bluuebunny/crossref_metadata_2025 huggingface dataset:
Approximate confidence intervals for the difference in proportions for partially observed binary data
Authors: Das Ujjwal , Basu Ranojoy
Published: November 2021

We consider partially observed binary matched-pair data. We assume that the incomplete subjects are missing at random. Within this missing framework, we propose an EM-algorithm based approach to construct an interval estimator of the proportion difference incorporating all the subjects. In conjunction with our proposed method, we also present two improvements to the interval estimator through some correction factors. The performances of the three competing methods are then evaluated through extensive simulation. Recommendation for the method is given based on the ability to preserve type-I error for various sample sizes. Finally, the methods are illustrated in two real-world data sets. An R-function is developed to implement the three proposed methods.
Neonatal Resuscitation: Research Issues
Authors: Chawla Deepak
Published: November 2021

Birth asphyxia is one of the most important cause of neonatal mortality and neurological morbidity of perinatal origin. Neonatal resuscitation as per standard guidelines results in decrease in asphyxia-specific neonatal mortality and morbidity. Evidence base for resuscitation practices has been improving over successive years. However, evidence for many resuscitation practices is of lower than desired quality. In addition, contextual resource-specific necessities in a heterogenous country like India need further modifications of resuscitation practices. This article reviews the current gaps in evidence and outlines the research agenda for various steps of neonatal resuscitation.
Sternal malformation/vascular dysplasia or PHACES syndrome?
Authors: Kaur Prabhjeet , Singh Paramjit , Pandit Sadhbhavana
Published: November 2021

We report a 1 month boy with absent manubrium sternii, hypopigmented dimple and coarctation of aorta. This combination of clinical features has been described as incomplete presentation of the sternal malformation/vascular dysplasia syndrome. However, there is an overlap with features of PHACES syndrome. The combination of clinical features presented in the case has not been mentioned in literature till date.
Comparison of Preoperative Measurement Methods of Alveolar Cleft Volume Using Cone Beam Computed Tomography between Computer Simulation and Water Displacement Methods
Authors: Phienwej Kaninut , Chaiworawitkul Marasri , Jotikasthira Dhirawat , Khwanngern Krit , Sriwilas Patiyut
Published: November 2021

Objective

To compare the use of a computer simulation by Mimics software and the water displacement method as means for measurement of alveolar cleft volume on cone beam computed tomography (CBCT) data.

Design

Prospective study.

Settling

Institutional research.

Patients

Patients with unilateral complete cleft lip and palate (UCCLP) who would undergo alveolar bone grafting.

Interventions

CBCT images of twenty patients with UCCLP were included in the study. In the first method, the water displacement method was adopted to measure volume of plasticine filled in the alveolar cleft imprinted on 3D printed model of maxilla. In the second method a volumetric assessment function in Mimics software was adopted to measure volume of 3D virtual model of alveolar cleft constructed from CBCT images. A comparison on the alveolar cleft volumes derived from the two methods was assessed using the statistical paired t-test.

Main Outcome Measure

The paired-t test showed no statistically significant difference between alveolar cleft volumes measured by the two methods ( P = 0.075).

Results

Mean volume of the alveolar cleft measured by the water displacement method was 1.03 ± 0.31 ml whereas by the computer simulation using Mimics software the value was 1.00 ± 0.31 ml. The mean difference between the two methods was 0.03 ± 0.08 ml.

Conclusion

The computer simulation by Mimics software as a means for measurement of alveolar cleft volume on CBCT data is as accurate as the measurement by the water displacement method.
Psychological Autopsy: A Method to Assist in the Identification of Risk and Protective Factors for Intimate Partner Femicide
Authors: McPhedran Samara , Eriksson Li , Arnautovska Urska , Mazerolle Paul , Johnson Holly
Published: November 2021

The most common form of violence experienced by women is that perpetrated by intimate partners, and the gendered nature of intimate partner femicide (IPF) has received particular attention. Few studies to date have delved into the limitations associated with methods used in IPF research, and particularly the methods used to study homicide victims (rather than homicide perpetrators). This article outlines dominant methodologies used to study IPF, and considers a novel method of investigation—the “psychological autopsy”—that may help to improve existing knowledge about IPF.
Interaction Effects in Cross-Lagged Panel Models: SEM with Latent Interactions Applied to Work-Family Conflict, Job Satisfaction, and Gender
Authors: Ozkok Ozlem , Vaulont Manuel J. , Zyphur Michael J. , Zhang Zhen , Preacher Kristopher J. , Koval Peter , Zheng Yixia
Published: November 2021

