bluuebunny/crossref_metadata_2025 huggingface dataset:
Neoadjuvant Pembrolizumab and Radical Cystectomy in Patients with Muscle-Invasive Urothelial Bladder Cancer: 3-Year Median Follow-Up Update of PURE-01 Trial
Authors: Basile Giuseppe , Bandini Marco , Gibb Ewan A. , Ross Jeffrey S. , Raggi Daniele , Marandino Laura , Costa de Padua Tiago , Crupi Emanuele , Colombo Renzo , Colecchia Maurizio , Lucianò Roberta , Nocera Luigi , Moschini Marco , Briganti Alberto , Montorsi Francesco , Necchi Andrea
Published: October 2022

Purpose:

The PURE-01 study (NCT02736266) pioneered the neoadjuvant immune-checkpoint inhibitor (ICI) therapy before radical cystectomy (RC) in patients with muscle-invasive urothelial bladder carcinoma (MIBC). We herein present the survival outcomes after a median follow-up of three years.

Patients and Methods:

The intention-to-treat (ITT) population included 155 patients. Event-free survival (EFS) was defined as the time from pembrolizumab initiation until radiographic disease progression precluding RC, initiation of neoadjuvant chemotherapy, recurrence after RC, or death. Further outcomes were recurrence-free survival (RFS) post-RC and overall survival (OS). Multivariable Cox regression analyses for EFS were performed. Kaplan–Meier analyses compared EFS outcomes according with baseline programmed cell-death-ligand-1 (PD-L1) combined positive score (CPS) and according to the molecular subtypes.

Results:

After a median (interquartile range, IQR) follow-up of 39 (30–47) months, 36-month EFS and OS were 74.4% [95% confidence interval (CI), 67.8–81.7] and 83.8% (95% CI, 77.8–90.2) in the ITT population, respectively. Overall, 143 (92.3%) patients underwent RC. Within the cohort of patients who did not receive additional chemotherapy (N = 125), 36-month RFS was 96.3% (95% CI, 91.6–100) for patients achieving a ypT0N0, 96.1% (95% CI, 89–100) for ypT1/a/isN0, 74.9% (95% CI, 60.2–93) for ypT2–4N0, and 58.3% (95% CI, 36.2–94.1) for ypTanyN1–3 response. EFS was significantly stratified among PD-L1 tertiles (lower tertile: 59.7% vs. medium tertile: 76.7% vs. higher tertile: 89.8%, P = 0.0013). The claudin-low and basal/squamous subtypes displayed the lowest rates of events.

Conclusions:

At a median follow-up of three years, PURE-01 results further confirm the sustained efficacy of neoadjuvant pembrolizumab before RC. PD-L1 expression was the strongest predictor of sustained response post-RC.
Factors Affecting Pathologic Complete Remission in Patients with Hormone Receptor-Positive and Human Epidermal Growth Factor Receptor 2-Negative Breast Cancer Receiving Neoadjuvant Chemotherapy
Authors: Choi Hee Jun , Lee Jun Ho , Jung Chang Shin , Lee Jeong Eon , Jung Youn Joo , Lee Seungju , Kang Seok-Kyung , Kim Hyun Yul
Published: October 2022

Introduction: Pathological complete response (pCR) after neoadjuvant chemotherapy (NAC) is associated with improvement in survival outcomes. This study evaluated the pCR in patients with hormone receptor (HR)-positive and human epidermal growth factor receptor 2 (HER2)-negative breast cancer after NAC. Methods: We evaluated 417 patients who were diagnosed with invasive breast cancer and treated with NAC followed by curative surgery between January 2007 and December 2020 and analyzed the pCR for HR-positive and HER2-negative breast cancer. Results: The median age at the time of surgery was 45.4 years, and 9.1% of patients (38 of 417) with HR-positive/HER2-negative status had pCR. Among patients with HR-positive/HER2-negative breast cancer, patients with single HR-positivity had a 20.2% pCR rate, and patients with double HR-positivity had a 4.4% pCR rate. Patients with a high Ki-67 index exhibited a higher pCR rate than those with a lower Ki-67 index (14.5% vs. 3.2%). Patients with single HR-positive and high Ki-67 values exhibited a significantly higher pCR rate than those with double HR-positive and low Ki-67 values (27.8% vs. 2.1%; p < 0.001). Conclusion: NAC could improve prognosis in patients with HR-positive/HER2-negative breast cancer with a single HR-positive and high Ki-67 values.
Volumetric-Modulated Arc Therapy for Giant-Cell Tumor of Temporal Bone: An Illustrative Case Report
Authors: Kubo Katsumaro , Kenjo Masahiro , Tominaga Atsushi , Magaki Takuro , Kawabata Hideo , Miura Hideharu , Nagata Yasushi
Published: October 2022

