bluuebunny/crossref_metadata_2025_split huggingface dataset:
ESR1 mediates estrogen-induced feminization of genetic male Chinese soft-shelled turtle
Authors: Li Pan , Guo Yin , Jin Lin , Liang Xiao , Chen Gaoan , Sun Wei , Xiao Ling , Qian Guoying , Ge Chutian 
Published: May 2022

Abstract
Exogenous estrogen have shown their feminization abilities during the specific sex differentiation period in several reptiles. However, the specific regulatory mechanism and downstream regulatory genes of estrogen remain elusive. In the present study, 17β-estradiol (E2), as well as drugs of specific antagonists and/or agonists of estrogen receptors, were employed to figure out the molecular pathway involved in the E2-induced feminization in Chinese soft-shelled turtles, an important aquaculture species in China. E2 treatment led to typical female characteristics in the gonads of ZZ individuals, including thickened outer cortex containing a number of germ cells and degenerated medullary cords, as well as the disappearance of male marker SOX9, and the ectopic expression of ovarian regulator FOXL2 at the embryonic developmental stage 27 and 1 month after hatching. The specific ESR1 antagonist or a combination of three estrogen receptor antagonists could block the sex reversal of ZZ individuals induced by estrogen. In addition, specific activation of ESR1 by agonist also led to the feminization of ZZ gonads, which was similar to the effect of estrogen treatment. Furthermore, transcriptome data showed that the expression level of FOXL2 was significantly upregulated, whereas mRNA levels of DMRT1, SOX9, and AMH were downregulated after estrogen treatment. Taken together, our results indicated that E2 induced the feminization of ZZ Chinese soft-shelled turtles via ESR1, and decrease of male genes DMRT1, SOX9, and AMH and increase of ovarian development regulator FOXL2 might be responsible for the initiation of E2-induced feminization.
Expanding the Pulse–Reserve Paradigm to Microorganisms on the Basis of Differential Reserve Management Strategies
Authors: Garcia-Pichel Ferran , Sala Osvaldo 
Published: May 2022

Abstract
The pulse–reserve paradigm (PRP) is central in dryland ecology, although microorganismal traits were not explicitly considered in its inception. We asked if the PRP could be reframed to encompass organisms both large and small. We used a synthetic review of recent advances in arid land microbial ecology combined with a mathematically explicit theoretical model. Preserving the PRPs core of adaptations by reserve building, the model considers differential organismal strategies to manage these reserves. It proposes a gradient of organisms according to their reserve strategies, from nimble responders (NIRs) to torpid responders (TORs). It predicts how organismal fitness depends on pulse regimes and reserve strategies, partially explaining organismal diversification and distributions. After accounting for scaling phenomena and redefining the microscale meaning of aridity, the evidence shows that the PRP is applicable to microbes. This modified PRP represents an inclusive theoretical framework working across life-forms, although direct testing is still needed.
Disciplinary Neo-Liberalisation and the New Politics of Inequality
Authors: Nunn Alexander , Tepe Daniela 
Published: May 2022

AbstractOverlaps exist between critical Criminology and critical International Political Economy (IPE). However, while criminologists are keen to engage with political economy, there has been less interest in criminology from scholars in IPE. Recently, though, a literature started to emerge within IPE that focusses on discipline, including research which focusses on ‘authoritarian neoliberalism’ yet without explicitly engaging with the criminological literature. This paper engages with criminological research to demonstrate areas of shared interest, particularly in understanding the role of discipline and consent in the structuring of the ‘social ensemble’ thereby offering something of a corrective to the literature on ‘authoritarian neoliberalism’. We argue that combining insights from Gramscian and (critical) Feminist social theory can help to explain the social reproduction of ‘hegemony’ in which discipline – including self-discipline – plays an important role. Long-term trends in the fracturing of the hegemonic post-war social ensemble were displaced by temporary ‘fixes’ related to consumerism, credit and discipline (including in state institutions, changing economic and ideological structures). However, in the wake of the Global Financial Crisis of 2008 – the limits of these fixes are revealed and social polarisation is the result. In this context, disciplinary processes in and beyond state institutions are becoming more visible.
Constructive resilience in response to oppression: the strategy of Bahá’ís in Iran
Authors: Tavernaro-Haidarian Leyla 
Published: May 2022