Researchers often combine longitudinal panel data analysis with tests of interactions (i.e., moderation). A popular example is the cross-lagged panel model (CLPM). However, interaction tests in CLPMs and related models require caution because stable (i.e., between-level, B) and dynamic (i.e., within-level, W) sources of variation are present in longitudinal data, which can conflate estimates of interaction effects. We address this by integrating literature on CLPMs, multilevel moderation, and latent interactions. Distinguishing stable B and dynamic W parts, we describe three types of interactions that are of interest to researchers: 1) purely dynamic or WxW; 2) cross-level or BxW; and 3) purely stable or BxB. We demonstrate estimating latent interaction effects in a CLPM using a Bayesian SEM in Mplus to apply relationships among work-family conflict and job satisfaction, using gender as a stable B variable. We support our approach via simulations, demonstrating that our proposed CLPM approach is superior to a traditional CLPMs that conflate B and W sources of variation. We describe higher-order nonlinearities as a possible extension, and we discuss limitations and future research directions.
The role of anterior segment optical coherence tomography in uveitis-glaucoma-hyphema syndrome
Authors: Lippera Myrta , Nicolosi Cristina , Vannozzi Lorenzo , Bacherini Daniela , Vicini Giulio , Rizzo Stanislao , Virgili Gianni , Giansanti Fabrizio
Published: November 2021

Purpose

To describe features of uveitis-glaucoma-hyphema (UGH) syndrome, using Anterior Segment-Optical Coherence Tomography (AS-OCT) and Ultrasound Biomicroscopy (UBM) and to evaluate the diagnostic role of AS-OCT as an imaging technique alternative to UBM.

Design

Retrospective case series.

Methods

Four eyes of 4 patients with UGH syndrome were analyzed. All patients reported previous uncomplicated cataract surgery with in-the-bag implantation of single-piece-intraocular lens (IOL). They underwent at presentation complete ophthalmological examination and imaging with slit-lamp anterior segment photographs, UBM and AS-OCT.

Results

Although AS-OCT did not allow to visualize the structures behind the iris, it displayed a contact between IOL (plate and/or haptics) and iris and IOL tilting in 3 out of 4 eyes. AS-OCT directly detected the cause of UGH syndrome in one eye, 2 eyes required some expedients to display the iris chafing, like scans in mydriasis and/or patient's gaze direction change. AS-OCT did not allow to appreciate the IOL-iris contact (showed by UBM technique) only in one eye, probably due to the change of patient position from supine to sitting, and consequent anteriorization of iris diaphragm. Furthermore AS-OCT showed fine details, as capsular bag collapse and indirect signs of haptic malposition in 3 out of 4 eyes.

Conclusion

AS-OCT is a non-invasive technique that allows to determine IOL position and IOL-uveal contact in selected cases of UGH syndrome. Considering AS-OCT and UBM advantages and limitations, AS-OCT should be used as first imaging modality when clinical diagnosis is uncertain. When UGH diagnosis cannot be verified using AS-OCT, UBM should be performed.
Detecting subclinical keratoconus by biomechanical analysis in tomographically regular keratoconus fellow eyes
Authors: Augustin Victor A , Son Hyeck-Soo , Baur Isabella , Zhao Ling , Auffarth Gerd U , Khoramnia Ramin
Published: November 2021

Purpose

To analyze the tomographically non-affected second eyes of keratoconus patients using the Corvis ST to detect any biomechanical abnormalities or subclinical keratoconus.

Methods

In this retrospective, single-center, consecutive case series 244 eyes of 122 keratoconus patients were analyzed between November 2020 and February 2021. Fourteen fellow eyes fulfilled the inclusion criteria and showed no clinical or tomographic signs of keratoconus. Main outcome measures included best-corrected visual acuity, tomographic and biomechanical analyses using Scheimpflug imaging: Pentacam and Corvis ST (Oculus, Wetzlar, Germany). Tomographic analyses included anterior and posterior simulated keratometry, K-Max, central corneal thickness, thinnest corneal thickness, Belin/Ambrosio Ectasia Display, and the ABCD grading system. For biomechanical analyses, the corneal biomechanical index (CBI) and tomographic biomechanical index were used.

Results

The mean best-corrected visual acuity was 0.01 ± 0.10 logMAR. Mean K-Max was 43.79 ± 1.12 D, mean central corneal thickness 529 ± 25 µm, mean thinnest corneal thickness 524 ± 23 µm, and mean Belin/Ambrosio Ectasia Display 1.0 ± 0.32. The mean CBI was 0.30 ± 0.21. Regular CBI values were found in six of 14 patients. The mean tomographic biomechanical index was 0.47 ± 0.22 with regular values observed in only two of 14 patients. No signs of tomographic or biomechanical abnormalities were shown in only one of 14 keratoconus fellow eyes, with regular ABCD, Belin/Ambrosio Ectasia Display, CBI and tomographic biomechanical index values.

Conclusions

Tomographically normal fellow eyes of keratoconus patients are rare. In these cases, a biomechanical analysis of the cornea may help detect a subclinical keratoconus. The tomographic biomechanical index was the most sensitive index to verify a mild ectasia.
Outcomes of Combined Scleral Buckling Plus Pneumatic Retinopexy Vs. Scleral Buckling for Primary Rhegmatogenous Retinal Detachment
Authors: Weinberger Yehonatan , Sternfeld Amir , Hadar-Cohen Natalie , Tennant Matthew T.S. , Dotan Assaf
Published: November 2021

Purpose

To evaluate the outcomes and complications of scleral buckle surgery alone or combined with pneumatic retinopexy (pneumatic buckle) for the treatment of primary rhegmatogenous retinal detachment.

