bluuebunny/crossref_metadata_2025 huggingface dataset:
Opioid use in impending versus pathologic proximal femur fractures.
Authors: Yu Austin , Jones Conor M. , Vijayakumar Gayathri , Turkmani Amr , Cargill Andre , Colman Matthew W. , Gitelis Steven , Blank Alan T.
Published: June 2024

e24061

Background: Pathologic and impending fractures commonly occur in the proximal femur, and patients may be prescribed opioids prior to surgery and often require opioids for postoperative pain relief. This study compared postoperative opiate usage and ambulatory functional status in patients with impending versus pathologic fractures in the proximal femur. Methods: This was a retrospective review of patients using opioids postoperatively who underwent internal fixation for a pathologic or impending fracture between 2016 and 2022. Preoperative and postoperative opioid usage as well as ambulation status and risk factors at three and six months associated with postoperative opioid use were recorded. Results: Twenty-four pathologic fractures and twenty-three impending fractures were included. Preoperative opioid daily morphine milligram equivalent (MME) was significantly higher in the pathologic fracture group (p = 0.021), but there were no significant differences at three or six months. In the impending fracture group, daily MME at three months was significantly higher than preoperative daily MME (p = 0.018) but returned to preoperative levels at six months. There was statistically significant improvement in ambulation status in the combined cohort (p = 0.008) and impending fracture cohort (p = 0.016) at 6 months. Conclusions: Although patients did not experience a significant postoperative change in opioid use, patients with pathologic fractures notably required higher opioid dosages and there was overall improvement in function following fixation. Future studies should examine postoperative opioid use with careful consideration of concurrent pain management pain therapies and tumor characteristics.[Table: see text]
Advance care planning and predictive factors among Brazilian patients with cancer from an outpatient palliative care program.
Authors: Ananda Gomes Sarah Ananda , Silva Danielle , Sorice Flavia , Barreto Arantes Alexandra , Rodrigues Martins Matheus , de Paula Silva Elaine Cristina , Amaral Fagner , Peixoto Rafaela , Ferrari Renata , Laloni Mariana , Bergerot Cristiane Decat , Ferrari Bruno Lemos
Published: June 2024

e24062

Background: Advance care planning (ACP) is crucial for informed decision-making in patient care. However, barriers such as time constraints and discomfort with discussions hinder widespread ACP adoption. A previous study (Cohen et al. JNCCN 2023) indicated a low ACP engagement rate (17%), but participation in a palliative care program has shown potential to increase this proportion. Therefore, we sought to determine the prevalence of ACP and identify associated predictor factors among patients with cancer in Brazil enrolled in an outpatient palliative care (OPC) program. Methods: A retrospective analysis was performed from November 2022 to December 2023. Eligible patients were those who passed away during the study period and had received care from an OPC program at one of the largest private joint cancer centers in Latin America. We assessed the prevalence of ACP and explored its potential associations with clinical characteristics (age, gender and type of cancer), OCP support (follow-up period, appointments and family support), and end-of-life care (treatment in the past month, intensive care unit (ICU) admission in the past month, home care service referrals, and place of death).Comparative analyses involved two groups: those who had undergone ACP and those who had not (no-ACP). Logistic models were employed. Results: A total of 849 patients were included in the final analyses. Patients’ characteristics were well balanced between groups. Most patients were women (56%), with an average of 68.2 years (SD =15.3). Patients were mostly diagnosed with gastrointestinal (36%), breast (13%), and lung (13%) cancers. Notably, 43% of patients had ACP, significantly higher than literature controls (95% confidence interval [CI]= 22-31%, P = 0.001). Among the factors associated with ACP, clinical characteristics were not significant. However, OCP support and end-of-life care were significantly predicted by ACP, including the follow-up period (MACP= 179 vs. Mno-ACP= 101; P = 0.001), family support (MACP= 0.6 vs. Mno-ACP= 0.3; P < 0.001) , ICU admission at the last 30 days of life (ACP = 28% vs. no-ACP = 72%; P < 0.001), and home care service referral (ACP = 72% vs. no-ACP = 28%; P < 0.001). Conclusions: These findings underscore that prolonged engagement with the OPC program is associated with increased adoption of ACP among Brazilian patients with cancer. Given the scarcity of data from developing countries, our findings suggest that the OPC program plays a pivotal role in optimizing end-of life care support through ACP.
The efficacy of ketamine for pain management in patients with cancer: A systematic review.
Authors: Azari Leila , Saleh Anaraki Kimia , Hemati Homa , Tavasolian Ronia , Shahdab Sareh , Tomlinson Stephanie M. , Bobonis Babilonia Margarita , Huang Jeffrey , Tometich Danielle , Turner Kea , Jim Heather S.L. , Alishahi Tabriz Amir
Published: June 2024

