bluuebunny/crossref_metadata_2025 huggingface dataset:
From Global to Local: The Development of Heavy Water in International Nuclear Programs (1945–1970)
Authors: Sanz-Lafuente Gloria
Published: September 2023

Because of how heavy water is produced and used, it has a unique business history and structure. In the late 1940s and 1950s, heavy-water reactors offered the dream of nearly inexhaustible quantities of nuclear power generation. This was because they could operate using natural uranium and also produce plutonium that could be used as fuel in breeder reactors (and also as fissile material for nuclear weapons). Several of the processes and materials used in synthetic fertilizer production could also be used, in somewhat modified form, in the production of heavy water. Yet the production costs for heavy water are exceedingly high, requiring copious amounts of electricity and the infrastructure of an advanced chemical industry. This article suggests that in several countries the fertilizer and heavy-water industries had a close relationship. The governments in those countries, seeking to increase the national trade in fertilizers and to develop domestic nuclear programs, supported both industries. The case of the Spanish Nuclear Board and Energía e Industrias Aragonesas in Sabiñanigo is instructive in this regard.
The Relationship between Perceived Infectability and Psychological Well-being: The Mediating Role of Covid-19 Anxiety
Authors: Mushkbara Fatima S. , Khan Saira , Sadia Rayna
Published: September 2023

Background. COVID-19 has adversely affected economies and individuals globally. To this day, countries are facing the economic effects of the pandemic directly, and individuals’ mental health is in danger as they are still indirectly dealing with the pandemic. It is imperative to understand how pandemic-related anxiety affected individuals’ mental health so that all stakeholders can take essential remedial steps. Objective. The current research aimed to investigate the relationship between Perceived Infectability, Coronavirus Anxiety, and Psychological Well-being. It also sought to explore the role of coronavirus anxiety in mediating between perceived infectability and psychological well-being. Design. A cross-sectional correlational study design and non-probability convenience sampling technique were used to collect the data. The data were collected from 321 Pakistani adults, who filled out Google forms on the Perceived Infectability subscale of the Perceived Vulnerability to Disease Scale; the Coronavirus Anxiety Scale; and the Psychological Well-being Scale. Results. Correlation analysis indicated that both perceived infectability and coronavirus anxiety were negatively related to psychological well-being. However, a significant positive relationship was observed between perceived infectability and coronavirus anxiety. Our findings further proved the mediating role of coronavirus anxiety between perceived infectability and the psychological well-being of adults. Conclusion. Understanding perceived infectability and its association with COVID-19 anxiety and psychological well-being is pertinent in this post-pandemic period in both developing and developed nations. The post-pandemic world is still being jolted with the aftereffects of the pandemic. An in-depth understanding of how individuals coped with the pandemic, might help in designing better intervention and community health programs after the pandemic, and it could also help in preparing for the crises attending future pandemics (if any).
Loanwords in the Fiery Furnace
Authors: Gvaryahu Amit
Published: September 2023

This article is a discussion of two Greek loanwords found in the Rabbinic text Song of Songs Rabbah. It shows that these words are best identified and explained through a comparison with a Stoic theory of fire, described and refuted by Philo of Alexandria. That these words, both hapax legomena in Rabbinic literature, are used in the Midrash show that at least some rabbis were conversant in Greek scientific terminology—and perhaps specifically with a version of this Stoic dispute. The uses to which these terms were put show that the rabbis deployed their vast, specialized knowledge where it was most important to them: interpreting the scriptures.
Reference intervals for deconjugated urine metanephrines by Bhattacharya analysis
Authors: Li Bobby , King Richard , Sies Christiaan , Thompson Simon , Florkowski Chris
Published: September 2023

Background

Urine metanephrines are used to screen for phaeochromocytoma or paraganglioma (PPGL). Current reference intervals (RI) derived in healthy individuals are not age or sex-stratified, and lower than in hypertensive patients, leading to high false positive rates. This study aims to determine age and sex-stratified RI from a contingent screening population.

Methods

Patients with 24-h deconjugated urine metanephrines from 3/6/2010 to 27/8/2022 were included (2936 males, 5285 females), initially by liquid chromatography-electrochemical detection (LC-ECD) then liquid chromatography-tandem mass spectrometry (LC-MS/MS). Bhattacharya analysis was used after log transformation to determine age and sex-stratified RI for metanephrine excretion, normetanephrine excretion, metanephrine/creatinine and normetanephrine/creatinine ratios.

Results

Normetanephrine excretion increases with age (RI: males: 18–<30 years: <3.4 µmol/24 h, 30–<40 years: <3.7 µmol/24 h, 40+ years: <5.3 µmol/24 h; females: 18–<30 years: <2.7 µmol/24 h, 30–<40 years: <3.1 µmol/24 h, 40+ years: <3.7 µmol/24 h), while metanephrine excretion was consistent across adulthood (RI: males: 18+ years: <1.8 µmol/24 h; females: 18+ years: <1.2 µmol/24 h). However, normetanephrine/creatinine and metanephrine/creatinine increase steadily with age after early adulthood, likely due to a decrease in muscle mass, with females having higher normetanephrine/creatinine and metanephrine/creatinine ratios.

