bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond variegation: The territorialisation of states, communities and developers in large-scale developments in Johannesburg, Shanghai and London
Authors: Robinson Jennifer , Wu Fulong , Harrison Phil , Wang Zheng , Todes Alison , Dittgen Romain , Attuyer Katia
Published: February 2022

Large-scale urban development projects are a significant format of urban expansion and renewal across the globe. As generators of governance innovation and indicators of the future city in each urban context, large-scale development projects have been interpreted within frameworks of ‘variegations’ of wider circulating processes, such as neoliberalisation or financialisation. However, such projects often entail significant state support and investment, are strongly linked to a wide variety of transnational investors and developers and are frequently highly contested in their local environments. Thus, each project comes to fruition in a distinctive regulatory context, often as an exception to the norm, and each emerges through complex interactions over a long period of time amongst an array of actors. We therefore seek to broaden the discussion from an analytical focus on variegated globalised processes to consider three large-scale urban development projects (in Shanghai, Johannesburg and London) as distinctive (transcalar) territorialisations. Using an innovative comparative approach, we outline the grounds for a systematic analytical conversation across mega-urban development projects in very different contexts. Initially, comparability rests on the shared features of large-scale developments – that they are multi-jurisdictional, involve long time scales and bring significant financing challenges. Comparing three development projects, we are able to interrogate, rather than take for granted, how a range of wider processes, circulating practices, transcalar actors and territorial regulatory formations composed specific urban outcomes in each case. Thinking across these diverse cases provides grounds for rebuilding understandings of urban development politics.
Evaluation of Digital Dependence of Employees in the Organizational Environment
Authors: Gonçalves Lucio Lage , Egídio Nardi Antonio , Bortolanza Sandra , King Mariana , Santos Hugo , Rodrigues Douglas , King Anna Lucia Spear
Published: February 2022

Introduction: With the evolution of technologies, new digital resources have emerged establishing different practices in human behavior, including the excessive use of digital devices, causing different dependencies due to the nonconscious use of these technologies. The digital use of digital devices will always be very important to the organizational process, but the abusive or excessive use can bring performance problems at work and also for people. Collective environments of organizations also begin to show “symptoms” of these dependencies, and observing these behaviors can contribute to greater employees comfort and the functioning of the business organization. Objective: To identify the level of digital dependency of employees in organizational environments and to investigate this dependency associated with demographic characteristics. Method: Data collection took place online, from 11.05.2019 to 03.05.2020, with a sample totaling 307 volunteers and 13 questionnaires excluded due to filling error, ending with 294 valid questionnaires. A validated scale was used to Assess Digital Employee Dependence (EDDE), with 19 questions (Annex 1) and inserted in the Google Forms platform, widely used for data collection in surveys. After the collection procedure, a database was created for statistical analysis and discussion of the results. Results: Factor Analysis identified 4 factors using the Kaiser Method, via Scree Plot and 19 questions were maintained, according to previous applications of this questionnaire. The sample presented itself without digital dependence (42.2%) or with mild dependence (30.3%). Only women had a severe level of digital dependence, but with low significance (1.7%). Conclusion: The severe digital dependency had a very low score, while the sum of volunteers without dependence with a mild level characterizes a sample without relevant digital dependence. Women showed a higher level of digital dependence although more research needs to confirm this sign. The limitations found for applying the research did not compromise the results.
Meta-Analysis of Mindfulness-Based Program Soles of the Feet for Disruptive Behaviors
Authors: Felver Joshua C. , Clawson Adam J. , Ash Tory L. , Martens Brian K. , Wang Qiu , Singh Nirbhay N.
Published: February 2022

Mindfulness-based programs are a promising intervention modality for reducing disruptive behavior, and Soles of the Feet (SOF) is one program that teaches internal awareness of personal events (e.g., unpleasant emotions) and a self-regulation strategy to decrease disruptive behaviors. This study conducted a meta-analysis of single-case research design (SCRD) studies that implemented SOF to decrease disruptive behaviors. Existing SOF studies were evaluated using high-quality SCRD standards, resulting in 15 studies included in the analysis (49 participants; mean age 23.12 years ( SD = 15.87); highly heterogeneous backgrounds). Studies were analyzed to calculate effect sizes using Tau-U, an innovative non-parametric statistical approach for estimating effect sizes in SCRD studies. The aggregated weighted Tau-U effect size of SOF across all studies was −0.87. Moderator analyses indicated SOF’s effectiveness was robust across participant characteristics and delivery formats. This meta-analysis suggests that SOF is a moderately effective evidence-based practice for reducing disruptive behavior.
Constructing the Crime Canon: Dorothy L. Sayers as an Anthologist
Authors: Stewart Victoria
Published: February 2022

A consideration of Dorothy L. Sayers's work as an anthologist of short detective fiction during the late 1920s and early 1930s shows how, though hemmed in by considerations of cost and copyright, Sayers used the compiling of anthologies both as a means of promoting her ideas about the detective form and to foster connections with fellow practitioners. An analysis of Sayers's five anthologies shows her favouring particular authors and stories, even while accommodating different audiences and venues of publication. She thus constructed a canon of short detective fiction, one that continues to exert influence on understandings of the form.
Case Report of Hepatitis C Treatment Success in Male With Decompensated Cirrhosis and Polysubstance Abuse: The Important Role of the Pharmacist in Active Care Coordination
Authors: Bricker-Ford Robin , Brumenschenkel Amy
Published: February 2022

