bluuebunny/crossref_metadata_2025 huggingface dataset:
Personal narratives of learning self‐management: Lessons for practice based on experiences of people with serious mental illness
Authors: Strong Susan , Letts Lori
Published: June 2021

Introduction

Clinicians are challenged to deliver self‐management interventions in recovery‐oriented services for individuals living with serious mental illnesses. Little is known about how people learn self‐management skills and questions remain about how best to deliver support. To offer insights for delivery, this research describes the lived experiences of learning self‐management and the meaning of those experiences within recovery journeys and the context of health‐care delivery.

Methods

Design followed van Manen's approach of phenomenology through an occupational therapist's lens. Using purposeful criterion sampling until saturation, 25 adults with psychosis experiences (8–40 years) from six community‐based specialised mental health programs were interviewed. Conceptual maps were cocreated depicting key learning experiences, intersections with services, and recommendations. Data reduction, reconstruction and explication of meaning occurred concurrently, and multiple strategies were used to transparently support an open, iterative, reflexive process.

Findings

Participants described eight essential tasks to live well, learned often serendipitously, taking up to 15–30 years to find the right combination of supports and self‐management strategies to achieve what they felt was a life of quality. Self‐management needs were not routinely addressed by services and extended beyond illness or crisis management while participants grappled with emotions, self‐concept, relationships, and occupational issues. Participants asked providers to “teach us to teach ourselves”; “invite clients” to the decision table; and deal directly with emotions of fear, shame, and trust with respect to self and relationships. Findings challenge conventional conceptualisations of self‐management to consider clients living interdependent lives with tasks performed in context, dynamically influenced by complex personal, socio‐ecological relationships.

Conclusions

Participants' narratives compel increasing access to strategic personalised self‐management learning opportunities as an effort to shorten the prolonged recovery paths. Findings offer ways providers can understand and address eight self‐management learning tasks from the perspective of lived experiences. Self‐management was enmeshed with recovery, health, and building a life.
The Structure and Financing of Health Care Systems Affected How Providers Coped With COVID‐19
Authors: WAITZBERG RUTH , QUENTIN WILM , WEBB ERIN , GLIED SHERRY
Published: June 2021

Policy Points

We compared the structure of health care systems and the financial effects of the COVID‐19 pandemic on health care providers in the United States, England, Germany, and Israel: systems incorporating both public and private insurers and providers.

The negative financial effects on health care providers have been more severe in the United States than elsewhere, owing to the prevalence of activity‐based payment systems, limited direct governmental control over available provider capacity, and the structure of governmental financial relief.

In a pandemic, activity‐based payment reverses the conventional financial positions of payers and providers and may prevent providers from prioritizing public health because of the desire to avoid revenue loss caused by declines in patient visits.
Issue politicization and social class: How the electoral supply activates class divides in political preferences
Authors: ARES MACARENA
Published: June 2021

Against premature claims about the declining political relevance of social class in post‐industrial democracies, recent research indicates that class continues to be a relevant determinant of political preferences. In post‐industrial societies ‘old’ class divides on economic issues coexist with ‘new’ class alignments on cultural topics. While there is cumulated evidence of social classes’ distinct placement on these issues, this paper argues that the strength of class divides depends on the extent to which these issues are politicized by political parties. Studying preferences on economic and cultural issues (attitudes towards redistribution, immigration, gay rights and European integration), this study shows that class divides in preferences are context dependent. The multilevel analyses drawing on data from the European Social Survey and the Chapel Hill Expert Survey for 27 European democracies demonstrate that classes’ differences in preferences are accentuated on issues strongly contested and emphasized by parties, and mitigated on issues where party conflict is weaker. Adding to recent literature on parties and class conflict, this study identifies another stage at which parties can affect the strength of class voting. The varying strength of class divides across contexts also has implications for parties’ ability to garner support beyond a single class. This becomes increasingly unlikely in contexts of high issue politicization.
Vitamin C alleviates hyperuricemia nephropathy by reducing inflammation and fibrosis
Authors: Li Hongling , Liu Xuejiao , Lee Mee‐Hyun , Li Haitao
Published: June 2021

Hyperuricemia contributes to chronic kidney disease development. However, it has been historically viewed with limited research interest. In this study, we mimicked the development of hyperuricemic nephropathy by using a potassium oxonate‐induced hyperuricemia rat model. We found that administering vitamin C at 10 mg/kg/day effectively ameliorated hyperuricemic nephropathy. Compared to the control group, rats with hyperuricemia had significantly increased serum uric acid level, xanthine oxidase activity, and urine microalbumin level, by 5‐fold, 1.5‐fold, and 4‐fold, respectively. At the same time, vitamin C supplementation reverted these values by 20% for serum uric acid level and xanthine oxidase activity and 50% for microalbumin level. Vitamin C also alleviated renal pathology and decreased the expression of pro‐inflammatory and pro‐fibrotic markers. A further mechanistic study suggested that vitamin C might attenuate hyperuricemic nephropathy in renal tubular epithelial cells induced by monosodium urate (MSU) crystal, at least in part, by directly inhibiting IL‐6/JAK2/STAT3 signaling pathway. Meanwhile, in macrophages, vitamin C inhibited the expression of TGF‐β, and reduced ROS level induced by MSU by about 35%. In short, our results suggest that vitamin C supplementation delay the progression of hyperuricemic nephropathy.
Circulating miR‐19a‐3p and miR‐19b‐3p characterize the human aging process and their isomiRs associate with healthy status at extreme ages
Authors: Morsiani Cristina , Terlecki‐Zaniewicz Lucia , Skalicky Susanna , Bacalini Maria Giulia , Collura Salvatore , Conte Maria , Sevini Federica , Garagnani Paolo , Salvioli Stefano , Hackl Matthias , Grillari Johannes , Franceschi Claudio , Capri Miriam
Published: June 2021

