bluuebunny/crossref_metadata_2025 huggingface dataset:
Inequalities in the prevalence, diagnosis awareness, treatment coverage and effective control of diabetes: a small area estimation analysis in Iran
Authors: Perseh Lida , Peimani Maryam , Ghasemi Erfan , Nasli-Esfahani Ensieh , Rezaei Negar , Farzadfar Farshad , Larijani Bagher
Published: January 2023

Objective

This study aims to assess geographic inequalities in the prevalence, awareness of diagnosis, treatment coverage and effective control of diabetes in 429 districts of Iran.

Methods

A modelling study by the small area estimation method, based on a nationwide cross-sectional survey, Iran STEPwise approach to surveillance (STEPS) 2016, was performed. The modelling estimated the prevalence, awareness of diagnosis, treatment coverage, and effective control of diabetes in all 429 districts of Iran based on data from available districts. The modelling results were provided in different geographical and socio-economic scales to make the comparison possible across the country.

Results

In 2016, the prevalence of diabetes ranged from 3.2 to 19.8% for women and 2.4 to 19.1% for men. Theawareness of diagnosis ranged from 51.9 to 95.7% for women and35.7 to 100% for men. Therate of treatment coverage ranged from 37.2 to 85.6% for women and 24.4 to 80.5% for men. Therate of effective controlranged from 12.1 to 63.6% for women and 12 to 73% for men.The highest treatment coverage rates belonged to Ardebil for women and Shahr-e-kord for men. The highest effective control rates belonged to Sanandaj for women and Nehbandan for men. Across Iran districts, there were considerable differences between the highest and lowest rates of prevalence, diagnosis awareness, treatment coverage, and effective control of diabetes. The concentration indices of diabetes prevalence, awareness of diagnosis, and treatment coverage were positive and significant for both sexes.

Conclusion

Findings of this study highlight the existence of inequalities in diagnosis awareness, treatment coverage, and effective control of diabetes in all Iran regions. More suitable population-wide strategies and policies are warranted to handle these inequalities in Iran.
A high serum creatine kinase (CK)-MB-to-total-CK ratio in patients with pancreatic cancer: a novel application of a traditional marker in predicting malignancy of pancreatic masses?
Authors: Chen Cong , Lin Xianchao , Lin Ronggui , Huang Heguang , Lu Fengchun
Published: January 2023

Background

The finding that some benign pancreatic masses mimic the imaging appearance of carcinomas poses a challenge for pancreatic surgeons. Preoperative markers that assist in the diagnosis are critical under this circumstance. Abnormal serum creatine kinase (CK) isozyme levels were reported in cancer patients, and this study aimed to explore the potential value of the CK-MB-to-total-CK ratio (CK ratio) in differentiating pancreatic cancer (PC) from benign masses when combined with carbohydrate antigen 19-9 (CA19-9).

Methods

A total of 190 patients primarily diagnosed with pancreatic masses were retrospectively reviewed and assigned to the PC group and the benign pancreatic mass (BPM) group. Sixty-eight controls were enrolled for comparison. Levels of preoperative parameters, including total serum CK, CK-MB, absolute neutrophil count, absolute lymphocyte count, albumin, and CA19-9, were recorded as well as pathological information. A logistic regression model was established to assess the application value of the combination of CA19-9 and the CK ratio in diagnosis. Receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of the markers.

Results

The CK ratio was significantly elevated in the PC group compared with the BPM group (P < 0.001). In the multivariate analysis, a CK ratio greater than 0.220 was a statistically significant variable for predicting malignancy of pancreatic masses (P=0.001). Patients with stage III/IV PC had a higher CK ratio than those with stage I/II PC (P<0.01). Combined detection of CA19-9 and the CK ratio produced an increased Youden index (0.739 vs. 0.815) with improved sensitivity (82.2% vs. 89.8%).

Conclusions

The CK ratio is elevated in patients with pancreatic adenocarcinoma and is an independent factor predicting pancreatic adenocarcinoma. The CK ratio augments the diagnostic capacity of CA19-9 in detecting malignancy.
Sustained postconfluent culture of human mammary epithelial cells enriches for luminal and c-Kit+ subtypes
Authors: Todhunter Michael E. , Miyano Masaru , Carlson Eric G. , Hinz Stefan , LaBarge Mark A.
Published: January 2023

Background

A challenge in human mammary epithelial cell (HMEC) culture is sustaining the representation of competing luminal, myoepithelial, and progenitor lineages over time. As cells replicate in culture, myoepithelial cells come to dominate the composition of the culture with serial passaging. This drift in composition presents a challenge for studying luminal and progenitor cells, which are prospective cells of origin for most breast cancer subtypes.

Methods

We demonstrate the use of postconfluent culture on HMECs. Postconfluent culture entails culturing HMECs for 2–5 weeks without passaging but maintaining frequent feedings in low-stress M87A culture medium. In contrast, standard HMEC culture entails enzymatic subculturing every 3–5 days to maintain subconfluent density.

Results

When compared to standard HMEC culture, postconfluent culture yields increased proportions of luminal cells and c-Kit+ progenitor cells. Postconfluent cultures develop a distinct multilayered morphology with individual cells showing decreased physical deformability as compared to cells in standard culture. Gene expression analysis of postconfluent cells shows increased expression of lineage-specific markers and extracellular matrix components.

