bluuebunny/crossref_metadata_2025 huggingface dataset:
Engineering better chimeric antigen receptor T cells
Authors: Zhang Hao , Zhao Pu , Huang He
Published: December 2020

CD19-targeted CAR T cells therapy has shown remarkable efficacy in treatment of B cell malignancies. However, relapse of primary disease remains a major obstacle after CAR T cells therapy, and the majority of relapses present a tumor phenotype with retention of target antigen (antigen-positive relapse), which highly correlate with poor CAR T cells persistence. Therefore, study on factors and mechanisms that limit the in vivo persistence of CAR T cells is crucial for developing strategies to overcome these limitations. In this review, we summarize the rapidly developing knowledge regarding the factors that influence CAR T cells in vivo persistence and the underlying mechanisms. The factors involve the CAR constructs (extracellular structures, transmembrane and intracellular signaling domains, as well as the accessory structures), activation signaling (CAR signaling and TCR engagement), methods for in vitro culture (T cells collection, purification, activation, gene transduction and cells expansion), epigenetic regulations, tumor environment, CD4/CD8 subsets, CAR T cells differentiation and exhaustion. Of note, among these influence factors, CAR T cells differentiation and exhaustion are identified as the central part due to the fact that almost all factors eventually alter the state of cells differentiation and exhaustion. Moreover, we review the potential coping strategies aiming at these limitations throughout this study.
Nebivolol combined with tetrahydrobiopterin affects diastolic function in spontaneously hypertensive rats via the nitric oxide/cyclic guanosine monophosphate signalling pathway
Authors: Guan Xiaoli , Guan Xiaoying , Lu Changhong , Shang Bo , Zhao Yuan , Meng Ying , Zhang Zhengyi
Published: December 2020

Background

Hypertension is the the primary cause of diastolic heart failure. Oxidative stress plays an important role in cardiac diastolic dysfunction caused by hypertension. The occurrence of oxidative stress is related to the level of nitric oxide (NO) in the body. Tetrahydrobiopterin (BH4) is an essential cofactor for NO synthesis. Nebivolol can reduce myocardial oxidative stress and increase NO activity. Therefore, we investigated the effects of monotherapy or combination therapy of different doses of BH4 and nebivolol on cardiac diastolic function in spontaneously hypertensive rats, and preliminarily expounded the related mechanisms.

Methods

Left ventricular function was evaluated by non-invasive echocardiographic assessment and invasive right carotid artery catheterization methods. ELISA was used to measure myocardial 3-nitrotyrosine content, NO production, and cyclic guanosine monophosphate (cGMP) concentration in the myocardium; quantitative real-time PCR (qRT-PCR) was used to determine endothelial nitric oxide synthase (eNOS), phospholamban and sarcoplasmic reticulum Ca2+-ATPase 2a (SERCA2a) mRNA expression levels; Western blot was used to detect the protein expression levels of eNOS and eNOS dimers in myocardial tissue, and immunohistochemical detection of cGMP expression in the myocardium was performed.

Results

Studies have shown that compared with those in the control group, NO generation and the expression level of myocardial eNOS mRNA, eNOS expression of dimers, phospholamban, SERCA2a and cGMP increased significantly after the combined intervention of BH4 and nebivolol, while the expression of 3-nitrotyrosine was significantly decreased.

Conclusions

The combined treatment group had a synergistic effect on reducing myocardial oxidative stress, increasing eNOS content, and increasing NO production, and had a more obvious protective effect on diastolic dysfunction through the nitric oxide/cyclic guanosine monophosphate (NO/cGMP) pathway.
A rare case of PSA-negative metastasized prostate cancer to the stomach with serum CEA and CA19-9 elevation: a case report
Authors: Shindo Koji , Ohuchida Kenoki , Moriyama Taiki , Kinoshita Fumio , Koga Yutaka , Oda Yoshinao , Eto Masatoshi , Nakamura Masafumi
Published: December 2020

Background

Metastatic cancer to the stomach is relatively rare. Prostate-specific antigen (PSA) is a reliable biomarker used in the screening and management of patients with prostate cancer. However, it is difficult to definitively diagnose a PSA-negative metastatic gastric tumor of prostate cancer because the cancer sometimes resembles primary gastric cancer in clinical images. It is also difficult to distinguish metastatic cancer from primary cancer even in the pathological examination of biopsy samples when the lesion is poorly differentiated adenocarcinoma. There is a possibility that the characteristics of the cancer are changed during treatment such as chemotherapy or radiation therapy. Therefore, careful consideration is required for surgical indication.

Case presentation

A 60-year-old male underwent radical prostatectomy and subsequent radiation therapy for advanced prostate cancer (pT3N1M0) 10 years previously, and hormone therapy was started for metachronous multiple bone metastasis 10 months before. Upper gastrointestinal endoscopy revealed an irregular depressed lesion with a convergence of folds at the greater curvature of the upper gastric body. Biopsy showed poorly differentiated adenocarcinoma that was negative for PSA upon immunohistochemistry. He had high serum carcinoembryonic antigen (CEA) (946.1 ng/ml) and carbohydrate antigen 19-9 (CA19-9) (465.1 U/ml) levels with no elevation of PSA (0.152 ng/ml). The tumor was diagnosed as primary gastric cancer based on the clinical imaging and pathological examination of the biopsy sample including the PSA staining. Based on the diagnosis, laparoscopic proximal gastrectomy with lymphadenectomy was performed. However, pathological examination of the resected specimen revealed poorly differentiated adenocarcinoma that was positive for other prostate markers such as androgen receptor. Thus, the patient was diagnosed with metastasized prostate cancer to the stomach.

