bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of dynamic stiffness of fasteners on vibration and acoustic radiation of a ballastless track
Authors: Xu Han-Wen , Han Jian , Xiao Xin-Biao , Liu Xiao-Long , Liu Mou-Kai , Jin Xue-Song
Published: April 2022

A new model for a single wheel rolling over a metro ballastless track is developed. It is used to carry out the analysis on the effect of dynamic characteristics of fastener on the vibration and noise radiation of the wheel and the track in the vertical direction, under the excitation of the wheel/rail uneven surfaces in detail. In this analysis, a rail is modeled as a Timoshenko beam resting on discrete rubber booted short sleepers, and the sleepers are connected with the slab through linear springs and damping units, the slab is modeled by using the FE method, the fastener is characterized by using the Poynting-Thomson model which takes into account that the stiffness and dumping of the fasteners vary with vibration frequency in their service. The dynamic characteristics of the fastener include the variation of its stiffness and damping with frequency. The analysis considers that the fastener dynamic stiffness increases with the excitation frequency while its damping decreases. The vibration and acoustic radiation of the wheel/track is, to varying degree, affected by the dynamic property of the fastener. The vibration and acoustic radiation of the sleeper and the slab is greatly affected by the dynamic property of the fastener. But the effect of the total noise level of the wheel and the track by the dynamic property of the fastener is not so large because the wheel and rail noise is dominant in the whole analyzed system. These conclusions have certain reference values for the study of the vibration and noise reduction measures of the wheel and track coupled system using the fastening characteristic.
Says Who? Credibility Effects in Self-Verification Strivings
Authors: Szumowska Ewa , Wójcik Natalia , Szwed Paulina , Kruglanski Arie W.
Published: April 2022

Research shows that people prefer self-consistent over self-discrepant feedback—the self-verification effect. It is not clear, however, whether the effect stems from striving for self-verification or from the preference for subjectively accurate information. We argue that people prefer self-verifying feedback because they find it to be more accurate than self-discrepant feedback. We thus experimentally manipulated feedback credibility by providing information on its source: a student (control condition) or an experienced psychologist (experimental condition). In line with our expectations, the results of two preregistered studies with 342 adults showed that people preferred self-verifying feedback only in the control condition. In the experimental condition, the effect disappeared (or reversed, in Study 1). Study 2 showed that individual differences in credibility (epistemic authority) ascribed to the self and to psychologists matter as well. These findings suggest that feedback credibility, rather than the desire for self-verification, often drives the self-verification effect.
Conjunctions of resilience and the Covid-19 crisis of the creative cultural industries
Authors: Yue Audrey
Published: April 2022

This article compares the conjunctions of emergency resilience and ecological resilience that underpin the creative cultural industry (CCI) crisis. It first introduces three characteristics that socially construct the CCI crisis and its hegemonic practice of emergency resilience (time, disaster discourse, and the adaptation of aesthetic digitalization) and exposes multiple discourses – from the technologies of cultural statistics to corporate financial modelling – that construct an ideology of ‘resilience-as-deficit’. In contrast to this approach, the article develops three characteristics of ecological resilience: a focus on transition and the long term; resilience as a decentred strategy and networked resource; and aesthetic digitization as a radical praxis of adaptability. Examining arts impact and cultural policy reports, drawing on ecological, feminist and cultural resilience studies, and analysing a digital cultural event in Asia (the Singapore LGBT cultural festival, Pink Dot), the article argues that ecological resilience offers new capacities towards a cultural ecology that can nurture fair work, artistic innovation, economic growth and cultural vitality.
Crossing borders: Does it matter? Differences between (near-)domestic and cross-border sex traffickers, their victims and modus operandi
Authors: Kragten-Heerdink Suzanne L. J. , van de Weijer Steve G. A. , Weerman Frank M.
Published: April 2022

Hardly any research exists that empirically compares (near-)domestic and cross-border sex trafficking. The few studies that do are based on relatively small samples and only represent US data. This study substantially extends the scarce scientific knowledge about the differences between the two types of sex trafficking, based on European data. Our sample consists of all 658 (near-)domestic sex traffickers and all 424 cross-border sex traffickers, registered by the prosecution service in 2008–2017 who are brought to court in the Netherlands. We collected data on these traffickers from registers of the prosecution service, from a file analyses on the indictments/verdicts, and from registers of Statistics Netherlands. These data provide insight into the characteristics of the traffickers, their victims and modus operandi. Our findings show that significant differences between the two types of sex trafficking exist, which is of great importance for better tailored prevention and identification strategies. The most prominent finding is that the threshold to get involved in (near-)domestic sex trafficking is lower than for cross-border sex trafficking. (Near-)domestic sex traffickers are, compared to cross-border sex traffickers, younger (as are their victims), they seldom need to migrate, they operate on a smaller scale (more one-to-one and for a shorter period of time) and practically never in a criminal organization. Furthermore, they use violent means of coercion to control their victims more frequently than cross-border sex traffickers, which can be interpreted as additional evidence for a less organized practice. These findings contribute to a more complete understanding of sex trafficking, in particular of the traffickers who were seldom the direct subject of research.
Gamification for HRD: Systematic Review and Future Research Directions
Authors: Thomas Nibu John , Baral Rupashree , Crocco Oliver S.
Published: April 2022

