bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Capital Mediates the Relationship between Social Distancing and COVID-19 Prevalence in Japan
Authors: Kokubun Keisuke , Yamakawa Yoshinori
Published: April 2021

The threat of coronavirus disease (COVID-19) is increasing. Regarding the differences in the infection rate observed in each region, additionally to studies investigating the causes of differences in population density as a proxy for social distancing, an increasing trend of studies investigating the causes of differences in social capital has also been seen (ie, value sharing, acceptance of norms, unity, and trust through reciprocity). However, studies investigating whether social capital that controls the effects of population density also influences the infection rate are limited. Therefore, in this study, we analyzed the relationship between infection rate, population density, and social capital using statistical data of Japan’s every prefecture. Statistical analysis showed that social capital not only negatively correlates with infection rates and population densities, but also negatively correlates with infection rates controlling for the effects of population density. Additionally, controlling the relationship between the variables by mean age showed that social capital had a greater correlation with infection rate than population density. In other words, social capital mediates the relationship between population density and infection rates, indicating that social distancing alone is not enough to deter coronavirus disease; social capital needs to be recharged.
Validation of motor, cognitive, language, and socio-emotional subscales using the Caregiver Reported Early Development Instruments: An application of multidimensional item factor analysis
Authors: Waldman Marcus , McCoy Dana Charles , Seiden Jonathan , Cuartas Jorge ,   CREDI Field Team, Fink Günther
Published: April 2021

The Caregiver Reported Early Development Instruments (CREDI) are assessments tools for measuring the development of children under age three in global contexts. The present study describes the construction and psychometric properties of the motor, cognitive, language, and socio-emotional subscales from the CREDI’s long form. Multidimensional item factor analysis was employed, allowing indicators of child development to simultaneously load onto multiple factors representing distinct developmental domains. A total of 14,113 caregiver reports representing 17 low-, middle-, and high-income countries were analyzed. Criterion-related validity of the constructed subscales was tested in a subset of participants using data from previously established instruments, anthropometric data, and a measure of child stimulation. We also report internal-consistency reliability and test–retest reliability statistics. Results from our analysis suggest that the CREDI subscales display adequate reliability for population-level measurement, as well as evidence of validity.
Comparison of the corticosteroid injection and hyaluronate in the treatment of chronic subacromial bursitis: A randomized controlled trial
Authors: Hsieh Lin-Fen , Lin Yi-Jia , Hsu Wei-Chun , Kuo Ying-Chen , Liu Yu-Chia , Chiang Yi-Pin , Wang Chun-Ping
Published: April 2021

Objective:

To analyse the effectiveness of corticosteroid (CS) and hyaluronic acid (HA) subacromial – subdeltoid (SASD) injection compared with normal saline (NS) in patients with chronic subacromial bursitis (CSB).

Design:

A prospective three-arm double-blinded randomised controlled trial.

Setting:

Rehabilitation department of two teaching hospitals.

Subjects:

Patients with CSB ( N = 186) divided into CS ( N = 68), HA ( N = 60), and NS ( N = 58) groups.

Interventions:

Three SASD injections under ultrasound guidance: group A, 20 mg of triamcinolone; group B, 2.5 mL of HA; and group C, 2.5 mL of NS.

Outcome measures:

The primary outcome measures were the pain visual analogue scale (VAS) score at eight weeks. The secondary outcomes were scores on the Shoulder Pain and Disability Index (SPADI) and Shoulder Disability Questionnaire.

Results:

At eight weeks, the pain VAS scores during activity were 2.56 ± 2.29, 3.65 ± 2.50, and 4.71 ± 2.83 in the CS, HA, and NS groups, respectively (CS vs NS, P < 0.001; HA vs NS, P = 0.013; CS vs HA, P = 0.010). SPADI scores were 40.83 ± 21.75, 36.92 ± 22.78, and 33.35 ± 23.38 in the CS, HA, and NS groups, respectively (CS vs NS, P < 0.001; HA vs NS, P = 0.197; CS vs HA, P = 0.004).

Conclusion:

Ultrasound-guided corticosteroid injection into the subacromial – subdeltoid bursa was proven to be effective and superior to hyaluronic acid and normal saline injection for treating CSB. Hyaluronic acid injection was only marginally more effective than normal saline injection. Trial Registration: ClinicalTrials.gov: NCT02702206
The effectiveness of a family-centred intervention after traumatic brain injury: A pragmatic randomised controlled trial
Authors: Rasmussen Mari S , Andelic Nada , Pripp Are H , Nordenmark Tonje H , Soberg Helene L
Published: April 2021

Objectives:

To determine the effectiveness of a family-centred intervention for patients with traumatic brain injury and family members.

Design:

Open-labelled, two-armed randomised controlled trial.

Settings:

Outpatient clinic and family residences.

Participants:

Sixty-one patients (33 women) with traumatic brain injury, with mean (SD) age 43.8 (12.2), and 63 family members (33 women), with mean (SD) age 42.6 (11.3), were assign to intervention ( n = 30 families) and control group ( n = 31 families).

Intervention:

An eight-session single-family intervention to improve individual and family functioning.

