bluuebunny/crossref_metadata_2025 huggingface dataset:
Influenza vaccine uptake among at-risk adults (aged 16–64 years) in the UK: a retrospective database analysis
Authors: Oakley Simon , Bouchet Julien , Costello Paul , Parker James
Published: September 2021

Background

In the UK, annual influenza vaccination is currently recommended for adults aged 16–64 years who are in a clinical at-risk group. Despite recommendations, rates of vaccine uptake in the UK have historically been low and below national and international targets. This study aims to analyse vaccine uptake among adults in clinical at-risk groups from the 2015–2016 influenza season to the present.

Methods

A retrospective analysis of influenza vaccine coverage in the UK was conducted using data extracted from publicly available sources. Clinically at-risk individuals (as defined by Public Health England), including pregnant women, aged 16–64 years, were included in this study.

Results

Influenza vaccination coverage rates across the UK in adults aged 16–64 years in a clinical at-risk group have been consistently low over the past 5 years, with only 48.0, 42.4, 44.1 and 52.4% of eligible patients in England, Scotland, Wales and Northern Ireland receiving their annual influenza vaccination during the 2018–2019 influenza season. Influenza vaccine coverage was lowest in patients with morbid obesity and highest in patients with diabetes in 2018–2019. Coverage rates were below current national ambitions of ≥75% in all clinical risk groups. In these clinical at-risk groups, influenza vaccine coverage decreased between 2015 and 2019, and there was considerable regional variation.

Conclusions

Uptake of the influenza vaccine by adults aged 16–64 years in a clinical at-risk group was substantially below the national ambitions. As a result, many individuals in the UK remain at high risk of developing severe influenza or complications. Given that people who are vulnerable to COVID-19 are also at increased risk of complications from influenza, during the 2020–2021 season, there is a heightened need for healthcare professionals across the UK to address suboptimal vaccine uptake, particularly in at-risk patients. Healthcare professionals and policymakers should consider measures targeted at increasing access to and awareness of the clinical benefits of the influenza vaccine.
Social media use and social connectedness among adolescents in the United Kingdom: a qualitative exploration of displacement and stimulation
Authors: Winstone Lizzy , Mars Becky , Haworth Claire M. A. , Kidger Judi
Published: September 2021

Background

Connectedness to family and peers is a key determinant of adolescent mental health. Existing research examining associations between social media use and social connectedness has been largely quantitative and has focused primarily on loneliness, or on specific aspects of peer relationships. In this qualitative study we use the displacement hypothesis and the stimulation hypothesis as competing theoretical lenses through which we examine the complex relationship between social media use and feelings of connectedness to family and peers.

Methods

In-depth paired and individual interviews were conducted with twenty-four 13–14-year-olds in two inner-city English secondary schools. Interviews were transcribed verbatim, coded and thematically analysed.

Results

Analysis identified four themes: (i) ‘Displacement of face-to-face socialising’ (ii) ‘Social obligations’ (iii) ‘(Mis)Trust’ and (iv) ‘Personal and group identity’. Results indicated stronger support for the stimulation hypothesis than the displacement hypothesis. We found evidence of a complex set of reciprocal and circular relationships between social media use and connectedness consistent with a ‘rich-get-richer’ and a ‘poor-get-poorer’ effect for family and peer connectedness – and a ‘poor-get-richer’ effect in peer connectedness for those who find face-to-face interactions difficult.

Conclusion

Our findings suggest that parents should take a measured approach to social media use, providing clear guidance, promoting trust and responsible time management, and acknowledging the role of social media in making connections. Understanding and sharing in online experiences is likely to promote social connectedness. Supporting young people to negotiate breathing space in online interactions and prioritising trust over availability in peer relationships may optimise the role of social media in promoting peer connectedness.
Men’s comfort in distributing or receiving HIV self-test kits from close male social network members in Dar Es Salaam, Tanzania: baseline results from the STEP project
Authors: Matovu Joseph K. B. , Mbita Gaspar , Hamilton Akeen , Mhando Frank , Sims Wynton M. , Thompson Noah , Komba Albert N. , Lija Jackson , Zhang Jiajia , van den Akker Thomas , Duncan Dustin T. , Choko Augustine T. , Conserve Donaldson F.
Published: September 2021

Background

A variety of strategies have been used to reach men with HIV self-testing services, including social network-based HIV self-test kits distribution. However, few studies have assessed men’s comfort to distribute to or receive HIV self-test kits from close male friends within the same social network. In this study, we assessed men’s comfort to distribute to and/or receive HIV self-test kits from close male friends and associated factors among men who socialize in networks locally referred to as “camps” in Tanzania.

Methods

Data are from the baseline survey of a cluster-randomized controlled trial conducted in June 2019 with 18 social networks or “camps” in Dar es Salaam, Tanzania. Participants were 18-year-old or older male camp members who were HIV-negative at the time of enrolment. We used the Generalized Estimating Equations (GEE) to assess factors associated with being comfortable to distribute to and/or receive HIV self-test kits from close male members within one’s social network.

Results

Of 505 participants, 67.9% (n = 342) reported being comfortable to distribute to while 68.2% (n = 344) were comfortable to receive HIV self-test kits from their close male friends. Ever having heard about HIV self-testing (Adjusted Prevalence Ratio (Adj. PR): 1.6; 95% Confidence Interval [CI]: 1.3, 1.9), willingness to self-test for HIV in front of a sexual partner (Adj. PR: 3.0; 95%CI: 1.5, 6.1) and exposure to peer-led HIV self-testing education and promotion (Adj. PR: 1.4; 95%CI: 1.2, 1.7) were significantly associated with being comfortable to distribute HIV self-test kits to close male members within one’s social network. Similar results were observed for being comfortable to receive HIV self-test kits from a close male friend within one’s social network.

