bluuebunny/crossref_metadata_2025 huggingface dataset:
A systematic review of people’s lived experiences of inpatient treatment for anorexia nervosa: living in a “bubble”
Authors: Rankin Rebekah , Conti Janet , Ramjan Lucie , Hay Phillipa
Published: June 2023

Background

Treatment for anorexia nervosa (AN) is typically delivered on a continuum of care, starting with outpatient treatment, and moving onto intensive outpatient, day or residential treatment and/or inpatient hospitalisation. However, minimal attention has been afforded to the lived experiences of persons undergoing inpatient treatment for AN. In particular, qualitative literature pertaining to the lived experiences of specialist inpatient or residential treatment of AN remains fragmented and incomplete. The aim of this review was to synthesise current literature exploring patients’ lived experiences of residential and inpatient treatment for AN within eating disorder-specific treatment services.

Methods

Five databases were searched and a qualitative thematic systematic review and meta-synthesis of 11 studies were conducted.

Results

Eleven studies of 159 participants were included. Four meta-themes were constructed from the data: (1) a medical discourse—“I don’t think it’s individualised here”; (2) restrictive practice—living in a “bubble”; (3) myself, others and “a similar demon”; and (4) I am “not just another anorexic”. The data also revealed two cross-cutting themes: (1) more than a single experience; and (2) meaning making and identity.

Conclusions

These findings highlight the complex and multifaceted nature of the inpatient treatment experience as well as the inherent conflicts in balancing the necessity of medical and psychological intervention with person-centred treatment approaches in the treatment of AN.
Impact of anxiety and depression on the swallowing process among patients with neurological disorders and head and neck neoplasia: systemic review
Authors: Khayyat Yasir Mohammed , Abdul Wahab Rahaf Abdulrashid , Natto Nujood Khalid , Al Wafi Atheer Abdulhafiz , Al Zahrani Asmaa Ali
Published: June 2023

Background

Dysphagia is associated with depression and anxiety due to the severity, impact of symptoms itself or secondary to the underlying cause. This is more recognizable to brain diseases that has consequences common to the neural supply of the swallowing act and the cognition and behavior. Limited data are available to explore, quantitate and monitor these neurological outcomes. Our aim of this research to review the literature pertinent to depressive disorders, anxiety, and/or the quality of life (QoL) and psychological well-being. Search of Medline and Google Scholar databases for relevant articles had revealed a total of 1568 citations; 30 articles met the inclusion and exclusion criteria.

Results

Data about the direct effect of dysphagia on psychiatric aspects are limited. Studies of the relationship between severity of dysphagia and depressive symptoms demonstrated that several evaluation tools are available for objective and subjective assessment. The severity and progression of dysphagia was significantly associated with increased depressive symptoms.

Conclusion

Dysphagia is associated with and positively correlated to depression and anxiety scores observed in Parkinson disease (PD), multiple sclerosis (MS) and stroke. Similar association is observed in patients with head and neck cancer, tongue cancer and oral cancer. A bidirectional positive correlation exists with a vicious circle that loops between dysphagia and psychological disease. Moreover, the severity of dysphagia shows correlation with depression and/or anxiety scores (Fig. 1, Graphical abstract).

Graphical Abstract
Reasonable access: important characteristics and perceived quality of legal and illegal sources of cannabis for medical purposes in Canada
Authors: Capler N. Rielle , Balneaves Lynda G. , Buxton Jane A. , Kerr Thomas
Published: June 2023

Background

Throughout the past two decades of legal medical cannabis in Canada, individuals have experienced challenges related to accessing legal sources of cannabis for medical purposes. The objective of our study was to examine the sources of cannabis accessed by individuals authorized to use medical cannabis and to identify possible reasons for their use of illegal sources.

Methods

Individuals who participated in the Cannabis Access Regulations Study (CANARY), a national cross-sectional survey launched in 2014, and indicated they were currently authorized to use cannabis for medical purposes in Canada were included in this study. We assessed differences between participants accessing cannabis from only legal sources versus from illegal sources in relation to sociodemographic characteristics, health-related factors, and characteristics of medical cannabis they considered important. A secondary analysis assessed differences in satisfaction with various dimensions of cannabis products and services provided by legal versus illegal sources.

Results

Half of the 237 study participants accessed cannabis from illegal sources. Individuals accessing cannabis from illegal sources were significantly more likely to value pesticide-free products, access to a variety of strains, ability to select strain and dosage, ability to observe and smell cannabis, availability in a dispensary, and availability in small quantities than did individuals accessing cannabis from only legal sources (all p < 0.05). Additionally, participants gave significantly higher satisfaction scores to illegal sources than to legal sources on service-related dimensions of cannabis access (all p < 0.05).

Conclusion

Our findings contribute to an understanding of reasonable access to medical cannabis from a patient perspective and how to assess whether it has been achieved. Characteristics of cannabis products and services valued by patients and appropriate to their needs should be incorporated into legal medical cannabis programs to promote the use of legal medical sources. While pertaining specifically to medical use of cannabis in Canada, the findings of this study may also be instructive for understanding the use of illegal cannabis sources for non-medical purposes in Canada and provide insight for other jurisdictions implementing cannabis regulations for both medical and non-medical purposes.
A comprehensive assessment of VCAN transcriptional expression and evaluation as an effective prognostic biomarker against breast cancer: in silico study
Authors: Shovon Md. Hasan Jafre , Khan Dhrubo Ahmed , Tareq Md. Mohaimenul Islam , Imtiaz Md. , Zilani Md Nazmul Hasan , Hasan Md. Nazmul
Published: June 2023

Background

The VCAN gene provides instructions for making a protein called versican which is a type of protein known as a proteoglycan. Versican is a key ingredient of the extracellular matrix, and due to its widespread expression in the body, versican is involved in cell adhesion, proliferation, and migration. Mutations or alterations of this protein could result in the disintegration of the fine-tuned molecular machinery which can lead to uncontrolled cell proliferation.

