bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of agent-based modeling to model intermediate force capabilities in (counter)mobility crowd scenarios
Authors: Afara Jessica , Ajila Victoria , Macdonell Hannah , Dobias Peter
Published: December 2022

In this paper, we use an agent-based model (ABM) to run (counter)mobility scenarios to explore which characteristics of intermediate force capabilities (IFC) are relevant to these, and how they can affect outcomes in gray zone conflicts. Using an ABM called Map-Aware Non-Uniform Automata (MANA), developed by the New Zealand Defense Technology Agency, we implemented two scenarios where the friendly forces’ mobility was limited by large groups of civilians. Then, we employed data farming and analytics methods to analyze the data and identify key parameters influencing the outcomes. The main parameters appeared to be the IFC Range, Power (a measure of the duration of the effect), and Crowd Density. Future research could include a wide range of mobility scenarios and possibly a more detailed IFC representation.
Dopamine receptor D2, but not D1, mediates the reward circuit from the ventral tegmental area to the central amygdala, which is involved in pain relief
Authors: Huang Minjie , Wang Guoqing , Lin Yazhou , Guo Yanyan , Ren Xiuhua , Shao Jinping , Cao Jing , Zang Weidong , Li Zhihua
Published: December 2022

Pain involves both sensory and affective dimensions. The amygdala is a key player in linking nociceptive stimuli to negative emotional behaviors or affective states. Relief of pain is rewarding and activates brain reward circuits. Whether the reward circuit from the ventral tegmental area (VTA) to the central amygdala (CeA) is involved in pain relief remains unexplored. Using a model of experimental postsurgical pain, we found that pain relief elicited conditioned place preference (CPP), activated CeA-projecting dopaminergic cells in the VTA, and decreased dopaminergic D2 receptor expression in the CeA. Activation of the VTA–CeA neural pathway using optogenetic approaches relieved incisional pain. Administration of a D2 receptor agonist reversed the pain relief elicited by light-induced activation of the VTA-CeA pathway. These findings indicate that the VTA-CeA circuit is involved in pain relief in mice via dopamine receptor D2 in the CeA.
A New Way to Think About Internal and External Validity
Authors: Trafimow David
Published: December 2022

Researchers have been concerned with internal and external validity for decades, and the discussion continues. The present proposal is that there are less important and more important senses in which one can interpret internal and external validity, and these can be integrated with a taxonomy that includes theoretical, auxiliary, statistical, and inferential assumptions. The integration sheds light on recent exchanges in the literature on validity and suggests that the vaunted internal–external validity trade-off is false for more important senses of internal and external validity; internal and external validity increase or decrease together when there is an emphasis on underlying theories. Finally, the integration implies the desirability of some changes in typical research advice and practice.
Reliability analysis of k-out-of-n: G repairable systems considering common cause failure and multi-level maintenance strategy
Authors: Dong Qinglai , Liu Pin , Jia Xujie
Published: December 2022

A common cause failure occurs when two or more elements fail due to a shared cause. The system with such failure often needs different repairmen and a multi-level maintenance strategy. The paper studies the reliability of k-out-of-n: G repairable systems considering common cause failure and multi-level maintenance strategy. The models with a multi-level maintenance strategy are established by considering the failure of all and partial components due to common cause failure. The reliability indices of the systems, such as availability and the mean time to first failure, are derived. An optimization maintenance model is established by minimizing the cost, and a three-level maintenance strategy is determined. Numerical examples are provided to illustrate the application. The results show that the multi-level maintenance strategy improves the system reliability and reduces the maintenance costs of systems with common cause failure.
Andy Blake; or, the Irish Diamond
Authors: Meer Sarah , Zetter Nathaniel
Published: December 2022

This scholarly edition of Andy Blake includes an introduction arguing for its claim to be Dion Boucicault’s first Irish drama. It also emphasises Agnes Robertson’s part in developing Boucicault’s comic heroes, while playing a boy. Consideration of the French source text reveals a connection with a revolutionary figure, the gamin de Paris, and demonstrates how Boucicault’s adaptation added a backdrop of British military imperialism.
Interventions to facilitate interprofessional collaboration in the operating theatre: A scoping review
Authors: Levesque Marie-Julie , Etherington Cole , Lalonde Michelle , Moradi Narges , Sikora Lindsey , Stacey Dawn
Published: December 2022

Background:

Ineffective collaboration can increase adverse events in the operating theatre. When professionals work collaboratively, they are more likely to improve patient safety and outcomes.

Aim:

To identify interprofessional collaboration interventions involving operating theatre teams and describe their effect on facilitating communication, teamwork, and safety.

Methods:

A scoping review of four databases. Results were analysed by identifying interventions and mapping their related outcomes.

Results:

Twenty studies evaluated single or multi-faceted interventions. Despite low-quality study designs (no randomised controlled trials), four interventions (eg: briefings, checklists, team training, debriefing) improved communication and teamwork, and enhanced safety outcomes. Only one study, using team training, reported that organisational level interventions (eg: Standard Operating Procedures, Lean quality improvement management system) improved teamwork and safety outcomes.

