bluuebunny/crossref_metadata_2025 huggingface dataset:
Neighborhood Distribution of Unsheltered Homelessness and its Temporal Changes: Evidence from Los Angeles
Authors: Shin Eun Jin
Published: December 2021

Using the 2016–2020 point-in-time homeless count data, this study investigates neighborhood characteristics associated with the levels of and changes in unsheltered homeless population density in Los Angeles. The results show that unsheltered homeless people in the study area are heavily concentrated in and around the city center, and in neighborhoods with greater access to shelters and lower socioeconomic status. Notably, neighborhoods closer to the city center experienced a relatively large increase in unsheltered homelessness during the study period, implying a persistent spatial concentration of unsheltered homelessness. The results consistently indicate that residential land share, Hispanic resident share, and the number of bridges in the baseline year are significant predictors of relative changes in unsheltered homelessness in subsequent years, whereas access to shelters and poverty rates are not. This study’s findings provide several important policy implications that could potentially help prevent and mitigate unsheltered homelessness.
Incremental Validity of Multi-Method and Multi-Informant Evaluations in the Clinical Diagnosis of Preschool ADHD
Authors: Chen I-Chun , Lee Pai-Wei , Wang Liang-Jen , Chang Chih-Hao , Lin Cheng-Hsiu , Ko Li-Wei
Published: December 2021

Objectives:

This study investigated the discriminative validity of various single or combined measurements of electroencephalogram (EEG) data, Conners’ Kiddie Continuous Performance Test (K-CPT), and Disruptive Behavior Disorder Rating Scale (DBDRS) to differentiate preschool children with ADHD from those with typical development (TD).

Method:

We recruited 70 preschoolers, of whom 38 were diagnosed with ADHD and 32 exhibited TD; all participants underwent the K-CPT and wireless EEG recording in different conditions (rest, slow-rate, and fast-rate task).

Results:

Slow-rate task-related central parietal delta (1–4 Hz) and central alpha (8–13 Hz) and beta (13–30 Hz) powers between groups with ADHD and TD were significantly distinct ( p < .05). A combination of DBDRS, K-CPT, and specific EEG data provided the best probability scores (area under curve = 0.926, p < .001) and discriminative validity to identify preschool children with ADHD (overall correct classification rate = 85.71%).

Conclusions:

Multi-method and multi-informant evaluations should be emphasized in clinical diagnosis of preschool ADHD.
Understanding Adverse Childhood Experiences and Juvenile Court Outcomes: The Moderating Role of Race and Ethnicity
Authors: Lockwood Ashley , Peck Jennifer H. , Wolff Kevin T. , Baglivio Michael T.
Published: December 2021

Youth involved in the juvenile justice system have enhanced traumatic exposure including abuse, neglect, and household dysfunction compared to their non-involved counterparts. While prior research has conceptualized the role of trauma in predicting juvenile recidivism, the interrelated role of adverse childhood experiences (ACEs) and race/ethnicity in informing juvenile court processing and outcomes is unaddressed. As such, we examine the moderating role of race/ethnicity with ACEs across court outcomes (e.g., dismissal, diversion, probation, residential placement) among juveniles after their first ever arrest (37.2% Black, 18.3% Hispanic). Higher ACEs were associated with (1) decreased adjudication likelihood, (2) case dismissal for Black and Hispanic youth, (3) deeper dispositions versus diversion for Hispanic youth, (4) residential placement versus diversion for White youth, and (5) residential placement versus probation, with no racial or ethnic differences. Policy implications and future research surrounding the treatment of justice-involved youth with childhood traumatic exposure across race/ethnicity are discussed.
Corticospinal Tract Lesion Load Originating From Both Ventral Premotor and Primary Motor Cortices Are Associated With Post-stroke Motor Severity
Authors: Ito Kaori L. , Kim Bokkyu , Liu Jingchun , Soekadar Surjo R. , Winstein Carolee , Yu Chunshui , Cramer Steven C. , Schweighofer Nicolas , Liew Sook-Lei
Published: December 2021

Lesion load of the corticospinal tract (CST-LL), a measure of overlap between a stroke lesion and the CST, is one of the strongest predictors of motor outcomes following stroke. CST-LL is typically calculated by using a probabilistic map of the CST originating from the primary motor cortex (M1). However, higher order motor areas also have projections that contribute to the CST and motor control. In this retrospective study, we examined whether evaluating CST-LL from additional motor origins is more strongly associated with post-stroke motor severity than using CST-LL originating from M1 only. We found that lesion load to both the ventral premotor (PMv) cortex and M1 were more strongly related to stroke motor severity indexed by Fugl-Meyer Assessment cut-off scores than CST-LL of M1 alone, suggesting that higher order motor regions add clinical relevance to motor impairment.
The importance of aerobic capacity and nutrition in recreational master mountain runners’ performance and race-induced changes in body composition and biochemical blood indices
Authors: Methenitis Spyridon , Cherouveim Evgenia D. , Kroupis Christos , Tsantes Argyrios , Ketselidi Kleopatra , Vlachopoulou Elpiniki , Stavroulakis George , Mavrogenis Andreas , Tsolakis Charilaos , Koulouvaris Panagiotis
Published: December 2021

