bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding Patriarchal Ideology in Decision-Making on Induced Abortion in Jharkhand’s Korwa Tribe
Authors: Gupta Ujjwala
Published: June 2022

Abortion continues to be seen in many societies as an alternative method of contraception. It is a complex dynamic jumble in the patriarchal social structure where the concept of choice is not entirely in hands of women. Deciding to abort involves the interplay of social, cultural, family, and structural dynamics of traditional society. This article describes the study of one of Jharkhand’s primitive tribal communities in order to understand the dilemma that influences women to submit to abortion. Forty-one in-depth personal interviews were conducted with married women aged 13–49 years who were currently living with their husbands and had at least one living child. The interview guide included open-ended questions supported by prompts and the information collected during the discussions was carefully coded and analyzed by theme. The study assessed male hegemony over women’s sexuality expressed as a preference for the son that often triggered domestic violence. The choice to undergo abortion remained under the influence of asymmetric structure of patriarchal power as well as a number of other, juxtaposing social issues, including land rights and religious factors. The gender balance of power affects not only the determination of reproductive intentions but also the continuation or abandonment of reproductive outcomes. This reflects the need to include gender and cultural sensitivity in policies and programs of fertility control.
Liberalisation and Technological Accumulation Strategy in Industries from Developing Economies: An Analysis of Indian Capital Goods Manufacturing Firms
Authors: Kaur Swarnjeet , Mehta Swati
Published: June 2022

Technological accumulation is a complex process of correct mix of indigenous and/or imported technology, mainly for the firms belonging to developing economies after opening their economies. To understand these issues, the case of Indian capital goods industry is taken for the years 1994–1995 to 2015–2016. It was found that only 39% of the firms belonging to Indian capital goods sector are technologically active, that is, resorting to either embodied or disembodied technology acquisition. Multinomial logit model is estimated to find the impact of various variables in determining the strategy of technology accumulation. The factors such as age, size, technology spillovers and outward foreign direct investment were found to have a positive impact on the firms to resort to ‘indigenous R&D only’ as a strategy of technology accumulation. While ‘disembodied technology import only’ is influenced by factors like embodied and disembodied technology imports. However, strategy ‘both indigenous R&D and disembodied technology import’ is found to be influenced by foreign equity participation, mergers and acquisitions.
Nonsuicidal Self-injury in Southeast Asia: A Systematic Literature Review
Authors: Fernandez Janet Ann , Jaladin Rafidah Aga Mohd , Lau Poh Li
Published: June 2022

This article presents an overview on nonsuicidal self-injury in Southeast Asia. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted regarding self-injury in Southeast Asia. Seventeen studies eligible for inclusion were identified. Findings revealed that self-injury is most common among youth between the ages of 14 and 35 years old. The prevalence rates reported were from 7.1% to 11.4% in community samples and 20.7% to 75.9% in clinical samples. The most common function for self-injury is that it serves as an emotion regulation strategy, and the main causes appear to stem from individual (emotional dysregulation, low self-esteem, gender and psychiatric disorders) and environmental factors (childhood maltreatment, childhood neglect, parental invalidation and academic stress). Comorbidity with depressive disorders, adjustment disorders and anxiety disorders are most often reported. The paucity of studies with high heterogeneity calls for further research exploring self-injury which may inform better mental health practice and policymaking in Southeast Asia.
A man with difficulty dysphagia
Authors: Chen Po-An , Lee Yu-Hsuan , Huang Chun-Yen , Chu Sheng-En , Sim Shyh-Shyong , Sun Jen-Tang
Published: June 2022

A 50-year-old man with history of type II diabetic mellitus attended the emergency department with persistent foreign body sensation after swallowing a drug pill. He also had mild odynophagia. Tracing his history, it was found that he had progressive dysphagia in previous 2 months. There was no coughing or choking immediately after swallowing the pill and speech quality was normal. He denied weight loss in last 6 months. On physical examination, no palpable mass or thyroid goiter was noted. Laboratory data were in acceptable range. A point-of-care ultrasound with a linear probe over the patient’s neck was done. Later, computed tomography was done for confirming the diagnosis.
Pharmacy considerations: Use of anti-CD38 monoclonal antibodies in relapsed and/or refractory multiple myeloma
Authors: Shah Bhavesh , Gray Joy , Abraham Ivo , Chang Melody
Published: June 2022

Objective

This article reviews current evidence for the approved anti-CD38 monoclonal antibodies, isatuximab and daratumumab, for the treatment of patients with relapsed and/or refractory multiple myeloma (RRMM) and the implications for pharmacists.

Data sources

We conducted a literature search on PubMed/Medline and other sources using the drug names and the terms CD38, multiple myeloma, and pharmacists.

Data summary

Monoclonal antibodies targeting the CD38 transmembrane glycoprotein offer a promising treatment approach for patients with RRMM. Isatuximab and daratumumab bind to different epitopes on CD38. In this review, we describe the similarities and differences in their mechanism of action, regulatory labeling, and the current guidelines for isatuximab and daratumumab use in RRMM. We review the current evidence for the efficacy and safety of these agents in combination with pomalidomide or carfilzomib and dexamethasone from the landmark phase 3 clinical trials that led to their approval. We discuss key differences in the eligibility criteria between the clinical trials, and differences in dosing, administration, available formulations, and pre- and post-infusion medications for the two agents. We outline recent data from pharmacoeconomic analyses comparing the cost-effectiveness of isatuximab-based regimens with that of daratumumab-based regimens. A brief overview of other anti-CD38 agents in the pipeline for the treatment of patients with RRMM is presented.

