bluuebunny/crossref_metadata_2025 huggingface dataset:
Default Rules Theory: Implications on Teaching Contract Law in India
Authors: Srinivasan Badrinath , Yadav Seema
Published: May 2022

There is a wide gap between what is taught in classroom and that which is practised in law: this is an oft-made complaint. Various efforts have been taken in India to bridge this gap, but such efforts have not been regarded as adequate. How this serious shortcoming can be addressed has been the subject of various debates, not only in India but also world-over. Numerous solutions have been proposed to address this issue. There can be no single answer to the various challenges that this gap poses. One such solution is the default rules theory. This article explores the potential of default rules theory in bridging the gap between law as taught in the classroom and law in practice. It explains with illustrations how the theory can promote better understanding of contract law doctrines in action and enable a nuanced critique of contract law. This article argues that legal academia misses out by not including the default rules theory in legal analysis and critique.
Paper 20: Clinical Outcomes and Return to Sport in Patients Undergoing Osteochondral Allograft
Authors: Markus Danielle , Blaeser Anna , Manjunath Amit , Duenes Matthew , Campbell Kirk , Jazrawi Laith , Strauss Eric , Hurley Eoghan
Published: May 2022

Objectives:

The purpose of the current study was to evaluate the clinical outcomes and rates of return to play in patients who underwent an osteochondral allograft (OCA) procedure for a symptomatic osteochondral defect in the knee.

Methods:

A retrospective review of patients who underwent an OCA for an osteochondral defect of the knee, between June 2011 and March 2019 was performed. Return to play, the level of return and the timing of return were assessed. Additionally, the reasons for being unable to return were evaluated. A p-value of < 0.05 was considered to be statistically significant.

Results:

Overall, there were 103 patients who underwent OCA at our institution and met our inclusion and exclusion criteria. The mean age was 31.8 ± 11 years, and 63.9% were male, with a mean of 44.2 ± 23.3 month follow-up. The overall rate of return to play was found to be 63.1% (N=65), while the rate of RTP at the same or higher level was 32.0% (N = 33). With respect to the patients who were unable to return to their desired sport, reasons cited included pain in the operative knee (N = 18, 47.3%), physical inability to perform in the desired sport (N = 8, 21.1%), and fear of re-injury (N = 6, 15.8%).

Conclusions:

Overall, there was a poor rate of return to play following OCA. Additionally, the majority of patients were unable to return to play at their pre-injury level.
Preventing post-stroke dementia. The MARCH Trial. Protocol and statistical analysis plan of a randomized clinical trial testing the safety and efficacy of Maraviroc in post-stroke cognitive impairment
Authors: Assayag Einor Ben , Molad Jeremy , Seyman Estelle , Rotschild Ofer , Zeltzer Ehud , Sadeh-Gonik Udi , Bregman Noa , Alpernas Aviva , Segal Yahel , Bashat Dafna Ben , Nathan Talya , Hawwari Muhamad , Tene Oren , Hallevi Hen
Published: May 2022

Background:

Current evidence suggest that 25%–33% of stroke-survivors develop post-stroke cognitive impairment (PSCI). The licensed drug Maraviroc, a CCR5-antagonist, is postulated to act via a neuroprotective mechanism that may offer the potential of preventing progression to vascular dementia. Our hypothesis: Maraviroc may have the potential to augment learning skills and cognitive performance by affecting synaptic plasticity, along with neuro-inflammatory modulation in patients with cerebral small vessel disease (SVD) and PSCI.

Design:

MARCH is a multi-center, double-blind randomized-control Phase-II trial of Maraviroc 150 or 600 mg/day versus placebo for 12-months in five stroke centers in Israel. Included are patients diagnosed with recent (1–24 months) subcortical stroke who experience mild PSCI and have evidence of white matter lesions and SVD on neuroimaging.

Outcomes:

Primary outcomes: 1. Change in cognitive scores. 2. Drug related adverse events. Secondary outcomes: change in functional and affective scores, MRI-derived measures, inflammatory markers, carotid atherosclerosis, cerebrospinal-fluid biomarkers in a sub-study. A sample size of 60 in each treatment group and 30 in the placebo group (total – 150 participants) provides 80% power between the treatment and the placebo groups.

Conclusions:

The results of this work could lead to a novel, readily available, therapeutic avenue to reduce PSCI, and possibly other pathologies. This study will test safety and effectiveness of Maraviroc in limiting cognitive deterioration and/or post stroke cognitive impairment in patients with cerebral small vessel disease.

Schedule:

First-patient first-visit was May 2021. Recruitment to complete in 2023, follow-up to complete in 2024.
p16INK4A-dependent senescence in the bone marrow niche drives age-related metabolic changes of hematopoietic progenitors
Authors: Hellmich Charlotte , Wojtowicz Edyta , Moore Jamie A. , Mistry Jayna J. , Jibril Aisha , Johnson Benjamin B. , Smith James G. W. , Beraza Naiara , Bowles Kristian M. , Rushworth Stuart A.
Published: May 2022

