bluuebunny/crossref_metadata_2025 huggingface dataset:
Gender minority stress in trans and gender diverse adolescents and young people
Authors: Hunter Jessica , Butler Catherine , Cooper Kate
Published: July 2021

Gender minority stress refers to social stressors such as discrimination and stigma that gender minorities are subject to. This study examines the relationship between gender minority stress and psychological well-being in trans and gender diverse young people (TGDYP). We used a cross-sectional design to investigate the relationship between gender minority stress and mental well-being in TGDYP aged 16–25. We measured anxiety, depression, general psychological well-being, gender dysphoria, gender minority stress (distal and proximal), resilience and heteronormative beliefs in cisgender ( n = 135) and trans and gender diverse (TGD) ( n = 106) participants. Hierarchical regression was used to analyse the data. TGD participants had significantly higher levels of anxiety and depression, and poorer general well-being, than cisgender participants. Although the direction of the relationship cannot be determined through our analysis, TGD participants who experienced more minority stress and were assigned female at birth had higher levels of depression and anxiety. TGD participants with higher resilience scores and were assigned male at birth had better well-being overall. Our findings suggest that we should pay attention to minority stress when thinking about how to reduce anxiety and depression in TGDYP. The responsibility for improving well-being lies not just with services but instead should be held by our whole society.
Effect of AoA-L2 on L1 and L2 networks in early and late bilinguals
Authors: Liu Xiaojin , Tu Liu , Chen Xiaoxi , Wang Junjing , Li Meng , Lu Zhi , Huang Ruiwang
Published: July 2021

Aim:

The age of acquisition of second language (AoA-L2) affects the neural representation of the first language (L1) and L2. Although previous task-fMRI studies showed different activation patterns of language networks in early and late bilinguals, little is known about the effect of AoA-L2 on L1 and L2 resting-state fMRI (rs-fMRI) networks in bilinguals. In this study, we attempted to reveal the differences in resting-state functional connectivity (RSFC) and topological properties of L1 and L2 networks related to AoA-L2 in bilinguals.

Design:

We pooled 10 early bilinguals and 11 late bilinguals with high proficiency level in L2 (PL-L2) and acquired their brain rs-fMRI data. By taking the brain regions obtained from a previous meta-analysis study as the seeds, we constructed L1 and L2 networks, and then estimated the RSFC and topological properties of L1 and L2 networks.

Findings:

Significantly higher RSFC between the inferior frontal gyrus (IFG) and lateral occipital gyrus (LOG) in the L1 network, and significantly higher RSFC between the IFG and angular gyrus (ANG) in the L2 network were observed in early bilinguals than in late bilinguals. Early bilinguals showed significantly higher clustering coefficient, global and local efficiency, but lower characteristic path length, than late bilinguals in the L2 network.

Originality:

Through analyzing the RSFC and topological properties of L1 and L2 networks, we observed the influence of AoA-L2 on the brain neuroplasticity in bilinguals. The findings may provide a new perspective for understanding the neuroplasticity in bilinguals with different L2 experience.

Implications:

The AoA-L2 affects the RSFC and topological properties of the L2 network more obviously relative to the L1 network in bilinguals. The effect of the L2 experience on the L1 network is hardly detected in bilinguals with high PL-L2.
Experiencing work–family enrichment as a separated parent in Australia
Authors: Van den Eynde Annelies , Mortelmans Dimitri
Published: July 2021

Contrary to approaching work and family as conflictual roles, a shift towards acknowledgement of the positive interaction between work and family has been detected. This research investigated whether married/cohabiting and divorced/separated parents differ in terms of work–family enrichment, considering their gender and relationship status after separation. Data from 3993 married/cohabiting and 1455 divorced/separated parents from the Longitudinal Study of Australian Children (LSAC) database were analysed using regression analysis. The results revealed a complex interplay of relationship status and gender. Single mothers experience more work–family enrichment after a break-up than do mothers with a partner. No differences were found for fathers.
Reducing misperceptions through news stories with data visualization: The role of readers’ prior knowledge and prior beliefs
Authors: Mena Paul
Published: July 2021

Amid the global discussion on ways to fight misinformation, journalists have been writing stories with graphical representations of data to expose misperceptions and provide readers with more accurate information. Employing an experimental design, this study explored to what extent news stories correcting misperceptions are effective in reducing them when the stories include data visualization and how influential readers’ prior beliefs, issue involvement and prior knowledge may be in that context. The study found that the presence of data visualization in news articles correcting misperceptions significantly enhanced the reduction of misperceptions among news readers with less than average prior knowledge about an issue. In addition, it was found that prior beliefs had a significant effect on news readers’ misperceptions regardless of the presence or absence of data visualization. In this way, this research offers some support for the notion that data visualization may be useful to decrease misperceptions under certain circumstances.
Fuel consumption and aftertreatment thermal management synergy in compression ignition engines at variable altitude and ambient temperature
Authors: Bermúdez Vicente , Serrano José Ramón , Piqueras Pedro , Diesel Bárbara
Published: July 2021

