bluuebunny/crossref_metadata_2025 huggingface dataset:
Behavioral Acquisition Methods With Infants
Authors: Perkins Laurel , Lidz Jeffrey L.
Published: September 2023

This chapter reviews key findings in the domain of infant syntax, covering both the methods used to explore infant syntax and the discoveries linguists have made concerning the growth of syntactic knowledge. We first explore children’s initial steps in acquiring the syntactic categories of their language, how children use distributional evidence to build these categories and how these distributional properties are used in making syntactic and semantic inferences. Second, we examine children’s early phrase structure representations, focusing on hierarchical structure, the canonical order of subjects, verbs and objects, and the emergence of language-specific properties of clauses, such as the licensing of null subjects. Finally, we turn to infants’ acquisition of grammatical dependencies, exploring when and how infants detect dependencies that hold across non-adjacent morphemes in particular syntactic environments, dependencies that involve movement and dependencies that involve binding. This review provides a clear summary of both the prospects and challenges for examining syntax in infancy. While infant research must face the challenge that infants are limited in their behavioral repertoire, at the same time, studying infant syntax represents the frontier of our knowledge about the emergence of grammar. Gaining a richer understanding of infants’ sensitivities and their ability to make inferences from distributional observations to syntactic representations may ultimately help us to better understand how the language faculty allows us to acquire whatever language we are exposed to.
Artificial language learning
Authors: Culbertson Jennifer
Published: September 2023

Artificial language learning experiments have been used for decades by language acquisition researchers interested in how learners derive representations and make generalizations based on exposure to limited data. Recently, they have been co-opted by theoretical linguists to test hypotheses about how properties of human cognition shape natural language phonology, morphology, and syntax. Empirical evidence derived from these methods has been used to build more precise accounts of the link between how languages are learned (and processed) and cross-linguistic tendencies long-noted in the typological record. This chapter explains why artificial language learning is an important tool in the syntactician’s toolbox, what phenomena it has been used to study to date, and where research with these methods is heading in the future.
Typography
Authors: Misson James
Published: September 2023

The incendiary and hilarious pamphlets printed under the pseudonym Martin Marprelate in 1588 and 1589 contained some of the century’s weirdest typography. This chapter uses this unique episode in book history as a lens for the fundamentals of early modern English typography. It explores how the cultural and social circumstances of a text’s production are made legible in the design of the page, and how the sixteenth century’s multigraphy—its use of black letter, roman, and italic fonts at once—associated texts with certain times and certain places. New statistical research is used to demonstrate the idiosyncrasies of these pamphlets, and the norms in which they (and all early modern English books) participated.
‘The Book-sellars Shop’
Authors: Higgins Ben
Published: September 2023

This chapter examines early modern bookshops as vibrant homes of literary and material culture. ‘Outside’ imagines what a reader might notice about a typical bookshop from the street before ‘Inside’ crosses over the threshold to explore the various commodities and strategies found within. ‘Around’ explores connections between established bookshops and other forms of retail such as sheds, pedlars, and chapmen, before ‘Beyond’ briefly looks away from London and towards regional bookshops. Using a mixture of archival and printed evidence, the chapter argues that the ‘where’ of a book’s sale (on a stall board; in a back room; in a pedlar’s pack) imbued it with meaning and influenced how it was read. A bookshop was, the chapter contends, not only a physical place made of bricks and timber; it was also an environment that organized and regulated interpretative strategies.
Cataloguing the Past
Authors: Heffernan Megan
Published: September 2023

This chapter explores the polychronic history of early print, (1) with a sense of the increasing pace of sixteenth-century publication; (2) through the eighteenth-century consolidation of literary and print history; and (3) in twenty-first-century challenges to narratives of periodizing rupture. An attention to catalogues as the material and ideological tools that support bibliography helps unsettle simple developmental narratives of print and literature.
The Scale of Book History
Authors: Knight Jeffrey Todd
Published: September 2023

This chapter takes stock of the history of the book as a subfield of early modern literary studies amid the ongoing debates about scale and method that have shaped the discipline in recent years. It explores book history’s bifurcated genealogy, reaching back on one hand to the hyper-particularism of twentieth-century bibliography and bibliographic description, and on the other to the data-driven, wide-angle approaches of Annales School historiography. Looking forward, it asks what early modern book history can draw from (and contribute to) recent advances in the scale of literary study: from neo-philological ‘keywords’ approaches, the resurgent microhistory, and ‘copy-specific criticism’ to ‘distant reading’, ‘macroanalysis’, and ‘algorithmic criticism’, and from nations and periods to oceanic basins, ‘worlds’, and geological ‘deep time’ as literary history’s organizing basis.
Monuments and Trifles
Authors: Scott-Warren Jason
Published: September 2023

This chapter assesses the relationship between large and small books in early modern Britain. It explores that relationship in economic terms, thinking about how small print-jobs made large-scale printing possible; in material terms, pointing out that massive volumes were usually stitched together out of accumulations of smaller works; and in terms of the energies of modern scholarship, which has been as keen to explore the undergrowth of literary production as it has been to scale the mountain peaks. Finally the chapter turns to consider evidence of early modern readers who were enthusiasts both for weighty tomes and for catchpenny pamphlets, and of writers who played with the mysterious relationship between the miniature and the gigantic.
Cultural Attraction
Authors: Miton Helena
Published: September 2023

