bluuebunny/crossref_metadata_2025 huggingface dataset:
Developing multiple perspectives by eliding agreement: A conversation analysis of Open Dialogue reflections
Authors: Ong Ben , Barnes Scott , Buus Niels
Published: August 2021

Open Dialogue is an approach to working with mental health problems that emphasises promoting dialogue between multiple perspectives within an individual person and between all the people present, including the therapists. Therapists’ own perspectives are often introduced during conversations called reflections, which present a potential source of different perspectives. Using conversation analysis we analysed 14 hours of video-recorded Open Dialogue sessions with a focus on therapists’ reflections. We noticed that therapists did not display explicit agreement with each other’s reflections. This absence of explicit agreement was displayed through a variety of verbal and non-verbal forms. Eliding agreement facilitated deference to the epistemic authority of the client, assertion of epistemic rights from second position, emphasis of a positive perspective or to voice multiple perspectives. Therapists avoided consensus and thus presented multiple perspectives to the family while also attending to issues of contingency. The implications of epistemic primacy and asymmetry connected to sequential structures in talk pose a challenge to the generation of collaborative reflective dialogues.
Kontrpropaganda today: The roots of RT’s defensive practices and countering ethic
Authors: Kuznetsova Elizaveta
Published: August 2021

This article argues that the institutional practices and journalistic ethics on RT, formerly Russia Today, have been influenced by the Soviet kontrpropaganda tradition, a defence mechanism against anti-communist narratives. RT’s post-Soviet institutional structure has enabled the continuation of inherently ‘defensive’ practices in a way that they form a ‘countering’ ethic on the network. While kontrpropaganda informs the journalistic culture of RT’s Russian staff, its international journalists are socialised into it. This article uses historical texts, archival materials and interviews with current and former journalists of RT and the Rossiya Segodnya network to examine how these defensive practices have become an everyday norm. In their strive for broadening the audience and for changing public opinion in the West, RT’s staff adopts reactive, patriotic or legitimising practices. The countering ethic on RT informs the journalists’ scramble for legitimacy not only of Russia as a country but also of RT as their employer. By analysing the underpinnings that organise the work of RT journalists, the article sheds light on broader problems of countering as a status-seeking effort in the international media ecosystem and contributes to ongoing research on self-censorship and conspiracy theories.
Is the privatization of state functions always, and only intrinsically, wrong? On Chiara Cordelli’s The Privatized State
Authors: Herzog Lisa
Published: August 2021

The legitimacy of putting public activities – such as providing education and welfare, but also running prisons or providing military services – into the hands of private companies is hotly contested. In The Privatized State, Chiara Cordelli puts forward an original argument, from a Kantian perspective, for why it is problematic: it replaces the omnilateral will of all citizens, which is realized through public institutions, with the unilateral will of agents to whom these activities have been delegated. While adding an important dimension to the debate, I am not fully convinced that private institutions always fail to realize the omnilateral will, and that this is the only, or always most central, normative problem of privatization. Instead, many concrete cases of privatization seem normatively overdetermined in their wrongness. Nonetheless, Cordelli’s brilliant discussion invites us to rethink these phenomena from an important angle and helps us to better understand what an ideal civil service would look like.
Treatment of Complete Displacement of the Bilateral Legs into an Aortic Aneurysm Using an Iliac Branch Device
Authors: Murai Yuta , Tamura Yukio , Tanaka Yuki , Nakashima Kouki , Miyaji Kagami
Published: August 2021

Purpose:

Migration is a major cause of reintervention after endovascular aneurysm repair (EVAR). In patients with common iliac artery (CIA) dilation due to proximal migration of the iliac limb, internal iliac blood flow can be preserved by implanting an iliac branch device (IBD).

Case Report:

In this report, we discuss the case of a patient in whom the bilateral limbs were completely displaced into the aortic aneurysm due to proximal migration of the iliac limb after EVAR. By taking advantage of the characteristics of this migration, we formed a pull-through wire through the native terminal aorta without passing through the flow divider of the stent graft, and the IBD was deployed safely.

Conclusion:

The present case indicates that the preservation of at least 1 internal iliac artery is possible in patients with CIA dilation due to proximal migration of the iliac limb. However, the unique features of each case must be considered to determine the appropriate approach.
MicroRNA-215-5p Inhibits the Proliferation and Migration of Wilm’s Tumor Cells by Targeting CRK
Authors: Li Wang , Lingdi Li , Xiqiang Dang , Jiheng Liu , Xin Tan , Qin Huang , Haisha Li
Published: August 2021

Objective:

Wilm’s tumor is a common renal malignancy in childhood with unsatisfactory prognosis. microRNA-215-5p (miR-215-5p) has been reported as a tumor-suppressive miRNA in different types of human cancers, but rarely in the Wilm’s tumor. In light of this, we tried to investigate the regulatory role and underlying mechanism of miR-215-5p in the Wilm’s tumor.

Methods:

After sample collection and cell culture, the expression of miR-215-5p and CT10 Regulator of Kinase (CRK) was detected. Then rhabdoid tumor cell lines (formerly classified as Wilms’ tumor cell lines), G401 and WT-CLS1 cells were transfected with pcDNA3.1, pcDNA3.1-CRK, sh-NC, sh-CRK, agomir NC, miR-215-5p agomir, antagomir NC or miR-215-5p antagomir to explore the function of miR-215-5p and CRK in the Wilm’s tumor cell proliferation and migration. Moreover, the relationship between miR-215-5p and CRK was analyzed by dual luciferase reporter gene assay.

