bluuebunny/crossref_metadata_2025 huggingface dataset:
Using Institutional Ethnography to Explicate the Everyday Realities of Nurses’ Work in Labor and Delivery
Authors: Kelly Paula , Quance Maggie , Snow Nicole , Porr Caroline
Published: November 2022

Fetal health surveillance is a significant everyday work responsibility for labor and delivery nurses. Here, nursing care is increasingly focused on technological interventions, particularly with the use of continuous electronic fetal monitoring. Using Institutional Ethnography, we explored how nurses conduct this work and uncovered the ruling relations coordinating how nurses “do” fetal health surveillance. Analysis revealed how these powerful ruling relations associated with the biomedical and medical-legal discourses coordinated nurses’ fetal monitoring work. Forms requiring documentation of biophysical data caused nurses to focus on technological interventions with much less attention given to holistic and supportive care measures. In doing so, nurses inadvertently activated and participated in these powerful ruling discourses. The practice of ensuring the safe birth of the baby through advances in technological surveillance and medical interventions took priority over well-established approaches to holistic nursing care.
Prepandemic and Pandemic Marriages among Same-Sex and Different-Sex Couples
Authors: Julian Christopher A. , Manning Wendy D. , Westrick-Payne Krista K. , Carlson Lisa
Published: November 2022

Most states experienced declines in marriages during the pandemic, with variation across states. Given that marriages to same-sex couples make up a small share of total marriages, these trends are overwhelmingly representative of marriages of different-sex couples. To test if the decline observed among marriages of different-sex couples is also observed among marriages of same-sex couples, the authors calculated ratios (2020 marriage count divided by 2019 marriage count) for 13 states, disaggregating marriages of same- and different-sex couples. The 13 states selected were the only states in which same-sex marriage administrative data were available. The results reveal disparate effects of the pandemic on marriage counts for same-sex and different-sex couples. For 11 of the states examined, marriages of same-sex couples either did not decline or declined less than marriages of different-sex couples. Further investigation is warranted as more state-level data on same-sex marriage become available.
University Diversity Projects and the Inclusivity Challenge
Authors: Ovink Sarah M. , Murrell Ocqua Gerlyn
Published: November 2022

Growing numbers of women; Black, Indigenous, and People of Color; and low-income/first-in-family students attend U.S. colleges. Although sought after by universities eager to establish diverse campuses, many minoritized students still report ambivalence about inclusion at predominantly White institutions (PWIs). Like many PWIs, Meadow State University (MSU) promotes commitment to diversity, equity, and inclusion (DEI). Yet little is known about how students perceive institutions’ DEI-related efforts. The authors conducted focus groups with 144 undergraduates to identify students’ perspectives on what MSU is attempting and accomplishing in pursuing DEI goals. The authors find that MSU’s goals encompass a set of loosely connected policies, practices, and behaviors they term diversity projects. The authors reveal gaps between MSU’s intentions in providing institution-led diversity projects and respondents’ perceptions of them, highlighting their largely symbolic nature. Students advocating for an institutional responsibility for inclusion stressed requests for concrete, student-led diversity projects that fulfill expressed needs, particularly for minoritized students.
Improving executive compensation in the fossil fuel sector to influence green behaviors
Authors: Crichton Rohan , Shrivastava Paul , Walker Thomas , Farhidi Faraz , Weeratunga Vindhya , Renwick Douglas
Published: November 2022

The effects of climate change are being felt around the world, and the calls to mitigate are growing louder. In hopes of responding to this call, we examine strategic compensation practices as innovative solutions for tackling climate change. We employ a fixed panel analysis and examine organizational data from an array of global fossil fuel organizations—arguably the principal climate change contributors. Our findings suggest that executive stock-option compensation oriented around a 3-year or more vesting period will enhance organizational green behaviors. The contributions of this study add to the green human resource management literature in offering new perspectives on how compensation practices can enhance green behaviors and clarify key misconceptions related to linking sustainability targets to firm-level compensation schemes.
The veil of transparency: Blockchain and sustainability governance in global supply chains
Authors: Bernards Nick , Campbell-Verduyn Malcolm , Rodima-Taylor Daivi
Published: November 2022

This article interrogates the turn towards digital technologies for addressing sustainability challenges in global supply chains. Focusing on the case of blockchains, we assess industry claims that this set of distributed ledger technologies for undertaking, verifying, and publishing digital transactions provides the greater transparency necessary to resolve sustainability challenges. Our central contention is that blockchain-based initiatives to promote sustainability in global supply chains double-down on modes of third-party audit and disclosure governance that have thus far failed to address labour and environmental abuses. The turn towards these digital technologies, we show, extends interlinked processes of managerialization and the spread of ‘audit culture’ in the governance of global supply chains. These tendencies heighten obstacles to enhancing sustainability across global supply chains, exacerbating the very challenges blockchain initiatives are ostensibly meant to address. Worse than not fundamentally addressing sustainability problems, applications of this set of ‘sustech’ render failures to address sustainability abuses more opaque. The technological novelty of blockchain helps to construct what we call a ‘veil of transparency’ over sustainability abuses and marginalities in and across global supply chains.
Feasibility assessment of solar photovoltaic deployments on building surfaces with the constraint of visual impacts
Authors: Zheng He , Wu Bo , Lin Hui , Jia Junsong , Wei Heyi
Published: November 2022

