bluuebunny/crossref_metadata_2025 huggingface dataset:
Prosthesis selection for reconstruction of superior vena cava: comparison of midterm patency rates
Authors: Cho Han , Sohn Suk Ho , Choi Jae Woong , Hwang Ho Young , Kim Kyung Hwan , Na Kwon Joong , Kang Chang Hyun
Published: November 2024

OBJECTIVES

This study compared the mid-term patency of expanded polytetrafluoroethylene grafts without rings versus that of bovine pericardial conduits used for superior vena cava reconstruction for various thoracic diseases.

METHODS

Among 80 patients who underwent superior vena cava resection and reconstruction between 2009 and 2023 at our institution, 31 patients who received polytetrafluoroethylene grafts without rings (Polytetrafluoroethylene group) and 28 patients who received bovine pericardial conduits (Bovine group) were enrolled. Median follow-up durations were 19.5 and 64.6 months in the Polytetrafluoroethylene and Bovine groups, respectively. Primary outcome was midterm graft patency rate, and secondary outcomes were early and midterm clinical outcomes, including all-cause mortality and superior vena cava reintervention.

RESULTS

Operative mortality was 1.7%. Cumulative incidence of all-cause mortality was not significantly different between the groups. Graft occlusion was detected in 22 patients. Cumulative incidence of graft occlusion was 24.2%, 36.4%, 42.4%, 48.5% and 60.6% at 1 month, 3 months, 6 months, 1 year and 2 years, respectively, in the Bovine group, whereas no graft occlusion was observed in the Polytetrafluoroethylene group (P = 0.007). Although the incidence of graft occlusion was higher in the Bovine group, cumulative incidence of reintervention was not significantly different between the groups (0.0% vs 3.0% in Polytetrafluoroethylene vs Bovine groups at 1 year, P = 0.406). Multivariate analysis demonstrated that bovine pericardial conduit (polytetrafluoroethylene graft as reference) and left brachiocephalic vein reconstruction (right brachiocephalic vein reconstruction as reference) were significant risk factors for graft occlusion.

CONCLUSIONS

In superior vena cava reconstruction, polytetrafluoroethylene grafts without rings were superior to bovine pericardial conduits in terms of midterm graft patency.
ChatGPT, can you solve the content moderation dilemma?
Authors: Vargas Penagos Emmanuel
Published: November 2024

This article conducts a qualitative test of the potential use of large language models (LLMs) for online content moderation. It identifies human rights challenges arising from the use of LLMs for that purpose. Different companies (and members of the technical community) have tested LLMs in this context, but such examinations have not yet been centred in human rights. This article, framed within EU law—particularly the EU Digital Services Act and the European human rights framework—delimits the potential challenges and benefits of LLMs in content moderation. As such, this article starts by explaining the rationale for content moderation at policy and practical levels, as well as the working of LLMs. It follows with a summary of previous technical tests conducted on LLMs for content moderation. Then, it outlines the results of a test conducted on ChatGPT and OpenAI’s ‘GPTs’ service. Finally, it concludes with the main human rights implications identified in using LLMs for content moderation.
Relevance of therapeutic prescription modifications in Dutch community pharmacies
Authors: van Loon Ellen , Heringa Mette , Floor-Schreudering Annemieke , de Smet Peter , Bouvy Marcel
Published: November 2024

Objectives

Community pharmacists modify prescriptions to solve or prevent drug-related problems. To assess the relevance of prescription modifications, they are usually judged on clinical outcomes only, overlooking their humanistic and economic impact. This study aims to evaluate therapeutic prescription modifications performed by Dutch community pharmacists in terms of clinical outcome, along with the humanistic aspect “usability” and economic aspect “efficiency.”

Methods

A multidisciplinary panel evaluated the relevance of 160 cases of therapeutic prescription modifications collected in community pharmacies. Cases were stratified for type of drug-related problem based on their frequency in the original set of modifications. Both the relevance in general and the impact on the individual aspects of effectiveness and medication safety, usability, and efficiency were evaluated.

Key findings

Sixteen cases (10.0%) were excluded because of insufficient information for evaluation. Sixty percent of the 144 cases were evaluated as relevant (56.3% relevant and 4.2% highly relevant). The remaining cases (31.9%) were moderately relevant. For 7.6% of the cases, evaluations were inconclusive. In 25.0% of the cases, there was a major improvement on at least one of the aspects effectiveness, medication safety, usability, or efficiency.

Conclusions

The majority of therapeutic prescription modifications performed by Dutch community pharmacists were evaluated as relevant or highly relevant by a multidisciplinary panel. Modifications improved clinical, humanistic, and economic aspects. This shows the important role of community pharmacists in primary healthcare. Sharing more clinical information like indication, illness severity, and treatment plan will enable pharmacists to improve their contribution to safe medication use.
Discrete-to-continuum rates of convergence for nonlocal p-Laplacian evolution problems
Authors: Weihs Adrien , Fadili Jalal , Thorpe Matthew
Published: November 2024

Higher-order regularization problem formulations are popular frameworks used in machine learning, inverse problems and image/signal processing. In this paper, we consider the computational problem of finding the minimizer of the Sobolev $\mathrm{W}^{1,p}$ semi-norm with a data-fidelity term. We propose a discretization procedure and prove convergence rates between our numerical solution and the target function. Our approach consists of discretizing an appropriate gradient flow problem in space and time. The space discretization is a non-local approximation of the $p$-Laplacian operator and our rates directly depend on the localization parameter $\varepsilon _{n}$ and the time mesh-size $\tau _{n}$. We precisely characterize the asymptotic behaviour of $\varepsilon _{n}$ and $\tau _{n}$ in order to ensure convergence to the considered minimizer. Finally, we apply our results to the setting of random graph models.
Estimates for Smooth Weyl Sums on Major Arcs
Authors: Brüdern Jörg , Wooley Trevor D
Published: November 2024

