bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive models for lymph node metastasis in endometrial cancer: A systematic review and bibliometric analysis
Authors: Li He , Wang Junzhu , Zhang Guo , Li Liwei , Shen Zhihui , Zhai Zhuoyu , Wang Zhiqi , Wang Jianliu
Published: May 2024

Background:

Lymph node metastasis is associated with a poorer prognosis in endometrial cancer.

Objective:

The objective was to synthesize and critically appraise existing predictive models for lymph node metastasis risk stratification in endometrial cancer.

Design:

This study is a systematic review.

Data Sources and Methods:

We searched the Web of Science for articles reporting models predicting lymph node metastasis in endometrial cancer, with a systematic review and bibliometric analysis conducted based upon which. Risk of bias was assessed by the Prediction model Risk Of BiAS assessment Tool (PROBAST).

Results:

A total of 64 articles were included in the systematic review, published between 2010 and 2023. The most common articles were “development only.” Traditional clinicopathological parameters remained the mainstream in models, for example, serum tumor marker, myometrial invasion and tumor grade. Also, models based upon gene-signatures, radiomics and digital histopathological images exhibited an acceptable self-reported performance. The most frequently validated models were the Mayo criteria, which reached a negative predictive value of 97.1%–98.2%. Substantial variability and inconsistency were observed through PROBAST, indicating significant between-study heterogeneity. A further bibliometric analysis revealed a relatively weak link between authors and organizations on models predicting lymph node metastasis in endometrial cancer.

Conclusion:

A number of predictive models for lymph node metastasis in endometrial cancer have been developed. Although some exhibited promising performance as they demonstrated adequate to good discrimination, few models can currently be recommended for clinical practice due to lack of independent validation, high risk of bias and low consistency in measured predictors. Collaborations between authors, organizations and countries were weak. Model updating, external validation and collaborative research are urgently needed.

Registration:

None.
Care for both victim-survivors and police investigators of rape and serious sexual offences in England and Wales
Authors: Maguire Linda , Sondhi Arun , Norman Jennifer , Abinashi Daniela
Published: May 2024

‘Care’ in a policing context naturally focuses on supporting victim-survivors. The aim of this article is to consider care for police officers who have regular exposure to rape and serious sexual offences cases and officer gender roles. We consider the care provided to (predominantly) female victim-survivors of rape and serious sexual offences by both male and female police officers and differences by gender in how officers support their own wellbeing. The overall findings, based on a cross-sectional survey, interviews and focus groups in five police forces in England and Wales, suggest that officers’ perceptions of their ability to cope and wellbeing are affected differently by gender. The quantitative findings suggest that rape and serious sexual offences officers have high levels of emotional exhaustion, depersonalisation and burnout, but female officers are better at prioritising wellbeing than their male counterparts. This research recommends equipping officers through specialist rape and serious sexual offences training that recognises ‘care’ as a necessary component of policing.
Comparison of limited driving pressure ventilation and low tidal volume strategies in adults with acute respiratory failure on mechanical ventilation: a randomized controlled trial
Authors: Tongyoo Surat , Viarasilpa Tanuwong , Deawtrakulchai Phitphiboon , Subpinyo Santi , Suppasilp Chaiyawat , Permpikul Chairat
Published: May 2024

Background:

Ventilator-induced lung injury (VILI) presents a grave risk to acute respiratory failure patients undergoing mechanical ventilation. Low tidal volume (LTV) ventilation has been advocated as a protective strategy against VILI. However, the effectiveness of limited driving pressure (plateau pressure minus positive end-expiratory pressure) remains unclear.

Objectives:

This study evaluated the efficacy of LTV against limited driving pressure in preventing VILI in adults with respiratory failure.

Design:

A single-centre, prospective, open-labelled, randomized controlled trial.

Methods:

This study was executed in medical intensive care units at Siriraj Hospital, Mahidol University, Bangkok, Thailand. We enrolled acute respiratory failure patients undergoing intubation and mechanical ventilation. They were randomized in a 1:1 allocation to limited driving pressure (LDP; ⩽15 cmH2O) or LTV (⩽8 mL/kg of predicted body weight). The primary outcome was the acute lung injury (ALI) score 7 days post-enrolment.

Results:

From July 2019 to December 2020, 126 patients participated, with 63 each in the LDP and LTV groups. The cohorts had the mean (standard deviation) ages of 60.5 (17.6) and 60.9 (17.9) years, respectively, and they exhibited comparable baseline characteristics. The primary reasons for intubation were acute hypoxic respiratory failure (LDP 49.2%, LTV 63.5%) and shock-related respiratory failure (LDP 39.7%, LTV 30.2%). No significant difference emerged in the primary outcome: the median (interquartile range) ALI scores for LDP and LTV were 1.75 (1.00–2.67) and 1.75 (1.25–2.25), respectively ( p = 0.713). Twenty-eight-day mortality rates were comparable: LDP 34.9% (22/63), LTV 31.7% (20/63), relative risk (RR) 1.08, 95% confidence interval (CI) 0.74–1.57, p = 0.705. Incidences of newly developed acute respiratory distress syndrome also aligned: LDP 14.3% (9/63), LTV 20.6% (13/63), RR 0.81, 95% CI 0.55–1.22, p = 0.348.

