bluuebunny/crossref_metadata_2025 huggingface dataset:
Predicting rapist type based on crime-scene violence, interpersonal involvement, and criminal sophistication in U.S. stranger rape cases
Authors: Mellink Indy SK , Jeglic Elizabeth L , Bogaard Glynis
Published: August 2021

Stranger rape cases are one of the most difficult sexual assault crimes to solve for law enforcement. This study aimed to compare crime-scene characteristics between serial rapists and single-victim rapists in stranger rape cases and build a predictive model to predict rapist type. An archival database of released sex offenders included 385 who committed stranger rapes. Of those, 244 were single-victim rapists and 141 were serial rapists. The single-victim rapists were significantly more likely to have violently themed crime-scene characteristics than serial rapists, whereas serial rapists were significantly more likely than single-victim rapists to engage in criminally sophisticated behavior and induce participation from their victims. A logistic regression using 10 crime-scene characteristics correctly identified 75.8% of cases as perpetrated by either single-victim or serial rapists. The most significant predictors of rapist type were whether the offender digitally penetrated their victim, whether the offender choked their victim, whether they were at a new/unknown location or whether they threatened their victim. The implications of these results are that they benefit law enforcement in the investigation of stranger rape cases by potentially narrowing down their suspect pool and add to the classification of stranger rapists in offender profiling literature.
Whose money matters in public education: A “public” good that parents purchase
Authors: Kang Eunju
Published: August 2021

Instead of asking whether money matters, this paper questions whose money matters in public education. Previous literature on education funding uses an aggregate expenditure per pupil to measure the relationship between education funding and academic performance. Federalism creates mainly three levels of funding sources: federal, state, and local governments. Examining New York State school districts, most equitably funded across school districts among the 50 states, this paper shows that neither federal nor state funds are positively correlated with graduation rates. Only local revenues for school districts indicate a strong positive impact. Parents’ money matters. This finding contributes to a contentious discourse on education funding policy in the governments, courts, and academia with respect to education funding and inequality in American public schools.
Severities in persistent mild traumatic brain injury related headache is associated with changes in supraspinal pain modulatory functions
Authors: Flowers Matthew , Leung Albert , Schiehser Dawn M , Metzger-Smith Valerie , Delano-Wood Lisa , Sorg Scott , Kunnel Alphonsa , Wong Angeline , Vaninetti Michael , Golshan Shahrokh , Lee Roland
Published: August 2021

Emerging evidence suggests mild traumatic brain injury related headache (MTBI-HA) is a form of neuropathic pain state. Previous supraspinal mechanistic studies indicate patients with MTBI-HA demonstrate a dissociative state with diminished levels of supraspinal prefrontal pain modulatory functions and enhanced supraspinal sensory response to pain in comparison to healthy controls. However, the relationship between supraspinal pain modulatory functional deficit and severity of MTBI-HA is largely unknown. Understanding this relationship may provide enhanced levels of insight about MTBI-HA and facilitate the development of treatments. This study assessed pain related supraspinal resting states among MTBI-HA patients with various headache intensity phenotypes with comparisons to controls via functional magnetic resonance imaging (fMRI). Resting state fMRI data was analyzed with self-organizing-group-independent-component-analysis in three MTBI-HA intensity groups (mild, moderate, and severe) and one control group (n = 16 per group) within a pre-defined supraspinal pain network based on prior studies. In the mild-headache group, significant increases in supraspinal function were observed in the right premotor cortex (T = 3.53, p < 0.001) and the left premotor cortex (T = 3.99, p < 0.0001) when compared to the control group. In the moderate-headache group, a significant (T = −3.05, p < 0.01) decrease in resting state activity was observed in the left superior parietal cortex when compared to the mild-headache group. In the severe-headache group, significant decreases in resting state supraspinal activities in the right insula (T = −3.46, p < 0.001), right premotor cortex (T = −3.30, p < 0.01), left premotor cortex (T = −3.84, p < 0.001), and left parietal cortex (T = −3.94, p < 0.0001), and an increase in activity in the right secondary somatosensory cortex (T = 4.05, p < 0.0001) were observed when compared to the moderate-headache group. The results of the study suggest that the increase in MTBI-HA severity may be associated with an imbalance in the supraspinal pain network with decline in supraspinal pain modulatory function and enhancement of sensory/pain decoding.
Risk Factors for Prolonged Opioid Use After Ankle Fracture Surgery
Authors: Broggi Matthew S. , Oladeji Philip O. , Spenser Corey , Kadakia Rishin J. , Bariteau Jason T.
Published: August 2021

Background

The incidence of ankle fractures is increasing, and risk factors for prolonged opioid use after ankle fracture fixation are unknown. Accordingly, the purpose of this study was to investigate risk factors that lead to prolonged opioid use after surgery.

Methods

The Truven MarketScan database was used to identify patients who underwent ankle fracture surgery from January 2009 to December 2018 based on CPT codes. Patient characteristics were collected, and patients separated into 3 cohorts based on postoperative opioid use (no refills, refills within 6 months postoperative, and refills within 1 year postoperatively). The χ2 test and multivariate analysis were performed to assess the association between risk factors and prolonged use.

