bluuebunny/crossref_metadata_2025 huggingface dataset:
Factory-Calibrated Continuous Glucose Monitoring System Accuracy During Exercise in Adolescents With Type 1 Diabetes Mellitus
Authors: Dyess Ryan J. , McKay Timothy , Feygin Yana , Wintergerst Kupper , Thrasher Bradly J.
Published: September 2022

Background:

Continuous glucose monitors (CGMs) are widely used for individuals with diabetes mellitus, particularly those with type 1 diabetes (T1D). Advancements in CGM technology allow for glycemic assessment without capillary glucose measurements as many come factory calibrated. However, exercise, an essential component of diabetes care, has been reported to alter accuracy of earlier generation CGM. Considering the importance of physical activity for individuals with T1D and the progression of CGM technology, we aimed to investigate the accuracy of the Dexcom G6 during physical activity.

Methods:

Adolescents (ages 13-20 years) exercised on a treadmill for 40 minutes, with a 10-minute break at minute 20. We obtained paired CGM and glucometer measurements before and every 10 minutes during and after exercise. Accuracy analysis was determined by mean absolute relative difference (MARD), mean absolute difference (MAD), and Clarke Error Grid Analyses.

Results:

Mean absolute relative difference and MAD increased during exercise (14%-33% and 24.3-34 mg/dL) but improved after exercise. We noted certain CGM locations produced greater changes in accuracy as MARD and MAD increased markedly when the CGM was on the buttocks (18%-46% and 30-41 mg/dL). We also noted decreased odds of Zone A in the Clarke error grid when the CGM was on the buttocks compared to the abdomen (odds ratio [OR]: 0.146; P = 0.0003; 95% CI = 0.052-0.415).

Conclusions:

This CGM system showed alterations in accuracy during exercise. Our findings additionally suggest interstitial fluid changes in muscles during exercise alter accuracy of CGM; however, additional research is required.
Major radiological outcomes of CTA head and neck performed for dizziness in a major academic Emergency Department
Authors: Du Elizabeth HY , Tenenbaum Mary N , Bhadelia Rafeeque A , Sotman Timothy E , Edlow Jonathan A , Selim Magdy H , Chang Yu-Ming
Published: September 2022

Purpose: Routine head and neck CTAs (CTAhead+neck) performed for dizziness in the Emergency Department (ED) has steadily increased, but its clinical utility is still poorly elucidated. Our purpose was to assess the radiologic outcomes of CTAhead+neck in ED dizziness patients.

Methods: ED dizziness patients with CTAhead+neck from January 2010 through November 2019 were retrospectively identified and further stratified into central vertigo (CV), peripheral vertigo (PV), and non-specific dizziness (NSD) groups by final clinical diagnoses. Findings on CTAhead+neck (vessel stenosis >50%, occlusion, dissection, and infarct), and infarct on subsequent MRI if performed, were assessed. Differences in imaging findings were analyzed using chi-square or Fisher’s exact tests.

Results: Of 867 dizziness patients, 88 were diagnosed with CV, 383 with PV, and 396 with NSD. On CTAhead+neck, 11.4% of all patients had posterior CTA findings, including posterior occlusions (4.2%), dissections (1.2%), and infarcts (2.3%). CV patients had more posterior circulation findings (31.8%) versus PV (9.9%) and NSD (8.3%) patients (both p < 0.01). 21.6% of CV patients had acute infarcts on CT versus none for PV and 0.03% for NSD patients (both p < 0.01). On MRI, 46.6% of CV patients had acute posterior circulation infarcts versus none for PV and 0.3% for NSD patients ( p < 0.01).

Conclusion: Diagnostic yield for CTAhead+neck for dizziness patients is low except in central vertigo patients which constitute only 1/10th of CTAs performed. Our single institution results support that CTAhead+neck is likely low-yield in patients with high clinical suspicion for PV or NSD and further studies are needed to test this hypothesis.
Baseball Made ‘Whole’: Rhetorical Hierarchy and Post-racial Discourse in Major League Baseball’s Inclusion of the Negro Leagues
Authors: Faina Joseph M.
Published: September 2022

In December 2020, Major League Baseball announced a decision to formally include records of Negro League Baseball games as ‘official’ Major League status. Against the backdrop of widespread protests for social justice and discourses surrounding racial reckoning occurring during that same year, the decision garnered heightened importance given baseball’s symbolic resonance within US public culture. This essay asserts this decision, and the coverage it received among prominent sports outlets, reveal a rhetorical hierarchy wherein “Major League Baseball” status serves to legitimize the historical contributions of Negro League players via an act of statistical integration. In granting official “Major League” status to the Negro Leagues, Major League Baseball operates from a position of institutional legitimacy, statistically integrating the Negro Leagues via an act of mortification. Ultimately this serves to rhetorically construct a post-racial history of the game and reassert the legitimacy of baseball’s statistical record. The implications of this analysis for scholars of sport, rhetoric, and public memory are discussed.
Curve Overcorrection Predicts Coronal Imbalance in Selective Thoracic Fusion in Adolescent Idiopathic Scoliosis
Authors: Ohrt-Nissen Søren , Cheung Prudence Wing Hang , Kawasaki Sachiko , Shigematsu Hideki , Cheung Jason Pui Yin
Published: September 2022

Study Design

Retrospective cohort Study.

