bluuebunny/crossref_metadata_2025 huggingface dataset:
Burden and Heart Rate Variability in Bipolar Disorder Family Caregivers
Authors: Williams Elizabeth , Zauszniewski Jaclene A.
Published: December 2021

Family caregivers of persons with bipolar disorder experience considerable stress. Yet, studies have not examined whether their stress differs by race and gender. This preliminary analysis of baseline data from 228 African American and White family caregivers of adults with bipolar disorder who were enrolled in a randomized controlled trial examined race and gender differences on two validated self-report measures of psychological stress (caregiver burden and caregiver reactions) and an electrocardiography device used to capture heart rate variability (HRV). No statistically significant differences were found by race or gender on either measure of psychological stress. African American caregivers had significantly lower scores on two indices of HRV compared to White caregivers. Women had significantly lower scores on one index of HRV compared to men. Low HRV indicates greater stress and mortality risk. Future research should include HRV to measure caregiver stress and implement relevant interventions.
Beaten paths towards the transnational corporate elite
Authors: Valeeva Diliara , Takes Frank W , Heemskerk Eelke M
Published: December 2021

The transnationalization of economic activities has fundamentally altered the world. One of the consequences that has intrigued scholars is the formation of a transnational corporate elite. While the literature tends to focus on the topology of the transnational board interlock network, little is known about its driving mechanisms. This article asks the question: what are the trajectories that corporate elites follow in driving the expansion of this network? To answer this, the authors employ a novel approach that models the transnationalization of elites using their board appointment sequences. The findings show that there are six transnationalization trajectories corporate elites follow to expand the network. The authors argue that while the transnational elite network appears as a global social structure, its generating mechanisms are regionally organized. This corroborates earlier findings on the fragmentation of the global network of corporate control, but also provides insights into how this network was shaped over time.
Financial geography III: Research strategies, designs, methods and data
Authors: Wójcik Dariusz
Published: December 2021

I review research strategies, designs, methods and data in financial geography, by focussing on 449 articles published in 2001–2020. The analysis shows considerable methodological diversity and originality, contributing to geography and studies of finance. Over time, qualitative strategies, case study design and interviews as a method and data source are growing, while quantitative strategy, longitudinal design, regression methods and the use of government data are declining. The analysis helps identify gaps, opportunities and challenges, including the need for more methodological transparency, more in-depth qualitative and quantitative approaches supporting causal analysis, and a more ambitious historical and geographical scope.
Compréhension des pratiques des consommateurs face à la cherté de la vie
Authors: Pothin Gaëlle , Bachouche Hajer , Camelis Christèle , Sabri Ouidade
Published: December 2021

L’objectif de cet article est double : (1) développer une meilleure compréhension de la « vie chère » par une définition claire du concept et (2) rendre compte des différentes stratégies adaptatives développées par les individus en réaction. Au moyen d’une triangulation de trois collectes de données auprès de consommateurs réunionnais (12 entretiens exploratoires, une netnographie et 14 entretiens avec photo-élicitation), cette étude montre que la vie perçue comme chère se traduit par un sentiment de perte de pouvoir ou dis-empowerment chez les individus. Pour reprendre le contrôle sur leur consommation, des stratégies adaptatives permettant de vivre avec et/ou de lutter contre la vie chère sont développées par les consommateurs. Cette reprise de pouvoir ou re-empowerment s’exerce alors tant au niveau individuel que collectif (communautaire, collaboratif ou sociétal).
Promoting Healthy Food Access and Nutrition in Primary Care: A Systematic Scoping Review of Food Prescription Programs
Authors: Little Matthew , Rosa Ebony , Heasley Cole , Asif Aiza , Dodd Warren , Richter Abby
Published: December 2021

Objective

To conduct a scoping review to synthesize evidence on food prescription programs.

Data Source

A systematic search of PubMed, CINAHL, Web of Science, Embase, and the Cochrane Library was conducted using key words related to setting, interventions, and outcomes.

Study Inclusion and Exclusion Criteria

Publications were eligible if they reported food prescription administered by a health care practitioner (HCP) with the explicit aim of improving healthy food access and consumption, food security (FS), or health.

Data Extraction

A data charting form was used to extract relevant details on intervention characteristics, study methodology, and key findings.

Data Synthesis

Study and intervention characteristics were summarized. We undertook a thematic analysis to identify and report on themes. A critical appraisal of study quality was conducted using the Mixed Methods Appraisal Tool (MMAT).

Results

A total of 6145 abstracts were screened and 23 manuscripts were included in the review. Food prescriptions may improve fruit and vegetable consumption and reduce food insecurity (FI). Evidence for impacts on diet-related health outcomes is limited and mixed. The overall quality of included studies was weak. Addressing barriers such as stigma, transportation, and poor nutrition literacy may increase utilization of food prescriptions.

