bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Palliative Care and Nursing Intervention on the Psychology and Quality of Life of Elderly Patients with Colorectal Cancer
Authors: Zhang Ai , Fu He
Published: June 2022

Colorectal cancer patients face physical, psychological, and social difficulties. Psychosocial therapies appear to be successful in improving cancer patients’ psychological and social results. Preoperative and postoperative psychological therapies for colorectal surgery patients have not been extensively studied. During their treatment, up to 35% of cancer patients experience clinically severe psychological discomfort. As a consequence, a greater knowledge of health-related quality of life and its causes can assist oncology nurses in developing effective treatments to improve the health-related quality of life. The palliative care model and the nursing intervention model are used in this study to assess the effectiveness of an individually customized nursing intervention for lowering chemotherapy-related symptom distress in adult patients with colorectal cancer. Initially, the dataset is collected and split into the control group and the experimental group. The patient conditions are evaluated using the novel accelerated gradient boosting regression tree (AGBRT) estimation model. For improving the evaluation process, we have proposed the enriched gravitational search optimization algorithm (EGSOA). The system’s success is evaluated in terms of the patients’ psychological well-being and quality of life.
HomeGuardian: Detecting Anomaly Events in Smart Home Systems
Authors: Dai Xuan , Mao Jian , Li Jiawei , Lin Qixiao , Liu Jianwei
Published: June 2022

As a typical application of Internet of Things (IoT), home automation systems, namely, smart homes, provide a more convenient and intelligent life experience through event recognition, automation control, and remote device access. However, smart home systems have also given rise to new complications for security issues. As an event-driven IoT system, smart home environments are vulnerable to security attacks, and vulnerable devices are far-spread due to the quick development cycles. Attack vectors to smart homes inevitably manifest in abnormal event contexts. In this paper, we propose HomeGuardian, a context-based approach to identify abnormal events in smart homes. In our approach, we extract temporal context and environmental context from system logs, aggregate (embed) these hybrid contexts, and construct a learning-based classifier to identify the abnormal events. We develop a testbed to implement and evaluate our approach.
A Secure Private Cloud Storage Platform for English Education Resources Based on IoT Technology
Authors: Li Wei , Guo Ying
Published: June 2022

The contemporary ubiquitous “cloud” network knowledge and information resources, as well as ecological pedagogy theory, have enlarged teaching research’s perspective, widened teaching research’s innovation area, and created practical options for English classroom reform. Cloud education relies on the Internet of Things, cloud computing, and big data to have a huge impact on the English learning process. The key to the integration of English education resources is the storage of huge amount of English teaching data. Applying the technology and methods of cloud storage to the construction of English education resource integration can effectively save the educational resources of schools, improve the utilization rate of English education resources, and thus enhance the teaching level of English subjects. In this work, we examine the existing state of English education resource building and teaching administration and offer a way for creating a “private cloud” of English education materials. We not only examined the architecture and three-layer modules of cloud computing in depth, but we also analyzed the “private cloud” technology and built the cloud structure of English teaching materials on this foundation. We hope that this paper can help and inspire us to solve the problems of uneven distribution, irregular management, and difficult sharing in the construction of English education resources.
Determination of Volatile Compounds of Mentha piperita and Lavandula multifida and Investigation of Their Antibacterial, Antioxidant, and Antidiabetic Properties
Authors: Hamad Al-Mijalli Samiah , ELsharkawy Eman R. , Abdallah Emad M. , Hamed Munerah , El Omari Nasreddine , Mahmud Shafi , Alshahrani Mohammed Merae , Mrabti Hanae Naceiri , Bouyahya Abdelhakim
Published: June 2022

Mentha piperita and Lavandula multifida are widely used in Moroccan traditional medicine for the treatment of diabetes and infectious diseases. The aims of this work were the determination of the chemical composition of Mentha piperita (MPEO) and Lavandula multifida (LMEO) essential oils and the evaluation of their antibacterial, antioxidant, and antidiabetic activities. The chemical composition was determined by GC-MS analysis. The antibacterial effects were evaluated against several bacterial strains using disc diffusion, MIC, and MBC methods. The antioxidant activity was evaluated in vitro using DPPH, H2O2, and xanthine oxidase, and the antidiabetic activity was estimated by the inhibitory effects of α-amylase, α-glucosidase, and lipase activities. GC-MS results showed that the main compounds of MPEO were menthone (29.24%), levomenthol (38.73%), and eucalyptol (6.75%). However, eucalyptol (28.11%), 2-bornanone (11.57%), endo-borneol (7.82%), and linalyl acetate (5.22%) are the major compounds of LMEO. The results exhibited important inhibitory effects against some bacterial strains with MIC = MBC = 0.39 mg/mL for MPEO against Staphylococcus aureus ATCC. However, LMEO exhibited remarkable antioxidant and antidiabetic activities compared to MPEO. Indeed, LMEO inhibited DPPH, H2O2, and xanthine oxidase with concentrations of 15.23, 21.52, and 8.89 µg/mL, respectively. Moreover, LMEO exhibited α-amylase and α-glucosidase at IC50 = 85.34 and IC50 = 59.36 µg/mL, respectively. The findings showed that both MPEO and LMEO exhibit promising biological properties. However, the application of these species or their main bioactive compounds requires further investigation.
Serum miR-204 and miR-451 Expression and Diagnostic Value in Patients with Pulmonary Artery Hypertension Triggered by Congenital Heart Disease
Authors: Ji Dejiang , Qiao Yan , Guan Xiaoping , Zhang Tao
Published: June 2022

