bluuebunny/crossref_metadata_2025 huggingface dataset:
Foods Consumed by US Adults From Cafeterias and Vending Machines: NHANES 2005 to 2014
Authors: Onufrak Stephen J. , Zaganjor Hatidza , Moore Latetia V. , Hamner Heather C. , Kimmons Joel E. , Maynard Leah M. , Harris Diane
Published: January 2019

Purpose:

As part of wellness efforts, employers may seek to improve the nutritional quality of foods offered and consumed in cafeterias and vending machines. However, little is known about who consumes food from these venues and the types and dietary quality of the foods consumed.

Design:

Cross-sectional.

Setting:

Nonschool cafeterias and vending machines.

Participants:

US adults ≥20 years old.

Measures:

Prevalence of consuming foods, most common foods eaten, leading calorie sources, 2010 Healthy Eating Index

Analysis:

Using 24-hour dietary recall data from NHANES 2005-2014 (N = 25,549 adults), we estimated the prevalence of consuming foods, assessed the most commonly consumed foods, and calculated dietary quality of foods.

Results:

On a given day, 3.1% of adults consumed foods from cafeterias and 3.9% from vending machines. Consumers averaged 692 kcal from cafeterias and 264 kcal from vending machines. Cafeteria consumers had higher income and education, while vending consumers were more likely to be male and younger adults. Common cafeteria foods included vegetables and fruits, but cafeteria foods were generally high in sodium and low in whole grains. Sugar-sweetened beverages and candies accounted for approximately half of all vending calories.

Conclusion:

Foods chosen from cafeterias and vending machines do not align well with the Dietary Guidelines for Americans. Improving the dietary quality of foods consumed from these venues could impact millions of adults.
Impairment in Activities of Daily Living, Care Receipt, and Unmet Needs in a Middle-Aged and Older Rural South African Population: Findings From the HAALSI Study
Authors: Harling Guy , Payne Collin F. , Davies Justine I. , Gomez-Olive F. Xavier , Kahn Kathleen , Manderson Lenore , Mateen Farrah J. , Tollman Stephen M. , Witham Miles D.
Published: January 2019

Objectives: The objective of this study is to analyze the degree to which care needs are met in an aging rural African population. Method: Using data from the Health and Aging in Africa: Longitudinal Study of an INDEPTH Community (HAALSI) baseline survey, which interviewed 5,059 adults aged older than 40 years in rural South Africa, we assessed the levels of limitations in activities of daily living (ADLs) and in unmet care for these ADLs, and evaluated their association with sociodemographic and health characteristics. Results: ADL impairment was reported by 12.2% of respondents, with the proportion increasing with age. Among those with ADL impairment, 23.9% reported an unmet need and 51.4% more a partially met need. Relatives provided help most often; formal care provision was rare. Unmet needs were more frequent among younger people and women, and were associated with physical and cognitive deficits, but not income or household size. Discussion: Unmet care needs in rural South Africa are often found among individuals less expected to require care.
Investigation into reducing anthropomorphic hand degrees of freedom while maintaining human hand grasping functions
Authors: Zarzoura Mohamed , del Moral Pablo , Awad Mohammed I , Tolbah Farid A
Published: January 2019

Underactuation is widely used when designing anthropomorphic hand, which involves fewer degrees of actuation than degrees of freedom. However, the similarities between coordinated joint movements and movement variances across different grasp tasks have not been suitably examined. This work suggests a systematic approach to identify the actuation strategy with the minimum number for degrees of actuation for anthropomorphic hands. This work evaluates the correlations of coordinated movements in human hands during 23 grasp tasks to suggest actuation strategies for anthropomorphic hands. Our approach proceeds as follows: first, we find the best description for each coordinated joint movement in each grasp task by using multiple linear regression; then, based on the similarities between joint movements, we classify hand joints into groups by using hierarchical cluster analysis; finally, we reduce the dimensionality of each group of joints by employing principal components analysis. The metacarpophalangeal joints and proximal interphalangeal joints have the best and most consistent description of their coordinated movements across all grasp tasks. The thumb metacarpophalangeal and abduction/adduction between the ring and little fingers exhibit relatively high independence of movement. The distal interphalangeal joints show a high degree of independent movement but not for all grasp tasks. Analysis of the results indicates that for the distal interphalangeal joints, their coordinated movements are better explained when all fingers wrap around the object. Our approach fails to provide more information for the other joints. We conclude that 19 degrees of freedom for an anthropomorphic hand can be reduced to 13 degrees of actuation distributed between six groups of joints. The number of degrees of actuation can be further reduced to six by relaxing the dimensionality reduction criteria. Other resolutions are as follows: (a) the joint coupling scheme should be joint-based rather than finger-based and (b) hand designs may need to include finger abduction/adduction movements.
The Critical Incident Technique: Method or Methodology?
Authors: Viergever Roderik F.
Published: January 2019

The critical incident technique (CIT) is a qualitative research tool that is frequently used in health services research to explore what helps or hinders in providing good quality care or achieving satisfaction with care provision. However, confusion currently exists on the nature of the CIT: Is it a method for data collection and analysis or a methodology? In this article, I explain why this distinction is important and I argue that the CIT is a methodology (and not a method) for the following reasons: Key methodological dimensions are described for the CIT; it has a clear focus; studies that apply this technique make use of various methods for data collection and analysis; it describes, explains, evaluates, and justifies the use of a specific format for those methods; it implies philosophical and practical assumptions; and studies that use the CIT cannot easily make use of additional methodologies simultaneously.
Teaching Health-Care Providers to Query Patients With Cancer About Sexual and Gender Minority (SGM) Status and Sexual Health
Authors: Cathcart-Rake Elizabeth J. , Breitkopf Carmen Radecki , Kaur Judith , O’Connor Jennifer , Ridgeway Jennifer L. , Jatoi Aminah
Published: January 2019

