bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploring routinization and reflexivity in change and reproduction of consumption towards lower climate impact
Authors: Christensen Toke Haunstrup , Halkier Bente , Gram-Hanssen Kirsten , Freudendal-Pedersen Malene , Krog Juvik Amanda
Published: October 2023

A change to less carbon-intensive everyday practices is needed to address climate change. Based on existing literature, we discuss which relations between dynamics of routinization and reflexivity that potentially constitute reproduction and change of practices related to food, mobility and housing. Looking across different consumption fields can help clarify more general insights on the importance of routinization and reflexivity in reproduction and change of consumption. Our analysis is informed by practice theories, which emphasize how reproduction and change are intermingled in the performance of practices. We suggest three analytical themes for exploring the relations between routinization and reflexivity in consumption: Variation in performances of practices, visibility of practice performances and resource use, and social interaction involved in performances of practices. We explore the usefulness of variation, visibility and social interaction by applying them in a systematic discussion of food, housing and mobility consumption in order to shed light upon the relations between routinization and reflexivity and the implications for reproduction and change towards lower carbon intensity.
Retrievable Inferior Vena Cava Filter Trapped Embolus: A Risk Factor of Detachment of Thrombus Analysis Based on a Multicenter Prospective Observational Study
Authors: Zhang Lei , Hu Wen-Ping , Zhang Hao , Xia Shi-Bo , Wang Hong-Fei , Song Chao , Lu Qing-Sheng
Published: October 2023

Purpose:

Up to now, the indications of inferior vena cava filter placement still remain controversial in the academic field. The aim of this study was to determine the risk factors of detachment of thrombus and to evaluate the necessity of inferior vena cava filter placement to prevent fatal pulmonary embolism.

Materials and Methods:

A total of 2892 patients participated in the multicenter prospective observational study from January 1, 2018, to December 31, 2018, and underwent retrievable inferior vena cava filter (RIVCF) placement in 103 centers in China. The primary endpoint of the study was RIVCF trapped embolus detected by inferior vena cava venography/ultrasound/computed tomography scanning or visible macroscopic thrombus before or during RIVCF retrieval. The relative factors of RIVCF trapped embolus were analyzed accordingly.

Results:

The average age of the patients was 61.0 (50.0-71.0) years. Retrievable inferior vena cava filter trapped embolus occurred in 308 patients (10.65%). The fracture location, surgery location, and endovascular intervention differed between RIVCF trapped embolus and non-RIVCF trapped embolus groups (p<0.001, respectively). By multivariate analysis, RIVCF trapped embolus were less common in older patients (odds ratio [OR]=0.998; p<0.001) and more common in patients with below-the-knee fracture (OR=1.093, p=0.038), thigh fracture (OR=1.118, p=0.007), and pelvis surgery (OR=1.067, p=0.016). In addition, compared with patients without endovascular intervention, patients with percutaneous mechanical thrombectomy (PMT) + catheter-directed thrombolysis (CDT) were more prone to develop RIVCF trapped embolus (OR=1.060, p=0.010). However, RIVCF trapped embolus was less common in patients with CDT (OR=0.961, p=0.004).

Conclusions:

Lower limb fracture, pelvis surgery, and PMT + CDT are prone to cause trapped embolus. As a trapped embolus often represents the possibility of severe pulmonary embolism, lower limb fracture, pelvis surgery, and PMT + CDT could be risk factors of fatal pulmonary embolism. Due to the low incidence of trapped embolus, it is not necessary to place filters in elderly patients and CDT-only patients.

Clinical Impact

The purpose of this paper is to standardize the use of inferior vena cava filter and avoid unnecessary filter implantation through the summary and analysis of a large number of clinical data. At the same time, more attention should be paid to and active treatment should be given to high-risk groups of pulmonary embolism.
Assessing the Risk of Secondary Cancer Induction in Radiosensitive Organs During Trigeminal Neuralgia Treatment With Gamma Knife Radiosurgery: Impact of Extracranial Dose
Authors: Geraily Ghazale , Ameri Ali , Mahmoudi Atefeh , Moafee Mohadese , Teymouri Javad
Published: October 2023

Purpose

Gamma knife radiosurgery (GKRS) delivers high-dose external radiation to a small intracranial lesion. However, scattering and leaked radiation can deposit a portion of the dose outside the radiation field, which may pose a risk to radiation-sensitive patients, such as pregnant women. Trigeminal Neuralgia (TN) is treated with one of the highest GKRS doses (80–90 Gy). This study aimed to estimate the risk of secondary cancer induction in the uterus, ovaries, thyroid gland, and eyes of TN patients undergoing GKRS.

Methods

Radiation doses to the uterus, ovary, eyes, and thyroid gland were measured for 25 female TN patients, with a mean age of 35 years, utilizing Thermo Luminescent Dosimeters (TLD).

Results

The mean absorbed dose for the uterus, ovary, thyroid gland, and eyes were .63 ± .24, .471 ± .2, 8.26 ± 1.01, and 10.64 ± 1.08 cGy, respectively. Lifetime Attributable Risk (LAR) has been calculated using BEIR VII (2006) method. LAR for the uterus, ovary, and thyroid gland was 1, 2, and 23, respectively.