This study aimed to explore the importance of aerobic capacity and nutrition on 28-km mountain running performance and race-induced changes in body composition and biochemical blood indices, in recreational master athletes of different performance levels. Twenty male master runners (age: 44.6 ± 7.7 years) were divided into two groups, slower and faster runners, according to their race performance. Maximum oxygen uptake [Formula: see text], velocity at [Formula: see text] [Formula: see text], oxygen consumption [Formula: see text], and velocity [Formula: see text] during the second ventilatory threshold were evaluated. Nutrition was assessed for one week before and during the race. Body composition was evaluated, and blood samples were collected before and 3 h after the race. Slower runners exhibited a greater reduction in lean body mass and greater changes in all muscle damage/inflammation/metabolism blood indices than the faster runners ( η2 = 0.201–0.927; p < 0.05). When all the participants were assessed as one group ( n = 20), significant correlations were found between ([Formula: see text], vVO2Thr, race time, energy intake, expenditure, carbohydrate, protein intakes, and post-race changes in body composition and blood markers ( r: −0.825–0.824; p < 0.05). The strongest determinants were ([Formula: see text] and vVO2Thr, while energy intake, expenditure, carbohydrate, and protein intakes seemed to be the weakest determinants of race performance and race-induced changes in body composition and blood indices. The results suggest that race-induced changes in body composition and blood indices are determined mainly by master runners’ race performance and endurance capacity and to a lesser extent by nutrition. However, it seems that carbohydrate and protein intakes have equal importance.
Hardly visible, highly admired? Youth perceptions of the EU in Kazakhstan
Authors: Arynov Zhanibek
Published: December 2021

Youth have always been one of the central target audiences of the European Union’s (EU) policies towards Central Asia, which was once again emphasised in the recent EU Strategy for the region. This paper scrutinises how youth representatives in Kazakhstan, Brussels’ closest partner in the region, perceive the EU and its policies. By doing so, the paper shifts the focus from the EU-centric assessment of its external activities, which has long dominated the academic literature, and provides a ‘voice’ to the targets of the EU’s various initiatives. Examining data obtained through the method of pictorial test and focus group discussions with students of leading Kazakhstani universities, the paper argues that the issue Brussels faces among youth is not an image problem, rather it is a visibility issue. Although Kazakhstani youth are aware of the EU’s main ‘attributes’ at the basic level, they have little knowledge that goes beyond stereotypical, yet positive, images of it. This stereotyped admiration towards the EU, however, is not necessarily an outcome of Brussels’ successful policies, rather it is partly inherited from the historically idealised image of Europe. The paper suggests that increasing its visibility and better communicating its policies and messages need to be a priority for the EU in Central Asia.
Age-related Differences in Clinical Outcomes of Lumbar Discectomy
Authors: Behrbalk Eyal , Uri Ofir , Masarwa Rawan , Alfandari Liad , Fatal Shifra , Folman Yoram
Published: December 2021

Introduction

Lumbar discectomy is a common and effective treatment for symptomatic disk herniation. It has been suggested that lumbar discectomy in older patients may result in poorer clinical outcomes and lesser satisfaction. The purpose of this study was to assess age-related difference in patient reported outcomes of patients undergoing lumbar discectomy for chronic low back and radicular pain.

Materials and methods

Patients with chronic lumbar radiculopathy without neurological deficit underwent non-urgent single level lumbar discectomy in our institution between 2014 and 2017. Pain level (using VAS score), Oswestry Disability Index, and SF-12 scores were retrospectively reviewed and compared between younger patients (<60 years, group 1) and older patients (>60 years, group 2).

Results

Seventy-three patients, aged between 34–76 years participated in this study. VAS, ODI, and SF-12 scores improved significantly after the surgery for each group ( P < .01). When comparing between the groups, no significant differences in the outcomes measured were found after the surgery in both early post-operative follow-up and late post-operative follow-up ( P > .05).

Discussion

Elderly patients undergoing lumbar discectomy report a significant reduction in VAS, ODI, and SF-12 scores justifying the procedure.

Conclusion

Lumbar discectomy improved function and decreased pain level to similar extent in both younger and older patients suffering from radicular symptoms related to lumbar disc herniation.
The Role of Objectification in College Women’s Substance Misuse and Sexual Risk
Authors: Ertl Melissa M. , Sawyer Jacob S. , Martin Jessica L. , Brenner Rachel E.
Published: December 2021

Sexism and objectification present major challenges for mental and physical health among women. Scholars have called for research to identify mechanisms that underlie these associations as well as to delineate factors to target in prevention and intervention efforts. This study aimed to build on central tenets of objectification theory through its examination of sexist experiences in relation to body surveillance, body shame, depressive symptoms, and the health risk behaviors of substance use (i.e., alcohol and drug misuse) and sexual risk (i.e., condom use and number of sexual partners) among a large sample of college student women. We also examined whether body surveillance, body shame, and depressive symptoms would mediate theorized pathways extended to substance use and sexual risk. A sample of 505 full-time college student women ages 18–26 completed an online survey that assessed their health and behaviors. We used structural equation modeling to test mediation hypotheses. Results largely supported hypotheses, extended objectification theory to sexual risk, and expanded upon past research on objectification in relation to substance use. Notably, results of this study provided a more nuanced knowledge of how objectification may lead to increases in sexual risk when assessed by number of sexual partners (but not condom use). Further research is warranted to understand potential explanatory pathways between sexism, objectification, and sexual risk. Findings can inform prevention and intervention efforts to target body surveillance, body shame, and depressive symptoms to attempt to reduce the burden of sexist experiences on women’s health.
A case of intravascular lymphoma diagnosed with a primary vitreoretinal lymphoma-like fundus lesion
Authors: Asakage Masaki , Umazume Kazuhiko , Takoi Hiroyuki , Akahane Daigo , Ishibashi Yasunori , Yamaguchi Hiroshi , Gondo Masahide , Goto Hiroshi
Published: December 2021

Purpose

We report a case of intravascular lymphoma with primary vitreoretinal lymphoma-like fundus findings.