Conclusions

We report a case of metastatic gastric cancer of prostate cancer 10 years after radical prostatectomy. In the present case, it was difficult to diagnose a metastatic gastric tumor of prostate cancer preoperatively, because of its resemblance to primary gastric cancer without PSA expression and no serum PSA elevation. Although a rare case entity, it is important to consider the possibility of a metastatic gastric tumor when the surgical indication is determined in cases with another co-existing cancer.
The prevalence of iron deficiency and anemia and their impact on survival in patients at a cardio-oncology clinic
Authors: Čiburienė E. , Čelutkienė J. , Aidietienė S. , Ščerbickaitė G. , Lyon A. R.
Published: December 2020

Background

Iron deficiency (ID) and anemia are common in both heart failure (HF) and cancer patients and are associated with poor quality of life and survival. The aims of this study were (1) to evaluate the prevalence, types, and confounding factors of ID and anemia in patients referred to cardio-oncology clinic, and (2) identify the association between iron metabolism parameters and survival of cardio-oncology patients.

Methods

We assessed iron, ferritin, hemoglobin concentrations, transferrin saturation (TSAT), cancer type, brain natriuretic peptide (BNP), left ventricular ejection fraction (LVEF), kidney function, cardiovascular risk factors and survival in 599 patients who were referred to cardio-oncology clinic from 2011 to 2017.

ID was defined by a TSAT < 20%, absolute iron deficiency (AID) with a serum ferritin level < 100 μg/L while serum ferritin level of ≥ 100 μg/L was considered as functional iron deficiency (FID) and TSAT ≥ 20% was considered as no ID.

Results

The prevalence of ID, AID, and FID was 46, 31, and 15% of study patients, respectively. Anemia was present in approximately half (54%) of the patients with any ID.

Multivariate Cox analyses showed that male gender (HR 1.704 [1.207–2.404] p = 0.002); previous cancer history (HR 1.879 [1.079–3.272] p = 0.026); elevated BNP (HR 2.126 [1.258–3.590] p = 0.005); TSAT< 20% (HR 1.721 [1.214–2.439] p = 0.002); ferritin ≥ 100 μg/L (HR 2.008 [1.088–3.706] p = 0.026); serum iron concentration < 12 μmol/L (HR 2.292 [1.614–3.255] p < 0.001); FID (HR 2.538 [1.1618–3.981] p < 0.001) and anemia (HR 2.462 [1.734–3.495] p < 0.001) were significantly associated with increased risk of all-cause death.

Conclusions

About half of cardio-oncology patients had anemia and iron deficiency, with the absolute type being twice as prevalent as the functional one. Patients with breast, gastrointestinal, and genitourinary cancer were affected more often. Both anemia and iron deficiency independently predicted all-cause mortality. Future studies are required to confirm ID as a risk factor and evaluate the clinical benefits of iron replacement therapy.
A prospective observational study on acute exacerbation of chronic obstructive pulmonary disease in pulmonology department of tertiary care hospital
Authors: Thalla Sreenu , Yerubandi Akhila , Hafeezunnisa Sk. , Jareena Sk. , Makkapati Sivakshari
Published: December 2020

Background

Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities usually caused by significant exposure to noxious particles or gasses. An acute exacerbation of COPD refers to a flare up or episode where a person breathing becomes worse than normal. An acute exacerbation of COPD refers to a flare up or episode where a person breathing becomes worse than normal. Acute exacerbation in COPD (AECOPD) is frequent in the course of the illness and is the most common reason for medical visits, hospital admissions, and mortality among these patients. Exacerbations of COPD are associated with increased morbidity and mortality. To assess the exposure and severity of acute exacerbations of COPD with COPD Assessment Test (CAT Scale) and mMRC (modified Medical Research Council) Dyspnea scale. Study design was a hospital-based prospective observational study. Study site was conducted at Pulmonology Department of Government General Hospital, Vijayawada.

Results

The total patients were 197. Out of which, 119 were from In-patient Department (IPD) and 78 were from Out-patient Department (OPD). In this study, males were 167 (85%), among which, IPD were 97 (49%), OPD were 70 (36%), and females were 30 (15%), among which, IPD were 22 (11%), OPD were 8 (4%).

Conclusion

The morbidity and mortality of COPD have been increased in recent years. This study concludes that there is a relation between risk of acute exacerbations in COPD with habitual history and occupational history. Increase in exposure to occupational hazards, smoking habit leads to an increase in risk of acute exacerbations in COPD patients. The level of severity was more in smokers and the patients who had biomass, organic dust, and mineral exposure. When severity was observed, group D severity is more observed in population according to CAT scale and mMRC dyspnea scale.
School bullying and minority identity as a menace to mental well-being of students in Greece
Authors: Gkouliama Alexandra , Samakouri Maria , Serdari Aspasia
Published: December 2020

Increasing migration and the resultant multiculturalism in Greek society has highlighted the importance of studying the role of school ethnic composition in bullying and peer victimisation, not least because ethnic minority students involved in bullying behaviours seem to experience high levels of internalising and externalising problems. It is imperative that schools work towards ensuring a safe environment for all students. This can be achieved through the implementation of policies that facilitate positive social interactions and address issues of bias-based bullying, thus contributing to social justice. This article examines school bullying and related policies in Greece in the context of increasing diversity and reviews their evolution in the past decade.
Accuracy of individual and combined risk-scale items in the prediction of repetition of self-harm: multicentre prospective cohort study
Authors: Taylor Anna Kathryn , Steeg Sarah , Quinlivan Leah , Gunnell David , Hawton Keith , Kapur Nav
Published: December 2020

Background

Individuals attending emergency departments following self-harm have increased risks of future self-harm. Despite the common use of risk scales in self-harm assessment, there is growing evidence that combinations of risk factors do not accurately identify those at greatest risk of further self-harm and suicide.