Conclusion

The results of this study and its comparison with standard values demonstrate that on average, mean doses to mentioned organs were smaller than their tolerance doses, and there is no limitation to treating patients suffering from TN by GK.
Television will archive itself: Channel 4’s role in revalorising ‘old’ TV
Authors: Hewett Richard
Published: October 2023

A notable feature of Channel 4’s scheduling in the 1980s was the extent to which it drew upon repeats of archive television, long-unseen US and UK sitcoms and cult dramas either providing a nostalgic reminder of yesteryear or being discovered afresh by new generations. In addition, the themed archive evenings that began at Christmas 1982, culminating in 1992's extensive TV Heaven season, now seem prescient in an era when digital channels such as GOLD, Yesterday, Dave and Talking Pictures TV draw extensively upon the archive to compile their schedules. Channel 4’s use of archive programming receives little attention in academic histories, aside of Maggie Brown’s dismissal of its repeats as ‘tellyfilla’. This article redresses the balance, drawing upon publicity material from Channel 4’s press packs, research into patterns of repeats and original interviews with those involved in the curatorial process to investigate the extent to which Channel 4’s decision to revisit the archives was born of economic pragmatism, or was in fact a conscious act of contextualisation, re-evaluation and revalorisation.
A new magnetic internal distractor: cadaveric study of changes in trapeziometacarpal joint forces
Authors: Moradi Ali , Daliri Mahla , Rezaeian Amin , Hafiz Hamed , Hajiaghajani Ghazaleh , Hedjazi Arya , Akbarzadeh Alireza
Published: October 2023

Distraction is a new treatment for trapeziometacarpal joint osteoarthritis. The purpose of this study was to test the efficiency of magnetic distraction using a new internal distractor in cadavers. The distractor consists of two magnets embedded inside titanium capsules that are implanted on either side of the trapeziometacarpal joint with the same poles facing each other, so that the force between the magnets distracts the joint. Intra-articular forces were recorded pre-implantation, immediately after implantation and again 10 minutes later. We also studied the changes in the forces before and after the procedure in different thumb positions. Our findings show that the trapeziometacarpal joint could be offloaded in all the studied trapeziometacarpal positions.
Brooms and Ballots: #WitchTheVote, the Nostalgic Internet, and Intersectional Feminist Politics on Instagram
Authors: Mulvey Alora Paulsen , Keller Jessalynn Marie
Published: October 2023

Over the past decade, there has been significant scholarly and mainstream attention to the use of digital media technologies to engage in feminist politics and activism. This article explores an example of small-scale, feminist digital activism: the #WitchTheVote hashtag on Instagram. Using a visual and discursive analysis of 75 Instagram posts and interviews with four self-identified witches active on Instagram during the summer of 2020, we argue that #WitchTheVote is an example of reflective nostalgic activism that challenges the mediated popular feminism most visible across social media attention economies. This case study demonstrates the potential for doing intersectional feminist politics online that contradicts both popular feminism and its attendant platform conventions, imagining a different kind of feminist politics that troubles visibility, attention, celebrity, large audiences, and consumption as part of contemporary digital feminism.
Endocrine-Disrupting Chemicals: Science and Policy
Authors: Hilz Emily N. , Gore Andrea C.
Published: October 2023

Endocrine-disrupting chemicals (EDCs) are chemicals that disrupt the normal functioning of endocrine system hormones, leading to a range of adverse health effects in humans and wildlife. Exposure to EDCs is ubiquitous and occurs through contaminated food and water, air, consumer products, and transfer from parents to offspring. Effective regulation has been challenging due to a limited understanding of EDCs’ complex and nonlinear dose-response relationships, as well as difficulty in attributing specific health effects to individual EDC exposures in real-world scenarios. Current EDC policies face limitations in terms of the diversity and complexity of EDCs, the lack of comprehensive testing requirements, and the need for more robust regulatory frameworks that consider cumulative and mixture effects of EDCs. Understanding these aspects is crucial for developing effective and evidence-based EDC policies that can safeguard public health and the environment.
Socioeconomic Disparities in Failure to Thrive and Weight Gain for Patients With Cleft Lip and Palate
Authors: Villavisanis Dillan F. , Morales Carrie Z. , Wagner Connor S. , Blum Jessica D. , Folsom Nancy , Cho Daniel Y. , Bartlett Scott P. , Taylor Jesse A. , Swanson Jordan W.
Published: October 2023

Background:

Given the relatively resource-intensive burden of treating orofacial clefting and its functional and aesthetic sequelae, it is perhaps unsurprising that lower socioeconomic status is known to have adverse effects on outcomes in patients with cleft lip and/or palate (CL/P). Although outcomes in patients with CL/P are known to be influenced by socioeconomic status, the relationship between socioeconomic status and age-related weight gain has not been described. This study aimed to determine time-specific socioeconomic disparities in weight-for-age Z-scores and failure to thrive in patients with CL/P.

Methods:

This retrospective study evaluated patients presenting with CL/P from 2009 to 2019 at a tertiary children’s hospital. Failure to thrive status was determined by weight-for-age Z-scores less than −2.00 (second percentile) or from the EHR. Median income by block group was determined from US 2019 census data.

Results:

Multivariate linear regression models controlled for syndromic status, sex, and race revealed significant associations between median block group income and weight-for-age Z-scores at 4 weeks (β = .14, P = .009), 6 weeks (β = .15, P = .003), and 8 weeks (β = .14, P = .002). Mann Whitney U tests revealed significantly different weight-for-age Z-scores between low-income and high-income groups at 4 weeks ( P = .002), 6 weeks ( P < .001), 8 weeks ( P < .001), 10 weeks ( P = .005), and 12 weeks ( P = .004).

