bluuebunny/crossref_metadata_2025 huggingface dataset:
Inclusion of Older People Reflective of Real‐World Clinical Practice in Cardiovascular Drug Trials
Authors: Caughey Gillian E. , Inacio Maria C. , Bell J. Simon , Vitry Agnes I. , Shakib Sepehr
Published: October 2020

Background

Underrepresentation of older people in clinical trials remains. This study aimed to examine the inclusion of older people and associated safety and efficacy reports from clinical trials of new molecular entities for cardiovascular disease indications since commencement of the US Food and Drug Administration Drug Trial Snapshot (DTS) Program. The DTS provides concise information on participants included in clinical trials supporting US Food and Drug Administration approval of new drugs.

Methods and Results

A cross‐sectional analysis between January 1, 2015 and April 30, 2019 of DTS data including approval date, indication, number of trials and participants, age distribution, efficacy, and safety statements was conducted. Participation‐to‐prevalence ratio (PPR) was used to describe representation of older participants in trials relative to disease population. Efficacy and safety statements regarding age were compared with drug prescribing information. A total of 72 079 participants from 10 DTS reports were identified and 39 625 (55.0%) were aged ≥65 years old. Overall, 63.6% of cardiovascular disease DTS reports were representative of people aged ≥65 years old for specific cardiovascular disease conditions. Underrepresentation was observed in 4 DTS: 2 for heart failure (PPR 0.48 and 0.62), 1 for pulmonary arterial hypertension (PPR 0.72), and 1 for venous thromboembolism (PPR 0.38). Participants in clinical trials for new drugs for the treatment of atrial fibrillation (PPR 0.99 and 1.21) and hypercholesterolemia (PPR 0.84 and 0.97) were reflective of the older population for these diseases. An increased risk of adverse events in older participants was reported in 40% DTS safety statements but no differences were reported in the drug product information.

Conclusions

Despite the fact that >60% of cardiovascular disease trial participants for new molecular entities included in the DTS program were representative of the older population in real‐world clinical practice, concerns remain for conditions including heart failure or venous thromboembolism. Drug product information safety statements regarding age differences in adverse events were not reflective of trial findings. An increased directive is needed to facilitate the generation of real‐world evidence and appropriate reporting within drug product information for these potentially at‐risk patient populations.
Efficacy and Safety of ProGlide Versus Prostar XL Vascular Closure Devices in Transcatheter Aortic Valve Replacement: The RISPEVA Registry
Authors: Berti Sergio , Bedogni Francesco , Giordano Arturo , Petronio Anna S. , Iadanza Alessandro , Bartorelli Antonio L. , Reimers Bernard , Spaccarotella Carmen , Trani Carlo , Attisano Tiziana , Marella Cenname Angela , Sardella Gennaro , Bonmassari Roberto , Medda Massimo , Tomai Fabrizio , Tarantini Giuseppe , Navarese Eliano P. ,   the Italian Society of Interventional Cardiology‐GISE†
Published: October 2020

Background

Transcatheter aortic valve replacement (TAVR) requires large‐bore access, which is associated with bleeding and vascular complications. ProGlide and Prostar XL are vascular closure devices widely used in clinical practice, but their comparative efficacy and safety in TAVR is a subject of debate, owing to conflicting results among published studies. We aimed to compare outcomes with Proglide versus Prostar XL vascular closure devices after TAVR.

Methods and Results

This large‐scale analysis was conducted using RISPEVA, a multicenter national prospective database of patients undergoing transfemoral TAVR treated with ProGlide versus Prostar XL vascular closure devices. Both multivariate and propensity score adjustments were performed. A total of 2583 patients were selected. Among them, 1361 received ProGlide and 1222 Prostar XL. The predefined primary end point was a composite of cardiovascular mortality, bleeding, and vascular complications assessed at 30 days and 1‐year follow‐up. At 30 days, there was a significantly greater reduction of the primary end point with ProGlide versus Prostar XL (13.8% versus 20.5%, respectively; multivariate adjusted odds ratio, 0.80 [95% CI, 0.65–0.99];
P
=0.043), driven by a reduction of bleeding complications (9.1% versus 11.7%, respectively; multivariate adjusted odds ratio, 0.76 [95% CI, 0.58–0.98];
P
=0.046). Propensity score analysis confirmed the significant reduction of major adverse cardiovascular events and bleeding risk with ProGlide. No significant differences in the primary end point were found between the 2 vascular closure devices at 1 year of follow‐up (multivariate adjusted hazard ratio, 0.88 [95% CI, 0.72–1.10];
P
=0.902). Comparable results were obtained by propensity score analysis. During the procedure, compared with Prostar XL, ProGlide yielded significant higher device success (99.2% versus 97.5%, respectively;
P
=0.001).

Conclusions

ProGlide has superior efficacy as compared with Prostar XL in TAVR procedures and is associated with a greater reduction of composite adverse events at short‐term, driven by lower bleeding complications.

