bluuebunny/crossref_metadata_2025 huggingface dataset:
Politically related stress and low-birth-weight infants among Arab, Asian, Hispanic, non-Hispanic Black, and non-Hispanic White women in Michigan
Authors: Dallo Florence J , Williams David R , Ruterbusch Julie J , Mittleman Murray A , Sakyi Kwame S , Mostofsky Elizabeth , Rimawi Asmaa , Qu Xianggui , Reid Todd G , Schwartz Kendra
Published: July 2023

Background:

Despite the high cost of low birth weight and the persistent challenge of racial inequities affecting the Arab American community, there has been limited research to identify and examine risk factors for these inequities with validated data on Arab American ethnicity and recent population stressors.

Objectives:

This study examined whether the 2016 presidential election is associated with low birth weight among non-Hispanic White, Arab American, Hispanic, and non-Hispanic Black women.

Design:

This population-based study of singleton births in Michigan (2008–2017) used an algorithm to identify mothers who were of Arab descent.

Methods:

We used logistic regression to estimate odds ratios and 95% confidence intervals for the association between race/ethnicity and the odds of low birth weight. We examined whether these associations differed before and after the 2016 presidential election and according to maternal education.

Results:

There were 1,019,738 births, including 66,272 (6.5%) classified as low birth weight. The odds of having a low-birth-weight infant were higher among all minority women compared to non-Hispanic White women. The association was similar before and after the 2016 presidential election and stronger among women with higher levels of education.

Conclusion:

This is the first study to estimate low birth weight among Arab American women in the context of political events. There are opportunities for future studies to discuss this issue in depth.
Exiting the captaverse: Digital resistance and its limits pre and post the Covid-19 pandemic
Authors: Szakolczai Janos Mark
Published: July 2023

The term ‘data’, ubiquitous in the Digital Age, etymologically refers to a piece of information ‘given’ (datum). In this article, I argue that the term ‘capta’ would be more accurate, since information is often taken from us. Capturing information replicates normative elements of abuse, surveillance, control and harm becoming central and problematic within the emergence of the ‘onlife’. I illustrate my argument via an ethnomethodological consideration of my attempt to resist the unwilling capture of personal information. Since 2016, I have engaged in what I call an ‘offlife’ existence, phasing out all devices and platforms that covertly capture personal data. However, my experiment has proven problematic, impractical and has even been perceived as being anti-social, especially in light of the Covid-19 pandemic. In the conclusion of this article, I consider the problematics of engaging in some form of resistance to data collection.
Direct numerical simulation of SpraySyn burner: Impact of liquid solvent
Authors: Abdelsamie Abouelmagd , Wiggers Hartmut , Kruis Frank Einar , Thévenin Dominique
Published: July 2023

The SpraySyn burner is a new system recently developed at the University of Duisburg-Essen to investigate experimentally nanoparticle synthesis in spray flames for a variety of materials. The current project aims at performing direct numerical simulations with detailed physicochemical models of configurations closely related to this burner. The effect of using different solvents to produce titanium-dioxide (TiO[Formula: see text]) nanoparticles is discussed in this work. The two solvents considered are o-xylene and ethanol mixed in liquid state with tetraisopropoxide to form TiO[Formula: see text]. The liquid is injected into a pilot flame as dispersed spray with a carrier flow (dispersion gas). The resulting particle size distribution is examined as well. It is in particular observed that using ethanol leads to faster agglomeration and larger nanoparticles. This effect is qualitatively similar to that found when injecting smaller liquid spray droplets.
Pour une santé publique en faveur d’une justice épistémique
Authors: Fillol Amandine , Fonquerne Leslie , Cambon Linda , Ridde Valéry
Published: July 2023

La santé publique s'oriente de plus en plus vers l'étude des structures oppressives (telles que le racisme, le sexisme, ou le validisme) et de leur influence sur le marché de l’emploi, les systèmes éducatifs et judiciaires, et l’accès aux systèmes de santé de qualité. Ce commentaire vise à proposer une réflexion sur la manière dont ces structures influencent également la façon de faire de la santé publique. À travers le concept d'injustice épistémique, qui décrit le fait que l’organisation sociale influence la possibilité de connaître et de faire valoir sa connaissance dans une société donnée, nous montrons qu'en tant qu'acteur.rice de santé publique, nous pouvons reproduire et renforcer des injustices sociales. Les injustices épistémiques sont la plupart du temps le fruit de structures et de pratiques quotidiennes. Il est nécessaire de développer l'utilisation d'outils permettant de favoriser la réflexivité pour faciliter la mise en perspective des injustices et des privilèges.
Diabetes Research and Resource Sharing During the COVID-19 Pandemic: A Systematic Review and Experience from an Academic/Non-Profit Resource Website
Authors: Yeung Andrea M. , Dirisanala Sudha , Abraham Amalia , Huang Jingtong , Brennan Grayson M. , Urrutia María Agustina , Baran Jesica D. , Nguyen Kevin T. , Xu Nicole Y. , Shang Trisha , Zhang Jennifer Y. , Klonoff David C. , Davis Georgia M. , Pasquel Francisco J.
Published: July 2023

Background:

The magnitude of the response of the diabetes professional community to the COVID-19 pandemic is not known. We aimed to examine diabetes technology research trends and resources offered by professional organizations during this period.