Abstract
Efforts to respond to oppression are often framed as strategies of ‘resistance’ or ‘liberation.’ This paper uses critical discourse analysis (CDA) to examine the assumptions implicit in these strategies and shows that they derive from a realism of ‘normative adversarialism,’ where confrontation is seen as a natural and inevitable approach for achieving social change. The paper then asks what an alternative conceptual lens might yield, where social transformation is reimagined as evolutionary, developmental and integrative. It concludes that, through such a lens, responding to oppression can be recast as an effort of ‘constructive resilience.’ Coined in relation to the systematic persecution of Iran’s largest religious minority—the Bahá’í faith—this term describes a strategy of transcending years of state-sponsored discrimination through activities such as literacy and empowerment initiatives for children and youth in socio-economically marginalized neighborhoods, as well as through a home-based university initiative. Consequently, this paper introduces a shift from confrontation to cohesion as the main driver for social change.
Alpha Variant Coronavirus Outbreak in a Nursing Home Despite High Vaccination Coverage: Molecular, Epidemiological, and Immunological Studies
Authors: Zürcher Kathrin , Abela Irene A , Stange Madlen , Dupont Carole , Mugglin Catrina , Egli Adrian , Trkola Alexandra , Egger Matthias , Fenner Lukas 
Published: May 2022

Abstract

Background
Vaccination may control the coronavirus disease 2019 (COVID-19) pandemic, including in nursing homes where many high-risk people live. We conducted extensive outbreak investigations.

Methods
We studied an outbreak at a nursing home in Switzerland, where the uptake of messenger RNA vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was 82% among residents as of 21 January 2021. After diagnosis of COVID-19 in a vaccinated symptomatic healthcare worker (HCW) on 22 February, we performed outbreak investigations in house A (47 residents; 37 HCWs), using SARS-CoV-2–specific polymerase chain reaction (PCR) testing of nasopharyngeal swab samples. We performed whole-genome sequencing of SARS-CoV-2 and serological analyses.

Results
We identified 17 individuals with positive PCR results, 10 residents (5 vaccinated) and 7 HCWs (3 vaccinated). The median age (interquartile range) was 86 (70–90) years among residents and 49 (29–59) years among HCWs. Of the 5 vaccinated residents, 3 had mild disease and 2 had no symptoms, whereas all 5 unvaccinated residents had mild to severe disease, and 2 died. Vaccine effectiveness for the prevention of infection among residents was 73.0% (95% confidence interval, 24.7%–90.1%). The 12 available genomes were all alpha variants. Neutralizing titers were significantly higher in vaccinated individuals on reexposure (&gt;1 week after diagnosis) than in vaccinated, unexposed HCWs (P = .01). Transmission networks indicated 4 likely or possible transmissions from vaccinated to other individuals and 12 transmission events from unvaccinated individuals.

Conclusions
COVID-19 outbreaks can occur in nursing homes, including transmission from vaccinated persons to others. Outbreaks might occur silently, underlining the need for continued testing and basic infection control measures in these high-risk settings.
Prioritizing Pregnant Women for Coronavirus Disease 2019 Vaccination in African Countries
Authors: Nachega Jean B , Sam-Agudu Nadia A , Siedner Mark J , Rosenthal Philip J , Mellors John W , Zumla Alimuddin , Hermans Michel P , Ntakwinja Mukanire B , Mukwege Denis M , Langenegger Eduard , Mofenson Lynne M ,   for the African Forum for Research and Education in Health (AFREhealth) Research Collaboration on COVID-19 and Pregnancy
Published: May 2022