Outcome measures:

Self-reported questionnaires at start-of-treatment, median (IQR) 11.4 (8.4, 15.9) months post-injury, and at two follow-ups, 2.7 (2.3, 3.8) and 9.2 (8.2, 9.9) months after start-of-treatment. Primary outcome measures were the SF-36 Mental Component Summary (MCS) and Caregiver Burden Scale (CGB). Secondary outcome measures were the Family Adaptability and Cohesion Evaluation Scale (FACES) and Quality of Life after Brain Injury Questionnaire (QOLIBRI). Group differences were analysed with linear mixed-model analysis for repeated measurements.

Results:

No significant between-group differences were found. The intervention group significantly improved on the MCS, the CGB and FACES in the treatment period, whereas the controls did not. The mean (SD) MCS change in the treatment period was 2.4 (1.1) points P = 0.028 in the intervention group. Mean (SE) MCS scores were 47.9 (1.26) and 47.3 (1.27) in the intervention and control group at last follow-up.

Conclusions:

Receiving an eight-session family intervention, in addition to specialised rehabilitation for the patients, was not superior to rehabilitation at a specialised traumatic brain injury outpatient clinic.
Cannabidiol modulation of hippocampal glutamate in early psychosis
Authors: O’Neill Aisling , Annibale Luciano , Blest-Hopley Grace , Wilson Robin , Giampietro Vincent , Bhattacharyya Sagnik
Published: April 2021

Background:

Emerging evidence supports the antipsychotic effect of cannabidiol, a non-intoxicating component of cannabis, in people with psychosis. Preclinical findings suggest that this antipsychotic effect may be related to cannabidiol modulating glutamatergic signalling in the brain.

Aim:

The purpose of this study was to investigate the effects of cannabidiol on the neurochemical mechanisms underlying psychosis.

Methods:

We investigated the effects of a single oral dose of cannabidiol (600 mg) in patients with psychosis, using a double-blind, randomised, placebo-controlled, repeated-measures, within-subject cross-over design. After drug administration, 13 patients were scanned using proton magnetic resonance spectroscopy to measure left hippocampal glutamate levels. Symptom severity was rated using the Positive and Negative Syndrome Scale 60 min before drug administration (pre-scan), and 270 min after drug administration (post-scan). Effects of cannabidiol on hippocampal glutamate levels, symptom severity, and correlations between hippocampal glutamate and symptoms were investigated.

Results:

Compared to placebo, there was a significant increase in hippocampal glutamate ( p=0.035), and a significantly greater decrease in symptom severity ( p=0.032) in the psychosis patients under cannabidiol treatment. There was also a significant negative relationship between post-treatment total Positive and Negative Syndrome Scale score and hippocampal glutamate ( p=0.047), when baseline Positive and Negative Syndrome Scale score, treatment (cannabidiol vs placebo), and interaction between treatment and glutamate levels were controlled for.

Conclusions:

These findings may suggest a link between the increase in glutamate levels and concomitant decrease in symptom severity under cannabidiol treatment observed in psychosis patients. Furthermore, the findings provide novel insight into the potential neurochemical mechanisms underlying the antipsychotic effects of cannabidiol.
Reconstruction of coronoid process of the ulna: a literature review
Authors: Zhao Shanwen , Zeng Canjun , Yuan Song , Li Runguang
Published: April 2021

As a pivotal part of the elbow joint structure, the coronoid process of the ulna plays a vital role in maintaining elbow joint stability. Loss of coronoid process height causes instability of the elbow joint depending on the fracture characteristics and size. The diagnosis and treatment of coronoid process fractures has gained widespread attention from orthopedic surgeons. Nevertheless, few reports have described reconstruction of coronoid process fractures and defects that affect elbow joint stability. Treatment of elbow joint instability induced by coronoid process defects is challenging because most cases are complicated by other elbow joint injuries. Moreover, the clinical efficacy remains unclear. The present narrative review was performed to examine the research progress on reconstruction of the coronoid process. The findings of this review provide evidence for clinical repair and reconstruction of coronoid process defects and contribute to the published literature on this topic.
Ethnic minorities, ethnic conflict, and confidence in the UN across the world
Authors: Karakoç Ekrem , Wang Zhiyuan
Published: April 2021

This study investigates to what extent ethnic minorities differ from majorities in the degree of confidence in the UN and the scope conditions. Emphasizing the impact of the UN’s involvement, it argues that minorities are predisposed to hold a higher degree of confidence in the UN in countries where ethnic conflict has taken place and this difference is further complicated by the nature of the countries’ political regimes. Utilizing the World Value Surveys for the period 1981–2012, we find robust evidence for our arguments. We also find that minorities probably increase in such trust as ethnic conflict persists longer.
That’s a Good Question: Inquiry as a Pedagogical Strategy of Jesus in Matthew
Authors: Heflin Houston
Published: April 2021

This article analyzes the ways in which Jesus’ questions in Matthew’s gospel align with the categories of Bloom’s taxonomy, and how Jesus’ audience influenced the questions he asked. Results indicate Jesus asked the religious leaders higher-level questions more often than the disciples, who received a greater number of lower-level questions. These differences inform how teachers construct questions that help students learn. Recommendations are made for educators who construct questions that account for students’ preparation, students’ motivation, the value of silence, and the difficulty of questions.
Electrospun PU/MgO/Ag Nanofibers for Antibacterial Activity and Flame Retardency
Authors: Mamtha V. , Murthy H. N. Narasimha , Raj V. Pujith , Tejas Prashantha , Puneet C. S. , Venugopal Achyutha , AanMankunipoyil Sham , Manjunatha C.
Published: April 2021

