bluuebunny/crossref_metadata_2025 huggingface dataset:
Mechanism of roof presplitting in nonpillar coal mining technology and its reasonable parameters in hard roof and longwall top-coal caving face
Authors: Wang Haosen , Wang Jiong , He Manchao , Tian Xichun , Ma Zimin , Liu Peng
Published: December 2022

This article presents an integrated approach for theoretical analysis and numerical modeling to investigate the mechanism of roof presplitting and its reasonable parameters in the hard roof and longwall top-coal caving face. The test site is located in the city of Jinzhong, Shanxi Province, China. The theoretical analysis results indicated that when the presplitting angle remains constant, the tensile stress at the unpenetrated surface is approximately exponentially distributed with the presplitting height. When the presplitting height remains constant, the variation curve of tensile stress at the unpenetrated surface with the presplitting angle is parabolic. As the presplitting height increases, the presplitting angle required for the tensile stress at the unpenetrated face to exceed the ultimate tensile strength of limestone first increases and then decreases. The ground response of retained entry obtained with numerical modeling confirmed the theoretical analysis results. Meanwhile, numerical modeling results also showed that presplitting height affects the volume of the collapse gangues and the structure of the overlying strata above the retained entry. The presplitting angle is effective in reducing the frictional resistance between the collapse gangue and roof structure of retained entry. Moreover, based on the ground response of the retained entries, the reasonable parameters of the roof presplitting were determined at 17 m and 15°. The field application showed that reasonable roof presplitting parameters could achieve satisfactory effects at pressure relief and retained entry in the longwall top-coal caving panel. Furthermore, the proposed design principle of the roof presplitting technique can be applied to other projects.
The Spontaneous Counterfactual Inference Task: Misremembering What Might Have Been
Authors: Smallman Rachel , Summerville Amy , Lowe Jessica C.
Published: December 2022

Counterfactuals, thoughts about “what might have been,” play an important role in causal judgment, emotion, and motivation, and spontaneously arise during daily life. However, current methods to measure spontaneous counterfactual thinking are cumbersome and subjective. The current research adapts a paradigm from the Spontaneous Trait Inference literature to develop the Spontaneous Counterfactual Inference measure (SCFI), which uses false recognition of counterfactual statements as a measure of spontaneous counterfactual thought. Studies 1a and 1b demonstrate that the SCFI is sensitive to precursors of counterfactual thinking: norm violation and counterfactual closeness. Study 2 demonstrates that the SCFI converges with the generation of counterfactual statements in an open-ended writing task. The SCFI also predicts two important consequences of counterfactual thought, blame (Study 3), and intention endorsement (Study 4). The SCFI thus offers a new tool for researchers interested in counterfactual thinking.
Using structured templates or free text style in reporting CT staging on colon cancer: a national survey
Authors: Andersen Rasmus Dam , Vils Pedersen Malene Roland , Hesseldal Laura , Rafaelsen Søren Rafael
Published: December 2022

Background

Computed tomography (CT) is a widely used method for the staging of colon cancer. Accurate reports could lead to a better preoperative evaluation and planning of the treatment of colon cancer.

Purpose

To evaluate the use of CT free-text reports and structured report templates when it comes to staging CT imaging of colon cancer.

Material and Methods

A multiple choice questionnaire survey was conducted over four weeks. Online questionnaire software was used, and a link was shared to medical doctors with help from the Danish Colorectal Cancer Group (DCCG) and from a social media radiologist group.

Results

Clinicians preferred the template style (95%), whereas the level of support was lower among the radiologists (76%). All female responders preferred the template style, in contrast to only 84% of the male responders. Furthermore, the survey showed a slightly deficient level of the national CT reporting quality; only 7/13 questions and sub-questions, concerning CT report quality, achieved an approval rate >85%. The colorectal cancer multidisciplinary team consultants who always or usually work with template style reporting of CT scans of colon cancer tend to be more satisfied with the quality and content of the reports, compared to those who rarely use or read template reports.

Conclusion

The following indicators were insufficiently reported: tumor invasion growth; number of hepatic metastases; segment location of hepatic metastasis; and retroperitoneal lymph node involvement. In the template reports group, nearly all participants found relevant information easily accessible.
Patient perspectives on repeated contrast-enhanced mammography and magnetic resonance during neoadjuvant chemotherapy of breast cancer
Authors: Pires-Gonçalves Lígia , Henriques Abreu Miguel , Ferrão Anabela , Guimarães dos Santos António , Aguiar Ana Teresa , Gouvêa Margarida , Henrique Rui
Published: December 2022

Background

The burden perceived by the patient of repeated imaging required for neoadjuvant chemotherapy (NAC) monitoring warrants attention due to the increased use of NAC and imaging.

Purpose

To evaluate and compare the experienced burden associated with repeated contrast-enhanced mammography (CEM) and magnetic resonance imaging (MRI) during NAC for breast cancer from the patient perspective.

Material and Methods

Approval from the ethics committee and written informed consent were obtained. In this prospective study, CEM and MRI were performed on 38 patients with breast cancer before, during, and after NAC in a tertiary cancer center. The experienced burden was evaluated with a self-reported questionnaire addressing duration, comfort, anxiety, positioning, and intravenous contrast administration, each measured on a 5-point Likert scale. The participants were asked their preference between CEM or MRI. Statistical comparisons were performed and P<0.05 was considered significant.

