bluuebunny/crossref_metadata_2025 huggingface dataset:
Collateral status, hyperglycemia, and functional outcome after acute ischemic stroke
Authors: Arteaga Daniel F. , Ulep Robin , Kumar Kevin K. , Southerland Andrew M. , Conaway Mark R. , Faber James , Wintermark Max , Joyner David , Sharashidze Vera , Hirsch Karen , Giurgiutiu Dan-Victor , Hannawi Yousef , Aziz Yasmin , Shutter Lori , Visweswaran Anita , Williams Alana , Williams Kori , Gunter Sonya , Haughey Heather M. , Bruno Askiel , Johnston Karen C. , Patel Vishal N. ,   SHINE Trial Investigators
Published: November 2022

Background

Mixed data exist regarding the association between hyperglycemia and functional outcome after acute ischemic stroke when accounting for the impact of leptomeningeal collateral flow. We sought to determine whether collateral status modifies the association between treatment group and functional outcome in a subset of patients with large vessel occlusion enrolled in the Stroke Hyperglycemia Insulin Network Effort (SHINE) trial.

Methods

In this post-hoc analysis, we analyzed patients enrolled into the SHINE trial with anterior circulation large vessel occlusion who underwent imaging with CT angiography prior to glucose control treatment group assignment. The primary analysis assessed the degree to which collateral status modified the effect between treatment group and functional outcome as defined by the 90-day modified Rankin Scale score. Logistic regression was used to model the data, with adjustments made for thrombectomy status, age, post-perfusion thrombolysis in cerebral infarction (TICI) score, tissue plasminogen activator (tPA) use, and baseline National Institutes of Health Stroke Scale (NIHSS) score. Five SHINE trial centers contributed data for this analysis. Statistical significance was defined as a p-value < 0.05.

Results

Among the 1151 patients in the SHINE trial, 57 with angiographic data were included in this sub-analysis, of whom 19 had poor collaterals and 38 had good collaterals. While collateral status had no effect (p = 0.855) on the association between glucose control treatment group and functional outcome, patients with good collaterals were more likely to have a favorable functional outcome (p = 0.001, OR 5.02; 95% CI 1.37–16.0).

Conclusions

In a post-hoc analysis using a subset of patients with angiographic data enrolled in the SHINE trial, collateral status did not modify the association between glucose control treatment group and functional outcome. However, consistent with prior studies, there was a significant association between good collateral status and favorable outcome in patients with large vessel occlusion stroke.

Trial registration

ClinicalTrials.gov Identifier is NCT01369069. Registration date is June 8, 2011.
Heterogeneous early illness courses of Korean patients with bipolar disorders: replication of the staging model
Authors: Lee Yejin , Lee Dongbin , Jung Hyewon , Cho Yunji , Baek Ji Hyun , Hong Kyung Sue
Published: November 2022

Background

Clinical staging of bipolar disorder (BD) requires application of real-world data, as the next step in hypothesis. This study used the staging model to analyze the long-term course of BD in Korean patients based on clinical features and treatment responses to map the progression of bipolar illness from its early phase after the onset of illness.

Methods

A total of 136 patients diagnosed with BD-I (n = 62) or BD-II (n = 74) were recruited. Their progressive stages were retrospectively evaluated. A multi-state model was used to calculate the probability of progression to each stage. Hazard ratios of covariates expected to influence different courses of BD were calculated. Using the Alda score, long-term responses to mood stabilizers depending on the current stage were compared.

Results

Several sub-populations showed varied courses during the first five years after the onset of illness, with 41.5% remaining in stage 2 and 53% progressing to higher stages with shortened time for transition. Profiles of patients with BD-I and BD-II were different, suggesting biologically distinct groups. Comorbid psychiatric disorders, such as obsessive-compulsive disorder (OCD) and bulimia nervosa (BN) were associated with a recurrent course (stage 3a or 3b) or a malignant course (stage 3c or 4). Early age of onset, shorter duration of illness, older age at the start of medication, and poor response to lithium affected the illness progression.

Conclusion

We were able to apply the stage model based on episode recurrence patterns in early illness courses of Korean patients with BD. The stage progression pattern differed from the early phase in BD-I and BD-II patients. Psychotic comorbidity, age at onset, age at starting psychiatric treatment showed associations with the illness progression.
Identification, expression, and purification of DNA cytosine 5-methyltransferases with short recognition sequences
Authors: Miura Fumihito , Miura Miki , Shibata Yukiko , Furuta Yoshikazu , Miyamura Keisuke , Ino Yuki , Bayoumi Asmaa M. A. , Oba Utako , Ito Takashi
Published: November 2022

Background

DNA methyltransferases (MTases) are enzymes that induce methylation, one of the representative epigenetic modifications of DNA, and are also useful tools for analyzing epigenomes. However, regarding DNA cytosine 5-methylation, MTases identified so far have drawbacks in that their recognition sequences overlap with those for intrinsic DNA methylation in mammalian cells and/or that the recognition sequence is too long for fine epigenetic mapping. To identify MTases with short recognition sequences that never overlap with the CG dinucleotide, we systematically investigated the 25 candidate enzymes identified using a database search, which showed high similarity to known cytosine 5-MTases recognizing short sequences.

Results

We identified MTases with six new recognition sequences, including TCTG, CC, CNG, TCG, GCY, and GGCA. Because the recognition sequence never overlapped with the CG dinucleotide, MTases recognizing the CC dinucleotide were promising.

