bluuebunny/crossref_metadata_2025 huggingface dataset:
Who Identifies as Anti-Racist? Racial Identity, Color-Blindness, and Generic Liberalism
Authors: Perry Samuel L. , Frantz Kenneth E. , Grubbs Joshua B.
Published: November 2021

Although decades old, the terms “anti-racism/antiracism” and “anti-racist/antiracist” have grown in usage by scholars, authors, and activists to convey the necessity of active opposition to racial injustice. But as the terms have become more mainstream, researchers have yet to examine the social and ideological correlates of actually describing oneself as “anti-racist.” Drawing on nationally representative survey data fielded at the height of national interest in “antiracist/anti-racist” language, the authors find that Blacks and Hispanics are significantly less likely than whites to describe themselves as “anti-racist,” and only the “very liberal” are more likely than other political orientations to identify with the label. Considering ideological correlates, progressive racial ideology is the strongest predictor of identifying as “anti-racist.” However, the second strongest correlate is describing oneself as “color-blind.” Analyses of quadratic terms suggests that this correlation is curvilinear for nonwhites but more linear for whites. Although originally conveying more radical and subversive ideals, those currently most likely to self-describe as “anti-racist” are white progressives with what we call “generically liberal” racial views.
The Impact of Mass Shootings on Attitudes toward Gun Restrictions
Authors: Frey Arun , Kirk David S.
Published: November 2021

Is the American public more likely to favor stricter gun legislation in the aftermath of deadly mass shootings? The authors leverage the occurrence of several mass shootings during multiple survey waves of the General Social Survey between 1987 and 2018 to examine whether exposure to a mass shooting sways public opinion on gun legislation. The results reveal that mass shootings increase support for stricter gun permits among Democrats but not for individuals of other political orientations. An exception to this finding occurs with school shootings, which mobilize broad support for firearm legislation among both Democrats and Republicans.
Physician Executive Leadership Plus: An Approach to Business and Management Education for Medical Students
Authors: Beldick Stephanie R. , Ooi Gavyn , Shah Saloni A. , Morano Michael , Li Chris , Zimmerman Michael , Levine Leonard
Published: November 2021

INTRODUCTION

Physicians are looked upon to lead the healthcare team, a task that has grown increasingly complex and interdisciplinary, requiring a diverse extra-clinical skillset. Physician Executive Leadership (PEL) Plus is a student-run program that uniquely utilizes both didactic and real-world project-based approaches to deliver a business and management curriculum to medical students.

METHODS

We developed and implemented PEL Plus during the 2018-19 and 2019-20 academic years, geared at first- and second-year medical students. We provide an overview of this combined didactic and project-based curriculum, in addition to evaluating if the program was efficacious in teaching the desired skillset. We assessed short-term knowledge acquisition using multiple-choice questions, and investigated student perceptions of their learning and the program using Likert scales and narrative feedback. We also investigated the influence of student demographics on performance, in order to assess the appropriateness of our target audience.

RESULTS

28 students completed PEL Plus over the two years (14 students/year). Average performance on multiple-choice questions showed statistically significant improvement after the majority of sessions. There were no statistically significant effects of demographics on performance in the majority of sessions. Students self-rated stronger understandings of lecture topics after each session, and analysis of narrative feedback demonstrated thematic categories centred on teaching style, new knowledge, lecture content/material, projects, networking, program structure, and generic statements.

DISCUSSION

PEL Plus is an innovative and effective approach to teaching business, leadership, and management skills in undergraduate medical education. Development of similar programs at other institutions will positively impact the broader medical student community.
Relations between language, non-verbal cognition, and conceptualization in non- or minimally verbal individuals with ASD across the lifespan
Authors: Slušná Dominika , Rodríguez Andrea , Salvadó Berta , Vicente Agustín , Hinzen Wolfram
Published: November 2021

Background & aims

Individuals with non- or minimally verbal autism (nvASD) are primarily characterized by a severe speech production deficit, with speech limited to no or only a few words by school age. Significant unclarity remains over variability in language profiles across the lifespan, the nature of the language impairment seen, and (dis-) associations between linguistic and nonverbal cognitive measures.

Methods

To address these questions, we recruited both a school-age and an adult group with nvASD (total N = 49) and investigated relations between expressive and receptive language, and between these and nonverbal intelligence quotient (NVIQ) and sense-making capacities (the ComFor test).

Results

Results revealed limited variation across this sample in receptive language, which in turn predicted expressive language levels. Importantly, an upward trend in verbal mental age (VMA) across increasing chronological age was seen in the youngsters (only). A radical dissociation between NVIQ and both expressive and receptive language transpired as well, and a subset of individuals with normal NVIQ were comparable in terms of any other cognitive aspect. Sense-making reached symbolic levels in 62.2% of the sample and loaded on both verbal and nonverbal factors.

Conclusions

These patterns inform theories of nvASD by revealing an impairment that is not conceptualizable as one of expressive language only, sharply limits learning opportunities across the lifespan, and cannot be compensated for by nonverbal cognition.

