bluuebunny/crossref_metadata_2025 huggingface dataset:
Abstract IA045: Bio-behavioral approaches to reducing racial disparities in obesity and GI cancers
Authors: Carson Tiffany L.
Published: January 2023

Obesity is associated with increased risk for all major gastrointestinal cancers. These chronic conditions are hypothesized to be linked via inflammation and/or hormones. Racial disparities persist for obesity with nearly 50% of non-Hispanic Black adults and 45.6% of Hispanic adults having obesity compared to 41.4% of non-Hispanic White adults. Similarly, Black and Hispanic individuals are at increased risk of developing and/or dying from some GI cancers compared to White individuals. Interventions targeting diet and physical activity offer one approach to reducing obesity and risk for developing GI cancers by reducing adiposity and via physiologic processes (e.g. modification of the gut microbiota) to promote a less carcinogenic environment in the GI tract. For example, dietary modifications can lead to weight loss and also modify the gut microbiota to lower risk for colorectal cancer. Previous research from our team has also identified racial differences in the gut microbiota suggesting that the gut microbiota is a viable target for intervention to reduce racial disparities in obesity and GI cancers. Strategies to reduce disparities in obesity and cancer using bio-behavioral approaches that focus on diet and the gut microbiota will be discussed.

Citation Format: Tiffany L. Carson. Bio-behavioral approaches to reducing racial disparities in obesity and GI cancers [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr IA045.
TBX3 Promotes Cervical Cancer Proliferation and Migration via HPV E6 and E7 Signaling
Authors: Khan Saif F. , Burmeister Carly A. , Scott David J. , Sinkala Musalula , Ramburan Amsha , Wu Hue-Tsi , Schäfer Georgia , Katz Arieh A. , Prince Sharon
Published: January 2023

Cervical cancer is a leading cause of cancer-related deaths in women globally and 99% of cases are caused by persistent infection with high-risk strains of the human papillomavirus (HPV). The HPV oncoproteins E6 and E7 establish the cancer phenotype by cooperating with host proteins and identifying them may have important therapeutic benefits. T-box transcription factor 3 (TBX3) is a critical developmental regulator, and when it is overexpressed postnatally, it contributes to several cancers, but little is known about its expression and role in cervical cancer. The current study shows that TBX3 is upregulated in cervical cancer cell lines as well as precancerous and cervical cancer patient tissue and is associated with larger and more invasive tumors. Knockdown and overexpression cell culture models show that TBX3 promotes HPV-positive cell proliferation, migration, and spheroid growth; however, TBX3 inhibits these processes in HPV-negative cells. Importantly, we show that the tumor promoting activity of TBX3 in cervical cancer is dependent on E6/E7.

Implications:

In summary, our study highlights the importance of TBX3 as a cooperating partner of E6/E7 in HPV-positive cervical cancer and identifies TBX3 as a potential therapeutic target to treat this neoplasm.
Real-World Experience of Metronomic Chemotherapy in Metastatic Breast Cancer: Results of a Retrospective Unicenter Study
Authors: Krajnak Slavomir , Krajnakova Jana , Anic Katharina , Almstedt Katrin , Heimes Anne-Sophie , Linz Valerie Catherine , Loewe Amelie , Schmidt Mona Wanda , Hasenburg Annette , Schmidt Marcus , Battista Marco Johannes
Published: January 2023

Introduction: Metronomic chemotherapy (MCT) is increasingly used in oncology due to its favorable therapeutic index. There is still a lack of evidence for MCT in metastatic breast cancer (MBC). In this retrospective unicenter study, we demonstrated real-word data on MCT in MBC. Methods: MBC patients who received metronomic oral cyclophosphamide (CTX) (50 mg daily) and methotrexate (MTX) (2.5 mg every other day), CTX and capecitabine (CAPE) (500 mg thrice daily), CTX, or vinorelbine (VRL) (30 mg daily) alone for at least 4 weeks between 2009 and 2021 were included. The primary endpoint was disease control rate (DCR) ≥24 weeks. Secondary endpoints were progression-free survival (PFS) and overall survival (OS). Patient characteristics and therapy response were analyzed using χ2 test. For survival analyses, Kaplan-Meier estimator and log-rank test were used. Results: Seventy-two patients were identified. Sixty-two patients received CTX/MTX, three CTX/CAPE, two CTX, and five VRL. Median age at diagnosis MBC and at start of MCT was 59.0 years and 64.5 years, respectively. 72.2% tumors were hormone receptor positive and 27.8% were triple-negative. 54.2% patients had more than two different metastases. 80.6% patients showed visceral involvement. 31.9% patients achieved DCR ≥24 weeks. Median PFS was 17.0 weeks (95% CI 14.5–19.5) and median OS was 58.0 weeks (95% CI 29.0–87.0). MCT showed similar DCR ≥24 weeks and clinically meaningful but not statistically significant shorter median PFS compared to prior therapy (31.9% versus 32.8% [p = 0.570] and 17.0 weeks versus 20.0 weeks [p = 0.093], respectively) and statistically significant higher DCR ≥24 weeks and longer median PFS compared to subsequent therapy (31.9% versus 17.4% [p = 0.038] and 17.0 weeks versus 12.0 weeks [p = 0.006], respectively). Three (4.2%) patients terminated MCT because of toxicity. Conclusion: In this real-world retrospective study, MCT was effective and well tolerated and may thus represent a valuable treatment option in selected MBC patients.
Long-Term Experience with Anaphylaxis and Desensitization to Alglucosidase Alfa in Pompe Disease
Authors: Ertoy Karagol Hacer Ilbilge , Inci Asli , Terece Sinem Polat , Kilic Ayse , Demir Fevzi , Yapar Dilek , Koken Gizem , Okur Ilyas , Ezgu Fatih Suheyl , Tumer Leyla , Bakirtas Arzu ,   The Gazi University Enzyme Replacement Therapy Hypersensitivity Study Group
Published: January 2023