Design

Retrospective chart review.

Participants

Two hundred thirteen patients with rhegmatogenous retinal detachment of whom 101 underwent primary scleral buckle surgery at Rabin Medical Center in 2005–2015 (SB group) and 112 underwent pneumatic buckle surgery at Royal Alexandra Hospital in 2013–2015 (PB group).

Methods

All patients were followed for ≥12 months. Data on clinical and surgical parameters, outcome, and complications were collected from the medical files.

Main Outcome Measures

Best corrected visual acuity and anatomical outcomes.

Results

At 12 months, average best corrected visual acuity was 0.3 logMar in the SB group and 0.42 logMar in the PB group ( P < 0.05). Rates of anatomical reattachment were high and similar in the two groups (99% and 97%, respectively, P = 0.623). The SB group had a higher percentage of patients requiring additional laser applications (21% vs. 7%; P < 0.01) and buckle readjustment surgery (6% vs. 0; P = 0.01), and the PB group had a higher percentage of patients who required postoperative pars plana vitrectomy (30% vs. 17%; P = 0.03).

Conclusion

Scleral buckle surgery alone is efficient for the treatment of rhegmatogenous retinal detachment. Its combination with pneumatic retinopexy usually has no significant added value in terms of anatomical reattachment rate. Outcomes of Pneumatic buckling vs Scleral Buckling for RRD
Oral contraceptives do not modify the risk of a second attack and disability accrual in a prospective cohort of women with a clinically isolated syndrome and early multiple sclerosis
Authors: Otero-Romero Susana , Carbonell-Mirabent Pere , Midaglia Luciana , Zuluaga María , Galán Ingrid , Cobo-Calvo Alvaro , Rio Jordi , Arrambide Georgina , Vidal-Jordana Angela , Castillo Joaquín , Rodríguez-Acevedo Breogán , Comabella Manuel , Rodríguez Marta , Tur Carmen , Auger Cristina , Rovira Alex , Sastre-Garriga Jaume , Montalban Xavier , Tintoré Mar
Published: November 2021

Objective:

To evaluate whether oral contraceptive (OC) use is associated with the risk of a second attack and disability accrual in women with a clinically isolated syndrome (CIS) and early multiple sclerosis (MS).

Methods:

Reproductive information from women included in the Barcelona CIS prospective cohort was collected through a self-reported cross-sectional survey. We examined the relationship of OC exposure with the risk of a second attack and confirmed Expanded Disability Status Scale of 3.0 using multivariate Cox regression models, adjusted by age, topography of CIS, oligoclonal bands, baseline brain T2 lesions, body size at menarche, smoking, and disease-modifying treatment (DMT). OC and DMT exposures were considered as time-varying variables. Findings were confirmed with sensitivity analyses using propensity score models.

Results:

A total of 495 women were included, 389 (78.6%) referred to ever use OC and 341 (68.9%) started OC before the CIS. Exposure to OC was not associated with a second attack (adjusted hazard ratio (aHR) = 0.73, 95% confidence interval (CI) = 0.33–1.61) or disability accrual (aHR = 0.81, 95% CI = 0.17–3.76). Sensitivity analyses confirmed these results.

Conclusion:

OC use does not modify the risk of second attack or disability accrual in patients with CIS and early MS, once considered as a time-dependent exposure and adjusted by other potential confounders.
The role of parental advocacy in addressing service disparities for transition-aged youth on the autism spectrum
Authors: Lee Chung eun , Burke Meghan M. , DaWalt Leann Smith , Li Chak , Taylor Julie Lounds
Published: November 2021

Youth with autism spectrum disorder (ASD) face challenges accessing needed services as they transition to adulthood. Correlates of service access identified in the literature—such as family resources, race/ethnicity, or youth functioning—can be difficult to change and may not be feasible targets for intervention. This study focused on a potential contributor to service access that is malleable: parental advocacy. Specifically, we examined the association between parental advocacy activities and number of services among transition-aged youth with ASD, after accounting for indicators of youth functioning and family demographic variables (high school exit, co-occurring intellectual disability, social impairments, adaptive behaviors, race/ethnicity, state of residence, family income, and parental depression). Participants included 185 families of youth with ASD who are part of an ongoing randomized controlled trial. Data were collected at baseline (prior to intervention) via parental questionnaire and structured interview. Using hierarchical regression analyses, we found that parental advocacy activities were significantly and strongly associated with service receipt after controlling for youth functioning and family demographic factors. Youth whose parents are less involved in advocacy activities might be at-risk for service disparities. To close the gaps for service disparities, future interventions may target parental advocacy skills.

