bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical Research of Lightweight Foam Concrete Replacement Method of Deep Soft Foundation Treatment of Low-Filled Embankment
Authors: Li Fanfan , Zhang Zhifeng , Chen Xing , Chi Zecheng , Li Jianbin , Wang Wei
Published: June 2022

A new method of replacing soft soil with lightweight foam concrete (lightweight foam concrete replacement method, LFCRM) is carried out to treat deep soft foundation under the low-filled embankment. Two-dimensional models with different thicknesses of replacement are established by the finite element platform (MIDAS/GTS). Moreover, the deformation and stress distribution law of treated foundation is analyzed by numerical simulation with different models. The results are as follows: (1) LFCRM can offset part of dead load; (2) the transverse distribution of settlement presents an “arc” shape; (3) the replacement made of lightweight foam concrete can spread stress well; (4) increase of replacement thickness will cause the necking of the additional stress “bubble”; (5) initial excess pore water pressure is related to the additional stress, and its dissipation path is deduced; (6) preliminary analysis indicates the feasibility of LFCRM for treating deep soft foundation with the low-filled embankment.
Simulation Analysis and Experimental Testing of Spin-Magnetic Piezoelectric Generators
Authors: Tian Xiaochao , Wang Hu , Lin Jiaying , Wang Zhicong , Liu Jinlong , Li Shenfang , Hou Jun , Zhu Jinzhi , Lei Qing
Published: June 2022

In order to investigate the optimal power generation performance of piezoelectric materials, a spin-magnetic piezoelectric generator was designed and the relationship between output voltage and speed and external force was derived through theoretical analysis. The maximum deformation and resonant frequency of the piezoelectric oscillator under magnetic drive are derived from simulation analysis. Finally, the relationship between output voltage and magnet size, distance between two magnets, and speed was tested experimentally, and the experimental data agreed with the theoretical analysis. The results show that when the speed is 312 r/min, magnet pitch is 12 mm, and magnet size is 10 mm

 
∗

35 mm

∗

4, the maximum output voltage is 54 V. This can meet the power supply needs of micro and small electronic products.
Altered Cerebral Microstructure in Adults With Atrial Septal Defect and Ventricular Septal Defect Repaired in Childhood
Authors: Asschenfeldt Benjamin , Evald Lars , Salvig Camilla , Heiberg Johan , Østergaard Leif , Eskildsen Simon Fristed , Hjortdal Vibeke Elisabeth
Published: June 2022

Background

Delayed brain development, brain injury, and neurodevelopmental disabilities are commonly observed in infants operated for complex congenital heart defect. Our previous findings of poorer neurodevelopmental outcomes in individuals operated for simple congenital heart defects calls for further etiological clarification. Hence, we examined the microstructural tissue composition in cerebral cortex and subcortical structures in comparison to healthy controls and whether differences were associated with neurodevelopmental outcomes.

Methods and Results

Adults (n=62) who underwent surgical closure of an atrial septal defect (n=33) or a ventricular septal defect (n=29) in childhood and a group of healthy, matched controls (n=38) were enrolled. Brain diffusional kurtosis imaging and neuropsychological assessment were performed. Cortical and subcortical tissue microstructure were assessed using mean kurtosis tensor and mean diffusivity and compared between groups and tested for associations with neuropsychological outcomes. Alterations in microstructural tissue composition were found in the parietal, temporal, and occipital lobes in the congenital heart defects, with distinct mean kurtosis tensor cluster‐specific changes in the right visual cortex (pericalcarine gyrus,
P
=0.002; occipital part of fusiform and lingual gyri,
P
=0.019). Altered microstructural tissue composition in the subcortical structures was uncovered in atrial septal defects but not in ventricular septal defects. Associations were found between altered cerebral microstructure and social recognition and executive function.

Conclusions

Children operated for simple congenital heart defects demonstrated altered microstructural tissue composition in the cerebral cortex and subcortical structures during adulthood when compared with healthy peers. Alterations in cerebral microstructural tissue composition were associated with poorer neuropsychological performance.

Registration

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03871881.
Sex‐Based Differences in Outcomes Following Peripheral Artery Revascularization: Insights From VOYAGER PAD
Authors: Hess Connie N. , Baumgartner Iris , Anand Sonia S. , Nehler Mark R. , Patel Manesh R. , Debus E. Sebastian , Szarek Michael , Capell Warren , Muehlhofer Eva , Berkowitz Scott D. , Haskell Lloyd P. , Bauersachs Rupert M. , Bonaca Marc P. , Hsia Judith
Published: June 2022

Background

Despite high female prevalence of peripheral artery disease (PAD), little is known about sex‐based outcomes after lower extremity revascularization (LER) for symptomatic PAD. The effects of rivaroxaban according to sex following LER have not been fully reported.

Methods and Results

In VOYAGER PAD (Vascular Outcomes Study of ASA [acetylsalicylic acid] Along with Rivaroxaban in Endovascular or Surgical Limb Revascularization for Peripheral Artery Disease), low‐dose rivaroxaban versus placebo on a background of aspirin reduced the composite primary efficacy outcome of cardiovascular and limb events in patients with PAD undergoing LER. Unplanned index limb revascularization was prespecified and prospectively ascertained. The primary safety outcome was Thrombolysis in Myocardial Infarction major bleeding. Analyses of outcomes and treatment effects by sex were performed using Cox proportional hazards models. Among 6564 randomly assigned patients followed for a median of 28 months, 1704 (26.0%) were women. Among patients administered placebo, women were at similar risk for the primary efficacy outcome (hazard ratio [HR], 0.90; [95% CI, 0.74–1.09];
P
=0.29) as men, while female sex was associated with a trend toward higher risk of unplanned index limb revascularization (HR, 1.18; [95% CI, 1.00–1.40];
P
=0.0499). Irrespective of sex, effects of rivaroxaban were consistent for the primary efficacy outcome (
P
‐interaction=0.22), unplanned index limb revascularization (
P
‐interaction=0.64), and bleeding (
P
‐interaction=0.61). Women were more likely than men to discontinue study treatment (HR, 1.13; [95% CI, 1.03–1.25];
P
=0.0099).