End of life is difficult for all patients but sexual and gender minorities (SGM) are prone to isolation and loneliness, especially if their SGM status is unknown or unaccepted. In oncology clinics, where goals of care discussions about end of life are integral and frequent, querying patients about their SGM status and sexual health is of particular importance. The American Society of Clinical Oncology recently released a position statement that called for greater focus on SGM populations with the goal of reducing and eventually eliminating disparities in cancer care within this group. An important first step in addressing such disparities is learning how best to train cancer health-care providers to ask patients about their SGM status and about sexual health in general. This article summarizes the mandate for understanding cancer issues in SGM populations and the dearth of cancer-related data within this group. This article also describes an ongoing 3-part study intended to build a mini curriculum with the goal of helping cancer health-care providers to ask patients with cancer about SGM status and to ask all patients with cancer about sexual health issues. The results of this ongoing study could potentially improve end-of-life care for subgroups of patients.
Cleft and Craniofacial Team Orthodontic Care in the United States: A Survey of the ACPA
Authors: Khavanin Nima , Jenny Hillary , Jodeh Diana S. , Scott Michelle A. , Rottgers S. Alex , Steinberg Jordan P.
Published: January 2019

Objective:

To better understand the capacity for orthodontic care, service features, and finances among members of the American Cleft Palate-Craniofacial Association (ACPA).

Design:

Cross-sectional survey.

Setting:

ACPA-approved multidisciplinary cleft teams.

Participants:

Cleft team coordinators.

Interventions:

Coordinators were asked to complete the survey working together with their orthodontists.

Main Outcome Measure:

Model for orthodontic care.

Results:

Coordinators from 82 out of 167 teams certified by ACPA completed the survey (response rate = 49.1%). Most orthodontists were private practice volunteers (48%) followed by university/hospital employed (22.8%). Care was often delivered in community private practice facilities (44.2%) or combination of university and private practice facilities (39.0%). Half of teams reported offering presurgical infant orthopedics (PSIO), with nasoalveolar molding being the most common. Cleft/craniofacial patients typically comprise 25% or less of the orthodontists’ practices. The presence of a university/hospital-based orthodontist was associated with higher rates of offering PSIO ( P < .001) and an increased percentage dedication of their practice to cleft/craniofacial care ( P < .001).

Conclusion:

Orthodontic models across ACPA-certified teams are highly varied. The employment of full-time craniofacial orthodontists is less common but is highly correlated with a practice with a high percentage of cleft care and the offering of advanced services such as PSIO. Future work should focus on how to effectively promote such roles for orthodontists to ensure high-level care for cleft/craniofacial patients requiring treatment from infancy through skeletal maturity.
Catalyzing Employee OCBE in Tour Companies: Charismatic Leadership, Organizational Justice, and Pro-Environmental Behaviors
Authors: Tuan Luu Trong
Published: January 2019

Employees are crucial contributors to their tour companies’ green strategies. The main objective of our research is to assess the role of environmentally specific charismatic leadership in fostering employees’ organizational citizenship behavior for the environment (employee OCBE). The mediation and moderation mechanisms for such a relationship were also examined drawing on social learning and social identity perspectives. The data set for our research was derived from employees and their direct managers working in tour companies in Ho Chi Minh City, Vietnam. The analysis of these data was conducted through the use of structural equation modeling. Environmentally specific charismatic leadership demonstrated a role in shaping employee OCBE via employee environmental commitment as a mediator. The positive interaction effects between environmentally specific charismatic leadership and the three dimensions of organizational justice for pro-environmental behaviors—procedural, distributive, and interactional justice—were found to predict employee environmental commitment.
The Written Park: Reading Multiple Urban Park Subjectivities Through Signage, Writing, and Graffiti
Authors: Campbell Lindsay K. , McMillen Heather , Svendsen Erika S.
Published: January 2019

Urban parkland is a quintessential form of public space. Various actors—from government managers, to civic groups, to individual visitors—actively negotiate and co-create the governance, use, and meaning of parks. One form of negotiation occurs through signage and writing. Here, we focus on 42 parks in New York City and the multiple narratives within them. Through coding the messages, material qualities, and meanings in 784 signs, qualitative analysis of graffiti in parks, triangulated with ethnographic field notes, we identify and discuss what sort of urban park subjectivities are being constructed. These include not only an “ideal park subject,” but also alternative subjectivities such as the neighbor or steward, the graffiti writer, and “free agents” who use wilderness as refuge. We seek to inform new ways of thinking about parks as social–ecological resources that are co-created by users and managers as places that allow multiple subjectivities to be expressed.
The combined effect of La and heat treatment on the tribological performances of tin-Babbitt alloy
Authors: Ni Yuquan , Li Xing , Dong Guangneng , Tong Zhe , Mei Tangjie
Published: January 2019

