bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of imaging findings of 714 symptomatic and asymptomatic temporomandibular joints: a retrospective study
Authors: Li Chuanjie , Zhang Qingbin
Published: February 2023

Background

The correlation between temporomandibular disorders (TMD) and imaging features remains unclear. This study compared the cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI) features in the temporomandibular joints (TMJs) with and without TMD symptoms.

Methods

The participants were recruited from the TMJ Diagnosis and Treatment Center from March 2022 to September 2022. Condylar morphology and condylar position were evaluated by CBCT. Disc morphology, disc position, and joint effusion were evaluated by T2-weighted image of MRI. The Chi-Square test and binary logistic regression analysis were carried out.

Results

Eighty-two patients with bilateral symptoms, 196 patients with unilateral symptoms, and 79 asymptomatic participants received MRI and CBCT examination. There were significant differences in the distribution of sex, age, condylar morphology, condylar position, disc morphology, disc position, and joint effusion in symptomatic and asymptomatic TMJs (P < 0.05), which showed a positive correlation with symptoms (P < 0.05). In multiple logistic regression, 19–30-year-age group, > 30-year-age group, abnormal condylar morphology, posterior condylar position, disc displacement with reduction (DDWR), and disc displacement without reduction (DDWoR) were found to be statistically significant (P < 0.05). The odds of having symptomatic TMJ were 1.952 higher in the 19–30-year-age group and 1.814 higher in the > 30-year-age group when compared to those aged ≤ 18-year-age group. The odds of having symptomatic TMJ were 2.360 higher in persons with abnormal condylar morphology when compared to those with normal condylar morphology. The odds of having symptomatic TMJ were 2.591 higher in persons with posterior condylar position when compared to those with the normal condylar position. The odds of having symptomatic TMJ were 2.764 higher in persons with DDWR and 4.189 higher in persons with DDWoR when compared to those with normal disc position. The area under the curve of the model was 0.736 ± 0.019 (95% CI 0.700–0.773, P = 0.000), which indicated that the model has a good fitting effect.

Conclusions

The imaging findings of TMJs were significantly different between symptomatic and asymptomatic TMJs. TMD is affected by multiple factors including > 19-year-age, abnormal condylar morphology, posterior condylar position, DDWR, and DDWoR, which could be risk factors for the development of TMD symptoms.

Trial registration This study was retrospectively registered on 28/03/2022 and endorsed by the Ethics Committee of Affiliated Stomatology Hospital of Guangzhou Medical University (LCYJ2022014).
How do cancer patients refuse treatment? A grounded theory study
Authors: Khankeh Hamid Reza , Vojdani Reza , Saber Mahboobeh , Imanieh Mohamadhadi
Published: February 2023

Background

All cancer patients, except for a small fraction, seek treatment after becoming aware of the disease. That small fraction do not seek any treatment due to various reasons, and this phenomenon is unknown to us. Therefore, the present study aimed to discover the reasons for treatment refusal in cancer patients.

Methods

This qualitative grounded theory study was conducted on 22 participants including patients, caregivers, physicians, and nurses. Purposive theoretical sampling was employed. Data were collected through in-depth interviews. All interviews were gradually transcribed and analyzed. Data analysis was carried out through the three-step method of open, axial, and selective coding and was continued until theoretical saturation. Straussian Grounded Theory was used for data analysis.

Results

A total of 4 themes and 20 sub-themes were extracted in this study. The core variable extracted from the interviews was “resilience” Other related themes included encounter with cancer, fighting cancer, and coping with cancer. The findings showed that in the context of fighting cancer, patients lost their resilience through various processes and refused treatment.

Conclusion

Cancer patients abandon the treatment in silence, oncologists and even family members being unaware of the matter. In other words, refusal of treatment is like an iceberg and the majority of the patients who have abandoned treatment are unknown to the health system. The model obtained in this study can increase the knowledge of the process that leads patients to lose their resilience against cancer and abandon treatment, which can increase the possibility of recognizing and predicting treatment refusal for oncologists.
Deep learning approach to detection of colonoscopic information from unstructured reports
Authors: Seong Donghyeong , Choi Yoon Ho , Shin Soo-Yong , Yi Byoung-Kee
Published: February 2023

Background

Colorectal cancer is a leading cause of cancer deaths. Several screening tests, such as colonoscopy, can be used to find polyps or colorectal cancer. Colonoscopy reports are often written in unstructured narrative text. The information embedded in the reports can be used for various purposes, including colorectal cancer risk prediction, follow-up recommendation, and quality measurement. However, the availability and accessibility of unstructured text data are still insufficient despite the large amounts of accumulated data. We aimed to develop and apply deep learning-based natural language processing (NLP) methods to detect colonoscopic information.

Methods

This study applied several deep learning-based NLP models to colonoscopy reports. Approximately 280,668 colonoscopy reports were extracted from the clinical data warehouse of Samsung Medical Center. For 5,000 reports, procedural information and colonoscopic findings were manually annotated with 17 labels. We compared the long short-term memory (LSTM) and BioBERT model to select the one with the best performance for colonoscopy reports, which was the bidirectional LSTM with conditional random fields. Then, we applied pre-trained word embedding using large unlabeled data (280,668 reports) to the selected model.

