bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of transrectal ultrasound-guided prostate biopsy on erectile function and lower urinary tract symptoms: a prospective study
Authors: Nasseh Hamidreza , Asgari Seyyed Alaeddin , Sarmadian Roham , Meshkat Zahra , Haji Aghabozorgi Milad , Kazemnejad Ehsan , Asadollahzade Ahmad
Published: March 2023

Background

Prostate biopsy (PB) is the gold standard for verifying the diagnosis of prostate cancer in men with clinical symptoms. Transrectal ultrasound (TRUS)-guided PB is the most common method for diagnosis; however, it has a few adverse effects. Mild consequences like bleeding and pain are prevalent but temporary. Since the relationship between erectile dysfunction and lower urinary tract symptoms (LUTS) and TRUS-guided PB is inconsistent in the literature, we aimed to conduct a study on these two consequences on males within 1 month following TRUS-guided PB.

Methods

Patients with a PSA ≥ 4 ml/ng who were determined to undergoTRUS-guided PB were enrolled in this prospective study. Patients' urinary symptoms and erectile function were evaluated using the International Prostate Symptom Score (IPSS) and International Index of Erectile Function-5 (IIEF-5) questionnaires the day before and 1 month after PB. Also, using uroflowmetry, the patients' urinary peak flow rate (Qmax) was recorded. SPSS version 18 was used to compare and analyze variables.

Results

The mean age of the participants was 67.47 ± 9.38 years. Before the PB, the IIEF-5 score was 20.19 ± 7.24, and after the PB, it was 20.25 ± 7.24 (p = 0.865). The Qmax level rose from 7.35 ± 2.15 to 7.74 ± 2 ml/s (p = 0.07). After TRUS-guided PB, the average IPSS score reduced from 11.48 ± 9.93 to 9.88 ± 8.22 which was statistically significant (p < 0.001).

Conclusions

This study indicated that TRUS-guided PB had no negative impact on erectile function or LUTS in participants and may even relieve urinary symptoms to some extent. Overally, TRUS-guided PB appears to be a safe strategy for evaluating prostate cancer suspects.
Establishing a prognostic model of chromatin modulators and identifying potential drug candidates in renal clear cell patients
Authors: Liu Puyu , Luo Jihang , Tan Na , Li Chengfang , Xu Jieyu , Yang Xiaorong
Published: March 2023

Background

Renal carcinoma is a common malignant tumor of the urinary system. Advanced renal carcinoma has a low 5-year survival rate and a poor prognosis. More and more studies have confirmed that chromatin regulators (CRs) can regulate the occurrence and development of cancer. This article investigates the functional and prognostic value of CRs in renal carcinoma patients.

Methods

mRNA expression and clinical information were obtained from The Cancer Genome Atlas database. Univariate Cox regression analysis and LASSO regression analysis were used to select prognostic chromatin-regulated genes and use them to construct a risk model for predicting the prognosis of renal cancer. Differences in prognosis between high-risk and low-risk groups were compared using Kaplan–Meier analysis. In addition, we analyzed the relationship between chromatin regulators and tumor immune infiltration, and explored differences in drug sensitivity between risk groups.

Results

We constructed a model consisting of 11 CRs to predict the prognosis of renal cancer patients. We not only successfully validated its feasibility, but also found that the 11 CR-based model was an independent prognostic factor. Functional analysis showed that CRs were mainly enriched in cancer development-related signalling pathways. We also found through the TIMER database that CR-based models were also associated with immune cell infiltration and immune checkpoints. At the same time, the genomics of drug sensitivity in cancer database was used to analyze the commonly used drugs of renal clear cell carcinoma patients. It was found that patients in the low-risk group were sensitive to medicines such as axitinib, pazopanib, sorafenib, and gemcitabine. In contrast, those in the high-risk group may be sensitive to sunitinib.

Conclusion

The chromatin regulator-related prognostic model we constructed can be used to assess the prognostic risk of patients with clear cell renal cell carcinoma. The results of this study can bring new ideas for targeted therapy of clear cell renal carcinoma, helping doctors to take corresponding measures in advance for patients with different risks.
Novel R2R3 MYB transcription factors regulate anthocyanin synthesis in Aubergine tomato plants
Authors: Menconi Jacopo , Perata Pierdomenico , Gonzali Silvia
Published: March 2023

Background

A high content in anthocyanins, for their health beneficial properties, represents an added value for fruits and vegetables. Tomato (Solanum lycopersicum) is one of the most consumed vegetables worldwide and is rich in vitamins and carotenoids. In recent years, purple-skinned tomatoes, enriched of anthocyanins, were produced recovering allelic variants from wild Solanum species. The molecular basis of the Anthocyanin fruit (Aft) locus, exploited by breeders to activate the anthocyanin synthesis in tomato epicarp, has been recently identified in the correct splicing of the R2R3 MYB gene AN2like. Aubergine (Abg) is a tomato accession which introgressed from Solanum lycopersicoides a locus activating the synthesis of anthocyanins in the fruit. The Abg locus was mapped in the region of chromosome 10 containing Aft and the possibility that Abg and Aft represented alleles of the same gene was hypothesized.

Results

We dissected the R2R3 MYB gene cluster located in the Abg genomic introgression and demonstrated that AN2like is correctly spliced in Abg plants and is expressed in the fruit epicarp. Moreover, its silencing specifically inhibits the anthocyanin synthesis. The Abg allele of AN2like undergoes alternative splicing and produces two proteins with different activities. Furthermore, in Abg the master regulator of the anthocyanin synthesis in tomato vegetative tissues, AN2, is very poorly expressed. Finally, a novel R2R3 MYB gene was identified: it encodes another positive regulator of the pathway, whose activity was lost in tomato and in its closest relatives.