e24069

Background: Managing cancer-related pain poses significant challenges, prompting research into alternative approaches such as the study of ketamine. This systematic review aims to analyze and summarize the impact of ketamine as an adjuvant to opioid therapy for cancer-related pain. Methods: We conducted a literature review in MEDLINE, EMBASE, and Scopus, spanning from January 1, 1982, to October 20, 2022. Abstracts were screened against inclusion criteria, and eligible studies underwent a thorough full-text review. Data were extracted from the included studies, and a framework analysis approach was employed to summarize the evidence regarding ketamine's use in patients with cancer. The quality of included studies was assessed using the NIH Quality Assessment Tool for controlled intervention studies. Results: A total of 22 studies conducted between 2001 and 2019 were included, all assessed as having good quality. Three studies focusing on intrathecal administration of ketamine following oncological surgery demonstrated a substantial improvement in pain scores and a reduction in postoperative morphine requirements. Two studies exploring intramuscular use concluded that it led to improved pain scores. In contrast, three studies on subcutaneous administration and two studies on topical ketamine did not exhibit a significant impact on reducing pain scores or alleviating chemotherapy-induced peripheral neuropathy. Findings from two studies on oral administration and eight studies on intravenous administration indicated that intravenous ketamine reduced postoperative morphine requirements, while oral ketamine had no discernible effect on lowering pain scores. Conclusions: The use of intrathecal ketamine demonstrates significant improvement in post-op oncological pain and refractory cancer pain, resulting in lowered pain scores and decreased morphine requirements. Further research is essential to ascertain the extent to which incorporating ketamine with opioids in cancer pain treatment can enhance pain outcomes, especially in morphine-tolerant patients.
The use of complementary and alternative medicine (CAM) among patients with cancer in Hawaii.
Authors: Matriz Jobel , Hamachi April , Fukui Jami Aya
Published: June 2024

e24070

Background: Complementary and alternative medicine (CAM) involves medical products and practices that are not part of standard medical care. Various studies demonstrate potential benefits of CAM in alleviating certain side effects associated with cancer and cancer treatments. Our project aims to elucidate the prevalence, pattern of use, and proposed benefits of CAM among Hawaii residents with cancer. Methods: Our questionnaire based study recruited cancer patients from several outpatient oncology clinics across Oahu (n = 126). Patients were asked about CAM use and associated symptom benefit. Sociodemographic information was collected along with details about cancer type, treatment, and associated side effects. Participation was anonymous and optional. Results: At least one CAM therapy was used by 72/126 (57.1%) patients, while 54 (42.9%) did not use any CAM therapy. Among the CAM therapies, meditation and herbal supplements were most commonly used 26 (36.6%), followed by massage 25 (32.4%), and yoga 18 (25.4%). Stress reduction was the most common symptom benefit identified for various CAM therapies including meditation 13 (50%), herbal supplement 13 (50%), massage 13 (52%), and yoga 14 (77.8%). Anxiety reduction was another symptom benefit reported for meditation 13 (50%). Massage 13 (52%), CBD 14 (82.4%), and acupuncture 9 (64.3%) were also used for pain reduction. THC 12 (75%) and CBD 14 (82.4%) were used for sleep. Among the CAM users (n = 72), 52 (72.2%) did not speak to their clinician about CAM. We found that 107 (84.9%) patients experienced at least one side effect. The most common side effects experienced by patients were fatigue 81 (64.3%), hair loss 61 (48.4%), and constipation and/or diarrhea 57 (45.2%). The most commonly reported demographic information were the following: 95 (75.4%) female, 57 (45.2%) Asian, 33 (26.2%) 60-69 years old, 80 (63.5%) with breast cancer, and 33 (26.2%) with stage 4. Conclusions: We discovered that stress reduction is a symptom benefit associated with the most commonly used CAM therapies by cancer patients in Hawaii. Other symptom benefits involve anxiety, pain, and sleep. The modalities utilized were similar to nonpharmacologic therapies recommended by the NCCN guidelines for cancer survivorship, with the exception of herbal supplements. There is a lack of physician discussion regarding CAM use, which could impact the cancer burden in Hawaii. [Table: see text]
Trends in palliative care utilization among patients with ovarian cancer in the United States.
Authors: Adkoli Anusha , Tomita-Barber Jasmine , Patel Ankoor , Liu Nancy , Greenberg Patricia , Patankar Sonali , Girda Eugenia
Published: June 2024

e24083

Background: Palliative care is a resource that is utilized for patients with serious illnesses to focus on symptom management, quality of life, and goals of care for patients and their families. It can be initiated at any point in illness course with benefit beginning as early as the time of diagnosis. This study's objective is to evaluate trends in inpatient palliative care utilization and associated factors in patients with ovarian cancer. Methods: We performed a retrospective cohort study using the National Inpatient Sample (NIS) from 2010-2020. Patients with ovarian, fallopian tube, and primary peritoneal cancer and palliative care (PC) utilization were identified using ICD-10 codes. Chi square and t tests were used to evaluate differences between patients who received PC versus patients who did not. Multivariate and multinomial logistic regression was utilized to determine factors associated with PC use. Results: A total of 479,169 patients with a diagnosis of ovarian cancer were included, of which 58,970 (12.3%) utilized inpatient PC. Between 2010 and 2020, there was a significant upwards trend in PC usage in patients hospitalized with a diagnosis of ovarian cancer from 6.9% to 18.1%. Median age of patients using PC was 67 compared to 65 among those not using PC (p < 0.001). PC utilization was more prevalent among patients with a diagnosis of depression (8.7% v 6.4%; p < 0.001), Black race (12.4% v 10.3%; p < 0.001), in urban environments (94.0% v 92.2%; p < 0.001), and those at hospitals designated as teaching status (72.4% v 66.8%; p < 0.001). In a multivariate regression analysis, the odds of palliative care utilization were 1.59times higher (p < 0.001) for patients with moderate loss of function compared to patients with minor loss of function. Patients with hospital stays 0-3 days were more likely to utilize palliative care compared to 4-7 days (p < 0.001) Multinomial logistic regression for disposition among patients using palliative care to additional care versus routine care was 1.59 times higher in patients with 8+ days hospital stay compared to 4-7 days. For those with shorter stays of 1-3 days versus 4-7 days patients were 1.65 times more likely to die versus routine care. Conclusions: The use of inpatient PC for patients with ovarian cancer increased over time. Palliative care utilization was associated with older age, Black race, depression, and treatment in urban environments or in teaching hospitals. The utilization of inpatient palliative care was higher in patients with more extreme losses of function. These patients were more likely to have shorter lengths of stay due to a higher disposition of death over routine care. Given these findings, patients receiving palliative care may be sicker and closer to the end of life than those who do not. Although there have been higher rates of inpatient palliative care over time, there is still room for earlier implementation.
Natural supplementation to effectively combat cancer-related fatigue: Evidence from a meta-analysis on the use of guarana.
Authors: Maselli-Schoueri Jean Henri , Nazareth Aguiar Pedro , Del Giglio Auro
Published: June 2024

