bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and Predictors of Adverse Events Associated With Dipeptidyl Peptidase-4 (DPP-4) Inhibitors in Type 2 Diabetic Patients: A Cross-sectional Study
Authors: Reghunath Swetha R , Chackochan Ashna , Thunga Girish , Acharya Dinesh U , Shivashankara Kaniyoor Nagri , Ravindra Prabhu Attur , Acharya Leelavathi D
Published: October 2024

Background:

Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral hypoglycemic agents widely prescribed in India despite safety concerns. However, studies focused on their safety profile are scarce, especially in South India.

Objective:

To evaluate the prevalence and predictors of adverse events (AEs) with DPP-4 inhibitors in patients with type 2 diabetes mellitus (T2DM).

Research design and methods:

This retrospective cross-sectional study analyzed data from medical records of T2DM patients prescribed DPP-4 inhibitors admitted to the medicine department from 2019 to 2021 at a South Indian tertiary care hospital. The causality of AEs was assessed using the WHO-Uppsala Monitoring Centre (WHO-UMC) criteria and the Naranjo scale, and severity using the Modified Hartwig and Seigel scale. We applied a Generalized model with a binary response and logit-link function to understand the factors that best explain the AE. The best-fit models were chosen based on least Akaike’s information criterion and highest Pseudo R2 and presented the odds ratio (OR) with a 95% confidence interval. The analyses were performed in R software version 4.2.1.

Results:

Among the 796 patients included in the study, 26% experienced AEs. A total of 212 AEs were observed, and Saxagliptin-associated AEs were the most prevalent (66.6%). Hepatic AEs were predominant (37.7%), followed by gastrointestinal events (16.5%) and electrolyte imbalances (12.3%). Most AEs were possible based on WHO-UMC criteria (78.7%) and the Naranjo scale (86.7%), with 58% being of moderate severity and 42% mild. In the multivariate analysis, aspartate transaminase [OR: 1.013 (0.006–1.020)], alkaline phosphatase [OR: 1.004 (1.001–1.007)] and patients already on DPP-4 inhibitors [OR 1.191(1.012–1.366)] were significant predictors for AEs with DPP-4 inhibitors.

Conclusion:

The study highlighted a high prevalence of AEs with DPP-4 inhibitors and identified significant predictors of these AEs. These findings underscore the necessity of vigilant monitoring and risk assessment while prescribing DPP-4 inhibitors to the Indian population.
Best supportive care for patients with primary progressive multiple sclerosis (PPMS) in Germany prior to ocrelizumab treatment: Final results from the RETRO PPMS study
Authors: Schreiber Herbert , Penner Iris-Katharina , Maier Tanja , Hieke-Schulz Stefanie , Leemhuis Jost , Ziemssen Tjalf
Published: October 2024

Background

Best supportive care (BSC) measures are an essential component for the management of primary progressive multiple sclerosis (PPMS).

Objectives

RETRO PPMS (ML39631) is the first study to systematically analyze the therapeutic journey and standard of BSC of patients with PPMS in Germany.

Design

This multicenter, non-interventional study retrospectively analyzed patient charts. Methods: Data were recorded up until the first infusion of ocrelizumab (July 2018 to October 2021). Medical history, disease status, disease activity and treatments were assessed from 12 months before PPMS diagnosis until study start. Acute interventions, BSC parameters and rehabilitation measures from the past 27 months were assessed.

Results

The core analysis population (N = 462) had a mean age (range) of 57.4 (27–85) years and mean disease duration of 13.7 (0.3–55.2) years. The most frequently reported symptoms were muscle spasticity, bladder disorder, ataxia, gait disturbance and fatigue. The most commonly used treatment was physical/occupational therapy (66.5% of patients); 47.2% received off-label treatment with corticosteroids/disease-modifying therapies. BSC measures for many symptoms were strikingly rare – especially for fatigue and cognitive impairment.

Conclusion

This analysis uncovers severe BSC deficits for many debilitating PPMS symptoms. There is still a large unmet need for innovative multidisciplinary care concepts and improvements in neurological primary and secondary care.
Regular cannabis smoking and carotid artery calcification in the Multi-Ethnic Study of Atherosclerosis (MESA)
Authors: Corroon Jamie , Bradley Ryan , Grant Igor , Daniels Michael R , Denenberg Julie , Bancks Michael P , Allison Matthew A
Published: October 2024

Background:

Studies on cannabis use and adverse cardiovascular outcomes have reported conflicting results. Research on its relationship to calcified arterial plaque remains limited.

Methods:

Cross-sectional data from 2152 participants at Exam 6 (2016–2018) in the Multi-Ethnic Study of Atherosclerosis (MESA) were analyzed, including self-reported cannabis smoking patterns and carotid artery calcification (CAC) as measured via computed tomography. Multivariable relative and absolute risk regression models were used to estimate adjusted prevalence ratios (PRs) and prevalence differences, respectively, for the presence of calcified plaque. Multivariable linear regression was then used to compare group differences in the extent of CAC in those with calcified plaque.

