bluuebunny/crossref_metadata_2025 huggingface dataset:
Privacy-Preserving Technologies for Trusted Data Spaces
Authors: Bonura Susanna , Carbonare Davide Dalle , Díaz-Morales Roberto , Fernández-Díaz Marcos , Morabito Lucrezia , Muñoz-González Luis , Napione Chiara , Navia-Vázquez Ángel , Purcell Mark
Published: April 2022

The quality of a machine learning model depends on the volume of data used during the training process. To prevent low accuracy models, one needs to generate more training data or add external data sources of the same kind. If the first option is not feasible, the second one requires the adoption of a federated learning approach, where different devices can collaboratively learn a shared prediction model. However, access to data can be hindered by privacy restrictions. Training machine learning algorithms using data collected from different data providers while mitigating privacy concerns is a challenging problem. In this chapter, we first introduce the general approach of federated machine learning and the H2020 MUSKETEER project, which aims to create a federated, privacy-preserving machine learning Industrial Data Platform. Then, we describe the Privacy Operations Modes designed in MUSKETEER as an answer for more privacy before looking at the platform and its operation using these different Privacy Operations Modes. We eventually present an efficiency assessment of the federated approach using the MUSKETEER platform. This chapter concludes with the description of a real use case of MUSKETEER in the manufacturing domain.
Investive Statusarbeit als Modus der Lebensführung: Das theoretische Modell
Authors: Kumkar Nils C. , Holubek-Schaum Stefan , Gottschall Karin , Hollstein Betina , Schimank Uwe
Published: April 2022

Dieses Kapitel stellt ein generelles soziologisches Modell von Lebensführung und daran anschließend ein Modell investiver Statusarbeit im Speziellen vor. Damit wird ein Idealtypus als theoretischer Suchscheinwerfer ausgerichtet, der das empirische Vorgehen anleitet.
Erfassung und apparatives Monitoring des Ernährungsstatus von Patient*innen auf der Intensiv- und Intermediate Care Station
Authors: Weimann Arved , Hartl Wolfgang H. , Adolph Michael , Angstwurm Matthias , Brunkhorst Frank M. , Edel Andreas , de Heer Geraldine , Felbinger Thomas W. , Goeters Christiane , Hill Aileen , Kreymann K. Georg , Mayer Konstantin , Ockenga Johann , Petros Sirak , Rümelin Andreas , Schaller Stefan J. , Schneider Andrea , Stoppe Christian , Elke Gunnar
Published: April 2022

Die Erhebung des Ernährungsstatus zum Zeitpunkt der Aufnahme im Intensiv- oder Intermediate Care Bereich hat sowohl prognostische als auch therapeutische Relevanz im Hinblick auf die Planung einer individualisierten medizinischen Ernährungstherapie (engl. „medical nutrition therapy“, MNT). Diese Planung wird im Rahmen der Erstversorgung eines vital bedrohlichen Krankheitsbilds nachvollziehbar nicht priorisiert, jedoch im weiteren Verlauf häufig auch oft nicht mehr angemessen durchgeführt. Vor allem bei längerer Verweildauer besteht das Risiko einer Mangelernährung mit Aufbau eines kumulativen, prognoserelevanten Makro- und/oder Mikronährstoffdefizits. Bisher gibt es für Patient*innen auf Intensiv- und Intermediate Care Einheiten keine strukturierten Empfehlungen zur Erhebung des Ernährungsstatus. Das vorliegende Positionspapier der Sektion Metabolismus und Ernährung der Deutschen Interdisziplinären Vereinigung für Intensiv- und Notfallmedizin (DIVI) beinhaltet konsensbasierte Empfehlungen zur Erfassung und zum apparativen Monitoring des Ernährungsstatus von Patient*innen auf Intensiv- und Intermediate Care Stationen. Diese Empfehlungen ergänzen die aktuelle S2k-Leitlinie „Klinische Ernährung in der Intensivmedizin“ der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) und der DIVI.
Lessons from single-cell RNA sequencing of human islets
Authors: Ngara Mtakai , Wierup Nils
Published: April 2022

Islet dysfunction is central in type 2 diabetes and full-blown type 2 diabetes develops first when the beta cells lose their ability to secrete adequate amounts of insulin in response to raised plasma glucose. Several mechanisms behind beta cell dysfunction have been put forward but many important questions still remain. Furthermore, our understanding of the contribution of each islet cell type in type 2 diabetes pathophysiology has been limited by technical boundaries. Closing this knowledge gap will lead to a leap forward in our understanding of the islet as an organ and potentially lead to improved treatments. The development of single-cell RNA sequencing (scRNAseq) has led to a breakthrough for characterising the transcriptome of each islet cell type and several important observations on the regulation of cell-type-specific gene expression have been made. When it comes to identifying type 2 diabetes disease mechanisms, the outcome is still limited. Several studies have identified differentially expressed genes, although there is very limited consensus between the studies. As with all new techniques, scRNAseq has limitations; in addition to being extremely expensive, genes expressed at low levels may not be detected, noise may not be appropriately filtered and selection biases for certain cell types are at hand. Furthermore, recent advances suggest that commonly used computational tools may be suboptimal for analysis of scRNAseq data in small-scale studies. Fortunately, development of new computational tools holds promise for harnessing the full potential of scRNAseq data. Here we summarise how scRNAseq has contributed to increasing the understanding of various aspects of islet biology as well as type 2 diabetes disease mechanisms. We also focus on challenges that remain and propose steps to promote the utilisation of the full potential of scRNAseq in this area.