Results:

Lowly-expressed miR-215-5p and highly-expressed CRK were observed in the Wilm’s tumor tissues and cells. Transfection of pcDNA3.1-CRK or miR-215-5p antagomir could promote G401 and WT-CLS1 cell proliferation and enhance migration ability, while transfection of sh-CRK or miR-215-5p agomir led to opposite results. Additionally, miR-215-5p may bind to CRK. Moreover, transfection of pcDNA3.1-CRK in G401 and WT-CLS1 cells could partially reverse the inhibitory effect of miR-215-5p agomir on the proliferation and migration of Wilm’s tumor cells.

Conclusion:

Our study highlighted that miR-215-5p could suppress the proliferation and migration of Wilm’s tumor cells by regulating the expression of CRK, providing new ideas for molecular targeted therapy for Wilm’s tumor.
How to Become an Adult
Authors: Bagnall-Munson Adrianna
Published: August 2021

Specific actions like marriage, higher education, employment, living alone, etc., only partially define adulthood. These actions must also be performed correctly so that others recognize them as legitimate. Actions are legitimate when they take into account the person's responsibility to be self-motivated, responsible, and productive.
Straight Men’s Same-Sex Behavior
Authors: Silva Tony
Published: August 2021

In this article, the author addresses why some straight-identified men are primarily attracted to women, but have sex with men. This typically happens because they think that extramarital sex with men is less threatening to their marriages than extramarital sex with women. Additionally, many live what they consider a “straight life” and believe that sex with men is irrelevant to their identities.
Privilege and Disadvantage in Education
Authors: Silver Blake R.
Published: August 2021

This book review explores The Privileged Poor: How Elite Colleges are Failing Disadvantaged Students by Anthony Abraham Jack, which offers a fascinating look at the diverse experiences of low-income students at an elite university.
In-class and out-of-class interactions between international students and their host university teachers
Authors: Bai Li , Wang Ying Xian
Published: August 2021

The critical role of teacher–student interaction in students’ educational outcomes, sense of belonging, and psychological and social well-being makes teacher–student interaction between international students and their teachers at the host universities worthy of research. Using Norton’s model of language, identity and investment to examine Chinese students’ in-class interaction with their Australian teachers, we found Chinese students tended to avoid classroom interaction. Although this finding appears to be due to language and cultural reasons, Norton’s model seems to provide a more profound interpretation of our participants’ reluctance to invest in in-class teacher–student interaction, particularly with the addition of the ‘culture’ element to the model. Students’ out-of-class interaction with their Australian teachers seems to reveal a tension in intercultural communication: most participants favoured oral, face-to-face and immediate communication by using phones and social media apps rather than emails. Suggestions for enhancing intercultural understanding and interaction between international students and their host university teachers are discussed.
Invisible steps for a global endemy: molecular strategies adopted by Clostridioides difficile
Authors: Fettucciari Katia , Marconi Pierfrancesco , Marchegiani Andrea , Fruganti Alessandro , Spaterna Andrea , Bassotti Gabrio
Published: August 2021

Clostridioides difficile infection (CDI) is on the rise worldwide and is associated with an increase in deaths and socio-health burden. C. difficile has become ubiquitous in anthropized environments because of the extreme resistance of its spores. Based on the epidemiological data and knowledge of molecular pathogenesis of C. difficile, it is possible to predict its progressive colonization of the human population for the following reasons: first, its global spread is unstoppable; second, the toxins (Tcds) produced by C. difficile, TcdA and TcdB, mainly cause cell death by apoptosis, but the surviving cells acquire a senescence state that favours persistence of C. difficile in the intestine; third, proinflammatory cytokines, tumour necrosis factor-α and interferon-γ, induced during CDI, enhance the cytotoxicity of Tcds and can increase the survival of senescent cells; fourth, Tcds block mobility and induce apoptosis in immune cells recruited at the infection site; and finally, after remission from primary infection or relapse, C. difficile causes functional abnormalities in the enteric glial cell (EGC) network that can result in irritable bowel syndrome, characterized by a latent inflammatory response that contributes to C. difficile survival and enhances the cytotoxic activity of low doses of TcdB, thus favouring further relapses. Since a ‘global endemy’ of C. difficile seems inevitable, it is necessary to develop an effective vaccine against Tcds for at-risk individuals, and to perform a prophylaxis/selective therapy with bacteriophages highly specific for C. difficile. We must be aware that CDI will become a global health problem in the forthcoming years, and we must be prepared to face this menace.
Distribution and antimicrobial resistance profile of bacteria recovered from sewage system of health institutions found in Hawassa, Sidama Regional State, Ethiopia: A descriptive study
Authors: Mekengo Bereket Mugoro , Hussein Siraj , Ali Musa Mohammed
Published: August 2021

Objectives:

The aim of the study was to determine the distribution and antimicrobial susceptibility profile of bacteria recovered from the sewage systems of health institutions found in Hawassa, Sidama Regional State, Ethiopia.

Methods:

A cross-sectional study was conducted from 20 October 2020 to 1 December 2020. A total of 27 sewage samples were collected at two points, namely, before entering the septic tank and from the septic tank of seven health institutions. Samples were inoculated onto Mannitol salt agar, Blood agar, and MacConkey agar, and incubated for 24 h at 37°C. Bacteria were identified using colony morphology, Gram staining, and biochemical tests. An antimicrobial susceptibility test was performed using the Kirby–Bauer disk diffusion method. Data were analyzed by SPSS, version 25, and results were presented in text and tables.

