bluuebunny/crossref_metadata_2025 huggingface dataset:
Renal function outcome after selective bladder-preserving tetramodality therapy consisting of maximal transurethral resection, induction chemoradiotherapy and consolidative partial cystectomy in comparison with radical cystectomy for patients with muscle-invasive bladder cancer: a two-centre retrospective study
Authors: Fujiwara Motohiro , Yokoyama Minato , Toide Masahiro , Fujiwara Ryo , Tanaka Hajime , Oguchi Tomohiko , Komai Yoshinobu , Yoshida Soichiro , Matsuoka Yoh , Numao Noboru , Yamamoto Shinya , Fukui Iwao , Yonese Junji , Fujii Yasuhisa
Published: December 2022

Objective

To compare renal function (RF) outcomes after bladder-preserving tetramodal therapy against muscle-invasive bladder cancer (MIBC) to those after radical cystectomy (RC).

Methods

This study included 95 patients treated with tetramodal therapy consisting of transurethral bladder tumour resection, chemoradiotherapy and partial cystectomy (PC) and 300 patients treated with RC. The annual change in the estimated glomerular filtration rate (eGFR) was compared using the linear mixed model. Renal impairment was defined as a >25% decrease from the pretreatment eGFR, and renal impairment-free survival (RIFS) was calculated. The association between treatment type and renal impairment was assessed.

Results

The number of patients who received neoadjuvant chemotherapy was 8 (8.4%) in the tetramodal therapy group and 75 (25.0%) in the RC group. After the inverse probability of treatment weighting adjustments, the baseline characteristics were balanced between the treatment groups. The mean eGFR before treatment in tetramodal therapy and RC groups was 69.4 and 69.6 mL/min/1.73 m2 and declined with a slope of −0.7 and −1.5 mL/min/1.73 m2/year, respectively. The annual deterioration rate of post-treatment eGFR in the tetramodal therapy group was milder than in the RC group. The 5-year RIFS rate in the tetramodal therapy and the RC groups was 91.2 and 85.2%, respectively. Tetramodal therapy was an independent factor of better RIFS compared with RC.

Conclusions

RF was better preserved after tetramodal therapy than after radical therapy; however, even after tetramodal therapy, the eGFR decreased, and a non-negligible proportion of patients developed renal impairment.
Changes in geographic accessibility to mammography by state and rural-urban status, United States, 2006-2022
Authors: Wiese Daniel , Islami Farhad , Henry Kevin A
Published: December 2022

Although mammography is widely available in the United States, differences in accessibility in rural and urban areas and changes over time are not well described. In this study, we estimated the number and proportion of women aged 45-84 years who had limited travel time–based geographic accessibility to mammography by urban-rural status and state in the contiguous United States in 2006 and 2022. The proportion of women aged 45-84 years with limited accessibility to mammography did not substantially change from 2006 (12.7%; representing 7.5 million women) to 2022 (12.2%; 8.2 million women). Accessibility to mammography varied by state, but in 10 states, more than 26% of the statewide female population aged 45-84 years had limited accessibility in 2022. This proportion was substantially higher in rural areas (50.6% overall; ≥50% in 28 states in 2022) than in urban areas (3.0% overall). Increasing accessibility to mammography could increase utilization of breast cancer screening and, potentially, improve breast cancer survival.
The Cost of Forest Thinning Operations in the Western United States: A Systematic Literature Review and New Thinning Cost Model
Authors: Chang Heesol , Han Han-Sup , Anderson Nathaniel , Kim Yeon-Su , Han Sang-Kyun
Published: December 2022

Mechanical forest thinning treatments are implemented across the western United States (US) to improve forest health and reduce hazardous fuels. However, the main challenge in thinning operations is low financial feasibility. This study synthesized the stump-to-truck cost of forest thinning operations in the western US based on operations research articles published over the last 40 years (1980–2020). We systematically selected and reviewed 20 thinning studies to analyze key variables affecting machine productivity and harvesting costs. The average cost of forest thinning was lowest for a mechanized whole-tree thinning operation at $21.34/ton or $2,075/ha. Feller-bunchers and skidders showed the highest productivity in felling and extraction machines, respectively. We found that extraction cost accounted for the largest proportion of the stump-to-truck cost of forest thinning (33%, 43%, and 34% in whole-tree, tree-length, and cut-to-length thinning, respectively). Tree diameter and machine travel distance are common variables affecting thinning productivity and thus cost, regardless of the harvesting methods used. With thinning productivity and cost data from the selected studies, we developed a spreadsheet-based model to estimate thinning costs for various harvesting systems. This literature synthesis and new thinning cost model can help foresters develop a cost-effective plan for thinning operations.
Can we constrain galaxy geometry parameters using spatially integrated SED fitting?
Authors: Qiu Yisheng , Kang Xi , Luo Yu
Published: December 2022

Sophisticated spectral energy distribution (SED) models describe dust attenuation and emission using geometry parameters. This treatment is natural since dust effects are driven by the underlying star–dust geometry in galaxies. An example is the starduster SED model, which divides a galaxy into a stellar disc, a stellar bulge, and a dust disc. This work utilizes the starduster SED model to study the efficacy of inferring geometry parameters using spatially integrated SED fitting. Our method fits the SED model to mock photometry produced by combining a semi-analytic model with the same SED model. Our fitting results imply that the disc radius can be constrained, while the inclination angle, dust disc to stellar disc radius ratio, bulge radius, and intrinsic bulge to total luminosity ratio are unconstrained, even though 21 filters from ultraviolet to far-infrared are used. We also study the impact of signal-to-noise (S/N) ratio, finding that the increase of S/N (up to 80) brings limited improvements to the results. We provide a detailed discussion to explain these findings, and point out the implications for models with more general geometry.
Expanding fireball in magnetar bursts and fast radio bursts
Authors: Wada Tomoki , Ioka Kunihito
Published: December 2022