Conclusions

In the current study, we established a procedure for producing active CC-methylating MTases and applied it to nucleosome occupancy and methylome sequencing to prove the usefulness of the enzyme for fine epigenetic mapping. MTases that never overlap with CG dinucleotides would allow us to profile multiple epigenomes simultaneously.
Implementation of Coach McLungsSM into primary care using a cluster randomized stepped wedge trial design
Authors: Ludden Thomas , O’Hare Katherine , Shade Lindsay , Reeves Kelly , Patterson Charity G. , Tapp Hazel
Published: November 2022

Background

Asthma is a prevalent chronic disease that is difficult to manage and associated with marked disparities in outcomes. One promising approach to addressing disparities is shared decision making (SDM), a method by which the patient and provider cooperatively make a decision about asthma care. SDM is associated with improved outcomes for patients; however, time constraints and staff availability are noted implementation barriers. Use of health information technology (IT) solutions may facilitate the utilization of SDM. Coach McLungsSM is a collaborative web-based application that involves pediatric patients, their caregivers, and providers in a personalized experience while gathering patient-reported data. Background logic provides decision support so both audiences can develop a well-informed treatment plan together. The goal of this study is to evaluate the implementation of the Coach McLungsSM intervention into primary care.

Methods

Implementation will be evaluated using a stepped wedge randomized control study design at 21 pediatric and family medicine practices within a large, integrated, nonprofit healthcare system. We will measure changes in emergency department visits, hospitalizations, and oral steroid use, which serve as surrogate measures for patient-centered asthma outcomes. We will use a generalized linear mixed models with logit link to test the hypothesis for the reduction in exacerbation rates specifying the fixed effects of intervention and time and random effects for practice and practice*time. This design achieves 84% power to detect the hypothesized effect size difference of 10% in overall exacerbation between control (40%) and intervention (30%) periods (two-sided, p = 0.05). Implementation will be guided using the Expert Recommendations for Implementing Change (ERIC), a compilation of implementation strategies, and evaluated using the CFIR (Consolidated Framework for Implementation Research) and RE-AIM (Reach Effectiveness, Adoption, Implementation, Maintenance).

Discussion

We anticipate that a tailored implementation of Coach McLungsSM across diverse primary care practices will lead to a decrease in emergency department visits, hospitalizations, and oral steroid use for patients in the intervention group as compared to the control condition.

Trial Registration: Clincaltrials.gov, NCT05059210. Registered 28 September 2021, https://www.clinicaltrials.gov/ct2/show/NCT05059210
Safety and efficacy of corticosteroids in ARDS patients: a systematic review and meta-analysis of RCT data
Authors: Chang Xinyan , Li Shaojun , Fu Yueqiang , Dang Hongxing , Liu Chengjun
Published: November 2022

Purpose

Acute respiratory distress syndrome (ARDS) is an acute and critical disease among children and adults, and previous studies have shown that the administration of corticosteroids remains controversial. Therefore, a meta-analysis of randomized controlled trials (RCTs) was performed to evaluate the safety and efficacy of corticosteroids.

Methods

The RCTs investigating the safety and efficacy of corticosteroids in ARDS were searched from electronic databases (Embase, Medline, and the Cochrane Central Register of Controlled Trials). The primary outcome was 28-day mortality. Heterogeneity was assessed using the Chi square test and I2 with the inspection level of 0.1 and 50%, respectively.

Results

Fourteen RCTs (n = 1607) were included for analysis. Corticosteroids were found to reduce the risk of death in patients with ARDS (relative risk (RR) = 0.78, 95% confidence interval (CI): 0.70–0.87; P < 0.01). Moreover, no significant adverse events were observed, compared to placebo or standard support therapy. Further subgroup analysis showed that variables, such as adults (RR = 0.78; 95% CI: 0.70–0.88; P < 0.01), non-COVID-19 (RR = 0.71; 95% CI: 0.62–0.83; P < 0.01), methylprednisolone (RR = 0.70; 95% CI: 0.56–0.88; P < 0.01), and hydrocortisone (RR = 0.79; 95% CI: 0.63–0.98; P = 0.03) were associated with 28-day mortality among patients who used corticosteroids. However, no association was found, regarding children (RR = 0.21; 95% CI: 0.01–4.10; P = 0.30).

Conclusion

The use of corticosteroids is an effective approach to reduce the risk of death in ARDS patients. However, this effect is associated with age, non-COVID-19 diseases, and methylprednisolone and hydrocortisone use. Therefore, evidence suggests patients with age ≥ 18 years and non-COVID-19 should be encouraged during the corticosteroid treatment. However, due to substantial differences in the use of corticosteroids among these studies, questions still remain regarding the dosage, optimal corticosteroid agent, and treatment duration in patients with ARDS.
Association of angiotensin-converting enzyme insertion/deletion (ACE I/D) gene polymorphism with susceptibility to prostate cancer: an updated meta-analysis
Authors: Du Jianhui , Lan Jianhua , Yang Hai , Ying Qiao , Huang Guohua , Mou Jian , Long Jia , Qiao Zhenghua , Hu Qiyi
Published: November 2022

Objective

This meta-analysis aims to explore the association between angiotensin-converting enzyme (ACE) insertion/deletion (I/D) gene polymorphism and susceptibility to prostate cancer (PCa).

Methods

We searched studies related to ACE I/D polymorphism and susceptibility to PCa through PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases from inception to June 1, 2022. Five gene models, including allelic, dominant, recessive, homozygote, and heterozygote models, were analyzed. The pooled odds ratio (OR) was calculated using Stata 15.0 software. Publication bias was judged by the funnel plot and Egger’s test, with the robustness of the findings verified by sensitivity analysis.