Results:

All sewage samples ( n = 27) examined in the current study contained potential pathogenic bacteria. Overall, 129 different types of bacteria were identified. Of isolated bacteria, 14 (10.8%) were Gram positive, while 115 (89.2%) were Gram negative. The most prevalent bacteria were Escherichia coli ( n = 27, 20.9%) followed by Shigella species ( n = 26, 20.2%), Pseudomonas species ( n = 25, 19.4%), Salmonella species ( n = 25, 19.4%), Staphylococcus aureus ( n = 14, 10.9%), and Klebsiella species ( n = 12, 9.3%). All bacteria were susceptible to azithromycin. About 80% of bacteria were resistant to ampicillin, whereas greater than 80% of bacteria were susceptible to norfloxacin, ciprofloxacin, and gentamicin.

Conclusion:

All sewage systems of health institutions included in the current study contained different types of pathogenic bacteria, which are resistant to commonly prescribed antibiotics.
Longest reported case of symptomatic COVID-19 reporting positive for over 230 days in an immunocompromised patient in the United States
Authors: Chaudhry Bilal , Didenko Lidiya , Chaudhry Maaria , Malek Andrew , Alekseyev Kirill
Published: August 2021

Coronavirus 2019 (COVID-19) pneumonia was first noted in Wuhan, China. Since the start of the pandemic, there have been millions of cases diagnosed. The average time from onset of symptoms to testing negative SARS-CoV-2 via reverse transcription polymerase chain reaction is roughly 25 days. In patients who continually test positive for COVID-19, it is essential to determine precisely which risk factors contribute to the increase in viral shedding duration. We present a case about a 62-year-old man who has persistently tested positive for COVID-19 for more than 230 days. We followed his treatment course, in which he had been hospitalized multiple times since the onset of symptoms back in April 2020. We have determined that patients with immunosuppression, especially those taking corticosteroids, are at increased risk of prolonged viral shedding. It is essential to continually monitor these immunocompromised patients as they required a greater time period in order to have an appropriate immune response in which antibodies are created.
Does imagining interrupting the flow of urine really elicit contractions of the pelvic floor muscles in stress-incontinent postpartum women?
Authors: Ojukwu Chidiebele P , Orji Precious C , Ezeigwe Anne U , Ede Stephen S , Okemuo Adaora J , Mba Chidinma G , Ikele Ikenna T , Ugwu Augustus U , Okide Onyinye V
Published: August 2021

Objectives:

This study evaluated if imagining interrupting the flow of urine really elicits contractions of the pelvic floor muscles (PFM) in stress-incontinent postpartum women.

Methods:

A total of 21 postpartum women with recent vaginal deliveries performed four trials of Kegel’s exercises, each prompted by a different contraction technique. PFM activities were measured with a surface electromyography via a vaginal electrode. Inferential statistics of repeated-measures one-way analysis of variance with Bonferroni post hoc analysis were performed to compare the effective recruitment of the PFMs across the four trials.

Results:

PFM activities significantly varied across the four trials ( p<0.001), with ‘imagination of interrupting urine flow’ eliciting the least muscular activity (25.40±10.98) and ‘abdominal bracing with hip adduction’ elicited the highest activity (49.67±11.33).

Conclusion:

Findings showed that utilizing many contraction techniques during Kegel’s education is more effective compared to educating patients with one contraction technique.

Level of Evidence:

Level 2.
Nursing students’ professional identity development: An integrative review
Authors: Vabo Grete , Slettebø Åshild , Fossum Mariann
Published: August 2021

The aim of this integrative review was to identify and synthesize current evidence of factors that influence the professional identity development of nursing students in nursing educational programs. Cinahl (EBSCO), Medline, ERIC, Embase, and PsycINFO were searched. Three different appraisal tools and the PRISMA checklist were used. The data from both quantitative and qualitative studies (19 primary studies) were analyzed by applying qualitative content analysis. The analysis revealed two main themes: a caring practice–academic partnership and support in the learning environment. The following seven sub-categories were identified: clinical supervisors, ethical competence, preparation, self-confidence, predictability and safety, structure and cooperation, reflective space and safety. Our findings indicate that clinical supervisors play a central role as role models for nursing students. The main themes with sub-themes are critical in the professional identity development of nursing students in nursing educational programs.
Anti-inflammatory properties of a proprietary bromelain extract (Bromeyal™) after in vitro simulated gastrointestinal digestion
Authors: Bottega Roberta , Persico Ilaria , De Seta Francesco , Romano Federico , Di Lorenzo Giovanni
Published: August 2021

Introduction

Bromelain is a complex mixture of thiol proteases and other non-proteolytic constituents, commercially extracted primarily from the pineapple stem. Evidence from several in vitro and in vivo studies highlights its excellent bioavailability, lack of side effects, and broad spectrum of medical efficacies, of which the antiphlogistic properties are among the most valuable ones. Bromelain has indeed been employed for the efficient treatment of many inflammatory disorders, ranging from osteoarthritis and inflammatory bowel diseases to cancer-related inflammation.

Methods

The aim of the current study was to assess the anti-inflammatory effects of bromelain after gastrointestinal digestion simulated in vitro using stomach, intestinal, and chondrocyte human cellular models (AGS, Caco-2, and SW1353, respectively).

