bluuebunny/crossref_metadata_2025 huggingface dataset:
Sweet Beverages and Cancer: A Scoping Review of Quantitative Studies
Authors: Yeary Karen Hye-cheon Kim , Quisenberry Amanda J. , Hall Marissa G. , Yu Han , Henry Whitney Ann E. , Rodriguez Elisa Marie , Zoellner Jamie M.
Published: March 2022

We conducted a scoping review of sweet beverages (SB) and cancer outcomes to ascertain SB's relationship with cancer by SB type and cancer type. We used the PRISMA Scoping Review Guidelines to review quantitative studies of SB and cancer. Eligible studies included articles reporting a quantitative association between SB intake and a cancer-related health outcome in humans, including adiposity-related versus non–adiposity-related cancers. Studies included analyses not confounded by artificial sweeteners. SB was defined as beverages with added sugars, 100% fruit juices, or fruit drinks that were not 100% fruit juice. We used a data-charting form to extract study characteristics and results.

A total of 38 were included. The sample consisted predominately of adults from European countries outside of the United States or predominately White samples in the United States. Across all conceptualizations of SB, a greater proportion of studies examining carbonated drinks reported SB's relationship with poorer cancer outcomes, which was exacerbated in adiposity-related cancers.

The composition of different types of SB (e.g., high fructose corn syrup, natural fructose) as they relate to cancer is important. Studies including more diverse populations that bear a disproportionate burden of both SB intake and cancer are needed.

Prevention Relevance:

Different sugars in SB may impact cancer differently. Compared with SB made with other types of sugar, drinks made with man-made fructose (carbonated drinks) had poorer cancer outcomes, especially in cancers impacted by obesity. Understanding how different SB affect cancer would help us target which SB to avoid.
Late-Onset Pompe Disease Presenting with Isolated Tongue Involvement
Authors: Al-Hashel Jasem , Ismail Ismail
Published: March 2022

Late-onset Pompe disease (LOPD) is a rare autosomal recessive metabolic disorder that is caused by deficiency of the lysosomal enzyme acid alpha-glucosidase (GAA), which is responsible for glycogen breakdown. It has a wide clinical spectrum but usually presents with limb girdle and respiratory muscles weakness. Tongue involvement has been rarely reported as the sole initial symptom of LOPD. A 65-year-old male presented with difficulty in speech and eating for a 4-year duration. He started to notice speech difficulty with production of particular speech sounds such as /l/, /d/, and /t/. Within 1 year, he developed difficulties in manipulating food with the tongue and oral residue in lateral sulci requiring digital manipulation, which was suggestive of tongue muscles weakness. Clinical examination showed tongue fasciculations, mild atrophic changes, and mild tongue weakness. Investigations showed mildly elevated creatine kinase levels, and electromyography of the tongue muscles revealed moderate spontaneous activity, denervation, chronic reinnervation with high-amplitude motor unit potentials, and positive sharp waves, with preserved recruitment. Given the diagnostic uncertainty, a screening for LOPD was performed using a dried blood spot, and GAA enzyme activity levels were found to be low; 1.06 μmol/L/h (reference values in adults: 2.10–29.00 μmol/L/h). Next-generation sequencing showed pathogenic variant in GAA gene, confirming the diagnosis of LOPD. This rare report of LOPD presenting with isolated tongue involvement adds to the expanding phenotypic variability of this disease. Tongue involvement is an important and early clinical sign of LOPD that needs careful evaluation and can aid in early diagnosis of this rare and treatable disease.
Metastatic Primary Testicular Neuroendocrine Carcinoma Associated with Somatic Malignant Transformation of Teratoma: A Rare Case Report
Authors: Wonglhow Jirapat , Sunpaweravong Patrapim , Sathitruangsak Chirawadee , Kanjanapradit Kanet , Dechaphunkul Arunee
Published: March 2022

Testicular neuroendocrine tumor associated with teratoma is a rare disease. Very few cases have been reported in the literature, particularly cases involving visceral metastasis. Teratoma with somatic malignant transformation (SMT) is associated with a worse prognosis compared to teratoma without SMT. Previous data have suggested that chemotherapy regimens should be directed toward the transformed histology; however, those suggestions were based on patients with rhabdomyosarcoma, adenocarcinoma, and primitive neuroectodermal subtypes. To the best of our knowledge, only 2 cases with visceral metastasis have been reported, and a better outcome with the bleomycin/etoposide/cisplatin regimen, which responds strongly to germ cell tumors, has been reported in these cases. In contrast, 2 others with lymph node metastasis did not respond to these regimens. Here, we report a case of a patient with testicular neuroendocrine carcinoma associated with teratoma who achieved a good response to chemotherapy.
Cardiac Structure and Function in Epilepsy Patients with Drug-Resistant Convulsive Seizures
Authors: González Alba , Haugaa Kristina H. , Brekke Pål H. , Hopp Einar , Ørn Stein , Alvestad Silje , Taubøll Erik , Aurlien Dag
Published: March 2022