Blood circulating microRNAs (c‐miRs) are potential biomarkers to trace aging and longevity trajectories to identify molecular targets for anti‐aging therapies. Based on a cross‐sectional study, a discovery phase was performed on 12 donors divided into four groups: young, old, healthy, and unhealthy centenarians. The identification of healthy and unhealthy phenotype was based on cognitive performance and capabilities to perform daily activities. Small RNA sequencing identified 79 differentially expressed c‐miRs when comparing young, old, healthy centenarians, and unhealthy centenarians. Two miRs, that is, miR‐19a‐3p and miR‐19b‐3p, were found increased at old age but decreased at extreme age, as confirmed by RT‐qPCR in 49 donors of validation phase. The significant decrease of those miR levels in healthy compared to unhealthy centenarians appears to be due to the presence of isomiRs, not detectable with RT‐qPCR, but only with a high‐resolution technique such as deep sequencing. Bioinformatically, three main common targets of miR‐19a/b‐3p were identified, that is, SMAD4, PTEN, and BCL2L11, converging into the FoxO signaling pathway, known to have a significant role in aging mechanisms. For the first time, this study shows the age‐related increase of plasma miR‐19a/b‐3p in old subjects but a decrease in centenarians. This decrease is more pronounced in healthy centenarians and was confirmed by the modified pattern of isomiRs comparing healthy and unhealthy centenarians. Thus, our study paves the way for functional studies using c‐miRs and isomiRs as additional parameter to track the onset of aging and age‐related diseases using new potential biomarkers.
Predictors of early and sustained cessation of heavy drinking over 5 years among adult primary care patients
Authors: Palzes Vanessa A. , Kline‐Simon Andrea H. , Satre Derek D. , Sterling Stacy , Weisner Constance , Chi Felicia W.
Published: June 2021

Aims

To identify factors asociated with early and sustained cessation of heavy drinking.

Design

Retrospective cohort study over 5 years.

Setting

Kaiser Permanente Northern California, United States.

Participants

Adults reporting heavy drinking during primary care‐based alcohol screening between 1 June 2013 and 31 May 2014. The sample (n = 85 434) was 40.7% female and 33.8% non‐white; mean age was 50.3 years (standard deviation = 18.1).

Measurements

Following US guidelines, early and sustained cessation of heavy drinking was defined as reporting lower‐risk drinking or abstinence at 1 year and to 5 years after achieving early cessation, respectively. Associations between patient characteristics and service use and cessation outcomes were examined using logistic regression with inverse probability weights addressing attrition.

Findings

Nearly two‐thirds of participants achieved early cessation of heavy drinking. Women [odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.35, 1.44], middle‐age (35–64 years: ORs = 1.16–1.19), non‐white race/ethnicity (ORs = 1.03–1.57), medical conditions (OR = 1.05, 95% CI = 1.04, 1.06), psychiatric (OR = 1.10, 95% CI = 1.06, 1.15) and drug use disorders (OR = 1.35, 95% CI = 1.17, 1.56) and addiction treatment (OR = 1.19, 95% CI = 1.09, 1.30) were associated with higher odds of early cessation, while older age (≥ 65 years: OR = 0.91, 95% CI = 0.86, 0.96), smoking (OR = 0.81, 95% CI = 0.77, 0.84), higher index drinking levels (exceeding both daily and weekly limits: OR = 0.30, 95% CI = 0.29, 0.32) and psychiatric treatment (OR = 0.91, 95% CI = 0.84, 0.99) were associated with lower odds. Among those who achieved early cessation (n = 19 200), 60.0% sustained cessation. Associations between patient factors and sustained cessation paralleled those observed in analyses of early cessation. Additionally, routine primary care (OR = 1.57, 95% CI = 1.44, 1.71) and addiction treatment post‐1 year (OR = 1.41, 95% CI = 1.19, 1.66) were associated with higher odds of sustained cessation. Lower‐risk drinking versus abstinence at 1 year was associated with lower odds of sustained cessation (OR = 0.62, 95% CI = 0.57, 0.66).

Conclusions

Nearly two‐thirds of a large, diverse sample of patients who reported heavy drinking in a Californian health‐care system achieved early and sustained cessation of heavy drinking. Vulnerable subgroups (i.e. non‐white patients and those with psychiatric disorders), patients who received routine primary care and those who received addiction treatment were more likely to sustain cessation of heavy drinking than other participants.
Changes in drinking days among United States adults during the COVID‐19 pandemic
Authors: Nordeck Courtney D. , Riehm Kira E. , Smail Emily J. , Holingue Calliope , Kane Jeremy C. , Johnson Renee M. , Veldhuis Cindy B. , Kalb Luther G. , Stuart Elizabeth A. , Kreuter Frauke , Thrul Johannes
Published: June 2021

Aims

To examine changes in drinking behavior among United States (US) adults between March 10 and July 21, 2020, a critical period during the COVID‐19 pandemic.

Design

Longitudinal, internet‐based panel survey.

