bluuebunny/crossref_metadata_2025 huggingface dataset:
News is “toxic”: Exploring the non-sharing of news online
Authors: Mathews Nick , Bélair-Gagnon Valérie , Lewis Seth C
Published: October 2022

Sharing is a central activity on social media platforms and a key component in crafting one’s self-presentation online. In the context of news, user-driven sharing is seen as vital to the success of digital journalism. While research has examined why people choose to share news online, much less is known about non-sharing—that is, why people may be reluctant to share, and what that determination suggests about the nature of news and self-presentation. We examine qualitative interview responses from a cross-section of US news consumers to investigate this question. We find that non-sharers tend to believe that news is “toxic” and potentially damaging to their reputations as well as their relationships. Not sharing news is a protective mechanism for identity maintenance, even as it brings worries about one’s voice being silenced in the process.
Tensions as opportunities for transformation: Applying DisCrit Resistance to early childhood teacher education programs
Authors: Love Hailey R , Hancock Christine L
Published: October 2022

Efforts to “professionalize” early childhood through professional standards, licensure requirements, and standardized assessments have aimed to support effective practice and rectify the pay inequities experienced by early educators. However, such initiatives can inadvertently reinforce hegemonic developmentalism and have largely served to advance white, able-bodied norms and narrow views of teaching and learning. Teacher educators endeavoring to combat racism and ableism, therefore, can encounter several tensions that result from trying to apply critical perspectives while preparing pre-service teachers for graduation and certification in the current personnel preparation landscape. In this article, the authors employ Disability Critical Race Theory (DisCrit) Resistance to explore these tensions and offer potential ways they can serve as key opportunities for supporting equity. They discuss how teacher educators can enact DisCrit Curriculum, Pedagogy, and Solidarity to diversify the knowledge(s) that are represented in content; center and affirm the identities and gifts of multiply marginalized teachers of color; and disrupt power hierarchies to honor relationships and interdependence.
Dadkhah mothers of Iran, from Khavaran to Aban: digital dadkhahi and transnational coalitional mothering
Authors: Khosravi Ooryad Sama
Published: October 2022

This article offers a theoretical account of the figure of the ‘Dadkhah mother’, the ‘justice-seeking mother’, by highlighting her historical, political and feminist significance in contemporary Iran and beyond. By drawing on a conceptual analysis of visual images, oral and written history and social media posts, I outline the key qualities of the figure of the Dadkhah mother and her longstanding activism and solidarity-building practices. I elaborate on what I call ‘transnational coalitional mothering’ and ‘digital dadkhahi’. The article builds on feminist theorisations of mothering, resistance, affective (mediated) solidarity and conditions of (un)grievability to argue that the multiple mediatised, resistant and coalitional strategies of the Dadkhah mothers of Iran offer radical alternative modes of thinking about mothering and (elderly) women's resistance. Such modes acknowledge these women's undeniable contribution to activism and to doing gender and politics across borders, beyond patriarchal motherhood, familial kinship ties, Western-centric co-optive voices and hierarchical framings, and in direct opposition to authoritarian spatiotemporal nation-building myths and impositions.
Prediction and effect analysis for equilibrium profile of flexible porous canopy fabric
Authors: Zhang SiYu , Sun ZhiHong , Yu Li
Published: October 2022

Parachute is decelerator constructed of flexible porous fabrics that changes the motion state of the payload, aerodynamic characteristic in steady descent of which largely depends on equilibrium profile. A novel analytical method to predict the equilibrium profile of flexible porous canopy fabrics in steady decelerating stage is presented. This method introduces Forchheimer’s law and Ergun theory into Ross mechanical equilibrium model, and further considering both the flight status and the materials properties. The prediction error of projection radius of gore centreline is 3.83% compared with the airdrop test results, and the prediction errors of the projection radius of cord and gore centreline are 1.09% and 0.66% respectively compared with Fluid-Structure Interaction method. Results indicate that this proposed method can be an efficient way to obtain an accurate canopy profile with much less computation cost. Finally, some illustrative examples are given to evaluate the effect of structural parameters on the parachute equilibrium profile. It is found that the length of the suspension line should be somewhat longer than the nominal diameter and the spacing of suspension lines should be slightly longer than 1m. And it is recommended that the radius of apex vent should be 0.04 ∼ 0.1 times of the nominal radius of the parachute. The Young’s modulus of materials has little effect on the equilibrium profile. Overall, the new approach could predict the canopy profile quickly for the parachute design and provide an accurate shape basis for the subsequent aerodynamic research based on CFD method.
Modeling and optimization of the core-shell nanofibrous composite mat as a scaffold via hybrid models
Authors: Haghdoost Fatemeh , Razbin Milad , Bahrami Hajir , Barzin Jalal , Ghaee Azadeh
Published: October 2022

It has been a challenging subject for researchers to manipulate the electrospinning key factors to achieve a composite nanofiber with proper properties. In this study, an experiment according to central composite design to investigate the effect of parameters including polyvinylpyrrolidone concentration, zeolite concentration, voltage, core flow rate and shell flow rate on diameter, maximum strength and porosity of polyethersulfone/polyvinylpyrrolidone/zeolite core-shell composite nanofiber has been designed. Later on, two sets of models consisting of response surface methodology and artificial neural network are trained. Then, their performance was evaluated based on the definition of a novel goodness function. In the next step, the genetic algorithm is used to find the optimal design for scaffold applications. The results demonstrated that the average goodness value of models based on an artificial neural network ([Formula: see text] 1.999) is higher than response surface methodology ones ([Formula: see text] 1.780). Additionally, the genetic algorithm was able to find an optimal design with lower cost value (0.006) than the optimum sample (0.113) among the produced ones. Finally, the scanning electron microscopy micrographs highlighted that there is a strong and good cell proliferation on the selected design of nanofiber composite mat as the optimum scaffold.
ivcrc: An instrumental-variables estimator for the correlated random-coefficients model
Authors: Benson David , Masten Matthew A. , Torgovitsky Alexander
Published: October 2022