Rapid and effective leukocyte response to infection is a fundamental function of the bone marrow (BM). However, with increasing age, this response becomes impaired, resulting in an increased burden of infectious diseases. Here, we investigate how aging changes the metabolism and function of hematopoietic progenitor cells (HPCs) and the impact of the BM niche on this phenotype. We found that, in response to lipopolysaccharide-induced stress, HPC mitochondrial function is impaired, and there is a failure to upregulate the TCA cycle in progenitor populations in aged animals compared with young animals. Furthermore, aged mesenchymal stromal cells (MSCs) of the BM niche, but not HPCs, exhibit a senescent phenotype, and selective depletion of senescent cells from the BM niche, as well as treatment with the senolytic drug ABT-263, improves mitochondrial function of HPCs when stressed with lipopolysaccharide. In summary, age-related HPC metabolic dysfunction occurs indirectly as a “bystander phenomenon” in the aging BM niche and can be restored by targeting senescent MSCs.
Identification and characterization of RBM12 as a novel regulator of fetal hemoglobin expression
Authors: Wakabayashi Aoi , Kihiu Maryanne , Sharma Malini , Thrasher A. Josephine , Saari Megan S. , Quesnel-Vallières Mathieu , Abdulmalik Osheiza , Peslak Scott A. , Khandros Eugene , Keller Cheryl A. , Giardine Belinda M. , Barash Yoseph , Hardison Ross C. , Shi Junwei , Blobel Gerd A.
Published: May 2022

The fetal-to-adult hemoglobin transition is clinically relevant because reactivation of fetal hemoglobin (HbF) significantly reduces morbidity and mortality associated with sickle cell disease (SCD) and β-thalassemia. Most studies on the developmental regulation of the globin genes, including genome-wide genetics screens, have focused on DNA binding proteins, including BCL11A and ZBTB7A/LRF and their cofactors. Our understanding of RNA binding proteins (RBPs) in this process is much more limited. Two RBPs, LIN28B and IGF2BP1, are known posttranscriptional regulators of HbF production, but a global view of RBPs is still lacking. Here, we carried out a CRISPR/Cas9-based screen targeting RBPs harboring RNA methyltransferase and/or RNA recognition motif (RRM) domains and identified RNA binding motif 12 (RBM12) as a novel HbF suppressor. Depletion of RBM12 induced HbF expression and attenuated cell sickling in erythroid cells derived from patients with SCD with minimal detrimental effects on cell maturation. Transcriptome and proteome profiling revealed that RBM12 functions independently of major known HbF regulators. Enhanced cross-linking and immunoprecipitation followed by high-throughput sequencing revealed strong preferential binding of RBM12 to 5′ untranslated regions of transcripts, narrowing down the mechanism of RBM12 action. Notably, we pinpointed the first of 5 RRM domains as essential, and, in conjunction with a linker domain, sufficient for RBM12-mediated HbF regulation. Our characterization of RBM12 as a negative regulator of HbF points to an additional regulatory layer of the fetal-to-adult hemoglobin switch and broadens the pool of potential therapeutic targets for SCD and β-thalassemia.
Patient safety during anesthesia in Ukraine: national audit results
Authors: Bielka Kateryna , Kuchyn Iurii , Semenko Nataliia , Kashchii Uliana , Pliuta Iryna
Published: May 2022

Background

Although anesthesiologists are one of the leaders in patient safety, anesthesia in low and low-middle income countries still need improvement in safety mesures with evidence-based practice application. The study aim was to audit the safety principles implementation in the Ukrainian anesthesiologist`s practice.

Methods

The study was held in March 2021-Februrary 2022 by filling out an online questionnarie. The link to the survey was distributed through Ukrainian Anesthesiologists Association (UAA) members emails and also published on UAA webpage and facebook page. The email was sent to 1000 UAA members.

Results

Summary 210 respondents took part in the study. Among the respondents, 79.1% of respondents are aware of the Helsinki Declaration on Patient Safety in Anesthesiology, but only 40,3% declared that the principles of this Declaration had been implemented in their medical institutions. Even though most of the respondents declared that the quality of the work has improved with the application of the Helsinki Declaration, 16% stated, that there is no positive impact.

Most of the medical institutions include mandatory perioperative monitoring, while 17% of hospitals have no access to pulse oximetry for all patients in the operating room and intensive care unit. Concerning using clinical protocols, the one on the treatment of massive bleeding is used in 60.3% of cases, on infection control in 60.5%.

In relation to checklists, 28.2% of respondents have never heard about the WHO Safe Surgery checklist. Checklists for equipment inspection are used in only 27.8% of medical institutions. 72.8% hospitals keep records of anaesthesia complications.

Conclusion

The study showed that significant positive steps are being taken to improve patient safety in Ukraine, where most hospitals comply with the minimum standarts of monitoring during anesthesia. Although there are many challenges for improvement, more hospitals need to implement WHO Safe Surgery and equipment checklists, protocols etc. These areas are a priority for further development in Ukraine.

Trial registration

Clinicaltrials.gov NCT05175976 on 04/01/2022.
Development and validation of self-management scale for tuberculosis patients
Authors: Li Jin , Zhang Liwen , Zhou Jiani , Wang Geng , Zhang Rui , Liu Jiaqing , Liu Shili , Chen Yong , Yang Song , Yuan Quan , Li Ying
Published: May 2022

Background

Tuberculosis remains a major threat to global public health. Regarding its control, directly observed therapy is not suitable as a global strategy for all tuberculosis patients. Self-management may be an important patient-centered tuberculosis case management supplement to directly observed therapy. However, there is currently no well-established instrument for measuring the self-management of tuberculosis patients. This study aimed to develop and validate a self-management scale for tuberculosis patients.

Methods

We developed an initial scale based on the tuberculosis health promotion indicators framework developed by our research group. After item analysis and two rounds of exploratory factor analysis, a final version of the scale was developed. A survey of 462 tuberculosis patients was conducted to develop and validate this scale. Cronbach’s α and intraclass correlation coefficients were used to assess reliability, and Pearson’s correlation coefficients were used to evaluate content validity. Fit indices, convergent validity, and discriminant validity were evaluated using confirmatory factor analysis to determine the construct validity of the scale.