AbstractCoronavirus disease 2019 (COVID-19) in pregnancy is associated with excess maternal and infant morbidity and mortality in both African and higher-resource settings. Furthermore, mounting evidence demonstrates the safety and efficacy of COVID-19 vaccination for pregnant women and infants. However, national guidelines in many African countries are equivocal or lack recommendations on COVID-19 vaccine in pregnancy. We summarize key data on COVID-19 epidemiology and vaccination among pregnant African women to highlight major barriers to vaccination and recommend 4 interventions. First, policymakers should prioritize pregnant women for COVID-19 vaccination, with a target of 100% coverage. Second, empirically supported public health campaigns should be sustainably implemented to inform and support pregnant women and their healthcare providers in overcoming vaccine hesitancy. Third, COVID-19 vaccination for pregnant women should be expanded to include antenatal care, obstetrics/gynecology, and targeted mass vaccination campaigns. Fourth, national monitoring and evaluation of COVID-19 vaccine uptake, safety, surveillance, and prospective outcomes assessment should be conducted.
Hemizygous loss of function mutations in CLCN5 causing end-stage kidney disease without Dent disease phenotype
Authors: Leggatt Gary , Gast Christine , Gilbert Rodney D , Veighey Kristin , Rahman Tahmina , Ennis Sarah 
Published: May 2022

ABSTRACT
Dent disease type 1 is suspected in the presence of a complete phenotype of low molecular weight (LMW) proteinuria, hypercalciuria and at least one of the following: nephrocalcinosis, nephrolithiasis, haematuria, hypophosphatemia or chronic kidney disease (CKD). We present two brothers who presented with CKD alone. In the absence of typical clinical features, further assessment of LMW proteinuria and hypercalciuria was not undertaken. Whole-genome sequencing revealed hemizygous loss of function mutations in chloride voltage-gated channel 5 (CLCN5) consistent with Dent disease. Dent disease should, therefore, be considered in patients with an incomplete phenotype, including unexplained CKD alone.
Marx, Sraffa and Classical Price Theory
Authors: Shaikh Anwar 
Published: May 2022

Abstract
Five major propositions in classical price theory are discussed. First, Marx explicitly follows Smith’s analytical starting point to show that prices differ from labor values not because of competition or capitalist relations (wages and profits), but only when the latter interact with intersectoral capital–labor differences. Second, Okishio, Morishima and others long ago demonstrated that Marx’s transformation procedure was an iterative process, and Marx himself refers to a ‘standard’ industry immune to this process. Third, Sraffa correctly argues, in favor of Marx, that empirical economic aggregates are essentially the same in prices and values. Fourth, as matrix size increases the subdominant eigenvalues of IO matrices approach a smooth limiting curve, so contrary to Bródy, the first step in any price or quantity iterative process (such as Marx’s) does not become increasingly exact. Finally, Sraffa prices in large US matrices are overwhelmingly simple and extremely well approximated by Bienenfeld’s quadratic form.
Unconventional modes of peptide–HLA-I presentation change the rules of TCR engagement
Authors: Hopkins Jade R , MacLachlan Bruce J , Harper Stephen , Sewell Andrew K , Cole David K 
Published: May 2022

Abstract
The intracellular proteome of virtually every nucleated cell in the body is continuously presented at the cell surface via the human leukocyte antigen class I (HLA-I) antigen processing pathway. This pathway classically involves proteasomal degradation of intracellular proteins into short peptides that can be presented by HLA-I molecules for interrogation by T-cell receptors (TCRs) expressed on the surface of CD8+ T cells. During the initiation of a T-cell immune response, the TCR acts as the T cell’s primary sensor, using flexible loops to mould around the surface of the pHLA-I molecule to identify foreign or dysregulated antigens. Recent findings demonstrate that pHLA-I molecules can also be highly flexible and dynamic, altering their shape according to minor polymorphisms between different HLA-I alleles, or interactions with different peptides. These flexible presentation modes have important biological consequences that can, for example, explain why some HLA-I alleles offer greater protection against HIV, or why some cancer vaccine approaches have been ineffective. This review explores how these recent findings redefine the rules for peptide presentation by HLA-I molecules and extend our understanding of the molecular mechanisms that govern TCR-mediated antigen discrimination.
Open left thoracoabdominal esophagectomy a viable option in the era of minimally invasive esophagectomy
Authors: Klevebro F , Han S , Ash S , Mueller C , Cools-Lartigue J , Maynard N , Ferri L , Low D 
Published: May 2022

