bluuebunny/crossref_metadata_2025 huggingface dataset:
Dihydrolycorine Attenuates Cardiac Fibrosis and Dysfunction by Downregulating Runx1 following Myocardial Infarction
Authors: Ni Tingjuan , Huang Xingxiao , Pan Sunlei , Lu Zhongqiu
Published: October 2021

In spite of early interventions to treat acute myocardial infarction (MI), the occurrence of adverse cardiac remodeling following heart failure due to acute MI remains a clinical challenge. Thus, there is an increasing demand for the development of novel therapeutic agents capable of inhibiting the development of pathological ventricular remodeling. RNA‐seq data analysis of acute MI rat models from GEO revealed that Runx1 was the most differentially expressed MI‐related gene. In this study, we demonstrated that increased Runx1 expression under pathological conditions results in decreased cardiac contractile function. We identified dihydrolycorine, an alkaloid lycorine, as a promising inhibitor of Runx1. Our results showed that treatment with this drug could prevent adverse cardiac remodeling, as indicated by the downregulation of fibrotic genes using western blotting (collagen I, TGFβ, and p‐smad3), downregulation of the apoptosis gene Bax, upregulation of the apoptosis gene Bcl‐2, and improved cardiac functions, such as LVEF, LVSF, LVESD, and LVEDD. Additionally, dihydrolycorine treatment could rescue cardiomyocyte hypertrophy as demonstrated by wheat germ agglutinin staining, increased expression levels of the punctuate gap junction protein connexin 43, and decreased α‐SMA expression, resulting in cardiomyocyte fibrosis in immunofluorescence staining. Molecular docking, binding modeling, and pull‐down assays were used to identify potential dihydrolycorine‐binding sites in Runx1. When Ad‐sh‐Runx1 was transfected into hypoxia‐cardiomyocytes or injected into the hearts of MI rats, the cardioprotective effects of dihydrolycorine were abolished, and the normal electrophysiological activity of cardiomyocytes was disrupted. Taken together, the results of the present study indicate that dihydrolycorine may inhibit adverse cardiac remodeling after MI through the reduction of Runx1, suggesting that dihydrolycorine‐mediated‐Runx1 regulation might represent a novel therapeutic approach for adverse cardiac remodeling after MI.
Xingnao Jieyu Decoction Reduces Neuroinflammation through the NF-κB Pathway to Improve Poststroke Depression
Authors: Wang Dou , Li Tao , Han Xuefei , He Weiwei , Yan Yongmei
Published: October 2021

The neuroinflammatory pathway regulated by nuclear factor kappa-B (NF-κB) plays an important role in the occurrence, development, and prognosis of poststroke depression (PSD). The regulatory effect of the traditional Chinese medicine compound Xingnao Jieyu decoction (XNJY) on the NF-κB pathway of PSD is still unclear. This study aimed to observe the effect of XNJY on PSD and explore the molecular mechanism of its intervention in the NF-κB pathway. Middle cerebral artery occlusion (MCAO) and chronic unpredictable mild stress were used to establish a PSD rat model. Body mass measurement, behavioral testing, Nissl staining, ELISA, and Western blot were also performed. XNJY and fluoxetine hydrochloride (Flu) treatment of PSD model rats showed significant antidepressant effects. XNJY and Flu treatment could reduce cortical and hippocampal neuronal damage. XNJY reduced inflammation and restored the levels of IL-4, IL-10, and BDNF. In addition, XNJY showed a significant regulatory effect on the NF-κB pathway and the expression of synapse-related proteins PSD-95 and SYN. These results showed that XNJY could significantly reduce the depressive symptoms of PSD rats, and this reduction may be related to the regulation of the NF-κB signaling pathway to improve neuroinflammation and synaptic function.
Application of Thematic Context-Based Deep Learning in Foreign Language Teaching
Authors: Zhao Qinhua
Published: October 2021

Foreign language teaching is not simply the transfer of knowledge, but rather the placement of students in contexts to explore and discover problems. The thematic contexts do not exist in isolation. Teachers should adopt certain teaching strategies based on thematic contexts, rely on relevant discourse, study the discourse text, and use rich learning and activities as the driving force to highlight students’ active experience and emotional experience. In this paper, we propose an ELT (English Language Teaching) affective analysis method based on contextual classification and genetic algorithms. The method first constructs ELT topic sets and ELT topic word sets using the LDA (latent Dirichlet allocation) model, then applies genetic algorithms to each ELT topic word set one by one using ELT label data to automatically iterate the sentiment values of words in the word sets, and finally calculates the sentiment polarity of ELT texts using the sentiment values of words in the word sets. The experimental results show that the accuracy of this method improves 3.12% compared with LDA, the recall rate reaches 87.32%, and F1 reaches 73.79%, which can obtain ELT sentiment information from contextual and nonfeatured sentiment words and effectively improve the accuracy of sentiment classification.
Ferroptosis: Opportunities and Challenges in Myocardial Ischemia‐Reperfusion Injury
Authors: Zhao Wei-kun , Zhou Yao , Xu Tong-tong , Wu Qi
Published: October 2021