Objectives

To identify predictive factors for coronal imbalance after selective fusion in adolescent idiopathic scoliosis (AIS) with Lenke type 1 curves.

Methods

AIS patients with Lenke type 1 curve with A, B and C lumbar modifiers underwent selective thoracic fusion. The curve fulcrum flexibility and fulcrum bending correction index (FBCI) was studied. Coronal imbalance was defined as more than 2 cm of truncal shift or more than 2 cm list at two-year follow-up.

Results

A total of 301 patients were included in the study. Coronal imbalance at two-year follow-up was found in 38 patients (13%). At the preoperative stage, we found a significant difference in main curve flexibility with 66±15% in the balanced group and 60±15% in the imbalanced group (P = .032). At the immediate postoperative stage, mean curve correction was 71±13% vs 70±13% and mean FBCI was 112±29% vs 122±29% in the balance and unbalanced group, respectively (P = .031). Postoperative FBCI of more than 125% (third quartile) resulted in an odds ratio of 2.1 (95%CI:1.1-4.3) for coronal imbalance at two years (P=.031). No significant changes in fusion mass or LIV tilt was observed.

Conclusions

A decreased preoperative flexibility and a higher FBCI was significantly associated with coronal imbalance. A high FBCI is an indication of a curve correction that exceeds the inherent flexibility of the spine, and our results add to a growing body of evidence that “overcorrection” of the main curve can lead to postoperative imbalance.
Most Cited Articles in Body Contouring: A Bibliometric Analysis of the Past 45 Years
Authors: Antezana Luis A. , Kreutz-Rodrigues Lucas , Shapiro Daniel , Chen Austin , Sharaf Basel , Martinez-Jorge Jorys , Bakri Karim
Published: September 2022

Introduction: The purpose of this study is to produce a bibliometric review of the 30 most cited articles related to 6 major domains of body contouring—abdominoplasty, thighplasty, brachioplasty, gluteoplasty, body lift, and liposuction—for resident and fellow education. Methods: The authors utilized the Web of Science Citation Index to identify the 30 most cited articles related to surgery for body contouring published from 1975 to 2020. Articles were classified according to their level of evidence, type of study, and country of publication. Results: A total of 336 articles were reviewed to compile our list. The mean number of citations across the articles was 114.7 ±  SD 86.1. The highest prevalence of the papers was published between 2000 and 2009 (n = 15, 50%). The country with the highest number of contributions was the United States (n = 22, 73%). Plastic and Reconstructive Surgery served as the main journal of publication for these papers (n = 22, 73.3%). The majority of articles were designated for clinical-type studies (n = 26, 86.7%). No basic science or prevalence study design papers were listed. In terms of level of evidence (LoE), most papers were assigned IV (n = 11, 36.7%) and III (n = 7, 23.3%). Conclusions: Our study reveals that the most cited papers in body contouring are of LoE III and IV. Although the LoE of plastic surgery research, in general, has improved, in the past decade, a call for higher quality papers remains. Overall, this analysis provides an easy, electronic starting point for residents and fellows interested in understanding the field's evolution.
Translating Change: A Continuity of Craft Heritage at Coventry Cathedral, UK
Authors: Djabarouti Johnathan
Published: September 2022

Change is historically seen as incompatible with built heritage. Paradoxically, change can charge heritage with enough cultural activity to facilitate its ongoing valorization. Change may therefore be better understood as a collection of recreations by contemporary societies, like how UNESCO portrays intangible heritage. However, to understand built heritage in this way, interpretative approaches must reconceptualize physical sites as constantly evolving in response to their ever-changing sociocultural context. Expanding on the history of linguistic analogies for architectural interpretation, this article explores ‘translation’ as an analogy that can illuminate constantly recreated traditions at built heritage sites. Using the Grade 1 listed Coventry Cathedral, UK, the craft traditions associated with the site are used as a vehicle to reconceptualize built heritage as constantly recreated in relation to temporal traditions (or ICH), which both perpetuate and transform the physical building across time. The article concludes by suggesting physical changes made to the site have simultaneously sustained and changed its craft traditions. Through constant recreation or translation, the site has maintained a commitment to its history whilst continually responding to present-day social needs. This not only ensures relevance to contemporary society but also creates a rich foundation for translation of its heritage into the future.
Gambling with our climate futures: On the temporal structure of negative emissions
Authors: Andersson J Daniel
Published: September 2022

