bluuebunny/crossref_metadata_2025 huggingface dataset:
Dalfampridine improves slowed processing speed in multiple sclerosis patients with mild motor disability: post hoc analysis of a randomized controlled trial
Authors: Pozzilli Carlo , Prosperini Luca , Tommasin Silvia , Gasperini Claudio , Barbuti Elena , De Giglio Laura
Published: April 2021

Objective:

To evaluate baseline characteristics predictive of improving information processing speed in multiple sclerosis (MS) and the relationship between cognitive and motor response to dalfampridine (DA) treatment.

Methods:

This is a post hoc analysis of a randomized, double-blind, placebo-controlled trial in patients with MS randomized to receive DA 10 mg or placebo twice daily for 12 consecutive weeks. Here, we include only data from 71 patients in the arm treated with DA. According to the median value of Symbol Digit Modalities Test (SDMT) response, patients were categorized as “full responders” (FR) or “partially responders” (PR).

Results:

There was higher possibility of being FR in the presence of a baseline lower Expanded Disability Status Scale [odds ratio (OR) 0.69; 95% confidence interval (CI) 0.5–0.97, p = 0.034], a higher Multiple Sclerosis Functional Composite value (OR 1.37; 95%CI 1.05–1.8, p = 0.022), a lower Timed 25-Foot Walk Test (OR 0.76; 95% CI 0.6–0.98, p = 0.033), and a lower 9-Hole Peg Test with dominant hand (OR 0.92; 95% CI 0.86–0.99, p = 0.029). FR group did not show any significant improvement of motor performance compared with PR group.

Conclusion:

The current analysis shows that in MS patients with cognitive deficit, the greatest improvement in SDMT provided by DA was observed in patients with milder motor impairment; cognitive and motor responses to treatments are not related.

Trial registration:

EU Clinical Trials Register; ID 2013-002558-64 ( https://www.clinicaltrialsregister.eu/ctr-search/search?query=2013-002558-64 )
A Differentiated Approach to the Asset-Light Model in the Hotel Industry
Authors: Märklin Paulina , Bianchi Giuliano
Published: April 2021

This research note aims to prompt a debate over the asset-light strategy that hotels are increasingly implementing nowadays. First, it evaluates the impact of an asset-light model on hotel firms’ returns, return volatility, and the Sharpe ratio, based on annual data from 1970 to 2018 of 65 U.S. public hotel firms. Evidence shows that going asset-light has no significant impact on companies’ returns, return volatility, and performance. Second, the study offers possible explanations behind such results and raises questions for future research.
Online Incidental Exposure to News Can Minimize Interest-Based Political Knowledge Gaps: Evidence from Two U.S. Elections
Authors: Weeks Brian E. , Lane Daniel S. , Hahn Lauren B.
Published: April 2021

Concerns persist over the potential for the fragmented media environment to promote motivation-based political knowledge gaps between those who are interested in politics and those who are not. Yet, there is also evidence that the Internet can provide opportunities for individuals to incidentally encounter and learn from news, which may decrease these knowledge gaps. The current study tests this possibility using two, two-wave panel surveys of adults in the United States conducted during the 2012 and 2016 presidential elections. Across two distinct electoral contexts, we find evidence that incidental exposure to online news and political information promotes learning about presidential candidates’ policy positions over the course of the campaign. In addition, the data suggest the least politically interested benefit the most from this incidental exposure, as they see the largest gains in political knowledge. These findings indicate that opportunities to learn via incidental exposure have the potential to reduce motivation-based knowledge gaps.
Critical Qualitative Inquiry: Justice Matters(ings) in (En)tangled Times
Authors: Koro Mirka , Cannella Gaile S. , Huckaby M. Francyne , Wolgemuth Jennifer R.
Published: April 2021

The purpose of this special issue is to generate and expand the locations and perspectives from which justice and equity, in multiple forms, are and can be, orienting concepts for critical qualitative inquiry. Although critical inquiry originates from diverse views, concerns, and conditions, all forms would always and already address matters of privilege/harm, equity/ inequity, and justice/injustice, while at the same time challenging power-oriented dualisms, systematic western notions of progress, and capitalist gains. This introductory article describes the work of special issue authors asking questions like: How might critical qualitative inquiry build from the past while at the same time lead to more just possibilities, leading to something we might recognize as inquiry as/toward/for justice? How can critical scholarship be theorized, designed, and practiced with justice as the orienting focus within (en)tangled times, materials and material injustices?
Juvenile Osteochondritis Dissecans of the Knee Joint: Midterm Clinical and MRI Outcomes of Arthroscopic Retrograde Drilling and Internal Fixation with Bioabsorbable Pins
Authors: Komnos Georgios , Iosifidis Michael , Papageorgiou Fotios , Melas Ioannes , Metaxiotis Dimitrios , Hantes Michael
Published: April 2021

Objective

This study aimed to assess the clinical and radiographic outcomes of juvenile patients who suffered from stage II or III osteochondritis dissecans (OCD) of the knee and underwent arthroscopic retrograde drilling and internal fixation with bioabsorbable pins.

