bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive Factors for Stroke and TIA Following Carotid Artery Stenting
Authors: Pérez-Sánchez Soledad , Barragán Prieto Ana , Gamero García Miguel Ángel , Moniche Francisco , Tomasello Alejandro , Delgado-Acosta Fernando , González Alejandro , Montaner Joan
Published: January 2023

Purpose:

Carotid artery stenting (CAS) is an effective and minimally invasive method for the treatment of extracranial carotid artery stenosis. The aim of the present study was to explore independent risk factors to predict cerebrovascular events following CAS to identify high-risk patients and improve the safety of CAS in this population.

Materials and Methods:

HISPANIAS is a national prospective multicenter study that included 14 hospitals that collected data from patients who underwent CAS. We analyzed morbidity and mortality within 30 days after CAS, looking for factors that might be associated with cerebrovascular events (stroke and transient ischemic attack [TIA]).

Results:

The HISPANIAS cohort included 757 patients: 80.32% were men, the mean age was 70.73 years, and 82.96% underwent symptomatic CAS. Cerebrovascular complications occurred in 42 patients (5.6%), including TIA in 24 patients (70.8% ipsilateral; mean 2.79 days after CAS) and stroke in 18 patients (72.2% ipsilateral; mean 6.72 days after CAS). The main independent clinical predictors of stroke/TIA identified by logistic regression were female sex (odds ratio [OR] 2.29, 95% CI 1.15–4.54) and diabetes (OR 3.29, 95% CI 1.71–6.40). Survival analysis showed that diabetic women, compared with the rest of the patients, had a higher number of events concentrated mainly in the first days after the intervention (p=0.003).

Conclusion:

Cerebrovascular ischemic complications after CAS continue to be a challenge for the management of these patients. Although there are other factors, female sex and the presence of diabetes are emerging as strong risk factors for the development of complications after symptomatic CAS.

Clinical Impact

Carotid artery stenting (CAS) is an effective and minimally invasive method for the treatment of extracranial carotid artery stenosis. Although CAS has been regarded as a reliable and safety approach, some studies reported that CAS was associated with a higher risk of procedure-related stroke. Cerebrovascular complications after CAS continue to be a main problem and a challenge for the management of these patients. Therefore, it is essential to identify the factors involved in the development of these complications. Our study shows that the combination of female sex and diabetes is associated with a clearly worse outcome, with a greater number of events concentrated mainly in the first days. This is different from other studies that have explored each factor separately. It would be interesting to perform separate interventions for this group given the increased risk of complications.
The Clinical Impact of Thoracic Endovascular Aortic Repair in the Management of Thoracic Aortic Diseases
Authors: Molano Fernando , Rey Chaves Carlos Eduardo , Conde Danny , Girón Felipe , Núñez-Rocha Ricardo E. , Ayala Daniela , González Juliana , Cortés Felipe , Cortés Diana , Fajardo Ernesto , Barón Vladimir
Published: January 2023

Purpose:

Thoracic endovascular aortic repair (TEVAR) has been described to be superior to an open surgical approach, and previous studies have found superiority in TEVAR by reducing overall morbidity and mortality rates. This study aimed to describe the outcomes of TEVAR for patients with thoracic aortic disease at a high complexity.

Materials and Methods:

Descriptive study, developed by a retrospective review of a prospectively collected database. Patients aged above 18 years who underwent TEVAR between 2012 and 2022 were included. Patient demographics, perioperative data, surgical outcomes, morbidity, and mortality were described. Statistical and multivariate analyses were made. Statistical significance was reached when p values were <0.05.

Results:

A total of 66 patients were included. Male patients were 60.61% and the mean age was 69.24 years. Associated aortic diseases were aneurysms (68.18%), ulcer-related (4.55%), intramural-related hematoma (7.58%), trauma-related pathology (1.52%), and aortic dissection (30.30%). The mean hospital stay was 18.10 days, and intensive care unit was required for 98.48%. At 30 days, the mortality rate was 10.61% and the reintervention rate was 21.21%. Increased intraoperative blood loss (p=0.001) and male sex (p=0.04) showed statistical relationship with mortality. Underweight patients have 6.7 and 11.4 times more risk of complications and endoleak compared with higher body mass index values (p=0.04, 95% confidence interval [CI]=0.82–7.21) and (p=0.02, 95% CI=1.31–12.57), respectively.

Conclusion:

Thoracic endovascular aortic repair seems to be a feasible option for patients with thoracic aortic pathologies, with adequate rates of mortality and morbidity. Underweight patients seem to have an increased risk of overall morbidity and increased risk for endoleak. Further prospective studies are needed to prove our results.