Conclusions:

In adults with acute respiratory failure, the efficacy of LDP and LTV in averting lung injury 7 days post-mechanical ventilation was indistinguishable.

Clinical trial registration:

The study was registered with the ClinicalTrials.gov database (identification number NCT04035915).
Explorative cost-effectiveness analysis of colorectal cancer recurrence detection with next-generation sequencing liquid biopsy in Spain, France, and Germany
Authors: Schramm Wendelin , Hollenbenders Yasmin , Kurscheidt Maximilian
Published: May 2024

Background:

Next-generation sequencing liquid biopsy (NGS-LB) for colorectal cancer (CRC) detection and surveillance remains an expensive technology as economies of scale have not yet been realized. Nevertheless, the cost of sequencing has decreased while sensitivity has increased, raising the question of whether cost-effectiveness (CE) has already been achieved from the perspective of European healthcare systems.

Objectives:

This health economic (HE) modeling study explores the CE of NGS-LB for CRC based on direct treatment costs compared to standard care without liquid biopsy in Spain, France, and Germany.

Methods:

A structured literature search was used to collect evidence from 2009 to 2020 on the stage-dependent quality of life (quality-adjusted life-years, QALY), efficacy, and total direct treatment costs (TDC) of NGS-LB. A decision-analytic Markov model was developed. Over the remaining lifetime, cumulative life expectancy (LE), TDC, and QALYs were calculated for 60-year-old men and women in CRC stage III with different assumed effects of NGS-LB of 1% or 3% on improved survival and reduced stage progression, respectively.

Results:

The use of NGS-LB increases LE by 0.19 years in Spanish men (France: 0.19 years, Germany: 0.13 years) and by 0.21 years in Spanish women (France: 0.21 years, Germany: 0.14 years), respectively. The 3% discounted cost per QALY gained was 35,571.95 € for Spanish men (France: 31,705.15 €, Germany: 37,537.68 €) and 35,435.71 € for Spanish women (France: 31,295.57 €, Germany: 38,137.08 €) in the scenario with 3% improved survival and reduced disease progression. Compared to the other two countries, Germany has by far the highest TDC, which can amount to >80k euros in the last treatment year.

Conclusion:

In this explorative HE modeling study, NGS-LB achieves generally accepted CE levels in CRC treatment from the health system perspective in three major European economies under assumptions of small improvements in cancer recurrence and survival. Confirmation of these findings through clinical trials is encouraged.
Development of a tube-launched tail-sitter unmanned aerial vehicle
Authors: Cai Jiaze , Denton Hunter , Benedict Moble , Kang Hao
Published: May 2024

This paper describes the development and flight testing of a tail-sitter unmanned aerial vehicle (UAV) platform that has the potential to be tube-launched. Integrated with vertical take-off and landing (VTOL) capability, the platform can perform high-endurance loiter tasks along with low-speed and hovering flights, and land vertically in limited spaces. The current design utilizes a thrust-vectored counter-rotating coaxial propeller combined with a foldable conventional fixed-wing to accomplish both vertical and horizontal flights. A feedback control strategy capable of stabilizing and controlling the vehicle in both vertical and horizontal flight was designed and implemented on a custom-designed 1.7-gram autopilot. Several tests were conducted in hover and edgewise flight with aggressive pilot inputs to demonstrate the controllability of the aircraft even in the presence of moderate wind gusts. Additionally, transition flight tests were also performed, which demonstrated the vehicle’s capability of transitioning from vertical to fixed-wing horizontal flight using thrust-vectoring-based pitch control.
Association Between Statin Use and the Incidence of Clinically Diagnosed Osteoarthritis: A Nationwide Retrospective Cohort Study in Taiwan
Authors: Lin Guan-Ling , Keller Joseph Jordan , Wang Li-Hsuan
Published: May 2024

Objective

To investigate the effect of higher cumulative defined daily dose per year (cDDD/y) compared with lower cDDD/y of statin use in the incidence of any joint osteoarthritis (OA).

Design

In this population-based retrospective cohort study, patients who were aged ≥40 years were newly initiated on statin therapy between 2002 and 2011, and had a statin prescription for ≥90 days in the first year of treatment were identified from the 2000 Longitudinal Generation Tracking Database. All patients were separated into groups with higher cDDD/y (>120 cDDD/y) and lower cDDD/y (≤120 cDDD/y; as an active comparator) values. Propensity score matching was performed to balance potential confounders. All recruited patients were followed up for 8 years. Marginal Cox proportional hazard models were used to estimate time-to-event outcomes of OA.

Results

Compared with lower cDDD/y use, higher cDDD/y use did not reduce the risk of any joint OA (adjusted hazard ratio, 1.07; 95% confidence interval, 0.99-1.14). Dose-related analysis did not reveal any dose-dependent association. A series of sensitivity analyses showed similar results. Joint-specific analyses revealed that statin did not reduce the incidence of knee, hand, hip, and weight-bearing (knee or hip) OA.

