bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychometric Properties of a Self-Perception Questionnaire for Adults with Suspected Misophonia
Authors: Castillo Benjamín J. , Muñoz-Quezada María T. , Lucero Boris A.
Published: October 2024

Misophonia is a disorder of decreased tolerance to specific sounds or stimuli associated with such sounds, called triggers. The aim was to validate a questionnaire on self-perception of the type of sound, visual identification, and origin of sounds in adults with suspected misophonia by Spanish-speaking people. An interview was conducted with a total of 395 participants, divided into four distinct blocks of questions: the trigger of misophonia, the visual identification of gestures or actions related to selective sounds, the emotional closeness between listener and sender, and the impact on the daily personal relationships of the person with misophonia. Each block used classical test theory to factorially validate the instrument. The first group of questions gave as a result four factors: mouth and throat sounds, environmental sounds, material sounds, and pronunciation sounds (Cronbach’s alpha = .929; KMO = 0.894). The second group identified two dimensions of reaction to actions and gestures, one related to movements of the mouth and throat and the second to body movements or exaggerated gesticulation (Cronbach’s alpha = .840; KMO = 0.819). The third block linked low and high emotional closeness factors (Cronbach’s alpha = .690; KMO = 0.633). The fourth block obtained a factor for daily chores and another for affective relationships (Cronbach’s alpha = .861; KMO = 0.820). The questionnaire offers valuable insights into the nature of misophonia, and the necessity for further research in this field. These findings emphasize the importance of developing a comprehensive understanding of misophonia to enhance diagnosis.
Daily Life Experiences of People with Dementia with Lewy Bodies: A Qualitative Study
Authors: Yumoto Akiyo , Suwa Sayuri
Published: October 2024

Dementia with Lewy bodies (DLB) is the second most common cause of dementia and is associated with unique difficulties due to its characteristic symptoms. This study aimed to identify daily life changes experienced by people with DLB due to characteristic symptoms other than visual hallucinations. Semi-structured interviews and content analyses were conducted on 13 people with DLB and their 17 family members. Qualitative content analysis identified three categories of difficulties experienced by people with DLB in daily life: body discomfort, obstacles in daily life, and psychological pain. Participants experienced not only physical changes due to symptoms such as cognitive fluctuations, parkinsonism, and rapid eye movement sleep behavior disorder but also psychological pain related to daily life difficulties. This suggests the need for care that appreciates the unique experiences of people with DLB and includes psychological care to develop appropriate individual coping strategies, rather than focusing solely on alleviating physical symptoms.
The Development of Cultural Intelligence (CQ) in Situated Learning
Authors: Teixeira Kézia Andrade da Silva , Zanela Klein Amarolinda
Published: October 2024

The development of cultural intelligence is considered a crucial attribute for global leaders as it allows them to go through and work effectively in diverse cultural environments. Previous studies have shown that this intelligence, which can be measured through the Cultural Quotient (CQ) concept, is primarily developed through the experiences of individuals interacting with other cultures. However, there is a lack of research on how this occurs during an intercultural experience. This study aims to answer the following question: how situated learning contributes to the development of Cultural Intelligence (CQ) during international experiences? The research method was netnography. Using a mobile application, we followed 12 undergraduate management students during 6 months of their academic international exchanges in five different countries. We collected archival data, extracted data, and field note data. The main findings indicate that CQ primarily develops through everyday activities and interactions with locals and foreigners of various nationalities. Close relationships, friendships, trigger events, and the materiality of culture are critical factors in the development of CQ, particularly in the motivational and cognitive dimensions. In conclusion, the development of CQ is considered an essential factor for cross-cultural management success, as it provides the knowledge, skills, and abilities to effectively communicate, adapt and lead in a culturally diverse environment.
The Effect of Combinations of Task Relevance and Message Components on Construal Level and Purchase Intent: An Experimental Study on Female Students
Authors: Shin Myoungjin , Shin Sujeong
Published: October 2024

We conducted two experiments to determine how the combination of task relevance, loss framing, and psychological distance affects changes in construal level, emotion intensity, and purchase intent. Experiment 1 investigated how construal level fit between the loss and proximal frames affected emotion intensity and purchase intention for skin beauty items among 217 female students in their 20s using the construal matching hypothesis (CMH). Experiment 2 examined how changes in construal level caused by the combination of task relevance and loss framing affect purchase intention among 41 female students in their 20s. We discovered that combining the loss and proximal frames boosted the emotional intensity of worry and raised purchase intention for low-concept marketed products. Meanwhile, the loss frame message produced a high construal level through self-affirmation in individuals with high task relevance, lowering purchase intention for advertising that emphasized tangible facts. We provide an in-depth discussion of the implications and limitations of our findings, as well as future research prospects.
Development of a Second Primary Lung Cancer Following a Primary Breast Cancer: A Case Series
Authors: Sua Luz F. , Osorio Álvaro E. , Zuñiga-Restrepo Valeria , Ibarra Ciro D. , Quintero Natalia , Fernández-Trujillo Liliana
Published: October 2024

