bluuebunny/crossref_metadata_2025 huggingface dataset:
Medically Assisted Procreation and Same-Sex Couples: The Italian Corte di Cassazione Stands its Ground
Authors: Maoli Francesca
Published: December 2022

This contribution examines a recent ruling of the Italian Corte di Cassazione, concerning the recognition of parentage resulting from medically assisted procreation (“map”) techniques performed abroad by female same-sex couples. In cases where the birth of the child occurs in Italy, the Italian birth certificate usually contains the indication of the woman who gave birth, but does not mention the intentional mother, even when the latter has a biological relationship with the child. The Corte di Cassazione has confirmed its consolidated position in denying the amendment of the birth certificate, on the basis of a rigorous interpretation of the limits provided by the Law No. 40/2004. The Italian law prohibits the access of map techniques by same-sex couples, because their condition cannot be equated to a pathological infertility. The ruling under review overlooks the human rights implications possibly deriving from the recognition of intentional motherhood: in rejecting the allegations concerning the infringment of the fundamental rights enshrined by the European Convention on Human Rights (“echr”), the court has stated that the gaps in protection that may result from the application of Italian law may only be solved through an intervention of the lawmaker.
Poachers, Smugglers, Polluters and Other Environmental Criminals.
Authors: La Manna Mariangela
Published: December 2022

The review examines a recent publication on the International and EU law regimes governing environmental criminality. Following the structure of the book, the review accounts for both regimes, first by examining the main multilateral environmental agreements (“mea s”) accounted for in the first part of the publication, i.e. the Cites, Basel, and Marpol Conventions, then moving onto the relevant pieces of legislation under EU law, i.e. the Environmental Crime Directive and the Pollution from Ships Directive, only to acknowledge, consistently with the authors of the publication under review, the need for clearer and more stringent criminal provisions, coupled with enhanced forms of international cooperation, involving States, agencies, and international organizations alike.
International Criminal Law: Bone of Contention or Interdisciplinary Cooperation Opportunity?
Authors: La Manna Mariangela
Published: December 2022

The book review tackles Judge Aitala’s recently published International Criminal Law textbook and addresses its main features both against the background of existing textbooks and in light of the different conceptual and methodological toolkits used by international lawyers, on the one hand, and criminal lawyers, on the other, in their daily activities. It its purported that the two different groups should not think of icl as a bone of contention, but as an opportunity to cooperate and put to good use their respective knowledge and competence, instead.
Covenants and Craftsmanship in Gabriel’s World
Authors: Saillant John
Published: December 2022

This essay provides the theological background and the religious material culture context of Gabriel’s rebellion, Richmond, Virginia, 1800. Gabriel and some of his conspirators attended a covenanted Baptist church in Richmond. They adapted the idea of a covenant for a document in which they pledged with their signs or signatures, as enslaved men, to rise against their masters. They also engaged in theologically-inspired discourse about the sacred purpose of the material weapons they would use in their uprising. Additionally, scholars can today see meanings in other elements of their social world, such as food and alcohol. Alcohol consumption became a focus of the conspirators’ trial and one of the enslaved witnesses came to see sacred significance in it because he almost certainly understood that if he testified to exonerate his companions from suspicion of drunkenness he could save their lives.
Hoku—A Multispectral Software Tool to Recover Erased Writing on Palimpsests
Authors: Knox Keith T.
Published: December 2022

An image processing software package called Hoku is available to the public, free-of-charge, for use in recovering erased text from multispectral images of palimpsests. This software was developed by the author for his own use in recovering text, but has been built with an intuitive user interface that makes it suitable for non-technical users. It is written in Java and runs on both Windows and macOS computers. In this article, examples will be given of Hoku image processing results on data sets from three imaging systems—MegaVision, Phase One, and Lumiere Technology.
History of Palimpsest Photography in the Vatican Library
Authors: Altamura Irene , Angelini Emanuele , Massino Roberta , Schuler Irmgard
Published: December 2022

This paper focuses on the nearly 200-year history of reproduction and imaging of the famous correspondence of Fronto, transmitted in a palimpsest from the Abbey of Bobbio the pages of which are now kept in the Biblioteca Ambrosiana (Milan) and in the Vatican Library. In addition to the general difficulty in accessing an undertext, these pages present different problems that compromise the reading of Fronto. The application of chemical reagents and gelatin has left organic and inorganic material on the parchment. Together with the effects of humidity and changes in temperature, these make photographic recovery a special challenge. The ways and means for creating and processing reproductions and images of this palimpsest text, from the time of Angelo Mai to modern photography and digital images, will be illustrated.
Clinical Demographics of Laparoscopic Cholecystectomy: A Gender-Specific Analysis
Authors: Matsushima Kazuhide , Ciesielski Katharine M. , Mandelbaum Rachel S. , Matsuo Koji
Published: December 2022