Ferroptosis is a newly discovered form of regulated cell death dependent on iron and reactive oxygen species (ROS). It directly or indirectly affects the activity of glutathione peroxidases (GPXs) under the induction of small molecules, causing membrane lipid peroxidation due to redox imbalances and excessive ROS accumulation, damaging the integrity of cell membranes. Ferroptosis is mainly characterized by mitochondrial shrinkage, increased density of bilayer membranes, and the accumulation of lipid peroxidation. Myocardial ischemia‐reperfusion injury (MIRI) is an unavoidable risk event for acute myocardial infarction. Ferroptosis is closely associated with MIRI, and this relationship is discussed in detail here. This review systematically summarizes the process of ferroptosis and the latest research progress on the role of ferroptosis in MIRI to provide new ideas for the prevention and treatment of MIRI.
Distinction in Prevalence of Atherosclerotic Embolic Sources in Cryptogenic Stroke With Cancer Status
Authors: Kikuno Muneaki , Ueno Yuji , Takekawa Hidehiro , Kanemaru Kodai , Shimizu Takahiro , Kuriki Ayako , Tateishi Yohei , Doijiri Ryosuke , Shimada Yoshiaki , Yamaguchi Eriko , Koga Masatoshi , Kamiya Yuki , Ihara Masafumi , Tsujino Akira , Hirata Koichi , Hasegawa Yasuhiro , Aizawa Hitoshi , Hattori Nobutaka , Urabe Takao , Suzuki Ayano , Kanamoto Tadashi , Hira Kenichiro , Hagiwara Yuta , Kurita Naohide
Published: October 2021

Background

Cerebrovascular diseases are common comorbidities in patients with cancer. Although active cancer causes ischemic stroke by multiple pathological conditions, including thromboembolism attributable to Trousseau syndrome, the relationship between stroke and inactive cancer is poorly known. The aim of this study was to elucidate the different underlying pathogeneses of cryptogenic stroke in active and inactive patients with cancer, with detailed investigation by transesophageal echocardiography.

Methods and Results

CHALLENGE ESUS/CS (Mechanisms of Embolic Stroke Clarified by Transesophageal Echocardiography for Embolic Stroke of Undetermined Source/Cryptogenic Stroke) registry is a multicenter registry including data of patients initially diagnosed as having cryptogenic stroke and undergoing transesophageal echocardiography. Patients were divided into active cancer, inactive cancer, and noncancer groups, and their clinical features were compared. Of the total 667 enrolled patients (age, 68.7±12.8 years; 455 men), 41 (6.1%) had active cancer, and 51 (7.5%) had a history of inactive cancer. On multinomial logistic regression analysis, infarctions in multiple vascular territories (odds ratio [OR], 2.73; 95% CI, 1.39–5.40) and CRP (C‐reactive protein) (OR, 1.10; 95% CI, 1.01–1.19) were independently associated with active cancer, whereas age (OR, 1.05; 95% CI, 1.01–1.08), contralateral carotid stenosis from the index stroke lesion (OR, 4.05; 95% CI, 1.60–10.27), calcification of the aortic valve (OR, 2.10; 95% CI, 1.09–4.05), and complicated lesion of the aortic arch (OR, 2.13; 95% CI, 1.11–4.10) were significantly associated with inactive cancer.

Conclusions

Patients with cancer were not rare in cryptogenic stroke. Although patients with active cancer had more multiple infarctions, patients with inactive cancer had more atherosclerotic embolic sources potentially causing arteriogenic strokes.

Registration

URL:
https://www.umin.ac.jp/ctr/
; Unique identifier: UMIN000032957.
Comparison of the FRIEND and Wasserman‐Hansen Equations in Predicting Outcomes in Heart Failure
Authors: Myers Jonathan , de Souza e Silva Christina G. , Arena Ross , Kaminsky Leonard , Christle Jeffrey W. , Busque Vincent , Ashley Euan , Moneghetti Kegan
Published: October 2021

Background

Percentage of age‐predicted peak oxygen uptake (VO
2
) achieved (ppVO
2
) has been widely used to stratify risk in patients with heart failure. However, there are limitations to traditional normal standards. We compared the recently derived FRIEND (Fitness Registry and the Importance of Exercise: A National Data Base) equation to the widely used Wasserman‐Hansen (WH) ppVO
2
equation to predict outcomes in patients with heart failure.

Methods and Results

A subgroup of 4055 heart failure patients from the FRIEND registry (mean age 53±15 years) was followed for a mean of 28±16 months. The FRIEND and WH equations along with measured peak VO
2
expressed in mL/kg
−1
per min
−1
were compared for mortality and composite cardiovascular events. ppVO
2
was higher for the FRIEND versus the WH equation (66±30% versus 58±25%;
P
<0.001). The areas under the receiver operating characteristic curves were slightly but significantly higher for the FRIEND equation for mortality (0.74 versus 0.72;
P
=0.03) and cardiac events (0.70 versus 0.68;
P
=0.008). Area under the receiver operating characteristic curve for measured peak VO
2
was 0.70 (
P
<0.001) for mortality and 0.73 (
P
<0.001) for cardiovascular events. For each 1‐SD higher ppVO
2
for the FRIEND equation, mortality was reduced by 18% (hazard ratio, 0.82; 95% CI, 0.69–0.97;
P
<0.02); for each 1‐SD higher ppVO
2
for the WH equation, the mortality was reduced by 17% (hazard ratio, 0.83; 95% CI, 0.71–0.97;
P
=0.02). The corresponding reductions in risk per 1 SD for cardiovascular events for the FRIEND and WH equations were 23 and 21%, respectively (both
P
<0.001).