Results

Eight published articles (including ten studies) were identified. The pooled results showed that ACE I/D locus polymorphism was significantly correlated with the risk of PCa under all gene models except for the heterozygous model (D vs. I: OR= 1.58, 95% CI: 1.14–2.21; DD vs. DI+II: OR=1.68, 95% CI: 1.11–2.54; DD+DI vs. II: OR=1.76, 95% CI: 1.11–2.80; DI vs. II: OR= 1.44, 95% CI: 0.99–2.10; DD vs. II: OR= 2.12, 95% CI: 1.15–3.93). Subgroup analysis based on genotype frequencies in the control group meeting Hardy-Weinberg equilibrium showed statistically significant differences in all gene models. The funnel plot and Egger’s test indicated no publication bias. The sensitivity analysis verified the robustness of the conclusions obtained in this meta-analysis.

Conclusion

ACE I/D locus polymorphism correlates to PCa risk. Allele D, genotype DD+DI, and DD at the ACE I/D locus increase susceptibility to PCa and can therefore serve as a potential diagnostic and screening molecular marker for PCa patients.
Longitudinal phenotypes in patients with acute respiratory distress syndrome: a multi-database study
Authors: Chen Hui , Yu Qian , Xie Jianfeng , Liu Songqiao , Pan Chun , Liu Ling , Huang Yingzi , Guo Fengmei , Qiu Haibo , Yang Yi
Published: November 2022

Background

Previously identified phenotypes of acute respiratory distress syndrome (ARDS) have been limited by a disregard for temporal dynamics. We aimed to identify longitudinal phenotypes in ARDS to test the prognostic and predictive enrichment of longitudinal phenotypes, and to develop simplified models for phenotype identification.

Methods

We conducted a multi-database study based on the Chinese Database in Intensive Care (CDIC) and four ARDS randomized clinical trials (RCTs). We employed latent class analysis (LCA) to identify longitudinal phenotypes using 24-hourly data from the first four days of invasive ventilation. We used the Cox regression model to explore the association between time-varying respiratory parameters and 28-day mortality across phenotypes. Phenotypes were validated in four RCTs, and the heterogeneity of treatment effect (HTE) was investigated. We also constructed two multinomial logistical regression analyses to develop the probabilistic models.

Findings

A total of 605 ARDS patients in CDIC were enrolled. The three-class LCA model was identified and had the optimal fit, as follows: Class 1 (n = 400, 66.1% of the cohort) was the largest phenotype over all study days, and had fewer abnormal values, less organ dysfunction and the lowest 28-day mortality rate (30.5%). Class 2 (n = 102, 16.9% of the cohort) was characterized by pulmonary mechanical dysfunction and had the highest proportion of poorly aerated lung volume, the 28-day mortality rate was 47.1%. Class 3 (n = 103, 17% of the cohort) was correlated with extra-pulmonary dysfunction and had the highest 28-day mortality rate (56.3%). Time-varying mechanical power was more significantly associated with 28-day mortality in Class 2 patients compared to other phenotypes. Similar phenotypes were identified in four RCTs. A significant HTE between phenotypes and treatment strategies was observed in the ALVEOLI (high PEEP vs. low PEEP) and the FACTT trials (conservative vs. liberal fluid management). Two parsimonious probabilistic models were constructed to identify longitudinal phenotypes.

Interpretation

We identified and validated three novel longitudinal phenotypes for ARDS patients, with both prognostic and predictive enrichment. The phenotypes of ARDS can be accurately identified with simple classifier models, except for Class 3.
Genistein effect on cognition in prodromal Alzheimer’s disease patients. The GENIAL clinical trial
Authors: Viña José , Escudero Joaquín , Baquero Miquel , Cebrián Mónica , Carbonell-Asíns Juan Antonio , Muñoz José Enrique , Satorres Encarnación , Meléndez Juan Carlos , Ferrer-Rebolleda José , Cózar-Santiago Mª del Puig , Santabárbara-Gómez Jose Manuel , Jové Mariona , Pamplona Reinald , Tarazona-Santabalbina Francisco José , Borrás Consuelo
Published: November 2022

Background

Delaying the transition from minimal cognitive impairment to Alzheimer’s dementia is a major concern in Alzheimer’s disease (AD) therapeutics.

Pathological signs of AD occur years before the onset of clinical dementia. Thus, long-term therapeutic approaches, with safe, minimally invasive, and yet effective substances are recommended. There is a need to develop new drugs to delay Alzheimer’s dementia. We have taken a nutritional supplement approach with genistein, a chemically defined polyphenol that acts by multimodal specific mechanisms. Our group previously showed that genistein supplementation is effective to treat the double transgenic (APP/PS1) AD animal model.

Methods

In this double-blind, placebo-controlled, bicentric clinical trial, we evaluated the effect of daily oral supplementation with 120 mg of genistein for 12 months on 24 prodromal Alzheimer’s disease patients. The amyloid-beta deposition was analyzed using 18F-flutemetamol uptake. We used a battery of validated neurocognitive tests: Mini-Mental State Exam (MMSE), Memory Alteration Test (M@T), Clock Drawing Test, Complutense Verbal Learning Test (TAVEC), Barcelona Test-Revised (TBR), and Rey Complex Figure Test.

Results

We report that genistein treatment results in a significant improvement in two of the tests used (dichotomized direct TAVEC, p = 0.031; dichotomized delayed Centil REY copy p = 0.002 and a tendency to improve in all the rest of them.

The amyloid-beta deposition analysis showed that genistein-treated patients did not increase their uptake in the anterior cingulate gyrus after treatment (p = 0.878), while placebo-treated did increase it (p = 0.036). We did not observe significant changes in other brain areas studied.

Conclusions

This study shows that genistein may have a role in therapeutics to delay the onset of Alzheimer’s dementia in patients with prodromal Alzheimer’s disease. These encouraging results indicate that this should be followed up by a new study with more patients to further validate the conclusion that arises from this study.