Registration Information

URL:
clini​caltr​ials.gov
; Unique identifier: NCT02713932.
Approaches to Studying Determinants of Racial-Ethnic Disparities in Stroke and Its Sequelae
Authors: Elkind Mitchell S.V. , Lisabeth Lynda , Howard Virginia J. , Kleindorfer Dawn , Howard George
Published: October 2020

Disparities are differences in health outcomes among groups that originate from sources including historically experienced social injustice and broadly defined environmental exposures. Large health disparities exist, defined by many factors including race/ethnicity, sex, age, geography, and socioeconomic status. Studying disparities relies on measures of disease burden. Traditional measures, such as mortality, may be less applicable to neurological disorders, which often lead to substantial morbidity and lower quality of life, without necessarily causing death. Measures such as disability-adjusted life-years or healthy life expectancy may be more appropriate for assessing neurological disease and permit comparisons across diseases and communities. There are many approaches that can be used to study disparities. Analyses of population-based observational studies, patient registries, and administrative data all contribute to the understanding of disparities in humans. Animal and other experimental designs, including clinical trials, may be used to identify mechanisms and strategies to reduce disparities. All of these approaches have strengths and weaknesses. Ultimately, understanding and mitigating disparities will require use of all of these methods. Crucially, a focus on not only improving outcomes among all individuals in society but minimizing or eliminating differences between those with better outcomes and those who have historically been disadvantaged should drive the ongoing investigations into disparities. This review is focused on epidemiological approaches to examining the depth and determinants of racial-ethnic disparities in the United States related to stroke, stroke care, and stroke outcomes.
Association Between Sociodemographic Determinants and Disparities in Stroke Symptom Awareness Among US Young Adults
Authors: Mszar Reed , Mahajan Shiwani , Valero-Elizondo Javier , Yahya Tamer , Sharma Richa , Grandhi Gowtham R. , Khera Rohan , Virani Salim S. , Lichtman Judith , Khan Safi U. , Cainzos-Achirica Miguel , Vahidy Farhaan S. , Krumholz Harlan M. , Nasir Khurram
Published: October 2020

Background and Purpose:

Despite declining stroke rates in the general population, stroke incidence and hospitalizations are rising among younger individuals. Awareness of and prompt response to stroke symptoms are crucial components of a timely diagnosis and disease management. We assessed awareness of stroke symptoms and response to a perceived stroke among young adults in the United States.

Methods:

Using data from the 2017 National Health Interview Survey, we assessed awareness of 5 common stroke symptoms and the knowledge of planned response (ie, calling emergency medical services) among young adults (<45 years) across diverse sociodemographic groups. Common stroke symptoms included: (1) numbness of face/arm/leg, (2) confusion/trouble speaking, (3) difficulty walking/dizziness/loss of balance, (4) trouble seeing in one/both eyes, and (5) severe headache.

Results:

Our study population included 24 769 adults, of which 9844 (39.7%) were young adults who were included in our primary analysis, and represented 107.2 million US young adults (mean age 31.3 [±7.5] years, 50.6% women, and 62.2% non-Hispanic White). Overall, 2718 young adults (28.9%) were not aware of all 5 stroke symptoms, whereas 242 individuals (2.7%; representing 2.9 million young adults in the United States) were not aware of a single symptom. After adjusting for confounders, Hispanic ethnicity (odds ratio, 1.96 [95% CI, 1.17–3.28]), non-US born immigration status (odds ratio, 2.02 [95% CI, 1.31–3.11]), and lower education level (odds ratio, 2.77 [95% CI, 1.76–4.35]), were significantly associated with lack of symptom awareness. Individuals with 5 high-risk characteristics (non-White, non-US born, low income, uninsured, and high school educated or lower) had nearly a 4-fold higher odds of not being aware of all symptoms (odds ratio, 3.70 [95% CI, 2.43–5.62]).

Conclusions:

Based on data from the National Health Interview Survey, a large proportion of young adults may not be aware of stroke symptoms. Certain sociodemographic subgroups with decreased awareness may benefit from focused public health interventions.
Dynamic and Energetic Constraints on the Modality and Position of the Intertropical Convergence Zone in an Aquaplanet
Authors: Adam Ori
Published: October 2020

The tropical zonal-mean precipitation distribution varies between having single or double peaks, which are associated with intertropical convergence zones (ITCZs). Here, the effect of this meridional modality on the sensitivity of the ITCZ to hemispherically asymmetric heating is studied using an idealized GCM with parameterized Ekman ocean energy transport (OET). In the idealized GCM, transitions from unimodal to bimodal distributions are driven by equatorial ocean upwelling and cooling, which inhibits equatorial precipitation. For sufficiently strong equatorial cooling, the tropical circulation bifurcates to anti-Hadley circulation in the deep tropics, with a descending branch near the equator and off-equatorial double ITCZs. The intensity and extent of the anti-Hadley circulation is limited by a negative feedback: westerly geostrophic surface wind tendency in its poleward-flowing lower branches balances the easterly stress (and hence equatorial upwelling) required for its maintenance. For weak ocean stratification, which goes along with unimodal or weak bimodal tropical precipitation distribution, OET damps shifts of the tropical precipitation centroid but amplifies shifts of precipitation peaks. For strong ocean stratification, which goes along with pronounced double ITCZs, asymmetric heating leads to relative intensification of the precipitation peak in the warming hemisphere, but negligible meridional shifts. The dynamic feedbacks of the coupled system weaken the gradient of the atmospheric energy transport (AET) near the equator. This suggests that over a wide range of climates, the ITCZ position is proportional to the cubic root of the cross-equatorial AET, as opposed to the commonly used linear relation.
Diagnosing the Influence of a Receding Snow Boundary on Simulated Midlatitude Cyclones Using Piecewise Potential Vorticity Inversion
Authors: Breeden Melissa L. , Clare Ryan , Martin Jonathan E. , Desai Ankur R.
Published: October 2020

