bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Restrictive Family Presence Policies in Response to COVID-19 on Family Integrated Care in the NICU: A Qualitative Study
Authors: McCulloch Holly , Campbell-Yeo Marsha , Richardson Brianna , Dol Justine , Hundert Amos , Dorling Jon , Whitehead Leah , MacRae Gail , Bishop Tanya , Afifi Jehier , Earle Rebecca , Rose Annette Elliott , Foye Sarah , Inglis Darlene , Kim Theresa , Leighton Carye , Melanson Andrea , Simpson David C , Smit Mike
Published: December 2021

Objectives:

To conduct a needs assessment with families and their healthcare team to understand the impact of restrictive family presence policies in the neonatal intensive care unit (NICU) in response to COVID-19.

Background:

In response to the COVID-19 pandemic, significant restrictive family presence policies were instituted in most NICUs globally intended to protect infants, families, and HCPs. However, knowledge on the impact of the stress of the pandemic and policies restricting family presence in the NICU on vulnerable neonates and their families remains limited.

Methods:

Individuals were eligible to participate if they were a caregiver of an infant requiring NICU care or a healthcare provider (HCP) in the NICU after March 1, 2020. Semi-structured interviews were conducted using a virtual communication platform, and transcripts were analyzed using inductive thematic qualitative content analysis.

Results:

Twenty-three participants were interviewed (12 families and 11 HCPs). Three themes emerged: (1) successes (family-integrated care, use of technology), (2) challenges (lack of standardized messaging and family engagement, impact on parental wellbeing, institutional barriers, and virtual care), and (3) moving forward (responsive and supportive leadership).

Conclusions:

Our findings highlight the significant impact of family restrictions on the mental well-being of families, physical closeness with parents, and empathetic stress to HCPs. Further study of potential long-term impact is warranted.
Hepatic venoocclusive disease/sinusoidal obstruction syndrome with normal portal vein flow mimicking aggravated chronic hepatic GVHD following inotuzumab ozogamicin salvage therapy: a case report of pathologic-radiologic discrepancy
Authors: Lee Joonyeop , Yoon Jae-Ho , Kwag Daehun , Lee Jong-Hyuk , Kim Tong Yoon , Min Gi June , Park Sung-Soo , Park Silvia , Lee Sung-Eun , Cho Byung-Sik , Eom Ki-Seong , Kim Yoo-Jin , Kim Hee-Je , Min Chang-Ki , Cho Seok-Goo , Wook Lee Jong , Hak Lee Sung , Lee Seok
Published: December 2021

Inotuzumab ozogamicin (INO) showed improved treatment outcomes for relapsed or refractory B-cell precursor acute lymphoblastic leukemia (BCP-ALL) but can induce hepatotoxic adverse events. Hepatic venoocclusive disease/sinusoidal obstruction syndrome (VOD/SOS) frequently develops after allogeneic hematopoietic cell transplantation (allo-HCT), and INO is a strong pretransplant risk factor. However, VOD/SOS can occur just after INO therapy. Here, we describe a BCP-ALL patient treated with INO for isolated extramedullary relapse after allo-HCT. The patient experienced elevated liver enzymes with ascites at 21 days from the last INO dose. Although she met the criteria for VOD/SOS, the diagnosis was challenging because of her ongoing hepatic graft- versus-host disease (GVHD) and normal portal vein flow on Doppler sonogram. The radiologist suggested liver cirrhosis based on computed tomography, with VOD/SOS, liver cirrhosis, and GVHD assumed to be differential diagnoses. She received supportive care with GVHD management; however, due to progressive hepatic failure, we conducted emergent deceased-donor liver transplantation, and the pathologic findings indicated VOD/SOS. Her leukemia was stable, but she died of sepsis after 3 months. INO use is a high-risk factor for VOD/SOS, but an accurate diagnosis can be challenging due to various hepatic complications. Early diagnosis and proper management for VOD/SOS is important for improved outcomes.
The interplay among paranoia, social relationships and negative affectivity in a heterogeneous clinical sample: A network analysis
Authors: Januška Jakub , Straková Alexandra , Dančík Daniel , Pečeňák Ján , Heretik Anton , Hajdúk Michal
Published: December 2021

Previous evidence suggests paranoia affects people’s functioning in interpersonal relationships. However, less is known about the interconnections among specific aspects of paranoia and domains of social relationships. The goal of the current study was to explore the interplay among different aspects of paranoia, social relationships and negative affectivity (depression, anxiety and social anxiety) in a diverse clinical sample using network analysis. A sample of 366 participants (84.4% female) with a history of mental illness was recruited online. The mean age was 35.31 years. Data were modelled using the Gaussian Graphical Model with regularization. The network included the following scales: R-GPTS, SAD-D, National Institute of Health Toolbox Adult Social Relationship scales, PHQ-9 and GAD-7. The results revealed substantial connections between aspects of paranoia (ideas of reference and ideas of persecution) and both perceived hostility and perceived rejection. Furthermore, significant associations of ideas of reference with social anxiety and loneliness with depression were observed. Perceived rejection and loneliness were the most central nodes in the estimated network. The current study provides robust evidence for the interconnections of paranoia, social relationships and negative affectivity, present across different diagnoses. This further supports the transdiagnostic approach to paranoia research and the related important role of social relationships.
Structural and functional markers of optic nerve damage in myelin oligodendrocyte glycoprotein antibody-associated optic neuritis
Authors: Barnes Stephanie , You Yuyi , Shen Ting , Hardy Todd A , Fraser Clare , Reddel Stephen W , Brilot Fabienne , Ramanathan Sudarshini , Klistorner Alexandr , Yiannikas Con
Published: December 2021

Background

Optic neuritis (ON) occurs in immune-mediated disorders including multiple sclerosis (MS), aquaporin-4 antibody-positive (AQP4) neuromyelitis optica spectrum disorder (AQP4-NMOSD) and myelin oligodendrocyte glycoprotein (MOG) antibody-associated demyelination (MOGAD). Accurate determination of aetiology is critical for appropriate treatment and prognostication.