High frequency of convulsive seizures and long-lasting epilepsy are associated with an increased risk of sudden unexpected death in epilepsy (SUDEP). Structural changes in the myocardium have been described in SUDEP victims. It is speculated that these changes are secondary to frequent convulsive seizures and may predispose to SUDEP. The aim of this cross-sectional study was to investigate the impact of chronic drug-resistant epilepsy on cardiac function and structure in patients with a high frequency of convulsive seizures. We consecutively included 21 patients (17 women, 4 men) aged 18–40 years, with at least 10 years with epilepsy and a minimum of six convulsive seizures in the last year and without a history of status epilepticus or nonepileptic events. A complete clinical examination, resting 12-lead electrocardiogram, 72-h Holter monitoring, and echocardiography were recorded in all patients. Ten patients were assessed by 3-Tesla cardiac magnetic resonance imaging. Echocardiography and MRI data were compared with those from age- and sex-matched healthy control individuals. No significant changes in cardiac structure or function were found among patients with chronic drug-resistant epilepsy and high frequency of convulsive seizures. However, we cannot exclude that there are subgroups of patients who are more prone to epilepsy-associated cardiac alterations.
Thinking Beyond Acute Kidney Injury
Authors: El-Alali Emran , Moreno Cesar , Al Jaber Emad
Published: March 2022

Acute kidney injury (AKI) can be a significant clue to solving a puzzling patient presentation. Postrenal AKI should be suspected if imaging shows any degree of hydronephrosis and can be caused by a variety of conditions. Diagnosis of urinary obstruction without significant dilatation of the pelvic-ureteral system requires a higher degree of suspicion, and hence, its identification can become late. In patients without prior cancer screening, the etiology of obstructive uropathy must be broadened to include primary or metastatic malignancy. Clinicians should look beyond the AKI to properly evaluate the etiology of the patient’s presentation and symptoms. In this report, we present the case of a middle-aged female with no known past medical history who presented with AKI secondary to malignant retroperitoneal fibrosis as the first manifestation of metastatic breast cancer. Her AKI was associated with acute onset anuria and was found to have nondilated postrenal AKI with no significant abnormalities on renal imaging. Early onset anuria in the setting of AKI, which persists despite fluid resuscitation, can suggest complete urinary tract obstruction even with reassuring results of initial renal images, and in the patient with no history of cancer screening, malignancy should be suspected as a primary cause of obstructive uropathy.
Nerve Ultrasound Findings before and after Surgery in a Patient with Charcot-Marie-Tooth Disease Type 1A and Comorbid Carpal Tunnel Syndrome
Authors: Shields Lisa B.E. , Iyer Vasudeva G. , Zhang Yi Ping , Shields Christopher B.
Published: March 2022

The diagnosis of comorbid carpal tunnel syndrome (CTS) in patients with Charcot-Marie-Tooth (CMT) disease is challenging due to the overlapping symptoms and inconclusive electrodiagnostic studies (EDX). This case report is aimed at illustrating the value of ultrasonography (US) in a patient with CMT1 disease and comorbid CTS. A 28-year-old woman presented with symptoms of painful paresthesia and weakness of both hands. EDX demonstrated a demyelinating sensory-motor polyneuropathy in the upper and lower extremities, consistent with CMT1 disease. US showed an increased cross-sectional area (CSA) of the median nerve at the carpal tunnel inlet (CTI) with a significant drop in the diameter within the carpal tunnel, confirming concurrent CTS. Genetic testing confirmed PMP22 duplication consistent with CMT1A. Bilateral carpal tunnel releases were performed with partial symptom resolution within 3 weeks. Postoperative EDX demonstrated improved motor conduction across the wrist, but the sensory potentials continued to be unrecordable. US showed a significant reversal of the diameter-drop of the median nerve within the carpal tunnel and decrease in CSA at the CTI. US imaging is a valuable technique for identifying comorbid CTS in patients with CMT and directing appropriate treatment.
Understanding Sociodemographic Disparities in Maternal-Fetal Surgery Study Participation
Authors: Wilpers Abigail , Lynn Anna Y. , Eichhorn Barbara , Powne Amy B. , Lagueux Megan , Batten Janene , Bahtiyar Mert Ozan , Gross Cary P.
Published: March 2022

Background/Purpose: Although maternal-fetal surgery to treat fetal anomalies such as spina bifida continues to grow more common, potential health disparities in the field remain relatively unexamined. To address this gap, we identified maternal-fetal surgery studies with the highest level of evidence and analyzed the reporting of participant sociodemographic characteristics and representation of racial and ethnic groups. Methods: We conducted a systematic review of the scientific literature using biomedical databases. We selected randomized control trials (RCTs) and cohort studies with comparison groups published in English from 1990 to May 5, 2020. We included studies from across the globe that examined the efficacy of fetal surgery for twin-twin transfusion syndrome (TTTS), obstructive uropathy, congenital diaphragmatic hernia (CDH), myelomeningocele (MMC), thoracic lesions, cardiac malformations, or sacrococcygeal teratoma. We determined the frequency of reporting of age, gravidity/parity, race, ethnicity, education level, language spoken, insurance, income level, and relationship status. We identified whether sociodemographic factors were used as inclusion or exclusion criteria. We calculated the racial and ethnic group representation for studies in the USA using the participation-to-prevalence ratio (PPR). Results: We included 112 studies (10 RCTs, 102 cohort) published from 1990–1999 (8%), 2000–2009 (30%), and 2010–2020 (62%). Most studies were conducted in the USA (47%) or Europe (38%). The median sample size was 58. TTTS was the most common disease group (37% of studies), followed by MMC (23%), and CDH (21%). The most frequently reported sociodemographic variables were maternal age (33%) and gravidity/parity (20%). Race and/or ethnicity was only reported in 12% of studies. Less than 10% of studies reported any other sociodemographic variables. Sociodemographic variables were used as exclusion criteria in 13% of studies. Among studies conducted in the USA, White persons were consistently overrepresented relative to their prevalence in the US disease populations (PPR 1.32–2.11), while Black or African-American, Hispanic or Latino, Asian, American-Indian or Alaska-Native, and Native-Hawaiian or other Pacific Islander persons were consistently underrepresented (PPR 0–0.60). Conclusions: Sociodemographic reporting quality in maternal-fetal surgery studies is poor and inhibits examination of potential health disparities. Participants enrolled in studies in the USA do not adequately represent the racial and ethnic diversity of the population across disease groups.
Neuroprotective and Therapeutic Effects of Tocovid and Twendee-X on Aβ Oligomer-Induced Damage in the SH-SY5Y Cell Line
Authors: Hu Xiao , Yamashita Toru , Yu Haibo , Bian Zhihong , Hu Xinran , Feng Tian , Tadokoro Koh , Morihara Ryuta , Abe Koji
Published: March 2022