Case

A 61-year-old man with a one-week history of temporal visual field defect in the left eye was referred by a local ophthalmologist to our department. A yellowish-white raised patchy lesion was found in the nasal fundus of the left eye. Vitreoretinal lymphoma was suspected, and vitrectomy was performed in the left eye for diagnostic purpose. However, vitreous interleukin-10 concentration was low and no significant result was obtained. He had fever of around 38 °C, and respiratory failure that started 2 weeks before ophthalmological examination, worsened. Intravascular lymphoma was diagnosed from the results of histopathological examinations of transbronchial lung biopsy, bone marrow biopsy and random skin biopsy. With the start of systemic chemotherapy, the subretinal lesions shrank gradually and systemic condition was stable. However, 5 months after the start of chemotherapy, spread to the central nervous system was observed, and chimeric antigen receptor T cell (CAR-T) therapy was started in another hospital. After the start of CAR-T therapy, the subretinal lesions shrank further.

Conclusions

Intravascular lymphoma may be accompanied by primary vitreoretinal lymphoma-like intraocular lesions. If intraocular lesions are accompanied by systemic symptoms such as fever of unknown origin, the possibility of intravascular lymphoma should be suspected and systemic work-up should be performed.
Evaluation of a social determinants of health screening questionnaire and workflow pilot within an adult ambulatory clinic
Authors: Berkowitz Rachel L. , Bui Linh , Shen Zijun , Pressman Alice , Moreno Maria , Brown Stephanie , Nilon Anne , Miller-Rosales Chris , Azar Kristen M. J.
Published: December 2021

Background

There is increased recognition in clinical settings of the importance of documenting, understanding, and addressing patients’ social determinants of health (SDOH) to improve health and address health inequities. This study evaluated a pilot of a standardized SDOH screening questionnaire and workflow in an ambulatory clinic within a large integrated health network in Northern California.

Methods

The pilot screened for SDOH needs using an 11-question Epic-compatible paper questionnaire assessing eight SDOH and health behavior domains: financial resource, transportation, stress, depression, intimate partner violence, social connections, physical activity, and alcohol consumption. Eligible patients for the pilot receiving a Medicare wellness, adult annual, or new patient visits during a five-week period (February-March, 2020), and a comparison group from the same time period in 2019 were identified. Sociodemographic data (age, sex, race/ethnicity, and payment type), visit type, length of visit, and responses to SDOH questions were extracted from electronic health records, and a staff experience survey was administered. The evaluation was guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.

Results

Two-hundred eighty-nine patients were eligible for SDOH screening. Responsiveness by domain ranged from 55 to 67%, except for depression. Half of patients had at least one identified social need, the most common being stress (33%), physical activity (22%), alcohol (12%), and social connections (6%). Physical activity needs were identified more in females (81% vs. 19% in males,p < .01) and at new patient/transfer visits (48% vs. 13% at Medicare wellness and 38% at adult wellness visits,p < .05). Average length of visit was 39.8 min, which was 1.7 min longer than that in 2019. Visit lengths were longer among patients 65+ (43.4 min) and patients having public insurance (43.6 min). Most staff agreed that collecting SDOH data was relevant and accepted the SDOH questionnaire and workflow but highlighted opportunities for improvement in training and connecting patients to resources.

Conclusion

Use of evidence-based SDOH screening questions and associated workflow was effective in gathering patient SDOH information and identifying social needs in an ambulatory setting. Future studies should use qualitative data to understand patient and staff experiences with collecting SDOH information in healthcare settings.
Intussusception in preterm neonates: A systematic review of a rare condition
Authors: Kotb Mostafa , Abdelatty Mostafa , Rashwan Hayssam , AbdelMeguid Yasmine , Elrouby Ahmed
Published: December 2021

Background

While necrotizing enterocolitis (NEC) is a prevalent condition in preterm neonates admitted to neonatal intensive care unit (NICU), intussusception is exceedingly uncommon and often overlooked. This is due to the fact that they share many clinical characteristics. The initial misdiagnosis of intussusception in preterm neonates (IPN) especially has led to a delay in their management, which increases the risk of developing compromised bowel. Additionally, it is difficult to reach a diagnosis as neonatal intussusception does not have any classical radiological signs even when contrast enema is used. This systematic review is based on the published literature including case reports and case series to review the clinical features of IPN and how to differentiate it from NEC in order to shed the light on this rare disease and how having a high index of suspicion would help practitioners to make an early and accurate diagnosis

Methods

A systematic literature search to report all cases of relevant articles that reported IPN till date. All cases that were born before 37 weeks gestational age, presented within the neonatal period and having well established documentation were included in the study. Any case that did not have these criteria was excluded from our study.

Results

Only 52 cases met these criteria during the period from 1963 till date. An average of 10 days had elapsed before the cases were confirmed to have IPN either clinically or intraoperatively. The most frequent manifestations were abdominal distension and bilious gastric residuals, occurring in 85% and 77% of the cases respectively, followed by bloody stools in 43% of cases. However, this triad was present only in approximately one-third of the cases. Only 13 cases were diagnosed as having intussusception preoperatively. About two thirds of the intussusception were located in the ileum. Pathological lead point was present in 7 cases only; 4 of them were due to Meckel’s diverticulum. Nine cases only out of the 52 cases with IPN died.