Previous research has found a relationship between the equatorward extent of snow cover and low-level baroclinicity, suggesting a link between the development and trajectory of midlatitude cyclones and the extent of preexisting snow cover. Midlatitude cyclones are more frequent 50–350 km south of the snow boundary, coincident with weak maxima in the environmental Eady growth rate. The snow line is projected to recede poleward with increasing greenhouse gas emissions, possibly affecting the development and track of midlatitude cyclones during Northern Hemisphere winter. Detailed examination of the physical implications of a modified snow boundary on the life cycle of individual storms has, to date, not been undertaken. This study investigates the impact of a receding snow boundary on two cyclogenesis events using Weather Research and Forecasting Model simulations initialized with observed and projected future changes to snow extent as a surface boundary condition. Potential vorticity diagnosis of the modified cyclone simulations isolates how changes in surface temperature, static stability, and relative vorticity arising from the altered boundary affect the developing cyclone. We find that the surface warm anomaly associated with snow removal lowered heights near the center of the two cyclones investigated, strengthening their cyclonic circulation. However, the direct effect of snow removal is mitigated by the stability response and an indirect relative vorticity response to snow removal. Because of these opposing effects, it is suggested that the immediate effect of receding snow cover on midlatitude cyclones is likely minimal and depends on the stage of the cyclone life cycle.
Intensity Enhancement of a Two-Dimensional Asynchronous Spectrum Without Noise Level Fluctuation Escalation Using a One-Dimensional Spectra Sequence Change
Authors: Li Kaili , Zhou Fengshan , He Anqi , Guo Ran , Li Xiaopei , Xu Yizhuang , Noda Isao , Ozaki Yukihiro , Wu Jinguang
Published: October 2020

Previously, we demonstrated that the intensities of cross-peaks in a two-dimensional asynchronous spectrum could be enhanced using sequence change of the corresponding one-dimensional spectra. This unusual approach becomes useful when the determination of the sequential order of physicochemical events is not essential. However, it was not known whether the level of noise in the two-dimensional asynchronous spectrum was also escalated as the sequence of one-dimensional spectra changed. We first investigated the noise behavior in a two-dimensional asynchronous spectrum upon changing the sequence of the corresponding one-dimensional spectra on a model system. In the model system, bilinear data from a chromatographic–spectroscopic experiment on a mixture containing two components were analyzed using a two-dimensional asynchronous spectrum. The computer simulation results confirm that the cross-peak intensities in the resultant a two-dimensional asynchronous spectrum were indeed enhanced by more than 100 times as the sequence of one-dimensional spectra changed, whereas the fluctuation level of noise, reflected by the standard deviation of the value of a two-dimensional asynchronous spectrum at a given point, was almost invariant. Further analysis on the model system demonstrated that the special mathematical property of the Hilbert–Noda matrix (the modules of all column vectors of the Hilbert–Noda matrix being a near constant) accounts for the moderate variation of the noise level during the changes of the sequence of one-dimensional spectra. Next, a realistic example from a thermogravimetry–Fourier transform infrared spectroscopy experiment with added artificial noise in seven one-dimensional spectra was studied. As we altered the sequence of the seven FT-IR spectra, the variation of the cross-peak intensities covered four orders of magnitude in the two-dimensional asynchronous spectra. In contrast, the fluctuation of noise in the two-dimensional asynchronous spectra was within two times. The above results clearly demonstrate that a change in the sequence of one-dimensional spectra is an effective way to improve the signal-to-noise level of the two-dimensional asynchronous spectra.
Correlating arterial blood gas, acid–base and blood pressure abnormalities with outcomes in COVID-19 intensive care patients
Authors: Bezuidenhout Morne C , Wiese Owen J , Moodley Desiree , Maasdorp Elizna , Davids Mogamat R , Koegelenberg Coenraad FN , Lalla Usha , Khine-Wamono Aye A , Zemlin Annalise E , Allwood Brian W
Published: October 2020

Background

During the outbreak of coronavirus disease 2019 (COVID-19), many studies have investigated laboratory biomarkers in management and prognostication of COVID-19 patients, however to date, few have investigated arterial blood gas, acid–base and blood pressure patterns. The aim of the study is to assess the arterial blood gas and acid–base patterns, blood pressure findings and their association with the outcomes of COVID-19 patients admitted to an intensive care unit.

Methods

A single-centre retrospective, observational study in a dedicated COVID-19 intensive care unit in Cape Town, South Africa. Admission arterial blood gas, serum electrolytes, renal function and blood pressure readings performed on COVID-19 patients admitted between 26 March and 2 June 2020 were analysed and compared between survivors and non-survivors.

