bluuebunny/crossref_metadata_2025 huggingface dataset:
Dropout from exercise trials among cancer survivors—An individual patient data meta‐analysis from the POLARIS study
Authors: Western Benedikte , Ivarsson Andreas , Vistad Ingvild , Demmelmaier Ingrid , Aaronson Neil K. , Radcliffe Gillian , van Beurden Marc , Bohus Martin , Courneya Kerry S. , Daley Amanda J. , Galvão Daniel A. , Garrod Rachel , Goedendorp Martine M. , Griffith Kathleen A. , van Harten Wim H. , Hayes Sandi C. , Herrero‐Roman Fernando , Hiensch Anouk E. , Irwin Melinda L. , James Erica , Kenkhuis Marlou‐Floor , Kersten Marie José , Knoop Hans , Lucia Alejandro , May Anne M. , McConnachie Alex , van Mechelen Willem , Mutrie Nanette , Newton Robert U. , Nollet Frans , Oldenburg Hester S. , Plotnikoff Ron , Schmidt Martina E. , Schmitz Katie H. , Schulz Karl‐Heinz , Short Camille E. , Sonke Gabe S. , Steindorf Karen , Stuiver Martijn M. , Taaffe Dennis R. , Thorsen Lene , Velthuis Miranda J. , Wenzel Jennifer , Winters‐Stone Kerri M. , Wiskemann Joachim , Berntsen Sveinung , Buffart Laurien M.
Published: February 2024

Introduction

The number of randomized controlled trials (RCTs) investigating the effects of exercise among cancer survivors has increased in recent years; however, participants dropping out of the trials are rarely described. The objective of the present study was to assess which combinations of participant and exercise program characteristics were associated with dropout from the exercise arms of RCTs among cancer survivors.

Methods

This study used data collected in the Predicting OptimaL cAncer RehabIlitation and Supportive care (POLARIS) study, an international database of RCTs investigating the effects of exercise among cancer survivors. Thirty‐four exercise trials, with a total of 2467 patients without metastatic disease randomized to an exercise arm were included. Harmonized studies included a pre and a posttest, and participants were classified as dropouts when missing all assessments at the post‐intervention test. Subgroups were identified with a conditional inference tree.

Results

Overall, 9.6% of the participants dropped out. Five subgroups were identified in the conditional inference tree based on four significant associations with dropout. Most dropout was observed for participants with BMI >28.4 kg/m2, performing supervised resistance or unsupervised mixed exercise (19.8% dropout) or had low‐medium education and performed aerobic or supervised mixed exercise (13.5%). The lowest dropout was found for participants with BMI >28.4 kg/m2 and high education performing aerobic or supervised mixed exercise (5.1%), and participants with BMI ≤28.4 kg/m2 exercising during (5.2%) or post (9.5%) treatment.

Conclusions

There are several systematic differences between cancer survivors completing and dropping out from exercise trials, possibly affecting the external validity of exercise effects.
The gender citation gap: Approaches, explanations, and implications
Authors: Wu Cary
Published: February 2024

Do women face a disadvantage in terms of citation rates, and if so, in what ways? This article provides a comprehensive overview of existing research on the relationship between gender and citations. Three distinct approaches are identified: (1) per‐article approach that compares gender differences in citations between articles authored by men and women, (2) per‐author approach that compares the aggregate citation records of men and women scholars over a specified period or at the career level, and (3) reference‐ratio approach that assesses the gender distribution of references in articles written by men and women. I show that articles written by women receive comparable or even higher rates of citations than articles written by men. However, women tend to accumulate fewer citations over time and at the career level. Contrary to the notion that women are cited less per article due to gender‐based bias in research evaluation or citing behaviors, this study suggests that the primary reason for the lower citation rates at the author level is women publishing fewer articles over their careers. Understanding and addressing the gender citation gap at the author level should therefore focus on women's lower research productivity over time and the contributing factors. To conclude, I discuss the potential detrimental impact of lower citations on women's career progression and the ways to address the issue to mitigate gender inequalities in science.
Adapting moving‐window metrics to vector datasets for the characterization and comparison of simulated urban scenarios
Authors: Molinero‐Parejo Ramón , Aguilera‐Benavente Francisco , Gómez‐Delgado Montserrat
Published: February 2024

Descriptive scenarios about the possible evolution of land use in our cities are essential instruments in urban planning. Although the simulation of these scenarios has enormous potential, further characterization is needed in order to be able to evaluate and compare them so as to provide more effective support for public policy. One of the most commonly used tools for assessing these scenarios is spatial moving‐window metrics, a useful mechanism for extracting accurate information from simulated land‐use maps on urban diversity and urban growth patterns. This article seeks to explore this question further and has two main aims. First, to develop and implement vSHEI and vLEI, two multiscale composition and configuration vector moving‐window metrics for calculating urban diversity and urban growth patterns. Second, to test these metrics using the spatially explicit simulation of three prospective scenarios in the Henares Corridor (Spain), comparing the results and analyzing how well the scenario narratives match their spatial configuration, as measured using vSHEI and vLEI. Via the implementation of vSHEI and vLEI, we obtained urban diversity and urban expansion values at a local level, offering more precise and more realistic, mappable information on the composition and configuration of urban land use than that provided by raster metrics or by vector Patch‐Matrix model metrics. We also used these metrics to test whether the simulated scenarios matched their description in the narrative storylines. Our results demonstrate the potential of vector moving‐window metrics for characterizing the urban patterns that might develop under different scenarios at the parcel level.
CT features of cutaneous and subcutaneous canine mast cell tumors and utility of conventional and indirect lymphography to detect clinically unknown mast cell tumors and to map the sentinel lymph nodes
Authors: Gianni Beatrice , Franchi Roberta , Mattolini Mirko , Contiero Barbara , Carozzi Gregorio , Nappi Luigia , Cammarota Rocchina , Caleri Elvanessa , Rossi Federica
Published: February 2024