Giant-cell tumor of the skull is extremely rare. Surgery is the main treatment for this disease, but not all cases are suitable for complete resection. In this report, we present the clinical features of a case of giant-cell tumor of temporal bone that demonstrated good outcome after radiation therapy (RT) using volumetric-modulated arc therapy (VMAT). The patient was a 55-year-old man with giant-cell tumor of temporal bone who received surgery as the first treatment. Three months after the initial surgery, the tumor regrew, and the patient received surgical resection again. Although second partial resection was undergone, it regrew. Therefore, 36 months after initial surgery, RT was conducted. The prescribed dose was 54 Gy in 1.8 Gy fractions using VMAT. The tumor began to shrink from 4 months after the initiation of RT and kept shrinking slowly and gradually. At the last follow-up, there was no evidence of local recurrence. There was no report about VMAT for giant-cell tumor of the skull, and no report revealed the radiographic details after recent radiation techniques. Therefore, this case report was meaningful in describing the details and response during and after VMAT for giant-cell tumor of temporal bone. The adjuvant RT using VMAT seemed to demonstrate a sufficient local control benefit without severe adverse effects in our case with giant-cell tumor of temporal bone.
Applications of the Grading Scales for the Detection of Ototoxicity in Children after Treatment of Neuroblastoma and Extracranial Germinal Tumor
Authors: Polski Bartosz , Sosnowska-Sienkiewicz Patrycja , Szydłowski Jarosław , Januszkiewicz-Lewandowska Danuta
Published: October 2022

Introduction: Advances in treatment have resulted in a significant increase in survival rates for patients cured of malignant diseases such as neuroblastoma (NBL) and extracranial germ cell tumor (GCT). NBL is one of the pediatric cancers during which potentially ototoxic cytostatic drugs (cisplatin and carboplatin) are used for treatment. Other cancers include germinal tumors, hepatoblastoma, sarcomas, and brain tumors. Often, this very aggressive treatment has a high risk of causing long-term side effects, including hearing loss. Hence, the present study aimed to evaluate the usefulness of the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE), Brock, Chang, and International Society of Pediatric Oncology (SIOP) Boston scales in terms of detecting the high-frequency nature of hearing loss induced by ototoxic drugs and monitoring hearing status in children after completion of oncological treatment. Additionally, the frequency of hearing loss in children treated for NBL and extracranial GCT was assessed, and the principles of monitoring hearing in these patients were indicated. Methods: The study group consisted of 78 patients diagnosed with NBL (n = 47) and GCT (n = 31). There were 23 boys and 24 girls in the NBL group, aged 0–16 years, and 21 boys and 10 girls in the GCT group, aged 0–18 years. The control group consisted of 54 patients who had never received oncological treatment, were not taking potentially ototoxic drugs, and appeared socially efficient in the subjective audiological assessment. Audiometric examinations and DP-acoustic otoemission measurements were performed. Additionally, impedance audiometry tests were done to exclude a possible conductive component of the hearing loss. Results: The analysis shows that ototoxicity-induced hearing loss was observed in 13.8–65.5% of children. 75.9% of patients showed hearing loss in the 16 kHz frequency range, and at least 56.8% of patients showed hearing loss in the frequency range above 12.5 kHz. Hearing impairment, relevant to speech understanding, was displayed by more than 40% of children treated for NBL and GCT. Conclusions: The confirmation of hearing loss in nearly 65% of cases in both patients indicates the necessity to monitor the long-term side effects of anticancer treatment. Acoustic otoemission measurements, the adoption of articulatory indices based on an audiogram, or the use of arbitrary ototoxicity assessment scales such as Brock, Chang, or SIOP Boston are fully justified techniques for studying ototoxicity induced by cytostatic drugs. However, they all require continuous improvement to increase their sensitivity and specificity, especially in the pediatric group.
Migraine, Words and Fiction. Book Review
Authors: Koehler Peter J.
Published: October 2022

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Cervical Liposarcoma Revisited: A Case Report and Scoping Literature Review
Authors: Suzuki Takahiro , Noguchi Naoya , Shirane Shion , Ansai Nanako , Sato Teruyuki , Ise Kazue , Murakami Keigo , Murakami Kazuhiro , Nakamura Yasuhiro , Ohta Nobuo
Published: October 2022

The commonest sites for liposarcoma are the retroperitoneum and lower extremities. Liposarcoma of the head and neck region is a rare and potentially life-threatening malignancy. Tumors originating in the right cervical space cause special diagnostic and therapeutic difficulties. In the present report, we describe a case of differentiated liposarcoma of the right cervical region. The tumor continued to grow slowly over 3 years before a definitive diagnosis was established. Extended extirpation of the tumor was performed and proved efficacious in that no recurrence has been observed for 4 years. Recommendations for earlier and accurate diagnosis and treatment of this rare neoplasm are discussed.
The Prognostic Utilities of DNA Mismatch Repair Status and KRAS and BRAF Mutation in Korean Colorectal Cancer Patients: The KASID Multicenter Study
Authors: Kim Tae-Woo , Hwang Soon Woo , Kim Kyeong Ok , Cha Jae Myung , Joo Young-Eun , Cho Young-Seok
Published: October 2022

