bluuebunny/crossref_metadata_2025 huggingface dataset:
Memory, crisis and democracy in Africa
Authors: Adebayo Sakiru
Published: December 2021

This article provides an overview of the Digital Memory Studies Association (dMSA) online roundtable on “Memory, Crisis, Democracy and Africa” which took place on 21 May 2021. It also details how memory can be understood as a democratic phenomenon in postcolonial Africa and examines, at the same time, various crises of memory that emerge in regimes that undermine democracy on the continent. It ends with reflections on the state of memory studies in Africa and suggests various ways of approaching the study of memory and crisis on the continent.
The COVID-19 crisis chronotope: The pandemic as matter, metaphor and memory
Authors: Parui Avishek , Simi Raj Merin
Published: December 2021

This article draws on the concept of the chronotope – spatiotemporal entanglements theorized in literary and anthropological studies – and extends the same to an engagement with and an understanding of the experiential and ontological defamiliarization, deceleration and suspension of space, time and security generated by the COVID-19 pandemic. This article, thus, offers a study of COVID-19 as a connective metaphor and a crisis chronotope – denoting the un-certain space–time marked and defamiliarized by changed orders and vocabularies of presence, distance, trust, tactility and memory – characterizing a world of alienation, insecurity and fear of infection. In arguing how the globality of COVID-19 has ironically informed isolation, incomplete identification and new fiction-formations, while also foregrounding the difference between human time and planetary time, the article will re-examine the crisis chronotope through a study of sudden death and the defamiliarized public space, exemplified in the city of New Delhi during the second wave of the pandemic in April–May 2021.
Airway Nitric Oxide in Children with HDM-Induced Allergic Rhinitis
Authors: Sutiratanachai Woralak , Kanchongkittiphon Watcharoot , Klangkalya Natchanun , Jotikasthira Wanlapa , Kiewngam Potjanee , Manuyakorn Wiparat
Published: December 2021

Background

Rhinitis is a common problem in children. Airway nitric oxide (NO) was proposed to represent eosinophilic inflammation.

Objectives

To evaluate airway NO level in children with house dust mite (HDM)-induced allergic rhinitis

Methods

Children aged 5 to 18 years old with moderate–severe persistent rhinitis and positive result for the HDM nasal provocation test (NPT) was enrolled. The nasal symptoms evaluated by total nasal symptom score (TNSS) and visual analog scale (VAS) were recorded. Skin prick test (SPT) to common aeroallergens, fractional exhaled nitric oxide (FeNO), nasal nitric oxide (nNO), and blood test for specific IgE (sIgE) to HDM was measured. Rhinitis severity was categorized as severe if the VAS score > 7.

Results

Forty-eight children with HDM-induced allergic rhinitis with the mean age of 9.3 ± 2.4 years were enrolled. nNO levels and VAS score were significantly correlated (R = 0.398, P = .005). Children with severe rhinitis had significantly higher nNO levels than moderate rhinitis (1652.05 vs 941.30 parts per billion [ppb], P = .002), while there was no difference in FeNO level. ROC curve analysis demonstrated the cut-off value of nNO at 1350 ppb (AUC 0.764, 95% CI: 0.616-0.911, P = .002) for detecting severe HDM-induced allergic rhinitis with the sensitivity of 78% and the specificity of 71%. The level of FeNO in children who had HDM mean wheal diameter (MWD) > 8 mm was significantly higher than those with HDM MWD of 3 to 8 mm and those with a negative test (39.7 vs 14.3 vs 14.4 ppb; P = .006, respectively). Children who had sIgE to HDM < 0.35 KUA/L had significantly lower FeNO than those with sIgE to HDM 0.35 to 50 KUA/L and >50 KUA/L (9.5 vs 19.7 vs 40.4 ppb; P = .029, respectively).

Conclusions

Cut-off value for the diagnosis of severe HDM-induced chronic rhinitis was proposed. Rhinitis children who had a higher degree of HDM sensitization had a higher level of FeNO.
A Self-Critical Public: Cumulation of Opinion on Belarusian Oppositional YouTube before the 2020 Protests
Authors: Bodrunova Svetlana S. , Blekanov Ivan S.
Published: December 2021

YouTube-based discussions are a growing area of academic attention. However, we still lack knowledge on whether YouTube provides for forming critical publics in countries with no established democratic tradition. To address this question, we study commenting to Belarusian oppositional YouTube blogs in advance of the major wave of Belarusian post-election protests of 2020. Based on the crawled data of the whole year of 2018 for six Belarusian political videoblogs, we define the structure of the commenters’ community, detect the core commenters, and assess their discourse for aggression, orientation of dialogue, direction of criticism, and antagonism/agonism. We show that, on Belarusian YouTube, the commenters represented a genuine adversarial self-critical public with cumulative patterns of solidarity formation and find markers of readiness for the protest spillover.
Ethical Leadership, Flourishing, and Extra-Role Behavior Among Nurses
Authors: El-Gazar Heba E , Zoromba Mohamed A
Published: December 2021

Introduction

The nursing literature is silent about the relationship between ethical leadership, nurses’ flourishing, and extra-role behavior. This study was carried out to contribute to the relevant field research.

Objective

The aim of the present study was to investigate the relationship between nurses’ perceptions of their nursing managers’ ethical leadership behavior, nurses’ flourishing, and their extra-role behavior.

