bluuebunny/crossref_metadata_2025 huggingface dataset:
Statistical shape modelling to analyse the talus in paediatric clubfoot
Authors: Feng Yixuan , Bishop Aaron , Farley Daniel , Mitchell Joseph , Noonan Kenneth , Qian Xiaoping , Ploeg Heidi-Lynn
Published: April 2021

One fifth of idiopathic clubfoot deformities cannot be fully corrected by Serial Ponseti casting and deformity recurs in 20%–30% of cases. To avoid x-ray exposure, the joints with largely unossified bones are diagnosed with magnetic resonance images (MRI). Typically, geometric measurements are made in the MRI planes; however, this method is inaccurate compared to measurements on three-dimensional (3D) models of the joint. More accurate measurements using the 3D bone shapes may be better at identifying differences between groups; and therefore, improve diagnosis. The entire set of shape features from MRI can be analysed simultaneously through statistical shape modelling (SSM) which assesses bone morphology of clubfoot in a more sensitive way. A method for SSM of the talus is developed in this study and the shape of the normal talus is compared with the one in clubfeet with residual deformity through both geometric measurements and SSM. Significant differences between two groups were found by both methods; and therefore, might contribute to improve diagnosis of clubfoot.
Ginsenoside Rb1 Alleviates Lipopolysaccharide-Induced Inflammatory Injury by Downregulating miR-222 in WI-38 Cells
Authors: Wei Erhu , Fang Xiao , Jia Peisheng , Li Mingxia , Jin Peina , Li Fengyan , Wang Huaili , Gao Dan
Published: April 2021

Pneumonia is a serious respiratory tract infection disease in children, which threatens to the health or life of children patients. Ginsenoside Rb1 (Rb1) is a principle active ingredient extracted from the root of Panax notoginseng (Burk.) F.H. Chen with anti-inflammatory effect. Our study aimed to determine the effects and molecular mechanisms of Rb1 on lipopolysaccharide (LPS)-induced inflammatory injury of lung fibroblasts WI-38 cells. Cell viability and apoptosis were evaluated by CCK-8 and flow cytometry, respectively. The production of inflammatory cytokines were measured by ELISA and RT-qPCR. miR-222 expression was examined by RT-qPCR. The expression levels of the nuclear factor-kappa B (NF-κB) p65 and phosphorylated p65 were detected by western blot. We found that LPS stimulation induced WI-38 cell inflammatory injury by inhibiting cell viability, and inducing apoptosis and inflammatory cytokine production, while treatment with Rb1 significantly attenuated LPS-induced inflammatory injury in WI-38 cells. Additionally, Rb1 decreased LPS-induced upregulation of miR-222 and activation of the NF-κB pathway in WI-38 cells. Overexpression of miR-222 abolished the inhibitory effects of Rb1 on LPS-induced viability reduction, apoptosis, inflammatory cytokine production and activation of the NF-κB pathway. In conclusion, Rb1 alleviated LPS-induced inflammatory injury in WI-38 cells via downregulating miR-222 and inactivation of the NF-kB pathway.
TECHNO21: Design and Implementation of a New Performance Management System
Authors: Obaid Asfia , Rahman Saman , Mehmood Asia , Kayani Neelab
Published: April 2021

The case highlights the key concerns and issues an organization may face if its performance management system (PMS) does not serve its intended purpose and how it can cause demotivation and dissatisfaction among employees and result in an overall decline in organizational performance. It also illustrates how employees’ organizational culture and perception can be as important as the system design and can present challenges even if an elaborate system is planned. In the face of increasing turmoil among employees towards management and the decreasing performance of the organization, TECHNO21 decided to change its current PMS, which seemed a difficult but necessary step to achieve the desired performance levels and overall strategic objectives of the organization.
Hypoglycemia and seizures associated with canine primary hepatic neuroendocrine carcinoma
Authors: Dorn Amanda R. , Brower Alexandra , Turner Hailey , Lapa Klayton
Published: April 2021

A 10-y-old intact male Labrador Retriever dog had a history of ataxia, inability to stand, and grand mal seizures. Complete blood count and serum biochemistry profiles revealed profound hypoglycemia, mildly increased alanine aminotransferase (ALT) activity, mild hypernatremia, and lymphopenia. The seizures could not be controlled with intravenous dextrose, diazepam, or propofol. The dog was euthanized given poor quality of life, and an autopsy was performed. Primary autopsy findings included firm hepatic masses that ranged from dark-red to tan, with the largest ~1.5 cm diameter, and pulmonary edema. Histologic examination of the hepatic masses revealed redundant, several-cell-thick cords, and packeted or acinar arrangements of polygonal cells, supported on a fibrovascular stroma. The neoplastic cells were immunopositive for insulin, synaptophysin, and neuron-specific enolase immunohistochemistry; granules in the tumor cells had an affinity for Grimelius silver stain. The histologic features, as well as the immunohistochemical staining profile, identified the neoplasm as a primary multifocal hepatic neuroendocrine carcinoma. Neuroendocrine carcinomas are rare in dogs and usually occur in the gastrointestinal or respiratory tract.
Chronic Otitis in Cats: Clinical management of primary, predisposing and perpetuating factors
Authors: Brame Bailey , Cain Christine
Published: April 2021

Practical relevance:

Chronic otitis can be one of the most frustrating diseases to manage for a small animal practitioner. While it occurs less commonly in the cat than the dog, it is no less challenging. The purpose of this review is to discuss the common and uncommon causes of chronic otitis in the cat within the clinical framework used for diagnosis and treatment. The focus is on diseases that affect the ear canal, rather than those restricted to the pinnae.

