bluuebunny/crossref_metadata_2025 huggingface dataset:
Thyroid V40 is a good predictor for subclinical hypothyroidism in patients with nasopharyngeal carcinoma after intensity modulated radiation therapy: a randomized clinical trial
Authors: Xu Yun , Peng Hewei , Su Guangjian , Cheng Yanming , Guo Qiaojuan , Guo Lanyan , Peng Xian-E , Ke Jiangfeng
Published: August 2023

Background

Hypothyroidism (HT) and subclinical HT after radiotherapy is frequent in nasopharyngeal carcinoma (NPC) patients, results in negative impact on patients' quality of life. The percentage of thyroid volume receiving more than 40 Gy (V40) ≤ 85% was reported to be a useful dose constraint to adopt during intensity-modulated radiation therapy (IMRT) planning. This study aims to verify whether V40 ≤ 85% can be used as an effective dose constraint in IMRT planning in a randomized clinical trial.

Methods

This single-center 1:1 randomized clinical trial was conducted in Fujian province hospital between March 2018 and September 2022. All patients were treated with IMRT and randomized to induction chemo followed by concurrent chemo-IMRT or concurrent chemo-IMRT alone. Ninety-two clinically NPC patients were included in this study. The thyroid function tests were performed for all patients before and after radiation at regular intervals. Thyroid dose-constraint was defined as V40 ≤ 85%. The primary outcome in this study was subclinical HT.

Results

Median follow up was 34 months. Significant difference in the incidence of subclinical HT between the thyroid dose-constraint group and unrestricted group was observed (P = 0.023). The risk of subclinical HT in the thyroid dose-constraint group was lower than that in the unrestricted group (P = 0.022). Univariate and multivariate cox regression analysis indicated that thyroid dose-constraint was a protective effect of subclinical HT (HR = 0.408, 95% CI 0.184–0.904; HRadjusted = 0.361, 95% CI 0.155–0.841).

Conclusion

V40 ≤ 85% can be used as an effective dose constraint in IMRT planning to prevent radiation-induced subclinical HT.
Beyond Bruton’s tyrosine kinase inhibitors in mantle cell lymphoma: bispecific antibodies, antibody–drug conjugates, CAR T-cells, and novel agents
Authors: Jain Neeraj , Mamgain Mukesh , Chowdhury Sayan Mullick , Jindal Udita , Sharma Isha , Sehgal Lalit , Epperla Narendranath
Published: August 2023

Mantle cell lymphoma is a B cell non-Hodgkin lymphoma (NHL), representing 2–6% of all NHLs and characterized by overexpression of cyclin D1. The last decade has seen the development of many novel treatment approaches in MCL, most notably the class of Bruton's tyrosine kinase inhibitors (BTKi). BTKi has shown excellent outcomes for patients with relapsed or refractory MCL and is now being studied in the first-line setting. However, patients eventually progress on BTKi due to the development of resistance. Additionally, there is an alteration in the tumor microenvironment in these patients with varying biological and therapeutic implications. Hence, it is necessary to explore novel therapeutic strategies that can be effective in those who progressed on BTKi or potentially circumvent resistance. In this review, we provide a brief overview of BTKi, then discuss the various mechanisms of BTK resistance including the role of genetic alteration, cancer stem cells, tumor microenvironment, and adaptive reprogramming bypassing the effect of BTK inhibition, and then provide a comprehensive review of current and emerging therapeutic options beyond BTKi including novel agents, CAR T cells, bispecific antibodies, and antibody–drug conjugates.
Privatized graph federated learning
Authors: Rizk Elsa , Vlaski Stefan , Sayed Ali H.
Published: August 2023

Federated learning is a semi-distributed algorithm, where a server communicates with multiple dispersed clients to learn a global model. The federated architecture is not robust and is sensitive to communication and computational overloads due to its one-master multi-client structure. It can also be subject to privacy attacks targeting personal information on the communication links. In this work, we introduce graph federated learning, which consists of multiple federated units connected by a graph. We then show how graph-homomorphic perturbations can be used to ensure the algorithm is differentially private on the server level. While on the client level, we show that improvement in the differentially private federated learning algorithm can be attained through the addition of random noise to the updates, as opposed to the models. We conduct both convergence and privacy theoretical analyses and illustrate performance by means of computer simulations.
A systematic review of early motor interventions for infants with congenital heart disease and open-heart surgery
Authors: Kaeslin Rahel , Latal Beatrice , Mitteregger Elena
Published: August 2023

Background

Motor development delay is the first neurodevelopmental impairment that becomes apparent in infants with congenital heart disease (CHD). Early interventions have addressed high-risk groups like infants born preterm, but little is known about interventions to improve motor outcome in CHD infants at risk of motor delay. The purpose of this review was to systematically review the literature on type and effect of motor intervention applied during the first year of life in infants with CHD following open-heart surgery.

Methods

Scoping searches were performed in May 2020 and April 2023 via MEDLINE, Embase, CINAHL, Cochrane, PsycINFO, PEDro, and Scopus. The review included studies published in English from 2015 to 2022. Primary outcome was infants’ motor development measured by standardized and non-standardized motor assessments, and if available, infants’ language and cognitive development, and any parental quality-of-life assessments as secondary outcomes. The studies’ quality was evaluated with a modified Newcastle-Ottawa scale.