Conclusions

Higher cDDD/y statin use did not reduce the risk of OA in this Taiwanese nationwide cohort study. The complexity of OA pathogenesis might contribute to the ineffectiveness of statin. Repurposing statin with its anti-inflammation properties might be ineffective for OA development, and balancing the catabolism and anabolism of cartilage might be a major strategy for OA prevention.
Internal carotid artery rupture during endovascular thrombectomy in patients with tandem occlusion: A two-case report
Authors: Freitas Lopes Catarina , Lucas Neto Lia
Published: May 2024

Endovascular thrombectomy in patients with tandem occlusions can rarely result in the rupture of the internal carotid artery, leading to subarachnoid haemorrhage and death. However, this complication and its causes are rarely reported and discussed in the literature. We describe two cases of internal carotid artery rupture during endovascular thrombectomy in patients with tandem occlusion. It is hypothesised that the primary approach to the distal lesion, before recanalization, creates a blind alley that faces an intraluminal pressure increase upon manual contrast injection, surpassing the vessel’s resistance and resulting in arterial wall rupture. To prevent this complication, approaches such as treating the proximal occlusion first, injecting the contrast through a microcatheter or retracting the endovascular support catheter proximally to the stenosis of the cervical internal carotid artery have been suggested and are discussed.
The impact of digital social capital on the health of older adults: A moderated mediation effect test
Authors: Cui Yupeng , He Youshi , Xu Xinglong , Zhou Lulin , Nutakor Jonathan Aseye
Published: May 2024

Purpose

Older adults are struggling in the digital age due to lower digital literacy and other reasons. The purpose of this study was to explore the relationship between digital social capital, digital divide, learning ability, and health of older adults.

Methods

This study used data from the China General Social Survey (CGSS) to systematically analyze effects of digital social capital on the health of older adults using the moderated mediated effect test.

Results

Digital social capital has a significant positive effect on the health of older adults and significant household and regional heterogeneity. Internet usage has a mediating impact between social capital and the health of older adults. Learning ability positively moderates the effect of internet usage on the health of older adults, but negatively moderates the impact of digital social capital on internet usage. Learning ability moderates the mediating effect of internet usage between social capital and the health of older adults. The stronger the learning ability, the stronger the mediating effect of internet usage between social capital and health of older adults.

Conclusion

Digital social capital can promote the health of older adults, and internet usage and learning ability can play mediating and moderating roles in the process of digital social capital affecting the health of older adults, revealing that we should cultivate the digital social capital of older adults and improve the digital ability of older adults to improve their health.
Diagnostic accuracy of transvaginal ultrasonography and hysterosalpingography in the detection of uterine cavity pathologies among infertile women
Authors: Okonkwo Ifeanyi O , Eleje George U , Obiechina Nworah J , Ugboaja Joseph O , Okafor Chisolum O , Mbachu Ikechukwu I , Obiagwu Hillary I , Okwuosa Ayodele O , Onwusulu Daniel N , Okeke Chukwunwendu F , Ofojebe Chukwuemeka J , Okafor Chidinma C , Ogabido Chukwudi A , Olisa Chinedu L , Okafor Chigozie G
Published: May 2024

Background

Uterine cavity pathology may affect the endometrium or myometrium, resulting in distortion of the uterine cavity, and is responsible for 2%–5% of infertility. The methods for its assessment usually involve imaging modalities like pelvic ultrasonography, often transvaginal-(TVS), and hysterosalpingography-(HSG), with hysteroscopy-(HSC) as the gold standard. However, HSC is not readily available in resource-poor-settings.

Purpose

To determine and compare the diagnostic accuracy of TVS and HSG in detecting uterine cavity pathology using HSC as a gold standard.

Materials and Methods

A cross-sectional analytical study of consenting infertile women for evaluation of the uterine cavity using transvaginal-ultrasonography, hysterosalpingogram, and hysteroscopy. The primary-outcome-measures were the sensitivity, specificity, and accuracy of TVS and HSG in detecting uterine cavity abnormalities using HSG as the gold standard.

Results

Eighty-eight participants were analysed for this study. The lesions confirmed on HSC were intrauterine-adhesions (43.1%), endometrial polyps (14.8%), submucous fibroids (18.2%), intrauterine-septum (13.6%), and cavity distortion (14.8%). The overall sensitivity with TVS was 57.7%, with a specificity of 97.6%, a positive-predictive-value (PPV) of 88.2%, and a negative-predictive-value (NPV) of 88.2%, giving a percentage-accuracy of 88.2%. In comparison, HSG had a sensitivity of 72.1%, a specificity of 99.4%, a PPV of 97.4%, and an NPV of 92.0%, giving an overall accuracy of 92.9%. The detection rates of TVS and HSG in this category were: fibroids (97.7% vs 89.8%; p = .0004) and adhesions (73.9% vs 87.5%; p = .0002), respectively.

