bluuebunny/crossref_metadata_2025 huggingface dataset:
Data from Transcriptional Reprogramming Differentiates Active from Inactive ESR1 Fusions in Endocrine Therapy-Refractory Metastatic Breast Cancer
Authors: Gou Xuxu , Anurag Meenakshi , Lei Jonathan T. , Kim Beom-Jun , Singh Purba , Seker Sinem , Fandino Diana , Han Airi , Rehman Saif , Hu Jianhong , Korchina Viktoriya , Doddapaneni Harshavardhan , Dobrolecki Lacey E. , Mitsiades Nicholas , Lewis Michael T. , Welm Alana L. , Li Shunqiang , Lee Adrian V. , Robinson Dan R. , Foulds Charles E. , Ellis Matthew J.
Published: April 2023

Abstract
Genomic analysis has recently identified multiple ESR1 gene translocations in estrogen receptor alpha–positive (ERα+) metastatic breast cancer (MBC) that encode chimeric proteins whereby the ESR1 ligand binding domain (LBD) is replaced by C-terminal sequences from many different gene partners. Here we functionally screened 15 ESR1 fusions and identified 10 that promoted estradiol-independent cell growth, motility, invasion, epithelial-to-mesenchymal transition, and resistance to fulvestrant. RNA sequencing identified a gene expression pattern specific to functionally active ESR1 gene fusions that was subsequently reduced to a diagnostic 24-gene signature. This signature was further examined in 20 ERα+ patient-derived xenografts and in 55 ERα+ MBC samples. The 24-gene signature successfully identified cases harboring ESR1 gene fusions and also accurately diagnosed the presence of activating ESR1 LBD point mutations. Therefore, the 24-gene signature represents an efficient approach to screening samples for the presence of diverse somatic ESR1 mutations and translocations that drive endocrine treatment failure in MBC.
Significance:
This study identifies a gene signature diagnostic for functional ESR1 fusions that drive poor outcome in advanced breast cancer, which could also help guide precision medicine approaches in patients harboring ESR1 mutations.
Supplementary Table 1 from Risk and Protective Factors for Cancer Mortality among United States Service Members and Veterans (2001–2018)
Authors: Sharifian Neika , Carey Felicia R. , Seay Julia S. , Castañeda Sheila F. , Boyko Edward J. , Rull Rudolph P.
Published: April 2023

Supplemental Table 1. Health-related Factors and Self-Reported Diagnoses at Study Entry across Combat/Deployment Experience
FDA Approval Summary: Amivantamab for the Treatment of Patients with Non–Small Cell Lung Cancer with EGFR Exon 20 Insertion Mutations
Authors: Chon Katie , Larkins Erin , Chatterjee Somak , Mishra-Kalyani Pallavi S. , Aungst Stephanie , Wearne Emily , Subramaniam Sriram , Li Yangbing , Liu Jiang , Sun Jielin , Charlab Rosane , Zhao Hong , Saritas-Yildirim Banu , Bikkavilli Rama Kamesh , Ghosh Soma , Philip Reena , Beaver Julia A. , Singh Harpreet
Published: April 2023

The FDA granted accelerated approval for amivantamab-vmjw (hereafter referred to as amivantamab), a bispecific antibody directed against EGFR and mesenchymal–epithelial transition receptor, on May 21, 2021, for the treatment of adult patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations whose disease has progressed on or after platinum-based chemotherapy. Approval was based on results of an ongoing, multicenter, nonrandomized, open-label, multicohort clinical trial (CHRYSALIS, NCT 02609776), demonstrating a substantial overall response rate (ORR) and durable responses, with an ORR of 40% [95% confidence interval (CI): 29–51] and a median response duration of 11.1 months (95% CI: 6.9–not evaluable). Guardant360 CDx was contemporaneously approved as a companion diagnostic for this indication to identify EGFR exon 20 insertion mutations in plasma specimens.

The most notable safety finding was the high incidence (66%) of infusion-related reactions, which is addressed in both the Dosage and Administration and Warnings and Precautions sections of the product label. Other common adverse reactions (occurring in ≥20% of patients) were rash, paronychia, musculoskeletal pain, dyspnea, nausea and vomiting, fatigue, edema, stomatitis, cough, and constipation. The approval of amivantamab was the first approval of a targeted therapy for patients with advanced NSCLC harboring EGFR exon 20 insertion mutations.
An Immune-Related Gene Expression Signature Predicts Benefit from Adding Atezolizumab to FOLFOXIRI plus Bevacizumab in Metastatic Colorectal Cancer
Authors: Antoniotti Carlotta , Boccaccino Alessandra , Seitz Robert , Giordano Mirella , Catteau Aurélie , Rossini Daniele , Pietrantonio Filippo , Salvatore Lisa , McGregor Kimberly , Bergamo Francesca , Conca Veronica , Leonetti Simone , Morano Federica , Papiani Giorgio , Tamburini Emiliano , Bensi Maria , Murgioni Sabina , Ross Douglas Teller , Passardi Alessandro , Boquet Isabelle , Nielsen Tyler J. , Galon Jérôme , Varga Matthew Gordon , Schweitzer Brock L. , Cremolini Chiara
Published: April 2023

Purpose:

AtezoTRIBE phase II randomized study demonstrated that adding atezolizumab to first-line FOLFOXIRI (5-fluorouracil, oxaliplatin, irinotecan) plus bevacizumab prolongs progression-free survival (PFS) of patients with metastatic colorectal cancer (mCRC), with a modest benefit among proficient mismatch repair (pMMR). DetermaIO is an immune-related 27-gene expression signature able to predict benefit from immune checkpoint inhibition in triple-negative breast cancer. In this analysis of AtezoTRIBE, we investigated the predictive impact of DetermaIO in mCRC.