Given the evolving clinical demographics and both surgical and perioperative management strategies related to laparoscopic cholecystectomy (LAP-CHOL), continued monitoring of patient characteristics undergoing this procedure is of value. In an analysis of 2 345 246 patients who underwent LAP-CHOL identified in the Healthcare Cost and Utilization Project’s Nationwide Ambulatory Surgery Sample from 1/2016-12/2019 (female n = 1 722 420 [73.4%] and male n = 622 827 [26.6%]), female patients were more likely to be younger and obese but less likely to be smoker and have medical comorbidity compared to male patients. Moreover, female patients were more likely to have a diagnosis of cholelithiasis but less likely to have a diagnosis of cholecystitis compared to male patients. This was particularly robust in younger age. In conclusion, this contemporary national-level analysis suggested that there are distinct differences in the clinical characteristics of patients undergoing LAP-CHOL according to gender. Awareness and reconciliation of these gender-specific differences would be important in clinical practice.
Persistent Hypoxia After Blunt Thoracic Trauma due to Flail Tricuspid Valve Leaflet and Patent Foramen Ovale
Authors: Toomey Nikia T. , Doño Angel , Lounsbury Cassidy , Byerly Saskya , Craig John , Decampli William M. , Lenart Emily K.
Published: December 2022

Structural cardiac injury after blunt trauma is uncommon but usually life-threatening. While tricuspid injury is very rare and potentially lethal, the right heart can accommodate larger volumes and higher pressures in acute tricuspid insufficiency and facilitate initial stabilization prior to definitive valvular repair. ECMO may be used to ameliorate resulting right heart failure. The traumatic force required to cause cardiac structural injury is also associated with pulmonary complications related to pneumothorax, hemothorax, effusion, acute pain secondary to rib fractures, and pulmonary contusions causing hypoxia. We present an unusual case of hypoxia in a trauma patient caused by acute tricuspid regurgitation with pre-existing patent foramen ovale.
Convivial Gardens: Genesis 2–3 in Agrarian and Space-Critical Perspective
Authors: Gruseke Alison Acker
Published: December 2022

Genesis 2–3 is among the most beloved yet misunderstood texts in the Hebrew Bible. Many biblical and post-biblical interpretations focus on themes of sin, death, and God’s banishment of Adam and Eve from the Garden of Eden. These have fostered misapprehensions regarding the value of God’s creation and the dangerous image of an “Old Testament God of wrath.” This essay uses space-critical analysis to focus on the spaces of Eden—from ground to bodies to gardens—to show that Ivan Illich’s notion of “conviviality” best captures Eden’s true ethic of cooperation, environmental caretaking, and the positive portrait a gentle God who makes humans by hand.
Orienting a Transnational Lived Theology for Asian America: Becoming Friends on the Way
Authors: Law Easten
Published: December 2022

Reflecting on the life and death of Feng Daoyou, one of the victims of the 2021 Atlanta shootings, this article introduces a transnational orientation for discerning lived theology focused on the liminal and contingent natures of Asian American experience applied across cultural and geographical contexts between Asia and America. This orientation is rooted in three traits: an abductive posture toward the unfamiliar; a critical impulse toward nationality and empire; and a co-constructive sensibility that embraces our shared conditions across boundaries. These traits are illustrated with the author's research with mainland Chinese Christian sojourners in Hong Kong and examples from new media outlets that explore transnational links and religious heritages.
“Sober Message to Parents”: Representations of Parents in Australian News Media on Youth Drinking
Authors: Cook Megan , Caluzzi Gabriel , Pennay Amy
Published: December 2022

Traditional news media can both reflect and shape public perceptions, including expectations relating to alcohol and parenting. This paper examines representations of parents in Australian news media reporting on youth drinking to understand how parental standards related to alcohol are constructed and articulated. 150 news articles were sampled from a larger study of youth drinking, in which we identified four representations of parents—parents as to blame, good parents, parents as lost and parents as victims. These four representations of parents reflect dominant neoliberal ways of governing, which promote parental education, best practice standards and responsibility as solutions to concerns around youth drinking. We examine the way politicians, research findings and legal directives (most commonly secondary supply laws) were deployed to attribute parental responsibility and standards of care. While parents as “to blame” or as irresponsible was concretely established in the articles, good parents were far more elusive and strategically individualized in ways that abdicated responsibility from the state, industry and structural burdens. As such, while media representations were able to define and moralize bad parents and parenting practices when it came to youth drinking, what it meant to be a “good parent” was often an ambiguous ideal. We suggest these media representations contribute to intensive parenting standards by providing another platform in which parental behaviors can be publicly scrutinized and moralized.
Oppression by omission: An analysis of the #WhereIsTheInterpreter hashtag campaign around COVID-19 on Twitter
Authors: Lattimer Tahleen A , Ophir Yotam
Published: December 2022