This paper considers negative emissions—the deliberate removal of greenhouse gases from the atmosphere by human intervention—as a future-oriented imaginary of connected social and technological order. It does so in order to examine how expectations around the development and use of negative emission technologies are managed with the help of integrated assessment models (IAMs). By treating this family of models as a case study for drawing out historical associations between the terminology of risk saturating the discourse of net-zero emissions and the modern conception of the future as an unexplored territory to be profitably colonized, the paper argues that integrated assessment modeling, as a praxis of forecast, structure and organize our experience of the future through standards of risk management and utility maximization. It concludes that to consider risk as a means of navigating between possible futures is to engage with practices that are enacted in the name of a particular understanding of how one ought to act in the face of deep uncertainty. Aside from epistemic questions of how to treat various kinds of uncertainties inherent to IAMs, of pressing concern are thus also normative questions of how its representation of environmental hazards in terms of risk are distinctively writing the contours of our contemporary forms of responsibility toward nature, each other, as well as future generations.
Adjusting for Publication Bias in JASP and R: Selection Models, PET-PEESE, and Robust Bayesian Meta-Analysis
Authors: Bartoš František , Maier Maximilian , Quintana Daniel S. , Wagenmakers Eric-Jan
Published: September 2022

Meta-analyses are essential for cumulative science, but their validity can be compromised by publication bias. To mitigate the impact of publication bias, one may apply publication-bias-adjustment techniques such as precision-effect test and precision-effect estimate with standard errors (PET-PEESE) and selection models. These methods, implemented in JASP and R, allow researchers without programming experience to conduct state-of-the-art publication-bias-adjusted meta-analysis. In this tutorial, we demonstrate how to conduct a publication-bias-adjusted meta-analysis in JASP and R and interpret the results. First, we explain two frequentist bias-correction methods: PET-PEESE and selection models. Second, we introduce robust Bayesian meta-analysis, a Bayesian approach that simultaneously considers both PET-PEESE and selection models. We illustrate the methodology on an example data set, provide an instructional video ( https://bit.ly/pubbias ) and an R-markdown script ( https://osf.io/uhaew/ ), and discuss the interpretation of the results. Finally, we include concrete guidance on reporting the meta-analytic results in an academic article.
A Review of Modern Slavery in Britain: Understanding the Unique Experience of British Victims and Why it Matters
Authors: Heys Alicia , Barlow Craig , Murphy Carole , McKee Amy
Published: September 2022

This article offers an original contribution to the field of victimization studies by investigating the current context of, and responses to, British nationals who are victims of modern slavery in the UK (BVs). Through the examination of National Referral Mechanism and Duty to Notify statistics, a current picture of specific experiences of BVs in the UK is illustrated with reference to identification and access to support. An exploration of the reasons for non-engagement of BVs with services and the detrimental impact this may have on their recovery highlights pertinent issues of mistrust, stigma and shame. Compounded by the current criminal justice approach towards modern slavery, the effects on the well-being of victims and survivors document the barriers to accessing services. A lack of engagement with the complexity of modern slavery; a lack of knowledge, training and expertise; and a lack of comprehensive guidance result in poor outcomes for BVs. Overall, the findings of this article are important in recognizing that the needs of BVs are currently not adequately met. A comprehensive investigation is required to examine the specific needs and experiences of BVs so that responses can be improved to effectively and appropriately support them into long-term and meaningful recovery.
Professional Competencies for Diabetes Technology Use in the Care Setting
Authors: Patil Shivajirao P. , Albanese-O’Neill Anastasia , Yehl Kirsten , Seley Jane Jeffrie , Hughes Allyson S.
Published: September 2022

Purpose:

The integration of diabetes technology into diabetes care and self-management is evolving so rapidly that providing sufficient support has become an obstacle for many health care professionals (HCPs) in practice. Diabetes technology requires HCPs to stay current with treatment goals and practice guidelines. Diabetes care and education specialists (DCESs) are well positioned to take on this challenge by seizing opportunities to apply their skills, knowledge, and experience to contribute to a technology-enabled practice environment. Diabetes technology includes devices, hardware, and software utilized to manage all aspects of diabetes care, including lifestyle management, glucose monitoring, and insulin delivery. The complexities of caring for persons with diabetes (PWD) who utilize diabetes technology is best accomplished in partnership with other members of the care team and support staff to cover all aspects of technology including prior authorizations, onboarding PWD, downloading and interpreting data, and supporting ongoing utilization. The purpose of this article is to introduce a comprehensive set of role-based competencies for HCPs, DCESs, and staff for the selection, implementation, and sustainability of diabetes technology when providing diabetes care, education, and support. The role-based competencies described in this article are intended to support the initiation, continuation, and optimal use of diabetes technology in practice through ongoing education and guidance of care team members.

Conclusion:

This article describes the diabetes technology competencies essential for all levels of the care team and support staff in various care settings to deliver comprehensive diabetes management and support to PWD utilizing diabetes technology in their self-care regimen.
Long-term effectiveness of dual CFTR modulator treatment of cystic fibrosis
Authors: Muilwijk Danya , Zomer-van Ommen Domenique D. , Gulmans Vincent A.M. , Eijkemans Marinus J.C. , van der Ent Cornelis K. ,   Dutch Cystic Fibrosis Registry (NCFR) Steering Group:, Altenburg J. , Terheggen-Lagro S.W.J. , Heijerman H.G.M. , de Winter-de Groot K.M. , Bakker M. , Hoek R.A.S. , Janssens H.M. , van der Meer R. , Nuijsink M. , van der Vaart H. , Koppelman G.H. , Conemans L.H. , Bannier M.A.G.E. , Noordhoek J.J.
Published: September 2022

Background

Although short-term efficacy of lumacaftor/ivacaftor and tezacaftor/ivacaftor is clearly established in clinical trials, data on long-term effectiveness is limited. This registry-based cohort study assessed real-world longitudinal outcomes of F508del-homozygous people with cystic fibrosis (pwCF) ≥12 years, up to 3 years after the introduction of dual cystic fibrosis transmembrane conductance regulator (CFTR) modulators.