Lay abstract

It can be difficult for youth on the autism spectrum to get the services they need after they leave high school. Because of this, many studies have examined the different factors that are related to service access. These studies have shown that youth on the autism spectrum who belong to an underrepresented racial or ethnic group or whose families have lower incomes are less likely to receive the services that they need. However, it is difficult or impossible to change things like race/ethnicity or family income. It is important to also identify factors that might improve service access that we can change. One potential factor that fits into this category is parental advocacy activities. Using data collected from 185 parents of youth on the autism spectrum, we found that more parental advocacy activities were related to youth receiving more services, even after accounting for variables related to the functioning of the youth (e.g. whether they have an intellectual disability, their autism symptom severity) and demographic information about the family (e.g. state in which they live, parental race/ethnicity, and family income). Our findings suggest that building parental advocacy skills may be one important way to increase the number of services that youth on the autism spectrum receive as they transition to adulthood.
Bodies of concern? A qualitative exploration of eating, moving and embodiment in young mothers
Authors: Lucas Grace , Olander Ellinor K , Salmon Debra
Published: November 2021

In some countries, including the United Kingdom, young mothers’ pregnant and postnatal bodies remain an area of concern for policy and practice, with interventions developed to support improved health behaviours including diet and physical activity. This article explores what young women themselves think and feel about eating and moving during and after pregnancy. Semi-structured interviews with 11 young mothers were conducted within two voluntary organisations. Data were analysed using thematic analysis with the theoretical lens of embodiment, which provided an understanding of how young women’s eating and moving habits related to how they felt about their bodies in the world. Four themes situated in different experiences of being and having a body were identified: pregnant body, emotional body, social body and surveilled body. Stress and low mood impacted eating habits as young women responded to complex circumstances and perceived judgement about their lives. Food choices were influenced by financial constraints and shaped by the spaces and places in which young women lived. Whilst young women were busy moving in their day-to-day lives, they rarely had the resources to take part in other physical activity. Holistic approaches that focus on how women feel about their lives and bodies and ask them where they need support are required from professionals. Interventions that address the structural influences on poor diet and inequalities in physical activity participation are necessary to underpin this. Approaches that over-focus on the achievement of individual health behaviours may fail to improve long-term health and risk reinforcing young women’s disadvantage.
Home environmental change for child injury prevention in Nepal: A qualitative study
Authors: Bhatta Santosh , Mytton Julie , Deave Toity
Published: November 2021

In Nepal, unintentional home injury is a leading reason for death and disability among pre-school children. However, there is a lack of evidence to inform culturally appropriate interventions to reduce home injuries. This study explored the potential for home environmental change at a community level to prevent unintentional home injury in children and identified the barriers to, and facilitators of, such changes. Focus groups were conducted in the Nepali language with mothers, fathers, teachers, school students and community health volunteers in rural areas of Makwanpur district in Nepal. The discussions were audio-recorded, transcribed, translated into English and analysed thematically. NVivo software was used to support coding and identification of themes. Five focus groups, involving forty-seven participants, were completed leading to the development of four themes. Overall, the findings highlight that community people perceive injuries to be a normal part of childhood and, therefore, few prevention measures were considered. Parents were, however, able to identify ways to change their environment that made it safer. Changes included removing hazards or adding safety equipment, adapting the home or restricting access to potential hazards. Barriers to implementation included limited awareness about injury hazards and risk management, poor quality housing and financial constraint. Facilitators included raising community awareness, acquiring resources and financial support and involving the family and community. Development of interventions to prevent injuries at home in pre-school children should reflect local context and culture; this is best achieved through engagement with parents.
The Politics of Pain in Immigration Detention
Authors: Bosworth Mary
Published: November 2021

In this paper I draw on qualitative material from the first complete data set of the ‘ Measure of the Quality of Life in Detention’ (MQLD) survey in the UK to reflect on its implication for understanding and challenging these sites. While similarities between immigration detention centres and prisons make it tempting to place the testimonies from people in detention within the framework of the ‘pains of imprisonment’, I propose an alternative reading of these first-hand accounts. Rather than approaching them as sociological statements of suffering, caused by the loss of liberty, I interpret them as political statements which, in turn, demand a political response. Immigration removal centres (IRCs), these people assert, are fundamentally at odds with key values of a liberal democracy. Those detained within them are not considered to be equal members of a shared community of value; rather, their incarceration marks them out symbolically and, quite practically, as outsiders to these ideas. The pain people describe illuminates the need for a new politics of detention.
Determination of third order elastic constants from Morse potential for a Nitinol shape memory alloy
Authors: Gara Dheeraj Kumar , Potnuru Srikar , Raghavendra Gujjala , Syam prasad P
Published: November 2021

The current paper determines the third order elastic constants of the Ni-Ti based shape memory alloy from Morse potential using second nearest neighbour embedded atomic model (2NNEAM) in LAMMPS Molecular Dynamics (MD) simulation package. The complexities involved in the current work are lack of experimental data, such as amount of stress induced for the first order martensitic phase transition and plane about which the phase transformation takes place, which in our current work is considered as the amount of vibrations that the inherent anharmonicity possessed by the Shape memory alloy (SMA) for the first order phase transition. It is further attempted to justify the third elastic constants that are evaluated using VRH approximation, but however VRH approximation lacked stability and hence it is concluded that Morse potential is suitable.
Investigation of friction and wear behavior of hydroxyl-functionalized graphene nanoplatelets filled elastomer nanocomposites
Authors: Kasim Hasan , Onat Adem , Engin Barış , Saraç İsmail
Published: November 2021