Gamification integrates game components into contexts such as workplace learning and performance. A decade of research has shown that gamification is prevalent in various settings such as education, healthcare, and business. Recently, gamification has been applied and studied in interventions and contexts related to the field of human resource development (HRD). Given the emerging use of gamification in HRD, this paper undertakes a systematic literature review (SLR) to synthesize existing research on gamification in HRD. This paper identifies four areas where gamification has been studied in HRD: employee learning, task performance, employee wellness, and rising contexts. In addition, this SLR collects and organizes a series of future research directions and offers a set of potential research questions. These future research directions center around four areas of gamification for HRD: designing gamification, influencing factors, experiential outcomes, and sustaining gamification. Implications for HRD practice and research, as well as limitations, are discussed.
Discovery of an SphK1 inhibitor: A hybrid approach involving a receptor–ligand-complex-based pharmacophore and docking-based virtual screening
Authors: Ding Tiandi , Chen HaiJiao , Li Yan , Li Ying , Zhi Ying , Qu Zhiqiang , Sun Qiang , Yao Qingqiang , Liu Bo
Published: April 2022

Sphingosine kinase is a lipid kinase that catalyzes the phosphorylation of sphingosine to sphingosine-1-phosphate. Sphingosine-1-phosphate is a bioactive lipid that regulates biological processes. The overexpression of sphingosine kinases is related to a variety of pathophysiological conditions. For example, SphK1 has been shown to be highly expressed in various cancer cells including ovarian, cervical, colon, stomach, lung, and brain cancer. Inhibition of sphingosine kinases is a promising way to treat diseases such as cancer. Through computer-aided drug design, we have discovered a new SphK1 inhibitor named Amb30572637 (SAMS10). In this report, we describe the discovery process and biological characteristics. In biochemical experiments, SAMS10 shows a prominent inhibitory effect on SphK1, with an IC50 value of 9.8 μM. Subsequent MTT experiments show that SAMS10 has anticancer effects toward A549, SKVO3, A375, and LOVO cell lines and has essentially no cytotoxicity against the healthy cell L929. SAMS10 has significant inhibitory activity against the A549 and LOVO cell lines, with IC50 values of 14.64 and 14.48 μM, respectively. It belongs to a moderately active SphK1 inhibitor with lower anticancer activity than the control compound cisplatin, but the effect of SAMS10 toward SphK1 and its anticancer activity indicate that it is a promising lead compound for the development of effective SphK1 anticancer inhibitors.
Thermoresponsive fiber-based microwells capable of formation and retrieval of salivary gland stem cell spheroids for the regeneration of irradiation-damaged salivary glands
Authors: Hong Hye Jin , Cho Jae-Min , Yoon Yeo-Jun , Choi DoJin , Lee Soohyun , Lee Hwajung , Ahn Sujeong , Koh Won-Gun , Lim Jae-Yol
Published: April 2022

Three-dimensional spheroid culture enhances cell-to-cell interactions among stem cells and promotes the expression of stem cell properties; however, subsequent retrieval and delivery of these cells remain a challenge. We fabricated a thermoresponsive fiber-based microwell scaffold by combining electrospinning and hydrogel micropatterning. The resultant scaffold appeared to facilitate the formation of cellular spheroids of uniform size and enabled the expression of more stem cell-secreting growth factor genes ( EGF, IGF-1, FGF1, FGF2, and HGF), pluripotent stem cell-related genes ( SOX2 and NANOG), and adult epithelial stem cell-related genes ( LGR4, LGR5, and LGR6) than salivary gland stem cells in a monolayer culture (SGSCmonolayer). The spheroids could be retrieved efficiently by decreasing temperature. SGSC-derived spheroid (SGSCspheroid) cells were then implanted into the submandibular glands of mice at 2 weeks after fractionated X-ray irradiation at a dose of 7.5 Gy/day. At 16 weeks post-irradiation, restoration of salivary function was detected only in SGSCspheroid-implanted mice. The production of submandibular acini specific mucin increased in SGSCspheroid-implanted mice, compared with PBS control. More MIST1+ mature acinar cells were preserved in the SGSCspheroid-implanted group than in the PBS control group. Intriguingly, SGSCspheroid-implanted mice exhibited greater amelioration of tissue damage and preservation of KRT7+ terminally differentiated luminal ductal cells than SGSCmonolayer-implanted mice. The SGSCspheroid-implanted mice also showed less DNA damage and apoptotic cell death than the SGSCmonolayer-implanted mice at 2 weeks post-implantation. Additionally, a significant increase in Ki67+AQP5+ proliferative acinar cells was noted only in SGSCspheroid-implanted mice. Our results suggest that a thermoresponsive fiber-based scaffold could be of use to facilitate the production of function-enhanced SGSCspheroid cells and their subsequent retrieval and delivery to damaged salivary glands to alleviate radiation-induced apoptotic cell death and promote salivary gland regeneration.
Changes in nationwide in-hospital stroke care during the first four waves of COVID-19 in Germany
Authors: Dengler Julius , Prass Konstantin , Palm Frederick , Hohenstein Sven , Pellisier Vincent , Stoffel Michael , Hong Bujung , Meier-Hellmann Andreas , Kuhlen Ralf , Bollmann Andreas , Rosahl Steffen
Published: April 2022

Introduction:

In the early stages of the global COVID-19 pandemic hospital admissions for acute ischemic stroke (AIS) decreased substantially. As health systems have become more experienced in dealing with the pandemic, and as the proportion of the population vaccinated rises, it is of interest to determine whether the prevalence of AIS hospitalization and outcomes from hospitalization have returned to normal.