Implications

These findings stress the need to seize developmental opportunities that may disappear when youngsters turn into adults, via therapies that specifically target language as a central cognitive system comprising both production and comprehension.
The effects of vacant lot greening and the impact of land use and business presence on crime
Authors: Cui Jesse , Jensen Shane T , MacDonald John
Published: November 2021

We examine the effect of the Philadelphia LandCare vacant lot greening initiative on crime and the extent to which surrounding land uses and business types moderate this intervention. We rely on a propensity score matching analysis to account for substantial differences in demographic, economic, land use, and business characteristics between greened and ungreened vacant lots. We estimate larger and more significant crime reductions around vacant lots that are greened in our matched pairs analysis compared to unmatched analyses. The effects of vacant lot greening on crime are larger in areas with high residential, high civic, and low transportation land use and are moderated by the presence of different types of nearby businesses.
ELN2017 risk stratification improves outcome prediction when applied to the prospective GIMEMA AML1310 protocol
Authors: Buccisano Francesco , Palmieri Raffaele , Piciocchi Alfonso , Arena Valentina , Candoni Anna , Melillo Lorella , Calafiore Valeria , Cairoli Roberto , de Fabritiis Paolo , Storti Gabriella , Salutari Prassede , Lanza Francesco , Martinelli Giovanni , Luppi Mario , Capria Saveria , Maurillo Luca , Del Principe Maria Ilaria , Paterno Giovangiacinto , Irno Consalvo Maria Antonietta , Ottone Tiziana , Lavorgna Serena , Voso Maria Teresa , Fazi Paola , Vignetti Marco , Arcese William , Venditti Adriano
Published: November 2021

The 2017 version of the European LeukemiaNet (ELN) recommendations, by integrating cytogenetics and mutational status of specific genes, divides patients with acute myeloid leukemia into 3 prognostically distinct risk categories: favorable (ELN2017-FR), intermediate (ELN2017-IR), and adverse (ELN2017-AR). We performed a post hoc analysis of the GIMEMA (Gruppo Italiano Malattie EMatologiche dell’Adulto) AML1310 trial to investigate the applicability of the ELN2017 risk stratification to our study population. In this trial, after induction and consolidation, patients in complete remission were to receive an autologous stem cell transplant (auto-SCT) if categorized as favorable risk or an allogeneic stem cell transplant (allo-SCT) if adverse risk. Intermediate-risk patients were to receive auto-SCT or allo-SCT based on the postconsolidation levels of measurable residual disease as measured by using flow cytometry. Risk categorization was originally conducted according to the 2009 National Comprehensive Cancer Network recommendations. Among 500 patients, 445 (89%) were reclassified according to the ELN2017 criteria: ELN2017-FR, 186 (41.8%) of 455; ELN2017-IR, 179 (40.2%) of 445; and ELN2017-AR, 80 (18%) of 455. In 55 patients (11%), ELN2017 was not applicable. Two-year overall survival (OS) was 68.8%, 51.3%, 45.8%, and 42.8% for the ELN2017-FR, ELN2017-IR, ELN2017-not classifiable, and ELN2017-AR groups, respectively (P < .001). When comparing the 2 different transplant strategies in each ELN2017 risk category, a significant benefit of auto-SCT over allo-SCT was observed among ELN2017-FR patients (2-year OS of 83.3% vs 66.7%; P = .0421). The 2 transplant procedures performed almost equally in the ELN2017-IR group (2-year OS of 73.9% vs 70.8%; P = .5552). This post hoc analysis of the GIMEMA AML1310 trial confirms that the ELN2017 classification is able to accurately discriminate patients with different outcomes and who may benefit from different transplant strategies. This trial was registered as EudraCT number 2010-023809-36 and at www.clinicaltrials.gov as #NCT01452646.
Role of DNA methylation on the association between physical activity and cardiovascular diseases: results from the longitudinal multi-ethnic study of atherosclerosis (MESA) cohort
Authors: Shi Hangchuan , Ossip Deborah J. , Mayo Nicole L. , Lopez Daniel A. , Block Robert C. , Post Wendy S. , Bertoni Alain G. , Ding Jingzhong , Chen Si , Yan Chen , Xie Zidian , Hoeschele Ina , Liu Yongmei , Li Dongmei
Published: November 2021

Background

The complexity of physical activity (PA) and DNA methylation interaction in the development of cardiovascular disease (CVD) is rarely simultaneously investigated in one study. We examined the role of DNA methylation on the association between PA and CVD.

Results

The Multi-Ethnic Study of Atherosclerosis (MESA) cohort Exam 5 data with 1065 participants free of CVD were used for final analysis. The quartile categorical total PA variable was created by activity intensity (METs/week). During a median follow-up of 4.0 years, 69 participants developed CVD. Illumina HumanMethylation450 BeadChip was used to provide genome-wide DNA methylation profiles in purified human monocytes (CD14+). We identified 23 candidate DNA methylation loci to be associated with both PA and CVD. We used the structural equation modeling (SEM) approach to test the complex relationships among multiple variables and the roles of mediators. Three of the 23 identified loci (corresponding to genesVPS13D,PIK3CDandVPS45) remained as significant mediators in the final SEM model along with other covariates. Bridged by the three genes, the 2nd PA quartile (β = − 0.959; 95%CI: − 1.554 to − 0.449) and the 3rd PA quartile (β = − 0.944; 95%CI: − 1.628 to − 0.413) showed the greatest inverse associations with CVD development, while the 4th PA quartile had a relatively weaker inverse association (β = − 0.355; 95%CI: − 0.713 to − 0.124).