Conclusions

Overall, these findings suggest that distribution of HIV self-test kits through close male friends could improve the proportion of men reached with HIV self-testing services and improve HIV testing rates in this population where uptake remains low. However, additional promotional strategies such as peer-led HIV self-testing education are needed to raise awareness and increase the proportion of men who are comfortable to receive and/or distribute HIV self-testing kits.
Efficacy of platelet-rich plasma and plasma for symptomatic treatment of knee osteoarthritis: a double-blinded placebo-controlled randomized clinical trial
Authors: Dório Murillo , Pereira Rosa Maria Rodrigues , Luz Alexandre Galeno Branco , Deveza Leticia Alle , de Oliveira Ricardo Manoel , Fuller Ricardo
Published: September 2021

Background

Platelet-rich plasma (PRP) has a still conflicting efficacy for knee osteoarthritis (KOA) and might be a minimally invasive and safe treatment alternative. The potential benefit of only plasma (non-enriched) has never been investigated. Our aim was to evaluate the efficacy of intra-articular platelet-rich plasma (PRP) and plasma to improve pain and function in participants with KOA over 24 weeks.

Methods

Randomized, double-blind, placebo-controlled trial with 3 groups (n = 62): PRP (n = 20), plasma (n = 21) and saline (n = 21). Two ultrasound-guided knee injections were performed with a 2-week interval. The primary outcome was visual analog scale 0-10 cm (VAS) for overall pain at week 24, with intermediate assessments at weeks 6 and 12. Main secondary outcomes were: KOOS, OMERACT-OARSI criteria and TUGT.

Results

At baseline, 92% of participants were female, with a mean age of 65 years, mean BMI of 28.0 Kg/m2and mean VAS pain of 6.2 cm. Change in pain from baseline at week 24 were -2.9 (SD 2.5), -2.4 (SD 2.5) and -3.5 cm (SD 3.3) for PRP, plasma and saline, respectively (p intergroup = 0.499). There were no differences between the three groups at weeks 6 and 12. Similarly, there were no differences between groups regarding secondary outcomes. The PRP group showed higher frequency of adverse events (65% versus 24% and 33% for plasma and saline, respectively, p = 0.02), mostly mild transitory increase in pain.

Conclusions

PRP and plasma were not superior to placebo for pain and function improvement in KOA over 24 weeks. The PRP group had a higher frequency of mild transitory increase in pain.

Trial registration

ClinicalTrials.gov, NCT03138317, 03/05/2017.
Different concentrations of C5a affect human dental pulp mesenchymal stem cells differentiation
Authors: Liu Jie , Wei Xiaoling , Hu Junlong , Tan Xiaohan , Kang Xiaocui , Gao Li , Li Ning , Shi Xin , Yuan Mengtong , Hu Weiping , Liu Mingyue
Published: September 2021

Background

During the process of deep decay, when decay approaches the pulp, an immune response is triggered inside the pulp, which activates the complement cascade. The effect of complement component 5a (C5a) on the differentiation of dental pulp mesenchymal stem cells (DPSCs) is related to dentin reparation. The aim of the present study was to stimulate DPSCs with different concentrations of C5a and evaluate the differentiation of odontoblasts using dentin sialoprotein (DSP).

Methods

DPSCs were divided into the following six groups: (i) Control; (ii) DPSCs treated with 50 ng/ml C5a; (iii) DPSCs treated with 100 ng/ml C5a; (iv) DPSCs treated with 200 ng/ml C5a; (v) DPSCs treated with 300 ng/ml C5a; and (vi) DPSCs treated with 400 ng/ml C5a. Flow cytometry and multilineage differentiation potential were used to identify DPSCs. Mineralization induction, Real-time PCR and Western blot were conducted to evaluate the differentiation of odontoblast in the 6 groups.

Result

DPSCs can express mesenchymal stem cell markers, including CD105, CD90, CD73 and, a less common marker, mesenchymal stromal cell antigen-1. In addition, DPSCs can differentiate into adipocytes, neurocytes, chondrocytes and odontoblasts. All six groups formed mineralized nodules after 28 days of culture. Reverse transcription-quantitative PCR and western blotting indicated that the high concentration C5a groups expressed higher DSP levels and promoted DPSC differentiation, whereas the low concentration C5a groups displayed an inhibitory effect.

Conclusion

In this study, the increasing concentration of C5a, which accompanies the immune process in the dental pulp, has demonstrated an enhancing effect on odontoblast differentiation at higher C5a concentrations in vitro.
Interprofessional education on complex patients in nursing homes: a focus group study
Authors: Svensberg K. , Kalleberg B. G. , Rosvold E. O. , Mathiesen L. , Wøien H. , Hove L. H. , Andersen R. , Waaktaar T. , Schultz H. , Sveaass N. , Hellesö R.
Published: September 2021

Background

An ageing population leads up to increasing multi-morbidity and polypharmacy. This demands a comprehensive and interprofessional approach in meeting patients’ complex needs. This study describes graduate students’ experiences of working practice based in interprofessional teams with complex patients’ care needs in nursing homes.