A fireball of radiation plasma created near the surface of a neutron star (NS) expands under its own pressure along magnetic field lines, and produces photon emission and relativistic matter outflow. We comprehensively classify the expanding fireball evolution into five cases, and obtain the photospheric luminosity and the kinetic energy of the outflow, taking into account key processes; lateral diffusion of photons escaping from a magnetic flux tube, effects of strong magnetic field, baryon loading from the NS surface, and radiative acceleration via cyclotron resonant scattering, some of which have not been considered in the context of gamma-ray bursts. Applying our model to magnetar bursts with fast radio bursts (FRBs), in particular the X-ray short bursts from SGR 1935+2154 associated with the Galactic FRB 20200428A, we show that the burst radiation can accelerate the outflow to high-Lorentz factor with sufficient energy to power FRBs.
Severe COVID-19 in patients with immune-mediated rheumatic diseases: A stratified analysis from the SORCOM multicentre registry
Authors: Boteanu Alina , Leon Leticia , Pérez Esteban Silvia , Rabadán Rubio Elena , Pavía Pascual Marina , Bonilla Gema , Bonilla González-Laganá Carmen , García Fernandez Antia , Recuero Diaz Sheila , Ruiz Gutierrez Lucia , Sanmartín Martínez José Javier , de la Torre-Rubio Natalia , Nuño Laura , Sánchez Pernaute Olga , del Bosque Iván , Lojo Oliveira Leticia , Rodríguez Heredia José Manuel , Clemente Daniel , Abasolo Lydia , Bachiller-Corral Javier
Published: December 2022

Objectives

The aim of this study is to evaluate risk factors for severe coronavirus disease 2019 (COVID-19) in patients with immune-mediated rheumatic diseases, stratified by systemic autoimmune conditions and chronic inflammatory arthritis.

Methods

An observational, cross-sectional multicentre study was performed. Patients from 10 rheumatology departments in Madrid who presented with severe acute respiratory syndrome coronavirus-2 infection between February 2020 and May 2021 were included. The main outcome was COVID-19 severity (hospital admission or mortality). Risk factors for severity were estimated, adjusting for covariates (socio-demographic, clinical, and treatments), using logistic regression analyses.

Results

In total, 523 patients with COVID-19 were included, among whom 192 (35.6%) patients required hospital admission and 38 (7.3%) died. Male gender, older age, and comorbidities such as diabetes mellitus, hypertension, and obesity were associated with severe COVID-19. Corticosteroid doses >10 mg/day, rituximab, sulfasalazine, and mycophenolate use, were independently associated with worse outcomes. COVID-19 severity decreased over the different pandemic waves. Mortality was higher in the systemic autoimmune conditions (univariate analysis, P < .001), although there were no differences in the overall severity in the multivariate analysis.

Conclusions

This study confirms and provides new insights regarding the harmful effects of corticosteroids, rituximab, and other therapies (mycophenolate and sulfasalazine) in COVID-19. Methotrexate and anti-tumour necrosis factor therapy were not associated with worse outcomes.
Evaluation of a training programme for critical incident debrief facilitators
Authors: Johnson J , Pointon L , Keyworth C , Wainwright N , Moores L , Bates J , Hinsby K
Published: December 2022

Background

Critical incident debriefs are a commonly used occupational health tool for supporting staff after traumatic work incidents. However, there is a dearth of literature evaluating training programmes for debrief facilitators.

Aims

To evaluate a 5-day training programme to equip healthcare, social care and voluntary, community and social enterprise sector staff to act as post-incident peer supporters and debrief facilitators.

Methods

A mixed-methods, single-arm, before-and-after study. Data were collected at baseline and post-training. The quantitative outcome measure was ‘Confidence’; the sum of two items measuring confidence in (i) supporting peers after critical incidents and (ii) facilitating post-incident structured team discussions. At post-training, quantitative and qualitative feedback regarding experiences and perceptions of the training was also gathered.

Results

We recruited 45 participants between October 2021 and January 2022. Confidence in supporting peers following incidents and facilitating post-incident structured team discussions increased significantly following the training, t(35) = −6.77, P < 0.001. A majority of participants reported they would do things differently because of the training and that they found the training relevant, useful and engaging. Summative content analysis of qualitative feedback indicated that participants (i) believed the role plays were an important learning tool and (ii) thought it was important that the trainer was engaging. Some participants would have preferred in-person delivery.