Conclusions

Peak VO
2
expressed as percentage of an age‐predicted standard strongly predicts mortality and major cardiovascular events in patients with heart failure. The FRIEND registry equation exhibited test characteristics slightly superior to the commonly used WH equation.
Clinicopathologic Characteristics and Patient Outcomes of Phyllodes Tumors: A Single Institution Experience
Authors: Mohan Srivarshini Cherukupalli , Tseng Joshua , Angarita Stephanie , Marumoto Ashley , Dadmanesh Farnaz , Amersi Farin , Giuliano Armando , Chung Alice
Published: October 2021

Phyllodes tumors (PT) are rare fibroepithelial neoplasms that are classified as benign, borderline, or malignant. Patients with PT diagnosed between 2009 and 2019 were identified from a prospectively maintained single institutional database. 76 patients with PT were included; 47 (61.8%) were benign, 9 (11.8%) were borderline, and 20 (26.3%) were malignant. The mean age at diagnosis was 52. Surgical treatment of benign PT included excisional biopsy in 31 (66.0%) patients, segmental mastectomy in 15 (31.9%), and mastectomy in 1 (2.1%). Among patients with borderline PT, operative management was excisional biopsy in 4 (44.4%) and segmental mastectomy in 5 (55.6%). Of those with malignant PT, 7 (35.0%) were treated with excisional biopsy alone, 9 (45.0%) had lumpectomy (segmental mastectomy), and 4 (20.0%) underwent mastectomy. Malignant PT had a higher rate of necrosis compared to borderline or benign PT (25.0% vs 0% vs 4.3%, P = .016). Four patients had recurrent PT. Final positive margins were associated with recurrence ( P = .044). The median overall follow-up time was 86.3 months (range 1.5-1414.1 months), and no deaths occurred among patients with malignant PT. Overall, recurrence rates of PT are low but may be increased by presence of positive margins.
Aleramo’s Una donna via Ibsen’s A Doll’s House
Authors: De Francisci Enza
Published: October 2021

This article provides a detailed comparison of Henrik Ibsen's A Doll's House (1879) and Sibilla Aleramo's novel Una donna (1906), focussing specifically on the similar endings of both works where the respective protagonist walks out on her family. It begins by examining the various contexts and collaborative networks that enabled the theatre of Ibsen to travel into late nineteenth-century Italy, namely Luigi Capuana's translation of the play, Casa di bambola, and early interpretations of the lead role by Italy's star actress, Eleonora Duse. The article proceeds to offer a close reading of Casa di bambola and Una donna, elucidating how Aleramo's first-person novel is able to expand on key issues which are only dealt with briefly in Ibsen's play. In so doing, the analysis illustrates what it was about Aleramo's narrative technique which both aligns her with, but also sets her apart from, her predecessor, shedding new light on the connective associations between the two authors.
Ambulatory Care Pharmacist Perception of Formulary Medication Shortage: Tertiary Center Experience
Authors: Jaser Saud , Al Aamer Kholoud , Al Anizi Abdulaziz , Javed Nargis Begum , AL-Mohaithef Mohammed
Published: October 2021

Background: Medication shortage is a serious issue affecting public health and patient care. It causes a major burden on the medical team of a healthcare organization in the delivery of quality care. Objectives: This study aims to assess the perception of ambulatory care pharmacist about formulary medication shortage as well as to assess the rate of medication shortage and explore the highest classes of the not-available (NA) medication. Methods: A cross-sectional survey was performed to assess pharmacist perception regarding medication shortage. The data for NA medication was collected from the hospital health information system “HIS” (Best care) to investigate the type and classes of medication shortage. Results: The overall survey response rate was 92.7%. The majority (61%) of participants encountered 5 to 15 labels of NA medication per day, 43% of participants encountered unpleasant behavior from patients usually due to NA medication and the main reason of patient dissatisfaction was the negative effect of NA medication on their course of therapy. Ninety-seven percent of participants agreed that medication shortage adds extra pressure/workload and 66% agreed that medication shortage increases the chance of medication error. A total of 113 medication shortage was recorded between January and March 2020. The 2 drug classes, which showed maximum shortage, were gastrointestinal and cardiovascular medications. The most prevalent type of medication shortage was for drugs administered by oral route (91.2%). Conclusions: The study provides insights into the frequency, management, and problems confronted due to medication shortage from the pharmacist perception. The study findings highlight the classes and type of medication shortage in the hospital which needs intervention to enhance patient care. The findings of the study would help the higher administration to implement an effective strategy to mitigate the shortage of medication, improve patient satisfaction, and to reduce pharmacist workload.
Genome-wide Gene-by-Sex Interaction Studies Identify Novel Nonsyndromic Orofacial Clefts Risk Locus
Authors: Awotoye W. , Comnick C. , Pendleton C. , Zeng E. , Alade A. , Mossey P.A. , Gowans L.J.J. , Eshete M.A. , Adeyemo W.L. , Naicker T. , Adeleke C. , Busch T. , Li M. , Petrin A. , Olotu J. , Hassan M. , Pape J. , Miller S.E. , Donkor P. , Anand D. , Lachke S.A. , Marazita M.L. , Adeyemo A.A. , Murray J.C. , Albokhari D. , Sobreira N. , Butali A.
Published: October 2021