Aims

To evaluate and compare predictive accuracy in prediction of repeat self-harm from clinician and patient ratings of risk, individual risk-scale items and a scale constructed with top-performing items.

Method

We conducted secondary analysis of data from a five-hospital multicentre prospective cohort study of participants referred to psychiatric liaison services following self-harm. We tested predictive utility of items from five risk scales: Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS, Modified SAD PERSONS, Barratt Impulsiveness Scale and clinician and patient risk estimates. Area under the curve (AUC), sensitivity, specificity, predictive values and likelihood ratios were used to evaluate predictive accuracy, with sensitivity analyses using classification-tree regression.

Results

A total of 483 self-harm episodes were included, and 145 (30%) were followed by a repeat presentation within 6 months. AUC of individual items ranged from 0.43–0.65. Combining best performing items resulted in an AUC of 0.56. Some individual items outperformed the scale they originated from; no items were superior to clinician or patient risk estimations.

Conclusions

No individual or combination of items outperformed patients’ or clinicians’ ratings. This suggests there are limitations to combining risk factors to predict risk of self-harm repetition. Risk scales should have little role in the management of people who have self-harmed.
Course and outcome of patients with alcohol use disorders following an alcohol intervention during hospital attendance: mixed method study
Authors: Chambers Sophia E. , Baldwin David S. , Sinclair Julia M. A.
Published: December 2020

Background

Alcohol-related presentations to acute hospitals in the UK are increasing, but little is known of the clinical characteristics or natural history of this patient group.

Aims

To describe the clinical characteristics, drinking profile and trajectory of a cohort of patients with alcohol use disorder (AUD) attending hospital, and explore participant perspectives of the impact of hospital attendance on their relationship with alcohol.

Method

We conducted a mixed method, prospective, observational cohort study of patients with AUD seen in an acute hospital. Participants were interviewed with a range of questionnaires at baseline and followed up on at 6 months. A subsample also completed in-depth qualitative interviews.

Results

We recruited 141 patients; 132 (93.6%) were followed up at 6 months and 26 completed qualitative interviews. Of the 141 patients, 60 (42.6%) stated the index hospital episode included the first discussion of their alcohol use in a secondary care setting. Most rated discussion of their alcohol use in hospital as ‘very positive’ or ‘positive’ (102/141, 72.3%), but lack of coordinated care with community services undermined efforts to sustain change. At 6 months, 11 (7.8%) patients had died, but in those who survived and completed assessment (n = 121), significant and clinically meaningful improvements were seen across a range of outcomes, with 55 patients (45.5%) showing a favourable drinking outcome at 6 months.

Conclusions

Patients with AUD have high levels of morbidity and mortality, yet many made substantial changes following intervention in hospital for their alcohol use. Prospective trials need to identify the effect of alcohol care teams in optimising this ‘teachable moment’ for patients.
The neurodevelopmental nature of attention-deficit hyperactivity disorder in adults
Authors: Breda Vitor , Rohde Luis Augusto , Menezes Ana Maria Baptista , Anselmi Luciana , Caye Arthur , Rovaris Diego Luiz , Vitola Eduardo Schneider , Bau Claiton Henrique Dotto , Grevet Eugenio Horacio
Published: December 2020

Background

Population studies have suggested that most adults with attention-deficit hyperactivity disorder (ADHD) did not have the disorder in childhood, challenging the neurodevelopmental conceptualisation of ADHD. Arbitrary definitions of age at onset and lack of defined trajectories were accounted for the findings.

Aims

The objective of this study was to assess the proportion of individuals presenting with either a neurodevelopmental trajectory or late-onset disorder, and to assess risk factors associated with them.

Method

Data of 4676 individuals from the 1993 Pelotas birth cohort at 11, 15, 18 and 22 years of age were used. Polythetic and latent class mixed model analyses were performed to define ADHD trajectories from childhood to adulthood, and characterise the neurodevelopmental or late-onset courses. Regression models were applied to assess factors associated with different trajectories.

Results

Classical polythetic analyses showed that 67% of those with ADHD at 22 years of age had a neurodevelopmental course of the disorder. Latent class mixed model analysis indicated that 78% of adults with ADHD had a trajectory of persistent symptoms, more common in males. The remaining adults with ADHD had an ascending symptom trajectory that occurred after puberty, with late-onset ADHD associated with female gender and higher IQ.