Clinical Impact

Obesity and BMI are widely studied in the surgical literature. According to our study, there is a paradox regarding the outcomes of patients treated with TEVAR in terms of postoperative complications and mortality related to the body mass index. And shouldn’t be considered as a high-risk feature in terms of postoperative morbidity and mortality in this procedure.
The JCOE/JCOC manufacturing process and collapse resistance of submarine pipeline
Authors: Peng Deping , Wan Buyan , Jin Yongping , Han Likun , Chen Jia , Liu Hongkun
Published: January 2023

Submarine pipeline is an important part of deep-sea and ultra-deep-sea oil and gas development. In the cold forming process of longitudinal submerged arc welded (LSAW) pipe, the JCO manufacturing process is one of the key forming technologies for manufacturing submarine pipeline. The main problem encountered by submarine pipelines in offshore oil and gas transportation is insufficient pipeline collapse pressure, which leads to pipeline collapse and shortens the service life of the pipeline. Therefore, the analysis of the JCO manufacturing process is of great significance to improve the collapse resistance of pipelines. In this paper, the development and research status of the JCOE/JCOC manufacturing process are reviewed. The stress, contact, and deformation of the plate are symmetrical in the JCOE/JCOC manufacturing process. The effects of expanding and compression on pipe collapse performance in the JCO manufacturing process are summarized. The asymmetric factors can reduce the collapse performance of the pipeline. Compared with expanding, compression can effectively reduce the ovality of pipe and strengthen the compression performance of pipe, to improve the collapse performance of pipe; finally, the JCOE/JCOC manufacturing process and collapse resistance of submarine pipeline is summarized and prospected.
Abnormal vibration analysis of metro axlebox based on vehicle-track coupling system
Authors: Shi Yixuan , Dai Huanyun , Wang Qunsheng , Li Dadi , Peng Xinyu
Published: January 2023

In the operation process of metro, abnormal vibration occurs at the axlebox, and causing structure damage on some components, so the dynamic test was carried out. The result shows that the abnormal vertical vibration about 80–120 Hz is the direct cause in the vehicle operation, and it relates to the type of track bed. According to the track and vehicle, two finite element vertical models of vehicle-track coupling system were established. It determines that the first order vertical bending mode of rail in the coupling system is the excitation source of the abnormal vibration through frequency analysis. And this mode is mainly related to the vertical stiffness of fastener and rubber cushion under short sleeper, which will increase with these stiffness values. Finally, through actual stiffness measurement, it sees that the fastener vertical stiffness values in ordinary track section are mostly reduced to the frequency range corresponding to the first vertical bending mode of rail in the coupling system, which is the cause of abnormal vibration. Therefore, by adjusting the fastener vertical stiffness or adopting the track type to be a damping track bed, the impact of vibration near 80–120 Hz can be reduced, so as to avoid the structural failure of vehicle components and ensure the operation safety of metro vehicles.
Elastic-plastic analysis of circular tunnel based on unified strength theory and considering multiple plastic zones
Authors: Gao Feng , Li Shanqing
Published: January 2023

Considering that the internal friction angle of the surrounding rock is not a constant but a function of the mean normal stress, and the unified strength theory (UST) is used as the plastic condition of the tunnel surrounding rock, the plastic zone of the circular tunnel surrounding rock is divided into multiple annular regions. For different plastic zones, there are different yield conditions represented by different stress functions, the elastic-plastic analysis of circular tunnels is performed by using the piecewise linearization of nonlinear yield function, stress and displacement in the elastic-plastic zone and the radius of the plastic zone are obtained by combining the equilibrium equations. It is shown that the radius of the plastic zone increases, the radial stresses in the elastic-plastic zone and the circumferential stresses in the plastic zone become smaller and the circumferential stresses in the elastic zone becomes larger compared with that of only one plastic zone. By using single factor analysis method, the calculated values of the tunnel displacements and plastic radii by UST were compared with those obtained by the Mohr-Coulomb (M-C) criterion, Drucker-Prager (D-P) criterion, and Zienkiewicz-Pande (Z-P) criterion. The analysis shows that under the same conditions, the solution of UST is smaller than M-C criterion and D-P criterion, therefore, the selection of rock strength criterion has great influence on the calculation of rock mechanics and engineering, the proper application of UST will guarantee the safety of engineering practice and have more practical value.
A review on the application of intelligent control strategies for post-stroke hand rehabilitation machines
Authors: Liu Chang , Guo Kai , Lu Jingxin , Yang Hongbo
Published: January 2023

Among the approaches to functional hand rehabilitation after stroke, the use of hand rehabilitation robots can provide functional training of the hand or assist the paralyzed hand in activities of daily living, and in particular, intelligent control strategies play a very important role in rehabilitation robotics. The purpose of this review is to summarize the current status of commercially available intelligently controlled hand rehabilitation robots developed in recent years. Firstly, we summarize the theoretical basis of post-stroke hand rehabilitation in the reviewed literature, and the intelligent control strategies of hand rehabilitation robots. Then, representative intelligently controlled hand rehabilitation robots are listed. Finally, we discuss the future directions of the intelligently controlled hand rehabilitation robots. The results show that the development trend in recent years is more inclined to: combining the theoretical basis of stroke hand rehabilitation and studying intelligent control methods of hand function rehabilitation robots that combine human bioelectrical signals to achieve prediction of patients’ motor intentions and also induced stimulation of neuroplasticity in the brain. As well as fusing different bioelectrical signals as a way to improve the applicability of the assistive device in real life. This paper will help researchers to understand the current state of the art regarding intelligently controlled hand rehabilitation robotics after stroke in recent years.
Fritz Lang’s M – An Other among Us
Authors: Martire Jacopo
Published: January 2023

