bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prince in the Body of a Parrot (Cuckoo)
Authors: Kapišovská Veronika
Published: October 2022

The eighteenth-century Tibetan narrative The Tale of Moon Cuckoo and its subsequent adaptation as a Mongolian traditional opera was performed from the nineteenth century up to the early twentieth. The story is based on the motif of a prince who is tricked into entering the body of a cuckoo; later on, he is not able to regain his human form, stolen by his evil-minded companion. The narrative, along with its Mongolian-language versions and operatic adaptation, is a vivid example of Tibet-Mongolian literary transmission. The underlying motif of the tale is also closely linked to the so-called frame narratives of Indian origin concerning King Vikramāditya; the popularity of these narratives was very widespread in Central and Inner Asia in times past. This paper describes some of the literary contacts concerning the narrative and motifs of The Tale of Moon Cuckoo in Central and Inner Asia and beyond, with a view as well to cross-genre considerations.
Ciceronian Skeptical Fideism in the Octavius of Minucius Felix
Authors: Ribeiro Brian
Published: October 2022

The dialogue Octavius by Minucius Felix is a point of reception in the legacy of Ciceronian skeptical fideism, and as such it deserves its place in the history of skeptical fideism. Drawing on his Ciceronian model, Minucius depicts a skeptical fideist—Caecilius—struggling to hold on to his religious traditions in the face of the challenges posed by the new religion of Christianity. But Minucius himself is a convert to the new religion and writes in its defense. And this authorial intent distorts the skeptical fideism which Minucius found in Cicero’s De natura deorum by adding credulous and/or dogmatic elements that are ill-fitted to skeptical fideism but well-suited to his authorial intention of answering all available objections to Christianity in the hopes of winning converts.
Directly Sulfonated Carbon Nanofibers to Improve Single-Cell Performance of Pt/CNFs–SO3H Catalyst
Authors: Huang Qiankuan , Tang Shuihua , Yang Shuang , Shen Lieha , Zhou Tianli , Yu Limei , Yu Honglin , Xie Yuhang , Zhang Lei
Published: October 2022

Due to the high cost of electrocatalysts, mass manufacturing of fuel-cell driven cars is a challenge. In the catalytic layer, the Nafion ionomer allows for minimal Pt consumption. Various carbon compounds were produced and their catalytic activities for oxygen reduction process were
examined in this study. Results suggest that Pt/CNFs have the best performance due to their good electrical conductivity, rich surface defects, and the ease with which CNFs may be mass transported. As a result, CNFs were chosen to be sulfonated immediately by concentrated sulfuric acid at
high temperatures. After sulfonation, the sulfonic acid functional group (–SO3H) was identified in the spectrum of Fourier transform infrared spectroscopy at a wavenumber of 1033 cm−1, and a Pt/CNFs–SO3H electrocatalyst was made using the
ethylene glycol technique. After 10,000 cycles, the linear sweep voltammetry curve barely changes, and the current density can sustain 95% after 6 hours of chronoamperometric testing at 0.6 V. Pt/CNFs–SO3H can produce a maximum power density in a hydrogen/air single-cell is
397.5 mW cm−2, compared with 353.2 mW cm−2 of Pt/CNFs, a 12.5% increase, demonstrating CNFs–SO3H may significantly improve proton transportation capabilities.
New Parameterizations of Turbulence Statistics for the Atmospheric Surface Layer
Authors: Lee Temple R. , Meyers Tilden P.
Published: October 2022

Recent work has shown that bulk-Richardson (Rib) parameterizations for friction velocity, sensible heat flux, and latent heat flux have similar, and in some instances better, performance than long-standing parameterizations from Monin–Obukhov similarity theory (MOST). In this work, we expanded upon new Rib parameterizations and developed parameterizations of turbulence statistics, i.e., standard deviations in the 30-min u (horizontal), υ (meridional), and w (vertical) wind components (i.e., σu, συ, and σw, respectively), which allowed us to derive Rib-based parameterizations of turbulent kinetic energy (e), and standard deviations in the 30-min temperature and moisture measurements (σθ and σq, respectively). We used datasets from three 10-m micrometeorological towers installed during the Land Atmosphere Feedback Experiment (LAFE) conducted in Oklahoma from 1 to 31 August 2017 and evaluated the new parameterizations by comparing them against parameterizations from MOST. We used the LAFE datasets and fully independent datasets obtained from two micrometeorological towers installed in Alabama between February 2016 and April 2017 to evaluate the performance of the parameterizations. Based on the slope of the relationship between the observed and parameterized turbulence statistics (mb) and the coefficient of correlation (r), we found that the Rib relationships generally performed better than MOST at parameterizing συ, σw, σθ, and σq, and the Rib relationships performed better at low wind speeds than at high wind speeds. These results, coupled with recent developments of Rib parameterizations for surface-layer momentum, heat, and moisture fluxes, provide further evidence to consider using Rib-based parameterizations in weather forecasting models.

