bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of Local Evidence in Transferring Evidence-Based Interventions to Low- and Middle-Income Country Settings: Application to Global Cancer Prevention and Control
Authors: Parascandola Mark , Neta Gila , Salloum Ramzi G. , Shelley Donna , Rositch Anne F.
Published: August 2022

PURPOSE

Although the global burden of cancer falls increasingly on low- and middle-income countries (LMICs), much of the evidence for cancer prevention and control comes from high-income countries and may not be directly applicable to LMIC settings. In this paper, we focus on the following question: When the majority of the evidence supporting an evidence-based intervention or implementation strategy comes from high-income countries, what local, contextual evidence is needed when transferring and adapting an intervention or strategy to a specific LMIC setting?

METHODS

We draw on an existing framework (the Population, Intervention, Environment, Transfer-T process model) for assessing transferability of interventions between distinct settings and apply the model to two case studies as learning examples involving implementation of tobacco use treatment guidelines and self sampling for human papillomavirus DNA in cervical cancer screening.

RESULTS

These two case studies illustrate how researchers, policymakers, practitioners, and consumers may approach the need for local evidence from different perspectives and with different priorities. As uses and expectations around local evidence may be different for different groups, aligning these priorities through multistakeholder engagement in which all parties participate in defining the questions and cocreating the solutions is critical, along with promoting standardized reporting of contextual factors.

CONCLUSION

Local, contextual evidence can be important for both researchers and practitioners, and its absence may hinder translation of research and implementation efforts across different settings. However, it is essential for researchers, practitioners, and other stakeholders to be able to clearly articulate the type of data needed and why it is important. In particular, where resources are limited, evidence generation should be prioritized to address real needs and gaps in knowledge.
The Critical Role of Academic Clinical Trials in Pediatric Cancer Drug Approvals: Design, Conduct, and Fit for Purpose Data for Positive Regulatory Decisions
Authors: De Wilde Bram , Barry Elly , Fox Elizabeth , Karres Dominik , Kieran Mark , Manlay John , Ludwinski Donna , Reaman Gregory , Kearns Pamela
Published: August 2022

PURPOSE

For decades, academic clinical trials consortia have collaborated to optimize outcomes for childhood cancers through evaluating incremental improvements in conventional mutimodality treatment regimes. There are now increasing opportunities to partner with industry to test new medicines in academic-sponsored trials, but these collaborative studies rarely contribute to marketing authorizations. We addressed why this is the case and sought solutions to enable academic-sponsored trials to directly contribute to the licensing of new medicines.

METHODS

Under the auspices of the multistakeholder platform ACCELERATE, we convened a working group of representatives from clinical academia, pharmaceutical industry, European Medicines Agency, US Food and Drug Administration, and patient advocacy to define the challenges and propose recommendations to facilitate academic-sponsored trial design and conduct to be aligned to both the needs of the pharmaceutical company who own the asset and the expectations of the regulatory (licensing) authorities.

RESULTS

We identified that although academic consortia have long-standing expertise to conduct robust clinical trials, there were critical gaps in knowledge, standard procedures, and resources that hindered the trial data directly contributing to marketing authorization applications. We propose a suite of recommendations focused on (1) essential documents, (2) essential data, (3) data management, and (4) trial resources, specifically aimed at enabling academic-industry partnerships to deliver an academic-sponsored trial that meets the requirements for a marketing authorization submission. These recommendations pivot around transparency in academic-industry partnerships and early engagement with regulators.

CONCLUSION

Academic sponsors and industry partners need to prospectively recognize when the planned collaborative trial could contribute to an application to marketing authorization and plan accordingly. Transparent collaboration and knowledge sharing between the partners opens an important pathway for accelerating new treatments into clinical practice for children with cancer.
A Randomized, Double-Blind, Biomarker-Selected, Phase II Clinical Trial of Maintenance Poly ADP-Ribose Polymerase Inhibition With Rucaparib Following Chemotherapy for Metastatic Urothelial Carcinoma
Authors: Crabb Simon J. , Hussain Syed , Soulis Eileen , Hinsley Samantha , Dempsey Laura , Trevethan Avril , Song YeePei , Barber Jim , Frew John , Gale Joanna , Faust Guy , Brock Susannah , McGovern Ursula , Parikh Omi , Enting Deborah , Sundar Santhanam , Ratnayake Gihan , Lees Kathryn , Birtle Alison J. , Powles Thomas , Jones Robert J.
Published: August 2022

PURPOSE

A DNA repair deficiency (DRD) phenotype exists within a subset of metastatic urothelial carcinomas (mUC) predicting benefit from platinum-based chemotherapy. We tested switch maintenance therapy with the poly ADP-ribose polymerase inhibitor rucaparib, following chemotherapy, for DRD biomarker–positive mUC.

METHODS

DRD biomarker–positive mUC patients, within 10 weeks of chemotherapy, and without cancer progression, were randomly assigned (1:1) to maintenance rucaparib 600 mg twice a day orally, or placebo, until disease progression. The primary end point was progression-free survival (PFS). Statistical analysis targeted a hazard ratio of 0.5 with a 20% one-sided α for this signal-seeking trial. PFS (RECIST 1.1) was compared between trial arms, by intention to treat, within a Cox model.

