bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of airway stenting and nasogastric tube insertion in airway–esophageal fistula patients with airways compromised by advanced malignancy
Authors: Wu Xue , Lu Guangbing , Luo Lin cheng , Wei Hailong , Yi Qun , Luo Wei
Published: February 2024

Introduction

Whether airway‐compromised airway–esophageal fistula (AEF) patients should undergo combined airway and esophageal stenting is controversial. This study was designed to evaluate the survival prognosis and poststent interventions in AEF patients with airways compromised by advanced malignancy with or without airway stents.

Methods

A retrospective analysis of the medical records, survival times, and poststent interventions of 17 patients with or without airway stents was performed.

Results

The causes of AEF were esophageal cancer (11/17, 64.7%), lung cancer (6/17, 29.4%), and thyroid cancer (1/17, 5.9%). All patients received a nasogastric tube (n = 12) or underwent gastrostomy (n = 5) to resume enteral nutrition. Thirteen patients underwent airway stent insertion (13/17, 76.5%), whereas four patients did not. Four patients with a high risk of stent migration received external stent fixation to the trachea. Three of the patients with stents suffered severe granulation tissue formation and needed repeated bronchoscopy interventions. In the stented group, none of the patients developed stent migration, and the overall median survival time was 9 months, compared with 1.25 months in the nonstented group (P = 0.04). Cox proportional hazards regression revealed that stent insertion, nasogastric tube insertion, and transcatheter bronchial artery chemoembolization were protective factors against death, whereas surgery‐related fistula, fistula larger than 2 cm, continued chemotherapy, and age were risk factors for poor survival (P < 0.05).

Conclusion

In airway‐compromised AEF patients, airway stents and nasogastric tubes are probably the preferred treatments. Airway stenting is tolerable, and routine weekly poststent bronchoscopy is needed in the first month and depending on respiratory symptoms thereafter.
The diagnostic utility of Merkel cell polyoma virus immunohistochemistry in cytology specimens
Authors: Mubeen Aysha , Mito Jeffrey K.
Published: February 2024

Objective

Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine neoplasm that predominantly affects elderly and immunocompromised patients. Merkel cell polyoma virus (MCPyV) is clonally integrated into the majority of MCCs and has been linked to patient outcomes, playing a central role in the pathogenesis of the disease. We aimed to assess the utility of MCPyV immunohistochemistry (IHC) in the diagnosis of MCC in cytology cell block specimens and correlating with clinicopathologic features.

Methods

Fifty‐three cytology samples of MCC with sufficient cell block material were stained for MCPyV by IHC and scored semi‐quantitatively in extent and intensity. Morphologic mimics of MCC including small cell lung carcinoma (n = 10), non‐Hodgkin lymphoma (n = 10), basaloid squamous cell carcinoma (n = 6) and other neuroendocrine carcinomas (n = 8) were stained in parallel. Positive staining was defined as >1% of the tumour cells showing at least moderate staining intensity.

Results

The cytologic features of MCC were characterized by high nuclear‐cytoplasmic ratios, hyperchromatic nuclei with ‘salt and pepper’ chromatin, and nuclear moulding. MCPyV was detected in 24 of 53 cases (45%). Staining was strong and diffuse in roughly half of the positive samples. Of the morphologic mimics, one follicular lymphoma showed strong and diffuse staining. In contrast to prior studies, we saw no association between MCPyV status and patient outcomes.

Conclusion

Merkel cell polyoma virus IHC is highly specific (97%) for the diagnosis of MCC in our cohort, and can serve as a useful diagnostic tool for distinguishing MCC for morphologic mimics.
Publishing in the Open Access and Open Science era
Authors: Arita Masanori , Pulverer Bernd , Uemura Tadashi , Sakuma Chisako , Hayashi Shigeo
Published: February 2024

Our research activities would be better served if they were communicated in a manner that is openly accessible to the public and all researchers. The research we share is often limited to representative data included in research papers—science would be much more efficient if all reproducible research data were shared alongside detailed methods and protocols, in the paradigm called Open Science. On the other hand, one primary function of research journals is to select manuscripts of good quality, verify the authenticity of the data and its impact, and deliver to the appropriate audience for critical evaluation and verification. In the current paradigm, where publication in a subset of journals is intimately linked to research evaluation, a hypercompetitive “market” has emerged where authors compete to access a limited number of top‐tier journals, leading to high rejection rates. Competition among publishers and scientific journals for market dominance resulted in an increase in both the number of journals and the cost of publishing and accessing scientific papers. Here we summarize the current problems and potential solutions from the development of AI technology discussed in the seminar at the 46th Annual Meeting of the Molecular Biology Society of Japan.
Longitudinal changes in diffusion tensor imaging in hemodialysis patients
Authors: Richerson Wesley T. , Schmit Brian D. , Wolfgram Dawn F.
Published: February 2024

Introduction

Hemodialysis patients have increased white matter and gray matter pathology in the brain relative to controls based on MRI. Diffusion tensor imaging is useful in detecting differences between hemodialysis and controls but has not identified the expected longitudinal decline in hemodialysis patients. In this study we implemented specialized post‐processing techniques to reduce noise to detect longitudinal changes in diffusion tensor imaging parameters and evaluated for any association with changes in cognition.