Design

Medical and radiological records from patients aged 11 to 16 years, who underwent arthroscopic treatment for OCD lesions of the knee in 2 tertiary hospitals, were retrospectively reviewed. The procedure was indicated by persistent pain and by magnetic resonance imaging (MRI). All patients underwent retrograde drilling and arthroscopic fixation of the lesion with bioabsorbable pins. MRI was conducted at least 1 year postoperative in all patients to evaluate healing. Functional outcomes were evaluated through the Visual Analogue Scale (VAS) for pain, Lysholm, and IKDC (International Knee Documentation Committee) scores.

Results

A total of 40 patients, with an average age of 13.1 years (range = 11-16 years) and an average follow-up of 6.6 years (range = 3-13 years) were reviewed. MRI findings confirmed the healing of the lesion in 36 out of the 40 (90%) patients. In particular, the healing rate was 95% (20/21) and 84% (16/19) for stage II and stage III, respectively. Lysholm, IKDC, and VAS scores revealed a statistically significant improvement ( P < 0.05) at final follow-up in comparison to preoperative status. No infection, knee stiffness, or other complication was recorded.

Conclusions

Retrograde drilling combined with internal fixation with bioabsorbable pins, of stages II and III OCD lesions of the knee provides good to excellent outcomes to juvenile patients, with a high healing rate.
An international bibliometric study of scientific articles on intracranial aneurysms
Authors: Kiraz Murat , Demir Emre , Özdemir Ömer
Published: April 2021

Objectives

The number of original scientific researches on intracranial aneurysms has risen over the last 30 years. Despite the rise in the number of articles, there is no up-to-date exhaustive bibliometric research in the literature. This study aimed to contribute to the literature via a bibliometric analysis of the original scientific researches on intracranial aneurysms published over the last 30 years.

Methods

The literature review was done using the Web of Science. All articles and its citations containing aneurysm keywords were analyzed in the "title" section of articles published in the research areas: Neurosciences Neurology during 1980–2019. Correlation analyses between the number of articles produced by the countries and their economic and development indicators of gross domestic product, and Human Development Index were analyzed using the Spearman correlation coefficient. Linear regression analysis was utilized to estimate the number of articles to be published in the future.

Results

There were a total of 21,673 publications on intracranial aneurysms. Of these publications, 13,371 (61.7%) were articles. The three countries that produced the most articles were the USA (4098), Japan (2668), and China (937). A statistically significant correlation was found between the development indicators of world countries and publication productivity ( p<0.001). The three journals that produced the most publications were Neurosurgery, Journal of Neurosurgery, and American Journal of Neuroradiology. The most cited article was published in Journal of Neurosurgery.

Conclusion

This bibliometric study provides a collection of data that will help design future research on intracranial aneurysms more efficiently and make innovations at greater speed.
A Review of the Effects of Valenced Odors on Face Perception and Evaluation
Authors: Syrjänen Elmeri , Fischer Håkan , Liuzza Marco Tullio , Lindholm Torun , Olofsson Jonas K.
Published: April 2021

How do valenced odors affect the perception and evaluation of facial expressions? We reviewed 25 studies published from 1989 to 2020 on cross-modal behavioral effects of odors on the perception of faces. The results indicate that odors may influence facial evaluations and classifications in several ways. Faces are rated as more arousing during simultaneous odor exposure, and the rated valence of faces is affected in the direction of the odor valence. For facial classification tasks, in general, valenced odors, whether pleasant or unpleasant, decrease facial emotion classification speed. The evidence for valence congruency effects was inconsistent. Some studies found that exposure to a valenced odor facilitates the processing of a similarly valenced facial expression. The results for facial evaluation were mirrored in classical conditioning studies, as faces conditioned with valenced odors were rated in the direction of the odor valence. However, the evidence of odor effects was inconsistent when the task was to classify faces. Furthermore, using a z-curve analysis, we found clear evidence for publication bias. Our recommendations for future research include greater consideration of individual differences in sensation and cognition, individual differences (e.g., differences in odor sensitivity related to age, gender, or culture), establishing standardized experimental assessments and stimuli, larger study samples, and embracing open research practices.
Breaking the ice with a joke: The relief-inducing property of humor and its effect on sellers’ performance
Authors: Lunardo Renaud , Bompar Laurent , Saintives Camille
Published: April 2021

Research has identified humor as a communication technique that can help sellers be more effective during their sales pitches. However, the most developed theory of humor – that is, the arousal-safety (or relief) theory – posits some relieving power of humor but has never been applied to the selling context, although such a power could reveal interesting for sellers. Therefore, in this research, we adopt a seller’s perspective and apply this theory to investigate how sellers’ feelings of relief following their use of humor can positively affect their performance during negotiations. More specifically, we investigate the serial process whereby feelings of relief that emerge from humor increase relationship quality and ultimately performance. Finally, we identify empathy as a boundary condition for the effects of humor and subsequent responses, with humor prompting greater feelings of relief when sellers have little empathy with the purchaser. Using a sample of 200 trained students in B2B sales management and a sample of 157 professional sellers, we empirically test and support these predictions, which serve as a basis for managerial recommendations.
COVID-19 Vaccination Perception and Attitude among Healthcare Workers in Egypt
Authors: Fares Samar , Elmnyer Merihan M. , Mohamed Shimaa Sabry , Elsayed Radwa
Published: April 2021

Introduction

COVID-19 pandemic has affected the whole world, especially the frontline worriers. To get shielded through this war, the world is racing to reach and manufacture COVID-19 vaccines. Vaccination hesitancy is one of the significant obstacles to global health.

