bluuebunny/crossref_metadata_2025 huggingface dataset:
Monetary and environmental damage cost assessment of source-separated biowaste collection: Implications of new waste regulation in Finland
Authors: Mayanti Bening , Helo Petri
Published: September 2022

This study develops a cost model covering monetary and environmental damage costs for source-separated biowaste collection. The model provides an improved basis for decision-making by including environmental damage costs compared to the assessment that considers the only monetary cost. The monetary cost calculation integrated route optimisation using existing road networks, while the environmental damage cost was estimated using the life cycle impact assessment method based on the endpoint (LIME) model. The model was tested in the Finnish case where the new law implements the stricter requirement for source-separated biowaste. The costs of collection, transportation and treatment of three different scenarios were assessed: mixed waste under the old law (MW-OL), biowaste under the new law (B-NL) and mixed waste without biowaste under the new law (MW-NL). The results showed the economic and environmental benefits of sourced separated biowaste. The overall cost of collection and transportation (CT) under the old law and new laws were 80.7 € Mg−1 and 81.1 € Mg−1, respectively. Treatment costs were 79 € Mg−1 and 64.8 € Mg−1 under the old and new laws, respectively. The damage costs for CT under the old and new laws were 0.23 € Mg−1 and 0.24 € Mg−1, respectively. At the same time, the damage costs from the treatment stage were 4.9 € Mg−1 and 3.5 € Mg−1 under the old law and new law, respectively. The model supports decision-making when the collection scheme requires a change. Failing to plan an optimised solution and cost will lead to inefficient systems.
Exposure to Circadian Disruption During Adolescence Interacts With a Genetic Risk Factor to Modify Schizophrenia-relevant Behaviors in a Sex-dependent Manner
Authors: Cloutier Marie-Ève , Srivastava Lalit K. , Cermakian Nicolas
Published: September 2022

DTNBP1 is a gene associated with schizophrenia. Postmortem studies found a reduced expression of DTNBP1 in regions associated with schizophrenia in patients’ brains. Sandy (Sdy) mice have a loss-of-function mutation in Dtnbp1 gene, resulting in behavioral deficits and brain changes similar to those seen in patients with schizophrenia. We previously showed that exposing adult Sdy mice to circadian disruption led to an exacerbation of schizophrenia-relevant behaviors. Here we asked whether the interaction between this genetic risk factor and circadian disruption occurs during adolescence, a period when environmental insults can promote schizophrenia symptoms, and whether sex affects this interaction. Starting at postnatal day 21, wild-type (WT) and Sdy males and females were housed for 4 weeks either in a 12 h light:12 h dark (LD 12:12) cycle or under chronic jetlag (CJL). Then, after 2 weeks in LD 12:12, behavioral assessments were conducted, including elevated plus maze (EPM), novel object recognition (NOR), social interaction, and prepulse inhibition (PPI) of acoustic startle. NOR and social novelty tests showed that, surprisingly, CJL during adolescence had opposite effects on WT and Sdy males, that is, behavioral deficits in WT males while rescuing preexisting deficits in Sdy mice. CJL led to decreased sociability in WT and Sdy mice while decreasing PPI only in females. Sdy mice showed decreased anxiety-like behavior compared with wild-type (WT), which was further accentuated by CJL in males. Thus, circadian disruption during adolescence, on its own or in association with Dtnbp1 mutation, can influence cognition, sociability, sensorimotor gating, and anxiety-like behaviors in a sex-dependent manner.
Comprehension and Decision-Making Capacity Questionnaire About Palliative Care and Advance Care Planning: A Delphi Study
Authors: Trevizan Fulvio Bergamo , Paiva Carlos Eduardo , Julião Miguel , de Oliveira Valentino Talita Caroline , Miwa Michelle Uchida , Mingardi Mirella , D’Almeida Preto Daniel , Ciorlia Juliana Beraldo , de Angelis Nascimento Maria Salete , Kovács Maria Júlia , Dadalto Luciana , de Oliveira Livia Costa , da Costa Rosa Karla Santos , Ribeiro Paiva Bianca Sakamoto
Published: September 2022

Objective(s): To develop a questionnaire that assesses the level of comprehension and decision-making capacity of patients with breast cancer about palliative care and advance care planning. Methods: Questionnaire items were based on the scientific literature. Delphi Consensus, a three-round survey with experts (n  =  14), evaluated the relevance, clarity, and redundancies of the items. A pretest with breast cancer patients (n  =  15) evaluated whether they comprehended each item and identified doubts or discomforts. Results: The initial questionnaire was composed of 38 items. After the Delphi, 18 items were restructured, six were added, and 16 were removed. In the pretest phase, all items with the survey header, guidelines, and Likert model were evaluated. All items accomplished ≥80% cut-off score and were kept as in the original version. The final version of the questionnaire have 28 itens and five domains: determination, responsibility, independence, self-knowledge, and knowledge of reality. Conclusions: This study represents the first step in the development of a questionnaire that may be used in oncology clinical practice. The main findings revealed that Delphi and pretesting increased the quality of the questionnaire, making it compelling to assess breast cancer patients’ comprehension and decision-making capacity about PC and ACP.
PCL-nHAC/Mg-Ca alloy composite and preliminary study of its osteogenesis property
Authors: Liu Congying , Wang Chengyue , Yang Jingxin
Published: September 2022

