bluuebunny/crossref_metadata_2025 huggingface dataset:
Generation Z job seekers’ expectations and their job pursuit intention: Evidence from transition and emerging economy
Authors: Nguyen Ngoc Thang , Viet Dung Mai , Rowley Chris , Pejić Bach Mirjana
Published: July 2022

Understanding Generation Z job seekers’ expectations and job pursuit intentions can help organizations successfully attract them. However, there is limited research on this, especially for the transition and emerging economies. With these issues in mind, this study focused on two main objectives: (1) to examine Generation Z job seekers’ expectations and their job pursuit intention (JPI) in a transition and emerging economy, with samples from Vietnam, and (2) to advance the understanding of instrumental and symbolic attributes in recruitment literature. We apply the interpretive research method to explore the hidden reasons behind generation Z job seekers’ expectations and intentions of their job pursuit. Multiple combining questionnaires and group discussions were conducted with Vietnamese final year students soon to enter the workforce. The results showed that the Vietnamese Generation Z pays more attention to the job/organization in terms of intangible attributes (e.g. office atmosphere or workplace ethics) than physical features. Our study also found that Generation Z considered instrumental organizational attributes and symbolic meaning of corporate social responsibility (CSR). Although some studies have examined the Generation Z expectation in the workplace, no studies investigated the JPI of Gen Z job seekers. In addition, most recent studies investigated the Generation Z expectation in the workplace without using any solid, theoretical foundation underpinning human resource management. Therefore, using an instrumental-symbolic framework in recruitment, our study adds to the literature by examining how Generation Z job seekers react to instrumental attributes and symbolic attributes.
Volume and Variability of Foot and Ankle Case Exposure During Orthopaedic Residency: 2014-2019
Authors: Hartnett Davis A. , Lama Christopher J. , Garcia-Lopez Edgar , Daniels Alan H. , Richardson David R.
Published: July 2022

Background:

Exposure to a comprehensive breadth and volume of surgical cases is a fundamental component of orthopaedic education, though standardization of case exposures across residency programs is limited to a small amount of required case minimums. Significant variability in exposure to subspecialty cases, such as foot and ankle surgeries, can create distinctly different residency experiences.

Methods:

Accreditation Council for Graduate Medical Education (ACGME) surgical case logs from 2014 to 2019 for leg/ankle and foot/toes were examined following the 2013 implementation of case minimums. Average surgical case volume across subcategories and the average volume of different residency percentiles were analyzed to assess variability.

Results:

The mean total volume of case exposure for graduating orthopaedic residents has increased significantly since 2014 for both leg/ankle cases (28.6%) and foot/toes (27.8%), though totals were still down compared with when ACGME reporting began in 2007. Arthrodesis exposures have increased significantly for leg/ankle (69.2%) and foot/toes (93.8%) cases since 2014, and ankle arthroscopy has increased 20.7%. Disparities in total cases between 10th and 90th percentile programs have shown a nonsignificant decrease over time, with significant differences between leg/ankle arthrodesis (8-fold), leg/ankle arthroscopy (13-fold), and foot/toe arthrodesis (3.5-fold) in 2019.

Conclusion:

The mean volume of foot and ankle case exposures among graduating residents has continued to rise since the implementation of case minimums in 2013 but disparities in volume are present, most notably concerning arthrodesis and arthroscopy. Recognition and future attention toward addressing this variability can be meaningful in promoting a more comprehensive, standardized orthopaedics education.

Level of Evidence:

Level III: Retrospective comparative study.
Subarachnoid Hemorrhage due to Cerebral Cavernous Malformation in a Young Female
Authors: Thurman Cleopatra , Qureshi Kasim , Deol Baljit , Farooq Muhammad U.
Published: July 2022

Cerebral cavernous malformations (CCMs) are usually intraparenchymal lesions commonly associated with intraparenchymal hemorrhage. Extra-axial Lesions are uncommon and have rarely been reported as the cause of aneurysmal like subarachnoid hemorrhage (SAH). We present a 33-years-old female with a past medical history significant for hypertension who presented with acute onset head and neck pain after bending over. En route to the hospital, she had abnormal motor movements suggestive of seizures. Computed tomography (CT) of the head was significant for diffuse aneurysmal like SAH. Head CT angiography (CTA) and catheter digital subtraction angiography (DSA) were both negative for aneurysm. Magnetic resonance imaging (MRI) of the brain showed susceptibility artifact in the right parafalcine frontal lobe suspicious for underlying CCM. This lesion was in the area suspected of having an aneurysm on CT head. The patient was diagnosed with SAH secondary to cavernous malformation mimicking aneurysmal etiology. This case is important as it serves as a good reminder to consider cavernous malformations in the differential in patients presenting with angiogram negative SAH. Diagnosis of this entity has treatment implications including discontinuation of calcium channel blockers if initiated, discussion about duration of anti-seizure medication, in addition to consideration for surgical intervention in select populations.
Tweeting Others With Respect: Historicist Thinking Can Reduce Blame and Hostile Retaliation to Nasty Communications From Partisan Opponents
Authors: Gill Michael J. , Alam Raihan , Nagelhout Claire
Published: July 2022

