bluuebunny/crossref_metadata_2025 huggingface dataset:
Assessing cancer in people with profound and multiple disabilities
Authors: Satgé Daniel , Nishi Motoi , Trétarre Brigitte
Published: August 2023

Background

Cancers are as common in individuals with intellectual disabilities as in the general population (GP). For the subgroup of people with profound and multiple disabilities (PMD) who present with both severe intellectual disability and major motor disorders, the frequency and distribution of cancers are currently not known, preventing proper cancer surveillance.

Methods

We carried out a systematic and synthetic review of the medical literature, including a focused search of Japanese data.

Results

The total risk of cancer in individuals with PMD is thought to be lower than in the GP, possibly due to a shorter life expectancy. They have reduced exposure to cancer risk factors, such as alcohol, tobacco, sunlight, human papillomavirus infection, occupational toxins, and being overweight. On the other hand, individuals with PMD present a greater frequency of gastroesophageal reflux disease, Helicobacter pylori gastritis, chronic cystitis, and cryptorchidism, which increase the risk for cancer of the esophagus, stomach, urinary bladder, and testes. In addition, certain genetic disorders underlying compromised motor and cognitive functions are associated with higher risk of childhood cancers. An analysis of 135 cancers in persons with PMD in Japan suggested that they present a particular tumor profile, with certain cancers rarer than in the GP, whereas cancers of the digestive tract are frequent. Cancers of the digestive tract occurred significantly earlier than in the GP (colon: average age 48.3 years vs. 71.3 years in the GP, esophagus: 39 years vs. 72 years in the GP). An increasing number of therapeutic successes in children and adults with PMD have been reported in different countries when cancers are discovered early.

Conclusion

Individuals with PMD must be appropriately monitored for cancer. Screenings for breast and colon cancer, as well as regular monitoring of the esophagus, stomach, urinary bladder, and testicles, are necessary. Population-based epidemiological studies are needed to better understand risk factors, frequency, and distribution of cancers in the PMD population.
Euterpe oleracea extract (açaí) exhibits cardioprotective effects after chemotherapy treatment in a breast cancer model
Authors: Alessandra-Perini Jéssica , Machado Daniel Escorsim , Palmero Celia Yelimar , Claudino Marllow Caetano , de Moura Roberto Soares , Palumbo Junior Antônio , Perini Jamila Alessandra , Nasciutti Luiz Eurico
Published: August 2023

Background

Açaí, a Brazilian native fruit, has already been demonstrated to play a role in the progress of breast cancer and cardiotoxicity promoted by chemotherapy agents. Thus, the present study aimed to evaluate the combined use of açaí and the FAC-D chemotherapy protocol in a breast cancer model in vivo.

Methods

Mammary carcinogenesis was induced in thirty female Wistar rats by subcutaneous injection of 25 mg/kg 7,12-dimethylbenzanthracene (DMBA) in the mammary gland. After sixty days, the rats were randomized into two groups: treated with 200 mg/kg of either açaí extract or vehicle, via gastric tube for 45 consecutive days. The FAC-D protocol was initiated after 90 days of induction by intraperitoneal injection for 3 cycles with a 7-day break each. After treatment, blood was collected for haematological and biochemical analyses, and tumours were collected for macroscopic and histological analyses. In the same way, heart, liver, and kidney samples were also collected for macroscopic and histological analyses.

Results

Breast cancer was found as a cystic mass with a fibrotic pattern in the mammary gland. The histological analysis showed an invasive carcinoma area in both groups; however, in the saline group, there was a higher presence of inflammatory clusters. No difference was observed regarding body weight, glycaemia, aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and urea in either group. However, açaí treatment decreased creatine kinase (CK), creatine kinase MB (CKMB), troponin I and C-reactive protein levels and increased the number of neutrophils and monocytes. Heart histopathology showed normal myocardium in the açaí treatment, while the saline group presented higher toxicity effects with loss of architecture of cardiac tissue. Furthermore, the açaí treatment presented greater collagen distribution, increased hydroxyproline concentration and lower H2AX immunostaining in the heart samples.

Conclusion

Açaí decreased the number of inflammatory cells in the tumor environment and exhibited protection against chemotherapy drug cardiotoxicity with an increased immune response in animals. Thus, açaí can be considered a promising low-cost therapeutic treatment that can be used in association with chemotherapy agents to avoid heart damage.
“METAPAD” (METAbolic PAthways Decoded) – a gaming innovation to ease the complexity of metabolic pathways by promoting self-directed, active, participatory learning in small groups
Authors: Surapaneni Krishna Mohan
Published: August 2023

Background

In medical education, the conventional didactic lectures make the learning process tedious and cause disinterest among students. To overcome this, an effective experiential learning integrated with game-based approach that intends to make the learning process fun filled, interesting and enhance the active participation of students to understand complex topics in a simple and optimum manner should be adopted.