Methods

Annual data (2010–2019) were retrieved from the Dutch Cystic Fibrosis Registry. Longitudinal trends of per cent predicted forced expiratory volume in 1 s (FEV
1
% pred) decline, body mass index (BMI), BMI Z-score and intravenous antibiotic treatment duration before and after CFTR modulator initiation were assessed with linear and negative binomial mixed models.

Results

We included 401 participants (41.9% female, baseline age 24.5 years (IQR 18.0–31.5 years), baseline mean±
sd
FEV
1
70.5±23.4% pred). FEV
1
decline improved from −1.36% pred per year to −0.48% pred per year after modulator initiation (change: 0.88% pred, 95% CI: 0.35–1.39%, p=0.001). This change was even 1.40% pred per year (95% CI: −0.0001–2.82%, p=0.050) higher in participants with baseline FEV
1
<40% pred. In adults, annual BMI trend was not altered (change: 0.10 kg·m
−2
·year
−1
, 95% CI:−0.01–0.21, p=0.079). Annual BMI Z-score in children reversed from −0.08 per year before modulator treatment to 0.06 per year afterwards (change: 0.14 per year, 95% CI: 0.06–0.22, p<0.001). Intravenous antibiotic treatment duration showed a three-fold reduction in the first year after modulator initiation (incidence rate ratios (IRR): 0.28, 95% CI: 0.19–0.40, p<0.001), but the annual trend did not change in the subsequent years (IRR: 1.19, 95% CI: 0.94–1.50, p=0.153).

Conclusion

Long-term effectiveness of dual CFTR modulator therapies on FEV
1
decline, BMI and intravenous antibiotic treatment duration is less pronounced in a real-world setting than in clinical trials and varies considerably between pwCF and different baseline FEV
1
levels.
Performance of cough monitoring by Albus Home, a contactless and automated system for nocturnal respiratory monitoring at home
Authors: Do William , Russell Richard , Wheeler Christopher , Javed Hamza , Dogan Cihan , Cunningham George , Khanna Vikaran , De Vos Maarten , Satia Imran , Bafadhel Mona , Pavord Ian
Published: September 2022

Introduction

Objective cough frequency is a key clinical end-point but existing wearable monitors are limited to 24-h recordings. Albus Home uses contactless motion, acoustic and environmental sensors to monitor multiple metrics, including respiratory rate and cough without encroaching on patient lifestyle. The aim of this study was to evaluate measurement characteristics of nocturnal cough monitoring by Albus Home compared to manual counts.

Methods

Adults with respiratory conditions underwent overnight monitoring using Albus Home in their usual bedroom environments. Participants set-up the plug-and-play device themselves. For reference counts, each audio recording was counted by two annotators, and cough defined as explosive phases audio-visually labelled by both. In parallel, recordings were processed by a proprietary Albus system, comprising a deep-learning algorithm with a human screening step for verifying or excluding occasional events that mimic cough. Performance of the Albus system in detecting individual cough events and reporting hourly cough counts was compared against reference counts.

Results

30 nights from 10 subjects comprised 375 hours of recording. Mean±sdcoughs per night were 90±76. Coughs per hour ranged from 0 to 129. Albus counts were accurate across hours with high and low cough frequencies, with median sensitivity, specificity, positive predictive value and negative predictive values of 94.8, 100.0, 99.1 and 100.0%, respectively. Agreement between Albus and reference was strong (intra-class correlation coefficient (ICC) 0.99; 95% CI 0.99–0.99; p<0.001) and equivalent to agreement between observers and reference counts (ICC 0.98 and 0.99, respectively).

Conclusions

Albus Home provides a unique, contactless and accurate system for cough monitoring, enabling collection of high-quality and potentially clinically relevant longitudinal data.
Evolution, gene expression, and protein‒protein interaction analyses identify candidate CBL-CIPK signalling networks implicated in stress responses to cold and bacterial infection in citrus
Authors: Xiao Cui , Zhang Hu , Xie Fan , Pan Zhi-Yong , Qiu Wen-Ming , Tong Zhu , Wang Ze-Qiong , He Xiu-Juan , Xu Yu-Hai , Sun Zhong-Hai
Published: September 2022

Background

Cold is a major abiotic stress and Huanglongbing and citrus canker disease are two devastating bacterial diseases for citrus. The Ca2+-CBL-CIPK network is known to regulate different types of stress signalling in plants. How do CBL–CIPK signalling networks function in response to cold and infection by CLas or Xcc in citrus?

