bluuebunny/crossref_metadata_2025 huggingface dataset:
Hellp syndrome-related hypertensive chorioretinopathy: A multimodal imaging and optical coherence tomography angiography (OCTA) study
Authors: Interlandi Emanuela , Pellegrini Francesco , Silvestrin Chiara , Pece Alfredo , Pavesio Carlos
Published: October 2021

Introduction

Pregnancy may be associated to unique retinal disorders and is associated to worsening of retinal disease that also occurs in non-pregnant females. We report a case of chorioretinopathy caused by pre-eclampsia associated to HELLP (Hemolysis-Elevated-Liver enzymes and Low Platelet count) syndrome.

Methods

Multimodal Imaging features of HELLP syndrome-related hypertensive chorioretinopathy including retinography, Spectral Domain-Optical Coherence Tomography (SD-OCT), Fluorescein angiography (FA), Indocyanine-green angiography (ICG) along with OCT-angiography (OCTA) are presented and discussed.

Results

Multimodal imaging and OCTA show both retinal and choroidal involvement by HELLP syndrome, resolved after hypertension treatment.

Conclusions

Multimodal imaging is useful to study HELLP syndrome-related hypertensive chorioretinopathy. Moreover, OCTA is a new technology able to study and follow the circulatory status of the choriocapillaris during the disease.
Telemedicine-enabled ambulances and mobile stroke units for prehospital stroke management
Authors: English Stephen W , Barrett Kevin M , Freeman Willam D , Demaerschalk Bart M
Published: October 2021

The recognition and management of stroke in the prehospital setting has become increasingly important to improve patient outcomes. Several strategies to advance prehospital stroke care have been developed, including the mobile stroke unit and the telemedicine-enabled ambulance—or “mini-MSU.” These strategies both incorporate ambulance-based audio-visual telemedicine evaluation with a vascular neurologist to facilitate faster treatment but differ in several areas including upfront and recurring costs, scalability or growth potential, ability to integrate into existing emergency medical services systems, and interoperability across multiple specialties or conditions. While both the mobile stroke unit and mini-mobile stroke unit model are valid approaches to improve stroke care, the authors aim to compare these models based on costs, scalability, integration, and interoperability in order to guide our prehospital leaders to find the best solutions for their communities.
Early perceptions of COVID-19 intensity and anti-Asian prejudice among White Americans
Authors: Mandalaywala Tara M. , Gonzalez Gorana , Tropp Linda R.
Published: October 2021

Anecdotal reports suggested an uptick in anti-Asian prejudice corresponding with the initial outbreak of the COVID-19 pandemic. Examining responses from White U.S. citizens ( N = 589) during the first months of the pandemic, this study tested: (a) whether actual intensity (official number of cases or deaths reported) or perceived intensity (participants’ estimates of the same) of the COVID-19 outbreak predicted indicators of racial outgroup prejudice, particularly those associated with cross-group interaction, (b) whether outgroup prejudice was oriented toward Asian people specifically, or toward racial outgroups more broadly (e.g., toward both Asian people and Black people), and (c) whether contact with racial outgroups moderated relations between COVID-19 intensity and racial prejudice. Results showed that perceived COVID-19 intensity was associated with prejudice indicators representing the desire for social distance from Asian people, as well as from Black people, yet it was unrelated to reports of negative affect toward either racial outgroup. These patterns support the idea that prejudice during periods of disease outbreak might functionally serve to reduce willingness for interaction with, and likelihood of infection from, racial outgroups. Contact moderated the relation between official reports of COVID-19 intensity and support for anti-China travel policies, such that greater contact with Asian people was associated with less support for exclusionary, anti-China travel policies when actual COVID-19 intensity was high. Overall, these results suggest that intensity of disease threat can exacerbate racial outgroup prejudice and reduce willingness for cross-group interaction, but that intergroup contact may sometimes provide a prejudice-attenuating effect.
The Mother–Offspring Conflict: The Association Between Maternal Sleep, Postpartum Depression, and Interbirth Interval Length
Authors: Gunst Annika , Sjöström Elin , Sundén My , Antfolk Jan
Published: October 2021

To test the hypothesis that infant night waking is an adaptation to increase interbirth intervals (IBIs) (i.e., the time between a mother’s consecutive births) by exhausting the mother, we made an initial attempt at investigating whether maternal sleep disturbance is associated with longer IBIs. We also explored whether postpartum depression symptoms mediated the association between maternal sleep disturbance and IBI length. We used retrospective self-reports from 729 mothers living in Finland. We conducted structural regressions separately for the mother’s two first children at two different age intervals (0–1 and 1–3 years). Infant night waking was associated with maternal sleep disturbance (β  =  .78–.84) and maternal sleep disturbance was associated with postpartum depression symptoms (β  =  .69–.81). Postpartum depression symptoms were also associated with longer IBIs for the first child (β  =  .23–.28). This result supports the notion that postpartum depression in and of itself could be viewed as adaptive for the offspring’s fitness, and not just as an unintentional byproduct of the mother’s sleep disturbance. Contrary to our prediction, maternal sleep disturbance was, however, associated with shorter IBIs for the first child (β  =  −.22 to −.30) when including postpartum depression symptoms in the model. We discuss the potential role of social support as an explanation for this unexpected result.
Does it pay to Play by the Rules? Respect for Rule of law, Control of Corruption, and National Success at the Summer Olympics
Authors: Potts Todd B.
Published: October 2021