Conclusion

Food prescriptions are a promising health care intervention. There is a need for rigorous studies that incorporate larger sample sizes, control groups, and validated assessments of dietary intake, food security, and health.
Wealth accumulation and retirement preparedness in cross-national perspective: A gendered analysis of outcomes among single adults
Authors: Gornick Janet C , Sierminska Eva
Published: December 2021

Wealth is an increasingly important dimension of economic well-being and is attracting rising attention in discussions of social inequality. In this article, we compare – within and across countries – wealth outcomes, and link those to both employment-related factors and policy solutions that have the potential to improve wealth creation and retirement security for women. By constructing country-specific portraits of wealth outcomes and ‘retirement preparedness’, we reveal extensive cross-national variation in multiple facets of wealth. Our regression analysis finds a statistically significant and positive effect of work experience on wealth, with that effect, in general, increasing over time. The effect of work experience for single women is greater than for single men, suggesting that, among men, other, stronger forces are at work in creating wealth. The retirement preparedness outcomes indicate that single women in all three countries are in a precarious position at retirement, with much lower expected annual wealth levels than single men. The second preparedness indicator, which links expected annual wealth to income, demonstrates that men have the potential to cover larger shares of their income at retirement – and thus are more able, than their female counterparts, to maintain standards of living achieved earlier in life. Our policy discussion indicates that employment remains a viable option for ultimately bolstering women’s wealth accumulation. Many scholars, gender equality advocates and policymakers have argued for raising women’s employment rates – for a multitude of reasons – but few, if any, have made the case for strengthening women’s employment in order to ultimately bolster women’s wealth building. We hope to help reduce the gap in the literature on policy supports for women’s employment and re-open the discussion on how women can create more wealth.
‘Motivational orientation for adult learners’
Authors: Das Lata , Kumar Prakash
Published: December 2021

The present study is part of an exploratory research study conducted to understand the Learning experiences of adult learners in Higher Education Institutes in India. The primary aim of the present study was to examine the motivational orientations of adult learners for lifelong educational courses and hence, the Educational Participation Scale (EPS) by Boshier was used to examine the motivational orientations among adult learners enrolled in selected lifelong courses. In total, seven motivational factors were identified among the adult learners to enrol in the Programmes: Communication skills and Social contact, Professional advancement, Intellectual recreation, Cognitive interest, Family Togetherness, Children Relationship and Educational Compensation. Age, gender, type of course and educational background had varying influences on the motivational orientation of the adult learners. Though professional advancement was found to be higher, Communication skills, social contact and family togetherness was found to be significantly higher among older research participants aged 50 years and above.
Academic Engagement and Dropout Intention in Undergraduate University Students
Authors: Álvarez-Pérez Pedro Ricardo , López-Aguilar David , González-Morales María Olga , Peña-Vázquez Rocío
Published: December 2021

The relationship between engagement and the intention to drop out was the focus of this research. Following an empirical–analytical approach, a sample of 1,122 university students responded to a questionnaire designed to measure the engagement and the intention to drop out of school. The results confirmed that undergraduates who considered dropping out had lower scores on the engagement scale. These data are relevant for the adoption of preventive measures against academic dropouts.
Minority Versus Minority: Partisanship and Inter-Group Competitions Among Asian Americans
Authors: Liu Dongshu , Carrington Nathan
Published: December 2021

Increasingly salient in democratic politics are the divides among political parties regarding how they mobilize supports between ethnic majorities and minorities. Why, then, do some members of a minority group support political parties that seem antithetical to the interests of minority groups? We draw on group conflict theory to suggest that a partial explanation rests on perceived competition within minority groups. We test this theory by focusing on Republican Party support among Asian Americans in the United States. Based on two representative surveys and an original online survey experiment of Asian Americans, we demonstrate that perceived competition among racial minority groups has a significant effect on the partisanship of Asian American and pushes them toward the Republican Party. We also present observational evidence suggesting our theory applies to other minority groups. Our findings provide critical implications on how race affects politics in democracies with increasingly diversified ethnic minority groups.
Association Between the Diabetes mellitus Duration and the Severity of Diabetic Foot Disease in Hospitalized Patients in Latin America
Authors: Bedriñana-Marañón Belissa , Rubio-Rodríguez Maria , Yovera-Aldana Marlon , Garcia-Villasante Eilhart , Pinedo-Torres Isabel
Published: December 2021

The objective was to determine the association between a diabetes mellitus duration greater than 10 years and the severity of diabetic foot in hospitalized patients in Latin America.

Analytical, observational, and retrospective study based in secondary databases. Patients older than 18 years with diagnosis of diabetes mellitus (DM) and hospitalized for any causes were included. The independent and dependent variables were having more than 10 years of diagnosis of DM and the severity of the diabetic foot disease (Wagner> = 2), respectively. A crude Poisson regression analysis was performed to obtain prevalence rates adjusted to confounders.