Results

Eight calcineurin B-like proteins (CBLs) and seventeen CBL-interacting protein kinases (CIPKs) were identified from the cold-tolerant satsuma mandarin ‘Guijing2501’ (Citrus. unshiu) and CLas/Xcc-sensitive sweet orange (C. sinensis). Phylogenetic analysis revealed that both CBL and CIPK family members in citrus were classified into an ancient and a recent clade according to their conserved domain characteristics and/or intron/exon structures. Genome duplication analysis suggested that both tandem and segmental duplications contributed to the amplification of the CBL and CIPK gene families in citrus under intense purifying selection, and the duplication events only existed in the recent clades. Expression comparison of the duplicated gene pairs indicated that the duplicated CBL and CIPK genes underwent functional differentiation. Further expression analysis identified that CBL1, 5, 6, and 8 and CIPK2, 8, 12, 15, 16, and 17 were significantly regulated by multiple stresses, including cold, Xcc infection and/or CLas infection, in citrus, whereas CBL2/7 and CIPK1/4/5/11/13/14 were independently highly regulated by cold and CIPK3 was uniquely responsive to Xcc infection. The combination analyses of targeted Y2H assay and expression analysis revealed that CBL6-CIPK8 was the common signalling network in response to cold and Xcc infection, while CBL6/CBL8-CIPK14 was uniquely responsive to cold in citrus. Further stable transformation and cold tolerance assay indicated that overexpression of CuCIPK16 enhanced the cold tolerance of transgenic Arabidopsis with higher POD activity and lower MDA content.

Conclusions

In this study, evolution, gene expression and protein‒protein interaction analyses of citrus CBLs and CIPKs were comprehensively conducted over a genome-wide range. The results will facilitate future functional characterization of individual citrus CBLs and CIPKs under specific stresses and provide clues for the clarification of cold tolerance and disease susceptibility mechanisms in corresponding citrus cultivars.
Risk of hospital admission related to scooter trauma injuries: a national emergency room database study
Authors: Navarro Sergio M. , Vakayil Victor R. , Solaiman Rafat H. , Keil Evan J. , Cohen Matthew W. , Spartz Ellen J. , Tignanelli Christopher J. , Harmon James V.
Published: September 2022

Background

We investigated key risk factors for hospital admission related to powered scooters, which are modes of transportation with increasing accessibility across the United States (US).

Methods

We queried the National Electronic Injury Surveillance System (NEISS) for injuries related to powered scooters, obtaining US population projections of injuries and hospital admissions. We determined mechanism of injury, characterized injury types, and performed multivariate regression analyses to determine factors associated with hospital admission.

Results

One thousand one hundred ninety-one patients sustained electric-motorized scooter (e-scooter) injuries and 10.9% (131) required hospitalization from 2013 to 2018. This extrapolated to a US annual total of 862 (95% CI:745–979) scooter injuries requiring hospitalization, with estimated annual mortality of 6.7 patients per year (95% CI:4.8–8.5). The incidence of hospital admissions increased by an average of 13.1% each year of the study period. Fall (79 [60%]) and motor vehicle collision (33 [25%]) were the most common mechanism. Injury locations included head (44 [34%]), lower extremity (22 [17%]), and lower trunk (16 [12%]). On multivariable analysis, significant factors associated with admission included increased age (OR 1.02, 95% CI:1.01–1.02), torso injuries (OR 6.19, 2.93–13.10), concussion (25.45, 5.88–110.18), fractures (21.98, 7.13–67.66), musculoskeletal injury (6.65, 1.20–36.99), and collision with vehicle (3.343, 2.009–5.562). Scooter speed, seasonality, and gender were not associated with risk of hospitalization.

Conclusion

Our findings show increased hospital admissions and mortality from powered scooter trauma, with fall and motor vehicle collisions as the most common mechanisms resulting in hospitalization. This calls for improved rider safety measures and regulation surrounding vehicular collision scenarios.
ELEVATE – evaluating Temozolomide and Nivolumab in patients with advanced unresectable previously treated oesophagogastric adenocarcinoma with MGMT methylation: study protocol for a single arm phase II trial
Authors: Smyth Elizabeth , Cozens Kelly , Griffiths Daniel , Clark Kathryn L. , Ewings Sean , Petty Russell , Underwood Tim , Fitzgerald Rebecca C. , Tanner James , Giger Olivier , Anand Shubha , Griffiths Gareth
Published: September 2022

Background

For patients with oesophagogastric adenocarcinoma, surgery is the only curative option and despite the use of multimodality therapy, which combines it with chemotherapy and/or radiotherapy, more than 50% of patients will relapse and die. Many UK patients present with advanced disease which is already inoperable or metastatic at diagnosis. For these patients, standard care chemotherapy only offers them survival of less than a year. Nivolumab, a checkpoint blockade inhibitor, has been found to work in some advanced cancers. It is proposed, for those where immunotherapy hasn’t worked, that these immunologically evasive tumours need to be sensitized to immunotherapy drugs to allow them to act.