We discuss the ivcrc command, which implements an instrumental-variables (IV) estimator for the linear correlated random-coefficients model. The correlated random-coefficients model is a natural generalization of the standard linear IV model that allows for endogenous, multivalued treatments and unobserved heterogeneity in treatment effects. The estimator implemented by ivcrc uses recent semiparametric identification results that allow for flexible functional forms and permit instruments that may be binary, discrete, or continuous. The ivcrc command also allows for the estimation of varying-coefficient regressions, which are closely related in structure to the proposed IV estimator. We illustrate the use of ivcrc by estimating the returns to education in the National Longitudinal Survey of Young Men.
A Stata implementation of second-generation p-values
Authors: Bormann Sven-Kristjan
Published: October 2022

In this article, I introduce new commands to calculate second-generation p-values (SGPVs) for common estimation commands in Stata. The sgpv command and its companions allow the easy calculation of SGPVs and their associated diagnostics, as well as the plotting of SGPVs against the standard p-values.
Computing decomposable multigroup indices of segregation
Authors: Guinea-Martin Daniel , Mora Ricardo
Published: October 2022

Eight multigroup segregation indices are decomposable into a between and a within term. They are two versions of 1) the mutual information index, 2) the symmetric Atkinson index, 3) the relative diversity index, and 4) Theil’s H index. In this article, we present the command dseg, which obtains all of them. It contributes to the stock of segregation commands in Stata by 1) implementing the decomposition in a single call, 2) providing the weights and local indices used in the computation of the within term, 3) facilitating the deployment of the decomposability properties of the eight indices in complex scenarios that demand tailor-made solutions, and 4) leveraging sample data with bootstrapping and approximate randomization tests. We analyze 2017 census data of public schools in the United States to illustrate the use of dseg. The subject topic is school racial segregation.
ROMERIN: A new concept of a modular autonomous climbing robot
Authors: Hernando Miguel , Gambao Ernesto , Prados Carlos , Brito Daniel , Brunete Alberto
Published: October 2022

Climbing robots play an essential role in performing inspection work in civil infrastructures. These tasks require autonomous robots with competitive costs and the ability to adapt to different types of environments. This article presents ROMERIN, a new concept of a modular legged climbing robot where each leg is an autonomous robotic module in terms of processing capacity, control, and energy. The legs are equipped with suction cups that allow the robot to adhere to different types of surfaces. The proposed design allows the creation of climbing robots with a different number of legs to perform specific inspection tasks. Although each of the legs acts as an independent robot, they have the ability to share information and energy. The proposed control concept enables the development of climbing robots with the ability to adapt to different types of inspection tasks and with resilience characteristics. This article includes a description of the mechatronic design, the kinematics of the seven degree-of-freedom robotic legs, including the adhesion system, and the architecture of the control and simulation system. Finally, we present experimental results to test the modularity concept, mechanical design, and electronics using a four-legged robot configuration. We analyze the performance of the gripping system in different situations on four different surfaces and the behavior of the control architecture for two different robot body trajectories.
Mid-Term Outcomes of Cemented or Uncemented Total Hip Arthroplasty for Failed Proximal Femoral Nail Antirotation Following Intertrochanteric Femur Fractures: A Retrospective Observational Study
Authors: Huang Tao , Zhang Shi , Liu Xinhang , Lv Gang , Huang Heng , Wang Shuxin , Zhao Mingdong , Xiong Min , Yu Weiguang , Cheng Qiuxia , Huang Ting
Published: October 2022

Introduction

The aim of this retrospective study was to assess the clinical outcomes of cemented or uncemented total hip arthroplasty (CTHA or UTHA) following prior failed proximal femoral nail antirotation (PFNA) fixation in patients with intertrochanteric femur fractures (IFFs).

Materials and methods

Data from 244 patients with IFFs who experienced a conversion of PFNA to CTHA (n = 120) or to UTHA (n = 124) due to screw cut-out, mal/nonunion, or osteonecrosis during 2008-2018 were retrospectively analyzed. Follow-up occurred 1, 3, 6, and 12 months postoperatively and yearly thereafter. The primary outcome was the incidence of orthopedic complications; the secondary outcome was the Harris hip score (HHS).

Results

The median follow-up was 60 months (range, 50-67 months). The incidences of orthopedic complications were 10% in the PFNA to CTHA group and 19.3% in the PFNA to UTHA group (P = .040). Significant differences were also observed regarding the incidence of prosthesis revision (1.7% for PFNA to CTHA vs 7.2% for PFNA to UTHA, P = .036). From the three years after conversion surgery to the final follow-up, significant differences were detected in HHS between groups (each P < .05). At the final follow-up, a statistically significant difference was detected in the HHS (79.54±18.85 for PFNA to CTHA vs. 75.26±18.27 for PFNA to UTHA, P = .014).

