bluuebunny/crossref_metadata_2025 huggingface dataset:
Whether and whence preexistence in 1 Enoch? Isa 49:1–2 and the preexistent servant as the background for 1 En. 48:3, 6; 62:7
Authors: Martin Michael Wade
Published: March 2023

The study examines the debated questions of whether and whence preexistence is affirmed of the Son of Man in the parables of Enoch. With regard to the first question, I argue an old thesis on new grounds. Augmenting Johannes Theisohn’s analysis, I highlight the parallel intertextual engagement of Isa 49:1–2 evident in 1 En. 48:3, 6; 62:7. Then on the basis of this parallel intertextuality, I demonstrate how the strong dichotomy necessary to the argument against preexistence cannot be drawn between 1 En. 48:3, 6, on one hand, as affirming preexistence in the mind of God and 1 En. 62:7, on the other hand, as affirming real existence within history, as the verses in question are parallel expressions depicting the same set of events from Isaiah. With regard to the study’s second question, whence preexistence, I argue an altogether new thesis that Isa 49:1–2—and not Prov 8—is the true source. On one hand, there are no linguistic links in 1 En. 48:3, 5; 62:7 to Prov 8 and the parables clearly distinguish the Son of Man from Wisdom in other passages. On the other hand, the spatial and temporal markers in 1 En. 48:3, 6; 62:7 designating the Son of Man’s naming/hiding as occurring, respectively, in God’s heavenly presence and before creation correspond formally to spatial and temporal markers in Isa 49:1–2 attached to the naming/hiding of the servant and, for reasons we explore, should be seen as interpretations of those markers.
Parabiblical tradition in mediaeval Armenia and its social location(s)
Authors: Stone Michael E
Published: March 2023

The aim of this paper is to commence seeking an answer to the following question: What function did the developed parabiblical (pseudepigraphical) literature play in medieval Armenian culture? The question is approached by the examination of markers in the texts that might show the use to which they were put and reveal the contexts in which the various types of literature were composed, or preserved, or developed. The issues of folk tales and oral transmission are raised. The use of iconographic sources and their relationship to literary documents, oral or written, are investigated.
Tool surface modification methodology to improve the machinability of Ti6Al4V through combination of micro-EDM texturing and AlSi-10Mg soft coating techniques in dry turning
Authors: George Allan , Sahu Tejanshu Sekhar , Dhanish P B , Mathew Jose , Kuriachen Basil
Published: March 2023

Machinability of Ti-6Al-4V, despite its numerous applications, is challenging owing to its poor thermal conductivity, severe chemical affinity and strain hardening characteristics. Although various coating techniques and expensive lubrication strategies have been tried, a significant improvement in tool life characteristics are yet to be achieved. Hence this work aims at suggesting a novel cost-effective and ecofriendly tool treatment technique by exploring the impact of a dual combination of an AlSi-10Mg coating developed by an emerging pre-conditioning technique with the incorporation of micro-textures on tool face to observe significant improvements in tool life and machinability characteristics of the alloy. It was analyzed from the results that while the micro-textures played a vital role in reducing the severe contact stress and machining temperature due to its improved heat transfer by convection, AlSi-10Mg film effectively shielded the cutting edges of the tool by providing a dampening effect along the edges, thereby ensuring improved tool life and enhanced machinability characteristics at the same time. The proposed tool combination was observed to be successful in significantly reducing the flank wear by 35%, 43% and 30% where 75, 253, and 371 µm were observed at 80, 100, and 120 m/min as compared to 117, 449, and 531 µm in the case of uncoated non-textured tool at the same operating conditions. Surface roughness of Ti-6Al-4V also reduced by 25%, 34%, and 37% where 1394, 1168, and 872 nm as compared to plain tool where 1840, 1770, and 1370 nm were recorded. Moreover, average chip curl diameter was observed to be 2.62, 3.36, and 6.49 mm as compared to chips generated by uncoated tools which recorded values of 4.33, 11.9, and 18.87 mm at 80, 100, and 120 m/min respectively.
Enhancement of recovery stress by annealing and prestraining of NiTiNb wires
Authors: Yang Chan , Liu Tao , Zhong Minting , Wu Zhigang , Deng Jun , Du Yan-Liang
Published: March 2023

NiTiNb shape memory alloy has attracted much attention for its use in prestressing and remedying structural steel and concrete members due to its unique shape memory effect. However, the recovery stress values reported in the literature vary significantly, as the interplay between recovery stress and treatment parameters is not fully understood. In this study, we carefully investigated the effects of annealing and prestraining on the martensitic transformation behavior and mechanical properties of NiTiNb alloy and clarified their correlations to the recovery stress. Our results showed that the yield strength and superelasticity decreased while the ductility and retained stress-induced martensite increased with increasing annealing temperature. We found that high recovery stress can be achieved by annealing the sample above the recrystallization temperature while keeping the annealing temperature as low as possible to maintain high strength. Prestraining the sample to beyond the stress plateau but before yielding was found to be most effective for enhancing the recovery stress. By using these criteria, we were able to obtain large recovery stresses of greater than 550 MPa from 20°C to 200°C through a simple one-step annealing at 700°C and a 10% prestrain using commercial superelastic NiTiNb wire products.
Safety Assessment of Helianthus annuus (Sunflower)-Derived Ingredients as Used in Cosmetics
Authors: Becker Lillian C. , Boyer Ivan J. , Bergfeld Wilma F. , Belsito Donald V. , Hill Ronald A. , Klaassen Curtis D. , Liebler Daniel C. , Jr James G. Marks, , Shank Ronald C. , Slaga Thomas J. , Snyder Paul W. , Gill Lillian J. , Heldreth Bart
Published: March 2023