Background and Objective: Pompe disease (PD) is an inherited lysosomal storage disease that progresses with glycogen accumulation in many tissues, due to the deficiency of the acid-alpha glucosidase enzyme. Recombinant alglucosidase alfa (rhGAA) is the only disease-specific treatment option, in the form of enzyme replacement therapy (ERT). Anaphylaxis can develop with rhGAA. There is no study evaluating anaphylaxis and its management in PD in the long term. We aimed to evaluate the development of anaphylaxis and rapid drug desensitization (RDD) with rhGAA in children with PD. Materials and Methods: All children diagnosed and followed up in our institution with PD over 12 years between January 2009 and September 2021 were evaluated for development of anaphylaxis and RDD with rhGAA from medical records. Results: Fourteen patients, 64% of whom were female and diagnosed with PD (1 juvenile, 13 infantile types) during the study period included in the study. The median age at diagnosis was 3.2 months (1–40 months). The median follow-up time of the patients was 20 months (1–129 months). Thirteen patients were given rhGAA, one died before ERT. Four (30.8%) patients developed moderate to severe anaphylaxis, and RDD was applied with rhGAA. A total of 390 RDDs have been performed so far without any serious breakthrough reactions during all RDDs. Conclusions: Anaphylaxis with rhGAA is not rare and RDD with rhGAA is safe and effective in the long term.
Praktische Tipps zu Bronchiektasen in der Primärversorgung
Authors: Martinez-Garcia Miguel Angel , Garcia-Ortega Alberto , Oscullo Grace
Published: January 2023

Bronchiektasen sind nach der chronisch-obstruktiven Lungenerkrankung (COPD) und Asthma die dritthäufigste chronisch-entzündliche Atemwegserkrankung, deren Prävalenz wahrscheinlich aufgrund ihrer klinischen Ähnlichkeit mit anderen chronischen Atemwegserkrankungen deutlich unterschätzt wird. Bronchiektasen können durch ein Dutzend pulmonaler und extrapulmonaler Erkrankungen verursacht werden. Im Verlauf der Erkrankung kann es zu einer unterschiedlichen Anzahl und Schwere von Exazerbationen kommen, gewöhnlich mit einem infektiösen Profil. Die Erweiterung der Atemwege und die Entzündung/Infektion sind die radiologischen und pathophysiologischen Erkennungsmerkmale für Bronchiektasen. Die Primärversorgung sollte bei der Beurteilung der Bronchiektasen in vielen Aspekten eine wichtige Rolle spielen. In diesem Artikel werden wir versuchen, eine Reihe wichtiger Konzepte und praktischer Tipps zu einigen Schlüsselaspekten der Diagnose und des Managements von Bronchiektasen in der Primärversorgung anzubieten: klinischer Verdacht, diagnostische Methoden, Bewertung des Schweregrads, Überschneidung mit Asthma und COPD sowie mikrobiologische und therapeutische Aspekte.
Onset of Oral Lichen Planus Led to Direct-Acting Antiviral Therapy in a Patient with Long-Term Hepatitis C: The Role of a Dentist as Gatekeeper
Authors: Nagao Yumiko , Tsuji Masahide
Published: January 2023

Oral lichen planus (OLP), a chronic inflammatory mucocutaneous disease, is an extrahepatic manifestation of a hepatitis C virus infection. In recent years, direct-acting antivirals (DAAs) have made great strides in the treatment of hepatitis C. However, there might be a lack of information about the treatment strategies available among those with this condition. Herein, we report a case of an 85-year-old female patient who was diagnosed with hepatitis C at the age of 55 but had not received antiviral treatment over the past 30 years. She underwent DAA treatment following a recommendation from her oral surgeon after the onset of OLP. The patient had declined interferon therapy in the past, owing to concerns about its side effects. She was unaware of the benefits of DAA treatment, probably due to communication difficulties caused by senile hearing loss. Consultation with an oral surgeon for an erosive form of OLP led her to receive antiviral therapy for hepatitis C. She achieved a sustained virologic response (SVR) following the DAA treatment, along with improvements in the signs and symptoms of OLP. Oral surgeons play an important role as gatekeepers in guiding untreated hepatitis patients toward appropriate treatment.
Histamine Skin Prick Tests: From Established Diagnostic Technique to Advanced Experimental Biomarker
Authors: Bamps Dorien , Berdon Katarina , Hernandez Hasan , Schrijvers Rik , de Hoon Jan
Published: January 2023