RESULTS

Out of 248 patients, 74 (29.8%) were DRD biomarker–positive and 40 were randomly assigned. A total of 12 (60%) and 20 (100%) PFS events occurred in the rucaparib and placebo arms, respectively (median follow-up was 94.6 weeks in those still alive). Median PFS was 35.3 weeks (80% CI, 11.7 to 35.6) with rucaparib and 15.1 weeks (80% CI, 11.9 to 22.6) with placebo (hazard ratio, 0.53; 80% CI, 0.30 to 0.92; one-sided P = .07). In the safety population (n = 39) treatment-related adverse events were mostly low grade. Patients received a median duration of 10 rucaparib or six placebo cycles on treatment. Treatment-related adverse events (all grades) of fatigue (63.2% v 30.0%), nausea (36.8% v 5.0%), rash (21.1% v 0%), and raised alanine aminotransferase (57.9% v 10%) were more common with rucaparib.

CONCLUSION

Maintenance rucaparib, following platinum-based chemotherapy, extended PFS in DRD biomarker-selected patients with mUC and was tolerable. Further investigation of poly ADP-ribose polymerase inhibition in selected patients with mUC is warranted.
Alpha Cell Thioredoxin-interacting Protein Deletion Improves Diabetes-associated Hyperglycemia and Hyperglucagonemia
Authors: Lu Brian , Chen Junqin , Xu Guanlan , Grayson Truman B , Jing Gu , Jo SeongHo , Shalev Anath
Published: August 2022

Thioredoxin-interacting protein (TXNIP) has emerged as a key factor in pancreatic beta cell biology, and its upregulation by glucose and diabetes contributes to the impairment in functional beta cell mass and glucose homeostasis. In addition, beta cell deletion of TXNIP protects against diabetes in different mouse models. However, while TXNIP is ubiquitously expressed, its role in pancreatic alpha cells has remained elusive. We generated an alpha cell TXNIP knockout (aTKO) mouse and assessed the effects on glucose homeostasis. While no significant changes were observed on regular chow, after a 30-week high-fat diet, aTKO animals showed improvement in glucose tolerance and lower blood glucose levels compared to their control littermates. Moreover, in the context of streptozotocin (STZ)-induced diabetes, aTKO mice showed significantly lower blood glucose levels compared to controls. While serum insulin levels were reduced in both control and aTKO mice, STZ-induced diabetes significantly increased glucagon levels in control mice, but this effect was blunted in aTKO mice. Moreover, glucagon secretion from aTKO islets was >2-fold lower than from control islets, while insulin secretion was unchanged in aTKO islets. At the same time, no change in alpha cell or beta cell numbers or mass was observed, and glucagon and insulin expression and content were comparable in isolated islets from aTKO and control mice. Thus together the current studies suggest that downregulation of alpha cell TXNIP is associated with reduced glucagon secretion and that this may contribute to the glucose-lowering effects observed in diabetic aTKO mice.
The Painful Road to Freedom in Maram al-Masri’sElle Va Nue la Liberté(Freedom Walks Naked)
Authors: Mehta Brinda J.
Published: August 2022

This essay examines the poetry of the Francophone author Maram al-Masri, a diasporic feminist poet from Syria who has lived in exile in Paris since 1992. Elle va nue la liberté is an indictment of the regime of Bashar al-Assad and an ode to the creative resilience of ordinary people during the Syrian revolution (2011). This essay demonstrates how al-Masri’s poetry grafts landscapes of pain and resistance in a poetics of the gut that bears witness to horror, trauma, and resistance. It focuses on the trope of blood writing, documentary poetry or poésie-vérité, and the poet’s sense of exile in France.
Transcriptional targets of amyotrophic lateral sclerosis/frontotemporal dementia protein TDP-43 – meta-analysis and interactive graphical database
Authors: Cao Maize C. , Scotter Emma L.
Published: August 2022

TDP-43 proteinopathy is the major pathology in amyotrophic lateral sclerosis (ALS) and tau-negative frontotemporal dementia (FTD). Mounting evidence implicates loss of normal TDP-43 RNA-processing function as a key pathomechanism. However, the RNA targets of TDP-43 differ by report, and have never been formally collated or compared between models and disease, hampering understanding of TDP-43 function. Here, we conducted re-analysis and meta-analysis of publicly available RNA-sequencing datasets from six TDP-43-knockdown models, and TDP-43-immunonegative neuronal nuclei from ALS/FTD brain, to identify differentially expressed genes (DEGs) and differential exon usage (DEU) events. There was little overlap in DEGs between knockdown models, but PFKP, STMN2, CFP, KIAA1324 and TRHDE were common targets and were also differentially expressed in TDP-43-immunonegative neurons. DEG enrichment analysis revealed diverse biological pathways including immune and synaptic functions. Common DEU events in human datasets included well-known targets POLDIP3 and STMN2, and novel targets EXD3, MMAB, DLG5 and GOSR2. Our interactive database (https://www.scotterlab.auckland.ac.nz/research-themes/tdp43-lof-db/) allows further exploration of TDP-43 DEG and DEU targets. Together, these data identify TDP-43 targets that can be exploited therapeutically or used to validate loss-of-function processes.