Conclusions

Postconfluent culture is a novel, useful strategy for altering the lineage composition of HMECs, by increasing the proportional representation of luminal and progenitor cells. We speculate that postconfluent culture creates a microenvironment with cellular composition closer to the physiological state and eases the isolation of scarce cell subtypes. As such, postconfluent culture is a valuable tool for researchers using HMECs for breast cancer research.
Restoring Study PRGF: a randomized clinical trial on plasma rich in growth factors for knee osteoarthritis
Authors: Saiz Luis Carlos , Erviti Juan , Leache Leire , Gutiérrez-Valencia Marta
Published: January 2023

Background

A randomized clinical trial assessing plasma rich in growth factors (PRGF) versus hyaluronic acid for knee osteoarthritis was published in 2012 (sponsor trial ID BTI-01-EC/07/ART). Evidence of misreporting was discovered following access to unpublished materials. In accordance with the principles of the Restoring Invisible and Abandoned Trials (RIAT) initiative, we sought to re-analyse Study PRGF based on the unpublished trial materials.

Methods

Reanalysis was made possible primarily based on two unpublished study documents (original trial protocol and final report) obtained from the authors of the original publication. A call to action, calling on the authors to correct the original publication, was publicly issued. The involved ethics committee was repeatedly approached and extensive discussion with the authors ensued. After no agreement to correct the paper was reached, we embarked on this restoration. Reanalysis was focused on providing updated analyses for efficacy and safety.

Results

The efficacy of PRGF was not statistically different from hyaluronic acid for any prespecified primary or secondary efficacy outcomes. For the primary endpoint, the percent of patients on PRGF compared to hyaluronic acid with a decrease >40% in WOMAC pain subscale score was 5.4% higher; 95% confidence interval (CI) −10.4% to 21.3%;p= 0.505. This differs from the original publication that reported a non-prespecified primary endpoint (decrease >50% in WOMAC pain subscale score) which was 14.1% higher; 95% CI 0.5 to 27.6%;p=0.044. Furthermore, in contrast to the article statement that all the adverse events disappeared in 48 h, at least two patients in the hyaluronic arm and five patients in the PRGF arm reported persistent adverse events. Inadequate disclosure of conflicts of interest in the original publication was also noted.

Conclusions

This reanalysis of Study PRGF found no clinically or statistically significant benefit from PRGF compared to hyaluronic acid. The restoration of Study PRGF shows the urgency of important changes to trial reporting and oversight practices. In the future, timely access to all clinical trial documents is needed to minimize the risk of reporting bias. Similarly, ethics committees should be ready to intervene whenever a case of potential misconduct arises.

Trial registration

This is a RIAT project, whose original trial was approved and registered on 19 December 2007 by the Ethics Committee of the Basque Country, Spain, as BTI-01-EC/07/ART.
Reducing tobacco-associated lung cancer risk: a study protocol for a randomized clinical trial of AB-free kava
Authors: Xing Chengguo , Malaty John , Malham Melissa Bou , Nehme Anna Maria Abi , Freeman Breanne , Huo Zhiguang , Firpi-Morrel Roberto , Salloum Ramzi G.
Published: January 2023

Background

Tobacco use is the leading cause of many preventable diseases, resulting in premature death or disease. Given that the majority of adult who smoke want to stop, this health burden could be significantly reduced if the success rate of tobacco cessation can be improved. In addition, most adults planning to quit were interested in trying complementary approaches to facilitating tobacco cessation, which is currently lacking. Therefore, there is an unmet and urgent need for novel interventions to improve the success of tobacco cessation. If such an intervention can reduce tobacco-associated lung carcinogenesis, that will be more desirable. The goal of this project is to develop a safe and effective kava-based intervention to enable tobacco cessation and reduce lung cancer risk, which will improve the health of smokers.

Methods

A randomized controlled trial will enroll 80 adults who currently smoke at least 10 cigarettes daily and randomize 1:1 into the placebo and AB-free kava arms, being exposed for 4 weeks, with a total of six visits (weeks 0, 1, 2, 4, 8, and 12) to evaluate the compliance and potential issues of AB-free kava use among the participants, explore the potential effect of the AB-free kava intervention on tobacco dependence, tobacco use, and lung carcinogenesis biomarkers. Participants will be enrolled during their primary care clinic visit.

Discussion

Primary care settings play a critical role in tobacco-related disease screening, counseling, and early intervention, as the majority of adults who smoke visit their physicians annually. Building upon our promising pilot human trial results in conjunction with ample compelling lab animal results, and consistent with evidence of kava’s benefits from epidemiological data, this trial will evaluate the compliance of AB-free kava among adults who currently smoke with no intention to quit. The other exploratory aims include (1) whether AB-free kava intervention can reduce tobacco use and tobacco dependence; (2) whether AB-free kava use suppresses tobacco-induced carcinogenesis; and (3) the potential of the mechanism-based noninvasive biomarkers in precision AB-free kava intervention. The positive results from this study are expected to provide a great opportunity to effectively reduce smoking rates and tobacco-related diseases.

Trial registration

ClinicalTrials.gov with the identifier: NCT05081882. Registered on October 18, 2021.
Declined plasma microfibrillar-associated protein 4 levels in acute coronary syndrome
Authors: Han Chunming , Peng Yuanshu , Yang Xiaoyan , Guo Zongsheng , Yang Xinchun , Su Pixiong , Guo Shubin , Zhao Lei
Published: January 2023

Background

Microfibrillar-associated protein (MFAP4), initially identified as an extracellular matrix protein, has been demonstrated in multiple human disorders, but it is yet to be discovered following acute coronary syndrome (ACS) in clinical practice. Therefore, this study aimed to investigate the relationship between circulating MFAP4 levels and coronary stenosis in ACS.