Introduction: KRAS, BRAF, and DNA mismatch repair (MMR) mutations aid clinical decision-making for colorectal cancer (CRC) patients. To ensure accurate predictions, the prognostic utilities of these biomarkers and their combinations must be individualized for patients with various TNM stages. Methods: Here, we retrospectively analyzed the clinicopathological features of 904 Korean CRC patients who underwent CRC surgery in three teaching hospitals from 2011 to 2013; we also assessed the prognostic utilities of KRAS, BRAF, and MMR mutations in these patients. Results: The overall frequencies of KRAS and BRAF mutations were 35.8% and 3.2%, respectively. Sixty-nine patients (7.6%) lacking expression of ≥1 MMR protein were considered MMR protein deficient (MMR-D); the remaining patients were considered MMR protein intact. KRAS mutations constituted an independent risk factor for shorter overall survival (OS) in TNM stage I–IV and stage III patients. BRAF mutations were associated with shorter OS in TNM stage I–IV patients. MMR-D status was strongly positive prognostic in TNM stage I–II patients. Discussion/Conclusion: To our knowledge, this is the first multicenter study to explore the prognostic utilities of KRAS, BRAF, and MMR statuses in Korean CRC patients. Various combinations of KRAS, BRAF, and DNA MMR mutations serve as genetic signatures that affect tumor behavior; they are prognostic in CRC patients.
A learning-based approach to breast cancer screening using mammography images
Authors: Shaikh Khalid , Krishnan Sabitha , Thanki Rohit
Published: October 2022

The current big challenge facing radiologists in healthcare is the automatic detection and classification of masses in breast mammogram images. In the last few years, many researchers have proposed various solutions to this problem. These solutions are effectively dependent and work on annotated breast image data. But these solutions fail when applied to unlabeled and non-annotated breast image data. Therefore, this paper provides the solution to this problem with the help of a neural network that considers any kind of unlabeled data for its procedure. In this solution, the algorithm automatically extracts tumors in images using a segmentation approach, and after that, the features of the tumor are extracted for further processing. This approach used a double thresholding-based segmentation technique to obtain a perfect location of the tumor region, which was not possible in existing techniques in the literature. The experimental results also show that the proposed algorithm provides better accuracy compared to the accuracy of existing algorithms in the literature.
Automated detection of fake news
Authors: Fayez Eslam , Aboutabl Amal Elsayed , Abdulkader Sarah N.
Published: October 2022

During the last decade, the social media has been regarded as a rich dominant source of information and news. Its unsupervised nature leads to the emergence and spread of fake news. Fake news detection has gained a great importance posing many challenges to the research community. One of the main challenges is the detection accuracy which is highly affected by the chosen and extracted features and the used classification algorithm. In this paper, we propose a context based solution that relies on account features and random forest classifier to detect fake news. It achieves the precision of 99.8%. The system accuracy has been compared to other commonly used classifiers such as decision tree classifier, Gaussian Naïve Bayes and neural network which give precision of 98.4%, 92.6%, and 62.7% respectively. The experiments’ accuracy results show the possibility of distinguishing fake news and giving credibility scores for social media news with a relatively high performance.
A comparison of different methods of identifying publications related to the United Nations Sustainable Development Goals: Case study of SDG 13—Climate Action
Authors: Purnell Philip J.
Published: October 2022

As sustainability becomes an increasing priority throughout global society, academic and research institutions are assessed on their contribution to relevant research publications. This study compares four methods of identifying research publications related to United Nations Sustainable Development Goal 13—Climate Action (SDG 13). The four methods (Elsevier, STRINGS, SIRIS, and Dimensions) have each developed search strings with the help of subject matter experts, which are then enhanced through distinct methods to produce a final set of publications. Our analysis showed that the methods produced comparable quantities of publications but with little overlap between them. We visualized some difference in topic focus between the methods and drew links with the search strategies used. Differences between publications retrieved are likely to come from subjective interpretation of the goals, keyword selection, operationalizing search strategies, AI enhancements, and selection of bibliographic database. Each of the elements warrants deeper investigation to understand their role in identifying SDG-related research. Before choosing any method to assess the research contribution to SDGs, end users of SDG data should carefully consider their interpretation of the goal and determine which of the available methods produces the closest data set. Meanwhile, data providers might customize their methods for varying interpretations of the SDGs.
Implementation and Evaluation of a Prior Authorization Workflow for New-Start Inpatient Medications in Preparation for Discharge
Authors: Forshay Charlotte M. , Mellett John , Worley Marcia M. , Carnes Cynthia A. , Fernandes Andre , Jordan Trisha A.
Published: October 2022