Results:

A minority of participants ( n = 159, 7.4%) reported a history of regular cannabis smoking. Among all participants, 36.1% ( n = 777) had detectable CAC. In models adjusted for demographics, behavioral, and clinical cardiovascular disease factors, a history of regular cannabis smoking was not associated with the prevalence of CAC in either common carotid artery (PR: 1.14, 95% CI: 0.88 to 1.49). In the subset of participants with calcified plaque, and in separate fully adjusted multivariable linear regression models, a history of regular cannabis smoking was not associated with increased calcium volume (difference = 7.7%, 95% CI: –21.8 to 48.5), calcium density (difference = 0.4%, 95% CI: –6.6 to 7.9), or Agatston score (difference = 32.1%, 95% CI: –31.8 to 155.8) in either carotid artery. Models exploring potential effect modification by age, race/ethnicity, and tobacco smoking status showed no significant association, except for higher CAC prevalence in men with a history of regular cannabis smoking.

Conclusions:

In a racially and ethnically diverse cohort of older adults with a moderately high prevalence of CAC, no associations were found between a history of regular cannabis smoking, duration, or recency of cannabis smoking, and the prevalence of carotid calcified plaque. These findings were consistent across age, race/ethnicity, and cigarette smoking, except for an increased prevalence in men with a history of regular cannabis smoking. Similarly, in a subgroup with CAC, no association was found between a history of regular cannabis smoking and extent of calcification as measured by volume, density, and Agatston score.
Lifestyle factors as predictors of incident functional somatic disorder. Five-year follow-up of The DanFunD study
Authors: JØrgensen Torben , Jacobsen Rikke K. , Weinreich Petersen Marie , Bjerregaard Anne A. , Ulfbeck Schovsbo Signe , Gormsen Lise K. , Falgaard Eplov Lene , Linneberg Allan , Fink Per , Eriksen Benros Michael , Dantoft Thomas
Published: October 2024

Aims:

To assess whether lifestyle factors, including sleep pattern, are predictors for the development of functional somatic disorder (FSD).

Methods:

A population-based prospective cohort of 9656 men and women aged 18–76 years was established in 2011–2015 and invited for re-examination in 2017–2020, when 5738 participated. Median follow-up period was 65 months. Participants filled in validated questionnaires on lifestyle, sleep pattern and various delimitations of FSD, which were operationalized using two different approaches: bodily distress syndrome (BDS) and functional somatic syndromes (FSS) (i.e. chronic fatigue, chronic widespread pain (CWP), irritable bowel, and multiple chemical sensitivity (MCS)). Baseline lifestyle and sleep pattern in relation to incidence of BDS and FSS (chronic fatigue, CWP, irritable bowel, MCS) was analysed by logistic regressions, adjusted for age, sex and subjective social status.

Results:

Inferior sleep quality at baseline predicted both incidence of BDS and all FSS delimitations except MCS. Smoking, alcohol intake, and low physical activity, but not diet, were predictors for the development of BDS. No uniform pattern was observed for the FSS. Smoking predicted development of chronic fatigue, CWP and irritable bowel, but not MCS. Alcohol and food quality only influenced the development of chronic fatigue whereas low physical activity only influenced the development of chronic fatigue and CWP.

Conclusions:

Lifestyle factors and sleep pattern seem to be predictors for some delimitations of FSD, but the importance of the various lifestyle factors is different for the different delimitations. The study shows the importance of analysing the various FSSs separately.
Algorithm for forming hospital care episodes by combining attendance contacts in the Danish National Patient Register: A methodological consensus-driven study
Authors: Gregersen Rasmus , Fox Maule Cathrine , Bjørn Jensen Camilla , Winther-Jensen Matilde , Helms Andreasen Anne , Nygaard Hanne , Pottegård Anton , Schmidt Morten , Paaske Johnsen Søren , Petersen Janne , Villumsen Marie
Published: October 2024

Background:

Studying complete hospital care episodes from register data, for instance when assessing length of stay, discharges and readmissions, can cause methodological difficulties due to the lack of a contact linkage identifier. We aimed to develop an algorithm combining sequential attendance contacts in the Danish National Patient Register (DNPR) into hospital care episodes, spanning the entire duration and all contacts from hospital arrival to departure.

Methods:

The algorithm was developed under the consensus of experts from research institutions across Denmark. It reads in second and third version DNPR data, deletes contacts without attendance, duplicates elective outpatient contacts corresponding to attendance dates and modifies contact types (e.g. repeated acute contacts), among others. Thereafter, sequential contacts within 4 h are marked as the same hospital care episode, consisting of one or more DNPR contact. We tested the algorithm in a data set of adults living in Denmark during 2013–2021 and compared different hourly cut-offs.

Results:

For the demonstration, we included 120.2 m contacts from 5.7 m persons, combined into 105.9 m hospital care episodes. Of the hospital care episodes, 6.4% were acute inpatients, 8.3% were acute outpatients, 2.0% were elective inpatients and 83.3% were elective outpatients. Using 4 h as our recommendation, 3-h, 5-h and 6-h cut-offs for contact combining revealed only minor differences in the number of hospital care episodes (<0.4%), whereas 12-h (<1.7%) and 24-h cut-offs (<43.1%) had a larger impact.