Objectives

This study aimed to assess the perception and attitude of healthcare workers in Egypt toward COVID-19 vaccines, acknowledge the determinants of their attitude, and the factors that could increase the acceptance of the vaccine.

Methods

an observational web-based anonymous survey was conducted on 385 Egyptian healthcare workers in different governorates. The questionnaire-based on Vaccine Hesitancy Survey Questions of the World Health Organization was available in Arabic and English languages and was tested for reliability.

Results

Regarding vaccination decision, 51% of the participants were undecided, 28% refused, and 21% accepted vaccination. Reasons for vaccine acceptance mainly were risks of COVID-19 (93%), safety (57.5%), and effectiveness (56.25%) of the vaccine. Simultaneously, the reasons for vaccine hesitancy were the absence of enough clinical trials (92.4%) and fear of side effects of the vaccine (91.4%). The leading factor that could increase vaccination acceptance among the participants was to get sufficient and accurate information about the available vaccines. The participants revealed a high mean level of concern for COVID-19 vaccines’ safety (3.8 of 5) that differs significantly among the different study groups ( P-value .002).

Conclusion

Despite the COVID-19 pandemic, only approximately 21% of Egyptian healthcare workers in our study accepted the COVID-19 vaccination. Vaccine hesitancy represents a major barrier to implementing vaccination programs.
Peer-to-Peer Mental Health Support: Validating Scores on the Mental Distress Response Scale With High School Students
Authors: Kalkbrenner Michael T. , Goodman-Scott Emily
Published: April 2021

This investigation tested the internal structure of scores on the Mental Distress Response Scale (MDRS), a peer-to-peer mental health support screening tool, with a national sample of 237 adolescents from 111 high schools in 30 states. Results revealed psychometric support for the scores on the MDRS and demographic differences in students’ responses. We discuss implications for how school counselors can use the MDRS to enhance peer-to-peer mental health support as part of a comprehensive school counseling program.
The Intractable Malaise: Understanding the Patterns That Maintain the Terrorist Stronghold in Nigeria
Authors: Olofinbiyi Sogo Angel
Published: April 2021

The global manifestation of terrorism has been evident in Africa, with a significant allusion to Boko Haram jihadists in Nigeria. A critical corollary of this manifestation is a decade of humanitarian crisis that threatens human security in the country. Following Boko Haram’s re-emergence in Nigeria, the group has taken pre-eminence to present itself as the most intractable malaise ever known to ravage the peace and social fabric of the northern Nigerian state. The undue supremacy of the sect has not only earned it global notoriety but has also generated a continuum of controversial academic debates on the patterns that maintain the sect as a terrorist stronghold in Nigeria. However, rather than dwell on the questions of “who Boko Haram terrorists are” or “what the nature of their modus operandi and the number of casualties of their activities in Nigeria have been,” the study focuses on determining the influential factors that have fueled the burning flame of the insurgency in the affected region. It contends that submerging the problem in the traumatized region would have to do with resolving the causal efficacy of each of the foregoing triggering factors that are known to be fanning the flames of the insurgency. Accomplishing this aim, the study recommends provision and implementation of more effective research designs and policy recommendations to address the challenges and reposition the fight for better results.
The Role of Trust in the Strategic Management Process: A Case Study of Finnish Grocery Retail Company Kesko Ltd
Authors: Malkamäki Kirsti , Hiltunen Esa , Aromaa Eeva
Published: April 2021

Previous strategy management studies have devoted scant attention to the role of trust in the strategic management process (SMP). The purpose of this study is to investigate trust in the management of a grocery trade business. Prior literature was reviewed to deepen the current understanding of trust in the SMP, and then explored through a case study on a Finnish grocery retail company, Kesko Ltd. The study was conducted by employing a qualitative research methodology and is based on an interview with the president of Kesko, who is intensively involved in the SMP. This study stresses the consideration of trust development in strategy work. The findings indicate that trust considerations in the strategic choices of the top management team can provide efficiency, innovation, and engagement in strategy implementation.

Research Questions

In this article, we ask how trust develops during three phases of the strategy process: strategy formulation, strategic choices, and strategy implementation.

Links to Theory

Our analysis of trust development focuses on the five most operationalized dimensions of trust: (a) ability and competence, (b) benevolence, (c) integrity, (d) affective-based trust, and (e) cognitive-based trust (McEvily & Tortoriello, 2011). Strategic management is separated into three interlinked phases: strategic formulation, strategic choice making, and strategy implementation (Johnson et al., 2008).

Phenomenon Studied

The case focuses on trust development in the strategy management process.