Graphical abstract
Mediators of the association between educational attainment and type 2 diabetes mellitus: a two-step multivariable Mendelian randomisation study
Authors: Zhang Jia , Chen Zekai , Pärna Katri , van Zon Sander K. R. , Snieder Harold , Thio Chris H. L.
Published: April 2022

Aims/hypothesis

Type 2 diabetes mellitus is a major health burden disproportionately affecting those with lower educational attainment (EA). We aimed to obtain causal estimates of the association between EA and type 2 diabetes and to quantify mediating effects of known modifiable risk factors.

Methods

We applied two-step, two-sample multivariable Mendelian randomisation (MR) techniques using SNPs as genetic instruments for exposure and mediators, thereby minimising bias due to confounding and reverse causation. We leveraged summary data on genome-wide association studies for EA, proposed mediators (i.e. BMI, blood pressure, smoking, television watching) and type 2 diabetes. The total effect of EA on type 2 diabetes was decomposed into a direct effect and indirect effects through multiple mediators. Additionally, traditional mediation analysis was performed in a subset of the National Health and Nutrition Examination Survey 2013–2014.

Results

EA was inversely associated with type 2 diabetes (OR 0.53 for each 4.2 years of schooling; 95% CI 0.49, 0.56). Individually, the largest contributors were BMI (51.18% mediation; 95% CI 46.39%, 55.98%) and television watching (50.79% mediation; 95% CI 19.42%, 82.15%). Combined, the mediators explained 83.93% (95% CI 70.51%, 96.78%) of the EA–type 2 diabetes association. Traditional analysis yielded smaller effects but showed consistent direction and priority ranking of mediators.

Conclusions/interpretation

These results support a potentially causal protective effect of EA against type 2 diabetes, with considerable mediation by a number of modifiable risk factors. Interventions on these factors thus have the potential of substantially reducing the burden of type 2 diabetes attributable to low EA.

Graphical abstract
Integral points on curves $$\frac{f(X)-f(Y)}{X-Y}$$
Authors: Zannier Umberto
Published: April 2022

The following short article first arose as an Appendix to the paper Counting points of bounded height in monoid orbits, by Wade Hindes, which appears just above in this journal. Subsequently, due to the general nature of the underlying problem, we thought that the result could have further applications, and could be easily overlooked if it appeared as an appendix. So, with the welcome kind help of the Editors, we decided to publish the result separately.
GeoChemFoam: Direct modelling of flow and heat transfer in micro-CT images of porous media
Authors: Maes Julien , Menke Hannah P.
Published: April 2022

GeoChemFoam is an open-source OpenFOAM-based numerical modelling toolbox that includes a range of custom packages to solve complex flow processes including multiphase transport with interface transfer, single-phase flow in multiscale porous media, and reactive transport with mineral dissolution. In this paper, we present GeoChemFoam’s novel numerical model for simulation of conjugate heat transfer in micro-CT images of porous media. GeoChemFoam uses the micro-continuum approach to describe the fluid-solid interface using the volume fraction of fluid and solid in each computational cell. The velocity field is solved using Brinkman’s equation with permeability calculated using the Kozeny-Carman equation which results in a near-zero permeability in the solid phase. Conjugate heat transfer is then solved with heat convection where the velocity is non-zero, and the thermal conductivity is calculated as the harmonic average of phase conductivity weighted by the phase volume fraction. Our model is validated by comparison with the standard two-medium approach for a simple 2D geometry. We then simulate conjugate heat transfer and calculate heat transfer coefficients for different flow regimes and injected fluid analogous to injection into a geothermal reservoir in a micro-CT image of Bentheimer sandstone and perform a sensitivity analysis in a porous heat exchanger with a random sphere packing.
Rotational atherectomy of calcified coronary lesions: current practice and insights from two randomized trials
Authors: Allali Abdelhakim , Abdel-Wahab Mohamed , Elbasha Karim , Mankerious Nader , Traboulsi Hussein , Kastrati Adnan , El-Mawardy Mohamed , Hemetsberger Rayyan , Sulimov Dmitriy S. , Neumann Franz-Josef , Toelg Ralph , Richardt Gert
Published: April 2022

With growing experience, technical improvements and use of newer generation drug-eluting stents (DES), recent data showed satisfactory acute and long-term results after rotational atherectomy (RA) in calcified coronary lesions. The randomized ROTAXUS and PREPARE–CALC trials compared RA to balloon-based strategies in two different time periods in the DES era. In this manuscript, we assessed the technical evolution in RA practice from a pooled analysis of the RA groups of both trials and established a link to further recent literature. Furthermore, we sought to summarize and analyze the available experience with RA in different patient and lesion subsets, and propose recommendations to improve RA practice. We also illustrated the combination of RA with other methods of lesion preparation. Finally, based on the available evidence, we propose a simple and practical approach to treat severely calcified lesions.

Graphical abstract
Exosomal LncRNA RP5-977B1 as a novel minimally invasive biomarker for diagnosis and prognosis in non-small cell lung cancer
Authors: Min Ling , Zhu Ting , Lv Bo , An Taixue , Zhang Qichao , Shang Yanyan , Yu Zhiwu , Zheng Lei , Wang Qian
Published: April 2022

Background

Lung cancer is the leading cause of cancer-related deaths in the world. Non-small cell lung cancer (NSCLC) accounts for 85% of all lung cancer cases. For lack of conveniently sensitive and specific biomarkers, the majority of patients are in the late stage at initial diagnosis. Long non-coding RNAs (LncRNAs), a novel type of non-coding RNA, have recently been recognized as critical factors in tumor initiation and progression, but the role of exosomal LncRNAs has not been thoroughly excavated in NSCLC yet.

