bluuebunny/crossref_metadata_2025 huggingface dataset:
Prospects for new drugs to treat binge-eating disorder: Insights from psychopathology and neuropharmacology
Authors: Heal David J , Smith Sharon L
Published: July 2021

Background:

Binge-eating disorder (BED) is a common psychiatric condition with adverse psychological and metabolic consequences. Lisdexamfetamine (LDX) is the only approved BED drug treatment. New drugs to treat BED are urgently needed.

Methods:

A comprehensive review of published psychopathological, pharmacological and clinical findings.

Results:

The evidence supports the hypothesis that BED is an impulse control disorder with similarities to ADHD, including responsiveness to catecholaminergic drugs, for example LDX and dasotraline. The target product profile (TPP) of the ideal BED drug combines treating the psychopathological drivers of the disorder with an independent weight-loss effect. Drugs with proven efficacy in BED have a common pharmacology; they potentiate central noradrenergic and dopaminergic neurotransmission. Because of the overlap between pharmacotherapy in attention deficit hyperactivity disorder (ADHD) and BED, drug-candidates from diverse pharmacological classes, which have already failed in ADHD would also be predicted to fail if tested in BED. The failure in BED trials of drugs with diverse pharmacological mechanisms indicates many possible avenues for drug discovery can probably be discounted.

Conclusions:

(1) The efficacy of drugs for BED is dependent on reducing its core psychopathologies of impulsivity, compulsivity and perseveration and by increasing cognitive control of eating. (2) The analysis revealed a large number of pharmacological mechanisms are unlikely to be productive in the search for effective new BED drugs. (3) The most promising areas for new treatments for BED are drugs, which augment noradrenergic and dopaminergic neurotransmission and/or those which are effective in ADHD.
β-adrenoceptor antagonists and nightmares: A pharmacoepidemiological–pharmacodynamic study
Authors: Garcia Philippe , Montastruc Jean-Louis , Rousseau Vanessa , Hamard Jacques , Sommet Agnès , Montastruc François
Published: July 2021

Aim:

To compare different β-adrenoceptor antagonists for the risk of reporting nightmare.

Methods:

The study involved two approaches: first, we investigated in VigiBase®, the World Health Organization Individual Case Safety Report (ICSR) database, the disproportionality between exposure to each β-adrenoceptor antagonists and reports of nightmares between 1967 and 2019. Second, in a pharmacoepidemiological–pharmacodynamic analysis, we assessed whether use of β-adrenoceptor antagonists with moderate and high lipid solubility or strong 5-HT1A affinity were associated with an increased risk of reporting nightmares. We conducted multivariate logistic regression to estimate reporting odds ratios (RORs) of nightmares compared to all other adverse drug reactions.

Results:

Of the 126,964 reports recorded with β-adrenoceptor antagonists, 1138 (0.9%) were nightmares. The highest risk of reporting a nightmare was found with exposure of pindolol (adjusted ROR 2.82, 95%CI, 2.19–3.61), metoprolol (1.89, 1.66–2.16), and alprenolol (1.77, 1.06–2.97). Compared to use of low lipid solubility β-adrenoceptor antagonists, use of moderate or high lipid solubility β-adrenoceptor antagonists were significantly more associated with nightmare reports (aROR moderate vs. low 1.72, 95%CI 1.47–2.00 and aROR high vs. low 1.84, 95%CI 1.53–2.22). Use of moderate or high 5-HT1A affinity of β-adrenoceptor antagonists was associated with an increased ROR of nightmares compared with low 5-HT1A affinity of β-adrenoceptor antagonists (aROR moderate vs. low 1.22, 95%CI 1.04–1.43 and aROR high vs. low 2.46, 95%CI 1.93–3.13).

Conclusion:

In our large pharmacovigilance study, nightmares are more frequently reported for pindolol and metoprolol, and among β-adrenoceptor antagonists with high lipid solubility and high 5-HT1A receptor affinity.
Dynamic stability of wind farm multi-machine power system
Authors: Nacim Cherif , Tayeb Allaoui , Mohamed Tadjine , Zahira Seddiki
Published: July 2021

Since it is difficult to store electrical energy, production, and consumption must be in equilibrium under constant voltage and frequency. The producers, the receivers, and the electrical networks that connect them, have mechanical and electrical inertias which disturb this balance. Faced with a variation in power, the electrical system, after oscillations, returns to a stable state. In some cases, the oscillatory regime may diverge. Studies are being carried out to remedy this problem and ensure the stability of the electricity network. This manuscript focuses on FACTS regulation which helps electrical systems, subjected to strong disturbances, to maintain their stability. Magnetic Energy Storage Superconductor (SMES) contains a short-circuited superconducting coil on itself, which injects or absorbs active and reactive power into the system, thereby improving the stability of electrical systems.
US global military deployments, 1950–2020*
Authors: Allen Michael A , Flynn Michael E , Martinez Machain Carla
Published: July 2021

Recent research has shown the importance of studying military deployments and their effects on a wide range of social, political, and economic outcomes. In particular, it has demonstrated how the US has shaped the international system through the largest, and most enduring, military footprint in the twentieth and twenty-first centuries. However, data on US military deployments have been limited in scope and are often difficult to access, making it harder for researchers to use them more widely. In this article, we focus on three goals. First, we discuss the evolution of the quantitative US military deployment literature in recent years, highlighting some of the insights this work has generated for scholarship on international relations and US foreign policy. Second, we update the existing troop data assembled by Kane (2004) through 2020. We also include new data on deployment levels specific to US service branches. Third, to facilitate the use of these data we introduce troopdata, an R package containing the updated data and convenience functions to allow scholars to more easily access these data.
Validating Financial Knowledge Scale Using Item Response Theory
Authors: Bajaj Isha , Kaur Mandeep
Published: July 2021

