bluuebunny/crossref_metadata_2025 huggingface dataset:
Issues in Statewide Scale up of a Multi-Tiered System of Support
Authors: Choi Jeong Hoon , McCart Amy B. , Miller Dawn H. , Sailor Wayne
Published: March 2022

Tiered instructional supports are on a steep growth trajectory in the US and getting underway internationally as a means to providing equitable education to all student groups. In the US, the Department of Education funded the expansion of multi-tiered system of support (MTSS) through school and personnel improvement grants to states. This retrospective article examines the history of MTSS and California’s significant investment to scale up the practice statewide, with an eye to identifying key issues that are likely to surface in other such ambitious state efforts. We examine the infrastructure support methodology to develop local capacity to support school-level implementation with measured fidelity. We present some preliminary results from a small sample comparison study that demonstrate students’ academic achievement increased when the California MTSS efforts resulted in implementation with adequate fidelity. These findings suggest long-term replication of this initiative will mirror other student-level impact studies showing positive gains on measures of academic progress, in this case, English Language Arts and Math.
Long-term Outcomes of Pediatric Tracheostomy Home Care in a Limited Resource Setting of Professional Home Nurse
Authors: Phuaksaman Chutima , Niyomkarn Watit , Somboon Prapasri , Boonjindasup Wicharn , Hantragool Sumalee , Sritippayawan Suchada
Published: March 2022

Long-term outcomes of pediatric patients with a tracheostomy in developing countries where professional home nurse is not accessible has rarely been reported. We, therefore, investigated the prevalence and associating factors of long-term outcomes in these children. Retrospective chart review was conducted in 85 tracheostomized children who were discharged to home during January 2012 to December 2020. Tracheostomy home care was provided by caregivers who completed the tracheostomy home care program. Prevalence of unplanned readmission with acute respiratory problems within 30 days after the first hospital discharge was 17.6%. Lower respiratory tract infection (LRTI) after hospital discharge was found in 72.9% (median frequency of 1.0 episode/case/year). Among 80 children who had surveillance airway endoscopy, 46.3% demonstrated late tracheostomy-related airway complications. Independent factor associated with late tracheostomy-related airway complications was a follow-up period longer than 1 year. Decannulation success was found in 21.2%. Most of them had tracheostomy for their upper airway anomalies. The mortality rate was 7%. Most of them died from their underlying diseases. In conclusion, pediatric tracheostomy home care undertaken by caregivers is feasible in developing countries where home nurse is not available. The prevalence of unplanned readmission with acute respiratory problems within 30 days after hospital discharge and late tracheostomy-related airway complications were comparable with those reported in developed countries. However, we still had a high prevalence of post-tracheostomy LRTI which was a challenging problem that needed to be investigated and resolved.
Dysbiosis index to evaluate the fecal microbiota in healthy cats and cats with chronic enteropathies
Authors: Sung Chi-Hsuan , Marsilio Sina , Chow Betty , Zornow Kailee A , Slovak Jennifer E , Pilla Rachel , Lidbury Jonathan A , Steiner Jörg M , Park So Young , Hong Min-Pyo , Hill Steve L , Suchodolski Jan S
Published: March 2022

Objectives

Previous studies have identified various bacterial taxa that are altered in cats with chronic enteropathies (CE) vs healthy cats. Therefore, the aim of this study was to develop a targeted quantitative molecular method to evaluate the fecal microbiota of cats.

Methods

Fecal samples from 80 client-owned healthy cats and 68 cats with CE were retrospectively evaluated. A panel of quantitative PCR (qPCR) assays was used to measure the fecal abundance of total bacteria and seven bacterial taxa: Bacteroides, Bifidobacterium, Clostridium hiranonis, Escherichia coli, Faecalibacterium, Streptococcus and Turicibacter. The nearest centroid classifier algorithm was used to calculate a dysbiosis index (DI) based on these qPCR abundances.

Results

The abundances of total bacteria, Bacteroides, Bifidobacterium, C hiranonis, Faecalibacterium and Turicibacter were significantly decreased, while those of E coli and Streptococcus were significantly increased in cats with CE ( P <0.027 for all). The DI in cats with CE was significantly higher compared with healthy cats ( P <0.001). When the cut-off value of the DI was set at 0, it provided 77% (95% confidence interval [CI] 66–85) sensitivity and 96% (95% CI 89–99) specificity to differentiate the microbiota of cats with CE from those of healthy cats. Fifty-two of 68 cats with CE had a DI >0.

Conclusions and relevance

A qPCR-based DI for assessing the fecal microbiota of cats was established. The results showed that a large proportion of cats with CE had an altered fecal microbiota as evidenced by an increased DI. Prospective studies are warranted to evaluate the utility of this assay for clinical assessment of feline CE.
Gut microbiome and diabetic retinopathy
Authors: Jabbehdari Sayena , Sallam Ahmed B.
Published: March 2022

During the last decades, the incidence of diabetes and a variety of complications such as diabetic retinopathy (DR) and cardiovascular diseases have been increased exponentially. Gut bacterial composition -microbiota – has been associated with the pathobiology of many inflammatory and metabolic disorders such as diabetes. Gut microbiota plays a crucial role in preserving the metabolic and immune homeostasis, protecting against pathogens and regulating host immunity; however, gut microbiome ecosystem can be altered by lifestyle, cigarette smoking, dietary patterns, and oxidative stress.