Male gender was 54.8% and the median age was 62 years. In the group with more than10 years of disease (n = 903) 18% (n = 162) had severe injuries. We performed two Poisson regression analyzes, one of which included the entire sample; and in the other, only patients with some degree of ulcer were included at the time of evaluation (Wagner > = 1). In the first analysis the PR was 1.95 ( p < 0.01) adjusted for the significant variables in the bivariate analysis and in the second analysis the PR was 1.18 ( p < 0.01) adding to the adjustment the days of injury prior to hospitalization and the location of the ulcer.

We conclude that in patients with more than 10 years of diabetes mellitus, diabetic foot injuries are more severe, regardless type of diabetes, gender, age, history of amputation and days of injury prior to hospitalization for inpatients in Latin America.
Functional versatility of hybrid composite finishing of chitosan-titania NPs-organic UV-absorber for polyacrylonitrile fabric
Authors: Abo El-Ola Samiha M , Kotb Rehab M
Published: December 2021

This current study proposes a novel, successful method for multi-finishing polyacrylonitrile fabric. The performance of the polyacrylonitrile (PAN) fabric was successfully modified using functional finishing with hybrid composite (chitosan-titania NPs-organic UV absorber). PAN was activated to increase the number of reactive sites available for functional finishing. The effect of the finishing process on the fabric properties and the interaction between the activated PAN fabrics with the hybrid composite was demonstrated. Dyeing with reactive dye was done to monitor the reactive groups formed after alkali hydrolysis of PAN fabric and finishing and has been estimated as the starting point to determine the appropriate finishing bath formulation. The results revealed that the hybrid composite is a multifunctional agent in the fabrication process of bacterial and ultraviolet resistances. The maximum bacterial reduction was 95% E. coli and 92% for S. aureus and the maximum UPF value (108) and excellent protection category against UV radiation. The surface characteristics of the fabrics were investigated by Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX). The UPF and antibacterial properties show a minor decrease after five wash cycles. The reduction might be attributable to the unfixed and physically connected finishing agents.
Tribological behavior of grooves textured thrust cylindrical roller bearings under dry wear
Authors: Long Risheng , Pan Zhen , Jin Zhihao , Zhang Yimin , Sun Shaoni , Wang Yueyong , Wang Yibing , Li Manhong
Published: December 2021

To prolong the serve life of roller element bearings (REB) and improve the reliability of mechanical system, the tribological behavior of the “washers-cage-rollers” system of grooves textured thrust cylindrical roller bearings (TCRB, 81107TN) under dry wear was researched. The pattern parameters include: width of grooves (WOG, 50, 100, and 150 μm), depth of grooves (DPOG, 7, 11, and 15 μm), as well as groove deflection angle (GDA, 0°, 45°, 90°, and 135°). The influence mechanism of grooves on the tribological properties of REBs is discussed. The results show that: As the GDA is 45°, the coefficient of friction (COF) and mass loss of bearing is the lowest among four angles. The average COFs of grooves textured bearings are much higher than that of smooth one, and their mass losses are all lower than that of smooth bearing. The influence of pattern parameters on the surface stresses of grooves textured bearings is weak. In this work, when the WOG is 50 μm and the DPOG is 7 μm, the wear loss of grooves textured bearing is the lowest, reduced by up to 75.6%. This work can provide a valuable reference for the raceway design and optimization of REBs.
A multi-robot allocation model for multi-object based on Global Optimal Evaluation of Revenue
Authors: Li Xun , Zhang Zhi , Wu Dan-Dan , Medema Michel , Lavozik Alexander
Published: December 2021

The problem of global optimal evaluation for multi-robot allocation has gained attention constantly, especially in a multi-objective environment, but most algorithms based on swarm intelligence are difficult to give a convergent result. For solving the problem, we established a Global Optimal Evaluation of Revenue method of multi-robot for multi-tasks based on the real textile combing production workshop, consumption, and different task characteristics of mobile robots. The Global Optimal Evaluation of Revenue method could traversal calculates the profit of each robot corresponding to different tasks with global traversal over a finite set, then an optimization result can be converged to the global optimal value avoiding the problem that individual optimization easy to fall into local optimal results. In the numerical simulation, for fixed set of multi-object and multi-task, we used different numbers of robots allocation operation. We then compared with other methods: Hungarian, the auction method, and the method based on game theory. The results showed that Global Optimal Evaluation of Revenue reduced the number of robots used by at least 17%, and the delay time could be reduced by at least 16.23%.
Visiting the hegemon: Explaining diplomatic visits to the United States
Authors: Koliev Faradj , Lundgren Magnus
Published: December 2021

Diplomacy is a chief instrument of foreign policy. Through high-level diplomatic visits, governments can facilitate cooperation and signal the quality of their relations with other states. Because host countries cannot receive an indefinite number of visits, they must make strategic decisions, prioritizing some countries over others. This reveals information about their foreign policy priorities as well as diplomatic hierarchies and practices in the system as a whole. But what determines high-level diplomatic visits? Existing scholarship disagrees. In this research note, we assess the determinants of high-level diplomatic visits to the U.S. Theoretically, we draw on previous studies and formulate structural, domestic, and practice-oriented accounts of high-level visits as tools of foreign policy. Empirically, we gather original data on diplomatic visits to the U.S. by foreign leaders from 1946 to 2012. Our main results are two-fold. First, high-level diplomatic visits to the U.S. are primarily determined by structural factors such as economic relations. Second, we find clear differences in invited country profiles during and after the Cold War, demonstrating that high-level visits are used strategically to promote shifting foreign policy priorities.
Self-criticisms toward a socially responsible science in the field of management
Authors: de Frutos-Belizón Jesús , Martín-Alcázar Fernando , Sánchez-Gardey Gonzalo
Published: December 2021

