bluuebunny/crossref_metadata_2025 huggingface dataset:
The willingness of parents to vaccinate their children younger than 12 years against COVID-19: a cross-sectional study in Malaysia
Authors: Ng Diana-Leh-Ching , Gan Gin-Gin , Chai Chee-Shee , Anuar Nur Adila Bt , Sindeh Woweham , Chua Wei-Jing , Said Asri B. , Tan Seng-Beng
Published: June 2022

Background

The initiation of a new drug, for instance, the coronavirus disease 2019 (COVID-19) vaccine in children could be a source of major concern for parents. This study aims to determine the willingness of parents in Malaysia to vaccinate their children younger than 12 years against COVID-19.

Methods

An online cross-sectional survey was conducted nationwide in Malaysia from August 29, 2021, to October 17, 2021. Parents with children younger than 12 years were enrolled via the snowball sampling method.

Results

The analysis included data from 3,528 parents (79.5%) of the 4,438 survey responses received. Of these parents, 2,598 (73.6%) were willing, 486 (13.8%) were not willing, and 444 (12.6%) were still hesitant to vaccinate their children against COVID-19. Single parents (odds ratio [OR], 2.0; 95% confidence interval [CI], 1.32–3.04; P = 0.001), parents with secondary or lower education (OR, 1.5; 95% CI, 1.21–1.96; P < 0.001), healthcare workers (OR, 1.7; 95% CI, 1.34–2.26; P < 0.001), parents who had significant contact with COVID-19 (OR, 1.3; 95% CI, 1.09–1.63; P = 0.006), and parents who had been vaccinated against COVID-19 (OR, 15.4; 95% CI, 9.76–24.33; P < 0.001) were found more willing to immunize their children. The common reasons for vaccination given by parents who were willing to immunize their children include protection of children (99.4%), protection of other family members (99.3%), and effectiveness (98.2%). The common reasons against vaccination given by parents who were not willing to immunize their children were uncertainty about the new vaccine (96.1%), concerns about vaccine contents (93.2%), limited vaccine information from physicians (82.3%), and the belief of vaccine was unsafe (79.8%).

Conclusions

In this study, nearly three-quarters of parents were willing to vaccinate their children younger than 12 years against COVID-19. The parents’ history of COVID-19 vaccination was the strongest independent predictor of their willingness to vaccinate their children. Therefore, future health education for the COVID-19 vaccine should focus on parents who are prone to vaccine refusal or hesitation, address the common reasons for vaccine refusal, and highlight the vaccine’s benefits.
Is total thyroidectomy with bilateral central neck dissection the only surgery for papillary thyroid carcinoma patients with clinically involved central nodes?
Authors: Back Kyorim , Lee Jiyeon , Cho Anna , Choe Jun-Ho , Kim Jung-Han , Oh Young Lyun , Kim Jee Soo
Published: June 2022

Background

In clinical practice, we often observed that patients who underwent total thyroidectomy due to clinically involved nodal disease (cN1a) actually had less extensive CLNM on final pathology. This study investigates whether total thyroidectomy and therapeutic bilateral CND are necessary for all PTC patients with cN1a.

Methods

This study retrospectively reviewed 899 PTC patients who underwent total thyroidectomy with bilateral CND from January 2012 to June 2017. The patients were divided into two groups according to pre-operative central lymph node (CLN) status: cN0, no suspicious CLNM; cN1a, suspicious CLNM. We compared the clinicopathological features of these two groups.

Results

There was no significant difference in recurrence between cN0 and cN1a groups after a mean follow-up time of 59.1 months. Unilateral cN1a was related to the largest central LN size ≥ 2 mm (OR = 3.67, p < 0.001) and number of CLNM > 5(OR = 2.24, p = 0.006). On the other hand, unilateral cN1a was not associated with an increased risk of contralateral lobe involvement (OR = 1.35, p = 0.364) and contralateral CLNM (OR = 1.31, p = 0.359). Among 106 unilateral cN1a patients, 33 (31.1%) were found to be pN0 or had ≤ 5 metastatic CLNs with the largest node smaller than 2 mm.

Conclusions

Most cN1a patients were in an intermediate risk group for recurrence and required total thyroidectomy. However, lobectomy with CND should have performed in approximately 30% of the cN1a patients. Pre-operative clinical examination, meticulous radiologic evaluation, and intra-operative frozen sections to check the nodal status are prerequisites for this approach.
Effectiveness of primary school-based interventions in improving oral health of children in low- and middle-income countries: a systematic review and meta-analysis
Authors: Akera Peter , Kennedy Sean E. , Lingam Raghu , Obwolo Mark J. , Schutte Aletta E. , Richmond Robyn
Published: June 2022

Background

Risk factors for oral disease can potentially be ameliorated by school-based interventions. This review evaluates the effectiveness of primary school-based interventions in improving oral health among children in low-and middle-income countries (LMICs).

Methods

Our systematic review was conducted in accordance with the Joanna Briggs Institute methodology for systematic reviews of effectiveness. Medline, Embase, Global Health, CINAHL, Emcare, Scopus, Web of Science, WHO website, Google Advanced and Google Scholar were searched for experimental and observational studies published between 1995 and 2021 in English. Quality assessment and data extraction of the articles were performed by two independent reviewers. The primary outcome was decayed, missing, and filled teeth/surfaces [dmft(s)/DMFT(S)] scores. Seven meta-analyses were conducted.