Antibacterial activity and fire retardation are equally desired for protective clothing. For achieving this, AgNP and MgO are independently researched as nanofillers in Polyurethane based electrospun nanofibers and their synergistic effect is scarcely addressed. This article reports synthesis and characterization of MgO of 70.01 nm and AgNP of 51 to 76 nm by solution combustion and hydrothermal routes respectively and their incorporation in electrospinning of Polyurethane. Flow rate 1 ml/hr, applied voltage 13 kV, tip to collector distance 15 cm were adopted for the electrospinning. Nanofibers of 65 nm were obtained for PU/MgO (3 wt. %) and 106 nm for PU/MgO (3 wt. %)/Ag (1 wt. %). Addition of MgO increased the melting point, after flame time and afterglow time. Incorporation of AgNP improved antibacterial activity. PU/MgO/Ag (2 wt. %) exhibited zone of inhibition of 2.1 cm and 3 cm against E. Coli and S. Aureus, respectively.
What gets lost in Twitter ‘cancel culture’ hashtags? Calling out racists reveals some limitations of social justice campaigns
Authors: Bouvier Gwen , Machin David
Published: April 2021

Twitter campaigns attacking those who make racist or xenophobic statements are valuable, raising the public profile of opinions that will not tolerate racism in any form. They also indicate how our major institutions are failing to address important matters of social justice. But there is concern that social media, such as Twitter, tends to extremes, moral outrages, lack of nuance and incivility, which shape how issues become represented. In this paper, using Critical Discourse Analysis, we look at three Twitter hashtags calling-out racist behaviour. We ask how racism and anti-racism is represented on these hashtags? We show how these misrepresent fundamental aspects of racism in society, distracting from, what race theorists would argue, is the most important thing these incidents tell us about racism at this present time. The findings have consequences for all such Twitter social justice campaigns.
Running Aground: Reflections on Belief, Organizational Culture, Strategy, and Performance
Authors: Rowe W. Glenn , O’Brien James , Nason Kenneth A.
Published: April 2021

A Canadian Navy destroyer ran aground more than 45 years ago. I have been thinking about it ever since, while in the Navy, and during my career as a management educator. I also have discussed it with my coauthors. Here is what we believe we can learn from that grounding.
Active vibration control of building structure using active disturbance rejection control
Authors: Ramírez-Neria Mario , Morales-Valdez Jesús , Yu Wen
Published: April 2021

This article presents an active vibration control of seismically excited building structures. The control scheme is based on active disturbance rejection control, which is an attractive alternative technique for structural vibration suppression and practical motion control solution in the presence of parametric uncertainties and disturbances. The proposed active disturbance rejection control scheme uses a generalized proportional integral observer, which allows us to estimate in real time the unknown dynamics and disturbances in the building structure to cancel their effect using a part of the control signal. First, the active disturbance rejection control provides a proportional derivative controller with robustness to external disturbances and uncertainties, and its structure is expressed in a compact error-based form. An important advantage with respect to other methods is that the proposed scheme does not need the system parameters. Moreover, supposing that displacement and velocity cannot be measured directly, an online robust adaptive observer is introduced to estimate both data, required for the proportional derivative controller. The adaptive observer removes constant disturbance and attenuates measurement noise in acceleration data. Under this line, a second active disturbance rejection control scheme is introduced based on a proportional controller that, unlike proportional derivative, it only needs the velocities that can be directly estimated by integrating the acceleration signals and does not require the adaptive observer. An advantage of this scheme is its simplicity to be implemented because it only needs to tune the proportional gain. Furthermore, this scheme has a similar performance of the proportional derivative controller. The effectiveness of the proposed active disturbance rejection control schemes is demonstrated through experimental results of a reduced scale five-story building structure. The results are found to be a good step in that direction, confirming that the proposed method is promising for practical applications.
Validation of Michigan risk score and D-dimer to predict peripherally inserted central catheter-related thrombosis: A study of 206,132 catheter days
Authors: Kang Junren , Sun Wenyan , Li Hailong , Ma En ling , Chen Wei
Published: April 2021

Background:

The Michigan Risk Score (MRS) was the only predicted score for peripherally inserted central venous catheters (PICC) associated upper extremity venous thrombosis (UEVT). Age-adjusted D-dimer increased the efficiency for UEVT. There were no external validations in an independent cohort.

Method:

A retrospective study of adult patients with PICC insertion was performed. The primary objective was to evaluate the performance of the MRS and age-adjusted D-dimer in estimating risk of PICC-related symptomatic UEVT. The sensitivity, specificity and areas under the receiver operating characteristics (ROC) of MRS and age-adjusted D-dimer were calculated.