Results

The scale was composed of 17 items in three dimensions (“adherence to treatment behavior,” “transmission prevention behavior,” and “supportive therapy behavior”). These three dimensions explained 76.60% of the variance. Cronbach’s α of the scale was 0.905, and the intraclass correlation coefficient was 0.897. Additionally, Pearson’s correlation analysis showed that each item was strongly correlated with the dimension to which it belonged (r = 0.849–0.915, p < 0.01). Most fit indices (Comparative Fit Index, Normed Fit Index, Incremental Fit Index, Goodness of fit index) reached the recommended threshold, and the average variance extracted values of the three dimensions were higher than 0.5. The values of the square root of the average variance extracted within each dimension were greater than the correlation between dimensions, and all heterotrait–monotrait values were below 0.85.

Conclusions

The self-management scale for tuberculosis patient demonstrated good reliability and validity and could be used as an instrument to evaluate the self-management of patients. Additionally, it could be used to develop evidence-based self-management interventions and evaluate those interventions.
Risk prediction of 30-day mortality after stroke using machine learning: a nationwide registry-based cohort study
Authors: Wang Wenjuan , Rudd Anthony G. , Wang Yanzhong , Curcin Vasa , Wolfe Charles D. , Peek Niels , Bray Benjamin
Published: May 2022

Backgrounds

We aimed to develop and validate machine learning (ML) models for 30-day stroke mortality for mortality risk stratification and as benchmarking models for quality improvement in stroke care.

Methods

Data from the UK Sentinel Stroke National Audit Program between 2013 to 2019 were used. Models were developed using XGBoost, Logistic Regression (LR), LR with elastic net with/without interaction terms using 80% randomly selected admissions from 2013 to 2018, validated on the 20% remaining admissions, and temporally validated on 2019 admissions. The models were developed with 30 variables. A reference model was developed using LR and 4 variables. Performances of all models was evaluated in terms of discrimination, calibration, reclassification, Brier scores and Decision-curves.

Results

In total, 488,497 stroke patients with a 12.3% 30-day mortality rate were included in the analysis. In 2019 temporal validation set, XGBoost model obtained the lowest Brier score (0.069 (95% CI: 0.068–0.071)) and the highest area under the ROC curve (AUC) (0.895 (95% CI: 0.891–0.900)) which outperformed LR reference model by 0.04 AUC (p < 0.001) and LR with elastic net and interaction term model by 0.003 AUC (p < 0.001). All models were perfectly calibrated for low (< 5%) and moderate risk groups (5–15%) and ≈1% underestimation for high-risk groups (> 15%). The XGBoost model reclassified 1648 (8.1%) low-risk cases by the LR reference model as being moderate or high-risk and gained the most net benefit in decision curve analysis.

Conclusions

All models with 30 variables are potentially useful as benchmarking models in stroke-care quality improvement with ML slightly outperforming others.
Clinical significance and correlation of PD-L1, B7-H3, B7-H4, and TILs in pancreatic cancer
Authors: Yang Jiayue , Tian Zhen , Gao Han , Xiong Fan , Cao Cuiping , Yu Jiaojiao , Shi Wei , Zhan Qiang , Yang Cheng
Published: May 2022

Background

B7 molecules play significant roles in regulating tumor immunity, but their expression patterns and immuno-biological correlations in pancreatic cancer (PaCa) have not been fully discussed.

Methods

RNA-sequencing data of B7 molecules of PaCa samples in the Cancer Genome Atlas (TCGA) dataset was downloaded from the UCSC Xena to assess the expression, correlation, and mutation of the B7 family in PaCa. Next, two PaCa tissue microarrays (TMAs, Cat. HPanA150CS02 and HPanA120Su02) were obtained from Outdo BioTech (Shanghai, China). To detect the expression levels of PD-L1, B7-H3 and B7-H4, immunohistochemistry (IHC) staining was performed on these TMAs.

Results

Most B7 molecules, including B7–1, B7–2, PD-L1, B7-DC, B7-H2, and B7-H5 exhibited similar expression patterns, but B7-H3, B7-H4, B7-H6, and B7-H7 showed outlier expression patterns compared with other B7 molecules. Besides, B7 molecules were genetically stable and exhibited low alteration frequency. IHC staining indicated PD-L1, B7-H3, and B7-H4 were up-regulated in PaCa tissues and showed uncorrelated expression patterns. Furthermore, high expression of PD-L1 and B7-H3 indicated poor-differentiated grades in PaCa. PD-L1 was positively, but B7-H4 was negatively correlated with CD8+ TILs infiltration in PaCa. Moreover, combined PD-L1 and B7-H4 expression was a novel subtyping strategy in PaCa, namely patients with both high PD-L1 and B7-H4 expression exhibited decreased CD8+ TILs infiltration in tumor tissues.

Conclusion

Overall, we systemically analyzed the expression patterns of B7 molecules and proposed a novel subtyping strategy in PaCa. Patients with both high PD-L1 and B7-H4 expression exhibited the immuno-cold phenotype, which may be not suitable for immunotherapy.
Prevalence of diabetic retinopathy and self-reported barriers to eye care among patients with diabetes in the emergency department: the diabetic retinopathy screening in the emergency department (DRS-ED) study
Authors: Williams Andrew M. , Weed Jared M. , Commiskey Patrick W. , Kalra Gagan , Waxman Evan L.
Published: May 2022

Background

Screening for diabetic retinopathy (DR) is suboptimal, and patients with diabetes who present to the emergency department (ED) may be at particularly high risk of undiagnosed DR. The purpose of this study is to determine the prevalence of DR among diabetic patients who present to the ED of our tertiary medical center using teleophthalmology and to assess self-reported barriers to eye care.