Conclusions:

Patients with CL/P and lower socioeconomic status may be most susceptible to disparities in weight gain between 4 and 8 weeks of age. Lower socioeconomic status was an independent predictor of failure to thrive for patients with CL/P in this cohort. This study highlights a welcome opportunity for timed intervention in patients with CL/P and lower socioeconomic status.
Cytological and transcriptomic analysis to unveil the mechanism of web blotch resistance in Peanut
Authors: Wu Xiaohui , Sun Ziqi , Qi Feiyan , Liu Hua , Zhao Mingbo , Wang Juan , Wang Mengmeng , Zhao Ruifang , Wu Yue , Dong Wenzhao , Zheng Zheng , Zhang Xinyou
Published: October 2023

Background

Peanut is an important oil crop worldwide. Peanut web blotch is a fungal disease that often occurs at the same time as other leaf spot diseases, resulting in substantial leaf drop, which seriously affects the peanut yield and quality. However, the molecular mechanism underlying peanut resistance to web blotch is unknown.

Results

The cytological examination revealed no differences in the conidium germination rate between the web blotch-resistant variety ZH and the web blotch-susceptible variety PI at 12–48 hpi. The appressorium formation rate was significantly higher for PI than for ZH at 24 hpi. The papilla formation rate at 36 hpi and the hypersensitive response rate at 60 and 84 hpi were significantly higher for ZH than for PI. We also compared the transcriptional profiles of web blotch-infected ZH and PI plants at 0, 12, 24, 36, 48, 60, and 84 hpi using an RNA-seq technique. There were more differentially expressed genes (DEGs) in ZH and PI at 12, 36, 60, and 84 hpi than at 24 and 48 hpi. Moreover, there were more DEGs in PI than in ZH at each time-point. The analysis of metabolic pathways indicated that pantothenate and CoA biosynthesis; monobactam biosynthesis; cutin, suberine and wax biosynthesis; and ether lipid metabolism are specific to the active defense of ZH against YY187, whereas porphyrin metabolism as well as taurine and hypotaurine metabolism are pathways specifically involved in the passive defense of ZH against YY187. In the protein-protein interaction (PPI) network, most of the interacting proteins were serine acetyltransferases and cysteine synthases, which are involved in the cysteine synthesis pathway. The qRT-PCR data confirmed the reliability of the transcriptome analysis.

Conclusion

On the basis of the PPI network for the significantly enriched genes in the pathways which were specifically enriched at different time points in ZH, we hypothesize that serine acetyltransferases and cysteine synthases are crucial for the cysteine-related resistance of peanut to web blotch. The study results provide reference material for future research on the mechanism mediating peanut web blotch resistance.
Construction of risk prediction model for hyponatremia in patients with acute decompensated heart failure
Authors: Gong Huanhuan , Zhou Ying , Huang Yating , Liao Shengen , Wang Qin
Published: October 2023

Background

Patients with Heart failure (HF) commonly have a water-electrolyte imbalance due to various reasons and mechanisms, and hyponatremia is one of the most common types. However, currently, there are very few local studies on hyponatremia risk assessment in patients with acute decompensated heart failure (ADHF), and there is a lack of specific screening tools. The aim of this study is to identify a prediction model of hyponatremia in patients with acute decompensated heart failure (ADHF) and verify the prediction effect of the model.

Methods

A total of 532 patients with ADHF were enrolled from March 2014 to December 2019. Univariate and multivariate logistic regression analyses were performed to investigate the independently associated risk factors of hyponatremia in patients with ADHF. The prediction model of hyponatremia in patients with ADHF was constructed by R software, and validation of the model was performed using the area under the receiver operating characteristic curve (AUC) and calibration curves.

Results

A total of 65 patients (12.2%) had hyponatremia in patients with ADHF. Multivariate logistic regression analysis demonstrated that NYHA cardiac function classification (NYHA III vs II, OR = 12.31, NYHA IV vs II, OR = 11.55), systolic blood pressure (OR = 0.978), serum urea nitrogen (OR = 1.046) and creatinine (OR = 1.006) were five independent prognostic factors for hyponatremia in patients with ADHF. The AUC was 0.757; The calibration curve was near the ideal curve, which showed that the model can accurately predict the occurrence of hyponatremia in patients with ADHF.

Conclusions

The prediction model constructed in our study has good discrimination and accuracy and can be used to predict the occurrence of hyponatremia in patients with ADHF.
Variation in vitamin D status in infants and children: a two-year cross-sectional study in Shanghai, China
Authors: Li Aiguo , Wang Fang , Wu Ying , Gao Jiangfang , Li Bosheng , Sheng Huiming , Ma Jun , Liao Xiang-Peng
Published: October 2023

Background

Vitamin D deficiency (VDD) is a public health problem. The variation in vitamin D status across regions and populations remains unclear, and there is a lack of consensus regarding the screening for VDD in individuals.

Methods

Children who visited the hospital from January 2019 to December 2020 were included in this study. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were measured using an enzyme-linked immunosorbent assay. The cutoffs for serum 25(OH)D concentrations to define deficiency, insufficiency, and sufficiency were < 20 ng/mL, 20–30 ng/mL, and ≥ 30 ng/mL, respectively.