Results:

Two thousand one hundred sixty-three patients were included for a total of 206,132 catheter days. Fifty-six (2.6%) developed PICC-UEVT. The incidences of PICC-UEVT were 4.9% for class I, 7.5% for class II, 2.2% for class III, 0% for class IV of MRS ( p = 0.011). The incidences of PICC-UEVT were 4.5% for D-dimer above the age-adjusted threshold and 1.5% for below the threshold ( p = 0.001). The areas under ROC of MRS and age-adjusted D-dimer were 0.405 (95% confidence interval (CI) 0.303–0.508) and 0.639 (95% CI 0.547–0.731). The sensitivity and specificity of MRS were 0.82 (95% CI, 0.69–0.91), 0.09 (95% CI, 0.08–0.11), respectively. The sensitivity and specificity of age-adjusted D-dimer were 0.64 (95% CI, 0.46–0.79) and 0.64 (95% CI, 0.61–0.66), respectively.

Conclusions:

MRS and age-adjusted D-dimer have low accuracy to predict PICC-UEVT. Further studies are needed.
Space and Culture: Quarantine
Authors: Lozanovska Mirjana
Published: April 2021

The dead, not unlike the sick, are historically quarantined from the space of the living. Spatial separation is a constituent of civilization and this is epitomized by an architectural and urban separation, indeed division, between the space of the dead and the space of the living. Cemeteries are historically located on the periphery, quartered off by a clearly demarcated boundary, or in a separate site altogether as it is called, the City of the Dead. Architecture manifests a clarity of distinction between the living and the dead as spatially distinct building block of civilization. Yet we know this cannot be the whole story. This paper will draw on the death drive from psychoanalytic theory to discuss an architecture of quarantine.
Sensing Urban Values: Reassessing Urban Cultures and Histories Amidst Redevelopment Agendas
Authors: Birdsall Carolyn , Halauniova Anastasiya , van de Kamp Linda
Published: April 2021

Introduction to Sensing Urban Values. This special issue assembles a set of papers that respond to a neglected, undertheorized yet crucial question relating to spatial politics and urban renewal: How do economic and non-economic values depend on and co-constitute each other in different urban contexts? In response, the contributors to this special issue build on recent critical reassessments of value; they explore how the spatial and cultural politics of value unfolds in contemporary urban environments globally. They examine cases that traverse Poland, South Africa, Malaysia, Germany, and The Netherlands. The papers demonstrate a theoretical and empirically engaged concern with themes such as the cultural dimensions of place-making processes in contemporary cities; how identity, memory, heritage, and value-making processes may matter for the production of urban spaces today through sensing; aesthetic reorganizations of places, movements, and interactions with urban matters; and through storytelling. Taking up the theme of urban valuation with a multisensory approach has prompted the contributors to explore the multiple and translocal ways through which urban valuations unfold, are performed, and are experienced. This approach reveals the multiple valuations of spaces—not only economic but also symbolic—that inform the struggles for social and spatial justice in cities across the world as well as their scholarly examinations.
Civil war recurrence and postwar violence: Toward an integrated research agenda
Authors: Bara Corinne , Deglow Annekatrin , van Baalen Sebastian
Published: April 2021

Violence after civil war is a challenge to sustainable peace. Many armed conflicts today are recurrences of previous wars and much of the literature on violence after war explains why armed groups return to the battlefield. But even if peace prevails, many other types of violence take place in postwar environments. This postwar violence is likewise subject to a growing multidisciplinary literature. Using citation network analysis, we show that research on war recurrence and postwar violence has developed in relative isolation from each other—although these phenomena are interrelated. This compartmentalization leads us to overlook important similarities and differences in the drivers of different forms of violence after war. We demonstrate this by reviewing the literature in both of these closely related fields. While war recurrence and postwar violence share a set of common risk factors, some factors can have opposite effects on the two outcomes. Because these insights only emerge when systematically comparing the two strands of literature, we propose a novel framework for the study of violence after wars that aims at overcoming the compartmentalization of research within these two fields. The framework serves both as a conceptual lens and an analytical tool to categorize and compare different forms of violence after war. We then outline how the framework aids scholars in pursuing an integrated research agenda, with concrete suggestions for research questions that should be studied to expand our understanding of violence after wars.
Rethinking causal explanation in interpretive international studies
Authors: Norman Ludvig
Published: April 2021

This article develops a model for causal explanations amenable to interpretive International Relations (IR) research. A growing field of scholars has turned toward causal inquiry while stressing the importance of shared understandings, identities, and social practices for their explanations. This move has considerable potential to strengthen the contributions of interpretive approaches to IR. However, the article identifies shortcomings in the causal models on which this research is based which work to limit this potential. The article provides a detailed discussion of these limitations and offers an alternative model of causal explanations for interpretive IR. The proposed model builds on a clear differentiation between constitutive and causal analysis and supplies an explicit argument for how they can be combined to generate causal explanations. This paves the way for a more well-defined notion of causal explanation than has commonly been the case in interpretive IR. In doing so, it also offers a more coherent and detailed account of the points at which interpretive explanations intersect with more mainstream approaches and where they differ. Finally, the paper outlines an application of the model through a discussion on an updated form of interpretive process tracing (IPT).
Has tourism driven house prices in Germany? Time-varying evidence since 1870
Authors: Churchill Sefa Awaworyi , Inekwe John , Ivanovski Kris
Published: April 2021

