bluuebunny/crossref_metadata_2025 huggingface dataset:
Surface Expression of Kynurenine 3-Monooxygenase Promotes Proliferation and Metastasis in Triple-Negative Breast Cancers
Authors: Lai Min-Hua , Liao Chi-Hsun , Tsai Nu-Man , Chang Kai-Fu , Liu Cheng-Chi , Chiu Yi-Han , Huang Kuo-Ching , Lin Chen-Si
Published: April 2021

Kynurenine 3-monooxygenase (KMO) is the pivotal enzyme in the kynurenine pathway and is located on the mitochondrial outer membrane. The dysregulation of KMO leads to various neurodegenerative diseases; however, it is rarely mentioned in cancer progression. Our previous study showed that KMO overexpression in canine mammary gland tumors (cMGT) is associated with poor prognosis in cMGT patients. Surprisingly, it was also found that KMO can be located on the cell membranes of cMGT cells, unlike its location in normal cells, where KMO is expressed only within the cytosol. Since cMGT and human breast cancer share similar morphologies and pathogenesis, this study investigated the possibility of detecting surface KMO in human breast cancers and the role of surface KMO in tumorigenesis. Using immunohistochemistry (IHC), flow cytometry (FC), immunofluorescence assay (IFA), and transmission electron microscopy (TEM), we demonstrated that KMO can be aberrantly and highly expressed on the cell membranes of breast cancer tissues and in an array of cell lines. Masking surface KMO with anti-KMO antibody reduced the cell viability and inhibited the migration and invasion of the triple-negative breast cancer cell line, MDA-MB-231. These results indicated that aberrant surface expression of KMO may be a potential therapeutic target for human breast cancers.
Harmonic vibration moment suppression using hybrid repetitive control for active magnetic bearing system
Authors: Cui Peiling , Du Liang , Zhou Xinxiu , Li Jinlei , Li Yanbin , Wu Yang
Published: April 2021

The active magnetic bearing system exhibits mass imbalance and sensor runout which cause the system to generate harmonic vibration force and moment. Repetitive control is an effective method to eliminate such harmonic vibration. Traditional repetitive control will eliminate all of the harmonic frequency components. However, in a practical system, the odd harmonic components usually dominate. Meanwhile, the existing method only suppresses the vibration force in the magnetic bearing system, and there is little research on the suppression of moment. Aiming at these problems, the harmonic vibration moment of the active magnetic bearing system is taken as the control object. This study investigates a hybrid control method that combines a second-order odd harmonic repetitive control with finite-dimensional repetitive control. And the virtual variable sampling is applied to construct any virtual sampling period in the proposed method, which effectively solves the problem of non-integer delay of digital repetitive control. The stability of the active magnetic bearing system is analyzed. The experimental results show that this method has faster response speed and better robustness when the frequency fluctuates.
Surgical outcomes of modified capsular tension ring and intraocular lens implantation in Marfan syndrome with ectopia lentis
Authors: Chen Zexu , Zhang Min , Deng Michael , Chen Tianhui , Chen Jiahui , Zheng Jialei , Jiang Yongxiang
Published: April 2021

Objective:

To evaluate surgical outcomes of modified capsular tension ring (MCTR) and intraocular lens (IOL) implantation in eyes of Marfan syndrome (MFS).

Methods:

This retrospective case series included MFS patients receiving MCTR transscleral fixation and IOL in-the-bag implantation. The MCTR was sutured to the sclera through a sulcus by 9–0 polypropylene with the modified knotless Z-suture technique. Main outcomes were visual acuity and postoperative complications.

Results:

A total of 109 MFS patients (187 eyes) had the surgery. Patients were 15.47 ± 14.36 years old and followed up for 10.07 ± 8.99 months. MCTR and IOL implantations were performed in 174 eyes (93.05%). The postoperative BCVA (LogMAR) was 0.24 ± 0.24 (1 month), 0.26 ± 0.20 (3 months), 0.22 ± 0.20 (6 months), 0.20 ± 0.19 (12 months) and 0.25 ± 0.32 (over 12 months), which was significantly better than preoperatively (0.63 ± 0.35) ( p < 0.001). Major complications included posterior capsular opacification (PCO) in 41 eyes (23.56%) and decentered anterior capsular opacification (ACO) in 15 eyes (8.62%). The mean occurrence time was 9.44 ± 7.08 and 8.87 ± 15.08 months respectively. Other complications included transient intraocular pressure elevation in seven eyes (4.02%), retinal detachment in two eyes (1.15%), cystoid macula edema in one eye (0.57%), and endophthalmitis in one eye (0.57%). No eye had suture breakage or IOL dislocation.