Methods

This was a cross-sectional study involving 302 nurses from six hospitals in Damietta City, Egypt. Data were collected using the following three self-report scales: Ethical Leadership at Work questionnaire, Flourishing Scale, and extra-role behavior scale. The data were analyzed using descriptive statistical, Pearson correlation, regression analysis and the structure equation model.

Results

There was a significant positive relationship between nursing managers’ ethical leadership, nurses’ flourishing, and extra-role behavior. The regression analysis showed that the ethical leadership of nursing managers and nurses’ flourishing predict extra-role behavior.

Conclusion

Nurses with a high level of flourishing and who work with a manager exhibiting ethical leadership behavior are more likely to activate extra-role behavior. Hence, it is recommended that nursing managers embrace an ethical approach in their leadership practices and promote flourishing among nurses to encourage them to go the extra the mile in their jobs.
Interplay between auditory and visual environments in historic districts: A big data approach based on social media
Authors: Xie Hui , He Yi , Wu Xueying , Lu Yi
Published: December 2021

Historic districts play a vital role in stimulating urban economic development, conserving regional culture, and enhancing public participation. Both auditory and visual environments, and the interplay between them, are critical to visitors’ perception and evaluation of historic districts. However, most studies have explored either the auditory or visual environments separately. The handful of existing studies on audiovisual interaction were confined to laboratory environments, leading to limited external validity. Here, we performed a data-driven study of the features of auditory and visual environments and the interaction between them in 17 historic towns in China using posts containing soundscape-related keywords and streetscape photos from a popular Chinese social media platform. First, we found that the auditory environments in historic districts mainly consist of man-made sounds from folkloric activities, the sounds of street shop vendors, and natural sounds from running water and birds. Second, street greenery, spatial enclosure, and presence of pedestrian in visual environment are positively associated with emotional feedback of the soundscape. This study and others support the importance of studying the auditory and visual environments of historic districts in conjunction. The innovative methods used in this study can be used in further studies in the field.
白川静文字学在海内外的学术影响
Authors: 文莉 出野
Published: December 2021

白川静的文字学说，世称白川文字学，是日本战后具有突出文化功绩的大家。在日本，白川静文字学受到著名小说家宫城谷昌光、五木宽之的称赞。白川静著作中影响最大的是《字统》，该书揭示了作为表象文字的汉字字源具有文化的深远意义。松冈正刚、小山铁郎推出白川静的入门书籍，使白川文字学被世人所知。以白川文字学为中心的文字解释书籍也多数出版，足见白川著作受到广泛认可。在海外，白川静的《金文通释》成为在中国大陆、台湾地区解释金文时成为必须书籍。白川静的著作《汉字百话》、《常用字解》、《诗经的世界》、《孔子》等被翻译成中文，海外读者逐渐提高对白川静的认识程度，但是对于白川静文字学的基本认识还存在没有得到正确理解的部分。本文分析了日本、中国大陆、台湾地区学者对接受白川文字学的不同方式的原因，阐述对于白川文字学在不同国家区域接受现状及接受方式差异的根源。
Prognostic phenotypes of early-stage lung adenocarcinoma
Authors: Lamort Anne-Sophie , Kaiser Jan Christian , Pepe Mario A.A. , Lilis Ioannis , Ntaliarda Giannoula , Somogyi Kalman , Spella Magda , Behrend Sabine J. , Giotopoulou Georgia A. , Kujawa Willem , Lindner Michael , Koch Ina , Hatz Rudolf A. , Behr Juergen , Sotillo Rocio , Schamberger Andrea C. , Stathopoulos Georgios T.
Published: December 2021

Background

Survival after curative resection of early-stage lung adenocarcinoma (LUAD) varies and prognostic biomarkers are urgently needed.

Methods

Large-format tissue samples from a prospective cohort of 200 patients with resected LUAD were immunophenotyped for cancer hallmarks TP53, NF1, CD45, PD-1, PCNA, TUNEL and FVIII, and were followed for a median of 2.34 (95% CI 1.71–3.49) years.

Results

Unsupervised hierarchical clustering revealed two patient subgroups with similar clinicopathological features and genotype, but with markedly different survival: “proliferative” patients (60%) with elevated TP53, NF1, CD45 and PCNA expression had 50% 5-year overall survival, while “apoptotic” patients (40%) with high TUNEL had 70% 5-year survival (hazard ratio 2.23, 95% CI 1.33–3.80; p=0.0069). Cox regression and machine learning algorithms including random forests built clinically useful models: a score to predict overall survival and a formula and nomogram to predict tumour phenotype. The distinct LUAD phenotypes were validated in The Cancer Genome Atlas and KMplotter data, and showed prognostic power supplementary to International Association for the Study of Lung Cancer tumour–node–metastasis stage and World Health Organization histologic classification.

