bluuebunny/crossref_metadata_2025 huggingface dataset:
Feminism
Authors: Chambers Clare
Published: February 2024

This chapter goes deeper into the question of what feminism is, viewed as a political ideology. While it is in some ways misleading to think of feminism as an ideology, rather than as a reaction against the dominant ideology of patriarchy, nevertheless some key themes can be identified. Feminism, the chapter argues, stands against what Chambers calls ‘the fetishism of choice’ and ‘the prison of biology’; it stands for three theses of feminism: ‘the entrenchment of gender’, ‘the existence of patriarchy’, and ‘the need for change’. These three theses admit of a great deal of variety within feminist thought; nonetheless, they offer a coherent whole.
Feminism on Liberalism
Authors: Chambers Clare
Published: February 2024

This chapter considers what liberalism is, from the perspective of feminism. The chapter starts by considering the multiple feminist critiques of liberal theory. Liberalism, according to these critiques, is too universalist and abstract, failing to understand the significance of power and the private sphere. The chapter then moves to those who see the possibility of a productive partnership between liberalism and feminism, whether in philosophy or in activism. For some that partnership is forged by a liberal feminism or ‘choice feminism’ that centres women’s choices, whatever they may be; others endorse a more critical feminist liberalism. It is this latter option, a feminist liberalism, that holds the most potential.
Respect, Religion, and Feminism
Authors: Chambers Clare
Published: February 2024

This chapter considers whether political liberalism, specifically, can be used for feminist ends. There is significant disagreement among feminists and liberals about the compatibility between their two doctrines. Political liberalism is vulnerable to particular criticism from feminists, who argue that its restricted form of equality is insufficient. In contrast, Lori Watson and Christie Hartley argue that political liberalism can and must be feminist. This chapter raises three areas of disagreement with Watson and Hartley’s incisive account of feminist political liberalism. First, the chapter argues that an appeal to a comprehensive doctrine can be compatible with respecting others, if that appeal is to the value of equality. Second, the chapter takes issue with Watson and Hartley’s defence of religious exemptions to equality law. Third, the chapter argues that political liberalism can be compatible with feminism, but that it is not itself adequately feminist. The chapter concludes that political liberalism is not enough for feminists.
Each Outcome Is Another Opportunity
Authors: Chambers Clare
Published: February 2024

This chapter considers those forms of equal opportunity that go beyond mere non-discrimination, and argues that each of them face a choice. They can employ what Clare Chambers calls a ‘Moment of Equal Opportunity’, dividing a person’s life around a key Moment at which opportunities are equalised and after which they are not. The problem with this option is that the injustice of unequal opportunities persists throughout life, meaning that equality of opportunity becomes an arbitrarily temporary state. But if a Moment of Equality of Opportunity is not used, and equality of opportunity is ensured throughout life, serious inefficiencies and bad decisions ensue. To put it simply, the chapter argues that a theory of equality of opportunity is unjustified if it uses a Moment of Equal Opportunity, and unworkable if it does not.
The Decline and Fall of the Fascist Empire
Authors: Agbamu Samuel
Published: February 2024

This chapter considers the changes in Fascist imperial romanità in the late 1930s, during the Second World War, and in the immediate aftermath of Italy’s defeat and the loss of its African colonies. The memory of ancient Rome began to be more aggressively co-opted by racist ideologies. In particular, the Punic Wars were forcefully represented as a clash between the Aryan Roman empire and the ‘Semitic’ Carthage. This chapter takes a number of articles from the racist journal La Difesa della Razza as case studies, and looks at how Italy represented itself as a new Roman empire in exhibitions planned for the 1940s. With the outbreak of the Second World War, the conflict was seen by some Fascist Italian idealogues as a Fourth Punic War. The chapter concludes by looking at how proponents of empire made sense of Italy’s defeat, with reference to Rome’s empire in Africa.
Contrasting Objective and Perceived Risk: Predicting COVID-19 Health Behaviors in a Nationally Representative U.S. Sample
Authors: Thompson Rebecca R , Jones Nickolas M , Garfin Dana Rose , Holman E Alison , Silver Roxane Cohen
Published: February 2024

Background

Individuals confronting health threats may display an optimistic bias such that judgments of their risk for illness or death are unrealistically positive given their objective circumstances.

Purpose

We explored optimistic bias for health risks using k-means clustering in the context of COVID-19. We identified risk profiles using subjective and objective indicators of severity and susceptibility risk for COVID-19.

Methods

Between 3/18/2020-4/18/2020, a national probability sample of 6,514 U.S. residents reported both their subjective risk perceptions (e.g., perceived likelihood of illness or death) and objective risk indices (e.g., age, weight, pre-existing conditions) of COVID-19-related susceptibility and severity, alongside other pandemic-related experiences. Six months later, a subsample (N = 5,661) completed a follow-up survey with questions about their frequency of engagement in recommended health protective behaviors (social distancing, mask wearing, risk behaviors, vaccination intentions).

Results

The k-means clustering procedure identified five risk profiles in the Wave 1 sample; two of these demonstrated aspects of optimistic bias, representing almost 44% of the sample. In OLS regression models predicting health protective behavior adoption at Wave 2, clusters representing individuals with high perceived severity risk were most likely to report engagement in social distancing, but many individuals who were objectively at high risk for illness and death did not report engaging in self-protective behaviors.