Management scholarship should be placed in a unique position to develop relevant scientific knowledge because business and management organizations are deeply involved in most global challenges. However, different critical voices have recently been raised in essays and editorials, and reports have questioned research in the management field, identifying multiple deficiencies that can limit the growth of a relatively young field. Based on an analysis of published criticisms of management research, we would like to shed light on the current state of management research and identify some limitations that should be considered and should guide the growth of this field of knowledge. This work offers guidance on the main problems of the discipline that should be addressed to encourage the transformation of management research to meet both scientific rigor and social relevance. The article ends with a discussion and a call to action for directing research toward the possibility and necessity of reinforcing “responsible research” in the management field.

JEL CLASSIFICATION: M00, M10
Advocacy Experiences Among Rural Parents of Children With Disabilities
Authors: Buren Molly K. , Rios Kristina , Burke Meghan M.
Published: December 2021

Parent advocacy is an essential component to help children with disabilities receive appropriate school services. However, there are limited studies about parent advocacy for children with disabilities living in rural areas. To address this issue, semistructured interviews were conducted with 12 parents of children with disabilities. The purpose of the study was to identify and define unique barriers to and facilitators of advocacy among families of children with disabilities living in rural areas. Constant comparative analysis was used to analyze the interview data. The findings suggest that families living in rural areas lack the necessary resources to advocate successfully for their children with disabilities. Notably, participants expressed that advocating and maintaining relationships with school personnel took an emotional toll. Participants also reported that relationships with school personnel outside of school affected their experiences with advocacy. Implications for research and practice are discussed.
Direct oral anticoagulant (DOAC) interference in hemostasis assays
Authors: Moser Karen A. , Smock Kristi J.
Published: December 2021

Direct oral anticoagulants (DOACs) are a group of direct coagulation factor inhibitors including both direct thrombin inhibitors and direct factor Xa inhibitors. These medications may cause hemostasis assay interference by falsely increasing or decreasing measured values, depending on the analyte. Considering the potential for DOAC interference in a variety of hemostasis assays is essential to avoid erroneous interpretation of results. Preanalytic strategies to avoid DOAC interference include selecting alternatives to clot-based hemostasis assays in patients taking DOACs when possible and sample collection timed when the patient is off anticoagulant therapy or at the expected drug trough. Clinical laboratories may also provide educational materials that clearly describe possible interferences from DOAC, develop testing algorithms to aid in detection of DOAC in submitted samples, use DOAC-neutralizing agents to remove DOACs before continuing with testing, and write interpretive comments that explain the effects of DOAC interference in hemostasis tests. Using a combination of the described strategies will aid physicians and laboratorians in correctly interpreting hemostasis and thrombosis laboratory tests in the presence of DOACs.
The clinical and laboratory evaluation of patients with suspected hypocellular marrow failure
Authors: Keel Siobán , Geddis Amy
Published: December 2021

The overlap in clinical presentation and bone marrow features of acquired and inherited causes of hypocellular marrow failure poses a significant diagnostic challenge in real case scenarios, particularly in nonsevere disease. The distinction between acquired aplastic anemia (aAA), hypocellular myelodysplastic syndrome (MDS), and inherited bone marrow failure syndromes presenting with marrow hypocellularity is critical to inform appropriate care. Here, we review the workup of hypocellular marrow failure in adolescents through adults. Given the limitations of relying on clinical stigmata or family history to identify patients with inherited etiologies, we outline a diagnostic approach incorporating comprehensive genetic testing in patients with hypocellular marrow failure that does not require immediate therapy and thus allows time to complete the evaluation. We also review the clinical utility of marrow array to detect acquired 6p copy number-neutral loss of heterozygosity to support a diagnosis of aAA, the complexities of telomere length testing in patients with aAA, short telomere syndromes, and other inherited bone marrow failure syndromes, as well as the limitations of somatic mutation testing for mutations in myeloid malignancy genes for discriminating between the various diagnostic possibilities.
When to worry about inherited bone marrow failure and myeloid malignancy predisposition syndromes in the setting of a hypocellular marrow
Authors: Narla Anupama
Published: December 2021