Conclusion

In this study, we propose that AN2like is responsible of the anthocyanin production in Abg fruits. Unlike wild type tomato, the Abg allele of AN2like is active and able to regulate its targets. Furthermore, in Abg alternative splicing leads to two forms of AN2like with different activities, likely representing a novel type of regulation of anthocyanin synthesis in tomato.
Association between gestational weight gain and preterm birth and post-term birth: a longitudinal study from the National Vital Statistics System database
Authors: Zhu Yifang , Zhang Jiani , Li Qiaoyu , Lin Min
Published: March 2023

Background

To evaluate the association between gestational weight gain (GWG) and preterm birth and post-term birth.

Methods

This longitudinal-based research studied singleton pregnant women from the National Vital Statistics System (NVSS) (2019). Total GWG (kg) was converted to gestational age-standardized z scores. The z-scores of GWG were divided into four categories according to the quartile of GWG, and the quantile 2 interval was used as the reference for the analysis. Univariate and multivariate logistic regression analyses were performed to investigate the association between GWG and preterm birth, post-term birth, and total adverse outcome (preterm birth + post-term birth). Subgroup analysis stratified by pre-pregnancy body mass index (BMI) was used to estimate associations between z-scores and outcomes.

Results

Of the 3,100,122 women, preterm birth occurred in 9.45% (292,857) population, with post-term birth accounting for 4.54% (140,851). The results demonstrated that low GWG z-score [odds ratio (OR): 1.04, 95% confidence interval (CI): 1.03 to 1.05, P < 0.001], and higher GWG z-scores (quantile 3: OR: 1.42, 95% CI: 1.41 to 1.44, P < 0.001; quantile 4: OR: 2.79, 95% CI: 2.76 to 2.82, P < 0.001) were positively associated with preterm birth. Low GWG z-score (OR: 1.18, 95% CI: 1.16 to 1.19, P < 0.001) was positively associated with an increased risk of post-term birth. However, higher GWG z-scores (quantile 3: OR: 0.84, 95% CI: 0.83 to 0.85, P < 0.001; quantile 4: 0.59, 95% CI: 0.58 to 0.60, P < 0.001) was associated with a decreased risk of post-term birth. In addition, low GWG z-score and higher GWG z-scores were related to total adverse outcome. A subgroup analysis demonstrated that pre-pregnancy BMI, low GWG z-score was associated with a decreased risk of preterm birth among BMI-obesity women (OR: 0.96, 95% CI: 0.94 to 0.98, P < 0.001).

Conclusion

Our result suggests that the management of GWG may be an important strategy to reduce the number of preterm birth and post-term birth.
Correction loss following short-segment posterior fixation for traumatic thoracolumbar burst fractures related to endplate and intervertebral disc destruction
Authors: Hashimura Takumi , Onishi Eijiro , Ota Satoshi , Tsukamoto Yoshihiro , Yamashita Shinnosuke , Yasuda Tadashi
Published: March 2023

Background

There has been widespread use of short-segment posterior fixation (SSPF) for traumatic thoracolumbar burst fractures. The relationship between the destruction of the vertebral endplate and adjacent disc and postoperative correction loss has been studied in only a few studies. This study investigated the risk factors for correction loss following SSPF.

Methods

Forty-eight patients (mean age 35.0 years) who underwent SSPF for thoracolumbar burst fractures were enrolled. The mean follow-up period was 25.7 months (12–98 months). The neurological status and postoperative back pain were assessed by the medical records. Segmental kyphotic angle (SKA) and anterior vertebral body height ratio (AVBHR) were measured radiographically to assess indirect vertebral body reduction and local kyphosis. Preoperative Sander’s traumatic intervertebral disc lesion (TIDL) classification and AO classification were used to evaluate the severity of disc and vertebral endplate injury. The corrective loss was considered present if ΔSKA was ≥10°. A multivariate logistic regression analysis was performed to identify the risk factors associated with postoperative loss of correction.

Results

The fracture distribution was as follows: 10 at T12, 17 at L1, 10 at L2, 9 at L3, and 2 at L4. Vertebral fractures were classified in the following way: A3 in 13 patients, A4 in 11, B1 in 11, and B2 in 13. In 47 patients (98%), a union of the fractured vertebrae was achieved. SKA and AVBHR improved significantly after surgery from 11.6° to 3.5° and from 67.2 to 90.0%, respectively. However, the correction loss at follow-up was 10.4° and 9.7%, respectively. Twenty patients (42%) had severe TIDL (grade 3). Postoperative ΔSKA and ΔAVBHR were significantly higher in patients with TIDL grade 3 than with TIDL grade 0–2. The presence of cranial TIDL grade 3 and older age were significant risk factors for ΔSKA ≥10° on multivariate logistic regression analysis. All patients could walk at follow-up. TIDL grade 3 and ΔSKA ≥10° were associated with severe postoperative back pain.

Conclusions

Risk factors for loss of correction after SSPF for thoracolumbar burst fractures were severe disc and endplate destruction at the time of injury and older age.
Socio-economic variations of breast cancer treatment and discontinuation: a study from a public tertiary cancer hospital in Mumbai, India
Authors: Mohanty Sanjay K. , Wadasadawala Tabassum , Sen Soumendu , Khan Pijush Kanti
Published: March 2023

Background

The study examined the socio-economic variation of breast cancer treatment and treatment discontinuation due to deaths and financial crisis.

Methods

We used primary data of 500 patients with breast cancer sought treatment at India’s one of the largest cancer hospital in Mumbai, between June 2019 and March 2022. This study is registered on the Clinical Trial Registry of India (CTRI/2019/07/020142). Kaplan–Meier method and Cox-hazard regression model were used to calculate the probability of treatment discontinuation.