Utilizing the set of World Governance Indicators published by the World Bank, this paper finds that scoring highly in an indicator measuring respect for rule of law and control of corruption is associated with fewer athletes disqualified and higher medal shares at the Summer Olympics from 1996–2016. Notable reductions in disqualifications and increases in medal shares occur at coincident percentile ranks in the aforementioned indicator, with nations at the 67th percentile rank and above having a 13.8% higher probability of medaling and a 12.11% lower probability of having an athlete disqualified. These results uncover a new link between governance and Olympic success and provide support for the existing anti-doping rules and enforcement as, ceteris paribus, it would seem that nations whose athletes respect and abide by the rules achieve higher medal shares than those whose athletes do not.
The Journal of Sports Economics: 20 Years and Counting
Authors: Kahane Leo H.
Published: October 2021

This invited piece provides some thoughts and insights regarding the development and growth of the Journal of Sports Economics from its founding editor.
Forty Acres and a Mule: Reparation Blues
Authors: Denzin Norman K.
Published: October 2021

This one-act play occurs on Juneteenth 2021, a day when protest directed at the Catholic Church and statues of Saint Junipero Serra swept through the California mission system. Our play centers on the Carmel Mission, the site of Serra’s burial, one block from Clint Eastwood Mission Ranch Horel and Restaurant.
Decluttering the Pandemic: Marie Kondo, Minimalism, and the “Joy” of Waste
Authors: A. Sandlin Jennifer , Wallin Jason James
Published: October 2021

Born largely from discourses on environmental sustainability, the contemporary minimalist movement has produced a new relationship to consumer objects. Where the accumulation of objects once conferred the status of wealth and prosperity under capitalism, minimalism aims to rethink the object as a spiritual extension of our inner lives. This is nowhere as evident than in the writing of Marie Kondo, whose teachings on “joyous” decluttering has enraptured a new class of consumers. Yet, for as much as contemporary thinking on minimalism figures in the image of eco-conscious neo-spirituality, this essay aims to demonstrate the relationship of minimalism to waste. For as much as the decluttering of our private spaces signals to the values of self-control and discipline, it also inadvertently intensifies a relationship to objects in which things that fail to “spark joy” become consigned to the garbage dumps and landfills that today swell with the abject accumulation of consumer society. For as much as the fashion of minimalism gestures to the aspirations of anti-consumerism, it is concomitantly the positive condition upon which the overflowing possessions of a Western consumer class are fated to become trash.
The Heritage Strikes Back: Athlete Activism, Black Lives Matter, and the Iconic Fifth Wave of Activism in the (W)NBA Bubble
Authors: Williams A. Lamont
Published: October 2021

On August 26, 2020, the sporting world experienced a monumental return of athlete activism when National Basketball Association (NBA) players executed a boycott of the playoffs as a result of heightened frustration after video evidence of the unjust police shooting of Jacob Blake in Kenosha, Wisconsin, surfaced on social media on August 23, 2020. NBA players (followed by WNBA players) decided to cease play and enter into discussions with league officials to garner a deal that intertwined the promotion of the Black Lives Matter movement with that of the (W)NBA playoffs; players demanded that the (W)NBA playoffs ground zero for Black Lives Matter promotion and social justice initiatives. As the “fifth wave” of athlete activists stormed the sporting world, their demand for dialogic practices is starkly different than the pioneers of the past, while also aiming to accomplish the general mission of the Heritage—racial equality through athlete activism. This article aims to analyze the new frontier of athlete activism through a Critical Race Theory lens by analyzing the ways in which the implementation of dialogic practices led to one of the most iconic waves of athlete activism in sport history.
The Clinical Significance of RMI2 in Hepatocellular Carcinoma
Authors: Zheng, MS Bin , Wang, MS Heng , Wang, MS Jin-xue , Liu, MS Zheng-hong , Zhang, MD Pu , Zhang, MD Dahong
Published: October 2021

Background: Hepatocellular carcinoma (HCC), which is the most common type of primary liver cancer, often presents at advanced stage with a dismal prognosis. Novel tumor biomarkers are needed to aid in HCC early detection and prognostication. Methods: Immunohistochemical staining for RecQ-mediated genome instability protein 2 (RMI2) was performed in 330 surgically resected HCC specimens and 190 adjacent normal tissues. Univariate and multivariate regression analysis were applied to identify prognostic indicators of HCC outcomes. Patient's survival was assessed with the Kaplan–Meier method. Results: RMI2 in HCC tissue was significantly higher than that in adjacent normal tissues, and was positively correlated with HCC histological grade and stage ( P < .05) but negatively correlated with the survival period. RIM2 was identified to be an independent prognostic indicator for HCC. Conclusion: The abnormal expression of RMI2 may be related to the occurrence and development of HCC. RIM2 could potentially serve as a novel tumor-specific biomarker for HCC diagnosis and prognosis prediction.
Psychometric Properties and Analysis of the Masculinity Barriers to Medical Care Scale Among Black, Indigenous, and White Men
Authors: Rogers Charles R. , Brooks Ellen , Petersen Ethan , Campanelli Pamela , Figueroa Roger , Kennedy Carson , Thorpe Roland J. , Levant Ronald F.
Published: October 2021

