bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction: Combining learner psychology and ISLA research: Intersections in the classroom
Authors: Sato Masatoshi , Csizér Kata
Published: September 2021

This article explores intersections between two subfields of second language acquisition research: learner psychology (LP) and instructed second language acquisition (ISLA). Despite the common goal of discovering second language (L2) learning processes and products, the two inquiries have taken distinct paths. We argue that it is necessary to unite the knowledge and methods in the two inquiries, in order to answer theoretical and practical questions pertaining to classroom L2 teaching and learning. We make the case that the L2 classroom may be an ideal venue to explore the intersections of the two fields. Three intersections will be discussed. First, research can address the relationship between LP and interactional behaviors during classroom activities that have been investigated in ISLA research. Second, the roles of teachers, the classroom environment, and instruction – the primary variables in ISLA research – can be examined in relation to LP in the classroom. Third, research can target LP as a dependent variable in experimental designs that ISLA research often employs. LP is a primary concern of L2 teachers who face a range of LP (unmotivated students, silent students, anxious students, etc.). Some teachers are also concerned about the potential negative impact of a certain instructional technique on LP. Thus, combining LP and ISLA perspectives helps answer various pedagogical concerns, whether these are related to particular LP issues, or the impact of instructional techniques on LP. Throughout the article, we propose future research topics and make pedagogical recommendations addressing LP in the classroom.
Emergency department visits due to coronary artery disease during COVID-19 in Finland: A register-based study
Authors: Uimonen Mikko , Ponkilainen Ville , Kuitunen Ilari , Eskola Markku , Mattila Ville M.
Published: September 2021

Aims: This multi-centre study examined the effects of restricted availability of health-care services during the COVID-19 pandemic on treatment of coronary artery disease (CAD) in Finland. Methods: Data on referrals to cardiological units ( n=81,008), emergency department (ED) visits ( n=10,001) and hospitalisations ( n=8654) for CAD were collected from three large Finnish hospitals, and incidences were calculated per 100,000 persons for the years 2017 through 2020. Year 2020 was compared to the reference years 2017–2019 by incidence rate ratios (IRR) with 95% confidence intervals (CI). Results: Referrals to cardiological units decreased after the onset of the pandemic in March to May (IRR=0.83, 95% CI 0.81–0.86). ED visits due to acute coronary syndrome decreased during the first months of the pandemic, with the overall annual incidence 2–14% lower than in the reference years. ED visits due to chronic CAD increased prominently during in April and May compared to the corresponding months in the reference years (IRR=1.49, 95% CI 1.23–1.81 in April; IRR=1.57, 95% CI 1.32–1.89 in May) and remained elevated until the end of 2020, with an increase in annual incidence of 17% (IRR=1.17, 95% CI 1.11–1.24). Conclusions: The first COVID-19 wave decreased ED visits due to acute coronary syndromes and increased those due to chronic CAD. The changes in referral and ED visit incidences during the second wave were rather modest.
Intrinsic speed capabilities and alliance partner attractiveness
Authors: Hawk Ashton , Reuer Jeffrey J , Garofolo Andrew
Published: September 2021

This study focuses on the role of intrinsic speed capabilities, which refer to the ability to execute investment projects faster than competitors, in the attractiveness and selection of alliance partners. We predict that intrinsically faster firms have a higher likelihood of being selected as alliance partners due to the potential of accelerating the realization of future revenue streams of an alliance project as well as of preempting slower competitors. We also expect that intrinsic speed capabilities substitute for deficiencies in alliance experience and firm innovativeness. Using data on construction projects in the global Liquefied Natural Gas industry, we find empirical support for our theoretical expectations. Our results suggest that firm speed plays an important role in alliance partner selection and has the potential to facilitate the generation of future growth options for firms due to greater partner attractiveness in the market for alliance partners.
Gasoline in the Voter’s Pocketbook: Driving Times to Work and the Electoral Implications of Gasoline Price Fluctuations
Authors: Kim Sung Eun , Yang Joonseok
Published: September 2021

Gasoline prices are often a heated topic during presidential election campaigns in the United States. Yet, presidents have limited control over gasoline prices. Do voters reward or punish the president for changes in gasoline prices? Why might voters blame the president for an outcome beyond direct presidential control? This study addresses these questions by testing the effects of gasoline prices on pocketbook retrospection by voters. To capture the personal economic burden of gasoline prices, we rely on average driving times to work, given the inelastic nature of gasoline consumption for commuting. The results provide evidence for pocketbook voting: constituencies with longer average driving times to work are more likely to hold the president accountable for gasoline price increases. These findings have broader implications regarding electoral accountability and rationality in voting.
Optimizing Discharge After Shorter Hospitalizations: Lessons Learned Through After-Hours Calls with Thoracic Surgical Patients
Authors: Blumenthaler Alisa N. , Zhou Nicolas , Parikh Kavita , Hofstetter Wayne L. , Mehran Reza J. , Rajaram Ravi , Rice David C. , Sepesi Boris , Swisher Stephen G. , Vaporciyan Ara A. , Walsh Garrett L. , Antonoff Mara B.
Published: September 2021

Objective

Minimally invasive procedures coupled with enhanced recovery pathways enable faster postoperative recovery and shorter hospitalizations. However, patients may experience unexpected concerns after return home, prompting after-hours calls. We aimed to characterize concerns prompting after-hours calls to improve discharge strategies.