Computed tomography is frequently used to stage canine mast cell tumors (MCTs). The aims of this prospective, observational study were to describe the CT features of MCTs, to evaluate the performance of CT in detecting additional or incidental MCTs, to distinguish between cutaneous (cMCT) or subcutaneous (scMCT) MCTs, and to identify one or multiple sentinel lymph nodes (SLNs) by indirect CT lymphography (ICTL). Seventy‐two dogs affected by 111 MCTs were included. The recorded parameters were: shape, size, attenuation (Hounsfield units [HU]), location (cutaneous or subcutaneous), and presence of fat stranding. The SLNs were compared with the regional lymph nodes and supplementary MCTs were registered. Mast cell tumors mostly appeared with well‐defined margins (89%), round/oval shape (71%), homogeneous enhancement (90%) with a mean postcontrast density of 62.0 ± 23.4 HU and associated with fat stranding (43%). Cutaneous mast cell tumors were more frequently round (P = .003), whereas scMCTs were oval (P = .011) with a larger mean maximal diameter (2.91 ± 1.57 cm vs 1.46 ± 1.28 cm, P = .002) and more feeding vessels (77% vs 39% P = .044). Compared with histopathology, CT accuracy in differentiating cMCTs and sMCTs was 57%, with an interobserver agreement of 88% (three reviewers). Indirect CT lymphography showed the SLN in 82 of 85 (97%) cases, 32% of them not corresponding to the regional node. CT showed additional or incidental MCTs in 23 of 72 (32%) dogs. In conclusion, the common CT appearance of canine cMCTs and scMCTs is reported with some statistical differences between the two categories. CT is useful in identifying clinically undetected MCTs and SLNs, although it shows low accuracy in distinguishing between cMCT and scMCT.
Facilitators and barriers to implementation of telemedicine in nursing homes: A qualitative systematic review and meta‐aggregation
Authors: Chua Min , Lau Xue Kee , Ignacio Jeanette
Published: February 2024

Background

Telemedicine is an effective way to provide nursing home residents ease of access to consultations with healthcare professionals. It is safe, effective, and time‐ and cost‐efficient, and can be used when there are movement restrictions, such as during the COVID‐19 pandemic. This literature focuses only on healthcare professionals' experiences and perspectives on the use of telemedicine in long‐term care facilities.

Objectives

This review concentrated on telemedicine programs that did not involve remote monitoring. It aimed to comprehensively appraise existing literature examining the facilitators and barriers in implementing telemedicine services in nursing homes.

Methods

A systematic qualitative review was conducted with content analysis. Database searching was conducted in PubMed, Embase, Cochrane, Scopus, and CINAHL. Hand searching for gray literature and reference lists of included papers was also performed. Qualitative studies or mixed‐method studies with a qualitative analysis addressing implementation of telemedicine in any long‐term care facilities were included. The Critical Appraisal Skills Programme qualitative checklist was used to assess the quality of the included studies. The data were extracted and cross‐checked between two reviewers. A third reviewer was consulted for any disagreements. Meta‐aggregation was used to synthesize the results.

Results

Eighty‐one findings were extracted, which informed 16 categories and 13 synthesized findings. The synthesized findings were related to the innovation domain, infrastructure, work processes, individuals, and implementation processes.

Linking Evidence to Action

This review highlighted factors that affect the successful implementation of a telemedicine service in nursing homes. These findings provide evidence to support the future utilization of this service in the nursing home setting. Further research should explore the best approach to address these barriers and facilitators.
Is primary trabeculectomy cost-effective for patients with advanced primary open angle glaucoma? Results from the Treatment of Advanced Glaucoma Study economic model
Authors: Shabaninejad Hosein , Homer Tara , Kernohan Ashleigh , King Anthony J , Burr Jennifer , Azuara-Blanco Augusto , Vale Luke
Published: February 2024

Background/aims

Advanced primary open angle glaucoma (POAG) is a lifelong condition. The aim of this study is to compare medical treatment against trabeculectomy for patients presenting with advanced POAG using an economic evaluation decision model.

Methods

A Markov model was used to compare the two treatments, medical treatment versus trabeculectomy for the management of advanced POAG, in terms of costs and quality-adjusted life-years (QALYs). The uncertainty surrounding the model findings was assessed using probabilistic sensitivity analysis and deterministic analysis. Data for the model came from Treatment of Advanced Glaucoma Study supplemented with data from the literature. The main outcomes of the model presented in terms of Incremental costs and QALYs based on responses to the EQ-5D-5L, Health Utilities Index-3 and a Glaucoma Utility Index.

