bluuebunny/crossref_metadata_2025 huggingface dataset:
Bayesian K-means clustering based quality of experience aware multimedia video streaming
Authors: Peddareddygari Bayya Reddy Manjunatha , Shagathur Narayanappa Sheshappa
Published: January 2024

Media streaming is an essential approach for delivering multimedia information from the source distributor to the end-user through the Internet. Along with the development of more number of users and the spread of mobile devices, the availability and diversity of multimedia applications has also increased. Multimedia users primarily prioritize quality of experience (QoE), as they seek to access multimedia content with high availability and enjoy smooth video streaming in the shortest possible time. The impact of video delivery plays a significant role in QoE, which is efficiently made by delivering the content through a specialized content delivery network architecture. In this research, a Bayesian K-means clustering algorithm is proposed for the identification of QoE in multimedia video streaming. In this multimedia video streaming, the Amazon Prime video dataset is utilized for determining the performance of the proposed model. The proposed method is developed from the ‘Patching Up’ the video quality problem (PatchVQ) model, the from patches to pictures (PaQ-2-PiQ) model is utilized for the spatial feature extraction, and 3D ResNet-18 is utilized for temporal feature extraction. The proposed Bayesian K-means achieved a QoE reward function of 5,237.42 and 5841.36 as well as a fairness reward function of 5,841.36 and 8,732.08 at the speed of 1,500 kB/s and 2,000 kB/s respectively.
Oggetto e meta-oggetto in semiotica: un rapporto unico
Authors: Caputo Cosimo
Published: January 2024

In semiotica e in linguistica la necessità di un oggetto epistemologicamente definito e specifico rispetto al vasto campo dei vari fenomeni comunicativi, e di uno specifico meta-oggetto o metalinguaggio, si rafforza con l’approccio strutturale che porta con sé anche un mutamento dell’idea di scienza del linguaggio, porta a una scienza duale: “uno formato da due”. Si tratta di una scienza che non considera le sue categorie come autonome, ma le considera “per altro”, in relazione con altre categorie. Nella dualità la storicità si prospetta come compartecipazione di strati di tempi asimmetrici, come attualizzazione di potenzialità semantiche: l’oggetto teorico si palesa come un “cronotopo” per cui lo spazio della teoria s’intreccia col movimento del tempo. La lingua utilizza sempre la stessa materia antica per le sue innovazioni, è capace di parlare di se stessa, di essere oggetto e condizione del suo meta-oggetto; parla di se stessa producendo un metalinguaggio aperto, risultante da un processo di traduzione o di autotraduzione, di metariflessione. Il rapporto fra oggetto e meta oggetto è ambivalente ed è costitutivo della scienza del linguaggio: l’oggetto (il linguaggio) contiene la sua teoria, ragion per cui il loro è un “rapporto unico”.
La semiotica tra scienza e filosofia. Una duplicità epistemologica strategica
Authors: Fossali Pierluigi Basso
Published: January 2024

La semiotica ha una posizione epistemologica complessa e delicata: ascritta al novero delle scienze del linguaggio, o talora alle scienze dell'informazione e della comunicazione, emerge spesso come una disciplina con accenti o pretese filosofiche, anche se per alcuni dovrebbe limitarsi a un ruolo ancillare, offrendosi come puro apporto metodologico per altre discipline. I contributi “sproporzionati” della semiotica – debordanti nei temi e troppo sofisticati e gergali nelle argomentazioni – possono suggerire l’idea di rinunciare infine all'istituzionalizzazione di una disciplina autonoma; d'altra parte, si ritiene che il compito di prendere in considerazione tutti i linguaggi e i loro usi intrecciati sarebbe di per sé eccessivo. Questa rinuncia favorirebbe il riconoscimento del semiotico come dominio antropologico delle mediazioni simboliche, un dominio che può essere affrontato da diverse prospettive disciplinari classiche, o almeno da quelle che sono in grado di specificare meglio il loro oggetto e i limiti delle loro pertinenze descrittive. In questo contributo, cerchiamo di proporre alcuni argomenti per muoversi in una direzione opposta, al fine di riaffermare il progetto della semiotica come disciplina sui generis che cerca di articolare la filosofia e la scienza da una specifica angolatura, quella per cui una critica semiotica del pensiero dovrebbe articolarsi con un pensiero critico delle mediazioni.
Uma palestra motivacional: um olhar goffmaniano sobre uma forma de comunicação organizacional do capitalismo contemporâneo
Authors: Santos Ana Paula , Martino Luís Mauro Sá
Published: January 2024

Palestras motivacionais vêm se afirmando como uma das formas por excelência da comunicação organizacional, na medida em que parecem responder às lógicas contemporâneas de comprometimento e engajamento com os valores e as práticas das organizações. A partir de observação participante realizada entre 2018 e 2019, este texto delineia alguns dos principais aspectos desse tipo de comunicação, dirigindo ao objeto empírico um olhar inspirado nos trabalhos de Goffman, secundados por bibliografia referente às transformações contemporâneas do capitalismo. Três aspectos são observados: a adequação do formato às demandas do capitalismo informacional, a apresentação de si como fonte de validação da fala e como representação de valores a serem seguidos.
Protocolo de Comunicação Comunitária voltado aos territórios, às comunidades e aos modos de vida no Maranhão
Authors: Santos Amarilis Cardoso , Moura Flávia Almeida
Published: January 2024