Owing to their excellent properties, magnesium alloys are widely used in bone tissue engineering. However, considerable work has been conducted to control the degradation rate and improve the cytocompatibility of magnesium alloys. In this study, low-cost production introduced a new bone repair composite (PCL-nHAC/Mg-Ca), which was composed of nano-hydroxylapatite-collagen (nHAC), polycaprolactone (PCL) and Mg-Ca alloy substrate treated by micro- arc oxidation (MAO). The experimental results showed that compared with the Mg-Ca alloy treated by MAO alone, the PCL-nHAC/Mg-Ca composite has a porous structure and a slower degradation rate. Cell experiments showed that the PCL-nHAC/Mg-Ca composite had good biocompatibility and significantly enhanced the proliferation of the MC3T3-E1 cells. The rabbit skull defect model further proved that the PCL-nHAC/Mg-Ca composite could regulate the degradation rate of the Mg-Ca alloy and promote the formation of bone tissue. Histological analyses showed that the PCL-nHAC/Mg-Ca composite had good stability in vivo and could better accelerate bone formation.
Maternal and neonatal risk factors associated with increased mother-to-child transmission of HIV-1 in Mexico: Results of a case–control study
Authors: José Antonio Mata-Marín , Mónica Grisel Rivera-Mahey , Alberto Chaparro-Sánchez , Carla Ileana Arroyo-Anduiza , Luis Antonio Uribe-Noguez , María de los Angeles Berrospe-Silva , Norma Angélica Matías-Juan , Mara Soraya Rodríguez-Evaristo , Víctor Rodríguez-Pérez , Jesús Enrique Gaytán-Martínez
Published: September 2022

Background

Maternal, obstetric and neonatal factors that increase the possibility of mother-to-child HIV transmission (MTCT) are known as mechanisms of transmission. Our aim was to determine the risk factors associated with MTCT in Mexico.

Methods

We conducted a case–control study from March to December 2015. Cases were 60 mothers with HIV infection who transmitted HIV to their children, and controls were 120 mothers with HIV infection whose children tested negative for HIV. Data were extracted from medical records and a self-reported questionnaire for each participant. To determine associations with MTCT, odds ratios (ORs) and 95% confidence intervals (CI) were obtained with the chi-squared test and a logistic-regression modeling.

Results

A total of 180 patients were included. HIV diagnosis for cases occurred after pregnancy in 88% of the patients, during pregnancy in 9%, and before pregnancy in 3% of patients. Among the controls, 38% of patients were diagnosed before pregnancy, 32% during pregnancy, and 30% after pregnancy. In multivariate analysis, the risk factors associated with MTCT were: absence of antiretroviral treatment during pregnancy (OR 5.21; 95% CI 1.24–16.11; p = 0.019); vaginal delivery (OR 3.2; 95% CI 1.27–8.26; p = 0.014); forceps-assisted delivery (OR 13.4; 95% CI 1.91–93.66; p = 0.009); breastfeeding (OR 6.23; 95% CI 2.27–17.05; p = <0.001) and the practice of mixed breastfeeding (OR 4.6; 95% CI 1.56–13.73; p = 0.006).

Conclusions

MTCT is preventable with early diagnosis; treatment initiation before pregnancy and avoidance breastfeeding could decrease the risk of transmitting HIV to their children.
Walking in Her Shoes: Pretending to Be a Female Role Model Increases Young Girls’ Persistence in Science
Authors: Shachnai Reut , Kushnir Tamar , Bian Lin
Published: September 2022

Pretend play is a ubiquitous learning tool in early childhood, enabling children to explore possibilities outside of their current reality. Here, we demonstrate how pretend play can be leveraged to empower girls in scientific domains. American children ages 4 to 7 years ( N = 240) played a challenging science activity in one of three conditions. Children in the exposure condition heard about a successful gender-matched scientist, children in the roleplay condition pretended to be that scientist, and children in the baseline condition did not receive information about the scientist. Girls in the roleplay condition, but not in the exposure condition, persisted longer in the science activity than girls in the baseline condition. Pretending to be the scientist equated girls’ persistence to that of boys. These findings suggest that pretend play of role models motivates young girls in science and may help reduce gender gaps from their roots.
Modelling and simulation of eco-friendly solar cells sensitized by natural dyes
Authors: Tajvar Zarreen , Faraz Sadia Muniza , Awan Zahoorul Hussain , Sayyad Muhammad Hassan
Published: September 2022

One of the biggest environmental challenges for scientists and researchers is to minimize energy crisis by utilizing renewable energy without impacting the climate. Natural dyes based organic solar cells are third generation dye sensitized solar cells (DSSC) which are bio safe, low cost, and relatively easy to fabricate with flexibility than Silicon based solar cells. In this study dye sensitized solar cells are modelled and simulated using diffusion model. The simulations are carried out in MATLAB software to investigate the electrical characteristics. The simulations are performed for three different DSSCs made of pomegranate, beetroot and N-719 dyes. Physical parameters are extracted and their impact on the performance of solar cells is studied. Additionally, the effects of variations in electrode thickness and irradiance are also investigated. The results indicated that short-circuit current, open-circuit voltage and output power increased by decreasing the electrode thickness. Simulated results are in good agreement with the experimental results of preassembled DSSCs. A set of parameters based on electrical considerations is delivered which will not only help to study the impact of physical parameter of DSSC but will also help to control and improve the performance and efficiency of Dye sensitized solar cells.
Interaction Between Obesity and Hypertension on Arteriosclerosis in Chinese Urban Adults: A Population-Based Cross-Sectional Study
Authors: Li Xiaohan , Yu Junwu , Bai Jianjuan , Huang Huiming , Ying Shanshan , Wang Aiwen , Wang Ping
Published: September 2022