Using a historical data set and recent advances in non-parametric time series modelling, we investigate the nexus between tourism flows and house prices in Germany over nearly 150 years. We use time-varying non-parametric techniques given that historical data tend to exhibit abrupt changes and other forms of non-linearities. Our findings show evidence of a time-varying effect of tourism flows on house prices, although with mixed effects. The pre-World War II time-varying estimates of tourism show both positive and negative effects on house prices. While changes in tourism flows contribute to increasing housing prices over the post-1950 period, this is short-lived, and the effect declines until the mid-1990s. However, we find a positive and significant relationship after 2000, where the impact of tourism on house prices becomes more pronounced in recent years.
Mediation analysis of social deficits between self-criticism and aggression in adolescents
Authors: Zahra Sayyeda Taskeen , Saleem Sadia , Khurshid Halima
Published: April 2021

This research aims to determine the mediating role of social deficits in self-criticism and aggression using a sample of 695 adolescents (girls = 49%, boys = 51%), aged 12 to 19 years ( M = 14.97, SD = 1.30) from an urbanized city of Pakistan. Interpersonal Difficulties Scale, Self-Criticism Scale, and Aggressive Behavior Scale were used in the present study. Results indicated a significant positive association of social deficits with self-criticism and aggression ( p < .001). Furthermore, findings also suggested a significant positive association between self-criticism and aggression. Mediation analysis revealed that self-criticism partially mediated the relationship between social deficits and aggression. Findings are discussed in terms of the expression and manifestation of self-criticism, social deficits, and aggression in adolescents in collectivistic cultures.
Visibilities and invisibilities in data reuse: video records of practice in education
Authors: Yakel Elizabeth , Frank Rebecca D , Suzuka Kara , Smith Jasmine
Published: April 2021

This article investigates data reuse or the secondary analysis of qualitative data, specifically video records of practice in education, which are used to study the complex cognitive, social, and logistical issues involved in teaching and learning processes. It examines reuse through the lens of the invisibilities experienced by educational researchers who perform secondary analysis on video records of practice. Drawing on 22 in-depth interviews with educational researchers, we examine how they conceptualize secondary analysis of qualitative video data and cope with invisibilities in the data. For example, knowing the original research question was not sufficient: reusers needed to understand more about the intentionality of the data producer. They also sought more information on the reflexivity of the original researcher and how this influenced data production. Additionally, reusers discussed the creation of evidence from the video during secondary analysis as teaching and learning themselves entail invisible processes.
A Short Critique on the Stance of the Netherlands Food and Consumer Product Safety Authority on Melamine Polymer Formaldehyde Exposures
Authors: Hanekamp Jaap C.
Published: April 2021

In February 2021, the Netherlands Food and Consumer Product Safety Authority came out with their risk assessment on formaldehyde exposure from melamine crockery with bamboo fiber to especially young children. In this short commentary, I will critique their assessment of this type of food-contact material (FCM). The main flaws are at least: (i) absence of a proper valuation of the available principal scientific literature yielding a biased risk assessment; (ii) discounting the endogenous formaldehyde formation that outweighs background exposure substantially; (iii) ad hoc positing of an unjustifiable and unfounded low background exposure levels to formaldehyde whereby risks of exposure to melamine formaldehyde is grossly exaggerated. This biased assessment has created societal unrest that is wholly uncalled for. Additionally, it has wide-ranging European consequences for the use of all melamine FCM.
Transforming Trauma With Lifestyle Medicine
Authors: Gordon James S. , Znayenko-Miller Tatiana
Published: April 2021

A common misconception is that trauma—“injury” to the mind, body, and spirit—comes only to those individuals who have experienced threats of death, sexual violence, or serious injury. The SARS-CoV-2 (COVID-19) and the widespread disruption, anxiety, and stress it has left in its wake have shown us that this is not the case; trauma is universal. Left unaddressed, trauma can have long-term physical and psychological consequences. It appears that the consequences of trauma can also be transmitted from generation to generation through modifications in the DNA of the exposed individual that alter the function of one or more genes. Meditation and other practical, evidence-based mind-body skills can reverse what has been damaged by traumatic events and long-term stress. The Center for Mind-Body Medicine (CMBM), established in 1991, has developed a comprehensive, innovative, and evidence-based model that has been used by diverse populations to heal psychological trauma and promote resilience. Comprehensive, easily available programs of self-care and group support, such as The CMBM’s Mind-Body Skills Group Model, can ensure that children and adults everywhere have the psychological skills they need to address the trauma of the COVID-19 pandemic.
Synthetic glycolipid-based TLR4 antagonists negatively regulate TRIF-dependent TLR4 signalling in human macrophages
Authors: Palmer Charys , Facchini Fabio A , Jones Richard PO , Neumann Frank , Peri Francesco , Pirianov Grisha
Published: April 2021

