bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral fibroepithelial polyps (“chewing granulomas”) in 21 dogs: Histomorphology, immunohistochemical characterization, and clinical outcome
Authors: Nordio Laura , Stefanello Cristiano , Gasparini Stefania
Published: December 2022

Oral fibroepithelial polyps (FEPs) are common, benign, nonneoplastic lesions in humans that often develop slowly in sites of local irritation or trauma. This study analyzed 23 oral fibroepithelial polypoid lesions retrieved from 21 dogs (2014–2021). All lesions were pedunculated with usually an irregular/cauliflower-like or rarely smooth surface. FEPs most commonly arose under or lateral to the tongue; other sites included the labial and gingival mucosa, soft palate, and hard palate. All the lesions were characterized by a thick fibrovascular stalk consisting of bundles of fibrocytes and fibroblasts embedded in a collagenous matrix rich in blood vessels. The surface squamous epithelium, when evaluable, was hyperplastic (22/22; 100%) with frequent parakeratotic hyperkeratosis (12/22; 54.5%). Ulceration of variable extent was observed in 13/23 cases (56.5%). Inflammation was associated with 18/23 cases (78.3%), and was mostly lymphoplasmacytic. The connective tissue was consistently immunoreactive for vimentin and generally negative for smooth muscle actin and desmin. All FEPs in cases with available clinical outcome data did not recur after surgical excision. The presence of chronic inflammation and ulceration suggests a causative role of chronic irritation in the pathogenesis of canine oral FEPs. FEPs should be included among the differential diagnoses of proliferative lesions of the oral cavity in dogs.
Morphological study of apocrine gland tumors in domestic Richardson’s ground squirrels (Urocitellus richardsonii)
Authors: Okumura Naka , Takei Rina , Kondo Hirotaka , Shibuya Hisashi
Published: December 2022

The morphology of 58 apocrine tumors from 31 domestic Richardson’s ground squirrels ( Urocitellus richardsonii) was examined, comparing tumor subtypes with clinical information and histological findings. The squirrels included 23 males (74%) and 8 females (26%). Of the 58 tumors, 36 (62%) were located from the cervical skin to the dorsal skin, 17 (29%) were from the perioral region to the cheek, and the location was unrecorded for the remaining 5 squirrels (9%). Histologically, 49 tumors (84%) were apocrine adenocarcinomas, 6 were apocrine adenomas (10%), and 3 were apocrine cysts (5%). The 49 apocrine adenocarcinomas were subclassified as 16 (33%) cystic papillary type, 16 (33%) tubulopapillary type, 12 (24%) solid type, and 5 (10%) micropapillary invasive type. Fisher’s exact test revealed correlations between tumor subtypes and tumor diameters, nuclear atypia, tumor margins, vascular invasion, and periodic acid-Schiff (PAS) positivity. This study showed a predominance of apocrine adenocarcinomas with various histological subtypes. In addition, subclassification of these tumors was useful for predicting the biological behavior of apocrine gland tumors in Richardson’s ground squirrels.
The increasing importance of the alternate real estate sectors for institutional investors
Authors: Newell Graeme , Marzuki Muhammad Jufri Bin
Published: December 2022

The alternate real estate sectors (including healthcare, data centres, self-storage, university student accommodation and infrastructure) have taken on increased importance in recent years with institutional investors, as they have sought to broaden their real estate sector exposure. This has been driven by key real estate investment factors, including the changing global demographics, advances in technology and the impact of COVID-19. Importantly, this trend is expected to continue and has a major influence on real estate management and strategies by institutional investors going forward. Using a range of alternate real estate sectors across several countries (US, UK and globally) in the direct, non-listed and listed real estate spaces, this paper examines the risk-adjusted performance and portfolio diversification benefits of these alternate real estate sectors compared to the standard asset classes in the portfolios of institutional investors. The real estate management and strategic implications for institutional investors going forward are also assessed.
Elder Mistreatment and Dementia: A Comparison of People with and without Dementia across the Prevalence of Abuse
Authors: Rogers Michaela M. , Storey Jennifer E. , Galloway Sonia
Published: December 2022

This paper examines the prevalence of different types of elder mistreatment, care needs, and risk factors amongst older adults living with and without dementia in any setting (community or institution). Three years (2014–2017) of anonymized reported incidents of elder mistreatment to a national UK helpline were examined in an exploratory study, using a matched sample design ( N = 598) comparing adults with dementia ( n = 299) to those without ( n = 299) on mistreatment type, care needs, and risk factors for abuse. Financial exploitation was more common among older adults with dementia who required more daily care than those without. Risk factors for elder mistreatment among older adults without dementia were often chronic in nature (such as poor physical health) whereas risk factors for people with dementia were associated with a dementia diagnosis. Raising implications for health and social care, results show that older adults diagnosed with dementia had increased care needs and vulnerability to abuse.
Transitioning towards a sustainable circular city: How to evaluate and improve urban solid waste management in Brazil
Authors: Moraes Flávia Tuane Ferreira , Gonçalves Andriani Tavares Tenório , Lima Josiane Palma , da Silva Lima Renato
Published: December 2022