Breast cancer (BC) accounts for 24.2% of all women’s malignant tumors, with rising survival rates due to advancements in chemotherapy and targeted treatments. However, second primary cancers, particularly lung cancer (LC), have become more prevalent, often emerging approximately 10 years after BC treatment. This study presents a case series of 9 women diagnosed with second primary LC following BC, treated at a high-complexity hospital in Colombia between 2014 and 2019. All initial BCs were ductal carcinomas, 7 were triple negative, 1 was human epidermal growth factor receptor 2 positive, and 1 was estrogen and progesterone positive. Each patient had undergone radiation therapy, and 7 had received chemotherapy, increasing their LC risk. The second primary LCs, all adenocarcinomas, were confirmed using immunohistochemical stains for thyroid transcription factor-1 (TTF-1), Napsin A, and estrogen receptor (ER) status. The interval between treatments and LC detection ranged from 1 to 17 years, with 4 cases identified after 10 years and 3 within 1 to 3 years, underscoring the need for prolonged surveillance. Seven LCs were ipsilateral to the BC and radiation site, while 2 were contralateral, highlighting the necessity of monitoring both sides for potential LC development. This case series enhances the local epidemiological understanding, showing that prior radiotherapy for BC and histological analysis are key in characterizing second primary LC patients. The study emphasizes the critical role of accurate histological diagnosis in guiding treatment approaches for lung lesions in BC survivors.
Determining the Patient Acceptable Symptom State (PASS) for Shoulder Strength After Subscapularis Arthroscopic Repair and Evaluating the Preoperative Predictors for PASS Achievement
Authors: Gonzalez-Morgado Diego , Ardebol Javier , Kilic Ali Ihsan , Noble Matthew B. , Galasso Lisa A. , Menendez Mariano E. , Denard Patrick J.
Published: October 2024

Background:

Restoring shoulder strength after arthroscopic rotator cuff repair (ARCR) is critical, but there is limited understanding as to what patients consider satisfactory postoperative strength.

Purpose:

To determine the Patient Acceptable Symptom State (PASS) values for the Constant score strength parameter and internal rotation (IR) strength in patients who underwent ARCR for rotator cuff tears involving the subscapularis (SSC) muscle and evaluate for associations between preoperative and intraoperative patient characteristics with PASS achievement.

Study Design:

Case-control study; Level of evidence, 3.

Methods:

A retrospective analysis was conducted on prospectively collected data for 278 patients with an SSC tear (isolated or combined) who underwent ARCR and had minimum 2-year follow-up data. Functional outcomes (patient-reported outcomes, range of motion, Constant strength, and IR strength) were assessed preoperatively and at the latest follow-up. The overall, male, and female PASS values for postoperative strength measures were evaluated using receiver operating characteristic analysis. Correlation and logistic regression analyses were used to evaluate the relationship between preoperative variables and PASS achievement for Constant and IR strengths.

Results:

The mean follow-up time was 72.8 months. The overall, male, and female PASS values were 9.9 lb (4.5 kg), 14.5 lb (6.6 kg), and 8.5 lb (3.9 kg), respectively, for Constant strength and 15.2 lb (6.9 kg), 20.7 lb (9.4 kg), and 12.1 lb (5.5 kg), respectively, for IR strength. Older age, high fatty infiltration of the SSC tendon (Goutallier grades 3 and 4), and failure of SSC healing correlated negatively with PASS attainment for the strength measures. High fatty infiltration of the supraspinatus and infraspinatus muscles correlated negatively with Constant strength. Decreased coracohumeral distance (CHD) and larger SSC tears correlated negatively with achieving PASS for IR strength. Workers’ compensation, high supraspinatus and SSC fatty infiltration, and the use of knotted suture anchors were predictors of not achieving the overall Constant strength PASS, while lower SSC fatty infiltration and high CHD were predictors of achieving the overall IR strength PASS.

Conclusion:

This study established the PASS values for Constant and IR strengths for patients after ARCR involving the SSC tendon. Workers’ compensation, high supraspinatus and SSC fatty infiltration, and the use of knotted suture anchors were predictors of not achieving the overall Constant strength PASS, while lower SSC fatty infiltration and high CHD were predictors of achieving the overall IR strength PASS.
Adolescent Exposure to Restorative Practices and Their Perceptions of Support, Structure, and Bullying in the School Climate
Authors: Gregory Anne , Huang Francis L. , Ward-Seidel Allison Rae
Published: October 2024

This study investigated whether a restorative practice initiative improved school climate. The study presents findings from a cluster randomized, controlled trial conducted with 2,248 students from grades 5 to 12 (38% Black, 32% Hispanic) attending 18 schools in the U.S. Northeast. After 1 year of implementation, the experimental analyses of the whole-school initiative did not result in more positive perceptions of school climate for students in the intervention schools compared with students in the control schools. Correlational analyses were also conducted with student surveys in both intervention and control schools. Based on student report, restorative practice exposure in all 18 schools was associated with positive perceptions of the school climate. This suggests that initiatives may need to focus on fidelity of implementation and consistent implementation across more years for substantive school climate gains.
A novel mutation in the ATP1A2 gene associated with a sporadic hemiplegic migraine and multiple supraventricular arrhythmias: A case report
Authors: Shalchian Tehran Sarvnaz , Maquet Pierre
Published: October 2024

Introduction

ATP1A2 mutations are identified as a genetic cause of type 2 hemiplegic migraine, but to date, no ATP1A2 gene variant has been linked to heart rhythm disorders

Case presentation

A 37-year-old woman presented with sporadic hemiplegic migraine and multiple supraventricular arrhythmias refractory to medical treatment and electrophysiological interventions. Genetic workup revealed a mutation in the ATP1A2 gene (c.1827 + 10delT) which was not previously described. The co-segregation study supported the causal participation of the variant since it was found in the migrainous sister but not in the non-migrainous father.