Non-Hispanic (NH) Black, American Indian/Alaska Native (Indigenous), and NH-White men have the highest colorectal cancer (CRC) mortality rates among all other racial/ethnic groups. Contributing factors are multifaceted, yet no studies have examined the psychometric properties of a comprehensive survey examining potential masculinity barriers to CRC screening behaviors among these populations. This study assessed the psychometric properties of our Masculinity Barriers to Medical Care (MBMC) Scale among NH-Black, Indigenous, and NH-White men who completed our web-based MBMC, Psychosocial Factors, and CRC Screening Uptake & Intention Survey. We conducted exploratory factor analysis on a sample of 254 men and multivariate analysis of variance (MANOVA) on a separate sample of 637 men nationally representative by age and state of residence. After psychometric assessment, the MBMC scale was reduced from 24 to 18 items and from six to four subscales. NH-Black men’s mean scores were lowest on three of four subscales (Being Strong, Negative and Positive Attitudes) and highest on the Acknowledging Emotions subscale. Compared with both Indigenous and NH-White men, NH-Black men had significantly lower Negative Attitudes subscale scores and significantly higher scores on the Acknowledging Emotions subscale. Compared with both Indigenous and NH-Black men, NH-White men had significantly higher Being Strong and Positive Attitudes subscales scores. This study expands on previous research indicating that, among racialized populations of men, endorsement of traditional masculine ideologies influences engagement in preventive health behaviors. Our scale can be tailored to assess attitudes to screening for other cancers and diseases that disproportionately burden medically underserved populations.
Lightweight and green design of general bridge crane structure based on multi- specular reflection algorithm
Authors: Qi Qisong , Yu Yannan , Dong Qing , Xu Gening , Xin Yunsheng
Published: October 2021

At present, there are some problems that need to be solved in crane steel structure design, such as heavy self-weight of finished structure, high production energy consumption, and huge manufacturing costs. In view of this, a lightweight design method that meets the green product design principle is proposed for crane structure. In this method, an improved new swarm intelligence optimization algorithm named the multi-specular reflection algorithm (M-SRA) is proposed. This algorithm combines the specular reflection algorithm (SRA) with the traditional swarm intelligence optimization algorithm, which has higher computational efficiency. After that, M-SRA is applied to crane steel structure optimization. The results show that the improved algorithm has higher global searching ability and computational efficiency than traditional population intelligence optimization algorithms. The research in this paper provides a reliable design method for the green lightweight design of crane steel structure and a reference for the green design of mechanical products.
Computational analysis of hydromagnetic boundary layer stagnation point flow of nano liquid by a stretched heated surface with convective conditions and radiation effect
Authors: Rasheed Haroon Ur , Islam Saeed , Khan Zeeshan , Khan Jahangir , Mashwani Wali Khan , Abbas Tariq , Shah Qayyum
Published: October 2021

In this study, the boundary layer phenomena for stagnation point flow of water-based nanofluids is being observed with the upshot of MHD and convective heating on a nonlinear stretching surface. To develop a fundamental flow model, a boundary layer approximation is done, which signifies time-dependent momentum, energy, and concentration expressions. Through a proper transformation framework, the modeled boundary layer partial differential equations (PDEs) have been diminished to a dimensionless system of nonlinear ordinary differential equations (ODEs). With the assistance of a built-in algorithm in Mathematica software, the fundamental flow equations are analyzed numerically by imposing a shooting technique explicitly. A stability and convergence analysis were also unveiled, and the ongoing investigation was found to have converged. The effect of mathematical abstractions on velocity, energy, and concentration is plotted and discussed. The influence of skin-friction and Nusselt number on the sheet are debated for the various values of important parameters.
Structural analysis and optimization of an automotive propeller shaft
Authors: Choi Ji-Won , Han Seung-Ho , Lee Kwon-Hee
Published: October 2021

It is a trend to implement weight reduction in parts in recent years when developing a new car. This trend is because weight reduction is essential to respond to tightening environmental regulations. In other words, parts manufacturers of body, chassis, and power train systems have made considerable efforts to reduce weight from the proto design stage. This study performed structural analysis and optimization for weight reduction of a propeller shaft for a passenger car. The natural frequency and the durability of the developing propeller shaft were examined through finite element analyses and tests. Then, optimization was accomplished by focusing on the weight reduction of the tubes made of given steel material. In this process, the metamodel-based optimization technique, kriging interpolation, was applied, and the weight was reduced by 5.3% based on the propeller shaft and 14.1% based on the tube. ANSYS Workbench was used for structural analysis, an in-house program was used to build the kriging model, and MATLAB was used for optimization.
Consequences of Migrating U.S. Contagious Facilities Into General Hospitals, 1900–1950
Authors: Kisacky Jeanne
Published: October 2021