Conclusions

Participants valued training in post-incident peer support and debriefing skills. Organizations implementing post-incident support pathways could usefully include this training and ensure optimal uptake and engagement by (i) providing in-person and online delivery options and (ii) including role play as a learning technique.
Who Should We Be Online?
Authors: Frost-Arnold Karen
Published: December 2022

From social media to search engines to Wikipedia, the internet is thoroughly embedded in how we produce, locate, and share knowledge around the world. Who Should We Be Online? provides an account of online knowledge that takes seriously the role of sexist, racist, transphobic, colonial, and capitalist forms of oppression. Frost-Arnold argues against analyzing internet users as a collection of identical generic people with smartphones. The novel epistemology developed in this book recognizes that we are differently embodied beings interacting within systems of dominance. Our social identities and global inequalities shape who we are, who we can be online, and what we know. Tackling problems of online content moderation, fake news, and hoaxes, Frost-Arnold shows that oppressive online structures and practices help fuel ignorance. But she also reveals how the internet provides opportunities for marginalized people and activists to share knowledge online. Drawing on feminist accounts of objectivity, veritistic social epistemology, epistemologies of ignorance, virtue epistemology, and the epistemic injustice literature, this book argues for a social epistemology that values truth and objectivity, while recognizing that inequalities shape our collective ability to attain these goals. Timely and interdisciplinary, Who Should We Be Online? weaves together internet studies scholarship from across the humanities, social sciences, and computer science. Presenting case studies of moderators, imposters, tricksters, fakers, and lurkers, this book both explains the problems with our current internet ecosystem and imagines liberatory online futures.
Knowledge and Legal Proof
Authors: Moss Sarah
Published: December 2022

Existing discussions of legal proof address a host of apparently disparate questions: What does it take to prove a fact beyond a reasonable doubt? Why is the reasonable doubt standard notoriously elusive, sometimes considered by courts to be impossible to define? Can the standard of proof by a preponderance of the evidence be defined in terms of probability thresholds? Why is statistical evidence often insufficient to meet the burden of proof? This paper defends an account of proof that addresses each of these questions. Where existing theories take a piecemeal approach to these puzzles, my theory develops an insight that unifies them—namely, the thesis that legal proof requires knowledge. Although this thesis may seem radical at first, I answer several common objections to it, and I argue that it does better than several competing accounts when it comes to making sense of our intuitions about what legal proof requires.
Vaccines and the Covid-19 pandemic: lessons from failure and success
Authors: Kominers Scott Duke , Tabarrok Alex
Published: December 2022

The losses from the global Covid-19 pandemic have been staggering—trillions in economic costs, on top of significant losses of life, health, and well-being. The world made significant and successful investments in vaccines to mitigate the pandemic, yet there were missed opportunities, as well. We review what has been learnt about the value of vaccines, the speed at which vaccines can be developed, and the optimal and ethical approaches to vaccine distribution, as well as other issues related to pandemic and emergency preparedness. Surprisingly, spending on vaccines remains far below that which would be justified by the social return. We remain poorly prepared for future pandemics and other emergencies.
Expanding capacity for vaccines against Covid-19 and future pandemics: a review of economic issues
Authors: Athey Susan , Castillo Juan Camilo , Chaudhuri Esha , Kremer Michael , Simoes Gomes Alexandre , Snyder Christopher M
Published: December 2022

We review economic arguments for using public policy to accelerate vaccine supply during a pandemic. Rapidly vaccinating a large share of the global population helps avoid economic, mortality, and social losses, which in the case of Covid-19 mounted into trillions of dollars. However, pharmaceutical firms are unlikely to have private incentives to invest in vaccine capacity at the socially optimal scale and speed. The socially optimal level of public spending may cause some sticker shock but—as epitomized by the tagline ‘spending billions to save trillions’—is eclipsed by the benefits and can be restrained with the help of careful policy design and advance preparations. Capacity is so valuable during a pandemic that fractional dosing and other measures to stretch available capacity should be explored.
Hospital size, remoteness and stroke outcome
Authors: Harbison J , Collins R , McCormack Joan , Brych O , Fallon C , Cassidy T
Published: December 2022

Introduction

Previous studies have shown an association between number of stroke admissions and outcomes. Small hospitals often support more remote areas and we studied national data to determine if an association exists between hospital remoteness and stroke care.

Methods

Data from the Irish National Audit of Stroke (INAS) on average stroke admissions, adjusted mortality for ischaemic stroke, thrombolysis rate and proportion with door to needle (DTN) ≤45 min were analysed. Hospital remoteness was quantified by distance to the next hospital, nearest neurointerventional centre and location within 10 km of the national motorway network.

Results

Data for 23 of 24 stroke services were evaluated. Median number of strokes admitted per year was 186 (range 84–497). Nine hospitals (39%) admitted ≥200 stroke patients per year (mean 332). Average adjusted mortality (7.0 vs. 7.3, P = 0.67 t-test), mean thrombolysis rate (12.1% vs. 9.2%, P = 0.09) and mean proportion of patients treated ≤45 min (40.4% vs. 31.3%, P = 0.2) did not differ significantly between higher and lower volume hospitals.

Hospitals close to the motorway network (n = 15) had a higher mean thrombolysis rate (11.9% vs. 7.5%, P = 0.01 t-test) and proportion DTN ≤45 min (43.7–18.4%, P < 0.001).

Number of stroke admissions did not correlate with mortality (r = 0.06, P = 0.78), DTN (r = 0.12, P = 0.95) or thrombolysis rate (r = 0.35, P = 0.20). Distance to next hospital correlated strongly negatively with DTN (r = −0.47, P = 0.02) and thrombolysis rate (−0.43, P = 0.04).