Conclusions

Given that pharmacists play an integral role in driving cost-effective use of drugs without compromising efficacy and safety for the end user, educating pharmacists on the key differences between isatuximab and daratumumab can guide the selection of the appropriate anti-CD38 antibody.
Load share model based gear loss factor prediction in high contact ratio spur gear drive
Authors: Ravivarman R. , Prabhu Sekar R.
Published: June 2022

Gear loss factor is considered to be a crucial parameter, and is governed by factors like contact load, sliding velocity, contact ratio, etc. Sliding power loss is a function of the gear loss factor and friction coefficient. It depends on the contact tooth load and its contact surfaces. A small decline in the gear loss factor and variation in the friction coefficient reduces the energy consumption which improves gear efficiency significantly. Hence, accurate prediction of the gear loss factor is important. This paper deliberates on measuring the contact load of High Contact Ratio (HCR) non-standard gear drive, using the finite element contact model. The input for the gear loss factor is obtained from a 2D elastic contact model using ANSYS. In the previous works the load is considered as a rigid hypothetical element, but in the real case it is varying at each instantaneous contact point. To address this, a more accurate method of predicting the power loss using the contact load share model is proposed. The effectiveness of this technique, built on the computational data and its accuracy are examined. Based on the accuracy, the load share model was suggested to be the most effective one compared to other techniques. The results show that the proposed model provides an effective tool for making reliability assessments on power loss and efficiency of high contact ratio gear drives under diverse operating conditions.
Laser hexagonal texture on surface of Ti6Al4V for the improvement of fluid spreadability and tribological properties
Authors: Liu Qi , Yuan Hengdi , Jiang Sen , Ange Nsilani K , Li Jing , Liu Yang , Dong Guangneng
Published: June 2022

The joint capsule removal after artificial joint replacement surgery have led to improper lubrication, causing the pair to wear out quickly and reducing the joint lifespan. In this paper, laser processing and chemical corrosion were used to prepare a hexagonal convex texture on the surface of titanium alloy (Ti6Al4V). After etching and laser polishing, SEM images indicated the presence of secondary micro-nano textures in the grooves around the hexagonal texture, and the formation of anatase oxides on the surface, resulting in an increase of the surface energy and a very small contact angle (CA). The surfaces’ CA increases with the texture ratio, and the surface is super-hydrophilic when the texture ratio is less than 0.84. Furthermore, the effect of texture parameters and directions are studied by using UHMWPE and Ti6Al4V as friction pairs and simulated body fluid as lubricant. The COF is 0.068 with 0.84 area ratio, which is 51.4% lower than the original surface. The wear rate of UHMWPE on the textured surface decreases by 74.5% after two hours of tribological testing. In addition, high speed camera images and calculation results proved that creating grooves can promote fluid distribution on the textured surface. The surface texture on titanium alloy results in a significant COF and wear reduction, extending the service life of artificial joints.
Compositional tourists’ expenditure: Modeling through Dirichlet regression
Authors: Brida Juan Gabriel , Lanzilotta Bibiana , Moreno Leonardo
Published: June 2022

This study models the relative expenditure of tourists in terms of budget allocation according to their dependence on a group of covariates. A model that captures how tourist distributes its budget among the diverse items is introduced to characterize and compare different types of tourists according to their relative expenditure patterns. For the empirical exercise, data for the period 2014–2019 collected by the Ministry of Tourism from the Inbound Tourism survey in Uruguay is analyzed by means of the compositional data analysis and modeled by a Dirichlet regression. The empirical results show that the expending pattern in accommodation, food, and others items depend on the destination, the season, the nationality, and the type of accommodation. In addition, the inferential analysis reveals different typologies of tourist, providing a novel interpretation of the tourist behavior from the microeconomic perspective.

JEL ClassificationL83, Z30, C14.
The relationship of socio-demographic factors and patient attitudes to connected health technologies: A survey of stroke survivors
Authors: Drake Archie , Sassoon Isabel , Balatsoukas Panos , Porat Talya , Ashworth Mark , Wright Ellen , Curcin Vasa , Chapman Martin , Kokciyan Nadin , Modgil Sanjay , Sklar Elizabeth , Parsons Simon
Published: June 2022

More evidence is needed on technology implementation for remote monitoring and self-management across the various settings relevant to chronic conditions. This paper describes the findings of a survey designed to explore the relevance of socio-demographic factors to attitudes towards connected health technologies in a community of patients. Stroke survivors living in the UK were invited to answer questions about themselves and about their attitudes to a prototype remote monitoring and self-management app developed around their preferences. Eighty (80) responses were received and analysed, with limitations and results presented in full. Socio-demographic factors were not found to be associated with variations in participants’ willingness to use the system and attitudes to data sharing. Individuals’ levels of interest in relevant technology was suggested as a more important determinant of attitudes. These observations run against the grain of most relevant literature to date, and tend to underline the importance of prioritising patient-centred participatory research in efforts to advance connected health technologies.
Calcinosis universalis and breast cancer: A distinctive association
Authors: Nor Hashimah Abu Mansor Matardiah , Kan Sow Lai , Raymond Azman Ali
Published: June 2022

