bluuebunny/crossref_metadata_2025 huggingface dataset:
FOLFIRINOX relative dose intensity and disease control in advanced pancreatic adenocarcinoma
Authors: Vary Antonin , Lebellec Loïc , Di Fiore Frédéric , Penel Nicolas , Cheymol Claire , Rad Emilia , El Hajbi Farid , Lièvre Astrid , Edeline Julien , Bimbai André Michel , Le Deley Marie-Cécile , Turpin Anthony
Published: July 2021

Background:

Most patients with advanced pancreatic adenocarcinoma (PA) treated with FOLFIRINOX experience adverse events requiring dose reduction. We aimed to assess the association between relative dose intensity (RDI) and disease control in a European setting.

Methods:

We retrospectively included patients with advanced PA treated with three or more cycles of FOLFIRINOX between 2011 and 2018 in six French centers. We computed the cumulative single-agent RDI (csRDI) before the first reassessment for each FOLFIRINOX agent (oxaliplatin, irinotecan, 5FU bolus, and 5FU intravenous infusion) and the cumulative multi-drug RDI (cmRDI) of their combination. The association between RDI and disease control or objective response at first reassessment was evaluated using multivariable logistic regression models controlling for performance status, liver metastases, and center.

Results:

We included 243 patients. Median csRDIs were 81%, 79%, 75%, and 85% for oxaliplatin, irinotecan, 5FU bolus, and 5FU intravenous infusion, respectively. Median cmRDI was 80%. None of the RDIs was significantly associated with disease control or objective response. Including RDI in a clinical model did not improve its ability to predict disease control; the area under the curve was 0.79 (95% CI: 0.73–0.85) with RDI versus 0.78 (95% CI: 0.72–0.85) without. Similar results were observed for the objective response.

Conclusion:

Pragmatic dose adjustments of FOLFIRINOX should be made by oncologists without considering a loss of effect.
Intervertebral disc therapies for non-specific chronic low back pain: a systematic review and meta-analysis
Authors: Daste Camille , Laclau Stéphanie , Boisson Margaux , Segretin François , Feydy Antoine , Lefèvre-Colau Marie-Martine , Rannou François , Nguyen Christelle
Published: July 2021

Objectives:

We aim to evaluate the benefits and harms of intervertebral disc therapies (IDTs) in people with non-specific chronic low back pain (NScLBP).

Methods:

We conducted a systematic review and meta-analysis of randomized trials of IDTs versus placebo interventions, active comparators or usual care. EMBASE, MEDLINE, CENTRAL and CINHAL databases and conference abstracts were searched from inception to June 2020. Two independent investigators extracted data. The primary outcome was LBP intensity at short term (1 week–3 months), intermediate term (3–6 months) and long term (after 6 months).

Results:

Of 18 eligible trials (among 1396 citations), five assessed glucocorticoids (GCs) IDTs and were included in a quantitative synthesis; 13 assessed other products including etanercept ( n = 2), tocilizumab ( n = 1), methylene blue ( n = 2), ozone ( n = 2), chymopapaine ( n = 1), glycerol ( n = 1), stem cells ( n = 1), platelet-rich plasma ( n = 1) and recombinant human growth and differentiation factor-5 ( n = 2), and were included in a narrative synthesis. Standardized mean differences (95% CI) for GC IDTs for LBP intensity and activity limitations were −1.33 (−2.34; −0.32) and −0.76 (−1.85; 0.34) at short term, −2.22 (−5.34; 0.90) and −1.60 (−3.51; 0.32) at intermediate term and −1.11 (−2.91; 0.70) and −0.63 (−1.68; 0.42) at long term, respectively. Odds ratios (95% CI) for serious and minor adverse events with GC IDTs were 1.09 (0.25; 4.65) and 0.97 (0.49; 1.91).

Conclusion:

GC IDTs are associated with a reduction in LBP intensity at short term in people with NScLBP. Positive effects are not sustained. IDTs have no effect on activity limitations. Our conclusions are limited by high heterogeneity and a limited methodological quality across studies.

Registration

PROSPERO: CRD42019106336.
Bad debt: The women’s mobilization against the financial industry in Kyrgyzstan
Authors: Satybaldieva Elmira
Published: July 2021

This article offers a first person account of women’s mobilization against banking and microfinance sectors in Kyrgyzstan. It focuses on the key factors for the evolution of the anti-debt movement, and women’s political strategies to problematize interest and to denaturalize the discourse of financial inclusion. For many years, the financial industry has operated a gendered process of neoliberal capital accumulation under the guise of empowerment that has produced tensions between transnational capital and marginalized women. Building upon Bourdieusian ideas on social movements, the study shows the significance of strain and situational definition in the formation of the anti-debt mobilization. The article uses in-depth interviews with the leaders and activists of the anti-debt movement and borrowers to explore how gender, class and capital were intertwined. It contributes to the literature on post-Soviet politics by challenging the dominant elite-centered frameworks, which are inadequate to explain local movements and gendered activism.
Differentiation of Cartilage Repair Techniques Using Texture Analysis from T2 Maps
Authors: Juras Vladimir , Szomolanyi Pavol , Janáčová Veronika , Kirner Alexandra , Angele Peter , Trattnig Siegfried
Published: July 2021

Objective

The aim of this study was to investigate texture features from T2 maps as a marker for distinguishing the maturation of repair tissue after 2 different cartilage repair procedures.