Risk loci identified through genome-wide association studies have explained about 25% of the phenotypic variations in nonsyndromic orofacial clefts (nsOFCs) on the liability scale. Despite the notable sex differences in the incidences of the different cleft types, investigation of loci for sex-specific effects has been understudied. To explore the sex-specific effects in genetic etiology of nsOFCs, we conducted a genome-wide gene × sex (GxSex) interaction study in a sub-Saharan African orofacial cleft cohort. The sample included 1,019 nonsyndromic orofacial cleft cases (814 cleft lip with or without cleft palate and 205 cleft palate only) and 2,159 controls recruited from 3 sites (Ethiopia, Ghana, and Nigeria). An additive logistic model was used to examine the joint effects of the genotype and GxSex interaction. Furthermore, we examined loci with suggestive significance ( P < 1E-5) in the additive model for the effect of the GxSex interaction only. We identified a novel risk locus on chromosome 8p22 with genome-wide significant joint and GxSex interaction effects (rs2720555, p2df = 1.16E-08, pGxSex = 1.49E-09, odds ratio [OR] = 0.44, 95% CI = 0.34 to 0.57). For males, the risk of cleft lip with or without cleft palate at this locus decreases with additional copies of the minor allele ( p < 0.0001, OR = 0.60, 95% CI = 0.48 to 0.74), but the effect is reversed for females ( p = 0.0004, OR = 1.36, 95% CI = 1.15 to 1.60). We replicated the female-specific effect of this locus in an independent cohort ( p = 0.037, OR = 1.30, 95% CI = 1.02 to 1.65), but no significant effect was found for the males ( p = 0.29, OR = 0.86, 95% CI = 0.65 to 1.14). This locus is in topologically associating domain with craniofacially expressed and enriched genes during embryonic development. Rare coding mutations of some of these genes were identified in nsOFC cohorts through whole exome sequencing analysis. Our study is additional proof that genome-wide GxSex interaction analysis provides an opportunity for novel findings of loci and genes that contribute to the risk of nsOFCs.
A Pair of “ACEs”
Authors: Hersh E.V. , Wolff M. , Moore P.A. , Theken K.N. , Daniell H.
Published: October 2021

The emergence of the COVID-19 viral pandemic has generated a renewed interest in pharmacologic agents that target the renin angiotensin system (RAS). Angiotensin-converting enzyme 1 (ACE1) inhibitors decrease the synthesis of angiotensin II (Ang II) from its precursor angiotensin I and inhibit the breakdown of bradykinin, while Ang II receptor blockers antagonize the action of Ang II at the receptor level downstream. The actions of both classes of drugs lead to vasodilation, a blunting of sympathetic drive and a reduction in aldosterone release, all beneficial effects in hypertension and congestive heart failure. ACE2 cleaves the vasoconstrictor Ang II to produce the anti-inflammatory cytoprotective angiotensin 1–7 (Ang 1–7) peptide, which functions through the G protein–coupled receptor MAS to counteract the pathophysiologic effects induced by Ang II via its receptors, including vasoconstriction, inflammation, hypercoagulation, and fibrosis. SARS-CoV-2 enters human cells by binding ACE2 on the cell surface, decreases ACE2 activity, competes for ACE2 receptor-binding sites, and shifts the RAS toward an overexpression of Ang II, accounting for many of the deleterious effects of the virus. Thus, there is great interest in developing recombinant ACE2 as a therapeutic for prevention or treatment of COVID-19. Notably, ACE2 is highly expressed in the oral cavity, and saliva and dorsum of the tongue are major reservoirs of SARS-CoV-2. Cost-effective methods to debulk the virus in the oral cavity may aid in the prevention of viral spread. Here we review the pharmacology of targeted small molecule inhibitors of the RAS and discuss novel approaches to employing ACE2 as a therapeutic for COVID-19.
Promoting Ethics Management Strategies in the Public Sector: Rules, Values, and Inclusion in Sweden
Authors: Andersson Staffan , Ekelund Helena
Published: October 2021

This article studies two Swedish organizations with key roles in the facilitation and promotion of ethics management vis-à-vis other public-sector organizations. The study offers insights into how organizations combine and prioritize ethics management measures, involve submanagement employees, and consider external stakeholders, in contexts of democratic governance and public concern about corruption. Our findings suggest that these types of bird’s-eye view organizations studied are important as they are in a position less prone to ad hoc scandal-driven responses. They can thus promote strategies that consider a combination of aspects and avoid a narrow rules-based focus.
New results on stability and L1-gain characterization for switched positive systems: A persistent dwell time approach
Authors: Liu Jiao , Kang Le
Published: October 2021

This paper is concerned with the problem of stability and L1-gain characterization for a class of switched positive systems consisting of both stable and unstable subsystems. Such systems can be modeled ingeniously as switched positive systems satisfying persistent dwell time switching. Compared to the widely used dwell time and average dwell time switching in the previous literature, persistent dwell time switching is more general due to its covering such two switchings as special cases. A new sufficient criterion ensuring the stability of switched positive systems is derived by using a persistent dwell time approach. And then an unweighted L1-gain is computed by solving a linear programming problem. The presented method in this paper may decrease the conservatism. Finally, the effectiveness and advantage of the provided method are illustrated with an example.
Shell bead crafting at Greater Cahokia
Authors: Kozuch Laura
Published: October 2021