Method

Students from advanced geriatric nursing, clinical nutrition, dentistry, medicine and pharmacy at the University of Oslo in Norway were assigned to groups to examine and develop a care plan for a nursing home patient during a course. Focus groups were used, 21 graduate students participating in four groups. Data were collected during spring 2018, were inductively analysed according to a thematic analysis method (Systematic Text Condensation). An analytical framework of co-ordination practices was applied to get an in-depth understanding of the data.

Results

Three themes were identified: 1) Complex patients as learning opportunities- an eye-opener for future interprofessional collaboration 2) A cobweb of relations, and 3) Structural facilitators for new collective knowledge. Graduate university students experienced interprofessional education (IPE) on complex patients in nursing homes as a comprehensive learning arena. Overall, different co-ordination practices for work organization among the students were identified.

Conclusions

IPE in nursing homes facilitated the students’ scope from a fragmented approach of the patients towards a relational and collaborative practice that can improve patient care and strengthen understanding of IPE. The study also demonstrated the need for preparatory teamwork training to gain maximum benefit from the experience. Something that can be organized by the education institutions in the form of a stepwise learning module and as an online pre-training course in interprofessional teamwork. Further, focusing on the need for well thought through processes of the activity by the institutions and the timing the practice component in students’ curricula. This could ensure that IPE is experienced more efficient by the students.
Applying nonlinear measures to the brain rhythms: an effective method for epilepsy diagnosis
Authors: Torabi Ali , Daliri Mohammad Reza
Published: September 2021

Background

Epilepsy is a neurological disorder from which almost 50 million people have been suffering. These statistics indicate the importance of epilepsy diagnosis. Electroencephalogram (EEG) signals analysis is one of the most common methods for epilepsy characterization; hence, various strategies were applied to classify epileptic EEGs.

Methods

In this paper, four different nonlinear features such as Fractal dimensions including Higuchi method (HFD) and Katz method (KFD), Hurst exponent, and L-Z complexity measure were extracted from EEGs and their frequency sub-bands. The features were ranked later by implementing Relieff algorithm. The ranked features were applied sequentially to three different classifiers (MLPNN, Linear SVM, and RBF SVM).

Results

According to the dataset used for this study, there are five classification problems named ABCD/E, AB/CD/E, A/D/E, A/E, and D/E. In all cases, MLPNN was the most accurate classifier. Its performances for mentioned classification problems were 99.91%, 98.19%, 98.5%, 100% and 99.84%, respectively.

Conclusion

The results demonstrate that KFD is the highest-ranking feature; In addition, beta and theta sub-bands are the most important frequency bands because, for all cases, the top features were KFDs extracted from beta and theta sub-bands. Moreover, high levels of accuracy have been obtained just by using these two features which reduce the complexity of the classification.
Large-scale data analysis for robotic yeast one-hybrid platforms and multi-disciplinary studies using GateMultiplex
Authors: Tsai Ni-Chiao , Hsu Tzu-Shu , Kuo Shang-Che , Kao Chung-Ting , Hung Tzu-Huan , Lin Da-Gin , Yeh Chung-Shu , Chu Chia-Chen , Lin Jeng-Shane , Lin Hsin-Hung , Ko Chia-Ying , Chang Tien-Hsien , Su Jung-Chen , Lin Ying-Chung Jimmy
Published: September 2021

Background

Yeast one-hybrid (Y1H) is a common technique for identifying DNA-protein interactions, and robotic platforms have been developed for high-throughput analyses to unravel the gene regulatory networks in many organisms. Use of these high-throughput techniques has led to the generation of increasingly large datasets, and several software packages have been developed to analyze such data. We previously established the currently most efficient Y1H system, meiosis-directed Y1H; however, the available software tools were not designed for processing the additional parameters suggested by meiosis-directed Y1H to avoid false positives and required programming skills for operation.

Results

We developed a new tool named GateMultiplex with high computing performance using C++. GateMultiplex incorporated a graphical user interface (GUI), which allows the operation without any programming skills. Flexible parameter options were designed for multiple experimental purposes to enable the application of GateMultiplex even beyond Y1H platforms. We further demonstrated the data analysis from other three fields using GateMultiplex, the identification of lead compounds in preclinical cancer drug discovery, the crop line selection in precision agriculture, and the ocean pollution detection from deep-sea fishery.

Conclusions

The user-friendly GUI, fast C++ computing speed, flexible parameter setting, and applicability of GateMultiplex facilitate the feasibility of large-scale data analysis in life science fields.
Control of vein-forming, striped gene expression by auxin signaling
Authors: Krishna Anmol , Gardiner Jason , Donner Tyler J. , Scarpella Enrico
Published: September 2021

Background

Activation of gene expression in striped domains is a key building block of biological patterning, from the recursive formation of veins in plant leaves to that of ribs and vertebrae in our bodies. In animals, gene expression is activated in striped domains by the differential affinity of broadly expressed transcription factors for their target genes and the combinatorial interaction between such target genes. In plants, how gene expression is activated in striped domains is instead unknown. We address this question for the broadly expressed MONOPTEROS (MP) transcription factor and its target gene ARABIDOPSIS THALIANA HOMEOBOX FACTOR8 (ATHB8).

Results

We find that ATHB8 promotes vein formation and that such vein-forming function depends on both levels of ATHB8 expression and width of ATHB8 expression domains. We further find that ATHB8 expression is activated in striped domains by a combination of (1) activation of ATHB8 expression through binding of peak levels of MP to a low-affinity MP-binding site in the ATHB8 promoter and (2) repression of ATHB8 expression by MP target genes of the AUXIN/INDOLE-3-ACETIC-ACID-INDUCIBLE family.

