bluuebunny/crossref_metadata_2025 huggingface dataset:
An action plan for the agri-food sector at the time of the climate and biodiversity crises
Authors: Cherubini Francesco , Hua Ting , Zhao Wenwu
Published: March 2023

Agriculture is responsible for about one third of global greenhouse gas emissions and it is the primary driver of habitat destruction. A paradigm shift embracing changes in lifestyles, agricultural practices, and policies is required to realize a sustainable transition in the agri-food sector.
Strongyloides stercoralisin the US Military Health System
Authors: Taheri Branson , Kuo Huai-Ching , Hockenbury Nicole , Lu Dan , Mitre Edward , Hickey Patrick W
Published: March 2023

Background

Strongyloides stercoralis is an intestinal nematode most commonly found in subtropical and tropical locations. Military service members are believed to be at increased risk of exposure due to their unique occupational exposures in endemic regions.

Methods

Burden, clinical course, and risk factors associated with all Strongyloides infections within the US Military Health System from fiscal years 2012 to 2019 were assessed by manual chart review of records with International Classification of Diseases, Ninth Revision/Tenth Revision codes for Strongyloides infection. Infection risk in demographic subgroups based on region of birth, military occupation, and age was quantified with univariate analysis and multivariate logistic regression.

Results

We reviewed 243 charts based on diagnosis coding, yielding 210 confirmed diagnoses (86.4%). Immigrant patients born in Latin America/Caribbean, sub-Saharan Africa, and East Asia/Pacific regions had statistically significant increased risk ratios of infection at 34.4, 32.0, and 22.4, respectively, when compared to patients born in Europe and North America. In univariate analysis, active duty members in the healthcare occupational category had a statistically significant increased risk ratio of infection at 2.31 compared to those outside this occupation. Multivariate logistic regression analysis demonstrated that occupational categories of healthcare, admininstrative/support, warfighter/combat specialist, and engineering/repair/maintenance occupations, being an immigrant patient, and age ≥65 were all associated with statistically significant increased odds ratios for infection.

Conclusions

In the Military Health System, occupational exposures, region of birth, and age serve as risk factors for Strongyloides infection. Because infections may be chronic, the impact of targeted screening programs to complement routine medical care should be considered.
Analyzing an Emerging Pandemic on Twitter: Monkeypox
Authors: Cooper Lauren N , Radunsky Alexander P , Hanna John J , Most Zachary M , Perl Trish M , Lehmann Christoph U , Medford Richard J
Published: March 2023

Background

Social media platforms like Twitter provide important insights into the public's perceptions of global outbreaks like monkeypox. By analyzing tweets, we aimed to identify public knowledge and opinions on the monkeypox virus and related public health issues.

Methods

We analyzed English-language tweets using the keyword “monkeypox” from 1 May to 23 July 2022. We reported gender, ethnicity, and race of Twitter users and analyzed tweets to identify predominant sentiment and emotions. We performed topic modeling and compared cohorts of users who self-identify as LGBTQ+ (an abreviation for lesbian, gay, bisexual, transgender, queer, and/or questioning) allies versus users who do not, and cohorts identified as “bots” versus humans.

Results

A total of 48 330 tweets were written by LGBTQ+ self-identified advocates or allies. The mean sentiment score for all tweets was −0.413 on a −4 to +4 scale. Negative tweets comprised 39% of tweets. The most common emotions expressed were fear and sadness. Topic modeling identified unique topics among the 4 cohorts analyzed.

Conclusions

The spread of mis- and disinformation about monkeypox was common in our tweet library. Various conspiracy theories about the origins of monkeypox, its relationship to global economic concerns, and homophobic and racial comments were common. Conversely, many other tweets helped to provide information about monkeypox vaccines, disease symptoms, and prevention methods. Discussion of rising monkeypox case numbers globally was also a large aspect of the conversation.

Conclusions

We demonstrated that Twitter is an effective means of tracking sentiment about public healthcare issues. We gained insight into a subset of people, self-identified LGBTQ+ allies, who were more affected by monkeypox.
Surveillance of Severe Acute Respiratory Syndrome Coronavirus 2 and Variants Using Digital Droplet Polymerase Chain Reaction at a Large University and Healthcare System in California
Authors: Stafylis Chrysovalantis , Pernet Olivier , Hernandez-Tamayo Cassidy , Kovacs Andrea , Emerson Jane , Ward Pamela M , Van Orman Sarah , Gilliland Frank , Conti David , Weisenhaus Maia , Ghanem-Uzqueda Angie , Yepez Daniel , Stellar Sofia , Tadanki Aditya P , Max Jillian , Fottrell Honour , Ong Ethan , Navarro Sabrina , Moses Kaelyn , Akaolisa Michael , Hosseini Bijan , Sunesara Shaleen , Wang Yuzhu , Strum Earl , Casagrande Yolee , Arenas Nathalie , Williams Christopher , Thomas Paul , Chu Tara , Hu Howard , Klausner Jeffrey D
Published: March 2023

Background

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with different infectivity, transmission potential, and morbidity change the characteristics of local epidemics and affect vaccine effectiveness. As part of the University of Southern California COVID-19 Pandemic Research Center's efforts to understand, control, and inform local community on coronavirus disease 2019 (COVID-19), we implemented a SARS-CoV-2 surveillance program among students, employees, and USC Keck Medical Center patients. We present the epidemiology and distribution of SARS-CoV-2 and its variants among the population.