Results

A total of 7285 children aged 0–11 years were assessed; the mean 25(OH)D level was 31.4 ng/mL, and the median 25(OH)D level was 30.7 (interquartile range 24.4, 37.5) ng/mL. The 25(OH)D level declined with age in clinical visiting children aged 0–11 years, but maintained a consistently high level in health examination children aged 4–11 years. The percentages of 25(OH)D < 20 ng/mL and 25(OH)D < 30 ng/mL were 10.0% and 43.8%, respectively. Higher percentages of VDD were found in clinical visiting children than in health examination children within the 6–11-year group (53.3% vs. 14.7%) and winter (44.3% vs. 15.4%).

Conclusion

Low vitamin D status (deficiency and insufficiency) was more common in clinic-visiting children than in health examinations, especially in schoolchildren and in the winter. The study implies the positive effects of vitamin D assessments included in child health checkups to optimize vitamin D status.
Impacts of colonization on Indigenous food systems in Canada and the United States: a scoping review
Authors: Malli A. , Monteith H. , Hiscock E. C. , Smith E. V. , Fairman K. , Galloway T. , Mashford-Pringle A.
Published: October 2023

Background

Indigenous populations in Canada and the United States (US) have maintained reciprocal relationships with nature, grounded in respect for and stewardship of the environment; however, disconnection from traditional food systems has generated a plethora of physical and mental health challenges for communities. Indigenous food sovereignty including control of lands were found to be factors contributing to these concerns. Therefore, our aim was to conduct a scoping review of the peer-reviewed literature to describe Indigenous disconnection from Indigenous food systems (IFS) in Canada and the US.

Methods

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews (PRISMA-SR) and Joanna Briggs Institute guidelines, we searched MEDLINE, SCOPUS, International Bibliography of the Social Sciences, Sociological Abstracts, and Bibliography of Native North Americans. Data was extracted from 41 studies and a narrative review completed based on study themes.

Results

The overarching theme identified in the included studies was the impact of colonization on IFS. Four sub-themes emerged as causes for Indigenous disconnection from traditional food systems, including: climate change; capitalism; legal change; and socio-cultural change. These sub-themes highlight the multiple ways in which colonization has impacted Indigenous food systems in Canada and the US and important areas for transformation.

Conclusions

Efforts to reconnect Indigenous knowledge and values systems with future food systems are essential for planetary health and sustainable development. Traditional knowledge sharing must foreground authentic Indigenous inclusion within policymaking.
Assessment of correlation between hand-wrist maturation and cervical vertebral maturation: a fractal analysis study
Authors: Eninanç İlknur , Büyükbayraktar Zeynep Çoban
Published: October 2023

Background

To investigate whether fractal dimension (FD) measurements from hand-wrist radiographs and lateral cephalometric radiographs are correlated with each other and with skeletal maturation stages.

Methods

In this retrospective study conducted on hand-wrist and lateral cephalometric radiographs obtained from patients between 2017 and 2023, hand-wrist maturation stages (HWMS) and cervical vertebral maturation stages (CVMS) of 144 subjects (6 to 17 years of age) were assessed radiographically. The participants were divided into nine groups (n = 16 each) based on HWMS. Fractal analysis was performed on the radiographs of the radius, the middle finger phalanges (proximal, medial and distal), and the cervical vertebral bodies (C2, C3, C4). Mean and standard deviation values, Spearman’s and Pearson correlation analyses, one-way ANOVA, Kruskal-Wallis H tests and Mann-Whitney-U test were used to evaluate the data.

Results

Positive correlations were found between the FD values of the radius and HWMS or CVMS (r = .559, P = .001, r = .528 P = .001 respectively). The FD values of the radius were positively correlated with those of all cervical vertebrae (C2, C3, C4), proximal and medial phalanges as well as age. FD values measured from the proximal phalanx, medial phalanx and radius showed significant differences among both HWMS and CVMS (P < .05). HWMS was strongly correlated with CVMS (r = .929, P = .001). Age was strongly correlated with HWMS (r = .795, P = .001) and CVMS (r = .756, P = .001). There was a significant difference in terms of age distribution among HWMS and CVMS (P < .05).

Conclusions

FD measurements on hand-wrist radiographs can provide useful information for the assessment of skeletal maturation stage. Especially, FD measurements from the radius are important and more reliable to predict skeletal maturation stage.
Exploring patient perspectives on how they can and should be engaged in the development of artificial intelligence (AI) applications in health care
Authors: Adus Samira , Macklin Jillian , Pinto Andrew
Published: October 2023

Background

Artificial intelligence (AI) is a rapidly evolving field which will have implications on both individual patient care and the health care system. There are many benefits to the integration of AI into health care, such as predicting acute conditions and enhancing diagnostic capabilities. Despite these benefits potential harms include algorithmic bias, inadequate consent processes, and implications on the patient-provider relationship. One tool to address patients’ needs and prevent the negative implications of AI is through patient engagement. As it currently stands, patients have infrequently been involved in AI application development for patient care delivery. Furthermore, we are unaware of any frameworks or recommendations specifically addressing patient engagement within the field of AI in health care.

Methods

We conducted four virtual focus groups with thirty patient participants to understand of how patients can and should be meaningfully engaged within the field of AI development in health care. Participants completed an educational module on the fundamentals of AI prior to participating in this study. Focus groups were analyzed using qualitative content analysis.