Background: Alzheimer’s disease (AD) is the most frequent cause of dementia among the elderly. The accumulation of amyloid beta (Aβ) and its downstream pathological events such as oxidative stress play central roles in AD. Recent studies revealed that Aβ oligomer (AβO)-induced strong neurotoxicity in SH-SY5Y cells via the induction of oxidative stress. Objective: In the present study, we investigated the effect of two antioxidants, Tocovid and Twendee-X, on AβO-induced SH-SY5Y cell damage. Methods: AβOs (2.5 μM) were applied to induce cellular damage in the SH-SY5Y cell line. Cell viability following AβO toxicity, Tau protein phosphorylation, cell morphology, and intracellular reactive oxygen species were assayed with or without different concentrations of Tocovid or Twendee-X. Results: Tocovid (60 μg/mL) and Twendee-X (150 μg/mL) significantly recovered cell viability from AβO toxicity (**p < 0.01, vs. control), attenuated Tau protein phosphorylation (**p < 0.01, vs. AβOs), improved cell morphology (**p < 0.01, vs. AβOs), and suppressed intracellular ROS (**p < 0.01, vs. AβOs) in SH-SY5Y cells. Conclusion: These findings suggest the neuroprotective and therapeutic potential of Tocovid and Twendee-X for AD treatment.
Uniform International Method to Measure Cervical Length: Are We There Yet?
Authors: van Zijl Maud D. , Koullali Bouchra , Kleinrouweler Emily C. , Mol Ben W. , Kazemier Brenda M. , Pajkrt Eva
Published: March 2022

Introduction: Cervical length is an important predictor of spontaneous preterm birth. So far, the best way to measure cervical length has not been established. We aimed to compare the incidence of short cervical length between three methods of cervical length measurement with and without the inclusion of cervico-isthmic complex (CIC) (six methods in total) and to determine the positive predictive value for spontaneous preterm birth. Material and Methods: We performed a prospective single-center cohort study in women with a singleton pregnancy between August 2014 and December 2018. During the routine fetal anomaly scan (18–22 weeks), women were offered transvaginal ultrasound for cervical length measurement to screen for the risk of spontaneous preterm birth. Each cervix was measured in six different ways: single-line, two-line, and tracing method between the internal and external os of the cervix with and without CIC. We evaluated the predictive value of the different measurements for spontaneous delivery before 37 weeks using positive predictive values. Results: Our final study population comprised 1,691 women. The overall rate of preterm birth <37 weeks was 8.0% (4.6% spontaneous, 3.4% iatrogenic preterm birth). The mean gestational age at cervical length measurement was 19+6 weeks. The different measuring techniques resulted in significant different cervical lengths, showing a maximum difference of >8 mm between the techniques (41.04 mm [SD 7.1] with one-line without CIC and 49.18 [SD 9.05] mm with trace with CIC) with an incidence of short cervical length below <25 mm ranging from 0.4% to 1.1% (p = 0.18). The positive predictive values for spontaneous preterm birth <37 weeks ranged from 42.9% to 20.0%. Conclusion: Different measurement methods for cervical length resulted in statistically significant differences in measured cervical length. Depending on the chosen cut-off this translates to different incidences of short cervical length and influences the number of women designated as high risk for preterm birth and receiving treatment. For interpretation and comparability between (inter-) national studies, it is important to adequately report on the employed technique. Future research should focus on determining the optimal measuring technique and a universal method of measurement.
The New United Nations “Gender Architecture”: A Room with a View?
Authors: Charlesworth Hilary , Chinkin Christine
Published: March 2022

UN Reform in the 21st century has been motivated by the perceived need for institutional coherence. This was at the heart of UN Secretary- General Kofi Annan’s ambitious program for reform that he pursued throughout his term of office, seeking to ensure greater UN effectiveness through streamlining institutional functions. A significant development in the reform process was the creation in 2010 of the UN Entity for Gender Equality and the Empowerment of Women, known as UN Women. UN Women incorporates the four existing parts of the UN system dealing with women and has been styled as the new UN “gender architecture”. This article considers the implications of this new institutional structure for the situation of women worldwide from the perspective of international law, asking in particular whether institutional reform is matched by normative progress.
Space Debris as a Legal Challenge
Authors: Schladebach Marcus
Published: March 2022