Critical to managing a crisis such as COVID-19 is the propagation of information to all vulnerable populations. Despite guidelines regarding communicating with people with differing accessibility needs during crises, some often find their needs unmet. Following a lack of assisted communications for d/Deaf people during the COVID-19 pandemic, a Twitter hashtag campaign, #WhereIsTheInterpreter, was launched in the UK, protesting the lack of accessibility during official press briefings around the epidemic. The campaign received support from across the globe. This study analyzes the discourse around the campaign in tweets published from March 1st, 2020 and September 30th, 2021 ( N = 27,021) and analyzed the corpus using the Analysis of Topic Model Network (ANTMN) approach. We identified four major themes of discourse: discrimination, accessibility challenges, communication gaps and barriers, and Deaf rights. We analyze the discourse through the perspective of Critical Disability Theory (CDT) and hashtag activism, and discuss practical and theoretical implications.
Novel mutation in the MPZ gene causes early-onset but slow-progressive Charcot–Marie–Tooth disease in a Russian family: a case report
Authors: Kozina Anastasiya Aleksandrovna , Baryshnikova Natalia Vladimirovna , Ilinskaya Anna Yurievna , Kim Anna Alexandrovna , Plotnikov Nikolay Alekseevich , Pogodina Nadezhda Andreevna , Surkova Ekaterina Ivanovna , Shatalov Peter Alekseevich , Ilinsky Valery Vladimirovich
Published: December 2022

Charcot–Marie–Tooth disease (CMT) is a genetically heterogeneous group of peripheral neuropathies most of which are associated with mutations in four genes including peripheral myelin protein-22 ( PMP22), myelin protein zero ( MPZ), gap junction protein beta1 ( GJB1) and mitofusin2 ( MFN2). This current case report describes the clinical and genetic characteristics of a 6-year-old male proband. A physical examination revealed muscular hypotonia. He started walking on his own at 18 months. A nerve conduction study with needle electromyography revealed conduction block. A novel MPZ mutation (c.398C > T, p.Pro133Leu) was revealed in the proband. This mutation was also found in the 32-year-old father of the proband. The father had had deformity of the feet and distal muscle weakness since childhood. The novel p.Pro133Leu pathogenic mutation was responsible for early onset but slowly progressive CMT1B. We assume that this site is an intolerant to change region in the MPZ gene. This variant in the MPZ gene is an important contributor to hereditary neuropathy with reduced nerve conduction velocity in the Russian population. This case highlights the importance of whole exome sequencing for a proper clinical diagnosis of CMT associated with a mutation in the MPZ gene.
Standing on the pavement talking critically about educational leadership
Authors: Gunter Helen M
Published: December 2022

Educational professionals are not ordinary everyday critics using experiential expertise to comment on practice. Instead, they are critical researchers who are concerned with debates about the purposes of education, social justice and equity, and how research is vital to understanding and explaining change. Using the reflexive views of six educational professionals interplayed with my own research career I examine what this means in reality, and I consider how and why such critical research is subject to criticism, but how doctoral studies not only confront this but also develop significant ways of thinking and doing as professionals.
Disciplinary Maturity in Moving From Nurse Scientist to Nursing Scientist
Authors: Reed Pamela G.
Published: December 2022

In this article, I discuss a provocative recommendation by the American Association of Colleges of Nursing for research doctorate education as it relates to nursing education and the broader question whether nursing scientists should be nurse scientists. I use tools from the tradition of analytic philosophy to examine issues and language underlying this discussion about nursing science, knowledge, and practice. I draw some conclusions based on my review of the association’s documents and from philosophical perspectives on nursing science and practice.
Theoretical Substruction of Resilience Theory: Dementia Caregivers’ Burden and Their Care Recipients’ Behavior
Authors: Bekhet Abir K.
Published: December 2022

Theoretical substruction is vital in clarifying models and guiding research. In this article, the process of theoretical substruction was examined through resilience theory to provide an example of the congruence between theoretical and operational definitions in nursing research. The author examines the significance of resilience theory in the context of dementia caregivers’ burden and their care recipients’ behavioral problems. The steps of theoretical substruction are included, and a model of resilience is presented that includes middle-range concepts, relational statements, and propositions derived from the research literature. The rigorous process of theoretical substruction provides an example of a theoretically sound basis for exploring the role of positive thinking in the lives of dementia caregivers and their care recipients. Geropsychiatric nurses working with dementia patients and their caregivers should consider the role of positive thinking in decreasing caregivers’ burden.
An investigation on the modelling of a finite porous liner for the sound propagation in a rectangular duct
Authors: Song Xiang , Xu Jingjian , Yuan Tianyue , Sun Wenhao , Sui Dan , Xiao Heye , Zhou Jie
Published: December 2022

Acoustic liners take an essential role in the noise attenuation in ducts. In this work, the multimodal method based on the finite-difference method is extended to predict the acoustic field in a rectangular duct lined with a finite porous material and validated by the experiment. A modified immersed interface method is developed for the air–porous interface problem in the extended multimodal method without flow. When the flow exists, the treatments of the air–porous interface problem and the continuity of pressure between the wall and liner are also given. Three ways of describing the porous liner using the surface impedance at normal incidence named normal impedance, the surface impedance at grazing incidence named shear impedance and a cavity filled with the equivalent fluid of porous material are introduced. The comparison among the three ways reveals that the extended method of treating liners using a cavity filled with the equivalent fluid is more accurate for the acoustic evaluation of porous liners. The analysis finds that the shear impedance can reasonably present the influence of porous material during the comparisons of transmission loss curves of the liners with different lengths and depths at different Mach numbers. In most cases, the prediction by the shear impedance is closer to that simulated by the cavity filled with porous material than the normal impedance. Normal impedance is hardly utilized to describe the porous material and is only reliable when the cavity is very short and deep.
Laser photocoagulation of a hypofluorescent perifoveal exudative vascular anomalous complex/capillary macroaneurysm
Authors: Sagar Pradeep , Sahare Harshal , Shanmugam P Mahesh , Biswal Suchitra , Ravishankar H N
Published: December 2022

Purpose

To report successful treatment of a hypofluorescent perifoveal exudative vascular anomalous complex (PEVAC)/capillary macroaneurysm.