Setting

The Understanding America Study (UAS), a nationally representative panel of US adults age 18 or older.

Participants

A total of 4298 US adults who reported alcohol use.

Measurements

Changes in number of reported drinking days from March 11, 2020 through July 21, 2020 in the overall sample and stratified by sex, age, race/ethnicity, household structure, poverty status, and census region.

Findings

Compared with March 11, the number of drinking days per week was significantly higher on April 1 by an average of 0.36 days (95% CI = 0.30, 0.43), on May 1 by an average of 0.55 days (95% CI = 0.47, 0.63), on June 1 by an average of 0.41 days (95% CI = 0.33, 0.49), and on July 1 by an average of 0.39 days (95% CI = 0.31, 0.48). Males, White participants, and older adults reported sustained increases in drinking days, whereas female participants and individuals living under the federal poverty line had attenuated drinking days in the latter part of the study period.

Conclusions

Between March and mid‐July 2020, adults in the United States reported increases in the number of drinking days, with sustained increases observed among males, White participants, and older adults.
Loss of CDX‐2 expression is an independent poor prognostic biomarker in patients with early‐stage deficient mismatch repair colorectal cancer
Authors: Korphaisarn Krittiya , Sukhokanjanachusak Kanjana , Pongpaibul Ananya , Chinswangwatanakul Vitoon , Akewanlop Charuwan
Published: June 2021

Aim

To investigate the clinicopathological factors, molecular features, and prognostic implications associated with loss of Caudal‐related homeobox transcription factor 2 (CDX‐2) expression in colorectal cancer (CRC) patients.

Methods

Immunohistochemistry for CDX‐2 expression was performed on formalin‐fixed, paraffin‐embedded primary CRC tissue samples from 449 patients. Correlation between CDX‐2 expression and clinicopathological and molecular characteristics was evaluated. Univariate and multivariate survival analyses were performed to determine the prognostic value of loss of CDX‐2 expression.

Results

Of 449 patients, 84% were stage I–III. CDX‐2‐negative expression was identified in 18 of 441 (4.1%) patients. Loss of CDX‐2 expression was more commonly found in patients with right‐sided tumors rather than left‐sided tumors (odds ratio [OR] = 3.57; p = 0.009), deficient mismatch repair (dMMR) compared to proficient MMR (pMMR) (OR = 3.7; p = 0.012), and BRAF mutation compared to BRAF wild type (OR = 8.06; p = 0.002). Univariate analysis revealed that stage I–III CRC patients with loss of CDX‐2 expression had significantly worse overall survival (OS) and disease‐free survival (DFS) than those with positive CDX‐2 expression (5‐year OS = 33.3% vs. 74.6%, respectively; p < 0.001, and 5‐year DFS: 42.9% vs. 69.5%, respectively; p = 0.004). Loss of CDX‐2 expression remained significantly associated with worse OS compared to positive CDX‐2 expression in multivariate analysis (hazard ratio [HR] = 2.4; 95% confidence interval [CI], 1.12–5.11; p = 0.023).

Conclusions

Loss of CDX‐2 expression was found to be associated with right‐sided tumor, dMMR status, and BRAF mutation. Moreover, loss of CDX‐2 expression is a poor prognostic factor for OS in stage I–III, even among patients with dMMR tumors.
Media and the Meanings of Land: A South Korean Case Study
Authors: Shin Bokyong , Boonjubun Chaitawat
Published: June 2021

How land and property are treated has changed through history: from commons to commodities and financial assets. Nevertheless, studies on how the media contribute to this process are rare. Based on Anne Haila’s concept of “property mind” and the idea of “the culture of property,” this article analyzes how the media have framed the meanings of land and reflected on the treatment of land. We analyzed editorials on land, housing, and properties from seven South Korean newspapers over a 30‐year period using a structural topic model (STM). The results demonstrate that the media have played a vital role in contributing to the promotion of the private land tenure system and “the property mind” in South Korea, particularly since the late 1990s. Despite the recent trends that have intensified around market‐oriented topics, we also found that liberal and conservative newspapers can be quite different in how they shape “the culture of property.”
Government Infrastructure Investment Dividends and Urban Development
Authors: Pullen John
Published: June 2021

Urban developments in expanding economies require increasing investments in infrastructure and services. If these are not provided by developers and landowners, the cost has to be met by the government and taxpayers. Financial benefits of economic development accrue to developers and landowners in the form of increased land values, but previous attempts to redirect a share of these benefits to the government have rarely been successful. A more logical and practical alternative would be the introduction of a system that returns dividends to the government in proportion to its investments in infrastructure and services.
Agricultural Land Issues in the Middle East and North Africa
Authors: Bertini Rafaelle , Zouache Abdallah
Published: June 2021

The continuing economic stagnation of the Middle East and North Africa (MENA) has typically been explained in terms of the resource‐curse thesis. Yet, without analyzing the geographical constraints of MENA and the institutions of the region, particularly ones that pertain to land and property rights, this explanation is partial at best. Specifically addressing the structural constraints on using land for economic transformation, we offer a new explanation for the underdevelopment of MENA. We show that transformation in agriculture is inhibited by fuzzy property rights in land that were inherited from colonial and post‐colonial agricultural policies. Political‐economic transformation in MENA could unleash the power of land in the region.
Economic Insanity
Authors: Obeng‐Odoom Franklin
Published: June 2021