Calcinosis universalis (CU) is characterised by diffuse deposition of insoluble calcium salt in the skin, subcutaneous tissue or organs. Calcium deposits in the breast may be associated with an increased risk for developing breast cancer. We present a case of a 65-year-old woman diagnosed with CU secondary to undifferentiated connective tissue disease. She developed progressive calcification of her skin, which did not improve with oral medications aimed at reducing the calcification. Investigations to look for possible causes of calcification were all unremarkable. During follow-up, calcification was also found in both her breasts. Initial mammography was reported as fibroadenoma. However, 3 years later, she returned with metastatic breast cancer which presented with a massive pleural effusion of the right lung. Calcinosis universalis should now be considered as a risk factor for breast cancer.
A Pregnant Pause: System-Level Barriers to Perinatal Mental Health Care
Authors: Morain Stephanie R. , Fowler Leah R. , Boyd J. Wesley
Published: June 2022

Perinatal mood and anxiety disorders, defined as mood and anxiety disorders during pregnancy and the year following birth, affect one in five pregnant and postpartum individuals in the United States and are associated with substantial morbidity and mortality for both pregnant individuals and their infants. Despite this tremendous prevalence and associated disease burden, the overwhelming majority of those affected do not receive treatment. Although prior research has identified several patient-level barriers to effective treatment, the contributions of system-level factors have been underappreciated. We present a pilot study using a simulated patient approach to describe the accessibility and affordability of mental health care through the 18 clinics affiliated with U.S. reproductive psychiatry fellowship programs. Based on our experience, a prospective patient seeking care from these 18 clinics without a prior referral would only have been successful half of the time—and even then may have to wait as long as 2 months for an initial appointment. These data underscore the need for clinicians, public health professionals, and institutions to address system-level barriers that undermine effective referrals for care, including implementing “warm-handoffs” to mental health providers and ending practices that restrict appointments to existing patients within a health care system. They also reinforce the importance of contemporary federal policy efforts to address maternal health, particularly among low-income and racially minoritized communities. Key policies include expanding postpartum insurance coverage, which plays a critical role in reducing insurance disruptions that can undermine the accessibility of mental health care and other vital health services.
The Relationship Between Racial Attitudes and Perceived Economic Threat Among Whites: A Three Study Analysis
Authors: Lindsay Spencer
Published: June 2022

Multiple theoretical orientations propose a link between economic anxiety and racial attitudes. This article explores this link using three studies. The first study uses observational data from the 2016 CCES and ANES to determine whether or not anticipating a loss in income in the coming year is associated with negative racial affect. The second study uses observational data from the 2020 CCES to determine whether or not perceiving a greater risk of personal discrimination is associated with racial resentment. The last uses an original survey experiment from the 2020 CCES to gain insight into how priming intergroup competition shapes whites’ racial attitudes. These studies find an association between perceived economic threat and negative racial attitudes. However, the way respondents perceive economic threats seems to be largely shaped by partisan identification with Republicans perceiving greater levels of threat. They also suggest that material and symbolic threats may be mutually reinforcing. These findings support the claim that racial attitudes are deeply connected to economic anxieties and provide insight into how party identification shapes our psychology.
The Meaning of Public Safety
Authors: Fuentes Genesis
Published: June 2022

Christy E. Lopez joined the Georgetown faculty as a Distinguished Visitor from Practice in 2017, and was made Professor from Practice in 2020. From 2010 to 2017, Professor Lopez served as a Deputy Chief in the Special Litigation Section of the Civil Rights Division at the U.S. Department of Justice. She recently sat down for an interview with Contexts Managing Editor, Genesis Fuentes, to discuss her time at the Department of Justice where she was the primary drafter of the Ferguson Report.
Behind Gentrification’s Gloss
Authors: Duvisac Sara , Baiocchi Gianpaolo , Vantu Aviqail
Published: June 2022

Policy and scholarly debates on gentrification have mainly focused on displacement or improvements to neighborhood amenities. Less attention has been paid to actively worsening conditions for residents who don’t leave and for whom poor housing conditions are a perverse consequence of gentrification. Mapping city data on apartment code violations, we find that substandard housing conditions are surprisingly concentrated in gentrifying areas and not just low-income neighborhoods. Drawing on ethnographic observations our research finds that in gentrification while bringing new amenities to neighborhoods, can also give strong incentives to landlords to mistreat tenants in an attempt to drive them out intentionally.
Housing First is Not Enough
Authors: Grainger Garrett l.
Published: June 2022

This policy brief critically examines the Housing First turn in U.S. homeless policy. Housing First is a popular model of homeless services that rehouses people experiencing chronic homelessness without preconditions like sobriety, treatment, or employment. The Department of Housing and Urban Development promotes Housing First as an evidence-based practice that grantees should adopt. While I laud this as a step in the right direction, this paper identifies three shortcomings of Housing First that limit its ability to end chronic homelessness. I then discuss two supply-side interventions (i.e., tax credit expansion and integrated public housing) that can compensate for these shortcomings.
Early Results With a New Endovenous Radiofrequency Ablation Catheter, Venclose®
Authors: Vulakh Gennady , Segal Rianna , Hingorani Anil P. , Ascher Enrico , Marks Natalie
Published: June 2022

Objectives

Endovenous Radio-frequency Ablation (RFA) has become a common treatment for chronic venous insufficiency. The Medtronic® Closurefast catheter was previously the only RFA catheter approved for use in this procedure. In 2018 VenClose® Company’s new device was approved. As there has been little literature on this new device, we examined our results with this new alternative.