Design

Seventy-nine patients, after either microfracture (MFX) or matrix-associated chondrocyte transplantation (MACT), were examined on a 3-T magnetic resonance (MR) scanner with morphological and quantitative (T2 mapping) MR sequences 2 years after surgery. Twenty-one texture features from a gray-level co-occurrence matrix (GLCM) were extracted. The texture feature difference between 2 repair types was assessed individually for the femoral condyle and trochlea/anterior condyle using linear regression models. The stability and reproducibility of texture features for focal cartilage were calculated using intra-observer variability and area under curve from receiver operating characteristics.

Results

There was no statistical significance found between MFX and MACT for T2 values ( P = 0.96). There was, however, found a statistical significance between MFX and MACT in femoral condyle in GLCM features autocorrelation ( P < 0.001), sum of squares ( P = 0.023), sum average ( P = 0.005), sum variance ( P = 0.0048), and sum entropy ( P = 0.05); and in anterior condyle/trochlea homogeneity ( P = 0.02) and dissimilarity ( P < 0.001).

Conclusion

Texture analysis using GLCM provides a useful extension to T2 mapping for the characterization of cartilage repair tissue by increasing its sensitivity to tissue structure. Some texture features were able to distinguish between repair tissue after different cartilage repair procedures, as repair tissue texture (and hence, probably collagen organization) 24 months after MACT more closely resembled healthy cartilage than did MFX repair tissue.
Trends in mechanical thrombectomy and decompressive hemicraniectomy for stroke: A multicenter study
Authors: Oravec Chesney S , Tschoe Christine , Fargen Kyle M , Kittel Carol A , Spiotta Alejandro , Almallouhi Eyad , Starke Robert M , McCarthy David J , Simon Scott , Zyck Stephanie , Gould Grahame C , De Leacy Reade , Mocco J , Siddiqui Adnan , Vaziri Sasha , Fox W Christopher , Fraser Justin F , Chitale Rohan , Zipfel Gregory , Huguenard Anna , Wolfe Stacey Q
Published: July 2021

Background and purpose

Acute ischemic stroke has increasingly become a procedural disease following the demonstrated benefit of mechanical thrombectomy (MT) for emergent large vessel occlusion (ELVO) on clinical outcomes and tissue salvage in randomized trials. Given these data and anecdotal experience of decreased numbers of decompressive hemicraniectomies (DHCs) performed for malignant cerebral edema, we sought to correlate the numbers of strokes, thrombectomies, and DHCs performed over the timeline of the 2013 failed thrombolysis/thrombectomy trials, to the 2015 modern randomized MT trials, to post-DAWN and DEFUSE 3.

Materials and methods

This is a multicenter retrospective compilation of patients who presented with ELVO in 11 US high-volume comprehensive stroke centers. Rates of tissue plasminogen activator (tPA), thrombectomy, and DHC were determined by current procedural terminology code, and specificity to acute ischemic stroke confirmed by each institution. Endpoints included the incidence of stroke, thrombectomy, and DHC and rates of change over time.

Results

Between 2013 and 2018, there were 55,247 stroke admissions across 11 participating centers. Of these, 6145 received tPA, 4122 underwent thrombectomy, and 662 patients underwent hemicraniectomy. The trajectories of procedure rates over time were modeled and there was a significant change in MT rate ( p = 0.002) without a concomitant change in the total number of stroke admissions, tPA administration rate, or rate of DHC.

Conclusions

This real-world study confirms an increase in thrombectomy performed for ELVO while demonstrating stable rates of stroke admission, tPA administration and DHC. Unlike prior studies, increasing thrombectomy rates were not associated with decreased utilization of hemicraniectomy.
Writing a Feminine Subject: The Auto/Biographical Narratives of Indonesian Female Celebrities
Authors: Priyatna Aquarini
Published: July 2021

Situated in popular culture, celebrity auto/biography becomes both space and instrument for self-representation that illuminates the issues of public/private, global/local, normative/disruptive, and fact/fiction dichotomies. This article works on five auto/biographies of Indonesian female celebrities published in the 2000s, namely, Lenny Marlina, Krisdayanti, Tiara Lestari, Yuni Shara, and Dorce Gamalama. By conducting a close reading of the texts and how the celebrities present their lives, the article seeks to argue that the auto/biographies represent the complexity of Indonesian celebrity femininities that are culturally intertwined. The article also shows that the auto/biographies contribute to establishing their celebrity status and how they present their lives as exemplary. Finally, this study aims at contributing to the understanding of how celebrity auto/biographies complicate the notion of the feminine within Indonesian celebrity culture.
Nationalism and Reconciliation in Cypriot Documentary Film, 1976–1987
Authors: Tekerek Hüseyin
Published: July 2021