Conclusion:

Several studies reported interventions enhanced interprofessional collaboration within operating theatre teams. Although findings were in favour of improved communication and teamwork, more rigorous research is required.
Ginger Could Improve Gestational Diabetes by Targeting Genes Involved in Nutrient Metabolism, Oxidative Stress, Inflammation, and the WNT/β-Catenin/GSK3β Signaling Pathway
Authors: Luo Liping , Zhu Sihong , Akbari Abolfazl , Tan Buzhen
Published: December 2022

This study aimed to evaluate the effect in female rats of 6 weeks of ginger consumption on gestational diabetes by assessing glucose and lipid metabolism, oxidative damage, inflammation, and the WNT/β-catenin/glycogen synthase kinase-3 beta (GSK3β) signaling pathway. In this study, 40 adult female rats were divided into 4 equal groups as follows: pregnant rats, pregnant rats with diabetes, pregnant rats consuming ginger, and pregnant rats with diabetes consuming ginger. Induction of diabetes on day 0 of pregnancy was induced by streptozotocin (STZ) injection. Insulin, glucose, and lipid profiles as metabolic factors were measured along with the hepatic expression of glucose transporter type 4 (GLUT4), mechanistic target of rapamycin complex 1 (mTORc1), sterol regulatory element-binding protein-1c (SREBP-1c), peroxisome proliferator-activated receptor α (PPAR-α), β-catenin, GSK3β, PPAR-g, nuclear factor-κB (NF-kB), and nuclear factor erythroid 2-related factor 2 (Nrf2). The levels of tumor necrosis factor α (TNF-α), interleukin 1β (IL-1β), and oxidative parameters were measured in the liver. The level of metabolic factors was significantly impaired in diabetic pregnant rats compared to the control group. However, ginger improved these parameters in the diabetic pregnant—ginger group compared to the diabetic pregnant group. The hepatic expression of genes involved in metabolism, oxidative stress, inflammation, and the wingless and int-1 (WNT) signaling pathway was significantly impaired in diabetic pregnant rats, while ginger improved them in the hepatic tissue of diabetic pregnant rats. It can be concluded that ginger could improve gestational diabetes by genes involved in metabolism, the WNT signaling pathway, oxidative stress, and inflammation. These results suggest that ginger can be an adjunct drug during pregnancy as a metabolic modulator.
Reclaiming provincialism
Authors: Gosetti Valentina , Walsh Adrian , Finch-Race Daniel A
Published: December 2022

This article argues against the lingering pejorative usage of the term ‘provincialism’ in public discourse in particular. It engages with transnational debates emerging from Australia and French-speaking settings, where provincialism often denotes backwardness, isolation, and a lack of high culture. Through explorations of (a) the universalizing value of the provincial and (b) the diversifying concept of ‘provincializing’, the article advocates for a reconceptualization of the term ‘provincialism’. This is worthwhile on at least two counts: challenging stale dichotomies such as cosmopolitan/unworldly; acknowledging the agency of so-called ‘provincials’ and their essential cultural contributions. The article contributes to debates in human geography and related disciplines by unpacking longstanding questions of inclusion and exclusion. Ultimately, it reclaims the value of provincialism as a term with the capacity to bridge varied areas of scholarship, thereby fostering empowerment and moving beyond deleterious ideas of geography.
Sustained monomorphic ventricular tachycardia as the presenting sign of Chagas’ cardiomyopathy in a low prevalence setting, diagnosis and management challenges. A case report
Authors: Amin Devang R. , Behan Sean , Pengshung Michelle , Khanna Amber , Tzou Wendy S. , Mantini Nicholas , Henao-Martinez Andrés F. , Tumolo Alexis , Groves Daniel W.
Published: December 2022

Approximately 300,000 people in the United States are estimated to have Chagas’ disease, with cardiac manifestations including arrhythmias occurring in 20%–30% of patients. We report a patient diagnosed with Chagas’ cardiomyopathy after presenting in ventricular tachycardia. This patient was asymptomatic before her presentation with recurrent episodes of ventricular tachycardia, which motivated us to screen her since she was an immigrant from an endemic Chagas region. This manuscript highlights some of the characteristic cardiac magnetic resonance imaging (MRI) and electrophysiology findings present in patients with Chagas’ cardiomyopathy. We also detail the management of patients with Chagas’ cardiomyopathy who have suffered from ventricular tachycardia.
Detectable serum IgM monoclonal gammopathy in non-hepatitis-associated mixed cryoglobulinemic glomerulonephritis: A case report and literature review
Authors: Faisatjatham Surasak , Uaprasert Noppacharn , Iampenkhae Kroonpong , Udomkarnjananun Suwasin
Published: December 2022