Results

The NLP model with pre-trained word embedding performed better for most labels than the model with one-hot encoding. The F1 scores for colonoscopic findings were: 0.9564 for lesions, 0.9722 for locations, 0.9809 for shapes, 0.9720 for colors, 0.9862 for sizes, and 0.9717 for numbers.

Conclusions

This study applied deep learning-based clinical NLP models to extract meaningful information from colonoscopy reports. The method in this study achieved promising results that demonstrate it can be applied to various practical purposes.
The relationship between attitude and self-efficacy of labor support with supportive behaviors from the perspective of midwives
Authors: Heidari Khadijeh , Amiri-Farahani Leila , Pezaro Sally
Published: February 2023

Background and aim

Effective support given by a midwife during labor and childbirth is associated with numerous positive outcomes. Yet the delivery of such support can be hindered by negative workplace cultures. The purpose of the current study was to examine the relationship between attitude and self-efficacy of labor support and labor supportive behaviors from the perspectives of midwives working in Iran.

Methods

Midwives (n = 213) employed in the labor wards of selected hospitals in an urban area of Iran participated in this cross-sectional study. Participants were recruited via convenience sampling from December 2016 to September 2017. The data were collected using a personal characteristics tool, the Labor Support Questionnaire, the Self-efficacy Labor Support Scale, and attitudes toward the Labor Support Questionnaire. Descriptive statistics along with multiple linear regression was used for data analysis.

Results

Participants had a supportive behavior score of 74.98 for mean (SD ± 13.39). The informational support dimension had the highest reported score of the supportive behaviors, whereas the tangible support dimension had the lowest score. The mean scores of attitude and self-efficacy toward labor support were 24.79 (SD ± 4.14) and 79.83 (SD ± 13.82). There were also statistically significant correlations between attitude and self-efficacy, and labor support behaviors and its dimensions. Multiple linear regression analysis results indicated that interests in occupation, attitude, and self-efficacy were predictors of labor supportive behaviors.

Conclusion

Midwives’ level of interest in the profession, attitude, and self-efficacy of labor support were significantly associated with labor support behaviors. Thus midwives’ interest in their profession, along with their attitudes and self-efficacy could usefully be developed to enhance their supportive behaviors during labor.
Newly diagnosed with inflammatory arthritis (NISMA)–development of a complex self-management intervention
Authors: Lindgren L. H. , Thomsen T. , de Thurah A. , Aadahl M. , Hetland M. L. , Kristensen S. D. , Esbensen B. A.
Published: February 2023

Background

Patients newly diagnosed with inflammatory arthritis (IA) request regular consultations and support from health professionals to manage physiological, emotional, and social challenges. Evidence suggests that providing a tailored multi-component self-management program may benefit disease management. However, there is a lack of evidence of effective interventions with multiple components targeting the needs of this group. Therefore, the aim of this study was to develop a self-management intervention targeting newly diagnosed patients with IA, following the Medical Research Council (MRC) framework for developing complex interventions.

Methods

The development of the complex self-management intervention covered three steps. First, the evidence base was identified through literature reviews, in which we described a preliminary nurse-led intervention. Secondly, we chose Social Cognitive Theory as the underlying theory along with Acceptance and Commitment Theory to support our communication strategy. Thirdly, the preliminary intervention was discussed and further developed in workshops to ensure that the intervention was in accordance with patients’ needs and feasible in clinical practice.

Results

The developed intervention comprises a 9-month nurse-led intervention (four individual and two group sessions). A physiotherapist and an occupational therapist will attend the group sessions along with the nurse. All sessions should target IA-specific self-management with a particular focus on medical, role, and emotional management.

Conclusion

Through the workshops, we involved all levels of the organization to optimize the intervention, but also to create ownership and commitment, and to identify barriers and shortcomings of the preliminary intervention. As a result, from the existing evidence, we believe that we have identified effective mechanisms to increase self-management in people newly diagnosed with IA. Further, we believe that the involvement of various stakeholders has contributed significantly to developing a relevant and feasible intervention. The intervention is a nurse-led complex self-management intervention embedded in a multidisciplinary team (named NISMA). The intervention is currently being tested in a feasibility study.
Gaps in protection: the actual challenge in malaria elimination
Authors: Paaijmans Krijn P. , Lobo Neil F.
Published: February 2023

Progress in reducing both malaria cases and deaths has stalled with regression seen in many geographies. While significant attention is given to the contributing challenges of drug and insecticide resistance, ‘residual’ malaria is often diminished to transmission resulting from outdoor-biting or zoophagic/opportunistic mosquito vectors. These specific vector bionomic traits are only part of the problem, as residual transmission may be driven by (a combination of) (1) sub-optimal intervention coverage, quality, acceptance, and/or usage, (2) drug resistance, (3) insecticide resistance, (4) refractory, resistant and adaptive vector and human behaviours that lower intervention effectiveness, (5) lack of, limited access to, and/or willingness to use healthcare systems, (6) diagnostic sensitivity along with the parallel issue of hrp2/3 mutations, (7) (inter)national policy, (8) the research and development pipeline, and (9) external factors such as natural disasters and conflict zones. Towards combating the minimization of this extensive and multipronged issue among the scientific community, funding agencies, and public health officials responsible for guiding or developing malaria programmes, an alternative way of describing this transmission is proposed by focusing in on the causative ‘gaps in protection’. Defining and wording it as such zeros in on the drivers that result in the observed remaining (or increasing) transmission, allowing the malaria community to focus on solutions by identifying the actual causes. Outlining, defining and quantifying the gaps in protection for a given system is of utmost importance to understand what needs to be done, differentiating what can be done versus what cannot be tackled at that moment, along with delineating the technical and financial capacity required.
Estimating the neural spike train from an unfused tetanic signal of low-threshold motor units using convolutive blind source separation
Authors: Rohlén Robin , Lundsberg Jonathan , Antfolk Christian
Published: February 2023