Results

We successfully demonstrated the capability of bromelain to reduce an inflammatory stimulus by reproducing its exposure to the gastro-enteric environment in vitro and assaying its effect in human cell lines derived from stomach, intestinal, and chondrocytes.

Conclusion

Consistently with the previously published data, our work underpins the relevance of bromelain in the development of safer and more effective anti-inflammatory therapies.
An Empirical Study on Chinese University Students’ English Language Classroom Anxiety With the Idiodynamic Approach
Authors: He Xiang , Zhou Dandan , Zhang Xiaofei
Published: August 2021

Foreign language classroom anxiety (FLCA) is a very critical affective factor for learners’ language learning and development. The present study was designed to explore the features of Chinese university students’ FLCA and to investigate the possible influencing factors on the fluctuations of Chinese university students’ FLCA. Two female and two male Chinese university students were selected as the participants and their in-class performances were recorded. Data collection instrument included the classroom observation, the self-rated evaluation of FLCA, and the stimulated recall interview. To capture the micro-changes of the Chinese learners’ FLCA per second, an idiodynamic approach was adopted to carry out the exploratory analysis for the learners’ experiences of FLCA over the language instruction. Zooming in on the microdynamic variation of the participants’ FLCA, the final results indicated that Chinese university students’ FLCA, both within individuals and across individuals, is characterized of a dynamic system’s features. Furthermore, a series of contributing factors were identified to trigger the participants’ FLCA, with the classroom activity types and the teacher’s feedback being the key external factors and the gender difference and self-efficacy being the major internal factors. The idiodynamic method shed new light on exploring the FLCA from an emic and dynamic perspective and some pedagogical implications were also put forward as well.
Linking Proactive Personality to Well-Being: The Mediating Role of Person-Environment Fit
Authors: Liao Pen-Yuan
Published: August 2021

This study used work adjustment theory to develop a model of linking proactive personality to employee job satisfaction, career satisfaction, and job involvement. This model was tested using two samples. The first sample, collected using a cross-sectional survey, consisted of 278 employees nested in 25 organizations located in Taiwan, including 17 service organizations and eight manufacturing organizations. The second sample, collected using a two-wave survey, consisted of 300 employees nested in 22 organizations located in Taiwan, including eight service organizations and 14 manufacturing organizations. The results of hierarchical linear modeling (HLM) analysis of Sample 1 revealed that person-job fit and person-organization fit fully mediated the effects of proactive personality on job satisfaction and career satisfaction. The results of HLM analysis of Sample 2 revealed that person-job fit and person-organization fit fully mediated the effects of proactive personality on job satisfaction, career satisfaction, and job involvement. Results are offered, and implications are discussed.
Marketization of Public Universities: Lessons from a Developing Economy
Authors: Wali Andy Fred , Atswenbuma AGYO , Amangala Emmanuel A. , Nkpurukwe Obabuike Ikeni
Published: August 2021

This study investigates the marketization of public universities in a developing economy with the aim of providing findings for repositioning public universities for global attraction. It adopts a qualitative approach, and the sample population comprise undergraduate and postgraduate students from four public universities (two federal- and two state-owned) in Nigeria. Purposive sampling was used to identify the students selected from each of these universities, and focus group interviews were conducted. We employed content and thematic template analysis techniques to analyze the generated data with NVivo 11. The findings show that the key themes that shape interviewees’ experiences include: infrastructure deficit, poor tutor commitment, unprofessionalism, and inadequate training. Policy recommendations were suggested for the tripartite work relationship between the government, university leadership and the academic staff union for repositioning public universities. The study is limited to a single research paradigm but offers future research opportunities using alternative strategy for strengthening emerging themes and new findings.
A 16-Week Home-Based Progressive Resistance Tube Training Among Older Adults With Type-2 Diabetes Mellitus: Effect on Glycemic Control
Authors: Ooi Theng Choon , Mat Ludin Arimi Fitri , Loke Seng Cheong , Fiatarone Singh Maria Antoinette , Wong Teck Wee , Vytialingam Nathan , Anthony Abdullah Muhammad Mikhail Joseph , Ng Ooi Chuan , Bahar Norhaniza , Zainudin Norliza , Lew Leong Chen
Published: August 2021

Research has proven that aerobic exercise improves glucose homeostasis among patients with type 2 diabetes mellitus (T2DM). Elastic resistance (tube or band) is suggested as a good alternative for home-based strength training among older adults including those with T2DM due to its low cost, simplicity, portability, and versatility. This study aimed to measure the effects of 16-week home-based progressive resistance training (PRT), using a resistance tube on glucose homeostasis and cardiovascular risk factors among older adults with T2DM. A total of 70 participants aged 61.68 (5.50) years with T2DM were assigned to the intervention ( n = 35) and control ( n = 35) groups in this quasi-experimental trial. The intervention group underwent 16 weeks of home-based PRT using a resistance tube. Significant improvements in HbA1c (−1.34% point, p < 0.001), fasting blood glucose (−1.30 mmol/L, p < 0.001), and systolic blood pressure (−1.42 mmHg, p < 0.05) were observed after 16 weeks of intervention. However, no significant changes were observed in lipid profile, diastolic blood pressure, resting heart rate, and ankle–brachial index. The finding suggests that 16 weeks of home-based PRT using a resistance tube has the potential to improve glycemic control and reduce systolic blood pressure among older adults with T2DM and caused no adverse events.
“Make Sure You See This”: Counternarratives of Multilingual Black Girls’ Language and Literacy Practices
Authors: Presiado Vivian E. , Frieson Brittany L.
Published: August 2021