Results

A total of 56 intensive care unit patients had admission arterial blood gas performed at the time of intensive care unit admission. An alkalaemia (pH > 7.45) was observed in 36 (64.3%) patients. A higher arterial pH (median 7.48 [interquartile range: 7.45–7.51] versus 7.46 [interquartile range: 7.40–7.48], P = 0.049) and partial pressure of oxygen in arterial blood (median 7.9 kPa [interquartile range: 7.3–9.6] versus 6.5 kPa [interquartile range: 5.2–7.3], P = <0.001) were significantly associated with survival. Survivors also tended to have a higher systolic blood pressure (median: 144 mmHg [interquartile range: 134–152] versus 139 mmHg [interquartile range: 125–142], P = 0.078) and higher arterial HCO3 (median: 28.0 mmol/L [interquartile range: 25.7–28.8] versus 26.3 mmol/L [interquartile range: 24.3–27.9], P = 0.059).

Conclusions

The majority of the study population admitted to intensive care unit had an alkalaemia on arterial blood gas. A higher pH and lower partial pressure of oxygen in arterial blood on arterial blood gas analysis were significantly associated with survival.
Role of traditional healers in the pathway of service for a sample of obsessive compulsive disorder patients in Egypt
Authors: Okasha Tarek , Elhabiby Mahmoud M , Mohsen Nesreen , Sharaf Hussein , Elnagar Zeinab
Published: October 2020

Background:

The diagnosis and treatment of an illness using traditional medicine is in most cases culture-specific and based on beliefs in the community. The majority of mentally ill patients prefer to attend to traditional healers because of the trust problems in the system, affordability, accessibility, and ease of the service.

Aim:

To assess the role of traditional healers among the pathway of psychiatric services of OCD patients, and to highlight its clinical correlates.

Methods:

we assessed 93 patients with OCD after confirmation of the diagnosis with fifth version of MINI semi structured interview, using a questionnaire designed and accustomed by authors to assess help seeking behavior in OCD patients and its sociodemographic and clinical correlates. Type of symptomatology and its severity were assessed using Y-BOCS.

Results:

A total of 39.8% sought traditional healers help, 94.6% were before psychiatric advice, main symptoms related to traditional healers seeking were religious and sexual obsessions. Main causes of traditional healers’ preference were stigma of seeking psychiatric advice in 89.2% of cases, considering disease related to religion in 81.1%, considering that religious commitment help in treatment 75, 7%, and considering disease related to magic and superstitions in 45.9%. Religious origin of illness was the most statistically significant factor related to seeking advice at traditional healers.

Conclusion:

This study shows that a significant percentage of the patients suffering from OCD prefer to approach traditional healers first due to their own beliefs mainly religious, and society acceptance.
Anxiety and depression in frontline health care workers during the outbreak of Covid-19
Authors: Xing Li-qun , Xu Min-ling , Sun Jia , Wang Qin-Xia , Ge Dan-dan , Jiang Ming-ming , Du Wenjun , Li Qiang
Published: October 2020

Background:

The pandemic of coronavirus disease (Covid-19) seriously impacts the health and well-being of all of us.

Aims:

We aim to assess the psychological impact of Covid-19 on frontline health care workers (HCWs), including anxiety, depression and stress of threat of the disease.

Method:

The study was a cross-sectional survey among the frontline HCWs in a hospital at Jinan, China. Data were collected through an anonymous, self-rated questionnaire, including basic demographic data, a 10-item Covid-19 stress questionnaire, the Self-Rating Anxiety Scale (SAS) and the Self-Rating Depression Scale (SDS). The risk and rate of anxiety, depression and stress of Covid-19 were estimated.

Results:

Among the 309 participants, there were 88 (28.5%) with anxiety and 172 (56.0%) with depression. Multivariate logistic regression analyses showed that age ⩽ 30 years, age > 30 to 45 years, working in confirmed case isolation wards, and worrying about disinfection measures being not sufficient were independently associated with anxiety with an odds ratio (95% confidence interval, CI) of 4.4 (1.6–12.2), 3.1 (1.1–8.8), 2.3 (1.4–4.0) and 2.5 (1.5–4.3), respectively; age ⩽ 30 years, age > 30 to 45 years, nurse and worrying about disinfection measure being not sufficient were independently associated with depression with an odds ratio (95% CI) of 3.8 (1.8–7.8), 2.7 (1.3–5.7), 2.5 (1.1–5.6) and 2.1 (1.3–3.5), respectively.

Conclusions:

A high prevalence of anxiety and depression was found among frontline HCWs during the COVID-19 outbreak. More psychological care should be given to young staffs and nurses. Measures to prevent professional exposure is important for HCWs’ physical and mental health.
Between life and death: organizational change in central state bureaucracies in cross-national comparison
Authors: Carroll Brendan J. , Bertels Jana , Froio Caterina , Kuipers Sanneke , Schulze-Gabrechten Lena , Viallet-Thévenin Scott
Published: October 2020

Identifying and explaining change in the structure of central state bureaucracies and the determinants of survival of individual public organizations are two closely related areas of research in public administration. We aim to bridge the gap between these two main strands of studies of organizational change by presenting a novel approach to collecting event history data for public organizations. We have developed this framework as part of the Structure and Organisation of Governments Project, which aims to map entire central state bureaucracies in three Western European countries. Our approach is flexible enough to describe macro-trends in public sector organization populations and to explain these trends by analysing the event histories of the organizations they comprise. In addition to presenting our framework and how we applied it to create this data set, we also present some initial cross-national comparisons of the distribution of the event types recorded, highlighting initial findings and promising avenues for further research.