Conclusion

The results of the study may demonstrate a significant statistical advantage with respect to the orthopedic complication rate and HHS in favor of CTHA compared to UTHA in patients with failed PFNA.
The Effect of Stimulation Position and Ear Canal Occlusion on Perception of Bone Conducted Sound
Authors: Wang Jie , Stenfelt Stefan , Wu Shengjian , Yan Zhihao , Sang Jinqiu , Zheng Chengshi , Li Xiaodong
Published: October 2022

The position of a bone conduction (BC) transducer influences the perception of BC sound, but the relation between the stimulation position and BC sound perception is not entirely clear. In the current study, eleven participants with normal hearing were evaluated for their hearing thresholds and speech intelligibility for three stimulation positions (temple, mastoid, and condyle) and four types of ear canal occlusion produced by headphones. In addition, the sound quality for three types of music was rated with stimulation at the three positions. Stimulation at the condyle gave the best performance while the temple showed the worst performance for hearing thresholds, speech intelligibility, and sound quality. The in-ear headphones gave the highest occlusion effect while fully open headphones gave the least occlusion effect. BC stimulated speech intelligibility improved with greater occlusion, especially for the temple stimulation position. The results suggest that BC stimulation at the condyle is generally superior to the other positions tested in terms of sensitivity, clarity, and intelligibility, and that occlusion with ordinary headphones improves the BC signal.
MagMin_PT: An Excel-based mineral classification and geothermobarometry program for magmatic rocks
Authors: Gündüz Mesut , Asan Kürşad
Published: October 2022

Igneous rock forming minerals carry valuable information from the deep earth that is not directly accessible at the surface. Each mineral represents the physico-chemical conditions at which various magmatic processes have occured over a wide range of depths from upper mantle to shallow crustal levels. These processes are cryptically inscribed in the whole-rock and mineral compositions (e.g. major elements, trace elements and isotopic ratios) and textures (equilibrium vs. disequilibrium features), together with intensive variables (e.g. pressure, P; temperature, T). Therefore, particular attention should be given to igneous minerals to understand better the processes that took place during their journey from the source through magma chambers and conduit systems to the Earth's surface.

MagMin_PT is an Excel© based user-friendly program, designed to calculate mineral formulae and end-members, and to estimate pressure and temperature (e.g. geothermobarometry) from electron microprobe analytical data. The program operates using the most common igneous rock-forming minerals (olivine, pyroxene, amphibole, biotite, feldspar, magnetite, ilmenite, apatite and zircon), resulting in various classification diagrams and P–T diagrams. The program allows for whole-rock or glass composition to be entered together with the EPMA data to evalaute the equilibration status for most P–T calculation models. Fe2+ and Fe3+ estimation is routinely performed in MagMin_PT based on stoichiometric constraints, and to some extent using machine learning methods for different iron-bearing minerals. MagMin_PT is also able to carry calculations of fugacity, magmatic water content and saturation temperature. Graphical and numerical outputs produced by the program can be easily copied to other media for further processing.
Murine allogeneic CAR T cells integrated before or early after posttransplant cyclophosphamide exert antitumor effects
Authors: Patterson Michael T. , Khan Shanzay M. , Nunes Natalia S. , Fletcher Rochelle E. , Bian Jing , Hadjis Ashley D. , Eckhaus Michael A. , Mendu Suresh K. , de Paula Pohl Alessandra , Venzon David J. , Choo-Wosoba Hyoyoung , Ishii Kazusa , Qin Haiying , Fry Terry J. , Cam Maggie , Kanakry Christopher G.
Published: October 2022

Relapse limits the therapeutic efficacy both of chimeric antigen receptor (CAR) T cells and allogeneic hematopoietic cell transplantation (allo-HCT). Patients may undergo these therapies sequentially to prevent or treat relapsed malignancy. However, direct integration of the 2 therapies has been avoided over concerns for potential induction of graft-versus-host disease (GVHD) by allogeneic CAR T cells. We have shown in murine T-cell-replete MHC-haploidentical allo-HCT that suppressive mechanisms induced immediately after posttransplant cyclophosphamide (PTCy), given on days +3/+4, prevent GVHD induction by alloreactive T cells infused as early as day +5. Therefore, we hypothesized that allogeneic CAR T cells given in a similarly integrated manner in our murine MHC-haploidentical allo-HCT model may safely exert antitumor effects. Indeed, allogeneic anti-CD19 CAR T cells given early after (day +5) PTCy or even prior to (day 0) PTCy cleared leukemia without exacerbating the cytokine release syndrome occurring from the MHC-haploidentical allo-HCT or interfering with PTCy-mediated GVHD prevention. Meanwhile, CAR T-cell treatment on day +9 or day +14 was safe but less effective, suggesting a limited therapeutic window. CAR T cells infused before PTCy were not eliminated, but surviving CAR T cells continued to proliferate highly and expand despite PTCy. In comparison with infusion on day +5, CAR T-cell infusion on day 0 demonstrated superior clinical efficacy associated with earlier CAR T-cell expansion, higher phenotypic CAR T-cell activation, less CD4+CD25+Foxp3+ CAR T-cell recovery, and transcriptional changes suggesting increased activation of CD4+ CAR T cells and more cytotoxic CD8+ CAR T cells. This study provides mechanistic insight into PTCy’s impact on graft-versus-tumor immunity and describes novel approaches to integrate CAR T cells and allo-HCT that may compensate for deficiencies of each individual approach.
Rhinitis phenotypes and multimorbidities in the general population: the CONSTANCES cohort
Authors: Savouré Marine , Bousquet Jean , Leynaert Bénédicte , Renuy Adeline , Siroux Valérie , Goldberg Marcel , Zins Marie , Jacquemin Bénédicte , Nadif Rachel
Published: October 2022

Background

Scarce epidemiological studies have characterised allergic rhinitis (AR) and non-allergic rhinitis (NAR) in adults. In a population-based cohort, our aims were to 1) describe rhinitis, AR and NAR, and 2) explore how asthma and conjunctivitis may lead to the identification of novel rhinitis phenotypes.