Critical scholarship in bilingualism and bilingual education has documented multiple ways that the rich language and literacy practices of Black children participating in bilingual education programs are often erased in favor of dominant narratives about the literacy practices of their White Mainstream English–speaking peers. Utilizing Black girl literacies, raciolinguistics, and translanguaging as theoretical orientations, and counternarratives as an analytical tool, this article presents a cross-case analysis of two ethnographic case studies that explored how multilingual Black American girls enrolled in an elementary dual-language bilingual education program employed their literacies to navigate their social worlds by challenging raciolinguistic ideologies and hegemonic systems of oppression in their daily lives. It also presents the nuanced nature of multilingual Black girls’ literacies and the various roles that they serve, which are often ignored in multilingual spaces. The need to learn from multilingual Black girls’ counternarratives is emphasized by engaging in a deeper sociopolitical understanding of the complex issues that Black girls face on a regular basis, which are often extended in bilingual spaces. Specifically, we call for educators to create critical translanguaging spaces that honor multidimensional counternarratives and intimately connect with the unique epistemologies and literacies that Black girls in bilingual programs bring to the table.
Visual Impairment and Self-Efficacy in Diabetes Management
Authors: Heydarian Nazanin M. , Brown-Podgorski Brittany , Ramirez Jahanett
Published: August 2021

Purpose

The purpose of this study is to examine the relationship between visual impairment and diabetes management self-efficacy.

Methods

The present study utilized pooled cross-sectional data (2008-2018) from the Medical Expenditure Panel Survey Household Component and Diabetes Care Survey. Binary and generalized ordinal logit regression models were used to compare diabetes management self-efficacy between patients with and without visual impairments.

Results

Compared to their non-visually impaired counterparts, visually impaired persons had a lower odds of reporting high diabetes management self-efficacy. Similarly, visually impaired adults with diabetes have a significantly lower odds of being very confident in their ability to manage their conditions compared with adults who reported being not confident, somewhat confident, or confident. Several control factors, including self-behaviors and receipt of diabetes self-management education (DSME), were also associated with diabetes management self-efficacy.

Conclusions

Visually impaired persons experience significant disparities in diabetes management self-efficacy. Given the relationship between self-efficacy and diabetes-related outcomes, it is crucial that DSME be tailored to effectively meet the individual needs of this population. Future research should explore the relationship between DSME and self-care behaviors, self-efficacy, and diabetes-related outcomes in visually impaired persons.
A predictive algorithm using clinical and laboratory parameters may assist in ruling out and in diagnosing MDS
Authors: Oster Howard S. , Crouch Simon , Smith Alexandra , Yu Ge , Abu Shrkihe Bander , Baruch Shoham , Kolomansky Albert , Ben-Ezra Jonathan , Naor Shachar , Fenaux Pierre , Symeonidis Argiris , Stauder Reinhard , Cermak Jaroslav , Sanz Guillermo , Hellström-Lindberg Eva , Malcovati Luca , Langemeijer Saskia , Germing Ulrich , Holm Mette Skov , Madry Krzysztof , Guerci-Bresler Agnes , Culligan Dominic , Sanhes Laurence , Mills Juliet , Kotsianidis Ioannis , van Marrewijk Corine , Bowen David , de Witte Theo , Mittelman Moshe
Published: August 2021

We present a noninvasive Web-based app to help exclude or diagnose myelodysplastic syndrome (MDS), a bone marrow (BM) disorder with cytopenias and leukemic risk, diagnosed by BM examination. A sample of 502 MDS patients from the European MDS (EUMDS) registry (n > 2600) was combined with 502 controls (all BM proven). Gradient-boosted models (GBMs) were used to predict/exclude MDS using demographic, clinical, and laboratory variables. Area under the receiver operating characteristic curve (AUC), sensitivity, and specificity were used to evaluate the models, and performance was validated using 100 times fivefold cross-validation. Model stability was assessed by repeating its fit using different randomly chosen groups of 502 EUMDS cases. AUC was 0.96 (95% confidence interval, 0.95-0.97). MDS is predicted/excluded accurately in 86% of patients with unexplained anemia. A GBM score (range, 0-1) of less than 0.68 (GBM < 0.68) resulted in a negative predictive value of 0.94, that is, MDS was excluded. GBM ≥ 0.82 provided a positive predictive value of 0.88, that is, MDS. The diagnosis of the remaining patients (0.68 ≤ GBM < 0.82) is indeterminate. The discriminating variables: age, sex, hemoglobin, white blood cells, platelets, mean corpuscular volume, neutrophils, monocytes, glucose, and creatinine. A Web-based app was developed; physicians could use it to exclude or predict MDS noninvasively in most patients without a BM examination. Future work will add peripheral blood cytogenetics/genetics, EUMDS-based prospective validation, and prognostication.
Efficacy of the BNT162b2 mRNA COVID-19 vaccine in patients with B-cell non-Hodgkin lymphoma
Authors: Perry C. , Luttwak E. , Balaban R. , Shefer G. , Morales M. M. , Aharon A. , Tabib Y. , Cohen Y. C. , Benyamini N. , Beyar-Katz O. , Neaman M. , Vitkon R. , Keren-Khadmy N. , Levin M. , Herishanu Y. , Avivi I.
Published: August 2021