Case Context

The context of the case is a participatory strategic management process in a large Finnish grocery retail chain in a highly competitive and concentrated market. The role of trust development was studied in the case company between the K-retailers, who are independent entrepreneurs, and Kesko management staff and actors responsible for management and constant development of the business model.

Findings

This study shows how trust emerged as a result of participatory practices and dialogue between actors from different levels of organization in the strategy formulation phase. Increased understanding and contribution to strategy empowered top management to make new and brave strategic choices. This study illustrates how consistency between the strategic choices and actions for implementation enhanced trust among the organizational actors, who felt a sense of enhanced engagement in the implementation of the new strategy in their everyday work.

Discussions

This study highlights the role of trust in strategy formulation, strategic choices, and strategy implementation. It contributes to the understanding of trust in the SMP, which has not been widely researched in previous literature. Based on our results, we suggest that trust between parties is earned and evolves at each of the three stages of the SMP.
It’s Not That You Said It, It’s How You Said It: Exploring the Linguistic Mechanisms Underlying Values Affirmation Interventions at Scale
Authors: Dowell Nia M. M. , McKay Timothy A. , Perrett George
Published: April 2021

Over the last decade, psychological interventions, such as the values affirmation intervention, have been shown to alleviate the male-female performance difference when delivered in the classroom, however, attempts to scale the intervention are less successful. This study provides unique evidence on this issue by reporting the observed differences between two randomized controlled implementations of the values affirmation intervention: (a) successful in-class and (b) unsuccessful online implementation at scale. Specifically, we use natural language processing to explore the discourse features that characterize successful female students’ values affirmation essays to gain insight on the underlying mechanisms that contribute to the beneficial effects of the intervention. Our results revealed that linguistic dimensions related to aspects of cohesion, affective, cognitive, temporal, and social orientation, independently distinguished between males and females, as well as more and less effective essays. We discuss implications for the pipeline from theory to practice and for psychological interventions.
Simulation of Random Differential Periodontitis Outcome Misclassification with Perfect Specificity
Authors: Alshihayb T.S. , Heaton B.
Published: April 2021

Introduction:

Misclassification of clinical periodontitis can occur by partial-mouth protocols, particularly when tooth-based case definitions are applied. In these cases, the true prevalence of periodontal disease is underestimated, but specificity is perfect. In association studies of periodontal disease etiology, misclassification by this mechanism is independent of exposure status (i.e., nondifferential). Despite nondifferential mechanisms, differential misclassification may be realized by virtue of random errors.

Objectives:

To gauge the amount of uncertainty around the expectation of differential periodontitis outcome misclassification due to random error only, we estimated the probability of differential outcome misclassification, its magnitude, and expected impacts via simulation methods using values from the periodontitis literature.

Methods:

We simulated data sets with a binary exposure and outcome that varied according to sample size (200, 1,000, 5,000, 10,000), exposure effect (risk ratio; 1.5, 2), exposure prevalence (0.1, 0.3), outcome incidence (0.1, 0.4), and outcome sensitivity (0.6, 0.8). Using a Bernoulli trial, we introduced misclassification by randomly sampling individuals with the outcome in each exposure group and repeated each scenario 10,000 times.

Results:

The probability of differential misclassification decreased as the simulation parameter values increased and occurred at least 37% of the time across the 10,000 repetitions. Across all scenarios, the risk ratio was biased, on average, toward the null when the sensitivity was higher among the unexposed and away from the null when it was higher among the exposed. The extent of bias for absolute sensitivity differences ≥0.04 ranged from 0.05 to 0.19 regardless of simulation parameters. However, similar trends were not observed for the odds ratio where the extent and direction of bias were dependent on the outcome incidence, sensitivity of classification, and effect size.

Conclusions:

The results of this simulation provide helpful quantitative information to guide interpretation of findings in which nondifferential outcome misclassification mechanisms are known to be operational with perfect specificity.

Knowledge Transfer Statement:

Measurement of periodontitis can suffer from classification errors, such as when partial-mouth protocols are applied. In this case, specificity is perfect and sensitivity is expected to be nondifferential, leading to an expectation for no bias when studying periodontitis etiologies. Despite expectation, differential misclassification could occur from sources of random error, the effects of which are unknown. Proper scrutiny of research findings can occur when the probability and impact of random classification errors are known.
The Recognition of Business Opportunity in Female Entrepreneurship: State of Play in a Tunisian Context
Authors: Mokline Bechir
Published: April 2021

The objective of this research is to formulate an analytical framework to identify the determinants of business opportunities in the field of female entrepreneurship based on a triple perspective: subjectivist, objectivist and constructive. More specifically, we will try to develop a research model that identifies the factors influencing the process of recognising business opportunities in women’s entrepreneurship in the Tunisian context.

