bluuebunny/crossref_metadata_2025 huggingface dataset:
Associação da espessura do músculo adutor do polegar e indicadores antropométricos em idosos da comunidade
Authors: Alves Luana Ferreira , Carregosa Mariana Passos , Oliveira Juliana de Souza , Oliveira Carolina Cunha de
Published: November 2022

Introdução: A espessura do músculo adutor do polegar (EMAP) tem sido sugerido como um índice de massa muscular e desnutrição. Objetivo: Verificar a associação da EMAP com indicadores antropométricos convencionais em idosos da comunidade. Métodos: Estudo transversal realizado com 159 idosos da comunidade, de ambos os sexos, com média de idade de 70,9±29,4 anos. Foram avaliados a EMAP, o índice de massa corporal (IMC), as circunferências do braço (CB), muscular do braço (CMB) e da panturrilha (CP). Para classificação da EMAP se considerou o valor do percentil 25 (P25≤9 mm) da amostra para identificar déficit de massa muscular. Teste Qui-quadrado, Correlação de Pearson e Regressão de Poisson foram realizados, sendo adotado um nível de significância de p<0,05. Resultados: Entre os homens, a EMAP apresentou correlação com a CB (r=0,350; p<0,01) e entre as mulheres foi com o IMC (r=0,337; p=0,01). Houve associação entre a classificação do IMC e o percentil da EMAP (p=0,020). Os idosos com IMC<23 kg/m² tinham 1,28 vezes mais chances de possuir EMAP≤P25 (p=0,007) e idosos com IMC adequado tinham 1,23 vezes mais chance (p=0,023). Idosos com CP reduzido apresentaram 1,18 vezes mais chance de apresentar EMAP≤P25 (p=0,064). Conclusão: A EMAP apresentou associação com o IMC em idosos, demostrando ser um bom parâmetro para a avaliação da desnutrição.
Percepção de puérperas sobre a violência obstétrica durante o trabalho de parto
Authors: Santos Vanessa de Melo , Westphal Flavia , Rocha Chayene Aguiar , Fernandes Hugo , Souza Fabiana de , Goldman Rosely Erlach
Published: November 2022

Não se aplica
Nonnegative solutions for a class of semipositone nonlinear elliptic equations in bounded domains of R^{n}
Authors: Bachar Imed , M�agli Habib , Eltayeb Hassan
Published: November 2022

In this paper, we obtain sufficient conditions for the existence of a unique nonnegative continuous solution of semipositone semilinear elliptic problem in bounded domains of \(\mathbb{R}^n\) (\(n\geq 2\)). The global behavior of this solution is also given.
Strong consistency of the local linear relative regression estimator for censored data
Authors: Bouhadjera Feriel , Said Elias Ould
Published: November 2022

In this paper, we combine the local linear approach to the relative error regression estimation method to build a new estimator of the regression operator when the response variable is subject to random right censoring. We establish the uniform almost sure consistency with rate over a compact set of the proposed estimator. Numerical studies, firstly on simulated data, then on a real data set concerning the death times of kidney transplant patients, were conducted. These practical studies clearly show the superiority of the new estimator compared to competitive estimators.
Co-occurrence of seagrass vegetation and coral colonies supports unique fish assemblages: a microhabitat-scale perspective
Authors: Nanami Atsushi
Published: November 2022

Numerous studies have suggested that seagrass beds provide nursery habitats for juvenile fish in both tropical and subtropical regions. Most of these previous studies applied a landscape-scale perspective, in which seagrass beds and coral reefs are treated as independent, homogenous habitats. However, this perspective might overlook the microhabitat-scale perspective within the habitats, for example, the possibility that small-sized hard substrates (e.g., coral colonies) within seagrass beds might serve as fish nurseries. The present study aimed to examine the effects of the presence of microhabitats (small-sized coral colonies) within seagrass beds on the structure of fish assemblages. Fieldwork was conducted at Urasoko Bay, Ishigaki Island, Okinawa, Japan. Four habitat zones were selected: (1) seagrass bed with presence of massive coral colonies (SGCO), (2) seagrass bed without coral colonies (SG), (3) sandy bottom (without seagrass vegetation) with massive coral colonies (CO), and (4) sandy bottom without seagrass vegetation or coral colonies (SA). Six 20 m × 2 m line transects were established and monthly underwater observations were conducted between June and October in 2018 and 2019. A cluster analysis, analysis of similarity, and principal component analysis revealed that the fish assemblage at SGCO was significantly different from the other three habitat zones. This was because some fish species (e.g., Ostorhinchusishigakiensis and Lutjanus gibbus) were almost exclusively present at SGCO and rarely seen at CO, SG, and SA. Most individual fish belonging to these species were found on coral colonies at SGCO, suggesting that the co-occurrence of seagrass vegetation and coral colonies is essential for the habitats of these fish species. Although other fish species present at SGCO were also found at SG, three species, Parupeneus barberinus, Stethojulis strigiventer, and Lethrinus atkinsoni, were more abundant at SGCO with some found on coral colonies in this habitat zone. Several fish species that occurred at both SGCO and CO (e.g., Ostorhinchus properuptus, Cheilodispterus quinquelineatus, Chrysiptera cyanea, and Pomacentrus chrysurus) were more abundant or showed a greater size range at SGCO, suggesting greater survival rates in this habitat zone because of the co-occurrence of seagrass vegetation and coral colonies. This study demonstrated the existence of a unique fish assemblage structure at SGCO. Although the adoption of a landscape-scale perspective (three-dimensional structure of the vegetation) is necessary, a microhabitat-scale perspective that includes the presence of small hard substrates should also be considered to accurately evaluate the nursery function of seagrass beds.
Utility of Abraham Lens in YAG Laser Capsulotomy: A Prospective Study
Authors: Das Matuli , Sen Saswati , Chugh Tej Mehar Singh , Sahu Pallavi Priyadarshini , Pokharna Ridhima
Published: November 2022