Methods

We collected anatomical and diffusion MRIs as well as cognitive testing from in‐center hemodialysis patients at baseline and 1 year later. Gray matter thickness, white matter volume, and white matter diffusion tensor imaging parameters were measured to identify longitudinal changes. We analyzed the diffusion tensor imaging parameters by averaging the whole white matter and using a pothole analysis. Eighteen hemodialysis patients were included in the longitudinal analysis and 15 controls were used for the pothole analysis. We used the NIH Toolbox Cognition Battery to assess cognitive performance over the same time frame.

Findings

Over the course of a year on hemodialysis, we found a decrease in white matter fractional anisotropy across the entire white matter (p < 0.01), and an increase in the number of white matter fractional anisotropy voxels below pothole threshold (p = 0.03). We did not find any relationship between changes in whole brain structural parameters and cognitive performance.

Discussion

By employing noise reducing techniques, we were able to detect longitudinal changes in diffusion tensor imaging parameters in hemodialysis patients. The fractional anisotropy declines over the year indicate significant decreases in white matter health. However, we did not find that declines in fractional anisotropy was associated with declines in cognitive performance.
Association between tumor morphology and efficacy of atezolizumab plus bevacizumab for advanced hepatocellular carcinoma
Authors: Ishihara Nobuaki , Komatsu Shohei , Sofue Keitaro , Ueshima Eisuke , Yano Yoshihiko , Fujishima Yoshimi , Ishida Jun , Kido Masahiro , Gon Hidetoshi , Fukushima Kenji , Urade Takeshi , Yanagimoto Hiroaki , Toyama Hirochika , Ueda Yoshihide , Kodama Yuzo , Murakami Takamichi , Fukumoto Takumi
Published: February 2024

Aim

The IMbrave150 trial revealed that atezolizumab plus bevacizumab (AtezoBv) showed a higher objective response rate (ORR) in patients with advanced hepatocellular carcinoma (HCC). Although conversion therapy after AtezoBv has been recently reported, markers predictive of its efficacy, particularly radiological imaging markers, have not yet been identified. The present study focused on tumor morphological appearance on radiological imaging and evaluated whether it could be associated with AtezoBv efficacy.

Methods

Ninety‐five intrahepatic lesions in 74 patients who were given AtezoBv for advanced HCC were recruited for evaluation. The lesions were divided into two groups, simple nodular (SN group) and non‐simple nodular (non‐SN group), based on the gross morphology on pretreatment imaging, and retrospectively evaluated for treatment response and other relevant clinical outcomes.

Results

Assessing the size of individual tumors after treatment, waterfall plots showed that tumor shrinkage in the non‐SN group including 56 lesions was higher than that in the SN group comprising 39 lesions. The ORR was significantly higher in the non‐SN group (39.3% vs. 15.4%, p = 0.012). Additionally, the median time to nodular progression was longer in the non‐SN group (21.0 months vs. 8.1 months, p = 0.119) compared to the SN group. Six patients with non‐SN lesions underwent sequential local therapy.

Conclusions

Atezolizumab plus bevacizumab may show increased therapeutic efficacy in patients with tumors with a higher potential for aggressive oncological behavior, such as non‐SN lesions. Treatment strategies focusing on conversion therapy may be crucial in patients with non‐SN lesions.
A qualitative study assessing allied health provider perceptions of telepractice functionality in therapy delivery for people with disability
Authors: Benz Cloe , Dantas Jaya , Welsh Mai , Norman Richard , Robinson Suzanne , Hendrie Delia
Published: February 2024

Introduction

Telepractice service delivery of allied health interventions to people with disability can potentially reduce access barriers and improve service equity. However, questions remain regarding telepractice functionality for people with disability. This study addressed questions related to how allied health clinicians and managers perceive telepractice as functioning in the provision of therapy services to people with disability.

Methods

Thirteen interviews of allied health clinicians and managers from across Australia were conducted between 21 November and 22 February via MS teams. Qualitative methodology and critical realist theoretical paradigm underpin the study. Data analysis was completed using a reflective thematic analysis method and five themes were generated and described utilising an analytic metaphor.

Results

The study themes were described in relation to a shopping for shoes analytic metaphor and the five themes included (1) a shoe for every foot, (2) planned purchases, (3) shoe on the other foot, (4) you need both shoes and (5) help choosing their shoes. In summary, the function of telepractice fits differently for each individual, similar to pairs of shoes.

Conclusions

Telepractice has its own strengths and weaknesses and isn't a direct substitute for in‐person sessions, much like left and right shoes are similar but not the same. The results support participant perceptions that telepractice functions best as an adjunct to in‐person sessions through a flexible hybrid delivery model in the provision of therapy services to people with a disability. A strategy for improving perceived usefulness may involve positioning telepractice as unique with strengths and weaknesses, not replacing in‐person care.