Conclusions

Both polythetic and latent trajectories analyses provided empirical evidence supporting that the large majority of adults with ADHD had a neurodevelopmental disorder.
Drosophila MICOS knockdown impairs mitochondrial structure and function and promotes mitophagy in muscle tissue
Authors: Wang Li-jie , Hsu Tian , Lin Hsiang-ling , Fu Chi-yu
Published: December 2020

The mitochondrial contact site and cristae organizing system (MICOS) is a multi-protein interaction hub that helps define mitochondrial ultrastructure. While the functional importance of MICOS is mostly characterized in yeast and mammalian cells in culture, the contributions of MICOS to tissue homeostasis in vivo remain further elucidation. In this study, we examined how knocking down expression of Drosophila MICOS genes affects mitochondrial function and muscle tissue homeostasis. We found that CG5903/MIC26-MIC27 colocalizes and functions with Mitofilin/MIC60 and QIL1/MIC13 as a Drosophila MICOS component; knocking down expression of any of these three genes predictably altered mitochondrial morphology, causing loss of cristae junctions, and disruption of cristae packing. Furthermore, the knockdown flies exhibited low mitochondrial membrane potential, fusion/fission imbalances, increased mitophagy, and limited cell death. Reductions in climbing ability indicated deficits in muscle function. Knocking down MICOS genes also caused reduced mtDNA content and fragmented mitochondrial nucleoid structure in Drosophila. Together, our data demonstrate an essential role of Drosophila MICOS in maintaining proper homeostasis of mitochondrial structure and function to promote the function of muscle tissue.
Chorismate synthase mediates cerebral malaria pathogenesis by eliciting salicylic acid-dependent autophagy response in parasite
Authors: Chakrabarti Malabika , Kannan Deepika , Munjal Akshay , Choudhary Hadi Hasan , Mishra Satish , Singh Subhash , Singh Shailja
Published: December 2020

Cerebral malaria caused by Plasmodium falciparum is the severest form of the disease resulting in the morbidity of a huge number of people worldwide. Development of effective curatives is essential in order to overcome the fatality of cerebral malaria. Earlier studies have shown the presence of salicylic acid (SA) in malaria parasite P. falciparum, which plays a critical role in the manifestation of cerebral malaria. Further, the application of SA for the treatment of acute symptoms in cerebral malaria increases the activity of iNOS leading to severe inflammation-mediated death, also called as Reye's syndrome. Therefore, modulation of the level of SA might be a novel approach to neutralize the symptoms of cerebral malaria. The probable source of parasite SA is the shikimate pathway, which produces chorismate, a precursor to aromatic amino acids and other secondary metabolites like SA in the parasite. In this work, we performed the immunological, pathological and biochemical studies in mice infected with chorismate synthase knocked-out Plasmodium berghei ANKA, which does not produce SA. Fewer cerebral outcomes were observed as compared to the mice infected with wild-type parasite. The possible mechanism behind this protective effect might be the hindrance of SA-mediated induction of autophagy in the parasite, which helps in its survival in the stressed condition of brain microvasculature during cerebral malaria. The absence of SA leading to reduced parasite load along with the reduced pathological symptoms contributes to less fatality outcome by cerebral malaria.
Amphiphilic Immobilized Diphenylprolinol Alkyl Ether Catalyst on PS-PEG Resin
Authors: Koshino Seitaro , Hattori Shusuke , Hasegawa Shota , Haraguchi Naoki , Yamamoto Takeshi , Suginome Michinori , Uozumi Yasuhiro , Hayashi Yujiro
Published: December 2020

Diphenylprolinol silyl ether is a widely used organocatalyst, and its immobilization on a solid support was investigated for the easy recycling and reuse of this catalyst. Because a silyl ether bond of the catalyst is weak, its alkyl ether was attached to polymers such as a polyquinoxaline-based polymer, a polystyrene polymer (PS) resin, and a polystyrene–poly(ethylene glycol) graft copolymer (PS-PEG) resin. Although a polymer-supported organocatalyst generally decreases its reactivity compared with the monomer catalyst, diphenylprolinol anthrylmethyl ether supported on PS-PEG was found to be a reactive organocatalyst; it catalyzed the Michael reaction of an aldehyde and a nitroalkene in water without an organic solvent being present, with excellent diastereo- and enantioselectivities.
Χαρακτηριστικά Προγραμμάτων Περιβαλλοντικής Εκπαίδευσης στην Πρωτοβάθμια Εκπαίδευση: Η εμπειρία 7 ετών σε πανελλαδική κλίμακα
Authors: Μαλανδράκης Γεώργιος , Δημητρίου Αναστασία , Γεωργόπουλος Αλέξανδρος
Published: December 2020