Introduction: Neodymium-doped Yttrium Aluminum Garnet (Nd: YAG) laser capsulotomy remains the safest treatment for Posterior Capsular Opacification (PCO). The use of capsulotomy lens has some benefits to offer especially when learning the procedure and in uncooperative patients. With changing curriculum in medical teaching which focusses more on practical aspects it will serve as an asset for the trainees. Even if not used routinely its importance cannot be altogether undermined. Aim: To assess the utility of Abraham capsulotomy lens in YAG laser capsulotomy procedure and compare it with capsulotomy performed without lens. Materials and Methods: This was a prospective, longitudinal study conducted in the Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India, from June 2020 to February 2021. A total of 79 patients who developed PCO after more than six months of cataract surgery and had decrease in visual acuity on Snellen’s chart by two or more lines from baseline were included. Visual acuity, Intraocular Pressure (IOP) measurement, fundoscopy, Ocular Coherence Tomography (OCT) was done for Central Macular Thickness (CMT) in all patients at presentation, one and three months following YAG capsulotomy. Nd-YAG laser capsulotomy was then done with and without the use of Abraham’s capsulotomy lens in two groups. Parameters such as visual acuity change, IOP, CMT, energy used in capsulotomy, type of PCO were then compared between the two groups. Independent t-test, repeated Analysis of Variance (ANOVA) and Spearman’s correlation tests were used to analyse the data. Results: Of the 79 patients, 40 underwent capsulotomy without the Abraham lens (Group 1) and 39 with Abraham lens (Group 2). Females were more than males in both the groups. The improvement in visual acuity was statistically significant in both groups. There was statistically significant difference in CMT in both groups at each visit. The average energy used for dealing with fibrous type of calcification was significantly more than that used in elsching pearls (13.96 mj). Complications like Intraocular Lens (IOL) pitting, raised IOP, cystoid macular oedema, uveitis and retinal detachment were encountered which were managed by appropriate medical and surgical therapy. Conclusion: Use of capsulotomy lens decreases the amount of energy needed for capsulotomy and helps to stabilise the eye and to focus better especially for ophthalmologists in their initial training days.
MDCT Evaluation of Celiac Axis Compression SyndromeA Rare Case Series
Authors: Naveen D , Raj DR Vishwaprem , Basappa Mallikarjunappa , Babu CR Srinivasa , Keshav Ashish
Published: November 2022

Celiac axis compression syndrome is an uncommon entity of abdominal vascular compression syndrome which results from the compression of the proximal celiac artery by the hypertrophied median arcuate ligament. The patients present clinically with postprandial abdominal pain predominantly in the epigastric region and weight loss. The use of thin-section Multidetector Computed Tomography (MDCT) and 3-Dimensional (3D) image reconstruction has greatly improved the ability to obtain detailed images and helped to assess the abdominal vascular system non invasively. Five cases of celiac axis compression syndrome with its characteristic MDCT imaging features like hooked appearance, thickened median arcuate ligament more than 4 mm, poststenotic dilatation and posterior and inferior displacement of celiac artery with indentation on aorta have been described in the present case series and the imaging findings described by other authors in their reported studies have also been compared.
Graph Theoretic Technique to the Global Stability Analysis of the Discrete Age Structured SVEIR Model with Application to Ebola Virus Disease
Authors: Onyango Brenda , Lawi George O. , Tireito Frankline
Published: November 2022

Discrete age structured models provide a better approach of discussing the spread of infectious diseases with infectivity, mortality and recovery being age dependent. Measures such as vaccination are carried out in discrete time or applied to individuals in certain age-groups. In the past Ebola Virus disease (EVD) outbreaks, infections in children under 5 years was associated with high mortality rates. In this work, a general discrete SVEIR epidemic model with age structure is formulated. The study establishes the existence of the endemic equilibrium and further shows that it is globally stable using the graph theoretic approach on the method of Lyapunov functions. The model is then applied to EVD dynamics to study the impact of vaccination on the age structured population. The numerical simulation of the discrete age case scenario demonstrates that vaccination of children under 5 years of age against EVD has a great impact in reducing their susceptibility because of the active immune system as compared to the older population who have a poor response to vaccine immunity. For the older population, vaccination is not very eective in reducing their susceptibility.
Information Sources to Cocoa Farmers on Indegenious Knowledge (IK) Utilisation in Ogun State, Nigeria
Authors: D. J. Awodumila , O. A. Orimogunje , T. E. Ogunjobi , O. A. Dada , S. B. Rahman , A. A. Adelusi , F. B. Mustopha
Published: November 2022

The study assessed information sources to Indigenous Knowledge utilization among cocoa farmers in Ogun State. One hundred and fifty-two respondents were randomly sampled from two randomly selected communities in two local government areas of Ijebu North. Both primary and secondary data were used for the study. The data collected from the field were analyzed using descriptive statistics such as frequency and percentage distributions. Also chi-square statistics was used in the data analysis for this study. The result of the finding on personal characteristics of the respondents revealed that 50.6 percent of the respondents were within the age range of 41 – 60 years and 84.2 percent were male. Also, 67.1 percent were married. The findings also revealed that 74.2 percent had above five hectares of cocoa farm and 85.5 percent of the respondents got information about Indigenous Knowledge through grandparents and parents. Some major constraints to the use of Indigenous Knowledge include high cost of Indigenous Knowledge, religious belief, inadequate information on Indigenous Knowledge and gender. The result of chi-square analysis revealed a significant relationship between age and information source to IK utilization also, there is a significant relationship between sex and information source to IK utilization among cocoa farmers in the study area. It is therefore recommended that Cocoa farmers should be encouraged to practice indigenous knowledge also, efforts should be geared towards documentation of indigenous knowledge so that it can be transferred from generation to generation.
Response of Biofertilizers on Growth and Yield Parameters of Brinjal (Solanum melongena L.) cv. Azad B-3
Authors: Padhiary Gargi Gautami , Dubey A. K.
Published: November 2022