Patient or Public Contribution

The paper forms part of a larger codesign process which included customer and carer participants throughout the design and planning of the project, inclusion of a peer researcher, and the selection of the analytic metaphor including in the findings of this article production.
Periocular sebaceous carcinoma: updates in the diagnosis, treatment, staging, and management
Authors: Dini Federica , Susini Pietro , Nisi Giuseppe , Cuomo Roberto , Grimaldi Luca , Massi Daniela , Innocenti Alessandro , Doni Laura , Mazzini Cinzia , Santoro Nicola , De Giorgi Vincenzo
Published: February 2024

Periocular sebaceous carcinoma (PSC) is a rare, aggressive, and potentially metastatic adnexal malignancy. Due to the ability of PSC to resemble several benign and malignant conditions, diagnosis is often delayed or mistaken. In addition, even with a known diagnosis, choosing the right treatment is still an open debate. For this reason, we decided to review the most up‐to‐date literature on PSC and propose a dedicated procedural protocol to help clinicians when dealing with PSC. A PubMed search was carried out using the terms “Sebaceous Carcinoma”, “Adnexal Periocular Cancer”, “Sebaceous Carcinoma AND eyelid”, “Periocular Sebaceous Carcinoma”, and “Ocular Adnexa”. Pertinent studies published in English from 1997 up to December 2022 were compared to the selection criteria and if suitable, included in this review. Through the initial search, 84 articles were selected. Of these, 36 were included in the final study. Several papers explored different diagnostic and therapeutic strategies regarding PSC diagnosis and management. In light of the current literature review and the multidisciplinary experience of three clinical centers, a dedicated procedural protocol is proposed. PSC diagnosis may be achieved through accurate clinical evaluation, but it requires histopathologic confirmation, which can be challenging. Dermoscopy, in vivo reflectance confocal microscopy, and optical coherence tomography may facilitate PSC clinical examination, while immunohistochemistry stains may support histological diagnosis. Appropriate disease staging is necessary before choosing the treatment, as local disease requires radically different treatment compared to advanced disease. In addition, recent innovations in nonsurgical treatments, including radio‐chemotherapy, immunotherapy, and targeted therapy, may be a viable option in the most challenging cases.
Pulsed electric field processing in the dairy sector: A review of applications, quality impact and implementation challenges
Authors: Vashisht Pranav , Singh Lovepreet , Mahanta Shikhadri , Verma Digvijay , Sharma Sachin , Saini Gursharn Singh , Sharma Aditya , Chowdhury Bhaswati , Awasti Nancy , Gaurav  , Mahanta Snehadri , Chauhan Divya Singh
Published: February 2024

Customer priority for consuming dairy products with intact natural characteristics is leading the food processing trends towards the extensive exploration of non‐thermal technologies. Pulsed electric field (PEF) technique has arisen as a potential and sustainable processing solution. This review discusses the microbial and enzyme inactivation potential of PEF technique in milk and milk products. Alongside its effect on their natural characteristics. Its potential for better probiotic retention in spray‐dried powders, dairy waste treatment and nutrient enrichment application in dairy products has also been highlighted. PEF has demonstrated its effectiveness in ensuring the dairy product's safety with minimal effects on quality parameters. However, these findings are limited to lab and pilot scale level. Further, extensive research is needed at a commercial scale for the implementation of this technology in the dairy industry.
Nurse‐led self‐management education and support programme on self‐management behaviour and quality of life among adults with type 2 diabetes: A pilot randomized controlled trial
Authors: Diriba Dereje Chala , Leung Doris Y. P. , Suen Lorna K. P.
Published: February 2024

Aim

This study examined the preliminary effects of a nurse‐led self‐management education and support programme on the self‐management behaviours and quality of life among people with type 2 diabetes in Western Ethiopia.

Methods

A pilot randomized controlled trial was conducted between January and August 2021. Participants were recruited in the hospital and randomly assigned to the control arm to continue usual care (n = 38) or the intervention arm to receive usual care and the diabetes self‐management education and support programme (n = 38) in the community. Self‐management behaviours and quality of life were assessed using a 10‐item summary of diabetes self‐care activity (expanded) scale and a 34‐item diabetes quality of life measure, respectively, at baseline and 2 months after follow‐up. Generalized estimating equation models were used to examine the preliminary effects of the programme on the outcomes.

Results

Preliminary results indicated that the programme outperformed usual care in self‐management practise, with large effect sizes immediately postintervention and at 2 months after the intervention, and quality of life at 2 months after the intervention.

Conclusion

A nurse‐led diabetes self‐management education and support intervention, including the families of people with diabetes, may be an option to boost the self‐management practise and quality of life of patients with diabetes.
Impact of the COVID‐19 related border restrictions on influenza and other common respiratory viral infections in New Zealand
Authors: Huang Q. Sue , Turner Nikki , Wood Tim , Anglemyer Andrew , McIntyre Peter , Aminisani Nayyereh , Dowell Tony , Trenholme Adrian , Byrnes Cass , Balm Michelle , McIntosh Christine , Jefferies Sarah , Grant Cameron C. , Nesdale Annette , Dobinson Hazel C. , Campbell‐Stokes Priscilla , Daniells Karen , Geoghegan Jemma , de Ligt Joep , Jelley Lauren , Seeds Ruth , Jennings Tineke , Rensburg Megan , Cueto Jort , Caballero Ernest , John Joshma , Penghulan Emmanuel , Tan Chor Ee , Ren Xiaoyun , Berquist Klarysse , O'Neill Meaghan , Marull Maritza , Yu Chang , McNeill Andrea , Kiedrzynski Tomasz , Roberts Sally , McArthur Colin , Stanley Alicia , Taylor Susan , Wong Conroy , Lawrence Shirley , Baker Michael G. , Kvalsvig Amanda , Van Der Werff Koen , McAuliffe Gary , Antoszewska Hanna , Dilcher Meik , Fahey Jennifer , Werno Anja , Elvy Juliet , Grant Jenny , Addidle Michael , Zacchi Nicolas , Mansell Chris , Widdowson Marc‐Alain , Thomas Paul G. ,   BorderRestrictionImpactOnFluRSV Consortium, Webby Richard J.
Published: February 2024

Background

New Zealand's (NZ) complete absence of community transmission of influenza and respiratory syncytial virus (RSV) after May 2020, likely due to COVID‐19 elimination measures, provided a rare opportunity to assess the impact of border restrictions on common respiratory viral infections over the ensuing 2 years.