Methods

We performed the study in 148 ACS subjects, including 75 ST-segment elevation myocardial infarction (STEMI), 27 non-ST-segment elevation myocardial infarction (non-STEMI) and 46 unstable angina (UA). Clinical variables were collected and Gensini and Syntax stenosis scoring systems were applied to assess the severity of coronary stenosis. Kaplan–Meier and logistic regression analysis were used to analyze the relationship between MFAP4 and the severity of coronary stenosis or ACS outcomes. Spearman analysis was used to describe the correlation between MFAP4 and clinical parameters.

Results

Circulating MFAP4 levels were significantly decreased in the STEMI group (0.008 ng/ml) compared with the non-STEMI group (0.014 ng/ml) and UA group (0.019 ng/ml) (p < 0.001). After adjusting for confounding factors, we found that MFAP4 was an independent risk factor for STEMI (odds ratio = 0.395, 95% CI 0.174–0.895, p = 0.026). MFAP4 level was negatively correlated with Gensini score and Syntax score (r = − 0.311 and − 0.211, p < 0.001 and 0.01, respectively). Based on the MFAP4 level of 0.117 ng/ml, ACS patients were divided into two groups: the low-MFAP4 group (< 0.117 ng/ml, n = 60) and the high-MFAP4 group (≥ 0.117 ng/ml, n = 88). After the median follow-up of 165 days, Kaplan–Meier survival analysis revealed that the MACE-free rate was significantly lower in ACS patients with lower MFAP4 levels (p = 0.009).

Conclusions

MFAP4 has a potential as a biomarker for the degree of coronary stenosis in ACS. Confirmation of observations in larger cohorts and longer follow-up periods is warranted.
Designing and validating a scale for evaluating the sources of unreliability of a high-stakes test
Authors: Nikmard Fateme , Tavassoli Kobra , Pourdana Natasha
Published: January 2023

The idea of sources other than the test-takers’ knowledge leading to different results on high-stakes tests was the motif based on which the present investigation was initiated on the probable sources of unreliability of a test. For this purpose, the researchers went through a thorough literature review with the aim to identify the issues to be counted as sources of unreliability of a high-stakes test, i.e., the MA University Entrance Exam of English (UEEE) in Iran. First, 17 MA UEEE test-takers were asked to take part in a semi-structured interview to find out their ideas about such sources. The outcome of the thematic coding of the information from the literature and interviews was a 57-item Likert scale questionnaire which was reviewed by three assessment experts, revised accordingly, piloted with 57 MA UEEE test-takers, and revised again with 55 items remaining. The revised questionnaire was administered to 312 MA UEEE test-takers in Iran, and its reliability and construct validity were checked through Cronbach alpha (.89) and exploratory factor analysis, respectively. After checking its reliability and construct validity, 46 items remained and loaded on four factors which were named as the effect of test-takers (16 items), structure of the test and external concerns (13 items), administration conditions of the test (13 items), and role of proctors (4 items). The results of this study might familiarize test developers, test administrators, teachers, and test-takers with issues they should be aware of in developing or preparing for a high-stakes test like the MA UEEE.
Sleep fragmentation affects glymphatic system through the different expression of AQP4 in wild type and 5xFAD mouse models
Authors: Vasciaveo Valeria , Iadarola Antonella , Casile Antonino , Dante Davide , Morello Giulia , Minotta Lorenzo , Tamagno Elena , Cicolin Alessandro , Guglielmotto Michela
Published: January 2023

Alzheimer’s disease (AD) is characterized by genetic and multifactorial risk factors. Many studies correlate AD to sleep disorders. In this study, we performed and validated a mouse model of AD and sleep fragmentation, which properly mimics a real condition of intermittent awakening. We noticed that sleep fragmentation induces a general acceleration of AD progression in 5xFAD mice, while in wild type mice it affects cognitive behaviors in particular learning and memory. Both these events may be correlated to aquaporin-4 (AQP4) modulation, a crucial player of the glymphatic system activity. In particular, sleep fragmentation differentially affects aquaporin-4 channel (AQP4) expression according to the stage of the disease, with an up-regulation in younger animals, while such change cannot be detected in older ones. Moreover, in wild type mice sleep fragmentation affects cognitive behaviors, in particular learning and memory, by compromising the glymphatic system through the decrease of AQP4. Nevertheless, an in-depth study is needed to better understand the mechanism by which AQP4 is modulated and whether it could be considered a risk factor for the disease development in wild type mice. If our hypotheses are going to be confirmed, AQP4 modulation may represent the convergence point between AD and sleep disorder pathogenic mechanisms.
Leveraging national laboratories to increase Black representation in STEM: recommendations within the Department of Energy
Authors: Hampton-Marcell Jarrad , Bryson Tasia , Larson Jeffrey , Childers Taylor , Pasero Spencer , Watkins Cortez , Reed Thomas , Flucas-Payton Dorletta , Papka Michael E.
Published: January 2023

Increasing diversity in STEM disciplines has been a goal at scientific institutions for many decades. Black representation in STEM, however, has remained critically low at all levels (high school, undergraduate, graduate, and professional) for over 40 years, highlighting the need for innovative strategies that promote and retain Black students and professionals in STEM. We refocus efforts on increasing Black representation in STEM by promoting early exposure and continued engagement while leveraging national laboratories—an underutilized resource with immense potential to centralize diversity and inclusion efforts nationally.
Integration of computational thinking in K-12 mathematics education: a systematic review on CT-based mathematics instruction and student learning
Authors: Ye Huiyan , Liang Biyao , Ng Oi-Lam , Chai Ching Sing
Published: January 2023