Purpose: Medications that require prior authorization can complicate the discharge planning process. This study implemented and evaluated a process for identifying and completing prior authorizations during the inpatient setting prior to patient discharge. Methods: A patient identification tool was developed within the electronic health record to alert the patient care resource manager of inpatient orders for targeted medications that frequently require prior authorization with the potential to delay discharge. A workflow process using the identification tool and flowsheet documentation was developed to prompt the initiation of a prior authorization, if necessary. Following hospital-wide implementation, descriptive data for a 2-month period was collected. Results: The tool detected 1353 medications for 1096 patient encounters over the 2-month period. The most frequent medications identified included apixaban (28.1%), enoxaparin (14.4%), sacubitril/valsartan (6.4%), and darbepoetin (6.4%). For the medications identified, there were 93 medications documented in the flowsheet data for 91 unique patient encounters. Of the 93 medications documented, 30% did not require prior authorization, 29% had prior authorization started, 10% were for patients discharged to a facility, 3% were for home medications, 3% were medications discontinued at discharge, 1% had prior authorization denied, and 24% had missing data. The most frequent medications documented in the flowsheet included apixaban (12%), enoxaparin (10%), and rifaximin (20%). Of the 28 prior authorizations processed, 2 led to a referral to the Medication Assistance Program. Conclusion: The implementation of an identification tool and documentation process can help improve PA workflow and discharge care coordination.
Book review: Bala Ramulu Chinnala, Marginalized Communities and Decentralized Institutions in India: An Exclusion and Inclusion Perspective
Authors: Ravinder D.
Published: October 2022

Bala Ramulu Chinnala, Marginalized Communities and Decentralized Institutions in India: An Exclusion and Inclusion Perspective. New York: Routledge (South Asia Edition), 2021, xviii + 141, pp. ₹995.
Disposable Spaces: How Special Education Enrollment Affects School Closures
Authors: Weber Rachel N. , Waitoller Federico R. , Drucker Joshua M.
Published: October 2022

Informed by austerity politics, struggling school districts have closed buildings to pursue cost savings. We investigate the factors affecting which schools are shuttered, proposing that the share of students with an Individualized Education Program (SIEP) influences the way building utilization is measured because of the different instructional spaces required. We examine the case of elementary schools in Chicago, where 44 of 402 schools were closed in 2013. Simulating administrative decision-making parameters with a logistic regression model and demographic, student, and school data, we find that Chicago Public Schools was more likely to close school buildings with higher shares of SIEPs. Such punitive measures reflect the politics of austerity and disposability, leaving students with disabilities, particularly those in low-income neighborhoods of color, with fewer educational options.
The Decline of U.S. Labor Unions: Import Competition and NLRB Elections
Authors: Schaller Zachary
Published: October 2022

Why has private sector union participation fallen away so much in the United States since the late 1950s? Featuring an improved dataset on National Labor Relations Board (NLRB) representation elections, I present evidence that import penetration accounts for approximately 40 percent of the decline in union formation for U.S. manufacturing. This estimate translates to 4.6 percent of the decline in private sector union density. The effect is driven by trade with low-income countries and, to some extent, other high-income countries. China is not a factor early on, but their strong import growth since 2000 can account for about 12 percentage points of the total decline.
Factors Affecting Information and Communication Technology Use for University Students With and Without Learning Disabilities
Authors: Wu Ting-Fang , Chen Cheng-Ming
Published: October 2022

The purpose of the current study was to develop an appropriate model to represent the relationships among all the significant factors about information and communication technology use for university students, both with and without learning disabilities. This study was conducted in Taiwan with a sample consisting of an international array of research participants. A 40-item researcher-developed questionnaire was used to collect data from 400 students with learning disabilities and 747 students without disabilities. The structural equation modeling approach was a good model fit for both the measurement and structural models. The results indicated that the model proposed can explain the use of information and communication technology by students both with and without learning disabilities in universities. The model can explain 92% of information and communication technology use for students without learning disabilities, and 73% of that for students with learning disabilities. The present study illustrated that a model developed through structural equation modeling could demonstrate structural relations of the essential factors and information and communication technology usage for universities students, both with and without learning disabilities, in a holistic and comprehensive framework.
Reliability and Validity of the Adolescence Stress Scale (ADOSS) for Indian Adolescents
Authors: Jagannathan Narayanaswamy , Anjana Ranjit Mohan , Mehreen Thaharullah Shah , Yuvarani Kanniyappan , Sathishkumar Dhanasekar , Poongothai Subramani , Mohan Viswanathan , Latha Sathish , Ranjani Harish
Published: October 2022

Background:

Stress levels increase tremendously in adolescence. Indian adolescents derive much of their stress from school and family pressures. Developing a standardized tool to assess adolescent stress can help early diagnosis. This article aimed to assess the reliability and validity of the ADOlescence Stress Scale (ADOSS).

Methods:

ADOSS was administrated by trained interviewers to 100 adolescents (10–17 years) of both sexes in Chennai, South India. Salivary cortisol was used as an objective measure of stress in 40 adolescents. Reliability was assessed within a two weeks interval. Exploratory factor analysis was done for the baseline ADOSS scores. The internal consistency (Cronbach’s alpha and spilt-half correlation), test-retest agreement (Kappa value), and inter-rater reliability (ICC) were assessed. Pearson correlation between salivary cortisol and ADOSS score was done.

Results:

The inter-factor correlation between the inherent four ADOSS factors (personal, academic, family, and social) was between 0.73 and 0.87, and split-half correlation was between 0.70 and 0.83, showing that the factors are reliable and coherent. Test-retest agreement was Kappa: 0.63, P = 0.001, and ICC was 0.84. Pearson correlation showed a statistically significant positive correlation between cortisol levels and ADOSS scores ( r = 0.87, P = 0.001).