This study recruited 9,830 participants to identify whether the interaction between obesity and hypertension affects the occurrence of arteriosclerosis in Chinese adults. Brachial–ankle pulse wave velocity (baPWV) was measured to diagnose arteriosclerosis. Unconditional logistic regression was used for multiplicative interaction. The additive interaction was represented by relative excess risk due to interaction (RERI), attributable proportion (AP), and synergy (S). Hypertension was an independent risk factor for baPWV ( p < .01), but obesity was not ( p = .08). The interaction between obesity and hypertension on arteriosclerosis was not multiplicative (adjusted odds ratio = 0.89 (0.79–1.01), p = .07), but a negative additive interaction (RERI = −4.33, AP = −2.91, S = 0.10; p < .01) exists. Therefore, obesity may reduce the risk of arteriosclerosis caused by hypertension when hypertension and obesity coexist, especially in women and middle-aged people, which supports the obesity paradox.
Association of Statin Adherence With the Development of Nonalcoholic Fatty Liver Disease: A Nested Case-Control Study Using a Japanese Claims Database
Authors: Nakagawa Chihiro , Yokoyama Satoshi , Hosomi Kouichi
Published: September 2022

Background:

Statins are expected to have beneficial effects on nonalcoholic fatty liver disease (NAFLD); however, evidence remains insufficient.

Objective:

In this study, we aim to investigate the association between statin adherence and NAFLD development.

Methods:

We conducted a nested case-control study of statin users using the Japan Medical Data Center administrative claims database (January 2005 to January 2020). Individuals who developed NAFLD were designated as cases. For each case, we randomly selected a maximum of 10 controls using risk set sampling. Good adherence was defined as the proportion of days covered (PDC) of ≥0.80. Higher intensity was defined as the median or higher of a cumulative defined daily dose (cDDD) per day covered by statin prescription. Conditional logistic regression analysis was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs).

Results:

In this study, 253 383 patients with the first statin prescription were identified. Of them, 7080 were selected and matched to 70 734 controls. The medians of PDC and intensity were 0.88 (interquartile range [IQR], 0.61-0.96) and 0.32 (IQR, 0.25-0.50) cDDD/day, respectively. Good adherence was significantly associated with a reduced risk of NAFLD development (adjusted OR, 0.82; 95% CI, 0.78-0.86). Higher intensity was not significantly associated with a reduced risk of NAFLD development (adjusted OR, 1.02; 95% CI, 0.97-1.08).

Conclusion and Relevance:

Good adherence to statins is associated with a reduced risk of NAFLD development, regardless of the statin intensity. Appropriate statin therapy could reduce the risk of NAFLD development.
Effectiveness and tolerability of the fluocinolone acetonide implant in patients with diabetic macular edema in the UAE: 24 and 36-month outcomes
Authors: Elbarky Ahmed
Published: September 2022

Introduction

The effectiveness and safety of the fluocinolone acetonide (FAc) implant was evaluated at Month 24 and, in some sustained for up to 36 months, in patients with diabetic macular edema (DME) and a pseudophakic lens treated in the UAE following prior anti-vascular endothelial growth factor and dexamethasone (DEX) implant.

Methods

This was a retrospective, observational audit study conducted between September 2017–September 2020 in which 22 patients were treated with the FAc implant and outcomes monitored for up to 36 months. Effectiveness outcomes were: best-corrected visual acuity (BVCA) and central macular thickness (CMT). Safety was assessed by monitoring intraocular pressure (IOP). All outcomes were measured at Months 1, 3, 6, 12, 24, and 36.

Results

Significant improvements in mean BCVA were observed versus baseline from Month 1, which were maintained up to Month 24 (P < 0.0001 versus baseline). In all five patients completing 36 months follow-up, the improvements in BVCA were maintained through to Month 36 P < 0.005 versus baseline. Similarly, mean CMT improved versus baseline at Month 1 through to Month 24 (P < 0.0001 versus baseline), with significant improvements also noted in the 5 patients completing 36 months follow-up (P < 0.005 versus baseline). An IOP rise to 32 mmHg was observed in one eye, but returned to normal values at next measure. Five eyes required IOP lowering drops and one required IOP-lowering surgical intervention.

Conclusion

The FAc intravitreal implant is effective for 24 months, and sustained for 36 months, in a UAE population previously treated with a DEX implant, with tolerability profile in-line with previous reports.
Acute idiosyncratic liver injury after Cladribine treatment for multiple sclerosis: first case report and review on associated hepatic disorders
Authors: Saraceno Lorenzo , Pirro Fiammetta , Stigliano Rosa , Agostoni Elio Clemente , Protti Alessandra
Published: September 2022

In recent years, several disease-modifying therapies have been developed for the treatment of multiple sclerosis (MS). Cladribine transiently depletes B and T lymphocytes, with subsequent gradual cell recovery. No cases are reported in literature describing Cladribine drug-induced liver injury (DILI). We describe the case of a 19-year-old woman who developed acute idiosyncratic liver injury 12 days after treatment with Cladribine. Post-marketing adverse event reporting is of paramount importance to allow an early recognition and treatment. Moreover, evaluation of the physiopathological mechanism underlying drug-induced hepatic toxicity can provide clinicians with valuable instruments for prevention and treatment.
Feasibility and reliability of telemedicine examinations for respiratory distress in children: A pilot study
Authors: Florin Todd A , Lorenz Douglas , Ramgopal Sriram , Burns Rebecca , Rainwater Daniel , Benedetti Jillian , Ruddy Richard M , Gerber Jeffrey S , Kuppermann Nathan
Published: September 2022