The present experiment was carried out during kharif 2017-18 with the objective to know the effect of biofertilizers on growth and yield parameters of brinjal cv. Azad B-3. The experiment was conducted in Randomized Block Design (RBD) with ten treatments each replicated thrice. The treatments consisted of both biofertilizers, chemical fertilizers and different combinations of both along with control. The observations were recorded on growth and yield parameters like plant height, no. of primary branches per plant, no. of secondary branches per plant, fruit length, fruit width, total no. of fruits per plot and fruit yield/ha. From the investigation, it was found that the treatment T5 (Azospirillum +PSB + 75% N + Full P&K) recorded maximum plant height (96.23 cm), no. of primary branches (6.32), no. of secondary branches (11.27), fruit length (13.89 cm), fruit width (8.42 cm), total no. of fruits per plot (724.66) and yield (448.65 q/ha) and  proved as a best combination of biofertilizers along with inorganic fertilizer for the improvement of brinjal cultivation through organically. Where treatment T5 significantly enhances the growth and yield traits of brinjal, it also recorded maximum benefit per hectare (B:C ratio 1:3.50).
In vitro Screening of New Fungicide Molecules against Alternaria sp. Isolated from Tomato
Authors: Blessina J. Jane , Hubbali Manjunath , Mesta Raghavendra K. , Haveri Norulla , Meti Shankar , Raut Namita Bhaskar
Published: November 2022

Early blight disease caused by Alternaria spp. is one of the major limiting factors in tomato-growing areas of the country, causing considerable yield loss. Early blight can be effectively managed by cultural practices, chemical fungicides, and through the use of resistant genotypes. Cultural practice alone are not sufficient for the control of early blight, hence several fungicides have been developed and tried for the management of early blight. In the present study, in order to develop effective management practices against the early blight of tomato, a total of 22 fungicides comprising six systemic, six contact and ten combi products were tested for their fungitoxicity against Alternaria sp. under in vitro by following the poisoned food technique. All the fungicides significantly reduced the radial mycelial growth of Alternaria spp. Based on the maximum inhibition at the lowest concentration, the six fungicides i.e. Hexaconazole 5% EC (50.00), Propiconazole 25 % EC (65.00), Tebuconazole 25.9% EC(53.03),Mancozeb 75 % WP (54.44), Propineb 70 % WP (50.00), Copper oxychloride 50 % WP(63.15), Tricyclazole 45% W G + Hexaconazole 10 % WG(93.17), Fluxapyroxad 250 g/L + Pyraclostrobin 250 g/L SC (92.08)and Zineb 68% + Hexaconazole 4% WP(86.01)were recorded the best against Alternaria sp. compared to control.
External Validation of the Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) in a Large European Solid Organ Transplant Recipient Cohort
Authors: Gómez-Tomás Álvaro , Bouwes Bavinck Jan Nico , Genders Roel , González-Cruz Carlos , de Jong Estella , Arron Sarah , García-Patos Vicente , Ferrándiz-Pulido Carla
Published: November 2022

Importance

The Skin and UV Neoplasia Transplant Risk Assessment Calculator (SUNTRAC) tool has been developed in the US to facilitate the identification of solid organ transplant recipients (SOTRs) at a higher risk of developing skin cancer. However, it has not yet been validated in populations other than the one used for its creation.

Objective

To provide an external validation of the SUNTRAC tool in different SOTR populations.

Design, Setting, and Participants

This retrospective external validation prognostic study used data from a prospectively collected cohort of European SOTRs from transplant centers at teaching hospitals in the Netherlands (1995-2016) and Spain (2011-2021). Participants were screened and followed up at dermatology departments. Data were analyzed from September to October 2021.

Main Outcomes and Measures

The discrimination ability of the SUNTRAC tool was assessed via a competing risk survival analysis, cumulative incidence plots, and Wolbers concordance index. Calibration of the SUNTRAC tool was assessed through comparison of projected skin cancer incidences. Skin cancer diagnoses included squamous cell carcinoma, basal cell carcinoma, melanoma, and Merkel cell carcinoma.

Results

A total of 3421 SOTRs (median age at transplant, 53 [quartile 1: 42; quartile 3: 62] years; 2132 [62.3%] men) were assessed, including 72 Asian patients (2.1%), 137 Black patients (4.0%), 275 Latinx patients (8.0%), 109 Middle Eastern and North African patients (3.2%), and 2828 White patients (82.7%). With a total of 23 213 years of follow-up time, 603 patients developed skin cancer. The SUNTRAC tool classified patients into 4 groups with significantly different risks of developing skin cancer during follow-up. Overall, the relative rate for developing skin cancer estimated using subdistribution hazard ratios (SHRs) and using the low-risk group as the reference group, increased according to the proposed risk group (medium-risk group: SHR, 6.8 [95% CI, 3.8-12.1]; P < .001; high-risk group: SHR, 15.9 [95% CI, 8.9-28.4]; P < .001; very-high–risk group: SHR, 54.8 [95% CI, 29.1-102.9]; P < .001), with a concordance index of 0.72. Actual skin cancer incidences were similar to those predicted by the SUNTRAC tool (5-year skin cancer cumulative incidence for medium-risk group: predicted, 6.2%; observed, 7.0%).