With our increasing understanding of inherited marrow failure and myeloid malignancy predisposition syndromes, it has become clear that there is a wide phenotypic spectrum and that these diseases must be considered in the differential diagnosis of both children and adults with unexplained defects in hematopoiesis. Moreover, these conditions are not as rare as previously believed and may present as aplastic anemia, myelodysplastic syndrome, or malignancy over a range of ages. Establishing the correct diagnosis is essential because it has implications for treatment, medical management, cancer screening, and family planning. Our goal is to highlight insights into the pathophysiology of these diseases, review cryptic presentations of these syndromes, and provide useful references for the practicing hematologist.
Double-hit lymphoma: optimizing therapy
Authors: Dunleavy Kieron
Published: December 2021

Aggressive B-cell lymphoma is a heterogeneous entity with disparate outcomes based on clinical and pathological characteristics. While most tumors in this category are diffuse large B-cell lymphoma (DLBCL), the recognition that some cases have high-grade morphology and frequently harbor MYC and BCL2 and/or BCL6 translocations has led to their separate categorization. These cases are now considered distinct from DLBCL and are named “high-grade B-cell lymphoma” (HGBL). Most are characterized by distinct rearrangements, but others have high-grade morphological features without these and are called HGBL-not otherwise specified. Studies have demonstrated that this group of diseases leads to poor outcomes following standard rituximab, cyclophosphamide, hydroxydaunorubicin, vincristine, and prednisone therapy; retrospective and recent single-arm, multicenter studies suggest they should be approached with dose-intense treatment platforms. As yet, this has not been validated in randomized trial settings due to the rarity of these diseases. In the relapsed and refractory setting, novel approaches such as anti-CD19 chimeric antigen receptor T cells and antibodies against CD19 have demonstrated high efficacy in this subgroup. Recently, genomic studies have made much progress in investigating some of the molecular underpinnings that drive their lymphomagenesis and have paved the way for testing additional novel approaches.
Allogeneic hematopoietic cell transplantation for older patients
Authors: Lin Richard J. , Artz Andrew S.
Published: December 2021

Hematologic malignances are more common and often higher risk in older patients. Allogeneic hematopoietic cell transplantation (alloHCT) best enables long-term disease control for patients with poor risk or relapsed/refractory hematologic malignancies such as acute myeloid leukemia, myelodysplastic syndromes, or myelofibrosis. Rates of alloHCT among older patients, while still relatively low compared with younger patients, have risen sharply over the past decade. Accumulating evidence supports alloHCT for patients ≥60 years of age relative to non-HCT therapies based on improved overall and disease-free survival. However, a significant proportion of older adults have limitations characterized by geriatric assessment. A systematic process to evaluate and optimize older patients may improve decision making, transplant outcomes, and alloHCT access. We present case-based studies to illustrate a stepwise and rational approach to proper older patient evaluation, pretransplant optimization, and posttransplant care with attention to important geriatric issues and quality of life.
Diagnosis and clinical management of enzymopathies
Authors: Luzzatto Lucio
Published: December 2021

At least 16 genetically determined conditions qualify as red blood cell enzymopathies. They range in frequency from ultrarare to rare, with the exception of glucose-6-phosphate dehydrogenase deficiency, which is very common. Nearly all these enzymopathies manifest as chronic hemolytic anemias, with an onset often in the neonatal period. The diagnosis can be quite easy, such as when a child presents with dark urine after eating fava beans, or it can be quite difficult, such as when an adult presents with mild anemia and gallstones. In general, 4 steps are recommended: (1) recognizing chronic hemolytic anemia; (2) excluding acquired causes; (3) excluding hemoglobinopathies and membranopathies; (4) pinpointing which red blood cell enzyme is deficient. Step 4 requires 1 or many enzyme assays; alternatively, DNA testing against an appropriate gene panel can combine steps 3 and 4. Most patients with a red blood cell enzymopathy can be managed by good supportive care, including blood transfusion, iron chelation when necessary, and splenectomy in selected cases; however, some patients have serious extraerythrocytic manifestations that are difficult to manage. In the absence of these, red blood cell enzymopathies are in principle amenable to hematopoietic stem cell transplantation and gene therapy/gene editing.
CHIP: is clonal hematopoiesis a surrogate for aging and other disease?
Authors: Gondek Lukasz P.
Published: December 2021

Somatic mutations are an unavoidable consequence of aging tissues. Even though most mutations are functionally silent, some may affect genes critical to proper tissue self-renewal and differentiation, resulting in the outgrowth of affected cells, also known as clonal expansion. In hematopoietic tissue such clonal dominance is known as clonal hematopoiesis (CH). Sporadic CH is frequent in aging and affects over 10% of individuals beyond the fifth decade of life. It has been associated with an increased risk of hematologic malignancies and cardiovascular disease. In addition to aging, CH has been observed in other hematologic conditions and confers an adaptation of hematopoietic stem cells (HSCs) to various environmental stressors and cell-intrinsic defects. In the presence of extrinsic stressors such as genotoxic therapies, T-cell-mediated immune attack, or inflammation, somatic mutations may result in augmentation of HSC fitness. Such attuned HSCs can evade the environmental insults and outcompete their unadapted counterparts. Similarly, in inherited bone marrow failures, somatic mutations in HSCs frequently lead to the reversion of inherited defects. This may occur via the direct correction of germline mutations or indirect compensatory mechanisms. Occasionally, such adaptation may involve oncogenes or tumor suppressors, resulting in malignant transformation. In this brief article, we focus on the mechanisms of clonal dominance in various clinical and biological contexts.
Mechanisms of somatic transformation in inherited bone marrow failure syndromes
Authors: Choijilsuren Haruna Batzorig , Park Yeji , Jung Moonjung
Published: December 2021

