bluuebunny/crossref_metadata_2025 huggingface dataset:
Oculomotor Rehabilitation Improves Reading Abilities in Dyslexic Children With Concurrent Eye Movement Abnormalities
Authors: Jafarlou Fatemeh
Published: January 2024

The oculomotor abnormalities have been reported in some dyslexic children. The purpose of the study was to evaluate the effects of oculomotor rehabilitation on the reading performance of dyslexic children. Subjects were 50 dyslexic children. Those with oculomotor abnormalities ( n = 30) were randomly assigned into 2 groups matched for age. The case group received oculomotor rehabilitation. The rehabilitation program consists of 3 diﬀerent exercises. The reading and dyslexia tests were performed before and after the intervention. The correct scores of reading tests in the case group posttest increased significantly compared with the control group, and there is a significant difference between the two groups ( P = .001). The positive effects of oculomotor rehabilitation on the reading performance of dyslexic children confirmed that the oculomotor program could be a practical tool for improving reading performance in dyslexic children.
Electrolyzed Saline Targets Biofilm Periodontal Pathogens In Vitro
Authors: Zayed N. , Munjaković H. , Aktan M.K. , Simoens K. , Bernaerts K. , Boon N. , Braem A. , Pamuk F. , Saghi M. , Van Holm W. , Fidler A. , Gašperšič R. , Teughels W.
Published: January 2024

Preventing the development and recurrence of periodontal diseases often includes antimicrobial mouthrinses to control the growth of the periodontal pathogens. Most antimicrobials are nonselective, targeting the symbiotic oral species as well as the dysbiosis-inducing ones. This affects the overall microbial composition and metabolic activity and consequently the host–microbe interactions, which can be detrimental (associated with inflammation) or beneficial (health-associated). Consequently, guiding the antimicrobial effect for modulating the microbial composition to a health-associated one should be considered. For such an approach, this study investigated electrolyzed saline as a novel rinse. Electrolyzed saline was prepared from sterile saline using a portable electrolysis device. Multispecies oral homeostatic and dysbiotic biofilms were grown on hydroxyapatite discs and rinsed daily with electrolyzed saline (EOS). Corresponding positive (NaOCl) and negative (phosphate-buffered saline) controls were included. After 3 rinses, biofilms were analyzed with viability quantitative polymerase chain reaction and scanning electron microscopy. Supernatants of rinsed biofilms were used for metabolic activity analysis (high-performance liquid chromatography) through measuring organic acid content. In addition, human oral keratinocytes (HOKs) were exposed to EOS to test biocompatibility (cytotoxicity and inflammation induction) and also to rinsed biofilms to assess their immunogenicity after rinsing. Rinsing the dysbiotic biofilms with EOS could reduce the counts of the pathobionts (>3 log10 Geq/mm2 reduction) and avert biofilm dysbiosis (≤1% pathobiont abundance), leading to the dominance of commensal species (≥99%), which altered both biofilm metabolism and interleukin 8 (IL-8) induction in HOKs. EOS had no harmful effects on homeostatic biofilms. The scanning electron micrographs confirmed the same. In addition, tested concentrations of EOS did not have any cytotoxic effects and did not induce IL-8 production in HOKs. EOS showed promising results for diverting dysbiosis in in vitro rinsed biofilms and controlling key periopathogens, with no toxic effects on commensal species or human cells. This novel rinsing should be considered for clinical applications.
Progress and development on the synthesis and application of two-dimensional molybdenum disulphide
Authors: Getaneh Seyoum A. , Temam Abdudin G. , Nwanya Assumpta C. , Ejikeme Paul M. , Ezema Fabian I.
Published: January 2024

Two-dimensional (2D) molybdenum disulphide (MoS2) stands out with its unique tunable bandgap and optoelectronic properties, making it a prime focus in transition metal dichalcogenides (TMDs) research. It has wide-ranging applications in energy storage, electronics, optoelectronics and high-performance sensing materials. Synthesis methods fall into top-down (chemical, mechanical and liquid-phase exfoliation) and bottom-up (physical vapour deposition, chemical layer deposition, atomic layer deposition and solvothermal/hydrothermal) categories. Choosing the right synthesis method is pivotal as it significantly impacts the material's properties and application potential. 2D MoS2, owing to its natural abundance, adaptability, adjustable bandgap and high surface-to-volume ratio, finds utility in various domains like energy storage, catalysis, composite and sensors. This review delves into recent progress, challenges and future prospects in 2D MoS2 synthesis and applications.
Sexual Assault Among College Women: The Role of Survivor Acknowledgment, Rape Myth Acceptance, Weight Bias, and Body Appreciation
Authors: Sall Kayla E. , Miller Julia Caroline , Jansen Emily , Shonrock Abigail T. , Byrd Rhonda , Carels Robert A.
Published: January 2024

Approximately one in five college women experience a sexual assault (SA), though a meaningful percentage of survivors do not acknowledge or label their experience as such. Research indicates that acknowledgment status is often influenced by how closely SA incidents align with the “real rape” script and degree of survivor rape myth acceptance (RMA). However, studies evaluating acknowledgment paired with other attitudes and health outcomes among survivors is sparse. The current study examined the relation between acknowledgment status, RMA, weight-related constructs, and psychological well-being among three groups of college women ( N = 584): non-survivors, unacknowledged survivors, and acknowledged survivors. Findings indicate that, among survivors, acknowledged compared to unacknowledged SA is significantly associated with diminished body appreciation, self-esteem, and increased internalized weight bias, though no differences in psychological distress were found.
RUL prediction of rolling bearings based on adaptive variational mode decomposition and double-discriminator conditional CycleGAN
Authors: Yu Jun , Zhao Kun , Guo Zhenyu , Deng Sier
Published: January 2024