Results

Most participants (n = 29, 76%) preferred CEM over MRI ( P = 0.0008). CEM was associated with a significantly shorter duration ( P < 0.001), greater overall comfort ( P < 0.01), more comfortable positioning ( P = 0.01), and lower anxiety ( P = 0.03). Intravenous contrast administration perception revealed no significant difference. Only 4 (10%) participants preferred MRI over CEM, due to the absence of breast compression.

Conclusion

In the hypothetical scenario of equal diagnostic accuracy, most participants preferred CEM and compared CEM favorably to MRI in all investigated features at repeated imaging required for NAC response assessment. Our results indicate that repeated examinations with CEM is well tolerated and constitutes a patient-friendly alternative for NAC imaging monitoring in breast cancer.
The Olympics, nationalism, and multiculturalism: News coverage of naturalized players in the Korean men’s national ice hockey team
Authors: Choi Yeomi
Published: December 2022

The naturalization of athletes for the purpose of participating in the Olympics is a noticeable feature of today's superdiverse sporting contexts. Focusing on the 2018 PyeongChang Winter Olympic Games, in this paper, I explore how North American-born male ice hockey players who have become naturalized into South Korea are reproduced in media coverage of Canada and South Korea. Applying insights from critical discourse studies, transnationalism, and critical multiculturalism, I specifically examine how each country re/forms its own imagined community through these transnational sporting migrants and the ways that concepts of immigration, citizenship, whiteness, masculinity, and multiculturalism are linked, fused, and/or conflicted within it. Analysis suggests that in both countries, the hockey migrants have been illuminated as new national symbols enhancing the multicultural national brand of each country, whether as immigrants or emigrants, solidifying in the process the hegemonic position of whiteness as a global phenomenon beyond the West.
Health Equity Considerations: HIV Intervention Adaptation for Black Women in Community Corrections
Authors: Johnson Karen A. , Hunt Timothy , Goddard-Eckrich Dawn , Wu Elwin , Richards Stanley , Tibbetts Rick , Rowe Jessica C. , Maynard Quentin R. , Goodwin Sharun , Okine Joana , Wainberg Milton L. , El-Bassel Nabila , Gilbert Louisa
Published: December 2022

Objectives: This article describes the process used to adapt the only group-based, computer-assisted, HIV/sexually transmitted infections (STI) prevention intervention designed for drug-using Black women in community corrections using an integrated health equity ADAPT-ITT framework with a peer engagement lens. Methods: Key adaptation partners included cisgender, drug-using Black women in community corrections, and Black, female, community reentry providers slated to deliver the adapted intervention. Focus groups and a study pilot were held. Results: The resulting intervention, Empowering African-American Women on the Road to Health (E-WORTH), features HIV/STI-specific Afrocentric themes of risk and resiliency tailored for and by Black women in the criminal legal system. Evaluation of E-WORTH confirms its cultural resonance. Participants had a 54% lowered odds of testing positive for any STI and reported 38% fewer acts of condomless vaginal or anal intercourse at 12-month follow-up. Conclusions: Findings underscore the need to develop an adaptation model that is explicitly health equity in focus.
Effectiveness of Trauma-Focused Cognitive Behavioral Therapy Among Maltreated Children: A Meta-Analysis
Authors: Wang Weiwei , Chen Keyu , Zhang Huiping
Published: December 2022

Objectives: To assess the effects of trauma-focused cognitive behavioral therapy (TF-CBT) among maltreated children, and to examine the role of potential moderators. Methods: A search of eight databases was conducted. Eighteen studies involving 11 randomized and quasi-randomized controlled trials with 965 maltreated children were included, and the effect sizes were pooled using random-effect models. Results: There were large effect sizes for posttraumatic growth and emotional management. Moderate to large effects were evident for PTSD and depression, while small effects were found for anxiety, internalizing behavior, sexualized behavior, and parenting practice. Effects were maintained at 3–12 months for some outcome domains. The effectiveness of TF-CBT was better when delivered to older children, and versions of TF-CBT, delivery format, sessions, and treatment length will not affect effectiveness. Conclusions: TF-CBT effectively reduces abuse-related symptoms and improves positive psychosocial outcomes among maltreated children.
A Novel App for Assessing the Caregivers’ Physical Activity: A Pilot/Feasibility Study
Authors: Jeong Yoo Seok , Kwon Dong Rak , Kim Sang Won , Özçakar Levent , Kwak Sang Gyu
Published: December 2022

This study sought to determine the feasibility and clinical value of using a novel mobile application (app) to record the muscle/physical activity (PA) of caregivers. In all, 23 caregivers were enrolled and they were trained to use the app and a wearable device that automatically recorded their care activities and PA/burden. Data were collected for 42 days. Muscle activity was measured for 3 weeks during maximum voluntary isometric contraction (MVIC) and PA. Approximately 80% of the caregivers agreed that they conveniently used the wearable device through the mobile app. The most active %MVIC was noted for the back muscles during feeding assistance. As regard subjective pain evaluation, back pain was the most prevalent and pain level in the left knee was the highest. Incorporating mobile apps with wearable devices to record every activity of the caregivers may be feasible and can provide valuable clinical data for optimizing their pain management.
Relationship Between Hallux Valgus Recurrence and Sesamoid Position on Anteroposterior Standing Radiographs After Distal Chevron Metatarsal Osteotomy
Authors: Kim Tae-Hoon , Choi Young-Rak , Lee Ho-Seong , Bak Gyeong-Gu , Moon Sung-Ho
Published: December 2022

Background:

Recurrence of the hallux valgus deformity has various causes, and the incomplete reduction of sesamoids may be one of the important issues. However, we have seen several patients with postoperative lateral sesamoid displacement on anteroposterior (AP) standing radiographs who did not experience hallux valgus recurrence. Therefore, we hypothesized that lateral displacement of the sesamoid on AP standing radiographs does not cause hallux valgus recurrence.