Conclusions

Among >1700 women with PAD undergoing LER, women and men were at similar risk for the primary outcome, but a trend for greater risk of unplanned index limb revascularization among women was observed. Effects of rivaroxaban were consistent by sex, though women more often discontinued treatment. Better understanding of sex‐based outcomes and treatment adherence following LER is needed.

Registration

URL:
http://clinicaltrials.gov
; Unique identifier: NCT02504216.
Transcatheter Aortic Valve Implantation With and Without Resheathing and Repositioning: A Systematic Review and Meta‐analysis
Authors: Moroni Francesco , Azzalini Lorenzo , Sondergaard Lars , Attizzani Guilherme F. , García Santiago , Jneid Hani , Mamas Mamas A. , Bagur Rodrigo
Published: June 2022

Background

There is a concern that resheathing/repositioning of transcatheter heart valves during transcatheter aortic valve implantation (TAVI) may lead to an increased risk of periprocedural complications. We aimed to evaluate the short‐ and long‐term impact on clinical outcomes of resheathing for repositioning of transcatheter heart valves during TAVI procedures.

Methods and Results

We conducted a systematic search of Embase, MEDLINE, and Cochrane Central Register of Controlled Trials databases to identify studies comparing outcomes between patients requiring resheathing/repositioning during TAVI and those who did not. Random‐effects meta‐analyses were used to estimate the association of resheathing compared with no resheathing with clinical outcomes after TAVI. Seven studies including 4501 participants (pooled mean age, 80.9±7.4 years; 54% women; and 1374 [30.5%] patients requiring resheathing/repositioning) were included in this study. No significant differences between the 2 groups were identified with regards to safety: 30‐day mortality (n=3125; odds ratio [OR], 0.74 [95% confidence interval [CI], 0.41–1.33];
I
2
=0%), stroke (n=4121; OR, 1.09 [95% CI, 0.74–1.62];
I
2
=0%), coronary obstruction (n=3000; OR, 2.35 [95% CI, 0.17–33.47];
I
2
=75%), major vascular complications (n=3125; OR, 0.92 [95% CI, 0.66–1.33];
I
2
=0%), major bleeding (n=3125; OR, 1.13 [95% CI, 0.94–2.01];
I
2
=39%), acute kidney injury (n=3495; OR, 1.30 [95% CI, 0.64–2.62];
I
2
=44%), and efficacy outcomes: device success (n=1196; OR, 0.77 [95% CI, 0.51–1.14];
I
2
=0%), need for a second valve (n=3170; OR, 2.86 [95% CI, 0.96–8.48];
I
2
=62%), significant (moderate or higher) paravalvular leak (n=1151; OR, 1.53 [95% CI, 0.83–2.80];
I
2
=0%), and permanent pacemaker implantation (n=1908; OR, 1.04 [95% CI, 0.68–1.57];
I
2
=58%). One‐year mortality was similar between groups (n=1972; OR, 1.00 [95% CI, 0.68–1.47];
I
2
=0%).

Conclusions

Resheathing of transcatheter heart valves during TAVI is associated with similar periprocedural risk compared with no resheathing in several patient‐important outcomes. These data support the safety of current self‐expanding transcatheter heart valves with resheathing features.

Registration

URL:
https://www.crd.york.ac.uk/prospero/
; Unique identifier: CRD42021273715.
Prediction of Prehospital Change of the Cardiac Rhythm From Nonshockable to Shockable in Out‐of‐Hospital Patients With Cardiac Arrest: A Post Hoc Analysis of a Nationwide, Multicenter, Prospective Registry
Authors: Emoto Ryo , Nishikimi Mitsuaki , Shoaib Muhammad , Hayashida Kei , Nishida Kazuki , Kikutani Kazuya , Ohshimo Shinichiro , Matsui Shigeyuki , Shime Nobuaki , Iwami Taku
Published: June 2022

Background

Predicting a spontaneous rhythm change from nonshockable to shockable before hospital arrival in patients with out‐of‐hospital cardiac arrest can help emergency medical services develop better strategies for prehospital treatment. The aim of this study was to identify predictors of spontaneous rhythm change before hospital arrival in patients with out‐of‐hospital cardiac arrest and develop a predictive scoring system.

Methods and Results

We retrospectively reviewed data of eligible patients with out‐of‐hospital cardiac arrest with an initial nonshockable rhythm registered in a nationwide registry between June 2014 and December 2017. We performed a multivariable analysis using a Cox proportional hazards model to identify predictors of a spontaneous rhythm change, and a ridge regression model for predicting it. The data of 25 804 patients were analyzed (derivation cohort, n=17 743; validation cohort, n=8061). The rhythm change event rate was 4.1% (724/17 743) in the derivation cohort, and 4.0% (326/8061) in the validation cohorts. Age, sex, presence of a witness, initial rhythm, chest compression by a bystander, shock with an automated external defibrillator by a bystander, and cause of the cardiac arrest were all found to be independently associated with spontaneous rhythm change before hospital arrival. Based on this finding, we developed and validated the Rhythm Change Before Hospital Arrival for Nonshockable score. The Harrell’s concordance index values of the score were 0.71 and 0.67 in the internal and external validations, respectively.