M is one of the most celebrated movies by Fritz Lang. Examining the movie as a ‘jurisprudential text’, the present article will explore three interconnected problems: how in modern mass society, the legal gaze works as a device that both traces and tracks the subject within the multitude; how the presence of a radical Other within our midst is troublesome for law and can turn society against itself in autoimmunitary fashion; and, finally, how the legal subject is prevented from speaking precisely by the legal procedures that are supposed to make them vocal, superimposing the legal truth over the truth of the Other.
The Modeling Possibilities of the Comparative Analysis of Heterogeneous Diasporas: The Case of Armenia
Authors: Torosyan Tigran , Vardanyan Arax
Published: January 2023

The article discusses the problems of the effectiveness of a comparative analysis method used for diaspora studies. Depending on their nature, diasporas can be either comparable or non-comparable. The article provides a methodology for studying diasporas as well as its paradigm and implementation algorithm. It relies on the approach that one of the key factors of comparative analysis is whether the cases compared are comparable or not. Thus, it becomes necessary to reveal the nature of diasporas and their communities. To ensure the effectiveness of the analysis of comparable diasporas, the article proposes to classify the variables defining diasporas into two groups: identity variables and institutional variables. Identity variables can be used when there is a need for more detailed assessment of the nature of diasporas. The comparative analysis of diasporas or communities with the same nature should be based on institutional variables. The article examines the cases of the Armenian community in Russia and Lebanon to test the proposed methodology. It argues that these communities have different nature and thus their comparative analysis for the purpose of disclosing the prerequisites for the preservation of identity and effective functioning of institutions is senseless.
Gender Nonconformity Leads to Identity Denial for Cisgender and Transgender Individuals
Authors: Morgenroth Thekla , van der Toorn Jojanneke , Pliskin Ruthie , McMahon Casey E.
Published: January 2023

In modern Western cultures, gender is largely viewed as binary, and individuals who challenge the gender/sex binary face discrimination and marginalization. Across three preregistered studies ( N = 1,096), we examine gender discrimination against gender-nonconforming people. Studies 1 and 2 show that behavioral and appearance-based gender nonconformity leads to the misgendering of cisgender and transgender women and men. This was true for the gendered perception of these targets and the binary assignment to gender/sex-based spaces and policies (e.g., access to bathrooms or gender/sex-based leadership training). Surprisingly, whether the target was transgender or cisgender did not affect these results. Study 3 replicated findings for transgender targets and showed that adherence to gender stereotypes is seen as a necessity for transgender individuals who want their gender identity recognized by others (e.g., on official documents or through pronoun use).
Fat in the brain: Facts and features
Authors: Palasamudram Kumaran Sunitha , Reddy K Shreyas , Harish Priyadarshini , Ghosal Nandita , Nagappa Sriramanakoppa Nayana
Published: January 2023

The presence of fat within a lesion in the brain is not only easy to identify on both CT/MRI but also can help narrow the differential. The purpose of this paper is to illustrate the spectrum of common and rare fat-containing lesions in the brain that are encountered in clinical practice. This paper intends to discuss 15 such lesions which are confirmed by MRI findings and histopathological correlation. We divided the spectrum of fat-containing lesions into lesions with adipose cells, lesions with cholesterol-rich content and tumours with lipomatous differentiation/transformation. Knowledge of these common and rare fat-containing lesions is essential for making the right diagnosis or narrowing the differential diagnosis.
How do phytocannabinoids affect cardiovascular health? An update on the most common cardiovascular diseases
Authors: Dziemitko Sylwia , Harasim-Symbor Ewa , Chabowski Adrian
Published: January 2023

Cardiovascular disease (CVD) causes millions of deaths worldwide each year. Despite the great progress in therapies available for patients with CVD, some limitations, including drug complications, still exist. Hence, the endocannabinoid system (ECS) was proposed as a new avenue for CVDs treatment. The ECS components are widely distributed through the body, including the heart and blood vessels, thus the action of its endogenous and exogenous ligands, in particular, phytocannabinoids play a key role in various pathological states. The cardiovascular action of cannabinoids is complex as they affect vasculature and myocardium directly via specific receptors and exert indirect effects through the central and peripheral nervous system. The growing interest in phytocannabinoid studies, however, has extended the knowledge about their molecular targets as well as therapeutical properties; nonetheless, some areas of their actions are not yet fully recognized. Researchers have reported various cannabinoids, especially cannabidiol, as a promising approach to CVDs; hence, the purpose of this review is to summarize and update the cardiovascular actions of the most potent phytocannabinoids and the potential therapeutic role of ECS in CVDs, including ischemic reperfusion injury, arrhythmia, heart failure as well as hypertension.
A Phenomenological Investigation of Universal Mental Health Screening: Making Meaning for School Counseling
Authors: Goodman-Scott Emily , Donohue Peg , Betters-Bubon Jennifer
Published: January 2023