This work is exploratory, and we have adopted a qualitative approach through semi-directive interviews addressed to 12 Tunisian women entrepreneurs.
Visualizing the potential for transit-oriented development: Insights from an open and interactive planning support tool in Flanders, Belgium
Authors: Caset Freke , Teixeira Filipe M
Published: April 2021

This paper reports on the development trajectory of an empirical tool for transit-oriented development planning in Flanders, Belgium. The tool, StationsRadar, draws on a branch of empirical railway station assessment tools that aim to support transit-oriented development planning processes by visualizing the performance of station locations for a range of transport (‘node’) and land use (‘place’) accessibility indicators. At the root of this paper lies the observation that, while the vast majority of reviewed studies highlight the relevance of the developed tools for planning practice, little work is undertaken to systematically verify that claim. Against this backdrop, we invoke an experiential research strategy as recently proposed in the field of planning research; we organize a series of experiential workshops in which we probe the tool’s added value for regional planning in Flanders. In the process, we specifically work towards a qualitative appraisal of tool ‘usability’ and discuss how our findings bear relevance to the well-rehearsed practice of developing empirical transit-oriented development support tools. Additionally, we elaborate on and illustrate the ramifications of our findings in terms of the subsequent/iterative technical revision of the tool. We conclude this paper by putting forward three major usability recommendations pertaining to: interactive and diversified data visualizations, actor-mobilizing momentum in light of data transparency, and the integration of ‘hard’ and ‘soft’ data in light of crowdsourcing aspirations. We reflect on the broader technical and methodological challenges that come with implementing these in practice.
Machine learning to reveal an astute risk predictive framework for Gynecologic Cancer and its impact on women psychology: Bangladeshi perspective
Authors: Asaduzzaman Sayed , Ahmed Md. Raihan , Rehana Hasin , Chakraborty Setu , Islam Md. Shariful , Bhuiyan Touhid
Published: April 2021

Background

In this research, an astute system has been developed by using machine learning and data mining approach to predict the risk level of cervical and ovarian cancer in association to stress.

Results

For functioning factors and subfactors, several machine learning models like Logistics Regression, Random Forest, AdaBoost, Naïve Bayes, Neural Network, kNN, CN2 rule Inducer, Decision Tree, Quadratic Classifier were compared with standard metrics e.g., F1, AUC, CA. For certainty info gain, gain ratio, gini index were revealed for both cervical and ovarian cancer. Attributes were ranked using different feature selection evaluators. Then the most significant analysis was made with the significant factors. Factors like children, age of first intercourse, age of husband, Pap test, age are the most significant factors of cervical cancer. On the other hand, genital area infection, pregnancy problems, use of drugs, abortion, and the number of children are important factors of ovarian cancer.

Conclusion

Resulting factors were merged, categorized, weighted according to their significance level. The categorized factors were indexed using ranker algorithm which provides them a weightage value. An algorithm has been formulated afterward which can be used to predict the risk level of cervical and ovarian cancer in relation to women's mental health. The research will have a great impact on the low incoming country like Bangladesh as most women in low incoming nations were unaware of it. As these two can be described as the most sensitive cancers to women, the development of the application from algorithm will also help to reduce women’s mental stress. More data and parameters will be added in future for research in this perspective.
Dynamic model updating (DMU) approach for statistical learning model building with missing data
Authors: Jain Rahi , Xu Wei
Published: April 2021

Background

Developing statistical and machine learning methods on studies with missing information is a ubiquitous challenge in real-world biological research. The strategy in literature relies on either removing the samples with missing values like complete case analysis (CCA) or imputing the information in the samples with missing values like predictive mean matching (PMM) such as MICE. Some limitations of these strategies are information loss and closeness of the imputed values with the missing values. Further, in scenarios with piecemeal medical data, these strategies have to wait to complete the data collection process to provide a complete dataset for statistical models.

Method and results

This study proposes a dynamic model updating (DMU) approach, a different strategy to develop statistical models with missing data. DMU uses only the information available in the dataset to prepare the statistical models. DMU segments the original dataset into small complete datasets. The study uses hierarchical clustering to segment the original dataset into small complete datasets followed by Bayesian regression on each of the small complete datasets. Predictor estimates are updated using the posterior estimates from each dataset. The performance of DMU is evaluated by using both simulated data and real studies and show better results or at par with other approaches like CCA and PMM.

Conclusion

DMU approach provides an alternative to the existing approaches of information elimination and imputation in processing the datasets with missing values. While the study applied the approach for continuous cross-sectional data, the approach can be applied to longitudinal, categorical and time-to-event biological data.
Intraspecific convergence of floral size correlates with pollinator size on different mountains: a case study of a bumblebee-pollinated Lamium (Lamiaceae) flowers in Japan
Authors: Toji Tsubasa , Ishimoto Natsumi , Egawa Shin , Nakase Yuta , Hattori Mitsuru , Itino Takao
Published: April 2021

Background

Geographic differences in floral size sometimes reflect geographic differences in pollinator size. However, we know little about whether this floral size specialization to the regional pollinator size occurred independently at many places or occurred once and then spread across the distribution range of the plant species.