TLRs, including TLR4, play a crucial role in inflammatory-based diseases, and TLR4 has been identified as a therapeutic target for pharmacological intervention. In previous studies, we investigated the potential of FP7, a novel synthetic glycolipid active as a TLR4 antagonist, to inhibit haematopoietic and non-haematopoietic MyD88-dependent TLR4 pro-inflammatory signalling. The main aim of this study was to investigate the action of FP7 and its derivative FP12 on MyD88-independent TLR4 signalling in THP-1 derived macrophages. Western blotting, Ab array and ELISA approaches were used to explore the effect of FP7 and FP12 on TRIF-dependent TLR4 functional activity in response to LPS and other endogenous TLR4 ligands in THP-1 macrophages. A different kinetic in the inhibition of endotoxin-driven TBK1, IRF3 and STAT1 phosphorylation was observed using different LPS chemotypes. Following activation of TLR4 by LPS, data revealed that FP7 and FP12 inhibited TBK1, IRF3 and STAT1 phosphorylation which was associated with down-regulation IFN-β and IP-10. Specific blockage of the IFN type one receptor showed that these novel molecules inhibited TRIF-dependent TLR4 signalling via IFN-β pathways. These results add novel information on the mechanism of action of monosaccharide FP derivatives. The inhibition of the TRIF-dependent pathway in human macrophages suggests potential therapeutic uses for these novel TLR4 antagonists in pharmacological interventions on inflammatory diseases.
Transoral incisionless fundoplication demonstrates durability at up to 9 years
Authors: Bell Reginald C. W. , Freeman Katherine , Heidrick Rachel , Ayazi Shahin
Published: April 2021

Goals:

To assess the long-term results of transoral incisionless fundoplication (TIF 2).

Background:

TIF with the EsophyX2 is an accepted procedure to treat gastroesophageal reflux disease (GERD). Long-term data have been limited. We report clinical outcomes of 151 patients followed up to 9 years.

Study:

A single institution prospective registry of patients undergoing TIF 2 between 11/2008 and 7/2015. Outcomes were assessed by complications, re-interventions, and a mixed effect model of clinical response over time.

Results:

A total of 151 patients (87 women), mean age 62 years (30–91), mean body mass index (BMI) 26.6 (20–36.1), 93% on daily proton pump inhibitor (PPI), underwent TIF 2 without hiatal hernia repair; 131 of the 151 patients (86%) were available for follow-up at a median of 4.92 years (0.7–9.7 years). Of 120 patients ⩾5 years post-TIF, 62 (51%) were followed for a median 6.8 years. Median GERD-health-related quality of life (HRQL) scores decreased from 21 (interquartile range (IQR) 9.5–30) off PPI and 14 (4–24) on PPI at baseline to 4 (2–8) at 4.92 years and remained at 5 (2–9) in the 62 patients 5–9 years post-TIF. Sixty-four per cent had successful (>50%) reductions in GERD-HRQL scores at 4.92 years and 68% of patients followed ⩾5 years. Median regurgitation decreased from 15 (8–20) off PPI and 11 (5–20) on PPI at baseline to 0 (0–4) at 4.92 years, remaining at 1 (0–3) in 62 patients 5–9 years post-TIF. Mixed model analyses confirmed significant and stable improvements in GERD-HRQL and regurgitation scores at all annual follow-up time points after TIF. Daily PPI use decreased from 93% to 32% at 4.92, and 22% at ⩾5 years post-TIF. Revision to laparoscopic fundoplication in 33(22%) showed comparable outcomes. Two patients recovered uneventfully after laparoscopic surgery for localized perforation.

Conclusions:

TIF 2 provides durable relief of GERD symptoms at up to 9 years with 69–80% of patients having a successful outcome by symptom response and PPI use.
Rediscovering histology: what is new in endoscopy for inflammatory bowel disease?
Authors: Solitano Virginia , D’Amico Ferdinando , Allocca Mariangela , Fiorino Gionata , Zilli Alessandra , Loy Laura , Gilardi Daniela , Radice Simona , Correale Carmen , Danese Silvio , Peyrin-Biroulet Laurent , Furfaro Federica
Published: April 2021

The potential of endoscopic evaluation in the management of inflammatory bowel diseases (IBD) has undoubtedly grown over the last few years. When dealing with IBD patients, histological remission (HR) is now considered a desirable target along with symptomatic and endoscopic remission, due to its association with better long-term outcomes. Consequently, the ability of endoscopic techniques to reflect microscopic findings in vivo without having to collect biopsies has become of upmost importance. In this context, a more accurate evaluation of inflammatory disease activity and the detection of dysplasia represent two mainstay targets for IBD endoscopists. New diagnostic technologies have been developed, such as dye-less chromoendoscopy, endomicroscopy, and molecular imaging, but their real incorporation in daily practice is not yet well defined. Although dye-chromoendoscopy is still recommended as the gold standard approach in dysplasia surveillance, recent research questioned the superiority of this technique over new advanced dye-less modalities [narrow band imaging (NBI), Fuji intelligent color enhancement (FICE), i-scan, blue light imaging (BLI) and linked color imaging (LCI)]. The endoscopic armamentarium might also be enriched by new video capsule endoscopy for monitoring disease activity, and high expectations are placed on the application of artificial intelligence (AI) systems to reduce operator-subjectivity and inter-observer variability. The goal of this review is to provide an updated insight on contemporary knowledge regarding new endoscopic techniques and devices, with special focus on their role in the assessment of disease activity and colorectal cancer surveillance.
Inflammation in multiple sclerosis
Authors: Haase Stefanie , Linker Ralf A.
Published: April 2021