New regulations applied to the transportation sector are widening the operation range where the pollutant emissions are evaluated. Besides ambient temperature, the driving altitude is also considered to reduce the gap between regulated and real-life emissions. The altitude effect on the engine performance is usually overcome by acting on the turbocharger control. The traditional strategy assumes to keep (or even to increase) the boost pressure, that is, compressor pressure ratio increase, as the altitude is increased to offset the ambient density reduction, followed by the reduction of the exhaust gas recirculation to reach the targeted engine torque. However, this is done at the expense of an increase on fuel consumption and emissions. This work remarks experimentally the importance of a detailed understanding of the effects of the boost pressure and low-pressure exhaust gas recirculation (LP-EGR) settings when the engine runs low partial loads at different altitudes, accounting for extreme warm and cold ambient temperatures. The experimental results allow defining and justifying clear guidelines for an optimal engine calibration. Opposite to traditional strategies, a proper calibration of the boost pressure and LP-EGR enables reductions in specific fuel consumption along with the gas temperature increase at the exhaust aftertreatment system.
Understanding EAL: International Secondary School Teachers’ Experiences and Attitudes in Ukraine and Eastern Europe
Authors: Spencer James
Published: July 2021

This article highlights the need to understand mainstream international secondary school teachers’ attitudes to and experiences of accommodating English as an Additional Language (EAL) learners, and what current collaborative relationships there are between mainstream and EAL teachers in terms of co-teaching and co-planning. The article draws on data collected from a questionnaire sent to secondary teachers at an international school in a major city in Ukraine and to other international schools that offer International Baccalaureate programmes in Eastern Europe. The questionnaire investigated English language training in education, attitudes to EAL in mainstream subjects and participants’ collaboration with EAL teachers. Further follow-up qualitative data collected from a focus group in the school in Ukraine investigated the topics of competencies, responsibilities and collaboration with respect to EAL in the mainstream classroom. Building on this data, the discussion ultimately focuses on the challenges for mainstream teachers and how collaboration with EAL teachers is often confused and lacks definition in terms of current practice and ways forward. Recommendations for next steps of research are made.
Successful Endovascular Treatment of a Spontaneous Rupture of the Ascending Lumbar Vein: A Case Report
Authors: Zhang Xiaosong , Wang Yusheng , Tang Hao , Huang He , Zhang Honggang , Huang Xiaomin , Li Da
Published: July 2021

Although there have been a few case reports of spontaneous rupture of pelvic veins, such as the iliac vein, to date, there have been no reports of spontaneous rupture of the ascending lumbar vein. Here, we report a case of spontaneous rupture of the ascending lumbar vein for the first time. A 66-year-old woman visited the emergency department due to the swelling of the left lower limb for 2 hours. After admission, the patient developed symptoms of pain in the left lumbar region, as well as symptoms of shock, such as increased heart rate and decreased blood pressure. During emergency venography, it was found that the ascending lumbar vein was ruptured, which was accompanied by the compression and occlusion of the iliac vein (May-Thurner syndrome). During the endovascular surgical treatment, a covered stent was placed in the iliac vein, and the occluded common iliac vein was treated with a bare stent. Immediately after the surgical procedure, the patient’s abdominal computed tomography examination showed the formation of a large retroperitoneal haematoma, and continuous routine blood parameter monitoring showed that haemoglobin was stable. Postoperative recovery was uneventful, and the patient was discharged on the ninth postoperative day.
The Experiences of Healthcare Students Who Have Been Accused of Breaching Academic Integrity: A Study Protocol
Authors: Summers Anthony , Wadsworth Daniel , Bratby Karryn , Hobbs Eilish , Wood Denise
Published: July 2021

Design:

A mixed-methods design will be used to collect data for the study, with each stage being of equal importance. Stage one is an online survey and stage two is a series of semi-structured interviews.

Context of study:

To explore the experiences of healthcare students who have faced allegations of breaching academic integrity, to improve the support provided to these students.

Objectives:

The main objectives of this study are to explore and describe the experiences of these students to develop an understanding of the areas they need support while going through this process.

Study population:

Healthcare students studying at a regional university in Australia.
The effect of low-frequency equalisation on preference and sensorimotor synchronisation in music
Authors: Beveridge Scott , Cano Estefanía , Herff Steffen A
Published: July 2021

Equalisation, a signal processing technique commonly used to shape the sound of music, is defined as the adjustment of the energy in specific frequency components of a signal. In this work, we investigate the effects of equalisation on preference and sensorimotor synchronisation in music. A total of 21 participants engaged in a goal-directed upper body movements in synchrony with stimuli equalised in three low-frequency sub-bands (0–50, 50–100, and 100–200 Hz). To quantify the effect of equalisation, music features including spectral flux, pulse clarity, and beat confidence were extracted from seven differently equalised versions of music tracks—one original and six manipulated versions for each music track. These music tracks were then used in a movement synchronisation task. Bayesian mixed-effects models revealed different synchronisation behaviours in response to the three sub-bands considered. Boosting energy in the 100–200 Hz sub-band reduced synchronisation performance irrespective of the sub-band energy of the original version. An energy boost in the 0–50 Hz band resulted in increased synchronisation performance only when the sub-band energy of the original version was high. An energy boost in the 50–100 Hz band increased synchronisation performance only when the sub-band energy of the original version was low. Boosting the energy in any of the three sub-bands increased preference regardless of the energy of the original version. Our results provide empirical support for the importance of low-frequency information for sensorimotor synchronisation and suggest that the effects of equalisation on preference and synchronisation are largely independent of one another.
Endoscopic management of anastomotic leak after esophageal or gastric resection for malignancy: a multicenter experience
Authors: Hallit Rachel , Calmels Mélanie , Chaput Ulriikka , Lorenzo Diane , Becq Aymeric , Camus Marine , Dray Xavier , Gonzalez Jean Michel , Barthet Marc , Jacques Jérémie , Barrioz Thierry , Legros Romain , Belle Arthur , Chaussade Stanislas , Coriat Romain , Cattan Pierre , Prat Frédéric , Goere Diane , Barret Maximilien
Published: July 2021