Conclusions

Age and sex-stratified RI were derived for metanephrine excretion, normetanephrine excretion, metanephrine/creatinine and normetanephrine/creatinine ratios. This is expected to reduce false positives while flagging most PPGL.
Eugenol as anesthetic for Cnesterodon decemmaculatus (Cyprinodontiformes, Poeciliidae)
Authors: Vercellini Maria C , Rearte Ramiro , di Cesare Luca , Ayala Miguel A , Montes Martin M
Published: September 2023

Anesthetics are commonly used in fish for surgery and to facilitate capture, handling and transport in aquaculture and experimental procedures. In research, the selection of the anesthetic depends on its properties and on the recovery time. Eugenol has been pointed out as an effective anesthetic for fish, alternative to traditional drugs. Although Cnesterodon decemmaculatus is widely used as a model in ecological bioassays, no anesthetic protocol has been reported for this species. The aim of the present study was to evaluate the induction time (i.e. time to reach anesthetic stage VI) and recovery time in individuals of C. decemmaculatus subjected to eugenol at a fixed concentration, according to sex and pregnancy status. Forty-one fish were divided into three groups: males, pregnant females and non-pregnant females. They were measured for total length, standard length and weight, and the condition factor (K) was calculated. No significant differences in induction and recovery times were found for sex, pregnancy status and K between groups. Results are a contribution toward the development protocol of a standard anesthetic protocol for C. decemmaculatus.
The Effect of Distributional Restrictions in Speech Perception: A Case Study From Korean and Taiwanese Southern Min
Authors: Hwang Jiwon , Lu Yu-An
Published: September 2023

In Korean, voiced oral stops can occur intervocalically as allophones of their voiceless lenis counterparts; they can also occur initially as variants of nasal stops as a result of initial denasalization (e.g., /motu/→[bodu] “all”). However, neither [ŋ] nor [ɡ] (the denasalized variant of the velar nasal) is allowed in the initial position due to the phonotactic restriction against initial [ŋ] in Korean. Given the distribution of nasal and voiced stops in Korean, this study draws on the idea of cue informativeness, exploring (a) whether Korean listeners’ attention to nasality and voicing cues is based on the distributional characteristics of nasal and voiced stops, and (b) whether their attention can be generalized across different places of articulation without such linguistic experience. In a forced-choice identification experiment, Korean listeners were more likely than Taiwanese listeners to perceive items on the voiced oral-to-nasal stop continua as nasal when they occurred in the initial position than in the intervocalic position, with the exception of velar stops. The results demonstrate that the Korean listeners attended to the nasality cue more reliably in the medial position than in the initial position, since the nasality cue in this position is less informative due to initial denasalization. Two additional forced-choice identification experiments suggested that upon hearing initial velar nasal [ŋ], Korean listeners variably employed different perceptual strategies (i.e., vowel insertion and place change) to repair the phonotactic illegality. These findings provide support for exemplar models of speech perception in which cue attention is specific to the position of a word, and to segments rather than to features.
Brexit Rebordering, Sticky Relationships and the Production of Mixed-Status Families
Authors: Zambelli Elena , Benson Michaela , Sigona Nando
Published: September 2023

This article examines the Brexit-driven remaking of some EU families into mixed-status families. Drawing on original research conducted in 2021–2022 with British, EU/EEA and non-EU/EEA citizens living in the UK or the EU/EEA, it shows how families whose members have previously enjoyed equal rights to freedom of movement across the EU/EEA variously negotiate the consequences of Brexit on their lives. Central to our analysis is the interplay between hardening borders and the stickiness of family relations, and its effects on families’ migration and settlement projects. The article brings to the fore these emerging entanglements offering a much-needed relational analysis of the impact of Brexit on the directly affected populations, while contributing more widely to expanding the existing scholarship on mixed-status families, by attending to the peculiar ways in which families whose members previously enjoyed equal status under EU law have experienced their transformation into subjects with unequal rights.
Political leaders and military spending
Authors: Carter Jeff
Published: September 2023

How are patterns of military spending shaped by political leaders who have substantive policy preferences and need the support of their constituents to remain in power? A formal model developed to address this question indicates leaders’ preferences, political vulnerability, and motivation and their domestic audiences’ preferences jointly influence equilibrium military spending. I find variation in patterns of military spending consistent with the model's implications between 1946 and 2010. My analyses demonstrate that leaders’ desire to remain in power and individual-level characteristics and domestic audiences’ preferences jointly shape policy outcomes and, accordingly, suggest studying the interactions among them can provide insights into a range of topics central to peace science.
A Real-World Comparison of Apixaban and Rivaroxaban in Obese and Morbidly Obese Patients With Nonvalvular Atrial Fibrillation
Authors: Burnham Kevin T. , Yang Tianrui , Wooster Jessica
Published: September 2023