Points for practitioners

We present here a novel approach for representing the structural changes that organizations and sub-departments experience over time that can apply to any hierarchical organization (public or private). Applying the approach illuminates the historical development of organizations and their parts, and allows cross-national comparisons of events and trends across organizations. Our comparison of ministerial organizations in France, Germany and the Netherlands from 1980 to 2013 shows that trends in the size of bureaucracies mask considerable structural changes within.
Mechanical properties of mechanically-defibrated cellulose nanofiber reinforced epoxy resin matrix composites
Authors: Kurita Hiroki , Ishigami Ryugo , Wu Chen , Narita Fumio
Published: October 2020

Cellulose nanofibers (CNF) have recently attracted attention as one of the reinforcements for composite materials. However, the same as other nanofibers, CNFs can be easily agglomerated and the nano-level defibration is necessary to obtain their outstanding properties in polymer matrices. To overcome this issue, two major defibration methods, chemical and mechanical defibration have been considered. The chemically-defibrated CNF is expensive and so prevents the practical realization of CNF as general-purpose products. Therefore, the mechanical defibration method by a clean low-cost water jet was focused on. Mechanically-defibrated CNF reinforced epoxy resin matrix (Epoxy-CNF) composite was fabricated via mechanical mixing and the variation of their tensile and flexural properties with different CNF volume fractions was evaluated. The tensile and flexural moduli of the epoxy resin were increased by CNF addition, while the fracture elongation was decreased. The calculated ultimate tensile strength (UTS) and ultimate flexural strength (UFS) of the Epoxy-CNF composites, using the aspect ratio of the agglomerated CNF clusters, indicated the validity of the random dispersion model considering the agglomerated CNF as one whole fiber. It seems that epoxy resin is enhanced by the mechanical interaction when the CNF volume fraction is higher than 0.37 vol.%.
Wnt/β-Catenin Signaling Promotes the Formation of Preodontoblasts In Vitro
Authors: Vijaykumar A. , Root S.H. , Mina M.
Published: October 2020

Odontoblast differentiation is a complex and multistep process regulated by signaling pathways, including the Wnt/β-catenin signaling pathway. Both positive and negative effects of Wnt/β-catenin signaling on dentinogenesis have been reported, but the underlying mechanisms of these conflicting results are still unclear. To gain a better insight into the role of Wnt/β-catenin in dentinogenesis, we used dental pulp cells from a panel of transgenic mice, in which fluorescent protein expression identifies cells at different stages of odontoblast and osteoblast differentiation. Our results showed that exposure of pulp cells to WNT3a at various times and durations did not induce premature differentiation of odontoblasts. These treatments supported the survival of undifferentiated cells in dental pulp and promoted the formation of 2.3GFP+ preodontoblasts and their rapid transition into differentiated odontoblasts expressing DMP1-Cherry and DSPP-Cerulean transgenes. WNT3a also promoted osteogenesis in dental pulp cultures. These findings provide critical information for the development of improved treatments for vital pulp therapy and dentin regeneration.
Multidisciplinary management of a giant cervico-mediastinal liposarcoma: A case report and literature review
Authors: Galli Andrea , Giordano Leone , Muriana Piergiorgio , Bandiera Alessandro , Negri Giampiero , Zannini Piero , Bussi Mario
Published: October 2020

Liposarcomas are rare mesenchymal tumors that usually develop in lower extremities or retroperitoneum; cervico-mediastinal presentation is quite uncommon. These neoplasms are commonly diagnosed at a late stage because they remain asymptomatic until nearby structures are compressed. This makes radical excision particularly challenging. To date, alternative chemoradiotherapy protocols have not yet been standardized. We report a case of a 55-year-old man with a right laterocervical mass and without substantial symptoms. Fine-needle aspiration cytology results were compatible with a well-differentiated liposarcoma. Contrast-enhanced magnetic resonance imaging revealed the magnitude of the mass, which was expanding into the mediastinum; displacing the trachea, esophagus, cervical neurovascular bundle, and thoracic aorta; and encasing the brachiocephalic artery. Compression of the left brachiocephalic vein resulted in a focal enhancement spot in the fourth liver segment, the expression of superior vena cava compression, which can promote the development of collateral venous pathways, such as the caval-mammary-phrenic-hepatic capsule-portal venous pathway. The mass was successfully excised by a team of surgical subspecialists (otorhinolaryngologists and thoracic, cardiac, and vascular surgeons). Adjuvant tomotherapy was administered to increase local disease control. The patient remained disease-free 38 months postoperatively. This case underlines the importance of accurate pre-operative radiologic evaluation in patients presenting with neck masses but without substantial symptoms. Because of the involvement of many critical structures, the cooperation of many surgical subspecialties is mandatory to achieve a satisfying oncologic outcome.
Caregiver Health by Context: Moderating Effects of Mental Health and Health Behaviors
Authors: Longacre Margaret L. , Brewer Benjamin , Hubbard Adeline , Ashare Rebecca L. , Patterson Freda
Published: October 2020