Richard Giles, a leading Australian Georgist political economist, suggests that criticisms of mainstream economics can be reduced to three: neglect of the Physiocrats, rejection of Georgist political economy, and the attempted revival of Georgist land economics with faulty variants of those principles. Yet, in defending Georgism, Giles fails to show it can resolve the legacies of chattel slavery, colonialism, and neocolonialism. Despite that limitation, Giles shows that the renewal of land economics is essential to achieving economic justice. Along the way, Giles provides original insights about the limitations of modern monetary theory, the Malthusian economics of global migration, and the rise of global nationalism.
The Commons in an Age of Uncertainty: A Review Essay
Authors: Duchrow Ulrich
Published: June 2021

Franklin Obeng‐Odoom's recent work offers an alternative to both conventional economics and to what he calls the "Western left consensus." Obeng‐Odoom's option involves placing justice at the center of policy regarding commons, not as a side note. Justice requires a focus on the land issue. This much is true, but Obeng‐Odoom ignores the plurality of views that are critical of the dominant political economy. A successful transition to a sustainable future will make use of many cultural and religious traditions working together.
Multimodal deep learning with feature level fusion for identification of choroidal neovascularization activity in age‐related macular degeneration
Authors: Jin Kai , Yan Yan , Chen Menglu , Wang Jun , Pan Xiangji , Liu Xindi , Liu Mushui , Lou Lixia , Wang Yao , Ye Juan
Published: June 2021

Purpose

This study aimed to determine the efficacy of a multimodal deep learning (DL) model using optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) images for the assessment of choroidal neovascularization (CNV) in neovascular age‐related macular degeneration (AMD).

Methods

This retrospective and cross‐sectional study was performed at a multicentre, and the inclusion criteria were age >50 years and a diagnosis of typical neovascular AMD. The OCT and OCTA data for an internal data set and two external data sets were collected. A DL model was developed with a novel feature‐level fusion (FLF) method utilized to combine the multimodal data. The results were compared with identification performed by an ophthalmologist. The best model was tested on two external data sets to show its potential for clinical use.

Results

Our best model achieved an accuracy of 95.5% and an area under the curve (AUC) of 0.9796 on multimodal data inputs for the internal data set, which is comparable to the performance of retinal specialists. The proposed model reached an accuracy of 100.00% and an AUC of 1.0 for the Ningbo data set, and these performance indicators were 90.48% and an AUC of 0.9727 for the Jinhua data set.

Conclusion

The FLF method is feasible and highly accurate, and could enhance the power of the existing computer‐aided diagnosis systems. The bi‐modal computer‐aided diagnosis (CADx) system for the automated identification of CNV activity is an accurate and promising tool in the realm of public health.
Comparative study of pregnancy outcomes in women with inflammatory bowel disease treated with thiopurines and/or anti‐TNF: a French nationwide study 2010–2018
Authors: Meyer Antoine , Drouin Jérôme , Weill Alain , Carbonnel Franck , Dray‐Spira Rosemary
Published: June 2021

Background

Data about thiopurines or anti‐TNF use during pregnancy in women with inflammatory bowel diseases (IBD) are reassuring. However, many studies are based upon small sample sizes.

Aims

To assess IBD medication safety during pregnancy.

Methods

Using the French national health database, which covers more than 99% of the French population, around 65 000 000 people, we identified pregnancies ending with a birth in IBD patients in France between 2010 and 2018. Pregnancy outcomes (vital status at birth, birth term, and weight for gestational age) were compared according to treatment exposure during pregnancy using propensity score‐weighted marginal logistic regression models.

Results

27 729 pregnancies were included: 3554 were exposed to thiopurines monotherapy, 3525 to anti‐TNF monotherapy, 839 to combination therapy, and 19 811 unexposed. Pregnancies exposed to thiopurines monotherapy compared to unexposed pregnancies more frequently resulted in stillbirths (1.0% vs 0.5%, aOR 2.04; 95%CI: 1.18‐3.55), preterm birth (12.3% vs 7.1%, aOR 1.76; 95%CI: 1.55‐2.00), large for gestational age (10.6% vs 8.4%, aOR 1.32; 95%CI: 1.13‐1.53) and less frequently in small for gestational age (9.6% vs 11.1%, aOR 0.79; 95%CI: 0.67‐0.92). By contrast, pregnancies exposed to anti‐TNF monotherapy were not different from unexposed pregnancies as regards to these outcomes. Compared to unexposed pregnancies, those exposed to combination therapy more frequently resulted in preterm births (aOR 1.55; 95%CI: 1.15‐2.11) and larger for gestational age (aOR 1.61; 95%CI: 1.13‐2.29) but did not differ as regards to stillbirths.

Conclusions

Pregnancies exposed to thiopurines more frequently resulted in stillbirths, preterm births and large for gestational age compared to pregnancies exposed to anti‐TNF or unexposed pregnancies. By contrast, pregnancies exposed to anti‐TNF monotherapy were not associated with these outcomes.
Postoperative analgesic effect of ultrasound‐guided rectus sheath block and local anesthetic infiltration after laparoscopic cholecystectomy: Results of a prospective randomized controlled trial
Authors: Kitamura Naomi , Iida Hiroya , Maehira Hiromitsu , Mori Haruki , Sada Yoko , Shimizu Tomoharu , Kitagawa Hirotoshi , Tani Masaji
Published: June 2021

Introduction

Even if laparoscopic cholecystectomy (LC) has lower invasiveness through small incisions compared with laparotomy, postoperative pain control is important.