It is important to have knowledge about financial products and services to make rational financial decisions. Financial knowledge is a wider term and hence difficult to measure. The previous studies have used various methods and instruments to measure it. But there is a need of comprehensive and validated instrument to measure the financial knowledge. In this study, an attempt has been made to measure financial knowledge using a scale consisting of multiple-choice questions on basic and specific financial knowledge related with banking products and services. Each correct answer has been scored ‘1’ and each wrong answer has been scored ‘0’. This dichotomous scale has been validated using Item Response Theory. The theory focuses on the appropriateness of the questions (items) included in the scale with respect to difficulty and discriminability. The results reveal that the overall instrument fulfils both the criteria. The test consisting of twenty-two items is reliable as well as valid with the discrimination index having all positive values ranging from 0.23 to 1.96 and the difficulty index ranging from –5.66 to 0.90. The purpose of this article is to encourage the usage of validated scales for the measurement of financial knowledge and discourage the perplexity in the field of financial knowledge and financial literacy.
Transitions Into and Out of Work: Stay-at-Home Fathers’ Thoughts and Feelings: A Brief Report
Authors: Jones Catherine , Wells Jasmine , Imrie Susan , Golombok Susan
Published: July 2021

This qualitative study explored how stay-at-home fathers (SAHFs) think and feel about transitioning back into paid employment. Findings from a thematic analysis on interviews with 21 SAHFs in the United Kingdom revealed that many of the SAHFs expected to return to work. However, most of the fathers suggested that this would be part-time, or self-employment, which would allow them to remain highly involved in caregiving, representing their commitment to moving away from the traditional gender roles that are largely evident in parenting. Some fathers expressed a desire to return to the paid workforce whilst others showed apprehension, indicating tensions over negotiating work and care. These findings have practical implications for fathers who are highly involved in caregiving.
Role of anaesthesia in endoscopic and external dacryocystorhinostomy: A meta-analysis of 3282 cases
Authors: Vinciguerra Alessandro , Nonis Alessandro , Giordano Resti Antonio , Ali Mohammad Javed , Bussi Mario , Trimarchi Matteo
Published: July 2021

Distal acquired lacrimal obstruction is a common adulthood pathology whose primary treatment is represented by EXT-DCR and END-DCR. When considering their influencing factors, the role of the type of anaesthesia applied during these surgeries has a major role. The aim of this study is to systematically analyse the influence of general and local/regional anaesthesia on the final success rates of EXT-DCR and END-DCR. Primary EXT-DCR and END-DCR articles published later than 2000 with at least 50 single clinician procedures were selected. Exclusion criteria included acute dacryocystitis, tumours, studies focussing on revision surgeries, surgeries with adjunctive procedures, not clearly demarcated surgeons, mixed cohort study of acquired and congenital disorders. This systematic review was conducted in accordance with MOOSE guidelines; where feasible, a meta-analysis of the collected results was conducted. As a result, 11,445 articles were selected of which 2741 were examined after screening, and 16 included after full text review (0.6% of the initial papers). Among all papers included, the number of EXT-DCR was not enough to provide a solid analysis of the effect of anaesthesia; conversely, a significant difference of success rate was noted between local anaesthesia + sedation (85.1%, IC 77.8%–90.4%), and general anaesthesia (90.8%, IC 88.8%–92.4%) in END-DCR ( p = 0.048). In conclusion, END-DCR performed with general anaesthesia should be considered as the solution of choice; however, local anaesthesia, eventually associated with a sedation, can be used as an alternative in selected cases. No meaningful conclusions could be drawn for EXT-DCR, due to the lack of data.
Primary periocular squamous cell carcinoma in central Spain: Factors related to recurrence
Authors: Galindo-Ferreiro Alicia , Sanchez-Tocino Hortensia , Diez-Montero Cecilia , Belani-Raju Minal , García-Sanz Raquel , Diego-Alonso Miguel , Llorente-Gonzalez Ines , Callejo Perez Patricia , Ferrer-Gómez Ana , Sales-Sanz Marco , Martinez-Fernandez Elvira , Schellini Silvana
Published: July 2021

Purpose:

To describe the characteristics and recurrence rates of primary periocular squamous cell carcinoma (SCC) in Spain.

Methods:

This retrospective study investigates the characteristics of primary periocular SCC at two tertiary centers in Spain from 2000 to 2020. Data were collected on demographics, skin phenotype, location, clinical and histological diagnosis, the commitment of surgical margins, recurrence, and risk factors. Multivariate analysis and risk factors were used to investigate recurrence rates, considering p < 0.05 as statistically significant.