Cryoglobulinemia is the presence of circulating cryoglobulin which can cause systemic vasculitis and glomerulonephritis. Monoclonal gammopathy of renal significance is strongly associated with type I cryoglobulinemia, but the role of detectable serum monoclonal gammopathy in mixed (type II) cryoglobulinemia is not clearly established. We report a case of a 71-year-old woman who presented with skin rash, leg edema, and azotemia. Investigations showed a positive result for rheumatoid factor, low complement C4 level, positive result for serum cryoglobulin, and positive M-spike on serum protein electrophoresis and IgM kappa monoclonal gammopathy on serum immunofixation. Kidney biopsy revealed membranoproliferative glomerulonephritis, polytypic IgM-dominant deposits in an immunofluorescence study, and microtubular substructures in an electron microscopic study. After an extensive workup, no evidence of myeloma or lymphoma was found. A diagnosis of monoclonal gammopathy of renal significance–associated mixed cryoglobulinemic glomerulonephritis was made. Due to the detectable IgM kappa monoclonal gammopathy in the patient’s serum, clonal-directed therapy was administered. The patient had been in clinical remission after treatment with clone-directed therapy with cyclophosphamide and steroids. The literature review for cases of type II cryoglobulinemic glomerulonephritis that have detectable serum monoclonal gammopathy are summarized in this study.
Conception following successful repair of two previous failed attempts at repair of partial transverse vaginal septum diagnosed after marital union: A case report
Authors: Eleje George Uchenna , Ihekwoaba Eric Chukwudi , Onu Onyekachi Amos , Igbodike Emeka Philip , Ilokanuno Chinedu Nnaemeka , Chukwuanukwu Titus Osita , Okoro Chukwuemeka Chukwubuikem , Obioha Kingsley Chukwu , Okpala Boniface Chukwuneme
Published: December 2022

Transverse vaginal septum is a congenital anomaly in which a membrane obstructs the vagina. This can be partial or complete in type. Although rare, it presents peculiar challenges in symptomatology, diagnosis, and ultimate management. To our knowledge, we are the first to report a shortest vaginoplasty-conception interval following successful repair of previously failed repair of partial transverse vaginal septum.

A 28-year-old Nigerian married nulliparous lady who presented to us with history of inability of penile–vaginal penetration with the presence of normal menstrual flow after two previous failed attempts at repair. She had a vaginoplasty with placement of a vaginal mold to prevent stenosis. She was subsequently able to have successful sexual intercourse and achieved pregnancy after 2 months, without recurrence of vaginal stenosis.

When transverse vaginal septum is encountered in a married nullipara, a thorough clinical evaluation of the viability and feasibility of a vaginoplasty should be made during the first surgery. If repeated failed repair occurs, as in our case, we recommend meticulous and experienced surgical attention from the outset. The originality in this report lies in the very short period between repair and successful conception. Thus, we obtained satisfactory short-term clinical outcome of successful conception at the 2 months follow-up.
The influencing factors of digital health passport adoption and acceptance during COVID-19 in Saudi Arabia
Authors: Samha Amani K. , Alrashdi Addal M. , Alshammri Ghalib H.
Published: December 2022

Background

The COVID-19 outbreak has left a destructive trail around the world in terms of deaths, travel restrictions, trade deficits, and an economy that is collapsing, including job losses, real estate, health benefit loss, and a decrease in the quality of access to care and services in almost all sectors, as well as generally in the overall quality of life. The successful development of COVID-19 vaccines may hasten the acceleration of global post-pandemic recovery by vaccinating residents, with a particular focus on important groups, in order to decrease secondary transmission. This will facilitate the easing of enforced restrictions on global and local travel, the tourism industry, education sectors, and other aspects of social life. Vaccinating residents may also help reduce the risk of secondary transmission. The efforts that Saudi Arabia made to control the epidemic were outstanding on all fronts and in all spheres, including the health, education, commerce, and tourism industries, among others.

Objective

The purpose of this research was to investigate the elements that influence a traveler's decision to acquire and use a digital health passport (DHP), which was introduced by the Tawakkalna application in Saudi Arabia at the COVID-19 conference.

Methods

The technology acceptance model (TAM) and the information system success model (ISSM) were the primary theoretical frameworks that guided this investigation. The terms “perceived ease of use” (PEOU), “perceived usefulness” (PU), “information quality” (IQ), “service quality” (SQ), and “net benefit” (NB) were applied in order to investigate the user's acceptance and use of the DHP, as well as how it contributes to the facilitation of traveling and public perception toward using the DHP.

Results

In order to assess the validity of the proposed model and its four assumptions, a survey was sent through social media platforms to get responses from nationals and residents of Saudi Arabia. The SPSS program was used to evaluate a total of 103 replies that were considered valid. Following the completion of the study, the findings revealed that PEOU, PU, IQ, SQ, and NB all had favorable impacts on the use of DHP.

Conclusion

PEOU, PU, IQ, and SQ have a significant relationship with NB that affects the public's acceptance and use of DHP. This study has established validity and reliability while testing the relationship between the variables suggested in the research model.
Emerging Digital Inequalities: A Comparative Study of Older Adults’ Smartphone Use
Authors: Beneito-Montagut Roser , Rosales Andrea , Fernández-Ardèvol Mireia
Published: December 2022

Older adults are increasingly using smartphones. Researchers have identified demographic, attitudinal factors and social outcomes related to inequalities in access, skills, and activities of internet use. While this research has been ongoing for years, studies about the digital inequalities related to the use of smartphones by older adults are still scarce, and they rarely have undertaken sociocultural comparisons of usage. This article builds on an analysis of tracking data of older adults’ (pp. 55–79) smartphone use, to explore digital inequalities around traditional axes of inequality and sociocultural factors that shape older adults’ smartphone use. It adds a comparative perspective for understanding emerging inequalities related to sociocultural contexts to the existing literature. The results show that differences cannot be explained solely by sociodemographic factors, but also possibly by national policies and culture. Particularly, age, on its own, is not able to explain the differences reported. Older adults engage in a range of different activities on their smartphones, and differences between groups across the traditional axes of inequalities do not mirror exactly the differences found in previous research on internet use. This is important considering the risk of emerging new inequalities and the ongoing revisiting of policies to mitigate them.
Variables Contributing to the Awareness of Online Gendered Violence: Focus on Observers
Authors: Aranda María , García-Domingo Marta , Montes-Berges Beatriz , Fuentes Virginia
Published: December 2022