Conclusions:

The visual improvement is significant in eyes of MFS undergoing MCTR transscleral fixation and IOL in-the-bag implantation. The long-term monitoring of complications is warranted, especially in the first-two years.
‘Journalism Alongside’: A Reflection on Teaching Journalism Through Community Engagement
Authors: Ross Tara
Published: April 2021

This paper reflects on a service-learning public journalism project in which postgraduate journalism students have explored several ways to engage with and report alongside diverse communities. The aim of this paper has been to experiment with community journalism practices that give greater power to communities by prioritizing listening, reciprocity and bilateral engagement. By testing a ‘side-by-side’ storytelling process and prioritizing reflection on students’ relationships, dialogues and interactions with sources and communities, the community-focused and embedded project, has aimed to build students’ understanding of inclusive journalism, civic responsibility and intercultural communication as it relates to their practice.
Social Media and Emotional Well-being: Pursuit of Happiness or Pleasure
Authors: Graciyal D. Guna , Viswam Deepa
Published: April 2021

Virtual engagement of lives has been made possible with the advent of social media. Almost 80% of the day are spent virtually on Facebook, Instagram, Twitter, YouTube, Snapchat, etc. Usage of social media to connect to and communicate with the ones we care about is always healthy, termed as social networking. Social dysfunction occurs when the constant communication leads to the point where our real or offline life gets replaced by virtual or online life. There is a slight boundary between social networking and social dysfunction. When social networking is advantageous, social dysfunction affects emotional well-being. When emotional well-being is affected, many users experience a compulsion to dissociate from the real world as they find virtual world, full of fantasy and enjoyment. When the Internet was created, perhaps no one was aware of its potential. More than the convenience for sharing of information it has brought the world so close to crumbling the geographical boundaries. The more people-to-people communication is, the more is the strengthening of relationships, bonds grow stronger with ‘more’ social media platforms. Being on ‘more’ social media platforms has become a benchmark for living amidst the younger generation. Either as an activity of happiness or as an activity of pleasure, users tend to use social media at varying levels. This paper aims to conceptualize the the intricacies of social media in young lives and to discern whether their association is happiness or pleasure activity. The research method of this paper has a mixed-methods research design combining data from structured survey with information outputs from in-depth interviews.
Increase associated risk of gynaecological cancer due to long-term exposure to high concentration of atmospheric SO2 industrial pollutant
Authors: Xu Qian , Lu Chan , Murithi Rachael Gakii , Cao Lanqin
Published: April 2021

A cohort case–control study was conducted in XiangYa Hospital, Changsha, China, which involved 305 patients and 399 healthy women, from June 2010 to December 2018, to evaluate the association between Chinese women’s short- and long-term exposure to industrial air pollutant, SO2 and gynaecological cancer (GC). We obtained personal and family information from the XiangYa Hospital electronic computer medical records. Using data obtained from the air quality monitoring stations in Changsha, we estimated each woman’s exposure to the industrial air pollutant, sulphur dioxide (SO2), for different time windows, including the past 1, 5, 10 and 15 years before diagnosis of the disease. A multiple logistic regression model was used to assess the association between GC and SO2 exposure. GC was significantly associated with long-term SO2 exposure, with adjusted odds ratio (95% confidence interval) = 1.56 (1.10–2.21) and 1.81 (1.07–3.06) for a per interquartile range increase in the past 10 and 15 years, respectively. Sensitivity analysis showed that different groups reacted in different ways to long-term SO2 exposure. We concluded that long-term exposure to high concentration of industrial pollutant, SO2 is associated with the development of GC. This finding has implications for the prevention and reduction of GC.
Health consumers’ social media adoption behaviours in Australia
Authors: Khan Irfanuzzaman , Saleh Md Abu , Quazi Ali , Johns Raechel
Published: April 2021

This research identifies the underlying drivers impacting on health consumers’ social media usage and acceptance behaviours using technology acceptance model (TAM) as the theoretical lens. A cross-sectional survey of 265 health consumers was conducted through a mall intercept technique. Participants in the survey were over the age of 18 and had access to a public or private healthcare service provider. The data were analysed using structural equation modelling (SEM). The major findings show that perceived ease of use, privacy threat, information quality, social influence and self-efficacy influence health consumers’ social media adoption behaviours. Perceived usefulness was not found to affect health consumers’ social media adoption behaviours. The moderation analysis showed that influences of privacy threats are non-significant for mature age respondents and non-frequent users of social media. This study’s findings have important implications for designing social media strategies for the healthcare industry. The drivers that positively impact on health consumers’ social media usages can be integrated into meaningful strategies to capture the attention of potential consumers. They need to be educated, informed and engaged as health consumers so that they employ social media effectively to their advantage.
Using crystallization to understand loneliness in later life: integrating social science and creative narratives in sensitive qualitative research
Authors: Barbosa Neves Barbara , Wilson Josephine , Sanders Alexandra , Kokanović Renata
Published: April 2021

This article draws on crystallization, a qualitative framework developed by Laurel Richardson and Laura Ellingson, to show the potential of using sociological narratives and creative writing to better analyze and represent the lived experiences of loneliness among older people living in Australian care homes. Crystallization uses a multi-genre approach to study and present social phenomena. At its core is a concern for the ethics of representation, which is critical when engaging with vulnerable populations. We use two case studies from research on loneliness to illustrate an application of crystallization through different narrative types. To supplement our sociological narratives, we invited author Josephine Wilson to write creative narratives based on the case studies. Josephine was awarded the prestigious Miles Franklin Literary Award in 2017 for Extinctions, a novel exploring themes such as later life and loneliness. By contrasting the two approaches—sociological and creative narratives—we discuss the implications of crystallization for qualitative research.
Death, taxes and uncertainty: Economic motivations in end-of-life decision making
Authors: Mellgard George Slade , Appel Jacob M
Published: April 2021