Results

Of the 500 patients, three-fifths were under 50 years, with the median age being 46 years. More than half of the patients were from outside of the state and had travelled an average distance of 1,044 kms to get treatment. The majority of the patients were poor with an average household income of INR15,551. A total of 71 (14%) patients out of 500 had discontinued their treatment. About 5.2% of the patients died and 4.8% of them discontinued treatment due to financial crisis. Over one-fourth of all deaths were reported among stage IV patients (25%). Patients who did not have any health insurance, never attended school, cancer stage IV had a higher percentage of treatment discontinuation due to financial crisis. Hazard of discontinuation was lower for patients with secondary (HR:0.48; 95% CI: 0.27–0.84) and higher secondary education (HR: 0.42; 95% CI: 0.19–0.92), patients from rural area (HR: 0.79; 95% CI: 0.42–1.50), treated under general or non-chargeable category (HR: 0.60; 95% CI:0.22–1.60) while it was higher for the stage IV patients (HR: 3.61; 95% CI: 1.58–8.29).

Conclusion

Integrating breast cancer screening in maternal and child health programme can reduce delay in diagnosis and premature mortality. Provisioning of free treatment for poor patients may reduce discontinuation of treatment.
Flipped classroom applied to Neurosurgery in undergraduate medical education
Authors: Gutiérrez-González R , Zamarron A , Royuela A , Rodriguez-Boto G
Published: March 2023

Purpose

To compare the academic achievement obtained in Neurosurgery in a class of undergraduate students according to the pedagogical methodology employed: flipped classroom (FC) versus traditional lecture. Students’ satisfaction with the FC model is also analyzed.

Methods

A quasi-experimental study was designed. The traditional lecture was the pedagogical method employed in teaching units (TUs) 1, 2, and 3 (61, 60, and 66 enrolled students, respectively), whereas TU 4 (69 enrolled students) used the FC methodology.

Results

The dropout rate was lower, whereas the academic achievement and the rate of correct answers were higher in TU 4 compared to the rest of the TUs, but these results were not statistically significant. However, the mean score obtained in Neurosurgery was significantly higher in TU 4 compared to the rest of the TUs (p = 0.042). Active learning activities based on clinical cases were positively emphasized. The main weakness was with the time consumed for video-recorded lecture viewing.

Conclusions

The FC approach showed better academic results than traditional lectures when comparing students in the same Medical School during the same academic year undergoing the same exam. The students rated the FC approach positively, considering it stimulating and useful for learning.
Theranostic applications of selenium nanomedicines against lung cancer
Authors: Liu Shaowei , Wei Weifeng , Wang Jinlin , Chen Tianfeng
Published: March 2023

The incidence and mortality rates of lung cancer are among the highest in the world. Traditional treatment methods include surgery, chemotherapy, and radiotherapy. Although rapid progress has been achieved in the past decade, treatment limitations remain. It is therefore imperative to identify safer and more effective therapeutic methods, and research is currently being conducted to identify more efficient and less harmful drugs. In recent years, the discovery of antitumor drugs based on the essential trace element selenium (Se) has provided good prospects for lung cancer treatments. In particular, compared to inorganic Se (Inorg-Se) and organic Se (Org-Se), Se nanomedicine (Se nanoparticles; SeNPs) shows much higher bioavailability and antioxidant activity and lower toxicity. SeNPs can also be used as a drug delivery carrier to better regulate protein and DNA biosynthesis and protein kinase C activity, thus playing a role in inhibiting cancer cell proliferation. SeNPs can also effectively activate antigen-presenting cells to stimulate cell immunity, exert regulatory effects on innate and regulatory immunity, and enhance lung cancer immunotherapy. This review summarizes the application of Se-based species and materials in lung cancer diagnosis, including fluorescence, MR, CT, photoacoustic imaging and other diagnostic methods, as well as treatments, including direct killing, radiosensitization, chemotherapeutic sensitization, photothermodynamics, and enhanced immunotherapy. In addition, the application prospects and challenges of Se-based drugs in lung cancer are examined, as well as their forecasted future clinical applications and sustainable development.

Graphical Abstract
Migration of nurses and doctors: pull factors to work in Saudi Arabia
Authors: Almansour Husam , Aldossary Ameera , Holmes Sandra , Alderaan Thamer
Published: March 2023

Background

Although Saudi Arabia is a common destination to which nurses and doctors migrate, few studies have explored the pull factors attracting them to work in the Middle East and Saudi Arabia. This qualitative study explores the pull factors drawing nurses and doctors to work in Saudi Arabian hospitals.

Methods

The study utilized a qualitative approach with focus groups. The participants included 83 doctors and nurses at two government hospitals.

Results

Five themes (rewards, job entry requirements, religion, influence of family and friends, and changing work environments) were identified based on the 10 focus group sessions.

Conclusion

Moving forward, health managers should proactively plan the state of healthcare as the need for migrant healthcare workers changes.
Enhanced recovery after surgery (ERAS) relieves psychological stress in patients with osteoporotic vertebral compression fracture undergoing percutaneous kyphoplasty: an observational retrospective cohort study
Authors: Ji Zhong-wei , Fan Chun-yang , Yu Zi-lin , Wu Xie-xing , Mao Hai-qing
Published: March 2023

Study design

This is an observational retrospective cohort study.

Objective

The purpose of this study is to investigate the incidence rate of depression and anxiety and the changes in patients treated with percutaneous kyphoplasty (PKP) following ERAS protocol.