Methods

A single-institution, retrospective review was conducted of thoracic surgical patients from 11/4/2019 to 6/14/2020. Records were reviewed and elements of patient demographics, surgical procedures, postoperative courses, reasons for calls, and outcome of calls were collected. We compared characteristics of patients who made after-hours calls to those who did not, and performed multivariable analysis to identify characteristics associated with making an after-hours call.

Results

During the study period, 379 patients underwent thoracic surgical procedures, among whom 88 (23.2%) initiated after-hours calls. Of these, 62 (70%) addressed patient symptoms, while 26 (30%) addressed patient questions including drain management, medications, and hospital policy questions. Patients making after-hours calls more frequently had undergone complex operations (26.1% vs 8.2%, P = 0.001), and were less likely to have received a standardized, clinician-initiated post-discharge telephone follow-up (29.5% vs 54.3%, P < 0.001). Complex operations increased likelihood of after-hours calls (OR: 3.33, 95% CI: 1.69-6.57, P < 0.001), while receipt of clinician-initiated telephone follow-up decreased likelihood of after-hours calls (OR: 0.38, 95% CI: 0.22-0.64, P < 0.001). There were no differences in emergency visits between the 2 groups (11% vs 8%, P = 0.370).

Conclusions

Despite efforts to optimize patient symptoms and knowledge prior to discharge, a substantial number of patients still have concerns after discharge. Many after-hours calls are related to knowledge gaps that may be addressed with improved predischarge education. Moreover, clinician-initiated telephone follow-up shows benefit in reducing after-hours calls.
Completion of Target Vessel Stenting After FEVAR via Snare Technique in a Patient with Tortuous Right Renal Artery
Authors: Tschischka Alexander , Schott Peter , Freyhardt Patrick , Mamopoulos Apostolos , Gäbel Gabor , Katoh Marcus
Published: September 2021

Target vessel catheterization remains challenging in patients with complex anatomies. Fenestrated endovascular aneurysm repair (FEVAR) is an established technique to treat aortic aneurysms. In this case report, we treated a juxtarenal aneurysm using FEVAR. Initial attempts to complete the target vessel stenting were unsuccessful because of an unfavorable orifice and tortuosity of the right renal artery. The completion of FEVAR was achieved with a bifemoral approach using a snare system, which aligned the tip of a steerable sheath at the level of the fenestration for the right renal artery to create a stable condition. Control angiography and computed tomography confirmed a successful stenting of the target vessel and the sealing of the fenestration without an endoleak.
Longitudinal size effects on electrical and actuation behaviors of ionic polymer-metal composite
Authors: Zhang Qingfeng , Chen Shuang , Liu Hongguang , Xiong Ke
Published: September 2021

The structural characteristics of ionic polymer-metal composite (IPMC) were analyzed, and the effects of IPMC length ranging from 1 to 5 cm (with a width of 0.5 cm) were evaluated in terms of electrical parameters and actuation behavior. It has been concluded that the electrical parameters of IPMC materials (including capacitance, electrode resistance in thickness-direction, and internal resistance) decrease, and the bending strain of the setpoint increases as the length increases. The simulation of the current response of IPMC to 2 V DC voltage shows that the error between simulated peak current using 1 cm-IPMC parameters and the measured value is 8.23 times higher than that of 5 cm-IPMC. The strain of the set point on 5 cm-IPMC sample is 5.65 times bigger than that of the 1 cm-IPMC sample.
Effect of modifiable risk factors in Parkinson’s disease: A case-control study looking at common dietary factors, toxicants, and anti-inflammatory medications
Authors: Shermon Suzanna , Goldfinger Matthew , Morris Alexander , Harper Brian , Leder Adena , Santella Anthony J , Krishnamachari Bhuma
Published: September 2021

Objective

To investigate how common modifiable exposures, including dietary factors, select toxicants, and anti-inflammatory medications, may affect Parkinson’s disease.

Methods

Using surveys, a case-control study was conducted at a medical center, comparing Parkinson’s disease patients ( N  =  149) and healthy controls ( N  =  105). Subjects reported exposure to red meats, vegetables, alcohol, tobacco, anti-inflammatory medications, and pesticides. The relationship between exposures and Parkinson’s disease diagnosis was analyzed by logistic regression to generate odds ratio and 95% confidence interval.

Results

Consuming red meat “sometimes” or “always” was positively associated with Parkinson’s disease as compared to eating red meats “rarely” or “never”; (odds ratio  =   2.15, 95% confidence interval   =   1.06, 4.39; p  =  0.03) and (odds ratio   =   4.47, 95% confidence interval   =   1.67, 11.94; p  =  0.003), respectively. Exposure to pesticides showed a positive association with Parkinson’s disease (odds ratio  =   2.84, 95% confidence interval   =   1.34, 6.00; p  =  0.007). “Always” use of aspirin was inversely associated with Parkinson’s disease (odds ratio  =   0.32, 95% confidence interval   =   0.14, 0.70; p  =  0.004). “Ever” having used anti-histamines was inversely associated with Parkinson’s disease (odds ratio  =   0.37, 95% confidence interval  =  0.17, 0.81; p  =  0.01).