This is a review of the scientific literature and unpublished data that are relevant for assessing the safety of 12 Helianthus annuus (sunflower)-derived ingredients as used in cosmetics. Because final product formulations may contain multiple botanicals, each containing similar constituents of concern, formulators are advised to be aware of these constituents and to avoid levels that may be hazardous to consumers. Helianthus annuus (sunflower)-derived ingredients may contain allergens, including 2S albumins and sesquiterpene lactones. Industry should use current good manufacturing practices (cGMP) to limit impurities and constituents of concern. The Expert Panel for Cosmetic Ingredient Safety (Panel) concluded that 9 Helianthus annuus (sunflower) seed- and flower-derived ingredients are safe as used in cosmetics in the present practices of use and concentration described in this safety assessment. The data are insufficient to evaluate the safety of 3 ingredients that are derived from other plant parts.
Diagnostic value of cerebrospinal fluid analysis in epileptic cats with unremarkable brain MRI or hippocampal signal changes only
Authors: Majercikova Rozalia , Rütgen Barbara C , Luckschander-Zeller Nicole , Lörincz Borbala A , Pakozdy Akos
Published: March 2023

Objectives

Cerebrospinal fluid (CSF) analysis is used in the diagnostic investigation of cats with epileptic seizures. The aim of this retrospective study was to evaluate the diagnostic value of CSF analysis in cats with epileptic seizures that have unremarkable brain MRI or only hippocampal signal changes.

Methods

Unremarkable brain MRI or MRI studies with signal alterations in the hippocampus only in cats with suspected epilepsy and CFS analysis performed at the Small Animal Internal Department or Diagnostic Imaging Department at Vetmeduni Vienna, Austria, between 2011 and 2017 were reviewed. Total nucleated cell count, total protein, blood contamination and cytology data from CSF analysis were evaluated.

Results

In total, 87 cats were included. Seventy cats (80.5%) had unremarkable MRI, five (5.7%) had hippocampal signal changes with contrast enhancement and 12 (13.8%) had hippocampal signal changes without contrast enhancement. Overall, four cats (4.6%) had abnormalities on CSF analysis; all (100%) had an increased total nucleated cell count (22 cells/μl, 7 cells/μl, 6 cells/μl and 6 cells/μl, respectively), and no cat had increased total protein (100%), although in one cat total protein was not evaluated. Three of these cats had unremarkable MRI and one had hippocampal signal changes without contrast enhancement. The median duration of epileptic signs prior to the MRI study was 2 days.

Conclusions and relevance

Our results show that, in our cohort of epileptic cats with unremarkable brain MRI or with hippocampal signal changes, CSF analysis was usually normal. This should be considered before performing a CSF tap.
Prevalence and nature of prior developmental and medical concerns in toddlers who screen positive for autism in primary care
Authors: Herkert Darby , Sullivan Connor , Zhu YiQin , Dawson Geraldine
Published: March 2023

The American Academy of Pediatrics recommends that children be screened for autism at 18 and 24 months. It is unknown whether a positive screen usually represents the first developmental concern or is typically preceded by other developmental and/or medical concerns. This study evaluated the proportions of toddlers (M = 18.69 months) who screened positive for autism for whom caregivers or providers had prior concerns, the nature and timing of prior concerns, and their relationship with family characteristics. The electronic health records of 242 children who screened positive using the Modified Checklist for Autism in Toddlers–Revised with Follow-up during routine well-child visits were reviewed. Among toddlers who screened positive for autism, the majority (79.34%) had a documented prior motor, language, and/or autism concern. The presence of specific concerns was associated with earlier timing and higher Modified Checklist for Autism in Toddlers–Revised with Follow-up scores. Prior medical concerns were common, such as sleep (23.14%) and gastrointestinal (66.12%) problems. A positive autism screen often occurs in the context of pre-existing concerns. Thus, screening can provide providers with an opportunity to contextualize feedback about autism in the context of prior developmental and medical concerns.