Hostile partisan communication pervades social media. Partisan hostility often takes the form of reciprocal blaming, where one feels blamed by an out-party member (“She said my beliefs are stupid!”) and then reciprocates with blame-fueled verbal hostility. Here, we examine whether historicist narratives, story-like descriptions of how someone developed her beliefs, can reduce such hostile verbal retaliation. In three experiments, strongly liberal or strongly conservative participants were presented with “tweets” that criticized their views. They replied with a “tweet” of their own. Experiments 1 and 2 showed that historicist narratives regarding their criticizer reduced hostile verbal retaliation by both liberals and conservatives. Experiment 3 showed that an abstract historicist reminder—a general message about how life history shapes people—reduced hostile verbal retaliation by liberals. Across experiments, reductions in verbal retaliation were mediated by reduced blame of the criticizer.
Advancing understanding of dietary and movement behaviours in an Asian population through real-time monitoring: Protocol of the Continuous Observations of Behavioural Risk Factors in Asia study (COBRA)
Authors: Edney Sarah Martine , Park Su Hyun , Tan Linda , Chua Xin Hui , Dickens Borame Sue Lee , Rebello Salome A , Petrunoff Nick , Müller Andre Matthias , Tan Chuen Seng , Müller-Riemenschneider Falk , van Dam Rob M
Published: July 2022

Background

Modifiable risk factors for non-communicable diseases, including eating an unhealthy diet and being physically inactive, are influenced by complex and dynamic interactions between people and their social and physical environment. Therefore, understanding patterns and determinants of these risk factors as they occur in real life is essential to enable the design of precision public health interventions.

Objective

This paper describes the protocol for the Continuous Observations of Behavioural Risk Factors in Asia study (COBRA). The study uses real-time data capture methods to gain a comprehensive understanding of eating and movement behaviours, including how these differ by socio-demographic characteristics and are shaped by people's interaction with their social and physical environment.

Methods

COBRA is an observational study in free-living conditions. We will recruit 1500 adults aged 21–69 years from a large prospective cohort study. Real-time data capture methods will be used for nine consecutive days: an ecological momentary assessment app with a global positioning system enabled to collect location data, accelerometers to measure movement, and wearable sensors to monitor blood glucose levels. Participants receive six EMA surveys per day between 8 a.m. and 9.30 p.m. to capture information on behavioural risk factors including eating behaviours and diet composition movement behaviours (physical activity, sedentary behaviour, sleep), and related contextual factors. The second wave of ecological momentary assessment surveys with a global positioning system enabled will be sent 6 months later. Data will be analysed using generalised linear models to examine associations between behavioural risk factors and contextual determinants.

Discussion

Findings from this study will advance our understanding of dietary and movement behaviours as they occur in real-life and inform the development of personalised interventions to prevent chronic diseases.
Mixed epithelial and stromal tumor of the kidney composed mainly of solid components: A case report
Authors: Maeba Kiyoka , Kanki Akihiko , Watanabe Hiroyuki , Yamamoto Akira , Fujimoto Yasuto , Yoshiyuki Miyaji , Tamada Tsutomu
Published: July 2022

Mixed epithelial and stromal tumor (MEST) is a relatively rare lesion of mixed epithelial and mesenchymal origin, consisting of epithelial components that form cysts and stromal cells that are positive for estrogen and progesterone receptors. The present case was a 54-year-old female who presented with hematuria. Abdominal ultrasonography revealed a 41 x 30 mm tumor in the right kidney, with the tumor protruding outward in the direction of the renal pelvis. Dynamic contrast-enhanced computed tomography and magnetic resonance imaging confirmed a solid tumor in the right kidney that showed gradual contrast enhancement and contained a central non-enhancing area with the appearance of a cystic component. Based on the imaging findings, the provisional diagnosis was papillary renal cell carcinoma or angiomyolipoma with epithelial cysts. Right nephrectomy was performed and the tumor was confirmed histopathologically as MEST. We report a very rare case of MEST that was composed mainly of solid components.
Combination of laparoscopic side-to-end colorectal anastomosis and vaginal nose (natural orifice specimen extraction) surgery for colorectal endometriosis: Technique and outcomes
Authors: Kale Ahmet , Kuru Betul , Baydili Kursat Nuri , Cokay Deniz , Basol Gulfem , Cansu Gundogdu Elif , Mat Emre , Ertugrul Ismail , Altuntas Yunus Emre , Usta Taner , Aboalhasan Yasmin , Oral Engin
Published: July 2022

Objective:

To investigate the effectiveness of combining side-to-end anastomosis and vaginal NOSE (Natural orifice specimen extraction) surgery in colorectal endometriosis.

Material and methods:

We included 11 patients treated with laparoscopic side-to-end colorectal anastomosis and vaginal NOSE surgery between January 2019 and May 2021. We questioned the visual analog score (VAS) for pain symptoms, the short form-36 (SF-36) for health survey questionnaire, The Female Sexual Function Index (FSFI), EHP-5 for endometriosis health profile, The Hospital Anxiety and Depression Scale (HADS), OAB-V8 for overactive bladder symptoms and Constipation Severity Instrument (CSI).

Results:

VAS, EHP-5, and SF-36 scores were better at postoperative third and sixth months than preoperative values ( p < 0.05). There were no statistically significant differences in terms of FSFI, OAB-V8, HADS, and the CSI.