Fifty years of Space flight has left many objects in Outer Space. For a long time the Space community has debated the implementation of regulations concerning the increasing problem of the resulting Space debris. The reasons for this have been intensively analyzed, but the international community is yet to find an effective legal answer. The traditional Space Law treaties do not cover this question and in particular cannot offer a suitable solution for the most urgent need: the avoidance of Space debris through its removal from Outer Space back to earth. The legal outcome of this debate is rather disappointing. The UN Committee on the Peaceful Uses of Outer Space has released special Space Debris Mitigation Guidelines which are neither legally binding nor meet the real necessity. They can only be recognized as a first tentative step in the right direction. But their implementation could foresee the serious danger that the international community leaves the state of law as it is and fails to develop it further. Therefore it is necessary to negotiate a new provision and insert it into the Outer Space Treaty. This article offers a draft of such a legally binding obligation.
Two Jungs: Two Sciences?
Authors: Saban Mark
Published: March 2022

Two tendencies co-exist within the field of analytical psychology. The first is to locate Jung’s psychology within the established bounds of official science (by for example insisting on its implicit consistency with orthodox scientific findings). The second is to make claims that Jung’s psychology is extra- (or super-) scientific. It seems to me however that neither approach can do justice to the difficulty of the problem Jung has set us. In order to develop a third approach I place Jung’s problematic engagement with science into a creative encounter with the philosophical ideas of Deleuze & Guattari. The French philosophers distinguish two contrasting ways of doing science: “Royal” or “state” science privileges the fixed, stable and constant. “Nomad” or “minor” science emphasizes the malleable, fluid, and metamorphic nature of being. These are not alternatives but “ontologically, a single field of interaction” (Deleuze & Guattari, A Thousand Plateaus, p. 367). When it comes to Jung’s writings on science, the irredeemable ambiguity of his psychology shows up in what appear to be two contradictory approaches. One highlights the intrinsically scientific nature of his project and insists upon his empiricism. The other takes the form of a profound and relentless critique of the materialistic, reductive and rationalistic assumptions Jung finds behind the scientific approach. My suggestion here is that the dynamic tension between these two opposing visions of science that forms the crucial condition for the on-going individuation of his psychology.
A new species of Epicaerus Pascoe, 1881 (Coleoptera: Curculionidae: Entiminae: Geonemini) associated with potato cultivars in Tierras Altas de Chiriquí,
Panama
Authors: ATENCIO RANDY , BARBA ANOVEL , COLLANTES RUBÉN , PITTÍ JAVIER , MUÑOZ JORGE , DE MEDEIROS BRUNO A. S. , GIRÓN JENNIFER
Published: March 2022

Epicaerus panamensis Girón & de Medeiros, a new species of broad-nosed weevil in the tribe Geonemini (Coleoptera: Curculionidae: Entiminae) is described. Specimens have been collected on or around potato cultivars in Tierras Altas de Chiriquí, Panama. Field and habitus images, images of the male and female genitalia, an image of the feeding damage caused by the weevils on potato leaves, and a locality map are provided. The species is compared to the closely related Epicaerus inaequalis (Sharp, 1891), including a brief discussion regarding their morphological affinities and current taxonomic placement.
Processes and Mechanisms of Persistent Extreme Rainfall Events in the Antarctic Peninsula during Austral Summer
Authors: Wang Sai , Ding Minghu , Liu Ge , Chen Wen
Published: March 2022

Using ERA-Interim and output of the regional climate model MAR (Modèle Atmosphérique Régional) forced by ERA-Interim, this study investigates the mechanisms governing the persistent extreme rainfall events (PEREs) in the Antarctic Peninsula (AP) during austral summer (December–February) for the period 1980–2017. Due to the topography’s blocking effect on the warm and humid airflow, the increase in the rainfall is concentrated over the western AP during the periods of the PEREs. Contributed mainly by the low-frequency variations, the positive rainfall anomalies on the western AP can persist for multiple days, leading to the persistence of the extreme rainfall events. The additional rainfall anomalies can be attributed to the increase in the total precipitation. Through regulating the total precipitation, the low-frequency atmospheric circulation anomalies are vital to the formation of the PEREs. Specifically, a persistent circulation pattern with an anomalous cyclone (anticyclone) to the east (west) of the AP is conductive to the enhancement of poleward moisture fluxes. As a result, the total precipitation around the AP is strengthened, as well as the rainfall. Further investigation reveals that the barotropic feedback of the high-frequency eddies plays an important role in maintaining the low-frequency circulation anomalies.
Farmers’ Strategies for Drought Adaptation Based on the Indigenous Knowledge System: The Case of Iran
Authors: Aliabadi Vahid , Ataei Pouria , Gholamrezai Saeed
Published: March 2022