Babbitt alloy is a widely used bearing material. In order to improve its thermal and anti-fatigue performance, the combined effect of additive La and heat treatment of tin-Babbitt were studied. The microhardness, wettability, and tribological performances of the Babbitt were first considered. The Babbitt alloy modified with La element (0.1 wt%) was prepared and then heat treatment was carried out (marked by the modified Babbitt). The friction and wear performances of the bare Babbitt, heated Babbitt, and modified Babbitt were conducted by a ball-on-disc tester under oil lubricated condition. The results showed that the microstructure of the modified Babbitt alloy was homogeneous. The cubic phase of SnSb intermetallic was refined and the SnSb cubes were also passivated. The microhardness of the modified Babbitt increased from 24.67 Hv to 37.84 Hv and wettability was improved with the addition La and heat treatment. Therefore, the anti-wear performance of the Babbitt was improved. The modified Babbitt alloy is observed to resist the instant scratching from the journal.
Relative plausibility and a prescriptive theory of evidence assessment
Authors: Kolflaath Eivind
Published: January 2019

While the theory of relative plausibility is presented by Allen and Pardo (2019) as a descriptive theory of the proof process, this commentary discusses their theory as a possible starting point for a prescriptive theory of evidence assessment. Generally, naturalness and simplicity are necessary for the success of such a theory. The theory of relative plausibility is very promising in this respect, as its key concept is the straightforward and intuitive notion of explanation, according to which an explanation is an answer to a “why” question. Still, both the explanatory and the comparative dimensions of relative plausibility are in need of elaboration if one wants to give advice on evidence assessment in terms of Allen and Pardo’s framework. For one thing, it is necessary to examine the epistemological status of the various explanatory criteria regarding their potential as guides to truth or likelihood. Only epistemic (i.e., truth-conductive) criteria should be included in recommendations to fact-finders. Moreover, given the author’s interpretation of the ‘beyond any reasonable doubt’ standard, it is unclear what the comparative dimension amounts to in criminal trials. At least a comparison of the kind involved in the author's account of civil trials standards is absent in their interpretation of BARD. If the comparative dimension of relative plausibility is relevant at all in criminal trials, it must be clarified what is to be compared.
Fuel-to-air ratio control under short-circuit conditions through UEGO sensor signal analysis
Authors: Guardiola Carlos , Pla Benjamín , Real Marcelo , Travaillard Cyril , Dambricourt Frederic
Published: January 2019

The impact of short-circuit pulses on the after-treatment system of a spark-ignited engine must be taken into account to keep the fuel-to-air equivalence ratio within the three-way catalyst window, thereby reducing pollutant emissions. The fuel-to-air equivalence ratio overestimation that suffers the wide-range λ-sensor upstream three-way catalyst in the presence of short circuit is especially relevant. In this study, a novel approach to deal with the fuel-to-air equivalence ratio control under short-circuit conditions is introduced. Under this scope, this work proposes a strategy for the on-board correction of the aforementioned fuel-to-air equivalence ratio overestimation, by means of the information regarding short-circuit level that provides the frequency content of the λ-sensor at the engine frequency. Finally, the potential of this approach to minimize pollutant emissions, in particular the NO x penalty arisen as a consequence of running the engine under leaner conditions than expected, is assessed through experimental tests.
Hardin’s imagined tragedy is pig shit: A call for planning to recenter the commons
Authors: Brinkley Catherine
Published: January 2019

Hardin was wrong. There was not a tragedy of overuse. The Commons were dismantled by the state to make room for the formal economy and higher income user groups. I revisit the history of the Commons as a central, planned space in cities in order to ask two main questions. First, what role did the Commons play for cities and how is its lost felt? Second, how might planning reintroduce the Commons? In response, this research builds a functional theory of self-sufficiency at multiple scales of governance based on the opportunities of the Commons. The conclusion charts an urgent agenda for planning practice during a global population phase shift as cities increasingly house a greater proportion of humanity.
Responding to a complex world: Explorations in spatial planning
Authors: Chettiparamb Angelique
Published: January 2019

This article discusses three aspects in relation to Complexity Theory. First, from an understanding of time and space specificities in the rise of theories, it discusses the wider socio-political reasons that may account for the rise of complexity theory and its interest for planners today. The rise of the third sector in governance, the decentralisation of the nation state, the rise of informality, the exponential rise of information and knowledge in every sphere of human and non-human activity and the rise of new normative ideologies are argued to provide the social context for interest in complexity theory. Second, this article positions complexity theory within general social science theories and argues that complexity theory best suits the second-order realm of social science theorisation. Third, this article positions complexity theory within planning theory and suggests that complexity theorists within planning might engage with the theory in three ways. These are by suggesting new ways of ordering of society and space by configuring or re-configuring planning systems in the first order, unravelling new opportunities for actors to work in society and space with largely self-organised entities and finally by searching for and discovering new dynamics for systems in the first order in society and space.
Cardiac ventricular sizes are reduced in patients with long-term, normoalbuminuric type 1 diabetes compared to the non-diabetic background population
Authors: Hjortkjær Henrik Ø , Jensen Tonny , Hilsted Jannik , Mogensen Ulrik M , Corinth Helle , Rossing Peter , Sigvardsen Per E , Fuchs Andreas , Kühl J Tobias , Nordestgaard Børge G , Køber Lars , Kofoed Klaus F
Published: January 2019

Aims:

Type 1 diabetes entails increased cardiovascular morbidity and cardiac chamber sizes are associated with cardiovascular disease. The aim of this study was to compare cardiac chamber sizes in normoalbuminuric persons with type 1 diabetes to a background population without diabetes.

Methods:

In a cross-sectional study, we examined 71 normoalbuminuric persons with long-term type 1 diabetes without known cardiovascular disease using cardiac multi-detector computed tomography. Cardiac chamber sizes and left ventricular remodelling were compared to persons without diabetes from the Copenhagen General Population Study.