Conclusions

Two molecular subtypes of LUAD exist and their identification provides important prognostic information.
Nanoindentation Characterization of Creep-fatigue Interaction on Local Creep Behavior of P92 Steel Welded Joint
Authors: Song Yuxuan , Ma Yi , Pan Zhouxin , Li Yuebing , Zhang Taihua , Gao Zengliang
Published: December 2021

In modern fossil and nuclear power plants, the components are subjected to creep, fatigue, and creep-fatigue (CF) due to frequent start-up and shut-down operations at high temperatures. The CF interaction on the in-service P92 steel welded joint was investigated by strain-controlled CF tests with different dwell times of 30, 120, 300, 600 and 900 s at 650 °C. Based on the observations of the fracture surface by scanning electron microscope (SEM), the characteristic microstructure of fatigue-induced damage was found for the CF specimens with short dwell times (30 and 120 s). The hardness, elastic modulus and creep deformation near the fracture edges of four typical CF specimens with 30, 120, 600 and 900 s dwell times were measured by nanoindentation. Compared to specimens with post-weld heat treatment (PWHT), lower hardness and creep strength were found for all CF specimens. In addition, significant reductions in hardness, elastic modulus, and creep strength were measured near the fracture edges for the CF specimens with short dwell times compared to the PWHT specimens. Compared to PWHT specimens (0.007), the increased strain rate sensitivities (SRS) of 0.010 to 0.17 were estimated from secondary creep. The increased values of SRS indicate that the room temperature creeps behavior is strongly affected by the decrease in dislocation density after the CF tests.
Comparative study of microbial structure and functional profile of sunflower rhizosphere grown in two fields
Authors: Nwachukwu Blessing Chidinma , Ayangbenro Ayansina Segun , Babalola Olubukola Oluranti
Published: December 2021

Background

Microbial communities inhabiting the rhizosphere play pivotal roles in determining plant health and yield. Manipulation of the rhizosphere microbial community is a promising means to enhance the productivity of economically viable and important agricultural crops such as sunflower (Helianthus annuus). This study was designed to gain insights into the taxonomic and functional structures of sunflower rhizosphere and bulk soil microbiome at two different locations (Sheila and Itsoseng) in South Africa.

Results

Microbial DNA extracted from the sunflower rhizosphere and bulk soils was subjected to next-generation sequencing using 16S amplicon sequencing technique. Firmicutes, Actnobacteria and Proteobacteria predominated sunflower rhizosphere soils. Firmicutes, Cyanobacteria, Deinococcus-Thermus and Fibrobacteres were positively influenced by Na+ and clay content, while Actinobacteria, Thaumarchaeota, Bacteroidetes, Planctomycetes, Aquificae and Chloroflexi were positively influenced by soil resistivity (Res) and Mg2+. The community-level physiological profiling (CLPP) analysis showed that the microbial communities in SHR and ITR used the amino acids tryptophan and malic acid efficiently. The metabolisms of these carbon substrates may be due to the dominant nature of some of the organisms, such as Actinobacteria in the soils.

Conclusion

The CLPP measurements of soil from sunflower rhizosphere were different from those of the bulk soil and the degree of the variations were based on the type of carbon substrates and the soil microbial composition. This study has shown the presence of certain taxa of rhizobacteria in sunflower rhizosphere which were positively influenced by Na+ and Mg2+, and taxa obtained from SHR and ITR were able to effectively utilized tryptophan and malic acid. Many unclassified microbial groups were also discovered and it is therefore recommended that efforts should further be made to isolate, characterize and identify these unclassified microbial species, as it might be plausible to discover new microbial candidates that can further be harnessed for biotechnological purpose.
Phytophthora infestans RXLR effector Pi04089 perturbs diverse defense-related genes to suppress host immunity
Authors: Luo Ming , Sun Xinyuan , Qi Yetong , Zhou Jing , Wu Xintong , Tian Zhendong
Published: December 2021

Background

The oomycete pathogen secretes many effectors into host cells to manipulate host defenses. For the majority of effectors, the mechanisms related to how they alter the expression of host genes and reprogram defenses are not well understood. In order to investigate the molecular mechanisms governing the influence that the Phytophthora infestans RXLR effector Pi04089 has on host immunity, a comparative transcriptome analysis was conducted on Pi04089 stable transgenic and wild-type potato plants.

Results

Potato plants stably expressing Pi04089 were more susceptible to P. infestans. RNA-seq analysis revealed that 658 upregulated genes and 722 downregulated genes were characterized in Pi04089 transgenic lines. A large number of genes involved in the biological process, including many defense-related genes and certain genes that respond to salicylic acid, were suppressed. Moreover, the comparative transcriptome analysis revealed that Pi04089 significantly inhibited the expression of many flg22 (a microbe-associated molecular pattern, PAMP)-inducible genes, including various Avr9/Cf-9 rapidly elicited (ACRE) genes. Four selected differentially expressed genes (StWAT1, StCEVI57, StKTI1, and StP450) were confirmed to be involved in host resistance against P. infestans when they were transiently expressed in Nicotiana benthamiana.

Conclusion

The P. infestans effector Pi04089 was shown to suppress the expression of many resistance-related genes in potato plants. Moreover, Pi04089 was found to significantly suppress flg22-triggered defense signaling in potato plants. This research provides new insights into how an oomycete effector perturbs host immune responses at the transcriptome level.
Parents’ pandemic NICU experience in the United States: a qualitative study
Authors: Vance Ashlee J. , Malin Kathryn J. , Miller Jacquelyn , Shuman Clayton J. , Moore Tiffany A. , Benjamin Annella
Published: December 2021

Background

Prior to the COVID-19 pandemic, parents of infants in the Neonatal Intensive Care Unit (NICU) frequently reported high levels of stress, uncertainty, and decreased parenting confidence. Early research has demonstrated that parents have had less access to their infants in the hospital due to restrictions on parental presence secondary to the pandemic. It is unknown how parents have perceived their experiences in the NICU since the beginning of the COVID-19 pandemic. The purpose of this study was to describe the lived experience of parents who had an infant in the NICU in the context of the COVID-19 pandemic to inform healthcare providers and policy makers for future development of policies and care planning.