Methods

Patients with symptomatic venous insufficiency had their lower extremities mapped via ultrasound. If superficial reflux (>.5 s) was found the patients were recommended a 6-week conservative course of compression stockings, elevation, and NSAIDs. If conservative treatment failed, the patient was scheduled for an RFA. The procedure was done at the outpatient clinic, instructions were given to return for follow-up in 3-5 days, and every 3 months thereafter for the first year. 1032 procedures were performed over 14 months.

Results

We had 503 patients, 69% female, mean age 54 ± 12. Under the CEAP system, clinical manifestation portion, the majority of our limbs were class C3 and class C4. The majority of veins closed were GSV above knee and SSV. Follow-up duration ranged from 1 to 276 days (Mean (M) = 10 SD: 20 days). Our success rate was 99.32% at initial follow-up. We observed EHITs in 12 cases (1.16%), 8 of which were class I, 2 of which were class II, and 2 of which were class III. We noted SVTs of proximal varicose veins in 40 cases (3.88%) and SVT of distal GSV in 4 cases (.38%). There were 4 (.38%) cases of DVT, 3 in calf muscular veins (.29%), and one in a perforator vein (.09%). We observed two cases of puncture abscess (.193%), 8 cases of infection at the puncture site (.77%), with 8 infections occurring at locations other than the puncture site and not as a result of the procedure.

Conclusion

These preliminary results indicate that this new machine and catheter are promising with low rates of EHIT, recanalizations, and other complications. It is important to research this catheter and further studies should continue to follow up to examine recanalization rates over a more long-term follow-up.
A Comprehensive Meta-Analyses of the Nomological Network of Psychological Capital (PsyCap)
Authors: Loghman Saeed , Quinn Michael , Dawkins Sarah , Woods Megan , Om Sharma Sumeet , Scott Jenn
Published: June 2022

This paper presents the most rigorous meta-analysis undertaken to date of empirical literature examining antecedents and outcomes related to psychological capital (PsyCap), and moderators of these relationships. We investigated seven leadership styles as antecedents of PsyCap (authentic, ethical, servant, empowering, transactional, transformational, and abusive leadership), five outcomes (burnout, turnover intentions, work engagement, performance, and satisfaction), and the impact of four moderators (country of sample origin, cultural characteristics, industry type, and research design). Our analysis of PsyCap research (2007–2020) examined 244 studies (254 independent samples and over 96000 participants), which is over twice as large as previous PsyCap meta-analyses. To optimize the quality and reliability of findings, we corrected for artefacts and included heterogeneity, sensitivity, and publication bias analyses. Our results provide several new findings beyond previous PsyCap meta-analyses. We found that empowering, servant, transformational, and transactional leadership were all positively associated with PsyCap, with empowering and transformational leadership being the strongest antecedents of PsyCap and abusive and transactional leadership being the weakest. The findings demonstrated PsyCap was positively associated with work engagement, and negatively associated with burnout. Country of sample origin moderated all the relationships, except for servant and transactional leadership. Additionally, cultural characteristics (e.g., power distance, masculinity, long-term orientation, and uncertainty avoidance) moderated several conceptual relationships. Study design was also found to moderate the PsyCap—work engagement relationship. Collectively, these findings offer new and extended insights into the antecedents, outcomes, and moderators related to PsyCap, beyond previous meta-analyses. The theoretical and practical implications of these new findings are also discussed.
Immunoinflammatory and vascular inflammatory factors can be potential disease biomarkers of age-related hearing loss
Authors: Jeong Junhui , Han Ji Hyuk , Choi Hyun Seung , Moon In Seok
Published: June 2022

Objectives: The relationship between age-related diseases and chronic inflammation associated with aging has recently been investigated. This study aimed to investigate how chronic inflammation is associated with age-related hearing loss (ARHL). Methods: Twenty ARHL patients aged ≥65 years were prospectively enrolled from July 1 to 31 December 2015. Audiological tests and serological tests, such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), immunoglobulin G (IgG), interleukin 6 (IL-6), white blood cell (WBC) counts, neutrophil counts, lymphocyte counts, and platelet counts, were performed. The patients were divided into two groups: mild hearing loss group (n = 7) and moderate to profound hearing loss group (n = 13). Results: Immunoinflammatory biomarkers, such as CRP, ESR, and IL-6, and vascular inflammatory biomarkers, such as neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio, were higher in the moderate to profound hearing loss group. IgG, WBC counts, and neutrophil counts were similar in both groups. Conclusion: The present preliminary pilot study demonstrated that high levels of inflammatory biomarkers may be associated with ARHL. The results suggest a possible association between chronic inflammation and ARHL. Further well-designed studies of ARHL, based on a new perspective of chronic inflammation, should be performed.
Management of varices and variceal hemorrhage in liver cirrhosis: a recent update
Authors: Diaz-Soto Maria P. , Garcia-Tsao Guadalupe
Published: June 2022