Economic motivations are key drivers of human behavior. Unfortunately, they are largely overlooked in literature related to medical decisionmaking, particularly with regard to end-of-life care. It is widely understood that the directions of a proxy acting in bad faith can be overridden. But what of cases in which the proxy or surrogate appears to be acting in good faith to effectuate the patient’s values, yet doing so directly serves the decision-maker’s financial interests? Such situations are not uncommon. Many patients care as deeply about economic wellbeing of their families as they do for their own lives and health. This brief work examines three scenarios that raise ethical issues regarding the role of pecuniary motives in making critical medical decisions. Each scenario presents a potential financial conflict of interest between an incapacitated patient and a third-party decision-maker and offers a framework for integrating ethical and legal concerns into clinical care. It is our hope that this work prepares physicians for unexpected ethical conflicts of interest and enables them to further the interests of his or her patients.
Safety of four SGLT2 inhibitors in three chronic diseases: A meta-analysis of large randomized trials of SGLT2 inhibitors
Authors: Qiu Mei , Ding Liang-Liang , Zhang Miao , Zhou Hai-Rong
Published: April 2021

There are no relevant meta-analyses that have assessed the safety of the sodium-glucose transporter 2 (SGLT2) inhibitors in different chronic diseases. We aimed at evaluating the safety of four SGLT2 inhibitors in three chronic diseases by meta-analysis of the large randomized trials of SGLT2 inhibitors. We performed random-effects meta-analysis and carried out subgroup analysis according to type of underlying diseases and type of SGLT2 inhibitors. SGLT2 inhibitors versus placebo significantly reduced the risk of acute kidney injury (RR 0.75, 95% CI 0.66–0.85), and showed the reduced trend in the risk of severe hypoglycemia (RR 0.86, 95% CI 0.71–1.03). SGLT2 inhibitors significantly increased the risks of diabetic ketoacidosis (RR 2.57), genital infection (RR 3.75), and volume depletion (RR 1.14); and showed the increased trends in the risks of fracture (RR 1.07), amputation (RR 1.21), and urinary tract infection (RR 1.07). These effects exhibited by SGLT2 inhibitors were consistent across three chronic diseases (i.e. type 2 diabetes, chronic heart failure, and chronic kidney disease) and four SGLT2 inhibitors (i.e. dapagliflozin, empagliflozin, ertugliflozin, and canagliflozin) (all Psubgroup > 0.05). These findings will guide that specific adverse events are monitored when SGLT2 inhibitors are used in clinical practice.
COVID-19 Toes and Other Skin Lesions During the Pandemic: Emerging Entities?
Authors: Vas Prashanth R. J. , Georgiadis George S. , Papanas Nikolaos
Published: April 2021

There is accumulating evidence to indicate an association between coronavirus infectious disease 2019 (COVID-19) and clusters of incident cutaneous eruptions. Of these, chilblains-like perniosis have received widespread medical and media attention. These typically affect the toes, and have been called “COVID-toes.” Other acral lesions such as large bullae have also been reported. However, a definitive causal relationship with the severe acute respiratory syndrome coronavirus 2 has not yet been definitively proven, nor has a pathogenic mechanism been established. These episodes are self-limiting, but we need to know whether long-term sequelae exist.
The Search for Autoimmune-Associated Epilepsy Continues—Are We Getting Closer to Our Target?
Authors: Steriade Claude
Published: April 2021

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UAV attitude estimation based on MARG and optical flow sensors using gated recurrent unit
Authors: Liu Xiaoqin , Li Xiang , Shi Qi , Xu Chuanpei , Tang Yanmei
Published: April 2021

Three-dimensional attitude estimation for unmanned aerial vehicles is usually based on the combination of magnetometer, accelerometer, and gyroscope (MARG). But MARG sensor can be easily affected by various disturbances, for example, vibration, external magnetic interference, and gyro drift. Optical flow sensor has the ability to extract motion information from image sequence, and thus, it is potential to augment three-dimensional attitude estimation for unmanned aerial vehicles. But the major problem is that the optical flow can be caused by both translational and rotational movements, which are difficult to be distinguished from each other. To solve the above problems, this article uses a gated recurrent unit neural network to implement data fusion for MARG and optical flow sensors, so as to enhance the accuracy of three-dimensional attitude estimation for unmanned aerial vehicles. The proposed algorithm can effectively make use of the attitude information contained in the optical flow measurements and can also achieve multi-sensor fusion for attitude estimation without explicit mathematical model. Compared with the commonly used extended Kalman filter algorithm for attitude estimation, the proposed algorithm shows higher accuracy in the flight test of quad-rotor unmanned aerial vehicles.
Chorionic bump: Progression to a subamniotic hematoma
Authors: Galleguillos Claudia , Sepulveda Waldo
Published: April 2021

Introduction

A chorionic bump is an increasingly recognized ultrasound finding in first-trimester scans, which has been associated with early pregnancy loss. In ongoing second-trimester pregnancies, however, chorionic bumps usually resolve over time with no deleterious effect on the fetus. In this report, we describe the incidental ultrasound detection of a chorionic bump in early pregnancy and its progression to a subamniotic hematoma in the second trimester of pregnancy that persisted as such until delivery.