Conclusion

Remoteness of hospitals is associated with worse measures of stroke outcome and management.
Cholera, Quarantines and Social Modernisation at the Danube Border of the Ottoman Empire: The Romanian Experience between 1830 and 1859
Authors: Trăușan-Matu Lidia , Buda Octavian
Published: December 2022

This study focuses on the history of the quarantine system established at the naval border of the Romanian Principalities (Wallachia and Moldavia) between 1830 and 1859. We survey both the state’s ability to organise defences against contagious diseases and the society’s reaction to strict quarantine rules. In the end, we show that the Danube quarantine was not only a means of combating contagious diseases but also an instrument of pressure, surveillance and state regulation. To reconstruct an image of that period, we used information from five categories of sources: archive documents, health legislation, the press of the time, memoirs and diplomatic reports. By bringing the Romanian quarantine experience to the foreground, this study broadens both the perspective on quarantines and modernisation in the Romanian Principalities and also the knowledge regarding the free movement, politics and economy at the Danube border of the Ottoman Empire.
Selective inhibition of integrin αvβ6 leads to rapid induction of urinary bladder tumors in cynomolgus macaques
Authors: Guffroy Magali , Trela Bruce , Kambara Takahito , Stawski Lukasz , Chen Huidong , Luus Lia , Montesinos Monica S , Olson Lauren , He Yupeng , Maisonave Kevin , Carr Tracy , Lu Min , Ray Adrian S , Hazelwood Lisa A
Published: December 2022

Administration of a novel and selective small molecule integrin αvβ6 inhibitor, MORF-627, to young cynomolgus monkeys for 28 days resulted in the rapid induction of epithelial proliferative changes in the urinary bladder of 2 animals, in the absence of test agent genotoxicity. Microscopic findings included suburothelial infiltration by irregular nests and/or trabeculae of epithelial cells, variable cytologic atypia, and high mitotic rate, without invasion into the tunica muscularis. Morphologic features and patterns of tumor growth were consistent with a diagnosis of early-stage invasive urothelial carcinoma. Ki67 immunohistochemistry demonstrated diffusely increased epithelial proliferation in the urinary bladder of several monkeys, including those with tumors, and αvβ6 was expressed in some epithelial tissues, including urinary bladder, in monkeys and humans. Spontaneous urothelial carcinomas are extremely unusual in young healthy monkeys, suggesting a direct link of the finding to the test agent. Inhibition of integrin αvβ6 is intended to locally and selectively block transforming growth factor beta (TGF-β) signaling, which is implicated in epithelial proliferative disorders. Subsequent in vitro studies using a panel of integrin αvβ6 inhibitors in human bladder epithelial cells replicated the increased urothelial proliferation observed in monkeys and was reversed through exogenous application of TGF-β. Moreover, analysis of in vivo models of liver and lung fibrosis revealed evidence of epithelial hyperplasia and cell cycle dysregulation in mice treated with integrin αvβ6 or TGF-β receptor I inhibitors. The cumulative evidence suggests a direct link between integrin αvβ6 inhibition and decreased TGF-β signaling in the local bladder environment, with implications for epithelial proliferation and carcinogenesis.
Cannabidiol-induced transcriptomic changes and cellular senescence in human Sertoli cells
Authors: Li Yuxi , Li Xilin , Cournoyer Patrick , Choudhuri Supratim , Yu Xiaozhong , Guo Lei , Chen Si
Published: December 2022

Cannabidiol (CBD), one of the major cannabinoids in the plant Cannabis sativa L., is the active ingredient in a drug approved for the treatment of seizures associated with certain childhood-onset epileptic disorders. CBD has been shown to induce male reproductive toxicity in multiple animal models. We previously reported that CBD inhibits cellular proliferation in the mouse Sertoli cell line TM4 and in primary human Sertoli cells. In this study, using a transcriptomic approach with mRNA-sequencing analysis, we identified molecular mechanisms underlying CBD-induced cytotoxicity in primary human Sertoli cells. Analysis of differentially expressed genes demonstrated that DNA replication, cell cycle, and DNA repair were the most significantly affected pathways. We confirmed the concentration-dependent changes in the expression of key genes in these pathways using real-time PCR. mRNA sequencing showed upregulation of a group of genes tightly associated with the senescence-associated secretory phenotype (SASP) and with the activation of the p53 signaling pathway, a key upstream event in cellular senescence. Prolonged treatment of 10 μM CBD-induced cellular senescence, as evidenced by the stable cessation of proliferation and the activation of senescence-associated β-galactosidase (SA-β-gal), 2 hallmarks of senescence. Additionally, using real-time PCR and Western blotting assays, we observed that CBD treatment increased the expression of p16, an important marker of cellular senescence. Taken together, our results show that CBD exposure disturbs various interrelated signaling pathways and induces cellular senescence in primary human Sertoli cells.
EU energy governance—moving targets and flexible ambitions between opacity and opportunism?
Authors: Hancher Leigh
Published: December 2022