Results

Four papers with low to high methodological quality met inclusion criteria. All studies investigated the influence of early physiotherapy. Four studies involved parents, and three studies used standardized tools to assess motor outcomes. No conclusion can be drawn about any positive effect of early motor interventions.

Conclusions

Early motor intervention in CHD infants may improve motor development; however, the few existing studies do not provide clear evidence. Thus, more prospective early intervention studies are needed.

Trial registration

PROSPERO CRD42020200981.
Optimization of HIV testing services in Germany using HIV indicator diseases: study protocol of the HeLP study
Authors: Valbert Frederik , Koppe Uwe , Schmidt Daniel , Krings Amrei , Gunsenheimer-Bartmeyer Barbara , Dröge Patrik , Ruhnke Thomas , Behrens Georg , Bickel Markus , Boesecke Christoph , Esser Stefan , Wasem Jürgen , Neumann Anja
Published: August 2023

Background

Despite the potentially accompanying negative clinical, epidemiologic, and health economic effects, a large proportion of persons living with the human immunodeficiency virus (HIV) are diagnosed late. Internationally, numerous diseases are known to be HIV indicator diseases. Adequate HIV testing in the presence of HIV indicator diseases could help to diagnose unknown HIV infections earlier. The objective of the HeLP study is to validate published HIV indicator diseases for the German setting and to identify guidelines in terms of these indicator diseases in order to reduce knowledge gaps and increase HIV testing when HIV indicator diseases are diagnosed.

Methods

A mixed methods approach is used. In a first step, published HIV indicator diseases will be identified in a systematic literature review and subsequently discussed with clinical experts regarding their relevance for the German setting. For the validation of selected indicator diseases different data sets (two cohort studies, namely HIV-1 seroconverter study & ClinSurv-HIV, and statutory health insurance routine data) will be analyzed. Sensitivity analyses using different time periods will be performed. Guidelines of HIV indicator diseases validated in the HeLP study will be reviewed for mentioning HIV and for HIV testing recommendations. In addition, semi-standardized interviews (followed by a free discussion) with guideline creators will identify reasons why HIV testing recommendations were (not) included. Subsequently, a random sample of physicians in medical practices will be surveyed to identify how familiar physicians are with HIV testing recommendations in guidelines and, if so, which barriers are seen to perform the recommended tests in everyday care.

Discussion

The HeLP-study adopts the challenge to validate published HIV indicator diseases for the German setting and has the potential to close a knowledge gap regarding this objective. This has the potential to improve targeted HIV testing for patients with HIV indicator diseases and consequently lead to earlier HIV diagnosis.

Trial registration

DRKS00028743
Associations between exposure to cadmium, lead, mercury and mixtures and women’s infertility and long-term amenorrhea
Authors: McClam Maria , Liu Jihong , Fan Yihan , Zhan Tingjie , Zhang Qiang , Porter Dwayne E. , Scott Geoffrey I. , Xiao Shuo
Published: August 2023

Background

Cadmium (Cd), lead (Pb), and mercury (Hg) have been shown to exhibit endocrine disrupting properties. Their effects on women’s reproductive health, however, remain elusive. Here, we investigated associations between blood concentrations of Pb, Cd, Hg, and their mixture and infertility and long-term amenorrhea in women aged 20–49 years using the US National Health and Nutrition Examination Survey (NHANES) 2013–2018 cross-sectional survey.

Methods

A total of 1,990 women were included for the analysis of infertility and 1,919 women for long-term amenorrhea. The methods of log-transformation and use of quartiles were used to analyze blood heavy metal concentrations. Statistical differences in the covariates between the outcome groups were evaluated using a chi-squared test for categorical variables and a t-test for continuous variables. Multiple logistic regression models were used to examine the associations.

Results

The blood concentrations of Pb and heavy metal mixtures were significantly higher in ever-infertile women than pregnant women, but the concentrations of Cd and Hg were comparable. After full adjustment, multiple logistic regression analyses revealed a significant and dose-dependent positive association between blood Pb concentrations and women’s historical infertility, a negative association between Cd and women’s long-term amenorrhea, and no associations between Hg and heavy metal mixture and women’s infertility or long-term amenorrhea.

Conclusions

Our study suggests that exposure to heavy metals exhibit differential associations with history of infertility and amenorrhea, and Pb may adversely impact women’s reproduction and heighten the risks of infertility and long-term amenorrhea.
Influence of night-time light pollution on the photosynthesis and physiological characteristics of the urban plants Euonymus japonicus and Rosa hybrida
Authors: Wei Yaxi , Li Zhen , Zhang Jiaolong , Hu Dan
Published: August 2023

Background

Night-time light pollution (NLP), which breaks the natural cycle of day and night, has become a new threat to urban ecosystems. Plants are the main component of urban ecosystems and play an irreplaceable role in maintaining urban ecological balance. The effects of NLP with various radiation sources, including green, white, blue and red light provided by light-emitting diodes, on urban plants, Euonymus japonicus and Rosa hybrida, were examined in a block field experiment.