Results:

Over the 20-year studied period, 107 patients with primary periocular SCC were assessed. The mean age of SCC was 76.8 ± 12.8 years, 55 (50.9%) were females, and 105 (98.1%) had Fitzpatrick skin phenotype type II or III. SCC lesions affected less than 1/3 of the eyelid (56/52.3% cases), mainly the lower lid (42/39.3% lesions). Sixty (56.1%) cases were SCC differentiated, 76 (71%) had clear margins. Clinical diagnosis of SCC corroborated with histological in 84 (78.5%) cases and orbital involvement occurred in 18 (16.8%) cases. Recurrence was observed in 13 (12.1%) cases, occurring more in large tumors and undifferentiated subtype (53.8%), with committed margins (69.2%) ( p = 0.001), being the commitment of margins a significant predictor for recurrence, although thickness was an independent predictor.

Conclusion:

Periocular SCC in Spain showed a similar pattern as in the world. The risk of recurrence is increased in undifferentiated and large periocular SCC, partially removed with committed margins.
Common sense or censorship: How algorithmic moderators and message type influence perceptions of online content deletion
Authors: Gonçalves João , Weber Ina , Masullo Gina M. , Torres da Silva Marisa , Hofhuis Joep
Published: July 2021

Hateful content online is a concern for social media platforms, policymakers, and the public. This has led high-profile content platforms, such as Facebook, to adopt algorithmic content-moderation systems; however, the impact of algorithmic moderation on user perceptions is unclear. We experimentally test the extent to which the type of content being removed (profanity vs hate speech) and the explanation given for its removal (no explanation vs link to community guidelines vs specific explanation) influence user perceptions of human and algorithmic moderators. Our preregistered study encompasses representative samples ( N = 2870) from the United States, the Netherlands, and Portugal. Contrary to expectations, our findings suggest that algorithmic moderation is perceived as more transparent than human, especially when no explanation is given for content removal. In addition, sending users to community guidelines for further information on content deletion has negative effects on outcome fairness and trust.
Measuring political legitimacy with Twitter: Insights from India’s Aadhaar program
Authors: Mahrenbach Laura C , Pfeffer Jürgen
Published: July 2021

As emerging powers forge ahead with big data initiatives, questions arise regarding the implications of these programs for governance in the Global South more broadly. One understudied aspect deals with how actors attribute legitimacy to governments’ big data activities. We explore actors’ agency in one crucial case: the world’s largest demographic and biometric data program, India’s Aadhaar. Analyzing roughly 250,000 tweets collected in the first 10 years of Aadhaar’s operation, we find that both normative acceptance and cost–benefit calculations are crucial for legitimacy attribution. This finding challenges mainstream theoretical approaches, which prioritize normative factors and often fail to examine how normative and material factors interact during legitimacy attribution. In addition, our study demonstrates a new, mixed-methods approach to measuring legitimacy attribution using Twitter data, which overcomes traditional challenges. As such, we underline the viability of Twitter data as a tool for social measurement.
Got to be real: An investigation into the co-fabrication of authenticity by fashion companies and digital influencers
Authors: Colucci Mariachiara , Pedroni Marco
Published: July 2021

This article investigates how fashion companies build their relationships with digital influencers (DIs), a new group of cultural intermediaries who are increasingly central to brand communication strategies. Scholars have mostly studied DIs’ role in influencing the market, but largely neglected the process through which they build their work. Through a qualitative inductive research directed at 21 Italian fashion companies, we describe the process through which companies fabricate the authenticity work, while collaborating with DIs. By taking the overlooked perspective of the company brand owner, we identify the underlying dynamics of achieving co-fabricated authenticity, unpacking the mechanisms through which companies select DIs, shape the connections and regulate the reciprocity with them. Our findings highlight how companies and DIs’ practices become intertwined, with the commodity of authenticity being constructed at the crossroads between the former’s commercial needs and the latter’s grassroots narratives and practices. ‘Co-fabricated authenticity’ ultimately emerges as the result of the work of those actors who are engaged in managing the authenticity or processes of authentication of marketable goods: the intangible and ephemeral value of authenticity is made tangible and co-produced through the collaboration between brands and cultural intermediaries such as DIs.
Combining CFD, ASE, and HEKF approaches to derive all of the hydrodynamic coefficients of an axisymmetric AUV
Authors: Rasekh Mohamad , Mahdi Miralam
Published: July 2021

In this proposed method, which is based on combination of the nonlinear Hybrid Extended Kalman Filter (HEKF) observer, Analytical and Semi-Empirical (ASE) formulas, and Computational Fluid Dynamics (CFD) simulations, all of the hydrodynamic coefficients of a REMUS AUV are estimated to simulate its motions in 6 Degrees of Freedom (6-DoF). First, Using ASE formulas along with necessary static simulations of the AUV using commercial CFD code of ANSYS CFX software, some hydrodynamic derivatives like drag, lift, and fin coefficients are obtained. Then, utilizing the dynamic simulation of the Straight-Line Test (SLT), the longitudinal added mass coefficient is derived. Finally, benefiting from the HEKF code based on the parameter identification, other unknown coefficients like added mass and damping are estimated in the MATLAB software environment. In HEKF, positions and velocities of the vehicle, which are the system output vector, are obtained from a 6-DoF dynamic maneuver in CFX. It is worth mentioning that, in the present study, the remeshing algorithm in the dynamic mesh approach is used to simulate the dynamic maneuvers of the vehicle. Results, obtained from the proposed combined method, indicate a good agreement for estimated coefficients in comparison with the available analytical and experimental values.
A Wrinkle in Measuring Time Use for Cognitive Health: How should We Measure Physical Activity, Sedentary Behaviour and Sleep?
Authors: Falck Ryan S. , Davis Jennifer C. , Khan Karim M. , Handy Todd C. , Liu-Ambrose Teresa
Published: July 2021