Methods

We used digital droplet reverse-transcriptase polymerase chain reaction (PCR) to analyze in real-time remnant SARS-CoV-2 PCR-positive saliva specimens stored at the USC Keck Medicine laboratory between September 2020 and April 2022. Samples were tested for the original strain (A20) and 9 SARS-CoV-2 variants: α(B.1.1.7, Q.1–Q.8), β(B.1.351, B.1.351.2, B.1.351.3), γ(P.1, P.1.1, P.1.2), δ(B.1.617.2), δ+(or δ417N), ε(B.1.427 and B.1.429), η(B.1.525), λ(C.37) and ο(B.1.1.529, ΒΑ.1, BA.2). We reviewed deidentified health information from positive cases including demographics, history of COVID-19 (eg, symptoms, hospitalizations, and repeat infections), and COVID-19 vaccination status.

Results

We reviewed 1169 cases and determined the variant type of 482 specimens: 77 specimens were original strain, 119 “Delta”, 165 “Omicron”. The original strain was detected during the third and fourth quarters of 2020. The Delta variant appeared during the second quarter of 2021, whereas Omicron appeared in the fourth quarter of 2021.

Conclusions

Prospectively tracking SARS-CoV-2 variants in a university population and a hospital system, utilizing a low-cost, high-throughput PCR assay, was feasible. Local variant monitoring remains important to inform prevention and control efforts among university and clinical settings.
Effect of Sepsis on Death as Modified by Solid Organ Transplantation
Authors: Ackerman Kevin S , Hoffman Katherine L , Díaz Iván , Simmons Will , Ballman Karla V , Kodiyanplakkal Rosy P , Schenck Edward J
Published: March 2023

Background

Patients who have undergone solid organ transplants (SOT) have an increased risk for sepsis compared with the general population. Paradoxically, studies suggest that SOT patients with sepsis may experience better outcomes compared with those without a SOT. However, these analyses used previous definitions of sepsis. It remains unknown whether the more recent definitions of sepsis and modern analytic approaches demonstrate a similar relationship.

Methods

Using the Weill Cornell-Critical Care Database for Advanced Research, we analyzed granular physiologic, microbiologic, comorbidity, and therapeutic data in patients with and without SOT admitted to intensive care units (ICUs). We used a survival analysis with a targeted minimum loss-based estimation, adjusting for within-group (SOT and non-SOT) potential confounders to ascertain whether the effect of sepsis, defined by sepsis-3, on 28-day mortality was modified by SOT status. We performed additional analyses on restricted populations.

Results

We analyzed 28 431 patients: 439 with SOT and sepsis, 281 with SOT without sepsis, 6793 with sepsis and without SOT, and 20 918 with neither. The most common SOT types were kidney (475) and liver (163). Despite a higher severity of illness in both sepsis groups, the adjusted sepsis-attributable effect on 28-day mortality for non-SOT patients was 4.1% (95% confidence interval [CI], 3.8–4.5) and −14.4% (95% CI, −16.8 to −12) for SOT patients. The adjusted SOT effect modification was −18.5% (95% CI, −21.2 to −15.9). The adjusted sepsis-attributable effect for immunocompromised controls was −3.5% (95% CI, −4.5 to −2.6).

Conclusions

Across a large database of patients admitted to ICUs, the sepsis-associated 28-day mortality effect was significantly lower in SOT patients compared with controls.
Adherence to NCCN Genetic Testing Guidelines in Pancreatic Cancer and Impact on Treatment
Authors: Crowley Fionnuala , Gandhi Sonal , Rudshteyn Michelle , Sehmbhi Mantej , Cohen Deirdre J
Published: March 2023

Introduction

National Comprehensive Cancer Network (NCCN) 2019 Guidelines recommend universal germline (GL) testing for patients (pts) with pancreatic cancer (PC), given germline mutations (gMut) can occur at a similar rate irrespective of an individual’s family history of cancer. Molecular analysis of tumors in those with metastatic disease is also recommended. We aimed to determine rates of genetic testing at our institution, factors associated with testing, and outcomes of those tested.

Methods

Frequency of GL and somatic testing was examined in pts diagnosed with non-endocrine PC, with >2 visits between June 2019 and June 2021 at the Mount Sinai Health System. The clinicopathological variables and treatment outcomes were also recorded.

Results

A total of 149 pts met the inclusion criteria. Sixty-six pts (44%) underwent GL testing: 42 (28%) at time of diagnosis with the remainder later in treatment. The rate of GL testing increased every year: 33% (2019), 44% (2020), and 61% (2021). A family history of cancer was the only variable associated with the decision to perform GL testing. Eight pts (12% of pts tested) had pathological gMut: BRCA1 (1), BRCA2 (1), ATM (2), PALB2 (2), NTHL1 (1), both CHEK2 and APC (1). Neither gBRCA pt received a PARP inhibitor, all except one received first-line platinum. Ninety-eight pts (65.7%) had molecular tumor testing (66.7% of patients with metastases). Two pts with BRCA2 somatic mut did not have GL testing. Three pts received targeted therapies.