e24087

Background: Cancer-related fatigue (CRF) is one of the most common symptoms reported and is estimated to affect up to 90% of cancer patients during the course of the disease. CRF may persist even after the end of cancer treatment. There is no definitive effective treatment with a high level of evidence and several alternatives have been sought after to aid traditional medications, with emphasis on natural supplements as a form of adjuvant treatment. In previous studies carried out by the Department of Oncology at ABC Medical School, a purified extract of Guarana ( Paullinia cupana), a plant native to the Amazon, showed promising results in clinical trials with patients undergoing chemotherapy, but with a limited number of patients and, thus, lower level of evidence. Therefore, the present study carried out a systematic review and meta-analysis of the supplementation of Guarana and its derivatives to combat CRF to produce more robust evidence regarding its possible therapeutic effect. Methods: Systematic review with meta-analysis registered at the International Prospective Register of systematic reviews (PROSPERO) under code CRD42023484144. Two independent researchers searched for articles in English on PUBMED, MEDLINE and Cochrane Library using controlled vocabulary (MeSH terms) and keywords related to CFR, Guarana and its related terms. Eligible studies were selected based on predefined criteria and were assessed for quality according to Cochrane Handbook for Systematic Reviews of Interventions. Data extraction was independently performed by two reviewers – any discrepancies were resolved by a third researcher. On the rare occasions in which a study was published as an abstract and then published as a full article, only its complete version was considered eligible for inclusion to avoid duplicates and reduce risk of bias. All analyses were conducted with RevMan 5.4.1 and employed random-effects model. Results: Of the 117 articles found, 4 full articles and 1 abstract were added to the meta-analysis, comprehending a total of 229 patients and the years of 2007-2023. With high heterogeneity between studies (I² = 78%, Chi² = 18.51, df = 4, P = 0.0010), our analysis found benefit in using guarana to combat CRF: Standard Mean Difference -0.77 (IC95% -1.34; -0.21), Test for overall effect: Z = 2.68 (P = 0.007). Conclusions: Our analysis supports the use of Guarana to combat Cancer-Related Fatigue. Further investigation with prospective randomized controlled trials should be carried out to validate our findings.
A phase II trial to assess the impact of β2 adrenergic blockade in immune checkpoint inhibitor (ICI)– refractory metastatic triple negative breast cancer (mTNBC).
Authors: Gandhi Shipra , Roy Arya Mariam , Minderman Hans , Rosario Spencer , Repasky Elizabeth A.
Published: June 2024