Results

VCAN is a novel prognostic marker for multiple cancers, and it showed tremendous results on breast cancer prognosis based on the data available on multiple websites. So, we targeted VCAN to analyze the expression and the outcome of breast cancer. This is a server-based study, and the expression of VCAN shows upregulation in breast cancer subtypes as compared to the normal tissue. The promoter methylation analysis suggested that overexpression of VCAN may be due to hypomethylation. Mutation analysis showed a positive correlation with VCAN expression where missense-type mutation has the highest percentage (77.33%), truncating (17.33%), and splice (4%) and somatic mutation frequency is 1.8%. VCAN was closely related to ten different genes and coexpressed with five of the genes among them. Five distinct compounds are linked to the methylation and mutagenesis of VCAN, according to the gene–drug interaction.

Conclusions

The upregulation of VCAN is closely correlated with promoter methylation and the clinical features of breast cancer patients. The whole study suggests that the breast cancer patient’s survival rate gets lower when the VCAN expression level gets higher. We anticipated that these findings will lead to further improvements in breast cancer prognosis and the significance of VCAN as a biomarker for breast cancer prognosis.
Case report on successful treatment for brain abscess in a Japanese monkey (Macaca fuscata)
Authors: Kimura Tohru
Published: June 2023

Background

A brain abscess in human beings is a focal infection of the central nervous system frequently characterized by areas of localized cerebritis and central necrosis surrounded by a well vascularized capsule. A brain abscess, although sporadically reported, is relatively rare disease in domestic animals (horses, cattle, goats and alpacas), companion animals (dogs and cats) and laboratory nonhuman primates. Brain abscesses are life threatening disease that needs early and aggressive veterinary therapy.

Case presentation

The purpose of this study on a brain abscess in a Japanese monkey was to report the investigational and therapeutic processes including clinical observations, hematological and serum biochemical profiles, and magnetic resonance imaging (MRI) features, probiotic and antibiotic therapy. In clinical observation, the monkey presented with slowly progressive gentle and depressed behavioral change. Hematological findings showed that slightly declined platelet counts gradually increased in the course of the treatment. Serum biochemical profiles revealed initial markedly elevated. A series of chemotherapy provide prominent relief from the influence of the brain abscess. MRI images illustrated that a brain abscess was located in the right frontal lobe and the mass was delineated by a thick rim, indicating the capsule formation stage. The lesion chronologically decreased in size over the course of treatment. Until 11 weeks after treatment of the brain abscess, the size of brain abscess continued to reduce, leaving an organized lesion trace. To the best of my knowledge, this is the first report on successful treatment for a brain abscess in a Japanese monkey (Macaca fuscata).

Conclusions

Medical management of simian brain abscesses is possible based on the controlled and resolving nature of the lesions as determined by MRI and completion of a of chemical antibiotic treatment presented in this study.
De-implementing public health policies: a qualitative study of the process of implementing and then removing body mass index (BMI) report cards in Massachusetts public schools
Authors: Poole Mary Kathryn , Lee Rebekka M. , Kinderknecht Kelsey L. , Kenney Erica L.
Published: June 2023

Background

This study explored reasons for the adoption of a policy to distribute report cards to parents about children’s weight status (“BMI report cards”) in Massachusetts (MA) public schools in 2009 and the contextual factors influencing the policy removal in 2013.

Methods

We conducted semi-structured, qualitative interviews with 15 key decision-makers and practitioners involved with implementing and de-implementing the MA BMI report card policy. We analyzed interview data using a thematic analytic approach guided by the Consolidated Framework for Implementation Research (CFIR) 2.0.

Results

Primary themes were that (1) factors other than scientific evidence mattered more for policy adoption, (2) societal pressure spurred policy adoption, (3) problems with the policy design contributed to inconsistent implementation and dissatisfaction, and (4) media coverage, societal pressure, and organizational politics and pressure largely prompted de-implementation.

Conclusions

Numerous factors contributed to the de-implementation of the policy. An orderly process for the de-implementation of a policy in public health practice that manages drivers of de-implementation may not yet exist. Public health research should further focus on how to de-implement policy interventions when evidence is lacking or there is potential for harm.
Using qualitative comparative analysis to understand the conditions that produce successful PrEP implementation in family planning clinics
Authors: Piper Kaitlin N. , Anderson Katherine M. , Kokubun Caroline W. , Sheth Anandi N. , Sales Jessica
Published: June 2023

Background

Title X-funded family planning clinics have been identified as optimal sites for delivery of pre-exposure prophylaxis (PrEP) for HIV prevention to U.S. women. However, PrEP has not been widely integrated into family planning services, especially in the Southern U.S., and data suggest there may be significant implementation challenges in this setting.

Methods

To understand contextual factors that are key to successful PrEP implementation in family planning clinics, we conducted in-depth qualitative interviews with key informants from 38 family planning clinics (11 clinics prescribed PrEP and 27 did not). Interviews were guided by constructs from the Consolidated Framework for Implementation Research (CFIR), and qualitative comparative analysis (QCA) was used to uncover the configurations of CFIR factors that led to PrEP implementation.