Respiratory disorders are a leading cause of acute care visits by children. Data establishing the reliability of telemedicine in evaluating children with respiratory concerns are limited. The overall objective of this pilot study was to evaluate the use of telemedicine to evaluate children with respiratory concerns. We performed a pilot prospective cohort study of children 12 to 71 months old presenting to the emergency department (ED) with lower respiratory tract signs and symptoms. Three examinations were performed simultaneously—one by the ED clinician with the patient, one by a remote ED clinician using telemedicine, and one by the child's parent. We evaluated measures of agreement between (a) the local and remote clinicians, (b) the local clinician and the parent, and (c) the parent and the remote clinician. Twenty-eight patients were enrolled (84 paired examinations). Except for heart rate, all examination findings evaluated (general appearance, capillary refill time, grunting, nasal flaring, shortness of breath, retractions, impression of respiratory distress, respiratory rate, and temperature) had acceptable or excellent agreement between raters. In this pilot study, we found that telemedicine respiratory examinations of young children are feasible and reliable, using readily available platforms and equipment.
Disturbed sleep and patterns of psychiatric symptoms and function in a school-based sample of adolescents
Authors: Åslund Lie , Andreasson Anna , Lekander Mats , Henje Eva , Dennhag Inga
Published: September 2022

Background

Sleep problems are common in adolescence and often related to psychopathology and impaired functioning. However, most studies have used summative scores, and little is known about how adolescents with disrupted sleep perceive their specific symptoms and dysfunctions. This study explored differences in levels of psychiatric symptoms and functional ability between Swedish adolescents with and without self-reported disturbed sleep in a school-based sample.

Methods

Swedish adolescents ( n = 618, mean age 15.7+/-1.9yrs) answered the PROMIS pediatric measures for fatigue, anxiety, depression, pain interference, anger, physical activity and peer and family relationships. Logistic regression analyses were performed to assess differences between respondents with and without disturbed sleep.

Results

Disturbed sleep was associated with higher levels of symptoms of fatigue, anxiety, depression, anger and pain interference, as well as lower functional abilities in terms of physical activity and peer- and family relationships. Adolescents reporting disturbed sleep generally displayed a pattern of impaired executive functioning, internal emotional distress and school- and sleep related worry and dysfunction, as compared to physical disability, aggressive behavior, stress and generalized worry.

Conclusions

The present study adds to the understanding of how disturbed sleep and specific psychiatric symptoms and functional ability are interrelated, which may also have clinical implications.
Ethnomethodological ethnography: Historical, conceptual, and methodological foundations
Authors: Meier zu Verl Christian , Meyer Christian
Published: September 2022

This text discusses the relationship between ethnomethodology and ethnography and sketches what can be called an ethnomethodological ethnography. To do so, it shows that Garfinkel and his collaborators work ethnographically in order to adequately describe social phenomena and make their phenomenal field properties noticeable. To highlight the distinctive features of ethnomethodological ethnography, the text first discusses other ethnographic approaches. Differences between these approaches and the ethnomethodological ethnography become apparent through two argumentative steps: first, by discussing Garfinkel’s reflections on ethnomethodology and ethnography, and second, by discussing actual ethnographies by Garfinkel's collaborators. The text concludes with a general reflection on the methodological principles of ethnomethodological ethnography.
Numerical investigation to increase ship efficiency in regular head waves using an alternative engine control strategy
Authors: Thiaucourt Jonas , Horel Boris , Tauzia Xavier , Ncobo Chuma
Published: September 2022

According to the International Maritime Organization (IMO)’s Greenhouse Gas (GHG) strategy whose aim is to reduce the shipping industry’s total carbon emissions by 50% by the year 2050, it is desirable to increase ships energy efficiency to reduce GHG emissions and fuel costs. To do so, a short-term measure is to develop innovative engine control strategies in waves that will reduce ship’s GHG emissions. In this study, a mathematical model is developed to assess two engine control strategies: the standard constant rotational speed mode and an innovative constant fuel rack approach. The coupled model is made of a mean value engine, propeller curves and a ship behavior simulator. Emphasis is placed on the presentation of the engine model and references are given for further details on the ship simulator. After verifying the coupling between the engine model and the ship simulator, the fuel consumption is compared, for the two strategies, at the same average speed and for three head regular waves. This paper presents the basics of a further long time research project and shows that coupling ship simulators with engine simulators leads to promising simulation tools for a ship’s GHG emissions reduction. Results from a first application case show that the constant fuel rack approach reduces fuel consumption (up to 1.6%).
An Analysis of Sex-Based Outcomes Following Transcarotid Artery Revascularization
Authors: Husman Regina , Tanaka Akiko , George Mitchell , Cambiaghi Tommaso , Leonard Samuel D. , Motaganahalli Raghu L. , Fajardo Andres , Wang S. Keisin
Published: September 2022

Objective

Several studies suggest that females have higher perioperative adverse events and decreased benefit from carotid artery revascularization with transfemoral carotid artery stenting and carotid endarterectomy (CEA) compared to males. However, there are limited data of sex-based outcomes for transcarotid artery revascularization (TCAR).