Experimental Design:

Patients with mCRC unselected for MMR status were randomly assigned (1:2) to FOLFOXIRI plus bevacizumab (control arm) or the same regimen with atezolizumab (atezolizumab arm). qRT-PCR by DetermaIO was performed on RNA purified from pretreatment tumors of 132 (61%) of 218 enrolled patients. A binary result (IOpos vs. IOneg) adopting the preestablished DetermaIO cut-off point (0.09) was obtained, and an exploratory optimized cut-off point (IOOPT) was computed in the overall population and in pMMR subgroup (IOOPTpos vs. IOOPTneg).

Results:

DetermaIO was successfully determined in 122 (92%) cases, and 23 (27%) tumors were IOpos. IOpos tumors achieved higher PFS benefit from atezolizumab arm than IOneg (HR: 0.39 vs. 0.83; Pinteraction = 0.066). In pMMR tumors (N = 110), a similar trend was observed (HR: 0.47 vs. 0.93; Pinteraction = 0.139). In the overall population, with the computed IOOPT cut-off point (0.277), 16 (13%) tumors were IOOPTpos and they derived higher PFS benefit from atezolizumab than IOOPTneg (HR: 0.10 vs. 0.85, Pinteraction = 0.004). Similar results were found in the pMMR subgroup.

Conclusions:

DetermaIO may be useful to predict benefit of adding atezolizumab to first-line FOLFOXIRI plus bevacizumab in mCRC. The exploratory IOOPT cut-off point should be validated in independent mCRC cohorts.
Supplementary Data from Changes in Aged Fibroblast Lipid Metabolism Induce Age-Dependent Melanoma Cell Resistance to Targeted Therapy via the Fatty Acid Transporter FATP2
Authors: Alicea Gretchen M. , Rebecca Vito W. , Goldman Aaron R. , Fane Mitchell E. , Douglass Stephen M. , Behera Reeti , Webster Marie R. , Kugel Curtis H. , Ecker Brett L. , Caino M. Cecilia , Kossenkov Andrew V. , Tang Hsin-Yao , Frederick Dennie T. , Flaherty Keith T. , Xu Xiaowei , Liu Qin , Gabrilovich Dmitry I. , Herlyn Meenhard , Blair Ian A. , Schug Zachary T. , Speicher David W. , Weeraratna Ashani T.
Published: April 2023

Supplementary Figures and Legends.
Analysis of Donor Pancreata Defines the Transcriptomic Signature and Microenvironment of Early Neoplastic Lesions
Authors: Carpenter Eileen S. , Elhossiny Ahmed M. , Kadiyala Padma , Li Jay , McGue Jake , Griffith Brian D. , Zhang Yaqing , Edwards Jacob , Nelson Sarah , Lima Fatima , Donahue Katelyn L. , Du Wenting , Bischoff Allison C. , Alomari Danyah , Watkoske Hannah R. , Mattea Michael , The Stephanie , Espinoza Carlos E. , Barrett Meredith , Sonnenday Christopher J. , Olden Nicholas , Chen Chin-Tung , Peterson Nicole , Gunchick Valerie , Sahai Vaibhav , Rao Arvind , Bednar Filip , Shi Jiaqi , Frankel Timothy L. , Pasca di Magliano Marina
Published: April 2023

The adult healthy human pancreas has been poorly studied given the lack of indication to obtain tissue from the pancreas in the absence of disease and rapid postmortem degradation. We obtained pancreata from brain dead donors, thus avoiding any warm ischemia time. The 30 donors were diverse in age and race and had no known pancreas disease. Histopathologic analysis of the samples revealed pancreatic intraepithelial neoplasia (PanIN) lesions in most individuals irrespective of age. Using a combination of multiplex IHC, single-cell RNA sequencing, and spatial transcriptomics, we provide the first-ever characterization of the unique microenvironment of the adult human pancreas and of sporadic PanIN lesions. We compared healthy pancreata to pancreatic cancer and peritumoral tissue and observed distinct transcriptomic signatures in fibroblasts and, to a lesser extent, macrophages. PanIN epithelial cells from healthy pancreata were remarkably transcriptionally similar to cancer cells, suggesting that neoplastic pathways are initiated early in tumorigenesis.

Significance:

Precursor lesions to pancreatic cancer are poorly characterized. We analyzed donor pancreata and discovered that precursor lesions are detected at a much higher rate than the incidence of pancreatic cancer, setting the stage for efforts to elucidate the microenvironmental and cell-intrinsic factors that restrain or, conversely, promote malignant progression.

See related commentary by Hoffman and Dougan, p. 1288.

This article is highlighted in the In This Issue feature, p. 1275
Supplementary Table S3 from Interethnic Differences in Bladder Cancer Incidence and the Association Between Type 2 Diabetes and Bladder Cancer in the Multiethnic Cohort Study
Authors: Bogumil David , Cortessis Victoria K. , Wilkens Lynne R , Le Marchand Loic , Haiman Christopher A , Maskarinec Gertraud , Setiawan Veronica Wendy
Published: April 2023

Supplementary Table 3: Race/ethnicity specific incidence rates, per 100,000, adjusted to U.S. standard 2000 population, with left truncation.
Supplementary Tables S1-S6 from Ultra High-Plex Spatial Proteogenomic Investigation of Giant Cell Glioblastoma Multiforme Immune Infiltrates Reveals Distinct Protein and RNA Expression Profiles
Authors: Bonnett Shilah A , Rosenbloom Alyssa B , Ong Giang T , Conner Mark , Rininger Aric BE , Newhouse Daniel , New Felicia , Phan Chi Q. , Ilcisin Saskia , Sato Hiromi , Lyssand John S , Geiss Gary , Beechem Joseph M.
Published: April 2023