Patients diagnosed with B-cell non-Hodgkin lymphoma (B-NHL), particularly if recently treated with anti-CD20 antibodies, are at risk of severe COVID-19 disease. Because studies evaluating humoral response to COVID-19 vaccine in these patients are lacking, recommendations regarding vaccination strategy remain unclear. The humoral immune response to BNT162b2 messenger RNA (mRNA) COVID-19 vaccine was evaluated in patients with B-NHL who received 2 vaccine doses 21 days apart and compared with the response in healthy controls. Antibody titer, measured by the Elecsys Anti-SARS-CoV-2S assay, was evaluated 2 to 3 weeks after the second vaccine dose. Patients with B-NHL (n = 149), aggressive B-NHL (a-B-NHL; 47%), or indolent B-NHL (i-B-NHL; 53%) were evaluated. Twenty-eight (19%) were treatment naïve, 37% were actively treated with a rituximab/obinutuzumab (R/Obi)–based induction regimen or R/Obi maintenance, and 44% had last been treated with R/Obi >6 months before vaccination. A seropositive response was achieved in 89%, 7.3%, and 66.7%, respectively, with response rates of 49% in patients with B-NHL vs 98.5% in 65 healthy controls (P < .001). Multivariate analysis revealed that longer time since exposure to R/Obi and absolute lymphocyte count ≥0.9 × 103/μL predicted a positive serological response. Median time to achieve positive serology among anti-CD20 antibody-treated patients was longer in i-B-NHL vs a-B-NHL. The humoral response to BNT162b2 mRNA COVID-19 vaccine is impaired in patients with B-NHL who are undergoing R/Obi treatment. Longer time since exposure to R/Obi is associated with improved response rates to the COVID-19 vaccine. This study is registered at www.clinicaltrials.gov as #NCT04746092.
Defect and Doping Engineered Penta-graphene for Catalysis of Hydrogen Evolution Reaction
Authors: Hao Jinbo , Wei Feng , Zhang Xinhui , Li Long , Zhang Chunling , Liang Dan , Ma Xiaoguang , Lu Pengfei
Published: August 2021

Water electrolysis is a sustainable and clean method to produce hydrogen fuel via hydrogen evolution reaction (HER). Using stable, effective and low-cost electrocatalysts for HER to substitute expensive noble metals is highly desired. In this paper, by using first-principles calculation, we designed a defect and N-, S-, P-doped penta-graphene (PG) as a two-dimensional (2D) electrocatalyst for HER, and its stability, electronic properties and catalytic performance were investigated. The Gibbs free energy (ΔGH), which is the best descriptor for the HER, is calculated and optimized, the calculation results show that the ΔGH can be 0 eV with C2 vacancies and P doping at C1 active sites, which should be the optimal performance for a HER catalyst. Moreover, we reveal that the larger charge transfer from PG to H, the closer ΔGH is to zero according to the calculation of the electron charge density differences and Bader charges analysis. Ulteriorly, we demonstrated that the HER performance prefers the Volmer–Heyrovsky mechanism in this study.
Transcriptome-wide m6A profiling reveals mRNA post-transcriptional modification of boar sperm during cryopreservation
Authors: Qin Ziyue , Wang Wencan , Ali Malik Ahsan , Wang Yihan , Zhang Yan , Zhang Ming , Zhou Guangbin , Yang Jian-dong , Zeng Changjun
Published: August 2021

Background

Cryopreservation induces transcriptomic and epigenetic modifications that strongly impairs sperm quality and function, and thus decrease reproductive performance. N6-methyladenosine (m6A) RNA methylation varies in response to stress and has been implicated in multiple important biological processes, including post-transcriptional fate of mRNA, metabolism, and apoptosis. This study aimed to explore whether cryopreservation induces m6A modification of mRNAs associated with sperm energy metabolism, cryoinjuries, and freezability.

Results

The mRNA and protein expression of m6A modification enzymes were significantly dysregulated in sperm after cryopreservation. Furthermore, m6A peaks were mainly enriched in coding regions and near stop codons with classical RRACH motifs. The mRNAs containing highly methylated m6A peaks (fts vs. fs) were significantly associated with metabolism and gene expression, while the genes with less methylated m6A peaks were primarily involved in processes regulating RNA metabolism and transcription. Furthermore, the joint analysis of DMMGs and differentially expressed genes indicated that both of these play a vital role in sperm energy metabolism and apoptosis.

Conclusions

Our study is the first to reveal the dynamic m6A modification of mRNAs in boar sperm during cryopreservation. These epigenetic modifications may affect mRNA expression and are closely related to sperm motility, apoptosis, and metabolism, which will provide novel insights into understanding of the cryoinjuries or freezability of boar sperm during cryopreservation.
Effect of a self-care educational intervention to improve self-care adherence among patients with chronic heart failure: a clustered randomized controlled trial in Northwest Ethiopia
Authors: Dessie Getenet , Burrowes Sahai , Mulugeta Henok , Haile Dessalegn , Negess Ayenew , Jara Dubie , Alem Girma , Tesfaye Bekele , Zeleke Haymanot , Gualu Tenaw , Getaneh Temsgen , Kibret Getiye Dejenu , Amare Desalegne , Worku Mengesha Endalkachew , Wagnew Fasil , Khanam Rasheda
Published: August 2021

Background

As the burden of cardiovascular disease increases in sub-Saharan Africa, there is a growing need for low-cost interventions to mitigate its impact. Providing self-care health education to patients with chronic heart failure (CHF) is recommended as an intervention to prevent complications, improve quality of life, and reduce financial burdens on fragile health systems. However, little is known about health education’s effectiveness at improving CHF self-management adherence in sub-Saharan Africa. Therefore the present study aimed to assess the effectiveness of an educational intervention to improve self-care adherence among patients with CHF at Debre Markos and Felege Hiwot Referral Hospitals in Northwest Ethiopia.