In the United States, K–12 schools have been going through a double pandemic: the COVID-19 pandemic and ongoing systemic racial injustices. Multitiered systems of support (MTSS), including universal mental health screening (UMHS), are highly recommended to assist students through these pandemics. While research on MTSS for school counselors is ample, school counseling UMHS literature is much more limited. As such, in the present study, we conducted a phenomenological investigation of participants’ experiences with UMHS, recruiting multidisciplinary, school-based UMHS team members, particularly school counselors. In describing the essence of participants’ experiences with UMHS, we identified 2 themes. The first theme is UMHS shifting the school culture, with subthemes (a) prioritizing prevention, (b) increasing collaboration, (c) using data, (d) gaining a holistic perspective, and (e) advocating for school counseling. The second theme is working through roadblocks, with subthemes (a) liability, (b) screener concerns, (c) resistance, (d) lack of time, and (e) staff wellness.
Alcohol and Cannabis Use Within Emerging Adults’ Committed Romantic Relationships: Associations With Relationship Functioning and Quality of Life
Authors: Tucker Joan S. , Troxel Wendy M. , Rodriguez Anthony , Seelam Rachana , D’Amico Elizabeth J.
Published: January 2023

This study examines alcohol and cannabis use within emerging adults’ committed romantic relationships and its association with relationship functioning (satisfaction, stability) and well-being (life satisfaction, anxiety, depression). Participants completed surveys in 2020 and 2021 ( N = 1214). Latent profile analysis identified four classes of couples’ substance use patterns: concordant (similar) infrequent use (81.9% of sample), near-daily partner cannabis use (6.0%), near-daily respondent cannabis use (6.5%), and concordant moderate alcohol and near-daily cannabis use (5.5%). Cross-sectionally, respondents who reported concordant infrequent use had significantly higher well-being than those who reported concordant heavier use; there were no class differences involving the two types of discordant couples. In general, class membership did not predict changes in well-being or relationship functioning over a 1-year period. Results provide new insights into patterns of both alcohol and cannabis use within committed romantic relationships of emerging adults that may have implications for well-being during this developmental period.
A Culturally Responsive Disposition: How Professional Learning and Teachers’ Beliefs About and Self-Efficacy for Culturally Responsive Teaching Relate to Instruction
Authors: Comstock Meghan , Litke Erica , Hill Kirsten Lee , Desimone Laura M.
Published: January 2023

Persistent social inequities in the United States demand attention to culturally responsive (CR) teaching, which requires a specific disposition toward students and teaching. Using survey data of secondary teachers ( N = 417) in seven urban districts across the country engaging in equity-oriented professional learning (PL) initiatives, we examine the relationship between teachers’ beliefs about, self-efficacy for, and engagement in PL around CR teaching and their self-reported CR teaching practices. We find correlational evidence that teacher-reported self-efficacy with CR teaching and engagement in PL focused on CR teaching are associated with higher self-reported frequency of CR teaching. We also find that teachers who have beliefs aligned with CR teaching have a stronger relationship between their CR teaching self-efficacy and self-reported CR teaching practices. Finally, we find evidence that changes in CR teaching self-efficacy are associated with changes in self-reported CR teaching—suggesting that CR teaching self-efficacy may drive changes in CR teaching.
Earning to Learn: Working While Enrolled in Tennessee Colleges and Universities
Authors: Ecton Walter G. , Heinrich Carolyn J. , Carruthers Celeste K.
Published: January 2023

Although some students choose to work while enrolled in college, others may have no choice but to work, even if work may be detrimental to their chances of succeeding in college. Leveraging 17 years of statewide student-level records from Tennessee, the authors examine the relationship between working while enrolled and degree completion, time to degree, credit accumulation, and grade point average. The authors aim to increase understanding of how the timing and intensity of work relate to student outcomes and to explore how these relationships differ by college sector, industry of employment, and student characteristics. The authors find consistent negative associations between work and academic success, especially at higher levels of work intensity. Working students attempt and earn fewer credits and are 4 to 7 percentage points less likely to complete college. Among completers, working students take longer to graduate, even though they earn similar grade point averages and complete their attempted credits at similar rates to nonworking students.
Ability of patients with acute ischemic stroke to recall given information on intravenous thrombolysis: Results of a prospective multicenter study
Authors: Schuster Luzie , Essig Fabian , Daneshkhah Naeimeh , Herm Juliane , Hellwig Simon , Endres Matthias , Dirnagl Ulrich , Hoffmann Frank , Michalski Dominik , Pfeilschifter Waltraud , Urbanek Christian , Petzold Gabor C , Rizos Timolaos , Kraft Andrea , Haeusler Karl Georg
Published: January 2023

Introduction:

Intravenous thrombolysis (IVT) is an on label treatment for selected patients with acute ischemic stroke (AIS). As major bleeding or allergic shock may occur, the need to ensure patients’ informed consent for IVT is a matter of debate.

Patients and methods:

Prospective investigator-initiated multi-center observational study to assess the ability of AIS patients to recall information, provided by a physician during a standardized educational talk (SET) on IVT use. The recall of 20 pre-defined items was assessed in AIS after 60–90 min ( n = 93) or 23–25 h ( n = 40) after SET. About 40 patients with subacute stroke, 40 non-stroke patients, and 23 relatives of AIS patients served as controls, and were surveyed 60–90 min after SET.