Abstract
Minimally invasive surgical technique has become standard at many institutions in esophageal cancer surgery. In some situations, however other surgical approaches are required. Left thoracoabdominal esophagectomy (LTE) facilitates complete resection of esophageal cancer particularly for bulky distal esophageal tumors, but there are concerns that this approach is associated with significant morbidity. Prospectively entered esophagectomy databases from three high-volume centers were reviewed for patients undergoing LTE or MIE 2009–2019. Patient demographics, tumor characteristics, operative outcomes, postoperative outcomes, and pathologic surrogates of oncologic efficacy (R0 resection rate, and number of resected lymph nodes) were compared. In total 915 patients were included in the study, LTE was applied in 684 (74.8%) patients, and MIE in 231 (25.2%) patients. LTE patients had more locally advanced tumor stage and received more neoadjuvant treatment. Patients treated with MIE had more comorbidities. The results showed no difference in overall postoperative complications (LTE = 61.7%, MIE = 65.7%, P = 0.289), severe complications (Clavien–Dindo ≥IIIa (LTE = 25.9%, MIE 26.8%, P = 0.806)), pneumonia (LTE = 29.0%, MIE = 24.7%, P = 0.211), anastomotic leak (LTE = 7.8%, MIE = 11.3%, P = 0.101), or in-hospital mortality (LTE = 2.6%, MIE = 3.5%, P = 0.511). Median number of resected lymph nodes was 24 for LTE and 25 for MIE (P = 0.491). LTE was used for more advanced tumors in patients that were more likely to have received neoadjuvant treatment compared with MIE, however postoperative morbidity, mortality, and oncologic outcomes were equivalent to that of MIE in this cohort. In conclusion open resection with left thoracoabdominal approach is a valid option in selected patients when performed at high-volume esophagectomy centers.
Burnout amongst cardiology fellows and internal medicine residents in tertiary cardiac centres
Authors: Ahmed A , Suliman A , Mohemmed T , Elsayed A , Abdelbagi A , Osman S 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Burnout is an occupational hazard in medicine and affects more than one-quarter of US cardiologists and fellows in training. The absence of burnout does not indicate well-being; however, along the continuum of clinician well-being, burnout is one of the more severe negative components. Clinician well-being is an imperative component of health care and can be broadly defined as experiencing wellness (optimized physical and mental health), resiliency, and professional fulfilment. Burnout is not the result of an individual’s weakness but is due to work-related stresses, including excessive workload, moral injury, and cognitive dissonance. Strategies must be developed both to address burnout and to improve and sustain clinician well-being. Similar to the concept of cardiovascular disease prevention, secondary prevention is accomplished with tactics directed to prevent recurrent burnout; however, targeted investment in primordial and primary prevention is also crucial to mitigate burnout and to cultivate esprit de corps.

Purpose
To assess burnout syndrome prevalence amongst cardiology fellows and internal medicine residents in tertiary cardiac centres.

Methods
This is a multicenter cross-sectional study conducted in three major cardiac tertiary hospitals. The Maslach Burnout Inventory - Human Services Survey for Medical Personnel (MBI-HSS (MP)) with its three elements of Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA), was used to assess burnout in cardiology fellows and internal medicine (IM) residents rotating in cardiology in three tertiary cardiac centres from March to June 2021. Questionnaires were entered online using Google docs application and then analyzed using SPSS (Version 25).

Results
Of 47 respondents, 66% were IM residents, while 34% were cardiology fellows. The mean age was 31.53(+/- 3.694) years. High burnout scores in the three elements of the questionnaire, namely EE, DP, and PA, were recorded in 23.4%, 61.7%,46.8% of the respondents, respectively. Burnout was recorded in 10.6% of the participants.
No significant correlation was seen between high burnout scores and gender, marital status, study location, or whether the respondent was a fellow or IM resident.

Conclusion
Prevalence of burnout is high in our study population, especially in the sphere of emotional exhaustion and depersonalization, and was not related to marital status, gender, hospital location, or level of training.
Heart failure correction in patients with chronic renocardiac syndrome
Authors: Demikhov A , Demikhova N , Orlovskiy A , Zharkova A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.
In case of inadequate diagnosis and correction of the basic disease, which triggers the development of chronic heart failure (CHF), left ventricular (LV) remodeling leads to myocardial dysfunction and decompensation. Patients who entered the study EUCLID, demonstrated nephroprotective effect of lisinopril, which reduces the appearance of microalbuminuria.