Clinical challenges:

Otitis is multifactorial, which complicates management. A common clinical mistake is to focus solely on treating the infection present. Only by addressing all factors will a clinician successfully control chronic otitis. For the purposes of this review, the authors have adopted the established model of separating primary, predisposing and perpetuating causes of otitis. Primary factors are those that directly cause otitis (inflammation); predisposing factors are those that put the patient at risk for development of otitis; and perpetuating factors are those that result in ongoing clinical signs of otitis or that prevent clinical resolution.

Audience:

This review is aimed at veterinarians who treat cats and particularly those with an interest in feline dermatology and otology.

Equipment:

While many practitioners rely on a hand-held otoscope, a video-otoscope can be very helpful for the diagnosis and treatment of chronic otitis.

Evidence base:

This review presents up-to-date information regarding the diagnosis and treatment of chronic otitis in cats, with emphasis on the most recent peer-reviewed literature.
Eye disorders in patients with celiac disease and inflammatory bowel disease: A study using clinical data warehouse
Authors: Martins Thiago Goncalves dos Santos , Miranda Sipahi Aytan , dos Santos Fabiana Maria , Schor Paulo , Anschütz Andreas , Mendes Luís Guilherme Arneiro , Silva Rufino
Published: April 2021

Background and aim:

To analyze the prevalence of ophthalmic manifestations in patients with celiac disease, Crohn’s disease and ulcerative colitis in Munich/Germany.

Methods:

A total of 272,873 patients of Ludwig Maximilians Universitat Ophthalmological Hospital with eye disease were evaluated between 2003 and 2019. The International Classification of Diseases, 10th revision (ICD-10) of celiac disease Crohn’s disease, ulcerative colitis, and all medical records which had the diagnosis of these diseases were analyzed.

Results:

A total of 272,873 patients were analyzed, with a mean age of 53 years, with approximately 48% female patients, and 51% male patients. We selected 72 patients with celiac disease (68% women and 32% men), with a minimum age of 8 years, maximum of 103 years, and an average of 52 years. The most common diagnoses were dry eye (32%) and cataract (12%). The mean intraocular pressure of patients with celiac disease was 15 mmHg. During the same study period, 103 patients with Crohn’s disease were analyzed, with an average intraocular pressure of 14 mmHg.The minimum age of the patients was 12 years and a maximum of 93 years with an average age of 55 years, with 57% of females and 43% of males. The most common diagnoses were cataract (22%) and dry eye (19%). During the same study period, 99 patients with ulcerative colitis were analyzed, with an average intraocular pressure of 14 mmHg.The minimum age of the patients was 6 years and a maximum of 96 years, with an average age of 61 years, with 36% of females and 64% of males. The most common diagnoses were cataract (29.2%) and dry eye (12%).

Conclusions:

The main ophthalmological manifestations of patients requiring eye follow-up were dry eye and cataract for all the diseases analyzed, which can be considered as coincident complications. None of the three diseases had increased intraocular pressure. Thus, celiac disease presented a profile of ophthalmological manifestation similar to the other intestinal inflammatory diseases studied.
Carbohydrate intake and risk of glaucoma in the sun cohort
Authors: Moreno-Montañés Javier , Gutierrez-Ruiz Itziar , Gándara Elsa , Moreno-Galarraga Laura , Santiago Susana , Ruiz-Canela Miguel , Martínez-González Julio , Martínez-González Miguel Ángel , Fernandez-Montero Alejandro
Published: April 2021

Purpose:

To assess the association between carbohydrates (CH) intake and glaucoma incidence.

Methods:

18,247 volunteer participants (183,067 person-years at risk) with 10-year of median follow-up were included in this prospective dynamic cohort. Baseline total CH intake (g/d) was categorised in quartiles and classified in nine different CH food sources. Self-reported diagnosis of glaucoma was collected at baseline and on biennial follow-up questionnaires. CH intake and glaucoma diagnosis were validated in a subsample of participants. We studied potential confounders and effect modificators, including diabetes. The relationship between CH intake and glaucoma incidence was analysed using multivariable Cox proportional hazards ratio (HR) models to adjust for potential confounding factors.

Results:

During 10 years of median follow-up, a total of 242 new cases of glaucoma were identified. Participants in the highest quartile of baseline CH intake had a significantly higher risk of glaucoma as compared to participants in the lowest quartile [HR 1.50 (95% Confidence interval (CI): 1.01–2.25), p for trend = 0.042]. None of the nine CH food groups was individually related to glaucoma. In stratified analyses, after excluding all cases of diabetes, the HR comparing extreme quartiles of CH intake was 1.77 (95% CI: 1.15–2.74).