Conclusions

Our findings suggest that a common regulatory logic controls activation of gene expression in striped domains in both plants and animals despite the independent evolution of their multicellularity.
Elevated risk of attention deficit hyperactivity disorder (ADHD) in Japanese children with higher genetic susceptibility to ADHD with a birth weight under 2000 g
Authors: Rahman Md Shafiur , Takahashi Nagahide , Iwabuchi Toshiki , Nishimura Tomoko , Harada Taeko , Okumura Akemi , Takei Nori , Nomura Yoko , Tsuchiya Kenji J.
Published: September 2021

Background

Both genetic and pre- and perinatal factors, including birth weight, have been implicated in the onset of attention deficit hyperactivity disorder (ADHD) traits among children. This study aimed to elucidate to what extent the genetic risk of ADHD moderates the association between birth weight and ADHD traits among Japanese children.

Methods

We conducted a longitudinal birth cohort study (Hamamatsu Birth Cohort for Mother and Children Study) to investigate the association of genetic risk for ADHD and low birth weight with ADHD traits among Japanese children. Out of 1258 children, we included 796 who completed follow-ups at 8 to 9 years of age. Birth weight was categorized as <2000 g, 2000–2499 g, and ≥2500 g. Polygenic risk score for ADHD was generated using the summary data of a large-scale genome-wide association study. The Rating Scale IV (ADHD-RS) assessed ADHD traits (inattention and hyperactivity/impulsivity) based on parental reports. Following previous studies, sex, birth order of the child, gestational age at birth, mother’s age at delivery, educational attainment, pre-pregnancy body mass index, pre-pregnancy or during pregnancy smoking status, alcohol consumption during pregnancy, father’s age, education, and annual family income were considered as covariates. Multivariable negative binomial regression was applied to evaluate the association between birth weight and ADHD traits, while adjusting for potential covariates. The interaction term between birth weight categories and binary polygenic risk was added to the model.

Results

Birth weight of 2000–2499 g was not associated with ADHD traits. Birth weight under 2000 g was significantly associated with both inattention and hyperactivity. When accounting for higher and lower genetic risk for ADHD, only those with higher genetic risk and birth weight < 2000 g were associated with inattention (rate ratio [RR] 1.56, 95% CI 1.07–2.27) and hyperactivity (RR 1.87, 95% CI 1.14–3.06).

Conclusions

Birth weight under 2000 g, together with the genetic risk of ADHD, contributes to higher levels of ADHD traits among Japanese children aged 8 to 9 years. The suggested association between low birth weight and ADHD is confined to children with a genetic susceptibility to ADHD, indicating the relevance of genetic-environmental interactions in the etiology.
Prognostic impact of liver fibrosis and steatosis by transient elastography for cardiovascular and mortality outcomes in individuals with nonalcoholic fatty liver disease and type 2 diabetes: the Rio de Janeiro Cohort Study
Authors: Cardoso Claudia R. L. , Villela-Nogueira Cristiane A. , Leite Nathalie C. , Salles Gil F.
Published: September 2021

Background

Liver stiffness measurement (LSM, which reflects fibrosis) and controlled attenuation parameter (CAP, which reflects steatosis), two parameters derived from hepatic transient elastography (TE), have scarcely been evaluated as predictors of cardiovascular complications and mortality in individuals with type 2 diabetes and nonalcoholic fatty liver disease (NAFLD).

Methods

Four hundred type 2 diabetic patients with NAFLD had TE examination (by Fibroscan®) performed at baseline. Multivariate Cox analyses evaluated the associations between TE parameters and the occurrence of cardiovascular events (CVEs) and mortality. TE parameters were assessed as continuous variables and dichotomized at low/high values reflecting advanced liver fibrosis (LSM > 9.6 kPa) and severe steatosis (CAP > 296 or > 330 dB/m). Improvements in risk discrimination were assessed by C-statistic and by the relative Integrated Discrimination Improvement (IDI) index.

Results

During a median follow-up of 5.5 years, 85 patients died (40 from cardiovascular causes), and 69 had a CVE. As continuous variables, an increasing LSM was a risk marker for total CVEs (hazard ratio [HR]: 1.05; 95% CI: 1.01–1.08) and all-cause mortality (HR: 1.04; 95% CI: 1.01–1.07); whereas an increasing CAP was a protective factor for both outcomes (HR: 0.93; 95% CI: 0.89–0.98; and HR: 0.92; 95% CI: 0.88–0.97; respectively). As dichotomized variables, a high LSM remained a risk marker of adverse outcomes (with HRs ranging from 2.5 to 3.0) and a high CAP was protective (with HRs from 0.3 to 0.5). The subgroup of individuals with low-LSM/high-CAP had the lowest risks while the opposite subgroup with high-LSM/low-CAP had the highest risks. Both LSM and CAP improved risk discrimination, with increases in C-statistics up to 0.037 and IDIs up to 52%.