Trial registration

NCT01982578, registered on November 13, 2013.
Impact of suboptimal or inappropriate treatment on healthcare resource use and cost among patients with uncomplicated urinary tract infection: an analysis of integrated delivery network electronic health records
Authors: Shafrin Jason , Marijam Alen , Joshi Ashish V. , Mitrani-Gold Fanny S. , Everson Katie , Tuly Rifat , Rosenquist Peter , Gillam Michael , Ruiz Maria Elena
Published: November 2022

Background

Although uncomplicated urinary tract infections (uUTIs; occurring in female patients without urological abnormalities or history of urological procedures or complicating comorbidities) are one of the most common community infections in the United States (US), limited data are available concerning associations between antibiotic resistance, suboptimal prescribing, and the economic burden of uUTI. We examined the prevalence of suboptimal antibiotic prescribing and antibiotic resistance and its effects on healthcare resource use and costs.

Methods

This retrospective cohort study utilized electronic health record data from a large Mid-Atlantic US integrated delivery network database, collected July 2016–March 2020. Female patients aged ≥ 12 years with a uUTI, who received ≥ 1 oral antibiotic treatment within ± 5 days of index uUTI diagnosis, and had ≥ 1 urine culture with antimicrobial susceptibility test, were eligible for inclusion in the study. The study examined the proportion of antibiotics that were inappropriately or suboptimally prescribed among patients with confirmed uUTI, and total healthcare costs (all-cause and UTI-related) within 6 months after a uUTI, stratified by antibiotic susceptibility and/or inappropriate or suboptimal treatment. Patient outcomes were assessed after 1:1 propensity score matching of patients with antibiotic-susceptible versus not-susceptible isolates and then by other covariates (e.g., demographics and recent healthcare use). A similar propensity score calculation was used to analyze the effect of inappropriate/suboptimal treatment on health outcomes. Costs were adjusted to 2020 US dollars ($).

Results

Among 2565 patients with a uUTI included in the analysis, the most commonly prescribed antibiotics were nitrofurantoin (61%), trimethoprim-sulfamethoxazole (19%), and ciprofloxacin (15%). More than one-third of the sample (40.2%) had isolates that were not-susceptible to ≥ 1 antibiotic indicated for treating patients with uUTI. Two-thirds (66.6%) of study-eligible patients were prescribed appropriate treatment; 29.9% and 11.9% were prescribed suboptimal and/or inappropriate treatment, respectively. Inappropriate or suboptimally prescribed patients had greater all-cause and UTI-related costs compared with appropriately prescribed patients. Differences were most striking among patients with antibiotic not-susceptible isolates.

Conclusions

These findings highlight how the increasing prevalence of antibiotic resistance combined with suboptimal treatment of patients with uUTI increases the burden on healthcare systems. The finding underlines the need for improved prescribing accuracy by better understanding regional resistance rates and developing improved diagnostic tests.
A case of undifferentiated pleomorphic sarcoma in esophagus after multiple cancer treatments of surgery and chemoradiotherapy
Authors: Ebata Yuho , Sakaguchi Yoshihisa , Tsuda Yasuo , Nambara Sho , Kudou Kensuke , Kusumoto Eiji , Yoshida Rintaro , Kusumoto Tetsuya , Ikejiri Koji
Published: November 2022

Background

Undifferentiated pleomorphic sarcoma (UPS) in the esophagus is extremely rare. Therefore, there are few reports of UPS in the esophagus (UPSE). We present a case of UPSE after multiple cancer treatments.

Case presentation

A 73-year-old man with a history of cancer treatment, including distal gastrectomy, transverse colectomy, and chemoradiotherapy, was diagnosed with an elevated lesion such as a submucosal tumor in the lower esophagus by regular endoscopy. A boring biopsy was performed, and the specimen showed features of sarcoma. The patient underwent a partial esophagectomy without lymph node dissection. Histopathological findings confirmed an undifferentiated pleomorphic sarcoma. Adjuvant therapy was not administered, and the patient survived without recurrence 1 year after surgery.

Conclusions

Currently, complete resection is the only treatment option for UPSE. An optimal treatment strategy using chemotherapy or radiotherapy should be established.
Molar pregnancy unveiled by DNA profiling: a rare forensic case study
Authors: Pande Amulya , Daware Sudhakar , Thakare Vijay , Mahajan Vaishali , Dikshit Ankita , Dhawane Mitali
Published: November 2022

Background

Forensic DNA analysis is one of the most advanced tools in the criminal investigation. It is used successfully in solving offenses involving rape, paternity disputes, murder or attempt to murder, and dacoity as well as identification of mutilated body remains. DNA profiling is used to determine paternity in sexual offense cases where abortion takes place and the product of conception can be anywhere from 6 to 10 weeks of gestation to 8 months. In the present case, a tissue sample stated as a vesicular mole and blood samples of the mother and suspected father were submitted to the DNA division of our laboratory for paternity analysis.

Results

Genotyping results revealed a single allele at all the tested short tandem repeat (STR) loci. The allele obtained at each locus was common with the suspected father. Such type of genotype was very rare and not observed earlier; therefore, repeated analysis was done and the same genotype was obtained every time. DNA profiling revealed all the alleles in the vesicular mole to be of paternal origin only, devoid of any maternal alleles. After referring to books on gynecology, it was confirmed that the genotype obtained was of hydatidiform mole.