Discussion

Our study suggests that there are modifiable external factors that are associated with Parkinson’s disease. The present study can thus assist clinicians, policy makers, and people living with Parkinson’s disease in improving the experience and management of Parkinson’s disease.
‘A wee kick up the arse’: Mentoring, motivation and desistance from crime
Authors: Kirkwood Steve
Published: September 2021

Mentoring is an increasingly popular approach for supporting people who have a history of offending. Previous research provides some evidence that it may contribute to reductions in offending behaviour and support desistance from crime. The present study analysed interviews with 33 people who used mentoring services in Scotland to examine the relationships between mentoring, motivation and desistance. The findings suggest that the offer of mentoring may translate a general desire to change into motivation by providing the means to achieve this change. Mentoring may help people develop ‘hooks for change’ through practical assistance that leads to positive changes and by encouraging people see the value of such changes. Mentors can also model ways of being that outline possible future selves and services can structure in pro-social activities that support stakes in conformity. The article contributes to theoretical understandings of motivation and desistance by specifying the interplay of agency and structure.
The Same, Yet Different: Understanding the Perceived Acceptability of Redface and Blackface
Authors: Lopez Julisa J. , Eason Arianne E. , Fryberg Stephanie A.
Published: September 2021

In recent years, several high-profile individuals were sanctioned (e.g., fired) when photos of them dressed in blackface surfaced. Yet, every weekend during sports seasons, fans dress in redface to support teams with Native mascots. Given the observed discrepancy, five studies examined whether and why the perceived acceptability of these two racialized representations differs. Across varying methods and designs, we found that redface was perceived as more acceptable than blackface. The differential acceptability was explained by the extent to which people believe that Native (vs. Black) Peoples: 1) largely do not exist within contemporary social contexts (i.e., social erasure) and 2) experience less racism. The results suggest that eliminating racialized representations requires understanding the role that sociocultural factors play in sustaining discrimination and prejudice.
Cost-effectiveness of telemedicine care for patients with uncontrolled type 2 diabetes mellitus during the COVID-19 pandemic in Saudi Arabia
Authors: Faleh AlMutairi Manal , Tourkmani Ayla M. , Alrasheedy Alian A. , ALHarbi Turki J. , Bin Rsheed Abdulaziz M. , ALjehani Mohammed , AlRuthia Yazed
Published: September 2021

Background and aim:

Telemedicine could be used to provide diabetes care with positive clinical outcomes. Consequently, this study evaluated the cost-effectiveness of telemedicine for patients with uncontrolled type 2 diabetes mellitus (i.e. HbA1c >9).

Patients and methods:

This was a retrospective chart review of patients with uncontrolled type 2 diabetes attending an outpatient integrated care clinic. The study consisted of two arms, namely a telemedicine care model and a traditional care model with 100 patients in each. The clinical effectiveness (i.e. reduction in HbA1c) and the total cost in both arms were determined, and the incremental cost-effectiveness ratio was calculated. This study adopted propensity score matching.

Results:

The patients in the telemedicine care model had a mean reduction in their HbA1c level of 1.82 (95% CI = 1.56–2.09, p < 0.001), while those in the traditional care model had a mean reduction of 1.54 (95% CI = 1.23–1.85, p < 0.001). Consequently, the incremental effect was 0.28 (95% CI = −0.194 to 0.546). The mean total costs were SAR 4819.76 (US$1285.27) and SAR 4150.69 (US$1106.85) for patients in the telemedicine and traditional care models, respectively. Consequently, the incremental cost was SAR 669.07 (US$178.42) [95% CI = SAR 593.7 (US$158.32)–SAR 1013.64 (US$270.30)]. The ICER was estimated to be SAR 2372.52 (US$632.67) per 1% reduction in the level of HbA1c. Moreover, the telemedicine care model resulted in a higher cost and better outcome (i.e. reduction in the HbA1c level) with an 81.80% confidence level.

Conclusion:

Telemedicine care is cost-effective in managing type 2 patients with poorly controlled diabetes. Consequently, we believe that telemedicine care can be further expanded and incorporated into routine diabetes care.
Prevalence of programmed death ligand-1 in patients diagnosed with non-small cell lung cancer in Lebanon
Authors: Fakhri Ghina , Akel Reem , Khalifeh Ibrahim , Chami Hassan , Hajj Ali Adel , Al Assaad Majd , Atwi Haneen , Kadara Humam , Tfayli Arafat
Published: September 2021

Introduction:

Programmed death ligand-1 expression has been shown to be a good predictor of response to cancer therapy with checkpoint inhibitors. Its expression varies among different tumor types and among non-small cell lung cancer patients with different clinical and demographic characteristics. The prevalence and determinants of programmed death ligand-1 expression have been previously reported from various regions of the world, but data from Lebanon are lacking. This study examines the prevalence and the clinical, demographic and pathological predictors of programmed death ligand-1 expression in patients diagnosed with non-small cell lung cancer in Lebanon.

Methods:

Medical records of 180 patients diagnosed with primary non-small cell lung cancer at our institution and tested for programmed death ligand-1 expression were reviewed. Clinical, demographic and pathological information were collected and correlated with programmed death ligand-1 expression using the chi-square test and logistic regression.

Results:

One hundred eleven of the 180 non-small cell lung cancer tumor samples tested positive for programmed death ligand-1 expression (61.7%). 27.2% of those tumor samples expressed programmed death ligand-1 in 1%–49% of tumor cells, while 34.4% of tumor samples expressed programmed death ligand-1 in 50% or more of their cells. Squamous histology and advanced stage were significant predictors of programmed death ligand-1 expression (odds ratio = 2.79, 95% confidence interval [1.13–6.90], p = 0.012 and odds ratio = 2.48, 95% confidence interval [1.23–4.99], p = 0.044, respectively).