Results

We found that participants in our study wanted to be engaged at the problem-identification stages using multiple methods such as surveys and interviews. Participants preferred that recruitment methodologies for patient engagement included both in-person and social media-based approaches with an emphasis on varying language modalities of recruitment to reflect diverse demographics. Patients prioritized the inclusion of underrepresented participant populations, longitudinal relationship building, accessibility, and interdisciplinary involvement of other stakeholders in AI development. We found that AI education is a critical step to enable meaningful patient engagement within this field. We have curated recommendations into a framework for the field to learn from and implement in future development.

Conclusion

Given the novelty and speed at which AI innovation is progressing in health care, patient engagement should be the gold standard for application development. Our proposed recommendations seek to enable patient-centered AI application development in health care. Future research must be conducted to evaluate the effectiveness of patient engagement in AI application development to ensure that both AI application development and patient engagement are done rigorously, efficiently, and meaningfully.
Analysis of the efficacy and factors influencing survival of adjuvant radiotherapy for stage II-III biliary tract carcinoma
Authors: Guo Yan-Ling , Guo Jia-Xing , Zhao Jian-Guo , Bao Ying-Na
Published: October 2023

Background

To determine the efficacy of adjuvant radiotherapy for stage II–III biliary tract carcinoma.

Methods

We retrospectively analyzed the data of 37 patients who underwent radical resection of biliary tract carcinomas at the Affiliated Hospital of Inner Mongolia Medical University between 2016 and 2020. We analyzed survival differences between patients who did (n = 17) and did not (n = 20) receive postoperative adjuvant radiotherapy by using Kaplan–Meier analysis. The log-rank test and Cox univariate analysis were used. The Cox proportional risk regression model was used for the multifactorial analysis of factors influencing prognosis.

Results

The median survival time (28.9 vs. 14.5 months) and the 1-year (82.40% vs. 55.0%) and 2-year survival rates (58.8% vs. 25.0%) were significantly higher among patients who received adjuvant radiotherapy than among those who did not (χ2 = 6.381, p = 0.012). Multifactorial analysis showed that pathological tumor type (p = 0.004), disease stage (p = 0.021), and adjuvant radiotherapy (p = 0.001) were independent prognostic factors in biliary tract carcinoma. Subgroup analyses showed that compared to no radiotherapy, adjuvant radiotherapy significantly improved median survival time in patients with stage III disease (21.6 vs. 12.7 months; p = 0.017), positive margins (28.9 vs. 10.5 months; p = 0.012), and T3 or T4 tumors (26.8 vs. 16.8 months; p = 0.037).

Conclusion

Adjuvant radiotherapy significantly improved the survival of patients with biliary tract carcinoma, and is recommended especially for patients with stage III disease, positive surgical margins, or ≥ T3.
The efficacy and safety of anti-EGFR target agents in patients with potentially resectable metastatic colorectal cancer: a meta-analysis of randomized controlled trials
Authors: Wang Yang , Li Xiangyuan , Huang Tongmin , Wang Dongying , He Yujing , Wei Mengfei , Chen Yujie , Zheng Matao , Shi Yetan , Zhang Jianjian
Published: October 2023

Background

Adding anti-epidermal growth factor receptor (anti-EGFR) target agents to conversion therapy may improve the resection rates and survival of patients with potentially resectable metastatic colorectal cancer (mCRC). This study aims to analyze the efficacy and safety of additional anti-EGFR target agents.

Methods

A systematic search was conducted on PubMed, Web of Science, Embase, and Cochrane Library. And all relevant studies published in English before January 2023 were collected to explore the impact of additional anti-EGFR targeted agent on the efficacy and safety of patients with potentially resectable mCRC (PROSPERO: CRD42022340523, https://www.crd.york.ac.uk/PROSPERO/).

Results

This study included a total of 8 articles, including 2618 patients. The overall response rate (ORR) and R0 resection rates of the experimental group were higher than those of the control group, while there was no significant difference in progression-free survival (PFS) and overall survival (OS) between the two groups. In RAS/KRAS wild-type patients, the ORR (RR: 1.20, 95% Cl: 1.02–1.41, p = 0.03), R0 resection rate (RR: 1.60, 95% Cl: 1.17–2.20, p = 0.003), PFS (HR: 0.80, 95% Cl: 0.68–0.93, p = 0.003), and OS (HR: 0.87, 95% Cl: 0.76–0.99, p = 0.031) of the experimental group were higher than those of the control group. While in KRAS mutant patients, there was no statistical difference between the two groups in ORR, R0 resection rate, PFS, and OS.

Conclusion

The addition of anti-EGFR targeted agents can improve the prognosis of RAS/KRAS wild-type patients with potentially resectable mCRC, while KRAS mutant patients may not benefit. In addition, the overall safety factor was controllable.
Predictive value of DNA methylation patterns in AML patients treated with an azacytidine containing induction regimen
Authors: Schmutz Maximilian , Zucknick Manuela , Schlenk Richard F. , Mertens Daniel , Benner Axel , Weichenhan Dieter , Mücke Oliver , Döhner Konstanze , Plass Christoph , Bullinger Lars , Claus Rainer
Published: October 2023

Background

Acute myeloid leukemia (AML) is a heterogeneous disease with a poor prognosis. Dysregulation of the epigenetic machinery is a significant contributor to disease development. Some AML patients benefit from treatment with hypomethylating agents (HMAs), but no predictive biomarkers for therapy response exist. Here, we investigated whether unbiased genome-wide assessment of pre-treatment DNA-methylation profiles in AML bone marrow blasts can help to identify patients who will achieve a remission after an azacytidine-containing induction regimen.