Background

Individual motor units have been imaged using ultrafast ultrasound based on separating ultrasound images into motor unit twitches (unfused tetanus) evoked by the motoneuronal spike train. Currently, the spike train is estimated from the unfused tetanic signal using a Haar wavelet method (HWM). Although this ultrasound technique has great potential to provide comprehensive access to the neural drive to muscles for a large population of motor units simultaneously, the method has a limited identification rate of the active motor units. The estimation of spikes partly explains the limitation. Since the HWM may be sensitive to noise and unfused tetanic signals often are noisy, we must consider alternative methods with at least similar performance and robust against noise, among other factors.

Results

This study aimed to estimate spike trains from simulated and experimental unfused tetani using a convolutive blind source separation (CBSS) algorithm and compare it against HWM. We evaluated the parameters of CBSS using simulations and compared the performance of CBSS against the HWM using simulated and experimental unfused tetanic signals from voluntary contractions of humans and evoked contraction of rats. We found that CBSS had a higher performance than HWM with respect to the simulated firings than HWM (97.5 ± 2.7 vs 96.9 ± 3.3, p < 0.001). In addition, we found that the estimated spike trains from CBSS and HWM highly agreed with the experimental spike trains (98.0% and 96.4%).

Conclusions

This result implies that CBSS can be used to estimate the spike train of an unfused tetanic signal and can be used directly within the current ultrasound-based motor unit identification pipeline. Extending this approach to decomposing ultrasound images into spike trains directly is promising. However, it remains to be investigated in future studies where spatial information is inevitable as a discriminating factor.
Subtype frequency, demographic features, treatment and outcome of Juvenile Arthritis in one Centre in Abu Dhabi in the United Arab Emirates
Authors: Khawaja K. , Kalas R. , Almasri N.
Published: February 2023

Background

Juvenile Idiopathic Arthritis is a chronic inflammatory disease that affects 1 in 1000 children worldwide. Our population in the United Arab Emirates is diverse.

The objective of this study is to describe the subtype frequency, demographic features and treatments received and outcome of our patients.

Methods

Patients with the diagnosis of Juvenile Arthritis identified through the hospital electronic medical records system (EMR), which was implemented for all medical documentation in January 2011. All patients included are patients who presented to our center for treatment and follow up from 2011 to end of 2021. Retrospective case notes review of patients electronic medical records with the diagnosis of JIA was performed.

Results

One hundred thirty-eight patients in total. Oligoarticular subtype was the most represented with 75 patients (55%) followed by Rheumatoid factor negative polyarticular JIA with 32 patients (23%) then Enthesitis related arthritis (ERA) with 10 patients (7%) then psoriatic (6%) then systemic JIA (5%). Undifferentiated subtype of 2%.

The most diagnostic delay is in enthesitis related arthritis subtype with a mean of 11.4 months (6–25) followed by undifferentiated JIA with a mean of 7.5 months (4–8.5).

131 (96%) out of 138 received steroid treatment. Only 6 patients did not receive steroids.

Out of 138 patients, 101 (73%) were on synthetic disease modifying medication methotrexate. Sixty-eight patients out of the total 138 required biologic treatment (49%).

In total 93 patients achieved clinical remission (67%). In remission on treatment 78 patients which is (56%) of the total number of patients with follow up ranging from 1 to 5 years and 84% of patients in remission. In remission off treatment 15 patients (11% of all patients and 16% of patients in remission).

Conclusion

The most common subtype in our cohort of patients is oligoarticular JIA. Longest delay is for ERA subtype.

All our patients with oligoarticular JIA received Intra articular steroid injection as first line treatment. 49% of our patients received biologic treatment similar to rate in Northern Europe. Our remission rate is 67% with 11% of patients are in remission off treatment.

Access to care remains a priority to treat patients effectively.
Potential role of doravirine for the treatment of HIV-1-infected persons with transmitted drug resistance
Authors: Rhee Soo-Yon , Schapiro Jonathan M. , Saladini Francesco , Zazzi Maurizio , Khoo Saye , Shafer Robert W.
Published: February 2023

Background

Doravirine has a unique resistance profile but how this profile might increase its usefulness beyond first-line therapy in persons with susceptible viruses has not been well studied. We sought to determine scenarios in which doravirine would retain activity against isolates from ART-naïve persons with transmitted drug resistance (TDR) and to identify gaps in available doravirine susceptibility data.