This article examines the production of documentary films about the Cyprus conflict produced between the late 1970 and late 1980s. Two films have been selected for analysis: Cyprus: The Other Reality (1976, dir. Lambros Papadimitrakis and Thekla Kittou), an anti-nationalist documentary produced in the immediate aftermath of the Turkish incursion of the island, and A Detail in Cyprus (1987, dir. Panicos Chrysanthou), which looks back at the social effects of the incursion and the estrangement of the Greek and Turkish Cypriot communities. Based on original interviews with their directors, this article gives an account of the production histories of the two documentaries and looks at their means through which they were distributed to the public. The article also examines the ways in which these two films represent the Cyprus conflict, in particular their engagement with the prevailing nationalist ideologies at work in both Greek and Turkish Cypriot communities and the alternate concept of Cypriocentrism. Finally, this article examines the ways in which both films were politically suppressed following their release within the Republic of Cyprus.
Klamath Tribal Response to the Pandemic of COVID-19 Among Klamath Tribal Community in Oregon, USA
Authors: Oleribe Obinna , Miller Rachel , Wadzeck Misty , Mendez Nikowa , Tibay Joseph , Langford Timothy , Devine Anjanette , Taylor-Robinson Simon D
Published: July 2021

Introduction

Socially-disadvantaged populations are more at risk of contracting COVID-19 than those with access to better medical facilities. We looked at responses of Klamath Tribes in Oregon, USA to mitigate spread of COVID-19 in a community with a higher incidence of obesity, diabetes and coronary heart disease, compared to the general US population. This study reports on Klamath Tribes response to COVID-19 March -September 2020.

Methods

Klamath Tribes Tribal Health and Family Services established a COVID-19 Incident Management Team (IMT), instituting creative programs including a Walk-In Testing Center, implementing strict infection control protocols and regular sharing of information on the pandemic and prevalence of COVID-19 amongst Klamath Tribes. All COVID-19 tests were documented with positive cases isolated and people with high risk exposures quarantined and provided with wrap-around medical and social services until recovered or past quarantine time period.

Results

A total of 888 (12%) tribal members were tested for COVID1-19 between March to September 2020; 50 were found positive for COVID-19, giving a test positivity rate of 5.6% (Male – 6.3%; Female – 5.2%). No deaths have been reported amongst the local Klamath Tribes and other American Indians/Alaska Native (AI/AN) population served by the tribe.

Conclusion

Despite the fact that structural inequities including income disparities have shaped racial and ethnic impact of epidemics around the world, the timely response, establishment of partnerships and proactive control of the epidemic resulted in minimal impact among the Klamath Tribal and other AI/AN populations served by the tribal facilities.
Child Care Policy as an Anti-Poverty Strategy: The Need to Address Neurophysiological Self-Regulation
Authors: Holochwost Steven J. , Gomes Lindsay A. , Propper Cathi B. , Brown Eleanor D. , Iruka Iheoma U.
Published: July 2021

High-quality early care and education can mitigate the short- and long-term effects of poverty on young children’s development. Therefore, policies that expand access to high-quality early care and education can be an effective anti-poverty strategy. A number of programs demonstrably foster volitional processes of self-regulation—the capacity to control emotions, thoughts, and behaviors—among young children in poverty. However, relatively little is known about how the activity of the neurophysiological systems that form the interface between brain and body supports these processes of self-regulation in early care and education settings. Maximizing the efficacy of early care and education as an anti-poverty strategy requires adopting policies to advance three interrelated goals: understanding, accommodating, and reconfiguring young children’s neurophysiological function in the early care and education environment.
Steering Sustainable Economic Growth: Entrepreneurial Ecosystem Approach
Authors: Opute Abdullah Promise , Kalu Kalu Ibe , Adeola Ogechi , Iwu Chux Gervase
Published: July 2021

The importance of entrepreneurship in steering sustained economic growth and improved well-being has been re-echoed over the past decade. Regrettably, the sub-Saharan Africa setting lags behind from the point of harnessing the economic development impact of entrepreneurship, and the obvious implication is ever increasing unemployment and poverty. Utilising a systematic review approach, this article draws from the body of knowledge to shed light on critical strategies towards achieving productive entrepreneurship. Specifically, we forward an entrepreneurial ecosystem framework that underlines the importance of institutional level and enterprise level attributes in achieving effective entrepreneurial ecosystem and maximising economic growth gains. We highlight strategic and pro-active initiatives for ensuring active and ambitious entrepreneurial orientation that will contribute to economic growth and create employment. Towards achieving these targets, we also flag critical policy guides, drawing attention to the facilitating role that governments can play in ensuring an effective and economic growth impacting entrepreneurial ecosystem. Directions for future research have been flagged.
Digit Necrosis After Hand Surgery in Pregnancy: A Case Report
Authors: Ziolkowski Natalia , Dengler Jana , Goldberg Cory S
Published: July 2021

Digital blocks are routinely used for excision of lesions. We describe a unique presentation of digit necrosis after excisional biopsy with digital block and finger tourniquet in a pregnant patient with a history of ulcerative colitis. The patient had a history of a long-standing painful dorsal PIP joint mass and was scheduled for excision under local anaesthetic. On the day of the procedure, she disclosed that she was pregnant in the second trimester. After extensive discussion of risks and benefits between the patient and the surgeon, the decision was made to proceed with an excisional biopsy of the lesion because of its impact on her quality of life. Twelve hours after the procedure, she presented to the emergency department with blistering and severe pain to the digit. Doppler ultrasound showed flow through both digital arteries and the digit appeared viable. Over the coming days her pain continued to worsen and on post-operative day 3, she was admitted to hospital for attempted salvage of the digit using conservative methods. Her digit went on to demarcate at the level of the middle phalanx. Five weeks after her initial procedure, the patient underwent partial amputation of the small finger at the level of the DIP joint and 2-stage groin flap for soft tissue coverage. We discuss the effects of pregnancy and ulcerative colitis on thromboembolic events, and review the literature on digital blocks, digital tourniquet use and management of early digit necrosis. This case highlights the importance of delaying elective hand procedures in pregnant patients, especially if they have additional comorbidities such as pro-thrombotic diseases like inflammatory bowel disease.
Nightcrawler commodities: A brief history on the commodification of the humble dew worm
Authors: Steckley Joshua
Published: July 2021