Conclusion

Genetic testing based on provider discretion results in low rates of GL testing. Early results of genetic testing can have an impact on treatment decisions and trajectory of disease. Initiatives to increase testing are needed but must be feasible in real-world clinic settings.
Feasibility of Point-of-Care Genomic Profiling in the Diagnosis and Treatment of Cancer of Unknown Primary
Authors: Wang Xin , Beharry Andrea , Sheffield Brandon S , Cheema Parneet K
Published: March 2023

Introduction

Cancer of unknown primary remains a challenging clinical entity. Despite receiving empiric chemotherapy, median overall survival is approximately 6-12 months. Site-specific therapy based on molecular characterization has been shown to improve outcomes; however, feasibility outside of clinical trials, especially in community centers, is lacking. This study explores the application of rapid next-generation sequencing in defining cancer of unknown primary and to identify therapeutic biomarkers.

Methods

A retrospective chart review was performed by identifying pathological samples designated cancer of unknown primary. Next-generation sequencing testing was based on an automated workflow utilizing the Genexus integrated sequencer, validated for clinical use. Genomic profiling was further integrated within a routine immunohistochemistry service, with results reported directly by anatomic pathologists.

Results

Between October 2020 and October 2021, 578 solid tumor samples underwent genomic profiling. Among this cohort, 40 were selected based on an initial diagnosis of cancer of unknown primary. The median (range) age at diagnosis was 70 (42-85) and 23 (57%) were female. Genomic data were used to support a site-specific diagnosis in 6 patients (15%). Median turnaround time was 3 business days (IQR: 1-5). Most common alterations identified were KRAS (35%), CDKN2A (15%), TP53 (15%), and ERBB2 (12%). Actionable molecular targeted therapies were identified in 23 (57%) patients, including alterations in BRAF, CDKN2A, ERBB2, FGFR2, IDH1, and KRAS. Immunotherapy-sensitizing mismatch repair deficiency was identified in 1 patient.

Conclusion

This study supports the adoption of rapid next-generation sequencing among patients with cancer of unknown primary. We also demonstrate the feasibility of integration of genomic profiling with diagnostic histopathology and immunohistochemistry in a community practice setting. Diagnostic algorithms incorporating genomic profiling to better define cancer of unknown primary should be considered for future study.
Postoperative Radiotherapy in Completely Resected IIIA-N2 Non-small Cell Lung Cancer: Quit or Not?
Authors: Chen Yu , Yu Jinming , Meng Xiangjiao
Published: March 2023

This commentary highlights the potential role of postoperative radiotherapy for patients with completely resected ⅢA-N2 non-small cell lung cancer.
PagUNE12 encodes a basic helix-loop-helix transcription factor that regulates the development of secondary vascular tissue in poplar
Authors: Song Chengwei , Guo Yayu , Shen Weiwei , Yao Xiaomin , Xu Huimin , Zhao Yuanyuan , Li Ruili , Lin Jinxing
Published: March 2023

Secondary growth in woody plants generates new cells and tissues via the activity of the vascular cambium and drives the radial expansion of stems and roots. It is regulated by a series of endogenous factors, especially transcription factors. Here, we cloned the basic helix–loop–helix (bHLH) transcription factor gene UNFERTILIZED EMBRYO SAC12 (UNE12) from poplar (Populus alba × Populus glandulosa Uyeki) and used biochemical, molecular, and cytological assays to investigate the biological functions and regulatory mechanism of PagUNE12. PagUNE12 mainly localized in the nucleus and possessed transcriptional activation activity. It was widely expressed in vascular tissues, including primary phloem and xylem and secondary phloem and xylem. Poplar plants overexpressing PagUNE12 showed significantly reduced plant height, shorter internodes, and curled leaves compared with wild-type plants. Optical microscopy and transmission electron microscopy revealed that overexpressing PagUNE12 promoted secondary xylem development, with thicker secondary cell walls than wild-type poplar. Fourier transform infrared spectroscopy, confocal Raman microscopy, and 2D Heteronuclear Single Quantum Correlation analysis indicated that these plants also had increased lignin contents, with a lower relative abundance of syringyl lignin units and a higher relative abundance of guaiacyl lignin units. Therefore, overexpressing PagUNE12 promoted secondary xylem development and increased the lignin contents of secondary xylem in poplar, suggesting that this gene could be used to improve wood quality in the future.
ABRE-BINDING FACTOR3-WRKY DNA-BINDING PROTEIN44 module promotes salinity-induced malate accumulation in pear
Authors: Alabd Ahmed , Cheng Haiyan , Ahmad Mudassar , Wu Xinyue , Peng Lin , Wang Lu , Yang Shulin , Bai Songling , Ni Junbei , Teng Yuanwen
Published: March 2023

Malate impacts fruit acidity and plays a vital role in stress tolerance. Malate accumulation is induced by salinity in various plants as a metabolite in coping with this stress. However, the exact molecular mechanism responsible for salinity-induced malate accumulation remains unclear. Here, we determined that salinity treatment induces malate accumulation in pear (Pyrus spp.) fruit, calli, and plantlets compared to the control. Genetic and biochemical analyses established the key roles of PpWRKY44 and ABRE-BINDING FACTOR3 (PpABF3) transcription factors in promoting malate accumulation in response to salinity. We found that PpWRKY44 is involved in salinity-induced malate accumulation by directly binding to a W-box on the promoter of the malate-associated gene aluminum-activated malate transporter 9 (PpALMT9) to activate its expression. A series of in-vivo and in-vitro assays revealed that the G-box cis-element in the promoter of PpWRKY44 was targeted by PpABF3, which further enhanced salinity-induced malate accumulation. Taken together, these findings suggest that PpWRKY44 and PpABF3 play positive roles in salinity-induced malate accumulation in pears. This research provides insights into the molecular mechanism by which salinity affects malate accumulation and fruit quality.
Neofunctionalization of tandem duplicate genes encoding putative β-L-arabinofuranosidases in Arabidopsis
Authors: Tao Feng , Sollapura Vishwanath , Robert Laurian S , Fan Chuanzhu
Published: March 2023