Methods

We isolated exosomes from the serum of patients with NSCLC and healthy controls. Exosome RNA deep sequencing was subsequently performed to detect differentially expressed exosomal LncRNAs. qRT-PCR assay was then utilized to validate dysregulated LncRNAs in both testing and multicentric validation cohort. Receiver operating characteristic (ROC) curve was used to detect the diagnostic capability of exosomal biomarkers. Furthermore, Kaplan–Meier analysis was applied to evaluate the prognostic values of these molecules.

Results

On the basis of analysis, we found that novel exosomal LncRNA RP5-977B1 exhibited higher levels in NSCLC than that in the healthy controls. The area under the curve (AUC) value of exosomal RP5-977B1 was 0.8899 and superior to conventional biomarkers CEA and CYFRA21-1 both in testing and multicentric validation cohort. Interestingly, the diagnostic capability of exosomal RP5-977B1 was also validated in early-stage patients with NSCLC. Furthermore, high expression of exosomal RP5-977B1was closely related with worse prognosis in NSCLC (P = 0.036).

Conclusions

Our results suggested that exosomal RP5-977B1 might serve as a novel “liquid biopsy” diagnostic and prognostic biomarker to monitor NSCLC and improve possible therapy.
Teaching Experiences of Inclusive Spanish STEM Faculty with Students with Disabilities
Authors: Moriña Anabel , Orozco Inmaculada
Published: April 2022

This paper explores the experiences of 14 inclusive STEM faculty members from five Spanish universities who taught students with disabilities. Their students with disabilities nominated them for having contributed to their success in their degrees. The article presents part of a larger qualitative study comprising individual interviews with faculty members. Data were analysed through an inductive system of categories and codes. The results show what the faculty did when they knew they had students with disabilities studying their subjects, how they valued their experiences with disability and what recommendations they would make to other colleagues regarding how to be more inclusive. The conclusions suggest that, in order to respond to diversity, faculty must be well-informed and well-trained, contact the disability office and plan the lectures in a proactive and accessible way, making reasonable adjustments. The experiences of these inclusive professionals can help other members of the university community to perceive disability as an opportunity to improve teaching practices, learn how to help their students with disabilities and design educational practices for all.
Atypical Tactile Perception in Early Childhood Autism
Authors: Espenhahn Svenja , Godfrey Kate J. , Kaur Sakshi , McMorris Carly , Murias Kara , Tommerdahl Mark , Bray Signe , Harris Ashley D.
Published: April 2022

We assessed different aspects of tactile perception in young children (3–6 years) with autism. Autistic and neurotypical children completed vibrotactile tasks assessing reaction time, amplitude discrimination (sequential and simultaneous) and temporal discrimination (temporal order judgment and duration discrimination). Autistic children had elevated and more variable reaction times, suggesting slower perceptual-motor processing speed and/or greater distractibility. Children with autism also showed higher amplitude discrimination and temporal order judgement thresholds compared to neurotypical children. Tactile perceptual metrics did not associate with social or tactile sensitivities measured by parent-reports. Altered tactile behavioral responses appear in early childhood, can be quantified but appear dissociated from sensitivity. This implies these measures are complementary, but not necessarily related, phenomena of atypical tactile perception in autism.
High Photoluminescence Polyindole/CuInS Quantum Dots for Pb Ions Sensor
Authors: Elkony Yasmeen , Ali Mohamed , Ebrahim Shaker , Adel Rania
Published: April 2022

Polyindole is considered an excellent conducting polymer with interested properties for different applications. A novel polyindole (PIn)/CuInS (CIS)/ZnS quantum dots (QDs) nanocomposite was synthesized via in situ polymerization of PIn in presence of CIS/ZnS QDs. By investigating the effect of CIS/ZnS QDs on optical properties of PIn, it was found that the optical band gaps of PIn, CIS/ZnS QDs, and PIn/CIS/ZnS QDs nanocomposite were 3.24 eV, 4.68 eV and 3.44 eV, respectively. From the luminance spectra, it was observed that emission peaks of PIn at 442 and 468 nm are independent of the excitation wavelength with the highest intensity at excitation wavelength of 380 nm. However, the luminance spectrum of PIn/CIS/ZnS QDs nanocomposite exhibited a quenching peak for CIS/ZnS QDs while the intensity of PIn peak was enhanced. High resolution of transmission electron microscope image of CIS/ZnS QDs revealed nanocrystals with a size of 3–4.5 nm and lattice space of 0.2 nm. PIn/CIS/ZnS QDs nanocomposite as the fluorescent probe was employed for sensing different concentrations of Pb2+from 5 to 50 ppb. The reaction between PIn/CIS/ZnS QDs and Pb2+was slightly quenched and fixed after 90 min. The emission peak was reduced gradually with increasing concentration of lead via photo-induced electron transfer or ion exchange mechanism. The value of correlation coefficient (R2) was 0.99, the sensitivity was 0.0041 ppb−1and limit of detection value was 4.48 ppb.
Optical Properties of Cellulose Nanofibre Films at High Temperatures
Authors: Niskanen Ilpo , Zhang Kaitao , Karzarjeddi Mohammad , Liimatainen Henrikki , Shibata Shuhei , Hagen Nathan , Heikkilä Rauno , Yoda Hidehiko , Otani Yukitoshi
Published: April 2022