Cultural attraction theory, also known as the ‘Paris school’ in cultural evolution, has gained popularity over the past few decades as a framework for understanding cultural evolution. Cultural attraction emphasizes the role of transformation as the key mechanism in cultural evolution, in contrast to other frameworks that rely more heavily on analogies with biological evolution. Transformations routinely occur as part of cultural transmission episodes and contribute both to cultural stability and cultural change. At the heart of cultural attraction theory are also the concepts of cultural causal chains, cultural attractors, and factors of attraction. Cultural attraction theory can be used as a pluralistic framework in cultural evolution by articulating these three concepts. In particular, several empirical case studies in different domains have successfully used cultural attraction theory to relate cultural phenomena (attractors) to their causes (factors of attraction). Finally, cultural attraction theory has implications for cultural evolution at large, including by calling to consider a larger diversity of mechanisms as relevant to understand cultural evolution.
Fluorescence in situ hybridisation for interphase chromosomal aberration-based biological dosimetry
Authors: Meher Prabodha Kumar , Lundholm Lovisa , Wojcik Andrzej
Published: September 2023

Metaphase spreads stained with Giemsa or painted with chromosome-specific probes by fluorescence in situ hybridisation (FISH) have been in use since long for retrospective dose assessment (biological dosimetry). However, in cases of accidental exposure to ionising radiation, the culturing of lymphocytes to obtain metaphase chromosomes and analysis of chromosomal aberrations is time-consuming and problematic after high radiation doses. Similarly, analysing chromosomal damage in G0/G1 cells or nondividing cells by premature chromosome condensation is laborious. Following large-scale radiological emergencies, the time required for analysis is more important than precision of dose estimate. Painting of whole chromosomes using chromosome-specific probes in interphase nuclei by the FISH technique will eliminate the time required for cell culture and allow a fast dose estimate, provided that a meaningful dose-response can be obtained by scoring the number of chromosomal domains visible in interphase nuclei. In order to test the applicability of interphase FISH for quick biological dosimetry, whole blood from a healthy donor was irradiated with 8 Gy of gamma radiation. Irradiated whole blood was kept for 2 h at 37°C to allow DNA repair and thereafter processed for FISH with probes specific for Chromosomes-1 and 2. Damaged chromosomal fragments, distinguished by extra color domains, were observed in interphase nuclei of lymphocytes irradiated with 8 Gy. These fragments were efficiently detected and quantified by the FISH technique utilising both confocal and single plane fluorescence microscopy. Furthermore, a clear dose-response curve for interphase fragments was achieved following exposure to 0, 1, 2, 4 and 8 Gy of gamma radiation. These results demonstrate interphase FISH as a promising test for biodosimetry and for studying cytogenetic effects of radiation in nondividing cells.
Sex and dose rate effects in automated cytogenetics
Authors: Garty Guy , Royba Ekaterina , Repin Mikhail , Shuryak Igor , Deoli Naresh , Obaid Razib , Turner Helen C , Brenner David J
Published: September 2023

Testing and validation of biodosimetry assays is routinely performed using conventional dose rate irradiation platforms, at a dose rate of approximately 1 Gy/min. In contrast, the exposures from an improvised nuclear device will be delivered over a large range of dose rates with a prompt irradiation component, delivered in less than 1 μs, and a protracted component delivered over hours and days. We present preliminary data from a large demographic study we have undertaken for investigation of age, sex and dose rate effects on dicentric and micronucleus yields. Our data demonstrate reduced dicentric and micronucleus yields at very high dose rates. Additionally, we have seen small differences between males and females, with males having slightly fewer micronuclei and slightly more dicentrics than females, at high doses.
A standardized and automated CBMN assay for biological dosimetry: the CytoRADx™ system
Authors: Schunck Christian , Lörch Thomas , Kowalski Richard , Porter Michael , Mahnke Ryan , Capaccio Chris , Perrier Jay , Damer Ken
Published: September 2023

Major nuclear accidents can result in many casualties, and it is important to assess the absorbed radiation dose to support treatment decisions. Biological dosimetry (BD) allows retrospective determination of dose using biological markers. To achieve consistent cytogenetic assay results across labs, the current practice requires each lab to generate periodic, unique calibration curves using in vitro dose-effect experiments. Here, we present CytoRADx™, a standardized biodosimetry system that integrates automated dose calculation in a high-throughput platform without the need for lab-specific calibration curves. CytoRADx consists of an improved, standardized Cytokinesis Block Micronucleus assay combined with automated analysis utilizing an established slide scanning device. We tested CytoRADx for accuracy and reproducibility across different instruments, sites, days and operators. Our results demonstrate that CytoRADx eliminates the time-consuming, lab-specific calibration curves, allowing multiple laboratories to obtain consistent results and to distribute the testing burden in the event of a large-scale accident.
A preliminary report on retrospective dose assessment by FISH translocation assay in FDNPP Nuclear Emergency Worker Study (NEWS)
Authors: Abe Yu , Takashima Yoshio , Akiyama Miho , Tsuyama Naohiro , Takebayashi Kai , Nakayama Ryo , Goh Valerie S T , Sugai-Takahashi Misaki , Alkebsi Lobna , Ishii Kotaro , Kudo Kenichi , Sakai Akira , Kurihara Osamu , Miura Tomisato , Suto Yumiko , Akashi Makoto
Published: September 2023