Objective

To evaluate demyelination and axonal loss in MOG-ON to facilitate differentiation from MS-ON and AQP4-ON.

Methods

15 MOGAD patients with previous ON (25 eyes) underwent multifocal visual evoked potential (mfVEP) recordings and optical coherence tomography scans. Comparison was made to previously reported MS patients ( n = 67, 69 eyes) and AQP4-NMOSD patients ( n = 15, 23 eyes) with prior ON and healthy controls ( n = 37, 74 eyes).

Results

MOG-ON patients had less retinal nerve fibre layer (RNFL) loss than AQP4-ON patients ( p < 0.05) and less mfVEP latency prolongation than MS-ON patients ( p < 0.01). Number of ON episodes in MOGAD was associated with reduced RNFL thickness (global, p = 0.07; temporal, p < 0.001) and mfVEP amplitude ( p < 0.001). There was no abnormality in non-ON eyes.

Conclusions

Our study demonstrated a distinct pattern of damage in MOG-ON compared to AQP4-ON and MS-ON. ON in MOGAD produces less axonal loss than AQP4-NMOSD. Damage accumulates with relapses, supporting the role of maintenance immunosuppression to induce remission. Compared to MS, MOGAD causes less demyelination.
Acute kidney injury in a mouse model of meningococcal disease
Authors: Kolbe Karin R , Sanches Talita R , Fanelli Camilla , Garnica Margoth R , Urbano de Castro Letícia , Gooch Karen , Thomas Stephen , Taylor Stephen , Gorringe Andrew , Noronha Irene de L. , Andrade Lucia
Published: December 2021

Introduction

Meningococcal disease is associated with high mortality. When acute kidney injury (AKI) occurs in patients with severe meningococcal disease, it is typically attributable to sepsis, although meningococcal disease and lipopolysaccharide release are rarely investigated. Therefore, we evaluated renal tissue in a mouse model of meningococcal disease.

Methods

Female BALB/c mice were induced to AKI by meningococcal challenge. Markers of renal function were evaluated in infected and control mice.

Results

In the infected mice, serum concentrations of tumor necrosis factor alpha, interferon gamma, interleukins (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-10, and IL-12), and granulocyte–macrophage colony-stimulating factor were elevated, as was renal interstitial infiltration with lymphocytes and neutrophils ( p < 0.01 for the latter). Histological analysis showed meningococcal microcolonies in the renal interstitium, without acute tubular necrosis. Infected mice also showed elevated renal expression of toll-like receptor 2, toll-like receptor 4, and Tamm–Horsfall protein. The expression of factors in the intrinsic pathway of apoptosis was equal to or lower than that observed in the control mice. Urinary sodium and potassium were also lower in infected mice, probably due to a tubular defect.

Conclusion

Our findings corroborate those of other studies of AKI in sepsis. To our knowledge, this is the first time that meningococci have been identified in renal interstitium and that the resulting apoptosis and inflammation have been evaluated. However, additional studies are needed in order to elucidate the mechanisms involved.
The Prognostic Utility of Personality Traits Versus Past Psychiatric Diagnoses: Predicting Future Mental Health and Functioning
Authors: Waszczuk Monika A. , Hopwood Christopher J. , Luft Benjamin J. , Morey Leslie C. , Perlman Greg , Ruggero Camilo J. , Skodol Andrew E. , Kotov Roman
Published: December 2021

Past psychiatric diagnoses are central to patient case formulation and prognosis. Recently, alternative classification models such as the Hierarchical Taxonomy of Psychopathology (HiTOP) proposed to assess traits to predict clinically relevant outcomes. In the current study, we directly compared personality traits and past diagnoses as predictors of future mental health and functioning in three independent, prospective samples. Regression analyses found that personality traits significantly predicted future first onsets of psychiatric disorders (change in [∆] R2 = .06–.15), symptom chronicity (∆ R2 = .03–.06), and functioning (∆ R2 = .02–.07), beyond past and current psychiatric diagnoses. Conversely, past psychiatric diagnoses did not provide an incremental prediction of outcomes when personality traits and other concurrent predictors were already included in the model. Overall, personality traits predicted a variety of outcomes in diverse settings beyond diagnoses. Past diagnoses were generally not informative about future outcomes when personality was considered. Together, these findings support the added value of personality traits assessment in case formulation, consistent with the HiTOP model.
The influence of adolescents’ romantic relationship on individual development: Evidence from China
Authors: Honghao Jin , Po Yang , Tianyu Yang
Published: December 2021