This is a case report of a man with decompensated cirrhosis and polysubstance abuse that was cured of chronic hepatitis C virus (HCV) infection through pharmacist active care coordination. The patient was prescribed Epclusa (sofosbuvir 400 mg/velpatasvir 100 mg) 1 tablet by mouth daily for 24 weeks, but finished his course 18 days late due to poor compliance and treatment interruptions. The active role of the clinical pharmacist in the hepatology clinic facilitated the patient’s ongoing engagement in care, leading to treatment success.
Multi-objective surrogate model-based optimization of a small aircraft engine air-intake duct
Authors: Drężek Przemysław S , Kubacki Sławomir , Żółtak Jerzy
Published: February 2022

Aviation industry is constantly striving for more efficient design processes in respect to optimal time, human and computational resources utilization. This implies a need for application of an approximation techniques enabling for fast responses generation with maintained level of results quality. This study focuses on an advancement of aerodynamic shape optimization process of a small aircraft engine intake system by introduction of a surrogate modelling step into the design loop. The multi-objective metamodel assisted optimization is carried out in order to reduce pressure losses along the engine intake duct and increase flow homogeneity at the engine compressor intake plane. Latin Hypercube Design method is utilized in order to sample the design space. A set of initial objective function evaluations is generated with application of Reynolds-averaged Navier–Stokes solver. The ensemble of samples is further used to train a Kriging-based surrogate model. The Efficient Global Optimization algorithm basing on the Expected Improvement function is employed to gradually increase the metamodel prediction quality by usage of sequential sampling technique. Finally, the optimal point predicted by the Kriging surrogate is validated against the high-fidelity model with usage of the Computational Fluid Dynamics code. The paper presents an application of the abovementioned methodology to the design process of the I-31T aircraft turboprop engine intake system. Proposed Kriging-based optimization workflow is utilized in order to reduce pressure losses and improve flow homogeneity in the engine air-intake duct.
Effect of carbon nanotube surface modification on tensile properties of carbon fiber epoxy impregnated bundle composites
Authors: Naito Kimiyoshi , Nagai Chiemi
Published: February 2022

The effect of carbon nanotubes (CNTs) on the tensile properties of polyacrylonitrile (PAN)-based carbon fiber epoxy impregnated bundle composites was investigated. To grow CNTs on the carbon fibers, the following catalysts were selected: Ferrocene ([Fe(C5H5)2]) catalyst applied to the bundles using chemical vapor deposition (CVD), and iron (III) nitrate nonahydrate ([Fe(NO3)3•9H2O]) catalyst applied by dipping the bundles in ethanol solutions of different concentrations ranging from 0.01 to 0.5 M. For bundle composites with Fe(C5H5)2-catalyzed CNTs, the Weibull modulus was 29% higher than the as-received state, although the tensile strength is almost unchanged. The Weibull modulus is 9–39% higher than the as-received state for Fe(NO3)3•9H2O catalyst solutions in the range 0.01–0.3 M, while it decreases by 22–32% for 0.4–0.5 M solutions. The tensile strength is lower in both cases; 4–7% lower for 0.01–0.3 M solutions and 14–17% lower for 0.4–0.5 M solutions. Fe(NO3)3•9H2O catalysts 0.1 M solutions gives the best combination of tensile strength and Weibull modulus improvement. The results also show that for each type of CNT-grafted and as-received PAN-based carbon fibers, an almost linear relation between the Weibull modulus and average tensile strength on the log-log scale is observed. This relation indicates that Fe(C5H5)2 catalyst-grafting of CNTs gives better tensile strength and Weibull modulus results.
Spaces out of reach? Service user involvement in residents’ meetings at recovery-oriented social housing facilities for young people with mental health disorders
Authors: Steno Anne Mia , Jønsson Alexandra Brandt Ryborg
Published: February 2022

Through anthropological fieldwork among people with severe mental health disorders, this article focuses on these service users’ interactions and relations with the professionals and with other service users at recovery-oriented housing facilities in Denmark. We discuss how recovery-oriented spaces designed for the service users may feel out of reach to them, hence making the service users feel awkward and reluctant to participate. The study shows how service users, initially recognized as “unengaged,” rather are to be understood as active actors involved in their recovery and forming social bonds. The research seeks to put forward new perspectives on recovery as a concept in psychosocial rehabilitation, arguing that recovery and healing may take up different forms in different spaces and that recognizing services users’ enactment of reluctancy and disengagements could serve as an important part of recovery work in rehabilitation.
A search for the determinants of students’ educational expectations for higher education in four European cities: The role of school SES composition and student engagement
Authors: Van den Broeck Laura , Blöndal Kristjana Stella , Elias Marina , Markussen Eifred
Published: February 2022