Shell beads were important to Mississippians, and thousands of beads were found mostly associated with burials. Here I synthesize data on shell bead workshops from Greater Cahokia, along with crafting techniques. Different bead types required different tools, which, in conjunction with shell remains, allow the differentiation of columella versus disk bead workshops. Perishable drill tips were probably used. Bead size standardization is distinguished from craft specialization, and time spent on crafting indicates full-time specialists. Expeditions to get lightning whelk shells from the Gulf of Mexico were a part of the operational chain. The resources spent traveling to obtain shells, large workshop areas, time spent crafting beads, ethnohistoric accounts of shell barter, and the roles lightning whelk artifacts had/have in helping souls travel during liminal situations such as transitioning to death, all underscore the importance of Mississippian shell beads.
Informational development: A new form of human development in future society
Authors: Da Kaiyan
Published: October 2021

This paper aims to propose a new form of human development: informational development. Informational development, different from traditional human development, focuses on understanding, interpreting, and promoting human development in terms of information and informational relations. “Informational” here is not only a word denoting something related to data in information science & library science, but also a state, a way, or a form of human development opposing to “material”. According to the Chinese philosophy of information, all things are composed of matter and information, so there are two forms of human development, i.e., material development and informational development accordingly, but we have never noticed the informational development before. In this paper, I have provided the philosophical arguments for informational development in five aspects, including ontology, epistemology, evolution theory, thinking theory, and value theory. The conclusion of the paper is, informational development is a new form of human development, which is suitable for humans to survive and develop in the future society, so we should focus on the informational changes, examine the informational contents, and grasp the informational state of human development, and understand, interpret, and promote human development in terms of information and informational relations, thus finally achieving the free, all-round, and sustainable development of all humans.
Successful application of extracorporeal circulation compression perfusion in the treatment of diabetic foot: a retrospective cross-sectional study
Authors: Gao Lei , Li Tianbo , Wang Shuo , Wang Jiangning
Published: October 2021

Objective

To investigate the clinical effect of extracorporeal circulation compression perfusion (ECCP) in the treatment of diabetic foot.

Methods

We retrospectively evaluated 89 patients with diabetic foot admitted from January 2017 to April 2019. The patients were grouped according to whether they received ECCP treatment; experimental group: 27 patients, controls: 62 patients. After applying the inclusion criteria and exclusion criteria, there were 21 patients in the experimental group and 21 patients in the control group. Foot microcirculation was evaluated by measuring the percutaneous oxygen partial pressure (TcPO2) and infrared thermography (IRT). Wound healing time and ulcer recurrence rate 1 year after discharge were compared between the groups.

Results

TcPO2 and IRT values in the experimental group differed significantly compared with the control group. Foot ulcer healing time in the experimental group was shorter than that in the control group (17.10 ± 3.08 days vs 25.38 ± 4.40 days, respectively), and the recurrence rate after 1 year in the experimental group was lower than that in the control group (2/21, 9.5% vs 9/21, 42.8%, respectively).

Conclusion

ECCP improved foot microcirculatory perfusion in diabetic foot treatment. ECCP has clinical practicality and may accelerate wound healing speed and reduce ulcer recurrence.
Effect of dynamic stratified potassium supplementation in elderly patients with chronic heart failure and moderate to severe hypokalaemia—a randomised, controlled trial
Authors: Zheng Tuokang , Wang Jia , Meng Qingbing , Zhang Rui , Ma Yu , Dong Yanling , Jin Yingli , Gao Hengbo , Yao Dongqi , Tian Yingping
Published: October 2021

Objective

To compare the effectiveness of dynamic stratified potassium supplementation at high concentrations with enteral potassium supplementation in older patients with chronic heart failure and moderate to severe hypokalaemia.

Methods

We performed a single-centre, short-term, randomised, controlled, open-labelled, clinical trial, and patients were randomly allocated to the control or intervention group. The intervention group received intermittent infusions of 30 mmol/100 mL potassium chloride. In the control group, 10% potassium chloride was administered orally in a bolus dose. Short-term efficacy and adverse events were compared.

Results

The intervention group received less potassium than that in the control group. T-wave normalisation and U-wave disappearance occurred sooner in the intervention group than in the control group after potassium supplementation. The rate of increase in potassium concentrations gradually became similar in both groups. The initial blood potassium concentration, method of potassium supplementation, potassium supplement dose, and 24-hour urinary potassium excretion significantly affected the rate of increase in blood potassium concentrations after supplementation.

Conclusions

The efficacy of enteral potassium supplementation is equivalent to that of supplementation with high intravenous potassium concentrations in elderly patients with chronic heart failure and moderate to severe hypokalaemia. High intravenous potassium concentrations may lead to a superior potassium recovery rate.
Novel Approach for Design of Merging and Diverging Length at Toll Plazas: A Case Study
Authors: Bari Chintaman , Chandra Satish , Dhamaniya Ashish , Navandar Yogeshwar
Published: October 2021