Objectives

The purpose of this study is to assess the efficiency of a puzzle-based innovation, METAPAD (METAbolic PAthways Decoded) in understanding the complexity of biochemical pathways by enhancing the self-directed learning of students through active engagement in small groups

Methods

In this mixed-method study, 103 first professional year medical students in small groups were enrolled for the METAPAD gaming puzzle-based learning activity. The puzzles were integrated with a relevant clinical case study. Decoding the puzzle after identification of the metabolic pathway involved in the case was conducted in level 1,2 and 3 with increasing complexity of puzzles at every level. Following the puzzle activity, A 21-item questionnaire was administered to evaluate the usefulness of the innovation and students’ perceptions towards different learning styles. Also, students’ feedback was obtained through personal interviews for qualitative analysis and thematic analysis was performed.

Results

One hundred and three first year undergraduate medical students participated in the study. Most of the students perceived the METAPAD gaming puzzle to be an effective and innovative style of learning. There was not any significant association between age, gender and acceptance towards the METAPAD gaming puzzle. The predominant type of learning style among the students was multimodal (49.5%). Also, there was no great influence of the learning styles on the overall perception towards the METAPAD gaming puzzle. However, learners emphasized the need to focus more while solving the puzzles.

Conclusion

Students perceive the METAPAD gaming puzzle as an actively engaging teaching-learning method that enhances their creativity, critical thinking and problem-solving abilities. It promotes self-directed learning of complex pathways in biochemistry which helps in remembering and recalling information and improves their learning skills.
Morphological, radiographic, three-dimensional computed tomographic, and histological features of the primary upstroke and downstroke muscles and bones in the domestic duck (Anas platyrhynchos domesticus) and the cattle egret (Bubulcus ibis, Linnaeus, 1758), reflecting the evolutionary transition towards the irreversible flightlessness
Authors: El-Ghazali Hanaa M. , Abdelbaset-Ismail Ahmed , Goda Nehal I. A. , Aref Mohamed
Published: August 2023

Background

The purpose of this study was to explore whether domestication could lead to evolutionary changes towards flightlessness in the domestic duck (Anas platyrhynchos domesticus) compared to the cattle egret (Bubulcus ibis) as a nonflying and flying biological model, respectively. Bones of the pectoral girdle (scapula, clavicle, and coracoid) and the foramen triosseum were comparatively assessed using anatomical, radiographic, and 3D computed tomographic (CT) studies. Additionally, the muscles pectoralis and the supracoracoideus were histologically and immunohistochemically assessed.

Results

Among the differences observed, radiographically, the distance between the paired clavicles was significantly wider (p < 0.05) in the domestic duck (mean ± SD 1.43 ± 0.23 cm) compared with the cattle egret (0.96 ± 0.13 cm). Unlike cattle egrets, there was no connection between the sternum and the hypocladium of furcula in domestic ducks. The scapula, clavicle, coracoid, sternum, and humerus were considerably longer in domestic ducks than in cattle egrets. The foramen triosseum appeared significantly (p < 0.01) wider in domestic ducks (0.7 ± 1.17 cm) compared to cattle egrets (0.49 ± 0.03 cm). Histologically, compared to cattle egrets, the muscle fibers in domestic ducks were loosely connected and contained fewer nuclei and perimysial/endomysial spaces. A higher myoglobin expression was evident in cattle egrets compared with domestic ducks.

Conclusions

Results of this study indicate that the bones and muscles of the pectoral girdle generally show specific morphological and structural changes reflective of the loss of prerequisites associated with flight behavior in domestic ducks due to domestication effects compared to cattle egrets.
Subcutaneous adipose tissue alteration in aging process associated with thyroid hormone signaling
Authors: Zhang Wen-Na , Zhu Hao , Ma Zhen-Wu , Yu Jing , Yang Yun , Lu Xuan-Bei , Lv Yi-Fan , Wang Xiao-Dong
Published: August 2023

Background

Functional changes in subcutaneous adipose tissue (SAT) occur earlier in the aging process and play an important role in the occurrence and development of age-related metabolic diseases. The mechanism of this phenomenon is still unclear, and the change in adipose tissue with age is poorly understood.

Methods

We used transcriptome sequencing (RNA seq) to screen differentially expressed genes at the mRNA level, and analyzed the functional characteristics of the differential genes through GO and KEGG analysis in human SAT of all ages. In order to clarify the specific mechanism of the functional change, we analyzed the chromatin accessibility in the promoter region in the same SAT used in the RNA seq by the assay for transposase-accessible chromatin with high throughput sequencing (ATAC-seq) and obtained the functional genes in SAT changed with age. To verify these changes, we enlarged our sample content of human SAT. The primary mice adipocytes were extracted and stimulated by thyroid hormone of different concentration to construct an animal model, and the expression of the genes were determined through real-time Polymerase Chain Reaction(RT-PCR). The oxygen consumption test and immunofluorescence staining were used to determine the mitochondrial function of SAT.

Results

RNA-seq showed characteristic gene expression of young and old human SAT, in which 331 genes were up-regulated and 349 genes were down-regulated. ATAC-seq, RNA-seq, combined with the mouse prediction model, determined the functional changed characteristics of seven genes. All these genes expressed differently in SAT of different ages, in which, NCF1, NLRP3, DUOX1 showed positive correlation with age; The expression of IFI30, P2RX1, P2RX6, PRODH, however, decreased with age. And all these genes showed dose dependent alternations under treatment of triiodothyroxine in mice SAT. The oxygen consumption rate revealed significant changes of the mitochondrial function and ROS accumulation in human SAT of different ages.

