bluuebunny/crossref_metadata_2025 huggingface dataset:
Access to Nutrition in Odisha
Authors: Saigal Neha , Shrivastava Saumya
Published: November 2021

Celebrated as a nutrition champion, Odisha state in India has achieved significant improvements in nutrition of its women and children. The overall progress, however, masks familiar inequities, evidenced in significantly higher levels of stunting, wasting and underweight in children. The article examines access, a key underlying determinant of undernutrition, to two nutrition government schemes of Odisha—the Supplementary Nutrition Programme and Mamata—for the most vulnerable groups in the state’s Angul district. The study identifies limited awareness and lack of proactive disclosure of scheme information, excessive distance from centres that provide the schemes, caste-based power dynamics and weak monitoring institutions as key factors restricting access of specific social groups to these two schemes. The article examines the factors constraining access and considers potential solutions to overcome these bottlenecks in order to provide more effective protection mechanisms.
Increased resting heart rate and glucose metabolism in a community population
Authors: Wenting Wei , Yeran Jia , Wenfeng Zhan , Faping Li , Pingyou Zhang , Hongxuan Zhang
Published: November 2021

Objective

Resting heart rate (RHR) independently predicts cardiovascular death. Increased RHR is related to chronic diseases, but community-based studies are rare. We investigated this population and factors related to RHR.

Methods

In total, 374 participants underwent medical examinations from March 2019 to December 2019. Participants were divided into groups with low RHR (LRHR; <65 beats/minute) and high RHR (HRHR; ≥65 beats/minute). RHR was judged using resting electrocardiogram at physical examination. We conducted laboratory examinations, including glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), and blood lipids, among participants with chronic diseases. We used Cox proportional risk regression and multivariate analyses for the following covariates: previous chronic diseases, body mass index (BMI), smoking, blood lipids, and FPG.

Results

The incidence of type 2 diabetes mellitus (T2DM) and HbA1c values were both significantly higher in the HRHR group than in the LRHR group. Spearman correlation analysis showed RHR had a positive correlation with low-density lipoprotein, BMI, FPG, and HbA1c (r = 0.104574, 0.117266, 0.116041, and 0.311761, respectively). Multiple linear regression analysis showed age, hypertension, T2DM, and HbA1c were factors influencing RHR.

Conclusion

RHR showed strong correlation with T2DM and HbA1c in our community population, suggesting that RHR may be a risk factor for cardiovascular disease.
Neonatal Group B Streptococcal Meningitis: Predictors for Poor Neurologic Outcome at 18 Months
Authors: Fister Petja , Peček Jerneja , Jeverica Samo , Primec Zvonka Rener , Paro-Panjan Darja
Published: November 2021

Aim

To find early predictors for poor neurodevelopmental outcome after neonatal group B streptococcal meningitis.

Methods

We retrospectively analyzed clinical characteristics of 23 patients with neonatal group B streptococcal meningitis and their neurodevelopmental outcome at 18 months. Available group B Streptococcus strains were serotyped and their genomes characterized.

Results

We found several differences between patients with early- (n = 5) and late-onset (n = 18) disease. Nine children had neurologic abnormalities at 18 months and 4 had epilepsy, all of them after late-onset disease. Most important risk factors for poor outcome were impaired consciousness at admission, hemodynamic instability, seizures, or abnormal electroencephalogram during the acute illness and abnormal neurologic and ophthalmologic examination at the end of treatment, whereas abnormalities in laboratory and imaging studies were not predictive. Hypervirulent serotype III, multilocus sequence type 17 group B Streptococcus was the predominant pathogen.

Conclusions

Neurodevelopmental impairment after neonatal group B streptococcal meningitis is likelier in those with clinical and neurophysiological features indicating worse disease severity.
A pathway towards healthy and naturally ventilated indoor built environment through phase change material and insulation techniques for office buildings in India
Authors: Arumugam Pappu , Vellaichamy Pandiyarajan , Ramalingam Velraj , Arun Prakash S , V Antony Aroul Raj
Published: November 2021

The thermal comfort of occupants is a necessary requirement for any building. The present pandemic demands us to opt for natural ventilation over air-conditioned spaces to reduce the spread of the infection. This work aims to prevent air-conditioner usage in a commercial building in India during daytime office hours while simultaneously enhancing the thermal comfort of the building occupants through natural ventilation/Phase Change Material (PCM)/insulation techniques. Four building configurations, such as Building A (conventional building with no PCM and no insulation), Building B (building-integrated with PCM), Building C (building-integrated with insulation) and Building D (building-integrated with PCM and insulation) were analysed for various locations using DesignBuilder software. From the results, it is understood that insulation integration is recommended for locations with average nighttime temperatures greater than 27°C, while PCM integration is recommended for locations with an average nighttime temperature less than 27°C during the summer season. Also, nighttime cooling of the building through an air-conditioner is necessary for all locations during summer to maintain adequate thermal comfort with natural ventilation in the daytime. Finally, an appropriate PCM/insulation technique is recommended for an office building located in each location that falls under each type of climate. Hence, the selection of PCM/insulation technique is to be made based on the specific site conditions.
Utilization of glucocorticoids among White and Black patients with systemic lupus erythematosus: Observations from the enrollment visit of a prospective registry
Authors: Sullivan James K , Littlejohn Emily A
Published: November 2021

Background

Black patients with systemic lupus erythematosus (SLE) face higher rates of morbidity and mortality compared to White patients. Long-term glucocorticoid use has been associated with worse health outcomes among patients with SLE. We sought to quantify chronic glucocorticoid use among Black and White patients with SLE within a prospective registry.