Significance Statement

Deficiencies in Monin–Obukhov similarity theory (MOST) are well known, yet MOST forms the basis in weather forecasting models for describing heat, moisture, and momentum transfer between the land surface and atmosphere. We expanded upon previous work suggesting a MOST alternative called the bulk-Richardson approach. We used data collected from meteorological towers installed in Oklahoma and compared the bulk-Richardson approach with MOST. We evaluated these two approaches using data from meteorological towers installed in Oklahoma and Alabama and found that, overall, the bulk-Richardson approach performed better than MOST in determining the 30-min variability in temperature, moisture, and wind. This result provides additional motivation to use a bulk-Richardson approach in weather forecasting models because doing so will likely yield improved forecasts.
Hyperfunctional Laryngeal Behavior: Is It the Cause or Consequence of Vocal Fold Polyps?
Authors: Menon Jayakumar R. , Mathew Amrita Suzanne
Published: October 2022

Objectives:

To evaluate the relationship between arytenoid adduction asymmetry (AAA) and the demographic and morphological characteristics of true vocal fold (TVF) polyps and establish the cause and effect relationship between AAA and TVF polyps.

Methods:

Videolaryngostroboscopic findings of 163 patients with TVF polyps were retrospectively reviewed and categorized into Group 1 with AAA or Group 2 without AAA. Demographic details, clinicomorphological polyp characteristics, supraglottic phenomena, and AAA attributes were analyzed.

Results:

Group 1 was younger than Group 2 (fourth vs fifth decade; P = .0066). Polyp characteristics showed no significant intergroup differences. The association between AAA and false vocal fold (FVF) adduction (65.28% vs 47.62% in Group 1 and 2 respectively; P = .0441) was significant. In relation to TVF polyp laterality, contralateral and bilateral AAA and FVF adduction respectively, was significant.

Conclusion:

AAA is a compensatory laryngeal adaptation akin to a FVF adduction muscle tension pattern. With a concomitant laryngeal pathology and high vocal demand, AAA is a consequence and not the cause for underlying laryngeal pathology which hinders glottic closure.
The impact of immersive video on a parenting programme for adoptive parents, foster carers and special guardians
Authors: Lucas Rebecca , Dickerson Paul , Rae John P , Tudor Andreea , Essau Cecilia
Published: October 2022

Training programmes for the carers of adopted and looked after children have mixed efficacy, and the beneficial effects of their specific components are unclear. This article seeks to address this deficiency by assessing the impact of a parenting training programme distinguished by the inclusion of immersive videos. Eleven adoptive parents, seven foster carers and four special guardians participated. A mixed methods approach comprising questionnaires and interviews was utilised with data collected before, during and after training. Overall satisfaction with the training and trainers was high, and participants reported increased understanding and greater empathy regarding children’s early-life trauma and neglect (ELTN), plus enhanced competence and confidence in addressing any associated behavioural challenges. Qualitative analysis revealed differences in trainees’ responses according to the extent of their carer experience, with those relatively new to the work appreciating open-ended discussion and more experienced carers preferring discourse and role play that focused on the issues important to them. All participants valued the immersive videos, especially one that gave a toddler’s visual point of view in an environment where he was alternately shouted at and neglected. The study concluded that training programmes that include immersive videos can improve parenting knowledge and skills and that future research should examine their impact on child outcomes.
Facing Change With Stability: The Dynamics of Occupational Career Trajectories
Authors: Medici Guri , Igic Ivana , Grote Gudela , Hirschi Andreas
Published: October 2022

In today’s dynamic work environments, individuals must manage their careers. Although research suggests that many individuals change jobs and organizations more frequently, they often pursue their careers within one occupation still. The current study addresses how such seemingly stable careers unfold in the face of societal, economic, and technological changes and explores the proactive and reactive strategies individuals use to sustain occupational stability throughout their careers. Applying qualitative content analysis to 32 semi-structured interviews, we revealed eight major strategies underlying the process of occupational stability maintenance. We discuss the identified strategies using control theory and job crafting as theoretical lenses and introduce the concept of occupational crafting for understanding stability maintenance in vocational careers. The study highlights occupations as meaningful reference points in contemporary careers and illustrates how proactive and reactive strategies lead to occupational stability.
Does the Gospel Require Self-Sacrifice? Paul and the Reconfiguration of the Self
Authors: Barclay John M.G.
Published: October 2022

Some modern Christian notions of ‘self-sacrifice’ and ‘cruciformity’ abstract an ethic of self-negation from its larger theological and teleological frame. A distinctively modern and Western trajectory has shaped an ‘exclusive altruism’ where the interests of the self and of the other stand in a competitive relationship. Although Paul's letter to the Philippians has often been cited as a prime example of such an ethic, closer scrutiny reveals a larger narrative frame, for both Christ and believers, that is oriented towards fullness, not kenosis. Within a community of solidarity and reciprocal asymmetry in Christ, each person's work in looking to the concerns of others is balanced and framed by a communal concern to safeguard the interests of each person in the interests of conjoint benefit. Pauline resources thus enable us to replace the modern polarity with an alternative: the proper opposite to being selfish is not to be ‘selfless’ but to be ‘self-with’.
How to do action research for transformations at a time of eco-social crisis, by Hilary S. Bradbury. Elgar, 2022. Four characters in search of a book review
Authors: Glenzer Kent
Published: October 2022