This article examines the robustness of the architecture of European energy and climate governance and the instruments developed to execute climate governance based on EU-wide targets and the ambition of ‘net-zero’ by 2050. Its primary focus is on the quality of the European energy and climate governance process.The Commission’s primary task is to monitor closely national efforts to achieve the EU’s binding targets for example on energy efficiency, greenhouse gas (GHG) emission reduction and renewables production, to report regularly on progress or lack thereof. Although a considerable literature on climate governance has now evolved its focus is primarily on the tools available to the Commission to realize the Union’s climate and energy governance strategy in the absence of legally binding national targets. Many important and central questions about this governance process remain largely unanswered and unresolved. Legally binding union-wide climate targets are embraced by the new EU Climate Law of 2021, and various measures to promote renewable energy, energy efficiency and emission reduction are expressed to be ‘legally binding’ on the European institutions. But what does this mean in practice – especially in the current ‘energy emergency’ situation? Are there any effective legal constraints if the Commission’s actions or its failure to act is likely to imperil the timely realization of these ‘binding’ European wide targets. The first part of this article analyses the climate and energy governance and assesses the Commission’s role and responsibilities. Two additional and inter-related instruments of European ‘net zero governance’ are dealt with in the second and third parts. These are the reliance on delegated acts (part two) and the use of state aid control (part three). The scope of the Commission’s discretion when drawing up delegated rules has become an essential element of the ‘net zero’ governance process. An assessment of the application of the Treaty state aid rules to national schemes to support fossil fuels provides useful legal as well as policy insights. It serves as an important testing ground for policy coherence and continuity in pursuing the Union’s climate goals. This assessment contributes to a practical appraisal of the quality of governance from the perspective of this article – in terms of the scope of discretion open to the Commission to continue to approve such subsidies even in the light of the Climate Law’s binding targets.
Artificially sweetened beverages and urinary incontinence—a secondary analysis of the Women's Health Initiative Observational Study
Authors: Ringel Nancy E. , Hovey Kathleen M. , Andrews Chris A. , Mossavar-Rahmani Yasmin , Shadyab Aladdin H. , Snetselaar Linda G. , Howard Barbara V. , Iglesia Cheryl B.
Published: December 2022

Objective

The aim of this study was to determine if higher artificially sweetened beverage intake is associated with higher prevalence of urinary incontinence symptoms.

Methods

We conducted a secondary analysis of data from the Women's Health Initiative Observational Study. Our analytic cohort included 80,388 women. Participants who answered questions about beverage consumption and urinary incontinence symptoms at a 3-year follow-up visit were included. Demographic characteristics were compared between three groups of beverage consumers: never to less than one serving per week, one to six servings per week, and greater than or equal to one serving per day. Multivariable logistic regression models were constructed to estimate odds and type of urinary incontinence and adjust for potential confounders.

Results

Most participants (64%) were rare consumers of artificially sweetened beverages, with 13% (n = 10,494) consuming greater than or equal to 1 serving per day. The unadjusted odds of reporting urinary incontinence were 10% to 12% higher in women consuming one to six servings per week (odds ratio [OR], 1.10; 95% CI, 1.06-1.14) or greater than or equal to one serving per day (OR, 1.12; 95% CI, 1.07-1.18) versus never to less than one serving per week. In multivariable analyses, women consuming greater than or equal to one serving per day (ref: never to <1 serving/wk) had 10% higher odds of reporting mixed urinary incontinence (OR, 1.10; 95% CI, 1.02-1.19). There were no significant differences for stress or urgency urinary incontinence symptoms between groups.

Conclusions

When compared to never to less than one serving per week, women consuming greater than or equal to one serving per day of artificially sweetened beverages had 10% greater odds of reporting mixed urinary incontinence after adjustments. Amount of artificially sweetened beverage consumption was not associated with stress or urgency urinary incontinence symptoms.
Smoking Cessation Interventions for Patients With Chronic Obstructive Pulmonary Disease
Authors: Coleman Sulamunn R. M. , Menson Katherine E. , Kaminsky David A. , Gaalema Diann E.
Published: December 2022

Purpose:

Reducing disease burden in patients with chronic obstructive pulmonary disease (COPD) focuses, in part, on helping patients become more functional through programs such as pulmonary rehabilitation (PR). Smoking cessation may be a prerequisite or component of PR, and determining which smoking interventions (eg, behavioral, pharmacotherapy, combination) are most effective can help guide efforts to extend them to patients with COPD. The purpose of this narrative review was to summarize evidence from studies testing smoking cessation interventions in patients with COPD and discuss how these interventions may be integrated into PR programs.

Review Methods:

Searches were conducted in the PubMed and Web of Science databases. Search terms included “(smoking cessation) AND (RCT OR clinical trial OR intervention) AND (pulmonary OR chronic bronchitis OR emphysema OR COPD).” Published original studies were included if they used a prospective, experimental design, tested a smoking cessation intervention, reported smoking cessation rate, and included patients with COPD or a subgroup analysis focused on smokers with COPD.

Twenty-seven distinct studies were included in the review. Most studies tested multitreatment smoking cessation interventions involving some form of counseling in combination with pharmacotherapy and/or health education. Overall, smoking cessation interventions may help promote higher rates of smoking abstinence in patients with COPD, particularly multifaceted interventions that include intensive counseling (eg, individual, group, and telephone support), smoking cessation medication or nicotine replacement therapy, and health education.
Effect of Left Ventricular Unloading by Pump Speed Adjustment on Myocardial Flow in Continuous-flow Left Ventricular Assist Device Patients
Authors: Yuzefpolskaya Melana , Ladanyi Annamaria , Bokhari Sabahat , Jorde Ulrich P. , Colombo Paolo C.
Published: December 2022