Results

NLP caused photoinhibition and oxidative stress in plants, and the extent of the deleterious effects varied with the spectral distribution of artificial light sources and species. Both E. japonicus and R. hybrida were more sensitive to blue and red light, which reduced the pigment concentration, net photosynthetic rate, stomatal limit value, effective quantum yield, apparent electron transfer rate and photochemical quenching coefficient, and markedly increased the malondialdehyde content and total antioxidant capacity. However, those negative effects under white light were only present in E. japonicus and not in R. hybrida. Furthermore, blue and red light significantly decreased the stomatal conductance of E. japonicus. In contrast, green light had no significant effect on the above indices for both species. All spectra did not significantly change the sugars and starch contents for either species.

Conclusions

Considering that the spectral distribution of artificial light at night in cities has great heterogeneity and that its effect varies with plant species, it is important to arrange tree species with NLP tolerance and install appropriate light sources in urban areas based on the corresponding physiological responses and adaptation of urban trees.
Are greenhouse gas fluxes lower from ley or perennial fallow than from arable organic soils? A systematic review protocol
Authors: Holzknecht Alena , Berglund Örjan , Land Magnus , Dessureault-Rompré Jacynthe , Elsgaard Lars , Lång Kristiina
Published: August 2023

Background

Cultivated peatlands are widespread in temperate and boreal climate zones. For example, in Europe about 15% of the pristine peatland area have been lost through drainage for agricultural use. When drained, these organic soils are a significant source of greenhouse gas (GHG) emissions. To reach climate goals, the agricultural sector must reduce its GHG emissions, and one measure that has been discussed is changing land use from cropland to ley production or perennial green fallow. This management change leads to lower reported emissions, at least when using the IPCC default emission factors (EF) for croplands and grasslands on organic soils (IPCC 2014). However, there was a limited background dataset available for developing the EFs, and other variables than management affect the comparison of the land use options when the data originates from varying sites and years. Thus, the implications for future policies remain uncertain. This protocol describes the methodology to conduct a systematic review to answer the question of whether ley production or perennial green fallow can be suggested as a valid alternative to annual cropping to decrease GHG emissions on organic soils in temperate and boreal climate.

Methods

Publications will be searched in different databases and bibliographies of relevant review articles. The comprehensiveness of the search will be tested through a list of benchmark articles identified by the protocol development team. The screening will be performed at title and abstract level and at full text level, including repeatability tests. Eligible populations are organic agricultural soils in temperate and boreal climate regions. Interventions are grasslands without tillage for at least 3 years, and comparators are annual cropping systems within the same study as the intervention. The outcome must be gas fluxes of either carbon dioxide (CO2), nitrous oxide (N2O), or methane (CH4), or any combination of these gases. Studies will go through critical appraisal, checking for internal and external validity, and finally data extraction. If possible, a meta-analysis about the climate impact of perennial green fallow compared to annual cropping on organic soils will be performed.
Moral disengagement, self-control and callous-unemotional traits as predictors of cyberbullying: a moderated mediation model
Authors: Li Haojian , Guo Qi , Hu Ping
Published: August 2023

Background

Cyberbullying has become more prevalent, more difficult to detect, and more harmful to the victims. Whereas considerable prior work has investigated predictors and consequences of cyberbullying, additional research is needed to better understand the mechanisms by which these factors relate to cyberbullying perpetration and victimization. The goal of the present study was to examine the extent to which the link between individual differences in moral disengagement and cyberbullying perpetration is mediated by low self-control and, if so, whether this mediation effect varies by individuals’ degree of callous-unemotional traits.

Method

To explore these questions, we used cyberbullying, moral disengagement, self-control, and callous-unemotional traits scales and collected online survey data from a sample of 860 Chinese internet users aged 18 years old or older.

Result

As hypothesized, a significant positive relation between moral disengagement and cyberbullying emerged that was mediated by individual differences in self-control. Additionally, evidence of moderated mediation was found. That is, the indirect effect varied by degree of callous-unemotional traits, with a significantly stronger mediation effect (and association between self-control and cyberbullying) for individuals who were relatively higher in callous-unemotional traits.

Conclusion

We conclude that moral disengagement partially predicts cyberbullying through self-control, while callous-unemotional traits moderate the pathway between self-control and cyberbullying.
The Musashi RNA-binding proteins in female cancers: insights on molecular mechanisms and therapeutic relevance
Authors: Sicking Mark , Falke Isabel , Löblein Maria T. , Eich Hans Th. , Götte Martin , Greve Burkhard , Troschel Fabian M.
Published: August 2023

RNA-binding proteins have increasingly been identified as important regulators of gene expression given their ability to bind distinct RNA sequences and regulate their fate. Mounting evidence suggests that RNA-binding proteins are involved in the onset and progression of multiple malignancies, prompting increasing interest in their potential for therapeutic intervention.