Methods

The study design was a qualitative description of the impact of the COVID-19 pandemic on parents’ experiences of having an infant in the NICU. Free-text responses to open-ended questions were collected as part of a multi-method study of parents’ experiences of the NICU during the first six months of the pandemic. Participants from the United States were recruited using social media platforms between the months of May and July of 2020. Data were analyzed using a reflexive thematic approach.

Findings

Free-text responses came from 169 parents from 38 different states in the United States. Three broad themes emerged from the analysis: (1) parents’ NICU experiences during the COVID-19 pandemic were emotionally isolating and overwhelming, (2) policy changes restricting parental presence created disruptions to the family unit and limited family-centered care, and (3) interactions with NICU providers intensified or alleviated emotional distress felt by parents. A unifying theme of experiences of emotional distress attributed to COVID-19 circumstances ran through all three themes.

Conclusions

Parents of infants in the NICU during the first six months of the COVID-19 pandemic experienced emotional struggles, feelings of isolation, lack of family-centered care, and deep disappointment with system-level decisions. Moving forward, parents need to be considered essential partners in the development of policies concerning care of and access to their infants.
The cognitive impairment and risk factors of the older people living in high fluorosis areas: DKK1 need attention
Authors: Ren Chao , Zhang Peng , Yao Xiao-Yan , Li Hui-Hua , Chen Rui , Zhang Cai-Yi , Geng De-Qin
Published: December 2021

Objective

To evaluate cognitive impairment and risk factors of elders in high fluoride drinking water areas and investigate whether DKK1 is involved in this disorder.

Methods

MoCA-B and AD-8 were used to measure the cognitive functions of 272 and 172 subjects over the age of 60 came from the high and normal fluoride drinking water areas respectively, general information and peripheral blood were collected, the level of SOD, GSH and MDA were measured, mRNA level of DKK1, the concentration of blood fluoride and the polymorphism of APOE were tested.

Results

The blood fluoride concentration, mRNA level of DKK1 and ratio of abnormal cognitive function of subjects in high fluorine drinking water areas were higher than those in normal areas. The level of SOD of subjects in high fluorine drinking water was low compared with those in normal areas. The level of MDA and GSH had no difference between the two crowds in different fluorine drinking water areas. There were differences in cigarette smoking, education, dental status, hypertension, hyperlipidaemia and APOE results between the two crowds in different fluorine drinking water areas. The mRNA level of DKK1 and the level of cognitive function showed a positive correlation and DKK1 was one of five risk factors involved in cognitive impairment of older people living in high fluorosis areas.

Conclusions

The cognitive functions could be impaired in the older people living in high fluoride drinking water areas, and DKK1 may as a potential intervention point of this brain damage process need attention.
Vascular involvement in chronic thromboembolic pulmonary hypertension is associated with spirometry obstructive impairment
Authors: Yanagisawa Asako , Naito Akira , Jujo-Sanada Takayuki , Tanabe Nobuhiro , Ishida Keiichi , Matsumiya Goro , Suda Rika , Kasai Hajime , Sekine Ayumi , Sugiura Toshihiko , Shigeta Ayako , Sakao Seiichiro , Tatsumi Koichiro , Suzuki Takuji
Published: December 2021

Background

Chronic thromboembolic pulmonary hypertension (CTEPH) is a type of pulmonary hypertension caused by persistent thromboembolism of the pulmonary arteries. In clinical practice, CTEPH patients often show obstructive ventilatory impairment, even in the absence of a smoking history. Recent reports imply a tendency for CTEPH patients to have a lower FEV1.0; however, the mechanism underlying obstructive impairment remains unknown.

Methods

We retrospectively analyzed CTEPH patients who underwent a pulmonary function test and respiratory impedance test to evaluate their exertional dyspnea during admission for right heart catheterization from January 2000 to December 2019. We excluded patients with a smoking history to rule out the effect of smoking on obstructive impairment.

Results

A total of 135 CTEPH patients were analyzed. The median FEV1.0/FVC was 76.0%, %FEV 1.0 had a negative correlation with the mean pulmonary artery pressure and pulmonary vascular resistance and the CT Angiogram (CTA) obstruction score. A multivariate regression analysis revealed that the CTA obstruction score was an independent factor of a lower %FEV1.0. In the 54 patients who underwent pulmonary endarterectomy, %FEV1.0 was improved in some cases and was not in some. Mean PAP largely decreased after PEA in the better %FEV1.0 improved cases, suggesting that vascular involvement in CTEPH could be associated with spirometry obstructive impairment.

Conclusion

%FEV1.0 had a significant correlation with the CTA obstruction score. Obstructive impairment might have an etiological relationship with vascular involvement. Further investigations could shed new light on the etiology of CTEPH.
Determinants of desire for more children among women in Ethiopia
Authors: Muluneh Mitiku Wale , Moyehodie Yikeber Abebaw
Published: December 2021

Background

Desire for more children has an impact on couple’s fertility behaviors. It can be a precursor of actual fertility performance. However, the desire for more children is declining over time in Ethiopia. Therefore, this study aimed to identifying the determinants of the desire for more children among women in Ethiopia.

Methods

The 2016 Ethiopian Demographic and Health Survey data were used for the analysis. The sample consisted of 15,683 women. The binary logistic regression model was used to assess the determinants of desire for more children among women in Ethiopia. The results are presented as crude odds ratios (COR) and adjusted odds ratios (AOR) together with their corresponding 95% confidence intervals.