Σκοπός της παρούσας έρευνας είναι να διερευνήσει τη διάχυση και το εύρος εφαρμογής της Περιβαλλοντικής Εκπαίδευσης (ΠΕ) στην πρωτοβάθμια εκπαίδευση μέσα από την εφαρμογή αντίστοιχων προγραμμάτων, καθώς και τα βασικά χαρακτηριστικά των προγραμμάτων αυτών. Η έρευνα διεξήχθη σε πανελλαδική κλίμακα και καλύπτει την επταετία από το σχολικό έτος 2006-2007 έως και το 2013-2014, εκτός από το 2008-2009 για το οποίο δεν υπάρχουν δεδομένα. Ως κύρια πηγή δεδομένων χρησιμοποιήθηκαν τα ετήσια απογραφικά δελτία των Υπευθύνων ΠΕ κάθε Διεύθυνσης Πρωτοβάθμιας Εκπαίδευσης προς το ΥΠΕΠΘ. Συνολικά, με την βοήθεια του λογισμικού Excel, αναλύθηκαν 231 απογραφικά δελτία από τις 58 Διευθύνσεις Εκπαίδευσης της χώρας, τα οποία αντιστοιχούν σε 14 Περιφέρειες Εκπαίδευσης και σε περίπου 18.000 σχολικά προγράμματα σε βάθος επταετίας. Λόγω του πολύ μεγάλου όγκου των δεδομένων, το επίπεδο αναφοράς είναι η Περιφερειακή Διεύθυνση. Το μέσο ποσοστό πληρότητας των δεδομένων ήταν 57% ως προς τις Διευθύνσεις Πρωτοβάθμιας, το οποίο κατά μέσο όρο αντιστοιχεί σε δεδομένα από 33 από τις 58 Διευθύνσεις ανά έτος μελέτης. Από την ανάλυση των δεδομένων προέκυψε ότι υπάρχουν σοβαρές ελλείψεις στην συλλογή αξιόπιστων στατιστικών δεδομένων τόσο από τις Διευθύνσεις Πρωτοβάθμιας όσο και από το Υπουργείο. Το μέσο ποσοστό συμμετοχής μαθητών1, στην υπό μελέτη επταετία, σε προγράμματα ΠΕ ήταν 16%, ενώ μόνο το 7% των εκπαιδευτικών Πρωτοβάθμιας φαίνεται να εμπλέκεται σε τέτοιου είδους δραστηριότητες, με το μέσο χρόνο διάρκειας των προγραμμάτων να είναι πέντε μήνες. Ωστόσο, παρά τα αρχικά μικρά ποσοστά συμμετοχής μαθητών και εκπαιδευτικών σε προγράμματα ΠΕ, τα τελευταία χρόνια υπάρχει μια ισχυρή ανοδική τάση, η οποία όμως θα πρέπει να συνεχιστεί αλλά και να εμπλουτιστεί ποιοτικά προκειμένου να υπάρξει ουσιαστική βελτίωση.
Contextualising COVID-19 as a Digital Pandemic
Authors: Tsekeris Charalambos , Mastrogeorgiou Yannis
Published: December 2020

Growing systemic complexity and interdependence have made a large variety of systems (economic, public health, cyber, etc.) susceptible to irreversible and cascading failure. The coronavirus (COVID-19) pandemic is indicative of such complexity and currently causing vast human suffering all around the world, but also triggers a global online revolution with new opportunities, risks, threats and dangers. Starting from its description as the world's first digital pandemic, the central aim of this editorial is to contextualise Homo Virtualis's special issue on the COVID-19 disruption to the digital landscape and its societal impact. A concise overview of such disruption is presented and a few examples are given, along with a variety of interdisciplinary perspectives on mediatisation and globalisation, with special emphasis on Globalisation 4.0 and the transition to Artificial Intelligence Society.
Costs and Reimbursements for Mental Health Hospitalizations at Children's Hospitals
Authors: Herndon Alison C , Williams Derek , Hall Matt , Gay James C , Browning Whitney , Kreth Heather , Plemmons Greg , Morgan Kate , Neeley Maya , Ngo My‐Linh , Clewner‐Newman Lisa , Dalton Evan , Griffith Hannah , Crook Travis , Doupnik Stephanie K
Published: December 2020

The financial impact of the rising number of pediatric mental health hospitalizations is unknown. Therefore, this study assessed costs, reimbursements, and net profits or losses for 111,705 mental health and non–mental health medical hospitalizations in children's hospitals with use of the Pediatric Health Information System and Revenue Management Program. Average financial margins were calculated as (reimbursement per day) – (cost per day), and they were lowest for mental health hospitalizations ($136/day), next lowest for suicide attempt ($518/day), and highest for other medical hospitalizations ($611/day). For 10 of 17 hospitals, margin per day for mental health hospitalizations was lower than margin per day for other medical hospitalizations. For these 10 hospitals, the total net loss for inpatient and observation status mental health hospitalizations, compared with other medical hospitalizations, was $27 million (median, $2.2 million per hospital). Financial margins were usually lower for mental health vs non–mental health medical hospitalizations.
The social work Reconceptualisation Movement in Latin America and the renewal in Brazil: the protagonist role of the Latin American Social Work Centre
Authors: Raichelis Raquel , Bravo Maria Inês
Published: December 2020

This article is part of the research ‘The Social Work Reconceptualization Movement in Latin America: Historical Determinants, International Interlocutions and Memory’. It portrays the 1960s’ socio-political framework in Latin America, as well as the cultural, ideo-political and socio-economic processes that have deeply affected global societies. In this context, it situates the contribution of the Latin American Social Work Centre to the Reconceptualisation Movement of social work in Latin America, when breaking with traditional social work, and the so-called ‘turnaround’ of Brazilian social work, responsible for profound transformations in academic and professional development and education, professional activity, and organisation, through the political articulation of several professional entities.
The Fine Line Between Informing and Coercing: Community Health Center Clinicians’ Approaches to Counseling Young People About IUDs
Authors: Biggs M. Antonia , Tome Lucia , Mays Aisha , Kaller Shelly , Harper Cynthia C. , Freedman Lori
Published: December 2020

CONTEXT

While community health centers (CHCs) are meeting increased demand for contraceptives, little is known about contraceptive counseling in these settings. Understanding how clinicians counsel about IUDs in CHCs, including whether they address or disregard young people's preferences and concerns during counseling, could improve contraceptive care.