Results

A total of n = 155 patients with newly diagnosed AML treated in the AMLSG 12-09 trial were randomly assigned to a screening and a refinement and validation cohort. The cohorts were divided according to azacytidine-containing induction regimens and response status. Methylation status was assessed for 664,227 500-bp-regions using methyl-CpG immunoprecipitation-seq, resulting in 1755 differentially methylated regions (DMRs). Top regions were distilled and included genes such as WNT10A and GATA3. 80% of regions identified as a hit were represented on HumanMethlyation 450k Bead Chips. Quantitative methylation analysis confirmed 90% of these regions (36 of 40 DMRs). A classifier was trained using penalized logistic regression and fivefold cross validation containing 17 CpGs. Validation based on mass spectra generated by MALDI-TOF failed (AUC 0.59). However, discriminative ability was maintained by adding neighboring CpGs. A recomposed classifier with 12 CpGs resulted in an AUC of 0.77. When evaluated in the non-azacytidine containing group, the AUC was 0.76.

Conclusions

Our analysis evaluated the value of a whole genome methyl-CpG screening assay for the identification of informative methylation changes. We also compared the informative content and discriminatory power of regions and single CpGs for predicting response to therapy. The relevance of the identified DMRs is supported by their association with key regulatory processes of oncogenic transformation and support the idea of relevant DMRs being enriched at distinct loci rather than evenly distribution across the genome.

Predictive response to therapy could be established but lacked specificity for treatment with azacytidine. Our results suggest that a predictive epigenotype carries its methylation information at a complex, genome-wide level, that is confined to regions, rather than to single CpGs. With increasing application of combinatorial regimens, response prediction may become even more complicated.
Cultured meat acceptance for global food security: a systematic literature review and future research directions
Authors: Lewisch Leonore , Riefler Petra
Published: October 2023

Cultured meat is a novel technology-based meat alternative with the potential to complement protein supply for a growing world population. An increasing body of consumer research has investigated personal factors explaining consumers’ acceptance of cultured meat. Research on cultural and economic drivers impacting consumer responses across countries, however, is scant. In this light, this article aims to provide a cross-cultural perspective on cultured meat acceptance and guide future empirical research in this domain. First, this article proposes a framework to explain cross-national differences in cultured meat acceptance comprising societal factors (i.e., culture and religion), indicators of the food environment (i.e., meat production and consumption), and economic market parameters (i.e., gross domestic product, carbon dioxide emissions, and population growth). Second, the paper applies a systematic literature review, including 105 empirical consumer studies related to cultured meat. Third, the identified papers are analyzed according to the proposed framework. The findings of this descriptive analysis demonstrate that empirical research to date has predominately been conducted in countries that produce and consume high amounts of meat and are characterized by high gross domestic products per capita. Many of these surveyed countries harbor secular-rational and self-expressional cultural value orientations. Other country types have been less prominently explored, although they represent potentially relevant target markets for cultured meat in the future. Cross-cultural research aiming to explain differences across countries is scarce. To guide future research, the paper develops research propositions relating societal factors, food environment, and market-related factors to consumer acceptance of cultured meat across countries.
Bacterial survival in radiopharmaceutical solutions: a critical impact on current practices
Authors: Leenhardt Julien , Choisnard Luc , Plasse Maelle , Ardisson Valérie , de Leiris Nicolas , Djaileb Loic , Bedouch Pierrick , Brunet Marie-Dominique
Published: October 2023

Background

The aim of this brief communication is to highlight the potential bacteriological risk linked to the processes control of radiopharmaceutical preparations made in a radiopharmacy laboratory. Survival rate of Pseudomonas aeruginosa (ATCC: 27853) or Staphylococcus aureus (ATCC: 25923) or Staphylococcus epidermidis (ATCC: 1228) in multidose technetium-99 m solution was studied.

Results

Depending on the nature and level of contamination by pathogenic bacteria, the lethal effect of radioactivity is not systematically observed. We found that P. aeruginosa was indeed affected by radioactivity. However, this was not the case for S. epidermidis, as the quantity of bacteria found in both solutions (radioactive and non-radioactive) was rapidly reduced, probably due to a lack of nutrients. Finally, the example of S. aureus is an intermediate case where we observed that high radioactivity affected the bacteria, as did the absence of nutrients in the reaction medium. The results were discussed in the light of current practices on the sterility test method, which recommends waiting for radioactivity to decay before carrying out the sterility test.