A circular city (CC) promotes circular economy (CE) principles. Efficient urban solid waste management (USWM) strategies are essential for promoting a CE at the municipal level. New tools are needed to evaluate waste management (WM) and increase the reuse and recycling of materials to accelerate the transition towards a CC. These tools could assist decision and policymakers in adopting, implementing, and monitoring circular practices. This study proposes creating an index (USWM-index) to evaluate WM in urban areas and discuss how it could be better managed in future sustainable circular cities in Brazil. The index allows city managers to integratively and sustainably assess their USWM. Decision-makers can also use the index to set goals and objectives for recycling and reusing generated waste in cities. The index comprises 19 indicators and 51 sub-indicators. These elements were divided into five groups: Operational, Environmental, Political-economic, Educational, and Social. Cities can assess their performance in each group by using the USWM-index. The index was applied to four Brazilian cities. All cities had their USWM classified as average, and they did not have initiatives to transition to sustainable circular cities regarding WM. This study presents guidelines for transitioning from a linear city to a sustainable circular city in terms of WM.
Biomimetic surface modification of Three-dimensional printed Polylactic acid scaffolds with custom mechanical properties for bone reconstruction
Authors: Shams Amir , Masaeli Elahe , Ghomi Hamed
Published: December 2022

3D printing has recently emerged as an innovative fabrication method to construct critical-sized and patient-specific bone scaffolds. The ability to control the bulk geometry of scaffolds in both macro and micro-scales distinguishes this technology from other fabrication methods. In this study, bone tissue-specific scaffolds with different pore geometries were printed from polylactic acid (PLA) filaments at three given infill densities ranging from 20 to 30%. A hybrid hydrogel made of synthetic biphasic calcium phosphate (BCP) and collagen was applied to coat 3D printed well-structured triangular samples with 30% infill density. The coating process changed the surface texture, increased the average strand diameter and average pore size, and decreased the open porosity of samples, all of which increased the mechanical strength of biomimetic-coated scaffolds. According to matrix mineralization staining and osteo-related gene expression, the coating of scaffolds significantly facilitates metabolic activity and osteogenic differentiation of dental pulp-derived mesenchymal stem cells (DPSCs). Taken together, these results indicated that the biomimetic coating is a highly promising approach that could be taken into consideration in the design of a porous scaffold for bone tissue engineering.
Hemostatic Efficacy and Safety of 4-Factor Prothrombin Complex Concentrate in Doac-Associated Intracranial Hemorrhage
Authors: Whaley Patrick M. , Franco-Martinez Crystal , Lock Ashley E. , Ramaswamy Davana , Young Eric H. , Allen Stefan M. , Barthol Colleen A.
Published: December 2022

Background: Factor Xa (FXa) inhibitor use has increased over the last decade and though associated rates of major bleeding are lower compared to warfarin, outcomes from intracranial hemorrhage (ICH) are still significant. Targeted FXa inhibitor reversal agent became available in 2018, however use of 4-factor prothrombin complex concentrate (4F-PCC) for FXa inhibitor-associated ICH continues at many institutions. Objective: Evaluate the safety and hemostatic efficacy of 4F-PCC for FXa inhibitor-associated ICH. Methods: Single-center, retrospective study of patients who received 4F-PCC for FXa inhibitor-associated ICH. The primary efficacy endpoint was hemostasis and thrombosis was the main safety endpoint. Secondary endpoints included in-hospital mortality and discharge disposition. Results: 76 patients on apixaban or rivaroxaban were included. Good or excellent hemostasis was achieved in 80.3% of patients. Five patients experienced a thrombotic event. Favorable discharge disposition and lower in-hospital mortality was more likely in patients who achieved excellent hemostasis. Conclusion: 4F-PCC is safe and effective for FXa inhibitor associated ICH.
Negotiating limits on algorithmic management in digitalised services: cases from Germany and Norway
Authors: Doellgast Virginia , Wagner Ines , O’Brady Sean
Published: December 2022

Artificial intelligence (AI)-based algorithms are increasingly used to monitor employees and to automate management decisions. In this article, we ask how worker representatives adapt traditional collective voice institutions to regulate the adoption and use of these tools in the workplace. Our findings are based on a comparative study of union and works council responses to algorithmic management in contact centres from two similar telecommunications companies in Germany and Norway. In both case studies, worker representatives mobilised collective voice institutions to protect worker privacy and discretion associated with remote monitoring and workforce management technologies. However, they relied on different sources of institutional power, connected to co-determination rights, enforcement of data protection laws, and labour cooperation structures.
“You Hope and Pray”: A Composite Counterstory of New Mothers’ Racism Experiences, Fears, and Plans to Address It for Their Children
Authors: Hall Jodi , Averett Paige
Published: December 2022

Utilizing the critical race theory framework, this article shares the emergent data from a larger study of new mothers that provided a composite counterstory of racism and plans to address racism with their children. Interviews of 12 African American women who were receiving Medicaid for pregnant women and delivered in a Southeastern hospital revealed that race and racism were underlying the variety of other topics discussed. Critical race theory provides a way of understanding their experiences and management of racism. Shared in the findings are applications to social work practice and education to address the racism that is experienced by African American women and their children.
Listening as Methodological Resistance: Hearing Voices at the Margins of Educational Leadership
Authors: Odell Sarah Margaret
Published: December 2022