As a major component of social acceptance, visual impact is often considered a significant constraint in solar applications. Visual impact assessment of solar applications, however, has been limited to pedestrians in previous studies. The extent to which PV systems can have visual impacts on occupants and whether it is necessary to include occupants in the measurement of visual impact remains uncertain. To fill this gap, we extended it from pedestrians to occupants and proposed a quantitative method to integrate pedestrians and occupants into a framework, combining the estimation of solar potential for the feasibility assessment of PV applications in a built environment. The concept is tested with a real case, located in Qingdao city, China, to present the technical flowchart for the feasibility assessment of solar PV deployments with the visual constraint. Building surfaces with qualified solar irradiation and low visibility were identified and compared in two cases, that is, with and without the inclusion of occupants as the visual constraint. The comparison results show that the change of suitable building surfaces for solar applications is 172,306 m2 (21% of suitable area) and 126 GWh (19% of yield energy) across the study area, indicating the significance of including occupants in the visibility assessment for the deployment of solar applications. The proposed method considers the visual constraint for the feasibility assessment of solar applications from the perspective of pedestrians and occupants, and it is helpful to identify the suitable surfaces for the large-scale deployment of solar applications at an early planning stage of solar city.
Association of Preoperative Opioid Use With Postoperative Opioid Use and Patient-Reported Outcomes in Ankle Fracture Fixation Patients
Authors: Reiners Nicholas , Vang Sandy , Rivard Rachael , Bostrom Nicholas , Nguyen Mai P.
Published: November 2022

Background:

Ankle fracture surgery is a common procedure with many patients receiving opioid medications for postoperative pain control. Whether there are factors associated with higher medication quantities or patient-reported outcomes, however, remains largely unknown.

Methods:

Patients with isolated, rotational ankle fractures who underwent surgical fixation between January 2018 and March 2020 were retrospectively reviewed. Patient demographics, injury characteristics, and preoperative and postoperative opioid prescription information were recorded. Clinical follow-up and Foot and Ankle Ability Measure (FAAM) questionnaires were collected at 6 weeks and 3 months postoperatively. Multiple linear regression was used to examine the influences of age, sex, body mass index (BMI), fracture characteristics, medical comorbidities, and preoperative opioid use (OU) on postoperative opioid morphine milligram equivalent (MME) amount and FAAM scores.

Results:

A total of 294 patients were included with an average age of 52.11 ± 17.13 years (range, 18-97). Fracture types were proportional to one another. Chronic pain (mean = 145.89, 95% CI = 36.72, 255.05, P = .0009), preoperative OU (mean = 178.22, 95% CI = 47.46, 308.99, P = .0077), psychiatric diagnoses (mean = 143.81, 95% CI = 58.37, 229.26, P = .001), tobacco use (mean = 137.37, 95% CI = 33.35, 229.26, P = .0098), and trimalleolar fractures (mean = 184.83, 95% CI = 86.82, 282.84, P = .0002) were associated with higher postoperative opioid MME amounts. Older age (mean = ‒0.05, 95% CI = ‒0.08, –0.02, P = .0014) and higher BMI (mean = ‒0.06, 95% CI = ‒0.12, 0.00, P = .048) were both independently associated with lower FAAM scores at 6 weeks. At 3 months, higher BMI (mean = ‒0.09, 95% CI = ‒0.13, –0.04, P = .0002), bimalleolar fractures (mean = ‒1.17, 95% CI = ‒2.17, –0.18, P = .021), and higher postoperative MME amounts (mean = ‒0.10, 95% CI = ‒0.19, –0.01, P = .0256) were each independently associated with lower FAAM scores.

Conclusion:

In this study, we found that patients with chronic pain, preoperative OU, psychiatric diagnoses, tobacco use, and trimalleolar fractures were more likely to have higher amounts of opioid prescribed following ankle fracture surgery. However, only age, BMI, bimalleolar fractures, and postoperative MME amount were associated with lower FAAM scores postoperatively.

Level of Evidence:

Level III, retrospective cohort study.
The Role of Probiotics as an Adjunctive Therapy in Psoriasis
Authors: Gilli Isadora O. , da Silva Gabriela C. , Mendes Victoria , Duarte Marcella G. , Tanaka Anber A.
Published: November 2022

Background

During the past decades, several unconventional strategies for controlling chronic inflammatory diseases, including psoriasis, have been developed. The use of probiotics has been gaining importance as an adjuvant therapy in the treatment of these pathologies.

Objectives

Evaluate the impact of the use of the Lactobacillus rhamnosus probiotic strain in patients diagnosed with common and palmoplantar psoriasis.