Methods

We collected the data from multiple surveillance systems, including hospital‐based severe acute respiratory infection surveillance, SHIVERS‐II, ‐III and ‐IV community cohorts for acute respiratory infection (ARI) surveillance, HealthStat sentinel general practice (GP) based influenza‐like illness surveillance and SHIVERS‐V sentinel GP‐based ARI surveillance, SHIVERS‐V traveller ARI surveillance and laboratory‐based surveillance. We described the data on influenza, RSV and other respiratory viral infections in NZ before, during and after various stages of the COVID related border restrictions.

Results

We observed that border closure to most people, and mandatory government‐managed isolation and quarantine on arrival for those allowed to enter, appeared to be effective in keeping influenza and RSV infections out of the NZ community. Border restrictions did not affect community transmission of other respiratory viruses such as rhinovirus and parainfluenza virus type‐1. Partial border relaxations through quarantine‐free travel with Australia and other countries were quickly followed by importation of RSV in 2021 and influenza in 2022.

Conclusion

Our findings inform future pandemic preparedness and strategies to model and manage the impact of influenza and other respiratory viral threats.
Analgesic efficacy of local infiltration anaesthesia versus femoral nerve block in alleviating postoperative wound pain following total knee arthroplasty: A systematic review and meta‐analysis
Authors: Yu Dongdong , Wu Yajing , Han Shuang , Wang Xiaoyu , Jiang Li
Published: February 2024

Total knee arthroplasty (TKA) often involves significant postoperative pain, necessitating effective analgesia. This meta‐analysis compares the analgesic efficacy of local infiltration anaesthesia (LIA) and femoral nerve block (FNB) in managing postoperative wound pain following TKA. Adhering to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, this meta‐analysis was structured around the PICO framework, assessing studies that directly compared LIA and FNB in TKA patients. A comprehensive search across PubMed, Embase, Web of Science and the Cochrane Library was conducted without time restrictions. Studies were included based on specific criteria such as participant demographics, study design and outcomes like pain scores and opioid consumption. Quality assessment utilized the Cochrane Collaboration's risk of bias tool. The statistical approach was determined based on heterogeneity, with the choice of fixed‐ or random‐effects models guided by the I2 statistic. Sensitivity analysis and evaluation of publication bias using funnel plots and Egger's linear regression test were also conducted. From an initial pool of 1275 articles, eight studies met the inclusion criteria. These studies conducted in various countries from 2007 to 2016. The meta‐analysis showed no significant difference in resting and movement‐related Visual Analogue Scale scores post‐TKA between the LIA and FNB groups. However, LIA was associated with significantly lower opioid consumption. The quality assessment revealed a low risk of bias in most studies, and the sensitivity analysis confirmed the stability of these findings. There was no significant publication bias detected. Both LIA and FNB are effective in controlling postoperative pain in TKA patients, but LIA offers the advantage of lower opioid consumption. Its simplicity, cost‐effectiveness and opioid‐sparing nature make LIA the recommended choice for postoperative analgesia in knee replacement surgeries.
Variable rate premiums and defined benefit pension funding
Authors: Sadler Abbie
Published: February 2024

This study investigates the association between variable rate premiums (VRPs) charged by the Pension Benefit Guaranty Corporation (PBGC) and defined benefit pension funding in the United States. The PBGC requires VRPs from firms that fail to adequately fund their pension plans. Because millions rely on pension income, it is important to understand how government incentives impact pension funding decisions. In the aggregate, VRPs are positively associated with increases in pension funding. However, these premiums are not associated with excess pension contributions (EPCs) for financially distressed firms. These results suggest that financially distressed US firms engage in risk shifting. The lack of association persists even for financially distressed firms with tax benefits associated with pension funding. Finally, the association between VRPs and EPCs holds only for firms with combined lower borrowing costs and higher premiums. This finding suggests that higher premiums are not an effective incentive when firms also face higher borrowing costs and that lower premiums are not an effective incentive for EPCs, regardless of a firm's borrowing cost.
Exosome inhibition improves response to first‐line therapy in small cell lung cancer
Authors: Irep Nesrin , Inci Kubilay , Tokgun Pervin Elvan , Tokgun Onur
Published: February 2024