One new case of dementia is detected every 4 seconds and no effective drug therapy exists. Effective behavioural strategies to promote healthy cognitive ageing are thus essential. Three behaviours related to cognitive health which we all engage in daily are physical activity, sedentary behaviour and sleep. These time-use activity behaviours are linked to cognitive health in a complex and dynamic relationship not yet fully elucidated. Understanding how each of these behaviours is related to each other and cognitive health will help determine the most practical and effective lifestyle strategies for promoting healthy cognitive ageing. In this review, we discuss methods and analytical approaches to best investigate how these time-use activity behaviours are related to cognitive health. We highlight four key recommendations for examining these relationships such that researchers should include measures which (1) are psychometrically appropriate; (2) can specifically answer the research question; (3) include objective and subjective estimates of the behaviour and (4) choose an analytical method for modelling the relationships of time-use activity behaviours with cognitive health which is appropriate for their research question.
Postoperative management of zones V-VI extensor tendon repairs: A survey of practice in Malaysia and comparison to IFSHT member countries
Authors: Howell Julianne W , Hirth Melissa J , Chai Siaw Chui , Brown Ted , O’Brien Lisa
Published: July 2021

Introduction

A survey of International Federation of Societies for Hand Therapy (IFSHT) member countries identified relative motion extension as the preferred approach to management of zones V-VI extensor tendon repairs. The aims of this survey were to identify and compare hand therapy practice patterns in Malaysia (a non-IFSHT member country) with findings of the IFSHT survey including an IFSHT subset of Asia-Pacific therapists and to investigate if membership status of the Malaysian Society for Hand Therapists (MSHT) influenced therapy practice patterns.

Methods

An online English-language survey was distributed to 90 occupational therapists and physiotherapists including MSHT members and non-members. Participation required management of at least one extensor tendon repair in the preceding year. Five approaches were surveyed: immobilisation, early passive motion (EPM) with dynamic splinting, and early active motion (EAM) delivered by resting hand (RH), palmar resting interphalangeal joints free (PR), and relative motion extension (RME) splints.

Results

Thirty-seven of the 53 therapists (68%) who commenced the survey completed it. The most used approach was dynamic/EPM (28%), followed by RH/immobilisation (22%) and RH/EAM (22%). A preference for RME/EAM was identified with implementation barriers being surgeon preference and hand therapist confidence.

Discussion

Approach selection for Malaysian therapists differed from the combined IFSHT and Asia-Pacific respondents, with the former using dynamic/EPM and RH/immobilisation compared to IFSHT respondents who predominately used RME/EAM and PR/EAM. This survey provides valuable insights into Malaysian hand therapists’ practices. If implementation barriers and therapist confidence are addressed, Malaysian practice patterns may change to better align with current evidence.
Confronting Forensic Pathologists
Authors: Weedn Victor W.
Published: July 2021

Background:

The Sixth Amendment Confrontation Clause gives defendants a right to confront their accusers.

Method:

U.S. Supreme Court cases that interpreted this right as applied to forensic scientists were reviewed.

Results:

Melendez-Diaz, Bullcoming, and Williams examined constitutional rights to confront forensic scientists. Lower courts have specifically examined their application to forensic pathology. Whether autopsy reports are considered “testimonial” varies among jurisdictions and has not been definitively settled. Defendants are generally able to compel testimony of forensic pathologists. Where the forensic pathologist is truly unavailable, the surrogate expert should be in a position to render an independent opinion.
Leaf Nutrient Relations of Cycads in a Common Garden
Authors: Marler Thomas E. , Lindström Anders J.
Published: July 2021

Background and Aims

Research required to clarify leaf nutrient relations of cycad species has been inadequate. Common garden studies are useful for determining the influence of genetics on leaf traits because of the homogeneous environment among experimental units. To date, there have been no common garden studies which included all ten genera of cycads. The full phylogenetic breadth has, therefore, not been included in this important area of study.

Methods

We examined macronutrient and micronutrient content of leaves from one representative species from each of the ten cycad genera at Nong Nooch Tropical Botanical Garden in Thailand. Nitrogen content was determined by dry combustion, and the remaining nutrients were quantified by spectrometry.

Results

The least variable elements were nitrogen and phosphorus, and the most variable elements were boron and sodium. Nutrient content based on leaflet area was more variable than based on leaflet mass, reflecting species differences in specific leaf area. There were no universal macronutrient or micronutrient signals indicating clear phylogenetic distinctions. Implications for Conservation: Active management of threatened cycad taxa requires research to develop the knowledge to enable evidence-based decisions. This common garden study inclusive of all 10 cycad genera creates a foundation to determine leaf nutrient sufficiency ranges to inform management decisions.
Daratumumab in combination with proteasome inhibitors, rapidly decreases polyclonal immunoglobulins and increases infection risk among relapsed multiple myeloma patients: a single center retrospective study
Authors: Vitkon Roy , Netanely Dan , Levi Shai , Ziv-Baran Tomer , Ben-Yzak Ronit , Katz Ben-Zion , Benyamini Noam , Trestman Svetlana , Mittelman Moshe , Cohen Yael , Avivi Irit
Published: July 2021

Background:

Daratumumab (Dara) is generally well tolerated, but is associated with increased risk of infection.