Conclusion

It is crucial to detect the clues for diagnosis of intussusception because in contrast to NEC, it is unresponsive to conservative management, affects the viability of the bowel and surgery is essential.
Total unilateral pulmonary collapse secondary to allergic bronchopulmonary aspergillosis: a case series of an unusual cause of complete atelectasis
Authors: Benkalfate N. , Dirou S. , Germaud P. , Defrance C. , Cavailles A. , Pigeanne T. , Robert M. , Madjer T. , Corne F. , Cellerin L. , Sagan C. , Blanc F. X.
Published: December 2021

Background

Allergic bronchopulmonary aspergillosis (ABPA) is a bronchopulmonary disease caused by a complex hypersensitivity to Aspergillus and is usually associated with underlying respiratory diseases such as asthma or cystic fibrosis. Mucus plugging can lead to segmental or lobar atelectasis, but complete lung atelectasis has been exceptionally reported in the literature, making it difficult to diagnose. The diagnosis of ABPA may however be suggested in patients without known predisposing respiratory disorder, even in the absence of other relevant radiographic findings.

Case presentation

We report five cases of total unilateral lung collapse secondary to ABPA in 70–81-year-old women. Two of them had a past history of ABPA, while total unilateral lung collapse was the first sign of the disease in the other three patients, contributing to the initial misdiagnosis. Flexible bronchoscopy was initially performed to remove mucus plugs from the obstructed airways but was inefficient in four cases. Corticosteroid and/or antifungal treatment was needed.

Conclusion

ABPA can cause total unilateral lung collapse even in patients without known underlying chronic respiratory disease, making the diagnosis difficult. Flexible bronchoscopy should be considered when lung collapse is associated with respiratory distress but corticosteroids are the mainstay treatment for ABPA.
Gender differences in the association between sleep duration and body mass index, percentage of body fat and visceral fat area among chinese adults: a cross-sectional study
Authors: Fan Yaqi , Zhang Li , Wang Yuxue , Li Chunjun , Zhang Binbin , He Jiangshan , Guo Pei , Qi Xin , Zhang Mianzhi , Guo Congfang , Guo Yirui , Zhang Minying
Published: December 2021

Background

The relationship between sleep duration and anthropometric indices are still unclear. This study aimed to explore the association between sleep duration and body mass index (BMI), percentage of body fat (PBF) and visceral fat area (VFA) among Chinese adults, further to explore gender difference in it.

Methods

We analyzed part of the baseline data of a cohort study among adult attendees at two health-screening centers in China. Sleep duration was self-reported and categorized into short (< 7 h/day), optimal (7-9 h/day) and long sleep (≥ 9 h/day). BMI, PBF and VFA were assessed by bioelectric impedance analysis. Demographic characteristics, chronic diseases and medication history, physical activity, smoking and alcohol drinking behaviors were measured by an investigator-administrated questionnaire.

Results

A total of 9059 adult participants (63.08% were females) were included in the analysis. The participants aged from 19 to 91 years with the mean age of 45.0 ± 14.6 years. Short sleep was independently associated with elevated odds of general obesity (defined using BMI) and visceral obesity (defined using VFA) among the total study population, and gender differences were observed in these associations. Among women, short sleep was associated with 62% increased odds of general obesity (OR = 1.62, 95% CI: 1.24-2.12) and 22% increased odds of visceral obesity (OR = 1.22, 95% CI: 1.02-1.45). Among men, long sleep duration was associated with 21% decreased odds of visceral obesity (OR = 0.79, 95% CI: 0.64-0.99). No association was observed between sleep duration and PBF in both sexes.

Conclusions

Sleep duration was associated with increased odds of general and visceral obesity, and this association differed between men and women. No association was observed between sleep duration and PBF among either males or females.
Changes in patient activation following cardiac rehabilitation using the Active+me digital healthcare platform during the COVID-19 pandemic: a cohort evaluation
Authors: Frith Gabbi , Carver Kathryn , Curry Sarah , Darby Alan , Sydes Anna , Symonds Stephen , Wilson Katrina , McGregor Gordon , Auton Kevin , Nichols Simon
Published: December 2021

Background

Restrictions on face-to-face contact, due to COVID-19, led to a rapid adoption of technology to remotely deliver cardiac rehabilitation (CR). Some technologies, including Active+me, were used without knowing their benefits. We assessed changes in patient activation measure (PAM) in patients participating in routine CR, using Active+me. We also investigated changes in PAM among low, moderate, and high risk patients, changes in cardiovascular risk factors, and explored patient and healthcare professional experiences of using Active+me.

Methods

Patients received standard CR education and an exercise prescription. Active+me was used to monitor patient health, progress towards goals, and provide additional lifestyle support. Patients accessed Active+me through a smart-device application which synchronised to telemetry enabled scales, blood pressure monitors, pulse oximeter, and activity trackers. Changes in PAM score following CR were calculated. Sub-group analysis was conducted on patients at high, moderate, and low risk of exercise induced cardiovascular events. Qualitative interviews explored the acceptability of Active+me.