Methods

In this cross-sectional analysis, current rhinitis was defined as present in the last 12 months using a questionnaire from the French CONSTANCES cohort. Participants with current rhinitis reporting nasal allergies were considered as AR, otherwise as NAR. We described AR and NAR phenotypes, and their phenotypes including co-occurrence with ever-asthma and ever-conjunctivitis.

Results

Among the 20 772 participants included in this analysis (mean±sdage 52.6±12.6 years; 55.2% female), crude prevalences of AR and NAR were 28.0% and 10.9%. AR participants more frequently reported persistent rhinitis (31.6%versus25.1%) and moderate-to-severe rhinitis (40.1%versus24.2%) than NAR participants. Among AR or NAR participants, those with ever-asthma reported more moderate-to-severe rhinitis. Participants with AR, ever-asthma and ever-conjunctivitis had an earlier age of rhinitis onset, more severe rhinitis and higher eosinophil counts than participants in other groups. Results were replicated in another cohort.

Conclusions

In this large population-based cohort, 40% reported current rhinitis, with a lower prevalence of moderate-to-severe rhinitis than in clinical practice. For the first time in a general adult population, we showed that AR and NAR alone or in combination with asthma or in combination with asthma and conjunctivitis are different phenotypes. These results provide new insights on how best to manage rhinitis and its multimorbidities.
Baseline clusters and the response to positive airway pressure treatment in obstructive sleep apnoea patients: longitudinal data from the European Sleep Apnea Database cohort
Authors: Yassen Ashraf , Coboeken Katrin , Bailly Sébastien , Burghaus Rolf , Buskova Jitka , Dogas Zoran , Drummond Marta , Gouveris Haralampos , Joppa Pavol , Lippert Joerg , Lombardi Carolina , Mihaicuta Stefan , Pépin Jean Louis , Zou Ding , Hedner Jan , Grote Ludger ,   the ESADA collaborators, Steiropoulos P. , Verbraecken J. , Petiet E. , Trakada G. , Fietze I. , Penzel T. , Laharnar N. , Ludka O. , Bouloukaki I. , Schiza S. , McNicholas W.T. , Ryan S. , Riha R.L. , Kvamme J.A. , Grote L. , Hedner J. , Zou D. , Pevernagie D. , Bailly S. , Pépin J.L. , Tamisier R. , Hein H. , Basoglu O.K. , Tasbakan M.S. , Buskova J. , Joppa P. , Staats R. , Testelmans D. , Gouveris H. , Ludwig K. , Lombardi C. , Parati G. , Bonsignore M.R. , Fanfulla F. , Petitjean M. , Roisman G. , Drummond M. , van Zeller M. , Treml M. , Randerath W. , Dogas Z. , Pecotic R. , Pataka A. , Mihaicuta S. , Anttalainen U. , Saaresranta T. , Sliwinski S.
Published: October 2022

Introduction

The European Sleep Apnea Database was used to identify distinguishable obstructive sleep apnoea (OSA) phenotypes and to investigate the clinical outcome during positive airway pressure (PAP) treatment.

Method

Prospective OSA patient data were recruited from 35 sleep clinics in 21 European countries. Unsupervised cluster analysis (anthropometrics, clinical variables) was performed in a random sample (n=5000). Subsequently, all patients were assigned to the clusters using a conditional inference tree classifier. Responses to PAP treatment change in apnoea severity and Epworth sleepiness scale (ESS) were assessed in relation to baseline patient clusters and at short- and long-term follow-up.

Results

At baseline, 20 164 patients were assigned (mean age 54.1±12.2 years, 73% male, median apnoea–hypopnoea index (AHI) 27.3 (interquartile range (IQR) 14.1–49.3) events·h−1, and ESS 9.8±5.3) to seven distinct clusters based on anthropometrics, comorbidities and symptoms. At PAP follow-up (median 210 [IQR 134–465] days), the observed AHI reduction (n=1075) was similar, whereas the ESS response (n=3938) varied: largest reduction in cluster 3 (young healthy symptomatic males) and 6 (symptomatic males with psychiatric disorders, −5.0 and −5.1 units, respectively (all p<0.01), limited reduction in clusters 2 (obese males with systemic hypertension) and 5 (elderly multimorbid obese males, −4.2 (p<0.05) and −3.7 (p<0.001), respectively). Residual sleepiness in cluster 5 was particularly evident at long-term follow-up (p<0.05).