Each year, 500 to 700 million dew worms are sold from thousands of gas stations, convenience stores, big box retailers, making this particular species, Lumbricus terrestris, the most popular live bait for recreational freshwater fisherman across North America. In fishing parlance, these effective bait worms are referred to as “Canadian Nightcrawlers,” not because they are native to the region (they are not) or because they cannot be found elsewhere (they can), but because the entire global supply comes from a stretch of rural land between Toronto and Windsor in Ontario, Canada. How did this simple garden worm become a valuable commodity, and why is production relegated to one single region in the world? In this paper, I rely on newspaper archives and key informant interviews to construct a “capitalist commodification story” that explain why demand for Canadian Nightcrawlers emerged in North America, why the production of nightcrawlers is relegated to southwestern Ontario, and how this lowly living, breathing, squirming creature beneath our feet became a capitalist commodity producing value through competitive markets. In sum, I argue L. terrestris became a capitalist commodity when burgeoning demand from a new class of recreational fishermen increased competition between nightcrawler suppliers. The inability of capital to take hold of the ecological conditions of nightcrawler production relegated the most productive producers to southwestern Ontario who had the contingent privileges of useful soils combined and cheap and efficient labor. The materiality of L. terrestris physiology is thus constitutive of how capital seeks to accumulate surplus value in a peculiar industry. At the same time, this research shows that no matter how peculiar or banal a commodity may be capitalist logics are constantly experimenting with heterogenous peoples and environments to find a way to increase productivity and accumulate surplus value through market exchange.
Clinical outcomes and safety of Diphoterine® irrigation for chemical eye injury: A single-centre experience in the United Kingdom
Authors: Nahaboo Solim Muzammil Ahmad , Lupion-Duran Teresa Maria , Rana-Rahman Romeela , Patel Trushar , Ah-Kine Desiree , Ting Darren S. J.
Published: July 2021

Purpose:

Diphoterine® is an amphoteric irrigating solution armed with rapid pH-neutralising action. It serves as an effective first-aid treatment for managing chemical burns, including chemical eye injury (CEI). However, its use is not widely adopted in current clinical practice, primarily attributed to limited clinical evidence. This study aims to highlight the experience in using Diphoterine for managing CEI in a UK tertiary referral centre.

Methods:

This retrospective case series included all patients who presented with CEI and treated with Diphoterine at the James Cook University Hospital, UK, between April 2018 and February 2020.

Results:

Seven patients (10 eyes) were included; the mean age was 28.2 ± 17.0 years (ranged, 3–70 years) and 85.7% were male. All patients presented with an alkaline injury with a mean presenting pH of 8.7 ± 0.7 and a median (±interquartile range [IQR]) corrected-distance visual acuity (CDVA) of 0.10 ± 0.28 logMAR. Based on Roper-Hall classification, 90% and 10% of the eyes were of grade-I and -IV CEI, respectively. All eyes received normal saline/water as the first irrigation fluid and Diphoterine as second irrigation fluid. The mean pH improved slightly after first irrigation (8.4 ± 0.7; p = 0.13) and significantly after second irrigation (7.6 ± 0.4; p = 0.001). The volume of irrigation used was significantly less for Diphoterine (520 ± 193 mL) than for normal saline/water (2700 ± 2451 mL; p = 0.016). At final follow-up (median = 5 days), the median CDVA remained stable at 0.10 ± 0.28 logMAR ( p = 0.60). One patient developed near-total limbal stem cell deficiency as a complication of grade-IV injury and was awaiting limbal stem cell transplantation at last follow-up.

Conclusion:

This study represents the first case series in the United Kingdom, reporting the use of Diphoterine in managing CEI. The rapid pH-neutralising action of Diphoterine, with less volume required, makes it an ideal initial treatment for efficiently managing adult and paediatric patients with CEI in clinics.
Multichannel impedance monitoring for distinguishing nonerosive reflux esophagitis with minor changes on endoscopy in children
Authors: Junko Fujino , Moore David , Omari Taher , Seiboth Grace , Abu-Assi Rammy , Hammond Paul , Couper Richard
Published: July 2021

Objectives:

There are reports describing the relationship between baseline impedance level and esophageal mucosal integrity at endoscopy, such as erosive and nonerosive reflux esophagitis. However, many children with symptoms of gastroesophageal reflux disease have normal findings or minor changes on esophagogastroduodenoscopy. We aimed to examine whether modest changes at esophagogastroduodenoscopy can be evaluated and correlated with esophageal multichannel intraluminal impedance monitoring.

Methods:

Patients (ages 0–17 years) with upper gastrointestinal symptoms who underwent combined esophagogastroduodenoscopy and multichannel intraluminal impedance monitoring at the Women’s and Children’s Hospital, Adelaide, Australia, between 2014 and 2016 were retrospectively studied and the following data were collected and used for analysis: demographics, multichannel intraluminal impedance data, included baseline impedance. Endoscopic findings were classified by modified Los Angeles grading, Los Angeles N as normal, Los Angeles M as with minimal change such as the erythema, pale mucosa, or friability of the mucosa following biopsy. Patients on proton pump inhibitor were excluded.

