bluuebunny/crossref_metadata_2025 huggingface dataset:
Missed Approach, a Safety-Critical Go-Around Procedure in Aviation: Prediction Based on Machine Learning-Ensemble Imbalance Learning
Authors: Khattak Afaq , Chan Pak-Wai , Chen Feng , Peng Haorong , Mongina Matara Caroline
Published: July 2023

The final approach phase of an aircraft accounts for nearly half of all aviation incidents worldwide due to low-level wind shear, heavy downpours, runway excursions, and unsteady approaches. Adopting the missed approach (MAP) procedures may prevent a risky landing, which is usually executed in those situations, but it is safety-critical and a rare occurrence. This study employed machine learning-ensemble imbalance learning to predict MAPs under low-level wind shear conditions based on environmental and situational parameters. The models were developed using the 2017–2021 Hong Kong International Airport (HKIA) Pilot Reports (PIREPs). Initially, imbalance data were applied to machine learning models such as the random forest (RF), light gradient boosting machine (LGBM), and extreme gradient boosting (XGBoost), but these were unable to accurately predict the occurrence of MAPs. Then, these models were used as base estimators for ensemble imbalance learning methods, including the self-paced ensemble (SPE) framework, the balance cascade model, and the easy ensemble model. The SPE framework utilizing XGboost as the base estimator performed better than other frameworks in terms of recall, F1-score, balanced accuracy, and geometric mean. Afterwards, SHAP was utilized to interpret the SPE framework with XGboost as the base estimator. Results showed that low-level wind shear magnitude, runway orientation, and vertical location of low-level wind shear contributed most to MAPs. Runways 07C and 07R had the most MAPs. Most MAPs were initiated when low-level wind shear was within 500 feet of the ground. Strong tailwind triggered MAPs more than headwind. For aviation safety researchers and airport authorities, the framework proposed in this study is a valuable tool.
Data from Validating Wave 1 (2014) urinary cotinine and TNE-2 cut-points for differentiating Wave 4 (2017) cigarette use from non-use in the US using data from the PATH Study.
Authors: Edwards Kathryn C. , Khan Asia , Sharma Eva , Wang Lanqing , Feng June , Blount Benjamin C. , Sosnoff Connie S. , Smith Danielle M. , Goniewicz Maciej L. , Pearson Jennifer , Villanti Andrea C. , Delnevo Cristine D. , Bover Manderski Michelle T. , Hatsukami Dorothy K. , Niaura Raymond , Everard Colm , Kimmel Heather L. , Duffy Kara , Rostron Brian L. , Del Valle-Pinero Arseima Y. , van Bemmel Dana M. , Stanton Cassandra A. , Hyland Andrew
Published: July 2023

Abstract
Background: Sex and racial/ethnic identity specific cut-points for validating tobacco use using Wave 1 (W1) of the PATH Study were published in 2020. The current study establishes predictive validity of the W1 (2014) urinary cotinine and Total Nicotine Equivalents-2 (TNE-2) cut-points on estimating Wave 4 (W4; 2017) tobacco use.
Methods: For exclusive and polytobacco cigarette use, weighted prevalence estimates based on W4 self-report alone and with exceeding the W1 cut-point were calculated to identify the percentage missed without biochemical verification. Sensitivity and specificity of W1 cut-points on W4 self-reported tobacco use status were examined. Receiver Operating Characteristic curves were used to determine the optimal W4 cut-points to distinguish P30D users from non-users, and evaluate if the cut-points significantly differed from W1.
Results: Agreement between W4 self-reported use and exceeding the W1 cut-points was high overall and when stratified by demographic subgroups (0.7- 4.4% of use was missed if relying on self-report alone). The predictive validity of using the W1 cut-points to classify exclusive cigarette and polytobacco cigarette use at W4 was high (>90% sensitivity and specificity, except among polytobacco Hispanic smokers). Cut-points derived using W4 data did not significantly differ from the W1 derived cut-points (e.g., W1 exclusive= 40.5 ng/mL cotinine [95% CI: 26.1-62.8], W4 exclusive = 29.9 ng/ml cotinine [95% CI: 13.5-66.4]), among most demographic subgroups.
Conclusion: The W1 cut-points remain valid for biochemical verification of self-reported tobacco use in W4.
Impact: Findings from can be used in clinical and epidemiological studies to reduce misclassification of cigarette smoking status.
Activator Protein-1 (AP-1) Signaling Inhibits the Growth of Ewing Sarcoma Cells in Response to DNA Replication Stress
Authors: Croushore Emma E. , Koppenhafer Stacia L. , Goss Kelli L. , Geary Elizabeth L. , Gordon David J.
Published: July 2023