Protocolo de Comunicação Comunitária voltado aos territórios, às comunidades e aos modos de vida no Maranhão; um método de correlação entre a teoria e a prática a partir das particularidades desse território para assim se tornar uma possibilidade para o mercado adotar e reaplicar. Este artigo é resultado da nossa dissertação de mestrado que revisitou as teorias voltadas ao estudo da comunicação organizacional, comunicação comunitária e da alteridade, especialmente por meio do legado acadêmico da professora Cicilia Peruzzo, a fim de propiciar uma solução e contribuir com a área de comunicação comunitária no Maranhão ao se entregar um protocolo como forma de contribuição à ação da prática profissional a partir da contemplação do local.
Lideranças e cuidado na gestão de riscos em organizações brasileiras
Authors: Oliveira Rosângela Florczak de , Nunes Ana Karin , Silva Diego Wander da
Published: January 2024

Apontados como elementos que atrasam a gestão de riscos e de crise no Brasil, a cultura organizacional e as lideranças seguem constando na lista de entraves. Ao analisar a Pesquisa de Mercado: gestão de risco e crise, realizada pelo Grupo de Pesquisa Risco, Crise e Comunicação (RCCom), da Universidade Federal do Rio Grande do Sul (UFRGS) e Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS), o objetivo deste artigo é refletir sobre a atuação das lideranças nas estratégias de cuidado que caracterizam a gestão de riscos e a cultura preventiva às crises.
Reputação Sensível: narrativas que acionam sentimentos, emoções e afetos
Authors: Scroferneker Cleusa Maria Andrade , Pagnussatt Denise
Published: January 2024

O presente artigo tem como objetivo discutir a materialidade das dimensões sensíveis acionadas nos discursos reputacionais da Natura, especialmente da Natura Sou. Para atender esse objetivo, que se constitui num recorte da tese de doutorado, optamos pela Hermenêutica de Profundidade, pelo Estudo de Caso e Análise de Discurso. Os resultados evidenciam que os discursos da Natura Sou configuram o que denominamos de Reputação Sensível por meio de narrativas que enfatizam sentimentos, emoções e afetos.
Prediction of Intracranial Atherosclerotic Disease‐Related Large‐Vessel Occlusion Stroke on the Basis of Novel Cerebral Blood Volume Parameters
Authors: Koh Seungyon , Park So Young , Liebeskind David S. , Choi Jin Wook , Kim Han Ki , Choi Jun Young , Kim Min , Lee Seong‐Joon , Hong Ji Man , Lee Jin Soo
Published: January 2024

Background

Mechanical thrombectomy is an effective treatment method for large‐vessel occlusion stroke (LVOS); however, it has limited efficacy for intracranial atherosclerotic disease (ICAD)‐related LVOS. We investigated the use of cerebral blood volume (CBV) maps for identifying ICAD as the underlying cause of LVOS before the initiation of endovascular treatment (EVT).

Methods and Results

We reviewed clinical and imaging data from patients who presented with LVOS and underwent endovascular treatment between January 2011 and May 2021. The CBV patterns were analyzed to identify an increase in CBV within the hypoperfused area and estimate infarct patterns within the area of decreased CBV. Comparisons were made between the patients with an increase in CBV and those without, and among the estimated infarct patterns: territorial, cortical wedge, basal ganglia–only, subcortical, and normal CBV. Overall, 243 patients were included. CBV increase in the hypoperfused area was observed in 23.5% of patients. A significantly higher proportion of ICAD was observed in those with increased CBV than in those without (56.4% versus 19.8%;
P
<0.001). Regarding the estimated infarct patterns on the CBV, ICAD was most frequently observed in the normal CBV group (territorial, 14.9%; cortical wedge, 10.0%; basal ganglia–only, 43.8%; subcortical, 35.7%; normal, 61.7%). CBV parameters, including “an increase in CBV,” “normal CBV infarct pattern,” and “an increase in CBV or normal CBV infarct pattern composite,” were independently associated with ICAD.

Conclusions

An increased CBV or normal CBV pattern may be associated with ICAD LVOS on the pretreatment perfusion imaging.
United States Education Structure is Under Stress: Exploring the Destabilization of Academia's System Settings
Authors: Riley Jen , Bryant Morgan M. , Nicewicz-Scott Kate , Watson Amy , Turner-Henderson Tiffanie
Published: January 2024

This research interprets the destabilization in U.S. higher education using Layton's theory of marketing systems to detail disruptions to academia's system settings. It highlights three impacted areas: governance, sentiment, and transformation. The authors examine the interplay between societal, technological, competitive, and political power shifts as major disruptors reshaping higher education. It critically examines these shifts by intertwining history with the demands of today's evolving landscape, emphasizing the need for transformative change. Layton's theory is utilized in this study to provide stakeholders a starting point to make informed, situationally aware strategic decisions during the choice and value-added phases of the framework based on Layton's Marketing Systems Theory.
Risk of cardiovascular disease in patients with multiple sclerosis treated with fingolimod compared to natalizumab: A nationwide cohort study of 2095 patients in Denmark
Authors: Framke Elisabeth , Thygesen Lau Caspar , Malmborg Morten , Schou Morten , Sellebjerg Finn , Magyari Melinda
Published: January 2024

Background:

Fingolimod may be associated with risk of developing cardiovascular disease (CVD). Studies including reference groups and long follow-up are scarce.

Objectives:

We hypothesized that patients treated with fingolimod would be at higher risk of developing CVD compared to patients treated with natalizumab.