Lay abstract

The American Academy of Pediatrics recommends that all children be screened for autism at their 18- and 24-month well-child visit. For children who screen positive for autism, it is unknown whether this usually represents the first time a developmental concern has been raised or if other developmental concerns typically precede a positive autism screen. Such knowledge could help guide providers in how to appropriately convey feedback regarding autism screening. This study found that, for close to 80% of children with a positive autism screen, caregivers or providers had a prior autism, language, motor, or other developmental concern documented in the electronic health record. Many also had other prior concerns frequently linked to autism, such as sleep and gastrointestinal problems, and received physical or speech therapy. On average, prior to screening children who received a positive Modified-Checklist for Autism in Toddlers had two documented concerns by at 1 year of age and three concerns by 2 years of age. These findings imply that screening for autism as a part of routine pediatric care likely takes place in the context of larger conversations regarding existing developmental concerns, allowing for a less stigmatizing discussion of autism. Framing the presence of prior concerns in the setting of a positive screen in this context may create a reaffirming space for existing caregiver concerns and a lessened emotional burden on caregivers.
Just Listen! The importance of listening in foreign correspondents–governments relationships
Authors: Bejerano Amira , Magen Clila
Published: March 2023

This study examines the role of listening methods within public diplomacy (PD)/foreign correspondents' relations. Listening theory plays a double role in the study: a) It serves as the theoretical basis for analyzing whether listening and, more specifically, feedback are applied by Israeli public diplomacy (PD) bodies; b) It serves as the core methodology of this study. We demonstrate the value of listening within the context of these professional relationships by applying a methodological simulation of listening. By systematically listening to both parties, one can uncover and trace gaps between the parties' perceptions and better understand their relationship. Based on fifty semi-structured, in-depth interviews with PD seniors and foreign correspondents, the study compares and contrasts the parties' perceptions regarding tactical and strategic aspects of Israeli PD organizations’ actions. The findings indicate a substantial lack of critical listening methods in Israel's PD mechanism. By applying systematic listening methods, gaps and weak links in the parties’ relationship surfaced. To address these gaps, we recommend implementing recurring feedback platforms. These might assist the parties in developing more authentic and open dialogue, despite disagreements and disputes.
Brand Name Versus Generic?
Authors: Aungaroon Gewalin
Published: March 2023

[Box: see text]
Violence, Discrimination, Psychological Distress, and HIV Vulnerability Among Men Who Have Sex With Men in Memphis, Tennessee
Authors: Denney Meredith R. , Pichon Latrice C. , Brantley Meredith L.
Published: March 2023

Gay, bisexual, and other men who have sex with men (MSM) are disproportionally impacted by HIV. Discrimination, violence, and psychological distress (PD) may influence engagement with HIV prevention services and amplify HIV vulnerability among this priority population. These dynamics are understudied in the Southern United States. Understanding how these relationships interact is critical to designing effective HIV programs. We examined associations between MSM-related discrimination, MSM-related violence, and severe PD with HIV status among 2017 National HIV Behavioral Surveillance study participants in Memphis, Tennessee. Eligible participants were aged ≥18 years, born and identified as male, and reported having sex with another man in their lifetime. Participants completed a Centers for Disease Control and Prevention–designed anonymous survey and self-reported discrimination and violence across their lifetime, and PD symptoms within the past month, scored on the Kessler-6 Scale. Optional HIV rapid tests were performed on-site. Logistic regressions examined the associations between the exposure variables and HIV antibody-positive results. Among 356 respondents, 66.9% were aged <35 years and 79.5% identified as non-Hispanic Black; 13.2% reported experiencing violence, 47.8% reported discrimination, and 10.7% experienced PD. Of the 297 participants who tested, 33.33% were living with HIV. Discrimination, violence, and PD were significantly associated with each other ( p < .0001). HIV antibody-positive test results were associated with violence ( p < .01). Memphis-based MSM face a complex array of social experiences, which may increase vulnerability to HIV. On-site testing at community-based organizations and clinical settings among MSM may be an opportunity to screen for violence and incorporate strategies when designing HIV programs.
Vibrational coupling mechanism and experimental study of rotor system with double-disk magnetic coupler
Authors: Wang Shuang , Ma Xin , Guo Yongcun , Sun Shousuo , Hu Zeyong
Published: March 2023

At present, the vibrational coupling mechanism of the rotor system with a double-disk magnetic coupler has not been sufficiently studied. Based on the mechanical impedance theory, the patterns of structural mass and stiffness distribution were quantitatively described, to establish the model for the vibrational coupling mechanism. Methods were proposed to determine the vibrational coupling point and to simulate the transient response to the interacting excitations, so as to analyze the potential vibrational coupling point and the dynamic response characteristics. Then, the Campbell diagram of the shared support-dual rotor system was combined with the mechanical impedance characteristics of the shared support. As a result, it was found that although the base vibration of the shared support was significantly amplified, the single-axis trajectory showed that both the output and input rotors were synchronized with the forward vortex motion, with almost no coupling between them. A double-disk magnetic coupler test bench with a rated power of 55 kW was designed to verify the experiments. The results showed that the vibration displacement occurred in a periodic variation pattern. Moreover, the maximum errors between the theoretical, simulated, and experimental values of the vibration displacement at different input speeds were less than 5%. The experiments verified the validity of the model for the vibrational coupling mechanism and the simulation of the transient response to the interacting excitation. The results of the study could be used as a basis for calculating the vibration of the rotor system with a double-disk magnetic coupler.
Coloniality and frictions: Data-driven humanitarianism in North-Eastern Nigeria and South Sudan
Authors: Squire Vicki , Alozie Modesta
Published: March 2023