In Japan, a national project of longitudinal health care and epidemiological research (NEWS) was developed in 2014 to analyse the effects of radiation on human health for workers who responded to the Fukushima Dai-ichi nuclear emergency in 2011. In 2018, peripheral blood for chromosome translocation analysis was collected from 62 workers. Retrospective dose assessment was performed with fluorescence in situ hybridisation translocation (FISH-Tr) assay. The range of estimated doses by FISH-Tr assay was 0–635 mGy, in which 22 workers had estimated doses of more than 189 mGy. Biological dose estimates were five times higher in workers with physically measured total exposure recordings above 70 mGy. It is likely that smoking and medical exposure caused the discrepancy between estimated biological and physical total exposure doses. Thus, there is a possibility that retrospective biodosimetry assessment might over-estimate occupational exposures to workers exposed to chronic radiation during nuclear emergency work.
Combination of CD49b and CD229 Reveals a Subset of Multipotent Progenitors With Short-Term Activity Within the Hematopoietic Stem Cell Compartment
Authors: Somuncular Ece , Su Tsu-Yi , Dumral Özge , Johansson Anne-Sofie , Luc Sidinh
Published: September 2023

Hematopoiesis is maintained by hematopoietic stem cells (HSCs) that replenish all blood lineages throughout life. It is well-established that the HSC pool is functionally heterogeneous consisting of cells differing in longevity, self-renewal ability, cell proliferation, and lineage differentiation. Although HSCs can be identified through the Lineage–Sca-1+c-Kit+CD48–CD34–CD150+ immunophenotype, the cell surface marker combination does not permit absolute purification of functional HSCs with long-term reconstituting ability. Therefore, prospective isolation of long-term HSCs is crucial for mechanistic understanding of the biological functions of HSCs and for resolving functional heterogeneity within the HSC population. Here, we show that the combination of CD229 and CD49b cell surface markers within the phenotypic HSC compartment identifies a subset of multipotent progenitor (MPP) cells with high proliferative activity and short-term reconstituting ability. Thus, the addition of CD229 and CD49b to conventional HSC markers permits prospective isolation of functional HSCs by distinguishing MPPs in the HSC compartment.
Receipt, uptake, and satisfaction with tailored DVD and patient navigation interventions to promote cancer screening among rural women
Authors: Rawl Susan M , Baltic Ryan , Monahan Patrick O , Stump Timothy E , Hyer Madison , Ennis Alysha C , Walunis Jean , Renick Katherine , Hinshaw Karen , Paskett Electra D , Champion Victoria L , Katz Mira L
Published: September 2023

Process evaluation is essential to understanding and interpreting the results of randomized trials testing the effects of behavioral interventions. A process evaluation was conducted as part of a comparative effectiveness trial testing a mailed, tailored interactive digital video disc (DVD) with and without telephone-based patient navigation (PN) to promote breast, cervical and colorectal cancer screening among rural women who were not up-to-date (UTD) for at least one screening test. Data on receipt, uptake, and satisfaction with the interventions were collected via telephone interviews from 542 participants who received the tailored interactive DVD (n = 266) or the DVD plus telephone-based PN (n = 276). All participants reported receiving the DVD and 93.0% viewed it. The most viewed sections of the DVD were about colorectal, followed by breast, then cervical cancer screening. Most participants agreed the DVD was easy to understand, helpful, provided trustworthy information, and gave information needed to make a decision about screening. Most women in the DVD+PN group, 98.2% (n = 268), reported talking with the navigator. The most frequently discussed cancer screenings were colorectal (86.8%) and breast (71.3%); 57.5% discussed cervical cancer screening. The average combined length of PN encounters was 22.2 minutes with 21.7 additional minutes spent on coordinating activities. Barriers were similar across screening tests with the common ones related to the provider/health care system, lack of knowledge, forgetfulness/too much bother, and personal issues. This evaluation provided information about the implementation and delivery of behavioral interventions as well as challenges encountered that may impact trial results.
Letrozole During Frozen Embryo Transfer in Women With Polycystic Ovarian Syndrome
Authors: Yuan Yuan , Chang Qiyuan , Wen Yangxing , Gao Jun , Huang Sunxing , Xu Yanwen , Zhou Canquan , Mai Qingyun
Published: September 2023

OBJECTIVE:

To compare live-birth rates between letrozole application and artificial cycle for endometrium preparation during frozen embryo transfer (FET) cycle among women with polycystic ovarian syndrome (PCOS).

METHODS:

A randomized controlled trial was conducted. Women with PCOS were randomized to letrozole application for ovulation induction compared with artificial cycle for endometrial preparation during FET. The primary outcome was live-birth rate per embryo transfer. Secondary outcomes included pregnancy-related outcomes, perinatal outcomes, and maternal complication rates. Assuming α=0.05 and 80% power, 186 patients per group were required to demonstrate a difference of 15% in live-birth rate: 205 patients (at least) per group were randomized to allow for a 10% dropout rate.