Results

Forty-six patients were recruited (Age: 60.4 ± 10.9 years; BMI: 27.9 ± 5.0 kg.m2; 78.3% male). PAM scores increased from 65.5 (range: 51.0 to 100.0) to 70.2 (range: 40.7 to 100.0; P = 0.039). PAM scores of high risk patients increased from 61.9 (range: 53.0 to 91.0) to 75.0 (range: 58.1 to 100.0; P = 0.044). The PAM scores of moderate and low risk patients did not change. Resting systolic blood pressure decreased from 125 mmHg (95% CI: 120 to 130 mmHg) to 119 mmHg (95% CI: 115 to 122 mmHg; P = 0.023) and waist circumference measurements decreased from 92.8 cm (95% CI: 82.6 to 102.9 cm) to 85.3 cm (95% CI 79.1 to 96.2 cm; P = 0.026). Self-reported physical activity levels increased from 1557.5 MET-minutes (range: 245.0 to 5355.0 MET-minutes) to 3363.2 MET-minutes (range: 105.0 to 12,360.0 MET-minutes; P < 0.001). Active+me was acceptable to patients and healthcare professionals.

Conclusion

Participation in standard CR, with Active+me, is associated with increased patient skill, knowledge, and confidence to manage their condition. Active+me may be an appropriate platform to support CR delivery when patients cannot be seen face-to-face.

Trial registration

As this was not a clinical trial, the study was not registered in a trial registry.
Cancer cell membrane-coated nanoparticles for bimodal imaging-guided photothermal therapy and docetaxel-enhanced immunotherapy against cancer
Authors: Chen Qiaoqi , Zhang Liang , Li Lin , Tan Mixiao , Liu Weiwei , Liu Shuling , Xie Zhuoyan , Zhang Wei , Wang Zhigang , Cao Yang , Shang Tingting , Ran Haitao
Published: December 2021

Background

Mono-therapeutic modality has limitations in combating metastatic lesions with complications. Although emerging immunotherapy exhibits preliminary success, solid tumors are usually immunosuppressive, leading to ineffective antitumor immune responses and immunotherapeutic resistance. The rational combination of several therapeutic modalities may potentially become a new therapeutic strategy to effectively combat cancer.

Results

Poly lactic-co-glycolic acid (PLGA, 50 mg) nanospheres were constructed with photothermal transduction agents (PTAs)-Prussian blue (PB, 2.98 mg) encapsulated in the core and chemotherapeutic docetaxel (DTX, 4.18 mg)/ immune adjuvant-imiquimod (R837, 1.57 mg) loaded in the shell. Tumor cell membranes were further coated outside PLGA nanospheres (designated “M@P-PDR”), which acted as “Nano-targeted cells” to actively accumulate in tumor sites, and were guided/monitored by photoacoustic (PA)/ magnetic resonance (MR) imaging. Upon laser irradiation, photothermal effects were triggered. Combined with DTX, PTT induced in situ tumor eradication. Assisted by the immune adjuvant R837, the maturation rate of DCs increased by 4.34-fold compared with that of the control. In addition, DTX polarized M2-phenotype tumor-associated macrophages (TAMs) to M1-phenotype, relieving the immunosuppressive TME. The proportion of M2-TAMs decreased from 68.57% to 32.80%, and the proportion of M1-TAMs increased from 37.02% to 70.81%. Integrating the above processes, the infiltration of cytotoxic T lymphocytes (CTLs) increased from 17.33% (control) to 35.5%. Primary tumors and metastasis were significantly inhibited when treated with “Nano-targeted cells”-based cocktail therapy.

Conclusion

“Nano-targeted cells”-based therapeutic cocktail therapy is a promising approach to promote tumor regression and counter metastasis/recurrence.

Graphical Abstract
Impact of moderate-to-severe psoriasis on quality of life in China: a qualitative study
Authors: Zhong Hua , Yang Huan , Mao Zhuxin , Chai Xiaoyun , Li Shunping
Published: December 2021

Purpose

Psoriasis is a serious health problem. Since limited research has investigated the impact of psoriasis on the quality of life of patients with moderate-to-severe psoriasis, this study aimed to explore this issue.

Methods

A qualitative study was conducted with 22 psoriasis patients from two cities in Shandong province of eastern China participating in one-to-one semi-structured in-depth interviews.

Results

Thematic analysis generated five major themes: (1) Symptoms, symptoms management and pain; (2) Functioning and activities of daily living (ADLs); (3) Psychological impact; (4) Social impact; (5) Employment and finances.

Conclusion

Our study detailed the effects of psoriasis on patients’ symptoms, symptoms management and pain, functioning and activities of daily living (ADLs), psychological impact, social impact, employment and finances. These data can provide a reference for studying the quality of life in patients with psoriasis.
The concept of HRQoL for patients on hemodialysis in Saudi Arabia: an exploratory study
Authors: AL Garni Rima Saleem , Cooke Mary
Published: December 2021

Background

The concept of health-related quality of life (HRQoL), a patient-reported outcome measure, is poorly defined within the Saudi literature. There is a lack of culturally adapted measures to assess the HRQoL of patients on hemodialysis in Saudi Arabia. Hence, this study aims to explore and define the concept of HRQoL, identify its key domains and develop a conceptual model as perceived by patients with renal failure who are undergoing hemodialysis in Saudi Arabia.

Methods

Qualitative research methods was used; data were collected in one dialysis center in the Eastern Region of Saudi Arabia. Twenty-two semi structured qualitative interviews were conducted using a topic guide. The data were analyzed using thematic analysis methods as the transcripts were coded, the categories identified, and the themes generated.