Results:

Within 60–90 min after SET, AIS patients (median age 70 years, 31% female, median NIHSS score on admission 3 points) who were considered capable to provide informed consent recalled 55% (IQR 40%–66.7%) of the provided SET items. In multivariable linear regression analysis recapitulation by AIS patients was associated with their educational level (β = 6.497, p < 0.001), self-reported excitement level (β = 1.879, p = 0.011) and NIHSS score on admission (β = −1.186, p = 0.001). Patients with subacute stroke (70 years, 40% female, median NIHSS = 2) recalled 70% (IQR 55.7%–83.6%), non-stroke patients (75 years, 40% female) 70% (IQR 60%–78.7%), and AIS relatives (58 years, 83% female) 70% (IQR 60%–85%). Compared to subacute stroke patients, AIS patients less often recalled the frequency of IVT-related bleeding (21% vs 43%), allergic shock (15% vs 39%), and bleeding-related morbidity and mortality (44% vs 78%). AIS patients recalled 50% (IQR 42.3%–67.5%) of the provided items 23–25 h after SET.

Conclusion:

AIS patients eligible for IVT remember about half of all SET-items after 60–90 min or 23–25 h, respectively. The fact that the recapitulation of IVT-associated risks is particularly poor should be given special consideration.
Age of onset of cerebral venous thrombosis: the BEAST study
Authors: Ranjan Redoy , Ken-Dror Gie , Martinelli Ida , Grandone Elvira , Hiltunen Sini , Lindgren Erik , Margaglione Maurizio , Le Cam Duchez Veronique , Bagan Triquenot Aude , Zedde Marialuisa , Mancuso Michelangelo , Ruigrok Ynte M , Worrall Brad , Majersik Jennifer J , Putaala Jukka , Haapaniemi Elena , Zuurbier Susanna M , Brouwer Matthijs C , Passamonti Serena M , Abbattista Maria , Bucciarelli Paolo , Lemmens Robin , Pappalardo Emanuela , Costa Paolo , Colombi Marina , Aguiar de Sousa Diana , Rodrigues Sofia , Canhao Patrícia , Tkach Aleksander , Santacroce Rosa , Favuzzi Giovanni , Arauz Antonio , Colaizzo Donatella , Spengos Kostas , Hodge Amanda , Ditta Reina , Han Thang S , Pezzini Alessandro , Coutinho Jonathan M , Thijs Vincent , Jood Katarina , Tatlisumak Turgut , Ferro José M , Sharma Pankaj
Published: January 2023

Background:

Cerebral venous thrombosis (CVT) is an uncommon cause of stroke in young adults. We aimed to determine the impact of age, gender and risk factors (including sex-specific) on CVT onset.

Methods:

We used data from the BEAST (Biorepository to Establish the Aetiology of Sinovenous Thrombosis), a multicentre multinational prospective observational study on CVT. Composite factors analysis (CFA) was performed to determine the impact on the age of CVT onset in males and females.

Results:

A total of 1309 CVT patients (75.3% females) aged ⩾18 years were recruited. The overall median (IQR-interquartile range) age for males and females was 46 (35–58) years and 37 (28–47) years ( p < 0.001), respectively. However, the presence of antibiotic-requiring sepsis ( p = 0.03, 95% CI 27–47 years) among males and gender-specific risk factors like pregnancy ( p < 0.001, 95% CI 29–34 years), puerperium ( p < 0.001, 95% CI 26–34 years) and oral contraceptive use ( p < 0.001, 95% CI 33–36 years) were significantly associated with earlier onset of CVT among females. CFA demonstrated a significantly earlier onset of CVT in females, ~12 years younger, in those with multiple (⩾1) compared to ‘0’ risk factors ( p < 0.001, 95% CI 32–35 years).

Conclusions:

Women suffer CVT 9 years earlier in comparison to men. Female patients with multiple (⩾1) risk factors suffer CVT ~12 years earlier compared to those with no identifiable risk factors.
A barrier too far: Understanding the role of intersection crossing distance on bicycle rider behavior in Chicago
Authors: Aras Rohan L , Ouellette Nicholas T , Jain Rishee K
Published: January 2023

For a variety of environmental, health, and social reasons, there is a pressing need to reduce the automobile dependence of American cities. Bicycles are well suited to help achieve this goal. However, perceptions of rider safety present a large hindrance toward increased bicycle adoption. These perceptions are largely influenced by the design of our current road infrastructure, including the crossing distances of large intersections. In this paper, we examine the role of intersection crossing distances in modifying rider behavior through the construction of a novel dataset integrating street widths and probable trip routes from Chicago’s Divvy bikeshare system. We compare real trips to synthetic trips that are not influenced by the width of intersections and exploit behavior differences that result from the semi-dockless nature of the bikeshare system. Our analysis reveals that bikeshare riders do avoid large intersections in limited circumstances; however, these preferences appear to be heavily outweighed by the relative spatial positions of origins and destinations (i.e., the urban morphology of Chicago). Our results suggest that specific infrastructural investments such as protected intersections could prove feasible alternatives to reduce the perception and safety concerns associated with large road barriers and enhance the attractiveness of non-motorized mobility.
Esophageal Manometry and pHmetry Profile in Obese Patients Selected for Bariatric Surgery
Authors: Bernui Vigo Grazia , Paiva del Solar Marco , Romani Pozo Diego , Bryce Alberti Mayte , Rojas Reyes Rodrigo , Poggi Garland Luciano , Poggi Machuca Luis
Published: January 2023

Background:

Obesity is a highly prevalent disease and risk factor for gastroesophageal reflux disease (GERD) which could predispose to esophageal motility disorders. Few studies exist regarding manometric and phmetric findings in patients with obesity who are candidates to bariatric surgery. The objective was to describe the preoperative profile of patients with obesity selected for bariatric surgery.