Results

In total, 34 691 patients were analyzed. Comorbidities most highly associated with prolonged opioid use include 2+ preoperative opioid prescriptions (odds ratio [OR] = 11.92; P < .001), tobacco use (OR = 2.03; P < .001), low back pain (OR = 1.81; P < .001), depression (OR = 1.48; P < .001), diabetes (OR = 1.34; P < .001), and alcohol abuse (OR = 1.32; P < .001).

Conclusion

Opioid use after ankle fracture surgery is common and may be necessary; however, prolonged opioid use and development of dependence carries significant risk. Identifying those patients at an increased risk for prolonged opioid use can aid providers in tailoring their postoperative pain regimen.

Levels of Evidence

Prognostic, Level III
Pricing Research: State of the Art and Future Opportunities
Authors: Mattos Aliomar Lino , Oyadomari José Carlos Tiomatsu , Zatta Fernando Nascimento
Published: August 2021

The most commonly used pricing approaches adopted by companies worldwide are based on costs, customer value, and competition. The purpose of the present study is to review the current status of publications on pricing globally with the addition of Brazilian literature, identify the most cited authors and highest publishing institutions, and outline further research opportunities. To this end, we use the bibliometric method to analyze relevant publications from the following four databases: Web of Science, Emerald, Elsevier, and Spell. A total of 286 papers from 195 periodicals and 31 journals (primarily from marketing, accounting, economics, and production engineering) are reviewed. The findings show that pricing is a complex and multifaceted topic involving far more than merely establishing selling prices, and that pricing managers face substantial challenges. The results also reveal that the cost-based pricing approach is superior to the perceived customer-value-based and the competition-based approaches. Finally, the findings show that pricing remains an underresearched topic, and is thus a fertile ground for further investigation.
Recorded Business Meetings and AI Algorithmic Tools: Negotiating Privacy Concerns, Psychological Safety, and Control
Authors: Cardon Peter W. , Ma Haibing , Fleischmann Carolin
Published: August 2021

Artificial intelligence (AI) algorithmic tools that analyze and evaluate recorded meeting data may provide many new opportunities for employees, teams, and organizations. Yet, these new and emerging AI tools raise a variety of issues related to privacy, psychological safety, and control. Based on in-depth interviews with 50 American, Chinese, and German employees, this research identified five key tensions related to algorithmic analysis of recorded meetings: employee control of data versus management control of data, privacy versus transparency, reduced psychological safety versus enhanced psychological safety, learning versus evaluation, and trust in AI versus trust in people. More broadly, these tensions reflect two dimensions to inform organizational policymaking and guidelines: safety versus risk and employee control versus management control. Based on a quadrant configuration of these dimensions, we propose the following approaches to managing algorithmic applications to recording meeting data: the surveillance, benevolent control, meritocratic, and social contract approaches. We suggest the social contract approach facilitates the most robust dialog about the application of algorithmic tools to recorded meeting data, potentially leading to higher employee control and sense of safety.
Older Adults’ Mental Health Through Leisure Activities During COVID-19: A Scoping Review
Authors: Rivera-Torres Solymar , Mpofu Elias , Jean Keller Marian , Ingman Stan
Published: August 2021

Older adults are at high risk for mental health distress due to COVID-19 pandemic restrictions. This scoping review aimed to map emerging evidence on the types of leisure and recreation activities (LRA) adults, 60 years and older, are engaged in for their mental health during the COVID-19 pandemic. We identified 10 studies on LRA for mental health by older adults with COVID-19 mitigation from a search of the following databases: Medline/PubMed, Excerpta Medica database (EMBASE), Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews, JBI Evidence Synthesis, and Epistemonicos. A narrative synthesis of the data revealed age cohorts of young-old (60–69 years) and middle-old (70–79 years) engaging mainly in online LRA for mental health compared to the older-old adults (80 years and older). The middle-old (70–79 years) and older-old adults (80–89 years) engaged in more physical LRA for mental health compared to the younger-old adults. Across age cohorts, the older adults engaged in social connectedness LRA for mental health wellbeing. COVID-19–safe LRA mental health support interventions for older adults should be tailored to their age cohort predispositions for optimal benefit.
Adherence to Long‐Term Follow‐up in Patients With Sporadic Vestibular Schwannomas Managed With Serial Observation
Authors: Raymond Mallory , Ghanouni Arian , Brooks Kaitlyn , Clark Sarah M. , Mattox Douglas E.
Published: August 2021

Objectives

To examine the long‐term adherence to serial imaging of patients with sporadic vestibular schwannoma and analyze factors associated with being lost to follow‐up.

Study Design

Retrospective chart review with telephone interview.

Setting

Single tertiary care center.

Methods

Patients with a sporadic vestibular schwannoma and started on observational surveillance management between January 2005 and December 2010 were included. Demographic data, tumor size, hearing and vestibular changes, and follow‐up length were recorded. Patient factors were analyzed for association with being lost to follow‐up.

Results

In total, 122 patients were included with a median length of follow‐up of 5 months (range, 0‐146). After initial surveillance, 22.1% (n = 27) of patients had a change in management to either microsurgery or radiosurgery. Of the remaining 77.9% (n = 95), nearly half (44.2%, n = 42) never returned for a second visit, and all but 3 were eventually lost to follow‐up. There was no association between sex, race, age at diagnosis, initial tumor size, insurance status, household income, or driving distance to hospital and being lost to follow‐up. Of 26 interviewed patients initially lost to follow‐up, 11 (42.3%) sought care at another institution, 5 (19.2%) chose to no longer receive care, 1 (3.8%) had transportation difficulties, and 9 (36.4%) had poor understanding of their diagnosis or instructions.