The Listening Guide method was founded in opposition to other forms of interview coding which either put data into predetermined and/or binary categories. Feminist psychologists believed that other methods of qualitative research disappeared the undertheorized portions of subjects’ narratives. This method does not seek to only hear voices of queer or gender non-conforming educational leaders, but also to hear the contradictions, complexities and multiple voices of cisgendered men and women and enable researchers to hear that a binary construction of gender is not the place where most school leaders live. The Listening Guide is an act of resistance, forcing research away from calcifying experience into static categories. The Listening Guide also acknowledges that multiplicity of self is authentic. Individuals tend to speak in more than one voice at a given time, depending on their context and the culture in which they exist. One can think of this as being like a borderland where different pieces of our identity converge, some taking on greater importance based on context. Gender, race, and sexual identities exist in relationship to one another within everyone, and the contextual nature of how these identities cause us to behave or influence how we are perceived can be heard using this method. The messiness of identity is allowed to come to the surface, resisting binaries and hierarchy in categorization. Listening meets at the intersection of method and praxis, and voice enables researchers to hear the stories at the margins of educational leadership.
Family-Centered Prevention During Elementary School to Reduce Growth in Emotional and Behavior Problems
Authors: Garbacz S. Andrew , Stormshak Elizabeth A. , McIntyre Laura Lee , Bolt Daniel , Huang Mingya
Published: December 2022

The purpose of this study was to examine the efficacy of the Family Check-Up initiated during kindergarten on teacher-report of children’s emotional and behavior concerns in fourth grade. Participants were 57 primary caregivers, along with their children and teachers. Participants were randomized to a Family Check-Up condition or school-as-usual control condition. Teachers reported on children’s emotional and behavior concerns at kindergarten and fourth grade. Findings suggested children whose caregivers were randomized to the Family Check-Up condition outperformed children in the school-as-usual control condition on moderate and serious emotional and behavior concerns in fourth grade. Implications for aligning and integrating family-centered assessment and treatment in schools are discussed.
Health Information Technology Adoption at U.S. Home Health Care Agencies: Results from a Multi-Methods Study
Authors: Pogorzelska-Maziarz Monika , Chastain Ashley M. , Perera Uduwanage Gayani E. , Cohen Catherine C. , Stone Patricia W. , Woo Kyungmi , Shang Jingjing
Published: December 2022

Health information technology (HIT) holds potential to transform Home Health Care (HHC), yet, little is known about its adoption in this setting. In the context of infection prevention and control, we aimed to: (1) describe challenges associated with the adoption of HIT, for example, electronic health records (EHR) and telehealth and (2) examine HHC agency characteristics associated with HIT adoption. We conducted in-depth interviews with 41 staff from 13 U.S. HHC agencies (May-October 2018), then surveyed a stratified random sample of 1506 agencies (November 2018-December 2019), of which 35.6% participated (N = 536 HHC agencies). We applied analytic weights, generating nationally-representative estimates, and computed descriptive statistics, bivariate and multivariable analyses. Four themes were identified: (1) Reflections on providing HHC without EHR; (2) Benefits of EHR; (3) Benefits of other HIT; (4) Challenges with HIT and EHR. Overall, 10% of the agencies did not have an EHR; an additional 2% were in the process of acquiring one. Sixteen percent offered telehealth, and another 4% were in the process of acquiring telehealth services. In multivariable analysis, EHR use varied significantly by geographic location and ownership, and telehealth use varied by geographic location, ownership, and size. Although HIT use has increased, our results indicate that many HHC agencies still lack the HIT needed to implement technological solutions to improve workflow and quality of care. Future research should examine the impact of HIT on patient outcomes and the impact of the COVID-19 pandemic on HIT use in HHC.
The Intersection of Technology, Accessible Tourism and Tourists With Intellectual Disabilities: Proposing a Novel Conceptual Framework
Authors: Ali Faizan , Cain Lisa , Legendre Tiffany S. , Wu Laurie
Published: December 2022

This research aimed to understand the experiences of tourists with intellectual disabilities using travel technologies , and to identify determinants and deterrents. A qualitative approach was adopted to execute the research across two studies. In Study 1, topic modeling analysis of online travel forum discussions was conducted to unearth consumer concerns around accessibility. Study 1 revealed that the voices of people with disabilities were omitted in the forum data. Building upon Study 1, in Study 2 we conducted four focus group interviews with tourists with intellectual disabilities to understand their opinions, attitudes, and perceptions towards the use of technology before and during travel. The findings yielded a redefined model conceptualizing the technology usage of tourists with disabilities, particularly for tourists with intellectual disabilities. Implications for co-creating experiences with technology with tourists with disabilities were discussed in relevance with theory and practice.
Bioinformatics and System Biology Techniques to Determine Biomolecular Signatures and Pathways of Prion Disorder
Authors: Mredul Md Bazlur Rahman , Khan Umama , Rana Humayan Kabir , Meem Tahera Mahnaz , Awal Md Abdul , Rahman Md Habibur , Khan Md Salauddin
Published: December 2022