Until the 1880s, hospitals excluded contagious disease patients from admission because of the danger they posed to other patients; by the 1950s, contagious disease care had literally moved into the general hospital. This article correlates the changing isolation facility designs with changing disease incidence and prevention strategies. It argues that isolation moved into the hospital in stages that have consequence for isolation facility design today. Between the 1890s and 1940s, contagious disease care shifted from remote isolation hospitals (commonly known as pest houses) to separate contagious disease hospitals, to contagious disease “units” adjacent to or within a general hospital facility, and to isolation rooms included in nursing units. The architectural history of isolation facility designs shows that the integration of isolation facilities into general hospitals relied on the success of new aseptic nursing procedures that prevented contact transmission but which downgraded the need for spatial separation to prevent airborne transmission. In the second half of the 20th century, federal funding and standards made isolation rooms in the hospital the norm. This migration coincided with a historically unprecedented reduction in contagious disease incidence produced by successful vaccines and antibiotics. By the 1980s, the rise of new and antibiotic resistant diseases led to extensive redesigns of the in-house isolation rooms to make them more effective. This article suggests that it is time to rethink isolation not just at the detail level but in terms of its location in relation to the general hospital.
Novel Use of Intraarticular Granulocyte Colony Stimulating Factor (hG-CSF) Combined with Activated Autologous Peripheral Blood Stem Cells Mobilized with Systemic hG-CSF: Safe and Efficient in Early Osteoarthritis
Authors: Papadopoulos Konstantinos I. , Paisan Mantana , Sutheesophon Warachaya , Turajane Thana
Published: October 2021

Osteoarthritis (OA) tends to occur in older individuals frequently burdened with comorbidities and diverse pharmacological interactions. As articular cartilage has low regenerative power, potent local tissue engineering approaches are needed to support chondrogenic differentiation. Acellular preparation methods as well as approaches to coax endogenous reparative cells into the joint space appear to have limited success. Supported by our in-vitro and clinical studies, we propose that our novel intra-articular administration of human granulocyte colony stimulating factor (IA-hG-CSF) combined with autologous activated peripheral blood stem cells (AAPBSC) is safe and offers treatment advantages not seen with other cellular interventions in early osteoarthritis.
Assessment of anti-factor Xa activity in critically ill COVID-19 patients receiving three different anticoagulation regimens
Authors: Hamad Mohammed A , Dasuqi Shereen A , Aleem Aamer , Omran Rasha A , AlQahtani Rakan M , Alhammad Fahad A , Alzeer Abdulaziz H
Published: October 2021

Introduction:

Critically ill COVID-19 patients are at increased risk of thrombosis with an enhanced risk of bleeding. We aimed to explore the role of anti-factor Xa levels in optimizing the high-intensity anticoagulation’s safety and efficacy and finding possible associations between D-dimer levels, cytokine storm markers, and COVID-19-induced coagulopathy or thrombophilia.

Methods:

Retrospective cohort study conducted on 69 critically ill COVID-19 patients who received three regimens of higher intensity anticoagulation.

Results:

Seventeen patients (24.6%) received high-dose enoxaparin prophylaxis, 29 patients (42%) received therapeutic doses of enoxaparin, and 23 patients (33.3%) were on therapeutic unfractionated heparin infusion. Fewer than one-third of the whole cohort ( n = 22; 31.8%) achieved the target range of anti-factor Xa. The patients were divided into three subgroups based on anti-factor Xa target status within each anticoagulation regimen; when compared, the only association observed among them was for interleukin-6 levels, which were significantly higher in both the “above the expected range” and “below the expected range” groups compared with the “within the expected range” group ( p = 0.009). Major bleeding episodes occurred in 14 (20.3%) patients and were non-significantly more frequent in the “below the expected anti-factor Xa range group” ( p = 0.415). Seven patients (10.1%) developed thrombosis. The majority of patients had anti-factor Xa levels below the expected ranges (four patients, 57.1%).

Conclusion:

Conventional anti-factor Xa ranges may not be appropriate as a predictive surrogate for bleeding in critically ill COVID-19. The clinical decision to initiate therapeutic anticoagulation preemptively may be individualized according to thrombosis and bleeding risks. Cytokine storm markers, namely, interleukin-6, may play a role in COVID-19-induced coagulopathy or thrombophilia.
Integrative analyses reveal RNA regulatory network in Ti particles induced inflammation
Authors: Jiang Yonghui , Ma Huanzhi , Zhang Qin , Shi Jun , Gao Yutong , Sun Chengliang , Zhang Wei
Published: October 2021