This article has an associated First Person interview with the first author of the paper.
Advances in the management of spinal metastases: what the radiologist needs to know
Authors: Bahouth Sarah M , Yeboa Debra N , Ghia Amol J , Tatsui Claudio E , Alvarez-Breckenridge Christopher A , Beckham Thomas H , Bishop Andrew J , Li Jing , McAleer Mary Frances , North Robert Y , Rhines Laurence D , Swanson Todd A , Chenyang Wang , Amini Behrang
Published: August 2022

Spine is the most frequently involved site of osseous metastases. With improved disease-specific survival in patients with Stage IV cancer, durability of local disease control has become an important goal for treatment of spinal metastases. Herein, we review the multidisciplinary management of spine metastases, including conventional external beam radiation therapy, spine stereotactic radiosurgery, and minimally invasive and open surgical treatment options. We also present a simplified framework for management of spinal metastases used at The University of Texas MD Anderson Cancer Center, focusing on the important decision points where the radiologist can contribute.
A multicentric, 2 × 2 factorial, randomised, open-label trial to evaluate the clinical effectiveness of structured physical activity training and cognitive behavioural therapy versus usual care in heart failure patients: a protocol for the PACT-HF trial
Authors: Jeemon Panniyammakal , Reethu Salim , Ganapathi Sanjay , Lakshmi Kanth Lakshmipuram Rajappan , Punnoose Eapen , Abdullakutty Jabir , Mattumal Shafeeq , Joseph Johny , Joseph Stigi , Venkateswaran Chitra , Sunder Poornima , Babu Abraham Samuel , Padickaparambil Sebastian , Neenumol Kandagathuparambil Rajan , Chacko Susanna , Shajahan Shamla , Krishnankutty Krishnaja , Devis Selma , Joseph Rani , Shemija Bhagavathikandy , John Sneha Anna , Harikrishnan Sivadasanpillai
Published: August 2022

Background: Heart failure (HF) is a multi-morbid chronic condition, which adversely affects the quality of life of the affected individual. Engaging the patient and their caregivers in self-care is known to reduce mortality, rehospitalisation and improve quality of life among HF patients. The PACT-HF trial will answer whether clinical benefits in terms of mortality and hospitalisation outcomes can be demonstrated by using a pragmatic design to explore the specific effects of physical activity, and cognitive behavioural therapy in HF patients in India.

Methods: We will conduct a 2 × 2 factorial, randomized, open-label trial, which aims to see if rehabilitation strategies of structured physical activity training and cognitive behavioural therapy for depression and self-management reduce the risk of repeat hospitalisation and deaths in HF patients in India. Patients will be randomised to (1) physical activity + usual care (2) cognitive behaviour therapy + usual care, (3) physical activity + cognitive behaviour therapy + usual care, and (4) usual care at 1:1:1:1 ratio. Time to mortality will be the primary outcome. A composite of mortality and hospitalisation for HF will be the main secondary outcome. Additional secondary outcomes will include ‘days alive and out of hospital’, cumulative hospitalisation, quality of life, Minnesota Living with Heart Failure questionnaire score, depression score, six minutes walking distance, handgrip strength, and adherence to medicines and lifestyle.  The effects of intervention on the primary outcome will be estimated from Cox proportional hazard models. For the continuous secondary outcome variables, differences between randomised groups will be estimated from linear mixed models or generalised estimating equations (GEE) as appropriate.

Discussion: PACT-HF is designed to provide reliable evidence about the balance of benefits and risks conferred by physical activity and cognitive behavioural therapy-based cardiac rehabilitation for those with HF, irrespective of their initial disease severity.
Possible transgenerational associations between grandparents’ childhood exposures and religious belief in their granddaughters: a longitudinal cohort study
Authors: Golding Jean , Gregory Steven , Northstone Kate , Pembrey Marcus , Ellis Genette , Watkins Sarah , Iles-Caven Yasmin , Suderman Matthew
Published: August 2022

Background: Research in non-genetic inheritance indicates that grandparents’ smoking habits and their childhood experiences of trauma can influence the physical and psychological attributes of their grandchildren. This was particularly apparent for outcomes such as autism and obesity where the population prevalence changed over time. Other factors which have changed temporally include religious and spiritual beliefs (RSBs) which have been declining in Western populations.

Methods: We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to explore whether grandparental exposures were associated with the religious and/or spiritual beliefs of their grandchildren. In line with other inter/trans-generational human studies we predicted that: (P1) grandparents’ childhood exposures to cigarette smoking (whether in utero or by active smoking) and/or exposure to traumatic events during childhood will be associated with their grandchild’s RSB; (P2) associations will differ between maternal and paternal lines of inheritance; (P3) relationships will vary with age at grandparental exposure, and (P4) associations will differ between grandsons and granddaughters.

Results: We found significant associations between the grandchild’s RSB and both the grandparents’ smoking and their childhood trauma histories (P1 supported). These associations were mainly found down the maternal line (P2 possibly supported) and results varied with age of exposure of the grandparents; being strongest for in utero exposure of cigarette smoke and for pre-puberty exposure of traumatic events (P3 supported), and that granddaughters were more affected than grandsons (P4 supported).