Conclusions:

Our results suggest that a higher intake of total carbohydrates is associated with a higher risk of incident glaucoma. The total amount of CH, rather than the specific food sources of CH, seems to play a major role, and this association does not seem to be confounded or modified by diabetic status.
Implication of Long-Term Terracing Watershed Development on Soil Macronutrients and Crop Production in Maybar Subwatershed, South Wello Zone, Ethiopia
Authors: Taye Tilahun , Moges Awdenegest , Muluneh Alemayehu , Lebay Muluken , Abiye Wudu
Published: April 2021

Long-term watershed management in Ethiopia was evaluated in various agro-ecologies starting in the 1980s. Our research was carried out to investigate the effects of long-term watershed management on soil macronutrient status and crop production in the Maybar subwatershed terrace positioning system, which has a long-term data set on various aspects, such as hydroclimatology, agriculture, and social studies. Crop yield data were collected from 40 fixed plots of that data set, and soil samples were collected by topo-sequencing of the catchment from the cultivation field based on different terrace position plot arrangements. The results showed higher crop yield and production of biomass in the upper section or deposition zone of soil and water conservation structure than below the structure or loss zone, but did not vary significantly from the annual production potential. The annual production of cereals was marginally decreased, but not pulse crops, reducing the wheat harvest production from the middle to the loss zone (23.8%) rather than the deposition zone to middle portion of the terrace (8.0%). In comparison, to increase the slope position of the terrace, the redaction percentage of pulse crops (field pea and lentil) is greater, because in the first terrace location (upper to middle) and in the second terrace, the output capacity of field pea was reduced by 22.4%. The condition of soil fertility between the 2 consecutive systems for soil and water protection differed from the upper to the lower land positions. Improvement in soil chemical and physical properties relatively increased toward the upper land position. Soil organic matter, available phosphorus, bulk density, and soil moisture content were significantly affected by soil and water conservation structures ( P ⩽ .05). Long-term terrace growth typically has a positive effect on improvements in onsite soil resources and the capacity for crop production. It therefore has a beneficial impact on onsite natural resources, such as enhancing soil macronutrients and increasing productivity in crop yields.
Development of a new diamond-like carbon surface treatment method with electric discharge for short running-in and friction reduction
Authors: Murashima Motoyuki , Maeda Misato , Xingrui Deng , Umehara Noritsugu , Kousaka Hiroyuki
Published: April 2021

The present paper proposes a new treatment method for diamond-like carbon (DLC) coatings using electric discharge. DLC coatings exhibit excellent mechanical and tribological properties due to their unique carbonaceous structure. Several surface treatment methods were presented to achieve short running-in and low friction. However, in-situ surface treatment is needed to extend the life of machines and maintain their performance. Here, we propose an electric discharge treatment with a simple electrical circuit. As a result, the friction coefficient drastically drops from 0.3 to 0.11. Interestingly, the drop starts shortly after the discharge starts. Consequently, the running-in is shortened to about 6-m sliding compared to no discharge condition, which does not show any running-in more than 68-m sliding. Raman analysis reveals that a transfer layer on the ball surface is composed of carbonaceous material and the structure exhibits graphite-like characteristics. However, there is visible damage on the DLC surface. Another friction test shows a very low friction coefficient of 0.04 using a transfer layer-covered ball and a new DLC disk with a smooth surface. In conclusion, the combination of a transfer layer and smooth DLC surface is needed to exhibit excellent tribological performance, indicating the importance of less damage treatment. Next, pulse discharge treatment is demonstrated to achieve less damage to the DLC coating. As a result, the pulse discharge method reduces friction and surface damage. In conclusion, the proposed treatment methods using electric discharge not only show the potential for reducing friction, but also the feasibility of in-situ treatment during machine operation.
‘Architecture is forever unfinished’
Authors: Escobedo Frida
Published: April 2021

In this interview, the celebrated Mexican architect Frida Escobedo explains the intricacies of her design practice and her longstanding interests in Minimalism, Mexican Modernism, and the socio-political concerns facing architecture. The interview provides an insightful mid-career look at one of the most creative and compelling architects working in the world today. Escobedo and Gardner engage in a lively discussion that ranges from design theory to feminism in contemporary architecture. The interview was conducted at Harvard University on 12 December 2019.
Multimarket contact and target size: The moderating effect of market concentration and location
Authors: Ljubownikow Grigorij , Benischke Mirko , Nadolska Anna
Published: April 2021

Acquisitions are competitive moves that disrupt an industry’s competitive structure. As a result, firms are often not passive observers of their rival’s acquisitions, but actively retaliate against such competitive moves. In this study, we explore these dynamics by analyzing one way in which multimarket contact may influence acquisition strategies, namely, the type of targets acquired. We contribute to the acquisition literature by clarifying the role that pre-acquisition competitive interdependencies play in firms’ acquisition strategies. Specifically, we suggest that high multimarket contact firms do not necessarily avoid acquisition activity. Instead, these firms are more likely to acquire targets that are less likely to incur retaliation from interconnected rivals. We also explore two important boundary conditions to this relationship: (1) the market’s competitive structure and (2) the location of the target firm. Our empirical tests of a sample of 741 bank holding companies from 1995 to 2014 offer support for our hypotheses.
Study on the Prognostic Values of Dynactin Genes in Low-Grade Glioma
Authors: Su Xiaotao , Li Haoyu , Chen Shaohua , Qin Chao
Published: April 2021

Objective:

This present study aims to investigate the potential prognostic values of dynactin genes ( DCTN) for predicting the overall survival (OS) in low-grade glioma (LGG) patients.