We present estimates for smooth Weyl sums of use on sets of major arcs in applications of the Hardy–Littlewood method. In particular, we derive mean value estimates on major arcs for smooth Weyl sums of degree $k$ delivering essentially optimal bounds for moments of order $u$ whenever $u>2\lfloor k/2\rfloor +4$.
The USP35-CXCR3 Axis plays an oncogenic role in JeKo-1 mantle cell lymphoma cells
Authors: Zou Zongkai , Chen Shumin , Wu Yonghe , Ji Siling
Published: November 2024

In B cells, the chemokine receptor CXCR3 is expressed only by a subset of B cells. However, CXCR3 is highly expressed in a rare type of B-cell lymphoma known as Mantle Cell Lymphoma (MCL) and CXCR3 inhibitor impairs proliferation and induces apoptosis in the MCL cell line JeKo-1. Despite this, the mechanism responsible for maintaining high levels of CXCR3 in MCL cells remains unclear. In this study, we assessed CXCR3 expression and amplification in MCL samples and confirmed that CXCR3 is overexpressed in MCL tissues. We also observed that CXCR3 amplification is present in a small portion of MCL patients and is associated with MCL classification. We then screened ubiquitin-specific proteases (USPs) that might control the degradation of CXCR3 protein. Our investigation revealed that USP35 acts as a potent stabilizer of CXCR3 protein. Knockdown of USP35 substantially reduced the CXCR3 protein levels in JeKo-1 cells, resulting in reduced cell viability, cell cycle arrest, increased apoptosis, and mitigated migration and invasion in these cells. At the molecular level, USP35 deubiquitinates and stabilizes CXCR3. USP35 deficiency attenuated the activation of the JAK1/STAT1 pathway and reduced the expression of β-catenin and c-Myc in JeKo-1 cells. Furthermore, we observed that overexpression of CXCR3 rescued the impaired tumorigenicity of USP35-deficient JeKo-1 cells, and the mechanism may be related to the fact that USP35 promotes CXCR3 deubiquitination to stabilize its expression. These findings collectively demonstrate the oncogenic role of the USP35-CXCR3 axis in JeKo-1 MCL cells.
Aromatic amino acid metabolism and active transport regulation are implicated in microbial persistence in fractured shale reservoirs
Authors: Ugwuodo Chika Jude , Colosimo Fabrizio , Adhikari Jishnu , Purvine Samuel O , Eder Elizabeth K , Hoyt David W , Wright Stephanie A , Lipton Mary S , Mouser Paula J
Published: November 2024

Hydraulic fracturing has unlocked vast amounts of hydrocarbons trapped within unconventional shale formations. This large-scale engineering approach inadvertently introduces microorganisms into the hydrocarbon reservoir, allowing them to inhabit a new physical space and thrive in the unique biogeochemical resources present in the environment. Advancing our fundamental understanding of microbial growth and physiology in this extreme subsurface environment is critical to improving biofouling control efficacy and maximizing opportunities for beneficial natural resource exploitation. Here, we used metaproteomics and exometabolomics to investigate the biochemical mechanisms underpinning the adaptation of model bacterium Halanaerobium congolense WG10 and mixed microbial consortia enriched from shale-produced fluids to hypersalinity and very low reservoir flow rates (metabolic stress). We also queried the metabolic foundation for biofilm formation in this system, a major impediment to subsurface energy exploration. For the first time, we report that H. congolense WG10 accumulates tyrosine for osmoprotection, an indication of the flexible robustness of stress tolerance that enables its long-term persistence in fractured shale environments. We also identified aromatic amino acid synthesis and cell wall maintenance as critical to biofilm formation. Finally, regulation of transmembrane transport is key to metabolic stress adaptation in shale bacteria under very low well flow rates. These results provide unique insights that enable better management of hydraulically fractured shale systems, for more efficient and sustainable energy extraction.
Jansen metaphyseal chondrodysplasia: analysis of craniofacial manifestations
Authors: Obiezu Fiona , Almpani Konstantinia , Kim Hung Jeffrey , Zalewski Christopher , Chu Emily , Jahanmir Golnar , Roszko Kelly L , Boyce Alison , Farhadi Faraz , Weinstein Lee S , Gafni Rachel I , Ferreira Carlos R , Jüppner Harald , Collins Michael T , Lee Janice S , Jha Smita
Published: November 2024