Introduction: Skin prick tests have a long history as diagnostic and pharmacodynamic biomarker. Besides visual assessments of the wheal and flare, objective blood flow measurements using laser Doppler imaging (LDI) and laser speckle contrast imaging (LSCI) have been reported. In light of these advancements, an up-to-date characterization of the histamine-evoked response is worthwhile. Methods: A single-centre study was completed in healthy males. Two parameters were addressed: (1) dermal blood flow (DBF) within a 7.65-mm ring encircling the skin prick site (DBFring), and (2) surface area of the flare (AREAflare). First, the dose response was assessed using placebo (0.9% sodium chloride) or histamine (histamine dihydrochloride 1, 3, or 10 mg/mL) skin pricks on the volar surface of subjects’ (n = 12) forearm. The DBFring was measured by LDI, and the AREAflare by LDI and by ruler. Secondly, the inter-arm and inter-period reproducibility of the DBFring and AREAflare, as evoked by histamine (10 mg/mL) and measured by LDI and LSCI, was examined (n = 14). Lastly, the effect of aprepitant (125 mg), ketotifen (1 mg), and a single (5 mg) and fourfold (20 mg) dose of desloratadine and levocetirizine on the histamine-induced (10 mg/mL) DBFring and AREAflare was evaluated with LSCI (n = 13 or 12). Results: All three histamine doses induced a time-dependent vasodilation. Ruler recordings did not conclusively correlate with LDI assessments of the AREAflare. The DBFring and AREAflare were reasonably reproducible when measured by using LDI or LSCI, with negligible bias between arms and study periods and poor to moderate within-subject reproducibility (0.23 ≤ ICC ≤ 0.71). While the fourfold dose of desloratadine (p = 0.0041) and the single and fourfold dose of levocetirizine (p < 0.0001) managed to reduce the AREAflare, only the fourfold dose of levocetirizine (p = 0.0052) reduced the DBFring. Conclusion: Caution is warranted when translating years of clinical experience with histamine skin prick tests to objective recordings of the associated changes in skin perfusion. Ruler and LDI assessments of the AREAflare do not consistently correlate, and the reproducibility and histamine dependency of the measurements are not obvious. While 10 mg/mL histamine may be a good choice for qualitative diagnostic evaluations, a lower dose may be better suited to use as a quantitative biomarker.
Impact of Selective Fetal Growth Restriction on Laser Therapy Outcomes in Twin-Twin Transfusion Syndrome
Authors: Carmant Laurence Sophie , Audibert François , Wavrant Sandrine , Thériault Katherine , Codsi Elisabeth
Published: January 2023

Introduction: The aim of this study was to determine if outcomes of fetoscopic laser photocoagulation in isolated twin-twin transfusion syndrome (TTTS) differ from TTTS with concomitant selective fetal growth restriction (sFGR). Methods: This is a retrospective cohort study of all cases of TTTS treated at the CHU Sainte-Justine between February 2006 and January 2020. Data were collected from maternal, obstetrical, and neonatal chart review. Results: A total of 149 patients were included in our study. Forty-seven patients (31.5%) had a pregnancy complicated by TTTS and sFGR. Mean gestational age at diagnosis and at treatment was 20+4 weeks and 20+6 weeks for TTTS alone, and 20+5 weeks and 21+2 weeks with concomitant sFGR. The presence of concomitant sFGR negatively impacted survival. Double survival in the TTTS + sFGR was 48.9% (23/47) versus 68.6% (70/102) in the TTTS-only group (p = 0.021). Fetal donor survival was 59.6% (28/47) in the TTTS + sFGR group and 84.3% (86/102) in the TTTS-only group (p = 0.001). However, the survival of at least one twin did not differ between the two groups: 93.6% (44/47) in the TTTS + sFGR group versus 92.2% (94/102) in the TTTS-only group (p = 0.751). The presence of type 2–3 sFGR (OR = 0.56; 95% CI 0.32–0.96, p = 0.033) and gestational age at laser therapy (OR = 1.17; 95% CI 1.01 = 1.36, p = 0.036) were independently associated with dual survival. Conclusion: sFGR is independently associated with decreased double survivorship at the expense of the donor in TTTS undergoing laser therapy. Type 2 or 3 sFGR and early gestational age at treatment are especially at risk. A larger cohort is needed to validate our results.
Evaluation of a Novel Combination Therapy, Based on Trifluridine/Tipiracil and Fruquintinib, against Colorectal Cancer
Authors: Nukatsuka Mamoru , Fujioka Akio , Nagase Hideki , Tanaka Gotaro , Hayashi Hiroaki
Published: January 2023

Introduction: Trifluridine/tipiracil hydrochloride (FTD/TPI, Lonsurf®) is an oral antineoplastic agent that has been approved as late-stage chemotherapy for colorectal cancer. Its major mechanism of action is the dysfunction of tumoral DNA including DNA strand breaks and decreased replication. Fruquintinib (ELUNATE®) is a novel kinase inhibitor that selectively inhibits the vascular endothelial growth factor receptor-1, -2, and -3. In this study, we evaluated the antitumor activity of combination therapy with FTD/TPI and fruquintinib in vivo. Methods: The enhancement of the antitumor effects with FTD/TPI and fruquintinib combination, compared to the single drugs given alone was evaluated using two human colorectal cancer xenografts in nude mouse models. FTD/TPI (200 mg/kg) was orally administered for 5 consecutive days followed by 2 days of rest in a 7-day period. Fruquintinib (10 mg/kg) was orally administered consecutively for 2 and 3 weeks in SW48 and HCT 116 tumor-bearing models, respectively. After treatment with these agents, the microvessel density was evaluated by CD31 immunohistochemical analyses. Results: In both models, FTD/TPI and fruquintinib significantly inhibited tumor growth, and the activity of the combined treatment was significantly superior to that of either monotherapy. Body weight loss of greater than 20% was not observed in any group. A histochemical analysis showed nuclei enlargement, abnormal mitosis, and karyorrhexis in the FTD/TPI treatment group. The microvessel density in the HCT 116 tumors treated with FTD/TPI and fruquintinib was significantly lower than that in the control group. Conclusion: The combination of FTD/TPI and fruquintinib could be a promising treatment option for colorectal cancer.
Relevance of Fetal Brain Magnetic Resonance Imaging Compared to Ultrasound for Detecting Cerebral Anomalies in Fetuses with Cleft Lip and/or Palate: A Cohort Study
Authors: Eydoux Raphaëlle , Lesieur Emmanuelle , Blanc Julie , Girard Nadine , D’ercole Claude , Sigaudy Sabine , Chaumoitre Kathia , Bretelle Florence
Published: January 2023