Results

We investigated the relationship between the local floral size of flowers and local pollinator size in 12 populations of Lamium album var. barbatum on two different mountains in the Japan Alps. Then, using 10 microsatellite markers, we analyzed genetic differentiation among the 12 populations. The results showed that local floral size was correlated with the average size of relevant morphological traits of the local pollinators: floral size was greater in populations visited frequently by the largest flower visitors, Bombus consobrinus queens, than it was in other populations. We also found that the degree of genetic similarity between populations more closely reflected interpopulation geographic proximity than interpopulation similarity in floral size.

Conclusions

Although genetic similarity of populations was highly associated with geographic proximity, floral size varied independently of geographic proximity and was associated with local pollinator size. These results suggest that in L. album var. barbatum, large floral size evolved independently in populations on different mountains as a convergent adaptation to locally abundant large bumblebee species.
Effects of peak time of myocardial injury biomarkers on mid-term outcomes of patients undergoing OPCABG
Authors: Hu Bo , Gao Fei , Lv Mengwei , Liu Ban , Shi Yu , Chen Xi , Feng Yipeng , Meng Xiaoqi , Li Zhi , Zhang Yangyang
Published: April 2021

Background

With the development of cardiac surgery techniques, myocardial injury is gradually reduced, but cannot be completely avoided. Myocardial injury biomarkers (MIBs) can quickly and specifically reflect the degree of myocardial injury. Due to various reasons, there is no consensus on the specific values of MIBs in evaluating postoperative prognosis. This retrospective study was aimed to investigate the impact of MIBs on the mid-term prognosis of patients undergoing off-pump coronary artery bypass grafting (OPCABG).

Methods

Totally 564 patients undergoing OPCABG with normal courses were included. Cardiac troponin T (cTnT) and creatine kinase myocardial band (CK-MB) were assessed within 48 h before operation and at 6, 12, 24, 48, 72, 96 and 120 h after operation. Patients were grouped by peak values and peak time courses of MIBs. The profile of MIBs and clinical variables as well as their correlations with mid-term prognosis were analyzed by univariable and multivariable Cox regression models.

Result

Continuous assessment showed that MIBs increased first (12 h after surgery) and then decreased. The peak cTnT and peak CK-MB occurred within 24 h after operation in 76.8% and 67.7% of the patients respectively. No significant correlation was found between CK-MB and mid-term mortality. Delayed cTnT peak (peak cTnT elevated after 24 h after operation) was correlated with lower creatinine clearance rate (69.36 ± 21.67 vs. 82.18 ± 25.17 ml/min/1.73 m2), body mass index (24.35 ± 2.58 vs. 25.27 ± 3.26 kg/m2), less arterial grafts (1.24 ± 0.77 vs. 1.45 ± 0.86), higher EuroSCORE II (2.22 ± 1.12 vs.1.72 ± 0.91) and mid-term mortality (26.5 vs.7.9%). Age (HR: 1.067, CI: 1.006–1.133), left ventricular ejection fraction (HR: 0.950, CI: 0.910–0.993), New York Heart Association score (HR: 1.839, CI: 1.159–2.917), total venous grafting (HR: 2.833, CI: 1.054–7.614) and cTnT peak occurrence within 24 h (HR: 0.362, CI: 0.196–0.668) were independent predictors of mid-term mortality.

Conclusion

cTnT is a better indicator than CK-MB. The peak value and peak occurrence of cTnT are related to mid-term mortality in patients undergoing OPCABG, and the peak phases have stronger predictive ability. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000033850. Registered 14 June 2020, http://www.chictr.org.cn/edit.aspx?pid=55162&htm=4.
The Turkish version of the SPPIC validated among informal caregivers with a Turkish immigrant background
Authors: van Wezel Nienke , van der Heide Iris , Devillé Walter L. J. M. , Duran Gozde , Hoopman Rianne , Blom Marco M. , Pot Anne Margriet , Spreeuwenberg Peter , Francke Anneke L.
Published: April 2021

Background

This study assesses the internal consistency and known group validity of the Turkish version of the SPPIC, a measurement instrument to assess the self perceived pressure from informal care in family caregivers of people with dementia that was originally in Dutch.

Methods

The feasibility, comprehensibility and appropriateness of the Turkish SPPIC were assessed during a pilot test. Internal consistency was examined based on data from 117 family caregivers with a Turkish immigrant background by calculating Cronbach’s alpha and by conducting a single-factor Confirmatory Factor Analysis (CFA). Known group validity was determined to obtain an understanding of the validity of the translated instrument, testing differences in the self-perceived pressure from informal care, depending on frequency of caregiving, living with a person with dementia and level of education.

Results

The pilot test showed that the translated SPPIC was considered to be feasible, comprehensible and appropriate. The internal consistency appeared to be strong (Cronbach’s alpha: 0.94). The CFA indicated that the factor ‘Self-perceived Pressure from Informal Care’ explained varying levels of variance in the items of the SPPIC (ranging from .52 to .87). Family caregivers who provided care at least once a week and who shared a home with a person with dementia perceived a greater pressure from informal care (p = 0.007, p = 0.001).