Methods:

Retrospective analysis of 338 patients with obesity, subjected to 24 hour-pHmetry with impedance and manometry prior to bariatric surgery between 2006 and 2021. Descriptive and analytical statistics were used for analysis.

Results:

The mean age and body mass index was 41.94 ± 0.70 years and 38.75 ± 0.37 kg/m2, respectively. GERD symptoms were present in 43.3% (139/321). A 24-hour pHmetry analysis showed a pathologic DeMeester index in 46.7% of patients, of which 64.3% (63/98) were symptomatic. Impedance was abnormal in 53.4%, of which 67% (73/109) were symptomatic. Manometry registered dysmotility in 22.7% (69/304) of patients, a mean lower esophageal sphincter (LES) pressure of 11.93 ± 0.43 mmHg and hypotensive LES in 38.5%. Mean gastric pressure was 9.79 ± 0.33 mmHg after deglutition and only 11.4% (34/299) presented abnormal gastroesophageal gradients.

Conclusions:

There is a high prevalence of dysmotility and GERD in candidates to bariatric surgery with obesity. Esophageal 24 hour-pHmetry with impedance and manometry should be considered within preoperative tests as pathologic results could guide appropriate procedure selection, at least in symptomatic patients.
Wrangling Diabetes: Illuminating the Latent Processes That Impact Diabetes Self-Management Behaviors
Authors: Pullyblank Kristin , Fink Amanda
Published: January 2023

Purpose:

The purpose of this study is to discern the mechanisms that impact diabetes self-management from the perspective of individuals living with diabetes.

Methods:

Using a critical realist perspective, this qualitative descriptive study enrolled 54 individuals living with diabetes who had been exposed to diabetes self-management education and support within the previous 3 years. Focus groups were conducted between January and March 2021. Reflexive thematic analysis was used to develop themes and subthemes.

Results:

The overarching theme was wrangling diabetes: getting in control. Enablers to getting in control included professional and informal support and constant reassurance that they were on the right track. Individual-level barriers to getting in control included competing priorities, difficult emotions, and financial concerns. Health system barriers included inconsistent messaging from providers, lack of care coordination, and insurance driving treatment decisions. The latent force underlying these barriers was the limited agency individuals with diabetes had in reference to self-management behaviors.

Conclusions:

Although the health care system ostensibly wants individuals to be in control of and responsible for managing their diabetes, system-level structures and processes do not allow for some people living with diabetes to effectively self-manage.
Effects of mixing modes on nonresponse and measurement error in an economic panel survey
Authors: Sakshaug Joseph W. , Beste Jonas , Trappmann Mark
Published: January 2023

Numerous panel surveys around the world use multiple modes of data collection to recruit and interview respondents. Previous studies have shown that mixed-mode data collection can improve response rates, reduce nonresponse bias, and reduce survey costs. However, these advantages come at the expense of potential measurement differences between modes. A major challenge in survey research is disentangling measurement error biases from nonresponse biases in order to study how mixing modes affects the development of both error sources over time. In this article, we use linked administrative data to disentangle both nonresponse and measurement error biases in the long-running mixed-mode economic panel study “Labour Market and Social Security” (PASS). Through this study design we answer the question of whether mixing modes reduces nonresponse and measurement error biases compared to a single-mode design. In short, we find that mixing modes reduces nonresponse bias for most variables, particularly in later waves, with only small effects on measurement error bias. The total bias and mean-squared error are both reduced under the mixed-mode design compared to the counterfactual single-mode design, which is a reassuring finding for mixed-mode economic panel surveys.
Polymorphism analysis of the chloroplast and mitochondrial genomes in soybean
Authors: Yue Yanlei , Li Jiawen , Sun Xuegang , Li Zhen , Jiang Bingjun
Published: January 2023

Background

Soybean is an important protein- and oil-rich crop throughout the world. Much attention has been paid to its nuclear genome, which is bi-parentally inherited and associated with many important agronomical traits. However, less is known about the genomes of the semi-autonomous and essential organelles, chloroplasts and mitochondria, of soybean.

Results

Here, through analyzing the polymorphisms of these organelles in 2580 soybean accessions including 107 wild soybeans, we found that the chloroplast genome is more variable than the mitochondrial genome in terms of variant density. Consistent with this, more haplotypes were found in the chloroplast genome (44 haplotypes) than the mitochondrial genome (30 haplotypes). These haplotypes were distributed extremely unevenly with the top two haplotypes (CT1 and CT2 for chloroplasts, MT1 and MT2 for mitochondria) accounting for nearly 70 and 18% of cultivated soybean accessions. Wild soybeans also exhibited more diversity in organelle genomes, harboring 32 chloroplast haplotypes and 19 mitochondrial haplotypes. However, only a small percentage of cultivated soybeans shared cytoplasm with wild soybeans. In particular, the two most frequent types of cytoplasm (CT1/MT1, CT2/MT2) were missing in wild soybeans, indicating that wild soybean cytoplasm has been poorly exploited during breeding. Consistent with the hypothesis that soybean originated in China, we found that China harbors the highest cytoplasmic diversity in the world. The geographical distributions of CT1–CT3 and MT1–MT3 in Northeast China were not significantly different from those in Middle and South China. Two mitochondrial polymorphism sites, p.457333 (T > C) and p.457550 (G > A), were found to be heterozygous in most soybeans, and heterozygosity appeared to be associated with the domestication of cultivated soybeans from wild soybeans, the improvement of landraces to generate elite cultivated soybeans, and the geographic adaptation of soybean.