Methods

35 patients were randomly divided into two groups: 18 using probiotics and 17 using placebo. They were evaluated on days 0 and 60, with photographic records of lesions, IL17 and IL23 quantification and calculations of Psoriasis Area Severity Index (PASI), Body Surface Area (BSA) and Dermatology Life Quality Index (DLQI) clinical evaluation scores.

Results

There was significative improvement in the clinical presentation and a reduction in the index of all clinical scores (PASI from 4.53 ± 4.457 to 3.57 ± 3.333, BSA from 5.44 ± 6.451 to 4.94 ± 5.961 and DLQI from 8.83 ± 8.631 to 7 ± 7.814, in the probiotic group.) However, there was no reduction in the quantification of IL23 and IL17. Adverse events related to the use of probiotics were minimal.

Conclusions

There was a Positive correlation between the use of probiotics and improvement of clinical aspects and clinical scores of disease severity, not associated with reduction in interleukins 17 and 23 blood levels.
Influenza vaccination coverage rates and other related factors in high-risk groups in Birjand, East of Iran
Authors: Ebrahimzadeh Azadeh , Bijari Bita , Azarnoosh Amin , Shakhs Emampour Fatemeh
Published: November 2022

Background and Aims:

Influenza is an acute respiratory disease with the highest mortality rate in the high-risk groups. Vaccination is a key public health strategy to prevent influenza in high-risk people. This study aimed to assess the influenza vaccination coverage rate and identify its demographic determinants in patients with end-stage renal disease (ESRD), chronic obstructive pulmonary disease (COPD), and diabetes in Birjand, Eastern Iran.

Methods:

This cross-sectional study included 400 patients (300 diabetic, 60 dialysis, and 40 COPD patients) from September 2017 to August 2018. Using interview method, we completed a questionnaire containing the patients’ demographic characteristics, questions about patients’ knowledge and attitude toward influenza vaccination, the influenza vaccination history, and the most common causes for vaccination. The relationship between the type of disease and patients’ characteristics (exposure) with vaccination coverage (outcome) was investigated.

Results:

The mean age of participants was 58.7 ± 11.3 years. Also, 58.8% of the patients received at least one dose of the vaccine and the regular injection rate was 32.8%. The coverage of influenza vaccine in dialysis patients was significantly higher than other patients ( p < 0.001). The mean knowledge score was 6.17 ± 2.15 out of maximum 9 scores. There was a positive association between age [ p = 0.001, odds ratio (OR) = 1.04] and patients’ knowledge ( p < 0.001, OR = 1.42) with the vaccination coverage.

Conclusion:

The coverage of influenza vaccine in high-risk patients in Birjand was low. Hence, it is essential to increase the knowledge of high-risk groups about the importance of influenza vaccination and facilitate their access to vaccines.
The Primary Prevention of Female Sexual Offending: Current Opportunities
Authors: Grant Jennifer
Published: November 2022

A public health approach to the primary prevention of sexual offending has generated positive outcomes. Recent campaigns have challenged societal stereotypes of sexual offenders; changed organizational policies and increased public knowledge. However, primary prevention has largely been missing for female sexual offenders. This is because female sexual abuse has generated much less attention than its male equivalent. To introduce relevant context, this article initially presents a short literature review. This aims to critically explore the extent of the issue and what motivates relevant women. Typologies are then applied to introduce the distinctions between solo offenders and co-offenders. This distinction is utilized to consider how primary prevention could address female sexual offending. Two key themes emerge in terms of societal stereotypes and key offending spaces. The current evidence highlights the need to challenge societal norms, which minimize women’s propensity to commit sexual offences. It also appears significant to challenge stereotypes, which glorify attractive women who sexually abuse adolescent males. The opportunities within institutional spaces and the domestic setting are also considered, with deliberation to targeting relevant professionals and guardians in future primary prevention efforts.
The Epidemiology of Surgically Managed Hiatal Hernia: A Nine Year Review of National Trends
Authors: Till Brian M. , Mack Shale J. , Whitehorn Gregory , Collins Micaela Langille , Yang Chi-Fu Jeffrey , Grenda Tyler , Evans Nathaniel R. , Okusanya Olugbenga
Published: November 2022

Background:

National-level data on the burden of disease related to surgically managed hiatal hernia (HH) is not available. This study intends to define this burden of disease in the United States with attention to patient demographics, surgical approach, readmissions, mortality, and charges.

Methods:

Data from national Healthcare Utilization Project (HCUP) databases for 2010-2018 were retrospectively reviewed. Adult patients undergoing elective or emergent non-congenital diaphragmatic hernia repair were included. Spearman’s rank correlation was utilized to determine significance of trends over time.

Results:

In 2018, an estimated 62 528 HH repairs were performed, an incidence of 19.14/100 000 persons per year. The non-ambulatory procedure incidence was 7.52/100 000 persons in 2010 compared to 12.76/100 000 persons in 2018. Between the first and final years of analysis, patients undergoing non-elective repairs increased in age (2010: 62 years vs 2018: 69 years, P < .01) and frailty (4.9% vs 16.3%, P < .01). Rates of 30-day readmission remained similar for elective (6.5% vs 5.7%, P = .06) and non-elective operations (9.9% vs 9.5%, P = .71). In-hospital mortality increased for elective repairs (0.3% vs 0.6%, P < .01). In the final year of analysis, median charges were: Ambulatory: $37 864 versus Elective laparoscopic: $54 377 versus Elective Open: $73 436 versus Non-elective Laparoscopic: $85 906, versus Non-elective Open: $117 845, and total annual healthcare charges were $4.28 billion.