Results

In the base-case analysis (lifetime horizon and EQ-5D-5L measure), participants receiving trabeculectomy had on average, an additional cost of £2687, an additional 0.28 QALYs and an incremental cost per QALY of £9679 compared with medical treatment. There was a 73% likelihood of trabeculectomy being considered cost-effective when society was willing to pay £20 000 for a QALY. Over shorter time horizons, the incremental cost per QALY gained from trabeculectomy compared with medical treatment was higher (47 663) for a 2-year time horizon. Our results are robust to changes in the key assumptions and input parameters values.

Conclusion

In patients presenting with advanced POAG, trabeculectomy has a higher probability of being cost-effective over a patient’s lifetime compared with medical treatment.
Biological therapy for inflammatory bowel disease: cyclical rather than lifelong treatment?
Authors: Selinger Christian Philipp , Rosiou Konstantina , Lenti Marco V
Published: February 2024

Inflammatory bowel disease (IBD) treatment was revolutionised with the arrival of biological therapy two decades ago. There are now multiple biologics and increasingly novel small molecules licensed for the treatment of IBD. Treatment guidelines highlight the need for effective control of inflammation and early escalation to advanced therapies to avoid long-term complications. Consequently, a large proportion of patients with IBD receive advanced therapies for a long time. Despite their beneficial risk–benefit profile, these treatments are not without risk of side effects, are costly to healthcare providers and pose a burden to the patient. It is, therefore, paramount to examine in which circumstances a temporary cessation of therapy can be attempted without undue clinical risk. Some patients may benefit from cyclical rather than continuous treatment. This review examines the risk of relapse after discontinuation of advanced therapies, how to identify patients at the lowest risk of relapse and the chance of recapturing response when flaring after discontinuation.
Representations of an Ebola ‘outbreak’ through Story Technologies
Authors: Frankfurter Raphael , Malik Maya , Kpakiwa Sahr David , McGinnis Timothy , Malik Momin M , Chitre Smit , Barrie Mohamed Bailor , Dibba Yusupha , Mulalu Lulwama , Baldwinson Raquel , Fallah Mosoka , Rashid Ismail , Kelly J Daniel , Richardson Eugene T
Published: February 2024

Background

Attempts to understand biosocial phenomena using scientific methods are often presented as value-neutral and objective; however, when used to reduce the complexity of open systems such as epidemics, these forms of inquiry necessarily entail normative considerations and are therefore fashioned by political worldviews (ideologies). From the standpoint of poststructural theory, the character of these representations is at most limited and partial. In addition, these modes of representation (asstories) do work (astechnologies) in the service of, or in resistance to, power.

Methods

We focus on a single Ebola case cluster from the 2013–2016 outbreak in West Africa and examine how different disciplinary forms of knowledge production (including outbreak forecasting, active epidemiological surveillance, post-outbreak serosurveys, political economic analyses, and ethnography) function asStory Technologies. We then explore how these technologies are used to curate ‘data,’ analysing the erasures, values, and imperatives evoked by each.

Results

We call attention to the instrumental—in addition to the descriptive—role Story Technologies play in ordering contingencies and establishing relationships in the wake of health crises.

Discussion

By connecting each type of knowledge production with the systems of power it reinforces or disrupts, we illustrate how Story Technologies do ideological work. These findings encourage research from pluriversal perspectives and advocacy for measures that promote more inclusive modes of knowledge production.
Inflammatory markers and functional outcome score in different subgroups of ischaemic stroke: a prospective cohort study
Authors: Fakhari Mohammad Sadegh , Poorsaadat Leila , Almasi-Hashiani Amir , Ebrahimi-Monfared Mohsen
Published: February 2024

Background

Acute ischaemic stroke (AIS) is a leading cause of disability and mortality worldwide. Determining subgroups and outcomes of AIS may lead to better treatment. We aimed to investigate the relationship between inflammatory markers and subgroups of AIS with further follow-up of patients in terms of functional outcome score.

Methods

In this prospective cohort study, we examined white cell count (WCC), neutrophil count, lymphocyte count, neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR) and qualitative C reactive protein (CRP), in the first 24 hours of patients’ admission. Patients were assigned to AIS subgroups as defined by the TOAST criteria. Then patients’ disability score was followed up after 3 and 6 months, using the modified Rankin Scale.

Results

We included 217 patients with AIS. The mean age of participants was 72.07 years, and we included 92 women (42.4%). For the AIS subgroup, 83 (38.25%) patients had large artery atherosclerosis (LAA), 41 (18.89%) had cardioembolism and 62 (28.57) had small vessel obstruction. Neutrophil count and NLR showed a statistically significant difference in the subgroups of AIS and were highest in the ‘other’ subgroup of AIS (p<0.05). Lymphocyte count, ESR and qualitative CRP showed no statistically significant difference between subgroups (p>0.05). WCC, neutrophil count and NLR showed a positive correlation with functional outcomes (p<0.05), other markers did not correlate with outcomes (pp>0.05).

