bluuebunny/crossref_metadata_2025 huggingface dataset:
A spline-based framework for the flexible modelling of continuously observed multistate survival processes
Authors: Eletti Alessia , Marra Giampiero , Radice Rosalba
Published: September 2023

Multistate modelling is becoming increasingly popular due to the availability of richer longitudinal health data. When the times at which the events characterising disease progression are known, the modelling of the multistate process is greatly simplified as it can be broken down in a number of traditional survival models. We propose to flexibly model them through the existing general link-based additive framework implemented in the R package GJRM. The associated transition probabilities can then be obtained through a simulation-based approach implemented in the R package mstate, which is appealing due to its generality. The integration between the two is seamless and efficient since we model a transformation of the survival function, rather than the hazard function, as is commonly found. This is achieved through the use of shape constrained P-splines which elegantly embed the monotonicity required for the survival functions within the construction of the survival functions themselves. The proposed framework allows for the inclusion of virtually any type of covariate effects, including time-dependent ones, while imposing no restriction on the multistate process assumed. We exemplify the usage of this framework through a case study on breast cancer patients.
A morphological study of fivefold Islamic geometric patterns using formal grammar for computer-aided design applications
Authors: Refalian Ghazal , Coloma Eloi , Moya Joaquim Narcis
Published: September 2023

This paper presents a morphological study of Islamic geometric patterns (IGP) and their role in application of formal grammar in computational modeling of IGPs. Through a comprehensive literature review and data collection, we analyze the morphological properties of these patterns using techniques such as geometric transformations, pattern classification, and symmetry analysis. Based on our findings, we explore how these properties can be used in constructing a formal grammar through string rewriting system for a CAD application. Building on a study on the potential of a string rewriting system for modeling IGPs, the current research suggests an update to the previous system and introduces a new morphological structure for IGPs. The new method has an expanded sample set and is tested on a class of 5-fold star patterns with 12 members and demonstrates successful development. The results are implemented in a Grasshopper add-on, providing a flexible platform to generate the patterns through strings and to control their parameters. This tool opens up new possibilities to bridge traditional patterns with contemporary technologies and make them more accessible. Furthermore, it contributes to the preservation of IGPs as a significant cultural and architectural heritage, while also advancing the evolution of these patterns to a new and contemporary generation.
synth2: Synthetic control method with placebo tests, robustness test, and visualization
Authors: Yan Guanpeng , Chen Qiang
Published: September 2023

The synthetic control method (Abadie and Gardeazabal, 2003, American Economic Review 93: 113–132, Abadie, Diamond, and Hainmueller, 2010, Journal of the American Statistical Association 105: 493–505) is a popular method for causal inference in panel data with one treated unit that often uses placebo tests for statistical inference. While the synthetic control method can be implemented by the excellent command synth (Abadie, Diamond, and Hainmueller, 2011, Statistical Software Components S457334, Department of Economics, Boston College), it is still inconvenient for users to conduct placebo tests. As a wrapper program for synth, our proposed synth2 command provides convenient utilities to automate both in-space and in-time placebo tests, as well as the leave-one-out robustness test. Moreover, synth2 produces a complete set of graphs to visualize covariate or unit weights, covariate balance, actual or predicted outcomes, treatment effects, placebo tests, ratio of posttreatment mean squared prediction error to pretreatment mean squared prediction error, pointwise p-values (two-sided, right-sided, and left-sided), and the leave-one-out robustness test. We illustrate the use of the synth2 command by revisiting the classic example of California’s tobacco control program (Abadie, Diamond, and Hainmueller 2010).
ebct: Using entropy balancing for continuous treatments to estimate dose–response functions and their derivatives
Authors: Tübbicke Stefan
Published: September 2023

Interest in evaluating dose–response functions of continuous treatments has been increasing recently. To facilitate the estimation of causal effects in this setting, I introduce the ebct command for the estimation of dose–response functions and their derivatives using entropy balancing for continuous treatments. First, balancing weights are estimated by numerically solving a globally convex optimization problem. These weights eradicate Pearson correlations between covariates and the treatment variable. Because simple uncorrelatedness may be insufficient to yield consistent estimates in the next step, higher moments of the treatment variable can be rendered uncorrelated with covariates. Second, the weights are used in local linear kernel regressions to estimate the dose–response function or its derivative. To perform statistical inference, I use a bootstrap procedure. The command also provides the option of producing publication-quality graphs for the estimated relationships.
Cluster randomized controlled trial analysis at the cluster level: The clan command
Authors: Thompson Jennifer A. , Leurent Baptiste , Nash Stephen , Moulton Lawrence H. , Hayes Richard J.
Published: September 2023

In this article, we introduce a new command, clan, that conducts a cluster-level analysis of cluster randomized trials. The command simplifies adjusting for individual- and cluster-level covariates and can also account for a stratified design. It can be used to analyze a continuous, binary, or rate outcome.
Investigation on the impact of elevated temperature on sustainable geopolymer composite
Authors: Verma Manvendra , Meena Rahul Kumar , Singh Indrajeet , Gupta Nakul , Saxena Kuldeep K , Reddy M Madhusudhan , Salem Karrar Hazim , Salmaan Ummal
Published: September 2023