Patients and methods:

In this observational, retrospective cohort study, we compared the prevalence and outcomes of AIS during the first four waves of the pandemic to corresponding pre-pandemic periods in 2019 using administrative data collected from a nationwide network of 76 hospitals that manages 7% of all in-hospital cases in Germany.

Results:

We included 25,821 AIS cases in the study period (2020/2021) and used 26,295 AIS cases as controls (2019). Compared to pre-pandemic numbers, mean daily AIS admissions decreased only during wave 1 (from 39.6 to 34.1; p < 0.01) and wave 2 (from 39.9 to 38.3; p = 0.03) and returned to normal levels during waves 3 and 4. AIS case fatality increased in wave 1 only (from 6.0% to 7.6%; p = 0.03). We observed a consistent decrease in the prevalences of arterial hypertension, diabetes, and obesity among AIS cases throughout the pandemic and no changes in rates of systemic thrombolysis, mechanical thrombectomy, or decompressive craniectomy. The rate of transfer to stroke units increased only during waves 2 (by 4.6%; p < 0.01) and 3 (by 3.0%; p < 0.01). The proportion of patients with coinciding SARS-CoV-2 and AIS was low, peaking at 3.4% in wave 2 and subsequently decreasing to 0.4% in wave 4.

Conclusion:

In Germany, the COVID-19 pandemic seems to have had a larger effect on nationwide in-hospital AIS care during the early pandemic stages, in which AIS case numbers decreased and case fatality rose. This may reflect a nationwide “learning curve” within health care systems in providing AIS care in times of a pandemic.
Chromosome-level genome assembly of grass carp (Ctenopharyngodon idella) provides insights into its genome evolution
Authors: Wu Chang-Song , Ma Zi-You , Zheng Guo-Dong , Zou Shu-Ming , Zhang Xu-Jie , Zhang Yong-An
Published: April 2022

Background

The grass carp has great economic value and occupies an important evolutionary position. Genomic information regarding this species could help better understand its rapid growth rate as well as its unique body plan and environmental adaptation.

Results

We assembled the chromosome-level grass carp genome using the PacBio sequencing and chromosome structure capture technique. The final genome assembly has a total length of 893.2 Mb with a contig N50 of 19.3 Mb and a scaffold N50 of 35.7 Mb. About 99.85% of the assembled contigs were anchored into 24 chromosomes. Based on the prediction, this genome contained 30,342 protein-coding genes and 43.26% repetitive sequences. Furthermore, we determined that the large genome size can be attributed to the DNA-mediated transposable elements which accounted for 58.9% of the repetitive sequences in grass carp. We identified that the grass carp has only 24 pairs of chromosomes due to the fusion of two ancestral chromosomes. Enrichment analyses of significantly expanded and positively selected genes reflected evolutionary adaptation of grass carp to the feeding habits. We also detected the loss of conserved non-coding regulatory elements associated with the development of the immune system, nervous system, and digestive system, which may be critical for grass carp herbivorous traits.

Conclusions

The high-quality reference genome reported here provides a valuable resource for the genetic improvement and molecular-guided breeding of the grass carp.
Serum cystatin C is associated with the prognosis in acute myocardial infarction patients after coronary revascularization: a systematic review and meta-analysis
Authors: Chen Jun , Yang Yang , Dai Chuxing , Wang Yimin , Zeng Rui , Liu Qiang
Published: April 2022

Objective

Our study aimed to assess the association between serum cystatin C levels and prognosis in acute myocardial infarction (AMI) patients after coronary reconstructive surgery.

Methods

We searched PubMed, Embase, and Cochrane Library up to January 21, 2022 without language restriction. Outcomes were major cardiovascular events (MACEs) and mortality. The risk ratio (RR) and 95% confidence interval (CI) were merged by random-effect models.

Results

We included 8 studies with a total of 7,394 subjects in our meta-analysis. Our meta-analysis showed that higher-level of serum cystatin C levels were associated with higher risk of MACEs (RR = 2.52, 95% CI 1.63–3.89, P < 0.001) and mortality (RR = 2.64, 95% CI 1.66–4.19, P < 0.001) in AMI patients after coronary revascularization. Subgroup analysis showed that the serum cystatin C levels were associated with significantly higher risk of MACEs (RR = 2.72, 95% CI 1.32–5.60, P = 0.006) and mortality (RR = 2.98, 95% CI 1.21–7.37, P = 0.020) in AMI patients after percutaneous coronary intervention (PCI). However, in AMI patients after coronary artery bypass surgery, there were no significantly higher risk of MACEs (RR = 2.41, 95% CI 0.98–5.93, P = 0.05) and mortality (RR = 3.15, 95% CI 0.76–13.03, P = 0.10). Further subgroup analysis showed that this significantly higher risk of MACEs and mortality did not change with the study sample size, study population area or study follow-up time.