Case Report

A round, echogenic mass protruding from the choriodecidual surface measuring 13 × 11 × 8 mm was first identified during a transvaginal scan at 6.3 weeks’ gestation. Subsequent follow-up scan at 8.3 weeks revealed an increase in the size of the chorionic bump to 25 × 20 × 19 mm, which remained stable as determined by the routine late first-trimester scan. At the second-trimester scan, a subamniotic hematoma was identified in the surface of the placenta, close to the insertion of the umbilical cord. Subsequently, the pregnancy proceeded uneventfully.

Discussion

The etiopathology and clinical significance of a chorionic bump remain unclear. The case herein reported demonstrates that a chorionic bump can grow considerably without having a deleterious effect on the early embryo and, occasionally, can persist throughout pregnancy as a subamniotic hematoma.

Conclusion

A chorionic bump can occasionally progress to a subamniotic hematoma from the second trimester onwards. This observation further supports the hypothesis that a chorionic bump is the result of choriodecidual bleeding. An alternative explanation for the development of subamniotic hematomas is proposed.
Early discontinuation and dose reduction of adjuvant chemotherapy in stage III colon cancer patients
Authors: Boakye Daniel , Jansen Lina , Halama Niels , Chang-Claude Jenny , Hoffmeister Michael , Brenner Hermann
Published: April 2021

Background:

The benefit of chemotherapy in colon cancer patients is well documented but depends largely on whether patients complete the planned treatment regimen. We evaluated predictors of early discontinuation (EDChemo) and dose reduction of chemotherapy, especially the role of adverse treatment effects, in stage III patients who received adjuvant chemotherapy.

Methods:

Stage III colon cancer patients who were diagnosed in 2003–2014 and recruited into a population-based study in Germany and received FOLFOX [5-fluorouracil (5-FU), leucovorin (LV), and oxaliplatin], capecitabine monotherapy (CapMono), or 5-FU/LV were included. We assessed determinants of EDChemo and dose reduction using multivariable logistic regression. Also, we estimated proportions of EDChemo and dose reduction that are attributable to adverse effects using attributable fractions.

Results:

EDChemo and dose reduction rates were 52% and 17% for FOLFOX, 28% and 9% for CapMono, and 45% and 6% for 5-FU/LV, respectively. Predictors of EDChemo were low-grade tumor and treatment in a medium-volume hospital (for FOLFOX), obesity (for CapMono), and increasing age, T4 stage, and treatment in a medium-volume hospital (for 5-FU/LV). Adverse effects were particularly strongly associated with EDChemo and contributed to about 63%, 51%, and 32% of EDChemo of FOLFOX, CapMono, and 5-FU/LV, respectively. Of the various adverse effects, gastrointestinal events showed the strongest associations with EDChemo and accounted for about 7%, 26%, and 20% of EDChemo of FOLFOX, CapMono, and 5-FU/LV, respectively. Adverse effects were, moreover, a strong determinant of dose reduction and accounted for about 82% of all cases.

Conclusions:

EDChemo is common in stage III colon cancer patients receiving chemotherapy and more than half of the cases of EDChemo and dose reduction are due to adverse treatment effects. Further research should address the potential for reducing EDChemo and dose reduction rates by close monitoring of patients for early signs and enhanced management of adverse effects, especially gastrointestinal events.
Temporal Orientation and Customer Loyalty Programs
Authors: Hendler Flavia , LaTour Kathryn A. , Cotte June
Published: April 2021

Loyalty programs play a prominent role in many firms’ customer relationship management programs, but not all programs are successful. Providers need to understand not only what benefits customers want in a program, but also how they want to be treated as a loyalty member. We posit that because loyalty programs offer rewards that are time-bound (immediate or delayed), and that loyalty programs seek to develop a relationship that extends over time, an important, but overlooked dimension for hospitality managers to consider is how their customers view time. Our research focuses on customers’ temporal orientation—the tendency to think in the present, future, or past. We use depth interviews to explore existing casino loyalty program participants’ thoughts and feelings about their ideal loyalty program. We find the customers’ temporal orientation influences the type of relationship as well as the type of benefits sought in the loyalty program. Our research offers managerially practical insights for identifying customers more likely to engage in co-production of a long-term loyalty relationship as well as for creating communication strategies that are likely to interest and provoke different temporal mindsets.
Surgical Management of Giant Intrapericardial Teratoma Encasing the Coronary Artery
Authors: Minocha Prashant , Hodzic Emina , Sharma Madhu , Bhatla Puneet , Nielsen James , Ramirez Michelle , Magid Margret , Fisher Jason C. , Mosca Ralph , Kumar TK Susheel
Published: April 2021