Supplementary Table S1: A list of materials and reagents that are recommended for the GeoMx DSP assays that are not supplied by NanoString. Supplementary Table S2. A list of NanoString supplied materials and reagents. Supplementary Table S3: A list of Human protein targets by module. Supplementary Table S4: A list of Mouse protein targets by module. Supplementary Table S5: The 11-cell pellet array (CPA) used in assay development. Supplementary Table S6: The 45-cell pellet array (CPA) used in assay development.
Supplementary Table S2 from Interethnic Differences in Bladder Cancer Incidence and the Association Between Type 2 Diabetes and Bladder Cancer in the Multiethnic Cohort Study
Authors: Bogumil David , Cortessis Victoria K. , Wilkens Lynne R , Le Marchand Loic , Haiman Christopher A , Maskarinec Gertraud , Setiawan Veronica Wendy
Published: April 2023

Supplementary Table 2: Poisson model variable coefficients used to estimate absolute risk. Example rate, per 100,000 for 50 year old
African Americans with diabetes: 21.6 = exp(-7.23 + 4.31*(log(50/70)) + 0.24*1) * 100,000
Supplementary Figure S9 from Interethnic Differences in Bladder Cancer Incidence and the Association Between Type 2 Diabetes and Bladder Cancer in the Multiethnic Cohort Study
Authors: Bogumil David , Cortessis Victoria K. , Wilkens Lynne R , Le Marchand Loic , Haiman Christopher A , Maskarinec Gertraud , Setiawan Veronica Wendy
Published: April 2023

Supplementary Figure 9: Sex stratified analysis for the association between Any T2D and BCA. Models adjusted for pack-years smoked
(0, 1-10, 11-20, 21-30, 31-40, >40), alcohol consumption (<1 drinks/month, ≤1 drinks/day, >1 drinks/day), number of cigarettes smoked
per day among smokers (5 cigarettes or less, 6-10 cigarettes, 11-20, 21-30, 31 or more), race/ethnicity (European American, African
American, Japanese American, Latin American, Native Hawaiian), and reproductive factors among females. Body mass index (BMI,
kg/m3
) and smoking status (ever, never, current) were included as strata variables due to their proportional hazard violation. Categorical
birthyear was also included as a strata variable to adjust for possible cohort effects. CI: Confidence Interval; HR: Hazard Ratio; P het:
P- heterogeneity for likelihood ratio test for difference in association across covariate levels.
Supplementary Figures S16-S18 from Ultra High-Plex Spatial Proteogenomic Investigation of Giant Cell Glioblastoma Multiforme Immune Infiltrates Reveals Distinct Protein and RNA Expression Profiles
Authors: Bonnett Shilah A , Rosenbloom Alyssa B , Ong Giang T , Conner Mark , Rininger Aric BE , Newhouse Daniel , New Felicia , Phan Chi Q. , Ilcisin Saskia , Sato Hiromi , Lyssand John S , Geiss Gary , Beechem Joseph M.
Published: April 2023

Supplementary Figure S16: Representative grey scale images of used in the assessment of spatial proteogenomic data quality across mouse tissue types. FFPE sections were stained with the GeoMx NGS Mouse Protein modules (137-plex), GeoMx Mm WTA, and antibodies against CD45 (Immune), PanCK (Tumor) and Syto13 (nuclear, DNA). Supplementary Figure S17: ROI-to-ROI comparison of the proteogenomic data to the single analyte controls. Mouse FFPE sections were stained with 137-plex GeoMx NGS Mouse Protein modules and GeoMx Mm WTA. The Pearson’s R was calculated between each ROI from the proteogenomic assay against all ROIs in the single analyte (A) RNA and (B) protein controls. Protein targets with SNR ≥ 3 and RNA targets with SNR ≥ 4 were used in the analysis. Supplementary Figure S18: Expression levels of select matching RNA and protein targets in several mouse tissue types. For protein targets with SNR ≥ 3 and the respective RNA target with SNR ≥ 4, a pairwise scatter plot was generated to visualize the concordance between respective analytes.
Supplementary Figure S6 from Interethnic Differences in Bladder Cancer Incidence and the Association Between Type 2 Diabetes and Bladder Cancer in the Multiethnic Cohort Study
Authors: Bogumil David , Cortessis Victoria K. , Wilkens Lynne R , Le Marchand Loic , Haiman Christopher A , Maskarinec Gertraud , Setiawan Veronica Wendy
Published: April 2023

Supplementary Figure 6 Association between Any T2D and bladder cancer in the multiethnic sample stratified by sex, smoking status,
alcohol consumption, and BMI, with censorship of BCA cases that occurred within 2 years of incident T2D as non-cases. Models
adjusted for pack-years smoked (0, 1-10, 11-20, 21-30, 31-40, >40), alcohol consumption (<1 drinks/month, ≤1 drinks/day, >1
drinks/day), sex (male, female), number of cigarettes smoked per day among smokers (5 cigarettes or less, 6-10 cigarettes, 11-20, 21-
30, 31 or more), race/ethnicity (European American, African American, Japanese American, Latin American, Native Hawaiian), and
reproductive factors among females. Body mass index (BMI, kg/m3
) and smoking status (ever, never, current) were included as strata
variables due to their proportional hazard violation. Categorical birth year was also included as a strata variable to adjust for possible
cohort effects. CI: Confidence Interval; HR: Hazard Ratio; P het: P- heterogeneity for likelihood ratio test for difference in association
across covariate levels.
Supplementary Figure S3 from Interethnic Differences in Bladder Cancer Incidence and the Association Between Type 2 Diabetes and Bladder Cancer in the Multiethnic Cohort Study
Authors: Bogumil David , Cortessis Victoria K. , Wilkens Lynne R , Le Marchand Loic , Haiman Christopher A , Maskarinec Gertraud , Setiawan Veronica Wendy
Published: April 2023