Social inequality in students’ educational expectations, a strong predictor of educational attainment, differs substantially between countries. Although education system characteristics are translated into school composition effects, the school level is often forgotten in comparative research. Moreover, to explain school effects, we introduce the concept of student engagement into sociological research on expectations. Results of multilevel analyses (R) on data from 7566 students in 126 high schools in four cities—Barcelona (Spain), Ghent (Belgium), Bergen (Norway), and Reykjavík (Iceland)—demonstrated positive effects of (1) SES composition, but mainly in systems with substantial school segregation, (2) behavioral and emotional engagement on expectations.
Design and motion control scheme of a new stationary trainer to perform lower limb rehabilitation therapies on hip and knee joints
Authors: Sunilkumar Parvathi , Mohan Santhakumar , Mohanta Jayant Kumar , Wenger Philippe , Rybak Larisa
Published: February 2022

Limb disability is one of the serious problems and rehabilitation of lower limb requires an assistive force to the patient. A new design for stationary trainer for performing rehabilitation therapies for lower limb at the knee as well as hip joints in the sitting/lying positions is presented in this article. A passive orthosis (similar to an exoskeleton) is suggested in this system to provide a support to lower limb of the patient. The suggested mechanism also comprises of an active Cartesian manipulator based upon a spatial three parallel prismatic–revolute–revolute–revolute kinematic arrangement to perform the required limb therapeutic motions in the transverse/horizontal/lateral and sagittal/longitudinal plane. Numerically, the usefulness of the designed stationary trainer is confirmed using computer-based simulations along with a motion control scheme by performing various clinically suggested therapeutic motion tracking (passive range of motions) tasks. The article demonstrates the accomplishment of the control scheme for various training procedures of the lower limb.
How Transformational Leadership Motivates Employee Involvement: The Roles of Psychological Safety and Traditionality
Authors: Xu Guangyi , Zeng Jianji , Wang Hongli , Qian Chen , Gu Xinran
Published: February 2022

This study aims to explore how transformational leadership affects employee job involvement. Using the cross-sectional survey method, a questionnaire survey was conducted among 205 teachers in 15 universities located in Southern China. Hierarchical regression and bootstrapping technique were combined to test the hypothesis. The results reveal that psychological safety mediates the link between transformational leadership and job involvement. Moreover, the traditionality of university teachers strengthens the effect of psychological safety on job involvement. This study expands job involvement literature by examining the integrative effects of multiple resources, and all resources are aligned to extend the pool of resources owned by university teachers. These findings also bring some enlightenment on how to motivate university teachers to engage actively in their work.
Deliberately Causing Brand Confusion: State of the (Unfair) Art
Authors: Dugar Anurag , Moorthi Y. L. R.
Published: February 2022

Brand Confusion is a time-worn yet highly relevant topic for marketers, researchers, and regulatory agencies because colossal and ever-increasing number of legal cases on brand confusion have kept them interested in it.

This study aims to provide a commentary on worldwide scientific literature on brand confusion highlighting the evolution, advances, trends, and inter-connections. For this purpose, 200 documents on brand confusion published between 1985 and 2019 have been systematically reviewed using Bibliometrix, a software based on R Studio.

This study contributes by presenting a snapshot of the extant research on brand confusion and by providing useful insights for practitioners and researchers in terms of managerial implications and directions for further research.

This is the first study to explore a wide range of global interdisciplinary scholarly work on brand confusion and its causes.
European Stroke Organisation (ESO) guidelines on mobile stroke units for prehospital stroke management
Authors: Walter Silke , Audebert Heinrich J , Katsanos Aristeidis H , Larsen Karianne , Sacco Simona , Steiner Thorsten , Turc Guillaume , Tsivgoulis Georgios
Published: February 2022

The safety and efficacy of mobile stroke units (MSUs) in prehospital stroke management has recently been investigated in different clinical studies. MSUs are ambulances equipped with a CT scanner, point-of-care lab, telemedicine and are staffed with a stroke specialised medical team. This European Stroke Organisation (ESO) guideline provides an up-to-date evidence-based recommendation to assist decision-makers in their choice on using MSUs for prehospital management of suspected stroke, which includes patients with acute ischaemic stroke (AIS), intracranial haemorrhage (ICH) and stroke mimics. The guidelines were developed according to the ESO standard operating procedure and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology. The working group identified relevant clinical questions, performed systematic reviews and aggregated data meta-analyses of the literature, assessed the quality of the available evidence and made specific recommendations. Expert consensus statements are provided where sufficient evidence was not available to provide recommendations based on the GRADE approach. We found moderate evidence for suggesting MSU management for patients with suspected stroke. The patient group diagnosed with AIS shows an improvement of functional outcomes at 90 days, reduced onset to treatment times and increased proportion receiving IVT within 60 min from onset. MSU management might be beneficial for patients with ICH as MSU management was associated with a higher proportion of ICH patients being primarily transported to tertiary care stroke centres. No safety concerns (all-cause mortality, proportion of stroke mimics treated with IVT, symptomatic intracranial bleeding and major extracranial bleeding) could be identified for all patients managed with a MSU compared to conventional care. We suggest MSU management to improve prehospital management of suspected stroke patients.
Toxicological assessment of truebroc® glucoraphanin-rich broccoli seed extract
Authors: Kruger Claire , Symonds Jennifer , Conze Dietrich
Published: February 2022