Conclusion

In elderly individuals, the function, in addition to distribution, of SAT undergoes significant changes, primarily in mitochondria, which may be due to insensitivity to thyroid hormone signaling. These results identified seven novel genes regulated by thyroid hormone, exhibiting significant changes in SAT of different age, and are probably related to the dysfunction of the aged SAT due to the mitochondrial damage and ROS accumulation.
Intrinsic disorder in PRAME and its role in uveal melanoma
Authors: Antonietti Michael , Gonzalez David J. Taylor , Djulbegovic Mak , Dayhoff Guy W. , Uversky Vladimir N. , Shields Carol L. , Karp Carol L.
Published: August 2023

Introduction

The PReferentially expressed Antigen in MElanoma (PRAME) protein has been shown to be an independent biomarker for increased risk of metastasis in Class 1 uveal melanomas (UM). Intrinsically disordered proteins and regions of proteins (IDPs/IDPRs) are proteins that do not have a well-defined three-dimensional structure and have been linked to neoplastic development. Our study aimed to evaluate the presence of intrinsic disorder in PRAME and the role these structureless regions have in PRAME( +) Class 1 UM.

Methods

A bioinformatics study to characterize PRAME’s propensity for the intrinsic disorder. We first used the AlphaFold tool to qualitatively assess the protein structure of PRAME. Then we used the Compositional Profiler and a set of per-residue intrinsic disorder predictors to quantify the intrinsic disorder. The Database of Disordered Protein Prediction (D2P2) platform, IUPred, FuzDrop, fIDPnn, AUCpred, SPOT-Disorder2, and metapredict V2 allowed us to evaluate the potential functional disorder of PRAME. Additionally, we used the Search Tool for the Retrieval of Interacting Genes (STRING) to analyze PRAME's potential interactions with other proteins.

Results

Our structural analysis showed that PRAME contains intrinsically disordered protein regions (IDPRs), which are structureless and flexible. We found that PRAME is significantly enriched with serine (p-value < 0.05), a disorder-promoting amino acid. PRAME was found to have an average disorder score of 16.49% (i.e., moderately disordered) across six per-residue intrinsic disorder predictors. Our IUPred analysis revealed the presence of disorder-to-order transition (DOT) regions in PRAME near the C-terminus of the protein (residues 475–509). The D2P2 platform predicted a region from approximately 140 and 175 to be highly concentrated with post-translational modifications (PTMs). FuzDrop predicted the PTM hot spot of PRAME to be a droplet-promoting region and an aggregation hotspot. Finally, our analysis using the STRING tool revealed that PRAME has significantly more interactions with other proteins than expected for randomly selected proteins of the same size, with the ability to interact with 84 different partners (STRING analysis result: p-value < 1.0 × 10–16; model confidence: 0.400).

Conclusion

Our study revealed that PRAME has IDPRs that are possibly linked to its functionality in the context of Class 1 UM. The regions of functionality (i.e., DOT regions, PTM sites, droplet-promoting regions, and aggregation hotspots) are localized to regions of high levels of disorder. PRAME has a complex protein–protein interaction (PPI) network that may be secondary to the structureless features of the polypeptide. Our findings contribute to our understanding of UM and suggest that IDPRs and DOT regions in PRAME may be targeted in developing new therapies for this aggressive cancer.
Applying quantitative spatial phenotypes analysis to the investigation of peltate glandular trichomes development pattern in Perilla frutescens
Authors: Jiang Zheng , Zhou Peina , Shao Yongfang , Zhang Qianqian , Yue Wei , Qu Cheng , Wu Qinan
Published: August 2023

Background

Glandular trichomes, often referred to as “phytochemical factories”, plays a crucial role in plant growth and metabolism. As the site for secretion and storage, the development of glandular trichomes is related to the dynamic biosynthesis of specialised metabolites. The study aims to explore the relationship between spatial phenotype and dynamic metabolism of glandular trichomes, and establish a novel approach for the exploration and study of the regulatory mechanism governing the development of glandular trichomes.

Results

In this study, we proposed a technical route based on the relative deviation value to distinguish the peltate glandular trichomes (PGTs) from the background tissues and extract their spatial phenotype. By defining glandular trichome developmental stages based on the leaf vein growth axis, we found that young PGTs were densely distributed near the proximal end of growth axis of the leaf veins, where perillaketone, a primary metabolite of PGTs, is predominantly accumulated. Conversely, mature PGTs are typically found near the distal end of the mid-vein growth axis and the lateral end of the secondary vein growth axis, where the accumulation rate of isoegomaketone and egomaketone exceeds that of perillaketone in PGTs. We further identified spatial phenotypic parameters, Lsum and d, as independent variables to construct a linear regression model that illustrates the relationship between the spatial phenotypes and metabolite content of PGTs, including perillaketone (R2 = 0.698), egomaketone (R2 = 0.593), isoegomaketone (R2 = 0.662) and the sum of the amount (R2 = 0.773).