Conclusions

Seven factors were identified as predictors of a spontaneous rhythm change from nonshockable to shockable before hospital arrival. We developed and validated a score to predict rhythm change before hospital arrival.
Between Visual Scenes and Beautiful Lives: A Conversation with Saidiya Hartman
Authors: Copeland Huey , Dickerman Leah , Lee Pamela M.
Published: June 2022

This wide-ranging conversation with Black cultural theorist Saidiya Hartman—occasioned by the twenty-fifth anniversary of her groundbreaking first book, Scenes of Subjection, to be republished this year in an edition by Norton—explores the author's shifting approaches to the visual over time, the limitations and potentialities of the archive for its discontents, and the models she has both turned to and herself invented—most notably the concept of “critical fabulation”—in the ongoing attempt to find ethical modes of engaging African/Diasporic life, thought, and form in an anti-Black world.
Lawrence Weiner's Materialism
Authors: Stark Trevor
Published: June 2022

From the 1960s until his death in 2021, Lawrence Weiner developed an art practice operating in language, which he described as being that of a “materialist.” This paper examines the scope of Weiner's career to determine what he could mean by that term—to derive the specific characteristics of his linguistic materialism. Differentiating his work from existing materialist paradigms in poetics and linguistics, this paper argues that the matter of language for Weiner was not reducible to the visual character of the signifier or to the physicality of the referent. Rather than attempt to define language as such, Weiner's materialism set into motion the infinite social uses of words within the “stream of life.”
On Dan Graham: Memories in Alteration
Authors: De Bruyn Eric C. H.
Published: June 2022

Written in memory of Dan Graham, “Memories in Alteration” considers the important legacy of the artist's work, focusing on the topological and paralogical devices that characterize his discursive and artistic practice. The text adumbrates how the multidisciplinary work of Graham—addressing such diverse cultural phenomena as suburbia, 1960s counterculture, television, and punk music—traced the emergence of a postwar “liberal” order of capitalism and its constitutive technologies of colonization and the domestication of social and urban environments.
Double Dan
Authors: Miller John
Published: June 2022

“Double Dan” is an account of helping to produce a Dan Graham multiple for Veronica Gonzalez's Rocky Point Press.
Dan Graham: Sunday Painter
Authors: Miller John
Published: June 2022

“Sunday Painter” is a contemporary re-consideration of Dan Graham's 1967 essay “Eisenhower and the Hippies.”
Dan Graham: Pedagogue
Authors: Guagnini Nicolás
Published: June 2022

Artist and writer Nicolas Guagnini's obituary for his friend Dan Graham deploys the genre's tropes of anecdote and remembrance to elucidate the artist's idiosyncratic pedagogy. Both at the methodological and the art-historical levels these bits of conversations from over more than two decades touch on Graham's position towards his postminimalist peers, his approach to architecture, public space, writing, artistic genealogies, and anthropology.
Handbook of Feelings
Authors: Sia Tiffany
Published: June 2022

Hong Kong's National Security Law was passed on June 30, 2020, followed by a film-censorship amendment on October 27, 2021. While the public experienced the ensuing censorship as an absence and an occlusion of works, the mechanisms of censorship are opaque and bureaucratic, made effective through myriad methods. This article focuses on a first-person telling that weaves personal conversations, rumors, and everyday experiences in the new normal to analyze the evolving codes and reveal the trip wires that threaten the creation and presentation of films, artworks, and print materials in Hong Kong. Artists and filmmakers face a developing shadow bureaucracy, which they are only slowly coming to understand. Tracing the visible and invisible red lines through a group of mostly anonymized artists and practitioners—except for the author or those cited in the news—this essay confronts the haunting power of newly passed national-security laws to atomize fear, threaten some more than others, and generally to produce paranoia.
Money, Sex, and Legitimacy at Chicago, circa 1892–1940:
Lillie’s Center of Reproductive Biology
Authors: Clarke Adele E.
Published: June 2022

Despite the controversial nature of studies of reproductive phenomena, a major center of reproductive biology emerged and coalesced in the Department of Zoology at the University of Chicago circa 1892–1940. Led by Frank R. Lillie, several small groups of researchers pioneered the study of sex determination and sex hormones, pursuing these via a Chicago approach to framing biological practice at both cellular and organismic levels. They worked in an interdisciplinary manner, however much in tandem, and drew strongly on local resources—from the stockyards to local philanthropy. Most remarkably, Lillie redirected the mission of the major National Research Council (NRC) Committee for Research Problems of Sex to address the biology of sex and then garnered about a fifth of its funds for Chicago. He thus guided Chicago biology into the fully modern era of external support for on-campus research and elaborate national scientific networks via promising biological solutions to social problems.
Lakatos’s “Internal History” as
Historiography
Authors: Palmer Eric
Published: June 2022