Conclusion

OSA patients can be classified into clusters based on clinically identifiable features. Importantly, these clusters may be useful for prediction of both short- and long-term responses to PAP intervention.
A genome-wide landscape of mRNAs, lncRNAs, circRNAs and miRNAs during intramuscular adipogenesis in cattle
Authors: Yang Xinran , Ma Xinhao , Mei Chugang , Zan Linsen
Published: October 2022

Background

Intramuscular preadipocyte differentiation plays a critical role in bovine intramuscular fat (IMF) deposition. However, the roles of different RNAs, including mRNAs, circRNAs, lncRNAs and miRNAs, in regulating the adipogenic differentiation of intramuscular preadipocytes remain largely unclear.

Results

In the present study, a whole transcriptome sequencing and analysis, including the analysis of mRNAs, circRNAs, lncRNAs and miRNAs, during different differentiation stages (0, 3, 6, and 9 d) of intramuscular preadipocytes from Qinchuan cattle was performed. All samples were prepared with 3 biological replicates. Here, a total of 27,153 mRNAs, 14,070 circRNAs, 7035 lncRNAs, and 427 miRNAs were annotated. Among them, we identified 4848 differentially expressed mRNAs (DEMs), 181 DE circRNAs (DECs), 501 DE lncRNAs (DELs) and 77 DE miRNAs (DEmiRs) between 0 d and other differentiation days (3, 6, and 9 d). GO and KEGG functional enrichment analyses showed that these differentially expressed genes were mainly enriched in cell differentiation, fat metabolism and adipogenesis-related pathways. Furthermore, weighted gene coexpression network analysis (WGCNA) and co-expression network analysis screened out multiple important mRNAs, circRNAs and lncRNAs related to intramuscular adipogenesis. Based on the competing endogenous RNA (ceRNA) regulatory mechanism, we finally identified 24 potential ceRNA networks and 31 potential key genes, including FOXO1/miR-330/circRNA2018/MSTRG.20301, GPAM/miR-27b/ciRNA489 and SESN3/miR-433/circRNA2627MSTRG.20342.

Conclusions

This study provides new insights into the differential expression patterns of different transcript types (i.e., mRNAs, circRNAs, lncRNAs and miRNAs) in intramuscular preadipocyte differentiation. Our findings provide data support for studying the molecular mechanism of key mRNAs and noncoding RNAs in IMF deposition, and provide new candidate markers for the molecular breeding of beef cattle.
Right displacement of trachea to reduce right bronchial misplacement of left double lumen tube: a prospective, double-blind, randomized study
Authors: Guan Jianqiang , Zhu Wenxiu , Xiao Xue , Huang Ziyan , Xing Jibin , Hei Ziqing , Zhang Yihan , Yao Weifeng
Published: October 2022

Background

Misplacement of double-lumen endobronchial tubes (DLTs) during bronchial intubation, especially when bronchoscopy guidance is not applicable, threatens effective lung isolation and brings about airway injury during reposition. We aimed to examine whether a novel maneuver called right tracheal displacement (RTD) can reduce left-sided DLT misplacement during first-attempt intubation without bronchoscopy guidance.

Methods

Patients that underwent thoracic surgeries requiring one-lung ventilation during November 2020 to January 2021 were recruited and randomized into control and RTD group, with 54 cases in each group. The primary outcomes included the incidence of DLT misplacement and the time to complete desired bronchial intubation. The secondary outcomes included mucosal injury, sore throat and hoarseness upon emergence and at 24 h post-operatively.

Result

The incidence of DLT misplacement in RTD group was significantly lower compared to control group (0% vs. 16.7%) The time to complete bronchial intubation was also significantly shortened in RTD group compared to control (52.88 ± 9.36 s vs. 63.04 ± 20.02 s). The incidence of mucosal injury, sore throat and hoarseness were comparable between two groups.

Conclusion

RTD maneuver can effectively improve the success rate of first-attempt proper DLT positioning and shorten the time required by bronchial intubation.

Trial registration

This prospective, double-blind, randomized study has completed the registration of the Chinese Clinical Trial Center at 2/11/2020 with the registration number ChiCTR2000040212. It was conducted from 26/11/2020 to 31/7/2021 in third affiliated hospital of Sun Yat-sen university.
Clinical outcomes and treatment patterns of older adults with dementia-related psychosis by dementia type in the United States
Authors: Forns Joan , Danysh Heather E. , McQuay Lisa J. , Turner Mary Ellen , Dempsey Colleen , Anthony Mary S. , Demos George , Layton J. Bradley
Published: October 2022

Background

Little is known about the incidence of clinical events and treatment patterns among older adults with dementia-related psychosis. Given that dementia-related psychosis comprises various dementia types, this study describes the incidence of clinical events and treatment patterns by dementia type after patients with dementia are diagnosed with psychosis.

Methods

Adults aged ≥ 65 years with dementia and newly diagnosed with psychosis were identified in US Medicare claims during 2013–2018. Baseline characteristics were evaluated at the time of the psychosis diagnosis. After the initial psychosis diagnosis, incidence rates (IRs) of clinical events (e.g., falls/fractures, infections, healthcare utilization), mortality, and patterns of antipsychotic treatment were described for each dementia type (Alzheimer’s disease [AD], Parkinson’s disease dementia [PDD], dementia with Lewy bodies [DLB], frontotemporal dementia [FTD], vascular dementia [VD], and unspecified dementia). Daily mean cumulative counts were estimated to describe the incidence of recurrent events over time. Mortality was described using Kaplan–Meier survival curves.