Methods:

We investigated hypogammaglobinemia occurrence in different Dara-based regimens. Multiple myeloma (MM) patients were treated with ⩾2 cycles of Dara-based therapy during 2016–2020, mainly for relapsed/refractory disease. Data on patient characteristics, treatment regimens, polyclonal IgG (poly-IgG) and uninvolved free light chain (Un-FLC) levels during treatment, as well as predictors for hypogammaglobinemia and predictors for infections, were evaluated retrospectively.

Results:

A total of 84 patients, median age 67.2 years, were included. Dara, mainly as ⩾2 line therapy (88.1%, n = 74), was combined with immunomodulating drugs (IMiDs) (53%), proteasome inhibitors (PIs) (15%), IMiDs-PIs (11%), or dexamethasone only (21%). Median treatment duration was 13 months. Median Poly-IgG levels at 0, 2, and 4 months were 7.1 g/l, 4.5 g/l, and 4 g/l, respectively, and remained low throughout treatment. Lower poly-IgG pre-Dara ( p = 0.001) and Dara-PIs (±IMiDs) regimen were associated with lower poly-IgG levels at 4 months ( p = 0.03). Only patients treated with Dara monotherapy had partial immune reconstitution, reflected by resumption of IgM levels. Most (85%) patients developed ⩾1 infections, mostly grade 1–2 respiratory (76%). A lower poly-IgG level post Dara (RR = 1.137 p = 0.026) predicted increased risk of any infection. Intravenous immunoglobulin (IVIG) was associated with a significant decrease in all infections.

Conclusion:

Relapsed MM patients treated with Dara, often experience persistent hypogammaglobinemia, irrespective of responsiveness to treatment. Infections, especially respiratory, are frequent and apparently related to low Poly-IgG levels. IVIG should be considered for reducing infections in these patients.
Malignant pericardial effusion complicated by cardiac tamponade under atezolizumab
Authors: Benjamin Lardinois , Jean-Charles Goeminne , Laurence Miller , Adrien Randazzo , Terry Laurent , Régis Debois
Published: July 2021

Immune-related adverse events including cardiac toxicity are increasingly described in patients receiving immune checkpoint inhibitors. We described a malignant pericardial effusion complicated by a cardiac tamponade in an advanced non-small cell lung cancer patient who had received five infusions of atezolizumab, a PDL-1 monoclonal antibody, in combination with cabozantinib. The definitive diagnosis was quickly made by cytology examination showing typical cell abnormalities and high fluorescence cell information provided by the hematology analyzer. The administration of atezolizumab and cabozantinib was temporarily discontinued due to cardiogenic hepatic failure following cardiac tamponade. After the re-initiation of the treatment, pericardial effusion relapsed. In this patient, the analysis of the pericardial fluid led to the final diagnosis of pericardial tumor progression. This was afterwards confirmed by the finding of proliferating intrapericardial tissue by computed tomography scan and ultrasound. This report emphasizes the value of cytology analysis performed in a hematology laboratory as an accurate and immediate tool for malignancy detection in pericardial effusions.
From Living in Bondage to Queen Amina: An Aesthetic Evaluation of Contemporary Nollywood
Authors: Ezepue Ezinne Michaelia
Published: July 2021

The history of the Nigerian cinema remains a popular discourse in scholarship. However, one phase in the history of its emergence and development remains more prominent and dominant over others—the video boom era. While some scholars discuss this with appreciation of the doggedness and determination of its players, some are condescending, even condemning as the industry is mirrored against the professionality and remarkability of renowned industries especially Hollywood. This negativity has persisted, warranting that some industry players distance themselves from the sobriquet, Nollywood, which has come to stand for the Nigerian video and film industry. This study takes up the call from industry players for scholarship to re-evaluate and redefine the contemporary Nollywood whose history as well as industrial activity has gone beyond the video boom era. Beyond discussing factors that are currently reshaping Nollywood, this study uses two select films and data collected via interviews with over 20 industry players to re-evaluate production and distribution of films in the industry.
Impact of Racial Disparities on All-Cause Mortality in Patients With Tumors of the Spinal Cord or Spinal Meninges: A Propensity-Score Analysis
Authors: Elsamadicy Aladine A. , Freedman Isaac , Koo Andrew B. , David Wyatt B. , Reeves Benjamin C. , Hengartner Astrid , Pennington Zach , Laurans Maxwell , Kolb Luis , Shin John H. , Sciubba Daniel
Published: July 2021

Study Design:

Retrospective cohort study.

Objective:

The influence that race has on mortality rates in patients with spinal cord tumors is relatively unknown. The aim of this study was to investigate the influence of race on the outcomes of patients with primary malignant or nonmalignant tumors of the spinal cord or spinal meninges.

Methods:

The Surveillance, Epidemiology, and End Results (SEER) Registry was used to identify all patients with a code for primary malignant or nonmalignant tumor of the spinal cord (C72.0) or spinal meninges (C70.1) from 1973 through 2016. Racial groups (African-American/Black vs. White) were balanced using propensity-score (PS) matching using a non-parsimonious 1:1 nearest neighbor matching algorithm. Overall survival (OS) estimates were obtained using the Kaplan-Meier method and compared across non-PS-matched and PS-matched groups using log-rank tests. Associations of survival with clinical variables was assessed using doubly robust Cox proportional-hazards (CPH) regression analysis.