Introduction Wear particles induced inflammatory osteolysis is the most important initiating factors in the mechanism of aseptic loosening. However, the molecular network changes in this process remain largely elusive. Methods Here, we performed whole transcriptome analysis using Ti particles induced RAW264.7 cell model to identify specific genes and pathways. Results Sequencing results totally identified 159 mRNAs, 96 lncRNAs, 31 circRNAs, and 12 miRNAs were significantly differently expressed. Of these, we selected two of each RNA for qRT-PCR validation and the results were highly consistent with the RNA-seq data. GSEA analysis shows that upregulated gene sets were related to the three classical inflammation pathway, cytokine–cytokine receptor interaction, TNF, and NF-kappa B signaling pathway. The enriched genes included not only IL-1β and TNF- α, which were independently verified before sequencing, but also other inflammatory osteolysis-related genes such as Mmp9, Fas, and Ccl2. Co-differentially expressed RNAs were employed to construct the ceRNA co-regulatory network. Conclusion: The results revealed that 4 lncRNAs and 2 circRNAs formed a regulatory network to simultaneously regulate miR-3065-3p targeting Myo18a. The present study helps to comprehensively understand the molecular mechanisms and regulatory interaction networks during early inflammatory response.
Citizen Science in Schools: Predictors and Outcomes of Participating in Voluntary Political Research
Authors: Heiss Raffael , Schmuck Desirée , Matthes Jörg , Eicher Carolin
Published: October 2021

Citizen science research has been rapidly expanding in the past years and has become a popular approach in youth education. We investigated key drivers of youth participation in a citizen social science school project and the effects of participation on scientific and topic-related (i.e., political) interest and efficacy. Findings suggest that females, more politically and scientifically interested and more scientifically efficacious adolescents were more motivated to learn from the project. Science efficacy was also positively related to external reward motivation (i.e., winning an award). Both learning and external reward motivation increased the likelihood of participation. Pre- and post-measurement further indicated that participation in the project slightly increased science interest, but not science efficacy. However, it did increase both political interest and efficacy. Furthermore, our data revealed a decrease in science efficacy and interest in those who did not participate in the project, indicating an increasing gap in adolescents’ scientific involvement.
Beyond Bloom’s Taxonomy: Emergence of Entrepreneurial Education
Authors: Panthalookaran Varghese
Published: October 2021

Twenty years have elapsed since the publication of the Revised Bloom’s Taxonomy (RBT) in 2001, which has established itself as a major tool for defining the objectives of educational programs worldwide. It is, however, high time to revisit the efficacy of RBT in defining educational objectives of the digital natives. The current article initiates a discussion on an entrepreneurial mode of education, which requires learners to venture beyond the paradigms of RBT. The article is meant to catalyze educational reforms in tune with the anticipated life and work spaces of the age of information and digitalization. It follows a visionary approach and project future scenarios, accounting for the rationale behind those predictions. The article concludes that the digital natives will have to develop a new set of skills that equip them to venture into a holistic and integrated thinking style, which it names as grey/fuzzy thinking and white/fractal thinking, respectively. The conclusions drawn in the article require further validations from field experiments. With those validations, the insights of this article could pave way for a radical transformation of education sector worldwide, bringing about an entrepreneurial paradigm shift in its conception and conduct.
Developing a Culture of Caring in Classrooms: Best Practices During a Global Pandemic and Beyond
Authors: Kruger Jessica S. , Godley Sophie , Heavey Sarah Cercone
Published: October 2021

The past year has challenged educators in all directions, from switching courses to an online format overnight to addressing student needs within and outside the classroom, and many external factors have extensively affected student performance and engagement. In the United States, the COVID-19 pandemic and a myriad other sociopolitical movements highlight the need for faculty to go beyond educating and start building deeper connections with students. This article provides a rationale for providing an intentionally supportive classroom environment for public health students and outlines the benefits not only to the students but also to the faculty and institution. Furthermore, this article identifies necessary boundaries to caring, including setting appropriate limits and maintaining professional student–educator relationships. Creating an inclusive and supportive learning environment is important not only for training future health professionals but also for cultivating a culture of caring among the profession.
The Impact of COVID-19 Pandemic on Cleft Care Services at a Tertiary Health Facility in Nigeria
Authors: Sabo Vinishe Y. , James Olutayo , Adamson Olawale O. , Otoghile Bright , Adeyemo Wasiu L. , Ladeinde Akinola , Ogunlewe Mobolanle O.
Published: October 2021

Background: This study assessed the impact of COVID-19 Pandemic on cleft care services at a Nigerian tertiary health facility and the adaptations made during and after the population quarantine period. Methodology: A prospective and retrospective survey of all patients with orofacial cleft who had cleft surgeries, orthodontic interventions, and speech therapy in isolation or any of the combination was carried out. The survey period was divided into pre-COVID-19 lockdown period, the COVID-19 lockdown period, and the post-COVID-19 lockdown period with each of the periods spanning 4 months. The data which include: number of cleft clinic attendance, number of cleft surgical procedures, orthodontic interventions, and speech therapy session were retrieved from patients’ case records in the cleft and orthodontic clinics. The data was also reported for each period and represented as numbers and percentages. The trend of cleft services was plotted as line graphs and the impact of the COVID-19 pandemic on cleft care services is said to be significant when P value is <.005. Result: During the COVID-19 Lockdown period, there was a 66% drop in level of cleft clinic attendance, 78% drop in cleft surgeries, 78% drop in Orthodontic interventions, and a 58% drop in the number of Speech Therapy sessions. After the Lockdown period, the clinic attendance increased by a 190%, cleft surgeries rose by more than 10-fold, and the orthodontic interventions increased 10-fold. The speech therapy sessions dwindled further by 6% during the post-COVID-19 Lockdown period. The drop in cleft care service during the study period was significant ( P = .001). The post Lockdown surge in cleft care services was also statistically significant ( P = .001). Conclusion: The COVID-19 pandemic significantly altered the volume of cleft care services but also with a significant rebound post-lockdown period.
Identification of common microRNA between COPD and non-small cell lung cancer through pathway enrichment analysis
Authors: Fathinavid Amirhossein , Ghobadi Mohadeseh Zarei , Najafi Ali , Masoudi-Nejad Ali
Published: October 2021