Results

We identified 3 distinct construct configurations, or pathways, that led to successful PrEP implementation: (1) high “Leadership Engagement” AND high “Available Resources”; OR (2) high “Leadership Engagement” AND NOT located in the Southeast region; OR (3) high “Access to Knowledge and Information” AND NOT located in the Southeast region. Additionally, there were 2 solution paths that led to absence of PrEP implementation: (1) low “Access to Knowledge and Information” AND low “Leadership Engagement”; OR (2) low “Available Resources” AND high “External Partnerships”.

Discussion

We identified the most salient combinations of co-occurring organizational barriers or facilitators associated with PrEP implementation across Title X clinics in the Southern U.S. We discuss implementation strategies to promote pathways that led to implementation success, as well as strategies to overcome pathways to implementation failure. Notably, we identified regional differences in the pathways that led to PrEP implementation, with Southeastern clinics facing the most obstacles to implementation, specifically substantial resource constraints. Identifying implementation pathways is an important first step for packaging multiple implementation strategies that could be employed by state-level Title X grantees to help scale up PrEP.
Imaging point diffractors using a low-rank approximation method
Authors: Chen Wei , Oboué Yapo Abolé Serge Innocent , Saad Omar M. , Yang Liuqing , Wang Hang , Chen Yangkang
Published: June 2023

Diffraction separation plays a critical role in obtaining high-resolution images of subsurface diffractors by eliminating the diffractions’ contribution from reflections. It is usually based on the difference in spatial coherency between seismic reflection and diffraction energy in the time domain. Methods based on local slope differences, e.g., plane-wave destruction (PWD) method, tend to separate point and line diffractors simultaneously. This paper applies a rank-based diffraction separation method, known as the localized rank-reduction (LRR) method, to distinguish point diffractors in poststack data sets from line diffractors, thereby obtaining a higher resolution when characterizing point discontinuities such as karst caves. To make the LRR method more adaptive, a novel rank determination method based on a newly defined accumulated singular value ratio sequence is developed. The effectiveness of the proposed method is proved via a variety of 2D/3D synthetic and real data examples and a detailed discussion of its practical potential. Despite a larger computational cost compared to the PWD method, the proposed method helps interpretation by enabling us to distinguish between line and point diffractors.
Safety analysis of lurbinectedin versus topotecan in elderly patients.
Authors: Subbiah Vivek , Lorusso Domenica , Trigo Perez Jose Manuel Manuel , Leary Alexandra , Moreno Victor , Kristeleit Rebecca , Vergote Ignace , Lopez-Vilariño Jose Antonio , Fernandez Cristian Marcelo , Siguero Mariano , Kahatt Carmen Maria , Zeaiter Ali Hassan , Boni Valentina , Navarro Alejandro , Gutierrez Calderon Vanesa , Pardo Beatriz , Berton Dominique , Scambia Giovanni
Published: June 2023

e20632

Background: Lurbinectedin is a selective inhibitor of oncogenic transcription. The US FDA granted accelerated approval for lurbinectedin as monotherapy (3.2 mg/m2 q3wk) for relapsed small cell lung cancer (SCLC) based on a phase 2 basket trial (NCT02454972). The ATLANTIS trial (NCT02566993) investigated lurbinectedin 2.0 mg/m2 plus doxorubicin 40.0 mg/m2 q3wk versus topotecan or CAV in relapsed SCLC. The CORAIL trial (NCT02421588) evaluated lurbinectedin (3.2 mg/m2 i.v. q3wk) compared to pegylated liposomal doxorubicin or topotecan in patients with platinum-resistant ovarian cancer. The elderly population is usually under-represented in clinical trials despite its interest due to the increased frailty and high comorbidity. Methods: Data from Basket and CORAIL trials were included in an integrated safety analysis to evaluate lurbinectedin safety profile at the approved regimen (3.2 mg/m2 q3wk). This post hoc safety analysis compares the outcomes of lurbinectedin in elderly population (n = 207 patients ≥65 years old; Basket n = 113 and CORAIL n = 94) versus topotecan (n = 75 patients ≥65 years old; ATLANTIS n = 45 and CORAIL n = 30). Results: Treatment-related adverse events (AEs) and laboratory abnormalities regardless of relationship occurring in > 10% of patients, were: Compared with topotecan, lurbinectedin showed lower frequency of treatment-related grade ≥3 AEs (53.1% vs. 85.3%; p < 0.01) and grade ≥3 serious adverse events (SAEs) (19.8% vs. 34.7%; p = 0.01) and a trend for less AEs leading to treatment discontinuation (5.3% vs. 8.0%; p = 0.40) or deaths (1.4% vs. 5.3%; p = 0.08). Use of supportive treatments was significantly lower with lurbinectedin: G-CSF (17.9% vs. 29.3%; p < 0.05), red blood cells transfusions (20.8% vs. 56.0%; p < 0.01) or erythropoietin (2.4% vs. 14.7%; p < 0.01). Conclusions: Lurbinectedin is well tolerated in elderly patients and has a predictable and manageable safety profile. No new safety signals were observed. With the limitations of cross-trial comparisons, lurbinectedin shows a clear advantage in terms of hematological toxicity compared with topotecan in patients ≥ 65 years old. Furthermore, fewer elderly patients treated with lurbinectedin had severe AEs, SAEs, treatment discontinuations and deaths compared to elderly patients treated with topotecan. Clinical trial information: NCT02454972 , NCT02566993 , NCT02421588 . [Table: see text]
Apollo: A randomized phase II double-blind study of olaparib versus placebo following curative intent therapy in patients with resected pancreatic cancer and a pathogenic BRCA1, BRCA2, or PALB2 mutation—ECOG-ACRIN EA2192.
Authors: Reiss Kim Anna , Hong Sung Chul , Kasi Anup , O'Reilly Eileen Mary , Maithel Shishir K. , Yao Xin , Hamilton Stanley R. , Boursi Ben , Pishvaian Michael J. , Klempner Samuel J , Domchek Susan M. , Catalano Paul J. , Chiorean E. Gabriela , Philip Philip Agop , O'Dwyer Peter J.
Published: June 2023