What are the crucial ingredients missing in our search for transformative – structural, cultural, political-economic – changes to entrenched systems of oppression right now? Why do so many smart, informed, data-driven efforts fail? This book says what’s missing is ART: Action Research for Transformation, a contemporary expression of action research. The book offers surprising, counter-intuitive, and most importantly, experienced-based insights on both what ART is, and how to do it. It reveals pathways to disrupt the academic détentes regarding quantitative versus quantitative, objective versus subjective, macro versus micro, and asks what is knowledge and what is it for. The book offers practical approaches, tools, and case studies, while featuring personal narratives from a wide range of active ARTists about their successes, challenges, doubts, and perhaps most importantly, the joy and value they experience performing ART. Its preponderant thesis is this: the problems of eco-social crisis aren’t “out there” so much as within, between and among each one of us, and the types of relationships we create with others. The book is therefore of value to educators and change leaders perhaps especially within our universities’ professional schools.
Magnesio-lucchesiite from the Kowary vicinity, Karkonosze Mountains, SW Poland: the third occurrence worldwide
Authors: Sęk Mateusz P. , Włodek Adam , Stachowicz Marcin , Woźniak Krzysztof , Pieczka Adam
Published: October 2022

Two tourmaline samples occurring in quartz veinlets, which cross-cut an amphibolite body at the Budniki camp near the Kowary town in the south-west part of the Karkonosze Mountains, SW Poland, were studied through microprobe and single crystal X-ray diffraction. Samples were extracted from core and rim regions of crystals with concentric zoning. Chemical and structural data revealed that the core tourmaline is characterised by a dravite–oxy-dravite composition, with the formula: X(Na0.82Ca0.07K0.01Sr0.01□0.09)Σ1Y(Mg1.73Fe2+0.81Fe3+0.41Ti0.04V0.01)Σ3Z(Al5.85Fe3+0.15)Σ6(TSi6O18)(BO3)3(OH)3W(OH0.50O0.50)Σ1 and unit cell parameters a = 15.97377(14) Å and c = 7.22644(7) Å. The rim part of the crystals has a magnesio-lucchesiite composition, described by the formula: X(Ca0.49Na0.41K0.04Sr0.02□0.04)Σ1Y(Mg1.87Fe2+0.95Ti0.15Fe3+0.02V0.02)Σ3Z(Al5.49Fe3+0.51)Σ6(BO3)3(TSi6O18)(OH)3W(O0.81F0.18OH0.01)Σ1 with unit cell parameters a = 15.9863(3) Å and c = 7.22426(15) Å. Both tourmalines show similar refined populations at the Y and Z sites: Y[(Fe2+0.810Mg0.680)Σ1.490(Al1.044Fe3+0.413V0.009)Σ1.465Ti0.045]Σ3Z(Al4.806Mg1.042Fe3+0.152)Σ6 (dravite–oxy-dravite), and Y[(Fe2+0.945Mg0.750)Σ1.695(Al0.737Fe3+0.404V0.018)Σ1.159Ti0.146]Σ3Z(Al4.749Mg1.115Fe3+0.137)Σ6 (magnesio-lucchesiite), with a comparable Mg/(Mg + Fe) ratio of ~0.54–0.56, oxidation of Fe expressed as Fe3+/Fetotal ratio ~0.36–0.41, and trace components such as Ti, Sr, V, Cr, Ni and Co. The geological history of the eastern Karkonosze region in the Kowary vicinity indicates that both tourmalines crystallised from B-bearing metamorphic fluids mobilised by Variscan prograde metamorphism from the protoliths of the Velká Upá mica schists that host the Budniki amphibolite. The fluids migrated into the tectonised amphibolite enriched in Ti, V, Cr, Ni and Co, and mineralised the fractures within it through deposition of soluble species in the form of quartz–tourmaline veinlets. Magnesio-lucchesiite crystallised in an early retrogression stage, probably from Ca- and F-bearing fluids secondary enriched in B by the dissolution of dravite–oxy-dravite. The Budniki camp is, in addition to the type and co-type magnesio-lucchesiite localities, the third documented occurrence of the species worldwide.
A 9‑gene expression signature to predict stage development in resectable stomach adenocarcinoma
Authors: Liu Zining , Liu Hua , Wang Yinkui , Li Ziyu
Published: October 2022

Background

Stomach adenocarcinoma (STAD) is a highly heterogeneous disease and is among the leading causes of cancer-related death worldwide. At present, TNM stage remains the most effective prognostic factor for STAD. Exploring the changes in gene expression levels associated with TNM stage development may help oncologists to better understand the commonalities in the progression of STAD and may provide a new way of identifying early-stage STAD so that optimal treatment approaches can be provided.

Methods

The RNA profile retrieving strategy was utilized and RNA expression profiling was performed using two large STAD microarray databases (GSE62254, n = 300; GSE15459, n = 192) from the Gene Expression Omnibus (GEO) and the RNA-seq database within the Cancer Genome Atlas (TCGA, n = 375). All sample expression information was obtained from STAD tissues after radical resection. After excluding data with insufficient staging information and lymph node number, samples were grouped into earlier-stage and later-stage. Samples in GSE62254 were randomly divided into a training group (n = 172) and a validation group (n = 86). Differentially expressed genes (DEGs) were selected based on the expression of mRNAs in the training group and the TCGA group (n = 156), and hub genes were further screened by least absolute shrinkage and selection operator (LASSO) logistic regression. Receiver operating characteristic (ROC) curves were used to evaluate the performance of the hub genes in distinguishing STAD stage in the validation group and the GSE15459 dataset. Univariate and multivariate Cox regressions were performed sequentially.