Conclusion

We can conclude that neutrophil count and NLR are available inflammatory biomarkers for predicting outcomes and these two biomarkers are associated with AIS subgroups. However, ESR, qualitative CRP and lymphocyte count do not appear to be correlated with outcomes or subgroup of AIS.
Insulin resistance prior to term age in very low birthweight infants: a prospective study
Authors: Zamir Itay , Stoltz Sjöström Elisabeth , van den Berg Johannes , Naumburg Estelle , Domellöf Magnus
Published: February 2024

Objective

To explore the glucose-related hormone profile of very low birthweight (VLBW) infants and assess the association between neonatal hyperglycaemia and insulin resistance during the admission period.

Design

A prospective observational study—the Very Low Birth Weight Infants, Glucose and Hormonal Profiles over Time study.

Setting

A tertiary neonatal intensive care unit and four neonatal units in county hospitals in Sweden.

Patients

48 infants born <1500 g (VLBW) during 2016–2019.

Outcome measures

Plasma concentrations of glucose-related hormones and proteins (C-peptide, insulin, ghrelin, glucagon-like peptide 1 (GLP-1), glucagon, leptin, resistin and proinsulin), insulin:C-peptide and proinsulin:insulin ratios, Homoeostatic Model Assessment 2 (HOMA2) and Quantitative Insulin Sensitivity Check (QUICKI) indices, measured on day of life (DOL) 7 and at postmenstrual age 36 weeks.

Results

Lower gestational age was significantly associated with higher glucose, C-peptide, insulin, proinsulin, leptin, ghrelin, resistin and GLP-1 concentrations, increased HOMA2 index, and decreased QUICKI index and proinsulin:insulin ratio. Hyperglycaemic infants had significantly higher glucose, C-peptide, insulin, leptin and proinsulin concentrations, and lower QUICKI index, than normoglycaemic infants. Higher glucose and proinsulin concentrations and insulin:C-peptide ratio, and lower QUICKI index on DOL 7 were significantly associated with longer duration of hyperglycaemia during the admission period.

Conclusions

VLBW infants seem to have a hormone profile consistent with insulin resistance. Lower gestational age and hyperglycaemia are associated with higher concentrations of insulin resistance markers.
Preconception health risk factors documented in general practice electronic medical records
Authors: Withanage Nishadi Nethmini , Botfield Jessica R , Black Kirsten , Mazza Danielle
Published: February 2024

Background

Documenting medical and lifestyle preconception health risk factors in electronic medical records (EMRs) could assist general practitioners (GPs) to identify those reproductive-aged women who could most benefit from preconception care (PCC). However, it is unclear to what extent PCC risk factors are identifiable in general practice records. This study aimed to determine the extent to which medical and lifestyle preconception health risk factors are documented in general practice EMRs.

Methods

We conducted an audit of the documentation of medical and lifestyle preconception risk factors in 10 general practice EMRs in Melbourne, Australia. We retrospectively analysed the EMRs of 100 consecutive women aged 18–44 years who visited each practice between January and September 2022. Using a template informed by PCC guidelines, we extracted data from structured fields in the EMR and conducted a descriptive analysis.

Results

Among the data extracted, the more commonly documented medical and lifestyle preconception health risk factors in the EMRs included smoking (79%), blood pressure (74%), alcohol consumption (63%) and body mass index (57%). Among the women audited, 14% were smokers, 24% were obese, 7% had high blood pressure, 5% had diabetes, 28% had a mental health condition, 13% had asthma, 6% had thyroid disease and 17% had been prescribed and could be using a potentially teratogenic medication.

Conclusions

Better documentation of medical and lifestyle preconception health risk factors in structured fields in EMRs may potentially assist primary care providers including GPs in identifying and providing PCC to women who could most benefit from it.
Seeking support for abortion online: a qualitative study of women’s experiences
Authors: Wilson-Lowe Rachel Victoria , Purcell Carrie , Lewis Ruth , McDaid Lisa
Published: February 2024

Introduction

Social support can mitigate the impact of stress and stigma before or after an abortion. However, stigma anticipation can limit access to in-person support. Informal online spaces can offer opportunities to address unmet support needs including supplementing in-person support lacking within stigmatised contexts. While earlier studies have explored content of posts comprising personal accounts of abortion, little is known about the nuances of how and to what end online spaces are navigated.

Methods

Semi-structured interviews were conducted remotely (online or by telephone) with 23 women living in Scotland (aged 20–54 years) recruited through social media and online advertisements. Reflexive thematic analysis was supported by NVivo12 software.

Results

Key themes: obtaining support that was unavailable from in-person networks; preparation for abortion; reducing feelings of isolation. The majority of participants independently searched online for accounts of abortion, with only three receiving any signposting to specific resources. Without guidance, finding relevant, supportive content was not straightforward. The search process was additionally complicated by the prevalence of abortion stigma online, which generated an additional burden at a potentially challenging time. Those who received direction towards particular resources reported primarily positive online experiences.

Conclusions

While online content could address perceived in-person support gaps, the process of finding supportive content without guidance can be complex. Online searching may also expose women to stigmatising material and interactions. Signposting by abortion services towards well-moderated and trustworthy online resources could be constructive in limiting exposure to stigma and misinformation, while allowing those seeking it to access better support.
Psychosocial well-being and firearm storage practices: evidence from five US states
Authors: Datta Biplab Kumar , Jaremski Jennifer E , Johnson J Aaron
Published: February 2024

Objective

Gun safety practices can play a pivotal role in preventing suicide and unintentional injuries involving a firearm. This study aimed to assess whether psychosocial well-being, measured by emotional support, feeling of social isolation and life satisfaction, influenced safe storage practices among individuals who had firearms in or around their home.

