bluuebunny/crossref_metadata_2025 huggingface dataset:
An in-vitro method for comparative analysis of aspiration catheter tracking performance
Authors: Wodarg Fritz , Brouwer Patrick , Power Sarah , Gilvarry Michael , Mirza Mahmood , Conlon Richard , Johnson Sarah , McCarthy Ray
Published: August 2024

Background and purpose

Mechanical thrombectomy (MT) for acute ischemic stroke (AIS) relies on efficient tracking of aspiration catheters through complex vascular anatomies. Differences in catheter design lead to variation in tracking performance which may only become apparent after use in patients. We developed an in-vitro methodology for evaluating aspiration catheter performance under a variety of pre-defined circumstances, that can be used during catheter development for design optimization.

Methods

Validation of the in-vitro methodology involved testing four large bore aspiration catheters on recreated challenging vascular access routes derived from patient angiograms. Two experienced neurointerventionalists conducted the tests under controlled physiological and procedural conditions. Each catheter design was evaluated across 30 unique anatomy-procedural set-up combinations. A fifth, prototype large bore catheter was evaluated by trained engineers to assess the applicability of the in-vitro test.

Results

Results from statistical analysis using a general linear model demonstrated the methodology's effectiveness in detecting significant tracking differences among catheter designs ( p < 0.01). Minimal inter-operator variability was observed ( p = 0.304), while procedural techniques significantly influenced tracking performance ( p < 0.01). The tortuosity of the arterial access route notably impacted catheter performance ( p < 0.01), with anatomical features revealing varying degrees of influence on desirable and undesirable catheter design aspects.

Conclusion

We successfully developed a test methodology for evaluating the trackability of large bore aspiration catheters intended for treating acute ischemic stroke with large vessel occlusions. This methodology offers a robust approach to pre-clinical design assessment, utilizing anatomical models that simulate real-world vascular challenges to enhance catheter optimization.
Axillary compared to brachial access for endovascular procedures
Authors: Altaha Mustafa A , Bailey Shawn , Mafeld Sebastian , Jaberi Arash , Tan Kong Teng
Published: August 2024

Objectives

Limited knowledge exists regarding access site complication rates between trans-axillary and trans-brachial approaches with sheath sizes ≥6Fr. We retrospectively reviewed our institution experience with access site complications for percutaneous trans-axillary and trans-brachial arterial interventions using sheath sizes ranging from 6Fr to 10Fr.

Methods

We examined 67 endovascular interventions performed over 18 months, restricted to sheath sizes of 6Fr to 10Fr. Procedures utilizing trans-brachial (41 cases) and trans-axillary (26 cases) approaches under sonographic guidance were included. Cases involving hemodialysis accesses and those requiring surgical cut-down were excluded. The primary outcome measure was the occurrence of major access site complications (SIR grade-II/III) within 30 days, with data collected on hemostasis method, sheath size, and complications. Statistical analysis involved ANCOVA and Fisher’s exact tests, with significance set at p < .05.

Results

Successful percutaneous arterial access was achieved in all cases using either approach (trans-axillary or trans-brachial). Closure devices were employed in all axillary punctures and in 71% of brachial punctures. Major access site complications occurred in 7 out of 41 cases (17%) in the trans-brachial group and in 4 out of 26 cases (15%) in the trans-axillary group. However, there was no statistically significant difference in complication rates between the two groups, regardless of access site or sheath size.

Conclusion

Trans-axillary access serves as a safe and effective upper limb access method for percutaneous endovascular procedures requiring sheath size of 7Fr or larger when compared to trans-brachial approach.
Successful use of lithoplasty for re-expansion of covered iliac stents with unilateral occlusion
Authors: Damara Fachreza A , Wolfers Matthew , Kirksey Lee
Published: August 2024

Background:

Vessel wall calcification is associated with stent under-expansion and in-stent restenosis. The traditional approaches to treat peripheral artery calcification are percutaneous transluminal angioplasty (PTA) and atherectomy. Shockwave intravascular lithotripsy (IVL) uses sonic wave pressure to disrupt calcium of the severely calcified lesions. Published reports of IVL to treat in-stent restenosis are limited to coronary interventions and bare metal platforms.

Methods

We describe the case of a 55-year-old male with extremely compressed under-expanded covered stents associated with severe wall calcification that resulted in stent occlusion.

Results

The IVL system balloon was deployed uneventfully, in a phased manner. Bilateral bare metal stents were also placed in a kissing fashion to further re-expand the arterial segments. Reintervention with IVL facilitated successful revascularization and the stent remained patent at 24 months.

Conclusion

Our case highlights the use of IVL as an effective tool in the management of vessel wall calcification both for primary and secondary interventions.
Exploring patient perception of decision-making in carpal tunnel release surgery: A systematic review and thematic synthesis of qualitative studies
Authors: Lui Bing Chun , Jerosch-Herold Christina
Published: August 2024

Background

Carpal tunnel syndrome is a common condition, but some controversies remain regarding diagnostics and the most effective treatments. As a result, patients often experience decisional conflicts, especially when considering carpal tunnel release surgery. Understanding factors that influence decision-making in surgery can help clinicians better grasp patient treatment preferences and priorities, reducing decisional conflicts, and enabling patients to make informed, value-aligned choices through shared decision-making. This qualitative evidence synthesis aims to explore patient perceptions of carpal tunnel release, examine the decision-making factors, and critically appraise and synthesise the existing evidence.