Conclusions

This model proved that the development of PGTs was correlated with the growth of the entire leaf, and the development stage of PGTs can be identifined by spatial phenotypes based on the leaf veins. In conclusion, the findings of this study enhance our understanding of correlation between spatial phenotype and development of glandular trichomes and offer a new approach to explore and study the regulatory mechanism of glandular trichome development.
Incidental radiological findings during clinical tuberculosis screening in Lesotho and South Africa: a case series
Authors: Glaser Naomi , Bosman Shannon , Madonsela Thandanani , van Heerden Alastair , Mashaete Kamele , Katende Bulemba , Ayakaka Irene , Murphy Keelin , Signorell Aita , Lynen Lutgarde , Bremerich Jens , Reither Klaus
Published: August 2023

Background

Chest X-ray offers high sensitivity and acceptable specificity as a tuberculosis screening tool, but in areas with a high burden of tuberculosis, there is often a lack of radiological expertise to interpret chest X-ray. Computer-aided detection systems based on artificial intelligence are therefore increasingly used to screen for tuberculosis-related abnormalities on digital chest radiographies. The CAD4TB software has previously been shown to demonstrate high sensitivity for chest X-ray tuberculosis-related abnormalities, but it is not yet calibrated for the detection of non-tuberculosis abnormalities. When screening for tuberculosis, users of computer-aided detection need to be aware that other chest pathologies are likely to be as prevalent as, or more prevalent than, active tuberculosis. However, non­-tuberculosis chest X-ray abnormalities detected during chest X-ray screening for tuberculosis remain poorly characterized in the sub-Saharan African setting, with only minimal literature.

Case presentation

In this case series, we report on four cases with non-tuberculosis abnormalities detected on CXR in TB TRIAGE + ACCURACY (ClinicalTrials.gov Identifier: NCT04666311), a study in adult presumptive tuberculosis cases at health facilities in Lesotho and South Africa to determine the diagnostic accuracy of two potential tuberculosis triage tests: computer-aided detection (CAD4TB v7, Delft, the Netherlands) and C-reactive protein (Alere Afinion, USA). The four Black African participants presented with the following chest X-ray abnormalities: a 59-year-old woman with pulmonary arteriovenous malformation, a 28-year-old man with pneumothorax, a 20-year-old man with massive bronchiectasis, and a 47-year-old woman with aspergilloma.

Conclusions

Solely using chest X-ray computer-aided detection systems based on artificial intelligence as a tuberculosis screening strategy in sub-Saharan Africa comes with benefits, but also risks. Due to the limitation of CAD4TB for non-tuberculosis-abnormality identification, the computer-aided detection software may miss significant chest X-ray abnormalities that require treatment, as exemplified in our four cases. Increased data collection, characterization of non-tuberculosis anomalies and research on the implications of these diseases for individuals and health systems in sub-Saharan Africa is needed to help improve existing artificial intelligence software programs and their use in countries with high tuberculosis burden.
Non-invasive assessment of muscle compartment elasticity by pressure-related ultrasound in pediatric trauma: a prospective clinical study in 25 cases of forearm shaft fractures
Authors: Sellei R. M. , Beckers A. , Kobbe P. , Weltzien A. , Weber C. D. , Spies C. K. , Reinhardt N. , de la Fuente M. , Radermacher K. , Hildebrand F.
Published: August 2023

Background

Soft-tissue swelling after limb fractures in pediatric patients is well known to be a risk factor for developing acute compartment syndrome (ACS). Clinical assessment alone is uncertain in specific cases. Recently, we proposed a non-invasive ultrasound-based method to objectify muscle compartment elasticity for monitoring. We hypothesize a strong correlation between the soft-tissue swelling after stabilization of upper limb fractures and the compartment elasticity objectified with a novel ultrasound-based approach in pediatric trauma.

Patients and methods

In a prospective clinical study, children suffering forearm fractures but not developing an ACS were included. The muscle compartment elasticity of the m. flexor carpi ulnaris was assessed after surgical intervention by a non-invasive, ultrasound-based method resulting in a relative elasticity (RE in %) in both the control (healthy limb) and study group (fractured limb). Soft-tissue swelling was categorized in four different levels (0–3) and correlated with the resulting RE (%).

Results

The RE in the study group (15.67%, SD ± 3.06) showed a significantly decreased level (p < 0.001) compared with the control (22.77%, SD ± 5.4). The categorized grade of soft-tissue swelling resulted in a moderate correlation with the RE (rs = 0.474).

Conclusions

The presented study appears to represent a novel approach to assess the posttraumatic pressure changes in a muscle compartment after fracture stabilization non-invasively. In this first clinical study in pediatric cases, our measurement method represents a low-cost, easy, and secure approach that has the potential to substitute invasive measurement of suspected ACS in muscle compartment conditions. Further investigations in lager cohorts are required to prove its daily clinical practicability and to confirm the expected reliability.
Development and validation of a predictive model for depression risk in the U.S. adult population: Evidence from the 2007–2014 NHANES
Authors: Tian Wei , Zhang Yafeng , Han Xinhao , LI Yan , Liu Junping , Wang Hongying , Zhang Qiuju , Ma Yujie , Yan Guangcan
Published: August 2023

Background

Depression is a prevalent mental health disorder with a complex etiology and substantial public health implications. Early identification of individuals at risk for depression is crucial for effective intervention and prevention efforts. This study aimed to develop a predictive model for depression by integrating demographic factors (age, race, marital status, income), lifestyle factors (sleep duration, physical activity), and physiological measures (hypertension, blood lead levels). A key objective was to explore the role of physical activity and blood lead levels as predictors of current depression risk.