It is now over a decade since the proclamation of a humanitarian ‘data revolution’, with the rise of ‘innovation’ and the proliferation of ‘data solutions’ rendering data-based humanitarianism an important area of critical investigation. This article contributes to debates within the field by exploring the role of data in the provision of humanitarian assistance within camps for internally displaced persons (IDPs) across north-eastern Nigeria and South Sudan. It draws on qualitative interviews carried out with humanitarian practitioners specialising in data and information management, as well as with camp residents and stakeholders located in each region. The analysis focuses attention on the ways in which epistemic injustices have been further perpetuated by the ‘data revolution’ due to the intensification of paternalistic dynamics associated with the coloniality of humanitarianism. It shows how a logic of extractivism structures the humanitarian data ecosystem, while also generating a series of tensions and disagreements. Data-driven humanitarianism, the article concludes, is characterised by recurring colonial dynamics as well as intensified frictions that bring epistemic injustices into sharper focus.
Development and Validation of the Cancer Fatigue Scale: A Methodological Study
Authors: Kim Hee Jeong , Yeun Eun Ja
Published: March 2023

Cancer fatigue (CF) is a major issue facing cancer patients that can negatively impact their quality of life. This study describes the development and validation of the Cancer Fatigue (CF) scale for the assessment of fatigue in cancer patients. A total of 202 cancer patients at university hospitals in South Korea were recruited and completed the questionnaires. Descriptive analysis was performed to determine the participants’ socio-demographic characteristics; the construct validity was examined using exploratory factor analysis; internal consistency reliability of the scale was estimated for the meaningful total scale and factors; and confirmatory factor analysis was performed to confirm the repetitive reproducibility of the factors. Findings indicated that the CF scale had good psychometric properties. 67.89% of the variance was explained by four subfactors: socio-cognitive (six items), physical (five items), psycho-affective (three items), and social-relationship networks (two items). The Cronbach’s alpha of the 16-item CF scale was 0.89 for the total scale, and the range of Cronbach’s alpha for subfactors was .75 to .89, indicating that it is valid and reliable. The 16-item CF scale is a feasible and time-efficient tool for assessing the fatigue of cancer patients in the clinical setting. Healthcare providers may use this measurement tool to explore cancer patients’ fatigue and routinely track the effect of a customized intervention on CF. This study also informs healthcare providers in other countries about the fatigue characteristics of Korean cancer patients.
The Moderating Effect of Customer Relationship on Supply Chain Risk Management and Organization Performance in Logistics Sector of Pakistan
Authors: Amin Fahim ul , Ji Qingkai , Martínez María del Carmen Valls , Dong Qian-Li , Kanwal Shamsa , Zulfiqar Iram
Published: March 2023

The current study aims to determine the moderating effect of customer relationship on supply chain risk management and organizational performance, specifically for Pakistan’s logistics sector. The logistics sector is selected for the study as it has considerable significance in the country’s economy and also having substantial growth due to the China-Pakistan Economic Corridor (CPEC). This study is quantitative in nature and data collection is performed through a questionnaire based on several instruments (operation risk management, strategic risk management, perceived performance, customer relationship) from officials (administrative and management) of various public and private logistics companies involved in supply chain and customer relationships. A total of 227 responses are received out of 300, with 11 incomplete responses being eliminated. The hypotheses are formulated based on the literature and research theme. The hypotheses testing are performed using the Partial Least Squares Structural Equation Modeling (PLS-SEM) methodology. The findings suggest that strategic risk management and supply chain performance have a favorable relationship. The study also showed that there exists a negative association between customer relationship and performance. Conversely, the relationship between operational risk management and performance was not established in this study. The findings of this study offer inspiration for future research that can apply these findings on large sample of companies.
Time for More Support? Stakeholder Engagement for a Long-Term Care Planning Dementia Decision Aid Prototype
Authors: Huber Kathryn , Cassidy Jessica , Brungardt Adreanne , Resman Kathleen , Plys Evan , Bogdewiecz Taryn , Matlock Dan D. , Lum Hillary D.
Published: March 2023

Clinical decision aids around long-term care can help support persons living with dementia (PLWD), family care partners, and healthcare providers navigate current and future care decisions. This study describes the iterative development of a long-term care planning dementia decision aid and explores care partner and geriatric providers’ insights regarding its acceptability and usability. Using a convergent parallel mixed methods design, we gathered surveys and completed interviews with 11 care partners and 11 providers. The quantitative and qualitative data were then converged, resulting in four findings: (1) helpfulness of the decision aid in supporting future care planning; (2) versatility of the decision aid in practice; (3) preferences for structure and content of the decision aid; and (4) perceived shortcomings of the decision aid in decision making. Future work should continue to refine the decision aid, pilot implementation, and evaluate potential effects on decision making as part of dementia care.
US Invasion of Iraq, 2003: Indirect Link of ISIS Rising
Authors: Israeli Ofer
Published: March 2023