To accurately evaluate the remaining life (RUL) of rolling bearings under small sample conditions and strong noise interference, a RUL prediction scheme using adaptive variational mode decomposition (VMD) and double-discriminator conditional CycleGAN (DD-cCycleGAN) is put forward. Combining chimp optimization algorithm (ChOA) with VMD, an adaptive VMD algorithm based on ChOA is presented, which selects effective mode components for reconstruction and reduces interference from strong background noise. A DD-cCycleGAN is developed to generate new samples which not only retain sample information of source domain, but also resemble samples of target one. A LSTM network after training is utilized to predict the bearing RUL in test samples. The performance of this scheme was validated by using the XJTU-SY bearing test dataset. The comparison analyses demonstrate this scheme has strong noise resistance and high accuracy.
Effects of a Mindfulness-based Intervention on Well-being Among Rural Adolescents with Academic Anxiety
Authors: Jaismin  , Chukkali Surekha , Jain Avni , Peter Anoop
Published: January 2024

Background:

Academic anxiety revolves around scholastic work and performance and can be detrimental to students’ health and overall subjective well-being. It has been found to be significantly high in adolescents, leading to consequences that prove to be detrimental to their academic performance, focus, and overall self-esteem. This phenomenon acts as a vicious cycle impacting all aspects of a student’s life.

Method:

The current study aimed to explore mindfulness-based intervention (MBI) as a possible option to deal with academic anxiety in rural adolescent students and improve their overall subjective well-being. A total of 600 students were screened for academic anxiety and a total of 47 students were subjected to an eight-week MBI. MBI aims to bring more present-moment awareness and cultivate overall well-being and thereby works against anxiety. Mixed repeated measures ANOVA was carried out to compare pre, post, and follow-up scores.

Result:

The results indicated a significant effect of MBI on adolescents, suggesting a significant decline in academic anxiety from pre-to-post and an increase in mindfulness and subjective well-being from pre-to-post and follow-up assessments.

Conclusion:

Academic anxiety and subjective well-being improved significantly with the MBI intervention, thereby implication that MBI is a feasible option for rural adolescents with academic anxiety.
The Be REAL Framework: Enhancing Relationship-Building Skills for Community Health Workers
Authors: Jamison Amelia M. , Brewer Janesse , Hamlin Mary Davis , Forr Amanda , Roberts Robin , Carey Aleen , Fugal Adriele , Mankel Magda E. , Tovar Yazmine , Adams Stephanie , Shapcott Katie , Salmon Daniel
Published: January 2024

Trust plays an integral part in the effective functioning of public health systems. During the COVID-19 pandemic, distrust of public health fueled vaccine hesitancy and created additional barriers to immunization. Although most Americans have received at least one COVID-19 vaccine, the percentage of fully immunized adults remains suboptimal. To reach vaccine-hesitant communities, it is vital that public health be worthy of trust. As trusted members of their communities, community health workers (CHWs) can serve as ideal messengers and conversation partners for vaccination decision-making. We developed the Be REAL framework and training materials to prepare CHWs to work with vaccine-hesitant communities nationwide. Through the four steps of “Relate,” “Explore,” “Assist,” and “Leave (the door open),” CHWs were taught to prioritize relationship building as a primary goal. In this shift from focusing on adherence to public health recommendations (e.g., get vaccinated) to building relationships, the value of vaccine uptake is secondary to the quality of the relationship being formed. The Be REAL framework facilitates CHWs harnessing the power they already possess. The goal of the Be REAL framework is to foster true partnership between CHWs and community members, which in turn can help increase trust in the broader public health system beyond adherence to a specific recommendation.
Adoption intention of e-government application for public health risk communication: Risk information, social media competence and trust in the government
Authors: Chuah Soo-Cheng , Mohamad Arshad Afiza Azura , Mohd Arifin Azitadoly
Published: January 2024

Backgrounds:

Effective risk communication depends on the government’s ability to deploy the latest communication technologies to promptly educate its citizens of new hazards and assist them in making informed decisions. This study investigates the influence of risk information seeking, social media competency and trust in the government on the intention to adopt e-government apps for communicating public health risks.

Design and methods:

To achieve the study’s objective, a convenience sample of 149 Malaysian residents residing in Shah Alam was obtained via a structured questionnaire and subsequently analyzed using the Partial Least Squares-Structural Equation Method. The validity and reliability of the study were evaluated through the outer loadings, Average Variance Extracted (AVE), and Composite Reliability (CR). The influence of underlying factors on the outcome was evaluated by examining path coefficients, standard errors, and t-values.