Conclusions

The length of follow‐up for patients undergoing surveillance of sporadic vestibular schwannoma varies widely, and patients are commonly lost to follow‐up. Further efforts should be made to identify at‐risk patients and provide adequate education to improve long‐term surveillance.
Energy transition, rural transformation and local land-use planning: Insights from Ontario, Canada
Authors: Calvert Kirby , Smit Emily , Wassmansdorf Dan , Smithers John
Published: August 2021

A transition toward decentralized and land-intensive renewable energy production systems is one among many factors re-shaping rural areas, leading to reimaginations and contestations. Especially in the Global North, the rural narrative now includes not just rural ‘production’ but also the ‘consumption’ of rural amenity and experience. Previous research into public attitudes toward renewable energy correlates the former with positive attitudes to renewable energy, and the latter with negative attitudes toward renewable energy. Territorial structures, such as official land-use plans, reflect dominant discourses and narratives that shape ongoing rural transformation. The purpose of this work is to understand the extent to which, if at all, those correlations at the individual level between landscape conceptualizations and sentiment toward renewable energy are manifest in territorial structures. In what ways are energy transitions present in rural land-use plans and planning systems? Is there a relationship between how rural landscapes are conceptualized and how energy transitions are framed and addressed, in land-use planning systems? These questions are answered through a structured content and discourse analysis of 10 land-use plans of rural municipalities in southern Ontario; an agriculturally intensive region that hosts much of Ontario’s large-scale renewable energy systems. Correlations observed between landscape conceptualizations and sentiment toward renewable energy observed are not strongly reflected in land-use plans. Land-use plans in this region are not positioned to manage the place-based opportunities and impacts associated with renewable energy development. The research reveals an opportunity for rural land-use planning systems to more explicitly incorporate energy transitions in their evolving discourses, identities and development trajectories.
Before colonization (BC) and after decolonization (AD): The Early Anthropocene, the Biblical Fall, and relational pasts, presents, and futures
Authors: Keeler Kyle
Published: August 2021

Anthropocene debate centers on the start-date and the cause of the geologic Epoch. One argument for the Epoch’s start-date is the “Early Anthropocene,” contending humanity “took control” of Earth systems during the Neolithic Revolution. Adherents contend agriculture contributed to rising carbon emissions and laid the groundwork for societal ills such as colonialism and extractive capitalism. Such a deterministic theory erases centuries of relational agriculture practiced by Indigenous peoples in the Americas. This article upsets the narrative of the “Early Anthropocene” that would mark all agriculture and agricultural societies as destructive and extractive, and instead offers embodied Indigenous narratives that view agriculture as a relational system of partnerships between humans and other-than-human beings over centuries. First, I trace the “Early Anthropocene” narrative from its origins with paleoclimatologist William Ruddiman to its contemporary adherents and show how such a theory lines-up with the narrative of the Christianized Biblical Fall. I show that “Early Anthropocene” theorists portray agriculture as society’s “ultimate sin,” wherein humans fall from a hunter–gatherer Eden and must toil to cultivate crops, eventually giving way to colonialism and extractive capitalism, ultimately causing environmental degradation and destruction and leading to a second coming of the hunter-gathering Eden. I then argue against such stories, tracing examples of relational agriculture practiced prior to settler colonization into our contemporary moment by Cherokee, Anishinaabe, Haudenosaunee, Western Apache, Karuk, Coast Salish, and Ponca peoples. Such stories show a pattern of missteps, understanding, and knowledge production between human groups and the more-than-human, rather than the environmental and societal destruction that Early Anthropocene theorists portray as the inevitable end of agricultural societies. This study disproves the agricultural “Early Anthropocene” as a starting point for Earth’s Epoch. It also presents relational environmental understanding through decolonized agriculture on repatriated land as a future method for interacting with the other-than-human environment.
The Fast and the Furious: Golgi Contact Sites
Authors: David Yotam , Castro Inês G. , Schuldiner Maya
Published: August 2021

Contact sites are areas of close apposition between two membranes that coordinate nonvesicular communication between organelles. Such interactions serve a wide range of cellular functions from regulating metabolic pathways to executing stress responses and coordinating organelle inheritance. The past decade has seen a dramatic increase in information on certain contact sites, mostly those involving the endoplasmic reticulum. However, despite its central role in the secretory pathway, the Golgi apparatus and its contact sites remain largely unexplored. In this review, we discuss the current knowledge of Golgi contact sites and share our thoughts as to why Golgi contact sites are understudied. We also highlight what exciting future directions may exist in this emerging field.
Effects of CYP3A4 and P-glycoprotein inhibition or induction on the pharmacokinetics of ubrogepant in healthy adults: Two phase 1, open-label, fixed-sequence, single-center, crossover trials
Authors: Jakate Abhijeet , Boinpally Ramesh , Butler Matthew , Ankrom Wendy , Dockendorf Marissa F , Periclou Antonia
Published: August 2021

Background:

Ubrogepant is metabolized by cytochrome P450 3A4 (CYP3A4) and is a P-glycoprotein (P-gp) substrate.

Objective:

To assess effects of multiple-dose moderate-strong CYP3A4 and strong P-gp inhibitors and inducers on ubrogepant pharmacokinetic (PK) parameters.