Supplemental Figure 3: Distribution of MEC participation across participation opportunities by race/ethnicity, represented as percentage
by race/ethnicity. BL: baseline questionnaire; FU QX: follow-up questionnaire; BR: biorepository questionnaire; CMS: Medicare FFS.
Nutrition and Cancer Care – American and European Context
Authors: Keaver Laura , Abreu Bruno
Published: April 2023

The Oncology Care Model (OCM) is a US Centers for Medicare & Medicaid Services (CMS) specialty model implemented in 2016, to provide higher quality, more highly coordinated oncology care at the same or lower costs. Under the OCM, oncology clinics enter into payment arrangements that include financial and performance accountability for patients receiving chemotherapy treatment. In addition, OCM clinics commit to providing enhanced services to Medicare beneficiaries, including care coordination, navigation, and following national treatment guidelines. Nutrition is a component of best-practice cancer care, yet it may not be addressed by OCM providers even though up to 80% of patients with cancer develop malnutrition and poor nutrition has a profound impact on cancer treatment and survivorship. Only about half of US ambulatory oncology settings screen for malnutrition, registered dietitian nutritionists (RDNs) are not routinely employed by oncology clinics, and the medical nutrition therapy they provide is often not reimbursed. Thus, adequate nutrition care in US oncology clinics remains a gap area. Some oncology clinics are addressing this gap through implementation of nutrition-focused quality improvement programs (QIPs) but many are not. What is needed is a change of perspective. This paper outlines how and why quality nutrition care is integral to the OCM and can benefit patient health and provider outcomes.
Clinical Nutrition as a Human Right
Authors: Poulia Kalliopi Anna
Published: April 2023

The International Working Group for Patients' Right to Nutritional Care presents its position paper regarding nutritional care as a human right intrinsically linked to the right to food and the right to health. All people should have access to food and evidence-based medical nutrition therapy including artificial nutrition and hydration. In this regard, the hospitalized malnourished ill should mandatorily have access to screening, diagnosis, nutritional assessment, with optimal and timely nutritional therapy in order to overcome malnutrition associated morbidity and mortality, while reducing the rates of disease-related malnutrition. This right does not imply there is an obligation to feed all patients at any stage of life and at any cost. On the contrary, this right implies, from an ethical point of view, that the best decision for the patient must be taken and this may include, under certain circumstances, the decision not to feed. Application of the human rights-based approach to the field of clinical nutrition will contribute to the construction of a moral, political and legal focus to the concept of nutritional care. Moreover, it will be the cornerstone to the rationale of political and legal instruments in the field of clinical nutrition.
Real-World Experience of PD-1 Inhibitors for Relapsed and Refractory Hodgkin Lymphoma: A Multicenter Retrospective Analysis of Patients in China
Authors: Yu Wenyan , Geng Mei , Hao Jie , Yan Zeying , Mi Jian-Qing
Published: April 2023

Introduction: Despite the promising clinical trial data regarding programmed death 1 (PD-1) inhibitors in relapsed/refractory classical Hodgkin lymphoma (R/R cHL), there remains a paucity of studies describing the outcomes of patients in a real-world setting, especially for Asian cohort. Methods: We present a multicenter retrospective analysis of patients with R/R cHL who had failed ≥2 prior lines of therapies and received sintilimab or tislelizumab developed in China (sintilimab or tislelizumab monotherapy) at 3 medical centers from January 2019 to September 2021. Efficacy was evaluated with progression-free survival (PFS), overall survival, duration of response (DOR), best overall response (BOR) including objective response rate (ORR), complete response rate (CRR). Safety data were also recorded. Results: 74 patients were reviewed. The median age was 38 years (range, 14–85 years). The ORR, CRR, and disease control rate were 78.3%, 52.7%, and 91.9%, respectively. The median duration of follow-up was 22 (4–36) months. Four patients (5.4%) died of disease progression. The median PFS and DOR was 22.1 and 23.5 months. BOR as a new emergent endpoint was found to be the only independent prognostic factor for PFS in our study (HR = 6.234, p = 0.005), suggesting this endpoint carries stronger prognostic value over traditional endpoints in the immunotherapy era. 66 (89.2%) patients reported adverse event (AE) with any grade, with the majority of AEs being grade 1 or 2. Conclusion: We presented a unique real-life experience and conducted a relatively long follow-up of PD-1 antibodies developed in China for R/R HL patients which confirmed their promising effectiveness and manageable side effects given in real world in an Asian cohort. Even for those who would usually be excluded in most of clinical trials such as elderly or minor patients, anti-PD-1 monotherapy also showed a significant improvement of outcomes. Furthermore, the depth of response seemed to be a more powerful predictive tool in new era, which might serve as a basis for future immune risk-adapted strategies.
Ayurvedic Treatment in the Rehabilitation of Ischemic Stroke Patients in India: A Randomized Controlled Trial Study Protocol
Authors: Sylaja Padmavathy Narayana , Nair Jaya Pankajakshi Raghavan , Kate Mahesh Pundlik , Dhasan Aneesh , Nambiar Vivek , Narayan Sunil , Renjith Vishnu , Arora Deepti , Verma Shweta Jain , Sharma Meenakshi , Dhaliwal Rupinder , Khatter Himani , Sarma PS , Pandian Jeyaraj Durai ,   RESTORE Collaborators
Published: April 2023