Conclusion

HSG appears to be the superior modality for detection of obliterative uterine cavity pathologies, while TVS is better suited for myometrium and endometrial lesions.
The Global Impact of Chinese Education: Wisdom and Global Vision
Authors: Zhu (朱旭东) Xudong
Published: May 2024

Highlights

China's global vision of education seeks to address various educational challenges from a global perspective. In terms of geopolitical education, China has geographical advantages for enhancing education collaboration with cultural and economic impact. Despite the global learning crisis, China will continue the opening-up of education and advancing of its global technology leadership. Amid unprecedented global change, driving innovation in education has become a pressing issue in China's education system. China is embracing the diverse opportunities arising from global changes and challenges, seeking to forge stronger international bonds through education.
Hepatitis C Treatment Among Primary Care and Specialty Providers: A Single Center Study, 2015 to 2022
Authors: Scialli Anna , Saab Sammy , Salimian Anabel , Bhattacharya Debika , Goodman-Meza David
Published: May 2024

Introduction:

Despite national goals to eliminate Hepatitis C (HCV) and the advancement of curative, well-tolerated direct-acting antiviral (DAAs) regimens, rates of HCV treatment have declined nationally since 2015. Current HCV guidelines encourage treatment of HCV by primary care providers (PCPs). Payors have reduced restrictions to access DAAs nationally and in California however it remains unclear if the removal of these restrictions has impacted the proportion of PCPs prescribing DAAs at a health system level. Our objective was to examine the proportion of DAAs prescribed by PCPs and specialists and to describe the population receiving treatment in a single health system from 2015 to 2022.

Methods:

We examined the proportion of DAAs prescribed by PCPs and specialists and the population receiving treatment through a retrospective analysis of claims data in the University of California, Los Angeles (UCLA) Health System from 2015 to 2022. We described number of prescriptions for HCV medication prescribed by PCPs and specialists by year, medication type, and physician specialty. We also described numbers of prescriptions by patient demographics and comorbidities.

Results:

A total of 1515 adult patients received a prescription for HCV medication through the UCLA Health System between 2015 and 2022. The proportion of patients receiving prescriptions for PCPs peaked at 19% in 2016, yet decreased to 5.7% in 2022, an average of 13% across all years. Median age of patients receiving treatment was 60 years old, and 56% of patients receiving HCV treatment had commercial insurance as their primary payer.

Conclusions:

HCV treatment declined from 2015 to 2022 among specialists and PCPs in our health system. Older patients comprised the majority of patients receiving treatment, suggesting a need for novel approaches to reach patients under 40, an age group with significant increases in HCV transmission.
“When You Look at This Chart, That Is Not My Whole Life”: Caregiver Perspectives to Inform Improved Primary Care Practice and Outcomes
Authors: Quinn Monique , Parsons Allison , Anyigbo Chidiogo , Corley Alexandra M. S. , Lipps Lauren , Gilliam Jamaica , Ladipo Julietta O. , Behle Caitlin Jee Hae , Bennett Desiré , Riley Carley
Published: May 2024

Objective:

Worsening rates of infant and maternal mortality in the United States serve as an urgent call for multi-modal intervention. Infant Well Child Visits (WCVs) provide an opportunity for prevention, however not all infants receive the recommended schedule of visits, with infants of low-income and Black families missing a higher portion of WCVs. Due to diverse experiences and needs of under-resourced communities throughout the United States, caregiver voice is essential when designing improvement efforts.

Methods:

Purposeful sampling and interviewing of 10 caregivers in Cincinnati, OH was performed by community peer researchers. Interview transcripts were evaluated by the research team, with identification of several important themes.

Results:

Nine out of 10 caregivers self-identified as Black. All young children of the interviewed caregivers had Medicaid as their insurance provider. All interviews highlighted rich perspectives on caregiver hopes for their child, family, and selves. Establishing trust through empathy, shared decision making, and the nurturing of interpersonal patient-practitioner relationships is crucial for fostering a positive healthcare experience. Levels of mistrust was perceptibly high across several interviews, with lack of racial concordance between medical provider and family exacerbating the issue for some caregivers. Caregivers voiced a tendency to rely on family and community members for when to seek out health care for their children, and additionally cited racism and perceptions of being rushed or judged as barriers to seeking further care.

Conclusion:

This study emphasizes the importance of being community-informed when considering interventions. Prior research on the topic of missed WCV’s often focused on material resource availability and limitations. While that was commented on by caregivers in this study as well, equal—if not more—attention was directed toward interpersonal relationship formation, the presence or absence of trust between practitioner and caregiver, and the importance of social-emotional support for caregivers. We highlight several opportunities for systemic improvements as well as future directions for research.
Discursive Construction of Hong Kong’s Future Beyond 2047: A Press Media-Based Study
Authors: Yufei Guo
Published: May 2024

This study explores the public discourse about Hong Kong’s future beyond 2047 through the lens of local press media during the first half of the “unchanged 50 years” since the handover. The data contains a number of 187 newspaper articles centered on the issue of 2047, extracted from 16 local news outlets in Chinese. Using qualitative and quantitative methods of content analysis, the study observes the development of media discourse over a long span of time and points out people’s major concerns about Hong Kong’s long-term future. It distinguishes three major discourses in terms of identity construction and modes of anticipation, and explores the links between future-oriented suggestions and real-world actions. As part of an ongoing research on Hong Kong’s future narratives, this study contributes to the research on social mentality during the first half of the “one country and two systems” and explores how the future is imagined and built through discursive practices.
Network Approach to Work Addiction: A Cross-Cultural Study
Authors: Bereznowski Piotr , Atroszko Paweł A. , Konarski Roman
Published: May 2024