Methods:

Two phase 1, open-label, fixed-sequence, single-center, crossover trials enrolled healthy adults to receive ubrogepant 20 mg with/without verapamil 240 mg (a moderate CYP3A4 inhibitor) or ketoconazole 400 mg (a strong CYP3A4 and P-gp transporter inhibitor) (Study A), or ubrogepant 100 mg with/without rifampin 600 mg (a strong CYP3A4 inducer and P-gp inducer) (Study B). Outcomes included ubrogepant PK parameters (area under plasma concentration-time curve, time 0 through infinity [AUC0-∞], peak plasma concentration [Cmax]), and safety (treatment-emergent adverse events [TEAEs]). PK parameters were compared between ubrogepant with/without coadministered medications using linear mixed-effects models. Cmax and AUC0-∞ least-squares geometric mean ratios (GMR) of ubrogepant with/without coadministration were constructed.

Results:

Twelve participants enrolled in Study A and 30 in Study B. AUC0-∞ and Cmax GMR (90% CI) were 3.53 (3.32–3.75) and 2.80 (2.48–3.15), respectively, for ubrogepant with verapamil; 9.65 (7.27–12.81) and 5.32 (4.19–6.76) with ketoconazole; and 0.22 (0.20–0.24) and 0.31 (0.27–0.36) with rifampin. TEAEs were predominantly mild; no treatment-related serious TEAEs or TEAE-related discontinuations occurred.

Conclusion:

The PK of ubrogepant were significantly affected by the concomitant use of CYP3A4 moderate-strong inhibitors and strong inducers.
Comparative effect of statin intensity between prediabetes and type 2 diabetes mellitus after implanting newer-generation drug-eluting stents in Korean acute myocardial infarction patients: a retrospective observational study
Authors: Kim Yong Hoon , Her Ae-Young , Jeong Myung Ho , Kim Byeong-Keuk , Hong Sung-Jin , Kim Seunghwan , Ahn Chul-Min , Kim Jung-Sun , Ko Young-Guk , Choi Donghoon , Hong Myeong-Ki , Jang Yangsoo
Published: August 2021

Background

Comparative studies regarding the long-term clinical outcomes of statin intensity between acute myocardial infarction (AMI) patients with prediabetes and those with type 2 diabetes mellitus (T2DM), after successful implantation of newer-generation drug-eluting stents (DES) with statin treatment, are limited. We compared the 2-year clinical outcomes between these patients.

Methods

A total of 11,612 AMI patients were classified as statin users (n = 9893) and non-users (n = 1719). Thereafter, statin users were further divided into high-intensity (n = 2984) or low-moderate-intensity statin (n = 6909) treatment groups. Those in these two groups were further classified into patients with normoglycemia, prediabetes, and T2DM. The major outcomes were the occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), or any repeat coronary revascularization.

Results

After adjusting for both high-intensity and low-moderate-intensity statin users, the cumulative incidences of MACE (p = 0.737, p = 0.062, respectively), all-cause death, Re-MI, and any repeat revascularization were similar between the prediabetes and T2DM groups. In the total study population, both high-intensity and low-moderate-intensity statin treatments showed comparable results. However, in the patients who enrolled after October 2012, the cumulative incidences of MACE (aHR 1.533; 95% CI 1.144–2.053; p = 0.004) and any repeat revascularization (aHR, 1.587; 95% CI 1.026–2.456; p = 0.038) were significantly lower in high-intensity statin users than in low-moderate intensity statin users. The beneficial effects of high-intensity compared to low-moderate-intensity statin therapy were more apparent in the normoglycemia group than hyperglycemia group, as it reduced the cumulative incidences of MACE (aHR 1.903; 95% CI 1.203–3.010; p = 0.006) and any repeat revascularization (aHR 3.248; 95% CI 1.539–6.854; p = 0.002).

Conclusions

In this retrospective registry study, prediabetes and T2DM groups showed comparable clinical outcomes, after administering both high-intensity and low-moderate-intensity statin treatments. However, these results are likely to be clearly proved by further studies, especially in patients with AMI who are being treated in contemporary practice.

Trial registration

Retrospectively registered.
Predisposing factors of long-term responsiveness in a cardio-metabolic cohort: Tehran Lipid and Glucose Study
Authors: Cheraghi Leila , Amiri Parisa , Vahedi-Notash Golnaz , Jalali-Farahani Sara , Khalili Davood , Azizi Fereidoun
Published: August 2021

Background

Non-participation in cohort studies, if associated with both the exposure and occurrence of the event, can introduce bias in the estimates of interest. This study aims to identify factors associated with follow-up participation in Tehran Lipid and Glucose Study, a large-scale community-based prospective study in West Asia.

Methods

A sample of 10,368 adults from TLGS was included in the analysis. All analyses were split according to sex and age groups (20–39, 40–59, and 60 years). The associations between socio-demographic, health, and lifestyle factors with response rate were identified using the Generalized Estimating Equations model.