Results:

The measurement model suggested to use three items to measure the risk information seeking and five to measure trust in the government information and social competence. Loadings ranged from 0.681 to 0.972. The three factors explained the 43.2% of the outcome variability, and all had a positive effect on the intention to adopt information from the e-government application with coefficients estimates ranging from 0.133 to 0.541. The model showed an adequate predictive relevance with Q2 = 0.381

Conclusion:

Public health risk communication via e-government applications rely on the active and accountable engagement of the citizens. To stimulate higher acceptance and utilization of government digital services for sustainable health risk communication and management, the government must raise the public’s level of digital literacy and proficiency. By offering training programs and demonstrations, the government may also need to think about making investments in education about digital and technological skill levels.
The Impact of Completing X-Waiver Training and Clinical Addiction Exposure on Internal Medicine Residents Treating Patients With Opioid Use Disorder
Authors: Callister Catherine , Porter Samuel , Vatterott Phillip , Keniston Angela , McBeth Lauren , Mann Sarah , Calcaterra Susan L. , Limes Julia
Published: January 2024

Background:

Treating opioid use disorder (OUD) with buprenorphine or methadone significantly reduces overdose and all-cause mortality. Prior studies demonstrate that clinicians and residents reported a lack of preparedness to diagnose or treat OUD. Little is known about how clinical exposure or buprenorphine X-waiver training impacts OUD care delivery by resident physicians.

Objective:

Distinguish the effects of X-waiver training and clinical exposure with OUD on resident’s knowledge, attitudes, feelings of preparedness, and practices related to OUD treatment provision.

Methods:

From August 2021 to April 2022, we distributed a cross-sectional survey to internal medicine residents at a large academic training program. We analyzed associations between self-reported clinical exposure and X-waiver training across 4 domains: knowledge about best practices for OUD treatment, attitudes about patients with OUD, preparedness to treat OUD, and clinical experience with OUD.

Results:

Of the 188 residents surveyed, 91 responded (48%). A majority of respondents had not completed X-waiver training (60%, n = 55) while many had provided clinical care to patients with OUD (65%, n = 59). Most residents had favorable attitudes about OUD treatment (97%). Both residents with clinical exposure to treating OUD and X-waiver training, and residents with clinical exposure without X-waiver training, felt more prepared to treat OUD ( P < .0008) compared to residents with neither clinical exposure or X-waiver training or only X-waiver training.

Conclusions:

Residents with clinical exposure to treating OUD are more prepared to treat patients with OUD than those without clinical exposure. Greater efforts to incorporate clinical exposure to the treatment of OUD and education in internal medicine residency programs is imperative to address the opioid epidemic.
Comparative analysis of medicinal plants Scutellaria baicalensis and common adulterants based on chloroplast genome sequencing
Authors: Li Zhen , Duan Baozhong , Zhou Zhongyu , Fang Hui , Yang Meihua , Xia Conglong , Zhou Ying , Wang Jing
Published: January 2024

Background

Scutellaria baicalensis Georgi has been extensively used as a medicinal herb in China for over 2000 years. They may be intentionally or inadvertently substituted or blended with comparable species in the local market, threatening clinical medication safety. Molecular markers are effective tools to prevent misidentification and eliminate doping and falsification among Scutellaria plants. This study screened four highly variable regions to identify Scutellaria and its adulterants. In addition, a phylogenetic analysis was performed using the complete cp genome combined with published Scutellaria species samples. Moreover, a comparative analysis of the cp genomes was conducted to investigate the cp genome evolution of S. baicalensis.

Results

The complete cp genome of five species of Scutellaria was sequenced for the first time, and four previously published Scutellaria species were re-sequenced. They all exhibited a conserved quadripartite structure in their cp genomes, including two distinct regions, namely a small and large single copy region, respectively, and two inverted repeats encompassing the majority of ribosomal RNA genes. Furthermore, the nine species exhibited high conservation from aspects of the genome structure, codon usage, repeat sequences, and gene content. Four highly variable regions (matK-rps16, ndhC-trnV-UAC, psbE-petL, and rps16-trnQ-UUG) may function as potential molecular markers for differentiating S. baicalensis from its adulterants. Additionally, the monophyly of Scutellaria was ascertained and could be reclassified into two subgenera, subgenus Anaspis and subgenus Scutellaria, as evidenced by the phylogenetic analyses on sequences of cp genome and shared protein-coding sequences. According to the molecular clock analysis, it has been inferred that the divergence of Scutellaria occurred at approximately 4.0 Mya during the Pliocene Epoch.

Conclusion

Our study provides an invaluable theoretical basis for further Scutellaria species identification, phylogenetics, and evolution analysis.
Creating and evaluating the score to assess overdose: the OD score
Authors: Nagashima Kazuki , Yasuno Nobuhiro , Watanabe Machiko
Published: January 2024

Background

During disasters (including epidemics such as coronavirus disease 2019), the capacity of emergency departments is exceeded, thereby hindering the administration of appropriate lifesaving measures. Furthermore, the number of overdose patients increases because of the stress overload during emergency situation. The fact that overdose patients are forced to be transported to medical facilities that do not typically treat them is becoming worrisome. Moreover, there is no definitive score for overdose. This study aimed to create a patient-specific scoring system to assess overdose.

Methods

This was a retrospective single-center study. The evidence-based OD score was evaluated on a scale of 0–15. Further, logistic analysis and receiver operating characteristic (ROC) curve analysis were performed to evaluate the score.