Methods

Data are from the firearm safety module of the 2022 Behavioural Risk Factor Surveillance System survey of 11 722 individuals having firearms and living in California, Minnesota, Nevada, New Mexico and Ohio. Respondents were asked to identify how guns were stored in their homes including: (1) not loaded, (2) loaded but locked and (3) loaded and unlocked. Multinomial logistic regression models with controls for sociodemographic correlates assess the relative risks of certain storage measures.

Results

Relative to the base outcome of not loaded, the adjusted relative risks of having firearms loaded and unlocked among individuals who usually/always felt socially isolated were 1.72 (95% CI: 1.02 to 2.88) times that of individuals who never felt socially isolated. The adjusted risks among individuals who were dissatisfied with their life were 1.82 (95% CI: 1.02 to 3.24) times that of their counterparts who were very satisfied. The adjusted risks were not statistically significant among individuals who rarely/never received needed emotional support compared with individuals who always received support.

Conclusion

The results suggest a strong relationship between social isolation and life satisfaction and safe storage practices at home. Policies designed to improve psychosocial well-being, therefore, may present an important opportunity for preventing unintentional firearm injuries.
Bringing people together through shared purpose and identity: lessons learnt from NHS Providers CEO Sir Julian Hartley
Authors: James Richard , Hartley Julian , Stroud Laura
Published: February 2024

Introduction

The healthcare sector is facing increased demand with reduced resources, yet despite these challenges, leaders such as NHS Providers CEO Sir Julian Hartley have created cultures where the workforce can realise shared values, through a focus on staff engagement. This article describes Julian’s journey, through the eyes of a doctor-in-training working in an organisation he has led, to understand what we can learn from his approach to leadership.

Narrative

As a manager, Julian saw how many different people it takes to make the NHS work, and decided the role of an NHS leader was to bring people together, through a strong sense of shared purpose and identity. As CEO of Trusts in Blackpool and Leeds, he put this focus on staff engagement into practice to great success. Julian then introduced lean methods that flourished in the culture he had created, and when external factors such as COVID-19 began to erode that culture, returned to refresh that underpinning shared purpose.

Reflection

Julian has developed a toolkit of behaviours and approaches, refined through experience and reflection, to help him elucidate and bring to life both the values and goals of the workforce. Because he shares these values, he has been able to lead with authenticity, creating engaged workforces, empowered to drive continuous improvement. We can reflect on Julian’s approach as leaders ourselves: how can we align the values and visions of our staff, and ensure they are empowered to realise both?
Diagnosing Shosha: literature as a lens to view disease and history
Authors: Klugman Craig M , Levine Carol
Published: February 2024

In recent decades, physicians have diagnosed fictional and non-fictional characters through portraits, biographies and writing. We argue that such an exercise can be beneficial for a uniquely health humanities reason—better understanding of our current world and the social determinants of health. Drawing on the method of health and social justice studies, we explore the character of Shosha, who appears repeatedly in the writings of Nobel Prize winner Isaac Bashevis Singer. Singer’s strong story-telling skill and commitment to writing about the Jewish communities of prewar Poland in vivid detail preserve a slice of history, ensure that future generations will better understand what was destroyed by Nazi extermination policies, and provide lessons for modern political, hunger and war threats to human health. Shosha suffers from a lifelong debilitating disease that neither Singer nor subsequent commentaries ever name. The authors focus first on diagnosing the disease by consulting medical literature and experts. They then examine the value and pitfalls of this exercise and suggest that the lessons of understanding the disease historically, for teaching physicians how to recognise diseases rooted in war and poverty, and for enlightening all of us to the risks faced in human health by a world increasingly taking up arms and sliding towards fascism make diagnosing Shosha necessary and meaningful.
Genetic algorithm for multilayer shield optimization with a custom parallel computing architecture
Authors: Cordella F. , Cappelli M. , Ciotti M. , Claps G. , De Leo V. , Mazzotta C. , Pacella D. , Tamburrino A. , Panza F.
Published: February 2024