Summary of background data

The incidence of depression and anxiety is not uncommon in patients with osteoporotic vertebral compression fracture (OVCF), which affects the prognosis of surgery. Enhanced recovery after surgery (ERAS) protocols can improve the perioperative stress response of patients.

Materials and methods

Patients were treated conventionally in 2019 as the control group (CG) (n = 281), and patients were treated according to the ERAS protocol in 2020 as the intervention group (IG) (n = 251). All patients were evaluated for depression and anxiety using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 at admission, postoperative 1 week, 1 month and 3, 6, 12 months.

Results

The degree of depression statistically decreased in the IG at follow-up periods (p < 0.001), and the degree of anxiety statistically decreased at 1 week (p < 0.001), 1 month (p < 0.001), 3 months (p = 0.017). Patients in the IG could soothe depression and anxiety disorders faster than patients in the CG and maintain psychological stability at the follow-up periods. The percentage of moderate or above depression in the IG was statistically fewer than in the CG at follow-up periods (p < 0.01). The odds ratio (OR) was respectively 0.410, 0.357, 0.294, 0.333, 0.327 from 1 week to 12 months. While the percentage of patients with moderate or above anxiety significantly decreased in the IG at 1 week (p < 0.001), OR = 0.528, 1 month (p = 0.037), OR = 0.309 and 12 months (p = 0.040), OR = 0.554, no differences between 3 months (p = 0.187) and 6 months (p = 0.133).

Conclusion

PKP following ERAS protocol to treat patients with OVCF had a better effect on relieving postoperative anxiety and depression than following conventional protocol.
Increasing incidence rate of breast cancer in cystic fibrosis - relationship between pathogenesis, oncogenesis and prediction of the treatment effect in the context of worse clinical outcome and prognosis of cystic fibrosis due to estrogens
Authors: Stastna Nela , Brat Kristian , Homola Lukas , Os Audun , Brancikova Dagmar
Published: March 2023

Cystic fibrosis (CF) is the most common genetic disease in the Caucasion population. Thanks to the CFTR modulators therapy, life expectancy will significantly improve. New therapeutic challenges can be expected, including diseases associated with ageing and higher incidence of cancer, as evidenced by recent epidemiological studies. The increasing incidence of tumors includes also breast cancer. The risk of breast cancer is higher in CF patients compared to the general population. Sex hormones, especially estrogens, also affect on the pathophysiology and immunology of the CF. Previous research, has demonstrated unequivocal survival rates for female CF patients compared to their male counterparts. Is demonstrated, that chemotherapy used for breast cancer affects the CFTR channel and CFTR modulator therapy has frequent side effects on breast tissue. In this review, we focus on the effects of female sex hormones on CF disease, pathophysiological relationships between CF and breast cancer, and the impact of antitumor treatment on both, malignant disease and CF. The potential for further investigation is also discussed.
The relationship between different bispectral index and the occurrence of dreams in elective surgery under general anesthesia: protocol for a randomized controlled clinical trial
Authors: Zhang Yufei , Song Bijia , Zhu Junchao
Published: March 2023

Introduction

Dreaming reported after anesthesia remains a poorly understood phenomenon. At present, there is a hypothesis that dreaming occurs intraoperatively and is related to light or inadequate anesthesia; thus, in order to further verify the hypothesis, we choose elective surgery under general anesthesia to observe whether the generation of dreams is related to the dose of general anesthetics maintenance.

Methods and analysis

This randomized, double-blind controlled trial to observe whether the generation of dreams is related to the dose of general anesthetics maintenance in the elective surgery under general anesthesia. A total of 124 participants will be randomly allocated to a low bispectral index or high bispectral index group at a ratio of 1:1. The Hospital Anxiety and Depression Scale (HADS) is used to assess the anxiety and depression status of participants during the perioperative period. Ramsay score is used to assess patients’ sedation level after surgery in the PACU. Modified Brice questionnaire and awareness classification are used to assess whether patients experienced dreaming during the surgery.

Ethics and dissemination

This randomized, double-blind controlled trial received prospective ethics committee approval at the Human Research Ethical Committee of Shengjing Hospital, Shenyang, Liaoning Province, China (Institutional Review Board registration number 2021PS664K), and was compliant with the Declaration of Helsinki. Written informed consent was obtained from all subjects participating in the trial.
Phylogenetic trees, conserved motifs and predicted subcellular localization for transcription factor families in pearl millet
Authors: Qu Yingwei , Dudhate Ambika , Shinde Harshraj Subhash , Takano Tetsuo , Tsugama Daisuke
Published: March 2023

Objectives

Pearl millet (Pennisetum glaucum) is a cereal crop that is tolerant to a high temperature, a drought and a nutrient-poor condition. Characterizing pearl millet proteins can help to improve productivity of pearl millet and other crops. Transcription factors in general are proteins that regulate transcription of their target genes and thereby regulate diverse processes. Some transcription factor families in pearl millet were characterized in previous studies, but most of them are not. The objective of the data presented was to characterize amino acid sequences for most transcription factors in pearl millet.