Conclusions

The current study is among the first to simultaneously examine the relationships among PA, DNA methylation, and CVD in a large cohort with long-term exposure. We identified three DNA methylation loci bridged the association between PA and CVD. The function of the identified genes warrants further investigation in the pathogenesis of CVD.
Acceptance of seasonal influenza vaccination and associated factors among pregnant women in the context of COVID-19 pandemic in China: a multi-center cross-sectional study based on health belief model
Authors: Wang Ruitong , Tao Liyuan , Han Na , Liu Jihong , Yuan Chuanxiang , Deng Lixia , Han Chunhua , Sun Fenglan , Chi Liqun , Liu Min , Liu Jue
Published: November 2021

Background

Seasonal influenza can circulate in parallel with coronavirus disease (COVID-19) in winter. In the context of COVID-19 pandemic, the risk of co-infection and the burden it poses on healthcare system calls for timely influenza vaccination among pregnant women, who are the priority population recommended for vaccination. We aimed to evaluate the acceptance of influenza vaccination and associated factors among pregnant women during COVID-19 pandemic, provide evidence to improve influenza vaccination among pregnant women, help reduce the risk of infection and alleviate the burden of healthcare system for co-infected patients.

Methods

We conducted a multi-center cross-sectional study among pregnant women in China. Sociodemographic characteristics, health status, knowledge on influenza, attitude towards vaccination, and health beliefs were collected. Locally weighted scatterplot smoothing regression analysis was used to evaluate the trends in the acceptance of influenza vaccine. Logistic regression was applied to identify factors associated with vaccination acceptance.

Results

The total acceptance rate was 76.5% (95%CI: 74.8–78.1%) among 2568 pregnant women enrolled. Only 8.3% of the participants had a history of seasonal influenza vaccination. In the logistic regression model, factors associated with the acceptance of influenza vaccine were western region, history of influenza vaccination, high knowledge of influenza infection and vaccination, high level of perceived susceptibility, perceived benefit, cues to action and low level of perceived barriers. Among 23.5% of the participants who had vaccine hesitancy, 48.0% of them were worried about side effect, 35.6% of them lacked confidence of vaccine safety.

Conclusions

Our findings highlighted that tailored strategies and publicity for influenza vaccination in the context of COVID-19 pandemic are warranted to reduce pregnant women’s concerns, improve their knowledge, expand vaccine uptake and alleviate pressure for healthcare system.
Baseline malaria prevalence at the targeted pre-elimination districts in Ethiopia
Authors: Nega Desalegn , Abera Adugna , Gidey Bokretsion , Mekasha Sindew , Abebe Abnet , Dillu Dereje , Mehari Degu , Assefa Gudissa , Hailu Samuel , Haile Mebrahatom , Etana Kebede , Solomon Hiwot , Tesfaye Gezahagn , Nigatu Daniel , Destaw Zelalem , Tesfaye Berhane , Serda Belendia , Yeshiwondim Asnakew , Getachew Assefaw , Teka Hiwot , Nahusenay Honelegn , Abdelmenan Semira , Reda Hailemariam , Bekele Worku , Zewdie Ayele , Tollera Getachew , Assefa Ashenafi , Tasew Geremew , Woyessa Adugna , Abate Ebba
Published: November 2021

Background

Encouraged by the previous success in malaria control and prevention strategies, the Ethiopian ministry of health launched malaria elimination with a stepwise approach by primarily targeting the low-transmission Districts and their adjacent areas/zones in order to shrink the country’s malaria map progressively. Hence, this community survey was conducted to establish baseline malaria information at the preliminary phase of elimination at targeted settings.

Methods

A community-based cross-sectional survey was conducted at 20 malaria-elimination targeted Districts selected from five Regional states and one city administration in Ethiopia. The GPS-enabled smartphones programmed with Open Data Kit were used to enumerate 9326 study households and collect data from 29,993 residents. CareStart™ Malaria PAN (pLDH) Rapid Diagnostic Tests (RDTs) were used for blood testing at the field level. Armpit digital thermometers were used to measure axillary temperature.

Result

Overall malaria prevalence by RDTs was 1.17% (339/28973). The prevalence at District levels ranged from 0.0 to 4.7%. The proportion of symptomatic cases (axillary temperature > 37.5oc) in the survey was 9.2% (2760/29993). Among the 2510 symptomatic individuals tested with RDTs, only 3.35% (84/2510) were malaria positive. The 75.2% (255/339) of all malaria positives were asymptomatic. Of the total asymptomatic malaria cases, 10.2% (26/255) were under-five children and 89.8% (229/255) were above 5 years of age.