This study will describe an indirect link of the US Invasion of Iraq (2003) and test how the US occupation of Iraq served, from an American perspective, as a derivative product with negative side effects several years later in the Middle East. In seeking to understand the dynamic of any event in foreign policy, political scientists need to be aware of the role and spread of key ideas and how they emerged, developed, and eventually influenced events. Accordingly, analysis of existing perceptions should also consider the critical impacts of past events and crises. “The power of the ideas,” as presented by the rebirth of the ancient idea of the Muslim Caliphate, was mostly covert throughout the years. However, understanding this event requires examining the formative influence of the US Invasion of Iraq (2003), which ended with the Islamic State taking power in Iraq and al-Sham (ISIS). This radical group has declared a Muslim Caliphate and claims control over a large area of Iraq and Syria.
Understanding implementation completion of tailored motivational interviewing in multidisciplinary adolescent HIV clinics
Authors: Naar Sylvie , Fernandez M. Isabel , Todd Lisa , Green Sara K. Shaw , Budhwani Henna , Carcone April , Coyle Karin , Aarons Gregory A. , MacDonell Karen , Harper Gary W.
Published: March 2023

Background

Understanding the barriers and facilitators of implementation completion is critical to determining why some implementation efforts fail and some succeed. Such studies provide the foundation for developing further strategies to support implementation completion when scaling up evidence-based practices (EBPs) such as Motivational Interviewing.

Method

This mixed-methods study utilized the Exploration, Preparation, Implementation, and Sustainment framework in an iterative analytic design to compare adolescent HIV clinics that demonstrated either high or low implementation completion in the context of a hybrid Type III trial of tailored motivational interviewing. Ten clinics were assigned to one of three completion categories (high, medium, and low) based on percentage of staff who adhered to three components of implementation strategies. Comparative analysis of staff qualitative interviews compared and contrasted the three high-completion clinics with the three low-completion clinics.

Results

Results suggested several factors that distinguished high-completion clinics compared to low-completion clinics including optimism, problem-solving barriers, leadership, and staff stress and turnover.

Conclusions

Implementation strategies targeting these factors can be added to EBP implementation packages to improve implementation success.
Bilateral TMJ Ankylosis: Total Joint Reconstruction in a Patient With Zero Mouth Opening: A Case Report
Authors: Malakuti Iman , Thor Andreas
Published: March 2023

Objective

Present a case of a young patient with bilateral bony ankylosis of the TMJ with zero mouth opening treated with TMJ prosthesis.

Methods

The ankylosis was studied in detail with computed tomography (CT) and we used virtual surgical planning in the pre-operative phase to provide splints and cutting guides. The patient was treated with bilateral custom-made alloplastic TMJ prosthesis.

Results

Optimal functional improvement at the 5.5 year follow up after total joint reconstruction without any adverse effects. Mouth opening was 35 mm and the patient was free from pain. CT-images showed no signs of pathology or increased remodeling and bone formation.

Conclusion

Ankylosis of the TMJ in young and adult population presents unique challenges given the need to account for growth of the mandible and anatomical variations. This report supports the use of total joint reconstruction for end-stage TMJ disease.
Gene expression variability in long-term survivors of childhood cancer and cancer-free controls in response to ionizing irradiation
Authors: Grandt Caine Lucas , Brackmann Lara Kim , Foraita Ronja , Schwarz Heike , Hummel-Bartenschlager Willempje , Hankeln Thomas , Kraemer Christiane , Zahnreich Sebastian , Drees Philipp , Mirsch Johanna , Spix Claudia , Blettner Maria , Schmidberger Heinz , Binder Harald , Hess Moritz , Galetzka Danuta , Marini Federico , Poplawski Alicia , Marron Manuela
Published: March 2023

Background

Differential expression analysis is usually adjusted for variation. However, most studies that examined the expression variability (EV) have used computations affected by low expression levels and did not examine healthy tissue. This study aims to calculate and characterize an unbiased EV in primary fibroblasts of childhood cancer survivors and cancer-free controls (N0) in response to ionizing radiation.

Methods

Human skin fibroblasts of 52 donors with a first primary neoplasm in childhood (N1), 52 donors with at least one second primary neoplasm (N2 +), as well as 52 N0 were obtained from the KiKme case–control study and exposed to a high (2 Gray) and a low dose (0.05 Gray) of X-rays and sham- irradiation (0 Gray). Genes were then classified as hypo-, non-, or hyper-variable per donor group and radiation treatment, and then examined for over-represented functional signatures.

Results

We found 22 genes with considerable EV differences between donor groups, of which 11 genes were associated with response to ionizing radiation, stress, and DNA repair. The largest number of genes exclusive to one donor group and variability classification combination were all detected in N0: hypo-variable genes after 0 Gray (n = 49), 0.05 Gray (n = 41), and 2 Gray (n = 38), as well as hyper-variable genes after any dose (n = 43). While after 2 Graypositive regulation of cell cyclewas hypo-variable in N0, (regulation of)fibroblast proliferationwas over-represented in hyper-variable genes of N1 and N2+. In N2+, 30 genes were uniquely classified as hyper-variable after the low dose and were associated with theERK1/ERK2cascade. For N1, no exclusive gene sets with functions related to the radiation response were detected in our data.