Conclusions

We suggest that the c.1827 + 10delT mutation in the ATP1A2 gene is a novel pathogenic mutation linked to both hemiplegic migraine and supraventricular arrhythmias.
Gray relational analysis for parametric optimization of micro-EDM of thermo-mechanically processed AA7075 and AA7075/SiC/Gr composite
Authors: Debnath Kishore , V Murugabalaji , Rout Matruprasad , Pal Manas Ranjan , Rao Gorrepotu Surya , Sahoo Biranchi Narayan
Published: October 2024

The AA7075 alloy and AA7075/SiC/Gr hybrid composite prepared by the stir-casting method have been further thermo-mechanically processed through unidirectional hot rolling and hot cross-rolling routes to eliminate casting defects like voids, blow holes etc. Three initial sample temperatures, that is, 350℃, 400℃, and 450℃, have been considered for the hot cross-rolling. The Al alloy and its hybrid composite prepared at different rolling temperatures are studied to investigate their micro-machining behavior through micro-electric discharge machining (µ-EDM). The micro-holes are made on the rolled samples along the rolling direction of the final rolling pass using a tool with twist drill bit geometry. Further, multi-objective optimization of the µ-EDM process parameters considering the response parameters viz. material removal rate (MRR) and tool wear rate (TWR) has been carried out using the gray relational analysis (GRA) technique. The µ-EDM parameters chosen to optimize in this study are voltage, pulse on time, and tool rotation. The obtained GRA results are further analyzed through normality and equal variance tests. The R-squared values of 95.02% and 95.53% for AA7075 alloy and hybrid composite, respectively, indicate that the data fit well with the statistical model. In material removal, the different electrical and thermal characteristics of the Al matrix and the reinforcements possibly generate sparks with a different characteristic that ultimately affects the MRR of the composite. Through scanning electron microscopy (SEM), the morphological study confirmed the presence of globules and voids on the machined surface. The formation of globules and voids is more significant in the AA7075 alloy than in the composite.
Sex Education Training as Capacity Building Tool for Mothers and their Children with Intellectual Disability: A Qualitative Study
Authors: Gupta Babita
Published: October 2024

Sex is a biological need of human beings and the aspects of sexuality and sexual development are less discussed in people with intellectual disability (ID). Sex education training (SET) for persons with ID and their parents is pivotal in mitigating challenges and creating a safe and healthy space for expressing their sexual needs.

The aim was (a) to see the effects of SET in the enhancement of knowledge and skills about sexual health among adults with ID, (b) To see the effect of mothers as an observer during SET on their perception, attitude and practice on sexual health for their children with ID. The sample consisted of 11 mothers and their children who were above 18 years with ID. Awareness of sexual health education for parents of intellectually challenged children and family life and sexual health assessment tools were used. A qualitative/descriptive analysis was done. SET was started for the period of three months, two sessions in a week, each session lasting one and half hours. It was done in a playful manner on self and social awareness, safe/unsafe touch, relationships, personal safety rules and sexual harassment of women at workplace (POSH).

SET shows not only enhancement in the level of awareness, knowledge on sexual health but also improved communication skills and decision-making skills among adults with ID and their mothers. Mothers feel more confident and comfortable to have open discussions with their children on sexual health.
Assessment of Sexual Dysfunction in Male Patients with Young-Onset Parkinson’s Disease: A Case-Control Study
Authors: Paneyala Shasthara , Chalasani Sri Harsha , Syed Jehath , Sundaramurthy Harsha , Chandrasekhar Nemichandra Siddanakatte
Published: October 2024

Introduction:

There is a need for a comprehensive assessment of sexual dysfunction in patients with young-onset Parkinson’s disease (PD) to better understand its impact on this population. This study aimed to assess sexual dysfunction in patients with young-onset PD.

Methods:

This case-control study was conducted using a self-administered International Index of Erectile Function Scale (IIEF) questionnaire. The questionnaire included questions related to sexual function, including the ability to achieve and maintain erection and sexual desire. The participants included 30 individuals with young-onset PD and 30 controls without PD who were matched for age and gender.

Results:

The study enrolled 30 patients with an average age of 37.2 ± 5.29 years and PD symptom duration ranging from less than two years to over two years. Most patients were classified as having stage 2 or 3 PD and exhibited a range of symptoms, such as bradykinesia, tremors, rigidity, and postural instability. The findings revealed that 40% of the PD group experienced moderate erectile dysfunction, while 23.33% reported severe dysfunction, in contrast to the absence of dysfunction observed in the control group. The analysis indicated that patients with a disease duration of less than two years had higher scores across all five components of the IIEF questionnaire. Furthermore, anxiety, depression, increased medication use, and disease severity significantly affected sexual function.