This paper introduces a novel architecture for optimizing radiation shielding using a genetic algorithm with dynamic penalties and a custom parallel computing architecture. A practical example focuses on minimizing the Total Ionizing Dose for a silicon slab, considering only the layer number and the total thickness (additional constraints, e.g., cost and density, can be easily added). Genetic algorithm coupled with Geant4 simulations in a custom parallel computing architecture demonstrates convergence for the Total Ionizing Dose values. To address genetic algorithm issues (premature convergence, not perfectly fitted search parameters), a Total Ionizing Dose Database Vault object was introduced to enhance search speed (data persistence) and to preserve all solutions’ details independently. The Total Ionizing Dose Database Vault analysis highlights boron carbide as the best material for the first layer for neutron shielding and high-Z material (e.g., Tungsten) for the last layers to stop secondary gammas. A validation point between Geant4 and MCNP was conducted for specific simulation conditions. The advantages of the custom parallel computing architecture introduced here, are discussed in terms of resilience, scalability, autonomy, flexibility, and efficiency, with the benefit of saving computational time. The proposed genetic algorithm-based approach optimizes radiation shielding materials and configurations efficiently benefiting space exploration, medical devices, nuclear facilities, radioactive sources, and radiogenic devices.
Acute Ischaemic Stroke in Patients Treated with Direct Oral Anticoagulants: Potential Causes, Clinical Characteristics, and Short-Term Outcomes
Authors: Sawczyńska Katarzyna , Włodarczyk Ewa , Pawlicka Aleksandra , Kołodziejczyk Bartosz , Wrona Paweł , Wężyk Kamil , Homa Tomasz , Sarba Paulina , Wróbel Dominik , Zdrojewska Kaja , Sobolewska Maria , Rolkiewicz Dawid , Slowik Agnieszka
Published: February 2024

Introduction. Direct oral anticoagulants (DOAC) are the first-line treatment for primary and secondary acute ischaemic stroke (AIS) prevention in patients with nonvalvular atrial fibrillation (NVAF), but a significant percentage of patients develop AIS despite being treated with DOAC. As the number of DOAC-treated patients is growing, so is the number of patients with AIS on DOAC. The aim of the study was to assess the incidence of AIS with prestroke DOAC treatment among patients hospitalised in the University Hospital in Kraków, to analyse the clinical characteristics of AIS occurring in patients on DOAC, and to identify potential causes of treatment ineffectiveness in this group. Materials and Methods. In the study, we included all patients hospitalised in the Department of Neurology of the University Hospital in Kraków within one year (July 2022 to June 2023) with the diagnosis of AIS. The group was divided into two subgroups of patients with and without prestroke DOAC treatment. Based on medical files, we retrospectively analysed the profile of cardiovascular risk factors, stroke severity (assessed with National Institutes of Health Stroke Scale, NIHSS), use of causative stroke treatment and short-term outcomes (defined as NIHSS score, modified Rankin scale (mRS) score at discharge, in-hospital mortality, and secondary intracerebral haemorrhage among patients treated with mechanical thrombectomy, MT). Within the DOAC-treated subgroup, we looked for potential causes of AIS occurring despite DOAC treatment (valvular AF, poor adherence to treatment, underdosing, other prothrombotic conditions, aetiology of stroke other than thromboembolic, and drug-drug interactions). Results. In the study, we included 768 AIS patients. 109 (14.2%) had a history of prestroke DOAC treatment. A potential cause of DOAC treatment failure was identified in the majority of them (n=63, 57.8%). Patients with prestroke DOAC treatment had worse functional condition before stroke and higher stroke severity on admission but similar short-term outcomes and similar short-term effects of treatment with MT. DOAC (+) and DOAC (-) patients had different profiles of cardiovascular risk factors and different factors associated with short-term outcome. Conclusions and Clinical Implications. A potential cause of AIS occurring in DOAC-treated patients can be identified in most cases and in many of them prevented.
Clinical and Imaging Characteristics of Metastatic Orbital Tumours in North China
Authors: Zhao Yun , Yu Shasha , Mu Mengxia , Li Jiagen , Li Hongxun , Zhao Hong
Published: February 2024

Purpose. This study was designed to review the primary sites, clinical manifestations, imaging features, treatments, and outcomes of 36 patients with orbital metastasis in North China. Methods. This was a retrospective review of 36 patients with orbital metastasis at Tianjin Eye Hospital between January 2010 and December 2020 in North China as well as a review of the literature. Results. Thirty-six patients were included in the study; 17 were male, and 19 were female, with an age range of 1–82 years (average 54.9 ± 19.8 years). All the tumours were unilateral. The mean duration from the onset of orbital signs to presentation at the hospital was 2.4 months (range 1–10 months). Breast carcinoma, gastrointestinal tract carcinoma, and lung carcinoma were the most common histological types. Proptosis, ocular pain, and diplopia were the most common clinical manifestations. The superior orbit was the most common quadrant involved. All patients received comprehensive therapy, including surgery, radiotherapy, or chemotherapy. The average follow-up time was 2.45 years (range 7 months to 5.5 years). Ten patients in this study died as a result of disseminated metastasis from the primary tumour. Conclusions. In North China, the most common primary cancer that metastasizes to the orbit is breast cancer, followed by gastrointestinal tract carcinoma and lung cancer. The increasing trend of orbital gastrointestinal tract metastases in North China in recent years is noteworthy. The survival rate of patients with orbital metastasis of neuroblastoma is low.
Association between Perceived Control and Quality of Life among Patients with Breast Cancer: Structural Equation Analysis
Authors: Rahman Rabigul , Wang Haiyan , Mahsut Maynur , Shang Hongmei , Zhang Xiaoyan
Published: February 2024