Conclusions:

Laparoscopic side-to-end anastomosis with vaginal NOSE surgery is feasible, scarless, and could be offered to patients with deep symptomatic bowel endometriosis.
Adherence, Effectiveness and Safety of Dolutegravir Based Antiretroviral Regimens among HIV Infected Children and Adolescents in Tanzania
Authors: Mutagonda Ritah F. , Mlyuka Hamu J. , Maganda Betty A. , Kamuhabwa Appolinary A. R.
Published: July 2022

Objectives:This study aimed at assessing adherence, effectiveness, and safety of DTG-based HAART regimens among HIV-infected children and adolescents in Tanzania. Methods: This was a single-center prospective cohort study, conducted at the pediatric HIV Clinic in Mbeya, Tanzania. A binary logistic regression model was used to determine predictors of undetectable viral load at week 24. The results were significant when P-value was <0.05. Results: A total of 200 patients were enrolled with the majority (85.5%) being treatment experienced. High adherence levels (71%) were observed using the pharmacy refill method. At week 24, the overall proportion of patients with undetectable viral load was 70.2%. The predictors of undetectable viral load were age, World Health Organization (WHO) clinical stage, baseline VL and adherence to pharmacy refill. Conclusion: The majority of patients attained undetectable viral load 6 months after using DTG based regimen. DTG-based regimens were generally safe with few ADEs reported.
“PrEP Gives the Woman the Control”: Healthcare Worker Perspectives on Using pre-Exposure Prophylaxis (PrEP) During Pregnancy and Postpartum in Kenya
Authors: Mwongeli Nancy , Wagner Anjuli D. , Dettinger Julia C , Pintye Jillian , Brown Trinidad Susan , Awuor Merceline , Kimemia Grace , Ngure Kenneth , Heffron Renee A. , Baeten Jared M. , Mugo Nelly , Bukusi Elizabeth A. , Kinuthia John , Kelley Maureen C. , John-Stewart Grace C. , Beima-sofie Kristin M.
Published: July 2022

Background: Pregnant and postpartum women in high HIV prevalent regions are at increased HIV risk. Oral pre-exposure prophylaxis (PrEP) can decrease HIV incidence reducing infant HIV infections. Understanding healthcare worker (HCW) beliefs about PrEP prior to national roll-out is critical to supporting PrEP scale-up. Methods: We conducted 45 semi-structured interviews among a range of HCW cadres with and without PrEP provision experience purposively recruited from four clinics in Kenya to compare their views on prescribing PrEP during pregnancy and postpartum. Interviews were analysed using a conventional content analysis approach to identify key influences on PrEP acceptability and feasibility. Results: All HCWs perceived PrEP as an acceptable and feasible HIV prevention strategy for pregnant and postpartum women. They believed PrEP meets women’s needs as an on-demand, female-controlled prevention strategy that empowers women to take control of their HIV risk. HCWs highlighted their role in PrEP delivery success while acknowledging how their knowledge gaps, concerns and perceived PrEP implementation challenges may hinder optimal PrEP delivery. Conclusion: HCWs supported PrEP provision to pregnant and postpartum women. However, counseling tools to address risk perceptions in this population and strategies to reduce HCW knowledge gaps, concerns and perceived implementation barriers are required.
Do Mixed Emotions Matter in a Crisis? The Impact of Expressing Sadness and Sympathy on Organizational Reputation and Forgiveness
Authors: Ndone James
Published: July 2022

This study seeks to advance the literature in emotional crisis communication by comparing the effects of single emotional message framing to mixed emotional message framing in organizational crisis on organizational reputation and forgiveness. Through an online four (emotional message framing: control vs. negative emotion [sadness] vs. positive emotion [sympathy] vs. mixed-valence emotions [both sadness + sympathy]) by two (crisis type: preventable vs. victim crisis) between-groups experiment, this study investigated the effects of mixed-valence emotions, where the CEO expressed both positive and negative discrete emotions ( N = 424). Additionally, the current study sought to test the mediating effects of perceived sincerity and empathy toward the CEO on the relationship between the crisis type and message framing on both organizational reputation and forgiveness. The findings show that, during a preventable crisis, expressing mixed emotions results in a more positive organizational reputation and organizational forgiveness than expressing single emotions (sadness or sympathy). Also, both empathy toward the CEO and perceived sincerity mediated the relationship between a preventable crisis and organizational reputation as well as forgiveness. Both practical and theoretical implications of this study are discussed.
Appearance, Parentage, and Paradox: The White Privilege of Bi/Multiracial Americans with White Ancestry
Authors: Waring Chandra D. L.
Published: July 2022

The growth of the bi/multiracial American population has inspired a corresponding surge in scholarship on this historically understudied racial group. Simultaneously, a much-needed mainstream discussion has emerged about the unearned, often invisible privileges of being White in American society. In this article, I enrich the literature in both areas by elucidating how some bi/multiracial Americans benefit from, yet also pay a price for, whiteness and White privilege through the narratives of 30 participants from a variety of racially mixed backgrounds, all of whom have White ancestry. First, I explore how some participants experience traditional White privilege through their White-appearing features. Second, I examine an almost invisible iteration of White privilege that participants acquired through their white parent, irrespective of my respondents’ skin color. Third, I illuminate the price of appearing White (and light) for bi/multiracials in ways that are similar to but also different from monoracism. This article analyzes the paradoxical manifestation of White privilege in a growing cohort of Americans: bi/multiracials with White ancestry.
A Qualitative Examination of Barriers and Facilitators to Providing Pedagogical Training for Doctoral Students in Behavioral and Social Sciences Programs at US Schools of Public Health
Authors: Walker Elizabeth Reisinger , Lederer Alyssa M. , Stolow Jeni A.
Published: July 2022