Conclusions:

The algorithm automates data reading, modification and linkage of sequential attendance contacts. The algorithm can be initiated as a SAS macro and is available from an online repository.
The Norwegian Counties Public Health Survey (NCPHS): a design study
Authors: AarØ Leif Edvard , Knapstad Marit , Nilsen Thomas , Skogen Jens Christoffer , Nes Ragnhild Bang , Leino Tony , Riise Ingunn Agnete , Johansen Rune , GrØtvedt Liv , Vedaa Øystein , Stigen Ole Trygve , Reneflot Anne , Gulseth Hanne LØvdal , Klepp Knut-Inge
Published: October 2024

Background:

Effective public health initiatives should be founded on a comprehensive and robust understanding of health-related factors including societal and community contexts. The Norwegian Counties Public Health Survey (NCPHS) aims for insights into the adult population on topics relevant for planning public health practices at county and municipality levels.

Methods:

The NCPHS includes a core questionnaire on public health-related topics and demographics, including indicators of socio-economy, with additional optional questions and scales varying across data collections. Samples are drawn from the Norwegian National Population Register and ‘washed’ against the Common Contact Register to retrieve digital contact information and exclude those who cannot be contacted electronically. NCPHS was piloted in 2015 and 2018 (four counties). After some revision of instruments and sampling procedures, surveys have been carried out in most Norwegian counties since 2019. The total number of participants has now passed 400,000.

Results:

Expedient data analysis has enabled the Norwegian Institute of Public Health to present comprehensive reports within 6 weeks of completed data collections. In these, outcome variables are analysed against district (within counties), gender, age, educational attainment and self-reported sufficiency of household income. Tables are also made available at the municipality level.

Conclusions:

The NCPHS represents a valuable addition to existing data sources, providing critical information for planning purposes for local and regional public health authorities, for assessing trends over time, comparisons across counties and regions and for evaluation of policies and interventions. The value of such a system during times of crisis was demonstrated during the COVID-19 pandemic.
Epidemiological investigation support application and user evaluation based on infectious disease self-management model in the endemic era
Authors: Park Jihwan , Rho Mi Jung
Published: October 2024

Objectives: Rapid epidemiological investigations are fundamental to prevent the spread of infectious diseases such as coronavirus disease 2019. An epidemiological investigation presents significant challenges for both epidemiologists and infected individuals. It requires creating an environment that enables people to independently manage infectious diseases and voluntarily participate in epidemiological investigations. Methods: We developed the KODARI application, an epidemiological investigation support system that users can voluntarily use. We developed the questionnaires based on literature reviews. We evaluated the application through an online survey from December 2 to 14, 2022. Results: The application automatically or manually collect epidemiological investigation information. The application improved data accuracy through accurate information collection. It voluntarily can transmit self-management information to epidemiologist terminals or users in real time. We collected 248 users from an online survey. Most users had high ratings and willingness to use. They have willingness to manage infectious patients was substantial. The application was evaluated as helpful for epidemiological investigations and could shorten the time required for epidemiological investigations by more than 30 min. Conclusion: The application proposes a model based on people’s voluntary participation. We demonstrated that the application could enhance epidemiological investigations and diminish the duration of existing epidemiological investigation processes.
Consumer possessed: A comment on assessing Belk’s “Possessions and the Extended Self”
Authors: Firat A Fuat
Published: October 2024

While outstanding in observing the contemporary experience of being a “consumer” to become a “canonical article” in consumer research, as Thompson deftly analyzes, Belk’s “Possessions and the Extended Self” is subject to varied traps of remaining within the “mainstream marketing’s ideological boat.” This commentary attempts to highlight these ideological traps as we hopefully escape contemporary capitalism’s system of production of consumer subjectivity.
Comparative didactics today: Introducing a special issue
Authors: Ågerup Karl
Published: October 2024

This special issue aims to advance and disseminate research in the field of comparative didactics, offering a comprehensive overview of its current state. Featuring contributions from leading scholars across diverse continents and disciplines, the publication seeks to foster the growth and internationalization of comparative didactics, promote cross-disciplinary methodology transfer between school subjects, and support scholars in identifying and sharing theoretical perspectives across different contexts. While each paper presents unique findings, they collectively enable deeper comparisons of the meaning and impact of comparative didactics worldwide.
Embedding the Third Mission of universities in humanitarian crisis response: Profiling the role of the University of Duhok in addressing health needs of internally displaced people and refugees
Authors: Borkowska Katarzyna , Aziz Ketuly Kamal , Osborne Michael , Abid Mohammed Sizar , Azizi Nematollah
Published: October 2024

This article attempts to contribute to the debates on the role of the higher education sector in addressing the immediate and long-term challenges incurred as a result of humanitarian crises. The focal point of consideration is profiling the role of the University of Duhok, Iraq, in addressing health needs of internally displaced people and refugees. The article demonstrates the nexus between the so-called Third Mission and the range of responses the University provides to support the health needs of displaced populations in Duhok Governorate. It is argued that the higher education sector has to be recognised and positioned as a key stakeholder in the process of humanitarian relief and local recovery.
Examining the Prevalence and Effects of Gender-based Violence in Academic Settings: A Systematic Review and Meta-analyses
Authors: Nowrouzi-Kia Behdin , Chan Hong Yi , Zhu Shangkai , Nandan Sharada , Bani-Fatemi Ali , Howe Aaron , Gross Douglas P. , Gohar Basem , Yazdani Amin , Chattu Vijay Kumar
Published: October 2024