Herein, we present a hypothesis on the potential complex association between gut microbiota and DR as one of the microvascular complications of diabetes.
Leopard retinopathy: An unusual presentation of sympathetic ophthalmia
Authors: Shah Mauli , Pradhan Arkaprava , Dutta Majumder Parthopratim
Published: March 2022

We report an unusual case of sympathetic ophthalmia (SO) in an elderly gentleman following multiple eye surgeries. He presented with diffuse granulomatous panuveitis resembling leopard retinopathy in the left eye. There was a delay in the initiation of effective treatment of his intraocular inflammation, but he responded to corticosteroid and azathioprine. The pigmentary changes in his fundus were highly unusual, and he was investigated extensively to rule out other possible causes including a search for occult malignancy. The delay in initiation of effective treatment or suboptimal therapy in SO, can lead to variable clinical picture in elderly patients. A proper screening to exclude any malignancy along with aggressive immunosuppressive therapy can achieve optimum results.
Creating effective visuals for destination marketing videos: Scenery vs people
Authors: Alamäki Ari , Rhee Cheul , Suomala Jyrki , Kaski Timo , Kauttonen Janne
Published: March 2022

By drawing from imagery and consumer choice theories, we examine how visuals of faces and social groups can foster behavioural intention and emotional effects in the case of nature tourism video marketing. We implemented an experimental study by creating three different videos with altering levels of human presence. Data were analysed using linear regression and partial least-squares path analysis methods. Unlike prior research had suggested, video content with fewer direct visuals of human beings was found to be more entertaining. Thus, scenery performed better than people as visuals in our destination marketing case. The visuals of faces and social groups had no effect on consumers’ behavioural intention or emotions, even if they did arouse feelings of social presence. Behavioural intention was mainly associated with entertainment value, while social presence had only a minor effect. Gender, nationality and outdoor activity also affected the media effects of videos, showing them to be complex and context-dependent phenomena.
Palpating history: Magical healing and revolutionary care in Rural Serbia and Macedonia
Authors: Novakov-Ritchey Christina
Published: March 2022

Marxist feminist Silvia Federici has identified the figure of the witch as exemplifying a non-capitalist worldview. While Federici’s analysis has significantly nuanced understandings of primitive accumulation, its significance for traditions of magical healing remains to be studied. While Federici focuses on the violent campaign against witchcraft in Western Europe, she does not deal with those people who still practice ways of healing glossed as ‘witchcraft’ or ‘magic’ in the present, which have been largely subsumed by the academic discipline of folklore. As the Ottoman Empire was exempt from the early-modern witch craze, the ongoing practices of magical healing found in Serbia and Macedonia provide a particularly rich site for such an investigation. Grounded in ethnographic research on incantation-based healing practices in the Balkan region, this article reveals the contemporary significance of vernacular healing practices in cultivating a relational view of the body. While folklorists have anticipated the death of these practices since the 19th century, the continuation of these practices in the Balkan region tells us that these premonitions of cultural death did not come to fruition. By revealing the false distinction between the social body, the physical body and the mind, healers recognize the body as not only a sack of organs, but as a historical subject embedded in a specific set of material relations. Health is constituted not only by the absence of disease, but by intersubjective relations with the natural world and an ongoing obligation to act ethically toward the dead, toward one’s neighbors and toward future generations. Refusing to accept a vision of time and history that regards incantations as archaic, the dead as foreign and the village as the site of the past, the healing practices discussed in this article provide a fertile agenda for revolutionary planning.
Emotion, Action, and Passivity: A Commentary on Müller
Authors: Furtak Rick Anthony
Published: March 2022

According to Jean Moritz Müller's The world-directedness of emotional feeling, the reason why emotions do not apprehend or disclose value is that one cannot apprehend what one has already apprehended: the value in question, he claims, is apprehended prior to the emotional feeling. Emotions, then, should not be conceived as apprehending value since they already presuppose awareness of it. I can be acquainted with a fact without feeling aware of the meaning it holds. Yet I argue that only an emotional reaction (e.g., grief) actually registers value or disvalue (e.g., personal loss). My value-responsive concept of emotion is one that Müller rejects. Yet I contend that to recognize the loss of a beloved person, for instance, just is to feel the emotion of grief.
Oncotype DX Recurrence Score in premenopausal women
Authors: Zhang Shiliang , Fitzsimmons Kasey C. , Hurvitz Sara A.
Published: March 2022

In the past 20 years, clinicians have shifted away from relying solely on clinicopathologic indicators toward increasing use of multigene expression assays in guiding treatment decisions regarding adjuvant chemotherapy for early-stage hormone receptor (HR)-positive, HER2-negative breast cancer. Oncotype DX Recurrence Score (RS) is one of the most widely used multigene assays when considering indications for adjuvant chemotherapy, and guidelines have recently incorporated its use in women with early HR-positive HER2-negative breast cancer and up to three positive lymph nodes. While multiple retrospective and prospective clinical studies have demonstrated that most women with a low- to mid-range RS (0–25) can safely forgo chemotherapy, premenopausal women remain an important subgroup for which recommendations based on RS are ill-defined. The majority of patients included in clinical trials and retrospective analyses validating the use of RS have been postmenopausal women. In the subgroup of premenopausal women with HR-positive HER2-negative breast cancer, studies indicate that traditional clinicopathologic methods for assessing risk continue to be powerful tools when combined with RS to predict benefit from chemotherapy. This suggests that there is an element of uncaptured risk inherent to the premenopausal state that evades characterization by RS alone. This review describes the evidence that has supported the recommendation of RS in clinical guidelines, specifically focusing on data for its current use in premenopausal women. We review available data regarding the impact of the menstrual cycle on hormonally regulated gene expression, which may drive variations in the RS. Further research on the reliability and interpretation of the RS in the premenopausal subgroup is necessary and represents a gap in knowledge of how the RS should be applied in premenopausal women.
When CNN Praises Trump: Effects of Content and Source on Hostile Media Perception
Authors: Lee Seungsu , Cho Jaeho
Published: March 2022