Conclusion

The meta-analysis demonstrated that higher serum cystatin C levels were associated with significantly higher risk of MACEs and mortality in AMI patients after PCI. It is a biomarker for risk stratification for predicting the prognosis in AMI patients after PCI.
The association between SYNTAX score and long-term outcomes in patients with unstable angina pectoris: a single-centre retrospective study
Authors: Xu Min , Chen Hui , Li Hong-Wei
Published: April 2022

Background

The SYNTAX score affects clinical outcomes in early studies. However, the prognostic value of the SYNTAX Score for long-term outcomes and differences by SYNTAX score risk stratification in long-term prognosis between medical therapy and percutaneous coronary intervention (PCI) in patients with unstable angina pectoris (UAP) are not well known in the era of new generation drug-eluting stents and medication.

Methods

In this single-centre retrospective study, a total of 2364 patients with UAP from January 2014 to June 2017 at Beijing Friendship Hospital were enrolled. The primary endpoint was a composite of major adverse cardiovascular events (MACEs), including all-cause death, cardiac death, nonfatal myocardial infarction and stroke at least 2 years after discharge.

Results

In this study, 1695 patients had low SYNTAX scores ($$\leqq 22$$

≦
22

), 432 patients had medium SYNTAX scores (23–32), 237 patients had high SYNTAX scores (≥ 33), 1018 received medical therapy, and 1346 patients underwent PCI. Long-term MACEs occurred in 95 patients during the 3.38 ± 0.99-year follow-up. Compared to the medical therapy group, the PCI group showed lower MACEs and cardiac death in patients with high SYNTAX scores (7.4% vs. 16.7%, P = 0.048; 3.7% vs. 14.6%, P = 0.004) but no reduction in patients with low and medium SYNTAX scores. Cox multivariate regression analysis showed that advanced age, diabetes mellitus, left ventricular ejection fraction (LVEF), hs-CRP and high SYNTAX score were independent predictors for MACEs in the medical therapy group (P < 0.05), whereas chronic kidney disease (CKD) and LVEF were predictors of MACEs in the PCI group.

Conclusions

Compared to medical therapy, PCI could only significantly reduce long-term MACEs and cardiac death for patients with high SYNTAX scores but not for patients with low and medium SYNTAX scores. A high SYNTAX score could predict long-term MACEs for UAP patients in the medical therapy group but not in the PCI group.
Pathways to the emergency department - a national, cross-sectional study in Sweden
Authors: Henricson Joakim , Ekelund Ulf , Hartman Jens , Ziegler Bruno , Kurland Lisa , Björk Wilhelms Daniel
Published: April 2022

Background

Swedish Emergency Departments (EDs) see 2.6 million visits annually. Sweden has a strong tradition of health care databases, but information on patients’ pathways to the ED is not documented in any registry.

The aim of this study was to provide a national overview of pathways, degree of medical acuteness according to triage, chief complaints, and hospital admission rates for adult patients (≥18 years) visiting Swedish EDs during 24 h.

Methods

A national cross-sectional study including all patients at 43 of Sweden’s 72 EDs during 24 h on April 25th, 2018. Pathway to the ED, medical acuteness at triage, admission and basic demographics were registered by dedicated assessors present at every ED for the duration of the study. Descriptive data are reported.

Results

A total of 3875 adult patients (median age 59; range 18 to 107; 50% men) were included in the study. Complete data for pathway to the ED was reported for 3693 patients (98%). The most common pathway was self-referred walk-in (n = 1310; 34%), followed by ambulance (n = 920; 24%), referral from a general practitioner (n = 497; 1 3%), and telephone referral by the national medical helpline “1177” (n = 409; 10%). In patients 18 to 64 years, self-referred walk-in was most common, whereas transport by ambulance dominated in patients > 64 years.

Of the 3365 patients who received a medical acuteness level at triage, 4% were classified as Red (Immediate), 18% as Orange (very urgent), 47% as Yellow (Urgent), 26% as Green (Standard), and 5% as Blue (Non-Urgent).

Abdominal or chest pain were the most common chief complaints representing approximately 1/3 of all presentations.

Overall, the admission rate was 27%. Arrival by ambulance was associated with the highest rate of admission (53%), whereas walk-in patients and telephone referrals were less often admitted.

Conclusion

Self-referred walk-in was the overall most common pathway followed by ambulance. Patients arriving by ambulance were often elderly, critically ill and often admitted to in-patient care, whereas arrival by self-referred walk-in was more common in younger patients.
Professionals’ perspectives on existing practice and conditions for nurse-led gout care based on treatment recommendations: a qualitative study in primary healthcare
Authors: Sedelius Helene , Tistad Malin , Bergsten Ulrika , Dehlin Mats , Iggman David , Wallin Lars , Svärd Anna
Published: April 2022

Background

Gout affects nearly 2 % of the population and is associated with repeated painful flares of arthritis. Preventive urate-lowering therapy is widely available, but only one third of patients receive adequate treatment. Lack of knowledge among healthcare professionals and patients within primary healthcare are implicated as partial explanations for this undertreatment. Nurse-led care has proved to be an effective model when treating patients with gout, but there is a need for more knowledge about factors that can be expected to influence the future implementation of such care. The aim of this study was to describe factors influencing existing gout care in primary healthcare and the conditions for a future implementation of nurse-led gout care based on national treatment recommendations.