Methods

A retrospective review of prospectively maintained system-wide TCAR databases was performed between December 2015-January 2022. Patients who underwent TCAR were stratified based on sex. Relevant demographics, medical conditions, anatomical characteristics, intra- and postoperative courses, and adverse events were captured.

Results

729 patients underwent TCAR, 486 (66.6%) male and 243 (33.3%) female. Males were more likely to be diagnosed with coronary artery disease (56.9% vs 47.7%, P<.01) and were active smokers (30.4% vs 21.4%, P < .01). Age, symptomatic status, BMI, hypertension, hyperlipidemia, diabetes mellitus, arrhythmia, chronic obstructive pulmonary disease, history of myocardial infarction, heart failure with reduced ejection fraction <30%, end-stage renal disease and Charlson Comorbidity Index were similar. In the perioperative period, there was no significant difference in reintervention rates (1.6% vs 1.2%, P = .75), cranial nerve palsy (.6% vs .4%, P > .99), ipsilateral stroke (1.9% vs 3.3%, P = .29), stent thrombosis (.4% vs .8%, P > .99), myocardial infarction (0% vs 0%, P > .99) and death (1.2% vs 1.2%, P > .99). In follow-up, no significant difference was found in reintervention, ipsilateral stroke, contralateral stroke, myocardial infarction, in-stent restenosis >50%, stent thrombosis, and death.

Conclusions

Males and females did not have a statistically significant difference in outcomes when comparing ipsilateral stroke, in-stent thrombosis, conversion to CEA, and death after TCAR. However, our cohort comprised predominantly male patients and may conceal statistical significance as the females in our cohort did have a higher tendency toward developing complications. Future studies with a larger female cohort should be conducted to determine whether there is a true disparity of outcomes between the males and females undergoing TCAR.
Lifestyle Strategies to Boost Total Body Iron
Authors: Moore Scott
Published: September 2022

Patients who switch to a whole food plant-based eating pattern (WFPBD) generally have an uneventful transition, but may present with dizziness and lightheadedness. Research demonstrates that anemia is no more common when transitioning to a WFPBD than in the normal population, but Iron deficiency is possible in the context of a transition to a whole food plant-based diet resulting in either microcytic or normocytic anemia. All six pillars of lifestyle medicine; diet, activity, sleep, stress, social engagement, and risky substances, can affect absorption of Iron and are discussed. This paper discusses how the use of lifestyle modifications can potentiate iron supplementation, or replace the need for it altogether, to reverse anemia.
“I just want us to be heard”: A qualitative study of perinatal experiences among women of color
Authors: Barnett Kierra S , Banks Ashley R , Morton Tiffany , Sander Christine , Stapleton Maureen , Chisolm Deena J
Published: September 2022

Objectives:

Long-standing racial disparities, particularly between White and Black women, in maternal and birth outcomes necessitate an examination of the factors influencing these disparities. This study aimed to understand the experiences of women of color as they relate to pregnancy and/or birth complications to inform policy and strategy to decrease racial and ethnic health disparities.

Methods:

Six focus groups were conducted with women ( n = 31) who were identified as a woman of color, were 18 years or older, self-identified as having experienced pregnancy or birth complications after 2016, and who spoke English. A focus group guide co-created with the research team, community partners, and peer researchers from the local community was utilized to elicit discussions related to barriers, successes, and existing opportunities to provide equitable care and services to families throughout the perinatal period. An inductive and iterative approach to qualitative analyses of the focus group transcripts was used to identify key themes.

Results:

The seven themes identified include: lack of knowledge, mental health, communication with providers, support systems, representation, social determinants of health, and discrimination and stigma. Women shared a variety of experiences related to their health care from before pregnancy into their post-partum period, revealing many areas for improvement to extant systems.

Conclusion:

The inclusion of voices of the populations most deeply affected by health disparities is crucial to understanding how care and services provided can be improved. This analysis suggests the need for change at multiple levels of the health care and social services systems. These experiences provide valuable insight into some of the many struggles and barriers that women of color face during pregnancy and beyond.
Movement-based patient-therapist attunement in psychological therapy and its association with early change
Authors: Schwartz Brian , Rubel Julian A. , Deisenhofer Anne-Katharina , Lutz Wolfgang
Published: September 2022

Objective

Attunement is a novel measure of nonverbal synchrony reflecting the duration of the present moment shared by two interaction partners. This study examined its association with early change in outpatient psychotherapy.

Methods

Automated video analysis based on motion energy analysis (MEA) and cross-correlation of the movement time-series of patient and therapist was conducted to calculate movement synchrony for N = 161 outpatients. Movement-based attunement was defined as the range of connected time lags with significant synchrony. Latent change classes in the HSCL-11 were identified with growth mixture modeling (GMM) and predicted by pre-treatment covariates and attunement using multilevel multinomial regression.

Results

GMM identified four latent classes: high impairment, no change (Class 1); high impairment, early response (Class 2); moderate impairment (Class 3); and low impairment (Class 4). Class 2 showed the strongest attunement, the largest early response, and the best outcome. Stronger attunement was associated with a higher likelihood of membership in Class 2 ( b = 0.313, p = .007), Class 3 ( b = 0.251, p = .033), and Class 4 ( b = 0.275, p = .043) compared to Class 1. For highly impaired patients, the probability of no early change (Class 1) decreased and the probability of early response (Class 2) increased as a function of attunement.