Prion disorder (PD) is caused by misfolding and the formation of clumps of proteins in the brain, notably Prion proteins resulting in a steady decrease in brain function. Early detection of PD is difficult due to its unpredictable nature, and diagnosis is limited regarding specificity and sensitivity. Considering the uncertainties, the current study used network-based integrative system biology approaches to reveal promising molecular biomarkers and therapeutic targets for PD. In this study, brain transcriptomics gene expression microarray datasets (GSE160208 and GSE124571) of human PD were evaluated and 35 differentially expressed genes (DEGs) were identified. By employing network-based protein–protein interaction (PPI) analysis on these DEGs, 10 central hub proteins, including SPP1, FKBP5, HPRT1, CDKN1A, BAG3, HSPB1, SYK, TNFRSF1A, PTPN6, and CD44, were identified. Employing bioinformatics approaches, a variety of transcription factors (EGR1, SSRP1, POLR2A, TARDP, and NR2F1) and miRNAs (hsa-mir-8485, hsa-mir-148b-3p, hsa-mir-4295, hsa-mir-26b-5p, and hsa-mir-16-5p) were predicted. EGR1 was found as the most imperative transcription factor (TF), and hsa-mir-16-5p and hsa-mir-148b-3p were found as the most crucial miRNAs targeted in PD. Finally, resveratrol and hypochlorous acid were predicted as possible therapeutic drugs for PD. This study could be helpful in better understanding of molecular systems and prospective pharmacological targets for developing effective PD treatments.
From school strikes to webinars: Mapping the forced digitalization of Fridays for Future’s activism during the COVID-19 pandemic
Authors: Sorce Giuliana , Dumitrica Delia
Published: December 2022

This paper discusses the forced digitalization of activism brought about by the COVID-19 pandemic in the case of the transnational environmental youth movement Fridays for Future (FFF). Theoretically, we engage with social movement action repertoires to study the shifts in protest tactics associated with the social restrictions during the early stages of the pandemic. A qualitative content analysis of 781 posts across all 27 national FFF Facebook pages in the European Union reveals four clusters of digital action types: digital contentious actions; online information and education; digital community engagement and online partnership development. While digital media were part of FFF’s action repertoire in pre-pandemic times, our findings yield that the shift from the movement’s iconic street protests to exclusively digital tactics privileges community-building and education over contentious actions, potentially softening the political impact of the movement’s landmark ‘school strike’. Furthermore, although timely tactical flexibility kept the movement going during country lockdowns, the forced digitalization in the early stages of the pandemic primarily recombined existing action tactics rather than innovating them.
Theoretical and experimental study on sound absorption performance of Al2O3-polyurethane foam and microperforated plate composite structure
Authors: Binxia Yuan , Weiguang Hou , Jianben Liu , Bing Zhou , Rui Zhu , Lan Cao
Published: December 2022

Low-frequency noise pollution in substations has a significant impact on the physical and mental health of workers. Reduction low-frequency noise pollution is an urgent problem to solve for researchers. In this paper, the different structures of Al2O3-polyurethane composites and micro-perforated plate were constructed, and the effects of cavity depth, perforated plate, and foam position on sound absorption properties were comprehensively investigated. The results showed that the position of perforated plate and the arrangement of resonance structure were the two most important factors affecting sound absorption performance. When the sound wave passed through the plexiglass plate–cavity–composites foam–perforated plate in turn, the peak position of sound absorption coefficient was located in the ultra-low frequency range. Meantime, the simulation study showed that the friction between the air column and the cavity wall in the perforated plate can consume sound energy to achieve sound absorption.
Utilizing Digital Storytelling to Develop a Public Health Professions Pathway for Native American High School Students
Authors: Dreifuss Heather Marie , Yuan Nicole P. , Russo Carroll Stephanie , Bauer Mark C. , Teufel-Shone Nicolette I.
Published: December 2022

Digital storytelling is a decentering methodology in health promotion that positions the storyteller as an expert to create a narrative of their lived experiences. This article describes using a two-phase digital storytelling process within the Diné (Navajo) Educational Philosophy framework to guide the development of a culturally grounded curriculum plan that actively engages Diné youth in exploring health professions pathways in their community. The first phase consisted of developing a high school digital storytelling team by training three Diné youth attending high school on the Navajo Nation located in southwest United States, in digital storytelling. In the second phase, the high school digital storytelling team worked collaboratively with seven Diné students enrolled at the local tribal college to develop digital stories about navigating from high school to college. Data from seven completed digital stories were analyzed with assistance from a community advisory board to identify asset-based themes that contributed to positively transitioning from high school to a tribal college. The results revealed several strategies for successful transitions from high school to a public health college major. The culturally relevant strategies and stories were incorporated into a school-based health professions pathway curriculum plan for Diné youth.
Guillotine Transmetatarsal Amputations With Staged Closure Promote Early Ambulation and Limb Salvage in Patients With Advanced Chronic Limb-Threatening Ischemia
Authors: Lepow Brian D. , Zulbaran-Rojas Alejandro , Park Catherine , Chowdhary Saakshi , Najafi Bijan , Chung Jayer , Ross Jeffrey A. , Mills Joseph L. , Montero-Baker Miguel
Published: December 2022

Purpose:

Transmetatarsal amputation (TMA) with primary closure has long been an option for limb salvage in patients with advanced chronic limb-threatening ischemia (CLTI) with extensive tissue loss of the forefoot. However, TMA healing and closure techniques are challenging, specifically in high-risk patients. Guillotine transmetatarsal amputations (gTMA) with staged closure may provide an alternative treatment in this population. We report long-term outcomes of such technique.