Cirrhosis consists of two main stages: compensated (asymptomatic) and decompensated, the latter with a higher mortality. Variceal hemorrhage, together with ascites or encephalopathy, or both, are events that define cirrhosis decompensation and are driven by portal hypertension. The approach and management of patients with compensated cirrhosis has been mostly focused on preventing variceal hemorrhage in those who have high-risk varices on endoscopy. Recent studies suggest a paradigm shift aimed at preventing all decompensating events, not only variceal hemorrhage, in patients with cirrhosis and clinically significant portal hypertension identified via noninvasive measures such as liver stiffness and platelet count. In these patients, nonselective beta-blockers have been shown to prevent ascites (the most common decompensating event) and variceal growth. Variceal hemorrhage has a high mortality rate and even though advances in diagnostic approach and standard of care over the past decades have led to a decrease in mortality, it is still high with a 6-week mortality rate of 15–20%. Survival has improved with the preemptive placement of the transjugular intrahepatic portosystemic shunt in patients at high risk of failing standard therapy. In this review, we provide an overview of the pathophysiology and bases for therapy of portal hypertension and varices, the diagnostic approach and management of compensated cirrhosis with clinically significant portal hypertension, and the management of acute variceal hemorrhage as well as prevention strategies for variceal hemorrhage recurrence.
Propionic acid beneficially modifies osteoporosis biomarkers in patients with multiple sclerosis
Authors: Duscha Alexander , Hegelmaier Tobias , Dürholz Kerstin , Desel Christiane , Gold Ralf , Zaiss Mario M. , Haghikia Aiden
Published: June 2022

Background:

The impact of the gut and its microbiota are increasingly appreciated in health and disease. Short-chain fatty acids (SCFAs) are among the main metabolites synthesized from bacterial fermentation. Recently, we showed the anti-inflammatory and potentially neuroprotective effect of propionic acid (PA) in multiple sclerosis (MS). Osteoporosis is one of the most common co-morbidities for MS patients with limited therapeutic options available. Osteoporosis is closely linked to an imbalance of cells of the immune system and an immune-mediated impact on bone structure via the gut has been shown. Interestingly, intake of SCFA leads to bone mass increase and concomitant reduction of inflammation-induced bone loss in mice.

Objective:

To determine the impact of PA supplementation on markers of bone metabolism in MS patients.

Methods:

We investigated the influence of 14 days supplementation with PA on bone metabolism in 20 MS patients. To this end, β-CrossLaps and osteocalcin, established markers of bone metabolism, were measured in serum before and after PA intake and correlated with phenotypic and functional immunodata.

Results:

Supplementation with PA induced a significant increase in serum levels of osteocalcin, a surrogate marker for bone formation. Levels of β-CrossLaps, a marker for bone resorption, were significantly decreased after therapy. Regulatory T-cell (Treg) numbers and suppressive capacity positively correlated with serum levels of osteocalcin while Th17 cell numbers showed an inverse correlation. Our findings are in line with animal studies showing that SCFA induced increased bone formation and reduced bone resorption.

Conclusion:

In addition to its immune regulatory, disease-modifying effect on MS disease course, supplementation with PA beneficially influences serum levels of β-CrossLaps and osteocalcin and may thus also protect against osteoporosis, a common co-morbidity in MS.
RET kinase inhibitors for RET-altered thyroid cancers
Authors: Vodopivec Danica M. , Hu Mimi I.
Published: June 2022

Precision oncology has opened a new era in cancer treatment focused on targeting specific cellular pathways directly involved in tumorigenesis. The REarrangement during Transfection ( RET) proto-oncogene is involved in the pathogenesis of various thyroid cancer subtypes. Mutations in RET give rise to both hereditary and sporadic medullary thyroid cancer (MTC). RET fusions are found in follicular cell-derived thyroid cancers (papillary, poorly differentiated, and anaplastic). Hence, drugs that block the RET tyrosine kinase receptor have been explored in the management of locally advanced or metastatic thyroid cancer. The multikinase inhibitors (MKIs) with nonselective RET inhibition are sorafenib, lenvatinib, vandetanib, cabozantinib, and sunitinib. Although the efficacy of these drugs varies, a major issue is the lack of specificity resulting in a higher rate of drug-related toxicities, leading to dose reduction, interruption, or discontinuation. Moreover, MKIs are subject to drug resistance by RET Val804 residue gatekeeper mutations. In phase I/II clinical studies, the highly selective first-generation RET inhibitors, selpercatinib and pralsetinib, demonstrate high efficacy in controlling disease even in the presence of gatekeeper mutations combined with greater tolerability. However, resistance mechanisms such as RET solvent front mutations (SFMs) have evolved in some patients, giving the need to develop the selective second-generation RET inhibitors. Although the approval of selpercatinib and pralsetinib in 2020 has profoundly benefited patients with RET-altered thyroid cancer, further research into optimal treatment strategies, mechanisms of drug resistance, long-term consequences of potent RET-inhibition, and development of more effective agents against emergent mutations are much needed.
Management and outcomes of catatonia: A prospective study in urban South Africa
Authors: Zingela Zukiswa , Stroud Louise , Cronje Johan , Fink Max , van Wyk Stephan
Published: June 2022

Objectives:

Rapid intervention for catatonia with benzodiazepines and electroconvulsive therapy can prevent fatal complications. We describe the management and treatment response of 44 patients with catatonia in a psychiatric unit in urban South Africa. The objective was to screen admissions for catatonia and investigate management, treatment response, and treatment outcomes.