Background: Contemporary guidelines for managing nonvalvular atrial fibrillation (NVAF) include apixaban and rivaroxaban as first-line anticoagulation treatment options. Minimal guidance is available regarding selecting anticoagulants for patients with class I-III obesity. Objective: This study aims to evaluate the comparative effectiveness and safety of apixaban and rivaroxaban in both obese and morbidly obese patients with NVAF. Methods: A retrospective cohort study was conducted at an outpatient cardiovascular clinic after Institutional Review Board approval. Patients were eligible if they were ≥18 years of age, had a BMI ≥30 kg/m2, and took apixaban or rivaroxaban for NVAF for ≥3 months. The primary endpoint was the composite rate of stroke, transient ischemic attack (TIA), myocardial infarction (MI), or presence of atrial thrombosis. Bleeding events were evaluated as the primary safety endpoint. Results: Combined, the cohorts consisted of 303 obese or morbidly obese patients. The primary composite endpoint occurred in 3.8% of patients taking apixaban and 1.7% of patients taking rivaroxaban ( P = .28). Both clinically relevant, non-major and major bleeding occurred more often in the apixaban arm, but this difference was not statistically significant; however, bleeding risk may have been skewed due to differences in baseline characteristics. Conclusion and Relevance: For obese and morbidly obese patients prescribed either apixaban or rivaroxaban for NVAF, rates of stroke, TIA, MI, and atrial thrombosis did not differ. The preferred DOAC for patients with class I-III obesity remains elusive, but current data points to a patient-centered approach for anticoagulant selection.
Off-Label Reduced Dose Apixaban in Older Adults With Atrial Fibrillation and Associated Outcomes
Authors: Campbell Ashley M. , Pae Elizabeth , Lee Eunice , Jacisin Timothy , Price Alina , DeAngelo Jessica
Published: September 2023

Background:

Apixaban is commonly used to prevent stroke in older adults with nonvalvular atrial fibrillation (AF). Although its package insert has specific dose reduction criteria, providers may dose reduce outside of these parameters based on clinical scenarios.

Objective:

The primary objective was to determine the incidence of apixaban off-label reduced dosing, while secondarily determining the safety and efficacy outcomes associated with such dosing.

Methods:

A retrospective analysis of patients aged 65 and older with orders for apixaban for AF was institutional review board (IRB)-approved and conducted across 3 academic medical centers. Patients receiving off-label reduced-dose apixaban (ie, “underdosed”) were matched to a cohort of patients dosed according to the package insert at the standard dosing (5 mg twice daily) using stratified random sampling. Secondary outcomes included 1-year incidence of major bleeding, clinically relevant non-major bleeding (CRNMB), stroke or transient ischemic attack (TIA), and mortality. The Fisher exact tests were used to compare between-group differences.

Results:

Of the 1172 patients meeting initial inclusion criteria, 201 (17%) were dosed off-label, with 175 (15%) “underdosed.” The 147 “underdosed” patients with documented follow-up were matched with 139 patients receiving standard Food and Drug Administration (FDA)-labeled dosing. There were no significant differences in incidence of stroke (2.7% vs 2.2%), major bleeding (0% vs 0.7%), and CRNMB (2.7% vs 1.4%) in the off-label reduced dosing versus standard dosing groups. All-cause mortality was higher in the off-label reduced-dose group (16 [10.9%] vs 2 [1.4%], P < 0.05).

Conclusion and Relevance:

Older adults with nonvalvular AF are commonly prescribed lower-than-recommended doses of apixaban. However, no significant association was found between empiric off-label reduced dosing and stroke or bleeding outcomes.
Hope as a Moderator of Intimate Partner Violence and Suicide Risk Behaviors Among Latinas
Authors: Edwards Lisa M. , Torres Lucas , Lewis Kayla Deanna , Loyo Karina
Published: September 2023

The current study investigated the role of hope in the relationship between intimate partner violence (IPV) and suicide risk behaviors among a community sample of Latinas ( N = 180). Moderation analyses revealed significant interaction effects demonstrating that both aspects of hope—agency and pathways—were associated with suicide risk behaviors at high levels of IPV. Results suggest hope may be helpful when IPV is at low levels, but it may exacerbate suicide risk when high levels of IPV are experienced among Latinas. Future directions and implications are discussed, including the importance of understanding the unique cultural context in which Latina survivors exist.
Finite element study of V-shaped crack-tip fields in a three-dimensional nonlinear strain-limiting elastic body
Authors: Gou Kun , Mallikarjunaiah S. M.
Published: September 2023