Conclusions

Among patients with high impairment, stronger patient-therapist attunement was associated with early response, which predicted a better treatment outcome. Video-based assessment of attunement might provide new information for therapists not available from self-report questionnaires and support therapists in their clinical decision-making.
Twitter Users’ Privacy Behavior: A Reasoned Action Approach
Authors: Schmidt Peter , Gordoni Galit , Ajzen Icek , Beuthner Christoph , Davidov Eldad , Silber Henning , Steinmetz Holger , Weiß Bernd
Published: September 2022

Social networking sites have become a predominant means of communication across the globe. Activities on these sites generate massive amounts of personal information and raise concerns about its potential abuse. Means designed to protect the user’s privacy and prevent exploitation of confidential data often go unused. In this study, we draw on the theory of planned behavior, a reasoned action approach, to explain intentions to adopt privacy behaviors on social networking sites, with a focus on Twitter users. Consistent with the theory, an online survey of Twitter users ( n = 1,060) found that instrumental and experiential attitudes and descriptive and injunctive subjective norms regarding these behaviors were direct predictors of intentions. Perceived behavioral control had a moderating effect, such that subjective norm was a better predictor of intentions for participants high as opposed to low in perceived control. We briefly discuss the implications of these results for developing theory-driven and evidence-based interventions to promote privacy behavior.
Historical Development of Legal Aid System in India: A Legal Perspectives
Authors: Nazim Sohail
Published: September 2022

Human civilisation has always been plagued by the problem of access to justice for the weak. With human development, the modern state took up the responsibility of administering justice. Modern states have complex legal systems, making legal aid an essential part of access to justice for the poor. In 1976, the Indian Constitution was amended to add Article 39A, mandating the state’s responsibility to provide free legal aid to the impoverished. Legal aid is discussed in the article, along with its origins and meaning. This article examines the history and legal framework of legal aid in India. Further, a judicial analysis is provided that makes legal aid a fundamental right. The article also emphasises the lacunas in the judicial system in India.
Cross-sectional associations of optimism with artery calcification and function: The SCAPIS study
Authors: Natt och Dag Yvonne , Engström Gunnar , Rosvall Maria
Published: September 2022

Background:

An increasing amount of research indicates that positive psychological factors, such as optimism, might be beneficial for cardiovascular health. However, most studies have focused on cardiovascular events. The present study aimed to investigate associations between optimism and subclinical outcomes related to cardiovascular health.

Methods:

This cross-sectional study used data from SCAPIS Malmö, Sweden, including 6251 randomly selected men and women from the Malmö municipality area, aged 50 to 64 years. Optimism was assessed via the LOT-R questionnaire, but also by using the two subscales of LOT-R, assessing optimism and pessimism separately. Arterial health was assessed as the coronary artery calcium score, ankle-brachial index, and aortic augmentation index. Cardiovascular risk was estimated using the SCORE instrument. Adjustments were made for sociodemographic factors, depression, and cardiovascular risk factors.

Results:

Those who were most optimistic had lower odds of coronary artery calcification, with an odds ratio of 0.74 (95% confidence interval 0.58, 0.93), compared to those who were least optimistic. Also, higher levels of optimism were associated with a general pattern of lower aortic augmentation index, and with higher ankle-brachial index on both left and right side. For coronary artery calcification associations seemed to be mediated primarily through an absence of pessimism. The associations were reduced after adjustments, but persisted for measures of arterial function.

Conclusions:

The results indicate that optimism might be health protective with regard to arterial function, but with regard to coronary artery calcification it was rather the absence of pessimism that was of importance.
Stakeholder perceptions of the use of a rapidly deployed modified ECHO to train and prepare healthcare providers for COVID-19
Authors: Casanova Madeline P , Blades Kayla C , Palmer Kathleen , Smith Lachelle H , Fuerst Peter , Seegmiller Jeffrey G , Baker Russell T
Published: September 2022

Background:

Innovative approaches to deliver timely information to rural healthcare providers are necessary with the COVID-19 pandemic. Project Extension for Community Healthcare Outcomes (ECHO) is a telementoring program designed to provide practitioners in rural communities with opportunities to engage in specialty training. We examined participant perceptions of a rapidly deployed, single continuing education session to improve healthcare provider preparedness for COVID-19 in Idaho.

Methods:

A modified Project ECHO session was developed to inform providers about emergency preparedness, treatment, testing, and resources for COVID-19. A post-session survey examined session impact and barriers on clinical practice.

Results:

Respondents believed the modified ECHO session increased COVID-19 knowledge and would improve their clinical practice and preparedness. Respondents were satisfied with the session and identified content, interdisciplinary collaboration, and format as beneficial; perceived barriers for utilizing session information included a lack of relevance of content and clinical applicability, and time constraints.