Nanocelluloses and their different designs, such as films and nanopapers, have gained considerable interest in many application areas due to their unique properties. For many purposes, such as packaging and electronics, the thermal stability and optical properties of nanocellulose materials are crucial characteristics. In this study, the effects of heat treatment (100 ºC, 150 ºC and 200 ºC) on the optical and mechanical properties of 2,2,6,6-tetramethylpiperidinyl-1-oxy radical-oxidised cellulose nanofibre (TO-CNF) films were investigated, especially the alteration of the colour, complex refractive index and birefringence. Exposing TO-CNF films to high temperatures (> 150 ºC) induced permanent transformations in the CNF structure, leading to an increase in the refractive index, decreases in the birefringence and crystallinity index, colour darkening and significant deterioration of the mechanical properties.

Graphical abstract
Estimating heart mass from heart volume as measured from post-mortem computed tomography
Authors: Aitken-Buck Hamish M. , Moore Matthew , Whalley Gillian A. , Lohner Larissa , Ondruschka Benjamin , Coffey Sean , Tse Rexson D. , Lamberts Regis R.
Published: April 2022

Heart mass can be predicted from heart volume as measured from post-mortem computed tomography (PMCT), but with limited accuracy. Although related to heart mass, age, sex, and body dimensions have not been included in previous studies using heart volume to estimate heart mass. This study aimed to determine whether heart mass estimation can be improved when age, sex, and body dimensions are used as well as heart volume. Eighty-seven (24 female) adult post-mortem cases were investigated. Univariable predictors of heart mass were determined by Spearman correlation and simple linear regression. Stepwise linear regression was used to generate heart mass prediction equations. Heart mass estimate performance was tested using median mass comparison, linear regression, and Bland–Altman plots. Median heart mass (P = 0.0008) and heart volume (P = 0.008) were significantly greater in male relative to female cases. Alongside female sex and body surface area (BSA), heart mass was univariably associated with heart volume in all cases (R2 = 0.72) and in male (R2 = 0.70) and female cases (R2 = 0.64) when segregated. In multivariable regression, heart mass was independently associated with age and BSA (R2 adjusted = 0.46–0.54). Addition of heart volume improved multivariable heart mass prediction in the total cohort (R2 adjusted = 0.78), and in male (R2 adjusted = 0.74) and female (R2 adjusted = 0.74) cases. Heart mass estimated from multivariable models incorporating heart volume, age, sex, and BSA was more predictive of actual heart mass (R2 = 0.75–0.79) than models incorporating either age, sex, and BSA only (R2 = 0.48–0.57) or heart volume only (R2 = 0.64–0.73). Heart mass can be more accurately predicted from heart volume measured from PMCT when combined with the classical predictors, age, sex, and BSA.
A small microring array that performs large complex-valued matrix-vector multiplication
Authors: Cheng Junwei , Zhao Yuhe , Zhang Wenkai , Zhou Hailong , Huang Dongmei , Zhu Qing , Guo Yuhao , Xu Bo , Dong Jianji , Zhang Xinliang
Published: April 2022

As an important computing operation, photonic matrix–vector multiplication is widely used in photonic neutral networks and signal processing. However, conventional incoherent matrix–vector multiplication focuses on real-valued operations, which cannot work well in complex-valued neural networks and discrete Fourier transform. In this paper, we propose a systematic solution to extend the matrix computation of microring arrays from the real-valued field to the complex-valued field, and from small-scale (i.e., 4 × 4) to large-scale matrix computation (i.e., 16 × 16). Combining matrix decomposition and matrix partition, our photonic complex matrix–vector multiplier chip can support arbitrary large-scale and complex-valued matrix computation. We further demonstrate Walsh-Hardmard transform, discrete cosine transform, discrete Fourier transform, and image convolutional processing. Our scheme provides a path towards breaking the limits of complex-valued computing accelerator in conventional incoherent optical architecture. More importantly, our results reveal that an integrated photonic platform is of huge potential for large-scale, complex-valued, artificial intelligence computing and signal processing.
Probing fluorination promoted sodiophilic sites with model systems of F16CuPc and CuPc
Authors: Liu Yuan , Lian Xu , Xie Zhangdi , Yang Jinlin , Ding Yishui , Chen Wei
Published: April 2022

Sodium metal batteries (SMBs) are receiving broad attention due to the high specific capacity of sodium metal anodes and the material abundance on earth. However, the growth of dendrites results in poor battery performance and severe safety problems, inhibiting the commercial application of SMBs. To stabilize sodium metal anodes, various methods have been developed to optimize the solid electrolyte interphase (SEI) layer and adjust the electroplating/stripping behavior of sodium. Among the methods, developing anode host materials and adding electrolyte additives to build a protective layer are promising and convenient. However, the understanding of the interaction process between sodium metal and those organic materials is still limited, but is essential for the rational design of advanced anode hosts and electrolyte additives. In this study, we use copper(II) hexadecafluorophthalocyanine (F16CuPc), and copper(II) phthalocyanine (CuPc), as model systems to unravel the sodium interaction with polar functional groups by in-situ photoelectron spectroscopy and density functional theory (DFT) calculations. It is found that sodium atoms prefer to interact with the inner pyrrolic nitrogen sites of CuPc, while they prefer to interact with the outer aza bridge nitrogen atoms, owing to Na-F interaction at the Na/F16CuPc interface. Besides, for the both organic molecules, the central Cu(II) ions are reduced to Cu(I) ions by charge transfer from deposited sodium. The fluorine-containing groups are proven to promote the interaction process of sodium in organic materials, which sheds light on the design of functional interfaces in host materials and anode protective layers for sodium metal anodes.