Methods:

We explored patterns of the response from the professional diabetes community to the pandemic by (1) systematically searching for articles related to diabetes, COVID-19, and diabetes technologies; (2) examining publication trends of research protocols (clinicaltrials.gov) and preprints (medRxiv); and (3) reviewing online resources from professional organizations including our website (COVIDinDiabetes.org; an Emory University—Diabetes Technology Society collaboration).

Results:

We identified 492 articles published between December 2019 and December 2022 meeting our inclusion criteria. Telemedicine and continuous glucose monitoring were the most common reported technologies from most parts of the world. The largest number of preprint articles was published in 2020, with a decline in 2021 and 2022. The number of research protocols related to COVID-19 was the highest in 2020 and declined in 2021 and 2022. Resources from organizations included protocols adapted to treat patients with diabetes and COVID-19, training programs, emergency preparedness, and literature on diabetes and COVID-19. On our website (COVIDinDiabetes.org), there were 12 236 visits and 18 149 pageviews, with 1.6 actions per visits, with most visits coming from North America (N = 7233, 54.2%), South America (N = 2663, 21.8%), and Europe (N = 1219).

Conclusions:

We conclude that the COVID-19 pandemic promoted unprecedented global research productivity related to diabetes and COVID-19 and that the transition to the use of technology resources has been evident during this period.
First Generation of a Modular Interoperable Closed-Loop System for Automated Insulin Delivery in Patients With Type 1 Diabetes: Lessons From Trials and Real-Life Data
Authors: Benhamou Pierre-Yves , Adenis Alice , Lablanche Sandrine , Franc Sylvia , Amadou Coralie , Penfornis Alfred , Kariyawasam Dulanjalee , Beltrand Jacques , Charpentier Guillaume
Published: July 2023

Background:

DBLG1 (Diabeloop Generation 1) stands as one of the five commercially available closed-loop solution worldwide for patients with type 1 diabetes as of 2023. Our aim was to provide an overview of all data obtained with this system regarding outcomes and populations, with an emphasis on interoperability.

Methods:

This report includes all available sources of data (three randomized control trials and five surveys on real-life data). Collection ran from March 3, 2017 to April 30, 2022.

Results:

We gathered data from 6859 adult patients treated with closed-loop from three to 12 months. Overall, all sources of data showed that time in range (TIR) 70 to 180 mg/dL, starting from 47.4% to 56.6%, improved from 12.2 to 17.3 percentage points. Time in hypoglycemia was reduced by 48% in average (range: 26%-70%) and reached a level of 1.3% in the largest and most recent cohort. In patients with excessive time in hypoglycemia at baseline (≥5%), closed-loop allowed a reduction in time below range (TBR) by 59%. The comparison of days with declared physical activity versus days without physical activity did not show differences in TBR. The improvement in TIR observed with three different pump systems (Vicentra Kaleido, n = 117; Sooil Dana-I, n = 84; and Roche Insight, n = 6684) ranged from 15.4 to 17.3 percentage points.

Discussion:

These data obtained in different European countries were consistent throughout all reports, showing that this closed-loop system is efficient (high improvement in TIR), safe (remarkably low level of TBR), and interoperable (three pump settings so far).
Investigating the effect of ceramic-polyurea-aluminum layers on ballistic performance of composite target
Authors: Jafari S , Alavi Nia A
Published: July 2023

In this research, the ballistic performance of ceramic-polyurea-aluminum composite targets under the impact of flat-nose projectile was investigated for different thicknesses. The relevant experiments were designed based on the thickness of the layers and the effect of their configuration was explored. Experimental tests were carried out using two types of gas gun devices with different calibers. Residual velocity of the projectile was extracted using ls-dyna software for all targets and compared with the experimental data and after validation, the ballistic limit velocity was extracted. Taguchi method was used to design experiments and optimization and ballistic limit velocity, surface density, and strength-to-weight ratio were considered as objective functions. Moreover, the residual velocity of the projectile, damage mechanism of layers, the diameter of the hole at the back layer, central displacement of the back layer, absorbed energy, and changes in the projectile velocity were also investigated. Based on the numerical results, ceramic had the greatest effect on reducing the velocity of the projectile (approximately between 55 and 65%). Strength-to-weight ratio and armor weight were considered as two objective functions in the optimization. The effect of each of the armor materials on the target functions was investigated. According to the results, ceramic had the greatest effect on increasing the strength-to-weight ratio (about 83.88%), and polyurea had the least effect (about 14.09%) on increasing the total weight of the armor.
A case series in individuals with multiple sclerosis using direct current electrical stimulation to inhibit spasticity and improve functional outcomes
Authors: Ellerbusch Courtney L , Chapple Kristina M , Seibert Julie B
Published: July 2023

Background and Purpose

Multiple sclerosis (MS) has a high incidence of debilitating spasticity. Central Nervous System (CNS) intrafusal settings have an impact on spasticity level. Mechanoreceptors of the Peripheral Nervous System (PNS) communicate monosynaptically with the central nervous system (CNS). This case series assesses feasibility of multimodal treatment of individuals with MS using a direct current electrical stimulation (DC) to influence mechanoreceptors.