Inherited bone marrow failure syndromes (IBMFS) cause hematopoietic stem progenitor cell (HSPC) failure due to germline mutations. Germline mutations influence the number and fitness of HSPC by various mechanisms, for example, abnormal ribosome biogenesis in Shwachman-Diamond syndrome and Diamond-Blackfan anemia, unresolved DNA cross-links in Fanconi anemia, neutrophil maturation arrest in severe congenital neutropenia, and telomere shortening in short telomere syndrome. To compensate for HSPC attrition, HSPCs are under increased replication stress to meet the need for mature blood cells. Somatic alterations that provide full or partial recovery of functional deficit implicated in IBMFS can confer a growth advantage. This review discusses results of recent genomic studies and illustrates our new understanding of mechanisms of clonal evolution in IBMFS.
When are idiopathic and clonal cytopenias of unknown significance (ICUS or CCUS)?
Authors: Osman Afaf E. W. G.
Published: December 2021

Rapid advances in sequencing technology have led to the identification of somatic mutations that predispose a significant subset of the aging population to myeloid malignancies. Recently recognized myeloid precursor conditions include clonal hematopoiesis of indeterminate potential (CHIP) and clonal cytopenia of unknown significance (CCUS). These conditions can present diagnostic challenges and produce unwarranted anxiety in some instances. While the risk of progression to myeloid malignancies is very low in CHIP, true CCUS confers an exponential increase in risk. Idiopathic cytopenia of unknown significance (IDUS) lacks the predisposing genetic mutations and has a variable course. In this review we define the early myeloid precursor conditions and their risk of progression. We present our diagnostic approach to patients with unexplained cytopenias and discuss the clinical consequences of CHIP and CCUS.
Running interferon interference in treating PV/ET: meeting unmet needs
Authors: Traxler Elizabeth A. , Hexner Elizabeth O.
Published: December 2021

Enthusiasm about interferons for the treatment of myeloproliferative neoplasms has recently arisen. How does a nontargeted therapy selectively target the malignant clone? Many foundational questions about interferon treatment are unanswered, including who, when, and for how long do we treat. Using an individual case, this review touches on gaps in risk assessment in polycythemia vera (PV) and essential thrombocythemia (ET) and the history of treatment with interferons. How is it that this proinflammatory cytokine effectively treats ET and PV, themselves proinflammatory states? We summarize existing mechanistic and clinical data, the molecular context as a modifier for treatment response, the establishment of treatment goals, and the challenges that lie ahead.
Rebalanced hemostasis in liver disease: a misunderstood coagulopathy
Authors: Roberts Lara N.
Published: December 2021

The combination of frequently abnormal hemostatic markers and catastrophic bleeding as seen with variceal hemorrhage has contributed to the longstanding misperception that chronic liver disease (CLD) constitutes a bleeding diathesis. Laboratory studies of hemostasis in liver disease consistently challenge this with global coagulation assays incorporating activation of the protein C pathway demonstrating rebalanced hemostasis. It is now recognized that bleeding in CLD is predominantly secondary to portal hypertension (rather than a coagulopathy) and additionally that these patients are at increased risk of venous thrombosis, particularly in the portal venous system. This narrative review describes the current understanding of hemostasis in liver disease, as well as the periprocedural management of hemostasis and anticoagulation for management of venous thromboembolism in patients with CLD.
Updates in chronic graft-versus-host disease
Authors: Hamilton Betty K.
Published: December 2021

Chronic graft-versus-host disease (GVHD) is the leading cause of late morbidity and mortality after allogeneic hematopoietic cell transplantation. Symptoms and manifestations of chronic GVHD are heterogeneous and pleomorphic, and there are no standard treatments beyond corticosteroids. Therapy is typically prolonged, and chronic GVHD and its treatment are associated with adverse effects that have a significant impact on long-term quality of life and functional status. Several advances have been made over the last 2 decades to define the diagnosis of chronic GVHD as well as its severity and response criteria for clinical trials. Further understanding into the biologic mechanisms of the development of chronic GVHD has led to the investigation of several novel immunomodulatory and targeted therapies. Multi-institutional collaboration and pharmaceutical support in the development of therapies based on sound biologic mechanisms and clinical trials with defined end points and responses have led to several promising agents on the horizon of approval for treatment of chronic GVHD. This article reviews advances in our knowledge of chronic GVHD and its biologic framework to improve approaches to prevention and treatment.
Indications for transfusion in the management of sickle cell disease
Authors: Han Hyojeong , Hensch Lisa , Tubman Venée N.
Published: December 2021