Method:

We used a prospective, descriptive, observational study design and collected data using a data collection sheet, the Bush Francis Catatonia Screening Instrument, the Bush Francis Catatonia Rating Scale, and the Diagnostic Statistical Manual-5 to assess catatonia in new admissions from September 2020 to August 2021.

Results:

Of the 241 participants screened on admission, 44 (18.3% of 241) screened positive for catatonia on the Bush Francis Catatonia Screening Instrument, while 197 (81.7% of 241) did not. Thirty-eight (86.4% of 44) received lorazepam, seven (15.9%) received clonazepam, and two (4.6%) received diazepam, implying that three (6.8%) of the 44 participants with catatonia received more than one benzodiazepine sequentially. Ten (22.7% of 44) patients received electroconvulsive therapy. Seven of those treated with electroconvulsive therapy (15.9% of 44 and 70% of 10) responded well and were discharged, whereas 22 (50% of 44 and 64.7% of 34) of those given lorazepam were discharged. Patients treated with electroconvulsive therapy had a higher initial Bush Francis Catatonia Rating Scale score. One patient (2.3%) relapsed within 4 weeks of discharge. Twenty (45.5%) of the 44 patients with catatonia had low average iron levels, 14 (31.8%) had low vitamin B12, and 24 (54.6%) had high creatinine kinase.

Conclusion:

Both lorazepam and electroconvulsive therapy were found to be effective treatments for catatonia with good response and outcomes. The length of hospital stay of patients with catatonia was similar to that of patients without catatonia. Treatment guidelines for catatonia need to include the role and timing of electroconvulsive therapy to augment current treatment protocols for the use of lorazepam.
Acute nephrotic-range glomerular proteinuria following ibuprofen intoxication in two cats
Authors: Herrero Yaiza , Iannucci Claudia , Schreiber Nora , Hansen Bernard D , Vigani Alessio
Published: June 2022

Case series summary

In this report we describe the origin of protein loss and development of acute kidney injury after ibuprofen intoxication in two cats. Two 13-month-old neutered male domestic shorthair siblings were presented with acute kidney injury (AKI) and severe glomerular proteinuria following witnessed ibuprofen intoxication 3 days prior. Both cats presented with severe azotaemia (creatinine >900 µmol/l [>10 mg/dl]) and severe proteinuria (urine protein:creatinine [UPC] >20, normal <0.5). Urine protein electrophoresis upon presentation revealed mainly albumin and primary glomerular protein losses. The proteinuria and azotaemia resolved completely within 5 days of hospital treatment (8 days after ingestion). Urine protein electrophoresis, once the azotaemia and proteinuria resolved (UPC 0.11; normal <0.5), had a similar pattern to the one from admission. Both cats made a full recovery with supportive care.

Relevance and novel information

This is the first clinical report of AKI with nephrotic-range protein losses following ibuprofen intoxication in cats. We propose that this finding is due to idiosyncratic glomerular injury, as described in humans.
NTRK1-related Hereditary Sensory and Autonomic Neuropathy Type 4: The Role of the Histamine Challenge Test
Authors: Mirchi Amytice , Richer Julie , Oskoui Maryam , McMillan Hugh J.
Published: June 2022

Hereditary sensory and autonomic neuropathies (HSAN) are rare, genetically inherited disorders characterized by impaired unmyelinated nerve fiber function. Here we report a patient with self-mutilation behavior and decreased response to pain, suggestive of an underlying small fiber neuropathy. Nerve conduction studies were normal but sympathetic skin response was absent at the left arm. Intradermal histamine challenge test was performed to evaluate the function of small unmyelinated nerve fibers and revealed absence of a flare response. Using whole genome sequencing, a novel variant in the neurotrophic tyrosine kinase type 1 gene was identified, expanding the known disease-causing variants associated with HSAN type 4. Through this case, we demonstrate the role of the histamine challenge test in patients suspected to have a small fiber neuropathy where electrophysiological testing may be normal and who may present with non-specific symptoms including hypotonia and failure to thrive. The information gained can guide genetic testing and contribute to interpretation of new variants identified.
Nicholas H. A. Evans, Far from the Caliph’s Gaze: Being Ahmadi Muslim in the Holy City of Qadian
Authors: Ahmed Suhail
Published: June 2022

Nicholas H. A. Evans, Far from the Caliph’s Gaze: Being Ahmadi Muslim in the Holy City of Qadian (Ithaca: Cornell University Press, 2020), 240 pp. US$125, ISBN: 9781501715686 (Hardback).
A UK qualitative study of living and dying with dementia in the last year of life
Authors: Crowther Jacqueline , Horton Siobhan , Wilson Kenneth , Lloyd-Williams Mari
Published: June 2022

Background:

Dementia is a life-limiting illness, but the trajectory of dying can be difficult to establish and care at end of life can be variable and problematic.

Methods:

This UK study was carried out to explore the end-of-life-care experiences of people with dementia from the perspective of their family carers. In-depth interviews were conducted with 40 bereaved family carers of people with dementia.