Results:

Participants were median (interquartile range) 54 (48–60) (type 1 diabetes) and 57 (50–64) (without diabetes) years old and 59% were men (both groups). Participants with type 1 diabetes had smaller left ventricular mass (−3.5 g/m2, 95% confidence interval −5.8 to −1.3) and left (−4.0 mL/m2, 95% confidence interval −6.9 to −1.0) and right (−11.7 mL/m2, 95% confidence interval −15.4 to −7.9) ventricular volumes in multivariable analyses (adjusted for age, sex, body composition, blood pressure and antihypertensive medication), but no differences in atrial volumes.

Conclusion:

Persons with long-term type 1 diabetes had smaller left ventricular mass and biventricular volumes, yet similar atrial sizes, compared to a background population without diabetes. These findings may reflect subclinical development of diabetic cardiomyopathy.
Efficacy and Tolerability of CyberKnife Stereotactic Robotic Radiotherapy for Primary or Secondary Orbital Lesions: A Single-Center Retrospective Experience
Authors: Desideri Isacco , Francolini Giulio , Carta Giulio Alberto , Di Cataldo Vanessa , Masi Laura , Meattini Icro , Bonomo Pierluigi , Loi Mauro , Greto Daniela , Visani Luca , Lo Russo Monica , Grassi Roberta , Teriaca Maria Ausilia , Garlatti Pietro , Nardi Cosimo , Livi Lorenzo
Published: January 2019

Introduction:

Orbital lesions are rare, but are likely to become symptomatic and can impact on patients’ quality of life. Local control is often difficult to obtain, because of proximity to critical structures. CyberKnife stereotactic robotic radiotherapy could represent a viable treatment option.

Materials and Methods:

Data on patients treated for intraorbital lesions from solid malignancies were retrospectively collected. All patients underwent treatment with CyberKnife system. We analyzed local control, response rate, symptoms control, progression-free survival and overall survival, acute and late toxicity.

Results:

From January 2012 to May 2017, 20 treatments on 19 patients were performed, with dose ranging from 24 to 35 Gy in 1 to 5 fractions, prescribed at an average isodose line of 79.5% (range: 78-81). After a mean follow-up of 14.26 months (range: 0-58), overall response rate was 75%, with 2 and 4 patients presenting a partial and complete response, respectively. Mean time to best measured response was 15.16 months (range: 2-58). Thirteen patients were alive, with a local control rate of 79%. Mean time to local progression was 5 months (range: 3-7). Three patients reported improvement in symptoms after treatment. Mean planning target volume dose coverage was 97.2% (range: 93.5-99.7). Mean maximum dose (D max) to eye globe, optic nerve, optic chiasm, and lens was 2380.8 cGy (range: 290-3921), 1982.82 cGy (range: 777.3-2897.8), 713.14 cGy (range: 219.5-2273), and 867.9 cGy (range: 38-3118.5). Four patients presented acute toxicity.

Conclusion:

This current retrospective series demonstrated that CyberKnife robotic stereotactic radiotherapy is a feasible and tolerable approach for intraorbital lesions.
Effect of Vitamin D on Cognitive Functions in Older Adults: 24-Week Follow-Up Study
Authors: Ates Bulut Esra , Soysal Pinar , Yavuz Idil , Kocyigit Suleyman Emre , Isik Ahmet Turan
Published: January 2019

The purpose of this study is to assess the effect of vitamin D replacement on cognitive function in older adults. A total of 560 patients who underwent comprehensive geriatric assessment including Global cognitive assessment, Basic Activities of Daily Living (BADL), and Instrumental Activities of Daily Living (IADL) twice in 6-month period were retrospectively reviewed. Oral cholecalciferol was replaced to patients with vitamin D deficiency routinely. In baseline cognitive scores, BADL-IADL scores were lower in the severe deficiency group than in the deficiency and adequate groups ( P < .05). With regard to the relation between changes in cognitive functions, BADL-IADL scores on the 6-month versus baseline, no difference was determined in patients with and without dementia ( P > .05). Vitamin D replacement may not improve cognitive performance in older adults, even if vitamin D is raised to adequate level, suggesting that longer term replacement therapy may be needed to improve cognitive function.
The Negative Impact of Higher Body Mass Index on Sperm Quality and Erectile Function: A Cross-Sectional Study Among Chinese Males of Infertile Couples
Authors: Zhang Jianzhong , Yang Bin , Cai Zhonglin , Li Hongjun , Han Taoli , Wang Ying
Published: January 2019

The objective of the current study was to explore the role of body mass index (BMI) in sperm quality and erectile function in Chinese males of infertile couples. A total of 28 fertility centers in different regions of China were enrolled. Patient data were collected from June 1, 2017, through October 31, 2017. Semen analyses and demographic data were collected and the five-item International Index of Erectile Function (IIEF-5) questionnaire was used to evaluate the erectile function in participants with different BMIs. In total, 3,174 Chinese men of infertile couples with an average age of 33.11 ± 6.08 years were enrolled. The occurrence of obesity, overweight, normal weight, and underweight were 5.4%, 36.6%, 56.8%, and 1.2%, respectively. In addition to hypertension and diabetes, primary infertility, a longer course of infertility, and chronic prostatitis were risk factors for obesity. Compared with men of normal weight, adjusted odds ratios (ORs) for men with obesity, overweight, and underweight for semen volume <2 ml were 2.53 (95% CI [1.61, 3.97]), 1.33 (95% CI [1.09, 1.62]), and 0.84 (95% CI [0.29, 2.43]); for sperm progressive motility (A + B) (%) <32, the ORs were 1.60 (95% CI [1.16, 2.22]), 1.30 (95% CI [1.12, 1.51]), and 1.03 (95% CI [0.54, 1.98]); and for IIEF-5 ≤ 21, the ORs were 1.52 (95% CI [1.10, 2.10]), 1.11 (95% CI [0.96, 1.30]), and 0.62 (95% CI [0.31, 1.26]), respectively. Obesity was associated with lower semen volume, lower sperm motility, and erectile dysfunction in Chinese males of infertile couples.
Reliability and validity of the self-reported Activities of Daily Living Scale for people with mental illness
Authors: Pan Ay-Woan , Wu Chao-Yi , Chung LyInn , Chen Tsyr-Jang
Published: January 2019