Conclusion

N2+ showed high degrees of variability in pathways for the cell fate decision after genotoxic insults that may lead to the transfer and multiplication of DNA-damage via proliferation, where apoptosis and removal of the damaged genome would have been appropriate. Such a deficiency could potentially lead to a higher vulnerability towards side effects of exposure to high doses of ionizing radiation, but following low-dose applications employed in diagnostics, as well.
In vivo imaging of prostate tumor-targeted folic acid conjugated quantum dots
Authors: Pandey Sulaxna , Choudhary Prakash , Gajbhiye Virendra , Jadhav Sachin , Bodas Dhananjay
Published: March 2023

Cancer is a major threat to human health; thus, early detection is imperative for successful management. Rapid diagnosis can be achieved by imaging primary (subcutaneous) tumors using fluorophores conjugated with tumor markers. Here, the application of biocompatible, quantum efficient, monodisperse, and photostable polymer-coated quantum dots (PQDs) is demonstrated for targeted prostate tumor imaging in living SCID mice. Briefly, PQDs (blue) are conjugated to folic acid (FA-PQDs) using DCC-NHS chemistry. Initially, in vitro targeted imaging via FA-PQDs is evaluated in LNCaP cells. The confocal microscopic evaluation demonstrates the uptake of FA-PQDs. To understand the dispersion of PQDs in vivo, the biodistribution of PQDs is assessed at different time intervals (1- 180 min) using whole-body fluorescence imaging and computed tomography (CT) scan. PQDs are seen to accumulate in organs like the liver, kidneys, spleen, lungs, and urinary bladder within 60 min, however, PQDs are not observed at 180 min indicating renal clearance. Further, to target the prostate tumor (~ 200 mm3) in mice, FA-PQDs are injected intravenously, and whole-body fluorescence imaging along with a CT scan is recorded. FA-PQDs are seen at the tumor site as compared to PQDs. The results confirm that the FA-PQDs function as excellent nanoprobes for targeted tumor imaging in vivo.
Unfair older patients restriction in cancer drug trials in mainland China and corresponding solution
Authors: Huang Huiyao , Tang Yu , Wu Dawei , Meng Xinyu , Wang Shuhang , Wang Jun , Yu Yue , Fang Yuan , Fang Hong , Zhu Qi , Li Ning , Xu Binghe , Sun Yan , He Jie
Published: March 2023

Background

Older adults are a growing segment of oncology population in China and beyong. However, older cancer patients were vastly underrepresented in clinical trial. To facilitate that all patients with cancer have equal access to the cutting edging treatment and receive evidence-based medication in mainland China, it’s of particular importance to fully grasp the proportion of upper age restriction in cancer clinical trials, as well as associated factors.

Methods

Based on clinical trials registered on the China Food and Drug Administration Registration and Information Disclosure Platform, we sought to characterize the overall proportion and trajectory of upper age-restriction among registered cancer drug trials in mainland China from 2009 to 2021, and potential influencing factors were determined by multivariate logistic regression.

Results

According to the 3485 trials, upper age restriction proportion of cancer drug trials for patients over 65 years and 75 years was 18.8% (95% CI = 17.5%-20.1%) and 56.5% (95% CI = 51.3%-54.6%), respectively. Phase IV trials, international multicenter trials, or trials initiated by global companies seldom excluded patients over 65 years compared with phase I trials, domestic trials and trials initiated by Chinese enterprise, similar for 75 years and above. Both of 65 and 75 years old age limit sponsored by domestic enterprises showed slowly downward trend, while no such trend was observed for that of foreign companies. Solution to upper age eligibility of cancer drug trials was also provided.

Conclusions

Although there is a certain downward trend, use of eligibility criteria that explicitly exclude older cancer patients in mainland China was remarkably high, especially for trials initiated by domestic enterprise, domestic trials and early-phase trials. Action is urgently needed to promote treatment equity in the older patients while obtaining adequate evidence in clinical trials.
Transscleral vs endoscopic cyclophotocoagulation: safety and efficacy when combined with phacoemulsification
Authors: Nirappel Abraham , Klug Emma , Neeson Cameron , Chachanidze Mari , El Helwe Hani , Hall Nathan , Chang Ta C. , Shen Lucy Q. , Solá-Del Valle David
Published: March 2023

Purpose

To compare the effectiveness and safety of phacoemulsification combined with endoscopic cyclophotocoagulation (phaco/ECP), phacoemulsification combined with MicroPulse transscleral cyclophotocoagulation (phaco/MP-TSCPC), and phacoemulsification alone (phaco) in the treatment of coexisting cataract and glaucoma.

Methods

Retrospective cohort study of consecutive cases at Massachusetts Eye & Ear. The main outcome measures were the cumulative probabilities of failure between the phaco/ECP group, phaco/MP-TSCPC group, and the phaco alone group with failure defined as reaching NLP vision at any point postoperatively, undergoing additional glaucoma surgery, or the inability to maintain ≥ 20% IOP reduction from baseline with IOP between 5–18 mmHg while maintaining ≤ baseline medications. Additional outcome measures included changes in average IOP, number of glaucoma medications, and complication rates.