Results

Seven definitions of the HRQoL concept emerged from data analysis in terms of health status and psychological wellbeing including the satisfaction with life, socialization and the ability to play the expected social role and having social relationships that are supportive, religiosity and the belief in God and being able to perform religious worships and finally needs satisfaction was used to define HRQoL which included financial needs and the quality of healthcare services. All these themes were utilized to develop one common definition that emphasized the personal satisfaction with health, social, psychological and financial needs in addition to religious performance and the quality of healthcare services provided. The conceptual model was developed using five key domains of HRQoL: physiological, social, psychological, religious and vocational domains that were defined by certain indicators and the relationships between the domains were clarified in the model.

Conclusion

The findings of this study could guide the selection of the appropriate HRQoL instrument to assess the HRQoL of patients on hemodialysis in Saudi Arabia, which would ensure the validity of the findings that could be used in healthcare decisions and planning of care.
Establishment and validation of in-house cryopreserved CAR/TCR-T cell flow cytometry quality control
Authors: Cai Yihua , Prochazkova Michaela , Jiang Chunjie , Song Hannah W. , Jin Jianjian , Moses Larry , Gkitsas Nikolaos , Somerville Robert P. , Highfill Steven L. , Panch Sandhya , Stroncek David F. , Jin Ping
Published: December 2021

Background

Chimeric antigen receptor (CAR) or T-cell receptor (TCR) engineered T-cell therapy has recently emerged as a promising adoptive immunotherapy approach for the treatment of hematologic malignancies and solid tumors. Multiparametric flow cytometry-based assays play a critical role in monitoring cellular manufacturing steps. Since manufacturing CAR/TCR T-cell products must be in compliance with current good manufacturing practices (cGMP), a standard or quality control for flow cytometry assays should be used to ensure the accuracy of flow cytometry results, but none is currently commercially available. Therefore, we established a procedure to generate an in-house cryopreserved CAR/TCR T-cell products for use as a flow cytometry quality control and validated their use.

Methods

Two CAR T-cell products: CD19/CD22 bispecific CAR T-cells and FGFR4 CAR T-cells and one TCR-engineered T-cell product: KK-LC-1 TCR T-cells were manufactured in Center for Cellular Engineering (CCE), NIH Clinical Center. The products were divided in aliquots, cryopreserved and stored in the liquid nitrogen. The cryopreserved flow cytometry quality controls were tested in flow cytometry assays which measured post-thaw viability, CD3, CD4 and CD8 frequencies as well as the transduction efficiency and vector identity. The long-term stability and shelf-life of cryopreserved quality control cells were evaluated. In addition, the sensitivity as well as the precision assay were also assessed on the cryopreserved quality control cells.

Results

After thawing, the viability of the cryopreserved CAR/TCR T-cell controls was found to be greater than 50%. The expression of transduction efficiency and vector identity markers by the cryopreserved control cells were stable for at least 1 year; with post-thaw values falling within ± 20% range of the values measured at time of cryopreservation. After thawing and storage at room temperature, the stability of these cryopreserved cells lasted at least 6 h. In addition, our cryopreserved CAR/TCR-T cell quality controls showed a strong correlation between transduction efficiency expression and dilution factors. Furthermore, the results of flow cytometric analysis of the cryopreserved cells among different laboratory technicians and different flow cytometry instruments were comparable, highlighting the reproducibility and reliability of these quality control cells.

Conclusion

We developed and validated a feasible and reliable procedure to establish a bank of cryopreserved CAR/TCR T-cells for use as flow cytometry quality controls, which can serve as a quality control standard for in-process and lot-release testing of CAR/TCR T-cell products.
Spleen tyrosine kinase facilitates neutrophil activation and worsens long-term neurologic deficits after spinal cord injury
Authors: McCreedy Dylan A. , Abram Clare L. , Hu Yongmei , Min Sun Won , Platt Madison E. , Kirchhoff Megan A. , Reid Shelby K. , Jalufka Frank L. , Lowell Clifford A.
Published: December 2021

Background

Spinal cord injury elicits widespread inflammation that can exacerbate long-term neurologic deficits. Neutrophils are the most abundant immune cell type to invade the spinal cord in the early acute phase after injury, however, their role in secondary pathogenesis and functional recovery remains unclear. We have previously shown that neutrophil functional responses during inflammation are augmented by spleen tyrosine kinase, Syk, a prominent intracellular signaling enzyme. In this study, we evaluated the contribution of Syk towards neutrophil function and long-term neurologic deficits after spinal cord injury.

Methods

Contusive spinal cord injury was performed at thoracic vertebra level 9 in mice with conditional deletion of Syk in neutrophils (Sykf/fMRP8-Cre). Hindlimb locomotor recovery was evaluated using an open-field test for 35 days following spinal cord injury. Long-term white matter sparing was assessed using eriochrome cyanide staining. Blood-spinal cord barrier disruption was evaluated by immunoblotting. Neutrophil infiltration, activation, effector functions, and cell death were determined by flow cytometry. Cytokine and chemokine expression in neutrophils was assessed using a gene array.

Results

Syk deficiency in neutrophils improved long-term functional recovery after spinal cord injury, but did not promote long-term white matter sparing. Neutrophil activation, cytokine expression, and cell death in the acutely injured spinal cord were attenuated by the genetic loss of Syk while neutrophil infiltration and effector functions were not affected. Acute blood-spinal cord barrier disruption was also unaffected by Syk deficiency in neutrophils.