The study aimed to examine variables that could contribute to the awareness of online gendered violence (OGV). For this, an online survey was used. First, we assessed whether sexism and violence justification affect awareness of gender-based cyberviolence. Second, this effect was evaluated considering the smartphone usage. Third, we studied differences in awareness of OGV according to gender, digital generation, and academic field of study. Fourth, we tested for multiple associations of attitudinal variables, smartphone usage, and sociodemographic variables with OGV. The study involved 453 young adults from the Andalucia region, Spain ( Mage = 21.9, SD = 2.15; 64% women). The results showed that, with more sexist attitudes and normalization of violence, the limits regarding what constitute gender-based violence in digital media are more permissive (less awareness). Regarding smartphone use, when it became problematic, desensitization to cyberviolence against women and sexual and gender minorities increased. Multiple correspondence analysis revealed an observer profile, that is, a woman studying for a humanistic or healthcare career who does not believe in psychosocial sex differences, or that violence as a reaction is justified, and also does not support biological fatalism of sexism and violence. This observer also has high awareness of the cyber-behaviors that constitute OGV. In conclusion, this study provides key data for psychoeducational strategies aiming to increase awareness of gender-based cyberviolence.
The recent violation of Thai airspace by a Myanmar MiG-29 fighter jet: Understanding Thailand's unusual response
Authors: Chotisut Kridsana , Bunyavejchewin Poowin , Promprasit Nattaraporn
Published: December 2022

Foreign aircraft trespassing national airspace is considered a violation of state sovereignty and tends to precipitate serious responses, ranging from shooting down offenders to diplomatic protests. In late June 2022, a Myanmar MiG-29 fighter jet flew over Thailand's Phop Phra district, made a low pass, and fired at ethnic-minority armed groups stationed along the border. The incident was a clear-cut airspace incursion, apparently intended to incite retaliation from Bangkok. However, despite the harshly worded initial response in a press release issued promptly by the Royal Thai Air Force, the Prayut government attempted to minimize the seriousness of the Myanmar fighter jet's actions. This unexpected reaction triggered considerable public criticism. Nevertheless, given Thailand's complex positioning in the Thai–Myanmar borderlands, the mitigated response might have had a certain logic, especially if, as some onlookers suggested, the intrusion was intentional.
Anomalous Origin of the Left Coronary Artery from the Pulmonary Artery Associated with Right Coronary Giant Aneurysm
Authors: Antelo Martin , Freire Diego , Dendi Alvaro , Parma Gabriel , Fernandez Nicolas , Picarelli Dante
Published: December 2022

Anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital malformation, usually diagnosed in the infant period due to myocardial ischemia and heart failure, with the need for emergency surgery. Less commonly, it can be asymptomatic until adulthood. Coronary artery aneurysms are also rare anatomical anomalies with symptoms of acute or chronic angina or even remain completely asymptomatic. We present an unusual case of ALCAPA, associated with a giant aneurysm of the right coronary artery.

Meeting presentation: American Association for Thoracic Surgery 102nd annual meeting, Boston MA, USA, May 16, 2022.
Sex Difference in the Treatment of Dupuytren's Disease: A Systematic Review and Meta-Analysis of Clinical Trials
Authors: Saggaf Moaath M. , Liu Kathy , Ho George , Anastakis Emily E. , Baltzer Heather
Published: December 2022

Purpose: The aim of this study was to assess the sex differences in enrollment into clinical trials for Dupuytren's disease (DD), treatment efficacy, and complications. Methods: Three databases were searched; Ovid MEDLINE, Ovid EMBASE, and EBSCO CINAHL. Included studies were clinical trials on adult patients with DD. Exclusion criteria were non-English studies and other study designs. Two independent reviewers completed abstract screening, full-text review, and data extraction. The number and percentage of studies that reported ad hoc analyses for sex differences in treatment efficacy, tolerability, and complications were reported. A meta-analysis was performed on the proportion of female participants enrolled in clinical trials for DD. Results: A total of 3172 references were screened, and 59 studies were identified for full-text review. We identified 28 clinical trials for DD of which none reported secondary analyses for sex differences. Only 2 trials discussed sex differences in complications, and one trial reported sex differences in tolerability. The proportion of female participants in the meta-analysis was 19.5% [95% CI: 16.1-23.0%]. Conclusion: Sex differences in the clinical trials for DD are not widely considered in clinical trials despite their critical role. Males and females do not have equal representation in clinical trials for DD. Future studies should account for sex differences in the design and the analysis of clinical trials.
Strength of Attentional Modulation on Cortical Auditory Evoked Responses Correlates with Speech-in-Noise Performance in Bimodal Cochlear Implant Users
Authors: Lee Jae-Hee , Shim Hwan , Gantz Bruce , Choi Inyong
Published: December 2022