Results

The search yielded 1178 publications and after removing duplicates, 753 remained. A further 648 publications were excluded after screening titles and abstracts. 105 publications were reviewed in full and 34 were included. Narrative synthesis showed school-based interventions had a positive effect on oral health outcomes. Meta-analysis showed a significant positive effect on dental caries measured by DMFT scores (standardised mean difference (SMD) =  − 0.33; 95% CI − 0.56 to − 0.10;P = 0.005), net increment in DMFS scores (SMD =  − 1.09; 95% CI − 1.91 to − 0.27;P = 0.009), dmft and DMFT/S score > 1 (Risk Ratio = 0.70; 95% CI 0.53 to 0.94;P = 0.02) and plaque scores (SMD =  − 0.32; 95% CI − 0.46 to − 0.18;P < 0.00001). Non-significant positive effect was observed for dental caries measured by net increment in DMFT scores (SMD =  − 0.34; 95% CI − 0.69 to 0.02;P = 0.06) and DMFS scores (SMD =  − 0.26; 95% CI − 0.70 to 0.18;P = 0.24), and gingival health (SMD = 0.12; 95% CI − 0.32 to 0.55;P = 0.60). Certainty of evidence was assessed as very low for all oral health outcomes.

Conclusion

School-based interventions can be effective in reducing the burden of oral disease among primary school children in LMICs, with skills-based education, teacher training, provision of access to oral health services and parental engagement emerging as particularly promising. Further research is required to provide evidence of effectiveness of primary school-based interventions to improve oral health.

Systematic review registrationThe title of this review was registered with PROSPERO (registration number: CRD42020202599).
A comparison of Knowledge, attitude and practice (KAP) of nurses on nursing Post-stroke dysphagia patients between iii-A and ii-A hospitals in China: a propensity score-matched analysis
Authors: Deng Shumin , Mao Xiaolan , Meng Xianmei , Yu Liping , Xie Fei , Huang Guiling , Duan Zhizhou
Published: June 2022

Background

Whether knowledge, attitude and practice of nurses on nursing post-stroke dysphagia patients varies between different ranking hospitals is still unknown. This study aimed to compare the knowledge, attitude and practice level of nurses on nursing post-stroke dysphagia patients between iii-A and ii-A hospitals in China.

Design

A cross-sectional study design was used.

Methods

Data were collected from eighteen hospitals in Wuhan, Hubei in May–July 2020, and a total of 824 nurses were recruited by convenient sampling. After propensity score matching, 205 participants in iii-A hospitals were matched with 205 participants in ii-A hospitals.

Results

There were no statistically differences in the socio-demographic characteristics between two groups after propensity score matching. Before matching, the regression coefficients between hospital ranking and knowledge, attitude, practice were -0.415, -0.718 and -1.855, respectively. After matching, the coefficients changed to -0.394, -0.824 and -1.278. Nurses from iii-A hospitals had higher knowledge and attitude scores than nurses from ii-A hospitals, but no significant practice scores difference was observed between various rankings of hospitals.

Conclusions

The KAP of nurses on nursing post-stroke dysphagia patients were different in iii-A and ii-A hospitals. Administrators should strengthen management, provide more learning resources and trainings to meet nurses’ needs about methods to deal with and recognize dysphagia, so as to further improve the quality of post-stroke dysphagia management.
Model-based estimation of QT intervals of mouse fetal electrocardiogram
Authors: Widatalla Namareq , Funamoto Kiyoe , Kawataki Motoyoshi , Yoshida Chihiro , Funamoto Kenichi , Saito Masatoshi , Kasahara Yoshiyuki , Khandoker Ahsan , Kimura Yoshitaka
Published: June 2022

Background

Abnormal prolongation in the QT interval or long QT syndrome (LQTS) is associated with several cardiac complications such as sudden infant death syndrome (SIDS). LQTS is believed to be linked to genetic mutations which can be understood by using animal models, such as mice models. Nevertheless, the research related to fetal QT interval in mice is still limited because of challenges associated with T wave measurements in fetal electrocardiogram (fECG). Reliable measurement of T waves is essential for estimating their end timings for QT interval assessment.

Results

A mathematical model was used to estimate QT intervals. Estimated QT intervals were validated with Q-aortic closure (Q-Ac) intervals of Doppler ultrasound (DUS) and comparison between both showed good agreement with a correlation coefficient higher than 0.88 (r > 0.88, P < 0.05).

Conclusion

Model-based estimation of QT intervals can help in better understanding of QT intervals in fetal mice.
Buprenorphine and naloxone access in pharmacies within high overdose areas of Los Angeles during the COVID-19 pandemic
Authors: Dadiomov David , Bolshakova Maria , Mikhaeilyan Melania , Trotzky-Sirr Rebecca
Published: June 2022

Background

Buprenorphine and naloxone are first-line medications for people who use opioids (PWUO). Buprenorphine can reduce opioid use and cravings, help withdrawal symptoms, and reduce risk of opioid overdose. Naloxone is a life-saving medication that can be administered to reverse an opioid overdose. Despite the utility of these medications, PWUO face barriers to access these medications. Downtown Los Angeles has high rates, and number, of opioid overdoses which could potentially be reduced by increasing distribution of naloxone and buprenorphine. This study aimed to determine the accessibility of these medications in a major urban city by surveying community pharmacies regarding availability of buprenorphine and naloxone, and ability to dispense naloxone without a prescription.