Geopolymer concrete (GPC) is an eco-friendly, sustainable, cementless and green concrete. It could be an alternative to the conventional concrete. In alkaline circumstances, the alumina and silica concentration in geopolymer concrete creates the geopolymer bond, while regular concrete creates C-S-H (calcium silicate hydrate bond). The final result of the geopolymer bond does not include any water. At elevated temperatures, geopolymer concrete would thus be more stable. Due to its greater strength and durability quality, geopolymer concrete may be the ideal replacement for ordinary portland cement (OPC) concrete. This research intends to examine how specimens of geopolymer concrete and regular concrete respond to exposure to increased temperatures between 100°C and 800°C. Mass loss, ultrasonic pulse velocity, compressive strength, X-ray diffraction, thermogravimetric analysis and derivative thermogravimetric analysis were all examined throughout the experimental examination. Both concrete specimens lose mass or weight as the exposure temperature rises; OPC concrete samples spalls at 600°C, while GPC sample fail at 800°C. GPC specimens lose around 12% of their original mass after being exposed to temperatures of 800°C, while OPC specimens lose about 7%. The GPC specimens maintained 60% of their initial compressive strength after being exposed to a temperature of 700°C, but the OPC concrete specimens only kept 52%. With each increase in exposure to extreme temperatures, the peaks of quartz and cristobalite are lowered. Only the form or structure of the mineral oxide would change; the chemical linkages would remain. The GPC samples subjected to temperatures of 100°C exhibit effective thermal stability than all other specimens exposed to extreme temperatures. As the exposure temperature rises, the GPC specimens become more thermally stable. According to the experimental findings, the GPC specimens’ bonding structure makes them more resistant to high temperatures than regular concrete specimens. Micropores are present in the voids of the geopolymer matrix, while mesopores and micropores are present in the voids of the OPC matrix. While OPC bonding is C-S-H formed by the hydration of lime and silica contained in the cement, the geopolymer bonding did not include the water content in the final or end result of geopolymerisation for strengthening.
Punching shear capacity of expanded polystyrene (EPS) lightweight concrete flat slabs without shear reinforcement
Authors: Rashied Ahmed Faris
Published: September 2023

This work presents an experimental and theoretical study on the punching shear behavior of Lightweight Concrete Slabs. Lightweight obtained using Expanded polystyrene (EPS) beads as partial coarse aggregate’s replacement, without adding supplementary bonding additives, to reduce concrete density from 2400 to 1800 kg/m3. The EPS content, concrete strength and column aspect ratio were test parameters. Five groups of concrete prepared by partially replacing natural coarse aggregate with 0%, 10%, 20%, 30% and 40% (by volume) of EPS balls. Ten reinforced concrete slabs without shear reinforcement with a monolithic column were tested under concentric loading. The study aimed to examine the effect of the EPS on the density and compressive strength of concrete and eventually on the flat slabs punching capacity. Five series of mixtures identified and compared with conventional normal weight concrete. Results showed that with increasing EPS content, rate of reduction in concrete strength is faster than the reduction in concrete density. Also, showed that the failure base area increased while the concrete density decreased, this yielded a higher punching capacity compared to rate of decrease in the concrete strength. International standards models showed overestimation of punching shear capacity and didnot reflect the reduced concrete strength action of lightweight concrete.
Stroke in women between 2006 and 2018: Demographic, socioeconomic, and age disparities
Authors: Jacobs Molly M , Ellis Charles
Published: September 2023

Background:

Black Americans have a higher prevalence of stroke and stroke-related deaths than any other racial group. Racial disparities in stroke outcomes are even wider among women than men. Conventional studies have cited differences in lifestyle (i.e. smoking, alcohol consumption, etc.) and vascular risk factors between races as the source of these disparities. However, these studies fail to account for the higher prevalence of minoritized populations at the lower end of the socioeconomic distribution.

Objectives:

This study explores differences in stroke risk factors across age and socioeconomic cohorts to determine whether comorbidities can sufficiently explain disparities at all ages and income levels.

Design:

Using the 2006–2018 National Health Interview Survey data, statistical analysis evaluated differences in risk factors among a full sample cohort (aged 18–85 years; n = 131,091) and a “young” subsample cohort (aged 18–59 years; n = 6183) of women.

Methods:

Logistics and unconditional quantile regression models assessed the relationship between stroke and comorbid, demographic, and behavioral characteristics across socioeconomic classes.

Results:

Results suggest that Black women had a 1.415-fold (confidence interval = 1.259, 1.591) higher likelihood of stroke compared with White women after controlling for age, behavior, and comorbidities. Racial disparities were not statistically significant at the higher income ranges for either the full (odds ratio = 1.404, p = 0.3114) or young samples (odds ratio = 1.576, p = 0.7718). However, Blacks had significantly higher odds of stroke in the lower quartiles (lower odds ratio: 1.329, p = 0.0242; lower middle odds ratio: 1.233, p = 0.0486; and upper middle odds ratio: 1.994, p = 0.0005). Disparities were larger among young women (odds ratio = 1.449, confidence interval = 1.211, 1.734).