Case Description and Intervention

Seven MS diagnosed participants with Expanded Disability Status Scale (EDSS) = 6.0–8.0 completed 18 visits over 6 weeks of using DC combined with neuromuscular reeducation. Design included pre-, post- outcome measures of EDSS, 12-item MS Walking Scale (MSWS-12), Range of Motion (ROM), Manual Muscle Testing (MMT), Modified Ashworth Test (MAT), Timed 25-Foot walk (T25WT), Timed Up and Go (TUG) and the Multiple Sclerosis Impact Scale-29 (MSIS-29).

Outcome

125 out of a possible 126 visits were completed, demonstrating a high level of tolerance. Individual results included trends towards improvement in spasticity and agonists.

Discussion

This case series design of seven heterogenous subjects with MS is a low sample size for statistical analysis and should be considered a pilot. The study demonstrates a high level of feasibility and possible correlations to consider. Further research is warranted.
Data Security, Customer Trust and Intention for Adoption of Fintech Services: An Empirical Analysis From Commercial Bank Users in Pakistan
Authors: Zhang Wenxiang , Siyal Saeed , Riaz Samina , Ahmad Riaz , Hilmi Mohd Faiz , Li Zhi
Published: July 2023

The research aims to empirically investigate the effect of perceived easiness of use (PEU), perceive usefulness (PU), data security (DAS) on adoption intention of Fintech services through Fintech promotion (FP), and customer trust (CT) in commercial banks of Pakistan using Technology Acceptance Model (TAM) in Pakistan. The data of 297 banking services users were collected through self-administered survey. This quantitative study employs cross sectional research design, and data was analyzed through Partial Least Square (PLS)-Structural Equation Modeling (SEM) technique. The regression results indicate that DAS, PEU, PU, FP, CT have positive and significant influence on adoption intention of Fintech Services. The PEU, DAS, PU also have positive and significant effect on CT. In addition, customers’ perception about DAS and PEU also have a positive and significant influence on customers’ perception about importance of FP. On the contrary, FP has insignificant effect on CT and PU also has insignificant effect on FP. Based on researchers findings, this study would be an addition to the existing literature pertaining to adoption of Fintech services by providing novel understanding about the determinants of users’ behavior for adoption of Fintech services. Therefore, this study could help to regulators that how data security through proper IT infrastructure could help to increase the adoption of Fintech. Moreover, findings of the study also indicates that it is precisely important for Fintech innovators to understand their customers’ attitude regarding transparency of data and its security. Such operational activities enable customers to be aware of adequate use of their data and its secure storage.
An Ontology of Semiotic Activity and Epistemic Figuration of Heritage, Memory and Identity Practices on Social Network Sites
Authors: Kirtiklis Kęstas , Laužikas Rimvydas , Kelpšienė Ingrida , Dallas Costis
Published: July 2023

This study presents the construction and validation of a formal conceptual model, or domain ontology, useful for the formal representation and analysis of conversations on heritage, memory and identity (HMI) on social network sites (SNS), of interviews with participants in such conversations, and of scholarly works engaging with such phenomena. The ontology provides for the first time a conceptual framework for HM interactions on SNS addressing the semiotic and discursive nature of such interactions in the context of cultural-historical activity theory and semiosphere theory. Part of the Connective Digital Memory in the Borderlands research project, it is developed using an evidence-based knowledge elicitation and domain modeling approach. The study presents the three components of the ontology: an event-centric core conceptual model, an inductively derived concept taxonomy, and a meta-theoretical conceptual scheme, based on a combination of conceptual analysis and lexical analysis of relevant scholarly literature. To validate the ontology, it then provides an example of how it can be used to represent an actual HMI-related SNS conversation and scholarly intervention using knowledge graphs, a quantitative analysis of the occurrence of taxonomy terms in different subfields of HMI on SNS studies, a qualitative analysis of concepts used in studies on non-professional, archeological, and institutional heritage communication on SNS, and a meta-theoretical account of studies of HMI on SNS. The ontology can be used as a framework for theorization and for the development of data models, questionnaire protocols, thematic analysis vocabularies, and analysis queries relevant to HMI on SNS research.
The Role of Shame in the Sexual-Orientation Disparity in Mental Health: A Prospective Population-Based Study of Multimodal Emotional Reactions to Stigma
Authors: Pachankis John E. , Hatzenbuehler Mark L. , Klein Daniel N. , Bränström Richard
Published: July 2023

Despite the prominence of shame in stigma theories, its role in explaining population-level mental-health disparities between the stigmatized and nonstigmatized has not been investigated. We assessed shame explicitly (via self-report) and implicitly (via a behavioral task) in a prospective, representative cohort of sexual-minority and heterosexual young adults in Sweden (baseline n = 2,222). Compared with heterosexuals, sexual minorities evidenced higher explicit and implicit shame, which explained sexual-orientation disparities in depression, social anxiety, and suicidal thoughts. Among sexual minorities, there was an indirect effect of shame in the association between interpersonal stigma (i.e., past-year family rejection and childhood bullying) and later experiences of adverse mental health; an indirect effect did not exist for the related construct, internalized stigma. Results suggest extending existing stigma theories to consider emotions such as shame as characteristic reactions to stigma and guide the search for treatment targets focused on reducing the mental-health sequelae of stigma.
Operating Room Nurses’ Understanding of Their Roles and Responsibilities for Patient Care and Safety Measures in Intraoperative Practice
Authors: Chellam Singh Bisma , Arulappan Judie
Published: July 2023

Introduction

Surgical care has been a vital part of healthcare services worldwide. Several patient safety measures have been adopted universally in the operating room (OR) before, during, and following surgical procedures. Despite this, errors or near misses still occur. Nurses in the OR have a pivotal role in the identification of factors that may impact patient safety and quality of care. Therefore, exploring the OR nurses’ understanding of their roles and responsibilities for patient care and safety in the intraoperative practice, which could lead to optimal patient safety, is essential.