We study the crack-tip fields in a three-dimensional (3D) plate with a V-shaped crack employing Rajagopal’s theory of elasticity with the strain-limiting effect. The classical linear elastic fracture mechanics (LEFM) theory bears a well-documented inconsistency, i.e., for a static crack problem under the traction-free boundary condition, the LEFM theory predicts singular crack-tip strains. Such results are inconsistent with the constitutive relation derived using the assumption of uniform bound for the strain values. Instead, Rajagopal’s recent theory of elasticity provides implicit constitutive relations between the linearized strain and Cauchy stress in which one can impose an a-priori upper bound for strains. We formulate the strain-limiting theory comprehensively in this article. The linearized strain is expressed as a nonlinear function of the Cauchy stress. The equation for the equilibrium of the linear momentum under a special type of nonlinear constitutive relation reduces to a second-order quasilinear elliptic boundary value problem (BVP). Using a Picard-type linearization and a continuous Galerkin-type finite element technique, we solve several BVPs with tensile and shear displacement loading. The numerical results for the strains, the stresses, the stress intensity factor (SIF), and strain energy density (SED) are obtained for different Poisson values, strain-limiting parametric values, and the V-shaped angles. The growth of the near-tip strains is far less than that of stresses, and the results for both the SIF and SED are also consistent with the results from LEFM. Our work demonstrates that the framework of Rajagopal’s theory of elasticity can provide a basis for developing physically meaningful and mathematically well-posed BVPs to study evolution of cracks, damage, nucleation, or failure in elastic bodies.
Flow field characteristics analysis of vortex-induced vibration of bridge tower based on dynamic mode decomposition method
Authors: Ma Zhenxing , Li Jiawu , Zhang Xi , Qiao Xiaoru , Zhao Guohui , Shen Zhengfeng
Published: September 2023

As a high-rise structure, the tower of a suspension bridge has low stiffness due to the lack of cable system constraints when it is self-supporting. Wind-induced vibration is one of the key factors in design and construction. In this paper, the wind tunnel test of the bridge tower aeroelastic model is carried out in two different flow fields, and the wind vibration response under a self-supporting state is systematically studied. Meanwhile, numerical simulation of the unsteady flow field around the tower section is carried out, and the dynamic modal decomposition (DMD) method is used to study the modal frequency of the flow field, the surface pressure of the section, flow field reconstruction error, and the stability of the flow field around tower section is discussed. The results show that in the self-supporting state, the displacement of the tower top presents a quadratic curve relationship with the wind speed, and no galloping phenomenon occurs under the test wind speed. However, in the uniform flow, when the wind attack angle is 90°, the bridge tower has an obvious vortex-induced vibration (VIV) phenomenon. After decomposing the flow field by the DMD method, it is found that there is strong aerodynamic interference between the double rectangular column sections, the first seven orders of modal energy play a major role in the flow field, and when the main modal energy accounts for more than 90%, the reconstruction can realize the accurate restoration of the information such as the surface pressure. For the complex flow field structure, it shows that the method can more accurately identify the coherent structure and background part in the unsteady flow field. This paper provides an idea for future research on the characteristics of the flow field around complex sections and helps to further improve the understanding of the VIV mechanism.
Structural temperature gradient evaluation based on bridge monitoring data extended by historical meteorological data
Authors: Yang Dong-Hui , Guan Ze-Xin , Yi Ting-Hua , Li Hong-Nan , Liu Hua
Published: September 2023

The structural temperature gradient (STG) is one of the most key factors causing cracking and even damage to bridge structures. However, its real effects on bridge structures are often over- or underestimated in practice. For most operating bridges, the structural health monitoring systems have just been put into use recently, and the monitoring structural temperature data are limited, which always leads to unreasonable STG representative value for a long return period based on such short-term structural temperature data. To solve the problems, this article proposes an STG determination method based on the long-term historical meteorological parameters at bridge sites. First, the main meteorological parameters affecting the STG were determined by correlation analysis. Second, considering the different influence mechanisms of various meteorological conditions on STG, a training sample set construction method is proposed by clustering the meteorological parameters and STG monitoring data. Based on such training data, a correlation model between STG and meteorological parameters can be established to extend the STG dataset based on the historical meteorological data. Finally, the peak over threshold method is applied to analyze the obtained extended STG data and to estimate its representative value. The proposed method was verified through a long-span cable-stayed bridge. The results show that the monitoring dataset of the STG can be effectively extended through the established correlation model. Compared with the short-term monitoring data, more reasonable representative values of the STG can be obtained through the extended dataset of monitoring STG.
Does Providing an Example Social Network Map Increase Referrals or Affect Types of Ties Reported in an Online Survey?
Authors: Clements Kaylin R. , Cross Jennifer E. , McCarty Christopher , Solomon Jennifer N.
Published: September 2023

Social network research often depends on the willingness of respondents to provide personal information about themselves and alters. Survey design strategies that increase willingness to share this information are necessary for social network research to be feasible, especially when name generators are used for sampling because rosters are unavailable. We conducted an experiment in which one group of respondents ( n = 94) received an online survey that included an example network map and the other group ( n = 100) received one that did not. Results show the map did not increase or decrease provision of network contacts nor influence the types of ties reported. Furthermore, respondents were reluctant to provide names and contact information of alters. Our study demonstrates the difficulty of collecting network information without a previously defined roster and an attempt to improve data collection through strategic survey design.
Development and evaluation of a multi-functional welding protective clothing system
Authors: Jin Peng , Jiang RT , Shen Lei
Published: September 2023