Methods

This prospective, randomized, single‐blinded, interventional, single‐center study was conducted from December 2016 to March 2018 at the Shiga University of Medical Science Hospital in Japan. Enrolled patients were assigned to either a rectus sheath block (RSB) group or an infiltrative local anesthesia (LA) group. After LC, the RSB group received bilateral RSB with 10 mL of 0.375% ropivacaine and the LA group received subcutaneous and fascial injection with 10 mL of 0.75% ropivacaine at the umbilical wound. The primary endpoint was a visual analog scale (VAS) score on postoperative day (POD) 1.

Results

This study enrolled 62 patients (RSB group = 31, LA group = 31). On POD1, the mean VAS scores were 36.4 ± 18.9 and 29.4 ± 15.4 in the RSB group and LA groups, respectively, showing that the LA group tended to describe lesser postoperative pain than the RSB group (P = 0.062).

Conclusions

VAS scores on POD1 were not different between the groups. LC patients might obtain postoperative pain control via long‐acting local analgesia.
Physiological breech birth training: An evaluation of clinical practice changes after a one‐day training program
Authors: Mattiolo Stella , Spillane Emma , Walker Shawn
Published: June 2021

Background

The “physiological breech birth” one‐day training program is based on evidence about the physiology of breech births and how clinicians learn breech skills. Previous evaluations have demonstrated positive effects on confidence and knowledge, but the training's effect on clinical practice and outcomes is unknown.

Methods

A mixed‐methods evaluation was conducted in eight National Health Service hospitals in England and Northern Ireland. Changes in confidence and knowledge were assessed using pretraining and post‐training surveys. Mode of birth and maternal birth positions were evaluated using audit data covering one year before the training and one year after, for all singleton vaginal breech births at term.

Findings

A total of 263 participants completed the surveys. Confidence in managing breech births in both upright and supine positions significantly increased, as did participant knowledge. Audited data for 1402 women were collected. Overall vaginal birth rates remained similar in both periods. Among singleton vaginal breech births >37 weeks, the use of upright birthing positions increased significantly (P = .002). The study was not powered to detect differences in other outcomes, but pilot data were collected to inform the design of future studies.

Conclusions

Increase in use of upright birthing positions suggests that physiological breech birth training is likely to lead to clinical practice changes, which may help support maternal choice in line with current guidance. However, provision of a one‐day training program did not change overall vaginal breech birth rates. Adequately powered research is needed to determine effects of clinical practice changes on clinical outcomes.
Reward produces learning of a consciously inaccessible feature
Authors: Dong Xue , Zhang Mingxia , Dong Bo , Jiang Yi , Bao Min
Published: June 2021

Reward has a significant impact on behaviour and perception. Most past work in associative reward learning has used perceptually distinct visual cues to associate with different reward values. Thus, it remains unknown to what extent the learned bias towards reward‐associated stimuli depends on consciousness of the apparent differences between stimuli. Here, we resolved this issue by using an inter‐ocular suppression paradigm with the monetary rewarding and non‐rewarding cues identical to each other except for their eye‐of‐origin information. Thus, the reward coding system cannot rely on consciousness to select the reward‐associated cue. Surprisingly, the targets in the rewarded eye broke into awareness faster than those in the non‐rewarded eye. We further revealed that producing this effect required both top‐down attention and inter‐ocular suppression. These findings suggest that the human’s reward coding system can produce two different types of reward‐based learning. One is independent of consciousness yet fairly consuming attentional resources. The other one results from volitional selection of stimuli of behavioural significance.
Le droit à la ville ou le droit à la mobilité? Les demandeurs d'asile d'Amérique centrale en attente dans l'espace urbain tijuanense
Authors: Candiz Guillermo , Basok Tanya
Published: June 2021

Des recherches récentes ont montré que les migrant‐e‐s disposent du potentiel pour remettre en question les pratiques qui limitent leur mobilité et compromettent leur sécurité et leur bien‐être. Les chercheur‐e‐s travaillant sur le paradigme du droit à la ville et adoptant une approche critique sur la citoyenneté ont constaté que les migrant‐e‐s revendiquent leur citoyenneté (par exemple, un statut juridique ou des revendications formelles et informelles de protection, d'espace, de reconnaissance et de participation à la ville). Au même moment, les chercheur‐e‐s œuvrant dans le cadre de l'approche de l'autonomie des migrations ont attiré l'attention sur la détermination inébranlable des migrant‐e‐s à franchir les frontières malgré les obstacles. Conceptualisant ces deux types d'actions comme des « actes de citoyenneté » et des « actes de mobilité », nous analysons leur relation dans cet article. En nous basant sur notre travail de terrain auprès de demandeurs d'asile d'Amérique centrale durant l'été 2019 dans la ville de Tijuana, au Mexique, nous démontrons que les migrant‐e‐s sont obligées de choisir entre poursuivre leurs rêves de mobilité vers les États‐Unis ou revendiquer la citoyenneté dans la ville frontalière de Tijuana.
Phase II study of tazemetostat for relapsed or refractory B‐cell non‐Hodgkin lymphoma with EZH2 mutation in Japan
Authors: Izutsu Koji , Ando Kiyoshi , Nishikori Momoko , Shibayama Hirohiko , Teshima Takanori , Kuroda Junya , Kato Koji , Imaizumi Yoshitaka , Nosaka Kisato , Sakai Rika , Hojo Seiichiro , Nakanishi Tadashi , Rai Shinya
Published: June 2021