Research on hostile media perception (HMP) has suggested that both news slants and partisan source cues influence individuals’ perception of news bias. Yet, relatively little attention has been paid to the possibility that the two message features may interact. Extending the literature on HMP, the present experiment investigates the content-source interaction in the context of President Trump’s policy on immigration, with two audience characteristics as potential moderators: political ideology strength (PIS) and need for cognition (NFC). Results show that (1) the effect of news slants on HMP is greater when the news is from an in-group source and (2) such interaction is more pronounced for those with higher levels of PIS and lower levels of NFC. Implications for our understanding of HMP and for public opinion in an increasingly fragmented and partisan media environment will be discussed.
Associations with Discharge to Post-Acute Care Facilities Among Patients Undergoing Open Reduction Internal Fixation of Distal Radius Fractures
Authors: Donato Daniel P. , Simpson Andrew M. , Willcockson James , Veith Jacob , King Brody W. , Agarwal Jayant P.
Published: March 2022

Introduction: Distal radius fractures are a common injury of the hand and wrist that often require intensive rehabilitation. We sought to identify risk factors associated with discharge to a post-acute care facility following distal radius fracture repair. Methods: The 2011 to 2016 National Surgical Quality Improvement Program® (NSQIP) database was queried for all Current Procedural Terminology (CPT) codes that corresponded with open distal radius fracture repair. Patients with concomitant traumatic injuries were excluded. Patient demographics, comorbidities, perioperative factors, laboratory data, and surgical details were collected. Our primary outcome was to determine postoperative discharge destination: home versus a post-acute care facility, and to identify factors that predict discharge to post-acute care facility. Secondary outcomes included unplanned readmission, reoperation, and complications. Results: Between 2011 and 2016, a total of 12,001 patients underwent open distal radius fracture repair and had complete information for their discharge. Of these analyzed patients, 3.24% (n  =  389) were discharged to rehabilitation facilities. The following factors were identified on multivariate analysis to have an association with discharge to a post-acute care facility: 65 years or older, White race, underweight, using steroids preoperatively, American Society of Anesthesiologists (ASA) classification > 2, admitted from a nursing home or already hospitalized, anemic, undergoing bilateral surgery, wound classification other than clean, and complications prior to discharge. Conclusion: Factors identified by our study to have associations with discharge to post-acute care facilities following distal radius fracture repair can help in appropriate patient counseling and triage from the hospital to home versus a post-acute care facility.
Conceptualisation and Validation of Multidimensional Measure of Workplace Spirituality
Authors: Saxena Anubhuti , Prasad Asha
Published: March 2022

Workplace spirituality (WPS) has gained acknowledgement as a significant discipline in the corporate world. The dynamic environment leaves all the organisations in a quandary as to how to manage and take relevant and ethical decisions at the same time. However, despite the unprecedented challenges, organisations need to continuously stay agile, innovate for self-development and growth, and ultimately augment the wealth of the nation. It is at this time that WPS acquires utmost importance for the leaders. The research article intends to develop a scale and add new dimensions to the literature for measuring WPS from the point of view of the existing bank employees. We conducted two studies for testing the scale. For conducting Study 1, we applied exploratory factor analysis (EFA) with varimax rotation, and for Study 2, we applied second-order confirmatory factor analysis (CFA). Statistics were drawn from 406 employees from banks in Delhi National Capital Region (NCR). The results showed that WPS has seven dimensions, namely, meaningfulness, compassion, gratitude, authenticity, embracing diversity, resilience and inner peace, and others’ orientation. It may be useful for managers to analyse these dimensions in detail in order to identify their impact on employee work attitudes and job outcomes. We believe that this is a pioneering wherein WPS has been represented as a second-order factor. The concluding part of this paper contains an incisive discussion on future developments in the spirituality domain.
Book review: Bellapu Anuradha and Gita Ramaswamy (eds.), Prison Notes of a Woman Activist
Authors: Bhagyanagar Vipanchika Sahasri
Published: March 2022

Bellapu Anuradha and Gita Ramaswamy (eds.), Prison Notes of a Woman Activist. Ratna Books, 2021, 195 pp., ₹399. ISBN-10: 9352907442, ISBN-13: 978-9352907441
Identifying higher risk subgroups of health care workers for priority vaccination against COVID-19
Authors: Haq Mohsina , Rehman Asif , Haq Momina , Haq Hala , Rajab Hala , Ahmad Junaid , Ahmed Jawad , Anwar Saeed , Ahmad Sajjad , Haq Najib Ul
Published: March 2022

Background:

Health care workers (HCWs) are exposed to high risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection due to close contact with infected patients in hospital. The objective of this study was to estimate the seroprevalence and to identify the exposure risk of various subgroups among HCWs to prioritize them for early vaccination.