Conclusion:

This study highlights the impact of young-onset PD on sexual function and underscores the importance of the early recognition and management of sexual dysfunction in patients with PD.
A roadmap to cure CHD2-related disorders
Authors: Prince Stephanie , Bonkowski Emily , McGraw Christopher , SanInocencio Christina , Mefford Heather C , Carvill Gemma , Broadbent Brian
Published: October 2024

Coalition to Cure CHD2 (CCC) is a patient advocacy group dedicated to improving the lives of those affected by CHD2-related disorders (CHD2-RD) by increasing education, building community, and accelerating research to uncover a cure. CHD2 is a chromatin remodeler that was identified in 2013 as being a genetic cause for developmental and epileptic encephalopathies. Pathogenic changes in CHD2 can cause treatment-resistant epilepsy, intellectual and developmental delays, and autism, and some individuals experience neurodevelopmental regression. There are currently no targeted therapies available for CHD2-related disorders. Haploinsufficiency of CHD2 is a causative mechanism of disease for individuals with pathogenic variants (primarily truncating) in CHD2. Recently, identification of individuals with deletion of nearby gene CHASERR, a regulator of CHD2 gene expression, has established dosage sensitivity in CHD2 and solidified the CHASERR gene as a potential therapeutic target for CHD2 levels. Through collaboration with our community and our scientific advisory board, CCC has created a Roadmap to Cure CHD2 as our guide toward a targeted cure that can benefit our community, with steps including (1) identifying and defining patients, (2) developing models of CHD2, (3) studying models of CHD2, (4) testing therapies, (5) involving patients, and (6) reaching a cure. Despite some of the challenges inherent in CHD2 research including establishing animal and cellular models that recapitulate the CHD2 clinical phenotype, identifying measurable outcomes and reliable biomarkers, or testing emerging therapeutic approaches, CCC continues to engage with our community to support ongoing research that aligns with our priorities. CCC sees new and exciting opportunities for additional research that can move our community toward our common goal of a cure that will improve the lives of individuals and their families now and in the future.
Custom Glenoid Baseplate to Address Massive Glenoid Bone Loss in Reverse Total Shoulder Arthroplasty
Authors: Moran Thomas E. , Ramamurti Pradip , Nauert Richard , Werner Brian C. , Brockmeier Stephen F.
Published: October 2024

Background:

A patient-specific, 3-dimensional-printed, custom glenoid baseplate can be utilized to address severe glenoid deficiency in reverse total shoulder arthroplasty (rTSA).

Indications:

A 73-year-old woman with right shoulder pain, weakness, and decreased range of motion in the setting of glenohumeral arthritis with severe glenoid bone loss. Additionally, this implant system was used in a 77-year-old man undergoing conversion to rTSA in the setting of glenoid erosion following prior failed total shoulder arthroplasty.

Technique Description:

A standard deltopectoral approach is utilized. In the revision setting, prior components are removed. Adequate glenoid exposure is obtained to allow for positioning and implantation of the custom glenoid baseplate. The glenoid is prepared utilizing patient-specific guides and trials before the custom glenoid component is seated within the glenoid vault and fixated with locking screws. Compatible glenosphere and humeral components are utilized for the remainder of the surgical procedure, as performed standardly.

Results:

There were no immediate complications following surgery. Surgical management led to improvement in the patient's pain and shoulder function.

Discussion/Conclusion:

Patient-specific, 3-dimensional-printed, custom glenoid baseplates may be used to manage severe glenoid deformity and bone loss in patients indicated for primary or revision rTSA.

Patient Consent Disclosure Statement:

The author(s) attests that consent has been obtained from any patient(s) appearing in this publication. If the individual may be identifiable, the author(s) has included a statement of release or other written form of approval from the patient(s) with this submission for publication.
Evolutions and paths: Voluntary employee turnover theories in search of new empirical tests
Authors: Allen David G. , Hancock Julie
Published: October 2024

The retention of human capital remains a vital point of interest for both organizations and scholars today, as it has for over a century. While many models of voluntary turnover exist, we identify two turnover theories, Steel's (2002) Evolutionary Job Search Model of Turnover and Lee and Mitchell's Unfolding Model of Turnover, that we believe offer significant opportunities for future research. In this editorial, we review these two theories, highlighting the impact of each and offering several recommendations for future replication. Specifically, after reviewing 183 articles that cited Steel, we found that only a few of these directly tested the core propositions of the model, likely due to the complexity of the challenges of sufficiently capturing the dynamic components, and none have fully tested the model. Additionally, despite being published only six years prior, we identified 748 articles that cited Lee and Mitchell, yet we found that only 127 empirically examined the model, with most focused on specific components of the model, and only 15 attempted to test the entire model. We provide several methodological and theoretical suggestions for progressing these two models towards a better understanding of voluntary turnover.
ADHESIVE RESIN FOR MULTI-LAYER FILMS USED FOR SHRINK OR THERMOFORMING PROCESSES
Authors: Tanaka Haruhiko , Shigemoto Hiromi , Kawachi Hideshi
Published: October 2024