Methods

In this qualitative study, focus group discussions with 56 nurses and physicians and individual interviews with eight managers were conducted at nine primary healthcare units in central Sweden. A deductive qualitative content analysis based on the main constructs of the framework Integrated Promoting Action on Research Implementation in Health Services was followed by an inductive analysis within the frames of the main constructs: innovation, recipients and context.

Results

Gout-related contacts with primary healthcare was described as being patient initiated, diagnostics was in some respects complex and nurse-led care was experienced as a favourable primary healthcare model in general (innovation). Gout was seen as a low-priority condition with acute flares and there was inadequate knowledge of gout, including preventive treatment (recipients). Primary healthcare was perceived as having a holistic but fragmented responsibility for gout care, recommendations against keeping waiting lists complicated follow-up appointments and a need for motivation and support when introducing new practices was emphasised (context).

Conclusion

In this study, investigating the perspective of professionals, several factors were found to influence existing gout care. It will be crucial to target these factors in the development of a future implementation strategy.
Hemostatic efficacy and safety of the hemostatic powder UI-EWD in patients with lower gastrointestinal bleeding
Authors: Cha Boram , Lee Donghyun , Shin Jongbeom , Park Jin-Seok , Kwon Gye-suk , Kim Hyungkil
Published: April 2022

Background and aims

Acute lower gastrointestinal bleeding (LGIB) is a common cause of emergency hospitalization and may require readmission for re-bleeding. Recently, a novel endoscopic hemostatic powder (UI-EWD/Nexpowder™, Nextbiomedical, Incheon, South Korea) was developed and applied for the control of LGIB. The aim of this study was to evaluate the hemostatic efficacy and long-term safety of UI-EWD in LGIB.

Patients and methods

We conducted a retrospective cohort study of LGIB at a single tertiary center in south Korea. One hundred and sixty-seven consecutive patients with LGIB who were initially successful in endoscopic hemostasis were included and divided into the conventional treatment group (n = 112) and the UI-EWD therapy group (n = 55; 38 patients with conventional treatment and 17 patients with UI-EWD alone). The success rate of hemostasis, adverse events related to UI-EWD, and re-bleeding rate were evaluated.

Results

The incidence of endoscopic hemostasis applied to the hepatic flexure (7.3% vs. 0%, p = 0.011) and larger than 4 cm (25.5% vs. 8.0%, p = 0.002) were significantly higher in the UI-EWD group than in the conventional therapy group. The cumulative rebleeding rate within 28 days in the UI-EWD group was 5.5% (3/55), which was significantly lower than that in the conventional treatment group (17.0% [19/112]; p = 0.039). No UI-EWD-related adverse events were recorded.

Conclusion

Based on our results, application of UI-EWD in LGIB showed promising results for the prevention of re-bleeding, especially in locations where it is difficult to approach or cases with more bleeding. There were no significant complications, such as perforation or embolism. In particular, UI-EWD should be considered first for anatomical or technical impediments to endoscopic access in LGIB.
Acquired aplastic anemia complicated with anti-glomerular basement membrane disease successfully treated with immunosuppressive therapy: a case report
Authors: Matsui Kenji , Kamata Wataru , Mochida Yasuhiro , Ishioka Kunihiro , Moriya Hidekazu , Hidaka Sumi , Ohtake Takayasu , Tamai Yotaro , Kobayashi Shuzo
Published: April 2022

Background

Aplastic anemia (AA) is a rare but fatal disorder characterized by pancytopenia due to bone marrow hypoplasia. Anti-glomerular basement membrane disease (anti-GBM disease) is an immune complex small-vessel vasculitis that presents as rapidly progressive glomerulonephritis and/or pulmonary hemorrhage. Although both involve autoreactive T cells that are partially triggered by human leukocyte antigen (HLA)-DR15, there have been no reports of their co-existence and the treatment strategy is not well understood.

Case presentation

A 67-year-old woman presented with fever, malaise, and acute kidney injury with proteinuria and hematuria requiring hemodialysis. She was diagnosed with anti-GBM antibody disease based on high serum anti-GBM antibody titer and crescentic glomerulonephritis on a renal biopsy. Pulse administration of methylprednisolone (MP), oral prednisolone (PSL), and plasmapheresis were performed. Only 2 weeks after the diagnosis of anti-GBM disease, the patient developed pancytopenia requiring frequent blood transfusions. The blood cell count did not recover even 1 month after discontinuing the drugs that could cause pancytopenia. Bone marrow examination showed hypocellularity without abnormal infiltrates or fibrosis, which led to the diagnosis of severe acquired AA. Further HLA phenotyping revealed that she had HLA-DR15. Increased dose of PSL with the secondary MP pulse and the addition of cyclosporine improved pancytopenia. Although she remained dialysis-dependent, anti-GBM disease and pancytopenia did not recur for more than 2 years.

