bluuebunny/crossref_metadata_2025 huggingface dataset:
Baseline Characteristics of Pediatric Patients With Heart Failure Due to Systemic Left Ventricular Systolic Dysfunction in the PANORAMA-HF Trial
Authors: Shaddy Robert , Burch Michael , Kantor Paul F. , Solar-Yohay Susan , Garito Tania , Zhang Sijia , Kocun Michele , Bonnet Damien
Published: January 2023

Background:

Sacubitril/valsartan has been approved for the management of heart failure (HF) with reduced ejection fraction in adults. PANORAMA-HF trial (Prospective Trial to Assess the Angiotensin Receptor Blocker Neprilysin Inhibitor LCZ696 Versus Angiotensin-Converting Enzyme Inhibitor for the Medical Treatment of Pediatric HF) investigated its effects on clinical outcomes in pediatric patients with HF.

Methods:

PANORAMA-HF is a multicenter, Phase II/III study using an adaptive, seamless, 2-part design. The study aimed to evaluate the pharmacokinetics and pharmacodynamics of single doses of sacubitril/valsartan (Part 1), and the efficacy and safety of sacubitril/valsartan versus enalapril administered twice daily for 52 weeks (Part 2) in pediatric patients with HF due to left ventricular systolic dysfunction with biventricular heart physiology. An innovative trial design using a novel global rank assessment of severity was employed. For analysis, eligible patients were stratified into 3 age groups (Group 1, 6 to <18 years; Group 2a, 2 to <6 years; and Group 3a, 1 month to <2 years) and functional classification (New York Heart Association/Ross class I/II and III/IV).

Results:

We report the key demographic, baseline, and clinical characteristics of 375 pediatric patients randomized to receive the study medication. The mean age for patients in Groups 1, 2a, and 3a was 12.2, 3.2, and 1.3 years, respectively. About 70% of patients had a prior HF hospitalization, 85% had New York Heart Association/Ross class I/II HF, and ≈8% were angiotensin-converting enzyme inhibitor/angiotensin receptor blocker naïve.

Conclusions:

Compared to other pediatric HF studies, PANORAMA-HF recruited a relatively homogeneous pediatric HF population across 3 age groups, enabling a more robust evaluation of pharmacokinetics/pharmacodynamics and efficacy/safety of sacubitril/valsartan. Most patients had mildly symptomatic HF at baseline.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT02678312.
Pilgrimage Space, Hinduization of Space, Hindutva Politics of Space, and the Case of Ayodhyā as a Religious and Religiopolitical Hotspot
Authors: Jacobsen Knut A.
Published: January 2023

In this article I analyze aspects of religious geography in the mobilization by Hindu nationalists in India in the 1980s and 1990s and how Hindu nationalism and Hindu religious geography were merged in the case of the Ayodhyā conflict. Ayodhyā was consciously changed from a pilgrimage center (tīrtha) of diminishing religious importance into a religiopolitical hotspot by political forces. The potential for a Hindu–Muslim conflict and for mobilizing support for their vision of a Hinduized India was probably what made the place attractive for Hindu nationalists. The article argues that Hindu nationalism exploited the views of territoriality of traditions of pilgrimage and salvific space and merged these with their political nationalist agenda, and that it was this blending of views of space from the pilgrimage traditions, ideas of national territory, and Hindu nationalists’ ideas of a homogeneous Hindu nation with aggressive political agitation that turned Ayodhyā into a religiopolitical hotspot.
Locality Bias Effect and Interpretation of Thai Reflexive Anaphors
Authors: Supwatanapaisan Gazidate , Ratitamkul Theeraporn
Published: January 2023

The two forms of Thai reflexive anaphors, tuaɁeeŋ ‘self’ and tua+pronoun+Ɂeeŋ ‘pronoun-self’, have been claimed to exhibit different referential patterns. While tuaɁeeŋ only co-refers with a local antecedent np within the same clause, tua+pronoun+Ɂeeŋ can refer to both local and distant antecedent np s. In this study, a self-paced reading experiment was used to examine whether and how Locality Bias guided the comprehenders’ online interpretation of tuaɁeeŋ and tua+pronoun+Ɂeeŋ. Our results showed that the reading time was significantly faster when a reflexive anaphor referred to a local np than when it did to a a distant np, regardless of the forms. This suggests that a local antecedent was preferred for both types of reflexives manifesting locality bias effect. Post hoc tests revealed that tua+pronoun+Ɂeeŋ appeared to be more sensitive to the locality bias than tuaɁeeŋ. This may result from the presence of the personal feature in tua+pronoun+Ɂeeŋ, which could restrict reference to local antecedents.
Connecting Ships: Using Dendrochronological Network Analysis to Determine the Wood Provenance of Roman-Period River Barges Found in the Lower Rhine Region and Visualise Wood Use Patterns
Authors: Visser Ronald M. , Vorst Yardeni
Published: January 2023