Conclusion:

Similar to reports from other populations, our results suggest that programmed death ligand-1 expression in non-small cell lung cancer is highly prevalent in the Lebanese population, especially in patients with advanced stage at diagnosis or squamous cell carcinoma histology. Because of the small sample size, while more that 60% of the patients are Lebanese, the results of this article cannot be extrapolated to the Middle Eastern and the Levantine population.
Two Types of Concession: Evidence From Discourse Markers
Authors: Jarrah Marwan , Alghazo Sharif , Bader Yousef
Published: September 2021

This study investigates the use of concessive discourse markers (DMs) in Jordanian Arabic (JA), particularly relying on a corpus analysis of naturally occurring data. It argues that there are mainly two types of concession in JA: extrinsic concession and intrinsic concession. The two types of concession are shown to differ from each other with respect to Kratzer’s compatibility of propositions. Intrinsic concession occurs when a speaker has a manifest intention/meaning that does not cause hearers to question its occurrence. This type is realized when one discourse segment is not compatible (i.e., does not normally happen at the same time) with another discourse segment (e.g., somebody is so rich, but he/she lives in a very poor house). Extrinsic concession, on the other hand, occurs when a speaker has a latent intention/meaning that normally causes hearers to question its occurrence. This type of concession emerges when discourse segments are compatible with each other (i.e., may normally happen at the same time), in which case the made-up concession is enforced by the speaker (e.g., somebody is poor, but he/she lives in a poor house). The study shows that certain discourse markers in JA are preferred over others in each type.
Cervical Spinal Cord Compression in Adult Scoliosis
Authors: Nakashima Hiroaki , Kawakami Noriaki , Ohara Tetsuya , Saito Toshiki , Tauchi Ryoji , Imagama Shiro
Published: September 2021

Study Design

Retrospective cohort study.

Objectives

The aim was to examine cervical spinal cord compression (SCC) in adult scoliosis and clarify the prevalence of and risk factors for cervical SCC.

Methods

This study included 270 adult scoliosis patients and 1211 healthy volunteers. Cervical SCC was evaluated on cervical magnetic resonance imaging (MRI). The rates of SCC for those with adult scoliosis and the healthy volunteers were compared. Logistic regression analysis was conducted to examine the factors associated with cervical SCC on MRI.

Results

In cases with adult scoliosis, preoperative major scoliosis curve was 56.0° ± 18.8°, and cervical SCC was detected in 25 patients (9.3%). Among the healthy volunteers, 64 cases with cervical SCC were detected. Only in cases with adult scoliosis, logistic regression analysis revealed higher age (OR 1.09, 95% CI 1.04–1.14, P < .001), narrow canal diameter (OR 2.27, 95% CI 1.35–3.85, P = .002), and inferior sagittal balance (OR 2.45, 95% CI 1.02–5.89, P = .04) as significant risk factors. In the logistic regression analysis in all subjects (including adult scoliosis and healthy volunteers), higher age (OR 1.08, 95% CI 1.06–1.10, P < .001) and narrow canal diameter (OR 1.62, 95% CI 1.37–1.92, P < .001) were also found to be significant risk factors, but the presence of scoliosis was not a significant factor.

Conclusions

Adult scoliosis itself was not significantly associated with cervical SCC. Inferior sagittal balance in addition to scoliosis constituted a significant risk factor for cervical SCC.
Intramedullary femoral nail fixation for A pathological fracture distal to A resurfacing arthroplasty
Authors: MacDonald David RW , Stevenson Iain
Published: September 2021

Traumatic femoral shaft fractures distal to a hip resurfacing arthroplasty (HRA) are rare. Only four cases have been described in which an intramedullary nail was used to treat the fracture. We present the first case in the literature of a pathological femoral shaft fracture distal to a HRA, and describe its treatment with an anterograde intramedullary femoral nail with proximal locking screws placed into the femoral head overlapping the HRA stem. This demonstrates that the presence of a hip resurfacing arthroplasty does not preclude from utilising an intramedullary nail with recon screws to stabilise a pathological fracture.
The current implementation of Oslo Sports Trauma Research Center cycling injury prevention exercises among male elite cyclists in the Gulf Cooperation Council
Authors: Al Attar Wesam Saleh A , Husain Mohamed A , Komir Ramy , Alanazi Khulud , Ghulam Hussain
Published: September 2021

Background/purpose

Cyclists are expected to present with sport-related injuries. The Oslo Sports Trauma Research Center provided exercises for preventing the most common injuries in cycling. We aimed to survey the compliance with Oslo Sports Trauma Research Center exercises among cyclists in the Gulf Cooperation Council countries. It is expected that most cyclists in the Gulf Cooperation Council countries are implementing these exercises as part of their warm-up sessions.

Methods

This cross-sectional online survey collected the participants’ demographic characteristics (country, age, and sex) and assessed their compliance with the programme.