Objective. To determine the level of expression and clinical importance of serum miR-204 and miR-451 in patients with pulmonary arterial hypertension caused by congenital heart disease (CHD-PAH). Methods. From July 2019 to January 2021, 114 infants with congenital heart disease (CHD) were hospitalized at Qingdao’s Fuwai Cardiovascular Hospital. They were grouped into categories: CHD (53 cases) and CHD-PAH (61 cases) based on whether they had pulmonary hypertension (PAH). In addition, 60 healthy children were selected as the control group. All children underwent routine biochemical examination, echocardiography, and pulmonary arterial pressure examination. By using an enzyme-linked immunosorbent assay (ELISA), the levels of brain natriuretic peptide (BNP) and asymmetric dimethylarginine (ADMA) in the blood were measured. Additionally, reverse transcription-polymerase chain reaction (RT-PCR) was used to determine the expression levels of miR-204 and miR-451 in peripheral blood. The correlation between miR-204, miR-451, BNP, ADMA, and mPAP was investigated using Pearson correlation analysis. Results. Consequently, the TC, BNP, and ADMA serum levels were considerably higher in the CHD and CHD-PAH groups than in the control group (

P
<
0.05

), whereas BNP and ADMA serum levels were significantly higher in the CHD-PAH group than in the CHD group (

P
<
0.05

). According to RT-PCR data, the expression levels of miR-204 and miR-451 in the peripheral blood of children in the CHD and CHD-PAH groups were significantly lower (

P
<
0.05

) when compared to the control group. The expression levels of miR-204 and miR-451 in the peripheral blood of children in the CHD-PAH group were substantially lower (

P
<
0.05

) than in the CHD group. Significantly, the findings of the ROC curve revealed that the area under the curve (AUC) of CHD-PAH diagnosed by miR-204 and miR-451 alone was 0.737 and 0.725, respectively, and the AUC of joint diagnosis was 0.840, which was greater than that of single diagnosis (

P
<
0.05

). Patients with CHD-PAH had lower levels of miR-204 and miR-451 in their blood, and this was found to be associated with BNP, ADMA, and mPAP, analyzed by Pearson correlation. Conclusions. Children with CHD-PAH can be diagnosed based on aberrant expressions of miR-204 and miR-451 in their peripheral blood serum. Moreover, CHD-PAH can be diagnosed if the combination of miR-204 and miR-451 is detected as a biomarker, which has a higher diagnostic value.
Renal Protective Mechanisms of Shenyuan Particle in Db/Db Mice: A Study Based on Network Pharmacology
Authors: Zhu Guoshuang , Wang Lan , Wu Zenan , Qiu Mingliang , Ke Shiwen , Liu Liangji , Wang Xiaoqin
Published: June 2022

Aim. The renal protective mechanisms of Shenyuan particle (SYP) in the treatment of diabetic kidney disease (DKD) were investigated, focusing on the main targets and pathways. Materials and Methods. In this study, the potential targets of compounds identified in SYP were predicted by Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP), and a “herb-compound-target” network was constructed via Cytoscape. Next, the Gene Ontology (GO) terms and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional enrichment analyses were dissected using R language. A protein-protein interaction network was fabricated using STRING to obtain the main target information. In addition, db/db mice were used as the DKD models to explore the renal protective effects of SYP. Transmission electron microscopy, western blot, pathological staining, TUNEL staining, and biochemical methods were used to identify the apoptotic pathways and establish the primary mechanism of SYP. Results. Network pharmacology analysis revealed 67 potential targets based on the analysis of different databases. The targets of SYP were primarily associated with apoptosis. The network hub genes included caspase 3, caspase 7, caspase 8, caspase 9, Bax, and Bcl-2. In vivo, SYP materially improved renal function and inhibited apoptosis in the db/db mouse kidneys by improving the mitochondrial health. In addition, our results showed that SYP significantly decreased the expression of Bax, caspase 3, and Cyto-c and increased the expression of Bcl-2. Conclusions. Network pharmacology analysis and experimental results suggest that SYP ameliorates DKD mediated via multiple components, targets, and pathways. Our study further demonstrates that SYP inhibits apoptosis in the kidneys of db/db mice by improving the mitochondrial health and thereby alleviating renal damage.
Massive Intestinal Bleeding in an Adult with IgA Vasculitis Treated with Intravenous Immunoglobulin
Authors: Nassereddin Ibrahim , Kenig Ariel , Ishay Yuval , Lehmann Hillel , Hurvitz Noa , Elkhateeb Narmine , Gelman Ram , Ratz Yael , Sarig Inon , Burstain Ido , Benshushan Stephanie , Kharouf Fadi
Published: June 2022

We report the case of a 29-year-old adult presenting with severe IgA vasculitis, with cutaneous, urologic, and renal manifestations. The late appearance of severe gastrointestinal bleeding dominated the clinical picture, necessitating the administration of tens of units of packed cells and the augmentation of the immunosuppressive protocol. It was not until therapy with intravenous immunoglobulin (IVIG) was introduced that the massive bleeding was controlled. We herein discuss the patient’s presentation, the gastrointestinal manifestations of IgA vasculitis, the recommended treatments, and the existent evidence about IVIG therapy.
Reference-Adjusted Loss in Life Expectancy for Population-Based Cancer Patient Survival Comparisons—with an Application to Colon Cancer in Sweden
Authors: Andersson Therese M.-L. , Rutherford Mark J. , Møller Bjørn , Lambert Paul C. , Myklebust Tor Åge
Published: June 2022

Background:

The loss in life expectancy, LLE, is defined as the difference in life expectancy between patients with cancer and that of the general population. It is a useful measure for summarizing the impact of a cancer diagnosis on an individual's life expectancy. However, it is less useful for making comparisons of cancer survival across groups or over time, because the LLE is influenced by both mortality due to cancer and other causes and the life expectancy in the general population.