The Musashi RNA binding proteins Musashi-1 and Musashi-2 were initially identified as developmental factors of the nervous system but have more recently been found to be ubiquitously expressed in physiological tissues and may be involved in pathological cell behavior. Both proteins are increasingly investigated in cancers given dysregulation in multiple tumor entities, including in female malignancies. Recent data suggest that the Musashi proteins serve as cancer stem cell markers as they contribute to cancer cell proliferation and therapy resistance, prompting efforts to identify mechanisms to target them. However, as the picture remains incomplete, continuous efforts to elucidate their role in different signaling pathways remain ongoing.

In this review, we focus on the roles of Musashi proteins in tumors of the female – breast, endometrial, ovarian and cervical cancer – as we aim to summarize current knowledge and discuss future perspectives.
Sensitivity of slip distribution on tsunami trace heights and geological evidences: a case study of the 2011 Tohoku-Oki earthquake
Authors: Kusumoto Satoshi , Imai Kentaro , Hori Takane , Sugawara Daisuke , Satake Kenji
Published: August 2023

We examined whether it is possible to estimate the tsunami source model of the 2011 Tohoku-Oki earthquake from a comparison of numerical simulations of tsunami propagation and sediment transport, the measured trace heights, and the sediment thickness of tsunami deposits. Twelve models with different subfault numbers were prepared based on a reference model inferred from tsunami waveform inversion. The reference model with 55 subfaults considering rupture propagation and the model with instantaneous slip successfully reproduced both the tsunami trace heights and sediment thickness distribution of tsunami deposits in the Idagawa Lowland and Sendai Plain. Other models with the same moment magnitude but fewer subfaults could not reproduce the observed trace heights, and the reproducibility of sediment thickness distribution strongly depended on the slip distribution. Models with increased slip amounts and moment magnitude could reproduce the trace heights; however, the simulated sediment thickness was underestimated for the Idagawa Lowland while overestimated for the Sendai Plain. Our results indicate that the combination of trace heights, sediment thickness of tsunami deposits, and numerical simulations of tsunami propagation and sediment transport can be used to estimate historical earthquakes and tsunamis. Efforts should be made to increase the number of subfaults for the study of historical events, although the obtained solutions may not be unique because of fewer trace heights or tsunami deposit data.
Implementation resources to support teachers’ use of behavioral classroom interventions: protocol of a randomized pilot trial
Authors: Lawson Gwendolyn M. , Owens Julie Sarno , Mandell David S. , Tavlin Samantha , Rufe Steven , Lyon Aaron R. , Eiraldi Ricardo , Power Thomas J.
Published: August 2023

Background

Teacher-delivered behavioral classroom management interventions are effective for students with or at-risk for attention-deficit/hyperactivity disorder (ADHD) or other disruptive behavior challenges, but they can be difficult for teachers to use in the classroom. In this study, we will pilot test a package of implementation strategies to support teachers in using behavioral classroom interventions for students with ADHD symptoms.

Methods

We will use a 2-group, randomized controlled trial to compare outcomes for teachers who receive Positive Behavior Management Implementation Resources (PBMIR), a theory and data-driven implementation resource package designed to increase teacher implementation of behavioral classroom management interventions, with those who do not receive this additional implementation support. We will measure teacher implementation outcomes (e.g., observed fidelity to behavioral classroom interventions) and student clinical outcomes (e.g., ADHD-related impairment, ADHD symptoms, student–teacher relationship, academic performance) before and after an 8-week intervention period for both groups; we will also measure teacher-reported acceptability, appropriateness, and feasibility for the PBMIR group following the intervention period.

Discussion

If there is preliminary evidence of feasibility and effectiveness, this pilot study will provide the foundation for evaluation the PBMIR at a larger scale and the potential to improve outcomes for students with or at risk for ADHD.

Trial registration

This clinical trial was registered at ClinicalTrials.gov. (https://clinicaltrials.gov/) on 8/5/2022 which was prior to the time of first participant enrollment. The registration number is: NCT05489081.
The combined application of bleomycin with triamcinolone acetonide in port wine stains: inhibiting proliferation and recurrence of port wine stains
Authors: Luo Quan-Feng
Published: August 2023

Background

Port wine stains slowly grow thicker over time, nodules appear on the surface, and the color slowly deepens from pink to purple. Even after laser treatment, some port wine stains will recur and slowly grow, and the erythema appears again. The purpose of this study was to investigate the effectiveness of bleomycin in combination with triamcinolone acetonide in the treatment of inhibiting the proliferation and recurrence of port wine stains.

Results

Histopathological change: Before treatment, dense capillaries were distributed within the lesion, and blood fills the lumen. Lack of normal skin structure: After bleomycin and triamcinolone acetonide injection, the number of capillaries was significantly reduced, and fibrosis occurred in tissues. Changes in facial morphology: After treatment, the port wine stains became thinner, the asymmetry of the face was effectively improved, and the appearance have been significantly improved. After 5 years of follow-up, there were no recurrent cases.