Methods:

The DCTN mRNA expression data were downloaded from The Cancer Genome Atlas database containing 518 patients with LGG. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analyses for DCTN genes were performed by using Database for Annotation, Visualization, and Integrated Discovery platform, and their enrichment results were verified by using the Biological Networks Gene Ontology tool. Next, the correlations between DCTN genes and LGG were identified by Pearson correlation coefficient analysis. The OS was estimated by Kaplan-Meier survival analysis. The cBio Cancer Genomics Portal was used to analyze the mutations of DCTN genes and their effects on the prognosis of LGG. The correlation between the abundance of immune infiltration and tumor purity of DCTN genes were predicted by The Tumor Immune Estimation Resource.

Results:

Our research showed that the mRNA expression of DCTN4 in tumor tissues was much higher ( P < 0.01) than that in normal tissues. Meanwhile, there was a certain correlation between the DCTN genes. Survival analysis showed that the high expression of DCTN1, DCTN3, DCTN4, DCTN6, and their co-expression were significantly correlated with favorable OS in LGG patients ( P < 0.05). In DCTN2, a high mutation rate was observed. Further research showed that the genetic alteration in DCTN genes was related to a poor OS and progression-free survival of LGG patients. The expression of DCTN genes had a certain correlation with immune infiltrating cells.

Conclusion:

Our study showed that the high expressions of DCTN1, DCTN3, DCTN4, and DCTN6 were associated with a favorable OS of LGG patients, indicating that these DCTN genes are potential biomarkers for evaluating the prognosis of LGG patients.
The Role of Multiliteracies in Changing Learning Spaces and Promoting Self-Advocacy for Students with Complex Support Needs
Authors: Krishnan Sudha
Published: April 2021

Traditional literacy practices using print-based texts exclude students with complex support needs from the full range of literacy activities provided to peers without disabilities, which may limit them to low-level literacy skills or functional skills. By contrast, by including various forms of representation and text, multiliteracies are uniquely positioned to address the literacy development of students with complex support needs. The present study aimed to investigate the changes in student engagement, teacher–student interaction, staff and parent perceptions, and self-advocacy opportunities created during the implementation of multiliteracies with students with complex support needs. In a public high school classroom in northern California with a teacher and six paraeducators, two students with complex support needs created a multimodal book to present as student input at their individualized education program meetings. The book included the students’ favorite images of family and school, videos and images of their favorite activities at home and school, an identity chart with adjectives that best described them, a description of their strengths, and a transition plan describing what they wanted to do after school. Grounded theory was used to analyze the data collected through interviews, observations, and video and audio recordings. Data suggested that multiliteracies’ pedagogy created new learning spaces, empowering teacher–student interactions, and student self-advocacy.
Critical Protocols in Indigenous Gamespace
Authors: Miner Joshua D.
Published: April 2021

This article examines Indigenous video games that critique mainstream environmental politics at the level of mechanics. An analysis of video games’ influences on ecological values requires looking beyond the representational to the mechanical relationships between player and software. As a cultural–computational medium, video games are embedded with ethics of interaction that inflect this representational dimension by requiring that players generate the text as participant. With the recent visibility of Indigenous rights movements, developers have embedded Indigenous cultural protocols in the mechanical interactions (or technical protocols) of gameplay. In the context of critique, their integration produces “critical protocols,” configurations of gamic action that encourage players to evaluate their treatment of real-world environments. Critical protocols emerge between the technical and cultural, where scripts for interaction in algorithmic spaces intervene in affirmative game design and work as an analog beyond the game. Indigenous developers call for new ways of computing and critiquing settler digitality through play. These games aim toward representational as well as computational sovereignty.
Magnitude and determinants of the psychological impact of COVID-19 among health care workers: A systematic review
Authors: Bekele Firomsa , Hajure Mohammedamin
Published: April 2021

Introduction:

The mental health of the health care professionals is more likely to be affected by the coronavirus disease-19 compared to the general population. Accordingly, the current study aimed to summarize the magnitudes and determinants of the psychological impact of coronavirus among health care professionals.

Methods:

The studies from Medline via PubMed, Science Direct, and Google Scholar were searched from 5 September to 19 October 2020. The review was conducted as per PRISMA-2009 (Preferred Reporting Items for Systematic Reviews and Meta-analyses).

Result:

Initially, 6316 articles were searched from three databases (PubMed, Science Direct, and Google Scholar). Finally, 20 articles were filtered to be included in our review. Among different types of psychological impact, stress was reported that lies within the range from 5.2% to 100%, anxiety was reported from 11.1% to 100%, depression was from 10.6% to 58%, and insomnia was from 28.75% to 34%. Several factors were related to the negative psychological state of health care workers due to coronavirus disease-19 like educational level, occupation, gender, age, working environment, work experience, legal status, ethnicity, psychological comorbidity, social support, personal/family exposure, and feeling of health care providers.