Tandem duplication, one of the major types of duplication, provides the raw material for the evolution of divergent functions. In this study, we identified 1 pair of tandem duplicate genes (AT5G12950 and AT5G12960) in Arabidopsis (Arabidopsis thaliana) that originated within the last 16 million years after the split of Arabidopsis from the Capsella-Boechera ancestor. We systematically used bioinformatic tools to redefine their putative biochemical function as β-L-arabinofuranosidases that release L-Arabinose from the β-L-Araf-containing molecules in Arabidopsis. Comprehensive transcriptomic and proteomic analyses using various datasets showed divergent expression patterns among tissues between the 2 duplicate genes. We further collected phenotypic data from 2 types of measurements to indicate that AT5G12950 and AT5G12960 have different roles resulting in divergent phenotypic effects. Overall, AT5G12950 and AT5G12960 represent putative β-L-arabinofuranosidase encoding genes in Arabidopsis. After duplication, 1 duplicate copy developed diverged biological functions and contributed to a different phenotypic evolution in Arabidopsis.
Transcription factors GmERF1 and GmWRKY6 synergistically regulate low phosphorus tolerance in soybean
Authors: Wang Ruiyang , Liu Xiaoqian , Zhu Hongqing , Yang Yuming , Cui Ruifan , Fan Yukun , Zhai Xuhao , Yang Yifei , Zhang Shanshan , Zhang Jinyu , Hu Dandan , Zhang Dan
Published: March 2023

Soybean (Glycine max) is a major grain and oil crop worldwide, but low phosphorus (LP) in soil severely limits the development of soybean production. Dissecting the regulatory mechanism of the phosphorus (P) response is crucial for improving the P use efficiency of soybean. Here, we identified a transcription factor, GmERF1 (ethylene response factor 1), that is mainly expressed in soybean root and localized in the nucleus. Its expression is induced by LP stress and differs substantially in extreme genotypes. The genomic sequences of 559 soybean accessions suggested that the allelic variation of GmERF1 has undergone artificial selection, and its haplotype is significantly related to LP tolerance. GmERF1 knockout or RNA interference resulted in significant increases in root and P uptake efficiency traits, while the overexpression of GmERF1 produced an LP-sensitive phenotype and affected the expression of 6 LP stress-related genes. In addition, GmERF1 directly interacted with GmWRKY6 to inhibit transcription of GmPT5 (phosphate transporter 5), GmPT7, and GmPT8, which affects plant P uptake and use efficiency under LP stress. Taken together, our results show that GmERF1 can affect root development by regulating hormone levels, thus promoting P absorption in soybean, and provide a better understanding of the role of GmERF1 in soybean P signal transduction. The favorable haplotypes from wild soybean will be conducive to the molecular breeding of high P use efficiency in soybean.
Acinetobacter baumannii adaptation to the host pH microenvironment is mediated by allelic variation in a single residue of BauA protein
Authors: Li Tao , Luo Deyan , Ning Nianzhi , Liu Xiong , Chen Fanghong , Zhang Liangyan , Bao Chunmei , Li Zhan , Li Deyu , Gu Hongjing , Qu Fen , Yang Xiaolan , Huang Yanyu , Li Boan , Wang Hui
Published: March 2023

Acinetobacter baumannii has been listed as one of the most critical pathogens in nosocomial infections; however, the key genes and mechanisms to adapt to the host microenvironment lack in-depth understanding. In this study, a total of 76 isolates (from 8 to 12 isolates per patient, spanning 128 to 188 days) were longitudinally collected from eight patients to investigate the within-host evolution of A. baumannii. A total of 70 within-host mutations were identified, 80% of which were nonsynonymous, indicating the important role of positive selection. Several evolutionary strategies of A. baumannii to increase its potential to adapt to the host microenvironment were identified, including hypermutation and recombination. Six genes were mutated in isolates from two or more patients, including two TonB-dependent receptor genes (bauA and BJAB07104_RS00665). In particular, the siderophore receptor gene bauA was mutated in multiple isolates from four patients with three MLST types, and all mutations were at amino acid 391 in ligand-binding sites. With 391T or 391A, BauA was more strongly bound to siderophores, which promoted the iron-absorption activity of A. baumannii at acidic or neutral pH, respectively. Through the A/T mutation at site 391 of BauA, A. baumannii displayed two reversible phases to adapt to distinct pH microenvironments. In conclusion, we demonstrated the comprehensive within-host evolutionary dynamics of A. baumannii, and discovered a key mutation of BauA site 391 as a genetic switch to adapt to different pH values, which may represent a model in the pathogen evolutionary adaption of the host microenvironment.
Generalized matter parities from finite modular symmetries
Authors: Kobayashi Tatsuo , Nishimura Satsuki , Otsuka Hajime , Tanimoto Morimitsu , Yamamoto Kei
Published: March 2023