There is increasing attention regarding the preparation of doctoral students in schools of public health (SPH) to teach; however, few studies have examined pedagogical preparation for doctoral students in public health-related disciplines. This study aimed to describe the pedagogical training and experiences available for doctoral students in behavioral and social sciences (BSS) programs in SPH and examine the facilitators and barriers to offering pedagogical training and experiences. Qualitative semi-structured interviews were completed with 13 pedagogy instructors, program directors, or administrators in SPH with BSS doctoral programs. Data were analyzed using thematic analysis. Just over half (54%) of the doctoral programs offered or planned to offer a pedagogy course in their curricula. Doctoral students in most programs had access to other teaching training opportunities, most commonly through university centers for teaching and learning. All doctoral programs required or provided students with the option to serve as a teaching assistant and, in some cases, instructor. Key factors contributing to if pedagogical training and experiences were available in the doctoral programs were the degree of priority placed on teaching preparation for doctoral students; logistic challenges, such as time and funding constraints; the level of need to fill teaching assistant and instructor positions; and competencies requiring teaching training for Doctor of Public Health students. Doctoral programs considering changes or expansion of pedagogical training and experiences should consider how to overcome common barriers and leverage facilitators in order to provide students with the best possible pedagogical preparation for both academic and non-academic careers.
The Court of Bigotry: Contested Sexuality of Dalit and Non-Dalit Women
Authors: Diwakar Jyoti
Published: July 2022

In the Indian context, women, especially Dalit women, have been subjected to scripturally and culturally sanctioned misogyny. These deep-rooted prejudices are manifested at both the societal and the institutional levels. In such a scenario, any assertion of justice by Dalit women is fraught with tensions. The sexual violence against them is routinized, normalized and invisibilized. For the victims, it is a lonely struggle as civil society scarcely registers such crimes; for the law and judiciary, it is another claim for meagre compensation. Their bodies are bereft of honour, and their sexuality is viewed with suspicion, easily accessible to any male of the dominant communities who can lay claim to it. This article explores two case studies—Khairlanji and Nirbhaya, geographically distinct spaces, where Dalit women were brutally raped and mutilated, and the perpetrators were let off lightly. The mainstream media largely ignored the developments. The article also focuses on the fissures within the feminist movement vis-à-vis caste and the politics of sexuality.
Removal of ivermectin from aqueous media using commercial, bentonite-based organophilic clay as an adsorbent
Authors: Nippes Ramiro Picoli , Macruz Paula Derksen , Coslop Thaísa Frossard , Molinari Deise , Scaliante Mara Heloísa Neves Olsen
Published: July 2022

The worldwide use of pharmaceuticals is of concern to those researchers who develop new techniques for the removal of these compounds from the aquatic medium. The objective of the present work was to characterize and evaluate the performance of a commercial, bentonite-based organophilic clay in removing ivermectin from aqueous solution. The adsorbent was characterized by nitrogen physisorption, thermogravimetric-differential scanning calorimetry (TG-DSC), X-ray diffraction (XRD) and Fourier-transform infrared spectroscopy (FTIR). Batch-scale adsorption experiments were performed to evaluate the kinetics, isotherms, thermodynamics and effect of pH on removal of this drug and reuse of the clay. The bentonite has a small specific surface area with an irregular surface. The Elovich kinetic model fits the experimental data better than other models, indicating that chemisorption contributes to drug removal in this case. The Langmuir and Sips isothermal models best fit the experimental equilibrium data. The process was shown to be favorable (ΔG°ads<0), endothermic (ΔH°ads>0), with an increase in the degrees of freedom at the solid–liquid interface (ΔS°ads>0), and with characteristics of a physical-chemical adsorption process (Ea = 11.065 kJ mol–1) under the study conditions. Adsorption was favored at the natural pH of the solution and the organophilic clay could be regenerated with water and reused in consecutive adsorption cycles. The amount of ivermectin adsorbed on the organophilic clay ranged from 1.78 to 3.88 mg g–1. The organophilic clay was shown to be a cost-effective potential adsorbent for ivermectin-contaminated water-treatment applications.
The crystal structure of Pd8As3, a synthetic analogue of stillwaterite
Authors: Karimova Oxana V. , Mezhueva Anna A. , Zgurskiy Nikolay A. , Zolotarev Andrey A. , Chareev Dmitriy A.
Published: July 2022

The synthetic analogue of mineral stillwaterite, Pd8As3, was synthesised and its crystal structure was solved to R1 = 0.0341 based on single crystal X-ray diffraction data. Pd8As3 is trigonal and the space group is P$\bar{3}$. The unit-cell parameters are a = 7.4261(4), c = 10.3097(9) Å and V = 492.38(7) Å3 with Z = 3. The structure builds up by layers of Pd and As atoms. Pd-nets and As-nets are parallel to (110) and stack along the c axis direction. The stacking sequence is ABCDEEDCBA. The relation between structures of minerals with the common formula Pd8T3 (T = As or/and Sb) are discussed. They are formed by nets of pnictogen and palladium atoms. The common feature of the structures is 36 topology of pnictogen nets. The differences are stacking sequences and topology of the palladium nets.
How I treat and prevent COVID-19 in patients with hematologic malignancies and recipients of cellular therapies
Authors: El Chaer Firas , Auletta Jeffery J. , Chemaly Roy F.
Published: July 2022