Conclusion:

The most common psychological impacts among health care workers were anxiety and stress. Besides different sociodemographic factors that determine the psychological impacts, front-line health care workers and participants having psychological comorbidity have a high risk of negative psychological state impacts as compared to their counterparts. Therefore, special attention should tend to health care workers directly involved in the prevention and management of coronavirus disease-19 and having a different risk of mental health condition.
Clinicopathological and Prognostic Characteristics in Spinal Chondroblastomas: A Pooled Analysis of Individual Patient Data From a Single Institute and 27 Studies
Authors: Zheng Bo-Wen , Huang Wei , Liu Fu-Sheng , Zhang Tao-Lan , Wang Xiao-Bin , Li Jing , Lv Guo-Hua , Yan Yi-Guo , Zou Ming-Xiang
Published: April 2021

Study Design:

Retrospective pooled analysis of individual patient data.

Objectives:

Spinal chondroblastoma (CB) is a very rare pathology and its clinicopathological and prognostic features remain unclear. Here, we sought to characterize the clinicopathological data of a large spinal CB cohort and determine factors affecting the local recurrence-free survival (LRFS) and overall survival (OS) of patients.

Methods:

Electronic searches using Medline, Embase, Google Scholar and Wanfang databases were performed to identify eligible studies per predefined criteria. A retrospective review was also conducted to include additional patients at our center.

Results:

Twenty-seven studies from the literature and 8 patients from our local institute were identified, yielding a total of 61 patients for analysis. Overall, there were no differences in clinicopathological characteristics between the local and literature cohorts, except for absence or presence of spinal canal invasion by tumor on imagings and chicken-wire calcification in tumor tissues. Univariate Kaplan-Meier analysis revealed that previous treatment, preoperative or postoperative neurological deficits, type of tumor resection, secondary aneurysmal bone cyst (ABC), chicken-wire calcification and radiotherapy correlated closely with LRFS, though only type of tumor resection, chicken-wire calcification and radiotherapy were predictive of outcome based on multivariate Cox analysis. Analyzing OS, we found that a history of preoperative treatment, concurrent ABC, chicken-wire calcification, type of tumor resection and adjuvant radiotherapy had a significant association with survival, whereas only type of tumor resection remained statistically significant after adjusting for other covariables.

Conclusion:

These data may be helpful in prognostic risk stratification and individualized therapy decision making for patients.
When Affirmative Action Disappears: Unexpected Patterns in Student Enrollments at Selective U.S. Institutions, 1990–2016
Authors: kehal prabhdeep Singh , Hirschman Daniel , Berrey Ellen
Published: April 2021

Discussions of U.S. affirmative action policy assume that considering race in undergraduate admissions increases Black and Latinx student enrollments. We show that this assumption that affirmative action is linked to Black and Latinx student enrollments holds true for higher-status colleges and universities, but not institutions across the field of higher education. We use fixed effects modeling to analyze the association between a stated affirmative action admissions policy and enrollment trends for first-year students of different racialized backgrounds between 1990 and 2016 at 1,127 selective institutions. We find that, at the most selective institutions, stated policy usage was associated with increased Black student enrollments. However, at less selective institutions, policy usage was associated with decreased Black student enrollments and increased Non-U.S. resident enrollments. We also identify close-to-zero estimates of this relationship for enrollment trends of additional demographic backgrounds. We use these findings to elaborate the role of field-level status dynamics in racialized organizations theory. Paradoxically, U.S. American higher education’s contemporary racialized status order roughly consists of higher-status institutions that consider race in admissions but do not enroll racially heterogeneous cohorts, middle-status institutions that do not consider race but enroll racially heterogeneous cohorts, and lower-status non-selective institutions that enroll disproportionately high numbers of Black, Indigenous, and Latinx students.
SARS-COV-2 infection in pregnant women and newborns in a Spanish cohort (GESNEO-COVID) during the first wave
Authors: Carrasco Itzíar , Muñoz-Chapuli Mar , Vigil-Vázquez Sara , Aguilera-Alonso David , Hernández Concepción , Sánchez-Sánchez César , Oliver Cristina , Riaza Mónica , Pareja Marta , Sanz Olga , Pérez-Seoane Beatriz , López Juan , Márquez Elena , Domínguez-Rodríguez Sara , Hernanz-Lobo Alicia , De León-Luis Juan Antonio , Sánchez-Luna Manuel , Navarro María Luisa
Published: April 2021

Background

Knowledge about SARS-CoV-2 infection in pregnancy and newborns is scarce. The objective of this study is to analyse clinical and epidemiological characteristics of a cohort of women infected with SARS-CoV-2 during pregnancy and their newborns exposed to SARS-CoV-2 during gestation.

Methods

Multicentric observational study of Spanish hospitals from the GESNEO-COVD cohort, participants in RECLIP (Spanish Network of Paediatric Clinical Assays). Women with confirmed SARS-CoV-2 infection by PCR and/or serology during pregnancy, diagnosed and delivering during the period 15/03/2020–31/07/2020 were included. Epidemiological, clinical, and analytical data was collected.