Conclusions

We report the first case of acquired AA complicated with anti-GBM disease in an elderly woman with HLA-DR15, which was successfully treated with immunosuppressive therapy (IST). This report is valuable not only because it shows they may co-occur, but also because it provides a therapeutic option for this complex condition. It was also suggested that pancytopenia in patients with anti-GBM disease recalls serious hematologic diseases including AA that require immediate treatment based on bone marrow examination.
Mindful with your baby for mothers of infants with (parental) stress in a non-clinical setting: a wait-list controlled pilot trial
Authors: Potharst Eva Sophie , Veringa-Skiba Irena , van Broekhuizen Esther , Bögels Susan Maria
Published: April 2022

Background

Because of the far-reaching negative consequences of high levels of (parental) stress for the mother, infant, the mother-infant relationship, and family functioning, psychological support for young mothers is important. Mindful with Your Baby is a mindfulness-based intervention, originally developed and evaluated in a clinical population of mothers with mental health issues and/or babies with regulation problems. The current pilot examines whether Mindful with Your Baby for mothers with symptoms of (parental) stress offered in a non-clinical setting is also effective and acceptable.

Methods

In this pilot waitlist-controlled trial, 17 mothers with infants (2–15 months) admitted themselves for a Mindful with Your Baby training in a non-clinical setting because of (parental) stress. Mindful with Your Baby was offered in groups of three to six mother-infant dyads and consisted of eight weekly 2-h sessions. Participants completed questionnaires on symptoms of parental stress, general stress, depression, anxiety, mindfulness and self-compassion at 8-week waitlist, pretest, posttest and 8-week follow-up.

Results

There were no training drop-outs, attendance rate was 92.5%, and the training was evaluated positively: all mothers (100%) felt they got something of lasting importance as a result of taking the training, and reported becoming more conscious as a parent, and 93% reported changing their lifestyle or parenting as a result of the training. Multilevel analyses showed no significant changes between waitlist and pretest. At posttest, a significant improvement occurred in all outcome measures compared to pretest, of moderate to large effect sizes. At follow-up, a significant improvement was seen compared to pretest in all outcomes except anxiety compared to pretest, of small to moderate effect sizes.

Conclusions

Mindful with Your Baby appears an acceptable and effective intervention for mothers with a baby who experience (parental) stress but who have not been referred to specialized mental health care. A low threshold access to Mindful with Your Baby in non-clinical settings could provide a timely and positive interference in (parental) stress.
Concomitant Temozolomide plus radiotherapy for high-grade and recurrent meningioma: a retrospective chart review
Authors: Belanger Katherine , Ung Timothy H. , Damek Denise , Lillehei Kevin O. , Ormond D. Ryan
Published: April 2022

Background

High-grade and recurrent meningiomas are often treatment resistant and pose a therapeutic challenge after surgical and radiation therapy (RT) failure. Temozolomide (TMZ) is a DNA alkylating agent that appears to have a radiosensitizing effect when used in combination with RT and may be worthwhile in meningioma treatment. Thus, we investigated the potential efficacy of concomitant RT plus TMZ compared to historical controls of just RT used in the treatment of high-grade and recurrent meningiomas.

Methods

We performed a retrospective analysis of patients with meningioma treated at the University of Colorado with TMZ chemoradiation. Progression free survival (PFS) and overall survival (OS) were calculated from the start of chemoradiation to local recurrence or death, respectively.

Results

Eleven patients (12 tumors) were treated with chemoradiation with a median follow-up of 41.5 months. There were two WHO grade 1, eight grade 2 and two grade 3 meningiomas. Three patients died during the follow-up period—one being disease related (11.1%). Two patients had meningioma recurrence—at 2.3 months (WHO grade 3), and 5.4 years (WHO grade 2). Three-year OS and PFS for grade 2 meningiomas were each 88%. Historical controls demonstrate a 3-year median OS and PFS of 83% and 75.8%, respectively.

Conclusions

Treatment options are limited for meningiomas after local failure. In this study, TMZ chemoradiation demonstrated no significant difference in PFS and OS in the treatment of grade 2 meningiomas compared to historic controls. Further study is warranted to find novel methods for the treatment of malignant and recurrent meningiomas.
TIM-1 promotes proliferation and metastasis, and inhibits apoptosis, in cervical cancer through the PI3K/AKT/p53 pathway
Authors: Chen Liuyan , Qing Jilin , Xiao Yangyang , Huang Xiaomei , Chi Yanlin , Chen Zhizhong
Published: April 2022

Background

T-cell immunoglobulin mucin-1 (TIM-1) has been reported to be associated with the biological behavior of several malignant tumors; however, it is not clear whether it has a role in cervical cancer (CC).

Methods

TIM-1 expression in cervical epithelial tumor tissues and cells was detected by immunohistochemistry or real-time quantitative-PCR and western blotting. CC cells from cell lines expressing low levels of TIM-1 were infected with lentiviral vectors encoding TIM-1. Changes in the malignant behavior of CC cells were assessed by CCK-8, wound healing, Transwell migration and invasion assays, and flow cytometry in vitro; while a xenograft tumor model was established to analyze the effects of TIM-1 on tumor growth in vivo. Changes in the levels of proteins related to the cell cycle, apoptosis, and Epithelial-mesenchymal transition (EMT) were determined by western blotting.