Results

We identified 484,520 patients with dementia-related psychosis: mean age, 84 years (standard deviation, 7.8); female, 66%. At the time of psychosis diagnosis, the most prevalent type of dementia was unspecified dementia (56%), followed by AD (31%), VD (12%), PDD (10%), DLB (3%), and FTD (< 1%), and most patients had scores indicating severe illness on the Charlson Comorbidity Index (71%) and frailty index (62%). Across all dementia types, IRs (per 100 person-years) were high for emergency department visits, oral anti-infective use, and urinary tract infections after the initial psychosis diagnosis. Patients with DLB had the highest incidence of most clinical outcomes. After 1 year of follow-up, the cumulative probability of death was about 30% for all dementia types, and after 5 years, was about 80% among patients with DLB, VD, AD, or PDD and about 60%-65% among patients with FTD or unspecified dementia.

Conclusions

Patients with dementia-related psychosis had a high burden of comorbidities, frailty, emergency department visits, infections, and death. Specifically, after DRP diagnosis, patients with DLB and VD had the highest burden of clinical events of interest.
Circulating levels of PCSK9, ANGPTL3 and Lp(a) in stage III breast cancers
Authors: Wong Chong Emilie , Joncas France-Hélène , Seidah Nabil G. , Calon Frédéric , Diorio Caroline , Gangloff Anne
Published: October 2022

Background / synopsis

Cholesterol and lipids play an important role in sustaining tumor growth and metastasis in a large variety of cancers. ANGPTL3 and PCSK9 modify circulating cholesterol levels, thus availability of lipids to peripheral cells. Little is known on the role, if any, of circulating lipid-related factors such as PCSK9, ANGPTL3 and lipoprotein (a) in cancers.

Objective/purpose

To compare circulating levels of PCSK9, ANGPTL3, and Lp(a) in women with stage III breast cancer versus women with premalignant or benign breast lesions.

Methods

Twenty-three plasma samples from women diagnosed with a stage III breast cancer (ductal, lobular or mixed) were matched for age with twenty-three plasma samples from women bearing premalignant (stage 0, n = 9) or benign (n = 14) breast lesions. The lipid profile (Apo B, total cholesterol, HDL cholesterol and triglycerides levels) and Lp(a) were measured on a Roche Modular analytical platform, whereas LDL levels were calculated with the Friedewald formula. ANGPTL3 and PCSK9 plasma levels were quantitated by ELISA. All statistical analyses were performed using SAS software version 9.4.

Results

PCSK9 levels were significantly higher in women with stage III breast cancer compared to age-matched counterparts presenting a benign lesion (95.9 ± 27.1 ng/mL vs. 78.5 ± 19.3 ng/mL, p < 0.05, n = 14). Moreover, PCSK9 levels positively correlated with breast disease severity (benign, stage 0, stage III) (Rho = 0.34, p < 0.05, n = 46). In contrast, ANGPTL3 and Lp(a) plasma levels did not display any association with breast disease status and lipids did not correlate with disease severity.

Conclusion

In this small cohort of 46 women, PCSK9 levels tended to increase with the severity of the breast disease. Given that PCSK9 plays an important role in maintaining cholesterolemia, and a potential role in tumor evasion, present results warrant further investigation into a possible association between PCSK9 levels and breast cancer severity in larger cohorts of women.
Association between the efficacy and immune-related adverse events of pembrolizumab and chemotherapy in non-small cell lung cancer patients: a retrospective study
Authors: Kurokawa Kana , Mitsuishi Yoichiro , Shimada Naoko , Kawakami Yuta , Miura Keita , Miyawaki Taichi , Asao Tetsuhiko , Ko Ryo , Shukuya Takehito , Shibayama Rina , Nojiri Shuko , Takahashi Kazuhisa
Published: October 2022

Background

The combination of immune-checkpoint inhibitors with chemotherapy has become the standard of treatment for non-small cell lung cancer (NSCLC) patients. However, the association between therapeutic efficacy and the development of immune-related adverse events (irAEs) remains unclear in patients treated with combination therapy. We aimed to investigate the frequency of irAEs, and the association between therapeutic efficacy and the development of irAEs in patients with NSCLC.

Materials and methods

We retrospectively surveyed patients with chemo-naïve advanced NSCLC who received pembrolizumab plus platinum-based chemotherapy or pembrolizumab monotherapy at Juntendo University Hospital, Japan, between February 2017 and May 2021.

Results

Among 148 patients (median [range] age, 68 (33–85) years; 107 men [72.3%] and 41 women [27.7%]), 74 each received pembrolizumab plus chemotherapy and pembrolizumab monotherapy. IrAEs were observed in 46 (62.2%) and 41 patients (55.4%) in the combination therapy and monotherapy group, respectively. Patients with irAEs showed significantly longer progression-free survival (PFS) than those without irAEs in the combination therapy group (8.9 vs. 5.7 months; Hazard Ratio [HR], 0.53; 95% CI, 0.29–0.98; P = 0.041) and monotherapy group (11.7 vs. 5.0 months; HR, 0.40; 95% CI, 0.22–0.70; P = 0.001). In the multivariable analysis, development of irAEs was positively associated with PFS in both the groups (HR, 0.48; 95% CI, 0.26–0.89; P = 0.019 and HR, 0.38; 95% CI, 0.21–0.68; P < 0.01). In the inverse probability of treatment weighting adjusted analysis, development of irAEs was significantly associated with combination therapy (OR, 0.56; 95% CI, 0.34–0.91; P = 0.019).