Ribonucleotide reductase (RNR) catalyzes the rate-limiting step in the synthesis of deoxyribonucleosides and is required for DNA replication. Multiple types of cancer, including Ewing sarcoma tumors, are sensitive to RNR inhibitors or a reduction in the levels of either the RRM1 or RRM2 subunits of RNR. However, the polypharmacology and off-target effects of RNR inhibitors have complicated the identification of the mechanisms that regulate sensitivity and resistance to this class of drugs. Consequently, we used a conditional knockout (CRISPR/Cas9) and rescue approach to target RRM1 in Ewing sarcoma cells and identified that loss of the RRM1 protein results in the upregulation of the expression of multiple members of the activator protein-1 (AP-1) transcription factor complex, including c-Jun and c-Fos, and downregulation of c-Myc. Notably, overexpression of c-Jun and c-Fos in Ewing sarcoma cells is sufficient to inhibit cell growth and downregulate the expression of the c-Myc oncogene. We also identified that the upregulation of AP-1 is mediated, in part, by SLFN11, which is a replication stress response protein that is expressed at high levels in Ewing sarcoma. In addition, small-molecule inhibitors of RNR, including gemcitabine, and histone deacetylase inhibitors, which reduce the level of the RRM1 protein, also activate AP-1 signaling and downregulate the level of c-Myc in Ewing sarcoma. Overall, these results provide novel insight into the critical pathways activated by loss of RNR activity and the mechanisms of action of inhibitors of RNR.

Significance:

RNR is the rate-limiting enzyme in the synthesis of deoxyribonucleotides. Although RNR is the target of multiple chemotherapy drugs, polypharmacology and off-target effects have complicated the identification of the precise mechanism of action of these drugs. In this work, using a knockout-rescue approach, we identified that inhibition of RNR upregulates AP-1 signaling and downregulates the level of c-Myc in Ewing sarcoma tumors.
Life’s Essential 8 and Risk of Stroke: A Prospective Community-Based Study
Authors: Wu Shouling , Wu Zhijun , Yu Dongmei , Chen Shuohua , Wang Aitian , Wang Anxin , Gao Xiang
Published: July 2023

BACKGROUND:

Data are lacking regarding cardiovascular health (CVH) with Life’s Essential 8 approach and future stroke risk. We sought to elucidate whether the CVH score constructed by the Life’s Essential 8 metrics predicted stroke risk in 2 Chinese ongoing cohorts.

METHODS:

This included 41 043 participants of the Kailuan I study and 27 842 participants of the Kailuan II study who were free of cardiovascular disease or cancer in 2014. CVH score (ranged from 0 to 100) was assessed using the Life’s Essential 8 metrics (body mass index, cigarette smoking, diet quality, physical activity, sleep health, lipid, blood glucose, and blood pressure). A composite of incident stroke events (ischemic stroke and hemorrhagic stroke) was identified via review of medical records. The follow-up period was calculated from the finishing date of the 2014 survey to either the date of stroke occurrence, death, loss to follow-up, or the end of follow-up (December 31, 2020). We also examined the longitudinal association between the CVH score and arterial stiffness status, as assessed by brachial-ankle pulse wave velocity, in 25 922 participants free of cardiovascular disease during the follow-up. We performed a meta-analysis to assess the association between CVH, based on the 2010 American Heart Association recommendation, and stroke integrating the results of current study and previous studies.

RESULTS:

During a median follow-up of 5.65 years (interquartile range, 5.20–6.09), a total of 1750 incident stroke events were identified in the pooled Kailuan study. The pooled hazard ratios were 0.33 (95% CI, 0.20–0.54) for ideal versus poor health category of CVH (
P
trend
<0.0001). Higher CVH scores were also associated with lower brachial-ankle pulse wave velocity values at baseline and slower increments of brachial-ankle pulse wave velocity during follow-up (
P
trend
≤0.001 for both). Arterial stiffness mediated 9.07% (95% CI, 5.83%–15.0%) of the total association between CVH and incident stroke. The pooled hazard ratio comparing 2 extreme CVH categories for stroke was 0.45 (95% CI, 0.35–0.59) when including 10 published studies and the current study.

CONCLUSIONS:

The CVH score as assessed by the Life’s Essential 8 metrics significantly predicted future stroke risk and arterial stiffness status.
Study of the Chinese Members of the Subfamily Anabropsinae (Orthoptera: Anostostomatidae) VII: Description of two new subgenera and five new species of Anabropsis from China
Authors: PANG SIYU , LU XIANGYI , BIAN XUN
Published: July 2023

This paper is further study Chinese Anabropsinae and proposes two new subgenera of Anabropsis from China, Anabropsis (Spinanabropsis) subgen. nov. and Anabropsis (Pseudapteranabropsis) subgen. nov.. Five new species are described, namely Anabropsis (Apteranabropsis) daweishanensis sp. nov., Anabropsis (Spinanabropsis) pengi sp. nov., Anabropsis (Spinanabropsis) erythronota sp. nov., Anabropsis (Pseudapteranabropsis) nigrimaculatis sp. nov. and Anabropsis (Pseudapteranabropsis) flavimaculata sp. nov. All the specimens are deposited in Guangxi Normal University.
Of babies, bathwater, and big data: Going beneath the surface of Franzén’s (2023) Google Trends recommendations
Authors: Raubenheimer Jacques
Published: July 2023