Results

Four-hundred and twenty-three cyclists responded, of which 52% were aged 20–29 years. The pelvic control exercise was the most implemented (56%), followed by the elephant and isolated pelvic rotation exercises (54%); the single-leg pelvic rotation exercise was the least implemented (46%). The implementation rate did not differ significantly according to age or country. Saudi Arabia and Kuwait reported the highest mean implementation scores, while the United Arab Emirates reported the lowest

Conclusions

The implementation rate of Oslo Sports Trauma Research Center exercises was low among cyclists in the Gulf Cooperation Council countries. There is a need to increase awareness between players, programme deliverers, and policymakers and educate them about the importance of implementing such programmes in injury reduction.
Cardiac Complications Caused by Respiratory Syncytial Virus Infection: Questionnaire Survey and a Literature Review
Authors: Kawashima Hisashi , Inagaki Natsuko , Nakayama Toshihiro , Morichi Shinichiro , Nishimata Shigeo , Yamanaka Gaku , Kashiwagi Yasuyo
Published: September 2021

We investigated 22 cases of patients with myocarditis during respiratory syncytial virus (RSV) infection by a questionnaire survey, and performed a literature search to clarify their characteristics. The age distribution was divided into 2 groups, that is, 1 group comprised of patients younger than 4-years old and the other comprised patients older than 15 years. ECG demonstrated disturbance of the conduction system (AV block) in 7 out of 18 patients (38.8%), myocardial damage (ST-T change) in 9 out of 18 patients (50.0%), and tachycardia in 3 out of 18 patients (16.6%). Echocardiography displayed a robust decrease in left-heart function in 12 out of 14 patients. The outcome was 2 deaths, 1 pacemaker placement, 4 patients with mild sequel. Our data suggest that RSV myocarditis caused by RSV infection can be divided into 3 different pathophysiologies, characterized by disturbance of the conduction system, myocardial damage, and increase of autonomy.
Divine Epidemiologists: Christianity, Faith, and Public Health in Africa, 1918–2021
Authors: Asamoah-Gyadu J. Kwabena
Published: September 2021

How have African Christians responded to the COVID-19 pandemic, which broke out at the beginning of 2020 and has affected every aspect of human life? Globally, the responses to the pandemic have ranged from the scientific to the religious. Many believe that it is simply a conspiracy wreaked on the world by a satanic medical scientist or that it is an apocalyptic signal. In Africa, the religious responses to the pandemic have been fascinating. This article discusses six such responses, considering what they reveal about the intersections between Christianity, faith, and the ubiquitous presence of evil.
How Servant Leadership Drives Project Team Performance Through Collaborative Culture and Knowledge Sharing
Authors: Nauman Shazia , Bhatti Sabeen Hussain , Imam Hassan , Khan Mohammad Saud
Published: September 2021

Drawing on social learning theory, this research compared and tested how two distinct mediating mechanisms—collaborative culture and knowledge sharing—influence the servant leadership–project team performance relationship. Survey data were collected from 275 employees representing 70 project teams, and multilevel structural equation modeling was adopted to test the hypotheses. The findings indicated that collaborative culture fully mediates, whereas knowledge sharing does not mediate, the servant leadership–project team performance relationship. These findings reveal collaborative culture as the intervening mechanism that translates servant leadership to project team performance. For project-based organizations, the research puts forth theoretical and practical implications.
Frequency and prognostic impact of blood-circulating tumor mast cells in mastocytosis
Authors: Henriques Ana , Muñoz-González Javier I. , Sánchez-Muñoz Laura , Matito Almudena , Torres-Rivera Lidia , Jara-Acevedo María , Caldas Carolina , Mayado Andrea , Pérez-Pons Alba , García-Montero Andrés C. , Álvarez-Twose Iván , Orfao Alberto
Published: September 2021

Circulating tumor mast cells (CTMCs) have been identified in the blood of a small number of patients with advanced systemic mastocytosis (SM). However, data are limited about their frequency and prognostic impact in patients with MC activation syndrome (MCAS), cutaneous mastocytosis (CM) and nonadvanced SM. We investigated the presence of CTMCs and MC-committed CD34+ precursors in the blood of 214 patients with MCAS, CM, or SM using highly sensitive next-generation flow cytometry. CTMCs were detected at progressively lower counts in almost all patients with advanced SM (96%) and smoldering SM (SSM; 100%), nearly half of the patients (45%) with indolent SM (ISM), and a few patients (7%) with bone marrow (BM) mastocytosis but were systematically absent in patients with CM and MCAS (P < .0001). In contrast to CTMC counts, the number of MC-committed CD34+ precursors progressively decreased from MCAS, CM, and BM mastocytosis to ISM, SSM, and advanced SM (P < .0001). Clinically, the presence (and number) of CTMCs in blood of patients with SM in general and nonadvanced SM (ISM and BM mastocytosis) in particular was associated with more adverse features of the disease, poorer-risk prognostic subgroups as defined by the International Prognostic Scoring System for advanced SM (P < .0001) and the Global Prognostic Score for mastocytosis (P < .0001), and a significantly shortened progression-free survival (P < .0001) and overall survival (P = .01). On the basis of our results, CTMCs emerge as a novel candidate biomarker of disseminated disease in SM that is strongly associated with advanced SM and poorer prognosis in patients with ISM.
Impact of vitamin D level at diagnosis and transplantation on the prognosis of hematological malignancy: a meta-analysis
Authors: Ito Yusuke , Honda Akira , Kurokawa Mineo
Published: September 2021