Tie layers and other multilayer technology have made possible the combination of gas barrier polymers, e.g., polyamide and ethylene vinyl alcohol (EVOH) films, and moisture barrier polymers, e.g., polyethylene (PE) and polypropylene (PP). The result is that these multilayer films are finding increasing use in packages such as pouches and containers. However, the thermoforming process for cups or trays and the orientation process for shrink films can significantly reduce adhesion strength and often cause delamination of multilayered films. By combining graft and polymer blending technology, a new generation of tie layer adhesives has been developed to maintain high adhesion strength after thermoforming or orientation processes.
TR4 and BCL11A repress γ-globin transcription via independent mechanisms
Authors: Wang Yu , Myers Greggory , Yu Lei , Deng Kaiwen , Balbin-Cuesta Ginette , Singh Sharon A. , Guan Yuanfang , Khoriaty Rami , Engel James Douglas
Published: October 2024

Nuclear receptor TR4 (NR2C2) was previously shown to bind to the –117 position of the γ-globin gene promoters in vitro, which overlaps the more recently described BCL11 transcription factor A (BCL11A) binding site. The role of TR4 in human γ-globin gene repression has not been extensively characterized in vivo, whereas any relationship between TR4 and BCL11A regulation through the γ-globin promoters is unclear at present. We show here that TR4 and BCL11A competitively bind in vitro to distinct, overlapping sequences, including positions overlapping –117 of the γ-globin promoter. We found that TR4 represses γ-globin transcription and fetal hemoglobin accumulation in vivo in a BCL11A-independent manner. Finally, examination of the chromatin occupancy of TR4 within the β-globin locus, compared with BCL11A, shows that both bind avidly to the locus control region and other sites, but only BCL11A binds to the γ-globin promoters at statistically significant frequency. These data resolve an important discrepancy in the literature and, thus, clarify possible approaches to the treatment of sickle cell disease and β-thalassaemia.
T-cell lymphomas in recipients of CAR-T cells: assessing risks and causalities
Authors: Hu Jingqiong , Dunbar Cynthia E.
Published: October 2024

The US Food and Drug Administration announcement in November 2023 regarding reports of the occurrence of secondary T-cell lymphomas in patients receiving chimeric antigen receptor T cells (CAR-Ts) for B-cell malignancies resulted in widespread concern among patients, clinicians, and scientists. Little information relevant to assessing causality, most importantly whether CAR retroviral or lentiviral vector genomic insertions contribute to oncogenesis, was initially available. However, since that time, several publications have provided clinical and molecular details on 3 cases showing clonal CAR vector insertions in tumor cells but without firm evidence these insertions played any role in oncogenic transformation. In addition, several other cases have been reported without vector detected in tumor cells. In addition, epidemiologic analyses as well as institutional long-term CAR-T recipient cohort studies provide important additional information suggesting the risk of T-cell lymphomas after CAR-T therapies is extremely low. This review will provide a summary of information available to date, as well as review relevant prior research suggesting a low susceptibility of mature T cells to insertional oncogenesis and documenting the almost complete lack of T-cell transformation after natural HIV infection. Alternative factors that may predispose patients treated with CAR-Ts to secondary hematologic malignancies, including immune dysfunction and clonal hematopoiesis, are discussed, and likely play a greater role than insertional mutagenesis in secondary malignancies after CAR therapies.
Outcome of patients with large B-cell lymphoma treated with tafasitamab plus lenalidomide either before or after CAR T-cell therapy
Authors: Camus Vincent , Houot Roch , Brisou Gabriel , Tessoulin Benoit , Bailly Sébastien , Sesques Pierre , Decroocq Justine , Krzisch Daphné , Oberic Lucie , Lemonnier François , Bouabdallah Krimo , Campidelli Arnaud , Tounes Ledraa , Abraham Julie , Herbaux Charles , Morschhauser Franck , Damaj Gandhi Laurent , Guidez Stéphanie , Carras Sylvain , Fornecker Luc-Matthieu , Choquet Sylvain , Hermine Olivier , Paillassa Jérome , Chauchet Adrien , Casasnovas Olivier , Drieu La Rochelle Laurianne , Castilla-Llorente Cristina , Joris Magalie , Dupont Vivien , Marquet Alexandra , Le Gouill Steven , Jardin Fabrice
Published: October 2024