Considering the widespread and cross-cultural effects of climate on various production sectors, environmental factors, and human societies, drought is nowadays regarded as one of the most important environmental challenges of the current century. Because of their close relationship with the natural environment and their limited opportunities, rural communities have long been exposed to drought, and farmers in dry and semiarid regions have been applying measures to adapt to and cope with it. The main purpose of this study was to investigate and identify farmers’ native methods to reduce the effects of drought. The research method was phenomenological and survey based. The population included villagers in Kangavar County, Kermanshah Province, in Iran. Sampling was done by the targeted and snowflake method. The data collection instrument was an in-depth interview in the qualitative section and a self-designed questionnaire in the quantitative section. The results showed that farmers used different measures for coping with and adapting to drought, including using no-tillage farming; uprooting trees with high water demands; hope and oblation; mulching; reducing, changing, and/or mixing livestock types (reaction behaviors); diversifying the sources of livelihoods; changing cropping patterns; correcting irrigation practices; changing planting time; seeding before the drought; and using water storage techniques (fractional behaviors). In addition, farmers had a weaker capability to cope with the environmental, economic, and social vulnerabilities than with drought. This presented the vulnerability of farmers to drought in all economic, social, and environmental spheres.
A “GAP” in Activation: A Better Way to Manage Geriatric and Anticoagulated Patients with Head Trauma
Authors: Lee Janet S. , Khan Abid D. , Brockman Valerie , Schroeppel Thomas J.
Published: March 2022

Background

Older age and anticoagulant use have been associated with worse outcomes in trauma. At the study institution, elderly and anticoagulated patients with suspected traumatic brain injury (TBI) were previously triaged as a second tier trauma team activation (TTA) with a high rate of over-triage. A novel “GAP” (Geriatric or Anticoagulated Pathway) alert was created to streamline care delivery to these patients. The purpose of the study is to assess the efficacy and outcomes of the GAP alert.

Methods

A retrospective review was conducted on adult patients presenting to a level-1 trauma center from 1/2018-12/2020. The GAP alert was implemented in 2/2018. The GAP alert group was compared to the second tier TTA group.

Results

1743 patients were identified. 504 (29%) received a GAP alert. GAP alert patients were older (79 years vs 47 years, P < .0001), had a lower injury severity score (ISS) (8.6 vs 9.9, P = .006), and had a higher rate of pre-injury anticoagulant use (28.4% vs 2.5%, P < .0001). The in-hospital mortality was higher in the GAP group (2.4% vs .7%, P = .004). On multivariable logistic regression, GAP alert was not identified as a predictor of mortality. Age, ISS, and pre-injury anticoagulant use predicted mortality. During the study period, the number of GAP alerts increased ( B = .15, P = .003) and the number of second tier TTAs decreased ( B = −.33, P < .0001).

Conclusion

Implementation of the GAP alert led to a decrease in trauma resource utilization while providing timely diagnosis and treatment of geriatric patients or those on anticoagulation medication with suspected TBI.
Range Restriction Affects Factor Analysis: Normality, Estimation, Fit, Loadings, and Reliability
Authors: Franco-Martínez Alicia , Alvarado Jesús M. , Sorrel Miguel A.
Published: March 2022

A sample suffers range restriction (RR) when its variance is reduced comparing with its population variance and, in turn, it fails representing such population. If the RR occurs over the latent factor, not directly over the observed variable, the researcher deals with an indirect RR, common when using convenience samples. This work explores how this problem affects different outputs of the factor analysis: multivariate normality (MVN), estimation process, goodness-of-fit, recovery of factor loadings, and reliability. In doing so, a Monte Carlo study was conducted. Data were generated following the linear selective sampling model, simulating tests varying their sample size ([Formula: see text] = 200 and 500 cases), test size ([Formula: see text] = 6, 12, 18, and 24 items), loading size ([Formula: see text] = .50, .70, and .90), and restriction size (from [Formula: see text] = 1, .90, .80, and so on till .10 selection ratio). Our results systematically suggest that an interaction between decreasing the loading size and increasing the restriction size affects the MVN assessment, obstructs the estimation process, and leads to an underestimation of the factor loadings and reliability. However, most of the MVN tests and most of the fit indices employed were nonsensitive to the RR problem. We provide some recommendations to applied researchers.
Topical Fluoride Effectiveness in High Caries Risk Adults
Authors: Jurasic M.M. , Gibson G. , Orner M.B. , Wehler C.J. , Jones J.A. , Cabral H.J.
Published: March 2022

This retrospective analysis of longitudinal data was developed to determine which types, combinations, and intensities of topical fluorides more effectively prevent new caries-related restorations and extractions in high caries risk adults. We included data from October 1, 2008, through June 30, 2018, from electronic dental and medical records and pharmacy database from the US Department of Veterans Affairs. Veterans who were eligible for continuing and comprehensive care, met the criteria of high caries risk (received 2 or more caries-related restorations within a 365-d period), and had 3 y of follow-up were included. Multivariable logistic regression models estimated the odds of caries-related treatment during the 1-y observation period, controlling for age, gender, race and ethnicity, illness burden (Selim comorbidity index), use of prescription medications, attendance at dental prophylaxis appointments, number of caries-related restorations during the index year, and time between first and last caries-related restoration during the index year. The study sample included 68,757 veterans, who were primarily male (91.5%), were White (73.6%), had a mean age of 59.2 ± 13.5 y, and had significant medical comorbidity as measured by the Selim index (3.7 ± 2.4 physical and 1.3 ± 1.2 mental diagnoses). They had 10.8 ± 6.3 prescription VA drug classes, took 0.6 ± 0.8 strong anticholinergic medications, and had 3.9 ± 2.6 teeth restored due to caries during the index year. Adjusted multivariable logistic regression models showed veterans who received a varnish or gel/rinse fluoride intervention versus no fluoride had an approximately 29% decreased odds of receiving caries-related treatment during the observation period (gel/rinse adjusted odds ratio [AOR] = 0.72; 95% confidence interval [CI], 0.67–0.76; varnish AOR = 0.71; 95% CI, 0.67–0.75). The receipt of a varnish and gel/rinse did not demonstrate statistically better odds than each intervention alone (AOR = 0.69; 95% CI, 0.64–0.75). A dose–response effect was observed. Two-plus applications of varnish versus none (AOR = 0.73; 95% CI, 0.69–0.77) and 2-plus applications of gel/rinse versus none (AOR = 0.71; 95% CI, 0.67–0.75) were more effective than 1 application of either modality versus none.
Impact of COVID-19 Pandemic on Mental Health and Quality of Life. An Exploratory Study During the First Outbreak in Italy
Authors: Cavazzoni Federica , Pancake Rachel , Veronese Guido
Published: March 2022