Conclusion

The study shows a decrease in malaria prevalence compared to the reports of previous malaria indicator surveys in the country. The finding can be used as a baseline for measuring the achievement of ongoing malaria elimination efforts. Particularly, the high prevalence of asymptomatic individuals (0.88%) in these transmission settings indicates there may be sustaining hidden transmission. Therefore, active case detection with more sensitive diagnostic techniques is suggested to know more real magnitude of residual malaria in the elimination-targeted areas.
In-hospital mortality associated with community-acquired pneumonia due to methicillin-resistant Staphylococcus aureus: a matched-pair cohort study
Authors: Sakamoto Yukiyo , Yamauchi Yasuhiro , Jo Taisuke , Michihata Nobuaki , Hasegawa Wakae , Takeshima Hideyuki , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo , Nagase Takahide
Published: November 2021

Background

It remains unclear whether methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is associated with higher mortality compared with non-MRSA pneumonia. This study’s objective was to compare outcomes including in-hospital mortality and healthcare costs during hospitalisation between patients with MRSA pneumonia and those with non-MRSA pneumonia.

Methods

Using a national inpatient database in Japan, we conducted a 1:4 matched-pair cohort study of inpatients with community-acquired pneumonia from 1 April 2012 to 31 March 2014. In-hospital outcomes (mortality, length of stay and healthcare costs during hospitalisation) were compared between patients with and without MRSA infection. We performed multiple imputation using chained equations followed by multivariable regression analyses fitted with generalised estimating equations to account for clustering within matched pairs. All-cause in-hospital mortality and healthcare costs during hospitalisation were compared for pneumonia patients with and without MRSA infection.

Results

Of 450,317 inpatients with community-acquired pneumonia, 3102 patients with MRSA pneumonia were matched with 12,320 patients with non-MRSA pneumonia. The MRSA pneumonia patients had higher mortality, longer hospital stays and higher costs. Multivariable logistic regression analysis revealed that MRSA pneumonia was significantly associated with higher in-hospital mortality compared with non-MRSA pneumonia (adjusted odds ratio = 1.94; 95% confidence interval: 1.72–2.18; p < 0.001). Healthcare costs during hospitalisation were significantly higher for patients with MRSA pneumonia than for those with non-MRSA pneumonia (difference = USD 8502; 95% confidence interval: USD 7959–9045; p < 0.001).

Conclusions

MRSA infection was associated with higher in-hospital mortality and higher healthcare costs during hospitalisation, suggesting that preventing MRSA pneumonia is essential.
Mid-term clinical outcomes and complications of primary total knee arthroplasty in hemodialysis patients: a retrospective comparative cohort study
Authors: Kii Sakumo , Sonohata Motoki , Hashimoto Akira , Nakashima Takema , Kawaguchi Atsushi , Matsumura Yosuke , Shimazaki Takafumi , Nagamine Satomi , Mawatari Masaaki
Published: November 2021

Background

Numerous patients who receive hemodialysis (HD) undergo total knee arthroplasty (TKA) due to advanced knee joint arthritis. However, there are few studies that describe the clinical outcomes and complications of TKA in HD patients. This study investigated the mid-term results of TKA in patients undergoing HD.

Methods

This single-center retrospective study compared clinical and surgical outcomes following TKA in patients who were receiving HD with those who were not. We used propensity scores to match 21 knees of 18 patients who received HD to 706 knees of 569 patients who had not received HD, from a total of 727 knees (587 patients) that underwent primary unilateral TKA. The clinical outcomes were evaluated using the American Knee Society Score-knee (AKSS-knee) and AKSS-function scores. The primary surgical outcome measure was the number of knees with postoperative complications.

Results

In both the HD and non-HD groups, postoperative AKSS-knee and function scores significantly improved when compared to preoperative values. Postoperative AKSS-knee and function scores were not significantly different between the groups. The number of knees with postoperative complications was larger in the HD group than the non-HD group within the first postoperative month, 0–12 months, 12–24 months, 0–24 months, and two years after surgery. Additionally, in the HD group, more complications occurred in the first month than any subsequent month in the two years after surgery.

Conclusions

TKA improves AKSS-knee and function scores equivalently for HD patients and non-HD patients. However, HD patients develop more complications after TKA, especially within the first month. Therefore, surgeons who perform TKA for HD patients should obtain informed consent after explaining the possible complications, and HD patients should be carefully observed following TKA.
Prevalence of vitamin D deficiency and its associated risk factors among rural population of the northern part of the Persian Gulf
Authors: Marzban Maryam , Kalantarhormozi Mohammadreza , Mahmudpour Mehdi , Ostovar Afshin , Keshmiri Saeed , Darabi Amir Hossein , Khajeian Abdolmohammad , Bolkheir Amirreza , Amini Azam , Nabipour Iraj
Published: November 2021

Background

Accumulating evidence indicates that vitamin D deficiency has been increased globally over the last two decades. However, the majority of these studies are concerned with cities and there is scant information regarding the prevalence of vitamin D in rural areas. The main aim of this study was to investigate the prevalence of vitamin D deficiency and its associated risk factors among the rural population in Bushehr province which shares the longest border with the Persian Gulf.

Methods

The rural inhabitants of more than 25 years old from three mountainous, plain, and seashore areas of Bushehr province were selected through a stratified multi-cluster random sampling method. After obtaining the participants’ demographic and anthropometric data and their past medical history, serum 25-hydroxyvitamin D [25(OH)D] was measured using ELISA.