Tafasitamab plus lenalidomide (TAFA-LEN) treatment relevance pre- or post-anti-CD19 chimeric antigen receptor (CAR) T-cell therapy is debated. We analyzed patients with large B-cell lymphoma in the DESCAR-T registry treated with axi[1]cel or tisa-cel in ≥3rd line and TAFA-LEN before (n = 15, “TL-pre-CAR-T” set) or directly after (n = 52, “TL-post-CAR-T” set) CAR T-cell therapy. We compared TAFA-LEN v. other treatments using inverse probability weighting in the TL-post-CAR[1]T set. In the TL-post-CAR-T set, the median progression-free survival (mPFS), overall survival (mOS), and duration of response (mDOR) since the first treatment for progression (mPFS2/mOS2/mDOR2) were 3, 4.7, and 8.1 months, respectively. The best overall response rate (bORR) and best complete response rate (bCRR) after TAFA-LEN were 13.5% and 7.7%, respectively. Outcomes were better for patients who relapsed >6 months after CAR T-cell therapy (mPFS2: 5.6 vs 2 months, P = .0138; mOS2: not reached vs 3.8 months, P = .0034). The bORR and bCRR between TAFA-LEN and other treatments were 20.6% vs 24.9% and 11.6% vs 15.6%, respectively. Outcomes were similar between TAFA-LEN and other treatments (mPFS2: 2.9 vs 2.4 months, P = .91; mOS2: 3.3 vs 5.5 months, P = .06). In an exploratory analysis of the TL-pre-CAR-T set, the median TAFA-LEN treatment duration before CAR-T was 3.7 months with no patient becoming CD19 negative. The bORR, bCRR, 6- month PFS, and OS rates after CAR T-cell infusion were 45.5%, 36.4%, 20.1%, and 58.2%, respectively. Neither TAFA-LEN nor comparative salvage treatment improved outcomes for patients relapsing after CAR T-cell therapy.
Assessing the impact of different types of masks on COPD patients: A randomized controlled trial
Authors: Fan Jingchun , Feng Tiantian , Jiang Xiaomei , Wei Caihong , Zhang Xuhui , Li Caiyun , Yue Feiyan , Yang Hong , Bao Shisan , Chen Xuwen
Published: October 2024

Background

Wearing masks imposes an additional respiratory burden on COPD patients. This study aimed to investigate the impact of various mask types on physiological parameters and subjective feelings in COPD patients.

Methods

This randomized, open-label, parallel-controlled trial randomly assigned 129 COPD patients from 2 Chinese hospitals to the N95 mask group, the surgical mask group and the no mask group, who were required to complete a 6-minute rest (6MR) and a 6-minute walking test (6MWT) while wearing their designated masks, and were assessed for blood pressure, oxygen saturation, pulse rate, Borg score, RPE score, 6-minute walk distance (6MWD), and subjective feeling score. Data were analyzed using intention-to-treat analysis and per-protocol analysis.

Results

No significant differences were observed in blood pressures, oxygen saturation, pulse rate, or the 6MWD among the three groups following a 6MR or 6MWT. Wearing N95 masks and surgical masks during the 6MWT significantly elevated perceived dyspnea (p<0.001) and exertion scores (p<0.001) in COPD patients. The differences in the 2 scores between the highest and lowest groups were 2 and 4 points, respectively.

Conclusion

Wearing surgical masks or N95 masks for 6MR or 6MWT did not adversely affect physiological parameters in COPD patients. However, it significantly increased perceived dyspnea and exertion.
Differential expression of components of the CGRP-receptor family in human coronary and human middle meningeal arteries: functional implications
Authors: de Vries Tessa , Schutter Dennis , van den Bogaerdt Antoon , Vincent Arnaud , Dammers Ruben , Danser A. H. Jan , MaassenVanDenBrink Antoinette
Published: October 2024

Background

Different responses in human coronary arteries (HCA) and human middle meningeal arteries (HMMA) were observed for some of the novel CGRP receptor antagonists, the gepants, for inhibiting CGRP-induced relaxation. These differences could be explained by the presence of different receptor populations in the two vascular beds. Here, we aim to elucidate which receptors are involved in the relaxation to calcitonin gene-related peptide (CGRP), adrenomedullin (AM) and adrenomedullin 2 (AM2) in HCA and HMMA.

Methods

RNA was isolated from homogenized human arteries (23 HCAs; 12 F, 11 M, age 50 ± 3 years and 26 HMMAs; 14 F, 12 M, age 51 ± 3 years) and qPCR was performed for different receptor subunits. Additionally, relaxation responses to CGRP, AM or AM2 of the human arteries were quantified using a Mulvany myograph system, in the presence or absence of the adrenomedullin 1 receptor antagonist AM22-52 and/or olcegepant.

Results

Calcitonin-like receptor (CLR) mRNA was expressed equally in both vascular beds, while calcitonin receptor (CTR) and receptor activity-modifying protein 3 (RAMP3) expression was low and could not be detected in all samples. RAMP1 expression was similar in HCA and HMMA, while RAMP2 expression was higher in HMMA. Moreover, receptor component protein (RCP) expression was higher in HMMA than in HCA. Functional experiments showed that olcegepant inhibits relaxation to all three agonists in both vascular beds. In HCA, antagonist AM22-52 did not inhibit relaxation to any of the agonists, while a trend for blocking relaxation to AM and AM2 could be observed in HMMA.