Methods:

The study included 269 feet (185 patients) with hallux valgus treated with distal chevron metatarsal osteotomy. Mean patient age was 64.26 (range, 15-80) years. Patients were followed up for an average of 33.85 (range, 12-228) months between April 2002 and December 2019. The patients were divided into 4 groups, according to the presence or absence of hallux valgus recurrence and sesamoid reduction.

Results:

During outpatient follow-up, we discovered 99 feet (42.1%) in which hallux valgus did not recur despite lateral sesamoid displacement (grade IV-VII) on AP standing radiographs. Hallux valgus angle (HVA, 2.7 to 7.9 degrees), intermetatarsal angle (IMA, 4.6 to 6.2 degrees), and sesamoid grades (2.1 to 3.5) all deteriorated over time after surgery, and each indicator was statistically significantly altered, and changes in the 3 indicators had a statistically significant positive correlation. Changes in HVA and IMA between feet with and without sesamoid reduction on AP standing radiographs increased over time, with the differences in HVA (2.9 degrees) and IMA (0.9 degrees) being significant at final follow-up ( P < .05 for each). Regardless of whether sesamoid reduction was achieved on AP standing radiographs, the final analysis showed that HVA and IMA in both groups worsened over time. Further, there were no differences between the 2 groups in the patterns of change over time.

Conclusion:

In our cohort, postoperative sesamoid position on AP standing radiographs was not associated with hallux valgus recurrence based on radiographic criteria.

Level of Evidence:

Level III, retrospective comparative study.
The Mesencephalic Locomotor Region: Multiple Cell Types, Multiple Behavioral Roles, and Multiple Implications for Disease
Authors: Ryczko Dimitri
Published: December 2022

The mesencephalic locomotor region (MLR) controls locomotion in vertebrates. In humans with Parkinson disease, locomotor deficits are increasingly associated with decreased activity in the MLR. This brainstem region, commonly considered to include the cuneiform and pedunculopontine nuclei, has been explored as a target for deep brain stimulation to improve locomotor function, but the results are variable, from modest to promising. However, the MLR is a heterogeneous structure, and identification of the best cell type to target is only beginning. Here, I review the studies that uncovered the role of genetically defined MLR cell types, and I highlight the cells whose activation improves locomotor function in animal models of Parkinson disease. The promising cell types to activate comprise some glutamatergic neurons in the cuneiform and caudal pedunculopontine nuclei, as well as some cholinergic neurons of the pedunculopontine nucleus. Activation of MLR GABAergic neurons should be avoided, since they stop locomotion or evoke bouts flanked with numerous stops. MLR is also considered a potential target in spinal cord injury, supranuclear palsy, primary progressive freezing of gait, or stroke. Better targeting of the MLR cell types should be achieved through optimized deep brain stimulation protocols, pharmacotherapy, or the development of optogenetics for human use.
Comparison of ultrasound energy consumption between low-energy femtosecond laser-assisted cataract surgery and conventional phacoemulsification cataract surgery in patients with different cataract densities
Authors: Ou YouCi , Wang YuanShen , Wu TzuEn
Published: December 2022

Purpose

Femtosecond laser-assisted cataract surgery (FLACS)'s effect on reducing ultrasound energy, accumulated with cumulative dispersed energy (CDE) units, still remains controversial. This study aims to evaluate the effect of low-energy FLACS on CDE with that of conventional phacoemulsification surgery (CPS) in different cataract densities from multiple surgeons.

Methods

It was a retrospective case–control study. Total 629 eyes receiving either low-energy FLACS (performed with Ziemer LDV Z8 platform) or CPS were divided into two groups according to preoperative grading of Lens Opacity Classification System III (LOCSIII): milder and harder cataract group. The mean CDE were compared in different cataract densities and surgeons. A linear regression analysis was performed to evaluate the effect of using low-energy FLACS on CDE in harder cataract cases.

Results

We found overall CDE had no significant difference between two surgeries. However, low-energy FLACS led to a significantly lower CDE in patients with harder cataracts than CPS (18.47 ± 4.32 vs. 12.96 ± 2.34; p < 0.001). Similar results were observed in the three surgeon subgroups and in linear regression analysis and no significant difference of the effect accounting for surgeons. Moreover, low-energy FLACS results in a reduction of energy consumption comparing to CPS and has endothelial sparring effect in patients with harder cataracts.