Results:

Forty family carers (male n = 9, female n = 31) age range: 18–86 years were interviewed. Issues with poor communication were common. The hard work of caring and issues regarding unpredictability of living and dying with dementia were also commonplace within the study. Only three patients were referred for specialist palliative care support at the end of life, all of whom had a dual diagnosis of dementia and cancer.

Conclusion:

This qualitative study has identified that there are several gaps in the end-of-life care of people with dementia, and frequently, there is poor communication during the last year of life. The need for high-quality integrated care for people dying with dementia with appropriate support during the last year of life is identified. COVID-19 has disproportionately affected people with dementia, and in the post-pandemic era, there is an urgent need to ensure every person dying with dementia is supported to die in their preferred place and that family members are supported and enabled to be treated as the ‘expert’ in terms of their knowledge of their relatives’ care and preferences.
Early Sonographic Detection of Gallbladder Carcinoma Can Improve Patient Outcomes: A Case Report
Authors: Kimbrow Lori A. , Smith Lela
Published: June 2022

Gallbladder carcinoma (GBC) is a lethal and rare disease despite it being the most common malignancy of the biliary tract. Most cases of GBC are also associated with cholelithiasis and inflammation. The poor prognosis of GBC is mainly due to a lack of symptoms in the early stages of the disease. Early detection and cholecystectomy can lead to a higher survival rate when the cancer is confined to the gallbladder mucosa. This case study describes a man in his late 50s who presented with elevated liver function tests and was diagnosed incidentally with GBC with sonography.
Predicting the Outcome of a Pregnancy of Unknown Location: What Can the Endometrial Stripe Thickness Reveal?
Authors: Hajiahmadi Somayeh , Adibi Atoosa , Mosavi Sardashti Golnar , Rasti Sina
Published: June 2022

Objective:

To investigate the role of the uterine endometrial thickness and sonographic pattern as potential predictors for a pregnancy with an unknown location (PUL) and its possible outcomes.

Materials and Methods:

A convenient sample of 330 symptomatic extra preposition female patients were enrolled in this study with a diagnosis of PUL. The clinical variables of endometrial stripe thickness and endometrial sonographic pattern were determined with transvaginal sonography. These sonographic examinations (it seems that examination in this context is a countable noun) were conducted during the first 24 hours of referral, and their predictive values for PUL outcomes (normal intrauterine pregnancy (IUP), ectopic pregnancy (EP), and pregnancy loss) were assessed after clinical follow-up sessions provided a definite outcome. The statistical significance was set a priori at a P value < .05.

Results:

The mean initial endometrial stripe thickness among participants, with a normal IUP, was more than those patients with an abnormal pregnancy outcome ( P < .05). The optimum cut-off value for predicting a an EP, compared to a normal IUP was 11 mm and had a sensitivity of 73.3% and specificity of 39% ( P < .001). These results also demonstrated no statistically significant relationship between the PUL outcome and the categories of endometrial sonographic pattern ( P = .15).

Conclusion:

In this large cohort of patients, the endometrial stripe thickness of more than 11 mm, among those who were symptomatic and deemed as PUL, had the potential to predict ectopic pregnancy as an unlikely diagnosis.
Pevonedistat plus azacitidine vs azacitidine alone in higher-risk MDS/chronic myelomonocytic leukemia or low-blast-percentage AML
Authors: Adès Lionel , Girshova Larisa , Doronin Vadim A. , Díez-Campelo María , Valcárcel David , Kambhampati Suman , Viniou Nora-Athina , Woszczyk Dariusz , De Paz Arias Raquel , Symeonidis Argiris , Anagnostopoulos Achilles , Munhoz Eduardo Ciliao , Platzbecker Uwe , Santini Valeria , Fram Robert J. , Yuan Ying , Friedlander Sharon , Faller Douglas V. , Sekeres Mikkael A.
Published: June 2022

PANTHER is a global, randomized phase 3 trial of pevonedistat+azacitidine (n = 227) vs azacitidine monotherapy (n = 227) in patients with newly diagnosed higher-risk myelodysplastic syndromes (MDS; n = 324), higher-risk chronic myelomonocytic leukemia (n = 27), or acute myeloid leukemia (AML) with 20% to 30% blasts (n = 103). The primary end point was event-free survival (EFS). In the intent-to-treat population, the median EFS was 17.7 months with pevonedistat+azacitidine vs 15.7 months with azacitidine (hazard ratio [HR], 0.968; 95% confidence interval [CI], 0.757-1.238; P = .557) and in the higher-risk MDS cohort, median EFS was 19.2 vs 15.6 months (HR, 0.887; 95% CI, 0.659-1.193; P = .431). Median overall survival (OS) in the higher-risk MDS cohort was 21.6 vs 17.5 months (HR, 0.785; P = .092), and in patients with AML with 20% to 30% blasts was 14.5 vs 14.7 months (HR, 1.107; P = .664). In a post hoc analysis, median OS in the higher-risk MDS cohort for patients receiving >3 cycles was 23.8 vs 20.6 months (P = .021) and for >6 cycles was 27.1 vs 22.5 months (P = .008). No new safety signals were identified, and the azacitidine dose intensity was maintained. Common hematologic grade ≥3 treatment emergent adverse events were anemia (33% vs 34%), neutropenia (31% vs 33%), and thrombocytopenia (30% vs 30%). These results underscore the importance of large, randomized controlled trials in these heterogeneous myeloid diseases and the value of continuing therapy for >3 cycles. The trial was registered on clinicaltrials.gov as #NCT03268954.
D-dimer and risk for thrombosis in adults with newly diagnosed acute lymphoblastic leukemia
Authors: Anderson Daniela R. , Stock Wendy , Karrison Theodore G. , Leader Avi
Published: June 2022