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) that is characterised pathologically by demyelination, gliosis, neuro-axonal damage and inflammation. Despite intense research, the underlying pathomechanisms driving inflammatory demyelination in MS still remain incompletely understood. It is thought to be caused by an autoimmune response towards CNS self-antigens in genetically susceptible individuals, assuming autoreactive T cells as disease-initiating immune cells. Yet, B cells were recognized as crucial immune cells in disease pathology, including antibody-dependent and independent effects. Moreover, myeloid cells are important contributors to MS pathology, and it is becoming increasingly evident that different cell types act in concert during MS immunopathology. This is supported by the finding that the beneficial effects of actual existing disease-modifying therapies cannot be attributed to one single immune cell-type, but rather involve immunological cooperation. The current strategy of MS therapies thus aims to shift the immune cell repertoire from a pro-inflammatory towards an anti-inflammatory phenotype, involving regulatory T and B cells and anti-inflammatory macrophages. Although no existing therapy actually exists that directly induces an enhanced regulatory immune cell pool, numerous studies identified potential net effects on these cell types. This review gives a conceptual overview on T cells, B cells and myeloid cells in the immunopathology of relapsing-remitting MS and discusses potential contributions of actual disease-modifying therapies on these immune cell phenotypes.
Analgesic and Anti-Inflammatory Potential of Essential Oil of Eucalyptus camaldulensis Leaf: In Vivo and in Silico Studies
Authors: Mondal Milon , Quispe Cristina , Sarkar Chandan , Bepari Tapash Chandra , Alam Md. Jahir , Saha Sushmita , Ray Pranta , Rahim Mohammod Abdur , Islam Muhammad Torequl , Setzer William N. , Salehi Bahare , Ahmadi Mehdi , Abdalla Mohnad , Sharifi-Rad Javad , Kundu Sukalyan Kumar
Published: April 2021

The objective of our present study is to scrutinize the analgesic and anti-inflammatory potentials of essential oil of Eucalyptus camaldulensis leaf using different in vivo assay models at doses of 100, 200, and 400 mg/kg body weight. Twenty chemical compounds, which were isolated from the leaves essential oil of E. camaldulensis, were docked using AutodockVina against cyclooxygenase 2, tumor necrosis factor-α, and interleukin-1β convertase to elucidate the analgesic and anti-inflammatory activity. The essential oil of E. camaldulensis exhibited noteworthy analgesic activities in the writhing test. In the tail immersion and hot-plate test, the essential oil significantly extended the latency period. The number of licks in the formalin-induced paw licking test was markedly reduced following essential oil administration. In addition, E. camaldulensis essential oil revealed notable anti-inflammatory responses in carrageenan-induced paw edema, xylene induced ear edema and cotton pellet induced granuloma methods. Among 20 compounds, 5 ( cis-sabinol, globulol, α-eudesmol, β-eudesmol, and γ-eudesmol) showed better binding for cyclooxygenase-2 while β-eudesmol exhibited higher affinity for TNFα than that of TNF-alpha-IN-1 and standard drug. In the case of interleukin 1β convertase, maximum affinity was shown by α-eudesmol than the synthetic drug belnacasan. Chemical components of the essential oil interacted with diverse amino acid residues which were similar to the natural substrate and standard drugs. In conclusion, E. camaldulensis essential oil can be an effective source of analgesic and anti-inflammatory treatment and additional modification and docking studies will be required to justify the efficiency of globulol, α-eudesmol, β-eudesmol, and γ-eudesmol.
Clinical Problem Solving: An Older Woman With Weakness from Head to Toe
Authors: Hartmann David A. , Bock Meredith , Douglas Vanja , Gerdts Josiah , Ramani Biswarathan , Shah Maulik
Published: April 2021

A 67-year-old woman was admitted to our hospital for progressive weakness, dysphagia, muscle pain, and weight loss. Here we detail the clinical problem solving involved in diagnosing and treating her immune-mediated necrotizing myopathy caused by anti-HMGCoA reductase autoantibodies. Interestingly, this diagnosis coincided with discovery of a gastrointestinal stromal tumor (GIST) and positivity for anti-nuclear matrix protein (anti-NXP2), another myositis specific autoantibody.
Scaffold-Free Engineering of Human Cartilage Implants
Authors: Frerker Nadine , Karlsen Tommy A. , Lilledahl Magnus Borstad , Brorson Sverre-Henning , Tibballs John E. , Brinchmann Jan E.
Published: April 2021

Objective

Despite new strategies in tissue engineering, cartilage repair remains a major challenge. Our aim is to treat patients with focal lesions of articular cartilage with autologous hyaline cartilage implants using a scaffold-free approach. In this article, we describe experiments to optimize production of scaffold-free cartilage discs.

Design

Articular chondrocytes were expanded in vitro, seeded in transwell inserts and redifferentiated using established chondrogenic components. Experimental variables included testing 2 different expansion media, adding bone morphogenetic protein 2 (BMP2), insulin-like growth factor 1 (IGF1), growth/differentiation factor 5 (GDF5), or fibroblast growth factor 18 (FGF18) to the differentiation medium and allowing the disc to float freely in large wells. Cartilage discs were analyzed by weight and thickness, real-time RT-qPCR (reverse transcriptase qualitative polymerase chain reaction), fluorescence immunostaining, transmission electron microscopy, second harmonic generation imaging, and measurement of Young’s modulus.

Results

Addition of BMP2 to the chondrogenic differentiation medium (CDM) was essential for stable disc formation, while IGF1, GDF5, and FGF18 were redundant. Allowing discs to float freely in CDM on a moving platform increased disc thickness compared with discs kept continuously in transwell inserts. Discs cultured for 6 weeks reached a thickness of almost 2 mm and Young’s modulus of >200 kPa. There was abundant type II collagen. Collagen fibrils were 25 nm thick, with a tendency to be organized perpendicular to the disc surface.