Methods:

A nationwide 12-year cohort study linking individual-level data from the Danish Multiple Sclerosis Registry with health registries on 2095 adult patients with multiple sclerosis (MS) without any health records of CVD at follow-up start. Exposure to fingolimod and natalizumab was defined by the first treatment of at least 3 months. Cohort entry was from 2011 to 2018. We defined CVD as a composite measure, including hypertension, ischemic heart disease, atrial fibrillation, heart failure, and stroke. We used multivariable adjusted Cox regression.

Results:

There were 28.8 and 17.4 CVD events per 1000 person-years in fingolimod and natalizumab groups, respectively. Compared to natalizumab-treated patients, fingolimod-treated patients had a higher risk of CVD (hazard ratio (HR) = 1.57; 95% confidence interval (CI) = 1.18–2.08). Hypertension comprised 200 of 244 CVD events.

Conclusion:

We found an increased risk of CVD in patients with MS treated with fingolimod. This increased risk was mainly due to hypertension.
Association between concussion understanding and stakeholder knowledge translation in collegiate sports
Authors: Giguere Debbie , Barnes Martha , Faught Brent E.
Published: January 2024

The purpose of this study was to determine if there was an association between concussion understanding and stakeholder knowledge translation in collegiate sports following the mandate of Rowan's Law in Ontario, Canada. To our knowledge, this is the first study to examine concussion knowledge translation within a sport network using social network analysis. A cross-sectional design was used to evaluate 76 collegiate athletes (54 females, 21 males, 1 not identified), aged 20.55 years (SD = 3.4) who completed a survey on sport demographics, concussion knowledge and stakeholders who provided concussion information during the sport season. Athlete concussion knowledge scores and reported stakeholders were examined. An average of three key stakeholders provided concussion information to 82% of the varsity athletes in our study. Athletes reported that a coach or athletic trainer most often provided concussion knowledge. Overall, athlete concussion knowledge scores were the same for athletes who sought concussion knowledge from stakeholders and those who did not. Over 95% of athletes in the study did not access the Rowan's Law website for mandated concussion education. These findings suggest that Rowan's Law is hugely neglected resulting in stakeholder knowledge translation having minimal influence on an athletes’ understanding of concussions. Future recommendations include verified review of mandated concussion education resources and testing of concussion knowledge for all persons associated with sport in Ontario. Due to the number of athletes seeking concussion knowledge in their varsity athlete network, accurate sport specific resources should be provided to support stakeholders who are in direct contact with athletes.
The Feasibility of Using Point of Care Ultrasound as a Visual Substitute for Physical Examination During Telehealth Visits: A Pilot Project
Authors: Passero Vida C. , Conley Nicole , Finley Erin P. , Schott Christopher Kevin
Published: January 2024

Telehealth provides greater opportunity for specialty access but lacks components of the physical exam. Point-of-care ultrasound (POCUS) may assist telehealth as a visual substitute for the provision of palpation. We conducted a prospective observational pilot project to survey oncologists about (1) their expectations of POCUS, (2) their use of POCUS in oncology telehealth visits, and (3) post-project assessment of their experiences. The results of the pre-assessment survey showed an interest among the oncologists in the ability to evaluate structures remotely via POCUS. POCUS was utilized in 6.4% of visits, most commonly for lymph node assessment (60% of use). POCUS was not utilized most often due to not being applicable to the patient's visit. There were 14 instances of technical issues limiting views of the relevant anatomy reported. Oncologists rated the use of POCUS as very satisfied or satisfied in the vast number of recorded responses. This pilot study suggests POCUS can be integrated into oncology telehealth visits for specific applications such as lymph node assessment. The surveys indicated a potential interest and positive responses that provide for the foundation of expansion to subspecialty care access for patients with telehealth supported by POCUS.
Adherence to Practice Guidelines in the Implementation of Emergency Obstetric and Newborn Care in Referral Hospitals in Osun State, Nigeria
Authors: Komolafe Abiola Olubusola , Olajubu Aanuoluwapo Omobolanle , Ijarotimi Omotade Adebimpe , Ogunlade Oluwasayo Bolarinwa , Olowokere Adekemi Eunice , Irinoye Omolola Oladunni
Published: January 2024

Introduction

While practice guidelines support clinical decision-making for optimal patient outcomes, there is often nonadherence to practice guidelines in implementing evidence-based interventions.

Objectives

This article aimed to assess adherence to practice guidelines in emergency obstetric and newborn care (EmONC) and the outcome of pregnancy in cases of obstetric complications in referral hospitals.

Method

The study employed a descriptive design. A purposive sampling technique was used to select the three tertiary hospitals and six out of nine state hospitals in Osun State. A data extraction form developed based on a fidelity framework was used to collect data on Adherence from 264 cases of obstetric complications. Descriptive statistics, such as frequency and percentage, and inferential statistics, such as chi-square, were done with the significance level set as p < .05.

Results

Findings showed low adherence to practice guidelines in 70.8% of hemorrhage care, 52.0% of fetal distress care, 60.0% of prolonged obstructed labor care, and 44.4% of preeclampsia/eclampsia care. The study's findings also showed that 64.3% of cases of prolonged/obstructed labor, 54.9% of cases of fetal distress, and 46.7% of all cases of obstetric complications were referred out at the state hospitals. Neonatal mortality in state and tertiary hospitals was 3.7% and 21.7%, respectively, which was significantly different ( p < .001).