Methods:

We present an approach for making LLE estimates comparable across groups and over time by using reference expected mortality rates with flexible parametric relative survival models. The approach is illustrated by estimating temporal trends in LLE of patients with colon cancer in Sweden.

Results:

The life expectancy of Swedish patients with colon cancer has improved, but the LLE has not decreased to the same extent because the life expectancy in the general population has also increased. When using a fixed population and other-cause mortality, that is, a reference-adjusted approach, the LLE decreases over time. For example, using 2010 mortality rates as the reference, the LLE for females diagnosed at age 65 decreased from 11.3 if diagnosed in 1976 to 7.2 if diagnosed in 2010, and from 3.9 to 1.9 years for women 85 years old at diagnosis.

Conclusions:

The reference-adjusted LLE is useful for making comparisons across calendar time, or groups, because differences in other-cause mortality are removed.

Impact:

The reference-adjusted approach enhances the use of LLE as a comparative measure.
Lack of Clinical Relevance of Bilastine-Food Interaction in Healthy Volunteers: A Wheal and Flare Study
Authors: Coimbra Jimena , Puntes Montserrat , Gich Ignasi , Martínez Joan , Molina Pol , Antonijoan Rosa , Campo Cristina , Labeaga Luis
Published: June 2022

Introduction: The aim of this study was to compare the pharmacodynamic activity of bilastine administered under fasting and fed conditions in healthy volunteers. Methods: In this randomized, open-label, two-period, crossover study involving 24 healthy subjects, once-daily oral bilastine 20 mg was administered for 4 days under fasting and fed conditions, with a 7-day washout period. Bilastine plasma concentrations were measured for 24 h after the first and fourth doses in each period. Pharmacodynamic activity was assessed by wheal and flare surface inhibition and subjective assessment of itching, after intradermal injection of histamine 5 μg. Results: When administered under fed versus fasting conditions, exposure to bilastine 20 mg decreased (mean maximum plasma concentration and area under the curve from time 0 to 24 h decreased by 34.27% and 32.72% [day 1], respectively, and 33.08% and 28.87% [day 4]). Despite this, the antihistaminic effect of bilastine 20 mg was not altered by food. On day 1, as assessed by wheal and flare surface inhibition, the maximum effect and duration of action of bilastine did not differ to a significant extent between fasting and fed conditions, with only a short 30-min delay in the onset of wheal inhibition. At steady state (day 4), bilastine’s pharmacodynamic effects were not significantly affected under fasting or fed conditions. Conclusion: The pharmacokinetic interaction of bilastine with food does not imply a significant reduction of its peripheral antihistaminic efficacy. Despite a slight delay in onset of action on the first treatment day, the global clinical efficacy of bilastine is not affected by coadministration with food.
COL7A1 Homozygous Arg2471Ter Mutation Leads to the Severe Phenotype of Autosomal Recessive Dystrophic Epidermolysis Bullosa in the Fetus
Authors: Zhao Xuliang , Sun Weiwei , Cui Zhihui , Yu Min , Wang Qi , Wang Pengcheng , Tian Ruixia
Published: June 2022

Introduction: Autosomal recessive dystrophic epidermolysis bullosa (RDEB) is a rare disease with an early onset and severe phenotype. The pathogenic mechanism associated with mutations in the gene COL7A1 has been widely studied and many related cases have been reported, but prenatal cases are rare. Here, we report the prenatal diagnosis of a sporadic case of RDEB. Methods: In this study, the fetus with abnormal skin manifestations, which were determined during a prenatal ultrasound, was evaluated based on the ultrasound and autopsy findings and the results of molecular diagnostic analyses. Samples of the fetus and the parents were subjected to trio whole-exome sequencing, and in vitro functional analyses were conducted to analyze the pathogenicity of the detected mutation. Results: During the conventional prenatal ultrasound, the fetus showed abnormal epidermal lines on both lower limbs and the plantar skin as well as an interruption of the continuity of the lateral epidermal line below the ankle of the right lower limb. Gene testing revealed a homozygous nonsense mutation in COL7A1 (c.7411C>T, p.Arg2471Ter), which gave rise to RDEB in the fetus. Further, the results of the in vitro functional experiments confirmed that the mutation might lead to protein degradation. Conclusion: Most prenatal diagnoses of RDEB are the result of targeted molecular analyses carried out based on family history, and prenatal ultrasound reports of severe RDEB phenotypes are extremely rare. Our case suggests that the observation of abnormal epidermal lines should be given due consideration during prenatal diagnosis, as they may be a sign of possible epidermolysis bullosa.
Clinical Characteristics and Treatment Outcome of Central Nervous System Nocardiosis: A Systematic Review of Reported Cases
Authors: Meena Durga Shankar , Kumar Deepak , Bohra Gopal Krishana , Midha Naresh , Garg Mahendra Kumar
Published: June 2022