Introduction: Relevance of fetal brain magnetic resonance imaging (MRI) in cases of cleft lip and/or palate (CL/P) is still discussed to date. The aim of our study was to review the contribution of fetal brain MRI for detecting cerebral anomalies in cases of CL/P comparing antenatal data with neonatal outcomes. Methods: A retrospective multicenter study was conducted from January 2010 to October 2020 in two multidisciplinary prenatal diagnosis centers among women with a fetal ultrasound (US) diagnosis of CL/P. Prenatal imaging and genetic analysis data were collected, as well as postnatal data, including outcomes of children who had an abnormal prenatal MRI. Results: Among the 202 fetuses with a US diagnosis of CL/P, 96 underwent US and fetal brain MRI. 19 brain MRIs were found to be abnormal: 14 (73.7%) involved CL/P associated with other US abnormalities and five (26.3%) involved isolated clefts, of which four were cleft lip and alveolus and secondary palate (CLP). MRI identified severe abnormalities that changed the prognoses of 3 cases of clefts associated with other US abnormalities. In contrast, MRI found only minor abnormalities for the five isolated clefts, with no postnatal disorders found in these children. Conclusion: Fetal brain MRI should be proposed in cases of clefts associated with other anomalies or if US examination is limited by local conditions. MRI could also be discussed in cases of isolated CLP but should not be performed in cases of isolated cleft lip.
The Association between Frailty and Dementia-Free and Physical Disability-Free Survival in Community-Dwelling Older Adults
Authors: Ekram A.R.M. Saifuddin , Ryan Joanne , Espinoza Sara E. , Newman Anne B. , Murray Anne M. , Orchard Suzanne G. , Fitzgerald Sharyn M. , McNeil John J. , Ernst Michael E. , Woods Robyn L.
Published: January 2023

Introduction: Frailty is a common geriatric syndrome that adversely impacts health outcomes. This study examined correlates of physical frailty in healthy community-dwelling older adults and studied the effect of frailty on disability-free survival (DFS), defined as survival free of independence-limiting physical disability or dementia. Methods: This is a post hoc analysis of 19,114 community-dwelling older adults (median age: 74.0 years, interquartile range or IQR: 6.1 years) from Australia and the USA enrolled in the “ASPirin in Reducing Events in the Elderly (ASPREE)” clinical trial. Frailty was assessed using a modified Fried phenotype and a deficit accumulation frailty index (FI) utilizing a ratio score derived from 66 items. Multinomial logistic regression was used to examine the correlates of frailty and Cox regression to analyze the association between frailty and DFS (and its components). Results: At study enrollment, 39.0% were prefrail, and 2.2% of participants were frail, according to Fried phenotype. Older age, higher waist circumference, lower education, ethnoracial origin, current smoking, depression, and polypharmacy were associated with prefrailty and frailty according to Fried phenotype and FI. Fried phenotype defined prefrailty and frailty predicted reduced DFS (prefrail: HR: 1.67; 95% CI: 1.50–1.86 and frail: HR: 2.80; 95% CI: 2.27–3.46), affecting each component of DFS including dementia, physical disability, and mortality. Effect sizes were larger, according to FI. Conclusion: Our study showed that prefrailty is common in community-dwelling older adults initially free of cardiovascular disease, dementia, or independence-limiting physical disability. Prefrailty and frailty significantly reduced disability-free survival. Addressing modifiable correlates, like depression and polypharmacy, might reduce the adverse impact of frailty on dementia-free and physical disability-free survival.
A Phase II Study of Nab-Paclitaxel and Gemcitabine as First-Line Therapy in Patients with Cholangiocarcinoma Ineligible for Cisplatin-Based Chemotherapy (NACHO)
Authors: Virchow Isabel , Treckmann Jürgen-Walter , Prasnikar Nicole , Linden Gabriele , Markus Peter , Schumacher Brigitte , Albers David , Herold Thomas , Ting Saskia , Schmidt Hartmut , Radunz Sonja , Wiesweg Marcel , Siveke Jens , Schuler Martin , Kasper Stefan
Published: January 2023