Methods

Pharmacies were identified in the Los Angeles downtown area by internet search and consultation with clinicians. Phone calls were made to pharmacies at two separate time points–September 2020 and March 2021 to ask about availability of buprenorphine and naloxone. Results were collected and analyzed to determine percentage of pharmacies that had buprenorphine and/or naloxone in stock, and were able to dispense naloxone without a prescription.

Results

Out of the 14 pharmacies identified in the downtown LA zip codes, 13 (92.9%) were able to be reached at either time point. The zip code with one of the highest rates of opioid-related overdose deaths did not have any pharmacies in the area. Most of the pharmacies were chain stores (69.2%). Eight of the 13 (61.5%) pharmacies were stocked and prepared to dispense buprenorphine upon receiving a prescription, and an equivalent number was prepared to dispense naloxone upon patient request, even without a naloxone prescription. All of the independent pharmacies did not have either buprenorphine or naloxone available.

Conclusions

There is a large gap in care for pharmacies in high overdose urban zip codes to provide access to medications for PWUO. Unavailability of medication at the pharmacy-level may impede PWUO ability to start or maintain pharmacotherapy treatment. Pharmacies should be incentivized to stock buprenorphine and naloxone and encourage training of pharmacists in harm reduction practices for people who use opioids.
Neutrophil activation in patients with anti-neutrophil cytoplasmic autoantibody-associated vasculitis and large-vessel vasculitis
Authors: Michailidou Despina , Duvvuri Bhargavi , Kuley Runa , Cuthbertson David , Grayson Peter C. , Khalidi Nader A. , Koening Curry L. , Langford Carol A. , McAlear Carol A. , Moreland Larry W. , Pagnoux Christian , Seo Philip , Specks Ulrich , Sreih Antoine G. , Warrington Kenneth J. , Mustelin Tomas , Monach Paul A. , Merkel Peter A. , Lood Christian
Published: June 2022

Objective

To assess markers of neutrophil activation such as calprotectin and N-formyl methionine (fMET) in anti-neutrophil cytoplasmic autoantibody-associated vasculitis (AAV) and large-vessel vasculitis (LVV).

Methods

Levels of fMET, and calprotectin, were measured in the plasma of healthy controls (n=30) and patients with AAV (granulomatosis with polyangiitis (GPA,n=123), microscopic polyangiitis (MPA,n=61)), and LVV (Takayasu’s arteritis (TAK,n=58), giant cell arteritis (GCA,n=68)), at times of remission or flare. Disease activity was assessed by physician global assessment. In vitro neutrophil activation assays were performed in the presence or absence of formyl peptide receptor 1 (FPR1) inhibitor cyclosporine H.

Results

Levels of calprotectin, and fMET were elevated in patients with vasculitis as compared to healthy individuals. Levels of fMET correlated with markers of systemic inflammation: C-reactive protein (r=0.82,p<0.0001), and erythrocyte sedimentation rate (r=0.235,p<0.0001). The neutrophil activation marker, calprotectin was not associated with disease activity. Circulating levels of fMET were associated with neutrophil activation (p<0.01) and were able to induce de novo neutrophil activation via FPR1-mediated signaling.

Conclusion

Circulating fMET appears to propagate neutrophil activation in AAV and LVV. Inhibition of fMET-mediated FPR1 signaling could be a novel therapeutic intervention for systemic vasculitides.
Bridge-over-water detection via modulated deformable convolution and attention mechanisms
Authors: Tang Rui , Dong Ganggang
Published: June 2022

Bridge-over-water detection plays vital role in urban surveillance and military reconnaissance. Bridges have arbitrary orientations and extreme aspect ratios in remote sensing images, and the preceding works cannot adequately extract bridge-related features. Small bridges are difficult to detect accurately in optical remote sensing images. The oriented bounding box annotations are required by previous deep-learning-based methods for detecting rotated objects. But obtaining the annotations is a laborious task. Though widely studied previously, they are still challenging problems. To address these problems, modulated deformable convolution and attention mechanisms were introduced in this paper. Modulated deformable convolution made the receptive field more flexible. The feature extraction capability of the network was enhanced. A new weighted structure was designed to quantify the contributions of channel and spatial attention mechanisms. A selective attention usage strategy was proposed to improve the detection performance. To locate bridge-over-water more precisely, a new bounding box conversion module was presented. There was no need for oriented bounding box annotations, and the process only relied on bridge-related prior knowledge. Multiple experiments were performed to verify the effectiveness of proposed methods.
Success factors of citizen energy cooperatives in north western Germany: a conceptual and empirical review
Authors: Ahlemeyer Kai , Griese Kai-Michael , Wawer Tim , Siebenhüner Bernd
Published: June 2022

Background

Citizen energy cooperatives (CECOs) are an important element for realising the transformation of the European energy system from a central system, dominated by a few market players to a decentralized system with the participation of many citizens, in which energy supply is largely based on renewable energy sources. This article identifies success factors that ensure a working organization that is capable of implementing projects to support the energy transition and improving the well-being of citizens.