Methods:

This was a multicentre cross-sectional study conducted between 15 and 29 June 2020. A total of 987 HCWs were recruited randomly from two major tertiary-care hospitals of Peshawar city, Pakistan. The HCWs included doctors, nurses, paramedics and hospital support staff. The US Food and Drug Administration (FDA)–approved kit was used for the detection of SARS-CoV-2 antibodies.

Results:

Overall, 310 (31.4%) HCWs were seropositive for SARS-CoV-2 antibodies (95% confidence interval, CI: 28.5–34.4). Seroprevalence was higher in males (33.5%) and in age group 51–60 years (40.9%). Seropositivity increased with increasing age from 8.3% in age group ⩽20 to 40.9% in 51–60 years of age group ( p < 0.05). The highest seroprevalence was identified in paramedical staff (42·5%, 95% CI: 36.6–48.6) followed by nursing staff (38·8%, 95% CI: 32.1–45.7). In logistic regression, being a male HCW led to higher risk of seropositivity (odds ratio, OR: 1.50, 95% CI: 1·06–2.13. p < 0.05) compared with female staff members. The odds of seropositivity was higher in nurses (OR: 3·47, 95% CI: 1.99–6.05. p < 0.01), paramedical staff (OR: 3·19, 95% CI: 1.93–5.28. p < 0.01) and hospital support staff (OR: 2·47, 95% CI: 1.29–4.7. p < 0.01) compared with consultants.

Conclusion:

Overall, our results concluded that nursing and paramedical staff are at higher risk and should be vaccinated on priority.
How Changes in Treatment Guidelines Affect the Standard of Care: Ethical Opinions Using the Chicago 4.0 Classification for Esophageal Motility Disorders as Example
Authors: Herbella Fernando A. M. , Patti Marco G. , Filho Roberto Maia , Serodio Aluisio M. B. , Adão Diego , Bastos Isis Boll de Araujo , Soares Flaviana Rampazzo , Wagar Chip
Published: March 2022

Background:

Traditionally, guidelines issued by medical societies have provided a standard of care for the treatment of disease processes, establishing clear pathways, and limiting litigation. A major ethical dilemma may occur when an update in guidelines may lead to an instant change in the standard of care.

Methods:

We present a hypothetical clinical scenario of esophagogastric obstruction outflow obstruction (EGJOO) where guidelines were changed, and we asked the opinion of experts in different areas—surgeons, ethicists, and lawyers.

Results:

Each group of experts presented their opinion on ethical issues relevant to the clinical case.

Conclusions:

The clinical case presented and the guidelines for the treatment of primary esophageal motility disorders based on the Chicago classification 4.0, represent a current issue that the world of medicine has to face. While guidelines are usually particularly useful for practitioners, they must be based on irrevocable principles. They must be the result of a rigorous scientific analysis of available data by a group of real experts, and opinions should be avoided if not based on evidence. The level of evidence should be clearly stated, stressing the weakness of some recommendations when present. Conflicts of interest of the Authors of the guidelines should be not only declared, but carefully analyzed in order to avoid biases. Finally, radical changes in a short period of time should be avoided as they expose the practitioners to poor outcomes and litigation.
Competency Assessment for Laparoscopic Anti-Reflux Surgery: Design and Delphi Review, a Collaboration With the American Foregut Society
Authors: Turner Simon R. , Louie Brian E. , Dunst Christy , Molena Daniela , Bédard Eric L. R.
Published: March 2022

Background:

Laparoscopic anti-reflux surgery, including hiatus hernia repair, is a common operation performed by both general and thoracic surgeons and an important learning objective for surgical trainees. This study aimed to design a competency assessment instrument for laparoscopic anti-reflux surgery.

Method:

A comprehensive competency assessment instrument was designed by a process of logical analysis by 4 expert thoracic surgeons with an interest in foregut surgery, and then reviewed informally by a panel of experts. The instrument was then further assessed and refined using a modified Delphi process. The Delphi questionnaire was distributed to all members of the Fellowship Training Committee of the American Foregut Society (n = 21).

Results:

A first draft of the competency assessment instrument included 32 steps in 4 categories. The first round of the Delphi review was completed by 14 respondents (response rate 66.7%). A total of 3 rounds of Delphi review were performed. Ultimately, 25 items were retained from the original instrument and 1 modified and 4 new items were added. The final instrument has 30 steps in 4 categories.

Conclusions:

An international and inter-specialty consensus was established on the key components of assessing competence to perform anti-reflux surgery. The resulting instrument could be used to guide competency based assessments of general and thoracic surgeons and trainees.
Characterizing uncertainty of general building stock exposure data
Authors: Huyck Charles K , Hu Zhenghui “Z” , Eguchi Michael , Esquivias Georgiana , Amyx Paul , Smith Kay , Jordan Colm
Published: March 2022

Effective disaster risk management (DRM) and disaster risk reduction (DRR) require modeling potential and post-event impacts using building exposure data. The data used to develop building exposure databases will influence the accuracy of risk assessments and the appropriateness of subsequent decisions. This article proposes a framework for classifying approaches of developing building exposure databases into levels. To examine the uncertainty introduced through using various approaches to exposure development, a probabilistic seismic risk assessment was run with the exposure data corresponding to each proposed level using the County of Los Angeles as the study area. A factor of ∼2.5 was observed in the final loss estimates. The variance was less dependent on the spatial scale of data than on key values, most notably estimates of building size and replacement cost.
Dynamic contrast enhanced MRI for the evaluation of lung perfusion in idiopathic pulmonary fibrosis
Authors: Torres Luis A. , Lee Kristine E. , Barton Gregory P. , Hahn Andrew D. , Sandbo Nathan , Schiebler Mark L. , Fain Sean B.
Published: March 2022

Background

The objective of this work was to apply quantitative and semiquantitative dynamic contrast enhanced magnetic resonance imaging (DCE-MRI) methods to evaluate lung perfusion in idiopathic pulmonary fibrosis (IPF).