We aimed to estimate and compare networks of work addiction among Norwegian and Polish working individuals. The Bergen Work Addiction Scale was used to measure work addiction in four samples, two comprising responses of working Norwegians ( n1 = 16,426; n2 = 764) and two comprising responses of working Poles ( n3 = 719; n4 = 711). The networks were estimated jointly with the fused graphic lasso method. Additionally, we estimated symptoms’ centrality, symptoms’ predictability, and networks’ stability, as well as quantitatively compared the four networks. The results showed highly similar networks across the four samples. There were several strong direct relationships between symptoms. The most and the least central symptoms were Relapse and Mood modification, respectively. Mean symptom predictability varied between 22.6 and 28.3% across samples. We discussed the possible intervention strategies based on the obtained results.
Moderating Effect of Social Media in Shaping Ecotourism Loyalty: A Two-Stage-Cross-Sectional Study
Authors: Hoang Sinh Duc , Tučková Zuzana , Pham Nhat Tan , Tran Tuan Hoang , Nguyen Diep T. N.
Published: May 2024

This study aims to evaluate the moderating role of social media influence before and after the trip in Vietnam and Czech Republic. Primary data, gathered during time lag data surveys conducted among international tourists travelling to the Czech Republic and Vietnam, was analyzed with the Structural Equation Modelling (SEM) in R. The findings revealed that social media influence with higher level positively strengthened the connection between tourist motivation and the post trip destination image. Furthermore, social media had a significant moderating effect on the relationship between tourist satisfaction and ecotourism loyalty. However, there are strong differences between the destinations of developed and emerging economies. For Czech Republic, as developed economy, social media influence plays a more important role as a value-expressive mechanism at the post-trip stage whereas for the developing economy of Vietnam, social media plays a more important role as an information source before the trip. This study extends the Expectation Confirmation Theory (ECT) by introducing the moderating effect of social media influence, which first time measures this moderating effect before and after the trip accounting for the dynamic nature of the destination image as an antecedent of ecotourism loyalty. Limitations, theoretical implications, and recommendations for practice and further research are addressed.

JEL Classification: L83, Z30, Z39
Moving Together, Apart: Impacts of Travel Restrictions on a UK–Egypt Collaboration in Health Profession Education
Authors: Ragab Lamis , Wassim Monica , Arfeen Zakia , Newman Rhiannon , Rashid Mohammed Ahmed
Published: May 2024

Objective

University College London (UCL) and Newgiza University (NGU) have been in an academic collaboration since 2016 to establish undergraduate healthcare programmes in Egypt with an underlying ethos of capacity building and co-development. We explored impacts of pandemic-related travel restrictions on staff across both organisations.

Methods

We conducted 30 semi-structured interviews with academic and professional services staff from UCL and NGU schools of medicine, dentistry, and pharmacy. Data were jointly coded using reflexive thematic analysis and categorised according to the American Council on Education's Comprehensive Internationalisation Framework.

Results

Nine themes were identified, which related to each of the six components of the framework. In addition to mobility, participants’ experiences also spread across the other five components (institutional commitment, leadership, curriculum, faculty support, and partnerships). Successful adaptations were made and staff felt able to ‘keep the show on the road’. However, staff remained keen to keep in-person engagement a priority when possible, especially for quality management site visits.

Conclusions

Travel restrictions can have widespread impacts on all aspects of international collaborations. In this well-established relationship, there was sufficient resilience to withstand these impacts and, many positive unintended consequences emerged. A hybrid engagement model should be prioritised in future partnerships.
Forests high on CO2: A glimpse into how scientists study the biochemical machinery of forest ecosystems
Authors: Ehrenstein Véra
Published: May 2024

Are forests across the planet storing more carbon as a result of rising atmospheric carbon dioxide (CO2) concentration? In this text, I propose to reflect on the work of researchers who are asking that very question. The focus is on a particular approach called free-air CO2 enrichment (FACE) experiments, in which forests in their local environment are subjected to a CO2 concentration higher than in the ambient air, to test the CO2 fertilization hypothesis. This hypothesis predicts that forests store more carbon in those conditions. FACE studies held the promise of establishing cause–effect relations and transcending the here and now. They emerged in the United States in the late 1980s, at a time when ecology scaled up to make itself relevant to the then nascent Earth System science. FACE experiments in forests are now conducted in Australia, the United Kingdom, and Brazil, and their results are closely scrutinized by a small research community. The text, first, presents the engineering feat that underpins FACE experiments in forests and discuss two problems highlighted by scientists because they impede hasty generalization from the data: the timescale needed to witness forests change and the spatial heterogeneity of forest soils. It then shows how scientists contend with their incomplete understanding of forest ecosystems as they bring together computer models and empirical data to build consensus around the sources of epistemic uncertainty. To conclude, I propose to rework the idea of “the macroscope” to conceptualize what scientists do when they seek to study forests as complex, layered, multi-scale systems. I wish to capture how researchers, who willingly endorse a planetary gaze, problematize their own predicament. This, as I suggest, has to do with the immanence of forests in the world.
Liquefaction ground deformations and cascading coastal flood hazard in the 2023 Kahramanmaraş earthquake sequence
Authors: Bassal Patrick , Papageorgiou Elena , Moug Diane M , Bray Jonathan D , Cetin Kemal Onder , Şahin Arda , Kubatko Ethan J , Nepal Suranjan , Toth Charles , Kendır Sena B , Bikçe Murat
Published: May 2024