Background:

Most anastomotic leaks after surgical resection for esophageal or esophagogastric junction malignancies are treated endoscopically with esophageal stents. Internal drainage by double pigtail stents has been used for the endoscopic management of leaks following bariatric surgery, and recently introduced for anastomotic leaks after resections for malignancies. Our aim was to assess the overall efficacy of the endoscopic treatment for anastomotic leaks after esophageal or gastric resection for malignancies.

Methods:

We conducted a multicenter retrospective study in four digestive endoscopy tertiary referral centers in France. We included consecutive patients managed endoscopically for anastomotic leak following esophagectomy or gastrectomy for malignancies between January 2016 and December 2018. The primary outcome was the efficacy of the endoscopic management on leak closure.

Results:

Sixty-eight patients were included, among which 46 men and 22 women, with a mean ± SD age of 61 ± 11 years. Forty-four percent had an Ivor Lewis procedure, 16% a tri-incisional esophagectomy, and 40% a total gastrectomy. The median time between surgery and the diagnosis of leak was 9 (6–13) days. Endoscopic treatment was successful in 90% of the patients. The efficacy of internal drainage and esophageal stents was 95% and 77%, respectively ( p = 0.06). The mortality rate was 3%. The only predictive factor of successful endoscopic treatment was the initial use of internal drainage ( p = 0.002).

Conclusion:

Endoscopic management of early postoperative leak is successful in 90% of patients, preventing highly morbid surgical revisions. Internal endoscopic drainage should be considered as the first-line endoscopic treatment of anastomotic fistulas whenever technically feasible.
Bilateral Tibial Stress Fractures and Osteoporosis in a Young Patient
Authors: Gürbüz Ali , Gür Mustafa
Published: July 2021

Stress fractures result from microscopic bone injury due to repetitive submaximal stress and include fatigue and insufficiency fracture components. Fatigue fractures generally occur in runners and athletes and are caused by abnormal physical load on the bone. On the other hand, insufficiency fractures are generally seen in the elderly secondary to osteoporosis, typically involving the pelvis and surrounding bones. Insufficiency fracture occurs as a result of normal loading in the abnormal bone. In this case report, we describe a young patient with bilateral tibial stress fractures with both fatigue and insufficiency components.
Recurrent Facial Focal Seizures With Chronic Striatopathy and Caudate Atrophy—A Double Whammy in an Elderly Woman With Diabetes Mellitus
Authors: Chatterjee Subhankar , Ghosh Ritwik , Ojha Umesh Kumar , Diksha  , Biswas Payel , Benito-León Julián , Dubey Souvik
Published: July 2021

Seizures and involuntary movements are relatively rare, but well-known neurological complications of non-ketotic hyperglycemia. While hemichorea-hemiballism secondary to diabetic striatopathy is increasingly being reported, unilateral caudate atrophy resulting from chronic vascular insufficiency/insult in a backdrop of poorly controlled diabetes mellitus is sparsely described in literature. We herein report a 75-year-old woman with poorly controlled diabetes mellitus who presented with concurrent epilepsia partialis continua involving left side of her face and hemichorea on the right side in the context of non-ketotic hyperglycemia. Neuroimaging revealed a space-occupying lesion suggestive of low-grade glioma in the right superior frontal cortex and left-sided caudate atrophy as well. Possibly, space-occupying lesion in motor cortex acted as an inciting factor for seizures and non-ketotic hyperglycemia further lowered the seizures threshold. On the other hand, atrophied left caudate had led to persistent choreiform movements secondary to chronic uncontrolled hyperglycemia. The simultaneous presence of acute and chronic neurological complications of diabetes mellitus makes this case unique. It also highlights the need for strict control of blood glucose and utility of appropriate neuroimaging to rapidly diagnose and prevent further complications.
Reticular enhancement of the submandibular gland on contrast-enhanced magnetic resonance imaging in three cases with IgG4-related chronic sclerosing sialadenitis
Authors: Suto Taketo , Kato Hiroki , Kawaguchi Masaya , Matsuo Masayuki , Takiwaki Masato , Ogawa Takenori
Published: July 2021

The present case study reports contrast-enhanced magnetic resonance findings in three patients with histopathologically proven IgG4-related chronic sclerosing sialadenitis of the submandibular gland. All three patients presented with painless swelling of the submandibular region. The contrast-enhanced T1-weighted images showed reticular enhancement of the swollen submandibular gland. Radiological–pathological correlation revealed that the characteristic reticular enhancement corresponded to fibrosis and to inflammatory cell infiltration in the interlobular septa and in the periductal region of the submandibular gland.
Detection of dengue virus serotype 1 in central nervous system of a child in Bandung, West Java: A case report
Authors: Alisjahbana Dewi Hawani , Nurmawati Syndi , Hakim Dzulfikar DL , Milanti Mia , Dewi Yora Permata , Johar Edison , Myint Khin Saw Aye , Lederman Jeremy P , Powers Ann M , Alisjahbana Bachti , Antonjaya Ungke
Published: July 2021