The coronavirus pandemic has been sweeping the world for more than a year. As physical health begins to stabilize in the western world, an increasing concern is related to the impact of the virus and its containment measures on people’s mental health. This work aimed to explore the effect of demographic factors (age, gender, level of education, and socioeconomic status) and variables such as fear of COVID-19 and social support in predicting the quality of life and mental health of adults during the first wave of the pandemic in Italy. Through an online survey with 1087 Italian adults (M = 39.7, SD = 16.39; 74.4% women), gender and socioeconomic status emerged as crucial factors in determining differences regarding people’s responses and reactions to the pandemic. In addition, the results highlighted the importance of perceived social support and a moderate fear of COVID-19 in predicting people’s quality of life and mental health. The study suggests important guidelines for the development of interventions to support the population’s well-being and mental health.
Statewide Assessment of the Hepatitis C Virus Care Cascade for Incarcerated Persons in Vermont
Authors: Hale Andrew J. , Mathur Shivani , Dejace Jean , Lidofsky Steven D.
Published: March 2022

Objectives:

Incarcerated persons in the United States have a high burden of hepatitis C virus (HCV) infection. This study assessed the impact of a statewide effort in Vermont to treat HCV in this group.

Methods:

We performed a retrospective, observational cohort study of all HCV-infected persons who were imprisoned in Vermont during the 19-month study period (December 2018–June 2020). The cascade of care comprised opt-out HCV screening, full access to direct-acting antiviral treatment (without hepatic fibrosis-based treatment restrictions), HCV specialist involvement, and medication-assisted treatment for patients with opioid use disorder. The primary outcome was sustained virologic response at 12 weeks after treatment completion (SVR12).

Results:

The study included 217 HCV-infected patients; the median age was 35 years (range, 18-73 years), 89% were male, 76% had opioid use disorder, 67% had a psychiatric comorbidity, and 9% had cirrhosis. Of the 217 patients, 98% had a liver fibrosis assessment, 59% started direct-acting antiviral treatment, 55% completed direct-acting antiviral treatment, and 51% achieved documented SVR12. Of the 129 HCV-infected persons who started direct-acting antiviral treatment, 92% completed therapy and 86% achieved documented SVR12. Psychiatric comorbidity was not significantly associated with achieving SVR12 (odds ratio = 0.67; 95% CI, 0.27-1.65; P = .38), nor was receiving medication-assisted treatment for patients with opioid use disorder (odds ratio = 1.45; 95% CI, 0.62-2.56; P = .45).

Conclusions:

This study reports the highest SVR12 rate achieved in a state incarcerated population to date. HCV treatment in incarcerated populations is a practical and efficacious strategy that should serve a foundational role in HCV elimination.
Report of a patient with refractory atrial tachycardia whose heart rate was controlled using ivabradine
Authors: Zhao Lanting , He Rong , Liu Yuanwei , She Fei , Xie Ying , Zhang Ping
Published: March 2022

Ivabradine is an effective treatment for focal atrial tachycardia. However, it may also be effective for re-entrant atrial arrhythmia. An 85-year-old woman with a history of underlying ischaemic cardiomyopathy complained of worsening symptoms of heart failure because of rapid atrial tachycardia that was resistant to several rate-controlling drugs, but responded well to ivabradine. An electrophysiology study demonstrated a roof-dependent macro-re-entrant tachycardia of the left atrium. Linear ablation of the left atrial roof resulted in termination of the tachycardia. Thus, ivabradine can be an effective treatment for re-entrant atrial tachycardia.
Gonadotropin-releasing hormone receptor inhibits triple-negative breast cancer proliferation and metastasis
Authors: Chen Cai-Ping , Lu Xiang
Published: March 2022

Background

Gonadotropin-releasing hormone receptor (GnRHR) is expressed in several malignant tumors and inhibits the proliferation and metastasis of cancer cells, but its role in triple-negative breast cancers (TNBCs) is unclear. This study investigated the biological effects of GnRHR and their influence on TNBC prognosis.

Methods

The GSE21653 database was used to obtain information about GnRHR expression and clinicopathological factors in patients with TNBC. GnRHR was activated in cultured MDA-MB-231 and MDA-MB-468 cells by leuprolide acetate and antagonized by elagolix sodium. Cell proliferation was assessed by the cell counting kit-8 and colony formation assays. Cell metastasis was detected by the wound healing assay and Transwell assay. Apoptosis and the cell cycle were investigated by flow cytometry. GnRHR protein expression was determined by western blotting.