Graphical Abstract
“It’s a win for the clinic, it’s a win for the frontline, but, most importantly, it’s a win for the client”: Task Shifting HIV Prevention Services from Clinicians to Community Health Workers in Ontario, Canada
Authors: Brennan David J. , Charest Maxime , Turpin Aaron , Griffiths Dane , Adam Barry D. , Maxwell John , McCrady Keith , Ahmed Robbie
Published: April 2022

Introduction

Despite strong evidence from low- and middle-income countries supporting the use of task shifting to provide quality, cost-effective HIV-related health services, this strategy has been adopted less widely in high-income countries such as Canada.

Methods

In 2020, we conducted semi-structured interviews with 19 clinicians (e.g., psychologists, nurses, physicians) and 14 community health workers (CHWs) in Ontario to examine their perspectives on the prospect of shifting HIV/STBBI testing services and PrEP in Ontario, Canada. Interviews were transcribed and then analyzed using content analysis. A community consultation with key stakeholders was also performed to assess the validity of the findings.

Results

There was substantial agreement between clinicians and CHWs with respect to shifting specific tasks related to HIV/STBBI testing and PrEP. In particular, most participants felt that rapid HIV testing could and should be provided by CHWs and that ASOs could be ideal sites for clients to obtain and use self-testing kits for STBBIs. Most respondents agreed that CHWs have the skills and expertise required to perform most non-clinical services related to PrEP (e.g., pre-counselling, follow-up, case management). The co-location of clinicians and CHWs could help support the development of task shifting initiatives.

Conclusion

Findings indicate that there is enthusiasm among both clinicians and CHWs with respect to shifting HIV prevention services. Creative solutions are required to have a meaningful impact on HIV incidence in this population.

Policy Implications

With adequate training and supervision, non-regulated CHWs should be allowed to provide certain HIV prevention services such as rapid HIV testing. A provincial, publicly funded program for PrEP is recommended.
Thermal expansion and temperature-dependent Young’s modulus of Invar fabricated via laser powder-bed fusion
Authors: Hitzler Leonhard , Shahul Hameed Muhammed Zubair , Kah Adrian , Merkel Markus , Werner Ewald
Published: April 2022

Invar alloys possess the peculiarity of dimensional invariance, which is of importance for high precision applications, such as measurement instruments. As ductile face-centered cubic (fcc) material, it is adequately weldable and is nowadays readily available as powder feed stock for additive manufacturing processes. Single-phase fcc alloys are known to often be highly textured, when fabricated via laser powder-bed fusion. Within this study, the thermal expansion behavior was analyzed via true differential dilatometry and the directional Young’s moduli were determined via impulse excitation technique in the temperature range up to 850 °C. The coefficient of thermal expansion was found to be nearly independent of the analyzed orientations. However, Young’s moduli differed by 20 GPa, with the highest stiffness obtained for specimens orientated parallel to the x-axis of the machines’ coordinate system.
Racial and Ethnic Variation in Genetic Susceptibility: Are Disparities in Infertility Prevalence and Outcomes more than Black and White?
Authors: Morris Jerrine R. , Plowden Torie Comeaux , Green Lisa J. , Edwards Digna R. Velez , Jackson-Bey Tia
Published: April 2022

Race, as a social construct without a clear genetic underpinning, is frequently referenced in medicine as predictor of multiple diseases including that of infertility. The authors will discuss how systematic racism can have downstream consequences ranging from overt physician bias to use of medical algorithms that may potentiate the same disparities they attempt to narrow. Then, the authors explore the utility and pragmatic use of genetic ancestry to estimate disease prevalence, instead of racial categories. Finally, the authors explore how health inequities, rooted in systematic racism, can influence disease heritability effectively advocating for research to disentangle the contributions of racism to genetic susceptibility in infertility.
CACA guidelines for holistic integrative management of gastric cancer
Authors:   Society of Gastric Cancer of China Anti-Cancer Association
Published: April 2022

According to statistics, the rates of incidence and death of gastric cancer in China have risen to the fourth worldwide, resulting in huge social burden. Regrettably, international guidelines, such as NCCN or ESMO, could not provide enough consideration to Chinese clinical practice, making it difficult to achieve individual therapy in China. In 2020, China Anti-Cancer Association (CACA) invited domestic multi-disciplinary experts and made the guideline of gastric cancer, involving surgeon, oncologist, pathologist, radiologist, herbalist, physiatrist and psychologist. This gastric cancer guideline recommends comprehensive treatment scheme with high-evidence and well-feasibility, which is mainly based on evidence-based medicine, Chinese experience and expert consensus. We provided MDT to HIM system of “prevention, screening, diagnosis, treatment, rehabilitation” for gastric cancer, which embodied the integration of research evidence, clinical experience and patient needs. The CACA guideline is more suitable for China’s clinical practice, reflecting scientificity, accessibility and Chinese characteristics, highlights the concept of integrated medicine, and has guiding value of clinical practice.
Fragile Futures
Authors: Tanzi Vito
Published: April 2022