Conclusions:

Incidence of HH repair and charges increased over the study period. The proportion of frail patients undergoing elective and non-elective repairs increased. Changes in the incidence of underlying disease, patient perceptions and symptom tolerance, or surgeon decision-making may have contributed to these trends.
Supporting All Students to Be Self-Determined: Using the Self-Determined Learning Model of Instruction Within Multi-Tiered Systems of Supports
Authors: Raley Sheida K. , Hagiwara Mayumi , Burke Kathryn M. , Kiblen Jessie C. , Shogren Karrie A.
Published: November 2022

Opportunities for youth with and without disabilities to develop and practice abilities, skills, and attitudes associated with self-determination (e.g., decision-making, goal setting, problem-solving) lead to positive in- and postschool outcomes. However, implementation of whole-school interventions to promote self-determination is complex. A multi-tiered systems of supports (MTSSs) framework can support the identification of solutions to address these complexities to positively impact self-determination outcomes for all students, inclusive of students with extensive support needs (ESNs). In this article, we describe how an evidence-based intervention, the Self-Determined Learning Model of Instruction (SDLMI), can be provided through MTSS to support all students in becoming more self-determined. We translate research into practice by describing how to use universal screening data collected using validated self-determination assessment to guide the delivery of impactful self-determination intervention using the SDLMI across tiers of support in inclusive contexts to enhance self-determination for all students, including students with ESN.
The relationship between clinical measures of cognitive function and grip strength in healthy older adults
Authors: Richardson James K. , Ellmers Toby J.
Published: November 2022

Background

Handgrip strength is considered a surrogate for musculoskeletal strength, however there is emerging evidence of an association with cognition. The specific neurocognitive attribute which best associates with grip strength is unknown.

Methods

We performed a secondary analysis on baseline data in 49 healthy older adults. Grip strength was corrected for body mass index. Control independent variables included age, Montreal Cognitive Assessment, and Trails B. Experimental variables included a clinical measure of simple reaction time, and clinical and computerized go/no-go tasks. The clinical Go/No-Go measure was determined with ReacStick, a rod-shaped device which – when released by the examiner – requires the participant to decide within 390 ms whether to catch the device or let it fall to the ground.

Results

Bivariate analysis demonstrated that age and all cognitive measures other than the computer go/no-go response accuracy related to grip strength. Multivariate analyses showed that following inclusion of the control variables, only ReacStick measures (reaction accuracy/simple reaction time) significantly predicted grip strength, explaining an additional 15.90% variance (p = 0.026). In contrast, computerized Go/No-Go accuracy (p = 0.391), response time variability (p = 0.463), and the control variables (p value range = 0.566–0.942) did not predict grip strength.

Conclusion

A short latency (< 390 ms) visuomotor Go/No-Go task independently predicted over 15% of grip strength variance, whereas a slower screen-based Go/No-Go task did not. These findings support the notion that declining grip strength likely reflects sub-clinical brain changes as well as musculoskeletal dysfunction, possibly explaining the potent relationships between grip strength, disability, chronic disease, and mortality.
A general framework for selecting work participation outcomes in intervention studies among persons with health problems: a concept paper
Authors: Ravinskaya Margarita , Verbeek Jos H. , Langendam Miranda W. , Madan Ira , Verstappen Suzanne M. M. , Kunz Regina , Hulshof Carel T. J. , Hoving Jan L.
Published: November 2022

Background

Work participation is important for health and can be considered as engagement in a major area of life which is of significance for most people, but it can also be thought of as fulfilling or discharging a role. Currently, academic research lacks a comprehensive classification of work participation outcomes. The International Classification of Functioning is the foremost model in defining work functioning and its counterpart work disability, but it does not provide a critical (core) set of outcomes. Standardizing the definitions and nomenclature used in the research of work participation would ensure that the outcomes of studies are comparable, and practitioners and guideline developers can better decide what works best. As work participation is a broad umbrella term including outcome categories which need unambiguous differentiation, a framework needs to be developed first.

Aim

To propose a framework which can be used to develop a generic core outcome set for work participation.

Methods

First, we performed a systematic literature search on the concept of (work) participation, views on how to measure it, and on existing classifications for outcome measurements. Next, we derived criteria for the framework and proposed a framework based on the criteria. Last, we applied the framework to six case studies as a proof of concept.

Results

Our literature search provided 2106 hits and we selected 59 studies for full-text analysis. Based on the literature and the developed criteria we propose four overarching outcome categories: (1) initiating employment, (2) having employment, (3) increasing or maintaining productivity at work, and (4) return to employment. These categories appeared feasible in our proof-of-concept assessment with six different case studies.