Conclusions

The Turkish translation of the SPPIC can be used in future research and practice to obtain insight into self-perceived pressure from informal care of family caregivers with Turkish immigrant backgrounds. At the same time it is recommended to conduct more research on how the measurement of self-perceived pressure from informal care in this group can be further improved.
Nerve transfer surgery in spinal cord injury: online information sharing
Authors: Moltaji Syena , Novak Christine B. , Dengler Jana
Published: April 2021

Background

Nerve transfer to improve upper extremity function in persons with cervical spinal cord injury (SCI) is a new reconstructive option, and has led to more people seeking and sharing surgical information and experiences. This study evaluated the role of social media in information-sharing on nerve transfer surgery within the SCI community.

Methods

Data were collected from Facebook, which is the favored information-sharing platform among individuals seeking medical information. Searched terms included ‘spinal cord injury’ and ‘SCI’ and excluded groups with: less than two members (n = 7); closed groups (n = 2); not pertaining to SCI (n = 13); restricted access (n = 36); and non-English (n = 2). Within public and private accessed groups, searches were conducted for ‘nerve’, ‘transfer’, ‘nerve transfer’, and ‘nerve surgery’. Each post about nerve transfer, responses to posts, and comments about nerve transfer in response to unrelated posts were tabulated. Thematic content analyses were performed and data were categorized as seeking information, sharing information, sharing support, and sharing appreciation.

Results

The search yielded 99 groups; 35 met the inclusion criteria (average size = 2007, largest = 12,277). Nerve transfer was discussed in nine groups, with 577 total mentions. In the seeking information axis, posts were related to personal experience (54%), objective information (31%), surgeon/center performing the procedure (9%), and second opinion (4%). At least 13% of posts were from individuals learning about nerve transfers for the first time. In the sharing information axis, the posts: shared personal experience (52%); shared objective information (13%); described alternative treatment (3%); tagged someone to share information (11%); linked to outside resources (12%); and recommended a specific surgeon/center (9%).

Conclusion

Social media is an important source of information and support for people with SCI. There is a paucity of information on nerve transfers. These study findings will inform implementation of future education strategies.
Ultrasonographic study of fetal facial profile markers during the first trimester
Authors: Ji Chunya , Jiang Xiaoli , Yin Linliang , Deng Xuedong , Yang Zhong , Pan Qi , Zhang Jun , Liang Qing
Published: April 2021

Background

To establish reference ranges of fetal facial profile markers and study their correlations with crown-rump length (CRL) during the first trimester (11 ~ 13+ 6weeks’ gestation) in a Chinese population.

Methods

Ultrasonographic images of measuring fetal nuchal translucency (NT) were retrospectively selected randomly in normal fetuses whose parents were both Chinese. The facial markers included inferior facial angle (IFA), maxilla-nasion-mandible (MNM) angle, facial maxillary angle (FMA) and profile line (PL) distance. These markers were measured through ViewPoint 6 software by two experienced sonographers.

Results

Three hundred and eighty fetuses were selected. The ICCs (95 % CI) of intra-operator 1 reproducibility of IFA, MNM angle, FMA, PL distance were 0.944 (0.886 ~ 0.973), 0.804 (0.629 ~ 0.902), 0.834 (0.68 ~ 0.918) and 0.935 (0.868 ~ 0.969), respectively. The ICCs (95 % CI) of intra-operator 2 reproducibility of IFA, MNM angle, FMA, PL distance were 0.931 (0.857 ~ 0.967), 0.809 (0.637 ~ 0.904), 0.786 (0.600 ~ 0.892) and 0.906 (0.813 ~ 0.954), respectively. The ICCs (95 % CI) of inter-operator reproducibility of IFA, MNM angle, FMA, PL distance were 0.885 (0.663 ~ 0.953), 0.829 (0.672 ~ 0.915), 0.77 (0.511 ~ 0.891) and 0.844 (0.68 ~ 0.925), respectively. The average ± SD of IFA, MNM angle, FMA and PL distance were 80.2°±7.25°, 4.17°±1.19°, 75.36°±5.31°, 2.78 ± 0.54 mm, respectively. IFA and PL distance significantly decreased with CRL, while MNM angle and FMA significantly increased with CRL.

Conclusions

It was feasible to measure fetal facial markers during the first trimester. In Chinese population, the reference ranges of IFA, MNM angle, FMA and PL distance were 80.2°±7.25°, 4.17°±1.19°, 75.36°±5.31°, 2.78 ± 0.54 mm, respectively, and the measurements were found to correlate with CRL.
Global, regional, and national mortality trends of female breast cancer by risk factor, 1990–2017
Authors: Liu Hui , Shi Wenjie , Jin Zhi , Zhuo Rui , Dong Jie , Lao Qiufeng , Li Shengle , Pang Weiyi
Published: April 2021

Background

Female breast cancer (FBC) is a malignancy involving multiple risk factors and has imposed heavy disease burden on women. We aim to analyze the secular trends of mortality rate of FBC according to its major risk factors.

Methods

Death data of FBC at the global, regional, and national levels were retrieved from the online database of Global Burden of Disease study 2017. Deaths of FBC attributable to alcohol use, high body-mass index (BMI), high fasting plasma glucose (FPG), low physical activity, and tobacco were collected. Estimated average percentage change (EAPC) was used to quantify the temporal trends of age-standardized mortality rate (ASMR) of FBC in 1990–2017.