Results

22 DEGs were commonly upregulated (n = 19) or downregulated (n = 3) in the training and TCGA datasets. Nine genes, including MYOCD, GHRL, SCRG1, TYRP1, LYPD6B, THBS4, TNFRSF17, SERPINB2, and NEBL were identified as hub genes by LASSO-logistic regression. The model achieved discrimination in the validation group (AUC = 0.704), training-validation group (AUC = 0.743), and GSE15459 dataset (AUC = 0.658), respectively. Gene Set Enrichment Analysis (GSEA) was used to identify the potential stage-development pathways, including the PI3K-Akt and Calcium signaling pathways. Univariate Cox regression indicated that the nine-gene score was a significant risk factor for overall survival (HR = 1.28, 95% CI 1.08–1.50, P = 0.003). In the multivariate Cox regression, only SCRG1 was an independent prognostic predictor of overall survival after backward stepwise elimination (HR = 1.21, 95% CI 1.11–1.32, P < 0.001).

Conclusion

Through a series of bioinformatics and validation processes, a nine-gene signature that can distinguish STAD stage was identified. This gene signature has potential clinical application and may provide a novel approach to understanding the progression of STAD.
Validity and reliability of the Farsi version of the ascertain dementia 8-item (AD8-F) informant interview in Iranian patients with mild neurocognitive disorder
Authors: Pourshams Maryam , Galvin James E. , Afshar Pouya Farokhnezhad , Santos Pamela Gail , Bazargan-Hejazi Shahrzad , Kamalzadeh Leila , Shariati Behnam , Malakouti Seyed Kazem
Published: October 2022

Background

For screening and distinguishing between mild neurocognitive disorder (mNCD) and normal cognitive age-related changes in primary care centers, a simple and practical tool is necessary. Therefore, this study aims to determine the validity and reliability of the Farsi version of the Ascertain Dementia 8-item (AD8-F) informant interview in patients with mNCD.

Methods

This is a study of the psychometric properties of the Farsi AD8. The participants include sixty informant-patient dyads with mNCD and sixty controls with normal cognition. The AD8 was compared to the mini-mental state examination (MMSE) and the Mini-Cog. As a gold standard, the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for mNCD was used. The reliability was measured using internal consistency and test-retest. Validity was assessed by evaluating the content, concurrent, and construct validity. Data were analyzed via Cronbach’s α, Pearson correlation, independent t-test, and analysis of variance (ANOVA) and area under the curve (AUC) by statistical package for the social sciences (SPSS) v.23.

Results

Cronbach’s α was 0.71. Test-retest reproducibility was 0.8. The AD8 had inverse correlations with the Mini-Cog (r = − 0.70, P < 0.01) and MMSE (r = − 0.56, P < 0.01). The area under the curve was 0.88. The optimal cutoff score was > 2. Sensitivity and specificity were 80 and 83%, respectively. The positive predictive value was 83%. The negative predictive value was 81%.

Conclusion

Our results suggest that this tool can be used as a screening tool to detect a mild neurocognitive disorder in primary care centers.
Constrained acetabular liners are a viable option in second-stage re-implantation for chronic infected total hip arthroplasty with abductor or greater trochanter deficiency and large acetabular bone defects
Authors: Xiao Qiang , Ling Tingxian , Zhou Kai , Yuan Mingcheng , Xu Bing , Zhou Zongke
Published: October 2022

Background

Abductor mechanism deficiency is a clear indication for using constrained acetabular liners (CALs), and large acetabular bone defects are considered a relative contraindication to CALs. We report the results of using CALs in special cases in which abductor or greater trochanter deficiency was accompanied by large acetabular bone defects at second-stage re-implantation for chronic infected total hip arthroplasty (THA).

Methods

Between January 2010 and January 2018, 19 patients who used CALs at second-stage re-implantation and had abductor or greater trochanter deficiency and large acetabular bone defects were included in this study. We followed up with the clinical and radiological results of these patients. Complications and infection-related information were also recorded.

Results

Eight patients, 4 patients, and 7 patients had Paprosky type IIB, type IIC, and type IIIA acetabular bone defects at second-stage re-implantation, respectively. The indication for using CALs was abductor deficiency in 14 patients and greater trochanter deficiency in the other 5 patients. The mean follow-up was 74.4 months (range 50–96). The mean Harris Hip Score (HHS) was 76.3 points (range 62–86) at the last follow-up. Three patients presented acetabular radiolucent lines with no progress: zone 3, zone 3 and zone 2 and 3, respectively. One patient suffered transient sciatic nerve palsy. There was no dislocation, failure of the CALs, reoperation, or recurrence of infection.