Imre Lakatos’s conception of the history of science is explicated with the purpose of replying to criticism leveled against it by Thomas Kuhn, Ian Hacking, and others. Kuhn’s primary argument is that the historian’s internal-external distinction is methodologically superior to Lakatos’s distinction because it is “independent” of an analysis of rationality. That distinction, however, appears to be a normative one, harboring an implicit and unarticulated appeal to rationality, despite Kuhn’s claims to the contrary. Lakatos’s history, by contrast, is clearly the history of a normatively defined discipline; of science and not scientists and their activities. How such history can be written, the historiographic and critical tools available for its construction, and its importance as history are considered in detail. In an afterword, the prevalence of Lakatos’s treatment of history in philosophical discussion is indicated: a related approach is shown to arise in social contract theory.
Two new diminutive species of Begonia (Begoniaceae) from the north coast of São Paulo State, Brazil
Authors: MIRANDA MARCELO DIAS , JACQUES ELIANE DE LIMA
Published: June 2022

Two new species of Begonia (Begoniaceae) from the Atlantic Coastal Forest of Brazil are described and illustrated. Begonia atlantica and Begonia umbrosa are found living in rocky outcrops present on the slopes of Serra do Mar State Park, taxonomic affinities and provisional conservation assessments are also provided.
Gerronema confusum (Porotheleaceae), a new species from North China
Authors: ZHAO TAO-YU , FAN LI
Published: June 2022

Gerronema confusum sp. nov. is described and illustrated from North China, which is diagnosed by the combination of grayish brown omphalinoid basidiomata, decurrent lamellae, a central stipe, smooth, ellipsoid to subglobose, inamyloid basidiospores, 1–2-spored basidia, abundant cheilocystidia, a pileipellis disrupted by clusters of pileocystidia, and a stipitipellis disrupted by caulocystidia.  ITS-phylogeny supported G. confusum as a distinct species.
Revision of the Pseudepipona herrichii-group of the eumenine wasps (Hymenoptera: Vespidae: Eumeninae) with the description of two new species from China and Russia
Authors: FATERYGA ALEXANDER V.
Published: June 2022

The Pseudepipona herrichii-group includes species of the genus Pseudepipona de Saussure, 1856, subgenus Pseudepipona s. str., without long setae on the gena, the scutum, and the propleura, with the transverse carina of the propodeum forming laterally a tooth or at least a blunt angle, and with the preapical tooth of the male mandible of approximately equal width and length. Taxonomic revision of this group revealed the existence of six species: Pseudepipona aldrichi (Fox, 1892), stat. nov. (= P. herrichii mongolica Giordani Soika, 1970, syn. nov.), P. herrichii (de Saussure, 1856) (= P. herrichii afromontana Gusenleitner, 1977, syn. nov.), P. kozhevnikovi (Kostylev, 1927), P. tingjingliae Fateryga, sp. nov., P. tricarinata (Kokujev, 1913), and P. valentinae Fateryga, sp. nov. A complete diagnosis of the males and females of these species is provided, as is an identification key. Maps detailing the geographic distributions of each species are presented. The available data on their bionomics are also summarized.
New species of the genus Eupithecia (Lepidoptera, Geometridae) from China. Part VII
Authors: MIRONOV VLADIMIR , ŠUMPICH JAN
Published: June 2022

In this seventh part of this series, 8 new species of Eupithecia Curtis, 1825 are described from China: Eupithecia prochazkai sp. n., Eupithecia anickae sp. n., Eupithecia divertenta sp. n., Eupithecia saldaitisi sp. n., Eupithecia ludificata sp. n., Eupithecia butvilai sp. n., Eupithecia ursina sp. n. and Eupithecia nesciaria sp. n. Three previously described species are recorded in China for the first time: Eupithecia oxycedrata (Rambur, 1833), Eupithecia phulchokiana Herbulot, 1984, and a range extension is given for a fourth, Eupithecia pannosa Mironov & Galsworthy, 2008, and Eupithecia matrona Mironov & Galsworthy, 2004. Adults and genitalia are illustrated for all species.
Axial load ratio and limit for ductility design of steel fiber-reinforced concrete composite shear walls
Authors: Zhang Ying , Zhang Hongmei , Li Xin , Lu Xilin
Published: June 2022

Serious compression failure of reinforced concrete shear walls under high axial load ratios can be effectively prevented by adding steel fibers at the bottom, combined with an imbedded steel profile in the boundary element. However, the existing axial load ratio limit for conventional reinforced concrete shear walls is not suitable for performance-based design of such composite structural member. The seismic behavior of three composite walls with different fiber volume fractions (0–2.0%) was investigated through experimental and numerical studies under the preliminarily determined axial load ratio limit. The influence of the axial load ratio and boundary element requirements on the displacement ductility was numerically quantified. Addition of fibers assisted in mitigating the crushing of bottom concrete, improving the displacement ductility, and maintaining the bearing capacity under large deformations. Subsequently, an axial load ratio limit relax of 0.1 to 0.2 was adopted for such walls with fiber volume fraction of 1.0% to 2.0% to obtain a displacement ductility consistent with traditional walls. Finally, the axial load ratio limit and corresponding requirements on boundary elements for such walls with separate ductility demand have been recommended, which can provide guidance for performance-based design of such composite walls with flexure-controlled failure mode, however, shear-controlled walls should also be investigated in further studies.
Experimental and numerical investigation on seismic performance of semi-precast concrete sandwich shear wall
Authors: Liu Yun-Lin , Liu Chang , Pan Hao , Fu Jia-Li , Huang Jun-Qi , Hong Jia-Qiang
Published: June 2022