Methods

A systematic search was conducted across four electronic databases (MEDLINE, EMBASE, CINAHL Ultimate, PsycINFO) from inception to August 2023, supplemented by referencing and citation searching to identify eligible qualitative studies. Thematic synthesis was adopted as synthesis methodology, involving a line-by-line coding of the primary study findings, and the development of descriptive and analytical themes. Quality appraisal was conducted using the modified Critical Appraisal Skills Programme checklist, supplemented with the COnsolidated criteria for REporting Qualitative research checklist.

Results

Synthesis of six qualitative studies encompassing 66 participants generated five analytical themes: (1) Journey to normalcy, (2) Patient-centred care, (3) Work and life considerations, (4) Weighing up alternatives, and (5) Shaping the expectations, highlighting the complexity of patient decision-making in carpal tunnel release.

Discussion

In the management of carpal tunnel syndrome, therapists should consider various decision-making factors, prioritising communication and shared decision-making. This, along with personalised interactions, achieves patient-centred care and enhances patient care quality and therapeutic alliance.
Navigating the Unique Challenges of Automated Insulin Delivery Systems to Facilitate Effective Uptake, Onboarding, and Continued Use
Authors: Tanenbaum Molly L. , Commissariat Persis V. , Wilmot Emma G. , Lange Karin
Published: August 2024

Advances in diabetes technologies have enabled automated insulin delivery (AID) systems, which have demonstrated benefits to glycemia, psychosocial outcomes, and quality of life for people with type 1 diabetes (T1D). Despite the many demonstrated benefits, AID systems come with their own unique challenges: continued user attention and effort, barriers to equitable access, personal costs vs benefits, and integration of the system into daily life. The purpose of this narrative review is to identify challenges and opportunities for supporting uptake and onboarding of AID systems to ultimately support sustained AID use. Setting realistic expectations, providing comprehensive training, developing willingness to adopt new treatments and workflows, upskilling of diabetes team members, and increasing flexibility of care to tailor care to individual needs, preferences, lifestyle, and personal goals will be most effective in facilitating effective, widespread, person-centered implementation of AID systems.
Exploration of the Therapeutic Potential of Salvianolic Acid B Against senile Cataracts Based on Network Pharmacology and Experimental Validation
Authors: Dong Yongxiao , Zhao Jin , Zheng Xueli , Xue Tao , Ma Wenting , Cao Panpan , Wang Ling , Yuan Xiaoyong
Published: August 2024

Background

The aim of this study was to explore the preventive and therapeutic potential of salvianolic acid B in inhibiting senile cataracts through network pharmacology and experimental validation.

Methods

Disease-related genes were obtained from the DisGeNET and GeneCards databases. Drug targets were identified from the Swiss Target Prediction and PharmMapper databases, shared genes were identified via the Venny website, links between genes were identified via a protein–protein interaction (PPI) network, and GO and KEGG analyses were subsequently performed via R software. The key genes were identified via Cytoscape software, and their binding with Sal-B was demonstrated by molecular docking. Then, the results were verified by cell experiments. A CCK-8 assay was used to assess the activity of human LECs with or without H2O2 or Sal-B treatment, and the cell apoptosis rate of each group was determined by flow cytometry. The gene expression levels of caspase 3, TNF-α and MMP-9 in human LECs treated with or without H2O2 or Sal-B were determined by qPCR.

Results

A total of 705 and 152 cataract-related genes and salvianolic acid B-related genes, respectively, were identified, with 37 shared genes. The PPI results showed that MMP9, IL-2, JUN, TNF-α and caspase 3 were the core genes. GO data analysis revealed that the biological process, cell component and molecular function terms were most enriched in the categories “apoptosis progress”, “cytosol” and “protein binding”. Through KEGG enrichment analysis, we found that the core genes were related to the IL-17 and TNF signalling pathways. Cytoscape results showed that MMP9, TNF-α and caspase 3 were the key genes, and molecular docking showed that the drugs interacted well with the target molecules. The experimental results showed that salvianolic acid B inhibited H2O2-induced decreases in LEC activity and apoptosis and inhibited the gene expression of MMP9, TNF-α and caspase 3.

Conclusion

Network pharmacology and molecular docking results showed that salvianolic acid B has the potential to prevent and treat senile cataracts. The experimental results verified the finding that salvianolic acid B can inhibit the decrease in LEC activity and apoptosis induced by H2O2 and verified the expression of the key molecules MMP9, TNF-α and caspase 3.
Contesting elite capture: Repositioning insurgent planning for mass movements
Authors: Kirk Richard , Behm Josa Derrick
Published: August 2024

Some scholars have called on insurgent planning to contest the elite capture of our cities. We take this opportunity to critique and thicken the original conceptual formulation of insurgent planning and explore the limitations of its resistance against elite capture. The view that we challenge suggests that insurgent action should be folded into institutionalized planning practice in order that urban planners—wielding expert knowledge and technical skills bestowed upon them by their discipline—might harness insurgent forces from the margins to bring about change. Instead, we leverage the “people as infrastructure” framework to argue that insurgent planning faces major challenges posed by a concretizing elite-captured urban landscape and highly entrenched, pervasive capitalist ideology. We advocate and reiterate that potent counter-elite capture tactics continuously emerge from outside of institutionalized planning, arising from the changemaking power of marginalized urbanites and, once united, into mass movements transformative of social relations.
What Drives Support for Armed Humanitarian Intervention? Experimental Evidence From Dutch Citizens on International Law and Probability of Success
Authors: Mazepus Honorata , Aloyo Eamon , Kubalová Natália
Published: August 2024