Conclusions

Objective risk of disease severity only inconsistently predicted health protective behavior. Risk profiles may help identify groups that need more targeted interventions to increase their support for public health policy and health enhancing recommendations more broadly.
Development and Validation of a Vocabulary Measure in the Mobile Toolbox
Authors: Young Stephanie Ruth , Dworak Elizabeth M , Kaat Aaron J , Adam Hubert , Novack Miriam A , Slotkin Jerry , Stoeger Jordan , Nowinski Cindy J , Hosseinian Zahra , Amagai Saki , Pila Sarah , Diaz Maria Varela , Correa Anyelo Almonte , Alperin Keith , Omberg Larsson , Kellen Michael , Camacho Monica R , Landavazo Bernard , Nosheny Rachel L , Weiner Michael W , Gershon Richard M
Published: February 2024

Objective

We describe the development of a new computer adaptive vocabulary test, Mobile Toolbox (MTB) Word Meaning, and validity evidence from 3 studies.

Method

Word Meaning was designed to be a multiple-choice synonym test optimized for self-administration on a personal smartphone. The items were first calibrated online in a sample of 7,525 participants to create the computer-adaptive test algorithm for the Word Meaning measure within the MTB app. In Study 1, 92 participants self-administered Word Meaning on study-provided smartphones in the lab and were administered external measures by trained examiners. In Study 2, 1,021 participants completed the external measures in the lab and Word Meaning was self-administered remotely on their personal smartphones. In Study 3, 141 participants self-administered Word Meaning remotely twice with a 2-week delay on personal iPhones.

Results

The final bank included 1363 items. Internal consistency was adequate to good across samples (ρxx = 0.78 to 0.81, p < .001). Test–retest reliability was good (ICC = 0.65, p < .001), and the mean theta score was not significantly different upon the second administration. Correlations were moderate to large with measures of similar constructs (ρ = 0.67–0.75, p < .001) and non-significant with measures of dissimilar constructs. Scores demonstrated small to moderate correlations with age (ρ = 0.35 to 0.45, p < .001) and education (ρ = 0.26, p < .001).

Conclusion

The MTB Word Meaning measure demonstrated evidence of reliability and validity in three samples. Further validation studies in clinical samples are necessary.
Association between cumulative metabolic risk exposure and cardiovascular disease: a nationwide cohort of over 3.6 million young adults
Authors: Lee Heesun , Rhee Tae-Min , Park Hyo Eun , Han Kyungdo , Choi Su-Yeon
Published: February 2024

Aims

As lifetime accumulation of cardiovascular risk factors is gaining importance, early identification and management of risk factors are being emphasized. The global prevalence of metabolic syndrome (MetS), a constellation of these risk factors, is increasing, particularly among young adults. In this study, we aim to investigate the association between cumulative exposure to metabolic risk and cardiovascular disease (CVD) in young adults.

Methods and results

In this nationwide population-based cohort, we analysed 3 688 787 young adults (<40 years) with 2 biennial National Health Screening examinations from 2009 to 2012. Participants were categorized into MetS-free, MetS-developed, MetS-recovered, or MetS-persistent group, based on MetS presence at each examination. The endpoint was new CVD development, including myocardial infarction (MI) and ischaemic stroke. During follow-up (median, 7.7 years), CVD occurred in 19 219 individuals (0.5%). The incidence rates of CVD were 0.58, 1.17, 1.20, and 1.83 (1000 person-years) in the MetS-free, MetS-developed, MetS-recovered, and MetS-persistent groups, respectively. The CVD risk was proportionally associated with cumulative metabolic risk exposure, with a maximum two-fold increase in the MetS-persistent group [adjusted hazard ratio (aHR) 1.94, 95% confidence interval (CI) 1.84–2.04], followed by the MetS-recovered and the MetS-developed groups with similar risks. Among the MetS components, persistent exposure to elevated blood pressure (BP) had the greatest association with CVD risk (aHR 1.69, 95% CI 1.63–1.76). This tendency was consistent in the separate analyses of the risk of MI and ischaemic stroke.

Conclusion

The risk of CVD increased in an exposure-dependent manner among young adults. Efforts to optimize the cardiometabolic profile, particularly BP, even after the establishment of MetS, might help promote long-term cardiovascular prognosis.
Genome-Wide Search Links Senescence-Associated Secretory Proteins With Susceptibility for Coronary Artery Disease in Mouse and Human
Authors: Zhu Yuan-Zheng , Liu Jian-Kun , Li Xue-Er , Yu Zhen-Ping , Yang Lu-Qin , Wan Qin , Zhao Ya , Saeed Muhammad , Wu An-Dong , Tian Xiao-Li
Published: February 2024

Advanced age is an independent risk factor for coronary artery disease (CAD), the leading global cause of mortality. Senescent vascular cells in the atherosclerotic plaques exhibit senescence-associated secretory phenotype (SASP). How SASP contributes to atherosclerosis and CAD, however, remains unclear. Here, we integrated RNA-array datasets of senescent human coronary arterial endothelial cells (HCAECs) and aortic smooth muscle cells (HASMCs) as well as genome-wide association data for CAD. We identified 26 genes from HCAECs and 6 genes from HASMCs related to SASP and CAD in both in-house and published datasets. Of which, Cystatin C (CST3), a CAD susceptibility gene, was found to be expressed in both HCAECs and HASMCs, thus, it was prioritized for further investigation. We demonstrated it was significantly elevated in senescent vascular cells, aged arteries, and early atherosclerosis. In vitro experiments showed that CST3 enhances the monocyte–endothelial cell adhesion. Additionally, ligand–receptor pairing analyses revealed two important pathways, COL4A1-ITGA1 and LPL-LRP1 pathways, linked to the critical processes in the development of atherosclerosis, including cell adhesion, inflammation response, extracellular matrix organization, and lipid metabolism. We further demonstrated a reduced monocyte–endothelial cell adhesion following the knockdown of COL4A1 or ITGA1 and a significantly increased expression of COL4A1, ITGA1, and LPL in arterial intima of aged mice and ApoE−/− mice. Our findings demonstrate that vascular cell-derived SASP proteins increase the CAD susceptibility and identify CST3 functionally contributing to atherosclerosis.
On the necessity of the inf-sup condition for a mixed finite element formulation
Authors: Bertrand Fleurianne , Boffi Daniele
Published: February 2024