RESULTS:

Four hundred twenty patients were enrolled from 2018 to 2021. Two hundred ten patients were assigned to the letrozole application group, and 210 were assigned to the artificial cycle group. There was no difference in the live-birth rate (42.4% vs 42.9%, P=>.99). There was no difference in secondary outcomes, including clinical pregnancy rate (51.4% vs 56.2%, P=.378), implantation rate (51.8% vs 55.8%, P=.401), and miscarriage rate (8.6% vs 11.0%, P=.511). For perinatal outcomes, singleton birth weight was significantly higher in the artificial cycle group (3,108±56 g vs 3,301±58, P=.018), and the incidence of gestational diabetes mellitus (GDM) was significantly higher in letrozole application group (14.6% vs 5.6%, P=.050). The other outcome was no difference in maternal complications.

CONCLUSION:

There was no difference in pregnancy outcomes between letrozole application compared with artificial cycle for endometrial preparation in women with PCOS who underwent FET. The risk of GDM was higher in the letrozole application group, and the singleton birth weight was lower in the artificial cycle group.

CLINICAL TRIAL REGISTRATION:

Chinese Clinical Trial Registry, ChiCTR1800014746.
Using a Patient Educational Video to Improve Knowledge of Maternal Mortality Warning Signs
Authors: White Kelsey J. , Tortal Danna , Callahan Kathryn , Eng Kimberly , Hyland Michelle , Underwood Erica , Senter Lindsay , León-Martínez Daisy , Son Moeun , Lipkind Heather
Published: September 2023

OBJECTIVE:

To determine whether a community-informed, language-concordant postpartum video education campaign, developed with community input, improves patients' knowledge of warning signs for postpartum maternal mortality (infection, hemorrhage, hypertensive disorders, and postpartum depression) compared with routine discharge procedures.

METHODS:

A single-center, investigator-blinded, parallel-group randomized controlled trial of postpartum individuals who delivered at a large, urban, tertiary care hospital. Eligible participants were enrolled and completed a baseline knowledge questionnaire. After delivery, they were randomized to routine discharge education (control) or routine education plus video education (intervention). After discharge education, patient knowledge was again assessed in both groups before participants left the hospital. The primary outcome was the percentage of participants who showed improvement in their knowledge, measured by the number of correct questionnaire responses after education compared with their baseline, assessed as a binary outcome. A sample size of 150 (75 per group) was planned to detect a 25% absolute increase in the frequency of the primary outcome.

RESULTS:

From July to August 2022, 296 participants were screened and 200 were randomized (100 per group). Eighty-two percent of participants had college or graduate education, and 71.5% had commercial insurance. There was no significant difference in baseline characteristics. There was no statistically significant difference in the percentage of participants who improved their scores between the baseline and posteducation questionnaires (64.5% vs 50.0%, P=.09). However, the median posteducation questionnaire total score was significantly higher in the video education group (14 [interquartile range 12–15] vs 13 [interquartile range 12–14], P=.003). In addition, they more frequently reported that video education was “very helpful” (83.9% vs 72.5%, P=.23) and that they were “very satisfied” with their education (86.1% vs 75.5%, P=.29).

CONCLUSION:

Enhanced postpartum education through a novel video did not result in a statistically significant difference in frequency of improved score on the posteducation questionnaires but was associated with increased satisfaction with care.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT05159726.
Experiences and Communication Preferences in Pregnancy Care Among Patients With a Spanish Language Preference
Authors: Salinas Kevin E. , Bazan Maria , Rivera Luis , Butler Haylie , Larson Elysia , Guise Jeanne-Marie , Hacker Michele R. , Kaimal Anjali J. , Molina Rose L.
Published: September 2023

OBJECTIVE:

To explore Spanish-speaking patients' experiences and preferences regarding communication during pregnancy care with specific attention to language barriers.

METHODS:

Patients with a Spanish language preference who gave birth between July 2022 and February 2023 at an academic medical center were invited to participate in focus groups. Focus groups were held over Zoom, audio-recorded, transcribed in Spanish, translated into English, and reviewed for translation accuracy. Thematic analysis was conducted with deductive and inductive approaches. Three investigators double-coded all transcripts, and discrepancies were resolved through team consensus.

RESULTS:

Seven focus groups (27 total participants, range 2–6 per group) were held. Three key themes emerged regarding patient experiences and communication preferences when seeking pregnancy care: 1) language concordance and discordance between patients and clinicians are not binary—they exist on a continuum; 2) language-discordant care is common and presents communication challenges, even with qualified interpreters present; and 3) language discordance can be overcome with positive interpersonal dynamics between clinicians and patients.

CONCLUSION:

Our findings highlight the importance of relationship to overcome language discordance among patients with limited English proficiency during pregnancy care. These findings inform potential structural change and patient–clinician dyad interventions to better meet the communication needs of patients with limited English proficiency.
Metaplastic Breast Carcinoma
Authors: McMurtry Valarie , Cleary Allison S. , Ruano Ana L. , Lomo Lesley , Gulbahce H. Evin
Published: September 2023

Objectives:

Metaplastic breast carcinoma (MBC) is a rare, aggressive form of cancer comprising epithelial and mesenchymal elements. The purpose of this study was to use population-based data to review the clinicopathologic, molecular features, and outcomes of MBC.

Methods:

Surveillance, Epidemiology, and End Results Program (SEER) data were used to identify MBC and invasive ductal carcinoma (IDC), no special type (NOS) between 2004 and 2015. Results from Oncotype DX’s 21-gene assay linked to SEER registries were included for hormone receptor (HR)-positive tumors. χ2 analysis was performed to determine the differences between MBC and IDC. Kaplan-Meier curves and multivariate Cox proportional hazards models were used for breast cancer specific death (BCSD).