Introduction: Gemcitabine and cisplatin is the standard first-line systemic treatment in patients with advanced cholangiocarcinoma (CCA). However, a substantial number of patients do not qualify for cisplatin due to comorbidities or poor performance status. The phase II pilot study NACHO evaluated the efficacy of nab-paclitaxel (125 mg/m2) and gemcitabine (1000 mg/m2) given on days 1, 8, and 15 every 4 weeks as first-line therapy in patients with advanced CCA ineligible for cisplatin-based chemotherapy. Methods: Patients with any comorbidity precluding cisplatin therapy, such as renal impairment, impaired hearing, increased risk or history for thromboembolic events, intolerance of extensive hydration, or significant cardiovascular disease were eligible. Primary endpoint was overall response rate (ORR) per RECIST 1.1. Secondary endpoints were progression-free survival (PFS), overall survival (OS), safety, and patient reported outcome. Results: From December 2016 to July 2017, 10 patients were prospectively enrolled and treated. The ORR with nab-paclitaxel/gemcitabine was 50%, the disease control rate (DCR) was 90%. Median PFS was 5.7 months (95% CI: 5.3–6.1), and median OS was 7.8 months (95% CI: 5.4–10.2). In total, 13 SAEs were documented without any new safety signals. There were 14 grade 3–4 treatment-related adverse events (TRAEs) in 10 patients of the ITT population. Exploratory subgroup analyses including known prognostic markers were performed. Conclusions: The NACHO trial supports safety and efficacy of nab-paclitaxel and gemcitabine in patients with advanced CCA ineligible for cisplatin-based therapy and should be further evaluated in a larger prospective trial.
1.2 Challenges to Current Food Systems
Authors: Al-Jawaldeh Ayoub , Meyer Alexa
Published: January 2023

Chapter 2 presents challenges to current food systems, particularly those arising from climate change, globalization, demographic trends, and conflicts like the recent war in Ukraine, for instance, that are leading to changes in food availability and dietary patterns. These factors have strong effects on the production and offer of food and thus its availability and access to it. Globally, there is a trend towards higher consumption of processed foods, which is reinforced by increasing urbanization. Globalization leads to a higher dependency of some countries on others, making them vulnerable to supply shortages. This was particularly evident during the recent crises. The need to feed a growing population and the increasing demand for animal foods that accompanies economic development have led to increasing intensification of agriculture, which contributes to climate change and damages the environment.
1.4 Sustainable Food Systems for Healthy Diets of the Future
Authors: Al-Jawaldeh Ayoub , Meyer Alexa
Published: January 2023

Approaches to make food systems more sustainable and healthier are discussed in chapter 4. Besides reducing food loss and waste, increasing productivity must play a central role, through a more efficient use of resources and the support of local agriculture that provides income to smallholders and reduces the need for long transports and packaging. At the same time, changes in the dietary habits of consumers are also required.
2.3 Micronutrient Deficiencies
Authors: Al-Jawaldeh Ayoub , Meyer Alexa
Published: January 2023

The issue of micronutrient status and deficiencies in the Eastern Mediterranean Region is discussed, the focus being on anaemia as the main symptom of iron deficiency, iodine status as well as zinc, vitamin A, vitamin D, folate and vitamin B12. While the status of iodine has improved in recent years, not least due to efficient salt iodization programmes, the prevalence of anaemia is high in the region, especially in children, women of child-bearing age and pregnant women, and even though data about the status of other micronutrients is less abundant, there is evidence that deficiencies of zinc, vitamin A, vitamin D, folate and, to a lesser extent, vitamin B12 are also common.
2.4 Young Children and Infant Feeding Practices
Authors: Al-Jawaldeh Ayoub , Meyer Alexa
Published: January 2023

This chapter is dedicated to the practice of breastfeeding in the region. Breastfeeding is the optimal nutrition for young children and during the first six months of life should be the only food given to the infant. However, the rate of exclusive breastfeeding of children up to 6 months varies widely between the countries of the Eastern Mediterranean Region, ranging from 8 to 61.5%, showing the need to promote and protect breastfeeding. The proportion of children that were introduced to adequate complementary food at the age of 6 months was also insufficient in many countries. Overall, the findings from different nutrition surveys indicate a need to improve young child and infant feeding practices in the region.
3.1 Fiscal Policies for Healthy and Sustainable Diets
Authors: Al-Jawaldeh Ayoub , Meyer Alexa
Published: January 2023

The high prevalence of overweight and obesity and the non-communicable diseases associated with it place a heavy burden on healthcare systems of the Eastern Mediterranean Region. Accordingly, governments of the region’s countries have a growing interest in policies and strategies to encourage healthier and more sustainable dietary patterns and make healthy food more available and accessible. To support member states in this effort, the WHO, as anchor agency of Action Track 2 of the Food Systems Summit 2021 “Shifting to Sustainable and Healthy Consumption Patterns” has proposed six “game-changing” actions: 1) fiscal policies for healthy and sustainable diets; 2) public food procurement and service policies for a healthy diet sustainably produced; 3) regulation of marketing of foods and non-alcoholic beverages, including breastmilk substitutes; 4) food product reformulation; 5) front-of-pack labelling; and 6) food fortification. Part 3 of the book takes a closer look at these actions with a special focus on their implementation in the Eastern Mediterranean Region. Chapter 3.1 is dedicated to the use of fiscal policies to promote healthy and sustainable food choices while reducing consumption of less healthy products. Such policies include the repurposing of agricultural and food subsidies to increase the availability of and access to healthy foods and the taxation of unhealthy foods. Subsidies for staple foods are intended to ensure food security, but they have the side effect of encouraging consumption of energy-rich but nutrient-poor foods at the expense of more nutritious but more expensive foods like fruits and vegetables. Repurposing subsidies to make the latter more affordable is therefore a goal of nutrition and health policies in many countries in the region, even though subsidization of fruits and vegetables is not widely practised so far. A growing number of countries worldwide are introducing taxation of unhealthy foods and beverages to discourage their consumption. In most cases, taxes are imposed on sugar-sweetened beverages and this approach has also been taken by the Member states of Gulf Cooperation Council as well as Egypt, Iran, Morocco, and Tunisia. Although the recent introduction of these measures in most countries does not allow a conclusive evaluation, the first effects look promising, with a notable decrease in sales of carbonated soft drinks and energy drinks in the kingdom of Saudi Arabia.
4. Conclusion and Outlook
Authors: Al-Jawaldeh Ayoub , Meyer Alexa
Published: January 2023