Conclusions

The haplotypes of thousands of soybean cultivars should be helpful in evaluating the impact of cytoplasm on soybean performance and in breeding cultivars with the desired cytoplasm. Mitochondrial heterozygosity might be related to soybean adaptation, and this hypothesis needs to be further investigated.
Effect of gabapentin on length of stay, opioid use, and pain scores in posterior spinal fusion for adolescent idiopathic scoliosis: a retrospective review across a multi-hospital system
Authors: Zhang De-An , Brenn Bruce , Cho Robert , Samdani Amer ,   Shriners Spine Study Group, Diu Michelle , Fedorak Graham , Gupta Purnendu , Kuestner Matthew , Lawing Cheryl , Luhmann Scott , Moore Robert , Oswald Sarah , Roberto Rolando , Stondell Casey , Talwalkar Vishwas , Taneja Pravin , Vax Richard , Voronov Polina , Welborn Michelle , Poon Selina C.
Published: January 2023

Background

Gabapentin has been adopted in Enhanced Recovery After Surgery protocols as a means to reduce opioid consumption while maintaining adequate post-operative analgesia. The purpose of our study was to review and compare changes in length of stay, opioid use, and patient reported pain scores after the addition of gabapentin into five, distinct pain protocols for posterior spinal fusion in adolescent idiopathic scoliosis.

Methods

A retrospective review was completed using a database of electronic medical data from a single pediatric orthopedic healthcare system that was queried for patients with adolescent idiopathic scoliosis who underwent first-time posterior spinal fusion. Perioperative data including demographics, hospital length of stay, surgical details, opioid use, patient reported pain scores, and non-opioid analgesic use were collected.

Results

From December 2012 to February 2019, 682 hospitalizations for posterior spinal fusion in adolescent idiopathic scoliosis were identified with complete inpatient data; 49% were administered gabapentin. For the gabapentin cohort, the system saw no statistically significant effect on length of stay or pain averaged over POD#0–3. Opioid use was statistically lower averaged over POD#0–3. Individual sites saw variation on length of stay and opioid use compared to the system.

Conclusion

In conclusion, system-wide data showed gabapentin containing protocols reduced opioid use while maintaining clinically equivalent analgesia. However, variations of individual site results make it difficult to conclude the degree to which gabapentin were responsible for this effect.
Pro-inflammatory diet, cardio-metabolic risk factors and risk of type 2 diabetes: A cross-sectional analysis using data from RaNCD cohort study
Authors: Namazi Nazli , Anjom-Shoae Javad , Najafi Farid , Ayati Mohammad Hossein , Darbandi Mitra , Pasdar Yahya
Published: January 2023

Background

Inflammation and cardiometabolic risk factors can be involved in developing type 2 diabetes mellitus (T2DM). This study aimed to investigate and compare the association between a pro-inflammatory diet and cardiometabolic risk factors in patients with T2DM and non-T2DM cases.

Methods

In this cross-sectional population-based study, considering the baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort, patients with T2DM (n = 785) and non-T2DM cases (n = 8254) were included. The dietary inflammatory index (DII) was calculated using a food frequency questionnaire (FFQ) and was classified into four groups (quartiles) with lowest to highest scores. Logistic regression analysis was conducted to determine the association between DII and cardiometabolic risk factors in both groups.

Results

The participants were 9,039 (4140 men and 4889 women) with a mean age of 47.4 ± 8.2 years; the mean body mass index (BMI) and DII were 27.49 ± 4.63 kg/m2 and − 2.49 ± 1.59, respectively. After adjustment for confounding factors, we found that DII can increase the risk of T2DM by 61% (95% CI 1.27 to 2.05, P < 0.001). A comparison of two groups revealed that the association of DII, obesity/overweight and dyslipidemia were also significant in both diabetic (P < 0.05) and non-diabetic cases (P < 0.05). However, no significant association was found between DII, MetS, and hypertension in either of the groups. The association between DII and cardiovascular diseases (CVDs) was only significant in diabetic patients (1.65; 95%CI: 1.02 to 2.65, P = 0.04) and T2DM showed an interaction with the association between DII and CVDs.

Conclusion

Inflammatory potential of diet may increase the risk of T2DM. Although it can increase the risk of some cardiometabolic risk factors in both diabetic and non-diabetic cases, its effects were greater among patients with T2DM. However, further prospective studies are required to confirm these associations.
Predicting the risk of a clinical event using longitudinal data: the generalized landmark analysis
Authors: Yao Yi , Li Liang , Astor Brad , Yang Wei , Greene Tom
Published: January 2023

Background

In the development of prediction models for a clinical event, it is common to use the static prediction modeling (SPM), a regression model that relates baseline predictors to the time to event. In many situations, the data used in training and validation are from longitudinal studies, where predictor variables are time-varying and measured at clinical visits. But these data are not used in SPM. The landmark analysis (LA), previously proposed for dynamic prediction with longitudinal data, has interpretational difficulty when the baseline is not a risk-changing clinical milestone, as is often the case in observational studies of chronic disease without intervention.