Conclusions:

A rapidly deployed modified Project ECHO session was perceived as an effective mechanism to foster collaboration and relay information to promote best practices at the start of the COVID-19 pandemic. An established Project ECHO network may be useful to rapidly exchange knowledge and information during a health emergency.
Increasing tissue requirements in lymphoma trials may exclude patients with high-risk disease or worse prognosis
Authors: Desai Sanjal H. , Mwangi Raphael , Ng Wern Lynn , King Rebecca L. , Maurer Matthew J. , Cerhan James R. , Feldman Andrew L. , Farooq Umar , Mou Eric , Habermann Thomas M. , Thompson Carrie A. , Wang Yucai , Witzig Thomas E. , Nowakowski Grzegorz S.
Published: September 2022

An enhanced understanding of the molecular heterogeneity of diffuse large B-cell lymphoma (DLBCL) has opened the door to clinical trials evaluating novel agents with subtype-specific activity. It is an emerging question whether core needle biopsies (CNB) can adequately meet the increasing tissue requirements of these clinical trials. This can potentially lead to selective enrollment of patients who can undergo excisional biopsy (EB). It is also important to know whether patients who can undergo extensive diagnostic work up differ in their disease characteristics and outcomes from those who cannot. In this observational study, we describe the characteristics, outcomes, and adequacy of diagnostic tissue in patients with newly diagnosed DLBCL and primary mediastinal large B-cell lymphoma who underwent EB vs CNB. Of the 1061 patients, 532 (49.8%) underwent EB and 529 (50.1%) underwent CNB. A significantly higher proportion of patients with CNB had advanced stage disease, an international prognostic index of ≥3, and inadequate tissue for molecular analyses. Patients with CNB had significantly worse 5-year event-free survival (67.6% vs 56.9%; hazard ratio [HR], 0.76; confidence interval [CI]95, 0.6-0.9, P < .001) and 5-year overall survival (76.4% vs 69.2%; HR, 0.8; CI95, 0.6-0.9, P < .001). Thus, patients who underwent CNB have poor-risk features and inferior outcomes on frontline chemoimmunotherapy, are more likely to have inadequate tissue for molecular analyses, and might not meet the tissue requirements of biomarker-driven clinical trials. Thus, the increasing tissue requirements of biomarker-driven clinical trials may result in the exclusion of patients with high-risk DLBCL who need novel agents.
Genetically defined individual reference ranges for tryptase limit unnecessary procedures and unmask myeloid neoplasms
Authors: Chovanec Jack , Tunc Ilker , Hughes Jason , Halstead Joseph , Mateja Allyson , Liu Yihui , O’Connell Michael P. , Kim Jiwon , Park Young Hwan , Wang Qinlu , Le Quang , Pirooznia Mehdi , Trivedi Neil N. , Bai Yun , Yin Yuzhi , Hsu Amy P. , McElwee Joshua , Lassiter Sheryce , Nelson Celeste , Bandoh Judy , DiMaggio Thomas , Šelb Julij , Rijavec Matija , Carter Melody C. , Komarow Hirsh D. , Sabato Vito , Steinberg Joshua , Hafer Kurt M. , Feuille Elizabeth , Hourigan Christopher S. , Lack Justin , Khoury Paneez , Maric Irina , Zanotti Roberta , Bonadonna Patrizia , Schwartz Lawrence B. , Milner Joshua D. , Glover Sarah C. , Ebo Didier G. , Korošec Peter , Caughey George H. , Brittain Erica H. , Busby Ben , Metcalfe Dean D. , Lyons Jonathan J.
Published: September 2022

Serum tryptase is a biomarker used to aid in the identification of certain myeloid neoplasms, most notably systemic mastocytosis, where basal serum tryptase (BST) levels >20 ng/mL are a minor criterion for diagnosis. Although clonal myeloid neoplasms are rare, the common cause for elevated BST levels is the genetic trait hereditary α-tryptasemia (HαT) caused by increased germline TPSAB1 copy number. To date, the precise structural variation and mechanism(s) underlying elevated BST in HαT and the general clinical utility of tryptase genotyping, remain undefined. Through cloning, long-read sequencing, and assembling of the human tryptase locus from an individual with HαT, and validating our findings in vitro and in silico, we demonstrate that BST elevations arise from overexpression of replicated TPSAB1 loci encoding canonical α-tryptase protein owing to coinheritance of a linked overactive promoter element. Modeling BST levels based on TPSAB1 replication number, we generate new individualized clinical reference values for the upper limit of normal. Using this personalized laboratory medicine approach, we demonstrate the clinical utility of tryptase genotyping, finding that in the absence of HαT, BST levels >11.4 ng/mL frequently identify indolent clonal mast cell disease. Moreover, substantial BST elevations (eg, >100 ng/mL), which would ordinarily prompt bone marrow biopsy, can result from TPSAB1 replications alone and thus be within normal limits for certain individuals with HαT.
Introducing oxygen transfer rate measurements as a novel method for time-resolved cytotoxicity assessment in shake flasks
Authors: Ihling Nina , Munkler Lara Pauline , Paul Richard , Lang Dietmar , Büchs Jochen
Published: September 2022

Background

Determining the cytotoxicity of test substances is essential for the safety assessment of chemicals. To quantify the cytotoxicity, dose–response curves are determined and the half-maximum inhibitory concentration (IC50) is subsequently calculated. Results often rely on a single endpoint evaluation which typically requires manual sampling and subsequent sample analysis to determine the IC50. Hence, no information on culture behavior are available during treatment. Here, measurement of the oxygen transfer rate (OTR) was applied as a method for time-resolved assessment of the cytotoxicity to (a) provide information on culture behavior during treatment and (b) quantitatively assess the cytotoxic effect of a test substance.