Methods

Using enrollment data from a registry at a large academic institution, we compared glucocorticoid use among Black and White patients with SLE. Multivariable logistic regression of race and glucocorticoid use was performed, adjusting for covariates exhibiting a bivariate association with glucocorticoids at significance level p < 0.10.

Results

114 White participants (mean age 45; standard deviation (SD) 15) and 59 Black participants (mean age 42; SD 14) were analyzed. White participants had mean SLEDAI-2K score of 3.7 (SD 5.2). Black participants had mean SLEDAI-2K scores of 6.3 (SD 6.0). Among Black participants, 43 (72%) utilized glucocorticoids compared to White participants 39 (34%) (unadjusted odds ratio (OR) 5.17; 95% confidence interval (CI) 2.59–10.33). We did not observe differences between unadjusted hydroxychloroquine (OR 0.69; 95% CI 0.28–1.65) or conventional disease-modifying anti-rheumatic drug (cDMARD) (OR 1.07; 95% CI 0.57–2.01) utilization among Black and White participants. SLEDAI-2K, disability, recent hospitalization, and past or present hydroxychloroquine or cDMARD use were included in a logistic regression model. Adjusting for covariates, Black participants were more likely to be on glucocorticoids (adjusted OR 5.69; 95% CI 2.17–14.96); p = 0.0004).

Conclusion

Adjusting for disease activity and other medications, Black patients had more exposure to chronic glucocorticoids than White patients in the Cleveland Clinic SLE registry. These patients may face increased glucocorticoid-related morbidity, which could contribute significantly to long-term health outcomes and utilization of health care resources. Future research in larger, more diverse registries should be conducted to further characterize patterns of glucocorticoid use.
Utilizing patient information to identify subtype heterogeneity of cancer driver genes
Authors: Wu Ho-Hsiang , Hua Xing , Shi Jianxin , Chatterjee Nilanjan , Zhu Bin
Published: November 2021

Identifying cancer driver genes is essential for understanding the mechanisms of carcinogenesis and designing therapeutic strategies. Although driver genes have been identified for many cancer types, it is still not clear whether the selection pressure of driver genes is homogeneous across cancer subtypes. We propose a statistical framework MutScot to improve the identification of driver genes and to investigate the heterogeneity of driver genes across cancer subtypes. Through simulation studies, we show that MutScot properly controls the type I error in detecting driver genes. In addition, we demonstrate that MutScot can identify subtype heterogeneity of driver genes. Applications to three studies in The Cancer Genome Atlas (TCGA) project showcase that MutScot has a desirable sensitivity for detecting driver genes and that MutScot identifies subtype heterogeneity of driver genes in breast cancer and lung cancer with regards to the status of hormone receptor and to the smoking status, respectively.
“Yo sí te Creo”: Alcohol-facilitated sexual violence among young women in the Spanish night-time economy
Authors: Gómez Pilar Tarancón , Romo-Avilés Nuria , Pavón-Benítez Laura
Published: November 2021

This study investigates the factors associated with alcohol-facilitated sexual violence among young women in the Spanish night-time economy, through the analysis of twenty-six qualitative interviews with eleven young women and fifteen young men who frequent these spaces. Our results show how this type of violence originates, both from the perspective of the young women and the young men. The young women warn of the risk of sexual victimization associated with the abuse of alcohol. The young men, for their part, describe the tactics used to gain non-consensual sexual contact. These data contribute to showing how important it is for the legislation on these matters to have a gender perspective. They also add to the complex debate on the penal reform that is ongoing in Spain, in particular on sexual crimes facilitated by alcohol abuse.
Waiting or Acting? The Gender Gap in International Football Success
Authors: Lago Ignacio , Lago-Peñas Santiago , Lago-Peñas Carlos
Published: November 2021

The conditions under which women's national football teams do better or worse in international tournaments remains an open question. Using data from 116 countries worldwide, we have examined three arguments accounting for the gender gap in international football success, focusing on positive externalities from economic development and women's empowerment, and the active policies promoting women's football. Our findings show that the international performance of women's national football teams compared to men's national football teams increases with women's empowerment and in countries committed to the promotion of women's football, while economic development is not relevant. The general question we address is whether gender gaps disappear because of economic and social development, or if active policies promoting women are required to achieve gender equality.
The ABCs of Teaching Family Counseling: Putting “Fun” into the Fundamentals of the Profession
Authors: Gladding Samuel T. , Robert Casares D.
Published: November 2021

Becoming a family counselor requires knowledge of the history, theories, techniques, and trends within the profession. These tasks are not easy to accomplish and require a dedication of learning where the field has been as well as where it appears to be going. Multiple-choice tests, essay questions, term papers, case histories, internships, special projects, and class presentations are some of the means used to teach and evaluate student’s mastery of the field. However, another way that is fun and effective is class exercises and games. One such game titled “The ABCs of Family Counseling” is explained here. This article examines the rationale for using this teaching tool and how the pedagogy tied to this exercise can help students become more aware of what they have learned, as well as help students develop a readiness to begin working with couples and families.
Therapist Use of Self and the Development of a Culturally-Aware Professional in Family Therapy
Authors: Haber Russell , Braga Cristina , Benda John , Fitch Jenelle , Mitran Carrie L. , Nelson Kimberly A.
Published: November 2021