Target
Study the effectiveness of lisinopril in the correction of CHF in patients with chronic renocardiac syndrome based on a study of LV diastolic function.

Methods
59 patients with chronic renocardiac syndrome were investigated. All patients received lisinopril 10-20 mg per day. LV diastolic function was evaluated for Acuson Sequoia-512 before and after treatment.

Results
Changes in the kinetics of myocardial contractility were characterized by high amplitude of the interventricular septum, increased by 20%, end-systolic contractility index by 9.1%, the degree of shortening of the left ventricular size by 11.4%. A significant decrease in the rate of diastolic filling by passive relaxation (E) of 23.4% and a filling rate due to atrial contraction (A) at 20%. Violation of intracardiac hemodynamics as manifested by increasing the restrictive properties of the myocardium, as well as reducing the effectiveness of time and deceleration rate of early LV filling flow by 23.2 and 27.4%, increase and decrease of LV filling time active by reducing atrial 49.9% . Decreased as the time of isovolumic LV relaxation of the heart. During treatment with lisinopril was an increase in ejection fraction (EF) of 16.4% (p=0.004) or 53.2% (49.1, 58.9) to 61.9% (53.4, 68.0 ). The rate of mitral filling period of relaxation (Ve) increased from 0.53 m/s (0.43, 0.58) to 0.56 m/s (90.47, 0.63), or 5.7 % (p=0.039), while maintaining the diastolic filling due to atrial contraction. This has led to the restructuring of diastolic filling of the normal type, which was confirmed by the change of the reflectance upwards: Ratio of Ve/Va to treatment was 1.45 units. (1.02, 1.63), vand during treatment - 1.58 units (1.21, 1.90), or a 9.0% increase (p = 0.013). Equally, there was a decrease IVRT: from 61.9 ms (54.6, 78.8) to 56.4 ms (50.3, 72.4) or 8.9% (p=0.044).

Conclusions
Improvement of LV diastolic function is due to improved myocardial relaxation. ACE inhibitor (lisinopril), as a means of LV remodeling, reduce the degree of diastolic dysfunction by improving myocardial relaxation in patients with chronic renocardiac syndrome.
Levosimendan increases time out-of-hospital in decompensated advanced heart failure
Authors: Silva G , Silva M , Queiros P , Caeiro D , Brandao M , Ferreira D , Fontes-Carvalho R 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Advanced heart failure is associated with a high rate of hospitalization due to clinical decompensating. Adding Levosimendan (LVS), an inodilatador which metabolite has long-lasting effect, to intravenous diuretic therapy (standard therapy) is a therapeutic option in these patients, although the magnitude of the short and long-term benefit still remains controversial.

Objective
The aim of this study was to determine whether combination of LVS with standard therapy in patients with decompensated advanced heart failure (DAHF) increases time out-of-hospital compared to standard therapy alone. The secondary endpoint was duration of hospital stay for each type of hospitalization.

Methods and Results
Retrospective analysis of patients with advanced heart failure who met the following criteria: at least one hospitalization with standard therapy and at least one hospitalization with standard therapy plus LVS, separated less than 6 months from each other.
From a total of 71 patients who took LVS in our cardiac care unit, 7 patients met the inclusion criteria. All these patients were male, mean age was 64,1 ± 10,6 years, mean left ventricular ejection fraction was 24,57 ± 7,3% and 71,4% had ischemic cardiomyopathy. A total of 22 hospitalizations were analysed (12 with standard therapy plus LVS and 10 with standard therapy), with 4 patients having more than two hospitalizations.
The administration of LVS increased the time out-of-hospital until readmission compared to standard therapy alone (70.5 days vs 34.7 days, p = 0.023) (figure 1). The length of stay during LVS administration was longer (12.1 days vs 6.0 days, p &lt;0.001).
In 75% of cases after LVS infusion patients stay out-of-hospital more than 2 months while after standard therapy this event occurred only once (10%) (figure 2). 1-year mortality was 71,4%.

Conclusion
Use of Levosimendan increases time out-of-hospital in patients with DAHF. This is an opportunity to improve quality of life in patients with severe disease and recurrent hospitalizations.