This study assessed caregivers’ perceptions of their physical health by care context and explored the moderating role of mental health and health behaviors. This a cross-sectional, secondary analysis using de-identified Behavioral Risk Factor Surveillance System survey data. Deficits in mental health and engaging in healthier behaviors was associated with an increased odds of experiencing at least one week of poor physical health or being in a fair or better health category, respectively. Differences in the odds were noted according to care context (i.e., reason for care). For example, with each unit increase in mental health score (worse mental health), the odds of experiencing at least one week of poor physical health increased among cancer caregivers at about one-and-a-half times as compared to old age caregivers (p=0.006). Findings suggest that some caregiving groups derive less benefit from positive health behaviors, while some groups are more adversely impacted by poorer mental health.
New-onset cardiac mass due to left atrial appendage inversion during cardiac surgery
Authors: Orozco-Vinasco David , Andrade Dario , Vinasco Adriana Orozco , Muñoz Luis
Published: October 2020

Cardiac mass assessment is challenging in the intraoperative scenario. We present the case of a 22-year-old woman with a new-onset left atrial mass during cardiopulmonary bypass following closure of a ventricular septal defect. We discuss the role of intraoperative echocardiographic examination, the differential diagnosis, and raise awareness of the left atrial appendage as a rare etiology of an acute left atrial mass.
Linguistic Markers in Women’s Discussions on Miscarriage and Abortion Illustrate Psychological Responses to Their Experiences
Authors: Blackburn Kate G. , Wang Weixi , Pedler Rhea , Thompson Rachel , Gonzales Diana
Published: October 2020

This study analyzed thousands of women’s online conversations in relation to their miscarriage or abortion experiences, classified as unplanned and planned traumas, respectively. Linguistic Inquiry Word Count text analysis revealed that people experiencing a planned trauma use distancing language patterns in higher frequency and engage in emotion regulation more than those who experienced trauma unexpectedly. On the other hand, planned trauma conversations used more self-focused language and more social-based language. Implications and future directions for trauma research are discussed.
Effectiveness of pain coping skills training on pain, physical function, and psychological outcomes in patients with osteoarthritis: A systemic review and meta-analysis
Authors: Wang Lin , Zhang Liming , Yang Lin , Cheng-qi He
Published: October 2020

Objective:

To investigate the effectiveness of pain coping skills training in pain, function, and psychological outcomes for patients with osteoarthritis, compared to the control group; and to compare the effectiveness of pain coping skills training between the intervention involving and without involving exercise.

Data sources:

PubMed, Embase, the Cochrane Library, PEDro, Clinical Trials, and the WHO Clinical Trials Registry Platform (to 30 September 2020).

Review methods:

To calculate the results, we used standardized mean difference, and mean difference for the outcomes of continuous variables, risk difference for the risk of adverse events. Heterogeneity was identified with I2 test, and publication bias was identified with Egger’s test.

Results:

A total of 1195 patients with osteoarthritis underwent ten trials were included. The intervention group had significant differences in pain (SMD = −0.18; 95% CI −0.29 to −0.06), function (SMD = −0.19; −0.30 to −0.07), coping attempts (SMD = 0.37; 0.24 to 0.49), pain catastrophizing (SMD = −0.16; −0.29 to −0.02), and self-efficacy (SMD = 0.27; 0.07 to 0.46) than the control group. Between-group differences measured by the McMaster Universities Osteoarthritis Index subscales of pain (MD = −0.62; −1.48 to 0.24) or function (MD = −3.01; −6.26 to 0.24) were not statistically significant and did not reach the minimal clinically important differences that have been established. Subgroup analyses revealed no significant subgroup differences. Besides, no specific intervention-related adverse events were identified.

Conclusion:

Our results supported the effectiveness and safety of pain coping skills training for managing osteoarthritis in pain, function, and psychological aspects. Besides, exercise could not add benefits when combined with pain coping skills training.
Blood lipid markers are associated with hippocampal viscoelastic properties and memory in humans
Authors: Sanjana Faria , Delgorio Peyton L , Hiscox Lucy V , DeConne Theodore M , Hobson Joshua C , Cohen Matthew L , Johnson Curtis L , Martens Christopher R
Published: October 2020

Age-related memory loss shares similar risk factors as cardiometabolic diseases including elevated serum triglycerides (TGs) and low-density lipoprotein cholesterol (LDL-C) and reduced high-density lipoprotein cholesterol (HDL-C). The mechanisms linking these aberrant blood lipids to memory loss are not completely understood but may be partially mediated by reduced integrity of the hippocampus (HC), the primary brain structure for encoding and recalling memories. In this study, we tested the hypothesis that blood lipid markers are independently associated with memory performance and HC viscoelasticity—a noninvasive measure of brain tissue microstructural integrity assessed by high-resolution magnetic resonance elastography (MRE). Twenty-six individuals across the adult lifespan were recruited (14 M/12 F; mean age: 42 ± 15 y; age range: 22–78 y) and serum lipid profiles were related to episodic memory and HC viscoelasticity. All subjects were generally healthy without clinically abnormal blood lipids or memory loss. Episodic memory was negatively associated with the TG/HDL-C ratio. HC viscoelasticity was negatively associated with serum TGs and the TG/HDL-C ratio, independent of age and in the absence of associations with HC volume. These data, although cross-sectional, suggest that subtle differences in blood lipid profiles in healthy adults may contribute to a reduction in memory function and HC tissue integrity.
Severe bone disease caused by primary hyperparathyroidism: a case report and review of the literature
Authors: Wang Yu , Liu Jie
Published: October 2020