Results

No education (having no formal education) (AOR = 1.85, 95% CI 1.61–2.13), attained primary education (AOR = 1.62, 95% CI 1.43–1.83), age at first marriage 10–19 years (AOR = 1.80, 95% CI 1.27–2.54), Orthodox religion (AOR = 1.48, 95% CI 1.01–2.19), Catholic religion (AOR = 2.15, 95% CI 1.17–3.97), Muslim religion (AOR = 1.70, 95% CI 1.15–2.50), living in Amhara (AOR = 1.45, 95% CI 1.18–1.78), Oromia (AOR = 2.10, 95% CI 1.73–2.54), Benishangul (AOR = 1.17, 95% CI 1.01–1.45), SNNPR (AOR = 1.30, 95% CI 1.05–1.60), Gambela (AOR = 1.25, 95% CI 1.02–1.57), Harari (AOR = 2.24, 95% CI 1.82–2.76), ideal number of children four or fewer (AOR = 0.47, 95% CI 0.42–0.53), number of living children four or fewer (AOR = 2.12, 95% CI 1.90–2.37), and not use of contraceptives (AOR = 1.51, 95% CI 1.35–1.68) were associated with a higher desire for more children.

Conclusion

This finding showed that the age of women, educational level, age at first marriage, religion, region, occupation, ideal number of children, number of living children, and use of contraceptives were significant determinants of desire for more children. Therefore, it is important to adopt programs to encourage the desire for more children, implement policies in an attempt to increase the total fertility rate in Ethiopia ought to critically consider these factors. Moreover, continuous education and knowledge on reproductive health will help for better fertility behaviour for the women.
Application of blended teaching model based on SPOC and TBL in dermatology and venereology
Authors: Zeng Jinrong , Liu Liyao , Tong Xiaoliang , Gao Lihua , Zhou Lu , Guo Aiyuan , Tan Lina
Published: December 2021

Background

In this study, we applied the small private online course (SPOC) and team-based learning (TBL) blended teaching model to dermatology and venereology to ensure a higher quality learning experience for clinical medical students.

Methods

A total of 52 fifth-grade clinical undergraduates from Xiangya School of Medicine of Central South University were randomly divided into an experimental (n= 26) and a control group (n= 26). In March 2018, we used the SPOC and TBL blended teaching model in the experimental group and explored the effects of innovative teaching in the dermatology and venereology course, compared with the control group receiving the conventional teaching method. We analyzed the two groups’ theoretical assessment scores and questionnaire results to evaluate the efficiency of the new pedagogy.

Results

Students in the experimental group had a better understanding than the control group of the dermatology and venereology content and higher scores on the case analysis questions in the final theoretical examination. The results revealed that the majority of the experimental group students agreed that the novel teaching model blended with SPOC&TBL helped them significantly stimulate motivation and develop their ability in self-directed learning, independent thinking, literature retrieval, presentation board, teamwork, communication, and systematic clinical thinking. The teaching satisfaction survey of the two groups showed that the students’ satisfaction in the experimental group was significantly higher than in the control group (p< 0.05).

Conclusions

The SPOC&TBL teaching model is better than the traditional one in enriching students’ professional knowledge and cultivating their comprehensive ability. It can effectively promote educational quality, improve students’ learning effects, and enhance their satisfaction. This method has broad application prospects.
Evaluation of pediatric rheumatology telehealth satisfaction during the COVID-19 pandemic
Authors: Waqar-Cowles Lindsay N. , Chuo John , Weiss Pamela F. , Gmuca Sabrina , LaNoue Marianna , Burnham Jon M.
Published: December 2021

Background

During the Coronavirus disease 2019 pandemic, ambulatory pediatric rheumatology healthcare rapidly transformed to a mainly telehealth model. However, pediatric patient and caregiver satisfaction with broadly deployed telehealth programs remains largely unknown. This study aimed to evaluate patient/caregiver satisfaction with telehealth and identify the factors associated with satisfaction in a generalizable sample of pediatric rheumatology patients.

Methods

Patients with an initial telehealth video visit with a rheumatology provider between April and June 2020 were eligible. All patients/caregivers were sent a post-visit survey to assess a modified version of the Telehealth Usability Questionnaire (TUQ) and demographic and clinical characteristics. TUQ total and sub-scale (usefulness, ease of use, effectiveness, satisfaction) scores were calculated and classified as “positive” based on responses of “agree” or “strongly agree” on a 5-point Likert scale. Results were analyzed using standard descriptive statistics and Wilcoxon signed rank testing. The association between demographic and clinical characteristics with TUQ scores was assessed using univariate linear regression.

Results

597 patients/caregivers met inclusion criteria, and the survey response rate was 42% (n = 248). Juvenile idiopathic arthritis was the most common diagnosis (33.5%). The majority of patients were diagnosed greater than 6 months previously (72.6%) and were prescribed chronic medications (59.7%). The median total TUQ score was 4 (IQR: 4–5) with positive responses in 81% of items. Of the subscales, usefulness scores were lowest (median: 4, p < 0.001). Telehealth saves time traveling was the highest median item score (median = 5, IQR: 4–5). Within subscales, items that scored significantly lower included convenience, providing for needs, seeing rheumatologist as well as in person, and being an acceptable way to receive rheumatology services (all p < 0.001). There were no significant demographic or clinical features associated with TUQ scores.