Results

GnRHR mRNA expression was significantly higher in patients with TNBC than in hormone receptor+/human epidermal growth factor receptor (HER)2– and HER2+ patients with breast cancer. Patients with high GnRHR expression had significantly better disease-free survival than those with lower expression. Activated GnRHR significantly inhibited cell proliferation and metastasis, increased apoptosis, and enhanced GnRHR protein expression levels.

Conclusion

GnRHR inhibits TNBC proliferation and metastasis, suggesting it could be targeted for TNBC treatment.
Therapeutic drug monitoring of vancomycin in neurosurgery patients, from trough concentration to area under the curve: a retrospective single center cohort study in a tertiary hospital
Authors: Chen Yue , Kong Xudong , Liu Lei
Published: March 2022

Objective

To evaluate the effect of therapeutic drug monitoring (TDM) of vancomycin in neurosurgery patients.

Methods

In this retrospective, single-center cohort study, data were collected from patients administered vancomycin after neurosurgery during 2020. Intervention by a pharmacist using an area under the curve (AUC)-based strategy for TDM of vancomycin was started on 1 July 2020. The trough concentration was monitored previously. Data regarding basic demographics, vancomycin application, and TDM were collected and analyzed.

Results

Ninety and 155 samples were included in the non-intervention and intervention groups, respectively. No difference in baseline characteristics was detected. After intervention, the attainment rate of vancomycin TDM was significantly increased from 36.7% to 52.3%. The intervention resulted in an increased daily vancomycin dose (28.9 vs. 26.7 mg/kg/day), a more reasonable sample extraction time (sixth vs. ninth dose), reductions in dose adjustments (37.4% vs. 54.4%) and preventative applications (66.7% vs. 52.3%), and no difference in kidney function impact. The intervention group had a shorter hospital stay.

Conclusions

Intervention by a clinical pharmacist using an AUC-based strategy for vancomycin TDM can provide benefits other than pharmacokinetic attainment in neurosurgery patients. Further prospective multi-center studies are needed to establish standardized intervention measures and evaluation indicators.
Superior performances strategies of different hybrid renewable energy systems configurations with energy storage units
Authors: Yahiaoui Adel , Tlemçani Abdelhalim
Published: March 2022

The essential function of a hybrid renewable energy system is to produce an adequate electrical supply to the load demand with low cost. This paper proposes the optimization and operation of the renewable energy power sources for electrification of isolated rural city in Algeria desert. For this purpose, a system composed by PV panel (PV), Wind Turbine (WT), Battery Bank (BB) for storage of the electrical energy and Fuel Cell (FC) with hydrogen tank (H2 Tank) and electrolyzer (Elect) system for storage of the chemical energy is used to fulfill the need of the load. In the present paper we are interested in evolutionary algorithms for solving optimization problem of hybrid configuration of power system. However, a new heuristic algorithm namely whale optimization algorithm (WOA) is used to obtained the best solution of multi-objective optimization system of cost of energy (COE), total net present cost (TNPC) and loss power supply probability (LPSP). Two recent algorithms, particle swarm optimization (PSO) and grey wolf optimizer (GWO) are also implemented in this work. Seven cases studies have been tested for examining the efficient of proposed optimization technique. The suggested whale optimization algorithm, as demonstrated by simulations and comparisons with existing methods, solves the problem of multi-objective optimization of hybrid power system configurations with high accuracy and validity.
Multi-Objective Optimization of Imperfect Pavement Repair Policy: A Reliability-Based Approach
Authors: Das Saswati , Siddagangaiah Anjan Kumar
Published: March 2022

This study proposes a reliability-based framework for scheduling pavement repairs in a way that considers the imperfect effect of repair. Highway agencies can use this framework in the absence of comprehensive data sets for pavement performance prediction. To model imperfect pavement repairs, this study uses a hybrid hazard rate model. Further, a multi-objective optimization technique called NSGA II (non-dominated sorting genetic algorithm II) was used; it was integrated with a pavement reliability model. Rather than consider a fixed planning horizon, the number of repair cycles required ( N) is kept as a decision variable considering reconstruction at the end of N cycles. Maximizing system reliability under repair at the end of the replacement cycle and minimizing the expected cost function were considered objective functions. Along with N, the algorithm also found the optimum target reliability for repair intervention. In this study, the uncertainty in construction quality (CQ) and traffic characteristics were considered in the reliability analysis. They are represented with appropriate probability distributions. Demonstrating the use of the framework, a case study was undertaken, and the reliability–cost trade-off solutions for different uncertainty levels of traffic and CQ were identified. The framework captured the effect of increased uncertainty resulting in frequent repair needing replacement much earlier. Notably, the impact of uncertainty in CQ on the Pareto fronts was more prominent than that of traffic attributes, highlighting the importance of CQ. A sensitivity analysis of the adjustment factors was performed, which found that the age reduction factor affected the optimum solutions substantially.
Accounting for Heterogeneity of Travel Time Reliability Valuation in Shippers’ Freight Mode Choice
Authors: Jian Wenliang , Xie Xinyu , Zhu Lichao , Gao Liangpeng
Published: March 2022