Auditory selective attention is a crucial top-down cognitive mechanism for understanding speech in noise. Cochlear implant (CI) users display great variability in speech-in-noise performance that is not easily explained by peripheral auditory profile or demographic factors. Thus, it is imperative to understand if auditory cognitive processes such as selective attention explain such variability. The presented study directly addressed this question by quantifying attentional modulation of cortical auditory responses during an attention task and comparing its individual differences with speech-in-noise performance. In our attention experiment, participants with CI were given a pre-stimulus visual cue that directed their attention to either of two speech streams and were asked to select a deviant syllable in the target stream. The two speech streams consisted of the female voice saying “Up” five times every 800 ms and the male voice saying “Down” four times every 1 s. The onset of each syllable elicited distinct event-related potentials (ERPs). At each syllable onset, the difference in the amplitudes of ERPs between the two attentional conditions (attended - ignored) was computed. This ERP amplitude difference served as a proxy for attentional modulation strength. Our group-level analysis showed that the amplitude of ERPs was greater when the syllable was attended than ignored, exhibiting that attention modulated cortical auditory responses. Moreover, the strength of attentional modulation showed a significant correlation with speech-in-noise performance. These results suggest that the attentional modulation of cortical auditory responses may provide a neural marker for predicting CI users’ success in clinical tests of speech-in-noise listening.
Parent–child interaction therapy (PCIT) with families of children with autism spectrum disorder
Authors: Vess Sarah F. , Campbell Jonathan M.
Published: December 2022

Background and Aims

Parent–child interaction therapy (PCIT) is an evidence-based behavioral parent training program designed for preschool-age children that emphasizes supporting parent–child interaction patterns to improve child behavior and enhance the quality of parent–child relationships. PCIT has been deemed efficacious in treating children with disruptive behavior disorders, and recent studies have shown promising results utilizing aspects of PCIT with children with autism spectrum disorder (ASD), but none of these studies applied the entire PCIT intervention per manual protocol. The present study is the first to test the efficacy of PCIT, without modification, with families of preschool-age children with ASD without comorbid behavioral difficulties.

Methods

This study employed a single-subject multiple-probe design to evaluate the efficacy of PCIT with four families with children with ASD between the ages of 2 and 4 years old ( M = 40 months) over a 4-month period.

Results

PCIT was effective in increasing positive parenting behavior, decreasing negative parenting behavior, and increasing child compliance to parental commands. Parents reported greater confidence in parenting abilities post-treatment and significant improvement in the core areas of autism symptomatology. Parents endorsed significant improvement in aspects of the parent–child relationship, such as attachment and involvement.

Conclusions

Parents of children with ASD demonstrated more positive and effective parenting behavior and reported enhancements in the parent–child relationship after participating in PCIT. Children were more compliant to parental commands and exhibited improvements in social and behavioral functioning. Increases in positive parenting behaviors and child compliance to parental requests were maintained 1 month after treatment and outside the clinic setting during generalization sessions. Parents of children with ASD reported a high degree of satisfaction with PCIT.

Implications

The present study provides initial evidence of the efficacy of utilizing PCIT with families of preschool-age children with ASD and supports the continued investigation of the efficacy of PCIT with this population.
Finite element analysis of coronoid prostheses with different fixation methods in the treatment of comminuted coronoid process fracture
Authors: Zhang Hailong , Lin Kun-Jhih , Liu Po-Yi , Lu Yi
Published: December 2022

Background

Comminuted fractures of the coronoid process significantly compromise the stability and function of the elbow joint. Reconstruction of the coronoid process with a prosthesis has been suggested as an alternative to restore the architecture. The purpose of this study was to investigate the strength and stability of various methods for the fixation of a coronoid prosthesis by finite element analysis.

Materials and methods

A coronoid prosthesis was designed based on the morphological information from computed tomography images acquired from 64 subjects in whom the top 40% of the coronoid process height was replaced. Four methods for the fixation of the prosthesis were suggested: (1) a double 2.0-mm fixation bolt, anterior to posterior; (2) a double 2.5-mm fixation bolt, anterior to posterior; (3) a single 4.0-mm fixation bolt, posterior to anterior; (4) a single 4.5-mm fixation bolt, posterior to anterior. The integrated prosthesis-bone constructs were analyzed via the finite element analysis of 10 simulated proximal ulna models with loading applied along the axis of the humerus and with three different elbow flexion angles (30°, 90°, and 130°). The maximum principal stress and the total deformation were quantified and compared.

Results

A coronoid prosthesis was developed. The maximum principal stress of the fixation bolts occurred around the neck of the fixation bolt. For a comparison of the strengths of the four fixation methods, the maximum principal stress was the lowest for fixation using a single 4.5-mm fixation bolt. The value of the maximum principal stress significantly decreased with increased elbow flexion angle for all fixation methods. The maximum deformation of the fixation bolts occurred at the head of the fixation bolt. For a comparison of the maximum deformations in the four fixation methods, the maximum deformation was the lowest for fixation using a single 4.5-mm fixation bolt. The value of the maximum deformation significantly decreased with increased elbow flexion angle for all fixation methods.

Conclusions

The present study suggested that fixation of a coronoid prosthesis with a single 4.5-mm fixation bolt from posterior to anterior is an excellent option in terms of the strength and stability.