Background/objectives

Patient-reported outcome measures have been found to be an effective method of reflecting client perspectives on their personal health condition. The primary aim of this study was to determine the reliability and validity of the self-reported Activities of Daily Living Scale (sf-ADLS) using Rasch analysis in Taiwan.

Methods

A total of 455 people were included in this study; 224 were persons with mental illness and 231 were healthy adults. We applied Rasch analysis as the means of testing the psychometrics of the scale.

Results

The final version of the sf-ADLS used in this study included 14 items, with no differential item functioning being discernible on the gender variable. The scale was found to be of use in classifying the subjects into four levels of independence.

Conclusions

The revised sf-ADLS conforms to the Rasch measurement model in the formulation of a unidimensional scale. The scale can be used to measure the level of independence with acceptable reliability (internal consistency as 0.9) and validity.
A Historical Study of Chinese Nursing Unit Design Evolution Since 1989
Authors: Cai Hui , Lu Yi , Sheward Hugo
Published: January 2019

Objectives:

To provide a historical review on the evolution of contemporary Chinese nursing unit design and contextual factors that drive the design and changes.

Background:

China is undergoing a major healthcare construction boom. A systematic investigation of the characteristics and development of Chinese nursing unit design is warranted to help U.S. healthcare designers to provide design that fits the local context.

Methods:

The investigation is developed in two phases. The first phase is a large-scale spatial analysis of 176 Chinese acute care unit layouts from three periods: 1989–1999, 1999–2004, and 2005–2015. In addition to qualitative descriptions of the nursing unit typologies, the percentage of various typologies, patient room (PR) types, the number of beds, visibility from nurse station (NS) to PRs, and access to natural light during each period were evaluated quantitatively. The second phase defined key factors that shape Chinese nursing unit design through expert interviews.

Results:

Significant differences were found between design in these three periods. Chinese nursing unit size has continuously grown in the number of beds. Most PRs have shifted from three-bed to double-bed rooms. Most Chinese hospitals use single corridor, racetrack, and mutated racetrack layouts. Mutated racetrack has taken over single corridor as the dominant configuration. The access to southern sunlight remains important. The average visibility from NS to some PRs is restricted by the preferences of allocating most PRs on the south side of a unit.

Conclusions:

Chinese nursing unit design has undergone transformations to fit the local cultural, socioeconomic context and staffing model.
Political Extremity, Social Media Use, Social Support, and Well-Being for Emerging Adults During the 2016 Presidential Election Campaign
Authors: Leighton Dana C. , Brandt Mark J. , Kennedy Lindsay A.
Published: January 2019

The 2016 U.S. presidential election was marked by hostile political discourse, often on social media, where users were exposed to divergent, and potentially distressing, political discourse. This research explores the effects of this election on the well-being of emerging adults who receive the majority of their news via social media. Using data from the Emerging Adulthood Measured at Multiple Institutions 2 Study, we expected greater social media use to be associated with greater perceived stress, and lower well-being, among emerging adults who are more politically extreme, and expected these relationships would be moderated by social support and social media use. Our preregistered analysis did not support our hypotheses. Although there were some effects of extremity on stress and well-being, overall the direction of the effects were inconsistent and neither social media use nor social support was found to moderate the effects of extremity on stress and well-being.
A Growth Curve Analysis of Self-Esteem and Depressive Symptomatology Throughout Emerging Adulthood: The Role of Family
Authors: Reed-Fitzke Kayla , Withers Mathew C. , Ferraro Anthony J. , Lucier-Greer Mallory , Duncan James M.
Published: January 2019

Research suggests family-level factors remain an important contributor to emerging adult mental health. Guided by the stress process framework, this study used latent growth curve modeling to examine the role of parent–child relationships, specifically emotional closeness and conflict, in child self-esteem and depression throughout emerging adulthood. Longitudinal associations between self-esteem and depression were also explored using four waves of data from the Longitudinal Study of Generations ( N = 196 emerging adults; M = 20.88 years old at Wave 1). This period was characterized by steep increases in self-esteem and decreases in depression. Findings suggested parent–child emotional closeness and conflict in early emerging adulthood were associated with the intercept of self-esteem and were indirectly related to the intercept of depression through self-esteem; the rate of change in self-esteem predicted the rate of change in depression. Findings underscore the importance of parent–child relationships during early emerging adulthood and the long-term impact of personal resources on well-being.
Cosmopolitanism, Materialism, Consumer Ethnocentrism and Consumer Behaviour: Evidence from Aboriginal Tripuri Tribe of India
Authors: Das Manish , Mukherjee Debarshi
Published: January 2019