TrueBroc® Glucoraphanin-Rich Broccoli Seed Extract (TrueBroc®), is a hot water extract of Brassica oleracea var. Italica Plenck (Brassicaceae) seeds. The broccoli seeds are non-genetically modified and are tested and selected for their specific glucosinolate content. TrueBroc® contains greater than 99% of the aliphatic glucosinolate glucoraphanin and its precursor glucoerucin in the glucosinolate fraction. A battery of toxicology assays was conducted on TrueBroc® which includes in vitro and in vivo genotoxicity studies, an acute oral toxicity study in rats, a subchronic toxicology study in rats. The result from the subchronic rat study establishes a NOAEL of 1500 mg/kg/day.
Upsurge of Dengue Prevalence During the Third Wave of COVID-19 Pandemic in Bangladesh: Pouring Gasoline to Fire
Authors: Rahman Fahad Imtiaz , Ether Sadia Afruz , Islam Md. Rabiul
Published: February 2022

Recently, there has been an alarming increase in Coronavirus Disease-2019 (COVID-19) and dengue virus infection cases in Bangladesh. As the 2 viral diseases share many similar symptoms, healthcare practitioners are facing difficulty in correctly diagnosing them. Even with the help of confirmatory diagnostic tests, the misdiagnosis has been reported in several countries and cases of co-infections are also emerging. This study presents the clinical symptoms of dengue fever and COVID-19 and identifies the overlapping symptoms seen in these 2 diseases that might cause difficulty in diagnosis. We have also discussed cases of misdiagnosis and incidences of co-infection seen in other countries. Finally, we present our recommendations for preventing the surge of dengue and possible solutions for differentiating and managing these 2 diseases. Immediate measures are required from health practitioners and public health policymakers before these viral diseases spiral out of control.
Most anti-PF4 antibodies in vaccine-induced immune thrombotic thrombocytopenia are transient
Authors: Schönborn Linda , Thiele Thomas , Kaderali Lars , Günther Albrecht , Hoffmann Till , Seck Sabrina Edigna , Selleng Kathleen , Greinacher Andreas
Published: February 2022

Vaccine-induced thrombotic thrombocytopenia (VITT) is triggered by vaccination against COVID-19 with adenovirus vector vaccines (ChAdOx1 nCoV-19; Ad26.COV2-S). In this observational study, we followed VITT patients for changes in their reactivity of platelet-activating antiplatelet factor 4 (PF4) immunoglobulin G (IgG) antibodies by an anti-PF4/heparin IgG enzyme immunoassay (EIA) and a functional test for PF4-dependent, platelet-activating antibodies, and new thrombotic complications. Sixty-five VITT patients (41 females; median, 51 years; range, 18-80 years) were followed for a median of 25 weeks (range, 3-36 weeks). In 48/65 patients (73.8%; CI, 62.0% to 83.0%) the functional assay became negative. The median time to negative functional test result was 15.5 weeks (range, 5-28 weeks). In parallel, EIA optical density (OD) values decreased from median 3.12 to 1.52 (P < .0001), but seroreversion to a negative result was seen in only 14 (21.5%) patients. Five (7.5%) patients showed persistent platelet-activating antibodies and high EIA ODs for >11 weeks. None of the 29 VITT patients who received a second vaccination dose with an mRNA COVID-19 vaccine developed new thromboses or relevant increase in anti-PF4/heparin IgG EIA OD, regardless of whether PF4-dependent platelet-activating antibodies were still present. PF4-dependent platelet-activating antibodies are transient in most patients with VITT. VITT patients can safely receive a second COVID-19 mRNA-vaccine shot.
PΨFinder: a practical tool for the identification and visualization of novel pseudogenes in DNA sequencing data
Authors: Abrahamsson Sanna , Eiengård Frida , Rohlin Anna , Dávila López Marcela
Published: February 2022

Background

Processed pseudogenes (PΨgs) are disabled gene copies that are transcribed and may affect expression of paralogous genes. Moreover, their insertion in the genome can disrupt the structure or the regulatory region of a gene, affecting its expression level. These events have been identified as occurring mutations during cancer development, thus being able to identify PΨgs and their location will improve their impact on diagnostic testing, not only in cancer but also in inherited disorders.

Results

We have implemented PΨFinder (P-psy-finder), a tool that identifies PΨgs, annotates known ones and predicts their insertion site(s) in the genome. The tool screens alignment files and provides user-friendly summary reports and visualizations. To demonstrate its applicability, we scanned 218 DNA samples from patients screened for hereditary colorectal cancer. We detected 423 PΨgs distributed in 96% of the samples, comprising 7 different parent genes. Among these, we confirmed the well-known insertion site of the SMAD4-PΨg within the last intron of the SCAI gene in one sample. While for the ubiquitous CBX3-PΨg, present in 82.6% of the samples, we found it reversed inserted in the second intron of the C15ORF57 gene.

Conclusions

PΨFinder is a tool that can automatically identify novel PΨgs from DNA sequencing data and determine their location in the genome with high sensitivity (95.92%). It generates high quality figures and tables that facilitate the interpretation of the results and can guide the experimental validation. PΨFinder is a complementary analysis to any mutational screening in the identification of disease-causing mutations within cancer and other diseases.
Characteristics and outcomes of patients screened by rapid response team who transferred to the intensive care unit
Authors: Lee Song-I. , Koh Jeong Suk , Kim Yoon Joo , Kang Da Hyun , Lee Jeong Eun
Published: February 2022

Background

The utilization of a rapid response team (RRT) has influenced the clinical outcomes of patients in the general ward. However, the characteristics of RRT-screened patients who are transferred to the intensive care unit (ICU) are unknown. Therefore, the present study aimed to evaluate these factors.