Background: The clinical spectrum of systemic nocardiosis encompasses pulmonary and disseminated disease. Central nervous system (CNS) involvement is an important feature of disseminated disease with significant mortality and high relapse rate, especially in those with suppressed cell-mediated immunity. This systematic review aimed to evaluate the epidemiology, clinical features, diagnosis, therapeutic interventions, and outcome in patients with CNS nocardiosis. Methods: A literature search was performed in major databases (PubMed, Google Scholar, and Scopus) by using distinct keywords: “CNS disease,” “Nocardia,” “meningitis,” “brain abscess,” “disseminated disease,” and “Cotrimoxazole.” We included all patients ≥18 years with CNS nocardiosis reported between January 2000 and December 2020. Results: A total of 129 papers were included in the final analysis. The mean age of patients was 55 ± 16 years, and the majority were male (70.8%). Nocardia farcinica was the commonest species (39.6%), followed by Nocardia nova (5.9%). Thirty-four percent of the patients were found to be immunocompetent. Corticosteroid use was the most common predisposing factor (55.8%). Among neuroimaging findings, brain abscess was most common (86.9%), followed by leptomeningeal enhancement (12.1%). The overall case-fatality rate in CNS disease was 22.8%. On multivariate analysis, patients who underwent surgery (OR 2.4, 95% CI 0.99–4.11, p value 0.046) had better survival than those treated with antimicrobial therapy alone. Immunodeficient state (OR 0.32, 95% CI 0.15–0.90, p value 0.019) was independently associated with poor outcome. Conclusion: CNS nocardiosis carries significant mortality, especially in immunodeficient patients. We advocate the use of surgery combined with antimicrobials to improve clinical outcome.
Evaluation of a Population‐Wide Mobile Health Physical Activity Program in 696 907 Adults in Singapore
Authors: Yao Jiali , Lim Nicole , Tan Jeremy , Matthias Müller Andre , Martinus van Dam Rob , Chen Cynthia , Tan Chuen Seng , Müller‐Riemenschneider Falk
Published: June 2022

Background

Evidence of scaled‐up physical activity interventions is scarce. This study evaluates the uptake, engagement, and effectiveness of one such intervention program.

Methods and Results

The program was open to individuals aged ≥17 years in Singapore. The main intervention components comprised device‐based daily physical activity recording paired with step count goals and financial rewards. According to the different reward opportunities, we divided the evaluation period (August 2017 to June 2018) into the baseline monitoring phase, the main challenge phase, and the maintenance phase. Uptake was assessed by the number of individuals registered, and engagement by the step recording duration after registration. The effectiveness was defined as changes in mean daily step count from baseline to the main challenge phase and the maintenance phase. A total of 696 907 participants registered, including more Singapore citizens (versus noncitizens), women, and younger (aged 17–39 years) individuals. The evaluation of engagement and effectiveness included 421 388 (60.5%) participants who provided plausible characteristic information and step count data. The median duration of engagement was 74 (IQR, 14–149) days. Compared with the baseline of 7509 (SD, 3467) steps, mean daily step count increased by 1579 (95% CI, 1564–1594) steps during the main challenge phase and 934 (95% CI, 916–952) steps during the maintenance phase. Greater engagement and activity increase were found in participants who are citizens, women, aged ≥40 years, non‐obese, and using separate wearables (versus smartphones).

Conclusions

Mobile health physical activity interventions can successfully reach a large population and be effective in increasing physical activity, despite declining program engagement over time.
Relative Contribution of Blood Pressure in Childhood, Young‐ and Mid‐Adulthood to Large Artery Stiffness in Mid‐Adulthood
Authors: Meng Yaxing , Buscot Marie‐Jeanne , Juonala Markus , Wu Feitong , Armstrong Matthew K. , Fraser Brooklyn J. , Pahkala Katja , Hutri‐Kähönen Nina , Kähönen Mika , Laitinen Tomi , Viikari Jorma S. A. , Raitakari Olli T. , Magnussen Costan G. , Sharman James E.
Published: June 2022

Background

Blood pressure associates with arterial stiffness, but the contribution of blood pressure at different life stages is unclear. We examined the relative contribution of childhood, young‐ and mid‐adulthood blood pressure to mid‐adulthood large artery stiffness.

Methods and Results

The sample comprised 1869 participants from the Cardiovascular Risk in Young Finns Study who had blood pressure measured in childhood (6–18 years), young‐adulthood (21–30 years), and mid‐adulthood (33–45 years). Markers of large artery stiffness were pulse wave velocity and carotid distensibility recorded in mid‐adulthood. Bayesian relevant life course exposure models were used. For each 10‐mm Hg higher cumulative systolic blood pressure across the life stages, pulse wave velocity was 0.56 m/s higher (95% credible interval: 0.49 to 0.63) and carotid distensibility was 0.13%/10 mm Hg lower (95% credible interval: −0.16 to −0.10). Of these total contributions, the highest contribution was attributed to mid‐adulthood systolic blood pressure (relative weights: pulse wave velocity, childhood: 2.6%, young‐adulthood: 5.4%, mid‐adulthood: 92.0%; carotid distensibility, childhood: 5.6%; young‐adulthood: 10.1%; mid‐adulthood: 84.3%), with the greatest individual contribution coming from systolic blood pressure at the time point when pulse wave velocity and carotid distensibility were measured. The results were consistent for diastolic blood pressure, mean arterial pressure, and pulse pressure.