The transfusion of red blood cells (RBCs) is a crucial treatment for sickle cell disease (SCD). While often beneficial, the frequent use of transfusions is associated with numerous complications. Transfusions should be offered with specific guidelines in mind. Here we present updates to the indications for transfusion of RBCs in SCD. We review recent publications and include expert perspectives from hematology and transfusion medicine. For some clinical indications, such as ischemic stroke, the role of transfusion has been well studied and can be applied almost universally. For many other clinical scenarios, the use of transfusion therapy has less conclusive data and therefore must be tailored to individual needs. We highlight the roles of RBC transfusions in preventing or mitigating neurological disease, in reducing perioperative complications, in managing acute chest syndrome, and in optimizing pregnancy outcomes in SCD. We further highlight various transfusion techniques and when each might be considered. Potential complications of transfusion are also briefly discussed.
Association of mental demands in the workplace with cognitive function in older adults at increased risk for dementia
Authors: Zülke Andrea E. , Luppa Melanie , Röhr Susanne , Weißenborn Marina , Bauer Alexander , Samos Franziska-Antonia Zora , Kühne Flora , Zöllinger Isabel , Döhring Juliane , Brettschneider Christian , Oey Anke , Czock David , Frese Thomas , Gensichen Jochen , Haefeli Walter E. , Hoffmann Wolfgang , Kaduszkiewicz Hanna , König Hans-Helmut , Thyrian Jochen René , Wiese Birgitt , Riedel-Heller Steffi G.
Published: December 2021

Objectives

Growing evidence suggests a protective effect of high mental demands at work on cognitive function in later life. However, evidence on corresponding associations in older adults at increased risk for dementia is currently lacking. This study investigates the association between mental demands at work and cognitive functioning in the population of the AgeWell.de-trial.

Methods

Cross-sectional investigation of the association between global cognitive functioning (Montreal Cognitive Assessment) and mental demands at work in older individuals at increased risk for dementia (Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE)score ≥ 9; n = 941, age: 60–77 years). Occupational information was matched to Occupational Information Network (O*NET)-descriptors. Associations between cognitive function and O*NET-indices executive, verbal and novelty were investigated using generalized linear models.

Results

Higher values of index verbal (b = .69, p = .002) were associated with better cognitive function when adjusting for covariates. No association was observed for indices executive (b = .37, p = .062) and novelty (b = .45, p = .119). Higher education, younger age, and employment were linked to better cognitive function, while preexisting medical conditions did not change the associations. Higher levels of depressive symptomatology were associated with worse cognitive function.

Conclusions

Higher levels of verbal demands at work were associated with better cognitive function for older adults with increased dementia risk. This suggests an advantage for older persons in jobs with high mental demands even after retirement and despite prevalent risk factors. Longitudinal studies are warranted to confirm these results and evaluate the potential of workplaces to prevent cognitive decline through increased mental demands.
PG-SGA SF in nutrition assessment and survival prediction for elderly patients with cancer
Authors: Zhang Qi , Li Xiang-Rui , Zhang Xi , Ding Jia-Shan , Liu Tong , Qian Liang , Song Meng-Meng , Song Chun-Hua , Barazzoni Rocco , Tang Meng , Wang Kun-Hua , Xu Hong-Xia , Shi Han-Ping ,   Investigation on Nutrition Status and its Clinical Outcome of Common Cancers (INSCOC) Group
Published: December 2021

Background

This study was sought to report the prevalence of malnutrition in elderly patients with cancer. Validate the predictive value of the nutritional assessment tool (Patient-Generated Subjective Global Assessment Short Form, PG-SGA SF) for clinical outcomes and assist the therapeutic decision.

Methods

This is a secondary analysis of a multicentric, observational cohort study. Elderly patients with cancer older than 65 years were enrolled after the first admission. Nutritional status was identified using the PG-SGA SF.

Results

Of the 2724 elderly patients included in the analysis, 65.27% of patients were male (n = 1778); the mean age was 71.00 ± 5.36 years. 31.5% of patients were considered malnourished according to PG-SGA SF. In multivariate analysis, malnutrition(PG-SGA SF > 5) was significantly associated with worse OS (HR: 1.47,95%CI:1.29–1.68), affects the quality of life, and was related to more frequent nutrition impact symptoms. During a median follow-up of 4.5 years, 1176 death occurred. The mortality risk was 41.10% for malnutrition during the first 12 months and led to a rate of 323.98 events per-1000-patient-years. All nutritional assessment tools were correlated with each other (PG-SGA SF vs. PG-SGA: r = 0.98; PG-SGA SF vs. GLIM[Global Leadership Initiative on Malnutrition]: r = 0.48, all P < 0.05). PG-SGA SF and PG-SGA performed similarly to predict mortality but better than GLIM. PG-SGA SF improves the predictive ability of the TNM classification system for mortality in elderly patients with cancer, including distinguishing patients’ prognoses and directing immunotherapy.