Methods

This paper studies the generalized landmark analysis (GLA), a statistical framework to develop prediction models for longitudinal data. The GLA includes the LA as a special case, and generalizes it to situations where the baseline is not a risk-changing clinical milestone with a more useful interpretation. Unlike the LA, the landmark variable does not have to be time since baseline in the GLA, but can be any time-varying prognostic variable. The GLA can also be viewed as a longitudinal generalization of localized prediction, which has been studied in the context of low-dimensional cross-sectional data. We studied the GLA using data from the Chronic Renal Insufficiency Cohort (CRIC) Study and the Wisconsin Allograft Replacement Database (WisARD) and compared the prediction performance of SPM and GLA.

Results

In various validation populations from longitudinal data, the GLA generally had similarly or better predictive performance than SPM, with notable improvement being seen when the validation population deviated from the baseline population. The GLA also demonstrated similar or better predictive performance than LA, due to its more general model specification.

Conclusions

GLA is a generalization of the LA such that the landmark variable does not have to be the time since baseline. It has better interpretation when the baseline is not a risk-changing clinical milestone. The GLA is more adaptive to the validation population than SPM and is more flexible than LA, which may help produce more accurate prediction.
Estimation of marginal structural models under irregular visits and unmeasured confounder: calibrated inverse probability weights
Authors: Kalia Sumeet , Saarela Olli , Escobar Michael , Moineddin Rahim , Greiver Michelle
Published: January 2023

Clinical information collected in electronic health records (EHRs) is becoming an essential source to emulate randomized experiments. Since patients do not interact with the healthcare system at random, the longitudinal information in large observational databases must account for irregular visits. Moreover, we need to also account for subject-specific unmeasured confounders which may act as a common cause for treatment assignment mechanism (e.g. glucose-lowering medications) while also influencing the outcome (e.g. Hemoglobin A1c). We used the calibration of longitudinal weights to improve the finite sample properties and to account for subject-specific unmeasured confounders. A Monte Carlo simulation study is conducted to evaluate the performance of calibrated inverse probability estimators using time-dependent treatment assignment and irregular visits with subject-specific unmeasured confounders. The simulation study showed that the longitudinal weights with calibrated restrictions improved the finite sample bias when compared to the stabilized weights. The application of the calibrated weights is demonstrated using the exposure of glucose lowering medications and the longitudinal outcome of Hemoglobin A1c. Our results support the effectiveness of glucose lowering medications in reducing Hemoglobin A1c among type II diabetes patients with elevated glycemic index ($$\ge 8.5 \%$$≥8.5%) using stabilized and calibrated weights.
SPOCK1 and POSTN are valuable prognostic biomarkers and correlate with tumor immune infiltrates in colorectal cancer
Authors: Gan Caiqin , Li Mengting , Lu Yuanyuan , Peng Ganjing , Li Wenjie , Wang Haizhou , Peng Yanan , Hu Qian , Wei Wanhui , Wang Fan , Liu Lan , Zhao Qiu
Published: January 2023

Background

Immune cells and stromal cells in the tumor microenvironment play a vital role in the progression of colorectal cancer (CRC). The study aimed to screen valuable prognostic biomarkers in CRC based on stromal and immune scores.

Method

The ESTIMATE algorithm was used to calculate the immune and stromal scores of CRC samples in TCGA. Then samples were divided into high and low score groups based on the median value of the scores. Differentially expressed genes (DEGs) associated with immune and stromal scores were screened. WGCNA and univariate COX regression analysis were performed to further identify key prognostic genes. Analysis of scRNA-seq for CRC was used for verifying the main source of the key genes. The prognostic value of they was validated based on The Gene Expression Profiling Interactive Analysis and GSE17536 dataset. TIMER and CIBERSORT algorithms were applied to analyze the correlations among key genes and tumor-infiltrating immune cells. Several pairs of colon cancer tissue were used to be proven.

Result

1314 upregulated and 4 downregulated genes were identified, which were significantly enriched in immune-related biological processes and pathways. Among these DEGs, SPOCK1 and POSTN were identified as key prognostic genes and mainly expressed in cancer-associated fibroblasts for CRC. High expression of SPCOK1 and POSTN was associated with advanced clinical stage, T stage, N stage, and poor prognosis of CRC. The results from CIBERSORT and TIMER revealed that SPOCK1 and POSTN were associated with tumor-infiltrating immune cells, especially macrophages and neutrophils. Meanwhile, in several pairs of human colorectal tissue samples, SPOK1 and POSTN were found to be significantly overexpressed in colorectal tissue compared with para-cancer tissue, and macrophage surface markers CD68 (co-expressed by M1 and M2 macrophages) and CD206 (M2-specific macrophage expression) were also overexpressed in cancer tissue. Besides, SPOCK1 and POSTN expression were positively correlated with the expression of immune checkpoints.

Conclusion

Collectively, our results indicate that SPOCK1 and POSTN associated with CAF may be novel prognostic biomarkers in CRC and correlate with immune infiltrates.