Jansen metaphyseal chondrodysplasia (JMC) is an ultra-rare disorder caused by constitutive activation of parathyroid hormone type 1 receptor (PTH1R). We sought to characterize the craniofacial phenotype of patients with the disease. Six patients with genetically confirmed JMC underwent comprehensive craniofacial phenotyping revealing a distinct facial appearance that prompted a cephalometric analysis demonstrating a pattern of mandibular retrognathia. Oral examination was notable for flat and shallow palate, delayed eruption pattern, and impacted maxillary teeth. Subclinical and/or mild hearing loss was noted in 4 of 5 patients studied. The most common etiology was conductive, likely due to overcrowding of epitympanum which impedes the normal vibration of ossicles to sound. Paranasal sinus obliteration was noted in 5 of 6 patients. Computed tomography (CT) scan evaluation of craniofacial bones revealed bilaterally symmetric expansile lesions with predominant involvement of neural crest cell (NCC)-derived bones. Bilateral narrowing of facial nerve canals, particularly at the labyrinthine segment, was seen in 5 of 6 patients when compared to age-matched controls; 1 patient presented with progressive facial nerve palsy. Sagittal suture craniosynostosis was present in 5 of 6 patients—one of whom had a history of cranial reconstruction for pansynostosis in infancy. All patients demonstrated a significant degree of upper airway stenosis, as well as a more anterior hyoid bone displacement. Two patients had a diagnosis of obstructive sleep apnea. 18F-NaF Positron-emission tomography (PET)-CT revealed increased uptake associated with the skull base and gnathic bones in all patients. In conclusion, this first detailed systematic evaluation of the craniofacial phenotype of patients with JMC demonstrates a distinct and pronounced phenotype that predominantly affects the NCC-derived cranial bones indicating a critical role of PTH1R signaling in their development. These affects can result in significant disease-related morbidity, include hearing loss, nerve compression, craniosynostosis, dentoskeletal malocclusion, and airway compromise; all of which require close monitoring.
Administration and cancer-control outcomes of bone-modifying agents in real-world patients with metastatic castration-resistant prostate cancer
Authors: Wenzel Mike , Hoeh Benedikt , Humke Clara , Welte Maria , Cano Garcia Cristina , Siech Carolin , Saad Fred , Karakiewcz Pierre I , Tilki Derya , Steuber Thomas , Graefen Markus , Traumann Miriam , Chun Felix K H , Mandel Philipp
Published: November 2024

Hormonal agents administered for metastatic castration-resistant prostate cancer (mCRPC) may lead to osteoporosis, skeletal events, reduced quality of life, and even reduced overall survival (OS). Bone-modifying agents may prevent those events but their effect on cancer-control outcomes remains uncertain. Relying on our institutional tertiary-care database, we explored the effect of bone-modifying agents (bisphosphonates such as zoledronic acid and denosumab) on OS and progression-free survival in patients with mCRPC with at least 1 bone metastasis using Kaplan-Meyer estimates and Cox regression models. Of 420 patients with mCRPC, 60% received bone-modifying agents who were younger (68 vs 69 years), with more systemic treatment lines for mCRPC (3 vs 2), and a higher proportion of initial de novo metastatic disease (72% vs 62%, all p ≤ .04) than patients without bone-modifying agents. In progression-free survival analyses, no significant differences were observed between both groups. In OS analyses, significant median OS differences were observed in favor of patients with bone-modifying agents (58 vs 45 months; hazard ratio [HR]: 0.66), even after multivariable adjustment (HR: 0.37; both p ≤ .01). In bone-modifying agent–stratified analyses, 57% received denosumab vs 43% bisphosphonates, with a significantly higher rate of Eastern Cooperative Oncology Group status of ≥2 in the bisphosphonates group. In progression-free and OS analyses, no significant differences were observed between bisphosphonates and denosumab patients, with numerically better results in progression-free survival analysis for denosumab after adjusting for covariates. The cumulative rate of osteonecrosis of the jaw at any treatment time was 12% in both groups and significantly decreased over time. Real-world data suggest a relatively low administration rate of bone-modifying agents in patients with osseous mCRPC. However, real-world data also suggest an OS benefit when bone-modifying agents are used, even after controlling for possible confounding patient and tumor characteristics.
Inferring bivariate associations with continuous data from studies using respondent-driven sampling
Authors: Malatesta Samantha , Jacobson Karen R , Carney Tara , Kolaczyk Eric D , Gile Krista J , White Laura F
Published: November 2024

Respondent-driven sampling (RDS) is a link-tracing sampling design that was developed to sample from hidden populations. Although associations between variables are of great interest in epidemiological research, there has been little statistical work on inference on relationships between variables collected through RDS. The link-tracing design, combined with homophily, the tendency for people to connect to others with whom they share characteristics, induces similarity between linked individuals. This dependence inflates the Type 1 error of conventional statistical methods (e.g. t-tests, regression, etc.). A semiparametric randomization test for bivariate association was developed to test for association between two categorical variables. We directly extend this work and propose a semiparametric randomization test for relationships between two variables, when one or both are continuous. We apply our method to variables that are important for understanding tuberculosis epidemiology among people who smoke illicit drugs in Worcester, South Africa.
A Bayesian spatio-temporal Poisson auto-regressive model for the disease infection rate: application to COVID-19 cases in England
Authors: Alaimo Di Loro Pierfrancesco , Böhning Dankmar , Sahu Sujit K
Published: November 2024

The COVID-19 pandemic provided new modelling challenges to investigate epidemic processes. This paper extends Poisson auto-regression to incorporate spatio-temporal dependence and characterize the local dynamics by borrowing information from adjacent areas. Adopted in a fully Bayesian framework and implemented through a novel sparse-matrix representation in Stan, the model has been validated through a simulation study. We use it to analyse the weekly COVID-19 cases in the English local authority districts and verify some of the epidemic-driving factors. The model detects substantial spatio-temporal heterogeneity and enables the formalization of novel model-based investigation methods for assessing additional aspects of disease epidemiology.
Defining digital humanities and examining its relationship with linguistics through the lens of Digital Scholarship in the Humanities
Authors: Yan Jianwei , Li Qidi , Liu Haitao
Published: November 2024