METHODS

As part of a training program, 20 clinicians from 11 San Francisco Bay Area CHC sites who counsel young people about contraception were interviewed by telephone in 2015 regarding their IUD counseling approaches. An iterative grounded theory approach was used to analyze interview transcripts and identify salient themes related to clinicians’ contraceptive counseling, IUD removal practices and efforts to address patient concerns regarding side effects.

RESULTS

Most clinicians offered comprehensive contraceptive counseling and method choice. While several clinicians viewed counseling as an opportunity to empower their patients to make contraceptive decisions without pressure, they also described a tension between guiding young people toward higher‐efficacy methods and respecting patients’ choices. Many clinicians engaged in what could be considered coercive practices by trying to dissuade patients from removals within a year of placement and offering to treat or downplay side effects.

CONCLUSIONS

Providers try to promote their young patients’ autonomous decision making, but their support for high‐efficacy methods can result in coercive practices. More training is needed to ensure that providers employ patient‐centered counseling approaches, including honoring patient requests for removals.
Modeling and system identification of transient STOP models of optical systems
Authors: Haber Aleksandar , Draganov John E. , Heesh Kevin , Tesch Jonathan , Krainak Michael
Published: December 2020

Structural, Thermal, and Optical Performance (STOP) analysis is important for understanding the dynamics and for predicting the performance of a large number of optical systems whose proper functioning is negatively influenced by thermally induced aberrations. Furthermore, STOP models are being used to design and test passive and active methods for the compensation of thermally induced aberrations. However, in many cases and scenarios, the lack of precise knowledge of system parameters and equations governing the dynamics of thermally induced aberrations can significantly deteriorate the prediction accuracy of STOP models. In such cases, STOP models and underlying parameters need to be estimated from the data. To the best of our knowledge, the problem of estimating transient state-space STOP models from the experimental data has not received significant attention. Similarly, little attention has been dedicated to the related problem of obtaining low-dimensional state-space models of thermally induced aberrations that can be used for the design of high-performance model-based control and estimation algorithms. Motivated by this, in this manuscript, we present a numerical proof of principle for estimating low-dimensional state-space models of thermally induced aberrations and for characterizing the transient dynamics. Our approach is based on the COMSOL Multiphysics simulation framework for generating the test data and on a system identification approach. We numerically test our method on a lens system with a temperature-dependent refractive index that is used in high-power laser systems. The dynamics of such a system is complex and described by the coupling of thermal, structural, and ray-tracing models. The approach proposed in this paper can be generalized to other types of optical systems.
Quantitative lipidomic analysis of Ascaris suum
Authors: Wang Tao , Nie Shuai , Ma Guangxu , Vlaminck Johnny , Geldhof Peter , Williamson Nicholas A. , Reid Gavin E. , Gasser Robin B.
Published: December 2020

Ascaris is a soil-transmitted nematode that causes ascariasis, a neglected tropical disease affecting predominantly children and adolescents in the tropics and subtropics. Approximately 0.8 billion people are affected worldwide, equating to 0.86 million disability-adjusted life-years (DALYs). Exploring the molecular biology of Ascaris is important to gain a better understanding of the host-parasite interactions and disease processes, and supports the development of novel interventions. Although advances have been made in the genomics, transcriptomics and proteomics of Ascaris, its lipidome has received very limited attention. Lipidomics is an important sub-discipline of systems biology, focused on exploring lipids profiles in tissues and cells, and elucidating their biological and metabolic roles. Here, we characterised the lipidomes of key developmental stages and organ systems of Ascaris of porcine origin via high throughput LC-MS/MS. In total, > 500 lipid species belonging to 18 lipid classes within three lipid categories were identified and quantified–in precise molar amounts in relation to the dry weight of worm material–in different developmental stages/sexes and organ systems. The results showed substantial differences in the composition and abundance of lipids with key roles in cellular processes and functions (e.g. energy storage regulation and membrane structure) among distinct stages and among organ systems, likely reflecting differing demands for lipids, depending on stage of growth and development as well as the need to adapt to constantly changing environments within and outside of the host animal. This work provides the first step toward understanding the biology of lipids in Ascaris, with possibilities to work toward designing new interventions against ascariasis.
The recurring impact of storm disturbance on black sea bass (Centropristis striata) movement behaviors in the Mid-Atlantic Bight
Authors: Wiernicki Caroline J. , O’Brien Michael H. P. , Zhang Fan , Lyubchich Vyacheslav , Li Ming , Secor David H.
Published: December 2020

Storm events are a significant source of disturbance in the Middle Atlantic Bight, in the Northwest Atlantic, that cause rapid destratification of the water column during the late summer and early fall. Storm-driven mixing can be considered as a seasonal disturbance regime to demersal communities, characterized by the recurrence of large changes in bottom water temperatures. Black sea bass are a model ubiquitous demersal species in the Middle Atlantic Bight, as their predominantly sedentary behavior makes them ideal for tagging studies while also regularly exposing them to summer storm disturbances and the physiological stresses associated with thermal destratification. To better understand the responsiveness of black sea bass to storm impacts, we coupled biotelemetry with a high-resolution Finite Volume Community Ocean Model (FVCOM). During the summers of 2016–2018, 8–15 black sea bass were released each year with acoustic transponders at three reef sites, which were surrounded by data-logging receivers. Data were analyzed for activity levels and reef departures of black sea bass, and fluctuations in temperature, current velocity, and turbulent kinetic energy. Movement rates were depressed with each consecutive passing storm, and late-season storms were associated with permanent evacuations by a subset of tagged fish. Serial increases in bottom temperature associated with repeated storm events were identified as the primary depressor of local movement. Storm-driven increases in turbulent kinetic energy and current velocity had comparatively smaller, albeit significant, effects. Black sea bass represents both an important fishery resource and an indicator species for the impact of offshore wind development in the United States. Their availability to fisheries surveys and sensitivity to wind turbine impacts will be biased during periods of high storm activity, which is likely to increase with regional climate change.
Genetic interactions among ADAMTS metalloproteases and basement membrane molecules in cell migration in Caenorhabditis elegans
Authors: Imanishi Ayaka , Aoki Yuma , Kakehi Masaki , Mori Shunsuke , Takano Tomomi , Kubota Yukihiko , Kim Hon-Song , Shibata Yukimasa , Nishiwaki Kiyoji
Published: December 2020