We study a nonstandard mixed formulation of the Poisson problem, sometimes known as dual mixed formulation. For reasons related to the equilibration of the flux, we use finite elements that are conforming in $\textbf{H}(\operatorname{\textrm{div}};\varOmega )$ for the approximation of the gradients, even if the formulation would allow for discontinuous finite elements. The scheme is not uniformly inf-sup stable, but we can show existence and uniqueness of the solution, as well as optimal error estimates for the gradient variable when suitable regularity assumptions are made. Several additional remarks complete the paper, shedding some light on the sources of instability for mixed formulations.
Trilemma Tradeoffs in International Relations: An Analytical Framework
Authors: Lewis Olivier
Published: February 2024

Over the past fifty years, scholars have drawn attention to the consequences of trying to overcome openness/effectiveness/autonomy trilemmas, especially in monetary policy and trade policy. Despite this, few have noticed the ubiquity of such policy trilemmas in international relations. This article presents a comprehensive analytical framework that captures the core concepts and causal mechanisms relevant to understanding these trilemmas, and identifies opportunities for future research. The first section provides an analytical review of openness/effectiveness/autonomy trilemmas. By doing so, it highlights three features of trilemmas: that goal attainment is a question of degree, that goal attainment varies across time, and that policy constraints affect states asymmetrically. The second section presents a typology of trilemma-based policy goals (openness, regulatory effectiveness, and policymaking autonomy) and associated “disciplining” mechanisms that explain the likelihood of trilemma tradeoffs (i.e., market-based, politics-based, and law-based mechanisms). The third section shows how the trilemma framework presented in this article can facilitate the empirical study of threefold policy tradeoffs in all aspects of international relations, including security and defense.
Structure-specific DNA endonuclease T7 endonuclease I cleaves DNA containing UV-induced DNA lesions
Authors: Matsubara Kazuki , Ueda Shouta , Yamamoto Junpei , Iwai Shigenori , Shioi Narumi Aoki , Takedachi Arato , Kuraoka Isao
Published: February 2024

The T7 gene 3 product, T7 endonuclease I, acts on various substrates with DNA structures, including Holliday junctions, heteroduplex DNAs and single-mismatch DNAs. Genetic analyses have suggested the occurrence of DNA recombination, replication and repair in Escherichia coli. In this study, T7 endonuclease I digested UV-irradiated covalently closed circular plasmid DNA into linear and nicked plasmid DNA, suggesting that the enzyme generates single- and double-strand breaks (SSB and DSB). To further investigate the biochemical functions of T7 endonuclease I, we have analysed endonuclease activity in UV-induced DNA substrates containing a single lesion, cyclobutane pyrimidine dimers (CPD) and 6–4 photoproducts (6–4PP). Interestingly, the leading cleavage site for CPD by T7 endonuclease I is at the second and fifth phosphodiester bonds that are 5′ to the lesion of CPD on the lesion strand. However, in the case of 6–4PP, the cleavage pattern on the lesion strand resembled that of CPD, and T7 endonuclease I could also cleave the second phosphodiester bond that is 5′ to the adenine–adenine residues opposite the lesion, indicating that the enzyme produces DSB in DNA containing 6–4PP. These findings suggest that T7endonuclease I accomplished successful UV damage repair by SSB in CPD and DSB in 6–4PP.
Temptation and Commitment: a Model of Hand-to-Mouth Behavior
Authors: Attanasio Orazio , Kovacs Agnes , Moran Patrick
Published: February 2024

This paper presents a model of consumption behavior that explains the presence of “wealthy hand-to-mouth” consumers using a mechanism that differs from those analyzed previously. We show that a two-asset model with temptation preferences generates a demand for commitment and thus illiquidity, leading to hand-to-mouth behavior even when liquid assets deliver higher returns than illiquid assets. This preference for illiquidity has important implications for consumption behavior and for fiscal stimulus policies. Our model matches the recent empirical evidence that Marginal Propensity to Consume remain high even for large income shocks, suggesting a larger response to targeted fiscal stimulus than previously believed.
Analysis of comb-gnawing behavior in Apis cerana cerana (Hymenoptera: Apidae)
Authors: Meng Qingxin , Huang Rong , Li Hui , Gong Xueyang , Yue Dan , Jiang Wutao , Tian Yakai , Dong Kun
Published: February 2024