Objective

This study explored the understanding of OR nurses regarding their roles and responsibilities for patient care and safety measures in the intraoperative practice.

Methods

The study was conducted in one of the tertiary care hospitals in the United Arab Emirates. Qualitative, descriptive, exploratory research design was utilized. The data were collected using semi-structured face to face interviews. Purposive sampling included eight nurses. Data analysis was performed following Colaizzi's seven-step strategy.

Results

Seven emerging themes were identified. The main themes are: patient safety, preoperative preparation, standardization of practice, time management, staffing appropriateness, staff education and communication, and support to the patient in the OR.

Conclusion

OR nurse leaders may take into consideration the current findings as a reference for quality improvement projects in the hospital, considering the specific characteristics of each local setting. Although the participants consider that the environment is safe and the quality of care is high in the study setting, there is still room for improvement on workflows and processes. OR workflow should be improved especially by addressing the potential patient safety issues.
Geopolitics and genocide: The Gambia vs. Myanmar at the International Court of Justice
Authors: Jeffrey Alex
Published: July 2023

At a time of increasing prominence of the workings and judgements of international courts, recent interdisciplinary work has illuminated the deeply uneven ways in which violence is labelled, understood, and acted upon. Attempting to place work in genocide studies in conversation with current geographical scholarship, this paper argues that there are intrinsic spatial qualities to deliberations over whether an act of violence constitutes genocide. Understanding these invocations of space helps explain how accountability for violence is spatially contained, often severing judgement from wider historical or geopolitical contexts. This argument is made through analysis of the build up to, and enactment of, the legal deliberations at the International Court of Justice brought by The Gambia against Myanmar in relation to the expulsion of the Rohingya from Rakhine State, Myanmar. Such investigative work reveals the intrinsically geographical nature of both designations of genocidal acts and the intimate processes of legal deliberation itself.
Technopolitics of future-making: The ambiguous role of energy communities in shaping energy system change
Authors: Envall Fredrik , Rohracher Harald
Published: July 2023

Implementing the EU Clean Energy Package (CEP) and its provisions for strengthening energy communities – the cooperative production and management of energy at local level by citizens, a concept emphasising citizen participation and empowerment – has opened a new arena for contestations over energy futures in Sweden. An aim of CEP is to contribute to just energy transitions through citizen participation and democratisation by using the potential of energy communities to reconfigure socio-material relations of the energy system. However, different actor constellations claim interpretative privilege about the role and importance of energy communities in a low-carbon future. To better understand political contestations over energy futures, we unpack broader discursive patterns and their socio-material enactments related to legally define and regulate the operation of energy communities in Sweden. Through the analytical lens of socio-technical imaginaries and technopolitics, we explore struggles over energy futures within conduits of institutionalised policymaking and attempts by energy communities to navigate technopolitical barriers in relation to grid infrastructure, power relations, actor constellations, rules and regulations and knowledge claims. We find that energy communities are not easily accommodated to the dominant socio-technical imaginary of Sweden’s energy future. What is at stake in processes related to the transposition of the CEP into national law is essentially different political ideas of how society should be organised.
Advances in contraception: vaginal contraceptive rings
Authors: Al-Haddad Sara , Branham Ki’ara K. R. , Clare Camille A.
Published: July 2023

The vaginal contraceptive ring is very effective and user dependent. In this article, we will discuss the different types of vaginal contraceptive rings, namely, the etonogestrel/ethinyl estradiol (ENG/EE) ring (NuvaRing, Merck, Rahway, NJ, USA) and the segesterone acetate (SA)/EE (Annovera, Mayne Pharma, Raleigh, NC, USA) ring. The details of dosing and administration, indications, advantages, disadvantages, and cost-effectiveness are presented. This literature review was conducted using PubMed and Google Scholar. The search terms included ‘vaginal contraceptive ring’, ‘etonogestrel/ethinyl estradiol ring’, and ‘segesterone acetate/ethinyl estradiol ring’. The search was then sorted by year from 2000 until present, and the most recent articles were reviewed. The purpose of this article is to provide a comprehensive reference on the two vaginal contraceptive rings widely used in the United States for clinicians to guide management. Both vaginal contraceptive rings are combination of hormonal contraceptives that suppress ovulation and create physiologic conditions unfavorable for pregnancy. The ENG/EE ring is designed to be replaced monthly, while the SA/EE ring is a single device used over the course of 1 year. Common side effects of both devices include headaches, nausea, vomiting, and vaginitis. Serious adverse reactions can occur with the vaginal contraceptive rings including venous thromboembolism, psychiatric events, and hypersensitivity. Both devices are contraindicated in patients at high risk for arterial or venous thrombotic events, patients with a history of breast cancer or other estrogen/progesterone cancers, and patients with severe liver disease. Overall, the vaginal contraceptive ring is well tolerated and liked by patients. Patients should be well counseled on known severe adverse reactions. The vaginal contraceptive ring is more expensive than other forms of contraception and this should be an important point of discussion with patients.
Effects of machining parameters on H13 die steel using CNC drilling machine
Authors: KB Hariharan , S Vijayalakshmi , G Navaneethakrishnan , R Palanisamy , Alwetaishi Mamdooh , Alahmadi Ahmad Aziz , Alzaed Ali Nasser , MA Kalam , Shahapurkar Kiran
Published: July 2023