TPS1141

Background: In PD-L1+ mTNBC patients (pts), the standard of care treatment is chemotherapy and pembrolizumab (P) in the first-line setting. It has been shown that acquired resistance to P occurs as a result of immune exhaustion. Further, our group and others have demonstrated that chronic β2-adrenergic receptor (β-AR) signaling suppresses CD8+ cytotoxic T lymphocytes (CTL) function, drives their exhaustion, and increases the numbers of immunosuppressive myeloid-derived suppressor cells (MDSCs) and regulatory T cells (Tregs) in the tumor microenvironment (TME), thus supporting tumor proliferation. Consequently, abrogation of β-AR signaling using the pan β-blocker propranolol or β-AR-/- knockout mice increased the intratumoral frequency of CTLs and elevated the CTL:Treg ratio (Bucsek et al. Cancer Res. 2017; PMID: 28819022). Similarly, mouse tumor models also demonstrated decreased exhaustion markers (PD1, TIM3, LAG3) on CTLs when β-AR was blocked, via propranolol (Qiao G et al. Cancer Immunol Res. 2021, PMID: 33762351). Confirming this phenomenon, we have shown, in a prospective clinical trial in metastatic melanoma, that β-AR blockade with propranolol significantly increased response to P with an objective response rate (ORR) of 78%, as opposed to 30-40% with P monotherapy (Gandhi et al, Clin Cancer Res 2021, PMID: 33127652). Therefore, we hypothesize that using propranolol in an ICI refractory population should improve responses to ICIs. Methods: This is a phase II single-arm, non-randomized single-center study for mTNBC pts. Participants will bewomen >=18 yrs with PD-L1+ mTNBC, who have progressed on treatment with chemotherapy and P in the upfront setting. They will continue P every 3 weeks in addition to 30 mg propranolol twice a day, based on our ongoing clinical trial in metastatic melanoma (NCT03384836) which has demonstrated safety with this combination. Treatment will continue until disease progression per irRECIST. The primary endpoint is ORR, defined as complete or partial response to treatment. The secondary endpoint is safety, 6-month progression-free survival and overall survival. As an exploratory endpoint, changes in tumor and blood immune markers will be assessed. In stage 1, n1=12 evaluable pts will be enrolled. If ≥ 1/12 response is observed, then the study will continue to enroll another n2=9 pts for a total of n=21, otherwise it will be suspended for futility. If ≥ 3/21 responses are observed, then the proposed therapy will be considered promising. Pre- and post-treatment tumor biopsies and sequential blood samples will be analyzed for changes in stress-induced biomarkers (epinephrine, norepinephrine, and frequency of CTL, MDSC, Treg) and expression of exhaustion markers (PD1, TIM3, LAG3). The study is currently open. Clinical trial information: NCT05741164 .
Olanzapine Plus Triple Antiemetic Therapy for the Prevention of Carboplatin-Induced Nausea and Vomiting: A Randomized, Double-Blind, Placebo-Controlled Phase III Trial
Authors: Inui Naoki , Suzuki Takahito , Tanaka Kazuki , Karayama Masato , Inoue Yusuke , Mori Kazutaka , Yasui Hideki , Hozumi Hironao , Suzuki Yuzo , Furuhashi Kazuki , Fujisawa Tomoyuki , Matsuura Shun , Nishimoto Koji , Matsui Takashi , Asada Kazuhiro , Hashimoto Dai , Fujii Masato , Niwa Mitsuru , Uehara Masahiro , Matsuda Hiroyuki , Koda Keigo , Ikeda Masaki , Inami Nao , Tamiya Yutaro , Kato Masato , Nakano Hideki , Mino Yasuaki , Enomoto Noriyuki , Suda Takafumi
Published: June 2024

PURPOSE

We evaluated the efficacy and safety of antiemetic therapy with olanzapine, a neurokinin-1 receptor antagonist (RA), a 5-hydroxytryptamine-3 (5-HT3) RA, and dexamethasone for preventing chemotherapy-induced nausea and vomiting in patients receiving carboplatin-containing chemotherapy.

PATIENTS AND METHODS

Chemotherapy-naïve patients scheduled to receive carboplatin (AUC ≥5) were randomly assigned to receive either olanzapine 5 mg once daily (olanzapine group) or placebo (placebo group) in combination with aprepitant, a 5-HT3 RA, and dexamethasone. The primary end point was the complete response (CR; no vomiting and no rescue therapy) rate in the overall phase (0-120 hours). Secondary end points included the proportion of patients free of nausea and safety.

RESULTS

In total, 355 patients (78.6% male, median age 72 years, 100% thoracic cancer), including 175 and 180 patients in the olanzapine and placebo groups, respectively, were evaluated. The overall CR rate was 86.9% in the olanzapine group versus 80.6% in the placebo group. The intergroup difference in the overall CR rate was 6.3% (95% CI, –1.3 to 13.9). The proportions of patients free of chemotherapy-induced nausea in the overall (88.6% in the olanzapine group v 75.0% in the placebo group) and delayed (89.7% v 75.6%, respectively) phases were significantly higher in the olanzapine group than in the placebo group (both P < .001). Somnolence was observed in 43 (24.6%) and 41 (22.9%) patients in the olanzapine and placebo groups, respectively, and no events were grade ≥3 in severity.

CONCLUSION

The addition of olanzapine was not associated with a significant increase in the overall CR rate. Regarding the prevention of nausea, adding olanzapine provided better control in patients receiving carboplatin-containing chemotherapy, which needs further exploration.
Navigating Skin Delivery Horizon: An Innovative Approach in Pioneering Surface Modification of Ultradeformable Vesicles
Authors: Nayak Devika , Rathnanand Mahalaxmi , Tippavajhala Vamshi Krishna
Published: June 2024

In the dynamic landscape of pharmaceutical advancements, the strategic application of active pharmaceutical ingredients to the skin through topical and transdermal routes has emerged as a compelling avenue for therapeutic interventions. This non-invasive approach has garnered considerable attention in recent decades, with numerous attempts yielding approaches and demonstrating substantial clinical potential. However, the formidable barrier function of the skin, mainly the confinement of drugs on the upper layers of the stratum corneum, poses a substantial hurdle, impeding successful drug delivery via this route. Ultradeformable vesicles/carriers (UDVs), positioned within the expansive realm of nanomedicine, have emerged as a promising tool for developing advanced dermal and transdermal therapies. The current review focuses on improving the passive dermal and transdermal targeting capacity by integrating functionalization groups by strategic surface modification of drug-loaded UDV nanocarriers. The present review discusses the details of case studies of different surface-modified UDVs with their bonding strategies and covers the recent patents and clinical trials. The design of surface modifications holds promise for overcoming existing challenges in drug delivery by marking a significant leap forward in the field of pharmaceutical sciences.
Rear cortex contraction aids in nuclear transit during confined migration by increasing pressure in the cell posterior
Authors: Keys Jeremy , Cheung Brian C. H. , Elpers Margaret A. , Wu Mingming , Lammerding Jan
Published: June 2024