Methods

ELEVATE is a single arm phase II trial testing the overall response to nivolumab following temozolomide treatment in patients with advanced unresectable previously treated adenocarcinoma which is O6-methylguanine-DNA-methyltransferase (MGMT) methylated. 18 patients are being recruited from UK secondary care sites. To be eligible, participants must have been treated with at least 3 months of platinum and fluoropyrimidine chemotherapy. Participants will receive 50 mg/m2 temozolomide continuously for 3 months. If their disease progresses during the 3 months, they will stop temozolomide and start nivolumab at a dose of 240mg every 2 weeks. If there is no progression after 3 months the participant will continue taking temozolomide in combination with nivolumab. All treatment will stop once the participant progresses on nivolumab. The primary endpoint is the best overall response to nivolumab, using both Response Evaluation Criteria in Solid Tumours version 1.1 and immunotherapy modified Response Evaluation Criteria in Solid Tumours. Secondary endpoints include progression-free survival, overall survival, and quality of life.

Discussion

ELEVATE will provide evidence for whether giving nivolumab after temozolomide in patients with previously treated advanced oesophagogastric adenocarcinoma is safe and biologically effective prior to future randomised trials.

Trial registrations

EudraCT Number: 2020-004771-41(issued 01 October 2020); ISCRTN11398887(registered 14 July 2021).
Prevalence, correlates, and behavioral outcomes of alcohol gifting in China
Authors: Zhang Lu , Huang Lixin , Weiger Caitlin , Jiao Can , Li Ying , Wu Dan
Published: September 2022

Introduction

Alcohol gifting is a very common practice in China. However, little is known about the potentially adverse consequences of alcohol gifting. This study aimed to investigate the prevalence of, and factors associated with, alcohol gifting, and explore whether drinking and tobacco use were associated with alcohol gifting.

Methods

Using a cross-sectional multi-stage survey, a sample of 982 household heads from Guangdong Province and 530 household heads from Shaanxi Province was collected online from 30 April to 30 July 2020 in China. Participants completed questionnaires regarding socio-demographic characteristics, social capital, drinking status, and gifting alcohol behavior. Chi-square analysis and multiple logistic regression analysis were used to identify the factors associated with alcohol gifting, and to identify its relationship with alcohol and cigarette use status.

Results

Multiple logistic regression analysis showed that age, gender, household annual income, province, drinking status, and social participation were prominent correlates of both offering and receiving alcohol. Participants who were married, had an education level of junior high school, or had a large social network had higher odds of receiving alcohol. When both alcohol gifting behaviors were included in the models, participants who offered alcohol had 2.15 (95% CI: 1.63–2.85) times higher odds of current drinking than those who didn’t offer alcohol and participants who received alcohol had 1.87 (95% CI: 1.45–2.41) times higher odds of current drinking than those who did not receive alcohol. Those who received alcohol had significantly higher odds of current smoking (AOR = 1.64; 95% CI: 1.25–2.14), while those who offered alcohol had significantly lower odds of current smoking (AOR = 0.71;95% CI:0.53–0.95).

Conclusions

Social participation is an important correlate of alcohol gifting. Alcohol receiving behaviors were significantly associated with both current alcohol and tobacco use. These associations can be used to inform alcohol gifting interventions in China.
Neighborhood-level socioeconomic factors moderate the association between physical activity and relative age effect: a cross-sectional survey study with Japanese adolescents
Authors: Mori Takaaki , Aoki Takumi , Oishi Kan , Harada Tetsuo , Tanaka Chiaki , Tanaka Shigeho , Tanaka Hideki , Fukuda Kazuhiko , Kamikawa Yasuko , Tsuji Nobuhiro , Komura Keisuke , Kokudo Shohei , Morita Noriteru , Suzuki Kazuhiro , Watanabe Masashi , Kasanami Ryoji , Hara Taketaka , Miyazaki Ryo , Abe Takafumi , Yamatsu Koji , Kume Daisuke , Asai Hedenori , Yamamoto Naofumi , Tsuji Taishi , Nakaya Tomoki , Ishii Kojiro
Published: September 2022

Background

Relative age effect is defined as a phenomenon where children born early generally perform better than children born later in the same cohort. Physical activity is an important factor that might be influenced by the relative age effect. Socioeconomic factors (e.g., parent’s income, education level) are also associated with the adolescent’s physical activity. However, no existing study has examined whether socioeconomic factors moderate the relative age effect on the adolescent’s physical activity. This study aims to clarify whether and how birth month and socioeconomic factors relate to organized sports and physical activity among adolescents in Japan.

Methods

We conducted a questionnaire survey targeting 21,491 adolescents who live in a widespread neighborhood. We included 8102 adolescents (4087 males and 4015 females: mean age 13.1 ± 1.4) in the analysis. Based on the participants’ birth months, we divided them into four groups (April to June, July to September, October to December, January to March). We asked participants to report their organized sports participation. Using the International Physical Activity Questionnaire for Japanese Early Adolescents, we identified their moderate to vigorous physical activity (MVPA). Neighborhood-level socioeconomic factors (areal deprivation, average annual income, education level) were analyzed based on national surveys, such as the population census. We performed multilevel logistic and linear regression analysis for organized sports participation and MVPA, respectively. Moreover, a simple slope analysis was implemented if the interaction between birth month and socioeconomic factor was significant in the multilevel linear regression analysis.