Franzén (2023 : 1) has warned of ‘big problems’ when researchers attempt to use Google Trends (GT) data. The evidence she provides is examined, additional evidence is obtained and analysed, and a new set of conclusions are derived. The anomalies previously encountered are due to a combination of factors, but can be explained by noting that Google samples its data to provide GT results, these data are also scaled, which can exacerbate variation between samples, and Denmark is a small country and Jakob Scharf a low-probability search term, both of which would increase variation in search probabilities provided by GT. When multiple samples are obtained and aggregated (medians are best for low-probability search terms), this variation is controlled, and a stable time series is derived. Researchers should not see GT as an easy source of data, but should do the work required to understand the data, and should use it, and interpret their results, within the limitations inherent in these data. It is important to aggregate multiple samples (preferably with the median for each time point) in order to obtain more stable estimates from GT.
Factors Constraining Rural Road Transport Systems in Enugu State, Nigeria
Authors: Ali Alphonsus Nwachukwu , Madu Ignatius Ani , Okafor Uchenna Paulinus
Published: July 2023

The study investigated the underlying factors constraining sustainable development of rural road transport systems in Enugu State. Interview schedules and field observations data were purposively collected from 714 respondents comprising vehicle operators, passengers and representatives of transport units of Local Government Works Departments of the state. Principal Component Analysis was used to identify five constraints to sustainable rural road transport systems’ improvement in Enugu State. These constraints accounted for 84.71% of the observed poor improvement of rural road transport systems in Enugu State. Recommendations were made to achieve sustainable rural road transport improvement in Enugu state.
Nnamdi Azikiwe Center: Historicizing the Immortalization of Zik’s Lodge in Nigeria—the Journey, the Project, and Tourism Potentials
Authors: Onyejegbu Maureen , Okemini Ogbonna Onyebuchi , Ikenegbu ThankGod Chukwuemeka , Unaegbu Jeff , Onyegiri Chikodiri
Published: July 2023

This paper examined the recent immortalization project of Hon. Dr. Nnamdi Azikiwe at Enugu. Historicizing his achievements and legacies, the paper studied the roles he played in ensuring that independent Africa is attained and why he continues to be remembered even after his death. The research method is qualitative and descriptive. Secondary data such as newspapers, books, journals and online materials are used to enrich the work. The result shows that the inauguration of the Nnamdi Azikiwe Centre and other previous projects that immortalized him were as a result of his outstanding and selfless services to Africa and Nigeria in particular. The paper discovered that the new Nnamdi Azikiwe Centre was his renovated residential lodge which richly embodies his political history and career years, thoughts, ideology, and philosophy. The findings of this research will help government officials, historians, tourists, and students in making decisions on good governance, consulting material in education, and tourism development.
The Relations between Systems of Oppression and Oral Care Access in the United States
Authors: Bastos J.L. , Fleming E. , Haag D.G. , Schuch H.S. , Jamieson L.M. , Constante H.M.
Published: July 2023

We applied a structural intersectionality approach to cross-sectionally examine the relationships between macro-level systems of oppression, their intersections, and access to oral care in the United States. Whether and the extent to which the provision of government-funded dental services attenuates the emerging patterns of associations was also assessed in the study. To accomplish these objectives, individual-level information from over 300,000 respondents of the 2010 US Behavioral Risk Factor Surveillance System was linked with state-level data for 2000 and 2010 on structural racism, structural sexism, and income inequality, as provided by Homan et al. Using multilevel models, we investigated the relationships between systems of oppression and restricted access to oral health services among respondents at the intersections of race, gender, and poverty. The degree to which extended provision of government-funded dental services weakens the observed associations was determined in models stratified by state-level coverage of oral care. Our analyses bring to the fore intersectional groups (e.g., non-Hispanic Black women and men below the poverty line) with the highest odds of not seeing a dentist in the previous year. We also show that residing in states where high levels of structural sexism and income inequality intersect was associated with 1.3 greater odds (95% confidence interval, 1.1–1.5) of not accessing dental services in the 12 mo preceding the survey. Stratified analyses demonstrated that a more extensive provision of government-funded dental services attenuates associations between structural oppressions and restricted access to oral health care. On the basis of these and other findings, we urge researchers and health care planners to increase access to dental services in more effective and inclusive ways. Most important, we show that counteracting structural drivers of inequities in dental services access entails providing dental care for all.
Carceral connections: The role of policing in the management of public housing in New York City
Authors: Rodriguez James
Published: July 2023

Between 2006 and 2022, the New York City Housing Authority (NYCHA) attempted to address the fiscal and infrastructural crises in public housing through a number of controversial privatisation strategies. This contested push occurred alongside the pervasive role of policing in public housing. The New York City Police Department utilises several policing strategies specific to NYCHA communities, collaborating with the housing authority in the management of public housing residents. This article draws on qualitative content analysis of local policing strategies and public housing policy reforms in New York City to investigate how the state facilitates the displacement of disproportionately poor, non-white, public housing tenants while simultaneously sponsoring privatised redevelopment in their communities in ways that mirror gentrification processes usually studied in private housing. I focus on the content of and linkages between public housing-specific policing strategies and privatising public housing redevelopment plans. By examining police as collaborators within public housing policy, I uncover the entanglement of law enforcement in urban development, as well as the underlying roles and relationships between the state, capital and police in contemporary urban development and gentrification. The findings illuminate the processes of carceral urbanism, where the logics of the carceral state emerge as priorities throughout the urban governance of the contemporary neoliberal state in general, and public housing policy reform in particular.
Prediction models of bioaerosols inside office buildings: A field study investigation
Authors: Jiang Dong , Gong Xiaoqiang , Xu Zhengsong , Yuan Kai , Bu Zengwen
Published: July 2023