As cells migrate through biological tissues, they must frequently squeeze through micron-sized constrictions in the form of interstitial pores between extracellular matrix fibers and/or other cells. Although it is now well recognized that such confined migration is limited by the nucleus, which is the largest and stiffest organelle, it remains incompletely understood how cells apply sufficient force to move their nucleus through small constrictions. Here, we report a mechanism by which contraction of the cell rear cortex pushes the nucleus forward to mediate nuclear transit through constrictions. Laser ablation of the rear cortex reveals that pushing forces behind the nucleus are the result of increased intracellular pressure in the rear compartment of the cell. The pushing forces behind the nucleus depend on accumulation of actomyosin in the rear cortex and require Rho kinase (ROCK) activity. Collectively, our results suggest a mechanism by which cells generate elevated intracellular pressure in the posterior compartment to facilitate nuclear transit through three-dimensional (3D) constrictions. This mechanism might supplement or even substitute for other mechanisms supporting nuclear transit, ensuring robust cell migrations in confined 3D environments.
Data and the Aggregate Economy
Authors: Veldkamp Laura , Chung Cindy
Published: June 2024

Recent data technology innovations, such as artificial intelligence and machine learning, have transformed the production of knowledge and increased the importance of data. This review explores how data—digitized information—has been modeled within classic macroeconomic frameworks. It compares the economics of data to other concepts such as ideas, patents, and learning-by-doing. This paper also shows potential ways to model applications for data, including innovation, process optimization, and matching. Because this research area is nascent, much of the article is devoted to open questions and directions for future data economy research. (JEL C80, D21, D83, E23, E24, J23)
Debunking Immigration Myths: A Review Essay of Streets of Gold: America’s Untold Story of Immigrant Success
Authors: Tabellini Marco
Published: June 2024

This essay reviews Streets of Gold: America’s Untold Story of Immigrant Success by Ran Abramitzky and Leah Boustan. This elegantly written book, whih is a must-read for anyone interested in the topic of immigration, walks the reader through a history of US immigration, examining patterns of immigrant assimilation from the mid-nineteenth century to today. The book challenges two myths about US immigration. First, it shows that historical European immigrants did not always arrive poor and quickly climb the economic and social ladder. Second, it documents that the pace of immigrant assimilation today resembles that prevailing at the turn of the twentieth century. (JEL J15, J18, K37, N31, N32, Z13)
Conformational dynamics of the hepatitis C virus 3′X RNA
Authors: Sperstad Parker D. , Holmstrom Erik D.
Published: June 2024

The 3′ end of the hepatitis C virus genome is terminated by a highly conserved, 98 nt sequence called 3′X. This untranslated structural element is thought to regulate several essential RNA-dependent processes associated with infection. 3′X has two proposed conformations comprised of either three or two stem–loop structures that result from the different base-pairing interactions within the first 55 nt. Here, we used single-molecule Förster resonance energy transfer spectroscopy to monitor the conformational status of fluorescently labeled constructs that isolate this region of the RNA (3′X55). We observed that 3′X55 can adopt both proposed conformations and the relative abundance of them can be modulated by either solution conditions or nucleotide deletions. Furthermore, interconversion between the two conformations takes place over the course of several hours. The simultaneous existence of two slowly interconverting conformations may help prime individual copies of the viral genome for either viral protein or RNA synthesis, thereby minimizing conflicts between these two competing processes.
Μελέτη σύγκρισης πρωτόκολλων εισαγωγής ξηρών καρπών στη διατροφή ασθενών με αλλεργία στους ξηρούς καρπούς
Authors: Πασιώτη Μαρία
Published: June 2024

Η από του στόματος απευαισθητοποίηση σε τρόφιμα αποτελεί μια καινοτόμο μέθοδο αντιμετώπισης της τροφικής αλλεργίας, που έχει προσελκύσει το ενδιαφέρον των ιατρών και των ασθενών τα τελευταία χρόνια. Η μέθοδος εφαρμόζεται σε εξειδικευμένα κέντρα και περιλαμβάνει συχνές επισκέψεις κατά τις οποίες αυξάνονται κατά πολύ οι χορηγούμενες δόσεις του αλλεργιογόνου, με κίνδυνο εμφάνισης αναφυλακτικών αντιδράσεων. Προκειμένου να ελέγξουμε την εφαρμοσιμότητα της μεθόδου εκτός νοσοκομειακού περιβάλλοντος, αναπτύξαμε δυο πρωτόκολλα απευαισθητοποίησης, ένα με αυξήσεις στο νοσοκομείο και ένα με αυξήσεις στο σπίτι, και τα συγκρίναμε μεταξύ τους, σε 36 παιδιά με αλλεργία στους ξηρούς καρπούς. Τα πρωτόκολλα δε διέφεραν μεταξύ τους ως προς την ασφάλεια [ποσοστό επίπτωσης 0,004 (0-0,018) vs 0,009 (0,004-0,014), p=0,506], τη συμμόρφωση (96% vs 100%), και την αποτελεσματικότητα (75% έκαστο). Επιπλέον μελετήσαμε την επίδραση της αλλεργίας στους καρπούς στην ποιότητα ζωής των ασθενών και των φροντιστών τους, την ικανοποίησή τους από την τρέχουσα αντιμετώπιση και το ενδιαφέρον τους για νεότερες θεραπευτικές επιλογές. Για το σκοπό αυτό αναλύθηκαν οι απαντήσεις 182 συμμετεχόντων σε ειδικά διαμορφωμένα ερωτηματολόγια. Τα αποτελέσματά μας δείχνουν ότι η αλλεργία σε καρπούς έχει μέτρια επιβάρυνση στην ποιότητα ζωής των ασθενών, με τους έφηβους να αναφέρουν τα χειρότερα αποτελέσματα και τους ενήλικες τα καλύτερα. Επιπλέον, ενώ οι περισσότεροι ασθενείς δηλώνουν πολύ ικανοποιημένοι από την τρέχουσα αντιμετώπιση της αλλεργίας τους, παράλληλα θα τους ενδιέφερε πάρα πολύ μια θεραπεία που θα παρείχε προστασία από αντιδράσεις μετά από τυχαίες εκθέσεις ή/και θα επέτρεπε την ελεύθερη κατανάλωση καρπών.
Consideraciones sobre los orígenes de los populismos progresistas en América Latina y la persistencia del Socialismo del Siglo XXI en Venezuela
Authors: Cubas Ramacciotti Ricardo
Published: June 2024