Results:

Seventy patients (43 boys; 61%) were enrolled with a mean age of 7.9 years (range 10 months to 17 years). Fifty-one patients (72.9%) were allocated to Los Angeles N, while Los Angeles M was evident in 19 patients (27.1%). Statistically significant differences were observed in the following parameters: frequency of acid and nonacid reflux and baseline impedance in channels 5 and 6. The median values of the data were 18.3 episodes, 16.0 episodes, 2461.0 Ω, 2446.0 Ω in Los Angeles N, 36.0 episodes, 31.0 episodes, 2033.0 Ω, 2009.0 Ω in Los Angeles M, respectively.

Conclusion:

Lower baseline impedance is helpful in predicting minimal endoscopic changes in the lower esophagus. A higher frequency of acid and nonacid reflux episodes was also predictive of minimal endoscopic change in the lower esophagus.
MSCFS: inferring circRNA functional similarity based on multiple data sources
Authors: Shu Liang , Zhou Cheng , Yuan Xinxu , Zhang Jingpu , Deng Lei
Published: July 2021

Background

More and more evidence shows that circRNA plays an important role in various biological processes and human health. Therefore, inferring the circRNA’s potential functions and obtaining circRNA functional similarity has become more and more significant. However, there is no effective approach to explore the functional similarity of circRNAs.

Methods

In this paper, we propose a new approach, called MSCFS, to calculate the functional similarity of circRNA by integrating multiple data sources. We combine circRNA-disease association, circRNA-gene-Gene Ontology association, and circRNA sequence information to explore the functional similarity of circRNA. Firstly, we employ different learning representation methods from three data sources to establish three circRNA functional similarity networks. Then we integrate the three networks to obtain the final circRNA functional similarity.

Results

We utilize circRNA–miRNA association similarity and circRNA co-expression similarity to evaluate the performance of MSCFS. The results show a positive correlation with miRNA association ($$R=0.213$$

R
=
0.213

) and circRNA co-expression similarity ($$R=0.8991$$

R
=
0.8991

). Finally, we construct a circRNA functional similarity network and perform case analysis. The result shows our method can be applied to infer new potential functions of circRNA and other associations.

Conclusions

MSCFS combines multiple data sources related to circRNA functions. Correlation analysis and case analyses prove that MSCFS is a useful method to explore circRNA functional similarity.
KLRD1, FOSL2 and LILRB3 as potential biomarkers for plaques progression in acute myocardial infarction and stable coronary artery disease
Authors: Zhang Qiang , Zheng Yue , Ning Meng , Li Tong
Published: July 2021

Background

Myocardial infarction (MI) contributes to high mortality and morbidity and can also accelerate atherosclerosis, thus inducing recurrent event due to status changing of coronary artery walls or plaques. The research aimed to investigate the differentially expressed genes (DEGs), which may be potential therapeutic targets for plaques progression in stable coronary artery disease (CAD) and ST-elevated MI (STEMI).

Methods

Two human datasets (GSE56885 and GSE59867) were analyzed by GEO2R and enrichment analysis was applied through Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis. To explore the seed genes, the protein–protein interaction (PPI) network was constructed and seed genes, as well as top30 ranking neighbours were screened out. To validate these findings, one human dataset GSE120521 was analyzed. Linear regression analysis and ROC curve were also performed to determine which seed genes above mentioned could be independent factors for plaques progression. Mice MI model and ELISA of seed genes were applied and ROC curve was also performed for in vivo validation.

Results

169 DEGs and 573 DEGs were screened out in GSE56885 and GSE59867, respectively. Utilizing GO and KEGG analysis, these DEGs mainly enriched in immune system response and cytokines interaction. PPI network analysis was carried out and 19 seed genes were screened out. To validate these findings, GSE120521 was analyzed and three genes were demonstrated to be targets for plaques progression and stable CAD progression, including KLRD1, FOSL2 and LILRB3. KLRD1 and LILRB3 were demonstrated to be high-expressed at 1d after MI compared to SHAM group and FOSL2 expression was low-expressed at 1d and 1w. To investigate the diagnostic abilities of seed genes, ROC analysis was applied and the AUCs of KLRD1, FOSL2 and LILRB3, were 0.771, 0.938 and 0.972, respectively.

Conclusion

This study provided the screened seed genes, KLRD1, FOSL2 and LILRB3, as credible molecular biomarkers for plaques status changing in CAD progression and MI recurrence. Other seed genes, such as FOS, SOCS3 and MCL1, may also be potential targets for treatment due to their special clinical value in cardiovascular diseases.
Determinants of acquired disability and recovery from disability in Indian older adults: longitudinal influence of socio-economic and health-related factors
Authors: Paul Ronak , Srivastava Shobhit , Muhammad T. , Rashmi Rashmi
Published: July 2021

Background

There is a higher burden of functional disability for Indian older adults with substantial variations across different geographic regions and socioeconomic groups as compared to other ageing Asian countries. Thus, using a national sample of older adults aged 60+ years, we aim to explore how common is acquiring of disability and recovery from disability among the older population of a developing country like India, and how do the various socioeconomic and health-related conditions impact this transition in disability status.