This study combines standard dendrochronological analyses with network science and spatial analysis to determine the provenance of wood used to build river barges in the Roman period. The river barges studied were found in the Lower Rhine region and would have carried bulk goods, such as grain, military supplies, and building materials. The importance of these vessels in the supply of the local economy and military units is evident since many were found in the area, including some in the vicinity of military complexes. However, it remains unknown where these ships were built and how and where the raw materials for their construction were obtained. To better understand the provenance of the wood, network science was applied to visualise and understand the complex patterns of similarity between the tree-ring curves. For the interpretation of the networks we have studied the context, the position of the trees in the network and the use of these trees in shipbuilding. In addition, the shape of the converted timber was used to visualise the wood use patterns in this type of Roman-period shipbuilding. For the river barges, we were able to determine several possible regions for wood procurement. Based on the analysed material, we assume that there was at least one shipyard in the Lower Rhine region where two ships, found in separate excavations, were most likely produced at the same time.
Upper-Oceanic Warming in the Gulf of Mexico between 1950 and 2020
Authors: Wang Zhankun , Boyer Tim , Reagan James , Hogan Patrick
Published: January 2023

We estimate ocean heat content (OHC) change in the upper 2000 m in the Gulf of Mexico (GOM) from 1950 to 2020 to improve understanding of regional warming. Our estimates are based on 192 890 temperature profiles from the World Ocean Database. Warming occurs at all depths and in most regions except for a small region at northeastern GOM between 200 and 600 m. GOM OHC in the upper 2000 m increases at a rate of 0.38 ± 0.13 ZJ decade−1 between 1970 and 2020, which is equivalent to 1.21 ± 0.41 terawatts (TW). The GOM sea surface temperature (SST) increased ∼1.0° ± 0.25°C between 1970 and 2020, equivalent to a warming rate of 0.19° ± 0.05°C decade−1. Although SST in the GOM increases at a rate approximately twice that for the global ocean, the full-depth ocean heat storage rate in the GOM (0.86 ± 0.26 W m−2) applied to the entire GOM surface is comparable to that for the global ocean (0.82–1.11 W m−2). The upper-1000-m layer accounts for approximately 80%–90% of the total warming and variations in the upper 2000 m in the GOM. The Loop Current advective net heat flux is estimated to be 40.7 ± 6.3 TW through the GOM. A heat budget analysis shows the difference between the advective heat flux and the ocean heat storage rate (1.76 ± 1.36 TW, 1992–2017) can be roughly balanced with the annual net surface heat flux from ECCO (−37.9 TW).
A Vanishing Food Infrastructure: The Closure of Food Outlets in Flint in a Pandemic Era
Authors: Bell Ashley , Taylor Dorceta E.
Published: January 2023

Most food access studies focus on large cities, examine traditional grocery stores, and only consider operational food outlets. This siloed approach exposes a gap in food access literature. Therefore, as a part of our assessment of Flint’s food landscape, we examined closed food outlets in the city and surrounding townships. We investigated the relationship between the racial composition of census tracts and the number and type of defunct food outlets identified. We used Data Axle to collect and verify data on open and closed food outlets between September 2020 and December 2021. We made a final verification of the food outlet closures in June 2022. We used ArcGIS 10.8.1 and SPSS Version 28 to map and analyze the data. We used negative binomial regression models to determine differences in the likelihood of having an additional closed food outlet in census tracts with low and high percentages of Black residents. We also investigated the relationship between a census tract’s median income and the likelihood of having an additional closed food outlet. There were 173 closed food outlets; 81 were in Flint, and 92 were in surrounding townships. The most frequently closed food outlets were restaurants; they accounted for 45.1% of the closures. The mean number of closed food venues in census tracts where less than 40% of the residents were Black was 1.5. The mean was similar in census tracts where 40% or more of the residents were Black; it was 1.6. This difference was not significant. However, the median income of a census tract was a significant predictor of the likelihood of having an additional closed food outlet. Every one-thousand-dollar increase in median income resulted in a 2% less likelihood of having an additional closed food outlet. The results of this study show that there is more to the food landscape of a city than its operational food outlets. Focusing exclusively on active food outlets does not accurately depict a city's food infrastructure.
Glycated albumin and post-transplant diabetes mellitus in kidney transplant recipients
Authors: Bleskestad Inger H , Skadberg Øyvind , Åsberg Anders , Gøransson Lasse G
Published: January 2023

Background

Post-transplant diabetes mellitus is one of the most important cardiovascular risk factors after solid organ transplantation. Factors other than hyperglycaemia found in patients post-transplant, affect the level of haemoglobin A1c (HbA1c), and new markers of hyperglycaemia are needed. Our aim was to establish a 95% reference interval for glycated albumin in kidney transplant recipients, and to compare glycated albumin concentrations to the diagnostic criteria for diabetes mellitus post-transplant using oral glucose tolerance test and HbA1c.

Methods

A total of 341 non-diabetic kidney transplant recipients aged ≥18 years who underwent an oral glucose tolerance test at 8 weeks and 1 year after transplantation were included. Glycated albumin was determined by liquid chromatography coupled with tandem mass spectrometry.

Results

The 95% reference interval for glycated albumin was 8.2 (90% CI: 7.2–8.5) to 12.8% (90% CI: 12.2–13.5) which is not significantly different from our laboratory’s 95% reference interval for persons without diabetes. At both 8 weeks and 1 year after transplantation, 35 patients (10.3%) fulfilled one, two or all three diagnostic criteria for diabetes mellitus. One year after transplantation, eight additional patients had glycated albumin concentration >12.8%.