Digital humanities (DH) is an emerging interdisciplinary academic field that has gained prominence in recent decades. This study explores the evolution of topics, research impact, and attractiveness of DH through the lens of the journal Digital Scholarship in the Humanities (DSH), a leading platform for DH research, from 1986 to 2023 (in three phases: 1986–2003, 2004–2014, and 2015–2023). The study also examines the role of linguistic research in DH. The results reveal that: (1) the primary themes and trends in DH research have evolved from text encoding and analysis to critical studies of technology, infrastructure, and knowledge production; (2) the citation patterns demonstrate the growing influence and recognition of DH within the humanities and computer sciences; (3) European and North American scholars have dominated DH networks, but new centers and scholars are emerging in Asia, South America, and Oceania; and (4) linguistics-related publications have given less attention to specific linguistic features but have provided vital intellectual support for DH. This study provides a data-based perspective on the development and direction of DH, and demonstrates the value of linguistic methods for mapping scholarly fields over time. Based on these findings, suggestions are made for scholars interested in DH.
Atrial fibrillation
Authors: Dan Gheorghe-Andrei , Steffel Jan
Published: November 2024

Atrial fibrillation (AF) is the commonest cardiac arrhythmia in hospitalized patients, with an increasing incidence with age and an epidemic increase projected for the next 10 years. Therapy of AF has several goals: to decrease mortality (mainly due to cardiovascular diseases), stroke rate, ventricular deterioration, and heart failure, cognitive impairment, and dementia, as well as to increase quality of life. The recent European AF guidelines specify the management strategies for each of the above-mentioned goals. For stroke prevention, treatment with a non-vitamin K antagonist oral anticoagulant (NOAC) has emerged as the therapy of choice for the majority of patients with AF in the absence of rheumatic mitral disease and mechanical valve prostheses. However, in daily use of these drugs, many challenges remain that healthcare providers need to be aware of. Regarding treatment of the arrhythmia itself, it remains a therapy addressing the quality of life. Catheter ablation has emerged as a valid alternative for a variety of patients. Nevertheless, pharmacological antiarrhythmic drug therapy remains an important pillar for the majority of patients, and effective and safe use implies an important skill for every cardiologist.
Associations of social vulnerability index with patient-reported outcomes in women treated with chemotherapy for early-stage breast cancer
Authors: Almond Natalie , Deal Allison M , Page Annie , Nyrop Kirsten A , Muss Hyman B
Published: November 2024

Background

In a convenience sample of women scheduled for chemotherapy for early-stage breast cancer, we investigated associations of the Center for Disease Control and Prevention’s neighborhood-level social vulnerability index (SVI) with pretreatment demographics and patient-reported outcome (PRO) measures (health behavior, function and quality of life, treatment toxicities during chemotherapy).

Methods

The SVI Overall score is comprised of 4 themes: socioeconomic, household composition, minority status/language, and household type/transportation, with scores ranging from 0 = lowest to 1 = highest vulnerability neighborhoods. Participant SVI scores were derived from zip codes listed in the patient’s address within the electronic medical record (EMR). Associations of study variables with SVI were evaluated using Spearman correlation for continuous variables and Kruskal–Wallis tests for categorical variables.

Results

In a sample of 309 women, the mean age was 56 years (range 23-83) and 75% White. Greater vulnerability SVI Overall score was associated with lower education (P =.02), nonmarriage (P ≤.0001), higher body mass index (P =.03), and prechemotherapy PRO measures such as fewer self-reported walking minutes/week (P ≤.001), history of smoking (P =.02) and alcohol use (P < .001), depression (P =.01), and lower emotional social support (P =.008). During chemotherapy, moderate, severe, or very severe symptoms were associated with greater vulnerability SVI Overall scores for hot flashes (P =.03), arthralgia (P =.02), myalgia (P =.02), peripheral neuropathy (P =.01), edema of limbs (P =.04), and nausea (P <.001).

Conclusions

SVI scores derived from addresses in the patient’s EMR can be used to generate information that adds to the patient’s social history in ways that are informative for anticipating and monitoring chemotherapy-related toxicities.
Molecular dynamics and machine learning stratify motion-dependent activity profiles of S-layer destabilizing nanobodies
Authors: Cecil Adam J , Sogues Adrià , Gurumurthi Mukund , Lane Kaylee S , Remaut Han , Pak Alexander J
Published: November 2024

Nanobody (Nb)-induced disassembly of surface array protein (Sap) S-layers, a two-dimensional paracrystalline protein lattice from Bacillus anthracis, has been presented as a therapeutic intervention for lethal anthrax infections. However, only a subset of existing Nbs with affinity to Sap exhibit depolymerization activity, suggesting that affinity and epitope recognition are not enough to explain inhibitory activity. In this study, we performed all-atom molecular dynamics simulations of each Nb bound to the Sap binding site and trained a collection of machine learning classifiers to predict whether each Nb induces depolymerization. We used feature importance analysis to filter out unnecessary features and engineered remaining features to regularize the feature landscape and encourage learning of the depolymerization mechanism. We find that, while not enforced in training, a gradient-boosting decision tree is able to reproduce the experimental activities of inhibitory Nbs while maintaining high classification accuracy, whereas neural networks were only able to discriminate between classes. Further feature analysis revealed that inhibitory Nbs restrain Sap motions toward an inhibitory conformational state described by domain–domain clamping and induced twisting of domains normal to the lattice plane. We believe these motions drive Sap lattice depolymerization and can be used as design targets for improved Sap-inhibitory Nbs. Finally, we expect our method of study to apply to S-layers that serve as virulence factors in other pathogens, paving the way forward for Nb therapeutics that target depolymerization mechanisms.
Spatial organization and stochastic fluctuations of immune cells impact clinical responsiveness to immunotherapy in melanoma patients
Authors: Giuliani Giuseppe , Stewart William , Li Zihai , Jayaprakash Ciriyam , Das Jayajit
Published: November 2024