Patients with acute lymphoblastic leukemia (ALL) are at increased risk of thrombotic and/or bleeding events during early chemotherapy, especially when receiving asparaginase. D-dimer is a marker of fibrinolysis that has been associated with thrombotic risk in solid cancers and acute myeloid leukemia; however, to date, no ALL-based study has assessed D-dimer level and risk for thrombosis. We sought to examine D-dimer as a biomarker for risk of thrombosis or bleeding during ALL treatment in a retrospective cohort study at The University of Chicago. We identified 61 consecutive adult patients with ALL, gathering demographic characteristics, treatment regimens, initial biomarkers including D-dimer, and assessing occurrence of venous or arterial thrombosis and bleeding in the first 100 days after diagnosis (index). The 100-day cumulative incidence (95% confidence interval [CI]) of venous or arterial thrombosis in patients with high D-dimer (≥4 µg/mL) was 52.9% (95% CI, 26.4-73.8) compared with 13.8% (95% CI, 5.5-25.7) in patients with low to moderate D-dimer (<4 µg/mL), corresponding with a hazard ratio of 5.04 (95% CI, 1.79-14.22). When testing for potential confounders in a series of bivariate logistic regression models, the association between D-dimer and thrombosis remained after adjusting for body mass index, age, sex, asparaginase treatment, disseminated intravascular coagulation score, initial platelet level, and ALL phenotype. In conclusion, D-dimer levels at ALL diagnosis are associated with venous or arterial thrombosis at 100 days. Future studies should include D-dimer collated with other known risk factors to build a risk assessment model for thrombosis in patients with newly diagnosed ALL.
CD58 loss in tumor cells confers functional impairment of CAR T cells
Authors: Yan Xin , Chen Deyun , Ma Xinran , Wang Yao , Guo Yelei , Wei Jianshu , Tong Chuan , Zhu Qi , Lu Yuting , Yu Yang , Wu Zhiqiang , Han Weidong
Published: June 2022

Chimeric antigen receptor (CAR) T-cell therapy has achieved significant success in treating a variety of hematologic malignancies, but resistance to this treatment in some patients limited its wider application. Using an unbiased genome-wide clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 (Cas9) screening, we identified and validated loss of CD58 conferred immune evasion from CAR T cells in vitro and in vivo. CD58 is a ligand of the T-cell costimulatory molecule CD2, and CD58 mutation or downregulated expression is common in hematological tumors. We found that disruption of CD58 in tumor cells induced the formation of suboptimal immunological synapse (IS) with CAR T cells, which conferred functional impairment of CAR T cells, including the attenuation of cell expansion, degranulation, cytokine secretion, and cytotoxicity. In summary, we describe a potential mechanism of tumor-intrinsic resistance to CAR T-cell therapy and suggest that this mechanism may be leveraged for developing therapeutic strategies to overcome resistance to CAR T-cell therapy in B-cell malignancies.
Clear cell adenocarcinoma of the male urethra: a case report
Authors: Adebayo Sikiru A. , Chibuzo Ijeoma N. C. , Takure Augustine O. , Ifeh Marcus O. , Adeoye Adewunmi O. , Omenai Sebastian A. , Shittu Olayiwola B.
Published: June 2022

Background

Primary urethral cancer in males is rare. Clear cell adenocarcinoma is more rare. We report a case in an African male suspected to have a urethral stricture.

Case presentation

A 66-year-old man presented in with preceding intermittent haematuria and acute urinary retention. Failed attempts at catheterisation necessitating a suprapubic catheter insertion raised the suspicion of a urethral stricture. Multiple irregular urethral filling defects were seen on a retrograde urethrogram. Urethroscopy revealed obstructing urethral masses. Histology reported clear cell adenocarcinoma.

Conclusion

Primary urethral cancer should be entertained as a differential diagnosis of a urethral stricture in a patient with haematuria, difficult urethral catheterisation and ambiguous urethrogram findings. Cystoscopy and biopsy are essential in the investigative work-up to make the distinction.
The periodicity and initial evolution of micro-mobility systems: a case study of the docked bike-sharing system in New York City, USA
Authors: Zhang Liye , Song Jie
Published: June 2022

Objectives

This study developed an analytical framework that aims at understanding the evolutionary processes of a micro-mobility system (for example, bike-sharing), which offers insights into the transforming nature of a city transport system.

Methods

Firstly, the framework applied a Gaussian Mixture Model to examine the long-term fluctuations of travel demands. Secondly, it investigated the growth trajectories of service points via exponential and logistic growth models. Cumulative connections with other points represented the growth of a service location. An eigendecomposition approach was used to uncover the hidden structures behind the growth curves.

Results

This framework was applied in the docked bike-sharing program in New York City, USA. The results show that there existed periodic patterns of travel demands in the long term. The majority of stations grew rapidly after they began to operate. However, the temporal signatures of stations’ growth displayed some variations across different locations.

Conclusion

This proposed workflow can be employed in other cities with similar context to better investigate how micro-mobility systems evolve.