Gender-based violence (GBV) in the academic job sector is a critical issue that intersects with broader systemic and structural inequities, but research is limited. To study the prevalence, effects, and prevention measures of interpersonal GBV within the academic job sector, a meta-analysis and systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis protocol. Rigorous searches were conducted across the databases PubMed, OVID, Scopus, Web of Science, and CINAHL, using specific keywords related to GBV, workplace, and virtual work environments, identifying papers published between January 2013 and February 2023. Studies were evaluated based on the Population, Intervention, Comparison, Outcomes framework. Data from papers were extracted and grouped by reported instances, and prevalence data for interpersonal GBV were reported in university settings, including in-person, hybrid, and virtual environments, and among men, women, and those who identify as 2SLGBTQ+. A random effects meta-analysis of proportions was conducted to evaluate the reported point prevalence rates of interpersonal GBV in academia between 2012 and 2015. Subgroup analyses were performed for university staff only, females only, and males only. Out of the 1,290 records, 16 studies met the inclusion criteria. The types of violence identified include sexual harassment, workplace bullying and online harassment, which affects career advancement, and employee well-being. The meta-analyses, conducted with a 95% confidence interval [CI], identified that 51.4% (95% CI [39.9%, 63.0%]) of university staff members experience GBV, with females, 59.3% [38.1%, 80.5%], experiencing greater rates than males, 44% [28.1%, 44.1%]. The findings underscore the need for institutional interventions to address interpersonal GBV in academic workplaces.
Predicting Bone Marrow Metastasis in Neuroblastoma: An Explainable Machine Learning Approach Using Contrast-Enhanced Computed Tomography Radiomics Features
Authors: Wang Haoru , He Ling , Chen Xin , Ding Shuang , Xie Mingye , Cai Jinhua
Published: October 2024

Purpose

To predict bone marrow metastasis in neuroblastoma using contrast-enhanced computed tomography (CECT) radiomics features and explainable machine learning.

Methods

This cohort study retrospectively included a total of 345 neuroblastoma patients who underwent testing for bone marrow metastatic status. Tumor lesions on CECT images were delineated by two radiologists, and 1409 radiomics features were extracted. Correlation analysis, Least Absolute Shrinkage and Selection Operator regression, and one-way analysis of variance were used to identify radiomics features associated with bone marrow metastasis. A predictive model for bone marrow metastasis was then developed using the support vector machine algorithm based on the selected radiomics features. The performance of the radiomics model was evaluated using the area under the curve (AUC), 95% confidence interval (CI), accuracy, sensitivity, and specificity.

Results

The radiomics model included 16 features, with a predominant focus on texture features (12/16, 75%). In the training set, the model demonstrated an AUC of 0.891 (95% CI: 0.848-0.933), an accuracy of 0.831 (95% CI: 0.829-0.832), a sensitivity of 0.893 (95% CI: 0.840-0.946), and a specificity of 0.757 (95% CI: 0.677-0.837). In the test set, the AUC, accuracy, sensitivity, and specificity were 0.807 (95% CI: 0.720-0.893), 0.767 (95% CI: 0.764-0.770), 0.696 (95% CI: 0.576-0.817), and 0.851 (95% CI: 0.749-0.953), respectively.

Conclusion

Radiomics features extracted from CECT images are associated with the presence of bone marrow metastasis in neuroblastoma, providing potential new imaging biomarkers for predicting bone marrow metastasis in this disease.
Evaluating the Reliability of Name Writing Rubric Scoring
Authors: Demchak Alisha , Dahl-Leonard Katlynn , Connor Carlin , Solari Emily J.
Published: October 2024

Early literacy screening tools are often a critical component of schools’ intervention frameworks. As the use of screening tools becomes more prevalent for identifying students who may be at risk for learning difficulties and in need of additional instruction, it is important to continuously evaluate teachers’ implementation of these screening tools and to improve efforts to support their implementation. Measures of name writing as a part of a screening tool can pose specific implementation challenges due to the subjectivity that rubric scoring allows. As such, this study aimed to evaluate the reliability of a rubric used by pre-kindergarten teachers to score a name writing task, as part of a larger screening tool, in the context of their own classrooms, and to examine scoring patterns between researchers and teachers on the name writing rubric. Results revealed that researchers had higher interrater reliability among themselves than the reliability between researchers and teachers. Although there was not a substantial difference between the two groups, it is worthwhile to examine the implementation of screening tool scoring systems in the field to ensure proper identification of and intervention for students who may be at risk for learning difficulties. Implications for researchers and teachers are discussed.
The War on Drugs in Juvenile Court? The Influence of Community Context on Juvenile Court Outcomes for White, Black, and Hispanic Youth
Authors: Peck Jennifer H.
Published: October 2024

Prior research on race/ethnicity and juvenile court processing have found that youth of color often receive disadvantaged outcomes compared to their White counterparts, and that community context may condition this relationship. The current study examined this association between race/ethnicity (White, Black, Hispanic) and type of drug offense (possession vs. distribution) with adjudication and disposition outcomes, especially the tempering effect of disadvantaged community characteristics. Results from multi-level models indicated that Black youth who were charged with a drug distribution offense were more likely to receive residential placement compared to similarly situated Whites. Underclass poverty and racial/ethnic inequality moderated these associations, but the significance and direction of the results differed depending on the stage examined. The findings reveal ongoing racial/ethnic disparities in the juvenile justice system, and offer clearer insights into the conditions under which youth of color charged with different drug offenses are processed in juvenile court.
Feasibility of the MIND+SOUL Culturally Tailored Brain Healthy Diet: A Pilot Study
Authors: Shaw Ashley R. , Honea Robyn , Mudaranthakam Dinesh Pal , Young Kate , Vidoni Eric D. , Morris Jill K. , Billinger Sandra , Key Mickeal N. , Berkley-Patton Jannette , Burns Jeffrey M.
Published: October 2024