Materials and Methods:

A single-center retrospective cohort study of CLTI patients undergoing gTMA between 2017 and 2020 was performed. Limb salvage, wound healing, and survival rates were quantified using Kaplan-Meier (KM) analysis. Multivariate regression was used to identify the effect of patient characteristics on the outcomes.

Results:

Forty-four gTMA procedures were reviewed. Median follow-up was 381 (interquartile range [IQR], 212–539.75) days. After gTMA, 87.8% (n=36) of the patients were able to ambulate after a median interval of 2 (IQR, 1–3) days. Eventual coverage was achieved in a personalized and staged approach by using a combination of skin substitutes (88.6%, n=39) ± split thickness skin grafts (STSG, 61.4%, n=27). KM estimates for limb salvage, wound healing, and survival were 84.1%, 54.5%, and 88.6% at 1 year and 81.8%, 63.8%, and 84.1% at 2 years. Wound healing was significantly associated with STSG application (p=0.002, OR=16.5, 95% CI 2.87–94.81).

Conclusion:

gTMA resulted in high limb salvage rates during long-term follow-up in CLTI patients. Adjunctive STSG placement may enhance wound healing at the gTMA site, thus leading to expedited wound closure. Surgeons may consider gTMA as an alternative to reduce limb loss in CLTI patients at high risk of major amputation.

Clinical Impact

Currently, the clinical presentation of CLTI is becoming more complex to deal with due to the increasing comorbidities as the society becomes older. The data shown in this article means for clinicians that when facing diffused forefoot gangrene and extensive tissue loss, limb preservation could still be considered instead of major amputation. Guillotine transmetatarsal amputations in the setting of an aggressive multidisciplinary group, can be healed by the responsibly utilization of dermal substitutes and skin grafts leading to the preservation of the extremity, allowing mobility, avoiding of sarcopenia, and decreasing frailty. This will equate to maintenance of independent living and preservation of lifespan.
Increasing Awareness of Complications of Nerve Injury Following Shoulder Surgery: Preventing Delays in Referral and Treatment
Authors: Patterson Brendan M. , Reed Evelyn R. , Hill Elspeth , Buckwalter V Joseph A. , Bozoghlian Maria F. , Mackinnon Susan E.
Published: December 2022

Background:

Nerve injuries remain a challenging complication after shoulder surgery. While most resolve spontaneously, some require surgical intervention. This study describes the characteristics of patients sustaining nerve injuries following shoulder surgery, evaluates referral patterns to nerve surgeons, and characterizes nerve surgeries performed and their outcomes. Increased awareness of these injuries allows patients and providers to be better informed regarding the appropriate management when these complications occur.

Methods:

A retrospective review of referrals with nerve injuries following shoulder surgery between 2007 and 2015 was performed. The final analysis included 65 patients. Data reviewed included demographics, procedure and anesthesia type, and diagnosis of nerve injury. Time to referral to nerve surgeon and proportional changes in the Disabilities of the Arm, Shoulder, and Hand (DASH) scores were determined. Outcomes were categorized as failed, partially successful, and successful based on final follow-up.

Results:

Patients were referred following arthroscopic shoulder surgeries (35.4%), shoulder arthroplasties (24.6%), open shoulder procedures (21.5%), and combined open and arthroscopic procedures (18.5%). The mean time to referral was 7.6 months. Nerve injuries involved brachial plexus (33) and individual and multiple peripheral nerve branches (23 and 7, respectively). Twenty-five (38%) nerve injuries demonstrated spontaneous recovery. Thirty-five patients underwent surgical intervention, of which 27 were successful, 3 were partially successful, and 3 failed.

Conclusions:

This is the largest series of patients with iatrogenic nerve injury following shoulder surgeries to date. Our data demonstrate a lack of timely referral to nerve surgeons, especially after arthroscopy. There continues to be a variable injury pattern even among similar surgeries. Despite this, timely surgical intervention, when indicated, can lead to favorable outcomes.
Abbreviated new drug submission approval process: An overview
Authors: Amrutkar Sonali S , Patil Sanjay B , Mundada Atish S
Published: December 2022