Methods

Data were extracted from the 2007–2014 National Health and Nutrition Examination Survey (NHANES). We applied a logistic regression analysis to these data to assess the predictive value of the above eight factors for depression to create the predictive model.

Results

The predictive model had bootstrap-corrected c-indexes of 0.68 (95% CI, 0.67–0.70) and 0.66 (95% CI, 0.64–0.68) for the training and validation cohorts, respectively, and well-calibrated curves. As the risk of depression increased, the proportion of participants with 1.76 ~ 68.90 µg/L blood lead gradually increased, and the proportion of participants with 0.05 ~ 0.66 µg/L blood lead gradually decreased. In addition, the proportion of sedentary participants increased as the risk of depression increased.

Conclusions

This study developed a depression risk assessment model that incorporates physical activity and blood lead factors. This model is a promising tool for screening, assessing, and treating depression in the general population. However, because the corrected c-indices of the predictive model have not yet reached an acceptable threshold of 0.70, caution should be exercised when drawing conclusions. Further research is required to improve the performance of this model.
A brief history of and future prospects for pneumococcal vaccination in Malaysia
Authors: Lister Alex J. J. , Dombay Evelin , Cleary David W. , Sulaiman Lokman H. , Clarke Stuart C.
Published: August 2023

Pneumococcal pneumonia remains a significant global public health issue. Malaysia has recently added the 10 valent pneumococcal conjugate vaccine to its national immunisation programme. Data on pneumococcal serotype epidemiology is vital for informing national vaccination policy. However, there remains a lack of representative population-based pneumococcal surveillance in Malaysia to help both the assessment of vaccine effectiveness in the country and to shape future vaccine policy. This review explores the history of pneumococcal vaccination, the burden of pneumococcal disease in Malaysia, and offers an insight into the prospects for reducing pneumococcal disease in Malaysia.
Small secreted peptides (SSPs) in tomato and their potential roles in drought stress response
Authors: Xu Kexin , Tian Dongdong , Wang TingJin , Zhang Aijun , Elsadek Mohamed Abdou Youssef , Liu Weihong , Chen Liping , Guo Yongfeng
Published: August 2023

Tomato (Solanum lycopersicum) is one of the most important vegetable crops in the world and abiotic stresses often cause serious problems in tomato production. It is thus important to identify new regulators in stress response and to devise new approaches to promote stress tolerance in tomato. Previous studies have shown that small secreted peptides (SSPs) are important signal molecules regulating plant growth and stress response by mediating intercellular communication. However, little is known about tomato SSPs, especially their roles in responding to abiotic stresses. Here we report the identification of 1,050 putative SSPs in the tomato genome, 557 of which were classified into 38 known SSP families based on their conserved domains. GO and transcriptome analyses revealed that a large proportion of SlSSPs might be involved in abiotic stress response. Further analysis indicated that stress response related cis-elements were present on the SlCEP promotors and a number of SlCEPs were significantly upregulated by drought treatments. Among the drought-inducible SlCEPs, SlCEP10 and SlCEP11b were selected for further analysis via exogenous application of synthetic peptides. The results showed that treatments with both SlCEP10 and SlCEP11b peptides enhanced tomato drought stress tolerance, indicating the potential roles of SlSSPs in abiotic stress response.

Graphical Abstract
Toward Precision Perioperative Therapy in GI Malignancies
Authors: Glover Michael J. , Bien Jeffrey , Chen Christopher T.
Published: August 2023

We review perioperative precision therapy as an emerging treatment paradigm in curable GI cancers.
Race-Associated Genomic Correlates of Therapeutic Response in African American Patients With Non–Small-Cell Lung Cancer
Authors: Li Pin , Kane Kaitlyn , Wolf Frank M. , Berry Anna B. , Gadgeel Shirish , Pilling Amanda
Published: August 2023

PURPOSE

African American individuals are disproportionately affected by lung cancer in terms of incidence and mortality. In oncogene-driven non–small-cell lung cancer (NSCLC), emerging evidence indicates that underlying molecular heterogeneity, which can be affected by ancestry, contributes to variable drug sensitivity and therapeutic responses. The purpose of this study was to evaluate race-associated differences in reported treatment decisions, therapeutic outcomes, and molecular features in KRAS- and EGFR-mutant NSCLC.

MATERIALS AND METHODS

This is a retrospective study using real-world clinical-genomic data from health systems in the United States to evaluate race-associated outcomes in advanced-stage KRAS- or EGFR-driven NSCLC. Our overall objectives were to evaluate race-associated therapeutic outcomes and to describe molecular features in non-Hispanic Black (NHB) and non-Hispanic White (NHW) patients with NSCLC.

RESULTS

A total of 723 NSCLC patients with KRAS and 315 patients with EGFR oncogenic mutations were evaluated. In KRAS-mutant patients, variable outcomes were observed in NHB and NHW patients on the basis of receiving chemotherapy alone or in combination with immune checkpoint inhibitors. NHB patients received treatment at significantly lower rates compared with NHW patients. In the EGFR-mutant cohort, NHB and NHW patients received EGFR-targeted agents at similar rates, and overall survival was not significantly different. Race-associated differences in molecular features included a higher frequency of TP53 comutation in KRAS-mutant NHB patients and higher prevalence of EGFR G719S subtype in NHB patients.