There has been substantial research undertaken on the integration of computational thinking (CT) in K-12 mathematics education in recent years, particularly since 2018 when relevant systematic reviews were conducted on the topic. Many empirical studies in this area have yet to elaborate clearly and explicitly on how CT may support mathematics learning, or otherwise, in CT-based mathematics activities. Addressing this research gap, we conducted a systematic review on the integration of CT in K-12 mathematics education with a focus on CT-based mathematics instruction and students learning under such instruction. The Web of Science database was searched for in terms of studies published from 2006 to 2021, from which 24 articles were selected to provide illustrations of CT-based mathematics instruction and related student learning, and they were further analyzed according to education levels and contexts, programming tools, learning outcomes in CT and mathematics, and the mutual relationship between CT and mathematics learning. Among the results, this review found that geometrized programming and student-centered instructional approaches were facilitators of productive learning in CT and mathematics. Moreover, CT-based mathematics learning entails an interactive and cyclical process of reasoning mathematically and reasoning computationally, which can occur when: (1) applying mathematics to construct CT artefacts; (2) applying mathematics to anticipate and interpret CT outputs; and (3) generating new mathematical knowledge in parallel with the development of CT. The findings contribute to an in-depth understanding of what, and how, CT-based mathematics instruction impacts student learning in K-12 contexts.
The relationship between coping styles and family burden in chronic schizophrenic and bipolar type I patients’ caregivers
Authors: Abbaslou Tahereh , Farsham Aida , Bidaki Reza , Bozorg Bonnie
Published: January 2023

Background

Caregivers play an essential role in caring of patients with psychiatric disorders. It is important to focus on family burden and coping styles of chronic psychiatric disorders’ caregivers. In this survey, the aim was to measure coping styles’ of schizophrenic and bipolar type I patients’ caregivers, their burden and its relationship between these scales. In this cross-sectional study, 100 main caregivers of patients (50 schizophrenic patients, 50 bipolar type I patients) from both Razi psychiatric hospital were enrolled in the study in 2014. The instruments were family burden interview schedule (FBIS) and Weintraub coping orientations to problems experienced (COPE). Chi-square, Pearson correlation coefficient, and independent t-test were used for data analysis.

Results

There was inverse correlation between burden and problem-focused coping strategy about caregivers of both groups (r = − 0.29,P < 0.01). There was a direct correlation between burden and emotional-oriented and less benefit and not effective coping strategies, but it was not significant. The independent t-test demonstrated caregivers’ burden is not significantly different between bipolar mood disorder and schizophrenia.

Conclusions

Social support and health services to caregivers of chronic schizophrenia and bipolar disorder are necessary. Training effective coping style reduces perceived caring burden.
Striking the right balance: understanding the strategic applications of hydrogen in transitioning to a net zero emissions economy
Authors: Whitehead Jake , Newman Peter , Whitehead Jessica , Lim Kai Li
Published: January 2023

The hydrogen economy has been a major vision for many futurists, for over half a century, as a way to transition to a world not dependent on fossil fuels (Bockris, Science 176:1323, 1972). As with many world views, the hydrogen economy has a complete perspective from which all potential change can be viewed. It therefore has a passionate if somewhat fundamentalist following. This paper outlines how electrification has now superseded much of the originally envisaged hydrogen economy and thus it deconstructs what is left of this vision to highlight hydrogen’s strategic, niche, yet important roles, that remain for supporting the transition to a global net zero emissions economy. In our view, it is critical that policy-makers, industry and researchers take a strategic view on striking the right balance on the adoption of hydrogen. Here we propose a framework for hydrogen development globally, with support directed towards enabling the decarbonisation of harder-to-electrify sectors using renewable hydrogen, including, but not limited to: steel, cement, fertilisers, chemical feedstocks, shipping, and aviation.
Value of 18F-FDG PET/CT in guiding management of facet joint arthropathy
Authors: Houseni Mohamed , Bural Gonca , Elnaggar Mohamed Ahmed , Omar Hazem
Published: January 2023

Background

Facet joint arthropathy is one of the causes of back and neck pain. Diagnosing facet arthropathy as the source of pain is a medical challenge. The purpose of this study was to investigate the potential role of 18F-FDG PET/CT imaging to precisely target the active inflammatory facet joints.

Methods

A prospective study included 129 patients with chronic neck or back pain and no neurologic or radiologic findings to diagnose intervertebral-disk-related pain. 18F-FDG PET/CT imaging was performed to evaluate the cause of pain. None of the patients had any malignant or traumatic lesions in the spine. The PET findings were compared to the CT findings. In addition, the PET/CT findings were correlated with the clinical findings.

Results

The images of PET/CT of 54 patients demonstrate abnormally increased FDG uptake in facet joints. Thirty patients had bilateral abnormally increased FDG uptake in facet joints (24 lumbar, 6 cervical facet joints). Of these 30 patients, 12 had a normal appearance of facet joints on CT, 12 had mild degenerative changes limited to the affected facet joints, and 6 had moderate multilevel degenerative changes affecting the facet joints on CT. Twenty-four patients had unilateral increased FDG uptake at facet joints (6 lumbar, 18 cervical facet joints). Among these 24 patients with unilateral increased FDG uptake at facet joints, 12 had a normal facet joints appearance on CT, while the other 12 had marked multilevel degenerative changes affecting the facet joints. The positive findings of PET or CT have been correlated with the neurological examination and injection therapy outcome.