It has been well established that strong therapeutic alliances correlate with positive outcomes in the course of any therapy. For therapists who seek to enhance their professional development, the contribution of familial alliances to therapy necessitates information about their proclivities with different types of family systems. Since the early days of family therapy, the genogram has served as a tool for identifying family patterns, resources, and potential hindrances. More recently, genograms have aided trainees to better understand how cultural, gender and other biases and assumptions affect administration of therapy. In this manuscript, we introduce the theoretical framework of a new model where the family-of-origin forms an important resource for the professional development of the therapist in training.
Judging What Others Enjoy: Desirability and Observability of Interests
Authors: McIntyre Miranda M.
Published: November 2021

Interests guide major life decisions such as choosing a career path, yet little is known about the subjective characteristics of individual differences in interests. Prior research on personality traits has demonstrated that subjective trait perceptions influence the validity and reliability of personality assessments. The current work expands the study of these subjective characteristics to individual differences in interests. Desirability and observability were assessed among 13 constructs: person orientation, thing orientation, RIASEC career interests, and Big Five traits. Judgments of interest dimensions varied considerably, with socially-related interests rated more desirable than thing-related interests. Some career-related interests were low in observability, and thus may be susceptible to being overlooked or categorized inaccurately. The patterns observed in interest characteristics were comparable to patterns in career choice hit rates, occupational prestige, and self-other convergence. The findings advance knowledge of differences between interest dimensions and suggest that subjective perceptions should be considered in interest assessment.
‘Keeping the children close and the daughters closer.’ Is family housing support in Greece gendered?
Authors: Dagkouli–Kyriakoglou Myrto
Published: November 2021

The welfare regime of Southern Europe, and Greece in particular, does not adequately cover the needs of its citizens. On the contrary, and within this context, family welfare has to be much more efficient. Moreover, the support received from the family imposes a sense of reciprocity, as receivers are expected to be givers in the future. This reciprocity is assisted mainly by the female members of the kin, defining to a degree their housing practices. Data for this paper is derived from a wider research project investigating young people's housing practices and family strategies through in-depth interviews in Athens, Greece. Bringing gender to the fore, it explores how the housing provision from family is impacted by the receivers’ gender role in connection to family welfare obligations.
Experimental research on cage motion with different pocket shapes in angular contact ball bearing
Authors: Yuan Dujuan , Wang Ruixiang , Chen Shijin , Chen Xiaoyang
Published: November 2021

The cage motion with different pocket shapes, such as spherical, square, and cylindrical, in an angular contact ball bearing under different operating conditions are studied experimentally. A test rig with two laser displacement sensors is used to obtain the displacements of the cage in five freedom degrees. The results reveal that these three type cage shapes have different trends of the centroid trajectory versus rotating speed or radial load. The whirling radius is equal to half of the pocket clearance for the spherical pocket, and half of the guiding clearance for both square and cylindrical pocket. The slip rates of all cages decrease with increasing radial load, and increase with rotating speed. Both inclination angel and slip rate of the spherical, cylindrical and square pocket decrease in turn.
Characterisation of the plane anisotropy and its effect on interstitial free steel thin sheet metal forming simulation
Authors: Arfaoui Latifa , Samet Amel , Znaidi Amna
Published: November 2021

The main purpose of this paper is to study the orthotropic plastic behaviour of the cold-rolled interstitial free steel HC260Y when it is submitted to various loading directions under monotonic tests. The experimental database included tensile tests carried out on specimens (in the as-received condition and after undergoing an annealing heat treatment) cut in different orientations according to the rolling direction. A model was proposed, depending on a plasticity criterion, a hardening law and an evolution law, which takes into account the anisotropy of the material. To validate the proposed identification strategy, a comparison with the experimental results of the planar tension tests, carried out on specimens cut parallel to the rolling direction, was considered. The obtained results allowed the prediction of the behaviour of this material when it is subjected to other solicitations whether simple or compound.
The Effect of Tri-Modality Therapy with Bladder Preservation for Selective Muscle-Invasive Bladder Cancer
Authors: Zhiyu Zhang , Qi Zhou , Zhen Song , Jun Ouyang , Jianglei Zhang
Published: November 2021