Central nervous system involvement of dengue virus is increasingly reported from endemic areas. This study describes the clinical characteristics and laboratory features of a pediatric patient enrolled in a central nervous system illness study conducted in 2017–2018 to identify viral and bacterial etiologies in Indonesian children. Dengue diagnostics including molecular and serological testing were performed on an encephalitis patient who presented with both classical dengue and neurological clinical symptoms. Dengue virus serotype 1 RNA was detected in both cerebrospinal fluid and serum by serotype-specific reverse transcription polymerase chain reaction, and the E gene was successfully sequenced. Anti-dengue virus immunoglobulin M was detected in both admission and discharge sera, whereas anti-dengue virus immunoglobulin G was identified only in the discharge serum. This study describes the central nervous system complications in a case with dengue virus infection in West Java, Indonesia, and highlights the potential for dengue virus serotype 1, a serotype rarely associated with neurotropism, to cause encephalitis.
A Novel De Novo Variant in DYNC1H1 Causes Spinal Muscular Atrophy Lower Extremity Predominant in Identical Twins: A Case Report
Authors: Derksen Alexa , Mirchi Amytice , Tran Luan T. , Cao-Lei Lei , Oskoui Maryam , Srour Myriam , Poulin Chantal ,   Care4Rare Canada Consortium, Bernard Geneviève
Published: July 2021

Mutations in DYNC1H1 have been shown to cause spinal muscular atrophy lower extremity predominant type 1 (SMALED1), an autosomal dominant genetic neuromuscular disorder characterized by degeneration of spinal cord motor neurons resulting in muscle weakness. Here, we describe monozygotic twins, one with a more severe upper motor neuron phenotype as a result of a suspected perinatal hypoxic-ischemic event and the other presenting a typical lower motor neuron phenotype. Using exome sequencing, we identified the novel de novo variant c.752G>T; p.Arg251Leu in DYNC1H1. We thereby add this variant to the growing list of mutations in DYNC1H1 that cause SMALED1.
“It’s Created by a Community”: Local Context Mediating Districts’ Approaches to Serving Immigrant and Refugee Newcomers
Authors: Hopkins Megan , Weddle Hayley , Bjorklund Peter , Umansky Ilana M. , Blanca Dabach Dafney
Published: July 2021

Literature examining the context of reception reveals how various structural and cultural factors shape newcomers’ experiences, and thus their opportunities for integration. Fewer studies explore how school districts are situated in this broader context of reception, or how district policies and practices for newcomers are enabled or constrained by the local context. This study draws on a zones of mediation framework to examine how external forces mediated districts’ approaches to serving growing numbers of immigrant and refugee newcomers. Analysis of interviews with 57 stakeholders from across three districts revealed that the presence or absence of community-based support networks, as well as the extent to which local policies and perceptions emphasized inclusion, mediated districts’ programmatic approaches. Implications for district and community leaders are discussed.
Estimating the Period Prevalence of Mothers Who Have Abortions: A Population Based Study of Inclusive Pregnancy Outcomes
Authors: Studnicki James , Fisher John W. , Longbons Tessa , Reardon David C. , Harrison Donna J. , Craver Christopher , Tsulukidze Maka , Skop Ingrid
Published: July 2021

Introduction:

The prevalence of induced abortion among women with children has been estimated indirectly by projections derived from survey research. However, an empirically derived, population-based conclusion on this question is absent from the published literature.

Objective:

The objective of this study was to describe the period prevalence of abortion among all other possible pregnancy outcomes within the reproductive histories of Medicaid-eligible women in the U.S.

Methods:

A retrospective, cross-sectional, longitudinal analysis of the pregnancy outcome sequences of eligible women over age 13 from the 17 states where Medicaid included coverage of most abortions, with at least one identifiable pregnancy between 1999 and 2014. A total of 1360 pregnancy outcome sequences were grouped into 8 categories which characterize various combinations of the 4 possible pregnancy outcomes: birth, abortion, natural loss, and undetermined loss. The reproductive histories of 4,884,101 women representing 7,799,784 pregnancy outcomes were distributed into these categories.

Results:

Women who had live births but no abortions or undetermined pregnancy losses represented 74.2% of the study population and accounted for 87.6% of total births. Women who have only abortions but no births constitute 6.6% of the study population, but they are 53.5% of women with abortions and have 51.5% of all abortions. Women with both births and abortions represent 5.7% of the study population and have 7.2% of total births.