CONCLUSION

In a real-world cohort of patients with NSCLC, we identified race-associated differences in therapeutic outcomes and described molecular characteristics in NHB and NHW patients with NSCLC. To proactively identify patients most likely to respond to systemic therapies, a more comprehensive approach is needed to help guide therapy selection in individualized patient populations.
“They Will Know in the End That We Are Men”: Gunpowder and Gendered Discourse in Creek-British Diplomacy, 1763–1776
Authors: McCutchen Jennifer Monroe
Published: August 2023

This article investigates the use of gendered discourse in Upper Creek negotiations with the British in the late eighteenth-century Southeast. It employs gunpowder and related discussions of masculinity as a tool for understanding how Native and European leaders communicated with one another to achieve their respective goals following the Seven Years’ War. The lens of gunpowder, an exclusively male commodity that could only be produced in Europe, allows ethnohistorians to explore how Upper Creek men dealt with the problem of dependence while attempting to retain power and authority during a period of significant sociopolitical change. An analysis of gunpowder highlights the challenges associated with accessing important foreign goods in an era where certain manufactures functioned as more than simple commodities. Possession and use of gunpowder held the potential to determine individual status as well as one’s ability to fulfill community responsibilities. It also shaped notions of gender, revealing how dependence on important, yet unstable, goods could threaten traditional Creek conceptions of masculine leadership. Gunpowder, therefore, illuminates the ways in which Creek leaders used European concepts of gender against British officials to cement their own authority on Indigenous terms, allowing them to maintain conventional avenues toward power and leadership within the confederacy.
Implementing and Evaluating an Older Adult Physical Activity Model at Scale: Framework for Action
Authors: McKay Heather A. , Sims-Gould Joanie , Nettlefold Lindsay , Hoy Christa L. , Bauman Adrian E.
Published: August 2023

Most research intervention trials demonstrate efficacy in selected samples. However, to improve population health, interventions that prove efficacious or effective in a research setting need to be delivered at scale. Despite this, relatively little attention has been paid to mechanisms and factors that support scaling up effective interventions. Thus, the purpose of this article is to describe the conceptual frameworks that guide implementation at scale of an evidence-based physical activity strategy for older adults (Choose to Move), our partnership approach to implementation and scale-up, and the methods we adopted to evaluate implementation and impact of this scaled-up model on older adults' physical activity, mobility, and social connectedness. From a socioecologic perspective, we describe 1) the design of the Choose to Move intervention, 2) the partnerships with key delivery organizations, 3) the implementation and scale-up frameworks that guide our approach, 4) the delivery of Choose to Move at scale, and 5) the protocols we will adopt to evaluate implementation and impact of Choose to Move. We adopt a type 2 hybrid effectiveness–implementation pre- and post-study design guided by scale-up, implementation, and evaluation frameworks. Specifically, we will first evaluate contextual factors that influence the implementation of Choose to Move. Second, we will evaluate effectiveness of Choose to Move on older adults' physical activity, sedentary time, capacity for mobility, and social connectedness using mixed methods. To address the escalating proportion of older adults that comprise our population and low levels of physical activity among them, it seems timely to refocus away from small-scale interventions. Should Choose to Move, a scalable, evidence-based physical activity model, be successfully delivered at scale, our approach has great implications to enhance older adult health at the population level.
Translation Goes Both Ways: The Power of Reverse Translation from Human Trials into Animal Models
Authors: Lightfoot J. Timothy , Bamman Marcas M. , Booth Frank W.
Published: August 2023

Much attention has been given to “translational research” with the assumption that such models follow a stepwise progression from basic/discovery science at the bench to application at the bedside. This practice ignores the valuable reverse aspect of translational research (i.e., “reverse translation”) where discoveries or observations at the bedside can inform and stimulate more mechanistic, basic work back at the bench, which in turn should expedite clinical applicability. This commentary reflects on the current thinking regarding reverse translation, with particular emphasis on the value of reverse translational design in understanding acute responses and chronic adaptations to exercise. Overall, we conclude that reverse translational designs offer a powerful avenue of investigation that should be fully leveraged to maximize impact on the understanding and treatment of human disease.
Exercise in the Prevention and Treatment of Breast Cancer: What Clinicians Need to Tell Their Patients
Authors: Kraschnewski Jennifer L. , Schmitz Kathryn H.
Published: August 2023

In 2016, nearly a quarter-million women were diagnosed with invasive breast cancer, the second deadliest cancer type. Lifestyle behaviors are well-established risk factors for both the development of, and negative outcomes from, breast cancer. New findings demonstrate that engaging in even minimal amounts of exercise is protective against breast cancer. Further, numerous studies have identified the role of exercise in the treatment of breast cancer and improvement in treatment side effects, quality of life, and overall survival. Unfortunately, few patients are physically active due to multiple barriers. Physicians may be helpful in engaging patients in being more active. Further research is necessary to identify programs and approaches to help patients both with, and at-risk for, breast cancer to engage in exercise.
Endocannabinoid and Mood Responses to Exercise in Adults with Varying Activity Levels
Authors: Brellenthin Angelique G. , Crombie Kevin M. , Hillard Cecilia J. , Koltyn Kelli F.
Published: August 2023

Acute aerobic exercise improves mood and activates the endocannabinoid (eCB) system in physically active individuals; however, both mood and eCB responses to exercise may vary based on habitual levels of physical activity.