Conclusion:

While comorbidities were highly associated with stroke prevalence in all socioeconomic cohorts, Blacks only had higher relative odds in the lower income classes. Lack of biological or behavioral explanations for these findings suggests that unobserved or uncontrolled factors such as systemic racism, prejudicial institutions, or differential treatment may contribute to this.
Shifting Artistic Identity on Canvas: From ‘Painter-Worker’ to ‘Painter-Artist’ in a Commercial Painting Community
Authors: Tian Jiayi
Published: September 2023

This study investigates how painters in Village F use artworks to facilitate their identity shift from ‘painter-workers’ to ‘painter-artists’. Focusing on the painters’ interpretation of the visual contents, types of paints, and painting techniques, this article highlights the artworks’ role as a medium for identity construction, thus avoiding the silencing of artworks. Drawing on interview and observation data, it argues that the artwork offers a space where art/commerce negotiate with each other, and where the painters are reconciled with their past experience and identity. The complexity and ambiguity of artworks allow juxtaposition of various interpretations by the artists, which deconstructs the dualistic view of art/commerce and authentic/inauthentic artistic images. By introducing what the artists do in addition to what they say, this study views artistic identity as emerging from the interaction between the artists and artworks. It thus dialogues with the production of culture perspective and the interactionist approach to the construction of an artistic identity, and responds to the calling of bringing the artworks back in the sociology of art. It concludes by discussing the findings’ broader implications, the methodological effectiveness, and the limitations of this research.
Synthesis and Evaluation of Acetylcholinesterase Inhibitory and Cytotoxic Activities of Pyrano[2,3-d]pyrimidines
Authors: Thanh Nguyen Ha , Giang Nguyen Thi Quynh , Ha Nguyen Van , Phuong Hoang Thi , Thuy Giang Le Nhat , Anh Nguyen Tuan , Cham Ba Thi , Huy Le Duc , Anh Dang Thi Tuyet , Van Kiem Phan , Tuyen Nguyen Van
Published: September 2023

Objective: The study was conducted to evaluate the in vitro acetylcholinesterase (AchE) inhibition activity of novel pyrano[2,3- d]pyrimidine derivatives. Methods: A series of new pyrano[2,3- d]pyrimidine derivatives were synthesized in moderate to good yields (63%-81%) by using microwave-prompted “one-pot” two-step multicomponent reactions of cyclohexane-1,3-dione, malononitrile, aldehydes, and acetic anhydride. Noticeably, Diazabicyclo[2.2.2]octane was successfully employed as a basic catalyst for the formation of 2-amino-4H-pyran-3-carbonitrile intermediates. These products were identified using spectral data, and assessed in terms of their AChE inhibition activity and cytotoxicity against three types of human cancer cell lines including epidermoid carcinoma (KB), hepatoma carcinoma (HepG2), and non-small lung cancer (A549) cell lines. Results: Most of the products depicted moderate to good AChE inhibitory activity, among them, one product with methoxy moiety at meta-position on phenyl group showed the best AchE inhibition activity with IC50 values of 2.20 ± 0.17 µg/mL. Moreover, products exhibited no cytotoxicity against cancer cell lines. Conclusion: This study highlighted that pyrano[2,3- d]pyrimidine derivatives as promising candidates for further investigations directed to the discovery of new AChE inhibitors which could be used in Alzheimer's disease therapy.
Data Collection: Time to revisit the WHY, WHAT, and HOW
Authors: Stanislo Kimberly J.
Published: September 2023

This is the first in a series of three articles looking at school health data collection from identification of data points to utilizing data to share your story and submitting your data to contribute to the National School Health Data Set: Every Student Counts! Many school nurses cringe at the mention of data collection. However, everything we do as school nurses is data driven. Every documented assessment, observation, and conversation provides the school nurse with data. The barriers often noted to participating in formal data collection efforts are time, workload, access to an electronic health record, and not understanding the WHY, WHAT, and HOW. The key to data collection is identifying the data already being collected and starting where you are. Data collection is not something new that you need to find a way to fit into your already busy schedule. WHAT do you currently collect? WHY are you collecting the data you have? HOW do you collect it? WHAT do you do with the data? These are all very important questions, but let’s take a closer look at the WHY, WHAT, and HOW behind data collection.
Reconstructing vascular networks promotes the repair of skeletal muscle following volumetric muscle loss by pre-vascularized tissue constructs
Authors: Chen Chih-Long , Wei Shih-Yen , Chen Wei-Lin , Hsu Ting-Lun , Chen Ying-Chieh
Published: September 2023

Current treatment for complex and large-scale volumetric muscle loss (VML) injuries remains a limited success and have substantial disadvantages, due to the irreversible loss of muscle mass, slow muscle regeneration, and rapid formation of non-functional fibrosis scars. These VML injuries are accompanied by denervation and the destruction of native vasculature which increases difficulties in the functional restoration of muscle. Here, reconstruction of the vascular network at the injury site was offered as a possible solution for improving the repair of muscle defects through the timely supply of nutrients and oxygen to surrounding cells. A hydrogel-based tissue construct containing various densities of the vascular network was successfully created in the subcutaneous space of mice by manipulating hydrogel properties, and then implanted into the VML injury site. One month after implantation, the mouse treated with the highly vascularized tissue had extensive muscle repair at the injury site and only spent a shorter time completing the inclined plane tests. These findings suggest that the reconstruction of the functional vascular network at the VML injury site accelerated muscle fiber repair through a timely supply of sufficient blood and avoided invasion by host fibroblasts.
“If We Don’t Have a Good Relationship, We Won’t Deliver Anything Good”: Emotion Regulation in Small Music Ensembles, Insights from Higher Music Education
Authors: Tahirbegi Damla
Published: September 2023