Methods

The aim of this study is to identify success factors using the example of CECOs in north western Germany through a two-step process. The first step is a literature review to identify success factors of CECOs. Second, 12 semi-structured expert interviews with managers of CECOs are conducted and evaluated by means of a qualitative content analysis. The interviews identified the success factors and barriers of CECOs. The interviews were recorded and transcribed verbatim. The coding process was carried out using a qualitative data analysis software (ATLAS.ti 8.4.5,).

Results

The results show that three factors particular should be present, but can influence each other, to lead to successful CECOs: (1) the CECOs require business models with low complexity, as business models that span different stages of the value chain can overwhelm organizational managers. (2) Committed key individuals must be found and promoted. They need the support of the members. (3) Social and ecological principles are the core values of CECOs. The maintenance and strengthening of social–ecological credibility must be promoted in the public perception.

Conclusions

The results show that CECOs emerge from a strong social cohesion in a society. In addition, local "key individuals" need to be identified and supported. To this end, the framework conditions (e.g., policy, legislation, municipal support, etc.) must be adapted in such a way that these "key individuals" in CECOs are not overburdened. The analysis of the interviews also revealed that political or regulatory barriers are often cited as obstacles to the implementation of community energy projects.
Estrogenic activity of freeze-dried silkworm extracts through the activation of estrogen receptors in MCF-7 cells
Authors: Lee Sullim , Nguyen Quynh Nhu , Kim Sung Jin , Lee Joohwan , Shin Myoung-Sook
Published: June 2022

Silkworm is an insect that feeds on mulberry leaves only, and silkworm powder has been reported to have antioxidant, hypoglycemic, and anticholesterol activities. In this study, we measured the content of 1-deoxynojirimycin (1-DNJ) in 24 different extracts from silkworm cocoons and also investigated the estrogenic activities of these extracts and their effects on the activation of intracellular signaling pathways in MCF-7 breast cancer cells. Among the 24 silkworm extracts, relatively high 1-DNJ content and estrogenic activity were shown by Extract 11 (30E3H20-1), which was prepared by a single extraction of silkworm powder with 20 times the volume of 30% ethanol against each powder weight for 3 h. The estrogen receptor activity of this extract was confirmed based on its promoting effects on the phosphorylation of the estrogen receptor α (ERα) and mRNA expression of the ESR1 and ESR2 genes. In addition, treatment with Extract 11 (30E3H20-1) increased the phosphorylation of AKT, p38, and JNK, which are downstream proteins of ERα. Based on our findings, a silkworm extract could be developed as a natural estrogen supplement in the future.
A systems perspective on early childhood development education in South Africa
Authors: Venter Lieschen
Published: June 2022

South Africa’s basic education system is dysfunctional. It scores last or close to last in a myriad of metrics and delivers learners with some of the worst literacy and numeracy competencies worldwide. A bimodal distribution in the results exists when learners from the richest socioeconomic quintile are performing adequately well, while learners from the poorest quintiles are failing. This paper presents a system dynamics simulation model to describe the causal linkages between improved early childhood and pre-school learning practices on the education system as a whole. The paper investigates the difference in performance between rich and poor communities. Three interventions explore the research question of whether it is the number of enrolments into early childhood development programs that increases a cohort’s school readiness, or rather the quality of the early childhood development programs into which they were enrolled. The results answer the research question for the Western Cape province by showing that increasing the quality of the formal ECD programs leads to a greater percentage of school-ready five year olds than increasing the percentage of enrolled children, but that decreasing community poverty leads to better results than either intervention. The results show the simulation model to be a powerful tool to assist with policy setting and intervention testing for any other province or country by simply changing the input data and calibration.
Combination of rGO/S, N/TiO2 for the enhancement of visible light-driven toluene photocatalytic degradation
Authors: Winayu Birgitta Narindri Rara , Mao Wan-Hua , Chu Hsin
Published: June 2022

Toluene is one type of common volatile organic compounds that is harmful to human health. Therefore, the degradation of toluene is critical to improving air quality value. Performance improvement of TiO2, a typically applied photocatalyst, has advantages in light absorption and electron transfer process. In this study, the TiO2 catalyst was improved by the doping of reduced graphene oxide (rGO), sulfur, and nitrogen (S, N) elements. The highest toluene photocatalytic degradation was performed under the composition of 1wt%rGO/S0.05N0.1TiO2. Improvement in photocatalytic activity was achieved by higher specific surface area, formation of oxygen-containing functional group, and chemical defect structure. However, a higher amount of rGO addition creates the shielding effect and inhibits the light penetration. Moreover, the relative humidity and applied temperature influence the photocatalytic activity through the competitive adsorption or increase the collisions frequency, respectively. During the photocatalytic degradation using 0.1wt%rGO/S0.05N0.1TiO2, toluene will be converted into benzyl alcohol, benzaldehyde, benzoic acid, water, and carbon dioxide.
Gut microbiome/metabolome predicts response to immune checkpoint blockers (ICB) in patients with recurrent metastatic head and neck squamous cell cancer (RM HNSCC).
Authors: Bari Shahla , Jain Shalini , Yadav Hariom , Liu Min , Hodge Eli , Kirtane Kedar , Chung Christine H. , Conejo-Garcia Jose , Muzaffar Jameel
Published: June 2022