El régimen establecido por Hugo Chávez y continuado por Nicolás Maduro en Venezuela ha generado repercusiones sociales, migratorias, económicas y políticas que han trascendido las fronteras del país, convirtiéndose en un factor desestabilizador para la democracia y la seguridad de América Latina. Para explicar dicho fenómeno, se propone analizar los antecedentes, contextos y elementos que propiciaron su surgimiento y consolidación. Para ello, después de discutir el concepto y las características del populismo, se hace una revisión de su plasmación histórica en los populismos clásicos latinoamericanos de mediados del siglo XX. La sección final se centra en analizar las peculiaridades del neopopulismo latinoamericano y del Socialismo del Siglo XXI en Venezuela. A través de esta exploración, se busca comprender sus bases ideológicas, características y consecuencias, así como proponer hipótesis sobre las causas de su permanencia en el poder.
For the sake of Venezuela: Power-Sharing mechanism challenges and opportunities
Authors: Salvador Barroso Cortes Francisco
Published: June 2024

This essay examines Venezuelan political elite behavior and how decisionmakers might contemplate power-sharing as a means to restore the nation-state. The article delves into the challenges and prospects of adopting power-sharing as a strategy not only for peacekeeping but also, crucially, peace-making processes. Starting with an overall assessment of Venezuelan democracy, the paper identifies factors that may hinder consociational democracy. It then analyzes sociopolitical elements favoring autocracy and partitocracy before discussing current challenges and opportunities for effective power-sharing. It highlights the role of Venezuelan elites and the persistent issue of elite non-circulation as critical factors in the ongoing political deadlock. Additionally, it explores the relationship between democracy, state-building, and the impact of autocratization
El cine en tiempos de paz. La visión del conflicto norirlandés en el cine después de los acuerdos de Viernes Santo: Omagh (2004), Hunger (2008), Five minutes of heaven (2009), ’71 (2011) y Belfast (2021)
Authors: Díaz-Maroto Isidro Aitor
Published: June 2024

En el presente artículo se realiza un recorrido por las revisiones y representaciones que el cine de ficción ha realizado en torno a la violencia política en Irlanda del Norte tras la firma de los Acuerdos de Viernes Santo en 1998 y la desaparición del IRA Provisional, una de las principales organizaciones armadas activas en la zona durante el periodo conocido como The Troubles. Analizando un total de cinco ejemplos cinematográficos, se pretende demostrar que, una vez finalizada la violencia política, se abre un nuevo escenario en el que se hace necesario revisitar los relatos históricos ya confeccionados, adaptarlos a la nueva realidad o construir unos nuevos con elementos ignorados previamente. Será mediante este análisis como se señalará la situación actual del relato cinematográfico, sus referencias, la atención que otorga a cada elemento histórico, así como el mensaje que se muestra en las pantallas.
Frontiers: The Effect of an Ad Ban on Retailer Sales: Insights from a Natural Experiment
Authors: Gabel Sebastian , Molitor Dominik , Spann Martin
Published: June 2024

A natural experiment reveals that an ad ban reduces sales of a grocery retailer by 6% but does not affect overall market size.
Variance-Reduced Accelerated First-Order Methods: Central Limit Theorems and Confidence Statements
Authors: Lei Jinlong , Shanbhag Uday V.
Published: June 2024

In this paper, we consider a strongly convex stochastic optimization problem and propose three classes of variable sample-size stochastic first-order methods: (i) the standard stochastic gradient descent method, (ii) its accelerated variant, and (iii) the stochastic heavy-ball method. In each scheme, the exact gradients are approximated by averaging across an increasing batch size of sampled gradients. We prove that when the sample size increases at a geometric rate, the generated estimates converge in mean to the optimal solution at an analogous geometric rate for schemes (i)–(iii). Based on this result, we provide central limit statements, whereby it is shown that the rescaled estimation errors converge in distribution to a normal distribution with the associated covariance matrix dependent on the Hessian matrix, the covariance of the gradient noise, and the step length. If the sample size increases at a polynomial rate, we show that the estimation errors decay at a corresponding polynomial rate and establish the associated central limit theorems (CLTs). Under certain conditions, we discuss how both the algorithms and the associated limit theorems may be extended to constrained and nonsmooth regimes. Finally, we provide an avenue to construct confidence regions for the optimal solution based on the established CLTs and test the theoretical findings on a stochastic parameter estimation problem.