Culture plays an important and complex role in shaping consumer behaviour. This article attempts to appraise the role of culture in determining consumer behaviour of the aboriginal Tripuri tribes. Cultural aspects are measured by three globalization-linked cultural dispositions: cosmopolitanism (COSMO), materialism (MAT) and consumer ethnocentrism (CET). Consumer behaviour is measured by the importance a consumer attaches to purchase/use of a particular product. A total of 39 product items from seven product categories are evaluated. The categories included are global foods, global fashion, local foods, luxury items, appliances, technology and electronic items, and networking platforms. Collecting and analysing data from 702 Tripuri tribes, this study concludes that CET is the most dominant construct among Tripuri tribes. CET and COSMO also had significant roles in shaping consumer behaviour. COSMO is observed to have a significant positive association with both MAT and CET. No significant association is observed between MAT and CET. Tripuri tribes’ income class, religious belief, nature of residential location and dominating culture of the location are observed to have significant impact on shaping COSMO, MAT and CET tendencies. The study also concludes that it is not desirable for firms to utilize generalized findings related to impact of globalization-linked cultural dispositions in shaping consumer behaviour in their marketing strategy for specific niche groups like aboriginal tribes in India.
An innovative total temporomandibular joint prosthesis with customized design and 3D printing additive fabrication: a prospective clinical study
Authors: Zheng JiSi , Chen XuZhuo , Jiang WenBo , Zhang ShanYong , Chen MinJie , Yang Chi
Published: January 2019

Background

Total temporomandibular joint (TMJ) prosthesis is an effective and reliable method of joint reconstruction. However, there is still an urgent need to design a new TMJ prosthesis because of no commercially available TMJ prosthesis appropriate for the clinical application on the Chinese population. This study was introduced to prospectively confirm the safety and effectiveness of a new TMJ prosthesis with customized design and 3D printing additive fabrication in clinical application.

Methods

Patients with unilateral end-stage TMJ osteoarthrosis were recruited in this study from Nov 2016 to Mar 2017. Computed tomography scans for all patients were obtained and transformed into three-dimensional (3D) reconstruction models. The customized TMJ prosthesis consisted of three components including the fossa, condylar head, and mandibular handle units, which were designed based on the anatomy of the TMJ and were fabricated using the 3D printing technology. The prominent characters of the prosthesis were the customized design of the fossa component with a single ultra-high-molecular-weight polyethylene and the connection mechanism between the condylar head (Co–Cr–Mo alloy) and mandibular handle components (Ti6Al4 V alloy). The clinical follow-up, radiographic evaluation and laboratory indices were all done to analyze the prosthesis’ outcomes in the clinical application.

Results

12 consecutive patients were included in the study. There were no complications (infection of the surgical wound, damage of liver and kidney, displacement, breakage, or loosening of the prosthesis) found after surgery. Pain, diet, mandibular function, and maximal interincisal opening showed significant improvements after surgery. But the lateral movement was limited to the non-operated side and the mandible deviated towards the operated side on opening mouth following surgery.

Conclusions

The presented TMJ prosthesis is considered an innovative product in TMJ Yang’s system, which is unique compared to other prostheses for the special design and 3D printing additive manufacture. Moreover, the prosthesis is very safe and efficient for clinical use.

Trial registration Prospective reports on Chinese customized total temporomandibular joint prosthesis reconstruction cases, ChiCTR-ONC-16009712. Registered 22 Nov 2016, http://www.chictr.org.cn/showproj.aspx?proj=16091
Efficacy and prognostic factor analysis in second-line chemotherapy for elderly patients with metastatic gastric cancer.
Authors: Shoji Ayaka , Hasegawa Hiroko , Kato Seiya , Kiyota Ryosuke , Shinkai Kazuma , Tashiro Taku , Ishihara Akio , Iwasaki Tetsuya , Tanaka Satoshi , Akasaka Tomofumi , Sakakibara Yuko , Nakazuru Shoichi , Ishida Hisashi , Hirao Motohiro , Mita Eiji
Published: January 2019

143

Background: Recently, the proportion of elderly patients (pts) with advanced gastric cancer has increased in Japan. Survival benefits of second-line chemotherapy (CTX) such as weekly paclitaxel (PTX)±Ramucirumab (RAM) or irinotecan (CPT) were shown in several phase 3 trials for metastatic gastric cancer (mGC). However, efficacy and prognostic factors in the second line CTX for elderly pts are not well studied. Methods: We retrospectively reviewed for mGC pts aged ≥ 70 years who underwent PTX+RAM, PTX or CPT as second-line CTX. Eligibility criteria were as follows: PS 0-2, refractory to an S-1containing CTX. Response rate (RR), overall survival (OS), progression-free survival (PFS), and adverse events (AEs) were evaluated. Univariate and multivariate analyses were performed to determine prognostic factors of survival. Results: There were 250 pts with mGC treated at our institution between April 2007 and March 2017. Of all, total of 85 pts were eligible. Median age was 75 years (71-85). The RR was 28.0% in the PTX+RAM group (n=28), 17.2% in the PTX group (n=29) and 18.5% in the CPT group (n=28). Median PFS was 5.1 months(M) and MST was 12.2 M in the PTX+RAM group, compared with 4.1 M and 9.7 M in the PTX group, or 3.3M and 9.8M in the CPT group. The ORR, PFS and OS were better in the PTX+RAM group though differences between groups were not statistically significant. Grade 3 or higher non-hematological AEs such as fatigue or diarrhea were more frequent in the CPT group on the other hand, hematological AEs were more frequent in the PTX+RAM group. On multivariate analysis, PS (HR,3.13; 95%CI, 1.60-5.77), LDH (HR,3.19; 95%CI, 1.80-5.57), and CEA (HR,2.35; 95%CI, 1.30-4.16) were found to be significant prognostic factors for elderly pts with mGC who underwent second-line CTX. Conclusions: PTX+RAM therapy seemed to be more effective than the other regimens. Furthermore, this analysis for prognostic factors may help clinicians to better select elderly pts who may benefit from a second-line CTX.
Relationship between human epidermal growth factor receptor 2 (HER2) status and central nervous system metastases in gastroesophageal cancer.
Authors: Ma Lucy Xiaolu , Lim Charles Henry , Sun Peiran , Jiang Maria , Sim Hao-Wen , Natori Akina , Chan Bryan Anthony , Yokom Daniel , Moignard Stephanie , Le Lisa W , Chen Eric Xueyu , Liu Geoffrey , Swallow Carol Jane , Darling Gail Elizabeth , Kongkham Paul N. , Shultz David , Hafezi-Bakhtiari Sara , Conner James , Elimova Elena , Jang Raymond Woo-Jun
Published: January 2019