Conclusion:

Abortion among low-income women with children is exceedingly uncommon, if not rare. The period prevalence of mothers without abortion is 13 times that of mothers with abortion.
Working Women’s Decision-Making Power at Home: Evidence from Four North Indian Urban Clusters
Authors: Maxwell Megan , Vaishnav Milan
Published: July 2021

Do working women enjoy greater levels of human agency? While the theoretical foundations underlying this connection are clear, the empirical evidence is quite mixed. We leverage detailed, new data on intra-household decision-making and labour market behaviour from four north Indian urban clusters to shed light on this question. We find that women who work exercise greater say in important decisions around the home. However, this ‘work advantage’ exhibits significant heterogeneity across decision types, decision-making domains, and definitions of work.
Myofascial Pain Syndrome Focused on the Upper Trapezius Muscle: A Comparative Randomized Controlled Trial of the Court-Type Traditional Thai Massage versus the Thai Hermit
Authors: Boonruab Jurairat , Poonsuk Phiyaphon , Damjuti Watchara , Supamethangkura Wichit
Published: July 2021

Myofascial pain syndrome is a common problem that can develop at any age. This study compares the efficacy of the court-type traditional Thai massage (CTTM) to the Thai hermit exercise (THE) in improving the cervical range of motion (CROM) and reducing pain in the upper trapezius muscle. In this study, 46 patient subjects were randomized into 2 groups, with 1 group administered CTTM and the other administered THE. Prior to and following the experiment, their demographic characteristics, pain levels and CROM were measured using a visual analog scale (VAS) and a goniometer, respectively. Data was then analyzed using descriptive statistics, percentage, mean, and standard deviation, as well as inferential statistics. The findings indicate that subjects in both groups demonstrated significantly lower pain and significantly better CROM (P < 0.05). In terms of comparative treatment between the CTTM and THE groups, the results were not found to differ in the range of motion, but a clear difference in pain level measured by VAS was found, in which CTTM provides a better way of reducing pain at the trigger point than THE (P < 0.05). From the findings, it can be concluded that both CTTM and THE are comparably efficacious therapies for myofascial pain in the upper trapezius muscle.
Emotional Bonding and Sexual Activity During COVID-19 Lockdown: A Cross-National Pilot Study
Authors: Roy Deblina , Kar Sujita Kumar , Arafat S. M. Yasir , Sharma Pawan , Kabir Russell
Published: July 2021

Background:

The COVID-19 pandemic and lockdown measures have affected the sexuality and emotional bonding among the couple across the world.

Objectives:

We aimed to assess the effects of the COVID-19 pandemic and lockdown on the married people’s emotional bonding and sexual relationships in 3 south Asian counties (Bangladesh, India, and Nepal).

Methods:

A cross-sectional online survey was conducted among Bangladesh, India, and Nepal residents from April 3 to April 15, 2020. The survey was designed in English. The participants were selected through convenience sampling technique, the link of the online questionnaire was shared with the participants. Only participants older than 18 years and above, married, and living with their spouses were included in the study.

Results:

A total number of 120 respondents were included finally for analysis from the participating countries (India, Nepal, and Bangladesh). The mean age of the participants was 35.42 (±5.73) years; the majority were males under the age of 40 years and had completed postgraduation as their qualification. Among the study participants, more than half (53.8%) of the women reported being sexually active during the lockdown, whereas 41% of the men reported being sexually active. Among the sexually active participants, most women (57.7%) reported that they perceived positive emotional bonding with their partners. Nevertheless, there was no significant difference observed when compared with men. There are variations in responses. However, no significant association was identified.

Conclusion:

There are a few insights from the study, that is, there was no significant difference found in almost 3 countries in emotional intimacy. There had been a trend that there is improved emotional bonding with their partners, although no significant difference was observed.
Reduced-intensity conditioning hematopoietic stem cell transplantation for chronic lymphocytic leukemia and Richter’s transformation
Authors: Lahoud Oscar B. , Devlin Sean M. , Maloy Molly A. , Roeker Lindsey E. , Dahi Parastoo B. , Ponce Doris M. , Gyurkocza Boglarka , Koehne Guenther , Young James W. , Castro-Malaspina Hugo R. , Barker Juliet N. , Papadopoulos Esperanza B. , Jakubowski Ann A. , Zelenetz Andrew D. , Mato Anthony R. , Giralt Sergio A. , Perales Miguel A. , Sauter Craig S.
Published: July 2021

Allogeneic hematopoietic stem cell transplantation (HSCT) may potentially cure patients with chronic lymphocytic leukemia (CLL) and Richter’s transformation (CLL-RT) or CLL without RT, but the impact of novel agents on HSCT is unclear. CLL-RT patients have a grave prognosis, and their outcomes after HSCT are uncertain. We conducted a retrospective analysis of all 58 CLL patients, including 23 CLL-RT patients, who underwent reduced intensity conditioning (RIC) HSCT at Memorial Sloan Kettering Cancer Center (New York, NY) between September 2006 and April 2017. With a median follow-up of 68 months (range, 24-147 months), 5-year progression-free survival (PFS) was 40% (95% confidence interval [CI], 28%-56%), and overall survival (OS) was 58% (95% CI, 48%-74%). The 1-year graft-versus-host disease/relapse-free survival (GRFS) was 38% (95% CI, 25%-50%). Patients with CLL-RT and CLL patients without RT had comparable outcomes. In both cohorts, treatment-sensitive response and ≤3 previous lines of therapy produced superior PFS and OS. Outcomes were agnostic to adverse cytogenetic and molecular features. Novel agents did not have a negative impact on HSCT outcomes. Total body irradiation (TBI)-containing RIC yielded inferior PFS, OS, and GRFS. CLL-RT patients older than age 55 years who had an HSCT Comorbidity Index score of ≥2 demonstrated inferior OS. This study, which is the largest series of RIC-HSCT for patients with CLL-RT, provides evidence supporting RIC-HSCT in early remission courses for patients with CLL-RT and poor-risk CLL patients. TBI-containing RIC should be considered with caution.
Parenchymal mucinous cystadenoma of the kidney: a case report and literature review
Authors: Kalantari Mahmoudreza , Kalantari Shakiba , Mottaghi Mahdi , Aghaee Atena , Soltani Salman , Pedram Rad Behtash
Published: July 2021

Background

Mucinous cystadenoma (MC) of the kidney is exceedingly rare. We found 22 similar cases in the literature. These masses are underdiagnosed due to radiologic similarities with simple renal cysts.