Traffic operations at toll plazas are influenced by the merging and diverging behavior of vehicles near the toll plaza in the flare area. Proper guidelines for the design of merging and diverging sections at toll plazas under mixed traffic conditions are not specified by the Indian Highway Capacity Manual, the Indian Road Congress, or the American Association of State Highway and Transportation Officials. Thus, the present study attempts to develop design criteria for diverging and merging lengths. The field data were collected using the performance-box instrument at Ghoti toll plaza located at National Highway No. 60 in India, operating under mixed traffic conditions. The concept of discretization of speed profile is proposed and applied to segregate sections of the zone of influence into ten equal parts each of 50 m length. The statistical test shows that speed has a significant difference between the sections and also in between the different classes of vehicle. Results of the speed-distance plot show that the second-degree polynomial function is the best fit for zone of deceleration and power function for the zone of acceleration. The study revealed that, for 50 km/h approach speed, the minimum diverging and merging distances should be 125.67–308.98 m and 47.93–294.23 m, respectively. The proposed guidelines for merging and diverging length are useful for the design of the flare area and to improve operational efficiency and level of service at toll plazas operating under mixed traffic conditions.
Living a Calling During COVID-19: A Resource Gain Perspective
Authors: Terry Jeffrey Drake , Cigularov Konstantin P.
Published: October 2021

Massive disruptions to work and threats to employee well-being due to the coronavirus disease 2019 (COVID-19) pandemic have highlighted the need to identify resources which enable employees to gain other valuable resources. Using a resource gain perspective, we examined the role of living a calling as a potentially robust resource, enabling employees to gain work readiness during the COVID-19 pandemic, and, in turn, resulting in a greater well-being in the form of lower job strain. Using a sample of clergy ( N = 216) from various denominations, we provide initial evidence that living a calling may be associated with lower levels of job strain through increased COVID-19 work readiness. This study underscores the relevance of living a calling in a time of high potential or actual loss of resources.
Transit intestinal: Tactical mobility and the Parisian netherworld in Raymond Queneau's Zazie dans le métro
Authors: Yoshioka-Maxwell Livi
Published: October 2021

This article draws on Michel de Certeau's notion of tactical resistance to examine the practices of reading and of using urban space in Raymond Queneau's Zazie dans le métro. Departing from formalist approaches that frame Queneau's Paris as a ‘construction verbale,’ I offer a historically situated analysis of the novel's representation of post-war Paris, demonstrating that the theme of semiotic instability, frequently explored in studies of the novel, reflects not only the author's preoccupations with language but also the social and cultural upheavals of its historical moment. The article first examines the Parisian metro's status as a uniquely legible site in the chaotic urban landscape of Zazie dans le métro in relation to the conflicting images of the metro as alternately a hellscape and a refuge in the post-war period. The article then shifts the usual critical focus on the eponymous Zazie's anarchic adventures on the city's surface to explore the transgressive détournements of subterranean urban space performed by a range of characters seeking to resist the dominant social order. The article closes with a discussion of underground Paris as a zone of ambiguity that eschews simple truths and rigid categories of identity.
Methods for modelling excess mortality across England during the COVID-19 pandemic
Authors: Barnard Sharmani , Chiavenna Chiara , Fox Sebastian , Charlett Andre , Waller Zachary , Andrews Nick , Goldblatt Peter , Burton Paul , De Angelis Daniela
Published: October 2021

Excess mortality is an important measure of the scale of the coronavirus-2019 pandemic. It includes both deaths caused directly by the pandemic, and deaths caused by the unintended consequences of containment such as delays to accessing care or postponements of healthcare provision in the population. In 2020 and 2021, in England, multiple groups have produced measures of excess mortality during the pandemic. This paper describes the data and methods used in five different approaches to estimating excess mortality and compares their estimates.

The fundamental principles of estimating excess mortality are described, as well as the key commonalities and differences between five approaches. Two of these are based on the date of registration: a quasi-Poisson model with offset and a 5-year average; and three are based on date of occurrence: a Poisson model without offset, the European monitoring of excess mortality model and a synthetic controls model. Comparisons between estimates of excess mortality are made for the period March 2020 through March 2021 and for the two waves of the pandemic that occur within that time-period.

Model estimates are strikingly similar during the first wave of the pandemic though larger differences are observed during the second wave. Models that adjusted for reduced circulation of winter infection produced higher estimates of excess compared with those that did not. Models that do not adjust for reduced circulation of winter infection captured the effect of reduced winter illness as a result of mobility restrictions during the period. None of the estimates captured mortality displacement and therefore may underestimate excess at the current time, though the extent to which this has occurred is not yet identified. Models use different approaches to address variation in data availability and stakeholder requirements of the measure. Variation between estimates reflects differences in the date of interest, population denominators and parameters in the model relating to seasonality and trend.
Impact of coronavirus of 2019 on the delivery of pharmacy services to patients with cancer: An international survey of oncology pharmacy practitioners
Authors: Chazan Grace , Jupp Jennifer , Bauters Tiene , Duncan Nick , Weddle Kellie Jones , Nomura Hisanaga , O’Connor Shaun , Chan Alexandre , Alkhudair Nora , Alshamrani Majed , Buie Larry W , Chambers Pinkie , Chieh Tan Wen , DeRemer David L , Duvivier France , Katabalo Deogratias , McFarlane Thomas , Mckavanagh Daniel , Mensah Kofi , Martinez Estela Moreno , Rowan Gail , Sae-teaw Manit , Tadesse Tamrat Assefa , Weru Irene , Alexander Marliese
Published: October 2021

Introduction

The coronavirus of 2019 pandemic has necessitated vast and rapid changes in the way oncology pharmacy services are delivered around the world.