Conclusions: We hope that these results will motivate collection of similar data to further evaluate these questions in other populations, including a possible role for biological mechanisms.
Communication of a University Teacher: New Realities and Facets of Transformation
Authors: Semenova L.
Published: August 2022

Introduction. The article is devoted to an actual problem - the study of the problems of pedagogical communication in modern higher education, the design and modeling of a modern teacher. Modern realities, state and social orders are changing the requirements for competencies and skills of hard skills and soft skills, predicting future skills.

Aim. The purpose of the article is to develop the design of a modern university teacher by analyzing current trends in the transformation of higher education and pedagogical communication.

Methodology and methods. The study is based on the integrative-competence paradigm and professional approach. Research methods: analytical review of literary sources and the content of the research, pedagogical modeling and design, included observation, analysis, synthesis, generalization.

Results. Based on the analysis of literary sources, current trends in the transformation of higher education and pedagogical communication, the requirements for a modern teacher and problems in pedagogical communication are determined.

Scientific novelty lies in the identification and systematization of a set of requirements for a modern teacher, which replenishes scientific knowledge about pedagogical communication.

Practical significance. The results of the study can be useful for developing ideas about the formation of professional competence of a university teacher and can be applied by them in the process of self-development, professional development.
A rare case of woman with complete androgen insensitivity syndrome
Authors: Grądzik Anna , Gorajek Anna , Kudan Małgorzata , Osiejewska Aleksandra , Mikut Karolina
Published: August 2022

Introduction: Androgen insensitivity syndrome (AIS) is an inherited disorder of sexual development caused by mutations in the androgen receptor encoding gene.Case report: A female patient born in 1984, at the age of 17, was diagnosed with complete androgen insensitivity syndrome, during the diagnosis of primary amenorrhea. She was assigned grade 7 in the Quigley scale. Cytogenetic analysis showed a 46 XY karyotype. Gynecological examination revealed a blind ending vagina and a lack of uterus. Physical examination revealed normal breast development and scanty pubic and axillary hair. The patient kept seeing herself as a woman. At the age of 18, the patient underwent laparoscopic gonadectomy. After the procedure, the patient was under medical supervision and was taking orally 1 mg of estradiol daily. At the age of 24 patient was diagnosed with. The patient received sodium alendronate and ibandronic acid. The level of FSH was 35.50 mlU / ml and LH was 13.05 mlU/ml.

Discussion: Quigley grades 6 and 7 correspond to complete androgen insensitivity. The genitals are completely feminized and newborns at birth are assigned as females. The diagnosis is usually established during the diagnostics of primary amenorrhea. CAIS is associated with high risks of gonad carcinogenesis and therefore a gonadectomy must be performed. Hormone replacement therapy (HRT) is required after gonadectomy in order to maintain secondary sexual characteristics. Due to the high risk of osteoporosis patient requires calcium and vitamin D supplementation and bone density control. The prognosis is good, and gonadectomy and HRT usually give satisfactory long-term results.
The popularity and usability of mobile applications for women and expecting mothers
Authors: Grądzik Anna , Gorajek Anna , Osiejewska Aleksandra , Wojtachnio Dominika , Nowakowska Izabela , Bartoszewicz Jakub
Published: August 2022

Introduction and purpose: There are many applications for women, including those planning to conceive, being pregnant or having a small child. These applications have various functions, among others: menstrual cycle control, information about fetal development, labor contractions counting or lifestyle advice. Aim of the study was to assess the popularity, usability, most frequently used functions and expectations of users in relation to mobile applications designed for period tracking, for pregnant women and for parents.

Material and methods: The study was conducted in the form of a self-prepared, anonymous survey shared on social media.

Results: 522 correctly completed questionnaires were analysed. The main sources of knowledge about pregnancy and motherhood were: Internet (90.4%) and doctor (73.5%). 78.7% of participating women used period tracking applications. The most useful functions were: date of period (94.7%), fertile days and ovulation (86.4%) and menstrual cycle regularity (58,2%). 86.6% of women used pregnancy tracker applications. The most useful features were: information about week of pregnancy (98.5%), child development (95.3%) and countdown to childbirth (83%). Using application during pregnancy: 74.8% of women felt more aware and 68.6% enjoyed the expectation time more. Parenting applications were the least popular - only 25% of respondents used them.

Conclusions: Thanks to the mobile applications, women can be more aware and better prepared for planning pregnancy and motherhood. Encouraging them to use the applications can bring many benefits in a doctor-patient relationships, provided that the information contained therein is properly constructed.
The development of sport and tourism in the Międzychód County and the concept of the European Green Deal
Authors: Poczta Joanna , Styperek Jarosław
Published: August 2022

Sport and tourism may become one of the most important areas of the local economy of the four communes in the Międzychód district. Its areas are associated with the Międzychodzko - Sierakowskie Lake District, and the studies of the intensity of tourist traffic confirm this exactly. They show that guests' stays in the region are mainly limited to visits to two tourist centers, the cities of Sieraków and Międzychód, and usually they are not long stays. The proposal for the development of sports and tourism in the Międzychód County is to increase the tourist traffic for sports tourism and extend the stay of tourists using the rich natural, cultural and landscape resources as well as agritourism infrastructure in rural areas. This idea is also guided by the inhabitants involved in the development of the region, representatives of local authorities, non-governmental organizations, cultural institutions, schools and entrepreneurs, therefore the main goal of the presented article is to find out about the opinion of the inhabitants of the Międzychód district on bicycle transport in the context of the European Green Deal.
A Computational Framework for Solving Nonlinear Binary Optimization Problems in Robust Causal Inference
Authors: Islam Md Saiful , Morshed Md Sarowar , Noor-E-Alam Md.
Published: August 2022