Case description

A 63 year old healthy gentleman had a perifoveal isolated aneurysmal lesion with white rim. Optical coherence tomography (OCT) showed cystoid macular edema (CME) with neurosensory detachment. The aneurysmal lesion was seen in the inner retina as a hyperreflective intraretinal structure with a heterogenous lumen suggestive of PEVAC/capillary macroaneurysm. OCT angiography showed a capillary loop and a slightly hyperreflective lesion at the tip of the loop in the superficial capillary plexus slab. Minimal reduction in edema was noted following one dose of intravitreal triamcinolone (2 mg). Fundus fluorescein angiography performed at 6 weeks demonstrated the capillary loop, but the aneurysmal lesion remained hypofluorescent with no definite leak in the late phase. Few perifoveal microaneurysms were seen in both the eyes. Six weeks later, focal laser photocoagulation of the aneurysmal lesion was performed, which resulted in complete resolution of macular edema at 1 month. There was no recurrence of macular edema till his recent follow up, which is 4 month post laser.

Discussion

PEVAC is typically described as unifocal lesion and is not associated with other retinal vascular abnormalities. But in this case, in addition to the lesion, perifoveal microaneurysms were seen in both the eyes. Despite the absence of leak on fundus fluorescein angiography, targeted focal laser photocoagulation resulted in complete resolution of macular edema at 1 month.

Conclusion

Laser photocoagulation would be helpful even in hypofluorescent PEVAC/capillary macroaneurysms.
Early return to activity of daily living after total hip arthroplasty: a systematic review and meta-analysis
Authors: Zampogna Biagio , Papalia Giuseppe Francesco , Parisi Francesco Rosario , Luciano Claudia , Gregori Pietro , Vorini Ferruccio , Marinozzi Andrea , Farsetti Pasquale , Papalia Rocco
Published: December 2022

Background:

Total hip arthroplasty (THA) is an orthopaedic procedure that improves the quality of life in patients suffering from hip pain related to osteoarthritis, fractures, and avascular osteonecrosis of the femoral head. Different surgical approaches can be used for THA leading to different recovery times. Because of the lowering medium age of people undergoing THA, it is important to focus on the earlier return of physiological activity after surgery.

Aim:

To evaluate the best approach for THA in terms of earlier return to activity.

Method:

Studies comparing the postoperative outcomes in patients who underwent THA through different approaches were analysed focusing on patients’ self-reported outcomes, ADL score and UCLA activity score with a short follow-up.

Results:

A total of 1990 articles were identified in the search, and 14 met the inclusion criteria. The Review Manager software version 5.4 was used to conduct a meta-analysis to compare the direct anterior (DAA) and posterior (PA) approaches, which are the most adopted approaches. An earlier return to walk without aids and to independent ADLs were reported with DAA, but without statistical significance (respectively p  = 0.06 and p  = 0.10). The time to return to drive was similar among the 2 groups ( p  = 0.88). The return to work was faster with PA, but no statistical significance was reported ( p  = 0.47).

Conclusions:

Further studies are needed with a larger number of patients, that present homogeneous outcomes, follow-ups and rehabilitation programmes, and that compare similar surgical approaches to assess the early return to activity of daily living after THA.
Introduction: Surveying the survey
Authors: Rowe David , Bennett Tony
Published: December 2022

This article reviews the terms in which the Australian Cultural Fields project engaged with the concepts of fields, capitals, and habitus. It also places these concepts in the context of their longer histories of use and interpretation in Bourdieusian sociology, and identifies the new inflections acquired in bringing them to bear on the relations between culture and inequality in Australia. It involves a discussion of some of the key dynamics that have characterised the relations across and between the six cultural fields selected for study in the Australian Cultural Fields project – the art, literary, sport, television, heritage, and music fields – since the landmark 1994 Creative Nation cultural policy statement of the Keating Labor government. This analytical elaboration is followed by a summary of the main findings of both the survey and interview components of the project that are reported in Fields, Capitals, Habitus: Australian Culture, Inequalities and Social Divisions.
The Effectiveness of Population Mass Screening to Oral Cancer: A Simulation Study
Authors: Su Chiu-Wen , Su William Wang-Yu , Chen Sam Li-Sheng , Chen Tony Hsiu-Hsi , Hsu Tsui-Hsia , Chen Mu-Kuan , Yen Amy Ming-Fang
Published: December 2022