High-dimensional, spatial single-cell technologies, such as CyTOF imaging mass cytometry (IMC), provide detailed information regarding locations of a large variety of cancer and immune cells in microscopic scales in tumor microarray slides obtained from patients prior to immune checkpoint inhibitor (ICI) therapy. An important question is how the initial spatial organization of these cells in the tumor microenvironment (TME) changes with time and regulates tumor growth and eventually outcomes as patients undergo ICI therapy. Utilizing IMC data of melanomas of patients who later underwent ICI therapy, we develop a spatially resolved interacting cell system model that is calibrated against patient response data to address the above question. We find that the tumor fate in these patients is determined by the spatial organization of activated CD8+ T cells, macrophages, and melanoma cells and the interplay between these cells that regulate exhaustion of CD8+ T cells. We find that fencing of tumor cell boundaries by exhausted CD8+ T cells is dynamically generated from the initial conditions that can play a protumor role. Furthermore, we find that specific spatial features such as co-clustering of activated CD8+ T cells and macrophages in the pretreatment samples determine the fate of the tumor progression, despite stochastic fluctuations and changes over the treatment course. Our framework enables the determination of mechanisms of interplay between a key subset of tumor and immune cells in the TME that regulate clinical response to ICIs.
Outpatient Physical Therapy Attendance by Older Adults After Emergency Department Discharge was a Predictor for Lower 30-Day Revisits—But Demographic Factors Affected Attendance
Authors: Ryer Suzanne V , Simpson Michelle , Singh Maharaj
Published: November 2024

Objective

Given the high risk of functional loss and revisits among older adults presenting to the emergency department (ED), there is a need to understand how post-ED discharge outpatient physical therapy affects outcomes. This study sought to examine patient demographics and their association with outpatient physical therapy utilization after ED discharge and physical therapy attendance with 30-day ED revisits among older adults discharged to home.

Methods

In this retrospective cohort study, we analyzed data from 1395 older adults (65 years old and older) who had a referral to outpatient physical therapy upon discharge from 15 EDs between January 2021 and December 2022. Descriptive statistics and multivariate logistic regression were used to evaluate the likelihood of attending outpatient physical therapy and the odds of a 30-day ED revisit.

Results

Of the sample, 39.3% attended outpatient physical therapy. Older adults in the first and second neighborhood income quintile had a 51% lower odds of attending outpatient physical therapy than those in the fourth quintile. Patients with a diagnosis of vertigo had a 67% higher odds of attending outpatient physical therapy (OR = 1.67; 95% CI = 1.21–2.29) than those with back pain. Older adults who did not attend outpatient physical therapy within 30 days of ED visit had a 88% higher odds of returning to the ED than those who did attend (OR = 1.88; 95% CI = 1.34–2.64). Older adults in the first and second income quintile had a 66% higher odds of revisiting the ED than those in the fourth quintile.

Conclusion

Outpatient physical therapy attendance after ED discharge was a predictor of revisit within 30 days. Patient diagnosis of vertigo and higher median household income were predictors of higher outpatient physical therapy attendance. However, a diagnosis of falls or mobility concerns and a lower household income status were associated with lower attendance.

Impact

Physical therapy after ED discharge has the potential to reduce 30-day ED revisit but requires strategies to improve access equity across diagnostic groups and household income levels.
Identifying diagnosed major chronic diseases associated with recent housing instability among aging adults: data from the ‘All of Us’ research program
Authors: Beydoun Hind A , Mayno Vieytes Christian A , Beydoun May A , Lampros Austin , Tsai Jack
Published: November 2024

Background

Housing instability is a known barrier to healthcare utilization potentially affecting the prevention, diagnosis and treatment of chronic diseases among diverse groups of adults. We examined the intersection of recent housing instability with prevalent cardiovascular disease, diabetes, cancer and psychiatric diagnoses among aging adults.

Methods

Cross-sectional data on 147 465 participants of the ‘All of Us’ Research Program (6 May 2018–1 July 2022), ≥50 years of age at enrollment, were analyzed. Self-reported housing instability over the past 6 months was examined in relation to diagnosed conditions at age ≥50 years based on electronic health records. Multivariable logistic regression models sequentially adjusting for demographic and socioeconomic characteristics were constructed to estimate odds ratios (OR) with their 95% confidence intervals (CI).

Results

After adjusting for confounders, past 6 months housing instability was associated with lower odds of diagnosed cardiovascular disease (OR = 0.89, 95% CI: 0.87, 0.93) and cancer (OR = 0.82, 95% CI: 0.78, 0.86), higher odds of diagnosed psychiatric (OR = 1.35, 95% CI: 1.30, 1.40) conditions, but was unrelated to diagnosed diabetes (OR = 0.98, 95% CI: 0.94, 1.01).