Background

Different factors have been introduced which influence the pathogenesis of chronic obstructive pulmonary disease (COPD) and non-small cell lung cancer (NSCLC). COPD as an independent factor is involved in the development of lung cancer. Moreover, there are certain resemblances between NSCLC and COPD, such as growth factors, activation of intracellular pathways, as well as epigenetic factors. One of the best approaches to understand the possible shared pathogenesis routes between COPD and NSCLC is to study the biological pathways that are activated. MicroRNAs (miRNAs) are critical biomolecules that implicate the regulation of several biological and cellular processes. As such, the main goal of this study was to use a systems biology approach to discover common dysregulated miRNAs between COPD and NSCLC, one that targets most genes within common enriched pathways.

Results

To reconstruct the miRNA-pathways for each disease, we used the microarray miRNA expression data. Then, we employed “miRNA set enrichment analysis” (MiRSEA) to identify the most significant joint miRNAs between COPD and NSCLC based on the enrichment scores. Overall, our study revealed the involvement of the targets of miRNAs (such as has-miR-15b, hsa-miR-106a, has-miR-17, has-miR-103, and has-miR-107) in the most important common biological pathways.

Conclusions

According to the promising results of the pathway analysis, the identified miRNAs can be utilized as the new potential signatures for therapy through understanding the molecular mechanisms of both diseases.
Breed-specific reference sequence optimized mapping accuracy of NGS analyses for pigs
Authors: Wang Dan , Yang Liu , Ning Chao , Liu Jian-Feng , Zhao Xingbo
Published: October 2021

Background

Reference sequences play a vital role in next-generation sequencing (NGS), impacting mapping quality during genome analyses. However, reference genomes usually do not represent the full range of genetic diversity of a species as a result of geographical divergence and independent demographic events of different populations. For the mitochondrial genome (mitogenome), which occurs in high copy numbers in cells and is strictly maternally inherited, an optimal reference sequence has the potential to make mitogenome alignment both more accurate and more efficient. In this study, we used three different types of reference sequences for mitogenome mapping, i.e., the commonly used reference sequence (CU-ref), the breed-specific reference sequence (BS-ref) and the sample-specific reference sequence (SS-ref), respectively, and compared the accuracy of mitogenome alignment and SNP calling among them, for the purpose of proposing the optimal reference sequence for mitochondrial DNA (mtDNA) analyses of specific populations

Results

Four pigs, representing three different breeds, were high-throughput sequenced, subsequently mapping reads to the reference sequences mentioned above, resulting in a largest mapping ratio and a deepest coverage without increased running time when aligning reads to a BS-ref. Next, single nucleotide polymorphism (SNP) calling was carried out by 18 detection strategies with the three tools SAMtools, VarScan and GATK with different parameters, using the bam results mapping to BS-ref. The results showed that all eighteen strategies achieved the same high specificity and sensitivity, which suggested a high accuracy of mitogenome alignment by the BS-ref because of a low requirement for SNP calling tools and parameter choices.

Conclusions

This study showed that different reference sequences representing different genetic relationships to sample reads influenced mitogenome alignment, with the breed-specific reference sequences being optimal for mitogenome analyses, which provides a refined processing perspective for NGS data.
A low follicle-stimulating hormone level is a protective factor for non-alcoholic fatty liver disease in older men aged over 80
Authors: Zhu Yunxia , Xu Jun , Zhang Xiaoyan , Ke Yingying , Fu Guoxiang , Guo Qihao
Published: October 2021

Purpose

Recent studies have suggested the significant relationship between follicle-stimulating hormone (FSH) and non-alcoholic fatty liver disease (NAFLD) in postmenopausal women. However, it is unknown whether FSH impacts the risk of NAFLD in men. This study aimed to investigate the association between serum FSH levels and NAFLD in elderly Chinese men aged 80–98, a particular group with worse outcomes of NAFLD.

Patients and methods

A cross-sectional analysis was performed in 444 subjects in a geriatric health center. The highest quartile of serum FSH was used as reference. Hepatic steatosis was defined according to the results of liver ultrasound. Fibrosis-4 (FIB-4) Index> 2.67 was defined as advanced fibrosis.