This study investigated the seismic performance of an innovative semi-precast concrete sandwich shear wall (SCSSW) system. The system consists of two precast reinforced concrete (RC) wythes, a core cast-in-place RC wythe, a core thermal insulation layer, the fiber reinforced polymer connectors and the steel trusses. A total of three RC shear wall specimens were fabricated and tested under in-plane cyclic load. They consists of one conventional cast-in-place RC shear wall, one structural wythe of SCSSW (i.e., the assemble of a precast and a cast-in-place RC wythe), and one typical SCSSW. The failure mode, hysteretic curve, ductility and energy dissipation of the three specimens were studied and compared. Furthermore, numerical simulation based on multi-layer shell element was conducted to reproduce the test, and parametric analysis was conducted to facilitate a better understanding on the SCSSW. It was concluded that the SCSSW presented a ductile failure behavior; the seismic performance of the SCSSW including hysteretic curves, skeleton curves, stiffness degradation and the energy dissipation was similar to that of the cast-in-place RC shear wall, while the ductility of the SCSSW was slightly lower; and the facade precast RC wythe contributed few effect on the seismic performance of the SCSSW.
Cost-effectiveness of polatuzumab vedotin combined with chemoimmunotherapy in untreated diffuse large B-cell lymphoma
Authors: Kambhampati Swetha , Saumoy Monica , Schneider Yecheskel , Pak Stacy , Budde Lihua Elizabeth , Mei Matthew G. , Siddiqi Tanya , Popplewell Leslie L. , Wen Yi-Ping , Zain Jasmine , Forman Stephen J. , Kwak Larry W. , Rosen Steven T. , Danilov Alexey V. , Herrera Alex F. , Thiruvengadam Nikhil R.
Published: June 2022

In patients with treatment-naive diffuse large B-cell lymphoma (DLBCL), the POLARIX study (A Study Comparing the Efficacy and Safety of Polatuzumab Vedotin With Rituximab-Cyclophosphamide, Doxorubicin, and Prednisone [R-CHP] Versus Rituximab-Cyclophosphamide, Doxorubicin, Vincristine, and Prednisone [R-CHOP] in Participants With Diffuse Large B-Cell Lymphoma) reported a 6.5% improvement in the 2-year progression-free survival (PFS), with no difference in overall survival (OS) or safety using polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisone (pola-R-CHP) compared with standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). We evaluated the cost-effectiveness of pola-R-CHP for DLBCL. We modeled a hypothetical cohort of US adults (mean age, 65 years) with treatment-naive DLBCL by developing a Markov model (lifetime horizon) to model the cost-effectiveness of pola-R-CHP and R-CHOP using a range of plausible long-term outcomes. Progression rates and OS were estimated from POLARIX. Outcome measures were reported in incremental cost-effectiveness ratios, with a willingness-to-pay (WTP) threshold of $150 000 per quality-adjusted life-year (QALY). Assuming a 5-year PFS of 69.6% with pola-R-CHP and 62.7% with R-CHOP, pola-R-CHP was cost-effective at a WTP of $150 000 (incremental cost-effectiveness ratio, $84 308/QALY). pola-R-CHP was no longer cost-effective if its 5-year PFS was 66.1% or lower. One-way sensitivity analysis revealed that pola-R-CHP is cost-effective up to a cost of $276 312 at a WTP of $150 000. pola-R-CHP was the cost-effective strategy in 56.6% of the 10 000 Monte Carlo iterations at a WTP of $150 000. If the absolute benefit in PFS is maintained over time, pola-R-CHP is cost-effective compared with R-CHOP at a WTP of $150 000/QALY. However, its cost-effectiveness is highly dependent on its long-term outcomes and costs of chimeric antigen receptor T-cell therapy. Routine usage of pola-R-CHP would add significantly to health care expenditures. Price reductions or identification of subgroups that have maximal benefit would improve cost-effectiveness.
Rheumatic heart disease prevalence in Namibia: a retrospective review of surveillance registers
Authors: Shimanda Panduleni Penipawa , Söderberg Stefan , Iipinge Scholastika Ndatinda , Neliwa Ebba Mwalundouta , Shidhika Fenny Fiindje , Norström Fredrik
Published: June 2022

Background

Rheumatic heart disease (RHD) is the most commonly acquired heart disease in children and young people in low and middle-income settings. Fragile health systems and scarcity of data persist to limit the understanding of the relative burden of this disease. The aims of this study were to estimate the prevalence of RHD and to assess the RHD-related health care systems in Namibia.

Methods

Data was retrieved from outpatient and inpatient registers for all patients diagnosed and treated for RHD between January 2010 to December 2020. We used descriptive statistics to estimate the prevalence of RHD. Key observations and engagement with local cardiac clinicians and patients helped to identify key areas of improvement in the systems.

Results

The outpatient register covered 0.032% of the adult Namibian population and combined with the cumulative incidence from the inpatient register we predict the prevalence of clinically diagnosed RHD to be between 0.05% and 0.10% in Namibia. Young people (< 18 years old) are most affected (72%), and most cases are from the north-eastern regions. Mitral heart valve impairment (58%) was the most common among patients. We identified weaknesses in care systems i.e., lack of patient unique identifiers, missing data, and clinic-based prevention activities.