Methods

This cross-sectional, single-institution study recruited clinically stable diabetic patients who presented to the ED during daytime hours over 29 total weekdays across 2 months in 2018 and 2019. Participants had nonmydriatic, 45-degree, single-field digital retinal photographs taken on site (Digital Retinal System, Centervue). Following retinal imaging, participants then completed a survey about barriers to regular eye care and their acceptance of potential interventions to promote screening. Digital retinal photographs were interpreted remotely by a board-certified ophthalmologist and communicated to participants’ primary care physician and/or endocrinologist.

Results

Over the study period, 275 ED patients had a documented diagnosis of diabetes, of whom 167 were deemed clinically stable for the study and 141 were invited to participate. Sixty-four were enrolled, of whom 50 had gradable-quality fundus images (78%). Of these 50 patients, almost all had type 2 diabetes (47, 94%), with an average disease duration of 12 ± 9 years and mean hemoglobin A1c of 8.1 ± 2.0% (mmol/mol). Based on fundus photography, 14 patients (28%) were diagnosed with DR, which was newly diagnosed for 10 (20% of the total study population). Severity was most commonly mild or moderate (12/14, 86%), with 1 case of severe nonproliferative DR and 1 proliferative DR. The majority (26, 52%) reported at least one barrier to routine eye care in our self-administered survey, of which having too many appointments (6, 12%) and cost (5, 10%) were frequently cited as most important. The majority were receptive to interventions to promote DR screening, including reminder phone calls (29, 58%) and text messages (28, 56%).

Conclusions

Digital fundus photography in the ED detected a high rate of undiagnosed DR. Half of participants reported barriers to routine care, and most were receptive to messaging interventions to schedule an eye exam. Future studies are warranted to assess scalability of ED-based screening programs and their follow-through rates.
Early neonatal mortality is modulated by gestational age, birthweight and fetal heart rate abnormalities in the low resource setting in Tanzania – a five year review 2015–2019
Authors: Shayo Aisa , Mlay Pendo , Ahn Emily , Kidanto Hussein , Espiritu Michael , Perlman Jeffrey
Published: May 2022

Background

Early Neonatal mortality (ENM) (< 7 days) remains a significant problem in low resource settings. Birth asphyxia (BA), prematurity and presumed infection contribute significantly to ENM. The study objectives were to determine: first, the overall ENM rate as well as yearly ENM rate (ENMR) from 2015 to 2019; second, the influence of decreasing GA (< 37 weeks) and BW (< 2500 g) on ENM; third, the contribution of intrapartum and delivery room factors and in particular fetal heart rate abnormalities (FHRT) to ENM; and fourth, the Fresh Still Birth Rates (FSB) rates over the same time period.

Methods

Retrospective cohort study undertaken in a zonal referral teaching hospital located in Northern Tanzania. Labor and delivery room data were obtained from 2015 to 2019 and included BW, GA, fetal heart rate (FHRT) abnormalities, bag mask ventilation (BMV) during resuscitation, initial temperature, and antenatal steroids use. Abnormal outcome was ENM < 7 days. Analysis included t tests, odds ratios (OR), and multivariate regression analysis.

Results

The overall early neonatal mortality rate (ENMR) was 18/1000 livebirths over the 5 years and did not change significantly comparing 2015 to 2019. Comparing year 2018 to 2019, the overall ENMR decreased significantly (OR 0.62; 95% confidence interval (CI) 0.45–0.85) as well as infants ≥37 weeks (OR 0.45) (CI 0.23–0.87) and infants < 37 weeks (OR 0.57) (CI 0.39–0.84). ENMR was significantly higher for newborns < 37 versus ≥37 weeks, OR 10.5 (p < 0.0001) and BW < 2500 versus ≥2500 g OR 9.9. For infants < 1000 g / < 28 weeks, the ENMR was ~ 588/1000 livebirths. Variables associated with ENM included BW - odds of death decreased by 0.55 for every 500 g increase in weight, by 0.89 for every week increase in GA, ENMR increased 6.8-fold with BMV, 2.6-fold with abnormal FHRT, 2.2-fold with no antenatal steroids (ANS), 2.6-fold with moderate hypothermia (all < 0.0001). The overall FSB rate was 14.7/1000 births and decreased significantly in 2019 when compared to 2015 i.e., 11.3 versus 17.3/1000 live births respectively (p = 0.02).

Conclusion

ENM rates were predominantly modulated by decreasing BW and GA, with smaller/ less mature newborns 10-fold more likely to die. ENM in term newborns was strongly associated with FHRT abnormalities and when coupled with respiratory depression and BMV suggests BA. In smaller newborns, lack of ACS exposure and moderate hypothermia were additional associated factors. A composite perinatal approach is essential to achieve a sustained reduction in ENMR.
Time perception of individuals with subthreshold autistic traits: the regulation of interpersonal information associations
Authors: Xuan Bin , Li Shuo , Li Peng , Yang Lu
Published: May 2022

Background

People with high subthreshold autistic traits usually share behavioral patterns similar to those of individuals on the autism spectrum, but with fewer social and cognitive changes. The effect of autistic traits on time perception and the role of interpersonal information in this effect remain unexplored.