Results

A total of 105 pregnant women with a median of 34.1 years old (IQR: 28.8–37.1) and 107 newborns were included. Globally, almost 65% of pregnant women had some COVID-19 symptoms and more than 43% were treated for SARS-COV-2. Overall, 30.8% of pregnant women had pneumonia and 5 (4.8%) women were admitted to the intensive care unit needing invasive mechanical ventilation. There was a rate of 36.2% of caesarean sections, which was associated with pneumonia during pregnancy (OR: 4.203, CI 95%: 1.473–11.995) and lower gestational age at delivery (OR: 0.724, CI 95%: 0.578–0.906). The prevalence of preterm birth was 20.6% and prematurity was associated with pneumonia during gestation (OR: 6.970, CI95%: 2.340–22.750) and having a positive SARS-CoV-2 PCR at delivery (OR: 6.520, CI95%: 1.840–31.790). All nasopharyngeal PCR in newborns were negative at birth and one positivized at 15 days of life. Two newborns died, one due to causes related to prematurity and another of unexpected sudden death during early skin-to-skin contact after delivery.

Conclusions

Although vertical transmission has not been reported in this cohort, the prognosis of newborns could be worsened by SARS-CoV-2 infection during pregnancy as COVID-19 pneumonia increased the risk of caesarean section deliveries and preterm births.
Self-assessment, attitude and perception of interprofessional learning in hospital acquired infection control practices among health professionals in Klang Valley, Malaysia
Authors: Thangarajoo Saraswathy , Rosliza A. M. , Nalliah Sivalingam , Karim Jalina , Shohaimi Shamarina , Ramasamy S. , Amin-Nordin S.
Published: April 2021

Background

Interprofessional learning (IPL) is a key challenge in Malaysia in incorporating the current profession-specific medical education into the interprofessional learning curriculum. Safe practices would be enhanced with improved collaboration among the health professionals when they learn with, from, and about each other. The main objective of this study was to determine the significant differences in self-assessment, attitude, and perception of interprofessional learning among doctors and nurses in a teaching hospital in Klang Valley, Malaysia. The second objective was to determine if there is any significant difference in the selected demography factors, mean and total scores between doctors and nurses in self-assessment, attitude, and perceptions of IPL aspects.

Methods

A total of doctors (39) and nurses (37) were recruited for an interventional study on the interprofessional learning approach on hospital acquired infection control. The participants responded to the University of West England Interprofessional (UWEIP) questionnaire at baseline consisting of four dimensions in IPL aspects; Self-assessment on communication and teamwork skills (CTW), interprofessional learning (IPL), interprofessional interaction (IPI), and interprofessional relationship (IPR). The Cronbach alpha value for the total questionnaire was established at 0.79.

Results

The majority of doctors scored positive in CTW, IPL, IPR, and neutral in IPI. Nurses’ also recorded the highest positive scores in CTW, IPL, and IPR, and neutral in IPI. Negative scores were found in CTW and IPI. A significant difference was revealed between doctors and nurses in IPL attitude; p = 0.024 and there was no significant difference in other dimensions (p > .05). Results also found a significant difference between participants’ and non-participants of IPL training sessions; p = 0.009.

Conclusions

This study revealed the infusion of interprofessional learning training among the health professionals displayed better self-assessments, attitudes, and perceptions towards collaborative practices.
Association of professional identity, job satisfaction and burnout with turnover intention among general practitioners in China: evidence from a national survey
Authors: Zhang Tao , Feng Jing , Jiang Heng , Shen Xin , Pu Bo , Gan Yong
Published: April 2021

Background

The complex interrelationships between professional identity, job satisfaction, burnout, and turnover intention among general practitioners (GPs) are insufficiently understood in China. This study aimed to investigate the interrelationships between professional identity, job satisfaction, burnout, and turnover intention in China, and to examine whether job satisfaction and burnout played mediating roles between professional identity and turnover intention.

Methods

A cross-sectional survey was conducted between October, 2017 and February, 2018 in China. The participants were selected using a multistage stratified random sampling method. Data were collected with a self-administered questionnaire from 3236 GPs (response rate, 99.8%) working in community health institutions in China. Professional identity was measured by the 13 items scale, and job satisfaction scale with an 11-item designed by Shi et al. was employed. Burnout was measured using a 22-item Maslach Burnout Inventory-Human Services Survey, and turnover intention was measured with a 6 items scale. Descriptive statistics were calculated and groups’ differences were estimated Student’s t-test and analyses of variance. Pearson’s correlation analysis was used to assess the degree of correlation among different dimensions of professional identity, job satisfaction, burnout, and turnover intention. Structural equation modeling analysis was applied to examine the interrelationships among these study variables based on the hypothesized model.

Results

The proposed model achieved a good model fit. Job satisfaction had a direct negative effect on turnover intention (β = − 0.38, P < 0.001), burnout had a direct positive effect on turnover intention (β = 0.37, P < 0.001), and professional identity had an indirect negative effect on turnover intention through the mediating effect of job satisfaction and burnout.

Conclusions

Our study elucidated the pathways linking professional identity, job satisfaction, and burnout to turnover intention of GPs. This revealed that turnover intention was significantly affected by job satisfaction and burnout, and the effects of professional identity on turnover intention can be mediated by job satisfaction and burnout.
Pregnancy-related aeromedical retrievals in rural and remote Australia: national evidence from the Royal Flying Doctor Service
Authors: Gonzalez-Chica David , Gillam Marianne , Williams Susan , Sharma Pritish , Leach Matthew , Jones Martin , Walters Lucie , Gardiner Fergus
Published: April 2021

Background

Inequalities in the availability of maternity health services in rural Australia have been documented, but not the impact on aeromedical retrievals. This study aims to examine the prevalence of pregnancy-related aeromedical retrievals, the most common conditions (overall and in specific age groups), and their distribution according to operation area and demographic characteristics.