Conclusions

In this POCSO Act case, the product of conception (about 1.5 months old) was termed a vesicular mole, and blood samples of the mother and suspected father were sent for the DNA paternity test. STR profiling of the product of conception sample displayed no maternal tissue contamination and non-inheritance of maternal alleles, showing the case to be of molar pregnancy also called hydatidiform mole, a very rare phenomenon in the forensic scenario. After thorough analysis, the case was reported and it was the first of its kind to be reported in a forensic laboratory in Maharashtra, India.
MR imaging biomarkers for evaluation of adhesive capsulitis of the shoulder. Additive value of anterior capsule abnormality as a reliable criterion for diagnosis of adhesive capsulitis: a cross sectional analytic study
Authors: ElSayed Mennatallah , Hafez Moustafa Raafat Mahmoud , Kamal Heba
Published: November 2022

Background

Adhesive capsulitis of the shoulder is a pain syndrome of progressive nature, associated with reduced active and passive range of motion of the gleno-humeral joint. Previous studies suggested an underlying synovial inflammatory process, followed by capsular hypertrophy and reactive fibrosis. The aim of our study was to investigate the influence of anterior shoulder joint capsule abnormal thickening and abnormal signal intensity on MRI, as important imaging biomarkers, for the diagnosis of as adhesive capsulitis.

Results

This cross sectional analytic study involved 28 patients with adhesive capsulitis ((17 males, 11 females, age range:23–65 years, mean age: 45.61 years ± 11.95) and 28 controls (14 males, 14 females; age range, 39 to 61 years; mean age 52.82 years ± 6.45;). The patients and the controls were reviewed by two radiologists with experience of more than 10 years, blinded to each other's results. Adhesive capsulitis was diagnosed based on clinical criteria of significant restricted passive motion of shoulder joint. The thickness and abnormal signal intensity of anterior glenohumeral joint capsule were evaluated at its thickest portion, positioned underneath the subscapularis muscle. Additionally, the formerly known MR characteristics of adhesive capsulitis, involving the thickness of humeral and glenoid portions of axillary recess, maximal thickness of axillary capsule, and thickness of coracohumeral ligament, were assessed. The estimation of abnormal hyperintensity of humeral and glenoid capsule in axillary recess, subcoracoid fat triangle obliteration and abnormal hyperintensity were also included in our study. All magnetic resonance imaging (MRI) quantitative values showed significant difference between adhesive capsulitis group and control group. Regarding qualitative values, only abnormal high signal intensity of the anterior portion of joint capsule, of the axillary portion of joint capsule and of glenoid portion of axillary capsule showed statisticaly significant difference between cases and controls. In receiver operating characteristic (ROC) curve study, the anterior capsule thickness revealed a high diagnostic value with an area under the curve (AUC) of 1.0. An anterior capsule thickness cut off value of at 2.45 mm showed a very high diagnostic performance, revealing a sensitivity of and specificity of 100%.

Conclusions

The anterior glenohumeral joint capsule abnormal thickening, and abnormal hyperintensity have a high diagnostic performance, in addition to the previously known abnormal MRI findings, in the evaluation of adhesive capsulitis.
Onco-Hypertension: Changing Paradigm of Treating Hypertension in Patients With Cancer
Authors: Sahni Gagan
Published: November 2022

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology , to patients seen in their own clinical practice.

Hypertension (HTN) in patients with cancer remains an underestimated yet complex clinical conundrum to merit its own marker of Onco-Hypertension. A myriad of antineoplastic drugs from vascular endothelial growth factor (VEGF) inhibitor antibodies such as bevacizumab, tyrosine kinase inhibitors (TKIs), cisplatin, and carfilzomib cause new or worsening HTN, and HTN is also a risk factor for certain cancers such as renal cell carcinoma. Untreated HTN before and during cancer treatment potentially increases the short-term and long-term risk of cardiotoxicity, such as heart failure, and affects both cancer and cardiovascular mortality. However, efficient and early management of HTN in patients with cancer is often challenging because of multiple drug interactions, noncompliance, and intolerance of medications because of the side effects of cancer treatments, labile nature of HTN, use of non-neoplastic drugs such as steroids and erythropoietin, and pharmacogenetic interactions between cancer treatment and HTN-related genes. The Oncology Grand Rounds aim to examine the bidirectional association and challenges of managing HTN in patients with cancer and the necessity for precision medicine to manage it.
Spatiotemporal Stratifications: Engaging Containment and Resistance in Italian Agrifood Districts
Authors: Peano Irene
Published: November 2022

This essay explores the author's engaged research trajectory into several agro-industrial enclaves in contemporary Italy. Stemming from solidarity work in support of migrant laborers living in slums and camps, and of their demands for legal recognition and better living and work conditions, the essay shows how the interrogation of these spaces’ multiple, layered pasts helps to better understand and contrast forms of containment, extraction, and racialized and gendered violence in the present. In particular, the essay pits narratives that portray such agro-industrial enclaves and the people that inhabit them as anachronistic residues against deep genealogies of racial capitalism and of the rhetorical tropes that sustained them. Carceral-like containment and, more generally, spatial segregation are shown to run through and thus be foundational in the history of capitalist agriculture, across geographies that link Italy to global flows.
Mapping Grounds for Infrastructural Reparations in Jaraguá Peak
Authors: Pappalardo Laura
Published: November 2022