During development of theCaenorhabditis elegansgonad, the gonadal leader cells, called distal tip cells (DTCs), migrate in a U-shaped pattern to form the U-shaped gonad arms. The ADAMTS (adisintegrinandmetalloprotease withthrombospondin motifs) family metalloproteases MIG-17 and GON-1 are required for correct DTC migration. Mutations inmig-17result in misshapen gonads due to the misdirected DTC migration, and mutations ingon-1result in shortened and swollen gonads due to the premature termination of DTC migration. Although the phenotypes shown bymig-17andgon-1mutants are very different from one another, mutations that result in amino acid substitutions in the same basement membrane protein genes,emb-9/collagen IV a1,let-2/collagen IV a2andfbl-1/fibulin-1, were identified as genetic suppressors ofmig-17andgon-1mutants. To understand the roles shared by these two proteases, we examined the effects of themig-17suppressors ongon-1and the effects of thegon-1suppressors and enhancers onmig-17gonadal defects. Some of theemb-9,let-2andfbl-1mutations suppressed bothmig-17andgon-1, whereas others acted only onmig-17orgon-1. These results suggest thatmig-17andgon-1have their specific functions as well as functions commonly shared between them for gonad formation. The levels of collagen IV accumulation in the DTC basement membrane were significantly higher in thegon-1mutants as compared with wild type and were reduced to the wild-type levels when combined with suppressor mutations, but not with enhancer mutations, suggesting that the ability to reduce collagen IV levels is important forgon-1suppression.
Compositional and provenance study of glass beads from archaeological sites in Mali and Senegal at the time of the first Sahelian states
Authors: Truffa Giachet Miriam , Gratuze Bernard , Mayor Anne , Huysecom Eric
Published: December 2020

The presence of glass beads in West African archaeological sites provides important evidence of long-distance trade between this part of the continent and the rest of the world. Until recently, most of these items came from historical Sub-Saharan urban centers, well known for their role in the medieval trans-Saharan trade. We present here the chemical analysis by Laser Ablation-Inductively Coupled Plasma-Mass Spectrometry (LA-ICP-MS) of 16 glass beads found in three rural sites excavated during the past decade: the funerary site of Dourou-Boro and settlement sites of Sadia, in central Mali, as well as the settlement site of Djoutoubaya, in eastern Senegal, in contexts dated between the 7th-9thand the 11th-13thcenturies CE. Results show that the raw materials used to manufacture the majority of the glass most probably originated in Egypt, the Levantine coast and the Middle East. One bead is of uncertain provenance and shows similarities with glass found in the Iberian Peninsula and in South Africa. One bead fragment found inside a tomb is a modern production, probably linked to recent plundering. All of these ancient beads were exchanged along the trans-Saharan trade routes active during the rise of the first Sahelian states, such as the Ghana and the Gao kingdoms, and show strong similarities with the other West African bead assemblages that have been analysed. Despite the remoteness of their location in the Dogon Country and in the Falémé River valley, the beads studied were therefore included in the long-distance trade network, via contacts with the urban commercial centers located at the edge of the Sahara along the Niger River and in current southern Mauretania. These results bring a new light on the relationships between international and regional trade in Africa and highlight the complementarity between centres of political and economic power and their peripheries, important because of resources like gold for eastern Senegal.
Voices of the vulnerable: Exploring the livelihood strategies, coping mechanisms and their impact on food insecurity, health and access to health care among Syrian refugees in the Beqaa region of Lebanon
Authors: Nabulsi Dana , Ismail Hussein , Abou Hassan Fida , Sacca Lea , Honein-AbouHaidar Gladys , Jomaa Lamis
Published: December 2020

Lebanon has approximately one million Syrian refugees (SR) registered with the United Nations High Commission on Refugees (UNHCR) and an unknown number of unregistered SR, who cannot benefit from formal assistance. This study aimed to examine the livelihoods, coping strategies, and access to healthcare among SR based on registration status and accompanying formal assistance. A mixed-method approach with more emphasis on the qualitative design was adopted. A purposive convenient sampling approach was used to recruit SR from informal tented settlements (ITS) in the Beqaa region in Lebanon. Data collection included 19 focus group discussions (FGDs) that were conducted with participants, who were further divided into three groups: registered refugees with assistance, registered without assistance and unregistered. Twelve in-depth interviews were conducted with key informants from humanitarian organizations. All interviews and FGDs were audio recorded, transcribed, and thematically analyzed. SR were highly dependent on formal assistance when received, albeit being insufficient. Regardless of registration status, refugees resorted to informal livelihood strategies, including informal employment, child labor, early marriage, and accruing debt. Poor living conditions and food insecurity were reported among all SR. Limited healthcare access and high out-of-pocket costs led to limited use of antenatal care services, prioritizing life-threatening conditions, and resorting to alternative sources of healthcare. Severity of these conditions and their adverse health consequences were especially pronounced among unregistered refugees. Our findings shed light on the economic and health disparities among marginalized SR, with the lack of registration and formal assistance increasing their vulnerability. More tailored and sustainable humanitarian programs are needed to target the most vulnerable and hard-to-reach groups.
Comparative transcriptome and metabolome analyses of two strawberry cultivars with different storability
Authors: Min Kyeonglim , Yi Gibum , Lee Jeong Gu , Kim Hyun Sook , Hong Yoonpyo , Choi Jeong Hee , Lim Sooyeon , Lee Eun Jin
Published: December 2020