Methods

We analyzed published in vitro doravirine susceptibility data and applied the results to 42,535 RT sequences from ART-naïve persons published between 2017 and 2021. NNRTI drug resistance mutations (DRMs) were defined as those with a Stanford HIV Drug Resistance Database doravirine penalty score either alone or in combination with other mutations.

Results

V106A, Y188L, F227C/L, M230L, and Y318F were associated with the greatest reductions in doravirine susceptibility. However, several NNRTI DRMs and DRM combinations lacking these canonical resistance mutations had > tenfold reduced susceptibility including G190E, one isolate with G190S, three isolates with L100I + K103N, one isolate with K103N + P225H, and isolates with L100I + K103N + V108I and K101E + Y181C + G190A. Of the 42,535 ART-naïve sequences, 3,374 (7.9%) contained a NNRTI DRM of which 2,788 (82.6%) contained 1 DRM (n = 33 distinct mutations), 426 (12.6%) contained 2 DRMs (79 distinct pairs of mutations), and 143 (4.2%) contained ≥ 3 DRMs (86 distinct mutation patterns). Among the 2,788 sequences with one DRM, 112 (4.0%) were associated with ≥ 3.0-fold reduced doravirine susceptibility while 2,625 (94.2%) were associated with < 3.0-fold reduced susceptibility. Data were not available for individual NNRTI DRMs in 51 sequences (1.8%). Among the 426 sequences with two NNRTI DRMs, 180 (42.3%) were associated with ≥ 3.0 fold reduced doravirine susceptibility while just 32 (7.5%) had < 3.0 fold reduced susceptibility. Data were not available for 214 (50.2%) sequences containing two NNRTI DRMs.

Conclusions

First-line therapy containing doravirine plus two NRTIs is expected to be effective in treating most persons with TDR as more than 80% of TDR sequences had a single NNRTI DRM and as more than 90% with a single DRM were expected to be susceptible to doravirine. However, caution is required for the use of doravirine in persons with more than one NNRTI DRM even if none of the DRMs are canonical doravirine-resistance mutations.
Extensive clinical target volume in postoperative chemoradiotherapy for esophageal squamous cell carcinoma: a phase II clinical trial (ESO-Shanghai 9)
Authors: Ai Dashan , Chen Yun , Liu Qi , Deng Jiaying , Zhang Xiaofei , Zhang Junhua , Chu Li , Shen Jingyi , Ma Longfei , Zhang Yawei , Chen Haiquan , Miao Longsheng , Zhao Kuaile , Xiang Jiaqing
Published: February 2023

Background

To compare the efficacy and safety of postoperative extensive target volume irradiation with elevated radiation dose and concurrent chemotherapy with radiotherapy only for the postoperative treatment of esophageal squamous cell carcinoma.

Methods

This trial was a single-arm phase II trial. Patients who underwent a radical transthoracic resection with negative margins within 3 months and histologically confirmed esophageal squamous cell carcinoma (pT3-4N0M0 or pTxN + M0, AJCC 7th) were eligible for this study. Postoperative radiotherapy was performed at a total dose of 45 Gy in 25 fractions with clinical target volumes of the tumor bed, anastomosis, bilateral supraclavicular, mediastinal, left gastric and celiac trunk lymph node areas. Five cycles of weekly TC (paclitaxel 50 mg/m2, d1, carboplatin AUC = 2, d1) were given as concurrent chemotherapy. The primary endpoint was the 2-year local control rate, and the secondary endpoints were overall survival, disease free survival, local-regional recurrence free survival, distant metastasis free survival and adverse events. All endpoints were compared with those in ESO-Shanghai 8 study with postoperative radiotherapy alone (40 Gy/20Fx).

Results

A total of 70 patients were enrolled from 2016 to 2018. The 2-year local control rate was 87.9% (95% CI: 83.3–92.3) in this study, which achieved the hypothesized 2-year local control rate of at least 83%. Overall survival, disease free survival, local-regional recurrence free survival and distant metastasis free survival in this study were also longer than those in previous ESO-Shanghai 8 study while most toxicities were increased and two patients in this study died of radiation pneumonitis.

Conclusions

Postoperative extensive target volume irradiation with elevated radiation dose and concurrent chemotherapy was effective. Treatment related toxicity was increased due to higher treatment intensity.

Trial registration clinicaltrials.gov: NCT02916511.
Patient and Public Involvement (PPI) in outcome selection in breast cancer and nephrology trials
Authors: Buckley Ciara , Treweek Shaun , Laidlaw Lynn , Shiely Frances
Published: February 2023

We recently reported that according to patients and healthcare professionals in breast cancer and nephrology trials, teams conducting the trials got their choice of primary outcome wrong (72% of the time) more often than they got it right (28% of the time). A Patient and Public Involvement (PPI) representative, co-author of this letter, asked (on Twitter) whether PPI contributors had been involved in the design of the original trials and by extension the outcome selection. The purpose of this study was to answer this question.
The AuTOMATIC trial: a study protocol for a multi-arm Bayesian adaptive randomised controlled trial of text messaging to improve childhood immunisation coverage
Authors: Currie Grace E. , Totterdell James , Bowland Grahame , Leeb Alan , Peters Ian , Blyth Chris C. , Waddington Claire , Marsh Julie A. , Snelling Thomas L.
Published: February 2023

Background

While most Australian children are vaccinated, delays in vaccination can put them at risk from preventable infections. Widespread mobile phone ownership in Australia could allow automated short message service (SMS) reminders to be used as a low-cost strategy to effectively ‘nudge’ parents towards vaccinating their children on time.