Conclusion

Our results suggested that for screened patients, CALs are a viable option in second-stage re-implantation for chronic infected THA with abductor or greater trochanter deficiency and large bone defects.
A simple method to improve the antibiotic elution profiles from polymethylmethacrylate bone cement spacers by using rapid absorbable sutures
Authors: Tseng Tzu-Hao , Chang Chih-Hao , Chen Chien-Lin , Chiang Hongsen , Hsieh Hao-Ying , Wang Jyh-Horng , Young Tai-Horng
Published: October 2022

Objective

Antibiotic-loaded bone cement beads and spacers have been widely used for orthopaedic infection. Poor antibiotic elution is not capable of eradicating microbial pathogens and could lead to treatment failure. The elution profiles differ among different cement formulations. Although Simplex P cement has the least release amount, it is widely used due to its ready availability. Previous methods aiming to improve the elution profiles were not translated well to clinical practice. We sought to address this by using easily available materials to improve the elution profile of antibiotics from PMMA, which allows clinicians to implement the method intraoperatively.

Methods

Vancomycin was mixed with Simplex P cement. We used Vicryl Rapide sutures to fabricate sustained-release cement beads by repetitively passing the sutures through the beads and/or mixing suture segments into the cement formulation. Vancomycin elution was measured for 49 days. The mechanism of antibiotic release was observed with gross appearance and scanning electron microscopic images. The antimicrobial activities against MRSA were tested using an agar disk diffusion bioassay.

Results

Passing Vicryl Rapide sutures through cement beads significantly improved the elution profiles in the 7-week period. The increased ratios were 9.0% on the first day and 118.0% from the 2nd day to the 49th day. Addition of suture segments did not increase release amount. The Vicryl Rapide sutures completely degraded at the periphery and partially degraded at the center. The antibiotic particles were released around the suture, while antibiotic particles kept densely entrapped in the control group. The antimicrobial activities were stronger in passing suture groups.

Conclusion

Passing fast absorbable sutures through PMMA cement is a feasible method to fabricate sustained-release antibiotic bone cement. Intra-cement tunnels can be formed, and the effect can last for at least 7 weeks. It is suitable for a temporary spacer between two stages of a revision surgery.
The explorations of the awareness, contemplation, self-Efficacy, and readiness of advance care planning, and its predictors in Taiwanese patients while receiving hemodialysis treatment
Authors: Chen Li-Chen , Tu I-Te , Yu I-Chen , Tung Tao-Hsin , Huang Hsiang-Ping , Lin Yung-Chang , Beaton Randal D. , Jane Sui-Whi
Published: October 2022

Background

End-stage renal disease (ESRD) is a major chronic illness worldwide, and Taiwan reports one of the highest incidence rates of ESRD with 529 cases per million population (pmp). A number of patients with ESRD patients might require lifelong hemodialysis (HD) or peritoneal dialyses (PD). Due to the progression of dialysis, patients are likely to experience other chronic comorbidities, anxiety and depression, frequent hospitalizations, and higher rates of mortality compared to patients with other types of chronic illnesses. As a result, dialysis patients are prone to experience advance care planning (ACP) needs, such as whether they withdraw from receiving dialysis while approaching their end-of-life (EOL). Yet, existing studies have shown that dialysis patients seldom receive timely consultation regarding ACP and there are limited studies examining ACP amongst Taiwan HD patients.

Purpose

The purpose of this study was to examine ACP awareness, contemplation, self-efficacy and readiness; and factors influencing ACP readiness.

Design

This cross-sectional descriptive study with convenience sampling was conducted in the out-patient HD unit at a regional teaching hospital in southern Taiwan. A total of 143 ESRD patients undergoing HD treatments were recruited. A 55-item ACP engagement survey containing the subscales of awareness, contemplation, self-efficacy, and readiness was employed. The data were analyzed with t-tests, one-way ANOVAs, Pearson’s correlations and multiple regressions.

Results

The results of our investigation revealed that approximately half of the participants (n = 67, 46.9%) were not informed of ACP. Although they reported considering their EOL, medical decisions and desired care, they demonstrated significantly low self-efficacy in discussing ACP (t= -5.272, p < 0.001). HD duration influenced all four ACP subscales; religious beliefs significantly influenced ACP-self-efficacy and readiness; and marital status, education, and primary decision-maker status significantly influenced ACP-readiness. The predictors of ACP-readiness were high self-efficacy and being the primary decision-maker (Adjusted R2 61%).

Conclusion

Most of the HD patients in this study had low ACP-awareness, contemplation, self-efficacy, and readiness, and most had not completed any ACP-related advance directives (AD). Healthcare professionals should proactively provide HD patients with ACP-related information and answer patients’ and medical decision-makers’ questions in a timely manner, thereby improving the quality of EOL care.
Acting on the call for cervical cancer elimination: Planning tools for low- and middle- income countries to increase the coverage and effectiveness of screening and treatment
Authors: Herrick Tara , Thomson Kerry A. , Shin Michelle , Gannon Sarah , Tsu Vivien , de Sanjosé Silvia
Published: October 2022

Introduction

Accessible planning tools tailored for low-and middle-income countries can assist decision makers in comparing implementation of different cervical cancer screening approaches and treatment delivery scenarios in settings with high cervical cancer burden.