Based on China Education Panel Survey (CEPS) data, this paper explores the influence of adolescents’ romantic relationship on individual development in terms of academic, emotional, and interpersonal development. The research finds that the academic performance of adolescents who involved in romantic relationship is relatively lower and their risk of having negative emotions is also lower than their counterparts outside relationship. The romantic relationship provides an opportunity learning how to maintain intimacy relationship and build positive self-concept, and thus, it has a positive effect on growth of interpersonal ability. Due to differences in gender roles, the romantic relationship has a stronger impact on female adolescents. In addition, in a high-pressure environment, individuals with romantic relationship bear greater psychological pressures. A more open, tolerant, and supportive environment toward adolescents’ romantic relationship will promote their holistic development.
Por Qué Enseñar Música No Es Suficiente: Educación Musical y su Red Nomológica
Authors: Morante Basilio Fernández , Mas Amalia Casas
Published: December 2021

En este trabajo se hace una revisión del concepto «educación» con base en su red nomológica a partir de los trabajos de Esteve (1979, 1983, 2010). El objeto de la red es comenzar a delimitar las claves lingüísticas básicas alrededor del término «educación» a partir de la pedagogía y ser conscientes de sus consecuencias que tanto condicionan el proceso educativo. A partir de los métodos activos de enseñanza musical como principales referentes de la pedagogía musical moderna, y algunos rasgos característicos de la enseñanza musical formal, se configura la difusa red nomológica en la educación musical. Se constata su difícil compatibilidad con la red de «educación» dadas las inmensas imprecisiones terminológicas en el área, derivadas de la gran distancia todavía existente entre la música y la ciencia educativa. Se presenta un planteamiento (Bowman, 2002, 2009, 2012) que puede implementar la red genérica de educación en el contexto musical mediante un enfoque educativo más inclusivo basado en valores como inicio de un camino que, por un lado, convierta a los profesionales de la enseñanza musical en verdaderos profesionales de la educación y produzca personas con sentido crítico implicadas en la sociedad para construir una vida mejor.
El taller de estimulación musical temprana según la metodología Suzuki: Una mirada desde la etapa sensorio-motriz según Piaget
Authors: Romero Ana Elena Buitrón , Riquelme Romina Urra
Published: December 2021

A partir de los trabajos de Piaget ha sido posible visualizar el desarrollo de la mente humana desde el primer día de vida. De ellos surgen propuestas de estimulación para bebés. El objetivo de este trabajo es analizar las actividades del taller de estimulación musical temprana que se imparte desde la metodología Suzuki para determinar si existen relaciones entre éstas y lo propuesto por Piaget dentro de los estadios de la etapa sensorio-motriz, comprendida dentro de su propuesta de desarrollo cognitivo. Para esto se organizó un taller para bebés de 0 a 18 meses de edad, se observó el hacer de los participantes y se analizaron entrevistas aplicadas a los adultos acompañantes. Se concluyó que existe una relación entre el desarrollo mostrado por los niños durante su actividad en el taller con los estadios de la etapa sensorio-motriz propuestos por Piaget.
La dirección musical de agrupaciones juveniles: un referente de liderazgo y competencias socioemocionales
Authors: Carnicer Salvador Oriola Requena y Josep Gustems
Published: December 2021

La dirección musical es un claro ejemplo de liderazgo eficiente en el que el director, a través de sus competencias y su formación socioemocional, intenta encabezar una agrupación y sacarle el máximo rendimiento. El presente estudio, fundamentado en un marco conceptual sobre el liderazgo y las dimensiones socioemocionales en la dirección musical, pretende describir, analizar y comparar el perfil intra e interpersonal (capacidad de liderazgo, satisfacción vital, desgaste profesional y empatía) de los directores que lideran una agrupación musical juvenil. Para ello, a partir de una metodología descriptiva no experimental, se ha aplicado un protocolo de cuestionarios a una muestra conformada por 10 directores de bandas juveniles de la Comunidad Valenciana y 10 directores de corales juveniles de Cataluña. Los resultados obtenidos confirman que los directores poseen unas competencias destacables para liderar agrupaciones integradas por adolescentes, en las que la dimensión socioemocional es imprescindible para el buen funcionamiento y el éxito colectivo en todas sus facetas.
Estrategias de Aprendizaje Musical Formal e Informal: Construcción y Validación de un Instrumento de Medición
Authors: Carrillo Rubén , González-Moreno Patricia A.
Published: December 2021

El propósito de este artículo es presentar el proceso de desarrollo y validación de un instrumento de medición basado en la Teoría de Expectativas y Valores para examinar la motivación de los estudiantes universitarios en relación con estrategias de aprendizaje musical formales e informales. El interés sobre este tema surge dado que el panorama de ofertas de educación formal musical en México, al igual que en muchos otros países, se encuentra fuertemente influenciado por la tradición clásica. En contraste, los géneros musicales populares, con excepción del jazz, no han tenido el suficiente reconocimiento dentro de los programas curriculares de las instituciones educativas. Existen elementos que difieren significativamente entre los modelos formales e informales de aprendizaje musical; generalmente, el modelo formal favorece la lectura, el uso de repertorio de compositores clásicos y la mera interpretación de dicho material, mientras que los ambientes informales se caracterizan por favorecer tocar de oído, tocar en grupo y desarrollar la creatividad en actividades de composición e improvisación. Para el proceso de validación del instrumento, se aplicó a 56 estudiantes de música de una universidad privada de la ciudad de México que fueron elegidos a través de un muestreo por conveniencia. El instrumento desarrollado muestra rangos de buenos a altos en cuanto niveles de confiabilidad interna y validez. Los resultados preliminares son consistentes con los supuestos teóricos de Eccles y Wigfield, y reflejan en buena medida lo propuesto por diversos autores en referencia al aprendizaje musical formal e informal.
Propuesta de un Marco Teórico para Abordar el Emprendimiento en la Formación Musical Superior
Authors: de Reizábal Margarita Lorenzo , Gómez Manuel Benito
Published: December 2021