Vitamin D deficiency impairs prognosis in many types of cancer; however, its significance in each subtype of hematological malignancies is unclear. In addition, data on the association between pretransplant vitamin D levels and outcomes of hematopoietic stem cell transplantation (HSCT) are inconsistent. This systematic review and meta-analysis aimed to elucidate the impact of vitamin D levels at diagnosis or pre-HSCT on the prognosis of hematological malignancies. Thirty articles and abstracts were extracted from PubMed, Embase, and Cochrane Library databases and conference proceedings. Fixed and random effect models were used to analyze primary outcomes: overall survival (OS) and progression-free survival (PFS). Lower vitamin D level was significantly associated with poorer OS and PFS in myeloid malignancies (hazard ratio [HR], 1.39; 95% confidence interval [CI], 1.06-1.82 and HR, 2.03; 95% CI, 1.23-3.32, respectively) and lymphoid malignancies (HR, 2.07; 95% CI, 1.79-2.40 and HR, 1.91; 95% CI, 1.61-2.25, respectively), as well as outcomes for several lymphoma subtypes individually. Furthermore, a lower pretransplant vitamin D level was associated with poorer OS in autologous and allogeneic HSCT (HR, 1.65; 95% CI, 1.04-2.61 and HR, 1.50; 95% CI, 1.03-2.18, respectively). Despite the relatively small number of studies evaluated, these data suggest the importance of vitamin D status in outcomes of hematological malignancies (PROSPERO registration number: CRD42020205821).
Increased hemoglobin and heme in MALDI-TOF MS analysis induce ferroptosis and promote degeneration of herniated human nucleus pulposus
Authors: Shan Liang , Xu Ximing , Zhang Jing , Cai Peng , Gao Han , Lu Yingjie , Shi Jiangang , Guo Yinlong , Su Yue
Published: September 2021

Background

Neovasculogenesis is characteristic of herniated lumbar discs, in which extruded nucleus pulposus is prone to heme iron-induced cytotoxicity (increased oxidative stress causing ferroptosis). However, recent analyses of neovascularization are very complicated, and the mechanism of action is rarely reported.

Methods

Matrix-assisted laser desorption/ionization–time-of-flight mass spectrometry (MALDI-TOF MS) was performed to analyze human herniated and nonherniated nucleus pulposus. Then, the clinical relevance of the MALDI-TOF MS results and Pfirrmann classification of the degenerative nucleus pulposus were analyzed. To explore the mechanism, the heme-induced ferroptosis effect was evaluated at both the tissue and cell levels using high-resolution MALDI-TOF MS and molecular biology methods.

Results

The spectra revealed that hemoglobin (Hb) and heme signals were greatly increased, thus serving as predictors of vasculogenesis in herniated nucleus pulposus. The clinical relevance analysis demonstrated that the intensity of Hb and heme peaks was closely related to the Pfirrmann classification of degenerative nucleus pulposus. Mechanistically, increased heme catabolism and downregulation of glutathione peroxidase 4 (GPX4) levels were detected in herniated nucleus pulposus, reflecting iron-dependent cell death or ferroptosis. Iron levels was also increased in herniated nucleus pulposus compared with that in nonherniated nucleus pulposus. Furthermore, accuracy mass measurements confirmed that the levels of ferroptosis-related metabolites, such as glutathione, arachidonic acid (AA), sphinganine, polyunsaturated fatty acid (PUFA), and tricarboxylic acid (TCA) cycle metabolites, were significantly different between herniated and nonherniated tissues, indicating that the interior of the herniated tissues is a pro-oxidant environment. Moreover, heme-induced ferroptosis was verified in human nucleus pulposus cells (HNPCs), and the underlying mechanism might be associated with the Notch pathway.

Conclusions

Neovascularization in herniated nucleus pulposus may expose tissues to high levels of heme, which can induce cytotoxicity and ferroptosis within tissues and accelerate the progressive degeneration of herniated nucleus pulposus. This study is beneficial for understanding the pathological mechanism of herniated nucleus pulposus and facilitating the development of nonoperative interventions for treating lumbar disc herniation (LDH).
Research on RNA secondary structure predicting via bidirectional recurrent neural network
Authors: Lu Weizhong , Cao Yan , Wu Hongjie , Ding Yijie , Song Zhengwei , Zhang Yu , Fu Qiming , Li Haiou
Published: September 2021

Background

RNA secondary structure prediction is an important research content in the field of biological information. Predicting RNA secondary structure with pseudoknots has been proved to be an NP-hard problem. Traditional machine learning methods can not effectively apply protein sequence information with different sequence lengths to the prediction process due to the constraint of the self model when predicting the RNA secondary structure. In addition, there is a large difference between the number of paired bases and the number of unpaired bases in the RNA sequences, which means the problem of positive and negative sample imbalance is easy to make the model fall into a local optimum. To solve the above problems, this paper proposes a variable-length dynamic bidirectional Gated Recurrent Unit(VLDB GRU) model. The model can accept sequences with different lengths through the introduction of flag vector. The model can also make full use of the base information before and after the predicted base and can avoid losing part of the information due to truncation. Introducing a weight vector to predict the RNA training set by dynamically adjusting each base loss function solves the problem of balanced sample imbalance.

Results

The algorithm proposed in this paper is compared with the existing algorithms on five representative subsets of the data set RNA STRAND. The experimental results show that the accuracy and Matthews correlation coefficient of the method are improved by 4.7% and 11.4%, respectively.

Conclusions

The flag vector introduced allows the model to effectively use the information before and after the protein sequence; the introduced weight vector solves the problem of unbalanced sample balance. Compared with other algorithms, the LVDB GRU algorithm proposed in this paper has the best detection results.
Transcriptional responses to Fusarium oxysporum f. sp. lycopersici (Sacc.) Snyder & Hansen infection in three Colombian tomato cultivars
Authors: López Walter Ricardo , Garcia-Jaramillo Dora Janeth , Ceballos-Aguirre Nelson , Castaño-Zapata Jairo , Acuña-Zornosa Ricardo , Jovel Juan
Published: September 2021

Background

Fusarium oxysporum f. sp. lycopersici (Fol) is a compendium of pathogenic and non-pathogenic fungal strains. Pathogenic strains may cause vascular wilt disease and produce considerable losses in commercial tomato plots. To gain insight into the molecular mechanisms mediating resistance to Fol in tomato, the aim of our study was to characterize the transcriptional response of three cultivars (CT1, CT2 and IAC391) to a pathogenic (Fol-pt) and a non-pathogenic (Fo-npt) strain of Fo.