This book revisits a distinction introduced in 1921 by economists Frank Knight and John Maynard Keynes: that between statistically predictable future events ('risks') and statistically unpredictable, uncertain events ('uncertainties'). Governments have generally ignored the latter, perceiving phenomena such as pandemics, natural disasters and climate change as uncontrollable Acts of God. As a result, there has been little if any preparation for future catastrophes. Our modern society is more interconnected and more globalized than ever. Dealing with uncertain future events requires a stronger and more globally coordinated government response. This book suggests a larger, more global government role in dealing with these disasters and keeping economic inequalities low. Major institutional changes, such as regulating the private sector for the common good and dealing with special harms, risks and crises, especially those concerning climate change and pandemics, are necessary in order to achieve any semblance of future progress for humankind.
Motor Band Sign in Motor Neuron Disease: A Marker for Upper Motor Neuron Involvement
Authors: Chung Hee Sahng , Melkus Gerd , Bourque Pierre , Chakraborty Santanu
Published: April 2022

Background and Objective:

The prevalence and role of the motor band sign (MBS) remain unclear in motor neuron disease. We report the frequency of MBS in amyotrophic lateral sclerosis (ALS) and primary lateral sclerosis (PLS), its correlation with clinical upper motor neuron (UMN) signs, and prognostic value in ALS.

Methods:

We conducted a retrospective study of ALS, PLS, and controls with retrievable MRI between 2010 and 2018. We compared the frequencies of MBS across the three groups, and studied correlation between susceptibility-weighted MRI measurements in primary motor cortices and contralateral UMN features. Clinical outcomes were compared between ALS with and without MBS.

Results:

Thirteen ALS, 5 PLS, and 10 controls were included (median age 60 years, IQR 54–66 years; 14/28 males). MBS was present in 9/13 (69.2%, 95% CI 38.9–89.6%) and 4/5 (80.0%, 95% CI 29.9–99.0%) of ALS and PLS, respectively, and none in controls. 2/13 (15.4%, 95% CI 2.7–46.3%) ALS and 3/5 (60.0%, 95% CI 17.0–92.7%) PLS had MBS in the absence of corticospinal T2/FLAIR hyperintensity sign. Susceptibility measurements in left motor cortices had a significantly positive correlation with contralateral UMN signs in ALS (τb = 0.628, p = 0.03). Similar but nonsignificant trends was observed for right motor cortices in ALS (τb = 0.516, p = 0.07). There were no significant differences in mRS at last follow-up, mortality, or time from symptom onset to last follow-up between ALS patients with and without MBS.

Conclusions:

We provide limited evidence that MBS and susceptibility quantification measurements in motor cortices may serve as surrogate markers of UMN involvement in motor neuron disease.
La importancia de la obsidiana de Otumba durante el período Arcaico en la Cuenca de México: Un análisis mediante pXRF
Authors: Acosta Ochoa Guillermo , García Gómez Víctor Hugo
Published: April 2022

Se caracterizó mediante análisis de fluorescencia de rayos X portable (pXRF) un conjunto de obsidianas (n= 142) del sitio San Gregorio Atlapulco, en Xochimilco, Ciudad de México, procedentes de los niveles precerámicos, a través del análisis de 10 elementos químicos (Mn, Fe, Zn, Ga, Th, Rb, Sr, Y, Zr, Nb); esto nos permitió conocer la composición elemental de cada uno de los artefactos para posteriormente efectuar comparaciones con obsidianas de yacimientos sistemáticamente muestreados. Los resultados indican una amplia dominancia de la subfuente de Soltepec en Otumba (94%), además de otras dos fuentes menores que incluyen a Pachuca. Lo anterior tiene implicaciones importantes sobre los procesos de interacción de los grupos precerámicos del Holoceno medio en la Cuenca de México, y permite vislumbrar la importancia de la obsidiana de Otumba para el período denominado Arcaico, y la formación de redes de intercambio tempranas que continuarían durante el período Formativo.
Population genetics reveal multiple independent invasions of Spodoptera frugiperda (Lepidoptera: Noctuidae) in China
Authors: Jiang Yun-Yuan , Zhang Yi-Yin , Zhou Xin-Yu , Hong Xiao-Yue , Chen Lei
Published: April 2022

The fall armyworm (Spodoptera frugiperda), a destructive pest that originated in South and North America, spread to China in early 2019. Controlling this invasive pest requires an understanding of its population structure and migration patterns, yet the invasion genetics of Chinese S. frugiperda is not clear. Here, using the mitochondrial cytochrome oxidase subunit I (COI) gene, triose phosphate isomerase (Tpi) gene and eight microsatellite loci, we investigated genetic structure and genetic diversity of 16 S. frugiperda populations in China. The Tpi locus identified most S. frugiperda populations as the corn-strains, and a few were heterozygous strains. The microsatellite loci revealed that the genetic diversity of this pest in China was lower than that in South America. Furthermore, we found moderate differentiation among the populations, distinct genetic structures between adjacent populations and abundant genetic resources in the S. frugiperda populations from China sampled across 2 years. The survival rate of S. frugiperda was significantly higher when it was fed on corn leaves than on rice leaves, and the larval stage mortality rate was the highest under both treatments. Our results showed that S. frugiperda probably invaded China via multiple independent introductions and careful pesticide control, continuous monitoring and further studies will be needed to minimize its potential future outbreak.
The alchemy of suffering in the laboratory of the world: Vedāntic Hindu engagements with the affliction of animals
Authors: Gupta Akshay , Barua Ankur
Published: April 2022