El concepto de emprendimiento paulatinamente ha ido permeando todas las áreas de conocimiento y actividades sociales como un valor central que define el perfil de los individuos que conduce a la consecución de logros personales, laborales y económicos, permitiendo la creación de productos de valor, bienes y servicios. E l emprendimiento artístico, no obstante, no se ha abordado con rigor académico hasta hace menos de una década. En el ámbito de la música se están dando ahora los primeros pasos hacia la investigación en emprendimiento, si bien los principales escollos que se han de salvar están aún a nivel conceptual y a nivel referencial. Asimismo, se echa en falta una reflexión y análisis del modo en que influye la formación musical recibida en el emprendizaje (aprender a emprender) y la manera en que los centros superiores de educación musical pueden proveer a sus estudiantes de las habilidades necesarias para convertirse en músicos profesionales emprendedores. Para que esto tenga lugar es preciso un diagnóstico de la situación educativa actual, los retos y las posibles resistencias para la introducción de cambios en la misma. Estos son los aspectos que se abordan en este artículo, además de una aproximación a distintos modelos de implementación del emprendimiento en los centros superiores de música y el planteamiento de interrogantes para la reflexión como primer y necesario paso hacia la transformación y el cambio.
Aculturación en los programas de educación musical de nivel superior: Una mirada desde la historia del tiempo presente en la relación México-Alemania
Authors: Vaca Irma Susana Carbajal
Published: December 2021

En el contexto del análisis semiótico de una escuela de piano alemana, presente durante más de tres décadas en México, la autora de este artículo reflexionó sobre los modelos actuales de educación musical en relación con el perfil de ingreso real de los estudiantes de música, el cual se proyecta cada vez con mayor fuerza hacia la diversidad y la multiculturalidad. Se presenta una mirada al fenómeno de aculturación (Berry, 2005) en los procesos de educación musical formal como un interés por documentar la historia del tiempo presente de la educación musical de nivel superior en México.
Estudio multi-caso sobre disfunciones vocales en futuros maestros de música: una aproximación biopsicosocial
Authors: Tarrés Miquel Alsina
Published: December 2021

La profesión docente supone un uso intensivo de la voz como medio comunicativo y herramienta básica para gestión de la actividad en el aula. En el caso particular del docente de música, la salud y plenitud de sus capacidades fonadoras tiene una gran repercusión en la calidad y autosatisfacción de su vida laboral diaria. En esta investigación se indaga en las causas y consecuencias de las disfunciones vocales en futuros maestros de música. Se centra la atención en elementos biopsicosociales ligados a la personalidad, las conductas y las expectativas de la muestra, consistente en cinco casos seleccionados entre los estudiantes (N=124) de la mención de música en educación primaria de un centro universitario español de formación de profesorado. Para ello, se realizan entrevistas individuales en doble sesión, incluyendo ejercicios individuales de fonación, grabadas en video para su posterior análisis. También se aplica a la muestra la prueba de personalidad NEO PI-R, en versión en línea, de formato y corrección estandarizados para la población que corresponde. Tras un análisis exploratorio, categorización y triangulación de las fuentes, los resultados revelan una fuerte correspondencia entre elementos de personalidad ligados al neuroticismo, y los relacionados con los factores de responsabilidad. A su vez se hallan antecedentes y desencadenantes críticos, como aquéllos vinculados al entorno familiar y a conductas coincidentes. Se concluye la trascendencia de las disfunciones vocales para el futuro profesional del alumno, origen de angustia e incertidumbre, ante lo cual se requiere acompañamiento, formación, y prevención.
Outrageous: Defending the art of free expression
Authors: Evans Brad , Reid Julian
Published: December 2021

This essay makes a critical defence of free expression through the spirit of outrageousness. Drawing upon the ideas of Oscar Wilde, along with artists such as Frida Kahlo, Francis Bacon, Gilbert and George and Jake and Dinos Chapman, it looks beyond the current attempts to reduce the question of freedom to quintessential liberal tropes. In doing so, the paper both offers a critique of the moral absolutism that’s taken over certain sectors of the so-called ‘radical left’, while demanding more political appreciation for creatives and those with the abilities to reimagine the human subject. Such a critique not only suggests the need to rethink the meaning for freedom beyond the play of libertarians, but it also calls forth a new political subjectivity who appears timely and yet timeless – the much maligned and theoretically ignored figure of the infidel, who allows us to break free from moral entrapments.
New dissidence in contemporary Russia: Students, feminism and new ethics
Authors: Surman Jan , Rossman Ella
Published: December 2021

The essay is devoted to the specifics of the contemporary Russian opposition and civil society. We describe the characteristics of contemporary ‘intellectual activism’ and the growing network of small civil and political groups in today’s Russia. We show that Russian civil society remains fragile and fragmented; the public discussion is not focused on strategies of resistance to arbitrariness but on constructing moral categories such as the wide and vague concept of ‘new ethics’. We also show how outsiders appear among contemporary Russian dissidents, who are not supported by most independent leaders and intellectuals – these are young ‘new leftists’ and feminist activist groups. These political activists find themselves under pressure from both the siloviki and the authorities, and in the focus of criticism of opposition leaders, becoming, in fact, dissidents among dissidents in contemporary Russia.
Long-term Effects of Maternal Separation on Anxiety-Like Behavior and Neuroendocrine Parameters in Adult Balb/c Mice
Authors: Kestering-Ferreira Erika , Tractenberg Saulo Gantes , Lumertz Francisco Sindermann , Orso Rodrigo , Creutzberg Kerstin Camile , Wearick-Silva Luis Eduardo , Viola Thiago Wendt , Grassi-Oliveira Rodrigo
Published: December 2021