Apis cerana cerana exhibits a prominent biological trait known as comb gnawing. In this study, gnawed combs from colonies during different seasons were collected, investigating the comb age and locations of gnawing. Patterns of comb gnawing were recorded, and the effects of 2 factors, namely, comb type and season, on the mass of wax residues and the gnawed surface area were measured. The results revealed that A. c. cerana predominantly gnaws combs that have been used for over 6 months, with gnawing concentrated in the brood-rearing area. In the first 3 seasons, significantly higher masses of wax residues and larger gnawed surface areas were found in greater wax moth larvae (GWML)-infested combs compared to newly built and old combs. Also, there were significantly higher masses and areas gnawed by A. c. cerana in old combs compared to newly built combs in all 4 seasons. Compared to other seasons, it exhibited significantly higher masses and areas resulting from comb-gnawing in newly built or old combs in winter. However, there were no significant differences in the masses of wax residues and surface areas gnawed in GWML-infested combs across the first 3 seasons. In conclusion, this study documented the impact of comb type and season on the comb-gnawing behavior of A. c. cerana, contributing to beekeeping management practices and the current understanding of bee biology.
Effects of comprehensive medication review on opioid overuse among medicare beneficiaries
Authors: Sim Yongbo , Hausberger Clayton F , Wang Junling
Published: February 2024

Objectives

This study examined the effects of the comprehensive medication review of Medicare medication therapy management programs on opioid overuse among Medicare beneficiaries.

Methods

This retrospective study analyzed Medicare data from 2016 to 2017. The intervention group included Medicare beneficiaries who newly received comprehensive medication review in 2017; the control group referred to patients who met the general eligible criteria for the medication therapy management program but did not enroll in 2016 or 2017. Propensity score matching was performed to increase characteristic compatibility between the intervention and control groups. Three measures of opioid overuse were analyzed: use of opioids at a high dosage, use of opioids from multiple providers, and concurrent use of opioids and benzodiazepines. The effects of comprehensive medication review on opioid overuse were analyzed with a multivariate logistic regression with an interaction term between the receipt of comprehensive medication review and the year 2017.

Key Findings

The proportion of concurrent use of opioids and benzodiazepines declined at a greater rate among the recipients (2.21%) than non-recipients (1.55%) of the comprehensive medication review. In the adjusted analysis, the odds ratio of no concurrent use of opioids and benzodiazepines was 5% higher (1.05; 95% confidence interval = 1.02–1.09) among recipients than non-recipients. These significant findings were not found for the other two measures of opioid overuse.

Conclusions

Comprehensive medication review is associated with reduced concurrent use of opioids and benzodiazepines among Medicare beneficiaries. Such service should be incorporated into the current approaches for addressing the opioid epidemic.
Lessons From Organic Chemistry: The Case for Considering Both High Standards and Equity in Assessment
Authors: Caretta-Weyer Holly A. , Schumacher Daniel J. , Kinnear Benjamin
Published: February 2024

In this commentary, the authors explore the tension of balancing high performance standards in medical education with the acceptability of those standards to stakeholders (e.g., learners and patients). The authors then offer a lens through which this tension might be considered and ways forward that focus on both patient outcomes and learner needs.

In examining this phenomenon, the authors argue that high performance standards are often necessary. Societal accountability is key to medical education, with the public demanding that training programs prepare physicians to provide high-quality care. Medical schools and residency programs, therefore, require rigorous standards to ensure graduates are ready to care for patients. At the same time, learners’ experience is important to consider. Making sure that performance standards are acceptable to stakeholders supports the validity of assessment decisions.

Equity should also be central to program evaluation and validity arguments when considering performance standards. Currently, learners across the continuum are variably prepared for the next phase in training and often face inequities in resource availability to meet high passing standards, which may lead to learner attrition. Many students who face these inequities come from underrepresented or disadvantaged backgrounds and are essential to ensuring a diverse medical workforce to meet the needs of patients and society. When these students struggle, it contributes to the leaky pipeline of more socioeconomically and racially diverse applicants.

The authors posit that 4 key factors can balance the tension between high performance standards and stakeholder acceptability: standards that are acceptable and defensible, progression that is time variable, requisite support structures that are uniquely tailored for each learner, and assessment systems that are equitably designed.
Lipoprotein(a): A Review of Risk Factors, Measurements, and Novel Treatment Modalities
Authors: Karp Avrohom , Jacobs Menachem , Barris Ben , Labkowsky Alexander , Frishman William H.
Published: February 2024

The study of lipoprotein(a) [Lp(a)] has long been a source of interest as a possible independent risk factor for atherosclerotic cardiovascular disease (ASCVD). The results of large sample observational studies, genome-wide association studies, and Mendelian randomization studies have been strong indicators supporting the link between ASCVD and Lp(a) despite early studies, with less sensitive assays, failing to show a connection. The recommendations for the indications and frequency of testing Lp(a) levels vary between US, Canadian, and European organizations due to the uncertain role of Lp(a) in ASCVD. The innovation of recent therapies, such as antisense oligonucleotides and small interfering RNA, designed to specifically target and reduce Lp(a) levels by targeting mRNA translation have once more thrust LP(a) into the spotlight of inquiry. These emerging modalities serve the dual purpose of definitively elucidating the connection between elevated Lp(a) levels and atherosclerotic cardiovascular risk, as well as the possibility of providing clinicians with the tools necessary to manage elevated Lp(a) levels in vulnerable populations. This review seeks to examine the mechanisms of atherogenicity of Lp(a) and explore the most current pharmacologic therapies currently in development.
Chronic postsurgical pain
Authors: Martinez Valeria , Lehman Thomas , Lavand’homme Patricia , Harkouk Hakim , Kalso Eija , Pogatzki-Zahn Esther M. , Komann Marcus , Meissner Winfried , Weinmann Claudia , Fletcher Dominique
Published: February 2024

BACKGROUND

Chronic postsurgical pain (CPSP) is a clinical problem, and large prospective studies are needed to determine its incidence, characteristics, and risk factors.