A generic drug is a copy of a brand name drug which can be introduced into the market once innovators patent expires. More than 73% of prescription drugs sold at retail in Canada are generics and thus Canada represents the world’s 9th biggest market for generic drugs in terms of value. Canada’s generic pharmaceutical sector produces domestically less than 10% of the active pharmaceutical ingredients used in its medicines. It also imports 88% of the finished dose products. Drug manufacturer has to demonstrate that its product is pharmacologically effective and bioequivalent to the innovator’s drug. The generic drug is bioequivalent or pharmaceutically equivalent to the Canadian Reference Product (CRP). The Abbreviated New Drug submission (ANDS) regulations were created to make the generic drug approval process simpler and more cost-effective by health drug Canada.
Therapeutic efficacy and complications of radial versus femoral access in endovascular treatment of unruptured intracranial aneurysms
Authors: Fuga Michiyasu , Tanaka Toshihide , Tachi Rintaro , Tomoto Kyoichi , Okawa Shun , Teshigawara Akihiko , Ishibashi Toshihiro , Hasegawa Yuzuru , Murayama Yuichi
Published: December 2022

Purpose

The transradial approach (TRA) in neuroendovascular treatment is known to have a lower risk of complications than the transfemoral approach (TFA). However, little research has focused on assessments of efficacy and risk of complications in the treatment of intracranial aneurysms. This study aimed to compare the efficacy and complications of TRA and TFA in coil embolization of unruptured intracranial aneurysms (UIAs) at our institution.

Methods

Consecutive patients who underwent endovascular surgery via TRA or TFA at a single institution from 1 April 2019, to 28 February 2022, were retrospectively analyzed. Patients were classified into TRA and TFA groups and assessed using propensity-adjusted analysis for outcomes including fluoroscopy time, volume embolization ratio (VER), and complications.

Results

A total of 163 consecutive UIAs were treated with coil embolization during the 35-months study period. The incidence of minor access site complications (ASCs) was significantly higher with TFA (20%, 25/126) than with TRA (2.7%, 1/37; p = 0.01). Propensity-adjusted analysis (matched for age, sex, aneurysm volume, embolization technique, and sheath size) revealed that TRA was associated with a lower risk of minor ASCs (odds ratio, 0.085; 95% confidence interval 0.0094–0.78; p = 0.029). However, TRA did not differ significantly from TFA with respect to fluoroscopy time, VER, major ASCs, and non-ASCs.

Conclusions

Coil embolization for UIAs via TRA can reduce risk of minor ASCs without increasing the risk of non-ASCs compared with conventional TFA, and can achieve comparable results in term of efficacy and fluoroscopy time.
Reasons for admission to a general medical hospital for patients taking clozapine
Authors: Gee Siobhan , Almeida Vasco , Hughes Adam , McMullen Isabel , Taylor David
Published: December 2022

Background:

Clozapine is associated with a diverse range of side effects. In addition, patients prescribed clozapine commonly suffer with medical comorbidities.

Objectives:

This study aimed to characterise patients prescribed clozapine who required medical admission, understand reasons for admission, identify areas for interventions to prevent future admission and describe clozapine management during the inpatient stay.

Design:

We conducted a retrospective analysis of patients prescribed clozapine who were admitted to a general medical hospital in a 12-month period.

Method:

Data were collected using electronic drug charts and notes.

Results:

In total, 114 clozapine patients were hospitalised. Twenty-eight patients (25%) were admitted because of infection, 12 (11%) were elective admissions and 12 (11%) had gastrointestinal problems. Most patients admitted were Black (54%) and half were female. Few changes were made to clozapine dosing on admission or during the inpatient stay. Most patients had been taking clozapine for many years at the point of admission, the majority were able to continue taking it for the duration of their medical treatment and were discharged on the same dose they were taking prior to admission. Clozapine plasma concentrations were not consistently measured with only 18 (16%) patients having one or more plasma concentrations determined during their admission. The median clozapine plasma concentration on admission was 0.48 mg/L (nor-clozapine 0.21 mg/L), with a range of 0.09 to 3.9 mg/L. Three patients were admitted to the intensive care unit during their admission; all were discharged on clozapine. Four patients died; one from lung adenocarcinoma, one bowel obstruction, one cardiac arrest and one chest sepsis. In total, 27 patients (23%) had their clozapine stopped on admission, 6 (22% of this group) unintentionally.

Conclusions:

Our study found that the most common reason for admission for patients taking clozapine was infection. Plasma concentrations were not measured routinely despite clozapine having a narrow therapeutic index and enhanced potential for toxicity in the medically unwell patient.
Intravesical gentamicin treatment for recurrent urinary tract infections: A systematic review over the last two decades
Authors: Rutherford Georgia , Tan Lieo Jiun , Aboumarzouk Omar , de Souza John , Khan Rehan , Somani Bhaskar , Amer Tarik
Published: December 2022

Objectives:

Recurrent urinary tract infections (rUTIs) have a significant effect on a patient’s quality of life and frequent use of antibiotics increases multi-drug resistance. Previous research on intravesical antibiotics suggests that this has a local effect on bacteria with reduced systemic absorption and associated side effects. We conducted a systematic review to assess the effectiveness and adverse effects of intravesical gentamicin treatment.

Methods:

Systematic review of all English published articles from January 2001 to October 2021 according to the Cochrane and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards.