Methods

We conducted a retrospective study using patient data from a tertiary medical center in Republic of Korea between January 2016 and December 2017. Multivariate logistic regression analyses were performed to assess the factors associated with the risk of in-hospital mortality.

Results

A total of 1,096 patients were included: 389 patients were transferred to the ICU, and 707 patients stayed in the ward. Patients in the ICU group were more likely to be admitted for medical reasons, hepatobiliary disease, and high heart rate. More interventions were performed, hospital stays were longer, and the 28-day and in-hospital mortality rates were higher in the ICU group than in the ward group. Multivariate logistic regression analyses showed that risk factors affecting ICU admission were higher Sequential Organ Failure Assessment (SOFA) score, National Early Warning Score (NEWS), platelet count, and lactate level. ICU transfer was not associated with in-hospital mortality.

Conclusions

Among RRT-screened patients, those with higher SOFA score, NEWS, and lactate level were more likely to be transferred to the ICU. Therefore, these patients should be closely monitored and considered for ICU transfer.
Nonthyroidal illness syndrome in acute pancreatitis patients: an 8-year cohort study
Authors: Qu Cheng , Duan Zehua , Xiao Xiaojia , Wei Mei , Gao Kun , Yu Xianqiang , Ke Lu , Tong Zhihui , Li Weiqin
Published: February 2022

Background

Nonthyroidal illness syndrome (NTIS) is common in critical illness and is associated with poor prognosis. The aim of this study was to find the prevalence, charateristics, and prognosis of NTIS and its correlation with outcomes in AP patients.

Methods

A retrospective review of AP patients with a diagnosis of NTIS from Jan 2012 to September 2020 was performed. The serum thyroidal hormone (TH) disturbances, as well as the demographic characteristics and clinical outcomes of the study patients, were collected and analyzed.

Results

Over the eight years, 183 included AP patients were diagnosed as NTIS, constituting an incidence of 64.7%. Patients with NTIS were admitted with worse condition based on the higher APACHE II score, SOFA score, Balthazar's CT score, CRP and lower albumin than euthyroid patients. Also, these patients had a longer ICU duration (3, 2–10 vs 2, 0–3, days,P = 0.039) and tended to be more likely to develop infected pancreatic necrosis (IPN) (15.3% vs 6.3%,P = 0.087) and gastrointestinal fistula (6% vs 0%,P = 0.082) than euthyroid patients. Free triiodothyronine (FT3) was found the best performance in predicting death compared by other well-recognized biomarkers.

Conclusion

NTIS is common in AP patients within 7 days after the onset of the disease. NTIS is associated with the worse characteristics at admission and poor outcome during the course. FT3 should be investigate as a potential biomarker in the prediction of death in AP patients.
Needs of family members caring for stroke survivors in china: A deductive qualitative content analysis study by using the caregiver task inventory-25
Authors: Lu Qi , Mårtensson Jan , Zhao Yue , Johansson Linda
Published: February 2022

Background

In China, family caregivers are usually the main carers of relatives after stroke due to traditional Chinese culture and the limited development of the primary healthcare system. This responsibility often results in burdens and negative health outcomes. However, family caregivers seldom receive support. To improve informal care, as well as the health and well-being of family caregivers, it is important to identify their needs.

Objective

This study aimed to deductively explore the needs of family members caring for stroke survivors in China.

Methods

Twenty-six semi-structured interviews were performed with family caregivers of stroke survivors who were selected from one city and three communities by purposive sampling. A deductive qualitative content analysis method was performed by using the Caregiver Task Inventory-25 (CTI-25), an instrument measuring the needs of family caregivers, as a framework.

Results

All subscales, as well as all belonging items in the CTI-25, were identified in the present study, meaning that the family caregivers had needs related tolearning to cope with new role, providing care according to care-receiver’s needs, managing own emotional needs, appraising supportive resources, and balancing caregiving needs and one’s own needs. Moreover, needs related to financial support, both direct and indirect, were identified but not part of the CTI-25.

Conclusion

These findings identified that family caregivers of stroke survivors in China had various needs, which is important knowledge when assessing needs and improving health care for family caregivers. Cultural adjustments and modifications should be made if CTI-25 is used in mainland China. This study also indicated a comprehensive and holistic perspective (individual, community, and social level) when identifying, assessing needs or implementing interventions to support family caregivers.
Blood culture surveillance in a secondary care hospital in Benin: epidemiology of bloodstream infection pathogens and antimicrobial resistance
Authors: Ombelet Sien , Kpossou Gutemberg , Kotchare Carine , Agbobli Esenam , Sogbo Frédéric , Massou Faridath , Lagrou Katrien , Barbé Barbara , Affolabi Dissou , Jacobs Jan
Published: February 2022

Background

Although global surveillance of antimicrobial resistance (AMR) is considered key in the containment of AMR, data from low- and middle-income countries, especially from sub-Saharan Africa, are scarce. This study describes epidemiology of bloodstream infections and antimicrobial resistance rates in a secondary care hospital in Benin.