Under what conditions do individuals support armed humanitarian intervention (AHI) in situations where mass atrocities are ongoing? This article tests several hypotheses about support for AHIs to isolate and interact two potential drivers: international law and the probability of success. It leverages an original, pre-registered experiment from a (quota) representative sample of over 1500 Dutch citizens. Consistent with our hypotheses, we find that support for AHI increases when an action is authorized by the UN Security Council (UNSC) and has a high (80%) chance of success. But the Dutch remain supportive of AHI in situations of mass atrocities even when AHI has a low chance of success (20%). Importantly, we find that the chance of success does not affect the support for AHIs as much as the international law does. This suggests that in similar situations legal and procedural reasons may influence public opinion more than a logic of consequences.
Unilateral Spinal Anesthesia in Hip Fracture Surgery for Geriatric Patients With High Cardiovascular Risk due to Aortic Stenosis is Safe and Effective
Authors: Çağıran Zeynep , Vahabi Arman , Özgül Kazım Koray , Aljasim Omar , Karaman Semra , Özkayın Nadir , Aktuğlu Kemal , Sertöz Nezih
Published: August 2024

Introduction

Aortic stenosis is a cause of mortality or morbidity. It complicates the selection and management of anesthetic procedures. The aim of this study was to evaluate the efficacy, hemodynamic effects and postoperative outcome of unilateral spinal anesthesia in geriatric patients with hip fractures with moderate or severe aortic stenosis.

Material and Method

A retrospective observational study was conducted on geriatric high-risk patients with cardiac conditions who underwent surgery for hip fractures under unilateral spinal anesthesia with low-dose hyperbaric bupivacaine. The study period spanned from January 2018 to December 2021. The inclusion criteria were individuals with moderate to severe aortic stenosis, as defined by the American Heart Association Criteria. Data on demographic information, cardiac pathologies, hemodynamic data, data on motor and sensory block, perioperative complications, and mortality rates at 30th and 180th days were collected.

Results

Mortality rates at the 30th day and 180th day were 8.9% (n:4) and 24.4% (n:11), respectively. T6 level was predominantly obtained level of anesthesia (44.4%). Motor and sensory block formation times averaged 7.6 and 4.8 minutes, respectively. Surgical procedures were performed mostly within 1 hour (66.7%), and complications were rare (11.1% hypotension). Initial analgesic effect showed a rapid resolution, with 64.4% of patients requiring analgesic within the first hour postoperatively.

Conclusion

In elderly patients with moderate to severe aortic stenosis scheduled for hip fracture surgery, we posit that unilateral spinal anesthesia with ultra-low dose is safe and effective option.
Revisit the Syntax of Nominal-Internal Phrases in Mandarin Chinese
Authors: Ma Yanxiao
Published: August 2024

The article revisits the canonical (Dem>Num>A>N) and non-canonical (A>Dem>Num>N & Dem>A>Num>N) prenominal patterns in Mandarin Chinese, from the perspective of the Labeling Algorithm. It shows that the syntactic distribution of adjectives are different, depending on the attributive-predicative sources and the presence or absence of the subordinator - de. The attributive adjective (with or without - de) and the de-less predicative adjective are analyzed as direct modification of the noun phrase, and it derives as a specifier of the noun, then falling into an agreement Agr projection. The non-canonical pattern undergoes AgrP-movement to the nominal left-periphery, which involves focus moving. However, the predicative adjective with - de is associated with a predicate of a reduced relative clause, and it undergoes successive focus-driven movement in the non-canonical pattern. The supporting evidence is illustrated in superlative and exclamatory adjectives as well as the CP-DP splitting hypothesis. The labeling-based explanation provides a specific picture to see the internal structure of adjectives, to look at how to package the informational constituents in the prenominal pattern, and to demonstrate the systematic parallelism between nominal and clausal domains in Mandarin Chinese.
Time Evolution Analysis of Riders’ Preference Attention and Satisfaction on Real-Time Crowdsourcing Logistics Platform
Authors: Zhang Yi , Li Dan , Liu Shengren
Published: August 2024

This study examines the evolutionary trends in preference focus and satisfaction among real-time crowdsourced logistics platform riders (hereafter referred to as riders) in China since the outbreak of the COVID-19 pandemic. By analyzing real-time comments from 5,652 riders and applying the Latent Dirichlet Allocation (LDA) model to identify riders’ preferences and calculate their attention levels, combined with riders’ actual ratings to infer satisfaction levels (ranging from very dissatisfied to satisfied), this research for the first time explores the changing patterns of riders’ preferences and their attention and satisfaction trends in the pandemic context from a long-term dynamic perspective. The findings reveal that riders prioritize interaction quality; the range of fluctuation in average attention levels is large when high and small when low; attention to platform management, system utility, and rider relationships is on the rise, whereas interest in other preferences is declining; there is a significant correlation between rider attention and platform policies; and social media and related public opinion influence riders’ preferences. These insights are instrumental for the platform to adjust the policy direction duly and meet the core demands of riders according to the limited priority.
Lecturers’ Feedback, Students’ Psychology Variables and Students’ Engagement in Economics: The Moderating Role of Students’ Gender
Authors: Amedu Amos Nnaemeka , Ezeudu Samuel Agozie , Eneogu Njideka Dorathy
Published: August 2024