Objectives: To compare the efficacy of complete transurethral resection of bladder tumor combined with postoperative chemoradiotherapy and radical cystectomy (RC) in the treatment of muscle-invasive bladder cancer (MIBC). Methods: This is a single-center, retrospective study. Clinical data of 125 patients with MIBC admitted to the First Affiliated Hospital of Soochow University from December 2012 to December 2015 were retrospectively analyzed, in which 79 patients (tri-modality therapy [TMT] group) received TMT bladder-sparing treatment, and 41 patients (RC group) received RC. The differences of probabilities for 1-year, 2-year, 5-year, and comprehensive overall survival (OS), progress-free survival (PFS) between 2 groups were calculated using Kaplan–Meier product limited estimates. Univariate and multivariate analyses were performed to detect potential risk factors for OS and PFS. Results: There was no statistical difference between the TMT group and RC group in the 1-year, 2-year, 5-year, comprehensive OS rate, and PFS rate. And survival analysis found no significant difference in OS and PFS between the 2 groups. Univariate analysis showed that age, TNM staging, and prognostic nutritional index (PNI) were associated with OS, while PNI was connected to tumor recurrence. Multiple linear regression analysis indicated that TNM staging and PNI were independent risk factors for OS. Conclusions: TMT can be used as an alternative to RC for MIBC patients under the premise of strict control of indications, rigorous postoperative follow-up, and timely salvage cystectomy. PNI was negatively correlated with OS and PFS, while TNM staging was positively correlated with OS.
Fostering Desistance
Authors: Bushway Shawn , Uggen Christopher
Published: November 2021

In the past three decades, social scientists have made real progress in understanding “desistance,” or the process of transitioning away from criminal behavior. Yet criminal justice policies and practices have been slow to adopt the lessons of life course criminology. Connecting research on desistance theories, particularly identity-based theories, to reentry policies is crucial to understanding the context of criminal offending. Repeated interactions between individuals involved in crime and the police, courts or prison populations can actually increase the salience of criminal identities and strengthen relationships with others involved in crime. Alternatively, movement toward more positively valued adult roles can help foster and gradually stabilize non-criminal identities through the same role commitment process. As a short-term reform, “the problem facing those returning to civilian life from prison is fundamentally a problem of entry rather than reentry.” Furthermore, if the task of entry is one of integrating into “pro-social adult life”, people need programs that support desistance by fostering success in education, employment, family relationships, maintaining a residence, and participating as a citizen in the community. In the medium-term, we see a crucial need to eliminate most collateral consequences of criminal justice involvement because “It makes little sense for a system to encourage or support the adoption of an identity if the people who pass through it are marked as unredeemable.” Finally, there is a long-term need to eliminate structural barriers that prevent people from fully participating in civil society and minimize crime through equitable social policy.
Training and Employment for Correctional Populations
Authors: Duwe Grant , Henry-Nickie Makada
Published: November 2021

Education and employment are both moderate risk factors for recidivism. There is a well-documented relationship between low educational achievement and antisocial behaviors. Education programming in correctional facilities is crucial for improving the educational attainment of incarcerated and re-integrating populations. A brief discussion situates policy reform efforts against a backdrop of extensive research that has documented the interaction between employment and increased educational attainment as pivotal to reducing an individual’s propensity to recidivate. The policies then focus on three pillars that reduce employment barriers for returning citizens: workforce training, educational upgrading, and regulatory employment barriers. In the short-term, policymakers should study and address systemic remedial educational needs in tandem with increasing access to and occupational skills-based training that builds a skill base congruent with the current labor market for incarcerated students. In the mid-term, it is essential to match policy support with the intersecting barriers faced by returning citizens. As an example of federal policies that can help center the public workforce development system around the need to improve quality employment outcomes for returning citizens, the DOL’s dormant pilot Linking to Employment Activities Pre-Release (LEAP). Finally, policymakers should target other consequential screening barriers, such as the accuracy of criminal records that employers can check and have been shown to adversely affect employment prospects.
Studying Sex to Understand Sexual Assault
Authors: Sorin Cierra Raine
Published: November 2021

This book review explores Sexual Citizens: A Landmark Study of Sex, Power, and Assault on Campus by Jennifer S. Hirsch and Shamus Khan, and describes the complicated nature of sexual experiences as an undergraduate.
Inhibitory Activity of Proanthocyanidins Against Escherichia coli 1-Deoxy-D-Xylulose-5-Phosphate Reductoisomerase
Authors: Hui Xian , Zhu Bo-Rong , Wu Long-Long , Gao Wen-Yun , Li Yi-Ming , Jia Qi , Li Heng
Published: November 2021

1-Deoxy-D-xylulose 5-phosphate reductoisomerase (DXR) is a key enzyme in the methylerythritol phosphate pathway for terpenoid biosynthesis. Furthermore, it is an ideal target for the screening of novel antibiotics because it is present in causative organisms, but absent from humans. To identify more lipophilic DXR inhibitors from natural resources, we tested the DXR inhibitory activity of five proanthocyanidins in this study. The results indicated that all these compounds specifically restrained the activity of DXR, with procyanid B2 exhibiting a relatively low effect against DXR (IC50 ∼ 305 μM) and procyanid C1 displaying moderate activity (IC50 75.1 μM). The other three compounds cinnamtannin A2, cinnamtannin B1, and cinnamtannin D1 (IC50 ∼ 89.3, 105.0, and 97.8 μM, respectively) showed DXR inhibitory effects that were slightly weaker than that of procyanid C1. In addition, based on the initial characterization, the structure–activity relationship of this series of compounds against DXR is discussed.
A robust effect size measure Aw for MANOVA with non-normal and non-homogenous data
Authors: Ching-Hong Li Johnson , Nesca Marcello , Michael Waisman Rory , Cheng Yongtian , Man Chung Tze Virginia
Published: November 2021