Exosomes are recognized as important mediators of cell‐to‐cell communication, facilitating carcinogenesis. Although there have been significant advancements in exosome research in recent decades, no drugs that target the inhibition of sEV secretion have been approved for human use. For this study, we employed GW4869 and Nexinhib20 as inhibitors of exosome synthesis and trafficking combined. First, we found that Nexinhib20 and GW4869 effectively inhibited RAB27A and neutral sphingomyelinase 2 (nSMase2) nsMase2. Interestingly, the inhibition of nsMase2 and RAB27A decreased expression of CD9, CD63 and Tsg101, both at RNA and protein levels. We used a combination treatment strategy of cisplatin/etoposide plus GW4869 or Nexinhib20 on small cell lung cancer (SCLC) cell lines. The combination treatment of GW4869 or Nexinhib20 effectively enhanced the inhibitory effects of first‐line chemotherapy on the SCLC cells. Furthermore, we demonstrated that reducing exosome release through GW4869 and Nexinhib20 treatment effectively reduced cellular proliferation and significantly induced apoptosis in SCLC cells. Also, we showed that combining exosome inhibition with chemotherapy has a significant synergistic effect on cellular proliferation. We also found increased p53 and p21 expressions with western blot and significantly changing Bax, BCL2, caspase‐3 and caspase‐9 expressions. Inhibiting the exosome pathway offers opportunities for developing novel, effective treatment strategies for SCLC.
Crowd‐based spatial risk assessment of urban flooding: Results from a municipal flood hotline in Detroit,MI
Authors: Larson Peter S. , Thorsby Jamie Steis , Liu Xinyu , King Eleanor , Miller Carol J.
Published: February 2024

Climate change is increasing the frequency and intensity of extreme precipitation events, raising the risk of urban flood disasters. This study uses a crowd‐sourced municipal call database to characterize the spatial distribution of flood risk in Detroit, MI. Call data including dates and addresses were obtained from the City of Detroit Department of Public Works for 2021. Calls were mapped and aggregated to census tract counts and merged with neighborhood‐level data. Associations of predictors with flood calls were tested using spatial regression models. Flooding calls were located throughout the city but were concentrated in specific areas. Multivariate models of census tract level call counts indicated that increased poverty and Black, immigrant, and older residents were positively associated with flood calls, while increased elevation was associated with protective effects. Longer distances from waste water interceptors were associated with higher risk for calls. Crowd‐sourced flood hotline call data can be used for effective spatial flood risk assessment. Though flooding occurs throughout the city of Detroit, infrastructural, neighborhood, and household factors influence flooding extent. Limitations included the self‐reported nature of calls. Future modeling efforts might include input from local stakeholders to improve spatial risk assessment.
Comparison of postoperative survival between early‐onset and late‐onset adenocarcinoma of esophagogastric junction: a population‐based study
Authors: Chen Liubo , Jin Tian , Fang Yimin , Wu Gaoqi , Yuan Ying
Published: February 2024

Background and Aim

The prognosis of early‐onset adenocarcinoma of esophagogastric junction (AEG) remains unclear. This research aimed at comparing the prognosis between early‐onset and late‐onset AEGs.

Methods

We extracted eligible patients with surgically resected, pathologically confirmed, nonmetastatic AEG from the Surveillance, Epidemiology, and End Results database from 2004 to 2015. The cutoff age of early‐onset AEG was set at ≤50 years old. Univariate and multivariate Cox analysis as well as competing risk model were adopted for comparing overall survival (OS) and cancer‐specific survival (CSS) between early‐onset and late‐onset AEGs. In addition, multiple imputation and propensity score matching (PSM) were also carried out for sensitivity analysis.

Results

In total, 4610 eligible AEG patients were collected in this study, including 610 early‐onset AEGs and 4000 late‐onset AEGs. Kaplan–Meier curves revealed significantly better survival in early‐onset AEGs than late‐onset AEGs. After interpolating missing data by multiple imputation, multivariate Cox regression analysis similarly showed better OS and CSS in early‐onset AEGs. By using PSM analysis at a ratio of 1:1, we matched 610 early‐onset AEG patients with 610 late‐onset AEG patients. After PSM, univariate Cox regression model still revealed favorable prognosis in early‐onset AEGs. Similar results were confirmed by performing PSM analysis at a ratio of 1:2 and 1:3. In addition, competing risk model demonstrated significantly lower cancer‐specific death in early‐onset AEGs compared to late‐onset AEGs before and after matching.

Conclusion

By applying several effective sensitivity analyses, we reported significantly favorable OS and CSS in early‐onset AEGs compared to late‐onset AEGs.
More options, more problems? Lost in the health insurance maze
Authors: Biener Christian , Zou Lan
Published: February 2024

While the opportunity to choose from a diverse range of options can be advantageous, consumers often struggle to make optimal decisions in the domain of health insurance. In this study, we examine the effects of decision aids on improving choice optimality in a health insurance setting that allows for variations in coverage but is standardized otherwise. While this relatively simplistic setting theoretically implies optimal conditions for observing large fractions of optimal choices, we observe widespread adoption of non‐welfare‐maximizing plans, with at least 36% of the population winding up with suboptimal insurance plans. In a hypothetical‐choice survey experimental setting, we estimate the treatment effects of increasing transparency through information provision and restricting choice on choice optimality. We find that decision quality cannot be improved meaningfully by our interventions and that nonoptimal choice is economically relevant, as it accounts for an increase of approximately 9.4% in total annual cost.
Classification of patients with migraine and healthy subjects using gross brain volume changes
Authors: De Fonseka Irushi , Lawanya Dewmi , Amarasinghe Dhilki , Wijewickrama Irusha , Wishwanthi Dineesha , Fernando Nikesha , Senanayake Gayani , Pushpakumara Saman , Arachchi Wasana Ediri
Published: February 2024

Background and Purpose

Despite reports of changes in gray matter and white matter in individuals with migraines, research on detecting whole‐brain gross volume changes in migraines is very rare. Therefore, we aimed to investigate gross volume changes associated with migraine and test its potential in developing a neuroimaging biomarker for objective diagnosis of migraine.