Situated within the context of higher music education, the empirical orientation of this study is on the reflective accounts of young musicians participating in collaborative ensemble work in an educational institution in Norway. Drawing on theories of regulated learning from educational psychology, this study explores the affective and relational aspects of music students’ experiences of small ensembles. Specifically, it examines students’ perceptions of an ideal ensemble environment, socio-emotional challenges encountered during rehearsals, and the emotion-regulation strategies employed within these contexts. Eleven participants, 4 women and 7 men, with a median age of 22, were interviewed. The data were analyzed using a combination of inductive and deductive approaches to thematic analysis. The findings reveal that music students highly value collaborative ensembles as a gateway to acquiring new knowledge and performance skills, which are predominantly gained through peer interaction and active participation in the learning processes. Respect and receptivity emerged as critical qualities for fruitful musical collaborations. Notably, participants prioritized the well-being of the socio-emotional climate over musical competency, underscoring the formative role of emotions in these social learning environments. Furthermore, the study explored the self-reported emotion-regulation strategies employed by student musicians to maintain and/or re-establish a positive socio-emotional group climate. These regulation strategies involved both self- and other- directed processes.
Connectivity, centrality, and adaptation: The coproduction of political space in China’s standardization of autonomous driving technologies
Authors: Huppenbauer Nicolas
Published: September 2023

Technical standards are a topic of intense geopolitical competition. This article introduces standardization as a practice constitutive of meaning and social order, and, in particular, one that coproduces political space. It engages with the argument that China in international standardization aims to make itself more central, and increasingly rejects domestic adaptation, in order to promote a new spatial vision of Sino-centric connectivity for international relations. After situating this argument in the literature on standardization and space-making, the article analyzes China’s policy discourse on the standardization of Intelligent and Connected Vehicles. The analyzed discourse reveals a position towards connectivity that is partially Sino-centric, but also reproduces established narratives of openness, technical expertise, and cooperation. The article adds to the debate on the coproduction of political space by introducing standardization as a site through which connectivity as a geopolitical vision is negotiated. Empirically, it adds to recent findings that China's different national goals for digital infrastructure development may compete with each other, reducing the country's potential to coherently connect with the world on its own terms.
Which Phenotypes Should We Include in the Hypoplastic Left Heart Syndrome?
Authors: Anderson Robert H. , Spicer Diane E. , Crucean Adrian
Published: September 2023

The recent special issue of the World Journal for Pediatric and Congenital Heart Surgery devoted to hypoplastic left heart syndrome, and its related anomalies, contained significant information of great clinical relevance. Very little attention, however, was devoted to the integrity of ventricular septum as providing a criterion to distinguish between the phenotypes to be included within the syndrome, as opposed to the related anomalies. In this commentary, we summarize the evidence in support of the notion that the phenotypes to be included within the syndrome can be interpreted on the basis of an acquired disease of fetal life. We suggest that it is the integrity of the ventricular septum that provided the major criterion for the distinction between the lesions making up the syndrome and the related anomalies. The subsets of lesions to be included within the syndrome can then be recognized in terms of the time, subsequent to the closure of the embryonic interventricular communication, at which the left ventricle ceased its growth relative to the remainder of the cardiac components. On this basis, it is possible to recognize the combinations of aortic and mitral atresia, mitral stenosis with aortic atresia, combined mitral and aortic stenosis, and hypoplasia of the left ventricle with commensurate hypoplasia of the aortic and mitral valves; the latter combination now recognized as the hypoplastic left heart complex.
The Congenital Heart Surgeons’ Society Kirklin/Ashburn Fellowship: The Fellows’ Perspective
Authors: Jegatheeswaran Anusha , Argo Madison B. , Devlin Paul J. , Callahan Connor P. , Meza James M. , Wilder Travis J. , Hickey Edward J. , Karamlou Tara
Published: September 2023

Since its establishment in 2001, the Congenital Heart Surgeons’ Society John W. Kirklin/David Ashburn Fellowship has contributed substantially to the field of congenital heart surgery research while simultaneously training the next generation of surgeon- scientists. To date, ten fellows (and counting) have successfully completed this rigorous training, producing over 40 published articles focused on longitudinal outcomes from the various Congenital Heart Surgeons’ Society cohorts. As the Kirklin/Ashburn Fellowship expands and additional fellows matriculate, its legacy, the network of support, and the contribution to congenital heart surgery research will undoubtedly hold strong.
The Academic Impact of Congenital Heart Surgeons’ Society (CHSS) Studies
Authors: Jacobs Jeffrey Phillip , DeCampli William M. , Karamlou Tara , Najm Hani K. , Marino Bradley S. , Blackstone Eugene H. , McCrindle Brian W. , Jegatheeswaran Anusha , St. Louis James D. , Austin Erle H. , Caldarone Christopher A. , Mavroudis Constantine , Overman David M. , Dearani Joseph A. , Jacobs Marshall L. , Tchervenkov Christo I. , Svensson Lars G. , Barron David , Kirklin James K. , Williams William G.
Published: September 2023

Purpose

We reviewed all 64 articles ever published by The Congenital Heart Surgeons’ Society (CHSS) Data Center to estimate the academic impact of these peer-reviewed articles.