Conclusions

Measured by hepatic TE, advanced liver fibrosis is a risk marker and severe steatosis is a protective factor for cardiovascular complications and mortality in individuals with type 2 diabetes and NAFLD.
MEST promotes lung cancer invasion and metastasis by interacting with VCP to activate NF-κB signaling
Authors: Wang Yang , Zhang Jing , Li Yang-Jia , Yu Nan-Nan , Liu Wan-Ting , Liang Jun-Ze , Xu Wen Wen , Sun Zheng-Hua , Li Bin , He Qing-Yu
Published: September 2021

Background

Cell invasion is a hallmark of metastatic cancer, leading to unfavorable clinical outcomes. In this study, we established two highly invasive lung cancer cell models (A549-i8 and H1299-i8) and identified mesoderm-specific transcript (MEST) as a novel invasive regulator of lung cancer. We aim to characterize its biological function and clinical significance in lung cancer metastasis.

Methods

Transwell invasion assay was performed to establish high-invasive lung cancer cell model. Immunohistochemistry (IHC) was used to detect MEST expression in tumor tissues. Mass spectrometry and bioinformatic analyses were used to identify MEST-regulated proteins and binding partners. Co-immunoprecipitation assay was performed to detect the interaction of MEST and VCP. The biological functions of MEST were investigated in vitro and in vivo. Immunofluorescence staining was conducted to explore the colocalization of MEST and VCP.

Results

MEST overexpression promoted metastasis of lung cancer cells in vivo and in vitro by activating NF-κB signaling. MEST increased the interaction between VCP and IκBα, which accelerated IκBα degradation and NF-κB activation. Such acceleration was abrogated by VCP silencing, indicating that MEST is an upstream activator of the VCP/IκBα/NF-κB signaling pathway. Furthermore, high expressions of MEST and VCP were associated with poor survival of lung cancer patients.

Conclusion

Collectively, these results demonstrate that MEST plays an important role in driving invasion and metastasis of lung cancer by interacting with VCP to coordinate the IκBα/NF-κB pathway. Targeting the MEST/VCP/IκBα/NF-κB signaling pathway may be a promising strategy to treat lung cancer.
Review of English pastoral: An inheritance by James Rebanks
Authors: Kerr Brian
Published: September 2021

Book details

Rebanks, J

English Pastoral: An Inheritance

Penguin Random House, 2020

286 pages, ISBN: 978-0-241-24572-9
Burkitt-type lymphoma incidentally found as the cause of acute appendicitis: a case report and review of literature
Authors: Shahmanyan Davit , Saway Brian , Palmerton Hannah , Rudderow John S. , Reed Christopher M. , Wattsman Terri-Ann , Faulks Emily R. , Collier Bryan R. , Budin Robert E. , Hamill Mark E.
Published: September 2021

Background

Appendectomy remains one of the most common emergency operations. Recent research supports the treatment of uncomplicated appendicitis with antibiotics alone. While nonoperative management of appendicitis may be safe in some patients, it may result in missed neoplasms. We present a case of acute appendicitis where the final pathology resulted in a diagnosis of a Burkitt-type lymphoma.

Case presentation

An 18-year-old male presented to the emergency department with 24 h of right lower quadrant pain with associated urinary retention, anorexia, and malaise. Past medical history was significant for intermittent diarrhea and anal fissure. He exhibited focal right lower quadrant tenderness. Workup revealed leukocytosis and CT uncovered acute appendicitis with periappendiceal abscess and no appendicolith. Laparoscopic appendectomy was performed and found acute appendicitis with associated abscess abutting the rectum and bladder. Pathology of the resected appendix reported acute appendicitis with evidence of Burkitt-type lymphoma. A PET scan did not reveal any residual disease. Hematology/oncology was consulted and chemotherapy was initiated with an excellent response.

Conclusions

Appendiceal lymphomas constitute less than 0.1% of gastrointestinal lymphomas. Primary appendix neoplasms are found in 0.5–1.0% of appendectomy specimens following acute appendicitis. In this case, appendectomy allowed for prompt identification and treatment of an aggressive, rapidly fatal lymphoma resulting in complete remission.
Psychometric validation of the Female Sexual Distress Scale-Desire/Arousal/Orgasm
Authors: Derogatis Leonard R. , Revicki Dennis A. , Rosen Raymond C. , Jordan Robert , Lucas Johna , Spana Carl
Published: September 2021

Background

For the treatment of female sexual dysfunction, the most relevant outcome measures are patient-reported treatment effects and changes in symptoms, underscoring the need for reliable, validated patient-reported outcome (PRO) instruments. The aim of this study was to evaluate the psychometric characteristics (validity and reliability) of the Female Sexual Distress Scale-Desire/Arousal/Orgasm (FSDS-DAO) PRO measure, which was adapted from the validated FSDS-Revised (FSDS-R) questionnaire and added 2 questions involving arousal and orgasm.

Methods

Psychometric analyses were based on the data from a multicenter phase 2b dose-finding study that compared the safety and efficacy of bremelanotide versus placebo and were conducted in the evaluable modified intent-to-treat population (N = 325) from that study. Psychometric evaluation of the new items in the FSDS-DAO included confirmatory factor analyses, tests of internal consistency and test–retest reliability, examinations of convergent and discriminant validity, and determination of responsiveness. The validity of the FSDS-DAO was evaluated based on previously developed instruments, including the Female Sexual Function Index (FSFI), General Assessment Questionnaire (GAQ), Women’s Inventory of Treatment Satisfaction (WITS-9), and Female Sexual Encounter Profile-Revised (FSEP-R).