Tazemetostat is a selective, reversible, small‐molecule inhibitor of the histone methyltransferase enzyme, enhancer of zest homolog 2 (EZH2). In this multicenter, open‐label, phase II study, we assessed the efficacy and safety of tazemetostat in Japanese patients with relapsed or refractory (R/R) B‐cell non‐Hodgkin lymphoma harboring the EZH2 mutation. Tazemetostat (800 mg twice daily) was given orally (28‐day cycle) until disease progression or unacceptable toxicity. Among the 20 eligible patients, 17 were enrolled in cohort 1 (follicular lymphoma [FL]), and three were enrolled in cohort 2 (diffuse large B‐cell lymphoma). At data cut‐off, the objective response rate in cohort 1 was 76.5%, including six patients (35.3%) with complete response and seven patients (41.2%) with partial response (PR). All three patients in cohort 2 achieved PR. In cohort 1, median progression‐free survival (PFS) was not reached at the median follow‐up of 12.9 months. The estimated PFS rate at 12 and 15 months was 94.1% and 73.2%, respectively. The most common grade 3 treatment‐emergent adverse event (TEAE) was lymphopenia (n = 2). Grade 4 TEAEs included hypertriglyceridemia and pneumonia aspiration (n = 1 each), which were not related to tazemetostat. Treatment‐emergent adverse events leading to study drug discontinuation were reported in four of the 20 patients, indicating that the safety profile of tazemetostat was acceptable and manageable. Tazemetostat 800 mg twice daily showed encouraging efficacy in patients with R/R EZH2 mutation‐positive FL with a manageable safety profile in the overall population. Thus, tazemetostat could be a potential treatment for R/R EZH2 mutation‐positive FL.
Male pituitary–gonadal axis dysfunction in post‐acute COVID‐19 syndrome—Prevalence and associated factors: A Mediterranean case series
Authors: Moreno‐Perez Oscar , Merino Esperanza , Alfayate Rocio , Torregrosa Maria Eugenia , Andres Mariano , Leon‐Ramirez Jose‐Manuel , Boix Vicente , Gil Joan , Pico Antonio ,   COVID19‐ALC Research group
Published: June 2021

Objective

Severe acute respiratory syndrome coronavirus 2 through angiotensin‐converting enzyme 2 receptor can harm testes function. The objectives were to analyse the prevalence of low serum testosterone (LT) and impaired fertility potential (Leydig and Sertoli cells dysfunction, respectively) in coronavirus disease 2019 (COVID‐19) male survivors and to evaluate acute infection‐related associated factors. Also, we explore its association with post‐acute COVID‐19 syndrome (PCS) and quality of life (QOL).

Materials and Methods

Male adults recovered from polymerase chain reaction‐confirmed COVID‐19 were offered a structured evaluation 8–12 weeks after recovery. The main outcome measure(s) were as follows: LT, defined as total testosterone (TT) < 2 ng/ml or if TT levels 2–4 ng/ml as calculated free testosterone < 6.36 ng/dl; Sertoli cell dysfunction was defined as inhibin‐B < 89 pg/ml. Secondary outcome‐associated factors were analysed by multiple logistic regression (odds ratio; 95% confidence interval [CI]). QOL was evaluated by SF‐36 v.2.

Results

One hundred and forty‐three patients were evaluated at a median (interquartile range) of 77 days (72–83) after disease onset; 72% of them recovered from severe pneumonia. LT was detected in 41 patients (28.7%; 95% CI: 21.8–36.5). Low levels of inhibin‐B were detected in 25 patients (18.1%; 95% CI: 12.5–25.3). After multivariate adjustment, obesity and hypokalaemia were associated with LT, whereas age more than 65 was an independent predictor of Sertoli cell dysfunction. LT or Sertoli cell dysfunction was not associated with PCS. Patients with LT had a lower score in four domains of QOL.

Conclusions

Prevalence of male LT and impaired fertility potential in COVID‐19 survivors is high in the medium term. Traditional risk factors and severity markers for COVID‐19 could be predictive.
Clinical implications of age and excellent response to therapy in patients with high‐risk differentiated thyroid carcinoma
Authors: Jin Meihua , Ahn Jonghwa , Lee Yu‐Mi , Sung Tae‐Yon , Song Dong Eun , Kim Tae Yong , Chung Ki‐Wook , Ryu Jin‐Sook , Kim Won Bae , Shong Young Kee , Jeon Min Ji , Kim Won Gu
Published: June 2021

Background

Patients with American Thyroid Association (ATA) high‐risk differentiated thyroid carcinoma (DTC) have poor clinical outcomes. This study aimed to evaluate the clinical implications of age and response to therapy classification in patients with ATA high‐risk DTC.

Design and Patients

This study included 222 patients with high‐risk DTC who initially underwent therapy between 2000 and 2010 in a single tertiary center in Korea. We evaluated the prognostic parameters associated with progression‐free survival (PFS) and disease‐specific survival (DSS) with a focus on age and achieving an excellent response (ER).

Results

During the median follow‐up period of 11.3 years, disease progression was detected in 77 patients (34.7%), and disease‐specific mortality was reported in 31 patients (14.0%). Older age (≥55 years) and not achieving ER (not‐ER) were independent risk factors associated with PFS (age, p < .001; not‐ER, p < .001) and DSS (age, p < .001; not‐ER, p = .015). Of the 74 patients in the ER group, 7 (9.5%) displayed disease progression and 1 (1.4%) died from DTC. There were no significant differences in PFS and DSS according to age in the ER group. However, older patients had significantly worse PFS and DSS than younger patients in the not‐ER group (p = .002 and p < .001, respectively).