Resting myocardial blood flow (MBF) and myocardial flow reserve (MFR) are reduced in heart failure (HF) patients supported by pulsatile left ventricular assist devices (LVADs). The effect of continuous-flow (CF) physiology on these parameters is underexplored in CF-LVAD patients. We investigated the impact of CF-LVADs on resting MBF and MFR under two left ventricular (LV) loading conditions. Nine HeartMate II patients (42 ± 12 years, 100% male) on support for 370 ± 281 days were enrolled. Results were compared with 9 HF patients (58 ± 13 years, 67% male, LV ejection fraction 27 ± 9%) and 10 healthy volunteers (56 ± 10 years, 20% male). CF-LVAD patients underwent transthoracic echocardiography with ramp study. MBF and MFR were measured utilizing positron emission/computed tomography imaging under two LV loading conditions: “high-speed” (HS), promoting aortic valve (AV) closure and LV unloading; “low-speed” (LS), promoting AV opening and LV loading. Global resting MBF was similar in HS, LS, HF, and healthy: 0.8 ± 0.3, 0.7 ± 0.3, 0.7 ± 0.1, 0.9 ± 0.2 ml/min/g, respectively; p = NS. HS global MFR was reduced compared with LS and HF: 1.6 ± 0.6 versus 1.9 ± 0.5, p = 0.004; 1.6 ± 0.6 versus 2.4 ± 0.5, p = 0.01, respectively. HS regional MFR was reduced compared with LS in the left anterior descending (1.7 ± 0.7 vs. 2.0 ± 0.6, p = 0.027) and left circumflex (1.8 ± 0.7 vs. 2.2 ± 0.9, p = 0.008), but not in right coronary artery (1.7 ± 0.7 vs. 1.7 ± 0.6, p = 0.76). Resting MBF is preserved among CF-LVAD patients and is similar to HF and healthy. Promoting LV ventricular unloading with higher speed was associated with lower global and regional left coronary MFR, while right coronary MFR did not change.
One institutions’ experience with a true standard 15 mCi dose of I-131 for the treatment of Graves’ disease
Authors: Muhleman Mitchel A. , Fahim Ali , Benefield Thad , Oldan Jorge D. , Khandani Amir H.
Published: December 2022

Introduction

Currently, there is a lack of consensus on the fixed dosage of RAI to be administered for this purpose between the main guideline frameworks set forth by the American Thyroid Association (ATA), Society of Nuclear Medicine and Molecular Imaging (SNMMI), European Association of Nuclear Medicine (EANM) and the European Thyroid Association (ETA). In this retrospective study, we will investigate the effectiveness of using a standard dose of 15 mCi ±10% of RAI in the treatment of Graves’.

Methods

A retrospective chart review was conducted for the period between 1 May 2014 and 2 September 2020, to identify patients diagnosed with hyperthyroidism due to Graves’ disease. The patients were grouped based on outcome and assessed for the efficacy of the dosage of 15 mCi ±10% of RAI in a successful treatment.

Results

Sixty-seven patients were identified that met the inclusion criteria between 1 May 2014 and 2 September 2020. Of the 67 RAI ablations; 60 patients became hypothyroid [60/67, (89.55%)], 2 euthyroid [2/67, (2.99%)] and 5 remained hyperthyroid [5/67, (7.46%)].

Conclusions

For the treatment of Graves’ disease, the use of a standard low dose of 15 mCi ±10% has a high success rate without additional measurements or calculations beyond a standard planar image and 24-h uptake %. The adoption of a standard low dose of 15 mCi of I-131 across institutional guidelines would streamline dosage questions and eliminate the need to determine the weight of the thyroid for calculations in all RAI treatments for hyperthyroidism caused by Graves’ disease.
Influence of the methodological aspects of the dichotomization of total metabolic tumor volume measured through baseline fluorine-18 fluorodeoxyglucose PET on survival prediction in lymphoma
Authors: Lue Kun-Han , Chen Yu-Hung , Wu Yi-Feng , Liu Shu-Hsin
Published: December 2022

Objective

The total metabolic tumor volume (TMTV) measured from fluorine-18 fluorodeoxyglucose (18F-FDG) PET can be useful for determining the prognosis of patients with lymphoma. Stratifying patients into high- and low-TMTV risk groups requires a cutoff point, which is determined through the dichotomization method. This study investigated whether different TMTV dichotomization methods influenced survival prediction in patients with lymphoma.

Methods

We retrospectively enrolled 129 patients with lymphoma who had undergone baseline 18F-FDG PET. TMTV was calculated using a fixed standardized uptake value threshold of 4.0. A total of six methods were employed to determine the optimal TMTV cutoff point using receiver-operating characteristic curve analyses, X-Tile bioinformatics software, and the Cutoff Finder web application. The prognostic performance of each method in survival prediction was examined.

Results

The median (interquartile range) TMTV was 123 cm3 (21–335 cm3). The optimal TMTV cutoff values for predicting progression-free survival (PFS) and overall survival (OS) were in the range of 144–748 cm3. The cutoff points were used to dichotomize patients into two groups with distinct prognoses. All TMTV dichotomizations were significantly predictive of PFS and OS. The survival curves showed significant differences between the high- and low-TMTV groups. The C-indices of the survival models did not significantly differ in any of the dichotomizations.

Conclusion

The prognostic significance of TMTV was maintained regardless of the methodological aspects of dichotomization. However, the optimal TMTV cutoff point varied according to the chosen dichotomization method. Care should be taken when establishing an optimal TMTV cutoff point for clinical use.
Associations Between Dysfunctional Thoughts, Leisure Activities, and IL-6 in Caregivers of Family Members With Dementia
Authors: Vara-García Carlos , Romero-Moreno Rosa , Barrera-Caballero Samara , Pedroso-Chaparro María del Sequeros , Jiménez-Gonzalo Lucía , Olazarán Javier , Mausbach Brent , von Känel Roland , Losada-Baltar Andrés
Published: December 2022

Objective

Dementia caregiving is associated with negative physical health consequences, including inflammation processes. The objective of this study was to analyze the associations between dysfunctional thoughts, frequency of leisure activities, and interleukin 6 (IL-6) in a sample of dementia family caregivers.