Conclusions

Although mid‐adulthood blood pressure contributed most to mid‐adulthood large artery stiffness, we observed small contributions from childhood and young‐adulthood blood pressure. These findings suggest that the burden posed by arterial stiffness might be reduced by maintaining normal blood pressure levels at each life stage, with mid‐adulthood a critical period for controlling blood pressure.
Active RhoA Exerts an Inhibitory Effect on the Homeostasis and Angiogenic Capacity of Human Endothelial Cells
Authors: Hauke Michael , Eckenstaler Robert , Ripperger Anne , Ender Anna , Braun Heike , Benndorf Ralf A.
Published: June 2022

Background

The small GTPase RhoA (Ras homolog gene family, member A) regulates a variety of cellular processes, including cell motility, proliferation, survival, and permeability. In addition, there are reports indicating that RhoA‐ROCK (rho associated coiled‐coil containing protein kinase) activation is essential for VEGF (vascular endothelial growth factor)‐mediated angiogenesis, whereas other work suggests VEGF‐antagonistic effects of the RhoA‐ROCK axis.

Methods and Results

To elucidate this issue, we examined human umbilical vein endothelial cells and human coronary artery endothelial cells after stable overexpression (lentiviral transduction) of constitutively active (G14V/Q63L), dominant‐negative (T19N), or wild‐type RhoA using a series of in vitro angiogenesis assays (proliferation, migration, tube formation, angiogenic sprouting, endothelial cell viability) and a human umbilical vein endothelial cells xenograft assay in immune‐incompetent NOD
scid
gamma mice in vivo. Here, we report that expression of active and wild‐type RhoA but not dominant‐negative RhoA significantly inhibited endothelial cell proliferation, migration, tube formation, and angiogenic sprouting in vitro. Moreover, active RhoA increased endothelial cell death in vitro and decreased human umbilical vein endothelial cell‐related angiogenesis in vivo. Inhibition of RhoA by C3 transferase antagonized the inhibitory effects of RhoA and strongly enhanced VEGF‐induced angiogenic sprouting in control‐treated cells. In contrast, inhibition of RhoA effectors ROCK1/2 and LIMK1/2 (LIM domain kinase 1/2) did not significantly affect RhoA‐related effects, but increased angiogenic sprouting and migration of control‐treated cells. In agreement with these data, VEGF did not activate RhoA in human umbilical vein endothelial cells as measured by a Förster resonance energy transfer–based biosensor. Furthermore, global transcriptome and subsequent bioinformatic gene ontology enrichment analyses revealed that constitutively active RhoA induced a differentially expressed gene pattern that was enriched for gene ontology biological process terms associated with mitotic nuclear division, cell proliferation, cell motility, and cell adhesion, which included a significant decrease in VEGFR‐2 (vascular endothelial growth factor receptor 2) and NOS3 (nitric oxide synthase 3) expression.

Conclusions

Our data demonstrate that increased RhoA activity has the potential to trigger endothelial dysfunction and antiangiogenic effects independently of its well‐characterized downstream effectors ROCK and LIMK.
Integrating a Polygenic Risk Score for Coronary Artery Disease as a Risk‐Enhancing Factor in the Pooled Cohort Equation: A Cost‐Effectiveness Analysis Study
Authors: Mujwara Deo , Henno Geoffrey , Vernon Stephen T. , Peng Siyang , Di Domenico Paolo , Schroeder Brock , Busby George B. , Figtree Gemma A , Bottà Giordano
Published: June 2022

Background

Cardiovascular diseases are the leading cause of death in the United States, yet a significant proportion of adults at high risk remain undetected by standard screening practices. Polygenic risk score for coronary artery disease (CAD‐PRS) improves precision in determining the 10‐year risk of atherosclerotic cardiovascular disease but health benefits and health care costs associated with CAD‐PRS are unknown. We examined the cost‐effectiveness of including CAD‐PRS as a risk‐enhancing factor in the pooled cohort equation (PCE)—the standard of care for determining the risk of atherosclerotic cardiovascular disease—versus PCE alone.

Methods and Results

We applied a Markov model on a cohort of 40‐year‐old individuals with borderline or intermediate 10‐year risk (5% to <20%) for atherosclerotic cardiovascular disease to identify those in the top quintile of the CAD‐PRS distribution who are at high risk and eligible for statin prevention therapy. Health outcomes examined included coronary artery disease (CAD; ie, myocardial infarction) and ischemic stroke. The model projected medical costs (2019 US$) of screening for CAD, statin prevention therapy, treatment, and monitoring patients living with CAD or ischemic stroke and quality‐adjusted life‐years for PCE+CAD‐PRS versus PCE alone. Deterministic and probabilistic sensitivity analyses and scenario analyses were performed to examine uncertainty in parameter inputs. PCE+CAD‐PRS was dominant compared with PCE alone in the 5‐ and 10‐year time horizons. We found that, respectively, PCE+CAD‐PRS had 0.003 and 0.011 higher mean quality‐adjusted life‐years and $40 and $181 lower mean costs per person screened, with 29 and 50 fewer events of CAD and ischemic stroke in a cohort of 10 000 individuals compared with PCE alone. The risk of developing CAD, the effectiveness of statin prevention therapy, and the cost of treating CAD had the largest impact on the cost per quality‐adjusted life‐year gained. However, this cost remained below the $50 000 willingness‐to‐pay threshold except when the annual risk of developing CAD was <0.006 in the 5‐year time horizon. Results from Monte Carlo simulation indicated that PCE+CAD‐PRS would be cost‐effective. with the probability of 94% and 99% at $50 000 willingness‐to‐pay threshold in the 5‐ and 10‐year time horizon, respectively.