145

Background: Central nervous system (CNS) metastases (mets) in gastroesophageal (GE) cancers are rare. There have only been limited studies examining the role of HER2 status in CNS mets in GE cancers. Methods: A retrospective analysis was performed for patients (pts) treated for GE cancers at the Princess Margaret Cancer Centre from 2011-2016. Quantitative and qualitative data were collected for all pts with CNS mets. Kaplan-Meier method was used to calculate overall survival (OS) and CNS progression free survival (PFS) for CNS mets pts. Results: Of 34 GE cancer pts diagnosed with CNS mets, 11 were HER2+, 11 HER2- and 12 had unknown HER2 status. Median time from initial cancer diagnosis to CNS mets was 10.3 months (13.4 in HER2+, 5.8 in HER2-, 11.7 in HER2 unknown). Characteristics at CNS mets diagnosis included: median age 63; 85% male; 74% had extracranial systemic mets; performance status ECOG 0-1 (64%), 2 (12%), 3-4 (24%). Treatment for CNS mets is shown in Table 1. Median OS from diagnosis of CNS mets was 6.1 months (95%CI 3.2-16.4) for all pts, 17.1 (95%CI 9.9-NA) in HER2+, 1.8 (95%CI 0.6-NA) in HER2-, 6.0 (95%CI 1.9-NA) in HER2 unknown, p=0.01. Median OS from initial cancer diagnosis was 18.5 months (95%CI 13.6-33.7) for all pts, 28.9 (95%CI 21.32-NA) in HER2+, 10.8 (95%CI 6.37-NA) in HER2-, 18.6 (95%CI 10-NA) in HER2 unknown, p=0.015. The 1 year CNS PFS rate was 35% (95%CI 22.1 – 55.5%) for all pts, 53% (95%CI 29.9 – 94%) in HER2+, 18.2% (95%CI 5.3 – 63.7%) in HER2-, 33% (95%CI 15 – 74.2%) in HER2 unknown, p=0.053. Conclusions: HER2+ pts tended to develop CNS mets later than HER2-. HER2+ pts were more likely to receive CNS-directed interventions, with more HER2+ pts having surgery for CNS mets while more HER2- had supportive care. This analysis is the first to suggest that in pts with CNS mets, HER2+ pts had longer survival than HER2-, both from initial diagnosis and after developing CNS metastases.[Table: see text]
Alterations of plasma glutamine and surgical stress in gastric cancer surgery.
Authors: Hayashi Tsutomu , Aoyama Toru , Yamamoto Hiroshi , Yamada Takanobu , Sato Tsutomu , Rino Yasushi , Masuda Munetaka , Cho Haruhiko , Tsuburaya Akira , Ogata Takashi , Yoshikawa Takaki
Published: January 2019

176

Background: The plasma glutamine levels are known to decrease after major surgery, which is related to a negative clinical outcome. However, the influence of surgical stress on the decrease in the plasma glutamine concentration is unclear. The aim of this study was to evaluate the change in glutamine in relation to the types of gastrectomy and approaches as well as the amount of surgical stress evaluated by serum interleukin-6(IL-6) as an objective indicator. Methods: This was a prospective observational study. The eligibility criteria were (1) gastric adenocarcinoma of the stomach confirmed by pathology and (2) patients scheduled to receive gastrectomy with D1 or D2 lymphadenectomy for gastric cancer. Blood samples were taken at 7 AM on the day of surgery and at 12 h after surgery to measure the plasma glutamine and interleukin-6 (IL-6) levels. Results: Between May 2011 and December 2011, 81 consecutive patients were enrolled in this study. The plasma glutamine level was significantly decreased in all patients, regardless of distal or total gastrectomy and laparoscopic or open surgery. No significant differences were observed in the IL-6 level between total and distal gastrectomy patients or between patients treated via a laparoscopic or open approach. Decreases in the plasma glutamine level were positively correlated with the logarithmically transformed-plasma IL-6 (logIL6) (r = 0.471, p < 0.001) overall. Conclusions: Decreases in the glutamine concentration depended on the amount of surgical stress. When conducting a clinical trial to evaluate glutamine administration, personalized adjustment may be key to avoiding glutamine depletion in response to surgical stress.
Randomized, open label, multicenter, phase II trial comparing transarterial chemoembolization (TACE) plus sorafenib with TACE alone in patients with hepatocellular carcinoma (HCC): TACTICS trial.
Authors: Kudo Masatoshi , Ueshima Kazuomi , Ikeda Masafumi , Torimura Takuji , Tanabe Nobukazu , Aikata Hiroshi , Izumi Namiki , Yamasaki Takahiro , Nojiri Shunsuke , Hino Keisuke , Tsumura Hidetaka , Kuzuya Teiji , Isoda Norio , Yasui Kohichiroh , Yoshimura Kenichi , Okusaka Takuji , Furuse Junji , Kokudo Norihiro , Okita Kiwamu , Arai Yasuaki ,   For the TACTICS Trial Group
Published: January 2019