Results

Sixty-four eyes from 64 patients (25 phaco/ECP, 20 phaco/MPTSCPC, 19 phaco alone) were included in this study. The groups did not differ in age (mean 71.04 ± 6.7 years) or length of follow-up time. Baseline IOPs were significantly different between groups (15.78 ± 4.7 mmHg phaco/ECP, 18.37 ± 4.6 mmHg phaco/MP-TSCPC, 14.30 ± 4.2 mmHg phaco alone, p = 0.02). Primary open-angle glaucoma was the most common type of glaucoma in the phaco alone (42%) and phaco/ECP (48%) groups while mixed-mechanism glaucoma was the most common type in the phaco/MP-TSCPC group (40%). Surgical failure was less likely in eyes in the phaco/MP-TSCPC (3.40 times, p = 0.005) and phaco/ECP (1.40 times, p = 0.044) groups compared to phaco alone based on the Kaplan–Meier survival criteria. These differences maintained statistical significance when differences in preoperative IOP were taken into account using the Cox PH model (p = 0.011 and p = 0.004, respectively). Additionally, surgical failure was 1.98 times less likely following phaco/MP-TSCPC compared to phaco/ECP (p = 0.038). This difference only approached significance once differences in preoperative IOP were accounted for (p = 0.052). There was no significant difference in IOP reduction at 1 year between groups. Mean IOP reductions at 1 year were 3.07 ± 5.3 mmHg from a baseline of 15.78 ± 4.7 in the phaco/ECP group, 6.0 ± 4.3 mmHg from a baseline of 18.37 ± 4.6 in the phaco/MP-TSCPC group and 1.0 ± 1.6 from a baseline of 14.30 ± 4.2 mmHg in the phaco alone group. There were no differences in complication rates among the three groups.

Conclusions

Both Phaco/MP-TSCPC and phaco/ECP appear to provide superior efficacy for IOP control when compared to phaco alone. All three procedures had similar safety profiles.
Association between women’s household decision-making autonomy and health insurance enrollment in sub-saharan Africa
Authors: Zegeye Betregiorgis , Idriss-Wheeler Dina , Ahinkorah Bright Opoku , Ameyaw Edward Kwabena , Seidu Abdul-Aziz , Adjei Nicholas Kofi , Yaya Sanni
Published: March 2023

Background

Out of pocket payment for healthcare remains a barrier to accessing health care services in sub-Saharan Africa (SSA). Women’s decision-making autonomy may be a strategy for healthcare access and utilization in the region. There is a dearth of evidence on the link between women’s decision-making autonomy and health insurance enrollment. We, therefore, investigated the association between married women’s household decision making autonomy and health insurance enrollment in SSA.

Methods

Demographic and Health Survey data of 29 countries in SSA conducted between 2010 and 2020 were analyzed. Both bivariate and multilevel logistic regression analyses were carried out to investigate the relationship between women’s household decision-making autonomy and health insurance enrollment among married women. The results were presented as an adjusted odds ratio (AOR) and the 95% confidence interval (CI).

Results

The overall coverage of health insurance among married women was 21.3% (95% CI; 19.9-22.7%), with the highest and lowest coverage in Ghana (66.7%) and Burkina Faso (0.5%), respectively. The odds of health insurance enrollment was higher among women who had household decision-making autonomy (AOR = 1.33, 95% CI; 1.03–1.72) compared to women who had no household decision-making autonomy. Other covariates such as women’s age, women’s educational level, husband’s educational level, wealth status, employment status, media exposure, and community socioeconomic status were found to be significantly associated with health insurance enrollment among married women.

Conclusion

Health insurance coverage is commonly low among married women in SSA. Women’s household decision-making autonomy was found to be significantly associated with health insurance enrollment. Health-related policies to improve health insurance coverage should emphasize socioeconomic empowerment of married women in SSA.
An integrative review of adult patient-reported reasons for non-urgent use of the emergency department
Authors: McIntyre Amanda , Janzen Shannon , Shepherd Lisa , Kerr Mickey , Booth Richard
Published: March 2023

Objective

To conduct an integrative review of the scientific literature to explore adult patient-reported reasons for using the emergency department (ED) non-urgently.

Method

A literature search of CINAHL, Cochrane, Embase, PsycINFO, and MEDLINE was conducted with filters for humans, published January 1, 1990-September 1, 2021, and English language.

Methodological quality was assessed using Critical Appraisal Skills Programme Qualitative Checklist for qualitative and National Institutes Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies for quantitative studies. Data was abstracted on study and sample characteristics, and themes/reasons for ED use. Cited reasons were coded using thematic analysis.

Results

Ninety-three studies met inclusion criteria. Seven themes were found: need to be risk averse with respect to the health issue; knowledge and awareness of alternative sources of care; dissatisfaction with primary care provider; satisfaction with ED; ED accessibility and convenience resulting in low access burden; referred to the ED by others; and relationships between patients and health care providers.