Data description

Sequences of 2395 pearl millet proteins that have transcription factor-associated domains were extracted. Subcellular and suborganellar localization of these proteins was predicted by MULocDeep. Conserved domains in these sequences were confirmed by CD-Search. These proteins were classified into 85 families on the basis of those conserved domains. A phylogenetic tree including pearl millet proteins and their counterparts in Arabidopsis thaliana and rice was constructed for each of these families. Sequence motifs were identified by MEME for each of these families.
Transcriptome dataset from Solanum lycopersicum L. cv. Micro-Tom; wild type and two mutants of INDOLE-ACETIC-ACID (SlIAA9) using long-reads sequencing oxford nanopore technologies
Authors: Lubis Wahyu Muhammad Yuha , Adrian M , Jadid Nurul , Widiastuti Ani , Ezura Hiroshi , Mubarok Syariful , Hapsari Dhika Prita , Poerwanto Roedhy , Matra Deden Derajat
Published: March 2023

Objective

Tomatoes are the most widely consumed fruit vegetable and are relatively easy to cultivate. However, an increase in temperature causes some plants to respond with a decrease in fruit production. So, it is necessary to develop plants resistant to extreme temperature changes. The tomato cv. Micro-Tom has genetic variations in the gene of INDOLE-ACETIC-ACID, namely SlIAA9-3 and SlIAA9-5. However, the genetic information regarding the full-length transcript of the gene from this type of tomato plant is unknown. Therefore, this study aimed to determine the full-length transcript of the genes of these three types of tomatoes using long-reads sequencing technology from Oxford Nanopore.

Data description

The total RNA from three types of Micro-Tom was isolated with the RNeasy PowerPlant Kit. Then, the RNA sequencing process used PCR-cDNA Barcoding kit - SQK-PCB109 and continued with the processing of raw reads based on the protocol from microbepore protocol (https://github.com/felixgrunberger/microbepore). The resulting raw reads were 578 374, 409 905, and 851 948 for wildtype, iaa9-3, and iaa9-5, respectively. After obtaining cleaned reads, each sample was mapped to the tomato reference genome (S. lycopersicum ITAG4.0) with the Minimap2 program. In particular, 965 genes were expressed only in the iaa9-3 mutant, and 2332 genes were expressed only in the iaa9-5 mutant. Whereas in the wild type, 1536 genes are specifically expressed. In cluster analysis using the heatmap analysis, separate groups were obtained between the wild type and the two mutants. This proves an overall difference in transcript levels between the wild type and the mutants.
Blood pressure and dementia risk by physical frailty in the elderly: a nationwide cohort study
Authors: Cho Mi Hee , Han Kyungdo , Lee Seungwoo , Jeong Su-Min , Yoo Jung Eun , Kim SangYun , Lee Jinkook , Chun Sohyun , Shin Dong Wook
Published: March 2023

Background

Midlife hypertension has been recognized as a modifiable risk factor for dementia, but association between blood pressure (BP) in late life and dementia has been inconclusive. In addition, few studies have investigated effects of BP control on dementia incidence in the frail elderly. Thus, this study aimed to investigate the association of BP and dementia incidence with concomitant consideration of physical frailty in the young elderly population.

Methods

Using the Korean National Health Information Database, we identified 804,024 subjects without history of dementia at age 66. Dementia diagnosis was defined with prescription records of anti-dementia drugs and dementia-related diagnostic codes. Physical frailty was measured using the Timed Up and Go test. Association of BP and dementia incidence with concomitant consideration of physical frailty was investigated using Cox hazards analyses.

Results

The risks of Alzheimer’s and vascular dementia increased from systolic BP ≥ 160 and 130–139 mmHg, respectively; a significant association of dementia incidence with low BP was not observed. In the analyses stratified by the physical frailty status, low BP was not associated with increased risks of dementia within the groups both with and without physical frailty.

Conclusions

High BP was associated with increased risks of dementia, especially for vascular dementia, while low BP was not associated with increased risks of any type of dementia in young elderly people, even in those with physical frailty. This study suggests the need for tight BP control in young elderly people, irrespective of frailty status, to prevent dementia and supports the current clinical guidelines of hypertension treatment.
Decision-making regarding immediate vs. interval postpartum levonorgestrel intrauterine device insertion timing
Authors: Davenport Abigail , Morello Laura , Arora Kavita Shah
Published: March 2023

Background

Understanding decision-making for contraception initiation timing postpartum may help guide patients in selecting a contraceptive method most aligned with their reproductive goals. The objective of this study was to explore the decision-making process in patients who chose immediate postplacental (IPP) levonorgestrel intrauterine device (LNG IUD) insertion versus interval insertion at the postpartum follow-up visit.

Methods

We recruited English-speaking, reproductive-aged adult postpartum participants who received either an IPP or interval postpartum LNG IUD from September to December 2017 at MetroHealth Medical Center. We conducted interviews over the phone utilizing a pilot-tested, semi-structured interview guide. Interview topics included past experiences with contraception, provider counseling, intrapartum factors, and current experiences after IUD insertion.

Results

We interviewed 20 participants (12 IPP and eight interval IUD recipients). Participants receiving an IPP IUD described convenience, desire for immediate contraception, pain control and availability of alternative contraception options as influential for their decision. Patients who received an interval IUD performed outside research, focused on the events surrounding delivery, and generally favored additional recovery time before obtaining an IUD. Patients who received interval IUDs were often not aware that IPP IUDs were available. Early, frequent, and comprehensive counseling was viewed favorably when compared to counseling upon arrival to the laboring unit. While overall there was congruence of participant expectations and experiences, unexpected expulsion affected desire for future IUD use in some participants.

Conclusion

Providers should be mindful that prior experience and knowledge as well as delivery room considerations affect insertion timing decision-making.

Trial registration

N/A
Isolated Hepatic Perfusion With Melphalan for Patients With Isolated Uveal Melanoma Liver Metastases: A Multicenter, Randomized, Open-Label, Phase III Trial (the SCANDIUM Trial)
Authors: Olofsson Bagge Roger , Nelson Axel , Shafazand Amir , All-Eriksson Charlotta , Cahlin Christian , Elander Nils , Helgadottir Hildur , Kiilgaard Jens Folke , Kinhult Sara , Ljuslinder Ingrid , Mattsson Jan , Rizell Magnus , Sternby Eilard Malin , Ullenhag Gustav J. , Nilsson Jonas A. , Ny Lars , Lindnér Per
Published: March 2023

PURPOSE

About half of patients with metastatic uveal melanoma present with isolated liver metastasis, in whom the median survival is 6-12 months. The few systemic treatment options available only moderately prolong survival. Isolated hepatic perfusion (IHP) with melphalan is a regional treatment option, but prospective efficacy and safety data are lacking.