We classify a supersymmetric extension of the Standard Model by discrete symmetries originating from finite modular symmetries ΓN. Since all the couplings in supersymmetric theories of finite modular symmetries ΓN are described by holomorphic modular forms with even modular weights, renormalizable and non-renormalizable operators such as baryon- and/or lepton-number violating operators are severely constrained. From the modular transformation of matter multiplets with modular weight 1/M, we find $\mathbb {Z}_{2M}$ symmetries, including the generalized baryon and lepton parities, R-parity, $\mathbb {Z}_3$ baryon triality and $\mathbb {Z}_6$ proton hexality. Such $\mathbb {Z}_{2M}$ symmetries are enlarged to $\mathbb {Z}_{2M} \rtimes \mathbb {Z}_2^{\text{CP}}$ symmetries together with the CP transformation.
Imperfect Risk Sharing and the Business Cycle
Authors: Berger David , Bocola Luigi , Dovis Alessandro
Published: March 2023

This article studies the macroeconomic implications of imperfect risk sharing implied by a class of New Keynesian models with heterogeneous agents. The models in this class can be equivalently represented as a representative-agent economy with wedges. These wedges are functions of households’ consumption shares and relative wages, and they identify the key cross-sectional moments that govern the impact of households’ heterogeneity on aggregate variables. We measure the wedges using U.S. household-level data and combine them with a representative-agent economy to perform counterfactuals. We find that deviations from perfect risk sharing implied by this class of models account for only 7% of output volatility on average but can have sizable output effects when nominal interest rates reach their lower bound.
N-glycan in the variable region of monoclonal ACPA (CCP-Ab1) promotes the exacerbation of experimental arthritis
Authors: Kawataka Masatoshi , Ouhara Kazuhisa , Kobayashi Eiji , Shinoda Koichiro , Tobe Kazuyuki , Fujimori Ryousuke , Mizuno Noriyoshi , Sugiyama Eiji , Ozawa Tatsuhiko , Kishi Hiroyuki
Published: March 2023

Objectives

The variable region of most ACPA IgG molecules in the serum of RA patients carries N-glycan (N-glycanV). To analyse the pathogenicity of N-glycanV of ACPAs, we analysed the pathogenicity of a monoclonal ACPA, CCP-Ab1, with or without N-glycanV, which had been isolated from a patient with RA.

Methods

CCP-Ab1 with no N-glycosylation site in the variable region (CCP-Ab1 N-rev) was generated, and antigen binding, the effect on in vitro differentiation of osteoclasts from bone marrow mononuclear cells of autoimmune arthritis–prone SKG mice (the cell size of TRAP+ cells and bone resorption capacity) and the in vivo effect on the onset or exacerbation of autoimmune arthritis in SKG mice were evaluated in comparison with glycosylated CCP-Ab1.

Results

Amino acid residues in citrullinated peptide (cfc1), which are essential for binding to CCP-Ab1 N-rev and original CCP-Ab1, were almost identical. The size of TRAP+ cells was significantly larger and osteoclast bone resorption capacity was enhanced in the presence of CCP-Ab1, but not with CCP-Ab1 N-rev. This enhancing activity required the sialic acid of the N-glycan and Fc region of CCP-Ab1. CCP-Ab1, but not CCP-Ab1 N-rev, induced the exacerbation of experimental arthritis in the SKG mouse model.

Conclusions

These data showed that N-glycanV was required for promoting osteoclast differentiation and bone resorption activity in both in vitro and in vivo assays. The present study demonstrated the important role of N-glycanV in the exacerbation of experimental arthritis by ACPAs.
Comparisons of SLE-DAS and SLEDAI-2K and classification of disease activity based on the SLE-DAS with reference to patient-reported outcomes
Authors: Onishi Akira , Tsuji Hideaki , Takase Yudai , Nakakubo Yuto , Iwasaki Takeshi , Kozuki Tomohiro , Yoshida Tsuneyasu , Shirakashi Mirei , Onizawa Hideo , Hiwa Ryosuke , Kitagori Koji , Akizuki Shuji , Nakashima Ran , Yoshifuji Hajime , Tanaka Masao , Morinobu Akio
Published: March 2023

Objectives

Although the SLE Disease Activity Score (SLE-DAS) and its definitions to classify disease activity have been recently developed to overcome the drawbacks of the SLE Disease Activity Index 2000 (SLEDAI-2K), the performance of the SLE-DAS for patient-reported outcomes (PROs) has not been fully examined. We aimed to compare SLE-DAS with SLEDAI-2K and validate the classifications of disease activity based on SLE-DAS in terms of PROs.

Methods

We assessed generic quality of life (QoL) using the Medical Outcome Survey 36-Item Short-Form Health Survey (SF-36), disease-specific QoL using the lupus patient-reported outcome tool (LupusPRO), burden of symptoms using the SLE Symptom Checklist (SSC), patient global assessment (PtGA) and physician global assessment (PhGA).

Results

Of the 335 patients with SLE, the magnitudes of the mean absolute error, root mean square error, Akaike information criterion, and Bayesian information criterion were comparable for most PROs between the SLE-DAS and SLEDAI-2K. In contrast, SLEDAI-2K had a higher predictive value for health-related QoL of LupusPRO and PtGA than SLE-DAS. Low disease activity, Boolean and index-based remission and categories of disease activity (remission, mild and moderate/severe activity) were significantly associated with health-related QoL in LupusPRO, SSC and PhGA, but not SF-36 or PtGA.