Discussion

This integrative review examined patient-reported reasons for attending the ED on a non-urgent basis. The results suggest that ED patients are heterogenous and many factors influence their decision-making. Considering the complexity with which patients live, treating them as a single entity may be problematic. Limiting excessive non-urgent visits likely requires a multi-pronged approach.

Conclusion

For many ED patients, they have a very clear problem which needed to be addressed. Future studies should explore psychosocial factors driving decision-making (e.g., health literacy, health-related personal beliefs, stress and coping ability).
Effects of major depression and bipolar disorder on erectile dysfunction: a two-sample mendelian randomization study
Authors: Chen Wei-Kang , Zhou Tao , Yu Dong-Dong , Li Jing-Ping , Wu Jing-Gen , Li Le-Jun , Liang Zhong-Yan , Zhang Feng-Bin
Published: March 2023

Background and Aims

There are currently no clear conclusions about whether major depression (MD) and bipolar disorder (BD) increase the risk of erectile dysfunction (ED). In our study, we used a Mendelian randomization (MR) analysis to discover the causal associations between MD, BD and ED.

Methods

We got single-nucleotide polymorphisms (SNPs) related to MD, BD and ED from the MRC IEU Open genome-wide association study (GWAS) datasets. After a series of selection, SNPs left were selected as instrumental variables (IVs) of MD and BD for the following MR test to evaluate the relationship of genetically predicted MD or BD with the incidence of ED. Among them, we used the random-effects inverse-variance weighted (IVW) method as the main analysis. Finally, sensitivity analyses were further performed using Cochran’s Q test, funnel plots, MR-Egger regression, Leave-one-out method and MR- pleiotropy residual sum and outlier (PRESSO).

Results

Genetically-predicted MD was causally related to the incidence of ED in the IVW methods (odds ratio (OR), 1.53; 95% confidence interval (CI), 1.19–1.96; p = 0.001), while no causal impact of BD on the risk of ED (OR = 0.95, 95% CI 0.87–1.04; p = 0.306). The results of sensitivity analyses supported our conclusion, and no directional pleiotropy were found.

Conclusion

The findings of this research found evidence of a causal relationship between MD and ED. However, we did not find a causal relationship between BD and ED in European populations.
Septin-3 autoimmunity in patients with paraneoplastic cerebellar ataxia
Authors: Miske Ramona , Scharf Madeleine , Borowski Kathrin , Rieckhoff Nicole , Teegen Bianca , Denno Yvonne , Probst Christian , Guthke Kersten , Didrihsone Ieva , Wildemann Brigitte , Ruprecht Klemens , Komorowski Lars , Jarius Sven
Published: March 2023

Background

Septins are cytoskeletal proteins with filament forming capabilities, which have multiple roles during cell division, cellular polarization, morphogenesis, and membrane trafficking. Autoantibodies against septin-5 are associated with non-paraneoplastic cerebellar ataxia, and autoantibodies against septin-7 with encephalopathy with prominent neuropsychiatric features. Here, we report on newly identified autoantibodies against septin-3 in patients with paraneoplastic cerebellar ataxia. We also propose a strategy for anti-septin autoantibody determination.

Methods

Sera from three patients producing similar immunofluorescence staining patterns on cerebellar and hippocampal sections were subjected to immunoprecipitation followed by mass spectrometry. The identified candidate antigens, all of which were septins, were expressed recombinantly in HEK293 cells either individually, as complexes, or combinations missing individual septins, for use in recombinant cell-based indirect immunofluorescence assays (RC-IIFA). Specificity for septin-3 was further confirmed by tissue IIFA neutralization experiments. Finally, tumor tissue sections were analyzed immunohistochemically for septin-3 expression.

Results

Immunoprecipitation with rat cerebellum lysate revealed septin-3, -5, -6, -7, and -11 as candidate target antigens. Sera of all three patients reacted with recombinant cells co-expressing septin-3/5/6/7/11, while none of 149 healthy control sera was similarly reactive. In RC-IIFAs the patient sera recognized only cells expressing septin-3, individually and in complexes. Incubation of patient sera with five different septin combinations, each missing one of the five septins, confirmed the autoantibodies’ specificity for septin-3. The tissue IIFA reactivity of patient serum was abolished by pre-incubation with HEK293 cell lysates overexpressing the septin-3/5/6/7/11 complex or septin-3 alone, but not with HEK293 cell lysates overexpressing septin-5 as control. All three patients had cancers (2 × melanoma, 1 × small cell lung cancer), presented with progressive cerebellar syndromes, and responded poorly to immunotherapy. Expression of septin-3 was demonstrated in resected tumor tissue available from one patient.

Conclusions

Septin-3 is a novel autoantibody target in patients with paraneoplastic cerebellar syndromes. Based on our findings, RC-IIFA with HEK293 cells expressing the septin-3/5/6/7/11 complex may serve as a screening tool to investigate anti-septin autoantibodies in serological samples with a characteristic staining pattern on neuronal tissue sections. Autoantibodies against individual septins can then be confirmed by RC-IIFA expressing single septins.