Results

TIM-1 expression was higher in CC tissues, than in high grade squamous intraepithelial lesion, low grade squamous intraepithelial lesion, or normal cervical tissues, and was also expressed in three CC cell lines. In HeLa and SiHa cells overexpressing TIM-1, proliferation, invasion, and migration increased, while whereas apoptosis was inhibited. Furthermore, TIM-1 downregulated the expression of p53, BAX, and E-cadherin, and increased cyclin D1, Bcl-2, Snail1, N-cadherin, vimentin, MMP-2, and VEGF. PI3K, p-AKT, and mTOR protein levels also increased, while total AKT protein levels remained unchanged.

Conclusions

Our study indicated that TIM-1 overexpression promoted cell migration and invasion, and inhibited cell apoptosis in CC through modulation of the PI3K/AKT/p53 and PI3K/AKT/mTOR signaling pathways, and may be a candidate diagnostic biomarker of this disease.
Age as a potential predictor of acute side effects during chemoradiotherapy in primary cervical cancer patients
Authors: Holmqvist Annica , Lindahl Gabriel , Mikivier Rasmus , Uppungunduri Srinivas
Published: April 2022

Background

Toxicity during chemoradiotherapy (CRT) in cervical cancer patients might limit the chances of receiving an optimal treatment and to be cured. Few studies have shown relationships between acute side effects and patient’s age. Here, the association between age and acute side effects such as nausea/vomiting, diarrhea and weight loss during CRT was analysed in cervical cancer patients.

Methods

This study included 93 patients with primary cervical cancer stage IBI to IVA who received CRT from 2013 to 2019. The frequency of symptoms/toxicity grade was analysed by using the Common Terminology Criteria for Adverse Events (CTCAE) version 5.0.

Results

Patients ≥ 52 years had a significantly higher frequency of nausea/vomiting and increased grade ≥ 3 toxicity during CRT compared to younger patients (p < 0.001, p = 0.001). Toxicity grade ≥ 3 of nausea/vomiting was associated with increased frequency of weight loss (p = 0.001), reduced ADL (p = 0.001) and dose modifications of both radiotherapy (RT) (p = 0.020) and chemotherapy (CT) (p = 0.030) compared to toxicity grade 2. The frequency of diarrhea (p = 0.015) and weight loss (p = 0.020) was higher in older patients compared to younger.

Conclusions

Older patients have an increased risk of acute side effects as nausea/vomiting, diarrhea and weight loss. Age could be useful in predicting acute side effects in primary cervical cancer patients with CRT.
Evaluation of the applicability of the current CDC pediatric ventilator-associated events (PedVAE) surveillance definition in the neonatal intensive care unit population
Authors: Arthur Novisi , Kaur Ishminder , Carey Alison J.
Published: April 2022

Background

There is limited data on pediatric ventilator-associated events (PedVAE) in the neonatal intensive care unit (NICU) setting, since the CDC mandated state reporting of these events in January 2019. This study sought to describe PedVAE rates and characteristics in the NICU population.

Methods

Single-center case-control study of infants requiring mechanical ventilation in a 39-bed level IV NICU between January 1, 2018 and December 31, 2020. Baseline infant demographic, respiratory support and antibiotic use data was obtained and comparisons were performed between patients with potential PedVAEs and those without events.

Result

Two hundred and nine infants were mechanically ventilated. Two of the 126 patients ventilated for ≥4 days met CDC criteria for PedVAEs with a total of 3 events, and 32 (25%) received antibiotics with escalation of respiratory support, primarily for tracheitis.

Conclusion

NICU-specific data on PedVAE is limited. Only 2 infants in the study period met the current CDC criteria for PedVAE with a rate of 0.9 events per 1000 ventilator days. The current CDC PedVAE definition might be inadequate to identify actionable VAEs to inform prevention efforts in the NICU population, and alternate indices could better characterize these events.
Associations between health literacy, cognitive function and general literacy in people with schizophrenia attending community mental health clinics in Australia
Authors: Thomson Sumana , Galletly Cherrie , Prener Christopher , Garverich Suzanne , Liu Dennis , Lincoln Alisa
Published: April 2022

Background

Health literacy (HL) has been defined as the ability of individuals to access, understand, and utilise basic health information. HL is crucial to patient engagement in treatment through supporting patient autonomy, informed consent and collaborative care. In people with physical disorders, poor HL is associated with poor health outcomes, but less is known about HL in people with severe mental illness. This study aimed to assess HL and investigate the associations between education, cognitive function, general literacy, and HL in participants with schizophrenia attending community mental health clinics.

Method

Fifty-two outpatients with schizophrenia attending a public community mental health clinic in Adelaide, Australia completed the Test of Functional Health Literacy in Adults—Short Form (S-TOFHLA) along with tests of cognition, aural and reading literacy and numeracy including Digit Symbol Coding (DSC), verbal fluency, the Wechsler Adult Intelligence Scale (WAIS-IV), Woodcock-Johnson III (Part 4 and 9) and the Lipkus numeracy scale. Sixty-one percent of participants were male. Participants had a mean age of 41.2 (SD 9.9) years and a mean of 11.02 (SD 1.5) years of education.

Results

The majority of participants had very poor aural and verbal literacy and poorer literacy correlated with fewer years of education. On the S-TOFHLA, 81% of participants had adequate HL; 6% were marginal and 13% were inadequate. There was a positive correlation between education and HL, with those with more years of education scoring higher for HL. There was also a significant association between better HL and better working memory and attention.