Patients with hematologic malignancies and recipients of hematopoietic cell transplantation (HCT) are more likely to experience severe coronavirus disease 2019 (COVID-19) and have a higher risk of morbidity and mortality after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Compared with the general population, these patients have suboptimal humoral responses to COVID-19 vaccines and subsequently increased risk for breakthrough infections, underscoring the need for additional therapies, including pre- and postexposure prophylaxis, to attenuate clinical progression to severe COVID-19. Therapies for COVID-19 are mostly available for adults and in the inpatient and outpatient settings. Selection and administration of the best treatment options are based on host factors; virus factors, including circulating SARS-CoV-2 variants; and therapeutic considerations, including the clinical efficacy, availability, and practicality of treatment and its associated side effects, including drug-drug interactions. In this paper, we discuss how we approach managing COVID-19 in patients with hematologic malignancies and recipients of HCT and cell therapy.
Airway autoantibodies are determinants of asthma severity
Authors: Salter Brittany , Zhao Nan , Son Kiho , Tan Nadia Suray , Dvorkin-Gheva Anna , Radford Katherine , LaVigne Nicola , Huang Chynna , Kjarsgaard Melanie , Li Quan-Zhen , Tselios Konstantinos , Lim Hui Fang , Khalidi Nader , Nair Parameswaran , Mukherjee Manali
Published: July 2022

Background

Local airway autoimmune responses may contribute to steroid dependence and persistent eosinophilia in severe asthma. Auto-IgG antibodies directed against granule proteins such as eosinophil peroxidase (EPX), macrophage scavenger receptor with collagenous structure (MARCO) and nuclear/extranuclear antigens (antinuclear antibodies (ANAs)) have been reported. Our objective was to describe the prevalence and clinical characteristics of asthmatic patients with airway autoreactivity, and to assess if this could be predicted from clinical history of autoreactivity.

Methods

We analysed anti-EPX, anti-MARCO and ANAs in 218 sputum samples collected prospectively from 148 asthmatic patients, and evaluated their association with lung function parameters, blood/airway inflammation, severity indices and exacerbations. Additionally, 107 of these patients consented to fill out an autoimmune checklist to determine personal/family history of systemic autoimmune disease and symptoms.

Results

Out of the 148 patients, 59 (40%) were anti-EPX IgG+, 53 (36%) were anti-MARCO IgG+and 64 out of 129 (50%) had ≥2 nuclear/extranuclear autoreactivities. A composite airway autoreactivity score (CAAS) demonstrated that 82 patients (55%) had ≥2 airway autoreactivities (considered as CAAS+). Increased airway eosinophil degranulation (OR 15.1, 95% CI 1.1–199.4), increased blood leukocytes (OR 3.5, 95% CI 1.3–10.1) and reduced blood lymphocytes (OR 0.19, 95% CI 0.04–0.84) predicted CAAS+. A third of CAAS+patients reported an exacerbation, associated with increased anti-EPX and/or anti-MARCO IgG (p<0.05). While no association was found between family history or personal diagnosis of autoimmune disease, 30% of CAAS+asthmatic patients reported sicca symptoms (p=0.02). Current anti-inflammatory (inhaled/oral corticosteroids and/or adjunct anti-interleukin-5 biologics) treatment does not attenuate airway autoantibodies, irrespective of eosinophil suppression.

Conclusion

We report 55% of moderate–severe asthmatic patients to have airway autoreactivity that persists despite anti-inflammatory treatment and is associated with exacerbations.
Cacna2d2 inhibits axonal regeneration following surgical decompression in a rat model of cervical spondylotic myelopathy
Authors: Liu Peisheng , Li Xiaofeng , Liu Jing , Zhang Hengjia , You Zhitao , Zhang Jianfeng
Published: July 2022

Background

Cervical spondylotic myelopathy (CSM) is a clinically symptomatic condition due to spinal cord compression, leading to spinal cord dysfunction. Surgical decompression is the main treatment of CSM, but the mechanisms of axonal regeneration after surgical decompression are still fragmentary.

Methods

In a rat model of CSM, the cacna2d2 (α2δ2) expression levels in anterior horn of spinal cord were observed following compression and decompression by western blot and immunofluorescence. The expression levels of 5 hydroxytryptamine (5HT) and GAP43 were also analyzed by immunofluorescence. Furthermore, gabapentin intervention was performed for 4 weeks after decompression to analyze the changes of behaviors and anterior horn of spinal cords.

Results

Following decompression, the expression levels of α2δ2 in the anterior horn of spinal cord were decreased, but the expression levels of 5HT andGAP43 were increased. Compared with the vehicle treated rats, gabapentin treatment for 4 weeks ameliorated the behaviors of rats and improved the damaged anterior horn of spinal cord. Besides, inhibition of α2δ2 through gabapentin intervention enhanced the axonal regeneration in the anterior horn of damaged spinal cord.

Conclusions

Inhibition of α2δ2 could enhance axonal recovery in anterior horn of damaged spinal cord induced by CSM after surgical decompression, providing a potential method for promoting axon regeneration following surgery.
Preoperative frailty and chronic pain after cardiac surgery: a prospective observational study
Authors: Arends Britta C. , Timmerman Leon , Vernooij Lisette M. , Verwijmeren Lisa , Biesma Douwe H. , van Dongen Eric P. A. , Noordzij Peter G. , van Oud-Alblas Heleen J Blussé
Published: July 2022

Background

Chronic pain after cardiac surgery, whether or not related to the operation, is common and has negative impact on health related quality of life (HRQL). Frailty is a risk factor for adverse surgical outcomes, but its relationship with chronic pain after cardiac surgery is unknown. This study aimed to address the association between frailty and chronic pain following cardiac surgery.