Results

Overall, 262 patients (including 118 overdose patients) receiving care at the intensive care unit of Japan’s Teikyo University Hospital in 2021 were targeted. Regarding the total OD score, ROC analysis revealed a cutoff of 8 (area under the curve [AUC]: 0.99, 95% confidence interval [CI]: 0.980–0.997, sensitivity: 0.95, specificity: 0.95, p < 0.05), which was considered to indicate an overdose. Of the items evaluated in the OD score, the scenario at the location of the patient’s discovery (adjusted odds ratio [AOR]: 16.8, 95% CI: 5.0–255.9, p = 0.002) and recent experience of mental anxiety (AOR: 55.7, 95% CI: 2.8–5399.5, p = 0.03) significantly predicted an overdose in multivariable logistic regression analysis. External validation revealed that the OD score could also identify overdose in patients treated in a cohort from 2022 (average cutoff: 8.6, average AUC: 1.0, p < 0.0001).

Conclusions

The OD score could accurately assess overdose patients. Medical facilities that do not frequently address overdose patients will benefit from the use of this score.
Facilitators and barriers to accessing hepatitis B care in the postpartum period among foreign-born New Yorkers: a qualitative analysis of case notes
Authors: Tang Liz Y. , Pene Farma , Cherfas Lina , Schwartz Jessie , Baquero María C.
Published: January 2024

Background

Approximately 241,000 people are living with hepatitis B in New York City. Among those living with hepatitis B, pregnant people are particularly at risk for elevated viral load due to changes in immune response and require prompt linkage to health care. The New York City Department of Health and Mental Hygiene’s Viral Hepatitis Program implemented a telephone-based patient navigation intervention for people living with hepatitis B in the postpartum period to connect them with hepatitis B care.

Methods

During the intervention, patient navigators called participants to inquire about their past experience with receiving care, available supports, and barriers to care, and worked with them to develop a plan with participants for linkage to hepatitis B care. The information collected during initial assessments and follow-up interactions were recorded as case notes. In this qualitative study, researchers conducted a thematic analysis of 102 sets of case notes to examine facilitators and barriers to accessing hepatitis B care among the intervention participants, all of whom were foreign-born and interested in receiving hepatitis B patient navigation services.

Results

The qualitative analysis illustrated the various ways in which patient navigators supported access to hepatitis B care. Findings suggest that receiving care through a preferred provider was a central factor in accessing care, even in the presence of significant barriers such as loss of health insurance and lack of childcare during appointments. Expectations among family members about hepatitis B screening, vaccination and routine clinical follow up were also identified as a facilitator that contributed to participants’ own care.

Conclusions

This study suggests that while there are numerous barriers at the personal and systemic levels, this patient navigation intervention along with the identified facilitators supported people in accessing hepatitis B care. Other patient navigation initiatives can incorporate the lessons from this analysis to support people in connecting to a preferred provider.
Ideal cardiovascular health metrics have better identification of arthritis
Authors: Wang Yuxiang , Sun Mengzi , Yao Nan , Qu Shifang , Guo Ruirui , Wang Xuhan , Li Jing , Xie Zechun , Liu Yan , Wu Zibo , Wang Fengdan , Li Bo
Published: January 2024

Background

This study aimed to explore the association between ideal cardiovascular health metrics (ICVHM) and arthritis (AR), as well as the interactions of various indicators in ICVHM on AR in US adults.

Methods

We involved 17,041 participants who were interviewed by NHANES from 2011 to 2018. AR included osteoarthritis or degenerative arthritis (OA), rheumatoid arthritis (RA), and psoriatic arthritis and other arthritis (Other AR). Logistic regression was applied to analyze the association between AR and ICVHM. Mixed graphical model (MGM) was used to explore the interaction between variables in ICVHM.

Results

Higher ICVHM scores had a protective effect on AR. Compared to “≤1” score, the ORs of AR in participants with 2, 3, 4, and ≥5 were 0.586, 0.472, 0.259, and 0.130, respectively. Similar results were also found in different types of AR. ICVHM has a maximum area under the curve value of 0.765 and the interaction between blood pressure and total cholesterol was 0.43.

Conclusions

ICVHM correlates significantly with AR and is better at identifying AR than individual indicators. ICVHM can be better improved by controlling the indicators with stronger interactions. Our findings provide guidance for promoting health factors, which have important implications for identification and prevention of AR.
Stability of class II correction with the Austro Repositioner associated with multi-brackets fixed appliances in dolichofacial patients
Authors: Austro-Martinez María Dolores , Nicolás-Silvente Ana I. , Requena Mª Angeles , Carazo-Austro Marta , Alarcón José Antonio
Published: January 2024

Background

The purposes of the present study were to evaluate the changes produced by the Austro Repositioner, and to assess the stability of Class II malocclusion treatment with the Austro Repositioner associated with fixed appliances and its capacity to control the vertical dimension in dolichofacial patients.

Methods

A group of patients with Class II malocclusion due to mandibular retrognathism and a dolichofacial growth pattern treated with the Austro Repositioner combined with fixed appliances were compared to a matched untreated control group of subjects with Class II malocclusion. Evaluations were made on the basis of lateral cephalograms taken at T1 (initial records), T2 (end of treatment), and T3 (1 year after treatment). Statistical comparisons were performed with paired- and two-sample t tests.

Results

The experimental (treated) group comprised 30 patients, 14 boys and 16 girls, and the control group comprised 30 subjects (15 boys and 15 girls) with similar ages at T1, T2 and T3.