Methods

The Cervical Precancer Planning Tool (CPPT) was developed by PATH for users to explore and compare the accuracy of screening approaches, what treatment equipment to procure, and how best to deploy treatment equipment in a given country. The CPPT compares four screening approaches: 1) visual inspection with acetic acid (VIA), 2) HPV testing, 3) HPV testing followed by a VIA triage, and 4) HPV testing followed by an enhanced triage test. Accuracy of screening outcomes (e.g., true positives, false positives) is based on published sensitivity and specificity of tests to detect cervical precancerous lesions. The CPPT compares five scenarios for deploying ablative treatment equipment: 1) cervical precancer equipment at every location a woman is screened (single visit approach), 2) equipment only at a hospital level, 3) a single unit of equipment in each district, 4) allowing two districts to share a single unit of equipment, and 5) equipment placed at select district hospitals paired with mobile outreach. Users can customize the CPPT by adjusting pre-populated baseline values and assumptions, including population estimates, screening age range, screening frequency, HPV and HIV prevalence, supply costs, and health facility details.

Results

The CPPT generates data tables and graphs that compare the results of implementing each of the four screening and five treatment scenarios disaggregated by HIV status. Outputs include the number and outcomes of women screened, cost of each screening approach, provider time and cost saved by implementing self-sampling for HPV testing, number of women treated, treatment equipment needed by type, and the financial and economic costs for each equipment deployment scenario.

Conclusion

The CPPT provides practical information and data to compare tradeoffs of patient access and screening accuracy as well as efficient utilization of equipment, skilled personnel, and financial resources. Country decision makers can use outputs from the CPPT to guide the scale-up of cervical cancer screening and treatment while optimizing limited resources.
Establishment and evaluation of module-based immune-associated gene signature to predict overall survival in patients of colon adenocarcinoma
Authors: Lu Jing , Annunziata Francesco , Sirvinskas Dovydas , Omrani Omid , Li Huahui , Rasa Seyed Mohammad Mahdi , Krepelova Anna , Adam Lisa , Neri Francesco
Published: October 2022

Background

Patients with colon adenocarcinoma (COAD) exhibit significant heterogeneity in overall survival. The current tumor-node-metastasis staging system is insufficient to provide a precise prediction for prognosis. Identification and evaluation of new risk models by using big cancer data may provide a good way to identify prognosis-related signature.

Methods

We integrated different datasets and applied bioinformatic and statistical methods to construct a robust immune-associated risk model for COAD prognosis. Furthermore, a nomogram was constructed based on the gene signature and clinicopathological features to improve risk stratification and quantify risk assessment for individual patients.

Results

The immune-associated risk model discriminated high-risk patients in our investigated and validated cohorts. Survival analyses demonstrated that our gene signature served as an independent risk factor for overall survival and the nomogram exhibited high accuracy. Functional analysis interpreted the correlation between our risk model and its role in prognosis by classifying groups with different immune activities. Remarkably, patients in the low-risk group showed higher immune activity, while those in the high-risk group displayed a lower immune activity.

Conclusions

Our study provides a novel tool that may contribute to the optimization of risk stratification for survival and personalized management of COAD.

Graphical Abstract
Influence of COPD systemic environment on the myogenic function of muscle precursor cells in vitro
Authors: Casadevall Carme , Sancho-Muñoz Antonio , Vicente Ignacio , Pascual-Guardia Sergi , Admetlló Mireia , Gea Joaquim
Published: October 2022

Background:

Loss of muscle mass and function are well-recognized systemic manifestations of chronic obstructive pulmonary disease (COPD). Acute exacerbations, in turn, significantly contribute to upgrade these systemic comorbidities. Involvement of myogenic precursors in muscle mass maintenance and recovery is poorly understood. The aim of the present study was to investigate the effects of the vascular systemic environment from stable and exacerbated COPD patients on the myogenic behavior of human muscle precursor cells (MPC)in vitro.

Methods:

Serum from healthy controls and from stable and exacerbated COPD patients (before and after Methylprednisolone treatment) was used to stimulate human MPC cultures. Proliferation analysis was assessed through BrdU incorporation assays. MPC differentiation was examined through real-time RT-PCR, western blot and immunofluorescence analysis.

Results:

Stimulation of MPCs with serum obtained from stable COPD patients did not affect myogenic precursor cell function. The vascular systemic environment during an acute exacerbation exerted a mitotic effect on MPCs without altering myogenic differentiation outcome. After Methylprednisolone treatment of acute exacerbated COPD patients, however, the mitotic effect was further amplified, but it was followed by a deficient differentiation capacity. Moreover, these effects were prevented when cells were co-treated with the glucocorticoid receptor antagonist Mifepristone.

Conclusion:

Our findings suggest that MPC capacity is inherently preserved in COPD patients, but is compromised after systemic administration of MP. This finding strengthens the concept that glucocorticoid treatment over the long term can negatively impact myogenic stem cell fate decisions and interfere with muscle mass recovery.
Prognostic value of the modified systemic inflammation score in non-small-cell lung cancer with brain metastasis
Authors: Wang Feng , Chen Limin , Wang Zhao , Xu Qiuyan , Huang He , Wang Hairong , Li Xi , Yu Mingjie , Chen Jiangen , Lin Fuhua , Chen Zhenghe , Zhang Xiangheng , Yang Qunying , Mou Yonggao , Guo Chengcheng
Published: October 2022

Background

Brain metastases (BM) from non-small-cell lung cancer (NSCLC) is the most common brain malignancy. Systemic inflammation biomarkers have recently been evaluated as prognosis indicators in several tumors. The combination of these markers has not been evaluated in NSCLC with BM yet. Here, we explored the predictive value of pretreatment inflammatory biomarkers and established a novel, clinically applicable prognostic index for NSCLC patients with BM.