Level of Evidence Experimental study.
Feasibility of evaluating the histologic and genetic subtypes of WHO grade II-IV gliomas by diffusion-weighted imaging
Authors: Liu Sirui , Zhang Yiwei , Kong Ziren , Jiang Chendan , Wang Yu , Zhao Dachun , You Hui , Ma Wenbin , Feng Feng
Published: December 2022

Background

To explore the feasibility of diffusion-weighted imaging (DWI) metrics to predict the histologic subtypes and genetic status of gliomas (e.g., IDH, MGMT, and TERT) noninvasively.

Methods

One hundred and eleven patients with pathologically confirmed WHO grade II-IV gliomas were recruited retrospectively. Apparent diffusion coefficient (ADC) values were measured in solid parts of gliomas on co-registered T2-weighted images and were compared with each other in terms of WHO grading and genotypes using t-tests. Receiver operating characteristic analysis was performed to assess the diagnostic performances of ADC. Subsequently, multiple linear regression was used to find independent variables, which can directly affect ADC values.

Results

The values of overall mean ADC (omADC) and normalized ADC (nADC) of high grade gliomas and IDH wildtype gliomas were lower than low grade gliomas and IDH mutated gliomas (P < 0.05). nADC values showed better diagnostic performance than omADC in identifying tumor grade (AUC: 0.787 vs. 0.750) and IDH status (AUC: 0.836 vs. 0.777). ADC values had limited abilities in distinguishing TERT status (AUC = 0.607 for nADC and 0.617 for omADC) and MGMT status (AUC = 0.651 for nADC). Only tumor grade and IDH status were tightly associated with ADC values.

Conclusion

DWI metrics can predict glioma grading and IDH mutation noninvasively, but have limited use in detecting TERT mutation and MGMT methylation.
External validation of existing dementia prediction models on observational health data
Authors: John Luis H. , Kors Jan A. , Fridgeirsson Egill A. , Reps Jenna M. , Rijnbeek Peter R.
Published: December 2022

Background

Many dementia prediction models have been developed, but only few have been externally validated, which hinders clinical uptake and may pose a risk if models are applied to actual patients regardless. Externally validating an existing prediction model is a difficult task, where we mostly rely on the completeness of model reporting in a published article.

In this study, we aim to externally validate existing dementia prediction models. To that end, we define model reporting criteria, review published studies, and externally validate three well reported models using routinely collected health data from administrative claims and electronic health records.

Methods

We identified dementia prediction models that were developed between 2011 and 2020 and assessed if they could be externally validated given a set of model criteria. In addition, we externally validated three of these models (Walters’ Dementia Risk Score, Mehta’s RxDx-Dementia Risk Index, and Nori’s ADRD dementia prediction model) on a network of six observational health databases from the United States, United Kingdom, Germany and the Netherlands, including the original development databases of the models.

Results

We reviewed 59 dementia prediction models. All models reported the prediction method, development database, and target and outcome definitions. Less frequently reported by these 59 prediction models were predictor definitions (52 models) including the time window in which a predictor is assessed (21 models), predictor coefficients (20 models), and the time-at-risk (42 models). The validation of the model by Walters (development c-statistic: 0.84) showed moderate transportability (0.67–0.76 c-statistic). The Mehta model (development c-statistic: 0.81) transported well to some of the external databases (0.69–0.79 c-statistic). The Nori model (development AUROC: 0.69) transported well (0.62–0.68 AUROC) but performed modestly overall. Recalibration showed improvements for the Walters and Nori models, while recalibration could not be assessed for the Mehta model due to unreported baseline hazard.

Conclusion

We observed that reporting is mostly insufficient to fully externally validate published dementia prediction models, and therefore, it is uncertain how well these models would work in other clinical settings. We emphasize the importance of following established guidelines for reporting clinical prediction models. We recommend that reporting should be more explicit and have external validation in mind if the model is meant to be applied in different settings.
Timed up and go test and long-term survival in older adults after oncologic surgery
Authors: Hendriks Sharon , Huisman Monique G. , Ghignone Frederico , Vigano Antonio , de Liguori Carino Nicola , Farinella Eriberto , Girocchi Roberto , Audisio Riccardo A. , van Munster Barbara , de Bock Geertruida H. , van Leeuwen Barbara L.
Published: December 2022

Background

Physical performance tests are a reflection of health in older adults. The Timed Up and Go test is an easy-to-administer tool measuring physical performance. In older adults undergoing oncologic surgery, an impaired TUG has been associated with higher rates of postoperative complications and increased short term mortality. The objective of this study is to investigate the association between physical performance and long term outcomes.

Methods

Patients aged ≥65 years undergoing surgery for solid tumors in three prospective cohort studies, ‘PICNIC’, ‘PICNIC B-HAPPY’ and ‘PREOP’, were included. The TUG was administered 2 weeks before surgery, a score of ≥12 seconds was considered to be impaired. Primary endpoint was 5-year survival, secondary endpoint was 30-day major complications. Survival proportions were estimated using Kaplan-Meier curves. Cox- and logistic regression analysis were used for survival and complications respectively. Hazard ratios (aHRs) and Odds ratios (aOR) were adjusted for literature-based and clinically relevant variables, and 95% confidence intervals (95% CIs) were estimated using multivariable models.