Conclusions

Our results suggest telehealth is a promising mode of healthcare delivery for pediatric rheumatic diseases but also identifies opportunities for improvement. Innovation and research are needed to design a telehealth system that delivers high quality and safe care that improves healthcare outcomes. Since telehealth is a rapidly emerging form of pediatric rheumatology care, improved engagement and training of patients, caregivers, and providers may help improve the patient experience in the future.
Bispecific antibody-activated T cells enhance NK cell-mediated antibody-dependent cellular cytotoxicity
Authors: Wang Zhaoming , Yin Chaobo , Lum Lawrence G. , Simons Andrean , Weiner George J.
Published: December 2021

Resistance to anti-cancer monoclonal antibody (mAb) therapy remains a clinical challenge. Previous work in our laboratory has shown that T cell help in the form of interleukin-2 maintains long-term NK cell viability and NK cell-mediated antibody-dependent cellular cytotoxicity (ADCC). Lack of such T cell help may be a potential mechanism for resistance to mAb therapy. Here, we evaluate whether concomitant treatment with anti-CD3 × anti-cancer bispecific antibodies (bsAbs) can overcome this resistance by enhancing T cell help, and thereby maintaining long-term NK cell-mediated ADCC. Normal donor peripheral blood mononuclear cells were depleted of T cells, replenished with defined numbers of autologous T cells (from 0.75 to 50%) and co-cultured with mono-/bispecific antibody-treated target tumor cells for up to 7 days. At low T cell concentrations, bsAb-activated T cells (mainly CD4+ T cells) were more effective than resting T cells at maintaining NK cell viability and ADCC. Brief (4 h to 2 day) bsAb exposure was sufficient to enhance long-term ADCC by NK cells. These findings raise the hypothesis that local T cell activation mediated by systemic treatment with anti-CD3 X anti-cancer bsAb may enhance the anti-tumor efficacy of monospecific mAbs that mediate their primary therapeutic effect via NK-mediated ADCC.
Programmed genomic instability regulates neural transdifferentiation of human brain microvascular pericytes
Authors: Rezaei-Lotfi Saba , Vujovic Filip , Simonian Mary , Hunter Neil , Farahani Ramin M.
Published: December 2021

Background

Transdifferentiation describes transformation in vivo of specialized cells from one lineage into another. While there is extensive literature on forced induction of lineage reprogramming in vitro, endogenous mechanisms that govern transdifferentiation remain largely unknown. The observation that human microvascular pericytes transdifferentiate into neurons provided an opportunity to explore the endogenous molecular basis for lineage reprogramming.

Results

We show that abrupt destabilization of the higher-order chromatin topology that chaperones lineage memory of pericytes is driven by transient global transcriptional arrest. This leads within minutes to localized decompression of the repressed competing higher-order chromatin topology and expression of pro-neural genes. Transition to neural lineage is completed by probabilistic induction of R-loops in key myogenic loci upon re-initiation of RNA polymerase activity, leading to depletion of the myogenic transcriptome and emergence of the neurogenic transcriptome.

Conclusions

These findings suggest that the global transcriptional landscape not only shapes the functional cellular identity of pericytes, but also stabilizes lineage memory by silencing the competing neural program within a repressed chromatin state.
Development of a core outcome set (COS) for studies relating to awareness and clinical management of reduced fetal movement: study protocol
Authors: Hayes Dexter J. L. , Devane Declan , Dumville Jo C. , Smith Valerie , Walsh Tanya , Heazell Alexander E. P.
Published: December 2021

Background

Concerns regarding reduced fetal movements (RFM) are reported in 5–15% of pregnancies, and RFM are associated with adverse pregnancy outcomes including fetal growth restriction and stillbirth. Studies have aimed to improve pregnancy outcomes by evaluating interventions to raise awareness of RFM in pregnancy, such as kick counting, evaluating interventions for the clinical management of RFM, or both. However, there is not currently a core outcome set (COS) for studies of RFM. This study aims to create a COS for use in research studies that aim to raise awareness of RFM and/or evaluate interventions for the clinical management of RFM.

Methods

A systematic review will be conducted, to identify outcomes used in randomised and non-randomised studies with control groups that aimed to raise awareness of RFM (for example by using mindfulness techniques, fetal movement counting, or other tools such as leaflets or mobile phone applications) and/or that evaluated the clinical management of RFM.

An international Delphi consensus will then be used whereby stakeholders will rate the importance of the outcomes identified in the systematic review in (i) awareness and (ii) clinical management studies. The preliminary lists of outcomes will be discussed at a consensus meeting where one final COS for awareness and management, or two discrete COS (one for awareness and one for management), will be agreed upon.