Methods

AuTOMATIC is an adaptive randomised trial which aims to both evaluate and optimise the use of SMS reminders for improving the timely vaccination of children at primary care clinics across Australia. The trial will utilise high levels of digital automation to effect, including eligibility assessment, randomisation, delivery of intervention, data extraction and analysis, thereby allowing healthcare-embedded trial delivery. Up to 10,000 parents attending participating primary care clinics will be randomised to one of 12 different active SMS vaccine reminder content and timing arms or usual practice only (no SMS reminder). The primary outcome is vaccine receipt within 28 days of the scheduled date for the index vaccine (the first scheduled vaccine after randomisation). Secondary analyses will assess receipt and timeliness for all vaccine occasions in all children. Regular scheduled analyses will be performed using Bayesian inference and pre-specified trial decision rules, enabling response adaptive randomisation, suspension of any poorly performing arms and early stopping if a single best message is identified.

Discussion

This study will aim to optimise SMS reminders for childhood vaccination in primary care clinics, directly comparing alternative message framing and message timing. We anticipate that the trial will be an exemplar in using Bayesian adaptive methodology to assess a readily implementable strategy in a wide population, capable of delivery due to the levels of digital automation. Methods and findings from this study will help to inform strategies for implementing reminders and embedding analytics in primary health care settings.

Trial registration

ANZCTR: ACTRN12618000789268.
Nitrate-rich beet juice intake on cardiovascular performance in response to exercise in postmenopausal women with arterial hypertension: study protocol for a randomized controlled trial
Authors: Benjamim Cicero Jonas R. , Sousa Yaritza Brito Alves , Porto Andrey Alves , de Moraes Pontes Yasmim Mota , Tavares Simone Sakagute , da Silva Rodrigues Guilherme , da Silva Leonardo Santos Lopes , da Silva Goncalves Leonardo , Guimaraes Carolina Scoqui , Rebelo Macário Arosti , da Silva Sobrinho Andressa Crystine , Tanus-Santos Jose E. , Valenti Vitor Engracia , Gualano Bruno , Bueno Júnior Carlos Roberto
Published: February 2023

Background

There is no evidence of the use of beetroot juice with a previously recommended dose of nitrate (NO3) (> 300 mg) on the cardiovascular performance during and recovery following exercise in postmenopausal women with systemic arterial hypertension (SAH).

Methods

We will investigate the effects of beetroot juice rich in NO3 acutely (800 mg) and during a week with daily doses (400 mg) on blood pressure, heart rate (HR), cardiac autonomic control, endothelial function, inflammatory, hormonal, and stress biomarkers oxidative stress and enzymes involved in nitric oxide synthesis and mitochondrial regulation, under resting conditions, as well as mediated by submaximal aerobic exercise sessions. Through a randomized, crossover, triple-blind, placebo-controlled clinical trial, 25 physically inactive women with SAH will undergo an acute and 1-week trial, each with two intervention protocols: (1) placebo and (2) beetroot, in which will ingest beet juice with or without NO3 in its composition with a 7-day washout interval. On collection days, exercise will be performed on a treadmill for 40 min at a speed corresponding to 65–70% of VO2peak. The collection of variables (cardiovascular, autonomic, and blood samples for molecular analyses) of the study will take place at rest (135 min after ingestion of the intervention), during exercise (40 min), and in the effort recovery stage (during 60 min) based on previously validated protocols. The collections were arranged so that the measurement of one variable does not interfere with the other and that they have adequate intervals between them.

Discussion

The results of this research may help in the real understanding of the nutritional compounds capable of generating safety to the cardiovascular system during physical exercise, especially for women who are aging and who have cardiovascular limitations (e.g., arterial hypertension) to perform physical exercise. Therefore, our results will be able to help specific nutritional recommendations to optimize cardiovascular health.

Trial registration

ClinicalTrials.gov NCT05384340. Registered on May 20, 2022.
Photochemical synthesis of pyrano[2,3-d]pyrimidine scaffolds using photoexcited organic dye, Na2 eosin Y as direct hydrogen atom transfer (HAT) photocatalyst via visible light-mediated under air atmosphere
Authors: Mohamadpour Farzaneh
Published: February 2023

The Knoevenagel-Michael cyclocondensation of barbituric acid/1,3-dimethylbarbituric acid, malononitrile, and arylaldehyde derivatives was used to construct a multicomponent green tandem method for the metal-free synthesis of pyrano[2,3-d]pyrimidine scaffolds. At room temperature in aqueous ethanol, photo-excited state functions generated from Na2 eosin Y were employed as direct hydrogen atom transfer (HAT) catalysts by visible light mediated in the air atmosphere. This research looks towards expanding the use of a non-metallic organic dye that is both affordable and readily available. Because of its good yields, energy-effectiveness, high atom economy, time-saving qualities of the reaction, and operational simplicity, Na2 eosin Y is photochemically produced with the least amount of a catalyst. As a result, various ecological and sustainable chemical properties are met. Surprisingly, such cyclization may be carried out on a gram scale, indicating the reaction's potential industrial application.
Initial levels of β-amyloid and tau deposition have distinct effects on longitudinal tau accumulation in Alzheimer’s disease
Authors: Cai Yue , Du Jing , Li Anqi , Zhu Yalin , Xu Linsen , Sun Kun , Ma Shaohua , Guo Tengfei ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: February 2023