The 2023 Kahramanmaraş earthquake sequence produced extensive liquefaction-induced ground deformations and ongoing flooding along the shoreline of the Mediterranean port city of İskenderun, Türkiye. This study compiles field observations and analyses from cross-disciplinary perspectives to investigate whether earthquake-induced liquefaction was a significant factor for increasing the flood hazard in İskenderun. Geotechnical reconnaissance observations following the earthquakes included seaward lateral spreading, settlement beneath buildings, and failures of coastal infrastructure. Three presented lateral spreading case histories indicate consistent ground deformation patterns with areas of reclaimed land. Persistent scatterer interferometry (PSI) measurements from synthetic aperture radar (SAR) imagery identify a noticeably greater rate of pre- and post-earthquake subsidence within the İskenderun coastal and urban areas relative to the surrounding regions. The PSI measurements also indicate subsidence rates accelerated following the earthquakes and were typically highest near the observed liquefaction manifestations. These evaluations suggest that while the liquefaction of coastal reclaimed fill caused significant ground deformations in the shoreline area, ongoing subsidence of İskenderun and other factors likely also exacerbated the flood hazard. Insights from this work suggest the importance of evaluating multi-hazard liquefaction and flood consequences for enhancing the resilience of coastal cities.
Tricking the trickster: precision medicine approaches to counteract leukemia immune escape after transplant
Authors: Tameni Annalisa , Toffalori Cristina , Vago Luca
Published: May 2024

Over the last decades, significant improvements in reducing the toxicities of allogeneic hematopoietic cell transplantation (allo-HCT) have widened its use as consolidation or salvage therapy for high-risk hematological malignancies. Nevertheless, relapse of the original malignant disease remains an open issue with unsatisfactory salvage options and limited rationales to select among them. In the last years, several studies have highlighted that relapse is often associated with specific genomic and nongenomic mechanisms of immune escape. In this review we summarize the current knowledge about these modalities of immune evasion, focusing on the mechanisms that leverage antigen presentation and pathologic rewiring of the bone marrow microenvironment. We present examples of how this biologic information can be translated into specific approaches to treat relapse, discuss the status of the clinical trials for patients who relapsed after a transplant, and show how dissecting the complex immunobiology of allo-HCT represents a crucial step toward developing new personalized approaches to improve clinical outcomes.
Novel functions for von Willebrand factor
Authors: Atiq Ferdows , O’Donnell James S.
Published: May 2024

For many years, it has been known that von Willebrand factor (VWF) interacts with factor VIII, collagen, and platelets. In addition, the key roles played by VWF in regulating normal hemostasis have been well defined. However, accumulating recent evidence has shown that VWF can interact with a diverse array of other novel ligands. To date, over 60 different binding partners have been described, with interactions mapped to specific VWF domains in some cases. Although the biological significance of these VWF-binding interactions has not been fully elucidated, recent studies have identified some of these novel ligands as regulators of various aspects of VWF biology, including biosynthesis, proteolysis, and clearance. Conversely, VWF binding has been shown to directly affect the functional properties for some of its ligands. In keeping with those observations, exciting new roles for VWF in regulating a series of nonhemostatic biological functions have also emerged. These include inflammation, wound healing, angiogenesis, and bone metabolism. Finally, recent evidence supports the hypothesis that the nonhemostatic functions of VWF directly contribute to pathogenic mechanisms in a variety of diverse diseases including sepsis, malaria, sickle cell disease, and liver disease. In this manuscript, we review the accumulating data regarding novel ligand interactions for VWF and critically assess how these interactions may affect cellular biology. In addition, we consider the evidence that nonhemostatic VWF functions may contribute to the pathogenesis of human diseases beyond thrombosis and bleeding.
How I manage iron overload in the hematopoietic cell transplantation setting
Authors: Angelucci Emanuele
Published: May 2024

The success of hematopoietic transplantation for hemoglobinopathies and hematological malignancies has been accompanied by the new challenge of how to identify, risk stratify, and treat iron overload and toxicity before and after transplantation. Substantial progress has been made in our understanding of iron metabolism and the pathophysiology of iron overload, making us aware that not only the total amount of iron in the body is important but also the effect of toxic iron species and duration of exposure are equally relevant. Challenges still remain in how to assess cellular and tissue damage and define the mechanism that may detrimentally affect the outcome of hematopoietic transplantation. In this article, I discuss the impact of iron toxicity in relation to the different phases of hematopoietic transplantation, before, during, and after, for both malignant and nonmalignant diseases. Different clinical scenarios and possibilities for therapeutic intervention are also outlined and discussed.
Complete remission with partial hematological recovery as a palliative endpoint for treatment of acute myeloid leukemia
Authors: Le Robert Q. , Przepiorka Donna , Chen Haiyan , Shen Yuan Li , Pulte E. Dianne , Norsworthy Kelly , Theoret Marc R. , De Claro R. Angelo
Published: May 2024