Identifying cause-effect relations among variables is a key step in the decision-making process. Whereas causal inference requires randomized experiments, researchers and policy makers are increasingly using observational studies to test causal hypotheses due to the wide availability of data and the infeasibility of experiments. The matching method is the most used technique to make causal inference from observational data. However, the pair assignment process in one-to-one matching creates uncertainty in the inference because of different choices made by the experimenter. Recently, discrete optimization models have been proposed to tackle such uncertainty; however, they produce 0-1 nonlinear problems and lack scalability. In this work, we investigate this emerging data science problem and develop a unique computational framework to solve the robust causal inference test instances from observational data with continuous outcomes. In the proposed framework, we first reformulate the nonlinear binary optimization problems as feasibility problems. By leveraging the structure of the feasibility formulation, we develop greedy schemes that are efficient in solving robust test problems. In many cases, the proposed algorithms achieve a globally optimal solution. We perform experiments on real-world data sets to demonstrate the effectiveness of the proposed algorithms and compare our results with the state-of-the-art solver. Our experiments show that the proposed algorithms significantly outperform the exact method in terms of computation time while achieving the same conclusion for causal tests. Both numerical experiments and complexity analysis demonstrate that the proposed algorithms ensure the scalability required for harnessing the power of big data in the decision-making process. Finally, the proposed framework not only facilitates robust decision making through big-data causal inference, but it can also be utilized in developing efficient algorithms for other nonlinear optimization problems such as quadratic assignment problems.

History: Accepted by Ram Ramesh, Area Editor for Data Science and Machine Learning.

Funding: This work was supported by the Division of Civil, Mechanical and Manufacturing Innovation of the National Science Foundation [Grant 2047094].

Supplemental Material: The online supplements are available at https://doi.org/10.1287/ijoc.2022.1226 .
Browse or Experience
Authors: Ning Z. Eddie , Villas-Boas J. Miguel
Published: August 2022

Consumer learning prior to and after the purchase, with endogenous pricing, leads to greater search prior to the purchase for more durable products.
The extraordinary early years
Authors: Wright Caroline
Published: August 2022

When forming their new curriculum, the team at Bright Horizons put their ethos at the centre of this process: ‘The child is at the very heart of everything that our teams do, and it's that relationship between a practitioner and a child that is the key to inspiring early childhood education’.
Tantrum or dysregulation?
Authors: Grenier Julian
Published: August 2022

The recent opinion piece in EYE, ‘Mind Your Language’, raises an important question: what sort of language should we use when we talk about children? Whilst the topic is important, I believe the argument is flawed, and the examples used are also problematic. My view is that the term ‘tantrum’ is more appropriate and accessible than the suggestion of ‘dysregulation’.
Statistical process control and geostatistics on the characterization of the noise produced by a backhoe loader
Authors: Silva Fabiano Battermarco da , Ferraz Gabriel  Araújo e Silva , Cunha João Paulo Barreto , Marin Diego Bedin , Santana Lucas Santos , Santos Luana Mendes dos
Published: August 2022

Workers in their labor activities may be subject to operational risks, such as noise. The objective of this work was to use geostatistics and Statistical Process Control (SPC) through individual charts to map and characterize the magnitude of the spatial variability of noise produced by a backhoe, to identify areas of health for workers. The experiment was developed at the technical college of the Federal Rural University of Rio de Janeiro. A 63-kW backhoe loader and a digital decibel meter were used to collect noise levels at points distributed in a regular 2.0 x 2.0 m sampling grid around the machine. The spatial dependence of the noise was analyzed by adjusting the Wave-type semi-variogram, interpolation by ordinary kriging, and SPC. It was possible to characterize the spatial dependence of noise levels produced by the backhoe as well as to carry out, through individual letters in dialogue with geostatistics, the mapping of their spatial distribution to identify healthy areas for workers. It could have been found in the evaluation of the backhoe loader control chart, that there was no reduction in the variability of noise data, which was approximately 73.29 dB(A) for the sampled points. This shows an average very close to the analysis found in the execution of the descriptive statistics of the noise generated by the backhoe loader.
Complications and Difficulties Encountered in the Management of a Neglected Osteoporotic Proximal Humerus Fracture
Authors: Mohanty Sarthak , Patro Bishnu , Priya Behera Shri Hari , Mohanty Chita Ranjan
Published: August 2022