Results

Based on liver ultrasound, 108 (24.3%) subjects had NAFLD. FSH level were negatively correlated with total testosterone, estradiol, nutritional risk, and the prevalence of high education level (allP < 0.01), and positively correlated with age, luteinizing hormone, alanine aminotransferase and aspartate aminotransferase (allP < 0.05). The correlation between FSH and body mass index or antihypertensive drug usage was marginally significant (P = 0.057;P = 0.066, respectively). The percentage of subjects with NAFLD had a trend to increase following the quartiles of serum FSH (20.0% in quartile 1, 18.2% in quartile 2, 27.3% in quartile 3, and 31.6% in quartile 4). After adjustment for common pathogenic risk factors, nutritional risk, and other sex hormones, serum FSH were progressively associated with odds ratios for NAFLD. The adjusted odds ratios and 95% CIs for quartile 1, quartile 2, and quartile 3, compared with quartile 4 were 0.132 (0.034–0.516), 0.190 (0.052–0.702), and 0.404 (0.139–1.173), respectively. Obesity was not involved in the potential negative role of circulating FSH on the risk of NAFLD in our population. Furthermore, our results revealed no significant association between FSH and advance fibrosis, the OR (95% CI) for advanced fibrosis was 1.018 (0.983–1.054) (P = 0.316) after adjusting for the potential covariates, although a positive correlation of FSH and FIB-4 score was observed (r = 0.325,P = 0.001).

Conclusion

Low FSH level may decrease the risk of NAFLD in elderly Chinese men. These findings warrant replication in more extensive studies.
Mortality risk factors among hospitalized children with severe pertussis
Authors: Shi Tingting , Wang Ling , Du Shuling , Fan Huifeng , Yu Minghua , Ding Tao , Xu Xuehua , Zhang Dongwei , Huang Li , Lu Gen
Published: October 2021

Background

Some children hospitalized for severe pertussis need intensive care; moreover, some children die because of deterioration alone or in combination with other complications. The purpose of this study was to identify the mortality risk factors among hospitalized children with severe pertussis.

Methods

This study evaluated the medical records of 144 hospitalized children with severe pertussis at the Guangzhou Women and Children’s Medical Centre between January 2016 and December 2019.

Results

The median age of patients was 2 months (IQR 1–4 months), with 90.3% of the patients aged < 6 months and 56.9% of the patients aged < 3 months. A total of 38 patients were admitted to intensive care unit (ICU), 13 patients died, and the mortality of severe pertussis was 34.2%, with patients younger than 6 weeks accounting for 76.9% of the deaths. On the multivariate analysis, the independent risk factors for death were WBC > 70.0 × 109/L (odds ratio [OR], 230.66; 95% confidence interval [CI], 5.16–10,319.09 P = 0.005) and pulmonary hypertension (PH) (OR 323.29; 95% CI 16.01–6529.42; P < 0.001).

Conclusion

Severe pertussis mainly occurred in children aged < 3 months. The mortality of severe pertussis was 34.2%, with patients younger than 6 weeks accounting for the majority of the deaths. We recommend the first dose of diphtheria-tetanus-pertussis (DTP) should be advanced to the age of 2 months or even 6 weeks. The presence of a WBC > 70.0 × 109/L and PH were the prognostic independent variables associated with death.
Spatial analysis of tuberculosis cure in primary care in Rio de Janeiro, Brazil
Authors: Prado Junior José Carlos , Medronho Roberto de Andrade
Published: October 2021

Background

Tuberculosis (TB) presents a high burden of disease and is considered a global emergency by the World Health Organization (WHO), as the leading cause of death from infectious disease in adults. TB incidence is related directly to access to health services and socioeconomic determinants and inequality. Providing primary care settings can lead to improved access, shorter waiting times for patients, and enhanced TB case detection. The article aims to identify the spatial and temporal risk areas for TB and the relationship between TB cure and primary healthcare coverage from 2012 to 2014 in Rio de Janeiro, Brazil.

Methods

A cross-sectional study was conducted in Rio de Janeiro, Brazil. All cases of TB reported to the Information System on Diseases of Notification (SINAN) from 2012 to 2014 were included. Socioeconomic variables from the 2010 Brazilian national census were also added. Socioeconomic variables were selected from multivariate analysis using principal factors analysis. Spatial association was verified with generalized additive model (GAM). It was possible to identify areas at higher risk of failure to cure TB.

Results

TB rates showed strong positive spatial autocorrelation. TB cure rate varied according to schooling (individuals with complete secondary schooling had higher cure rates than illiterate individuals; OR 1.72, 95% CI 1.30–2.29), alcohol consumption (OR 0.47, 95% CI 0.35–0.64), contact investigation (OR 2.00, 95% CI 1.56–2.57), positive HIV serology (OR 0.31, 95% CI 0.23–0.42), and census tracts with higher elderly rates (OR 9.39, 95% CI 1.03–85.26). Individuals who had been covered by primary healthcare (PHC) for 35 to 41 months had 1.64 higher odds of cure, compared to those with no PHC coverage (95% CI 1.07–2.51).

Conclusion

A comprehensive risk map was developed, allowing public health interventions. Spatial analysis allowed identifying areas with lower odds of TB cure in the city of Rio de Janeiro. TB cure was associated statistically with time of coverage by primary healthcare. TB cure rate also varied according to sociodemographic factors like schooling, alcohol abuse, and population density.