Results

Among males, relatively younger adolescents (adolescents who were born later in the same grade) were less likely to participate in organized sports activites (OR=0.90, 95% CI 0.82–0.97, p<0.05), while both males and females engaged in less MVPA (b=-0.54, b=-0.25, p< 0.01, respectively). We observed an interaction between birth month and socioeconomic factors. Among males in low-income neighborhoods, and females in more deprived neighborhoods, relatively younger adolescents engaged in less MVPA.

Conclusions

Socioeconomic factors moderate the relative age effect on adolescents’ physical activity. The relative age effect on adolescents’ physical activity might be more likely to appear among adolescents from socioeconomically disadvantaged neighborhoods.
Periapical and endodontic status among 65-year-old Oslo-citizens
Authors: Diep My Tien , Hove Lene Hystad , Ørstavik Dag , Skudutyte-Rysstad Rasa , Sødal Anne Thea Tveit , Sunde Pia Titterud
Published: September 2022

Aim

This cross-sectional study aimed to investigate the prevalence of apical periodontitis (AP) and root-filled teeth in a 65-year-old population in Oslo, Norway, and to investigate associations of pathosis and endodontic treatment with selected individual risk indicators and technical quality of root fillings.

Material and methods

A random sample of 450 65-year-olds in Oslo answered a questionnaire and underwent a clinical and radiological examination (52% men and 48% women). Periapical radiographs were taken of all root-filled teeth and of teeth with apical radiolucency, and periapical status was evaluated using the Periapical Index. Apex-to-filling distance and homogeneity were assessed for all root fillings. Analyses on individual level and tooth level were performed. The outcome variables were ‘non-root-filled tooth with AP’ (‘untreated AP’), ‘root-filled tooth’, and 'root-filled tooth with AP’. The explanatory variables were gender, education, dental attendance pattern, smoking, remaining teeth (n), tooth group, and root filling quality. Chi-square test and logistic regression analyses were used to assess the associations between outcome variables and explanatory variables. The level of significance was set top < 0.05.

Results

The mean number of remaining teeth was 26 (SD: 4). AP was present in 45% of the individuals. Sixteen percent of the individuals had untreated AP and 38% had at least one root-filled tooth with AP. Sixty-six percent of the individuals had one or more root-filled teeth. Untreated AP was significantly associated with a decreasing number of remaining teeth and smoking. All the outcome variables were significantly more prevalent in molars compared with premolars and anterior teeth. Thirty-five percent of the root-filled teeth had AP, and AP was more prevalent in teeth with too short apex-to-filling distance (53%) or unsatisfactory homogeneity (46%).

Conclusions

The remaining number of teeth was high, and AP and root-filled teeth were prevalent in the present young-elderly population. A notable amount of untreated AP was observed, especially in smokers. The findings in the present study indicate a substantial need for dental care associated with endodontic conditions in the future elderly.
Exploratory application of machine learning methods on patient reported data in the development of supervised models for predicting outcomes
Authors: Verma Deepika , Jansen Duncan , Bach Kerstin , Poel Mannes , Mork Paul Jarle , d’Hollosy Wendy Oude Nijeweme
Published: September 2022

Background

Patient-reported outcome measurements (PROMs) are commonly used in clinical practice to support clinical decision making. However, few studies have investigated machine learning methods for predicting PROMs outcomes and thereby support clinical decision making.

Objective

This study investigates to what extent different machine learning methods, applied to two different PROMs datasets, can predict outcomes among patients with non-specific neck and/or low back pain.

Methods

Using two datasets consisting of PROMs from (1) care-seeking low back pain patients in primary care who participated in a randomized controlled trial, and (2) patients with neck and/or low back pain referred to multidisciplinary biopsychosocial rehabilitation, we present data science methods for data prepossessing and evaluate selected regression and classification methods for predicting patient outcomes.

Results

The results show that there is a potential for machine learning to predict and classify PROMs. The prediction models based on baseline measurements perform well, and the number of predictors can be reduced, which is an advantage for implementation in decision support scenarios. The classification task shows that the dataset does not contain all necessary predictors for the care type classification. Overall, the work presents generalizable machine learning pipelines that can be adapted to other PROMs datasets.

Conclusion

This study demonstrates the potential of PROMs in predicting short-term patient outcomes. Our results indicate that machine learning methods can be used to exploit the predictive value of PROMs and thereby support clinical decision making, given that the PROMs hold enough predictive power
Teledentistry during COVID-19 pandemic: scientometric and content analysis approach
Authors: Mahdavi Abdullah , Atlasi Rasha , Naemi Roya
Published: September 2022

Introduction

During Covid-19 pandemic, people have been reluctant to visit dentist due to the fear of infection. Dentists have also suffered from severe turmoil. Teledentistry has been considered as a key strategy for managing people’s oral health. The aim of this study was to investigate teledentistry services in the world during the Covid-19 pandemic and to learn from different experiences.

Materials and methods

The Web of Science database was searched by scientometric analysis approach, using keywords such as Covid-19, telemedicine, teledentistry and synonymous keywords derived from MeSH. Consequently, 94 articles were extracted from which, 15 articles related to teledentistry during Covid-19 were included in the study, considering the inclusion and exclusion criteria.