Conclusions

Implementing CAD‐PRS as a risk‐enhancing factor in the PCE to determine the risk of atherosclerotic cardiovascular disease reduced the mean cost per individual, improved quality‐adjusted life‐years, and averted future events of CAD and ischemic stroke when compared with PCE alone.
Interaction Between Race, Ethnicity, Severe Mental Illness, and Cardiovascular Disease
Authors: O'Gallagher Kevin , Teo James TH. , Shah Ajay M. , Gaughran Fiona
Published: June 2022

Severe mental illnesses, such as schizophrenia or bipolar disorder, affect ≈1% of the population who, as a group, experience significant disadvantage in terms of physical health and reduced life expectancy. In this review, we explore the interaction between race, ethnicity, severe mental illness, and cardiovascular disease, with a focus on cardiovascular care pathways. Finally, we discuss strategies to investigate and address disparities in cardiovascular care for patients with severe mental illness.
Association of Race and Ethnicity on the Management of Acute Non−ST‐Segment Elevation Myocardial Infarction
Authors: Tertulien Tarryn , Broughton Stephen T. , Swabe Gretchen , Essien Utibe R. , Magnani Jared W.
Published: June 2022

Background

Prior studies have reported disparities by race in the management of acute myocardial infarction (MI), with many studies having limited covariates or now dated. We examined racial and ethnic differences in the management of MI, specifically non–ST‐segment‐elevation MI (NSTEMI), in a large, socially diverse cohort of insured patients. We hypothesized that the racial and ethnic disparities in the receipt of coronary angiography or percutaneous coronary intervention would persist in contemporary data.

Methods and Results

We identified individuals presenting with incident, type I NSTEMI from 2017 to 2019 captured by a health claims database. Race and ethnicity were categorized by the database as Asian, Black, Hispanic, or White. Covariates included demographics (age, sex, race, and ethnicity); Elixhauser variables, including cardiovascular risk factors and other comorbid conditions; and social factors of estimated annual household income and educational attainment. We examined rates of coronary angiography and percutaneous coronary intervention by race and ethnicity and income categories and in multivariable‐adjusted models. We identified 87 094 individuals (age 73.8±11.6 years; 55.6% male; 2.6% Asian, 13.4% Black, 11.2% Hispanic, 72.7% White) with incident NSTEMI events from 2017 to 2019. Individuals of Black race were less likely to undergo coronary angiography (odds ratio [OR], 0.93; [95% CI, 0.89–0.98]) and percutaneous coronary intervention (OR, 0.86; [95% CI, 0.81–0.90]) than those of White race. Hispanic individuals were less likely (OR, 0.88; [95% CI, 0.84–0.93]) to undergo coronary angiography and percutaneous coronary intervention (OR, 0.85; [95% CI, 0.81–0.89]) than those of White race. Higher annual household income attenuated differences in the receipt of coronary angiography across all racial and ethnic groups.

Conclusions

We identified significant racial and ethnic differences in the management of individuals presenting with NSTEMI that were marginally attenuated by higher household income. Our findings suggest continued evidence of health inequities in contemporary NSTEMI treatment.
Prognostic Value of Exercise Capacity in Kidney Transplant Candidates
Authors: Tan Sean , Thang Yi Wen , Mulley William R. , Polkinghorne Kevan R. , Ramkumar Satish , Cheng Kevin , Chan Jasmine , Galligan John , Nolan Mark , Brown Adam J. , Moir Stuart , Cameron James D. , Nicholls Stephen J. , Mottram Philip M. , Nerlekar Nitesh
Published: June 2022

Background

Exercise stress testing for cardiovascular assessment in kidney transplant candidates has been shown to be a feasible alternative to pharmacologic methods. Exercise stress testing allows the additional assessment of exercise capacity, which may have prognostic value for long‐term cardiovascular outcomes in pre‐transplant recipients. This study aimed to evaluate the prognostic value of exercise capacity on long‐term cardiovascular outcomes in kidney transplant candidates.

Methods and Results

We retrospectively evaluated exercise capacity in 898 consecutive kidney transplant candidates between 2013 and 2020 who underwent symptom‐limited exercise stress echocardiography for pre‐transplant cardiovascular assessment. Exercise capacity was measured by age‐ and sex‐predicted metabolic equivalents (METs). The primary outcome was incident major adverse cardiovascular events, defined as cardiac death, non‐fatal myocardial infarction, and stroke. Cox proportional hazard multivariable modeling was performed to define major adverse cardiovascular events predictors with transplantation treated as a time‐varying covariate. A total of 429 patients (48%) achieved predicted METs. During follow‐up, 93 (10%) developed major adverse cardiovascular events and 525 (58%) underwent transplantation. Achievement of predicted METs was independently associated with reduced major adverse cardiovascular events (hazard ratio [HR] 0.49; [95% CI 0.29–0.82],
P
=0.007), as was transplantation (HR, 0.52; [95% CI 0.30–0.91],
P
=0.02). Patients achieving predicted METs on pre‐transplant exercise stress echocardiography had favorable outcomes that were independent (HR, 0.78; [95% CI 0.32–1.92],
P
=0.59) and of similar magnitude to subsequent transplantation (HR, 0.97; [95% CI 0.42–2.25],
P
=0.95).