Results

Over the median of 15.7 years of follow up the response rate was 64.5%. The highest response rate was observed in those aged 40–59 years for both sexes. Current smokers had lower odds of response in both sexes for all age groups, ranging from 0.51 to 0.74, p < 0.01. In young adults, being single (OR = 0.79, OR = 0.57, p ≤ 0.01, respectively for men and women) and unemployed (OR = 0.73, OR = 0.76, p ≤ 0.01, respectively for men and women) in both sexes, high physical activity in men (OR = 0.77, p < 0.01), high education (OR = 0.75, p = 0.02) and obesity (OR = 0.85, p = 0.05) in women were associated with lower response rate. For the middle-aged group, diabetes in men (OR = 0.77, p = 0.05) and hypertension (OR = 0.84, p = 0.05), and having a history of cancer (OR = 0.43, p = 0.03) in women were factors associated with lower response rates. Finally, interventions for both sexes (OR = 0.75, OR = 0.77, p ≤ 0.05, respectively for men and women) and being divorced/widow in women (OR = 0.77, p = 0.05) were the factors associated with the lower response rate in the elderly.

Conclusions

Long-term participation was influenced by socio-demographic, health, and lifestyle factors in different sex- and age-specific patterns in TLGS. Recruitment strategies targeting these factors may improve participant follow-up in longitudinal studies.
Prevalence of sero-markers and non-invasive assessment of liver cirrhosis in patients with Hepatitis B virus infection in Freetown, Sierra Leone: a cross-sectional study
Authors: Lakoh Sulaiman , Firima Emmanuel , Jiba Darlinda F. , Kamara Matilda N. , Gashau Wadzani , Deen Gibrilla F. , Adekanmbi Olukemi , Yendewa George A.
Published: August 2021

Background

Hepatitis B virus (HBV) is a major global health problem. Although sub-Saharan Africa has a high proportion of the global burden of HBV, the epidemiology and clinical features of HBV in this region are poorly characterized, and access to diagnostic and treatment services remain limited.

Methods

We conducted a retrospective study of HBV-infected children and adults of all age groups who were evaluated at public and private health facilities in Freetown, Sierra Leone between January 2017 and January 2019. We assessed their clinical presentation, HBV sero-markers, stages of liver disease, prevalence of cirrhosis by non-invasive tools, and the proportion of treatment eligible patients using the criteria recommended by the World Health Organization’s 2015 treatment guidelines for HBV. Logistic regression was used to identify predictors of liver cirrhosis.

Results

163 HBV patients included in the study, with mean age 32.6 years and 65.0% (106) being males. Most (84.0%) were asymptomatic at presentation. The majority (69.9%) were classified as having HBeAg-negative chronic infection (or inactive HBsAg carrier phase), 24.5% were in the HBeAg-negative immune active phase, 3.1% had HBeAg positive hepatitis, and 2.5% were HBsAg negative. The median Aspartate aminotransferase to Platelet Ratio (APRI) and Fibrosis-4 (FIB-4) scores were 0.37 and 0.80, respectively. The prevalence of cirrhosis was 7.6% and 6.2%, estimated by the APRI and FIB-4 scores, respectively. About 20.0% of patients were eligible for treatment with antiviral agents. Based on APRI scores, the presence of any symptom [adjusted odds ratio (aOR) 20.0, 95% confidence interval (CI) (4.1–85.9);p < 0.001], elevated direct bilirubin [aOR 12.1, 95% CI (1.9–63.0);p = 0.003], and elevated total bilirubin [aOR 16.1, 95% CI (3.2–80.8);p = 0.001] were independent predictors of cirrhosis.

Conclusion

Although most patients with HBV infection were asymptomatic, the prevalence of liver cirrhosis and proportion of patients requiring antiviral treatment were substantial. This small study from a hyperendemic setting in Sierra Leone suggests that routine population-based screening may increase early detection and linkage of HBV patients to care before development of complications. Larger studies are needed to confirm our findings.
Obesity and metabolic abnormalities as risks of alcoholic fatty liver in men: NAGALA study
Authors: Yoshimura Yuta , Hamaguchi Masahide , Hashimoto Yoshitaka , Okamura Takuro , Nakanishi Naoko , Obora Akihiro , Kojima Takao , Fukui Michiaki
Published: August 2021

Background

Hepatic steatosis has a pivotal role in the development of chronic liver diseases, even in alcohol-related liver disease. Alcoholic fatty liver disease is an important phenotype among alcohol-related liver diseases. While metabolic syndrome is a dominant risk factor of incident nonalcoholic fatty liver disease, the role of metabolic syndrome in alcoholic fatty liver disease has not been clarified yet.

Methods

A retrospective cohort study was performed at a health check-up center in Japan. Subjects consisted of male participants without fatty liver who consumed ethanol of 420 g/week or higher. Adjusted hazard ratios and 95% confidence intervals at the baseline examinations for incident alcoholic fatty liver disease were estimated using Cox model.

Results

A total of 640 participants were included in this study. During 3.91 years (IQR 1.63–7.09) of follow-up, 168 new cases of alcoholic fatty liver disease developed (49.1 cases per 1000 persons per year). After adjustment for age, smoking status, alcohol consumption, the hazard ratio for a 1 kg/m2 increase in body mass index was 1.2 (1.12–1.28). The hazard ratio of subjects with high triglyceride and low high-density lipoprotein-cholesterol levels were 1.56 (1.12–2.18) and 1.52 (1.03–2.25), respectively.