Conclusions

Response to therapy classification is important for predicting PFS and DSS in patients with high‐risk DTC. Patients in the ER group had a relatively good prognosis, but disease progression occurred in 9.5% of patients. Age was a key predictor of both PFS and DSS in high‐risk patients who did not achieve ER.
Computer‐assisted image analysis of cytological specimens clarify the correlation between nuclear size and intranuclear cytoplasmic inclusions regardless of BRAFV600E mutation in papillary thyroid carcinoma
Authors: Suzuki Midori , Moriya Shunichi , Kobayashi Sayaka , Nishijima Yoshimi , Fujii Takaaki , Ikota Hayato , Yokoo Hideaki , Saio Masanao
Published: June 2021

Objective

The morphological features of nuclei in cytological and histological specimens were compared and examined for the presence of BRAFV600E mutation and the appearance rate of intranuclear cytoplasmic inclusions (NI).

Methods

BRAFV600E mutation was identified using a mutation‐specific antibody (clone; VE1) in 103 thyroid papillary carcinoma cases at Gunma University Hospital. The nuclear area, perimeter, and roundness of the corresponding cytological specimens and haematoxylin and eosin‐stained specimens were analysed using image analysis software, and the appearance rate of NI was calculated and compared.

Results

BRAFV600E mutation was detected in 71 (69%) cases. The appearance rate of NI was significantly higher in the BRAFV600E mutation‐positive group in cytological and histological specimens (P = .0070 and .0184, respectively). Significant differences were observed between the BRAFV600E mutation‐negative and ‐positive groups in the average nuclear area and average nuclear perimeter in cytological specimens (P = .0137 and .0152, respectively). In addition, nuclear enlargement was correlated with the appearance rate of NI regardless of the presence of BRAFV600E mutation in cytological specimens. In the BRAFV600E mutation‐negative group, the nuclear area and perimeter were significantly smaller in the lymph node metastasis‐positive cases (P = .0182 and .0260, respectively).

Conclusion

This study found that the appearance rate of NI was positively correlated with the nuclear area and perimeter and negatively correlated with nuclear roundness in cytological specimens. Furthermore, these results were observed regardless of the existence of BRAFV600E mutation. These results have never been previously reported and clearly demonstrate the usefulness of cytological specimens in computer‐assisted image analysis.
Primary squamous cell carcinoma of the endometrium—Case report with cytological characteristics in direct and indirect endometrial samples
Authors: Rajhvajn Sanda , Barišić Ana , Škopljanac‐Mačina Lada , Jurič Danijela , Mahovlić Vesna
Published: June 2021

This case presents Primary Squamous Cell Carcinoma of The Endometrium with cytological and immunocytological characteristics in specimens from endometrial aspirate, Pap smear and peritoneal washing. Initial TVUS and clinical examination showed no abnormalities, and the first curettage sample was interpreted as benign while the second was histopathologically inconclusive. The final histopathology diagnosis in the hysterectomy specimen confirmed the diagnosis of this rare tumour.
Can fractal dimension analysis be used in quantitating collagen structure?
Authors: Tian Feng , Jiang Yuzhi , Liu Yi , Lu Shuliang , Yang Jianfei , Cao Yemin
Published: June 2021

It is well known that collagen tissue, especially the collagen structure, plays an important role in wound healing. However, most research on collagen has been qualitative and morphological, based on sections, and cannot be used for real‐time monitoring and clinical prediction. There are no standardized methods of quantitative analysis based on the whole skin sample in three dimensions (3‐D). In order to explore a 3‐D quantitative analysis, we developed a method that was derived from that of material science and physics, combined with our previous technique, X‐ray scattering (SAXS). We hypothesized that the dermis might be analysed by fractal dimensions. To test this hypothesis, we performed the analysis in different pathological conditions, such as scar tissue, different time points after wounding, skin in different degrees of burns and skin in diabetes. The results showed that fractal dimension analysis could detect differences in different locations of the scar tissue, at different time points after wounding, and at a different extent of the severity of skin in diabetes. The research demonstrated that fractal dimension analysis can describe the 3‐D structure of the collagen tissue of the skin, which will be beneficial for studying wound healing and finding new clinical treatments.
Potential of lucerne sowing rate to influence root development and its implications for field stand productivity
Authors: Hakl Josef , Pisarčik Martin , Fuksa Pavel , Šantrůček Jaromír
Published: June 2021

The relationship between root morphology and productivity in lucerne (Medicago sativa L.) has been well documented, but the effect of sowing rate on root development is unclear. Results from three field experiments were analysed to address these objectives: (a) to investigate lucerne root development as a function of distance among plants, (b) to evaluate the effect of sowing rates on lucerne root traits and (c) to investigate the relationship between root traits and forage yield and yield components. A 4‐year experiment that compared spaced plants (50 × 50 cm, four plants m2) versus row seeding (12.5 cm, 700 germinated seeds m−2) revealed fast annual tap‐root diameter (TD) development in spaced plants, with about 12 mm, and three times greater TD and five times the lateral root number compared with row‐spaced plants. Three‐year field plot experiments at one site compared sowing rates of 400 versus 700 germinated seeds m−2 in less favourable soil for lucerne, and 700 versus 900 seeds m−2 in a better soil. Across experiments, higher plant density and root potential index were positively related to forage yield only when in association with better soil conditions and optimal water supply. Lower plant density offered advantages for faster root development. An effect of reduction in the sowing rate was increased stand height and increased yield in the third cut in a year with drought stress. Results show the need for investigation of effects of more precise spatial arrangement of lucerne plants to ensure optimization of root development and to enable yield benefits and drought resistance.
The American Headache Society Consensus Statement: Update on integrating new migraine treatments into clinical practice
Authors: Ailani Jessica , Burch Rebecca C. , Robbins Matthew S. ,   the Board of Directors of the American Headache Society
Published: June 2021