In the treated group, a significant decrease in the ANB angle was found (− 3.79 ± 1.46; p < 0.001). No significant differences were found in the maxillary skeletal measurements. In contrast, the SNB angle showed a significant increase of 3.77 ± 1.49 in the treated group compared with a nonsignificant increase of 0.77 ± 1.55 in the control group (p = 0.002). Vertical changes showed a significant decrease in the FMA angle (− 3.36 ± 1.62), while the lower anterior facial height distance and the overbite increased significantly in the treated group, reflecting a change in vertical dimensions after treatment. No significant changes were observed in either the treated or control group during the one-year posttreatment period; thus, the treatment results remained stable.

Conclusions

The Austro Repositioner combined with fixed appliances could be considered an optimal treatment modality in Class II dolichofacial patients.
A neuropsychological feedback model for memory clinic trainees
Authors: Rindge Melissa E. , Strainge Lauren , O’Connor Maureen K.
Published: January 2024

Memory clinics that specialize in evaluating and treating cognitive decline in older adults are increasingly common and serve as an important training setting for neuropsychology practicum students, interns, and postdoctoral residents. Following a neuropsychological evaluation, trainees are tasked with sharing results, diagnoses, and treatment recommendations, a practice referred to as feedback. Despite the importance and complexity of providing feedback in this setting, no specific model of feedback delivery exists to guide trainees when learning this crucial skill within a memory clinic. The following article presents a feedback model for memory clinic trainees and details its development based on best practices available in the literature. The feedback model aims to promote trainees’ confidence in their clinical skills and increase patient and visit partner understanding of evaluation results. It is also our hope that this model will advance the field of education within neuropsychology.
A Delphi consensus study to determine the workload components and activity standards of dietitians in South Africa’s central and tertiary public hospitals
Authors: Naicker Vertharani Nolene , Naidoo Keshan , Muchiri Jane W. , Legodi Modiehi Heather
Published: January 2024

Background

The global Human Resources for Health (HRH) strategy emphasizes the need to invest in HRH to meet population needs and improve the provision of quality health care services. In South Africa, dietitians are recognized as registered professionals who provide nutrition services. In this paper, we used 2 key steps (3 and 4) of the eight step World Health Organization (WHO) Workload Indicators of Staffing Need (WISN) methodology to determine the workload components and activity standards for dietitians at South African central and tertiary public hospitals.

Methods

All (9) provincial nutrition managers (phase one) and 21 out of a total 22 head dietitians at central and tertiary public hospitals (phase two) participated in an online survey. In phase one, the provincial managers provided the job descriptions (JDs) of dietitians in their provinces, and the JDs were analyzed to determine the baseline workload components. In phase two, dietitians participated in a multi-stage Delphi process to reach consensus on workload components and activity standards. Consensus was deemed to be agreement of 70% or more, while the median of participants’ responses was used to obtain consensus on the activity standards.

Results

The JDs of dietitians were a useful baseline for the consensus exercise as there were no other suitable source documents. The response rate was 100% for all three rounds of the Delphi survey. Dietitians reached agreement (consensus ≥ 70%) on 92% of proposed workload components and activity standards. Following the removal of duplicate and certain administrative activities, a total of 15 health, 15 support and 15 additional service activities with aligned activity standards resulted from the consensus exercise.

Conclusion

The Delphi technique was a suitable method for reaching agreement on workload components and activity standards for dietitians at South African central and tertiary public hospitals. The findings from this study can now be used to compile a standardized list of workload components and activity standards and ultimately to determine dietetic staffing needs for the central and tertiary public hospital level of care.
Classifying disaster risk reduction strategies: conceptualizing and testing a novel integrated approach
Authors: Dimitrova Mariya , Snair Megan
Published: January 2024

Background

Although disaster risk reduction (DRR) addresses underlying causes and has been shown to be more cost-effective than other emergency management efforts, there is lack of systematized DRR categorization, leading to insufficient coherence in the terminology, planning, and implementation of DRR. The aim of this study was to conceptualize and test a novel integrated DRR framework that highlights the intersection between two existing classification systems.

Methods

Grounded theory was used to conceptualize a novel DRR framework. Next, deductive conceptual content analysis was used to categorize interventions from the 2019 Cities100 Report into the proposed DRR framework. The term “connection” indicates that an intervention can be categorized into a particular section of the novel integrated approach. A “connection” was determined to be present when the intervention description stated an explicit connection to health and to the concept within one of the categories from the novel approach. Further descriptive statistics were used to give insight into the distribution of DRR interventions across categories and into the application of the proposed framework.

Results

The resulting framework contains nine intersecting categories: “hazard, prospective”, “hazard, corrective”, “hazard, compensatory”, “exposure, prospective”, “exposure, corrective”, “exposure, compensatory”, “vulnerability, prospective”, “vulnerability, corrective”, and “vulnerability, compensatory”. The thematic analysis elucidated trends and gaps in the types of interventions used within the 2019 Cities100 Report. For instance, exposure-prospective, exposure-compensatory, and vulnerability-compensatory were the most under-utilized strategies, accounting for only 3% of the total interventions. Further descriptive statistics showed that upper middle-income countries favored “hazard, corrective” strategies over other DRR categories while lower middle-income countries favored “exposure, corrective” over other DRR strategies. Finally, European cities had the highest percentage of DRR connections (51.39%) compared to the maximum possible DRR connections, while African cities had the lowest percentage of DRR connections (22.22%).