Bioaerosols formed by microorganisms in the air directly affect people’s health. The air quality in an office building in Shenzhen, China, is investigated and pollutant levels measured on 36 occasions; six times for each of six indoor spaces. A relationship between indoor bioaerosols and environmental factors was determined using both linear regression analysis and Poisson regression analysis. Our results and analysis indicate that linear regression is a poor predictor for the concentration of bioaerosols based on a single indicator. In contrast, Poisson regression can better predict the concentration of bioaerosols, and PM10 may be the indicator with the greatest impact on bioaerosols. As a result, a simple, fast, and low-cost online monitoring method for monitoring indoor bioaerosols is developed and reported. Our paper provides first-hand basic data to predict the indoor bioaerosol concentration and helps to formulate appropriate monitoring guidelines. The proposed method offers more practical values compared to existing studies as our prediction model facilitates estimation of the concentration of bioaerosols at low cost. Additionally, due to the current maturity and low cost of indoor environmental sensors, the proposed method is suitable for large-scale deployment for most buildings.

Practical application

Based on measurement data from a real office building, our investigation explores the relationship between indoor microorganisms and building environmental indicators through a combination of probability analysis and actual measurement. We establish a novel indoor microbial prediction model using the Poisson regression model. Our work presents an effective, low-cost, method for estimating the concentration of bioaerosols and discusses the possibility for large-scale deployment of microbial monitoring equipment inside buildings which may then support real-time monitoring of indoor microbial concentration to provide healthy indoor environments for personnel.
Atezolizumab as the First Systemic Therapy Approved for Alveolar Soft Part Sarcoma
Authors: Bergsma Emilie J. , Elgawly Mariam , Mancuso David , Orr Roger , Vuskovich Theresa , Seligson Nathan D.
Published: July 2023

Objective

The objective was to review the pharmacology, efficacy, and safety of atezolizumab (Tecentriq) for the treatment of adult and pediatric patients aged 2 years and older with unresectable or metastatic alveolar soft part sarcoma (ASPS).

Data Sources

A literature search was conducted using PubMed and MEDLINE databases, published abstracts, and ongoing studies from ClinicalTrials.gov between January 1, 1981, and May 31, 2023. Keywords included atezolizumab, Tecentriq, MPDL3280, immunotherapy, PD-L1, PD-1, pediatrics, sarcoma, and ASPS.

Study selection and data extraction

All English-language studies involving atezolizumab for ASPS were included and discussed.

Data synthesis

Atezolizumab is an anti-programmed death-ligand 1 (PD-L1) monoclonal antibody designed to block the interaction between PD-L1 and the programmed cell death protein 1 (PD-1) receptor. Atezolizumab was granted approval by the FDA specifically for ASPS based on a phase II clinical trial in adult and pediatric patients (n = 49), which reported an overall response rate of 24% and a durable response rate at 6 and 12 months of 67% and 42%, respectively. Common grade 3/4 adverse reactions include musculoskeletal pain (8%), followed by hypertension (6%), weight gain (6%), headache (4%), and dizziness (4%).

Relevance to patient care and clinical practice in comparison with existing drugs

Advanced ASPS is a high-risk disease with limited treatment options. Atezolizumab appears to be a viable treatment option in ASPS demonstrating clinical efficacy and a manageable toxicity profile.

Conclusions

With no other treatments that are FDA approved specifically for ASPS, and few demonstrating efficacy in the advanced setting, the approval of atezolizumab, including the first approval for pediatric patients, represents a landmark improvement to the therapeutic arsenal against this rare disease.
Effects of barley seedling powder on rheological properties of dough and quality of steamed bread
Authors: Cao Xiaohuang , Islam Md. Nahidul , Lu Dandan , Han Congying , Wang Lei , Tan Mingxiong , Chen Yuan , Xin Ning
Published: July 2023

In order to find the optimal share of barley seedling powder (BSP) to improve the rheological properties of wheat dough and physico-chemical properties of steamed bread (SB), BSP was added with wheat flour at various proportions (2–10%). Results showed that with the increasing amount of BSP additive, the farinograph index (86.33–123), dough stability (9.37–12.63 min), and dough development time (6.23–7.63 min) in blend flour increased. Similarly, with the increasing BSP, SB became darker and more greenish, and the total flavonoid content increased. The content of chlorophyll-b, and total chlorophyll demonstrated a faster increase than that of chlorophyll-a. The hardness and chewability of SB improved as well whereas the springiness increased first and then decreased. The best springiness and gumminess of SB were found with 2% and 8% BSP additives respectively. 2%, 4%, and 6% addition of BSP resulted in a slight fluctuation in the bound water quantity than 8% and 10% BSP additive. No new compound formation was confirmed by Infrared analysis and there was only a heat and mass transfer process. Results from this study indicated that SB with improved quality attributes can be prepared from wheat ﬂour fortiﬁed with BSP at 2–4%.
The heterogeneous well-being effects of intergenerational mobility perceptions
Authors: Gugushvili Alexi
Published: July 2023