METHODS

In this multicenter, randomized, open-label, phase III trial, patients with previously untreated isolated liver metastases from uveal melanoma were randomly assigned to receive a one-time treatment with IHP with melphalan or best alternative care (control group). The primary end point was overall survival at 24 months. Here, we report the secondary outcomes of response according to RECIST 1.1 criteria, progression-free survival (PFS), hepatic PFS (hPFS), and safety.

RESULTS

Ninety-three patients were randomly assigned, and 87 patients were assigned to either IHP (n = 43) or a control group receiving the investigator's choice of treatment (n = 44). In the control group, 49% received chemotherapy, 39% immune checkpoint inhibitors, and 9% locoregional treatment other than IHP. In an intention-to-treat analysis, the overall response rates (ORRs) were 40% versus 4.5% in the IHP and control groups, respectively ( P < .0001). The median PFS was 7.4 months versus 3.3 months ( P < .0001), with a hazard ratio of 0.21 (95% CI, 0.12 to 0.36), and the median hPFS was 9.1 months versus 3.3 months ( P < .0001), both favoring the IHP arm. There were 11 treatment-related serious adverse events in the IHP group compared with seven in the control group. There was one treatment-related death in the IHP group.

CONCLUSION

IHP treatment resulted in superior ORR, hPFS, and PFS compared with best alternative care in previously untreated patients with isolated liver metastases from primary uveal melanoma.
The Colocation Model in Community Cancer Care: A Description of Patient Clinical and Demographic Attributes and Referral Pathways
Authors: Stockman Leah S. , Gundersen Daniel A. , Gikandi Ajami , Akindele Ruth N. , Svoboda Ludmila , Pohl Sarah , Drews Mark R. , Lathan Christopher S.
Published: March 2023

PURPOSE:

Cancer disparities are well documented among Black, Indigenous, and People of Color, yet little is known about the characteristics of programs that serve these populations. Integrating specialized cancer care services within community settings is important for addressing the needs of historically marginalized populations. Our National Cancer Institute–Designated Cancer Center initiated a clinical outreach program incorporating cancer diagnostic services and patient navigation within a Federally Qualified Health Center (FQHC) to expedite evaluation and resolution of potential cancer diagnoses with the goal of collaboration between oncology specialists and primary care providers in a historically marginalized community in Boston, MA.

MATERIALS AND METHODS:

Sociodemographic and clinical characteristics were analyzed from patients who were referred to the program for cancer-related care between January 2012 and July 2018.

RESULTS:

The majority of patients self-identified as Black (non-Hispanic) followed by Hispanic (Black and White). Twenty-two percent of patients had a cancer diagnosis. Treatment and surveillance plans were established for those with and without cancer at a median time to diagnostic resolution of 12 and 28 days, respectively. The majority of patients presented with comorbid health conditions. There was a high prevalence of self-reported financial distress among patients seeking care through this program.

CONCLUSION:

These findings highlight the wide spectrum of cancer care concerns in historically marginalized communities. This review of the program suggests that integrating cancer evaluation services within community-based primary health care settings offers promise for enhancing the coordination and delivery of cancer diagnostic services among historically marginalized populations and could be a method to address clinical access disparities.
The Indispensable (and Strangely Disposable) Corpse in Early Parodies of Detective Fiction
Authors: Robinson Michelle
Published: March 2023

This essay argues that by studying parodies of detective fiction from the turn of the twentieth century, one can envision a more complete history of the detective genre's development and the alternate paths it might have pursued. Mark Twain's A Double-Barrelled Detective Story (1902), Melville Davisson Post's The Strange Schemes of Randolph Mason (1896), and Robert Louis Stevenson and Lloyd Osbourne's The Wrong Box (1889) instruct the reader to regard detective fiction as a genre about the production of the corpse and the transnational economic systems that generated it, rather than the ratiocinative mastery of the detective. These three parodies of detective fiction burlesque incipient genre texts from the nineteenth century by painstakingly regurgitating the global political and economic stakes that set the stage for local mysteries, even when they defer rather than advance the plot. They also foreground the corpse-as-spectacle by engineering human remains that resist forensic elucidation and are the product of bizarre and cataclysmic histories of violence. In emphasizing detective fiction's nineteenth-century literary antecedents, Twain's, Post's, and Stevenson and Osbourne's detective parodies indicate that the genre might have pursued a different direction, one where its dominant element was the disturbing debasement of a body by a complex circuit of global political and economic relations.
Ambivalent Man: The Is-and-Isn't World of Ralph Ellison's “Tell It Like It Is, Baby”
Authors: Pinkerton Steve
Published: March 2023