OBJECTIVE

To find predictive factors for CPSP in an international survey

DESIGN

Observational study

SETTING

Multicentre European prospective observational trial

PATIENTS

Patients undergoing breast cancer surgery, sternotomy, endometriosis surgery, or total knee arthroplasty (TKA).

METHOD

Standardised questionnaires were completed by the patients at 1, 3, and 7 days, and at 1, 3, and 6 months after surgery, with follow-up via E-mail, telephone, or interview.

MAIN OUTCOME MEASURE

The primary goal of NIT-1 was to propose a scoring system to predict those patient likely to have CPSP at 6 months after surgery.

RESULTS

A total of 3297 patients were included from 18 hospitals across Europe and 2494 patients were followed-up for 6 months. The mean incidence of CPSP at 6 months was 10.5%, with variations depending on the type of surgery: sternotomy 6.9%, breast surgery 7.4%, TKA 12.9%, endometriosis 16.2%. At 6 months, neuropathic characteristics were frequent for all types of surgery: sternotomy 33.3%, breast surgery 67.6%, TKA 42.4%, endometriosis 41.4%. One-third of patients experienced CPSP at both 3 and 6 months. Pre-operative pain was frequent for TKA (leg pain) and endometriosis (abdomen) and its frequency and intensity were reduced after surgery. Severe CPSP and a neuropathic pain component decreased psychological and functional wellbeing as well as quality of life. No overarching CPSP risk factors were identified.

CONCLUSION

Unfortunately, our findings do not offer a new CPSP predictive score. However, we present reliable new data on the incidence, characteristics, and consequences of CPSP from a large European survey. Interesting new data on the time course of CPSP, its neuropathic pain component, and CPSP after endometriosis surgery generate new hypotheses but need to be confirmed by further research.

TRIAL REGISTRATION

clinicaltrials.gov ID: NCT03834922
Zurzuvae (zuranolone) for postpartum depression in Pakistan
Authors: Azhar Ayesha , Taimuri Muskan A. , Oduoye Malik Olatunde , Hashmi Mahnoor R. , Tarar Hamna M. , Zubair Rooja , Ali Tooba
Published: February 2024

Postpartum depression (PPD) is a condition that affects some women after giving birth, characterized by feelings of sadness, hopelessness, and emotional distress. Around 30% of Pakistani women suffer from PPD and although multiple treatment options are available, none of these are feasible for Pakistan, a lower-middle-income country with a subpar healthcare system. In August 2023, the Food and Drug Administration (FDA) approved Zurzuvae (zuranolone), the first oral medication for the treatment of PPD. As a low-cost, self-administered oral drug, independent of the need for a healthcare professional, Zuranolone emerges as an efficacious and long-term approach to address PPD in Pakistan.
Hemoadsorption Combined with Hemodialysis and the “Inflammation Mitigation Hypothesis”
Authors: Brendolan Alessandra , Lorenzin Anna , De Cal Massimo , Virzi Grazia Maria , Cantaluppi Vincenzo , Marengo Marita , Lentini Paolo , Ronco Claudio
Published: February 2024

Clinical outcomes are still unsatisfactory in patients undergoing chronic maintenance dialysis. Signs and symptoms of uremic intoxication are often present even in presence of an adequate dialysis delivery. These along with cardiovascular and skeletal complications, have been correlated to the accumulation of inflammatory chemical mediators, beta-2 microglobulin (β2M), parathyroid hormone (PTH) and other middle to large molecular weight toxins that are insufficiently cleared by current dialysis techniques. Such condition determines a vicious loop where a subclinical status of inflammation causes a disruption of the immunological response affecting outcomes by accelerated atherosclerosis, anemia, and frequent infections. The overall picture can be described as a systemic inflammatory syndrome with simultaneous activation of the innate and the adaptive immunity. In such condition, new options and techniques are required to achieve a more effective blood purification and to correct the altered immuno-homeostasis. New efficient and biocompatible sorbents are today available (HA 130 Cartridge, Jafron Medical, Zhuhai, China) and they can be advantageously coupled in series with the hemodialyzer to perform hemoadsorption combined with hemodialysis (HA-HD). This technique has been already studied in at least two randomized trials demonstrating an effective improvement of clinical and biochemical outcomes. We have calculated the kinetics of β2M in a single session, in a series of three consecutive sessions of a week and in a period of three months using different frequencies of application (first month: Three sessions per week; second month: Two sessions per week; third month: One session per week). In the single session the reduction ratio was superior to other techniques such as hemodialysis (HD), high-flux hemodialysis (HFD) or hemodiafiltration (HDF). In the thrice weekly regime, the time average concentration (TAC) of β2M resulted inferior to HD and HDF. In the long period, a lower concentration of β2M was maintained even with a once-a-week regime. Considering the parallel reduction of inflammatory parameters, we could hypothesize that the enhanced removal of uremic toxins and chemical mediators led to a mitigation of the systemic inflammation with a progressive reduction in the generation of β2M. This “inflammation mitigation hypothesis (IMH)” supports the prescription of HA-HD once a week, possibly after a month of thrice weekly regime.
Associations of Intimate Partner Violence and Drug Use on Viral Suppression Among Women Living With HIV in South Florida: A Secondary Analysis
Authors: Deaterly Caroline , Richards Veronica , Weaver Michael , Villalba Karina , Varma Deepthi , Payton Isaac , Cook Robert
Published: February 2024