Background

To better assist with the design of future clinical trials for Alzheimer’s disease (AD) and aid in our understanding of the disease’s symptomatology, it is essential to clarify what roles β-amyloid (Aβ) plaques and tau tangles play in longitudinal tau accumulation inside and outside the medial temporal lobe (MTL) as well as how age, sex, apolipoprotein E (APOE) ε4 (APOE-ε4), and Klotho-VS heterozygosity (KL-VShet) modulate these relationships.

Methods

We divided the 325 Aβ PET-positive (A+) participants into two groups, A+/T− (N = 143) and A+/T+ (N = 182), based on the threshold (1.25) of the temporal meta-ROI 18F-flortaucipir (FTP) standardized uptake value ratio (SUVR). We then compared the baseline and slopes of A+/T− and A+/T+ individuals’ Aβ plaques and temporal meta-ROI tau tangles with those of A−/T− cognitively unimpaired individuals (N = 162) without neurodegeneration. In addition, we looked into how baseline Aβ and tau may predict longitudinal tau increases and how age, sex, APOE-ε4, and KL-VShet affect these associations.

Results

In entorhinal, amygdala, and parahippocampal (early tau-deposited regions of temporal meta-ROI), we found that baseline Aβ and tau deposition were positively linked to more rapid tau increases in A+/T− participants. However, in A+/T+ individuals, the longitudinal tau accumulation in fusiform, inferior temporal, and middle temporal cortices (late tau-deposited regions of temporal meta-ROI) was primarily predicted by the level of tau tangles. Furthermore, compared to older participants (age ≥ 65), younger individuals (age < 65) exhibited faster Aβ-dependent but slower tau-related tau accumulations. Additionally, compared to the KL-VShet− group, KL-VShet+ individuals showed a significantly lower rate of tau accumulation associated with baseline entorhinal tau in fusiform and inferior temporal regions.

Conclusion

These findings offer novel perspectives to the design of AD clinical trials and aid in understanding the tau accumulation inside and outside MTL in AD. In particular, decreasing Aβ plaques might be adequate for A+/T− persons but may not be sufficient for A+/T+ individuals in preventing tau propagation and subsequent downstream pathological changes associated with tau.
Importance of continuing health care before emergency hospital evacuation: a fatal case of a hospitalized patient in a hospital within 5 km radius of Fukushima Daiichi Nuclear Power Plant: a case report
Authors: Yoshida Makoto , Sawano Toyoaki , Kobashi Yurie , Hori Arinobu , Nishikawa Yoshitaka , Ozaki Akihiko , Nonaka Saori , Tsuboi Motohiro , Tsubokura Masaharu
Published: February 2023

Background

After a disaster, it is essential to maintain the health care supply levels to minimize the health impact on vulnerable populations. During the 2011 Fukushima Daiichi Nuclear Power Plant accident, hospitals within a 20 km radius were forced to make an immediate evacuation, causing a wide range of short- and long-term health problems. However, there is limited information on how the disaster disrupted the continuity of health care for hospitalized patients in the acute phase of the disaster.

Case presentation

An 86-year-old Japanese man who needed central venous nutrition, oxygen administration, care to prevent pressure ulcers, skin and suctioning care of the trachea, and full assistance in the basic activities of daily living had been admitted to a hospital within 5 km radius of Fukushima Daiichi Nuclear Power Plant and experienced Fukushima Daiichi Nuclear Power Plant accident. After the accident, the hospital faced a manpower shortage associated with hospital evacuation, environmental changes caused by infrastructure and medical supply disruptions, and the difficulty of evacuating seriously ill patients. As a result, antibiotics and suction care for aspiration pneumonia could not be appropriately provided to the patient due to lack of caregivers and infrastructure shortages. The patient died before his evacuation was initiated, in the process of hospital evacuation.

Conclusions

This case illustrates that decline in health care supply levels to hospitalized patients before evacuation during the acute phase of a radiation-released disaster may lead to patient fatalities. It is important to maintain the health care supply level even in such situations as the radiation-released disaster; otherwise, patients may experience negative health effects.
Development and validation of a nomogram to predict failure of 14-day negative nucleic acid conversion in adults with non-severe COVID-19 during the Omicron surge: a retrospective multicenter study
Authors: Gui Honglian , Zhang Zhenglan , Chen Bin , Chen Yaoxing , Wang Yue , Long Zhuo , Zhu Chuanwu , Wang Yinling , Cao Zhujun , Xie Qing
Published: February 2023

Background

With the variability in emerging data, guidance on the isolation duration for patients with coronavirus disease 2019 (COVID-19) due to the Omicron variant is controversial. This study aimed to determine the predictors of prolonged viral RNA shedding in patients with non-severe COVID-19 and construct a nomogram to predict patients at risk of 14-day PCR conversion failure.