Conclusions

Syk facilitates specific neutrophil functional responses to spinal cord injury including activation, cytokine expression, and cell death. Long-term neurologic deficits are exacerbated by Syk signaling in neutrophils independent of acute blood-spinal cord barrier disruption and long-term white matter sparing. These findings implicate Syk in pathogenic neutrophil activities that worsen long-term functional recovery after spinal cord injury.
Vertebral body and splenic irradiation are associated with lymphopenia in localized pancreatic cancer treated with stereotactic body radiation therapy
Authors: Reddy Abhinav V. , Deek Matthew P. , Jackson Juan F. , Hill Colin S. , Sehgal Shuchi , He Jin , Zheng Lei , Herman Joseph M. , Meyer Jeffrey , Narang Amol K.
Published: December 2021

Objectives

The purpose of this study was to determine if vertebral body and splenic dosimetry was associated with the development of lymphopenia in patients with borderline resectable (BRPC) and locally advanced pancreatic cancer (LAPC) treated with stereotactic body radiation therapy (SBRT).

Methods

Patients with BRPC/LAPC who were treated with SBRT and who had lymphocyte counts and radiation treatment plans available for review were included in the study. Vertebral body levels T11-L3 and the spleen were retrospectively contoured for each patient. Univariate (UVA) and multivariable analyses (MVA) were performed to identify associations between vertebral body and splenic dosimetric parameters with absolute lymphocyte count (ALC) and grade ≥ 2 lymphopenia. Receiver operator characteristic curves were generated to identify dose-volume thresholds in predicting grade ≥ 2 lymphopenia.

Results

A total of 132 patients were included in the study. On UVA and MVA, vertebral V15 (regression coefficient [β]: − 0.026, 95% CI − 0.044 to − 0.009, p = 0.003), vertebral V2.5 (β: − 0.011, 95% CI − 0.020 to − 0.002, p = 0.015), and log10PTV (β: − 0.15, 95% CI − 0.30 to − 0.005, p = 0.042) were associated with post-SBRT ALC. On UVA and MVA, vertebral V15 (odds ratio [OR]: 3.98, 95% CI 1.09–14.51, p = 0.027), vertebral V2.5 (OR: 1.04, 95% CI 1.00–1.09, p = 0.032), and spleen V10 (OR: 1.05, 95% CI 1.09–1.95, p = 0.004) were associated with development of grade ≥ 2 lymphopenia. Development of grade ≥ 2 lymphopenia was more likely in patients with vertebral V15 ≥ 5.84% (65.5% vs 34.0%, p = 0.002), vertebral V2.5 ≥ 48.36% (48.9% vs 23.8%, p = 0.005), and spleen V10 ≥ 4.17% (56.2% vs 26.9%, p < 0.001).

Conclusions

Increasing radiation dose to vertebral bodies and spleen were associated with the development of lymphopenia in BRPC/LAPC treated with SBRT. Optimization of vertebral body and splenic dosimetry may reduce the risk of developing lymphopenia and improve clinical outcomes in this population.
Staples versus sutures for skin closure in hip arthroplasty: a meta-analysis and systematic review
Authors: Liu Zirui , Liu Binfeng , Yang Hao , Zhao Liang
Published: December 2021

Objective

The purpose of the present study was to estimate complications and other outcomes associated with staple and suture closure after hip arthroplasty through meta-analysis techniques and a systematic review.

Methods

We searched for articles in EMBASE, PubMed, Medline, Web of Science and the Cochrane Library. To determine the eligibility of the searched trials, Cochrane Collaboration's Review Manager software was used to perform the meta-analysis.

Results

Five randomized controlled trials and one retrospective cohort trial were included in our study. Our study indicated that for skin closure after hip arthroplasty, the risks of superficial infection and prolonged discharge were higher with staples than with sutures. There was no significant difference between the two groups in terms of allergic reaction, dehiscence, inflammation, abscess formation, the Hollander Wound Evaluation Scale or patient's satisfaction with skin closure methods. However, suturing required a longer operating time.

Conclusions

Closure with sutures is associated with lower risks of superficial infection and prolonged discharge than closure with staples following hip arthroplasty, but it may take more time.
Effects of cervical rotatory manipulation on the cervical spinal cord: a finite element study
Authors: Xue Fan , Chen Zujiang , Yang Han , Chen Taijun , Li Yikai
Published: December 2021

Background

Little information is available concerning the biomechanism involved in the spinal cord injury after cervical rotatory manipulation (CRM). The primary purpose of this study was to explore the biomechanical and kinematic effects of CRM on a healthy spinal cord.

Methods

A finite element (FE) model of the basilaris cranii, C1–C7 vertebral bodies, nerve root complex and vertebral canal contents was constructed and validated against in vivo and in vitro published data. The FE model simulated CRM in the flexion, extension and neutral positions. The stress distribution, forma and relative position of the spinal cord were observed.

Results

Lower von Mises stress was observed on the spinal cord after CRM in the flexion position. The spinal cord in CRM in the flexion and neutral positions had a lower sagittal diameter and cross-sectional area. In addition, the spinal cord was anteriorly positioned after CRM in the flexion position, while the spinal cord was posteriorly positioned after CRM in the extension and neutral positions.