Alzheimer’s disease (AD) disproportionately impacts Black Americans, who are three times more likely to develop AD. While heart-healthy diets have shown potential in reducing AD risk, research on adapted dietary interventions for Black American communities remains limited. This pilot study assessed the feasibility and acceptability of an adapted brain healthy diet intervention (MIND + SOUL) and explored changes in cardiometabolic risk and cognition. Twenty-nine participants completed the 12-week intervention, which included culturally tailored health education, cooking classes, health coaching, and groceries. Feasibility was assessed by attendance and retention rates, while acceptability was measured by two questionnaires. Participants had a mean age of 70.3, with 10.3% male. The intervention demonstrated high feasibility (89.3% retention) and acceptability (mean = 71.9, SD = 8.59), with meaningful improvements in body mass index (estimate = −0.54, P = 0.009), dietary intake (estimate = 28.39, P = 0.042), and executive function (estimate = 3.32, P < 0.001). However, no significant changes in blood-based biomarkers were observed. The MIND + SOUL intervention demonstrated high feasibility and acceptability, improvements in body composition, cognitive function, and dietary behaviors, despite no significant changes in blood-based biomarkers. Findings suggest potential benefits for reducing AD risk factors and promoting healthy aging. Clinical Trials Registry: ClinicalTrials.Gov; NCT05414682.
OfSTED from within: Inspectors’ views on challenges and future direction
Authors: Tian Meng , Diamond Colin
Published: October 2024

In England, current punitive and performative inspection practices have intensified public resentment towards the Office for Standards in Education, Children's Services and Skills (OfSTED). In 2024, a new His Majesty's Chief Inspector was appointed, initiating a system-wide review of the inspection framework and practice. In July 2024, the Labour government won the general election, raising hopes of resetting the accountability system. Against this backdrop, this paper presents an insider's view of OfSTED. Eleven former Her Majesty's Inspectors and serving OfSTED inspectors were interviewed. Through the lenses of espoused theories and theories-in-use, this study uncovered inspectors’ shared concerns about an increasingly politicised OfSTED, a narrowed focus on education quality, an increased workload and diminished professional autonomy. Some root causes behind inconsistent inspection judgements and highly standardised inspection reports were explained. While only a few inspectors wanted to abolish one-word judgements at the time of the interviews, all expressed genuine belief in the value of inspection when carefully designed and properly conducted to serve pupils and schools. This paper highlights why scrapping one-word judgements is a welcome change, but more work is needed to rebuild trust, professionalise and depoliticise OfSTED, encourage local ingenuity and lower the stakes of inspections.
Me? A criminal? Relationships with offenders and implicit criminal associations
Authors: Saad Marina K
Published: October 2024

The collateral consequences of criminal justice involvement on friends and families of offenders is well documented in criminological literature. One less-understood consequence is the impact of these relationships and experiences on the cognitions of friends and family members of offenders. This study examines implicit, unconscious, and explicit, or conscious cognitions of non-criminal individuals who have personal relationships with offenders versus those who do not. Moreover, the effects of reminders of past experiences, nature of the relationship, and closeness with the offender were examined. The Implicit and Explicit Criminal-Self Association Tests were used to measure implicit and explicit criminal-self associations. Results showed that those who were close with an offender and were reminded of a past experience with an offender exhibited stronger implicit associations with the group criminal in comparison to those who were not close with an offender. This research has implications for understanding the effects of relationships with offenders for non-criminal individuals.
Prognostic value of the TP53 mutation in patients with pancreatic ductal adenocarcinoma receiving FOLFIRINOX
Authors: Kim Min Kyu , Cho In Rae , Kim Yooeun , Choi Jin Ho , Jung Kwangrok , Kim Jaihwan , Kim Sheehyun , Yun Hongseok , Yoon Jeesun , Oh Do-Youn , Kim Kwangsoo , Lee Sang Hyub
Published: October 2024

Background:

KRAS, TP53, CDKN2A, and SMAD4 have been the main driver mutations in pancreatic ductal adenocarcinoma (PDAC). Studies on the clinical significance and treatment response to 5-fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) regimen in terms of the presence of these mutations remain inconclusive.

Objectives:

This study aimed to compare the survival outcome and response to FOLFIRINOX chemotherapy based on the presence of four driver mutation genes.

Design:

A multi-center retrospective study conducted at two tertiary medical centers.

Methods:

This study analyzed PDAC patients who were treated with FOLFIRINOX chemotherapy as the initial treatment. Tumor specimens were analyzed by a targeted next-generation sequencing platform at two tertiary referral hospitals from January 2016 to March 2022. Patients’ demographics, survival outcomes, and chemotherapeutic response were investigated and compared according to the presence of driver mutations.