Conclusion

No clear differences were identified in the use of the SLE-DAS over the SLEDAI-2K in assessing PROs in patients with SLE. The classification of disease activity based on the SLE-DAS was validated against several PROs. SLE-DAS and its categories of disease activity effectively explain some of the PROs.
‘The Unseen Enemy Persists’: Delusion, Trauma and the South African War in Australian Asylum Case Notes
Authors: Karageorgos Effie
Published: March 2023

Australian troops travelling to South Africa in 1899 to join Britain in fighting the Boers left behind communities consumed with the conflict. The colonies that would form the Australian nation in 1901 organised parades, concerts and eagerly awaited news from the battlefield. This article analyses these cultural responses to the South African War alongside the experiences of institutionalised delusional men. It traces ways the conflict penetrated the walls of Australian asylums, and the minds of the insane within them, as well as the sane existing in society. Delusions based on the conflict appeared not only in the words of men who had travelled to South Africa, but also those who were evidently deeply affected by Australian involvement in the war, following the fervour within the societies from which they came. The resulting analysis of the words and experiences of the insane expands the historiography of the conflict in new ways.
How can ultrasonography help in the management of CPPD? From diagnosis to clinical subset identification
Authors: Filippou Georgios , Sirotti Silvia
Published: March 2023

Purpose of review

Clinical manifestations of calcium pyrophosphate deposition (CPPD) disease are quite heterogeneous, ranging from asymptomatic presentation to severe forms of arthritis. In recent years, imaging, particularly ultrasound (US) has gained a central role for the diagnosis of CPPD. However, many questions are still open. Aim of this review is to present how US could be a key tool in the diagnosis and assessment of CPPD and for the identification of subsets of the disease.

Recent findings

awareness and research interest around CPPD is increasing in the recent years, as several international taskforces are working on the validation of outcome measures and classification criteria for CPPD, but many pieces of the puzzle are still missing. Recent studies demonstrated that CPPD is an underdiagnosed disease, frequently misdiagnosed as rheumatoid arthritis or polymyalgia rheumatica. US has been increasingly used in the past decade for the diagnosis of CPPD and US definitions have been validated by the OMERACT US working group in the recent years, making of US a valuable tool for diagnosis.

The most challenging aspects of CPPD are the differential diagnosis with other form of arthritis of the elderly, and the classification of patients in clinical subsets. In this review, we will present the available data for the use of US in the diagnosis of CPPD and we will provide a mainly experienced-based approach to the potential role of the technique in differential diagnosis and phenotypization of patients.
The utility of ultrasound and plain radiographs in the management of developmental dysplasia of the hip
Authors: Aw Angeline Ai Ling , Wong Kenneth Pak Leung , Lee Nicole Kim Luan , Mahadev Arjandas
Published: March 2023

The purpose of this study is to assess the utility of follow-up radiological imaging in the management of developmental dysplasia of the hip (DDH) in patients successfully treated with the Pavlik harness. A retrospective review was conducted on all children under 6 months diagnosed with DDH at a tertiary pediatric hospital between January 2004 and December 2018. Inclusion criteria included successful Pavlik harness treatment following a standardized protocol with complete radiological documentation at 2 years of age. Ultrasonography was reviewed to measure the α and β angles and Graf classification. Anteroposterior pelvic radiographs were evaluated for the acetabular index and residual acetabular dysplasia. Seventy-eight hips from 57 infants were included in this study. The mean 6-month, 12-month and 2-year acetabular index of Graf I, IIa and IIc hips on ultrasound at 12 weeks were within the normal range according to age. There were no Graf IIb, IId, III and IV hips. All infants had normal radiographs at 2 years follow-up. The 6- and 12-month residual dysplasia rates in patients with DDH normalization at 12 weeks and 6 months range from 2.5 to 8.82%. Regardless of when the acetabular index normalized, all patients eventually had normal hip radiographs at 2 years of age. Following a standardized protocol, patients undergoing Pavlik harness treatment for DDH with Graf I and IIa hips at 12 weeks are likely to have normal plain radiographs at discharge. The incidence of residual dysplasia is very low and hence, radiographic surveillance is probably unnecessary until discharge at 2 years. Level II, retrospective study.
Clinical impact of vaping on cardiopulmonary function and lung cancer development: an update
Authors: Petrella Francesco , Rizzo Stefania , Masiero Marianna , Marzorati Chiara , Casiraghi Monica , Bertolaccini Luca , Mazzella Antonio , Pravettoni Gabriella , Spaggiari Lorenzo
Published: March 2023

The word ‘vaping’ is used to define the usage of electronic cigarettes or other instruments to inhale a wide variety of heated and aerosolized substances. Although proposed as a less dangerous and oncogenic alternative than standard nicotine products, e-cigarettes and vaping devices are quite far from being considered benign. In fact, although vaping devices do not generate carcinogenic agents as polycyclic aromatic hydrocarbons produced by the combustion of standard cigarettes and their liquids do not present tobacco-related carcinogens like nitrosamines, there is nowadays clear evidence that they produce dangerous products during their use. Several different molecular mechanisms have been proposed for the oncogenic impact of vaping fluids – by means of their direct chemical action or derivative products generated by pyrolysis and combustion ranging from epithelial–mesenchymal transition, redox stress and mitochondrial toxicity to DNA breaks and fragmentation. In this review we focus on vaping devices, their potential impact on lung carcinogenesis, vaping-associated lung injury and other clinical implications on cardiovascular, cerebrovascular and respiratory diseases, as well as on the psychological implication of e-cigarettes both on heavy smokers trying to quit smoking and on younger non-smokers approaching vaping devices because they are considered as a less dangerous alternative to tobacco cigarettes.
Autoimmune pancreatitis with different clinical manifestations and imaging findings: a series of three cases
Authors: Gao Changhao , Fan Zhiyao , Zhan Hanxiang
Published: March 2023