Conclusions

Achievement of predicted METs on pre‐transplant exercise stress echocardiography confers excellent prognosis independent of and of similar magnitude to subsequent kidney transplantation. Future studies should assess the benefit on exercise training in this population.
Integrating moving average control procedures into the risk-based quality control plan in small-volume medical laboratories
Authors: Lukić Vera , Ignjatović Svetlana
Published: June 2022

The modern approach to quality control (QC) in medical laboratories implies the development of a risk-based control plan. This paper aims to develop a risk-based QC plan for a laboratory with a small daily testing volume and to integrate the already optimized moving average (MA) control procedures into this plan.
A multistage bracketed QC plan for ten clinical chemistry analytes was made using a Westgard QC frequency calculator. Previously, MA procedures were optimized by the bias detection simulation method.
Aspartate aminotransferase, HDL-cholesterol and potassium had patient-risk sigma metrics greater than 6, albumin and cholesterol greater than 5, creatinine, chlorides, calcium and total proteins between 4 and 5, and sodium less than 4. Based on the calculated run sizes and characteristics of optimized MA procedures, for 6 tests, it was possible to replace the monitoring QC procedure with an MA procedure. For the remaining 4 tests, it was necessary to keep the monitoring QC procedure and introduce MA control for added security.
This study showed that even in a laboratory with a small volume of daily testing, it is possible to make a risk-based QC plan and integrate MA control procedures into that plan.
Heartbreak Liberalism, or the Case for Militant Translation
Authors:   Sr/The Lausan Collective
Published: June 2022

In a social movement beset by internal divisions even as it confronts an ever-escalating crackdown, the meaning of “militancy” in Hong Kong has taken on conflicting if not antagonistic dimensions in the years since the protests of 2019. These “field notes” attempt to chart a course through the ins and outs of organizing on the ground and from a distance through the work of the Lausan Collective, tracking its epoch-making aesthetics and practices of militancy. As a prioritized ethic and moral-political compass that has aligned seamlessly with not only the mainstream liberal currents of the 2019 uprising but also with a storied postcolonial tradition of bourgeois Han centrism in Hong Kong identity formation, the legacy of militancy remains inextricably tied to valorized masculinist and techno-orientalist imaginaries of dissent, as well as a readiness to invoke sympathetic affect, or “heartbreak,” to sanction modes of injury and sacrifice and to allocate activist merit. Instead, Lausan Collective puts forward translation as a militant practice—a reciprocal and persistent mode of survival and solidarity that endures beyond and despite a visuality of valiance and the dominant affective orders of “heartbreak liberalism.”
Credentialing Scientific Claims
Authors: Suppe Frederick
Published: June 2022

This article seeks rapprochement between the sociology of knowledge and philosophy of science by attempting to capture the best social constructionist insights within a strongly realistic philosophy of science. Key to doing so are (1) separating the grounds for the individual scientist coming to know that P from those grounds for socially credentialing the claim that P within the relevant scientific subcommunity and (2) showing how truth considerations can enter into the analysis of knowledge without interfering with social constructionist treatments of credentialing claims. A detailed epistemology and associated account of the social credentialing of knowledge claims are presented. Close attention is paid to the epistemological and social aspects of (a) the nature and role of observation reports, (b) the interpretation of data, (c) simplifications, idealizations, and approximations, and (d) the nature of replication. The article contains a National Aeronautics and Space Administration (NASA) remote-sensing case study and a detailed analysis of replication in the 1881–1933 Michelson-Morley-Miller interferometer ether studies.
A Humanistic Science: Charles Judson Herrick and the Struggle for
Psychobiology at the University of Chicago
Authors: Kingsland Sharon E.
Published: June 2022

This article examines the study of mind and behavior at the University of Chicago through the career of Charles Judson Herrick (1869–1960), neuroanatomist and psychobiologist. Herrick’s views on human nature, education, and social control are discussed in the context of the progressive evolutionism pervading the university in the early twentieth century. The religious background of Herrick’s work is important to understanding the service ethos that permeated his science, which was also the basis of his interest in pragmatism and of his opposition to certain tenets of behaviorism. Herrick was dedicated to interdisciplinary collaboration, which he thought crucial to the development of psychobiology. His relationship with Karl S. Lashley in the 1920s is analyzed. Their disagreements about the relationship between science and humanism, as revealed in their views on behaviorism, did not prevent them from working together to articulate a holistic theory of brain function and learning.
Expressions of Tense and Aspect in the Tunisian Varieties of Arabic: A Comparative Study of Jewish and Muslim Dialects
Authors: Gębski Wiktor
Published: June 2022

The aspectual and temporal value of the verb is one of the most discussed problems in Semitic linguistics. Nonetheless, in the field of North African Arabic dialectology this subject has not received its due attention, and compared to other Arabic dialects, it remains terra incognita. The present article explores strategies by which spoken varieties of Tunisian Arabic express tense and aspect. The core data examined in this study comes from an endangered dialect spoken by the Jews of Gabes (southern Tunisia). Comparative material includes an array of examples from both Jewish and Muslim varieties. I reconstruct the origin of the preverbal particles and auxiliaries in Tunisian Arabic, and argue that, in contradistinction to Moroccan Arabic, the ka- particle in Jewish Gabes does not originate in kān. I present evidence that the active participle in Jewish and Muslim varieties has divergent functional distribution, which suggests a Northwest Semitic substrate in Judeo-Arabic.
First record of Vespa crabro Linnaeus (Hymenoptera: Vespidae) in western North America with a review of recorded species of Vespa Linnaeus in Canada
Authors: BASS AMBER , NEEDHAM KAREN , BENNETT ANDREW M.R.
Published: June 2022