206

Background: There is no proven evidence that combination therapy of TACE with sorafenib (TS group) prolong progression-free survival (PFS) and/or overall survival (OS) compared to TACE alone (T group) in patients with unresectable HCC. Methods: In this randomized, open label, multicenter, comparative trial (NCT01217034), patients with unresectable HCC, Child-Pugh score ≤7, ECOG performance status 0-1, no vascular invasion (VI), no extrahepatic spread (EHS), size≤10 cm and number≤10 and adequate organ function were randomized 1:1 (stratification by institution, Milan criteria in or out, and number of previous TACE 0 or 1-2) to T or TS. In TS group, sorafenib 400 mg once daily was pretreated for 2-3 weeks prior to TACE followed by 800mg once daily during on-demand conventional TACE sessions until the time to untreatable progression (TTUP), which was defined as the time to the date of a state when TACE continuation is not possible due to untreatable tumor progression, deterioration to Child-Pugh C or appearance of VI/EHS. Co-primary endpoints are PFS and OS. Multiplicity is adjusted using a gatekeeping hierarchical testing. PFS event in this trial was defined as death or time to TTUP. Key secondary endpoints were time to progression and safety. PFS is expected to 40% extension from 18 months (control arm) to 25 months, target HR was 0.71, with a power of 0.80. Results: The trial was conducted in 33 institutions and a total of 156 patients were randomized to T (n = 76) or TS (n = 80). Median PFS in the T group and TS group was 13.5 and 25.2 months (HR = 0.59, 95%CI 0.41-0.87; p = 0.006), respectively. The number of OS events has not reached. Median TTP was 13.5 and 24.1 months in the T and TS groups (HR = 0.56, 95%CI 0.38-0.83; p = 0.004). Median TTUP was 20.6 and 26.7 months in the T and TS groups (HR = 0.57, 95%CI 0.35-0.92; p = 0.02), respectively. There was no unexpected toxicity. Conclusions: Sorafenib in combination with TACE significantly improved PFS over TACE alone in patients with unresectable HCC. Adverse events were consistent with the known safety profile with previous TACE combination trials. Clinical trial information: NCT01217034.
KEYNOTE-224: Pembrolizumab in patients with advanced hepatocellular carcinoma previously treated with sorafenib.
Authors: Zhu Andrew X. , Finn Richard S. , Cattan Stéphane , Edeline Julien , Ogasawara Sadahisa , Palmer Daniel H. , Verslype Chris , Zagonel Vittorina , Rosmorduc Olivier , Vogel Arndt , Sarker Debashis , Verset Gontran , Chan Stephen Lam , Knox Jennifer J. , Daniele Bruno , Ebbinghaus Scot , Ma Junshui , Siegel Abby B. , Cheng Ann-Lii , Kudo Masatoshi
Published: January 2019

209

Background: Immunotherapy approaches, including immune checkpoint blockade, have shown initial promising results in HCC. Anti PD-1 therapy with pembrolizumab has demonstrated antitumor activity and manageable safety in multiple cancers. KEYNOTE-224 (NCT02702414), an open label, phase 2 trial assessed the efficacy and safety of pembrolizumab in pts with advanced HCC previously treated with sorafenib. Methods: Eligible pts were age ≥18 y with confirmed HCC, radiographic progression after sorafenib and disease not amenable to curative treatment, Child Pugh A, ECOG PS 0-1 and predicted life expectancy > 3 mo. Pts received pembrolizumab 200 mg Q3W for 2 y or until disease progression, unacceptable toxicity, withdrawal of consent or investigator decision. Response was assessed every 9 wk (RECIST v1.1, central review). Primary endpoint was ORR (RECIST v1.1, central review). Secondary endpoints included DOR, DCR, PFS, OS, and safety and tolerability. Data cutoff date was Aug 24, 2017. Results: Of 104 treated pts, 23 continued therapy (median follow up 8.4 mo, range 0.4-13.6). Median age of pts was 68y (range 43-87), 21.2% were HBV+, 26% were HCV+, 94.2% were Child Pugh A, 79.8% had PD on sorafenib and 63.5% had extrahepatic disease. ORR was 16.3% (95% CI, 9.8 to 24.9) and similar across subgroups with different etiology. Median time to response was 2.1 mo (range 1.8-4.8) and 94% of responders were estimated to have a response duration ≥6 mo. Best responses were CR in 1 patient (1.0%), PR in 16 (15.4%), SD in 47 (45.2%) and PD in 34 (32.7%); DCR was 61.5%. Median PFS was 4.8 mo (95% CI, 3.4 to 6.6) and median OS (9.4 to NA) was not reached. The 6 mo PFS and OS rates were 43.1% and 77.9%, respectively. Treatment related (TR) AE occurred in 73.1% of pts; fatigue (21.2%) and increased aspartate aminotransferase (12.5%) were seen in ≥10% of pts and grades 3-5 TRAE in 25% including 1 death (ulcerative esophagitis). No cases of HBV/HCV flare occurred; immune mediated hepatitis occurred in 3 (2.9%) pts. Conclusion: Pembrolizumab treatment resulted in durable responses and favorable PFS and OS in pts with advanced HCC previously treated with sorafenib. Safety was generally comparable to that established for pembrolizumab monotherapy. Clinical trial information: NCT02702414.