A common research question in psychology entails examining whether significant group differences (e.g. male and female) can be found in a list of numeric variables that measure the same underlying construct (e.g. intelligence). Researchers often use a multivariate analysis of variance (MANOVA), which is based on conventional null-hypothesis significance testing (NHST). Recently, a number of quantitative researchers have suggested reporting an effect size measure (ES) in this research scenario because of the perceived shortcomings of NHST. Thus, a number of MANOVA ESs have been proposed (e.g. generalized eta squared [Formula: see text], generalized omega squared [Formula: see text]), but they rely on two key assumptions—multivariate normality and homogeneity of covariance matrices—which are frequently violated in psychological research. To solve this problem we propose a non-parametric (or assumptions-free) ES ( Aw) for MANOVA. The new ES is developed on the basis of the non-parametric A in ANOVA. To test Aw we conducted a Monte-Carlo simulation. The results showed that Aw was accurate (robust) across different manipulated conditions—including non-normal distributions, unequal covariance matrices between groups, total sample sizes, sample size ratios, true ES values, and numbers of dependent variables—thereby providing empirical evidence supporting the use of Aw, particularly when key assumptions are violated. Implications of the proposed Aw for psychological research and other disciplines are also discussed.
The Role of Tolerance Education in Diversity Management: A Cultural Historical Activity Theory Perspective
Authors: Sakallı Özge , Tlili Ahmed , Altınay Fahriye , Karaatmaca Ceren , Altınay Zehra , Dağlı Gökmen
Published: November 2021

Tolerance education aims to promote the culture of peace and acceptance of others for well-being and diversity management. Therefore, it is important to create learning environments, content, and facilities for tolerance education in line with the universal values in education. However, little is known about how the literature investigated and summarized the findings related to tolerance education. Therefore, this study conducts a systematic review about this topic, where 75 reviewed studies were analyzed according to the Cultural-Historical Activity Theory (CHAT) components. Findings highlighted that: (1) from the subject component, future research should involve more stakeholders, like parents and policymakers, when discussing tolerance education; (2) from the object component, tolerance education should not only focus on the physical environment, but also on the virtual environment; (3) from the tools component, limited digital tools and technology have been used to promote tolerance education; (4) from the community component, more investigation of tolerance education should be outside of school contexts; (5) from the rules component, more ICT training should be provided. The use of big data and learning analytics could be one of the potential methods to assess students in tolerance education; (6) from the labor division component, school family interaction role is very important to manage risks and diversities through tolerance education; and (7) from the outcomes component, tolerance education studies should go beyond simply investigating the awareness and attitudes of learners, and investigate, for instance, the behavioral changes of learners. Finally, recommendations were made under each CHAT component.
Factors That Influence Physical Activity Among Older Adults Living in Rural Community in Wangthong District, Phitsanulok, Thailand
Authors: Kitreerawutiwong Nithra , Keeratisiroj Orawan , Mekrungrongwong Sunsanee
Published: November 2021

This study aimed to assess the individual, interpersonal, and environmental factors that relate to physical activity (PA) among older adults in rural communities in Wangthong district, Phitsanulok, Thailand. A cross-sectional study was conducted on 545 elders by multi-stage sampling. The data were collected via a validated questionnaire. Multiple logistic regression analysis was performed to identify potential determinants of PA. Factors including youngest-old (adjusted OR 1.55, 95% CI [1.05–2.28]), high level of income (adjusted OR 1.89, 95% CI [1.17–3.19]), being a member of the elders’ club (adjusted OR 1.68, 95% CI [1.15–2.46]), and high level of perceived self-efficacy (adjusted OR 1.79, 95% CI [1.23–2.61]) indicated higher likelihood of PA ( p < .05). Interventions to improve PA among older people should include improving physical environmental attributes, creating more inexpensive and less time-consuming alternatives for PA, promoting peer support networks and activities to enhance self-efficacy.
The Utility of Online Information Sessions for Medical Student Recruitment in Plastic Surgery: A New Paradigm Amidst the COVID-19 Pandemic
Authors: Chocron Yehuda , Sebag Victoria , Zammit Dino , Thibaudeau Stephanie
Published: November 2021

Background: The COVID-19 pandemic has led to increased barriers for medical students seeking to engage with plastic surgery. Traditional approaches such as pursuing clinical electives broadly are no longer feasible and medical students are seeking innovative approaches for engagement. The current study evaluated the efficacy of online information sessions on medical student perception and proposed a timeline for longitudinal medical student recruitment. Methods: The McGill Plastic and Reconstructive Surgery residency program held an online information session for medical students focusing on a wide array of topics related to plastic surgery and residency. Following the session, an anonymous survey was sent to participants gauging their satisfaction with the event and potential effects it had on career planning. Results: Thirty-four participants completed the survey, comprising more than 60% of annual applicants to Canadian plastic surgery programs. 94% of participants stated that their view of McGill’s training program improved and reported a desire for additional sessions from other training programs. 68% of respondents reported being more likely to consider training at McGill and 100% agreed that such sessions could influence their decision to pursue a given training program. Social media was the most common resource used by participants to gain information on training programs. Conclusion: Online information sessions are valuable tools for medical student recruitment and can directly influence their views of a specific training program and affect career planning. Investing in generating high quality content through online forms of communication is paramount as most medical students are turning to these platforms amidst the pandemic.
The Impact of Simulation-Based Education on Nurses’ Perceived Predeployment Anxiety During the COVID-19 Pandemic Within the Cultural Context of a Middle Eastern Country
Authors: Sullivan Jacqueline , Al-Marri Alanoud , Almomani Emad , Mathias Jesveena
Published: November 2021