Funding: This work was supported by the Office of Naval Research [Grant N00014-22-1-2589] and Basic Energy Sciences [Grant DE-SC0023303]. The work of J. Lei was partially supported by the National Natural Science Foundation of China [Grants 72271187 and 62088101].

Supplemental Material: The online appendix is available at https://doi.org/10.1287/moor.2021.0068 .
Optimal Cash Management with Payables Finance
Authors: Yan Xiaoyue , Chen Li , Ding Xiaobo
Published: June 2024

Payables finance, also known as reverse factoring or supply chain finance, is a form of trade finance offered by a bank that provides a supplier with the option to receive a buyer’s payables early while allowing the buyer to extend its payment due date. There has been an increasing adoption of payables finance by various industries in recent years. In “Optimal Cash Management with Payables Finance,” X. Yan, L. Chen, and X. Ding characterize the supplier’s optimal cash policy under the payables finance arrangement with a buyer and a bank. The authors show that it is the supplier’s future cash flow uncertainty, together with the supplier’s risk averseness, that drives the cash liquidity value of payables finance. Numerical results of applying the analysis to data sets obtained from a major U.S. chemical company suggest that adopting payables finance can generate considerable value for the company and its suppliers.
Building oral skill
Authors: Bakopoulou Ioanna
Published: June 2024

In the second article in this series, Dr Ioanna Bakopoulou shares the results from research evaluating the Supporting Spoken Language in the Classroom Programme
Do occupational therapy and/or physiotherapy interventions improve activity and participation function for children and adolescents with functional neurological disorder? A systematic review
Authors: Gould Danielle , Taylor Nicholas F
Published: June 2024

Background/Aims

Functional neurological disorder is increasingly common in paediatric neurological practice, yet the role and scope for occupational therapy and physiotherapy intervention remains unclear. The aim of this systematic review was to evaluate if occupational therapy and/or physiotherapy interventions improve activity and participation for children and adolescents with functional neurological disorder compared to usual care.

Methods

CINAHL, Embase and Medline were searched until May 2023. Eligibility criteria were applied by two reviewers independently. Methodological quality was assessed using the Mixed Methods Appraisal Tool. Data were synthesised narratively and the certainty of evidence assessed using a Grading of Recommendations, Assessment, Development and Evaluation approach.

Results

A total of eight non-randomised studies (n=451 participants, mean age 13.2 years) were selected. There was very low certainty evidence that for approximately three in four participants, inpatient or outpatient multidisciplinary programmes involving physiotherapy and/or occupational therapy led to recovery at the end of the programme, with recovery and school attendance retained at 12 months. Two studies provided very low certainty evidence that two in three participants attending multidisciplinary programmes were independent on all Pediatric Functional Independence Measure items at programme discharge.

Conclusions:

There is insufficient evidence to suggest routine occupational therapy and/or physiotherapy interventions improve activity and participation function for children and adolescents with functional neurological disorder compared to usual care.

Implications for practice

The implications for clinical practice for allied health professionals are ambiguous because of the low-quality of the available evidence. Until further research is conducted to support clinical practice, clinicians must rely on the combination of their clinical expertise and the best available evidence to guide practice.
Relationship between Kawasaki disease and abdominal pain
Authors: Pan Yan , Jiao Fu-Yong
Published: June 2024

This editorial presents an analysis of an article recently published in the World Journal of Clinical Cases . Kawasaki disease (KD) is a well-known pediatric vasculitis characterized by fever, rash, conjunctivitis, oral mucosal changes, and swelling of the extremities. This editorial aims to delve into the intricate relationship between KD and abdominal pain, drawing insights from recent research findings to provide a comprehensive understanding and potential avenues for future investigation.
Impact of specialized nursing outpatient case management on post-coronary artery bypass grafting patients
Authors: Li Tong , Lu Fang-Hui , Zhao Qing
Published: June 2024

BACKGROUND

Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events (MACE) and require readmission after Coronary Artery Bypass Grafting (CABG) surgery. This is often attributed to patients' unhealthy lifestyles and dietary habits, inadequate understanding of the disease, and poor disease management compliance. Thus, searching for more targeted nursing intervention models that can enhance patients' self-management abilities and reduce the risk of readmission after CABG surgery is significant.

AIM

To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.

METHODS

A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample. The patients were divided into two groups using an odd-even number grouping method. The control group received routine nursing care, while the case management group received specialized nursing outpatient case management. The differences in psychological status, adherence to medical treatment, self-care ability, knowledge mastery, quality of life scores, and the occurrence rate of MACE were compared between the two groups.

RESULTS

After the intervention, the case management group had lower scores on the self-rating depression scale and self-rating anxiety scale and lower MACE rate, as well as higher scores for adherence to a healthy diet, medication adherence, good lifestyle habits, regular exercise, and timely follow-up, higher scores on the Coronary Heart Disease Self-Management Scale, higher scores for managing adverse habits, symptoms, emotional cognition, emergency response, disease knowledge, general lifestyle, and treatment adherence, higher scores for understanding coronary heart disease, recognizing the importance of medication adherence, understanding self-care points after CABG surgery, and being aware of post-CABG precautions, higher scores for physical well-being, disease condition, general health, social-psychological well-being, and work-related aspects (P < 0.05).