Methods/aims

An international survey of oncology pharmacists and technicians was conducted via the International Society of Oncology Pharmacy Practitioners and collaborating global pharmacy organisations to determine the impact that the coronavirus of 2019 has had on pharmacy service delivery, pharmacy practitioners and oncology practice.

Results

The survey received 862 responses from 40 different countries from September to October 2020. The majority of respondents were pharmacists ( n = 841, 97.6%), with 24% involved in the direct care of patients with the coronavirus of 2019. Of the survey participants, 55% increased their time working remotely, with remote activities including dispensing, patient assessment/follow-up and attending multi-disciplinary rounds. Respondents reported a 72% increase in the use of technology to perform remote patient interaction activities and that participation in educational meetings and quality improvement projects was reduced by 68% and 44%, respectively. Workforce impacts included altered working hours (50%), cancelled leave (48%) and forced leave/furloughing (30%). During the pandemic, respondents reported reduced access to intensive care (19%) and anti-cancer (15%) medications. In addition, 39% of respondents reported reduced access to personal protective equipment, including N95 masks for chemotherapy compounding. Almost half of respondents (49%) reported that cancer treatments were delayed or intervals were altered for patients being treated with curative intent. A third of practitioners (30%) believed that patient outcomes would be adversely impacted by changes to pharmacy services. Sixty-five percent of respondents reported impacts on their mental health, with 12% utilising support services.

Conclusion

The coronavirus of 2019 pandemic has altered the way oncology pharmacy services are delivered. These results demonstrate the adaptability of the oncology pharmacy profession and highlight the importance of formal evaluation of the varied practice models to determine the evidence-based practices that enhance pharmacy services and, thus, should be reinstated as soon as practical and reasonable.
Personalized Remote Mobile Surveys of Adult ADHD Symptoms and Function: A Pilot Study of Usability and Utility for Pharmacology Monitoring
Authors: Surman Craig , Boland Heidi , Kaufman Daniel , DiSalvo Maura
Published: October 2021

Objective:

Validate the usability and treatment-sensitivity of a remote SMS-based ADHD monitoring method.

Method:

206 adults taking stimulants for ADHD participated. Participants selected ADHD symptoms and functional impairments that they anticipated to be stimulant-sensitive, which were rated via mobile messages up to 20 times over 10 days.

Results:

A majority of participants found it only somewhat or not at all difficult to identify an ADHD symptom sensitive to presence of stimulant medication, and 79% responded to at least one survey message. As expected, a majority of participants endorsed it was “easy” to participate, and less burdensome than a paper diary. Surveys significantly discriminated between on and off medication states, both between days, and within the same day.

Conclusion:

Our findings suggest SMS-based monitoring of patient-selected ADHD-related challenges is both feasible and sensitive to stimulant treatment. This remote assay method may be a meaningful adjunct to in-visit treatment monitoring
Networks of ADHD and SCT Symptoms in Emerging Adulthood
Authors: Lee Christine A. , Goh Patrick K. , Shelton Christopher R. , Hartung Cynthia M.
Published: October 2021

Objective:

Emerging adulthood (18–25 years) is a transitional and understudied developmental period. Yet, little is known about how specific symptoms of ADHD, as well as those from the related SCT domain, may differentially relate to one another during this period, if there are differences based on biological sex, or how closely results will align with adulthood.

Methods:

We used network analysis techniques to explore the structure of ADHD and SCT symptoms within emerging adulthood, with additional comparisons between sexes as well as between emerging adulthood and adulthood. Using an online platform, 8,506 adults reported on their symptoms of ADHD and SCT.

Results:

Symptoms grouped together within their respective domains during emerging adulthood with no significant differences in overall network structure between sexes. Similarly, network structure appeared to be robust across emerging adulthood and adulthood.

Conclusion:

Such consistency supports a conceptualization of ADHD in emerging adulthood as similar to adulthood.
Assessment of the MAGIC recommendations in context of evolving evidence based on the use of PICC in ICU
Authors: Pinelli Fulvio , Little Andrew , Kokotis Kathy , Alsbrooks Kim , Pittiruti Mauro
Published: October 2021

The goal of the 2015 Michigan Appropriateness Guide for Intravenous Catheters (MAGIC) was to define indications and appropriate practices for peripherally inserted central catheters (PICC) use; however, MAGIC recommendations virtually reduced the use of PICC in hospital settings, including critical care. The aim of this review is to present an assessment of the MAGIC guidelines, considering contemporary evidence to date. The validity of the MAGIC recommendations and their applicability to current practice are called into question given important concerns with the methodology for their development (e.g. high volume of clinical scenarios for evaluation) and the supporting evidence used. There is a considerable amount of contemporary evidence not considered in MAGIC that reports on evolving practices, techniques, and technologies targeted to reduce complications associated with central venous access devices (CVADs). Recent evidence dictates that CVADs are necessary in the intensive care unit (ICU), and that PICCs are a safe, reliable, and appropriate type of central lines, which cannot be replaced in several ICU situations. In light of evolving evidence and practice, as well as the methodological concerns identified, the MAGIC guidelines should be revisited. It is also recommended to create a clinical assessment tool that identifies potential uses of specific CVADs, based on patient needs. The choice of the CVAD should be based on unique clinical considerations and current scientific evidence, not on fears informed by antiquated data.
Deliberate training and incidental learning through the Autobiography of Intercultural Encounters through Visual Media: Capitalising on a European tool to enhance visual literacy and intercultural dialogue globally
Authors: Méndez-García María-del-Carmen , Cores-Bilbao Esther
Published: October 2021