Discussion

A well-developed COS will provide researchers with the minimum set of outcomes that should be measured and reported in studies that aim to quantify the effects of interventions.
Teaching reproducible research for medical students and postgraduate pharmaceutical scientists
Authors: Meid Andreas D.
Published: December 2021

In medicine and other academic settings, (doctoral) students often work in interdisciplinary teams together with researchers of pharmaceutical sciences, natural sciences in general, or biostatistics. They should be fundamentally taught good research practices, especially in terms of statistical analysis. This includes reproducibility as a central aspect. Acknowledging that even experienced researchers and supervisors might be unfamiliar with necessary aspects of a perfectly reproducible workflow, a lecture series on reproducible research (RR) was developed for young scientists in clinical pharmacology. The pilot series highlighted definitions of RR, reasons for RR, potential merits of RR, and ways to work accordingly. In trying to actually reproduce a published analysis, several practical obstacles arose. In this article, reproduction of a working example is commented to emphasize the manifold facets of RR, to provide possible explanations for difficulties and solutions, and to argue that harmonized curricula for (quantitative) clinical researchers should include RR principles. These experiences should raise awareness among educators and students, supervisors and young scientists. RR working habits are not only beneficial for ourselves or our students, but also for other researchers within an institution, for scientific partners, for the scientific community, and eventually for the public profiting from research findings.
The ENmix DNA methylation analysis pipeline for Illumina BeadChip and comparisons with seven other preprocessing pipelines
Authors: Xu Zongli , Niu Liang , Taylor Jack A.
Published: December 2021

Background

Illumina DNA methylation arrays are high-throughput platforms for cost-effective genome-wide profiling of individual CpGs. Experimental and technical factors introduce appreciable measurement variation, some of which can be mitigated by careful “preprocessing” of raw data.

Methods

Here we describe the ENmix preprocessing pipeline and compare it to a set of seven published alternative pipelines (ChAMP, Illumina, SWAN, Funnorm, Noob, wateRmelon, and RnBeads). We use two large sets of duplicate sample measurements with 450 K and EPIC arrays, along with mixtures of isogenic methylated and unmethylated cell line DNA to compare raw data and that preprocessed via different pipelines.

Results

Our evaluations show that the ENmix pipeline performs the best with significantly higher correlation and lower absolute difference between duplicate pairs, higher intraclass correlation coefficients (ICC) and smaller deviations from expected methylation level in mixture experiments. In addition to the pipeline function, ENmix software provides an integrated set of functions for reading in raw data files from mouse and human arrays, quality control, data preprocessing, visualization, detection of differentially methylated regions (DMRs), estimation of cell type proportions, and calculation of methylation age clocks. ENmix is computationally efficient, flexible and allows parallel computing. To facilitate further evaluations, we make all datasets and evaluation code publicly available.

Conclusion

Careful selection of robust data preprocessing methods is critical for DNA methylation array studies. ENmix outperformed other pipelines in our evaluations to minimize experimental variation and to improve data quality and study power.
A likelihood ratio test for the homogeneity of between-study variance in network meta-analysis
Authors: Hu Dapeng , Wang Chong , O’Connor Annette M.
Published: December 2021

Background

Network meta-analysis (NMA) is a statistical method used to combine results from several clinical trials and simultaneously compare multiple treatments using direct and indirect evidence. Statistical heterogeneity is a characteristic describing the variability in the intervention effects being evaluated in the different studies in network meta-analysis. One approach to dealing with statistical heterogeneity is to perform a random effects network meta-analysis that incorporates a between-study variance into the statistical model. A common assumption in the random effects model for network meta-analysis is the homogeneity of between-study variance across all interventions. However, there are applications of NMA where the single between-study assumption is potentially incorrect and instead the model should incorporate more than one between-study variances.

Methods

In this paper, we develop an approach to testing the homogeneity of between-study variance assumption based on a likelihood ratio test. A simulation study was conducted to assess the type I error and power of the proposed test. This method is then applied to a network meta-analysis of antibiotic treatments for Bovine respiratory disease (BRD).

Results

The type I error rate was well controlled in the Monte Carlo simulation. We found statistical evidence (p value = 0.052) against the homogeneous between-study variance assumption in the network meta-analysis BRD. The point estimate and confidence interval of relative effect sizes are strongly influenced by this assumption.

Conclusions

Since homogeneous between-study variance assumption is a strong assumption, it is crucial to test the validity of this assumption before conducting a network meta-analysis. Here we propose and validate a method for testing this single between-study variance assumption which is widely used for many NMA.
Effect of commuting on the risk of COVID-19 and COVID-19-induced anxiety in Japan, December 2020
Authors: Ando Hajime , Ikegami Kazunori , Nagata Tomohisa , Tateishi Seiichiro , Eguchi Hisashi , Tsuji Mayumi , Matsuda Shinya , Fujino Yoshihisa , Ogami Akira ,   for the CORoNaWork Project
Published: December 2021

Background

To prevent the spread of coronavirus disease (COVID-19), it is important to avoid 3Cs (closed spaces, crowded places, and close-contact settings). However, the risk of contact with an unspecified number of people is inevitable while commuting to and from work. In this study, we investigated the relationship between commuting, and the risk of COVID-19 and COVID-19-induced anxiety.

Methods

An internet-based questionnaire survey was conducted to obtain a dataset from 27,036 respondents. One-way commuting time was evaluated using a five-case method. The commuting distance was estimated using zip codes of the home and workplace. Logistic regression analysis was performed with the following outcomes: COVID-19 risk, close contact, infection anxiety, and infection anxiety due to commuting. Commuting distance and commuting time were analyzed separately in the model. We excluded participants with incalculable commuting distance, commuting distance exceeding 300 km, commuting distance of 0 km, or who telecommuted at least once a week.

Results

The total number of participants included in the analysis was 14,038. The adjusted odds ratios (aORs) of using public transportation for severe acute respiratory syndrome coronavirus 2 infection were 4.17 (95% confidence interval [CI]: 2.51–6.93) (commuting time) and 5.18 (95% CI: 3.06–8.78) (commuting distance). The aOR of COVID-19 diagnosis decreased significantly with increasing commuting distance. The aORs of using public transportation to infection anxiety were 1.44 (95% CI: 1.31–1.59) (commuting time) and 1.45 (95% CI: 1.32–1.60) (commuting distance). The longer the commuting time, the more the aOR increased.