Results:

A total of 139 studies were identified, 20 full-text articles were screened and 6 subsequently included totalling 166 patients. All studies reported a decrease in the mean number of urinary tract infections (UTIs) with a significant reduction ( p = 0.0025 and p < 0.004) in two studies. When the number of breakthrough UTIs on prophylactic gentamicin installations was assessed, 65% ( n = 86/133) remained UTI free. Throughout treatment, 99% of serum gentamicin levels were <0.3 ng/dL, and reported instances of increased creatinine were low (2%). A decrease in the growth of multi-drug-resistant bacteria was reported in two papers ( p = 0.065 and p = 0.04).

Conclusion:

Intravesical gentamicin seems to be an effective treatment in patients with symptomatic rUTIs. The evidence suggests it also reduces UTIs caused by multi-drug-resistant bacteria with no systemic absorption and minimal renal toxicity.

Level of evidence:

2a
The Effect of Primary Care Visits on Total Patient Care Cost: Evidence From the Veterans Health Administration
Authors: Gao Jian , Moran Eileen , Grimm Rachel , Toporek Andrew , Ruser Christopher
Published: December 2022

Background:

Since the 1980s, primary care (PC) in the US has been recognized as the backbone of healthcare providing comprehensive care to complex patients, coordinating care among specialists, and rendering preventive services to contain costs and improve clinical outcomes. However, the effect of PC visits on total patient care cost has been difficult to quantify.

Objective:

To assess the effect of PC visits on total patient care cost.

Methods:

This is a retrospective study of over 5 million patients assigned to a PC provider in the Veterans Health Administration (VHA) in each of the 4 fiscal years (FY 2016-2019). The main outcome of interest is total annual patient care cost. We assessed the effect of primary care visits on total patient care cost first by descriptive statistics, and then by multivariate regressions adjusting for severity of illness and other confounders. We conducted in-depth sensitivity analyses to validate the findings.

Results:

On average, each additional in-person PC visit was associated with a total cost reduction of $721 (per patient per year). The first PC visit was associated with the largest savings, $3976 on average, and a steady diminishing return was observed. Further, the higher the patient risk (severity of illness), the larger the cost reduction: Among the top 10% of high-risk patients, the first PC in-person visit was associated with a reduction of $16 406 (19%).

Conclusions:

These findings, substantiated by our exhaustive sensitivity analyses, suggest that expanding PC capacity can significantly reduce overall health care costs and improve patient care outcomes given the former is a strong proxy of the latter.
Parents’ Knowledge, Attitudes, and Practices of Childhood Obesity in Singapore
Authors: Straughan Paulin Tay , Xu Chengwei
Published: December 2022

The obesity pandemic is increasingly threatening Asian populations. This is especially so for children from higher-income countries, such as Singapore. Among the various driving factors of obesity, parents’ health knowledge, attitudes, and practices are underexplored. The present study uses a nationally representative sample of 1,491 responses from Singapore to investigate parental knowledge, attitudes, and practices (KAP) about childhood obesity. Latent class analysis (LCA) on parents’ responses to the KAP survey reveals four unique parenting patterns: the limited knowledge group, the group with negative attitudes, the best practice group, and the limited practice group. Children of families in the best practice group are shown to have the lowest obesity risk. Furthermore, statistically significant variations in parental subgroups are found across several socio-economic factors. For example, parents with positive responses to all KAP variables tend to be younger, have a higher household income, do not work full-time, and live in a separate household from the children’s grandparents. The findings may provide important policy implications for targeted preventative interventions for parents whose children may face higher obesity risks.
Evaluating the Impacts of Rice Technological Innovation on the Social Economy
Authors: Lijie An , Jiajia Hu , Qiong Li , Dong-Joo Kim
Published: December 2022

Grain production is important role in ensuring food security. In order to support the local government’s promotion of technological innovation on the rice plantations, the paper aims to evaluate chemical fertilizer reduction and productivity improvement technology modes in a rice paddy in Huai’an Jiangsu from the perspective of its evaluating the social economic effects. Firstly, a brief introduction of the rice plantation requirements including fertilizer and soil requirements, are introduced. Secondly, briefly introduce the most important factors impact rice technological modes including (Economic benefit, Social benefit, Technical characteristics, and management) are briefly discussed. Thirdly, details of multi-correlation of social economic model based on gray correlation analysis for the promotion of organic fertilizer to replace part of the chemical fertilizer technology, followed by the special fertilizer mode, and the other three technology modes. Results show that among the final weights obtained through the gray correlation weighting method, the economic benefit index was 27.15%, followed by the social benefit index with 21.45%, the technical feature index has the highest weight of 34.24%, and the management index with the lowest weight was 17.16%. The evaluation scores of the five technical modes, the ranking of their comprehensive evaluation score from high to low is mode 2 (0.305925) > mode 1 (0.240125) > mode 4 (0.179925) > mode 5 (0.1447) > mode 3 (0.129825). The application of mode 2, that is, the organic substitution of partial fertilizer technology, ranks the first among the five technical modes in the comprehensive evaluation; therefore, it is worthy of prioritization.
Exploring Emotional and Cognitive Priming Effects in Mediated Sports Using Psychophysiological Measures: How Sport Program-Induced Emotions and Ad Schema Congruity Influence Effectiveness of Advertising
Authors: Lee Minkyo , Read Glenna L.
Published: December 2022