Results:

The analysis included 100 patients. KRAS mutation was identified in 92 (92.0%) patients, followed by TP53, CDKN2A, and SMAD4 in 63 (63.0%), 18 (18.0%), and 17 (17.0%) patients, respectively. The TP53 wild-type group demonstrated longer overall survival (OS) than the TP53 mutated group (median OS: 29 vs 19 months, p = 0.03), and TP53 served as a prognostic factor for survival (hazard ratio = 1.74, 95% confidence interval: 1.00–3.00, p = 0.048). The difference in OS according to TP53 mutation was intensified in localized pancreatic adenocarcinoma (37 vs 19 months, p = 0.01). The TP53 wild-type group demonstrated a higher objective response rate to FOLFIRINOX chemotherapy than the TP53 mutation group in localized pancreatic adenocarcinoma (50.0% vs 17.6%, p = 0.024).

Conclusion:

PDAC patients with wild-type TP53 demonstrated longer OS than those with TP53 mutation, and this trend was intensified in patients with localized disease. This result may be due to an impaired response to FOLFIRINOX chemotherapy in patients with TP53 mutation.
The impact of neurological impairment and tone on hip joint development
Authors: Ciftci Sadettin , Almeida da Silva Luiz Carlos , Howard Jason J , Shrader Michael Wade , Miller Freeman
Published: October 2024

Purpose:

The purpose of this study was to define how different force environments by neuromuscular diagnosis (hypertonic versus hypotonic) impact the growth and morphology of the proximal femoral and acetabular regions relative to typically developing children.

Methods:

Children with cerebral palsy and spinal muscular atrophy were compared with typically developing children aged 6 months to 11 years. Routine pelvic radiographs were evaluated using measures of hip geometry for the proximal femur and acetabulum. The data were analyzed using general linear models to estimate the developmental patterns according to age and diagnosis.

Results:

One hundred eighty-four children met the inclusion criteria: 58 spastic cerebral palsy Gross Motor Function Classification System I–V (263 hips), 32 spinal muscular atrophy (79 hips)), and 94 typically developing (187 hips) were included with a mean age of 4.9 ± 3.1 years. Using spinal muscular atrophy as a reference, significant differences in proximal femoral development included long thin versus short neck ( p < 0.01) and round versus flat epiphysis ( p = 0.001). A thin neck-wide epiphysis was found in spinal muscular atrophy versus thick neck-small epiphysis for typically developing ( p < 0.05). The ratio of acetabular width to proximal femoral epiphysis width differed significantly for typically developing ( p = 0.001) compared with cerebral palsy and spinal muscular atrophy. There was a negative correlation between migration percentage and acetabular width to epiphysis width in children with cerebral palsy, but no correlation in children with spinal muscular atrophy.

Conclusion:

Hip geometry was impacted by the force environment experienced during growth. These findings emphasize the crucial roles of gross motor function, muscle tone, and strength differences in determining hip morphology.

Level of Evidence:

III, retrospective case control.
Longer Multimorbidity Intervals Are Associated With Lower Mortality in Diabetes: A Whole-Population Nested Case-Control Study
Authors: Liu Wenlong , Hu Yuqi , Wei Cuiling , Zhou Lingyue , Liu Boyan , Sun Qi , Chu Rachel Yui Ki , Wan Eric Yuk Fai , Wong Ian Chi Kei , Lai Francisco Tsz Tsun
Published: October 2024

Background:

Approximately two-thirds of diabetes patients develop multimorbidity, which is associated with increased mortality. We aimed to examine whether, and to what extent, the time interval between pre-existing diabetes and a second chronic disease may be associated with the risk of mortality.

Methods:

We carried out a territory-wide nested case-control study using incidence density sampling, utilizing electronic health records from Hong Kong’s public healthcare facilities. Among 158 732 patients first diagnosed with diabetes from January 1, 2010 to December 31, 2012 and subsequently developed multimorbidity as of December 31, 2019, we extracted those who died before December 31, 2019 as case participants. For each participant, we randomly matched with up to 4 people of the same sex, multimorbidity age, and second chronic condition who had not died after going through the same survival period of the case participant. Multimorbidity interval was included as a continuous variable. We used conditional logistic regression to estimate adjusted odds ratios (aOR) for mortality.

Results:

In total, 3508 case participants were matched with 14 032 control participants. Conditional logistic regression showed there were 19%-reduced odds of mortality following the extension of multimorbidity interval by 1 year. Similar associations were observed in men, women, people aged 64 years or younger, and older people aged 65 years or more.

Conclusions:

Delayed multimorbidity among patients living with diabetes may be related to a lower risk of mortality. This study suggests that we should focus on mitigating and lowering the risk of multimorbidity in clinical management of diabetes to reduce further complication and mortality.
They Deserve to Live: Impact of the Berlin Heart EXCOR on Small Children's Heart Transplant Waitlist in Low-Resource Settings
Authors: Caneo Luiz Fernando , Turquetto Aida Luiza Ribeiro , Rodrigues Gonçalves Fábio Augusto , Trindade Evelinda Marramon , Buchholz Holger , Garros Daniel , Miana Leonardo Augusto , Massoti Maria Raquel Brigoni , Tanamati Carla , Penha Juliano Gomes , Jatene Marcelo Biscegli , Jatene Fabio Biscegli
Published: October 2024