Methods

Blood cultures were sampled, according to predefined indications, in BacT/ALERT FA Plus and PF Plus (bioMérieux, Marcy-l’Etoile, France) blood culture bottles (BCB) in a district hospital (Boko hospital) and to a lesser extent in the University hospital of Parakou. These BCB were incubated for 7 days in a standard incubator and twice daily inspected for visual signs of growth. Isolates retrieved from the BCB were processed locally and later shipped to Belgium for reference identification [matrix-assisted laser desorption/ionization time-of-flight spectrometry (MALDI-TOF)] and antibiotic susceptibility testing (disk diffusion and E-tests).

Results

From October 2017 to February 2020, 3353 BCB were sampled, corresponding to 3140 blood cultures (212 cultures consisting of  > 1 BCB) and 3082 suspected bloodstream infection (BSI) episodes. Most of these cultures (n = 2471; 78.7%) were sampled in children < 15 years of age. Pathogens were recovered from 383 (12.4%) cultures, corresponding to 381 confirmed BSI. 340 of these pathogens were available and confirmed by reference identification. The most common pathogens were Klebsiella pneumoniae (n = 53; 15.6%), Salmonella Typhi (n = 52; 15.3%) and Staphylococcus aureus (n = 46; 13.5%). AMR rates were high among Enterobacterales, with resistance to third-generation cephalosporins in 77.6% of K. pneumoniae isolates (n = 58), 12.8% of Escherichia coli isolates (n = 49) and 70.5% of Enterobacter cloacae isolates (n = 44). Carbapenemase production was detected in 2 Escherichia coli and 2 Enterobacter cloacae isolates, all of which were of the New Delhi metallo-beta lactamase type. Methicillin resistance was present in 22.4% of S. aureus isolates (n = 49).

Conclusion

Blood cultures were successfully implemented in a district hospital in Benin, especially among the pediatric patient population. Unexpectedly high rates of AMR among Gram-negative bacteria against commonly used antibiotics were found, demonstrating the clinical and scientific importance of clinical bacteriology laboratories at this level of care.
Evolution of TP53 abnormalities during CLL disease course is associated with telomere length changes
Authors: Olbertova Helena , Plevova Karla , Pavlova Sarka , Malcikova Jitka , Kotaskova Jana , Stranska Kamila , Spunarova Michaela , Trbusek Martin , Navrkalova Veronika , Dvorackova Barbara , Tom Nikola , Pal Karol , Jarosova Marie , Brychtova Yvona , Panovska Anna , Doubek Michael , Pospisilova Sarka
Published: February 2022

Background

Telomeres are protective structures at chromosome ends which shorten gradually with increasing age. In chronic lymphocytic leukemia (CLL), short telomeres have been associated with unfavorable disease outcome, but the link between clonal evolution and telomere shortening remains unresolved.

Methods

We investigated relative telomere length (RTL) in a well-characterized cohort of 198 CLL patients by qPCR and focused in detail on a subgroup 26 patients who underwent clonal evolution of TP53 mutations (evolTP53). In the evolTP53 subgroup we explored factors influencing clonal evolution and corresponding changes in telomere length through measurements of telomerase expression, lymphocyte doubling time, and BCR signaling activity.

Results

At baseline, RTL of the evolTP53 patients was scattered across the entire RTL spectrum observed in our CLL cohort. RTL changed in the follow-up samples of 16/26 (62%) evolTP53 cases, inclining to reach intermediate RTL values, i.e., longer telomeres shortened compared to baseline while shorter ones prolonged. For the first time we show that TP53 clonal shifts are linked to RTL change, including unexpected RTL prolongation. We further investigated parameters associated with RTL changes. Unstable telomeres were significantly more frequent among younger patients (P = 0.032). Shorter telomeres were associated with decreased activity of the B-cell receptor signaling components p-ERK1/2, p-ZAP-70/SYK, and p-NFκB (P = 0.04, P = 0.01, and P = 0.02, respectively).

Conclusions

Our study revealed that changes of telomere length reflect evolution in leukemic subclone proportion, and are associated with specific clinico-biological features of the explored cohort.
Healthcare professionals’ longitudinal perceptions of group phenomena as determinants of self-assessed learning in organizational communities of practice
Authors: Durand François , Richard Lucie , Beaudet Nicole , Fortin-Pellerin Laurence , Hudon Anahi Morales , Tremblay Marie-Claude
Published: February 2022

Background

Given the importance of continuous learning as a response to the increasing complexity of health care practice, there is a need to better understand what makes communities of practice in health effective at fostering learning. Despite the conceptual stance that communities of practice facilitate individual learning, the scientific literature does not offer much evidence for this. Known factors associated with the effectiveness of communities of practice – such as collaboration, psychological safety within the community, and commitment to the community – have been studied in cross-sectional qualitative designs. However, no studies to date have used a quantitative predictive design. The objective of this study is to assess how members of a community of practice perceive interactions among themselves and determine the extent to which these interactions predict self-assessed learning over time.

Methods

Data was collected using validated questionnaires from six communities of practice (N = 83) in four waves of measures over the course of 36 months and was analysed by means of General Estimating Equations. This allowed to build a longitudinal model of the associations between perceptions of collaboration, psychological safety within the community, commitment to the community and self-assessed learning over time.