This methodology can be generalized to other areas and/or other public health problems.

Highlights

We studied standardized municipal TB cure rates in an area of social inequality in Brazil.

TB rates showed strong positive spatial autocorrelation.

Higher rates were associated with population density and socioeconomic conditions. Illiterate individuals were less likely to achieve TB cure.

TB cure was less likely in individuals with HIV and alcohol abuse.

TB cure was greater in areas with high primary healthcare coverage.
Quality of dying in hospital general wards: a cross-sectional study about the end-of-life care
Authors: Binda Filippo , Clari Marco , Nicolò Gabriella , Gambazza Simone , Sappa Barbara , Bosco Paola , Laquintana Dario
Published: October 2021

Background

In the last decade, access to national palliative care programs have improved, however a large proportion of patients continued to die in hospital, particularly within internal medicine wards.

Objectives

To describe treatments, symptoms and clinical management of adult patients at the end of their life and explore whether these differ according to expectation of death.

Methods

Single-centre cross-sectional study performed in the medical and surgical wards of a large tertiary-level university teaching hospital in the north of Italy. Data on nursing interventions and diagnostic procedure in proximity of death were collected after interviewing the nurse and the physician responsible for the patient. Relationship between nursing treatments delivered and patients’ characteristics, quality of dying and nurses’ expectation about death was summarized by means of multiple correspondence analysis (MCA).

Results

Few treatments were found statistically associated with expectation of death in the 187 patients included. In the last 48 h, routine (70.6%) and biomarkers (41.7%) blood tests were performed, at higher extent on patients whose death was not expected. Many symptoms classified as severe were reported when death was highly expected, except for agitation and respiratory fatigue which were reported when death was moderately expected. A high Norton score and absence of anti-bedsore mattress were associated with unexpected death and poor quality of dying, as summarized by MCA. Quality of dying was perceived as good by nurses when death was moderately and highly expected. Physicians rated more frequently than nurses the quality of dying as good or very good, respectively 78.6 and 57.8%, denoting a fair agreement between the two professionals (k = 0.24, P <  0.001). The palliative care consultant was requested for only two patients.

Conclusion

Staff in medical and surgical wards still deal inadequately with the needs of dying people. Presence of hospital-based specialist palliative care could lead to improvements in the patients’ quality of life.
Determining the effect of tele-rehabilitation on patients with stutter using the goal attainment scaling (GAS)
Authors: Eslami Jahromi Maryam , Ahmadian Leila
Published: October 2021

Background

Lack of proper and timely patients' access to speech pathologists can affect the treatment and follow-up process; therefore, patients do not achieve the expected therapeutic goals. The aim of this study was to determine the effect of tele-rehabilitation on the stuttering patients using the goal attainment scaling (GAS).

Methods

This interventional study was carried out on patients who visited the rehabilitation centers affiliated to the Jahrom Welfare Office. They underwent remote speech therapy using Skype. To evaluate the treatment outcomes of the stuttering patients, GAS was used.

Results

The participants' speech and lingual skills improved using videoconferencing. The mean score of total GAS for patients was 53.08. Of 112 health goals, patients reached the expected or higher than expected levels in 78 goals.

Conclusions

Rehabilitation through video conferencing was effective for patients with stuttering, improved their speech, and decreased their stuttering. Since, application of remote rehabilitation services can provide regular access to healthcare services, it can lead to improving patient treatment provide more frequent and faster treatment follow-up.
The association between experience of hospital accreditation and nurses’ perception of patient safety culture in South Korean general hospitals: a cross-sectional study
Authors: Kwan M. R. , Seo H. J. , Lee S. J.
Published: October 2021

Background

Hospital accreditation programs can positively affect nurses’ perceptions of patient safety culture. However, no previous research has identified the association between experience of hospital accreditation and nurses’ perception of patient safety culture in general hospitals. This study aims to examine 1) the level of perception of each area of patient safety culture in nurses working in general hospitals and 2) the relationship between experience of hospital accreditation and nurses’ overall perceptions of safety in Korean general hospitals.

Methods

A cross-sectional survey design was used, with a convenience sample of 310 nurses from six general hospitals. Nurses were asked to complete the self-reported Korean version of the Hospital Survey on Patient Safety Culture and the experience of hospital accreditation. A hierarchical multiple regression analysis was used to examine the associations between hospital accreditation experience and perception of patient safety culture.

Results

The patient safety composites with the highest positive response were the frequency of events reported (90.6) and supervisor/manager expectations promoting patient safety (69.4%). The composites with the lowest scores were non-punitive responses to errors (22.9%) and organizational learning/continuous improvement (35.5%). Hierarchical multiple regression analysis showed that the experience of hospital accreditation had a very small increase on overall perceptions of safety (β = 0.097, p = 0.023).

Conclusions

This study found that general hospital nurses’ experience of hospital accreditation had very weak relationship with their overall perceptions of patient safety. Therefore, a longitudinal study is needed to confirm the influence of hospital accreditation on nurses’ patient safety culture in general hospitals.