Methodology

In this study, 45 patients with migraine and 46 healthy controls were scanned using a 3T MRI scanner, and 3D, T1‐weighted brain MR images were obtained. First, Tensor‐based morphometry and Voxel‐based morphometry were performed using Computational Anatomy Toolbox (CAT 12) to compute gross volumes, gray matter volumes, white matter volumes, and cerebrospinal fluid volumes. Univariate analyses were performed using two‐sample t‐test and the results were corrected for multiple comparisons. Second, multivariate pattern analyses (MVPA) were conducted to classify the patients with migraine and healthy controls.

Results

Reduced gross volumes in patients were detected in middle frontal gyrus, superior frontal gyrus, inferior temporal gyrus and middle temporal gyrus of right cerebrum, middle temporal gyrus and angular gyrus of the left cerebrum, cuneus, and left cerebellum. Reduced gray matter volumes were detected in superior frontal, right middle frontal, right inferior temporal, and right middle temporal. The results of MVPA indicated that gross volume changes can improve the classification accuracy (73.63%) than other structural metrics such as gray matter (70%), white matter (66.3%), and cerebrospinal fluid volumes (58.69%).

Conclusion

We conclude that the gross volumetric alterations can serve as a better neuroimaging marker for the objective diagnosis of migraine.
An autopsy case of MV 2K + C subtype of Creutzfeldt–Jakob disease
Authors: Uchino Akiko , Saito Yuko , Tokuda Sho , Saburo Yagishita , Murayama Shigeo , Hasegawa Kazuko
Published: February 2024

Methionine/valine (MV) 2 type of sporadic Creutzfeldt–Jakob (sCJD) is divided into three subtypes based on neuropathological criteria: MV2‐kuru (MV2K), MV2‐cortical (MV2C), and MV2K + C, exhibiting the co‐occurrence of these two pathological features. We report an autopsy case of MV2K + C subtype of sCJD. A 46‐year‐old Japanese man began to make mistakes at work. Two months later, he gradually developed gait instability. The initial neurological examination revealed limb ataxia and myoclonus. Diffusion‐weighted images (DWI) showed a hyperintensity in the right frontal cortex, basal ganglia, and thalamus. Ten months after the onset of disease, he fell into akinetic mutism. He died at 47 years of age, 12 months after the initial presentation. Pathological investigation revealed microvacuolation and confluent vacuoles in the cerebral cortex. In the basal ganglia and thalamus, there was severe neuronal loss and gliosis with mild spongiform change. Kuru plaques were found within the cerebellum. Prion protein (PrP) immunostaining revealed synaptic, perivacuolar, perineuronal, and plaque‐like deposits in the cerebral cortex. There were synaptic and plaque‐like PrP deposits in the basal ganglia, thalamus, and granular cell layer of the cerebellum. In these areas, plaque‐like deposits mainly consisted of small deposits, whereas plaque‐like deposits in the cerebral cortex consisted both of coarse granular and small deposits. Analysis of the PrP gene showed no pathogenic mutations, and Western blot examination revealed a mixture of type 2 and intermediate‐type PrP. The progressive cognitive decline and ataxia in addition to the hyperintensity in the basal ganglia and/or thalamus on DWI are the basis for clinical diagnosis of MV2. The severe gliosis in the basal ganglia and various morphologies of plaque‐like deposits that differ by the region may be characteristic of MV2K + C. Detailed neuropathological examination together with Western blot analysis is important to collect more cases for elucidating the pathogenesis of MV2K + C.
Analysis of admissions to intensive care units that could be supported on an intermediate care unit
Authors: Tack Jérôme , Bruyneel Arnaud , Taccone Fabio , Thys Fréderic , Mélot Christian , Van Wilder Phillipe , Pirson Magali
Published: February 2024

Background

Only one third of European countries use intermediate care units (IMCs). An IMC makes it possible to manage patients who do not require intensive care but who need a higher level of nursing care that cannot be provided on the general ward. In Belgium, there are no national criteria for ICU admission or discharge, and no policies regarding IMC care or for differentiating ICU intensity levels.

Aim/s

The aim of our study was to analyse the profile of ICU patients in Belgium on the basis of registered nursing activity in order to quantify the number of ICU days potentially transferable to an IMC.

Study Design

The study was conducted on 310 ICU beds. Patients admitted to the study were recruited during two different one‐month periods in 2018 and were included into a prospective database that evaluated nursing workload carried out in 15 hospitals in the French‐speaking part of Belgium. The number of ICU days that could be supported on an IMC was defined according to the Nursing Activities Score (NAS) items.

Results

A total of 3279 ICU patients for a total of 13 942 ICU days were included. 4987 days (35.8%) were considered as “transferable” to an IMC. The proportion of ICU days transferable to an IMC was highly variable among hospitals, ranging from 20.4% to 59.5% of all ICU days. On the day of ICU admission, 665/2142 (31.0%) of the patients were already identified as transferable to an IMC; this percentage significantly increased on day 2 (972/2066, 47.1%) and day 3 (650/1390, 46.7%).

Conclusions

In Belgian ICUs, 35.8% of ICU hospital days, as per recorded NAS, do not necessitate intensive monitoring. These 35.8% of days of ICU hospitalization could be supported on an IMC.