Conclusion

There was low adherence to practice guidelines for the implementation of EmONC in state and tertiary hospitals, and a significant number of cases of obstetric complications were referred out in the state hospitals. The low adherence to practice guidelines and numerous referrals truncate the successful implementation of EmONC and hinder women and newborns from receiving optimal care for obstetric complications. There is a need to develop strategies that promote adherence to practice guidelines in implementing EmONC.
Determinants of bleeding before and during immune tolerance in 222 boys with severe hemophilia A and inhibitors >5 BU
Authors: Fischer Kathelijn , Kenet Gili , Kurnik Karin , Carcao Manuel , Oldenburg Johannes , Stamm-Mikkelsen Torben , Cid Haro Ana Rosa , Koskenvuo Minna , Blatny Jan , Königs Christoph
Published: January 2024

Prevention of bleeding and its consequences is the main goal of hemophilia treatment and determines treatment choices for patients who develop inhibitors. To assess bleeding before and during immune tolerance induction (ITI) and its association with ITI regimen and inhibitor titer, we selected and analyzed data on patients receiving high-titer inhibitors from the international prospective PedNet cohort study. In total, 222 patients with severe hemophilia A and inhibitor titers of >5 Bethesda units (BU) were followed from the first positive to the first negative inhibitor result (median overall follow-up, 1.7 years). Mean annual (joint) bleeding rates (AJBR) and 95% confidence intervals (CIs) were compared according to treatment and inhibitor titer using multivariable negative binomial regression. Before ITI, 115 patients showed an ABR of 6.1 (5.0-7.4) and an AJBR 2.6 (2.1-3.2). Bleeding was independent of inhibitor titer. During ITI, 202 patients had an ABR of 4.4 (3.9-5.1) and an AJBR of 1.7 (1.5-2.0). AJBR during ITI increased with inhibitor titer (hazard ratio [HR] for ≥200 BU vs 5 to 39 BU [4.9; CI, 3.2-7.4]) and decreased with daily ITI infusions (HR, 0.4; CI, 0.3-0.6) or activated prothrombin complex concentrate prophylaxis (HR, 0.4; CI, 0.2-0.8), whereas ITI dose and recombinant activated factor VII prophylaxis did not independently affect bleeding. These data provide evidence for a protective effect of repeated FVIII infusions (ITI) on bleeding in patients who have developed inhibitors; these data should be used to plan ITI and/or serve as a comparator for prophylaxis with nonreplacement therapy.
Single-cell transcriptomic analysis of human pleura reveals stromal heterogeneity and informsin vitromodels of mesothelioma
Authors: Obacz Joanna , Valer Jose Antonio , Nibhani Reshma , Adams Taylor S. , Schupp Jonas C. , Veale Niki , Lewis-Wade Amanah , Flint Jasper , Hogan John , Aresu Giuseppe , Coonar Aman S. , Peryt Adam , Biffi Giulia , Kaminski Naftali , Francies Hayley , Rassl Doris M. , Garnett Mathew J. , Rintoul Robert C. , Marciniak Stefan J.
Published: January 2024

The pleural lining of the thorax regulates local immunity, inflammation and repair. A variety of conditions, both benign and malignant, including pleural mesothelioma, can affect this tissue. A lack of knowledge concerning the mesothelial and stromal cells comprising the pleura has hampered the development of targeted therapies. Here, we present the first comprehensive single-cell transcriptomic atlas of the human parietal pleura and demonstrate its utility in elucidating pleural biology. We confirm the presence of known universal fibroblasts and describe novel, potentially pleural-specific, fibroblast subtypes. We also present transcriptomic characterisation of multiplein vitromodels of benign and malignant mesothelial cells, and characterise these through comparison within vivotranscriptomic data. While bulk pleural transcriptomes have been reported previously, this is the first study to provide resolution at the single-cell level. We expect our pleural cell atlas will prove invaluable to those studying pleural biology and disease. It has already enabled us to shed light on the transdifferentiation of mesothelial cells, allowing us to develop a simple method for prolonging mesothelial cell differentiationin vitro.
Influence of physical activity on the prognosis of COPD patients: the HADO.2 score – health, activity, dyspnoea and obstruction
Authors: Esteban Cristóbal , Larrea Nere , Aramburu Amaia , Moraza Javier , Chasco Leyre , Aburto Myriam , Aizpiri Susana , Golpe Rafael , Quintana José M.
Published: January 2024

Objective

The aim of this study was to create a prognostic instrument for COPD with a multidimensional perspective that includes physical activity (PA). The score also included health status, dyspnoea and forced expiratory volume in 1 s (HADO.2 score).

Methods

A prospective, observational, non-intervention study was carried out. Patients were recruited from the six outpatient clinics of the respiratory service of a single university hospital. The component variables of the HADO.2 score and BODE index were studied, and PA was measured using an accelerometer. The outcomes for the HADO.2 score were mortality and hospitalisations during follow-up and an exploration of the correlation with health-related quality of life at the moment of inclusion in the study.

Results

401 patients were included in the study and followed up for three years. The HADO.2 score showed good predictive capacity for mortality: C-index 0.79 (0.72–0.85). The C-index for hospitalisations was 0.72 (0.66–0.77) and the predictive ability for quality of life, as measured by R2, was 0.63 and 0.53 respectively for the Saint George's Respiratory Questionnaire and COPD Assessment Test.