Conclusion

Based on the combined results from receptor subunit mRNA expression and the functional responses in both vascular tissues, relaxation of HCA is mainly mediated via the canonical CGRP receptor (CLR-RAMP1), while relaxation of HMMA can be mediated via both the canonical CGRP receptor and the adrenomedullin 1 receptor (CLR-RAMP2). Future research should investigate whether RAMP2 predominance over RAMP1 in the meningeal vasculature results in altered migraine susceptibility or in a different response to anti-migraine medication in these patients. Moreover, the exact role of RCP in CGRP receptor signalling should be elucidated in future research.
Implementation of an early attention strategy to reduce emergency room overcrowding in an academic institution in Colombia, a pilot study
Authors: Jaramillo German Devia , Zuluaga Nathalia Esmeral , Avellaneda Viviana Andrea Velandia , Ramirez Salvador Menendez , Neira Fernando Jose Pimienta , Contador Angie Paola Lopez , Gallo Juan Pablo Vargas
Published: October 2024

Overcrowding is a worldwide problem, and long waiting times are associated with increased morbidity and even mortality of patients regardless of triage classification. Although there are many tools published in the literature that contribute to the reduction of overcrowding, for the Colombian population there are not many tools evaluated to reduce the length of stay of patients in the emergency department. This is a retrospective analytical study that compared whether there was a difference in patient definition time and ED length of stay between a group attended under an early care protocol (PAT) versus the usual protocol. Of the total of 969 patients included it was found that the group attended under the PAT protocol had a shorter definition time than the usual protocol, also the Emergency department length of stay (EDLOS) was significantly lower in the PAT group compared to the usual protocol. The implementation of the PAT protocol performed by emergency physicians allows a faster contact with the patient by the physician, and leads to a significant reduction of EDLOS, contributing to the reduction of overcrowding in the emergency department.
Lost in space and time: robust demography and enhanced resilience buffer adverse environmental effects in a highly isolated and sedentary pre-pleistocene landscape vertebrate
Authors: Kok Philippe J. R. , Broholm Tessa L. , van Doorn Loïc , Fiorillo Bruno Ferreto , Smith Carl
Published: October 2024

Background

Few animal populations have been studied under the framework of the OCBIL theory, which addresses the ecology and evolution of biodiversity on old climatically buffered infertile landscapes. Available genetic data challenge the low connectivity and high genetic differentiation predicted for isolated tepui-summit vertebrate communities, suggesting potential dispersal among summits. However, the OCBIL theory posits reduced dispersibility, enhanced resilience to habitat fragmentation and inbreeding due to small populations. We tested these hypotheses by conducting the first analytic evaluation of the spatial ecology and population biology of a tepui-summit vertebrate at multiple spatial scales.

Results

We used harmonic radar tracking (100 individuals/448 points of contact) and capture-mark-recapture data (596 individuals captured/52 recaptured) to reveal the temporal niche, microhabitat use, population size, and dispersal abilities of the tepui-summit endemic toad Oreophrynella quelchii on Roraima-tepui. Abundance was determined using a closed population model incorporating sources of variation in capture probability. We tested the relative influence of biotic and abiotic variables on distances moved through model selection. Our data indicate that the population size of O. quelchii is remarkably large (ca. 12 million individuals), with strong seasonal demographic fluctuations. Ecology and observed limited spatial movements challenge the likelihood of active dispersal among tepui tops in this species. Our results are counter to those predicted by the available genetic data but support two hypotheses of the OCBIL theory: reduced dispersibility and enhanced resilience. However, they do not support the expectation of a small refugial population size.

Conclusion

We postulate that the insular, hostile tepui-summit environment tends to produce robust demographic populations, likely to buffer stochastic adverse environmental effects, rather than diversity, as observed in much younger post-Pleistocene Neotropical landscapes. Our results draw attention to the value of faunal studies using an OCBIL framework to better understand the ecology and evolution of this unique biota worldwide.
Strategies for implementation of a transmural fall-prevention care pathway for older adults with fall-related injuries at the emergency department
Authors: Charmant W. M. , Snoeker B. A. M. , van Hout H. P. J. , Geleijn E. , van der Velde N. , Veenhof C. , Nanayakkara P. W. B.
Published: October 2024

Background

Although indicated, referrals for multifactorial fall risk assessments in older adults with fall related injuries presenting at the emergency department (ED) are not standard. The implementation of a transmural fall-prevention care pathway (TFCP) could bridge this gap by guiding patients to multifactorial fall risk assessments and personalised multidomain interventions in primary care. This study aims to develop and evaluate implementation strategies for a TFCP.

Methods

In this mixed-methods implementation study, strategies were developed using the Consolidated Framework for Implementation Research Expert Recommendations for Implementing Change Matching Tool. These were evaluated with patients, involved healthcare professionals, and other stakeholders using the Reach, Adoption, Implementation, and Maintenance of the RE-AIM framework in two cycles. Patients of the TFCP consisted of frail community dwelling individuals aged 65 and over presenting at the ED with fall related injuries.

Results

During the first implementation phase, strategies were focussed on assessing readiness, adaptability, local champions, incentives and education for all involved healthcare professions in the TFCP. Only 34.4% of eligible patients were informed of the TFCP at the ED, 30.6% agreed to a fall risk assessment and 8.3% patients received the fall risk assessment. In the second phase, this improved to 67.1%, 64.6%, and 35.4%, respectively. Strategies in this phase focussed on adaptability, obtaining sustainable financial resources, local champions, assessing readiness, and education. The implementation was facilitated by strategies related to awareness, champion recruitment, educational meetings, adaptability of TFCP elements and evaluations of facilitators and barriers.