Designing efficient strategies to adjust freight transportation mode structure requires in-depth understanding of shippers’ mode choice behavior. This paper presents an empirical study to investigate preference heterogeneity in value of reliability (VOR) for hinterland leg transportation mode choice. A stated preference survey using a D-efficient design approach is carried out in the corridor from Yiwu to the port of Ningbo to collect data on shippers’ behavior. Two model specifications including the Base Model and the Heterogeneous Model are developed to analyze these data. Mixed logit is applied to estimate the parameters of models. The estimation results of the base model reveal significant preference heterogeneity in shippers’ VOR. We then calculate the mean and variation of overall VOR. In addition, the potential factors leading to heterogeneity in VOR are identified. Results imply that commodity characteristics including shipment size, value, and weight could partially explain the shippers’ heterogeneity in VOR. Based on these factors, eight sub-groups of container shippers are obtained, and the mode shares of railway under different levels of railway reliability are estimated for each sub-group. Results show that improvement in the level of reliability is important to increase the mode share of rail, especially in the sub-group where shipments are light and of high value. The findings of this paper can be used for demand forecasting and transportation policy making.
Incorporating Horizontal Curves and Roadway Geometry into the Automated Updated Grade Severity Rating System
Authors: Ampadu Vincent , Alrejjal Anas , Ksaibati Khaled
Published: March 2022

Highway agencies all around the country, including the Wyoming Department of Transportation (WYDOT), have deep concerns about truck crashes resulting from brake temperatures exceeding the critical brake temperature as they descend steep downgrades. Through a series of research initiatives starting in the 1980s, WYDOT has developed a Grade Severity Rating System (GSRS) to estimate the maximum safe speed for trucks during downgrade descent. In 2020, the updated mathematical model was automated through an interactive, intuitive, aesthetically appealing, and user-friendly objected-oriented Visual Basic.net software. Additional research on the GSRS model was commissioned by WYDOT to account for large truck vehicle stability—specifically, rollovers and skidding/side slip during grade descent. These scenarios become relevant in the presence of horizontal curves. Consequently, this latest mathematical model has been automated to simplify the computation of maximum safe descent speed on the downgrades combined with curves, all based on the truck weight. As in the previous version of the software, it provides functionality for both the continuous slope and the separate downgrade method. The primary beneficiaries of the software will be highway agencies who will be able to estimate the maximum safe speed of descent for trucks descending downgrades with horizontal curves at various weight categories and therefore produce Weight Specific Speed (WSS) signs for each downgrade or multi-grade section.
Skilled Nursing Facility Care at Home for Adults Discharged From the Hospital: A Pilot Randomized Controlled Trial
Authors: Levine David M. , Cueva Mary A. , Shi Sandra , Limaj Idriz , Wambolt Bessey , Grabowski David C. , Schnipper Jeffrey L. , Pu Charles T.
Published: March 2022

Objectives

The ability to deliver SNF-level care at home is unclear. We sought to demonstrate the feasibility of rehabilitation at home (RAH) via a pilot randomized controlled trial.

Methods

Daily care from a home health aide, certified nursing assistant, nurse, and physician. Core technologies included remote PT, automated medication dispensing, and continuous monitoring. Primary outcome: episode cost.

Results

We randomized 10 patients. Home patients’ episode cost a median $8404 (IQR, $2697) versus $9215 (IQR, $5702). LOS for both was 14 days. Home patients’ ADLs improved between admission and 30-days post-discharge by median 4 (IQR, 5) versus 1 (IQR, 2). Home patients’ median Picker patient experience score was 12/14 (IQR, 2) versus 7/14 (IQR, 3).

Discussion

A RAH pilot compared favorably to traditional SNF, with trends toward lower cost, greater functional status improvement, and better patient experience. This delivery innovation could reimagine how we deliver post-acute care but requires replication.

Clinicaltrials.gov registration

NCT04048590.
From Nativeness to Strangeness and Back: Ascribed Ethnicity, Body Work, and Contextual Insiderness
Authors: Trzeszczyńska Patrycja
Published: March 2022

This article offers a reflection on a certain variant of broadening the position of “being inside” with some “buts,” or through “within but.” Drawing on my field experience in the Ukrainian diaspora in Canada, I discuss the context-dependent, fluid and labile insiderness and the case of using a researcher’s embodied distinctions (senses, ethnicity, class) in the research site created by the fieldwork participants, and not the researcher him/herself. My considerations are embedded with the dialectics (not opposition) of the insider–outsider and point to the contextual “nativeness” and “strangeness” of the researcher. I also discuss the fluidity and contextuality of a researcher’s field familiarity, as well as when s/he conducts research in cooperation with “their own people,” as well as circumstances and factors that transform this familiarity into strangeness. I argue that the latter, instead of being an obstacle or barrier in the research, is a beneficial and mind-opening ethnographic tool.
Researching While Trans: Being Clocked and Cooling Cistress
Authors: Schiffer Davida Jae
Published: March 2022

In this article, I investigate how predominantly cisgender and straight participants of a university LGBT Ally Training program perceived transgender topics. As a trans woman, my positionality and gendered embodiment shaped my research process—depending on whether or not I was perceived as trans. Drawing on 21 interviews with 12 training participants and the training instructor, plus 12 hours of ethnographic observations of 4 Ally Trainings, I show the interactive nature of the research process and how I navigated what I call participant distress. Participant distress manifested due to participant anxiety regarding how I, a trans researcher, perceived their responses. I analyze distress through the lens of Goffman, and offer cistress as a more specific interactive process of disrupting cisnormative statements that results in guilt or anger.