Background: Mass screening of high-risk populations for oral cancer has proven to be effective in reducing oral cancer mortality. However, the magnitude of the effectiveness of the various screening scenarios has rarely been addressed. Methods: We developed a simulation algorithm for a prospective cohort under various oral cancer screening scenarios. A hypothetical cohort of 8 million participants aged ≥30 years with cigaret smoking and/or betel quid chewing habits was constructed based on parameters extracted from studies on oral cancer screening. The results of a population-based screening program in Taiwan and a randomized controlled trial in India were used to validate the fitness; then, the effectiveness of the model was determined by changing the screening parameters. Results: There was a reduction in the risk of advanced oral cancer by 40% (relative risk [RR] = 0.60, 95% confidence interval [CI]:0.59-0.62) and oral cancer mortality by 29% (RR = 0.71, 95% CI: 0.69-0.73) at the 6-year follow-up in a screening scenario similar to the biennial screening in Taiwan, with a 55.1% attendance rate and 92.6% referral rate. The incremental effect in reducing advanced oral cancer was approximately 5% with a short 1-year screening frequency, and the corresponding reduction in mortality was, on average, 6.5%. The incremental reduction in advanced oral cancer per 10% increase in the compliance rate was 3% to 4%, while only 1% to 2% reduction was noted per 10% increase in the referral rate. The effectiveness of screening in reducing advanced oral cancer was 5% to 6% less when both betel quid chewing and alcohol drinking habits were present. Conclusion: Our computer simulation model demonstrated the effect of screening on the reduction in oral cancer mortality under various scenarios. The results provide screening policymakers with the necessary guidance to implement screening programs to save lives.
Journal editors and publishers’ legal obligations with respect to medical research misconduct
Authors: Holbeach Naomi , Freckelton AO QC Ian , Mol Ben W
Published: December 2022

As the burden of misconduct in medical research is increasingly recognised, questions have been raised about how best to address this problem. Whilst there are existing mechanisms for the investigation and management of misconduct in medical literature, they are inadequate to deal with the magnitude of the problem. Journal editors and publishers play an essential role in protecting the veracity of the medical literature. Whilst ethical guidance for journal editors and publishers is important, it is not as readily enforceable as legal obligations might be. This article questions the legal obligations that might exist for journal editors and publishing companies with respect to ensuring the veracity of the published literature. Ultimately, there is no enforceable legal obligation in Australia, the United Kingdom, or the United States. In light of this, more robust mechanisms are needed to deliver greater confidence and transparency in the investigative process, the management of concerns or findings of misconduct and the need to cleanse the literature. We show that the law disincentivises journals and publishers from ensuring truth in their publications. There are harmful consequences for medical care and public confidence in the medical profession and health care system when the foundations of medical science are questionable.
Vigabatrin-associated brain abnormalities on MRI in tuberous sclerosis complex patients with infantile spasms: are they preventable?
Authors: Wan Lin , He Wen , Wang Yang-Yang , Xu Yong , Lu Qian , Zhang Meng-Na , Wang Qiu-Hong , Dun Shuo , Liu Li-Ying , Shi Xiu-Yu , Wang Jing , Hu Lin-Yan , Zhang Bo , Yang Guang , Zou Li-Ping
Published: December 2022

Background:

Vigabatrin (VGB) is currently the most widely prescribed first-line medication for individuals with infantile spasms (IS) and especially for those with tuberous sclerosis complex (TSC), with demonstrated efficacy. Meanwhile, its adverse events, such as vigabatrin-associated brain abnormalities on magnetic resonance imaging (MRI; VABAM), have also been widely reported.

Objectives:

The objectives of this study were to observe the occurrences of VABAM in patients with IS caused by TSC (IST) and further explore the associated risk factors.

Methods:

Children with IS receiving VGB were recruited from our institution; clinical, imaging, and medication data were collected. Cerebral MRI was reviewed to determine the occurrence of VABAM. Group comparisons (IS caused by TSC and other etiologies) were performed; subgroup analyses on IST were also performed. Next, a retrospective cohort study of children taking VGB was conducted to explore risk/protective factors associated with VABAM.

Results:

The study enrolled 172 children with IS who received VGB. VABAM was observed in 38 patients (22.1%) with a peak dosage of 103.5 ± 26.7 mg/kg/day. Subsequent analysis found the incidence of VABAM was significantly lower in the 80 patients with IST than in the 92 patients with IS caused by other etiologies (10% versus 32.6%, p-value < 0.001). In subgroup analyses within the IST cohort, VABAM was significantly lower in children who received concomitant rapamycin therapy. Univariate and multivariate logistic regression analysis of the 172 IS children showed that treatment with rapamycin was the independent factor associated with a lower risk of VABAM; similar results were observed in the survival analysis.