Suboptimal viral suppression is associated with worse outcomes and increased HIV transmission among women with HIV (WWH). Based on syndemic theory, we hypothesized that women exposed to recent intimate partner violence (IPV) and current drug use would be most likely to have suboptimal HIV viral suppression. We analyzed baseline data from a longitudinal clinical trial (WHAT-IF? Will Having Alcohol Treatment Improve My Functioning?) that enrolled WWH from Miami, FL, who reported heavy drinking. Bivariate logistic regression was done, mean age was 48 years (n = 194; SD: 8.7), 40% had current drug use (other than alcohol), and 14% reported recent IPV. WWH who reported both IPV and drug use had the highest rate of suboptimal viral suppression (45%), but these differences were not statistically significant. The high rates of suboptimal viral suppression, drug use, and IPV suggest a need to include screening for IPV in clinical guidelines related to HIV care in women.
Essential Components of a Neuroscience Nursing Orientation: A Delphi Study
Authors: Bautista Cynthia , Vyas Marianne Beare , Daniels Lorin , Guanci Mary , Rhudy Lori
Published: February 2024

BACKGROUND: The essential components of an effective neuroscience nurse orientation program for those caring for the adult general care population have not been well defined or standardized. METHODS: Using a 2-round, modified Delphi methodology, electronic surveys were distributed to 53 experts in neuroscience nursing orientation to gain consensus on the essential components of orientation for the neuroscience nurse. Survey data included demographics of the expert, literature-based components of neuroscience nurse orientation, and an opportunity to agree/disagree or write in additional components. RESULTS: Round 1 of the consensus survey elicited a response rate of 55% (29/53), and round 2 had a 51% (27/53) response rate. On the basis of round 1 expert responses, 4 new orientation components were added, and 36 components of a neuroscience nursing orientation were revised to include only the elements with ≥75% agreement. Twenty-two elements in round 2 met the criteria of ≥75% very important and important to include as components of a neuroscience nursing orientation. CONCLUSION: An expert consensus was reached on the necessary components of a neuroscience nursing orientation. The identified neuroscience nursing orientation components concentrated on improving nursing practice and provision of care to adult neuroscience patients. This study demonstrates priority components within a standardized orientation program for neuroscience nurses based on literature and expert consensus. A comprehensive neuroscience nursing orientation is a vital step in sustaining high-quality care for patients and improving neurological outcomes.
Second-look upper endoscopy as the initial approach to subepithelial lesions: a reassuring and reliable strategy
Authors: Capela Tiago Lima , Macedo Silva Vítor , Freitas Marta , Cúrdia Gonçalves Tiago , Dias de Castro Francisca , Magalhães Joana , Leite Sílvia , Cotter José
Published: February 2024

Background

Although endoscopic ultrasound (EUS) plays a critical role in the management of subepithelial lesions (SEL) of upper gastrointestinal tract many can be classified solely by a thorough upper gastrointestinal endoscopy (UGE) which can reduce the burden of additional studies.

Aims

Analyze the impact of a stepwise approach starting with a second-look UGE before the decision of EUS in patients referred to our center with suspected SEL.

Methods

Retrospective cohort study which included all adult patients referred to our center between 2015 and 2020 with suspected SEL.Second-look UGE evaluated the location, size, color, surface characteristics, movability and consistency of the SEL and bite-on-bite biopsies were performed. Decisions on SEL management and follow-up were collected.

Results

A total of 193 SEL (190 patients) were included. At the index-UGE, stomach was the most frequent location (n = 115;59.6%). Most patients performed a second-look UGE (n = 180; 94.7%). A minority was oriented directly to EUS (n = 8;4.2%) or endoscopic resection (n = 2; 1.1%). In patients who underwent a second-look UGE, SEL were excluded in 25 (13.9%) and 21 (11.7%) did not need further work-up. The remaining patients were submitted to EUS (n = 88;48.9%), surveillance by UGE (n = 44; 24.4%) or endoscopic resection (n = 2; 1.1%).

Conclusion

Systematically performing a second-look UGE, in patients referred with suspected SEL, safely preclude the need for subsequent investigation in approximately one-fourth of the patients. As UGE is less invasive and more readily available, we suggest that a second-look UGE should be the initial approach in SEL management.
Neither hepatic steatosis nor fibrosis is associated with clinical outcomes in patients with intestinal Behçet’s disease
Authors: Hyun Hye Kyung , Park Jihye , Park Soo Jung , Park Jae Jun , Kim Tae Il , Lee Jae Seung , Lee Hye Won , Kim Beom Kyung , Park Jun Yong , Kim Do Young , Ahn Sang Hoon , Kim Seung Up , Cheon Jae Hee
Published: February 2024

Background

Behçet’s disease (BD) and nonalcoholic fatty liver disease (NAFLD) are chronic inflammatory diseases that share pathogenetic mechanisms. In this study, we investigated whether NAFLD influences the clinical outcomes in patients with intestinal BD.

Methods

Patients with intestinal BD and available hepatic steatosis index (HSI) and fibrosis-4 (FIB-4) scores were recruited between 2005 and 2022. An HSI of ≥30 and FIB-4 of ≥1.45 were used to diagnose hepatic steatosis and significant liver fibrosis, respectively. The primary outcomes were intestinal BD-related hospitalization, surgery, emergency room visits, or the first use of corticosteroids, immunomodulators, or biologic agents for intestinal BD.