Conclusion

The prevalence of RHD is expected to be lower than previously reported. It will be valuable to investigate latent RHD and patient follow-ups for better estimates of the true burden of disease. Surveillance systems needs improvements to enhance data quality. Plans for expansions of the clinic-based interventions must adopt the “Awareness Surveillance Advocacy Prevention” framework supported by relevant resolutions by the WHO.
Development of the use of primary health care emergency departments after interventions aimed at decreasing overcrowding: a longitudinal follow-up study
Authors: Liedes-Kauppila Marja , Heikkinen Anna M. , Rahkonen Ossi , Lehto Mika , Mustonen Katri , Raina Marko , Kauppila Timo
Published: June 2022

Background

This study, conducted in a Finnish city, examined whether decreasing emergency department (ED) services in an overcrowded primary care ED and corresponding direction to office-hours primary care would modify service usage for specific gender, age or diagnosis groups.

Methods

This was an observational retrospective study carried out by gradually decreasing ED services in primary care. The interventions aimed at decreasing use of EDs were a) application of ABCDE-triage combined with public guidance on the proper use of EDs, b) closure of a minor supplementary ED, and finally, c) application of “reverse triage” with enhanced direction of the public to office-hours services and away from the remaining ED The annual number of visits to office-hours primary care GPs in different gender, age and diagnosis groups (International Classification of Diseases (ICD − 10) were recorded during a 13-year follow-up period.

Results

The total number of monthly visits to EDs decreased slowly over the whole study period. This decrease was similar in women and men. The decrease was stronger in the youngest age groups (0–19 years). GPs treated decreasing proportions of ICD-10 groups. Recorded infectious diseases (Groups A and J, and especially diagnoses related to infections of respiratory airways) tended to decrease. However, visits due to injuries and symptomatic diagnoses increased.

Conclusion

Decreasing services in a primary health care ED with the described interventions seemed to reduce the use of services by young people. The three interventions mentioned above had the effect of making the primary care ED under study appear to function more like a standard ED driven by specialized health care.
Effect of intermediate/high versus low dose heparin on the thromboembolic and hemorrhagic risk of unvaccinated COVID-19 patients in the emergency department
Authors: Marchioni Claudia , Esposito Gaetano , Calci Mario , Bais Bruno , Colussi GianLuca
Published: June 2022

Background

The optimal prophylactic dose of heparin in patients with coronavirus-associated disease 2019 (COVID-19) in the emergency department (ED) is debated. This study aimed to analyze different thromboprophylaxis approaches in unvaccinated COVID-19 patients admitted to ED without initial venous thromboembolism.

Methods

Retrospectively, the effect of intermediate/high versus low dose heparin treatment was evaluated from December 2020 to July 2021 in a tertiary Academic Hospital in northeast Italy. The primary outcome comprised arterial or venous thromboembolism or all-cause death within 30 days. Secondary outcomes comprised each single primary outcome component or major hemorrhagic event. Cox regression was used to determine predictors of the primary outcome and propensity score weights to balance the effect of heparin treatment on all outcomes.

Results

Data of 144 consecutive patients (age 70 ± 13, 33% females) were included in the study. High-dose prophylactic heparin was used in 69%, intermediate in 15%, and low in 17% of patients. The primary outcome occurred in 48 patients. Independent predictors of the primary outcome were COVID-19 severity (hazards ratio (HR) 1.96, 95% confidence interval (CI) 1.05–3.65, p = 0.035) and D-dimer levels (HR each log ng/dl 1.38, 95% CI 1.04–1.84, p = 0.026). Intermediate/high dose heparin did not affect the risk of the primary outcome compared with the low dose (weighted HR 1.39, 95% CI 0.75–2.56, p = 0.292). Intermediate/high heparin increased the risk of major hemorrhagic events (weighted HR 5.92, 95% CI 1.09–32, p = 0.039).

Conclusions

In unvaccinated COVID-19 patients admitted to ED, prophylaxis with heparin at the intermediate/high dose did not reduce primary outcome compared with the low dose but increased the risk of major hemorrhagic events.
Nutrition-wide association study of microbiome diversity and composition in colorectal cancer patients
Authors: Hoang Tung , Kim Min Jung , Park Ji Won , Jeong Seung-Yong , Lee Jeeyoo , Shin Aesun
Published: June 2022

Background

The effects of diet on the interaction between microbes and host health have been widely studied. However, its effects on the gut microbiota of patients with colorectal cancer (CRC) have not been elucidated. This study aimed to investigate the association between diet and the overall diversity and different taxa levels of the gut microbiota in CRC patients via the nutrition-wide association approach.

Methods

This hospital-based study utilized data of 115 CRC patients who underwent CRC surgery in Department of Surgery, Seoul National University Hospital. Spearman correlation analyses were conducted for 216 dietary features and three alpha-diversity indices,Firmicutes/Bacteroidetesratio, and relative abundance of 439 gut microbial taxonomy. To identify main enterotypes of the gut microbiota, we performed the principal coordinate analysis based on the β-diversity index. Finally, we performed linear regression to examine the association between dietary intake and main microbiome features, and linear discriminant analysis effect size (LEfSe) to identify bacterial taxa phylogenetically enriched in the low and high diet consumption groups.

Results

Several bacteria were enriched in patients with higher consumption of mature pumpkin/pumpkin juice (ρ, 0.31 to 0.41) but lower intake of eggs (ρ, -0.32 to -0.26). We observed negative correlations betweenBacteroides fragilisabundance and intake of pork (belly), beef soup with vegetables, animal fat, and fatty acids (ρ, -0.34 to -0.27); an inverse correlation was also observed betweenClostridium symbiosumabundance and intake of some fatty acids, amines, and amino acids (ρ, -0.30 to -0.24). Furthermore, high intake of seaweed was associated with a 6% (95% CI, 2% to 11%) and 7% (95% CI, 2% to 11%) lower abundance ofRikenellaceaeandAlistipes, respectively, whereas overall beverage consumption was associated with an 10% (95% CI, 2% to 18%) higher abundance ofBacteroidetes,Bacteroidia, andBacteroidales, compared to that in the low intake group. LEfSe analysis identified phylogenetically enriched taxa associated with the intake of sugars and sweets, legumes, mushrooms, eggs, oils and fats, plant fat, carbohydrates, and monounsaturated fatty acids.