Conclusion

Our findings are in accordance with the notion that kidney transplant recipients form glycation end products like normal controls as estimated by glycated albumin and HbA1c. Further studies should address glycated albumin as a supplemental tool for the diagnosis of post-transplant diabetes mellitus in kidney transplant recipients.
Social Disadvantages and Intergenerational Solidarity Views From Older Adults: A Qualitative Study
Authors: Fragoso António , Valadas Sandra T. , Paulos Liliana
Published: January 2023

In this article we aim at understanding the influence of social disadvantages on intergenerational solidarity. For this study, we have considered biographical research through narratives. These narratives help explain and reflect on the beliefs of the participants, implicit theories, and their life experiences. A snowball sampling technique was considered, and the data were collected by means of 58 narrative interviews with men aged between 60 and 93 years of age, living in urban and rural areas of southern Portugal. The interviews were conducted face-to-face in the participants’ houses or community centers. Content analysis was performed and our results indicated that a low educational background was determinant in the trajectories of these men. Unqualified or low qualified occupations and, in consequence, low financial capital, had both a direct and indirect effect on various domains of life. As a result, a significant part of the men live in poverty, and many others experience a very difficult situation. The results also revealed that social disadvantages had an impact on structural, functional, and associational solidarities. The levels of intergenerational exchanges are reduced and unsatisfying. Our study suggests that social class is a key factor in explaining the inequalities of older adults and also influences intergenerational solidarity at a family level.
Framework for Economic Potential Analysis of Marine Transportation: A Case Study for Route Choice Between the Suez Canal Route and the Northern Sea Route
Authors: Wang Yangjun , Zhang Ren , Liu Kefeng , Fu Delong , Zhu Yingqian
Published: January 2023

This paper presents a new framework for economic analysis of marine transportation, where uncertainty is given more attention than in the current research. A new quantitative method combined with the importance ranking method is used to access the uncertainty of evidence and for fusion of evidence from multiple sources. The Bayesian network model is chosen as a tool to convey the uncertainty from one variable to another variable. Finally, with the help of information flow method, key factors are selected for sensitivity analysis. This framework is applied to a case study of maritime transportation from Shanghai to Rotterdam, aiming to investigate the economic potential of the Arctic routes and to explore the possibility of Arctic routes as a substitute for the traditional routes. A well-trained Bayesian network shows that the traditional routes will still dominate marine transportation in the near future. Sensitivity analysis reveals the asymmetric impact of key factors on the plan choice.
Nonextruded Grafts Result in Better Cartilage Quality After Lateral Meniscal Allograft Transplantation: Quantitative 3-T MRI T2 Mapping
Authors: Lee Hyo Yeol , Bin Seong-Il , Kim Jong-Min , Lee Bum-Sik , Kim Seung-Min , Lee Seon-Jong
Published: January 2023

Background:

Several studies have reported that graft extrusion after meniscal allograft transplantation (MAT) is associated with deterioration of surgical outcomes. However, no study has investigated the effect of graft extrusion on the articular cartilage using objective quantitative methods.

Purpose/Hypothesis:

This study aimed to investigate the influence of graft extrusion on the chondroprotective effect of lateral MAT on knee articular cartilage. We hypothesized that MAT without graft extrusion would result in better cartilage quality than MAT with graft extrusion.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Altogether, 105 patients who underwent isolated lateral MAT were divided into the extrusion and nonextrusion groups based on postoperative 3-month magnetic resonance imaging. Quantitative T2 mapping was performed on pre- and postoperative magnetic resonance imaging at midterm follow-up (mean ± SD, 3.2 ± 0.7 years). The weightbearing area of the femoral and tibial plateau articular cartilage was divided into 6 segments (F1, F2, F3, TP1, TP2, and TP3) from the anterior to posterior direction according to the meniscal coverage area. Each segment was further segmented into superficial and deep layers for zonal analysis. Longitudinal change in cartilage T2 value was compared between the groups. Lysholm scores were used to evaluate clinical function.

Results:

The mean T2 value of the nonextrusion group showed a significant improvement in 14 of 18 segments after lateral MAT, whereas the extrusion group demonstrated no statistically significant change. The biochemical properties of cartilage tissue as judged by quantitative T2 mapping indicated improvement in the nonextrusion group as compared with the extrusion group in the F2, TP2, and TP3 segments overall; the deep layers of the F1, F2, and TP2 segments; and the superficial layer of the TP3 segment ( P < .05).

Conclusion:

This study shows that the nonextruded graft results in better cartilage properties of the knee joint after lateral MAT as compared with the extruded graft at midterm follow-up.
The Boundaries of Competition: Examining Charter Schools’ Impact on Traditional Schools
Authors: Uttermark Matthew J. , Mackie Kenneth R. , Weissert Carol S. , Artiles Alexandra
Published: January 2023

For decades, charter schools have been promoted as a panacea for increasing competition in the educational marketplace. Supporters argue that increased choice forces neighboring schools to innovate, while opponents contend that charters “skim” students and funds away from traditional public schools (TPS). We test the two differing views by comparing academic achievement and school segregation in TPS in South Florida facing competition from charter schools compared to TPS with no competition. We find that when a charter school moves into the community, it fails to substantively change test scores or diversity of the nearby TPS, even 10 years after a charter is established.
Heat transfer characteristics of magnetohydrodynamic two fluid oscillatory flow in an inclined channel with saturated porous medium
Authors: Bala Anasuya J , Srinivas Suripeddi
Published: January 2023