Results

A total of 1806 (means ±SD, 46± 14years old) rural subjects (35 % males and 65 % females) participated in this study. The prevalence of vitamin D deficiency, insufficiency, and sufficiency were 28 %, 50 %, and 22 %, respectively. The deficiency of vitamin D in women was higher than in men (OR=1.27, 95 % CI: 1.05 to 1.54, P=0.04). There was a positive significant correlation between age and serum vitamin D levels. Men with vitamin D deficiency had higher BMI (P=0.008); this association was not observed among women (P=0.7). There was no significant difference between the food item’s consumption frequencies, and vitamin D status (P>0.05). The mountainous, and plain areas had the highest and lowest vitamin D levels, respectively.

Conclusions

Although, Bushehr province is located in a sunny part of Iran, the prevalence of vitamin D deficiency was high among its rural population. The shift of their lifestyle patterns and rapid industrialization in these rural areas may be responsible. Therefore, the enrichment of dietary sources with vitamin D and the use of vitamin D supplements are recommended to tackle the high prevalence of vitamin D deficiency in the rural population of the northern part of the Persian Gulf.
When is it considered reasonable to start a risky and uncomfortable treatment in critically ill patients? A random sample online questionnaire study
Authors: Zink M. , Horvath A. , Stadlbauer V.
Published: November 2021

Background

Health care professionals have to judge the appropriateness of treatment in critical care on a daily basis. There is general consensus that critical care interventions should not be performed when they are inappropriate. It is not yet clear which chances of survival are considered necessary or which risk for serious disabilities is acceptable in quantitative terms for different stakeholders to start intensive care treatment.

Methods

We performed an anonymous online survey in a random sample of 1,052 participants recruited via email invitation and social media. Age, sex, nationality, education, professional involvement in health care, critical care medicine and treatment decisions in critical care medicine as well as personal experience with critical illness were assessed as potential influencing variables. Participants provided their opinion on the necessary chances of survival and the acceptable risk for serious disabilities to start a high-risk or uncomfortable therapy for themselves, relatives or for their patients on a scale of 0–100%.

Results

Answers ranged from 0 to 100% for all questions. A three-peak pattern with different distributions of the peaks was observed. Sex, education, being a health care professional, being involved in treatment decisions and religiosity influence these opinions. Male respondents and those with a university education would agree that a risky and uncomfortable treatment should be started even with a low chance of survival for themselves, relatives and patients. More respondents would choose a lower necessary chance of survival (0–33% survival) when deciding for patients compared to themselves or relatives to start a risky and uncomfortable treatment. On the other hand, the majority of respondents would accept only a low risk of severe disability for both themselves and their patients.

Conclusion

No cut-off can be identified for the necessary chances of survival or the acceptable risk of disability to help quantify the “inappropriateness” of critical care treatment. Sex and education are the strongest influencing factors on this opinion. The large variation in personal opinions, depending on demographic and personality variables and education needs to be considered in the communication between health care professionals and patients or surrogates.
Implementation of mandatory opioid prescribing limits in North Carolina: healthcare administrator and prescriber perspectives
Authors: Blackburn Natalie A. , Joniak-Grant Elizabeth , Nocera Maryalice , Dorris Samantha Wooten , Dasgupta Nabarun , Chelminski Paul R. , Carey Timothy S. , Wu Li-Tzy , Edwards David A. , Marshall Stephen W. , Ranapurwala Shabbar I.
Published: November 2021

Background

Recent increases in state laws to reduce opioid prescribing have demonstrated a need to understand how they are interpreted and implemented in healthcare systems. The purpose of this study was to explore the systems, strategies, and resources that hospital administrators and prescribers used to implement the 2017 North Carolina Strengthen Opioid Prevention (STOP) Act opioid prescribing limits, which limited initial prescriptions to a five (for acute) or seven (for post-surgical) days’ supply.

Methods

We interviewed 14 hospital administrators and 38 prescribers with degrees in medicine, nursing, pharmacy, business administration and public health working across North Carolina. Interview guides, informed by the Consolidated Framework for Implementation Research, explored barriers and facilitators to implementation. Interview topics included communication, resources, and hospital system support. Interviews were recorded and transcribed, then analyzed using flexible coding, integrating inductive and deductive coding, to inform analytic code development and identify themes.

Results

We identified three main themes around implementation of STOP act mandated prescribing limits: organizational communication, prescriber education, and changes in the electronic medical record (EMR) systems. Administrators reflected on implementation in the context of raising awareness and providing reminders to facilitate changes in prescriber behavior, operationalized through email and in-person communications as well as dedicated resources to EMR changes. Prescribers noted administrative communications about prescribing limits often focused on legality, suggesting a directive of the organization’s policy rather than a passive reminder. Prescribers expressed a desire for more spaces to have their questions answered and resources for patient communications. While hospital administrators viewed compliance with the law as a priority, prescribers reflected on concerns for adequately managing their patients’ pain and limited time for clinical care.