Case presentation

A 66-year-old man with a previous history of hypertension and anxiety was referred to our tertiary clinic with left flank pain. Ultrasound revealed a 60 mm-sized, complex cystic mass with irregular septa in the lower pole of the left kidney (different from last year's sonographic findings of a simple benign cyst with delicate septa). CT scan showed the same results plus calcification. Due to suspected renal cell carcinoma, a radical nephrectomy was performed. Postoperative histopathologic examination revealed a cyst lined by a single layer of columnar mucin-producing cells with small foci of pseudo-stratification, consistent with the MC’s diagnosis. The first follow-up visit showed normal blood pressure without medication and no flank pain and anxiety after a month.

Conclusion

It is quite challenging to distinguish the primary MC of the kidney from a simple renal cyst based on clinical and imaging findings. The radiologic features of these entities overlap significantly. Thus, complex renal cyst and renal cysts with mural nodules should be followed closely to detect malignancy earlier.
Comparative genome and transcriptome analyses reveal innate differences in response to host plants by two color forms of the two-spotted spider mite Tetranychus urticae
Authors: Huo Shi-Mei , Yan Zhi-Chao , Zhang Feng , Chen Lei , Sun Jing-Tao , Hoffmann Ary A. , Hong Xiao-Yue
Published: July 2021

Background

The two-spotted spider mite, Tetranychus urticae, is a major agricultural pest with a cosmopolitan distribution, and its polyphagous habits provide a model for investigating herbivore-plant interactions. There are two body color forms of T. urticae with a different host preference. Comparative genomics and transcriptomics are used here to investigate differences in responses of the forms to host plants at the molecular level. Biological responses of the two forms sourced from multiple populations are also presented.

Results

We carried out principal component analysis of transcription changes in three red and three green T. urticae populations feeding on their original host (common bean), and three hosts to which they were transferred: cotton, cucumber and eggplant. There were differences among the forms in gene expression regardless of their host plant. In addition, different changes in gene expression were evident in the two forms when responding to the same host transfer. We further compared biological performance among populations of the two forms after feeding on each of the four hosts. Fecundity of 2-day-old adult females showed a consistent difference between the forms after feeding on bean. We produced a 90.1-Mb genome of the red form of T. urticae with scaffold N50 of 12.78 Mb. Transcriptional profiles of genes associated with saliva, digestion and detoxification showed form-dependent responses to the same host and these genes also showed host-specific expression effects.

Conclusions

Our research revealed that forms of T. urticae differ in host-determined transcription responses and that there is form-dependent plasticity in the transcriptomic responses. These differences may facilitate the extreme polyphagy shown by spider mites, although fitness differences on hosts are also influenced by population differences unrelated to color form.
Comparative study on fruit development and oil synthesis in two cultivars of Camellia oleifera
Authors: Zhang Fanhang , Li Ze , Zhou Junqin , Gu Yiyang , Tan Xiaofeng
Published: July 2021

Background

The oil-tea tree (Camellia oleifera Abel.) is a woody tree species that produces edible oil in the seed. C. oleifera oil has high nutritional value and is also an important raw material for medicine and cosmetics. In China, due to the uncertainty on maturity period and oil synthesis mechanism of many C. oleifera cultivars, growers may harvest fruits prematurely, which could not maximize fruit and oil yields. In this study, our objective was to explore the mechanism and differences of oil synthesis between two Camellia oleifera cultivars for a precise definition of the fruit ripening period and the selection of appropriate cultivars.

Results

The results showed that ‘Huashuo’ had smaller fruits and seeds, lower dry seed weight and lower expression levels of fatty acid biosynthesis genes in July. We could not detect the presence of oil and oil bodies in ‘Huashuo’ seeds until August, and oil and oil bodies were detected in ‘Huajin’ seeds in July. Moreover, ‘Huashuo’ seeds were not completely blackened in October with up to 60.38% of water and approximately 37.98% of oil in seed kernels whose oil content was much lower than normal mature seed kernels. The oil bodies in seed endosperm cells of ‘Huajin’ were always higher than those of ‘Huashuo’ from July to October.

Conclusion

Our results confirmed that C. oleifera ‘Huashuo’ fruits matured at a lower rate compared to ‘Huajin’ fruits and that ‘Huajin’ seeds entered the oil synthesis period earlier than ‘Huashuo’ seeds. Moreover, ‘Huashuo’ fruits did not mature during the Frost’s Descent period (October 23–24 each year).
Impact of a patient-centered medical home demonstration on quality of life and patient activation for older adults with complex needs in Singapore
Authors: Sum Grace , Ho Soon Hoe , Lim Zoe Zon Be , Chay Junxing , Ginting Mimaika Luluina , Tsao Mary Ann , Wong Chek Hooi
Published: July 2021

Background

The first Patient-Centered Medical Home (PCMH) demonstration in Singapore was launched in November 2016, which aimed to deliver integrated and patient-centered care for patients with bio-psycho-social needs. Implementation was guided by principles of comprehensiveness, coordinated care, shared decision-making, accessible services, and quality and safety. We aimed to investigate the impact of implementing the PCMH in primary care on quality of life (QoL) and patient activation.