This study modelled the influence of lecturers’ feedback and students’ psychological variables on students’ engagement as moderated by students’ gender. The data were collected from 400 students who responded to feedback, self-efficacy, motivation, interest, and engagement questionnaires. Path diagrams and path coefficients were used to answer research questions. Hypotheses were tested with the average path coefficient (APC), average R-squared (ARS), and average adjusted R-squared (AARS). This study found that the causal model for explaining students’ engagement is a recursive model involving lecturers’ feedback and students’ psychological variables. The study found that the composite effects of lecturers’ feedback and students’ psychological variables explained 69% of the variation in students’ engagement in learning economics. In addition, this study revealed that the most significant variable that affected students’ engagement in this model was self-efficacy, followed by interest and motivation. In addition, lecturers’ feedback positively and significantly affected all psychological variables as well as students’ engagement in this model. Finally, the moderating effect of gender was not significant with respect to students’ engagement. Based on this study’s findings, lecturers should consider students’ psychological variables when providing feedback. Also, seminars and workshops should be organized for economics lecturers to improve feedback quality.
Eroding Landscapes, Emerging Carescapes: How Migrants from Coastal Louisiana Experience Disasters and Care from Afar
Authors: Folse Brandon
Published: August 2024

Although we now know that disaster and climate migration is complex and nonlinear, less is known about how migrants from environmentally threatened areas are affected by disasters back home. This study centers the perspectives and care of 30 migrants from several high-risk coastal Louisiana communities who helped their kin in the wake of Hurricane Ida (2021). In fusing the disaster migration and disaster care literature, it illustrates how migrants engage in gendered care work from afar. It also shows how gender shapes decision making to stay in or stay attached to such environments and even perpetuates the need for future care. The theoretical concept of a “disaster carescape” is proposed to highlight intergenerational care across time and space while emphasizing place (environmentally threatened landscapes) and place attachment in shaping these care relations. The author concludes by suggesting that disaster carescapes will be important to understand as demographics in climate-affected areas shift during this century.
Atrial cardiopathy biomarkers and atrial fibrillation in the ARCADIA trial
Authors: Kamel Hooman , Elkind Mitchell SV , Kronmal Richard A , Longstreth WT , Plummer Pamela , Aragon Garcia Rebeca , Broderick Joseph P , Pauls Qi , Elm Jordan J , Nahab Fadi , Janis L Scott , Di Tullio Marco R , Soliman Elsayed Z , Healey Jeff S , Tirschwell David L
Published: August 2024

Background:

ARCADIA compared apixaban to aspirin for secondary stroke prevention in patients with cryptogenic stroke and atrial cardiopathy. One possible explanation for the neutral result is that biomarkers used did not optimally identify atrial cardiopathy. We examined the relationship between biomarker levels and subsequent detection of AF, the hallmark of atrial cardiopathy.

Methods:

Patients were randomized if they met criteria for atrial cardiopathy, defined as P-wave terminal force >5000 μV*ms in ECG lead V1 (PTFV1), NT-proBNP >250 pg/mL, or left atrial diameter index (LADI) ⩾3 cm/m2. For this analysis, the outcome was AF detected per routine care.

Results:

Of 3745 patients who consented to screening for atrial cardiopathy, 254 were subsequently diagnosed with AF; 96 before they could be randomized and 158 after randomization. In unadjusted analyses, ln(NT-proBNP) (RR per SD, 1.99; 95% CI, 1.85–2.13), PTFV1 (RR per SD, 1.15; 95% CI, 1.03–1.28) and LADI (RR per SD, 1.34; 95% CI, 1.20–1.50) were associated with AF. In a model containing all 3 biomarkers, demographics, and AF risk factors, age (RR per 10 years, 1.24; 95% CI, 1.09–1.41), ln(NT-proBNP) (RR per SD, 1.88; 95% CI, 1.67–2.11) and LADI (RR per SD, 1.25; 95% CI, 1.14–1.37) were associated with AF. These three variables together had a c-statistic of 0.82 (95% CI, 0.79–0.85) but only modest calibration. Discrimination was attenuated in sensitivity analyses of patients eligible for randomization who may have been more closely followed for AF.