Ralph Ellison's long-neglected essay “Tell It Like It Is, Baby” (1965) has lately received increased critical attention as a revealing paratext for Ellison's unfinished second novel. Yet little has been said about that essay's conspicuous psychosexual themes or its confoundingly ambivalent rhetoric of avowal and disavowal. Nor have scholars yet charted the essay's unique evolution over a full decade's worth of drafts and revisions. Drawing on original archival research, this article reads “Tell It” as responding to two contexts that for Ellison were both achingly personal and pressingly political: first, the often hostile criticism he endured from the ideological left during the 1960s, and second, his deep-seated antipathy to the sociology of race. Both of these contexts carried psychological implications concerning Black masculinity and the fates of fatherless Black families such as the one in which Ellison was raised. (His essay largely narrates “a personal dream” that symbolically equates Lincoln's assassination with the untimely death of Ellison's own father.) In obliquely writing back to his critics and to then-regnant theories about Black lives, Ellison mingles quasi-confessional feints with strident denials and abrupt volte-faces in ways that elude any straightforward interpretation. Yet this very tangle of contradiction may itself be his way of “telling it like it is”: of exploring the massive contradictions of US history and American identity that, for Ellison, must inform any individual or collective effort to make sense of “our orphan's loneliness.”
Adorno’s Cosmopolitan Solidarity
Authors: Basnett Caleb J.
Published: March 2023

Dominant approaches to cosmopolitanism have been criticized for failing to sufficiently account for how power and privilege have entwined with cosmopolitan proposals, and cosmopolitanism itself has been accused of being the ideology of global capitalism. Taking seriously cosmopolitanism’s complicity in domination, this article draws on the work of Theodor W. Adorno to sketch a theory of cosmopolitanism as solidarity. It argues that prominent approaches to cosmopolitanism understand solidarity as an identification of particular with universal, with pernicious political consequences. The article examines three concepts from Adorno’s philosophy that challenge contemporary cosmopolitanism: his concept of “constellations” offers a different way of relating particular to universal; his claim to solidarity with “tormentable bodies” reimagines moral action informed by this transformed relation; and his concept of a “global subject” offers a way to theorize the relation between this moral action and political intervention at the global level.
Revolt against Time: Jean Améry on the Constitution of the Self
Authors: Feller Yaniv
Published: March 2023

This article offers a new reading of Jean Améry’s idea of resentment, identifying resentment against time as another dimension of the concept alongside resentment against the perpetrators and the willingness of society to move on. This new facet of resentment is elaborated by showing the centrality of Frantz Fanon’s thought for Améry’s theory of self-constitution. In highlighting the relation between resentment and counterviolence, the article shows how Fanon’s influence on Améry goes beyond what has been recognized in current scholarship. Améry agreed with Fanon that counterviolence and revenge reattain the dignity of the victim. The problem of resentment emerges for Améry when revenge is no longer possible. Resentment is in this sense a revolt against time as an unstoppable force that blocks the way to revenge and hence to the reattainment of the dignity of the victim.
“My Program Is Still Broader Than the Sea”: Gershom Scholem’s Letters to Abraham Joshua Heschel, 1940–1953
Authors: Fiano Emanuel , Kessler Samuel J.
Published: March 2023

This study makes available for the first time five previously unknown letters from Gershom Scholem to Abraham Joshua Heschel, sent between 1940 and 1953. A contextualizing introduction precedes a transcription and annotated English translation of the original Hebrew letters. The letters printed here, along with two more from Heschel to Scholem that remain unpublished due to copyright issues, trace an arc of scholarly interaction that begins with gestures toward overlapping historical interest and ends with the silent acknowledgment of a methodological and more broadly intellectual distance.
Το συγκρουσιακό τοπίο στα "ορφανά" της Λεωφόρου Αλεξάνδρας
Authors: Παπακώστας Ιωάννης
Published: March 2023

H διατριβή ασχολείται με το συγκρουσιακό τοπίο που αναπτύσσεται σε ένα αστικόκενό, στην καρδιά της πόλης, με αφορμή το ζήτημα της διεκδίκησης στέγης σεστεγασμένους ή μη, δημόσιους χώρους, σε ένα κεντρικό οδικό άξονα, καισυγκεκριμένα στην λεωφόρο Αλεξάνδρας. Το πεδίο έρευνας εντοπίζεται στιςπροσφυγικές κατοικίες (Προσφυγικά) στην πάνω πλευρά της Λεωφόρου και στοΠεδίον του Άρεως, (Πάρκο), στο άλλο άκρο της, μιας λεωφόρου που ταυτόχροναφιλοξενεί καταλήψεις, όπως τα «Προσφυγικά» και κτίρια σύμβολα της επιβολής τηςκρατικής εξουσίας στην πόλη, όπως η «ΓΑΔΑ» και ο «Άρειος Πάγος.» Η διατριβήξεκινά με την παραδοχή οτι η πόλη αποτελεί διαχρονικά χώρο ετερογένειας καιποικιλομορφίας. Μεγαλουπόλεις σαν την Αθήνα της κρίσης, φιλοξενούν ανθρώπουςκοινωνικά, εθνοτικά και πολιτισμικά «ξένους» μεταξύ τους, επιβάλλοντας τους τηνσυμβίωση σε ένα σκηνικό με στερεότυπα και προκαταλήψεις που αναπόφευκταδημιουργεί συγκρούσεις. Η υποτίμηση της ζωής από πρώτιστο αγαθό σε ανάγκηαπλής επιβίωσης αποτελεί το εύφλεκτο υλικό των συγκρουσιακών σχέσεων πουαναπτύσσονται στον αστικό χώρο και συμβάλουν στην κοινωνική κατασκευή τουνέο-οριζόμενου τόπου. Έτσι προκύπτει ένα συγκρουσιακό τοπίο που αφορά όλουςτους συμμετέχοντες στο σχήμα του κοινωνικού διαχωρισμού και της δυσφορίας πουαναπτύσσεται απέναντι στον «άλλο» που αποτελεί την απειλή της καθημερινότητας..Η ανάδειξη του συγκρουσιακού τοπίου των περιπτώσεων μελέτης, «Προσφυγικά»και «Πάρκο» αναλύεται μέσα από το λόγο και τις δράσεις των χρηστών τους, όπωςαυτές αποτυπώνονται από την επιτόπια παρατήρηση του ερευνητή αλλά και τη χρήσηανοιχτών και σε βάθος συνεντεύξεων με τους δρώντες (χρήστες και Πολιτεία).Έννοιες και λέξεις όπως αδιαφορία, αλληλέγγυα οικονομία, άμεση δημοκρατία,ανασφάλεια, ανυπακοή, αυτονομία, ελπίδα, ετεροτοπία, κοινά, κοινωνικά όρια,οικιστικό απόθεμα, ουτοπία, συλλογικότητες, συμβίωση, και φόβος, δημιουργούν έναπάζλ που αναφέρεται στην ανάπτυξη της συγκρουσιακής εικόνας στις δυοπεριπτώσεις μελέτης της Λεωφόρου Αλεξάνδρας. Είναι αυτή η εικόνα που καταλύειτην περιθωριοποίηση των συλλογικών αντιδράσεων του «όχλου» και προσφέρειάλλοθι σε υποθέσεις εργασίας.
Hedge fund returns and factors at the daily frequency
Authors: Αντωνιάδης Χρήστος
Published: March 2023