Methods

This sub-study of the Anesthesia Geriatric Evaluation study included 518 patients ≥ 70 years undergoing elective cardiac surgery. Pain was evaluated with the Short-Form 36 questionnaire prior to and one year after surgery. Associations between chronic postoperative pain and frailty domains, including medication use, nutritional status, mobility, physical functioning, cognition, HRQL, living situation and educational level, were investigated with multivariable regression analysis.

Results

Chronic pain one year after cardiac surgery was reported in 182 patients (35%). Medication use, living situation, mobility, gait speed, Nagi’s physical functioning and preoperative HRQL were frailty domains associated with chronic pain after surgery. For patients with chronic pain physical HRQL after one year was worse compared to patients without chronic pain (β –10.37, 99% CI –12.57 – –8.17).

Conclusions

Preoperative polypharmacy, living alone, physical frailty and lower mental HRQL are associated with chronic pain following cardiac surgery. Chronic postoperative pain is related to worse physical HRQL one year after cardiac surgery. These findings may guide future preoperative interventions to reduce chronic pain and poor HRQL after cardiac surgery in older patients.

Trial Registration

This trial has been registered before initiation under number NCT02535728 at clinicaltrials.gov.
Correlation between crown-rump length in the first trimester of pregnancy and neonatal outcomes
Authors: Xu Yin , Ni Meng , Zhang Qianqian , Zhao Jiuru , Tang Zheng , Liu Zhiwei
Published: July 2022

Background

To investigate the association of crown-rump length (CRL) during the first trimester of pregnancy with neonatal outcomes.

Methods

A total of 15,524 women with a reliable first day of the last menstrual period and a regular menstrual cycle (28 ± 4 days) were included from January 2015 to November 2016. CRL was measured by ultrasound from 7+0 to 13+6 weeks during pregnancy and transformed to a standard deviation score (SDS) adjusted for gestational age. Linear regression was used to explore risk factors for CRL. A generalised linear model was used to evaluate the association between CRL and neonatal outcomes.

Results

In the multivariate analysis, maternal age (0.25 mm, 95% CI = [0.22–0.28], P < 0.001; 0.04 SDS, 95% CI = [0.03–0.04], P < 0.001), multipara (0.30 mm, 95% CI = [0.08–0.52], P = 0.007; 0.04 SDS, 95% CI = [0.00–0.07], P = 0.031) and folic acid supplement use (0.78 mm, 95% CI = [0.49–1.08], P < 0.001; 0.05 SDS, 95% CI = [0.01–0.10], P < 0.019) were positively associated with CRL, while pre-pregnancy BMI (-0.17 mm, 95% CI = [-0.21 to -0.13], P < 0.001; -0.02 SDS, 95% CI = [-0.03 to -0.02], P < 0.001) was negatively related to CRL. For neonatal outcomes, CRL was negatively associated with small for gestational age (SGA) ([risk ratio] (RR) = 0.733, 95% [CI] = 0.673–0.8004, Padjusted < 0.001) and neonatal intensive care unit (NICU) admission ([RR] = 0.928, 95% [CI] = 0.883–0.976, Padjusted = 0.003), and preterm birth ([RR] = 1.082, 95% [CI] = 1.008–1.162, Padjusted = 0.029), but positively related to large for gestational age (LGA) ([RR] = 1.241, 95% [CI] = 1.184–1.301, Padjusted = 0.012). When stratified by pre-pregnancy BMI, the risk of SGA and LGA remained significant in all groups, while the increased risk of preterm birth was only observed in the lean group (BMI < 18.5 kg/m2) and decreased risk of NICU admission rate in the normal group (BMI 18.5–24 kg/m2).

Conclusions

Maternal characteristics were independently associated with CRL in the first trimester, which was negatively related to foetal size, SGA, preterm birth, and admission rate to the NICU, but positively related to LGA.
Developing shelf-stable Microbiota Directed Complementary Food (MDCF) prototypes for malnourished children: study protocol for a randomized, single-blinded, clinical study
Authors: Mostafa Ishita , Fahim Shah Mohammad , Das Subhasish , Gazi Md Amran , Hasan Md. Mehedi , Saqeeb Kazi Nazmus , Mahfuz Mustafa , Lynn Hannah B. , Barratt Michael J. , Gordon Jeffrey I. , Ahmed Tahmeed
Published: July 2022

Background

Childhood undernutrition is a major public health concern that needs special attention to achieve 2025 global nutrition targets. Moderate acute malnutrition (MAM), manifest as wasting (low weight-for-height), affects 33 million children under 5, yet there are currently no global guidelines for its treatment. We recently performed a randomized-controlled clinical study of a microbiota-directed complementary food formulation (MDCF-2) in 12-18-month-old Bangladeshi children with MAM. The results revealed that MDCF-2, freshly prepared each day, produced a significantly greater improvement in ponderal growth than a standard ready-to-use supplementary food (RUSF), an effect that is associated with repair of the disrupted gut microbial community development that occurs in children with MAM. To test the generalizability of these results in acutely malnourished children at other sites, there is a pressing need for a packaged, shelf-stable, organoleptically-acceptable formulation that is bioequivalent to MDCF-2. This report describes the protocol for a clinical study to evaluate candidate formulations designed to meet these criteria.