Methods

A retrospective investigation of 951 NSCLC patients newly diagnosed with BM at Sun Yat-sen University Cancer Center was conducted. We randomly divided patients into a training cohort (n = 674) or validation cohort (n = 277). Receiver operating characteristic (ROC) curve analysis was carried out to obtain the optimal cut-off values of pretreatment systemic inflammatory indexes. The associations between serum biomarkers and overall survival (OS) were analyzed by Kaplan–Meier curves and Cox proportional models. The resulting prediction model has been externally verified through the validation cohort.

Results

The optimal cut-off value of the neutrophil–lymphocyte ratio (NLR) in predicting OS was 4.71, while the clinical standard of 40 mg/L was chosen as the optimal cut-off value of albumin. Univariate and multivariate analyses revealed that patients receiving local treatment, chemotherapy, a NLR < 4.71 and albumin ≥ 40 mg/l independently predicted improved survival. We combined the two inflammatory indexes (NLR and albumin level) to establish the modified systemic inflammation score (mSIS) which divides patients into low risk, medium risk or high-risk groups. The 1-year OS rates of three groups were 59.7%, 40.5% and 29.4%, respectively in the training cohort. The same result was verified in the validation cohort with the 1-year OS rates 69.7%, 47.0% and 7.7%, respectively. The mSIS exhibited better discrimination power than the American Joint Committee on Cancer’s (AJCC) 7th T + N staging system in the training cohort (Harrell’s concordance index (C-index): 0.744 vs 0.502, P < 0.05), and the discrimination was also superior to that of AJCC’s 7th T + N staging system in the validation cohort (C-index: 0.724 vs 0.527, P < 0.05). The 1-year and 2-year OS rates of the AUC also exhibited superior survival predictive ability to that of the AJCC’s 7th T + N staging system in NSCLC patients with BM.

Conclusion

The pretreatment mSIS may be an independent prognostic factor for OS in NSCLC patients with BM and warrants further research.
Thrombus-targeted nano-agents for NIR-II diagnostic fluorescence imaging-guided flap thromboembolism multi-model therapy
Authors: Cao Zichen , Zhang Xinyu , Wei Zheng , Song Chuanhui , Zou Huihui , Ran Jianchuan , Zhang Hongbo , Xie Diya , Han Shengwei , Wang Yufeng , Cai Yu , Han Wei
Published: October 2022

In oral and maxillofacial surgery, flap repair is essential to the quality of postoperative life. Still, thrombosis is fatal for the survival of the flaps. Besides, some postoperative thrombotic diseases, such as pulmonary embolism, also intimidate patients’ life. The traditional diagnostic methods are still limited by a large amount of hardware and suffer from inconvenience, delay, and subjectivity. Moreover, the treatments mainly rely upon thrombolytics, such as urokinase (UK) plasminogen activator, which may cause bleeding risk, especially intracerebral hemorrhage. Herein, a kind of poly (lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) containing a first near-infrared window (NIR-I) phototheranostic agent Y8 and urokinase plasminogen activator (UK) as the core, and modified with the fibrin-targeting peptide Gly–Pro–Arg–Pro–Pro (GPRPP) were developed for the flap and postoperative thromboembolism treatment (named GPRPP-Y8U@P). The conjugated molecule Y8 endows GPRPP-Y8U@P with the capacity of NIR-II imaging and excellent photothermal/photodynamic therapeutic effects. In vivo experiments demonstrated that GPRPP-Y8U@P could quickly locate thrombus by NIR-II fluorescence imaging, and semi-quantitative analysis of the embolized blood vessels' paraffin section verified its thrombolytic efficiency. Additionally, the urokinase trapped in the NPs would not result in nonspecific bleeding, tremendously improving physical security and curative effects with minimizing side effects. Overall, the advantages of GPRPP-Y8U@P, such as precise localization of the thrombus, thrombus ablation in the site, and mild side effects, demonstrated the attractiveness of this approach for effective clinical monitoring of thrombus therapy.
TPM1 mediates inflammation downstream of TREM2 via the PKA/CREB signaling pathway
Authors: Li Rong , Zhang Jing , Wang Qiong , Cheng Meng , Lin Bin
Published: October 2022

Background

Microglia, the innate immune cells in the central nervous system, play an essential role in brain homeostasis, neuroinflammation and brain infections. Dysregulated microglia, on the other hand, are associated with neurodegenerative diseases, yet the mechanisms underlying pro-inflammatory gene expression in microglia are incompletely understood.

Methods

We investigated the role of the actin-associated protein tropomyosin 1 (TPM1) in regulating pro-inflammatory phenotype of microglia in the retina by using a combination of cell culture, immunocytochemistry, Western blot, qPCR, TUNEL, RNA sequencing and electroretinogram analysis. TREM2−/− mice were used to investigate whether TPM1 regulated pro-inflammatory responses downstream of TREM2. To conditionally deplete microglia, we backcrossed CX3CR1CreER mice with Rosa26iDTR mice to generate CX3CR1CreER:Rosa26iDTR mice.