Conclusion

Bleomycin and triamcinolone acetonide injection can effectively inhibit the proliferation of port wine stains and prevent port wine stains from recurring after treatment.
Sex-specific prevalence, awareness, treatment and control of hypertension in adults in India: a study for developing sex-specific public policy from the longitudinal ageing study in India (LASI) data 2017–2018
Authors: Singh Ayushi , Dixit Priyanka
Published: August 2023

Background and objective

Hypertension is a key risk factor for cardiovascular disease and the leading cause of mortality among Indian adults. The difference in health status between men and women is becoming a great burden in itself worldwide. This study aimed to examine the differences between men and women in the prevalence, awareness, treatment, and control of hypertension and related risk factors among people aged 45 and older in India using data from the Longitudinal Ageing Study in India in 2017–2018.

Methods

Descriptive statistics were presented separately for males and females. Multivariable logistic regression was used to analyze the socio-demographic, lifestyle behaviours, and biological factors associated with the prevalence of hypertension. All statistical analyses were conducted using Stata Version 16.0 statistical software. The study of the data was conducted using survey weights available in the LASI datasets.

Key findings

Overall, the study found that 45.1% of the study population had hypertension, with 26.9% self-reporting their condition and 30% having hypertension at the time of measurement. Approximately 41% of males and 59% of females had hypertension. The self-reported hypertension of men was found to differ significantly from measured hypertension by 8.7%, while in women the difference was only 1.2%. Diabetes was found to increase the odds of having hypertension in both males (OR = 3.65, 95% CI (3.37–3.97)) and females (OR = 3.46, 95% CI (3.21–3.74)).

Conclusion

The difference between self-reported and measured hypertension in men and women is contributing to sex-gender and health inequalities that must be addressed. For adult females with hypertension, it is important to prioritize obesity, education level, physical activity, and regular clinic visits to manage chronic conditions. Based on our findings, policy recommendations can be made to focus on increasing women's literacy, promoting men's screening for hypertension, banning tobacco and alcohol sales, and organizing hypertension awareness campaigns specifically for men and in rural areas.
Community perceptions on the effectiveness of herbal medicines and factors associated with their use in managing diarrhoea among under-five children in North-eastern Tanzania
Authors: Liheluka Edwin , Gibore Nyasiro Sophia , Lusingu John P. A. , Gesase Samwel , Minja Daniel T. R. , Lamshöft Maike , Dekker Denise , Bali Theodora
Published: August 2023

Background

The demand for herbal medicines continues to increase globally. However, community perceptions on their effectiveness and factors influencing their use have not been extensively investigated, notably in the Tanga Region, North-eastern Tanzania, where their use in treating various diseases, including paediatric diarrhoea, has flourished. According to studies, Tanga Region has a high prevalence of diarrhoea among under-five children. This study explored community perceptions on the effectiveness of herbal medicines and factors associated with their use in managing diarrhoea among under-five children in North-eastern Tanzania.

Methods

A qualitative approach and a narrative design were employed by the present study since they had the potential to reveal unrecognized or unreported research problems. Focus group discussions and in-depth interviews were used to facilitate data collection from June 2022 to February 2023. The methods were chosen since they are the most common sources of qualitative data in health research. Purposive sampling method was used to select 247 participants, which included 171 caretakers, 52 traditional healers, and 24 paediatric health workers. Interviews were conducted until the saturation point was reached. The purposive technique was considered since it was a method that enabled the researcher to select participants who were knowledgeable about the study topic. Data analysis was performed using thematic analysis.

Results

Economic hardship, culture and heritage, superstitious beliefs, failure to recover after receiving hospital medication, easy accessibility of herbal medicines, and long distance to the health facility were the factors perceived to be potentially associated with persistent use of herbal medicines among caretakers. The majority of participants believed that herbal treatments were harmless and effective in treating diarrhoea.

Conclusion

Superstitious beliefs, culture, and heritage were the primary justifications for using herbal medicines. It is vital for the relevant authority to educate the community on the risk of using unproven herbal medicines in order to diminish the effects that may arise from using uninvestigated herbs. As things stand, the use of herbal medications will continue owing to their relevance to the lives of people in the study setting.
Extra-musculoskeletal manifestations driving the therapeutic decision-making in patients with Spondyloarthritis: a 12-month follow-up prospective cohort study
Authors: dos Reis Annunciato Danielle , Oliveira Thauana Luiza , Magalhães Vanessa Oliveira , de Medeiros Pinheiro Marcelo
Published: August 2023

Background

The extra-musculoskeletal manifestations (EMMs) such as recurrent acute anterior uveitis (rAAU), psoriasis (Ps), and inflammatory bowel disease (IBD), are related to the Spondyloarthritis (SpA), as well as they are associated with disease activity and poor prognosis. However, there are no data addressing its relevance regarding therapeutic decision-making in clinical practice.

Objective

To evaluate the impact of EMMs to drive the treatment decision-making in patients with SpA in a 12-month follow-up.

Patients and methods

SpA patients, according to the axial and peripheral ASAS classification criteria, as well as CASPAR criteria, with any active EMM, defined as main entry criteria, were included in this longitudinal cohort study. Individuals with a history of any disease or condition that could be associated with some of the studied endpoints, including neoplasms and infectious diseases, were excluded. Specific tools related to each EMM, including Psoriasis Area Severity Index (PASI), ophthalmologic evaluation, according to the Standardization of Uveitis Nomenclature (SUN) criteria, and gut complaints were used at baseline and during the 3-, 6- and 12-month of follow-up as outcomes measures over time. Descriptive and inferential analyses were used appropriately, including Pearson’s correlation test, chi-squared test, and ANOVA. P value less than 0.05 was considered as significant.