Conclusions and Relevance

The findings of this external validation prognostic study support the use of the SUNTRAC tool in European populations for stratifying SOTRs based on their skin cancer risk and also detecting patients at a high risk of developing skin cancer. This can be helpful in prioritizing and providing better screening and surveillance for these patients.
Progressive Hair Loss With Short Hair in a Child
Authors: Li Chia-Lun , Chen Chih-Chiang
Published: November 2022

A school-aged girl presented to the dermatology clinic with a 6-year history of hair loss and short hair, and light microscopy of scalp hair shafts revealed no structural abnormalities, such as cuticular damage, twisting, bending, or miniaturization. What is your diagnosis?
Trends in Clinician Burnout With Associated Mitigating and Aggravating Factors During the COVID-19 Pandemic
Authors: Linzer Mark , Jin Jill O. , Shah Purva , Stillman Martin , Brown Roger , Poplau Sara , Nankivil Nancy , Cappelucci Kyra , Sinsky Christine A.
Published: November 2022

Importance

The COVID-19 pandemic has affected clinician health and retention.

Objective

To describe trends in burnout from 2019 through 2021 with associated mitigating and aggravating factors.

Design, Setting, and Participants

Cross-sectional surveys were sent to physicians and advanced practice clinicians throughout 120 large US health care organizations between February 2019 and December 2021. From 56 090 surveys, there were 20 627 respondents.

Exposures

Work conditions and COVID-19.

Main Outcomes and Measures

Surveys measured time pressure, chaos, work control, teamwork, electronic health record use, values alignment, satisfaction, burnout, intent to leave, and in 2021, feeling valued. Multivariate regressions controlling for gender, race and ethnicity, years in practice, and role determined burnout, satisfaction, and intent-to-leave correlates.

Results

Of the 20 627 respondents (median response rate, 58% [IQR, 34%-86%; difference, 52%]), 67% were physicians, 51% female, and 66% White. Burnout was 45% in 2019, 40% to 45% in early 2020, 50% in late 2020, and 60% in late 2021. Intent to leave increased from 30% in 2019 to more than 40% as job satisfaction decreased. Higher burnout was seen in chaotic workplaces (odds ratio [OR], 1.51; 95% CI, 1.38-1.66; P < .001) and with low work control (OR, 2.10; 95% CI, 1.91-2.30; P < .001). Higher burnout was associated with poor teamwork (OR, 2.08; 95% CI, 1.78-2.43; P < .001), while feeling valued was associated with lower burnout (OR, 0.22; 95% CI, 0.18-0.27; P < .001). In time trends, burnout was consistently higher with chaos and poor work control. For example, in the fourth quarter of 2021 burnout was 36% (95% CI, 31%-42%) in calm environments vs 78% (95% CI, 73%-84%) if chaotic (absolute difference, 42%; 95% CI, 34%-49%; P < .001), and 39% (95% CI, 33%-44%) with good work control vs 75% (95% CI, 69%-81%) if poor (absolute difference, 36%; 95% CI, 27%-44%; P < .001). Good teamwork was associated with lower burnout rates (49%; 95% CI, 44%-54%) vs poor teamwork (88%; 95% CI, 80%-97%; absolute difference, 39%; 95% CI, 29%-48%; P < .001), as was feeling valued (37%; 95% CI, 31%-44%) vs not feeling valued (69%; 95% CI, 63%-74%; absolute difference, 32%; 95% CI, 22%-39%; P < .001).

Conclusions and Relevance

Results of this survey study show that in 2020 through 2021, burnout and intent to leave gradually increased, rose sharply in late 2021, and varied by chaos, work control, teamwork, and feeling valued. Monitoring these variables could provide mechanisms for worker protection.
Association of Health Insurance Coverage Disruptions With Mortality Risk Among US Working-Age Adults
Authors: Yabroff K. Robin , Han Xuesong , Zhao Jingxuan , Kirby James , Nogueira Leticia , Zheng Zhiyuan
Published: November 2022

This cohort study assesses associations of a prior coverage disruption with mortality risk among large, nationally representative cohorts of working-age adults with public or private health insurance coverage.
Association of Concomitant Gestational Hypertensive Disorders and Gestational Diabetes With Cardiovascular Disease
Authors: Echouffo Tcheugui Justin B. , Guan Jun , Fu Longdi , Retnakaran Ravi , Shah Baiju R.
Published: November 2022

Importance

Accruing evidence suggests that gestational hypertensive disorders (GHTD) and gestational diabetes (GD) are each associated with an increased risk of cardiovascular disease (CVD). However, the extent to which the co-occurrence of GHTD and GD is associated with the risk of CVD remains largely unknown.

Objective

To estimate the individual and joint associations of GHTD and GD with incident CVD.

Design, Setting, and Participants

This population-based cohort study used the Ministry of Health and Long-Term Care of Ontario (Canada) health care administrative databases. All women in Ontario with a GHTD and/or GD diagnosis, and a live-birth singleton delivery between July 1, 2007, and March 31, 2018, were considered for inclusion. Women with pregravid diabetes, hypertension, or cardiovascular disease were excluded. Statistical analysis was performed from November 2021 to September 2022.

Exposures

GD and/or GHTD, defined using diagnosis coding.

Main Outcomes and Measures

Individual and joint associations of GHTD and GD with incident CVD (including a composite of myocardial infarction, acute coronary syndrome, stroke, coronary artery bypass grafting, percutaneous coronary intervention, or carotid endarterectomy), estimated using Cox regression models, adjusting for relevant cardiometabolic risk factors. The follow-up extended from the index pregnancy until March 31, 2020.