Results:

There were a total of 7,498 patients identified with 648 (6.8%) being African American. African-American patients with primary intradural spine tumors were more likely to die of all causes than were White patients in both the non-PS-matched [HR: 1.26, 95% CI: (1.04, 1.51), P = 0.01] and PS-matched cohorts [HR: 1.64, 95% CI: (1.28, 2.11), P < 0.0001]. On multivariate CPH regression analysis age at diagnosis [HR: 1.03, 95% CI: (1.02, 1.05), P < 0.0001], race [HR: 1.82, 95% CI: (1.22, 2.74), P = 0.004), and receipt of RT [HR: 2.62, 95% CI: (1.56, 4.37), P = 0.0002) were all significantly associated with all-cause mortality, when controlling for other demographic, tumor, and treatment variables.

Conclusions:

Our study provides population-based estimates of the prognosis for patients with primary malignant or nonmalignant tumors of the spinal cord or spinal meninges and suggests that race may impact all-cause mortality.
Human Factors Assessment of a Pediatric Elliptical Machine With Cost Effective Modifications
Authors: Begum Rumena , McCrory Bernadette
Published: July 2021

Background: Developing and sustaining cardio vascular fitness for ambulation are common rehabilitation foci for children with disabilities and their families. Properly designed elliptical trainers may help with pediatric rehabilitation training. Objective: This study focused on the investigation of human factors and ergonomics (HFE) associated with a pediatric elliptical machine, its redesign, and proposing further modifications based on user’s feedback to aid usability, comfort, safety, and interaction. Method: Twenty-eight children(11 typically developing and 17 with physical disabilities and/or chronic conditions) who are 3 to 12 years old, their parents and caregivers, and clinicians participated in the evaluation of the machine before and after modification. Temporospatial data of the children were collected, and their interaction with the machine was assessed. Results: Most features, (i.e., chair height, chair depth, console height, stride length, pedalstraps, and steps height etc.) resulted in positive child and adults’ assessments, whereas six other features resulted in divergent user assessments. Clinicia ns were satisfied with the positioningof chair, stationary handles, pedal, and pedalstraps. However, a lack of adjustability of the stride length was significantly associated with less-than-optimal elliptical training (p = 0.044). Clinicians and 94.3% adult caregivers agreed on the less-than-optimal elliptical training for the children while using the redesigned machine. Conclusion: The modified elliptical machine is a cost effective one and comfortable with im proved safety. A continuously adjustable stride length of 40cm to 110cm was recommended based on kinematic analyses. Additional modifications were suggested to improve the elliptical’s interaction design.
Through Their Eyes: Women and Human Security in Kashmir
Authors: Iqbal Sehar
Published: July 2021

‘Women’s responsibilities call upon them to function in many spheres of human experience … (and so) their perspective on human security is comprehensive, including factors overlooked by the state security paradigm’ (Reardon, 2010a, The gender imperative: Human security vs state security, Routledge, p. 16). Recognising this, the following research article records threats to human security in Kashmir as seen from the point of view of a representative cross-section of Kashmiri women. It argues that in the context of the Kashmir valley, no discussion of security is complete without broadening the perspective from state security to human security. Again, no analysis of human security in Kashmir is complete without taking into account Kashmiri women’s experience of human security threats. The lived experiences of women in Kashmir and their perspectives should be at the heart of any human security analysis. This article aims at recording these threats faced by Kashmiri women in their daily lives, using a case study model. It records the lived experiences of 20 women from different ethnicities, religions, regions and locations within the valley. In doing so, it acknowledges not only the constraints of the case study model but also the centrality of women’s rights to identify and confront the threats to their conceptions and experiences of security. It limits itself to the Kashmir valley where the worst of the violence has occurred since 1989. Twenty women from seven districts—Srinagar, Pulwama, Budgam, Kulgam, Anantnag, Baramulla and Kupwara—have been interviewed over a 6-month period. In order to understand diverse conceptions and experiences of threats to human security, care was taken to include women from diverse ethnic and religious communities. The study covers Sikh, Sunni and Shia Muslim, Gujjar, Pahari and Kashmiri Pandit women.
Veteran Patient Experience Academy: Putting Veterans First
Authors: Poorani Ali A. , Kane Vincent
Published: July 2021

With a national priority to make the Veteran Health Administration (VA) a leading customer service organization and provide patient-centric services to veterans and their families, the Wilmington VA Medical Center (W VAMC) partnered with the University of Delaware’s Department of Hospitality and Sport Business Management at the Lerner College of Business & Economics to develop the VA Patient Experience Academy. The program focused on employee training and provided tools to enhance the veterans’ experience, operationalized the VA Way (VA Core Values, Service Behaviors, Service Recovery), and Own the Moment. Phase 1 of the VA Patient Experience Academy launched with 25 managers in February 2019 and were followed by 5 cohorts including physicians, nurse practitioners, registered nurses, licensed practical nurses, medical staff assistants, and staff. The participants were selected from the W VAMC and 5 Community-Based Outpatient Clinics. The results were measured on 3 levels: Learning outcomes, application of training to practice, and the veterans’ satisfaction scores. Scores in all 3 areas showed significant improvements.
Management Patterns and Outcomes for Intravitreal Injection–Related Endophthalmitis
Authors: Soundararajan Srinath , Robbins Cason B. , Feng Henry L. , Fekrat Sharon
Published: July 2021

Purpose:

This work describes the clinical management and outcomes in cases of presumed infectious endophthalmitis following intravitreal injection at a tertiary academic medical center.