In conclusion, a shift towards sustainable and healthy consumption patterns is crucial to achieve sustainable development goals, make food systems more resilient to climate change, increase food security, prevent malnutrition and slow the rise in nutrition-related non-communicable diseases in the WHO Eastern Mediterranean Region. The countries in the region are pursuing this goal with varying degrees of commitment and success. Close cooperation can be of particular help to low-income countries or those afflicted by conflicts and crisis, at the same time as promoting regional trade.
Subseasonal Prediction of Central European Summer Heatwaves with Linear and Random Forest Machine Learning Models
Authors: Weirich-Benet Elizabeth , Pyrina Maria , Jiménez-Esteve Bernat , Fraenkel Ernest , Cohen Judah , Domeisen Daniela I. V.
Published: January 2023

Heatwaves are extreme near-surface temperature events that can have substantial impacts on ecosystems and society. Early warning systems help to reduce these impacts by helping communities prepare for hazardous climate-related events. However, state-of-the-art prediction systems can often not make accurate forecasts of heatwaves more than two weeks in advance, which are required for advance warnings. We therefore investigate the potential of statistical and machine learning methods to understand and predict central European summer heatwaves on time scales of several weeks. As a first step, we identify the most important regional atmospheric and surface predictors based on previous studies and supported by a correlation analysis: 2-m air temperature, 500-hPa geopotential, precipitation, and soil moisture in central Europe, as well as Mediterranean and North Atlantic sea surface temperatures, and the North Atlantic jet stream. Based on these predictors, we apply machine learning methods to forecast two targets: summer temperature anomalies and the probability of heatwaves for 1–6 weeks lead time at weekly resolution. For each of these two target variables, we use both a linear and a random forest model. The performance of these statistical models decays with lead time, as expected, but outperforms persistence and climatology at all lead times. For lead times longer than two weeks, our machine learning models compete with the ensemble mean of the European Centre for Medium-Range Weather Forecast’s hindcast system. We thus show that machine learning can help improve subseasonal forecasts of summer temperature anomalies and heatwaves.

Significance Statement

Heatwaves (prolonged extremely warm temperatures) cause thousands of fatalities worldwide each year. These damaging events are becoming even more severe with climate change. This study aims to improve advance predictions of summer heatwaves in central Europe by using statistical and machine learning methods. Machine learning models are shown to compete with conventional physics-based models for forecasting heatwaves more than two weeks in advance. These early warnings can be used to activate effective and timely response plans targeting vulnerable communities and regions, thereby reducing the damage caused by heatwaves.
Creating and Evaluating Uncertainty Estimates with Neural Networks for Environmental-Science Applications
Authors: Haynes Katherine , Lagerquist Ryan , McGraw Marie , Musgrave Kate , Ebert-Uphoff Imme
Published: January 2023

Neural networks (NN) have become an important tool for prediction tasks—both regression and classification—in environmental science. Since many environmental-science problems involve life-or-death decisions and policy making, it is crucial to provide not only predictions but also an estimate of the uncertainty in the predictions. Until recently, very few tools were available to provide uncertainty quantification (UQ) for NN predictions. However, in recent years the computer-science field has developed numerous UQ approaches, and several research groups are exploring how to apply these approaches in environmental science. We provide an accessible introduction to six of these UQ approaches, then focus on tools for the next step, namely, to answer the question: Once we obtain an uncertainty estimate (using any approach), how do we know whether it is good or bad? To answer this question, we highlight four evaluation graphics and eight evaluation scores that are well suited for evaluating and comparing uncertainty estimates (NN based or otherwise) for environmental-science applications. We demonstrate the UQ approaches and UQ-evaluation methods for two real-world problems: 1) estimating vertical profiles of atmospheric dewpoint (a regression task) and 2) predicting convection over Taiwan based on Himawari-8 satellite imagery (a classification task). We also provide Jupyter notebooks with Python code for implementing the UQ approaches and UQ-evaluation methods discussed herein. This article provides the environmental-science community with the knowledge and tools to start incorporating the large number of emerging UQ methods into their research.

Significance Statement

Neural networks are used for many environmental-science applications, some involving life-or-death decision-making. In recent years new methods have been developed to provide much-needed uncertainty estimates for NN predictions. We seek to accelerate the adoption of these methods in the environmental-science community with an accessible introduction to 1) methods for computing uncertainty estimates in NN predictions and 2) methods for evaluating such estimates.
Relationship Between Serum Uric Acid and Carotid Plaque in Patients With Coronary Artery Disease by Sex and Blood Pressure Status
Authors: Pan Guangwei , Liu Yijia , Yu Lu , Yang Rongrong , Yang Tong , Wang Yang , Su Jinyu , Li Zhu , Cheng Qi , Gao Sheng , Li Lin , Yu Chunquan
Published: January 2023