Methods

This study used a temporal bisection task between 400 and 1600 ms to compare the time perception of individuals with higher and lower autistic traits, and to explore the regulation of interpersonal information on their time perception by establishing associations between identities and geometric shapes. Thirty-two participants with high autistic traits and thirty-one participants with low autistic traits participated in this study.

Results

In the absence of identity information, people with high autistic traits tended to judge short durations as longer. Their subjective bisection point was lower, and the Weber ratio was higher than for those with low autistic traits, suggesting that their overestimation of short duration was due to decreased temporal sensitivity. With the involvement of interpersonal information, the proportion of long responses for no identity was significantly lower than for self, friends, and strangers, which seemed more obvious in individuals with low autistic traits although there was no significant interaction between identity and group. The Weber ratio of no identity was lower than that for other identities.

Conclusion

The results suggest that individuals with high autistic traits have more conservative responses that are relatively shorter in duration, and this change is related to a decline in perceptual sensitivity. Compared to individuals with high autistic traits, the time perception of individuals with low autistic traits seemed more susceptible to interpersonal information.
Physical therapy of patients undergoing first-time lumbar discectomy: a survey of current UK practice
Authors: Alsiaf Hanan , O’Neill Terence W. , Callaghan Michael J. , Goodwin Peter C.
Published: May 2022

Background

The type, timing, and extent of provision of rehabilitation for lumbar discectomy patients in the UK are currently unknown. The aim of this study was to determine the provision and type of rehabilitation for patients undergoing lumbar discectomy in UK neurosurgical centers.

Method

Physical therapists involved in treating lumbar discectomy patients in UK neurosurgery centers were invited to complete an online survey that asked about the type, timing (preop, postop), and rehabilitation content for patients undergoing lumbar discectomy.

Results

Seventeen UK neurosurgery centers completed the survey. Twelve (36%) responded from the 33 centers targeted as well as an additional five private centers. All participating centers provided a rehabilitation service for lumbar discectomy patients. Rehabilitation was provided preoperatively in n = 6 (35%) centers, postoperatively as an inpatient in all centers, and postoperatively as an outpatient in n = 14 (82%) centers. Factors that influenced the decision to provide rehabilitation included both external and internal or patient-related factors. Preoperative rehabilitation focused mainly on education, whilst postoperative outpatient rehabilitation focused more on exercises. Rehabilitation consistently included mobility, functional task training, and exercise prescription.

Conclusions

Whilst all neurosurgical centers in this survey provided some form of rehabilitation for patients undergoing LD surgery, the approach remains inconsistent. Rehabilitation was delivered most frequently postoperatively, with one in three centers providing it preoperatively. Rehabilitation content also varied depending on when it was provided. Further research is needed to determine the optimum timing, contents, and target of rehabilitation for patients undergoing LD surgery.
Distal interphalangeal joint arthrodesis with nonaxial multiple small screws: a biomechanical analysis with axial headless compression screw and clinical result of 15 consecutive cases
Authors: Woo Seung Hun , Kwak Sang Ho , Jang Hyo Seok , Kim Dong Hee , Seo Jang Hyeon , Lee Sang Hyun
Published: May 2022

Background

The axial headless compression screw (AHCS) technique is a widely used method for distal interphalangeal joint (DIPJ) and thumb IPJ arthrodesis. However, it might not be suitable for cases over 10° flexion of fusion angle and extremely small-sized phalanx. Here, the authors describe the nonaxial multiple small screws (NMSS) technique, compare the mechanical strength of the NMSS technique with the AHCS technique, and suggest clinical outcomes of the NMSS technique.

Methods

DIPJ and thumb IPJ arthrodesis models were simulated in the 4th generation composite bone hand. Fixation with three 1.5 mm cortical screws (NMSS) or one HCS (AHCS) was performed in each pair of the phalanx. The bending stiffness and load to failure were tested in 10 pairs of each specimen, and the torsional stiffness and torque to failure were tested in seven pairs of each specimen. Moreover, 15 consecutive clinical DIPJ and thumb IPJ arthrodesis cases were reviewed retrospectively.

Results

The NMSS specimens showed significantly higher bending load to failure, torsional stiffness, and torque to failure than the AHCS specimens. All 15 arthrodesis cases were united without severe complications. The mean fusion angle was 16.3° for the nine cases of the flexed target position.

Conclusions

The NMSS technique showed biomechanical stability comparable to that of the AHCS technique in DIPJ and thumb IPJ arthrodesis. Thus, the NMSS technique could be used as a feasible option in DIPJ and thumb IPJ arthrodesis, especially when a small finger is indicated and a significant flexion angle is required.
Rheumatic heart disease knowledge and associated factors among nurses working in cardiac centers at public and private hospitals of Addis Ababa: cross sectional study
Authors: Techane Tesfaye , Legesse Bethlehem , Ayalew Yohannes , Hailu Aklil
Published: May 2022

Background

It is proposed that the biggest gap in control of rheumatic heart disease is in implementing of ineffective primary and secondary preventive measures. These measures are supposed to be well addressed by nurses. For prevention and proper management, nurses are expected to have full knowledge about rheumatic heart disease. Therefor the main objective of the study was to assess the level of nurse’s knowledge and factors behind regarding RHD in the current study.

Method

Institution based cross sectional study was conducted on nurses working in cardiac centers of public and private hospitals at Addis Ababa from April 1 to 30, 2021. Total sample size is 163 selected by purposive sampling method. Data was entered in to Epi-data version 4.5 and exported to SPSS version 25.0 and was checked for missing values. Data was cleaned. Descriptive statistics such as frequency, mean and percentages were calculated, described and displayed in tables, graphs and charts. Binary logistic regression was done to see the crude significant relation of each independent variable with nurse’s good knowledge score. Significant factors were identified based on multivariate logistics regression in 95% confidence level at P-value less than 0.05.