Materials and Methods

The Congenital Heart Surgeons’ Society has performed research based on 12 Diagnostic Inception Cohorts. The first cohort (Transposition) began enrolling patients on January 1, 1985. We queried PubMed to determine the number of publications that referenced each of the 64 journal articles generated by the datasets of the 12 Diagnostic Inception Cohorts that comprise the CHSS Database. Descriptive summaries of the data were tabulated using mean with standard deviation and median with range.

Results

Sixty-four peer-reviewed papers have been published based on the CHSS Database. Fifty-nine peer-reviewed articles have been published based on the 12 Diagnostic Inception Cohorts, and five additional articles have been published based on Data Science. Excluding the recently established Diagnostic Inception Cohort for patients with Ebstein malformation of tricuspid valve, the number of papers published per cohort ranged from 1 for coarctation to 11 for transposition of the great arteries. The 11 articles generated from the CHSS Transposition Cohort were referenced by a total of 111 articles (median number of references per journal article = 9 [range = 0-22, mean = 10.1]). Overall, individual articles were cited by an average of 11 (mean), and a maximum of 41 PubMed-listed publications. Overall, these 64 peer-reviewed articles based on the CHSS Database were cited 692 times in PubMed-listed publications. The first CHSS peer-reviewed article was published in 1987, and during the 35 years from 1987 to 2022, inclusive, the annual number of CHSS publications has ranged from 0 to 7, with a mean of 1.8 publications per year (median = 1, mode = 1).

Conclusion

Congenital Heart Surgeons’ Society studies are widely referenced in the pediatric cardiac surgical literature, with over 10 citations per published article. These cohorts provide unique information unavailable in other sources of data. A tool to access this analysis is available at: [ https://data-center.chss.org/multimedia/files/2022/CAI.pdf ].
Perception of Goals and Expected Outcomes in Older Hip Fracture Patients and Their Medical Staff: A Cross Sectional Study
Authors: Schroeder Hanna S. , Israeli Avi , Liebergall Meir (Iri) , Or Omer , Abu Ahmed Wiessam , Paltiel Ora , Justo Dan , Zimlichman Eyal
Published: September 2023

Background

Goal-oriented patientcare is a key element in qualityhealthcare. Medical-caregiver’s (MC) are expected to generate a shared decision-making process with patients regarding goals and expected health-outcomes. Hip-fracture patients (HFP) are usually older-adults with multiple health-conditions, necessitating that agreed-upon goals regarding the rehabilitation process, take these conditions into consideration. This topic has yet to be investigated by pairing and comparing the perception of expected outcomes and therapeutic goals of multidisciplinary MCs and their HF patient’s. Our aim was to assess in a quantitative method whether HFPs and their multidisciplinary MCs agree upon target health-outcomes and their most important goals as they are reflected in the SF12 questionnaire.

Methods

This was a cross-sectional, multi-center, study of HFPs and their MCs. Patients and MCs were asked to rate their top three most important goals for rehabilitation from the SF12 eight subscales: physical functioning, physical role limitation, bodily pain, general health, vitality, social functioning, emotional role limitation and mental health, and indicate their expected outcome. Descriptive statistics and mixed effect logistic-regression were used to compare concordance of the ratings. Agreement between patients and MCs was assessed using interclass coefficients (ICCs).

Results

A total of 378 ratings were collected from 52 patients, 12 nurses, 12 physicians and 6 paramedical personnel. Each patient had between 3 and 9 raters. Patients considered physical functioning and physical role limitation more important than did MCs. Physicians and nurses emphasized the importance of bodily pain while patients referred to it as relatively less significant. The total ICC was low (2%) indicating poor agreement between MCs and patients. With the exception of physical-functioning, MCs predicted a less optimistic outcome in all of the SF12's subscales in comparison to HFPs.

Conclusion

Effective intervention in HFPs requires constructive communication between MCs and patients. The study suggests that caregivers have an insufficient understanding of the expectations of HFPs. More effective communication channels are required in order to better understand HFPs’ needs and expectations.
An Empirical Examination of the In-Prison Behaviors of Foreign-Born Individuals: Does Nationality Predict Misconduct?
Authors: Ramos Javier , Piatkowska Sylwia J. , Hernandez Cristal N.
Published: September 2023