Complete remission with partial hematological recovery (CRh) has been used as an efficacy endpoint in clinical trials of nonmyelosuppressive drugs for acute myeloid leukemia (AML). We conducted a pooled analysis to characterize the clinical outcomes for patients with AML who achieved CRh after treatment with ivosidenib, olutasidenib, enasidenib, or gilteritinib monotherapy in clinical trials used to support marketing applications. The study cohort included 841 adult patients treated at the recommended drug dosage; 64.6% were red blood cell or platelet transfusion dependent at study baseline. Correlations between disease response and outcomes were assessed by logistic regression modeling for categorical variables and by Cox proportional hazards modeling for time-to-event variables. Patients with CRh had a higher proportion with transfusion independence (TI) for at least 56 days (TI-56; 92.3% vs 22.3%; P < .0001) or TI for at least 112 days (TI-112; 63.5% vs 8.7%; P < .0001), a reduced risk over time for severe infection (hazard ratio [HR], 0.43; P = .0007) or severe bleeding (HR, 0.17; P = .01), and a longer overall survival (OS; HR, 0.31; P < .0001) than patients with no response. The effects were consistent across drugs. In comparison with patients with CR, the effect sizes for CRh were similar for TI-56 and for risk over time of infection or bleeding but less for TI-112 and OS. CRh is associated with clinical benefits consistent with clinically meaningful palliative effects for the treatment of AML with nonmyelosuppressive drugs, although less robustly than for CR.
Antigen escape as a shared mechanism of resistance to BCMA-directed therapies in multiple myeloma
Authors: Firestone Ross S. , Socci Nicholas D. , Shekarkhand Tala , Zhu Menglei , Qin Wei Ge , Hultcrantz Malin , Mailankody Sham , Tan Carlyn Rose , Korde Neha , Lesokhin Alexander M. , Hassoun Hani , Shah Urvi , Maclachlan Kylee H. , Rajeeve Sridevi , Landau Heather J. , Scordo Michael , Shah Gunjan L. , Lahoud Oscar B. , Giralt Sergio , Murata Kazunori , Usmani Saad Z. , Chung David J.
Published: May 2024

B-cell maturation antigen (BCMA)–targeting therapeutics have dramatically improved outcomes in relapsed/refractory multiple myeloma (RRMM). However, whether the mechanisms of resistance between these therapies are shared and how the identification of such mechanisms before therapy initiation could refine clinical decision-making remains undefined. We analyzed outcomes for 72 RRMM patients treated with teclistamab, a CD3 × BCMA bispecific antibody, 42% (30/72) of whom had prior BCMA-directed therapy exposure. Malignant plasma cell BCMA expression was present in all BCMA therapy–naïve patients. Prior therapy–mediated loss of plasma cell BCMA expression before teclistamab treatment, measured by immunohistochemistry, was observed in 3 patients, none of whom responded to teclistamab, and 1 of whom also did not respond to ciltacabtagene autoleucel. Whole exome sequencing of tumor DNA from 1 patient revealed biallelic loss of TNFRSF17 following treatment with belantamab mafodotin. Low-to-undetectable peripheral blood soluble BCMA levels correlated with the absence of BCMA expression by bone marrow plasma cells. Thus, although rare, loss of BCMA expression following TNFRSF17 gene deletions can occur following any BCMA-directed therapy and prevents response to subsequent anti-BCMA–directed treatments, underscoring the importance of verifying the presence of a target antigen.
How I Treat Challenging Transfusion Cases in Sickle Cell Disease
Authors: Chou Stella T. , Hendrickson Jeanne E
Published: May 2024

Transfusion of red blood cells (RBCs) can be lifesaving for individuals living with sickle cell disease (SCD). However, alloimmunization following transfusion is more common with SCD than other patient populations, resulting in morbidity and mortality. Management of complications related to RBC alloantibodies, including delayed hemolytic transfusion reactions (DHTRs) and identifying compatible RBCs for future transfusions, remains a challenge for hematologists and transfusion medicine providers. Although transfusion guidelines from organizations including the American Society for Hematology provide general recommendations, individual cases remain challenging. Antibody evanescence and the lack of widespread RBC alloantibody data sharing across hospitals pose unique challenges, as do RH variants in both transfusion recipients and blood donors. Further, as potentially curative therapies require RBC transfusions to lower the hemoglobin S prior to cellular therapy collections and infusions, highly alloimmunized patients may be deemed ineligible. The cases described are representative of clinical dilemmas the authors have encountered and the approaches are as evidence-based as the literature and the authors' experiences allow. A future desired state is one in which RBC alloantibody data are efficiently shared across institutions, Rh alloimmunization can be mitigated, better treatments exist for DHTRs, and a label of "difficult to transfuse" does not prevent desired therapies.
Microstructure, Corrosion and Mechanical Properties of Medium-Thick 6061-T6 Alloy/T2 Pure Cu Dissimilar Joints Produced by Double Side Friction Stir Z Shape Lap-Butt Welding
Authors: Tang Jiuxing , Dai Guoxin , Shi Lei , Wu Chuansong , Mironov Sergey , Patel Surendra Kumar , Gao Song , Wu Mingxiao
Published: May 2024