Relevance for Clinical Practice

In this study, a significant number of days spent in the ICU could be supported on an IMC, this could alleviate the workload of nurses and reduce the occupancy rate of intensive care units.
The effect of the alliance on social recovery outcomes and usage in a moderated online social therapy for first‐episode psychosis
Authors: Stiles B. J. , Halverson T. F. , Stone A. , Still C. , Gleeson J. F. , Alvarez‐Jimenez M. , Perkins D. O. , Penn D. L.
Published: February 2024

Objectives

We investigated the effect of the therapeutic alliance on both change in social recovery outcomes and usage of a moderated online social therapy platform for first‐episode psychosis (FEP), Horyzons.

Design

Secondary analysis of a single group pilot trial.

Methods

Clients completed an alliance measure adapted for guided digital interventions at mid‐treatment. A series of multi‐level models evaluated change in outcomes by mid‐ and post‐treatment assessments (relative to baseline) as a function of the overall alliance. Quasi‐Poisson models evaluated the effect of the overall alliance on aggregated counts of platform usage. Exploratory analyses repeated these models in terms of the bond (human–human) or the task/goal (human–program) alliance.

Results

Stronger overall alliance at mid‐treatment predicted lower loneliness at mid‐treatment and lower social anxiety at mid‐ and post‐treatment. It was also associated with higher completion of therapy activities and authoring of comments and reactions. A strong bond with an online therapist was associated with lower loneliness and higher perceived social support at mid‐treatment, lower social anxiety at post‐treatment as well as a higher number of reactions made on the social network. Stronger alliance with the platform's tasks and goals facilitated lower social anxiety at both follow‐up assessments and was further associated with higher completion of therapy activities and reactions in the social network.

Conclusions

The alliance may impact aspects of social recovery and usage in digital interventions for FEP. Specific aspects of the alliance (human–human and human–program relationships) should be considered in future research.
Benefit and hidden cost of organizational support for telework amid the COVID‐19 pandemic on public employees' job satisfaction and retention intention
Authors: Ki Namhoon , Lee David
Published: February 2024

This study examines the impact of crisis‐induced telework during the COVID‐19 pandemic 2020 on public sector employees' job satisfaction (JS) and retention intention (RI). Analyses of the 2020 Federal Employee Viewpoint Survey data reveal a negative association between the amount of COVID‐induced telework and the federal employees' JS and RI. However, this negative effect is mitigated by offering adequate organizational telework support for mandatory telework during the COVID peak and subsequently decreasing the amount of telework after the peak. Nevertheless, the findings also indicate that solid organizational support for teleworkers during the pandemic's peak can ironically discourage them from returning to the regular work setting even when it is safe, potentially compromising organizational performance—a hidden cost of the organizational support. Still, this hidden cost does not appear to be significant enough to warrant revisions in the level of crisis‐specific organizational support.
Lebanese Phoenicianism: Rebutting Anthony Smith's Ethno‐Symbolism
Authors: Maxwell Alexander , Hannah David
Published: February 2024

Examining national awakening in early twentieth‐century Lebanon tests the validity of Anthony D. Smith's ethno‐symbolism, which argues that modern national movements arise from older or ancient ethnic cores, which Smith calls ethnies. Since ethno‐symbolism contradicts Eric Hobsbawm's notion of an “invented tradition,” contrasting Smith with Hobsbawm illustrates the substance of Smith's argument. Supporters of independent Lebanon frequently proclaimed a Phoenician origin for the Lebanese nation, employing various Phoenician symbols to legitimise Lebanese independence. At first glance, Lebanese Phoenicianism seem to fit Smith's idea that nations are “based on, and being created out of, pre‐existing ethnies.” Other nationalists from Lebanon, however, rejected Phoenicianism and Lebanese particularist nationalism: self‐proclaimed “Syrian” nationalists imagined a nation that encompassed the entire Levant, while Pan‐Arab nationalists extended their national sympathies to the entire Arab world. Both Syrian and Pan‐Arab nationalists devised their own ancient pasts, suggesting that nationalists choose their own ancient pasts. If nationalists imagine the national past, ethnic symbols have no causal significance, so Smith's theory does not work.
STEM role models for students with disabilities: A systematic review highlighting recommendations for the classroom and future research
Authors: Locke Shannon , Rodrigues Jessica , Mirielli Lindsey G.
Published: February 2024

Multiple learning theories encourage the use of role models within K‐12 settings and have guided research on role model representation to diversify the pursuit of science, technology, engineering, and mathematics (STEM) fields. Research has been clear on benefits of using role models, primarily focused on promoting gender and racial/ethnic diversity. Yet a critical need that has received less attention is the use of STEM role models for students with disabilities. The present systematic literature review identifies and synthesizes research on STEM role model mentorship programs and/or interventions for K‐12 students with disabilities. Sixteen studies met the inclusion criteria and were coded across categories, with a particular focus on practical recommendations for effective use of STEM role models for students with disabilities and suggestions for future research. Practice‐based recommendations emphasized, for example, the importance of establishing role model‐student rapport and mentors receiving adequate training to best support their mentees. Research‐focused recommendations included determining saliency of program/intervention components. Authors also suggest conducting future studies that investigate effectiveness of matching salient characteristics between role models and mentees. Overall, the findings suggest that STEM role models for students with disabilities is a promising avenue for supporting disability representation in STEM that warrants further investigation.
A survey of low titer O whole blood use within the trauma quality improvement program registry
Authors: Schauer Steven G. , April Michael D. , Fisher Andrew D. , Wright Franklin L. , Winkle Julie M. , Wright Angela R. , Rizzo Julie A. , Getz Todd M. , Nicholson Susannah E. , Yazer Mark H. , Braverman Maxwell A
Published: February 2024

Introduction

The use of low titer O whole blood (LTOWB) has expanded although it remains unclear how many civilian trauma centers are using LTOWB.