Conclusions

There was no statistically significant difference between the mortality predictive capacity of the HADO.2 score and the BODE index. Adding PA to the original BODE index significantly improved the predictive capacity of the index. The HADO.2 score, which includes PA as a key variable, showed good predictive capacity for mortality and hospitalisations. There were no differences in the predictive capacity of the HADO.2 score and the BODE index.
Outcomes of listing for lung and heart–lung transplantation in pulmonary hypertension: comparative experience in France and the UK
Authors: Pradère Pauline , Le Pavec Jérome , Bos Saskia , Pozza Andre , Nair Arun , Meachery Gerard , Lordan James , Humbert Marc , Mercier Olaf , Fadel Elie , Savale Laurent , Fisher Andrew J.
Published: January 2024

Background

Lung or heart–lung transplantation (LT/HLT) for severe pulmonary hypertension (PH) as the primary disease indication carries a high risk of waiting list mortality and post-transplant complications. France and the UK both have coordinated PH patient services but with different referral pathways for accessing LT services.

Methods

We conducted a comparative analysis of adult PH patients listed for LT/HLT in the UK and France.

Results

We included 211 PH patients in France (2006–2018) and 170 in the UK (2010–2019). Cumulative incidence of transplant, delisting and waiting list death within 3 years were 81%, 4% and 11% in Franceversus58%, 10% and 15% in the UK (p<0.001 for transplant and delisting; p=0.1 for death). Median non-priority waiting time was 45 days in Franceversus165 days in the UK (p<0.001). High-priority listing occurred in 54% and 51% of transplanted patients respectively in France and the UK (p=0.8). Factors associated with achieving transplantation related to recipients’ height, male sex, clinical severity and priority listing status. 1-year post-transplant survival was 78% in France and 72% in the UK (p= 0.04).

Conclusion

Access to transplantation for PH patients is better in France than in the UK where more patients were delisted due to clinical deterioration because of longer waiting time. High rates of priority listing occurred in both countries. Survival for those achieving transplantation was slightly better in France. Ensuring optimal outcomes after transplant listing for PH patients is challenging and may involve early listing of higher risk patients, increasing donor lung utilisation and improving allocation rules for these specific patients.
Outcomes and risk assessment in pulmonary veno-occlusive disease
Authors: Boucly Athénaïs , Solinas Sabina , Beurnier Antoine , Jaïs Xavier , Keddache Sophia , Eyries Mélanie , Seferian Andrei , Jevnikar Mitja , Roche Anne , Bulifon Sophie , Bourdin Arnaud , Chaouat Ari , Cottin Vincent , Bertoletti Laurent , Savale Laurent , Humbert Marc , Sitbon Olivier , Montani David
Published: January 2024

Introduction

Pulmonary veno-occlusive disease (PVOD) is a rare and severe subtype of pulmonary arterial hypertension (PAH). Although European Society of Cardiology/European Respiratory Society (ESC/ERS) guidelines advise assessing PAH severity at baseline and during follow-up, no existing risk assessment methods have been validated for PVOD. This study aimed to identify prognostic factors, examine the impact of treatment strategies and evaluate risk assessment methods for PVOD patients.

Methods

The study analysed all incident PVOD patients included in the French Pulmonary Hypertension Registry between 2006 and 2021. Survival was assessed based on initial treatment strategy and risk status and compared to a matched (age, sex, pulmonary vascular resistance) PAH group. Six risk assessment methods (number of four low-risk and three noninvasive low-risk variables, ESC/ERS guidelines three-strata and four-strata models, REVEAL 2.0 and Lite 2) were applied at baseline and early follow-up, and their accuracy was compared using Harrell's c-statistic.

Results

Among the 327 included PVOD patients, survival rates at 1, 3 and 5 years were 86%, 50% and 27%, respectively. Multivariate analysis showed that only 6-min walk distance was associated with survival, with no significant difference based on initial treatment strategy. All six risk assessment methods could discriminate mortality risk, and the ESC/ERS four-strata model was the most accurate at both baseline and follow-up (C-index 0.64 and 0.74). PVOD survival rates were consistently lower than PAH when comparing baseline risk status using the ESC/ERS four-strata model.

Conclusion

PVOD is associated with poor outcomes, and initial treatment strategies do not significantly affect survival. Risk assessment methods can be useful in predicting survival for PVOD patients.
Immune checkpoint inhibitors in patients with lung cancer having chronic interstitial pneumonia
Authors: Isobe Kazutoshi , Nakamura Yasuhiko , Sakamoto Susumu , Tomii Keisuke , Takimoto Takayuki , Miyazaki Yasunari , Matsumoto Masaru , Sugino Keishi , Ichikado Kazuya , Moriguchi Shuhei , Yamaguchi Kakuhiro , Baba Tomohisa , Ozasa Hiroaki , Igata Fumiyasu , Anabuki Kazuki , Homma Sakae , Date Hiroshi , Suda Takafumi , Kishi Kazuma
Published: January 2024

Background

In interstitial pneumonia (IP)-associated lung cancer, immune checkpoint inhibitor pneumonitis (ICIP) is common with immune checkpoint inhibitor (ICI) treatment. The purpose of the present study was to clarify the safety and efficacy of ICI treatment for patients with lung cancer with IP.

Methods

This multicentre retrospective observational study was conducted from June 2016 to December 2020 in patients with primary lung cancer with IP who received ICI treatment.

Results

A total of 200 patients (median age 70 years; male/female, 176/24) were enrolled from 27 institutions. ICIP occurred in 61 patients (30.5%), pneumonitis grades 3–5 in 32 patients (15.5%) and death in nine patients (4.5%). The common computed tomography pattern of ICIP was organising pneumonia in 29 patients (47.5%). Subsequently, diffuse alveolar damage (DAD) pattern was observed in 19 patients (31.1%) who had a significantly worse prognosis than those with a non-DAD pattern (median progression-free survival (PFS) 115 daysversus226 days, p=0.042; median overall survival (OS) 334 daysversus1316 days, p<0.001). Immune-related adverse events (irAEs) occurred in approximately 50% of patients. Patients with irAEs (n=100) had a better prognosis than those without irAEs (n=100) (median PFS 200 daysversus77 days, p<0.001; median OS 597 daysversus390 days p=0.0074). The objective response rate and disease control rate were 41.3% and 68.5%, respectively.