Conclusions:

Biomarkers used to identify atrial cardiopathy in ARCADIA were moderately predictive of subsequent AF.
A phenomenological exploration of the lived experience of adults experiencing pathological demand avoidance
Authors: Kenny Neil , Doyle Alison
Published: August 2024

This study explores the lived experiences of adults with Pathological Demand Avoidance (PDA) in Ireland. There is a paucity of research exploring the experience of those living with PDA in Ireland which impacts levels of awareness and understanding of anxiety-based demand avoidance and its intersection with autism. As lifelong conditions, this has implications for adults who can struggle to access services or appropriate supports or can be isolated in the transition from Child and Adolescent services. This paper extracts data from a national study, Mapping Experiences of Pathological Demand Avoidance in Ireland, and examines the lived experience and personal histories of adults with a diagnosis of / self-identifying with PDA and autism, consisting of statements extracted from open-ended survey responses, and in-depth interviews. A deductive approach to the analysis of their testimonies discovered four superordinate themes: (1) Bidirectional social challenges, (2) Life experiences, (3) Trust and safety and (4) Accepting our truth. Subordinate leitmotifs describe: Pervasive anxiety, Challenges negotiating life demands and Flexibility in education settings. This paper reveals the interplay between PDA, autism and mental health for these participants combined, leading to significant challenges in daily life. To support better life quality and flourishing, participants advised greater autonomy and flexibility of support across all aspects of life and more awareness of PDA across society.
Trades-offs between pollinator attraction and florivore defense maximize reproductive success in the self-incompatible Rivea ornata (Convolvulaceae)
Authors: Chitchak Natthaphong , Stewart Alyssa B. , Traiperm Paweena
Published: August 2024

Background

Rivea ornata, a rare species from the morning glory family, exhibits uncommon characteristics compared to other typical morning glories, including nocturnal flowers that fit the classic moth pollination syndrome. However, the accuracy of its predicted pollination syndrome and its mating system have never been assessed. Additionally, R. ornata flowers attract not only pollinators but also florivores, potentially reducing plant reproductive success. Therefore, this study examined two populations of R. ornata in Thailand and assessed traits related to pollinator attraction and reward, determined its mating system, identified floral visitors and effective pollinators, and investigated the effect of florivory on reproductive success.

Results

Rivea ornata is highly fertile but self-incompatible and an obligate outcrosser, rendering it highly dependent on pollinators. Lepidopterans, particularly nocturnal hawk moths, were found to account for a significant proportion of all visits and were the sole effective pollinators of this plant species, in correspondence with its predicted pollination syndrome. Surprisingly, florivory did not significantly reduce reproductive success. This phenomenon may be explained by the strategies employed by R. ornata, which align with the optimal defense hypothesis and functional trade-offs. Specifically, R. ornata appears to invest resources in defending key floral structures while, simultaneously, guard ants are conspicuously absent from flowers, resulting in some florivore damage to non-vital floral organs but ensuring that pollinators are not deterred by ants and thus maintaining high pollinator visitation rates.

Conclusions

Our findings indicate that reproduction-related traits in R. ornata, including those involved in pollinator attraction and reward and florivore defense, are highly effective and work in concert to maximize plant reproductive success. Therefore, a main risk that R. ornata faces is the decline or disappearance of hawk moths and other lepidopterans given its extreme specialization and high dependence on pollinators, and conservation efforts should include habitat protection for both R. ornata and its pollinators.
Validation of a sleep-disordered breathing screening questionnaire during pregnancy and comparison between mothers and bedpartners prediction of risk
Authors: Booker Lauren A. , Howard Mark E. , Walker Susan P. , Wilson Danielle L.
Published: August 2024

Background

Sleep Disordered Breathing (SDB) in pregnant patients ranges from 3 to 27% and varies depending on gestational age and method used to diagnose. SDB increases the risk of advanced pregnancy complications such as gestational diabetes mellitus, pregnancy-induced hypertension, and preeclampsia. Screening and diagnosis of SDB during pregnancy remains a challenge, with existing screening tools underperforming during pregnancy. This study aimed to validate a previously developed model for predicting SDB during late pregnancy and compare the predictive value of bedpartner responses.

Methods

Ninety-six women in the third trimester of pregnancy underwent polysomnography and completed the Berlin Questionnaire (BQ), with 81 bedpartners completing the BQ about their pregnant partner. A subset of BQ items (snoring volume and tiredness upon awakening) along with BMI > 32 kg/m2was utilised to calculate the Wilson Optimized Model (WOM), which demonstrated strong predictive properties in development.

Results

SDB (RDI/hr ≥ 5) was detected in 43.8% of women. BQ identified 72% of pregnant mothers as high risk for SDB (Sensitivity = 83%, Specificity = 37%), compared to 29% of mothers identified by the WOM (Sensitivity = 45%, Specificity = 83%). At RDI of ≥ 15, the WOM correctly classified more women according to SDB risk than the BQ (76.0% vs. 41.7% cases correct,X2(1) = 23.42,p < .001), with no difference at RDI ≥ 5. Bedpartners were more likely to report high risk for SDB on the WOM than pregnant women themselves (38.3% vs. 28.4%), however predictive ability was not improved by bedpartner input (RDI ≥ 5 bedpartner AUC = 0.69 v mother AUC = 0.73).

Conclusion

BQ largely overestimates the prevalence of SDB in pregnancy compared to the WOM which underestimates. Utilising bedpartner responses didn’t improve screening for SDB in late pregnancy. More work is needed to develop a pregnancy-specific tool for quick and accurate screening for SDB.
The PROgnostic ModEl for chronic lung disease (PRO-MEL): development and temporal validation
Authors: Ng Sheryl Hui-Xian , Chiam Zi Yan , Chai Gin Tsen , Kaur Palvinder , Yip Wan Fen , Low Zhi Jun , Chu Jermain , Tey Lee Hung , Neo Han Yee , Tan Woan Shin , Hum Allyn
Published: August 2024

Background

Patients with chronic lung diseases (CLDs), defined as progressive and life-limiting respiratory conditions, experience a heavy symptom burden as the conditions become more advanced, but palliative referral rates are low and late. Prognostic tools can help clinicians identify CLD patients at high risk of deterioration for needs assessments and referral to palliative care. As current prognostic tools may not generalize well across all CLD conditions, we aim to develop and validate a general model to predict one-year mortality in patients presenting with any CLD.