6055

Background: Gut microbiome has emerged as an important predictor of response to ICB therapy in various cancers, most notably in melanoma. Due to functional redundancy of microbiota, there has been lack of consistency in gut microbial signature associated with ICB response. Microbial metabolites in addition to taxonomy may play a superior role in predicting response to ICB. Gut microbiome/metabolome signatures of ICB response is unknown in RM HNSCC patients. Methods: Two cohorts of patients were included (stool and plasma samples were collected)- cohort 1, newly diagnosed RM HNSCC patients starting first line ICB, for whom samples were collected before ICB initiation (baseline) and post-treatment at 3, 6, and 12 months. Cohort 2 with durable response (disease control lasting ≥ 6 months), with single sample collected at study entry. 16s rRNA sequencing was performed on stool samples while plasma metabolites were quantitated using Q Exactive plus Orbitrap mass spectrometer. Response was defined as partial response (PR) or complete response (CR) as per RECIST 1.1 Results: The 16-S sequence was carried on 31 samples (cohort 1- 16 baseline, 7 post treatment; cohort 2- 8 durable responders). Targeted metabolomics was completed on 92 plasma samples [cohort 1-27 baseline and 50 post-treatment, cohort 2- 15]. Responders had a significantly higher Shannon’s diversity index, lower Fermicutes to Bacteroidetes ratio, and were enriched with genus Bacteroides and Lachnospiracea incerate sedis at baseline and post treatment, compared to non-responders (p < 0.05). At species level, baseline and post treatment microbiome of responders was enriched with Eubacterium oxidoreducens and Bacteroides uniformis. Ruminococcus was preferentially enriched in durable responders. Targeted analysis of plasma metabolites (associated with gut microbial metabolism) showed that responders had a significantly lower baseline adenosine, Inosine and xanthine level as compared to non responders. Further, Inosine levels decreased with response, while levels increased in non-responders (p < 0.05), suggestive of consumption by re-activated T cells Further, ICB responders had significantly lower Kynurenine to tryptophan ratio compared to non responders Conclusions: This is the first study evaluating association of gut microbiome and metabolome on response to first line ICB, in RM HNSCC patients. We found higher diversity and specific gut microbial signatures associated with ICB response. Interestingly, we found that inosine and kynurenine/tryptophan pathways, both which play a crucial role in host as well as gut microbial metabolism were differentially expressed in ICB responders. Our results if validated in larger cohort, lays groundwork for gut microbiome and importantly microbial metabolite modulation to improve response to ICB in RM HNSCC.
Dynamic cell free HPV DNA is an early measure of treatment responsiveness in patients receiving induction chemotherapy for HPV-related head and neck cancer.
Authors: Cao Linda (Yilin) , Kiess Ana Ponce , Hwang Michael , Boudadi Karim , Saloura Vassiliki , Mattox Austin , Gramiccioni Emily , Schmitt David , Preston Jennifer , Starus Anna Malgorzata , Jones Frederick S. , Seiwert Tanguy Y. , Quon Harry
Published: June 2022

6062

Background: Induction chemotherapy (IC) is being studied as a chemoradiation (CRT) de-intensification strategy in HPV-related head and neck cancer (HNC), but using imaging response for eligibility selection is distinctly limited by delayed correlation with biological response and difficulty in distinguishing active tumor from treatment effect. We report serial cell free HPV DNA (cfHPV DNA) dynamics as a quantitative measure of early treatment responsiveness for HPV-related HNC patients receiving IC followed by CRT. Methods: Patients with high-risk HPV-positive (by in situ hybridization), locally advanced HNC who received IC followed by definitive CRT were enrolled starting on Sept 26, 2021. Patients received 1-2 cycles of platinum/taxane IC prior to initiating standard-dose CRT. Peripheral blood cfHPV DNA levels were measured biweekly during IC and weekly during CRT with the SafeSEQ HPV test from Sysmex Inostics, an NGS-based, CLIA-certified assay designed to sensitively detect and quantify HPV16 and HPV18 DNA in plasma. Tumor volumes were assessed on the pre- and post-IC planning CT scans by the treating radiation oncologist. Results: To date, 72 plasma samples have been processed across 11 enrolled patients with median age 66 years (range: 35-79). The primary disease sites included 7 oropharynx (OPX), 1 sinonasal, 2 nasopharyngeal, and 1 larynx. All patients had at least cT3 disease or cN3 disease (AJCC 8), with 6 patients having cT4 disease. Five (45.5%) have a smoking history, each > 10 pack-years. We report cfHPV DNA and tumor volume measurements at key timepoints for the 8 patients who have completed IC below. Conclusions: Serial cfHPV DNA identifies a group of locally advanced HPV-related HNC patients who have complete/near-complete cfDNA clearance during IC. This may provide an earlier readout of individualized treatment responsiveness compared to radiologic assessment, and may therefore be a preferred metric for CRT de-intensification eligibility. Clearance velocity will be evaluated with our granular biweekly IC and weekly CRT cfHPV DNA dataset to help further elucidate tumor response kinetics with this paradigm. [Table: see text]
Feasibility and quality of life of postoperative concurrent radiotherapy and toripalimab in elderly patients with head and neck squamous cell carcinoma (IMPORT trial).
Authors: Zhang Ximei , Dou Shengjin , Tao Lei , Jiang Wen , Ye Lulu , Li Rongrong , Zhu Guopei
Published: June 2022