The use of unfilled pure elastomer parts is limited in friction wheels, roller tires, sealing elements, and dynamic friction air suspension applications requiring high wear resistance. This study investigates the mechanical and tribological properties of new nanocomposites obtained by adding hydroxyl-functionalized graphene nanoplatelets at 1, 4, and 8 phr (parts per hundred rubber) ratios to the carbon black filled main rubber compound of sealing elements designed for axle hubs. The synergistic effect of nanofiller materials on the wear behavior of nanocomposites was tested with a block-on-ring wear tester under dry sliding conditions at 1000 rpm and 15 N normal load conditions. The worn surfaces were examined with scanning electron microscopy and circularly polarized light–differential interference contrast topology microscopy to reveal the wear mechanism. The addition of functionalized graphene nanoplatelets to the nanocomposite compound caused significant changes in tensile strength and elongation values by changing the cross-link density. The wear rate of nanocomposites prepared with graphene nanoplatelets at 1, 4, and 8 phr ratios was 11.15%, 25.24%, and 36.54% lower than the main rubber mixture used, respectively. While the hysteresis loss decreased by 14.83% at 1 phr, this value increased in other filler ratios. Significant differences in temperature change occurred as the amount of filler increased. After the test, the temperature values of nanocomposites with 1 and 4 phr filler ratios were between about 85–89°C, while it was measured as 99°C in nanocomposites with 8 phr filler ratios. It has been observed that the homogeneous distribution of two-dimensional carbon allotropes such as graphene nanoplatelet added to the rubber matrix at the optimum rate will improve tribological properties such as better surface lubrication, low wear rate, and low friction coefficient.
Entrepreneurship during crisis: Innovation practices of micro and small tour operators
Authors: Marx Susanne , Klotz Michael
Published: November 2021

Innovation as a response strategy to a crisis needs further understanding for small enterprises. This exploratory research investigates if, why, and with whom entrepreneurs in micro and small enterprises engage in innovation activities during the atypical context of the COVID-19 crisis in the tourism sector. The multiple case study with three German entrepreneurs in the tour operator market shows that micro and small enterprises despite their size hold the capacity to initiate and manage several innovation projects of different types and in different stages of the innovation value chain simultaneously during a crisis. To do so, the entrepreneurs preferably engage participants with strong social ties, independent from a place. The perceived benefits are both related to the innovation output (e.g. generate income), and the innovation activities (e.g. increased motivation of staff, increased trust of customers during the crisis). Further research is encouraged on the long-term effects of innovations resulting from a crisis.
Self-presentation strategies and the visual framing of political leaders on Instagram: evidence from the eventful 2019 Istanbul mayoral elections
Authors: Uluçay Dilek Melike , Melek Gizem
Published: November 2021

This study aims to explore how political leaders used Instagram to execute self-presentation strategies in mayoral elections, including the dominant use of personalized tactics. The article reports findings of a visual framing analysis of 2,776 images featuring 2019 Istanbul mayoral election candidates Ekrem İmamoğlu (the Republican People’s Party, CHP) and Binali Yıldırım (the Justice and Development Party, AKP). The case is unusual because the initial election, which had resulted in İmamoğlu’s victory, was cancelled and a re-run was subsequently held. After many events, İmamoğlu succeeded again, becoming the first opposition politician to take control of Istanbul from the ruling AKP. In this study, we adapt Grabe and Bucy’s (2009) quantitative visual framing analysis to examine Instagram posts, from candidacy announcements until the election re-run. The results show that both candidates used the Ideal Candidate frame, with occasional increases in the frequency of the application of the Populist Campaigner frame. Self-frames in different time periods during this election are discussed, as well the frames that voters engaged with most frequently.
Phenotypic Signals of Sexual Selection and Fast Life History Dynamics for the Long-Term but Not Short-Term Mating
Authors: Međedović Janko
Published: November 2021

Mating patterns are crucial for understanding selection regimes in current populations and highly implicative for sexual selection and life history theory. However, empirical data on the relations between mating and reproductive outcomes in contemporary humans are lacking. In the present research we examined the sexual selection on mating (with an emphasis on Bateman's third parameter – the association between mating and reproductive success) and life history dynamics of mating by examining the relations between mating patterns and a comprehensive set of variables which determine human reproductive ecology. We conducted two studies (Study 1: N = 398, Study 2: N = 996, the sample was representative for participants’ sex, age, region, and settlement size). The findings from these studies were mutually congruent and complementary. In general, the data suggested that short-term mating was unrelated or even negatively related to reproductive success. Conversely, long-term mating was positively associated with reproductive success (number of children in Study 1; number of children and grandchildren in Study 2) and there were indices that the beneficial role of long-term mating is more pronounced in males, which is in accordance with Bateman's third principle. Observed age of first reproduction mediated the link between long-term mating and number of children but only in male participants (Study 2). There were no clear indications of the position of the mating patterns in human life history trajectories; however, the obtained data suggested that long-term mating has some characteristics of fast life history dynamics. Findings are implicative for sexual selection and life history theory in humans.
Topical Cannabinoids for Treating Chemotherapy-Induced Neuropathy: A Case Series
Authors: D’Andre Stacy , McAllister Sean , Nagi Jasdeepa , Giridhar Karthik V. , Ruiz-Macias Eduardo , Loprinzi Charles
Published: November 2021

Background

Chemotherapy-induced peripheral neuropathy is a common and often severe side effect from many chemotherapeutic agents, with limited treatment options. There is no literature on the use of topical cannabinoids for chemotherapy-induced neuropathy.