Results

We revealed a vital role for TPM1 in regulating pro-inflammatory phenotype of microglia. We found that TPM1 drove LPS-induced inflammation and neuronal death in the retina via the PKA/CREB pathway. TPM1 knockdown ameliorated LPS-induced inflammation in WT retinas yet exaggerated the inflammation in TREM2−/− retinas. RNA sequencing revealed that genes associated with M1 microglia and A1 astrocytes were significantly downregulated in LPS-treated WT retinas but upregulated in LPS-treated TREM2−/− retinas after TPM1 knockdown. Mechanistically, we demonstrated that CREB activated by TPM1 knockdown mediated anti-inflammatory genes in LPS-treated WT retinas but pro-inflammatory genes in LPS-treated TREM2−/− retinas, suggesting a novel role for TREM2 as a brake on TPM1-mediated inflammation. Furthermore, we identified that TPM1 regulated inflammation downstream of TREM2 and in a microglia-dependent manner.

Conclusions

We demonstrate that TPM1 mediates inflammation downstream of TREM2 via the PKA/CREB signaling pathway. Our findings suggest that TPM1 could be a potential target for therapeutic intervention in brain diseases.
Beyond steps per day: other measures of real-world walking after stroke related to cardiovascular risk
Authors: Miller Allison , Collier Zachary , Reisman Darcy S.
Published: October 2022

Background

Significant variability exists in how real-world walking has been measured in prior studies in individuals with stroke and it is unknown which measures are most important for cardiovascular risk. It is also unknown whether real-world monitoring is more informative than laboratory-based measures of walking capacity in the context of cardiovascular risk. The purpose of this study was to determine a subset of real-world walking activity measures most strongly associated with systolic blood pressure (SBP), a measure of cardiovascular risk, in people with stroke and if these measures are associated with SBP after accounting for laboratory-based measures of walking capacity.

Methods

This was a cross-sectional analysis of 276 individuals with chronic (≥ 6 months) stroke. Participants wore an activity monitor for ≥ 3 days. Measures of activity volume, activity frequency, activity intensity, and sedentary behavior were calculated. Best subset selection and lasso regression were used to determine which activity measures were most strongly associated with systolic blood pressure. Sequential linear regression was used to determine if these activity measures were associated with systolic blood pressure after accounting for walking capacity (6-Minute Walk Test).

Results

Average bout cadence (i.e., the average steps/minute across all bouts of walking) and the number of long (≥ 30 min) sedentary bouts were most strongly associated with systolic blood pressure. After accounting for covariates (ΔR2 = 0.089, p < 0.001) and walking capacity (ΔR2 = 0.002, p = 0.48), these activity measures were significantly associated with systolic blood pressure (ΔR2 = 0.027, p = 0.02). Higher systolic blood pressure was associated with older age (β = 0.219, p < 0.001), male gender (β = − 0.121, p = 0.046), black race (β = 0.165, p = 0.008), and a slower average bout cadence (β = − 0.159, p = 0.022).

Conclusions

Measures of activity intensity and sedentary behavior may be superior to commonly used measures, such as steps/day, when the outcome of interest is cardiovascular risk. The relationship between walking activity and cardiovascular risk cannot be inferred through laboratory-based assessments of walking capacity.
The impact of a targeted education package on the knowledge, attitudes, and utilisation of patient reported outcome measures amongst chiropractors in Australia
Authors: Clohesy Natalie , Schneiders Anthony , Barbery Gaery , Obst Steven
Published: October 2022

Background

Patient Reported Outcome Measures (PROMs) have been shown to be valid and reliable indicators of health status and treatment outcomes, however, the current knowledge, understanding, and utilisation of PROMs within the Australian Chiropractic profession is limited. This study used the New World Kirkpatrick Model (NWKM) to evaluate whether an online PROM education package could improve knowledge, confidence, attitude, and utilisation of PROMs by chiropractors in Australia.

Methods

A longitudinal cohort interventional study of chiropractors in Australia. The recruitment phase and data collection period occurred from November 2020 – May 2021. Participants completed three online surveys two weeks before, four weeks after, and 12 weeks after receiving an online education package that included ten evidence-based region-specific modules on PROMs. Survey questions were grouped into five subthemes for analysis according to the NWKM levels: (1) Reaction; (2) Learning - knowledge; (3) Learning – confidence; (4) Behaviour – attitude; (5) and Behaviour - utilisation).

Results

Of the 116 participants that enrolled in the study, 43 completed all three survey and were included in the analysis. There was very positive reaction to the education package with mean response scores (1–5 Likert scale) for the reaction questions ranging from 3.75 to 4.43. There was a small, but significant, increase in knowledge (out of 32) at four weeks (24.3 ± 6.1) and 12 weeks after receiving the education package (27.2 ± 5.5), compared to baseline (27.4 ± 5.1). There was no effect of the intervention on clinician confidence or attitude towards PROMs. Utilisation of function- and pain-related PROMs did not change after the intervention. There was a small and significant (p < 0.05) increase in utilisation of health-related PROMs 12 weeks after the intervention.

Conclusion

Despite modest improvements in knowledge, which were retained 12 weeks after the educational package was provided, there was no evidence that participant confidence, attitude, or utilisation of PROMs changed because of the intervention. While the respondents’ have positive attitudes and beliefs regarding PROMs use, further education surrounding the clinical translation process into clinical practice is required. Caution is advised when interpreting these findings due to the low participant response and completion rate with the potential for selection bias and the inability to generalise the results.