TPS4202

Background: A meaningful subset of PDAC is characterized by a homologous recombination deficiency (HRD). The most well-defined patients within this group are those with pathogenic variants in BRCA1, BRCA2 and PALB2. In the metastatic setting, PARP inhibitor maintenance provides a progression-free survival benefit after a period of platinum based chemotherapy1,2, but the role of PARP inhibitors in the curative intent setting is undefined. The OlympiA study established one year of olaparib as the standard of care for patients with BRCA-related, early stage breast cancer who completed all other curative-intent treatment3. Therefore, we have designed a randomized, phase II double-blind study of one year of olaparib vs placebo in patients with pancreatic cancer and a germline or somatic variant in BRCA or PALB2 who have completed all curative intent therapy. Methods: We have enrolled and treated 29 of 152 planned patients on study NCT 04858334/EA2192. Eligibility criteria include: a pathogenic germline or somatic variant in BRCA1, BRCA2 or PALB2 as determined by local laboratory (central review required); completion of curative-intent resection and ≥ three months of multi-agent chemotherapy; no evidence of recurrent disease. At enrollment, patients must be within 12 weeks of their last anti-cancer intervention. Patients are randomized 2:1 to receive oral olaparib 300 mg twice daily or placebo for 12 28-day cycles. The primary endpoint is relapse-free survival. Overall survival is a secondary endpoint. Tumor tissue, fecal material (for microbiome analysis) and serial ctDNA samples are being collected. 1) Golan T, Locker GY, Kindler HL: Maintenance Olaparib for Metastatic Pancreatic Cancer. Reply. N Engl J Med 381:1492-1493, 2019. 2) Reiss KA, Mick R, O'Hara MH, et al: Phase II Study of Maintenance Rucaparib in Patients With Platinum-Sensitive Advanced Pancreatic Cancer and a Pathogenic Germline or Somatic Variant in BRCA1, BRCA2, or PALB2. J Clin Oncol 39:2497-2505, 2021. 3) Tutt ANJ, Garber JE, Geyer CE, Jr.: Adjuvant Olaparib in BRCA-Mutated Breast Cancer. Reply. N Engl J Med 385:1440, 2021. Clinical trial information: NCT04858334 .
Alliance A021806: A phase III trial evaluating perioperative versus adjuvant therapy for resectable pancreatic cancer.
Authors: Chawla Akhil , Shi Qian , Ko Andrew H. , Beg Shaalan , Varghese Anna M. , Behrman Stephen W , Bloomston Mark , Ahmed Firas Salem , Frankel Wendy L. , Dixon Jesse G. , Carrero Xiomara W. , Shergill Ardaman , Crawley Jamie , Akin Oguz , Renouf Daniel John , Zogopoulos George , Hubbard Joleen M. , Meyerhardt Jeffrey A. , O'Reilly Eileen Mary , Ferrone Cristina R.
Published: June 2023

TPS4204

Background: The role of neoadjuvant chemotherapy in resectable pancreatic cancer has yet to be defined. Recent phase II trial results demonstrate a median overall survival time (mOS) of only 22.4 months after treatment with perioperative modified FOLFIRINOX (mFOLFIRINOX) with 36% not reaching surgery due to disease progression during neoadjuvant therapy. While potential benefits and shortcomings of neoadjuvant chemotherapy have been well documented, to date, no phase III trial has directly compared a perioperative versus an adjuvant chemotherapy strategy in resectable pancreatic cancer. Alliance for Clinical Trials in Oncology A021806 is an actively accruing randomized controlled phase III trial evaluating the efficacy of perioperative chemotherapy with mFOLFIRINOX in patients with resectable pancreatic cancer. Methods: To qualify for enrollment, patients must have biopsy-proven localized resectable pancreatic adenocarcinoma as defined by the National Comprehensive Cancer Network. Patients must have good performance status (ECOG 0 or 1) and be candidates to receive mFOLFIRINOX treatment. All patients enrolled undergo central radiologic eligibility review for quality control and are then randomized to either Arm 1 which consists of 8 cycles of neoadjuvant mFOLFIRINOX followed by 4 cycles of adjuvant mFOLFIRINOX or Arm 2 which includes upfront surgery followed by 12 cycles of adjuvant mFOLFIRINOX. The primary endpoint of the trial is overall survival with secondary endpoints evaluating disease-free survival, margin-negative resection rate, surgical complications, and chemotherapeutic adverse events. Additional correlative endpoints include quality of life and radiomic imaging assessments. A total enrollment of 352 patients is planned from the US and Canada; current enrollment for this trial is at 145 patients. An OS interim analysis will be performed when 50% of the events (124) are observed combining the two arms. If the trial continues after interim analysis, the final OS analysis will be performed with a total of 248 events (combined arms). If the Cox model (stratified by tumor location and ECOG PS) comparing OS between arms produces a one-sided p-value < 0.05, then we will conclude that the OS of the perioperative therapy arm is superior to adjuvant therapy. The Alliance A021806 phase III trial aims to define a new standard of care for patients with resectable pancreatic cancer. Clinical trial information: NCT04340141 .
Thyroid Function Tests in Children and Adolescents With Trisomy 21: Definition of Syndrome-Specific Reference Ranges
Authors: Cattoni Alessandro , Molinari Silvia , Capitoli Giulia , Masera Nicoletta , Nicolosi Maria Laura , Barzaghi Silvia , Marziali Giulia , Lazzerotti Alessandra , Gazzarri Alessandra , Vimercati Chiara , Sala Debora , Biondi Andrea , Galimberti Stefania , Fossati Chiara
Published: June 2023