Conclusions

Our data elucidates the diet-microbe interactions in CRC patients. Additional research is needed to understand the significance of these results in CRC prognosis.
Impact of the initial site of metastases on post-recurrence survival for neuroendocrine cervical cancer
Authors: Pan Baoyue , Wan Ting , Jiang Yinan , Zheng Xiaojing , Liu Pingping , Xiang Huiling , Zheng Min
Published: June 2022

Objective

To summarize the risk factors and emphasize the prognostic importance of the site of recurrent neuroendocrine cervical cancer (NECC).

Methods

We enrolled 88 patients who developed recurrence after radical surgery for pathological stage I–IVa primary NECC between January 2003 and 30 December 2020 and classified these cases into 7 groups based on the initial recurrence. The risk factors for post-recurrence survival (PRS) were analyzed by Kaplan–Meier and Cox regression methods.

Results

Among 88 NECC patients, nearly all patients (95.50%) experienced progression within 3 years. The time to progression was significantly longer in patients with lung recurrence than in patients without lung recurrence (p = 0.008). After the first recurrence, the median follow-up was 11.1 months (range 2.37–65.50 months), and the 5-year PRS was only 20.6%. The depth of invasion in the primary surgery, number of recurrent sites, abdominal organ recurrence were correlated with PRS by univariate analysis. Multivariate analyses revealed that the number of recurrent sites (p = 0.025) and abdominal organ recurrence (p = 0.031) were independent prognostic factors. Notably, the combination of immune checkpoint inhibitors and chemotherapy, with or without surgery, showed a 43.8% objective response rate in recurrent NECC.

Conclusion

Patients with abdominal organ recurrence need more sophisticated therapy. The combination of immune therapy and chemotherapy might be an opportunity for recurrent NECC.
The effect of childhood socioeconomic status on depressive symptoms in middle-old age: the mediating role of life satisfaction
Authors: Tang Lei , Yin Ruoyun , Hu Qian , Fan Zhaoya , Zhang Fan
Published: June 2022

Background

Some studies have shown that childhood socioeconomic status (SES) can influence the development and progression of depression in adulthood. This study aimed to analyze the effects of childhood SES on depressive symptoms in individuals of middle-old age and examine the potential mediating role of life satisfaction based on national data in China.

Methods

Data were derived from the 2018 China Health and Retirement Longitudinal Study (CHARLS) data. A total of 17,129 individuals who were aged 45 years and older were included. The dependent variable was depressive symptoms in middle-old age. Childhood SES was the independent variable, and life satisfaction was the mediator. This study controlled four factors: general demographic characteristics, adult SES, childhood adversity and health and living status. Pearson correlations and hierarchical multiple regression analysis were performed, and the Baron and Kenny method was used to test the mediating role.

Results

The score of depressive symptoms among all participants was 7.88 ± 6.65. Gender, age, adult SES, childhood adversity and health and living status all affected the development of depression symptom in middle-aged and elderly individuals in China. After adjusting for all covariates, the higher the childhood SES, the lower the depressive symptom score (β = − 0.422, P < 0.001). Life satisfaction had a partial mediating effect between childhood SES and depressive symptoms. Low childhood SES may improve life satisfaction (β = 0.051, P < 0.001) and life satisfaction indirectly decreases depressive symptom scores (β = − 0.403, P < 0.001).

Conclusions

Life satisfaction was a partial mediator between childhood SES and depressive symptoms in middle and old age. Improving life satisfaction may serve as an intervention to reduce the incidence of depression symptoms in the future.
Evaluation of double-high insert mid-term outcomes in cruciate-retaining medial-pivotal total knee arthroplasty – a propensity score-matched analysis with averaged 8-year follow-up
Authors: Wang Wenzhe , Xiang Shuai , Wang Yingzhen , Lv Chengyu , Wang Changyao , Zhang Haining
Published: June 2022

Background

This study aimed to compare the mid-term clinical and radiographic outcomes between medial-pivotal (MP) insert and double-high (DH) insert used under the cruciate-retaining condition in ADVANCE® total knee arthroplasty (TKA).

Methods

The follow-up was conducted for 158 consecutive patients who underwent unilateral ADVANCE® TKA from January 2011 to April 2014. Eighty-four MP inserts and 74 DH inserts were used under cruciate-retaining conditions. A 1:1 propensity score matching (PSM) analysis was performed between MP inserts and DH inserts to compare the clinical and radiographic outcomes.

Results

After a 1:1 PSM, 120 patients (60 pairs) were matched between the MP and DH inserts groups. The baseline demographic parameters and clinical scores were comparable between the two groups. The postoperative clinical outcomes at an averaged 8-year follow-up of both groups were significantly improved. The range of motion (ROM) of the DH group was better than that of the MP group, and equivalent Knee Society Function Score (KSFS) between the two groups was found. However, the Knee Society Score (KSS), Western Ontario and McMaster Universities Arthritis Index (WOMAC) score, and Forgotten Joint Score (FJS) of the MP group were found to be significantly superior to those of the DH group. Comparable complication and revision rates were observed between the two groups. The radiographic results were also equally good between MP and DH groups.