Methods

One hundred forty dementia caregivers participated in this cross-sectional study. The relationships among caregivers’ dysfunctional thoughts, leisure activities, and IL-6 were adjusted for demographic characteristics, stressors, and physical and mental health indicators in a linear regression analysis.

Results

Higher levels of dysfunctional thoughts (t = −2.02, p = .045) were significantly associated with lower frequency of leisure activities. In turn, lower frequency of leisure activities was significantly associated with higher levels of IL-6 (t = −2.03, p = .045). Dysfunctional thoughts were no longer significantly associated with IL-6 levels when both dysfunctional thoughts and leisure activities were included in the same model (t = 1.78, p = .076). A significant indirect effect was found for the association between higher levels of dysfunctional thoughts and higher levels of IL-6 (standardized indirect effect = 0.036, bootstrap standard error = 0.026, 95% confidence interval = 0.0001–0.1000) through its association with fewer leisure activities.

Conclusions

Our findings suggest that the direct effect of caregivers’ dysfunctional thoughts on IL-6 may be mediated by the impact on caregivers’ frequency of leisure activities. Results suggest that training caregivers in reducing dysfunctional thoughts to thereby increase leisure activities may be useful in reducing inflammation.
Isolating the Effect of COVID-19-Related Disruptions on HIV Diagnoses in the United States in 2020
Authors: Viguerie Alex , Song Ruiguang , Johnson Anna Satcher , Lyles Cynthia M. , Hernandez Angela , Farnham Paul G.
Published: December 2022

Background:

Diagnoses of HIV in the United States decreased by 17% in 2020 due to COVID-related disruptions. The extent to which this decrease is attributable to changes in HIV testing versus HIV transmission is unclear. We seek to better understand this issue by analyzing the discrepancy in expected versus observed HIV diagnoses in 2020 among persons who acquired HIV between 2010 and 2019 because changes in diagnosis patterns in this cohort cannot be attributed to changes in transmission.

Methods:

We developed 3 methods based on the CD4-depletion model to estimate excess missed diagnoses in 2020 among persons with HIV (PWH) infected from 2010 to 2019. We stratified the results by transmission group, sex assigned at birth, race/ethnicity, and region to examine differences by group and confirm the reliability of our estimates. We performed similar analyses projecting diagnoses in 2019 among PWH infected from 2010 to 2018 to evaluate the accuracy of our methods against surveillance data.

Results:

There were approximately 3100–3300 (approximately 18%) fewer diagnoses than expected in 2020 among PWH infected from 2010 to 2019. Females (at birth), heterosexuals, persons who inject drugs, and Hispanic/Latino PWH missed diagnoses at higher levels than the overall population. Validation and stratification analyses confirmed the accuracy and reliability of our estimates.

Conclusions:

The substantial drop in number of previously infected PWH diagnosed in 2020 suggests that changes in testing played a substantial role in the observed decrease. Levels of missed diagnoses differed substantially across population subgroups. Increasing testing efforts and innovative strategies to reach undiagnosed PWH are needed to offset this diagnosis gap. These analyses may be used to inform future estimates of HIV transmission during the COVID-19 pandemic.
Sacrospinous Fixation and Vaginal Uterosacral Suspension—Evaluation in Uterine Preservation Surgery
Authors: Woodburn Katherine L. , Yuan Angela S. , Torosis Michele , Roberts Kasey , Ferrando Cecile A. , Gutman Robert E.
Published: December 2022

Importance

Vaginal hysteropexy can be performed via the uterosacral or the sacrospinous ligament(s), but little data exist comparing these routes.

Objective

The aim of the study was to compare prolapse recurrence, retreatment, and symptoms along with the incidence of adverse events between patients undergoing vaginal uterosacral hysteropexy and sacrospinous hysteropexy.

Study Design

This was a multicenter retrospective cohort study of patients who underwent vaginal uterosacral or sacrospinous hysteropexy (SSHP) between 2015 and 2019. Anatomic failure was the primary outcome, defined as prolapse beyond the hymen. Composite failure was defined as anatomic failure, bulge symptoms, and/or retreatment for prolapse.

Results

At 4 geographically diverse referral centers, 147 patients underwent SSHP and 114 underwent uterosacral hysteropexy. The 1-year follow-up rate was 32% (83/261) with no difference between groups. There were 10 (3.8%) anatomic failures: 3 (2%) sacrospinous and 7 (6.1%) uterosacral (P = 0.109). There was no difference in bulge symptoms (9.9%), composite failure (13%), or median prolapse stage (2).

The overall incidence of complications was low (7%; 95% confidence interval, 4.12%–10.43%) with a higher rate of ureteral kinking in the uterosacral group (7% vs 1.4%, P = 0.023). With a median follow-up of 17 months, 4.6% underwent subsequent hysterectomy and 6.5% had treatment for uterine/cervical pathology.