Case Presentations

The current manuscript presents a case series of patients presenting in oncology clinics at Sutter Health, CA and Mayo Clinic, Rochester, MN from April 2019 to December 2020 with chemotherapy-induced peripheral neuropathy who used topical creams containing the cannabinoids delta-nine-tetrahydrocannabinol (THC) and/or cannabidiol (CBD).

Conclusions

This case series suggests that topical cannabinoids may be helpful for patients with chemotherapy-induced peripheral neuropathy. This paper also discusses the potential mechanisms of action by which topical cannabinoids might alleviate established CIPN symptoms. A randomized placebo-controlled trial using a standardized product is planned to study the actual efficacy of such treatment.
Research on trajectory planning of closed loop grouting robot
Authors: Zhang Runmei , Ren Rui , Luo Guan , Li Shuai , Bi Lijun , Yuan Bin
Published: November 2021

In order to promote building intelligence and solve the disadvantages of traditional grouting technology, the trajectory planning of closed-loop grouting robot was designed. The minimumsnap optimization function was used to optimize the A* algorithm to realize the 2D trajectory planning, which could obtain a smooth, continuous route, and planning diagram of time distribution, speed, acceleration, and jerk. Further, the weight function of the improved A* algorithm was adjusted to perform 3D trajectory planning to reduce redundant nodes in the route. A new approaching law adaptive sliding mode control method was used to achieve precise trajectory tracking of the robotic arm and reduce the problem of chattering in sliding mode control. Through the design of closed-loop grouting robot and the research of trajectory planning, the two-dimensional and three-dimensional paths of grouting robot could be optimized. The system could realize automatic grouting operation. It could promote the development of high efficiency and safety in the construction grouting industry.
Primary healthcare reform for chronic conditions in countries with high or very high human development index: A systematic review
Authors: Alyousef Mohammed , Naughton Corina , Bradley Colin , Savage Eileen
Published: November 2021

Objective

To address the growing burden of chronic disease globally, many countries have developed a national policy for primary healthcare reform. In some countries with high and very high human development index, evaluations of the implementation of these reforms have been published. To date, there has been no systematic review of these evaluations. The objectives of this review are to identify: (a) the vision for primary healthcare; (b) the features of primary healthcare reforms; and (c) evaluation findings of primary healthcare reforms.

Methods

A systematic literature review was conducted guided by the PRISMA statement. We searched for academic articles and grey literature from 1 March 2008 to 1 September 2020. Screening and data extraction were conducted by two authors. Descriptive analysis and narrative synthesis were applied.

Results

A vision for integrated primary healthcare shifting chronic disease management from specialist hospital services to primary care was found to require new organization and funding models such as collaborative primary healthcare networks and commissioning along with shared governance across health sectors. The need for general practitioner leadership and engagement to support primary healthcare reform was identified. Although there was evidence of barriers in progressing primary healthcare reform, evaluation results showed some positive outcomes, most notably shifts in services towards increased primary care access and utilization.

Discussion

A challenge in undertaking the review was the heterogeneity of articles with little consistency in how primary healthcare reform was evaluated and reported on across countries. Evaluation of national health reforms involves complex system-wide projects and is an area that needs further exploration and discussion to determine the most appropriate methodologies for collecting and analysing large-scale data with consideration for service and health outcomes.
Noncontrast Computed Tomography Markers of Cerebral Hemorrhage Expansion: Diagnostic Accuracy Meta-Analysis
Authors: Arba Francesco , Rinaldi Chiara , Boulouis Gregoire , Fainardi Enrico , Charidimou Andreas , Morotti Andrea
Published: November 2021

Background and purpose

Assess the diagnostic accuracy of noncontrast computed tomography (NCCT) markers of hematoma expansion in patients with primary intracerebral hemorrhage.

Methods

We performed a meta-analysis of observational studies and randomized controlled trials with available data for calculation of sensitivity and specificity of NCCT markers for hematoma expansion (absolute growth >6 or 12.5 mL and/or relative growth >33%). The following NCCT markers were analyzed: irregular shape, island sign (shape-related features); hypodensity, heterogeneous density, blend sign, black hole sign, and swirl sign (density-related features). Pooled accuracy values for each marker were derived from hierarchical logistic regression models.

Results

A total of 10,363 subjects from 23 eligible studies were included. Significant risk of bias of included studies was noted. Hematoma expansion frequency ranged from 7% to 40%, mean intracerebral hemorrhage volume from 9 to 27.8 ml, presence of NCCT markers from 9% (island sign) to 82% (irregular shape). Among shape features, sensitivity ranged from 0.32 (95%CI = 0.20–0.47) for island sign to 0.68 (95%CI = 0.57–0.77) for irregular shape, specificity ranged from 0.47 (95%CI = 0.36–0.59) for irregular shape to 0.92 (95%CI = 0.85–0.96) for island sign; among density features sensitivity ranged from 0.28 (95%CI = 0.21–0.35) for black hole sign to 0.63 (95%CI = 0.44–0.78) for hypodensity, specificity ranged from 0.65 (95%CI = 0.56–0.73) for heterogeneous density to 0.89 (95%CI = 0.85–0.92) for blend sign.