Individuals make comparisons with their parents which determine their intergenerational mobility perceptions, yet very little is known about the areas used for intergenerational comparison and whether these matter for individuals’ well-being. In 2021 we commissioned a nationally representative survey in Georgia in which we explicitly asked 1159 individuals an open-ended question on the most important areas in their intergenerational comparisons. More than 170 types of answers were provided by respondents and many of these responses went beyond the standard indicators of intergenerational mobility. We show that the areas of intergenerational comparison significantly differ between those who perceive themselves as being downwardly and upwardly mobile or immobile using the measure of mobility previously validated in cross-national research. Using, among other statistical approaches, treatment effects estimators, we demonstrate that some areas of intergenerational comparison, particularly in terms of income attainment, are significantly and consistently associated with internationally validated measures of well-being.
Who feels marginalized? A latent class analysis of perceived societal marginalization
Authors: Bollwerk Michael , Wetzel Eunike , Schlipphak Bernd , Back Mitja D.
Published: July 2023

Previous research has followed a binary perspective in analyzing the effects of modernization and globalization, often assumed to produce the societal camps of both “winners” and “losers” in economic, cultural, and political terms. However, our understanding of these individual differences and the social groups that perceive themselves as disadvantaged by society is still limited. Hence, in contrast to previous findings we argue that the phenomenon may be better grasped by following a “pattern approach.” Hence, in three different samples (total N = 2,566), we applied Latent Class Analysis to investigate subgroups representing individual differences in Perceived Societal Marginalization (PSM). Furthermore, we explored sociodemographic, personal-resource-related, attitudinal, and personality determinants of people’s class membership probabilities to better understand the subgroups—or: patterns—we identified in substantive terms. In the discussion, we focus on the implications of our findings regarding societal cleavages, prejudice toward minority groups, and the support of far-right political parties.
Challenges navigating publicly funded home care in Ontario, Canada: Perspectives from unpaid caregivers of persons living with dementia
Authors: Marani Husayn , Shaw James , Marchildon Gregory P
Published: July 2023

In Canada, persons living with dementia represent a sizable number of home care recipients. Although home care is not wholly publicly funded under provincial health insurance plans, some provinces like Ontario subsidize a maximum number of hours of home care provided by a personal support worker (PSW) on the basis of need. The public subsidization of home care may be interpreted as a mechanism of financial risk protection, enabling unpaid caregivers to maintain employment, income levels, and personal health. However, deficits in the availability of home care call into question how the organization of home care may be contributing to financial risk among unpaid caregivers. Inspired by qualitative phenomenology, this study describes the financial risks experienced by unpaid caregivers of persons living with dementia navigating publicly funded homecare in Ontario. Based on 24 interviews conducted between August-December, 2020, we found financial risk emerges across three dimensions: 1) receiving information about publicly funded home care that anticipates future care needs; 2) receiving flexible hours of support from a PSW; and 3) maintaining consistent access to quality support. Financial risks included turning to privately funded home care options, or taking time off work to provide care. Findings may inform local and international home care reforms aiming to protect caregivers from financial risk.
Disentangling the Consequences of Systemic Racism and Clinical Paranoia to Promote Effectiveness of a Cognitive-Behavioral Intervention for Persecutory Delusions in Minoritized Individuals: A Case-Example
Authors: Moussa-Tooks Alexandra B. , Sheffield Julia M. , Freeman Daniel , Brinen Aaron P.
Published: July 2023

While everyone experiences threats, some threats are culturally specific and not universally recognized or addressed by providers. A prominent example is threat-based worry and hypervigilance in Black Americans and other minoritized individuals, which is higher due to systemic racism and increases risk for psychopathology like clinically significant paranoia. To date, there have been no adaptations of cognitive-behavioral therapies for Black Americans with psychosis, despite the long-standing history of systemic racism in the United States, and its increasingly recognized contribution to psychotic experiences. Accordingly, we present the first step towards developing an adapted cognitive-behavioral intervention for Black and minoritized Americans with psychosis. This adaptation of an empirically supported worry-based treatment for persecutory delusions was accomplished by comprehensive conceptualization and integration of how systemic racism and minoritization drive the prevalence and perception of threats. This contrasts with conceptualizing racism-related hypervigilance and cognitions as worry or ignoring these critical experiences altogether, which is invalidating and neglects optimal identification and intervention on behavioral targets. Using a validating and normalizing approach, the individual was able to identify how frequent threats related to systemic racism resulted in increased worry, vigilance, and distress. By identifying and intervening on the perception of threat and associated worry, the individual engaged in more helpful responses to the threat, which in turn increased participation in more meaningful activities and reduced worry and clinical paranoia. This case illustrates how accurate conceptualization clarifies behavioral targets and increases patient engagement, which together enhance the effectiveness of the intervention for minoritized individuals.
Novel Technique for Intentional Occlusion of Directional Branches During Complex Endovascular Aortic Repair Using Microvascular Plugs
Authors: Xodo Andrea , Taglialavoro Jacopo , Lepidi Sandro , Pilon Fabio , Calvagna Cristiano , Griselli Filippo , Milite Domenico , Badalamenti Giovanni , Ruaro Barbara , D’Oria Mario
Published: July 2023

Purpose

To demonstrate the feasibility and outcomes of using the microvascular plug (MVP) for intentional occlusion of directional branches (DB) during complex endovascular aortic procedures.