In patients with ischemic stroke, motor and sensory impairments are common and are associated with functional disability. Conventional physiotherapy (CP) is the primary modality of rehabilitation for post-stroke sensorimotor dysfunction. Ayurveda is a commonly practiced alternative system of medicine that offers unique rehabilitative measures for post-stroke recovery. We hypothesize that Ayurvedic rehabilitative treatment (ART) is superior to similar duration CP in improving the sensorimotor recovery of patients with ischemic stroke at 90 days after enrollment. AyuRvedic TrEatment in the Rehabilitation of Ischemic STrOke Patients in India: A Randomized controllEd trial (RESTORE) is an investigator-initiated, multicenter, prospective, randomized, controlled, parallel-arm, blinded outcome assessment trial being conducted under the Indian Stroke Clinical Trial (INSTRuCT) Network across the four comprehensive stroke centers in India. Consecutive hemodynamically stable adult patients with their first acute ischemic stroke between 1 and 3 months from stroke onset are being randomized (1:1) into two treatment groups to receive either 1 month of ART or 1 month of CP. The primary outcome measure is the Fugl Meyer Assessment-upper extremity for physical performance at 90 days. The secondary outcomes are the modified Rankin Scale, Barthel Index, Berg Balance, and SF-36 at 90 days. The safety outcomes include a composite of irreversible morbidity and mortality. A sample size of 140 (70 in each group) patients with ischemic stroke will allow us to detect a minimal clinical important difference of 9.4 (standard deviation) with superiority margin of 5, an attrition rate of 10%, alpha of 5%, and power of 80%. This randomized trial will systematically assess the efficacy and safety of traditional ART compared to CP. The trial has been registered in the Clinical Trial Registry India (CTRI/2018/04/013379).
Prevalência de Transtorno Mental Comum em militares do Exército Brasileiro em tempos de paz
Authors: Chaves Suellen Cristina da Silva , Socorro de Sousa Nóbrega Maria Do Perpétuo
Published: April 2023

Objetivo: estimar a prevalência da probabilidade deTranstorno Mental Comum e a relação com variáveissociodemográficas e laborais em uma amostra de militaresbrasileiros em tempos de não guerra. Método: estudotransversal com 229 militares de um Batalhão de Infantaria.Aplicaram-se o Self Report Questionnaire 20 e a análise decorrelação linear com o cálculo das razões de prevalência.Resultados: a prevalência de Transtorno Mental Comum foide 59 (25,76%). As perguntas perda de interesse (39,30%),sentimento de tristeza (41,05%) e dormir mal (44,98%)apresentaram maiores razões de prevalência. Não houverelação estatística entre o Transtorno Mental Comum eas variáveis sociodemográficas e laborais. Conclusão: aprevalência é elevada quando comparada às condições demilitares em guerra e reforça a necessidade de intervençõespara melhorar a saúde mental desses profissionais.
Risk and protective factors for suicide: a populational case-control study, Brazil, 2019
Authors: Ruiz Ana Maria Pita , Fernandez Mirla Randy Bravo , Komoda Denis Satoshi , Treichel Carlos Alberto dos Santos , Cordeiro Ricardo Carlos
Published: April 2023

OBJETIVE: To estimate risk and protection factors associated with suicide in Campinas, Brazil, in 2019. METHODS: This is a populational case-control study analyzing 83 cases of suicide that occurred in 2019 in Campinas, a Brazilian city with about 1.2 million inhabitants. Controls were composed of 716 inhabitants. An adjusted multiple logistic regression was used. Cases and controls were the dichotomous response variables. Sociodemographic and behavioral variables were the predictor variables. RESULTS: The categories which presented higher risk of suicide were: males [OR = 5.26 (p < 0.001)]; people aged 10–29 years [OR = 5.88 (p = 0.002)]; individuals without paid work [OR = 3.06 (p = 0.013)]; individuals presenting problematic use of alcohol [OR = 33.12 (p < 0.001)] and cocaine [14.59 (p < 0.007)]; and people with disabilities [OR = 3.72 (p < 0.001]. Moreover, the perception of fear was associated with reduced suicide risk [OR = 0.19 (p = 0.015)]. Higher district HDI levels also showed a 4% decrease in risk for each 0.01 increase in district HDI levels [OR = 0.02 (p = 0.008)]. CONCLUSIONS: This study evidenced the association between sociodemographic and behavioral variables and suicide. It also emphasized the complexity in the dynamics between personal, social, and economic factors to this external cause of death.
Diagnóstico precoce do autismo e outros transtornos do desenvolvimento, Brasil, 2013–2019
Authors: Girianelli Vania Reis , Tomazelli Jeane , Silva Cosme Marcelo Furtado Passos da , Fernandes Conceição Santos
Published: April 2023

OBJETIVO: Investigar os fatores associados ao diagnóstico precoce do autismo e de outros tipos de transtorno global do desenvolvimento (TGD) de crianças atendidas no Centro de Atenção Psicossocial Infantojuvenil do Sistema Único de Saúde, no período de 2013 a 2019, no Brasil. MÉTODOS: Estudo transversal exploratório, com base nos dados do Registro das Ações Ambulatoriais de Saúde (RAAS) do primeiro atendimento de crianças de 1 a 12 anos. Foram estimados o risco relativo bruto (RRb) e ajustado (RRa), e respectivo intervalo de confiança de 95% (IC95%), utilizando o modelo de regressão de Poisson com estimativa de variância robusta. RESULTADOS: Das 22.483 crianças incluídas no estudo, a maioria era do sexo masculino (81,9%), residia no mesmo município em que foi diagnosticada (96,8%) e na região Sudeste (57,7%). O diagnóstico precoce foi maior para autismo infantil (RRb = 1,48; IC95% 1,27–1,71), TGD sem designação de subtipo (RRb = 1,55; IC95% 1,34–1,80), outros TGD (RRb = 1,48; IC95% 1,21–1,81) e TGD não especificado (RRb = 1,44; IC95% 1,22–1,69) do que para autismo atípico. As crianças que residiam no mesmo município onde foi realizado o diagnóstico tiveram maior índice de diagnóstico precoce (RRb = 1,31; IC95% 1,10–1,55) do que as demais; bem como aquelas encaminhadas pela atenção básica (RRb = 1,51; IC95% 1,37–1,68) e por demanda espontânea (RRb = 1,45; IC95% 1,31–1,61) do que as oriundas de outros tipos de encaminhamento. O diagnóstico precoce foi maior a partir de 2014 e menor na região Norte quando comparada às demais. Na análise múltipla, a magnitude do RRa foi similar ao do RRb. CONCLUSÕES: A identificação precoce de autismo e outros TGD tem melhorado no país, mas ainda representa cerca de 30% dos diagnósticos realizados. As variáveis incluídas no modelo foram significativas, mas ainda explicam pouco do diagnóstico precoce de crianças com autismo e outros TGD.
Consumo de alimentos ultraprocessados no Brasil: distribuição e evolução temporal 2008–2018
Authors: Louzada Maria Laura da Costa , Cruz Gabriela Lopes da , Silva Karina Augusta Aparecida Nogueira , Grassi Ana Giulia Forjaz , Andrade Giovanna Calixto , Rauber Fernanda , Levy Renata Bertazzi , Monteiro Carlos Augusto
Published: April 2023