Postharvest storability is an important trait for breeding strawberry (Fragaria × ananassa Duch.). We evaluated the postharvest fruit quality of five strawberry cultivars (‘Durihyang’, ‘Kingsberry’, ‘Maehyang’, ‘Seolhyang’, and ‘Sunnyberry’) and identified differences in their fruit ripening during the transition from the big-green to fully-red stage between two cultivars with the highest (‘Sunnyberry’) and lowest (‘Kingsberry’) storability, using comparative transcriptome and -metabolome analysis. The differentially expressed genes revealed transcriptome changes related to anthocyanin biosynthesis and cell walls. Consistently, the metabolites of both cultivars showed general changes during ripening along with cultivar-specific characteristics in sugar and amino acid profiles. To identify the genes responsible for storability differences, we surveyed the expression of transcription factors, and found that the expression levels of WRKY31, WRKY70, and NAC83 correlated with delayed senescence and increased storability. Among them, the expression levels of NAC83, and its downstream target genes, in the five cultivars suggested that NAC83 expression can be used to predict postharvest strawberry fruit storability.
Association between tobacco control policies and hospital admissions for acute myocardial infarction in Thailand, 2006-2017: A time series analysis
Authors: Patanavanich Roengrudee , Glantz Stanton A.
Published: December 2020

Introduction

Studies in many countries have documented reductions of acute myocardial infarction (AMI) hospitalizations with smokefree policies. However, evidence on the association of cigarette tax with AMI events is unclear. There have been no studies of the associations between these two policies and AMI hospitalizations in Thailand.

Methods

We used negative binomial time series analyses of AMI hospitalizations (ICD-10 codes I21.0-I21.9), stratified by sex and age groups, from October 2006 to September 2017 to determine whether there was a change in AMI hospitalizations as a result of the changes in cigarette prices and the implementation of a 100% smokefree law.

Results

Cigarette price increases were associated with a significant 4.7% drop in AMI hospitalizations among adults younger than 45 (incidence rate ratio [IRR], 0.953; 95% confidence interval [CI], 0.914–0.993; p = 0.021). Implementation of the 100% smokefree law was followed by a significant 13.1% drop in AMI hospitalizations among adults younger than 45 (IRR, 0.869; 95% CI, 0.801–0.993; P = 0.001). There were not significant associations in older age groups.

Conclusions

The Thai cigarette tax policy and the smokefree law were associated with reduced AMI hospitalizations among younger adults. To improve effectiveness of the policies, taxes should be high enough to increase cigarette price above inflation rates, making cigarettes less likely to be purchased; smokefree laws should be strictly enforced.
Heterogeneous expression of CFTR in insulin-secreting β-cells of the normal human islet
Authors: Di Fulvio Mauricio , Bogdani Marika , Velasco Myrian , McMillen Timothy S. , Ridaura Cecilia , Kelly Lisa , Almutairi Mohammed M. , Kursan Shams , Sajib Abu A. , Hiriart Marcia , Aguilar-Bryan Lydia
Published: December 2020

Cystic fibrosis (CF) is due to mutations in the CF-transmembrane conductance regulator (CFTR) and CF-related diabetes (CFRD) is its most common co-morbidity, affecting ~50% of all CF patients, significantly influencing pulmonary function and longevity. Yet, the complex pathogenesis of CFRD remains unclear. Two non-mutually exclusive underlying mechanisms have been proposed in CFRD: i) damage of the endocrine cells secondary to the severe exocrine pancreatic pathology and ii) intrinsic β-cell impairment of the secretory response in combination with other factors. The later has proven difficult to determine due to low expression of CFTR in β-cells, which results in the general perception that this Cl−channel does not participate in the modulation of insulin secretion or the development of CFRD. The objective of the present work is to demonstrate CFTR expression at the molecular and functional levels in insulin-secreting β-cells in normal human islets, where it seems to play a role. Towards this end, we have used immunofluorescence confocal and immunofluorescence microscopy, immunohistochemistry, RT-qPCR, Western blotting, pharmacology, electrophysiology and insulin secretory studies in normal human, rat and mouse islets. Our results demonstrate heterogeneous CFTR expression in human, mouse and rat β-cells and provide evidence that pharmacological inhibition of CFTR influences basal and stimulated insulin secretion in normal mouse islets but not in islets lacking this channel, despite being detected by electrophysiological means in ~30% of β-cells. Therefore, our results demonstrate a potential role for CFTR in the pancreatic β-cell secretory response suggesting that intrinsic β-cell dysfunction may also participate in the pathogenesis of CFRD.