Introduction: Osteoporosis is a known complication of prolonged steroid therapy. Osteoporotic fracture is common in such a scenario and poses several challenges in its management. We present a case of neglected proximal humerus fracture in a 57-year-old osteoporotic female and the difficulties encountered in its management. Case Report: A 57- year-old female, rheumatoid arthritis patient, is on steroids for the past ten years. Four years back, she sustained a fracture of the left humerus neck following a trivial trauma. The fracture was not managed by an orthopaedician and was treated by a general practitioner. She presented to us in a state of painless displaced non-union of fragments with severe osteoporosis. DEXA scan revealed severe osteoporosis. She was started on oral calcium, magnesium, and vitamin D supplementation. Along with oral supplementation, the patient was advised 20 mcg of Teriparatide subcutaneously once daily and single dose of Denosumab 60 mg subcutaneously. Non -vascularized free fibular graft was harvested from the ipsilateral lower limb. A five-hole PHILOS plate was used to fix the fracture. Intra-operatively, the humeral head appeared too indistinct under fluoroscopy leading to difficulty in estimating screw length. An indirect method was used to assess the screw length. The post-operative radiograph was satisfactory but radiograph after two weeks showed an un-displaced fracture adjacent to the distal end of the plate. It was decided to continue with conservative management by a “‘U”’ cast. A follow- up radiograph at three3 months showed complete union of the stress fracture at the distal end of the plate end and progressive union of the fracture at the primary site. But En- block pull-out of the locking plate was noticed in the distal fragment of the fracture in the follow-up radiograph at 9 months from surgery. The limb was further immobilized in an arm sling for more four weeks. At one year from operation, there was good union of fracture with acceptable shoulder movement. Conclusion: Osteoporotic fractures are often difficult to treat. Careful pre-operative planning, active osteoporosis management, good implant selection, careful bone handling, and judicious rehabilitation are key to avoid complications and achieve good functional outcome.
A Symptomatic Swollen Ankle in an 8-year-old Male Child – A Rare Case Report of Dysplasia Epiphysealis Hemimelica
Authors: Koshire Spandan , Sarukte Vijay , Aher Ganesh
Published: August 2022

Introduction: Trevor’s disease also known as Dysplasia Epiphysealis Hemimelica is an uncommon epiphyseal affliction of childhood, developmental in nature with unknown etiology. It is an osteochondral lesion arising from the epiphyses and progressively increasing in size until skeletal maturity is reached. Surgical management is not advisable in cases, where there is absence of articular symptoms and mass evolution is present, until there is achievement of skeletal maturity. Pain, joint deformity, and impingement mandate surgical intervention and the result is good in cases, where the mass is juxta articular or extra-articular in location. Case Report: We report such a rare case of an 8-year-old male child who presented to us with a hard swelling over ankle with restricted movement and was promptly treated by us with medial malleolus osteotomy and surgical excision of the tumorous mass with subsequent malleolar screw fixation after establishing a diagnosis of osteochondroma of talus. Conclusion: Making a correct diagnosis with imaging and confirmation by histology is necessary, after which careful surgical planning should be carried out in cases, where bony masses are causing pain, ankle mobility hindrance, and impingement with footwear hampering daily activities, this helps prevent recurrence and its further complications.
All-fiber bidirectional mode-locked laser to generate cylindrical vector beam asynchronous noise-like pulses
Authors: Lu Yuan , Lin Jiaqiang , Lv Jialiang , Luo Jing , Liu Xiangzhong , Xu Lixin , Gu Chun , Yao Peijun
Published: August 2022

We proposed and demonstrated a bidirectional mode-locked fiber laser to generate cylindrical vector beam (CVB) asynchronous pulses based on a graded index multimode fiber. A homemade fused taper two-mode fiber optical coupler (TMF-OC) is employed as a mode converter. The central wavelength for clockwise (CW) pulses can be tuned from 1030.32 nm to 1041.04 nm due to the filtering effect based on multimode interference, that of counterclockwise (CCW) pulses is from 1030.81 nm to 1039.28 nm. When the central wavelengths are 1033.22 nm and 1032.71 nm for CW direction and CCW direction respectively, CVB asynchronous noise-like pulses with a repetition rate difference of ∼436.9 Hz can be obtained. The purity of CVB in CW direction and CCW direction is 95.7% and 93.4% respectively. This bidirectional mode-locked fiber laser with CVB output can be better applied to laser gyroscopes, asynchronous sampling, and dual-comb technique, and impel the interdisciplinary studies in the future.
Hyperfine coupling constants of the cesium 7D5/2 state measured up to the octupole term
Authors: Rahaman Bubai , Dutta Sourav
Published: August 2022

We report the measurement of hyperfine splitting (HFS) in the 7D5/2 state of 133Cs using high-resolution Doppler-free two-photon spectroscopy enabled by precise frequency scans using an acousto-optic modulator (AOM). All six hyperfine levels are resolved in our spectra. We determine the hyperfine coupling constants A = –1.70867(62) MHz and B = 0.050(14) MHz which represent an over 20-times improvement in the precision of both A and B. Moreover, our measurement is sufficiently precise to put bounds on the value of the magnetic octupole coupling constant C = 0.4(1.4) kHz for the 7D5/2 state. We additionally report the measurement of the ac Stark shift [–46 ± 4 Hz/(W/cm2)], collisional shift, and pressure broadening which are important for optical frequency standards based on the 6S1/2 → 7D5/2 two-photon transition.
Ultra low loss broadband 1 × 2 optical power splitters with various splitting ratios
Authors: Goudarzi Kiyanoush , Kim Doyoung , Lee Haneol , Park Ikmo , Han Haewook
Published: August 2022