Anxiety related to the COVID-19 pandemic is prevalent among the nursing workforce and has the potential to affect well-being and performance in the workplace. This paper reports on a joint education/nursing and midwifery workforce quality improvement initiative in the State of Qatar to address an urgent need for COVID-19 preparedness during the second wave of infection. A Simulation-Based Education (SBE) program was developed and delivered over a period of 2 months (February to April 2021) to prepare nurses for deployment to COVID-19 facilities. Perceived anxiety scores related to COVID-19 deployment were collected from 121 nurses before and after SBE attendance. The data demonstrates that SBE is an effective method to reduce deployment-related anxiety among registered nurses.
Reading runes with the sun. A geosemiotic analysis of the Rök runestone
Authors: Holmberg Per
Published: November 2021

In the field of runestone research, the importance of multimodal understanding has been downplayed although it is obvious that several semiotic resources interact when it comes to carving a stone and erecting it in the landscape. This study examines if it is possible to deal with the methodological challenges of a historical material and make a multimodal approach deepen our understanding of the Rök runestone, one of the most famous and enigmatic Viking Age runestones. The study applies Scollon and Scollon’s geosemiotic framework (2003). Through an investigation of how the visual semiotics interacts with place semiotics and interaction order, it turns out that the marked reading direction of the lines of the inscription symbolizes the movement of the sun, and that the change of font size in two lines probably mimics the change of solar brightness at sunrise and sunset. Further, it is suggested that the big crosses of cipher runes and the small crosses between some information units may represent the sun and stars, respectively. The conclusion is that the monument was risen for the enactment of a counsel of the gods with the aim of securing the rhythm of celestial light. Finally, implications for multimodal research are discussed.
Single Cell Analyses Reveal a Non-Canonical EZH2 Activity As a Main Driver of Retinoic Acid Resistance in PLZF/Rara Leukemia
Authors: Poplineau Mathilde , Platet Nadine , Mazuel Adrien , Hérault Léonard , Koide Shuhei , Kuribayashi Wakako , Carbuccia Nadine , N'Guyen Lia , Vernerey Julien , Oshima Motohiko , Birnbaum Daniel , Lachaud Christophe , Iwama Atsushi , Duprez Estelle
Published: November 2021

Resistance to treatment is due to the heterogeneity of the tumor which contains a subset of cancer cells that escape treatment and are responsible for the relapse. Acute Promyelocytic Leukemia (APL), the M3 subtype of AML, is a good model to illustrate these problematics. Indeed, APL driven by oncogenic fusion proteins such PML/RARA t(15;17) or PLZF/RARA t(11;17) behave differently to differentiation therapeutics. Both APLs differentiate in vivo upon Retinoic Acid (RA) treatment; however, while PML/RARA APL patients exhibit partial or complete remission, PLZF/RARA APL patients remain clinically resistant. In the present study we aim to decipher the transcriptional and epigenetic networks that is linked to t(11;17) APL resistance towards RA.

We took advantage of the PLZF/RARA RA resistant murine APL model to catch relapse-initiating cell features and their vulnerabilities. By developing an integrative single-cell multi-omics analysis (scRNA-seq and scATAC-seq), we uncovered transcriptional and chromatin heterogeneity of the PLZF/RARA APL blasts. We highlighted a subset of cells insensitive to RA-induced differentiation with a strong DNA repair signature ("Rep" cluster) and exhibiting a fine tuned transcriptional network targeting the histone methyltransferase Ezh2. To validate the function of Ezh2 in APL physiology, we combined epigenomic studies with RA-treated and non-RA-treated bone marrow transplantation experiments. We revealed high Ezh2 activity that marks the relapse of RA-treated APL. However, targeting Ezh2 methyltransferase activity was not sufficient to achieve disease cure and, suggests an independent methyltransferase Ezh2 activity linked to RA resistance.

These findings demonstrate the power of single-cell multi-omics integration to highlight path to sensitize therapy-resistant leukemia cells. In addition, our study uncovers a dual role of Ezh2 in APL and suggests that targeting non-canonical Ezh2 activity could be a new promising therapeutic approach for RA resistant APL.

Disclosures

Iwama: Nissan Chemical Corporation: Research Funding.
Serological Response to BNT162b2 Anti-Sars-Cov-2 mRNA Vaccine in Patients with Transfusion Dependent Thalassemia
Authors: Zucano Stefania , Tarantini Francesco , Vitucci Angelantonio , Palma Antonio , Campanale Daniela , Vimercati Luigi , Larocca Angela Maria Vittoria , Visceglie Domenico , Acquafredda Amalia , Tafuri Silvio , Musto Pellegrino
Published: November 2021