This investigation aims to examine the hydromagnetic flow of two liquid flows of fully developed incompressible Newtonian fluid in an inclined channel through the porous medium accounting for radiative heat flux, Joule heating, and viscous dissipation. The walls of the channel are maintained at different temperatures. A double perturbation method is employed to derive analytical results for velocity and temperature. Graphical results are presented for various arising parameters such as Hartmann number, Grashoff number, ratio of viscosity parameter, thermal conductivity ratio, and porous parameter. Further, the results for mass flux are presented in a tabular form and discussed. Reduction in the velocity and temperature distribution is observed by enhancing Darcy dissipation and frequency parameter. As the angle of inclination increases, there is a rise in flow and heat distribution. With the strength of the magnetic field and the rise in the Reynolds number, the mass flux decreases. A comparative study is carried out with the previously published work and the results are found to be in good agreement.
Association Between 24-Hour Movement Guideline and Physical, Verbal, and Relational Forms of Bullying Among Chinese Adolescents
Authors: Chen Shiyun , Liang Kaixin , Chen Sitong , Huang Liuyue , Chi Xinli
Published: January 2023

The Canadian 24-Hour Movement Guidelines for Children and Youth recommends specific guidance in physical activity, screen time, and sleep duration. The current research will further explore potential exposures between healthy movement and being involved in a bullying incident as a bully or a victim in a representative sample of adolescents in China. A total of 67 821 Chinese students (response rate = 98.4%) were included in this study (mean age = 13.04 years). The results showed that meeting sleep recommendation only, meeting screen time recommendation only, and meeting both these two recommendations might be protective factors against being bullied or bullying others. Meeting moderate-to-vigorous physical activity (MVPA) recommendation only reported higher odds of being victims in all forms of bullying while meeting both MVPA and another combination of the guideline would relate to lower odds of being a bully and a bully-victim in all forms of bullying involvement.
Poly Lactic-co-Glycolic Acid Absorbable Plate Graft for Secondary Rhinoplasty in Asian Patients with Unilateral Cleft Lip Nose Deformity
Authors: Park Hojin , Kim Haneul , Hwang Yong-Jae , Park Seung-Ha
Published: January 2023

Introduction

In secondary cleft lip and nasal deformity (CLND) correction, structural grafts are commonly used to control the nasal tip and restore the symmetry of the ala. However, the septal cartilage in Asians often weak and small. Biocompatible absorbable materials are alternatives to autologous grafts. This study assessed the surgical outcomes and complications of poly lactic-co-glycolic acid (PLGA) plate grafts in secondary CLND correction.

Methods

This study was retrospectively analyzed for patients who underwent secondary rhinoplasty for unilateral CLND correction between March 2015 and November 2020. Using open rhinoplasty, the PLGA plate was grafted as a columellar strut. Clinical photographs taken at the initial (T0) and follow-up visits (T1: short-term, T2: long-term) were analyzed and anthropometric parameters, such as nostril height and width, dome height, and tip height, were measured.

Results

Twenty-four patients were included in this study. The mean T1 and T2 periods were 1.0 ± 0.4 and 15.5 ± 3.1 months, respectively. The nostril height ratio increased from 0.78 ± 0.12 at T0 to 0.88 ± 0.08 at T1 and 0.86 ± 0.09 at T2 (p < 0.001; Relapse ratio −2.6 ± 6.7%). The tip height ratio increased from 0.60 ± 0.07 (T0) to 0.66 ± 0.05 (T2) (Relapse ratio −3.7 ± 3.0%).

Conclusions

The PLGA plate graft provided stable nasal tip projection and alar symmetry without major complications. It can be a good option for patients lacking available septal and concha cartilages or apprehensive of additional scarring.
A Comprehensive Assessment of Cleft Lip and Palate Websites and Patient Education Information
Authors: Sunkara Pranit R. , Powell Lauren E. , Quick Joseph D. , Landis George H.
Published: January 2023

Objective

The objective of this study is to evaluate online educational resources on cleft lip and palate teams.

Design

A Cross-Sectional Study.

Setting

An International, Multi-Institutional Study.

Participants

All American Cleft Palate and Craniofacial Association-approved teams with websites.

Interventions

None

Main Outcome Measures

Websites were assessed for patient education and support content. Affiliation between presence of materials and U.S. Newsweek Top 100 Hospitals was also assessed.

Results

187 teams were included. Presence of educational videos were available in 29.4% of websites, educational infographics in 18.2%, written materials in 66.8%, perioperative instructions in 19.3%, diagnosis information in 34.8% and treatment information in 63.1%. Information on team members were available on 77.0% of websites, resources in languages other than English in 38.5%, and support group resources in 25.7%. Cleft lip and palate diagnosis information was significantly associated with geographic region, with the largest impact from the West region ( P = .03). There was a significant difference between teams affiliated with U.S. Newsweek Top 100 hospitals: Top 100 hospitals had a higher presence of educational infographics, perioperative instructions, definitions, diagnosis, and treatment ( P < .01). There was no significant difference between presence of educational videos ( P = .37).