Results

Among 886 295 eligible women (mean [SD] age, 30 [5.6] years; 43 861 [4.9%] with isolated GHTD, 54 061 [6.1%] with isolated GD, and 4975 [0.6%] with GHTD and GD), there were 1999 CVD events over 12 years of follow-up. In the early postpartum phase (first 5 years post partum), there was no association of co-occurrence of GTHD and GD (adjusted hazard ratio [aHR], 1.42, 95% CI, 0.78-2.58) or GD alone (aHR, 0.80; 95% CI, 0.60-1.06) with CVD; there was an association between isolated GTHD and incident CVD compared with no GTHD and no GD (aHR, 1.90; 95% CI, 1.51-2.35). In the late postpartum period (after the initial 5 years post partum), compared with no GD and no GHTD, isolated GHTD (aHR, 1.41, 95% CI, 1.12-1.76) and co-occurrence of GHTD and GD (aHR, 2.43, 95% CI, 1.60-3.67) were each associated with a higher risk of incident CVD. There was no association between isolated GD and incident CVD.

Conclusions and Relevance

In this cohort study, GHTD was associated with a high risk of CVD post partum, and the co-occurrence of GD and GHTD was associated with a much greater postpartum CVD risk. These findings suggest that CVD preventive care is particularly needed in the aftermath of combined GD and GHTD.
Association of Opioid and Stimulant Use Disorder Diagnoses With Fatal and Nonfatal Overdose Among People With a History of Incarceration
Authors: Palis Heather , Gan Wenqi , Xavier Chloe , Desai Roshni , Scow Marnie , Sedgemore Kali-olt , Greiner Leigh , Nicholls Tonia , Slaunwhite Amanda
Published: November 2022

Importance

Studies have suggested a rise in opioid- and stimulant-involved overdoses in recent years in North America. This risk may be acute for individuals who have had contact with the criminal justice system, who are particularly vulnerable to overdose risk.

Objective

To examine the association of opioid and/or stimulant use disorder diagnoses with overdose (fatal and nonfatal) among people with histories of incarceration.

Design, Setting, and Participants

In this cohort study, population-based health and corrections data were retrieved from the British Columbia Provincial Overdose Cohort, which contains a 20% random sample of residents of British Columbia. The analysis included all people in the 20% random sample who had a history of incarceration between January 1, 2010, and December 31, 2014. Outcomes were derived from 5-years of follow-up data (January 1, 2015, to December 31, 2019). Statistical analysis took place from January 2022 to June 2022.

Exposures

Substance use disorder diagnosis type (ie, opioid use disorder, stimulant use disorder, both, or neither), sociodemographic, health, and incarceration characteristics.

Main Outcomes and Measures

Hazard ratios (HRs) are reported from an Andersen-Gill model for recurrent nonfatal overdose events and from a Fine and Gray competing risk model for fatal overdose events.

Results

The study identified 6816 people (5980 male [87.7%]; 2820 aged <30 years [41.4%]) with histories of incarceration. Of these, 293 (4.3%) had opioid use disorder only, 395 (6.8%) had stimulant use disorder only, and 281 (4.1%) had both diagnoses. During follow-up, 1655 people experienced 4026 overdoses including 3781 (93.9%) nonfatal overdoses, and 245 (6.1%) fatal overdoses. In adjusted analyses, the hazard of both fatal (HR, 2.39; 95% CI, 1.48-3.86) and nonfatal (HR, 2.45; 95% CI, 1.94-3.11) overdose was highest in the group with both opioid and stimulant use disorder diagnoses.

Conclusions and Relevance

This cohort study of people with a history of incarceration found an elevated hazard of fatal and nonfatal overdose among people with both opioid and stimulant use disorder diagnoses. This study suggests an urgent need to address the service needs of individuals who have had contact with the criminal justice system and who co-use opioids and stimulants.
Use of Acupuncture for Adult Health Conditions, 2013 to 2021
Authors: Allen Jennifer , Mak Selene S. , Begashaw Meron , Larkin Jody , Miake-Lye Isomi , Beroes-Severin Jessica , Olson Juli , Shekelle Paul G.
Published: November 2022

Importance

Acupuncture is a popular treatment that has been advocated for dozens of adult health conditions and has a vast evidence base.

Objective

To map the systematic reviews, conclusions, and certainty or quality of evidence for outcomes of acupuncture as a treatment for adult health conditions.

Evidence Review

Computerized search of PubMed and 4 other databases from 2013 to 2021. Systematic reviews of acupuncture (whole body, auricular, or electroacupuncture) for adult health conditions that formally rated the certainty, quality, or strength of evidence for conclusions. Studies of acupressure, fire acupuncture, laser acupuncture, or traditional Chinese medicine without mention of acupuncture were excluded. Health condition, number of included studies, type of acupuncture, type of comparison group, conclusions, and certainty or quality of evidence. Reviews with at least 1 conclusion rated as high-certainty evidence, reviews with at least 1 conclusion rated as moderate-certainty evidence, and reviews with all conclusions rated as low- or very low-certainty evidence; full list of all conclusions and certainty of evidence.

Findings

A total of 434 systematic reviews of acupuncture for adult health conditions were found; of these, 127 reviews used a formal method to rate certainty or quality of evidence of their conclusions, and 82 reviews were mapped, covering 56 health conditions. Across these, there were 4 conclusions that were rated as high-certainty evidence, and 31 conclusions that were rated as moderate-certainty evidence. All remaining conclusions (>60) were rated as low- or very low-certainty evidence. Approximately 10% of conclusions rated as high or moderate-certainty were that acupuncture was no better than the comparator treatment, and approximately 75% of high- or moderate-certainty evidence conclusions were about acupuncture compared with a sham or no treatment.