In order to enhance the fitness of the product and in order to improve productivity in turning operations, greater amount of challenges have been faced. In this paper, we have made a comparative analysis of HSS and carbide coated HSS drills while machining with H13 steel plates. For the drilling operation, process parameters were analysed using the Taguchi design of experiments. The response performance characteristics of surface roughness of H13 die steel plates for the drilling settings, cutting speed (rpm), and feed rate (mm/min) is optimized. The design of the experiment was conducted using the Taguchi technique for the L18 orthogonal array, and an analysis of variance was observed. The effect of drilling settings on the quality of drilled holes is examined; variation in surface roughness for various levels of speed and feed and the different combinations of these levels will form an L18 orthogonal array design of experiment by Taguchi analysis. A total of 36 cutting tests were performed with two different drill bits; here three different cutting speeds of 300, 600, and 900 rpm were taken with a feed rate of 0.02, 0.04, and 0.06 mm/rev combinations. The response of SN ratio for surface roughness of HSS and carbide tool has been found out for different levels of speed and feed. From this Taguchi analysis, it is identified that the optimal parameter. As a result, the factors are analysed, and optimized parameters have been concluded for H13 material using HSS, and carbide tools were examined both statistically and experimentally. The carbide coated drill bit gives 60% better surface roughness value based on experimental data obtained. The surface roughness value based on experimentation for HSS tool was found to be 34.16% and carbide coated drill bit was 23.40%.
The bone marrow stroma in human myelodysplastic syndrome reveals alterations that regulate disease progression
Authors: Kfoury Youmna S. , Ji Fei , Jain Esha , Mazzola Michael , Schiroli Giulia , Papazian Ani , Mercier Francois , Sykes David B. , Kiem Anna , Randolph Mark , Calvi Laura M. , Abdel-Wahab Omar , Sadreyev Ruslan I. , Scadden David T.
Published: July 2023

Myelodysplastic syndromes (MDSs) are a heterogenous group of diseases affecting the hematopoietic stem cell that are curable only by stem cell transplantation. Both hematopoietic cell intrinsic changes and extrinsic signals from the bone marrow (BM) niche seem to ultimately lead to MDS. Animal models of MDS indicate that alterations in specific mesenchymal progenitor subsets in the BM microenvironment can induce or select for abnormal hematopoietic cells. Here, we identify a subset of human BM mesenchymal cells marked by the expression of CD271, CD146, and CD106. This subset of human mesenchymal cells is comparable with mouse mesenchymal cells that, when perturbed, result in an MDS-like syndrome. Its transcriptional analysis identified Osteopontin (SPP1) as the most overexpressed gene. Selective depletion of Spp1 in the microenvironment of the mouse MDS model, Vav-driven Nup98-HoxD13, resulted in an accelerated progression as demonstrated by increased chimerism, higher mutant myeloid cell burden, and a more pronounced anemia when compared with that in wild-type microenvironment controls. These data indicate that molecular perturbations can occur in specific BM mesenchymal subsets of patients with MDS. However, the niche adaptations to dysplastic clones include Spp1 overexpression that can constrain disease fitness and potentially progression. Therefore, niche changes with malignant disease can also serve to protect the host.
ANCA-associated vasculitis in a HIV-infected patient:a case-based review
Authors: Vornicu Alexandra , Obrișcă Bogdan , Sorohan Bogdan , Berechet Andreea , Ismail Gener
Published: July 2023

Background

The occurrence of autoantibodies in human immunodeficiency virus (HIV)-infected patients has been previously reported, with a prevalence ranging from 20 to 83%. There are also a few reports of clinically relevant autoantibody profiles in HIV-positive patients that lead to true systemic autoimmune disease; these possible life-threatening diseases have to be considered and treated accordingly.

Case presentation

Here, we present the case of a 29-year-old female patient with a history of well-controlled HIV infection in the last 6 years who was admitted to our department for the evaluation of acute kidney injury and nephrotic syndrome with active urinary sediment. A diagnosis of systemic antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) with renal and pulmonary involvement was established. The patient was treated with cyclophosphamide, rituximab and tapering glucocorticoids,and the diffuse alveolar hemorrhage resolved, but the evolution of kidney function was unfavorable, which led to the need to initiate hemodialysis. We highlight the importance of establishing the correct diagnosis, treating the disease accordingly and the possible clinical issues that can appear in a patient with HIV infection during immunosuppressant treatment as induction treatment. Additionally, we performed a thorough literature review of ANCA positivity in HIV-infected patients to properly understand the current evidence.