Conclusions

The reduced energy consumption was observed by using low-energy FLACS irrespective of surgeons’ experience or the approaches adopted in patients with harder cataracts. Therefore, we can have more confidence to suggest this innovative platform to the patients in such cases.
Kindergarten children’s reactions to the COVID-19 pandemic: Creating a sense of coherence
Authors: Paryente Bilha , Gez-Langerman Roni
Published: December 2022

This article examines kindergarten children’s experience of the COVID-19 pandemic. It aims to understand the children’s thoughts, emotions, and coping strategies regarding the presence of the COVID-19 virus in their daily lives, using the salutogenic approach to study their sense of coherence and promote relevant professional instruction. Semi-structured in-depth interviews were held with 130 five- to six-year-old children with an equal number of boys and girls. All of the children were recruited from kindergartens affiliated with the state’s secular education system. Data were structured into three themes: (1) the child’s perception of the pandemic as manageable through significant accompanying and absent figures; (2) the child’s comprehension of the virus as dangerous, age-differentiating, and contagious; and (3) the child’s emotional processing of the pandemic as arousing fear of death and through images, such as “thorny” and “monster.” The results demonstrate the young children’s sense of coherence, characterized as extrapersonal perception, interpersonal coping, and intrapersonal emotional processing, and the need for greater acknowledgment of child-parent educators’ informed interventions that could give children a partial feeling of the adult’s awareness of their needs.
Educator perceptions of free-flowing routines in early childhood education and care
Authors: Collins Tian J , Jones Rachel A , Tonge Karen L
Published: December 2022

There is ongoing interest in free-flowing routines in early childhood education and care settings (ECEC), however little is known about educators’ perceptions of free-flowing routines. Therefore, the aim of this study was to explore the perceptions of educators regarding free-flowing routines. A focus group and five semi-structured interviews were conducted. Four main themes were identified: learning outcomes, learning opportunities, team characteristics, and pedagogy and practice. Free-flowing routines may offer additional affordances for children’s learning compared to structured routines, such as greater independence and agency for children, sustained time to engage in child-led learning, and deeper engagement in learning. Quality pedagogical practice was perceived as being highly important in free-flowing routines. It is recommended that ECEC settings implement an aspect of free-flowing routines for part, or all of the day, and be open to the learning opportunities that this may present for children. With further research, there is potential to better understand routines that best support children’s learning and development in ECEC, as well as opportunities to influence national and international policy and curricula.
Human Bodies in Motion: The Performative Intra-Actions of Materialization
Authors: Markula Pirkko
Published: December 2022

The human body in motion is both a material body and a body inscribed with sociocultural meanings. The new materialist premise of examining phenomena, such as bodies in motion, as hybrids of matter and meaning now offers a pathway to seamlessly bring nature and culture together in a more unified research agenda. Barad’s agentic realism, particularly, presents a promising option to analyze physically active bodies as socio-material practices through both natural science and social constructivist insights. This, however, requires rethinking the nature of natural and social scientific research to more fully comprehend the complexity of physical activity. To illustrate what such research might look like, I first present Barad’s critiques of realist science and social constructivist representationalism to arrive at their suggestion of meeting the universe halfway, performatively, through a relational ontology of the production of material bodies. I conclude with my attempt to think with Barad’s philosophical framework to consider how researchers of the moving human body may meet “halfway” to examine the materiality and mattering of the physically active body.
Systemic and Local Effects Among Patients With Betel Quid-Related Oral Cancer
Authors: Chuang Hui-Ching , Tsai Ming-Hsien , Lin Yu-Tsai , Chou Ming-Huei , Yang Kun-Lin , Chien Chih-Yen
Published: December 2022

The major predisposing factors of developing oral cancer include smoking, alcohol drinking, and betel quid chewing. Betel quid chewing could cause the abrasion and damage of oral mucosa by crude fibers, chemical insults by additive slaked lime, and arecoline from areca nut. These would lead to the local consequence of oral submucosal fibrosis, which is regarded clinically as a precancer lesion and a major cause of trismus. In addition, the components and additives in betel quid contain chemical toxins and carcinogens, which would further affect the oral mucosa and gradually develop a malignancy. Following literature review, aside from having a greater total tumor burden and more local diseases in the oral cavity and digestive tract, patients with betel quid-related oral cancer also have more systemic diseases from metabolic syndrome, hypertension, cardiovascular disease, type II diabetes mellitus, and obesity than those without this habit. In conclusion, those patients who have the history of smoking, alcohol drinking, and betel quid chewing would present much more unique clinical characteristics than those who only have a history of smoking and alcohol drinking. More attention should therefore be paid to pretreatment evaluation, treatment strategy, and posttreatment follow-up among betel quid chewers.
Resveratrol Ameliorates Hyperglycemic Cultured Cells and Inhibits the Rheb/mTOR Interaction
Authors: Lin Tzu-Yung , Cheng Ann-Chang , Chuang Hsiang-Chieh , Yao Jeng-Yuan
Published: December 2022

Resveratrol (RSV) is a natural polyphenol with anti-diabetic effects and has been reported to ameliorate diabetes-induced metabolic disorders through regulating activities of the mTOR signaling pathway. To delineate the effects of RSV treatment on the mTOR signaling pathway, hyperglycemic HepG2 cells were used for the following experiments. Cellular glucose uptake assays showed that high-glucose levels in the culture medium decelerate the glucose uptake of cultured cells. Co-immunoprecipitation showed that high-glucose culture promotes the interaction between mTOR and Rheb-GTP, which is the active form of Rheb. RSV treatment of the cells suppressed this interaction and accelerated the glucose uptake. Western blotting revealed that RSV down-regulated members of the mTOR signaling pathway, namely SREBP1, p70, and S6. Additionally, RSV ameliorated the metabolic disorders, including the decreased levels of AMPK, glycogen synthase, and glucose-6-phosphatase, in hyperglycemic HepG2 cells. These results indicate that RSV inhibits the Rheb/mTOR interaction and ameliorates metabolic disorders associated with high-glucose levels.
Cardioprotective Effects and Mechanisms of Saponins on Cardiovascular Disease
Authors: Ma Xin , Lu Jun , Gu Xue-Rong , Jia Yinnong , Shen Baochun , Weiming Yang , Du Guan-Hua , Zheng Chang-Bo
Published: December 2022