Methods

Cross-sectional study using administrative data from the Royal Flying Doctors Service (RFDS) including all pregnant women aged 15–49 years retrieved by the RFDS between 2015 and 2019. All pregnancy-related aeromedical retrievals were classified according to the International Classification of Diseases, Tenth Revision (ICD-10, chapter XV). The distribution of pregnancy-related conditions was presented overall and stratified by age group (i.e. < 20 years, 20–34 years and 35+ years). Retrieval and receiving sites were geographically mapped with Tableau mapping software® based on postcode numbers of origin and destination.

Results

A total of 4653 pregnancy-related retrievals were identified (mean age 27.8 ± 6.1 years), representing 3.1% of all RFDS transfers between 2015 and 18 and 3.5% in 2018–19 (p-value 0.01). The highest proportion of pregnancy-related retrievals (4.8%) occurred in Western operation. There was an apparent increase in pregnancy-related retrievals in South Australia and the Northern Territory (Central Operation) in 2018–19. Preterm labour/delivery was responsible for 36.4% of all retrievals (40.7% among women aged 15–19 years) and premature rupture of membranes for 14.9% (19.4% among women aged 35–49 years). Inter-hospital transfers represented 87.9% of all retrievals, with most patients relocated from rural and remote regions to urban hospitals; most retrievals occurred during the day, with a median distance of 300 km. Adolescents and Aboriginal and Torres Strait Islander were overrepresented in the sample (four and eight times higher than their metropolitan counterparts, respectively).

Conclusions

The proportion of pregnancy-related aeromedical retrievals varies geographically across Australia. Overall, one-third of retrievals were related to preterm/delivery complications, especially among adolescents. Most retrievals performed by the RFDS are susceptible to public health strategies aimed at improving antenatal care and preventing unintended pregnancies among adolescents and Aboriginal and Torres Strait Islander women. Greater capacity to manage pregnancy conditions in rural hospitals could reduce the requirement for aeromedical inter-hospital transfers.
Ischaemic postconditioning reduces apoptosis in experimental jejunal ischaemia in horses
Authors: Verhaar Nicole , de Buhr Nicole , von Köckritz-Blickwede Maren , Hewicker-Trautwein Marion , Pfarrer Christiane , Mazzuoli-Weber Gemma , Schulte Henri , Kästner Sabine
Published: April 2021

Background

Ischaemic postconditioning (IPoC) refers to brief periods of reocclusion of blood supply following an ischaemic event. This has been shown to ameliorate ischaemia reperfusion injury in different tissues, and it may represent a feasible therapeutic strategy for ischaemia reperfusion injury following strangulating small intestinal lesions in horses. The objective of this study was to assess the degree cell death, inflammation, oxidative stress, and heat shock response in an equine experimental jejunal ischaemia model with and without IPoC.

Methods

In this randomized, controlled, experimental in vivo study, 14 horses were evenly assigned to a control group and a group subjected to IPoC. Under general anaesthesia, segmental ischaemia with arterial and venous occlusion was induced in 1.5 m jejunum. Following ischaemia, the mesenteric vessels were repeatedly re-occluded in group IPoC only. Full thickness intestinal samples and blood samples were taken at the end of the pre-ischaemia period, after ischaemia, and after 120 min of reperfusion. Immunohistochemical staining or enzymatic assays were performed to determine the selected variables.

Results

The mucosal cleaved-caspase-3 and TUNEL cell counts were significantly increased after reperfusion in the control group only. The cleaved-caspase-3 cell count was significantly lower in group IPoC after reperfusion compared to the control group. After reperfusion, the tissue myeloperoxidase activity and the calprotectin positive cell counts in the mucosa were increased in both groups, and only group IPoC showed a significant increase in the serosa. Tissue malondialdehyde and superoxide dismutase as well as blood lactate levels showed significant progression during ischaemia or reperfusion. The nuclear immunoreactivity of Heat shock protein-70 increased significantly during reperfusion. None of these variables differed between the groups. The neuronal cell counts in the myenteric plexus ganglia were not affected by the ischaemia model.

Conclusions

A reduced apoptotic cell count was found in the group subjected to IPoC. None of the other tested variables were significantly affected by IPoC. Therefore, the clinical relevance and possible protective mechanism of IPoC in equine intestinal ischaemia remains unclear. Further research on the mechanism of action and its effect in clinical cases of strangulating colic is needed.
Association of plasma mitochondrial DNA with COPD severity and progression in the SPIROMICS cohort
Authors: Zhang William Z. , Hoffman Katherine L. , Schiffer Kristen T. , Oromendia Clara , Rice Michelle C. , Barjaktarevic Igor , Peters Stephen P. , Putcha Nirupama , Bowler Russell P. , Wells J. Michael , Couper David J. , Labaki Wassim W. , Curtis Jeffrey L. , Han Meilan K. , Paine Robert , Woodruff Prescott G. , Criner Gerard J. , Hansel Nadia N. , Diaz Ivan , Ballman Karla V. , Nakahira Kiichi , Choi Mary E. , Martinez Fernando J. , Choi Augustine M. K. , Cloonan Suzanne M.
Published: April 2021

Background

There is a lack of mechanism-driven, clinically relevant biomarkers in chronic obstructive pulmonary disease (COPD). Mitochondrial dysfunction, a proposed disease mechanism in COPD, is associated with the release of mitochondrial DNA (mtDNA), but plasma cell-free mtDNA has not been previously examined prospectively for associations with clinical COPD measures.