Purpose

This study aimed to examine eCB and mood responses to prescribed and preferred exercises among individuals with low, moderate, and high levels of physical activity.

Methods

Thirty-six healthy adults (21 ± 4 yr) were recruited from low (≤60 min moderate–vigorous physical activity [MVPA] per week), moderate (150–299 min MVPA per week), and high (≥300 MVPA per week) physical activity groups. Participants performed both prescribed (approximately 70%–75% max) and preferred (i.e., self-selected) aerobic exercise on separate days. Mood states and eCB concentrations were assessed before and after exercise conditions.

Results

Both preferred and prescribed exercise resulted in significant increases (P < 0.01) in circulating eCB (N-arachidonoylethanolamine [AEA] and 2-arachidonoylglycerol); however, increases in AEA (P < 0.05) were larger in the prescribed condition. Likewise, both preferred and prescribed exercise elicited positive mood improvements compared with preexercise values, but changes in state anxiety, total mood disturbance, and confusion were greater in the preferred condition (P < 0.05). Changes in 2-arachidonoylglycerol concentrations were found to negatively correlate with changes in depression, tension, and total mood disturbance in the preferred condition (P < 0.05), and changes in AEA were positively associated with changes in vigor in the prescribed condition (P < 0.05). There were no significant group differences for mood or eCB outcomes.

Conclusion

These results indicate that eCB and mood responses to exercise do not differ significantly between samples with varying physical activity levels. This study also demonstrates that in addition to prescribed exercise, preferred exercise activates the eCB system, and this activation may contribute to positive mood outcomes with exercise.
Effects of Task Difficulty on Kinematics and Task Performance during Walking Workstation Use
Authors: Harry John R. , Eggleston Jeffrey D. , Dunnick Dustin D. , Edwards Hannah , Dufek Janet S.
Published: August 2023

Although walking workstations do not seem to compromise task performance despite altered gait kinematics, current evidence stems from evaluations of relatively simple tasks that do not reflect typical work duties.

Purpose

This study aimed to examine the effects of simple cognitive (SC) and complex cognitive (CC) tasks on gait kinematics during walking workstation use in comparison to baseline walking.

Methods

Three-dimensional kinematic data of the lower extremity and trunk were collected while walking during baseline, SC, and CC conditions, with each condition performed at a self-selected velocity. Kinematic data were time normalized to 100% of the gait cycle and divided into subphases for analysis. Differences in walking velocity (baseline vs SC/CC) and task performance (SC vs CC) were tested using paired-samples t-test (α = 0.05). Kinematic data were tested for differences between baseline and SC, baseline and CC, and SC and CC using a point-to-point model statistic analysis (α = 0.05) at the single-subject level.

Results

Walking velocity was not different between baseline and SC/CC (1.10 ± 0.25 m·s−1, baseline; 1.11 ± 0.26 m·s−1, SC/CC; P = 0.409), nor was task performance time different between SC and CC (81.1 ± 25.6 s, SC; 87.6 ± 17.7 s, CC; P = 0.394). Similar percentages of differences were detected across participants during each gait subphase for all lower extremity joint angles during SC and CC when compared with baseline. A greater percentage of differences were observed in trunk angles during SC than during CC when compared with baseline.

Conclusions

Results indicate that trunk kinematics are influenced by task difficulty during walking workstation use, although lower extremity kinematics are not affected regardless of task difficulty. Thus, walking workstations do not compromise task performance during work-related tasks and walking safety does not seem threatened by tasks of greater difficulty.
Feasibility of the InPACT Intervention to Enhance Movement and Learning in the Classroom
Authors: Beemer Lexie R. , Ajibewa Tiwaloluwa A. , O’Sullivan Molly P. , Nagy Matthew R. , Ransier Ben , Stockdill Darin , Vance U. Sean , Colabianchi Natalie , Hasson Rebecca E.
Published: August 2023

Purpose

The purpose of this study was to test the feasibility of implementing ten 3-min moderate to vigorous physical activity breaks in the classroom.

Methods

Twenty third- through sixth-grade classrooms (approximately 500 students) in three schools across southeast Michigan: one suburban (90% white; 25% qualified for free/reduced lunch [FRL]), one rural (90% white; 50% FRL) and one urban (59% black; 74% FRL), participated in this 16-wk intervention. Before the start of the intervention, participating teachers were trained during a 2-d school-based in-service. Direct observation was used to assess 1) intervention fidelity, 2) exercise intensity of activity breaks (AB), 3) duration of AB, 4) transition time to start an AB, and 5) students returning to task post-AB. Postintervention, teachers completed surveys to document the number of AB per day to comment on the feasibility of the intervention. Students completed the Physical Activity Enjoyment Scale questionnaire and answered a single-item question from the Physical Activity Self-Efficacy Scale to assess AB enjoyment and confidence, respectively.