Conclusion

Scaffold-free engineering using BMP2 and providing free movement in CDM produced firm, elastic cartilage discs with abundant type II collagen. This approach may potentially be used in clinical trials.
Causes of discharge delays from the acute medical unit (AMU) in a tertiary level teaching hospital, Brunei Darussalam
Authors: Awang Husaini Dayang Nur Hilmiyah binti , Keasberry Justin Fook Siong , Haji Abdul Mumin Khadizah , Abdul Rahman Hanif
Published: April 2021

Background:

Many patients admitted to the acute medical unit experience a prolonged length of stay in hospital due to discharge delays. Consequently, this may impact the patients, healthcare institution and national economy in terms of patient safety, decreased hospital capacity, lost patient workdays and financial performance.

Objectives:

The main aim of this observational study was to identify the causes of discharge delays among acute medical unit patients admitted in the Raja Isteri Pengiran Anak Saleha Hospital, Brunei.

Methods:

A retrospective observational study, with data of patients admitted to the acute medical unit collected from Brunei Health Information Systems between September and December 2018. Statistical analyses were performed to obtain relevant results and any statistically significant associations.

Results:

A total of 357 patients were admitted to the acute medical unit over the 4-month period; 218 patients (61.1%) experienced discharge delays. Of these 218 patients, 158 patients (72.5%) encountered discharge delays mainly due to intrinsic patient factors, while the discharge delays in 88 patients (40.4%) were attributed to hospital factors. The main reason for discharge delays for patient factors was slow recovery among 67 patients (30.7%), whereas for hospital factors it was the weekend limitation of services available in 23 patients (10.6%).

Conclusions:

There were various causes of discharge delays identified among the 218 acute medical unit patients who experienced discharge delays. Older patients with frailty, polypharmacy and complex medical issues were more likely to have a prolonged hospital stay in the acute medical unit. Stringent inclusion criteria, increasing discharge planning as well as an effective multidisciplinary approach will aid in reducing discharge delays from the acute medical unit.
Impact of natalizumab on quality of life in a real-world cohort of patients with multiple sclerosis: Results from MS PATHS
Authors: Hersh Carrie M , Kieseier Bernd , Moor Carl de , Miller Deborah M , Campagnolo Denise , Williams James R , Fitzgerald Kathryn C , Xiong Kuangnan , McGinley Marisa P , Hyland Megan , Rudick Richard A , Ziemssen Tjalf , Koulinska Irene
Published: April 2021

Background

Optimizing multiple sclerosis treatment warrants understanding of changes in physical, mental, and social health.

Objective

To assess the impact of natalizumab on Quality of Life in Neurological Disorders (Neuro-QoL) scores.

Methods

Annualized change in T-scores and likelihood of ≥5-point improvement over baseline were calculated for each Neuro-QoL domain after natalizumab initiation. Comparisons with ocrelizumab-treated patients were conducted after propensity score weighting and adjustment for relevant co-medications, year, and drug-year interaction.

Results

Among 164 natalizumab patients analyzed, 8 of 12 Neuro-QoL domains improved significantly, with greater improvement in patients with abnormal baseline Neuro-QoL. In the subgroup comparison of natalizumab-treated ( n = 145) and ocrelizumab-treated ( n = 520) patients, significant improvement occurred in 9 of 12 and 4 of 12 domains, respectively. The difference between groups was statistically significant for positive affect and well-being ( p = 0.02), sleep ( p = 0.003), and satisfaction with social roles and activities (SRA) ( p = 0.03) in the overall population and for emotional and behavioral dyscontrol ( p = 0.01), participation in SRA ( p = 0.0001), and satisfaction with SRA ( p = 0.02) in patients with abnormal baseline Neuro-QoL.

Conclusions

Natalizumab can produce clinically meaningful improvements in mental and social health. Such improvements are unlikely to be primarily driven by expectation bias, as their magnitude exceeded improvements with another high-efficacy therapy, ocrelizumab.
Organizational Climate and Job Performance: Investigating the Mediating Role of Harmonious Work Passion and the Moderating Role of Leader–Member Exchange and Coaching
Authors: Obeng Anthony Frank , Zhu Yongyue , Azinga Samuel Awuni , Quansah Prince Ewudzie
Published: April 2021

Organizational performance has made it imperative for rural and community bank management to employ the best organizational conditions that influence employee’s performance. Recent banking clean-up in Ghana has also emphasized the need for employees’ performance. This has become necessary to espouse management practices, employee behaviors, and attitudes that predict job performance. Drawing on social exchange theory and reciprocity norm, the study examines the effect of organizational climate on job performance. Valid responses received through a structured questionnaire were 431. Hierarchical multiple regression was employed to validate the hypotheses from the literature review. Relying on empirical data from Ghana, the findings revealed that, first, harmonious work passion partially mediated organizational climate and job performance relationship. Second, leader–member exchange negatively moderated the relationship between organizational climate and harmonious work passion. Finally, however, coaching as a management practice positively strengthened organizational climate and job performance relationship. The theoretical and practical contribution is also discussed.