Conclusions

Obesity, high triglyceridemia, and low high-density lipoprotein-cholesterolemia are independent risk factors of alcoholic fatty liver disease in Japanese men who consumed alcohol habitually. In people with these risks, triglyceride lowering and high-density lipoprotein-cholesterol raising by improving insulin resistance and weight maintenance in addition to abstinence from alcohol would be effective in preventing the development of alcoholic fatty liver disease.
The effects of single and a combination of determinants of anaemia in the very old: results from the TULIPS consortium
Authors: Wang Pin-Chun , Gussekloo Jacobijn , Arai Yasumichi , Abe Yukiko , Blom Jeanet W. , Duncan Rachel , Jagger Carol , Kerse Ngaire , Martin-Ruiz Carmen , Palapar Leah , den Elzen Wendy P. J.
Published: August 2021

Background and objectives

Nutritional deficiencies, renal impairment and chronic inflammation are commonly mentioned determinants of anaemia. The aim of this study was to investigate the effects of these determinants, singly and in combination, on anaemia in the very old.

Method

The TULIPS Consortium consists of four population-based studies in oldest-old individuals: Leiden 85-plus Study, LiLACS NZ, Newcastle 85+ study, and TOOTH. Five selected determinants (iron, vitamin B12, and folate deficiency; low estimated glomerular filtration rate (eGFR); and high C-reactive protein (CRP)) were summed. This sum score was used to investigate the association with the presence and onset of anaemia (WHO definition). The individual study results were pooled using random-effects models.

Results

In the 2216 participants (59% female, 30% anaemia) at baseline, iron deficiency, low eGFR and high CRP were individually associated with the presence of anaemia. Low eGFR and high CRP were individually associated with the onset of anaemia.

In the cross-sectional analyses, an increase per additional determinant (adjusted OR 2.10 (95% CI 1.85–2.38)) and a combination of ≥2 determinants (OR 3.44 (95% CI 2.70–4.38)) were associated with the presence of anaemia. In the prospective analyses, an increase per additional determinant (adjusted HR 1.46 (95% CI 1.24–1.71)) and the presence of ≥2 determinants (HR 1.95 (95% CI 1.40–2.71)) were associated with the onset of anaemia.

Conclusion

Very old adults with a combination of determinants of anaemia have a higher risk of having, and of developing, anaemia. Further research is recommended to explore causality and clinical relevance.
Revisiting the structure of the Yale Global Tic Severity Scale (YGTSS) in a sample of Chinese children with tic disorders
Authors: Wen Fang , Gu Yi , Yan Junjuan , Liu Jingran , Wang Fang , Yu Liping , Li Ying , Cui Yonghua
Published: August 2021

Background

To the best of our knowledge, although the Chinese version of the Yale Global Tic Severity Scale (YGTSS) is widely used in child psychiatry departments in China, there is very little evidence focusing on the psychometric characteristics of the Chinese version of YGTSS. In this present study, we aim to re-examine the structure of the Chinese version of YGTSS and investigate its reliability and validity.

Methods

A total of 367 children and adolescents with tic disorders aged 5–16 years old participated in the study. The Cronbach’s alpha, test-retest reliability and concurrent validity will be calculated. Confirmatory Factor Analysis (CFA) also will be performed to assess the structure of YGTSS.

Results

The Cronbach’s alpha of the motor tic subscale of YGTSS was 0.84, for the phonic tic subscale of YGTSS, it was 0.90, but for the whole scale, it was 0.58. The test-retest reliability of YGTSS was 0.84. For the results of CFA, the Comparative Fit Index (CFI) of YGTSS based on the Two-Factor Model and Three-Factor Model was 0.97 and 0.96 respectively. The measurement invariance analysis suggested that the Two-Factor model of YGTSS across different age and sex groups was at the accepted level (≥0.90).

Conclusion

Overall, according to the results of this research, it suggested that the Chinese version of YGTSS showed good psychometric properties. It can be used in the assessment of tic disorders in the Chinese population. In the future, more comprehensive tools for assessing tics need to be further developed, which can cover the symptoms of premonitory urge and tic related obsessive-compulsive symptoms.
Closing-wedge distal femoral osteotomy combined with medial patellofemoral ligament reconstruction for recurrent patellar dislocation with genu valgum
Authors: Jing Lizhong , Wang Xiaole , Qu Xiaoliang , Liu Kun , Wang Xiaotan , Jiang Lu , Wu Di , Zhang Zhiwei , Li Zhuang , Yu Le , Wang Shaoshan , Yang Jiushan
Published: August 2021

Background

Medial patellofemoral ligament reconstruction (MPFLR) is a well-established procedure for addressing recurrent patellar dislocation (RPD) in young patients. However, despite being a promising procedure for RPD with genu valgum, there is a scarcity of reports on simultaneous MPFLR and closing-wedge distal femoral osteotomy (CWDFO). The purpose of the present study was to observe and analyse the clinical and imaging findings of CWDFO combined with MPFLR for RPD with genu valgum.

Methods

From May 2015 to April 2018, 25 patients with RPD and genu valgum were surgically treated in our department. Anteroposterior long-leg, weight-bearing, lower-extremity radiographs, lateral radiographs and computed tomography (CT) scans of the patellofemoral joint were obtained, and the anatomical femorotibial angle (aFTA), mechanical lateral distal femoral angle (mLDFA), weight-bearing line rate (WBLR), patellar height, patellar lateral shift (PLS) and tibial tubercle–trochlear groove (TT-TG) distance were analysed. Validated knee scores, such as the Kujala, Lysholm, visual analogue scale (VAS) scores and Tegner socres, were evaluated preoperatively and 2 years postoperatively.