Methods

A retrospective cohort study of patients with a CLD diagnosis at a public hospital from July 2016 to October 2017 was conducted. The outcome of interest was all-cause mortality within one-year of diagnosis. Potential prognostic factors were identified from reviews of prognostic studies in CLD, and data was extracted from electronic medical records. Missing data was imputed using multiple imputation by chained equations. Logistic regression models were developed using variable selection methods and validated in patients seen from January 2018 to December 2019. Discriminative ability, calibration and clinical usefulness of the model was assessed. Model coefficients and performance were pooled across all imputed datasets and reported.

Results

Of the 1000 patients, 122 (12.2%) died within one year. Patients had chronic obstructive pulmonary disease or emphysema (55%), bronchiectasis (38%), interstitial lung diseases (12%), or multiple diagnoses (6%). The model selected through forward stepwise variable selection had the highest AUC (0.77 (0.72–0.82)) and consisted of ten prognostic factors. The model AUC for the validation cohort was 0.75 (0.70, 0.81), and the calibration intercept and slope were − 0.14 (-0.54, 0.26) and 0.74 (0.53, 0.95) respectively. Classifying patients with a predicted risk of death exceeding 0.30 as high risk, the model would correctly identify 3 out 10 decedents and 9 of 10 survivors.

Conclusions

We developed and validated a prognostic model for one-year mortality in patients with CLD using routinely available administrative data. The model will support clinicians in identifying patients across various CLD etiologies who are at risk of deterioration for a basic palliative care assessment to identify unmet needs and trigger an early referral to palliative medicine.

Trial registration

Not applicable (retrospective study).
Effect of Advanced Footwear Technology Spikes on Sprint Acceleration: A Multiple N-of-1 Trial
Authors: Bernuz Benjamin , Laujac Steven , Sirial Cedric , Auffret Stephane , Preda Cristian , Slawinski Jean , Millot Benjamin , Pradon Didier , Coudrat Laure , Gavarry Olivier
Published: August 2024

Background

In contrast with Advanced Footwear Technology-AFT running shoes for long-distance, little is known about AFT sprint spikes on performance and acceleration parameters. However, their use has become widespread since the Tokyo 2020 Olympics, and knowledge of their effects would seem to be an essential starting point before any clinical or socio-economic considerations.

Objectives

Our objectives were to determine intra- and inter-subject sprinting performance modifications with Nike® AFT spikes (NAS) compared to standard spiked-shoes (SS).

Methods

Healthy regional to national sprint athletes (n = 21, ≥ 750 pts World Athletics) performed 16 repetitions of 30-m sprints with either the NAS or SS condition during a single session, based on the multiple N-of-1 method, with pairwise randomisation and double-blind procedure. Time on 30-m sprints (Stalker radar), force-velocity profile (F0, V0, Vmax, Pmax, RF, DRF and FVP slope), and confounding factors (wind and shoe mass) were measured. Statistical analyses included a mixed linear regression model for group analyses, and randomisation test inversion and non-overlap-of-all-pair (NAP) methods for intra-individual analysis.

Results

NAS improved 30-m time by a mean of − 0.02 s (SMD = 0.4, p = 0.014), with no interaction with any confounding factors. Significant changes were seen in velocity (Vmax : SMD = 0.9, p < 0.001; V0: SMD = 0.7, p < 0.001) and the horizontal ratio of force (RFmax: SMD = 0.5, p = 0.043), with no changes observed in force production. Whatever the footwear, one unit of positive wind (+ 1 m.s− 1 ) improved performance by − 0.03 s (p < 0.001). At an individual level, four athletes improved (NAP ≥ 0.69), and one had a statistical decrease in performance. Changes in F-V profiles were largely individual.

Conclusions

A positive effect on sprint acceleration characteristics was observed when using Nike® AFT spikes, due to an increase in velocity and the horizontal ratio of force. A major variability in inter-individual response justifies single-case experimental designs for research on the topic.

Trial Registration Number

NCT05881148.
Iron therapy effect on chronic heart failure and iron-deficiency anemia: a systematic review and meta-analysis
Authors: Pintaningrum Yusra , Yunandari Ni Putu
Published: August 2024

Background

Heart failure complicated with iron deficiency is associated with impaired functional capacity, poor quality of life, increased hospitalization, and mortality. This systematic review and meta-analysis were conducted to assess the effect of oral and intravenous iron therapy on functional capacity, hospitalization risk, and mortality risk in patients with chronic heart failure and iron-deficiency anemia.

Methods

Search for published scientific articles using the PRISMA (Preferred Reporting, Items for Systematic Reviews and Meta-Analysis) method conducted on Cochrane Library, PubMed Central, and Medline databases published in the last 20 years. Further systematic review and meta-analysis using RevMan version 5.4 were performed based on the included published scientific articles.