Context

The lack of syndrome-specific reference ranges for thyroid function tests (TFT) among pediatric patients with Down syndrome (DS) results in an overestimation of the occurrence of hypothyroidism in this population.

Objective

To (a) outline the age-dependent distribution of TFT among pediatric patients with DS; (b) describe the intraindividual variability of TFT over time; and (c) assess the role of elevated thyrotropin (TSH) in predicting the future onset of overt hypothyroidism.

Methods

In this retrospective, monocentric, observational analysis, we included 548 patients with DS (0-18 years) longitudinally assessed between 1992 and 2022. Exclusion criteria were abnormal thyroid anatomy, treatments affecting TFT, and positive thyroid autoantibodies.

Results

We determined the age-dependent distribution of TSH, FT3, and FT4 and outlined the relative nomograms for children with DS. Compared with non-syndromic patients, median TSH levels were statistically greater at any age (P < .001). Median FT3 and FT4 levels were statistically lower than controls (P < .001) only in specific age classes (0-11 for FT3, 11-18 years for FT4). TSH levels showed a remarkable fluctuation over time, with a poor (23%-53%) agreement between the TSH centile classes at 2 sequential assessments. Finally, the 75th centile was the threshold above which TSH values predicted future evolution into overt hypothyroidism with the best statistical accuracy, with a satisfactory negative predictive value (0.91), but poor positive predictive value (0.15).

Conclusion

By longitudinally assessing TFT in a wide pediatric DS population, we outlined the syndrome-specific reference nomograms for TSH, FT3, and FT4 and demonstrated a persistent upward shift of TSH compared to non-syndromic children.
Comorbidity in Congenital Hypothyroidism—A Nationwide, Population-based Cohort Study
Authors: Danner Emmi , Jääskeläinen Jarmo , Niuro Laura , Huopio Hanna , Niinikoski Harri , Viikari Liisa , Kero Jukka , Sund Reijo
Published: June 2023

Context

Patients with congenital hypothyroidism (CH) are affected more often than the general population by other chronic diseases and neurological difficulties.

Objective

The aim of this nationwide population-based register study was to investigate the incidence of congenital malformations, comorbidities, and the use of prescribed drugs in patients with primary CH.

Methods

The study cohort and matched controls were identified from national population-based registers in Finland. All diagnoses from birth until the end of 2018 were collected from the Care Register, and subject-specific prescription drug purchases were identified from The Prescription Register from birth until the end of 2017.

Results

Diagnoses of neonatal and chronic diseases were collected for 438 full-term patients and 835 controls (median follow-up time 11.6 years; range, 0-23 years). Newborns with CH were more often found to have neonatal jaundice (11.2% and 2.0%; P < .001), hypoglycemia (8.9% and 2.8%; P < .001), metabolic acidemia (3.2% and 1.1%; P = .007), and respiratory distress (3.9% and 1.3%; P < .003) as compared to their matched controls.

Congenital malformations were diagnosed in 66 of 438 (15.1%) CH patients and in 62 of 835 (7.4%) controls (P < .001). The most commonly affected extrathyroidal systems were the circulatory and musculoskeletal systems. The cumulative incidence of hearing loss and specific developmental disorders was higher among CH patients than controls. The use of antidepressant and antipsychotic drugs was similar in CH patients and their controls.

Conclusion

CH patients have more neonatal morbidity and congenital malformations than their matched controls. The cumulative incidence of neurological disorders is higher in CH patients. However, our results do not support the existence of severe psychiatric comorbidity.
Blood Cell Parameters From Early to Middle Pregnancy and Risk of Gestational Diabetes Mellitus
Authors: Ye Yi-Xiang , Wang Yi , Wu Ping , Yang Xue , Wu Linjing , Lai Yuwei , Ouyang Jing , Li Yanqin , Li Peishan , Hu Yayi , Wang Yi-Xin , Song Xingyue , Yan Shijiao , Lv Chuanzhu , Liu Gang , Pan An , Pan Xiong-Fei
Published: June 2023

Context

Chronic low-grade inflammation may play a crucial role in the pathogenesis of gestational diabetes mellitus (GDM). However, prospective studies on the relations of inflammatory blood cell parameters during pregnancy with GDM are lacking.

Objective

To prospectively investigate the associations of inflammatory blood cell parameters in both early and middle pregnancy, and their change patterns from early to middle pregnancy, with GDM risk.