Conclusions and Relevance

Despite a vast number of randomized trials, systematic reviews of acupuncture for adult health conditions have rated only a minority of conclusions as high- or moderate-certainty evidence, and most of these were about comparisons with sham treatment or had conclusions of no benefit of acupuncture. Conclusions with moderate or high-certainty evidence that acupuncture is superior to other active therapies were rare.
Geospatial Analysis of Access to Health Care and Internet Services in the US
Authors: Loccoh Eméfah C. , Nguyen Amanda , Kim Gaeun , Warraich Haider J.
Published: November 2022

This cross-sectional study examines internet access in areas of the US with limited health care services.
Estimating the Length of the Preclinical Detectable Phase for Open-Angle Glaucoma
Authors: Aspberg Johan , Heijl Anders , Bengtsson Boel
Published: November 2022

Importance

A 50% reduction of glaucoma-related blindness has previously been demonstrated in a population that was screened for open-angle glaucoma. Ongoing screening trials of high-risk populations and forthcoming low-cost screening methods suggest that such screening may become more common in the future. One would then need to estimate a key component of the natural history of chronic disease, the mean preclinical detectable phase (PCDP). Knowledge of the PCDP is essential for the planning and early evaluation of screening programs and has been estimated for several types of cancer that are screened for.

Objective

To estimate the mean PCDP for open-angle glaucoma.

Design, Setting, and Participants

A large population-based screening for open-angle glaucoma was conducted from October 1992 to January 1997 in Malmö, Sweden, including 32 918 participants aged 57 to 77 years. A retrospective medical record review was conducted to assess the prevalence of newly detected cases at the screening, incidence of new cases after the screening, and the expected clinical incidence, ie, the number of new glaucoma cases expected to be detected without a screening. The latter was derived from incident cases in the screened age cohorts before the screening started and from older cohorts not invited to the screening. A total of 2029 patients were included in the current study. Data were analyzed from March 2020 to October 2021.

Main Outcomes and Measures

The length of the mean PCDP was calculated by 2 different methods: first, by dividing the prevalence of screen-detected glaucoma with the clinical incidence, assuming that the screening sensitivity was 100% and second, by using a Markov chain Monte Carlo (MCMC) model simulation that simultaneously derived both the length of the mean PCDP and the sensitivity of the screening.

Results

Of 2029 included patients, 1352 (66.6%) were female. Of 1420 screened patients, the mean age at screening was 67.4 years (95% CI, 67.2-67.7). The mean length of the PCDP of the whole study population was 10.7 years (95% CI, 8.7-13.0) by the prevalence/incidence method and 10.1 years (95% credible interval, 8.9-11.2) by the MCMC method.

Conclusions and Relevance

The mean PCDP was similar for both methods of analysis, approximately 10 years. A mean PCDP of 10 years found in the current study allows for screening with reasonably long intervals, eg, 5 years.
Association of Household Income at Diagnosis With Financial Toxicity, Health Utility, and Survival in Patients With Head and Neck Cancer
Authors: Noel Christopher W. , Hueniken Katrina , Forner David , Liu Geoffrey , Eng Lawson , Hosni Ali , Hahn Ezra , Irish Jonathan C. , Gilbert Ralph , Yao Christopher M. K. L. , Monteiro Eric , O’Sullivan Brian , Waldron John , Huang Shao Hui , Goldstein David P. , de Almeida John R.
Published: November 2022

Importance

While several studies have documented a link between socioeconomic status and survival in head and neck cancer, nearly all have used ecologic, community-based measures. Studies using more granular patient-level data are lacking.

Objective

To determine the association of baseline annual household income with financial toxicity, health utility, and survival.

Design, Setting, and Participants

This was a prospective cohort of adult patients with head and neck cancer treated at a tertiary cancer center in Toronto, Ontario, between September 17, 2015, and December 19, 2019. Data analysis was performed from April to December 2021.

Exposures

Annual household income at time of diagnosis.

Main Outcome and Measures

The primary outcome of interest was disease-free survival. Secondary outcomes included subjective financial toxicity, measured using the Financial Index of Toxicity (FIT) tool, and health utility, measured using the Health Utilities Index Mark 3. Cox proportional hazards models were used to estimate the association between household income and survival. Income was regressed onto log-transformed FIT scores using linear models. The association between income and health utility was explored using generalized linear models. Generalized estimating equations were used to account for patient-level clustering.

Results

There were 555 patients (mean [SD] age, 62.7 [10.7] years; 109 [20%] women and 446 [80%] men) included in this cohort. Two-year disease-free survival was worse for patients in the bottom income quartile (<$30 000: 67%; 95% CI, 58%-78%) compared with the top quartile (≥$90 000: 88%; 95% CI, 83%-93%). In risk-adjusted models, patients in the bottom income quartile had inferior disease-free survival (adjusted hazard ratio, 2.13; 95% CI, 1.22-3.71) and overall survival (adjusted hazard ratio, 2.01; 95% CI, 0.94-4.29), when compared with patients in the highest quartile. The average FIT score was 22.6 in the lowest income quartile vs 11.7 in the highest quartile. In adjusted analysis, low-income patients had 12-month FIT scores that were, on average, 134% higher (worse) (95% CI, 16%-253%) than high-income patients. Similarly, health utility scores were, on average, 0.104 points lower (95% CI, 0.026-0.182) for low-income patients in adjusted analysis.