We designed Si-based all-dielectric 1 × 2 TE and TM power splitters with various splitting ratios by combining the use of the inverse design of adjoint and numerical 3D finite-difference time-domain methods. The structure of the designed Si-based power splitters contains two Si waveguide branches on a SiO2 substrate that is compatible with CMOS fabrication technology. The proposed devices exhibit ultra-high transmission efficiency above 98 and 99%, and excess losses below 0.1 and 0.035 dB, for TE and TM splitters, respectively. The merits of these devices include a minor footprint of 2.2 × 2.2 µm2 and a flat-broad operating bandwidth of 200 nm with a center wavelength of λ = 1.55 µm. Also, the other advantage of these optical power splitters is the very short optimization time of 2 h for each device. Because of the aforementioned merits, the optimized devices can be crucial candidates for optical integrated circuits.
Adaptive search space pruning in complex strategic problems
Authors: Amir Ofra , Tyomkin Liron , Hart Yuval
Published: August 2022

People have limited computational resources, yet they make complex strategic decisions over enormous spaces of possibilities. How do people efficiently search spaces with combinatorially branching paths? Here, we study players’ search strategies for a winning move in a “k-in-a-row” game. We find that players use scoring strategies to prune the search space and augment this pruning by a “shutter” heuristic that focuses the search on the paths emanating from their previous move. This strong pruning has its costs—both computational simulations and behavioral data indicate that the shutter size is correlated with players’ blindness to their opponent’s winning moves. However, simulations of the search while varying the shutter size, complexity levels, noise levels, branching factor, and computational limitations indicate that despite its costs, a narrow shutter strategy is the dominant strategy for most of the parameter space. Finally, we show that in the presence of computational limitations, the shutter heuristic enhances the performance of deep learning networks in these end-game scenarios. Together, our findings suggest a novel adaptive heuristic that benefits search in a vast space of possibilities of a strategic game.
Nurturing families: One year pilot outcomes for a modified Parent Child Assistance Program in Australia
Authors: Symons Martyn , Finlay-Jones Amy , Meehan Jennifer , Raymond Natalie , Watkins Rochelle
Published: August 2022

Alcohol and Other Drug (AOD) exposure during pregnancy is linked to serious adverse child outcomes, including Fetal Alcohol Spectrum Disorder (FASD). The Parent-Child Assistance Program (PCAP) supports women with problematic AOD use, who are pregnant or have young children, and are not effectively engaging with services. PCAP has been shown to reduce alcohol exposed pregnancies, promote AOD abstinence, increase employment and family planning and improve child outcomes. This manuscript reports the first pilot evaluation of the PCAP program delivered in Australia. A pre-post-intervention repeated measures design was used. Eleven women receiving PCAP from a not-for-profit organisation were invited to take part in the study, with eight providing complete pre-post data. Home visitation case management was provided by trained and experienced case-managers. Clients were assisted to engage with existing services effectively to meet their own goals via a combination of relational theory, motivational interviewing and harm reduction concepts. The PCAP Modified Addiction Severity Index 5th Edition was adapted for use in Australia and was used to measure domains of addiction severity related problems as the primary outcome. Secondary outcomes included client satisfaction and program fidelity. There were significant changes in composite addiction severity scores from baseline to one year. 80% of participants had periods of abstinence of longer than four months. All clients had better connection to services, no subsequent AOD exposed pregnancies, and were highly satisfied with the program. Four had children returned to their care. Implementation was similar to the original PCAP program with major differences including case-managers relying on training manuals only without undertaking in-person training; being more experienced; providing more direct AOD counselling; and having less supervision. The findings will inform future program delivery and methodology for a larger longitudinal study assessing outcomes at program exit.
Behavioral and psychosocial factors of quality of life among adult people living with HIV on Highly Active Antiretroviral Therapy, in public hospitals of Southwest Ethiopia
Authors: Gesese Abreha Addis , Desta Yitages Getachew , Behire Endale Zenebe
Published: August 2022