Results

Scientometric analysis and illustration of retrieved articles were performed to identify authors, organizations and countries, and to review cooperation and collaboration networks in this field. Teledentistry was studied during Covid-19 in countries such as China, United States, Japan, Italy and United Kingdom. Types of the software used for communication between dentists and patients were WeChat, BigWord telephone translator, iGAM, WhatsApp, Attend Anywhere (AA), DeRS. The software used for data storage were Mouthwatch TeleDent, and Proforma. For data processing and decision making decision tree algorithms, automated algorithms were employed.

Conclusion

Teledentistry has the potential to improve the provision of dental services. A fundamental review and careful planning is required to provide such services, particularly in developing countries. Furthermore teledentistry needs more in-depth studies in order to overcome existing and future obstacles and risks while taking advantage of its benefits.
Multidimensional associations between nutrient intake and healthy ageing in humans
Authors: Senior Alistair M. , Legault Véronique , Lavoie Francis B. , Presse Nancy , Gaudreau Pierrette , Turcot Valérie , Raubenheimer David , Le Couteur David G. , Simpson Stephen J. , Cohen Alan A.
Published: September 2022

Background

Little is known about how normal variation in dietary patterns in humans affects the ageing process. To date, most analyses of the problem have used a unidimensional paradigm, being concerned with the effects of a single nutrient on a single outcome. Perhaps then, our ability to understand the problem has been complicated by the fact that both nutrition and the physiology of ageing are highly complex and multidimensional, involving a high number of functional interactions. Here we apply the multidimensional geometric framework for nutrition to data on biological ageing from 1560 older adults followed over four years to assess on a large-scale how nutrient intake associates with the ageing process.

Results

Ageing and age-related loss of homeostasis (physiological dysregulation) were quantified via the integration of blood biomarkers. The effects of diet were modelled using the geometric framework for nutrition, applied to macronutrients and 19 micronutrients/nutrient subclasses. We observed four broad patterns: (1) The optimal level of nutrient intake was dependent on the ageing metric used. Elevated protein intake improved/depressed some ageing parameters, whereas elevated carbohydrate levels improved/depressed others; (2) There were non-linearities where intermediate levels of nutrients performed well for many outcomes (i.e. arguing against a simple more/less is better perspective); (3) There is broad tolerance for nutrient intake patterns that don’t deviate too much from norms (‘homeostatic plateaus’). (4) Optimal levels of one nutrient often depend on levels of another (e.g. vitamin E and vitamin C). Simpler linear/univariate analytical approaches are insufficient to capture such associations. We present an interactive tool to explore the results in the high-dimensional nutritional space.

Conclusion

Using multidimensional modelling techniques to test the effects of nutrient intake on physiological dysregulation in an aged population, we identified key patterns of specific nutrients associated with minimal biological ageing. Our approach presents a roadmap for future studies to explore the full complexity of the nutrition-ageing landscape.
Building a virtual community of practice: experience from the Canadian foundation for healthcare improvement’s policy circle
Authors: Sibbald Shannon L. , Burnet Maddison L. , Callery Bill , Mitchell Jonathan I.
Published: September 2022

Background

Communities of Practice are formed by people who interact regularly to engage in collective learning in a shared domain of human endeavor. Virtual Communities of Practice (VCoP) are online communities that use the internet to connect people who share a common concern or passion. VCoPs provide a platform to share and enhance knowledge. The Policy Circle is a VCoP that connects mid-career professionals from across Canada who are committed to improving healthcare policy and practice. We wanted to understand the perceived value of the VCoP.

Methods

We used qualitative and quantitative survey research to explore past and current Policy Circle members’ thoughts, feelings, and behaviours related to the program. Our research was guided by the Value Creation Framework proposed by Wenger and colleagues. Three surveys were created in collaboration with stakeholders. Data were analyzed within cohort and in aggregate across cohorts. Qualitative data was analyzed thematically, and quantitative data was analyzed using descriptive statistics (means of ranked and scaled responses).

Results

Survey participation was high among members (Cohort 1: 67%, Cohort 2: 64%). Participants came from a variety of disciplines including medicine, health policy, allied health, and nursing, with most members having a direct role in health services research or practice. The program was successful in helping participants make connections (mean = 2.43 on a scale from 1 to 5: 1 = yes, significantly, 5 = not at all); variances in both qualitative and quantitative data indicated that levels of enthusiasm within the program varied among individuals. Members appreciated the access to resources; quarterly meetings (n = 11/11), and a curated reading list (n = 8/11) were the most valued resources. Participants reported the development of a sense of belonging (mean = 2.29) and facilitated knowledge exchange (mean = 2.43). At the time of this study, participants felt the program had minor impact on their work (mean = 3.5), however a majority of participants (50%) from Cohort 2 planned to acknowledge the program in their professional or academic endeavours. Through reflective responses, participants expressed a desire for continued and deeper professional network development.

Conclusions

The Policy Circle was successful in facilitating knowledge exchange by creating a community that promoted trust, a sense of belonging and a supportive environment. Members were satisfied with the program; to promote further value, the Policy Circle should implement strategies that will continue member participation and networking after the program is finished.