Cardiovascular disease (CVD), a leading cause of morbidity and mortality, is among the most prevalent health problems worldwide and effective strategies for its prevention and treatment are urgently required. In this regard, increasing research has demonstrated that natural drugs offer antihypertensive, antiatherosclerotic, and cardioprotective activities, and many are applied widely for the treatment of CVD and its manifestations such as myocardial infarction, peripheral vascular diseases, and coronary heart disease. Natural drugs have significant advantages in the treatment of CVD due to their efficacy and safety profiles. Saponins are an important class of active components of plant natural products and play an important role in the treatment of CVD. This review covers the most up-to-date information on saponins concerning their cardioprotective effects and mechanisms of action.
Effect of steroid dose on efficacy of CT-guided pudendal nerve blocks for pudendal neuralgia
Authors: Gubbels Ashley , Linder Mitchell , Baran Timothy M , Koritysskiy Filip , Rahman Akm
Published: December 2022

Purpose:

The aim was to determine the impact of steroid dose on effectiveness of CT-guided pudendal nerve blocks. Secondary aim was to assess predictors for response.

Materials and methods:

A retrospective cohort study was performed. Two-hundred-and-seventeen patients with pudendal neuralgia were identified. Of these, 189 patients had data on response and 511 pudendal nerve blocks were analyzed. Demographics, social history, initial pain data, treatment data including steroid dosing, and follow-up data were collected. Non-responders to treatment were compared to responders.

Results:

The majority of patients were female (92.1%) and most common areas of pain involved the vulva/labia/ perineum/vagina (scrotum) (44.2%). Treatment response rates increased with number of blocks with maximum response rate of 92.2% after fourth injection. Responders underwent more blocks within the first year (3.1 ± 1.5 vs 2.6 ± 1.6, p = 0.026). Steroid dose did not have a significant effect on response rate nor did site of injection. Non-responders were more commonly on disability due to pain ( p = 0.043). History of childhood/adolescent sexual abuse was more common in non-responders (p=0.046) and was a significant predictor of response (OR = 0.27 [0.08–0.94 95% confidence interval], p = 0.04).

Conclusion:

Steroid dose does not appear to have an impact on the short-term response rates to CT-guided pudendal nerve blocks in patients with clinically diagnosed pudendal neuralgia and our data may further support the discontinuation of steroids from CT block protocols. Current long-term disability leave status was a predictor of poor response along with history of childhood/adolescent sexual abuse. Adverse childhood events are easily assessed and may represent a clinical predictor of lack of response in this patient population.

Clinical relevance:

Approaches to managing pudendal neuralgia are varied. Steroid dose may not impact response to pudendal nerve blocks. Current disability status and history of childhood/adolescent sexual abuse may be clinical predictors of poor response to treatment.
Heavy chain deposition disease (HCDD) of the kidney in a patient of treated chronic myeloid leukemia with imatinib
Authors: Mir Tajamul H , Jabeen Bushra , Sharma Alok , Wani Imtiyaz A , Zargar Parvaiz A , Fazili Nadia , Qamiri Derayat A , Bashir Sabah
Published: December 2022

Chronic myeloid leukemia is a clonal disorder of myeloid origin which transforms into more aggressive phenotypes, either acute myeloid leukemia or acute lymphoblastic leukemia. The long-term outcome of chronic myeloid leukemia has significantly improved with tyrosine kinase inhibitor imatinib. In contrast, heavy chain deposition disease is a disorder of lymphoid origin due to a plasma cell clone classified under monoclonal immunoglobulin deposition disease with truncated monoclonal heavy chain deposition along basement membranes of many organs, predominantly the kidneys causing significant organ dysfunction. The connection between the two disorders seems to be vague and undefined. We report a novel case of treated chronic myeloid leukemia with imatinib in sustained clinical and cytogenetic remission who presented with heavy chain deposition disease of the kidney, causing renal dysfunction and nephrotic range proteinuria that responded to clone-directed therapy. Given these disorders’ two different cell lines, their association could be fortuitous only. However, in the light of a few dozen cases published thus far in which the prototypical plasma cell disorders multiple myeloma and monoclonal gammopathy of undetermined significance have evolved from cases of treated CML, this association seems to be genuine, the possible genesis of which is discussed in this manuscript. Long-term exposure of chronic myeloid leukemia patients to imatinib could predispose some rare, vulnerable patients to a plasma cell disorder, including heavy chain deposition disease.
Evaluation of Risk of Cardiac or Cerebrovascular Events in Romosozumab Users Focusing on Comorbidities: Analysis of the Japanese Adverse Drug Event Report Database
Authors: Kotake Kazumasa , Mitsuboshi Satoru , Omori Yuki , Kawakami Yukio , Kawakami Yasuhiro
Published: December 2022