Conclusions

18F-PET/CT has incremental value in the management of pain resulting from facet arthropathy by targeting the affected joints, especially when conventional imaging findings are non-specific or show no abnormality. The most effective management for facet arthropathy is nerve root block; therefore, PET/CT may outline and guide the management to target the active inflammatory facet joints.
Utrecht Gender Dysphoria Scale – Gender Spectrum in a Chinese population: scale validation and associations with mental health, self-harm and suicidality
Authors: Chen Runsen , Feng Yi , Su Di , Wilson Amanda , Han Meng , Wang Yuanyuan
Published: January 2023

Background

Individuals with gender dysphoria display an incongruence between birth-assigned gender and gender expression. However, there is no existing Chinese measure for gender dysphoria.

Aims

This study aims to validate the Utrecht Gender Dysphoria Scale – Gender Spectrum (UGDS-GS) in a Chinese population, and compare the psychometric properties of the UGDS-GS with one frequently used scale for gender dysphoria measurement, the Gender Identity/Gender Dysphoria Questionnaire for Adolescents and Adults (GIDYQ-AA).

Method

A total of 2646 Chinese participants were recruited. The following information was collected: sociodemographic variables, gender identity, sexual orientation, gender dysphoria measured by the UGDS-GS and the GIDYQ-AA, anxiety, depression and suicide assessment. Principal component analyses and confirmatory factor analysis (CFA) were conducted to test the fitness of the model. Discriminant validity was tested with one-way analysis of variance.

Results

The UGDS-GS showed good psychometric properties, with the GIDYQ-AA demonstrating slightly better psychometric properties than the UGDS-GS. UGDS-GS also showed strong internal consistency (Cronbach's α = 0.89), and good convergent validity and criterion validity. Exploratory factor analysis showed a one-factor structure (Kaiser-Meyer-Olkin test, 0.93; χ2 = 13 342.50; d.f. = 153; P < 0.001). The UGDS-GS was positively associated with anxiety symptoms, depressive symptoms, suicidal ideation, attempted suicide and self-harm. We also found the results were robust in different samples.

Conclusions

The validated UGDS-GS can significantly stimulate and promote gender dysphoria assessment in Chinese populations, allowing for assessment in a more diverse subset of gender minorities.
HLA Class I Association With Autoimmune Diabetes in Chinese People: Distinct Implications in Classic Type 1 Diabetes and LADA
Authors: Xia Ying , Chen Yan , Li Xia , Luo Shuoming , Lin Jian , Huang Gan , Xiao Yang , Chen Zhiying , Xie Zhiguo , Zhou Zhiguang
Published: January 2023

Context

We aimed to investigate whether human leukocyte antigen (HLA) Class I loci differentially modulated the risk for and clinical features of Chinese people with classic type 1 diabetes (T1D) and latent autoimmune diabetes in adults (LADA).

Methods

In this case–control study, genotypes of HLA-A, -B, -C, -DRB1, -DQA1, and -DQB1 loci were obtained from 1067 cases with classic T1D, 1062 cases with LADA, and 1107 normal controls using next-generation sequencing.

Results

Despite 4 alleles shared between classic T1D and LADA (protective: A*02:07 and B*46:01; susceptible: B*54:01 and C*08:01), 7 Class I alleles conferred risk exclusively for classic T1D (A*24:02, B*15:02, B*15:18, B*39:01, B*40:06, B*48:01, and C*07:02) whereas only A*02:01 was an additional risk factor for LADA. Class I alleles affected a wide spectrum of T1D clinical features, including positive rate of protein tyrosine phosphatase autoantibody and zinc transporter 8 autoantibody (A*24:02), C-peptide levels (A*24:02), and age at diagnosis (B*46:01, C*01:02, B*15:02, C*07:02, and C*08:01). By contrast, except for the detrimental effect of C*08:01 on C-peptide concentrations in LADA, no other Class I associations with clinical characteristics of LADA could be reported. The addition of Class I alleles refined the risk model consisting only of DR-DQ data in classic T1D while the overall predictive value of the LADA risk model comprising both Class I and II information was relatively low.

Conclusion

The attenuated HLA Class I susceptibility to LADA was indicative of a less deleterious immunogenetic nature compared with classic T1D. These autoimmune diabetes–related Class I variants might serve as additional markers in future screening among Chinese people.
iTRAQ-based Proteomic Analysis Unveils ACSL4 as a Novel Potential Regulator of Human Endometrial Receptivity
Authors: Hu Shuanggang , Sun Zhe , Li Boyu , Zhao Hanting , Wang Yuan , Yao Guangxin , Li Xinyu , Bian Xuejiao , Li Tin Chiu , Vankelecom Hugo , Sun Yun
Published: January 2023