Conclusions

One year after hysteropexy, 1 in 3 patients were available for follow-up, and there were no differences in prolapse recurrence between patients who underwent uterosacral hysteropexy versus SSHP. The incidence of adverse events was low, and less than 5% of patients underwent subsequent hysterectomy for prolapse.
Kinship and similarity drive coordination of breeding-group choice in male spotted hyenas
Authors: Davidian Eve , Höner Oliver P.
Published: December 2022

When and where animals reproduce influences the social, demographic and genetic properties of the groups and populations they live in. We examined the extent to which male spotted hyenas (Crocuta crocuta) coordinate their breeding-group choice. We tested whether their propensity to settle in the same group is shaped by passive processes driven by similarities in their socio-ecological background and genotype or by an adaptive process driven by kin selection. We compared the choices of 148 pairs of same-cohort males that varied in similarity and kinship. We found strong support for both processes. Coordination was highest (70% of pairs) for littermates, who share most cumulative similarity, lower (36%) among peers born in the same group to different mothers, and lowest (7%) among strangers originating from different groups and mothers. Consistent with the kin selection hypothesis, the propensity to choose the same group was density dependent for full siblings and close kin, but not distant kin. Coordination increased as the number of breeding females and male competitors in social groups increased, i.e. when costs of kin competition over mates decreased and benefits of kin cooperation increased. Our results contrast with the traditional view that breeding-group choice and dispersal are predominantly solitary processes.
In vivo
measurement of human brain material properties under quasi-static loading
Authors: Bennion Nicholas J. , Zappalá Stefano , Potts Matthew , Woolley Max , Marshall David , Evans Sam L.
Published: December 2022

Computational modelling of the brain requires accurate representation of the tissues concerned. Mechanical testing has numerous challenges, in particular for low strain rates, like neurosurgery, where redistribution of fluid is biomechanically important. A finite-element (FE) model was generated in FEBio, incorporating a spring element/fluid–structure interaction representation of the pia–arachnoid complex (PAC). The model was loaded to represent gravity in prone and supine positions. Material parameter identification and sensitivity analysis were performed using statistical software, comparing the FE results to human
in vivo
measurements. Results for the brain Ogden parameters
µ
,
α
and
k
yielded values of 670 Pa, −19 and 148 kPa, supporting values reported in the literature. Values of the order of 1.2 MPa and 7.7 kPa were obtained for stiffness of the pia mater and out-of-plane tensile stiffness of the PAC, respectively. Positional brain shift was found to be non-rigid and largely driven by redistribution of fluid within the tissue. To the best of our knowledge, this is the first study using
in vivo
human data and gravitational loading in order to estimate the material properties of intracranial tissues. This model could now be applied to reduce the impact of positional brain shift in stereotactic neurosurgery.
Predicting phenotype transition probabilities via conditional algorithmic probability approximations
Authors: Dingle Kamaludin , Novev Javor K. , Ahnert Sebastian E. , Louis Ard A.
Published: December 2022

Unravelling the structure of genotype–phenotype (GP) maps is an important problem in biology. Recently, arguments inspired by algorithmic information theory (AIT) and Kolmogorov complexity have been invoked to uncover
simplicity bias
in GP maps, an exponentially decaying upper bound in phenotype probability with the increasing phenotype descriptional complexity. This means that phenotypes with many genotypes assigned via the GP map must be simple, while complex phenotypes must have few genotypes assigned. Here, we use similar arguments to bound the probability
P
(
x
→
y
) that phenotype
x
, upon random genetic mutation, transitions to phenotype
y
. The bound is

P
(
x
→
y
)
≲

2

−
a

K
~

(
y
|
x
)
−
b

, where

K
~

(
y
|
x
)

is the estimated conditional complexity of
y
given
x
, quantifying how much extra information is required to make
y
given access to
x
. This upper bound is related to the conditional form of algorithmic probability from AIT. We demonstrate the practical applicability of our derived bound by predicting phenotype transition probabilities (and other related quantities) in simulations of RNA and protein secondary structures. Our work contributes to a general mathematical understanding of GP maps and may facilitate the prediction of transition probabilities directly from examining phenotype themselves, without utilizing detailed knowledge of the GP map.
Evaluation of the ‘HG Group B Streptococcus’ loop-mediated isothermal amplification assay for accurate identification of Streptococcus agalactiae
Authors: van der Linden Mark , Jaschek Mareike , Junker Julia , Levina Natascha , Weidenhaupt Bruno
Published: December 2022

This study evaluated the HiberGene Group B Streptococcus test, a CE-IVD-approved molecular assay for rapid detection of

Streptococcus agalactiae

[Group B Streptococcus (GBS)] in human clinical specimens. Performance of the assay in terms of specificity, sensitivity and genotype inclusivity was investigated using an extended specificity panel of 113 human and animal GBS isolates, and eight isolates from other streptococcal species, from the isolate collection of the German National Reference Center for Streptococci. Broth cultures were tested according to the manufacturer’s protocol, including lysis, heat denaturation and isothermal amplification. All 104/104 (100 %) human GBS isolates of nine serotypes (Ia, Ib, II, III, IV, V, VI, VII, VIII and non-typeable) were correctly identified by the assay as GBS. Additionally, 7/9 (78 %) GBS isolates from elephants were also correctly identified. Six isolates of other streptococcal species/subspecies (

Streptococcus anginosus

,

S. constellatus

,

S. castoreus

,

S. dysgalactiae

and

S. dysgalactiae equisimilis

) were correctly reported as negative. Two

S. pyogenes

(Group A Streptococcus) isolates gave invalid results. The HG Group B Streptococcus assay identified human GBS isolates in culture with 100 % sensitivity.