Bone disease is an important complication of hyperparathyroidism. We herein report a rare case of severe bone disease caused by primary hyperparathyroidism. A 33-year-old man presented with pain and restricted mobility in his right upper limb and right hip due to a fall 3 days previously. X-ray examination showed a fracture of the proximal and distal humerus. Computed tomography examination showed a supracondylar fracture of the right humerus, a fracture of the right femoral neck, a fracture of the right sciatic branch, and multiple brown tumors. Ultrasonography showed a 3.5- × 1.6-cm hypoechoic mass below the left lobe of the thyroid. The patient was diagnosed with primary hyperparathyroidism based on increased serum calcium and parathormone concentrations, pathological fractures, and multiple brown tumors. He therefore underwent bilateral lower parathyroidectomy. Pathological examination revealed a parathyroid adenoma. The patient recovered well after surgery and was followed up for 6 months with no symptoms of hyperparathyroidism. This case report suggests that clinicians should be aware of the possibility of severe bone disease secondary to primary hyperparathyroidism. Active and early diagnosis and surgical treatment are important in such cases.
Commodities and the Import Trade in Early Plantation Ulster
Authors: Scott Brendan
Published: October 2020

As a new wave of British settlers moved into Ulster following the plantation there in the early seventeenth century, ports, towns, markets and fairs were both established and further developed. The survival of the port books for Londonderry, Coleraine, Carrickfergus and the Lecale ports of County Down for the years 1612–15 offers detailed information of goods imported into Ulster which affords us insights into the consumer habits and preferences of the British settlers now living in that province. While it was hoped by some that the introduction of a new market and trade culture would have a ‘civilising’ effect upon the Gaelic Irish, evidence of consumer preferences tells a somewhat different story, which a study of Ulster’s import trade and settler society in early Plantation Ulster can illustrate.
Toward a Regional Gerontological Agenda: The Use of Empowerment Evaluation
Authors: Schwartz Abby J. , Bower Kyle L. , Rowles Graham D. , Appert Karen M. , Ferguson Lee Ann S.
Published: October 2020

This article describes the application of an empowerment evaluation approach to nurturing the growth and priority setting of a regional organization. A model is provided of the processes whereby the Southern Gerontological Society (SGS) identified research and service priorities by conducting a survey of stakeholder perceptions of regional needs. The survey goal was to identify important issues faced by older adults in the South as a prelude to refining SGS research and service priorities and developing its contemporary regional gerontological agenda. We trace how the survey findings were translated into actions including shaping the annual meeting program, creating new standing committees, and developing service activities. Underlying the process of developing and refining this agenda are a set of key principles that have come to characterize the operation of SGS. These principles are discussed and provide a model for comparable organizations seeking to develop agendas consistent with their mission and identity.
The Role of Acculturation in the Relation Between Intimate Partner Violence and Substance Misuse Among IPV-victimized Hispanic Women in the Community
Authors: Reyes Miranda E. , Weiss Nicole H. , Swan Suzanne C. , Sullivan Tami P.
Published: October 2020

Hispanic women in the United States are disproportionately affected by intimate partner violence (IPV). One correlate of IPV among Hispanic women with important public health implications is substance misuse. However, limited research has identified culturally relevant factors that may impact the strength of the IPV-substance misuse association in this population. The present study examined the moderating role of acculturation in the relation between IPV types (i.e., physical, psychological, and sexual) and substance (i.e., alcohol and drug) misuse. Participants were 150 IPV-exposed Hispanic women in the community ( M age = 35.13). IPV types, substance misuse outcomes, and acculturation were significantly and positively correlated with each other at zero-order. Moderation analyses indicated that the relations between IPV and substance misuse were stronger among Hispanic women with higher (vs. lower) levels of acculturation. These findings suggest the potential utility of considering acculturation when assessing and treating substance misuse among IPV-exposed Hispanic women.
Examining Factors Associated with Stalking-Related Fears Among Men and Women Stalked by Male and Female Acquaintances
Authors: Logan TK
Published: October 2020

This study examines experiences of acquaintance stalking victims ( n = 389), recruited from a community sample, by victim and stalker gender and explores factors associated with three measures of fear (fear of harm, perceived capability of stalker to harm, and fear of significant life impact). There were five main findings from this study: (a) although research suggests ex-partner stalkers are the most threatening, assaultive, and harassing stalkers, particularly for women, this study shows that a significant number of acquaintance stalking victims experience high levels of fear, threats, life interference, and assault; (b) women had higher stalking-related fear levels and a greater belief that their stalker was capable of harming them regardless of stalker gender, while men stalked by females were least concerned about harm; (c) close to one-quarter of victims had one unknown background factor and one-third indicated not knowing about two or more background factors suggesting variation in the level of victim knowledge about acquaintance stalkers; (d) the number of threats, stalker history of violence to others, the belief that the stalker does not care about severe consequences, and a greater number of unknown stalker background factors were associated with higher stalking-related fear levels and an increased perception that the stalker was capable of harm; and, (e) higher concern about a significant life impact from the stalking was associated with forced confrontations, believing the stalker wanted revenge, victim vulnerability, proxy stalking, and technology facilitated stalking. Future research is needed to better understand the dynamics of acquaintance stalking, particularly with regard to how close or distant the stalker was to the victim. Considering victim and stalker gender dynamics in acquaintance stalking may be important for safety planning and risk assessment.
Investigations into fatigue failure in e-type fastening clips used in railway tracks
Authors: Ali Rashid , Shehbaz Tauheed , Felicis Daniele De , Sebastiani Marco , Bemporad Edoardo
Published: October 2020