Results

Confirmatory factor analyses demonstrated that the FSDS-DAO items fit very well (Bentler’s comparative fit index of 0.929). Cronbach’s α for the FSDS-DAO total score was ≥ 0.91 at Visits 1, 2, 5, and 12, demonstrating adequate internal consistency reliability. Test–retest reliability was acceptable with an intra-class coefficient of 0.61 and a Spearman’s correlation coefficient score of 0.62 between Visits 1 and 2 (4 weeks). Acceptable construct validity was demonstrated by significant correlations with related PRO scales in the expected directions and magnitude. For example, participants reporting the worst levels of sexual function on the FSFI also showed the worst FSDS-DAO scores at Visits 5 and 12. The FSDS-DAO total score was responsive to change.

Conclusions

Evidence supports the validity and reliability of the FSDS-DAO for assessing sexually related distress in women with female sexual arousal disorder and/or hypoactive sexual desire disorder; the addition of the arousal and orgasm items did not impact the validity and reliability of the measure.

Clinical Trial Registration ClinicalTrials.gov NCT01382719.
A scoping review of deep neural networks for electric load forecasting
Authors: Vanting Nicolai Bo , Ma Zheng , Jørgensen Bo Nørregaard
Published: September 2021

The increasing dependency on electricity and demand for renewable energy sources means that distributed system operators face new challenges in their grid. Accurate forecasts of electric load can solve these challenges. In recent years deep neural networks have become increasingly popular in research, and researchers have carried out many experiments to create the most accurate deep learning models. Players in the energy sector can exploit the increasing amount of energy-related data collected from smart meters to improve the grid’s operating quality. This review investigates state-of-the-art methodologies relating to energy load forecasting using deep neural networks. A thorough literature search is conducted, which outlines and analyses essential aspects regarding deep learning load forecasts in the energy domain. The literature suggests two main perspectives: demand-side management and grid control on the supply side. Each perspective has multiple applications with its challenges to achieve accurate forecasts; households, buildings, and grids. This paper recommends using a hybrid deep learning multivariate model consisting of a convolutional and recurrent neural network based on the scoping review. The suggested input variables should be historical consumption, weather, and day features. Combining the convolutional and recurrent networks ensures that the model learns as many repeating patterns and features in the data as possible.
A QR code based framework for auto-configuration of IoT sensor networks in buildings
Authors: Madsen Simon Soele , Santos Athila Quaresma , Jørgensen Bo Nørregaard
Published: September 2021

Worldwide buildings are responsible for about 40% of the overall consumption and contribute to an average of 30% percent of the global carbon emissions. Nevertheless, most current buildings lack efficient energy management systems because such solutions are very expensive, especially when necessary instrumentation needs to be installed after the building’s construction. As an alternative, we purpose the use of IoT sensor networks to retrofit existing medium and large-sized buildings to provide energy management capabilities in a cost-effective way. An IoT network auto-configuration platform for building energy management was developed. In order to efficiently manage metadata related to location and devices, a database using dynamic QR codes was created. Furthermore, we discuss the potential and shortcomings of different sensor-gateway pairing strategies that are applicable to an auto-configuring system. Lastly, we share our implementation of these concepts and demonstrate their use in a medium-sized building case study. The results show a trade-off between optimal configuration and total configuration time with a focus on the quality of the communication signal strength. The proposal provided the necessary automation for a cost-effective energy management system that can be deployed in both new constructions and existing buildings.
Evaluating the CO2 abatement effects of low-carbon city policy in China: a quasi-natural experiment
Authors: Li Qiangyi , Yang Mian , Xu Fei , Yang Fuxia , Xiang Xiaojian
Published: September 2021

The formulation and implementation of Low-Carbon City Policy (LCCP) is an essential initiative for China to build its low-carbon society. Based on the panel data of 282 prefecture-level cities in China from 2003 to 2016, this study evaluates the effects of LCCP implementation on pilot cities’ carbon emission performance using difference-in-differences method, and then the mechanism has also been examined with a mediating effect model. The results show that: first, the LCCP implementation has increased the carbon emission performance of the pilot cities significantly, indicating that it is an effective way to promote the low-carbon transformation of Chinese cities. Second, the positive effects in CO2 performance resulting from LCCP demonstrate significant heterogeneity: in general, the cities in east China, with higher economic development level and in a larger size, achieve more significant CO2 emission reduction than their respective counterparts. The results on the mechanism test imply that the LCCP helps improve pilot cities’ carbon emission performance in three ways, including reducing energy consumption, updating the industrial structure, and promoting technological progress. Finally, some useful policy recommendations are put forward to promote China’s low-carbon city construction.
Chemotherapy-related neurotoxicity in pediatric cancer patients: magnetic resonance imaging and clinical correlation
Authors: Abdou Mo’mena Abdel Aziz , El Kiki Hassan Ali , Madney Youssef , Youssef Ayda Aly
Published: September 2021

Background

Cancer is the second most common cause of death among children aged 1–14 years in the USA. Pediatric malignancies have elevated morbidity and mortality in the absence of proper treatment. Intensive treatment regimens have resulted in a significant increase in the number of survivors but also have been associated with the risk of developing neurotoxicity. The purpose of this study is to emphasize the role of advanced MRI techniques in the early detection of different chemotherapy neurotoxicities and make radiologists aware of them providing early management to prevent permanent damage.