Result

In the present study about 154 participants were participated. The mean correct answer response of the nurses for knowledge of RHD questions is 12.2 ± 5.2. Only 48.7% of the nurses have good knowledge towards RHD. Being male in gender, having history of sore throat, taking formal education in university or collage, taking in-service training on RHD, having higher wok experience, have found significantly associated with higher odds of nurses’ good knowledge towards RHD.

Conclusion and recommendation

Regular training regarding RHD management should be given to nurses who are working in cardiac centers. Rheumatic heart disease early treatment and prevention should be incorporated and reinforced in to nursing and other health related professions curriculums.
Mindfulness, empathy and moral sensitivity in nurses: a structural equation modeling analysis
Authors: Rezapour-Mirsaleh Yasser , Aghabagheri Mahdi , Choobforoushzadeh Azadeh , Mohammadpanah Ardakan Azra
Published: May 2022

Background

Ethical issues may pose challenges to nurses; moral sensitivity can help them to overcome these challenges. Identifying variables related to moral sensitivity can help in planning to increase nurses’ moral sensitivity. This study aimed to investigate the relationship among mindfulness, empathy, and moral sensitivity in a sample of nurses.

Methods

In the present study, a cross-sectional design utilizing Structural Equation Modeling (SEM) was conducted. The nurses in a private hospital in Yazd, Iran, were invited to participate in the study (n=162) using simple random sampling. In order to gather the data, the Freiburg’s mindfulness inventory, moral sensitivity questionnaire, and revised Jefferson’s empathy scale were used. The hypothesized model was analyzed by SEM.

Results

The results show that Mindfulness (β=0.41, t=5.53, p<0.01) and empathy (β=0.52, t=6.77, p<0.01) had a significant direct effect on moral sensitivity. However, mindfulness had an indirect effect on nurses’ moral sensitivity via empathy improvement (z= 6.25, p<.01).

Conclusion

Empathy played a significant mediating role in the relationship between mindfulness and moral sensitivity, so mindfulness-based interventions with an emphasis on empathy may provide an opportunity to increase moral sensitivity in nurses.
Brucella spp. distribution, hosting ruminants from Greece, applying various molecular identification techniques
Authors: Katsiolis Aristomenis , Papadopoulos Dimitrios K. , Giantsis Ioannis A. , Papageorgiou Konstantinos , Zdragas Antonis , Giadinis Nektarios D. , Petridou Evanthia
Published: May 2022

Background

Brucellosis still remains an endemic disease for both livestock and human in Greece, influencing the primary sector and national economy in general. Although farm animals and particularly ruminants constitute the natural hosts of the disease, transmission to humans is not uncommon, thus representing a serious occupational disease as well. Under this prism, knowledge concerningBrucellaspecies distribution in ruminants is considered a high priority. There are various molecular methodologies forBrucelladetection with however differential discriminant capacity. Hence, the aim of this survey was to achieve nationallyBrucellaepidemiology baseline genotyping data at species and subtype level, as well as to evaluate the pros and cons of different molecular techniques utilized for detection ofBrucellaspecies. Thirty-nine tissue samples from 30 domestic ruminants, which were found positive applying a screening PCR, were tested by four different molecular techniques i.e. sequencing of the 16S rRNA, the BP26 and the OMP31 regions, and the MLVA typing panel 1 assay of minisatellite markers.

Results

Only one haplotype was revealed from the 16S rRNA sequencing analysis, indicating that molecular identification ofBrucellabacteria based on this marker might be feasible solely up to genus level. BP26 sequencing analysis and MLVA were in complete agreement detecting bothB. melitensisandB. abortus.An interesting exception was observed in 11 samples, of lower quality extracted DNA, in which not all expected MLVA amplicons were produced and identification was based on the remaining ones as well as on BP26. On the contrary OMP31 failed to provide a clear band in any of the examined samples.

Conclusions

The present study reveals the constant circulation ofBrucellabacteria in ruminants throughout Greece. Further, according to our results, BP26 gene represents a very good alternative to MLVA minisatellite assay, particularly in lower quality DNA samples.
Risk of sharing resistant bacteria and/or resistance elements between dogs and their owners
Authors: Naziri Zahra , Poormaleknia Meisam , Ghaedi Oliyaei Azar
Published: May 2022

Background

The indiscriminate use and the similarity of prescribed antibiotics especially beta-lactams in human and small animal medicine, along with the close communication between pets and humans, increases the risk of the transfer of antibiotic-resistant bacteria and/or resistance elements especially integrons, between them. Therefore, we aimed to compare the frequencies of extended spectrum beta-lactamase (ESBL)-producing strains, major ESBL genes, classes 1 and 2 integrons, and antibiotic resistance patterns of fecal Escherichia coli (E. coli) isolates from dogs and their owners.

Methods

The present study was conducted on 144 commensal E. coli isolates from the feces of 28 healthy dog-owner pairs and 16 healthy humans who did not own pets. Phenotypic confirmatory test was used to identify the frequencies of ESBL-producing E. coli. Frequencies of blaCTX-M, blaSHV, and blaTEM genes, and also classes 1 and 2 integrons were determined by polymerase chain reaction. Resistance against 16 conventional antibiotics was determined by disk diffusion technique.