The current study investigates how immigrants cope and adapt to the “pains of imprisonment” by examining a specific maladjustment outcome—disciplinary infractions. Like other groups (e.g., females, LGBTQ, elderly), immigrants are regarded as a special population in prison considering that they encounter a unique set of challenges that the typical incarcerated person does not. At the same time, immigrants are not a monolithic group, and there are reasons why misconduct may differ when we separate them by country of birth. To this end, we explore whether the frequency and probability for institutional misconduct varies across Cubans, Puerto Ricans, Haitians, Jamaicans, Mexicans, as well as immigrants from other countries. We also consider whether any nationality group exhibits a higher (or lower or similar) propensity for in-prison offending than the native-born. Our results reveal there are greater differences in disciplinary infractions among our foreign-born groups than between them and natives, a finding that is obscured when immigrants are lumped into a single measure (i.e., all foreign-born).
Expectations and Management of Technology-Assisted Supplemental Work: A Managerial Perspective
Authors: De Alwis Sulakshana , Hernvall Patrik , Adikaram Arosha S.
Published: September 2023

Limitless connectivity enabled by Information Communication Technologies (ICTs) has aided organisations to keep their employees linked to work even after hours. Drawing from work boundary theory and sociomaterial theory, this study explores what leads to technology-assisted supplemental work (TASW) expectations and how these expectations are managed in organisations. In the analysis of qualitative data collected from 20 senior-level managers from two organisations in Sri Lanka, we found that organisational norms developed through top management influence led to TASW expectations among lower-level managers. These expectations are then imposed by managers, and nonresponses are controlled by means of confrontations and punishments. These punitive regimes could especially create discriminative effects on married female employees if they cannot meet the after-hour expectations due to gender roles associated with the home domain. However, having formal policy guidelines on TASW could reduce the negative consequences on employees. This study contributes to the literature by including the managerial perspective on TASW expectations.
Ventricular Tachycardia in an Elderly Male With Brugada Syndrome
Authors: Jaber Mohammad , Basharat Sohaib , Krishnan Rajagopal , Shah Shivang , Shu Richard
Published: September 2023

We present a case of Brugada syndrome in a 74-year-old patient who presented with urine retention and incidentally found to have non–sustained ventricular tachycardia (NSVT) on electrocardiogram (ECG) and telemetry. To reveal characteristic type 1 Brugada pattern, right-pericardial lead was placed in the third right intercostal space. No antiarrhythmics were started, a loop recorder was implanted, and on follow-up episodes of self-terminating sustained ventricular tachycardia (VT) were noted. The patient was started on quinidine with resolution of VT.
“The Terminology Might Be Ahead of Practice”: Embedding Shared Decision Making in Practice—Barriers and Facilitators to Implementation of SDM in the Context of Maternity Care
Authors: Waddell Alex , Goodwin Denise , Spassova Gerri , Bragge Peter
Published: September 2023

Background. It is a patient’s right to be included in decisions about their health care. Implementing shared decision making (SDM) is important to enable active communication between clinicians and patients. Although health policy makers are increasingly mandating SDM implementation, SDM adoption has been slow. This study explored stakeholders’ organizational- and system-level barriers and facilitators to implementing policy mandated SDM in maternity care in Victoria, Australia. Method. Twenty-four semi-structured interviews were conducted with participants including clinicians, health service administrators and decision makers, and government policy makers. Data were mapped to the Theoretical Domains Framework to identify barriers and facilitators to SDM implementation. Results. Factors identified as facilitating SDM implementation included using a whole-of-system approach, providing additional implementation resources, correct documentation facilitated by electronic medical records, and including patient outcomes in measurement. Barriers included health service lack of capacity, unclear policy definitions of SDM, and policy makers’ lack of resources to track implementation. Conclusion. This is the first study to our knowledge to explore barriers and facilitators to SDM implementation from the perspective of multiple actors following policy mandating SDM in tertiary health services in Australia. The primary finding was that there are concerns that SDM implementation policy is outpacing practice. Nonclinical staff play a crucial role translating policy to practice. Addressing organizational- and system-level barriers and facilitators to SDM implementation should be a key concern of health policy makers, health services, and staff.

Highlights

New government policies require shared decision making (SDM) implementation in hospitals. There is limited evidence for how to implement SDM in hospital settings. There are concerns SDM implementation policy is outpacing practice. Understanding and capacity for SDM varies considerably among stakeholders. Whole of system approaches and electronic medical records are seen to facilitate SDM.
Eltrombopag Can Achieve Treatment Free Remission as Upfront Therapy for Patient with Immune Thrombocytopenia
Authors: Obeidat Khaldun , Yassin Mohamad A
Published: September 2023

Immune Thrombocytopenic purpura (ITP) is an immune mediated thrombocytopenia caused by autoantibodies directed against platelet antigens which leads to destruction of the platelets by the spleen and inability of the bone marrow to restore normal counts. The main treatment for ITP is immunosuppressive medication and the first line treatment is glucocorticoids, intravenous immune globulin (IVIG) and Intravenous anti-D immune globulin. Here we report a 45-year old lady who was diagnosed with ITP and achieved treatment free remission after with Eltrombopag as upfront.
De Novo Intron 22 Inversion Carrier Detection—The Emerging Value of Genetic Analysis in a Developing Country
Authors: Kloppers Jean F. , du Plessis Jan , Janse van Rensburg Walter
Published: September 2023

Genetic analysis of the F8 gene can play a vital role in the diagnosis and management of people with hemophilia A (PWH). Knowing the causative mutation can assist treating clinicians in predicting the risk of inhibitor formation and a person’s response to treatment. It is also a vital tool for genetic counselors in assisting PWH with family planning. Mutational analysis has been limited in developing countries, mainly due to resource constraints; however, with the development of more cost-effective screening tools, these assays are becoming more common in developing countries. Unfortunately, the clinical utility of these assays remain unclear in some of these underresourced countries, resulting in a lack of clinician buy-in. We aimed to highlight the wide-ranging impact mutational analysis potentially has on PWH and their extended families in a developing country.