Conclusion

We propose to use the framework for work participation outcomes to develop a core outcome set for intervention studies to improve work participation.
Willingness of patients with cancer pain to participate in end-of-life decisions: a multi-center cross-sectional study from three coastal provinces in southern China
Authors: Ke Xi , Zhu Hongyu , Zhang Yu , Yang Ling , Shi Simei , Zhu Fang , Luo Huiyu
Published: November 2022

Background

Little is known about patients’ intention for participation in end-of-life decisions (EOLD) in three coastal provinces in southern China. This study aimed to explore the willingness of patients with cancer pain to participate in EOLD and potential influencing factors.

Methods

A multi-center cross-sectional study was performed in three coastal provinces in southern China. Two hundred and thirty patients with cancer pain were recruited and consented to fill out the questionnaires. The patients’ willingness to participate in EOLD, demographic and disease-related data was surveyed.

Results

In total, 223 patients completed and returned the survey (response rate = 96.95%). One hundred four cases (46.64%) were willing to participate in EOLD. 119 (54.36%) cases not willing to participate in EOLD, respectively. Multivariate logistic regression analysis shows that educational level (OR: 0.683, 95% CI: 0.482–0.966), history of alcoholism (OR: 8.353, 95%CI: 2.535–27.525), Eastern Cooperative Oncology Group (ECOG) score (OR: 0.645, 95% CI: 0.450–0.925) and experience of explosive pain (OR: 6.367, 95% CI: 3.103–13.062) and clinical rescue (OR: 3.844, 95% CI: 1.722–8.577) had significant effects on EOLD intention (P <  0.05). Finally, a predictive model combined above five factors was established, which showed a good discrimination (area under receiver operating characteristic curve: 0.849, 95% CI: 0.796–0.899, P <  0.001) and calibration (Hosmer-Lemeshow Test: Chi-square = 10.103, P = 0.258) for which patients more willing to participate in EOLD.

Conclusions

The willingness of patients with cancer pain to participate in EOLD is at a modest level in three coastal provinces in southern China. Patients with lower educational level, history of alcoholism, better health status and experience of explosive pain and clinical rescue may be more prone to participate in EOLD.
Machine learning model identifies aggressive acute pancreatitis within 48 h of admission: a large retrospective study
Authors: Yuan Lei , Ji Mengyao , Wang Shuo , Wen Xinyu , Huang Pingxiao , Shen Lei , Xu Jun
Published: November 2022

Background

Acute pancreatitis (AP) with critical illness is linked to increased morbidity and mortality. Current risk scores to identify high-risk AP patients have certain limitations.

Objective

To develop and validate a machine learning tool within 48 h after admission for predicting which patients with AP will develop critical illness based on ubiquitously available clinical, laboratory, and radiologic variables.

Methods

5460 AP patients were enrolled. Clinical, laboratory, and imaging variables were collected within 48 h after hospital admission. Least Absolute Shrinkage Selection Operator with bootstrap method was employed to select the most informative variables. Five different machine learning models were constructed to predictive likelihood of critical illness, and the optimal model (APCU) was selected. External cohort was used to validate APCU. APCU and other risk scores were compared using multivariate analysis. Models were evaluated by area under the curve (AUC). The decision curve analysis was employed to evaluate the standardized net benefit.

Results

Xgboost was constructed and selected as APCU, involving age, comorbid disease, mental status, pulmonary infiltrates, procalcitonin (PCT), neutrophil percentage (Neu%), ALT/AST, ratio of albumin and globulin, cholinesterase, Urea, Glu, AST and serum total cholesterol. The APCU performed excellently in discriminating AP risk in internal cohort (AUC = 0.95) and external cohort (AUC = 0.873). The APCU was significant for biliogenic AP (OR = 4.25 [2.08–8.72], P < 0.001), alcoholic AP (OR = 3.60 [1.67–7.72], P = 0.001), hyperlipidemic AP (OR = 2.63 [1.28–5.37], P = 0.008) and tumor AP (OR = 4.57 [2.14–9.72], P < 0.001). APCU yielded the highest clinical net benefit, comparatively.

Conclusion

Machine learning tool based on ubiquitously available clinical variables accurately predicts the development of AP, optimizing the management of AP.
LncRNA-mRNA co-expression analysis revealed 8 core lncRNAs in rheumatoid arthritis of collagen-induced arthritis rats
Authors: Wen Yuqi , He Cailin , Wang Yang , Zeng Siqin , Yang Bo , Xiong Xingui
Published: November 2022

Backgrounds

Rheumatoid arthritis (RA) is a chronic inflammatory and autoimmune disease. Current studies suggest that long noncoding RNAs (lncRNAs) may be key regulators in pathogenesis.

Methods

Analyzed lncRNAs and mRNAs using microarrays to find key differentially expressed lncRNAs in RA. GO and KEGG enrichment analysis together with coding non-coding co-expression (CNC) network was used for comprehensive analysis. Verify that their expression levels are consistent with the chip results by qRT-PCR.