Methods

In this prospective trial 41 subjects, including healthy control and IPF subjects, were studied using DCE-MRI at baseline. IPF subjects were then followed for 1 year; progressive IPF (IPFprog) subjects were distinguished from stable IPF (IPFstable) subjects based on a decline in percent predicted forced vital capacity (FVC % pred) or diffusing capacity of the lung for carbon monoxide (DLCO% pred) measured during follow-up visits. 35 out of 41 subjects were retained for final baseline analysis (control: n=15; IPFstable: n=14; IPFprog: n=6). Seven measures and their coefficients of variation (CV) were derived using temporally resolved DCE-MRI. Two sets of global and regional comparisons were made: controlversusIPF groups and controlversusIPFstableversusIPFproggroups, using linear regression analysis. Each measure was compared with FVC % pred,DLCO% pred and the lung clearance index (LCI % pred) using a Spearman rank correlation.

Results

DCE-MRI identified regional perfusion differences between control and IPF subjects using first moment transit time (FMTT), contrast uptake slope and pulmonary blood flow (PBF) (p≤0.05), while global averages did not. FMTT was shorter for IPFprogcompared with both IPFstable(p=0.004) and control groups (p=0.023). Correlations were observed between PBF CV andDLCO% pred (rs= −0.48, p=0.022) and LCI % pred (rs= +0.47, p=0.015). Significant group differences were detected in age (p<0.001),DLCO% pred (p<0.001), FVC % pred (p=0.001) and LCI % pred (p=0.007).

Conclusions

Global analysis obscures regional changes in pulmonary haemodynamics in IPF using DCE-MRI in IPF. Decreased FMTT may be a candidate marker for IPF progression.
Prevalence and characteristics of progressive fibrosing interstitial lung disease in a prospective registry
Authors: Hambly Nathan , Farooqi M. Malik , Dvorkin-Gheva Anna , Donohoe Kathryn , Garlick Kristopher , Scallan Ciaran , Chong Sy Giin , MacIsaac Sarah , Assayag Deborah , Johannson Kerri A. , Fell Charlene D. , Marcoux Veronica , Manganas Helene , Morisset Julie , Comes Alessia , Fisher Jolene H. , Shapera Shane , Gershon Andrea S. , To Teresa , Wong Alyson W. , Sadatsafavi Mohsen , Wilcox Pierce G. , Halayko Andrew J. , Khalil Nasreen , Cox Gerard , Richeldi Luca , Ryerson Christopher J. , Kolb Martin
Published: March 2022

Background

Progressive fibrosing interstitial lung disease (PF-ILD) is characterised by progressive physiological, symptomatic and/or radiographic worsening. The real-world prevalence and characteristics of PF-ILD remain uncertain.

Methods

Patients were enrolled from the Canadian Registry for Pulmonary Fibrosis between 2015 and 2020. PF-ILD was defined as a relative forced vital capacity (FVC) decline ≥10%, death, lung transplantation or any two of: relative FVC decline ≥5% and <10%, worsening respiratory symptoms or worsening fibrosis on computed tomography of the chest, all within 24 months of diagnosis. Time-to-event analysis compared progression between key diagnostic subgroups. Characteristics associated with progression were determined by multivariable regression.

Results

Of 2746 patients with fibrotic ILD (mean±sdage 65±12 years; 51% female), 1376 (50%) met PF-ILD criteria in the first 24 months of follow-up. PF-ILD occurred in 427 (59%) patients with idiopathic pulmonary fibrosis (IPF), 125 (58%) with fibrotic hypersensitivity pneumonitis (HP), 281 (51%) with unclassifiable ILD (U-ILD) and 402 (45%) with connective tissue disease-associated ILD (CTD-ILD). Compared with IPF, time to progression was similar in patients with HP (hazard ratio (HR) 0.96, 95% CI 0.79–1.17), but was delayed in patients with U-ILD (HR 0.82, 95% CI 0.71–0.96) and CTD-ILD (HR 0.65, 95% CI 0.56–0.74). Background treatment varied across diagnostic subtypes, with 66% of IPF patients receiving antifibrotic therapy, while immunomodulatory therapy was utilised in 49%, 61% and 37% of patients with CHP, CTD-ILD and U-ILD, respectively. Increasing age, male sex, gastro-oesophageal reflux disease and lower baseline pulmonary function were independently associated with progression.