Methods

Adult patients with non-severe COVID-19 were enrolled from three hospitals of eastern China in Spring 2022. Viral shedding time (VST) was defined as either the day of the first positive test or the day of symptom onset, whichever was earlier, to the date of the first of two consecutively negative PCR tests. Patients from one hospital (Cohort I, n = 2033) were randomly grouped into training and internal validation sets. Predictors of 14-day PCR conversion failure were identified and a nomogram was developed by multivariable logistic regression using the training dataset. Two hospitals (Cohort II, n = 1596) were used as an external validation set to measure the performance of this nomogram.

Results

Of the 2033 patients from Cohort I, the median VST was 13.0 (interquartile range: 10.0‒16.0) days; 716 (35.2%) lasted > 14 days. In the training set, increased age [per 10 years, odds ratio (OR) = 1.29, 95% confidence interval (CI): 1.15‒1.45, P < 0.001] and high Charlson comorbidity index (OR = 1.25, 95% CI: 1.08‒1.46, P = 0.004) were independent risk factors for VST > 14 days, whereas full or boosted vaccination (OR = 0.63, 95% CI: 0.42‒0.95, P = 0.028) and antiviral therapy (OR = 0.56, 95% CI: 0.31‒0.96, P = 0.040) were protective factors. These predictors were used to develop a nomogram to predict VST > 14 days, with an area under the ROC curve (AUC) of 0.73 in the training set (AUC, 0.74 in internal validation set; 0.76 in external validation set).

Conclusions

Older age, increasing comorbidities, incomplete vaccinations, and lack of antiviral therapy are risk factors for persistent infection with Omicron variant for > 14 days. A nomogram based on these predictors could be used as a prediction tool to guide treatment and isolation strategies.

Graphical Abstract
Sea ice directs changes in bowhead whale phenology through the Bering Strait
Authors: Szesciorka Angela R. , Stafford Kathleen M.
Published: February 2023

Background

Climate change is warming the Arctic faster than the rest of the planet. Shifts in whale migration timing have been linked to climate change in temperate and sub-Arctic regions, and evidence suggests Bering–Chukchi–Beaufort (BCB) bowhead whales (Balaena mysticetus) might be overwintering in the Canadian Beaufort Sea.

Methods

We used an 11-year timeseries (spanning 2009–2021) of BCB bowhead whale presence in the southern Chukchi Sea (inferred from passive acoustic monitoring) to explore relationships between migration timing and sea ice in the Chukchi and Bering Seas.

Results

Fall southward migration into the Bering Strait was delayed in years with less mean October Chukchi Sea ice area and earlier in years with greater sea ice area (p = 0.04, r2 = 0.40). Greater mean October–December Bering Sea ice area resulted in longer absences between whales migrating south in the fall and north in the spring (p < 0.01, r2 = 0.85). A stepwise shift after 2012–2013 shows some whales are remaining in southern Chukchi Sea rather than moving through the Bering Strait and into the northwestern Bering Sea for the winter. Spring northward migration into the southern Chukchi Sea was earlier in years with less mean January–March Chukchi Sea ice area and delayed in years with greater sea ice area (p < 0.01, r2 = 0.82).

Conclusions

As sea ice continues to decline, northward spring-time migration could shift earlier or more bowhead whales may overwinter at summer feeding grounds. Changes to bowhead whale migration could increase the overlap with ships and impact Indigenous communities that rely on bowhead whales for nutritional and cultural subsistence.
The association of dietary glycemic index and glycemic load with the risk of insomnia in the adult population
Authors: Farhadnejad Hossein , Sadat Samaneh , Jahromi Mitra Kazemi , Teymoori Farshad , Tehrani Asal Neshatbini , Mokhtari Ebrahim , Teymouri Hossein , Mirmiran Parvin
Published: February 2023

Background

A dietary pattern with a high glycemic index (GI) and glycemic load (GL) can be a precursor to sleep disorders that link to many chronic diseases. We aimed to assess the association of dietary GI and GL with the risk of insomnia in Iranian adults.

Methods

A total of 111 newly diagnosed insomnia cases and 333 controls aged 18–60 years were included in this case–control study. The participants’ dietary intakes were collected using a valid and reliable food frequency questionnaire. The diagnosis of insomnia in subjects was performed by a neurologist using the Insomnia Severity Index (ISI) questionnaire. Multivariable logistic regression models, adjusted for the potential confounders, were used to determine the risk of insomnia according to tertiles of dietary glycemic indices.

Results

The mean (SD) age and BMI of the study population (78.6% female) were 31.8 (10.0) years and 24.70 (3.62) kg/m2, respectively. The median (IQR) of dietary GI and GL in subjects was 62.7 (57.0–68.6) and 213.5(167.4–268.5), respectively. Based on the multivariable-adjusted model, after controlling for age, sex, physical activity, obesity, smoking, socioeconomic score, general health questionnaire (GHQ) score, and dietary energy intake, the odds of insomnia were increased across tertiles of dietary GL[(OR:2.72,95%CI:1.10–6.70),(Ptrend = 0.017)], however, no significant association was observed between high GI diet and insomnia risk [(OR:1.38,95%CI:0.77–2.47),(Ptrend = 0.298)].