Results

25 patients, with an average age of 19.8 years (14–27), were evaluated. During the 2-year follow-up period, all patients were able to achieve a better sports level without any problems, with no recurrence of patellar instability. Compared with preoperation, the aFTA, mLDFA, WBLR and PLS showed statistically significant improvement following the procedure (p < 0.001). Meanwhile, no significant differences in the Insall index and TT-TG distance were found. The mean Kujala score, average Lysholm score, VAS score and Tegner socres showed significant postoperative improvement.

Conclusions

CWDFO combined with MPFLR is a suitable treatment for RPD with genu valgum, and can lead to significant improvement in the clinical and imaging findings of the knee in the short term.
Maintenance of smoking cessation in Korean single mothers
Authors: Lee Mi-Ji , Lee Kang-Sook
Published: August 2021

Background

Single mothers in South Korea are vulnerable to developing smoking habits, due to many difficulties and limitations; however, they have often been overlooked by smoking cessation support services. Therefore, this study aimed to investigate the general and smoking-related characteristics of single mothers registered with the Visiting a Smoking Cessation Service in Seoul, South Korea, to identify factors associated with smoking cessation maintenance at 4 weeks and 24 weeks after they initially quit smoking.

Methods

The participants were 77 single mothers registered in the Smoking Cessation Service Program. Data were included from a three-year span (January 2017–December 2019). Smoking cessation counseling, motivational enhancement, and self-exploration counseling were provided for six months. The participants were evaluated on their smoking cessation status at 4 weeks and 24 weeks.

Results

Most participants were aged 22 years or younger. The rates of smoking cessation maintenance were 58.4 and 18% at 4 weeks and 24 weeks, respectively. The higher the number of counseling sessions, the higher the participants’ chances of maintaining smoking in all non-smoking periods, and whether pregnancy, CO level, and drinking were significant only in a short-term non-smoking period (4 weeks).

Conclusions

Our results suggest that the number of smoking cessation counseling sessions is important for long-term smoking cessation beyond short-term cessation in single mothers. To increase the smoking cessation rate of single mothers, it is important to conduct customized smoking cessation counseling at the time of smoking cessation and continue such counseling in the long term.
Development and psychometric properties of surveys to assess patient and family caregiver experience with care transitions
Authors: Sorra Joann , Zebrak Katarzyna , Carpenter Deborah , Famolaro Theresa , Rauch John , Li Jing , Davis Terry , Nguyen Huong Q. , McIntosh Megan , Mitchell Suzanne , Hirschman Karen B. , Levine Carol , Clouser Jessica Miller , Brock Jane , Williams Mark V.
Published: August 2021

Background

The purpose of this study was to develop and administer surveys that assess patient and family caregiver experiences with care transitions and examine the psychometric properties of the surveys. The surveys were designed to ask about 1) the transitional care services that matter most to patients and their caregivers and 2) care outcomes, including the overall quality of transitional care they received, patient self-reported health, and caregiver effort/stress.

Methods

Survey items were developed based on a review of the literature, existing surveys, focus groups, site visits, stakeholder and expert input, and patient and caregiver cognitive interviews. We administered mail surveys with telephone follow up to patients recently discharged from 43 U.S. hospitals. Patients identified the caregivers who helped them during their hospital stay (Time 1 caregiver) and when they were home (Time 2 caregiver). Time 1 and Time 2 caregivers were surveyed by telephone only. The psychometric properties of the survey items and outcome composite measures were examined for each of the three surveys. Items that performed poorly across multiple analyses, including those with low variability and/or a high missing data, were dropped except when they were conceptually important.

Results

The analysis datasets included responses from 9282 patients, 1245 Time 1 caregivers and 1749 Time 2 caregivers. The construct validity of the three proposed outcome composite measures—Overall Quality of Transitional Care (patient and caregiver surveys), Patient Overall Health (patient survey) and Caregiver Effort/Stress (caregiver surveys) —was supported by acceptable exploratory factor analysis results and acceptable internal consistency reliability. Site-level reliability was acceptable for the two patient outcome composite measures, but was low for Caregiver Effort/Stress (< 0.70). In all surveys, the Overall Quality of Transitional Care outcome composite measure was significantly correlated with other outcome composite measures and most of the single-item measures.

Conclusions

Overall, the final patient and caregiver surveys are psychometrically sound and can be used by health systems, hospitals, and researchers to assess the quality of care transitions and related outcomes. Results from these surveys can be used to improve care transitions, focusing on what matters most to patients and their family caregivers.
End of treatment cone-beam computed tomography (CBCT) is predictive of radiation response and overall survival in oropharyngeal squamous cell carcinoma
Authors: Sumner Whitney , Kim Sangwoo S. , Vitzthum Lucas , Moore Kevin , Atwood Todd , Murphy James , Miyauchi Sayuri , Califano Joseph A. , Mell Loren K. , Mundt Arno J. , Sharabi Andrew B.
Published: August 2021

Background

Image guidance in radiation oncology has resulted in significant improvements in the accuracy and precision of radiation therapy (RT). Recently, the resolution and quality of cone beam computed tomography (CBCT) for image guidance has increased so that tumor masses and lymph nodes are readily detectable and measurable. During treatment of head and neck squamous cell carcinoma (HNSCC), on-board CBCT setup imaging is routinely obtained; however, this CBCT imaging data is not utilized to predict patient outcomes. Here, we analyzed whether changes in CBCT measurements obtained during a course of radiation therapy correlate with responses on routine 3-month follow-up diagnostic imaging and overall survival (OS).