Conclusions

Although it is not clear whether HIV infection and AAV are causally or coincidentally related, the possibility of this systemic autoimmune phenomenon should be acknowledged by physicians to establish the correct diagnosis and treat the disease accordingly by maintaining a balance between the risks and benefits of immunosuppression in this category of patients, with treatment decisions being made by the members of a multidisciplinary team in centers with experience in AAV.
Impact of frequent intradialytic hypotension on quality of life in patients undergoing hemodialysis
Authors: Wang Jianhua , Yao Jing , Zhu Xiaoye , Wang Tingting , Lu Jianda , Wei Qiubo , Xue Jun , Wu Yuanhao , You Li
Published: July 2023

Background

Intradialytic hypotension (IDH) is frequently accompanied by symptoms of nausea, dizziness, fatigue, muscle spasm, and arrhythmia, which can adversely impact the daily lives of patients who undergo hemodialysis and may lead to decreased quality of life (QoL). This study employed the KDQOL™-36 scale to evaluate the impact of frequent IDH, based on the definition determined by predialysis blood pressure (BP) and nadir systolic blood pressure (SBP) thresholds, on the QoL of patients.

Methods

This is a single center retrospective cohort study involving 160 hemodialysis patients. We enrolled adult patients with uremia who received routine hemodialysis (4 h/time, 3 times/week) from October 1, 2019, to September 30, 2021. Frequent IDH was defined as an absolute nadir SBP < 90 mmHg occurring in no less than 30% of hemodialysis sessions when predialysis SBP < 159 mmHg (or < 100 mmHg when predialysis BP ≥ 160 mmHg).The differences between patients with and without frequent IDH were compared using the independent t test, Kruskal‒Wallis test, or chi-square test. The primary visit was at month 36, and the remaining visits were exploratory outcomes.

Results

Compared to patients with infrequent IDH at baseline, those with frequent IDH had significantly lower scores on the symptoms and discomfort of kidney disease dimension at all follow-up points (P < 0.05). The symptoms and discomfort of kidney disease dimension were worse in patients with frequent IDH. Those with frequent IDH had a significantly poorer QoL regarding the dimensions of symptoms and discomfort of kidney disease and the impact of kidney disease on life.

Conclusions

The findings of the study suggest an association between frequent IDH and QoL dimensions of symptoms and discomfort of kidney disease and the impact of kidney disease on life dimension under the definition of frequent IDH.
Factors associated with health-related quality of life in a cohort of cancer survivors in New Jersey
Authors: Manne Sharon , Devine Katie , Hudson Shawna , Kashy Deborah , O’Malley Denalee , Paddock Lisa E. , Bandera Elisa V. , Llanos Adana A. M. , Fong Angela , Singh Neetu , Frederick Sara , Evens Andrew M.
Published: July 2023

Background

Although there is extensive literature on correlates of health-related quality of life (HRQoL) among cancer survivors, there has been less attention paid to the role of socioeconomic disadvantage and survivorship care transition experiences in HRQoL. There are few large cohort studies that include a comprehensive set of correlates to obtain a full picture of what is associated with survivors’ HRQ0L. This cohort study of recent cancer survivors in New Jersey aimed to explore the association between social determinants of health, health history, health behaviors, survivorship care experiences, and psychosocial factors in HRQoL.

Methods

Eligible survivors were residents of New Jersey diagnosed with genitourinary, female breast, gynecologic, colorectal, lung, melanoma, or thyroid cancers. Participants completed measures of social determinants, health behaviors, survivorship care experiences, psychosocial factors, and HRQoL. Separate multiple regression models predicting HRQoL were conducted for each of the five domains (social determinants, health history, health behaviors, survivorship care experiences, psychosocial factors). Variables attaining statistical significance were included in a hierarchical multiple regression arranged by the five domains.

Results

864 cancer survivors completed the survey. Lower global HRQoL was associated with being unemployed, more comorbidities, a less healthy diet, lower preparedness for survivorship, more unmet support needs, and higher fear about cancer recurrence. Two psychosocial factors, unmet support needs and fear of recurrence, played the most important role in HRQoL, accounting for more than 20% of the variance. Both unmet support needs and fear of recurrence were significant correlates of physical, functional, and emotional HRQoL domains.

Conclusions

Interventions seeking to improve cancer survivors’ HRQoL may benefit from improving coordinated management of comorbid medical problems, fostering a healthier diet, addressing unmet support needs, and reducing survivors’ fears about cancer recurrence.
Common driver mutations and programmed death-ligand 1 expression in advanced non-small cell lung cancer in smokers and never smokers
Authors: LIAM Chong Kin , YEW Chian Yih , PANG Yong Kek , WONG Chee Kuan , POH Mau Ern , TAN Jiunn Liang , SOO Chun Ian , LOH Thian Chee , CHIN Ka Kiat , MUNUSAMY Vijayan , LIAM Yong Sheng , IBRAHIM Nur Husna
Published: July 2023

Background

In non-small cell lung cancer (NSCLC), there may be a relationship between programmed death-ligand 1 (PD-L1) expression, driver mutations and cigarette smoking.