6066

Background: For elderly patients with locally advanced head and neck squamous cell carcinoma (HNSCC), the role of postoperative concurrent chemotherapy was controversial since the intolerable toxicities and increased acute mortality, thus, radiotherapy alone was recommended. Aimed to seek out a feasible regimen for concurrent treatment, we evaluated the feasibility and quality of life of postoperative concurrent radiotherapy and toripalimab (anti-PD-1 antibody) in elderly HNSCC patients. Methods: The IMPORT trial was an investigator-initiated, multicentre, open-label, parallel-group, phase 2, randomized study. Patients were enrolled at 3 hospitals in China. We randomly assigned (1:1) patients aged＞65 years, with ECOG Performance Status(PS) of 0–2, and with postoperative Stage III-IV (AJCC 8th Staging system) HNSCC to concurrent radiotherapy (60-66Gy) and toripalimab (240mg on D0, D21 and D42)(RT+PD-1 group) or radiotherapy alone(RT group). Following stratification by PS(0-1 vs 2) and pathological adverse features (extranodal extension or positive margin vs others), patients were randomly assigned using a computer-generated randomization list. Acute toxicities were reported. Quality of life were evaluated by EORTC QLQ-C30 and QLQ-H&N35 at baseline, week3, week6 and 1 month after radiotherapy, and the standard scores were compared between groups by linear mixed-effects models. Results: Between September 2020 and December 2021, 38 patients randomly assigned(19 per group). The median age were 70 years (range 66-81) for the RT+PD-1 group and 73 years (range 67-78 years) for RT group. 16 (84.2%) patients in the RT+PD-1 group and 15 (78.9%) patients in the RT group complete the planed radiation dose. In the RT+PD-1 group, 13 (68.4%) patients completed 3 cycles of toripalimab, 3 (15.8%) patients completed 2 cycles due to adverse events and 3 (15.8%) patients declined toripalimab; The most common adverse events of grade 3-5 was oral mucositis (55.6% vs 58.8%) and lymphocyte count decreased(61.1% and 41.2%) in RT+PD-1 group and RT group. In the RT+PD-1 group, only 1 patients experienced grade 3 immune-related enteritis. As to the quality of life scores evaluated by QLQ-C30, no difference was found in standard score of global health status, as well as in most functional scales including: physical, emotion, cognitive and social, except for role functioning (p = 0.045). As to the symptom scale scores evaluated by QLQ-H&N35, no difference was found in standard score of pain, swallowing, dry mouth, opening mouth, and stick saliva, except for speech problem (p = 0.032). Conclusions: For elderly patients with locally advanced HNSCC, postoperative concurrent radiotherapy and toripalimab was safe and feasible. Concurrent toripalimab did not worsen quality of life scores in the majority of cases. Clinical trial information: NCT04523883.
Yatagarasu: A single-arm, open-label, phase 2 study of apalutamide (APA) plus goserelin (GOS) for patients (pts) with far locally advanced or recurrent/metastatic (fLA/RM) and androgen receptor (AR)-expressing salivary gland carcinoma (SGC).
Authors: Honma Yoshitaka , Monden Nobuya , Yamazaki Keisuke , Kano Satoshi , Satake Hironaga , Kadowaki Shigenori , Nagao Toshitaka , Nakatogawa Tomohiko , Fujii Koji , Koroki Yosuke , Aoyama Junya , Ouchi Shohei , Ogawa Tetsuro , McCarthy Sharon , Brookman-May Sabine D. , Mundle Suneel , Li Jinhui , Tada Yuichiro
Published: June 2022

6079

Background: Overexpression of AR is identified as a potential molecular target of SGC treatment. Combined androgen blockade (CAB) with bicalutamide has been evaluated previously, but the clinical usefulness of CAB with a next generation AR inhibitor has been unclear in SGC. We prospectively assessed the efficacy and safety of APA+GOS for pts with AR-expressing SGC. Methods: Eligible pts had fLA/RM SGC, and AR expression with at least 1% of cell nuclei immunohistochemistry staining positive. Pts were treated with APA 240 mg orally once daily and GOS 3.6 mg subcutaneously once 28 days. Primary endpoint was overall response rate (ORR) by central review according to RECIST v1.1, and a response (complete response [CR] or partial response [PR]) was confirmed by repeat assessments at least 4 weeks after the initial evaluation showing a response. Primary analysis was performed based on first 24 response evaluable (RE) pts who had been observed at least 24 weeks (Primary RE pts). The ORR was tested using exact test based on the binominal distribution, the null hypothesis for ORR of 14% was rejected when at least 8 of the 24 Primary RE pts were responders, and the efficacy was to be declared. Key secondary endpoints included clinical benefit rate (CBR), disease control rate (DCR), duration of response (DOR), and time to response (TTR) in the Primary RE pts, and overall survival (OS), progression free survival (PFS), and safety in the treated pts. Results: Twenty-six of the 31 pts treated with APA+GOS were regarded as RE by central review. For the 24 Primary RE pts, ORR was 25.0% (6/24), while 37.5% (9/24) including unconfirmed PR. Clinical benefit rate and DCR in the Primary RE pts were 50.0% and 70.8%, respectively. At the data cut-off (Apr 28, 2021), 5 of 6 pts with confirmed response were still on protocol treatment. Median PFS and OS in the treated pts were 7.43 months (mos) and not reached, respectively, with the median follow-up period of 8.57 mos. Grade 3 or higher treatment-related adverse events were reported in 4/31 (12.9%) pts, and the events were rash maculo-papular (n=2), anemia (n=1), and leukopenia (n=1). Conclusions: This is the first prospective trial evaluating CAB with APA for AR-expressing SGC. Although this study did not meet the predefined criteria of efficacy, clinically meaningful activity with well-tolerated safety profile of APA+GOS was shown. Clinical trial information: NCT04325828. [Table: see text]
Home Blood Pressure for the Prediction of Preeclampsia in Women With Preexisting Diabetes
Authors: Do Nicoline Callesen , Vestgaard Marianne , Ásbjörnsdóttir Björg , Andersen Lise Lotte Torvin , Jensen Dorte Møller , Ringholm Lene , Damm Peter , Mathiesen Elisabeth Reinhardt
Published: June 2022

Context

Outside of pregnancy, home blood pressure (BP) has been shown to be superior to office BP for predicting cardiovascular outcomes.