Traditionally, the problem of evil, in its various formulations, has been one of the strongest objections against perfect being theism. In the voluminous literature on this problem, the motif of evil has usually been discussed with respect to human flourishing. In recent decades more focused attention has been paid to animal suffering and the philosophical problems that such suffering poses for perfect being theists. However, this growing body of literature, in Anglo-American philosophical milieus, is largely aimed at sketching a specifically Christian or Christianity-inflected theodicy that would reconcile animal suffering with the existence of an omni-God. In contrast, there are few, if any, systematic attempts to put forth a Hindu theodicy that aims to offer morally justifiable reasons that God has for allowing animal suffering. In this article, we address this scholarly lacuna by illustrating how a Hindu perfect being theist might respond to the problem of animal suffering.
Language in educational apps for pre-schoolers. A comparison of grammatical constructions and psycholinguistic features in apps, books and child directed speech
Authors: KOLAK Joanna , MONAGHAN Padraic , TAYLOR Gemma
Published: April 2022

Language in touchscreen apps could be useful as an additional source of children’s language input, alongside child directed speech (CDS) and books. Here we performed the first analysis of language in apps, as compared with books and CDS. We analysed language in 18 of the most popular educational apps targeting pre-schoolers and compared their language content to children’s books and CDS with respect to types of constructions and psycholinguistic features of words. We found that apps contained lower frequency words and had lower lexical diversity compared to CDS, and shorter utterances compared to books. Apps may thus provide an enriched supplementary form of input for young children, due to containing less frequent words. However, apps do not expose children to a high proportion of questions and complex sentences, both of which are crucial for supporting child’s development of structurally rich constructions.
Long-Term Effects of Once-Daily Valbenazine in Older and Younger Adults with Tardive Dyskinesia
Authors: Sajatovic Martha , Farahmand Khody , Shah Chirag , Lundt Leslie
Published: April 2022

Introduction

Older patients taking a dopamine receptor blocking agent (eg, first- or second-generation antipsychotic) have an increased risk for tardive dyskinesia (TD), a persistent and potentially disabling movement disorder. Valbenazine, a selective and potent vesicular monoamine transporter 2 inhibitor, is approved for once-daily treatment of TD with no dosing adjustments required for older patients. This analysis of valbenazine clinical trial data, which is the first to evaluate an approved TD medication in a population ≥65 years, was conducted to better understand treatment outcomes in older patients.

Methods

Data from two 48-week long-term studies (KINECT 3-extension, KINECT 4) were pooled and analyzed in older (≥65 years) and younger (<65 years) participants. Analyses based on the Abnormal Involuntary Movement Scale (AIMS) total score included: mean change from baseline (BL); clinically meaningful response (≥30% improvement from BL [AIMS-30%]); and protocol-defined response (≥50% improvement from BL [AIMS-50%]). Additional analyses included response thresholds for Clinical Global Improvement-Tardive Dyskinesia and Patient Global Impression of Change as follows: rating of “minimally improved” or better (score ≤3) at week 48 (CGI-TD≤3, PGIC≤3); rating of “much improved” or “very much improved” (score ≤2) at week 48 (CGI-TD≤2, PGIC≤2).

Results

AIMS outcomes in the older subgroup were generally comparable to (or better than) outcomes in the younger subgroup and overall study populations. In participants ≥65 years, pooled AIMS results indicated substantial improvements in TD movements with valbenazine 40 mg (n = 8) and 80 mg (n = 20): mean change from BL (−6.4 and −9.8 [for 40 and 80 mg, respectively]); AIMS-30% (75% and 95%); AIMS-50% (75% and 85%). CGI-TD and PGIC response rates indicated that clinician- and patient-reported global improvements were also substantial in the older subgroup: CGI-TD = 3 (88% and 100% [for 40 and 80 mg, respectively]); CGI-TD = 2 (88% and 95%); PGIC = 3 (88% and 100%); PGIC = 2 (75% and 90%).

Conclusions

These analyses, which are the first to evaluate long-term valbenazine effects in patients ≥65 years, indicate that older study participants had clinically meaningful and substantial improvements in TD that were comparable to (or better than) those in younger participants.

Funding

Neurocrine Biosciences, Inc.
Planned Deprescribing to Protect Health Systems in Pandemics and Other Disasters: A Scoping Review
Authors: Black James E.
Published: April 2022

Background

How can psychiatrists best provide care in complex, sometimes overwhelming disasters? COVID-19 strained every aspect of health care to the breaking point, from finances to pharmaceutical supply lines. We can expect more challenges to prescribing in the future, as shown by recent hurricanes in Puerto Rico, fires in California, and ice storms in Texas. When medications become scarce or inaccessible, then clinicians need to make difficult prescribing decisions. We suggest that a culture of deprescribing, a systematic approach to reducing or simplifying medications, could be applied to a wide variety of crises. Deprescribing is defined as the planned reduction of medications to improve patient health or to reduce side effects (see deprescribing.org). It has been used to reduce polypharmacy in geriatric and other complex populations. It provides evidence-based guidance for phasing out many classes of medications. It is part of the larger program to reduce waste in health care and to make pharmacy more rational. Disasters and resource scarcity, however, require a different approach. In contrast to routine care focused on individual patients, crisis standards of care (CSC) shift the clinical focus to the community. Instead of deprescribing guidelines for individual clinicians, CSC deprescribing would be national policies addressing shortages of important medications. We did a scoping review looking for studies of deprescribing in a crisis.