Conclusions

Although the mid-term clinical and radiographic outcomes of the DH inserts are fairly good, the clinical scores of the DH group were worse than those of the MP group.
Biomechanical analysis of vertebral wedge deformity in elderly women with quantitative CT-based finite element analysis
Authors: Liu Jing , Cheng Xiaodong , Wang Yan , Zhang Ping , Gao Lei , Yang Xingyuan , He Shaoqiang , Liu Ying , Zhang Wei
Published: June 2022

Background

To explore the vertebral deformity angle (VD angle) of 1st lumbar vertebral body (L1) in elderly women, investigate the influence of VD on vertebral stiffness (VS) by biomechanical analysis using quantitative computed tomography-based finite element analysis (QCT-FEA).

Methods

Two hundred seventy eight participants were recruited, and underwent QCT scan. Measured VD angles of L1, and constructed QCT-FEA models of L1 with the minimum (0.59°), median (5.79°) and maximum (11.15°) VD angles, respectively. Loads in two directions were applied on the upper edge of L1 with a force of 700 N, and vertebral stiffness (VS) was defined as the ratio of 700 N and displacement at the superior reference point: (1) perpendicular to the upper edge of L1 (defined as VS-U); (2) perpendicular to the lower edge of L1(defined as VS-L).

Results

Age was very weak positively correlated with VD angle, moderate negatively correlated with vBMD, and moderate negatively correlated with VS (P < 0.05). VS-U was significantly different among three VD angles, so was VS-L (P < 0.001). VS-U was higher than VS-L in 5.79° and 11.15° VD angles (P < 0.05), however no difference in 0.59° VD angles (P > 0.10).

Conclusions

VD angle of L1 was slightly increased with age and not correlated with vBMD, and VS was moderate negatively correlated with age, showing that the vertebral body was more likely to fracture with aging. VS-U and VS-L were gradually decreased with the increase of VD angle, and VS-L was lower than VS-U with the increase of VD angle, which showed that vertebral body was more prone to fracture when the load was perpendicular to the lower edge of the vertebral body as the VD angle increasing.
Challenges encountered by family caregivers of prostate cancer patients in Cape Coast, Ghana: a descriptive phenomenological study
Authors: Owoo Benedicta , Ninnoni Jerry Paul , Ampofo Evelyn Asamoah , Seidu Abdul-Aziz
Published: June 2022

Background

In Ghana, prostate cancer is more prevalent than all other cancers, with a mortality rate of 75% partly due to late presentation to the health care facilities. Limited health services provision across the country and shortages of skilled nurses place a significant demand on family caregivers who are often ill-equipped for the caring role, resulting in many challenges. As they are expected to provide complex care at home with little resources, information, and support, the healthcare system rarely addresses the challenging needs of these family caregivers. This study explored the challenges encountered by family caregivers of people with prostate cancer.

Methods

We conducted interviews using a descriptive phenomenological approach. Twelve family caregivers of prostate cancer patients were selected through a purposive sampling technique at the Cape Coast Teaching Hospital. All interviews were recorded, transcribed, and analysed using Colaizzi’s (1978) data analysis approach.

Results

Three main themes were identified as critical challenges: education and training needs, resources and caregiver-nurse relationship issues. Under the three main themes emerged seven sub-themes that collectively hindered the family caregiver’s ability to meet the care demands. Sub-themes that emerged were; lack of preparedness towards the caring role, lack of knowledge about condition/ treatment, misconception about the condition, lack of accommodation facilities, financial constraints, poor communication, and poor staff attitude.

Conclusion

Caregiving is associated with significant challenges that hinder the family caregiver’s ability to care for the patient effectively, further diminishing the caregiver’s quality of life and patient care. Therefore, healthcare professionals, especially nurses, should consider these challenges family caregivers face and take measures to obviate them through education, preparation and support.
Effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses: a randomized controlled trial
Authors: Kousha Shohreh , Shahrami Ali , Forouzanfar Mohammad Mehdi , Sanaie Neda , Atashzadeh-Shoorideh Foroozan , Skerrett Victoria
Published: June 2022

Background

Witnessing or experiencing of incivility affected the nurses’ perception of the ethical climate and quality of their work life. The aim of this study was to investigate the effectiveness of educational intervention and cognitive rehearsal on perceived incivility among emergency nurses.

Method

This study was conducted as a randomized controlled parallel group clinical trial. Eighty emergency nurses participated in this study and were randomly assigned to intervention and control groups during December 2019—March 2020. Cognitive rehearsal program (include of definitions of incivility, ten common incivilities and appropriate practice methods for responding to each and role-plays) was delivered in five two-hour sessions over three weeks on different working days and shifts. The control group received only written information about what incivility is and how to deal with it before the implementation of intervention and one month after the completion of the training sessions, the demographic information form and the incivility scale were completed by the nurses.

Results

The results showed that there was a significant effect on overall incivility, general incivility, and supervisor incivility between the intervention and control groups. However, these significant reductions were seen in control group who received only written education. There were no significant differences in nurse's incivility towards other nurses, physician incivility, and patient/visitor incivility between the two groups.

Conclusion

The cognitive rehearsal program did not decrease perceived incivility among emergency department nurses in the short term.

Trial registration

Our research was registered on clinicaltrials.gov. Registration number: IRCT20200714048104N1, first registration 16/07/2020.