CONCLUSION

Specialized nursing outpatient case management can enhance patient adherence to medical treatment, knowledge mastery, psychological well-being, and overall quality of life in patients after CABG surgery.
Cardiovascular risk factors among older persons with cognitive frailty in middle income country
Authors: Ibrahim Azianah Mohamad , Singh Devinder Kaur Ajit , Ludin Arimi Fitri Mat , Sakian Noor Ibrahim Mohamed , Rivan Nurul Fatin Malek , Shahar Suzana
Published: June 2024

BACKGROUND

Cognitive frailty, characterized by the coexistence of cognitive impairment and physical frailty, represents a multifaceted challenge in the aging population. The role of cardiovascular risk factors in this complex interplay is not yet fully understood.

AIM

To investigate the relationships between cardiovascular risk factors and older persons with cognitive frailty by pooling data from two cohorts of studies in Malaysia.

METHODS

A comprehensive approach was employed, with a total of 512 community-dwelling older persons aged 60 years and above, involving two cohorts of older persons from previous studies. Datasets related to cardiovascular risks, namely sociodemographic factors, and cardiovascular risk factors, including hypertension, diabetes, hypercholesterolemia, anthropometric characteristics and biochemical profiles, were pooled for analysis. Cognitive frailty was defined based on the Clinical Dementia Rating scale and Fried frailty score. Cardiovascular risk was determined using Framingham risk score. Statistical analyses were conducted using SPSS version 21.

RESULTS

Of the study participants, 46.3% exhibited cognitive frailty. Cardiovascular risk factors including hypertension (OR:1.60; 95%CI: 1.12-2.30), low fat-free mass (OR:0.96; 95%CI: 0.94-0.98), high percentage body fat (OR:1.04; 95%CI: 1.02-1.06), high waist circumference (OR:1.02; 95%CI: 1.01-1.04), high fasting blood glucose (OR:1.64; 95%CI: 1.11-2.43), high Framingham risk score (OR:1.65; 95%CI: 1.17-2.31), together with sociodemographic factors, i.e. , being single (OR 3.38; 95%CI: 2.26-5.05) and low household income (OR 2.18; 95%CI: 1.44-3.30) were found to be associated with cognitive frailty.

CONCLUSION

Cardiovascular-risk specific risk factors and sociodemographic factors were associated with risk of cognitive frailty, a prodromal stage of dementia. Early identification and management of cardiovascular risk factors, particularly among specific group of the population might mitigate the risk of cognitive frailty, hence preventing dementia.
Unraveling the mechanism of malancao in treating ulcerative colitis: A multi-omics approach
Authors: Huang Xing-Long , Wu Lu-Na , Huang Qin , Zhou Yue , Qing Lei , Xiong Feng , Dong Hui-Ping , Zhou Tai-Min , Wang Kai-Li , Liu Jue
Published: June 2024

BACKGROUND

Malancao (MLC) is a traditional Chinese medicine with a long history of utilization in treating ulcerative colitis (UC). Nevertheless, the precise molecular mechanisms underlying its efficacy remain elusive. This study leveraged ultra-high-performance liquid chromatography coupled with exactive mass spectrometry (UHPLC-QE-MS), network pharmacology, molecular docking (MD), and gene microarray analysis to discern the bioactive constituents and the potential mechanism of action of MLC in UC management.

AIM

To determine the ingredients related to MLC for treatment of UC using multiple databases to obtain potential targets for fishing.

METHODS

This research employs UHPLC-QE-MS for the identification of bioactive compounds present in MLC plant samples. Furthermore, the study integrates the identified MLC compound-related targets with publicly available databases to elucidate common drug disease targets. Additionally, the R programming language is utilized to predict the central targets and molecular pathways that MLC may impact in the treatment of UC. Finally, MD are conducted using AutoDock Vina software to assess the affinity of bioactive components to the main targets and confirm their therapeutic potential.

RESULTS

Firstly, through a comprehensive analysis of UHPLC-QE-MS data and public database resources, we identified 146 drug-disease cross targets related to 11 bioactive components. The Gene Ontology and Kyoto Encyclopedia of Genes and Genomes analysis highlighted that common disease drug targets are primarily involved in oxidative stress management, lipid metabolism, atherosclerosis, and other processes. They also affect AGE-RAGE and apoptosis signaling pathways. Secondly, by analyzing the differences in diseases, we identified key research targets. These core targets are related to 11 active substances, including active ingredients such as quercetin and luteolin. Finally, MD analysis revealed the stability of compound-protein binding, particularly between JUN-Luteolin, JUN-Quercetin, HSP90AA1-Wogonin, and HSP90AA1-Rhein. Therefore, this suggests that MLC may help alleviate intestinal inflammation in UC, restore abnormal lipid accumulation, and regulate the expression levels of core proteins in the intestine.

CONCLUSION

The utilization of MLC has demonstrated notable therapeutic efficacy in the management of UC by means of the compound target interaction pathway. The amalgamation of botanical resources, metabolomics, natural products, MD, and gene chip technology presents a propitious methodology for investigating therapeutic targets of herbal medicines and discerning novel bioactive constituents.