Methods

The study design was a prospective single-arm pre-post study. We applied the 5-level EuroQol 5-dimension (EQ-5D-5L) and Visual Analog Scale (EQ VAS) instruments to assess health-related QoL. The CASP-19 tool was utilised to examine the degree that needs satisfaction was fulfilled in the domains of Control, Autonomy, Self-realisation, and Pleasure. The 13-item Patient Activation Measure (PAM-13) was used to evaluate knowledge, skills and confidence in management of conditions and ability to self-care. Multivariable linear regression models with random intercepts were applied to examine the impact of the PCMH intervention on outcome measures at 3 months and 6 months post-enrolment, compared to baseline.

Results

We analysed 165 study participants enrolled into the PCMH from November 2017 to April 2020, with mean age 77 years (SD: 9.9). Within-group pre-post (6 months) EQ-5D-5L Index (β= -0.01, p-value = 0.35) and EQ VAS score (β=-0.03, p-value = 0.99) had no change.

Compared to baseline, there were improvements in CASP-19 total score at 3 months (β = 1.34, p-value = 0.05) and 6 months post-enrolment (β = 1.15, p-value = 0.08) that were marginally out of statistical significance. There was also a significant impact of the PCMH on the CASP-19 Pleasure domain (β = 0.62, p = 0.03) at 6 months post-enrolment, compared to baseline. We found improved patient activation from a 15.2 % reduction in the proportion of participants in lower PAM levels, and a 23.4 and 16.7 % rise in proportion for higher PAM levels 3 and 4, respectively, from 3 months to 6 months post-enrolment.

Conclusions

Preliminary demonstration of the PCMH model shows evidence of improved needs satisfaction and patient activation, with potential to have a greater impact after a longer intervention duration.
Community- versus hospital-acquired acute kidney injury in hospitalised COVID-19 patients
Authors: Bell Jack S , James Benjamin D , Al-Chalabi Saif , Sykes Lynne , Kalra Philip A , Green Darren
Published: July 2021

Background

Acute kidney injury (AKI) is a recognised complication of coronavirus disease 2019 (COVID-19), yet the reported incidence varies widely and the associated risk factors are poorly understood.

Methods

Data was collected on all adult patients who returned a positive COVID-19 swab while hospitalised at a large UK teaching hospital between 1st March 2020 and 3rd June 2020. Patients were stratified into community- and hospital-acquired AKI based on the timing of AKI onset.

Results

Out of the 448 eligible patients with COVID-19, 118 (26.3 %) recorded an AKI during their admission. Significant independent risk factors for community-acquired AKI were chronic kidney disease (CKD), diabetes, clinical frailty score and admission C-reactive protein (CRP), systolic blood pressure and respiratory rate. Similar risk factors were significant for hospital-acquired AKI including CKD and trough systolic blood pressure, peak heart rate, peak CRP and trough lymphocytes during admission. In addition, invasive mechanical ventilation was the most significant risk factor for hospital-acquired AKI (adjusted odds ratio 9.1, p < 0.0001) while atrial fibrillation conferred a protective effect (adjusted odds ratio 0.29, p < 0.0209). Mortality was significantly higher for patients who had an AKI compared to those who didn’t have an AKI (54.3 % vs. 29.4 % respectively, p < 0.0001). On Cox regression, hospital-acquired AKI was significantly associated with mortality (adjusted hazard ratio 4.64, p < 0.0001) while community-acquired AKI was not.

Conclusions

AKI occurred in over a quarter of our hospitalised COVID-19 patients. Community- and hospital-acquired AKI have many shared risk factors which appear to converge on a pre-renal mechanism of injury. Hospital- but not community acquired AKI was a significant risk factor for death.
Sleep disorders in a sample of Lebanese children: the role of parental mental health and child nutrition and activity
Authors: Sfeir Elsa , Haddad Chadia , Akel Marwan , Hallit Souheil , Obeid Sahar
Published: July 2021

Background

Sleep habits are an important component of a child’s health and it is affected by parent–child relationship. Also, child’s diet and nutrition appear to be an important factor affecting sleep health. Few studies have addressed the effect of parental emotional disturbance that can leave on children’s sleep. Therefore, the objective of our study was to assess the prevalence of sleep disorders in pre- and school-aged children and evaluate its relation with parental mental health and child’s nutrition and activity.

Methods

A cross-sectional study, conducted between October 2020 and January 2021, which enrolled 402 Lebanese parents from all over Lebanon. The questionnaire was distributed online using the snowball technique. The Pediatric Sleep Questionnaire (PSQ) was used to assess pediatric sleep behaviors and the Family Nutrition and physical activity questionnaire was used to assess parental behaviors that might predispose children for obesity.