Case Report

Two patients were treated with the off-the-shelf four-branched Zenith t-Branch thoracoabdominal stent-graft (Cook Medical, Bloomington, Ind). In both cases, the renal arteries (on one side in patient #1 and on both sides in patient #2, respectively) were occluded at time of index intervention. Preoperative planning included the intentional occlusion of each DB with one 7Q-MVP. Technical success was achieved in all cases and maintained at mid-term follow-up (12 months and 36 months, respectively).

Conclusions

Use of the MVP appears to be feasible and effective for intentional occlusion of DB during complex endovascular aortic repair. This novel and simple technique may present some unique technical advantages, allowing precise placement of the device while avoiding extension using a bridging stent and DB cannulation with larger sheaths.
Surpass embolization of intracranial aneurysms: Perspective from a 2-year longitudinal follow-up study across high volume comprehensive stroke centers
Authors: Gupta Gaurav , Sreenivasan Sanjeev , Kane Ian , Salguiero Lauren , Saifuddin Ali , Sundararajan Srihari , Khandelwal Priyank , Nourallah-Zadeh Emad , Sun Hai , Sonig Ashish , Singla Amit , Nanda Anil , Roychowdhury Sudipta
Published: July 2023

Background

Surpass Streamline (SS; Stryker©) is an over-the-wire first-generation flow diverter (FD). There is a scarcity of data on real-world outcomes and complications of this FD.

Methods

A retrospective review of consecutive cases between January 2019 and July 2021 at two high-volume comprehensive stroke centers, involving SS was conducted.

Results

Fifty-five patients harbored 69 treated aneurysms, of which 96% were in the internal carotid petrous to terminus segments and 88% were <10 mm in size, and 12% measuring 10–24 mm. Raymond Roy Grade 1 occlusion was noted in 55 aneurysms (79.7%) at 1 year. Median follow-up duration was 26 months (mean = 26.06). Major complications were seen in eight patients (14.5%; 95% CI 6.5–26.7) and mortality attributable to SS stenting complications occurred in two (4.3%) patients. Four (7.2%) had ophthalmologic thromboembolic complications and two had (3.6%) ischemic complications. Procedural complications occurred in 10 patients (18.18%; 95% CI 9.1–30.9). Technical complications during procedure (n = 3, 5.3%) were: “confirmed” distal middle cerebral artery (MCA) guidewire perforation; “suspected” distal MCA guidewire perforation causing post-procedural subarachnoid hemorrhage and internal carotid artery dissection causing ischemic stroke. Seizures were seen in 5 (9.09%) and carotid-cavernous fistula in 1 (1.8%). Multivariate regression analysis showed technical challenges significantly predicted occurrence of major complications (p = 0.001; R2 = 0.39, F(13,43) = 2.15, p = 0.029). Univariate analysis showed technical challenges significantly predicted ophthalmological complications ( R2 = 0.06, F(1,55) = 4.04, p = 0.049) and major complications ( R2 = 0.21, F(1,55) = 15.11, p = 0.0002).

Conclusion

Large-scale future registry should focus on national data regarding SS safety, technical challenges, and procedural complications. We present one of the longest follow-ups for SS in literature.
Letter to Putin
Authors: Grint Keith
Published: July 2023

This letter sets out to provide helpful advice to President Putin following the recent mutiny of the Wagner Group. It suggests he has made a catastrophic mistake in invading Ukraine and needs to read the history of previous Russian mutinies to understand how they happen and what is likely to happen next. This is a story that starts in Ukraine and ends in chaos.
Urolithin A alleviates neuropathic pain and activates mitophagy
Authors: Wang Chenyi , Wang Zizhu , Xue Shiyu , Zhu Yutong , Jin Jiahao , Ren Qiuyu , Shi Xiaodong
Published: July 2023

Neuropathic pain (NP) occurs frequently in the general population and has a negative impact on the quality of life. There is no effective therapy available yet owing to the complex pathophysiology of NP. In our previous study, we found that urolithin A (UA), a naturally occurring microflora-derived metabolite, could relieve NP in mice by inhibiting the activation of microglia and release of inflammation factors. Here in this study, we sought to investigate whether mitophagy would be activated when UA alleviated NP in mice. We showed that the autophagy flow was blocked in the spinal dorsal horn of the chronic constriction injury (CCI) mice when the most obvious pain behavior occurs. Intraperitoneal injection of UA markedly activated the mitophagy mediated by PTEN-induced kinase 1/Parkin, promoted mitobiogenesis in both neurons and microglia, and alleviated NP in the CCI mice. In summary, our data suggest that UA alleviates NP in mice and meanwhile induces mitophagy activation, which highlights a therapeutic potential of UA in the treatment of NP.
Political settlements and expatriate dual citizenship in Australia and Indonesia
Authors: Rosser Andrew , Qiao-Franco Guangyu
Published: July 2023