Results

ESBL-production status was similar between the E. coli isolates of 71.4% of dog-owner pairs. The E. coli isolates of 75, 60.7, and 85.7% of dog-owner pairs were similar in terms of the presence or absence of blaCTX-M, blaTEM, and blaSHV genes, respectively. The presence or absence of class 1 and class 2 integrons was the same in E. coli isolates of 57.1% of dog-owner pairs. Prevalence of resistance to chloramphenicol and tetracycline was significantly higher in E. coli isolates of dogs than owners, but for other 10 (83.3%) tested antibiotics, no statistically significant difference was found in prevalence of antibiotic resistance between dogs and owners isolates. Furthermore, the antibiotic-resistance profile was the same in the E. coli isolates of 14.3% of dog-owner pairs.

Conclusions

The results of current research highlight the seriousness of the drug-resistance problem and the need to prevent further increases and spread of antibiotic-resistance to reduce treatment failure. Moreover, relatively similar characteristics of the E. coli isolates of dogs and their owners can show the risk of sharing resistant bacteria and/or resistance elements between them.
Utility of ultra-rapid real-time PCR for detection and prevalence of Rickettsia spp. in ticks
Authors: Truong A-Tai , Yun Bo-Ram , Yoo Mi-Sun , Lim Jiyeon , Min Subin , Yoon Soon-Seek , Yun Young-Min , Kim Jong-Taek , Cho Yun Sang
Published: May 2022

Background

Rickettsiaspp. are important tick-borne pathogens that cause various human and animal diseases worldwide. A tool for rapid and accurate detection of the pathogens from its vectors is necessary for prevention of Rickettsioses propagation in humans and animals, which are infested by ticks. Therefore, this study was conducted to evaluate a molecular tool, ultra-rapid real-time PCR (UR-qPCR), for rapid and accurate detection ofRickettsiaspp. from 5644 ticks in 408 pools collected from livestock and their surrounding environments in Gangwon and Jeju province in South Korea.

Results

The UR-qPCR ofRickettsiaDNA showed a limit of detection of 2.72 × 101copies ofRickettsiaDNA and no cross reaction with other tick-borne pathogens, namelyAnaplasma phagocytophilum,Ehrlichia chaffeensis,E. canis,Toxoplasma gondii, andBorrelia burgdorferi. In addition, the PCR assay also showed possibility of variousRickettsiaspecies detection includingR. monacensis,“CandidatusR. longicornii”, R. japonica, R. roultii,andR. tamurae.The collected ticks were identified with major species belonged toHaemaphysalis longicornis(81.62%), followed byH. flava(15.19%),andIxodes nipponensis(3.19%).Rickettsiadetection from tick samples using the UR-qPCR showed that the minimum infection rate (MIR) ofRickettsiain collected ticks was 1.24‰ and that all positive pools containedH. longicornis,equal to the MIR of 1.39‰ of this species. Additionally, MIR ofRickettsiaspp. detected in ticks collected in Gangwon and Jeju was 1.53‰ and 0.84‰, respectively. Furthermore, the sequencing results of the 17 kDa protein antigen gene andompAgene showed thatRickettsiaspp. sequences from all pools were related to “CandidatusR. longicornii” and “CandidatusR. jingxinensis”.

Conclusions

The UR-qPCR system was demonstrated to be useful tool for accurate and rapid detection ofRickettsiafrom its vector, ixodid ticks, within 20 min. The data onRickettsiaspp. in ticks detected in this study provide useful information on the distribution ofRickettsiain previously unstudied Korean provinces, which are important for the prevention and control of the spread of rickettsioses in both animals and humans in the country.
Predicting EGFR mutation, ALK rearrangement, and uncommon EGFR mutation in NSCLC patients by driverless artificial intelligence: a cohort study
Authors: Tan Xueyun , Li Yuan , Wang Sufei , Xia Hui , Meng Rui , Xu Juanjuan , Duan Yanran , Li Yan , Yang Guanghai , Ma Yanling , Jin Yang
Published: May 2022

Background

Timely identification of epidermal growth factor receptor (EGFR) mutation and anaplastic lymphoma kinase (ALK) rearrangement status in patients with non-small cell lung cancer (NSCLC) is essential for tyrosine kinase inhibitors (TKIs) administration. We aimed to use artificial intelligence (AI) models to predict EGFR mutations and ALK rearrangement status using common demographic features, pathology and serum tumor markers (STMs).

Methods

In this single-center study, demographic features, pathology, EGFR mutation status, ALK rearrangement, and levels of STMs were collected from Wuhan Union Hospital. One retrospective set (N = 1089) was used to train diagnostic performance using one deep learning model and five machine learning models, as well as the stacked ensemble model for predicting EGFR mutations, uncommon EGFR mutations, and ALK rearrangement status. A consecutive testing cohort (n = 1464) was used to validate the predictive models.

Results

The final AI model using the stacked ensemble yielded optimal diagnostic performance with areas under the curve (AUC) of 0.897 and 0.883 for predicting EGFR mutation status and 0.995 and 0.921 for predicting ALK rearrangement in the training and testing cohorts, respectively. Furthermore, an overall accuracy of 0.93 and 0.83 in the training and testing cohorts, respectively, were achieved in distinguishing common and uncommon EGFR mutations, which were key evidence in guiding TKI selection.