Conclusions

Hospital administrators and prescribers approached implementation of the STOP act prescribing limits with different mindsets. While administrators were focused on policy compliance, prescribers were focused on their patients’ needs. Strategies to implement the mandate then had to balance patient needs with policy compliance. As states continue to legislate to prevent opioid overdose deaths, understanding how laws are implemented by healthcare systems and prescribers will improve their effectiveness through tailoring and maximizing available resources.
Downregulation of miR-223 promotes HMGB2 expression and induces oxidative stress to activate JNK and promote autophagy in an in vitro model of acute lung injury
Authors: Tan Hao-Yu , Qing Bei , Luo Xian-Mei , Liang Heng-Xing
Published: November 2021

Background

Excessive autophagic activity in alveolar epithelial cells is one of the main causes of acute lung injury (ALI), but the underlying molecular mechanism has not been fully elucidated. Previous studies have shown that microRNAs (miRs) are involved in regulating autophagy in several diseases. This study aimed to determine the role of miR-223 in excessive autophagic activity in alveolar epithelial cells and the underlying mechanism to identify a novel therapeutic targets for the development of new drugs to treat acute respiratory distress syndrome (ARDS).

Methods

A549 cells were treated with lipopolysaccharide (LPS) to establish an ALI in vitro model. The expression of miR-223 and its role of miR-223 in regulating oxidative stress and autophagy in the LPS-treated A549 cells, were examined using RT-PCR, flow cytometry and ELISA. A luciferase reporter assay was performed to verify the interaction between miR-223 and the high-mobility group box 2 (HMGB2) protein.

Results

The results showed that the LPS treatment downregulated miR-223 expression in alveolar epithelial cells. We further proved that miR-223 directly targeted the 3-untranslated region of the HMGB2 gene and the downregulation of miR-223 increased HMGB2 protein level, which activated the JNK signalling pathway and thus induced oxidative stress and autophagy in LPS-treated alveolar epithelial cells. Knockdown of HMGB2 protein deactivated the JNK signalling pathway and inhibited autophagy and oxidative stress in alveolar epithelial cells.

Conclusions

The results of this study suggest that miR-223 regulates oxidative stress and autophagy in alveolar epithelial cells by targeting HMGB2 via the JNK signalling pathway.
Inhibition of protein tyrosine phosphatase improves mitochondrial bioenergetics and dynamics, reduces oxidative stress, and enhances adipogenic differentiation potential in metabolically impaired progenitor stem cells
Authors: Kornicka-Garbowska Katarzyna , Bourebaba Lynda , Röcken Michael , Marycz Krzysztof
Published: November 2021

Background

Protein tyrosine phosphatase 1B (PTP1B) and low molecular weight protein tyrosine phosphatase (LMPTP) are implicated in the development of metabolic disorders. Yet, their role in progenitor stem cell adipogenic differentiation and modulation of mitochondrial dynamics remains elusive.

Methods

In this study, we decided to investigate whether inhibition of PTP1B and LMPTP enhance adipogenic differentiation of metabolically impaired progenitor stem cells via modulation of mitochondrial bioenergetics and dynamics. Cells were cultured under adipogenic conditions in the presence of PTP1B and LMPTP inhibitors, and were subjected to the analysis of the main adipogenic-related and mitochondrial-related genes using RT-qPCR. Protein levels were established with western blot while mitochondrial morphology with MicroP software.

Results

Selective inhibitors of both PTP1B and MPTP enhanced adipogenic differentiation of metabolically impaired progenitor stem cells. We have observed enhanced expression of PPARy and adiponectin in treated cells. What is more, increased antioxidative defence and alternations in mitochondrial bioenergetics were observed. We have found that inhibition of PTP1B as well as C23 activates oxidative phosphorylation and enhances mitochondrial fusion contributing to enhanced adipogenesis.

Conclusions

The presented data provides evidence that the application of PTP1B and LMPTP inhibitors enhances adipogenesis through the modulation of mitochondrial dynamics.
Association between paternal age and singleton birthweight in frozen embryo transfer cycles
Authors: Ni Zhexin , Xia Demeng , Sun Shuai , Zhang Danying , Kuang Yanping , Yu Chaoqin
Published: November 2021

Background

Many studies have considered maternal age as a determinant factor for success in assisted reproductive technologies (ART), but the potential role of paternal age on neonatal outcomes has been overlooked. This study aimed to explore the association between paternal age and birthweight in frozen embryo transfer (FET) cycles.

Methods

This retrospective study involved singleton live births born to women undergoing frozen embryo transfer from January 2013 to December 2017 at a tertiary care center in Shanghai, China. The paternal age was classified into four categories: ≤ 30, 31–35, 36–40, and ≥ 41 years. The group consisting of respondents with paternal age of 31–35 was set as the reference group. Singleton birthweight was the primary outcome measure. Z-scores were calculated according to gestational age and newborn gender on birthweight based on the national birthweight reference. Multivariable linear regression analysis was performed to reveal the relationship between paternal age and newborns’ birthweight after considering several potential confounders.

Results

Exactly 9765 women who fulfilled the inclusion criteria were enrolled. No significant difference was found on mean birthweight (P = 0.082) and gestation-adjusted Z-scores (P = 0.569) among paternal age categories. The reference group and the group with aged 36–40 years had the highest mean birthweight and Z-scores, respectively (3350.2 ± 467.8 g, 0.36 ± 1.00). A decline in mean birthweight with paternal age was observed, and the group over 40 years had the lowest value of 3309.4 ± 474.3 g, but the difference was not statistically significant. In multivariate analyses, the adjusted odds of very low birthweight (LBW), LBW, and high birthweight in the reference group did not significantly differ with the three other groups. After correcting several potential confounders, no significant correlation was observed between paternal age and neonatal birthweight (P = 0.289).