Autoimmune pancreatitis (AIP) is a rare and emerging immune-mediated pancreatitis. The involvement of the pancreas with lymphoplasmacytic infiltration and fibrosis on histology is the most common features and has been well studied in the literature. It is characterized by a nonspecific presentation that mimics a malignant process. The purpose of this report is to explore the different clinical and paraclinical aspects of this disease, as well as the challenges posed by its management. The series are made up of three different cases of patients with elevated serum IgG4 levels and pancreatic changes. The first case initially revealed cholestatic jaundice with extrahepatic and intrahepatic cholangitis, and ultrasound reflected multiple occupying changes in the pancreas. The elevated serum IgG4 level was brilliant. Patient improved under the influence of corticosteroids. The second case was clinically asymptomatic, just found weight loss. Magnetic resonance revealed a round mass in the head of the pancreas and was considered as a neuroendocrine tumor. The patient showed slightly elevated serum IgG4 level, but was sensitive to hormone therapy. The third case concerned epigastric pain and enlarged lymph nodes. It was initially diagnosed as pancreatic cancer with distant metastasis, but also finally resolved by corticosteroid treatment. The clinical presentation of AIP is heterogeneous, as evidenced by our three clinical cases. Further observational and interventional studies are needed to better identify and manage this disease.
Nursing Strategies to Help Children Cope with Eco-anxiety
Authors: Rasmussen Jennifer
Published: March 2023

The threat of climate change is causing collective fear and worry among individuals and communities worldwide. Children may be among those who are most affected. As global temperatures continue to rise and subsequent natural disasters occur with more intensity, children are taking notice and, as a result, experiencing what experts are calling “eco-anxiety.” Eco-anxiety, a term used to describe the negative emotions associated with climate change, is becoming more prevalent in children as they witness these extreme weather events and hear future dire scenarios laid out by scientists. Children are becoming acutely aware that their governments are not doing enough to protect them or their future, resulting in a distress that could be reduced if world governments became more committed to the fight to protect the planet from climate change. In the interim, there are nursing strategies to help children cope with their overwhelming sense of doom. By having their concerns validated, implementing strategies to feel more connected to the natural world, and becoming more empowered to take action to protect the planet, children can begin to feel more optimistic and confident about their futures.
Longitudinal Association Among Illness Perceptions, Coping, and Quality of Life After Extremity Injury
Authors: Tonapa Santo Imanuel , Mulyadi Mulyadi , Yusuf Ah , Lee Bih-O
Published: March 2023

This longitudinal cohort study examined changes in illness perceptions, coping strategies, and quality of life in hospitalized participants who had sustained extremity injuries, and examined the associations among these changes. A sample of 138 patients with extremity injuries was recruited between August 2019 and April 2020 from the trauma units of two similar referral medical centers, each with a capacity of over 200 beds in Surabaya City, Indonesia. Outcome measures were assessed prior to hospital discharge and 3 months post-discharge, including the Brief Illness Perception Questionnaire, the Brief Coping Orientation to Problems Experienced, and the World Health Organization Quality of Life. Hierarchical multiple regression analyses were conducted. We found that lower scores for illness perceptions (i.e., how a participant appraised and understood their medical condition and its possible consequences) and maladaptive coping strategies were significantly associated with lower quality of life scores. In addition, scores for adaptive coping strategies moderated the association between illness perceptions and quality of life. Our findings suggest that clinicians should endeavor to improve patients' illness perceptions and adaptive coping strategies during the first 3 months post-injury to promote improvement in quality of life following extremity injury.
Death Due to Accidental Crossbow Arrow Injury
Authors: Tawil Michel , Revercomb Carolyn H.
Published: March 2023

Crossbows are weapons that shoot arrow-like projectiles using an elastic launching mechanism activated by a gun-like trigger. Accidental deaths due to crossbow injuries have been rarely reported in forensic practice. In this case report, a 40-year-old man was found dead in the woods with a wound to the upper torso. The wound was observed to have a corresponding slit-like defect in each layer of his clothing. A blood-stained crossbow with the safety features off was found at the scene, along with a nearby partially bent arrow. At autopsy, a hemorrhagic sharp-edged penetrating track was found in the left upper chest, which injured the subclavian vessels. The mechanism of death was determined to be severe bleeding due to the penetrating wound. Toxicological analyses of blood showed methamphetamines and metabolites of cocaine. According to the available evidence, the manner of death was determined to be an accident. In crossbow-related deaths, particularly when the arrow is removed from the wound, determining the weapon used proves challenging because of the similarity of the resulting wounds to the wounds of other weapons. This case report highlights the importance of integrating critical crime scene investigation with autopsy findings to reach a correct manner of death.
Breaking barriers and advancing diversity, equity, and inclusion in trauma and acute care surgery: A current perspective
Authors: Patel Heli , Breeding Tessa , Inouye Marissa , Hoops Heather , Elkbuli Adel
Published: March 2023