Results

A total of 780 patients with BD were selected. The prevalence of hepatic steatosis and significant liver fibrosis were 72.3% and 8.8%, respectively. Multivariate analysis showed that younger age, prior smoking history, concomitant skin lesions, higher white blood cell count, and lower serum albumin levels were independently associated with an increased risk of clinical relapse (all P < 0.05), whereas hepatic steatosis and significant liver fibrosis were not (hazard ratio [HR] = 1.164, 95% confidence interval [CI] 0.923–1.468; P = 0.199 for hepatic steatosis; HR = 0.982, 95% CI 0.672–1.436; P = 0.927 for significant liver fibrosis).

Conclusion

Hepatic steatosis and liver fibrotic burden were not independently associated with clinical outcomes in patients with intestinal BD.
Diverticulosis morphology is associated with risk of diverticulitis
Authors: Levy Miriam J. , Osterkamp Rebecca L. , Glauninger Kristof , Strate Lisa L.
Published: February 2024

The size, number and distribution of diverticula vary greatly in patients with diverticulosis. We aimed to study the association between the morphology of diverticulosis assessed on colonoscopy and the risk of diverticulitis. We performed a retrospective, case-control study of cases with a history of diverticulitis and controls with diverticulosis without diverticulitis matched on sex, age (within 5 years) and year of colonoscopy. Diverticulosis characteristics were obtained from endoscopy reports and were categorized according to severity, extent, number and size. We used conditional logistic regression on matched pairs to calculate the odds of diverticulitis among patients with diverticulosis according to differing morphologic characteristics. We identified 85 cases with computed tomography-documented diverticulitis and 85 matched controls with diverticulosis without a diagnosis of diverticulitis. In cases, 60% had left-sided only diverticulosis, 2% had right-sided only and 38% had both right and left-sided diverticulosis; whereas in controls, the distribution was 53%, 18% and 29%, respectively. Cases were more likely to have large diverticula [odds ratio (OR), 3.33; 95% confidence interval (CI), 1.30–8.56 for left colon only and 1.89, 95% CI, 0.78–4.57 for both right and left]. Similarly, when the severity of diverticulosis was compared between the groups, cases were more likely to have moderate or severe diverticulosis (OR, 3.44; 95% CI, 1.51–7.84 for moderate and OR, 8.87; 95% CI, 2.98–26.37 for severe). Diverticulitis cases were more likely to have large diverticula and severe diverticulosis when compared to controls suggesting that size and severity are novel risk factors for diverticulitis.
Efficacy of vedolizumab during intravenous induction therapy in ulcerative colitis and Crohn’s disease: post hoc analysis of patient-reported outcomes from the VISIBLE 1 and 2 studies
Authors: D’Haens Geert , Baert Filip , Danese Silvio , Kobayashi Taku , Loftus Edward V. , Sandborn William J. , Dornic Quentin , Lindner Dirk , Kisfalvi Krisztina , Marins Ed G. , Vermeire Séverine
Published: February 2024

Background

Vedolizumab is an anti-α4β7 integrin antibody used to treat moderate to severe ulcerative colitis (UC) and Crohn’s disease (CD). This post hoc analysis of patient-reported outcomes (PROs) from the VISIBLE 1 (NCT02611830) and 2 (NCT02611817) phase 3 studies evaluated onset of treatment effect on patient-reported symptoms during 6-week vedolizumab induction.

Methods

Patient-reported stool frequency (SF) and rectal bleeding (RB) (UC Mayo score), and SF and abdominal pain (AP) in CD were collected via electronic diary from VISIBLE patients receiving one or more open-label intravenous (IV) vedolizumab induction doses (weeks 0 and 2). PRO data were analyzed using descriptive statistics.

Results

Data from 994 patients (UC 383, CD 611) showed mean ratings for all PROs declined consistently week-on-week from baseline through week 6, with early onset of improvement. By week 2, 22% of patients with UC reported RB improvement (≥1-point reduction in RB subscore, 7-day mean), rising to 45% by week 6. By week 6, 18% of patients with UC achieved SF improvement (SF subscore 0; 21% antitumor necrosis factor alpha [anti-TNFα] naive, 13% anti-TNFα experienced). SF improvement in patients with CD (reduction of ≥3 stools, 7-day mean) was achieved by 32% at week 6 (34% anti-TNFα naive, 30% anti-TNFα experienced). Fewer patients with CD reported severe/moderate AP at week 6 (5.1%/28.5%) than baseline (14.6%/61.5%). SF decline appeared greater and faster for anti-TNFα-naive vs. anti-TNFα-experienced patients (UC and CD).

Conclusion

Results indicate early onset of patient-reported UC and CD symptom improvement during vedolizumab IV induction in VISIBLE 1 and 2.
High Prevalence of Cardiometabolic Risks and Health Needs Among Patients With Hepatocellular Carcinoma After Treatment
Authors: Chen Yi-Lin , Su Chang-Chao , Chang Chia-Hao , James Kathy , Chen Mei-Yen
Published: February 2024

Background

Many studies have indicated that inadequate health-related behavior is associated with the progression of cancer and cardiometabolic disorders. Because patients with hepatocellular carcinoma may adopt inadequate health behaviors, they are at risk for cancer recurrence, mortality, cardiometabolic disease progression, and worse quality of life.

Objective

To explore the prevalence of cardiometabolic risks and health-promoting behaviors associated with quality of life among patients with hepatocellular carcinoma after treatment.