Conclusion:

The incidence of VABAM was significantly lower in IST patients. Further research is needed to examine the mechanisms that underlie this phenomenon and to determine if treatment with rapamycin may reduce the risk of VABAM.
Gendered Pathways: Employment Behavior among Family-Based and Skill-Based Immigrants in the United States
Authors: Lee Rennie
Published: December 2022

The United States is the only country to admit the majority of its immigrants on the basis of kinship ties. Although policy makers typically view family migration as less favorable and assume that family immigrants do not contribute to the U.S. economy, this argument is oversimplified and ignores the role of gender and the various ways that family immigration works. This study captures the multiple aspects of immigrants’ entry visas and its intersection with gender to examine the employment behavior of college-educated immigrant men and women who arrived in the United States via several family-based and skill-based categories. Using nationally representative data from 2010, 2013, and 2015 National Survey of College Graduates, the author finds that immigrants’ initial entry pathways into the United States continue to stratify their employment behavior and trajectories, especially for immigrant women. The conditions of family-sponsored immigration matter; temporary migration as a spouse is negatively associated with immigrant women’s employment but not permanent family migration.
Predictive value of CAC score combined with clinical features for obstructive coronary heart disease on coronary computed tomography angiography: a machine learning method
Authors: Ren Yongkui , Li Yulin , Pan Weili , Yin Da , Du Jie
Published: December 2022

Objective

We investigated the predictive value of clinical factors combined with coronary artery calcium (CAC) score based on a machine learning method for obstructive coronary heart disease (CAD) on coronary computed tomography angiography (CCTA) in individuals with atypical chest pain.

Methods

The study included data from 1,906 individuals undergoing CCTA and CAC scanning because of atypical chest pain and without evidence for the previous CAD. A total of 63 variables including traditional cardiovascular risk factors, CAC score, laboratory results, and imaging parameters were used to build the Random forests (RF) model. Among all the participants, 70% were randomly selected to train the models on which fivefold cross-validation was done and the remaining 30% were regarded as a validation set. The prediction performance of the RF model was compared with two traditional logistic regression (LR) models.

Results

The incidence of obstructive CAD was 16.4%. The area under the receiver operator characteristic (ROC) for obstructive CAD of the RF model was 0.841 (95% CI 0.820–0.860), the CACS model was 0.746 (95% CI 0.722–0.769), and the clinical model was 0.810 (95% CI 0.788–0.831). The RF model was significantly superior to the other two models (p < 0.05). Furthermore, the calibration curve and Hosmer–Lemeshow test showed that the RF model had good classification performance (p = 0.556). CAC score, age, glucose, homocysteine, and neutrophil were the top five important variables in the RF model.

Conclusion

RF model was superior to the traditional models in the prediction of obstructive CAD. In clinical practice, the RF model may improve risk stratification and optimize individual management.
Amide proton transfer MRI differentiates between progressive multifocal leukoencephalopathy and malignant brain tumors: a pilot study
Authors: Koike Hirofumi , Morikawa Minoru , Ishimaru Hideki , Ideguchi Reiko , Uetani Masataka , Hiu Takeshi , Matsuo Takayuki , Miyoshi Mitsuharu
Published: December 2022

Background

Progressive multifocal leukoencephalopathy (PML) is a demyelinating disease of the central nerve system caused by the John Cunningham virus. On MRI, PML may sometimes appear similar to primary central nervous system lymphoma (PCNSL) and glioblastoma multiforme (GBM). The purpose of this pilot study was to evaluate the potential of amide proton transfer (APT) imaging for differentiating PML from PCNSL and GBM.

Methods

Patients with PML (n = 4; two men; mean age 52.3 ± 6.1 years), PCNSL (n = 7; four women; mean age 74.4 ± 5.8 years), or GBM (n = 11; 6 men; mean age 65.0 ± 15.2 years) who underwent APT-CEST MRI between January 2021 and September 2022 were retrospectively evaluated. Magnetization transfer ratio asymmetry (MTRasym) values were measured on APT imaging using a region of interest within the lesion. Receiver operating characteristics curve analysis was used to determine diagnostic cutoffs for MTRasym.

Results

The mean MTRasym values were 0.005 ± 0.005 in the PML group, 0.025 ± 0.005 in the PCNSL group, and 0.025 ± 0.009 in the GBM group. There were significant differences in MTRasym between PML and PCNSL (P = 0.023), and between PML and GBM (P = 0.015). For differentiating PML from PCNSL, an MTRasym threshold of 0.0165 gave diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of 100% (all). For differentiating PML from GBM, an MTRasym threshold of 0.015 gave diagnostic sensitivity, specificity, positive predictive value, and negative predictive value of 100%, 90.9%, 80.0%, and 100%, respectively.

Conclusion

MTRasym values obtained from APT imaging allowed patients with PML to be clearly discriminated from patients with PCNSL or GBM.
The impact of obesity on the accuracy of DXA BMD for DXA-equivalent BMD estimation
Authors: Kim Min-Woo , Lee Dong-Ha , Huh Jung-Wook , Bai Jang-Whan
Published: December 2022

Introduction

As the radiomics technique using texture features in CT is adopted for accessing DXA-equivalent bone mineral density (BMD), this study aims to compare BMD by DXA and predicted BMD to investigate the impact of obesity and central obesity in general patients.