Conclusion

While many websites had basic educational materials, very few included detailed information on peri-operative planning, as well as additional forms of information including videos, infographics, and non-English languages. Providing comprehensive patient education materials online is an important supplement for patients with cleft lip and palate and should be prioritized by cleft teams.
Alectinib-induced hemolytic anemia
Authors: Lee Chung-Shien , Sullivan Kevin
Published: January 2023

Introduction

Alectinib is an oral anaplastic lymphoma kinase tyrosine kinase inhibitor with central nervous system activity. It is currently approved and a preferred first-line option for those with anaplastic lymphoma kinase-positive non-small cell lung cancer. Alectinib has been shown to cause anemia, usually mild.

Case report

We report a case of alectinib-induced hemolytic anemia in a patient receiving alectinib as first-line treatment for anaplastic lymphoma kinase-positive non-small cell lung cancer.

Management and outcome

The patient's dose was reduced from 600 mg twice daily to 450 mg twice daily and further down to 300 mg twice daily and eventually discontinued. At that point, the hemoglobin normalized.

Discussion

Our case demonstrates objective evidence for hemolytic anemia induced by alectinib.
Abnormalities of Serum Antielastin Antibodies in Connective Tissue Diseases
Authors: Colburn Keith K. , Langga-Shariffi Euly , Kelly G. Timothy , Malto Marilyn C. , Sandberg Lawrence B. , Baydanoff Stephan , Green Lora M.
Published: January 2023

Background

Antibodies (Abs) to α-elastin (elastin breakdown product) and tropoelastin (elastin precursor) are found in the serum of all human subjects and correlate with their respective serum peptide levels; however, peptide levels vary with age and some disease states. This study was undertaken to determine if serum elastin Abs, peptides, and elastin metabolism were altered in autoimmune diseases by detecting a changing ratio of serum anti-α: tropoelastin Ab levels.

Methods

Serum from patients with a variety of connective tissue diseases, including 28 with systemic lupus erythematosus (SLE), 24 with scleroderma, 18 with rheumatoid arthritis (RA), 10 with polymyositis, and 39 with vasculitis, was compared with serum from 19 age-matched healthy subjects for levels of antitropoelastin and anti-α-elastin Abs.

Results

We found an increase in IgG anti-α-elastin and a decrease in antitropoelastin Abs in the sera of patients with scleroderma ( p < .02 and .00005) and SLE ( p < .006 and .011). There was also a marked increase in anti-α-elastin Abs in patients with polyarteritis nodosa ( p < .0005) and decreases in antitropoelastin Abs in patients with RA ( p < .05), polymyositis ( p < .01), and a variety of other vasculidities ( p < .0003).

Conclusions

Abnormal variations in elastin metabolism may be detected in several connective tissue diseases by measuring ratios of a- and tropoelastin IgG Abs as markers of elastin degradation and synthesis.
Tribunals of inquiry as instruments of legitimacy: A ritualization perspective
Authors: McGrath Paul , Marshall Donna
Published: January 2023

This paper is an exploratory qualitative study into how tribunals of inquiry act as instruments of legitimacy and hegemony for the State. Focusing on a case study of two consecutive tribunals of inquiry into the biggest health scandal in the history of the Irish State, the paper draws on ritual theory to offer a view of the tribunal as a process of ritualization, a strategic way of acting by the State in times of crisis. Through this process of ritualization, an authoritative, structured and structuring ritualized environment is created with schemes of ritualization imposed on participants directed toward creating ritualized bodies, hoped-for acceptance of the tribunal’s projection of reality and the re-legitimation of the role of the State in undertaking its core functions.
Identity knowledges remixed: reflections on the itinerary of transgender
Authors: Chaudhry V. Varun
Published: January 2023

This article explores the uptake and circulation of ‘transgender’ in academic and philanthropic institutions, as a way of taking seriously Robyn Wiegman’s call for a divergentist approach. In so doing, the article aims to demonstrate the intimate entanglements between non-profit and academic spheres and identity knowledges therein. Taken together, both contexts reveal the messiness and complexities of institutionality, not only as a lived reality for individuals such as philanthropy professionals and academics, but also as an object of study itself.
Identification of Subgroups of Activity Participation in Group of Community-Dwelling Older Adults
Authors: Uemura Jun-ichi , Uno Kohei , Hoshino Aiko , Tanikaga Miki , Tanaka Masahiro , Chishima Makoto
Published: January 2023

Occupational therapy in public health is advancing for groups of older adults, but few studies have focused on measuring population-based activity engagement. This study aimed to identify subgroups based on the daily activity pattern of community-dwelling older adults. Japanese older adults aged ≥65 years responded to a 128-activity-item questionnaire. Sparse principal component analysis was applied to summarize the activities, and k-means clustering was used to identify subgroups. Respondents were divided into three subgroups (subgroup 1: n = 39, high instrumental/leisure and social/cognitive activity; subgroup 2: n = 51, high instrumental/leisure and low social/cognitive activity; subgroup 3: n = 44, low instrumental/leisure and social/cognitive activity). The three subgroups were associated with sociodemographics (sex, area, education, and activity level) ( p < .05). This study highlighted the activity-based subgroups of older adults and provided a novel viewpoint regarding occupation-based community assessments in addition to previous community occupational therapy practice.
EEG Asymmetry Characteristics in Relation to Childhood Anxiety Subtypes: A Dimensional Approach
Authors: Shanok Nathaniel A. , Jones Nancy Aaron
Published: January 2023