Conclusion:

ADOSS is a reliable and valid tool to assess the overall stress of Indian adolescents in the age group of 10–17 years.
Landlords of the internet: Big data and big real estate
Authors: Greene Daniel
Published: October 2022

Who owns the internet? It depends where you look. The physical assets at the core of the internet, the warehouses that store the cloud’s data and interlink global networks, are owned not by technology firms like Google and Facebook but by commercial real estate barons who compete with malls and property storage empires. Granted an empire by the US at the moment of the internet’s commercialization, these internet landlords shaped how the network of networks that we call the internet physically connects, and how personal and business data is stored and transmitted. Under their governance, internet exchanges, colocation facilities, and data centers take on a double life as financialized real estate assets that circle the globe even as their servers and cables are firmly rooted in place. The history of internet landlords forces a fundamental reconsideration of the business model at the base of the internet. This history makes clear that the internet was never an exogenous shock to capitalist social relations, but rather a touchstone example of an economic system increasingly ruled by asset owners like landlords.
Morphometric and Biomechanical Comparison of the Scapular Spine and Coracoid Graft in Anterior Shoulder Instability
Authors: Kuan Fa-Chuan , Hsu Kai-Lan , Lin Fang-Hsien , Hong Chih-Kai , Chen Yueh , Shih Chien-An , Su Wei-Ren
Published: October 2022

Background:

The scapular spine has been described as a relatively new bone graft alternative used in glenoid augmentation. The classic Latarjet procedure, which transfers the coracoid as a graft, is regarded as the gold standard. The comparison of these 2 techniques has not been fully reported.

Purpose:

To compare the anatomic and biomechanical properties of glenoid augmentation using scapular spine graft or coracoid graft.

Study Design:

Controlled laboratory study.

Methods:

The study used 20 fresh-frozen human cadaveric shoulders. A 25% anterior glenoid defect was created, and the specimens were divided randomly to receive glenoid augmentation by scapular spine or coracoid grafts. For both procedures, the grafts were secured to the glenoid defect with 2 screws. Morphometric data, including the glenoid articular area, amount of restoration, and graft dimensions, were obtained. A biomechanical test was conducted in a direct-loading scenario. The construct stiffness, cyclic displacement, and ultimate failure of each specimen were collected.

Results:

No significant difference was found in glenoid articular restoration between the scapular spine group and the coracoid group (31% vs 33%, respectively; P = .311). Morphometric analysis indicated that coracoid grafts exhibited significantly greater thickness and height than scapular spine grafts. In biomechanical results, the scapular spine group exhibited significantly greater construct stiffness than the coracoid group (206.3 ± 58.8 vs 148.3 ± 76.0 N/mm, respectively; P = .023). The average failure load in the scapular spine group was not significantly higher than that in the coracoid group. No significant differences in cyclic displacement were found between the 2 techniques.

Conclusion:

In a simulated 25% anterior glenoid bony defect, a scapular spine graft was comparable with the classic Latarjet procedure in restoring the glenoid articular dimension and exhibited superior construct stiffness in a cadaveric model.

Clinical Relevance:

The scapular spine may serve as an alternative graft choice in glenoid augmentation surgery considering the amount of articular restoration and initial fixation stability.
Body Cameras and Adjudication: Views of Prosecutors and Public Defenders
Authors: Robertson O. Nicholas , McCluskey John D. , Smith Shakierah S. , Uchida Craig D.
Published: October 2022

The jury serves as an important reference point for criminal case processing, despite the fact that the majority of cases are disposed of by pleas or dismissals. This research examines the downstream impact of BWC footage on the adjudication process with a particular emphasis on the management of uncertainty. Research involved interviews with prosecutors and defense attorneys in urban counties in California, New York, and Texas. The results indicate that both defense and prosecution anticipate BWC changing approaches to cases and how cases may be negotiated to an outcome. They also report that jurors expect BWC footage, and that it functions as a means to establish case facts and the credibility of police, the defendant and witnesses. Policy implications regarding the introduction of BWC and future directions for research are discussed.
Intragovernmental Grant Distribution and Party Alignment Bias under Democratic and Authoritarian Governments: The Case of Poland
Authors: Siwińska-Gorzelak Joanna , Bukowska Grażyna
Published: October 2022

This article studies the party alignment bias in Poland. Relying on quasi-experimental regression discontinuity design and 2006–2019 data for over 2,400 municipalities, we aim to establish whether the impact of political alignment on the distribution of grants from the central to the local governments has increased under the rules of populist, authoritarian government. We report robust evidence that provides an affirmative answer to this question.
A Pilot Randomized Controlled Trial of an Online Educational Program for Primiparous Women to Improve Breastfeeding
Authors: Wong Mei Sze , Chien Wai Tong
Published: October 2022

Background:

There are different approaches to breastfeeding interventions, but the global 6-month exclusive breastfeeding rates remain suboptimal. The COVID-19 pandemic has brought extra difficulties in promoting breastfeeding.

Research Aim:

To test the feasibility and effectiveness of a theory-based, real-time online educational and support program for breastfeeding related outcomes.