Conclusion

Paternal age was not associated with mean birthweight and gestational age- and gender-adjusted birthweight (Z-scores) of singletons among women who became pregnant in FET cycles.
Fibroblast growth factor receptor fusions in cancer: opportunities and challenges
Authors: Chen Lingfeng , Zhang Yanmei , Yin Lina , Cai Binhao , Huang Ping , Li Xiaokun , Liang Guang
Published: November 2021

Fibroblast growth factors (FGFs) and their receptors (FGFRs) play critical roles in many biological processes and developmental functions. Chromosomal translocation of FGFRs result in the formation of chimeric FGFR fusion proteins, which often cause aberrant signaling leading to the development and progression of human cancer. Due to the high recurrence rate and carcinogenicity, oncogenic FGFR gene fusions have been identified as promising therapeutic targets. Erdafitinib and pemigatinib, two FGFR selective inhibitors targeting FGFR fusions, have been approved by the U.S. Food and Drug Administration (FDA) to treat patients with urothelial cancer and cholangiocarcinoma, respectively. Futibatinib, a third-generation FGFR inhibitor, is under phase III clinical trials in patients with FGFR gene rearrangements. Herein, we review the current understanding of the FGF/FGFRs system and the oncogenic effect of FGFR fusions, summarize promising inhibitors under clinical development for patients with FGFR fusions, and highlight the challenges in this field.
Synthesis of bimannich base with thiazole and its corrosion inhibition effect on H2S and CO2 at high temperature
Authors: Zhuoke Li , Jun Cao , Ting Mao , Dan Ni
Published: November 2021

A bimannich-based TZBM containing a thiazole ring was obtained by synthesis of mannich bases. TZBM featured a stable structure at 260 °C, and corrosion inhibition effect on carbon steel in a gas–liquid environment with Cl− + H2S + CO2 at 180 °C. By analyzing the weight loss of steel exposed to different TZBM concentrations, the coverages of the inhibitor adsorbed on the surfaces were determined, and the results conformed to Langmuir isotherm model. Furthermore, the negative Gibbs free energy indicated that the adsorption was a spontaneous process.

Graphical Abstract
Risk factors for immune-related adverse events: what have we learned and what lies ahead?
Authors: Liu Xiaoyan , Shi Yuequan , Zhang Dongming , Zhou Qing , Liu Jia , Chen Minjiang , Xu Yan , Zhao Jing , Zhong Wei , Wang Mengzhao
Published: November 2021

Immune checkpoint inhibitors (ICIs) have heralded the advent of a new era in oncology by holding the promise of prolonged survival in severe and otherwise treatment-refractory advanced cancers. However, the remarkable antitumor efficacy of these agents is overshadowed by their potential for inducing autoimmune toxic effects, collectively termed immune-related adverse events (irAEs). These autoimmune adverse effects are often difficult to predict, possibly permanent, and occasionally fatal. Hence, the identification of risk factors for irAEs is urgently needed to allow for prompt therapeutic intervention. This review discusses the potential mechanisms through which irAEs arise and summarizes the existing evidence regarding risk factors associated with the occurrence of irAEs. In particular, we examined available data regarding the effect of a series of clinicopathological and demographic factors on the risk of irAEs.
Customized exogenous ferredoxin functions as an efficient electron carrier
Authors: Song Zhan , Wei Cancan , Li Chao , Gao Xin , Mao Shuhong , Lu Fuping , Qin Hui-Min
Published: November 2021

Ferredoxin (Fdx) is regarded as the main electron carrier in biological electron transfer and acts as an electron donor in metabolic pathways of many organisms. Here, we screened a self-sufficient P450-derived reductase PRF with promising production yield of 9OHAD (9α-hydroxy4-androstene-3,17-dione) from AD, and further proved the importance of [2Fe–2S] clusters of ferredoxin-oxidoreductase in transferring electrons in steroidal conversion. The results of truncated Fdx domain in all oxidoreductases and mutagenesis data elucidated the indispensable role of [2Fe–2S] clusters in the electron transfer process. By adding the independent plant-type Fdx to the reaction system, the AD (4-androstene-3,17-dione) conversion rate have been significantly improved. A novel efficient electron transfer pathway of PRF + Fdx + KshA (KshA, Rieske-type oxygenase of 3-ketosteroid-9-hydroxylase) in the reaction system rather than KshAB complex system was proposed based on analysis of protein–protein interactions and redox potential measurement. Adding free Fdx created a new conduit for electrons to travel from reductase to oxygenase. This electron transfer pathway provides new insight for the development of efficient exogenous Fdx as an electron carrier.

Graphical Abstract
Relationship between hemodialysis and health-related quality of life: a cross-sectional study of diagnosis and duration of hemodialysis
Authors: Noto Shinichi , Miyazaki Masashi , Takeuchi Hidemi , Saito Shinya
Published: November 2021

Background

Hemodialysis is a medical technology implemented for various renal diseases and has a significant budget impact in Japan. Hemodialysis also affects health-related quality of life, as it interferes with daily life, but the effect of diagnosis and duration of hemodialysis is not clear. The purpose of this study was to examine the impact of hemodialysis on health-related quality of life, with a focus on diagnosis and duration of hemodialysis.