Methods

To address this gap, we adapted a health education intervention based on social cognitive theory comprising of intensive four-day training and, one-day follow-up sessions offered every four months. Patients also received illustrated educational leaflets. We then conducted a clustered randomized control trial of the intervention with 186 randomly-selected patients at Debre Markos and Felege Hiwot referral hospitals. We collected self-reported data on self-care behavior before each educational session. We analyzed these data using a generalized estimating equations model to identify health education's effect on a validated 8-item self-care adherence scale.

Results

Self-care adherence scores were balanced at baseline. After the intervention, patients in the intervention group (n = 88) had higher adherence scores than those in the control group (n = 98). This difference was statistically significant (β = 4.15,p < 0.05) and increased with each round of education. Other factors significantly associated with adherence scores were being single (β = − 0.25,p < 0.05), taking aspirin (β = 0.76,p < 0.05), and having a history of hospitalization (β = 0.91,p < 0.05).

Conclusions

We find that self-care education significantly improved self-care adherence scores among CHF patients. This suggests that policymakers should consider incorporating self-care education into CHF management.

Trial registration number: PACTR201908812642231
Prolonged viral shedding of SARS-CoV-2 in two immunocompromised patients, a case report
Authors: Niyonkuru Melissa , Pedersen Rune Micha , Assing Kristian , Andersen Thomas Emil , Skov Marianne Nielsine , Johansen Isik Somuncu , Madsen Lone Wulff
Published: August 2021

Background

The duration of viable Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) shedding in immunocompromised patients is still unknown. This case report describes the duration of viable SARS-CoV-2 in two immunocompromised patients with completely different clinical courses and further addresses the immunological aspects.

Case presentations

Oropharyngeal swaps were collected continuously during hospitalization for two immunocompromised patients infected with SARS-CoV-2 and sent for analysis to real time

reverse transcription polymerase chain reaction (RT-PCR), viral culture assessed by plaque assay and full genome sequencing. Blood samples for flow cytometry and further immunological analysis were taken once during admission. One patient was without symptoms of Coronavirus disease 2019 (COVID-19) whereas the other had severe respiratory symptoms requiring a stay at an intensive care unit (ICU) and treatment with remdesivir and dexamethasone. Despite their difference in clinical courses, they both continuously shed SARS-CoV-2 with high viral loads in culture. Both patients had undetectable anti SARS-CoV-2 IgG levels about 2 weeks after the first positive real time RT-PCR test of SARS-CoV-2, marked expansions of virus reactive CD8+ T cells but cellular markers indicative of attenuated humoral immunity.

Conclusions

Our case illustrates the importance of distinguishing isolation guidelines for patients infected with SARS-CoV-2 according to their immunological status. Furthermore, it demonstrates the need for immune markers relating to viral shedding in immunocompromised patients.
Empyema necessitans with osteomyelitis of fifth rib due to Nocardia farcinica: a case report
Authors: Tripathi Swapnil , Meena Durga Shankar , Rohila Amit Kumar , T.R. Neetha , Jain Vidhi , Kumar Deepak , Yadav Taruna , Garg Mahendra Kumar
Published: August 2021

Background

Empyema necessitans is a rare pulmonary condition described as the presence of pus in the pleural cavity with insidious extension into the surrounding soft tissue. The common microbial aetiology of empyema necessitans is tuberculosis. Nocardiosis a cause of empyema necessitans is rarely described in the literature. We herein present a case of an 80-year-old male with empyema necessitans with osteomyelitis of rib caused by Nocardia farcinica.

Case presentation

An 80-year-old male presented with complaints of soft swelling on the left lower posterior chest wall associated with dry cough and breathlessness on exertion. Computed Tomography (CT) thorax demonstrated empyema necessitans with features of left fifth rib osteomyelitis. Radiological guided aspiration of the chest wall collection revealed Nocardia species and surgical drainage of abscess was performed. Matrix-assisted laser desorption/ionization time-of-flight-mass spectrometry (MALDI-TOF-MS) identified the isolate as Nocardia farcinica. He was treated with three-drug regimen: Trimethoprim-sulfamethoxazole, amikacin and ceftriaxone for 2 weeks. After showing improvement patient was discharged and advised to take oral Trimethoprim-sulfamethoxazole for the next 6 months with periodic follow-up.

Conclusions

As our case demonstrates, the possibility of invasive Nocardiosis should not be overlooked even in immunocompetent patients. Clinicians should aware of this rare entity while treating patients with empyema necessitans.
Tuberculosis infection screening in children with close contact: a hospital-based study
Authors: Sun Lin , Qi Xue , Guo Yajie , Qi Hui , Li Jieqiong , Wu Xirong , Yin Qingqin , Guo Yan , Xu Baoping , Wang Yacui , Jin Qi , Gao Lei , Shen Adong
Published: August 2021

Background

Identifying and prioritizing at-risk populations is critical for pediatric tuberculosis control. We aimed to identify a latent tuberculosis infection (LTBI) screening strategy that is appropriate for the Chinese context among children with different TB exposure levels and to explore its clinical importance.