Objective. Perceived control refers to an individual’s subjective perception, affective experience, or cognitive beliefs regarding their level of control. The objective of this study was to examine the relationship between perceived control and quality of life (QoL) among breast cancer (BC) patients using a structural equation model. Method. Participants (N = 80) completed questionnaire surveys on perceived control and QoL using the Cancer Experience and Efficacy Scale (CEES) and the Quality of Life Questionnaire Core 30 (EORTC QLQ-C30 V3.0), respectively. Structural equation modeling was employed to examine the associations between perceived control factors, including cancer experience and control efficacy, and QoL. Results. The QoL in BC patients was found to be significantly negatively correlated with physical symptoms, accounting for 51.6%. This indicates that the QoL of patients decreased by 51.6% with each unit increase in physical symptoms. In terms of perceived control among BC patients, socioeconomic strain exerted the greatest influence on cancer experience, accounting for 44.3%, followed by emotional strain and personal strain at 40.08% and 34.6%, respectively. Group efficacy had the highest impact on control efficacy at 43.0%, followed by individual efficacy and medical efficacy at 41.8% and 29.7%, respectively. QoL in BC patients decreased by 4.2% with every unit increase in cancer experience but improved by 3.5% with every unit increase in control efficacy. Conclusion. The structural equation model facilitates a comprehensive understanding of the interrelationships among various variables in perceived control and QoL among BC patients. The cancer experience in perceived control is negatively correlated with the QoL, whereas control efficiency demonstrates a positive correlation with QoL. Consequently, healthcare professionals should implement appropriate interventions to alleviate physical symptoms and enhance control efficiency, thereby improving both perceived control and QoL levels among BC patients. This trial is registered with ChiCTR2300069476.
Unraveling Dengue Dynamics: In-Depth Epidemiological and Entomological Analyses in Bengaluru, India
Authors: H. C. Vani , N. Sujit Nath , M. K. Jaiswal , R. P. Tiwari , P. Bharathi , B. Asmita , G. Shankar , C. Jithen , V. D. Pallavi , V. Srinivas , M. Ashok , Shariff Mahamood , S. Renuka , B. M. Shrinivasa
Published: February 2024

In view of the increased number of detected dengue cases in Bengaluru, a request for situation analysis was received from local health authorities in the selected area. The study included epidemiological and entomological assessments to understand the same. The immature forms collected were allowed to emerge, pooled, and processed for vector incrimination. In the surveyed population (347), 20 (5.8%) reported fever cases and 12 (3.5%) were confirmed as dengue cases among the 102 families. Stegomyia indices were high. Vector incrimination studies revealed pools positive for the presence of dengue virus in flower pots, fridge trays, plastic barrels, and rubber tires habitats. This study highlights the increased risk of dengue fever incidence in communities wherepoor intra and peri-domestic sanitation practices are prevailing and recommendsregular entomological surveillance of denguevirus in its vector population..
Association Between MR‐Based Thrombus Imaging Characteristics and Endovascular Therapy Outcome in Acute Ischemic Stroke: A Systematic Review and Meta‐Analysis
Authors: Abbasi Mohammad Hossein , Dula Adrienne N. , Warach Steven J. , Saber Hamidreza
Published: February 2024

Background

Prediction of successful revascularization and achieving a favorable functional outcome may help determine the optimal treatment strategy and improve the management of stroke. A growing body of literature has implicated a predictive value for thrombus imaging characteristics for stroke outcomes.

Methods

We conducted an electronic search using PubMed, Ovid MEDLINE, and EMBASE, previously published meta‐analyses, and systematic review studies that intervened by endovascular thrombectomy or intravenous thrombolysis following large vessel occlusion stroke from 2000 to 2023 and involved magnetic resonance‐based thrombus imaging, then screened 2007 studies against our eligibility criteria. We extracted the enrollees’ characteristics and the association between clot features and radiological and functional outcome measures.

Results

Thirty‐three studies were found eligible, with a total number of 6902 enrollees. Susceptibility vessel sign was found in 3531 subjects (51.2%). Nine studies involved only the administration of intravenous thrombolysis, whereas 24 studies intervened by endovascular thrombectomy. Seventeen studies found at least an association between thrombus imaging characteristics and successful revascularization, whereas the others reported no association. only 13 studies found at least one thrombus characteristic associated with functional outcome, while the others showed no association between  the thrombus characteristics and functional outcome after stroke. Pooled meta‐analysis of studies that involved endovascular thrombectomy with or without intravenous thrombolysis showed a statistically significant association between the presence of susceptibility vessel sign and both successful reperfusion (odds ratio [OR]: 1.57 [1.09–2.27];
P
= 0.02) and favorable functional outcome (OR: 1.76 [1.17–2.66];
P
= 0.007).

Conclusion

The presence of susceptibility vessel sign on magnetic resonance‐based clot imaging was associated with functional outcome and successful reperfusion following thrombectomy.
Transportation Networks and the Geographic Concentration of Employment
Authors: Frye Dustin
Published: February 2024

This paper examines the effect of expanding transportation networks on spatial industrial growth across the United States from 1953 to 2016. I use a new methodological approach that applies network theory combined with a historic military map to address the two forms of endogeneity present in expanding transportation networks: route placement and construction timing. I find that Interstate counties experienced significant growth in employment and the number of establishments relative to non-Interstate counties. Growth rates are highest within two decades of receiving an Interstate. Results also reveal positive spillovers occurred in later decades among adjacent counties along the metropolitan periphery.
Immigration and the Top 1 Percent
Authors: Advani Arun , Koenig Felix , Pessina Lorenzo , Summers Andy
Published: February 2024