Intrapericardial teratomas are rare, predominantly benign tumors that warrant surgical resection in the neonatal period because of their potential detrimental effects on the cardiorespiratory system. Surgical resection can be a challenge when the tumor encases and obscures a coronary artery. Adherence to certain operative principles is necessary to achieve successful outcomes.
Assigning a Value to Volunteering in Requests for Proposals
Authors: Dostál Jakub
Published: April 2021

The economic value of volunteering is an increasingly important part of volunteering management. It has become part of public policies. Some requests for proposals (RFP) enable nonprofits to include the value of volunteer time in compulsory co-financing. These RFP include the European Economic Area (EEA) Grants and Norway Grants. This article addresses the relationship in the value of volunteering, also called in-kind volunteering contributions. The research includes two case studies of finances from EEA and Norway Grants in the Czech Republic: the Czech NGO Programme, responsible for allocating grants between 2009 and 2014, and the Active Citizens Fund, responsible for allocating grants between 2014 and 2021. They share elements through the EEA and Norway Grants rules. However, they use different types of specialist replacement wages. The article summarizes the arguments for including in-kind volunteering contributions. It presents the possible values of these contributions in the selected cases, including the relationship between the type of volunteering and the number of hours necessary to achieve these values. The article defines the theoretical basis for calculating the value of in-kind volunteer contributions and illustrates this with real examples of allocations from EEA and Norway Grants.
Analysis on the Sources of China’s Economic Growth From the Perspective of Cleaner Production
Authors: Zhou Na , Zhao Jinkai , Zhao Kai , Li Dong
Published: April 2021

Since the reform and opening up to the outside world, China’s economy has created a remarkable growth miracle. However, as China enters the new normal economy, the world is full of doubts about its potential for economic growth. The article proper concerns an analysis on some factors affecting China’s economic growth, such as physical capital, labor quality, labor quantity, energy consumption, and environmental cost. Also embraced in this article is the measurement of the contribution of each factor to total factor productivity. The research is conducted on the basis of the provincial panel data of China over 2002–2016, from the perspective of cleaner production. The results reveal that (a) China’s economic growth had significant positive correlations with factor inputs, including traditional input elements (physical capital, labor quantity, labor quality) and natural elements (energy consumption and environmental cost); (b) the direct and indirect effects of physical capital, labor quality, and energy consumption on economic growth were significantly positive, while those of environmental cost were significantly negative; and (c) the contributions of the factors to the total factor productivity were ranked respectively as follows: physical capital (48.63%), energy consumption (16.81%), labor quality (14.85%), environmental cost (10.88%), and labor quantity (8.83%). China’s economic growth belonged to “perspiration.” In addition to the traditional input factors, natural factors also played an important role in boosting China’s economic development. It is urgent how to highlight the role of labor quality, while downplaying the contribution of natural factors, and then shift to cleaner production in China.
Prediction Models in Degenerative Spine Surgery: A Systematic Review
Authors: Lubelski Daniel , Hersh Andrew , Azad Tej D. , Ehresman Jeff , Pennington Zachary , Lehner Kurt , Sciubba Daniel M.
Published: April 2021

Study Design:

Systematic review.

Objectives:

To review the existing literature of prediction models in degenerative spinal surgery.

Methods:

Review of PubMed/Medline and Embase databases was conducted to identify articles between January 1, 2000 and March 1, 2020 that reported prediction model performance for outcomes following elective degenerative spine surgery.

Results:

Thirty-one articles were included. Twenty studies were of thoracolumbar, 5 were of cervical, and 6 included all spine patients. Five studies were externally validated. Prediction models were developed using machine learning (42%) and logistic regression (42%) as well as other techniques. Web-based calculators were included in 45% of published articles. Various outcomes were investigated, including complications, infection, length of stay, discharge disposition, reoperation, readmission, disability score, back pain, leg pain, return to work, and opioid dependence.

Conclusions:

Significant heterogeneity exists in methods used to develop prediction models of postoperative outcomes after degenerative spine surgery. Most internally validate their scores, but a few have been externally validated. Areas under the curve for most models range from 0.6 to 0.9. Techniques for development are becoming increasingly sophisticated with different machine learning tools. With further external validation, these models can be deployed online for patient, physician, and administrative use, and have the potential to optimize outcomes and maximize value in spine surgery.
The Value of Cement Augmentation in Patients With Diminished Bone Quality Undergoing Thoracolumbar Fusion Surgery: A Review
Authors: Kolz Joshua M. , Freedman Brett A. , Nassr Ahmad N.
Published: April 2021

Study Design:

Systematic review.

Objectives:

Osteoporosis predisposes patients undergoing thoracolumbar (TL) fusion to complications and revision surgery. Cement augmentation (CA) improves fixation of pedicle screws to reduce these complications. The goal of this study was to determine the value and cost-effectiveness of CA in TL fusion surgery.

Methods:

A systematic literature review was performed using an electronic database search to identify articles discussing the cost or value of CA. As limited information was available, the review was expanded to determine the mean cost of primary TL fusion, revision TL fusion, and the prevalence of revision TL fusion to determine the decrease of revision surgery necessary to make CA cost-effective.