A new welding protective clothing system has been proposed to enhance the protective performance, comfort, and safety of welding protective clothing, considering the hazards associated with welding processes. The structure and fabric of the protective clothing carrier were redesigned, and a safety and protection system based on Internet of Things technology was developed. Objective tests and subjective evaluations were conducted on the protective clothing system. The results of objective tests showed that compared to regular welding protective clothing, the new protective clothing exhibited significant improvements in flame resistance, light resistance, and mechanical performance, with relatively lower vapor resistance. In subjective evaluations, the subjective evaluation scores (on a 5-point scale) of the new welding protective clothing were 26.46% and 27.95% higher than those of regular welding protective clothing, respectively ( p ≤ .05). Furthermore, the protective clothing system demonstrated a highly sensitive monitoring and feedback mechanism during testing, which can enhance workers’ ability to withstand risks and improve their psychological safety. The research on welding protective clothing with safety functions not only provides reference for innovative design of traditional welding protective clothing, but also lays a theoretical foundation for further research on other types of protective clothing.
Recent progress in epidemiology, clinical features, and therapy of multiple sclerosis in China
Authors: Wang Meng , Liu Caiyun , Zou Meijuan , Niu Zixuan , Zhu Jie , Jin Tao
Published: September 2023

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system characterized by inflammation, demyelination, and neurodegeneration. It mainly affects young adults, imposing a heavy burden on families and society. The epidemiology, clinical features, and management of MS are distinct among different countries. Although MS is a rare disease in China, there are 1.4 billion people in China, so the total number of MS patients is not small. Because of the lack of specific diagnostic biomarkers for MS, there is a high misdiagnosis rate in China, as in other regions. Due to different genetic backgrounds, the clinical manifestations of MS in Chinese are different from those in the West. Herein, this review aims to summarize the disease comprehensively, including clinical profile and the status of disease-modifying therapies in China based on published population-based observation and cohort studies, and also to compare with data from other countries and regions, thus providing help to develop diagnostic guideline and the novel therapeutic drugs. Meanwhile, we also discuss the problems and challenges we face, specifically for the diagnosis and treatment of MS in the middle- and low-income countries.
Epidemiology of podoconiosis in sub-Saharan Africa: A systematic review and meta-analysis
Authors: Abiso Temesgen Lera , Abebe Kerbo Amene , Wolka Woticha Eskinder
Published: September 2023

Objective:

Podoconiosis, one of the neglected tropical diseases (NTDs), affects barefoot people in impoverished regions and contributes to poverty by having negative impacts on economic output, education, and disability. People who have the disease waste nearly half of all of their productive workdays. There is limited evidence available on prevalence of podoconiosis in sub-Saharan Africa (SSA). Therefore, the aim of this research was to determine the pooled prevalence of podoconiosis in the SSA over the last 10 years.

Methods:

Studies were retrieved from PubMed, Embase, Web of Science, Scopus, Google Scholar, and Google by using a combination of search terms with Boolean operators. All authors independently assessed each study’s quality using the modified Newcastle–Ottawa Scale for cross-sectional studies. STATA Version 14 was used to conduct the statistical analysis. The random-effect approach of meta-analysis was used. To test for heterogeneity, I-Squared ( I2) statistics were employed and sensitivity analysis with a leave-one-out was done.

Result:

In this systematic review and meta-analysis, a total of 16 publications with 2,195,722 individuals were included. The pooled prevalence of podoconiosis was 2.66 (95% confidence interval (CI): 2.24, 3.10) with heterogeneity index ( I2) of 99.9%. Walking barefoot adjusted odd ratio (AOR) 5.35 (95% CI: 1.65, 9.05), p = 0.001, not washing feet with soap and water regularly AOR 2.8 (95% CI: 1.16, 4.44, p = 0.001), and an increased age AOR 2.23 (95% CI: 1.25, 5.58) were factors significantly associated with the prevalence of podoconiosis.

Conclusion:

This study revealed that pooled prevalence of podoconiosis was considerable in SSA. Age, being barefoot, and failing to wash one’s feet with soap and water have been identified to be factors that were significantly associated with the prevalence of podoconiosis. Therefore, creating awareness on shoe wearing and providing shoes in communication with supporting organizations in podoconiosis prevalent areas, and early diagnosis based on family history are needed for the prevention of podoconiosis
Valuing difference: How breed matters for animal lives and relations
Authors: Nash Catherine
Published: September 2023

Breed imaginations and practices fundamentally shape the lives of farmed, working and companion animals. Bringing together interests in animal breeding, interspecies kinship and multispecies care, this paper explores the relationship between investments in the continued existence and vitality of a breed as a whole and the encounter value of individual human–animal relations. It considers how breed matters to animal lives and relations through a conceptual focus on value and difference and an empirical focus on the breeding of horses in Iceland. These relations are not only limited to human–animal relations but also include social relations among animals. This paper firstly considers the significance of local and regional sub-species difference and practices of selection and inclusion in the making of horses in Iceland into a national breed. It then explores the perspectives of those involved in the breeding of horses in Iceland on what counts as quality and appropriate care for the breed and individual animals. Practices of care in Iceland are centred on allowing horses to live as sociable herd animals for extended periods of time each year, for the sake of individual animal well-being, to preserve the character of the breed, and in order to continue to enjoy the quality of human–horse relations that this system is understood to enable. Encounter value, in this case, depends on respecting difference and keeping at a distance. Multispecies care is thus not centred only on intimacy and the intersubjective; nor does treating animals as groups necessarily reduce the quality of care. The geographies of care for individual animals and for the breed are more complex and entangled. This suggests the need to address the implications of the positioning of animals as members of groups and species, as well as breeds, for animal lives and relations.
Brazilian Expert Consensus for NTRK Gene Fusion Testing in Solid Tumors
Authors: Petaccia de Macedo Mariana , Toledo Nascimento Ellen Caroline , Soares Fernando Augusto , Costa Santini Fernando , D’Almeida Costa Felipe , Werneck da Cunha Isabela , Ramella Munhoz Rodrigo , De Marchi Pedro , Carnier Jorge Thiago William , Ramos Moreira Leite Kátia
Published: September 2023