Introduction: Disruption of maternal care using maternal separation (MS) models has provided significant evidence of the deleterious long-term effects of early life stress. Several preclinical studies investigating MS showed multiple behavioral and biomolecular alterations. However, there is still conflicting results from MS studies, which represents a challenge for reliability and replicability of those findings. Objective: To address that, this study was conducted to investigate whether MS would affect anxiety-like behaviors using a battery of classical tasks, as well as central and peripheral stress-related biomarkers. Methods: Male Balb/c mice were exposed to MS from postnatal day (PND) 2 to 14 for 180-min per day. Two independent cohorts were performed to evaluate both baseline and anxiety-like behavior responses to MS at PND60. We performed composite scores to evaluate MS effects on anxiety and risk assessment phenotypes. Also, we assessed mRNA gene expression in the medial pre-frontal cortex (mPFC) of glucocorticoid and mineralocorticoid receptors (GR and MR) using real-time PCR and peripheral corticosterone levels (CORT) to investigate possible neurobiological correlates to anxiety behaviors. Results: We found increased anxiety-like behavior and decreased risk assessment and exploratory behaviors in MS mice. The animals exposed to MS also presented a decrease in MR mRNA expression and higher levels of CORT compared to controls. Conclusions: Our findings reinforce the body of evidence suggesting that long-term MS induces effects on anxiety and risk assessment phenotypes following the exposure to a standardized MS protocol. Moreover, MS affected the expression of MR mRNA and induced significant changes on CORT response. This data highlights that the reprograming MS effects on HPA axis could be mediate by MR gene expression in mPFC and chronic overactivity of peripheral CORT levels.
Caring for water in Northern Peru: On fragile infrastructures and the diverse work involved in irrigation
Authors: Domínguez-Guzmán Carolina , Verzijl Andres , Zwarteveen Margreet , Mol Annemarie
Published: December 2021

The term control used to be central to the scholarship on modern water management. More recently, however, scholars have remarked that the world is too unstable and capricious for control to ever fully succeed. They propose that technologically facilitating water to flow depends instead on care. Building on this, we here propose that holding on to a single catch-all theoretical concept, even if it is ‘care’, does not suffice. Instead, analytical terms are better adapted – and re-adapted to local specificities. To exemplify this, we here present the case of the Huallabamba, a canal that makes horticulture possible in the arid valley of Motupe on the Pacific coast of northern Peru. In this case, while ‘control’ was hard to find, ‘care’ took different forms: the tinkering that compensates for the not-quite-modern character of the infrastructures; the adaptive managerial style necessary given the absence of information; the watchful, hands-on cuidar of the men who walk along the canal high up in the Andes, repairing what is broken, cautious lest they anger the spirits; the listening to and singing for water in the catchment area; and the activism that resists the invasion of mining companies. This open-ended list is not meant to travel as a theoretical grid, but rather to inspire others to propose locally salient analytical terms to explore the sites and situations in which they are involved.
Negotiating power from the margins: Encountering everyday experiences and contestations to REDD + in Southern Tanzania
Authors: Mukono Danstan , Faustine Sambaiga Richard
Published: December 2021

This paper provides an account of everyday discursive and material practises deployed by marginalised forest-dependent groups in the course of resisting the implementation of Reduced Emission from Deforestation and forest degradation (REDD + ) and conservation regulations. Available literature have documented extensively that REDD + market-based models across the Global South, and Tanzania in particular, have led to increasing inequality, injustices, and exclusions. Nevertheless, there is little attention to exploring how different social actors that are unequally positioned resist exclusions. The paper explores selected case studies of marginalised forest-dependent groups in Lindi, Southern Tanzania, who creatively work to negotiate unequal power relations through a range of encounters around REDD+. Our analysis shows unequal social, spatial, and environmental ramifications of market-based conservation policies and strategies that have led to different kinds of material and discursive resistance to challenge exclusions. In doing so, it provides critical context-specific realities from the Global South and, specifically, Tanzanian scholarship to focus on both the dynamics of power and resistance in socially differentiated forest-dependent groups affected by envisioned market-based and development model-led conservation regimes.
(Counter)mapping renewables: Space, justice, and politics of wind and solar power in Mexico
Authors: Avila Sofia , Deniau Yannick , Sorman Alevgul H , McCarthy James
Published: December 2021