Introduction: Right frontal EEG asymmetry has been a commonly neurophysiological marker of anxiety and depressive symptoms throughout development. Method: In the current study, EEG asymmetry measures in frontal and parietal regions were examined as markers for specific subtypes of childhood anxiety disorder (eg, panic, generalized, social, separation, and school avoidance). Results: Notably, panic trait levels were significantly associated with prefrontal and lateral frontal alpha asymmetry, general anxiety was predicted by parietal beta asymmetry measures, and social anxiety levels were associated with mid-frontal alpha and beta asymmetry. School avoidance was significantly correlated with prefrontal and lateral frontal beta asymmetry scores; however, no significant findings were detected relating to separation anxiety which is considered unique to childhood anxiety. Discussion: In all cases, increased anxiety subtype scores related to a rightward shift in asymmetry, signifying this trait as a key neurophysiological marker of childhood anxiety symptoms. Conclusion: Overall, biomarker research of specific subtypes of broad conditions like anxiety could be highly useful for facilitating a deeper understanding of the mechanisms involved, as well as customizing treatment approaches.
Ecchordosis physaliphora presenting as hypnic headache
Authors: Magro Giuseppe , Lanza Pierluigi , Bono Francesco
Published: January 2023

Ecchordosis physaliphora (EP) is a rare benign congenital hamartomatous lesion originating from remnants of the notochord. EP has never been associated with hypnic headache before. We report for the first time two cases of EP associated with an hypnic headache. The latter is a form of sleep-related nocturnal headache whose pathogenesis has not been fully elucidated. A 61-year-old woman and a 41-year-old man had been complaining of a dull headache that woke them up every night for many months. In both cases, an enlarged cystic lesion in the prepontine cistern, compatible with ecchordosis physaliphora, was found on brain MRI. A diagnosis of hypnic headache secondary to EP was made. Ecchordosis physaliphora presenting as hypnic headache had never been described before. The low prevalence of both conditions (EP and HH) and their presence in two cases might suggest a possible causal association between the two conditions.
Frailty Viewed From a Nursing Perspective
Authors: Gobbens Robbert J. J. , Uchmanowicz Izabella
Published: January 2023

Introduction

More and more researchers are convinced that frailty should refer not only to physical limitations but also to psychological and social limitations that older people may have. Such a broad, or multidimensional, definition of frailty fits better with nursing, in which a holistic view of human beings, and thus their total functioning, is the starting point.

Purpose

In this article, which should be considered a Practice Update, we aim at emphasizing the importance of the inclusion of other domains of human functioning in the definition and measurement of frailty. In addition, we provide a description of how district nurses view frailty in older people. Finally, we present interventions that nurses can perform to prevent or delay frailty or its adverse outcomes. We present, in particular, results from studies in which the Tilburg Frailty Indicator, a multidimensional frailty instrument, was used.

Conclusion

The importance of a multidimensional assessment of frailty was demonstrated by usually satisfactory results concerning adverse outcomes of mortality, disability, an increase in healthcare utilization, and lower quality of life. Not many studies have been performed on nurses’ opinions about frailty. Starting from a multidimensional definition of frailty, encompassing physical, psychological, and social domains, nurses are able to assess and diagnose frailty and conduct a variety of interventions to prevent or reduce frailty and its adverse effects. Because nurses come into frequent contact with frail older people, we recommend future studies on opinions of nurses about frailty (e.g., screening, prevention, and addressing).
A stem cell epigenome is associated with primary nonresponse to CD19 CAR T cells in pediatric acute lymphoblastic leukemia
Authors: Masih Katherine E. , Gardner Rebecca A. , Chou Hsien-Chao , Abdelmaksoud Abdalla , Song Young K. , Mariani Luca , Gangalapudi Vineela , Gryder Berkley E. , Wilson Ashley L. , Adebola Serifat O. , Stanton Benjamin Z. , Wang Chaoyu , Milewski David , Kim Yong Yean , Tian Meijie , Cheuk Adam Tai-Chi , Wen Xinyu , Zhang Yue , Altan-Bonnet Grégoire , Kelly Michael C. , Wei Jun S. , Bulyk Martha L. , Jensen Michael C. , Orentas Rimas J. , Khan Javed
Published: January 2023