Methods:

A retrospective review took place of eyes that presented to the Duke Eye Center over a 9-year period and were diagnosed with intravitreal injection–related endophthalmitis. Clinical presentation, management, microbiologic yield, visual outcomes, and complications were abstracted from medical records.

Results:

Of 23 eyes diagnosed with postinjection endophthalmitis, 52.2% underwent anterior chamber tap (33.3% of which first underwent dry needle vitreous tap), 47.8% underwent needle vitreous tap, 17.4% underwent neither, and none underwent pars plana vitrectomy (PPV) for initial management. Subsequent PPV was performed in 6 eyes (26.1%). Mean visual acuity (VA) improved by 50 Early Treatment Diabetic Retinopathy Study letters at 6 months. Eyes that underwent initial anterior chamber tap had worse presenting VA than those that did not ( P = .01). Eyes undergoing subsequent PPV had worse VA at presentation ( P = .02) and at 6 months ( P < .001). Eyes presenting with VA of hand motion (20/8000) or worse were more likely to undergo subsequent PPV ( P = .02).

Conclusions:

Eyes with intravitreal injection–related endophthalmitis presenting with VA of hand motion or worse were more likely to undergo subsequent PPV. Future studies with larger cohorts may reveal whether earlier vitrectomy should be considered in these patients.
Swept-source optical coherence tomography changes and visual acuity among Palestinian retinitis Pigmentosa patients: a cross-sectional study
Authors: Shalabi Orjowan , Nazzal Zaher , Natsheh Muath , Iriqat Salam , Michaelides Michel , Ghanem Muyassar , Aslanian Alice , Alswaiti Yahya , AlTalbishi Alaa
Published: July 2021

Background

Retinitis pigmentosa (RP) is a heterogeneous group of inherited ocular diseases that result in progressive retinal degeneration. This study aims to describe different Swept-source Optical Coherence Tomographic (SS-OCT) changes in Palestinian RP patients and to explore possible correlations with Visual Acuity (VA).

Methods

A cross-sectional observational study was conducted on Retinitis Pigmentosa patients diagnosed with RP in a tertiary eye hospital. Full history and ocular examination were made. SS-OCT imaging was done for all eyes assessing the presence of cystoid macular edema, epiretinal membrane, macular holes, and external limiting membrane, ellipsoid zone status. Also, central macular thickness and choroidal vascular thickness were measured.

Results

The study was run on 161 eyes of 81 patients; 53 males and 28 females. The average age at examination was 26.1 (6–78) years. Twenty-six eyes (16.1%) were of syndromic RP patients, mostly Usher syndrome; 20 eyes (12.4%). The mean Logaritmic minimal angle of resolution (LogMAR) of Best Corrected Visual Acuity (BCVA)of the study sample was 0.66 ± 0.7. The most prevalent change was cystoid macular edema [28 eyes, (17.4%)], followed by epiretinal membrane [17eye, (10.6%)]. A macular hole was noted only in one eye (0.6%). Ellipsoid zone and external limiting membrane were absent in 55 eyes (35.0%) and 60 eyes 37.5%. Vitreous hyperreflective foci were found in 35 eyes (43.8%). LogMAR of BCVA was associated significantly with cystoid macular edema (p = 0.001), ellipsoid zone(p = 0.001), and external limiting membrane (p = 0.001).

Conclusions

Detailed SS-OCT assessment in Palestinian patients diagnosed with RP identified different morphologies from other populations. Cystoid macular edema and vitreous hyperreflective foci may reflect signs of early or intermediate stages of the disease. Disease progression can be monitored by measuring the length/width (area) of ellipsoid zone +/− external limiting membrane and choroidal vascular thickness, which should be evaluated serially using high-resolution OCT.
Provider attitudes towards a brief behavioral intervention for sexual health in Moldova
Authors: Stephenson Rob , Lesco Galina , Babii Viorel , Luchian Andrei , Bakunina Nataliia , De Vasconcelos Ana Sofia , Blondeel Karel , Cáceres Carlos F. , Pitter Renée A. , Metheny Nicholas , Goldenberg Tamar , Kiarie James , Toskin Igor
Published: July 2021

Background

Brief behavioral interventions are seen as an efficient way to improve knowledge, change behavior, and reduce provider stigma regarding sexual health. When grounded in evidence-based behavioral change techniques and delivered using Brief Sexuality-related Communication (BSC) tools, brief behavioral interventions can address client-driven sexual health goals in a single session with their provider. Evidence for the efficacy of brief interventions for creating gains in sexual health comes largely from resource rich settings, and there is a lack of knowledge of how brief interventions can be implemented in the more resource constrained environments of low- and middle-income countries. As a first step in developing a brief intervention to address sexual health issues in Moldova, this paper reports on qualitative data collected from Moldovan providers to understand their attitudes, willingness and perceived barriers to the brief intervention and its implementation.

Methods

Thirty-nine in-depth interviews (IDI) were conducted between February and March 2020, with health providers recruited from three primary health care institutions, two Youth Friendly Health Centers and counselors from three NGOs who work with key populations in Moldova, including health centers selected from two cites - the capital city, Chisinau and from the Comrat Region. The IDI addressed four domains of provider attitudes: 1) attitudes towards the intervention; 2) willingness and motivation to implement the intervention; 3) logistics of providing the intervention and 4) ability to implement the intervention. A coding analysis approach was applied to all interview transcripts.