Conclusions

The nutritional status as measured by PG-SGA SF which is a prognostic factor for OS in elderly cancer patients and could improve the prognostic model of TNM.
High-frequency radio wave electrocautery in modified Hotz operations for epiblepharon correction
Authors: Lee Hyunkyu , Youn Jimin , Baek Sehyun
Published: December 2021

To report the experience and advantageous effects of high-frequency radio wave electrocautery in modified Hotz operations for epiblepharon, We reviewed the records of all pediatric patients who underwent a modified Hotz operation with the use of high-frequency radio wave electrocautery (Ellman Surgitron Dual Frequency RF S5; Ellman International, Inc, Hewlett, NY) for epiblepharon between March 2016 and September 2019 at Korea University Guro Hospital. We evaluated the success rate, complications, recurrence rate and degree of satisfaction of our technique. Information from the medical records was collected, including demographics, ocular symptoms, severity of keratopathy, operation time, success/recurrence rate, and complications. 133 patients (98.52%) showed good correction of epiblepharon without complications or unpleasant cosmetic problems during 3 months of median follow-up period. Two patients (1.48%) showed recurrent corneociliary touch, but the degree was very mild and re-operation was not performed. One patient showed mild ectropion on his left lower eyelid, but the patient recovered well without operation. For complications, suture abscess and granulation were the most common, 3 cases in each, but all of those were temporary and resolved with conservative management. The approach with electrocautery for epiblepharon allows precise and fast incision of the lower eyelid, little bleeding, and minimal scarring. Surgical outcomes associated with the modified Hotz operation with electrocautery were consistent with previous studies.
Is cement-augmented sacroiliac screw fixation with partially threaded screws superior to that with fully threaded screws concerning compression and pull-out force in fragility fractures of the sacrum? – a biomechanical analysis
Authors: Hack Juliana , Safi Maiwand , Bäumlein Martin , Lenz Julia , Bliemel Christopher , Ruchholtz Steffen , Oberkircher Ludwig
Published: December 2021

Background

Providing a stable osteosynthesis in fragility fractures of the pelvis can be challenging. Cement augmentation increases screw fixation in osteoporotic bone. Generating interfragmentary compression by using a lag screw also improves the stability. However, it is not known if interfragmentary compression can be achieved in osteoporotic sacral bone by cement augmentation of lag screws.

The purpose of this study was to compare cement-augmented sacroiliac screw osteosynthesis using partially versus fully threaded screws in osteoporotic hemipelvises concerning compression of fracture gap and pull-out force.

Methods

Nine fresh-frozen human cadaveric pelvises with osteoporosis were used. In all specimens, one side was treated with an augmented fully threaded screw (group A), and the other side with an augmented partially threaded screw (group B) after generating a vertical osteotomy on both sides of each sacrum. Afterwards, first a compression test with fracture gap measurement after tightening of the screws was performed, followed by an axial pull-out test measuring the maximum pull-out force of the screws.

Results

The fracture gap was significantly wider in group A (mean: 1.90 mm; SD: 1.64) than in group B (mean: 0.91 mm; SD: 1.03; p = 0.028).

Pull-out force was higher in group A (mean: 1696 N; SD: 1452) than in group B (mean: 1616 N; SD: 824), but this difference was not statistically significant (p = 0.767).

Conclusions

Cement augmentation of partially threaded screws in sacroiliac screw fixation allows narrowing of the fracture gap even in osteoporotic bone, while resistance against pull-out force is not significantly lower in partially threaded screws compared to fully threaded screws.
Study on the correlation between preoperative inflammatory indexes and adhesional perinephric fat before laparoscopic partial nephrectomy
Authors: Ma Teng , Cong Lin , Ma Qianli , Huang Zhaoqin , Hua Qianqian , Li Xiaojiao , Wang Ximing , Chen Yunchao
Published: December 2021

Objective

This study was aimed to evaluate the effect of preoperative composite inflammatory index on adhesional perinephric fat (APF), providing a help for preoperative risk assessment of laparoscopic partial nephrectomy (LPN) in patients with renal cell carcinoma.

Materials and methods

A retrospective study was conducted on 231 patients with renal cell carcinoma, who underwent laparoscopic partial nephrectomy. They were divided into two groups according to whether there was APF during operation. Relevant clinical data, laboratory parameters and imaging examination were obtained before operation to calculate the composite inflammatory index and MAP score. The composite inflammatory index was divided into high value group and low value group by ROC curve method. The related predictive factors of APF were analyzed by logistic regression method.

Results

The APF was found in 105 patients (45.5%). In multivariate analysis, systemic immune inflammation index (SII) (high/low), MAP score, tumor size and perirenal fat thickness were independent predictors of APF. The operation time of patients with APF was longer, and the difference of blood loss was not statistically significant.

Conclusion

SII is an independent predictor of APF before laparoscopic partial nephrectomy.

Trial registration ChiCTR, ChiCTR2100045944. Registered 30 April 2021—Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=125703.