A novel double side friction stir Z shape lap-butt welding (DS-FSZW) process was proposed to achieve excellent mechanical properties of Al/Cu medium-thick dissimilar joints. The influence of welding parameters on weld microstructure and properties of DS-FSZW joint were systematically investigated. It indicated that defect-free medium-thick Al/Cu DS-FSZW joint could be achieved under an optimal welding parameter. DS-FSZW joint was prone to form void defects in the bottom of the second-pass weld. The recrystallization mechanisms at the top and middle of the weld nugget zone (WNZ) were continuous dynamic recrystallization (CDRX) and geometric dynamic recrystallization (GDRX). While the major recrystallization mechanism at the bottom of the WNZ was GDRX. DS-FSZW joint of the optimal welding condition with 850 r/min-400 mm/min was produced with a continuous thin and crack-free IMCs layer at the Al/Cu interface, and the maximum tensile strength of this joint is 160.57 MPa, which is equivalent to 65.54% of pure Cu base material. Moreover, the corrosion resistance of Al/Cu DS-FSZW joints also achieved its maximum value at the optimal welding parameter of 850 r/min-400 mm/min. It demonstrates that the DS-FSZW process can simultaneously produce medium-thick Al/Cu joints with excellent mechanical performance and corrosion resistance.
Clinical, genetic, and cognitive correlates of seizure occurrences in Phelan-McDermid syndrome
Authors: Levy Tess , Gluckman Jacob , Siper Paige M. , Halpern Danielle , Zweifach Jessica , Filip-Dhima Rajna , Holder J. Lloyd , Trelles M. Pilar , Johnson Kristina , Bernstein Jonathan A. , Berry-Kravis Elizabeth , Powell Craig M. , Soorya Latha Valluripalli , Thurm Audrey , Buxbaum Joseph D. , Sahin Mustafa , Kolevzon Alexander , Srivastava Siddharth ,   on behalf of the Developmental Synaptopathies Consortium
Published: May 2024

Background

Phelan-McDermid syndrome (PMS) is a genetic neurodevelopmental disorder caused by SHANK3 haploinsufficiency and is associated with an increased risk for seizures. Previous literature indicates that around one third of individuals with PMS also have epilepsy or seizures, with a wide range of types and ages of onset. Investigating the impact of seizures on intellectual and adaptive functioning for PMS is a primary concern for caregivers and is important to understanding the natural history of this syndrome.

Methods

We report on results from 98 individuals enrolled in a prospective, longitudinal study. We detailed seizure frequency, type, and age of onset, and we analyzed seizure occurrence with best estimate IQ, adaptive functioning, clinical features, and genotype. We conducted multiple linear regression analyses to assess the relationship between the presence of seizures and the Vineland Adaptive Behavior Scale, Second Edition (VABS-II) Adaptive Behavior Composite score and the best estimate full-scale IQ. We also performed Chi-square tests to explore associations between seizure prevalence and genetic groupings. Finally, we performed Chi-square tests and t-tests to explore the relationship between seizures and demographic features, features that manifest in infancy, and medical features.

Results

Seizures were present in 41% of the cohort, and age of onset was widely variable. The presence of seizures was associated with significantly lower adaptive and intellectual functioning. Genotype–phenotype analyses were discrepant, with no differences in seizure prevalence across genetic classes, but with more genes included in deletions of participants with 22q13 deletions and seizures compared to those with 22q13 deletions and no seizures. No clinical associations were found between the presence of seizures and sex, history of pre- or neonatal complications, early infancy, or medical features. In this cohort, generalized seizures were associated with developmental regression, which is a top concern for PMS caregivers.

Conclusions

These results begin to eludicate correlates of seizures in individuals with PMS and highlight the importance of early seizure management. Importantly, presence of seizures was associated with adaptive and cognitive functioning. A larger cohort might be able to identify additional associations with medical features. Genetic findings suggest an increased capability to realize genotype–phenotype relationships when deletion size is taken into account.
Comparison between catheter ablation versus permanent pacemaker implantation as an initial treatment for tachycardia–bradycardia syndrome patients: a prospective, randomized trial
Authors: Cho Min Soo , Lee Ji Hyun , Nam Gi-Byoung , Hwang Ki Won , Cha Myung-Jin , Kim Jun , Choi Kee-Joon
Published: May 2024

Background

Clinical outcomes after catheter ablation (CA) or pacemaker (PM) implantation for the tachycardia–bradycardia syndrome (TBS) has not been evaluated adequately. We tried to compare the efficacy and safety outcomes of CA and PM implantation as an initial treatment option for TBS in paroxysmal atrial fibrillation (AF) patients.

Methods

Sixty-eight patients with paroxysmal AF and TBS (mean 63.7 years, 63.2% male) were randomized, and received CA (n = 35) or PM (n = 33) as initial treatments. The primary outcomes were unexpected emergency room visits or hospitalizations attributed to cardiovascular causes.

Results

In the intention-to-treatment analysis, the rates of primary outcomes were not significantly different between the two groups at the 2-year follow-up (19.8% vs. 25.9%; hazard ratio (HR) 0.73, 95% confidence interval (CI) 0.25–2.20, P = 0.584), irrespective of whether the results were adjusted for age (HR 1.12, 95% CI 0.34–3.64, P = 0.852). The 2-year rate of recurrent AF was significantly lower in the CA group compared to the PM group (33.9% vs. 56.8%, P = 0.038). Four patients (11.4%) in the CA group finally received PMs after CA owing to recurrent syncope episodes. The rate of major or minor procedure related complications was not significantly different between the two groups.

Conclusion

CA had a similar efficacy and safety profile with that of PM and a higher sinus rhythm maintenance rate. CA could be considered as a preferable initial treatment option over PM implantation in patients with paroxysmal AF and TBS.

Trial registration

KCT0000155.