Conclusions

In this study, driverless AI based on robust variables could help clinicians identify EGFR mutations and ALK rearrangement status and provide vital guidance in TKI selection for targeted therapy in NSCLC patients.
Sodium‑glucose co-transporter‑2 inhibitors in the treatment of diabetes with heart failure
Authors: Liang Bo , Gu Ning
Published: May 2022

2022 AHA/ACC/HFSA guideline for the management of heart failure, which is valuable for clinical decision-making, was recently released. This guideline recommended patients with heart failure with type 2 diabetes sodium‑glucose co-transporter‑2 inhibitors for the management of hyperglycemia and to reduce heart failure-related morbidity and mortality (Class 1, Level A). It is important to note that the source of evidence based on this recommendation is from EMPEROR-Reduced, DAPA-HF, and DECLARE-TIMI 58 and does not include newly published PRESERVED-HF, CHIEF-HF, and EMPEROR-Preserved. Here we reviewed these important trials in order to provide more clinical references for patients with diabetes and heart failure, especially heart failure with preserved ejection fraction.
The circSPON2/miR-331-3p axis regulates PRMT5, an epigenetic regulator of CAMK2N1 transcription and prostate cancer progression
Authors: Yao Bing , Zhu Sha , Wei Xiyi , Chen Ming-Kun , Feng Yangkun , Li Zhimin , Xu Xinyu , Zhang Yuwei , Wang Yang , Zhou Jingwan , Tang Ningyuan , Ji Chengjian , Jiang Peng , Zhao Shan-Chao , Qin Chao , Feng Ninghan
Published: May 2022

Background

Prostate cancer (PCa) is the most frequently diagnosed malignancy in men, and its mechanism remains poorly understood. Therefore, it is urgent to discover potential novel diagnostic biomarkers and therapeutic targets that can potentially facilitate the development of efficient anticancer strategies.

Methods

A series of functional in vitro and in vivo experiments were conducted to evaluate the biological behaviors of PCa cells. RNA pulldown, Western blot, luciferase reporter, immunohistochemistry and chromatin immunoprecipitation assays were applied to dissect the detailed underlying mechanisms. High-throughput sequencing was performed to screen for differentially expressed circRNAs in PCa and adjacent normal tissues.

Results

Upregulation of protein arginine methyltransferase 5 (PRMT5) is associated with poor progression-free survival and the activation of multiple signaling pathways in PCa. PRMT5 inhibits the transcription of CAMK2N1 by depositing the repressive histone marks H4R3me2s and H3R8me2s on the proximal promoter region of CAMK2N1, and results in malignant progression of PCa both in vitro and in vivo. Moreover, the expression of circSPON2, a candidate circRNA in PCa tissues identified by RNA-seq, was found to be associated with poor clinical outcomes in PCa patients. Further results showed that circSPON2 induced PCa cell proliferation and migration, and that the circSPON2-induced effects were counteracted by miR-331-3p. Particularly, circSPON2 acted as a competitive endogenous RNA (ceRNA) of miR-331-3p to attenuate the repressive effects of miR-331-3p on its downstream target PRMT5.

Conclusions

Our findings showed that the epigenetic regulator PRMT5 aggravates PCa progression by inhibiting the transcription of CAMK2N1 and is modulated by the circSPON2/miR-331-3p axis, which may serve as a potential therapeutic target for patients with aggressive PCa.
Intermittent fasting reduces neuroinflammation in intracerebral hemorrhage through the Sirt3/Nrf2/HO-1 pathway
Authors: Dai Shuhui , Wei Jialiang , Zhang Hongchen , Luo Peng , Yang Yuefan , Jiang Xiaofan , Fei Zhou , Liang Wenbin , Jiang Jianli , Li Xia
Published: May 2022

Background

Inflammation contributes to the poor prognosis of intracerebral hemorrhage (ICH). Intermittent fasting (IF) has been shown to be protective against inflammation in multiple pathogenic processes. In the present study, we aimed to investigated the beneficial effects of IF in attenuating neuroinflammation and neurological deficits in a mouse model of ICH and to investigate the underlying mechanism.

Methods

ICH was modeled by intrastriatal injection of autologous blood and IF was modeled by every-other-day feeding in male control mice (C57BL/6), mice with and microglia specific knockout Sirt3f/f;Cx3cr1-Cre (Sirt3 cKO), and Sirt3f/f (wild-type) mice. Brain tissues and arterial blood were harvested at 1, 3, 7 and 28 days after ICH for immunohistochemistry analysis of Iba-1, DARPP-32 and HO-1, morphological analysis by HE staining and inflammatory factor release tests by ELISA. Neurological functions were approached by corner test and cylinder test. Fluorescent double-labeled staining of Iba-1 with CD16, Arg1 or Sirt3 was used to provide direct image of co-expression of these molecules in microglia. TUNEL, cleaved caspase-3 and Nissl staining was performed to evaluate cellular injuries.

Results

IF alleviated neurological deficits in both acute and chronic phases after ICH. Morphologically, IF enhanced hematoma clearance, reduced brain edema in acute phase and attenuated striatum atrophy in chronic phase. In addition, IF decreased the numbers of TUNEL+ cells and increased Nissl+ neuron number at day 1, 3 and 7 after ICH. IF suppressed CD16+Iba-1+ microglia activation at day 3 after ICH and reduced inflammatory releases, such as IL-1β and TNF-α. The above effects of IF were attenuated by microglia Sirt3 deletion partly because of an inhibition of Nrf2/HO-1 signaling pathway. Interestingly, IF increased Iba-1+ microglia number at day 7 which mainly expressed Arg1 while decreased the proinflammatory factor levels. In mice with microglia-specific Sirt3 deletion, the effects of IF on Iba-1+ microglia activation and anti-inflammatory factor expressions were attenuated when compared with wild-type Sirt3f/f mice.

Conclusions

IF protects against ICH by suppressing the inflammatory responses via the Sirt3/Nrf2/HO-1 pathway.