Objective

This work aimed to evaluate home BP as a predictor of preeclampsia in comparison with office BP in pregnant women with preexisting diabetes.

Methods

A prospective cohort study was conducted of 404 pregnant women with preexisting diabetes; home BP and office BP were measured in early (9 weeks) and late pregnancy (35 weeks). Discriminative performance of home BP and office BP for prediction of preeclampsia was assessed by area under the receiver operating characteristic curves (AUC).

Results

In total 12% (n = 49/404) developed preeclampsia. Both home BP and office BP in early pregnancy were positively associated with the development of preeclampsia (adjusted odds ratio (95% CI) per 5 mm Hg, systolic/diastolic): home BP 1.43 (1.21-1.70)/1.74 (1.34-2.25) and office BP 1.22 (1.06-1.40)/1.52 (1.23-1.87). The discriminative performance for prediction of preeclampsia was similar for early-pregnancy home BP and office BP (systolic, AUC 69.3 [61.3-77.2] vs 64.1 [55.5-72.8]; P = .21 and diastolic, AUC 68.6 [60.2-77.0] vs 66.6 [58.2-75.1]; P = .64). Similar results were seen when comparing AUCs in late pregnancy (n = 304). In early and late pregnancy home BP was lower than office BP (early pregnancy P < .0001 and late pregnancy P < .01 for both systolic and diastolic BP), and the difference was greater with increasing office BP.

Conclusion

In women with preexisting diabetes, home BP and office BP were positively associated with the development of preeclampsia, and for the prediction of preeclampsia home BP and office BP were comparable.
Context in Context
Authors: Burke Peter
Published: June 2022

This essay, published originally in 2002, is reprinted in “Contextualism—The Next Generation: Symposium on the Future of a Methodology,” because of its impact on the thinking that informs and has led to this new symposium. Burke's argument is that the term context has become “an intellectual slogan or shibboleth” and that “there is a price to pay” for its “more and more frequent use . . . in a number of disciplines—among them, anthropology, archaeology, art history, geography, intellectual history, law, linguistics, literary criticism, philosophy, politics, psychology, sociology, and theology.” A brief history of the uses of the term and its cognates in these disciplines is provided, along with an examination of “recent interest in the phenomenology of recontextualism or ‘reframing,’” which “depends on agency, creativity, and the power to adapt” and which, indeed, almost defines what is meant by “originality, innovation, invention, or creativity.” The essay concludes that context ought to be used mainly in the plural to indicate that no topic is properly interpretable in any single framework.
Blindfolded
Authors: Perl Jeffrey M.
Published: June 2022

In a monograph-length contribution to the Common Knowledge symposium on contextualism, the journal's editor decontextualizes and then recontextualizes the medieval iconographic trope of Ecclesia and Synagoga in an effort to make plausible a news story about Pope Francis that received little coverage in the press. During 2015, the fiftieth anniversary of the Vatican II declaration Nostra Aetate, Francis paid a surprise visit to a new statue in the United States, “Synagoga and Ecclesia in Our Time” by Joshua Koffman, as a sign of his endorsement of its radical reconsideration of a trope long associated with anti-Jewish sentiment in the Catholic Church. This article, which begins with a detailed analysis of Emeritus Pope Benedict XVI's essay on the Nostra Aetate treatise De Iudaeis, deals primarily with twelfth- and thirteenth-century uses of the iconography. Special attention is paid to the Anagogical Window of the Royal Abbey of Saint-Denis and to the Ecclesia, Synagoga, and King Solomon statues on the south facade of Strasbourg Cathedral, in both of which is found previously overlooked evidence of philo-Semitic, rather than anti-Semitic, thinking on the part of the designers. The article concludes that contextualist scholars of medieval art have found what they expected to find and ignored contrary indications.
Heterogeneous Global Booms and Busts
Authors: Farboodi Maryam , Kondor Péter
Published: June 2022

We investigate the heterogeneous boom and bust patterns across countries that emerge as a result of global shocks. Our analysis sheds light on the emergence of core and periphery countries, and the joint determination of the depth of recessions and tightness of credit across countries. The model implies that interest rates are similar across core and periphery countries in booms, with larger credit and output growth in periphery countries. However, a common global shock that leads to a credit crunch across the globe gives rise to a sharper spike in interest rates and a deeper recession in periphery countries, while a credit flight to the core alleviates the adverse consequences in these countries. (JEL E21, E32, E43, E44, F44, G01, G15)
Monetary Policy with Opinionated Markets
Authors: Caballero Ricardo J. , Simsek Alp
Published: June 2022