We used a gel-based in-house method to determine the inversion 22 (Inv22) mutation in a family where a young boy, without a family history, was recently diagnosed with hemophilia A. Inv22 was detected in the proband and his mother, but not in any other direct family member. Therefore, we concluded that the mutation was a de novo mutation in the mother. Subsequently, this result has bearing on at least 23 direct blood-relatives.

Genetic screening extends far wider than the treatment of PWH and is vital in the management of PWH and their extended families. With the availability of cost-effective genetic screening assays this should also be the case in developing countries.
The Impact of Glucose-6-Phosphate Dehydrogenase Deficiency on the Frequency of Vasoocclusive Crisis in Patients with Sickle Cell Anemia
Authors: Nnamezie Igwilo Hilary , Salawu Lateef , Adeoye Adedeji Tewogbade
Published: September 2023

Background and Objectives

Sickle cell anemia (SCA) and glucose-6-phosphate dehydrogenase (G6PD) deficiency are both hereditary diseases of the red blood cells that cause hemolysis. The impact of the interaction of both conditions on the clinical and laboratory presentations of the affected persons is sparse. This study, therefore, correlated G6PD activity with disease severity in persons with SCA by comparing disease severity in G6PD-deficient SCA persons with those with normal G6PD activity.

Methodology

This cross-sectional study was conducted in the department of Haematology and Blood Transfusion of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. G6PD activity, SCA disease severity, and hematological parameters including reticulocyte counts and Heinz body estimation, bilirubin, and aspartate transaminase were estimated in 67 SCA persons. The results were compared between SCA persons with G6PD deficiency and those with normal enzyme activity.

Results

The prevalence of G6PD deficiency was found to be 23.9%. The G6PD-deficient SCA patients included 4 (25.0%) males and 12 (75.0%) females. G6PD deficiency was significantly higher in females ( P = .047). There was no significant difference in disease severity scores between G6PD-deficient and G6PD-nondeficient SCA patients. However, G6PD-deficient persons reported significantly higher episodes of severe vasoocclusive crisis (VOC) per annum ( P = .048). The hematological and biochemical parameters were similar between G6PD-deficient and G6PD normal SCA persons except that the G6PD-deficient SCA persons have significantly higher reticulocyte response ( P = .001). There was no correlation between disease severity resulting from reduced G6PD activity and Heinz body formation in SCA persons in the steady state.

Conclusion

G6PD deficiency significantly contributes to recurrent painful vasoocclusive crisis in SCA persons in the steady state.
Experience of Daratumumab in Six Patients With Multiple Myeloma and Kidney Failure
Authors: Turgutkaya Atakan , Bolaman Ali Zahit , Yavaşoğlu İrfan
Published: September 2023

Purpose

Daratumumab, a monoclonal anti-CD38 antibody, has been administered for relapsed refractory multiple myeloma (RRMM). The Pollux and Castor trials proved its efficacy, yet excluded patients with advanced-stage renal disease. Therefore, available experience in these patients is limited. Here, we aimed to emphasize the safety of daratumumab in 6 patients with kidney disease.

Methods

Six patients with RRMM diagnoses and renal impairment were included. Their mean ± standard deviation age was 63.6 ± 8.38 years. Three, two, and one patient(s) had immunoglobulin (Ig) G kappa, lambda light chain, and IgA lambda MM, respectively. All patients received 4 to 6 lines of anti-MM therapy before daratumumab treatment. Five had chronic kidney disease and 1 was admitted to the hospital with acute kidney injury due to myeloma relapse. Daratumumab was administered to all patients with close follow-up.

Results

Following treatment with daratumumab, kidney function was improved in 1 patient. In 1 patient, the glomerular filtration rate was slightly decreased and hemodialysis was initiated. In 2 patients already receiving hemodialysis, their dependency on hemodialysis continued. No adverse reactions were recorded. One patient achieved complete remission and 4 patients achieved very good partial remission.

Conclusion

Daratumumab can be administered safely, with improvements in kidney function possible in some patients. Studies involving larger patient groups are required to obtain more accurate data.
Quality Attributes of Plasma Derived Human Fibrinogen (Fibrogen-I®)
Authors: Dolia Sheetal , Verma Sachin , Pawar Amit , Ray Suma
Published: September 2023

BACKGROUND

Fibrinogen is an important component of hemostasis and clot formation. Replacement therapy with a human Fibrinogen concentrate is the preferred therapeutic option for patients with congenital or acquired Fibrinogen insufficiency. To make the Fibrinogen available for treatment of such patients, Fibrogen-I®, a lyophilized product purified from pooled human plasma was developed and extensively characterized. The product quality attributes were assessed by different biochemical, functional and structural analytical methods.