Methods

We used data from the Tongji-Shuangliu Birth Cohort. Inflammatory blood cell parameters (white blood cells [WBC], neutrophils, lymphocytes, monocytes, neutrophil to lymphocyte ratio [NLR], and platelets) were assayed before 15 weeks and between 16 and 28 weeks of gestational age. Logistic regression was used to evaluate the associations between inflammatory blood cell parameters and GDM.

Results

Of the 6354 pregnant women, 445 were diagnosed with GDM. After adjustment for potential confounders, WBC, neutrophils, lymphocytes, monocytes, and NLR in early pregnancy were positively associated with GDM risk (odds ratios [95% CI] for extreme-quartile comparison were 2.38 [1.76-3.20], 2.47 [1.82-3.36], 1.40 [1.06-1.85], 1.69 [1.27-2.24], and 1.51 [1.12-2.02], respectively, all P for trend ≤ .010). Similarly, higher levels of WBC, neutrophils, monocytes, and NLR in middle pregnancy were associated with increased risk of GDM (all P for trend ≤ .014). Stable high levels (≥ median in both early and middle pregnancy) of WBC, neutrophils, monocytes, and NLR were positively associated with GDM risk (all P ≤ .001).

Conclusion

Increased WBC, neutrophils, monocytes, and NLR in both early and middle pregnancy and their stable high levels from early to middle pregnancy were associated with higher GDM risk, highlighting that they might be clinically relevant for identifying individuals at high risk for GDM.
Associations of Serum 25(OH)D With Risk of Recurrent Cardiovascular Events in Individuals With Coronary Heart Disease
Authors: Lin Xiaoyu , Chen Xue , Liu Sen , Deng Yulei , Wang Yuexuan , Lu Qi , Li Rui , Ou Yunjing , Tian Qingying , Liao Yunfei , Cui Guanglin , Yang Kun , Pan An , Liu Gang
Published: June 2023

Context

Few studies have examined the relationship between vitamin D and the risk of recurrent cardiovascular (CV) events in people with coronary heart disease (CHD).

Objective

This study aimed to investigate the associations of serum 25-hydroxyvitamin D (25(OH)D) concentration and the vitamin D receptor (VDR) polymorphisms with the risk of recurrent CV events in individuals with established CHD.

Methods

A total of 22 571 participants with CHD were included from the UK Biobank. Recurrent CV events, including myocardial infarction (MI), heart failure (HF), stroke, and CV disease mortality, were identified from electronic health records. Cox proportional-hazard models were used to calculate hazard ratios (HRs) and 95% CIs.

Results

The median (interquartile range) of serum 25(OH)D concentration was 44.8 nmol/L (range, 30.3-61.4 nmol/L), and 58.6% of participants had 25(OH)D below 50 nmol/L. During a median follow-up of 11.2 years, a total of 3998 recurrent CV events were documented. After multivariable adjustment, there was a nonlinear inverse relationship between serum 25(OH)D and recurrent CV events (P nonlinearity <.01), and the decreasing risk gradually leveled off at around 50 nmol/L. Compared with participants with serum 25(OH)D less than 25.0 nmol/L, the HRs (95% CIs) for participants with serum 25(OH)D of 50.0 to 74.9 nmol/L were 0.64 (0.58-0.71) for recurrent CV events, 0.78 (0.65-0.94) for MI, 0.66 (0.57-0.76) for HF, and 0.66 (0.52-0.84) for stroke. In addition, these associations were not modified by genetic variants in the VDR.

Conclusion

In people with established CHD, higher serum 25(OH)D concentrations were nonlinearly associated with a lower risk of recurrent CV events, with a potential threshold around 50 nmol/L. These findings highlight the importance of maintaining adequate vitamin D status in the prevention of recurrent CV events among individuals with CHD.
Stressed Microglia: Neuroendocrine–Neuroimmune Interactions in the Stress Response
Authors: Sequeira Michelle K , Bolton Jessica L
Published: June 2023

Stressful life experiences are associated with the development of neuropsychiatric disorders like depression. Emerging evidence indicates that microglia, the specialized resident macrophages of the brain, may be a key mediator of the relationship between psychosocial stressor exposure and adaptive or maladaptive responses at the level of synaptic, circuit, and neuroimmune alterations. Here, we review current literature regarding how psychosocial stressor exposure changes microglial structure and function, thereby altering behavioral and brain outcomes, with a particular focus on age- and sex-dependent effects. We argue that additional emphasis should be placed in future research on investigating sex differences and the impacts of stressor exposure during sensitive periods of development, as well as going beyond traditional morphological measurements to interrogate microglial function. The bidirectional relationship between microglia and the stress response, particularly the role of microglia in the neuroendocrine control of stress-related circuits, is also an important area for future investigation. Finally, we discuss emerging themes and future directions that point to the possibility of the development of novel therapeutics for stress-related neuropsychiatric disorders.
The Physiocratic Analysis of Money: A Reappraisal
Authors: Menuet Maxime , Villieu Patrick
Published: June 2023

Few studies have focused specifically on the physiocratic analysis of money. The physiocrats' position was based on their criticism of Law's system and more broadly on the role of finance. First, they rejected the idea that a large amount of money was the condition for the wealth of nations. Second, they rejected paper money, as well as any form of currency alteration. As a simple means of exchange, Quesnay and his followers recognized that money could be replaced by paper. However, in order to comply with the “value for equal value” principle of exchange, money had to be made of precious metals, as Le Trosne, the main architect of the physiocratic monetary doctrine, forcefully asserted. This doctrine of money created a tension: from the circulation perspective, money was not considered as a component of wealth and could be replaced by paper to simply represent flows in expenditure; but from the equality-of-exchange perspective, money had to be made of precious metals, thus becoming a storable asset in a portfolio. To overcome this tension, the économistes were to forcefully denounce hoarding and deny money the function of a store of value.
Tax Erosion in Seventeenth-Century Naples: Tommaso Campanella on Causes and Remedies
Authors: Costabile Lilia , Velde François R.
Published: June 2023