Results:

Two studies were identified discussing the cost and value of CA. The mean cost of CA for two vertebral levels was $10 508, while primary TL fusion was $87 346 and revision TL fusion was $76 825. Using a mean revision rate of 15.4%, the use of CA for TL fusion would need to decrease revision rates by 13.7% to be cost-effective. Comparison studies showed a decreased revision rate of 11.3% with CA, which approaches this value.

Conclusion:

CA for TL fusion surgery improves biomechanical fixation of pedicle screws and decreases complications and revision surgery in patients with diminished bone quality. The costs of CA are substantial and reported decreases in revision rates approach but do not reach the calculated value to be a cost-effective technique. Future studies will need to focus on the optimal CA technique to decrease complications, revisions, and costs.
Emergency Department Utilization Among People Living With HIV on Chronic Opioid Therapy
Authors: Thakarar Kinna , Kulkarni Amoli , Lodi Sara , Walley Alexander Y. , Lira Marlene C. , Forman Leah S. , Colasanti Jonathan A. , del Rio Carlos , Samet Jeffrey H.
Published: April 2021

Chronic pain among people with HIV (PWH) is a driving factor of emergency department (ED) utilization, and it is often treated with chronic opioid therapy (COT). We conducted a cross-sectional analysis of a prospective observational cohort of PWH on COT at 2 hospital-based clinics to determine whether COT-specific factors are associated with ED utilization among PWH. The primary outcome was an ED visit within 12 months after study enrollment. We used stepwise logistic regression including age, gender, opioid duration, hepatitis C, depression, prior ED visits, and Charlson comorbidity index. Of 153 study participants, n = 69 (45%) had an ED visit; 25% of ED visits were pain-related. High dose opioids, benzodiazepine co-prescribing, and lack of opioid treatment agreements were not associated with ED utilization, but prior ED visits (p = 0.002), depression (p = 0.001) and higher Charlson comorbidity score (p = 0.003) were associated with ED utilization. COT-specific factors were not associated with increased ED utilization among PWH.
Online Ratings of Primary Care Physicians: Comparison of Gender, Training, and Specialty
Authors: Wachs Daliah , Lorah Victoria , Boynton Allison , Hertzler Amanda , Nichols Brandon , Kraft Joseph , Wang Jerry , Dang Ivy , Kalekas Paul , Vanier Cheryl
Published: April 2021

The purpose of this study was to explore patient perceptions of primary care providers and their offices relative to their physician’s philosophy (medical degree [MD] vs doctorate in osteopathic medicine [DO]), specialty (internal medicine vs family medicine), US region, and gender (male vs female). Using the Healthgrades website, the average satisfaction rating for the physician, office parameters, and wait time were collected and analyzed for 1267 physicians. We found female doctors tended to have lower ratings in the Midwest, and staff friendliness of female physicians were rated lower in the northwest. In the northeast, male and female MDs were rated more highly than DOs. Wait times varied regionally, with northeast and northwest regions having the shortest wait times. Overall satisfaction was generally high for most physicians. Regional differences in perception of a physician based on gender or degree may have roots in local culture, including proximity to a DO school, comfort with female physicians, and expectations for waiting times.
Improving the structural and physical properties of boric acid-doped rigid polyurethane materials
Authors: Kırbaş İbrahim
Published: April 2021

In this study, the internal structure and physical properties of boric acid-doped rigid polyurethane (PU) materials were investigated. 5%, 10%, and 15% of boric acid were added into PU material compared to the total mass. These rigid PUs were subjected to scanning electron microscopy, energy-dispersive X-ray spectroscopy, X-ray diffraction, Fourier transform infrared spectroscopy, thermal conductivity, and density determination for analysis. Boric acid addition resulted in a decrease of 57.2% in thermal conductivity and 67.8% in density compared to raw PU material. It has been shown that it provides support for the formation of cell structure. In addition to, it is also found that there are no impurity atoms in the structure and the structure is formed in the tetragonal phase.
Engineering Resistance to Bacterial Blight and Bacterial Leaf Streak in Rice
Authors: Ni Zhe , Cao Yongqiang , Jin Xia , Fu Zhuomin , Li Jianyuan , Mo Xiuyu , He Yongqiang , Tang Jiliang , Huang Sheng
Published: April 2021

Background

Xanthomonas oryzae (Xo) is one of the important pathogenic bacterial groups affecting rice production. Its pathovars Xanthomonas oryzae pv. oryzae (Xoo) and Xanthomonas oryzae pv. oryzicola (Xoc) cause bacterial blight and bacterial leaf streak in rice, respectively. Xo infects host plants by relying mainly on its transcription activator-like effectors (TALEs) that bind to host DNA targets, named effector binding elements (EBEs), and induce the expression of downstream major susceptibility genes. Blocking TALE binding to EBE could increase rice resistance to the corresponding Xo.

Findings

We used CRISPR/Cas9 to edit the EBEs of three major susceptibility genes (OsSWEET11, OsSWEET14 and OsSULTR3;6) in the rice varieties Guihong 1 and Zhonghua 11. Both varieties have a natural one-base mutation in the EBE of another major susceptibility gene (OsSWEET13) which is not induced by the corresponding TALE. Two rice lines GT0105 (from Guihong 1) and ZT0918 (from Zhonghua 11) with target mutations and transgene-free were obtained and showed significantly enhanced resistance to the tested strains of Xoo and Xoc. Furthermore, under simulated field conditions, the morphology and other agronomic traits of GT0105 and ZT0918 were basically the same as those of the wild types.