The ongoing expansion of renewable energies entails major spatial reconfigurations with social, environmental, and political dimensions. These emerging geographies are, however, in the process of taking shape, as their early configurations are still open to democratic intervention and contestation. While a recent line of research highlights the prominent role that maps are playing in directing such processes, the potential effects of countermapping on these evolving geographies have not yet been explored. In this article, we present a countermapping initiative promoting a dialogue between critical geography, political ecology, and environmental justice. Our work is the result of an alliance between Geocomunes—a collective of activist cartographers based in Mexico—and the EjAtlas—a global collaborative project tracking cases of grassroots mobilizations against environmental injustices. We take the case of Mexico's low-carbon development strategy to dissect the spatial expansion of wind and solar mega-projects at both national and regional scales. Our project consists of a series of databases and maps aimed to “fill” the spaces and relations otherwise “emptied” by the state's cartographic tools designed to promote investments in the sector. When presenting our results, we highlight how renewable energy projects in Mexico have so far juxtaposed with local territories, peoples, and resources, in ways that trigger instances of environmental injustice on the ground. We close this article by discussing the role of critical cartography and countermapping in building alternative political–economic projects for the energy transition.
Prevalence of chronic pain in LTCs and multimorbidity: A cross-sectional study using UK Biobank
Authors: McQueenie Ross , Jani Bhautesh Dinesh , Siebert Stefan , McLoone Philip , McCowan Colin , Macdonald Sara , Mair Frances S , Nicholl Barbara I
Published: December 2021

Objectives:

Chronic pain is often experienced alongside other long-term conditions (LTCs), yet our understanding of this, particularly in relation to multimorbidity (≥2 LTCs) is poor. We aimed to examine associations between the presence/extent of chronic pain with type/number of LTCs experienced.

Methods:

We examined the relationship between number/type of LTCs (N = 45) in UK Biobank participants (n = 500,295) who self-reported chronic pain lasting ≥3 months in seven body sites or widespread. Relative risk ratios (RRR) for presence/extent of chronic pain sites were compared using logistic regression adjusted for sociodemographic (sex/age/socioeconomic status) and lifestyle factors (smoking/alcohol intake/BMI/physical activity).

Results:

218,648 participants self-reported chronic pain. Of these, 69.1% reported ≥1 LTC and 36.2% reported ≥2 LTCs. In 31/45 LTCs examined, >50% of participants experienced chronic pain. Chronic pain was common with migraine/headache and irritable bowel syndrome where pain is a primary symptom, but also with mental health conditions and diseases of the digestive system. Participants with >4 LTCs were over three times as likely to have chronic pain (RRR 3.56, 95% confidence intervals (CIs) 3.44–3.68) and 20 times as likely to have widespread chronic pain (RRR 20.13, 95% CI 18.26–22.19) as those with no LTCs.

Conclusions:

Chronic pain is extremely common across a wide range of LTCs. People with multimorbidity were at higher risk of having a greater extent of chronic pain. These results show that chronic pain is a key factor for consideration in the management of patients with LTCs or multimorbidity.
A Continuing Education Activity Durably Addressed Knowledge Gaps Related to Penicillin Allergies Among Pharmacists and Pharmacy Technicians
Authors: Covington Elizabeth W. , Durham Spencer H. , Bland Christopher M. , Bookstaver P. Brandon , Chahine Elias B. , Cho Jonathan C. , Diggs Fernando , Jones Bruce M. , Kyle Jeffrey A. , Stover Kayla R. , Wagner Jamie L. , Hughes Peter J.
Published: December 2021

Background: Penicillin allergy is one of the most frequent self-reported allergies; however, only about 10% of reported allergies are accurate. Objectives: Through the creation of a continuing pharmacy education (CPE) activity, we sought to assess knowledge gaps and comfort levels in the management of penicillin allergies. Methods: A 1-hour enduring-content CPE activity was offered as an interactive course from September 20, 2019, to September 20, 2020. Participants completed 3 surveys (pre-survey, post-survey, and follow-up survey). Participants were pharmacists and pharmacy technicians who completed, at a minimum, the activity and both pre- and post-surveys. The primary outcome was the percentage of participants scoring >80% on knowledge-based questions on the post-survey compared with the pre-survey. Secondary outcomes included pre-post comparisons on knowledge-based questions, participants’ self-report of an allergy, and comfort levels dispensing cephalosporins in a patient with a self-reported penicillin allergy. Results: A total of 389 participants completed the CPE activity, with 176 included for analysis. Significantly more participants scored >80% on knowledge-based questions on the post-survey compared with the pre-survey (71.6% vs 22.7%, P < .001). There was no significant difference between the percentage of participants scoring >80% on the post-survey and the follow-up survey (71.6% vs 65%, P = .119). The majority of participants (74%) felt comfortable dispensing a cephalosporin in a patient with a penicillin allergy on the pre-survey, with similar percentages on the post- and follow-up surveys (77% and 90%, respectively). Conclusion: A targeted continuing education program improved overall knowledge, which was sustained for up to 2 months.
Coping With Institutional Complexity and Voids: An Organization Design Perspective for Transnational Interorganizational Projects
Authors: Fu Yongcheng , Zhang Lihan , Chen Yongqiang
Published: December 2021

This study investigates how transnational interorganizational projects (IOPs) cope with institutional complexity and voids. A case study of a cross-border gas pipeline suggests the coexistence of institutional complexity and voids that amplify collaboration hazards in developing transnational IOPs. Institutional complexity harms the feasibility of a unified form of organizing, whereas institutional voids sabotage the ability of involved organizations to collaborate in a market-based approach. A hybrid organization featured by modular structure, complementary advantages, and system integrator, was designed to navigate complex institutional environments. This study contributes to the project–organization–institution linkage by depicting the impacts of institutions on project organizing.
Molecular features encoded in the ctDNA reveal heterogeneity and predict outcome in high-risk aggressive B-cell lymphoma
Authors: Meriranta Leo , Alkodsi Amjad , Pasanen Annika , Lepistö Maija , Mapar Parisa , Blaker Yngvild Nuvin , Jørgensen Judit , Karjalainen-Lindsberg Marja-Liisa , Fiskvik Idun , Mikalsen Lars Tore G. , Autio Matias , Björkholm Magnus , Jerkeman Mats , Fluge Øystein , Brown Peter , Jyrkkiö Sirkku , Holte Harald , Pitkänen Esa , Ellonen Pekka , Leppä Sirpa
Published: December 2021