Conclusions

Recent housing instability among aging adults is positively associated with psychiatric diagnoses, but negatively associated with cardiovascular and cancer diagnoses, with implications for chronic disease prevention.
Unsettling research quality
Authors: Franssen Thomas , Brorstad Borlaug Siri , Langfeldt Liv
Published: November 2024

This special section foregrounds the notion of research quality. In the introduction we contextualize the papers of this special section by, first, introducing the history of studies of research quality in the field of research evaluation. We then consider the what the six papers of the special section contribute to the study of research quality. We end our introduction by highlighting three interesting avenues for further research.
Toward a mission-oriented framework for funding public research institutions: a multi-case study approach
Authors: Alizadeh Parisa
Published: November 2024

This study proposes a mission-oriented framework for funding public research institutions (PRIs). Using a multi-case study approach and focus group interviews, a comprehensive framework was developed and refined. The framework encompasses three main dimensions: funding mechanisms, the amount of government funding, and organizational arrangements for resource allocation. It introduces diversified funding mechanisms for PRIs, including block grants, performance-based contracts, competitive funding, targeted allocations for specific missions, and excellence budgets. The proportion of each mechanism in the funding portfolio can vary depending on the mission types of PRIs. The framework recommends estimating government funding amounts using per capita formulas based on relevant input/output indicators tailored to the mission types of PRIs. Clear organizational arrangements are essential, including establishing a national research agency to oversee the estimation, steering, and monitoring of financial resource allocation and utilization.
Evaluation of the Electroconvulsive Therapy’s Impact on Retinal Structures in First-Episode Psychosis Patients Using Optical Coherence Tomography
Authors: Kurhan Faruk , Yıldız Veysi , Kamış Gülsüm Zuhal , Karataş Kübra , Batur Muhammed
Published: November 2024

Background and Hypothesis

Schizophrenia is a complex disorder thought to have neurodevelopmental and neurodegenerative aspects. Optical coherence tomography (OCT) measurements of schizophrenia patients revealed that the retinal layers of these patients were thinner than those of healthy controls. This study aimed to examine retinal changes in first-episode psychosis patients treated with electroconvulsive therapy (ECT) via OCT.

Study Design

Thirty first-episode psychosis patients (13 men, 17 women) aged 18 to 65 years who had no comorbidities and no smoking, alcohol, or substance use disorders and who were treated with ECT were included in the study. The patients were evaluated using OCT before treatment and after an average of 7.4 sessions of ECT in remission, and the results were compared.

Study Results

Statistically significant increases were observed in retinal layer thickness, inner plexiform layer, outer plexiform layer, and total retinal thickness within the 1 mm ring (P = .015, P = .045, and P = .025, respectively). The inner nuclear layer thickness significantly increased within the 6 mm ring (P = .037).

Conclusions

In conclusion, ECT noticeably affected retinal structures, particularly according to similar measurements, indicating potential improvements in and the ability to reverse neuronal degeneration after one month of treatment. This study highlights the potential impact of ECT on retinal structures in individuals experiencing first-episode psychosis, as it can enhance specific retinal layers and reverse neuronal degeneration.
Why are Latin American countries in the limbo of open-access scientific publications?
Authors: Chavarría Max , Lomonte Bruno , Gutiérrez José María , Moreno Edgardo , Pérez Alice L
Published: November 2024

Open Access (OA) model in scientific journals has brought about a range of benefits in terms of information accessibility. However, the high costs associated with Article Processing Charges (APCs) have posed a significant challenge for many scientists, leaving them in a ‘limbo’, where their ability to publish in reputable journals is contingent upon their financial capacity. Here, we intend to highlight the challenges faced by Latin American scientists that have arisen as a direct consequence of the implementation of the OA, specifically: (i) difficulties in disseminating our scientific work due to the impossibility of covering the high APCs imposed by journals, and (ii) the strong emergence and consolidation in our region of publishers with predatory practices. We urge the scientific community to establish policies that contribute to equity in OA models and to defend the right of Latin American scientists not only to read science freely but also to be read.
A randomized dose finding study of combination dronabinol and acetazolamide for the treatment of obstructive sleep apnea
Authors: Walsh Jennifer , Rankin Timothy , Mehra Sumit , Naughton Matthew T , Roebuck Teanau , McDermott Elizabeth , Pattichis Andreas , Smith Rafael , Walsh Rosemarie , Bleackley Mark , Maddison Kathleen , O’Brien Terence J
Published: November 2024

Study Objectives

Current treatments for obstructive sleep apnea (OSA) are ineffective or not tolerated in a proportion of patients. Other therapeutic options are needed and pharmaceuticals may provide an alternative. This randomized, double-blind, placebo-controlled, crossover study examined the effect of a combination of acetazolamide and dronabinol (IHL-42X) at low, medium, and high doses on OSA severity.

Methods

Participants with OSA (apnea–hypopnea index; AHI ≥15 events/hour) received 1 week of IHL-42X at each of three doses and placebo, each separated by a 1-week washout. The change from baseline in AHI, oxygen desaturation index (ODI), Epworth sleepiness score (ESS), and mood (profile of mood states) on the final night of each treatment arm relative to the change from baseline to placebo were the major endpoints. Adverse events (AEs) were monitored throughout.

Results

Ten of 11 participants completed the final night of at least one treatment arm. IHL-42X demonstrated a greater reduction in AHI from baseline compared with placebo (low, −19.7 ± 27.1; medium, −17.5 ± 23.3; high, −16.4 ± 23.8 vs. placebo, −2.8 ± 21.0 events/hour; all p < .05). The change from baseline in ODI3% was greater for the medium IHL-42X dose when compared with placebo (−15.4 ± 19.0 vs. placebo, −2.8 ± 21.0 events/hour; p < .05) but not the low or high doses (low, −15.2 ± 24.8; high, −8.3 ± 13.2 events/hour). IHL-42X did not change ESS or mood. No serious AEs occurred; however, 35 mild–moderate possibly, probably, or treatment-related AEs occurred during IHL-42X dosing and 5 occurred during placebo.