Results

Providers largely reported being willing to be trained in and implement the brief intervention. Willingness to implement the intervention stemmed from two perceptions: that it would improve the ability of providers to talk with their clients about sex, and that vulnerable groups would benefit from these conversations. However, while there were generally positive attitudes towards the intervention, providers consistently reported structural barriers to their perceived ability to implement the intervention.

Conclusions

While providers reported high levels of initial acceptance of a brief behavioral intervention, care is needed to ensure that brief interventions, and the training of providers on brief interventions, incorporate cultural attitudes and norms around sex, particularly in highly patriarchal settings, and provide opportunities for providers to practice the intervention in ways that address their assumptions and implicit biases.
Association between NR3C1 gene polymorphisms and age-related hearing impairment in Qingdao Chinese elderly
Authors: Song Wanxue , Cao Hainan , Zhang Dongfeng , Xu Haiyan , Zhang Qianqian , Wang Zhaoguo , Li Suyun , Wang Weijing , Hu Wenchao , Wang Bingling , Duan Haiping
Published: July 2021

Background

Age-related hearing impairment (ARHI) has attracted increasing attention recently. It is caused by genetic and environmental factors. A number of ARHI-related genes have been found. This study aimed to detect the potential association between NR3C1 gene polymorphisms and ARHI by means of weighted allele score.

Methods

A total of 861 participants from Qingdao city were selected by means of cluster random sampling. We statistically evaluated the characteristics of individuals and used the Mann–Whitney U test or chi-square test for comparison. The publicly available expression quantitative trait locus (eQTL) was queried on the website of the Genotype-Tissue Expression (GTEx). We used the weighted allele score and logistic regression analysis to explore the association between NR3C1 gene polymorphisms and ARHI. Finally, the prediction model was constructed by logistic regression and receiver operating characteristic (ROC) curve.

Results

All individuals over 60 years of age were enrolled in this study. The allele of rs61757411, rs41423247 and rs6877893 were significantly different between the ARHI group and the normal hearing group (P < 0.01). Though eQTL analysis, rs6877893 and rs33388 might affect the occurrence of ARHI by affecting the expression of NR3C1 gene in artery aorta. Then we performed two models: one without adding any covariates into model and the other adjusting for demographic characteristic, smoking and drinking, diet and exercise, and physical conditions. In the multivariate-adjusted model 2, the odds ratio with 95% confidence interval for weighted allele score (NR3C1) was 0.841 (0.710–0.995, P = 0.043). The area under the ROC curve was 0.755, indicating that the model had good predictability.

Conclusions

Our study suggests that NR3C1 gene polymorphisms was significantly associated with ARHI.
Identification of uterine leiomyosarcoma-associated hub genes and immune cell infiltration pattern using weighted co-expression network analysis and CIBERSORT algorithm
Authors: Shen Xiaoqing , Yang Zhujuan , Feng Songwei , Li Yi
Published: July 2021

Background

While large-scale genomic analyses symbolize a precious attempt to decipher the molecular foundation of uterine leiomyosarcoma (ULMS), bioinformatics results associated with the occurrence of ULMS based totally on WGCNA and CIBERSORT have not yet been reported. This study aimed to screen the hub genes and the immune cell infiltration pattern in ULMS by bioinformatics methods.

Methods

Firstly, the GSE67463 dataset, including 25 ULMS tissues and 29 normal myometrium (NL) tissues, was downloaded from the public database. The differentially expressed genes (DEGs) were screened by the ‘limma’ package and hub modules were identified by weighted gene co-expression network analysis (WGCNA). Subsequently, gene function annotations were performed to investigate the biological role of the genes from the intersection of two groups (hub module and DEGs). The above genes were calculated in the protein–protein interaction (PPI) network to select the hub genes further. The hub genes were validated using external data (GSE764 and GSE68295). In addition, the differential immune cell infiltration between UL and ULMS tissues was investigated using the CIBERSORT algorithm. Finally, we used western blot to preliminarily detect the hub genes in cell lines.

Results

WGCNA analysis revealed a green-yellow module possessed the highest correlation with ULMS, including 1063 genes. A total of 172 DEGs were selected by thresholds set in the ‘limma’ package. The above two groups of genes were intersected to obtain 72 genes for functional annotation analysis. Interestingly, it indicated that 72 genes were mainly involved in immune processes and the Neddylation pathway. We found a higher infiltration of five types of cells (memory B cells, M0-type macrophages, mast cells activated, M1-type macrophages, and T cells follicular helper) in ULMS tissues than NL tissues, while the infiltration of two types of cells (NK cells activated and mast cells resting) was lower than in NL tissues. In addition, a total of five genes (KDR, CCL21, SELP, DPT, and DCN) were identified as the hub genes. Internal and external validation demonstrated that the five genes were over-expressed in NL tissues compared with USML tissues. Finally, the correlation analysis results indicate that NK cells activated and mast cells activated positively correlated with the hub genes. However, M1-type macrophages had a negative correlation with the hub genes. Moreover, only the DCN may be associated with the Neddylation pathway.

Conclusion

A series of evidence confirm that the five hub genes and the infiltration of seven types of immune cells are related to USML occurrence. These hub genes may affect the occurrence of USML through immune-related and Neddylation pathways, providing molecular evidence for the treatment of USML in the future.