Oncogenic neurotrophic tropomyosin receptor kinase gene fusions occur in less than 1% of common cancers. These mutations have emerged as new biomarkers in cancer genomic profiling with the approval of selective drugs against tropomyosin receptor kinase fusion proteins. Nevertheless, the optimal pathways and diagnostic platforms for this biomarker’s screening and genomic profiling have not been defined and remain a subject of debate. A panel of national experts in molecular cancer diagnosis and treatment was convened by videoconference and suggested topics to be addressed in the literature review. The authors proposed a testing algorithm for oncogenic neurotrophic tropomyosin receptor kinase gene fusion screening and diagnosis for the Brazilian health system. This review aims to discuss the latest literature evidence and international consensus on neurotrophic tropomyosin receptor kinase gene fusion diagnosis to devise clinical guidelines for testing this biomarker. We propose an algorithm in which testing for this biomarker should be requested to diagnose advanced metastatic tumors without known driver mutations. In this strategy, Immunohistochemistry should be used as a screening test followed by confirmatory next-generation sequencing in immunohistochemistry-positive cases.
Co-occurring implementation strategies: The effects of academic detailing for opioid use disorder campaign on the advancing pharmacological treatments for opioid use disorder (ADaPT-OUD) study
Authors: Miller Wendy A. , Gordon Adam J. , Clothier Barbara A. , Ackland Princess E. , Bounthavong Mark , Garcia Carla , Kenny Marie E. , Noorbaloochi Siamak , Hagedorn Hildi J.
Published: September 2023

Background

Barriers at the system, clinician, and patient level limit access to medications for opioid use disorder (MOUD). The Advancing Pharmacological Treatments for Opioid Use Disorder (ADaPT-OUD) study implemented an external facilitation strategy within the Veterans Health Administration (VHA) aimed at facility-level barriers to improve uptake of MOUD. During ADaPT-OUD, an independent Academic Detailing Services Opioid Agonist Treatment of OUD Campaign was co-occurring and aimed to increase evidence-based practice for OUD at the clinician level. While both these initiatives aim to increase MOUD reach, they address different barriers and did not intentionally collaborate. Thus, understanding the interaction between these two independent implementation initiatives and their effect on MOUD reach will further inform and mold future implementation efforts of MOUD.

Methods

This was a secondary analysis of the ADaPT-OUD study that included 35 VHA facilities in the lowest quartile of MOUD reach; eight received the ADaPT-OUD external facilitation and 27 matched sites received implementation as usual. The number of academic detailing (AD) visits during ADaPT-OUD was used as a proxy for the intensity of Academic Detailing for OUD Campaign activity. The interaction between external facilitation status and AD intensity was evaluated by comparing the change in facility-level MOUD reach.

Results

There was a general increase in the number of AD visits, in both external facilitation and implementation as usual sites, over the course of ADaPT-OUD's implementation period. A non-statistically significant, positively sloped, linear relationship was observed between average number of AD visits per quarter and change in MOUD reach in facilities also receiving ADaPT-OUD external facilitation that was not observed in the implementation as usual sites.

Conclusion

Co-occurring initiatives focusing on different barriers to MOUD access have the potential to further increase MOUD in low-performing facilities, but further research into timing, quality, and collaboration between initiatives are warranted.
Critical Decision Making: Technical Aspects of Esophageal Ablation
Authors: Schnoll-Sussman Felice
Published: September 2023

Care for patients with dysplastic Barrett’s esophagus is rooted in endoscopic ablative therapies. Radiofrequency ablation (RFA), cryotherapy and argon plasma coagulation, in conjunction with endoscopic resection techniques and optimized pharmacologic and surgical therapy of reflux can lead to complete eradication when the appropriate ablative technology is used in the appropriate Barrett’s patient. This article reviews the critical decisions and technical considerations necessary to be successful in this aspect of Barrett’s care. Use of a cap device, optimal pre ablation preparation and technical aspects of RFA, cryotherapy and argon plasma coagulation are discussed. A detailed algorithm, that if followed, will greatly improve the opportunity for success is presented.
Polymer–lipid hybrid nanoparticles as potential lipophilic anticancer drug carriers
Authors: Salel Sedef , Iyisan Banu
Published: September 2023