For the Guarani Mbya, ka'aguy (Atlantic Forest) is sacred. Yet, only 12 percent of the Atlantic Forest's original coverage remains. A portion of that is in Jaraguá Peak. Two hundred years ago, São Paulo was ka'aguy. São Paulo's urban growth and the expansion of infrastructural networks (roads, power lines, dams) have disrupted Guarani infrastructures (the presence of Atlantic Forest, the continuity of paths between Guarani villages, access to clean water). Nonetheless, Guarani communities in São Paulo remake Guarani geographies every day, resisting Atlantic Forest encroachment and circumventing colonial networks. Guarani communities in the north and south of São Paulo hold a crucial infrastructural and environmental role for the entire city, increasing São Paulo's environmental security by recovering degraded soils and recuperating Atlantic Forest areas. This project maps the history of infrastructural dispossession in Jaraguá Peak. It represents the history of each infrastructural layer (roads, telecommunication towers, power lines) in sectional maps that expose long-term changes on the ground.
Η αρχή της αναλογικότητας ενώπιον του Ελεγκτικού Συνεδρίου
Authors: Κουλουμπίνη Ευαγγελία-Ελισάβετ
Published: November 2022

Με την παρούσα διατριβή ανιχνεύεται η έννοια της αρχής της αναλογικότητας της οποίας το εύρος, λόγω της αμφισημίας της, δύσκολα οριοθετείται και εξίσου δύσκολα τέμνεται. Αναζητείται η προέλευση και η ιστορική της εξέλιξη, η θεμελίωσή και η λειτουργία της, το πεδίο της εφαρμογής της σε όλους τους κλάδους του δικαίου και το είδος, το εύρος και η ένταση του ελέγχου λόγω της εφαρμογής της από το νομοθέτη, τη διοίκηση και το δικαστή.Στο κάδρο της εφαρμογής της εντάσσεται πλέον ο κλάδος του δημοσιονομικού δικαίου και δη η δημοσιονομική δίκη, όπου δεν υφίσταται αρχικώς προνομιακό πεδίο εφαρμογής της, λόγω της φύσης της πράξης του καταλογισμού, ως πράξης δεσμίας αρμοδιότητας του καταλογίζοντος οργάνου. Σε περιβάλλον πυκνής κανονιστικότητας για το καταλογίζον όργανο η αποτελεσματική δικαστική προστασία των προσώπων που καταλογίζονται για ελλείμματα στις διαχειρίσεις τους έθεσε την αρχή της αναλογικότητας ως κανόνα αναφοράς για τον δικαστικό έλεγχο της ουσιαστικής νομιμότητας των καταλογιστικών πράξεων.Πιο ευνοϊκά, με λιγότερα εμπόδια, εξελίχθηκε η εφαρμογή της αρχής αυτής στη συνταξιοδοτική δίκη ενώπιον του Ελεγκτικού Συνεδρίου, όπου το δικαίωμα στη σύνταξη των δημόσιων λειτουργών και υπαλλήλων είτε ως γεγενημένη αξίωση, είτε ως νόμιμη προσδοκία πρέπει να προστατευτεί, ως περιουσία τους, σύμφωνα με το άρθρο 1 του ΠΠΠ της ΕΣΔΑ.Η αρχή αυτή λειτουργεί στη δημοσιονομική δίκη ως έκφραση διορθωτικής δικαιοσύνης και στη συνταξιοδοτική δίκη ως έκφραση διανεμητικής δικαιοσύνης.
Ανάπτυξη ιοντικών υγρών για τον διαχωρισμό και την αφύγρανση αερίων
Authors: Βρούλιας Διονύσιος
Published: November 2022

Η αφύγρανση των αερίων είναι μια από τις πιο σημαντικές διεργασίες της βιομηχανίας (μεταφορά φυσικού αερίου, παραγωγή καθαρών ρευμάτων διοξειδίου του άνθρακα και υδρογόνου) και βρίσκει εφαρμογή στην καθημερινότητα (αφυγραντήρες, κλιματιστικά συστήματα). Οι τρεις βασικές μέθοδοι αφύγρανσης αέριων ρευμάτων είναι η απορρό-φηση, η προσρόφηση σε στερεά ξηραντικά υλικά και η ψύξη, βασικό μειονέκτημα των οποίων είναι η κατανάλωση πολύ μεγάλων ποσοτήτων ενέργειας. Μια εναλλακτική τεχνολογία είναι η χρήση συμπαγών μεμβρανών, η οποία θεωρείται «πράσινη» καθώς δεν απαιτείται πηγή θερμότητας για θερμική αναγέννηση. Ωστόσο, στην περίπτωση των πολυμερικών μεμβρανών, ανακύπτουν προβλήματα που συμβάλλουν στη μείωση της απόδοσης τους. Ο συνδυασμός ιοντικών υγρών με την τεχνολογία των μεμβρανών αποτελεί στρατηγική για την αντιμετώπιση των προβλημάτων αυτών. Μέχρι σήμερα, τα ιοντικά υγρά βασισμένα στη νικοτίνη έχουν μελετηθεί ως κα-ταλύτες σε διάφορες οργανικές αντιδράσεις αλλά ποτέ στoν διαχωρισμό και την αφύ-γρανση αερίων. Σε αυτή την εργασία, οι στηριζόμενες μεμβράνες με ιοντικά υγρά με βάση τη νικοτίνη εξετάστηκαν ως εκλεκτικές μεμβράνες διαχωρισμού υδρατμών. Πραγματοποιήθηκε διερεύνηση της επίδρασης του μήκους της ανθρακικής αλυσίδας, της παρουσίας αιθερικής ομάδας στην αλυσίδα και της επίδρασης του ανιόντος στα ιοντικά υγρά της νικοτίνης αλλά και σε πολυμερικά ιοντικά υγρά βασισμένα σε ένα πρόδρομο πολυαιθέρα με κύρια αλυσίδα βασισμένη στην πυριδίνη.Συμπερασματικά, η αύξηση του μήκους της αλκυλικής αλυσίδας του κατιόντος συμβάλλει στην αύξηση της υδροφοβικότητας των ιοντικών υγρών, ενώ η παρουσία αιθερικών ομάδων στην αλκυλική αλυσίδα έχει την πιο θετική επίδραση στη διαπερα-τότητα υδρατμών. Επιπλέον, αποδείχθηκε ότι η διαπερατότητα είτε των στηριγμένων μεμβρανών είτε των πολυμερικών ιοντικών υγρών μπορεί να βελτιωθεί, επιλέγοντας ένα αντισταθμιστικό ανιόν με υψηλή υδροφιλικότητα. Oι μεμβράνες με τα πιο υδρόφι-λα ανιόντα ([ΕtOEtNic][MeSO3]/PVDF και PIL-MeSO4) εμφάνισαν την υψηλότερη διαπερατότητα υδρατμών (1.46 x 10^6 και 1.84 x 10^5 Barrer στους 30 oC αντίστοιχα) και εκλεκτικότητα Η2Ο/αερίων. Η απόδοση αυτών των μεμβρανών όσον αφορά τις ιδιότη-τες διαπερατότητας υδρατμών είναι από τις υψηλότερες που έχουν αναφερθεί στη βιβλιογραφία.
Early life stress and the role of environmental and molecular moderators in the ontology of pathological and resilient behavioral phenotypes
Authors: Collins Nicholas J. , Campbell Taylor S. , Donoghue Katelyn M. , Ghosh Urmi , Smith Jessica N. , O'Shea Maeve C. , Nelson Christina M. , Bigham Olivia K. , Roth Tania L.
Published: November 2022