Many countries have extended rights of dual citizenship to their expatriates but, as Faist has noted, the road towards increasing tolerance of expatriate dual citizenship (EDC) has been ‘bumpy’. This study seeks to illuminate the reasons for this bumpiness by examining the political dynamics surrounding EDC in Australia and Indonesia, two countries that have pursued distinct approaches to the issue. In both cases, we find that their approaches have reflected the nature of their political settlements and, in the Australian case, that this effect was mediated by political elite strategizing. We accordingly call on researchers to give greater attention to how political settlements and politicians’ agency shape EDC adoption in future analysis.
Fostering Continuity in College and Career Counseling K–12: Training and Perceived Confidence Between K–8 and High School Counselors
Authors: Ockerman Melissa S. , Patrikakou Eva , Novakovic Alexandra
Published: July 2023

The current study presents results of a quantitative analysis of K–12 school counselors’ perceptions on and preparedness for college and career readiness counseling in a large urban school district serving a diverse, low-income student population. We highlight differences between K–8 and high school counselors’ perceptions related to preparedness, their preservice and in-service training in college and career readiness, and subsequent time allotted to these activities. We also discuss implications for future in-service and preservice training.
Infections following bispecific antibodies in myeloma: a systematic review and meta-analysis
Authors: Reynolds Gemma , Cliff Edward R. Scheffer , Mohyuddin Ghulam Rehman , Popat Rakesh , Midha Shonali , Liet Hing Melissa Ng , Harrison Simon J. , Kesselheim Aaron S. , Teh Benjamin W.
Published: July 2023

Bispecific antibodies, a novel immunotherapy with promising efficacy against multiple myeloma, form immune synapses between T-cell surface marker CD3 and malignant cell markers, including B-cell maturation antigen (BCMA), FcRH5, and G protein–coupled receptor GPRC5D. These bispecific antibodies so effectively deplete plasma cells (and to some extent T-cells) that patients are at increased risk of developing infections. A systematic review and meta-analysis of infections in published studies of patients with myeloma treated with bispecific antibodies was conducted to better characterize the infection risks. A literature search used MEDLINE, EMBASE, and Cochrane to identify relevant studies between inception and February 10, 2023, including major conference presentations. Phase 1b-3 clinical trials and observational studies were included. Sixteen clinical trials comprising 1666 patients were included. Median follow-up was 7.6 months and 38% of the cohort had penta-drug refractory disease. Pooled prevalence of all-grade infections was 56%, whereas the prevalence of grade ≥3 infections was 24%. Patients who were treated with BCMA-targeted bispecifics had significantly higher rates of grade ≥3 infections than non-BCMA bispecifics (25% vs 20%). Similarly, patients treated with bispecifics in combination with other agents had significantly higher rate of all-grade infection than those receiving monotherapy (71% vs 52%). In observational studies (n = 293), excluded from the primary analysis to ensure no overlap with patients in clinical trials, several infections classically associated with T-cell depletion were identified. This systematic review identifies BCMA-targeted bispecifics and bispecific combination therapy as having higher infection risk, requiring vigilant infection screening and prophylaxis strategies.
Improved outcomes of UM171–expanded cord blood transplantation compared with other graft sources: real-world evidence
Authors: Cohen Sandra , Bambace Nadia , Ahmad Imran , Roy Jean , Tang Xiaoying , Zhang Mei-Jie , Burns Linda , Barabé Frédéric , Bernard Léa , Delisle Jean-Sébastien , Kiss Thomas , Lachance Silvy , Roy Denis-Claude , Veilleux Olivier , Sauvageau Guy
Published: July 2023

Cord blood (CB) transplantation is hampered by low cell dose and high nonrelapse mortality (NRM). A phase 1-2 trial of UM171-expanded CB transplants demonstrated safety and favorable preliminary efficacy. The aim of the current analysis was to retrospectively compare results of the phase 1-2 trial with those after unmanipulated CB and matched-unrelated donor (MUD) transplants. Data from recipients of CB and MUD transplants were obtained from the Center for International Blood and Marrow Transplant Research (CIBMTR) database. Patients were directly matched for the number of previous allogeneic hematopoietic stem cell transplants (alloHCT), disease and refined Disease Risk Index. Patients were further matched by propensity score for age, comorbidity index, and performance status. Primary end points included NRM, progression-free survival (PFS), overall survival (OS), and graft-versus-host disease (GVHD)-free relapse-free survival (GRFS) at 1 and 2 years after alloHCT. Overall, 137 patients from CIBMTR (67 CB, 70 MUD) and 22 with UM171-expanded CB were included. NRM at 1 and 2 years was lower, PFS and GRFS at 2 years and OS at 1 year were improved for UM171-expanded CBs compared with CB controls. Compared with MUD controls, UM171 recipients had lower 1- and 2-year NRM, higher 2-year PFS, and higher 1- and 2-year GRFS. Furthermore, UM171-expanded CB recipients experienced less grades 3-4 acute GVHD and chronic GVHD compared with MUD graft recipients. Compared with real-world evidence with CB and MUD alloHCT, this study suggests that UM171-expanded CB recipients may benefit from lower NRM and higher GRFS. This trial was registered at www.clinicaltrials.gov as #NCT02668315.
Use of unsupervised machine learning to characterise HIV predictors in sub-Saharan Africa
Authors: Mutai Charles K. , McSharry Patrick E. , Ngaruye Innocent , Musabanganji Edouard
Published: July 2023

Introduction

Significant regional variations in the HIV epidemic hurt effective common interventions in sub-Saharan Africa. It is crucial to analyze HIV positivity distributions within clusters and assess the homogeneity of countries. We aim at identifying clusters of countries based on socio-behavioural predictors of HIV for screening.