OBJETIVO: Avaliar fatores sociodemográficos associados ao consumo de alimentos ultraprocessados e a evolução temporal do consumo no Brasil entre 2008 e 2018. MÉTODOS: Foram utilizados dados do consumo alimentar de indivíduos com idade ≥ 10 anos das Pesquisas de Orçamentos Familiares (POF) 2008–2009 e 2017–2018. Os alimentos foram agrupados segundo a classificação Nova. Modelos de regressão linear brutos e ajustados foram utilizados para avaliar a associação entre características sociodemográficas e o consumo de ultraprocessados em 2017–2018 e a variação temporal de seu consumo entre 2008 e 2018. RESULTADOS: Alimentos ultraprocessados representaram 19,7% das calorias em 2017–2018. A análise ajustada mostrou que seu consumo foi maior no sexo feminino (versus masculino) e nas regiões Sul e Sudeste (versus Norte), e menor em negros (versus brancos) e na área rural (versus urbana), além de diminuir com o aumento da idade e aumentar com escolaridade e renda. O consumo de ultraprocessados aumentou 1,02 pontos percentuais (pp) de 2008–2009 a 2017–2018, sendo este aumento mais expressivo em homens (+1,59 pp), negros (+2,04 pp), indígenas (+5,96 pp), na área rural (+2,43 pp), naqueles com até 4 anos de estudo (+1,18 pp), no quinto mais baixo de renda (+3,54 pp) e nas regiões Norte (+2,95 pp) e Nordeste (+3,11 pp). Por outro lado, seu consumo se reduziu na maior faixa de escolaridade (-3,30 pp) e no quinto mais alto de renda (-1,65 pp). CONCLUSÕES: Os segmentos socioeconômicos e demográficos que tiveram menor consumo relativo de ultraprocessados em 2017–2018 são justamente os que apresentaram um aumento mais expressivo na análise temporal, apontando para uma tendência de padronização nacional em um patamar de consumo mais alto.
Race, Ethnic, Sex, and Socioeconomic Inequities in Interhospital Transfer for Acute Ischemic Stroke in the United States
Authors: Oh Daniel M. , Markovic Daniela , Towfighi Amytis
Published: April 2023

Background:

Patients with stroke in the United States can be transferred for higher level of care. Little is known about possible inequities in interhospital transfers (IHTs) for acute ischemic stroke. We hypothesized that historically marginalized populations would have lower odds of IHT.

Methods:

A cross-sectional analysis was done for adults with a primary diagnosis of acute ischemic stroke in 2010 to 2017; n=747 982 were identified in the National Inpatient Sample. Yearly rates for IHT were assessed and adjusted odds ratios (aORs) of IHT in 2014 to 2017 were compared with that of 2010 to 2013. Multinomial logistic regression was used to determine the aOR of IHT, adjusting for sociodemographic variables (model 1), sociodemographic and medical variables such as comorbidity and mortality risk (model 2), and sociodemographic, medical, and hospital variables (model 3).

Results:

After adjusting for sociodemographic, medical, and hospital characteristics, there were no significant temporal differences in IHT from 2010 to 2017. Overall, women were less likely than men to be transferred in all models (model 3: aOR, 0.89 [0.86–0.92]). Compared with those who were White, individuals who were Black (aOR, 0.93 [0.88–0.99]), Hispanic (aOR, 0.90 [0.83–0.97]), other (aOR, 0.90 [0.82–0.99]), or of unknown race, ethnicity (aOR, 0.89 [0.80–1.00]) were less likely to be transferred (model 2), but these differences dissipated when further adjusting for hospital-level characteristics (model 3). Compared with those with private insurance, those with Medicaid (aOR, 0.86 [0.80–0.91]), self-pay (aOR, 0.64 [0.59–0.70]), and no charge (aOR, 0.64 [0.46–0.88]) were less likely to be transferred (model 3). Individuals with lower income were less likely to be transferred compared with those with higher income (model 3: aOR, 0.85 [0.80–0.90], third versus fourth quartile).