Early life stress (ELS) in the form of trauma or caregiver abuse and neglect is often associated with psychopathology. However, not everyone exposed to ELS develops a pathology; others display resilience, or the ability to adapt and persevere despite ongoing adversity. Several molecular moderator variables between ELS and behavioral phenotypes have been proposed, including single nucleotide polymorphisms (SNPs) and epigenetic markers. Specifically, several SNPs and aberrant methylation or expression of genes associated with neurotransmitter systems and brain-derived neurotrophic factor have been associated with anxiety, depression or schizophrenia. The present review seeks to explore the relationship between SNPs, epigenomics and disease, and offer data to suggest several SNPs may also predict specific treatment efficacy and psychological resilience. Due to this discrepancy in the literature, it is critical that environmental moderators be equally considered in determining the ontology of resilient or pathological phenotypes; this includes the infant-caregiver relationship, and the degree of control, magnitude, and type of the stressor experienced. Finally, we will offer evidence to suggest that several intervention strategies, including drug treatment, environmental enrichment, or exercise can ameliorate many of the psychological, biological, and molecular consequences of ELS exposure, and help shift one toward a resilient phenotype.
Review of commercially available biomarkers in the diagnosis of prostate cancer
Authors: Ostrowska Magdalena , Handzlik Iwona , Radomska Martyna , Ostrowski Adam
Published: November 2022

Introduction
Diagnosing prostate cancer is a complex process. Although PSA testing remains the basic laboratory study, new biomarkers and test are evolving quickly.
Aim
The aim of this review was to summarize available tests and markers for diagnosing prostate cancer.
Materials and methods
Literature search was conducted using PubMed and Cohrane databases.
Results and conclusions
Detailed description of ExoDx, PCA3, SelectMDx, Mi-prostate Score, SChLAP1, PSA, PHI, 4K Score tests was presented. Available test ease qualification for a prostate biopsy or observation. Patients should be qualified individually in deciding on  a specific test to be performed. Urologists should be aware of each test mechanism and limitations.
Multidisciplinary of depression spectrum disorders from a health care system perspective
Authors: Ziętara Karolina Joanna , Pawłowski Piotr , Chromiak Karol , Orzechowska Aleksandra , Michalczyk Justyna , Orzechowska Julia
Published: November 2022

Introduction: Depression is the leading cause of disability, and incapacity in the world and the most common mental disorder. Year after year, the incidence of this disease entity is increasing, therefore, depression is a serious challenge for modern medicine.
Aim of the study: To synthesize the knowledge of depression as a problem in modern medicine.
Material and method: A non-systematic review of scientific literature from 2012 - 2022 was carried out, according to the keyword’s depression, symptoms, diagnosis, and treatment.
Results and conclusions: Depression is a psychiatric disorder showing varied symptoms lasting more than 2 weeks. Prominent among them are lowered mood, anhedonia, reduced life activities, and others. Diagnosis of depression is difficult, requiring cooperation between the doctor and the patient. Treatment of depression is mainly based on pharmacotherapy and psychotherapy; unconventional treatment is also distinguished.
Potential mechanisms of action and effectiveness of electroconvulsive therapy in the treatment of depressive disorders
Authors: Smulewicz Klaudia , Wójcik Alicja , Pakaszewski Wojciech , Rusin Bartosz , Ziomko Bartłomiej
Published: November 2022

The aim of this study is to prove the positive effect of electroconvulsive therapy on depressive disorders.

Depression as a mental illness has not been fully studied in terms of its relationship in combination with electroconvulsive therapy. Nevertheless, despite many uncertainties, its positive effect on this type of treatment is indicated. Analysing a number of studies, electroconvulsive therapy is considered to be the most effective treatment for depression. As the research work shows, thanks to the use of electroconvulsive therapy in older people over 60 years of age, a positive effect on the patient's health can be observed in the entire study group.