Όλο και περισσότερα αντισταθμιστικά αμοιβαία κεφάλαια υψηλού κινδύνου (hedge funds) τα τελευταία χρόνια αποφασίζουν να ανακοινώνουν τις αποδόσεις τους σε ημερήσια βάση. Η παρούσα διπλωματική εργασία, αποτελείται από 3 κεφάλαια και έχει ως στόχο να ανοίξει το δρόμο για την ανάλυση των κεφαλαίων αυτών με τη χρήση και αξιοποίηση ημερήσιων δεδομένων. Το Κεφάλαιο 1 παρέχει λεπτομερείς κατευθυντήριες γραμμές που επιτρέπουν την κατασκευή παραγόντων αμοιβαίων κεφαλαίων αντιστάθμισης κινδύνου σε ημερήσια συχνότητα, με αποκλειστική χρήση δεδομένων από τη βάση Thomson Reuters Datastream, ακολουθώντας στρατηγικές που διαπραγματεύονται συμβόλαια μελλοντικής εκπλήρωσης (futures contracts) και δικαιώματα προαίρεσης (options contracts), όπως προτάθηκε από τους Fung και Hsieh (2001), Agarwal και Naik (2004) και Moskowitz, Ooi και Pedersen (2012). Παρουσιάζονται συγκριτικά αποτελέσματα, όπου υπάρχουν διαθέσιμα τα αρχικά δεδομένα των συγγραφέων, και προτείνονται βελτιώσεις που βασίζονται σε ένα διευρυμένο σύνολο συμβολαίων και σε μικρότερη ευαισθησία σε ακραίες τιμές. Χρησιμοποιώντας ένα από τα εκτενέστερα σύνολα ημερήσιων μεταβλητών στη σχετική βιβλιογραφία, το Κεφάλαιο 2 μελετά την αξιολόγηση της απόδοσης των hedge funds σε ημερήσιο επίπεδο και καταλήγει στο συμπέρασμα ότι τα ανοίγματα σε παράγοντες κινδύνου hedge fund που αξιολογούνται σε ημερήσια βάση είναι πιο ακριβή από τα αντίστοιχα που αξιολογούνται με μηνιαία δεδομένα. Η επιλογή παραγόντων κινδύνου με χρήση ημερήσιων δεδομένων οδηγεί σε μεγαλύτερο πλήθος παραγόντων για κάθε αμοιβαίο κεφάλαιο, γεγονός που μπορεί να επιφέρει μέσες ετήσιες μειώσεις άλφα (alpha) κατά 1% ή ακόμα και μείωση άλφα κατά 2% σε ειδικές περιπτώσεις διακεκριμένων κεφαλαίων. Η ένδειξη για χρονική διακύμανση των εκθέσεων σε κίνδυνο είναι επίσης ισχυρότερη στα ημερήσια δεδομένα. Τα ευρήματά μας υποδηλώνουν ότι πολλές έρευνες σχετικά με τα αντισταθμιστικά αμοιβαία κεφάλαια υψηλού ρίσκου και την έκθεση αυτών στον κίνδυνο θα πρέπει να ερμηνεύονται πολύ προσεκτικά. Το Κεφάλαιο 3 παρέχει λεπτομερείς οδηγίες σχετικά με την εξαγωγή, το χειρισμό και τη χρήση δεδομένων hedge funds υψηλής συχνότητας από τη βάση δεδομένων Bloomberg. Εξετάζει κατά πόσο η Bloomberg μπορεί να αξιολογηθεί ως ένας ικανός και αξιόπιστος πάροχος hedge funds για ανάλυση δεδομένων, διερευνά τις διαφορές μεταξύ των αμοιβαίων κεφαλαίων που αποφασίζουν να ανακοινώνουν καθημερινά την επίδοσή τους έναντι εκείνων που αναφέρουν μηνιαία στη Bloomberg και καταλήγει στο συμπέρασμα ότι η ανάλυση hedge funds με χρήση ημερήσιων δεδομένων μπορεί να οδηγήσει σε πλουσιότερα μοτίβα τον ερευνητή. Επιπλέον, συζητούνται συγκεκριμένα ζητήματα σχετικά με τα διάφορα είδη μεροληψιών που μπορούν να παρουσιάσουν τα αμοιβαία κεφάλαια αντιστάθμισης κινδύνου, την ικανότητα του διαχειριστή τους, καθώς και περιπτώσεις παρουσίας διαρθρωτικών μεταβολών κατά τη χρονική περίοδο που εξετάζεται.