Results

A total of 560 patients were enrolled, of whom 472 meet the eligibility criteria. The majority (N = 274; 59.6%) had one or more EMM related to SpA umbrella concept. Among the EMM, the one that most influenced therapeutic decision-making was psoriasis (28.5%), followed by uveitis (17.5%) and IBD (5.5%), regardless of musculoskeletal manifestations. Clinical improvement of EMMs outcomes was observed in most patients over 12-month follow-up, especially in those with rAAU and IBD (P < 0.001).

Conclusion

Our results showed that EMMs guided the therapeutic decision-making in half of SpA patients, regardless of musculoskeletal condition, suggesting the inter-disciplinarity among the rheumatologist, ophthalmologist, dermatologist, and gastroenterologist plays a crucial role to manage them.
Cultivation system influenced the critical period for weed control in cotton field
Authors: Ghalenovi Narges , Armin Mohammad , Jami Moeini Matin
Published: August 2023

Background

The critical period of weed control (CPWC) refers to the period of time during the crop growth cycle when weeds must be controlled to prevent yield losses. Ultra-narrow row (UNR) is a method of planting of cotton in rows that are 25 cm or less apart. Amongst cultural techniques for weed control, the use of narrow row spacing is considered to be a most promising approach that can effectively suppress weed growth and provide greater yields in cotton. This cultivation system can shorten the length of the critical weed-crop interference duration and results in greater yield. The current research aimed to determination of critical time of weed control in cotton (Gossypium hirsutum L.) under conventional and ultra-narrow row spacing conditions. Field experiments were arranged as factorial experiment in a randomized complete block design with three replications. Factors were cultivation system (conventional (50 cm row spacing) and ultra narrow row (25 cm row spacing and weed treatment including 30, 45, 60, and 75 days weeding after emergence during the growing season (weed free), and 30, 45, 60, and 75 without weeding (weed infested) in the growing season along with weedy and weed-free from sowing to harvesting. A four-parameter log-logistic model was fit to the two sets of relating relative crop yield to data obtained from increasing durations of weed interference and lengths of weed-free period.

Results

In both years and cultivation systems, the relative yield of cotton decreased with the increasing duration of weed-interference but increased with the increasing duration of weed-free period. Ultra-narrow row cultivation delayed the beginning of the CPWC in cotton. Under ultra-narrow row condition, the CPWC ranged from 21 to 99 days after germination in 2021 and 23 to 91 days in 2022 based on the 5% acceptable yield loss. Under conventional cultivation CPWC ranged from 17 to 102 days after emergence in 2021 and 18 to 95 days after emergence in 2022.

Conclusions

Under both conventional and Ultra-narrow row conditions, weed interference reduces seed yield. Under ultra-narrow row condition, weed interference until 21.1–23.5 days after cotton emergence and under conventional condition, weed interference until 16.9–18.5 days after cotton emergence had not significant reduction on cotton yield.
Role of magnetic resonance diffusion tensor imaging in assessment of back muscles in young adults with chronic low back pain
Authors: Shady Magda Mohammed , Abd El-Rahman Rehab Mostafa , Saied Ahmed Mostafa Mohamed , Taman Saher Ebrahim
Published: August 2023

Background

Low back pain (LBP) is one of the most common musculoskeletal complaints and considered as the most disabling condition among general population. Magnetic resonance imaging (MRI) is the preferred modality in imaging of LBP. Diffusion tensor imaging (DTI) is a version of MRI that can detect tissue microstructure changes occurring in different pathologies. The commonly used parameters are fractional anisotropy (FA) and mean diffusivity (MD). We aimed in this study to evaluate the role of DTI in the assessment of back muscles in young adults with chronic LBP with no major neurological or orthopedic disorders.

Results

There was a statistically significant difference in MD values of back muscles between patients and control groups. At the ROC curve, for psoas muscle, the AUC was 0.906 with a cutoff point of 0.951. Sensitivity and specificity were 89.2% and 90.9% with accuracy 89.8%. For multifidus muscle, the AUC was 0.919 with a cutoff point of 1.29. Sensitivity and specificity were 91.9% and 90.9% with accuracy 91.4%. For erector spinae muscle, the AUC was 0.834 with a cutoff point of 1.224. Sensitivity and specificity were 81.1% and 72.7% with accuracy 77.9%. There was a statistically significant difference in FA values of back muscles between the patients and control groups. At the ROC curve, for psoas muscle, the AUC was 0.840 with a cutoff point of 0.546. Sensitivity and specificity were 81.1% and 72.7% with accuracy 77.97%. For multifidus muscle, the AUC was 0.875 with a cutoff point of 0.415. Sensitivity and specificity were 81.1% and 90.9% with accuracy 84.7%. For erector spinae muscle, the AUC was 0.805 with a cutoff point of 0.437. Sensitivity and specificity were 81.1% and 77.3% with accuracy 79.7%.