Method

The current study uses two waves of the India Human Development Survey (IHDS) and is based on panel data of 10,527 older adults. Both bivariate and multiple variable regression analysis were performed using two binary outcome variables in this study – whether older adults acquired disability and recovered from disability between round-I and round-II, respectively.

Results

Nearly 31.5% and 4.4 % of older adults have acquired and recovered disability across the two rounds respectively. About 38.5%  and 45.8 % of female older adults’ disability status changes to disable and recovered in round-II respectively. A lesser proportion of older adults have recovered from a disability who have a chronic disease in round-I. Cataract chronic conditions among older adults in round-I had shown 1.45 times (CI: 1.07–1.97) a significantly higher likelihood of acquiring disability in round-I. Older adults who were unmarried and were not working in round-I have 1.12 times (CI: 1.01–1.25) and 1.21 times (CI: 1.06–1.39) higher likelihood of acquiring disability in round-II respectively. Recovering from disability was mostly seen among older adults who belong to the richest (OR: 2.38, CI: 1.31–4.33) and medium (OR: 2.16, CI: 1.27–3.69) wealth quintile households. Older adults residing in the central region of India have 2.72 times (CI: 2.31–3.19) significantly higher chance of acquiring disability than those who were residing in northern regions.

Conclusion

Appropriate measures are required to highlight the importance of chronic physical diseases and several socio-demographic factors that may negatively affect the trajectory of disability in older ages.
Modified FOLFIRINOX versus gemcitabine plus oxaliplatin as first-line chemotherapy for patients with locally advanced or metastatic cholangiocarcinoma: a retrospective comparative study
Authors: Zou Lu , Li Xuechuan , Wu Xiangsong , Cui Jiujie , Cui Xuya , Song Xiaoling , Ren Tai , Han Xusheng , Zhu Yidi , Li Huaifeng , Wu Wenguang , Wang Xu’an , Gong Wei , Wang Liwei , Li Maolan , Lau Wan Yee , Liu Yingbin
Published: July 2021

Background

Gemcitabine plus platinum as the first-line chemotherapy for cholangiocarcinoma (CCA) has limited efficacy. The aim of this study was to evaluate the effectiveness of modified FOLFIRINOX (mFOLFIRINOX) compared to that of gemcitabine plus oxaliplatin (Gemox) for patients with locally advanced or metastatic CCA.

Methods

From January 2016 to December 2019, consecutive patients who were diagnosed with locally advanced or metastatic CCA were treated with either mFOLFIRINOX or Gemox as a first-line chemotherapy. The main endpoint was Progression free survival (PFS). The second endpoints were Overall survival (OS), Disease control rate (DCR) and incidence of severe toxicity (grade 3–4). Tumors were evaluated at baseline and thence every 4–6 weeks. The study was designed and carried out in accordance with the principles of the declaration of Helsinki, approved by the Ethics Committee of Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine (XHEC-D-2020-154) and registered with ClinicalTrials.gov, number NCT04305288 (registration date: 12/03/2020).

Results

Of 49 patients in this study, 27 were in the FOLFIRINOX regimen group and 22 in the Gemox regimen group. There were no significant differences between groups in baseline characteristics. The DCR was 77.8% in the mFOLFIRINOX group and 63.5% in the Gemox group. The corresponding median PFS was 9.9 months (95% confidence interval [CI], 7.3–12.4) in the mFOLFIRINOX group versus 6.4 months (95% CI,3.6–9.2, p = 0.040) in the Gemox group. The corresponding median OS was 15.7 months (95% CI, 12.5–19.0) versus 12.0 months (95% CI, 9.3–14.8, p = 0.099). Significantly more grade 3–4 vomiting occurred in the mFOLFIRINOX than the Gemox groups (7 (25.9%) vs 1 (4.5%), p = 0.044).

Conclusions

First-line mFOLFIRINOX offered more promising results in patients with advanced or metastatic CCA.
Radiomic assessment as a method for predicting tumor mutation burden (TMB) of bladder cancer patients: a feasibility study
Authors: Tang Xin , Qian Wen-lei , Yan Wei-feng , Pang Tong , Gong You-ling , Yang Zhi-gang
Published: July 2021

Background

Tumor mutation burden (TMB) is an emerging prognostic biomarker of immunotherapy for bladder cancer (BLCA). We aim at investigating radiomic features’ value in predicting the TMB status of BLCA patients.

Methods

Totally, 75 patients with BLCA were enrolled. Radiomic features extracted from the volume of interest of preoperative pelvic contrast-enhanced computed tomography (CECT) were obtained for each case. Unsupervised hierarchical clustering analysis was performed based on radiomic features. Sequential univariate Logistic regression, the least absolute shrinkage and selection operator (LASSO) regression and the backward stepwise regression were used to develop a TMB-predicting model using radiomic features.

Results

The unsupervised clustering analysis divided the total cohort into two groups, i.e., group A (32.0%) and B (68.0%). Patients in group A had a significantly larger proportion of having high TMB against those in group B (66.7% vs. 41.2%, p = 0.039), indicating the intrinsic ability of radiomic features in TMB-predicting. In univariate analysis, 27 radiomic features could predict TMB. Based on six radiomic features selected by logistic and LASSO regression, a TMB-predicting model was built and visualized by nomogram. The area under the ROC curve of the model reached 0.853. Besides, the calibration curve and the decision curve also revealed the good performance of the model.