Results

Based on the meta-analysis of included studies, the analytical results of intravenous iron therapy in patient with chronic heart failure and iron-deficiency anemia showed there is 30.82 (MD = 30.82: 95% CI 18.23–43.40) meter change in patient 6MWT, there is likelihood of 0.55 times (55%) (RR = 0.45: 95% CI 0.30–0.68) lower risk of hospitalization and lower risk of mortality (RR = 0.18: 95% CI 0.04–0.78), because heart failure worsening both with statistically significant overall effect compared with placebo.

Conclusions

There is statistically significant effect of intravenous iron therapy to improve patient functional capacity and reduce likelihood of hospitalization risk of 0.55 times (55%) in patient with chronic heart failure and iron-deficiency anemia.
Correlation between bruxism and cervical function
Authors: Elmesseh Olivia I. Abd , El-Sayyad Mohsen M. , Karkousha Rania N.
Published: August 2024

Background

Temporomandibular joint has biomechanical and neurological interactions with cervical region in a complex functioning that is addressed as cranio-cervical mandibular system.

Subjects and methods

In a prospective cohort study of 67 patients, their mean age 24.3 ± 5.6 years of both genders with temporomandibular disorder “bruxism,” patients had fulfilled a questionnaire regarding bruxism manifestations. Pain pressure algometer was used to assess pain pressure threshold for trigger point in masseter, temporalis, sternocleidomastoid, and trapezius, and bubble inclinometer was used to assess cervical proprioception for all cervical ranges.

Results

There was a statistical significant indirect weak correlation between proprioception error of cervical flexion and pain pressure threshold of masseter (r = − 0.333) (p = 0.006), between proprioception error of cervical flexion and pain pressure threshold of trapezius (r = − 0.363) (p = 0.003), and also between proprioception error of cervical left-side bending and pain pressure threshold of trapezius (r − 0.298; p 0.014), while there was significant direct weak correlation between proprioception error of cervical left rotation and cervical bending to left (r 0.315; p 0.009), where the p-value was < 0.05.

Conclusion

The study proved that temporomandibular joint pain was correlated with impaired neck proprioception in whom with bruxism.

Trial registration

NCT05657353. Registered 28 November 2022 — prospectively registered, https://register.clinicaltrials.gov/prs/app/action/LoginUser?ts=1&cx=-jg9qo4.
Increasing Power in Phase III Oncology Trials With Multivariable Regression: An Empirical Assessment of 535 Primary End Point Analyses
Authors: Sherry Alexander D. , Passy Adina H. , McCaw Zachary R. , Abi Jaoude Joseph , Lin Timothy A. , Kouzy Ramez , Miller Avital M. , Kupferman Gabrielle S. , Beck Esther J. , Msaouel Pavlos , Ludmir Ethan B.
Published: August 2024

PURPOSE

A previous study demonstrated that power against the (unobserved) true effect for the primary end point (PEP) of most phase III oncology trials is low, suggesting an increased risk of false-negative findings in the field of late-phase oncology. Fitting models with prognostic covariates is a potential solution to improve power; however, the extent to which trials leverage this approach, and its impact on trial interpretation at scale, is unknown. To that end, we hypothesized that phase III trials using multivariable PEP analyses are more likely to demonstrate superiority versus trials with univariable analyses.

METHODS

PEP analyses were reviewed from trials registered on ClinicalTrials.gov. Adjusted odds ratios (aORs) were calculated by logistic regressions.

RESULTS

Of the 535 trials enrolling 454,824 patients, 69% (n = 368) used a multivariable PEP analysis. Trials with multivariable PEP analyses were more likely to demonstrate PEP superiority (57% [209 of 368] v 42% [70 of 167]; aOR, 1.78 [95% CI, 1.18 to 2.72]; P = .007). Among trials with a multivariable PEP model, 16 conditioned on covariates and 352 stratified by covariates. However, 108 (35%) of 312 trials with stratified analyses lost power by categorizing a continuous variable, which was especially common among immunotherapy trials (aOR, 2.45 [95% CI, 1.23 to 4.92]; P = .01).

CONCLUSION

Trials increasing power by fitting multivariable models were more likely to demonstrate PEP superiority than trials with unadjusted analysis. Underutilization of conditioning models and empirical power loss associated with covariate categorization required by stratification were identified as barriers to power gains. These findings underscore the opportunity to increase power in phase III trials with conventional methodology and improve patient access to effective novel therapies.
End Point Surrogacy in First-Line Chronic Lymphocytic Leukemia
Authors: Simon Florian , Ligtvoet Rudy , Robrecht Sandra , Cramer Paula , Kutsch Nadine , Fürstenau Moritz , Goede Valentin , von Tresckow Julia , Langerbeins Petra , Fink Anna-Maria , Huber Henriette , Tausch Eugen , Schneider Christof , Wendtner Clemens M. , Ritgen Matthias , Dreyling Martin , Müller Lothar , Jacobasch Lutz , Heinz Werner J. , Vehling-Kaiser Ursula , Sivcheva Liliya , Böttcher Sebastian , Dreger Peter , Illmer Thomas , Gregor Michael , Staber Philipp B. , Stilgenbauer Stephan , Niemann Carsten U. , Kater Arnon P. , Fischer Kirsten , Eichhorst Barbara , Hallek Michael , Al-Sawaf Othman
Published: August 2024

PURPOSE

Surrogate end points are commonly used to estimate treatment efficacy in clinical studies of chronic lymphocytic leukemia (CLL). This patient- and trial-level analysis describes the correlation between progression-free survival (PFS) and minimal residual disease (MRD) with overall survival (OS) in first-line trials for CLL.