Methods

We conducted EQ-5D-5L surveys among hemodialysis patients at a single hemodialysis hospital between November 2015 and September 2017 and used a scoring algorithm that was developed in Japan to calculate the scores.

Results

A total of 274 subjects without missing data were included in the data analysis. The mean score of the entire group was 0.772 ± 0.215. Compared with other domains, pain/discomfort had the highest percentage of problems (59.1%). There were no differences in the distributions with respect to diagnostic names in any domain. Multiple regression analysis showed that hemodialysis duration was the only explanatory variable that had a mild significant effect on EQ-5D-5L scores, but it was not large.

Conclusions

QOL measured using the EQ-5D-5L survey score was not affected by age, gender, or diagnosis but was affected by hemodialysis duration. Future studies are needed to investigate the impact of prolonged hemodialysis on health-related quality of life.
Larvae of the blue crab Callinectes sapidus Rathbun, 1896 (Decapoda: Brachyura: Portunidae) in the Balearic Archipelago (NW Mediterranean Sea)
Authors: Png-Gonzalez Lydia , Papiol Vanesa , Balbín Rosa , Cartes Joan Enric , Carbonell Aina
Published: November 2021

The invasive blue crab Callinectes sapidus has been frequently recorded during the last years along the NW Mediterranean Sea, leading to established populations. Two megalopae of C. sapidus were found during two different oceanographic surveys in open waters of the Balearic Archipelago, in July 2005 and October 2011, previous to the first reference of adult specimens documented in the Balearic sub-basin. The analyzed environmental conditions of the sampling periods allowed us to hypothesize the likely introduction pathways, namely by maritime transport and surface currents. Furthermore, the recorded megalopae seem to enlarge the life history of C. sapidus in regard to its native area, where spawning peaks occur in late July and early August.
Flipped learning in the context of postgraduate public health higher education: a qualitative study involving students and their tutors
Authors: Akparibo Robert , Osei-Kwasi Hibbah Araba , Asamane Evans Atiah
Published: November 2021

In higher education institutions, there is a growing popularity of the use of flipped learning (FL) pedagogy to enhance the learning experience of students. At the undergraduate level, there is increasing evidence to demonstrate the potential benefits of this teaching and learning approach. However, at the level of the postgraduate education, evidence is limited on potential impact of FL on students’ learning experience. We conducted qualitative in-depth interviews and focus groups involving postgraduate students and tutors to explore their perspectives of FL. Campus-based students pursuing the masters of public health (MPH) course, and their tutors at the School of Health and Related Research (ScHARR), University of Sheffield, UK were sampled to participate in the study. Tutors generally demonstrated good knowledge and understanding of the concept of FL and its application, although different tutors use different terms to describe FL. Motivations for the use of FL among tutors were identified as: decision informed by available evidence; curriculum design suited for FL; knowledge/expertise acquired through participating in an online FL short course; advise from colleagues and perception of how higher education students should be learning. Students’ views about FL suitability for their courses were generally positive, with only a few students showing a dislike of this teaching and learning method. Our study results show that tutors and postgraduate students in public health higher education place high value on FL pedagogy, and reported positive experiences of their encounter with the FL pedagogy. The results are encouraging and suggest that higher education institutions running postgraduate masters’ degree courses, particularly public health, could consider adopting and using FL approach to enhance the learning experiences of their students.
Understanding the visual function symptoms and associated functional impacts of phakic presbyopia
Authors: Bentley Sarah , Findley Amy , Chiva-Razavi Sima , Naujoks Christel , Patalano Francesco , Johnson Chloe , Arbuckle Rob , Wolffsohn James S.
Published: November 2021

Background

Presbyopia is defined as the age-related deterioration in the ability to focus on close objects, causing difficulty with near vision tasks. The study aim was to understand the lived experience of phakic presbyopia and identify all relevant visual function symptoms and associated functional impacts.

Methods

Fifty individuals with clinician-confirmed phakic presbyopia (US n = 30, France n = 10, Germany n = 10) and seven healthcare professionals (HCPs) participated in in-depth, face-to-face, qualitative concept elicitation interviews. Verbatim transcripts were analyzed using thematic analysis methods.

Results

Visual function symptoms reported by participants with phakic presbyopia were categorized as: primary near vision functioning symptoms (impaired near visual acuity, n = 50/50, 100%; difficulty with near vision in dim light, n = 42/50, 84%; difficulty focusing at close distances, n = 30/50, 60%; difficulty seeing things when glare is present, n = 30/50, 60%) and secondary symptoms (eye strain, n = 37/50, 74%; dry eyes, n = 35/50, 70%; headaches, n = 30/50, 60%). Proximal impacts on functional vision included difficulty reading in near vision (n = 49/50, 98%, including printed text and handwriting), seeing objects in near vision n = 48/50, 96%, and performing activities of daily living that require near vision (n = 49/50, 98%, including using a smartphone or computer). Distal impacts on functional vision included emotional, work, financial and social impacts. HCP interviews supported participant findings.

Conclusion

Findings provide a comprehensive understanding of the lived experience of phakic presbyopia which informed the development of a presbyopia conceptual model and patient-reported outcome assessments of vision correction independence and near vision functioning. The sample did not include those whose vision cannot be adequately corrected with lenses or surgery.