Results:

Compared with IDC, NOS (n=509,864), MBC (n=3876) were more likely to present at an older age, be black, have negative lymph nodes, be >2 cm, grade 3, and triple negative (TN). All subtypes [HR-positive/human epidermal growth receptor 2 (HER2)-negative, HR-positive/HER2-positive, HR-negative/HER2-positive, and TN] had higher BCSD than IDC, NOS. 22.3% of MBC cases were HR-positive. HR-positive MBCs tested for a recurrence score (RS) 65% were high-risk compared with 16.8% of IDC, NOS. Within the MBC cohort, no significant differences in BCSD were identified with respect to different molecular subtypes. In a fully adjusted model, TN or HER2-positive status did not adversely affect BCSD compared with HR-positive MBC.

Conclusions:

All molecular subtypes of MBC had a poorer prognosis compared with IDC, NOS. The different molecular subtypes of MBC did not affect the BCSD. HR-positive MBC patients had a significantly higher high-risk RS than IDC, NOS patients.
Fish Skin Graft: Narrative Review and First Application for Abdominal Wall Dehiscence in Children
Authors: Di Mitri Marco , Di Carmine Annalisa , Thomas Eduje , Iacobacci Giuseppe , Collautti Edoardo , D’Antonio Simone , Libri Michele , Gargano Tommaso , Lima Mario
Published: September 2023

Acellular fish skin grafts (FSGs) are tissue-based products created by minimally processing the skin of the Atlantic cod (Gadus morhua). The FSG is rich in omega-3 and facilitates tissue regeneration by supporting revascularization and ingrowth in the proliferation and remodeling phases of wound healing. FSG is structurally more similar to human skin than antiviral-processed skin substitutes such as amniotic membrane, and there are no known prion, bacterial, or viral diseases that can be transmitted from North-Atlantic cod to humans. The FSG is processed using a proprietary method that preserves the structure and lipid composition of the skin. FSG is CE marked, and US Food and Drug Administration cleared for multiple clinical applications in partial and full-thickness wounds. FSG is currently the only acellular dermal matrix product that does not originate from mammalian tissues. For this narrative review, Medline and UpToDate were used to include a total of 21 articles published from 2015 to 2022 about fish skin graft use. We also reported a case of a 7-year-old boy who underwent treatment with FSG for abdominal wall dehiscence at our department of pediatric surgery, IRCCS Sant’Orsola-Malpighi, Alma Mater Studiorum, University of Bologna, University Hospital of Bologna. FSG provides a valuable and sustainable treatment that improves wound healing in both adult and pediatric populations. We described the first application of an FSG for wound dehiscence of the abdominal wall in a pediatric patient, reporting how FSG was completely reabsorbed and improved the skin’s repair.
THE EFFECT OF INCREASING ACQUISITION SPEED ON OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IMAGES
Authors: Dolz-Marco Rosa , Muñoz-Solano Javier , Dechent Jan F. , Gallego-Pinazo Roberto
Published: September 2023

Purpose:

To evaluate the effect of two different A-scan rates on qualitative and quantitative parameters on optical coherence tomography angiography images in a clinical setting.

Methods:

Subjects undergoing a comprehensive ophthalmic examination were scheduled for optical coherence tomography angiography imaging using a new SPECTRALIS device allowing for 85 and 125 kHz scan rate. Consecutive registered 20° × 20° optical coherence tomography angiography images using both speeds were acquired using the follow-up tool. The acquisition time and the quality values of each scan were extracted and analyzed. The image quality was also graded in pairs by two independent graders.

Results:

Two-hundred and one eyes of 128 consecutive patients (67 males, 52.3%) were included. Mean acquisition time significantly decreased from 56.92 ± 24.6 seconds on the 85 kHz images to 39.39 ± 15.5 seconds on the 125 kHz images (P < 0.001). The percentage change in acquisition time showed a mean decrease of 28.47%. Mean Q value significantly decreased from 32.97 ± 2.8 dB on the 85 kHz images to 31.43 ± 2.6 dB on the 125 kHz images (P < 0.001). Overall, 92.5% of images were graded as equal or better at 125 kHz A-scan rate.

Conclusion:

The use of optical coherence tomography angiography in daily clinical practice may require higher A-scan rates for an optimal workflow. Increased speed may also reduce image sensitivity and thus image quality could be compromised. In this study, 125 kHz scan rate using SPECTRALIS showed significant benefit with reduction on the acquisition time and no clinically significant differences on image quality analysis. Further studies evaluating qualitative and quantitative data in specific retinal conditions and using other devices are required to confirm these results.
Study on Related Factors of the Treatment Zone After Wearing Paragon CRT and Euclid Orthokeratology Lenses
Authors: Kou Sasa , Ren Yaru , Zhuang Xinyu , Chen Yingjie , Zhang Xiaofeng
Published: September 2023

Objective:

To explore the influence factors of the treatment zone diameter (TZD) and its relationship with axial length growth (ALG) after wearing Paragon CRT and Euclid orthokeratology lenses.

Methods:

The right eye data of myopic patients wearing Paragon CRT and Euclid orthokeratology in the ophthalmology department of The First Affiliated Hospital of Soochow University were retrospectively reviewed from April 2019 to October 2022. The TZD and ALG were compared between the Paragon CRT and Euclid groups. The correlation factors of TZD after wearing lens for 1 month and the relationship between the overlapping treatment zone-to-pupil area ratio and the ALG after wearing lens for 1 year were analyzed between the two groups.