Results

There are 268 differentially expressed lncRNAs (DELs) and 286 differentially expressed mRNAs (DEMs). We found 8 core lncRNAs through the CNC network. Eight highly significantly differentially expressed lncRNAs corrected with microarray profiles. The functions and associated pathways of significantly differentially expressed lncRNAs were predicted by GO and KEGG analysis. They may be involved in the pathogenesis of RA.

Conclusion

The differential expression profiles of lncRNAs and mRNAs in the collagen-induced arthritis rat model preliminarily predicted functions through comprehensive analysis. However, its exact role and specific mechanism remain to be further studied.
Genome-wide methylation profiling identify hypermethylated HOXL subclass genes as potential markers for esophageal squamous cell carcinoma detection
Authors: Yu Qiuning , Xia Namei , Zhao Yanteng , Jin Huifang , Chen Renyin , Ye Fanglei , Chen Liyinghui , Xie Ying , Wan Kangkang , Zhou Jun , Zhou Dihan , Lv Xianping
Published: November 2022

Background

Numerous studies have revealed aberrant DNA methylation in esophageal squamous cell carcinoma (ESCC). However, they often focused on the partial genome, which resulted in an inadequate understanding of the shaped methylation features and the lack of available methylation markers for this disease.

Methods

The current study investigated the methylation profiles between ESCC and paired normal samples using whole-genome bisulfite sequencing (WGBS) data and obtained a group of differentially methylated CpGs (DMC), differentially methylated regions (DMR), and differentially methylated genes (DMG). The DMGs were then verified in independent datasets and Sanger sequencing in our custom samples. Finally, we attempted to evaluate the performance of these genes as methylation markers for the classification of ESCC.

Results

We obtained 438,558 DMCs, 15,462 DMRs, and 1568 DMGs. The four significantly enriched gene families of DMGs were CD molecules, NKL subclass, HOXL subclass, and Zinc finger C2H2-type. The HOXL subclass homeobox genes were observed extensively hypermethylated in ESCC. The HOXL-score estimated by HOXC10 and HOXD1 methylation, whose methylation status were then confirmed by sanger sequencing in our custom ESCC samples, showed good ability in discriminating ESCC from normal samples.

Conclusions

We observed widespread hypomethylation events in ESCC, and the hypermethylated HOXL subclass homeobox genes presented promising applications for the early detection of esophageal squamous cell carcinoma.
Rectal carcinoma with dual differentiation toward enteroblastic and neuroendocrine features arising in a patient with ulcerative colitis: a case report
Authors: Kihara Takako , Kuwahara Ryuichi , Kusunoki Kurando , Minagawa Tomohiro , Horio Yuki , Uchino Motoi , Ikeuchi Hiroki , Hirota Seiichi
Published: November 2022

Background

Colorectal carcinoma with enteroblastic differentiation is a rare subtype of colorectal carcinomas expressing at least one characteristic immunohistochemical marker among α-fetoprotein, glypican-3, and spalt-like transcription factor 4. On the other hand, colorectal carcinoma with neuroendocrine differentiation is also a unique subtype of colorectal carcinomas showing expression of at least one distinctive marker among chromogranin A, synaptophysin, and CD56.

Case presentation

We experienced an extremely rare case of rectal carcinoma with dual differentiation toward enteroblastic and neuroendocrine features in a 53-year-old male patient with long-standing ulcerative colitis (UC). Most of the tumor cells were positive for enteroblastic differentiation markers and approximately a half of them for neuroendocrine differentiation markers. Some tumor cells showed only enteroblastic differentiation, and some did only neuroendocrine feature, but some showed both enteroblastic and neuroendocrine differentiation.

Conclusion

Colorectal carcinoma with dual differentiation toward enteroblastic and neuroendocrine features has not been reported yet. Neoplastic transformation from pluripotent stem cells in dysplastic epithelium of long-standing UC patients may be associated with such dual differentiation features.
Primary ectopic breast carcinoma: a case report
Authors: Achouri Leila , Jellali Amani , Henchiri Houda , Boukhris Sabrine , Zaaimi Yosra , Mansouri Houyem , Mahjoub Najet
Published: November 2022

Background

Ectopic breast tissue is present in 2–6% of women. Ectopic mammary tissue can experience physiological changes and the same pathological processes as the eutopic breast. Ectopic breast cancer represents an uncommon condition accounting for 0.3% of all breast neoplasms, and it is most frequently located in the axilla.

Case report

We report a rare case of a 57-year-old Tunisian woman who presented with a left-sided axillary mass evolving for about 1 month. The axillary ectopic breast tissue containing the mass was excised with axillary dissection. Pathology revealed a medullary multifocal carcinoma and metastasis was detected in two lymph nodes. She had local radiotherapy after six cycles of chemotherapy. She received herceptin therapy and hormonotherapy. After a 2-year follow-up, no evidence of local recurrence or distant metastases have been identified.