Conclusions

Progression is common in patients with fibrotic ILD, and is similarly prevalent in HP and IPF. Routinely collected variables help identify patients at risk for progression and may guide therapeutic strategies.
Research advances and clinical management of bronchiectasis: Chinese perspective
Authors: Xu Jin-fu , Gao Yong-hua , Song Yuan-lin , Qu Jie-ming , Guan Wei-jie
Published: March 2022

Bronchiectasis is a debilitating chronic suppurative airway disease that confers a substantial burden globally. Despite the notable prevalence, research on bronchiectasis in mainland China remains in its infancy. Nevertheless, there has been a significant leap in the quantity and quality of research, which has contributed to the ever-improving clinical practice. A nationwide collaborative platform has been established to foster multicentre studies, which will help increase the level of evidence further. Here, we summarise thestatus quoof clinical management and consider the research priorities for bronchiectasis that have been published previously. We also highlight the efforts of the Chinese medical communities to outline the core tasks that need to be addressed within the next decade.
The effect of oxygen and carbon dioxide cross-sensitivity sensor error in the Eco Medics Exhalyzer D device on measures of conductive and acinar airway function
Authors: Bozier Jack , Jeagal Edward , Robinson Paul D. , Prisk G. Kim , Chapman David G. , King Gregory G. , Thamrin Cindy , Rutting Sandra
Published: March 2022

Introduction

The multiple breath nitrogen washout (MBNW) test provides important clinical information in obstructive airways diseases. Recently, a significant cross-sensitivity error in the O2and CO2sensors of a widely used commercial MBNW device (Exhalyzer D, Eco Medics AG, Duernten, Switzerland) was detected, which leads to overestimation of N2concentrations. Significant errors in functional residual capacity (FRC) and lung clearance index (LCI) have been reported in infants and children. This study investigated the impact in adults, and on additional important indices reflecting conductive (Scond) and acinar (Sacin) ventilation heterogeneity, in health and disease.

Methods

Existing MBNW measurements of 27 healthy volunteers, 20 participants with asthma and 16 smokers were reanalysed using SPIROWARE V 3.3.1, which incorporates an error correction algorithm. Uncorrected and corrected indices were compared using paired t-tests and Bland–Altman plots.

Results

Correction of the sensor error significantly lowered FRC (mean difference 9%) and LCI (8–10%) across all three groups.Scondwas higher following correction (11%, 14% and 36% in health, asthma and smokers, respectively) with significant proportional bias.Sacinwas significantly lower following correction in the asthma and smoker groups, but the effect was small (2–5%) and with no proportional bias.

Discussion

The O2and CO2cross-sensitivity sensor error significantly overestimated FRC and LCI in adults, consistent with data in infants and children. There was a high degree of underestimation ofScondbut minimal impact onSacin. The presence of significant proportional bias indicates that previous studies will require reanalysis to confirm previous findings and to allow comparability with future studies.
Effectiveness of high cardiorespiratory fitness in cardiometabolic protection in prediabetic rats
Authors: Thonusin Chanisa , Pantiya Patcharapong , Sumneang Natticha , Chunchai Titikorn , Nawara Wichwara , Arunsak Busarin , Siri-Angkul Natthaphat , Sriwichaiin Sirawit , Chattipakorn Siriporn C. , Chattipakorn Nipon
Published: March 2022

Background

Caloric restriction and exercise are lifestyle interventions that effectively attenuate cardiometabolic impairment. However, cardioprotective effects of long-term lifestyle interventions and short-term lifestyle interventions followed by weight maintenance in prediabetes have never been compared. High cardiorespiratory fitness (CRF) has been shown to provide protection against prediabetes and cardiovascular diseases, however, the interactions between CRF, prediabetes, caloric restriction, and exercise on cardiometabolic health has never been investigated.

Methods

Seven-week-old male Wistar rats were fed with either a normal diet (ND; n = 6) or a high-fat diet (HFD; n = 30) to induce prediabetes for 12 weeks. Baseline CRF and cardiometabolic parameters were determined at this timepoint. The ND-fed rats were fed continuously with a ND for 16 more weeks. The HFD-fed rats were divided into 5 groups (n = 6/group) to receive one of the following: (1) a HFD without any intervention for 16 weeks, (2) 40% caloric restriction for 6 weeks followed by an ad libitum ND for 10 weeks, (3) 40% caloric restriction for 16 weeks, (4) a HFD plus an exercise training program for 6 weeks followed by a ND without exercise for 10 weeks, or (5) a HFD plus an exercise training program for 16 weeks. At the end of the interventions, CRF and cardiometabolic parameters were re-assessed. Then, all rats were euthanized and heart tissues were collected.

Results

Either short-term caloric restriction or exercise followed by weight maintenance ameliorated cardiometabolic impairment in prediabetes, as indicated by increased insulin sensitivity, improved blood lipid profile, improved mitochondrial function and oxidative phosphorylation, reduced oxidative stress and inflammation, and improved cardiac function. However, these benefits were not as effective as those of either long-term caloric restriction or exercise. Interestingly, high-level baseline CRF was correlated with favorable cardiac and metabolic profiles at follow-up in prediabetic rats, both with and without lifestyle interventions.

Conclusions

Short-term lifestyle modification followed by weight maintenance improves cardiometabolic health in prediabetes. High CRF exerted protection against cardiometabolic impairment in prediabetes, both with and without lifestyle modification. These findings suggest that targeting the enhancement of CRF may contribute to the more effective treatment of prediabetes-induced cardiometabolic impairment.
Expression variations in ectodysplasin-A gene (eda) may contribute to morphological divergence of scales in haplochromine cichlids
Authors: Wagner Maximilian , Bračun Sandra , Duenser Anna , Sturmbauer Christian , Gessl Wolfgang , Ahi Ehsan Pashay
Published: March 2022

Background

Elasmoid scales are one of the most common dermal appendages and can be found in almost all species of bony fish differing greatly in their shape. Whilst the genetic underpinnings behind elasmoid scale development have been investigated, not much is known about the mechanisms involved in moulding of scales. To investigate the links between gene expression differences and morphological divergence, we inferred shape variation of scales from two different areas of the body (anterior and posterior) stemming from ten haplochromine cichlid species from different origins (Lake Tanganyika, Lake Malawi, Lake Victoria and riverine). Additionally, we investigated transcriptional differences of a set of genes known to be involved in scale development and morphogenesis in fish.