Results

On average, teachers implemented five AB per day (average duration: 202 s) with approximately 85% of students and 75% of teachers exercising at a moderate to vigorous intensity during a given AB; approximately 99% of students returned to a teacher-assigned task within 30 s of completing the break. Students reported high levels of AB enjoyment and confidence.

Conclusions

These preliminary findings suggest that ten 3-min AB are not feasible for a classroom setting because teachers on average implemented only five AB. Nevertheless, children accumulated over 16 min of activity in the classroom, most of which were moderate to vigorous physical activity minutes enabling teachers to provide approximately half of the school-based recommendations for physical activity in their classrooms.
Perspectives on High School “Pay to Play” Sports Fee Policies: A Qualitative Study
Authors: Eyler Amy A. , Valko Cheryl , Serrano Natalicio
Published: August 2023

Background

Participation in high school athletics is associated with many physical and psychosocial benefits. School budget cuts and increased program costs have resulted in policies requiring student athletes to pay fees for sports participation. The purpose of this study was to explore the implementation and perception of these policies among state and district key informants.

Methods

We conducted an Internet search to compile a list of state and district athletic directors for study recruitment to participate in qualitative interviews. Twelve key informants were interviewed via telephone, digitally audio-recorded, and the conversations transcribed verbatim. Two team members coded transcripts and themes were identified and summarized.

Results

The main reasons for implementing fee policies were increasing program costs, revenue loss or decreased school budget, and unsuccessful levy passage. The policies varied in fee structure and were reported by sport, by athlete, by year, or by family. Participants discussed fee waivers as a strategy to assist athletes unable to pay the sports participation fees. Waivers were most likely linked with federal poverty qualifications.

Conclusion

The results from these interviews provided insights into sports participation policies in U.S. high schools. More information is needed to explore the consequences of these policies on high school sports participation as well as longer-term outcomes.
Integrating Exercise into the Electronic Medical Record: A Case Series in Oncology
Authors: Santa Mina Daniel , Cutrono Stacy Edyth , Rogers Laura Q.
Published: August 2023

The Exercise is Medicine campaign initiated by the American College of Sports Medicine is intended to advance the integration of exercise into formalized medical care through strategic linkages between health care systems, providers, health-related digital technologies, and available exercise programs. Exercise is established as a fundamental element of comprehensive cancer care and given the critical role of the electronic medical record (EMR) in health care communication, optimizing the use of the EMR by qualified exercise professionals and for exercise-related referrals may improve clinical outcomes. The purpose of this article is to describe the strategies, facilitators, barriers, and opportunities in implementing exercise information in the EMR in three cancer centers in North America: The University of Alabama at Birmingham, the Sylvester Comprehensive Cancer Center, and the Princess Margaret Cancer Centre. The collective experience of three cancer centers identifies the diverse opportunities and challenges in connecting exercise programming with the EMR. The implementation of exercise programming, resources, and linkages in the EMR is complex, involves numerous stakeholders, and can be mapped against the Consolidated Framework of Implementation Research. Methods of establishing communication or referral pathways to exercise programs described here can serve as precedents for similar endeavors. Further research is needed to determine whether implementation strategies that target identified implementation science constructs can facilitate the implementation of exercise programming via EMR where the Consolidated Framework for Implementation Research may serve as a useful empirical framework.
A 2-yr, School-Based Resistance Exercise Pilot Program Increases Bone Accrual in Adolescent Girls
Authors: Dowthwaite Jodi N. , Weiss Deena M. , Thein-Nissenbaum Jill , Scerpella Tamara A.
Published: August 2023

The current analysis evaluates cumulative benefits after year 2 of a school-based resistance training intervention. Adolescent girls were enrolled and measured at the beginning of sixth grade (baseline [BL]) and again at first follow-up (Y1 end) and second follow-up (year 2 end). School gym classes met alternate school days. Site 1 had standard gym classes (CON). Site 2 gym classes included 8–12 min of resistance training (INT); INT girls were categorized based on observed participation effort and time (LO, HI). Measurements included the following: 1) height and weight, 2) questionnaires to assess extracurricular exercise and diet (calcium, vitamin D), and 3) dual-energy X-ray absorptiometry (Lunar Prodigy). Whole body less head scans yielded bone mineral content (BMC) and body composition. Lumbar spine (L1–L4) and femoral neck (FN) scans yielded BMC and areal bone mineral density (BMD); radius scans yielded ultradistal and 1/3 BMD. ANCOVA compared group means for percent gains from BL to second follow-up, accounting for biological maturity, BL height, height change, interscan interval, organized activity, calcium, and vitamin D. In 62 girls (21 CON, 41 INT), intention-to-treat analyses detected INT versus CON advantages for L1–L4 BMC and BMD (4.1%, 5.6%:P< 0.05). HI effort participants (n= 19) demonstrated advantages for BMC and BMD at L1–L4 and FN (5.7% to 8.2%,P< 0.01) versus CON. Over two school years, this resistance intervention yielded lumbar spine advantages; enthusiastic participation (HI) yielded lumbar spine and FN advantages. Further work is warranted to evaluate benefit persistence after intervention cessation.