Conclusion

Our study demonstrated that the incidence of irAEs was associated with favorable efficacy in patients treated with pembrolizumab plus chemotherapy, as well as pembrolizumab monotherapy. Also, the addition of chemotherapy to pembrolizumab significantly increased the incidence of irAEs.
Determinants of food preparation and hygiene practices among caregivers of children under two in Western Kenya: a formative research study
Authors: Ogutu Emily A. , Ellis Anna , Rodriguez Katie C. , Caruso Bethany A. , McClintic Emilie E. , Ventura Sandra Gómez , Arriola Kimberly R. J. , Kowalski Alysse J. , Linabarger Molly , Wodnik Breanna K. , Webb-Girard Amy , Muga Richard , Freeman Matthew C.
Published: October 2022

Introduction

Diarrhea is a leading cause of child morbidity and mortality worldwide and is linked to early childhood stunting. Food contamination from improper preparation and hygiene practices is an important transmission pathway for exposure to enteric pathogens. Understanding the barriers and facilitators to hygienic food preparation can inform interventions to improve food hygiene. We explored food preparation and hygiene determinants including food-related handwashing habits, meal preparation, cooking practices, and food storage among caregivers of children under age two in Western Kenya.

Methods

We used the Capabilities, Opportunities, and Motivations model for Behavior Change (COM-B) framework in tool development and analysis. We conducted 24 focus group discussions with mothers (N = 12), fathers (N = 6), and grandmothers (N = 6); 29 key informant interviews with community stakeholders including implementing partners and religious and community leaders; and 24 household observations. We mapped the qualitative and observational data onto the COM-B framework to understand caregivers’ facilitators and barriers to food preparation and hygiene practices.

Results

Facilitators and barriers to food hygiene and preparation practices were found across the COM-B domains. Caregivers had the capability to wash their hands at critical times; wash, cook, and cover food; and clean and dry utensils. Barriers to food hygiene and preparation practices included lack of psychological capability, for instance, caregivers’ lack of knowledge of critical times for handwashing, lack of perceived importance of washing some foods before eating, and not knowing the risks of storing food for more than four hours without refrigerating and reheating. Other barriers were opportunity-related, including lack of resources (soap, water, firewood) and an enabling environment (monetary decision-making power, social support). Competing priorities, socio-cultural norms, religion, and time constraints due to work hindered the practice of optimal food hygiene and preparation behaviors.

Conclusion

Food hygiene is an underexplored, but potentially critical, behavior to mitigate fecal pathogen exposure for young children. Our study revealed several knowledge and opportunity barriers that could be integrated into interventions to enhance food hygiene.
Plantar and dorsal approaches for excision of morton’s neuroma: a comparison study
Authors: Xu Wenpeng , Zhang Ning , Li Zhengxun , Wang Yifan , Li Xiucun , Wang Yang , Si Haipeng , Hu Yong
Published: October 2022

Background

Morton’s neuroma is a painful enlargement of the plantar digital nerve between the metatarsal heads that causes pain of the forefoot. Several approaches have been used to treat Morton’s neuroma, each of them having distinct advantages and disadvantages.

Objectives

The purpose of this study was to investigate and compare the clinical outcomes of neurectomy in the treatment of Morton’s neuroma through plantar and dorsal approaches.

Materials and methods

A total of 20 patients with a mean age of 48.5 ± 13.0 years (range: 19–66 years) who underwent excision of a Morton’s neuroma that did not respond to conservative treatment were retrospectively analysed from June 2014 to June 2021. All the neurectomies were performed using a plantar or dorsal approach. Outcomes were evaluated using visual analogue scale (VAS) scores, American Orthopedic Foot and Ankle Society (AOFAS) scores, the Foot and Ankle Ability Measure (FAAM), and complications. The appearance index (AI) was also used to assess the influence of foot appearance on the quality of life after surgery.

Results

Eight patients underwent neurectomy by the dorsal approach, and 12 patients underwent neurectomy by the plantar approach. The average follow-up time was 28.9 ± 12.9 months (range: 15–72 months). No statistically significant difference was found between the dorsal and plantar approach groups with respect to postoperative pain measured by the VAS score. The postoperative AOFAS scores and FAAM outcomes were not significantly different between the groups. The complications reported in the dorsal approach group were significantly less than those of the plantar group, mainly discomfort in wearing shoes. The AI of the plantar group and the dorsal group were significantly different.

Conclusion

The excision of the Morton’s neuroma by both the dorsal and plantar approach resulted in satisfactory outcomes. However, the foot appearance after surgery by the plantar approach had less influence on the quality of life than that using the dorsal approach. Our recommendation is that surgeons should choose the approach they are most familiar with and with which they are most confident in performing. In addition, the plantar approach is recommended if the patient needs a better appearance.
3D-printed hemipelvic prosthesis combined with a dual mobility bearing in patients with primary malignant neoplasm involving the acetabulum: clinical outcomes and finite element analysis
Authors: Wang Miao , Liu Tianze , Xu Changli , Liu Chang , Li Bo , Lian Qiujian , Chen Tongjiang , Qiao Suchi , Wang Zhiwei
Published: October 2022

Background

Limb salvage reconstruction for pelvic tumors, especially periacetabular tumors, is challenging. We combined the use of dual mobility bearing and 3D-printed hemipelvic prosthesis to improve function and reduce the probability of complications after hemi-pelvic resection in patients with primary acetabular malignancy. The purpose of this study was to evaluate the efficacy and safety of this combination.