Thalassemia is an inherited blood disorder characterized by defective hemoglobin production, ineffective erythropoiesis and chronic hemolytic anemia. Patients with both transfusion-dependent thalassemia (TDT) and non-transfusion dependent thalassemia (NTDT) have risk factors associated with severe SARS-CoV-2 infection including iron overload, endocrinopathies, massive splenomegaly or previous splenectomy and coagulopathy (Motta et al, Am J Hematol, 95: E198-E199., 2020). Although vaccination is encouraged for these patients, data on the efficacy and safety of anti Sars-CoV-2 vaccines are limited (Karimi, M, et al, Br J Haematol, 190: e137-e140, 2020; Mandana Zafari, et al, Hemoglobin, 45:1, 1-4, 2021) due to exclusion of these patients from clinical trials. In a single center, prospective, cohort study we compared 67 patients affected by TDT to 61 healthy controls (HC), matched for age and sex. Study population and HC received two doses of BNT162b2 anti-SARS-Cov-2 mRNA vaccine on days 1 and 21, between April 1st and May 15 th, 2021. Serological tests were performed by a commercially available immunoassay for the quantitative determination of anti-spike IgG antibodies to SARS-CoV-2. The results were reported as Arbitrary Units (AU)/mL, with a cut-off for defining response as 50 or greater AU/ml. Patients and HC samples were collected four weeks after the second dose of vaccine. Median age of patients was 43 years (range 19-77), 39% of them were male and 61% were female. Median age of HC was 39 years (range 19-86), 43% of them were male and 57% were female. All controls achieved a response (50 or greater AU/mL) to vaccination, whereas 66/67 (98,5%) patients responded. Antibody titers were significantly higher (p=0.0005) in the HC group (mean 9863 ± 7784; median 7712, range 1206-51664) compared to patients (mean 7945 ± 12326; median 4025, range 19-89202) (Figure 1). When analyzing the patients' factors, age, sex, transfusion interval, serum ferritin level, and spleen size did not impact on the response to vaccination. With a median follow-up of 12 weeks, no relevant side effects were recorded after vaccination and no case of COVID19 occurred among vaccinated TDT patients. In conclusion, BNT162b2 anti-SARS-Cov-2 mRNA vaccine demonstrated efficacy and safety in our cohort of TDT patients. Response rate was similar to that of HC. Nevertheless, antibody titers in TDT patients were significantly lower than in HC. Further observations are ongoing to assess duration of response, efficacy and possible factors influencing this finding.

Figure 1 Figure 1.

Disclosures

No relevant conflicts of interest to declare.
Genome-wide CRISPR screen identifies CDK6 as a therapeutic target in adult T-cell leukemia/lymphoma
Authors: Ishio Takashi , Kumar Sarvesh , Shimono Joji , Daenthanasanmak Anusara , Dubois Sigrid , Lin Yuquan , Bryant Bonita , Petrus Michael N. , Bachy Emmanuel , Huang Da Wei , Yang Yandan , Green Patrick L. , Hasegawa Hiroo , Maeda Michiyuki , Goto Hideki , Endo Tomoyuki , Yokota Takashi , Hatanaka Kanako C. , Hatanaka Yutaka , Tanaka Shinya , Matsuno Yoshihiro , Yang Yibin , Hashino Satoshi , Teshima Takanori , Waldmann Thomas A. , Staudt Louis M. , Nakagawa Masao
Published: November 2021

Adult T-cell leukemia/lymphoma (ATLL) is an aggressive T-cell malignancy with a poor prognosis with current therapy. Here we report genome-wide CRISPR-Cas9 screening of ATLL models, which identified CDK6, CCND2, BATF3, JUNB, STAT3, and IL10RB as genes that are essential for the proliferation and/or survival of ATLL cells. As a single agent, the CDK6 inhibitor palbociclib induced cell cycle arrest and apoptosis in ATLL models with wild-type TP53. ATLL models that had inactivated TP53 genetically were relatively resistant to palbociclib owing to compensatory CDK2 activity, and this resistance could be reversed by APR-246, a small molecule activator of mutant TP53. The CRISPR-Cas9 screen further highlighted the dependence of ATLL cells on mTORC1 signaling. Treatment of ATLL cells with palbociclib in combination with mTORC1 inhibitors was synergistically toxic irrespective of the TP53 status. This work defines CDK6 as a novel therapeutic target for ATLL and supports the clinical evaluation of palbociclib in combination with mTORC1 inhibitors in this recalcitrant malignancy.
Antibody response after 2 and 3 doses of SARS-CoV-2 mRNA vaccine in allogeneic hematopoietic cell transplant recipients
Authors: Maillard Alexis , Redjoul Rabah , Klemencie Marion , Labussière Wallet Hélène , Le Bourgeois Amandine , D'Aveni Maud , Huynh Anne , Berceanu Ana , Marchand Tony , Chantepie Sylvain , Botella Garcia Carmen , Loschi Michael , Joris Magalie , Castilla-Llorente Cristina , Thiebaut-Bertrand Anne , François Sylvie , Leclerc Mathieu , Chevallier Patrice , Nguyen Stephanie
Published: November 2021

Three reports address the protection of the vulnerable population of patients with hematologic malignancies in the face of the ongoing COVID pandemic. The reports suggest that some patients who fail to mount a B-cell response to vaccine may nevertheless have protective T cell responses. As a group, these reports suggest that patients should continue to be immunized with additional doses to attempt to improve immune response but that they need to maintain the precautions recommended for the unvaccinated.
Opportunities and Challenges: Classification of Skin Disease Based on Deep Learning
Authors: Zhang Bin , Zhou Xue , Luo Yichen , Zhang Hao , Yang Huayong , Ma Jien , Ma Liang
Published: November 2021