Methods

P-mtDNA, defined as copy number of mitochondrially-encoded NADH dehydrogenase-1 (MT-ND1) gene, was measured by real-time quantitative PCR in 700 plasma samples from participants enrolled in the Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) cohort. Associations between p-mtDNA and clinical disease parameters were examined, adjusting for age, sex, smoking status, and for informative loss to follow-up.

Results

P-mtDNA levels were higher in participants with mild or moderate COPD, compared to smokers without airflow obstruction, and to participants with severe COPD. Baseline increased p-mtDNA levels were associated with better CAT scores in female smokers without airflow obstruction and female participants with mild or moderate COPD on 1-year follow-up, but worse 6MWD in females with severe COPD. Higher p-mtDNA levels were associated with better 6MWD in male participants with severe COPD. These associations were no longer significant after adjusting for informative loss to follow-up.

Conclusion

In this study, p-mtDNA levels associated with baseline COPD status but not future changes in clinical COPD measures after accounting for informative loss to follow-up. To better characterize mitochondrial dysfunction as a potential COPD endotype, these results should be confirmed and validated in future studies.

Trial Registration: ClinicalTrials.gov NCT01969344 (SPIROMICS)
Single-cell characterization of a model of poly I:C-stimulated peripheral blood mononuclear cells in severe asthma
Authors: Chen Ailu , Diaz-Soto Maria P. , Sanmamed Miguel F. , Adams Taylor , Schupp Jonas C. , Gupta Amolika , Britto Clemente , Sauler Maor , Yan Xiting , Liu Qing , Nino Gustavo , Cruz Charles S. Dela , Chupp Geoffrey L. , Gomez Jose L.
Published: April 2021

Background

Asthma has been associated with impaired interferon response. Multiple cell types have been implicated in such response impairment and may be responsible for asthma immunopathology. However, existing models to study the immune response in asthma are limited by bulk profiling of cells. Our objective was to Characterize a model of peripheral blood mononuclear cells (PBMCs) of patients with severe asthma (SA) and its response to the TLR3 agonist Poly I:C using two single-cell methods.

Methods

Two complementary single-cell methods, DropSeq for single-cell RNA sequencing (scRNA-Seq) and mass cytometry (CyTOF), were used to profile PBMCs of SA patients and healthy controls (HC). Poly I:C-stimulated and unstimulated cells were analyzed in this study.

Results

PBMCs (n = 9414) from five SA (n = 6099) and three HC (n = 3315) were profiled using scRNA-Seq. Six main cell subsets, namely CD4 + T cells, CD8 + T cells, natural killer (NK) cells, B cells, dendritic cells (DCs), and monocytes, were identified. CD4 + T cells were the main cell type in SA and demonstrated a pro-inflammatory profile characterized by increased JAK1 expression. Following Poly I:C stimulation, PBMCs from SA had a robust induction of interferon pathways compared with HC. CyTOF profiling of Poly I:C stimulated and unstimulated PBMCs (n = 160,000) from the same individuals (SA = 5; HC = 3) demonstrated higher CD8 + and CD8 + effector T cells in SA at baseline, followed by a decrease of CD8 + effector T cells after poly I:C stimulation.

Conclusions

Single-cell profiling of an in vitro model using PBMCs in patients with SA identified activation of pro-inflammatory pathways at baseline and strong response to Poly I:C, as well as quantitative changes in CD8 + effector cells. Thus, transcriptomic and cell quantitative changes are associated with immune cell heterogeneity in this model to evaluate interferon responses in severe asthma.
Current and future treatment strategies in chronic lymphocytic leukemia
Authors: Patel Krish , Pagel John M.
Published: April 2021

Treatment decisions for patients with chronic lymphocytic leukemia (CLL) are dependent on symptoms and classification into high-, medium-, or low-risk categories. The prognosis for CLL hinges, in part, on the presence or absence of less-favorable genetic aberrations, including del(17p), del(11q), TP53 dysfunction, and IGHV mutations, as these markers are associated with worse treatment response. Promising results from multiple clinical trials show emerging therapies targeting Burton tyrosine kinase, B-cell leukemia/lymphoma 2, and phosphatidylinositol 4,5-bisphosphate 3-kinase catalytic subunit delta result in better outcomes and prolonged progression-free survival for patients both with and without certain high-risk aberrations. Favorable outcomes using these novel oral targeted therapies, either alone or in combination with other treatments such as anti-CD20 antibodies, has led to their use almost entirely supplanting chemoimmunotherapy in the treatment of CLL. In this narrative review, we summarize the current clinical evidence for the use of targeted mono- and combination therapies for CLL, discuss new and next-generation treatment approaches currently in development, and provide insight into areas of unmet need for the treatment of patients with CLL.