Conclusions

In this study, we first reported that the engineering rice lines obtained by editing the promoters of susceptibility genes are resistant to Xoo and Xoc, and their original agronomic traits are not affected.
Evaluation of indicators for cyanobacterial risk in 108 temperate lakes using 23 years of environmental monitoring data
Authors: Li J. , Persson K. M. , Pekar H. , Jansson D.
Published: April 2021

Background

Cyanobacterial blooms are of increasing concern for drinking water supply. In Sweden, a survey among drinking water producers showed that the sense of urgency was little. At 60% of the Swedish drinking water treatment plants, operators lacked monitoring strategies. To get a picture of the size of the problem the presence of cyanobacterial risk in 108 Swedish lakes was evaluated from 23 years of environmental monitoring data. The drivers and indicators for cyanobacterial growth were investigated by analyzing water quality in 9 lakes that have more frequent cyanobacteria bio-volume above the WHO drinking water alert level 1: 0.2 mm3L−1.

Results

The study shows that the most common species in those lakes are Anabaena/Dolichospermum and Aphanizomenon followed by Microcystis, Woronichinia and Planktothrix, which can produce a variety of toxins such as anatoxins, cylindrospermopsins, microcystins and saxitoxins, supported by literature study. Our results show that cyanobacterial risk in those problematic 9 lakes are mainly nutrients driven with possibly contribution of increased organic matter. By applying non-linear quantile regression with total phosphorus (TP) as an example, we demonstrated that certain drivers such as TP can be useful for cyanobacterial risk assessment and provide control measures by setting nutrients targets. We also evidenced that cyanobacterial peaks presented at low TN:TP ratio while not necessarily vice versa. We also further evaluated that chlorophyll-a and transparency might be suitable as indicators for cyanobacterial blooms in certain lakes, while for most of the lakes, their connection is low.

Conclusion

Nutrients are main drivers for higher cyanobacterial occurrence in the 9 lakes. We suggest TP concentrations should be investigated thoroughly to provide important knowledge which can be used to set nutrient targets to sustain safe drinking water supply and recreational services. The complexity of indicating cyanobacterial risk in a local condition was also highlighted in this study and future study is suggested. To classify different types of lake and identify their drivers and the similarities of species composition changes in those lakes will be future studied.
The expression and prognostic value of the epidermal growth factor receptor family in glioma
Authors: Xu Bin , Huo Zhengyuan , Huang Hui , Ji Wei , Bian Zheng , Jiao Jiantong , Sun Jun , Shao Junfei
Published: April 2021

Background

The epidermal growth factor receptor (EGFR) family belongs to the transmembrane protein receptor of the tyrosine kinase I subfamily and has 4 members: EGFR/ERBB1, ERBB2, ERBB3, and ERBB4. The EGFR family is closely related to the occurrence and development of a variety of cancers.

Materials/methods

In this study, we used multiple online bioinformatics websites, including ONCOMINE, TCGA, CGGA, TIMER, cBioPortal, GeneMANIA and DAVID, to study the expression profiles, prognostic values and immune infiltration correlations of the EGFR family in glioma.

Results

We found that EGFR and ERBB2 mRNA expression levels were higher in glioblastoma (GBM, WHO IV) than in other grades (WHO grade II & III), while the ERBB3 and ERBB4 mRNA expression levels were the opposite. EGFR and ERBB2 were notably downregulated in IDH mutant gliomas, while ERBB3 and ERBB4 were upregulated, which was associated with a poor prognosis. In addition, correlation analysis between EGFR family expression levels and immune infiltrating levels in glioma showed that EGFR family expression and immune infiltrating levels were significantly correlated. The PPI network of the EGFR family in glioma and enrichment analysis showed that the EGFR family and its interactors mainly participated in the regulation of cell motility, involving integrin receptors and Rho family GTPases.

Conclusions

In summary, the results of this study indicate that the EGFR family members may become potential therapeutic targets and new prognostic markers for glioma.
Intra- and interobserver concordance of a new classification system for myopic maculopathy
Authors: Zhang Rong-rong , Yu Yan , Hou Yin-fen , Wu Chang-fan
Published: April 2021

Background

Myopic maculopathy (MM) is one of the major causes of visual impairment and irreversible blindness in eyes with pathologic myopia (PM). However, the classification of each type of lesion associated with MM has not been determined. Recently, a new MM classification system, known as the ATN grading and classification system, was proposed; it is based on the fundus photographs and optical coherence tomography (OCT) images and includes three variable components: atrophy (A), traction (T), and neovascularization (N). This study aimed to perform an independent evaluation of interobserver and intraobserver agreement for the recently developed ATN grading system for MM.