Conclusions:

Adjusted odds of IHT for acute ischemic stroke remained stable from 2010 to 2017. There are numerous inequities in the rates of IHT by race, ethnicity, sex, insurance, and income. Further studies are needed to understand these inequities and develop policies and interventions to mitigate them.
Intensive Blood Pressure Control After Mechanical Thrombectomy for Acute Ischemic Stroke
Authors: Morris Nicholas A. , Jindal Gaurav , Chaturvedi Seemant
Published: April 2023

Optimal blood pressure targets following successful mechanical thrombectomy remain uncertain. While some observational studies suggest that the relationship between blood pressure and outcomes follows a
U
-shaped curve, others suggest a linear relationship where lower is better. The recent BP-TARGET study (Blood Pressure Target in Acute Stroke to Reduce Hemorrhage After Endovascular Therapy) did not find a benefit to intensive blood pressure lowering regarding the risk of symptomatic intracranial hemorrhage, but it was not sufficiently powered to detect differences in functional outcomes. On its heels arrived the ENCHANTED2 (Enhanced Control of Hypertension and Thrombectomy Stroke Study)/mechanical thrombectomy trial, the first trial of intensive blood pressure lowering in patients with hypertension following successful mechanical thrombectomy powered to detect a difference in functional outcomes. The trial randomized patients to either a systolic blood pressure less than 120 or 140 to 180 mm Hg. The trial was terminated early due to safety concerns in the more intensive blood pressure–lowering group. In this emerging therapy critique, we explore concerns regarding the generalizability of ENCHANTED2/mechanical thrombectomy, including the high prevalence of intracranial atherosclerosis in the studied population. We survey mechanisms for poor outcomes in patients who receive overly aggressive blood pressure reduction following successful thrombectomy, such as poststroke autoregulatory compromise and persistent microcirculatory hypoperfusion. Finally, we advocate for a more moderate approach, pending further research.
On the Stability and Behavioral Diversity of Single and Collective Bernoulli Balls
Authors: Howison Toby , Crisp Harriet , Hauser Simon , Iida Fumiya
Published: April 2023

The ability to express diverse behaviors is a key requirement for most biological systems. Underpinning behavioral diversity in the natural world is the embodied interaction between the brain, body, and environment. Dynamical systems form the basis of embodied agents, and can express complex behavioral modalities without any conventional computation. While significant study has focused on designing dynamical systems agents with complex behaviors, for example, passive walking, there is still a limited understanding about how to drive diversity in the behavior of such systems. In this article, we present a novel hardware platform for studying the emergence of individual and collective behavioral diversity in a dynamical system. The platform is based on the so-called Bernoulli ball, an elegant fluid dynamics phenomenon in which spherical objects self-stabilize and hover in an airflow. We demonstrate how behavioral diversity can be induced in the case of a single hovering ball via modulation of the environment. We then show how more diverse behaviors are triggered by having multiple hovering balls in the same airflow. We discuss this in the context of embodied intelligence and open-ended evolution, suggesting that the system exhibits a rudimentary form of evolutionary dynamics in which balls compete for favorable regions of the environment and exhibit intrinsic “alive” and “dead” states based on their positions in or outside of the airflow.
Efficient Quality Diversity Optimization of 3D Buildings through 2D Pre-Optimization
Authors: Hagg Alexander , Kliemank Martin L. , Asteroth Alexander , Wilde Dominik , Bedrunka Mario C. , Foysi Holger , Reith Dirk
Published: April 2023

Quality diversity algorithms can be used to efficiently create a diverse set of solutions to inform engineers' intuition. But quality diversity is not efficient in very expensive problems, needing hundreds of thousands of evaluations. Even with the assistance of surrogate models, quality diversity needs hundreds or even thousands of evaluations, which can make its use infeasible. In this study, we try to tackle this problem by using a pre-optimization strategy on a lower-dimensional optimization problem and then map the solutions to a higher-dimensional case. For a use case to design buildings that minimize wind nuisance, we show that we can predict flow features around 3D buildings from 2D flow features around building footprints. For a diverse set of building designs, by sampling the space of 2D footprints with a quality diversity algorithm, a predictive model can be trained that is more accurate than when trained on a set of footprints that were selected with a space-filling algorithm like the Sobol sequence. Simulating only 16 buildings in 3D, a set of 1,024 building designs with low predicted wind nuisance is created. We show that we can produce better machine learning models by producing training data with quality diversity instead of using common sampling techniques. The method can bootstrap generative design in a computationally expensive 3D domain and allow engineers to sweep the design space, understanding wind nuisance in early design phases.
Darwinian Bases of Religious Meaning: Interactionism, General Interpretive Theories, and 6E Cognitive Science
Authors: McCauley Robert N.
Published: April 2023

Interactionism holds that explanatory and interpretive projects are mutually enriching. If so, then the evolutionary and cognitive science of religions’ explanatory theories should aid interpretive projects concerning religious meaning. Although interpretive accounts typically focus on the local and the particular, interpreters over the past century have construed Freud and Marx as offering general interpretive theories. So, precedent for general interpretive theorizing exists. 4E cognitive science, which champions how cognition is embedded in natural and cultural settings, extended into external structures, enacted via motor routines, and embodied via representations rooted in human bodily form, has encouraged interpretive researchers. Theories of embodied cognition especially have embraced a sweeping view of meaning that attends to the emotions’ role and to their evolutionary origins. That inspires a 6E cognitive science that attends to the emotional and evolved dimensions of cognition too and opens up the possibility of general interpretive theories of broadly Darwinian character. Evolved cognitive systems qualify as maturationally natural cognition, which exhibits a distinctive constellation of features. The by-product theory holds that religious representations’ engagement of maturationally natural cognition fosters religions’ success. Representations with some minimal violation of intuitive expectations concerning some ontological category grab attention, stick in memory, and preserve the many automatic inferences accompanying the category. The empirical evidence for this and other elaborations of the by-product view suggests that it discloses dynamics of evolved cognition and associated emotions that tend to guide the pursuit of religious meanings systematically toward well-worn grooves in the semantic landscape.
The Moral Foundations of Left-Wing Authoritarianism: On the Character, Cohesion, and Clout of Tribal Equalitarian Discourse
Authors: Lane Justin E. , McCaffre Kevin , Shults F. LeRon
Published: April 2023