MATERIAL AND METHODS

Functional activity of Fibrinogen in the Fibrogen-I® was demonstrated by determination of its clottable protein activity. Purity profiling of Fibrogen-I® was evaluated by SE-HPLC method. Activation and fibrinolysis markers like D-dimer, plasminogen was determined by automated coagulometer and fibrinopeptide A activity by ELISA. Far UV CD analysis was also performed by CD Spectrometer.

RESULTS

The product exhibited high purity 89.7% by SE-HPLC. Activation and Fibrinolysis marker proteins in the drug product were negligible. The high purity and integrity of Fibrogen-I® is underlined by the ratio of Fibrinogen activity by Clauss/clottable protein with mean calculated value of 0.9 which is in close proximity with theoretical value 1 indicating fully native Fibrinogen. The results of far-UV CD spectroscopy revealed that Fibrogen-I® exists mostly as a β-sheet secondary structure, which is in accordance with the three-dimensional structure of human Fibrinogen. Downscaling experiments for the two dedicated orthogonal pathogen inactivation steps, ie solvent detergent treatment and dry heat treatment, exhibited pathogen safety.

DISCUSSION

Fibrogen-I® exhibited specific functional activity, desirable quality attributes, pathogen safety and the ability to be made available to patients requiring fast and effective Fibrinogen replacement.
Retrospective Analysis of a New Antigen Assay to Detect Anti-Transglutaminase Antibodies for Diagnosis and Monitoring of Celiac Disease
Authors: Verbeke Sandra , Canals Andrea
Published: September 2023

BACKGROUND

The improved diagnosis and monitoring of celiac disease (CD) requires increasingly sensitive and specific serological markers. The development of new antigens ( neo-epitopes) able to detect different sets of anti-transglutaminase antibodies requires studies to demonstrate their advantages.

OBJECTIVE

The goal of this study was to evaluate a new antigen for the detection of anti-tTG antibodies that combines tissue transglutaminase (tTG) and gliadin peptides. This protein complex occurs under physiological conditions in vivo at the time of deamination.

PATIENTS AND METHODS

In this retrospective study, serum samples collected from patients from January to December 2018 were analyzed. Results of the determinations for neo-epitope anti-tTG antibodies (manufacturer's cut-off values: negative <12 U/mL, indeterminate 12-18 U/mL; positive >18 U/mL) were recorded along with age, sex, and duodenal biopsy results. Neo-epitope assay results were correlated with clinical and laboratory data and final CD diagnoses, using the manufacturer's cut-off value and a proposed alternate cut-off value.

RESULTS

A total of 3820 neo-epitope anti-tTg determinations were analyzed. The percentage of values in the indeterminate zone was low (3.6%), with very few values (0.9%) at the exact manufacturer's cut-off limit (18 U/mL). This indicated a good resolution capacity for positives and negatives. The percentage of false positives was lower compared to a previous study (2013 study: 3.6%, vs current study (2018): 0.5%). A new positivity cut-off value was proposed: 20 U/mL, which increased the positive predictive value of the test.

CONCLUSIONS

The neo-epitope assay is a more precise tool than recombinant human transglutaminase assay for the diagnosis and monitoring of celiac patients. It has a greater ability to resolve positive and negative results (“minimum indeterminate area”). Its greater sensitivity could detect situations (presentation and/or dietary transgression) where conventional techniques show negative or weakly positive serology.
Conventional Therapeutic Plasma Exchange Versus Low Volume Plasma Exchange in Chronic Pathologies: Potential Benefit in Alzheimer’s Disease
Authors: Escolar Ginés , Páez Antonio , Cid Joan
Published: September 2023

Conventional therapeutic plasma exchange (TPE) is aimed at removing pathological agents from circulation using a medical device which separates out plasma from other components of blood. Usually, 1.0 to 1.5 plasma volumes are removed and replaced with a replacement solution. There is strong clinical evidence for the effectiveness of TPE in a wide spectrum of diseases, such as thrombotic thrombocytopenic purpura, severe acute inflammatory demyelinating polyneuropathy, and Guillain-Barré syndrome, among others. However, therapeutic approaches using lower plasma exchange volumes (LVPE) suggest some degree of effectiveness in a number of pathological conditions, although generally with low level of clinical evidence: hematology disorders (autoimmune hemolytic anemia), neuroimmunological diseases (Guillain-Barré syndrome, neuromyelitis optica, myasthenia gravis, multiple sclerosis), pulmonary disorders, liver failure, dermatology (pemphigus) and metabolic diseases (porphyria, cholesterol). Further or newer studies are needed to confirm LVPE as an alternative to TPE for such groups of pathologies. While plasma volume removed for TPE ranges 3-4.5 L per procedure, for LVPE ranges from 350 mL to 2 L (frequency and duration vary depending on the pathology treated). In the case of Alzheimer‘s disease (AD), the AMBAR trial recently investigated a combined sequence of intensive TPE with human albumin replacement followed by a maintenance phase LVPE (650-880 mL of plasma removed, similar to a plasma donation). The treatment slowed the decline or stabilized the disease symptoms. The AMBAR approach could justify investigating the use of LVPE in chronic conditions where plasma exchange strategies have proven successful.