Methods:

An assessor-blinded, prospective pilot randomized controlled trial with parallel-group, repeated-measures design was used. The sample was low-risk primiparous mothers ( N = 40) who delivered in the local public hospitals. Study outcomes consisted of exclusive breastfeeding rate, breastfeeding self-efficacy, and other breastfeeding outcomes measured by a self-reported questionnaire, including the Breastfeeding Self-Efficacy Scale and the Edinburgh Postnatal Depression Scale. Comparisons between the differences in the intervention and control groups were carried out.

Results:

Thirteen participants in the intervention group successfully completed the program. They had a higher exclusive breastfeeding rate, breastfeeding self-efficacy, breastfeeding initiation rate, and longer exclusive breastfeeding duration than the control group. Additionally, the intervention group had a lower partial breastfeeding rate, and a higher maternal postnatal depression score and infant’s morbidity at postnatal 2 months. However, all the results were not statistically significant ( p > .050). Overall, the intervention was highly valued by all participants who appreciated the regular postnatal follow-ups.

Conclusions:

Despite showing the satisfactory feasibility of the program, no significant improvements were found in all study outcomes. Considering the participants’ comments, we suggest refining and further testing the intervention with a larger sample size over a longer-term follow-up to confirm its effectiveness. This study has been registered at ClinicalTrials.gov (NCT04741425)
An accurate and numerically efficient time-varying mesh stiffness model for modified straight bevel gear under load
Authors: Chen Siyu , Tan Rulong , Guo Xiaodong , Zhang Weiqing , Shu Ruizhi
Published: October 2022

Gear time-varying mesh stiffness (TVMS) plays an important role in the analysis accuracy of a gear transmission mechanism. In previous research, the TVMS of a modified straight bevel gear (SBG) was mainly obtained by the finite element method (FEM), whose computation time is usually long to ensure computational accuracy. By contrast, this work proposes a fast calculation method with high accuracy for the TVMS of a modified SBG. First, B-spline surfaces are introduced to reconstruct a modified SBG using discrete tooth surface points. Next, based on the tooth contact analysis and loaded tooth contact analysis, combined with energy conservation principle and infinitesimal method, a semi-analytical instantaneous single mesh stiffness (SMS) model for the modified SBG is derived. Then, using the additional deformation compatibility condition and principle of force balance, the calculation method of the TVMS of the modified SBG is obtained. Finally, a comparison of the mesh stiffness calculation results between the method of this study and that of FEM is completed. The results show that the semi-analytical TVMS model used in this study can be accurately and quickly solved.
Amended Safety Assessment of Triglycerides as Used in Cosmetics
Authors: Fiume Monice M. , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Marks James G. , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Heldreth Bart
Published: October 2022

The Expert Panel for Cosmetic Ingredient Safety (Panel) assessed the safety of 51 triglycerides; 25 of these ingredients were previously reviewed by the Panel, and 26 are reviewed herein for the first time. The majority of the ingredients named in this assessment have several functions, with most reported to function as skin conditioning agents (occlusive or emollient) and/or viscosity increasing agents in cosmetics; some are also reported to function as a fragrance or solvent. The Panel reviewed relevant new data, including frequency and concentration of use, and considered the data from previous reports. The Panel concluded the 51 triglycerides reviewed in this report are safe in cosmetics in the present practices of use and concentration described in this safety assessment.
What is the outcome after a Girdlestone resection arthroplasty following a hip fracture?
Authors: Shah Nikki , Parker Martyn J
Published: October 2022

Background:

Joint infections or the complications of hip surgery may necessitate a Girdlestone resection arthroplasty. This is often kept as a last resort for patients with significant co-morbidities or when other treatments have been ineffective. The aim of this study was to define the outcome after Girdlestone excision arthroplasty when undertaken as a primary or secondary procedure for a hip fracture.

Patients and methods:

This is a retrospective review of a prospectively collected database involving 36 patients who underwent a Girdlestone procedure over a 30-year period. It compares the outcome for the 19 patients who survived to 1 year with those of 38 matched hip fracture patients.

Results:

Pain persisted in most patients after the procedure and was universal in those patients who could walk. Most patients experienced a significant loss of independence and a reduction in mobility status: 12/19 (63.1%) of those who survived to 1 year were immobile and of the remainder, all needed a Zimmer frame to walk. Overall, 41.7% of patients had died within 1 year of undergoing the procedure.

Conclusions:

This study concludes that Girdlestone resection arthroplasty after a hip fracture is associated with a high degree of morbidity and mortality and therefore, should only be used as a salvage procedure after all other surgical measures have been exhausted.
A Phase 1 randomized study of GSK3732394, an investigational long-acting biologic treatment regimen for HIV-1 infection
Authors: Krystal Mark , Chabria Shiven , Austin Daren , Wolstenholme Allen , Wensel David , Lataillade Max , Abberbock Judah , Baker Mark , Ackerman Peter
Published: October 2022

Background

The GSK3732394 multivalent protein was developed as a novel, long-acting, antiretroviral biologic treatment regimen with three independent, non–cross-resistant mechanisms for inhibiting HIV-1 entry.