Methods

We analyzed data on civilian LTOWB recipients in the American College of Surgeons Trauma Quality Improvement Program (TQIP) database 2020–2021. Unique facility keys were used to determine the number of centers that used LTOWB in that period.

Results

A total of 16,603 patients received LTOWB in the TQIP database between 2020 and 2021; 6600 in 2020, and 10,003 in 2021. The total number of facilities that reported LTOWB use went from 287/779 (37%) in 2020 to 302/795 (38%) in 2021. Between 2020 and 2021, among all level 1–3 designated trauma facilities that report to TQIP LTOWB use increased at level‐1 centers (118 to 129), and level‐2 centers (81 to 86), but decreased in level‐3 facilities (9 to 4). Among pediatric and dual pediatric‐adult designated hospitals there was a decrease in the number of pediatric level‐1 centers (29 to 28) capable of administering LTOWB. Among centers with either single or dual level‐1 trauma center designation with adult centers, the number that administered LTOWB to injured pediatric patients also decreased from 17 to 10, respectively.

Conclusions

There was an increase in the number of facilities transfusing LTOWB between 2020 and 2021. The use of LTOWB is underutilized in children at centers that have it available. These findings inform the expansion of LTOWB use in trauma.
Numerical Study of the Fluid Flow Over the Array of Rough Cylindrical Particles: An Analysis of Porous Media Flow
Authors: Thakur Pooja , Gautam Shruti , Thakur Aruna
Published: February 2024

The objective of the study is to thoroughly analyze the flow and heat transfer of Bingham plastic fluids through an array of uniformly gapped rough surface cylinders embedded between two confined boundaries. Radial notches are used as the surface roughness in the model, evenly distributed. Due to the formation of front vortices in uniformly gapped cylinders, a negative pressure gradient is developed. The results of the numerical simulation analysis have shown that, when compared to the averaged Nusselt number, roughness has a minimal effect on the drag coefficient and pressure drop. As the degree of roughness increases, the size of the vortices decreases, resulting in a drop in heat transfer. Moreover, the analysis of each column shows that the first column array of cylinders has a higher total drag coefficient and average Nusselt number.
Morphological and electrical characterization of gate recessed AlGaN/GaN high electron mobility transistor device by purge-free atomic layer etching
Authors: Miersch Christian , Seidel Sarah , Schmid Alexander , Fuhs Thomas , Heitmann Johannes , Beyer Franziska C.
Published: February 2024

An atomic layer etching (ALE) process without purge has been developed for gate recess etching of AlGaN/GaN high electron mobility transistors (HEMTs). The process consists of repeating ALE cycles where Cl2/BCl3 plasma modifies the surface by chemisorption. The modified layer is removed by the subsequential Ar ion removal step. In this manner, AlGaN/GaN HEMTs with three different gate recess etching depths of (7.3 ± 0.5), (13.6 ± 0.5), and (21.0 ± 0.5) nm were fabricated. The determined etch per cycle (EPC) of ∼0.5 nm corresponding to one unit cell in the c-direction of GaN was constant for all recesses, illustrating the precision and controllability of the developed ALE process. The root-mean-square surface roughness was 0.3 nm for every etching depth, which corresponds to the roughness of the unetched reference. The electrical measurements show a linear dependence between threshold voltage (Vth) and etching depth. An enhancement mode (E-mode) HEMT was successfully achieved. A deeper gate recess than 20 nm leads to an increased channel resistance, lower saturation current, and higher gate leakage. Hence, a compromise between the desired Vth shift and device performance has to be reached. The achieved results of electrical and morphological measurements confirm the great potential of recess etching using the ALE technique with precisely controlled EPC for contact and channel engineering of AlGaN/GaN HEMTs.
Selective and nonselective plasma etching of (Al0.18Ga0.82)2O3/ Ga2O3 heterostructures
Authors: Wan Hsiao-Hsuan , Chiang Chao-Ching , Li Jian-Sian , Ren Fan , Alema Fikadu , Osinsky Andrei , Pearton Stephen J.
Published: February 2024

The addition of CHF3 to Cl2/Ar inductively coupled plasmas operating at low dc self-biases (<100 V, corresponding to incident ion energies <125 eV) leads to etch selectivity for Ga2O3 over (Al0.18Ga0.82)2O3 of >30, with a maximum value of 55. By sharp contrast, without CHF3, the etching is nonselective over a large range of source and rf chuck powers. We focused on low ion energy conditions that would be required for device fabrication. This result has a direct application to selective removal of Ga2O3 contact layers to expose underlying (Al0.18Ga0.82)2O3 donor layers in high-electron-mobility transistor structures. It is expected that formation of nonvolatile AlF3 species helps produce this selectivity. X-ray photoelectron spectroscopy does detect F residues on the etched surface for the Cl2/Ar/ CHF3 plasma chemistry.