This article addresses visual literacy as a crucial competence for fostering intercultural literacy and intercultural dialogue. Visual literacy has been defined as a combination of skills needed to interpret the meaning of images, latent reasons behind their making and their impact on audiences. Individuals need to develop such skills to critically read the ‘vocabulary’ (content) and ‘grammar’ (composition) of images they are constantly flooded with to fully understand and appreciate the underlying meaning of visual representations of their own culture and other cultures, as well as the people belonging to different cultural groups. The Council of Europe’s Autobiography of Intercultural Encounters through Visual Media (AIEVM) has been designed to promote interculturality through the reflection on the other, as portrayed in visuals. By analysing AIEVMs produced by 18 adult learners of English in two contexts – featuring explicit intercultural training prior to AIEVM completion vs. its application without such previous input – the present study examines the impact of pertinent training in visual and intercultural competence development. The data suggest heightened levels of metacognition and critical thinking in the former context. Results for both groups also disclose the development of a powerful sense of self-discovery and empathy toward alterity, induced by the commonalities detected between the respondents themselves and the depicted. Overall, implementing the AIEVM seems to narrow the gap between the intercultural awareness discerned in both contexts, yet the dissimilar depth of the narratives produced corroborates the value of prior intercultural learning. The article concludes with a critical overview of the potential of the AIEVM, comprising prospective courses of action to supplement this instrument to sharpen users’ visual literacy and boost deeper intercultural reflection.
Cultural communication style and international joint venture contract length
Authors: Velez-Calle Andres , Sosa Santiago , Large Joshua
Published: October 2021

Purpose: Culturally bound communication styles affect the length of verbal and written messages. Legal contracts are no exception. This paper aims to explore the relationship between cultural communication style and the level of written detail in international joint venture (IJV) contracts. Using a database of actual IJV contracts, we empirically test the relationship between the parties’ cultural communication styles, cultural distance, and the textual length of contracts. We apply Edward T. Hall’s high- and low-context communication construct and find that contracts are longer when made between parties of low- and high-context cultures and shorter when both parties come from high-context cultures relative to when both parties are low context. Additionally, we find that the higher the cultural distance in terms of individualism versus collectivism between partners, the shorter the text of the contracts. The results highlight the influence of culture on contract text length and, as such, on contract negotiation and design costs. This article contributes to the culture and strategic alliance literature by going beyond the assumption that low-context culture contracts are longer and high-context culture contracts shorter by testing it empirically.
Cronenberg pedagogy and fleshy possibilities for educational futures
Authors: Sojot Amy N
Published: October 2021

Instead of seeking the slick aesthetics of consumer-friendly creative stories, this paper ventures to the sublime of the incomprehensible and invites us to look into the abyss of education’s possibilities. Drawing inspiration from Jeff Vandermeer’s 2017 novel, Borne, and filmmaker David Cronenberg’s aesthetic, this paper aims to tell a story that unfetters easily compartmentalized notions of creativity in education. Borne tells the story of a young female scavenger who finds and proceeds to care for a sentient—and quite vocally curious—experimental biotech remain, while Cronenberg’s films famously bridge science fiction and body horror. Popular culture, in identifying this aesthetic, developed the slang term “to Cronenberg,” meaning to affectively highlight exaggerated mutations. To this end, this paper explores specific questions for educational futures: what does creativity mean for a Cronenberg pedagogy and how does the ethics of creativity inform future educational policy directions?
Cyber-Victimization and Its Effect on Depression in Adolescents: A Systematic Review and Meta-Analysis
Authors: Tran Huong Giang Nguyen , Thai Truc Thanh , Dang Ngan Thien Thi , Vo Duy Kim , Duong Mai Huynh Thi
Published: October 2021

The difference in participants’ characteristics between samples and the inconsistency in the methodology have led to variability in both direction and magnitude of association between cyber-victimization and depression in adolescents. This systematic review and meta-analysis investigates the relationship between cyber-victimization and depression in adolescents. Primary studies on cyber-victimization and depression among adolescents (10–19 years of age based on WHO definition) on PubMed and EMBASE databases were included. The forward and backward snowballing searching method was also used to explore more publications. The main effect estimate extracted from eligible studies was the odds ratio which was synthesized based on the random-effect model. The protocol of this study was prospectively registered on PROSPERO database (registration number: CRD42020185700). Among 1,008 research articles identified, 17 were eligible which comprised a total sample of 79,202 adolescents. The odds of depression among cyber-victims was almost three-fold higher (OR = 2.73; 95% CI 2.25–3.31) compared to non–cyber-victims. The overall effect estimate remained positive irrespective of differences in sample and method characteristics (study location, female percentage, sampling procedures, the use of single vs. multiple items, and elaboration of cyber-bullying definition). The presence of traditional bullying items was found to be important moderator of this relationship. However, none of the anticipated moderators had a clear impact on this relationship. Moreover, absence of publication bias was confirmed. This study confirms findings from the literature about the significant association between cyber-victimization and depression in adolescents across settings and populations. More efforts should be made to address this issue rigorously and to a greater extent.