Conclusions

COVID-19 risk, close contact, and infection anxiety were all associated with the use of public transportation during commuting. Both commuting distance and time were associated with infection anxiety due to commuting, and the strength of the association increased with increase in commuting time distance. Since transportation by commuting is associated with COVID-19 risk and anxiety, we recommend the use of telecommuting and other means of work.
Electroencephalography-demonstrated mechanisms of dexmedetomidine-mediated deepening of propofol anesthesia: an observational study
Authors: Zhang Lei , Fang Kun , Tao Shengwei , Deng Liyun , Li Hua , Cao Yuanyuan , Wang Lei , Yu Fengqiong , Gu Erwei
Published: December 2021

Background

Although dexmedetomidine (Dex) is known to reduce bispectral index (BIS) values and propofol dosage, there is little information regarding raw electroencephalography (EEG) changes related to Dex deepening of propofol general anesthesia (GA). This study investigated the Dex effects on propofol GA via analysis of EEG changes.

Methods

A study cohort of 21 surgical patients (age range, 20–60 years) categorized as American Society of Anesthesiologists (ASA) class I or II was enrolled. We used time-varying spectral and bicoherence methods to compare electroencephalogram signatures 5 min before versus 10 min after intravenous Dex injection under propofol GA. The means and medians are reported with 95% confidence intervals (CIs) and inter-quartile ranges (IQRs), respectively.

Results

Dex augmented the slow waves power and theta (θ) oscillation bicoherence peak from a mean (95% CI) of 22.1% (19.0, 25.2) to 25.2% (21.8, 28.6). Meanwhile, Dex reduced alpha (α) peak power and bicoherence from 3.5 dB (1.0, 6.0) and 41.5% (34.0, 49.0) to 1.7 dB (− 0.6, 4.0) and 35.4% (29.0, 41.8), respectively, while diminishing the median frequency of α oscillation peak values and the mean frequency of α peaks in bicoherence spectra from 12.0 Hz (IQR 11.2, 12.6) and 11.7 Hz (11.3, 12.2) to 11.1 Hz (IQR 10.3, 11.8) and 11.2 Hz (10.9, 11.6), respectively.

Conclusions

Profound EEG changes support the supposition that Dex enhances propofol-induced GA from a moderate to a deeper state. The present findings provide a theoretical basis and reference regarding protocols aimed at reducing anesthetic/sedative dosage while maintaining sufficient depth of GA.

Clinical trial registration

ChiCTR, ChiCTR1900026955. Registered on 27 October 2019
PIG-A gene mutation as a genotoxicity biomarker in polycyclic aromatic hydrocarbon-exposed barbecue workers
Authors: Cao Yiyi , Xi Jing , Tang Chuanxi , Yang Ziying , Liu Weiying , You Xinyue , Feng Nannan , Zhang Xin Yu , Wu Jingui , Yu Yingxin , Luan Yang
Published: December 2021

Background

The PIG-A gene mutation assay is a valuable tool for measuring in vivo gene mutations in blood cells. The human PIG-A assay, used as a potential genotoxicity biomarker, is minimally invasive, sensitive, and cost-efficient; however, the relationship between carcinogen exposure and PIG-A mutations is not well understood.

Methods

We investigated the genotoxic effect of red blood cells using PIG-A assay and lymphocyte cytokinesis-block micronucleus test in barbecue restaurant workers (N = 70) exposed to polycyclic aromatic hydrocarbons (PAHs) and self-identified healthy control subjects (N = 56). Urinary PAH metabolites were measured to evaluate internal exposure levels.

Results

Multivariate Poisson regression showed that the PAH-exposed workers exhibited significantly higher PIG-A mutant frequency (MF) (8.04 ± 6.81 × 10− 6) than did the controls (5.56 ± 5.26 × 10− 6) (RR = 0.707, 95% CI: 0.615–0.812, P < 0.001). These results indicate that PAH exposure is a risk factor for elevated PIG-A MF. The frequencies of micronuclei (MN) and nuclear buds (NBUD) in the PAH-exposed workers (MN: 3.06 ± 2.07 ‰, NBUD: 1.38 ± 1.02 ‰) were also significantly higher than in the controls (MN: 1.46 ± 0.64 ‰, P < 0.001; NBUD: 0.70 ± 0.60 ‰, P < 0.001). Additionally, PIG-A MFs showed better associations with several urinary hydroxylated PAH metabolites (P2-OH-Flu = 0.032, r2-OH-Flu = 0. 268; P2-OH-Phe = 0.022, r2-OH-Phe = 0.286; P3-OH-Phe = 0.0312, r3-OH-Phe = 0.270; P4-OH-Phe = 0.018, r4-OH-Phe = 0.296), while the increase in MN, NPB, and NBUD frequencies was not associated with any OH-PAH metabolites; and high-PAH-exposed workers showed the highest PIG-A MFs. Furthermore, there was a significant association between PIG-A MF and PAH exposure levels (Chi-square test for trend, P = 0.006).

Conclusions

Our results indicate that an increase in PIG-A MF in barbecue workers could reflect the response to PAH exposure, providing evidence of its potential as a genotoxicity biomarker in human risk assessment.