Conclusion

CRM in the flexion position is less likely to injure the spinal cord, but caution is warranted when posterior vertebral osteophytes or disc herniations exist.
Effect of mineral excipients on processing traditional Chinese medicines: an insight into the components, pharmacodynamics and mechanism
Authors: Liu Yan , Li Xiaojie , Chen Cai , Leng Aijing , Qu Jialin
Published: December 2021

Traditional Chinese medicines are an important class of natural products mainly derives from animals, plants and minerals, most of which need to be improved and processed before clinical use due to their own hard texture, impurities or toxicity. As an important part of solid excipients, mineral excipients that contain some metal elements play indispensable and unique roles in the pretreatment process of traditional Chinese medicine. However, deficiency of holistic understanding of the effect of mineral excipients hinders their application and development. This article reviews several mineral excipients including alumen, talci pulvis, soil, soda lime, halloysitum rubrum and cinnabaris systemically. Their processing significance on traditional Chinese medicines were revealed from components, pharmacodynamics and mechanism aspects. Furthermore, prospect and problems including processing technologies, quality standards of mineral excipients and processing mechanism were put forward. This review supply comprehensive information for better and scientific usage of mineral excipients in processing traditional Chinese medicines.
Childhood rare diseases and the UN convention on the rights of the child
Authors: Matthews Lisa , Chin Vaughan , Taliangis Marisa , Samanek Amanda , Baynam Gareth
Published: December 2021

This letter discusses an initiative that considered the rights of a child living with a rare disease in the context of the United Nations Convention on the Rights of the Child (UNCRC). The aim was to inform laypeople on the intersection between the UNCRC and rare and undiagnosed diseases. The Project was initiated in Western Australia for a national audience, with a view that it might also provide a framework that is translatable to other jurisdictions internationally. This letter discusses some of the key themes raised by the Project and the potential for further work.
Integrated genomic and DNA methylation analysis of patients with advanced non-small cell lung cancer with brain metastases
Authors: Xu Yanjun , Huang Zhiyu , Yu Xiaoqing , Chen Kaiyan , Fan Yun
Published: December 2021

Background

Brain metastasis is a common and lethal complication of non-small cell lung cancer (NSCLC). It is mostly diagnosed only after symptoms develop, at which point very few treatment options are available. Therefore, patients who have an increased risk of developing brain metastasis need to be identified early. Our study aimed to identify genomic and epigenomic biomarkers for predicting brain metastasis risk in NSCLC patients.

Methods

Paired primary lung tumor tissues and either brain metastatic tissues or cerebrospinal fluid (CSF) samples were collected from 29 patients with treatment-naïve advanced NSCLC with central nervous system (CNS) metastases. A control group comprising 31 patients with advanced NSCLC who died without ever developing CNS metastasis was also included. Somatic mutations and DNA methylation levels were examined through capture-based targeted sequencing with a 520-gene panel and targeted bisulfite sequencing with an 80,672 CpG panel.

Results

Compared to primary lung lesions, brain metastatic tissues harbored numerous unique copy number variations. The tumor mutational burden was comparable between brain metastatic tissue (P = 0.168)/CSF (P = 0.445) and their paired primary lung tumor samples. Kelch-like ECH-associated protein (KEAP1) mutations were detected in primary lung tumor and brain metastatic tissue samples of patients with brain metastasis. KEAP1 mutation rate was significantly higher in patients with brain metastasis than those without (P = 0.031). DNA methylation analysis revealed 15 differentially methylated blocks between primary lung tumors of patients with and without CNS metastasis. A brain metastasis risk prediction model based on these 15 differentially methylated blocks had an area under the curve of 0.94, with 87.1% sensitivity and 82.8% specificity.

Conclusions

Our analyses revealed 15 differentially methylated blocks in primary lung tumor tissues, which can differentiate patients with and without CNS metastasis. These differentially methylated blocks may serve as predictive biomarkers for the risk of developing CNS metastasis in NSCLC. Additional larger studies are needed to validate the predictive value of these markers.
The relationship of platelet-to-lymphocyte ratio with cognitive decline in T2DM
Authors: Du Licheng , Hu Xueting , Zhang Beibei , Miao Xiaqi , Wang Jianing , Shen Jiamin , Ding Keke , Zeng Tian , Sun Fangyue , Yang Hong , Lin Hai
Published: December 2021

Purpose

We aimed to investigate the role of platelet-to-lymphocyte ratio (PLR) in cognitive decline in patients with type 2 diabetes mellitus (T2DM).

Methods

A total number of 261 T2DM patients were enrolled in this study. The T2DM patients were divided into two groups according to the median of PLR (PLR < 96.5, n = 130; PLR ≥ 96.5, n = 131). Cognitive impairment was defined as Mini-mental State Examination score ≤ 26. Student’s t test and Chi-square test were used to test the difference between the groups, and logistics regression analysis were performed to verify whether high PLR was an independent factor for cognitive impairment.

Results

T2DM patients with cognitive impairment had significantly higher PLR level when compared with the simple diabetes group (p = 0.003). Incidence of cognitive impairment was higher in the high PLR group, compared to low PLR group (p = 0.040). Multivariate logistic regression analysis suggested that PLR was a risk biomarker of cognitive decline in T2DM patients (odds ratio [OR] = 1.010, 95% CI: 1.001–1.018, p = 0.013).

Conclusions

We demonstrated that a higher PLR was associated with cognitive decline in T2DM patients. The PLR may help to identify high-risk patients in time and provide clues for further prevention of cognitive dysfunction in T2DM patients.