Nanocarrier systems are widely used for drug delivery applications, but limitations such as the use of synthetic surfactants, leakage of toxic drugs, and a poor encapsulation capacity remain as challenges. We present a new hybrid nanocarrier system that utilizes natural materials to overcome these limitations and improve the safety and efficacy of drug delivery. The system comprises a biopolymeric shell and a lipid core, encapsulating the lipophilic anticancer drug paclitaxel. Bovine serum albumin and dextran, in various molecular weights, are covalently conjugated via Maillard reaction to form the shell which serves as a stabilizer to maintain nanoparticle integrity. The properties of the system, such as Maillard conjugate concentration, protein/polysaccharide molar ratio, and polysaccharide molecular weight, are optimized to enhance nanoparticle size and stability. The system shows high stability at different pH conditions, high drug loading capacity, and effective in vitro drug release through the trigger of enzymes and passive diffusion. Serine proteases are used to digest the protein portion of the nanoparticle shell to enhance the drug release. This nanocarrier system represents a significant advancement in the field of nanomedicine, offering a safe and effective alternative for the delivery of lipophilic drugs.

Graphical abstract
Evaluation of the DBP formation potential of biocides and identification of knowledge gaps in environmental risk assessment
Authors: Usman Muhammad , Hüben Michael , Hahn Stefan , Wieck Stefanie , Kehrer-Berger Anja , Linnemann Volker , Wintgens Thomas
Published: September 2023

Disinfectants and preservatives used as biocides may contain or release active substances (a.s.) that can form by-products with the surrounding matrices during their application which may be released into the environment. Over the past 40 years, several hundred of these so-called disinfection by-products (DBPs) have been detected after applications of biocides used for disinfection. Due to intensive research and further development of analytical capabilities, many new DBP classes, such as iodinated DBPs (I-DBPs), halonitromethanes (HNMs), haloacetamides (HaAms), or halomethanesulfonic acids were detected worldwide in various matrices and applications. Due to the possible hazards and risks for humans and the environment, frequently occurring DBP classes, such as trihalomethanes (THM), haloacetic acids (HAA) and nitrosamines (NDMA), have already been included in many legislations and given limit values. In the European Union, biocides are assessed under the Biocidal Products Regulation 528/2012 (BPR) regarding their efficacy, potential hazards, and risks to human health and the environment. However, the available guidance for the environmental risk assessment (ERA) of DBPs remains vague. To identify knowledge gaps and to further develop the assessment scheme for the ERA of DBPs, a literature search on the multiple uses of biocides and their formation potential of DBPs was performed and the existing process for ERA was evaluated. The results show knowledge gaps on the formation of DBP in non-aqueous systems and DBP formation by non-halogen-based biocidal active substances. Based on the literature research on biocides, a possible proposal of grouping a.s. to consider their DBP formation potential is presented to simplify future ERAs. However, this also requires further research. Until then, a pragmatic approach considering the DBPs formation potential of the active substances and the identified knowledge gaps need to be established for the environmental risk assessment of DBPs in the EU.

Graphical Abstract
A unique case of a fulminant clonal CD8-positive T-cell lymphoproliferative disorder with CNS involvement
Authors: Mesbah-Oskui Lia , Alabkal Jarrah , Alduaij Waleed , Dhawan Priya S.
Published: September 2023

Background

This is a unique case that describes the presentation, investigations, and disease trajectory of a fatal, clonal CD8-positive T-cell lymphoproliferative disorder in an otherwise healthy and immunocompetent patient with Epstein-Barr virus seronegative status. Central nervous system involving T-cell lymphoproliferative disorders are rare and typically encountered in the setting of immunocompromise. These disorders are often associated with aggressive cytomorphological features and characteristic magnetic resonance imaging patterns, which were not seen in this case.

Case presentation

Here we describe a case of a 65 year-old male presenting with neuropsychiatric symptoms, truncal ataxia, and falls who’s bone marrow, cerebrospinal fluid, and brain biopsy were consistent with a clonal CD8-positive T-cell lymphoproliferative disorder that did not meet existing World Health Organization criteria for classification as T-cell lymphoma. The patient was treated with intrathecal methotrexate resulting in transient improvement of his symptoms followed by disease progression and death related to aspiration.

Conclusions

This case highlights the importance of urgent and comprehensive work-up in patients with clinical features suggestive of lymphoma with central nervous system involvement, despite atypical imaging features and lack of cytomorphological features satisfying current World Health Organization classification criteria.
Leptomeningeal neuraxis relapse in glioblastoma is an uncommon but not rare event associated with poor outcome
Authors: Wegener Eric , Horsley Patrick , Wheeler Helen , Jayamanne Dasantha , Kastelan Marina , Guo Linxin , Brown Chris , Back Michael
Published: September 2023

Background

Spinal neuraxis leptomeningeal metastasis (LM) relapse in glioblastoma is an uncommon event that is challenging to manage. This study aims to determine the incidence, associated factors, and outcome of LM relapse in patients with glioblastoma managed with radical intent.

Methods

Patients managed for glioblastoma using the EORTC-NCIC (Stupp) Protocol from 2007 to 2019 were entered into a prospective ethics-approved database. Follow-up included routine cranial MRI surveillance with further imaging as clinically indicated. LM relapse was determined by MRI findings and/or cerebrospinal fluid analysis. The chi-square test of independence was used to evaluate clinico-pathologic factors associated with increased risk of subsequent LM relapse. Median survival post-LM relapse was calculated using Kaplan-Meier technique.