Results

A total of 76 (19%) children had sleep disorders (PSQ scores of 8 or more). The multivariable analysis showed that higher paternal depression (Beta = 0.079,p = 0.010), maternal depression (Beta = 0.089,p = 0.001) and higher anxiety in the father (Beta = 0.064,p = 0.021) were significantly associated with higher PSQ scores (worse sleep) in the child. Higher Family Nutrition and Physical Activity Screening Tool scores in the child (Beta = -0.161,p < 0.001) was significantly associated with lower PSQ scores (better sleep).

Conclusion

Paternal anxiety and depression, as well as maternal depression, were factors associated with children’s sleeping disorders. Future studies are needed to assess parental influence on child’s development.
E-health roadmap for COVID-19 vaccine coverage in Iran
Authors: Maserat Elham , Keikha Leila , Davoodi Somayeh , Mohammadzadeh Zeinab
Published: July 2021

Background

Vaccination is the effective and long-term pharmacological solution to deal with COVID-19. Information technology (IT) and electronic immunization can be effective in accelerating and improving vaccine coverage. The aim of this paper is to develop multi-dimensional framework of e-health roadmap to response Covod-19 pandemic and examine the role of IT for improving vaccine distribution in Iran.

Methods

The study methodology was based on a two-stage Delphi method which included literature studies at the beginning. Key steps in creating a roadmap in this study include definition, development and evaluation. The initial conceptual model was developed after literature review. Proposed roadmap was reviewed and evaluated in two stages based on the Delphi method by experts in the fields of E-health.

Results

In the e-health roadmap model, 14 stages of vaccine distribution were presented in three phases of vaccination and then were determined the type of technology in each phase. The 4 conceptual models were approved based on the two stages Delphi approach in a survey of 14 e-health experts. In the second phase of the Delphi process, the selected items were sent back to the specialists to verification. Then e-health roadmap was confirmed by experts and was finalized the approved model.

Conclusions

The technology-based roadmap is one plan in the form of a transfer strategy that aligns goals with specific technical solutions and helps to meet them. This roadmap empowers decision makers to decide on alternative paths and achieve goals.
Mapping the molecular basis for growth related phenotypes in industrial producer CHO cell lines using differential proteomic analysis
Authors: Bryan Laura , Henry Michael , Kelly Ronan M. , Frye Christopher C. , Osborne Matthew D. , Clynes Martin , Meleady Paula
Published: July 2021

Background

The ability to achieve high peak viable cell density earlier in CHO cell culture and maintain an extended cell viability throughout the production process is highly desirable to increase recombinant protein yields, reduce host cell impurities for downstream processing and reduce the cost of goods. In this study we implemented label-free LC-MS/MS proteomic profiling of IgG4 producing CHO cell lines throughout the duration of the cell culture to identify differentially expressed (DE) proteins and intracellular pathways associated with the high peak viable cell density (VCD) and extended culture VCD phenotypes.

Results

We identified key pathways in DNA replication, mitotic cell cycle and evasion of p53 mediated apoptosis in high peak VCD clonally derived cell lines (CDCLs). ER to Golgi vesicle mediated transport was found to be highly expressed in extended culture VCD CDCLs while networks involving endocytosis and oxidative stress response were significantly downregulated.

Conclusion

This investigation highlights key pathways for targeted engineering to generate desirable CHO cell phenotypes for biotherapeutic production.
Use of oral health care services in the United States: unequal, inequitable—a cross-sectional study
Authors: Ju Xiangqun , Mejia Gloria C. , Wu Qiang , Luo Huabin , Jamieson Lisa M.
Published: July 2021

Background

Social determinants drive disparities in dental visiting. Disparities can be measured simply by comparing outcomes between groups (inequality) but can also consider concepts of social justice or fairness (inequity). This study aimed to assess differences in dental visiting in the United States in terms of both social inequality and inequity.

Methods

Data were obtained from a cross-sectional study—the National Health and Nutrition Examination Survey (NHANES) 2015–2016, and participants were US adults aged 30+ years. The outcome of interest, use of oral health care services, was measured in terms of dental visiting in the past 12 months. Disparity was operationalized through education and income. Other characteristics included age, gender, race/ethnicity, main language, country of birth, citizenship and oral health status. To characterize existing inequality in dental service use, we examined bivariate relationships using indices of inequality: the absolute and relative concentration index (ACI and RCI), the slope index of inequality (SII) and relative index of inequality (RII) and through concentration curves (CC). Indirect standardization with a non-linear model was used to measure inequity.

Results

A total of 4745 US adults were included. Bivariate analysis showed a gradient by both education and income in dental visiting, with a higher proportion (> 60%) of those with lower educational attainment /lower income having not visited a dentist. The concentration curves showed pro-higher education and income inequality. All measures of absolute and relative indices were negative, indicating that from lower to higher socioeconomic position (education and income), the prevalence of no dental visiting decreased: ACI and RCI estimates were approximately 8% and 20%, while SII and RII estimates were 50% and 30%. After need-standardization, the group with the highest educational level had nearly 2.5 times- and the highest income had near three times less probability of not having a dental visit in the past 12 months than those with the lowest education and income, respectively.

Conclusion

The findings indicate that use of oral health care is threatened by existing social inequalities and inequities, disproportionately burdening disadvantaged populations. Efforts to reduce both oral health inequalities and inequities must start with action in the social, economic and policy spheres.