Results

To investigate the applicability of the method, different types and concentrations of test substances were added and the OTR was measured for two different CHO suspension cell lines in shake flasks: (a) For CHO cell line one, culture behavior was not affected when 0.1 mM ZnCl2 was added. However, for both cell lines, adding up to 0.2 mM CoCl2 led to a decrease in the OTR that was concentration dependent. For CHO cell line two, adding up to 5% DMSO led to a concentration-dependent decrease in the OTR and in the slope of the OTR; (b) From the measured OTR, dose–response curves were established and used to calculate the IC50. For cell line one, the IC50 for CoCl2 was 0.03 mM while the IC50 from a comparative measurement based on trypan blue exclusion was 0.06 mM. Cell line two was less susceptible to CoCl2 as the IC50 was not reached at the concentrations tested. For DMSO, single OTR values and determined slopes were used for evaluation. In both cases, the IC50 was calculated to 2.3%.

Conclusions

Our approach provides a method for analyzing the cytotoxicity of a test substance based on OTR measurements. This method provides (i) insights on culture behavior, (ii) information on the progression of cytotoxicity, (iii) dose–response curves, and (iv) a first indication of IC50 values. Quantitative assessment of cytotoxicity is possible non-invasively and in real-time during treatment. Compared to traditional endpoint evaluation, our method simplifies experimentations and enhances the comparison of assay results.
Identification of a hippocampal lncRNA-regulating network in a natural aging rat model
Authors: Qi Li , Li Xiao , Liu Shi-min , Jiao Dan-li , Hu Dan , Ju Xin-yao , Zhao Shu-yu , Si Shu-han , Hu Li , Li Guo-na , Ma Bing-zhe , Zhou Shuang , Zhao Chen
Published: September 2022

Background

Dysregulation of long noncoding RNA (lncRNA) expression is related to aging and age-associated neurodegenerative diseases, and the lncRNA expression profile in the aging hippocampus is not well characterized. In the present investigation, the changed mRNAs and lncRNAs were confirmed via deep RNA sequencing. GO and KEGG pathway analyses were conducted to investigate the principal roles of the clearly dysregulated mRNAs and lncRNAs. Subsequently, through the prediction of miRNAs via which mRNAs and lncRNAs bind together, a competitive endogenous RNA network was constructed.

Results

A total of 447 lncRNAs and 182 mRNAs were upregulated, and 385 lncRNAs and 144 mRNAs were downregulated. Real-time reverse transcription-polymerase chain reaction validated the reliability of mRNA and lncRNA sequencing. KEGG pathway and GO analyses revealed that differentially expressed (DE) mRNAs were associated with cell adhesion molecules (CAMs), the p53 signaling pathway (SP), phagosomes, PPAR SP and ECM—receptor interactions. KEGG pathway and GO analyses showed that the target genes of the DE lncRNAs were related to cellular senescence, the p53 signaling pathway, leukocyte transendothelial migration and tyrosine metabolism. Coexpression analyses showed that 561 DE lncRNAs were associated with DE mRNAs. A total of 58 lncRNA–miRNA–mRNA target pairs were confirmed in this lncRNA‒miRNA‒mRNA network, comprising 10 mRNAs, 13 miRNAs and 38 lncRNAs.

Conclusions

We found specific lncRNAs and mRNAs in the hippocampus of natural aging model rats, as well as abnormal regulatory ceRNA networks. Our outcomes help explain the pathogenesis of brain aging and provide direction for further research.
Efficacy and safety of adrenergic alpha-1 receptor antagonists in older adults: a systematic review and meta-analysis supporting the development of recommendations to reduce potentially inappropriate prescribing
Authors: Mansbart Felix , Kienberger Gerda , Sönnichsen Andreas , Mann Eva
Published: September 2022

Background

Adrenergic alpha-1 receptor antagonists (alpha-1 antagonists) are frequently used medications in the management of lower urinary tract symptoms (LUTS) suggestive of benign prostatic hyperplasia (BPH) and in the management of therapy-resistant arterial hypertension, two conditions frequently found in older adults. This systematic review aims at presenting a complete overview of evidence over the benefits and risks of alpha-1 antagonist treatment in people ≥ 65 years, and at deriving recommendations for a safe application of alpha-1 antagonists in older adults from the evidence found.

Methods

A comprehensive literature search was performed (last update March 25th 2022) including multiple databases (Medline/Pubmed, Embase, the Cochrane Library) and using the PICOS framework to define search terms. The selection of the studies was done by two independent reviewers in a two-step approach, followed by a systematic data extraction. Quality appraisal was performed for each study included using standardised appraisal tools. The studies retrieved and additional literature were used for the development of recommendations, which were rated for strength and quality according to the GRADE methodology.

Results

Eighteen studies were included: 3 meta-analyses, 6 randomised controlled trials and 9 observational trials. Doxazosin in the management of arterial hypertension was associated with a higher risk of cardiovascular disease, particularly heart failure, than chlorthalidone. Regarding treatment of LUTS suggestive of BPH, alpha-1 antagonists appeared to be effective in the relief of urinary symptoms and improvement of quality of life. They seemed to be less effective in preventing disease progression. Analyses of the risk profile indicated an increase in vasodilation related adverse events and sexual adverse events for some agents. The risk of falls and fractures as well as the effects of long-term treatment remained unclear. All meta-analyses and 5 out of 6 interventional studies were downgraded in the quality appraisal. 7 out of 9 observational studies were of good quality.

Conclusions

It cannot be recommended to use doxazosin as first-line antihypertensive agent neither in older adults nor in younger patients. In the management of BPH alpha-1 antagonists promise to effectively relieve urinary symptoms with uncertainty regarding their efficacy in preventing long-term progression events.