Conclusions

Our results revealed that greater adherence to dietary pattern with high GL could be increased the odds of insomnia in Iranian adults.
Understanding the contemporary high obesity rate from an evolutionary genetic perspective
Authors: Wu Tong , Xu Shuhua
Published: February 2023

The topic of obesity is gaining increasing popularity globally. From an evolutionary genetic perspective, it is believed that the main cause of the high obesity rate is the mismatch between environment and genes after people have shifted toward a modern high-calorie diet. However, it has been debated for over 60 years about how obesity-related genes become prevalent all over the world. Here, we review the three most influential hypotheses or viewpoints, i.e., the thrifty gene hypothesis, the drifty gene hypothesis, and the maladaptation viewpoint. In particular, genome-wide association studies in the recent 10 years have provided rich findings and evidence to be considered for a better understanding of the evolutionary genetic mechanisms of obesity. We anticipate this brief review to direct further studies and inspire the future application of precision medicine in obesity treatment.
Impact of the COVID-19 pandemic on racial and ethnic discrimination - a systematic review
Authors: Kozioł Ilona Zofia , Budzyńska Julia , Leśniewska Magdalena , Kopystecka Agnieszka , Patryn Rafał
Published: February 2023

The COVID-19 pandemic has affected the entire society, being particularly detrimental to ethnic and racial minorities. Moreover, the problems faced by these communities are characterised and the measures that can be implemented to improve their situation are put forward. Many authors have suggested introducing the solutions according to the socio-ecological model which considers individual, organisational, community and policy factors. Due to the lack of trust of ethnic minorities in health care, no effort should be spared to restore their trust. To achieve this goal, educational programs should be carried out to dispel doubts about research and treatment. Furthermore, the impact of social media on the dissemination of discriminatory content should be meticulously analysed. The present paper is a systematic review of current literature, which analyses the authors` opinions on racial and ethnic discrimination during the COVID-19 pandemic.
Optimally Scheduling Heterogeneous Impatient Customers
Authors: Bassamboo Achal , Randhawa Ramandeep , Wu Chenguang (Allen)
Published: February 2023

Problem definition: We study scheduling multi-class impatient customers in parallel server queueing systems. At the time of arrival, customers are identified as being one of many classes, and the class represents the service and patience time distributions as well as cost characteristics. From the system’s perspective, customers of the same class at time of arrival get differentiated on their residual patience time as they wait in queue. We leverage this property and propose two novel and easy-to-implement multi-class scheduling policies. Academic/practical relevance: Scheduling multi-class impatient customers is an important and challenging topic, especially when customers’ patience times are nonexponential. In these contexts, even for customers of the same class, processing them under the first-come, first-served (FCFS) policy is suboptimal. This is because, at time of arrival, the system only knows the overall patience distribution from which a customer’s patience value is drawn, and as time elapses, the estimate of the customer’s residual patience time can be further updated. For nonexponential patience distributions, such an update indeed reveals additional information, and using this information to implement within-class prioritization can lead to additional benefits relative to the FCFS policy. Methodology: We use fluid approximations to analyze the multi-class scheduling problem with ideas borrowed from convex optimization. These approximations are known to perform well for large systems, and we use simulations to validate our proposed policies for small systems. Results: We propose a multi-class time-in-queue policy that prioritizes both across customer classes and within each class using a simple rule and further show that most of the gains of such a policy can be achieved by deviating from within-class FCFS for at most one customer class. In addition, for systems with exponential patience times, our policy reduces to a simple priority-based policy, which we prove is asymptotically optimal for Markovian systems with an optimality gap that does not grow with system scale. Managerial implications: Our work provides managers ways of improving quality of service to manage parallel server queueing systems. We propose easy-to-implement policies that perform well relative to reasonable benchmarks. Our work also adds to the academic literature on multi-class queueing systems by demonstrating the joint benefits of cross- and within-class prioritization.

Funding: A. Bassamboo received financial support from the National Science Foundation [Grant CMMI 2006350]. C. (A.) Wu received financial support from the Hong Kong General Research Fund [Early Career Scheme, Project 26206419].

Supplemental Material: The online appendix is available at https://doi.org/10.1287/msom.2023.1190 .
From Refuse to Reuse: How Much do Consumers Know about the Reclaimed Lumber Industry?
Authors: Montague Iris , Craig Mia , Shmulsky Rubin
Published: February 2023

Wood has thousands of uses and the industry plays an important role in the US economy. There are many sectors within the industry such as the lumber, engineered wood products, pulp and paper products, and reclaimed lumber sectors. However, most consumers are unaware of the importance and the diversity of the industry. Reclaimed lumber is one particular sector that can have a great economic and environmental impact among communities. In 2021, an online survey was conducted to assess consumer knowledge of the reclaimed lumber sector and perceptions and attitudes toward the sector and reclaimed lumber products. Of the 1,516 respondents, 59 percent indicated being somewhat knowledgeable of the wood products industry but only 44 percent felt they were knowledgeable of reclaimed lumber. Caucasian and male respondents were more likely to indicate they were knowledgeable. Although respondents had somewhat negative responses toward the environmentally friendliness of the industry, their responses toward the environmental and economic benefits of reclaimed lumber products were positive. The information obtained from this study will be beneficial to companies that are interested in creating strategies to market new or innovative products to reach new or existing customers.