Background: Romosozumab is associated with an increased risk of cardiac or cerebrovascular events. Identifying the risk factors for these events could contribute to the safe use of romosozumab. Objective: This study aimed to investigate risk factors for cardiac or cerebrovascular events in romosozumab users. Methods: First, disproportionality analysis was performed to compare the frequency of cardiac or cerebrovascular events, using data from the Japanese Adverse Drug Event Report database. Next, multivariate logistic analysis was performed to investigate risk factors for cardiac or cerebrovascular events in romosozumab users. Results: In total, 859 romosozumab users were identified. A disproportionality of both cardiac and cerebrovascular events was observed in only romosozumab users. Multivariate logistic analysis revealed that the risk of cardiac events in romosozumab users was significantly increased in patients with cardiac disease (odds ratio [OR]: 5.9, 95% confidence interval [CI] 3.5-9.9; P < 0.01) and hypertension (OR: 1.6, 95% CI 1.0-2.7; P = 0.047). In addition, the risk of cerebrovascular events in romosozumab users was significantly increased in the presence of cerebrovascular disease (OR: 2.7, 95% CI 1.2-6.2; P = 0.02) and hypertension (OR: 2.6, 95% CI 1.7-3.9; P < 0.01). Conclusion: Our findings suggest that hypertension may increase the risk of cardiac or cerebrovascular events in romosozumab users. Although additional studies are needed to assess other associated factors, these findings may contribute to the appropriate use of romosozumab and limit adverse events.
External control arm analysis: an evaluation of propensity score approaches, G-computation, and doubly debiased machine learning
Authors: Loiseau Nicolas , Trichelair Paul , He Maxime , Andreux Mathieu , Zaslavskiy Mikhail , Wainrib Gilles , Blum Michael G. B.
Published: December 2022

Background

An external control arm is a cohort of control patients that are collected from data external to a single-arm trial. To provide an unbiased estimation of efficacy, the clinical profiles of patients from single and external arms should be aligned, typically using propensity score approaches. There are alternative approaches to infer efficacy based on comparisons between outcomes of single-arm patients and machine-learning predictions of control patient outcomes. These methods include G-computation and Doubly Debiased Machine Learning (DDML) and their evaluation for External Control Arms (ECA) analysis is insufficient.

Methods

We consider both numerical simulations and a trial replication procedure to evaluate the different statistical approaches: propensity score matching, Inverse Probability of Treatment Weighting (IPTW), G-computation, and DDML. The replication study relies on five type 2 diabetes randomized clinical trials granted by the Yale University Open Data Access (YODA) project. From the pool of five trials, observational experiments are artificially built by replacing a control arm from one trial by an arm originating from another trial and containing similarly-treated patients.

Results

Among the different statistical approaches, numerical simulations show that DDML has the smallest bias followed by G-computation. In terms of mean squared error, G-computation usually minimizes mean squared error. Compared to other methods, DDML has varying Mean Squared Error performances that improves with increasing sample sizes. For hypothesis testing, all methods control type I error and DDML is the most conservative. G-computation is the best method in terms of statistical power, and DDML has comparable power at$$n=1000$$n=1000but inferior ones for smaller sample sizes. The replication procedure also indicates that G-computation minimizes mean squared error whereas DDML has intermediate performances in between G-computation and propensity score approaches. The confidence intervals of G-computation are the narrowest whereas confidence intervals obtained with DDML are the widest for small sample sizes, which confirms its conservative nature.

Conclusions

For external control arm analyses, methods based on outcome prediction models can reduce estimation error and increase statistical power compared to propensity score approaches.
Marital transition and cognitive function among older adults: the korean Longitudinal Study of Aging (2006–2020)
Authors: Nerobkova Nataliya , Park Yu Shin , Shin Jaeyong , Park Eun-Cheol
Published: December 2022

Background

Marital status has been suggested as an associated factor for cognitive impairment. The consequences of marital transitions are still understudied. This study evaluated the influence of marital transitions on cognitive function using longitudinal, nationwide data of Korean older adults.

Methods

This research comprised a longitudinal sample of older adults aged ≥ 45 years old, drawn from the Korean Longitudinal Study of Aging (2006–2020). Marital transition was determined through the biennial assessment of change in marital status; cognitive function was measured using the Korean version of the Mini-Mental State Examination. We employed general estimating equations to assess the temporal effect of marital transition on cognitive function.

Results

Compared to married individuals, the odds ratios (ORs) of cognitive decline were higher in not married and transitioned out of marriage participants: men (OR 1.32, 95% confidence interval (CI) 0.96–1.82; OR 1.42, 95% CI 0.90–2.24), women (OR 1.21, 95% CI 1.03–1.42; OR 1.20, 95% CI 1.01–1.52), respectively, despite the findings being not statistically significant in men. The participants who transitioned out of marriage over time also showed greater ORs for mild cognitive impairment: men (OR 1.39, 95% CI 0.79–1.87), women (OR 1.33, 95% CI 1.05–1.80), and dementia: men (OR 1.60, 95% CI 0.85–1.99), women: (OR 1.49, 95% CI 1.20–2.19).