Left-wing authoritarianism remains far less understood than right-wing authoritarianism. We contribute to literature on the former, which typically relies on surveys, using a new social media analytic approach. We use a list of 60 terms to provide an exploratory sketch of the outlines of a political ideology – tribal equalitarianism – with origins in 19th and 20th century social philosophy. We then use analyses of the English Corpus of Google Books (n > 8 million books) and scraped unique tweets from Twitter (n = 202,582) to conduct a series of investigations to discern the extent to which this ideology is cohesive amongst the public, reveals signatures of authoritarianism and has been growing in popularity. Though exploratory, our results provide some evidence of left-wing authoritarianism in two forms: (1) a uniquely conservative signature amongst ostensible liberals using measures derived from Moral Foundations Theory and (2) a substantial prevalence of anger, relative to anxiety or sadness, in tweets analyzed for sentiment. In general, results indicate that this worldview is growing in popularity, is increasingly cohesive, and shows signatures of authoritarianism.
Affective and Motivational Accounts of Moralizing COVID-19-Preventive Behaviors
Authors: Takamatsu Reina , Min May Cho , Takai Jiro
Published: April 2023

The purpose of this study was to investigate the role of perceived vulnerability to disease, emotions (disgust, anger), and perceived norms in predicting moral judgments of anti-COVID-19-preventive behaviors in US and Japan. A total of 442 Japanese and 365 American participants completed an online survey. Disgust and anger mediated the link between perceived vulnerability to disease (germ aversion) and moral judgments of preventive behaviors across both cultures. Perceived social norms among friends and family were associated with harsh judgments of anti-preventive behaviors for Japanese but not for American participants. Overall, our results suggest that effective strategies for promoting preventive behaviors may be culturally valid if they focus on the fear for infectious disease and related aversive affect. We also discussed the possibility that some strategies could be characteristic of collectivistic cultures, warranting further cross-cultural comparisons.
Distance from a Cultural Prototype and Psychological Distress in Urban Brazil: A Model
Authors: Dressler William W. , Balieiro Mauro C. , dos Santos José Ernesto
Published: April 2023

The metaphor of culture as a space or environment of meaning is widely employed. Going beyond metaphor, we present a model of culture as a 3-dimensional Euclidean space, using data from Brazil on cultural models of life goals. The dimensions of this space are defined by degree of sharing of culture (cultural competence); alternate configurations of that shared meaning (residual agreement); and social practice (cultural consonance). A cultural distance metric calculated within those dimensions identifies an individuals’ proximity to prototypical goals; greater distance from these goals is associated with higher psychological distress. Cultural distance is in turn influenced by one’s sense of personal agency. Finally, in a set of open-ended interviews, the more individuals employ spatial metaphors in talking about culturally defined life goals, the higher their sense of personal agency and cultural consonance. This model moves the discussion of culture as a space of meaning from metaphor to measurement.
One Year of Civil Family Law in the United Arab Emirates: A Preliminary Assessment
Authors: Möller Lena-Maria
Published: April 2023

This article provides a preliminary commentary on the new civil family law regime introduced in the emirate of Abu Dhabi in November 2021 which, since February 2023, applies nationwide through the adoption of a federal statute on civil personal status. Abu Dhabi’s Law No. 14 of 2021, its accompanying Procedural Regulations, and the more recent Federal Law No. 41 of 2022 have introduced legal concepts, such as civil marriage, no-fault divorce, and joint custody, as well as potentially adoption, which have previously been non-existent for both the local and the large foreign population in the United Arab Emirates. The new statutes thereby stand in sharp contrast to the family law system to which the local Muslim population is still subject. This article assesses the new provisions against the background of the federal Muslim family law regime, established patterns of family law jurisprudence in the country, and early case law in the newly established Civil Family Court in Abu Dhabi.
ENSO-Induced Teleconnection: Process-Oriented Diagnostics to Assess Rossby Wave Sources and Ambient Flow Properties in Climate Models
Authors: Annamalai H. , B. Neale Richard , Hafner Jan
Published: April 2023

Climate model fidelity in representing ENSO-induced teleconnection is assessed with process-oriented diagnostics that examine a chain of processes, from equatorial Pacific precipitation to the midlatitude circulation pattern over the Pacific–North American regions. Such processes are rarely addressed during model development. Using an upper-tropospheric divergent level, local vorticity gradient of the ambient zonal flow (
) and a restoring force for Rossby waves (
) are estimated, the equivalent barotropic vorticity equation is solved, and an anomalous Rossby wave source (RWS′) quantified. The analysis is applied to AMIP5 and AMIP6 simulations. For a realistic circulation response representation, the hypothesis that models accurately represent the strength and location of RWS′, and spatial variations in
is tested. Compared to AMIP5, in AMIP6 there are clear improvements in representing RWS′ and
. To validate the hypothesis, the analysis identifies two metrics: spatially coherent RWS′ in the subtropical North Pacific, and longitudes of negative
over the western-central North Pacific. By projecting these metrics in two and three-dimensional views, improvements or degradations in model versions are apparent. If a model’s fidelity in representing
and RWS′ are compromised, then radiated Rossby waves are reflected more equatorward, resulting in zonally elongated circulation anomalies over the central North Pacific. Thus, during climate model development, applying this analysis frequently will keep a regular check on the fidelity of the modeled response to anomalous El Niño convection in conjunction with changing model ambient flow dependencies. This analysis is intended to form a process-oriented diagnostics package, a community contribution to the NOAA Model Diagnostics Task Force.

Significance Statement

The seasonal changes in tropical Pacific sea surface temperatures associated with El Niño events can have a significant impact in the atmospheric circulation through the North Pacific and on the annual climate variations over North America. Our skill in predicting these impacts depends critically on the ability of climate models to represent these global-scale connections accurately. We show a number of metrics that describe critical processes along this North Pacific pathway that can be used to examine the progress in climate model skill. In the future, these models could benefit significantly from using these metrics with the end goal of much improved predictions of El Niño–related variability.