Methods

Between October 2011 and May 2021, 11 patients with malignancies involving the acetabulum received hemipelvic replacement with a 3D-printed prosthesis and dual mobility bearing. Follow‐up of postoperative survival, complications, and Musculoskeletal Tumor Society 93 (MSTS-93) lower limb functional scores were carried out. A finite element model of the postoperative pelvis was developed and input into the finite element analysis software. The Von Mises equivalent stress formula was used to analyze the stress distribution of each part of the pelvis under one gait cycle and the stress distribution at different angles of the hip joint.

Results

By the last follow-up, 9 of the 11 patients (81.8%) were still alive, and 2 patients had local tumor recurrence. The complications including 1 deep infection and 1 dislocation of the artificial joint. Excluding 1 amputation patient, the average score of the remaining 8 patients at the last follow-up was 21.4/30 (71.3%) on the MSTS-93. In the reconstructed pelvis, stress distributions were concentrated on the junction between hemipelvic prosthesis and screw and iliac bone on the resected side, and between femoral prosthesis stem and femoral bulb, while the stress of polyethylene lining was small. Before impact, the polyethylene lining will rotate at a small angle, about 3°. The inner stress of polyethylene liner is greater than the outer stress in all conditions. The polyethylene liner has no tendency to slide out.

Conclusion

Pelvic tumor resection and reconstruction using 3D-printed hemipelvic prosthesis combined with dual mobility bearing was an effective treatment for pelvic tumors. Our patients achieved good early postoperative efficacy and functional recovery. The dual mobility bearing is beneficial to prevent dislocation, and the mechanical distribution and wear of the prosthesis are acceptable.
Characteristics and place of death in home care recipients in Germany – an analysis of nationwide health insurance claims data
Authors: Schnakenberg Rieke , Fassmer Alexander Maximilian , Allers Katharina , Hoffmann Falk
Published: October 2022

Background

Most care-dependent people live at home, where they also would prefer to die. Unfortunately, this wish is often not fulfilled. This study aims to investigate place of death of home care recipients, taking characteristics and changes in care settings into account.

Methods

We retrospectively analysed a cohort of all home-care receiving people of a German statutory health insurance who were at least 65 years and who deceased between January 2016 and June 2019. Next to the care need, duration of care, age, sex, and disease, care setting at death and place of death were considered. We examined the characteristics by place of care, the proportion of dying in hospital by care setting and characterised the deceased cohort stratified by their actual place of death.

Results

Of 46,207 care-dependent people initially receiving home care, 57.5% died within 3.5 years (n = 26,590; mean age: 86.8; 66.6% female). More than half of those moved to another care setting before death with long-term nursing home care (32.3%) and short-term nursing home care (11.7%) being the most frequent transitions, while 48.1% were still cared for at home. Overall, 36.9% died in hospital and in-hospital deaths were found most often in those still receiving home care (44.7%) as well as care in semi-residential arrangements (43.9%) at the time of death. People who died in hospital were younger (mean age: 85.5 years) and with lower care dependency (low care need: 28.2%) as in all other analysed care settings.

Conclusion

In Germany, changes in care settings before death occur often. The proportion of in-hospital death is particularly high in the home setting and in semi-residential arrangements. These settings should be considered in interventions aiming to decrease the number of unwished care transitions and hospitalisations at the end of life.
The severity and duration of Hypoglycemia affect platelet-derived protein responses in Caucasians
Authors: Moin Abu Saleh Md , Sathyapalan Thozhukat , Atkin Stephen L. , Butler Alexandra E.
Published: October 2022

Objective

Severe hypoglycemia is associated with increased cardiovascular death risk, and platelet responses to hypoglycemia (hypo) have been described. However, the impact of deep transient hypo (deep-hypo) versus prolonged milder hypo (mild-hypo) on platelet response is unclear.

Research Design and methods

Two hypo studies were compared; firstly, mild-hypo in 18-subjects (10 type-2-diabetes (T2D), 8 controls), blood glucose to 2.8mmoL/L (50 mg/dL) for 1-hour; secondly deep-hypo in 46-subjects (23 T2D, 23 controls), blood glucose to < 2.2mmoL/L (< 40 mg/dL) transiently. Platelet-related protein (PRP) responses from baseline to after 1-hour of hypo (mild-hypo) or at deep-hypo were compared, and at 24-hours post-hypo. Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurement was used to determine PRP changes for 13 PRPs.

Results

In controls, from baseline to hypo, differences were seen for four PRPs, three showing increased %change in deep-hypo (Plasminogen activator inhibitor-1(PAI-1), CD40 ligand (CD40LG) and Protein-S), one showing increased %change in mild-hypo (von Willebrand factor (vWF)); at 24-hours in controls, %change for Protein-S remained increased in deep-hypo, whilst % change for vWF and plasminogen were increased in mild-hypo. In T2D, from baseline to hypo, differences were seen for 4 PRPs, three showing increased %change in deep-hypo (PAI-1, platelet glycoprotein VI and Tissue factor), one showing increased %change in mild-hypo (CD40LG); at 24-hours in T2D, %change for CD40LG remained increased, together with vWF, in deep-hypo.

Conclusion

Both mild-hypo and deep-hypo showed marked PRP changes that continued up to 24-hours, showing that both the severity and duration of hypoglycemia are likely important and that any degree of hypoglycemia may be detrimental for increased cardiovascular risk events through PRP changes.