PATIENTS AND METHODS

First, patient-level correlation was confirmed using source data from 12 frontline German CLL Study Group (GCLLSG)-trials. Additionally, a joint-frailty copula model was fitted to validate correlation in the setting of targeted therapies (TT). Second, a meta-analysis of first-line phase III trials in CLL from 2008 to 2024 was performed. Treatment effect correlation was quantified from seven GCLLSG and nine published trials, using hazard ratios (HRs) for time-to-event and odds ratios for binary end points.

RESULTS

The GCLLSG analysis set comprised 4,237 patients. Patient-level correlation for PFS/OS was strong with Spearman Rho >0.9. The joint-frailty copula indicated a weak correlation for chemotherapy/chemoimmunotherapy (C/CIT) with a tau of 0.52 (95% CI, 0.49 to 0.55) while the correlation was strong for TT (tau, 0.91 [95% CI, 0.89 to 0.93). The meta-analysis set contained a total of 8,065 patients including 5,198 (64%) patients treated with C/CIT and 2,867 (36%) treated with TT. Treatment-effect correlation of the HRs for PFS and OS was
R
= 0.75 (95% CI, 0.74 to 0.76,
R
2
= 0.56) while correlation of end-of-treatment MRD with PFS and OS was
R
= 0.88 (95% CI, –0.87 to 0.89;
R
2
= 0.78) and 0.71 (95% CI, 0.69 to 0.73;
R
2
= 0.5), respectively.

CONCLUSION

Patient-level correlation was confirmed in the setting of TTs while treatment-effect correlation between PFS and OS remains uncertain. MRD response status showed a high treatment-effect correlation with PFS but not OS, with the caveat of a limited number of randomized trials with available MRD data.
Preoperative Serum Lipids as Novel Predictors of Survival in 3575 Patients With Papillary Thyroid Cancer
Authors: Yuan Jimeng , Chen Zhendong , Zhang Jing , Chen Xianmeng , Chen Shitu , Wang Xumeng , Zhang Junbin , Su Xingyun , Zhu Weipu , Sheng Jinghao , Teng Lisong , Wang Weibin
Published: August 2024

Context

Papillary thyroid cancer (PTC) is an endocrine malignancy with rapidly increased rate. The relationship between lipids and PTC recurrence need further investigate.

Objective

The objective of this study is to investigate the association between preoperative serum lipids levels and the outcomes of PTC patients.

Methods

A retrospective cohort study including 3575 patients with PTC from 2012 to 2016 with follow-ups in our institute were enrolled. Preoperative serum lipids were divided into categorical variables by receiver operating curves. Univariable and multivariable Cox regression models were developed and independent risk factors were used to construct a nomogram to predict disease-free survival (DFS) rate.

Results

Among the 3575 patients, the mean follow-up time was 56.7 months. Comparing with the patients with high levels of triglyceride (TAG ≥ 0.605 mmol/L) and high-density lipoprotein (HDL ≥ 0.935 mmol/L), those with low levels of TAG (hazard ratio [HR] 2.20, 95% CI 1.30-3.72) and HDL (HR 1.60, 1.00-2.57) had a significantly higher risk of recurrence in PTCs. The 5-year DFS rate of patients with low levels of TAG was 94.4%, which was much lower than that in the high-level group (97.2%, P < .001). While cholesterol (P = .13), low-density lipoprotein (P = .07), and very low–density lipoprotein (P = .15) were not statistically correlated with recurrence of PTCs. The nomogram model showed clinical predictive value with a c-index of 0.80 (95% CI 0.73-0.87) and 0.82 (95% CI 0.73-0.90) for 3- and 4-year DFS in the training cohorts.

Conclusion

In the present study, we provide initial evidence that low levels of TAG and HDL were independently associated with the recurrence of PTC, indicating that preoperative serum concentrations of lipids are helpful in predicting the prognosis for patients with PTC in clinical practice.
Does genotype affect the ability to form root suckers? A case study in black poplar
Authors: Robak Dominika , Lewandowski Andrzej , Żukowska Weronika Barbara
Published: August 2024

It is believed that poplar species from the Aigeiros section form root suckers less often than other poplars. Nevertheless, juvenile plants growing from root suckers can be found in natural populations of black poplar. As they are clones only of certain trees, it seems that the emergence of root suckers may be under genetic control. Unfortunately, there are no studies carried out in more controlled conditions to verify this observation. Here we genotyped root suckers in the clone archive of black poplar. Samples were collected from the vicinity of 21 individuals originating from two natural populations located in the Vistula and Warta river valleys in Poland. One individual was also used in a pot experiment under control and drought-stress conditions. Most clones from the clone archive formed root suckers. Their number was positively correlated with the above-ground size of the plants. However, it did not depend on the origin of the trees. In the pot experiment, we observed root suckers only in control plants after their root system had been damaged. The outcomes of our study suggest that black poplar’s ability to form root suckers may be controlled by genotype-environment interactions. As shown by the pot experiment results, individuals may not have enough resources to invest in root suckers when environmental conditions are unfavorable. This is probably one of the reasons why only some genets in natural conditions form root suckers. Our findings are discussed in the context of their ecological significance.