Writing in the first decade of the seventeenth century, Tommaso Campanella (1568–1639) studied tax erosion and proposed remedies that he promised would “transform a harm into a benefit.” The factual evolution of tax revenues and prices under the monetary and fiscal systems of his time confirms his diagnosis. A simple model built on his assumptions shows how clipping produces tax erosion in a commodity money system, and it illustrates how Campanella's plan not only eliminates this harm but also produces the benefit of higher government purchases at the expense of rentiers. A broader reading of his work clarifies the distributional implications of his proposal in the light of his radical egalitarianism and his goal of a united, harmonious society.
Η κειμενική και η διεικονική προσέγγιση της διαλογικότητας του μυθιστορήματος "Η Παναγία των Παρισίων" του Β. Ουγκώ στις διασκευές για παιδιά
Authors: Ξανθούλη Παρασκευή
Published: June 2023

Στη συγκριτική μελέτη των υπό έρευνα διασκευών του κλασικού έργου η «Παναγία των Παρισίων» του Victor Hugo παρατηρείται ότι οι δημιουργοί διαχειρίζονται με σχετική ελευθερία το πρωτότυπο κείμενο που επανεγγράφουν. Ανάλογα με τους περιορισμούς που τούς θέτει το πολιτισμικό του συγκείμενο, ακολουθούν τις νόρμες που διέπουν τις επανεγγραφές τέτοιου είδους, είτε συντομεύοντας, είτε αφαιρώντας ή προσθέτοντας στο νέο κείμενο και οικειοποιούν και μετακενώνουν στα παιδιά τη γαλλική πολιτιστική παράδοση σ’ ένα διαφοροποιημένο νέο κείμενο.
Strategies for promoting sustainable use and conservation of indigenous chicken breeds in Sub-Saharan Africa: Lessons from low-income countries
Authors: Kanyama Christopher .M , Moss Amy .F , Crowley Tamsyn .M
Published: June 2023

This review explores innovative and sustainable strategies for the utilisation and conservation of indigenous chickens (IC) (Gallus domesticus) in Sub-Saharan Africa (SSA), drawing lessons from selected low-income countries. Small-scale farmers (SSF) have kept IC for hundreds of years to meet their households' nutritional needs, incomes, and social-cultural and religious uses. The commitment exhibited by SSF to keeping IC has made them the significant custodians of essential animal genetic resources for food and agriculture (AnGR) in most low-income countries. Between 1991 and 2012, Zambia's private breeders invested over US$95 million in the commercial poultry sector, resulting in over a 100% increase in the annual production of day-old chicks to 65 million. However, high production costs and low market access hindered rural farmers' full participation, hence their continued dependence on IC breeds. The erosion of AnGR poses the biggest threat to livelihoods in SSA. The Food and Agriculture Organisation, an international body of the United Nations, highlighted that over 3.5% (60) of chicken breeds were extinct, 21.3% (368) were at risk of extinction, and nearly 63% (1089) were under unknown risk status. The report stated that 12.3% of the known chicken breeds were not at risk. Poultry diseases, lack of sustainable conservation strategies, and poor use have significantly contributed to these losses. In 2012, 60% of IC were reportedly diseased in parts of SSA. The continued loss of IC-AnGR may negatively impact rural livelihoods, and future research and breeding programs in poultry may suffer. This paper reviews the IC sector in parts of SSA, the socioeconomic, cultural and religious roles of IC, and lessons on researcher community-stakeholder strategies from selected low-income countries. The paper concludes and outlines some recommendations for future research.
A triple helix model for the diffusion of Industry 4.0 technologies in firms in the Marche Region
Authors: Testi Niccolò
Published: June 2023

Background: Firms in the Marche Region, Italy, seem to struggle with understanding the importance of Industry 4.0 technologies, including blockchain technology, and delay the adoption of these innovative technologies.

Methods: This paper is based on findings of three levels of qualitative analysis: the first one is a literature review; the second uses secondary sources about the diffusion of Industry 4.0 in the Marche Region and the local institutions and policies favouring it, retrieved from institutional websites and web searches; the third uses primary data which has been collected through an explorative survey conducted by sending a questionnaire to local innovative firms between 25th and the 27th of October 2022.

Results: The literature review shows that collaboration between triple helix actors can foster innovation in firms. Secondary data about firms in the Marche Region describes an economy made prevalently of micro enterprises not capable of adopting Industry 4.0 technologies, and individuates some institutions located in the region having the role of innovation intermediaries that help firms innovate. Among the secondary sources, the new Smart Specialisation Strategy 2021-2027 of the Marche Region emphasises the role of Industry 4.0 for economic development which requires the involvement of the research and innovation actors present in the region. The survey conducted for this study shows that the firms that adopted Industry 4.0 technologies have strong ties and collaboration with triple helix institutions.