Competent endometrial receptivity is a prerequisite for successful embryo implantation. Identification of novel key molecules involved in endometrial receptivity is essential to better interpret human implantation and improve pregnancy rates in assisted reproduction treatment. Isobaric tags for relative and absolute quantitation (iTRAQ)-based proteomics was performed to profile the proteomes of the prereceptive (luteinizing hormone [LH] + 2, n = 4) and receptive (LH + 7, n = 4) endometrial tissues. A total of 173 differentially expressed proteins (DEPs) between LH + 2 and LH + 7 endometrial samples were identified. Integrated analysis of the proteomic data and published transcriptomic data was performed to identify the concordant DEPs with differential expression at both the messenger RNA and protein levels. Protein-protein interaction (PPI) network analysis was performed on concordant DEPs. We first identified 63 novel concordant DEPs and 5 hub proteins (ACSL4, ACSL5, COL1A1, PTGS1, and PLA2G4F) between LH + 2 and LH + 7 endometrial samples. ACSL4 was predominantly expressed in endometrial epithelial cells and its expression was significantly upregulated by progesterone in the LH + 7 endometrium and significantly downregulated in repeated implantation failure patients. Knockdown of ACSL4 in endometrial epithelial cells induced the downregulation of endometrial receptivity markers (HOXA10, COX2, and LIF) and the significant decrease of implantation rate during in vitro implantation analysis. This study provides the first gel-independent quantitative proteomes of the LH + 2 and LH + 7 human endometrium using iTRAQ technology. The identified concordant DEPs and hub proteins open a new avenue for future studies aimed at elucidating the underlying mechanisms governing endometrial receptivity. ACSL4 was identified as a novel regulatory molecule in the establishment of endometrial receptivity and might play important roles during implantation.
Fashions and Wars
Authors: Banerjee Ria
Published: January 2023

Most accounts of E. M. Forster recall him as a dowdy man in a suit, someone Lytton Strachey nicknamed “the Taupe” for his restricted sartorial palette. The ability to wear unfashionable clothes without causing remark is an exercise of privilege that Forster became aware of during his time working for the Red Cross (1916–19), and through interactions with his Egyptian friend, Mohamed El-Adl. Refusing to wear his uniform after work, Forster broke away from convention to wear one of the three suits he had brought with him to Egypt even as he embarked on a difficult love affair with El-Adl. Their clothes-based interactions prompted Forster to question and discard many of his colonialist biases. The suit, previously an unexamined everyday object, thus becomes a loaded metaphor for social privilege and unwilling complicity with national politics in Forster’s essay “Me, Them and You” (1925). The sartorial symbols that emerge from his letters, essays, and the archive he created of El-Adl’s notes allow us to reapproach the philosophical idea with which he is most closely associated: liberal humanism. This essay finally suggests that Forster’s experiences in Egypt led to an intersectional humanist position that holds interest for global modernist approaches.
Fashion in Așǫs
Authors: Okasaki Aymê
Published: January 2023

This article discusses the concept of Afro-Brazilian fashion in Candomblé, considering their transatlantic symbolic exchanges in an aesthetics of dress, based on the four vectors proposed by Cunnington—fabric, color, shape, and mobility—through which fashion is expressed. In the eighteenth and nineteenth centuries, Brazil received ships from the African coast with așǫ oke, a handwoven fabric created by the Yorùbás to be used as head wraps or to be sewn and worn as shawls by Black women. This and other fabrics, such as wax prints, enter the terreiros as a search for aesthetic identity through clothing, especially during the second half of the twentieth century with the (re)Africanization movement. In this scenario, fabric and color join the shapes and silhouettes of Candomblé costumes to create aesthetic crossovers. While silhouettes common to Brazil’s colonial period meet the various forms of fabric binding in traditional Candomblé costumes, the (re)Africanized terreiros bring more rectangular shapes to their dress. Adorning these costumes are the insignias worn by the òrìṣàs, which act as an extension of their gestures. Wielding, wearing, and adorning themselves with different insignias on their arms, head, and legs, the òrìṣàs dramatize their mythical stories, in narrative and symbolic performances of dress. Thus the Afro-Atlantic fashion seen in these costumes escapes the boundaries of Euro-Western fashion.
Lagerfeld, Fashion, and Cultural Heritage
Authors: Garelick Rhonda
Published: January 2023

When Karl Lagerfeld took over the Maison Chanel in 1983, its founder, Coco Chanel, had been dead for twelve years, and the iconic brand was foundering. Once the epitome of French glamour, history, and feminine luxury, the house was rapidly losing prestige and relevance. Lagerfeld revived the brand through a complex reinterpretation of its iconography, its founder’s persona, and especially its relationship to French identity and patrimoine culturel—cultural patrimony. His reign at Chanel amounted to a de facto commentary on nationality, personality, style, and gender, demonstrating how history and politics get filtered and expressed through fashion.
Διαδικτυακές πρακτικές των ΜΜΕ
Authors: Αγγέλου Ιωάννης
Published: January 2023