Despite the availability of Highly Active Antiretroviral Therapy, the quality of life (QOL) of People Living with HIV/AIDS (PLWHIV) has continued to be affected. However, previous studies focused on the magnitude and clinical determinants which lacks behavioral and psychosocial factors of QOL. Thus, this study aimed to identify behavioral and psychosocial determinants of QOL among Adult PLWHIV on HARRT, in Public Hospitals of Jimma Zone, South West, Ethiopia, 2018. A cross-sectional study design was conducted in Public Hospitals of Jimma Zone, Southwest Ethiopia from March 10 to April 10/2018. QOL of was measured using WHOQOL-HIV BREF instrument. A simple random sampling technique was employed to enroll study participants. A pretested interviewer-administered structured questionnaire was used to collect data. Then, data were entered into Epi-Data version 3.1 and analyzed using SPSS version 20. Bivariate and multiple variable logistic regression analyses were also performed. A total of 300 respondents were enrolled into the study yielding a response rate of 97.7%. The majority of respondents were from urban residence and between 35–44 years of age. About 47% of respondents have ever used substances, and 58.3% have obtained social support. Nearly 80% and 26.3% of the study participants were stigmatized and severely depressed. More than half of the study participants had good overall QoL with the highest domain QOL in level of independence and lowest in social relations. Factors associated with poor physical health include being government employee AOR 0.33 95%CI (0.15, 0.69), from private business AOR 0.33 95%CI (0.14, 0.79), being 1st wealth quintile AOR 2.44 95%CI (1.16, 5.14), and not obtaining financial support AOR 4.27 95%CI (1.94, 9.42). Lower wealth index has been associated with almost all domain scores of poor QOL except spiritual domain. More than half of the respondents had good overall QoL with the highest domain score in level of independence and lowest in social relations domain. Several factors have contributed to poor domain QOL of PLWHIV. Therefore, it will become all the most important to develop effective strategies, policies and programs targeting people living with HIV. Emphasis should be given to the socio-economic factors that affect their QOL on HAART. Professional counseling and guidance with life skill packages should be strengthened to cope up with adverse behavioral factors. Finally, psychosocial support should be provided from all responsible bodies.
Passion, commitment, and burnout: Experiences of Black gay men working in HIV/AIDS treatment and prevention in Atlanta, GA
Authors: Jones Marxavian , Smith Justin C. , Moore Shamia , Newman Antonio , Camacho-González Andrés , Harper Gary W. , del Río Carlos , Hussen Sophia A.
Published: August 2022

Background

HIV-focused organizations, care providers and research programs often hire Black gay, bisexual and other men who have sex with men (GBMSM) in their efforts to reach highly affected communities. Due to their unique social position within and outside of organizations, Black GBMSM are ideally situated to contribute to HIV care and prevention programming targeting their own communities, but may also be at risk for stress and burnout in these settings. Despite this critical role for Black GBMSM in efforts to end the epidemic, little is known about subjective experiences of Black GBMSM who work in the HIV field.

Methods

We conducted qualitative interviews with 19 Black GBMSM who were identified as key informants. All were working in community-based organizations, clinical or academic settings in the area of HIV prevention and treatment in Atlanta, Georgia. We used a thematic analysis approach to identify salient themes with respect to the workplace experiences of Black GBMSM as well as the role of their identities in their work in the field.

Results

Participants discussed: (1) Shared experiences and growth; (2) Work-related stressors; (3) Worker burnout; and (4) Commitment to continue working in the HIV field. On the whole, Black GBMSM derived meaning from their work, and found their intersectional identities to be a strength in fulfilling job duties. At the same time, Black GBMSM described multiple stresses faced as they balanced their personal and professional connections to this work, while also dealing with their own challenges related to discrimination, socioeconomic status, and health. Participants repeatedly described sacrificing their own well-being for the greater good of their communities, highlighting contributors to burnout within and outside of the workplace.

Conclusions

Our participants derived meaning from their work in the HIV field and were affirmed by professional interactions with other Black GBMSM. At the same time, they also faced work-related and other psychosocial stressors that predisposed them to frustration and burnout. To promote workplace equity and wellness for Black GBMSM, we share recommendations for HIV-focused organizations that employ and serve men in this demographic.
Increase in glycemic set point, alongside a decrease in waist circumference, in the non-diabetic population during the Japanese National Intervention Program for metabolic syndrome: A single-center, large-scale, matched-pair analysis
Authors: Sugiyama Takuya , Yamada Yuya , Ito Yoshito , Mineo Ryohei , Iwamoto Ryuya , Tamba Sachiko , Fujimoto Takashi , Yamamoto Koji , Matsuzawa Yuji
Published: August 2022

Background

In 2008, the Japanese government implemented a National Intervention Program for metabolic syndrome. Low-risk individuals were not direct targets of this intervention. Nevertheless, they were indirectly enlightened by this massive campaign. Documentation of the metabolic shifts in low-risk individuals following the program launch may inform public health policy regarding approaches to metabolic risks in the general population.

Methods

We conducted a cross-sectional analysis of data from non-diabetic participants who underwent general health check-ups at the Physical Check-up Center of Sumitomo Hospital. Participants during 2007–2008 were pair-matched with those during 2015–2016 with respect to sex, age, smoking status, hemoglobin level, and red blood cell (RBC) count. Each participant was included only once in the study.

Results

Totals of 3,140 men and 2,048 women were pair-matched. The non-diabetic participants showed lower waist circumference, blood pressure, heart rate, and serum lipid concentrations during the second study period. In contrast, the entire distributions of fasting plasma glucose (FPG) concentration in both sexes and glycated hemoglobin (HbA1c) in women were shifted upwards. In men, Δ FPG was +1.6 mg/dL (P < 0.001) and Δ HbA1c was ±0% (P = 0.6). In women, Δ FPG was +3.0 mg/dL (P < 0.001), and Δ HbA1c was +0.1% (P < 0.001). Δ Homeostasis model assessment of β-cell function was −6.6 in men (P < 0.001) and −10.3 in women (P < 0.001). The homeostasis model assessment of insulin resistance did not change significantly.

Conclusions

The “glycemic set point” has increased in non-diabetic people in Japan during recent years. Lifestyle or environmental changes may have caused this metabolic shift through obesity-independent pathways, possibly through effects on pancreatic β-cell function. The underlying mechanism awaits further investigation.