Methods

During 2013–2015, we enrolled hospitalized children with suspected respiratory infectious disease (RID) for LTBI screening using the tuberculin skin test (TST) and interferon-γ release assay (IGRA) T-SPOT.TB as part of a work up for their RID. Participants with confirmed diagnosis were classified into three subgroups according to level of exposure to TB: no reported contact risk, with household contact risk, and with non-household contact risk.

Results

A total 6202 children (median age: 4.76 years; interquartile range: 1.0–8.0 years) were enrolled. Children with no reported contact risk had the lowest proportions of positive results for the IGRA (0.7%) and TST (3.3%). The proportion of positive results for each test was higher for household contacts than non-household contacts. The TST positive proportion was much higher than that for the IGRA in all three groups. Children with IGRA+/TST+ results had larger indurations than those with IGRA− /TST+  results (15 mm vs. 13 mm, P = 0.02). For IGRA, older age (> 5 years) and non-household or household contact risk were associated with a positive result.

Conclusions

Positive IGRA results in children with a contact risk can serve as a critical reference for LTBI management. IGRA can be used, in preference to TST, for Chinese children with a TB exposure risk.
A cluster randomized trial of interferon ß-1a for the reduction of transmission of SARS-Cov-2: protocol for the Containing Coronavirus Disease 19 trial (ConCorD-19)
Authors: Iturriaga Carolina , Eiffler Nat , Aniba Rad , Ben-Othman Rym , Perez-Mateluna Guillermo , Meyer Jessica K. V. , Fish Eleanor N. , Kollmann Tobias R. , Severino Nicolas , Stick Stephen , Borzutzky Arturo , Perret Cecilia , Castro-Rodriguez José A. , Garcia-Huidobro Diego
Published: August 2021

Background

SARS-CoV-2 infection rapidly spreads in populations due to the high rates of community transmission. Interrupting the shedding of SARS-CoV-2 may reduce the incidence of Coronavirus Disease 19 (COVID-19). Herein we provide a protocol for a cluster randomized trial that will examine the effectiveness of treatment with interferon (IFN) ß-1a compared to standard of care in limiting the transmission of SARS-CoV-2. Co-primary objectives are to determine whether IFN therapy reduces (a) the proportion of infected cases shedding SARS-CoV-2 at day 11 post randomization and (b) the incidence of transmission of SARS-CoV-2 infection from index cases to treatment-eligible household post-exposure contacts at day 11 after randomization. Secondary objectives include assessing the impact of IFN treatment on duration of viral clearance, hospitalizations and fatalities, and evaluating the safety of IFN treatment.

Methods

Three hundred and ten households, each including an index case with a recent COVID-19 diagnosis and at least one asymptomatic treatment-eligible household contact, will be randomized to receive 3 doses of 125 μg IFN ß-1a by subcutaneous administration (days 1, 6, and 11), or standard of care. All participants will be followed until day 29.

Discussion

The results from this trial will identify whether IFN ß treatment of mild or moderate COVID-19 cases accelerates viral clearance and prevents disease progression and whether IFN ß treatment of post-exposure contacts of COVID-19 cases reduces transmission of infection.

Trial Registration:This trial is registered at ClinicalTrials.gov NCT04552379; date of registration September 17, 2020.
The elusive diagnosis and emergent management of a late-presenting ruptured interstitial pregnancy: a case report
Authors: Ahlschlager Lauren M. , Mysona David , Beckham A. Jenna
Published: August 2021

Background

Interstitial pregnancies are rare and often difficult to diagnose given their proximal position to the uterine cavity, however most are identified by 12 weeks gestation. Delayed or missed diagnosis contributes to heightened incidence of poor outcomes including hemorrhage and death.

Case presentation

A 35-year-old woman at 15 weeks gestation with confirmed intrauterine pregnancy on first trimester ultrasound and prior negative MRI presented in hemorrhagic shock and was found to have a ruptured interstitial pregnancy. Exploratory laparotomy revealed the fetus to be in the abdomen as well as a large cornual defect and abnormal placentation that resulted in supracervical hysterectomy.

Conclusions

Interstitial pregnancy should be considered in a patient presenting with symptoms consistent with ectopic rupture, especially in the setting of equivocal or suboptimal prior imaging. Earlier diagnosis may allow for fertility-sparing intervention and decreased risk of morbidity and mortality.
Case report: risk of skin necrosis related to injectable vancomycin in critically ill newborn infants
Authors: Gilliot Sixtine , Boukhris Mohamed Riadh , Masse Morgane , Storme Laurent , Décaudin Bertrand , Odou Pascal , Le Duc Kevin
Published: August 2021

Background

Vancomycin is commonly used as part of empiric antibiotic therapy in the preterm infants who develop signs and symptoms of infection. Although skin necrosis has been noted to occur following injection of vancomycin into a peripheral vein in an adult patient, this complication has not been previously described in a preterm infant.

Case presentation

We report the case of a very low birthweight male infant born at 30 weeks gestational age who developed skin necrosis, most likely as a complication of vancomycin administration via a peripheral venous catheter. The immature skin and endothelial cells of this preterm infant may have increased the risk of drugs related venous and skin toxicity. In this case, assumption of a cumulative toxicity with other drugs administered concomitantly via the same catheter can’t be excluded.

Conclusions

To prevent the risk of skin damage, we advocate that in newborn infants, the administration of vancomycin should be limited to a concentration of < 2.5 mg/mL via a peripheral intravenous catheter if a central venous catheter is not available.