Methods

A single-centre, Phase 1, double-blind, randomized, placebo-controlled study was conducted in healthy volunteers, using a 2-part adaptive study design: in Part 1, participants were randomized to receive subcutaneous injection of GSK3732394 or placebo (3:1) as single ascending doses (10-mg starting dose); in Part 2, participants were intended to receive multiple ascending doses. Primary and secondary objectives included safety, pharmacokinetics (PK) and pharmacodynamics (PD; cluster of differentiation four receptor occupancy [CD4 RO]) of GSK3732394 in healthy adults; PK/PD results in healthy volunteers were used to project HIV-1 treatment success.

Results

The most frequently reported adverse event was injection site reactions (ISRs; 8/18 [44%]). Most ISRs were mild (Grade 1–2; n = 7); one participant experienced a Grade 3 ISR (erythema ≥10 cm). All ISRs were delayed in onset (after Day 10). GSK3732394 demonstrated linear PK across all cohorts. Clearance was faster than expected, and PK/PD results were lower than expected, with the maximum dose investigated (80 mg) achieving mean trough CD4 RO of ∼25% on Day 7. The study was terminated as the PK/PD model linking PK and CD4 RO indicated that the maximum planned doses would not achieve the desired therapeutic profile.

Conclusions

This study demonstrated successful deployment of PK/PD dose relationships in the design and conduct of clinical trials by leveraging the findings toward predicting probability of success, resulting in appropriate early termination ( ClinicalTrials.gov , NCT03984812).
Assessing how Spirituality Affects Resiliency in the Pediatric Healthcare Practitioner
Authors: Fowler Emily K.
Published: October 2022

A literature review was conducted to examine the role of spirituality with resiliency in the pediatric workplace. Two themes emerged from the literature review: healthcare practitioners desire to have a sense of belonging at work and the utilization of chaplains is helpful. This study aims to discover how practitioners experience spiritual health in the workplace and identify interventions that enhance resiliency with the challenges of pediatrics. Implications from this study are applied to chaplaincy and research.
Postmortem Genetic Testing Is an Increasingly Utilized Tool in Death Investigation
Authors: Latimer Rebecca , MacLeod Heather , Dellefave-Castillo Lisa , Macaya Daniela , Hart Tara R.
Published: October 2022

Introduction:

Postmortem genetic testing (PMGT) can provide valuable information about an individual’s cause of death and potentially allow at-risk relatives to discern their risks for inherited cardiac disease. Postmortem genetic testing is most often successful with certain specimens.

Methods:

Investigators collected data on postmortem referrals to GeneDx, LLC for PMGT. Orders were reviewed and stratified based on provider, specimen type, and tests ordered.

Discussion:

This cohort included 601 deceased individuals referred for PMGT with a total of 673 genetic tests ordered from 247 different providers. The most common test categories ordered were arrhythmia (33.4%) and cardiomyopathy (29.3%). A likely pathogenic or pathogenic genetic variant was identified in approximately 15% of patients. Blood in EDTA was received for 21.6% of patients with a 95% success rate for completion of all test components. Blood samples in EDTA were most successful in completing PMGT, but sequencing was still successful in the majority of suboptimal specimens.

Conclusion:

The use of PMGT is increasing. Obtaining optimal samples (blood in EDTA) is important for successful completion of genetic testing. Obstacles may still exist for obtaining and storing ideal specimens. Continued efforts are needed for education and awareness around appropriate specimen types, storage and shipping of specimens, DNA banking, and overall availability of PMGT. In addition, access to resources such as supplies, proper storage conditions, DNA banking, and PMGT will allow for more opportunities to complete testing.
Integrating hand exoskeletons into goal-oriented clinic and home stroke and spinal cord injury rehabilitation
Authors: Yurkewich Aaron , Ortega Sara , Sanchez José , Wang Rosalie H , Burdet Etienne
Published: October 2022

Introduction

Robotic exoskeletons are emerging as rehabilitation and assistive technologies that simultaneously restore function and enable independence for people with disabilities.

Aim

We investigated the feasibility and orthotic and restorative effects of an exoskeleton-supported goal-directed rehabilitation program for people with hand impairments after stroke or Spinal Cord Injury (SCI).

Method

A single-arm case-series feasibility study was conducted using a wearable untethered hand exoskeleton during goal-directed therapy programs with in-clinic and at-home components. Therapists trained stroke and SCI patients to use a hand exoskeleton during rehabilitation exercises, activities of daily living and patient-selected goals. Each patient received a 1-hour in-clinic training session on five consecutive days, then took the exoskeleton home for two consecutive days to perform therapist-recommended tasks. Goal Attainment Scaling (GAS) and the Box and Block Test (BBT) were administered at baseline, after in-clinic therapy and after home use, with and again without wearing the exoskeleton. The System Usability Scale (SUS), Motor Activity Log, and Fugl-Meyer Assessment were also administered to assess the intervention’s acceptability, adherence, usability and effectiveness.