Conclusions

Although ICI treatment was effective for patients with lung cancer with IP, ICIP developed in approximately 30% of patients. Patients with irAEs had a significantly better PFS and OS than those without irAEs.
Barriers and enablers to implementing interprofessional primary care teams: a narrative review of the literature using the consolidated framework for implementation research
Authors: Grant Amy , Kontak Julia , Jeffers Elizabeth , Lawson Beverley , MacKenzie Adrian , Burge Fred , Boulos Leah , Lackie Kelly , Marshall Emily Gard , Mireault Amy , Philpott Susan , Sampalli Tara , Sheppard-LeMoine Debbie , Martin-Misener Ruth
Published: January 2024

Background

Interprofessional primary care teams have been introduced across Canada to improve access (e.g., a regular primary care provider, timely access to care when needed) to and quality of primary care. However, the quality and speed of team implementation has not kept pace with increasing access issues. The aim of this research was to use an implementation framework to categorize and describe barriers and enablers to team implementation in primary care.

Methods

A narrative review that prioritized systematic reviews and evidence syntheses was conducted. A search using pre-defined terms was conducted using Ovid MEDLINE, and potentially relevant grey literature was identified through ad hoc Google searches and hand searching of health organization websites. The Consolidated Framework for Implementation Research (CFIR) was used to categorize barriers and enablers into five domains: (1) Features of Team Implementation; (2) Government, Health Authorities and Health Organizations; (3) Characteristics of the Team; (4) Characteristics of Team Members; and (5) Process of Implementation.

Results

Data were extracted from 19 of 435 articles that met inclusion/exclusion criteria. Most barriers and enablers were categorized into two domains of the CFIR: Characteristics of the Team and Government, Health Authorities, and Health Organizations. Key themes identified within the Characteristics of the Team domain were team-leadership, including designating a manager responsible for day-to-day activities and facilitating collaboration; clear governance structures, and technology supports and tools that facilitate information sharing and communication. Key themes within the Government, Health Authorities, and Health Organizations domain were professional remuneration plans, regulatory policy, and interprofessional education. Other key themes identified in the Features of Team Implementation included the importance of good data and research on the status of teams, as well as sufficient and stable funding models. Positive perspectives, flexibility, and feeling supported were identified in the Characteristics of Team Members domain. Within the Process of Implementation domain, shared leadership and human resources planning were discussed.

Conclusions

Barriers and enablers to implementing interprofessional primary care teams using the CFIR were identified, which enables stakeholders and teams to tailor implementation of teams at the local level to impact the accessibility and quality of primary care.
Predicting fluid responsiveness in spontaneously breathing parturients undergoing caesarean section via carotid artery blood flow and velocity time integral measured by carotid ultrasound: a prospective cohort study
Authors: Dai Shaobing , Wang Chun , Tao Xia , Shen Jianjun , Xu Lili
Published: January 2024

Background

Present evidence suggests that the Doppler ultrasonographic indices, such as carotid artery blood flow (CABF) and velocity time integral (VTI), had the ability to predict fluid responsiveness in non-obstetric patients. The purpose of this study was to assess their capacity to predict fluid responsiveness in spontaneous breathing parturients undergoing caesarean section and to determine the effect of detecting and management of hypovolemia (fluid responsiveness) on the incidence of hypotension after anaesthesia.

Methods

A total of 72 full term singleton parturients undergoing elective caesarean section were enrolled in this study. CABF, VTI, and hemodynamic parameters were recorded before and after fluid challenge and assessed by carotid artery ultrasonography. Fluid responsiveness was defined as an increase in stroke volume index (SVI) of 15% or more after the fluid challenge.

Results

Thirty-one (43%) patients were fluid responders. The area under the ROC curve to predict fluid responsiveness for CABF and VTI were 0.803 (95% CI, 0.701–0.905) and 0.821 (95% CI, 0.720–0.922). The optimal cut-off values of CABF and VTI for fluid responsiveness was 175.9 ml/min (sensitivity of 74.0%; specificity of 78.0%) and 8.7 cm/s (sensitivity of 67.0%; specificity of 90.0%). The grey zone for CABF and VTI were 114.2-175.9 ml/min and 6.8–8.7 cm/s. The incidence of hypotension after the combined spinal-epidural anaesthesia (CSEA) was significantly higher in the Responders group 25.8% (8/31) than in the Non-Responders group 17.1(7/41) (P < 0.001). The total incidence of hypotension after CSEA of the two groups was 20.8% (15/72).

Conclusions

Ultrasound evaluation of CABF and VTI seem to be the feasible parameters to predict fluid responsiveness in parturients undergoing elective caesarean section and detecting and management of hypovolemia (fluid responsiveness) could significantly decrease incidence of hypotension after anaesthesia.