The purpose of this study was to explore the sex difference and effects of blood pressure (BP) on the relationship between serum uric acid (SUA) and carotid plaque in patients with coronary heart disease (CHD). This large multicenter retrospective study included 12099 patients with CHD (aged 35–75 years) between January 1, 2014 and September 30, 2020. Patients were divided into three groups according to systolic BP (SBP) and diastolic BP (DBP), and the SUA levels in males and females were converted into three groups. Logistic regression was used to analyze the influence of sex and BP on the relationship between SUA levels and carotid plaque in patients with CHD. In the model of male BP subgroups, using the BP of group A (normal with SBP <120 mmHg and DBP <80 mmHg) as a reference, SUA levels were significantly correlated with the occurrence of carotid plaque under different BP states ( P < .001). In contrast, in the model of female BP subgroups, most of these correlations were not statistically significant. Our study showed that SUA levels were significantly associated with carotid plaque occurrence in males with CHD, which remained significant across different BP states.
Screening Incarcerated Women for Opioid Use Disorder
Authors: Staton Michele , Tillson Martha , Levi Mary M. , Webster Matthew , Oser Carrie , Leukefeld Carl
Published: January 2023

The overall aim of the present study is to examine the utility of the DSM OUD Checklist and the NM-ASSIST screening tools to identify symptoms consistent with OUD among incarcerated women in county jails. This study contributes to the existing literature because research on screening and assessment approaches for incarcerated women has been limited. The focus of the current study is to describe the screening procedures and study recruitment for a larger parent study focused on increasing treatment linkages. Study findings indicate a positive correlation between indicators of OUD using the two screening tools, as well as a high degree of correlation between street opioid misuse and other high-risk drug indicators (overdose and injection practices). These findings underscore the importance of outreach, screening, and intervention in real-world settings, including jails, in order to increase access to OUD treatment among this vulnerable sample of women.
Turkish Translation/Cultural Adaptation and Psychometric Analyses of the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS)
Authors: Apaydın Umut , Eraslan Rabia , Balıkçı Aymen , Elbasan Bülent
Published: January 2023

In this study we translated the Affordances in the Home Environment for Motor Development-Infant Scale (AHEMD-IS) into Turkish, adapted the instrument culturally, examined its psychometric properties within a Turkish population, and identified its limitations. We administered the AHEMD-IS to families of 65 premature or full-term Turkish infants and repeated this testing for 17 families after one-two weeks to establish test-retest reliability. We calculated the Intraclass Correlation Coefficient (ICC) and Cronbach alpha coefficient to assess reliability, and we evaluated test validity using the Spearman’s correlation coefficient and correlations with the Bayley-III motor development score. The Cronbach Alpha coefficient of the questionnaire was 0.846, and, for test-retest reliability, the ICC score was 0.830. The Turkish AHEMD-IS total score was moderately correlated with the Bayley-III fine motor development score ( r = 0.469, p < 0.001), the Bayley-III gross motor development score ( r = 0.533, p < 0.001), and the Bayley-III total motor development score ( r = 0.526, p < 0.001). The Turkish version of the AHEMD-IS was found to be valid and reliable for children born prematurely or at full-term. The use of this questionnaire in Turkey will facilitate the creation of a home environment that will support motor development in children between 3-18 months of age.
THE PARIS AGREEMENT'S APPROACH TOWARD CLIMATE CHANGE LOSS AND DAMAGE
Authors: Amini Azam , Abedi Mohammad , Nesari Elnaz , Daryadel Ehsan , Kolahi Mahdi , Mianabadi Hojjat , Fisher Judith
Published: January 2023

Article 8 of the Paris Agreement introduces obligations upon the Parties to the Agreement “with respect to Loss and Damage associated with adverse impacts of climate change.” According to Paragraph 52 of the Conference of the Parties’ Decision, Article 8 is not a basis for liability or compensation. Therefore, the problem is whether violation of obligations leads to a state responsibility. Using a dogmatic method, this research contends that “recognizing the significance of averting, minimizing, and addressing Loss and Damage” means acceptance of responsibility for a breach of obligations. Although the means of seeking reparation would not be compensation, States are obliged to eliminate sources of damage and take precautionary measures to address loss and damage. Notwithstanding this, placing the issue of loss and damage under the Agreement into a separate article can reflect to a great extent the significance of the matter.
Hearths, Mythologies, and Livelihood Choices: Exploring Cultural Change under Poverty Alleviation with the Nuosu-Yi of Liangshan
Authors: Karlach Jan
Published: January 2023

In late 2020, the Chinese Communist Party triumphantly declared an end to (absolute) poverty in the country. As one of the most poverty-stricken areas of China, Liangshan Yi Autonomous Prefecture in Sichuan province came into the spotlight both domestically and internationally. International media reports, some of which embedded fragments of the author’s expert opinion, launched a discursive counter-offensive. Furthermore, both sides incorporated anecdotes told by local ethnic Nuosu-Yi individuals. Interested in discursive hegemony rather than informants’ voices, however, both somewhat conveniently failed to grasp the complex interplay between the everyday lives of Nuosu-Yi and the state-driven poverty alleviation campaign. Focusing on the creative livelihood strategies and choices reflected in the everyday practical and ritualistic treatment of the traditional Nuosu-Yi hearth, the present article ethnographically analyzes the tension between various (re)presentations of poverty and the Nuosu-Yi cosmology that is animated to absorb them and facilitate preservation and/or reinvention of Nuosu-Yi lifeways.
Nasopharyngeal Synovial Sarcoma; Report of A Rare Case
Authors: Gozgec Elif , Ozmen Sevilay , Ogul Hayri
Published: January 2023