We build a model in which the Fed and the market disagree about future aggregate demand. The market anticipates monetary policy “mistakes,” which affect current demand and induce the Fed to partially accommodate the market’s view. The Fed expects to implement its view gradually. Announcements that reveal an unexpected change in the Fed’s belief provide a microfoundation for monetary policy shocks. Tantrum shocks arise when the market misinterprets the Fed’s belief and overreacts to its announcement. Uncertainty about tantrums motivates further gradualism and communication. Finally, disagreements affect the market’s expected inflation and induce a policy trade-off similar to “ cost-push” shocks. (JEL D83, E12, E31, E43, E44, E52, E58)
Digital Addiction
Authors: Allcott Hunt , Gentzkow Matthew , Song Lena
Published: June 2022

Many have argued that digital technologies such as smartphones and social media are addictive. We develop an economic model of digital addiction and estimate it using a randomized experiment. Temporary incentives to reduce social media use have persistent effects, suggesting social media are habit forming. Allowing people to set limits on their future screen time substantially reduces use, suggesting self-control problems. Additional evidence suggests people are inattentive to habit formation and partially unaware of self-control problems. Looking at these facts through the lens of our model suggests that self-control problems cause 31 percent of social media use. (JEL D12, D61, D90, D91, I31, L86, O33)
Thin subsidies effects on food consumption pattern and nutritional status of poor Brazilian children
Authors: Da Costa Silva Maria Micheliana
Published: June 2022

This paper aims to analyze the thin subsidies effect on nutritional status and individual food acquisition for individuals in poverty between 2 and 9 years old. With the data of a Brazilian family budget survey, I estimated a model that identifies the individual consumption of calories, based on aggregate household consumption, followed by the estimation of a child health production function, which verifies the effect of a set of variables on Body Mass Index (BMI). Finally, I estimated the children's food demand system for various food categories (healthy and unhealthy). I found that the implementation of thin subsidies can be effective for the variability of healthy food destined to children, contributing significantly to the joint increase in food consumption that reduced prices (fruits, vegetables, fish and milk). However, only the variation in the amount of fruit suffers a variation that is more than proportional to the 20% variation in the price of the selected basket. The discount increases unhealthy food consumption (ultraprocessed and soft drinks) due to the complementarity relationship. Thereby, the combined discount granted to a healthy food basket increases the average total caloric intake. This intervention does not reverse the process of average BMI growth of economically vulnerable children and, consequently, it could not reduce the incidence of childhood obesity. In general, the analysis proposed was essential to understand how specific policy interventions can encourage healthy habits, giving attention to their impacts on vulnerable individuals. Children nutritional status. Children food demand system. Thin subsidies.
Interdisciplinary perspectives of rehabilitation in adult brachial plexus palsies
Authors: Trofin Dan , Trofin Daniela Marilena , Luca Catalina , Matei Daniela , Ignat Bogdan , Stamate Teodor
Published: June 2022

The aim of this study is to demonstrate that the interdisciplinary approach could have a positive result on the rehabilitation program in brachial plexus paralysis in adults. The prevalence of brachial plexus injuries is currently increasing worldwide, mainly due to the growing number of car accidents, extreme sports or work-related injuries. In this study we chose to present an analysis of one complex surgical case of brachial plexus paralysis, with clinical and electrophysiological investigations. (1) Background: Current reconstructive surgical nerve transfer procedures aim to rehabilitate elbow flexion in such cases. Surgical strategies are based not only on clinical evaluation or investigations by magnetic resonance imaging but also on classical electrophysiological methods, such as electromyography (EMG). (2) Methods: Along with the other types of therapies already established, in the case of this pathology, Transcranial Magnetic Stimulation (TMS) is also used, which provides valuable information about cortical reorganization models concomitant with surgical procedures for nerve reconstruction in the last 3 decades. (3) Results: The study shows that interdisciplinary leads to a faster and more complex rehabilitation of the patient with brachial plexus paralysis and that electrophysiological signals could predict constant motor benefits when associated with rehabilitation programs.
Keywords: brachial plexus; electromyography; transcranial magnetic stimulation; neuroplasticity;
The effects of pediatric flat foot on the frontal alignment of proximal segment
Authors: Panaet Adelina Elena , Alexe Cristina Ioana , Stângaciu Oana Ancuța , Hazar Fatih , Rață Gloria , Alexe Dan Iulian , Hofmeister Martin
Published: June 2022

The purpose of this study was to determine the effects of flat foot on the frontal alignment of calcaneus and tibia in 23 children with flat feet, aged 7-9 (7.43±0.58 years old). To evaluate the foot, the Foot Posture Index-6 (FPI 6) was used, while the posture of the calcaneus and the tibia was analyzed using the Global Postural System 400. The statistical results indicate strong intensity links between flat foot and the frontal alignment of the calcaneus and the tibia, as follows: FPI 6 right foot score and calcaneus - right foot angle (r= 0.824; p < 0.001), tibia - right foot angle (r= 0.588; p < 0.001); FPI 6 left foot score and calcaneus - left foot angle (r= 0.824; p < 0.001), tibia - left foot angle (r= 0.853; p < 0.001). Our study demonstrates that pediatric flat foot has the capacity to significantly influence the values of the angle of the calcaneus and tibia in a frontal plane.
Keywords: pediatric flat foot, Foot Posture Index-6,proximal segments