Trial registration

The trial was registered at the Chinese Clinical Trial Registry (ChiCTR) (www.chictr.org), registration number was ChiCTR1900022327 (The website link: https://www.chictr.org.cn/showproj.html?proj=37271 ) and the date of trial registration was in April 5, 2019. This study was performed in accordance with the Declaration of Helsinki and approved by the Research Ethics Committee of Women’s Hospital, Zhejiang University School of Medicine (20,180,120).
Exosomes derived from cancer-associated fibroblasts promote tumorigenesis, metastasis and chemoresistance of colorectal cancer by upregulating circ_0067557 to target Lin28
Authors: Yang Cheng , Zhang Yan , Yan Mingze , Wang Jiahao , Wang Jiaming , Wang Muhong , Xuan Yuhong , Cheng Haiyue , Ma Jiaao , Chai Cuicui , Li Mingzhe , Yu Zhiwei
Published: January 2024

Background

Cancer associated fibroblasts (CAFs) can remodel tumor microenvironment by secreting exosomes. This study aimed to investigate the role of exosomes derived from cancer-associated fibroblasts in colorectal cancer (CRC) progression.

Methods

Circular RNA (circRNA) array was used to identify differentially expressed circRNAs in exosomes from normal fibroblasts (NFs) and CAFs, and confirmed one differentially expressed circRNA circ_0067557 by real-time PCR. The effect of circ_0067557 on proliferation, metastasis, chemoresistance and apoptosis was verified by wound heal, tranwell, CCK8, sphere-forming and flow cytometry assay.

Results

Circ_0067557 expression in exosomes from CAFs was higher than those from NFs. CAF-derived exosomes promoted the proliferation, migration, invasion and chemoresistance of CRC cells while suppressed apoptosis. Silencing of circ_0067557 inhibited malignant phenotypes of CRC cells by targeting Lin28A and Lin28B. Moreover, CAF-derived exosomes enhanced the growth of CRC xenograft tumors.

Conclusion

Circ_0067557/Lin28A and Lin28B signal axis may be a potential therapy target for CRC.
Adjuvant administration of probiotic effects on sexual function in depressant women undergoing SSRIs treatment: a double-blinded randomized controlled trial
Authors: Hashemi-Mohammadabad Nazir , Taghavi Seyed-Abdolvahab , Lambert Nicky , Moshtaghi Raana , Bazarganipour Fatemeh , Sharifi Mahboubeh
Published: January 2024

Background

According to the Institute of Health Metrics and Evaluation’s Global Health Data Exchange (2023) it is estimated that 5% of all adults will experience depressive disorder. Amongst the general loss of pleasure and interest in everyday activities that are symptoms of low mood, reduced sexual desire and sexual dysfunction can be particularly overlooked. Human sexuality is complex, but finding solutions based on scientific evidence to limit the symptoms of depressive disorder and the iatrogenic impact of antidepressant treatment to improve this outcome is an important step in promoting psychological health and general wellbeing.

Objective

The present study aimed is to provide scientific evidence to assess the effect of oral probiotic on sexual function in women with depressive disorder treated with Selective Serotonin Reuptake Inhibitors (SSRIs) in an Iranian population.

Design

This study was a double-blind randomized clinical trial. Eligible women were assigned to lactofem plus SSRIs (n = 58) or SSRIs alone (n = 54). In group A, SSRI antidepressants were prescribed together with Lactofem, and in group B, SSRI antidepressants were prescribed alone. Lactofem including Lactobacillus acidophilus 2 × 109 cfu/g, Bifidobacterium bifidus 2 × 109 cfu/g, Lactobacillus rutri 2 × 109 cfu/g, Lactobacillus fermentum 2 × 109 cfu/g; capsule weight of 500 mg bio-capsule administered orally and daily. The duration of intervention in two groups was two months. All questionnaires were completed by the patients before and after the intervention. The Female Sexual Function Index (FSFI), Hamilton Depression Rating Scale and Larson's Sexual Satisfaction Questionnaire were used to evaluate sexual function, severity of depressive disorder and sexual satisfaction, respectively.

Results

Based on the results of the present study, there was a statistically significant difference in sexual satisfaction and severity of depressive disorder between the groups before and after the intervention (P < 0.05). Also, our findings showed that after eight weeks, the Lactofem plus SSRIs group showed significant improvement in FSFI domains and total scores compared to SSRIs alone group (P < 0.05).

Conclusions

The results of the present study show that taking probiotics for eight weeks may improve the severity of depressive disorder, sexual function and sexual satisfaction in depressed women treated with SSRIs.

Trial registration

ClinicalTrials.govidentifier: IRCT20160524028038N14 (19/12/2022)
Psychiatric disorders in older adults with cancer referred to psycho-oncology service in a tertiary care cancer centre: a 7-year real world experience from India
Authors: Deodhar Jayita K. , Sonkusare Lekhika N. , Goswami Savita S.
Published: January 2024

Background

Cancer affects mental health in older adults with cancer (OAC), affecting almost 50% of the patients. There are only a few studies on psychiatric disorders in OAC, especially in low resource settings. We report on our real-world experience of prevalence of and factors associated with psychiatric disorders in OAC referred to a psycho-oncology service in an Indian tertiary care cancer institute.

Methods

We retrospectively analysed medical and psycho-oncology records of patients aged 60 + on cancer-directed treatment or follow-up for < 2 years after treatment completion, referred to psycho-oncology services in a tertiary care cancer centre in Mumbai, India, from Jan 2011-Dec 2017. We recorded sociodemographic, clinical, and treatment-related variables, as well as past psychiatric disorders. The ICD-10 was used to record current psychiatric disorder type and presence. IBM SPSS version 24 (Armonk, NY, USA) was used for descriptive measures, tests of association, and logistic regression analysis. The study protocol was approved by Institutional Ethics Committee and registered with the Clinical Trials Registry-India (CTRI/2020/06/026095).