Conclusion

Diagnostic accuracy of NCCT markers remains suboptimal for implementation in clinical trials although density features performed better than shape-related features. This analysis may help in better tailoring patients’ selection for hematoma expansion targeted trials.
Same name, same game, but is it different? An investigation of female rugby union match events in Canadian Varsity players
Authors: West Stephen W. , Shill Isla J. , Clermont Christian , Pavlovic Nina , Cairns Joshua , Seselja Berlyn , Hancock Matthew V , Roberts Simon P. , Hendricks Sharief , Emery Carolyn A.
Published: November 2021

Rugby Union is team-based collision sport with increasing global popularity, particularly in the women's game. Despite this, there is currently no evidence demonstrating the frequency of match events outside of the international game. Therefore, the aim of this study is to outline the frequency and distribution of match events in non-international female rugby union to both outline the demands placed on players and to assess the patterns of play for future injury prevention strategies. Forty-eight games from three seasons of varsity rugby were coded and rates of events per match were calculated. Average ball in play percentage was 51%. The tackle was the most frequent contact match event [280.0 (95% CIs: 270.2-289.7)] while passes were the most frequent non-contact match events [323.2 (95% CIs: 311.8-334.5)]. The distribution of events across match quarter was largely consistent and neither the fixture type, nor the season was consistently associated with differences in match event count per game. This study provides the first analysis of match events outside of international game and provides a useful reference for coaches in preparation of players as well as comparable data for the women's game when informing decision making on injury prevention.
Acquired haemophilia A diagnosed during pregnancy
Authors: Ejaz Ayesha , O’Doherty Claire , Sharpley Faye A. , Curry Nicola , Shapiro Susan , Desborough Michael J R
Published: November 2021

Pregnancy-associated haemophilia A is an uncommon, acquired bleeding disorder which usually presents post-partum; very rarely it may present during pregnancy. No consensus guidelines exist on the management of this condition in pregnancy and very few cases have been reported in the literature. Here we describe the case of a woman presenting with acquired haemophilia A during pregnancy and outline the management of her bleeding disorder. We contrast her case with that of two other women, presenting to the same tertiary referral centre, with acquired haemophilia A presenting post-partum. These cases highlight the heterogeneous management of this condition and how it may be successfully managed in pregnancy.
Leading 20 drug–drug interactions, polypharmacy, and analysis of the nature of risk factors due to QT interval prolonging drug use and potentially inappropriate psychotropic use in elderly psychiatry outpatients
Authors: Das Biswadeep , Ramasubbu Saravana Kumar , Agnihotri Akash , Kumar Barun , Rawat Vikram Singh
Published: November 2021

Background:

Psychotropic medications extend corrected QT (QTc) period in the electrocardiogram (ECG). Psychiatric patients exposed to ⩾1 psychotropic medication(s) represent a group with marked probability of drug-activated QTc-prolongation. Prolonged QTc interval in elderly patients (age > 60 years) is connected to greater risk of all-cause and coronary heart disease deaths. This study aimed at investigating pattern of utilization of QTc-interval protracting medications, QT-extending drug interactions, and prevalence of QTc-interval extending hazard factors in elderly patients.

Methods:

This was a cross-sectional, prospective study at the Psychiatry OPD at All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India from 1 October 2017 to 30 August 2019 employing the pertinent prescriptions.

Results:

A total of 832 elderly patients (age 60 years or more) visiting the Psychiatry OPD during the aforementioned study duration were investigated. About 420 (50.5%) patients were males while 412 (49.5%) were females. Of the 832 patients, 588 (70.7%) were using interacting agents with capacity to produce TdP. Almost 1152 interacting torsadogenic medication pairs were unraveled. As per AzCERT/CredibleMeds Classification, 1016 (48.8%), 724 (34.8%), and 248 (12%) agents with potential to interact were identified with ‘known’, ‘possible’, and ‘conditional risk of TdP’, respectively. The common interacting medications belonged to antidepressant (288), proton pump inhibitor (364), antipsychotic (340), antinausea (184), antimicrobial (156), and H2 receptor antagonist (60) therapeutic categories. The all-inclusive frequency of potentially inappropriate psychotropic (PIP) agents administered was 62% (1343/2166) with Beers Criteria 2019, and 46% (997/2166) with STOPP Criteria 2015.