Inadequate molecular and clinical stratification of the patients with high-risk diffuse large B-cell lymphoma (DLBCL) is a clinical challenge hampering the establishment of personalized therapeutic options. We studied the translational significance of liquid biopsy in a uniformly treated trial cohort. Pretreatment circulating tumor DNA (ctDNA) revealed hidden clinical and biological heterogeneity, and high ctDNA burden determined increased risk of relapse and death independently of conventional risk factors. Genomic dissection of pretreatment ctDNA revealed translationally relevant phenotypic, molecular, and prognostic information that extended beyond diagnostic tissue biopsies. During therapy, chemorefractory lymphomas exhibited diverging ctDNA kinetics, whereas end-of-therapy negativity for minimal residual disease (MRD) characterized cured patients and resolved clinical enigmas, including false residual PET positivity. Furthermore, we discovered fragmentation disparities in the cell-free DNA that characterize lymphoma-derived ctDNA and, as a proof-of-concept for their clinical application, used machine learning to show that end-of-therapy fragmentation patterns predict outcome. Altogether, we have discovered novel molecular determinants in the liquid biopsy that can noninvasively guide treatment decisions.
Awareness and knowledge of congenital cytomegalovirus infection among pregnant women and the general public: a web-based survey in Japan
Authors: Kobayashi Masayuki , Okahashi Aya , Okuyama Kotoba , Hiraishi Naomi , Morioka Ichiro
Published: December 2021

Background

The best approach to reduce congenital cytomegalovirus infection (cCMVi) is to practice behaviors that reduce cytomegalovirus (CMV) transmission during pregnancy. Expanding awareness and knowledge of CMV is expected to result in increased practice of preventative behaviors. To this end, it is necessary to understand current awareness and knowledge of CMV.

Methods

This web-based cross-sectional survey assessed the awareness and knowledge of cCMVi among pregnant women and the general public in Japan. Participants aged 20–45 years (pregnant and non-pregnant women, and men) were identified from a consumer panel. Study outcomes (all participants) included awareness of cCMVi and other congenital conditions. Among those aware of cCMVi, outcomes included knowledge of CMV transmission routes, long-term outcomes of cCMVi, and behaviors to prevent CMV transmission during pregnancy. Outcomes limited to pregnant women included the practice of preventative behaviors and opinion on how easy it is to implement these behaviors. The data of the pregnant group (pregnant at the time of the survey) were compared with those of the general group (non-pregnant women and men).

Results

There were 535 participants in the pregnant group and 571 in the general group. Awareness of cCMVi was generally low (pregnant, 16.1%; general, 10.2%). Pregnant participants were significantly more aware of most congenital conditions than those in the general group, including cCMVi (P = 0.004). Knowledge about CMV/cCMVi was limited; there were no significant differences between the two groups for 24 of the 26 knowledge questions. A small proportion (one third or less) of pregnant women practiced behaviors to prevent the transmission of CMV, though most (73.3–95.3%) pregnant women who were aware of cCMVi considered such behaviors easy to implement.

Conclusions

Awareness and knowledge of CMV/cCMVi is low among pregnant women in Japan; the level of knowledge is similar to that among the general public. This needs to be improved. Most pregnant women considered behaviors to prevent CMV transmission easy to perform, which indicates that effectively educating pregnant women regarding the long-term outcomes of cCMVi, CMV transmission routes, and preventative behaviors will contribute to a reduced incidence of cCMVi.

Trial registration

UMIN Clinical Trials Registry, UMIN000041260.
Sleep problems among sexual minorities: a longitudinal study on the influence of the family of origin and chosen family
Authors: Chum Antony , Nielsen Andrew , Teo Celine
Published: December 2021

Background

There is growing evidence that lesbian, gay, and bisexual (LGB) adults experience more sleep problems than the general population. As LGB individuals experience a significantly greater risk of family rejection and low family support, our study investigates the role of family support as a potential determinant of LGB sleep problems over a prolonged period, and whether friend support (i.e. chosen family) can mitigate the effect of low family support. Given the importance of sleep on mental and physical health, study results may help shed light on persistent health disparities across sexual orientations.

Methods

Our sample included 1703 LGB individuals from theUK Household Longitudinal Study (UKHLS). Mixed-effect logistic regressions were used to estimate the effect of family and friend support on the development of sleep problems after 24 months while controlling for potential confounders. A modified Pittsburgh Sleep Quality Index was used to measure 1) presence of any sleep problems, 2) short sleep duration, and 3) poor sleep quality.

Results

Family support at baseline was independently associated with all sleep problems in our study after 24-months: 1 SD increase in family support was associated with a 0.94 times lower risk of sleep problems (95% C.I = 0.90-0.98), a 0.88 times lower risk of short sleep duration (95% C.I = 0.81-0.95), and a 0.92 times lower risk of sleep quality (95% C.I = 0.93-0.98). Support from one’s chosen family (proxied by friend support) did not mitigate the effects of low family support on sleep problems.