Results

All cultivars exhibited differentially expressed genes in response to each strain of the fungus at 36 h post-inoculation. For the pathogenic strain, CT1 deployed an apparent active defense response that included upregulation of WRKY transcription factors, an extracellular chitinase, and terpenoid-related genes, among others. In IAC391, differentially expressed genes included upregulated but mostly downregulated genes. Upregulated genes mapped to ethylene regulation, pathogenesis regulation and transcription regulation, while downregulated genes potentially impacted defense responses, lipid transport and metal ion binding. Finally, CT2 exhibited mostly downregulated genes upon Fol-pt infection. This included genes involved in transcription regulation, defense responses, and metal ion binding.

Conclusions

Results suggest that CT1 mounts a defense response against Fol-pt. IAC391 exhibits an intermediate phenotype whereby some defense response genes are activated, and others are suppressed. Finally, the transcriptional profile in the CT2 hints towards lower levels of resistance. Fo-npt also induced transcriptional changes in all cultivars, but to a lesser extent. Results of this study will support genetic breeding programs currently underway in the zone.
Circulatory trajectories after out-of-hospital cardiac arrest: a prospective cohort study
Authors: Langeland Halvor , Bergum Daniel , Nordseth Trond , Løberg Magnus , Skaug Thomas , Bjørnstad Knut , Gundersen Ørjan , Skjærvold Nils-Kristian , Klepstad Pål
Published: September 2021

Background

Circulatory
failure frequently occurs after out-of-hospital cardiac arrest (OHCA) and is part of post-cardiac arrest syndrome (PCAS). The aim of this study was to investigate circulatory disturbances in PCAS by assessing the circulatory trajectory during treatment in the intensive care unit (ICU).

Methods

This was a prospective single-center observational cohort study of patients after OHCA. Circulation was continuously and invasively monitored from the time of admission through the following five days. Every hour, patients were classified into one of three predefined circulatory states, yielding a longitudinal sequence of states for each patient. We used sequence analysis to describe the overall circulatory development and to identify clusters of patients with similar circulatory trajectories. We used ordered logistic regression to identify predictors for cluster membership.

Results

Among 71 patients admitted to the ICU after OHCA during the study period, 50 were included in the study. The overall circulatory development after OHCA was two-phased. Low cardiac output (CO) and high systemic vascular resistance (SVR) characterized the initial phase, whereas high CO and low SVR characterized the later phase. Most patients were stabilized with respect to circulatory state within 72 h after cardiac arrest. We identified four clusters of circulatory trajectories. Initial shockable cardiac rhythm was associated with a favorable circulatory trajectory, whereas low base excess at admission was associated with an unfavorable circulatory trajectory.

Conclusion

Circulatory failure after OHCA exhibits time-dependent characteristics. We identified four distinct circulatory trajectories and their characteristics. These findings may guide clinical support for circulatory failure after OHCA.

Trial registration

ClinicalTrials.gov: NCT02648061
Rapid diagnosis of SARS-CoV-2 pneumonia on lower respiratory tract specimens
Authors: De Pace Vanessa , Caligiuri Patrizia , Ricucci Valentina , Nigro Nicola , Galano Barbara , Visconti Valeria , Da Rin Giorgio , Bruzzone Bianca
Published: September 2021

Background

The ongoing SARS-CoV-2 pandemic requires the availability of accurate and rapid diagnostic tests, especially in such clinical settings as emergency and intensive care units. The objective of this study was to evaluate the diagnostic performance of the Vivalytic SARS-CoV-2 rapid PCR kit in lower respiratory tract (LRT) specimens.

Methods

Consecutive LRT specimens (bronchoalveolar lavage and bronchoaspirates) were collected from Intensive Care Units of San Martino Hospital (Genoa, Italy) between November 2020 and January 2021. All samples underwent RT-PCR testing by means of the Allplex™ SARS-CoV-2 assay (Seegene Inc., South Korea). On the basis of RT-PCR results, specimens were categorized as negative, positive with high viral load [cycle threshold (Ct) ≤ 30] and positive with low viral load (Ct of 31–35). A 1:1:1 ratio was used to achieve a sample size of 75. All specimens were subsequently tested by means of the Vivalytic SARS-CoV-2 rapid PCR assay (Bosch Healthcare Solutions GmbH, Germany). The diagnostic performance of this assay was assessed against RT-PCR through the calculation of accuracy, Cohen’s κ, sensitivity, specificity and expected positive (PPV) and negative (NPV) predictive values.

Results

The overall diagnostic accuracy of the Vivalytic SARS-CoV-2 was 97.3% (95% CI: 90.9–99.3%), with an excellent Cohen’s κ of 0.94 (95% CI: 0.72–1). Sensitivity and specificity were 96% (95% CI: 86.5–98.9%) and 100% (95% CI: 86.7–100%), respectively. In samples with high viral loads, sensitivity was 100% (Table 1). The distributions of E gene Ct values were similar (Wilcoxon’s test: p = 0.070), with medians of 35 (IQR: 25–36) and 35 (IQR: 25–35) on Vivalytic and RT-PCR, respectively (Fig. 1). NPV and PPV was 92.6% and 100%, respectively.