Conclusions

Consistent with previous research in schizophrenia, our participants had reduced educational attainment, aural and reading literacy and cognitive function compared to population norms. However, HL was better than expected given that previous research has found that people with psychiatric disorders tend to have lower HL, compared to the general population. This may reflect effective case management of our participants whilst attending the community clinics and supports ongoing research and intervention regarding HL in people living with mental illness.
Impact of fertility on the longevity of older rural Chinese women: an analysis of a longitudinal survey
Authors: Zhou Wan-li , Zhang Shuo , Yang Hua-lei , Gu Ying-wen , Yao Yi-dan , Wu Yuan-yang , Zhang Si-qing
Published: April 2022

Background

This study evaluates the impact of fertility during the childbearing period on the longevity of older rural Chinese women and verifies whether any trade-off exists between women’s longevity and their number of children to provide empirical evidence for improving health intervention policies and formulating active fertility policies in low-fertility countries.

Methods

Based on the data of the deaths of 1623 older adults aged 65 and above during 2014–2018 in the Chinese Longitudinal Healthy Longevity Survey, this study explores the relationship between the number of children born and older rural women’s longevity using the ordinary least squares method. Furthermore, the impact of fertility on the longevity of men and women in rural and urban areas, along with other reproductive behaviours on older rural women’s longevity, were analysed.

Results

There was a significant negative correlation between the number of children born and women’s longevity (β = − 0.555, p < 0.05). Additionally, their longevity exhibited a decreasing trend with having birthed more sons and an increasing trend with more daughters. Age at first and last births had a significant positive relationship with rural women’s longevity; however, the effect of fertility on the longevity of older rural and urban men and older urban women was not significant.

Conclusions

It is confirmed that there is a trade-off between fertility and longevity for rural women in China. Future research should focus on compensating for the decline in female longevity caused by the number of children born and promote the concept of a healthy pregnancy, scientific nurture, and gender equality in fertility.
Management and long-term outcomes of acute right colonic diverticulitis and risk factors of recurrence
Authors: Ma Zhilong , Liu Weiwei , Zhou Jia , Yao Le , Xie Wangcheng , Su Mingqi , Yang Jin , Shao Jun , Chen Ji
Published: April 2022

Background

Acute right-sided colonic diverticulitis (RCD) is a common disease in Asian populations for which the optimal treatment remains controversial. The aim of this study was to investigate management and evaluate long-term outcomes of treatment in patients with acute RCD.

Methods

We retrospectively collected and analyzed clinical data for patients with acute RCD admitted to the Tongren Hospital, Shanghai Jiao Tong University School of Medicine from December 2015 to December 2020. The patients were divided into two groups, according to primary treatment strategy, which was either conservative treatment or surgical treatment.

Results

A total of 162 consecutive patients with acute RCD were enrolled in the study. There was no significant difference in age, sex, history of abdominal surgery, medical co-morbidities, fever, previous history of RCD, treatment success rate and incidence of complications between the conservative and surgery groups. However, the recurrence rate in conservative groups was significantly higher than in surgery groups (16.53% vs 2.44%, P = 0.020). And more frequent bowel movements and previous history of RCD increased the risk of recurrence of acute RCD. Moreover, there was no significant difference in either treatment success rate or the overall recurrence rate between the patients with uncomplicated diverticulitis and patients with complicated diverticulitis.

Conclusions

Surgical treatment is also safe and effective for acute RCD. Surgical treatment should mainly be considered for patients with acute RCD with recurrence risk factors (more frequent bowel movements and previous history of RCD) or with complicated acute RCD.
Risk factors for postoperative ileus after diverting loop ileostomy closure
Authors: Nakao Toshihiro , Shimada Mitsuo , Yoshikawa Kozo , Tokunaga Takuya , Nishi Masaaki , Kashihara Hideya , Takasu Chie , Wada Yuma , Yoshimoto Toshiaki , Yamashita Syoko , Iwakawa Yosuke
Published: April 2022

Background

Postoperative ileus is one of the most common complications after diverting loop ileostomy closure. Some reports have investigated the risk factors for postoperative complications or ileus after ileostomy closure; however, these studies did not evaluate the index surgery sufficiently. In this study, we evaluated the risk factors, including the details of the index surgery, for ileus after diverting ileostomy closure.

Methods

This was a retrospective study of patients who underwent ileostomy closure following index surgery for rectal cancer. Patients who developed postoperative ileus [POI (+)] and patients who did not [POI (−)] after ileostomy closure were compared.

Results

Sixty-eight patients were evaluated and were divided into two groups: POI (+) (n = 11) and POI (−) (n = 57), and the groups were compared. There were no significant differences in the details of the index surgery, operative procedure, transanal total mesorectal excision, lateral lymph node dissection, operating time, or blood loss. The incidence of Clavien–Dindo grade ≥ III complications and adjuvant chemotherapy after index surgery were significantly higher in the POI (+) group.

Conclusions

The incidence of Clavien–Dindo grade ≥ III complications and adjuvant chemotherapy after index surgery may increase the risk of postoperative ileus after ileostomy closure.