Conclusion

Marital transition is found to be associated with cognitive function decline. Not-married individuals and those who became divorced or widowed were associated with the risk of cognitive function decline. Particular attention should be paid to these marital transitioned groups.
Ntrk1 promotes mesangial cell proliferation and inflammation in rat glomerulonephritis model by activating the STAT3 and p38/ERK MAPK signaling pathways
Authors: Dong Xiongjun , Tang Yingchun
Published: December 2022

Background

Mesangial proliferative glomerulonephritis (MsPGN) accounts for a main cause of chronic kidney disease (CKD), chronic renal failure and uremia. This paper aimed to examine the effect of Ntrk1 on MsPGN development, so as to identify a novel therapeutic target for MsPGN.

Methods

The MsPGN rat model was constructed by single injection of Thy1.1 monoclonal antibody via the tail vein. Additionally, the Ntrk1 knockdown rat model was established by injection of Ntrk1-RNAi lentivirus via the tail vein. Periodic acid-schiff staining and immunohistochemistry (IHC) were performed on kidney tissues. Moreover, the rat urinary protein was detected. Mesangial cells were transfected and treated with p38 inhibitor (SB202190) and ERK inhibitor (PD98059). Meanwhile, the viability and proliferation of mesangial cells were analyzed by cell counting kit-8 (CCK-8) and 5-Ethynyl-2′-deoxyuridine assays. Gene expression was detected by quantitative real-time polymerase chain reaction (qRT-PCR) and Western-blot (WB) assays.

Results

The proliferation of mesangial cells was enhanced in glomerulus and Ki67 expression was up-regulated in renal tubule of MsPGN rats. The urine protein level increased in MsPGN rats. Pro-inflammatory factors and Ntrk1 expression were up-regulated in glomerulus of MsPGN rats. Ntrk1 up-regulation promoted the viability, proliferation, expression of pro-inflammatory factors and activation of the STAT3, p38 and ERK signaling pathways in mesangial cells. Ntrk1 knockdown reduced mesangial cell proliferation, urine protein, pro-inflammatory factors, activation of STAT3, p38 and ERK signaling pathways in glomerulus, and decreased Ki67 expression in renal tubule of MsPGN rats. Treatment with SB202190 and PD98059 reversed the effect of Ntrk1 on promoting the viability, proliferation and inflammatory response of mesangial cells.

Conclusion

Ntrk1 promoted mesangial cell proliferation and inflammation in MsPGN rats by activating the STAT3 and p38/ERK MAPK signaling pathways.
Pertussis and influenza immunization: perceived attitude and decision of postpartum patients
Authors: Hebballi Nutan B. , Parker Tayler , Garcia Elisa I. , Ferguson Dalya M. , Lesser Susan , Tsao KuoJen , Broussard Maryam , Wootton Susan H.
Published: December 2022

Background

Vaccination of pregnant patients with tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) and influenza vaccine during influenza season can reduce maternal and fetal morbidity and mortality; nevertheless, vaccination rates remain suboptimal in this patient population. To investigate the effect of a brief educational counseling session on maternal Tdap and influenza vaccination and determine factors influencing women’s decision in regards to receiving Tdap and or influenza vaccine during their pregnancy.

Methods

A face-to-face semi-structured cross-sectional survey was administered to postpartum patients on their anticipated day of discharge (June 11-August 21, 2018). A brief educational counseling session about maternal pertussis and Tdap vaccine was provided to interested patients after which the Tdap vaccine was offered to eligible patients who did not receive it during their pregnancy or upon hospital admission. Medical records were reviewed to determine if surveyed patients were vaccinated prior to discharge.

Results

Two hundred postpartum patients were surveyed on their day of anticipated discharge. Of those who were surveyed, 103 (51.5%) had received Tdap and 80 (40.0%) had received influenza vaccinations prior to hospitalization. Among immunized patients, the common facilitators were doctor’s recommendation (Tdap: 68, 54.4%; influenza: 3, 6.0%), to protect their baby (Tdap: 57, 45.6%; influenza: 17, 34.0%) and for self-protection (Tdap: 17, 13.6%; Influenza: 17, 34.0%). Of the 119 participants who had not received either Tdap or influenza vaccine prior to the survey, the barriers cited were that the vaccine was not offered by the provider (Tdap: 36, 52.2%; influenza: 29, 27.6%), belief that vaccination was unnecessary (Tdap: 5, 7.2%; influenza: 9, 8.5%), safety concerns for baby (Tdap: 4, 5.8%; influenza: 2, 1.9%). Of 97 patients who were not immunized with Tdap prior to admission but were eligible to receive vaccine, 24 (25%) were vaccinated prior to survey as part of routine hospital-based screening and vaccination program, 29 (38.2%) after our survey.

Conclusion

Interventions to educate pregnant patients about the benefits of vaccination for their baby, addressing patient safety concerns, and vaccine administration in obstetricians’ offices may significantly improve maternal vaccination rates.
Neoadjuvant docetaxel and capecitabine (TX) versus docetaxel and epirubicin (TE) for locally advanced or early her2-negative breast cancer: an open-label, randomized, multi-center, phase II Trial
Authors: Yang Houpu , Xu Ling , Guan Shan , Hao Xiaopeng , Ge Zhicheng , Tong Fuzhong , Cao Yingming , Liu Peng , Zhou Bo , Cheng Lin , Liu Miao , Liu Hongjun , Xie Fei , Wang Siyuan , Peng Yuan , Wang Chaobin , Wang Shu
Published: December 2022

Purpose

The combination of taxanes and anthracyclines is still the mainstay of chemotherapy for early breast cancer. Capecitabine is an active drug with a favorable toxicity profile, showing strong anti-tumor activity against metastatic breast cancer. This trial assessed the efficacy and safety of the TX regimen (docetaxel and capecitabine) and compared it with the TE (docetaxel and epirubicin) regimen in locally advanced or high risk early HER2-negative breast cancer.