Objective

To incorporate recent research findings, expert consensus, and patient perspectives into updated guidance on the use of new acute and preventive treatments for migraine in adults.

Background

The American Headache Society previously published a Consensus Statement on the use of newly introduced treatments for adults with migraine. This update, which is based on the expanded evidence base and emerging expert consensus concerning postapproval usage, provides practical recommendations in the absence of a formal guideline.

Methods

This update involved four steps: (1) review of data about the efficacy, safety, and clinical use of migraine treatments introduced since the previous Statement was published; (2) incorporation of these data into a proposed update; (3) review and commentary by the Board of Directors of the American Headache Society and patients and advocates associated with the American Migraine Foundation; (4) consideration of these collective insights and integration into an updated Consensus Statement.

Results

Since the last Consensus Statement, no evidence has emerged to alter the established principles of either acute or preventive treatment. Newly introduced acute treatments include two small‐molecule calcitonin gene‐related peptide (CGRP) receptor antagonists (ubrogepant, rimegepant); a serotonin (5‐HT1F) agonist (lasmiditan); a nonsteroidal anti‐inflammatory drug (celecoxib oral solution); and a neuromodulatory device (remote electrical neuromodulation). New preventive treatments include an intravenous anti‐CGRP ligand monoclonal antibody (eptinezumab). Several modalities, including neuromodulation (electrical trigeminal nerve stimulation, noninvasive vagus nerve stimulation, single‐pulse transcranial magnetic stimulation) and biobehavioral therapy (cognitive behavioral therapy, biofeedback, relaxation therapies, mindfulness‐based therapies, acceptance and commitment therapy) may be appropriate for either acute and/or preventive treatment; a neuromodulation device may be appropriate for acute migraine treatment only (remote electrical neuromodulation).

Conclusions

The integration of new treatments into clinical practice should be informed by the potential for benefit relative to established therapies, as well as by the characteristics and preferences of individual patients.
Training needs of medical librarians in Nigeria: A survey
Authors: Ikolo Violet Elohor , Nongo Celina Jummai
Published: June 2021

Background

Health library and information professionals need continuing professional development to update their skills and knowledge. There is very limited evidence on the training needs of medical librarians in Nigeria.

Objectives

To identify the training needs of medical librarians in Nigeria, principally the content topics required, preferred formats of training, and barriers to training.

Methods

An online questionnaire was distributed to 94 registered members of the Medical Library Association of Nigeria.

Results

The majority of the 64 medical librarian respondents wanted training in information systems and technology usage. The respondents also indicated that they prefer participating in seminar/workshops and being involved in face‐to‐face courses. Very few of the respondents have attended any specialist training aimed at their work in the medical field. The foremost challenge identified is the high cost of training.

Discussion

This study confirmed that the librarianship degree acquired from library schools only serves as a foundation for medical librarians, and it does not provide the specific subject training required to work successfully as medical librarians.

Conclusion

There is a gap in knowledge base of medical librarians in Nigeria that needs to be filled by specific on‐the‐job training and courses which are affordable.
Stresses near the edges of ring‐loaded plates
Authors: Salem Jonathan A. , Manderscheid Jane M.
Published: June 2021

Strength testing of brittle materials often employs beams or plates loaded in bending. Solutions are provided for the in‐plane stresses between the support ring and edge of ring‐loaded circular plates (i.e., disks) having a diameter larger than the support ring. The region overhanging the larger support ring stiffens the plate and reduces the edge tangential stress. Its consideration is thus crucial to an accurate solution. For typical ceramic disks with little overhang, the edge stress is less than ~50% of the maximum, central stress. With a large overhang, the edge stress can be reduced to ~25% of the central stress. The radial stress reverses the sign outside the support ring, whereas that of the tangential stress remains the same, and thus tensile failure can occur from either face of the disk.
How and when actual‐ideal self‐discrepancy leads to counterfeit luxury purchase intention: A moderated mediation model
Authors: Shan Juan , Jiang Ling , Peng Cui Annie , Wang Yan , Ivzhenko Yuliia
Published: June 2021

Drawing on the self‐discrepancy and moral decoupling theories, this study investigates how and when actual‐ideal self‐discrepancy (AISD) leads to consumers' purchase intentions toward counterfeit luxury brands. Across a survey study (Study 1: N = 531) and an experimental study (Study 2: N = 543), this research demonstrates that AISD is positively related to consumers' purchase intention toward counterfeit luxury products, and this relationship is mediated by the need for self‐enhancement. Furthermore, moral decoupling moderates this relationship, such that the mediated relationship is stronger when moral decoupling is high rather than low. The findings provide strategic insights for brand managers and policy makers to reduce demands for counterfeit products and tackle the counterfeit industry effectively.