Methods

A randomized single-blind study will be conducted in 8-12-month-old Bangladeshi children with MAM to compare the efficacy of alternative shelf-stable MDCF prototypes versus the current MDCF-2 formulation that is produced fresh each day. V4-16S rDNA amplicon and shotgun sequencing datasets will be generated from faecal DNA samples collected from each child enrolled in each group prior to, during, and after treatment to determine the abundances of MDCF-2-responsive bacterial taxa. Efficacy will be assessed by quantifying the change in representation of MDCF-2-responsive gut bacterial taxa after 4-weeks of treatment with freshly prepared MDCF-2 compared to their changes in abundance after treatment with the prototype MDCFs. Equivalence will be defined as the absence of a statistically significant difference, after 4-weeks of treatment, in the representation of faecal bacterial taxa associated with the response to MDCF-2 in participants receiving a test MDCF.

Discussion

This trial aims to establish acceptability and equivalence with respect to microbiota repair, of scalable, shelf-stable formulations of MDCF-2 in 8-12-month-old Bangladeshi children with moderate acute malnutrition.

Trial registration

ClinicalTrials.gov (NCT05094024). The trial has been registered before starting enrolment on 23 October 2021.
Alterations in circulating levels of vitamin D binding protein, total and bioavailability of vitamin D in diabetic retinopathy patients
Authors: Maghbooli Zhila , Ebrahimi Meimand Sepideh , Malek Hosseini Ali-Asghar , Shirvani Arash
Published: July 2022

Aims

This study aimed to investigate the association between circulating levels of vitamin D binding protein (VDBP) and its genotypes and diabetic retinopathy risk.

Methods

This case–control study recruited 154 patients with type 2 diabetes mellitus; 62 with diabetic retinopathy (DR) and 92 without DR and diabetic nephropathy (DN). Circulating levels of 25-hydroxyvitamin D3 and VDBP levels were measured in the patients. The genotype and phenotype of VDBP were evaluated based on two common VDBP variations; rs7041 and rs4588.

Results

Serum levels of VDBP were significantly lower in patients with DR than in patients without DR and/or DN (Ln-VDBP (μg/ml): 6.14 ± 0.92 vs. 6.73 ± 1.45, p = 0.001) even after adjustment for age, sex, body mass index, disease duration, estimated glomerular filtration rate (eGFR), HbA1C, insulin therapy profile, and serum levels of 25(OH)D. The distribution of VDBP phenotypes and genotypes in the two studied groups were nearly the same, and the distribution was similar to that of the general population.

Conclusions

In this study, we found the association between lower circulating levels of VDBP and risk of DR. However, the precise mechanism linking these two remains unknown. Further and more in-depth research is needed to find out the underlying causes of the relationship.
Luteolin alleviates inflammation and autophagy of hippocampus induced by cerebral ischemia/reperfusion by activating PPAR gamma in rats
Authors: Li Lu , Pan Guanghua , Fan Rong , Li Dalei , Guo Lei , Ma Lili , Liang Hui , Qiu Jiaoxue
Published: July 2022

Background

Luteolin, a flavonoid compound with anti-inflammatory activity, has been reported to alleviate cerebral ischemia/reperfusion (I/R) injury. However, its potential mechanism remains unclear.

Methods

The binding activity of luteolin to peroxisome proliferator-activated receptor gamma (PPARγ) was calculated via molecular docking analysis. Rats were subjected to middle cerebral artery occlusion and reperfusion (MCAO/R). After reperfusion, vehicle, 25 mg/kg/d luteolin, 50 mg/kg/d luteolin, 10 mg/kg/d pioglitazone, 50 mg/kg/d luteolin combined with 10 mg/kg/d T0070907 (PPARγ inhibitor) were immediately orally treatment for 7 days. ELISA, TTC staining, H&E staining, immunohistochemistry, immunofluorescence and transmission electron microscope methods were performed to evaluate the inflammation and autophagy in damaged hippocampal region. The PPARγ, light chain 3 (LC3) B-II/LC3B-I and p-nuclear factor-κB (NF-κB) p65 proteins expression levels in damaged hippocampal region were analyzed.

Results

Luteolin showed good PPARγ activity according to docking score (score = − 8.2). Luteolin treatment downregulated the infarct area and the pro-inflammatory cytokines levels caused by MCAO/R injury. Moreover, luteolin administration ameliorated neuroinflammation and autophagy in damaged hippocampal region. Pioglitazone plays protective roles similar to luteolin. T0070907 concealed the neuroprotective roles of 50 mg/kg/d luteolin.

Conclusions

Luteolin exerts neuroprotective roles against inflammation and autophagy of hippocampus induced by cerebral I/R by activating PPARγ in rats.
Using an optimized generative model to infer the progression of complications in type 2 diabetes patients
Authors: Wang Xiaoxia , Lin Yifei , Xiong Yun , Zhang Suhua , He Yanming , He Yuqing , Zhang Zhikun , Plasek Joseph M. , Zhou Li , Bates David W. , Tang Chunlei
Published: July 2022

Background

People live a long time in pre-diabetes/early diabetes without a formal diagnosis or management. Heterogeneity of progression coupled with deficiencies in electronic health records related to incomplete data, discrete events, and irregular event intervals make identification of pre-diabetes and critical points of diabetes progression challenging.