Results

In total, 528 patients were included into analysis. Mean age was 75 years (SD 5.98), in 123 (23.3%) patients, the TUG was impaired. Five-year survival proportions were 0.56 and 0.49 for patients with normal TUG and impaired TUG respectively. An impaired TUG was an independent predictor of increased 5-year mortality (aHR 1.43, 95% CI 1.02-2.02). The TUG was not a significant predictor of 30-day major complications (aOR 1.46, 95% CI 0.70-3.06).

Conclusions

An impaired TUG is associated with increased 5-year mortality in older adults undergoing surgery for solid tumors. It requires further investigation whether an impaired TUG can be reversed and thus improve long-term outcomes.

Trial registration

The PICNIC studies are registered in the Dutch Clinical Trial database at www.trialregister.nl: NL4219 (2010-07-22) and NL4441 (2014-06-01). The PREOP study was registered with the Dutch trial registry at www.trialregister.nl: NL1497 (2008-11-28) and in the United Kingdom register (Research Ethics Committee reference 10/H1008/59). https://www.hra.nhs.uk/planning-and-improving-research/application-summaries/research-summaries/?page=15&query=preop&date_from=&date_to=&research_type=&rec_opinion=&relevance=true.
Calf circumference predicts frailty in older adults: the Chinese longitudinal healthy longevity survey
Authors: Xu Ke Ying , Wang Jun Jie , Chen Jing , Zhao Xinxiu , Yuan Ling Fang , Zhang Qin
Published: December 2022

Background

Although frailty is a common geriatric syndrome in old adults, a simple method to assess the degree of frailty in a person has not yet been established. In this study we have tried to establish the association between calf circumference (CC) and frailty among older Chinese people.

Methods

We used the data obtained from the 2014 edition of the Chinese Longitudinal Healthy Longevity Survey; 1216 participants aged ≥60 years were included for the study. Body mass index, CC and waist circumference measurement data, and laboratory test results were collected. Frailty status was measured using the frailty index (FI). Participants were then classified into non-frail (FI < 0.25) and frail (FI ≥ 0.25) groups.

Results

There were 874 participants (71.9%) in the non-frail group and 342 (28.1%) in the frail group. The CC was significantly different between the two groups (31.54 ± 4.16 versus 28.04 ± 4.53, P < 0.001). Logistic regression analysis revealed that CC (odds ratio = 0.947, 95% confidence interval: 0.904–0.993, P = 0.023) was an independent impact factor associated with frailty. The CC value of 28.5 cm was considered the best cut-off value in women with area under the curve (AUC) was 0.732 (P < 0.001) and 29.5 cm in men with AUC was 0.592 (P = 0.004);We created a simple prediction model for frailty that included age,sex and CC:$$\textrm{Logit}(P)=-9.756+0.123\ast \textrm{Age}-0.512\ast \textrm{Sex}\left(\textrm{man}=1,\textrm{woman}=0\right)-0.053\ast \textrm{CC},$$

Logit

(
P
)

=
-
9.756
+
0.123
*
Age
-
0.512
*
Sex

man
=
1
,
woman
=
0

-
0.053
*
CC
,

P = elogit(P) /1 + elogit(P), and AUC is 0.849 (P < 0.001).

Conclusions

CC is a convenient and predictable marker of frailty in older adults.
Women’s views on moderate and low alcohol consumption: stages of the subjective transition from pregnancy to postpartum
Authors: Pehlke-Milde Jessica , Radu Irina , Gouilhers Solène , Hammer Raphaël , Meyer Yvonne
Published: December 2022

Background

Alcohol consumption during pregnancy and breastfeeding is associated with a risk for the child’s healthy development. Nevertheless, about 16 to 25% of all women in the European region, including Switzerland, consume alcohol during pregnancy and probably even more during breastfeeding. Little is known about how women perceive this risk and how risk perception changes during the transition to motherhood. The present study aims to explore the subjective transition from the woman’s perspective, focusing on perceptions of alcohol as a risk, changes in alcohol consumption in daily life and experienced support from health professionals in this period.

Methods

The longitudinal qualitative, semi-structured interview study was jointly designed and conducted by health sociologists and midwifery researchers. Using the theoretical framework of sociocultural risk and life course transition, we interviewed 46 women from the French and German speaking part of Switzerland during pregnancy and until six months after birth.

Results

In our study, we found that pregnant and breastfeeding women perceive alcohol consumption as a risk to the health of the child. Abstinence is sought especially during pregnancy, but this does not preclude occasional and low-level consumption according to some women. Alcohol consumption and risk perception change during the transition to motherhood. We identified five stages that characterise this transition in terms of alcohol consumption and risk perception. From the women’s perspective, there was a lack of counselling from health professionals, and the women expressed a desire for respectful and more individualised counselling.