CD19 chimeric antigen receptor T-cell therapy (CD19-CAR) has changed the treatment landscape and outcomes for patients with pre–B-cell acute lymphoblastic leukemia (B-ALL). Unfortunately, primary nonresponse (PNR), sustained CD19+ disease, and concurrent expansion of CD19-CAR occur in 20% of the patients and is associated with adverse outcomes. Although some failures may be attributable to CD19 loss, mechanisms of CD19-independent, leukemia-intrinsic resistance to CD19-CAR remain poorly understood. We hypothesize that PNR leukemias are distinct compared with primary sensitive (PS) leukemias and that these differences are present before treatment. We used a multiomic approach to investigate this in 14 patients (7 with PNR and 7 with PS) enrolled in the PLAT-02 trial at Seattle Children’s Hospital. Long-read PacBio sequencing helped identify 1 PNR in which 47% of CD19 transcripts had exon 2 skipping, but other samples lacked CD19 transcript abnormalities. Epigenetic profiling discovered DNA hypermethylation at genes targeted by polycomb repressive complex 2 (PRC2) in embryonic stem cells. Similarly, assays of transposase-accessible chromatin–sequencing revealed reduced accessibility at these PRC2 target genes, with a gain in accessibility of regions characteristic of hematopoietic stem cells and multilineage progenitors in PNR. Single-cell RNA sequencing and cytometry by time of flight analyses identified leukemic subpopulations expressing multilineage markers and decreased antigen presentation in PNR. We thus describe the association of a stem cell epigenome with primary resistance to CD19-CAR therapy. Future trials incorporating these biomarkers, with the addition of multispecific CAR T cells targeting against leukemic stem cell or myeloid antigens, and/or combined epigenetic therapy to disrupt this distinct stem cell epigenome may improve outcomes of patients with B-ALL.
CD19 CAR T cells are an effective therapy for posttransplant relapse in patients with B-lineage ALL: real-world data from Germany
Authors: Bader Peter , Rossig Claudia , Hutter Martin , Ayuk Francis Ayuketang , Baldus Claudia D. , Bücklein Veit L. , Bonig Halvard , Cario Gunnar , Einsele Hermann , Holtick Udo , Koenecke Christian , Bakhtiar Shahrzad , Künkele Annette , Meisel Roland , Müller Fabian , Müller Ingo , Penack Olaf , Rettinger Eva , Sauer Martin G. , Schlegel Paul-Gerhardt , Soerensen Jan , von Stackelberg Arend , Strahm Brigitte , Hauer Julia , Feuchtinger Tobias , Jarisch Andrea
Published: January 2023

Patients with precursor B-cell acute lymphoblastic leukemia (pB-ALL) who have relapsed after allogeneic hematopoietic stem cell transplantation (allo-HSCT), have relapsed more than once, or are resistant upfront have a dismal prognosis. CD19-targeted chimeric antigen receptor (CAR) T cells have evolved as potent immune therapies. Tisagenlecleucel (Tisa-cel) is a commercially available autologous CD19-directed CAR T-cell product. We performed a retrospective study inviting all CAR T-cell centers in Germany to participate. Eighty-one patients with pB-ALL were included. Twenty-eight days after CAR T-cell infusion, 71 patients (87.7%) were in complete response, and 8 (9.9%) were in nonremission. At 2 years, the probabilities of event-free survival (pEFS), relapse-free survival (pRFS), and overall survival (pOS) were 45.3%, 51.7%, and 53.2%, respectively. pEFS was not different in patients without (n = 16, 55.0%) vs with prior allo-HSCT (n = 65, 43.4%). In patients treated after allo-HSCT, the time to relapse after allo-HSCT was a strong predictor of outcome. Patients relapsing within 6 months of allo-HSCT had a disappointing pEFS of 18.4% (pOS = 16.0%); the pEFS for those relapsing later was 55.5% (pOS = 74.8%). Our study provides real-world experience in pediatric, adolescent, and young adult patients with ALL treated with Tisa-cel, where most patients were treated after having relapsed after allo-HSCT. A total of 45.3% were rescued with a single dose of Tisa-cel. Our novel finding that patients with ALL after allo-HSCT had by far a better pEFS if relapse occurred beyond 6 months might be helpful in clinical decision-making and motivates studies to uncover the reasons.
Effect of alpha blockers on duration of urinary leakage post-percutaneous nephrolithotomy (PNL): a prospective randomized study
Authors: Kassem Ayman , Hamdy Ahmad , Mosharafa Ashraf , Abdelrazzak Omar M.
Published: January 2023

Background

Urinary leakage after removal of the nephrostomy tube post-percutaneous nephrolithotomy (PNL) is a common complication which could be secondary to ureteral stone fragments, blood clots, ureteral edema at the ureteropelvic or ureterovesical junction, or rupture calyx. Unfortunately, it could impact the patient’s hospital stay causing it to be lengthy, delaying time to return to work, and the negative psychological effect. The current study aimed at assessing the role and effectiveness of alpha blockers (tamsulosin) in minimizing the duration of urinary leakage post-percutaneous nephrolithotomy (PNL).

Methods

In this prospective randomized clinical study, 62 cases of PNL were included. Physical examination, laboratory investigations and radiological work up (KUB and plain computed tomography) were done. Cases were randomized into two equal groups: Group A (31 cases) received tamsulosin perioperatively; Group B (31 cases) did not receive tamsulosin. The two groups were followed postoperatively as regards duration of urinary leakage, urinary catheterization and hospital stay.

Results

Duration of urinary leakage was statistically significantly shorter in group A (10.61 ± 6.66 h) compared to group B (21.48 ± 12.41 h) (p-value ˂ 0.001). Similarly, duration of hospital stay was shorter in group A (2.52 ± 0.72 days) compared to group B (3.10 ± 0.98) (p-value 0.020).