The purpose of current study was to examine (1) the emotion transfer effect from sport programs and (2) program-ad congruity effects on the effectiveness of ads. A 2 (program-induced valence: pleasant, unpleasant) × 2 (program-induced arousal: arousing, calm) × 2 (advertising theme: sport, non-sport) within-subjects design, along with real-time psychophysiological measures, was employed to test the hypotheses. As predicted, an ad placed after a pleasant situation (favored team’s victory) was more effective than an ad placed after an unpleasant situation (favored team’s defeat). Also, an ad played after an arousing situation (close game) was more effective than an ad played after a non-arousing situation (lopsided game). Further, advertising effectiveness was greater for sport-themed ads (congruent) than non-sport-themed (non-congruent) ads. The findings suggest that the same ad can result in different persuasive impacts depending upon the emotional and cognitive context of the preceding sports program. The study offers new insights to existing sport marketing communication literature by examining emotional and cognitive priming effects in the context of sport media programing.
Nivolumab, Brentuximab Vedotin, +/- Bendamustine For R/R Hodgkin Lymphoma in Children, Adolescents, and Young Adults
Authors: Harker-Murray Paul , Mauz-Körholz Christine , Leblanc Thierry M , Mascarin Maurizio , Michel Gérard , Cooper Stacy , Beishuizen Auke , Leger Kasey J. , Amoroso Loredana , Buffardi Salvatore , Rigaud Charlotte , Hoppe Bradford S. , Lisano Julie M , Francis Stephen , Sacchi Mariana , Cole Peter D. , Drachtman Richard A. , Kelly Kara M. , Daw Stephen
Published: December 2022

Children, adolescents, and young adults (CAYA) with relapsed/refractory classical Hodgkin lymphoma (cHL) without complete metabolic response (CMR) before autologous hematopoietic cell transplantation (auto-HCT) have poor survival outcomes. CheckMate 744, a phase 2 study for CAYA (aged 5-30 years) with relapsed/refractory cHL, evaluated a risk-stratified, response-adapted approach with nivolumab plus brentuximab vedotin (BV) followed by BV plus bendamustine for patients with suboptimal response. Risk stratification was primarily based on time to relapse, prior treatment, and presence of B symptoms. We present the primary analysis of the standard-risk cohort. Data from the low-risk cohort are reported separately. Patients received 4 induction cycles with nivolumab plus BV; those without CMR (Deauville score >3, Lugano 2014) received BV plus bendamustine intensification. Patients with CMR after induction or intensification proceeded to consolidation (high-dose chemotherapy/auto-HCT per protocol). Primary endpoint was CMR any time before consolidation. Forty-four patients were treated. Median age was 16 years. At a minimum follow-up of 15.6 months, 43 patients received 4 induction cycles (1 discontinued); 11 of whom received intensification, 32 proceeded to consolidation. CMR rate was 59% after induction with nivolumab plus BV, and 94% any time before consolidation (nivolumab plus BV ± BV plus bendamustine). One-year PFS rate was 91%. During induction, 18% of patients experienced grade 3/4 treatment-related adverse events. This risk-stratified, response-adapted salvage strategy had high CMR rates with limited toxicities in CAYA with relapsed/refractory cHL. Most patients did not require additional chemotherapy (bendamustine intensification). Additional follow-up is needed to confirm durability of disease control. ClinicalTrials.gov: NCT02927769.
The 3-O sulfation of heparan sulfate proteoglycans contributes to the cellular internalization of tau aggregates
Authors: Ferreira Andreia , Royaux Ines , Liu Jian , Wang Zhangjie , Su Guowei , Moechars Diederik , Callewaert Nico , De Muynck Louis
Published: December 2022

Background

Considering the high correlation between the functional decline in Alzheimer’s disease (AD) and the propagation of aggregated tau protein, many research efforts are focused on determining the underlying molecular mechanisms of tau spreading. Heparan sulfate proteoglycans (HSPGs) were reported to mediate cellular uptake of tau aggregates. Specifically, the heparan sulfates (HS) sulfation plays a critical role in the interaction of HSPGs with aggregated tau. HS can be N−/2-O/6-O- or 3-O-sulfated, some of which have been reported to take part in the interaction with tau aggregates. However, the role of the 3-O sulfation remains enigmatic.

Results

Here, we studied the contribution of HS 3-O sulfation in the binding and cellular uptake of tau aggregates. We observed reduced tau aggregates uptake in absence of 3-O sulfation or when outcompeting available cellular 3-O sulfated HS (3S-HS) with antithrombin III. The lack of HS3ST1-generated HS products in the HS3ST1−/− cells was further corroborated with an LC-MS/MS using 13C-labeled HS calibrants. Here, we showed that these functional changes can be explained by a higher affinity of aggregated tau to 3S-HS. When targeting tau aggregates with 3-O sulfation-containing HS, we observed an increase in inhibition of tau aggregates uptake.

Conclusions

These data indicate that HS 3-O sulfation plays a role in the binding of tau aggregates and, thus, contributes to their cellular uptake, highlighting a potential target value to modulate tau pathogenesis.