Using administrative data on the universe of UK taxpayers, we study the contribution of migrants to the rise in UK top incomes. We show migrants are over-represented at the top of the income distribution, with migrants twice as prevalent in the top 0.01% as anywhere in the bottom 97% of taxpayers. These high incomes are predominantly from labour, rather than capital, and migrants are concentrated in only a handful of industries, predominantly finance. All of the observed growth in the UK top 1% income share over the past 20 years has accrued to migrants.
Consumption Response to Minimum Wages: Evidence from Chinese Households
Authors: Dautović Ernest , Hau Harald , Huang Yi
Published: February 2024

The paper evaluates the impact of the Chinese minimum wage policy on consumption of low-wage households for the period 2002-2009. Using a representative panel of urban households, we find that the consumption response to minimum wage income hikes increases in the share of minimum wage income in total household income. In particular, poorer households fully consume their additional income, while meaningful negative employment effects are absent. The large marginal propensity to consume is driven by households with at least one child, while poor, childless households save two-thirds of a minimum wage hike. The expenditure increase is concentrated in health care and education with potentially long-lasting benefits to household welfare.
Testing Monotonicity of Mean Potential Outcomes in a Continuous Treatment with High-Dimensional Data
Authors: Hsu Yu-Chin , Huber Martin , Lee Ying-Ying , Liu Chu-An
Published: February 2024

We propose a Cramér-von Mises-type test for testing whether the mean potential outcome given a specific treatment level has a weakly monotonic relationship with the continuous treatment under unconfoundedness. To flexibly control for a possibly high-dimensional set of covariates, our test is based on a double debiased machine learning method. We show that our test controls asymptotic size and is consistent against any fixed alternative. We apply our test to evaluate the Job Corps program and reject a weakly negative relationship between the treatment (hours in academic and vocational training) and labor market performance among relatively low treatment values.
Improving Estimation Efficiency via Regression-Adjustment in Covariate-Adaptive Randomizations with Imperfect Compliance
Authors: Jiang Liang , Linton Oliver B. , Tang Haihan , Zhang Yichong
Published: February 2024

We investigate how to improve efficiency using regression adjustments with covariates in covariate-adaptive randomizations (CARs) with imperfect subject compliance. Our regression-adjusted estimators, which are based on the doubly robust moment for local average treatment effects, are consistent and asymptotically normal even with heterogeneous probabilities of assignment and misspecified regression adjustments. We propose an optimal but potentially misspecified linear adjustment and its further improvement via a nonlinear adjustment, both of which lead to more efficient estimators than the one without adjustments. We also provide conditions for nonparametric and regularized adjustments to achieve the semiparametric efficiency bound under CARs.
The Risk of Narrow, Disputable Results in the U.S. Electoral College
Authors: Geruso Michael , Spears Dean
Published: February 2024

Close elections are important for many reasons, including that consequent election disputes can weaken democratic legitimacy and risk political violence. We quantify the probability of close outcomes in US presidential races with novel applications of empirical election models from several sources. We show that razor-thin margins are very likely under the Electoral College (EC). And we establish that the EC causes this closeness: It would not occur under any plausibly comparable popular vote system. The tendency of the EC to generate close elections is found today and throughout US presidential voting history.
Labor Migration, Capital Accumulation, and the Structure of Rural Labor Markets
Authors: Dinkelman Taryn , Kumchulesi Grace , Mariotti Martine
Published: February 2024

Between 1967 and 1974, a bilateral treaty increased circular labor migration from Malawi to South Africa by 200%, bringing over 53 million USD in earnings into origin communities. A deadly migrant worker plane crash in 1974 ended these flows and led to migrant repatriation. We study how this shock affected local labor markets. In regions receiving more migrant capital after the crash, workers, particularly women, shifted from farming into non-farm work over thirty years. Investments in non-farm physical and human capital contribute to these sectoral changes. This natural experiment shows that temporary capital inflows can permanently reshape rural labor markets.
Common Subcontracting and Airline Prices
Authors: Aryal Gaurab , Campbell Dennis J. , Ciliberto Federico , Khmelnitskaya Ekaterina A.
Published: February 2024

In the US airline industry, independent regional airlines fly passengers on behalf of several national airlines across different markets, giving rise to common subcontracting. On the one hand, we find that subcontracting is associated with lower prices, consistent with the notion that regional airlines tend to fly passengers at lower costs than major airlines. On the other hand, we find that common subcontracting is associated with higher prices. These two countervailing effects suggest that the growth of regional airlines can have anticompetitive implications for the industry.
Hindsight Bias and Trust in Government
Authors: Herz Holger , Kistler Deborah , Zehnder Christian , Zihlmann Christian
Published: February 2024

We empirically assess whether hindsight bias affects citizens' evaluation of their political actors. Using an incentivized elicitation technique, we demonstrate that people systematically misremember their past policy preferences regarding how to best fight the Covid-19 pandemic. At the peak of the first wave in the United States, the average respondent mistakenly believed that they supported significantly stricter restrictions at the onset of the first wave than they actually did. Exogenous variation in the extent of hindsight bias, induced through a randomized survey experiment, indicates that hindsight bias has a negative causal impact on the change in trust in government.