Results

We found that scales from the anterior and posterior part of the body strongly differ in their overall shape, and a separate look on scales from each body part revealed similar trajectories of shape differences considering the lake origin of single investigated species. Above all, nine as well as 11 out of 16 target genes showed expression differences between the lakes for the anterior and posterior dataset, respectively. Whereas in posterior scales four genes (dlx5, eda, rankl and shh) revealed significant correlations between expression and morphological differentiation, in anterior scales only one gene (eda) showed such a correlation. Furthermore, eda displayed the most significant expression difference between species of Lake Tanganyika and species of the other two younger lakes. Finally, we found genetic differences in downstream regions of eda gene (e.g., in the eda-tnfsf13b inter-genic region) that are associated with observed expression differences. This is reminiscent of a genetic difference in the eda-tnfsf13b inter-genic region which leads to gain or loss of armour plates in stickleback.

Conclusion

These findings provide evidence for cross-species transcriptional differences of an important morphogenetic factor, eda, which is involved in formation of ectodermal appendages. These expression differences appeared to be associated with morphological differences observed in the scales of haplochromine cichlids indicating potential role of eda mediated signal in divergent scale morphogenesis in fish.
De novo assembly and analysis of Polygonatum cyrtonema Hua and identification of genes involved in polysaccharide and saponin biosynthesis
Authors: Li Dandan , Wang Qing , Chen Songshu , Liu Hongchang , Pan Keqin , Li Jinling , Luo Chunli , Wang Hualei
Published: March 2022

Background

The investigation of molecular mechanisms involved in polysaccharides and saponin metabolism is critical for genetic engineering of Polygonatum cyrtonema Hua to raise major active ingredient content. Up to now, the transcript sequences are available for different tissues of P. cyrtonema, a wide range scanning about temporal transcript at different ages’ rhizomes was still absent in P. cyrtonema.

Results

Transcriptome sequencing for rhizomes at different ages was performed. Sixty-two thousand six hundred thirty-five unigenes were generated by assembling transcripts from all samples. A total of 89 unigenes encoding key enzymes involved in polysaccharide biosynthesis and 56 unigenes encoding key enzymes involved in saponin biosynthesis. The content of total polysaccharide and total saponin was positively correlated with the expression patterns of mannose-6-phosphate isomerase (MPI), GDP-L-fucose synthase (TSTA3), UDP-apiose/xylose synthase (AXS), UDP-glucose 6-dehydrogenase (UGDH), Hydroxymethylglutaryl CoA synthase (HMGS), Mevalonate kinase (MVK), 2-C-methyl-D-erythritol 2,4-cyclodiphosphate synthase (ispF), (E)-4-hydroxy-3-methylbut-2-enyl-diphosphate synthase (ispG), 4-hydroxy-3-methylbut-2-enyl diphosphate reductase (ispH), Farnesyl diphosphate synthase (FPPS). Finally, a number of key genes were selected and quantitative real-time PCR were performed to validate the transcriptome analysis results.

Conclusions

These results create the link between polysaccharides and saponin biosynthesis and gene expression, provide insight for underlying key active substances, and reveal novel candidate genes including TFs that are worth further exploration for their functions and values.
Typhoid fever presenting with gastric ulcer bleeding
Authors: Jeon Hong Jae , Lee Jong Seo , Lee Byung Seok , Kim Seok Hyun , Lee Eaum Seok , Sung Jae Kyu , Moon Hee Seok , Kang Sun Hyung , Lee Hyun Seok , Choi Seongwoo , Sa-Kong Heon , Cheon Shinhye , Eun Hyuk Soo
Published: March 2022

Background

Enteric fever is a systemic disease caused by Salmonella enterica serovar Typhi or Salmonella enterica serovar Paratyphi, characterized by high fever and abdominal pain. Most patients with enteric fever improve within a few days after antibiotic treatment. However, some patients do not recover as easily and develop fatal life-threatening complications, including intestinal hemorrhage. Lower gastrointestinal bleeding has been reported in 10% of cases. However, upper gastrointestinal bleeding has rarely been reported in patients with enteric fever. We present a case of gastric ulcer hemorrhage caused by enteric fever.

Case presentation

A 32-year-old woman, complaining of fever lasting four days and right upper quadrant pain and melena that started one day before admission, consulted our hospital. Abdominal computed tomography revealed mild hepatomegaly and gastroscopy revealed multiple active gastric ulcers with flat black hemorrhagic spots. The melena of the patient stopped on the third day. On the fifth admission day, she developed hematochezia. At that time, Salmonella enterica serovar Typhi was isolated from the blood culture. The antibiotic regimen was switched to ceftriaxone. Her hematochezia spontaneously resolved the following day. Finally, the patient was discharged on the 12th admission day without clinical symptoms. However, her fever recurred one month after discharge, and she was readmitted and Salmonella enterica serovar Typhi was confirmed again via blood culture. She was treated with ceftriaxone for one month, and was discharged without complications.