The mechanism of action of electroconvulsive therapy is multifaceted. There are several theories of how it works, affecting different areas of the individual's body. These include an anticonvulsant theory (GABAergic), effects on serotonergic and dopaminergic functions in the brain, effects on neurogenesis in the hippocampus and amygdala and neuropathicity, effects on gene transcription, an increase in the Narp protein with a presumed antidepressant effect, support for the neuroendocrine mechanism, as well as effects on inflammation (cytokines).
Single-Sourcing vs. Multisourcing: An Empirical Analysis of Large Information Technology Outsourcing Arrangements
Authors: Bapna Ravi , Gupta Alok , Ray Gautam , Singh Shweta
Published: November 2022

Single-Sourcing Versus Multisourcing: An Empirical Analysis of Large Information Technology Outsourcing Arrangements

Policy Abstract

As the information technology (IT) services landscape matures, clients are increasingly adopting multisourcing arrangements that involve multiple vendors. Although a large body of IS literature addresses issues of whether to outsource (to a single vendor), what types of contracts to use, and how to achieve optimal relational governance, little is known about the antecedents and consequents of the single versus multisourcing decision. Moreover, although conceptual and analytical models of single-sourcing versus multisourcing have been developed, there is no empirical IS research using a large-scale data set with rigorous econometric analysis that examines the antecedents and consequents of multisourcing in the IT context. This paper fills this void, using the transaction cost economic lens and a data set of 49,057 large IT outsourcing arrangements that spans multiple industries and dates back 25 years. For managers who plan to multisource IT outsourcing arrangements, this research provides guidance to minimize exchange hazards through a better understanding of the relationship between sourcing choice, client IT outsourcing capabilities, the competitiveness of the vendor landscape, and the number of IT services in an IT outsourcing arrangement. We provide empirical evidence that the choice between single-sourcing and multisourcing is material to the performance of outsourcing contracts, as an incorrect sourcing choice is likely to result in negative contract outcomes.
The Vehicle Routing Problem with Availability Profiles
Authors: Voigt Stefan , Frank Markus , Fontaine Pirmin , Kuhn Heinrich
Published: November 2022

In business-to-consumer (B2C) parcel delivery, the presence of the customer at the time of delivery is implicitly required in many cases. If the customer is not at home, the delivery fails—causing additional costs and efforts for the parcel service provider as well as inconvenience for the customer. Parcel service providers typically report high failed-delivery rates, as they have limited possibilities to arrange a delivery time with the recipient. We address the failed-delivery problem in B2C parcel delivery by considering customer-individual availability profiles (APs) that consist of a set of time windows, each associated with a probability that the delivery is successful if conducted in the respective time window. To assess the benefit of APs for delivery tour planning, we formulate the vehicle routing problem with availability profiles (VRPAP) as a mixed integer program, including the trade-off between transportation and failed-delivery costs. We provide analytical insights concerning the model’s cost-savings potential by determining lower and upper bounds. In order to solve larger instances, we develop a novel hybrid adaptive large neighborhood search (HALNS). The HALNS is highly adaptable and also able to solve related time-constrained vehicle routing problems (i.e., vehicle routing problems with hard, multiple, and soft time windows). We show its performance on these related benchmark instances and find a total of 20 new best-known solutions. We additionally conduct various experiments on self-generated VRPAP instances to generate managerial insights. In a case study using real-world data, despite little information on the APs, we were able to reduce failed deliveries by approximately 12% and overall costs by 5%.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2022.1182 .
The UK's points-based immigration system and its impact on the healthcare sector
Authors: Christen Alex
Published: November 2022

Alex Christen, senior associate at Capital Law, explains how changes to the UK's points-based visa system impacts the eligibility of overseas health and social care workers, and how this could affect the NHS.
Co-responding police and mental health service models: an exploration of how effective collaborative models are in responding to individuals experiencing a mental health crisis
Authors: Mulgrew Laura
Published: November 2022

Background/Aims

Joint working or co-responding police and mental health services are becoming increasingly common throughout the UK and aim to provide both effective and timely de-escalation and support to individuals experiencing a mental health crisis. Co-responding police and mental health services also aim to reduce unnecessary accident and emergency visits, provide signposting to appropriate services for longer-term care and to prevent injury to the individual, the general public, and health and social care colleagues. The aim of this article was to explore how effective co-responding police and mental health service models are at responding to an individual experiencing a mental health crisis.

Methods

This literature review was carried out through the use of thematic analysis. Databases including EBSCO, Medline, Psychinfo and AMED.

Results

A total of eight articles were reviewed. The review found that service users have largely positive feedback about the mental health care that they receive when in a mental health crisis, and services should be tailored to meet the needs of the geographical area.

Conclusions

There are a number of frameworks that can be implemented to respond to an individual experiencing a mental health crisis, including co-responding police mental health teams and the provision of comprehensive mental health training to police officers. Any model implemented must be constructed and launched in a thoughtful manner to meet the needs of the population.
Slipped Capital Femoral Epiphysis Managed by Ganz Safe Surgical Dislocation of Hip: A Case Report with 2 Years Follow-up
Authors: Packkyarathinam R P , Jeyaraman Madhan , Jeyaraman Naveen , Nallakumarasamy Arulkumar
Published: November 2022

Introduction: Slipped capital femoral epiphysis (SCFE) is commonly managed by in situ screw fixation. However, higher grades of slips require restoration of normal anatomy of the femoral head without compromising the blood supply. Case Report: A 16-year-old adolescent male presented with the left hip pain and progressive limping for 4 days with no history of previous trauma. On examination, the patient had severe tenderness and gross restriction of movements. Radiological examination revealed Grade 2 acute on chronic SCFE with unstable slip. Modified Dunn procedure through Ganz surgical hip dislocation facilitated the complete restoration of normal anatomy without avascular necrosis of femoral head changes at 2 years of follow-up. Conclusion: Ganz safe surgical dislocation of the hip is safe for the femoral head, preserving its blood supply in toto and the modified Dunn procedure facilitated the complete restoration of normal anatomy even in acute on chronic type of SCFE cases.