Conclusions and Relevance

In this cohort study, patients with head and neck cancer with a household income less than CAD$30 000 experienced worse financial toxicity, health status, and disease-free survival. Significant disparities exist for Ontario’s patients with head and neck cancer.
2021 Coronary Revascularization Guidelines—Lessons in the Importance of Data Scrutiny and Reappraisal of Evidence
Authors: Bakaeen Faisal G. , Chu Danny , Dayan Victor
Published: November 2022

This Viewpoint discusses whether or not the evidence cited in the 2021 American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography & Interventions guidelines for coronary artery revascularization support downgrading coronary artery bypass grafting relative to medical therapy.
Safety and Efficacy of Robotic vs Open Liver Resection for Hepatocellular Carcinoma
Authors: Di Benedetto Fabrizio , Magistri Paolo , Di Sandro Stefano , Sposito Carlo , Oberkofler Christian , Brandon Ellie , Samstein Benjamin , Guidetti Cristiano , Papageorgiou Alexandros , Frassoni Samuele , Bagnardi Vincenzo , Clavien Pierre-Alain , Citterio Davide , Kato Tomoaki , Petrowsky Henrik , Halazun Karim J. , Mazzaferro Vincenzo ,   Robotic HPB Study Group, Catellani Barbara , Guerrini Gian Piero , Coppa Jorgelina , Flores Maria
Published: November 2022

Importance

Long-term oncologic outcomes of robotic surgery remain a hotly debated topic in surgical oncology, but sparse data have been published thus far.

Objective

To analyze short- and long-term outcomes of robotic liver resection (RLR) for hepatocellular carcinoma (HCC) from Western high-volume centers to assess the safety, reproducibility, and oncologic efficacy of this technique.

Design, Setting, and Participants

This cohort study evaluated the outcomes of patients receiving RLR vs open liver resection (OLR) for HCC between 2010 and 2020 in 5 high-volume centers. After 1:1 propensity score matching, a group of patients who underwent RLR was compared with a validation cohort of OLR patients from a high-volume center that did not perform RLR.

Main Outcomes and Measures

A retrospective analysis was performed of prospectively maintained databases at 2 European and 2 US institutions of patients who underwent RLR for HCC between January 1, 2010, and September 30, 2020. The main outcomes were safety and feasibility of RLR for HCC and its oncologic outcomes compared with a European OLR validation cohort. A 2-sided P < .05 was considered significant.

Results

The study included 398 patients (RLR group: 125 men, 33 women, median [IQR] age, 66 [58-71] years; OLR group: 315 men, 83 women; median [IQR] age, 70 [64-74] years), and 106 RLR patients were compared with 106 OLR patients after propensity score matching. The RLR patients had a significantly longer operative time (median [IQR], 295 [190-370] minutes vs 200 [165-255] minutes, including docking; P < .001) but a significantly shorter hospital length of stay (median [IQR], 4 [3-6] days vs 10 [7-13] days; P < .001) and a lower number of admissions to the intensive care unit (7 [6.6%] vs 21 [19.8%]; P = .002). Incidence of posthepatectomy liver failure was significantly lower in the RLR group (8 [7.5%] vs 30 [28.3%]; P = .001), with no cases of grade C failure. The 90-day overall survival rate was comparable between the 2 groups (RLR, 99.1% [95% CI, 93.5%-99.9%]; OLR, 97.1% [95% CI, 91.3%-99.1%]), as was the cumulative incidence of death related to tumor recurrence (RLR, 8.8% [95% CI, 3.1%-18.3%]; OLR, 10.2% [95% CI, 4.9%-17.7%]).

Conclusions and Relevance

This study represents the largest Western experience to date of full RLR for HCC. Compared with OLR, RLR performed in tertiary centers represents a safe treatment strategy for patients with HCC and those with compromised liver function while achieving oncologic efficacy.
High‐Performance Green Thick‐Film Ternary Organic Solar Cells Enabled by Crystallinity Regulation
Authors: Zhao Heng , Xue Jingwei , Wu Hongbo , Lin Baojun , Cai Yuhang , Zhou Ke , Yun Daqin , Tang Zheng , Ma Wei
Published: November 2022

The power conversion efficiency (PCE) of organic solar cells (OSCs) has reached high values of over 19%. However, most of the high‐efficiency OSCs are fabricated by spin‐coating with toxic solvents and the optimal photoactive layer thickness is limited to 100 nm, limiting practical development of OSCs. It is a great challenge to obtain ideal morphology for high‐efficiency thick‐film OSCs when using non‐halogenated solvents due to the unfavorable film formation kinetics. Herein, high‐efficiency ternary thick‐film (300 nm) OSCs with PCE of 15.4% based on PM6:BTR‐Cl:CH1007 are fabricated by hot slot‐die coating using non‐halogenated solvent (o‐xylene) in the air. Compared to PM6:BTR‐Cl:Y6 blends, the stronger pre‐aggregation of CH1007 in solution induces the earlier aggregation of CH1007 molecules and longer aggregation time, and thus results in high and balanced crystallinity of donors and acceptor in CH1007‐based ternary film, which led to high‐carrier mobility and suppressed charge recombination. The ternary strategy is further used to fabricate high‐efficiency, thick‐film, large‐area, and flexible devices processed from non‐halogenated solvents, paving the way for industrial development of OSCs.
Toward Rapid and Accurate Molecular Diagnostics at Home
Authors: Liu Wenpeng , Lee Luke P.
Published: November 2022