Results:

There were 160 patients (160 eyes) in the Paragon CRT group and 155 patients (155 eyes) in the Euclid group. After wearing lens for 1 month, the TZD in the Paragon CRT group (3.72±0.37 mm) was larger than that in the Euclid group (3.26±0.37 mm) (P<0.001). The stepwise multivariate linear regression analysis showed that the eccentricity at the flattest meridians (Em) and the central corneal thickness were correlated with the TZD in both groups (P<0.05). After wearing lens for 1 year, the ALG in the Paragon CRT group (0.32±0.20 mm) was larger than that in the Euclid group (0.25±0.20 mm) (P=0.001). The stepwise multivariate linear regression analysis showed that the initial wearing age and the overlapping treatment zone area-to-pupil area ratio were correlated with the ALG in both groups (P<0.05).

Conclusion:

For both the Paragon CRT and Euclid orthokeratology, the wearers with thicker central corneal thickness and smaller Em usually had a smaller TZD. In both groups, the overlapping treatment zone area-to-pupil area ratio was correlated with the ALG.
Age dependent benefit of neoadjuvant treatment in adenocarcinoma of the esophagus and gastroesophageal junction – a multicenter retrospective observational study of young versus old patients
Authors: Rompen Ingmar F. , Crnovrsanin Nerma , Nienhüser Henrik , Neuschütz Kerstin , Fourie Lana , Sisic Leila , Müller-Stich Beat P. , Billeter Adrian T.
Published: September 2023

Objectives:

To provide evidence for age-dependent use of neoadjuvant treatment by clinical comparisons of young (lower quartile, <56.6 y) versus old (upper quartile, >71.3 y) esophageal and esophagogastric-junction adenocarcinoma (EAC) patients.

Background:

Neoadjuvant treatment is the standard of care for locally advanced and node-positive EAC. However, the effect of age on oncological outcomes is disputable as they are underrepresented in treatment defining randomized controlled trials.

Methods:

Patients with EAC undergoing esophagectomy between 2001 and 2022 were retrospectively analyzed from three centers. Patients having distant metastases or clinical UICC-Stage I were excluded. Cox proportional hazards regression was used to identify the variables associated with survival benefit.

Results:

Neoadjuvant treatment was administered to 185/248 (74.2%) young and 151 out of 248 (60.9%) elderly patients (P=0.001). Young age was associated with a significant overall survival (OS) benefit (median-OS: 85.6 vs. 29.9 mo, HR0.62, 95%CI:0.42-0.92) after neoadjuvant treatment versus surgery alone. In contrast, elderly patients did only experience a survival benefit equaling the length of neoadjuvant treatment itself (median-OS: neoadjuvant 32.8 vs. surgery alone 29.3 mo, HR0.89, 95%CI:0.63-1.27). Despite the clear difference in median OS benefit, histopathological regression (Mandard-TRG 1/2) was similar (young 30.7% vs. old 36.4%, P=0.286). More elderly patients had dose reduction or termination of neoadjuvant treatment (12.4% vs. 40.4%, P<0.001).

Conclusion:

Old patients benefit less from neoadjuvant treatment compared to younger patients in terms of gain in overall survival. Since they also experience more side effects requiring dose reduction, upfront surgery should be considered as the primary treatment option in elderly patients.
Comparative efficacy on outcomes of C-CABG, OPCAB and ONBEAT in coronary heart disease: A systematic review and network meta-analysis of randomized controlled trials
Authors: Zhu Lin , Li Dongjie , Zhang Xu , Wan Sitong , Liu Yuyong , Zhang HongJia , Luo Junjie , Luo Yongting , An Peng , Jiang Wenjian
Published: September 2023

Importance:

Coronary artery bypass grafting (CABG) remains the gold standard for the treatment of multivessel and left main coronary heart disease. However, the current evidence about the optimal surgical revascularization strategy is inconsistent and is not sufficient to allow for definite conclusions. Thus, this topic needs to be extensively discussed.

Objective:

The aim of this present study was to compare the clinical outcomes of off-pump CABG (OPCAB), conventional on-pump CABG (C-CABG) and on-pump beating heart (ONBEAT) CABG via an updated systematic review and network meta-analysis of randomized controlled trials (RCTs).

Data Sources:

PubMed, Web of Science and the Cochrane Central Registry were searched for relevant RCTs that were published in English before December 1, 2021.

Study Selection

Published trials that included patients who received OPCAB, C-CABG and ONBEAT CABG were selected.

Data Extraction and Synthesis:

Two authors independently screened the search results, assessed the full texts to identify eligible studies and the risk of bias of the included studies, and extracted data. All processes followed the Preferred Reporting Items for Systematic Review and Meta-analysis of Individual Participant Data.

Main Outcomes and Measures:

The primary outcome was postoperative mortality in patients who underwent C-CABG, OPCAB or ONBEAT CABG. The secondary outcomes were postoperative myocardial infarction, stroke, and renal impairment in the three groups. The time point for analysis of outcomes was all time periods during the postoperative follow-up.