Method

We used an agglomerative hierarchical, unsupervised machine learning, approach for clustering to analyse data for 146,733 male and 155,622 female respondents from 13 sub-Saharan African countries with 20 and 26 features, respectively, using Population-based HIV Impact Assessment (PHIA) data from the survey years 2015–2019. We employed agglomerative hierarchical clustering and optimal silhouette index criterion to identify clusters of countries based on the similarity of socio-behavioural characteristics. We analyse the distribution of HIV positivity with socio-behavioural predictors of HIV within each cluster.

Results

Two principal components were obtained, with the first describing 62.3% and 70.1% and the second explaining 18.3% and 20.6% variance of the total socio-behavioural variation in females and males, respectively. Two clusters per sex were identified, and the most predictor features in both sexes were: relationship with family head, enrolled in school, circumcision status for males, delayed pregnancy, work for payment in last 12 months, Urban area indicator, known HIV status and delayed pregnancy. The HIV positivity distribution with these variables was significant within each cluster.

Conclusions /findings

The findings provide a potential use of unsupervised machine learning approaches for substantially identifying clustered countries based on the underlying socio-behavioural characteristics.
The predictive role of psychotic-like experiences in suicidal ideation among technical secondary school and college students during the COVID-19 pandemic
Authors: Sun Meng , Wang Dongfang , Jing Ling , Zhou Liang
Published: July 2023

Background

Previous research has shown the strong association between psychotic-like experiences (PLEs) and suicide. However, the predictive role of PLEs in suicidal ideation (SI) during the COVID-19 pandemic remains unclear.

Aims

This study aimed to explore the association between PLEs before the pandemic and SI during the pandemic among late adolescents.

Methods

A total of 938 technical secondary school and college students completed both waves of the online survey before and during the pandemic. PLEs were assessed through the 15-item Positive Subscale of the Community Assessment of Psychic Experiences. SI was evaluated by the frequency of SI during the pandemic.

Results

In early stage of the pandemic, most students had low frequent SI, and only 3.3% students showed high frequent SI. Compared to the low frequent group, the high frequent group exhibited significantly higher levels of PLEs (p < 0.001) and scored lower in resilience (p = .001) and perceived social support (p = .008) across the two timepoints. PLEs were significantly associated with higher risk of high frequent SI (OR = 2.56, 95%: 1.07–6.13), while better resilience (OR: 0.93, 95% CI: 0.88–0.99) and stronger perceived social support (OR: 0.96, 95% CI: 0.93–0.99) appeared to be protective factors. No interactions were found among PLEs and other psychosocial and psychological factors.

Conclusions

PLEs may increase the risk of SI in early stage of the pandemic, while good resilience and adequate social support can help weaken the risk.
Subjective evaluation of facial asymmetry with three-dimensional simulated images among the orthodontists and laypersons: a cross-sectional study
Authors: Zhang Mingjin , Lyu Liang , Li Jing , Yan Huichun , Zhu Yujia , Yu Tingting , Wang Yong , Zhao Yijiao , Zhou Yanheng , Liu Dawei
Published: July 2023

Objectives

We used three-dimensional (3D) virtual images to undertake a subjective evaluation of how different factors affect the perception of facial asymmetry among orthodontists and laypersons with the aim of providing a quantitative reference for clinics.

Materials and methods

A 3D virtual symmetrical facial image was acquired using FaceGen Modeller software. The left chin, mandible, lip and cheek of the virtual face were simulated in the horizontal (interior/exterior), vertical (up/down), or sagittal (forward or backward) direction in 3, 5, and 7 mm respectively with Maya software to increase asymmetry for the further subjective evaluation. A pilot study was performed among ten volunteers and 30 subjects of each group were expected to be included based on 80% sensitivity in this study. The sample size was increased by 60% to exclude incomplete and unqualified questionnaires. Eventually, a total of 48 orthodontists and 40 laypersons evaluated these images with a 10-point visual analog scale (VAS). The images were presented in random order. Each image would stop for 30 s for observers with a two-second interval between images. Asymmetry ratings and recognition accuracy for asymmetric virtual faces were analyzed to explore how different factors affect the subjective evaluation of facial asymmetry. Multivariate linear regression and multivariate logistic regression models were used for statistical data analysis.

Results

Orthodontists were found to be more critical of asymmetry than laypersons. Our results showed that observers progressively decreased ratings by 1.219 on the VAS scale and increased recognition rates by 2.301-fold as the degree of asymmetry increased by 2 mm; asymmetry in the sagittal direction was the least noticeable compared with the horizontal and vertical directions; and chin asymmetry turned out to be the most sensitive part among the four parts we simulated. Mandible asymmetry was easily confused with cheek asymmetry in the horizontal direction.

Conclusions

The degree, types and parts of asymmetry can affect ratings for facial deformity as well as the accuracy rate of identifying the asymmetrical part. Although orthodontists have higher accuracy in diagnosing asymmetrical faces than laypersons, they fail to correctly distinguish some specific asymmetrical areas.