Conclusion

Our case showed that although rare, active gastric ulcers can develop in patients with enteric fever. Therefore, upper and lower gastrointestinal bleeding should be suspected in patients with enteric fever, especially showing relapsing bacteremia.
The prevalence and clinical correlates of medical disorders comorbidities in patients with bipolar disorder
Authors: Wang Zhonggang , Li Tao , Li Shuhua , Li Kunkun , Jiang Xianfei , Wei Chen , Yang Lei , Cao Haiyan , Li Shen , Li Jie
Published: March 2022

Objective

Medical disorders in patients with bipolar disorder (BD) have attracted more and more attention. So far, there is still a lack of studies on this issue utilizing large sample sizes in the Chinese sample. Therefore, we conducted this study to explore the clinical characteristics of BD patients comorbid medical disorders in a relatively large Chinese sample.

Methods

This was a cross-sectional study including 1,393 BD patients (882 patients with medical disorders and 511 patients without medical disorders). Their demographic and clinical characteristics were obtained by the Hospital Information System and self-designed questionnaires.

Results

The comorbidity rate of medical disorders in BD was 63.32%. The average number of medical disorders for a BD patient was 2.69. The top five comorbid medical disorders in BD patients were circulatory system diseases (19%), nervous system diseases (18%), endocrine and metabolic diseases (17%), digestive system diseases (16%), and respiratory system diseases (8%). BD patients with comorbid medical disorders had an older average age, lower education level, longer illness course, later onset age, lower ratio of psychotic features, more admission numbers, higher ratio of smoking and drinking alcohol, more number of manic episodes (All P < 0.05). Smoking, numbers of depressive episode, onset age, and illness course were independent risk factors of comorbidities in BD patients (All P < 0.05).

Conclusions

Medical disorders in Chinese BD patients are highly prevalent. The smoking, number of depressive episodes, onset age, illness course, are correlated with BD patients comorbid medical disorders. Clinicians should pay attention to the medical disorders comorbidities in BD patients, and take effective measures to improve treatment outcome and reduce the suffering. The integrative approach should be the imperative in clinical practice.
Comparison of mortality hazard ratios associated with health behaviours in Canada and the United States: a population-based linked health survey study
Authors: Fisher Stacey , Bennett Carol , Hennessy Deirdre , Finès Philippe , Jessri Mahsa , Bader Eddeen Anan , Frank John , Robertson Tony , Taljaard Monica , Rosella Laura C. , Sanmartin Claudia , Jha Prabhat , Leyland Alastair , Manuel Douglas G.
Published: March 2022

Background

Modern health surveillance and planning requires an understanding of how preventable risk factors impact population health, and how these effects vary between populations. In this study, we compare how smoking, alcohol consumption, diet and physical activity are associated with all-cause mortality in Canada and the United States using comparable individual-level, linked population health survey data and identical model specifications.

Methods

The Canadian Community Health Survey (CCHS) (2003–2007) and the United States National Health Interview Survey (NHIS) (2000, 2005) linked to individual-level mortality outcomes with follow up to December 31, 2011 were used. Consistent variable definitions were used to estimate country-specific mortality hazard ratios with sex-specific Cox proportional hazard models, including smoking, alcohol, diet and physical activity, sociodemographic indicators and proximal factors including disease history.

Results

A total of 296,407 respondents and 1,813,884 million person-years of follow-up from the CCHS and 58,232 respondents and 497,909 person-years from the NHIS were included. Absolute mortality risk among those with a ‘healthy profile’ was higher in the United States compared to Canada, especially among women. Adjusted mortality hazard ratios associated with health behaviours were generally of similar magnitude and direction but often stronger in Canada.

Conclusion

Even when methodological and population differences are minimal, the association of health behaviours and mortality can vary across populations. It is therefore important to be cautious of between-study variation when aggregating relative effect estimates from differing populations, and when using external effect estimates for population health research and policy development.
A new tool to evaluate burnout: the Italian version of the BAT for Italian healthcare workers
Authors: Borrelli Ivan , Santoro Paolo Emilio , Fiorilli Caterina , Angelini Giacomo , Buonomo Ilaria , Benevene Paula , Romano Luciano , Gualano Maria Rosaria , Amantea Carlotta , Moscato Umberto
Published: March 2022

Background

Healthcare workers (HCWs) represents one of the highest-risk population to develop burnout symptoms. Recently, a new tool has been designed to measure several dimensions that capture an exhaustive expression of burnout symptoms by six dimensions (i.e., exhaustion; mental distance; cognitive impairment; emotional impairment; psychological distress; psychosomatic complaints).

Methods

The current study aims to adapt the Burnout Assessment Tool (BAT) to an Italian Healthcare workers’ sample confirming the original second-order factorial structure. Furthermore, we expected to find good indexes of reliability and validity tests. Participants were 697 Italian Health Care Workers (Female = 68.44%; mean age = 36.47; SD = 11.20). Data were collected by self-report questionnaires submitted by the snowball method.

Results

Findings show a good fit of the BAT’s structure, confirming the hypothesized second-order factorial model. Furthermore, good reliability has been established with the study’s measures.

Conclusions

The BAT for HCWs is eligible as a new tool to evaluate burnout in the at-risk HCWs as a multi-facet constellation of symptoms.