Results

Four stroke patients (Chedoke McMaster Stage of Hand 2–4) and one SCI patient (ASIA C8 Motor Stage 1) 23 ± 19 months post-injury wore the hand exoskeleton to perform 280 ± 23 exercise repetitions in the clinic and additional goal-oriented tasks at home. The patients performed their own goals and the dexterity task with higher performance following the 7-days therapy program in comparison to baseline for both exoskeleton-assisted (ΔGAS: 18 ± 10, ΔBBT: 1 ± 5) and unassisted (ΔGAS: 14 ± 14, ΔBBT: 3 ± 4) assessments. Therapists and patients provided ‘good’ SUS ratings of 78 ± 6 and no harmful events were reported.

Conclusions

The exoskeleton-supported stroke and SCI therapy program with in-clinic and at-home training components was feasible.
“You Know, I Swipe My Card and Hope for the Best”: Technology and Cognition as Dual Landscapes of Change
Authors: Heatwole Shank Kendra S.
Published: October 2022

Mild cognitive impairment (MCI), or objective and subjective cognitive decline, affects an estimated 15%–20% of individuals over the age of 65 . People with MCI generally live in community settings but may be at risk for functional changes in out-of-home participation, particularly when their instrumental activities are cognitively demanding or complex. Technology is part of the interface in complex person-place relationships. The purpose of this study is to examine the nature of everyday technology use in the context of out-of-home participation for community-dwelling older adults with MCI. Community-dwelling older adults with MCI (MoCA <26, >17; ( n = 10)) were recruited for data collection using a Go-along method (naturalistic observation, semi-structured interviews, and photography) for multiple out-of-home activities. Findings from this project suggested that participants felt that technology, like their cognition, was out of their control and difficult to predict or change. Four ways the participants experienced the “technology landscape” in their daily lives included: enabling being present, facilitating participation, impeding goals, and constricting options. We present a model of the intersection of cognition, participation, and technology in daily life, and discuss ways that technology can most effectively be used to extend well-being for a population aging in place.
A machine learning-based data mining in medical examination data: a biological features-based biological age prediction model
Authors: Yang Qing , Gao Sunan , Lin Junfen , Lyu Ke , Wu Zexu , Chen Yuhao , Qiu Yinwei , Zhao Yanrong , Wang Wei , Lin Tianxiang , Pan Huiyun , Chen Ming
Published: October 2022

Background

Biological age (BA) has been recognized as a more accurate indicator of aging than chronological age (CA). However, the current limitations include: insufficient attention to the incompleteness of medical data for constructing BA; Lack of machine learning-based BA (ML-BA) on the Chinese population; Neglect of the influence of model overfitting degree on the stability of the association results.

Methods and results

Based on the medical examination data of the Chinese population (45–90 years), we first evaluated the most suitable missing interpolation method, then constructed 14 ML-BAs based on biomarkers, and finally explored the associations between ML-BAs and health statuses (healthy risk indicators and disease). We found that round-robin linear regression interpolation performed best, while AutoEncoder showed the highest interpolation stability. We further illustrated the potential overfitting problem in ML-BAs, which affected the stability of ML-Bas’ associations with health statuses. We then proposed a composite ML-BA based on the Stacking method with a simple meta-model (STK-BA), which overcame the overfitting problem, and associated more strongly with CA (r = 0.66,P < 0.001), healthy risk indicators, disease counts, and six types of disease.

Conclusion

We provided an improved aging measurement method for middle-aged and elderly groups in China, which can more stably capture aging characteristics other than CA, supporting the emerging application potential of machine learning in aging research.
Genome-wide meta-QTL analyses provide novel insight into disease resistance repertoires in common bean
Authors: Rahmanzadeh Asma , Khahani Bahman , Taghavi S. Mohsen , Khojasteh Moein , Osdaghi Ebrahim
Published: October 2022

Background

Common bean (Phaseolus vulgaris) is considered a staple food in a number of developing countries. Several diseases attack the crop leading to substantial economic losses around the globe. However, the crop has rarely been investigated for multiple disease resistance traits using Meta-analysis approach.

Results and conclusions

In this study, in order to identify the most reliable and stable quantitative trait loci (QTL) conveying disease resistance in common bean, we carried out a meta-QTL (MQTL) analysis using 152 QTLs belonging to 44 populations reported in 33 publications within the past 20 years. These QTLs were decreased into nine MQTLs and the average of confidence interval (CI) was reduced by 2.64 folds with an average of 5.12 cM in MQTLs. Uneven distribution of MQTLs across common bean genome was noted where sub-telomeric regions carry most of the corresponding genes and MQTLs. One MQTL was identified to be specifically associated with resistance to halo blight disease caused by the bacterial pathogenPseudomonas savastanoipv.phaseolicola, while three and one MQTLs were specifically associated with resistance to white mold and anthracnose caused by the fungal pathogensSclerotinia sclerotiorumandColletotrichum lindemuthianum, respectively. Furthermore, two MQTLs were detected governing resistance to halo blight and anthracnose, while two MQTLs were detected for resistance against anthracnose and white mold, suggesting putative genes governing resistance against these diseases at a shared locus. Comparative genomics and synteny analyses provide a valuable strategy to identify a number of well‑known functionally described genes as well as numerous putative novels candidate genes in common bean,Arabidopsisand soybean genomes.