Conclusions

Vivalytic SARS-CoV-2 can be used effectively on LRT specimens following sample liquefaction. It is a feasible and highly accurate molecular procedure, especially in samples with high viral loads. This assay yields results in about 40 min, and may therefore accelerate clinical decision-making in urgent/emergency situations.
Informing antimicrobial management in the context of COVID-19: understanding the longitudinal dynamics of C-reactive protein and procalcitonin
Authors: Ming Damien K. , Myall Ashleigh C. , Hernandez Bernard , Weiße Andrea Y. , Peach Robert L. , Barahona Mauricio , Rawson Timothy M. , Holmes Alison H.
Published: September 2021

Background

To characterise the longitudinal dynamics of C-reactive protein (CRP) and Procalcitonin (PCT) in a cohort of hospitalised patients with COVID-19 and support antimicrobial decision-making.

Methods

Longitudinal CRP and PCT concentrations and trajectories of 237 hospitalised patients with COVID-19 were modelled. The dataset comprised of 2,021 data points for CRP and 284 points for PCT. Pairwise comparisons were performed between: (i) those with or without significant bacterial growth from cultures, and (ii) those who survived or died in hospital.

Results

CRP concentrations were higher over time in COVID-19 patients with positive microbiology (day 9: 236 vs 123 mg/L, p < 0.0001) and in those who died (day 8: 226 vs 152 mg/L, p < 0.0001) but only after day 7 of COVID-related symptom onset. Failure for CRP to reduce in the first week of hospital admission was associated with significantly higher odds of death. PCT concentrations were higher in patients with COVID-19 and positive microbiology or in those who died, although these differences were not statistically significant.

Conclusions

Both the absolute CRP concentration and the trajectory during the first week of hospital admission are important factors predicting microbiology culture positivity and outcome in patients hospitalised with COVID-19. Further work is needed to describe the role of PCT for co-infection. Understanding relationships of these biomarkers can support development of risk models and inform optimal antimicrobial strategies.
Reduced serum albumin as a risk factor for poor prognosis in critically ill patients receiving renal replacement therapy
Authors: Zheng Lang Jing , Jiang Weiming , Pan Lingling , Pan Jingye
Published: September 2021

Background

Albumin is the primary body protein, which can predict the poor prognosis of several critical diseases. However, there are a few scientific studies on the relationship between albumin and the prognosis of dialysis patients. This study aims to explore the impact of hypoalbuminemia on the prognosis of critically ill patients with acute kidney injury (AKI) receiving continuous renal replacement therapy (CRRT).

Methods

This was a secondary study. Clinical, biochemical, and 28-day and 90-day mortality rates for critical patients with AKI who received CRRT between 2009 and 2016 were searched from the database to determine the effect of hypoalbuminemia on poor outcomes by univariate, multivariate, smooth curve fitting, and subgroup analysis.

Results

A total of 837 participants were enrolled in this study. Multivariate Cox proportional hazard regression analysis showed that hypoalbuminemia was associated with both 28-day and 90-day mortality risks after full adjustment for confounding variables, with an adjusted hazard ratio (95% confidence interval) of 0.63 (0.50–0.80) and 0.63 (0.51–0.78), respectively for each 1 g/dL increase of albumin. Stratified analysis showed that hypoalbuminemia was not associated with poor prognosis in oliguria.

Conclusion

Hypoalbuminemia is associated with poor prognosis in critically ill AKI patients with CRRT; therefore, measuring albumin may be helpful for predicting the prognosis. However, in those with oliguria, this conclusion is not valid.
Exosomal ERp44 derived from ER-stressed cells strengthens cisplatin resistance of nasopharyngeal carcinoma
Authors: Xia Tian , Tian Hui , Zhang Kaiwen , Zhang Siyu , Chen Wenhui , Shi Si , You Yiwen
Published: September 2021

Background

Nasopharyngeal carcinoma (NPC) is one of the most common malignancies in head and neck. Platinum-based chemotherapy is an important treatment for NPC. However, the molecular mechanism of resistance to platinum drug remains unknown. Endoplasmic reticulum resident protein 44(ERp44), an unfolded protein response (UPR)-induced endoplasmic reticulum(ER) protein, is induced during ER stress. This research explored the mechanism of ERp44 in strengthening cisplatin resistance in NPC.

Methods

Western blot and immunohistochemistry were used to investigate the expression of ERp44 and Glucose-Regulated Protein 78(GRP78) in NPC. We took CCK8 to detect the role of ERp44 on cell chemosensitivity. Flow cytometric analysis and western blot were taken to analyze cell apoptosis. We performed differential centrifugation to isolate exosomes from serum or conditioned media of cells and analyzed the impact of exosomal ERp44 on cells cisplatin sensitivity. Finally, the results were confirmed in vivo.

Results

We found the increased expression of ERp44 and GRP78 in NPC and ERp44 was highly expressed in ER-stressed tissues. Cell proliferation was inhibited after cisplatin treatment when ERp44 was knocked down and ERp44 strengthened cisplatin resistance by influencing cell apoptosis and pyroptosis. Then we also collected exosomes and cell viability was increased after the addition of NPC-derived-exosomes with cisplatin treatment. More importantly, our results showed under ERS, NPC cells secreted exosomes containing ERp44 and could transfer them to adjacent cells to strengthen chemoresistance.

Conclusion

Our data suggested that exosomal ERp44 derived from ER-stressed NPC cells took an inevitable role in NPC chemoresistance and might act as a treatment target.