Patients and methods

This randomized clinical trial was conducted at five academic centers in China. Eligible female patients were randomly assigned (1:1) to the TX (docetaxel 75 mg/m2 d1 plus capecitabine 1000 mg/m2 twice d1–14, q3w) or TE (docetaxel 75 mg/m2 d1 plus epirubicin 75 mg/m2 d1, q3w) groups for four cycles. The primary endpoint was a pathological complete response in the breast (pCR). Secondary endpoints included pCR in the breast and axilla, invasive disease-free survival (iDFS), overall survival (OS), and safety.

Results

Between September 1, 2012, and December 31, 2018, 113 HER2-negative patients were randomly assigned to the study groups (TX: n = 54; TE: n = 59). In the primary endpoint analysis, 14 patients in the TX group achieved a pCR, and nine patients in the TE group achieved a pCR (25.9% vs. 15.3%), with a not significant difference of 10.6% (95% CI -6.0–27.3%; P = 0.241). In a subgroup with high Ki-67 score, TX increased the pCR rate by 24.2% (95% CI 2.2–46.1%; P = 0.029). At the end of the 69-month median follow-up period, both groups had equivalent iDFS and OS rates. TX was associated with a higher incidence of hand-foot syndrome and less alopecia, with a manageable toxicity profile.

Conclusion

The anthracycline-free TX regimen yielded comparable pCR and long-term survival rates to the TE regimen. Thus, this anthracycline-free regimen could be considered in selected patients.

Trial Registration

ACTRN12613000206729 on 21/02/2013, retrospectively registered.
Choroidal melanoma tumor profile and treatment pattern for newly diagnosed patients at a reference public hospital in Sao Paulo, Brazil
Authors: Fernandes Arthur Gustavo , Tavares Jorge Henrique Cavalcante , Branco Ana Marisa Castello , Morales Melina Correa , Belfort Neto Rubens
Published: December 2022

Background

Choroid, ciliary body, and iris melanomas are often grouped as uveal melanoma, the most common intraocular primary malignancy. The purpose of the current study was to analyze the tumor profile of newly diagnosed cases of choroidal melanoma at a reference center in Sao Paulo, Brazil, and to investigate the frequency of eyes treated by enucleation that could have been treated with brachytherapy if available in the service.

Methods

Medical records of patients referred to our service with initial diagnostic hypothesis of choroidal melanoma from July 2014 to June 2020 were analysed on demographics, diagnosis confirmation, tumor measurement by ultrasonography and established treatment. Data were evaluated on clinical and demographic characteristics as age, sex, affected eye, ultrasound parameters, and treatment management of patients with clinically diagnosed choroidal melanoma. Among the patients submitted to enucleation, we investigated how many could have been selected to receive brachytherapy.

Results

From the 102 patients referred with the choroidal melanoma diagnosis hypothesis, 70 (68.62%) were confirmed. Mean measurements from the tumors in millimetres were: 9.19 ± 3.69 at height and 12.97 ± 3.09 by 13.30 ± 3.30 at basal. A total of 48 cases (68.57%) were enucleated, 8 (11.43%) were treated by brachytherapy in a different service, and 14 patients (20.00%) returned for enucleation at their original referral center. Out of the 48 patients enucleated, 26 (54.17%) could have been selected to brachytherapy treatment.

Conclusions

The results indicate a late diagnosis of choroidal melanoma cases referred to our service. Most enucleated cases could have been treated with brachytherapy if it was broadly available at the national public health insurance. Further public health political efforts should focus on early diagnosis and better quality of life post-treatment for oncologic patients.
NB housing study protocol: investigating the relationship between subsidized housing, mental health, physical health and healthcare use in New Brunswick, Canada
Authors: Woodhall-Melnik J. , Dunn J. R. , Dweik I. , Monette C. , Nombro E. , Pappas J. , Lamont A. , Dutton D. , Doucet S. , Luke A. , Matheson F. I. , Nisenbaum R. , Stergiopoulos V. , Stewart C.
Published: December 2022

Background

Income and housing are pervasive social determinants of health. Subsidized housing is a prominent affordability mechanism in Canada; however, waitlists are lengthy. Subsidized rents should provide greater access to residual income, which may theoretically improve health outcomes. However, little is known about the health of tenants who wait for and receive subsidized housing. This is especially problematic for New Brunswick, a Canadian province with low population density, whose inhabitants experience income inequality, social exclusion, and challenges with healthcare access. 

Methods

This study will use a longitudinal, prospective matched cohort design. All 4,750 households on New Brunswick’s subsidized housing wait list will be approached to participate. The survey measures various demographic, social and health indicators at six-month intervals for up to 18 months as they wait for subsidized housing. Those who receive housing will join an intervention group and receive surveys for an additional 18 months post-move date. With consent, participants will have their data linked to a provincial administrative database of medical records. 

Discussion

Knowledge of housing and health is sparse in Canada. This study will provide stakeholders with a wealth of health information on a population that is historically under-researched and underserved.