Results

Perception of collaboration in the community of practice, a personal sense of psychological safety and a commitment to the community of practice are predictors longitudinally associated with self-assessed learning.

Conclusions

In terms of theory, conceptual links can be made between intensity of collaboration and learning over time in the context of a community of practice. Recent work on psychological safety suggests that it is still unclear whether psychological safety acts as a direct enhancer of learning or as a remover of barriers to learning. This study’s longitudinal results suggest that psychological safety may enhance how and to what extent professionals feel they learn over time. Commitment towards the community of practice is a strong predictor of learning over time, which hints at differential effects of affective, normative and continuance commitment. Communities of practice can therefore apply these findings by making collaboration, psychological safety, commitment and learning regular reflexive topics of discussion.
Clinical guidelines for managing hearing loss as a complication of drug-resistant tuberculosis treatment: an evaluation of implementation fidelity in Kano, Nigeria
Authors: Muhammad Sani Ibrahim , Eboreime Ejemai Amaize , Ogbonna Vivian Ifeoma , Zubairu Iliyasu , Ibisomi Latifat
Published: February 2022

Background

Nigeria has a high burden of Tuberculosis (TB) including Drug-resistant Tuberculosis (DR-TB) and hearing loss. Despite several efforts directed toward its control, many patients fail to respond to treatment, having developed DR-TB. Lack of adherence to the DR-TB guidelines/improper implementation of the guideline has been identified as one of the factors impeding on effective treatment. This study sought to measure the implementation fidelity of health workers to management guidelines for hearing loss resulting from DR-TB treatment and to identify its determinants.

Method

A questionnaire-based cross-sectional study was conducted at the Infectious Disease Hospital, Kano. Implementation fidelity of the Programmatic Management guidelines for the treatment of Drug-resistant Tuberculosis was measured under the four domains of content, coverage, duration and frequency. The determinants examined are intervention complexity, facilitation strategies, quality of delivery and participant responsiveness as proposed by the Carroll et al. framework. Other determinants used are age, sex, professional cadre and work experience of healthcare providers.

Results

The Implementation fidelity score ranged from 40 to 64% with a mean of 47.6%. Quality of delivery, intervention complexity, participants’ responsiveness, and being a medical doctor exerted a positive effect on implementation fidelity while facilitation strategy, age and work experience exerted a negative effect on implementation fidelity.

Conclusion

The implementation fidelity of management guidelines for hearing loss resulting from DR-TB treatment was low. Implementation fidelity should be assessed early and at intervals in the course of implementing the Programmatic Management of Drug-resistant Tuberculosis guideline and indeed, in the implementation of any intervention.
Xq26.3-q27.1 duplication including SOX3 gene in a Chinese boy with hypopituitarism: case report and two years treatment follow up
Authors: Du Caiqi , Wang Feiya , Li Zhuoguang , Zhang Mini , Yu Xiao , Liang Yan , Luo Xiaoping
Published: February 2022

Background

SOX3 is essential for pituitary development normally at the earliest stages of development. In humans, variants of SOX3 can cause X-linked hypopituitarism with various clinical manifestations, with or without mental retardation.

Case presentation

We present an 8-year-old Chinese patient with congenital hypopituitarism who had a 6.180 Mb duplication on Xq26.3q27.1 including SOX3, F9, and eight other contiguous genes. The main complains of the boy was short stature. His height was 90.1 cm (− 5.87SDS), weight 11.5 kg (− 5.25SDS). He developed growth hormone (GH) deficiency, cryptorchidism and low thyroid function. Pituitary magnetic resonance imaging revealed the pituitary dysplasia. After diagnosis, levothyroxine was given for one month first, and the thyroid function basically returned to normal, but the growth situation did not improve at all. Then recombinant human GH was given, his height, growth rate and height SDS were improved significantly in the 2 years follow-up. The level of height SDS improved from − 5.87 SDS before treatment to − 3.27 SDS after the first year of treatment and − 1.78 SDS after the second years of treatment. Gonadal function and long-term prognosis of the patient still need further observation and follow-up.

Conclusions

This is the first case of Chinese male patient with multiple hypophysis dysfunction caused by SOX3 duplication, which will expand the range of phenotypes observed in patients with duplication of SOX3.
Hypoxic stress disrupts HGF/Met signaling in human trophoblasts: implications for the pathogenesis of preeclampsia
Authors: Li Guanlin , Wang Yongqing , Cao Guangming , Ma Yeling , Li Yu-Xia , Zhao Yangyu , Shao Xuan , Wang Yan-Ling
Published: February 2022

Background

Preeclampsia (PE), a placenta-associated pregnancy complication, is the leading cause of maternal and perinatal morbidity and mortality. Met/Erk signaling is inhibited in the placentas of patients with early-onset preeclampsia (E-PE), but the underlying mechanisms remain elusive. In this study, the expression modes of Met and endocytic vesicles in normal and preeclamptic placentas were compared. Biotinylation internalization/recycling assays were used to measure the endocytosis of Met under hypoxia and normoxia in HTR8/SVneo cells. In addition, the expression level of Cbl, a specific E3 ligase of Met, was measured under hypoxia and normoxia, and the endocytosis of Met was studied by using confocal microscopy.