Vespa crabro Linnaeus is newly reported as an adventive species in British Columbia, Canada which is the first record of this invasive species in western North America. The specimen of V. crabro was identified using morphological diagnostic keys and by comparison to authoritatively identified specimens. DNA barcoding provided support that the British Columbia specimen is conspecific with sequenced specimens of V. crabro. It is not possible to be certain of the origin of the specimen, but the DNA barcode was identical to sequence from specimens of V. crabro from South Korea. DNA barcoding was also performed on morphologically identified specimens of Vespa simillima and Vespa soror collected previously in British Columbia and the sequences were closest to V. simillima and V. soror Genbank sequences, respectively. There is no evidence that any of these species have established populations in the province. We provide diagnostic morphological characters to distinguish Canadian Vespa species from each other including Vespa mandarinia which has recently established populations in British Columbia and Washington State, USA. The potential detrimental impacts of each species are discussed.
The Cross-Cultural Practicum Training Experiences of Asian International Counseling Students
Authors: Lee Hang-Shim , Knutson Douglas , Koch Julie M. , Brown Colton , Keyes Candice
Published: June 2022

Despite the call to internationalize counseling psychology and calls for improved mentoring to Asian international students enrolled in counseling psychology training programs, there is a dearth of literature to help trainers understand this population’s clinical training experiences. The present study explored the practicum experiences of Asian international students ( N = 10) in counseling psychology programs using the consensual qualitative research method. Data analysis yielded five domains: Learning Outcomes, Challenges, Resources, Behavioral Strategies, and Suggestions. Participants described how they navigated their cross-cultural practicum training in the face of unique challenges and how they adapted, as well as relied on support systems. As our participants reflected on their cross-cultural clinical training experiences, they shared the lessons they learned and provided suggestions for current and future international students, supervisors, and programs. Scholarly and practical implications for this population are discussed.
Book review: Bihong Huang and Eden Yu (Eds), Ways to Achieve Green Asia 2020
Authors: Majumdar Devleena
Published: June 2022

Bihong Huang and Eden Yu (Eds), Ways to Achieve Green Asia 2020, Asian Development Bank Institute. 344 pp., ISBN: 978-4-89974-211-1 (Print), ISBN: 978-4-89974-212-8 (PDF).
Test-Retest Reliability of Self-Reported Substance Use and Sexual Risk Behavior Among at-Risk Adolescents
Authors: Charles Nora E. , Strong Stephanie J. , Floyd Paula N. , Burns Lauren C. , Sigurdson Lydia , Barry Christopher T.
Published: June 2022

Adolescents often engage in behaviors such as substance use and risky sexual activity that can lead to negative health and psychological consequences for themselves and others. Accurate measurement of these behaviors in surveys is challenging given that the behaviors are often viewed as undesirable and/or are illegal, so it is important to test the psychometric properties of instruments used to assess adolescent risk behaviors. The current study aimed to assess the test-retest reliability of a widely used measure of youth risk-taking behavior, the Youth Risk Behavior Survey (YRBS). A sample of 156 at-risk adolescents aged 16–18 years (81% male; 61% White) completed the YRBS retrospectively across intervals ranging from 3 to 12 days during their stay in a residential program at which they were under close supervision and had limited ability to engage in new risk behaviors. Participants were asked to complete the YRBS based on their “typical” (pre-program) behavior at both administrations, which were 10–14 weeks into their stay. The reliability of responses was assessed using kappa and weighted kappa analyses. Findings indicate moderate to substantial reliability for nearly all items, suggesting that at-risk youth reliably reported their engagement in health risk behaviors across multiple administrations and supporting the psychometric strength of the YRBS measure for use with this population.
Centralized COVID-19 Contact Tracing in a Home-Rule State
Authors: Macomber Kathryn , Hill Ashley , Coyle Joseph , Davidson Peter , Kuo Jeremy , Lyon-Callo Sarah
Published: June 2022

Contact tracing is an evidence-based intervention to control many communicable diseases, including COVID-19. Before the COVID-19 pandemic, contact tracing in Michigan focused on HIV, sexually transmitted infections, and tuberculosis, and it was conducted by state and local health department staff. Within 2 weeks of the first reported COVID-19 cases in Michigan in March 2020, the existing public health workforce was overwhelmed by the need for contact tracing and daily symptom monitoring. This case study narrates the development of a staffing plan that included volunteers and contractual staff to conduct centralized contact tracing in a home-rule state (ie, a state in which local health departments have full authority and autonomy under public health code to conduct the functions necessary to prevent disease, including contact tracing). This case study details various training, workforce management, and technology tools that were used. During the study period (May 2020–June 2021), contact tracers called 432 218 contacts and 269 439 were successfully reached, 48 134 of whom reported developing symptoms. The most important lesson learned was the need for more automated processes to improve efficiency in processing volunteer applicants, training, and scheduling. Nonetheless, the centralized workforce was successful, was flexible, and met the changing demands in Michigan.