The importance of diversity, equity, and inclusion (DEI) in trauma and acute care surgery (ACS) has become increasingly apparent in the field of medicine. Despite the growing diversity of the patient population, the surgical specialty has traditionally been dominated by White males. This involves increasing the representation of diverse individuals in leadership positions, professional societies, scholarships, graduate education, and practicing physicians. This opinion piece aims to address the gaps in the literature regarding DEI in trauma and acute care surgery and highlight the issues related to the workforce, gender gap, patient outcomes, and health services. To effectively guide DEI interventions, it is essential to capture patient-reported experience data and stratify outcomes by factors including race, ethnicity, ancestry, language, sexual orientation, and gender identity. Only then can generalizable findings effectively inform DEI strategies. Using validated measurement tools, it is essential to conduct these assessments with methodological rigor. Collaboration between health care institutions can also provide valuable insights into effective and ineffective intervention practices through information exchange and constructive feedback. These recommendations aim to address the multifactorial nature of health care inequities in trauma and ACS. However, successful DEI interventions require a deeper understanding of the underlying mechanisms driving observed disparities, necessitating further research.

LEVEL OF EVIDENCE

Level V.
Evaluation of the agri-food supply chain risks: the circular economy context
Authors: Krstić Mladen , Elia Valerio , Agnusdei Giulio Paolo , De Leo Federica , Tadić Snežana , Miglietta Pier Paolo
Published: March 2023

Purpose

Circular supply chains (CSC) are particularly important for the agri-food sector, which faces strict requirements generated by increased food consumption as a consequence of world population growth, changes in lifestyle, development of consumer society and increasing health awareness. Recent disruptive factors have placed the vulnerability of agri-food supply chains in the spotlight. Therefore, the purpose of this paper was to identify the most manageable groups of risks in order to ensure the smooth operation of agri-food circular supply chains.

Design/methodology/approach

Seven main risk groups were evaluated in relation to nine criteria. To solve this multi-criteria decision making (MCDM) problem, a novel MCDM model, which integrates the best-worst method (BWM) and the COmprehensive distance-Based RAnking (COBRA) method in a grey environment, was developed.

Findings

Three risks were singled out, namely, product features risks, logistics risks and managerial risks. The obtained risks are those whose management would create the most positive effects for the stakeholders and help them achieve their primary goals regarding the circularity of agri-food supply chains.

Originality/value

This study investigates the main characteristics of the CSC in the agri-food sector, identifies, simultaneously explores and ranks all main risk groups associated with them and expands the possibilities for solving these kinds of problems by developing a novel MCDM model. It also identifies the most significant risks, both for individual stakeholders and for all stakeholder groups together.
Evaluation of passengers' expectations and satisfaction in the airline industry: an empirical performance analysis of online reviews
Authors: Dike Somtochukwu Emmanuel , Davis Zachary , Abrahams Alan , Anjomshoae Ali , Ractham Peter
Published: March 2023

Purpose

Variations in customer expectations pose a challenge to service quality improvement in the airline industry. Understanding airline customers' expectations and satisfaction help service providers improve their offerings. The extant literature examines airline passengers' expectations in isolation, neglecting the overall impact of online reviews on service quality improvement. This paper systematically evaluates the airline industry's passengers' expectations and satisfaction using expectation confirmation theory (ECT) and the SERVQUAL framework. The paper analyzes online reviews to examine the relationship between airline service quality attributes and passengers' satisfaction.

Design/methodology/approach

The SERVQUAL framework was employed to examine the effects of customer culture, the reason for traveling, and seat type on customer's expectations and satisfaction across a large sample of airline customers.

Findings

A total of 17,726 observations were gathered from the Skytrax review website. The lowest satisfaction ratings were from passengers from the USA, Canada and India. Factors that affect perceived service performance include customer service, delays and baggage management. Empathy and reliability have the biggest impact on the perceived satisfaction of passengers.

Research limitations/implications

This research increases understanding of the consumer expectations through analysis of passengers' online reviews. Results are limited to a small sample of airline industries.

Practical implications

This study provides airlines with valuable information to improve customer service by analyzing online reviews.

Social implications

This study provides the opportunity for airline customers to gain better services when airline companies utilize the findings.

Originality/value

This paper offers insights into passengers' expectations and their perceived value for money in relation to seat types. Previous studies have not investigated value for money as a construct for passengers' expectations and satisfaction relative to service quality dimensions. This paper addresses this need.
Gender and leadership in the wake of the 2010 earthquake and tsunami in Chile
Authors: Fernández Saavedra Ana Gabriela , González Arias Rosario , Dema Moreno Sandra , Cocina Díaz Virginia
Published: March 2023

Purpose

The aim of this article is to reveal the extent to which a disaster situation contributed to fostering leadership in the population affected in terms of gender.

Design/methodology/approach

For this article, four focus groups were conducted, all of them composed of people directly involved in the earthquake and tsunami in Chile on February 27, 2010, two of them made up of women and the other two of men.

Findings

The research revealed that male leadership during the response and recovery processes is linked to traditional gender roles although the continuity of this differed between the two phases. With respect to women, they were found to be very active in the response phase in terms of managing emergency aid, a task linked to their reproductive and care roles. Women's leadership also appears in the recovery phase, where the collective dimension of their actions stands out, defying to some extent these roles and highlighting their capacity to adapt to the challenges of the disaster.

Originality/value

Understanding the leadership that unfolds in the population affected by this disaster during the response and recovery phases has significant potential to inform and influence the development of risk reduction policies that are more effective, egalitarian and resilient.