Conclusions

One week of nightly IHL-42X at low, medium, and high doses was well tolerated, safe, and associated with significant reductions in OSA severity.
Liver–gut axis signaling regulates circadian energy metabolism in shift workers
Authors: Yang Zhenning , Zarbl Helmut , Kong Bo , Taylor Rulaiha , Black Kathleen , Kipen Howard , Basaly Veronia , Fang Mingzhu , Guo Grace L.
Published: November 2024

Circadian rhythm is critical to maintaining the whole‐body metabolic homeostasis of an organism. Chronic disruption of circadian rhythm by shift work is an important risk factor for metabolic diseases. Fibroblast growth factor 15/19 (FGF15/19), a key component in the liver–gut axis, potently suppresses bile acid (BA) synthesis and improves insulin sensitivity. FGF15/19 emerges as a novel pharmaceutical target for prevention and treatment of metabolic diseases. The nicotinamide adenine dinucleotide (NAD+)‐dependent sirtuin 1 (SIRT1) deacetylase plays an important role in the maintenance of hepatic homeostasis by linking hepatic metabolism to circadian rhythm. Here, our clinical study identified that circadian rhythmicity and levels of plasma FGF19 and BA profiling, and cellular NAD+‐dependent SIRT1 signaling were disturbed in night shift (NS, n = 10) compared to day shift (DS, n = 12) nurses. Our in vitro data showed that recombinant FGF19 protein rescued cellular circadian rhythm disrupted by SIRT1 inhibitors. Furthermore, we determined the effect of FGF15 on circadian rhythm and hepatic metabolism in wild‐type (WT), Fgf15 knockout (KO), and Fgf15 transgenic (TG) mice. The expressions of circadian‐controlled genes (CCGs) involved in SIRT1 signaling, BA and lipid metabolism, and inflammation were disrupted in Fgf15 KO compared to WT and/or Fgf15 TG mice. Moreover, systemic FGF15 deficiency led to the circadian disturbance of NAD+‐dependent SIRT1 signaling and significant reduction during nighttime in mice. These findings suggest that FGF15/19 regulates the circadian energy metabolism, which warrants further studies as a putative prognostic biomarker and pharmaceutical target for preventing against metabolic diseases associated with chronic shift work.
Statewide Trends in Medications for Opioid Use Disorder Utilization in Rhode Island, United States, 2017–2023
Authors: Shaw Leah C. , Hallowell Benjamin D. , Paiva Taylor , Schulz Christina T. , Daly Mackenzie , Borden Samantha K. , Goulet Jamieson , Samuels Elizabeth A. , Cerdá Magdalena , Marshall Brandon D. L.
Published: November 2024

Background

Buprenorphine and methadone are US Food and Drug Administration-approved medications for opioid use disorder (MOUD). Although utilization of MOUD was increasing pre-COVID-19, it is not well understood how this trend shifted during and “after” the COVID-19 pandemic in Rhode Island. This analysis will consider the differential utilization of MOUD over time and by key demographic factors.

Methods

We utilized two of Rhode Island’s statewide databases to examine aggregate counts of dispensed buprenorphine and methadone from January 1, 2017, to December 31, 2023. Data were stratified by age group, sex assigned at birth, and race/ethnicity (where available). Counts were stratified into pre-COVID-19 (Q1 2017–Q1 2020), COVID-19 (Q2 2020–Q4 2022), and endemic COVID-19 (2023) eras. Averages and annualized percent change for each period were calculated to understand how utilization changed over time.

Results

Before COVID-19, buprenorphine and methadone utilization were increasing annually. During COVID-19, utilization declined annually by 0.40% and 0.43%, respectively. In the endemic COVID-19 time period, buprenorphine and methadone utilization declined more rapidly at 2.59% and 1.77%, respectively. Declines were more dramatic for adults aged 18–34.

Conclusions

We observed a decline in MOUD utilization during and after COVID-19 in Rhode Island, primarily driven by substantial decreases in MOUD use among the youngest group of adult residents. Interventions specifically tailored to youth, such as school-based or primary healthcare-based programs, may be particularly effective in engaging with youth in substance use disorder treatment.
Is Naltrexone Effective and Safe for Treating Amphetamine-Type Stimulant Use Disorder? A Systematic Review and Meta-analysis
Authors: Bastien Gabriel , McAnulty Christina , Sharafi Heidar , Mahroug Amani , Elkrief Laurent , Ziegler Daniela , Dubreucq Simon , Juteau Louis-Christophe , Jutras-Aswad Didier
Published: November 2024

Objectives

We conducted a systematic review and meta-analysis (PROSPERO ID: CRD42023401796) of randomized placebo-controlled trials evaluating the effectiveness and safety of naltrexone as a standalone pharmacotherapy for amphetamine-type stimulant use disorder (ATSUD).

Methods

We searched EMBASE, MEDLINE, EBM Reviews, PsycINFO, CINAHL, Google Scholar, and trial registries on April 11, 2023, and updated on September 24, 2024, to identify randomized placebo-controlled trials evaluating the effectiveness of naltrexone for the treatment of ATSUD. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed for reporting the study. Risk of bias and quality of evidence were assessed with the Cochrane Risk-of-bias Assessment tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Risk ratios (RRs) or Peto odds ratio were estimated for binary outcomes as appropriate. Standardized mean differences were calculated for continuous outcomes.