Conclusions

DTI is a valuable promising noninvasive tool in the assessment of back muscles quality in patient with chronic low back pain, with no detected neurological or orthopedic pathologies. This is due to its sensitivity to microscopic intracellular changes that could not be detected on conventional imaging, allowing better tissue characterization.
Impact of financial inclusion on household welfare in Ethiopia
Authors: Hussen Mohammed Seid , Mohamed Mustafe Abdi
Published: August 2023

Despite the overwhelming consensus on the positive effect of financial inclusion on economic outcomes, there is limited rigorous micro-econometric evidence on the causal impact of financial inclusion on household welfare in Ethiopia. This study uses the 2018 Ethiopian Socioeconomic Survey data and an endogenous switching regression model to investigate the determinants and the causal impact of financial inclusion on multiple measures of household welfare. The results suggest that households headed by older, more educated, wage or self-employed people in the non-agricultural sector are more likely to access financial services, as are those headed by non-Muslims. In addition, greater financial access appears to be associated with membership in a local social group (iddir), ownership of mobile phones, credit information, and knowledge of how to open bank accounts, but negatively associated with the distance from the household’s residence to the nearest formal financial institution. This study further indicates that financial inclusion has a positive and statistically significant impact on multiple household welfare indicators. The most considerable impact of access to formal financial institutions is on utility spending, followed by total expenditure, food expenditure, and education spending. These findings thus suggest that policies geared toward improving household access to formal financial institutions are essential to enhance household welfare in Ethiopia.
Three-dimensional distributed acoustic sensing at the Sanford Underground Research Facility
Authors: Cunningham Erin , Lord Neal , Fratta Dante , Chavarria Andres , Thurber Cliff , Wang Herb
Published: August 2023

Distributed acoustic sensing (DAS) is a valuable tool for monitoring seismic signals as it provides high spatial and temporal resolution strain sensing along the length of a fiber-optic cable. DAS records the seismic wavefields essentially synchronously at each sensing location (i.e., sensing channel with gauge lengths) because the interrogator senses the distributed strain at the speed of light in the fiber. Unlike traditional seismic sensors, DAS has an intrinsic directional sensitivity to the axial strain change along the fiber, leading to difficulties when using standard seismic analysis and interpretations that rely on 3D particle velocity sensing. In addition, cable deployments on the surface can be dominated by high-amplitude wind or urban noise, impeding the detection of low-amplitude distant seismic sources. Here we investigate the capabilities of a unique 3D array with spiral-like portions in the Sanford Underground Research Facility (SURF), the former Homestake Mine, between 1250 m (4100 ft) and 1488 m (4850 ft) in depth for detecting local, regional, and teleseismic sources of ground vibrations. Our pilot array finds that DAS records high frequency (above 5 Hz) vibration sources well, such as mine activities and local and regional blasting events. Furthermore, our deployment method (fiber resting on the surface with rocks placed every meter or so) may contribute to low-frequency noise that contaminates the interpretation of teleseismic waves, particularly lower frequency S-wave arrivals. Nevertheless, this 3D DAS array provides significant data for future analysis as well as the basis for improving and expanding the array in SURF.
Locoregional Thermal and Chemical Tumor Ablation: Review of Clinical Applications and Potential Opportunities for Use in Low- and Middle-Income Countries
Authors: Quang Tri T. , Yang Jeffrey , Mikhail Andrew S. , Wood Bradford J. , Ramanujam Nimmi , Mueller Jenna L.
Published: August 2023

This review highlights opportunities to develop accessible ablative therapies to reduce the cancer burden in LMICs.
Financial Toxicity Monitoring in a Randomized Controlled Trial of Patient-Reported Outcomes During Cancer Treatment (Alliance AFT-39)
Authors: Blinder Victoria S. , Deal Allison M. , Ginos Brenda , Jansen Jennifer , Dueck Amylou C. , Mazza Gina L. , Henson Sydney , Carr Philip , Rogak Lauren J. , Weiss Anna , Rapperport Anna , Jonsson Mattias , Spears Patricia A. , Cella David , Gany Francesca , Schrag Deborah , Basch Ethan
Published: August 2023

PURPOSE

Financial toxicity (FT) affects 20% of cancer survivors and is associated with poor clinical outcomes. No large-scale programs have been implemented to mitigate FT. We evaluated the effect of monthly FT screening as part of a larger patient-reported outcomes (PROs) digital monitoring intervention.

METHODS

PRO-TECT (AFT-39) is a cluster-randomized trial of patients undergoing systemic therapy for metastatic cancer. Practices were randomly assigned 1:1 to digital symptom monitoring (PRO practices) or usual care (control practices). Digital monitoring consisted of between-visit online or automated telephone patient surveys about symptoms, functioning, and FT (single-item screening question from Functional Assessment of Chronic Illness Therapy-COmprehensive Score for financial Toxicity) for up to 1 year, with automated alerts sent to practice nurses for concerning survey scores. Clinical team actions in response to alerts were not mandated. The primary outcome of this planned secondary analysis was development or worsening of financial difficulties, assessed via the European Organisation for Research and Treatment of Cancer QLQ-C30 financial difficulties measure, at any time compared with baseline. A randomly selected subset of patients and nurses were interviewed about their experiences with the intervention.