Conclusions

The study suggests that the proposed DRR framework could potentially be used to systematically evaluate DRR interventions for missing elements, aiding in the design of more equitable and comprehensive DRR strategies.
Prospects for online adaptive radiation therapy (ART) for head and neck cancer
Authors: Guberina Maja , Guberina Nika , Hoffmann C. , Gogishvili A. , Freisleben F. , Herz A. , Hlouschek J. , Gauler T. , Lang S. , Stähr K. , Höing B. , Pöttgen C. , Indenkämpen F. , Santiago A. , Khouya A. , Mattheis S. , Stuschke M.
Published: January 2024

Background

The aim of the present study is to examine the impact of kV-CBCT-based online adaptive radiation therapy (ART) on dosimetric parameters in comparison to image-guided-radiotherapy (IGRT) in consecutive patients with tumors in the head and neck region from a prospective registry.

Methods

The study comprises all consecutive patients with tumors in the head and neck area who were treated with kV-CBCT-based online ART or IGRT-modus at the linear-accelerator ETHOS™. As a measure of effectiveness, the equivalent-uniform-dose was calculated for the CTV (EUDCTV) and organs-at-risk (EUDOAR) and normalized to the prescribed dose. As an important determinant for the need of ART the interfractional shifts of anatomic landmarks related to the tongue were analyzed and compared to the intrafractional shifts. The latter determine the performance of the adapted dose distribution on the verification CBCT2 postadaptation.

Results

Altogether 59 consecutive patients with tumors in the head-and-neck-area were treated from 01.12.2021 to 31.01.2023. Ten of all 59 patients (10/59; 16.9%) received at least one phase within a treatment course with ART. Of 46 fractions in the adaptive mode, irradiation was conducted in 65.2% of fractions with the adaptive-plan, the scheduled-plan in the remaining. The dispersion of the distributions of EUDCTV-values from the 46 dose fractions differed significantly between the scheduled and adaptive plans (Ansari-Bradley-Test, p = 0.0158). Thus, the 2.5th percentile of the EUDCTV-values by the adaptive plans amounted 97.1% (95% CI 96.6–99.5%) and by the scheduled plans 78.1% (95% CI 61.8–88.7%). While the EUDCTV for the accumulated dose distributions stayed above 95% at PTV-margins of ≥ 3 mm for all 8 analyzed treatment phases the scheduled plans did for margins ≥ 5 mm. The intrafractional anatomic shifts of all 8 measured anatomic landmarks were smaller than the interfractional with overall median values of 8.5 mm and 5.5 mm (p < 0.0001 for five and p < 0.05 for all parameters, pairwise comparisons, signed-rank-test). The EUDOAR-values for the larynx and the parotid gland were significantly lower for the adaptive compared with the scheduled plans (Wilcoxon-test, p < 0.001).

Conclusions

The mobile tongue and tongue base showed considerable interfractional variations. While PTV-margins of 5 mm were sufficient for IGRT, ART showed the potential of decreasing PTV-margins and spare dose to the organs-at-risk.
Effects of stretching in a pilates program on musculoskeletal fitness: a randomized clinical trial
Authors: dos Reis Alex Lopes , de Oliveira Laís Campos , de Oliveira Raphael Gonçalves
Published: January 2024

Background

The scientific literature questions the impact of stretching exercises performed immediately before muscle strengthening exercises on different components of musculoskeletal physical fitness. Pilates is a physical exercise modality that typically uses stretching exercises preceding muscle-strengthening exercises. However, no studies have investigated the effects of stretching in a Pilates program on components of musculoskeletal fitness. The aim of the present study was to verify the effects of stretching in a Pilates exercise program on flexibility, strength, vertical jump height and muscular endurance.

Methods

Thirty-two sedentary young women were randomized into two groups: traditional Pilates (TP), who performed flexibility and muscle strengthening exercises (n = 16), and nontraditional Pilates (NTP), who only performed muscle-strengthening exercises (n = 16). Sessions took place 3 times a week for 8 weeks. The following tests were performed pre- and postintervention: 10-RM knee extensors, vertical jump, handgrip, 1-min sit-ups, Sorensen and sit-and-reach. The occurrence of adverse events was recorded throughout the intervention and compared between groups using odds ratio (OR). To compare the results of motor tests between groups, ANCOVA or Mann‒Whitney U test was used for parametric and nonparametric data, respectively. The data were analyzed by intention-to-treat.

Results

After intervention, the TP was superior to NTP for the sit-and-reach test, with a large effect size (d = 0.87;p = 0.035), with no differences between groups for the other tests. Intragroup comparisons showed significant differences (p < 0.05) for TP and NTP for improvement in 10-RM knee extensors and vertical jump measurements, while only TP showed significant intragroup improvement (p < 0.05) for the sit-and-reach test. A greater chance of experiencing pain or other discomfort as a result of exercise was shown by NTP (OR = 4.20, CI95%0.69 to 25.26).

Conclusion

Our findings demonstrated that stretching exercises performed at the beginning of sessions in a Pilates program did not impair or enhance the development of strength, vertical jump height and muscular endurance in young women. However, only the Pilates program with stretching improved flexibility and reduced the chances of adverse events such as musculoskeletal pain and other discomfort resulting from the exercise protocol.