Methods

In this single-center retrospective study, the relationship between common driver mutations (EGFR mutation and ALK rearrangement) and PD-L1 expression in advanced NSCLC according to the patients’ smoking history was examined. Light, moderate and heavy smokers had smoked < 20, 20–39, and ≥ 40 pack-years, respectively. The level of PD-L1 expression, assessed using Ventana SP263 monoclonal antibody assay, was defined by the tumor proportion score (TPS) as high expression (TPS ≥ 50%), low expression (TPS 1%—49%) and no expression (TPS < 1%).

Results

101 (52.9%) of 191 advanced NSCLC patients were never smokers. EGFR mutations were more common in never smokers (64.4%) than in smokers (17.8%) with advanced NSCLC (P < 0.0001). A higher proportion of smokers (26.7%) had high PD-L1 expression compared to never smokers (13.9%) (P = 0.042). There was a trend for a higher proportion of male NSCLC patients [28 of 115 (24.3%)] than female patients [10 of 76 (13.2%)] to have high PD-L1 expression (P = 0.087]. High PD-L1 expression was seen in 32 of 110 (29.1%) patients with EGFR wild-type NSCLC but only in 6 of 81 (7.4%) patients with EGFR-mutant tumors (P < 0.0001). Among the 90 smokers with NSCLC, a higher proportion of heavy smokers (35.8%) than non-heavy smokers (13.5%) had high PD-L1 expression (P = 0.034). In patients with adenocarcinoma, high PD-L1 expression was seen in 25 of 77 (32.5%) patients with EGFR wild-type tumors but only in 4 of 70 (5.7%) patients with EGFR-mutant tumors (P < 0.0001). Among patients with adenocarcinoma, a significantly higher proportion of ever smokers (29.3%) than never smokers (13.5%) had high PD-L1 expression (P = 0.032). Among smokers with adenocarcinoma, a significantly higher proportion of heavy smokers (44.1%) than non-heavy smokers (8.3%) had high PD-L1 expression (P = 0.004). On multivariate analysis, after adjusting for gender and smoking status, heavy smoking and EGFR wild-type tumors remained significantly associated with high PD-L1 expression in NSCLCs and also in adenocarcinoma.

Conclusions

Heavy smoking and EGFR wild-type tumors were significantly associated with high PD-L1 expression in NSCLCs and also in adenocarcinoma.
Immune inactivation by VISTA predicts clinical outcome and therapeutic benefit in muscle-invasive bladder cancer
Authors: Li Wandi , Liu Zhaopei , Jin Kaifeng , Shao Fei , Zeng Han , Wang Yiwei , Zhu Yu , Xu Le , Wang Zewei , Chang Yuan , Zhang Weijuan
Published: July 2023

Background

V domain Immunoglobulin suppressor of T cell activation (VISTA) has been proved to be a novel immune checkpoint molecule that positively regulates T cell infiltration in several malignancies. However, the clinical impact of VISTA on muscle-invasive bladder cancer (MIBC) patients remains relatively obscure.

Methods

This study enrolled 135 MIBC patients from Zhongshan Hospital (ZSHS) and 391 patients from The Cancer Genome Atlas (TCGA) to examine the VISTA expression and immune contexture based on immunohistochemistry (IHC) staining and CIBERSORT algorithm. Additionally, IMvigor210 Cohort included 195 bladder-derived urothelial carcinoma patients to evaluate the efficacy of immunotherapy. Kaplan-Meier curve and Cox regression analyses were conducted to assess clinical outcomes.

Results

MIBC patients with high VISTA+ immune cells (ICs) possessed poor overall survival and inferior therapeutic responsiveness to adjuvant chemotherapy (ACT), but superior responsiveness to PD-L1 inhibitor. VISTA+ ICs infiltration shaped an immunoevasive context featured by regulatory T cells (Tregs), M2 macrophages, mast cells and exhausted CD8+ T cells infiltration, with increased interleukin 10 (IL-10), transforming growth factor-β (TGF-β) and interferon-γ (IFN-γ), but also elevated T-cell immunoglobulin mucin-3 (TIM-3), lymphocyte activation gene 3 (LAG-3) and T-cell immunoglobulin and ITIM domain (TIGIT), which was also mainly presented in basal-squamous and luminal-infiltrated subtypes of MIBC.

Conclusion

VISTA+ ICs infiltration could be an independent predictor to identify poor prognosis and therapeutic responses (PD-L1 blockade and ACT) in MIBC patients, which was associated with immunoevasive contexture. The novel immune checkpoint VISTA might be utilized as a candidate treatment biomarker in MIBC patients.
Impact of the COVID-19 and psychological risk factors on non-suicidal self-injury behavior among high school students: a one-year follow-up study
Authors: Wang Lu-Jiao-Zi , Lan Yan , Liu Su-Jiao , Yan Wan-Sen
Published: July 2023

Objectives

Non-suicidal self-injury (NSSI) behavior is a severe public health issue in adolescents. This study investigated the possible impact of the coronavirus disease 2019 (COVID-19) and analyzed psychological risk factors on adolescent NSSI.