Materials/methods

Patients with oropharyngeal primary tumors who received radiation therapy between 2015 and 2018 were included. Anatomical measurements were collected of largest nodal conglomerate (LNC) at CT simulation, end of radiation treatment (EOT CBCT), and routine 3-month post-RT imaging. At each timepoint anteroposterior (AP), mediolateral (ML) and craniocaudal (CC) measurements were obtained and used to create a 2-dimensional (2D) maximum.

Results

CBCT data from 64 node positive patients were analyzed. The largest nodal 2D maximum and CC measurements on EOT CBCT showed a statistically significant correlation with complete response on 3-month post-RT imaging (r = 0.313, p = 0.02 and r = 0.318, p = 0.02, respectively). Furthermore, patients who experienced a 30% or greater reduction in the CC dimension had improved OS (Binary Chi-Square HR 4.85, p = 0.028).

Conclusion

Decreased size of pathologic lymph nodes measured using CBCT setup imaging during a radiation course correlates with long term therapeutic response and overall survival of HNSCC patients. These results indicate that CBCT setup imaging may have utility as an early predictor of treatment response in oropharyngeal HNSCC.
A rare disease patient-reported outcome measure: revision and validation of the German version of the Systemic Sclerosis Quality of Life Questionnaire (SScQoL) using the Rasch model
Authors: Kocher Agnes , Ndosi Mwidimi , Denhaerynck Kris , Simon Michael , Dwyer Andrew A. , Distler Oliver , Hoeper Kirsten , Künzler-Heule Patrizia , Redmond Anthony C. , Villiger Peter M. , Walker Ulrich A. , Nicca Dunja
Published: August 2021

Background

Rare disease patient-reported outcome measures (PROMs) require linguistic adaptation to overcome the challenge of geographically dispersed patient populations. Importantly, PROMs such as health-related quality of life (HRQoL) should accurately capture responses to patient-identified concerns. The Systemic Sclerosis Quality of Life Questionnaire (SScQoL) is a 29-item tool validated in six languages. Previous evaluation of the German version revealed problems with dichotomous responses. This study aimed to revise the German SScQoL, extend the response structure, and evaluate content and construct validity, reliability and unidimensionality.

Methods

The instrument validation study involved revising the German SScQoL response structure, cognitive debriefing with patients and validation using Rasch analysis. The revised SScQoL was completed by Swiss-German-speaking patients with SSc within the Swiss MANagement Of Systemic Sclerosis (MANOSS) study. Rasch analysis was employed to test the validity, reliability and unidimensionality of the revised instrument.

Results

Based on cognitive debriefing with patients (n = 6) dichotomous items were extended to a polytomous 4-point response structure. A total of 78 patients completed the revised SScQoL. Initial analysis of the 29 items suggested the scale lacked fit to the model (χ2 = 51.224, df = 29, p = 0.007). Grouping items into five domains resulted in an adequate fit to the Rasch model (χ2 = 5.343, df = 5, p = 0.376) and unidimensionality (proportion of significant independent t tests: 0.045, 95% CI 0.016–0.114). Overall, the scale was well targeted, had high internal consistency (Person Separation Index, PSI = 0.931) and worked consistently in patients with different demographic and clinical characteristics.

Conclusions

The revised German SScQoL has a 4-point response structure and is a valid, reliable measure. Rasch analysis is useful for validating continuous response structure of quality of life measures. Further evaluation of measurement equivalence with other German-speaking cultures is required for multinational comparisons and data pooling.
Three-dimensional printed hydroxyapatite bone tissue engineering scaffold with antibacterial and osteogenic ability
Authors: Zhongxing Liu , Shaohong Wu , Jinlong Li , Limin Zhang , Yuanzheng Wang , Haipeng Gao , Jian Cao
Published: August 2021

The development of an effective scaffold for bone defect repair is an urgent clinical need. However, it is challenging to design a scaffold with efficient osteoinduction and antimicrobial activity for regeneration of bone defect. In this study, we successfully prepared a hydroxyapatite (HA) porous scaffold with a surface-specific binding of peptides during osteoinduction and antimicrobial activity using a three-dimensional (3D) printing technology. The HA binding domain (HABD) was introduced to the C-terminal of bone morphogenetic protein 2 mimetic peptide (BMP2-MP) and antimicrobial peptide of PSI10. The binding capability results showed that BMP2-MP and PSI10-containing HABD were firmly bound to the surface of HA scaffolds. After BMP2-MP and PSI10 were bound to the scaffold surface, no negative effect was observed on cell proliferation and adhesion. The gene expression and protein translation levels of type I collagen (COL-I), osteocalcin (OCN) and Runx2 have been significantly improved in the BMP2-MP/HABP group. The level of alkaline phosphatase significantly increased in the BMP2-MP/HABP group. The inhibition zone test against Staphylococcus aureus and Escherichia coli BL21 prove that the PSI10/HABP@HA scaffold has strong antibacterial ability than another group. These findings suggest that 3D-printed HA scaffolds with efficient osteoinduction and antimicrobial activity represent a promising biomaterial for bone defect reconstruction.