Conclusion

In terms of patient safety, the results run counter to current practice and the latest EANM recommendation of 2021 that radiopharmaceutical preparations should be decayed before sterility testing.
The role of mild stressors in children’s cognition and inflammation: positive and negative impacts depend on timing of exposure
Authors: Francesconi Marta , Minichino Amedeo , Flouri Eirini
Published: October 2023

Although the impact of stressful life events (SLEs) on mental health is well-established, the research on the impact of such stressors on cognitive outcomes has produced mixed results. Arguably, the timing and severity of exposure may play a key role. In this study, we shed light on the relationship between timing of exposure to relatively minor SLEs and cognitive ability in children, while taking into account the role of a plausible biological mediator: inflammation. Using data from the Avon Longitudinal Study of Parents and Children, a general population birth cohort, we explored the role of relatively minor SLEs, experienced during two crucial developmental stages: up to transition to school (1–4.5 years) and up to transition to puberty (5.5–8.5 years). We then tested if they may impact differently on inflammatory markers (serum C-reactive protein [CRP] and interleukin 6 [IL-6]) at age 9 and general intelligence, measured with the Wechsler Abbreviated Scale of Intelligence at age 15. Data (n = 4,525) were analyzed using path analysis while controlling for covariates. We found that when relatively minor stressful events were experienced up to transition to school they were significantly associated with higher IQ at age 15, whereas when experienced up to transition to puberty they were significantly associated with higher levels of IL-6 at age 9. Results were robust to adjustment for relevant covariates, including IQ at age 8. Mild stressors in childhood may result in positive (i.e., improved cognition) or negative (i.e., inflammation) outcomes depending on the timing of exposure.
Survival Trends Among Adolescents and Young Adults Diagnosed With Cancer in the United States: Comparisons With Children and Older Adults
Authors: Keegan Theresa H.M. , Abrahão Renata , Alvarez Elysia M.
Published: October 2023

PURPOSE

Although data from 1975 to 1997 revealed a gap in cancer survival improvement in adolescents and young adults (AYAs; 15-39 years) compared with children and older adults, more recent studies have reported improvements in AYA cancer survival overall. The current analysis provides an update of 5-year relative survival and cancer survival trends among AYAs compared with children and older adults.

METHODS

We obtained data from the National Cancer Institute Surveillance, Epidemiology, and End Results Program for 17 regions to obtain recent (2010-2018) 5-year relative survival estimates by cancer type, stage, sex, and race/ethnicity by age group. In addition, we calculated 5-year relative survival trends during 2000-2014.

RESULTS

Across 33 common AYA cancers, AYAs and children had high 5-year relative survival (86%) and experienced similar survival improvements over time (average absolute change: AYAs, 0.33%; children 0.36%). Among AYAs, 73% of cancers had improvement in 5-year relative survival since 2000. Despite this overall progress, we identified cancers where survival was worse in AYAs than younger or older patients and cancers that have had either a lack of improvement (osteosarcoma and male breast) or decreases in survival (cervical and female bladder) over time. Furthermore, males had inferior survival to females for all cancers, except Kaposi sarcoma and bladder cancer, and non-Hispanic Black/African American AYAs experienced worse survival than other racial/ethnic groups for many cancers considered in this study.

CONCLUSION

Future studies should focus on identifying factors affecting survival disparities by age, sex, and race/ethnicity. Differences in biology, clinical trial enrollment, delivery of treatment according to clinical guidelines, and supportive and long-term survivorship care may account for the survival disparities we observed and warrant further investigation.
Growth factor use in patients with breast cancer treated with docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP) regimen: Cost implications in a safety-net system.
Authors: Kashanian Sarah , Kanjwal Shifa , Brown Steven , Li Hsiao Ching , Unni Nisha , Delgado Ramos Glenda Maria , Syed Samira K. , Sadeghi Navid
Published: October 2023

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Background: Growth factor (G-CSF) support has been shown to reduce the incidence of neutropenic complications after chemotherapy; however, it can be associated with a significant increase in cost of care. Here, we reviewed G-CSF use in breast cancer patients receiving docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP) regimen at a safety-net system. Methods: Parkland Health is the safety-net system that provides care to primarily uninsured/underinsured patients in Dallas County, Texas. The majority of patients treated at Parkland belong to racial and ethnic minorities. We reviewed electronic medical records of patients with HER-2 positive breast cancer who were treated with TCHP between 01/01/2017 and 12/31/2022 at Parkland. Data on patient demographics, treatment history, laboratory values, and treatment related complications were collected. Results: A total of 171 consecutive patients underwent neoadjuvant/adjuvant treatment with TCHP for HER-2 positive breast cancer. Forty-one patients (24.0%) received G-CSF for primary prophylaxis, as per discretion of treating physician. In the 130 patients (76.0%) who did not receive primary prophylaxis, G-CSF was added later in 41 patients (32.5%). Febrile neutropenia (FN), neutropenic treatment delays, and infections not meeting FN criteria accounted for the majority of cases where G-CSF was added later in the course of treatment. Overall, 529 cycles of TCHP were administered without G-CSF vs. 372 cycles with G-CSF. Without primary prophylaxis, 18.5% (24/130) of the patients developed FN vs 2.4% (1/41) for those who received primary prophylaxis, p=0.011. FN was a complication in 4.5% (24/529) of chemotherapy cycles without G-CSF vs. 1.1% (4/372) of cycles administered with G-CSF, p=0.003. In patients treated without G-CSF, the majority of FN episodes (71%) occurred within the first 3 cycles. FN resulted in a total of 150 days (median 5 days) of hospital stay resulting in $1.2 million (M) in charges (median $36,000 per admission). Universal G-CSF use in our patient population could have prevented 21 episodes of febrile neutropenia with an estimated saving of $1.05 M (hospital admission charges), at an extra cost of $1.8M (based on the pegfilgrastim Medicare average sales price (ASP) from 2017-2022). However, based on the 2023 Medicare ASP, by substituting pegfilgrastim for biosimilars, the estimated cost would have been $603,000. Conclusions: Our study did not show an FN rate >20% to warrant routine addition of G-CSF for primary prophylaxis as recommended by the NCCN. During the study period, the cost of G-CSF was prohibitive for its universal use. However, the recent introduction of G-CSF biosimilars has significantly reduced the cost burden and justifies routine G-CSF prophylaxis as a cost saving measure.
Absolute neutrophil count (ANC) cutoff in cancer clinical trials: Implications for minority accrual in the United States (US).
Authors: Gunaratne Madugodaralalage , Abeykoon Jithma P. , Wolanskyj-Spinner Alexandra P. , Sridharan Meera , Hook Carl C. , Rouse Rachelle , Elliott Michelle A. , Ashrani Aneel A. , Pardanani Animesh Dev , Pruthi Rajiv , Go Ronald S.
Published: October 2023