Methods

A cross-sectional study was conducted from October 2021 to August 2022. Data were collected through face-to-face interviews using a structured questionnaire, and cardiometabolic information was recorded from medical charts.

Results

In total, 115 patients with liver cancer after treatment were enrolled; 73% were male. The mean age was 67.7 years, and high prevalence rates of central obesity (72.2%) and metabolic syndrome (47%) were noted. Inadequate exercise, oral hygiene, and cigarette smoking were common. The health-promoting score was significantly associated with exercise, the number of remaining teeth, and metabolic syndrome, which correlated with quality of life, including positive functional and negative symptoms dimensions.

Conclusions

The findings demonstrated a high prevalence of cardiometabolic risks and inadequate health-related behaviors among patients with liver cancer after treatment. This study highlights the need for healthcare providers to help patients increase health literacy for preventing cardiometabolic risks at outpatient clinics.

Implications for Practice

Findings from this study can be used to advise healthcare providers to educate patients with liver cancer during and after treatment on improving their health-promoting behaviors.
Risk Factors for Postoperative Delirium in Patients Undergoing Major Head and Neck Cancer Surgery
Authors: Sun Jiaqi , Ji Ying , Huang Jingsi , Zhao Hong
Published: February 2024

Background

Postoperative delirium (POD) is a common and serious complication after extensive surgery. Understanding the independent and potential modifiable risk factors leading to POD in patients with head and neck cancer (HNC) can provide information for future intervention trials aimed at reducing this risk.

Objective

To systematically analyze influencing factors of POD in patients with HNC and identify high-risk individuals for delirium.

Methods

PubMed, EMBASE, Scopus, OVID, and Cochrane Library were searched for publications prior to June 2023. Comparative studies in which POD risk factors were investigated were identified following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The Newcastle-Ottawa Scale was used to evaluate the study quality. Pooled odds ratios or mean differences for individual risk factors were estimated using the Mantel-Haenszel and inverse-variance methods.

Results

This review included 17 studies with a total of 4188 patients undergoing HNC surgery. The pooled prevalence of POD was 15.44%. Based on pooled analysis, 8 significant risk factors were identified including age older than 70 years, male sex, history of smoking, history of psychiatric disorder, American Society of Anesthesiologists score, albumin level, postoperative insomnia, and fluid intake.

Conclusion

In the present study, 8 factors that correlated with POD were identified: 6 preoperative, 1 intraoperative, and 1 postoperative.

Implications for Practice

The influencing factors for POD in patients with HNC were identified that can provide a reference for improving the psychological state of the patient population and further development of effective treatment interventions.
HIV-1 envelope diversity and sensitivity to broadly neutralizing antibodies across stages of acute HIV-1 infection
Authors: VanderVeen Laurie A. , Selzer Lisa , Moldt Brian , Parvangada Aiyappa , Li Jiani , Ananworanich Jintanat , Crowell Trevor A. , Eron Joseph J. , Daar Eric S. , Haubrich Richard , Geleziunas Romas , Cyktor Joshua , Mellors John W. , Callebaut Christian
Published: February 2024

We studied the relationship between viral diversity and susceptibility to broadly neutralizing antibodies (bNAbs) in longitudinal plasma and peripheral blood mononuclear cells from 89 people with HIV who initiated antiretroviral therapy (ART) during acute and early HIV-1 infection (AEHI). HIV-1 diversity and predicted bNAb susceptibility were comparable across AEHI. Diversity evolution was not observed during ART, suggesting (pro)viruses at initiation or during treatment may identify individuals with susceptible virus for bNAb interventional trials.
Trends in HIV preexposure prophylaxis utilization and spending among individuals with commercial insurance
Authors: Dickson Sean , James Katelyn
Published: February 2024

In a cross-sectional analysis of HIV preexposure prophylaxis (PrEP) utilization by commercially insured patients from 2019 to 2021, most prescriptions were for branded formulations of PrEP despite the availability of a generic version. Accounting for the modest relative clinical benefit of branded TAF/FTC (tenofovir alafenamide fumarate/emtricitabine) PrEP over generic TDF/FTC (tenofovir disoproxil fumarate/emtricitabine) PrEP, use of generic TDF/FTC PrEP would have reduced commercial insurers’ spending by 33%.
Elevated levels of loneliness in migrant children compared to nonmigrant children in urban China: a systematic review and meta-analysis of comparative studies
Authors: Ge Lin-Feng , Wu Rui-Yao , Zhong Bao-Liang
Published: February 2024

Purpose of review

About one in four children in China is a migrant child. This population has a higher risk of experiencing loneliness. However, existing studies present conflicting findings regarding the levels of loneliness among migrant children as compared to local urban children in urban China. This review performs a meta-analysis of studies comparing loneliness levels between these two groups.

Recent findings

A literature search of major Chinese- and English-language databases revealed 27 eligible comparative studies. These studies reported the means and standardized deviations of loneliness scores for both migrant and nonmigrant children in urban China. Meta-analysis results showed that migrant children experienced significantly higher levels of loneliness than their urban nonmigrant counterparts [standardized mean difference (SMD) = 0.21, P < 0.001]. Subgroup analysis revealed that studies enrolling migrant children from migrant children's schools had significantly higher pooled SMDs than those enrolling children from public schools (0.346 vs. 0.120, P = 0.047).

Migrant children in urban China experience higher levels of loneliness compared to their local urban peers. Efforts to create a socially inclusive, migrant-friendly environment and reduce social isolation among migrant children are crucial to help alleviate their feelings of loneliness.