ClinicalTrials.gov

NCT05538520, prospectively registered on September 16, 2022.
Metformin and adipose-derived stem cell combination therapy alleviates radiation-induced skin fibrosis in mice
Authors: Malekzadeh Hamid , Surucu Yusuf , Chinnapaka Somaiah , Yang Katherine S. , Arellano José A. , Samadi Yasamin , Epperly Michael W. , Greenberger Joel S. , Rubin J. Peter , Ejaz Asim
Published: January 2024

Background

Radiation therapy often leads to late radiation-induced skin fibrosis (RISF), causing movement impairment and discomfort. We conducted a comprehensive study to assess the effectiveness of metformin and adipose-derived stem cells (ASCs), whether autologous or allogeneic, individually or in combination therapy, in mitigating RISF.

Methods

Using a female C57BL/6J mouse model subjected to hind limb irradiation as a representative RISF model, we evaluated metformin, ASCs, or their combination in two contexts: prophylactic (started on day 1 post-irradiation) and therapeutic (initiated on day 14 post-irradiation, coinciding with fibrosis symptoms). We measured limb movement, examined skin histology, and analyzed gene expression to assess treatment efficacy.

Results

Prophylactic metformin and ASCs, whether autologous or allogeneic, effectively prevented late fibrosis, with metformin showing promising results. However, combination therapy did not provide additional benefits when used prophylactically. Autologous ASCs, alone or with metformin, proved most effective against late-stage RISF. Prophylactic intervention outperformed late therapy for mitigating radiation skin damage. Co-culture studies revealed that ASCs and metformin downregulated inflammation and fibrotic gene expression in both mouse and human fibroblasts.

Conclusions

Our study suggests metformin's potential as a prophylactic measure to prevent RISF, and the combination of ASCs and metformin holds promise for late-stage RISF treatment. These findings have clinical implications for improving the quality of life for those affected by radiation-induced skin fibrosis.
Sex and gender correlates of sexually polymorphic cognition
Authors: Cartier Louis , Guérin Mina , Saulnier Fanny , Cotocea Ioana , Mohammedi Amine , Moussaoui Fadila , Kheloui Sarah , Juster Robert-Paul
Published: January 2024

Background

Sexually polymorphic cognition (SPC) results from the interaction between biological (birth-assigned sex (BAS), sex hormones) and socio-cultural (gender identity, gender roles, sexual orientation) factors. The literature remains quite mixed regarding the magnitude of the effects of these variables. This project used a battery of classic cognitive tests designed to assess the influence of sex hormones on cognitive performance. At the same time, we aimed to assess the inter-related and respective effects that BAS, sex hormones, and gender-related factors have on SPC.

Methods

We recruited 222 adults who completed eight cognitive tasks that assessed a variety of cognitive domains during a 150-min session. Subgroups were separated based on gender identity and sexual orientation and recruited as follows: cisgender heterosexual men (n = 46), cisgender non-heterosexual men (n = 36), cisgender heterosexual women (n = 36), cisgender non-heterosexual women (n = 38), gender diverse (n = 66). Saliva samples were collected before, during, and after the test to assess testosterone, estradiol, progesterone, cortisol, and dehydroepiandrosterone. Psychosocial variables were derived from self-report questionnaires.

Results

Cognitive performance reflects sex and gender differences that are partially consistent with the literature. Interestingly, biological factors seem to better explain differences in male-typed cognitive tasks (i.e., spatial), while psychosocial factors seem to better explain differences in female-typed cognitive tasks (i.e., verbal).

Conclusion

Our results establish a better comprehension of SPC over and above the effects of BAS as a binary variable. We highlight the importance of treating sex as a biological factor and gender as a socio-cultural factor together since they collectively influence SPC.
Risk factors and prognosis of orotracheal intubation in aquaporin-4-IgG neuromyelitis optica spectrum disorder attacks
Authors: Januel Edouard , Brochard Vincent , Le Guennec Loïc , Maillart Elisabeth , Louapre Céline , Lubetzki Catherine , Weiss Nicolas , Demeret Sophie , Papeix Caroline
Published: January 2024

Background

Aquaporin-4 immunoglobulin G Neuro Myelitis Optica spectrum disorders attacks (NMOSD-AQP4-IgG+ attacks) can cause respiratory failure requiring orotracheal intubation (OTI), but the risk factors and outcomes of OTI during attacks remain unclear. Our primary objective was to identify the clinical and radiological risk factors for OTI in NMOSD-AQP4-IgG+ attacks. As a secondary objective, we aimed to evaluate the prognosis of OTI-attacks.

Methods

We retrospectively analyzed NMOSD-AQP4-IgG+ attacks at the Pitié-Salpêtrière Hospital (Jan 2010–Jan 2021), excluding isolated optic neuritis. The primary outcome was the need for OTI due to neurological dysfunction an attack (OTI-attack). The secondary outcome was attack’s poor recovery after 12 months, defined as a modified Rankin score (mRS) > 2 in patients with an initial mRS ≤ 2, or an increase ≥ 1 point in mRS in other patients. Analyses were performed using a binomial generalized linear mixed model, with a random intercept for the patient ID to account for within-patient correlations.