Στόχος της παρούσας διατριβής είναι η αποτύπωση των τάσεων στις διαδικτυακέςπρακτικές που ακολουθούν τα μέσα ενημέρωσης, δίνοντας έμφαση στα μέσακοινωνικής δικτύωσης, καθώς και η δημιουργία μοντέλων πρόβλεψης τηςεπισκεψιμότητας των δικτυακών τόπων των μέσων ενημέρωσης, ώστε ναλειτουργήσουν ως εργαλεία για την αξιολόγηση των ακολουθούμενων πρακτικών. Ησυλλογιστική της διατριβής εντάσσεται στην επιστημονική συζήτηση σχετικά με τηναξιοποίηση εργαλείων της δεύτερης γενιάς του διαδικτύου από τα μέσα ενημέρωσηςκαι την σχέση των παραδοσιακών μέσων ενημέρωσης με τα μέσα κοινωνικήςδικτύωσης.Η μελέτη καταγράφει την ιστορική εξέλιξη της αξιοποίησης των εργαλείων τηςδεύτερης γενιάς του διαδικτύου από τα ελληνικά μέσα ενημέρωσης, διερευνά το βαθμόχρήσης των μέσων κοινωνικής δικτύωσης από τα μέσα ενημέρωσης και την εξάρτησηή ενίσχυση των δεύτερων από τα πρώτα, ενώ ανταποκρίνεται στην ανάγκη γιαανάπτυξη νέων δεικτών για την αξιολόγηση των δημοσιογραφικών πρακτικών. Ηπαρούσα έρευνα δεν περιορίζεται σε ένα δείγμα μέσων ενημέρωσης, αλλά χαρτογραφείτις διαδικτυακές πρακτικές στο σύνολο των ελληνικών τηλεοπτικών και ραδιοφωνικώνσταθμών, των ημερήσιων εφημερίδων εθνικής, περιφερειακής και τοπικήςκυκλοφορίας, ενώ μελετάει και τα μεγαλύτερα ελληνικά διαδικτυακά μέσαενημέρωσης.Η έρευνα περιλαμβάνει βιβλιογραφική επισκόπηση σε επιστημονικά βιβλία, διεθνήπεριοδικά και πηγές του διαδικτύου, καθώς επίσης πρωτογενείς, εμπειρικές έρευνεςανάλυσης περιεχομένου στους δικτυακούς τόπους των ελληνικών μέσων ενημέρωσηςκαι των επίσημων σελίδων και λογαριασμών τους στα μέσα κοινωνικής δικτύωσης.Αποτελεί μία από τις ελάχιστες έρευνες μεγάλης κλίμακας για τη συσχέτιση τωνδεικτών των μέσων κοινωνικής δικτύωσης με τα στοιχεία επισκεψιμότητας τωνδικτυακών τόπων, καθώς επίσης μία από τις ελάχιστες, αν όχι την μοναδικήπροσπάθεια δημιουργίας μοντέλων για την πρόβλεψη της επισκεψιμότητας τωνδικτυακών τόπων των μέσων ενημέρωσης, με βάση τους δείκτες των μέσων κοινωνικήςδικτύωσης.
Impact of the COVID-19 pandemic on the incidence and clinical outcomes of diabetic ketoacidosis among male and female children with type 1 diabetes: systematic review and meta-analysis
Authors: Meregildo-Rodriguez Edinson Dante , León-Jiménez Franco Ernesto , Tafur-Hoyos Brenda Aurora Dolores , Vásquez-Tirado Gustavo Adolfo
Published: January 2023

Background: Some studies suggest that the SARS-CoV-2 pandemic increased the incidence of type 1 diabetes mellitus (T1DM) and diabetic ketoacidosis (DKA). However, the impact of this pandemic on pediatric T1DM is still mostly unknown. Therefore, we aimed to assess the effect of the COVID-19 pandemic on clinical outcomes in children with T1DM.

Methods: We systematically searched for six databases up to 31 August 2022. We included 46 observational studies, 159,505 children of both sexes with T1DM, and 17,547 DKA events.

Results: The COVID-19 pandemic significantly increased, in both sexes, the incidence of 1) DKA (OR 1.68; 95% CI 1.44–1.96), 2) severe DKA (OR 1.84; 95% CI 1.59–2.12), 3) DKA in newly diagnosed T1DM (OR 1.75; 95% CI 1.51–2.03), and 4) ICU admissions (OR 1.90; 95% CI 1.60–2.26). However, we did not find a significant association between this pandemic and 1) the incidence of T1DM, 2) the incidence of DKA in established T1DM, 3) the incidence of KDA complications, 4) the length of hospitalization stay, and 5) mortality. Subgroup analysis showed that the study design and the continent of origin accounted for the heterogeneity.

Conclusions: The pandemic SARS-CoV-2 raised, in both sexes, the risk of DKA, severe DKA, DKA de novo, and ICU admissions.
Anatomical variations of frontal sinus pneumatization: A computed tomography-based study
Authors: Al Hatmi Asma Sulaiman , Al Ajmi Eiman , Albalushi Halima , Al Lawati Meetham , Sirasanagandla Srinivasa Rao
Published: January 2023

Background: The pneumatization of the frontal sinus is variable between individuals, including monozygotic twins. The volumetric anatomic variants of the frontal sinus are classified into aplasia, hypoplasia, medium-sized, and hyperplasia. We aimed to study the frontal sinus morphology in Omani patients using computed tomography (CT) evaluations.

Methods: Retrospectively, 1220 paranasal sinus CT scans from 610 patients investigated at Sultan Qaboos University Hospital, Oman, from January 2019 to December 2020 were reviewed. The frontal sinus morphology was classified according to the classification proposed by Guerram et al. The Chi-square test was used to determine the influence of sex.

Results: With regard to the unilateral occurrence, the most prevalent frontal sinus category observed was medium-sized (13.3%), followed by hyperplasia (7.9%), hypoplasia (5.4%), and aplasia (2%) categories. Similarly, in bilateral occurrence, the most common frontal sinus category observed was medium-sized (53%), followed by hyperplasia (13.1%), hypoplasia (3.4%) and aplasia (2%) categories. Right and left frontal sinus aplasia were observed in 2.1% and 1.8% of cases, respectively. In terms of sex influence, the left unilateral (p<0.01) and the bilateral hypoplasia (p<0.05) were significantly higher in females. On the other hand, the left unilateral (p<0.01) and the bilateral hyperplasia (p<0.05) were higher in males.