Conclusions

Our study found a consistent effect of family support across all sleep outcomes along with evidence of a persistent effect after 24 months. Our findings point to the importance of targeting family support in designing interventions aimed at reducing LGB sleep problems.
How robust are findings of pairwise and network meta-analysis in the presence of missing participant outcome data?
Authors: Spineli Loukia M. , Kalyvas Chrysostomos , Papadimitropoulou Katerina
Published: December 2021

Background

To investigate the prevalence of robust conclusions in systematic reviews addressing missing (participant) outcome data via a novel framework of sensitivity analyses and examine the agreement with the current sensitivity analysis standards.

Methods

We performed an empirical study on systematic reviews with two or more interventions. Pairwise meta-analyses (PMA) and network meta-analyses (NMA) were identified from empirical studies on the reporting and handling of missing outcome data in systematic reviews. PMAs with at least three studies and NMAs with at least three interventions on one primary outcome were considered eligible. We applied Bayesian methods to obtain the summary effect estimates whilst modelling missing outcome data under the missing-at-random assumption and different assumptions about the missingness mechanism in the compared interventions. The odds ratio in the logarithmic scale was considered for the binary outcomes and the standardised mean difference for the continuous outcomes. We calculated the proportion of primary analyses with robust and frail conclusions, quantified by our proposed metric, the robustness index (RI), and current sensitivity analysis standards. Cohen’s kappa statistic was used to measure the agreement between the conclusions derived by the RI and the current sensitivity analysis standards.

Results

One hundred eight PMAs and 34 NMAs were considered. When studies with a substantial number of missing outcome data dominated the analyses, the number of frail conclusions increased. The RI indicated that 59% of the analyses failed to demonstrate robustness compared to 39% when the current sensitivity analysis standards were employed. Comparing the RI with the current sensitivity analysis standards revealed that two in five analyses yielded contradictory conclusions concerning the robustness of the primary analysis results.

Conclusions

Compared with the current sensitivity analysis standards, the RI offers an explicit definition of similar results and does not unduly rely on statistical significance. Hence, it may safeguard against possible spurious conclusions regarding the robustness of the primary analysis results.
YY1 activates EMI2 and promotes the progression of cholangiocarcinoma through the PI3K/Akt signaling axis
Authors: Zhou Shuai , Qu Kang Lin , Li Jin Ang , Chen Shi Lei , Zhang Yi Gang , Zhu Chao , Jin Hao , Wang Yong , Pang Qing , Liu Hui Chun
Published: December 2021

Background

Cholangiocarcinoma (CCA) is one of the deadliest cancers of the digestive tract. The prognosis of CCA is poor and the 5-year survival rate is low. Bioinformatic analysis showed that early mitotic inhibitor 2 (EMI2) was overexpressed in CCA but the underlying mechanism is not known.

Methods

The data on bile duct carcinoma from TCGA and GEO databases were used to detect the expression of EMI2. The transcription factors of EMI2 were predicted using JASPAR and PROMO databases. Among the predicted transcription factors, YY1 has been rarely reported in cholangiocarcinoma, and was verified using the luciferase reporter gene assay. RT-PCR was performed to predict the downstream pathway of EMI2, and PI3K/Akt was suspected to be associated with it. Subsequently, in vivo and in vitro experiments were conducted to verify the effects of silencing and overexpressing EMI2 and YY1 on the proliferation, invasion, and metastasis of the bile duct cancer cells.

Results

EMI2 was highly expressed in CCA. Silencing EMI2 inhibited the proliferation, invasion, and migration of CCA cells, arrested cell cycle in the G1 phase, and promoted of apoptosis. The luciferase reporter gene assay showed that YY1 bound to the promoter region of EMI2, and after silencing YY1, the expression of EMI2 decreased and the progression of CCA was inhibited. Moreover, key proteins in the PI3K/Akt signaling pathway decreased after silencing EMI2.

Conclusion

EMI2 may be one of the direct targets of YY1 and promotes the progression of CCA through the PI3K/Akt signaling pathway.
Epithelial Wntless regulates postnatal alveologenesis
Authors: Fang Yinshan , Shao Hongxia , Wu Qi , Wong Neng Chun , Tsong Natalie , Sime Patricia J. , Que Jianwen
Published: December 2021

Alveologenesis requires the coordinated modulation of the epithelial and mesenchymal compartments to generate mature alveolar saccules for efficient gas exchange. However, the molecular mechanisms underlying the epithelial-mesenchymal interaction during alveologenesis are poorly understood. Here, we report that Wnts produced by epithelial cells are crucial for neonatal alveologenesis. Deletion of the Wnt chaperone protein Wntless homolog (Wls) disrupts alveolar formation, resulting in enlarged saccules in Sftpc-Cre/Nkx2.1-Cre; Wlsloxp/loxp mutants. Although commitment of the alveolar epithelium is unaffected, α-SMA+ mesenchymal cells persist in the alveoli, accompanied by increased collagen deposition, and mutants exhibit exacerbated fibrosis following bleomycin challenge. Notably, α-SMA+ cells include a significant number of endothelial cells resembling endothelial to mesenchymal transition (EndMT), which is also present in Ager-CreER; Wlsloxp/loxp mutants following early postnatal Wls deletion. These findings provide initial evidence that epithelial-derived Wnts are crucial for the differentiation of the surrounding mesenchyme during early postnatal alveologenesis.