Results:

A total of 39385 patients (83,496.2 person-years) in 65 studies who fulfilled the prespecified criteria were included. In the network meta-analysis, OPCAB was associated with an increase of 12% in the risk of all-cause mortality when compared with C-CABG (OR: 1.12; 95% CI: 1.04 to 1.21), a reduction of 49% in the risk of myocardial infarction when compared with ONBEAT (OR: 0.51; 95% CI: 0.26 to 0.99), a reduction of 16% in the risk of stroke when compared with C-CABG (OR: 0.84; 95% CI: 0.72 to 0.99) and a similar risk of renal impairment when compared with C-CABG and ONBEAT.

Conclusions and Relevance:

OPCAB was associated with higher all-cause mortality but lower postoperative stroke compared with C-CABG. OPCAB was associated with lower postoperative myocardial infarction than that of ONBEAT. Early mortality was comparable among OPCAB, ONBEAT and C-CABG.
Comparation of drug-eluting stents and control therapy for the treatment of infrapopliteal artery disease: a bayesian analysis
Authors: Li Yang , Shen XuWei , Zhuang Hui
Published: September 2023

Background:

Critical limb-threatening ischemia is a life-threatening disease which often combines with infrapopliteal arterial disease. Percutaneous transluminal angioplasty (PTA) is recommended as the first line treatment for infrapopliteal arterial disease. Drug eluting stent (DES) is another widely used option; however, its long-term therapeutic effect is controversial. The effectiveness of different DES for infrapopliteal arterial disease needs further exploration.

Methods and results:

The PubMed, EMBASE, Cochrane Library and Clinical trials were systematically searched from inception to 1 Feb 2023. Literatures were included if the study was original, peer-reviewed, published in English or Chinese, and contained patients diagnosed with simple infrapopliteal arterial disease or with properly treated combined inflow tract lesions before or during the study procedure. A total of 953 patients, 504 in the DES group and 449 in the PTA/BMS group, from twelve randomised controlled trials were included in the meta-analysis. The results showed that DES is superior to control group for improving clinical patency, reducing the restenosis rate, and reducing the amputation rate at 6 months, 1 year, and 3 years post-treatment (at 3 years, risk ratio [RR]: 1.90, 95% confidence interval [CI] 1.23–2.93; RR: 0.87, 95% CI 0.79–0.96; RR: 0.60, 95% CI 0.36–1.00, P=0.049). In addition, subgroup analyses suggested that DES is superior to BMS and PTA in improving clinical patency and reducing target lesion revascularisation and restenosis rates at 6 months and 1-year post-treatment. The network meta-analysis indicated that sirolimus-eluting stent (SES) was superior for improving clinical patency (at 1 year, RR: 0.23, 95% CI 0.08–0.60) and reducing the restenosis rate (at 6 months, RR: 31.58, 95% CI 4.41–307.53, at 1 year, RR: 3.80, 95% CI 1.84–8.87) significantly. However, according to the cumulative rank probabilities test, everolimus-eluting stent (EES) may have the lowest target lesion revascularisation rates and amputation rates at 1-year post-treatment (the cumulative rank probability was 77% and 49%, respectively).

Conclusions:

This systematic review and network meta-analysis showed that DES was associated with more clinical efficacy than PTA/BMS significantly. In addition, SES and EES may have better clinical benefits.
The Effect of Impact Seizure on the Recovery of Children and Adolescents With Concussion: A Matched Case–Control Study
Authors: Loo Benny Kai Guo , Fyffe Andrew , Lam Lawrence Tak Ming , Browne Gary
Published: September 2023

Objective:

Management of sport-related and recreation-related concussions (SRCs) in children and adolescents is challenging as brain maturation affects prognosis. However, impact seizure was removed as a prognosis modifying factor in children and adolescents with SRCs in the 2017 consensus statement on concussion in sport, based mostly on adult literature. Therefore, this study evaluates the association of impact seizure on the recovery in children and adolescents with SRCs.

Design:

Retrospective matched case–control study.

Setting:

Tertiary pediatric sports medicine service, from January 1, 2015, to June 30, 2022.

Patients:

A cohort of 452 patients, aged 7 to 18 years, with new episode of SRC was seen. From this cohort, 396 patients were included in the analysis, including 22 with impact seizures. Controls were generated using the propensity score matching approach. Patients with moderate or severe traumatic brain injury or incomplete treatment were excluded.

Independent Variable:

Impact seizure during SRC.

Main Outcome Measures:

Primary outcome was recovery duration in number of days.

Results:

The median recovery duration was longer in the cases (73 days, interquartile range [IQR] = 38-143 days) as compared with controls (49.5 days, IQR = 30.5-93.5 days). There was no difference in patients with prolonged recovery (ie >28 days) between both groups (OR 1.6, 95% CI, 0.4-6.6, P = 0.505).

Conclusions:

Impact seizures prolonged the recovery duration in children and adolescents with SRCs and therefore have a potential concussion modifying prognostic role. These findings could help provide evidence-based management principles for children and adolescents with SRCs in subsequent concussion consensus statements.
Financial Resource Management Knowledge, Skills, and Attitudes for Entry-level Physical Therapist Practice: A Survey of Physical Therapists in Ohio
Authors: Lairson Alexia , Berg-Carramusa Cara , McCallum Christine , Murray Leigh
Published: September 2023

Introduction.