Results

We evaluated 63 patients (43 males and 20 females), and their ages ranged from (2 to 17 years) with suspected chemotherapy-related neurotoxicity. MR examinations were performed with 1.5-T Philips systems. Clinical data were correlated with magnetic resonance imaging (MRI), and different treatment complications were diagnosed. All of our 63 patients were receiving chemotherapy treatment, and they developed different neurological symptoms. Patients diagnosed as posterior reversible encephalopathy syndrome were 41 with 8 patients had typical and 33 had atypical criteria, 16 patients diagnosed as cerebral venous sinus thrombosis with magnetic resonance venography (MRV) are the most important sequence that successfully diagnosed them, and finally, 6 patients diagnosed as methotrexate neurotoxicity with diffusion-weighted images (DWI) are the most important sequence for early diagnosis.

Conclusion

Chemotherapy is associated with certain neurotoxicities, conventional MRI can detect them, but by the use of advanced MRI techniques including MRV and DWI early detection of these neurotoxicities can occur. Therefore, the combination of conventional MRI together with advanced techniques improves the diagnostic efficacy of MRI in the early diagnosis of neurotoxicity.
Aberrant intrathyroidal lymph node metastasis in classical papillary thyroid carcinoma
Authors: Wan Zainon Wan Mohd Nazlee , Wan Abdul Rahman Wan Faiziah , Yahya Maya Mazuwin , Mat Nawi Nor Azwani , Suhaimi Nurul Shamimi , Mat Nawi Norazlina
Published: September 2021

Background

In cases of papillary thyroid carcinoma (PTC), lymph nodes are a typical site of metastasis. Extrathyroidal tissue involvement in differentiated thyroid carcinoma causes the disease to progress and affects the patients’ treatment options. Papillary thyroid carcinoma (PTC) is the common type in differentiated thyroid carcinoma (DTC), the other type is follicular thyroid carcinoma (FTC). Ectopic sites, such as intrathyroidal lymph node invasion in classical papillary thyroid malignancy, are extremely uncommon. It can be difficult to detect an intrathyroidal lymph node (ITLN) during a histopathological test, but it is important to do so since it affects the stage of the disease and subsequent treatment.

Case presentation

We present the case of a 63-year-old woman who presented with multinodular goitre and underwent total thyroidectomy. She was diagnosed with aberrant intrathyroidal lymph node metastases during pathological testing, resulting in an upgrade in treatment. Owing to the exceptionally unusual ectopic position of lymph node metastasis, in this case, there is a risk of diagnostic and therapeutic misinterpretation. This patient was treated with high-dose radioactive iodine in view of lymph node metastases.

Conclusions

Identification of ITLN by imaging characteristics is sometimes difficult, being often an intraoperative discovery and histopathological correlation that lead to upstage the disease and alter the final management.
Financial Burden of Drugs Prescribed for Cancer-Associated Symptoms
Authors: Gupta Arjun , Nshuti Leonce , Grewal Udhayvir S. , Sedhom Ramy , Check Devon K. , Parsons Helen M. , Blaes Anne H. , Virnig Beth A. , Lustberg Maryam B. , Subbiah Ishwaria M. , Nipp Ryan D. , Dy Sydney M. , Dusetzina Stacie B.
Published: September 2021

PURPOSE:

The financial toxicity of anticancer drugs is well-documented, but little is known about the costs of drugs used to manage cancer-associated symptoms.

METHODS:

We reviewed relevant guidelines and compiled drugs used to manage seven cancer-associated symptoms (anorexia and cachexia, chemotherapy-induced peripheral neuropathy, constipation, diarrhea, exocrine pancreatic insufficiency, cancer-associated fatigue, and chemotherapy-induced nausea and vomiting). Using GoodRx website, we identified the retail price (cash price at retail pharmacies) and lowest price (discounted, best-case scenario of out-of-pocket costs) for patients without insurance for each drug or formulation for a typical fill. We describe lowest prices here.

RESULTS:

For anorexia and cachexia, costs ranged from $5 US dollars (USD; generic olanzapine or mirtazapine tablets) to $1,156 USD (brand-name dronabinol solution) and varied widely by formulation of the same drug or dosage: for olanzapine 5 mg, $5 USD (generic tablet) to $239 USD (brand-name orally disintegrating tablet). For chemotherapy-induced peripheral neuropathy, costs of duloxetine varied from $12 USD (generic) to $529 USD (brand-name). For constipation, the cost of sennosides or polyethylene glycol was <$15 USD, whereas newer agents such as methylnaltrexone were expensive ($1,001 USD). For diarrhea, the cost of generic loperamide or diphenoxylate-atropine tablets was <$15 USD. For exocrine pancreatic insufficiency, only brand-name formulations were available, range of cost, $1,072 USD-$1,514 USD. For cancer-associated fatigue, the cost of generic dexamethasone or dexmethylphenidate was <$15 USD, whereas brand-name modafinil was more costly ($1,284 USD). For a 4-drug nausea and vomiting prophylaxis regimen, costs ranged from $181 USD to $1,430 USD.

CONCLUSION:

We highlight the high costs of many symptom control drugs and the wide variation in the costs of these drugs. These findings can guide patient-clinician discussions about cost-effectively managing symptoms, while promoting the use of less expensive formulations when possible.
Early Post-Renal Transplant Hyperglycemia
Authors: Iqbal Anira , Zhou Keren , Kashyap Sangeeta R , Lansang M Cecilia
Published: September 2021

Context

Though posttransplant diabetes mellitus (PTDM, occurring > 45 days after transplantation) and its complications are well described, early post–renal transplant hyperglycemia (EPTH) (< 45 days) similarly puts kidney transplant recipients at risk of infections, rehospitalizations, and graft failure and is not emphasized much in the literature. Proactive screening and management of EPTH is required given these consequences.