Background: In newly emerging economy countries, the shortage of pediatric donor hearts and poor healthcare infrastructure poses a significant challenge. Although mechanical circulatory support (MCS) has been proven effective in enhancing heart transplant waiting list outcomes, economic barriers hinder its widespread adoption. Methods: A single-center retrospective study reviewed children under 10 kg on the heart transplant (HTx) list from 2012 to 2023. Elective or priority status was assigned based on their clinical condition at the time of transplant. In cases of clinical decompensation, centrifugal pump and extracorporeal membrane oxygenation, transitioned to the Berlin Heart EXCOR (BHE) pediatric ventricular assist device (VAD) was employed. Pre- and post-HTx outcomes were analyzed with descriptive statistics, Cox regression, and competing survival risks. Results: Out of 81 infants on the HTx list, 61.7% (50/81) were in critical condition. The median wait time was 224 days, and 34% (28/81) died while waiting. Out of 37 transplanted patients, 6 (16%) had graft dysfunction, and 10 (27%) had acute renal injury. Survival to discharge was 84% (31/37). Patients who received the BHE exhibited higher chances of receiving a transplant (hazard ratio: 2.3; 95% confidence interval: 1.2-4.6; P = .01). Priority status or MCS use did not significantly impact mortality post-transplant. Conclusion: Advanced MCS technologies can potentially reduce the mortality risk on the pediatric HTx waitlist. The findings highlight the significant waiting time for HTx and the critical role of the BHE in improving outcomes in children, particularly those under 10 kg. The results advocate for the adoption of ventricular assist devices as a viable interim solution to bridge critically ill children to HTx, ultimately enhancing their chances of survival despite limited donor heart availability.
University Students Speak Out: Suggestions to Improve the Move to Emergency Remote Education
Authors: Howes Pauline A. , Pettigrew Justin E.
Published: October 2024

The 2020 COVID-19 crisis forced universities to make a dramatic shift to emergency remote education (ERE). While the urgency of the pandemic is gone, schools continue implementing ERE, but more often on a short-notice, short-term basis in response to various situations. This research examines students’ suggestions for improving university transitions to ERE and applies them to post-pandemic use of ERE. Qualitative thematic analysis was used to analyze responses to an open-ended survey question answered by 2,751 students at a large Southeastern U.S. university. Responses identified main concerns as Grades and Grading (38%), Better University and Instructor Preparation (23%), Improved Learning Experience (18%), Meeting Student Needs (12%), and No Suggestions (9%). The study found that reducing the uncertainty students felt about ERE’s impact on grades, course content, class schedules, assignments, and communication with instructors would improve their online learning experience. Recommendations suggest preemptive steps universities can take to improve post-pandemic use of emergency remote education.
A Top Model of Urban Residents’ Subjective Well-Being in China
Authors: Pan Bing , Kerstetter Deborah , Yi Xiaoli , Zhang Gaojun , Li Rui , Gao Jie , Shen Xiangyou Sharon , Li Guangming
Published: October 2024

Past research on subjective well-being (SWB) in Western society and China has revealed various contributing factors. This study conducted a series of interviews with Chinese urban residents to systematically analyze those factors based on Bronfenbrenner’s Ecological System Theory. The results revealed that 5 layers, 23 factors, and 55 elements, many of which had distinct Chinese characteristics, contributed to Chinese urban residents’ SWB. The Top Model of SWB, visualized as a spinning top or gyroscope, showcased the interdependent layers of factors impacting Chinese urban residents’ SWB. At its vertical axis is a time dimension as residents often reflect on factors by comparing their present situation with the past and the future. Discussion regarding each layer, the primary factors that comprise each layer, links between the layers, and the impact of a time dimension was included to substantiate the proposed model. The discussions focus on the study’s contribution to SWB literature, public policy-making, and future research on urban Chinese residents’ SWB.
Pre-service Teachers’ Perceived Importance of and Performance on Sustainable Development Goals
Authors: Hsieh Chuan-Chung , Chien Wei-Cheng , Lin Ting-Lu
Published: October 2024

This study aimed to examine the awareness and performance of pre-service teachers in Taiwan regarding the Sustainable Development Goals (SDGs). A mixed-methods research approach was employed, utilizing a questionnaire survey to obtain quantitative data on pre-service teachers’ perceived importance of and performance on SDGs. Qualitative data were supplemented through interviews with professors and pre-service teachers at a university that incorporated SDGs into its pre-service teacher education courses. The findings revealed that pre-service teachers perform best in “Quality Education” and “Gender Equality.” Men with STEM(Science, Technology, Engineering, Mathematics) fields demonstrated higher levels of awareness of sustainable development, and pre-service teachers majoring in STEM fields outperformed those in non-STEM fields in SDGs performance. Pre-service teachers identified “Good Health & Well-being,”“Life below Water,” and “Life on Land” as the indicators in most urgent need of improvement. Integrating the SDGs into teacher education programs can assist pre-service teachers in enhancing their awareness and performance regarding various SDG indicators.
Interpersonal Violence Victimization Among College-Attending and Non-College-Attending Emerging Adults
Authors: Daly Kelly A. , Heyman Richard E. , Smith Slep Amy M. , Lorber Michael F. , Cantor David , Fisher Bonnie S. , Lapshina Natalia , Chibnall Susan H. , Townsend Reanne
Published: October 2024