Conclusions: Based on the findings, a triple helix model is proposed to foster the diffusion of Industry 4.0 technologies in the Marche Region, where innovation intermediaries are called to manage knowledge flows both among them and between academia, government, and industry, to activate a virtuous cycle of innovation adoption and valorisation.
DEVELOPMENT OF A MATHEMATICAL MODEL AND AN AUTOMATED ALGORITHM FOR CALCULATING THROUGHPUT
Authors: Pokrovskaya O. D. , Marchenko M. A. , Kukushkina Ya. V.
Published: June 2023

Background. The problem of this work is to develop a methodology for calculating cash throughput, which is based on the well-known formulas for calculating cash throughput, the main innovation of which is to take into account the time spent by trains on acceleration and deceleration en route. Currently, in the process of calculating the available capacity, a formal approach is used to determine the removal coefficients, and the site speed is also taken into account, calculated taking into account acceleration and deceleration, but representing only the ratio of the length of a certain section of the railway polygon to the time of the train following it.

Materials and/or methods: simulation modeling, economic and mathematical modeling, AnyLogic software package, methods of general systems theory, logistics.

Results. An analytical formula is proposed that allows calculating the available throughput with higher accuracy. The results of the study can be used in the dispatch centers of transportation management of JSC “Russian Railways” in order to more fully analyze the operation of the landfill of the road, railway lines or individual sections in order to more fully analyze the work performed on transportation.

Conclusion. The article develops a methodology for calculating the available capacity on a railway line with full consideration of the effect of acceleration and braking of trains on their way to the resulting available capacity.
Aviation insurance industry in the global economic crisis
Authors: CAPRIAN Iulia , LOM Ionut Valentin , CAPRIAN Iurie
Published: June 2023

For five years now, the world economy has been affected by various crisis phenomena, which are currently forming as a consequence of the pandemic crisis, followed by the energy crisis, and the military conflict between Russia and Ukraine. Inevitably, this economic cataclysm has some influence on the global aviation insurance market. The recovery process of the global airline industry can be considered /seen as a beneficial factor in this context. At the same time, it is necessary to take into account the existing risk factors in this field of economic activity. Among the most important areas of adjustment in the aviation insurance market are the consequences of the pandemic crisis, cyber risks and the impact of the military conflict between Russia and Ukraine.
Study on Free Vibration Analysis of a Rotating Fibre-Graphene-Reinforced Hybrid Polymer Composites Pre-Twist Shel
Authors: RAMU I. , MALLESWARARAO Battina N. , CHANDRA SEKHAR J. , VENU M. , SENTHIL KUMAR P.
Published: June 2023

The present work aims to develop a computational procedure for investigating the vibration behaviour of pre-twisted laminated composite shell containing graphene inclusions in their matrix.
According to nanoscopic empirical equations, graphene's mechanical properties are determined by its size dependence. It has been demonstrated that the orthotropic mechanical properties of composite
laminates made from carbon fibres and hybrid matrix can be evaluated. Based on pre-twist and geometric configurations, finite element methods have been used to model hybrid materials shells that include carbon fibre, graphene, and graphene-fibre reinforcement. As part of the validation process, the proposed method is compared with other methods when possible. Finally, the vibrational behaviour of the composite shell is extracted by imposing a twisted angle on a cantilever boundary condition. An analysis of vibrations for each configuration is presented in this paper, as well as the effects of graphene inclusions on natural frequencies. As graphene volume fractions in the matrix increase, the natural frequencies of every mode also increase. When the hub radius and rotational speed are increased, the frequency parameter increases with an increase in graphene volume in the hybrid polymer composite
pre-twisted shell.
Zero stiffness method for fail-safe analysis
Authors: CORMOS Raul , NEAGOE Catalin Andrei
Published: June 2023

One of the major engineering tasks is to evaluate the structural behavior when one of the components has failed. In such cases it is necessary to carry out fail-safe analysis to evaluate if the structure can be used safely in loading conditions. Thus, fail-safe analysis is a vital and important task
to properly validate the mechanical structure. The implementation of the fail-safe analysis using the finite element method is usually done by eliminating the given component from the finite element model and carrying out the given analysis. But when due to finite element modeling issues such an approach cannot be carried out without causing singularities in the model, another approach should be used to perform the fail-safe analysis. One such method, presented in this paper, is the zero stiffness method, which applies near-zero stiffness to the structural component that is removed from the finite element model. The zero stiffness method is used by applying close to zero values to the material and element properties, and thus reducing the load that is in the given structural component.
Altitude-compensating axisymmetric supersonic nozzle design and flow analysis
Authors: HAIF Sidali , KBAB Hakim , BENKHEDDA Amina
Published: June 2023

Altitude-adapted nozzles are designed to facilitate flow adaptation during rocket ascent in the atmosphere, without requiring mechanical activation. As a consequence, the performance of the nozzle is significantly improved. The aim of this study is to develop a new profile of axisymmetric supersonic nozzles adapted at altitude (Dual Bell Nozzle with Central Body), which is characterized by an E-D nozzle as a basic profile. The performances obtained for this nozzle (E-D Nozzle) are then
compared to those of a Plug nozzle. The E-D nozzle shows significant performance advantages over the Plug nozzle, including a 13.02% increase in thrust, knowing that the length of the E-D nozzle is half
that of the Plug nozzle under the same design conditions. Finally, viscous calculations using the k-ω SST turbulence model were conducted to compare the performance of the dual bell nozzle with central body (DBNCB) and the E-D nozzle with the same cross-sectional ratio, and to assess the impact of nozzle pressure ratio (NPR) variations on the operation mode of the DBNCB. The results obtained show that the DBNCB offers the best performance in most phases of flight.