Methods

This was a retrospective study. Fundus photographs and OCT images of 125 patients (226 eyes) with various MMs were evaluated and classified using the ATN grading of the new MM classification system by four blinded and independent evaluators (2 attending ophthalmologists and 2 ophthalmic residents). All cases were randomly re-evaluated by the same observers after an interval of 6 weeks. The kappa coefficient (κ) and 95% confidence interval (CI) were used to determine the interobserver and intraobserver agreement.

Results

The interobserver agreement was substantial when considering the maculopathy type (A, T, and N). The weighted Fleiss κ values for each MM type (A, T, and N) were 0.651 (95% CI: 0.602–0.700), 0.734 (95% CI: 0.689–0.779), and 0.702 (95% CI: 0.649–0.755), respectively. The interobserver agreement when considering the subtypes was good or excellent, except for stages A1, A2, and N1, in which the weighted κ value was less than 0.6, with moderate agreement. The intraobserver agreement of types and subtypes was excellent, with κ > 0.8. No significant differences were observed between the attending ophthalmologists and residents for interobserver reliability or intraobserver reproducibility.

Conclusions

The ATN classification allows an adequate agreement among ophthalmologists with different qualifications and by the same observer on separate occasions. Future prospective studies should further evaluate whether this classification can be better implemented in clinical decision-making and disease progression assessments.
The prevalence and stressors of job burnout among medical staff in Liaoning, China: a cross-section study
Authors: Guo Youqi , Hu Shu , Liang Fei
Published: April 2021

Background

Sustained attention to the prevalence and associated factors of burnout in China is important for the health care service quality and related reform. In this study, we investigated the prevalence of job burnout among medical staff in Liaoning province, China; performed a survey of subjective perception ranking for the main stressors among respondents; estimated the effect of stresses from work tasks and the relationship with patients on job burnout in order to provide improved strategy and suggestion for hospital administrators.

Methods

The respondents were from 8 hospitals in 3 cities in Liaoning province, China. Data were collected and analyzed including the following sections: (1) demographic characteristics; (2) work situations; (3) ranking of six stressors; (4) job burnout scale; (5) effort-reward imbalance scale; (6) work violence scale; (7) fear of malpractice scale. A total of 1056 individuals became the study objects. A statistical analysis and hierarchical linear regression analysis were performed to explore the prevalence of burnout and the effects of stressors.

Results

The prevalence of job burnout was 20.5, and 72.9% of all respondents reported a least one symptom of burnout. The respondents who were male, 30–39 years old, had a master’s degree or high and working hours > 60 h per week, came from obstetrics and gynecology or pediatrics profession prone to job burnout. The relationship with patients and work tasks are the top two ranking stressors in the subjective perception survey. Regression analysis showed that the relationship with patients explained 19.2, 16.8 and 2.0% of variance in burnout subscales EE, DP and PA, respectively and work tasks explained 23.5, 16.0 and 5.24% of variance in burnout subscales EE, DP and PA, respectively.

Conclusion

The Chinese medical staff had high prevalence of job burnout. Some factors of demographic and work situations were associated with job burnout. The medical staff considered the relationship with patients and work tasks are the two major stressors. These two stressors are also the major indicators associated with job burnout. The hospital administrators should be aware of the risk of burnout. Efforts should be made to ameliorate the status of job burnout.
Divergent airway microbiomes in lung transplant recipients with or without pulmonary infection
Authors: Påhlman Lisa I. , Manoharan Lokeshwaran , Aspelund Anna Stjärne
Published: April 2021

Background

Lung transplant (LTx) recipients are at increased risk for airway infections, but the cause of infection is often difficult to establish with traditional culture-based techniques. The objectives of the study was to compare the airway microbiome in LTx patients with and without ongoing airway infection and identify differences in their microbiome composition.

Methods

LTx recipients were prospectively followed with bronchoalveolar lavage (BAL) during the first year after transplantation. The likelihood of airway infection at the time of sampling was graded based on clinical criteria and BAL cultures, and BAL fluid levels of the inflammatory markers heparin-binding protein (HBP), IL-1β and IL-8 were determined with ELISA. The bacterial microbiome of the samples were analysed with 16S rDNA sequencing and characterized based on richness and evenness. The distance in microbiome composition between samples were determined using Bray–Curtis and weighted and unweighted UniFrac.

Results

A total of 46 samples from 22 patients were included in the study. Samples collected during infection and samples with high levels of inflammation were characterized by loss of bacterial diversity and a significantly different species composition. Burkholderia, Corynebacterium and Staphylococcus were enriched during infection and inflammation, whereas anaerobes and normal oropharyngeal flora were less abundant. The most common findings in BAL cultures, including Pseudomonas aeruginosa, were not enriched during infection.

Conclusion

This study gives important insights into the dynamics of the airway microbiome of LTx recipients, and suggests that lung infections are associated with a disruption in the homeostasis of the microbiome.
Correction to: Subcellular localization of L-selectin ligand in the endometrium implies a novel function for pinopodes in endometrial receptivity
Authors: Nejatbakhsh Reza , Kabir-Salmani Maryam , Dimitriadis Evdokia , Hosseini Ahmad , Taheripanah Robabeh , Sadeghi Yousef , Akimoto Yoshihiro , Iwashita Mitsutoshi
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.