Conclusions

In patients undergoing PNL for renal stones and receiving tamsulosin, the duration of urinary leakage, and eventually hospital stay was shorter compared to those not receiving tamsulosin.
A computationally efficient method for approximating reliabilities in large-scale single-step genomic prediction
Authors: Gao Hongding , Kudinov Andrei A. , Taskinen Matti , Pitkänen Timo J. , Lidauer Martin H. , Mäntysaari Esa A. , Strandén Ismo
Published: January 2023

Background

In this study, computationally efficient methods to approximate the reliabilities of genomic estimated breeding values (GEBV) in a single-step genomic prediction model including a residual polygenic (RPG) effect are described. In order to calculate the reliabilities of the genotyped animals, a single nucleotide polymorphism best linear unbiased prediction (SNPBLUP) or a genomic BLUP (GBLUP), was used, where two alternatives to account for the RPG effect were tested. In the direct approach, the genomic model included the RPG effect, while in the blended method, it did not but an index was used to weight the genomic and pedigree-based BLUP (PBLUP) reliabilities. In order to calculate the single-step GBLUP reliabilities for the breeding values for the non-genotyped animals, a simplified weighted-PBLUP model that included a general mean and additive genetic effects with weights accounting for the non-genomic and genomic information was used. We compared five schemes for the weights. Two datasets, i.e., a small (Data 1) one and a large (Data 2) one were used.

Results

For the genotyped animals in Data 1, correlations between approximate reliabilities using the blended method and exact reliabilities ranged from 0.993 to 0.996 across three lactations. The slopes observed by regressing the reliabilities of GEBV from the exact method on those from the blended method were 1.0 for all three lactations. For Data 2, the correlations and slopes ranged, respectively, from 0.980 to 0.986 and from 0.91 to 0.96, and for the non-genotyped animals in Data 1, they ranged, respectively, from 0.987 to 0.994 and from 0.987 to 1, which indicate that the approximations were in line with the exact results. The best approach achieved correlations of 0.992 to 0.994 across lactations.

Conclusions

Our results demonstrate that the approximated reliabilities calculated using our proposed approach are in good agreement with the exact reliabilities. The blended method for the genotyped animals is computationally more feasible than the direct method when RPG effects are included, particularly for large-scale datasets. The approach can serve as an effective strategy to estimate the reliabilities of GEBV in large-scale single-step genomic predictions.
Detection of grey zones in inter-rater agreement studies
Authors: Demirhan Haydar , Yilmaz Ayfer Ezgi
Published: January 2023

Background

In inter-rater agreement studies, the assessment behaviour of raters can be influenced by their experience, training levels, the degree of willingness to take risks, and the availability of clear guidelines for the assessment. When the assessment behaviour of raters differentiates for some levels of an ordinal classification, a grey zone occurs between the corresponding adjacent cells to these levels around the main diagonal of the table. A grey zone introduces a negative bias to the estimate of the agreement level between the raters. In that sense, it is crucial to detect the existence of a grey zone in an agreement table.

Methods

In this study, a framework composed of a metric and the corresponding threshold is developed to identify grey zones in an agreement table. The symmetry model and Cohen’s kappa are used to define the metric, and the threshold is based on a nonlinear regression model. A numerical study is conducted to assess the accuracy of the developed framework. Real data examples are provided to illustrate the use of the metric and the impact of identifying a grey zone.

Results

The sensitivity and specificity of the proposed framework are shown to be very high under moderate, substantial, and near-perfect agreement levels for$$3\times 3$$3×3and$$4 \times 4$$4×4tables and sample sizes greater than or equal to 100 and 50, respectively. Real data examples demonstrate that when a grey zone is detected in the table, it is possible to report a notably higher level of agreement in the studies.

Conclusions

The accuracy of the proposed framework is sufficiently high; hence, it provides practitioners with a precise way to detect the grey zones in agreement tables.
Changes in vaginal microbiome after focused ultrasound treatment of high-risk human papillomavirus infection-related low-grade cervical lesions
Authors: Wang Wenping , Liu Yujuan , Yang Yamei , Ren Jiaojiao , Zhou Honggui
Published: January 2023

Background

In this study, the changes of vaginal microbiome after focused ultrasound (FU) treatment were evaluated to explore the possible mechanism of FU in the treatment of high-risk human papillomavirus (HR-HPV) infection.

Methods

This study was nested in the FU arm of a prospective cohort study. A total of 37 patients diagnosed with HR-HPV infection-related cervical low-grade squamous intraepithelial lesion (LSIL) who met the inclusion criteria were enrolled in this study from October 2020 to November 2021, and these patients were treated with FU. We used 16S ribosomal RNA (16S rRNA) gene amplicon sequencing to profile the vaginal microbiota composition of patients before and 3 months after FU treatment.

Results

After FU treatment, HR-HPV was cleared in 24 patients, with a clearance rate of 75.0% (24/32). Lactobacillus iners was the predominant species among all samples. No significant difference was found in alpha-diversity index before and 3 months after FU treatment (P > 0.05), but the rarefaction curves showed that the vaginal microbial diversity before FU treatment was higher than that after FU treatment. Linear discriminant analysis (LDA) effect size (LEfSe) showed that Bifidobacterium contributed the most to the difference between the two groups at the genus level, and the abundance after FU treatment was significantly higher than that before treatment (P = 0.000).

Conclusions

The decrease of vaginal microbial diversity may be related to the clearance of HR-HPV infection, and FU treatment contributed to the decrease of vaginal microbial diversity. Increased Bifidobacterium abundance in the vaginal microbiome may be associated with clearance of HR-HPV infection, and FU treatment may contribute to the increase in Bifidobacterium abundance.

Trial registration number: This study was registered in the Chinese Clinical Trial Registry on 23/11/2020 (ChiCTR2000040162).