Results

Five studies (n = 419 participants) were eligible. We found no significant difference between naltrexone and placebo for amphetamine-type stimulant use (RR = 0.903, 95% confidence interval [CI] = 0.698 to 1.167, P = 0.44, I
2 = 96.1%; 4 studies), study retention (RR = 1.055, 95% CI = 0.942 to 1.182, P = 0.35, I
2 = 45.0%; 4 studies), end-of-treatment craving (standardized mean difference = 0.069, 95% CI = −0.272 to 0.410, P = 0.69, I
2 = 0.0%; 2 studies), and serious adverse events (odds ratio = 1.086, 95% CI = 0.414 to 2.849, P = 0.87, I
2 = 0.0%; 3 studies). The quality of evidence was low to very low.

Conclusions

The available evidence does not support the use of standalone naltrexone to treat ATSUD. Significant research efforts must be put toward to identify effective pharmacotherapies to complement psychosocial interventions for ATSUD.
Robotic Versus Laparoscopic Liver Resection: A Nationwide Propensity Score Matched Analysis
Authors: Pilz da Cunha Gabriela , Sijberden Jasper P. , van Dieren Susan , Gobardhan Paul , Lips Daan J. , Terkivatan Türkan , Marsman Hendrik A. , Patijn Gijs A. , Leclercq Wouter K. G. , Bosscha Koop , Mieog J. Sven D. , van den Boezem Peter B. , Vermaas Maarten , Kok Niels F. M. , Belt Eric J. T. , de Boer Marieke T. , Derksen Wouter J. M. , Torrenga Hans , Verheijen Paul M. , Oosterling Steven J. , Rijken Arjen M. , Coolsen Marielle M. E. , Liem Mike S. L. , Tran T.C. Khé , Gerhards Michael F. , Nieuwenhuijs Vincent , Abu Hilal Mohammad , Besselink Marc G. , van Dam Ronald M. , Hagendoorn Jeroen , Swijnenburg Rutger-Jan ,   for the Dutch Hepatobiliary Audit Group
Published: November 2024

Objective:

To compare nationwide outcomes of robotic liver resection (RLR) with laparoscopic liver resection (LLR).

Background:

Minimally invasive liver resection is increasingly performed using the robotic approach as this could help overcome inherent technical limitations of laparoscopy. It is unknown if this translates to improved patient outcomes.

Methods:

Data from the mandatory Dutch Hepatobiliary Audit were used to compare perioperative outcomes of RLR and LLR in 20 centers in the Netherlands (2014–2022). Propensity score matching (PSM) was used to mitigate selection bias. Sensitivity analyses assessed the impact of the learning curve (≥50 procedures for LLR and ≥25 procedures for RLR), concurrent noncholecystectomy operations, high-volume centers, and conversion on outcomes.

Results:

Overall, 792 RLR and 2738 LLR were included. After PSM (781 RLR vs 781 LLR), RLR was associated with less blood loss (median: 100 mL [interquartile range (IQR): 50–300] vs 200 mL [IQR: 50–500], P = 0.002), less major blood loss (≥500 mL,18.6% vs 25.2%, P = 0.011), less conversions (4.9% vs 12.8%, P < 0.001), and shorter hospital stay (median: 3 days [IQR: 2–5] vs 4 days [IQR: 2–6], P < 0.001), compared with LLR. There were no significant differences in overall and severe morbidity, readmissions, mortality, and R0 resection rate. Sensitivity analyses yielded similar results. When excluding conversions, RLR was only associated with a reduction in reoperations (1.1% vs 2.7%, P = 0.038).

Conclusion:

In this nationwide analysis, RLR was associated with a reduction in conversion, blood loss and length of hospital stay without compromising patient safety, also when excluding a learning curve effect. The benefits of RLR seem to be mostly related to a reduction in conversions.
Knowledge Graph of Endoscopic Techniques Applied to the Treatment of Lumbar Disc Herniation
Authors: Zhao Jinlong , Zeng Lingfeng , Wei Wanjia , Liang Guihong , Yang Weiyi , Fu Haoyang , Zeng Yuping , Liu Jun , Zhao Shuai
Published: November 2024

Study Design:

Bibliometric analysis.

Objective:

This study explored the current research status, hotspots, and trends in the application of endoscopic techniques for treating lumbar disc herniation (LDH).

Background:

Endoscopic techniques are widely used to treat LDH, but there are no bibliometric studies on endoscopic technology and LDH.

Methods:

The Web of Science Core Collection database was used as the data source. Based on the principles of bibliometrics, we apply VOSviewer and CiteSpace software to conduct the data statistics and visual analysis.

Results:

A total of 965 studies were included, with 11893 citations (12.32 per study). The top 3 countries with the largest number of papers published are China (529), South Korea (164), and the United States (108). Yong Ahn and Jin-Sung Kim are prolific authors in this field. Representative academic journals are World Neuroscience, Pain Physician, and BioMed Research International. The results of keyword cooccurrence analysis indicate that the research topics in this field in the past decade have mainly focused on microdiscectomy, complications, percutaneous endoscopic lumbar discectomy, decompression, and the learning curve. Keyword burst analysis suggested that endoscopic drug injection and the identification of risk factors for LDH are the frontiers and trends for future research.

Conclusion:

The application of endoscopic techniques for LDH has received widespread attention from researchers, and research in this field has focused on percutaneous endoscopic lumbar discectomy, endoscopic decompression, complications, and the learning curve of endoscopic techniques. Future research trends will focus on the efficacy of endoscopic drug injection therapy for LDH and the identification of risk factors for LDH treatment failure.