Conclusions: The baseline data of frontal sinus category frequencies reported in the present study is helpful in the diagnostic evaluation of sinusitis in the clinical setting. The preoperative recognition of frontal sinus types, particularly frontal sinus aplasia in multiplanar CT scans, is crucial to avoid unexpected complications while performing endoscopic sinus surgery.
Anti-Black racism in clinical supervision: asynchronous simulated encounters facilitate reflective practice
Authors: Calhoun Amanda J. , Martin Andrés , Adigun Ayodola , Alleyne Shirley D. , Aneni Kammarauche , Thompson-Felix Tara , Asnes Andrea , de Carvalho-Filho Marco A. , Benoit Laelia , Genao Inginia
Published: January 2023

Background

Racist interactions in clinical practice remain a pervasive reality for Black healthcare providers. We sought to develop a framework to inform supervisors’ actions when confronting racism in clinical practice and protecting trainees under their oversight.

Methods

We conducted a prospective study in which experienced supervisors responded to seven short, videotaped interactions between: 1) Black trainees and a simulated patient (SP) in a racist role; 2) the trainees and their respective supervisors; and 3) the trainees and their supervisors together with the SP. The clinical exchanges exemplified different types of racist (entrenching) or antiracist (uprooting) behaviors by the supervisors. After viewing each clip, participants wrote their reflections confidentially; they later joined a structured debriefing together. We used thematic analysis to identify supervisors’ behavioral patterns when confronting racist interactions.

Results

Based on the input of 52 participants recruited into five two-hour-long sessions, we categorized the behaviors of supervisors facing anti-Black racial injuries involving learners under their oversight. We organized supervisor behaviors into five interlocking domains, each with a range of possible themes: 1) Joining: from conciliatory to confrontational in communicating with the aggressor; 2) Explicitness: from avoiding to naming racism; 3) Ownership: from individual to shared responsibility of the event and the response to it; 4) Involving: from excusing to including the aggrieved party when confronting the aggressor; and 5) Stance: from protective to paternalistic in supporting the learner’s autonomy.

Conclusions

Our qualitative findings can provide a framework for facilitated discussion toward reflective practice among healthcare providers who may have experienced, witnessed, or intervened in anti-Black racist interactions. They can also help medical educators to inform faculty development to fight anti-Black racism in clinical practice. The video materials we developed are available for viewing and download and can be used or adapted as springboards for reflective discussion or faculty development activities.
Ego depletion and implicit and explicit determinants of condom use intentions: an experimental study among young men
Authors: Wolfs Kenny , Bos Arjan E.R. , Mevissen Fraukje E.F. , Alberts Hugo , van Lankveld Jacques J.D.M.
Published: January 2023

Background: The Reflective Impulsive Model of Strack and Deutsch (2004) is a dual-process model and could be a dynamic theoretical framework of sexual risk behavior that is able to predict condom use under different circumstances. If we apply the Reflective Impulsive Model to sexual risk behavior, implicit attitudes regarding sexual risk behavior should have a stronger impact on behavior when working memory capacity is low. Explicit attitudes have a strong impact on intentions, which diminishes as participants have less working memory capacity.

Methods: In this study, we induced a state of ego depletion to examine the impact of low working memory capacity on implicit and explicit attitudes and condom use intentions. Young, male participants (N = 66) were randomly assigned to either an ego depletion condition (difficult calculus task) or a placebo condition (easy calculus task). At baseline, a questionnaire measuring explicit attitudes and intentions to use a condom, and an Implicit Association Test measuring implicit attitudes towards condoms were administered. After the ego calculus task, participants once more completed the questionnaire and Implicit Association Test.

Results: We found no evidence that ego depletion had an effect on intentions to use a condom in young men. Explicit attitudes predicted intentions to use a condom, regardless of participants’ state. We found no relationship between implicit condom attitudes and intentions to use a condom, neither in the ego depletion nor in the placebo condition.

Conclusions: The implications of this null finding are discussed.
Pakistani and Bangladeshi heritage mothers’ provision of primary education to their children in England during COVID-19: recommendations for involving mothers in policy decision-making processes
Authors: Khalid Aliya , Kamphausen Lavinia , Spencer-Bennett Kate
Published: January 2023

During COVID-19, children have suffered learning losses across the world which will likely be carried forward to the future. In England, research and various reports were conducted to understand the extent of learning loss so policy could be improved for a more equitable educational provision. Two key areas were highlighted because of these investigations. Firstly, children in marginalised communities suffered the greatest share of educational disadvantages during COVID-19. Secondly, there is a scarcity of knowledge around the processes surrounding educational environments of learners. This study focused on mothers as partners and facilitators of education especially during COVID-19. Interviews were conducted with eight mothers in England with Pakistani and Bangladeshi heritage exploring their experiences of educating their primary school-aged children during COVID-19. The perspectives of mothers shared with the researchers were analysed by focusing on the physical spaces and the psychological aspects that were experienced since the inception of the pandemic. The findings reveal that mothers were working at multiple fronts to help their children transition smoothly to a new way of learning and living by making a series of contributions. Firstly, mothers adapted the physical spaces so they would suit their children’s learning needs. Secondly, they structured time to bring some normalcy to the disrupted patterns of living. Thirdly, they drew on social relations to compensate for the socio-emotional gaps that lockdown situations were creating for children. Lastly, they redefined the meaning of education and its advantages and integrated the social and cultural with the formal aspect of education. The findings suggest that policy reform to rehabilitate an equitable education system will need to draw on these rich perspectives. It will be essential for policy discussions in the future to include the lived experiences of mothers in providing timely and tailored educational support to their children.