Conclusion

Ectopic breast carcinoma is a rare entity that should be the first diagnosis to be considered if an axillary lump is present in ectopic breast tissue. No particular guidelines on diagnosis and treatment are available. Therefore, physicians should be aware of this condition to avoid treatment delays. Once diagnosed, careful patient follow-up is essential because of the ambiguous natural history of this rare entity.
Efficacy and safety of blood derivatives therapy in Alzheimer’s disease: a systematic review and meta-analysis
Authors: Fei Zhangcheng , Pan Bo , Pei Renjun , Chen Zhongsheng , Du Xi , Cao Haijun , Li Changqing
Published: November 2022

Background

Blood derivatives therapy is a conventional clinical treatment, while the treatment for Alzheimer’s disease (AD) is relatively novel. To provide clinical references for treating AD, this meta-analysis was performed to evaluate the efficacy and safety of blood derivatives therapy on the patients with AD.

Methods

A systematic articles search was performed for eligible studies published up to December 6, 2021 through the PubMed, Embase, Cochrane library,ClinicalTrials.gov, Chinese National Knowledge Infrastructure database, and Wanfang databases. The included articles were screened by using rigorous inclusion and exclusion criteria. Study selection and data-extraction were performed by two authors independently. Random effects model or fixed effects model was used. Quality of studies and risk of bias were evaluated according to the Cochrane risk of bias tool. All analyses were conducted using Review Manager 5.4. The study was designed and conducted according to the Preferring Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline.

Results

A total of three plasma administrations (two plasma exchange and one young plasma infusion) and five intravenous immunoglobulin (IVIG) randomized controlled trials with a sample size of 1148 subjects diagnosed with AD were included. There was no significant difference in cognitive improvement and all-cause discontinuation between intervention and placebo groups (RR 1.10, 95% CI 0.79–1.54). And Intervention groups showed not a statistically significant improvement in cognition of included subjects measured by the ADAS-Cog (MD 0.36, 95% CI 0.87–1.59), ADCS-ADL (MD −1.34, 95% CI − 5.01–2.32) and NPI (MD 2.20, 95% CI 0.07–4.32) score compared to the control groups. IVIG is well tolerated for AD patients even under the maximum dose (0.4 g/kg), but it is inferior to placebo in Neuropsychiatric Inventory scale in AD patients (MD 2.19, 95% CI 0.02–4.37).

Conclusions

The benefits of blood derivatives therapy for AD are limited. It is necessary to perform well-designed randomized controlled trials with large sample sizes focusing on the appropriate blood derivatives for the specific AD sub-populations in the future.

Systematic review registration

PROSPERO CRD42021233886
Timing matters: age-dependent impacts of the social environment and host selection on the avian gut microbiota
Authors: Maraci Öncü , Antonatou-Papaioannou Anna , Jünemann Sebastian , Engel Kathrin , Castillo-Gutiérrez Omar , Busche Tobias , Kalinowski Jörn , Caspers Barbara A.
Published: November 2022

Background

The establishment of the gut microbiota in early life is a critical process that influences the development and fitness of vertebrates. However, the relative influence of transmission from the early social environment and host selection throughout host ontogeny remains understudied, particularly in avian species. We conducted conspecific and heterospecific cross-fostering experiments in zebra finches (Taeniopygia guttata) and Bengalese finches (Lonchura striata domestica) under controlled conditions and repeatedly sampled the faecal microbiota of these birds over the first 3 months of life. We thus documented the development of the gut microbiota and characterised the relative impacts of the early social environment and host selection due to species-specific characteristics and individual genetic backgrounds across ontogeny by using 16S ribosomal RNA gene sequencing.

Results

The taxonomic composition and community structure of the gut microbiota changed across ontogenetic stages; juvenile zebra finches exhibited higher alpha diversity than adults at the post-breeding stage. Furthermore, in early development, the microbial communities of juveniles raised by conspecific and heterospecific foster parents resembled those of their foster family, emphasising the importance of the social environment. In later stages, the social environment continued to influence the gut microbiota, but host selection increased in importance.

Conclusions

We provided a baseline description of the developmental succession of gut microbiota in zebra finches and Bengalese finches, which is a necessary first step for understanding the impact of the early gut microbiota on host fitness. Furthermore, for the first time in avian species, we showed that the relative strengths of the two forces that shape the establishment and maintenance of the gut microbiota (i.e. host selection and dispersal from the social environment) change during development, with host selection increasing in importance. This finding should be considered when experimentally manipulating the early-life gut microbiota. Our findings also provide new insights into the mechanisms of host selection.
Development of a patient-led clinic visit framework: a case study navigating a patient’s journey for rheumatology outpatient clinic consultations in England and Wales
Authors: Oyebanjo Sarah , Amlani-Hatcher Paul , Williams Ruth , Stevens Roger , Esterine Tom , Wilkins Kate , Jacklin Clare , Hamilton Jill , Fairfax Rosie , Lempp Heidi
Published: November 2022

Background

Involving patients and members of the public in healthcare planning is beneficial for many reasons including that the outcomes focus on topics relevant to service users. The National Early Inflammatory Arthritis Audit (NEIAA) aims to improve care quality for patients with inflammatory arthritis.