Results

We found considerable intracellular accumulation of Met, which was colocalized with caveolin-1 (CAV-1), in trophoblasts from E-PE placentas. Prolonged hypoxic stimulation led to the remarkable augmentation of CAV-1-mediated Met endocytosis in HTR8/SVneo cells. In addition, the expression of Cbl was substantially repressed by sustained hypoxia, disrupting ubiquitin degradation and the subsequent intracellular accumulation of Met in HTR8/SVneo cells. The abnormal degradation of Met hampered the ability of hepatocyte growth factor (HGF) to promote trophoblast cell invasion. In E-PE placentas, aberrant upregulation of CAV-1 and downregulation of Cbl were observed in parallel to the intracellular accumulation of Met.

Conclusions

These findings reveal that prolonged hypoxic stress induces the augmentation of endocytosis and repression of ubiquitin-mediated Met degradation, which leads to the impaired regulation of trophoblast invasion by HGF/Met signaling. These data provide novel evidence for elucidating the pathogenesis of preeclampsia, especially of the early-onset subtype.
Molecular evidence reveals thyrotropin intervention enhances the risk of developing radioiodine-refractory differentiated thyroid carcinoma
Authors: Samimi Hilda , Haghpanah Vahid
Published: February 2022

Radioiodine (RAI) is the mainstay of treatment for differentiated thyroid carcinoma (DTC) following total thyroidectomy. Nevertheless, about 5% of patients with DTC are RAI-refractory (RAI-R). Understanding the molecular mechanisms associated with DTC during progression towards RAI-R DTC, including thyroid-stimulating hormone levels, may help to explain the pathophysiology of challenging RAI-R DTC clinical cases.

Graphical Abstract
Demethylase ALKBH5 suppresses invasion of gastric cancer via PKMYT1 m6A modification
Authors: Hu Yiyang , Gong Chunli , Li Zhibin , Liu Jiao , Chen Yang , Huang Yu , Luo Qiang , Wang Sumin , Hou Yu , Yang Shiming , Xiao Yufeng
Published: February 2022

Background

Gastric cancer (GC) is one of the most pernicious tumors that seriously harm human healthcare. GC metastasis is one of the prime cause of failed cancer treatment, but correlation between N6-methyladenosine (m6A) and GC metastasis was less reported.

Methods

Methylated RNA immunoprecipitation sequencing (MeRIP-seq) of GC tissues was conducted. Quantitative real-time PCR (qRT-PCR), western blotting and immunohistochemistry (IHC) were taken to determine the expression of ALKBH5 in GC tissues and cell lines. RNA-seq together with MeRIP-qRT-PCR was used to screen the target gene of ALKBH5. RNA pulldown, mass spectrometry and RNA immunoprecipitation (RIP) were used to search the “reader” protein of target gene. The mechanism was also validated via a tail vein injection method for lung metastasis model.

Results

Decreased expression of ALKBH5 was detected in GC samples, and it was correlated with clinical tumor distal metastasis and lymph node metastasis. ALKBH5 interference promoted metastasis of GC cells and this effect was closely related to the demethylase activity of ALKBH5. PKMYT1, as a downstream target of ALKBH5, promoted invasion and migration in GC. Caused by ALKBH5 knockdown or its demethylase activity mutation, upregulated expression of PKMYT1 indicated that ALKBH5 modulates expression of PKMYT1 in an m6A-dependent manner. IGF2BP3 helped stabilize the mRNA stability of PKMYT1 via its m6A modification site.

Conclusions

This study established an ALKBH5-PKMYT1-IGF2BP3 regulation system in metastasis, representing a new therapeutic target for GC metastasis.
An invasive Haemophilus influenzae serotype b infection in an Anglo-Saxon plague victim
Authors: Guellil Meriam , Keller Marcel , Dittmar Jenna M. , Inskip Sarah A. , Cessford Craig , Solnik Anu , Kivisild Toomas , Metspalu Mait , Robb John E. , Scheib Christiana L.
Published: February 2022

Background

The human pathogenHaemophilus influenzaewas the main cause of bacterial meningitis in children and a major cause of worldwide infant mortality before the introduction of a vaccine in the 1980s. Although the occurrence of serotype b (Hib), the most virulent type ofH. influenzae, has since decreased, reports of infections with other serotypes and non-typeable strains are on the rise. While non-typeable strains have been studied in-depth, very little is known of the pathogen’s evolutionary history, and no genomes dating prior to 1940 were available.

Results

We describe a Hib genome isolated from a 6-year-old Anglo-Saxon plague victim, from approximately 540 to 550 CE, Edix Hill, England, showing signs of invasive infection on its skeleton. We find that the genome clusters in phylogenetic division II with Hib strain NCTC8468, which also caused invasive disease. While the virulence profile of our genome was distinct, its genomic similarity to NCTC8468 points to mostly clonal evolution of the clade since the 6th century. We also reconstruct a partialYersinia pestisgenome, which is likely identical to a published first plague pandemic genome of Edix Hill.

Conclusions

Our study presents the earliest genomic evidence forH. influenzae, points to the potential presence of larger genomic diversity in the phylogenetic division II serotype b clade in the past, and allows the first insights into the evolutionary history of this major human pathogen. The identification of both plague and Hib opens questions on the effect of plague in immunocompromised individuals already affected by infectious diseases.