Methods/Results

We extracted 1340 references in Google Scholar 2016 to 2021 using (deprescribing) AND (disaster OR crisis OR climate OR pandemic OR supply lines ). A scan of texts found 160 references matching our criteria, and only 19 of them addressed deprescribing as a strategy to strengthen health systems or providers in an emergency. Most of those were related to scarce supplies during COVID, and a few addressed the carbon impact of medications. We also reviewed related literatures on medication supply chain vulnerabilities, WHO Essential Medicines, and healthcare rationing.

Implications

Deprescribing gained attention during the COVID pandemic, responding to both disrupted supply lines and improving patient safety. Writers concerned with climate change support deprescribing to reduce the carbon impact of medications. Deprescribing as crisis policy could help streamline national stockpiles, supply chains, and manufacturing. Education could make deprescribing second nature for clinicians, potentially decreasing stress and increasing flexibility in future emergencies. Barriers to deprescribing generally include cultural inertia, industry lobbyists, education, and malpractice fears. In a crisis, deprescribing guidelines could provide clinicians with confidence and flexibility while conserving scarce resources. Research is needed to evaluate deprescribing guidelines for crises, especially ensuring equity in how they reduce polypharmacy and save money.

Funding

No funding
Weight Gain and Comorbidities Associated with Oral Second-Generation Antipsychotics: Analysis of Patients with Bipolar I Disorder or Schizophrenia
Authors: Meyer Jonathan M. , Bessonova Leona , Friedler Haley S. , Mortimer Kathleen M. , Cheng Harry , Brecht Thomas , O’Sullivan Amy K. , Cummings Hannah , McDonnell David , Doane Michael J.
Published: April 2022

Objective

Clinically significant weight gain (CSWG) is associated with increased morbidity and mortality. This study describes CSWG and comorbidities observed in patients with bipolar I disorder (BD-I) and schizophrenia (SZ) after initiating select second-generation antipsychotics (SGAs).

Methods

Percent change in weight, CSWG (=7% weight increase), and incident comorbidities within 12 months of treatment were assessed among patients initiating oral SGAs of moderate-to-high weight gain risk using medical records/claims (OM1 Real-World Data Cloud; January 2013-February 2020). Oral SGAs included clozapine (SZ), iloperidone (SZ), paliperidone (SZ), olanzapine, olanzapine/fluoxetine (BD-I), quetiapine, and risperidone. Outcomes were stratified by baseline body mass index and reported descriptively.

Results

Among patients with BD-I (N = 9142) and SZ (N = 8174), approximately three-quarters were overweight/obese at baseline. During treatment (mean duration = 30 weeks), average percent weight increase was 3.7% (BD-I) and 3.3% (SZ). Average percent weight increase was highest for underweight/normal weight patients (BD-I = 5.5%; SZ = 4.8%), followed by overweight (BD-I = 3.8%; SZ = 3.4%) and obese patients (BD-I = 2.7%; SZ = 2.3%). Within 3 months of treatment, 12% of all patients experienced CSWG. A total of 11.3% (BD-I) and 14.7% (SZ) of patients developed coronary artery disease, hypertension, dyslipidemia, or type 2 diabetes within 12 months of treatment; development of comorbidities was highest among overweight/obese patients and those with CSWG.

Conclusions

Patients who were underweight/normal weight at baseline had the greatest percent change in weight during treatment. Increased comorbidities were observed within 12 months of treatment, specifically among overweight/obese patients and those with CSWG. The magnitude of weight gain and development of comorbidities were similar for patients with BD-I and SZ.

Funding

Alkermes, Inc.
Timely Depression, Suicide Screening, and Transition of Care Coordination in an Addiction Treatment Setting
Authors: Weston Kristin , Jolles Diana
Published: April 2022

Background

People with substance use disorders (SUDs) experience higher rates of depression and suicide and lack primary care providers (PCP).

Local Problem

Twenty chart audits at the St. Lawrence Addiction Treatment Center (SLATC) showed 65% (n = 11) of SUD patients lacked a PCP. Standardized screening tools and timely appointments were lacking. The aim was to increase timely scheduled psychiatric appointments for SUD patients at discharge by 80% within 90 days.

Methods

A 90-day rapid cycle improvement project with plan-do-study-act was the process for improvement. Data were collected with four interventions from screening, checklist, patient, and team engagement concurrently. Run charts, spreadsheets, and aggregate data were interpreted for timely care. Interventions: Screening tools evaluated risks for depression and suicide. If patients screened positive, a decision aid was used for patient education. Discharge Care Coordination Checklist was used as a quality tool tracking all patients. The Project Briefing Tool and team engagement activities were used to improve participation.

Results

Screening tools were spread with 125 screenings showing 53 positives for depression and four positives for suicide. After using the decision aid, 24 (45.2%) chose depression medications, 29 (52.8%) chose complementary alternative medicine, and one patient chose neither. Of the 125 patients on the Discharge Care Coordination Checklist, 43.2% (n = 54) were scheduled with appointments, The Project Briefing Tool improved participation.

Conclusion

Standardized screening tools, CAM, and co-creation activities improved timeliness of care. A further study for the impact of mental health services for relapse prevention was recommended.

Funding

No funding