Objective

The aim of this article is to promote recognition of early post-renal transplant hyperglycemia, and to summarize available information on its pathophysiology, adverse effects, and management.

Methods

A PubMed search was conducted for “early post–renal transplant hyperglycemia,” “immediate posttransplant hyperglycemia,” “post–renal transplant diabetes,” “renal transplant,” “diabetes,” and combinations of these terms. EPTH is associated with significant complications including acute graft failure, rehospitalizations, cardiovascular events, PTDM, and infections.

Conclusion

Patients with diabetes experience better glycemic control in end-stage renal disease (ESRD), with resurgence of hyperglycemia after kidney transplant. Patients with and without known diabetes are at risk of EPTH. Risk factors include elevated pretransplant fasting glucose, diabetes, glucocorticoids, chronic infections, and posttransplant infections. We find that EPTH increases risk of re-hospitalizations from infections (cytomegalovirus, possibly COVID-19), acute graft rejections, cardiovascular events, and PTDM. It is essential, therefore, to provide diabetes education to patients before discharge. Insulin remains the standard of care while inpatient. Close follow-up after discharge is recommended for insulin adjustment. Some agents like dipeptidyl peptidase-4 inhibitors and glucagon-like peptide-1 receptor agonists have shown promise. The tenuous kidney function in the early posttransplant period and lack of data limit the use of sodium-glucose cotransporter 2 inhibitors. There is a need for studies assessing noninsulin agents for EPTH to decrease risk of hypoglycemia associated with insulin and long-term complications of EPTH.
Calcitonin Gene Related Peptide, Adrenomedullin, and Adrenomedullin 2 Function in Uterine Artery During Human Pregnancy
Authors: Chauhan Madhu , Betancourt Ancizar , Balakrishnan Meena , Mishra Akansha , Espinosa Jimmy , Shamshirsaz Alireza A , Fox Karin , Belfort Michael , Yallampalli Chandra
Published: September 2021

Rationale

Calcitonin gene-related peptide (CGRP) and its family members adrenomedullin (ADM) and adrenomedullin 2 (ADM2; also known as intermedin) support vascular adaptions in rat pregnancy.

Objective

This study aimed to assess the relaxation response of uterine artery (UA) for CGRP, ADM, and ADM2 in nonpregnant and pregnant women and identify the involved mechanisms.

Findings

(1) Segments of UA from nonpregnant women that were precontracted with U46619 (1μM) in vitro are insensitive to the hypotensive effects of CGRP, ADM, and ADM2; (2) CGRP, ADM, and ADM2 (0.1-100nM) dose dependently relax UA segments from pregnant women with efficacy for CGRP > ADM = ADM2; (3) the relaxation responses to CGRP, ADM, and ADM2 are differentially affected by the inhibitors of nitric oxide (NO) synthase (L-NAME), adenylyl cyclase (SQ22536), apamin, and charybdotoxin; (4) UA smooth muscle cells (UASMC) express mRNA for calcitonin receptor-like receptor (CRLR) and receptor activity modifying protein (RAMP)1 and RAMP2 but not RAMP3; (5) receptor heterodimer comprising CRLR/RAMP1 and CRLR/RAMP2 but not CRLR/RAMP3 is present in UA; (6) soluble fms-like tyrosine kinase (sFLT-1) and TNF-α treatment decrease the expression of RAMP1 mRNA (P < 0.05) in UASMC; and (7) sFLT-1 treatment impairs the association of CRLR with all 3 peptides while TNF-α inhibits the interaction of CGRP but not ADM or ADM2 with CRLR in UASMC (P < 0.05).

Conclusions

Relaxation sensitivity of UA for CGRP, ADM, and ADM2 is increased during pregnancy via peptide-specific involvement of NO system and endothelium-derived hyperpolarizing factors; vascular disruptors such as sFLT-1 and TNFα adversely impact their receptor system in UASMC.
Symmetry, Violence, and The Handmaiden's Queer Colonial Intimacies
Authors: Hu Jasmine
Published: September 2021

The Japanese annexation of Korea (1910–45) implicates a crisis of representation in South Korean national history. Both the traumatic wounds and complex intimacies of Japan's rule over its Korean subjects were met with postcolonial suppression, censorship, and disavowal. This article examines Park Chan-wook's The Handmaiden (Ah-ga-ssi, South Korea, 2016), a period film set in 1930s Korea under Japanese rule, in relation to the two nations’ fraught but interconnected colonial and postcolonial histories. By analyzing the film's explicit sexual depiction through discourses of ethnicity, gender, and nation, it argues that the lesbian sex scenes encode and eroticize latent anxieties and tensions surrounding Japan-Korea relations, making explicit the ambivalent longing and lingering identification shared between the colonizers and the colonized. Furthermore, through intertextual reference to the intertwined and imitative relations between the national cinemas of Japan and Korea—relations mediated and elided by a long history of state censorship—Park's film repudiates an essentialist South Korean identity propped up by both nationalist narratives and market liberalization policies. Through palimpsestic projection of the colonial era onto South Korea's neoliberal present, the film invites parallels between colonialism's unresolved legacy and contemporary modes of cultural production. Simultaneously, the film offers a utopian vision of a national self that surfaces—rather than suppresses—the violence and pleasure incurred in confrontations with the colonial or transnational other.