The purpose of this study was to explore the perceptions of physical therapists (PTs) regarding the importance of financial resource management (FRM) knowledge, skills, and attitudes (KSAs) for entry-level practice and investigate the roles of PT education programs (PTEPs), clinical education experiences (CEEs), and employers in addressing these KSAs.

Review of Literature.

FRM KSAs have been identified as components of professionalism and leadership and, as such, are a required element in student PTs (SPTs) educational preparation.

Subjects.

A purposive sampling of convenience strategy was employed by requesting a free mailing list for Ohio-licensed PTs.

Methods.

An online survey was developed based on PT Clinical Performance Instrument Criterion #17, “Patient Management: Financial Resources,” as this tool is frequently used to endorse entry-level status of SPTs. Potential participants were solicited through email. Mixed methodology was used to analyze survey results.

Results.

The survey was completed by 266 PTs. FRM KSAs in legal and regulatory compliance were perceived as most important, followed by coding and billing. Forty-eight percent of participants indicated that FRM KSAs were “less important” (n = 111) or “considerably less important” (n = 17) than clinical care skills, whereas 39.8% (n = 106) believed that these skills are of the same level of importance. Ten themes were derived from qualitative responses regarding the FRM content that should be provided by PTEPs. Participants indicated that the role of PTEPs was to provide an introduction and foundation to FRM, whereas CEEs should facilitate intentional exposure and opportunities to apply FRM KSAs with supervision. Employers were expected to provide education regarding clinic-specific operations and reimbursement considerations, as well as mentorship that included reviewing complex billing for accuracy, offering guidance for improving time management skills, and discussing fiscal responsibilities to both the employer and patient.

Discussion and Conclusion.

This information may guide PTEPs and clinical personnel in providing focused meaningful instruction regarding FRM aspects of PT practice to SPTs and entry-level clinicians.
A Critical Examination of Independent Medical Review Decision-making for Cardiovascular Procedures Shows Low Rate of Evidence Citation in Reviews
Authors: Varadharajulu Sara D. , Ji Robin Z. , Dhruva Sanket S. , Neuhaus John , Redberg Rita F.
Published: September 2023

Background:

The California Independent Medical Review (IMR) program was created in 2001 to provide an independent, external evaluation of insurers’ denials of coverage of health services.

Objective:

We sought to evaluate the quality and comprehensiveness of data used to support IMR decision-making between 2015 and 2020.

Results:

Of the 159 cases submitted to IMR regarding denials of cardiovascular procedures, 52% of these denials were overturned by IMR, thus restoring coverage. Despite a state-wide requirement that specific references to medical and scientific evidence should be provided in IMR reviews, fewer than a quarter of reviews cited any evidence to support decision-making. Slightly more than one third of IMR review decisions were inconsistent with recommendations from professional societies and peer-reviewed evidence; the primary reason for these inconsistencies was that invasive interventions were often recommended by reviewers before utilizing guideline-directed medical or less invasive therapies.

Conclusion:

Our findings highlight an opportunity for improvement in the quality of IMR decision-making through a more consistent use of available scientific evidence to guide clinical reasoning.
Association Between Adverse Social Determinants of Health and Suicide Death
Authors: Llamocca Elyse N. , Yeh Hsueh-Han , Miller-Matero Lisa R. , Westphal Joslyn , Frank Cathrine B. , Simon Gregory E. , Owen-Smith Ashli A. , Rossom Rebecca C. , Lynch Frances L. , Beck Arne L. , Waring Stephen C. , Lu Christine Y. , Daida Yihe G. , Fontanella Cynthia A. , Ahmedani Brian K.
Published: September 2023

Objective:

The aim of this study was to identify adverse social determinants of health (SDoH) International Statistical Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) code prevalence among individuals who died by suicide and to examine associations between documented adverse SDoH and suicide.

Research Design:

A case-control study using linked medical record, insurance claim, and mortality data from 2000 to 2015 obtained from 9 Mental Health Research Network-affiliated health systems. We included 3330 individuals who died by suicide and 333,000 randomly selected controls matched on index year and health system location. All individuals in the study (cases and controls) had at least 10 months of enrollment before the study index date. The index date for the study for each case and their matched controls was the suicide date for that given case.

Results:

Adverse SDoH documentation was low; only 6.6% of cases had ≥1 documented adverse SDoH in the year before suicide. Any documented SDoH and several specific adverse SDoH categories were more frequent among cases than controls. Any documented adverse SDoH was associated with higher suicide odds [adjusted odds ratio (aOR)=2.76; 95% CI: 2.38–3.20], as was family alcoholism/drug addiction (aOR=18.23; 95% CI: 8.54–38.92), being an abuse victim/perpetrator (aOR=2.53; 95% CI: 1.99–3.21), other primary support group problems (aOR=1.91; 95% CI: 1.32–2.75), employment/occupational maladjustment problems (aOR=8.83; 95% CI: 5.62–13.87), housing/economic problems (aOR: 6.41; 95% CI: 4.47–9.19), legal problems (aOR=27.30; 95% CI: 12.35–60.33), and other psychosocial problems (aOR=2.58; 95% CI: 1.98–3.36).

Conclusions:

Although documented SDoH prevalence was low, several adverse SDoH were associated with increased suicide odds, supporting calls to increase SDoH documentation in medical records. This will improve understanding of SDoH prevalence and assist in identification and intervention among individuals at high suicide risk.