The global outbreaks of infectious diseases have significantly driven an imperative demand for rapid and accurate molecular diagnostics. Nucleic acid amplification tests (NAATs) feature high sensitivity and high specificity; however, the labor‐intensive sample preparation and nucleic acid amplification steps remain challenging in order to carry out rapid and precision molecular diagnostics at home. This review discusses the advances and challenges of automatic solutions of sample preparation integrated with on‐chip nucleic acid amplification for effective and accurate molecular diagnostics at home. The sample preparation methods of whole blood, urine, saliva/nasal swab, and stool on chip are examined. Then, the repurposable integrated sample preparation on a chip using various biological samples is investigated. Finally, the on‐chip NAATs that can be integrated with automated sample preparation are evaluated. The user‐friendly approaches with combined sample preparation and NAATs can be the game changers for next‐generation rapid and precision home diagnostics.
Genetic and Pharmacological Inhibition of Astrocytic Mysm1 Alleviates Depressive‐Like Disorders by Promoting ATP Production
Authors: Zhang Heyang , Liu Shuirong , Qin Qiaozhen , Xu Zhenhua , Qu Yannv , Wang Yadi , Wang Jianing , Du Zhangzhen , Yuan Shanshan , Hong Shunming , Chang Zhilin , He Wenyan , Yan Xinlong , Lang Yiran , Tang Rongyu , Wang Yan , Zhu Lingling , Jiang Xiaoxia
Published: November 2022

Major depressive disorder (MDD) is a leading cause of disability worldwide. A comprehensive understanding of the molecular mechanisms of this disorder is critical for the therapy of MDD. In this study, it is observed that deubiquitinase Mysm1 is induced in the brain tissues from patients with major depression and from mice with depressive behaviors. The genetic silencing of astrocytic Mysm1 induced an antidepressant‐like effect and alleviated the osteoporosis of depressive mice. Furthermore, it is found that Mysm1 knockdown led to increased ATP production and the activation of p53 and AMP‐activated protein kinase (AMPK). Pifithrin α (PFT α) and Compound C, antagonists of p53 and AMPK, respectively, repressed ATP production and reversed the antidepressant effect of Mysm1 knockdown. Moreover, the pharmacological inhibition of astrocytic Mysm1 by aspirin relieved depressive‐like behaviors in mice. The study reveals, for the first time, the important function of Mysm1 in the brain, highlighting astrocytic Mysm1 as a potential risk factor for depression and as a valuable target for drug discovery to treat depression.
Renal Endothelial Cell‐Targeted Extracellular Vesicles Protect the Kidney from Ischemic Injury
Authors: Zhang Kaiyue , Li Rongrong , Chen Xiaoniao , Yan Hongyu , Li Huifang , Zhao Xiaotong , Huang Haoyan , Chen Shang , Liu Yue , Wang Kai , Han Zhibo , Han Zhong‐Chao , Kong Deling , Chen Xiang‐Mei , Li Zongjin
Published: November 2022

Endothelial cell injury plays a critical part in ischemic acute kidney injury (AKI) and participates in the progression of AKI. Targeting renal endothelial cell therapy may ameliorate vascular injury and further improve the prognosis of ischemic AKI. Here, P‐selectin as a biomarker of ischemic AKI in endothelial cells is identified and P‐selectin binding peptide (PBP)‐engineered extracellular vesicles (PBP‐EVs) with imaging and therapeutic functions are developed. The results show that PBP‐EVs exhibit a selective targeting tendency to injured kidneys, while providing spatiotemporal information for the early diagnosis of AKI by quantifying the expression of P‐selectin in the kidneys by molecular imaging. Meanwhile, PBP‐EVs reveal superior nephroprotective functions in the promotion of renal repair and inhibition of fibrosis by alleviating inflammatory infiltration, improving reparative angiogenesis, and ameliorating maladaptive repair of the renal parenchyma. In conclusion, PBP‐EVs, as an ischemic AKI theranostic system that is designed in this study, provide a spatiotemporal diagnosis in the early stages of AKI to help guide personalized therapy and exhibit superior nephroprotective effects, offering proof‐of‐concept data to design EV‐based theranostic strategies to promote renal recovery and further improve long‐term outcomes following AKI.
Sub‐second Lifetime of Photocarriers in Hybrid Lead Halide Perovskite
Authors: Lv Xingjie , Yuan Guoliang , Wu Tom , Yan Zhibo , Xu Ben , Liu Guanghua , Liu Jun‐Ming
Published: November 2022

Recently lead halide perovskite based solar cells have rapidly advanced and their power conversion efficiency (PCE) increased to 25.7%. The progress has been attributed to the super‐long carriers’ lifetime (τ) and long diffusion length (LD) of the photocarriers, however it has been a challenge to precisely characterize and understand the super‐long τ and LD of photocarriers. Here, a MAPbI3 single crystal exhibits four different τ which increase with LD extending from nm scale to mm scale. The prior two lifetimes estimated by transient photoluminescence (TPL) spectra are in the range of ns which comes from the recombination of photocarriers in the tens of nm thick surface layer. In contrast, the third lifetime estimated by transient open‐circuit voltage is hundreds of µs, which is a result of the excess photocarriers diffusing hundreds of µm to electrodes. Finally, the fourth lifetime estimated from the transient photoconductance is as long as sub‐second since the low‐density photocarriers under an electric field drift across the mm‐scale high‐quality single crystal. This study not only clarifies the physical mechanisms of four different lifetimes of photocarriers but also facilitates the design of novel electronics with the halide perovskite semiconductors.
Bruton tyrosine kinase inhibitors in the management of Waldenström macroglobulinemia
Authors: Castillo Jorge J. , Buske Christian , Trotman Judith , Sarosiek Shayna , Treon Steven P.
Published: November 2022

Bruton tyrosine kinase (BTK) inhibitors have taken a central role in the management of patients with Waldenström macroglobulinemia and are the only agents approved by the Food and Drug Administration (FDA) to treat these patients. Although associated with high rates of durable responses, unmet needs with BTK inhibitor therapy include indefinite duration therapy, high cost, scarcity of complete responses, and lower rates and shorter duration of response in patients with CXCR4 mutations. Herein, we review the data supporting the use of covalent BTK inhibitors, selected management issues, clinical trials with covalent BTK inhibitor combination regimens, and up‐and‐coming non‐covalent BTK inhibitors.