Results

Four-hundred-and-seven patients were eligible, with median follow-up of 60 months for surviving patients. Eleven (2.7%) had LM at first relapse and in total 21 (5.1%) experienced LM in the entire follow-up period. Sites of LM relapse were 8 (38%) focal spinal, 2 (10%) focal brainstem medulla and 11 (52%) diffuse spinal. Median overall survival from initial diagnosis for the entire cohort was 17.6 months (95% CI 16.7–19.0). Median survival from LM relapse to death was 39 days (95% CI: 19–107). Factors associated with LM relapse were age less than 50 years (p < 0.01), initial disease located in the temporal lobe (p < 0.01) and tumours lacking MGMT promoter methylation (p < 0.01).

Conclusions

LM relapse is an uncommon but not rare event in patients managed radically for glioblastoma. It is associated with poor outcome with the majority of patients deceased within two months of recognition.
Application of non-invasive neuromodulation in children with neurodevelopmental disorders to improve their sleep quality and constipation
Authors: Báez-Suárez Aníbal , Padrón-Rodríguez Iraya , Castellano-Moreno Elizabeth , González-González Erica , Quintana-Montesdeoca María P. , Medina-Ramirez Raquel Irina
Published: September 2023

Background

Children with neurodevelopmental disorders have a very wide clinical variability. A common prevalent factor is problems with stool and sleep quality. Currently, there are multiple studies related to their evaluation, but not so much related to a specific intervention. The aim was to evaluate the effectiveness and safety of the application of non-invasive neuromodulation as a treatment in children with neurodevelopmental disorders to improve constipation and quality of sleep.

Methods

A total of 23 minors aged between 2 and 16 were included in this cross-sectional study. All participants were applied the microcurrent device for 60 min, 3 times per week for a total of 4 weeks. The technique was based on non-invasive neuromodulation using a surface-applied microcurrent electrostimulation device that administers an external, imperceptible, pulsed electrical stimulation. It is applied to the extremities, in a coordinated manner, using gloves and anklets connected with electrodes to a control console. Sleep latency and microarousals were evaluated through a sleep diary. To assess the evolution and type of defecation, the adapted and validated version in Spanish of the Bristol Stool Form Scale was used.

Results

No adverse events occurred during the study and no incidences were registered. Clinically relevant improvements were registered in defecation frequency and type as well as in sleep related parameters. An increase in the hours of sleep was registered, from 7,35 (0,83) to 9,09 (1,35), and sleep interruptions decreased from 3,83 (1,95) to 1,17 (1,11), (p < .001).

Conclusion

Microcurrents can be used as an effective and safe treatment to improve quality of sleep and constipation in children with neurodevelopmental disorders. More studies are needed in order to obtain statistically significant results.

Trial Registration

ClinicalTrials.gov ID: NCT05265702.

First registration

03/03/2022

Protocol

https://clinicaltrials.gov/ct2/show/NCT05265702?term=baez+suarez&draw=2&rank=4
Association of liver function with health-related physical fitness: a cross-sectional study
Authors: Ye Bo , Zhang Jing , Tan Zeyu , Chen Jiangang , Pan Xinliang , Zhou Yuan , Wang Wanwan , Liu Longlong , Zhu Wenfei , Sun Yuliang , Ning Ke , Xie Qian , Liu Ronghua
Published: September 2023

Background

In this study, by analyzing the correlation between various components of health-related physical fitness (HPF) and liver function indicators, the indicators of physical fitness that were highly correlated with liver function and could be monitored at home were screened to prevent more serious liver disease in the future, and to provide experimental basis for prescribing personalized exercise.

Methods

A total of 330 faculties (female = 198) of a university were recruited. The indicators of HPF and liver function were measured. Spearman correlation analysis, multivariate linear regression, and cross-lagged panel model was used to data statistics.

Results

In males, body fat (BF) was positively correlated with alanine aminotransferase (ALT); vital capacity and the vital capacity index were positively correlated with albumin; and vertical jump was positively correlated with globulin and negatively correlated with the albumin-globulin ratio (P < 0.05). However, there was no significant correlation among all indicators controlled confounding factors. In females, BF was negatively correlated with direct bilirubin; VO2max was positively correlated with indirect bilirubin; and vertical jump was positively correlated with the albumin-globulin ratio and significantly negatively correlated with globulin (P < 0.05). Controlled confounding factors, body fat percentage was positively correlated with globulin (β = 0.174) and negatively correlated with direct bilirubin (β = –0.431), and VO2max was positively correlated with indirect bilirubin (β = 0.238, P < 0.05). Cross-lagged panel analysis showed that BF percentage can negatively predict direct bilirubin levels with great significance (β = -0.055, P < 0.05).

Conclusions

HPF may play a crucial role in liver function screening, particularly for female faculty members. For males, BF, vertical jump, vital capacity and vital capacity index could be associated with liver function but are susceptible to complex factors such as age, smoking, diabetes, and hypertension. In females, BF percentage is an important predictor of abnormal liver function in addition to VO2max and vertical jump, which are not affected by complex factors.