Methods

We utilized longitudinal electronic health records of 9298 patients with type 2 diabetes or prediabetes from 2005 to 2016 from a large regional healthcare delivery network in China. We optimized a generative Markov-Bayesian-based model to generate 5000 synthetic illness trajectories. The synthetic data were manually reviewed by endocrinologists.

Results

We build an optimized generative progression model for type 2 diabetes using anchor information to reduce the number of parameters learning in the third layer of the model from $$O\left(N\times W\right)$$

O

N
×
W

to $$O\left((N-C)\times W\right)$$

O

(
N
-
C
)
×
W

, where $$N$$
N
is the number of clinical findings, $$W$$
W
is the number of complications, $$C$$
C
is the number of anchors. Based on this model, we infer the relationships between progression stages, the onset of complication categories, and the associated diagnoses during the whole progression of type 2 diabetes using electronic health records.

Discussion

Our findings indicate that 55.3% of single complications and 31.8% of complication patterns could be predicted early and managed appropriately to potentially delay (as it is a progressive disease) or prevented (by lifestyle modifications that keep patient from developing/triggering diabetes in the first place).

Conclusions

The full type 2 diabetes patient trajectories generated by the chronic disease progression model can counter a lack of real-world evidence of desired longitudinal timeframe while facilitating population health management.
Development and validation of a health information system for assistance and research in gestational trophoblast disease
Authors: Martins Jaqueline , Bandiera-Paiva Paulo , Neto Antonio Rodrigues Braga , de Carvalho Lucas Ribeiro Borges , Padrini-Andrade Lúcio , Machado Vitor Tonini , da Silva Junior Antônio Carlos , Sun Sue Yazaki
Published: July 2022

Background

Gestational Trophoblastic Disease (GTD) comprises pathological forms of placental trophoblastic tissue proliferation. When benign, they present with hydatidiform moles, and when malignant, they are called Gestational Trophoblastic Neoplasia. With the growth of the practice of digital health, allied to updated therapeutic approaches, the Outpatient Clinic for Gestational Trophoblastic Disease has built a Health Information System (HIS), contributing to the teaching–learning binomial, as well as to self-care.

Methods

This is a cross-sectional and blind technological assessment research for developing SIS-Mola (Website for the medical team and the Application “MolaApp” aimed at patients with GTD). We used the Praxis management approach to manage the application creation project. In the tasks involving real-time chat, a WebSocket layer was created and hosted together with the project’s web services, which use the Arch Linux operating system. For the evaluations, we provided questionnaires developed based on the System Usability Scale (SUS), to determine the degree of user satisfaction, with objective questions on the Likert scale. We invited 28 participants for the evaluations, among ABDTG specialist physicians, doctors from the DTG Outpatient Clinic team, and the patients. The study was systematized according to the rules of treatment and follow-up in treating the disease.

Results

The tests were conducted from November 2021 to February 2022. The responses obtained on a Likert scale indicated reliability and credibility to the HIS, since the total usability score, measured by the ten questions of the SUS instrument, had a mean of 81.1 (clinicians), 80 (patients) and median of 77.5 for both groups. The sample was characterized according to the variables: age, gender, education, computer knowledge, and profession.

Conclusion

Developing a HIS in the GTD Outpatient Clinic met the objectives regarding the rules of treatment and follow-up of patients. With these digital tools, it is possible to obtain data about the patient’s health, sending information through exams performed and appropriate treatments. The connectivity capacity allows agile care, saving time, costs and solving the displacement problem. The TICs generate natural efficiency for the organization in the flow of service and the formation of a database, improving the quality of the assistance.
Provider competence in hypertension management and challenges of the rural primary healthcare system in Sichuan province, China: a study based on standardized clinical vignettes
Authors: Wu Yuju , Ye Ruixue , Wang Qingzhi , Sun Chang , Meng Sha , Sylvia Sean , Zhou Huan , Friesen Dimitris , Rozelle Scott
Published: July 2022

Background

Improving primary care providers’ competence is key to detecting and managing hypertension, but evidence to guide this work has been limited, particularly for rural areas. This study aimed to use standardized clinical vignettes to assess the competence of providers and the ability of the primary healthcare system to detect and manage hypertension in rural China.

Methods

A multi-stage random sampling method was administered to select target health facilities, providers, and households. The clinical vignette script was developed to evaluate provider competence in managing first-visit patients with symptoms of hypertension. Logistic regression was used to explore the factors correlated with provider competence. Provider referral and management rates were combined with patients’ facility sorting behaviors to assess the ability of the rural healthcare system to manage hypertension in three policy scenarios.

Results

A total of 306 providers and 153 facilities were enrolled in our study. In the 306 clinical vignette interactions, 25.9% of providers followed the national guidelines for hypertension consultation. The correct diagnosis was achieved by only 10.1% of providers, and 30.4% of providers were able to prescribe the correct treatment. Multi-variable regression results showed that younger providers (OR = 0.85, 95%CI: 0.73, 0.98) and those who work in township health centers (OR = 4.47, 95%: 1.07, 18.67) were more likely to provide a correct diagnosis. In a free-selection scenario, 29.8% of patients with hypertension were managed correctly throughout the rural system. When all patients first visit village clinics, system-level correct management is reduced to 20.5% but increases to 45.0% when all patients first visit township health centers.

Conclusions

Rural primary care providers do not have enough competence to detect and treat hypertension cases in China to an acceptable degree. Policy constraints may limit the competence of the rural healthcare system. Research to improve detection and treatment competence in hypertension and optimize health policy is needed.