Results

Worldwide, the number of deaths from FBC increased from 344.9 thousand in 1990 to 600.7 thousand in 2017. The ASMR of FBC decreased by 0.59% (95% CI, 0.52, 0.66%) per year during the study period. This decrease was largely driven by the reduction in alcohol use- and tobacco-related FBC, of which the ASMR was decreased by 1.73 and 1.77% per year, respectively. In contrast, the ASMR of FBC attributable to high BMI and high FPG was increased by 1.26% (95% CI, 1.22, 1.30%) and 0.26% (95% CI, 0.23, 0.30%) per year between 1990 and 2017, respectively.

Conclusions

The mortality rate of FBC experienced a reduction over the last three decades, which was partly owing to the effective control for alcohol and tobacco use. However, more potent and tailored prevention strategies for obesity and diabetes are urgently warranted.
Identification of NTRK3 as a potential prognostic biomarker associated with tumor mutation burden and immune infiltration in bladder cancer
Authors: Zhang Zhao , Yu Yongbo , Zhang Pengfei , Ma Guofeng , Zhang Mingxin , Liang Ye , Jiao Wei , Niu Haitao
Published: April 2021

Background

Bladder cancer (BLCA) is a common malignant tumor of urinary system with high morbidity and mortality. In recent years, immunotherapy has played a significant role in the treatment of BLCA. Tumor mutation burden (TMB) has been reported to be a powerful biomarker for predicting tumor prognosis and efficacy of immunotherapy. Our study aimed to explore the relationship between TMB, prognosis and immune infiltration to identify the key genes in BLCA.

Methods

Clinical information, somatic mutation and gene expression data of BLCA patients were downloaded from The Cancer Genome Atlas (TCGA) database. Patients were divided into high and low TMB groups according to their calculated TMB scores. Gene Set Enrichment Analysis (GSEA) was performed to screen for significantly enriched pathways. Differentially expressed genes (DEGs) between the two groups were identified. Univariate Cox analysis and Kaplan-Meier survival analysis were applied for screening key genes. Immune infiltration was performed for TMB groups and NTRK3.

Results

Higher TMB scores were related with poor survival in BLCA. After filtering, 36 DEGs were identified. NTRK3 had the highest hazard ratio and significant prognostic value. Co-expressed genes of NTRK3 were mainly involved in several pathways, including DNA replication, basal transcription factors, complement and coagulation cascades, and ribosome biogenesis in eukaryotes. There was a significant correlation among TMB scores, NTRK3 expression and immune infiltration.

Conclusions

Our results suggest that NTRK3 is a TMB-related prognostic biomarker, which lays the foundation for further research on the immunomodulatory effect of NTRK3 in BLCA.
Effectiveness of interventions on early neurodevelopment of preterm infants: a systematic review and meta-analysis
Authors: Aita Marilyn , De Clifford Faugère Gwenaëlle , Lavallée Andréane , Feeley Nancy , Stremler Robyn , Rioux Émilie , Proulx Marie-Hélène
Published: April 2021

Background

As preterm infants’ neurodevelopment is shaped by NICU-related factors during their hospitalization, it is essential to evaluate which interventions are more beneficial for their neurodevelopment at this specific time. The objective of this systematic review and meta-analysis was to evaluate the effectiveness of interventions initiated during NICU hospitalization on preterm infants’ early neurodevelopment during their hospitalization and up to two weeks corrected age (CA).

Methods

This systematic review referred to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses [PRISMA] guidelines and was registered in PROSPERO (CRD42017047072). We searched CINAHL, MEDLINE, PubMed, EMBASE (OVID), Cochrane Systematic Reviews, CENTRAL, and Web of Science from 2002 to February 2020 and included randomized controlled/clinical trials conducted with preterm infants born between 24 and 366/7 weeks of gestation. All types of interventions instigated during NICU hospitalization were included. Two independent reviewers performed the study selection, data extraction, assessment of risks of bias and quality of evidence.

Results

Findings of 12 studies involving 901 preterm infants were synthesized. We combined three studies in a meta-analysis showing that compared to standard care, the NIDCAP intervention is effective in improving preterm infants’ neurobehavioral and neurological development at two weeks CA. We also combined two other studies in a meta-analysis indicating that parental participation did not significantly improve preterm infants’ neurobehavioral development during NICU hospitalization. For all other interventions (i.e., developmental care, sensory stimulation, music and physical therapy), the synthesis of results shows that compared to standard care or other types of comparators, the effectiveness was either controversial or partially effective.

Conclusions

The overall quality of evidence was rated low to very low. Future studies are needed to identify interventions that are the most effective in promoting preterm infants’ early neurodevelopment during NICU hospitalization or close to term age. Interventions should be appropriately designed to allow comparison with previous studies and a combination of different instruments could provide a more global assessment of preterm infants’ neurodevelopment and thus allow for comparisons across studies.

Trial registration

Prospero CRD42017047072.