It is well-established that rates of interpersonal violence (IV; physical and emotional intimate partner violence [IPV], non-consensual sexual contact [NCSC], and stalking) peak at 18–24 years of age. Most emerging-adult IV research has been conducted with college samples, making increased risk for IV in college a widely held, but perhaps unjustified, assumption. This nationally representative study ( N = 1025) assessed high school seniors on IV victimization and re-assessed them the spring following college enrollment ( n = 779) or non-enrollment ( n = 246). Replicating prior research, we found few differences in prevalences of IV among college-attending and non-attending emerging adults. After controlling for demographics and baseline victimization, only clinically significant (impactful) physical IPV victimization differed between groups, with college conveying a protective effect (OR = 38, 95% CI: .15 – .99). Explication of proximal and distal factors that inform risk for IV among emerging adults on different trajectories is essential for improved prevention and response.
Association of the COVID-19 Pandemic With Outcomes After Anterior Cruciate Ligament Reconstruction: A Retrospective Comparative Study Examining Changes in Health Care Access, Delivery, and Functional Outcomes
Authors: Steiner Quinn , Zacharias Anthony , Chumanov Elizabeth , Baer Geoffrey S. , Walczak Brian E.
Published: October 2024

Background:

Structured rehabilitation optimizes outcomes and reduces reinjury risk after anterior cruciate ligament reconstruction (ACLR). The coronavirus 2019 (COVID-19) pandemic interrupted standard rehabilitation, possibly affecting ACLR outcomes.

Purpose:

To characterize changes to ACLR functional outcomes related to the COVID-19 pandemic.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Patients who underwent ACLR between June 11, 2019, and March 11, 2020, (postpandemic group) were compared retrospectively with those who underwent ACLR the year before (June 11, 2018, to March 11, 2019). A mixed-effects linear regression model was used to estimate group differences in isokinetic quadriceps testing. A Kaplan-Meier analysis assessed the probability of achieving >90% limb symmetry index (LSI) for isokinetic quadriceps strength at 60 deg/s and passing all return-to-sport functional outcomes at 1 year postoperatively.

Results:

A total of 176 patients (80 in the control group and 96 in the postpandemic group) were included. The rate of achieving >90% LSI in isokinetic strength at 60 deg/s at 1 year postoperatively was 39% (95% CI, 27%-49%) for the control group versus 22% (95% CI, 13%-30%) for the postpandemic group ( P = .01). Similarly, the rate of achieving >90% LSI in all functional tests at 1 year postoperatively was 15% (95% CI, 7%-22%) for the control group versus 7% (95% CI, 2%-12%) for the postpandemic group ( P = .04). The number of in-person physical therapy visits per patient was 25.8 ± 6.8 in the control group versus 24.4 ± 7.5 in the postpandemic group ( P = .23). Only the postpandemic group accessed physical therapy using remote telemedicine. Each additional telehealth rehabilitation visit was associated with a 1-week delay in achieving >90% LSI in isokinetic quadriceps strength for the postpandemic group.

Conclusion:

The COVID-19 pandemic was associated with a decrease in lower extremity strength and a lower probability of achieving limb symmetry and passing the criteria for return to sport at 1 year postoperatively. These results were not due to lack of access to physical therapy.
Community-Engaged Learning: Centering Public Health in Undergraduate Education by Examining Food Insecurity in the Tampa Bay Area
Authors: Kingsley Rachel
Published: October 2024

Community-engaged learning (CEL) is a “hands-on” approach to introducing undergraduate students to public health methods and theory in local contexts. CEL bridges academic theory and real-world practice by civic development and learning while addressing real-world problems, community needs, and interests. By applying public health theory and methods, students examined food insecurity and inequity in the Tampa Bay area by working in a community food garden and food distribution center to examine the social, economic, and environmental conditions that influence food insecurity. There were several learning outcomes for the students’ CEL experience, such as increasing the understanding of social issues through participation in the community, understanding the importance of offering culturally appropriate food, and examining how food insecurity is perpetuated by structural, social, and racial barriers within their community. This paper will discuss the process of creating community partnerships for CEL, student assignments, students feedback and reflection about their CEL experiences, and future recommendations for integrating CEL into undergraduate courses.
Professional–personal boundary work: Individuals torn between integration and segmentation
Authors: Weiss Silvana , Ortlieb Renate
Published: October 2024

What drives individuals to work until late at night or during holidays, and how do they stop work or keep work commitment in its place? This qualitative study examines boundary work between the professional and the personal life domains. Drawing on interviews with 26 academics employed at a university, we identify various boundary work drivers and tactics. Norms prevailing in the professional field, career requirements and high workloads, as well as strong intrinsic passion for science drive individuals to work long hours and to blend the professional–personal boundary. At the same time, individuals try to establish boundaries to ensure productivity and one’s health, or meeting family and personal life needs. Furthermore, our research reveals three patterns of the relationship between integration and segmentation. Firstly, individuals utilize segmentation to restrict integration, employing sophisticated tactics such as self-deception or self-isolation to shield themselves from the negative repercussions of excessive integration. Secondly, segmentation tactics can not only restrict integration but also enable it, for instance through the creation of ‘free’ times and spaces. Thirdly, individuals sometimes also utilize integration to enable segmentation. Our findings expand boundary theory by identifying manifold boundary-work drivers and tactics and by revealing that integration and segmentation are not just two opposing poles of a continuum but they are mutually connected, restricting or enabling one another.