Deep learning has become an extremely popular method in recent years, and can be a powerful tool in complex, prior-knowledge-required areas, especially in the field of biomedicine, which is now facing the problem of inadequate medical resources. The application of deep learning in disease diagnosis has become a new research topic in dermatology. This paper aims to provide a quick review of the classification of skin disease using deep learning to summarize the characteristics of skin lesions and the status of image technology. We study the characteristics of skin disease and review the research on skin disease classification using deep learning. We analyze these studies using datasets, data processing, classification models, and evaluation criteria. We summarize the development of this field, illustrate the key steps and influencing factors of dermatological diagnosis, and identify the challenges and opportunities at this stage. Our research confirms that a skin disease recognition method based on deep learning can be superior to professional dermatologists in specific scenarios and has broad research prospects.
Diurnal variations in muscle and liver glycogen differ depending on the timing of exercise
Authors: Iwayama Kaito , Tanabe Yoko , Tanji Fumiya , Ohnishi Takahiro , Takahashi Hideyuki
Published: November 2021

It has been suggested that glycogen functions not only in carbohydrate energy storage, but also as molecular sensors capable of activating lipolysis. This study aimed to compare the variation in liver and muscle glycogen during the day due to different timing of exercise. Nine healthy young men participated in two trials in which they performed a single bout of exercise at 70% of their individual maximal oxygen uptake for 60 min in the post-absorptive (morning) or post-prandial (afternoon) state. Liver and muscles glycogen levels were measured using carbon magnetic resonance spectroscopy (13C MRS). Diurnal variations in liver and muscle glycogen compared to baseline levels were significantly different depending on the timing of exercise. The effect of the timing of exercise on glycogen fluctuation is known to be related to a variety of metabolic signals, and the results of this study will be useful for future research on energy metabolism.
Universal probe-based intermediate primer-triggered qPCR (UPIP-qPCR) for SNP genotyping
Authors: Li Baowei , Liu Yanran , Hao Xiaodan , Dong Jinhua , Chen Limei , Li Haimei , Wu Wei , Liu Ying , Wang Jianxun , Wang Yin , Li Peifeng
Published: November 2021

Background

The detection and identification of single nucleotide polymorphism (SNP) is essential for determining patient disease susceptibility and the delivery of medicines targeted to the individual. At present, SNP genotyping technology includes Sanger sequencing, TaqMan-probe quantitative polymerase chain reaction (qPCR), amplification-refractory mutation system (ARMS)-PCR, and Kompetitive Allele-Specific PCR (KASP). However, these technologies have some disadvantages: the high cost of development and detection, long and time consuming protocols, and high false positive rates. Focusing on these limitations, we proposed a new SNP detection method named universal probe-based intermediate primer-triggered qPCR (UPIP-qPCR). In this method, only two types of fluorescence-labeled probes were used for SNP genotyping, thus greatly reducing the cost of development and detection for SNP genotyping.

Results

In the amplification process of UPIP-qPCR, unlabeled intermediate primers with template-specific recognition functions could trigger probe hydrolysis and specific signal release. UPIP-qPCR can be used successfully and widely for SNP genotyping. The sensitivity of UPIP-qPCR in SNP genotyping was 0.01 ng, the call rate was more than 99.1%, and the accuracy was more than 99.9%. High-throughput DNA microarrays based on intermediate primers can be used for SNP genotyping.

Conclusion

This novel approach is both cost effective and highly accurate; it is a reliable SNP genotyping method that would serve the needs of the clinician in the provision of targeted medicine.
Endoscopic negative pressure therapy as stand-alone treatment for perforated duodenal diverticulum: presentation of two cases
Authors: Wichmann Dörte , Jansen Kai Tobias , Onken Flurina , Stüker Dietmar , Zerabruck Emanuel , Werner Christoph R. , Yurttas Can , Thiel Karolin , Königsrainer Alfred , Quante Markus
Published: November 2021

Background

Endoscopic negative pressure therapy is a novel and successful treatment method for a variety of gastrointestinal leaks. This therapy mode has been frequently described for rectal and esophageal leakages. Duodenal diverticular perforations are rare but life-threatening events. The early diagnosis of duodenal diverticular perforation is often complicated by inconclusive symptoms. This is the first report about endoscopic negative pressure therapy in patients with perforated duodenal diverticula.

Case presentation

We present two cases of duodenal diverticula perforations treated with endoscopic negative pressure therapy as stand-alone treatment. Start of symptoms varied from one to three days before hospital admission. Early sectional imaging led to the diagnosis of duodenal diverticular perforation. Both patients were treated with endoluminal endoscopic negative pressure therapy with simultaneous feeding option. Three respective changes of the suction device were performed. Both patients were treated with antibiotics and antimycotics during their hospital stay and be discharged from hospital after 20 days.

Conclusions

This is the first description of successful stand-alone treatment by endoscopic negative pressure therapy in two patients with perforated duodenal diverticulum. We thus strongly recommend to attempt interventional therapy with endoluminal endoscopic negative pressure therapy in patients with duodenal diverticular perforations upfront to surgery.