RESULTS

One thousand one hundred ninety-one patients were enrolled (593 PRO; 598 control) at 52 US community oncology practices. Overall, 30.2% of patients treated at practices that received the FT screening intervention developed, or experienced worsening of, financial difficulties, compared with 39.0% treated at control practices ( P = .004). Patients and nurses interviewed stated that FT screening identified patients for financial counseling who otherwise would be reluctant to seek, or unaware of the availability of, assistance.

CONCLUSION

In this report of a secondary outcome from a randomized clinical trial, FT screening as part of routine digital patient monitoring with PROs reduced the development, or worsening, of financial difficulties among patients undergoing systemic cancer therapy.
Effect of a Community Health Worker–Led Intervention Among Low-Income and Minoritized Patients With Cancer: A Randomized Clinical Trial
Authors: Patel Manali I. , Kapphahn Kris , Wood Emily , Coker Tumaini , Salava Deborah , Riley Angela , Krajcinovic Ivana
Published: August 2023

PURPOSE

To determine whether a community health worker (CHW)–led intervention could improve health-related quality of life (HRQoL; primary outcome) more than usual care among low-income and racial and ethnic minoritized populations newly diagnosed with cancer.

METHODS

This randomized clinical trial was conducted from November 1, 2018, until August 31, 2021, in outpatient cancer clinics in Atlantic City, NJ, and Chicago, IL. Hourly low-wage worker members of an employer union health fund age 18 years or older with newly diagnosed solid tumor and hematologic malignancies were randomly assigned 1:1 to usual care (control group) or usual care augmented with a trained CHW for 12 months (intervention group). The CHW assisted participants with advance care planning (ACP), proactively screened symptoms, and referred participants to community-based resources for identified health-related social needs. Usual care comprised nurse case management and benefits redesign (waived copayments and free transportation for any cancer care received at preferred oncology clinics in each city). The primary outcome was HRQoL. Secondary outcomes included patient activation, satisfaction with decision, ACP documentation, health care use, total health care costs, and overall survival.

RESULTS

A total of 160 participants were enrolled. Intervention group participants had a greater increase in mean HRQoL scores at 4-month and 12-month follow-up as compared with baseline than control group participants (expected mean difference, 11.25 [95% CI, 7.28 to 15.22]; 11.29 [95% CI, 6.96 to 15.62], respectively).

CONCLUSION

In this randomized trial, a CHW-led intervention significantly improved HRQoL for low-income and racial and ethnic minoritized patients with cancer more than usual care alone.
Susceptibility to Low Vitamin B6 Diet–induced Gestational Diabetes Is Modulated by Strain Differences in Mice
Authors: Spinelli Philip , Fields Ashley M , Falcone Sierra , Mesaros Clementina , Susiarjo Martha
Published: August 2023

Gestational diabetes is a common pregnancy complication that adversely influences the health and survival of mother and child. Pancreatic islet serotonin signaling plays an important role in β-cell proliferation in pregnancy, and environmental and genetic factors that disrupt serotonin signaling are associated with gestational diabetes in mice. Our previous studies show that pregnant C57BL/6J mice fed a diet that is low in vitamin B6, a critical co-factor in serotonin synthesis, develop hyperglycemia and glucose intolerance, phenotypes that are consistent with gestational diabetes in humans. The current study shows that, unlike in the C57BL/6J mice, low vitamin B6 diet does not alter glucose tolerance and insulin secretion in pregnant DBA/2J mice. The hypothesis to be tested in the current study is that pregnant DBA/2J mice are protected against low vitamin B6–induced gestational diabetes due to their higher expression and enzymatic activities of tissue nonspecific alkaline phosphatase (ALPL) relative to C57BL/6J. ALPL is a rate-limiting enzyme that regulates vitamin B6 bioavailability. Interestingly, treating pregnant DBA/2J mice with 7.5 mg/kg/day of the ALPL inhibitor SBI-425 is associated with glucose intolerance in low vitamin B6–fed mice, implying that inhibition of ALPL activity is sufficient to modulate resilience to low vitamin B6–induced metabolic impairment.
Beyond Bananas
Authors: Raby Megan
Published: August 2023

From 1926 to 1974, the United Fruit Company operated the Lancetilla Experiment Station near Tela, Honduras. As a laboratory and botanical garden where one of the world's largest living collections of tropical fruits could be found, it stood in apparent contrast to the vast banana monocultures of the surrounding area. While United Fruit's infamous plantations depended on the application of pesticides and chemical knowledge to produce a single commodity crop, its Lancetilla Experiment Station pursued a broad research program oriented toward agricultural diversification. This essay examines the history of Lancetilla to explore the company's sponsorship of science and the multiple, shifting meanings of “diversification” within this prototypical transnational agribusiness. The history of experimentation at Lancetilla reveals a range of contested visions of economic development in twentieth-century Latin America, and it is a history that has left surprising traces in both local Honduran landscapes and the face of global agribusiness today. Ultimately, by introducing oil palm to Central America, United Fruit's crop diversification project served to replace one monoculture with another.