This study describes the investigations of failure in an e-type clip at the inside of rear arch, where the stresses are maximum owing to in-service loading and bending that occurs during forming operations. Visual inspection, stereomicroscopy, optical-microscopy and Scanning Electron Microscopy (SEM) coupled with energy dispersive spectroscopy (EDS) have been used as the characterization techniques. The microstructural, morphological changes were compared both in the central area and close to the location of failure in e-clip. During primary heating for forming steel rod into e-clip shape, the oxidation and decarburization occurs which caused the formation and penetration of iron oxide. The average thickness of oxide layer was found to be 20 µm with localized areas, where the oxides penetrated up to depth of 50 µm. During forming and shot peening operations, the iron oxide ingested in material at the inside circumferential region of rear arch, which triggered the initiation and propagation of fatigue phenomenon in service. The SEM-EDS analysis and fractography confirmed the presence of iron oxide and pearlite lamellar tearing at the crack initiation site, respectively. It is suggested to use electric induction heating for forming of steel rod into e-clip shape or increased the silicon content from two to three weight percent, which minimize the thickness of oxide layer. The finishing process by adding air spray or tapping of the rod after heating will further help to remove the scale at the critical region before taking it up for mechanical forming operations.
HIV infections among female sex workers in Mombasa, Kenya: current prevalence and trends over 25 years
Authors: Manguro Griffins O , Gichuki Carol , Ampt Frances H , Agius Paul A , Lim Megan SC , Jaoko Walter G , Hellard Margaret , L’Engle Kelly , Stoové Mark , Mandaliya Kishor , Chersich Matthew F , Temmerman Marleen , Luchters Stanley , Gichangi Peter
Published: October 2020

Over 20 years, interventions have targeted HIV among female sex workers (FSWs) in Kenya given their central role in new infections. To determine the effects of these interventions, we assessed the prevalence and correlates of HIV among a random sample of FSWs and modelled prevalence estimates from studies since 1993. FSWs aged 16–34 years were enrolled through multi-stage sampling. Regression models identified correlates of HIV infection. Generalised linear mixed modelling estimated temporal changes in prevalence between 1993 and 2016. 882 FSWs were enrolled. Prevalence rose from 3.6% among 16–20-year-olds to 31.6% among 31–34-year-old FSWs. Those aged 31 to 34 years had greater odds of HIV compared to those 16 to 20 years (AOR 14.2, 95% CI, 5.5–36.8). Infection was less prevalent among FSWs with tertiary education compared to those with primary or no education (AOR 0.23, 95% CI, 0.07–0.78). There was an overall 30% reduction in prevalence from 1993 to 2016 with an average annual decline of 3%. About one in ten FSWs in Mombasa are currently infected with HIV. Considering FSWs’ central role in sustaining population-level infections, these initiatives require continued support, focusing on reducing transmission from older FSWs and those with less education.
Commission entrepreneurship and EU employment policy – The fate of a former darling
Authors: Mailand Mikkel
Published: October 2020

An ongoing disagreement between researchers of EU decision-making processes is about who primarily drives the development – the Commission or the member states. The present article addresses this issue within the context of EU employment policy, a cornerstone in Social Europe. Research has often pointed to a gradually weakening and subordination of these policies to economic policies. However, recent in-depth studies have found a progressive ‘socialization’ taking place in the European Semester. In this article, it is argued that Commission entrepreneurship has been relatively successful and that the Commission stands out as the most important actor in a partial comeback of EU employment policy, which has taken place since the 2010s.
Reticular erythematous mucinosis: Literature review and case report of a 24-year-old patient with systemic erythematosus lupus
Authors: Ocanha-Xavier Juliana P , Cola-Senra Camila O , Xavier-Junior Jose Candido C
Published: October 2020

Reticular erythematous mucinosis (REM) was first described 50 years ago, but only around 100 case reports in English have been published. Its relation with other inflammatory skin disorders is still being debated. We report a case of REM, including the clinical and histopathological findings. Also, a systematic review of 94 English-language reported cases is provided. The described criteria for clinical and histopathological diagnosis are highlighted in order to REM can be confidently diagnosed.
Book review: Shirin M. Rai and Carole Spary, Performing Representation: Women Members in Indian Parliament
Authors: Ghosh Tuktuk
Published: October 2020

Shirin M. Rai and Carole Spary, Performing Representation: Women Members in Indian Parliament, New Delhi, Oxford University Press, 2019, 398 pages (Hardcover), ₹995. ISBN: 9780199489053.
Book review: Mahima Nayar, Against All Odds: Psychosocial Distress and Healing Among Women
Authors: Vindhya U.
Published: October 2020

Mahima Nayar, Against All Odds: Psychosocial Distress and Healing Among Women. New Delhi: SAGE Publications and Yoda Press, 2019, 256 pages, ₹795 (Hardcover). ISBN: 9789353281915.