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Background: In the US, minority patients are underrepresented in cancer clinical trials. This is due to multiple factors, including socioeconomic barriers, limited medical insurance coverage and restrictive clinical trial eligibility, e.g., ANC cutoff. For the latter, conservative ANC cutoff disadvantages Black patients. Two-in-three Black individuals have a Duffy-null phenotype, that is associated with lower ANC with 5% prevalence of ANC <1,500 cells/µl. To improve Black patient accrual to cancer clinical trials, lowering the ANC cutoff was proposed as a potential solution over a decade ago. Its implementation is not known. This study evaluates the ANC cutoff values as part of the eligibility criteria for cancer clinical trials. Methods: We accessed the Clinicaltrials.gov website on 5/25/2023 and obtained the ANC cutoff of cancer clinical trials conducted in the US. We included adult therapeutic trials in the phases of recruiting, not yet recruiting, enrolling by invitation, and active-not yet recruiting. Trials with drug interventions were selected. Those focusing on surgical, behavioral, nutritional and radiotherapeutic interventions were excluded. All ANC cutoff values were converted to “cells/µl” for analysis. Results: A total of 911 trials were evaluated, and 470 met the eligibility criteria. Of the 470 trials, 366 (78%) involved solid malignancies, and 104 (22%) involved hematologic malignancies. Hematologic trials have significantly lower ANC cutoffs compared to solid tumor trials with median ANC cutoff of 1,000 (range, 250-2000) vs. 1,500 (range 250-3,000); p=<0.001. In all, 323 trials (68.7%) required patients to have ANC >1,500, and 116 trials (24.6%), primarily hematologic, required patients to have ANC >1,000. For myeloma and prostate cancer, two cancers with higher incidence among Blacks, 12.9% and 86.4% of the trials require ANC >1,500, respectively. All genitourinary, breast, head & neck, sarcoma, lung, skin, and neuroendocrine tumor trials excluded patients with ANC <1,000. Conclusions: Most hematologic malignancy trials have a more liberal ANC cutoff allowing patients with ANC <1,500 to participate. However, solid tumor trials remain more conservative, with 4 in 5 trials requiring an ANC cutoff of >1,500. A strict ANC cutoff remains a barrier to minority accrual.[Table: see text]
Exploring the role of decentralized clinical trials in oncology: Insights from cancer centers.
Authors: Beg Shaalan , Werner Theresa Louise , George Thomas J. , Williams Erin Lee , Cameron Kendra , Honeycutt Hailey , Shaw Kate , Rahimi Asal Shoushtari , Lin Tara L.
Published: October 2023

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Background: Decentralized clinical trials (DCT) involve conducting some or all trial-related activities at a location separate from the investigator's site. DCT can help reduce the burden on patients, sites, and sponsors while improving patient accrual and retention rates and increasing the diversity of trial participants. While DCT methods provide patient-centric trial flexibilities, they can impact trial operations. This survey aimed to gain insights into the perspectives and experiences of cancer centers regarding DCT in the field of oncology. Methods: A 13-question survey that addressed prior experience, perceived benefits, and challenges in implementing DCT was developed by members of the Association of American Cancer Institutes (AACI) Clinical Research Innovation (CRI) Steering Committee. The survey was sent via email to the AACI CRI listserv, which consists of members of 90 cancer research centers in North America. Respondents were asked to consider their activity related to treatment and non-treatment interventional trials. Results: There were 75 total responses from members affiliated with 55 individual cancer centers. Of these centers, 73% were NCI-designated cancer centers. Of the individual respondents, 57% were clinical trial office administrators. The issues of highest concern by respondents were 1) meeting study timelines, 2) patient recruitment and 3) cost (83%, 65%, 44% respectively). All respondents had prior experience with DCT tools with the most common components being the use of local facilities for labs/imaging, telemedicine and e-consent (89%, 69%, 68% respectively). The areas of most perceived benefit from DCT include reduced participant burden, increased diversity and participant retention (81%, 80%, 68% respectively) while areas of perceived challenges include quality control, regulatory compliance and cost (61%, 59%, 49% respectively). While 92% respondents agreed/strongly agreed that DCT can improve clinical trial access, 92% agreed/strongly agreed that additional site staff training is required for successful DCT implementation. Conclusions: DCT tools have been widely implemented in oncology trials with all surveyed sites reporting prior experience. This survey emphasizes the perceived benefits of DCT in oncology, while underscoring the importance of addressing challenges and meeting the specific requirements of cancer centers. Future work should identify specific areas that require additional staff training to enable DCT readiness.