Conclusion

The study outlined strategies for implementing TFCPs in EDs. Strategies included increasing awareness, utilising local champions, educational initiatives, adaptability of the TFCP, and continuous monitoring of facilitators and barriers. These insights can serve as a blueprint for enhancing fall prevention efforts for older adults in emergency department settings.
A model of prevention of mother-to-child transmission and health management team for improving adverse outcomes of pregnancy syphilis in Ningxia, China
Authors: Zhang Chenglei , Yue Jinwei , Ji Liying , Huang Yongxiang , Shi Qingmei , Yang Xiulian , Wang Jingjiao
Published: October 2024

Regional variations exist in the implementation of Syphilis Mother-to-Child Transmission Prevention (PMTCT). Thus, it is crucial to assess the effectiveness of this model in the Ningxia region and explore the supplementary role of Health Management Teams (HMT). This study established the PMTCT + HMT model and examined its impact on adverse outcomes in pregnant women with syphilis infection. The majority of participants were urban residents, married, had a minimum high school education, and held public positions; 36.7% and 26.7% were from minority ethnic groups. The PMTCT + HMT model enhanced participants’ knowledge, rates of voluntary counseling, and testing. The incidence of adverse pregnancy outcomes (miscarriages, preterm births, stillbirths) significantly decreased, and adverse neonatal outcomes (low birth weight, neonatal mortality, congenital syphilis) were notably reduced. Simultaneously, we identified factors associated with adverse outcomes, including non-residency, unmarried status, lower educational attainment, minority ethnicity, primary syphilis, and positive titers. Thus, HMT may be an effective intervention to enhance the effect of PMTCT for syphilis. The unique population structure in Ningxia is closely linked to adverse outcomes, highlighting the significance of providing equitable treatment for vulnerable populations.
A rare cause of echogenic kidneys with oligohydramnios in the fetus: report of two different cases
Authors: Phetthong Tim , Achaloetvaranon Krit , Diawtipsukon Sanpon
Published: October 2024

Background

Prenatal ultrasound findings of fetal bilateral echogenic kidneys accompanied by oligohydramnios can be highly stressful for both pregnant women and physicians. The diversity of underlying causes makes it challenging to confirm a prenatal diagnosis, predict postnatal outcomes, and counsel regarding recurrence risks in future pregnancies.

Case Presentation

We report two cases of abnormal fetal echogenic kidneys with oligohydramnios detected in the early third trimester. Autosomal recessive polycystic kidney disease (ARPKD), a rare genetic syndrome, was initially suspected in both cases. However, postnatal diagnoses differed: the first case was confirmed as glomerulocystic kidney disease (GCKD) through renal pathology, while the second case was diagnosed as ARPKD with a compound heterozygous likely pathogenic PKHD1 mutation.

Conclusion

Prenatal diagnosis of fetal echogenic kidneys with oligohydramnios should prioritize accurate diagnosis. Given the differences in the clinical spectrum, GCKD should be considered a differential diagnosis for this condition, particularly ARPKD. This study highlights the importance and benefits of molecular diagnosis and postnatal renal pathology for precise diagnosis and effective counseling.
Development of graded prognostic assessment for breast Cancer brain metastasis incorporating extracranial metastatic features: a retrospective analysis of 284 patients
Authors: Wang Yan , Xu Hangcheng , Sa Qiang , Li Li , Han Yiqun , Wu Yun , Zhou Yiran , Xu Binghe , Wang Jiayu
Published: October 2024

Background

Breast cancer brain metastasis (BCBM) is associated with poor survival outcomes and reduced quality of life. The Graded Prognostic Assessment (GPA) score model serves as a well-established tool for predicting the prognosis of BCBM. Notably, the presence of extracranial metastasis (ECM) is considered as a significant prognostic factor in the breast GPA model. This study aims to further refine other features of ECM to enhance the prognostic prediction for BCBM.

Methods

This study included all inpatients diagnosed with BCBM at the Cancer Hospital, Chinese Academy of Medical Sciences, from January 2010 to July 2021. Baseline characteristics of patients were compared based on features of ECM, including the presence, number, location, and control status of metastases. Overall survival (OS) were compared using the Kaplan–Meier method with log-rank tests. Cox regression analyses were conducted to identify significant prognostic factors. The aforementioned ECM features were incorporated into the original Breast-GPA model to enhance its prognostic accuracy. The concordance index (C-index) and restricted mean survival time (RMST) were utilized to evaluate and compare the predictive accuracy of the updated and original survival models.

Results

284 patients with BCBM were included in the study. Kaplan–Meier survival curves suggested that patients without ECM when diagnosed with BCBM showed better survival (p = 0.007). In the subgroups with ECM, more than 3 organs involved, both bone and visceral metastasis and progressive ECM portended dismal OS (p = 0.003, 0.001 and <0.001). Multivariate analysis demonstrated that molecular subtype, presence of ECM, and number of brain metastasis significantly influenced OS after BCBM. By modifying the current GPA model to include more precise characteristics of ECM, the predictive accuracy was further enhanced as indicated by the C-index and RMST curve.

Conclusions

More ECM sites, both bone and visceral invasion and uncontrolled ECM were dismal prognostic factors for survival outcomes of BCBM patients. A new Breast-GPA model with better predictive effect was constructed.