Results

Of 763 patients included in the study, 475 (62.3%) were males and 436 (57.1%) were inpatients, with a median age of 65 years. 93% of the patients had a solid tumour and 207 (27.1%) had a history of psychiatric disorder. A current psychiatric diagnosis was noted in 556 patients (72.9%) on initial presentation, of which adjustment disorders, delirium and depression and anxiety disorders were most frequently seen in 25.2%, 21% and 11.1%, respectively. On univariate analysis, a past history of psychiatric disorders (χ2 = 34.6, p < 0.001), lower performance status (χ2 = 9.9, p = 0.002) and haematolymphoid malignancy (χ2 = 4.08, p = 0.04) significantly increased the risk of current psychiatric diagnosis. Logistic regression confirmed these variables as significant.

Conclusion

Older adults with cancer referred to psycho-oncology services have high rates of psychiatric disorders at their initial presentation, mainly adjustment disorders, delirium and depression and anxiety. A past history of psychiatric disorders, lower performance status and haematolymphoid cancers significantly increased the risk of psychiatric disorders. Multidisciplinary psycho-oncology teams including a psychiatrist should be integrated in comprehensive care of this group of patients. Further research outcomes and effect of psycho-oncological interventions is required in older adults with cancer in LMIC settings.
Optimizing the management of electrophysiology labs in Chinese hospitals using a discrete event simulation tool
Authors: Lin Wenjuan , Zhang Lin , Wu Shuqing , Yang Fang , Zhang Yueqing , Xu Xiaoying , Zhu Fei , Fei Zhen , Shentu Lihua , Han Yi
Published: January 2024

Background

The growing demand for electrophysiology (EP) treatment in China presents a challenge for current EP care delivery systems. This study constructed a discrete event simulation (DES) model of an inpatient EP care delivery process, simulating a generalized inpatient journey of EP patients from admission to discharge in the cardiology department of a tertiary hospital in China. The model shows how many more patients the system can serve under different resource constraints by optimizing various phases of the care delivery process.

Methods

Model inputs were based on and validated using real-world data, simulating the scheduling of limited resources among competing demands from different patient types. The patient stay consists of three stages, namely: the pre-operative stay, the EP procedure, and the post-operative stay. The model outcome was the total number of discharges during the simulation period. The scenario analysis presented in this paper covers two capacity-limiting scenarios (CLS): (1) fully occupied ward beds and (2) fully occupied electrophysiology laboratories (EP labs). Within each CLS, we investigated potential throughput when the length of stay or operative time was reduced by 10%, 20%, and 30%. The reductions were applied to patients with atrial fibrillation, the most common indication accounting for almost 30% of patients.

Results

Model validation showed simulation results approximated actual data (137.2 discharges calculated vs. 137 observed). With fully occupied wards, reducing pre- and/or post-operative stay time resulted in a 1–7% increased throughput. With fully occupied EP labs, reduced operative time increased throughput by 3–12%.

Conclusions

Model validation and scenario analyses demonstrated that the DES model reliably reflects the EP care delivery process. Simulations identified which phases of the process should be optimized under different resource constraints, and the expected increases in patients served.
The residue of salinomycin in the muscles of olive flounder (Paralichthys olivaceus) and black rockfish (Sebastes Schlegeli) after oral administration analyzed by LC-Tandem-MS
Authors: Lee Seungjin , Woo Won-Sik , Kim Jaekyeong , Jin Yeongwoon , Lee Jin Woo , Seo Jung-Soo , Kwon Mun-Gyeong , Lee Ji-Hoon , Park Chan-Il , Shim Sang Hee
Published: January 2024

Background

Salinomycin, an antibiotic, have potential as a veterinary drug for fish due to its anti-parasitic activity against several fish parasites. Thus the residual levels of salinomycin in muscles of two significant aquaculture species in Korea, olive flounder and black rockfish, were analyzed using HPLC-MS-MS.

Results

The proper method to analyze the residual salinomycin in fish muscles using LC-MS-MS was settled and the method was validated according to CODEX guidelines. The residues in three distinct groups for two fish species were analyzed using the matrix match calibration curves at points of five different times following oral administration. After oral administration, salinomycin rapidly breaks down in both olive flounder and black rockfish. After 7th days, the average residue in all groups of two fish spp. decreased below limit of quantitation (LOQ).

Conclusion

Due to low residue levels in fish muscles, salinomycin may therefore be a treatment that is safe for both fish and humans. This result could contribute to establishment of MRL (minimal residual limit) for approval of salinomycin for use in aquaculture.
Stronger stimulus triggers synaptic transmission faster through earlier started action potential
Authors: Zhang Zhuoyu , Huang Rong
Published: January 2024

Synaptic transmission plays an important and time-sensitive role in the nervous system. Although the amplitude of neurotransmission is positively related to the intensity of external stimulus, whether stronger stimulus could trigger synaptic transmission faster remains unsolved. Our present work in the primary sensory system shows that besides the known effect of larger amplitude, stronger stimulus triggers the synaptic transmission faster, which is regulated by the earlier started action potential (AP), independent of the AP’s amplitude. More importantly, this model is further extended from the sensory system to the hippocampus, implying broad applicability in the nervous system. Together, we found that stronger stimulus induces AP faster, which suggests to trigger the neurotransmission faster, implying that the occurrence time of neurotransmission, as well as the amplitude, plays an important role in the timely and effective response of nervous system.