Conclusion

Many women express a need for guidance and counselling by health care professionals at some stages of the transition to motherhood. The stages identified can be used as pointers to address the subject of alcohol consumption in professional practice. The stage around conception and early pregnancy should be taken more into account, as women experience themselves as particularly vulnerable during this time. Low-threshold counselling services should be therefore offered to women before or in the stage around conception and be continued until the end of the breastfeeding period.
The healthcare system and client failures contributing to maternal mortality in rural Kenya
Authors: Masaba Brian Barasa , Mmusi-Phetoe Rose , Rono Bernard , Moraa Damaris , Moturi John K. , Kabo Jane W. , Oyugi Samuel , Taiswa Jonathan
Published: December 2022

Background

The global maternal mortality ratio is estimated at 211/100 000 live births in 2017. In Kenya, progress on reducing maternal mortality appears to be slow and persistently higher than the global average, despite efforts by the government’s provision of free maternity services in both private and public facilities in 2013. We aimed to explore and describe the experiences of midwives on maternal deaths that are associated with the healthcare system and client failures in Migori, Kenya.

Methods

An explanatory, qualitative approach method was adopted. In-depth interviews were conducted with the purposively selected midwives working in peripartum units of the three sampled hospitals within Migori County in Kenya. The hospitals included two county referral hospitals and one private referral hospital. Saturation was reached with 37 respondents. NVivo 11 software was used for analysis. Content analysis using a qualitative approach was adopted. Accordingly, the data transcripts were synthesised, coded and organised into thematic domains.

Results

Identified sub-themes: sub-optimal care, staff inadequacy, theatre delays, lack of blood and essential drugs, non-adherence to protocols, staff shortage, inadequate equipment and supplies, unavailable ICU wards, clients’ ANC non-adherence.

Conclusion

In conclusion, the study notes that the healthcare system and client failures are contributing to maternal mortality in the study setting. The major failures are across the pregnancy continuum starting from antenatal care, and intrapartum to post-natal care. This can illustrate that some pregnant mothers are getting sub-optimal care reducing their survival chances. To reduce maternal mortality in Migori County, the key highlighted healthcare system and client failures should be addressed through a multidisciplinary approach mechanism.
Characteristics and chronologically changing patterns of late-onset breast cancer in Korean women of age ≥ 70 years: A hospital based-registry study
Authors: Paik Hyun-June , Kim Suk Jung , Kim Ku Sang , Kim Yongsuk , Lee Se Kyung , Kang Su Hwan , Joon Jeong , Youn Hyun Jo ,   Korean Breast Cancer Society
Published: December 2022

Background

Women from Asian and western countries have vastly different ages of onset of breast cancer, with the disease tending to occur at an older age in the West. Through an investigation of the patterns of old-onset breast cancer (OBC) in Korean women, we aimed to identify the characteristics of Korean OBC and evaluate whether these patterns are changing in relation to increasing westernization.

Methods

This study retrospectively evaluated 102,379 patients who underwent surgical treatment of primary breast cancer between January 1, 2000 and December 31, 2013 in Korea. We used hospital -based breast cancer registry and analyzed data from these patients using multiple linear regression analysis to compare the characteristics and chronologically changing patterns between OBC (70 years of age or older) and non-OBC (40–69 years of age) patients in Korea.

Results

A total of 6% of the 102,379 patients had OBC. Overall, OBC had more favorable biological features, such as a higher incidence of luminal A subtype, than did non-OBC, except for a higher incidence rate of triple-negative breast cancer (TNBC). However, OBC also presented with a higher overall disease stage, including higher T and M stages. Although the incidence rates of both OBC and non-OBC have increased overtime, the relative proportion of OBC patients has slightly increased, whereas that of non-OBC has slightly decreased. The increase in the incidence of both OBC and non-OBC was primarily due to the luminal A subtype.

Conclusions

Based on a hospital-based registry, overall, Korean OBC had favorable biological features but showed a higher rate of TNBC and advanced cancer stages. The incidence trend of breast cancer in Korea is slowly shifting toward an older age at onset, largely due to the luminal A subtype. Our results may provide novel insights into OBC in Asia, and aid in the development of optimal management of the disease in Asia.

Trial registration

Retrospectively registered.
MiR-214-3p targets Ras-related protein 14 (RAB14) to inhibit cellular migration and invasion in esophageal Cancer cells
Authors: Phatak Pornima , Burrows Whitney M. , Creed Timothy Michael , Youssef Mariam , Lee Goo , Donahue James M.
Published: December 2022

Background

MicroRNA (miR)-214-3p is emerging as an important tumor suppressor in esophageal cancer. In this study, we examined the interaction between miR-214-3p and RAB14, a membrane trafficking protein shown to exert oncogenic functions in other malignancies, in esophageal cancer cells.

Methods

Studies were performed in a human esophageal epithelial cell line and a panel of esophageal cancer cell lines, as well in human specimens. MiR-214-3p expression was measured by digital PCR. Biotinylated RNA pull-down and luciferase reporter assays assessed binding. The xCELLigence RTCA system measured cell migration and invasion in real time. A lentiviral expression vector was used to create an esophageal cancer cell line stably expressing miR-214-3p.

Results

MiR-214-3p expression was decreased in esophageal cancer cell lines and human specimens compared to non-malignant controls. RAB14 mRNA stability and protein expression were decreased following miR-214-3p overexpression. Binding between miR-214-3p and RAB14 mRNA was observed. Either forced expression of miR-214-3p or RAB14 silencing led to a marked decrease in cellular migration and invasion. Esophageal cancer cells stably expressing miR-214-3p demonstrated decreased growth in a subcutaneous murine model.

Conclusions

These results further support the tumor-suppressive role of miR-214-3p in esophageal cancer cells by demonstrating its ability to regulate RAB14 expression.