Methods

A one-year follow-up study was conducted in September 2019 (Time 1) and September 2020 (Time 2) among 3588 high school students. The completed follow-up participants (N = 2527) were classified into no NSSI (negative at both time points), emerging NSSI (negative at Time 1 but positive at Time 2), and sustained NSSI (positive at both time points) subgroups according to their NSSI behaviors before and during the COVID-19 pandemic. Perceived family functioning, perceived school climate, negative life events, personality traits (neuroticism, impulsivity, and self-control) were assessed using self-report scales.

Results

The data indicated an increase (10.3%) in the incidence of NSSI. Compared to no NSSI subjects, the emerging NSSI and sustained NSSI subgroups had lower perceived family functioning, higher neuroticism, higher impulse-system but lower self-control scores, and more negative life events. Logistic regressions revealed that after controlling for demographics, neuroticism and impulse-system levels at Time 1 positively predicted emerging NSSI behavior, and similarly, higher neuroticism and impulsivity and lower self-control at Time 1 predicted sustained NSSI behavior.

Conclusions

These findings highlighted the aggravated impact of the COVID-19 on NSSI, and suggested that individual neuroticism, impulsivity, and self-control traits might be crucial for the development of NSSI behavior among adolescent students.
Community-based organization perspectives on participating in state-wide community canvassing program aimed to reduce COVID-19 vaccine disparities in California
Authors: Mansfield Lisa N. , Carson Savanna L. , Sunku Nisha , Troutt Alana , Jackson Shelli , Santillan David , Vassar Stefanie D. , Slaughter Dale , Kim Gloria , Norris Keith C. , Brown Arleen F.
Published: July 2023

Background

Inequities in COVID-19 vaccine accessibility and reliable COVID-related information disproportionately affected marginalized racial and ethnic communities in the U.S. The Get Out the Vaccine (GOTVax) program, an innovative statewide government-funded COVID-19 vaccine canvassing program in California, aimed to reduce structural barriers to COVID-19 vaccination in high-risk communities with low vaccination rates. GOTVax consisted of a community-academic-government partnership with 34 local trusted community-based organizations’ (CBOs) to conduct COVID-19 vaccine outreach, education, and vaccine registration. The purpose of this qualitative evaluation study was to explore the barriers and facilitators of using local CBOs to deploy a geographically, racially, and ethnically diverse state-wide COVID-19 vaccine outreach program.

Methods

Semi-structured online interviews were conducted with participating GOTVax CBO leaders from November 2021 to January 2022. Transcripts were analyzed using reflexive thematic analysis.

Results

Thirty-one of 34 CBOs participated (91% response rate). Identified themes encompassed both facilitators and barriers to program participation. Key facilitators included leveraging trust through recognized entities; promoting empathetic, tailored outreach; and flexibility of milestone-based CBO funding contracts for rapid program implementation. Barriers included navigating community sociopolitical, geographic, and cultural factors; managing canvassers’ safety; desiring metrics for self-evaluation of outreach success; mitigating canvassing technology challenges; and concerns of program infrastructure initially limiting outreach. CBOs problem-solved barriers with academic and government partners.

Conclusions

Between May and December 2021, the GOTVax program reached over 2 million California residents and registered over 60,000 residents for COVID-19 vaccination. Public health campaigns may improve benefits from leveraging the expertise of community-trusted CBOs and universities by providing flexible infrastructure and funding, allowing CBOs to seamlessly tailor outreach most applicable to local minoritized communities.
Isolated nonsyndromic cleft palate: multicenter epidemiological study in the Brazil
Authors: Trezena Samuel , Machado Renato Assis , de Almeida Reis Silvia Regina , Scariot Rafaela , Rangel Ana Lúcia Carrinho Ayroza , de Oliveira Fabrício Emanuel Soares , Borges Anna Júlia , Silva Alissa Tamara , Martelli Daniella R. Barbosa , Martelli Júnior Hercílio
Published: July 2023

Background

Nonsyndromic orofacial clefts (NSOC) are the craniofacial most common congenital malformations. There are evidences that the nonsyndromic cleft palate (NSCP) development differs from other NSOC. However, most of the publications treat NSCP without considering that information. Furthermore, few studies focus on NSCP. The aim of this study was to describe epidemiological findings of patients with isolated NSCP in Brazil.

Methods

In this cross-sectional multicenter study, four reference Centers for treatment in three different Brazilian states was investigated. Data were obtained from clinical records of patients, between November 2021 and June 2022. Researched variables were sociodemographic, clinical characteristics and pregnancy and family history. Pearson’s chi-square and ANOVA One-way tests were used for associations.

Results

Majority were female (58.1%), white (60.7%) with incomplete NSCP (61.2%). There was an association between complete NSCP and a positive history of medical problems during pregnancy (p = 0.016; 27.9%; OR: 1.94; 1.12–3.35). Systemic alterations were perceived in 40.6% of the sample with odds ratio for development of the complete type (OR: 1.21; 0.74–1.97). Higher OR was visualized in medication use during pregnancy (OR: 1.35; 0.76–2.37) and positive family history of oral cleft (OR: 1.44; 0.80–2.55). Dental and surgical care was associated with higher age groups (p < 0.050).

Conclusions

NSCP was most prevalent in white skin color female. Complete NSCP is associated with medical problems during pregnancy. Medication use during pregnancy and positive family history of oral cleft increase the chance of developing complete NSCP.