Materials and methods

A total of 710 cases (621 patients) obtained from May 6, 2012, to June 30, 2021, were used in the study. We focused both their abdomen & pelvis CT’s first lumbar vertebrae axial cuts to predict estimated BMD and bone mineral content (BMC). In each patient’s CT, we extracted the largest trabecular region of the L1 vertebral body as a region of interest (ROI) using the gray-level co-occurrence matrices (GLCM) technique, and linear regression was applied to predict the indices. Cases were divided by central obesity/overall obesity and normal group by body mass index (BMI), waist circumference (WC), or index of central obesity (ICO) standard.

Results

The coefficients were all above 0.73, respectively. P-values from ICO were over 0.05 when the measures were Hip BMD and Hip BMC. In contrast, those from ICO were 0.0131 and 0.0351 when the measures were L1 BMD and L1 BMC, respectively, which show a difference between the two groups.

Conclusions

The CT HU texture analysis method was an effective and economical method for measuring estimated BMD and BMC and evaluating the impact of obesity. We found that central obesity especially exerted an effect on the disturbance of the clinical BMD measurements since groups were significantly different under the ICO standard.
Effect of predictors on incidence rate of pregnancy among reproductive age women on antiretroviral therapy at public hospitals of Jigjiga and Harar Towns, Eastern Ethiopia: a retrospective cohort study
Authors: Wariyo Abdi , Oljira Lemessa , Golicha Wako , Dirirsa Gebisa
Published: December 2022

Background

Globally, Human Immunodeficiency Virus (HIV) is the leading cause of death in women of reproductive age and accountable for a quarter of deaths during pregnancy in sub-Saharan Africa including Ethiopia. Introduction of antiretroviral therapy to women living with HIV highly improves lifestyle and the desire to have children. A comprehensive understanding of baseline predictors of pregnancy among women receiving ART essential to reduces unintended pregnancies, appropriate care, and preventing transmission from mother to child.

Objective

To determine the effect of baseline predictors on incidence rate of pregnancy among reproductive age women on antiretroviral therapy at public hospitals of Jigjiga and Harar town, Eastern Ethiopia from February 15 to march 15, 2020.

Methods

Retrospective cohort study was conducted on randomly selected 420 HIV-infected women using data recorded from September 11, 2014, to September 10, 2019 in Jigjiga and Harar town in Eastern Ethiopia. Simple random sampling was used to select study subjects from each hospital. Data were entered to Epi data version 3.2 and exported to Stata version 14.2 for analysis. Kaplan–Meier failure, and Cox proportional hazards model were used to estimate the incidence, and to identify predictors of pregnancy respectively. Variables which were significant (P value < 0.05) in the multivariate analysis were considered independent predictors of pregnancy.

Results

The overall incidence rate of pregnancy was 9.1 per 100 person-years (95% CI 7.19, 11.76). Being unadvanced HIV disease stage (AHR: 2.50; 95% CI 1.46, 4.19), having less than two children (AHR: 2.93; 95% CI 1.59, 5.40), and disclosed HIV status (AHR: 2.25; 95% CI 1.34, 3.79) were independent predictors of pregnancy.

Conclusion

The incidence rate of pregnancy among reproductive age women on ART was found to be considerable. Being unadvanced HIV disease stage, having less than two children, and disclosed HIV status were independent predictors of pregnancy. Thus, tailoring counseling have to be designed to enhance better pregnancy planning and consecutive health outcomes.
Cost-effectiveness analysis of dasatinib versus imatinib in pediatric philadelphia chromosome-positive acute lymphoblastic leukemia patients in China
Authors: Cao Wang , Yu Yuncui , Qiu Yingpeng , Liu Lu , Zhang Hao , Shi Liwei , Xiao Yue , Jia Lulu , Zhang Ruidong , Wang Xiaoling
Published: December 2022

Background

Dasatinib and imatinib are the recommended tyrosine kinase inhibitors (TKIs) for treating pediatric Philadelphia-positive acute lymphoblastic leukemia (Ph + ALL), and the one which has been approved indication in China is imatinib. Recently, clinical demand for Ph + ALL treatment is becoming unmet gradually with the increasing resistance of imatinib. There are some studies reporting the better efficacy and comparative safety of dasatinib compared with imatinib, but no economic comparison has been published. This study aims to supplement economic evidence by comparing the cost-effectiveness between imatinib and dasatinib in treating pediatric patients with Ph+ ALL in China, and to help clinical rational drug use via multi-dimensional value assessment.

Methods

A decision tree model combined with a 10-year Markov model were established based on the disease progression. The parameters were collected from published literatures and our hospital’s electronic medical records. From the health system perspective, the incremental cost-effectiveness ratio (ICER) between the two treatment groups was calculated through cost-effectiveness analysis and then compared with the willingness-to-pay (WTP) threshold. The set WTP threshold in this study was 1 times per capita gross domestic product (GDP) of China, as recommended by the World Health Organization. Direct medical costs and quality-adjusted life years (QALYs) were calculated and discounted at 5%. The sensitivity analyses were conducted to assess the uncertainty and robustness of the results.