Case study

This paper presents a case study detailing how the NEIAA Patient Panel worked with NEIAA governance groups, the National Rheumatoid Arthritis Society and the National Axial Spondyloarthritis Society to co-create an outpatient clinic visit framework for rheumatology professionals. A framework was co-created, divided into nine sections: pre-appointment preparation, waiting area (face-to-face appointments), face-to-face consultations, physical examination, establishing a forward plan, post consultation, annual holistic reviews, virtual appointments and key considerations. Providing insight into how the multi-disciplinary team can meet the diverse needs of patients with inflammatory arthritis, this framework now informs the teaching content about people who live with physical and mental disability for Year 3 and 4 undergraduate medical students at King’s College London.

Conclusion

Patients play an important role in helping to address gaps in health service provision in England/Wales. The co-production of a clinic visit framework, informed by their own lived experience and their own expectations can lead to improved and relevant outcomes for the benefit of patients and raises awareness to medical students what matters to patients with physical disabilities when attending outpatient care.
TNM Staging and Overall Survival in Patients With Pheochromocytoma and Sympathetic Paraganglioma
Authors: Jimenez Camilo , Ma Junsheng , Roman Gonzalez Alejandro , Varghese Jeena , Zhang Miao , Perrier Nancy , Habra Mouhammed Amir , Graham Paul , Waguespack Steven G
Published: November 2022

Context

Pheochromocytomas and paragangliomas (PPGL) are rare neuroendocrine tumors. Metastases develop in 15% to 20%. The American Joint Committee on Cancer (AJCC) established inaugural guidelines for PPGL tumor-node-metastasis (TNM) staging.

Objective

The objective of this analysis is to investigate the associations between TNM staging and overall survival (OS).

Methods

We retrospectively applied the TNM staging at the time of diagnosis of the primary tumor. The primary outcome was OS. Unadjusted survival rates were estimated by the Kaplan–Meier method. Cox proportional hazards regression models were used to evaluate the associations between OS and covariates of interest.

Results

The study included 458 patients. Median OS was 18.0 (95% CI, 15.6-not reached) years. At diagnosis, 126 (27.5%) tumors were stage I, 213 (46.5%) were stage II, 47 (10.3%) were stage III, and 72 (15.7%) were stage IV. The 10-year OS probabilities were 0.844 (95% CI, 0.768-0.928) for patients with stage I tumors, 0.792 (95% CI, 0.726-0.865) for stage II, 0.595 (95% CI, 0.435-0.813) for stage III, and 0.221 (95% CI, 0.127-0.384) for stage IV. Compared with stage I, the hazard ratios (HR) for death were 1.50 (0.87-2.57) for stage II, 2.85 (1.45-5.63) for stage III, and 8.88 (5.16-15.29) for stage IV (P < 0.001). Compared with patients with no germline mutations, those with RET 634/918 had better OS (HR: 0.28; 95% CI, 0.12-0.69). Other germline mutations, including SDHB, did not exhibit worse OS than patients with metastasis and sporadic disease.

Conclusion

OS rates correlated with the recently developed AJCC TNM staging and were not worse in hereditary disease. Stage IV disease exhibited a significantly shorter OS compared with stages I-III. Future staging systems could be adjusted to better separate stages I and II.
Developing dispute resolution policy for conflicts settlement in public-private partnership (PPP) projects in educational institutions
Authors: Oyeyoade Stephen
Published: November 2022

Background: United Nations Educational, Scientific and Cultural Organization (UNESCO) advocates a 15-20% allocation of the developing nations’ annual budget to educational development, but the available resources are not adequate to support the sector in the global south. Thus, University Hostel Development and Management (UHDM) policy was selected to attract private investors for the provision of educational facilities in Nigerian public universities. The policy considered a public-private partnership (PPP) model to ameliorate the menace of dilapidated infrastructures. Initially, there was massive investors’ participation until contractual disputes started to undermine the success recorded. Therefore, incessant disputes without resourceful resolutions motivate the need to examine this policy and spot the gaps for necessary improvement.

Policy: The National Universities Commission (NUC) augments the provision of infrastructure in Nigerian public universities through the UHDM initiative in 2004. Conflicts owing to the multiplicity of stakeholders’ contrasting interests overwhelmed the initiative. Many value-added projects were terminated. The poor condition of facilities lingers to serve as a basic factor for half-baked graduates, low employee productivity and declined socio-economic values of the nation. This brief focuses on the role of formal dispute resolution mechanisms (DRMs) for conflict management in PPP arrangements. By observation, stakeholders rarely envisage potential conflicts, thus, no contemplation of specific DRMs adoption despite the inevitability of contractual disputes.

Recommendations: This brief recommends the inclusion of the dispute resolution policy in the PPP Memorandum of Understanding (MoU). Recommendations are hereby generated from the analysis of the stakeholders’ opinions on the causes of the dispute, conflict prevention strategies, and the relevant dispute resolution mechanisms peculiar to the PPP contracts in educational institutions. Also, ambiguities in the policy that bordered on an inexplicit institutional framework, lack of PPP experts’ involvement, imperfect contract agreement, and deficiency of feasibility study, are resolved by the recommendations.