Results

Seventy-three attacks in 44 patients NMOSD-AQP4-IgG+ were analyzed. Of 73 attacks, 8 (11%) required OTI during the attack, related to acute restrictive respiratory failure (n = 7) and/or severe swallowing disorder (n = 2). None of the OTI-attacks occurred in patients previously treated with active disease-modifying treatment (DMT), while 36 (55.4%) of the non-OTI-attacks occurred in patients who were already on active DMT. On admission, OTI-attacks were more likely to have upper limbs motor paresis of (75.0% versus 29.2%, p = 0.366) and dyspnea (3 [50.0%] versus 4 [6.6%], p = 0.002) compared to non-OTI-attacks. MRI analysis showed that OTI-attacks had edematous lesions in the cervical spinal cord, mainly at levels C1 (75% versus 0% in non-OTI-attacks), C2 (75% versus 1.9%), C3 (62.5% versus 1.9%), and C4 and C5 levels (50% versus to 3.9%). One OTI-attack resulted in the death of one patient. Five patients with OTI-attack had mRS ≤ 2 one year after OTI-attack. Two (25%) OTI-attacks had poor recovery compared to 15 (24.2%) non-OTI-attacks (p = 0.468).

Conclusion

OTI-attacks occurred in untreated NMOSD-AQP4-IgG+ patients and were associated with edematous upper cervical lesions. The prognosis of these attacks may be favorable, and warrant maximal medical and supportive treatment.

Trial registration This was a retrospective observational monocentric cohort study nested in the NOMADMUS cohort (ClinicalTrials.gov Identifier: NCT02850705)

Graphical Abstract
Molecular profiling of biliary tract cancers reveals distinct genomic landscapes between circulating and tissue tumor DNA
Authors: Astier Clémence , Ngo Carine , Colmet-Daage Léo , Marty Virginie , Bawa Olivia , Nicotra Claudio , Ngo-Camus Maud , Italiano Antoine , Massard Christophe , Scoazec Jean-Yves , Smolenschi Cristina , Ducreux Michel , Hollebecque Antoine , Postel-Vinay Sophie
Published: January 2024

Biliary tract cancers (BTCs) are heterogeneous malignancies with dismal prognosis due to tumor aggressiveness and poor response to limited current therapeutic options. Tumor exome profiling has allowed to successfully establish targeted therapeutic strategies in the clinical management of cholangiocarcinoma (CCA). Still, whether liquid biopsy profiling could inform on BTC biology and patient management is unknown. In order to test this and generate novel insight into BTC biology, we analyzed the molecular landscape of 128 CCA patients, using a 394-gene NGS panel (Foundation Medicine). Among them, 32 patients had matched circulating tumor (ct) DNA and tumor DNA samples, where both samples were profiled. In both tumor and liquid biopsies, we identified an increased frequency of alterations in genes involved in genome integrity or chromatin remodeling, including ARID1A (15%), PBRM1 (9%), and BAP1 (14%), which were validated using an in-house-developed immunohistochemistry panel. ctDNA and tumor DNA showed variable concordance, with a significant correlation in the total number of detected variants, but some heterogeneity in the detection of actionable mutations. FGFR2 mutations were more frequently identified in liquid biopsies, whereas KRAS alterations were mostly found in tumors. All IDH1 mutations detected in tumor DNA were also identified in liquid biopsies. These findings provide novel insights in the concordance between the tumor and liquid biopsies genomic landscape in a large cohort of patients with BTC and highlight the complementarity of both analyses when guiding therapeutic prescription.
Preoperative prediction of early recurrence in resectable pancreatic cancer integrating clinical, radiologic, and CT radiomics features
Authors: Lee Jeong Hyun , Shin Jaeseung , Min Ji Hye , Jeong Woo Kyoung , Kim Honsoul , Choi Seo-Youn , Lee Jisun , Hong Sungjun , Kim Kyunga
Published: January 2024

Objectives

To use clinical, radiographic, and CT radiomics features to develop and validate a preoperative prediction model for the early recurrence of pancreatic cancer.

Methods

We retrospectively analyzed 190 patients (150 and 40 in the development and test cohort from different centers) with pancreatic cancer who underwent pancreatectomy between January 2018 and June 2021. Radiomics, clinical-radiologic (CR), and clinical-radiologic-radiomics (CRR) models were developed for the prediction of recurrence within 12 months after surgery. Performance was evaluated using the area under the curve (AUC), Brier score, sensitivity, and specificity.

Results

Early recurrence occurred in 36.7% and 42.5% of the development and test cohorts, respectively (P = 0.62). The features for the CR model included carbohydrate antigen 19-9 > 500 U/mL (odds ratio [OR], 3.60;P = 0.01), abutment to the portal and/or superior mesenteric vein (OR, 2.54;P = 0.054), and adjacent organ invasion (OR, 2.91;P = 0.03). The CRR model demonstrated significantly higher AUCs than the radiomics model in the internal (0.77 vs. 0.73;P = 0.048) and external (0.83 vs. 0.69;P = 0.038) validations. Although we found no significant difference between AUCs of the CR and CRR models (0.83 vs. 0.76;P = 0.17), CRR models showed more balanced sensitivity and specificity (0.65 and 0.87) than CR model (0.41 and 0.91) in the test cohort.

Conclusions

The CRR model outperformed the radiomics and CR models in predicting the early recurrence of pancreatic cancer, providing valuable information for risk stratification and treatment guidance.