Conclusions

Our work firstly proved the feasibility of using radiomics to predict TMB for patients with BLCA. The predictive model based on radiomic features from pelvic CECT has a promising ability to predict TMB. Future study with a larger cohort is needed to verify our findings.
Development and psychometric validity of the perioperative anxiety scale-7 (PAS-7)
Authors: Zhang Chengjiao , Liu Xitong , Hu Tianran , Zhang Fei , Pan Lingyi , Luo Yan , Wang Zhen
Published: July 2021

Background

Preoperative anxiety is a common psychological reaction in perioperative patients. The absence of a valid measurement tool hinders the evaluation of interventions to treat preoperative anxiety in China. This study aims to develop the Perioperative Anxiety Scale-7 (PAS-7) and test its reliability, validity, and cut-off value.

Methods

A total of 280 patients over 16 years old (M = 55.1, SD = 14.3) who were undergoing elective surgery were recruited to complete the PAS-7 and the Generalized Anxiety Disorder-7 scale (GAD-7) one day before surgery.

Results

The PAS-7 included seven items divided into two dimensions: mental anxiety and somatic anxiety. These two dimensions could explain 74.294% of the population variance. The internal consistency of each dimension ranged from 0.761–0.933. The confirmatory factor analysis showed that the model fit of the scale was good (χ2= 34.798, df = 13, χ2/df = 2.677, CFI = 0.949, TLI = 0.918, SRMR = 0.057, RMSEA = 0.115). The correlations between the GAD-7 and each dimension and the scale’s total score were significant (0.711–0.789). A cut-off score of 8, maximizing the Youden Index, yielded a sensitivity of 75% and a specificity of 84.6% (95% CI: 0.88 ~ 0.97).

Conclusions

The PAS-7 had good reliability and validity and could be used as an effective tool to evaluate preoperative anxiety.
An Indigenous food sovereignty initiative is positively associated with well-being and cultural connectedness in a survey of Syilx Okanagan adults in British Columbia, Canada
Authors: Blanchet Rosanne , Batal Malek , Johnson-Down Louise , Johnson Suzanne ,   Okanagan Nation Salmon Reintroduction Initiatives, Louie Colette , Terbasket Eliza , Terbasket Pauline , Wright Howie , Willows Noreen
Published: July 2021

Background

For the Syilx Okanagan Nation in Canada, salmon has vital nutritional, cultural, and spiritual significance. Yet, the Okanagan Sockeye salmon population came to near extinction, resulting in a drastic decline in salmon consumption from high historical levels. Thus, restoring and protecting salmon is crucial to Syilx well-being and way of life. A Syilx-led food sovereignty initiative re-established the Okanagan Sockeye salmon population, which has resulted in a rise in fish harvesting. The aim of this study was to assess whether engaging with this initiative was associated with health, well-being, and cultural connectedness (i.e., degree to which one is integrated in their culture) among Syilx adults. Eating Okanagan Sockeye salmon was conceptualized as a proxy for engaging with this Indigenous food sovereignty initiative.

Methods

265 Syilx adults completed a survey including a traditional food frequency questionnaire and questions on health status (e.g., BMI, self-assessed physical health), well-being (e.g., life satisfaction, stress levels), and cultural connectedness (e.g., sense of belonging, importance of cultural practices). Participants were divided into 3 groups based on their wild salmon eating during the year prior to the survey: (1) adults who ate Okanagan Sockeye salmon, (2) adults who ate salmon but did not usually know the species of the salmon they ate, or who solely ate salmon that were not Okanagan Sockeye; and (3) adults who did not eat any salmon.

Results

A statistically significant gradient was observed for enhanced well-being and cultural connectedness, with individuals in group 1 having better indicators than those in group 2, and adults in groups 1 and 2 having better indicators than adults in group 3. No differences were observed in physical health outcomes between the three groups.

Conclusion

Findings suggest that the initiative to re-establish Okanagan Sockeye salmon in the Okanagan River system may have led to better well-being and cultural connectedness among Syilx adults. This study highlights the importance of Indigenous food sovereignty as a way to enhance well-being and cultural connectedness among First Nations in Canada. Findings also reinforce the importance of assessing health and well-being in a wholistic way in Indigenous health research.
Using path analysis to test theory of change: a quantitative process evaluation of the MapSan trial
Authors: Bick Sarah , Buxton Helen , Chase Rachel P. , Ross Ian , Adriano Zaida , Capone Drew , Knee Jackie , Brown Joe , Nalá Rassul , Cumming Oliver , Dreibelbis Robert
Published: July 2021

Background

Although theory-driven evaluations should have empirical components, few evaluations of public health interventions quantitatively test the causal model made explicit in the theory of change (ToC). In the context of a shared sanitation trial (MapSan) in Maputo, Mozambique, we report findings of a quantitative process evaluation assessing intervention implementation, participant response and impacts on hypothesised intermediary outcomes on the pathway to trial health outcomes. We examine the utility of path analysis in testing intervention theory using process indicators from the intervention’s ToC.