Synovial sarcoma is a soft tissue tumor originating from mesenchymal precursor stem cells. It is usually seen in young males and lower extremities. It is only seen in 10% of head and neck region and nasopharynx which is a very unexpected location. We report a rare case treated with radiotherapy and chemotherapy.
Citizen Science in News Media: Boundary Mediation of Public Participation in Health Expertise
Authors: Mayes E. Carolina
Published: January 2023

In this article, I examine how scientific boundary work describes or represents citizen science as credible forms of expertise. Citizen science is an ambiguous concept, and I leverage that ambiguity to examine citizen science as a proxy for nonprofessional or noninstitutional scientific practices more generally. I argue that media representations of citizen science perform boundary work through different articulations of institutional “buy-in” to the legitimacy or credibility of citizen science. Using a discourse analysis of mainstream news media, I trace three framings of citizen science’s relationship to institutional networks, which I describe as subservient to, corrective to, and exceeding the norms of institutional expertise. I find that the perspectives of professional, credentialed scientists dominate public discourse concerning citizen science and perform different adjudications of how citizen science contributes to networks of expertise. By focusing on citizen science concerning human health and medicine, I additionally show how mainstream framings of citizen science engage with overlapping media representations of personal health responsibility and patient empowerment. I suggest that representations of citizen science as a form of “missing expertise” can conflict with portrayals of citizen science as “going too far” in the pursuit of treatments or interventions.
Hiding in Plain Sight: Organizational magic as a contested process of revelation and concealment
Authors: Backsell Jessica Inez , Schwarzkopf Stefan
Published: January 2023

This article seeks to theorize organizational magic. A vast literature in organization and management studies has come to understand magic as an epiphenomenon, a by-product, an outcome of affective encounters and aesthetic experiences, and thus often synonymous with enchantment. Drawing on classical anthropological and sociological theories, the article conceptualizes magic as skilled revelation, or the performative disclosure of strategically concealed performances. This leads us to highlight the important role of audiences who contest the success of these performances. We apply this theoretical perspective to study tax-exempt hiding places for expensive art collections, so-called freeports. A freeport maintains a symbolic order around charismatic, extraordinary objects. An analysis of how magic rituals of revelation, concealment, de-mystification and transformation come together to create a freeport not only adds to our knowledge about the role of revelatory performances and of contestations in the establishment of controversial business models. Using an anthropological perspective also normalizes our understanding of magic as organizational practice as it rejects conceptual juxtapositions with managerial rationality and disenchantment.
Right anterolateral thoracotomy with partial sternotomy for chronic type B aortic dissection with right aortic arch and Kommerell's diverticulum
Authors: Kasama Keiichiro , Uranaka Yasuko , Tomita Hiroto , Saba Takuya , Karube Norihisa , Suzuki Shinichi
Published: January 2023

Chronic type B aortic dissection with the right aortic arch was rare. We present the case of a 59-year-old man with a right aortic arch and chronic type B aortic dissection, with a maximum size of 80 mm. Graft replacement was successfully performed through right anterolateral thoracotomy with partial sternotomy through the fourth intercostal space. The patient's postoperative course was uneventful. He had no paralysis and was extubated on postoperative day 2 and discharged from the hospital on postoperative day 15. Anterolateral thoracotomy with partial sternotomy could be a suitable approach for right-sided aortic aneurysms.
Validation of a screening algorithm for hepatic fibrosis by Doppler ultrasound and elastography in a general population
Authors: Renard Anne-Sophie , Paisant Anita , Cartier Victoire , Calès Paul , Goyet-Prelipcean Mirela , Geagea Edmond , Tasu Jean-Pierre , Silvain Christine , Wagner Mathilde , Cleach Aline Le , Vilgrain Valérie , Castera Laurent , Bricault Ivan , Decaens Thomas , Savoye-Collet Céline , Montialoux Hélène , Correas Jean-Michel , Vallet-Pichard Anaïs , Boursier Jérôme , Aubé Christophe
Published: January 2023

Background

Early detection can prevent the initial stages of fibrosis from progressing to cirrhosis.

Purpose

To evaluate an algorithm combining three echographic indicators and elastographic measurements to screen for hepatic fibrosis in an unselected population.

Material and Methods

From May 2017 to June 2018, all patients with no history and no known chronic liver disease who were referred for an ultrasound (US) were prospectively included in eight hospitals. The indicators being sought were liver surface irregularity, demodulation of hepatic veins, and spleen length >110 mm. Patients presenting at least one of these underwent elastography measurements with virtual touch quantification (VTQ) or supersonic shear imaging (SSI). If elastography was positive, patients were referred to hepatologist for fibrosis evaluation. Reference standard was obtained by FibroMeterVCTE or biopsy. A FibroMeterVCTE result >0.384 indicated a “necessary referral” to a hepatologist.

Results

Of the 1501 patients included, 504 (33.6%) were positive for at least one US indicator. All of them underwent US elastography, with 85 being positive. Of the patients, 58 (3.6%) had a consultation with a liver specialist: 21 had positive FibroMeterVCTE and nine had an indication of biopsy for suspicion of fibrosis. This screening algorithm made it possible to diagnose 1.6% of patients in our population with unknown fibrosis. Of the patients, 50% referred to the liver specialist were “necessary referrals.”

Conclusion

Our study suggests that three simple US indicators with no systematic elastographic measurement could be applied in day-to-day practice to look for hepatic fibrosis in an unsuspected population allowing relevant referrals to a hepatologist.