Results

The total costs were CNY 1,020,995.35 and CNY 1,035,788.50 in imatinib group and dasatinib group during the 10-year simulation, and the total QALYs were 2.59 and 4.84. Compared with the imatinib treatment group, the ICER was around CNY 6,575.78/ QALY, which was less than the set threshold CNY 70,892/ QALY. The sensitive analyses indicated the robustness of the results.

Conclusions

The cost-effectiveness analysis shows the potential cost-effective advantages of adding dasatinib comparing with adding imatinib for pediatric Ph + ALL patients in China under the set WTP threshold, which indicates that those patients could achieve more QALYs by paying acceptable fee.
Conceptualizing the effective mechanisms of a social needs case management program shown to reduce hospital use: a qualitative study
Authors: Fleming Mark D. , Safaeinili Nadia , Knox Margae , Hernandez Elizabeth , Esteban Emily E. , Sarkar Urmimala , Brewster Amanda L.
Published: December 2022

Background

Social needs case management programs are a strategy to coordinate social and medical care for high-risk patients. Despite widespread interest in social needs case management, not all interventions have shown effectiveness. A lack of evidence about the mechanisms through which these complex interventions benefit patients inhibits effective translation to new settings. The CommunityConnect social needs case management program in Contra Costa County, California recently demonstrated an ability to reduce inpatient hospital admissions by 11% in a randomized study. We sought to characterize the mechanisms through which the Community Connect social needs case management program was effective in helping patients access needed medical and social services and avoid hospitalization. An in-depth understanding of how this intervention worked can support effective replication elsewhere.

Methods

Using a case study design, we conducted semi-structured, qualitative interviews with case managers (n = 30) and patients enrolled in social needs case management (n = 31), along with field observations of patient visits (n = 31). Two researchers coded all interview transcripts and observation fieldnotes. Analysis focused on program elements identified by patients and staff as important to effectiveness.

Results

Our analyses uncovered three primary mechanisms through which case management impacted patient access to needed medical and social services: [1] Psychosocial work, defined as interpersonal and emotional support provided through the case manager-patient relationship, [2] System mediation work to navigate systems, coordinate resources, and communicate information and [3] Addressing social needs, or working to directly mitigate the impact of social conditions on patient health.

Conclusions

These findings highlight that the system mediation tasks which are the focus of many social needs assistance interventions offered by health care systems may be necessary but insufficient. Psychosocial support and direct assistance with social needs, enabled by a relationship-focused program, may also be necessary for effectiveness.
Ethanol tolerance of Clostridium thermocellum: the role of chaotropicity, temperature and pathway thermodynamics on growth and fermentative capacity
Authors: Kuil Teun , Yayo Johannes , Pechan Johanna , Küchler Jan , van Maris Antonius J. A.
Published: December 2022

Background

Clostridium thermocellum is a promising candidate for consolidated bioprocessing of lignocellulosic biomass to ethanol. The low ethanol tolerance of this microorganism is one of the remaining obstacles to industrial implementation. Ethanol inhibition can be caused by end-product inhibition and/or chaotropic-induced stress resulting in increased membrane fluidization and disruption of macromolecules. The highly reversible glycolysis of C. thermocellum might be especially sensitive to end-product inhibition. The chaotropic effect of ethanol is known to increase with temperature. This study explores the relative contributions of these two aspects to investigate and possibly mitigate ethanol-induced stress in growing and non-growing C. thermocellum cultures.

Results

To separate chaotropic from thermodynamic effects of ethanol toxicity, a non-ethanol producing strain AVM062 (Pclo1313_2638::ldh* ∆adhE) was constructed by deleting the bifunctional acetaldehyde/alcohol dehydrogenase gene, adhE, in a lactate-overproducing strain. Exogenously added ethanol lowered the growth rate of both wild-type and the non-ethanol producing mutant. The mutant strain grew quicker than the wild-type at 50 and 55 °C for ethanol concentrations ≥ 10 g L−1 and was able to reach higher maximum OD600 at all ethanol concentrations and temperatures. For the wild-type, the maximum OD600 and relative growth rates were higher at 45 and 50 °C, compared to 55 °C, for ethanol concentrations ≥ 15 g L−1. For the mutant strain, no positive effect on growth was observed at lower temperatures. Growth-arrested cells of the wild-type demonstrated improved fermentative capacity over time in the presence of ethanol concentrations up to 40 g L−1 at 45 and 50 °C compared to 55 °C.

Conclusion

Positive effects of temperature on ethanol tolerance were limited to wild-type C. thermocellum and are likely related to mechanisms involved in the ethanol-formation pathway and redox cofactor balancing. Lowering the cultivation temperature provides an attractive strategy to improve growth and fermentative capacity at high ethanol titres in high-cellulose loading batch cultivations. Finally, non-ethanol producing strains are useful platform strains to study the effects of chaotropicity and thermodynamics related to ethanol toxicity and allow for deeper understanding of growth and/or fermentation cessation under industrially relevant conditions.