Methods

Process data were collected through a cross-sectional survey of intervention and control compounds of the MapSan trial > 24-months post-intervention, sampling adult residents and compound leaders. Indicators of implementation fidelity (dose received, reach) and participant response (participant behaviours, intermediary outcomes) were compared between trial arms. The intervention’s ToC (formalised post-intervention) was converted to an initial structural model with multiple alternative pathways. Path analysis was conducted through linear structural equation modelling (SEM) and generalised SEM (probit model), using a model trimming process and grouped analysis to identify parsimonious models that explained variation in outcomes, incorporating demographics of respondents and compounds.

Results

Among study compounds, the MapSan intervention was implemented with high fidelity, with a strong participant response in intervention compounds: improvements were made to intermediary outcomes related to sanitation ‘quality’ – latrine cleanliness, maintenance and privacy – but not to handwashing (presence of soap / soap residue). These outcomes varied by intervention type: single-cabin latrines or multiple-cabin blocks (designed for > 20 users). Path analysis suggested that changes in intermediary outcomes were likely driven by direct effects of intervention facilities, with little contribution from hygiene promotion activities nor core elements expected to mediate change: a compound sanitation committee and maintenance fund. A distinct structural model for two compound size subgroups (≤ 20 members vs. > 20 members) explained differences by intervention type, and other contextual factors influenced specific model parameters.

Conclusions

While process evaluation found that the MapSan intervention achieved sufficient fidelity and participant response, the path analysis approach applied to test the ToC added to understanding of possible ‘mechanisms of change’, and has value in disentangling complex intervention pathways.

Trial registration

MapSan trial registration:NCT02362932Feb-13-2015.
The prevalence of multimorbidity in primary care: a comparison of two definitions of multimorbidity with two different lists of chronic conditions in Singapore
Authors: Lee Eng Sing , Lee Poay Sian Sabrina , Xie Ying , Ryan Bridget L. , Fortin Martin , Stewart Moira
Published: July 2021

Background

The prevalence of multimorbidity varies widely due to the lack of consensus in defining multimorbidity. This study aimed to measure the prevalence of multimorbidity in a primary care setting using two definitions of multimorbidity with two different lists of chronic conditions.

Methods

We conducted a cross-sectional study of 787,446 patients, aged 0 to 99 years, who consulted a family physician between July 2015 to June 2016. Multimorbidity was defined as ‘two or more’ (MM2+) or ‘three or more’ (MM3+) chronic conditions using the Fortin list and Chronic Disease Management Program (CDMP) list of chronic conditions. Crude and standardised prevalence rates were reported, and the corresponding age, sex or ethnic-stratified standardised prevalence rates were adjusted to the local population census.

Results

The number of patients with multimorbidity increased with age. Age-sex-ethnicity standardised prevalence rates of multimorbidity using MM2+ and MM3+ for Fortin list (25.9, 17.2%) were higher than those for CDMP list (22.0%; 12.4%). Sex-stratified, age-ethnicity standardised prevalence rates for MM2+ and MM3+ were consistently higher in males compared to females for both lists. Chinese and Indians have the highest standardised prevalence rates among the four ethnicities using MM2+ and MM3+ respectively.

Conclusions

MM3+ was better at identifying a smaller number of patients with multimorbidity requiring higher needs compared to MM2+. Using the Fortin list seemed more appropriate than the CDMP list because the chronic conditions in Fortin’s list were more commonly seen in primary care. A consistent definition of multimorbidity will help researchers and clinicians to understand the epidemiology of multimorbidity better.
Nurses’ ethical decision-making during end of life care in South Korea: a cross-sectional descriptive survey
Authors: Lim Arum , Kim Sanghee
Published: July 2021

Background

Although nurses are crucial to ensure patients’ peaceful death in hospitals, many nurses experience various ethical conflicts during end-of-life care. Therefore, research on nurses’ entire ethical decision-making process is required to improve nurses’ ethical decision-making in end-of-life care. This study aimed to identify Korean nurses’ ethical decision-making process based on their moral sensitivity to end-of-life patients.

Methods

In total, 171 nurses caring for terminal patients responded to the survey questionnaire. To measure the participants’ moral sensitivity and ethical decision-making process, we used the Korean version of the Moral Sensitivity Questionnaire and Nurses’ Ethical Decision-Making around End of Life Care Scale. Finally, multiple linear regression analysis was used to investigate the effect of moral sensitivity on nurses’ ethical decision-making.

Results

The mean of moral sensitivity was 4.8 ± 0.5 (out of 7), and that of ethical decision-making was 4.6 ± 0.5 (out of 6). Among the sub-dimensions of ethical decision-making, the highest score was in perceived professional accountability (5.2 ± 0.5), and the lowest in moral reasoning and moral agency (3.9 ± 0.6); the score of moral practice was 4.4 ± 0.7. In the multiple linear regression model, moral sensitivity (β = 0.852, p < .001), clinical department (β =  − 7.018, p = .035), ethics education (β = 20.450, p < .001), job satisfaction (β = 5.273, p < .001), and ethical conflict (β =  − 2.260, p = 0.031) were influential ethical decision-making factors.

Conclusions

This study revealed a gap between nurses’ thoughts and practices through the ethical decision-making process. They failed to lead their thought to moral practice. It also implies that moral sensitivity could positively affect nurses’ ethical decision-making. To make nurses morally sensitive, exposing them to various clinical cases would be helpful. Additionally, ethics education and clinical ethics supporting services are valuable for improving nurses’ ethical decision-making. If nurses improved their ethical decision-making regarding end-of-life care, their patients could experience a better quality of death.