. J. , Englert Hanna , Rangaswamy Chandini , Konrath Sandra , Malle Mandy , Lampalzer Sibylle , Beisel Claudia , Wollin Salma , Frye Maike , Aberle Jens , Kluwe Johannes , Renné Thomas , Mailer Reiner K.
Published: December 2021

Objectives

Liver‐derived apolipoprotein B‐100 (ApoB100) is an autoantigen that is recognized by atherogenic CD4+ T cells in cardiovascular disease (CVD). CVD is a major mortality risk for patients with chronic inflammatory liver diseases. However, the impact of liver damage for ApoB100‐specific T‐cell responses is unknown.

Methods

We identified ApoB100‐specific T cells in blood from healthy controls, nonalcoholic fatty liver disease (NAFLD) patients, and CVD patients by activation‐induced marker expression and analyzed their differentiation pattern in correlation to the lipid profile and liver damage parameters in a cross‐sectional study. To assess the induction of extrahepatic ApoB100‐specific T cells upon transient liver damage in vivo, we performed hydrodynamic tail vein injections with diphtheria toxin A (DTA)‐encoding plasmid in human ApoB100‐transgenic mice.

Results

Utilizing immunodominant ApoB100‐derived peptides, we found increased ApoB100‐specific T‐cell populations in NAFLD and CVD patients compared to healthy controls. In a peptide‐specific manner, ApoB100 reactivity in healthy controls was accompanied by expression of the regulatory T (Treg)‐cell transcription factor FOXP3. In contrast, FOXP3 expression decreased, whereas expression of pro‐inflammatory cytokine interleukin (IL)‐17A increased in ApoB100‐specific T cells from NAFLD and CVD patients. Dyslipidemia and liver damage parameters in blood correlated with reduced FOXP3 expression and elevated IL‐17A production in ApoB100‐specific T‐cell populations, respectively. Moreover, DTA‐mediated transient liver damage in human ApoB100‐transgenic mice accumulated IL‐17a‐expressing ApoB100‐specific T cells in the periphery.

Conclusion

Our results show that liver damage promotes pro‐inflammatory ApoB100‐specific T‐cell populations, thereby providing a cellular mechanism for the increased CVD risk in liver disease patients.