Conclusion:

Many geriatric patients were administered drugs and drug combinations with heightened proclivity toward QT-interval prolongation. Furthermore, reliable evidence-based online drug knowledge resources, such as AzCERT/CredibleMeds Drug Lists, Medscape Drug Interactions Checker, Epocrates Online Interaction Check, and Drugs.com Drug Interactions Checker, can facilitate clinical professionals in selecting drugs for psychiatric patients. A wise choice of medications is imperative to preclude serious adverse sequelae. Therefore, we need to exigently embrace precautionary safety means, be vigilant, and forestall QT-extension and TdP in clinical environments.
Prediction of early clinical response in patients receiving tofacitinib in the OCTAVE Induction 1 and 2 studies
Authors: Lees Charlie W. , Deuring J. Jasper , Chiorean Michael , Daperno Marco , Bonfanti Gianluca , Germino Rebecca , Brown Pritha Bhadra , Modesto Irene , Edwards Roger A.
Published: November 2021

Introduction:

Tofacitinib is an oral, small molecule Janus kinase inhibitor for the treatment of ulcerative colitis (UC). Outcome prediction based on early treatment response, along with clinical and laboratory variables, would be very useful for clinical practice. The aim of this study was to determine early variables predictive of responder status in patients with UC treated with tofacitinib.

Methods:

Data were collected from patients treated with tofacitinib 10 mg twice daily in the OCTAVE Induction 1 and 2 studies (NCT01465763 and NCT01458951). Logistic regression and random forest analyses were performed to determine the power of clinical and/or laboratory variables to predict 2- and 3-point partial Mayo score responder status of patients at Weeks 4 or 8 after baseline.

Results:

From a complete list of variables measured in OCTAVE Induction 1 and 2, analyses identified partial Mayo score, partial Mayo subscore (stool frequency, rectal bleeding, and Physician Global Assessment), cholesterol level, and C-reactive protein level as sufficient variables to predict responder status. Using these variables at baseline and Week 2 predicted responder status at Week 4 with 84–87% accuracy and Week 8 with 74–79% accuracy. Variables at baseline, Weeks 2 and 4 could predict responder status at Week 8 with 85–87% accuracy.

Conclusion:

Using a limited set of time-dependent variables, statistical and machine learning models enabled early and clinically meaningful predictions of tofacitinib treatment outcomes in patients with moderately to severely active UC.
Surrogate endpoints for early-stage breast cancer: a review of the state of the art, controversies, and future prospects
Authors: Gion María , Pérez-García José Manuel , Llombart-Cussac Antonio , Sampayo-Cordero Miguel , Cortés Javier , Malfettone Andrea
Published: November 2021

Drug approval for early-stage breast cancer (EBC) has been historically granted in the context of registration trials based on adequate outcomes such as disease-free survival and overall survival. Improvements in long-term outcomes have made it more difficult to demonstrate the clinical benefit of a new cancer drug in large, randomized, comparative clinical trials. Therefore, the use of surrogate endpoints rather than traditional measures allows for cancer drug trials to proceed with smaller sample sizes and shorter follow-up periods, which reduces drug development time. Among surrogate endpoints for breast cancer, the increase in pathological complete response (pCR) rates was considered appropriate for accelerated drug approval. The association between pCR and long-term outcomes was strongest in patients with aggressive tumor subtypes, such as triple-negative and human epidermal growth factor receptor 2 (HER2)-positive/hormone receptor-negative breast cancers. Whereas in hormone receptor-positive/HER2-negative EBC, the most accepted surrogate markers for endocrine therapy–based trials include changes in Ki67 and the preoperative endocrine prognostic index. Beyond the classic endpoints, further prognostic tools are required to provide EBC patients with individualized and effective therapies, and the neoadjuvant setting provides an excellent platform for drug development and biomarker discovery. Nowadays, the availability of multigene signatures is offering a standardized quantitative and reproducible tool to potentiate the efficacy of standard treatment for high-risk patients and develop de-escalated treatments for patients at lower risk of relapse. In this article, we first evaluate the surrogacies used for long-term outcomes and the underlying evidence supporting the use of each surrogate endpoint for the accelerated or regular drug approval process in EBC. Next, we provide an overview of the most recent studies and innovative strategies in a (neo)adjuvant setting as a platform to accelerate new drug approval. Finally, we highlight some clinical trials aimed at tailoring systemic treatment of EBC using prognosis-related factors or early biomarkers of drug sensitivity or resistance.
Learning Transdisciplinary Collaboration: Undergraduate Student Perceptions of Successes and Areas for Improvement in Transdisciplinary, Problem-Focused Honors Seminar Courses
Authors: Velez Anne-Lise , Lewis Stephanie N. , Thomas Raymond C. , Ozkan Desen S.
Published: November 2021

The honors college at a large land-grant research university developed transdisciplinary courses to provide undergraduate opportunities for small, student-centered classes and collaborative problem engagement in a global context. In these courses, students engage principles of competency-based education and inquiry-based learning combined with instruction in transdisciplinarity and decision-making tied to the college mission statement and course learning outcomes. As an observational study, we surveyed 91 honors students from 12 transdisciplinary courses over three semesters, asking five-point Likert scale questions and open-ended perspective questions at the beginning and end of each semester. Participants predominantly identified as White (74%), male (57%), senior-level students (67%), and represent 34 majors. Findings emphasize outcomes of lasting faculty relationships and opportunities to explore interests outside students’ majors, which respondents report influencing their academic development. Students also report areas for curricular improvement in developing research skills and engaging problem-focused experiences. We describe new offerings made to address findings.